PMID- 3954224 TI - Myocardial ultrastructural alterations in ducklings with isoproterenol-induced cardiotoxicosis. AB - Fifty-two, 8-week-old, male White Pekin ducklings (Anas platyrhynchos domesticus) were allotted into control (n = 7) and isoproterenol-injected groups (n = 45). One control duck and 5 to 7 isoproterenol-injected (200 mg/kg of body weight) ducklings were euthanatized at postinjection hours (PIH) 1, 12, and 24 and at postinjection days (PID) 2, 4, 7, and 14. The left ventricular myocardium was examined, using electron microscopy. The earliest ultrastructural alteration in damaged myocytes was myofibrillar lysis at PIH 12. At PIH 24, affected myocytes had necrosis with mineralization of mitochondria. By PID 2, macrophages had invaded into areas of myocardial necrosis, mineralization was prominent in myocyte mitochondria, and dedifferentiated myocytes with reduced numbers of myofibrils, increased numbers of polysomes, large nuclei, and prominent nucleoli were first observed. The primary myocardial finding at PID 4, 7, and 14 was 2 populations of sublethally damaged myocytes. One population of injured myocytes had numerous polysomes in the sarcoplasm and large nuclei with prominent nucleoli, indicating attempts at repair of myofibrillar damage. The 2nd population of myocytes with myofibrillar lysis did not have morphologic evidence of myofibrillar repair. Therefore, the sequential ultrastructural alterations of damage and repair induced by isoproterenol in the duckling myocardium provided model for comparative studies of cardiotoxicity. PMID- 3954225 TI - Normal blood supply of the canine patella. AB - The normal blood supply of the canine patella was evaluated, using microangiography and correlated histology. Arterioles entered the cortex of the patella at multiple sites along the medial, lateral, and dorsal aspects. The body of the patella was vascularized uniformly, with many arterioles that branched and anastomosed extensively throughout the patella. The patella was not dependent on a single nutrient artery for its afferent supply, but had an extensive interior vascular network. These factors should ensure rapid revascularization and healing of patellar fractures, provided appropriate fracture fixation is achieved. PMID- 3954226 TI - Effects of urinary bladder distention on location of the urinary bladder and urethra of healthy dogs and cats. AB - Evaluation of the anatomic location of the distended and empty urinary bladders and urethras of healthy adult male and female dogs and cats by retrograde urethrocystography revealed substantial variations. In 15 dogs in lateral recumbency with empty bladder lumens, the caudal portion of the urinary bladder was within the pelvic canal in 5 of 7 male and 5 of 8 female dogs. In female dogs examined in ventrodorsal recumbency, only 4 of 8 had the empty urinary bladders in part within the pelvic canal. After luminal distention, 3 of 7 male and 3 of 8 female dogs, while in lateral recumbency, had the urinary bladders in part intrapelvically. However, when female dogs were placed in ventrodorsal recumbency, only 1 of 7 urinary bladders was in part within the pelvis. The urinary bladders of 14 cats were consistently within the abdominal cavity, irrespective of whether the bladder lumen was distended or empty. Urethral flexures occurred in dogs with intrapelvic bladders that were distended or empty. Urethral flexures were not found in cats. The urethras of dogs and cats in lateral recumbency were generally closer to the floor of the pelvis after urinary bladder distention than when the bladder was empty. The urethra of the dogs and cats in ventrodorsal recumbency was to the left or right of or on the midsagittal plane, whether the urinary bladder was empty or distended. A greater degree of lateral displacement was encountered in ventrodorsal recumbency after urinary bladder distention. PMID- 3954227 TI - Topography and differential growth of the nasal ventral concha (os conchae nasalis ventralis) of the pig from birth to six weeks of age. AB - To study the growth of nasal ventral concha (os conchae nasalis ventralis) of pigs between birth and 6 weeks of age, 7 undecalcified 80-micron thick nasal cross sections between the 3rd incisor and the 3rd premolar teeth were examined by microradiography and fluorescence microscopy, after labeling with tetracycline and alizarine red S. Conchal growth was particularly rapid in the pigs during the first 2 weeks of life. From the 3rd week, growth of the nasal ventral concha became slower. For a given age, the slow growing zone spread in the rostrocaudal direction. The transversely directed growth of the nasal ventral concha resulted in the optimal filling of the nasal cavities. PMID- 3954228 TI - Cross-sectional area of the aditus laryngis and rima glottidis before and after transection of the left recurrent laryngeal nerve in the horse. AB - The ventral-to-dorsal height of the rima glottidis was measured from lateral pharyngeal radiographs after correction for magnification. The rima glottidis height was used to enlarge accurately endoscopic photographs of 5 horses taken before and after transection of the left recurrent laryngeal nerve. Areas of the rima glottidis and aditus laryngis were measured, using a computerized digitizer. Mean area of the aditus laryngis was 1,908 mm2 before neurectomy and 1,346 mm2 after neurectomy (P = 0.025). Mean area of the rima glottidis was 1,198 mm2 before neurectomy and 805 mm2 after neurectomy (P = 0.025). Mean width of the rima glottidis was 31 mm before neurectomy and 20 mm after neurectomy (P = 0.001). Significant differences were not found between the pre- and postneurectomy heights of the rima glottidis. PMID- 3954229 TI - Polymorphonuclear leukocyte function in cattle with left displaced abomasum with or without concurrent infections. AB - Cattle submitted to the University of Minnesota for surgical correction of left displaced abomasum (LDA) were examined for the in vitro phagocytic and bactericidal activities of their polymorphonuclear leukocytes (PMN). The PMN from cattle with LDA with or without concurrent infection had depressed phagocytic function when compared with PMN from healthy animals (controls). Those with concurrent infection had phagocytic activities lower than those in the group of cattle with LDA without any concurrent infection, and the former group was also observed to have depressed intracellular killing. Cattle with LDA complicated by infection were the only group in which phagocytic function was altered during surgical correction of LDA (and recovery). Treatment of PMN from both groups of affected cattle with levamisole in vitro enhanced intracellular killing, but had no effect on phagocytosis. PMID- 3954230 TI - Guinea pig erythrocyte rosette formation as a nonspecific cell surface receptor assay in the cat. AB - The specificity of guinea pig erythrocyte (GPE) rosettes for feline peripheral blood lymphocytes was studied. Of the GPE rosette-positive cells from peripheral blood, 54% were monocytes, 29% were granulocytes, and only 17% were lymphocytes. Results were similar for rosettes incubated at 4 C and those incubated at 37 C. Mononuclear cells separated with polyvinylpyrrolidone-coated silica formed fewer monocyte rosettes (49%) and more granulocyte rosettes (34%) than did cells separated with sodium diatrizoate-Ficoll (60% monocyte rosettes and 18% granulocyte rosettes), whereas the percentage of lymphocyte rosettes was similar for both media. Mononuclear cells suspended in Eagle's minimum essential medium had a higher percentage of monocyte rosettes (75%) and a lower percentage of granulocyte rosettes (12%) than did cells suspended in RPMI 1640 medium (59% monocyte rosettes and 27% granulocyte rosettes). The percentage of lymphocyte rosettes was similar in the 2 media. Two sequential 45-minute plastic adherent cell depletions decreased monocyte rosettes to 51% and increased lymphocyte rosettes to 23% compared with 63% monocyte rosettes and 12% lymphocyte rosettes before adherent cell depletion. The granulocyte rosettes were unchanged by plastic adherent cell depletion. The percentage of rosette-positive cells (9%) was not significantly affected by incubation at 4 C or 37 C, cell separation with polyvinylpyrrolidone-coated silica or lymphocyte separation medium, or suspension in Eagle's minimum essential medium or RPMI 1640 medium. Plastic adherent cell depletion decreased the percentage of rosette-positive cells. Feline thymocytes were 38% to 80% GPE rosette-positive and a feline leukemia virus-infected lymphoblastic cell line (F422) was 88% GPE rosette-positive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954231 TI - In vitro bactericidal efficacy of equine polymorphonuclear leukocytes against Corynebacterium equi. AB - Polymorphonuclear leukocytes from adult horses were separated from whole blood, using a 2-step Percoll gradient, and were tested for bactericidal function against Corynebacterium equi. Staphylococcus aureus, an organism against which equine neutrophils have proved efficacy, was a positive control. The percentage of uptake after a 15-minute preincubation of the neutrophils and bacteria in the presence of normal horse serum was also calculated. The results indicated that equine neutrophils effectively phagocytosed and killed C equi and S aureus. The percentage of uptake for S aureus (95% +/- 3%) was greater than that for C equi (85% +/- 6%) (P less than 0.001), but the bactericidal efficacy was equivalent. More than 90% of the ingested or attached bacteria were destroyed during the 3 hour incubation period (mean percentage of C equi killed = 96 +/- 2%; mean percentage of S aureus killed = 91 +/- 8%). These results indicated that a failure of bacterial killing by neutrophils is unlikely to be important in the pathogenesis of C equi pneumonia in the horse. PMID- 3954232 TI - In vitro sulfoxidation of albendazole by ovine liver microsomes: assay and frequency of various xenobiotics. AB - The in vitro biological oxidation of albendazole to its pharmacologically active sulfoxide and its sulfone by ovine liver microsomes has been studied. Sulfoxidation (maximal rate = 0.412 nmole/min/mg of protein, Michaelis constant = 185 X 10(-6) M) was 107 times more potent than formation of albendazole sulfone. The sulfoxidation corresponds to a reduced nicotinamide-adenine dinucleotide phosphate-dependent enzymatic system characterized by a pH optima value around 8. Flavin adenine dinucleotide-containing monooxygenase could be responsible for this S-oxygenation because of the strong inhibitory effect of methimazole. Albendazole sulfoxidase is inhibited competitively by the related anthelmintic drug fenbendazole (inhibitory constant = 243 X 10(-6) M) and noncompetitively by chlorpromazine (inhibitory constant = 135 X 10(-6) M). At high concentration, chloramphenicol, erythromycin, nalidixic acid, and hexobarbital are less active inhibitors, whereas dexamethasone acetate significantly enhances the reaction which is not inhibited by either carbon monoxide, griseofulvin, imidazole, phenylbutazone, or proadifen. PMID- 3954233 TI - Anti-tumor evaluation of benzaldehyde in the dog and cat. AB - Fourteen dogs and 11 cats with various malignant tumors were treated daily with benzaldehyde at a dosage rate of 10 mg/kg of body weight, orally, divided into 4 doses. Clinical signs of toxicosis were not observed. A partial response (greater than 50% regression) was observed in animals with an oral squamous cell carcinoma and an oral melanoma. A minimal response (less than 50% regression) was observed in animals with a sweat gland adenocarcinoma and a mast cell sarcoma. One dog with an oral melanoma had stabilization of tumor growth for 8 weeks. Seemingly, benzaldehyde has only minimal anti-tumor activity at the dose studied. PMID- 3954234 TI - Pharmacokinetics of amikacin in pony foals after a single intramuscular injection. AB - Six healthy pony foals, from 2 to 11 days of age, were given a single IM injection of amikacin sulfate (250 mg/ml) at a dosage rate of 7 mg/kg of body weight. Serum amikacin concentrations were measured serially over a 24-hour period. The mean peak serum concentration was 14.7 micrograms/ml at 0.5 hour. The elimination rate constant for amikacin was 0.24/hour, the elimination half-life was 3.0 hours, and the apparent volume of distribution was 0.58 L/kg. PMID- 3954235 TI - Electrocardiogram of the clinically normal, ketamine-sedated Macaca fascicularis. AB - Electrocardiograms were obtained from 100 clinically normal cynomolgus macaques (Macaca fascicularis) sedated with ketamine hydrochloride. Calculations were made for heart rates and mean electrical axes (frontal, sagittal, and transverse planes) as well as for amplitudes and/or intervals for P, PR, QRS, Q, R, S, and QT. Proposed ECG reference ranges are set forth for this species. PMID- 3954236 TI - Evaluation of a spectrophotometric method for canine serum lipase determination. AB - The British antilewisite butyrate-dithionitrobenzoate (BALB-DTNB) spectrophotometric serum lipase assay was evaluated for precision, accuracy, and diagnostic usefulness in analyzing canine sera. Sera samples from clinically healthy dogs, dogs with experimentally induced pancreatitis, and dogs with spontaneous pancreatitis were analyzed. A titrimetric method of serum lipase determination was used for comparison. Although the BALB-DTNB method was not found to be precise or accurate for determining the lipase activity of canine serum samples, it seemed to be at least as diagnostically useful as the titrimetric procedure. The small sample size requirement and the speed of analysis of the BALB-DTNB procedure are advantages of this method over the titrimetric method, and thus, its use in place of the titrimetric method is justified. A laboratory reference range of 3 to 37 IU/L was determined for canine serum. PMID- 3954237 TI - Effect of flushing the vasa deferentia at the time of vasectomy on the rate of clearance of spermatozoa from the ejaculates of dogs and cats. AB - Flushing the vasa deferentia (ductus deferentes) at the time of vasectomy reduced to zero the number of intact spermatozoa by postvasectomy day 6 in the dog and by postvasectomy day 7 in the cat and shortened the time from vasectomy to azoospermia in the dog, but not in the cat. The fluid used to flush the vasa deferentia was not eliminated through the penile urethra, but flowed into the urinary bladder, indicating that the least resistant pathway for the exit of vasal content in the anesthetized dog and cat is toward the urinary bladder. Both control and treated dogs and cats had spermatozoa in the urine obtained by cystocentesis immediately after ejaculation or ejaculation and flushing of the vasa deferentia. Flushing the vasa deferentia at the time of vasectomy is easy to do, safe, and can be used in clinical practice to decrease the time from vasectomy to the safe utilization of dogs and cats as teasers. The procedure has potential application to males of other species. PMID- 3954238 TI - Dietary phosphorus for beef cows. AB - Hereford heifers (48 initially) were individually fed variable amounts of dietary phosphorus (P) from weaning through their 8th gestation. During phase I, 2 groups (24 cows each) were given 20.6 to 38.1 g of P/day and 6.0 to 12.1 g of P/day (increasing as animals grew). During phase II (the 4th gestation), half of the animals from each group were maintained with the same respective diets, and the other half were given 5.1 to 6.6 g of P/day. Within 6 months, animals given 5.1 to 6.6 g of P/day gradually developed signs of P deficiency. Clinical signs of deficiency and lesions included general unthriftiness, body weight loss, reduced feed consumption, reluctance to move, abnormal stance, spontaneous bone fractures, and finally, impaired reproductive performance. Cows given 7.8 to 8.9 g of P/day in diet 2 during phase II did not develop discernible clinical signs of P deficiency. Cows that were given 5.1 to 6.6 g of P/day apparently regained their health and reproductive capability when fed 11.7 to 12.6 or 17.1 to 20.5 g of P/day. The data indicate that bones serve as an effective storage source of P and support and buffer body needs until there is serious depletion of skeletal P. These results indicate that common recommendations for dietary P, such as those outlined by the National Research Council (17.5 g of P/day over the entire year for cows weighing 450 kg), exceed the basic requirements for beef cattle; 12 g of P/day is adequate for 450-kg beef cows. PMID- 3954239 TI - Frequency and consequence of caseous lymphadenitis in sheep and lambs slaughtered at a Western Australian abattoir. AB - A total of 8,711 sheep in 3 distinct age/sex groups were examined to determine for occurrence and extent of caseous lymphadenitis after slaughter at a major Western Australian abattoir. An adaptation of current mean inspection procedures to provide a numerical weighted evaluation according to number, site, and size of lesions was used to determine extent of involvement. Frequency in slaughter populations was estimated to be 3.4 +/- 0.6% for lambs, 41.8 +/- 3.9% for mixed age rams, and 53.7 +/- 1.5% for adult ewes at 95% confidence intervals. The results confirmed that frequency increased with age, but also revealed increases in extent of involvement and occurrence of visceral lesions, particularly in association with lesions of the body. Nevertheless, lesions occurred more frequently in the body than in the viscera. However, the mean visceral involvement was greater than mean body involvement in all groups, and the ratio was found to be more or less constant. Visceral involvement was found to be more extensive in rams than in ewes. Difficulties associated with complexity of current inspection procedures were also recorded. The relevance of these findings to pathogenesis and postmortem disposition after slaughter is discussed. It is suggested that current postmortem inspection criteria should be reevaluated. PMID- 3954240 TI - Developmental issues in child health psychology. PMID- 3954241 TI - Unethical intimacy. A survey of sexual contact and advances between psychology educators and female graduate students. PMID- 3954242 TI - Toward a diagnostic alliance between psychiatrist and psychologist. PMID- 3954243 TI - Experience with prospective payment in the Veterans Administration. Its impact on the delivery of mental health services. PMID- 3954244 TI - Diet, lipids, and coronary heart disease. PMID- 3954245 TI - Changes in bronchial reactivity to acetylcholine with type C influenza virus infection in dogs. AB - To investigate the mechanisms involved in increasing bronchial reactivity, we made a model of airway reactivity increase in dogs after Type C influenza virus infection. Five beagle dogs were inoculated intranasally with the virus, and the time courses of changes in the hemagglutination inhibition (HI) antibody titer and the bronchial reactivity were determined. To assess bronchial reactivity the dogs were anesthetized, and dose-response curves of pulmonary resistance were obtained against increasing concentrations of acetylcholine aerosol. The dogs infected with the virus showed mild symptoms of rhinorrhea and cough. The HI antibody titer was significantly increased in all dogs, with peak values at 1 to 3 wk after infection. The bronchial reactivity to acetylcholine began to increase towards Day 3, reached a peak at 1 to 2 wk, and returned to a normal level at 4 wk. The airway reactivity to acetylcholine at 2 wk after infection was increased by 2.3 to 6.5 times the normal value in terms of the acetylcholine provocative concentration. The mean increase was significant at 1 wk (p less than 0.05), 2 wk (p less than 0.01), and 3 wk (p less than 0.05). Although both the HI antibody titer and the airway responsiveness increased together towards 1 to 2 wk, no close relationship between these factors was observed thereafter. The present dog model of airway hyperreactivity may be useful for further investigation of the mechanism governing increase in bronchial reactivity with respiratory viral infection in normal subjects as well as in patients with asthma. PMID- 3954247 TI - The effects of hydralazine on exercise capacity in pulmonary hypertension secondary to chronic obstructive pulmonary disease. AB - Vasodilator therapy of pulmonary hypertension has been shown to improve hemodynamics in some patients, but the clinical benefits of this therapy have not been evaluated. We studied 14 patients who had pulmonary hypertension secondary to chronic obstructive pulmonary disease to determine the effect of hydralazine treatment on hemodynamics and maximal exercise. Baseline exercise in these subjects showed an abnormal pattern of excessive tachycardia and low stroke volumes, and the stroke volume correlated inversely with the pulmonary vascular resistance during exercise (r = -0.61, p less than 0.05). After 48 h of hydralazine there were decreases in the mean pulmonary artery pressure (43 +/- 8 to 38 +/- 8 mmHg, p less than 0.06) and pulmonary vascular resistance (3.97 +/- 0.97 to 2.88 +/- 1.28 units, p less than 0.05) measured at maximal exercise, and the maximal cardiac output was increased (8.05 +/- 2.57 to 10.13 +/- 2.79 L/min, p less than 0.05), but there was no change in symptom-limited maximal oxygen consumption (747 +/- 266 to 752 +/- 244 ml/min, p = NS). Significant increases in resting and maximal exercise values of minute ventilation and mixed venous oxygen tension were also noted with hydralazine. Repeat exercise testing after 2 to 4 months of chronic hydralazine therapy demonstrated no change in symptom-limited maximal oxygen consumption. We conclude that vasodilator therapy with hydralazine, although hemodynamically efficacious, does not increase exercise capacity in patients with severe chronic obstructive pulmonary disease and secondary pulmonary hypertension. PMID- 3954246 TI - Noninvasive assessment of hemodynamic improvement during chronic vasodilator therapy in obliterative pulmonary hypertension. AB - The ability to treat selected patients with obliterative pulmonary hypertension (OPH) with vasodilator therapy has been clearly demonstrated. However, the dangers involved in their use in patients who fail to have a beneficial response have also been well documented. A major problem in the management of these patients has been the lack of an easily measurable, noninvasive index of alterations in cardiopulmonary status that could be used at relatively frequent intervals to monitor the response to therapy. We have studied the utility of changes in noninvasively assessed exercise performance to predict changes in pulmonary vascular tone. In 10 patients with OPH, we compared symptom-limited oxygen consumption (Vo2ex) and oxygen pulse (Vo2/heart rate) at Vo2ex (O2 Pex) determined during progressive treadmill exercise with invasive measurements of cardiovascular function during steady-state supine bicycle submaximal exercise prior to and 8 wk after initiation of vasodilator therapy with nifedipine or diltiazem. After vasodilator therapy, total pulmonary vascular resistance decreased at rest and during exercise in 6 patients. At the same time, changes in Vo2ex ranged from -33 to 47% and in O2Pex from -26 to 57%. There was an excellent relationship between the magnitude of the change in exercise and resting total pulmonary vascular resistance and the change in both Vo2ex and O2Pex. We suggest that changes in Vo2ex and O2Pex may be a useful means of following the ability of vasodilators to improve cardiovascular function in patients with OPH. PMID- 3954248 TI - Preliminary study of the effects of low flow oxygen on oxygen delivery and right ventricular function in chronic lung disease. AB - This study was designed to test the feasibility of using the noninvasive radionuclide measurement of the right ventricular ejection fraction (RVEF) to identify which patients with chronic lung disease objectively benefit from low flow oxygen therapy. Two categories of benefit, pulmonary artery pressure/resistance and peripheral oxygen delivery, were examined in 19 patients. Fourteen subjects returned after at least 3 wk of continuous low flow oxygen therapy for restudy; 12 patients had complete radionuclide and hemodynamic data. The change in RVEF, in response to continuous oxygen, correlated significantly with the change in coefficient of oxygen delivery (r = 0.59, p less than 0.05) and the change in cardiac output (r = 0.62, p less than 0.05). The change in RVEF did not correlate significantly with the change in pulmonary artery pressure (r = 0.06) or the change in total pulmonary resistance (r = -0.35). The change in coefficient of oxygen delivery, representing oxygen delivery corrected for oxygen consumption, correlated positively with change in cardiac output (r = 0.58, p less than 0.05) and negatively with change in oxygen consumption (r = -0.63, p less than 0.05), arterial oxygen content (r = -0.63, p less than 0.05), and arterial oxygen tension (r = -0.61, p less than 0.05). That is, the fall in hemoglobin in these patients more than compensated for any increase in Pao2 so that improved oxygen delivery frequently occurred despite a decrease in arterial oxygen content, and improved oxygen delivery occurred for the most part among patients with smaller improvement in Pao2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954249 TI - Evaluation of a ventilatory muscle endurance training program in the rehabilitation of patients with chronic obstructive pulmonary disease. AB - To evaluate the role of ventilatory muscle endurance training (VMET) in the rehabilitation of outpatients with chronic obstructive pulmonary disease, we carried out a prospective random allocation trial of VMET versus IPPB. Data were obtained from 15 men allocated to VMET and from 17 men assigned to IPPB. The mean age of our experimental cohort was 61 +/- SEM 1 yr, and the FEV1 was 1.2 +/- 0.1 L. Prior to and after 6 wk of daily therapy, the following data were obtained on each subject: (1) vital statistics, (2) standard pulmonary function tests, (3) activities of daily living (ADL), (4) maximal sustainable ventilatory capacity (MSVC), (5) psychologic status (PS), and (6) exercise tolerance (ET). Prior to therapy, the VMET and IPPB groups showed no significant differences with respect to these parameters. After therapy, VMET subjects exhibited a greater increase (p less than 0.05) in MSVC than did IPPB subjects. However, VMET and IPPB groups did not differ with respect to improvements noted in ADL, PS, and ET. These results from our controlled study raise the possibility that some aspect of the experimental protocol, other than VMET, accounted for the improvements noted in ADL, PS, and ET. PMID- 3954250 TI - Relationship between respiratory muscle strength, nutritional status, and lung volume in cystic fibrosis and asthma. AB - We measured static inspiratory and expiratory pressures (PImax and PEmax) in 29 patients with asthma for comparison with a previously reported group of 25 patients with cystic fibrosis (CF) and 80 normal control subjects. The purpose of the study was to assess the relationship between respiratory muscle strength, nutritional status, lung volumes, and training effect of the increased work of breathing in patients with chronic air-flow limitation. PEmax was similar in the asthma group, CF group, and normal control subjects despite a significant degree of malnutrition in the CF group (mean body mass percentile (BMP), 78 versus 107% in the asthma group, p less than 0.001). There was no correlation between BMP and PImax or PEmax in either study group. PImax, when corrected for lung volume, was greater than age- and sex-matched control values in 24% of the patients with CF and 48% of the patients with asthma. We conclude that respiratory muscle strength is not related to nutritional status (as measured by BMP) in patients with CF and asthma. Above-normal inspiratory muscle strength may result from a training effect of the increased work of breathing in both CF and asthma, regardless of nutritional status. PMID- 3954251 TI - Active tuberculosis after isoniazid chemoprophylaxis of Southeast Asian refugees. AB - The outcome of isoniazid chemoprophylaxis for tuberculosis was assessed in refugees from Southeast Asia. From July 1979 through June 1982, 2,795 tuberculin positive refugees were prescribed isoniazid chemoprophylaxis at the time of their resettlement in King County, Washington. Through December 1983, 19 cases of active tuberculosis had arisen in those refugees. The annual incidence varied between 2.04 and 2.86 cases per 1,000 receiving treatment during the 4 yr after initiation of chemoprophylaxis (cumulative incidence, 9.66 per 1,000). Seven of the cases of tuberculosis occurring after isoniazid chemoprophylaxis were pulmonary, 1 was pulmonary and extrapulmonary (lymphatic), and 11 were extrapulmonary alone (lymphatic, 6 cases; pleural, 4 cases; soft tissue, 1 case). Fifteen of the 19 cases were culture positive, among which 8 M. tuberculosis isolates were susceptible to isoniazid and 7 were resistant. A case-control analysis showed that poor compliance, defined as taking isoniazid for 3 months or less, was associated with a sixfold increase in risk for subsequent isoniazid susceptible tuberculosis but with no increased risk for subsequent isoniazid resistant disease. Thus, active tuberculosis continued to occur with a low but relatively constant incidence after prescription of isoniazid chemoprophylaxis to Southeast Asian refugees. In this setting, poor compliance with chemoprophylaxis predisposed to isoniazid-susceptible, but not to isoniazid-resistant tuberculosis. There is a need to improve the approach to prevention of tuberculosis in Southeast Asian refugees. PMID- 3954252 TI - Abnormalities in pathways of alveolar fibrin turnover among patients with interstitial lung disease. AB - Fibrin deposition is prominent in the histopathologic features of chronic interstitial lung disease. Human alveolar macrophages can potentially modulate this process because normal macrophages synthesize and express the initial enzymes of both coagulation and fibrinolytic pathways. In the present study, we examined the cell-associated procoagulant activity of macrophages lavaged from patients with sarcoidosis (n = 14) or idiopathic pulmonary fibrosis (n = 13) and compared the enzyme activities with that of a group of normal volunteers (n = 16). Cells from sarcoid patients had a mean (+/- 1 SD) tissue factor activity of 1,491 +/- 2,160 units/5 X 10(5) cells, as compared with a mean of 480 units (range, 140 to 1,000 units) for normal control subjects. The same cells had a mean plasma Factor VII equivalent of 4.7 ng/10(6) cells, as compared with 0.81 ng/10(6) cells (range, 0.2 to 2.0 ng) for the normal control subjects. The enhanced activity correlated with disease activity as judged by radiographic stage: only patients with Stage II or Stage III disease had consistently elevated procoagulant activity. There was no correlation of procoagulant activity with the percentage of lymphocytes in the alveolar fluid. Cells from patients with idiopathic pulmonary fibrosis also had increased tissue factor (mean, 2,980 +/- 2,619 units) but less consistently elevated Factor VII. There was considerable variation in both procoagulant activity and cell differentials between lavage sites in 10 patients in whom 2 separate lobes were studied concurrently. In addition, we examined the plasminogen activator (PA) activities of lavaged cells and concentrated alveolar fluids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954253 TI - Assessment of interlobar variation of bronchoalveolar lavage cellular differentials in interstitial lung diseases. AB - Alveolitis is thought to precede permanent lung derangement in a variety of interstitial lung diseases (ILD). Bronchoalveolar lavage (BAL) cell differentials can be used to evaluate the intensity of alveolitis, whereas clinical, roentgenographic, and functional studies are insensitive monitors of lung inflammation. As ILD is generally diffuse, unilobar lavage is widely used and presumed to gauge overall lung inflammation. Consistency of lobe to lobe cell differential findings has not been systematically addressed. We analyzed 53 bilateral lobar lavages (right middle lobe and lingula) in 34 patients with sarcoidosis, idiopathic pulmonary fibrosis-collagen vascular disease (IPF-CV) and a group of mixed interstitial diseases. Cellular differentials from each lobe were independently assessed and compared. The sarcoid group, with predominantly T lymphocytes in BAL, showed excellent interlobar correlation (r = 0.92, p less than 0.001), with only 17% showing a discrepancy of greater than 10% in percentage of T-lymphocytes. In contrast, the IPF-CV group, with predominantly neutrophils in BAL, showed good interlobar correlation (r = 0.79; p less than 0.01), but 35% had a greater than 10% discrepancy in percentage of neutrophils. Finally, the mixed group, with lymphocytes as the predominant cell in BAL, showed poor interlobar correlation (r = 0.58; p greater than 0.10), with 42% showing a greater than 10% discrepancy in percentage of lymphocytes. These results were not explicable on the basis of differences in volume of lavage fluid or total cells recovered, these parameters being remarkably consistent between lobes in the 3 patient groups and in a control group of 8 subjects without ILD. The chest roentgenogram was markedly insensitive to lavage interlobar variation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954254 TI - The distribution of procoagulant and plasminogen activator activities among density fractions of normal rabbit alveolar macrophages. AB - Rabbit alveolar macrophages can directly stimulate either coagulation or fibrinolysis by producing tissue thromboplastin and plasminogen activator activities, respectively. However, it is not known whether these 2 opposed physiologic activities are expressed by the same or different cells within a population of alveolar macrophages. This study was undertaken to determine the distribution of procoagulant and plasminogen activator activities among density defined populations of rabbit alveolar macrophages. Normal rabbit alveolar macrophages were separated into 4 density fractions on continuous gradients of Percoll, and the distribution of procoagulant and plasminogen activator activities among these fractions was determined. The procoagulant activity of the least dense cells (Fraction 1) was as much as 6 times greater than the activity displayed by denser cells (Fractions 2 to 4). By contrast, both cell-associated and secreted plasminogen activator activities were equally and uniformly distributed among all density fractions. These distributions of activities among density fractions persisted after the cells were incubated in culture medium for 24 h. After culture in vitro with lymphokine, procoagulant activity increased in the denser cells so that the activity became equal among all density fractions. We conclude that procoagulant activity distributes differently from plasminogen activator activity among fractions of normal rabbit alveolar macrophages separated according to cell density. By using density gradient fractionation, alveolar macrophages with predominantly procoagulant or plasminogen activator activities can be enriched from the lavage cell population; the dissimilar distribution of these 2 activities within the alveolar macrophage cell population does not reflect the presence of cells with fixed differences in their functional capacities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954255 TI - The role of complement in cigarette smoke-induced chemotactic activity of lung fluids. AB - To help explain increased recruitment of leukocytes to smokers' lungs, we examined the possibility that the smoke-induced chemotactic activity in lung fluids may be partly complement-dependent. Acute inhalation exposure of rats to smoke from 2R1 Kentucky Reference cigarettes caused an increase in the leukocyte chemotactic activity of their lung secretions (collected by bronchoalveolar lavage 1 h after exposure). Prior depletion of circulating complement, by intravenous administration of purified cobra venom factor 24 h beforehand, prevented the smoke-induced rise in lavage fluid chemotactic activity. Crossed immunoelectrophoretic analysis of lavage C3 from smoke-exposed animals demonstrated a modified form of the molecule with increased electrophoretic (anodal) mobility. When 2 strains of mice, C5-deficient DBA/2 and C5-sufficient BALB/c, were acutely exposed to cigarette smoke, only the C5-sufficient animals (BALB/c) had increased neutrophil chemotactic activity in their lung fluids 1 h after exposure. These results show that the increased chemotactic activity in lung fluids of laboratory animals immediately after acute cigarette smoke exposure is complement-dependent. PMID- 3954257 TI - American Lung Association, American Thoracic Society, 1986 annual meeting. May 11 14, 1986, Kansas City, Missouri. Abstracts. PMID- 3954256 TI - Breathing and oxygenation during sleep in normal men and women. PMID- 3954258 TI - Infrared light scanning of the breast. AB - Transillumination and Infrared Light Scanning (I.L.S.) of the breast were evaluated in a high referral breast clinic over a 15-month period. Seven hundred (700) patients were examined and blindly transilluminated; 101 were biopsied, all had mammography. The study was conducted in two phases: Phase I evaluated transillumination without I.L.S. This included 22 biopsied patients out of 101, with eight carcinomas identified histologically, demonstrating 87 per cent sensitivity and 64 per cent specificity for transillumination, versus 87 per cent and 71 per cent for mammography, and 87 per cent and 57 per cent for examination. Phase II evaluated simple transillumination combined with I.L.S. This included 79 biopsied patients out of 101 with 26 carcinomas identified histologically, demonstrating 96 per cent sensitivity and 74 per cent specificity for transillumination combined with I.L.S. compared to 85 per cent and 72 per cent for mammography and 81 per cent and 73 per cent for examination. Of the 26 Phase II carcinomas identified, two were not felt by examination, and two were neither felt nor read correctly by mammography. I.L.S. of the breast has proven effective in the hands of trained personnel and should be used with routine breast examination or mammography to increase yield of breast pathology. PMID- 3954259 TI - Blunt esophagectomy and gastric interposition for tumors of the cervical esophagus and hypopharynx. AB - Between April 1982 and June 1984, 17 patients underwent blunt esophagectomy and gastric interposition for squamous carcinoma of the cervical esophagus or hypopharynx. There was one operative death; no bleeding complications required thoracotomy or re-exploration. In two patients, a previously unknown carcinoma of the resected esophagus was discovered at the time of surgery. Blunt esophagectomy with gastric interposition is a safe technique for cervical esophageal reconstruction, as it has the added benefit of removing the entire esophagus, which has a propensity for later or synchronous carcinoma in patients with head and neck malignancies. PMID- 3954260 TI - Malignant melanoma in childhood and adolescence. AB - A retrospective chart review of 25 patients under the age of 20 years with malignant melanoma, diagnosed between the years 1938 and 1984 at the University of Iowa Hospitals and Clinics, was conducted. Nine of the patients were under the age of 14 years, and 18 patients were females. There appeared to be a frequent delay in diagnosis of the primary lesion, occasionally incorrect initial diagnosis, and under-treatment in these young patients. Primary treatment varied from limited excision of the lesion to wide excision and regional lymph node dissection. Females appeared to have a better prognosis than males, and wide local excision with or without regional lymph node dissection was associated with the most favorable outcome. Overall 10-year survival in this group of patients was 56 per cent, a rate that compares well to the overall survival in adult patients with malignant melanoma. PMID- 3954261 TI - Management of squamous cell carcinoma of unknown origin in cervical lymph nodes. AB - Forty-three patients with the diagnosis of metastatic squamous cell carcinoma from unknown primary to the cervical lymph nodes were treated in EOVAMC between 1962-1982. Six of these patients were N1, 19 N2, and 18 N3. Five-year survival was 41 per cent for N1, 15 per cent for N2, and 6 per cent for N3 nodes. There was no significant difference in the treatment failure of those patients treated with unimodality versus multimodality. A subsequent primary was detected in the head and neck in 23 per cent of these patients (10/43), and eight of these patients had received previous radiotherapy. The most common site for these subsequent primaries was hypopharynx. Nine of the 43 patients developed distant metastasis with no correlation to stage of disease or treatment modality. These data show that the survival of these patients correlates with the stage of nodal disease, and that radiotherapy did not decrease the subsequent appearance of the primary lesions. PMID- 3954262 TI - Long-term, intermittent percutaneous administration of epidural and intrathecal morphine for pain of malignant origin. AB - Eight patients with intractable pain of malignant origin were treated by the surgical implantation of externalized catheters for percutaneous injection of morphine into the spinal epidural or the cerebral intraventricular space. Follow up ranged from 48 hr to 1 yr. Four catheters (50%) malfunctioned mechanically and were repaired. Two were imputed in systemic infection and were removed. One patient developed paradoxical responses and discontinued catheter use. Every patient enjoyed excellent relief for a significant time with full preservation of mental capacities. The attractive simplicity of this morphine delivery system deserves further study. PMID- 3954263 TI - Merkel cell carcinoma: combined surgery and radiation therapy. AB - Merkel cell carcinoma, first reported as "trabecular carcinoma" by Toker in 1972, is a dangerous, often fatal primary skin tumor. The current authors report eight patients, only one of whom is considered to have a totally successful clinical outcome. Two patients died and one was preterminal with widespread disease in 10 to 20 months. Two others had recurrence or metastases within a year, and two patients died early of intercurrent disease after first developing regional lymph node involvement. Review of 139 patients reported in the literature indicates local recurrence in 30 per cent, regional lymph node metastases in 50 per cent, and death from neoplasm in 18 per of the cases. All patients in the present series received radiation therapy with encouraging response. The tumor was quite radiosensitive, and in only one instance was there recurrence within an irradiated field. Wide surgical excision with prompt postoperative irradiation to the local site and regional lymphatics is the therapy of choice in early lesions. Regional lymphadenectomy is recommended whenever nodal involvement is suspected. Currently, an aggressive combined surgical and radio-therapeutic approach to this dangerous neoplasm appears warranted, although further data may show that early and routine use of radiotherapy in Merkel cell carcinoma could obviate the necessity for extensive operative procedures. PMID- 3954264 TI - Ocular and endocrine function in patients with pituitary tumors. Operative results following transnasal, transsphenoidal approach with marsupialization of the sella turcica. AB - Thirty-one patients with pituitary tumors underwent transphenoidal operation via a unilateral, trans-nasal technique preserving the nasal septum and marsupializing the sella turcica unless CSF leak could be demonstrated. These two modifications neither detracted from exposure nor predisposed to delayed complications and significantly facilitated the procedure. PMID- 3954265 TI - Is serum parathormone assay necessary in evaluating primary hyperparathyroidism? AB - Serum parathormone (PTH) values are believed useful in diagnosing hyperparathyroidism and in evaluating patients before parathyroid operation. From 1975 through 1983, 328 adults patients with persistent hypercalcemia and normal renal function underwent cervical exploration for presumed primary hyperparathyroidism. Preoperative serum PTH values were obtained in 137 patients. Eight had negative explorations (5.8%): serum PTH values were normal in three patients and elevated in five. Serum PTH values were normal or low in 31 of the other 129 patients (false-negative rate = 24%). Of 191 patients for whom neither serum PTH nor nephrogenic cyclic adenosine-3',5'-monophosphate values did not were obtained preoperatively serum PTH values did not reduce the incidence of negative cervical explorations and, when obtained, they were misleading in one fourth of patients who benefitted from parathyroid exploration. PMID- 3954266 TI - A review of 265 cases of parathyroid explorations. AB - The authors review their personal series of over 250 parathyroid explorations since 1957. The rationale for treatment of asymptomatic hypercalcemia is discussed. Emphasis is placed on early exploration of hypercalcemic crisis. The relationship of hyperparathyroidism to MEA syndromes is discussed with illustrate cases. The value of sonography, CT scanning, and other radiologic studies is presented. Measured to reduce failure rate are emphasized. PMID- 3954267 TI - Acute cholecystitis. Evaluation of factors influencing common duct exploration. AB - The clinical records of 216 patients with proven acute cholecystitis treated by cholecystectomy form the basis of this retrospective study. Common bile duct stones were present in 12.4 per cent of these patients. Thirty per cent of the patients with elevated SGOT values, 26.2 per cent of the patients with elevated alkaline phosphatase, and 23.1 per cent of the patients with elevated amylase had common duct stones. The authors found that 17.6 per cent of patients with bilirubin between 1.5 and 2.9 mg/dl had common duct stones, whereas 71.4 per cent of common bile ducts with a bilirubin greater than 5 mg/dl contained stones. Six of 28 patients with common duct stones had normal bilirubin. Cholangiograms were normal in 115 of the 154 cholangiograms performed; six of these common ducts were explored, and no common duct stones found (false-negative cholangiograms 0.0%). Cholangiograms showed stones in 24 patients; common bile duct stones were recovered from 20 of these patients (accuracy rate 83%, false-positive cholangiograms 17%). Wound infections occurred in seven patients (3.7%). Sepsis resulted in death of three patients, and the other two deaths resulted from multi system failure. This study demonstrates operative cholangiograms to be the most accurate method of detection of common duct stones, and its routine use in patients undergoing cholecystectomy is recommended. PMID- 3954268 TI - A review of twenty-one rectal mucosectomy and ileal pouch pull through procedures. AB - Twenty-one patients with chronic ulcerative colitis (CUC) or familial polyposis underwent total colectomy, rectal mucosectomy, ileal pouch formation and anastomosis of the pouch to the dentate line. Eleven (52%) intraoperative problems occurred. No deaths resulted. Ten (48%) postoperative complications were treated without operative intervention. Ten postoperative complications required a minor or major procedure to remedy the problem. The most common major complications were four small bowel obstructions. The only septic complication was a single wound infection. Functional results have been satisfactory with 14 of 19 (74%) having six or fewer bowel movements per day. Most patients do not wear perineal pads either day or night. Only one patient felt his lifestyle had worsened. Seventeen of 19 (90%) patients were satisfied with their result and would choose to have the operation again. Frequent diarrheal stools associated with incontinence was the primary reason for a failure and excision of one pouch. This procedure is becoming the alternative of choice for CUC and polyposis because of the ability to cure the disease as well as preserve anal sphincter function. PMID- 3954269 TI - Posttraumatic and postoperative acute cholecystitis. AB - The development of peritonitis in hospitalized patients, especially those with significant associated illness, can be a difficult and delayed diagnosis. To ascertain the clinical presentation of acute cholecystitis in this group, a retrospective analysis was performed. Over a 10-year period 18 patients were identified who developed either posttraumatic or postoperative acute cholecystitis. The condition occurred in 12 patients admitted for some form of trauma and in six patients after elective surgery. Fever and right upper quadrant pain and tenderness were present in most. These physical findings were generally accompanied by leukocytosis (average = 16,200), hyperbilirubinemia (average = 4.2), and elevated alkaline phosphatase (average = 214). At laparotomy gangrenous cholecystitis was found in the majority, reflecting delayed diagnosis. Eleven patients had acalculous disease, and seven patients calculous cholecystitis. Three patients died, yielding a 17 per cent mortality. The majority with acalculous disease had significant underlying illness. Shock, multiple transfusions, or infection preceded acute cholecystitis in this group. Those with calculous cholecystitis were usually not as ill prior to its development. The morbidity of acute cholecystitis in previously hospitalized patients can be reduced by an awareness of the predisposing factors in those with acalculous disease. Emphasis should be placed on signs and symptoms rather than laboratory values to ensure early diagnosis and treatment of acute cholecystitis in hospitalized patients regardless of the presence or absence of gallstones. PMID- 3954270 TI - Pseudocalculus sign. A pitfall of static cholangiography. AB - The pseudocalculus formation was first noted by Caroli in 1960, and was first called a sign by Beneventano and Schein in 1968. It is a cholangiographic illusion that appears as a filling defect in the distal common bile duct when static or "spot" films are exposed during the contractile phase of choledochal sphincter activity. Although first noted and most frequently seen in T-tube cholangiography, it is seen also during intravenous and intraoperative cholangiography. Because it mimics radiographically an impacted stone in the distal common bile duct, its delineation is critical to avoid unnecessary instrumentation of the common bile duct or even reoperation. In this review the authors discuss briefly the anatomy and physiology of the distal common bile duct and the etiology, differential diagnosis, and recognition of the pseudocalculus sign. PMID- 3954271 TI - Early definitive surgery for acute pancreatitis associated with cholelithiasis. AB - Since the natural history of pancreatitis associated with cholelithiasis is one of recurrence, surgery for the biliary tract disease is mandatory. But appropriate timing of the surgery remains controversial. Seventy-eight patients have been treated with early surgery once a diagnosis of cholelithiasis associated pancreatitis was made. Eighteen patients had previous episodes of nonalcoholic pancreatitis. Utilizing Ranson's prognostic signs, 52 patients had mild pancreatitis and 26 severe. Sixty-eight patients (87%) had surgery within 72 hours after admission and ten patients (13%) within 5 days. All patients had a cholecystectomy and operative cholangiogram performed. Fifty-six (72%) positive operative cholangiograms were obtained and common bile duct exploration revealed choledocholithiasis in 42 patients (75%). No mortality occurred, and four had six complications including mild persistent pancreatitis (two), wound infection (one), urinary tract infection (one), cardiac arrhythmia (one) and heart block requiring permanent pacemaker (one). The average hospital stay was 10.4 days. T tube cholangiogram done prior to discharge was normal in all patients, and there have been no episodes of recurrent pancreatitis. Early definitive surgery for pancreatitis associated with cholelithiasis is recommended and can be accomplished with minimal morbidity and mortality coupled with judicious utilization of hospital resources. PMID- 3954272 TI - Elective cholecystectomy for the patient with sickle cell disease and asymptomatic cholelithiasis. AB - Experience with elective cholecystectomy in ten patients with sickle cell disease and one patient with sickle-thalassemia from 1977-1984 was reviewed. In contrast to an earlier review from our institution, the current series had a low morbidity. This improvement is attributed to careful perioperative care, especially preoperative transfusion, hydration, and oxygenation. Because of the increasing longevity of sickle cell patients, because of the incidence of eventual significant complications of even asymptomatic cholelithiasis, and in order to simplify medical management by eliminating the diagnostic confusion between acute cholecystitis and sickle cell hepatobiliary crisis, the authors believe that elective cholecystectomy is to be recommended for the sickle cell patient with asymptomatic gall stones. PMID- 3954273 TI - Complications of the Angelchik prosthesis in the management of gastroesophageal reflux. AB - There have been a number of reports on the complications of the Angelchik silicone prosthesis since Angelchik and Cohen first reported the use of the device in 46 patients with gastroesophageal reflux. The exact incidence of complications is difficult to estimate; however, the company estimates 0.81 per cent for migration and 0.15 per cent for erosion of the prosthesis. The purpose of this paper is to review our experience with 13 complications related to the Angelchik prosthesis in eight patients referred to Emory University Hospital. These complications consisted of recurrent reflux esophagitis in six patients, intractable dysphagia in two, esophageal stricture in two, displacement of the prosthesis in two, disruption of the prosthesis in one patient, and gastric erosion in two patients. The management of these complications required removal of the prosthesis and performance of a Nissen fundoplication in six patients. Distal esophagectomy with esophagogastrostomy was performed in one patient, and colon interposition was performed in another patient. In summary, serious complications of the Angelchik prosthesis implanted for gastroesophageal reflux and their management are presented. PMID- 3954274 TI - Surgical experience of colon resection in the extreme elderly. AB - A retrospective review was undertaken at Mount Sinai Medical Center of Miami Beach for patients aged 70 and greater undergoing colon resection between January 1, 1983 and December 31, 1983. These resections were performed for carcinoma 67.3 per cent, diverticular disease 10.9 per cent, and other indications 21.8 per cent. The operations were performed by different surgeons with a wide spectrum of procedures and associated simultaneous procedures. The morbidity and mortality were reviewed. Complications occurred in 27.7 per cent (38 complications in 28 patients). The complication rate was highest in those with diverticular disease. The overall mortality rate was 4.95 per cent with a zero mortality in patients undergoing elective colon resections. It would appear that with careful monitoring and avoidance of emergency surgery, colon resection can be safely undertaken in this elderly portion of the population. PMID- 3954275 TI - Acute appendicitis during pregnancy. AB - Forty-one appendectomies were performed on pregnant patients during the period 1973-1983. The preoperative diagnosis of acute appendicitis was correct in 57 per cent of the cases (24 patients). Presenting complaints, physical examinations, and laboratory analysis did not prove helpful in establishing the diagnosis. The incidence of acute appendicitis during pregnancy was 1:4172 (birth/pregnancy). Rapid surgical intervention probably contributed to the low (25%) incidence of perforated appendices. A transverse incision and general anesthesia were preferred. There was no maternal mortality and a 2 per cent rate of fetal loss. PMID- 3954276 TI - The automatic implantable cardioverter-defibrillator: efficacy, complications, and device failures. AB - Twenty-six patients with refractory ventricular arrhythmias received the automatic implantable cardioverter-defibrillator. A patch lead only was placed during arrhythmia surgery in 7 other patients. During 13 +/- 6 (SD) months, the device discharged in 10 patients because of a sustained ventricular arrhythmia. No sudden deaths occurred. There were 31 complications in 17 patients, including postoperative refractory heart failure, coronary artery erosion, subclavian vein thrombosis, postoperative stroke after conversion of atrial fibrillation, atelectasis with pneumonia, symptomatic pleural effusions, and infection at the generator site. The cardioverter-defibrillator discharged in 9 asymptomatic patients, failed to terminate ventricular fibrillation during postoperative testing in 3 patients, and had premature battery failure in 4 patients. Tachycardia slowing during chronic amiodarone therapy and unipolar ventricular pacing during ventricular fibrillation precluded or delayed arrhythmia sensing. Thus, the cardioverter-defibrillator can be life saving, but its potential complications and interactions with antiarrhythmic drugs and pacemakers must be considered at patient selection. PMID- 3954277 TI - Risks for renal dysfunction with cardiac angiography. AB - In 139 patients with preexisting abnormal renal function (serum creatinine level of 2.0 mg/dL or greater) undergoing cardiac angiography (141 examinations), the incidence of contrast nephropathy, defined as a 1 mg/dL or greater rise in serum creatinine, was 23% (95% confidence interval, 17% to 30%). Stepwise logistic regression analysis showed that contrast nephropathy was independently associated with class IV heart failure with low cardiac output (71% incidence in this subgroup; p less than 0.0001), multiple radiocontrast studies within 72 hours (50%; p = 0.002), dose of radiocontrast administered (p = 0.009), and insulin dependent diabetes mellitus (44%; p = 0.007). Age, hypertension, and hyperuricemia were not associated. In patients without low cardiac output, other radiocontrast tests, or insulin-dependent diabetes mellitus, there was a 2% incidence of contrast nephropathy in those who received less than 125 mL radiocontrast and a 19% incidence in those who received 125 mL or greater. PMID- 3954278 TI - Intravenous cimetidine or two regimens of ranitidine to reduce fasting gastric acidity. AB - Fasting gastric pH (acidity) was measured over a 10-hour period in six patients with duodenal ulcer disease. Fasting pH was measured in a control study during which no medications were administered and in response to 300 mg of intravenous cimetidine given every 6 hours or 50 mg of intravenous ranitidine given every 6 or 8 hours. Each regimen produced gastric pH levels significantly higher than those obtained when no medication was given. Although patterns of gastric pH differed among the medication regimens, and although the ranitidine regimens maintained pH at or above 5.0 more reliably than cimetidine, there were no significant differences in mean pH, median pH, or mean hydrogen ion concentration. PMID- 3954279 TI - The erythrocyte sedimentation rate. Guidelines for rational use. AB - The erythrocyte sedimentation rate (ESR) is seldom the sole clue to disease in asymptomatic persons and is not a useful screening test. When the rate is increased, a careful history and physical examination will generally disclose the cause. An unexplained increase in the ESR is generally transitory and seldom due to serious disease. The test is most useful in diagnosing temporal arteritis and monitoring the patient's response to treatment. The test has little diagnostic value in rheumatoid arthritis but may be useful in monitoring disease activity when clinical findings are equivocal. The ESR is often normal in patients with cancer, infection, and connective tissue disease and is therefore of little use in excluding these diseases in patients with vague complaints. PMID- 3954280 TI - Residency training in internal medicine: time for a change? AB - Internal medicine residencies risk becoming obsolete if they are not adjusted to changing patterns of medical practice. Declining length of hospital stay, increased intensity of hospital care, movement of critical management decisions to outpatient settings, increased proportions of admissions for specific diagnostic procedures, and increased needs for perioperative consultations all erode the foundation of traditional internal medicine training. Furthermore, demographic shifts, the move to prepaid care, and a projected oversupply of subspecialists warrant more exposure to generalism and geriatrics. To prepare internists for clinical practice, some training should shift from medical wards and intensive care units to outpatient settings and surgical consultation, additional process skills must be taught, and the epidemiologically important non internal-medicine disciplines should be included in the curriculum. These shifts will require changes in methods to pay for residency training, accreditation procedures for residency programs, and the residency certifying process. Most importantly, the model and organization of internal medicine training need to be reconsidered. PMID- 3954281 TI - Training internists for the changing medical scene. PMID- 3954282 TI - Graduate medical education in internal medicine. PMID- 3954283 TI - Training in internal medicine: time to retool the factory? PMID- 3954284 TI - Nursing home placement and the demented patient. PMID- 3954285 TI - Immune thrombocytopenia in homosexual men. PMID- 3954286 TI - Congestive heart failure and thoracentesis. PMID- 3954287 TI - High-dose desferoxamine and Diamond-Blackfan anemia. PMID- 3954288 TI - Angioscopy and chronic pulmonary arterial obstruction. PMID- 3954289 TI - Lorazepam in myoclonic seizures after cardiac arrest. PMID- 3954290 TI - Skin tags and colonic polyps. PMID- 3954291 TI - Propafenone and a syndrome of the lupus erythematosus type. PMID- 3954292 TI - Nifedipine and ureteral colic. PMID- 3954293 TI - Side effects of transdermal nitrate. PMID- 3954294 TI - High carbohydrate diets in chronic obstructive pulmonary disease. PMID- 3954295 TI - Work-related eye injuries. AB - Twenty-one patients admitted between 1977 and 1982 to the Medical College of Virginia were studied retrospectively for work-related eye injuries. This group comprised 7.7% of all eye-injury admissions. Patients suffered both blunt and penetrating injuries; penetrating injuries had poorer prognoses. Twenty of the 21 patients had not worn protective eyewear. The average per-patient cost related to ocular injury was $2946, and the average hospital stay was 6.4 days. In contrast, the one patient who had worn protective eyewear had ocular-related costs and hospitalization of only $350 and a one-day stay. Protective eyewear is important in lessening the severity of injury as well as decreasing the financial and psychologic burden to the patient, hospital, and employer. PMID- 3954296 TI - A comparison of therapeutic bandage lenses, tarsorrhaphy, and antibiotic and hypertonic saline on corneal epithelial wound healing. AB - Bandage lenses, a complete tarsorrhaphy, chloramphenicol 0.5%, and sodium chloride 2% were tested for their effect on corneal epithelial wound healing in rabbits. The healing rate was decreased with bandage lenses and increased by tarsorrhaphy. There was no significant effect on healing rate with either chloramphenicol or hypertonic saline. PMID- 3954297 TI - Plasma amino acid levels in cataract. AB - Fasting plasma amino-acid profiles were determined in 32 subjects with either cataractous lenses (24 subjects) or normal lenses (eight subjects). The findings were compared with established laboratory normal values. The amino-acid levels of all subjects with normal lenses were within the normal range for the subjects' age groups. In contrast, subjects with presenile or senile cataracts had markedly elevated levels of glutamine, with similar elevations of alanine in presenile cataract and of histidine in senile cataract. To the best of our knowledge, this is the first report of such a plasma amino-acid pattern in subjects with presenile and senile cataracts. PMID- 3954298 TI - Distant arterial thromboembolization as a postoperative complication of cataract extractions. AB - This paper describes and analyzes an almost-unreported postoperative complication. Arterial thromboemboli are a concern with hospital populations, where their relative incidence is higher than in the general population. Four case reports are mentioned: Each patient underwent a cataract extraction and, following time periods varying from one day to two months, sustained a thrombosis of a main leg artery. Possible etiologies are discussed. All patients had an impaired immune status in some way, and either this or the resultant steroid treatment may be implicated in their postoperative complication. All patients had cardiovascular histories, and two had previous duodenal ulcers. PMID- 3954299 TI - Corneal power and astigmatism. AB - A study investigating the corneal power and degree of astigmatism in 520 patients at a university optometry clinic in Benin-City, Nigeria was undertaken. The mean low corneal power and the mean high corneal power were 42.7 +/- 1.5 diopters and 43.3 +/- 1.5 diopters, respectively. The mean corneal astigmatism was 0.61 +/- 0.63 diopters. Although female corneas were significantly steeper than those of males, there was no significant difference between the corneal astigmatism with regard to sex. The data reported suggest that nutrition plays a less important role in corneal astigmatism than other authors have proposed. PMID- 3954300 TI - Pulmonary edema as a complication of oral glycerol administration. AB - A 73-year-old man was treated with oral glycerol solution for elevated intraocular pressure. Forty-five minutes later, he developed severe pulmonary edema. To our knowledge, this is the first documented case of this severe complication. PMID- 3954301 TI - Rationale for the one-eye therapeutic trial. PMID- 3954302 TI - Use of sodium hyaluronate in severe penetrating ocular trauma. AB - This study describes the surgical treatment and eventual outcome of 15 cases of anterior-segment penetrating ocular trauma that would be classically considered as having a poor prognosis. Signs of poor prognosis included: corneal lacerations, complicated by signs of infection ranging from infiltration to necrotic digestion; large scleral lacerations, with ciliary body or choroidal prolapse; and an exaggerated inflammatory response to the trauma. Treatment included careful microsurgical techniques, vitrectomy (when necessary), use of antibiotics and anti-inflammatory agents, and the liberal use of sodium hyaluronate to break fibrin adhesions and maintain the chamber at the close of surgery. Such treatment resulted in no enucleations, an average best corrected visual acuity of 20/80, an average normal angle of 314 degrees, and 13 cases of normal intraocular pressure without medication. PMID- 3954303 TI - Corneal changes in homocystinuria. PMID- 3954304 TI - Radiographic visualization of congenital lacrimal sac mucoceles. AB - The clinical presentation of a congenital mucocele is a blue-gray tense mass located inferior to the medial canthal ligament. The differential diagnosis is that of tumor and encephalocele. Diagnostic modalities such as simple transillumination and ultrasound aid the physician, but dacryocystography confirms the marked lacrimal sac distension. In three infants the sac could not be decompressed by massage, indicating that the canalicular-punctal system as well as the inferior lacrimal system were blocked. When the distended lacrimal sac compresses the two canaliculi and bends them on themselves, there is a functional trapdoor-type block. During the probing of these patients, we felt a snap when the lacrimal syringe was withdrawn from the distended sac. We concluded that this was due to kinking of the canaliculus by the enlarged sac. PMID- 3954305 TI - Corneal thinning syndromes. AB - We performed central pachymetry on two patients with pellucid and Terrien's corneal marginal degeneration with mean central corneal thicknesses of .487 mm and .466 mm, respectively. We believe that differential corneal thickness measurements may assist in the differential diagnosis of the corneal thinning syndromes. PMID- 3954306 TI - Suggested vision standards for drivers in the United States with vision ranging from 20/175 (6/52) to 20/50 (6/15). AB - This article creates two categories for individuals with vision ranging from 20/175 (6/52) to 20/50 (6/15). Statistically, there are approximately 532,000 drivers with vision ranging from 20/175 (6/52) to 20/100 (6/30) and 56,000 drivers with vision ranging from 20/80 (6/24) to 20/50 (6/15). The author contends that the plan to test the vision of a number of drivers over the next four years will turn up a large number of failures. This will result in the loss of licenses and conceivably cause many people to lose their jobs. One way to avoid this is to issue limited licenses. It is important for the Department of Motor Vehicles to consider this step. PMID- 3954307 TI - Gastrojejunostomy: a simple method of treatment of gastric volvulus. AB - Ten patients treated for gastric volvulus over eleven years are reviewed. Nine were treated successfully by gastrojejunostomy. The advantages of this simple procedure are discussed. Changes occurring in the position of the pylorus may predispose to this condition. PMID- 3954308 TI - Cervical thymectomy in the treatment of myasthenia gravis. PMID- 3954309 TI - When do patients given intrathecal morphine need postoperative systemic opiates. PMID- 3954310 TI - Use of rhomboid flap in pilonidal sinus. PMID- 3954311 TI - Is a drip necessary for a cholecystectomy? AB - One hundred consecutive cholecystectomies were started without a drip. Three patients were given intravenous mannitol for jaundice, one intravenous Dextrose for diabetes control and four were given intravenous fluids following a transduodenal exploration of the common bile duct. Ninety-two patients who did not have a drip had a short postoperative stay (four days) with no complications that could be attributed to withholding IV fluids. We suggest that the use of intravenous fluids in most gallbladder surgery should cease. PMID- 3954312 TI - Maxillary development in cleft palate patients with special reference to the effects of operation. AB - Thirty-one patients whose complete unilateral clefts of lip and palate had been repaired by early operation were followed up for 18 years. The results showed that repair of the hard palate is followed by deformity of the maxilla in a sufficient number of patients to suggest that we need to look for improved methods of repair of the hard palate. PMID- 3954313 TI - Endoscopic management of upper urinary tract stones. AB - In a two year period from March 1983, 157 patients with upper urinary tract stones were managed primarily by endoscopy. Of 90 patients with renal stones, extraction was achieved in 91% of patients with complete extraction in 76%. Of the remaining patients with ureteric stones, successful extraction was achieved in 75%. Ten patients required open surgery which was for failed extraction in 9. Morbidity is low with a mean hospital stay of 4.7 days for patients with kidney stones, and of 3.7 days for patients undergoing extraction of ureteric stones. PMID- 3954314 TI - The prediction of incisional hernias by radio-opaque markers. AB - On the hypothesis that incisional defects occur soon after operation but the resulting hernia may not be diagnosed until months or years later, we attached three to five pairs of stainless steel haemostatic clips to the cut edges of the anterior aponeurosis during the closure of 59 major laparotomy incisions and X rayed the abdomen one month later. Three patients were withdrawn and the remaining 56 were examined with special reference to incisional herniation at their six-month follow-up visit. The senior author subsequently arranged a series of extra clinics for surviving patients up to three years later (median 30 months after operation). He had no knowledge of the results of the abdominal X-rays when assessing whether or not the patient had a hernia. Six patients were found to have incisional hernias, and correlation with the measurements on the one-month X rays showed separation of pairs of clips ranging from 12-70 mm (median 40). Three of the six hernias were discovered within seven months, the remaining three at 13, 28 and 29 months. In contrast none of the 50 patients without incisional hernias had more than 9 mm of separation of any pair of clips on the one-month X ray. We conclude that the origins of incisional hernias can be traced back to events during the first month after operation and that they are not the result of later weakening of a well-healed laparotomy wound. PMID- 3954315 TI - The correction of scalp hair defects by tissue expansion. AB - This paper presents the results and complications in the correction of partial scalp alopecia in ten patients using the technique of 'tissue expansion'. The average size of defect that was covered by expanded hair bearing scalp was 45.9 cms2, and the largest defect covered measured 11 X 6 cm. This series indicates that tissue expansion is now one of the most promising methods available for dealing with the difficult problems of partial alopecia which can present to surgeons and physicians in a wide range of specialties. PMID- 3954316 TI - Endoscopic thoracic sympathectomy in the treatment of upper limb hyperhidrosis. AB - The technique of endoscopic sympathectomy is described and its value in the treatment of upper limb hyperhidrosis is reported in an initial series of 7 patients (13 sympathectomies). It is recommended as the treatment of choice for this condition. PMID- 3954317 TI - The therapeutic dilatation of enteric strictures due to Crohn's disease. AB - The use of dilatation as a treatment of strictures due to Crohn's disease has hitherto received little attention. We report dilatation of small and large bowel strictures in twelve patients with Crohn's disease. The technique appears to be safe when carried out either endoscopically or as part of a laparotomy. Short term follow-up suggests that the technique may have a part to play in the treatment of suitable strictures that can be reached endoscopically but early restenosis limits its value at laparotomy when strictureplasty may provide a more lasting relief of the stenosis. PMID- 3954318 TI - Urinary diversion and bowel cancer. AB - A retrospective survey of 278 patients who underwent urinary diversion for benign disease has revealed an excess risk factor for cancer at the ureterocolic anastomosis of approximately 100 fold. No malignancies were detected in isolated ileal or colon conduits, although recently a few such cases have been reported. Coupling this experience with a review of the literature, it would appear that the tumour is of colonic origin, adenoma and adenocarcinoma occurring at, or close to, the ureteric implant into the colon after a long latency of approximately 25 years, often in young patients. Nitrate reducing bacteria and N.nitroso compounds have been demonstrated in rectal urines of patients with ureterocolic anastomoses and also in some isolated loop urines. In fact, N.nitrosation and, possibly, carcinogenesis appears to depend not so much upon the kind of diversion, but rather the presence or absence of a mixed bacterial flora in the urine. PMID- 3954319 TI - Metabolism of all-trans-[11-3H]retinyl acetate in the testes of young rats. AB - All-trans-[11-3H]retinyl acetate was injected directly into the testes of young rats and testicular and liver metabolites were analyzed by HPLC at 6, 24 and 72 h post injection. All-trans-retinyl acetate was hydrolyzed to retinol and further metabolized to polar compounds and a trace of retinoic acid, or reesterified to various retinyl esters including retinyl palmitate and retinyl stearate. Thus, retinyl ester hydrolyzing and esterifying enzymes are present in the testes of young rats. Eleven, twelve and ten radioactive peaks were observed at 6, 24 and 72 h, respectively. The amount of radioactivity in retinyl palmitate and retinyl stearate increased with time and reached 24 and 4%, respectively, by 72 h. Although retinol predominated, retinyl palmitate was the major esterified form in testis. The amount of radioactivity in retinol and retinyl acetate decreased with time and increased in unidentified metabolites and retinyl esters. An insignificant amount of radioactivity was found in liver. We conclude from these results that some vitamin A is stored/accumulated in the testes as retinyl esters in order to support the process of spermatogenesis and other physiological functions and that the retinol esterifying enzyme is quite active in the testes of young rats. PMID- 3954320 TI - Changes in the protein fractions of human milk during lactation. AB - The changes in the absolute and relative contents of alpha- and kappa-caseins, lactoferrin, alpha-lactalbumin, serum albumin and lysozyme in human milk have been studied through the period of lactation. Protein fractions of 209 samples were analyzed by a discontinuous polyacrylamide gel electrophoresis method. beta- and kappa-caseins decreased from colostrum to mature milk although their relative percentages remained constant. They accounted for 12-15 and 9-13% of the total protein in human milk, respectively. Lactoferrin decreased in absolute and relative amounts with advancing lactation. This protein represented 32-19% of the human milk proteins. alpha-Lactalbumin slightly decreased from colostrum to transitional milk but there was an increase in mature milk by 16-30 days. The percentages of this protein in colostrum and mature milk were approximately 23 and 30%, respectively. Serum albumin also decreased with advancing lactation, but the differences between transitional and mature milk were not statistically significant. Lysozyme increased from colostrum to mature milk both in relative and absolute amounts. Colostrum contained about 262 micrograms/ml, and mature milk 1,246 micrograms/ml, representing 1.5 and 12.1% of total milk proteins. PMID- 3954321 TI - Blood amino acid compartmentalization during pregnancy and lactation in the rat. AB - The blood amino acid compartmentalization during pregnancy and lactation of the rat have been studied. Cellular amino acid levels are similar to those of the plasmatic fraction. Important generalized decreases are detected on days 12 and 21 of the pregnancy; Glu + Gln, Ala and essential and semiessential amino acids being the most affected. During lactation, after a transient phase on day 1 after delivery, there is a generalized increase in blood levels, especially in the plasma fraction, that affects the whole essential values. The different patterns shown by amino acids during pregnancy and lactation confirm that the measurement of plasmatic levels underestimates the actual capacity of whole blood to transport amino acids. PMID- 3954322 TI - Pattern of metastases in human breast carcinoma in relation to estrogen receptor status. AB - The distribution of metastases at the first recurrence of breast cancer was studied in 57 estrogen receptor (ER) positive and in 23 ER negative patients, who constituted a subset of 460 patients with operable breast cancer. The pattern of metastases with respect to localization of metastases and the dominant site of first recurrence was similar in patients with ER positive and ER negative tumours. The recurrence-free survival (RFS) and the overall survival were associated with the ER status in the 460 patients. ER positive patients had both a significantly longer RFS (p = 0.0024) and survival (p = 0.0001) compared to ER negative patients. Survival after recurrence was prolonged in patients with soft tissue recurrences only, and the proportion of dead patients was highest in receptor negative patients with metastases to bone and viscera. In conclusion, we could not demonstrate that ER positive and negative tumours have a propensity for recurrence at specific sites. PMID- 3954323 TI - Experimental approaches to problems of invasion and metastasis. AB - The highly metastasizing ASML cells and the non-metastasizing AS cells, arisen as spontaneous tumors of the rat, were confronted with rat lung tissue in vitro. Small cubes of the lung were allowed to heal their cut edges, then tumor cells were added. Both tumor cell types adapted their shape to the environment, penetrated the superficial layer of lung cells, either of epithelial or of fibroblastoid character and settled on the basal lamina, which, however, was not pierced. In a second set of experiments the tumor cells were inoculated intravenously into the living animal. The lung loaded with tumor cells was excised and cut into cubes which were then incubated in vitro. Here also both tumor cell types exhibited an invasive behavior but the basal lamina of the vessels in which the tumor cells have been arrested was not penetrated. These data indicate that tumor cell behavior is strongly dependent on the environment and the complete invasion or extravasation must be considered as an inducible process. PMID- 3954324 TI - Temperature-dependent surface charge modulation, membrane fluidity, and metastatic ability of L51178Y lymphoma. AB - The isoelectric characteristics of Y/ES (metastasizing) and Y/E (non metastasizing) DBA/2 lymphoma, and the effects of reducing the ambient temperature on the surface charge density of the cells have been investigated. The change in the surface charge density caused by lowering the temperature is greater in the Y/ES than in the Y/E cells. It is suggested that the protrusion of membrane proteins into the aqueous phase, the consequent expression of cell surface charge, and the temperature-dependent modulation of the latter may be related to the lateral mosaicism of membrane lipids and reflect the state of membrane fluidity. PMID- 3954325 TI - Radioimmunoassay for a novel urinary nucleoside, N6-succinyladenosine. AB - A sensitive radioimmunoassay has been developed for an unusual urinary nucleoside, N6-succinyladenosine (N6-SAR). Antibodies were raised in rabbits and the antibody specificity was established by binding inhibition radioimmunoassay of compounds with structural similarity to N6-SAR. The assay is sensitive enough to detect up to a nanomole of N6-SAR in 1 ml of urine. The mean N6-SAR urinary excretion value for normal adults was 4.09 mg/gm of creatinine with a standard deviation of 1.22. The measurement of N6-SAR in the urines of a number of subjects with metastatic malignant disease suggests that these patients excreted in their urines elevated amounts of N6-SAR in comparison to that in the urines of normal subjects. PMID- 3954326 TI - Invasive activities of metastasizing and nonmetastasizing tumor cell variants in vitro. II. Studies on confrontations with aorta, vein, ductus thoracicus, diaphragm, and lung. AB - In continuation of a previous paper (1), we have prolonged the time of confrontation of two rat tumor cell variants (BSp73 AS and ASML) with normal epithelial cells and broadened the spectrum of confrontation partners. In addition to the aorta we have also used small veins, the ductus thoracicus as a lymphatic vessel, the diaphragm, and lung fragments. The organ sections were preserved for a longer period of time by incubating them in a gyratory shaker. Under these conditions the vessel material and diaphragm remained morphologically intact for up to 12 hrs; lung cubes concealed the cut surfaces by immediate wound healing, and were preserved intact for up to 40 days. All endothelia and the mesothelium of the diaphragm were destroyed by the nonmetastasizing AS cells, but the basal lamina remained intact by morphological criteria even after 18 hrs of exposure to the AS cells. The metastasizing ASML cells attached by filopodia mostly to the basal lamina of the vessels, but were unable to destroy neither the endothelia nor the basal lamina. The superficial cell layers of the lung cubes, however, were penetrated by the cells of both tumor lines, but to a different degree. PMID- 3954327 TI - DNA grading of urothelial carcinoma of the bladder. AB - The prognostic influence of the nuclear DNA distribution pattern of human urothelial carcinomas of the bladder was investigated in 25 patients. Nuclear DNA content was measured by scanning microphotometry in Feulgen-stained histologic sections. A DNA malignancy grade (DNA-MG) ranging from 0.01 to 3 on a continuous scale was computed for each patient from the single cell DNA values. With the aid of the Cox proportional hazard regression model, DNA-MG was revealed as having a strong influence on survival time (p = 0.0004). Possible influences of other parameters (histological grade, stage, endoscopical tumor size and multiplicity, age) on survival could not be assessed in this model. This may be explained by the low number of cases and by the weakness of the influence of these parameters. Divided into two groups of patients according to their DNA-MG (group I: DNA-MG less than 1.5, group II: DNA-MG greater than or equal to 1.5), the histological grade had an influence on survival (p = 0.021). There was a good association of DNA-MG and histological grade (p = 0.05). In comparison to the histological grade DNA-MG seems to allow a more precise prognostic statement for the individual patient as it reveals additional information on survival for patients categorized according to their histological grade. We conclude that DNA-MG is an objective and scalar index for the prognosis of bladder carcinoma patients. PMID- 3954328 TI - Tumor inhibition by titanocene complexes: activity against sarcoma 180. AB - The antitumor activity of various titanocene derivatives was examined against ascitic and solid, subcutaneously growing sarcoma 180. The complexes investigated were two dihalide compounds, (C5H5)2TiCl2 (I) and (C5H5)2TiBr2 (II), two carboxylato complexes, (C5H5)2Ti (cis-OOCCH = CHCOOH)2(III) and (C5H5)2Ti(OOCCCl3)2(IV), and the p-aminothiophenolate hydrochloride (C5H5)2Ti(p SC6H4NH3+Cl-)2(V). Against ascitic sarcoma 180, best results were obtained for I; an injection of 50 mg/kg resulted in the survival of 40-50% of the animals (ILS, 161-184%). A similar result was recorded for cis-diamminedichloroplatinum(II), whereas the compounds II-IV induced a maximum cure rate of 20% (ILS, 95-139%). Against solid sarcoma 180, triple injections of I-V caused reduction of mean tumor weight to 23-53% of control values, the dichloro complex I exhibiting most pronounced activity. These results clearly underline antitumor potency for titanocene complexes (C5H5)2TiX2 modified at the acido ligand X. PMID- 3954329 TI - Genetic control of the resistance to spontaneous immunocytoma (plasmacytoma-IR tumour) development in LOU/C rats. AB - Immunocytomas (immunoglobulin secreting tumours) appear with a highly spontaneous incidence in animals of the inbred LOU/C strain but never in those of the inbred OKA strain. Congenic rats with LOU/C genetic background, having either the heavy or the kappa light immunoglobulin chain loci from the OKA strain, have an immunocytoma incidence similar to that of the LOU/C strain. The congenic strain, having the major histocompatibility complex of the OKA strain on the LOU/C background, showed no immunocytoma incidence. These results indicate that the MHC locus of the rat, or a gene closely linked to it, determines resistance to immunocytoma development. Specific chromosomal translocation associated with Ig gene chromosome and c-myc play a major role in the origin of the rat IR tumours. These experiments show that the resistance of the OKA strain to the appearance of IR tumours is not correlated with special properties of Ig heavy and kappa gene segments. PMID- 3954330 TI - DNA damage, repair, replication, and tumor incidence in the BDIV rat strain following administration of N-ethyl-N-nitrosourea. AB - Berlin-Druckrey (BD-IV) rats were used to evaluate the level of neoplastic transformation, initiation of DNA damage and repair following treatment with N ethyl-N-nitrosourea (ENU). ENU, a potent neurocarcinogen in the Sprague-Dawley (CD) and BDIX rat strains, was a less potent neurocarcinogen when administered to 30 day old BDIV rats. ENU induced significantly higher levels of tumors of the nervous system, kidney, and liver in CD rats than in BDIV rats. Initial DNA damage was determined by quantitating and comparing the number of alkaline labile sites (ALS) and alkylation of [14C]ENU to deoxyguanosine in the brain, kidney, and liver of BDIV rats. A smaller percentage of ALS were lost from the DNA of the brain (10-15%) than from the kidney (19-27%) and liver (30%). Similarly, loss of 0(6)-ethylguanine was greatest in liver (100%), next in kidney (73%), and least in brain (23%) DNA during a seven-day period. Loss of N7-ethylguanine ranged between 23-44%. These levels of repair are similar to those previously observed in the more sensitive Sprague-Dawley rat. Cellular replication was highest in the liver and lowest in the brain of BDIV rats at 30 days of age and was inhibited to varying extents in all three tissues by ENU. These data indicate, that while there is a good correlation between organ sensitivity to ENU induced carcinogenesis and the persistence of DNA lesions and levels of DNA replication in the same strain of rat, there is no correlation across strains with different carcinogenic potential. PMID- 3954331 TI - Endometrial adenomatous hyperplasia and carcinoma and multiple endocrinopathies in rats exposed to N-nitrosomethylurea. AB - Female Sprague-Dawley strain rats were given 3 i.v. injections of N nitrosomethylurea, 4 mg/100 g body weight, at 4 weekly intervals. All rats developed mammary tumors, which were then excised to prolong survival. Seven months after the first injection, 14 of 27 (52%) rats examined has adenomatous hyperplasia of the endometrium, and 6 (22%) had endometrial carcinomas. The remaining 7 animals had varying degrees of hyperplasia, some with squamous metaplasia. Endocrine pathology in these same rats included hyperplasia of the eosinophilic and basophilic cells of the hypophysis (100%), adrenocortical adenomas (81%), polycystic ovaries (70%), thyroid follicular enlargement with colloid accumulation (67%), and parathyroid hyperplasia (7%). Serum TSH levels were elevated in the rats with thyroid abnormalities. PMID- 3954332 TI - Mouse neuroblastoma cloning efficiency modulation by quiescent 3T3 cells in culture. AB - In the mixed culture system nontransformed 3T3 fibroblasts cells inhibited the plating efficiency of neuroblastoma (N2a) cells, whereas heat or methanol killed fibroblasts did not. In contrast, chloroform/methanol extracted 3T3 cells inhibited the plating efficiency of neuroblastoma cells to the same extent as had been the case with living 3T3 cells. In the present study, we discuss the possibility that nontransformed cells surface components can modify the proliferation of neuroblastoma cells. PMID- 3954333 TI - Observations on wet weight, protein and DNA as reference for steroid receptors in malignant mammary tumours. AB - Estradiol and progesterone receptors were recorded together with DNA and soluble protein per unit wet weight for 235 breast cancer samples. Receptor concentration values per wet weight showed the greatest range of variation. Receptor expressed per unit wet weight, DNA or protein showed good correlation (rs greater than 0.90). In selected cases different information on receptor concentration levels may be obtained depending on the reference parameter used. An overrepresentation was found of tumours with low receptor concentrations or receptors below the level of detection in a subgroup with a low DNA content, indicating the possibility of false low receptor values in this group. High ER and PgR contents were significantly related to high level of tissue DNA. Low or high content of protein was not associated directly with low or high receptor levels. In this respect DNA is superior to wet weight and protein as reference standards for receptor concentration. Further, DNA offers the additional possibility of a rough correction for non-epithelial components of the tumours. A critical dilution of receptors, as shown by low DNA content in some homogenates, was not apparent but cannot be excluded. PMID- 3954334 TI - Uptake enhancement of platinum in the dog kidney by microencapsulation of cisplatin and local injection. AB - Microcapsules containing cisplatin were administered into the renal artery of mongrel dogs. Significant increase of the platinum tissue concentration in the kidney was observed 17 days after administration compared to injection of cisplatin only. The highest drug tissue levels were obtained when the renal artery was ligated after microcapsule injection. In addition the decrease in plasma levels indicated that microencapsulation causes, at least, a 100-fold enhancement of the ratio: exposure of infused tissue to the drug over total body exposure. On the contrary, no major change in drug urine excretion could be related to microencapsulation. PMID- 3954335 TI - Growth arrest and polyploidization induced by metahalone microtubule inhibitors on rat glioma cells in culture. AB - Two pyrimidine analogs (metahalones) NY 3163, NY 3170 have been tested for their effects on the growth of rat glioma cells in monolayer and in spheroid culture. Both substances have earlier been found to inhibit the microtubule system in malignant cells. In glioma cells, arrest of mitosis was accompanied by repeated cycles of DNA synthesis, leading to different levels of polyploidization up to 16 and 32 ploid cells. The effect was not reversible through a culture period of 4 days. Reduced ability of directional migration of cells on a plastic surface was seen for 16 days after exposure. The reaction to microtubule inhibitors seems to differ depending on the type of tumour cells, where some malignant cells have earlier been reported to escape mitotic arrest and proceed to the next G1 phase, in contrast to the present glioma cells which undergo polyploidization. PMID- 3954336 TI - Biochemical characteristics of Edwardsiella ictaluri. AB - A total of 119 isolates of Edwardsiella ictaluri collected over the last 7 years from several states were biochemically characterized. Although not very reactive biochemically, this bacterium shows a high degree of homogeneity. Differences were found only in the production of gas from formate or from glucose at 37 degrees C and in the production of hydrogen sulfide as detected by lead acetate paper. Analysis of E. ictaluri by year of geographic area indicated that some differences existed, but no clear-cut biotypic variations were found. All isolates studied were capable of degrading chondroitin sulfate, a major component of cartilage, which may be an important virulence factor in the formation of the hole-in-the-head lesion characteristic of infected fish. PMID- 3954337 TI - Improved method for production of antibodies against T-2 toxin and diacetoxyscirpenol in rabbits. AB - A new, improved approach for the production of antibodies against T-2 toxin and diacetoxyscirpenol (DAS) was developed. The method involves the use of immunogens which were prepared by conjugating O-carboxymethoxyl oxime (CMO) derivatives of both toxins to bovine serum albumin (BSA). Isomers a and b of CMO-T-2 toxin and isomer b of CMO-DAS were tested. Antibodies against both toxins were demonstrated as early as 4 weeks after immunization. a-CMO-T-2-BSA conjugate was a better immunogen than the b isomer, and the highest titers (6,000) were reached 14 weeks after immunization and one booster injection. Antibody titers for rabbits immunized with the b isomer of CMO-T-2 never reached more than 2,000. The specificity of antibodies obtained from rabbits after immunization with CMO-T-2 BSA was similar to that of hemisuccinate-T-2-BSA. Anti-b-T-2 antibodies had slightly higher cross-reactivity with H-T-2 toxin than did the antibody obtained from rabbits immunized with the conjugate of the a isomer. The relative cross reactivities of anti-a-CMO-T-2 antibody with T-2, acetyl-T-2, H-T-2, T-2-triol, 3'-OH-T-2, and T-2 tetraol were 1, 4.5, 5.7, 250, 500, and 3,000, respectively. The relative cross-reactivities of anti-b-T-2 antibody with T-2, acetyl-T-2, H-T 2, and T-2 triol were 1, 2, 3, and 488, respectively. Antibodies against b-CMO DAS showed a high degree of cross-reactivity with monoacetoxyscirpenols (MAS). The relative cross-reactivities of anti-B-DAS antibody with DAS, 4-MAS, 15-MAS, acetyl-deoxynivalenol, T-2-toxin, acetyl-T-2, and neosolaniol were 1, 4, 5, 76, 107, 147, and 266, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954338 TI - Characteristics of methanogens isolated from bovine rumen. AB - Six strains of methanogens were isolated from 10(-8) and 10(-9) ml of bovine rumen contents. All strains had the morphologic and physiologic characteristics of Methanobrevibacter spp. Four strains required coenzyme M; two did not. Growth of all strains either depended on or was stimulated by a mixture of isobutyric, isovaleric, 2-methylbutyric, and valeric acids. None of the strains reacted with antiserum against the type strain of Methanobrevibacter ruminantium. PMID- 3954339 TI - Isolation of a rat intestinal Clostridium strain producing 5 alpha- and 5 beta bile salt 3 alpha-sulfatase activity. AB - An unnamed sporeforming microorganism, termed Clostridium sp. strain S2, possessing bile salt sulfatase activity was isolated from rat intestinal microflora. The microorganism was a strictly anaerobic, nonmotile, gram-negative, asaccharolytic, sporeforming rod requiring CO2, vitamin K, and taurine; the guanine-plus-cytosine content of the DNA was 40.8 mol% (Tm), and the strain was tentatively classified as an atypical Clostridium species. Sulfatase activity was specific for 3 alpha-sulfate esters of 5 alpha- and 5 beta-bile salts, leaving the 3 beta-, 7 alpha-, and 12 alpha-sulfates unchanged. Strain S2 also deconjugated tauro- and glyco-conjugated bile salts and partially reduced into the corresponding 6 alpha-hydroxy bile salts. By these reactions, alpha muricholate and beta-muricholate were more than 80% converted into hyocholate and omega-muricholate, respectively. In addition, strain S2 produced 12 alpha hydroxysteroid dehydrogenase converting deoxycholate into 3 alpha-hydroxy-12-oxo 5 beta-cholanoate. When strain S2 was associated with gnotobiotic rats, the fecal bile salts were more than 90% desulfated and the fecal excretion of allochenodeoxycholate was five times lower than in control rats. PMID- 3954340 TI - Adhesion of the clay minerals montmorillonite, kaolinite, and attapulgite reduces respiration of Histoplasma capsulatum. AB - The respiration of three phenotypes of Histoplasma capsulatum, the causal agent of histoplasmosis in humans, was markedly reduced by low concentrations of montmorillonite but was reduced less by even higher concentrations of kaolinite or attapulgite (palygorskite). The reduction in respiration followed a pattern that suggested saturation-type kinetics: an initial sharp reduction that occurred with low concentrations of clay (0.01 to 0.5% [wt/vol]), followed by a more gradual reduction with higher concentrations (1 to 8%). Increases in viscosity (which could impair the movement of O2) caused by the clays were not responsible for the reduction in respiration, and the clays did not interfere with the availability of nutrients. Scanning electron microscopy after extensive washing showed that the clay particles were tightly bound to the hyphae, suggesting that the clays reduced the rate of respiration of H. capsulatum by adhering to the mycelial surface and, thereby, interfered with the movement of nutrients, metabolites, and gases across the mycelial wall. PMID- 3954341 TI - Anomalies in mineralization of low concentrations of organic compounds in lake water and sewage. AB - The rates of mineralization of nitrilotriacetic acid (NTA), 2,4 dichlorophenoxyacetic acid (2,4-D), p-nitrophenol, aniline, and isopropyl N phenylcarbamate (IPC) at one or more concentrations ranging from 100 pg/ml to 1.0 microgram/ml were proportional to chemical concentrations in samples of three lakes. The rates at 100 pg of NTA, 2,4-D, p-nitrophenol, and aniline per ml in samples of one or more lakes were less than predicted, assuming the rates were linearly related to the concentration. Neither NTA nor 2,4-dichlorophenol at 2.0 ng/ml was mineralized in some lake waters, but higher levels of the two chemicals were converted to CO2 in samples of the same waters. In samples from two lakes, little or no mineralization of IPC or 2,4-D occurred at 1.0 microgram/ml, but 10 ng/ml or lower levels of the herbicides were mineralized. The mineralization in sewage of 1.0 microgram of NTA per ml was biphasic; about 20% of the substrate was mineralized in 20 h, and mineralization was only reinitiated after a period of 130 h. The biphasic transformation was not a result of the accumulation of organic products, and it was still evident if protozoan activity was inhibited. NTA also underwent a biphasic mineralization in lake waters, and the biphasic pattern was not altered by additions of growth factors and inorganic nutrients. From 40 to 60% of the carbon of aniline added to lake water at levels of 100 pg/ml to 1.0 microgram/ml was mineralized, but more than 90% of the carbon of NTA, 2,4-D, or p-nitrophenol added to lake water at 10 ng/ml or 1.0 microgram/ml was mineralized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954342 TI - Pathogenicity of a fungus resembling Wangiella dermatitidis isolated from edible mushrooms. AB - A fungus resembling the human pathogen Wangiella dermatitidis (Kano) McGinnis, a dematiaceous hyphomycete, was recovered from imported desiccated "black fungus" mushrooms (Auricularia polytrichia (Mont.) Sacc.), a food item popular in Far Eastern cuisine. Except for its conidia, which are mostly reniform to allantoid rather than ovoid as is characteristic for W. dermatitidis, and the undecided mode of conidiogenesis, the isolate closely resembles W. dermatitidis in gross and microscopic morphology, thermotolerance, and general and neurotrophic infectivity patterns in mice injected intraperitoneally. The foodborne isolate was also infective for infant mice inoculated by oral intubation. The systematic position of the isolate is still under investigation. There has been no previous report of W. dermatitidis or of a fungus resembling it occurring in or on foods or of the infectivity of a fungus for a mammalian host by oral intubation. PMID- 3954344 TI - Inactivation of Campylobacter jejuni by chlorine and monochloramine. AB - Campylobacter jejuni and closely related organisms are important bacterial causes of acute diarrheal illness in the United States. Both endemic and epidemic infections have been associated with consuming untreated or improperly treated surface water. We compared susceptibility of three C. jejuni strains and Escherichia coli ATCC 11229 with standard procedures used to disinfect water. Inactivation of bacterial preparations with 0.1 mg of chlorine and 1.0 mg of monochloramine per liter was determined at pH 6 and 8 and at 4 and 25 degrees C. Under virtually every condition tested, each of the three C. jejuni strains was more susceptible than the E. coli control strain, with greater than 99% inactivation after 15 min of contact with 1.0 mg of monochloramine per liter or 5 min of contact with 0.1 mg of free chlorine per liter. Results of experiments in which an antibiotic-containing medium was used suggest that a high proportion of the remaining cells were injured. An animal-passaged C. jejuni strain was as susceptible to chlorine disinfection as were laboratory-passaged strains. These results suggest that disinfection procedures commonly used for treatment of drinking water to remove coliform bacteria are adequate to eliminate C. jejuni and further correlate with the absence of outbreaks associated with properly treated water. PMID- 3954343 TI - Interaction of albumin and phospholipid:cholesterol liposomes in growth of Mycoplasma spp. AB - Mycoplasma spp., sterol and fatty acid auxotrophs, are conventionally grown in complex media containing high concentrations of serum. Serum supplies the required lipids, but its presence complicates studies on the metabolism and antigenicity of mycoplasmas as well as the membrane dynamics of these organisms. In the present work, fetal bovine serum was replaced with dilipidated albumin and liposomes containing high concentrations of cholesterol. The liposomes were produced from phosphatidylcholine which contained other lipid species, including phosphatidylethanolamine, phosphatidylglycerol, and cholesterol. Other liposomes containing cholesterol and one phospholipid yielded significantly less growth of Mycoplasma gallisepticum, indicating that several phospholipids are required to achieve growth levels comparable to those obtained with complex medium. The sources and concentrations of cholesterol, albumin, phosphatidylcholine, and other phospholipids and the interactions among them were important affectors of mycoplasmal growth. Optimal lipid and albumin conditions established for M. gallisepticum were then used to propagate five diverse Mycoplasma spp. to growth levels which equalled or surpassed those obtained with medium containing 17% fetal bovine serum. PMID- 3954345 TI - Methods for isolating Campylobacter jejuni from low-turbidity water. AB - Membrane filtration methods were developed and evaluated for the quantitative recovery of Campylobacter jejuni from environmental waters of low turbidity. The best procedure studied involved passaging the test water through a filter (pore size, 0.45 micron) and plating it facedown on Campylobacter-selective agar. The filter was removed after overnight incubation, and the plate was streaked for isolation and then reincubated. This method, with or without prefiltration through 5.0- and 0.6-micron-pore-size membranes consistently resulted in the recovery of 30 C. jejuni CFU/250 ml of seeded natural waters. The other methods, plating the final filter face-up or preincubation of the filter in an enrichment medium, were not as sensitive. The technique described above could be useful in the routine monitoring of finished waters for C. jejuni or during investigations of suspected waterborne outbreaks for water of low turbidity. PMID- 3954346 TI - Methods for quantitative and qualitative evaluation of vaginal microflora during menstruation. AB - The quantitative and qualitative changes in the bacterial flora of the vagina during menstruation have received inadequate study. Similarly, the effect of vaginal tampons on the microbial flora as well as the relationship between the microbial flora of the vagina and that of the tampon has not been adequately evaluated. The purposes of the present study were (i) to develop quantitative methods for studying the vaginal flora and the flora of tampons obtained during menstruation and (ii) to determine whether there were differences between the microflora of the tampon and that of the vaginal vault. Tampon and swab samples were obtained at various times from eight young healthy volunteers for 8 to 10 menstrual cycles. Samples consisted of swabs from women wearing menstrual pads compared with swab and tampon samples taken at various times during the menstrual cycle. Samples were analyzed for total facultative and anaerobic bacterial counts, and the six dominant bacterial species in each culture were identified. Statistical evaluation of the results indicates that total bacterial counts decreased during menstruation and that swab and tampon samples yielded similar total counts per unit weight of sample. The numbers of bacteria in tampons tended to be lower than in swabs taken at the same time. Overall, during menstruation, the concentrations of lactobacilli declined, but otherwise there was little difference among the species found during menstruation compared with those found in intermenstrual samples. Cotton tampons had little discernible effect on the microbial flora. PMID- 3954347 TI - Rumen microbial changes in cattle fed diets with or without salinomycin. AB - Four rumen-fistulated steers, randomly assigned to two groups (control and salinomycin fed) were used to monitor the changes in rumen microbial populations and volatile fatty acids (VFA) concentrations associated with feeding salinomycin (0.22 mg X kg-1 X day-1). Steers were adapted to an alfalfa hay and grain (80:20) diet before supplementing the diet with salinomycin, and then the diet was changed to 50:50 and 20:80 ratios of alfalfa hay to grain at 2-week intervals. Rumen samples for total and selective enumeration of anaerobic bacteria. VFA analysis, and enumeration of protozoa were collected during the 80:20 alfalfa hay to-grain diet before salinomycin feeding, and during the 80:20, 50:50, and 20:80 hay-to-grain diets with salinomycin. At each sampling period, rumen samples were collected at 3 h after feeding on three consecutive days. Salinomycin feeding had no effect on rumen pH and total VFA concentration. The acetate-to-propionate ratio was significantly lower in salinomycin-fed steers than in the control. The molar proportion of butyrate increased in both control and salinomycin-fed steers. Total anaerobic bacterial counts were lower in salinomycin-fed steers than in the control steers after 8 weeks of salinomycin feeding. Salinomycin resistant bacteria increased from 7.6 to 15.6% in salinomycin-fed steers but remained unchanged in control steers. Salinomycin had no effect on cellulolytic and lactate-utilizing bacteria, but the proportion of amylolytic bacteria was higher in salinomycin-fed steers than in control steers. The total number of protozoa decreased initially in salinomycin-fed steers. The initial reduction was due to reduced numbers of Entodinium species. Holotrichs were unaffected by salinomycin feeding. PMID- 3954348 TI - Bioluminescence for USP sterility testing of pharmaceutical suspension products. AB - Bioluminescence measurement significantly improved the accuracy, sensitivity, precision, and reliability of the current visual endpoint determination for the USP sterility test and eliminated the day 7 transfer/dilution step required for testing suspension products. Thirteen strains of bacteria and fungi (representing potential contaminants in sterile products), three pharmaceutical suspension products, and four media were used in the experiment. No interference from suspension products was encountered in the detection of microbial growth by the bioluminescence measurement. The poor fungal growth encountered was attributed to insufficient diffusion of oxygen into the medium and was circumvented by use of a large tube size (38 by 200 mm) or by vortexing the medium once during the 2-week incubation period. Bioluminescence measurement would facilitate automated handling of the sterility test endpoint readout operation. The optimum parameters of bioluminescence measurement for application in sterility testing were determined. PMID- 3954349 TI - Fusarin C production by North American isolates of Fusarium moniliforme. AB - A liquid culture medium was developed to screen North American isolates of Fusarium moniliforme Sheldon and Fusarium subglutinans (Wollenw. and Reink.) Nelson, Toussoun, and Marasas for their ability to produce fusarin C. Parameters which were important for the optimal biosynthesis of fusarin C included pH (3.0 to 4.0), aeration, and sugar concentration (30 to 40%). Of seven sugars tested, sucrose and glucose were the best carbohydrate sources for mycotoxin production, resulting in levels of fusarin C of greater than 60 ppm (greater than 60 micrograms/g) in liquid culture (28 degrees C; 7 days). A time-course study of fusarin C production was done over a 21-day period, during which time pH values, glucose concentrations, nitrogen levels, and fungal biomass were determined. Of the two Fusarium spp. studied, 13 of 16 isolates of F. moniliforme produced fusarin C in liquid medium (14 of 16 in corn), while none of the 15 isolates of F. subglutinans studied was found to produce the compound. Levels of fusarin C produced by Fusarium sp. isolates growing on corn ranged from 18.7 to 332.0 micrograms/g. PMID- 3954350 TI - Enumeration of polysaccharide-degrading Bacteroides species in human feces by using species-specific DNA probes. AB - DNA probes that are specific for each of five predominant species of human colonic Bacteroides (B. thetaiotaomicron, B. uniformis, B. distasonis, "Bacteroides group 3452-A", and B. ovatus) were used to detect and enumerate these species in fecal samples from two adult volunteers. These five species are capable of fermenting many of the complex polysaccharides that are thought to be sources of carbon and energy for bacteria in the colon. Estimates for the concentrations of some of these species in feces have not been previously available because of the difficulties in differentiating colonic Bacteroides spp. by conventional biochemical tests. Our results indicate that all the species except B. ovatus were present in high numbers (greater than 10(9)/g [dry weight]) in the feces of both volunteers. However, the concentrations of the more versatile polysaccharide-degrading species within this group of organisms (7.6 X 10(9) to 12.0 X 10(9)/g [dry weight] for B. thetaiotaomicron; 2.9 X 10(9) to 6.3 X 10(9)/g [dry weight] for "Bacteroides group 3452-A") did not differ significantly from the concentrations of less versatile polysaccharide-degrading species (1.2 X 10(10) to 2.0 X 10(10)/g [dry weight] for B. uniformis; 5.8 X 10(9) to 8.4 X 10(9)/g [dry weight] for B. distasonis). B. ovatus was not detectable by our method. Since our lower limit of detection is approximately 1 X 10(9) to 2 X 10(9)/g (dry weight) of feces, this is consistent with earlier estimates that indicated that the concentration of B. ovatus in feces is near or below this value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954351 TI - Isolation of protozoa from water associated with a legionellosis outbreak and demonstration of intracellular multiplication of Legionella pneumophila. AB - At the site of a legionellosis outbreak, amoebae and two ciliates, Tetrahymena sp. and Cyclidium sp., were isolated from cooling-tower water containing Legionella pneumophila. The Tetrahymena sp. and the amoebae repeatedly showed the ability to support intracellular multiplication of L. pneumophila. Both were isolated from cooling towers specifically implicated as the source for the spread of legionellosis. These protozoa may be reservoirs supporting the survival and multiplication of virulent legionellae in cooling-tower water. PMID- 3954352 TI - Enumeration by DNA colony hybridization of virulent Yersinia enterocolitica colonies in artificially contaminated food. AB - A genetic probe was used to identify and enumerate virulent Yersinia enterocolitica colonies in 11 artificially contaminated foods. Efficiency of enumeration, determined by autoradiography after DNA colony hybridization, ranged from 66 to 100% (average, 86%) and was influenced by the number of indigenous bacteria. The use of nitrocellulose filters and agar medium had little effect on efficiency of enumeration. PMID- 3954353 TI - Susceptibility of psychrotrophic pseudomonads of milk origin to psychrotrophic bacteriophages. AB - A total of 47 psychrotrophic pseudomonads isolated from raw milk came from Newfoundland (19 isolates), British Columbia (6 isolates), Ontario (19 isolates), and Cork, Ireland (3 isolates). The susceptibility of these was tested against 30 bacteriophages isolated from cold-storage beef. Distinct lysotypes were observed with isolates representing different geographic regions. Phages as agents in the control of bacterial populations in milk is discussed. PMID- 3954354 TI - Isolation of Campylobacter jejuni from retail mushrooms. AB - Campylobacter jejuni was isolated from 3 (1.5%) of 200 retail, polyvinyl chloride film-wrapped, fresh mushrooms. These results indicate that fresh mushrooms may indeed be a source of C. jejuni and support previously reported epidemiological data (Seattle-King County Department of Public Health, Surveillance of the Flow of Salmonella and Campylobacter in a Community, 1984) which revealed an an elevated relative risk of developing campylobacter enteritis in individuals who consume mushrooms. PMID- 3954355 TI - Isolation and properties of lung 15-hydroxyprostaglandin dehydrogenase from pregnant rabbits. AB - A NAD-dependent 15-hydroxyprostaglandin dehydrogenase (PGDH) was purified to a specific activity of over 25,000 nmol NADH formed/min/mg protein with 50 microM prostaglandin E1 as substrate from the lungs of 28-day-old pregnant rabbits. This represented a 2600-fold purification of the enzyme with a recovery of 6% of the starting enzyme activity. The lungs of pregnant rabbits were used because a 42- to 55-fold induction of the PGDH activity was observed after 20 days of gestation. The enzyme was purified by CM-cellulose, DEAE-cellulose, Sephadex G 75, octylamino-agarose, and hydroxylapatite chromatography. The enzyme could not be purified by affinity chromatography using NAD- or blue dextran-bound resins. The purified enzyme was specific for NAD and had a subunit molecular weight of 29,000. The optimal pH range for the oxidation of prostaglandin E1 was between 10.0 and 10.4 using 3-(cyclohexylamino)propanesulfonic acid as the buffer. The Km and Vmax values for prostaglandin E1 were 33 microM and 40,260 nmol/min/mg protein, respectively, while the Km and Vmax values for prostaglandin E2 were 59 microM and 43,319 nmol/min/mg protein, respectively. The Km for prostaglandin F2 alpha was four times the value for prostaglandin E1. The PGDH activity was inhibited by p-chloromercuriphenylsulfonic acid but the enzymatic activity was restored by the addition of dithiothreitol. n-Ethylmaleimide also produced a rapid decline in enzymatic activity but when NAD was included in the incubation system, no inhibition was observed. PMID- 3954356 TI - Effects of pH on tubulin-nucleotide interactions. AB - Significant GTP-independent, temperature-dependent turbidity development occurs with purified tubulin stored in the absence of unbound nucleotide, and this can be minimized with a higher reaction pH. Since microtubule assembly is optimal at lower pH values, we examined pH effects on tubulin-nucleotide interactions. While the lowest concentration of GTP required for assembly changed little, GDP was more inhibitory at higher pH values. The amounts of exogenous GTP bound to tubulin at all pH values were similar, but the amounts of exogenous GDP bound and endogenous GDP (i.e., GDP originally bound in the exchangeable site) retained by tubulin rose as reaction pH increased. Endogenous GDP was more efficiently displaced by exogenous GTP than GDP at all pH values, but displacement by GTP was 10-15% greater at pH 6 than at pH 7. Dissociation constants for GDP and GTP were about 1.0 microM at pH 6 and 0.02 microM at pH 7. A small increase in the affinity of GDP relative to that of GTP occurs at pH 7 as compared to pH 6, together with a 50-fold absolute increase in the affinity of both nucleotides for tubulin at pH 7. The time courses of microtubule assembly and GTP hydrolysis were compared at pH 6 and pH 7. At pH 6, the two reactions were simultaneous in onset and initially stoichiometric. At pH 7, although the reactions began simultaneously, hydrolysis seemed to lag substantially behind assembly. Unhydrolyzed radiolabeled GTP was not incorporated into microtubules, however, indicating that GTP hydrolysis is actually closely coupled to assembly. The apparent lag in hydrolysis probably results from a methodological artifact rather than incorporation of GTP into the microtubule with delayed hydrolysis. PMID- 3954357 TI - Human liver alkaline phosphatase, purification and partial sequencing: homology with the placental isozyme. AB - Human liver alkaline phosphatase (AP) has been purified to homogeneity. The enzyme has a molecular weight of 150,000 in its native state and consists of two identical subunits of Mr 75,000. After treatment with endoglycosidase F the molecular weight is reduced to 50,000 indicating a high degree of glycosylation. The amino-terminal sequence up to 22 residues was found to be Leu-Val-Pro-Glu-Lys Glu-Lys-Asp-Pro-Lys-Tyr-(Ala)-Arg-Asp-Gln-Ala-Gln-?- Thr-Leu-Lys-Tyr. The amino terminal portions of human and bovine liver AP are identical. The amino termini of the human liver and human placental AP isozymes have appreciable homology. Conformationally the amino termini are very similar. PMID- 3954358 TI - Action of spermine on phosphate transport in liver mitochondria. AB - Spermine, at concentrations similar to those normally present in the cytosol of liver cells, facilitates the transport of phosphate into mitochondria and thus its accumulation within the matrix space. Both mersalyl and N-ethylmaleimide (NEM) inhibit phosphate influx either in the absence or in the presence of spermine. These inhibitors also inhibit, but only partially, the efflux from mitochondria of phosphate generated within the matrix space by the hydrolysis of ATP induced by carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP) or the valinomycin-K+ system. The inhibition of phosphate efflux by both mersalyl and NEM is almost completely removed, unlike that of phosphate influx, by spermine. The possibility that spermine may induce phosphate efflux by damaging mitochondrial membranes and consequently inducing an unspecific permeability to phosphate is excluded by the full restoration of transmembrane potential once FCCP has been removed by albumin. Since spermine does not react with either thiol groups or thiol group reagents, the simplest explanation of the reported results is that the pathway of phosphate efflux is distinct from that of phosphate influx. PMID- 3954359 TI - Synthesis of 2',3'-O-(2,4,6-trinitrocyclohexadienylidine)guanosine 5' triphosphate and a study of its inhibitory properties with adenylate cyclase. AB - A fluorescent GTP analog 2',3'-O-(2,4,6-trinitrocyclohexadienylidine) guanosine 5'-triphosphate (TNP-GTP) has been prepared and some of its physical properties characterized. TNP-GTP was found to be a potent inhibitor of chick embryo heart adenylate cyclase as activated by guanyl 5'-(beta,gamma-imido)triphosphate (GppNHp), F-, and forskolin with Ki values in the 8-15 microM range. It also appeared to inhibit substantially basal adenylate cyclase in this system. TNP-GTP demonstrated an effective competition with [3H]GppNHp, binding to membranes equivalently to GppNHp and about three times better than GTP. 8-Azidoguanosine 5' triphosphate (8N3GTP) mimics GTP activation of chick embryo heart adenylate cyclase and [gamma-32P]8N3GTP is effectively photoincorporated into a 42,000- to 44,000-Mr doublet when proteins are separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. TNP-GTP effectively prevents this photoincorporation, as does GTP, at concentrations that agree with their respective apparent inhibition and activation binding constants. The data suggest that TNP-GTP could prove to be a valuable tool for studying the mechanisms of GTP regulation of adenylate cyclase and other GTP-regulated systems. PMID- 3954360 TI - Structure and assembly of the endoplasmic reticulum: biosynthesis and intracellular sorting of ERp61, ERp59, and ERp49, three protein components of murine endoplasmic reticulum. AB - Rabbit antibodies have been prepared against ERp61, ERp59, and ERp49, three protein components of rough endoplasmic reticulum (RER) purified from mineral oil induced plasmacytoma 315 (MOPC-315) tissue. Analysis of subcellular fractions of MOPC-315 tissue by an immunoprecipitation procedure demonstrated that all three endoplasmic reticulum proteins (ERps) were most enriched in the RER. Immunologically cross-reacting proteins of similar molecular weight have been detected in other eucaryotic cell lines. We have used these antibodies to study the post-translational processing and biosynthetic sorting of the three ERps in pulse-labeled MOPC-315 cells. No larger precursor forms of the ERps were detected and none of the ERps were found to possess asparagine-linked oligosaccharide moieties. We have used a sucrose gradient analysis of pulse-labeled MOPC-315 cells to study the biosynthetic sorting of ERp61, ERp59 and ERp49 and have found no evidence to suggest that these proteins ever leave the endoplasmic reticulum. In addition, all three ERps appeared to have luminally exposed domains. ERp61 and ERp59 were entirely protected by the ER membrane in the absence of detergent, while ERp49 was a transmembrane protein that also possesses a cytoplasmically exposed domain. We have used the anti-ERp antibodies to quantitate the synthesis and accumulation of the three ERps during lipopolysaccharide (LPS)-induced lymphocyte differentiation. After 48 h of culture in the presence of LPS, the synthesis of ERp49 increased sixfold relative to that in control cells. The synthesis and membrane accumulation of ERp61 and ERp59 were less affected by the LPS treatment. Thus, membranes isolated from LPS-treated cells were enriched in ERp49 relative to those isolated from control cells. PMID- 3954361 TI - Intracellular free Ca2+ and the hypercontracture of adult rat heart myocytes. AB - The Ca2+ sensitivity of a population of isolated adult rat heart myocytes has been related to the Na+ content of the cells prior to Ca2+ exposure, and the intracellular free Ca2+ as reported by quin2 fluorescence when the cells are challenged with millimolar external Ca2+. Myocytes exposed to Ca2+ during quin2 loading show a resting intracellular free Ca2+ of 150 +/- 30 nM and retain the rod cell morphology of heart cells in situ. The myocytes take up Na+ and lose K+ when incubated in the cold in the absence of Ca2+. Large numbers of these rod shaped, Na+-loaded myocytes hypercontract into grossly distorted round cell forms when exposed to physiological levels of Ca2+. The number of cells that hypercontract is proportional to the Na+ content of the cells prior to Ca2+ addition and can be directly related to the intracellular free Ca2+ concentration attained following Ca2+ addition. Fifty percent of the cells in a myocyte population hypercontract when the internal free Ca2+ concentration reported by quin2 reaches 400 nM and virtually all of the cells hypercontract when this value reaches 1 microM. The entry of Ca2+ into Na+-loaded myocytes is biphasic with one phase inhibited by Ca2+ channel blockade. This suggests that Ca2+ enters Na+ loaded myocytes by the Ca2+ channel as well as by Na+/Ca2+ exchange. PMID- 3954362 TI - Thiol-disulfide exchange by thrombospondin: evidence for a thiol and a disulfide bond protected by calcium. AB - Thrombospondin (Tsp), a protein secreted by activated platelets, forms disulfide linked complexes with thrombin [K. J. Danishefsky, R. J. Alexander and T. C. Detwiler (1984) Biochemistry 23, 4984]. Thiols and disulfide bonds of Tsp were analyzed, and a search was made for other Tsp covalent complexes. Platelets in 1 mM EDTA were activated with ionophore A23187, and the secreted proteins were analyzed by gel electrophoresis in sodium dodecyl sulfate. One millimolar dithioerythritol (DTE) decreased the electrophoretic mobility of Tsp, indicating reduction of an intrachain disulfide bond; Ca2+ prevented this effect. Electrophoresis of single-chain Tsp prepared with 50 mM DTE in either EDTA or Ca2+ also revealed a Ca2+-stabilized intrachain disulfide bond. Ca2+ prevented the retention of Tsp on an activated thiol-Sepharose column, indicating protection of a thiol by Ca2+. Incubation at 37 degrees C for 60 min resulted in complexes with apparent mass much greater than 500 kDa. Formation of complexes was prevented by N-ethylmaleimide, by a temperature less than 25 degrees C, and by Ca2+ or Mg2+. From pH 6 to 9, complexes formed better at lower pH. Two dimensional (nonreduced/reduced) electrophoresis revealed Tsp but no other constituents of the complexes. With 10 nM thrombin, complexes formed faster and included thrombin; Ca2+ only partially inhibited. The complex was very susceptible to dissociation by low concentrations (2.5 mM) of DTE. It is concluded that Tsp has a reactive thiol and an intrachain disulfide bond that are protected by Ca2+. When these groups are unprotected, there is intermolecular thiol-disulfide exchange. PMID- 3954363 TI - Comparison of the ability of phospholipids from rat liver lysosomes to reconstitute glucocerebrosidase. AB - The in situ lipid activator of rat liver glucocerebrosidase was investigated. Rat liver lysosomes were purified (42.9-fold relative to the crude homogenate) by sequential isopycnic centrifugation in sucrose and metrizamide gradients. Lipids were extracted with chloroform:methanol (2:1) and phospholipids were separated by one-dimensional thin-layer chromatography. The phospholipid content of the lysosome preparation was 0.28 mumol lipid phosphorus/mg protein. Phosphatidylcholine was present as the major nonacidic phospholipid (39.3%). Of the acidic phospholipids, phosphatidylinositol and phosphatidylserine were present in the greatest amounts (12.0 and 19.7%, respectively). The resolved phospholipids were tested separately and in the presence of a heat-stable factor from Gaucher spleen for their ability to reconstitute butanol-delipidated rat liver glucocerebrosidase activity. Alone or in the presence of the heat-stable factor, phosphatidylserine and phosphatidylinositol were the most effective activators of glucocerebrosidase. Bis(monoacylglyceryl) phosphate derived from rat liver tritosomes or rabbit lung macrophages was also effective in reconstituting beta-glucosidase activity. PMID- 3954364 TI - The role of malate in exercise-induced enhancement of mitochondrial respiration. AB - Liver mitochondria isolated from rats immediately after exercise oxidize substrates more rapidly than do mitochondria from resting animals. In both fed and fasted rats, a 1-h period of exercise resulted in increased concentrations of malate in their livers and in the mitochondria isolated therefrom. This increase occurred in both untrained and exercise-trained rats. Because mitochondrial malate is known to facilitate mitochondrial uptake of other carboxylic substrates, it seems likely that the increased mitochondrial malate is responsible for the increased rate of oxidation. Rats injected with small amounts of malate (4.6 mumol/100 g body wt) yielded liver mitochondria with increased malate concentration and increased rates of oxidation of citrate, alpha ketoglutarate, and succinate. The beta adrenergic antagonist propranolol (0.25 mg/100 g body wt) and the alpha 1 antagonist prazosin (same dose) did not abolish the effect of exercise on mitochondrial malate concentration or substrate oxidation. PMID- 3954365 TI - The role of malate in hormone-induced enhancement of mitochondrial respiration. AB - Shortly after the injection of glucagon, epinephrine, norepinephrine, vasopressin, or angiotensin II into fasted rats, mitochondria isolated from their livers contained elevated concentrations of malate and oxidized citrate, alpha ketoglutarate, and, in some cases, succinate more rapidly than mitochondria from fasted, control rats. The administration of tryptophan, lactate, or ethanol and refeeding of rats fasted 24 h result in similar elevations of mitochondrial malate concentration and oxidation of added substrates. Treatments that resulted in elevated mitochondrial malate resulted also in increased uptake of added citrate, alpha-ketoglutarate, pyruvate, and, in some cases, succinate. It is postulated that the well-documented effect of gluconeogenic hormones on mitochondrial oxidation of carboxylic substrates may be mediated by malate which not only yields oxalacetate to support the tricarboxylic acid cycle but also facilitates the transport of added substrates, and which is regenerated in the tricarboxylic acid cycle. PMID- 3954366 TI - The acidic peptide-specific type II protein kinases from the nucleus and the cytosol of porcine liver are distinct. AB - The second messenger-independent acidic peptide-specific protein kinase II (casein kinase II) from the cytosol of porcine liver has been purified to apparent homogeneity by using DEAE-cellulose, hydroxyl apatite, and phosphocellulose chromatography. The native enzyme has an apparent Mr of 150,000. After sodium dodecyl sulfate-gel electrophoresis a band of Mr = 39,000 and a slightly diffuse band of Mr = 27,000 were found indicating an alpha 2 beta 2 structure of this protein kinase. A thorough comparison with the corresponding enzyme from the nucleus was performed. The two enzymes differ in the subunit composition, as the nuclear enzyme is composed of subunits with a Mr of 95,000; they further differ in the heparin sensitivity and binding to blue dextran Sepharose. Distinct differences in their nucleotide binding sites were found upon mapping with ATP analogs, although both enzymes utilize ATP as well as GTP. On the other hand, both enzymes phosphorylate identical sites in the casein variants beta A2 and alpha S1B at comparable rates. These results demonstrate for the first time the existence of distinct nucleus and cytoplasm specific type II "casein kinases". PMID- 3954367 TI - Mechanism of interaction between cytochromes P-450 RLM5 and b5: evidence for an electrostatic mechanism involving cytochrome b5 heme propionate groups. AB - The role of cytochrome b5 heme propionate groups in the functional interactions between cytochromes P-450 RLM5 and b5 has been investigated by comparing the capacity of RLM5 to interact with both native b5 and a b5 derivative in which the native heme was replaced with ferric protoporphyrin IX dimethyl ester (DME-b5). Both forms of b5 interacted with RLM5 causing an increase in the RLM5 spin state from 28 to 68% high-spin RLM5 at saturation, as judged using uv-visible spectrophotometry. However, DME-b5 exhibited a 7-fold weaker affinity for RLM5. The apparent dissociation constant (Kd) for the interaction between RLM5 and b5 was also shown to be a strong function of ionic strength, in a manner consistent with the involvement of electrostatic attraction in complex formation. Reconstitution of b5 into an RLM5-dependent monooxygenase system stimulated the p nitroanisole demethylase rate about 25-fold and 7-ethoxycoumarin deethylase about 6-fold. DME-b5, however, produced only 30% of the stimulation of RLM5-dependent turnover of p-nitroanisole observed at equivalent concentrations of native b5 without a change in Km. With 7-ethoxycoumarin, turnover was 50% diminished. The diminished capacity of DME-b5 to stimulate RLM5-dependent substrate turnover was shown not to be due to impairment of electron flow between NADPH-cytochrome P-450 reductase and DME-b5, since the Km of reductase for DME-b5 is 2.5-fold lower, and the Vmax is actually increased, but rather to an impairment of some aspect of functional interaction between the DME-b5 and RLM5. The data show that complex formation between cytochrome P-450 and b5 involves electrostatic attraction mediated in part by cytochrome b5 heme propionate groups. PMID- 3954368 TI - Subcellular distribution and properties of acyl/alkyl dihydroxyacetone phosphate reductase in rodent livers. AB - On subcellular fractionation, the enzyme acyl/alkyl dihydroxyacetone phosphate (DHAP) reductase (EC 1.1.1.101) in guinea pig and rat liver was found to be present in both the light mitochondrial (L) and microsomal fractions. By using metrizamide density gradient centrifugation, it was shown that the alkyl DHAP reductase activity in the "L" fraction is localized mainly in peroxisomes. From the distribution of the marker enzymes it was calculated that about two-thirds of the liver reductase activity is in the peroxisomes and the rest in the microsomes. The properties of this enzyme in peroxisomes and microsomes are similar with respect to heat inactivation, pH optima, sensitivity to trypsin, and inhibition by NADP+ and acyl CoA. The enzyme activity in the peroxisomes and microsomes from mouse liver is increased to the same extent by chronically feeding the animals clofibrate, a hypolipidemic drug. The kinetic properties of this enzyme in these two different organelles are also similar. From these results it is concluded that the same enzyme is present in two different subcellular compartments of liver. PMID- 3954369 TI - Human erythrocyte hexokinases are immunologically related. AB - Human erythrocytes contain three major hexokinase isoenzymes eluted by DE-52 chromatography between hexokinase type I and type II. Cross-reactivities of these isoenzymes were studied by means of a monospecific rabbit antibody against purified human placenta hexokinase type I. It was shown that the three hexokinase isoenzymes were immunologically related, supporting the concept of a postsynthetic mechanism(s) as their origin. PMID- 3954370 TI - [Randomized controlled study of high-dose metoclopramide (2 mg/kg x 4:H) vs moderate-dose metoclopramide (1 mg/kg x 4:M) in the prevention of CDDP-induced emesis]. AB - A comparison of the antiemetic effects of (H) and (M) was carried out by randomized control study in gynecologic cancer patients receiving CDDP (35-110 mg/m2). Metoclopramide was given at a dosage of 2 mg/kg (H) or 1 mg/kg (M), intravenously, 30 minutes before and 2.5 hours, 5.0 hours, and 7.5 hours following chemotherapy. Treatment with (H) resulted in 3.3 episodes of vomiting (range 0-5) whereas the episodes of vomiting noted with (M) were 3.4 (range 1-5). In patients receiving CDDP (H) or (M) dosage of metoclopramide gives similar antiemetic protection. PMID- 3954371 TI - [A study on the direct antitumoral effect of interferon-alpha on human glioma]. AB - The direct antitumoral effect of interferon-alpha on human glioma was suggested in a study involving tissue culture, and scanning and transmission electron microscopy. Consequently, intratumoral local administration of interferon-alpha for four cases of human glioma was performed, and each survival period from the initiation of its application was seven, eight, three and two months. Slight direct antitumoral effect of interferon was observed in the findings of both CT scan and autopsy in our series, but the survival time was not as great as we had expected. One of the reasons for this was thought to be insufficient permeability of interferon-alpha into the residual infiltrating tumor tissue. Therefore, the use of systemic administration of interferon or another adjuvant therapy with local administration of interferon would be expected to produce better results. PMID- 3954372 TI - [Pharmacokinetics of adriamycin vaginal suppository in uterine cervical cancer]. AB - Vaginal suppositories of Adriamycin (ADM, 5 mg), for reducing the capacity for repair from sublethal damage of X-ray-irradiated cells, were prepared using Wipepsol S-55 as the vehicle, and were intravaginally administered to patients with advanced uterine cervical cancer, and their pharmacokinetics and clinical effects were studied. The ADM concentration in the uterine cervical cancer tissues indicated high levels (17 to 566 micrograms/g), and migration into the cardinal ligament and regional lymph nodes was noted. However, little ADM was detected in serum (0 to 0.14 micrograms/g), probably because of its molecular weight and excellent tissue absorbance, and no side effects, such as cardiotoxicity and myelosuppression due to consecutive administration were detected. Histologically, the effect obtained when administered alone was limited, administration in combination with radiotherapy being more effective. Accordingly, radiotherapy of advanced uterine cervical cancer with concomitant administration of ADM vaginal suppositories seems to bring about a more powerful antitumoral effect with fewer systemic side effects. PMID- 3954373 TI - [Phase II study of NK 171 (etoposide) on malignant lymphomas and acute leukemia. A cooperative study group on NK 171 in hematological malignancies]. AB - A Phase II clinical trial of NK 171 (Etoposide), a semisynthetic podophyllotoxin, was undertaken in 56 patients with advanced malignant lymphoma and 36 patients with acute leukemia. The dosage of NK 171 was 110-130 mg/m2 day p.o. or 80-100 mg/m2 day i.v. for 5 consecutive days. Of the 92 patients, 23.9% obtained a complete or partial remission. By tumor type, good responses were obtained in non Hodgkin's lymphoma (34%, 17/50), Hodgkin's disease (25%, 1/4), AML (21.4%, 3/14), and CML-BC (25%, 1/4). Side effects included leukopenia (78.4%), alopecia (62.0%), anorexia (40.2%), nausea (30.4%) thrombocytopenia (25.6%) and fever (16.3%). These results demonstrated NK 171 to be an effective agent against malignant lymphoma and acute myeloblastic leukemia. PMID- 3954374 TI - [Changes in renal function on response to rapid administration of cisplatinum]. AB - Seven patients with urologic carcinomas were examined for changes in renal function as a result of administration of Cisplatinum (CDDP) at a high rate of 50 or 100 mg/m2 within 5 hours, superimposing 2 liters of fluid before and after the CDDP dose, and the results were compared with the pretreatment values. Renal function tests revealed that BUN was elevated to 20 mg/dl or more in 5 but not beyond 30 mg/dl in any of the patients, that serum creatinine was elevated to 1.4 mg/dl or more in 3 cases with a maximum of 1.5 mg/dl, and that Ccr was decreased to less than 70% of the pretreatment value in 3 patients. These manifestations of imparied renal function were all transient and reversible, being mostly restored to the pretreatment values during or within 1 month after the end of CDDP treatment, and did not necessitate the discontinuation of the treatment in any patients. The above findings proved the rapid infusion of CDDP to be as safe in terms of renal function as prolonged, continued i.v. infusion of the drug, which would these fore make CDDP treatment of outpatients possible. PMID- 3954376 TI - [Pharmacokinetic studies of THP-ADM (tetrahydropyranyl adriamycin)]. AB - THP-ADM is a new antitumor agent which belongs to the anthracycline family. This agent has shown a high therapeutic index compared with the mother compound, Adriamycin, in preclinical and clinical studies. This time, a pharmacokinetic study of THP-ADM was performed and the following characteristics of this agent were clarified. Short t1/2 was noted compared with that of Adriamycin in a 3 compartment open model. Leukocyte concentration of THP-ADM was much higher than that of plasma or red blood cells. Renal excretion over 48 hours was 9% and biliary excretion over the same period was 20%. Tissue concentration revealed high THP-ADM and low Adriamycin in all tissues excluding the liver. In liver tissue, a high concentration of Adriamycin and a low concentration of THP-ADM was observed. A small amount of Adriamycin was noted in the plasma following THP-ADM administration. The Adriamycin was most likely related to the small amount of existing Adriamycin in THP-ADM or conversion of THP-ADM to Adriamycin in the liver tissue or both. Poor penetration of THP-ADM was noted into the third space. PMID- 3954375 TI - [Endoscopic administration of OK-432 in gastric cancer]. AB - This paper describes the morphological and histological changes of gastric cancer following OK-432 injection into and around the lesion under endoscopic observation. Of 10 cases of unresectable gastric cancer, 7 revealed morphological changes and 3 a significant reduction of tumor size. In one of these cases, all the tumor cells disappeared. In 7 cases of resected gastric cancer preceded preoperatively by OK-432 administration, no obvious morphological changes were observed. However, histologically, marked infiltration of inflammatory cells was observed at the site of injection, especially in the submucosal layer. In regional lymph nodes, a lymphocyte predominance pattern which may have resulted from augmentation of T-cell activity was observed in many cases. The results suggested that local OK-432 injection therapy does not have such a marked direct effect on tumor cells, but may be useful as a means of prevention against invasion into the submucosal layer and regional lymph nodes. PMID- 3954377 TI - [Distribution of 1-hexycarbamoyl-5-fluorouracil in rats and human patients, and clinical results in patients with colorectal cancer]. AB - The distribution of 1-hexylcarbamoyl-5-fluorouracil (HCFU), one of the "masked type" derivatives of 5-fluorouracil (5-FU), was studied following oral administration in rats and human patients with colorectal cancer. In rats, the highest level of 5-FU from HCFU was shown in the stomach and kidney, followed by the large intestine. After oral administration of HCFU for seven days, the level of 5-FU in tumors from patients was higher than that in tumors from patients given single administration. The clinical response of HCFU administered orally was then evaluated in patients with colorectal cancer. Out of 25 evaluable patients the overall response rate including a CR and six PRs was 28.0%. Overall survival rates for patients were 75.0% in one year, 32.0% in two years, and 13.6% in three years. From these results, it was suggested that HCFU is a useful anticancer agent for colorectal cancer. PMID- 3954378 TI - [Combination therapy of local administration of OK-432 and radiation on a murine fibrosarcoma (NFSa)--combination effect and histological examination]. AB - The combined effect of radiation with local administration of OK-432 was studied using natural fibrosarcoma (NFSa) of C3H mice that are less immunogenic and resistant to radiation (TCD 50, 83, 15 Gy). When 2KE of OK-432 was administered together with 1 X 10(6) tumor cells, tumor survival was inhibited in 7/8 (87.5%) of mice. Single local administration of OK-432 (2KE, 4KE, 8KE) showed hardly any effect on tumor survival. Combined treatment of 2KE of OK-432 and 4-Gy radiation, however, not only controlled tumor growth but also eradicated 1/5 (20%) of them, compared with single application of 45-Gy radiation. OK-432 worked most effectively when administered just before or after the application of X-rays. The optimum dose of OK-432 was studied by administering 2KE, 4KE and 8KE of the agent together with the application of 55-Gy radiation. 8KE groups showed the best eradication rate but 4KE groups showed the best cure rate. Therefore, the optimum dose was considered to be between 4KE and 8KE. With regard to histological effects, both the single radiation treatment and its combined treatment with OK 432 were most effective on the 6th day. The degree of degeneration and necrosis of tumor cells together with lymphocyte exudation were much higher in the combined treatment than in single radiation application. PMID- 3954379 TI - [Phase II study of THP (2''R)-4'-0-tetrahydropyranyladriamycin) in breast cancer]. AB - In a phase II study of THP, fifty-six patients with advanced or recurrent breast cancer were evaluated, and a response rate of 23.2% including 1.8% with complete response and 21.4% with partial response, was obtained. Response rates of THP varied according to the location of metastasis and the highest rate was shown to be 38.5% in patients with soft tissue metastasis. The median dose for inducing response was 100 mg with a range from 60 mg to 160 mg. Toxicities such as leukopenia and gastrointestinal disorders were observed during THP treatment. The favorable response to THP was close to that of adriamycin, but it was noteworthy that a lower frequency of alopecia occurred. PMID- 3954380 TI - [Intra-arterial infusion of CDDP in advanced gastrointestinal cancer (combination of general chemotherapy)]. AB - We attempted to use CDDP for patients with advanced cancers of the gastrointestinal system by intra-arterial infusion, giving consideration to the side effects of CDDP. Of 19 cases treated with CDDP, 17 cases were evaluable. These 17 cases comprised 10 cases of gastric cancer, 1 of pancreatic cancer and 6 of colon cancer. Therapeutic effects were as follows. According to the criteria for judgement of solid cancers, there were 10 evaluable cases which comprised 1 case of PR, 2 of MR, 4 of NC and 3 of PD. According to the criteria for judgement of malignant ascites, there were 6 evaluable cases which comprised 4 effective and 2 non-effective cases. As to side effects, nausea and vomiting were observed in 10 cases, numbness in 1, fever in 1 and aggravation of diabetes in 2. From the above results, intra-arterial infusion of CDDP is considered to be an effective method for the treatment of advanced cancers of the gastrointestinal system, especially of malignant ascites. PMID- 3954381 TI - [Clinical evaluation of adriamycin ointment in advanced or local recurrent breast cancer]. AB - For the purpose of local therapy for advanced and recurrent breast cancer, we have applied a new Adriamycin (ADR) ointment. This new ADR ointment has been prepared by the technique of a two-factor composite experimental design and includes PEG: 25%, CVP: 0.65%, HPC: 1.35% and ADR: 0.04%. We have applied it to three patients with advanced breast cancer and six patients with locally recurrent breast cancer. By using this ointment, the skin ulcers have become dry, bleeding has stopped and the sense of heat has been lost. In some cases, the neoplastic ulcers have diminished in size. Some problems with this ointment are easy bleeding at the time of removing the gauze and an unstable effect in diminishing the size of the neoplasm. We therefore think that the use of this ointment alone is very effective for controlling the symptoms of the local lesion, but not so effective for diminishing the size of the neoplasm. PMID- 3954382 TI - [TNF induction in the serum and ascites of a gastric cancer patient treated with OK-432]. AB - A 73-year-old female was diagnosed as having gastric cancer (undifferentiated adenocarcinoma), and received gastrojejunal anastomosis as an initial treatment. One year after the operation, she was readmitted to our hospital with the complaint of fullness in her stomach. Physical examination revealed a palpable mass in the epigastric region and ascites. An attempt to induce endogenous TNF was made using OK-432. Four doses of OK-432 (10 KE) were administered intraperitoneally every other day. Seven days after the last administration of OK 432 (10 KE), OK-432 (50 KE) was given at the same site to induce TNF. At 1.5h after the injection of OK-432 (50 KE), 20.8 U/ml and 8.1 U/ml of TNF activity could be detected respectively in the serum and ascites. This is the first report describing the induction of TNF in a cancer patient. PMID- 3954383 TI - [Effects of cis-DDP in children with refractory malignant tumors]. AB - Eighteen children with refractory malignant tumors were treated with cis-DDP. They included 10 neuroblastomas, 2 rhabdomyosarcomas, and one each of hepatoblastoma, yolk sac tumor, osteosarcoma and pinealoma. Of 7 cases treated only with cis-DDP, 2 were NC, 6 PD and none were CR or PR. Of 11 cases treated with cis-DDP combined with other agents, 7 were PR, 2 NC, 2 PD and none were CR. The major side effect of cis-DDP was renal toxicity, but this was not serious and only transient. Three cases were treated with the continuous intra-arterial infusion method. These included 2 neuroblastomas and one yolk sac tumor. This treatment was therefore highly effective for children with malignant tumors, and few side effects were observed. PMID- 3954384 TI - [BAEPs of children with malignant tumor undergoing cisplatin treatment]. AB - The effect of cisplatin on the auditory nervous system was examined in five children using brainstem auditory evoked potentials (BAEPs). The cases comprized of two neuroblastoma, one yolk sac tumor one neurofibrosarcoma and one Hodgkin's disease. All patients except for one infant aged eight months showed a normal audiogram in the pre-treatment examination. Cisplatin was administered at a dose of 75-105 mg/m2 (body surface area). BAEP tests were performed after cisplatin treatment from two weeks to 20 months. The patients were tested at rest in bed using stimulation with a 3 KHz, 80-dBHL click at 150-msec intervals 2,000 times. Four cases showed an abnormal BAEP pattern in the post-treatment examination. Two of them showed not only delayed conduction velocity of the first wave but also auditory disturbance, but these findings were improved after discontinuation of drug administration. We concluded that cisplatin frequently affects the auditory nervous system, and that this disturbance might be transient in the early stage. PMID- 3954385 TI - [Criteria for the determination of the efficacy of solid cancer chemotherapy]. PMID- 3954386 TI - Adequate follow-up for treated basal cell carcinoma. PMID- 3954387 TI - Autofluorescence emission spectra of dermal lipofuscinosis associated with amiodarone therapy. PMID- 3954388 TI - Angiokeratoma circumscriptum following damage to underlying vasculature. PMID- 3954389 TI - Linear IgA bullous dermatosis clinically simulating pemphigus vulgaris. PMID- 3954390 TI - Woronoff ring during anthralin therapy for psoriasis. PMID- 3954391 TI - Sclerosing carcinomas of sweat ducts (microcystic adnexal carcinoma). PMID- 3954392 TI - Intralesional recombinant alpha-2 interferon for the treatment of patients with condyloma acuminatum or verruca plantaris. AB - We conducted a multicenter double-blind study comparing human recombinant intralesional alpha-2 interferon (IFN) and placebo in 237 patients with the clinical diagnosis of condyloma acuminatum or verruca plantaris. A single wart on each patient was injected with 0.1 mL containing 10(6) IU of IFN, 10(5) IU of IFN, or placebo three times weekly for three weeks, and the response to treatment was followed up for 12 weeks. Among 91 of the 114 patients with condyloma acuminatum who completed the study, complete clearing of the treated wart occurred in 16 (53%) of 30 patients receiving 10(6) IU of IFN compared with six (19%) of 32 receiving 10(5) IU of IFN and four (14%) of 29 receiving placebo. In the group of 100 patients with plantar warts, there was no apparent benefit associated with interferon administration. Seven patients (3%) had treatment discontinued due to adverse reactions. Intralesional alpha-2 IFN is of benefit in the treatment of a single condyloma; its role in the treatment of multiple lesions remains to be clarified. Its role in the treatment of verruca plantaris, where no response was seen, also remains to be clarified. PMID- 3954393 TI - Structural and functional properties of the dermoepidermal junction in obligate heterozygotes for recessive forms of epidermolysis bullosa. AB - To determine whether heterozygotes for the severe recessive forms of epidermolysis bullosa (EB) partially express characteristic structural or functional abnormalities of the dermoepidermal junction, and thereby allow detection of the carrier state, a controlled morphometric analysis of the junction and the measurement of suction blister times were undertaken in obligate heterozygotes for junctional EB and generalized-recessive dystrophic EB. Skin from generalized recessive dystrophic EB carriers had significantly reduced numbers of anchoring fibrils, and suction blisters showed a tendency to form more rapidly in junctional EB carriers. However, neither of these abnormalities is sufficiently large or consistent to enable the reliable identification of the respective heterozygote state. PMID- 3954394 TI - Microcystic adnexal carcinoma. Report of a case with 30-year follow-up. AB - Microcystic adnexal carcinoma is a recently described neoplasm characterized by a locally aggressive growth pattern. The tumor usually affects the upper lip of middle-aged women, but occurs in other facial areas and in men. Histologically, a distinctive combination of keratin-filled cysts, islands and strands of basaloid and squamous cells, and ducts and glandlike structures is seen. A dense, hyalinized stroma is also a feature as well as frequent perineural invasion by tumor cells. While microcystic adnexal carcinoma is deeply infiltrating in its growth, metastasis has not been reported. However, recurrences with extensive local tumor spread are often observed. We describe a middle-aged man who initially had a lesion of microcystic adnexal carcinoma excised 30 years prior to definitive treatment for a recurrence at the original site. To our knowledge, this is the longest follow-up of a patient with microcystic adnexal carcinoma and confirms its locally infiltrating, indolent biologic behavior. PMID- 3954395 TI - Cutaneous lesions of lymphomatoid granulomatosis. AB - Lymphomatoid granulomatosis is a rare multisystem disease involving the lungs, skin, and nervous system. The cutaneous disease may be the presenting complaint. A case with nodular and annular infiltrated lesions is reported to encourage the inclusion of lymphomatoid granulomatosis in the differential diagnosis of similar lesions. Prompt diagnosis and early long-term treatment with cyclophosphamide and prednisone can lead to prolonged remissions of this disease. If relapse occurs, prompt treatment with the same regimen may again induce a remission. PMID- 3954397 TI - Nodules on the hand of an American agronomist returning from Saudi Arabia. Acute cutaneous leishmaniasis. PMID- 3954396 TI - Generalized atrophic sarcoidosis with ulcerations. AB - A 53-year-old man presented to the Manhattan (NY) Veterans Administration Hospital with a 20-year history of generalized atrophic lesions associated with lower extremity ulcerations. Cutaneous biopsy specimens and other laboratory data confirmed the diagnosis of sarcoidosis involving the skin, lungs, eyes, joints, bones, pituitary gland, gonads, and liver. To our knowledge, generalized atrophic sarcoidal lesions have not been described previously in the English literature. Ulcerated cutaneous sarcoidal lesions, though recognized, are only rarely seen in the disease. The ulcerations, but not the atrophic lesions, responded to prednisone therapy. PMID- 3954398 TI - Pain, pruritus, and swelling localized to two toes. Tungiasis. PMID- 3954399 TI - Facial erythema and edema in a diabetic man. Mucormycosis. PMID- 3954400 TI - Pediculicides and ovicides. PMID- 3954401 TI - Spectrum of Becker's melanosis changes is greater than believed. PMID- 3954402 TI - Benign summer light eruption: a new entity? PMID- 3954403 TI - Successful treatment of generalized discoid skin lesions with azathioprine. PMID- 3954404 TI - Leopard vitiligo. PMID- 3954405 TI - Congenital malalignment of great toenails in two sets of monozygotic twins. PMID- 3954406 TI - Pentoxifylline (Trental) therapy for the vasculitis of atrophie blanche. PMID- 3954407 TI - Basic diphenoxylate therapy. PMID- 3954408 TI - Porphyria, pseudoporphyria, pseudopseudoporphyria...? PMID- 3954409 TI - American dermatology training programs and the foreign medical graduate from less advantaged geographical areas. PMID- 3954410 TI - The bone marrow in urticaria pigmentosa and systemic mastocytosis. Cell composition and mast cell density in relation to urinary excretion of tele methylimidazoleacetic acid. AB - The bone marrow sections from five normal subjects and 18 patients with mastocytosis were examined to establish criteria to distinguish urticaria pigmentosa from systemic mastocytosis. Nine patients had increased numbers of mast cells in bone marrow sections stained with a long toluidine blue staining technique specific for mast cells, whereas five patients exhibited increased numbers of mast cells on May-Grunwald-Giemsa-stained smears of bone marrow. A positive correlation between the number of mast cells in sections of the bone marrow and the urinary excretion of the main histamine metabolite tele methylimidazoleacetic acid was found. In ten of the examined bone marrow specimens, focal lesions containing mast cells, lymphocytes, and eosinophils appeared. The presence of these focal lesions together with either an increased number of mast cells in bone marrow sections and/or increased urinary excretion of telemethylimidazoleacetic acid is considered diagnostic of systemic mastocytosis. No patient exhibited myeloproliferative condition or other major hematologic abnormality. PMID- 3954411 TI - Report of a family with an unusual expression of recessive ichthyosis. Review of 42 cases. AB - A family with a history of ichthyosis is described in which the type of scale was thin and fine, resembling that of ichthyosis vulgaris, but the inheritance is of the autosomal recessive type. We have reviewed our previous experience with 42 additional patients whose condition had been diagnosed as recessively inherited ichthyosis and conclude that there is considerable heterogeneity in the cutaneous manifestations. We suggest that it is not possible to classify all patients into categories such as lamellar ichthyosis or congenital ichthyosiform erythroderma, and it may be better to use a more general term such as recessive ichthyosis until specific causes can be established. PMID- 3954412 TI - Naproxen-induced pseudoporphyria. A clinical and ultrastructural study. AB - Pseudoporphyria is a condition clinically and ultrastructurally identical to porphyria cutanea tarda but with no associated abnormality of heme synthesis. A 45-year-old woman with bullae on the dorsa of her hands was found on investigation to have pseudoporphyria. Her symptoms remitted following the cessation of naproxen therapy. PMID- 3954413 TI - Acquired macular pigmentation. Macular amyloidosis. PMID- 3954414 TI - Postproctoscopic periorbital purpura. Primary systemic amyloidosis. PMID- 3954415 TI - Bacterial infection and atopic eczema. AB - One hundred and ninety children with atopic eczema were studied prospectively for two and a half years. The mean period of observation was 13 months. Seventy six children (40%) had between them 164 episodes of exacerbation of eczema due to bacterial infection, and in 52 (32%) infection recurred within three months of a previous infection. Twenty five episodes (15%) led to admission to hospital. Staphylococcus aureus was recovered in 97% of episodes, in combination with beta haemolytic streptococci in 62%. Physical signs suggesting infection were pustules, crusting, and a weeping discharge, but these signs alone are not diagnostic, and an exacerbation was only attributed to infection if there was a response to anti-infective treatment. Exacerbation of atopic eczema due to bacterial infection is common, the physical signs of infection are not always clear, and there is a case for a trial of oral antibiotics in any child with troublesome atopic eczema. PMID- 3954417 TI - Chemoprophylaxis of meningitis. PMID- 3954416 TI - C reactive protein in the evaluation of febrile illness. AB - We studied prospectively 154 febrile children to determine the diagnostic value of the quantitative serum C reactive protein concentrations (CRP). Children with acute otitis media, acute tonsillitis, or treated with antibiotics during the two previous weeks and infants less than 2 months of age were excluded. Ninety seven children were from private paediatric practice and 57 were patients who had been admitted to hospital. The comparison group consisted of 75 children with confirmed bacterial infections whose CRP values were recorded retrospectively. In the study group 35 (23%) children had a confirmed viral infection, 92 (59%) had a probable viral infection as judged from the clinical picture and outcome of the illness, and 27 (18%) had a bacterial or probable bacterial infection. When the duration of the disease was more than 12 hours and the CRP value less than 20 mg/l, all children had a confirmed or probable viral infection. Nine children (one from the study group and eight from the comparison group) were found to have a septic infection and a CRP value of 20 mg/l or less. In all these cases, however, the duration of the symptoms was less than 12 hours. In addition CRP less than or equal to 20 mg/l was found in five (14%) children with urinary tract infection in the comparison group. CRP values of 20-40 mg/l were recorded in children with both viral and bacterial infections. A CRP value greater than or equal to 40 mg/l detected 79% of bacterial infections with 90% specificity. Our data show that determination of serum CRP concentrations is a valuable tool in evaluating children who have been ill for more than 12 hours. PMID- 3954418 TI - When does secretory otitis media affect language development? AB - Secretory otitis media is a very common disorder in early childhood, but its effects on language development are still uncertain. We describe 10 children with secretory otitis media and illustrate the wide range of disability attributable to this. It is suggested that the impact of secretory otitis media on language development depends on at least five factors: age of onset, duration of the episode(s), severity of the hearing loss, intrinsic qualities in the child, and the linguistic environment. The implications of this hypothesis for clinical practice and research are discussed. PMID- 3954419 TI - Deaths from asthma in New Zealand. AB - We report the first complete population based study of childhood deaths due to asthma. All deaths ascribed to asthma in New Zealand children aged 0-14 were investigated as part of a two year national study of mortality from asthma. The 16 children who died from asthma all developed asthma by the age of 4; 15 had a family history of asthma, and 12 had associated atopic disorders. Disturbed pyschosocial relationships were evident in eight families. Seven children died in less than three hours from the onset of their final attack. All children died outside hospital. Mortality from asthma in Maori children (3.14 per 100 000) was five times that of European children. With hindsight, factors which if avoided could have led to a different outcome were identified in eleven cases. The circumstances surrounding these deaths were similar to those described for adults with asthma; this study, however, underlines the importance of parental care and knowledge in the management of children with asthma. Inadequate long term medical care, underassessment of severity by family and doctors, failure of the family to call for help when required, and inadequate responses of medical services contributed to the fatalities. Excess beta2 sympathomimetic dosage or overreliance on home nebulisers were uncommon. Most childhood deaths from asthma should be prevented by increased family awareness, better assessment of severity, improved long term treatment, and rapid access to emergency medical care. PMID- 3954420 TI - The nutritional cost of measles in Africa. AB - A 24 hour energy balance study was carried out on 20 black Kenyan children with acute measles and repeated after recovery. The energy content of a weighed 24 hour food intake and of a simultaneous collection of faeces and urine was determined by bomb calorimetry. Energy expenditure was measured by indirect calorimetry using a purpose built flow over calorimeter. The nutritional state of the children was assessed by anthropometry at the time of each study and during convalescence. The results showed a fall of roughly 75% in the intake of gross and metabolisable energy during measles, while the resting energy expenditure was little affected. Thus the severe degree of negative apparent energy balance observed during measles is the combined effect of underfeeding in ill children, and failure, during starvation related to infection, of the early fall in metabolic rate that characterises simple underfeeding. PMID- 3954421 TI - Plasma fibronectin concentrations in mucocutaneous lymph node syndrome. AB - Plasma fibronectin concentrations were measured in 41 patients suffering from mucocutaneous lymph node syndrome (MCLS, Kawasaki disease). Plasma fibronectin concentrations were decreased significantly in the early days of the disease, but increased gradually and reached significantly high concentrations by the fourth week of the disease. In nine of the 41 patients, coronary involvement was found by echocardiographic examination. These patients showed significantly lower plasma fibronectin concentrations in the first and second weeks of the disease than those without coronary involvement. As the underlying pathology of MCLS is known to be vasculitis, the lower plasma fibronectin concentrations might be partly the result of injury inflicted upon the endothelial cells, which are thought to be the major site of synthesis of circulating plasma fibronectin concentrations. PMID- 3954422 TI - Intussusception--current trends in management. AB - Barium enema reductions were attempted in 65 (90%) of 72 intussusceptions, of which 51 (79%) were successful. This represents a success rate of 70% overall. The average hospital stay was 3 1/2 days. There was no mortality and, apart from a recurrence rate of 10%, no morbidity. It is suggested that barium enema reduction should be the treatment of choice provided that there is an emergency service of a paediatric radiologist and the patient is adequately resuscitated, the only absolute contraindication being evidence of pneumatosis intestinalis or peritonitis. Those patients who presented with shock, rectal bleeding, duration of symptoms longer than 48 hours, and pronounced degree of bowel obstruction had a higher rate of unsuccessful reduction. However, only the last two were significant. Further, provided that the clinical condition remains satisfactory and the reduction has been achieved to the caecum a repeat barium enema after some hours may be successful in achieving reflux of contrast into the ileum, confirming complete reduction. PMID- 3954423 TI - Neonatal respiratory distress due to mumps. AB - We report an infant of 35 weeks' gestation who developed severe respiratory distress and pneumonitis due to perinatal mumps virus infection. PMID- 3954424 TI - Suction biopsy in Hirschsprung's disease. AB - Seventy two children with symptoms and signs consistent with Hirschsprung's disease had full thickness and suction rectal biopsies performed. Results were identical with both methods, except for one case of total aganglionosis of the colon. Full thickness biopsy no longer has a place as a screening method. PMID- 3954425 TI - Acquired toxoplasma encephalitis. AB - Toxoplasma was the cause of encephalitis in a 4 year old boy. He recovered completely after treatment with pyrimethamine and sulphadimidine. Toxoplasma encephalitis has a high mortality, and active treatment is recommended. PMID- 3954426 TI - Immunoglobulin for neonatal agranulocytosis. AB - An infant with an alloimmune agranulocytosis whose granulocyte count temporarily returned to normal during intravenous, high dosage immunoglobulin treatment is described. PMID- 3954427 TI - Reversible inhibition of central precocious puberty with a long acting GnRH analogue. PMID- 3954428 TI - Insufficient early weight gain in preterm babies and influence on weight at 12 months. PMID- 3954429 TI - Impact of neonatal care--South West Thames region (less than 1000 grams) PMID- 3954430 TI - Food related asthma: a difference between two ethnic groups. PMID- 3954431 TI - Risk and pertussis vaccine. PMID- 3954432 TI - Inguinal hernias are common in preterm infants. PMID- 3954433 TI - Haemophilia, blood transfusion, and the AIDS virus. PMID- 3954434 TI - Open or closed incubators. PMID- 3954435 TI - When are we diagnosing growth hormone deficiency? AB - The height and age at presentation of 458 children beginning treatment with growth hormone between January 1980 and June 1984 were retrospectively analysed. Three hundred and nine children with isolated growth hormone deficiency had a mean (SD) age of 10 (4.1) years on beginning treatment and a mean (SD) height standard deviation score (SDS) of -3.73 (0.93). One hundred and nine patients with hypothalamopituitary tumours began treatment with growth hormone on average 3.3 years after diagnosis of the tumour and at a mean (SD) height SDS of -2.42 (1.49). In both of these categories the height SDS showed a considerable improvement compared with previous reports. Forty two patients with growth hormone deficiency secondary to cranial irradiation started treatment with growth hormone on average 6.1 years after treatment for their tumours and had a height SDS of -2.45 (1.02) compared with that of -2.45 (0.98) seen in nine similar patients from the United Kingdom starting treatment with growth hormone between 1975 and 1978. Although closer surveillance of short children in the community is leading to earlier diagnosis of growth hormone deficiency, this could possibly be diagnosed earlier if routine screening of height was to be carried out at school entry. In addition, patients who have received cranial irradiation should be regularly measured and investigated when their height velocity becomes subnormal. PMID- 3954436 TI - Serum fructosamine and glycated haemoglobin measurements in diabetic control. AB - Serum fructosamine and glycated haemoglobin (HbA1) were measured in capillary samples from diabetic children and compared with samples from non-diabetic children. Glycaemic control was assessed clinically and by average daily glucose values recorded by home monitoring. Fructosamine correlated with HbA1 and with average glucose values measured over 30 days. HbA1 also correlated with average glucose values measured over 60 days. Changes in fructosamine with time tended to parallel those of HbA1, and advance indication of deteriorating or improving glycaemic control was possible by observing changes in these. Fructosamine has many advantages over HbA1 measurement such as speed, technical ease, and low cost, and is a reliable alternative to HbA1 estimation as an indication of glycaemic control. PMID- 3954437 TI - Metabolic rhythms in adolescents with diabetes. AB - Metabolic rhythms were studied over 24 hours in eight adolescents with insulin dependent diabetes before and two months after attempting to improve diabetic control with home blood glucose monitoring. A significant improvement in blood glucose concentration was observed, although 24 hour mean concentrations remained grossly abnormal. This improvement was accompanied by significant falls in blood glycerol and total ketone bodies concentrations and a significant rise in blood lactate concentration. Without attention to other factors affecting diabetic control, the introduction of home blood glucose monitoring produces only a small improvement in control. PMID- 3954438 TI - Neurological aspects of biopterin metabolism. AB - Plasma total biopterin concentration was measured by bioassay in 59 infants with hyperphenylalaninaemia and in 50 children with developmental regression and or movement disorder with normal plasma phenylalanine concentrations. In infants with raised phenylalanine concentrations plasma biopterin concentrations were significantly raised in proportion to the phenylalanine values. Five patients had plasma biopterin concentrations at the extremes of the range, and of these two had defective biopterin metabolism. One with low plasma biopterin concentration apparently had a partial defect of biopterin synthesis but died before investigations were complete. One with high plasma biopterin concentration, even when phenylalanine concentrations had fallen to the normal range, had dihydropteridine reductase deficiency. In this patient concentrations of homovanillic acid and 5-hydroxyindolacetic acid in the cerebrospinal fluid (CSF) were severely reduced. In children without hyperphenylalaninaemia plasma biopterin concentrations were normal. Twenty two patients were subjected to lumbar puncture, of whom six with developmental regression without movement disorder had normal CSF biopterin concentrations, and 11 with movement disorder other than torsion dystonia had significantly lower CSF biopterin concentrations. Five patients with torsion dystonia had normal biopterin concentrations. PMID- 3954439 TI - Evolution of neonatal intensive care in a district general hospital. AB - Before 1975 in Blackburn in the Premature Baby Unit monitoring facilities were limited. Ambient oxygen monitoring, blood gas analysis, and ventilation were not being performed. Gradually, special care was introduced and from 1978-80 all babies requiring intensive care and long term ventilatory care were transferred to the Regional Neonatal Intensive Care Unit. Not all babies with incipient or established respiratory failure, however, could be accepted, and those declined had unfavourable outcomes. In 1981 local intensive and ventilatory care was begun, and since then the survival of all babies has improved considerably. Our early neonatal mortality and neonatal mortality have fallen below the regional levels. In a district general hospital it is possible to achieve survival figures comparable with those of a regional centre. PMID- 3954440 TI - The sodium and potassium intake of 3 to 5 year olds. AB - The sodium intake of preschool children in their home environment was investigated and the major sources of sodium other than added table salt identified. Thirty five children from a Southampton general practice were studied. Twenty four hour urinary sodium excretion was measured as a reliable indicator of daily total sodium intake. The daily intake of sodium other than that from added table salt, and of potassium and other nutrients, was also calculated from three day dietary diaries collected using the household measures method. Median excretion of sodium was 62 mmol/24h (range 28-105, 28 urine collections) and of potassium was 25 mmol/24 h (range 14-46). The sodium:potassium ratio was 2.7 (1.4-5.2). From the diaries, the average daily intake of sodium was 68 mmol (32-98) and of potassium was 47 mmol (24-95), and the sodium:potassium ratio was 1.4 (0.5-2.7) (median and ranges, 35 children). Foods contributing more than 30 mmol sodium to one day's intake were mainly processed convenience foods. PMID- 3954441 TI - Mild typhoid fever. AB - A series of 100 Zimbabwean children aged between 5 months and 13 years with culture positive typhoid fever is presented. The disease was found to be fairly mild with a low prevalence of complications, and no patient in the series died. Possible explanations for the relative mildness of typhoid in this paediatric population are discussed. PMID- 3954442 TI - Effects of posture and spinal bracing on respiratory function in neuromuscular disease. AB - Effects of posture and spinal bracing on lung function were studied in 40 children with neuromuscular disease, 20 of whom had scoliosis and were non ambulant. Change from sitting to supine position had little effect on lung function in ambulant children, but caused a significant 12% reduction in forced vital capacity in a group of 16 non-ambulant children with scoliosis, suggesting diaphragmatic weakness in some. Spinal bracing, using a rigid supporting jacket, resulted in a significant reduction in mean vital capacity of 22%. The degree of impairment in forced vital capacity was proportional to the severity of the scoliosis (as measured by the Cobb's angle), to the amount of correction achieved by the brace, and to the degree of diaphragmatic weakness. Spinal bracing in a child with established severe scoliosis causes appreciable respiratory impairment, and this may explain why it is less likely to be tolerated than early prophylactic bracing. PMID- 3954443 TI - Plasma concentrations of clonazepam after single rectal administration. AB - Clonazepam was administered rectally to six children aged 1.4 to 4.7 years in a dose of 0.05 mg/kg and to five children aged 1.4 to 4.1 years in a dose of 0.1 mg/kg. Plasma concentrations indicate that it is rapidly absorbed, and it may therefore be an alternative to rectal administration of diazepam in continuing convulsions. PMID- 3954444 TI - Congenital hypothyroidism missed on screening. AB - Three patients with congenital hypothyroidism missed on routine screening due to normal low thyrotrophin concentrations in the neonatal period presented in later childhood. Clinicians should remain aware of hypothyroidism as a cause of morbidity in early childhood despite a national screening programme. PMID- 3954445 TI - Biliary scintigraphy with DISIDA. A simpler way of showing bile duct patency in suspected biliary atresia. AB - 99mTC-diisopropyl iminodiacetic acid (DISIDA) scintigraphy after oral phenobarbitone treatment accurately indicated bile duct patency or obstruction in 28 of 32 (87%) infants, aged less than 12 weeks, with suspected biliary atresia. This investigation is more rapid than and as accurate as the 131I Rose-Bengal faecal excretion test. PMID- 3954446 TI - Splenunculectomy in thrombocytopenic purpura. AB - In six patients with thrombocytopenic purpura not cured by splenectomy platelets fell to less than 150 X 10(9)/l within six weeks of splenectomy. They 'failed to respond'. Two underwent splenunculectomy without improvement. Splenuculectomy offered little chance of improvement to published cases who failed to respond but may well be helpful after true relapse. PMID- 3954447 TI - Child health in Nigeria: past, present, and future. PMID- 3954448 TI - Immunoprophylaxis of infants born to hepatitis B virus exposed mothers. PMID- 3954449 TI - Pregnancy and delivery after cone biopsy of the cervix. AB - Seventy-seven women had 98 pregnancies after a cone biopsy of the cervix. There were 62 deliveries, 26 legal abortions, 9 spontaneous abortions and 1 ectopic pregnancy. Cervical cerclage was done for 22 out of 62 conized parturients (35.4%) and for none in the matched control group. There were 4 (6.4%) preterm deliveries in the cone biopsy group and 1 in the control group. The perinatal mortalities were 3.2% and 0% respectively. The mean duration of labour was 2.4 h shorter in the conized parturients than in the controls (P less than 0.05) but there were no difference in the mode of delivery in the two groups. PMID- 3954450 TI - Effects of alloxan-induced diabetes mellitus on the metabolism of the rat placenta. AB - Biochemical changes in the placenta were studied using alloxan-induced diabetes mellitus in the female rat. In comparison with a control group (n = 13) the placentas of the diabetic animals (n = 12) had significantly higher glucose, glycogen and protein levels. It was, however, shown that this supply of substrate was inadequately utilised for energy, as ATP/ADP quotient was lower and the ADP content was significantly higher. Metabolism still appeared to take place under aerobic conditions, as evidenced by the unchanged lactate levels. In terms of the protein content of the placentas, the activity of the enzymes we investigated (GOT, GPT, LDH, G-6-PDH, MDH, ICDH) was lowered by 25-44%. These results support the idea of global placental insufficiency in diabetics. PMID- 3954451 TI - Psychological profile of women with chronic pelvic pain. AB - Using the Middlesex Hospital Questionnaire (MHQ) and the Zung Self-Rating Depression Scale (SDS) psychological distress was measured in 30 women who underwent laparoscopy for chronic pelvic pain and in 30 matched controls. Both organic pelvic pain patients (OPPs) and idiopathic pelvic pain patients (IPPs) reported higher scores for somatisation than controls. IPPs scored higher than OPPs and controls on the Zung SDS, while no difference emerged in this scale between OPPs and controls. No correlations were found between age or duration of symptoms and somatisation and depression scores. On the basis of the above reported results the authors suggest that some forms of idiopathic chronic pelvic pain might represent an expression of a depressive disorder. PMID- 3954452 TI - Ruptured adenomyotic cyst of the uterus--a case report. AB - The clinical and pathological features of an apparently unique case of an adenomyotic cyst of the uterus are reported. The cyst was located within the subserosal myometrium of a 39-year-old woman. Prior to hysterectomy, it had ruptured with bleeding into the peritoneal cavity. The differential diagnosis of myometrial cysts is briefly discussed. PMID- 3954453 TI - Occlusive disease of the internal carotid arteries with vascular collaterals (moyamoya disease) in pregnancy. AB - A 29 year-old pregnant woman with occlusive disease of the internal carotid arteries and formation of collateral networks (moyamoya disease) is reported. Because of moyamoya disease and toxemia of pregnancy, cesarean section was performed at the 38th week of pregnancy. The patient had a second intracranial hemorrhage 7 months after cesarean section. Encephalo-duro-arterio synangiosis (EDAS) was performed for the prevention of further intracranial hemorrhage and at present she is well. Since intracranial hemorrhage is sometimes associated with bearing down and since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, elective cesarean section may be recommended for pregnant women with moyamoya disease. PMID- 3954454 TI - Relationship between iron deposits and tissue damage in the synovium: an ultrastructural study. AB - A detailed ultrastructural study was made of the synovial iron deposits in cases of haemophilic synovitis (HS), pigmented villonodular synovitis (PVNS), rheumatoid arthritis (RA), osteoarthritis (OA), seronegative inflammatory arthritis (SNA), and in controls, to investigate the relationship between iron deposits and tissue damage. Iron was seen by electron microscopy in about 75% of synovial lining cells in HS and PVNS but only in about 25% of synovial cells from cases of RA and SNA. In cases of OA and in controls iron deposits were scarce. The iron was usually deposited within pleomorphic siderosomes and in HS was most common in type A synovial cells. In contrast, deposits in all other cases were more common in type B cells, which were frequently the predominant cell type, and siderosomes were smaller, more homogeneous, and were more common in deeper synovial tissue. Considerable tissue damage was noted in the vicinity of iron rich siderosomes in synovial A cells from cases of HS, but such deposits in B cells in the synovium from the other cases had relatively little effect. We discuss the possibility that such differences directly reflect the differing functions of type A and B synovial cells, and particularly their relative ability to produce metabolically active oxygen metabolites with tissue destructive potential in the presence of iron. PMID- 3954455 TI - Distribution of joint mobility in a normal population: results of the use of fixed torque measuring devices. AB - Fixed torque measuring devices were used to measure the range of movement at three sites in 364 normal adolescents and young adults. The results confirm the findings of less reproducible measurement techniques that joint mobility at a particular site follows a Gaussian distribution with a wide range in a normal population. In addition, apart from very few individuals, mobility at one site could not predict mobility elsewhere. It seems likely that the degree of connective tissue laxity generally is of lesser importance than local factors in determining the range of joint mobility at a given site in normal individuals. PMID- 3954456 TI - Trichorhinophalangeal syndrome type I: symptoms and signs, radiology and genetics. AB - The present study shows the occurrence of the trichorhinophalangeal syndrome type I in a Swedish family. Five members were affected and they were examined clinically and radiologically, and four of them were also cytogenetically examined. Three of them had dysplasia of the hip joints reminiscent of the Legg Calve-Perthes disease. Functional hand problems were common. High resolution G banding displayed normal chromosome complements. The inheritance was autosomal dominant. The data presented stress the importance of identifying the syndrome early in life so as to prevent the development of impaired hand and hip function. PMID- 3954457 TI - Intracellular and extracellular sulphydryl levels in rheumatoid arthritis. AB - We detected no difference in the reduced glutathione content of erythrocytes obtained from patients with rheumatoid arthritis (RA) and controls. The stability of glutathione to oxidative stress (cumene hydroperoxide) was also the same. Although measured in the erythrocyte, our results indicate that changes in intracellular reduced glutathione are not involved in the aetiology of RA. Serum from patients with RA had a significantly reduced (p less than 0.01) sulphydryl (SH) concentration (415 +/- 89 (SD) mumol/l) compared with controls (583 +/- 74 mumol/l). This was also valid if the SH groups were expressed per gram of protein. Serum and synovial fluid from RA patients contained similar levels of SH groups (mumol/g protein). PMID- 3954458 TI - Acute poststreptococcal polymyalgia. AB - Three patients developed severe incapacitating diffuse pain and tenderness of the skeletal muscles after acute streptococcal infection. There was no evidence of concomitant arthritis, glomerulonephritis, or inflammatory muscle disease in any of the cases. All patients responded promptly to anti-inflammatory therapy. Severe myalgia should be considered an additional complication of immunologically mediated poststreptococcal response. PMID- 3954459 TI - Restricted expression of anti-type II collagen antibody isotypes in mice suppressed for collagen-induced arthritis. AB - The present study details the time course and isotype distribution of the immune response to type II collagen in collagen-induced arthritic mice and mice suppressed for collagen-induced arthritis. The serum of arthritic mice was observed to contain significantly higher (p less than 0.005) concentrations of antibodies to type II collagen than that of mice suppressed for arthritis at all times tested. For the arthritic mice anti-type II collagen antibodies ranged from 0.2 +/- 0.2 (SD) to 6.1 +/- 0.7 mg/ml (g/l). Serum values for mice suppressed for arthritis ranged from 0.05 +/- 0.04 to 0.6 +/- 0.04 mg/ml. Analysis of the isotypes of these responses showed an expression of anticollagen molecules restricted to the IgG1 subclass in mice suppressed for collagen arthritis throughout the time course (p less than 0.01). The data indicate that mice suppressed for collagen-induced arthritis can mount a primary and secondary immune response to the arthrogenic stimuli. This response, however, is mainly restricted to the IgG1 subclass of antibodies. This restricted subclass expression of anticollagen antibodies may represent a mechanism of suppression of arthritis in the murine model of collagen-induced arthritis. PMID- 3954460 TI - Facial rash with scarring due to granulomatous vasculitis in rheumatoid disease. AB - A 60-year-old man with destructive rheumatoid disease, multiple nodules, and vasculitis developed a facial rash with ulceration and scarring. Histology showed granulomatous vasculitis. The rash was rapidly controlled with oral corticosteroids. Granulomatous vasculitis has not previously been reported as causing this clinical picture in the absence of concomitant necrobiosis and palisading. PMID- 3954461 TI - Palindromic rheumatism with rheumatoid nodules: a case report with ultrastructural studies. AB - Rheumatoid nodules developed on the finger tips of a patient with palindromic rheumatism. The patient had no bone cysts or erosions and had no rheumatoid factor. A light microscopic and ultrastructural study of a nodule showed a necrotic centre with fibrin, collagen, and granular material surrounded by large histiocytes, fibrocytes, lymphocytes, and vessels with adjacent mast cells as has been seen with nodules in classical rheumatoid arthritis (RA). We describe the first immunoperoxidase studies on a rheumatoid nodule and have identified reaction products for immunoglobulins and C3 in perivascular and endothelial cell vacuoles and in the necrotic centre. PMID- 3954462 TI - Progressive proliferative glomerulonephritis in a patient with rheumatoid arthritis treated with D-penicillamine. AB - A 49 year old man with rheumatoid arthritis developed a proliferative glomerulonephritis with progressive renal impairment during treatment with D penicillamine. His renal function continued to deteriorate after the drug was stopped but improved after treatment with corticosteroids and azathioprine. PMID- 3954463 TI - Rabbit antisera to cross-reactive organisms--where's the problem. PMID- 3954464 TI - Sclerodactyly, CREST syndrome, proximal scleroderma. PMID- 3954465 TI - Anti-Ro positive rheumatoid arthritis. PMID- 3954466 TI - Hypothalamic-pituitary-adrenal axis suppression after repeated intra-articular steroid injections. PMID- 3954467 TI - Cytidine deaminase activity as a measure of acute inflammation in rheumatoid arthritis. AB - Cytidine deaminase (CD), a cytoplasmic enzyme, is thought to leak out of damaged cells and can be measured in fluids by a simple biochemical assay. This study has shown that serum CD activity is raised in rheumatoid arthritis (RA) compared with osteoarthritis (OA). Synovial fluid (SF) CD activity was always less than the corresponding serum activity (mean SF/serum ratio = 0.6) in OA but up to 22 times greater than the corresponding serum activity in RA (mean SF/serum ratio = 13.1), suggesting CD production in inflammatory joints. Evidence to support the SF neutrophil as a cell of CD origin is provided by the CD gradient running from cells to SF to synovium. The close correlation between SF CD activity and neutrophil count (r = 0.93) indicates that SF CD activity is an accurate measure of acute synovial inflammation. Weak correlation of serum CD activity with erythrocyte sedimentation rate (ESR) (r = 0.44) and C-reactive protein (CRP) (r = 0.49) implies that CD estimations supply different though related information about rheumatoid disease activity. We suggest that CD released from damaged neutrophils diffuses from all inflamed joints into the blood, so that serum CD activity may provide an integrated measure of joint inflammation more specific than traditional measures such as the ESR. PMID- 3954468 TI - Differential effects of therapeutic regimens on specific classes of rheumatoid factor. AB - This study was performed to define further the relationship of circulating IgM and IgG rheumatoid factor to the articular manifestations of rheumatoid arthritis. Patients with substantial clinical improvement (greater than 55%) or no improvement or worsening were chosen for study. Patients were further selected to include those treated with non-steroidal anti-inflammatory drugs (NSAIDs) alone, or NSAIDs plus D-penicillamine or gold. Significant reductions of IgM (p less than 0.001) and IgG (p less than 0.005) rheumatoid factor were seen only in those treated with gold who improved clinically. These observations suggest that in patients experiencing comparable degrees of clinical improvement the simultaneous alterations of circulating IgG and IgM rheumatoid factor observed are dependent upon the therapeutic regimen employed. PMID- 3954469 TI - Doctor-patient communication in rheumatology: studies of visual and verbal perception using educational booklets and other graphic material. AB - Patients (n = 404) with osteoarthrosis and control subjects (n = 233) were studied to examine the communicational value of five styles of illustration (cartoon (C), matchstick (M), representational (R), symbolic (S), photographic (P) and two levels of text ('easy', 'hard'), presented as educational booklets about osteoarthrosis. Booklet comprehension was tested with a multiple choice questionnaire (MCQ) scored by two raw score and two, more sensitive, weight-of evidence methods. Further studies assessed perception of image detail, tone, and colour by ranking, rating, latency, and questionnaire methods. A subgroup was tested psychometrically. The main findings were: pictures in booklets enhance communication; perception of pictorial style depends on its vehicle of presentation, cartoons being most effective in booklets, photographs overall; simplifying text does not significantly enhance communication; certain picture text 'interactions' appear to increase comprehension (e.g. 'hard' text with 'easy' pictures); several 'endogenous' factors are associated with increased comprehension: 'psychological' (e.g., intelligence, memory, reading skill); 'demographic' (e.g., the young, males, higher social grades, higher educational levels); 'disease' (e.g., longer disease duration, previous information about the disease). PMID- 3954470 TI - 2',5'-oligoadenylate synthetase induction in lymphocytes of patients with connective tissue diseases. AB - Spontaneous production of the interferon induced enzyme 2',5'-oligoadenylate synthetase (2',5'-A synthetase) was significantly greater in blood lymphocytes of patients with systemic lupus erythematosus (SLE), Behcet's syndrome, and rheumatoid arthritis than in control lymphocytes. Alpha interferon (IFN-alpha) induced comparable production of enzyme in normal, rheumatoid, and Behcet's lymphocytes, and reduced, but still appreciable amounts in SLE lymphocytes. Phytohaemagglutinin (PHA) did not induce enzyme. Thus spontaneous production of 2',5'-A synthetase is encountered in several connective tissue diseases and seems likely to be induced by in-vivo exposure to interferons. PMID- 3954471 TI - Structural consequences of traumatizing articular cartilage. AB - Articular cartilage-on-bone has been subjected to repeated impact loading in vitro and the associated structural changes occurring in the general matrix examined by optical and transmission electron microscopy (TEM). The study shows that repeated trauma transforms the pseudorandom arrangement of fibrils comprising the general matrix of normal articular cartilage into a structural configuration strongly aligned in the radial direction and displaying a prominent waveform or crimp. This stress-induced structural transformation can be predicted from the application of a recently developed structural model of articular cartilage. Further, this altered structure bears a close resemblance to that commonly observed in articular cartilage exhibiting both non-progressive degeneration and osteoarthritic changes. PMID- 3954472 TI - Metabolic activity of erosions in rheumatoid arthritis. AB - The hands of 10 patients with rheumatoid arthritis were investigated with diphosphonate scanning and radiology. Increased uptake of isotope can be associated with some erosions but not all and also reflects other processes more linked to acute inflammatory areas unassociated with the development of erosions. If the latter are the hallmark of active rheumatoid arthritis then bone scans are not. PMID- 3954473 TI - Amyloid in intervertebral discs: a histopathological investigation of surgical material from 100 consecutive operations on herniated discs. AB - Material from 100 consecutive operations on herniated discs has been investigated for amyloid. Various degrees of amyloid degeneration were found in disc tissue from 41 patients. Material from patients over 50 years old showed significantly more amyloid than that from younger patients; there was no sex difference. Eighteen patients had previously been operated on for herniated discs; seven of these (39%) had pyrophosphate deposits in their disc tissue, often in close topographical relation to amyloid. 26% of the patients had calcium phosphate deposits and 29% had slight inflammation--both without relation to amyloid. No pathogenetic correlation between amyloid degeneration and herniation of intervertebral disc tissue could be shown. PMID- 3954474 TI - Systemic lupus erythematosus without clinical renal abnormalities. PMID- 3954475 TI - Serology and bacteriology in reactive arthritis. PMID- 3954476 TI - Vascular surgery and accreditation. PMID- 3954477 TI - Use of monoclonal antiestrogen receptor antibody to evaluate estrogen receptor content in fine needle aspiration breast biopsies. AB - A monoclonal antibody prepared against estrogen receptor has been shown to be highly specific and sensitive for the detection and quantification of estrogen receptor in human breast lesions using immunohistochemical methods. A semiquantitative relationship has been shown between the intensity of staining and biochemical receptor analysis. To evaluate the usefulness of this technique in fine needle aspiration biopsies, 41 cases of breast cancer were studied. Nuclear localization of receptor antibody PAP complex was observed. Comparison of the immunocytochemical analysis of the aspiration cytologic specimens to the biochemical analysis of the excised tumor mass revealed a sensitivity and specificity of 80% and 89%, respectively. There was a significant semiquantitative correlation between the methods. These results extend the observation that antireceptor monoclonal antibody in immunohistochemical analysis is an effective tool in the evaluation of estrogen receptor content in human breast lesions and with careful specimen handling and proper controls may be extended to the evaluation of fine needle aspiration biopsies. PMID- 3954478 TI - Postoperative flexible choledochoscopy for residual primary intrahepatic stones. AB - Postoperative flexible choledochoscopy was carried out in 103 patients with residual biliary calculi. Forty-one patients had residual stones in the common duct, and 63 patients had residual stones in the intrahepatic ducts with or without stones in the common duct. The majority of the intrahepatic stones were primary stones. Postoperative choledochoscopy was very effective in removing residual common duct stones (95% removed, no morbidity). For intrahepatic stones, removal was more difficult and was associated with a higher morbidity (11.2%). Stone extraction through the stenotic intrahepatic ducts was made possible by the balloon dilatation of the ducts. Repeated endoscopic access to the biliary system was made easier by the construction of a hepatico-cutaneous-jejunostomy, which also provides a route to the biliary tree for future stone removal if stone reformation occurs. Complimented by these procedures, postoperative choledochoscopy was successful in removing the residual intrahepatic stones in 82.3% of the patients. At a median follow-up of 17 months, the majority of the patients who had all the stones removed as well as those who had stones left behind were symptom free. PMID- 3954479 TI - Postgraduate surgical flexible endoscopic education. AB - Postgraduate surgical education of residents in flexible gastrointestinal endoscopy is mandated by the American Board of Surgery. In that context, a retrospective analysis was performed of the general medical and endoscopic records of patients who experienced diagnostic and therapeutic flexible endoscopy during an 18-month period at the University of South Alabama Medical Center by surgical residents under the supervision of attending surgical endoscopists. That analysis revealed these procedures to be safe (diagnostic and therapeutic flexible endoscopy: morbidity incidence 0.4% and 2.2%, mortality incidence 0.2% and 1.1%, respectively), accurate (100%), and therapeutically beneficial (19% of the flexible endoscopic procedures were performed with therapeutic intent). Review of cumulative resident case profiles revealed that during the course of their clinical education (5 years), each resident performed approximately 400-500 endoscopic procedures, functioning successively as first assistant, primary endoscopist, and teaching assistant. The authors contend that: supervision by surgical endoscopists ensures safety and efficacy of the procedures during the education of postgraduate surgical residents; the surgical milieu--integration of endoscopic, surgical anatomic, and histopathologic data--provides the most effective educational format to acquire the skills necessary to achieve a high degree of accuracy associated with these endoscopic procedures; and therapeutic flexible endoscopy obviated the necessity for more invasive surgical procedures in approximately one-fifth of this patient population. PMID- 3954480 TI - Vocal cord paralysis and reoperative parathyroidectomy. A prospective study. AB - One hundred sixty-three patients undergoing reoperative parathyroidectomy were evaluated before and after operation to determine the incidence of, risk factors for, and morbidity of vocal cord paralysis. These patients were compared to 77 patients undergoing initial parathyroid operation, only one of whom had vocal cord paralysis on postoperative indirect laryngoscopy (1.3%). Preoperative examination of the reoperative patients revealed vocal cord paralysis from initial exploration in 11 patients who were excluded from this study. After re exploration, 10 patients (6.6%) had vocal cord paralysis, eight unilateral and two bilateral. Right vocal cords were paralyzed twice as often as left. In 90%, vocal cord paralysis was associated with removal or biopsy of an ipsilateral gland. Vocal cord paralysis occurred despite intraoperative visualization of the recurrent laryngeal nerves. Preoperative localization, parathyroid gland pathology, and concomitant thyroidectomy were not associated with increased risk of vocal cord paralysis. Hoarseness was the major symptom. Tracheostomy was required for two patients, one was permanent. One patient was treated for aspiration with a temporary gastrostomy. Nine of 10 patients had return of normal voice quality in an average of 4 months time. On examination 4 years or more after surgery, two of five patients had normal vocal cord motion. The oblique anatomic course of the right recurrent laryngeal nerve may account for the greater frequency of right vocal cord paralysis. PMID- 3954481 TI - Endoscopic decompression of acute colonic obstruction. Avoiding staged surgery. AB - Colostomy is the traditional treatment for acute obstruction of the sigmoid colon. This entails two or three surgical procedures in a high-risk group of patients. Presented is a nonsurgical approach used in three patients with acute colonic obstruction. Decompression of the bowel was achieved with a tube introduced proximal to the obstruction with the aid of a flexible sigmoidoscope. In a fourth patient, in whom the obstruction was next to the splenic flecture, the procedure failed. In all instances where decompression was successful, a one stage procedure--primary resection and anastomosis--was performed. PMID- 3954482 TI - Radionuclide visualization of acute occlusive and nonocclusive intestinal ischemia. AB - A noninvasive radionuclide technique to visualize ischemic small intestine was evaluated. Vascular ligation of 20-30 cm ileum was done in rabbits. After induction of ischemia, technetium (99mTc) methylene diphosphonate (TMDP) was injected IV at intervals up to 24 hours. Images were recorded 1 and 3 hours after injection of radioisotope and showed preferential (9:1) uptake by ischemic bowel. Positive scans were present in all animals up to 4 hours and in 75% at 10-12 hours, but in none 24 hours after induction of ischemia. Nonocclusive intestinal ischemia was simulated in 4 dogs by infusing norepinephrine into a jejunal mesenteric arterial branch. After 1 hour, an IV bolus of TMDP was injected and images recorded at intervals up to 3 hours. Selective uptake of isotope by the ischemic segment was observed in all animals. Angiography confirmed that isotope uptake was confined to the infused segment. These studies show that occlusive intestinal ischemia can be detected, by radionuclide imaging up to 12 hours, and nonocclusive (low flow) ischemia for at least 4 hours, after onset. PMID- 3954483 TI - Villous tumors of the duodenum. AB - Nineteen cases of villous tumors of the duodenum are reported. They have a predilection for the ampullary region, tend to present with obstructive jaundice, especially if malignancy is present, and have a high prevalence of cancer (12 of 19, or 63%). Even when biopsies are available, the diagnosis of cancer is frequently missed (5 of 9 proven cancers, 56% false-negative rate), and it may be impossible to assess the presence of carcinoma in situ or invasive carcinoma without complete excision of the lesion. The authors' experience suggests that some small benign ampullary villous adenomas or those with carcinoma in situ can be excised locally but that pancreaticoduodenectomy is preferable in the fit patient for better local control both of extensive benign lesions and cancers without distant metastases. PMID- 3954484 TI - Increased risk of colorectal cancer following breast cancer. AB - Identification of population groups at increased risk for colorectal cancer is important for deriving maximum benefit from screening procedures. A retrospective analysis of 7605 patients with cancer treated between 1958 to 1982 revealed that the colorectum was the site of metachronous primary in 38 patients (15 males and 23 females). The risk factor of developing the metachronous multiple primary cancer was determined by comparing the observed number of second primary malignancy with the expected number based on person years of observation, age, sex, and site specific incidence rates. Incidence of metachronous colonic cancer was twice the expected number and was the highest following a primary in the breast. This increased risk (2.0) is of equal magnitude as noted following primary colon cancer (1.7). Advanced metachronous colonic lesions were seen more often following breast cancer than following colon cancer. Since carcinoma of the breast is the leading cancer in women, it is urged that the follow-up management of such patients include the same aggressive screening program as that recommended for those with colorectal cancer. PMID- 3954485 TI - Cardiac wounds. Experience with 70 patients. AB - This study represents the personal experience of a general surgeon in 70 cases of penetrating injuries of the heart. Eighteen patients with no signs of life on admission were subjected to a thoracotomy on the stretcher with a mortality of 94%. Fifty-two patients were operated on in the operating theater with a mortality of 13.5%. Beck's triad (low blood pressure, raised central venous pressure, and distant cardiac sounds) was recorded in 77% of the cases with proven tamponade, but pulsus paradoxus in only 11%. In the author's opinion, percardiocentesis has no place in the diagnosis or treatment of cardiac injuries. Particular attention has been paid to the management of coronary artery injuries and the high incidence of air embolism in certain patients. PMID- 3954486 TI - Continuous venous oximetry in surgical patients. AB - A prospective study was performed to evaluate the efficacy of continuous venous oximetry to supplement traditional hemodynamic monitoring in 39 critically ill surgical patients. There was no statistically significant difference in SvO2 between the continuous in vivo values and in vitro values (0.694 +/- 0.095 vs. 0.698 +/- 0.108). There was no statistically significant correlation between continuously measured SvO2 and PaO2 (r = 0.09, p greater than 0.5), SaO2 (r = 0.08, p greater than 0.5), or oxygen consumption (r = 0.46, p greater than 0.5). There was a slight but statistically significant correlation between continuously measured SvO2 and cardiac output (r = 0.40, p less than 0.025) and oxygen delivery (r = 0.49, p less than 0.005). There was a highly significant correlation between continuously measured SvO2 and oxygen utilization coefficient (r = -0.96, p less than 0.001). Continuously measured SvO2 is a reliable predictor of SvO2 measured intermittently by in vitro methods. In critically ill surgical patients, SvO2 does not correlate highly with the individual determinants of oxygen transport but rather correlates with the oxygen utilization coefficient and therefore reflects the overall balance between oxygen consumption and delivery. PMID- 3954487 TI - Predictive ability of choledocholithiasis indicators. PMID- 3954488 TI - Endorectal ileal pullthrough with isoperistaltic ileal reservoir for colitis and polyposis. PMID- 3954489 TI - Postoperative sodium retention is a physiologic response to decreased extracellular volume. PMID- 3954490 TI - Is there an association between failed antireflux procedures and delayed gastric emptying? PMID- 3954491 TI - Esophagectomy without thoracotomy. PMID- 3954492 TI - Transthoracic versus extrathoracic esophagectomy: mortality, morbidity, and long term survival. AB - Extrathoracic esophagectomy for carcinoma is an acceptable substitute for transthoracic resection if it can be shown to have comparable or superior safety and no adverse effect on long-term survival. To test this hypothesis, we employed extrathoracic esophagectomy in 30 consecutive patients with carcinoma of the esophagus from January, 1978, to July, 1984. During this period, 65 comparable patients underwent transthoracic resection through a left thoracotomy for lower esophageal lesions or a right thoracotomy and laparotomy for upper thoracic lesions. Only patients with carcinoma limited to the gastric cardia were excluded from the study. Overall morbidity was higher in the extrathoracic than in the transthoracic group (13 of 30 or 43.3% versus 15 of 65 or 23.1%; p = 0.05), but the differences in hospital mortality (4 of 65 or 6.2% for the transthoracic group versus 4 of 30 or 13.3% for the extrathoracic group) and duration of hospital stay (17.4 +/- 11.7 days for the transthoracic group versus 20.5 +/- 13.4 days for the extrathoracic group) were not statistically significant. Considering all patients who either died or sustained a postoperative complication, we found significant differences favoring transthoracic resection in those subgroups of patients who were able to undergo primary reconstruction at the time of resection (12 of 57 or 21.1% versus 15 of 28 or 53.6%; p = 0.004), those with advanced Stage III lesions (11 of 47 or 23.4% versus 12 of 20 or 60%; p = 0.006), those with tumor of the lower esophagus (8 of 35 or 22.9% versus 6 of 10 or 60%; p = 0.04), and those with tumor that could be resected through a left thoracotomy (2 of 18 or 11.1% versus 17 of 30 or 56.7%; p = 0.002). Actuarial survival curves for all transthoracic and extrathoracic resections and separate analysis for Stage I and Stage III tumors revealed no statistically significant differences between these two techniques. PMID- 3954493 TI - Physiological adaptability: the secret of success of the internal mammary artery grafts. AB - Angiographic studies in 3 patients illustrate the physiological adaptability of internal mammary artery (IMA) grafts. Intact vascular smooth muscle permits the IMA grafts to retain a flexible caliber and a blood flow dictated by myocardial demands in the distribution of the grafted coronary artery. This physiological nature may be one of the reasons for their continued patency regardless of whether they are grafted to large or small coronary arteries. Further, this adaptable behavior permits use of the IMA even if its distal lumen is smaller than that of the recipient coronary artery, provided the anastomosis can be safely performed and the demand for flow is present. PMID- 3954494 TI - Somatosensory evoked potentials in the detection of spinal cord ischemia in aortic coarctation repair. AB - Cortical somatosensory evoked potential (SEP) monitoring was used in 15 patients 2 to 50 years old undergoing repair of aortic coarctation to detect the onset of spinal cord ischemia during the cross-clamp period. Three different response patterns were observed. In 8 patients (53%), the SEP remained unchanged throughout the cross-clamping. This was designated a type 1 response. Six patients (40%) showed a gradual deterioration in the SEP after 15 minutes of cross-clamping (type 2 response). All SEPs returned to normal levels within 5 minutes of release of the clamp. One patient (7%) demonstrated a decline in SEP commencing prior to the application of the cross-clamp when an intercostal vessel was controlled with slings. The SEP completely disappeared within 5 minutes of cross-clamping, but after 19 minutes the repair was completed and the SEP returned within 3 minutes of reperfusion (type 3 response). No patient sustained neurological sequelae of repair. We believe that SEP monitoring offers the potential to identify the patient at risk of developing spinal cord ischemia intraoperatively before irreversible damage occurs. However, it is susceptible to deep halothane anesthesia, which abolishes all cortical responses and requires expert monitoring. PMID- 3954495 TI - The protective effect of profound hypothermia on the canine central nervous system during one hour of circulatory arrest. AB - Circulatory arrest during profound hypothermia is a safe technique of cardiac surgery when used in selected instances. Despite its proven safety, the degree of cerebral protection offered by this technique is still poorly defined. Ten dogs anesthetized with Pentothal (thiopental sodium) were surface cooled to 32 degrees C. They were placed on cardiopulmonary bypass, cooled to 13 degrees C (cerebral temperature), and then underwent one hour of circulatory arrest. At the end of the arrest period, the dogs were rewarmed, resuscitated, and successfully weaned from bypass. A control group of 6 dogs were subjected to the same protocol but without the one-hour period of circulatory arrest. There were no group differences in animal weight, duration of surface cooling, cardiopulmonary bypass, or rewarming, mean flow, or mean arterial pressure. After a 7-day observation period, the dogs were killed with rapid tissue fixation using formalin. No neurological deficits were noted in any of the dogs during the observation period. The fixed brains were examined by a neuropathologist. No gross or microscopic evidence of cerebral hypoxia was seen in any of the animals. We conclude that one hour of circulatory arrest under profoundly hypothermic temperatures produces no detectable neurological changes or histological evidence of cerebral hypoxia. PMID- 3954496 TI - Study on myocardial contractility after cardiopulmonary bypass versus cardioplegic arrest in an air-ejecting in vivo heart model. AB - Cardiac function was assessed in a working in vivo canine heart preparation. Minute work and myocardial oxygen consumption (MVo2) were measured after a two hour period of hypothermic hyperkalemic crystalloid cardioplegic arrest in one group of dogs (Group 1, N = 6) and in another group of dogs on cardiopulmonary bypass (CPB) alone (Group 2, N = 6). Results indicate that at an afterload of 50 cm H2O, minute work was the same in all hearts but MVo2 was significantly higher in Group 1 hearts at all levels of preload. At higher afterloads, both minute work and MVo2 were significantly greater in Group 1 hearts over the range of preloads tested. Ventricular compliance was decreased in Group 1 over the range of preloads studied. These results suggest that hearts undergoing cardioplegic arrest had better left ventricular contractility than hearts undergoing CPB alone. PMID- 3954497 TI - Myocardial distribution of retrograde flow through the coronary sinus of the excised normal canine heart. AB - Myocardial distribution of the retrograde flow through the coronary sinus in the canine heart was evaluated by observing the corrosion casts of the myocardial vessels after coronary sinus injection of a low-viscosity resin, Mercox, a compound that passes through capillaries. The apex and the left ventricular free wall were well perfused at the microvascular level, even in the presence of complete left main coronary artery occlusion, whereas the right ventricular free wall was not perfused effectively at this level in any heart. Although there was considerable variation in the perfusion of the ventricular septum from heart to heart, the entire septum was not perfused in some of the hearts. We considered this poor perfusion of the septum to be due to the presence of well-developed thebesian veins in the septum. Retrograde coronary sinus perfusion of cardioplegic solution may be a valuable alternative to protect the left ventricular free wall, especially in cases of critical coronary artery stenosis or occlusion. However, antegrade perfusion should be used also, whenever possible, for adequate protection of the septum and the right ventricular free wall. PMID- 3954498 TI - The midterm and long-term results of the Mustard operation in patients with transposition of the great vessels and dynamic left ventricular outflow tract obstruction. AB - Eight of 43 patients with transposition of the great vessels (TGV) and either an intact ventricular septum or very small ventricular septal defect were found to have dynamic left ventricular outflow tract obstruction (LVOTO). The preoperative left ventricle-pulmonary artery (LV-PA) pressure gradient ranged between 14 and 60 mm Hg. In 3 patients the pulmonary artery could not be catheterized. They had a left ventricular pressure of 43, 45, and 62 mm Hg, respectively, no evidence of pulmonary vascular disease, and either echocardiographic or angiocardiographic demonstration of LVOTO. The outflow tract was explored in 3 patients at the time of the Mustard operation. Exposure of the LVOT was difficult, particularly in patients less than 6 months of age. A shallow septal myectomy was performed in 1 patient; a thin fibrous endocardial scar was resected in 2; and no procedure was performed in the third. All 8 patients survived and remain asymptomatic 1 to 11 years (mean, 5 years) after operation. The LV-PA pressure gradient has either remained the same or has increased in every patient except 1 in whom there was a slight reduction in the gradient. We conclude that dynamic LVOTO persists after the Mustard operation and is not amenable to direct surgical relief. However, an excellent clinical result can be obtained for up to 11 years after operation. PMID- 3954499 TI - Corrosive burns of the esophagus and stomach: a recommendation for an aggressive surgical approach. AB - During a six-year period ending in December, 1980, 62 patients with a history or clinical evidence of corrosive ingestion were admitted into our institutions. The majority were adults who had attempted suicide. Strong alkali (lye), the most common corrosive agent involved, was ingested by more than half of the patients (39). The remaining 23 patients had ingested weak alkali or nonalkali corrosive agents. Of the 27 patients with severe esophagogastric burns (second- and third degree), a 43.5% incidence overall, liquid lye was responsible in 21, including 7 of 8 patients with extensive full-thickness esophagogastric necrosis. In sharp contrast, only 1 of the 23 patients who had ingested weak alkali or nonalkali corrosive agents had serious esophagogastric injury. In the first two years of this review, the management approach was the so-called standard one (esophagoscopy, steroids, antibiotics, and dilation) (Group 1). The results were disappointing. In 5 of 9 patients with endoscopic findings of second-degree burns, stricture requiring dilation developed, and all 4 with extensive full thickness esophagogastric necrosis died. In contrast, during the last four years, with the adoption of a more aggressive surgical approach, that is, early surgical intervention including the use of an intraluminal esophageal stent and radical resection as indicated, missed or delayed diagnosis of full-thickness esophagogastric necrosis with its prohibitive mortality was avoided and the complication of severe esophageal stricture was virtually eliminated (Group 2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954500 TI - Surgical treatment of ruptured aneurysms of the sinus of Valsalva. AB - Aneurysms of the sinus of Valsalva are usually congenital in origin. When they rupture, it is generally into the right atrium or the right ventricle. Signs of a left-to-right shunt, aortic runoff, and cardiac decompensation are the cardinal features. Early diagnosis and surgical correction result in cure. We report our experience with 28 patients. In all patients, we used a combined aortocameral approach, and we recommend a sandwich patch for the repair. Aortic valve replacement is needed only in patients with severe degenerative changes. The overall operative mortality was 21.4%, but in the last 10 years, mortality was only 11.7%. The causes of operative and late mortality are discussed. PMID- 3954501 TI - Anatomic correction of double-outlet right ventricle with subpulmonary ventricular septal defect (the "Taussig-Bing" anomaly). AB - Seven patients with double-outlet right ventricle and subpulmonary ventricular septal defect (the Taussig-Bing anomaly) underwent anatomical repair at the arterial level with transfer of the coronary arteries. At the time of operation, patient ages ranged from 6 weeks to 33 months (mean 14.1 months) and weight ranged from 3.7 to 11.5 kg (mean 7.0 kg). Four patients had prior pulmonary artery banding: Two of these four also had coarctation repairs, and one had a Blalock-Hanlon septectomy. Three different patterns of coronary artery distribution were encountered. Five patients had side-to-side great arteries, and two had more or less anteroposterior great arterial relationships. There was one operative death (14.3%: 70% confidence limits 1.9 - 40.7%) resulting from muscular subvalvular right ventricular outflow tract obstruction (RVOTO). There have been no late deaths in the six survivors followed 6 to 31 months postoperatively (mean 14.8 months). One patient required closure of a residual ventricular septal defect (VSD) and infundibular resection for RVOTO 4 months postoperatively. All other survivors are functionally NYHA Class I. Five of the six survivors have undergone postoperative catheterization (mean interval 5.8 months). There was no aortic insufficiency and good ventricular function in all patients. In addition to the patient with the residual VSD, two other asymptomatic patients had mild or moderate RVOTO. Compared with alternative surgical procedures for this anomaly, anatomic correction has the advantages of acceptable operative mortality, use of the left ventricle as the systemic ventricle, no need for extracardiac conduits, and applicability to patients with all variations of coronary artery and great artery anatomy. PMID- 3954502 TI - Prevention of neurological injury during myocardial revascularization in patients with calcific degenerative aortic disease. AB - Neurological injury following myocardial revascularization may result from embolization of atheromatous debris from the diseased ascending thoracic aorta. Eight patients with calcified aortas who underwent elective myocardial revascularization suffered major strokes as a result of manipulation and clamping of the diseased ascending aorta during a 30-month period before July, 1981. computerized axial tomography scans demonstrated multiple cerebral infarctions in each patient. Six patients never regained consciousness and died as a result of neurological injury; 2 patients regained consciousness but were left with major neurological deficits. Later, 21 patients with calcific aortic degenerative disease underwent a specific operative protocol, designed to prevent neurological injury during elective myocardial revascularization. All 21 patients recovered without neurological complications. Specific attention to operative technique allowed this difficult group of patients with incapacitating angina and calcific degenerative aortic disease to have the benefit of coronary bypass. PMID- 3954503 TI - Indications for and diagnostic efficacy of open-lung biopsy in the patient with acquired immunodeficiency syndrome (AIDS). AB - Pulmonary infiltrates in the patient with acquired immunodeficiency syndrome (AIDS) may be associated with a spectrum of unusual neoplastic and infectious process. Transbronchial biopsy frequently reveals the cause of these infiltrates; however, when transbronchial biopsy is nondiagnostic or contraindicated, or if the patient fails to improve after a diagnostic transbronchial biopsy, further investigation is warranted to direct appropriate therapy. Efficacy of 23 open lung biopsies in 19 AIDS patients with pulmonary infiltrates was evaluated to define the indications for and the diagnostic yield of open-lung biopsy. Pulmonary infiltrates were recognized for a mean duration (+/- standard error) of 16 +/- 2 days before open-lung biopsy and were associated with fever and cough. These patients did not have prior transbronchial biopsy, and open-lung biopsy was diagnostic in all of these. Prior transbronchial biopsy performed in the remaining 16 patients was nondiagnostic in 10. Open-lung biopsy was diagnostic in 70% of these patients (Pneumocystis carinii pneumonia, 2 patients; Kaposi's sarcoma, 3 patients; Kaposi's sarcoma and Legionella pneumophila, 1 patient; cytomegalovirus, 1 patient). The other 6 patients having a previous diagnostic transbronchial biopsy failed to improve with therapy, and open-lung biopsy resulted in a therapeutic change in 67% of these patients. Two deaths were attributable to open-lung biopsy in patients with postoperative thrombocytopenic hemorrhage. Open-lung biopsy should be performed in AIDS patients when transbronchial biopsy is nondiagnostic or contraindicated, or in patients who fail to improve with appropriate therapy after diagnostic transbronchial biopsy, especially in patients with Kaposi's sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954504 TI - Electrocautery and pacemakers: management of the paced patient subject to electrocautery. AB - Electrocautery, commonly used during surgery to maintain hemostasis, can have significant detrimental effects in the paced patient. Damage to the pulse generator, reprogramming of the pacemaker, changes in the capture threshold, and ventricular fibrillation can all be induced by electrocautery. Familiarity with the particular pacemaker in use is critical in minimizing these adverse effects. Preoperative evaluation of the patient's dependence on the pacemaker and evaluation of pacemaker function should be performed and documented. We recommend close intraoperative monitoring of heart rate and rhythm, and suggest that a pacemaker programmer be on hand in the surgical suite during the operation. A postoperative check of pacemaker function should be carried out so that electrocautery-induced pacemaker malfunction will not go unnoticed or uncorrected. Three cases are presented which clearly illustrate these points. PMID- 3954505 TI - A giant congenital aneurysm of the right coronary artery. AB - A young woman with shortness of breath was diagnosed preoperatively as having a coronary artery aneurysm. The aneurysm originated from the right coronary artery and was extraordinarily large. The aneurysm was excised successfully under extracorporeal circulation. PMID- 3954506 TI - Mediastinal lymphangioma and chylothorax: the role of radiotherapy. AB - An 11-year-old boy with a capillary/cystic lymphangioma of the posterior mediastinum is described, in whom a symptomatic chylothorax proved to be refractory to surgical management. The addition of low dose mediastinal radiotherapy (2,000 cGy/10 fractions) resulted in prompt and permanent resolution of the chylothorax. Although operation is the primary modality of treatment for these lesions, the addition of radiotherapy in such refractory patients appears to be well tolerated and efficacious and should result in few long-term complications. PMID- 3954507 TI - Nonoperative control of retroperitoneal hemorrhage secondary to placement of an inferior vena cava occluding device in a patient with recurrent pulmonary emboli. AB - A woman with multiple recurrent pulmonary emboli and iatrogenic inferior vena cava perforation caused by the Hunter-Sessions introducer was treated successfully by placement of a Hunter-Sessions balloon to control the ensuing retroperitoneal hemorrhage and interrupt the inferior vena cava. Full anticoagulation therapy was continued throughout the operation and postoperatively. PMID- 3954508 TI - Thrombosis of aortic St Jude valve. PMID- 3954509 TI - Air in the aorta: treatment by reversed perfusion. AB - A ventricular septal defect was repaired in a 3 1/2-year-old child on cardiopulmonary bypass. Because of excessive pulmonary venous return, a period of circulatory arrest under deep hypothermia was used. A large volume of air was found in the arterial line and the ascending aorta before perfusion was reinstituted. The air probably entered the arterial system through a large aortopulmonary collateral artery during circulatory arrest. This artery was not visualized on angiocardiography and could have caused excessive pulmonary venous return during perfusion. Air was successfully expelled by reversed perfusion. There were no neurological sequelae. PMID- 3954510 TI - Submammary skin incision as a cosmetic approach to median sternotomy. AB - Median sternotomy is the incision of choice to allow access to the anterior mediastinum, heart, or both lungs. The vertical skin incision leaves an unsightly scar for many female patients. A bilateral submammary horizontal skin incision with dissection of a flap including the subcutaneous tissue and breasts allows exposure of the sternum so that a median sternotomy can be performed. Since November 1981, we have used this incision 40 times in female patients undergoing open heart surgery. The exposure of the mediastinum was excellent, and there were no difficulties in cannulating the ascending aorta for cardiopulmonary bypass. Complications associated with this incision are insignificant if close attention is paid to details. PMID- 3954511 TI - Surgical repair of tetralogy of Fallot with complete atrioventricular canal. AB - Total repair of tetralogy of Fallot and complete atrioventricular canal remains a surgical challenge; however, good results can be obtained if the lesions are repaired properly at operation. Our technique involves a combined right atrial and right ventricular approach with closure of the ventricular septal defect through the ventriculotomy, double-patch closure of the septal defects without dividing the bridging atrioventricular leaflets, and functional repair of the newly constructed mitral valve. PMID- 3954512 TI - Decreased thrombogenicity of Bjork-Shiley convexoconcave valve. PMID- 3954513 TI - Pulmonary stenosis in infants and young children. PMID- 3954514 TI - Phrenic nerve transection. PMID- 3954515 TI - Pulmonary artery balloon counterpulsation. PMID- 3954516 TI - Bacteremia and injection sclerotherapy. PMID- 3954517 TI - Listeriosis. New pieces to an old puzzle. PMID- 3954518 TI - A culprit in health care costs. PMID- 3954519 TI - Five-year follow-up of Friedreich's ataxia cardiomyopathy. AB - Ten patients with Friedreich's ataxia were reexamined at a five-year follow-up with electrocardiography and echocardiography. The three patients who initially had had the smallest left ventricular diastolic dimensions relative to their body surface areas (decreased 23% to 25% below predicted dimensions) had undergone dilatation of their left ventricles and atria, with decreasing fractional shortening of the left ventricle, but stable to decreasing ventricular wall thickness. The other seven patients, whose ventricular diastolic dimensions were initially closer to those predicted for their body surface areas, had not undergone significant dilatation. However, their left ventricular posterior walls and interventricular septa had thickened at a mean rate of 0.019 mm/mo. The interplay of these tendencies to hypertrophy and dilatation may explain the disagreement about the type of hypertrophic cardiomyopathy in Friedreich's ataxia. PMID- 3954520 TI - Prognostic factors in acute pulmonary edema. AB - Over a six-month period, 106 admissions of 94 patients for acute pulmonary edema were identified and their charts were reviewed. Precipitating factors for acute pulmonary edema included progressively worsening congestive heart failure in 25.5% of cases, coronary insufficiency in 20.8%, subendocardial myocardial infarction in 16.0%, acute transmural myocardial infarction in 10.4%, arrhythmia in 8.5%, medical noncompliance in 6.6%, and other causes in 12.6%. In-hospital mortality was 17.0% (16 patients). Of those patients discharged from the hospital, an additional 27 (39.7%) were dead at one year, giving an overall one year mortality of 51.2%. We found that patients with progressively worsening congestive heart failure have a better prognosis than patients with other precipitants. Also, patients with an initial systolic blood pressure in the emergency room of 160 mm Hg or higher had an improved survival over patients with an initial systolic blood pressure under 160 mm Hg. No other in-hospital or long term prognostic factors were identified. PMID- 3954521 TI - Sclerosing mesenteritis. Response to cyclophosphamide. AB - We present two patients with an aggressive form of sclerosing mesenteritis characterized by a progressive, life-threatening course, prominent retroperitoneal disease, and tubuloreticular structures in one case, an ultrastructural feature associated with autoimmune and cyclophosphamide responsive diseases. In both patients, aggressive immunosuppressive medical therapy with cyclophosphamide resulted in prompt, dramatic improvement, without recurrence. When the diagnosis of sclerosing mesenteritis is established, we recommend early aggressive medical therapy with cyclophosphamide, particularly when tubuloreticular structures are present. PMID- 3954522 TI - Combination chemotherapy and radiation therapy. The medical management of epidural spinal cord compression from testicular cancer. AB - Radiation and surgery are the mainstays of treatment for epidural spinal cord compression. There are reports in the literature, however, in which the use of chemotherapy alone or in combination with radiation and surgery has resulted in improved patient response. We present two patients with spinal cord compression from testicular cancer who developed progressive paraplegias that were successfully reversed with combination chemotherapy, steroids, and radiotherapy. In one case, the patient was unable to receive more than 600 rad (6 Gy) of radiation and his improvement was clearly related to the chemotherapy he received. In treating tumors causing spinal cord compression that are thought to be chemosensitive, one should consider adding chemotherapy to radiation or using chemotherapy alone if the options of surgery or radiation are not available. PMID- 3954523 TI - Intestinal parasites in a migrant farmworker population. AB - Three hundred thirty-nine migrant worker women and children were screened by single stool examination for intestinal parasites. Infection occurred in 34.2%. Giardia lamblia and Trichuris trichiura were the most common pathogens; Entamoeba coli and Endolimax nana were the most common commensals. Infants under 1 year of age were free of infection. Children between 2 and 5 years old and women between 25 and 35 years old had the highest prevalence. Significantly more Haitians were infected than Mexican-Americans or American blacks. Of ten symptoms, only abdominal pain and gas correlated significantly with infection. This migrant population has a greater prevalence of intestinal parasites than the general American public. Screening by stool examination may be beneficial to diminish the reservoir of infection. PMID- 3954524 TI - An outbreak of type 4b Listeria monocytogenes infection involving patients from eight Boston hospitals. AB - During September and October 1979, 23 patients admitted to hospitals in the Boston area had systemic Listeria monocytogenes infection. Twenty (87%) of these isolates were L monocytogenes type 4b, whereas only nine (33%) of the isolates serotyped during the preceding 26 months had been 4b. Patients with type 4b Listeria infection during the epidemic period (case patients) differed from patients with sporadic Listeria infection in the preceding two years in that more of the case patients had hospital-acquired infection (15/20 vs 4/18), had received antacids or cimetidine before the onset of listeriosis (12/20 vs 3/18), and had gastrointestinal tract symptoms that began at the same time as fever (17/20 vs 4/18). In addition, more case patients took antacids or cimetidine compared with patients matched for age, sex, and date of hospitalization (12/20 vs 10/40). Three foods were preferred by case patients more frequently than by control patients: tuna fish, chicken salad, and cheese. However, the only common feature appeared to be the serving of these foods with raw celery, tomatoes, and lettuce. The raw vegetables may have been contaminated with Listeria, which was able to survive ingestion because of gastric acid neutralization and subsequently to cause enteritis, bacteremia, and meningitis in susceptible hosts. However, we cannot exclude pasteurized milk as a source of this outbreak. PMID- 3954525 TI - Quinidine-induced hepatitis. A common and reversible hypersensitivity reaction. AB - In a retrospective survey of drug-induced hepatitis during a ten-year period, we found that quinidine sulfate was the most common offending agent. We analyzed the clinical and laboratory data of the 33 cases of quinidine-induced hepatitis and noted the following: (1) It is an easily recognized drug reaction, because, in most patients, fever preceded liver damage. (2) The clinical picture usually includes fever and sometimes is accompanied by gastrointestinal symptoms, rash, and thrombocytopenia, which resolved after discontinuation of drug therapy, but reappeared promptly after a rechallenge. (These features suggest a hypersensitivity mechanism.) (3) The histologic findings of the liver biopsy specimens consisted of portal and parenchymal, acute and chronic hepatitis, combined with granulomas. (4) In a long-term follow-up study of 15 patients, no liver function abnormalities were found. We thus conclude that quinidine-induced hepatitis, when recognized early, is a reversible drug reaction. PMID- 3954526 TI - Clinical and microbiologic consequences of amikacin use during a 42-month period. AB - In June 1980, 23% of our Pseudomonas aeruginosa isolates and 53% of our Serratia species were resistant to gentamicin and tobramycin. During a 3 1/2-year period of almost exclusive amikacin usage, we noted a fall in overall resistance of gram negative organisms to tobramycin and gentamicin from 18.8% and 19.3% to 15.2% and 16.2%, respectively. This fall in resistance was most notable for Escherichia coli, Proteus mirabilis, and Serratia species. During this period there was no increase in amikacin resistance. Age, hospitalization, prior antibiotic therapy, and Foley catheter use were predisposing factors in acquiring amikacin-resistant organisms. Amikacin-resistant gram-negative bacilli were usually sensitive to newer penicillins or cephalosporins. PMID- 3954527 TI - Transient hyperthyroxinemia in symptomatic hyponatremic patients. AB - Twenty-two patients with severe hyponatremia were divided into 12 patients with and ten without associated neurologic manifestations (groups 1 and 2, respectively). Marked hyperthyroxinemia was demonstrated in seven patients in group 1 but in none in group 2. The triiodothyronine concentration was also higher than normal in two patients in group 1. All serum iodothyronine concentrations in group 1 were significantly higher than in group 2. Thyrotropin and thyroxine-binding globulin levels were normal in both groups. The differences between groups were apparent only in the acute phase, and there were no clinical manifestations of hyperthyroidism. All iodothyronine concentrations returned to normal within two weeks after the correction of the hypo-osmolar disorder. Our results indicate that a transient asymptomatic increase in serum iodothyronine levels occurs during hyponatremia. Thus, thyroid test results should be interpreted cautiously in patients with acute, severe, symptomatic hyponatremia. PMID- 3954528 TI - Serum lactate dehydrogenase and its isozymes in lupus nephritis. AB - The relationship between the renal pathologic activity of systemic lupus erythematosus (SLE) and serum lactate dehydrogenase (LDH) was examined in 28 patients with active SLE involving only the kidney. Serum levels of total LDH, LDH1, and LDH2 were significantly higher in the patients with diffuse proliferative lupus nephritis (World Health Organization class IV) than in those with milder renal disease (classes I through III and V). Total LDH levels showed good correlations with the activity index and the total pathologic score of the renal pathologic scoring system, and with the glomerular hypercellularity and overall deposits. The elevated level of LDH was mainly due to elevated levels of its isozymes LDH1 and LDH2. These results suggest that the elevation of serum LDH levels in patients with SLE reflects the renal pathologic changes due to lupus nephritis. PMID- 3954529 TI - Immune thrombocytopenia and response to splenectomy in chronic liver disease. AB - Six patients had chronic liver diseases of diverse origin, persistent unexplained thrombocytopenia, and no palpable splenic enlargement. Platelet-associated IgG levels were increased in all cases. Two patients underwent splenectomy; the spleens weighed 375 and 230 g. Each patient had prompt, complete, and sustained platelet count normalization. Two other patients treated briefly with prednisone had no response. These observations indicate that a minimally enlarged spleen may be responsible for thrombocytopenia in chronic liver disease and suggest that immune mechanisms may contribute to thrombocytopenia in this setting. PMID- 3954530 TI - Twice-daily administration of oral verapamil in the treatment of essential hypertension. AB - The antihypertensive effect of twice-daily administration of verapamil hydrochloride was evaluated in 21 adult patients with mild to moderate essential hypertension. Following four weeks of placebo therapy, verapamil was given for four weeks with a treatment goal of sitting diastolic blood pressure (BP) of less than 90 mm Hg, or to a maximum dose of 160 mg twice daily. Sitting and standing BPs, heart rate, and verapamil plasma levels were determined weekly, ten to 12 hours post dose. At the maximal dose (mean, 154 +/- 19.2 mg), heart rate was not affected, side effects were minimal, and sitting diastolic BP was significantly reduced from placebo baseline, with 12 of 21 patients having a fall in sitting diastolic BP of 10 mm Hg or more or less than 90 mm Hg. A trough verapamil plasma level of greater than 80 ng/mL was associated with a good hypotensive response. These data indicate the safety and utility of twice-daily verapamil administration for the treatment of essential hypertension and suggest the value of obtaining verapamil plasma levels as a guide to dosage determination. PMID- 3954532 TI - Perceptions of ethical problems by nurses and doctors. AB - To identify how nurses and physicians perceive ethical problems in clinical medicine, we conducted structured interviews with 26 nurses and 24 physicians who work in acute-care units. Both groups thought that they frequently encounter ethical problems, although there was significant variation within each group about how often members of each group perceived such problems. Members of the health-care team often disagreed about ethical decisions. Nurses often described conflicts with physicians, but physicians rarely recognized disagreements with nurses. Clinical ethicists need to be aware of this heterogeneous perception in order to communicate effectively about ethical problems. PMID- 3954531 TI - Treatment of mitomycin-associated microangiopathic hemolytic anemia with vincristine. AB - A syndrome, including microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and renal insufficiency, has been recognized to occur as a complication of antineoplastic therapy with mitomycin. The clinical presentation can vary from a chronic course with mild anemia and slowly progressive renal dysfunction to a fulminant course with severe anemia, rapid deterioration of renal function, and death. The optimal treatment of the mitomycin-associated MAHA syndrome is unknown. Therapy with steroids, antiplatelet agents, and heparin sodium has failed to reverse the MAHA. Plasmapheresis has improved the MAHA in a few patients without reversing the renal failure. We treated two patients who had MAHA and renal dysfunction during chemotherapy that included mitomycin; the MAHA and hypertension both objectively improved after treatment that included vincristine sulfate. PMID- 3954533 TI - Inferior vena cava obstruction secondary to adenocarcinoma of the prostate. Role of orchiectomy in treatment. AB - We describe a patient with a radiologically verified inferior vena cava obstruction due to metastatic adenocarcinoma of the prostate who was treated by orchiectomy. The prompt regression of the disease causing the obstruction confirms that orchiectomy alone can be an effective treatment of massive, functionally significant metastatic carcinoma of the prostate. PMID- 3954534 TI - Postsplenectomy pericardial effusion in two patients with myeloid metaplasia. AB - Self-limited sympathetic pleural effusion is a well-known nonspecific sequela following any upper abdominal surgery, including splenectomy. However, to our knowledge, there is no report in the literature on sympathetic pericardial effusion immediately following splenectomy. We describe two patients with agnogenic myeloid metaplasia and refractory hemolytic anemia in whom pericardial effusion appeared a few days after splenectomy. The possible pathophysiologic mechanism is discussed. PMID- 3954535 TI - Division of physician-provider time between ambulatory and in-bed patients in the various medical specialties. PMID- 3954536 TI - Pneumonitis during low-dose methotrexate therapy. PMID- 3954537 TI - Potassium supplementation in diuretic-induced hypokalemia. PMID- 3954538 TI - Hypomagnesemia in digitalized patients. PMID- 3954539 TI - Sleep apnea syndrome and nocturnal bradyarrhythmias. PMID- 3954540 TI - Symptoms of anxiety and depression in a volunteer twin population. The etiologic role of genetic and environmental factors. AB - We examined the etiologic role of genetic and environmental factors in 14 symptoms of anxiety and depression reported by 3,798 pairs of adult twins from the Australian National Health and Medical Research Council Twin Register. Multifactorial multiple-threshold models fit the individual symptom scores well. For a substantial majority of the symptoms, the variance in liability was best explained by only genetic factors and environmental influences specific to the individual, where 33% to 46% of the variance was due to genetic factors. For four symptoms, it was not possible to choose definitively between models that, in addition to specific environment, included genetic vs familial environmental effects. These results provide strong evidence for the role of genetic factors in the etiology of symptoms of anxiety and depression as reported in a general population. Evidence for an etiologic role of familial environmental factors was much weaker. If familial environmental factors play any role in the production of these symptoms, they are more important in symptoms of depression than of anxiety, and the factors that predispose to these symptoms are only modestly correlated in males and females. PMID- 3954541 TI - Genetic factors in moderately severe and mild affective disorders. AB - The aim of this study was to investigate the contribution of hereditary factors in the development of affective and depressive adjustment disorders. I interviewed 151 index twins with moderately severe and mild affective illness, as well as their co-twins. The analysis of concordance rates indicates that hereditary factors may be important in the development of bipolar disorder and in major depression, except in non-psychotic, hysterical individuals. Furthermore, hereditary factors may not play any role in dysthymic disorder and depressive adjustment disorder. These findings are tentative and should be viewed against the methodologic limitations of this study, which include small sample size of the subgroups and the use of the Present State Examination as the basis for the DSM-III diagnoses. PMID- 3954542 TI - Relationship between panic disorder and agoraphobia. A family study. AB - A family study of patients with agoraphobia (n = 40), panic disorder (n = 40), and nonanxious controls (n = 20) showed that the morbidity risk for panic disorder was increased among the relatives of agoraphobics (8.3%) and the relatives of patients with panic disorder (17.3%). The morbidity risk for agoraphobia was also increased among the relatives of agoraphobics (11.6%) but not the relatives of panic disorder patients (1.9%). Male relatives of agoraphobics were shown to be at higher risk for alcohol disorders (30.8%). No greater risk for primary affective disorders was found among the relatives of agoraphobic or panic disorder patients or among the relatives of probands with secondary depression compared with relatives of probands without secondary depression. Probands and relatives with agoraphobia reported an earlier onset of illness, more persistent and disabling symptoms, more frequent complications, and a less favorable outcome than probands and relatives with panic disorder. The findings suggest that agoraphobia is a more severe variant of panic disorder. They also lend support to the separation between anxiety disorders and affective disorders. PMID- 3954543 TI - The validity of four definitions of endogenous depression. II. Clinical, demographic, familial, and psychosocial correlates. AB - Based on a survey of the classic literature and studies examining the correlates of a clinical diagnosis of endogenous or nonendogenous depression, we found 14 variables that should discriminate endogenous and nonendogenous depressives. We applied four definitions of endogenous depression (Feinberg and Carroll, DSM-III, Research Diagnostic Criteria, and Newcastle) to a consecutive series of 152 unipolar major depressive inpatients. We examined the concordance between the definitions and the relationship between each definition and clinical, demographic, family history, and psychosocial factors. The DSM-III and Newcastle definitions were less inclusive than the other two definitions. We found some support for the validity of each of the four definitions. The validity of the Newcastle scale was the most frequently supported, with the endogenous depressives having a lower rate of personality disorder, marital separations and divorces, familial alcoholism, life events, and nonserious suicide attempts. PMID- 3954544 TI - The validation of the concept of endogenous depression. A family study approach. AB - Depressive illnesses are subdivided into endogenous and nonendogenous types in psychiatry throughout the world. We used one method of validating this nosologic subdivision: the determination of the extent to which the disorder is familial. Rates of depression were examined in 2,942 first-degree relatives of 566 individuals diagnosed as having unipolar major depressive disorder. Because no single definition of endogenous depression is universally accepted, four different methods for defining endogenous depression were compared: the Newcastle Scale, the Research Diagnostic Criteria, DSM-III, and the definition of "autonomous depression" proposed by investigators at Yale University (New Haven, Conn). In general, no matter which definition was used, the relatives of the patients with endogenous illness did not have higher rates of depressive illness than those of the nonendogenous group. The Newcastle Scale was the most sensitive in picking up familial transmission of recurrent unipolar depression. The results of this investigation suggest that longitudinal approaches should be added to cross-sectional approaches for the best definition of endogenous depression. PMID- 3954545 TI - Adult sequelae of adolescent depressive symptoms. AB - We examined sequelae of depressive mood, experienced at ages 15 to 16 years, nine years later at ages 24 to 25 years in subjects formerly enrolled in New York State public high schools. Feelings of dysphoria in adolescence predict most strongly a similar experience in adulthood. Such feelings also predict psychiatric hospitalization for women but not for men, at least up to the period we investigated. In addition, adolescent depression is associated with heavy cigarette smoking, increased use of minor prescription tranquilizers (among women), more deviant activities and accidents as young adults, and selective effects on interpersonal relationships. The long-term effects of adolescent depression manifest themselves in a reduced ability to establish an intimate relationship with a member of the opposite sex rather than the ability to maintain a circle of male and female friends. The distance from spouse (or partner) repeats within the marital dyad the lack of closeness to parents experienced in adolescence. Dysphoric mood seems to be associated with a deficiency to establish close interpersonal relationships within the family that expresses itself differently at different stages of the life cycle: toward parents in adolescence, and toward spouses and parents in young adulthood. PMID- 3954546 TI - Effortful and automatic cognitive processes in depression. AB - Ten patients with major depression and ten age- and sex-matched normal controls were presented with two contrasting cognitive tasks: one required sustained effort and information processing, and the other required only superficial information processing that could be accomplished automatically, with little effort. Depressed patients performed more poorly only on the effort-demanding cognitive task. PMID- 3954547 TI - Facial electromyography in depression. Subgroup differences. AB - To study whether facial electromyographic (EMG) activity during affective imagery differed between normal subjects and depressive subtypes, we evaluated EMG responses in 29 normal controls, 37 endogenously depressed patients, and 26 nonendogenously depressed patients. Different imagery states produced more distinctive EMG patterns in normal controls than in depressed patients. Patients with endogenous depression had EMG levels that differentiated them from normal subjects and had significantly greater absolute values than the nonendogenous group in corrugator happy and corrugator sad imagery trials. Intensity of sad and happy imagery, age, and severity of depression did not systematically correlate with EMG activity among depressive subtypes. PMID- 3954548 TI - Facial discrimination and emotional recognition in schizophrenia and affective disorders. AB - Current research demonstrates that patients with schizophrenia display deficits in a broad range of interpersonal skills. To investigate the ability of patients with schizophrenia and major depression and normal controls to process facial stimuli, four tasks were constructed from 21 photographs of faces representing standardized poses of fundamental emotions. Two tasks were designed to investigate facial identity matching independent of emotion expressed, and two tasks were designed to test emotion recognition and emotion labeling, respectively. Results indicate that while depressed patients differed from controls only on the emotion-labeling task, those with schizophrenia showed deficits on all four tasks when compared with controls and did worse than patients with depression on the emotion tasks. The findings suggest that patients with schizophrenia are impaired on a broader range of facial perception skills than those with depression, when compared with controls. PMID- 3954549 TI - Recognition of emotion from vocal cues. AB - In two studies investigating the recognition of emotion from vocal cues, each of four emotions (joy, sadness, anger, and fear) was posed by an actress speaking the same, semantically neutral sentence. Judgments of emotion expressed in these segments were compared with similar judgments of voice-synthesized (Moog synthesizer) samples (study 1) or with three different alterations of the full speech mode (study 2). Correct identification of the posed emotion was high in the full-speech samples. Voice-synthesized samples seemed to capture some cues promoting emotion recognition, but correct identification did not approach that of other segments. Recognition of emotion decreased, but not as dramatically as expected in each of the three alterations of the original samples. PMID- 3954550 TI - An empirical study of the relationship between diagnosis and defense style. AB - The relationship between DSM-III diagnosis and defense style was studied in a sample of 74 psychiatric patients. The subjects completed a self-administered questionnaire composed of 81 statements about behaviors, thoughts, and feelings, which were designed to reflect various unconscious defense mechanisms. Factor analysis yielded four defense styles ranging on a continuum from primitive to mature. Patients' defense styles were compared with their diagnoses on axes I, II, and IV of DSM-III. Significant relationships were found between defense style and only one diagnosis, major affective disorder. The fact that DSM-III diagnosis could not predict defense style suggests that diagnosis and defense style are two independent dimensions. If this can be confirmed by further, more adequate studies, a sixth axis reflecting psychodynamic formulation would provide additional information necessary for therapeutic planning. PMID- 3954551 TI - Signs and symptoms of tobacco withdrawal. AB - To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by DSM-III, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the DSM-III symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation. PMID- 3954552 TI - Bruised toes in schizophrenia? An exchange. PMID- 3954553 TI - Coexistent obsessive-compulsive disorder and schizotypal personality disorder: a poor prognostic indicator. PMID- 3954554 TI - Social support and life events in working class women. Stress buffering or independent effects? AB - Several authors have suggested that social support reduces the risk of psychiatric disorder by providing a "buffer" against the adverse effects of stressful events. Others have proposed, in contrast, that social support is beneficial irrespective of life stress. We addressed this issue in a community survey of 193 working class mothers by measuring social support, threatening life events, psychiatric symptomatology, and psychological well-being via a detailed assessment combining a standardized interview and case-identification procedure with self-report questionnaires yielding continuous measures of distress and well being. Subject selection minimized confounding between support and events. The effects of life stress and social support were found to be largely independent of one another, although detailed analysis suggested that the conclusions drawn in such studies are affected by the measures and statistics used. PMID- 3954555 TI - Outcome after 40 years in DSM-III schizophreniform disorder. AB - In an earlier report, we described the course of the index episode and the family history of patients with schizophreniform disorder, schizophrenia, or affective disorder. Those data indicated that DSM-III schizophreniform disorder defined a heterogeneous group that bore a closer relationship to schizophrenia than to affective disorder. The present report extends the study of these same patients to a 40-year field follow-up. As the earlier short-term and family history findings predicted, marital, occupational, mental, and residential status ratings for the schizophreniform group assumed intermediate positions between those for patients with affective disorder and those for schizophrenics but fell closer to the latter. Contrary to the short-term outcome findings, the present data show no relationship between illness duration at index admission and outcome status ratings after 40 years. PMID- 3954556 TI - Schizotypal personality disorder. Chestnut Lodge follow-up study: VI. Long-term follow-up perspectives. AB - This study reports the first long-term follow-up of patients with schizotypal personality disorder (SPD) as defined by DSM-III. Patients with the pure syndrome (SPD, n = 10) were compared with patients with schizophrenia (S, n = 53) and borderline personality disorder (BPD, n = 81). Three "mixed" cohorts (S/SPD, n = 61; S/SPD/BPD, n = 30; SPD/BPD, n = 18) were added to investigate the effect of schizotypal disorder on the longitudinal course of comparison groups. Schizotypal personality disorder proved to be common in the Chestnut Lodge follow-up study patients, although it was rare as a pure syndrome. From the perspective of follow up, SPD appeared related to S but not to BPD. The mixed axis II borderline syndrome (SPD/BPD) had a long-term profile closer to BPD than to SPD, and adding SPD to S appeared (unexpectedly) to enhance outcome. PMID- 3954557 TI - The validity of the dexamethasone suppression test as a marker for endogenous depression. AB - The validity of the dexamethasone suppression test (DST) as an indicator of endogenous depression has been most frequently tested by examining its relationship to operational criteria of endogenous depression. However, these criteria sets themselves have not been empirically validated. We examined the DST in terms of a series of hypotheses and predictions that are consistent with the theoretical construct of endogenous depression. In a consecutively admitted sample of 187 primary unipolar depressed inpatients, the DST nonsuppressors were older, had less premobid personality disorder, better social support, less frequent marital separations or divorces, fewer nonindependent stressful life events during the year prior to admission, made fewer nonserious suicide attempts during the index episode, had fewer dysfunctional attitudes, and had a lower rate of treated alcoholism and antisocial personality in their first-degree relatives. The only clearly negative finding was the lack of association between DST results and family history of depression. Our results strongly support the construct validity of the DST as a marker of endogenous depression. PMID- 3954558 TI - Dopaminergic effects of carbamazepine. Relationship to clinical response in affective illness. AB - Carbamazepine, a drug used widely to treat epilepsy and trigeminal neuralgia, has been shown to be effective in the acute and prophylactic treatment of manic depressive illness. While the time course of its antimanic effects parallels that of classic neuroleptics, indirect clinical evidence, such as lack of parkinsonian side effects and tardive dyskinesia, suggests that carbamazepine does not act by blocking dopamine receptors. To assess the effects of carbamazepine on dopamine mechanisms, we measured the dopamine metabolite homovanillic acid (HVA) in the cerebrospinal fluid of affectively ill patients before and after treatment. Carbamazepine did not alter basal concentrations of HVA, but decreased probenecid induced accumulations of HVA, paralleling results in animal studies. In 25 patients, lower baseline cerebrospinal fluid HVA levels were related to subsequent better acute antidepressive responses to carbamazepine. While the precise mechanism of carbamazepine's effects on dopaminergic systems remains to be determined, this study provides further evidence that carbamazepine does not have a biochemical profile typical of neuroleptics. PMID- 3954559 TI - Health maintenance: paraplegic athletes and nonathletes. AB - The relationship between participation in competitive wheelchair sports and health maintenance in individuals having paraplegia was examined. Twenty-one wheelchair athletes and 21 nonathletes completed two self-report questionnaires. The t-test for Independent Groups, the Mann-Whitney U-Test, and the Test for Significance of Difference Between Two Proportions were used to test for group differences. A p value of 0.05 significance level was used. The subjects were similar in age, sex, race, education, age at onset of injury, duration of injury, and preinjury level of sports involvement. A large percentage of both groups had been hospitalized since rehabilitation discharge; however, the mean number of hospitalizations per year since discharge was almost three times greater for nonathletes. Fewer athletes had been hospitalized for pressure sores. Within the athlete group the more serious medical complications occurred before beginning wheelchair sports. Frequency counts of specific complications occurring during the past year showed that nonathletes had more serious conditions such as kidney infections and skin breakdowns due to pressure as opposed to those due to external trauma. The findings indicate that paraplegic athletes are more successful than nonathletes in avoiding the major medical complications for which they are at risk. It follows, then, that this athletically active subgroup of the paraplegic population is costing the individual, medical insurance companies, and the state less money for ongoing medical care and extensive repeat hospitalizations. PMID- 3954560 TI - Auditory processing in spinal cord injury: a preliminary investigation from a sensory deprivation perspective. AB - Research on sensory deprivation suggests that the loss of somatosensory input to the central nervous system may have an impact on cortical reactivity and subsequent cognitive task efficiency. Individuals with spinal cord injury have a permanent loss of such input to varying degrees. However, there have been few investigations of cognitive processing in spinal cord injury. In this study, six outpatients with quadriplegia and 12 able-bodied controls were administered a dichotic listening task while auditory evoked response data and auditory threshold data were recorded. There were no differences between groups in terms of auditory threshold or auditory evoked responses. However, the outpatient quadriplegic group was more successful than the able-bodied controls in performing the dichotic listening task at one but not all levels of complexity. Results suggest that differences in cognitive processing ability between spinal cord injured and able-bodied individuals may reflect higher level motivational attention-concentration differences rather than more basic auditory and neurophysiologic processing differences. PMID- 3954562 TI - Program evaluation of physical medicine and rehabilitation departments using self report Barthel. AB - The Barthel Index measures performance of personal care (feeding, dressing, hygiene) and mobility (transferring, walking/wheeling) activities. Since its inception, several revisions of this index have increased its accuracy in measuring functional ability of patients during medical rehabilitation. However, this activities of daily living (ADL) scale is rarely used to determine the abilities of individuals after discharge, leaving assessment of functional outcome incomplete. In this study this index has been converted to a self-report format, which can be completed easily by the patient or family member both during the rehabilitation stay and after discharge. The reliability of the self-report version is examined, by comparing the assessments of patients to those made by the health professionals. A sample of persons at an inpatient rehabilitation facility, who could both read and write, completed the self-report during the week before discharge. Results comparing the assessment of professionals and patients showed a statistically significant difference with p less than 0.001. This paper will suggest reasons for the difference and explore the possibility of using this self-report version as a means to evaluate both the short-and long term outcomes of rehabilitation programs. PMID- 3954561 TI - Team care: an analysis of verbal behavior during patient rounds in a rehabilitation hospital. AB - Patient rounds are an important aspect of multidisciplinary team care. Team perceptions of ideally functioning rounds were compared with the actual communication patterns in rounds in a physical rehabilitation hospital. Perceptions of the patients' needs in the content areas of physical, psychosocial, and support systems were also compared with the actual distribution of content in rounds. Physicians spoke more (41%) and made more authoritative statements (62%) than did staff from any other discipline. The physicians participated far more than was perceived as ideal in all areas but the physical. Patients contributed only 9% of the discussion and less than 1% of authoritative statements. The physical content area was overemphasized (65%) and the psychosocial area was underemphasized (14%) when compared with the perceived needs of the patients. Interpretations of these findings and implications for investigation of the impact of team care are discussed. PMID- 3954563 TI - Inflation pressure effect on performance of air-filled wheelchair cushions. AB - Air-filled wheelchair cushions are frequently used in the prevention of pressure sores. Their effectiveness in reducing interface pressures and in redistributing body weight (BW) appears dependent on their internal inflation pressure. This pilot study examines and defines this relationship. Interface pressures were measured with the TIPE (Texas Interface Pressure Evaluator) system for 14 subjects while sitting on each of three commercially available air-filled wheelchair cushions. This relationship between interface pressure and internal pressure was then determined for each of the three body-build categories. In each category the interface pressure displayed a higher degree of sensitivity to underinflation than to overinflation. A high correlation found between BW and internal air pressure (IAP), may be useful in the design of a customized pressure indicator system. The study documents the influence of IAP on seating pressure and supports the need for further research in the development of an indicator system that alerts users to under- or overinflation of the cushion. PMID- 3954564 TI - Spinal cord seizures in transverse myelopathy: report of two cases. AB - Paroxysmal sensorimotor phenomena of spinal cord origin are well documented in the literature dealing with multiple sclerosis, but have seldom been identified in other conditions. These seizures are characterized by tonic spasm in the extremities, often accompanied by painful dysesthesias, and are fleeting, usually lasting no more than two minutes. Although they may occur spontaneously, they are commonly precipitated by tactile stimulation or movement of the extremity. These episodes must be clinically differentiated from spasticity as they have been shown to be responsive to anticonvulsants such as carbamazepine (Tegretol). We present two patients admitted to our rehabilitation facility with a diagnosis of idiopathic transverse myelopathy. Clinical and diagnostic evaluation revealed no evidence of multiple sclerosis and follow-up studies for two and one-half years in case 1 and one year in case 2 continued to support the admitting diagnoses. Each patient developed focal sensorimotor phenomena relatively early in the course of the disease which interfered with rehabilitation. Effective treatment was obtained with administration of carbamazepine. Subsequently, both patients developed signs and symptoms of multiple sclerosis. The complication of spinal cord seizures may become a limiting factor in the rehabilitation of patients with idiopathic transverse myelopathy unless the disorder is recognized and appropriate anticonvulsant therapy initiated. It may also be the first indicator that multiple sclerosis rather than "idiopathic" transverse myelopathy is present. PMID- 3954565 TI - Diabetes insipidus in a quadriplegic patient. AB - An incomplete quadriplegic patient underwent investigation for production of copious amounts of dilute urine. Serum osmolality, electrolytes, BUN, glucose, and serum antidiuretic hormone (ADH) were recorded, as well as urinary osmolality, electrolytes, glucose, and pH. In response to subcutaneous vasopressin during the dehydration test, the patient's urinary osmolality increased by 12%, from 620 mOsm/l to 695 mOsm/l. A definitive diagnosis of partial central diabetes insipidus was made. Physicians involved in the care of patients with spinal cord injuries should be aware of the method of evaluating polyuric conditions, particularly while the patient is undergoing catheterization. PMID- 3954566 TI - Inhibition of the external urethral sphincter and sacral reflex by anal stretch in spinal cord injured patients. AB - Relaxation of both detrusor and external sphincter muscles by mechanical stretch instead of cutaneous stimulation of the anal sphincter has been recognized and applied clinically for bladder emptying and for aiding catheterization in patients with spastic urethral sphincter. In a three-year study anal stretch was included as part of urodynamic examination in patients who could potentially use this method for bladder management. Anal stretch was found to inhibit the bulbocavernosus reflex and to be a useful alternative technique for bladder emptying in patients having complete paraplegia with normal hand function and with detrusor-sphincter dyssynergia. It is recommended that anal stretch combined with Crede or Valsalva maneuvers be a part of the urodynamic study of such patients to determine whether or not these techniques can be utilized for bladder management. PMID- 3954567 TI - Treatment of agitation in head injury. PMID- 3954568 TI - The 35th John Stanley Coulter memorial lecture. Rehabilitation: ghosts . . . images . . . visions. PMID- 3954569 TI - Electrical stimulation of sciatic nerve of rats after partial denervation of soleus muscle. AB - The purpose of this study was to determine the effect of electrical stimulation of the sciatic nerve on the recovery of the weight and tension of partially denervated rat soleus muscle. Electrodes were implanted unilaterally adjacent to the sciatic nerve in 30 adult female Wistar rats. Fifteen rats underwent bilateral partial nerve section (PNS) of the sciatic nerve to stimulate the plantar flexors. Both the normal and partially nerve sectioned animals were stimulated unilaterally with 4 ms, 2-4 mA current given at 10 pulses per second. Groups of five normal and five partially denervated animals were stimulated for two, four or eight hours per day, five days per week for six weeks. The soleus muscles were evaluated for muscle weight (MW), twitch (Pt) and tetanic (Po) tension, contraction time (CT) and fiber areas of the type 1 and type 2 fibers. The MW, Pt, Po, CT and area of the type 1 and 2 muscle fibers of the normal soleus muscles were 114 +/- 15 mg, 21 +/- 4 mg, 95 +/- 20 mg, 95 +/- 21 ms, 1532 +/- 84 microns m2 and 1267 +/- 136 microns m2 respectively. The electrical stimulation had no effect on the normal soleus muscles. The MW, Pt, Po, CT and area of type 1 and 2 muscles fibers of the partially denervated control soleus muscles were 59 +/- 12 mg, 9 +/- 4 mg, 22 +/- 14 mg, 104 +/- 32 ms, 1028 +/- 514 microns m2, and 849 +/- 292 microns m2 respectively. Two hours of electrical stimulation significantly increased the MW (87 +/- 17 g), Pt (17 +/- 6g), and Po (49 +/- 23 g) but not the type 1 and 2 fiber areas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954570 TI - Stroke: morale, family functioning, health status, and functional capacity. AB - Twenty-two stroke patients and their spouses were studied. All patients were living at home and had had a stroke at least one year previously. Of the 22 patients 14 were men and eight were women. Couples were assessed on the variables of morale, family functioning, health status, and patient functional capacity. For all variables, patient-spouse and husband-wife differences were tested. Couples from a previously studied random community sample were matched to the stroke couples on age and socioeconomic status (SES). Identical morale, family functioning, and health status data collected on these couples were compared to the stroke data. The results included the following: Stroke patients and their spouses were healthy on all variables. Members of the couple did not differ on most variables whether compared as husband-wife or patient-spouse. Wives from the two samples did not differ on any variable. Husbands from the stroke sample differed from the matched husbands on only one health variable--the number of doctor visits made in the past six months. PMID- 3954571 TI - Neuromuscular reeducation versus traditional programs for stroke rehabilitation. AB - This study compares long-term effectiveness of traditional functional retraining (TFR) with neuromuscular retraining techniques (NRT) after cerebrovascular accident (CVA). Groups of post-CVA patients from two different rehabilitation programs were matched according to early prognostic indicators. In one program NRT was emphasized while in the other the emphasis was restricted to TFR of spontaneously acquired upper extremity dexterity. Follow-up was possible in 19 of the TFR group and 20 of the NRT group who survived eight months after CVA. At least eight months post-CVA patients/families completed a telephone questionnaire regarding current functional abilities. With the single exception of self feeding, no statistically significant differences in skill levels were found. NRT patients showed a slightly greater independence in feeding than the patients in functional retraining. It was also noted that rehabilitation hospitalization was significantly longer in the NRT group (28.57 days vs 68.3 days). The reason for this is not clear. If choice of therapeutic techniques was a contributing factor to increased lengths of stay, however, this would have major cost/effectiveness implications for program planning. PMID- 3954572 TI - Mechanical energy of walking of stroke patients. AB - The mechanical energy costs of walking have been studied in ten stroke patients with hemiplegia. A two-dimensional sagittal plane cinematographic analysis of two strides of the subjects' normal walking was undertaken, yielding continuous information about the mechanical energy costs of the whole body and each of its parts, about the energy types involved, and the amounts of energy conservation. The large head, arms, and trunk (HAT) were found to dominate the total pattern. Three major disturbances were seen. In contrast to normal subjects who show energy-conserving negatively correlated potential and kinetic energy curves for the HAT, the subjects who demonstrated the first disturbance showed gross irregularity of the curves, with almost no opportunity for exchange between energy types. In a second disturbance the curves of the HAT showed some energy conserving portions, but levels of kinetic energy curves were low, resulting in little energy exchange. In the third disturbance, some exchange was evident, but the pattern was dominated by potential energy changes in the form of a single large rise and fall, coinciding with swing phase of the affected leg. Each of these disturbances would require a different approach to treatment. Although mechanical energy analyses do not reflect certain energy costs, such as the effort required to hold the body up against the pull of gravity and that used in contracting antagonist muscles, they could be of considerable assistance in pinpointing costly variations in energy patterns during walking and in determining appropriate treatment procedures. PMID- 3954573 TI - Status of stroke patients: a community assessment. AB - The identification of norms relating to the status of stroke patients is significant to community plans to provide contemporary health services for stroke patients. This two-phase research study assessed the status of stroke patients for a large metropolitan area. The first phase of research was a retrospective hospital record review conducted on 1,665 subjects admitted to 13 Cincinnati hospitals with the primary diagnosis of stroke. This study showed that the Cincinnati outcomes were consistent with the outcomes demonstrated in the literature. The most typical stroke patient was a 71-year-old woman with right hemiplegia, who was living at home with another adult after spending 17.5 days in the acute care hospital. The behavioral functional levels of 105 disabled stroke patients were assessed in the second phase, using the Level of Rehabilitation Scale. Subjects were analyzed in five functional areas to determine their level of independent living. Demographic data were used to analyze the findings in comparisons. In general, stroke patients function higher in activities of daily living than they do in social interactions. Stroke patients living with another adult demonstrated a lower degree of functioning in activities of daily living than those who lived alone, but scored higher in social interactions. PMID- 3954574 TI - Ultrasound therapy: a comparative study of different coupling media. AB - Four different materials, water, oil, gel, and silicon, were considered for their relative efficiency as coupling media for ultrasonic therapy. The power loss (attenuation) as a function of distance in each medium was experimentally studied. The degree of impedance match (power reflection into the transmitter) between the medium and transducer head was also determined by measuring the standing wave ratio. The results of the study indicated that oil and water have a large degree of attenuation as well as poor impedance match with the sound head. Gel offered a smaller degree of attenuation and better impedance match. Silicon appeared to offer little attenuation but the encasing material has so much impedance mismatch with the sound head that very little power is transmitted into the silicon medium. For future automated clinical applications, the use of encased silicon such as is used for breast implant is proposed, if mismatch is reduced. PMID- 3954575 TI - Comparison of cold-quartz ultraviolet, low-energy laser, and occlusion in wound healing in a swine model. AB - A randomized, blind, controlled study used six pigs to examine the effectiveness of low-energy HeNe laser irradiation (632.8nm), cold-quartz UV (254nm), occlusion, and exposure in the treatment of full thickness skin wounds. Laser treated wounds received a nominal dose of 54mW daily on a schedule of six days/week, UV-treated wounds were given two minimal erythemal dose treatments, twice daily, six days a week, and occluded wounds were checked and dressings replaced as needed twice daily, six days a week. All wounds were treated until clinically healed. Time to closure, wound strength, and bacterial colonization were monitored. There were no complications. Although the laser-treated wounds healed faster than the exposed-control wounds (20.3 +/- 0.9 days vs 21.1 +/- 2 days), only the occluded wounds healed significantly (p less than or equal to 0.05) faster than the controls (18 +/- 1.6 days vs 20.6 +/- 1.4 days). No statistically significant difference in bacterial colonization or wound strength was noted although the occlusion-treated wounds tended to be the strongest. PMID- 3954576 TI - Treadmill exercise training in chronic obstructive pulmonary disease. AB - Eight men and six women with severe chronic obstructive pulmonary disease (COPD) performed a pulmonary function test and a treadmill exercise stress test before and after an individualized training program, which nominally consisted of three 20-minute sessions of treadmill exercise per week for five consecutive weeks. Training sessions were terminated before 20 minutes if there were subjective complaints, or if the subject's heart rate reached 80% of the maximum heart rate observed during the pretraining stress test. This program failed to improve any of the pulmonary function test parameters (lung volumes, airflows, maximum voluntary ventilation, and resting levels of blood gases) and failed to improve most exercise stress test parameters (maximum oxygen consumption and carbon dioxide production, respiratory exchange ratio, and heart rate at termination of exercise). This program, however, did increase the group's average stress test time from 9.0-13.7 minutes (p less than 0.001) and increased the total external work (calculated from the sum of its vertical and horizontal components) from 3.5 6.8kcal (p less than 0.01). Eight of the 11 subjects who initially received 2L/min of 100% oxygen, via a nasal cannula, to alleviate dyspnea and to promote endurance were completely weaned from supplemental oxygen by the end of the training program. These findings demonstrate that a treadmill exercise program based on stress test data can increase the efficiency (external work per unit of oxygen consumed) and thus, the exercise tolerance, of persons with severe COPD. PMID- 3954577 TI - Bilateral below-knee amputations: experience with 80 patients. AB - This review expands information concerning the bilateral below-knee (BK) amputee, describing the findings of a retrospective assessment of 80 such patients. Factors evaluated included etiology, associated conditions, time between amputations, late revisions, use of prostheses, and survival. In 63 patients both amputations were because of atherosclerosis. Of these patients, 86% were diabetic and 84% hypertensive. Peak incidence of the second amputation was during the 7th decade. Average time between amputations was 23 months. Forty-five (71%) of the atherosclerotic patients achieved some functional use of bilateral prostheses. The five patients employed at the time of the second amputation returned to work using prostheses. Average survival after the second amputation was 44 months for those deceased, and 64 months for those alive at the end of the study period. Nine patients had amputations because of various forms of injury, including one for sequential developments due to alcohol-related sensory loss. Eight of this group had a diagnosis of alcohol abuse of psychosis. Reasons for amputations included frostbite, burns, suicide attempt and sensory loss. Five achieved long term but generally suboptimal prostheses use. The findings support the impression that most atherosclerotic bilateral BK amputees can use prostheses and that their survival and low rate of late stump revisions justify restorative efforts. Mental status was the major determinant of amputation and prostheses use among the non atherosclerotic patients; discharge from psychiatric hospitals without adequate community support systems was probably contributory. Management and prevention require close collaboration between the rehabilitation, surgical, psychosocial, and public health disciplines. PMID- 3954578 TI - Disability, disease duration, and rehabilitation service needs in multiple sclerosis: patient perspectives. AB - The purpose of this study was to determine the medical, psychologic, social, and vocational needs of individuals with multiple sclerosis (MS) and to evaluate these needs with respect to age, disease duration, sex, and disability level. Individuals with MS in western Washington state were asked to participate by responding to a mailed questionnaire. Six hundred fifty-six completed the questionnaire of more than 250 variables covering symptoms, diagnosis, adjustment, service use and service need were found in this population. Medical needs, with the exception of bladder management and physical therapy, appeared well met. However, counseling and vocational needs appeared less well met. The perceived need for most medical and community services was correlated with increasing disability as might be expected. However, the need for vocational and psychologic services was not related to the level of disability but to the age of the patients and the recency of MS diagnosis. PMID- 3954579 TI - Amyotrophic lateral sclerosis: relationship between serum creatine kinase level and patient survival. AB - Various laboratory tests have been used to predict the survival of patients with amyotrophic lateral sclerosis (ALS). The serum creatine kinase (CK) level is frequently elevated in patients with ALS. This study evaluates the relationship between serum CK elevation and survival in patients with ALS and points to a lack of correlation. Thirty patients with ALS, who ranged in age from 21 to 73 years, were followed up from 7 to 57 months. All patients had neurologic and psychiatric evaluations, electromyographic examinations, and serum CK measurements. The CK level was elevated in 50% of the patients. On follow-up, 20 patients had died; ten of these had had elevated CK levels. The 3-year survival from the date of the examination was 47% for patients with elevated CK levels and 40% for patients with normal levels. This difference did not have statistical significance (p greater than 0.43). PMID- 3954580 TI - Microprocessor-based weight shift monitors for paraplegic patients. AB - The prevention of pressure sores for patients with spinal cord injuries includes pressure relief through the patient shifting position and, thus, weight. We have designed a microprocessor-based device to mount on the seat of a conventional wheelchair. This device has applications in hospital rehabilitation programs for improving patient care and in research to study the cause and prevention of pressure sores. It can use audible alarms, which can be disarmed, to train patients to regularly shift weight. The device stores in its memory data on the interval between and the duration of weight shifts. The contents of this memory can be transmitted to a laboratory microcomputer system and displayed in tabular, graphical, or histogram formats. This device is more versatile than previous timer-based systems, not only because its timer and alarm parameters easily can be reprogrammed, but especially because it can store and play back detailed data on the patient's performance. The device is powered by rechargeable NiCad batteries, which can last several days without recharging. PMID- 3954581 TI - Stroke hemiplegia and subsequent lower extremity amputation: which side is at risk? AB - The purpose of this study was to see 1) if there is a relationship between side of hemiparesis and subsequent lower extremity amputation and 2) if time from onset of cerebrovascular accident (CVA) to onset of amputation is less in patients with diabetes mellitus than in those without that disease. Twenty-two subjects with a mean age of 63.9 +/- 11.4 years met the criterion of having a CVA followed by a lower extremity amputation. Date and side of hemiparesis and amputation were noted and a relationship was determined using the two-tailed chi square test. Twenty-one of 22 subjects had the amputation on the same side as their hemiparesis which represents a significant relationship (chi 2 = 18.16, p less than 0.001). Mean time from CVA to amputation was 32.5 +/- 26.12 mo for diabetics and 55.0 +/- 33.1 mo for nondiabetics which also represents a significant difference (t = 1.74, p less than 0.05). It is concluded there is a strong relationship between side of hemiparesis and subsequent lower extremity amputation with the amputation occurring most often on the hemiparetic side and earlier in patients with diabetes mellitus. The causal relationship between side of CVA and subsequent same sided amputation may be due to altered autonomic nervous system control, altered sensation with increased incidence of local unobserved trauma or decreased/altered muscle fiber use on the affected side. Implications for clinical rehabilitation include education for skin protection and attempting to increase muscle fiber activity. PMID- 3954582 TI - Hysterical paralysis in the upper extremity of chronic pain patients. AB - The patient with chronic pain who develops the conversion symptom of hysterical paralysis in the upper extremity can be treated successfully by rehabilitation medicine services, using a shaping behavioral program. Four case reports illustrate the management of this condition and the basic ingredients for such a program are outlined. The approach is based upon learning principles and experience with conversion reactions affecting gait. Treatment outcome often is related directly to the care and skill with which psychological assessment is performed and to the coordinated effort of the various team members. PMID- 3954583 TI - Suction socket suspension for below-knee amputees. AB - In this study the current use of suction suspension for below-knee prostheses is examined by means of two questionnaire surveys. The experience of 56 below-knee (B-K) amputees wearing suction socket prostheses is evaluated comparing suction prostheses with previously worn limbs. A high degree of satisfaction was found, with amputees on the whole reporting improved skin condition, diminished pain, and increased activity levels compared to previous prosthetic history. The experience and opinions of 466 certified prosthetist members of the American Orthotist Prosthetist Association are examined in the second survey, including degree of contact, success, and evaluation of problems in using suction suspension for the B-K amputee. This survey indicated limited contact and familiarity with B-K suction suspension, with only 22% stating they had made this type of prosthesis. Prosthetists cited characteristics of the B-K residual limb as the chief deterrent to a successful fitting. PMID- 3954584 TI - The lost sheep. Presidential address. PMID- 3954585 TI - Ileoanal reservoir for ulcerative colitis and familial polyposis. AB - Although total proctocolectomy with permanent ileostomy is regarded as the definitive therapy for ulcerative colitis and familial polyposis, psychologic and physical complications with this operation have stimulated the development of the operation of total abdominal colectomy, mucosal proctectomy, ileal reservoir, and ileoanal anastomosis as an alternative surgical procedure. Since 1980, 104 of these operative procedures have been completed with no operative mortality; experience has been gained with both the J- and S-type reservoirs. Despite an appreciable number of postoperative complications, satisfactory function of the reservoir has been achieved in 86 of 91 patients followed up for at least three months after closure of the ileostomy. The remaining five patients have required reinstitution of fecal diversion. Functional results have not differed between two-limbed and three-limbed reservoirs. This operation must be considered a viable alternative in patients with ulcerative colitis and familial polyposis. PMID- 3954586 TI - Management of bile duct cysts in adults. AB - In 31 adult patients with bile duct cysts seen at the Lahey Clinic (Burlington, Mass) during a 20-year period, the median age at time of initial therapy at Lahey Clinic was 34 years. Abdominal pain was the most common presenting symptom, followed by jaundice and fever. The 31 patients underwent a total of 86 biliary tract procedures, of which 37 were performed at Lahey Clinic. Internal drainage was the most common operation, but it frequently resulted in recurrent symptoms requiring reoperation. Cyst excision was associated with a significantly lower incidence of recurrent cholangitis and need for reoperation and was not associated with increased operative mortality. Cystic disease was frequently associated with other hepatobiliary diseases. Biliary carcinoma occurred in five (16%) of our patients, and late deaths from biliary-related disease occurred in seven patients (22%). When technically possible, cyst excision is the treatment of choice. PMID- 3954587 TI - Paraesophageal hiatus hernia. AB - Fifty-five operations for paraesophageal hiatus hernia were performed at the Lahey Clinic, Burlington, Mass, between January 1970 and October 1985. Pain was present in 35 of 51 patients. Other less common symptoms were anemia and vomiting. Reflux symptoms were rare. Esophageal manometry disclosed a mean lower esophageal sphincter pressure of 18.2 mm Hg and a length of 3.5 cm. An anterior crural repair (Collis procedure) was employed in all patients. In 22 patients Stamm gastrostomies were also performed. In two patients, a Nissen fundoplication was also carried out because of coexisting gastroesophageal reflux. One patient died postoperatively of a pulmonary embolus. Of the patients, 88.4% benefited from the operation. Of the five poor results, four were due to hernial recurrence and only one was due to severe reflux symptoms. Gastroesophageal reflux is rare in patients with paraesophageal hiatus hernia. An antireflux procedure should be added to surgical correction of the anatomic defect only if evidence of a hypotensive lower esophageal sphincter is clearly present preoperatively or intraoperatively. The addition of gastrostomy to the procedure protects against recurrence of hernia. PMID- 3954588 TI - Intraoperative electron beam radiotherapy in the treatment of unresectable rectal cancer. AB - We treated 29 patients who had primarily unresectable rectal cancer with an aggressive combined surgical and radiotherapeutic approach. Each patient received 5,040 rad of preoperative external beam radiation therapy. Eighteen patients responded adequately to allow resection of all macroscopic tumor; 11 patients underwent resection but had residual cancer in the pelvis. A single bolus of 1,000 to 2,000 rad of intraoperative electron beam radiation was given. Follow-up time ranged from three to 66 months, with a median of 43 months for living patients. The actuarial local control rate at 36 months for the entire group was 87%. In the group of 18 patients who underwent resection, the local control rate was 92%, with a three-year survival rate of 70%. Our results are considerably improved over our prior experience without intraoperative radiation therapy--a 57% local control rate and a 30% three-year survival rate. PMID- 3954589 TI - Retroperitoneal approach to high-risk abdominal aortic aneurysms. AB - During a 14-month period we used a left-flank, retroperitoneal, retrorenal approach in 23 high-risk patients with abdominal aortic aneurysm (AAA). Fourteen patients underwent suprarenal/celiac cross clamp for juxtarenal/suprarenal AAA and/or associated occlusive disease. Other indications for this approach included diminished cardiac and/or pulmonary reserve, previous extensive abdominal surgery, obesity, and inflammatory AAA. There was only one death (4%) in this high-risk group and minimal operative morbidity. The flexibility afforded by this approach for high aortic exposure allowed expeditious proximal anastomoses with minimal postoperative renal dysfunction. Pulmonary complications, ileus, and pain were reduced and patient mobilization was rapid despite the complex nature of the operative procedures. We believe that this approach offers significant advantages for all cases of AAA but particularly for anatomically complex lesions and medically high-risk patients. PMID- 3954591 TI - Decreasing the incidence of surgical wound infections. Validation of a surveillance-notification program. AB - In an attempt to validate the observations of a previously published ten-year study of surgical wounds, we studied 8,474 wounds over an 18-month period using a protocol nearly identical to that of the previous study. Our study corroborated the following predictors of clean-wound infection: increasing duration of surgery, age less than 1 or greater than 50 years, increasing duration of preoperative hospitalization, use of drains, and shaving and emergency surgery. We failed to corroborate use of wound irrigation as a protective measure or time of preoperative shaving as a significant variable. Most importantly, we found a 42% reduction in the clean-wound infection rate during the study period (1.9% to 1.1%), adding support to the concept that a wound surveillance program with surgeon notification is both efficacious and cost-effective. PMID- 3954590 TI - Shoulder harness traction for roentgenographic assessment of the cervical spine. AB - We evaluated the clinical usefulness of a new shoulder traction device to facilitate a rapid complete cervical spine examination in an uncooperative patient population with multiple trauma. Forty-eight patients were randomly designated to receive the shoulder traction device or the standard technique (manual traction on the patient's upper extremities). Patient groups were equivalent in mean coma scale scores, trauma scores, age, and incidence of cervical fracture. Male-female ratios differed between groups, yet were biased against the harness technique. Fewer roentgenograms (lateral view) were required to visualize adequately all cervical vertebrae when the harness device was utilized (mean roentgenograms per patient, 1.2 vs 2.6; P less than .01). Shoulder harness traction during roentgenographic evaluation of the cervical spine may be a useful method to promote visibility of the lower cervical vertebrae. PMID- 3954592 TI - Prevention of postoperative pericardial adhesions. An animal study. AB - Following heart operations, adhesions uniformly form between the epicardium and surrounding structures such as the pericardium, mediastinal fat, pleura, and sternum. These adhesions make reoperations both difficult and hazardous. Three groups of 15 dogs each were studied to assess the effectiveness of pharmacologic manipulation in reducing the adhesions. In the control group, adhesions were created by allowing epicardial/pericardial surfaces to dry, and then adding cotton fibers and blood before closing the pericardium. In the methylprednisolone group, 500 mg of methylprednisolone was given intravenously at the time of operation, followed by 0.3 mg/kg orally three times a day for one week. In the ibuprofen group, 12.5 mg/kg of ibuprofen was given intravenously at operation and then orally three times in one day, followed by 5 mg/kg orally three times a day for six days. Dogs were killed at three to four weeks and the adhesions between pericardium and epicardium were graded. In the control group, none were adhesion free and none had filmy adhesions; three dogs had dense patchy adhesions and 12 had dense diffuse adhesions. In the methylprednisolone group, 14 dogs had no adhesions; one had filmy adhesions; and none had dense patchy or dense diffuse adhesions. In the ibuprofen group, none were adhesion-free; one dog had filmy adhesions; four had dense patchy adhesions; and ten had dense diffuse adhesions. The near-total elimination of pericardial/epicardial adhesions utilizing methylprednisolone, if also achievable in humans, would markedly reduce the difficulty and increase the safety of cardiac reoperations. PMID- 3954593 TI - Percutaneous drainage of diverticular abscess. An adjunct to surgical therapy. AB - We undertook this study to determine whether a computed tomography-guided, percutaneous preoperative drainage of a peridiverticular abscess can safely allow a one-stage procedure in patients requiring surgery for acute diverticulitis. In 17 patients evaluated prospectively by computed tomography, thin-needle aspiration demonstrated purulent fluid collection in 11 patients. Percutaneous catheter drainage was undertaken in eight patients. In the three remaining patients, the abscess was either too small to warrant drainage or no safe access route was present. Seven of eight patients had a single-stage resection within one to three weeks of percutaneous catheter drainage. There were no complications. Our studies suggest that a combined radiological-surgical approach has the potential to reduce morbidity and hospital costs without increasing mortality in the management of perforated colon diverticulitis with associated abscess formation. PMID- 3954595 TI - The left renal vein. PMID- 3954594 TI - Fate of left-sided cardiac bioprosthesis valves in children. AB - To avoid anticoagulation and minimize thromboembolic phenomena, between 1975 and 1980 we used 18 porcine bioprosthetic valves (BPVs) to replace 11 aortic and seven mitral valves in 17 children ranging from 7 to 18 years of age (mean, 8.2 years). Ten BPVs (91%) in the aortic position had to be replaced one to six years (mean, 4.2 years) after insertion. Nine of these valves developed severe calcification with leaflet immobility and severe stenosis. The tenth valve became insufficient with a disrupted cusp. Six (86%) of seven BPVs inserted in the mitral position required replacement two to four years (mean, 3.1 years) after insertion. Massive mitral regurgitation developed in three, while in the other three mitral stenosis was prominent. All explanted BPVs exhibited calcification with disruption and loss of mobility of the leaflets. Hemodynamic deterioration often occurred catastrophically, with nine patients requiring emergency valve replacement. Elective valve replacement carried no hospital mortality, whereas emergency valve replacement carried a 33% mortality. The BPV failure rate of 94% within six years leads us to recommend against the use of biologic valves in the pediatric age group in the aortic or mitral position. Bioprosthetic valve failure may occur catastrophically and replacement should be carried out early to avoid the higher operative mortality associated with emergency surgery. PMID- 3954596 TI - Choledochoduodenal fistula due to a chronic duodenal ulcer. PMID- 3954597 TI - Replication of sialodacryoadenitis virus of rat in LBC cell culture. Brief report. AB - Sialodacryoadenitis virus of rat readily propagated and induced marked cytopathic effect in a rat cell line, LBC cell culture, which provides a sensitive, practical assay system for viral infectivity and neutralizing antibody, and a satisfactory source of the virus. PMID- 3954598 TI - Comparative analysis of the genomes of orthopoxviruses isolated from elephant, rhinoceros, and okapi by restriction enzymes. Brief report. AB - Orthopoxviruses from different zoo-kept mammalian species including Elephas maximus (8 isolates), Ceratotherium simum (1 isolate), and Okapia johnstoni (2 isolates) were characterized by restriction enzyme analysis of the viral genome. The four enzymes BamHI, MluI, NcoI, and SalI were found to be optimal for strain differentiation. PMID- 3954599 TI - Complement activation by respiratory syncytial virus-infected cells. AB - Respiratory syncytial virus (RSV), a major respiratory pathogen of children, has been speculated to cause disease by immunologic mechanisms. Although circulating levels of complement (C) are normal during RSV infections, the role of C in respiratory tract secretion is unclear. Since epithelial cells of the respiratory tract of children infected with RSV express viral surface antigens, the ability of RSV infected human cells to activate C was studied. RSV infected human cells (HeLa) were found to activate both the classical and alternative C pathways as measured by the cleavage of native C3 into its breakdown products. Increased C activation occurred in the presence of antibody. Cytolysis of RSV infected cells was then studied using a chromium release assay. Both the classical and alternative C pathways in the presence of antibody participated in the lysis of RSV infected cells. The combined effects of activation of C and the lysis of RSV infected cells by C and antibody may contribute to the pathogenesis of disease. PMID- 3954600 TI - [Mechanism of formation of intramedullary cavities and their role in the regeneration of the spinal cord]. AB - The spinal cord preparations of 38 dogs and 20 rabbits have been studied with the aim to investigate the influence of the cerebrospinal fluid on the spinal cord nervous tissue. The spinal cord preparations of 8 patients having trauma of the vertebral column with interruption of the spinal cord have also been studied. As demonstrate histological investigations, the cerebral tissue of the pieces, put into the flask with liquor, in the subarachnoidal space of the canine spinal cord, in diastasis between the ends of the cut spinal cord during 6 h up to 7 days, swells, becomes edematous. Cavities occupying about 30% of the area in the slices studied appear in it. At hemisection of the rabbit spinal cord without closure of the defect in the meninx vasculosa with the glue MK-6, the area of the cavity formation varies from 24 up to 35%, comparing the whole area of the preparation, while in rabbits with hemisection and successive gluing of the defect in the meninx vasculosa the area of the nervous tissue destruction makes 13-18%. It has been proved that the scar forming in the traumatized segment of the spinal cord does not present a continuous formation, but contains a large amount of cavities that prevent regeneration of nerve fibers. The experimental data concerning lysing effect of the cerebrospinal fluid on the traumatized nervous tissue are confirmed by the results obtained at investigating the preparations of the spinal cord of the patients died as the cause of the spinal cord trauma. PMID- 3954601 TI - [Angioarchitectonics of the auricular and atrial walls of the human heart]. AB - Preparations of 103 human hearts at various ages have been investigated. The coronary veins are injected with contrast lead mass and a successive roentgenoangiography of the preparations is performed. The sources of blood supply of the atrial and auricular walls are determined taking into account branching variants of the atrial vessels. Vascularization peculiarities of the atrii and auriculae are described at the sinistrocoronary, dextrocoronary and even variants of the atrial branches. With age the diameter, length of the main atrial and auxillary auricular branches increase, as does their convolutivness. In the atrial and auricular walls there are areas comparatively poor in blood vessels. The branching variants do not always coinside with the types of the cardiac blood supply. PMID- 3954602 TI - [Anatomy and topography of the tracheobronchial lymph nodes in man during the postnatal period of ontogeny]. AB - Tracheobronchial lymph nodes (TBLN) have been studied in 71 corpses of persons at different ages. The TBLN are revealed by means of polychromic injection of Gerota mass into the lung tissue, or directly into the lymph nodes revealed. The number of the inferior and superior (right and left) TBLN varies within a wide range. Longitudinal dimentions of the lymph nodes increase with age. A certain age dependence in topography of the inferior and superior TBLN is stated. In persons of mature and elderly age, dextrobronchial type in arrangement of the inferior TBLN is found more often, and at younger age periods--even type of their arrangement is specific. The right superior TBLN in newborns, children and adolescents possess an evenly concentrated type of localization, and at later age periods--dispersive and unevenly concentrated. The superior left TBLN in newborns and children are mainly situated in the TB angle area, in persons of mature and elderly age--on the lateral surface of the thoracic part of the trachea. The form of the TBLN depends on their localization. A certain relation is determined between the localization of the inferior TBLN and the number of the superior (right and left) TBLN. PMID- 3954603 TI - [Changes in the structure of the plasmalemma of hepatocytes and its specialized portions--intercellular junctions in man in complicated forms of cholelithiasis]. AB - As demonstrates the electron microscopic investigation of the human liver at complicated forms of cholelithiasis, there is a stage-by-stage destruction of intercellular junctions and a change in the plasmolemma structure of hepatocytes depending on the degree of the disease. The greatest disorder in the plasmolemma structure is observed at gangrenous calculous cholecystitis, as well as at mechanical jaundice and suppurative cholangitis, dependent on choledocholithiasis. The most sensitive are the gap junctions; desmosomes and intermediate junctions are the second to suffer. The structure of the tight junctions is the last to be disturbed. This results in loss of specificity by different areas of plasmolemma in the hepatocytes, and the hepatocytes themselves loose their polarity. These alterations are evidently irriversible and result in death of the cells. PMID- 3954604 TI - [Synthesis and discharge of secretions in the pancreas of the white rat in the presence of excessive hydrocortisone]. AB - Under conditions of physiological loading at feeding, histologically and radio autographically (35S-methionine), granuloformation and protein metabolism have been studied in exocrinic pancreocytes in mature white rats under abundant injection of hydrocortisone (6 daily injections, 1 mg per 100 g of body mass). The procedure stimulates formation of zymogen granules, but intensity of the excretion remains unchanged. This results in overfilling the cell with the secretory product, considered as the base of the alterative changes, that in their turn could stimulate the development of the steroid pancreatitis. PMID- 3954605 TI - [Multivariate statistical analysis of tissue basophils in acute radiation sickness]. AB - By means of mark scale estimation method, discriminant and factor analyses, changes in integral indices on the state of mast cells in the rat mesentery have been investigated in dynamics of medullary, intestinal and cerebral forms of an acute radiation sickness. The integral indices are calculated basing on the morphometric parameters of the cells, that are obtained after the histological preparations are treated in a special automatic system for analysing images. At the medullary form of the acute radiation sickness, the greatest structural rearrangements of the mast cells take place during the first hours after the radiation, as well as during the climax of the disease, at the intestinal form, the analogous changes are revealed 1-3 days after the effect, and at the cerebral form--3 h after the radiation. The integral indices, calculated by means of the three methods, are well correlated with each other. PMID- 3954606 TI - [Changes in the metabolism of chondrocytes after chronic intake of phenol and lead]. AB - White rats and guinea pigs were given phenol (0.2 and 10 mg/kg) or lead acetate (10 mg/kg of the body mass) for 3-6 months. Intensity of biosynthesis was estimated by glycosaminoglycane cells and by collagene (by means of 35S and 3H glycine inclusion), distribution of glycoproteids, glycogene and alcaline phosphomonoesterase. The intensity of glycosaminoglycanes biosynthesis decrease in chondrocytes, as does glycogene content and alcaline phosphomonoesterase activity in the zones of the cartilage mineralization. In the intercellular cartilage substance, sertain deviations in quantity and in artio of different types of macromolecules appear, that results in decreasing rates of the cartilage substitution and of the osseous trabecules growth and in development of osteoporosis. PMID- 3954607 TI - [Evolution of blood vessels of the heart wall]. AB - In progressive development of the organisms, the cardio-vascular system perfects, its construction is adequate to the level and character of the animal's metabolism. The hypobranchial arteries, forming in the subbranchial area in fishes, make the immediate source for the branching off the coronary arteries. Comparison of the data concerning the places where the cranial coronary arteries take their origin in amphibia, reptiles, birds and mammalia demonstrates that the evolutional process is directed towards transference of the places of their branching off on the ventral aorta, and then on the nearest distance to the heart. Certain data are obtained on evolution of the blood circulation pathways in the myocardium and, particularly, on presence of blood vessels in the spongy myocardium in Elasmobranchii, Chondrosteoideii, as well as in the alligator. The most important of the myocardial blood vessels at all stages of evolution is their connection with the cardiac chambers. At definite stages of phylogenesis, simultaneously with compactization of the myocardium and formation of veins from the intertrabecular spaces, the subepicardial and intramural veins unite into a single venous system, bringing blood to the cardiac cavity. In birds, mammalia and human being, the coronary vessels have reached a high degree of development, having penetrated by their branches into all layers of the cardiac wall, and thus they exclude the dependence of the myocardial blood supply from the blood that is present in the cardiac cavity. PMID- 3954608 TI - [Topologic analysis of the dendritic branching of neurons]. PMID- 3954609 TI - [Methodology of preparing radial sections of the brain]. PMID- 3954610 TI - A case of muteness of cerebellar origin. PMID- 3954611 TI - Ocular bobbing in association with other signs of midbrain dysfunction. PMID- 3954612 TI - Critical frequency of photic driving in the diagnosis of multiple sclerosis. PMID- 3954613 TI - On the notion of doll's eyes. PMID- 3954614 TI - Neuropsychiatry . . . again. PMID- 3954615 TI - The validity of computed tomographic scan findings for the localization of cerebral functions. The relationship between computed tomography and hemiparesis. AB - We studied recovery from hemiparesis in 52 patients who participated in the Hennepin County (Minnesota) Recovery From Aphasia Study. Our intent was to determine the anatomic correlates of recovery from hemiparesis and then to contrast computed tomography (CT)-hemiparesis relationships with CT-aphasia relationships in this same population. Hemiparesis was assessed at one month after onset and again at six months after onset. Computed tomographic scans were obtained five months after onset and analyzed quantitatively for lesion location. The presence or absence of arm paresis was strongly predicted by CT scan findings in the supratentorial corticospinal pathway. However, three of 25 nonparetic patients had lesions in the corticospinal pathway, and one of 22 severely paretic patients lacked an appropriate lesion. This study demonstrated that a small but inherent lack of specificity and sensitivity existed in the predictive power of CT localization of lesions potentially affecting the motor system, suggesting that some caution is necessary in interpreting the lesion-deficit relationships in less well-localized functions, eg, language. Besides considering the lack of precision in localizing with CT, the existence of individual differences both in anatomy and localization of function must be taken into account. PMID- 3954616 TI - A syndrome of pathological left-handedness. Correlates of early left hemisphere injury. AB - A pattern of correlative changes in lateralization in individuals with known or suspected brain injury recently has been advanced as the syndrome of pathological left-handedness (PLH). This syndrome, which is believed to be caused by an early left-sided cerebral lesion, may include asymmetric motor and/or trophic changes on the right side of a body part in addition to changes in higher-level cognitive processing abilities. Several clinical case studies have provided support for such a syndrome. Despite their clinical subject to inherent biases of selection. The present study was therefore designed to evaluate the PLH syndrome in a systematic fashion by using a large number of brain-injured and normal subjects. The incidence of each of the putative elements of the PLH syndrome was investigated. The results suggest that traits such as atypical cerebral speech representation, motor impairment of the nondominant hand, and hypoplasia of the right foot are salient features of the syndrome. The results are discussed with reference to clinical diagnostic implications. PMID- 3954617 TI - Abnormalities of multimodality evoked potentials in amyotrophic lateral sclerosis. AB - Thirty-two patients with amyotrophic lateral sclerosis were studied with somatosensory evoked potentials (SEPs), visual evoked potentials, and brain-stem auditory evoked potentials. H-reflexes were used to screen for abnormalities of peripheral nerve conduction. Nineteen patients (59%) showed an abnormality of lower extremity SEPs. In 13 patients (40%) the delay was of central origin, while in six patients (19%) peripheral conduction delay was possible. Abnormality of upper limb SEPs was seen in 11 patients (34%), all but two of whom had abnormal lower limb SEPs as well. Four patients (12%) had abnormal brain-stem auditory evoked potentials, all of whom had abnormal SEPs from upper and lower limbs. Four patients had abnormal visual evoked potentials, which in three patients were of minor degree. These results give physiologic evidence to suggest that abnormalities in amyotrophic lateral sclerosis occur outside the motor system. PMID- 3954618 TI - ELISA in the diagnosis of neurocysticercosis. AB - IgM antibodies against cysticercus antigens were measured by enzyme-linked immunosorbent assay (ELISA) in 133 serum and 126 cerebrospinal fluid (CSF) samples from patients with active neurocysticercosis (NCC), in 61 serum and 32 CSF samples from patients with inactive NCC, and in 556 serum and 449 CSF samples from patients with other neurological disorders. For diagnosis of active NCC the test showed 50% sensitivity with 70% specificity in serum and 87% sensitivity with 95% specificity in CSF. We concluded that the use of the ELISA with serum is not reliable for diagnosis of NCC and therefore cannot be used routinely for the detection of cases or epidemiological studies. Conversely, ELISA used with CSF is highly dependable for detecting all forms of active NCC. The possible explanations for the discrepancy between serum and CSF results are discussed. PMID- 3954619 TI - Enzyme level changes in the cerebrospinal fluid of patients with acute stroke. AB - Creatine kinase (CK), brain CK (CKBB), lactate dehydrogenase (LD), and aspartate aminotransferase (ASAT) levels were determined in cerebrospinal fluid (CSF) obtained from 35 patients with acute stroke. In patients with transient, minor neurological disturbances, only LD levels increased; in those who remained comatose and died, the levels of all the enzymes, except ASAT, increased. Patients who remained with focal motor defects had increased CK and LD levels, while CKBB and ASAT levels were variable. In most of the CSF samples, muscle CK activity was also detectable, suggestive of a leakage from blood to CSF. The pattern of the enzyme increase could be related to the causative mechanisms for the strokes. The study suggests that CSF enzyme determinations may provide supplementary information as to the extent and severity of brain damage and the recovery potentials of selected patient groups with strokes. PMID- 3954620 TI - Aneurysmal subarachnoid hemorrhage and viral infection. Lack of association. AB - We tested the hypothesis that intracranial aneurysm develops because of viral infection that produces arterial damage, and that aneurysmal rupture is related to viral infection. The following viral agents were studied: influenza A, influenza B, and respiratory syncytial viral titers, by the indirect immunofluorescence method, in 29 patients and 29 controls; herpes simplex virus titers, by immunofluorescence, in 31 patients and 31 controls; rubella viral titers (Rubazyme test), in 34 patients and 34 controls; and influenza A and B viral titers, by the complement fixation method, in 54 patients and 54 controls. Patients were selected on the basis of documented aneurysmal subarachnoid hemorrhage. Analysis, with derivation of the chi 2 method, to compare titer levels in patients and controls for each specific viral titer did not reveal positive correlations between the viral titers and aneurysmal subarachnoid hemorrhage. PMID- 3954621 TI - Botulinum toxin in the management of blepharospasm. AB - Seventy-seven patients with blepharospasm unresponsive to other forms of therapy were treated with botulinum A toxin. The drug was injected into the orbicularis oculi muscle of both upper and lower eyelids and, in some patients, into the brows and upper part of the face as well. A total of 192 treatment sessions were given, with follow-up ranging from four weeks to 18 months. Orbicularis muscle spasms decreased markedly over the first five days following injection, both in patients with essential blepharospasm and in those with hemifacial spasm. Beneficial effect was temporary, however, and repeated injections were required for sustained relief. Fifty-two patients received multiple treatments, ranging from two to eight injections each, with a mean duration of benefit of 11.8 weeks. Results of subsequent injections were similar to the first in rapidity of onset, degree of benefit, and duration of effect. Complications were local, mild, and transient, and no systemic side effects were encountered. PMID- 3954623 TI - Cortical vs subcortical dementia. Neuropsychological differences. AB - The distinction between cortical and subcortical syndromes of dementia is controversial. Clinical reports suggest that subcortical syndromes (eg, Parkinson's disease) involve less severe intellectual and memory dysfunction and lack the aphasia, agnosia, and apraxia typical of the cortical dementias (eg, dementia of the Alzheimer type). A recent neuropsychological investigation using a standardized procedure failed to confirm the distinction. We examined patients with Alzheimer's disease, patients with Parkinson's disease, and normal controls by using a neuropsychological procedure specifically designed to quantitatively evaluate the proposed clinical differences. The results differentiated these dementia syndromes, and the pattern of performance was consistent with the cortical-subcortical hypothesis. PMID- 3954622 TI - Failure of immunosuppression with a ten- to 14-day course of high-dose intravenous cyclophosphamide to alter the progression of amyotrophic lateral sclerosis. AB - Amyotrophic lateral sclerosis (ALS) is a progressive disorder of the nervous system for which there is no known treatment. Because recent studies have suggested that there may be abnormalities of the immune function in patients with ALS and since we have found a beneficial effect from a short course of intensive immunosuppression with cyclophosphamide in progressive multiple sclerosis, we treated six patients with ALS with a ten- to 14-day course of intensive immunosuppression in a pilot study. At 18 months following therapy, all patients showed a continued progression of the disease; four of the six patients died. We conclude that this form of immunosuppression does not alter the course of ALS. PMID- 3954624 TI - Timing of levodopa therapy. PMID- 3954625 TI - Paraneoplastic opsoclonus-myoclonus. Association with medullary thyroid carcinoma and review of the literature. AB - The syndrome of opsoclonus-myoclonus (OM) is an infrequent but well-known "remote effect" of neuroblastoma in children. The OM syndrome is even less frequent in adults. A few cases of adult paraneoplastic OM have been described in association with several systemic neoplasms. We report the unique case of a 29-year-old man with metastatic medullary thyroid carcinoma in whom OM developed as part of a generalized transient encephalopathy. We outline the postulated anatomic lesions and pathophysiologic mechanisms underlying the OM syndrome, as well as examine the possible connections between the neuroendocrine derivation of medullary thyroid carcinoma and the neurotoxic and/or autoimmune theories of the causation of the OM syndrome in patients with systemic neoplasms. PMID- 3954626 TI - Extracapsular cataract extraction with posterior chamber intraocular lens implantation in a postradial keratotomy patient. PMID- 3954627 TI - Central retinal vein occlusion complicating spontaneous carotid-cavernous fistula. PMID- 3954629 TI - Eyelid tattooing. PMID- 3954628 TI - Adie's tonic pupil in a patient with carcinomatous neuromyopathy. PMID- 3954630 TI - Repairing the superior oblique tendon. PMID- 3954632 TI - Cord paralysis after Nadbath facial nerve block. PMID- 3954631 TI - Systemic effects of topical phenylephrine. PMID- 3954633 TI - Informed consent. Surrender or salvation? PMID- 3954634 TI - Reported satisfaction, fluctuation of vision, and glare among patients one year after surgery in the Prospective Evaluation of Radial Keratotomy (PERK) Study. AB - We studied satisfaction with the results of radial keratotomy one year after surgery on one eye as reported by 354 patients in the Prospective Evaluation of Radial Keratotomy (PERK) Study. We measured satisfaction using an index based on ten questions that were part of a longer psychometric questionnaire. Patients were generally satisfied with the results of radial keratotomy-48% were very satisfied, 42% were moderately satisfied, and 10% were dissatisfied. A lot of trouble with fluctuating vision was reported by 12% of patients before surgery and by 34% one year after surgery; 17% reported a lot of trouble with glare both before surgery and one year after surgery. The three major factors that influenced satisfaction were uncorrected visual acuity, residual refractive error, and subjective daily fluctuation in vision. A multiple regression equation that incorporated these three variables, glare, and patient sex was able to predict only 46% of the variance in patient satisfaction. PMID- 3954635 TI - Second nonocular tumors in survivors of heritable retinoblastoma. AB - We reviewed the records of 50 patients with heritable retinoblastoma to study the cause of death, if deceased, or the incidence of second nonocular malignant neoplasms. The incidence of second tumors in these patients was 6% at ten years, 14% at 20 years, and 14% at 30 years. These findings are lower than previously reported results. Pinealoma was the probable cause of death in three of the five patients who died of second nonocular tumors. PMID- 3954636 TI - Surgery for large-angle congenital esotropia. Two vs three and four horizontal muscles. AB - Large-angle congenital esotropia is usually managed surgically by either of two fundamentally different approaches: (1) the uniform approach, in which surgery is restricted to two extraocular muscles (bimedial recessions or monocular recession resection), or (2) the selective approach, in which bimedial recessions are combined with resections of one or both lateral rectus muscles. We compared surgical results of the two types of surgery during a ten-year period for 107 patients, of whom 57 underwent bimedial recessions, two had monocular recession resections, and 48 received three- or four-muscle surgery. The average follow-up time was 2.6 years. The percentage of good surgical results (orthophoria +/- 10 PD) in the selective group was 64.5%, compared with 37.3% in the uniform group. Only three of the 48 patients in the selective group required a second procedure, compared with 17 of 59 patients in the uniform group. PMID- 3954637 TI - Probing and irrigation for congenital nasolacrimal duct obstruction. AB - I reviewed the results of probing for congenital nasolacrimal duct obstruction in a series of 107 patients, with special reference to age at the time of probing. Relief of tearing and discharge was achieved in 90% of patients with the first probing, and an additional 6% were cured after a second probing. Altered nasolacrimal duct anatomy seemed to account for probing failures rather than any delay in probing. Primary probing continued to be an effective treatment well after 2 years of age and was successful in two 5-year-old patients. Unsuccessful probings were usually apparent at the time of the initial probing and were characterized by difficulty passing the probe and subsequent inability to irrigate saline through the nasolacrimal system into the nose. Dacryocystorhinostomy was an effective secondary procedure in the few patients in whom probing was unsuccessful. PMID- 3954638 TI - Intracranial extension and bone destruction in orbital pseudotumor. AB - Three cases of surgically proved pseudotumor of the orbital apex with intracranial extension occurred. All demonstrated bony destruction. Varying degrees of ophthalmoplegia and visual loss were present in all three. Previous computed tomographic descriptions of the patterns of orbital pseudotumor have not included bone destruction. Further, intracranial extension has been reported in only one patient. These three cases are reported to emphasize the fact that while these manifestations may be rare, it is appropriate to include orbital pseudotumor in the differential diagnosis of orbital apex lesions that are associated with both bone destruction and/or intracranial extension. PMID- 3954639 TI - Abnormal sperm and photoreceptor axonemes in Usher's syndrome. AB - Axonemes are organelles that are composed of microtubule doublets and singlets with a complex assembly of associated proteins. This study was designed to investigate the possibility that an abnormal axoneme is involved in the pathogenesis of Usher's syndrome. A masked structural and functional analysis of sperm was performed on samples from ten patients with Usher's syndrome and 33 controls, including duplicate samples from six patients and three controls. In the functional analyses, there was a significant decrease in patient sperm motility and velocity. Structurally, there was a significant increase in tail abnormalities at both the light and electron microscopic levels. Ejaculate volume and sperm concentration were normal in the patient population. The presence of abnormal axonemes was also confirmed in remnant photoreceptors of a whole eye donation from a patient with Usher's syndrome. The data suggest that defective connecting cilia axonemes may be involved in the irreversible, progressive loss of photoreceptors in Usher's syndrome. PMID- 3954640 TI - Dark-adapted foveal thresholds and visual acuity in retinitis pigmentosa. AB - To determine the relationship of foveal absolute thresholds to visual acuity in retinitis pigmentosa, we measured thresholds in 40 patients with various forms of retinitis pigmentosa (including Usher's syndrome) whose Snellen visual acuities were 20/30 or better. At all visual acuity levels, the patients' foveal thresholds were significantly higher than those of 20 similarly aged normal observers; threshold elevations tended to be greater for a 500-nm than for a 655 nm test flash. Foveal cone spatial summation functions were normal (test flash diameter range, 7' to 1.7 degrees), indicating that the patients' threshold elevations did not result from altered summation properties. A significant correlation between foveal cone thresholds and the midpoints of the patients' Rayleigh matches demonstrated that the threshold elevations resulted in part from a decreased cone optical density. PMID- 3954641 TI - Duration of automated suprathreshold vs quantitative threshold field examination. Impact of age and ocular status. AB - We investigated the impact of age and ocular status on the duration of automated threshold and suprathreshold testing of the visual field in a study of 57 eyes with glaucomatous field loss, 58 eyes with ocular hypertension, and 190 eyes of normal controls. It was faster to run a three-zone threshold-related suprathreshold 120-point full-field screening test on younger subjects and normal controls than on older subjects or subjects with early glaucomatous field loss. In contrast, the time required for full quantitative thresholding of 76 points within the central 30 degrees was unaffected by either age or ocular status. Normal individuals required 40% more time to complete the quantitative threshold test than the "full-field" screening test. PMID- 3954642 TI - Malignant melanoma at the site of penetrating ocular trauma. AB - We document clinically and histopathologically the development of a uveal melanocytic tumor at the site of penetrating ocular trauma in a 34-year-old man. A metallic intraocular foreign body was extracted via the inferonasal pars plana with an electromagnet in February 1975. At that time no intraocular tumor was noted and the visual acuity returned to 20/20. The patient developed floaters in January 1981, at which time findings from fundus examination and needle biopsy of the lesion suggested the presence of a spindle-cell melanoma. The diagnosis was confirmed histopathologically following enucleation. The possible association between trauma and ocular melanoma is discussed. PMID- 3954643 TI - Intravitreous fibronectin and platelet-derived growth factor. New model for traction retinal detachment. AB - In proliferative vitreoretinopathy and trauma, traction retinal detachments result from cellular migration into the vitreous cavity with contractile membrane formation. Cleary and Ryan have established the efficacy of intravitreous injection of autologous blood in reproducing this pathologic process in the rabbit eye. It has previously been shown that two serum components, fibronectin and platelet-derived growth factor, stimulate cellular migration. We now show that contractile membranes and traction retinal detachments occur in 72% of rabbit eyes within three weeks following intravitreous injection of fibronectin and platelet-derived growth factor. These results provide a straightforward new model to study the development of intravitreous cellular membranes and traction retinal detachments. PMID- 3954644 TI - A retinal pigment epithelial cell-derived growth factor(s). AB - Proliferation of retinal pigment epithelial (RPE) cells, fibroblasts, and glial cells has been implicated in the pathogenesis of proliferative vitreoretinopathy. In this study, we demonstrate that RPE cells in culture produce a factor(s) that stimulates the growth of each of these cell types. After 48 hours of incubation with RPE-conditioned media, cell number is increased over that of controls by 110% for RPE cells, 105% for astrocytes, and 360% for corneal fibroblasts. Thymidine incorporation demonstrates that this increase is due to a stimulation of DNA synthesis. Preliminary characterization of the RPE growth-promoting activity demonstrates that it is heat stable, stable to extremes of pH, nondialyzable, and partially trypsin sensitive. These data suggest that RPE cells in culture produce a growth factor(s) targeted primarily at fibroblasts, but that can also stimulate their own growth and that of astrocytes. PMID- 3954645 TI - Ocular toxicity of intravitreal vidarabine solubilized in dimethyl sulfoxide. AB - Intravitreal injections of the antiviral drug vidarabine in doses of 10, 50, 100, and 200 micrograms dissolved in 100% dimethyl sulfoxide (DMSO) were administered to the eyes of 12 Dutch and New Zealand pigmented rabbits to determine ocular toxicity. The eyes were examined one week, one month, and two months after inoculation with slit-lamp biomicroscopy, indirect ophthalmoscopy, electroretinography, and histopathologic examination with light and electron microscopy. No permanent damage to ocular tissue was found at a vidarabine concentration of 100 micrograms/mL. The antiviral activity and the toxicity of the vidarabine dissolved in DMSO were tested in vitro on herpes simplex virus type 1-infected rabbit corneal fibroblast monolayers. Vidarabine dissolved in DMSO was found to possess in vitro antiviral activity against herpes simplex virus type 1. Our results suggest that the intravitreal administration of vidarabine dissolved in DMSO may be a safe and effective means of drug therapy. PMID- 3954646 TI - Aqueous concentrations of fluorouracil after intravitreal injection. Normal, vitrectomized, and silicone-filled eyes. AB - Treatment of postoperative vitreoretinopathy with combined intravitreal fluorouracil and liquid silicone may result in increased corneal and retinal toxicity. We therefore investigated the movement of carbon 14-labeled fluorouracil from the vitreous into the anterior chamber in normal rabbit eyes and in eyes filled with either balanced salt solution or silicone after vitrectomy and lensectomy, with or without preservation of the anterior capsule. Only 0.56% of intravitreally injected fluorouracil was recovered from the anterior chamber over a four-hour period in normal eyes. This impermeability was partly maintained if the anterior capsule was retained (9.98%), particularly if the eye contained silicone (2.52%). The greatest amount was recovered when both lens capsules were removed (43.7%). Corneal toxicity is most likely to occur in this situation. PMID- 3954647 TI - Barrier function of corneal endothelium and the intraocular irrigating solutions. AB - I studied the in vitro effect of three intraocular irrigating solutions--a glutathione bicarbonate Ringer (GBR), a commercially available glucose glutathione bicarbonate solution (BSS Plus), and a citrate-acetate bicarbonate solution (S-MA2)--on the barrier function of the corneal endothelium. The major chemical differences between S-MA2 and GBR or BSS Plus are that S-MA2 does not contain glutathione and phosphate but does contain acetate and citrate. Paired rabbit corneas were perfused separately, and the endothelial permeability (Pac) to carboxyfluorescein was determined. Between the paired corneas perfused with GBR and BSS Plus, there was no significant difference in the Pac, while a significant difference in this factor was seen between the paired corneas perfused with GBR and S-MA2; the figure was about 20% larger for S-MA2. It is suggested that BSS Plus or GBR is less harmful to the endothelial barrier function than S-MA2 and that Pac to carboxyfluorescein can be a useful index in determining the safety of the intraocular irrigating solutions. PMID- 3954648 TI - Ophthalmology in China. Endogenous uveitis in a Chinese ophthalmological clinic. PMID- 3954649 TI - Diabetic retinopathy vitrectomy study. PMID- 3954650 TI - Simplified contact lens localizer. PMID- 3954651 TI - Alteration of the blood-retinal barrier by dipyridamole. PMID- 3954652 TI - The pressures on our standards of ethics. PMID- 3954653 TI - The physician with visual impairment or blindness. A reappraisal. PMID- 3954654 TI - Threshold Amsler grid testing. Cross-polarizing lenses enhance yield. AB - The Amsler grid is a commonly used test for evaluation of the 10 degrees of visual field surrounding fixation. The Amsler grid is a suprathreshold stimulus and thus may not detect relative scotomas. Therefore, we had ten patients with optic neuropathies view the grid through cross-polarizing filters that created low luminance conditions in which the grid was barely perceptible. The patients were also surveyed with a 2-m tangent screen protocol and threshold automated perimetry. The threshold Amsler grid technique increased both the number of defects found and the total area of these defects by approximately a factor of 5. Two thirds of the defects found were confirmed by one of the other screening techniques. Threshold Amsler grid testing is a rapid, inexpensive, and sensitive technique for the evaluation of the central 10 degrees of the visual field. PMID- 3954655 TI - Neodymium-YAG laser posterior capsulotomy. Central corneal endothelial cell density. AB - We determined central corneal endothelial cell densities in 39 eyes in a masked fashion before and after Q-switched neodymium-YAG laser posterior capsulotomy. The mean preoperative endothelial cell count was 1,840 cells per square millimeter (SD, 611 cells per square millimeter; range, 522 to 2,742 cells per square millimeter). The mean postoperative endothelial cell count was 1,798 cells per square millimeter (SD, 600 cells per square millimeter; range, 478 to 2,750 cells per square millimeter). The difference between the mean preoperative and postoperative cell density was 42 cells per square millimeter (2.3% cell loss). There was no significant correlation between central corneal endothelial cell loss and the laser energy used, pseudophakic status (posterior chamber intraocular lens vs no intraocular lens), size of capsulotomy, vitreocorneal touch, or preoperative corneal endothelial cell density. PMID- 3954656 TI - Improving the predictability of intraocular lens power calculations. AB - We reviewed the intraocular lens power calculations on 512 posterior chamber lens implantations and determined four ways to reduce the estimated 5% incidence of large postoperative refractive "surprises" (greater than 2 diopters [D]): First, preoperatively identify those patients who have greater than a 1-D difference between the theoretical and linear regression formulas. Second, repeat axial length and corneal power measurements in these patients to eliminate random error. Third, develop an individualized theoretical formula that accounts for constant bias. Fourth, encourage manufacturers to improve instrumentation for measuring corneal power and axial length. We also examined the disparity between the linear regression formula and the curvilinear theoretical formula. PMID- 3954657 TI - Ocular motility disturbances following cosmetic blepharoplasty. AB - Five patients developed diplopia following cosmetic blepharoplasty. While temporary diplopia and visual disturbances are known to occur following this type of surgery, the persistence of diplopia with demonstrable muscle imbalance is not common. We encountered ocular motility complications involving the inferior or oblique muscle, inferior rectus muscle, and superior oblique tendon. PMID- 3954658 TI - Blood-retinal barrier function in patients with cone or cone-rod dystrophy. AB - We assessed blood-retinal barrier function by vitreous fluorophotometry in 24 patients with either cone or cone-rod dystrophy who were segregated into three subgroups. Compared with a normal population, the patients demonstrated increased vitreous fluorescence (breakdown of the blood-retinal barrier) that positively correlated with peripheral pigmentary changes and an appreciable reduction in electroretinographic scotopic b-wave amplitude. A unique subgroup of three women with supernormal electroretinographic scotopic b-wave amplitudes to a high intensity stimulus had an abnormal increase in permeability of the blood-retinal barrier even without peripheral pigmentary fundus changes. PMID- 3954659 TI - Reliability of fixation preference testing in diagnosing amblyopia. AB - We evaluated the sensitivity and specificity of standard fixation preference testing and the 10-prism diopter (PD) fixation test in 427 patients. Standard fixation preference testing showed good sensitivity and specificity for than 10 PD. Patients with small angle tropias, however, had a high false-positive rate, with 40% of nonamblyopic patients inappropriately responding with strong fixation preference. The 10-PD fixation test reduced this high false-positive rate and showed only 1.5% false-positive results. Unfortunately, this shift to equal fixation preference was also seen in some patients with amblyopia, as five of 19 patients with three or more lines difference alternated fixation with the 10-PD fixation test. Retesting disclosed that, although these children would briefly alternate to the amblyopic eye while viewing a stationary target, they would not hold fixation with the amblyopic eye through smooth pursuit. Our conclusion is that standard fixation preference testing can be used to diagnose moderate to severe amblyopia in patients with tropias greater than 10 PD. Patients with small angle deviations or straight eyes should be examined with the 10-PD fixation test, with the criterion for equal vision being the ability to hold fixation well with either eye through smooth pursuit. PMID- 3954660 TI - Measurement of blood-retinal barrier function in central retinal vein occlusion. AB - Vitreous fluorophotometry was used to measure blood-retinal barrier permeability to fluorescein in eight patients (mean age, 42.9 years; range, 30 to 55 years) with central retinal vein occlusion (CRVO). Permeability coefficient was derived by fitting a mathematical model to the posterior vitreous fluorescence scan and plasma-free fluorescein concentration curve at 60 minutes after intravenous fluorescein sodium (14 mg X kg-1). A permeability index (PI) was estimated by dividing the area under the vitreous fluorescence scan by the area under the plasma-free fluorescein curve. The permeability coefficient and PI were comparable and highly correlated. Initial mean permeability coefficient was 28.78 X 10(-7) cm X s-1 (range, 14.42 X 10(-7) to 41.10 X 10(-7) and 1.89 X 10(-7) cm X s-2 (range, 0.96 X 10(-7) to 2.76 X 10(-7) in eight affected and seven unaffected eyes, respectively. The permeability coefficient and PI in unaffected eyes did not differ significantly from 18 eyes of ten normal subjects. After three to 12 months, permeability coefficient and PI in affected eyes approached the values in the contralateral eyes of four patients with mild and one patient with moderate CRVO but remained elevated in the remaining patients. The permeability coefficient and PI correlated well with changes in severity of retinal appearances on color photographs and fluorescein angiograms. Vitreous fluorophotometry quantitated changes in blood-retinal barrier permeability in CRVO. PMID- 3954661 TI - Severe retinal vaso-occlusive disease in systemic lupus erythematous. AB - Retinopathy in systemic lupus erythematosus generally consists of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report data from 11 patients with SLE and severe retinal vaso-occlusive disease. Visual outcome was often poor, with 55% of the involved eyes suffering visual loss, frequently to an acuity of worse than 20/200. The systemic feature significantly associated with severe retinal vascular disease was central nervous system involvement (CNS lupus), present in eight (73%) of the 11 patients vs an overall prevalence of 37%. The association of CNS lupus with severe retinal vaso occlusive disease probably reflects a similar pathogenetic mechanism and microangiopathy. PMID- 3954662 TI - Optic neuropathy in systemic lupus erythematosus. AB - We report data from seven cases of optic neuropathy in systemic lupus erythematosus. The visual outcome varied, but improvement occasionally occurred following treatment with corticosteroids. The clinical picture was variable and could present as acute retrobulbar optic neuritis, ischemic optic neuropathy, or slowly progressive visual loss. Visual evoked response testing revealed increased latency in two patients and loss of amplitude in two others; a fifth patient had both findings in the involved eye. Despite the variable presentation, the probable pathogenesis in all cases is vaso-occlusive disease in small vessels of the optic nerves. PMID- 3954663 TI - Electrodes for electroretinography. A comparison of four different types. AB - Electroretinograms of 11 healthy eyes were recorded on two occasions. Four different electrodes were used, and the B-wave amplitudes were compared. The Lovac contact lens electrode produced higher amplitudes than did the ERG-Jet lens electrode or the Burian-Allen lens electrode. The gold foil electrode gave the lowest amplitudes, but was superior in comfort. PMID- 3954664 TI - Diffuse toxoplasmic retinochoroiditis in a patient with AIDS. AB - Ocular toxoplasmosis typically presents as a focal necrotizing retinochoroiditis. We report a case of diffuse necrotizing retinochoroiditis due to toxoplasmosis in a patient with the acquired immunodeficiency syndrome (AIDS). The appearance at initial presentation was similar to the acute retinal necrosis syndrome. We recommend that toxoplasmosis be considered in the differential diagnosis of diffuse retinal necrosis in patients with AIDS. Although systemic disseminated toxoplasmosis is not rare in AIDS, this is, to our knowledge, the first reported case of diffuse ocular involvement. PMID- 3954666 TI - Primary localized amyloidosis presenting as an eyelid margin tumor. AB - A 40-year-old man had slow-growing, nodular, amyloid tumors of the eyelid margin associated with recurrent intradermal hemorrhages for 18 years. Medical evaluation revealed no evidence of primary systemic amyloidosis. We suggest that amyloidosis be included in the differential diagnosis of painless, slow-growing, nodular tumors of the eyelid margin. PMID- 3954665 TI - Congenital hereditary (juvenile X-linked) retinoschisis. Histopathologic and ultrastructural findings in three eyes. AB - One surgically enucleated and two postmortem eyes were obtained from two related men with congenital hereditary retinoschisis. A periodic acid-Schiff-positive amorphous material was identified within the retina adjacent to the schisis cavities. Ultrastructural examination of this material showed numerous extracellular filaments, measuring approximately 11 nm in diameter. Similar filaments were found in the vitreous in all three globes and in a normal globe. We believe that the intraretinal filaments are produced by defective Muller cells and that their extracellular accumulation may lead to degeneration of cells and subsequent schisis formation. PMID- 3954668 TI - Special short needles to inject and aspirate high-viscosity silicone oil. AB - The use of 16-gauge needles of shortened length (4 and 8 mm) allows intraocular injection of high-viscosity silicone oil (12,500 centistokes) without the need for special pumps. PMID- 3954667 TI - Experimental retinal detachment. XI. Furosemide-inhibitable fluid absorption across retinal pigment epithelium in vivo. AB - Rhegmatogenous retinal detachments were created in one eye of each of six cynomolgus monkeys. Total vitrectomy alone was performed in the fellow eyes. The rate of disappearance of fluorescein sodium injected into the vitreous cavity was measured with kinetic vitreous fluorophotometry. Intravitreal 10(-4)M probenecid was used to inhibit active outward transport of fluorescein. In eyes with retinal detachment, the rate of fluorescein loss from the vitreous cavity was decreased 44% and 22% following intravitreal injection of 10(-4) and 10(-5)M furosemide (Lasix), respectively. Intravitreal 10(-4)M furosemide decreased the rate of fluorescein loss in fellow eyes by 35%. The rate of fluorescein loss via the anterior chamber accounted for only 1% to 8% of the total rate of vitreous fluorescein loss. Thus, it is concluded that intravitreal absorption across the retinal pigment epithelium. PMID- 3954669 TI - Injury and repair of endothelium at sites of flow disturbances near abdominal aortic coarctations in rabbits. AB - The acute and chronic effects of flow disturbances on arterial endothelium were studied by locally constricting the diameter of the rabbit abdominal aorta by 62% + 2.4% (mean +/- SE). This procedure produced a region of elevated shear stress immediately upstream from the coarctation. A region of small irregular vortices was formed in the first 5 to 7 mm downstream, whereas an annular vortex was observed in the region from 2.0 to 2.5 cm further downstream. Morphologic changes to the endothelium near these coarctations were assessed by scanning electron microscopy; endothelial cell replication rates as a function of time after coarctation were monitored with 3H-thymidine. These studies established that profound alterations in endothelial cell shape caused by changes in local flow conditions immediately downstream from coarctations are primarily the result of alterations in morphology of pre-existing cells, rather than the proliferation of new cells with altered morphology. Definitive morphologic evidence of injury to endothelium was not seen at any sites after coarctation. Indeed, any early injury to endothelium caused by the flow disturbances was not sufficiently severe to cause a significant increase in endothelial cell turnover rate during the first week of coarctation. On the other hand, we observed a major increase in cell turnover (over 100-fold) by 30 days after coarctation at sites immediately upstream and immediately downstream of the coarctation. This finding suggests that flow-induced trauma can ultimately injure the cell sufficiently to cause cell death if the source of injury is persistent. Finally, we demonstrated that the high shear stress immediately upstream from the coarctation and the secondary flow disturbances immediately downstream can retard migration of endothelial cells into sites of injury, whereas repair was enhanced in the region of the primary annular vortex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954670 TI - Improved arterial distensibility in normotensive subjects on a low salt diet. AB - Arterial pulse wave velocity (PWV), a noninvasive index of arterial distensibility, was measured in 57 normotensive subjects who followed a voluntary low salt diet for a period ranging from 8 months to 5 years (mean, 24.8 months). Subjects who followed a regular diet were matched for age and mean arterial pressure with the low salt (LS) sample and were used as controls (C). For both samples, subjects were divided into three age groups: Group 1 (aged 2 to 19 years, n = 16), Group 2 (29 to 44 years, n = 26), and Group 3 (45 to 66 years, n = 15). There was a marked increase in aortic PWV with age in the control sample but not in the LS sample. There was no significant difference in aortic PWV for Group 1, but in Groups 2 and 3, the LS subjects showed a decrease of 21.8% and 22.7%, respectively, compared to C subjects. Aortic PWV (cm/sec) was: Group 1: C = 581 (SE44), LS = 614 (SE31); Group 2: C = 942 (SE46); LS = 737 (SE27) (p less than 0.001); Group 3: C = 958 (SE77), LS = 741 (SE25) (p less than 0.05]. Arm and leg PWV were also significantly lower in the older age groups. These findings suggest that normotensive adult subjects who follow a low salt diet (mean intake, 44 mmol Na/24 hours) have reduced arterial stiffness and that the effect is independent of blood pressure. This is prima facie evidence that reduced salt intake has a beneficial effect in improving distensibility of the central aorta and large peripheral arteries, which is independent of its antihypertensive action. PMID- 3954671 TI - Metabolism of low density lipoproteins by pigeon skin fibroblasts and aortic smooth muscle cells. Comparison of cells from atherosclerosis-susceptible and atherosclerosis-resistant pigeons. AB - Aortic smooth muscle cells from atherosclerosis-susceptible White Carneau (WC) pigeons lack a functional low density lipoprotein (LDL) receptor pathway. The purpose of the present study was to determine if atherosclerosis-resistant Show Racer pigeons (SR) shared this lack of an LDL receptor pathway and if LDL from normal and hypercholesterolemic pigeons were metabolized similarly. The amount of LDL bound, internalized, and degraded by skin fibroblasts, embryo fibroblasts, and aortic smooth muscle cells from WC and SR pigeons were similar and averaged from 2% to 25% of that seen with monkey smooth muscle cells incubated with the same LDL. LDL uptake by pigeon cells was due largely to nonspecific processes, while specific uptake predominated in monkey cells. A similar lack of specific uptake was obtained with LDL from normal and hypercholesterolemic pigeons. Sterol synthesis and HMG-CoA reductase activity were 10- to 35-fold higher in pigeon cells than in monkey cells incubated in serum-containing medium. LDL had little effect on cholesterol esterification and cholesteryl ester accumulation in pigeon cells. These results indicate that despite major changes in the size and composition of LDL from hypercholesterolemic pigeons, this LDL, like normal pigeon and monkey LDL, was not metabolized by specific uptake processes by pigeon cells. Cells from both WC and SR pigeons lack a functional LDL receptor pathway. PMID- 3954672 TI - Conservation of the low density lipoprotein receptor-binding domain of apoprotein B. Demonstration by a new monoclonal antibody, MB47. AB - The fact that low density lipoprotein (LDL) from multiple animal species binds to the human LDL receptor suggested that the LDL-receptor binding domain of apoprotein (apo)B must be evolutionarily conserved. To determine if a common receptor domain epitope existed on apo B, we generated a monoclonal antibody that was specific for the LDL-receptor domain of apo B. This was accomplished by using a screening procedure that selected for a hybridoma supernatant that could block specific cellular uptake and degradation of LDL. Western blots showed that this antibody, termed MB47, was specific for apo B-100. Fluid phase assays indicated a high binding affinity (Ka = 4 X 10(9) M-1) and demonstrated that all human LDL particles expressed the MB47 epitope. Scatchard analysis indicated that a maximum of one MB47 molecule bound to each LDL particle. In solid phase assays, antibody MB47 bound to plasma or LDL of multiple mammalian species, including guinea pig, rabbit, pig, dog, cat, seal, whale, bear, and lion, but it did not bind to mouse or rat LDL. In contrast, a rabbit antiserum to LDL and two other anti-apo B monoclonal antibodies, MB3 and MB19, which do not bind to the receptor domain, were specific only for human LDL. LDL from multiple species, including mouse LDL, competed effectively with 125I-human LDL for binding to human fibroblasts. MB47 effectively inhibited uptake and degradation of labeled human, guinea pig, and rabbit LDL by both human and guinea pig fibroblasts. We conclude that antibody MB47 binds to a single receptor domain on LDL and identifies a vital region conserved through mammalian evolution. PMID- 3954673 TI - Expression of factor V on human umbilical vein endothelial cells is modulated by cell injury. AB - Since human endothelial cells synthesize Factor V but do not secrete it into the medium, we studied the effects of cell injury on the availability of Factor V at the surface of these cells. Human umbilical vein endothelial cells (HUVEC), grown to confluency and incubated with human 125I Factor Va, specifically bound 5000 to 7000 molecules per cell. In the absence of added Va, no antigen was detected on adherent HUVEC with either labeled anti-V(Va) monoclonal or polyclonal IgG. However, exogenous Va, not V, prebound to these cells allows binding of labeled 125I anti-V(Va). Immunodectectibility of bovine Factor V contributed by fetal calf serum in the concentration used in cultures is less than 0.1% of that detected in human plasma. HUVEC, suspended by scraping from dishes, specifically bound 4000 molecules/cell of 125/I monoclonal IgG against V(Va). Although undisturbed cells excluded trypan blue, dye uptake by many of the suspended HUVEC indicated cell injury. Quantitation of injury by 51Cr release after scraping followed by multiple passages through an 18 g needle showed that 51Cr release increased with number of manipulations up to 60% and was observed almost immediately after manipulation. We suggest that little Factor V(Va) is present on the surface of intact adherent HUVEC. However, mechanical injury to HUVEC released or exposed endogenous Factor V(Va), resulting in expression of V that might mediate Factor Xa binding as well as activation of protein C by thrombin. Thus, injured, but not intact, HUVEC could participate in both promoting and limiting blood coagulation. PMID- 3954674 TI - Increased fibrinogen binding to platelets from patients with familial hypercholesterolemia. AB - Familial hypercholesterolemia (FH) is a disease marked by a high incidence of thrombotic episodes and hypersensitivity of the patients' platelets to naturally occurring aggregating agents. Prostaglandin/thromboxane (PG/Tx) formation, adenosine 5'-diphosphate (ADP) secretion, and fibrinogen binding to platelets are all believed to be involved in the mechanisms of platelet aggregation. Therefore, we studied the interrelated roles of these processes in the platelets of nine FH patients and 10 controls. In response to ADP, collagen, or thrombin, FH platelets bound about twice as much 125I-fibrinogen as controls. This ratio did not change after suppression of PG/Tx formation by aspirin. With or without aspirin, FH platelets always aggregated in response to significantly lower concentrations of these agents than did platelets from normal controls. After stimulation with thrombin or collagen, the hyperaggregable platelets from FH patients were shown to bind significantly more fibrinogen than control platelets even when PG/Tx formation was suppressed (aspirin) and secreted ADP was scavenged (apyrase). To determine whether the increased fibrinogen binding observed in FH platelets is due to a qualitative or quantitative abnormality of the platelet receptor, we used a monoclonal antibody (B79.7) that is specific for the receptor. The amount of B79.7 that bound to platelets from control and FH subjects was similar. In addition (as in normal individuals), the antibody inhibited aggregation and fibrinogen binding of FH platelets. PMID- 3954675 TI - Endothelial cell monolayer integrity. I. Characterization of dense peripheral band of microfilaments. AB - Although the endothelial cell (EC) cytoskeleton has been studied both in vitro and in vivo, little is known about its role in endothelial integrity. We have previously suggested that specific EC microfilament (MF) structure, which we have termed the "dense peripheral band (DPB)," may play a major role in this process. We have extended our studies to characterize this structure in pig aortic ECs in vitro. During the growth of EC cultures, the DPB appears only when the cultures have attained confluency. Using double fluorescent labeling, we found that alpha actinin, myosin, and tropomyosin colocalized with the F-actin making up the DPB. Occasional microtubules were present in this region, although there was no preferred association between microtubules and the DPB. Colocalization studies revealed vinculin plaques at the cell-cell interface. Thin MFs extended from the DPB into the cytoplasmic side of these plaques. The DPB was completely disrupted by low dose cytochalasin B within 30 minutes, whereas many central MF bundles were still present at 24 hours. The results of this study suggest that the DPB is a distinct structure in the confluent EC monolayer and is closely associated with the ability of ECs to form and maintain the EC monolayer. The disruption of the DPB as an important initial event in the pathogenesis of vascular diseases such as atherosclerosis is discussed. PMID- 3954676 TI - Correlation of endothelial cell shape and wall shear stress in a stenosed dog aorta. AB - The pattern of endothelial geometry at various locations along stenosed dog aortas was examined. This was done to test the hypotheses that the shape of an endothelial cell is related to the local wall shear stress associated with the flowing blood and that alterations in hemodynamics, produced by vascular geometrical changes, influence endothelial cell geometry. Aortic stenosis with a reduction of 71% of the cross-sectional area was produced. The animals were sacrificed 12 weeks later, and the endothelial cell geometry and orientation were studied using the vascular casting technique and a computerized analysis to determine cell area and shape index. The regions of the stenosis examined were those known to experience different hemodynamic conditions. The value of the shape index was found to fall rapidly in the convergent region of the stenosis and to increase suddenly in the divergent region, eventually returning to the prestenotic value at a more distal site. Using a model of a stenosis made from a vascular cast, laser Doppler anemometry was applied to measure velocity profiles and to estimate the local wall shear stress in a stenosed aorta. It is shown that the shape index distribution along these stenosed vessels may be correlated with the level of wall shear stress, with more elongated cells occurring in regions of higher shear stress. PMID- 3954677 TI - Biochemical composition of coronary arteries in Finnish children. AB - To study the early features of atherosclerosis, we analyzed coronary artery intima medias from 63 boys and 30 girls who were newborn to 15 years old at the time of accidental death. Fatty streaks were found in five boys and one girl and, with one exception, were not present until the second decade of life. From birth there was a continuous increase in esterified cholesterol (EC) and a two- to threefold rise in free cholesterol and phospholipid. DNA, total protein, and collagen tended to rise after the first decade. The content of hyaluronic acid remained fairly constant, but sulphated glycosaminoglycans (GAGs) rose during the second decade; the highest increases were in dermatan and chondroitin sulphates. The content of arterial EC showed significant positive correlations with those of GAGs, but associations with the contents of DNA, total protein, and collagen were not significant. As judged by the observed gradual increase in arterial EC and a change in its fatty acid composition, there is a continuous increase with age in LDL-derived EC in the arterial wall. The mechanism of this accumulation is unknown, but the findings provide circumstantial evidence to support the concept that arterial GAGs may cause retention of plasma-derived lipids, which may subsequently be altered and internalized by the intimal cells. PMID- 3954679 TI - High-frequency audiometry using precision earphones: reliability under laboratory and field conditions. AB - New circumaural earphones were tested in the frequency range from 100 Hz to 20 kHz and compared to commonly used supra-aural earphones. The circumaural earphone HD 230 (Sennheiser) generates test stimuli at up to 20 kHz with almost constant sound pressure levels when its pos ed on an artificial ear. The reproducibility of hearing threshold mea ed with a new microprocessor-controlled Bekesy audiometer using the ne was nearly as good as under free-field conditions. The practicabil diagnostic value of high-frequency audiometry have been demonstrated er field conditions. For this application, the good sound attenuation these earphones (30 dB above 1 kHz) are important. High-frequency he ds of healthy pupils and of pupils with a history of otitis media are kHz, the hearing threshold level difference between both groups reached 20 dB. PMID- 3954678 TI - Suppression of atherosclerosis in cholesterol-fed rabbits by diltiazem injection. AB - The effects of diltiazem, a calcium antagonist, on the development of atherosclerosis were studied in Japanese white rabbits. The rabbits were examined at the end of 10 weeks on the following regimens; a diet of standard pellets and daily intraperitoneal (ip) injections of saline; a diet of pellets containing 1% cholesterol and daily ip injections of saline; or a diet of pellets containing 1% cholesterol and daily ip injections of diltiazem (50 mg). The plasma total and LDL cholesterol levels for the third group were significantly lower than those of the cholesterol diet group. Macroscopically, atheromatous lesions covered 26.7% +/- 6.7% (mean +/- SE) of the intimal surface of the aorta in the second group, and 0.7% +/- 0.3% in the third group (p less than 0.005). The levels of cholesterol, calcium, and uronic acid in the aortic tissue of the second group were significantly higher than those in the third. We concluded that diltiazem administered intraperitoneally suppresses the plasma total and LDL cholesterol elevation induced by the cholesterol diet and inhibits experimentally-induced atherosclerosis. PMID- 3954680 TI - Frequency and rate discrimination by Meniere patients. AB - Discrimination tests were conducted for each ear of 6 patients with unilateral Meniere's disease. Differential sensitivity to changes in pure-tone frequency (presumably containing temporal and place cues) was compared to differential sensitivity to changes in rate of sinusoidally amplitude-modulated noise (presumably containing only a temporal cue) at common low frequencies and modulation rates (less than 400 Hz). An adaptive forced-choice psychophysical procedure was used. The better-ear results for the Meniere patients generally were similar to findings for normally hearing listeners. For the impaired ears, pure-tone frequency discrimination typically was impaired relatively more than was the rate discrimination up to 200 Hz. However, rate discrimination was difficult or impossible above 250-300 Hz. Absolute frequency difference limens (DLs) were, on average, smaller than or at least equivalent to absolute rate DLs. Moreover, frequency discrimination always was possible for the Meniere patients. PMID- 3954681 TI - Phonemic confusions in quiet and noise for the hearing-impaired. AB - In this study the effects of presentation level and signal-to-noise ratio on phonemic confusions are investigated in 25 hearing-impaired subjects. The confusions of initial consonants, vowels and final consonants in the perception of nonsense CVC words were determined at three presentation levels in quiet and three signal-to-noise ratios in noise. The group results of the different presentation conditions were analyzed by means of INDSCAL analyses. The presence or absence of interfering noise proved to be the most dominant factor: the presence of noise caused a reduced use of low-frequency information. The effects of presentation level are of secondary importance. PMID- 3954682 TI - Effect of click spectrum and polarity on round window N1N2 response in the rat. AB - The effect of the duration of click stimuli on the compound action potential recorded from the round window in the rat and the effect of low-pass filtering of short click sounds were studied. Thus the intensity functions of the round window N1 potential have a two-segment course and there is a difference in the response to rarefaction and condensation clicks, depending upon the content of low frequency components in the click stimulus. The intensity function of the rat's response to broadband clicks does not show the same two-segment course as has been reported in experiments in other animals, and there is little difference between the response to condensation clicks and that to rarefaction clicks in this animal. However, when the duration of the click is increased or when broadband clicks are subjected to low-pass filtering, the intensity functions in response to condensation clicks do show a change in course, while the response to rarefaction clicks remains essentially unchanged. A similar change in the response to a broadband click can be induced by adding a low-pass-filtered click to the broadband click. The response to such a combination is not only a linear summation of the neural response to the individual components of the stimuli and the cochlear microphonics, but the low-frequency components that are added also affect the response to the broadband click, mainly by reducing the amplitude of the response. PMID- 3954683 TI - Comparison between auditory brain stem responses evoked by rarefaction and condensation step functions and clicks. AB - In order to evaluate the influence of the trailing edge of clicks on the auditory brain stem response (ABR) in normal ears, rarefaction and condensation step functions (RS and CS) compared to rarefaction and condensation clicks (RC and CC) at an intensity of 70 dB nHL were used. Significant intraindividual differences could be found for the latencies and amplitudes in the RS-CS, RS-RC and RC-CC comparison. However, the mean values of the complete group of test subjects showed no significant differences for the latencies and amplitudes, except the significantly greater amplitudes of wave I and II for R versus C step and R versus C click. Only a tendency to shorter latency for wave VI with R versus C step and click was revealed. These results show that there was no essential influence of the trailing edge of the used R and C clicks on the ABR. The latency of the ABR with excitation of the cochlea by step or click function seemed to be mainly determined by the internal oscillation sequence in the cochlea and not by the stimulus polarity. PMID- 3954685 TI - Comments on 'Auditory brainstem responses to middle- and low-frequency tone pips'. AB - This article contains critical comments on data described in a recent paper dealing with differences between click- and tone-pip-evoked auditory brainstem responses (ABR) by Maurizi et al. [Audiology 23: 75-84, 1984]. The primary criticism relates to the lack of validity of comparing ABR obtained with different input filter settings. When utilizing identical input filter settings, click- and tone-pip-evoked brainstem responses exhibit similar morphologies: both consist of a slow vertex-positive wave with faster superimposed vertex-positive components. PMID- 3954684 TI - Comparison between simultaneously recorded auditory-evoked magnetic fields and potentials elicited by ipsilateral, contralateral and binaural tone burst stimulation. AB - Both auditory-evoked magnetic fields (AEMF) and auditory-evoked potentials (AEP) mainly consist of three peaks with latencies of about 50, 100 and 160 ms. Comparison of responses to ipsilateral, contralateral and binaural stimulation yields no significant amplitude or latency differences of the AEP peaks whereas the simultaneously recorded AEMF peaks exhibit a 10 ms shorter latency and an approximately 38% greater amplitude for contralateral versus ipsilateral stimulation. This fact can be due to differences in the strength, location (especially the depth) and the direction of the dipole source, and a decision cannot be made considering the data recorded from just one position. Another finding is that binaural stimulation reduces the peak amplitudes by approximately 25% compared with contralateral stimulation. This result indicates some kind of interference between the ipsilateral and contralateral pathways ('binaural interaction'). PMID- 3954686 TI - The prevalence of anthelmintic resistance in sheep nematodes on the central tablelands of New South Wales. AB - A survey was undertaken to assess the prevalence of anthelmintic resistance in sheep nematode populations on 40 commercial farms distributed throughout the central tablelands of New South Wales. Representatives of the 2 major groups of broad spectrum anthelmintics with different modes of action (thiabendazole and levamisole) were used at the manufacturer's recommended dose rates. Efficacy was assessed on the basis of the reduction in faecal strongyle egg counts 7 days after treatment. An efficacy of less than 90% using both anthelmintics was obtained on 4 farms. Thiabendazole had an efficacy of less than 90% on a further 21 farms and levamisole had an efficacy of less than 90% on an additional 4 farms. There was no evidence of anthelmintic resistance on 8 farms, while the remaining 3 had insignificant parasite burdens. Based on larval cultures from faeces, Ostertagia and Trichostrongylus were the most significant species in resistant populations. Haemonchus burdens were sporadic and levels of resistance relatively low. Nematodirus burdens were widespread but no evidence of resistance was detected. PMID- 3954687 TI - Stress in calves castrated surgically or by the application of rubber rings. AB - The effects of castration were studied in calves 4 to 11 weeks of age, using increases in salivary cortisol as an indicator of stress. Groups were castrated surgically or by rubber ring application or were non-castrated (control) females. The surgically castrated group showed more agitation during the operation, but both castrated groups resumed normal behaviour soon after the operation was completed. The short-term salivary cortisol response was significantly higher after surgical castration than after the application of rubber rings, where, in turn, it was significantly higher than in the control group. Salivary cortisol was elevated over a period from 15 min to 3 h following the castration, but at 4, 24 h and 6 days post-treatment there were no significant differences between treated groups and controls. PMID- 3954688 TI - Cerebellar abiotrophy and segmental axonopathy: two syndromes of progressive ataxia of Merino sheep. AB - Findings of a study of 39 sheep with progressive ataxia from 14 farms in the Yass district of New South Wales are described. Microscopic lesions in 25 sheep, 3.5 to 6 years of age, diagnosed as having clinical cerebellar disease, consisted of an apparent primary loss of cerebellar Purkinje neurons, and glial cell accumulation. It is suggested that this previously unreported disorder may be an hereditary cerebellar abiotrophy of Merino sheep. A further 14 sheep, 1 to 4 years of age, had distinguishable clinical signs referable to a spinal cord lesion with widespread segmental axonal ballooning, or "spheroids", in the white matter of the brain and spinal cord. It is suggested that these sheep have a unique form of neuroaxonal dystrophy, described here as segmental axonopathy, and that this is likely to be the same condition described previously as Murrurindi disease (Hartley and Loomis 1981). PMID- 3954689 TI - Hypocalcaemia in ewes after a drought. PMID- 3954690 TI - An outbreak of Toxoplasma gondii abortion, mummification and perinatal death in goats. PMID- 3954691 TI - Isolation of a new bovine ephemeral fever group virus. PMID- 3954693 TI - Distribution of Brucella ovis in the tissues of rams reacting in a complement fixation test for ovine brucellosis. PMID- 3954692 TI - Changes in plasma creatinine levels of sheep during submaintenance feeding. PMID- 3954694 TI - The frequency of infertility and abortion in cows infected with Tritrichomonas foetus var. brisbane. PMID- 3954695 TI - Control of helminthosis in lambs by strategic treatment with closantel and broad spectrum anthelmintics. AB - Treatment of ewes with broad-spectrum anthelmintic in August (pre-lambing) and early November, and of lambs in early November and early February, was effective in controlling infections with Trichostrongylus spp in lambs reared on contaminated pastures under set-stocked conditions. It was ineffective in controlling infections with Haemonchus contortus; 82% of lambs had to be withdrawn from the experiment because of severe haemonchosis. Treatment with closantel (7.5 mg/kg) at the same times was very effective against H. contortus but ineffective against Trichostrongylus spp; 25% of lambs had to be withdrawn because of severe trichostrongylosis. The same schedule using broad spectrum anthelmintic and closantel administered concurrently was effective against both parasites; no lambs had to be withdrawn and the bodyweight gain of lambs was higher than in lambs treated with broad-spectrum anthelmintic or closantel alone. The results provide a basis on which to develop a preventive anthelmintic treatment program to control haemonchosis and trichostrongylosis in sheep which will allow the current high frequency of treatment with broad-spectrum anthelmintics to be reduced. Such a program may retard selection for anthelmintic resistance in Trichostrongylus spp. PMID- 3954697 TI - Noise levels in cockpits of aircraft during normal cruise and considerations of auditory risk. AB - Noise data, including A-levels and C-minus-A values, are summarized for exposures associated with normal cruise flight in 13 groups of 593 aircraft; means and standard deviations are reported; degrees of auditory risk using OSHA-1983 criterion are presented; and at-the-ear protected and unprotected exposures are revealed. Mean A-levels were 95.0 for 528 fixed-wing; 100.9 for 65 rotary-wing; and 95.7 for all 593 aircraft. Of 13 sub-groups, the lowest mean A-level (85.5) was exhibited in the cockpits of tail-mounted turbojet/fan-powered aircraft, and the highest (105.0) was found in both reciprocating and turbine-powered twin rotor helicopters. All mean A-levels exceeded the OSHA damage-risk criterion for 8 h.d-1 exposures. At-the-ear exposures while wearing hearing protection are presented. Results clearly illustrate the potential for auditory damage of unprotected aircrews. Hearing protection must be considered to effectively control routinely encountered exposures. The material and illustrations resulting from this study will help health and safety monitors during indoctrination and counseling of aircrews concerning the need to protect their hearing against noise exposures during normal and routine flight operations. PMID- 3954696 TI - A study of nutritional myopathy in weaner sheep. AB - The effectiveness of various treatments upon, and pathological and biochemical changes in, ovine weaner nutritional myopathy were observed. Clinical myopathy was already apparent in the sheep at the start of the study, and they were fed decreasing amounts of a ration containing low levels of selenium and alpha tocopherol, and periodically deprived of water. In spite of this management there was a spontaneous remission of the clinical myopathy in the sheep, but a subclinical myopathy was identified in some of the sheep at the end of the trail. The conclusions were that the myopathy was not caused by a low dietary intake of selenium and/or alpha-tocopherol alone, that alpha-tocopherol was involved in the aetiology, that alpha-tocopherol was completely effective and selenium possibly partially effective in treating it, and that the condition may be a Type II muscle fibre disease. Data on plasma creatine phosphokinase and erythrocyte glutathione peroxidase activities, and terminal liver selenium and alpha tocopherol concentrations are presented, and their roles in the diagnosis of ovine weaner nutritional myopathy discussed. PMID- 3954698 TI - Effect of seat cushions on human response to +Gz impact. AB - Human response to vertical (+Gz) impact acceleration was evaluated as a function of various seat cushions, including current operational cushions used in such aircraft as the A-10, F-15, and F-111 and proposed alternative cushions comprised of rate-dependent, slow-recovery polyurethane foams. There were 133 tests conducted of volunteer subjects in seven different experimental conditions, using a vertical deceleration tower facility. The mean peak acceleration of the impact carriage for these tests was 9.85 G (S.D. = 0.07) and the mean carriage velocity change was 8.01 m X s-1 (S.D. = 0.05). Resultant seat loads and head and chest accelerations were significantly higher for the F-111 cushion than for the rate dependent foam cushions, which included cushions comprised of Confor foam or Temper foam. Resultant head and chest accelerations were also significantly higher for the ACES II cushion than for the rate-dependent foam cushions. Therefore, from an impact protection standpoint, the operational cushions were inferior to the proposed alternative cushions. Operational use of rate-dependent foam cushions is recommended to improve the impact protection performance of escape systems. Flight tests conducted by the USAF Strategic Air Command have shown that these cushions enhance crewmember sitting comfort during long-duration missions. PMID- 3954699 TI - Proteinuria in fighter pilots after high +Gz exposure. AB - Exposure to high gravitational forces acting along the body axis towards the feet (+Gz) causes considerable strain on several organ systems, including the kidneys. During +Gz tolerance studies without anti-G suits, significant amounts of protein and hyaline casts were found in 17 of 20 fighter pilots after centrifugation. The G load alternated between 3.5 and 5.5 G. Mean time in the centrifuge was 15 min. For comparison we examined another group of 19 fighter pilots after air combat maneuver training with anti-G suits. None showed proteinuria. The proteinuria most likely indicates a severely depressed renal blood flow during centrifugation. PMID- 3954700 TI - The flight surgeon and psychiatry: interest and skills. AB - Much of the flight surgeon's day-to-day clinical practice involves the use of psychiatric skills in the assessment and management of the problems of flyers and their families. Folklore holds that among nonpsychiatrists, the older, more experienced, nontrainee clinician is more interested in and knowledgeable about the psychiatric aspects of his practice. We studied this assumption in 170 flight surgeons who varied in age, experience, and whether or not they were presently in training or had already completed training in flight medicine. Measures of interest in psychiatry and self-assessed ability in seven areas of psychiatric skills and knowledge were obtained. Results indicate that age and experience are unrelated to interest in psychiatry, while being in training has a significant negative impact. Self-assessed ability is significantly related to training status, age, and experience. The flight surgeon's subjective assessment of needing further education was increased by being in a training status, but unaffected by age or experience. PMID- 3954701 TI - Flying and danger, joy and fear. AB - U.S. Air Force fliers are all volunteers who undergo rigorous training for their profession. Their motivation may be deeprooted and emotional, or may arise from a conscious decision made in early adulthood. Some motivation is flawed and fails early. Other motivation may be eroded by a single dangerous event, by an accumulation of "close calls" (one's own or others'), or by a growing interest in nonaviation elements. Since Air Force fliers may "quit" only at some personal cost to pride or pocketbook, they may develop a fear of flying. This may be truly phobic, a situational reaction, or an awareness of personal vulnerability. Some displace anxiety about flying into somatic symptoms. The author discusses motivation to fly, its various modes of failure, and some clinical aspects of fear of flying. PMID- 3954702 TI - Effect of wearing chemical protective clothing in the heat on signal detection over the visual field. AB - Sensitivity for detecting visual signals distributed at various locations throughout the visual field was studied in 16 male subjects who were all exposed to two degrees of ambient heat (91 degrees F/61% RH; 55 degrees F/35% RH) while wearing the Army chemical protective clothing system; also to 70 degrees F/35% RH while wearing Army battle-dress uniform (fatigues). Response time for signal detection increased systematically and significantly with peripheralization of stimulus locations. It was most impaired in the superior and inferior visual field areas and least affected along the horizontal axis area. The data support previous results obtained using this task. Both the MOPP and the heat + MOPP exposure conditions produced highly significant systematic increases in response time to all signals; the worst performance occurred under the heat + MOPP combination. Implications for visual performance while wearing chemical protective gear are discussed. PMID- 3954703 TI - On the use of a bubble formation model to calculate diving tables. AB - Previous decompression tables for humans were based upon unsupported assumptions because the underlying processes by which dissolved gas is liberated from blood and tissue were poorly understood. Some of those assumptions are now known to be wrong, and the recent formulation of a detailed mathematical model describing bubble nucleation has made it possible to calculate diving tables from established physical principles. To evaluate this approach, a comprehensive set of air diving tables has been developed and compared with those of the U.S. and British Navies. Conventional decompressions, altitude bends, no-stop thresholds, and saturation dives are all successfully described by one setting of four global nucleation parameters, which replace the U.S. Navy's matrices of M-values. Present air diving tables show great irregularity, even within sets created by the same authors. In contrast, this new approach is remarkably self-consistent, permitting accurate interpolation and extrapolation. PMID- 3954704 TI - Effect of rotopositioning on the growth and maturation of mandibular bone in immobilized rhesus monkeys. AB - As part of an ongoing effort to mimic the hypokinesia and hypogravity of spaceflight, the effects of 14 d immobilization and rotopositioning on mandibular bone osteon growth (= radial rate of closure) was assessed in 12 juvenile Rhesus monkeys by tetracycline labeling. The monkeys had been restrained in a supine position and rotated 908 every 30 min through a full 3608 arc for 14 d. Osteon growth was also assessed after the immobilized/rotopositioned animals had been permitted to recover in metabolism cages for periods of 28 and 56 d. The closure rates of osteons in the cortex of the inferior border of the mandible were not abnormal during immobilization/rotopositioning or during recovery. The regression line plots yielded slopes of: Controls = 0.946-1.000; Immobilized/Rotopositioned = 1.045; 28 d Recovery = 0.833; 56 d Recovery = 0.829. Microradiographs indicated a normal distribution of osteons of different mineral density: lowly (28%), moderately (53%), and highly mineralized (18%). Bone porosity values also remain within the normal range (18.3 6 4.1%). These results suggested that 14 d immobilization/rotopositioning did not effect abnormal changes in the rates of bone formation and mineralization in the mandibular cortex of the juvenile Rhesus monkey. PMID- 3954706 TI - Orthostatic tolerance of normal Indians and those with suspected abnormal cardiovascular reflex status. AB - There were 143 healthy Indian males subjected to 70 degrees headup tilt (HUT) for 20 min on 166 occasions to evaluate their cardiovascular response. They responded with a significant rise in heart rate, diastolic pressure, and mean arterial pressure. Pulse pressure fell significantly. Heart rate and diastolic pressure during the tilt were significantly (p less than 0.05) and positively correlated to the height of the subjects. None of the subjects had syncope, which has been reported in normal individuals elsewhere. Of the 57 subjects with suspected abnormality of the cardiovascular reflex status, who were also investigated by the tilt test, 13 (22.8%) developed various degrees of orthostatic intolerance. Of these 13 subjects, 10 had had syncope in the past. In view of these observations, it is concluded that 70 degrees head-up tilt is an important clinicophysiological investigation in the assessment of subjects with a suspected abnormality of their cardiovascular reflex status. PMID- 3954705 TI - Thymic involution in the suspended rat: adrenal hypertrophy and glucocorticoid receptor content. AB - The thymus gland and skeletal muscle are sensitive to the catabolic effects of glucocorticoids (GC). Previous studies using suspended rats demonstrated that muscle disuse atrophy resulting from hindlimb unloading was associated with an increase in glucocorticoid receptor site concentration. The objectives of the current studies were: to assess the temporal relationship between adrenal hypertrophy and thymic involution in suspended rats, to evaluate the role of positioning--antiorthostatic, (AO) vs. orthostatic (O)--in the thymic and adrenal responses, and to determine whether or thymic involution, like muscle disuse atrophy, was associated with an increase in GC receptor site concentration. The wet weight of the thymus was reduced by 50% (p less than 0.001) during 7 d of AO suspension. Suspended (AO) rats exhibited a significant (p less than 0.001) hypertrophy of the adrenal glands (33%), primarily on the initial day of suspension. Recovery for 7 d was associated with a return of thymus weight to control levels, but adrenal hypertrophy was not completely reversed. Rats suspended in an O position exhibited thymic and adrenal responses comparable to those of AO rats. Thymic involution in both AO and O rats was associated with a 20% (p less than 0.001) decrease in glucocorticoid receptor site concentration (pmol X mg-1 protein). However, when expressed relative to tissue weight, receptor site concentrations were not significantly different from control values. These results suggest a temporal correlation between adrenal hypertrophy and thymic involution in the suspended rat, but neither of these responses were dependent upon AO positioning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954707 TI - Anabolic steroids as a countermeasure against bone demineralization during space flight. AB - A progressive loss of bone mass is consistently reported in humans exposed to weightlessness during space flight. The mechanism of this metabolic alteration is unknown but may be due in part to the effects of disuse osteoporosis along with the influence of elevated corticosteroid levels. With a goal toward mankind's permanent presence in space, effective countermeasures against bone demineralization will be required. Synthetic anabolic steroids have been shown to prevent bone loss in ground-based immobilization studies and in excess corticosteroid states. These agents may offer a means of slowing or preventing bone loss thus facilitating long term space habitation. PMID- 3954708 TI - Air transport of the neonate with a congenital diaphragmatic hernia. AB - A congenital diaphragmatic hernia is the prenatal herniation of abdominal contents into the chest cavity; the infant usually has a hypoplastic lung on the side of the hernia. The neonate presents with cyanosis, tachypnea, retractions, and a scaphoid abdomen. A simple chest X-ray will confirm the diagnosis by revealing hollow viscera in the chest cavity. Survival is dependent upon rapid transport to a major surgical center equipped to perform the necessary surgery and provide the post-operative care. The newborn should be kept warm, well oxygenated, and normocapneic to avoid acidosis. Acidosis could result in reversal to fetal circulation, rapid deterioration, and death. Should we be called upon to transport a neonate with a congenital diaphragmatic hernia we must realize the severity of this anomaly and be prepared to prevent, recognize, and/or treat any life-threatening emergencies that occur. PMID- 3954709 TI - Inbreeding of Wistar-Kyoto rat strain with hyperactivity but without hypertension. AB - A genetic inbreeding program using Wistar-Kyoto rat strains as progenitors was used to combine the hyperactivity trait of the spontaneously hypertensive rat (SHR) with the normotensive trait of the WKY genetic control strain. From an SHR X WKY cross we produced a gene-assorting F2 population from which selected brother-sister matings were carried out through seven successive inbred populations. This program produced a new strain of hyperactive rats with normotensive mean systolic blood pressure levels, and we have designated the new strain as the Wistar-Kyoto hyperactive (WK/HA) rat. Another behavioral characteristic of the SHR rat, poor habituation in a nonreinforcing novel environment, did not appear as a characteristic trait of the new strain of WK/HA rats, suggesting a separate underlying genetic basis for the two traits that had been apparently fortuitously fixed in the SHR genotype as a result of intensive inbreeding of that strain. The new WK/HA strain, together with the WKY control strain, is considered as more suitable for subjects in studying hyperactivity in rats than the original SHR strain with its concomitant hypertension and poor habituation traits. PMID- 3954710 TI - Ethanol blockade of context change effects. AB - Rats were trained to run to four baited arms of an eight-arm radial maze. Half the subjects were trained in one context, half in another. Additionally, half of each of these groups received alcohol (1.5 g/kg ethanol) pretreatment while the rest were given saline. Following attainment of criterion, the context conditions were reversed for all subjects, but the drug assignment remained in force. Saline injected rats were strongly disrupted by the train-test context shift. Alcohol injected subjects were unaffected by the change in setting. Alcohol seems either to diminish the contextual composition of memories or to block the reaction to environmental mismatch during testing. PMID- 3954711 TI - Sensitivity to thermal stimulation in prairie rattlesnakes (Crotalus viridis) after bilateral anesthetization of the facial pits. AB - Six yearling prairie rattlesnakes (Crotalus viridis) were exposed to thermal stimuli prior to and after bilateral anesthetization of their facial pits with 2% xylocaine solution. This treatment eliminates trigeminally mediated electrophysiological responses of the pits to thermal stimulation. Nevertheless, the rattlesnakes continued to exhibit behavioral responses to thermal cues after anesthetization of the pits. An auxiliary infrared-sensitive system, nociceptors, or the common temperature sense could be responsible for these findings. PMID- 3954712 TI - Effects of septal-forebrain lesions on maternal aggression and maternal care. AB - Septal-forebrain lesions significantly increased the defensive reactions of lactating Long-Evans rats (n = 13) relative to nonlesioned control females. The lesions greatly enhanced defensive behaviors on a number of standard tests (e.g., responsiveness to humans and anesthetized conspecifics) while abolishing aggression toward intruding male conspecifics. The lesions also produced a striking disruption in maternal behavior as evidenced by absence of nest building, reduced litter weights, failure to retrieve, lick, or nurse pups, and increased cannibalization. While these results cannot be interpreted as indicating that maternal aggression is equivalent to offense, they are congruent with such a view. Certainly they are not supportive of a view that maternal aggression is primarily defensive. The lesion-induced abolition of maternal attack may have resulted from an inhibition of offensive tendencies by heightened defensiveness and/or reduced pup stimulation. There was no evidence that the lesion-induced impairment in maternal behavior resulted from a failure to sequence the individual behavioral acts comprising maternal behavior. Rather, all features of maternal care seemed to be greatly attenuated. PMID- 3954713 TI - The behavioral effects of depletions of brain serotonin induced by 5,7 dihydroxytryptamine vary with time after administration. AB - Ether-anesthetized Sprague-Dawley rats were depleted of brain serotonin (5HT) by intraventricular injections of 50 micrograms 5,7-dihydroxtryptamine (57DHT). Oral pretreatment with 25 mg/kg desmethylimipramine was used to protect brain noradrenergic neurons from 57DHT. Liquid chromatographic assays revealed that this treatment did not significantly alter catecholamine levels but depleted hippocampal 5HT by 92% and striatal 5HT by 45%. Three or eleven days after lesioning, locomotor and exploratory behavior was characterized in separate groups of animals with a behavioral pattern monitor (BPM). On Days 4 and 12, the animals were retested following saline or 1.0 mg/kg amphetamine. Three days after depletion, lesioned rats exhibited a decrease rate of habituation of locomotor activity relative to controls. When challenged with amphetamine (1.0 mg/kg), 5HT depleted rats exhibited increased corner and decreased center activity, as well as stereotyped patterns of locomotion. Eleven days following lesion, 5HT-depleted rats exhibited habituation rates greater than controls; amphetamine challenge yielded patterns of activity similar to those of control animals. These results show that central serotonergic pathways play an important role in modulating both spontaneous and amphetamine-elicited activity in rats, and that compensatory mechanisms operate over time to alter the behavioral effects of 57DHT-induced depletions of brain 5HT. PMID- 3954714 TI - The splanchnic nerve and food intake regulation. AB - Bilateral section of the greater splanchnic nerve in the rat abolishes the compensatory ingestion for nutrient removed from the stomach that occurs in normal animals. However, such section leaves normal ingestion unaffected. These results suggest that this nerve participates in food intake regulation. PMID- 3954715 TI - Weanlings' transfer of conditioned ethanol aversion from olfaction to ingestion depends on the unconditioned stimulus. AB - Weanling (21-day-old) rats were exposed to an alcohol odor paired with either an interoceptive (apomorphine-induced illness) or exteroceptive (footshock-induced distress) reinforcer. Twenty-four hours later, ethanol preferences were measured in a locational olfactory test (ethanol vs lemon odor) or an ingestion test (5.6% v/v ethanol vs 0.25% v/v citric acid solution). Weanling rats expressed substantial olfactory aversions, independent of the reinforcer employed in conditioning. During the drinking test, however, only rats that had experienced the ethanol odor paired with internal malaise showed a significant reduction in the intake of the ethanol solution when compared to unpaired controls. Furthermore, rats that had experienced the ethanol odor paired with external distress drank significantly more of the ethanol solution than their controls. These results provide further evidence that olfactory experiences with ethanol can lead to changes in ethanol ingestion, and indicate that the nature of the unconditioned stimulus is critical in establishing the ingestive effect. PMID- 3954716 TI - Effects of rapid eye movement sleep deprivation on regional brain metabolism as measured by 2-[14C]deoxyglucose autoradiography. AB - Regional brain metabolic activity of six male Sprague-Dawley rats was investigated with 2-[14C]deoxyglucose autoradiography. Regional brain metabolic activity was determined bilaterally for 60 brain structures, using laser densitometry. After 5 days of uninterrupted rapid eye movement sleep deprivation, increased metabolic activity was found in the lateral habenula, the caudal and middle parts of the limbic system, and in the corpus callosum. PMID- 3954717 TI - The effects of physostigmine and scopolamine on recognition memory in monkeys. AB - The visual recognition of rhesus monkeys was evaluated by means of a delayed nonmatching-to-sample task with trial-unique objects. Each daily session consisted of two lists of 20 objects each, which untreated animals were able to recognize at approximately 75% accuracy. When they were performing at this level reliably, doses of physostigmine (0.32, 1.0, 3.2, 10.0, 32.0, 56.0 micrograms/kg), scopolamine (1.0, 3.2, 5.6, 10.0, 17.8, 32.0 micrograms/kg), or saline were administered 20 min prior to the session. Physostigmine and scopolamine produced dose-related increases and decreases, respectively, in the number of objects correctly remembered. The systematic changes in performance support the view that cholinergic mechanisms contribute to recognition memory and suggest that tasks with trial-unique objects may be particularly useful for studying the mnemonic effects of cholinergic drugs. PMID- 3954718 TI - Patterns of exploratory behavior in the spiny mouse, Acomys cahirinus. AB - The present paper reports an investigation of patterns of exploratory behavior shown by laboratory-bred Spiny Mice (Acomys cahirinus) when given access to a large, novel arena. The aim was to test hypotheses suggested by our previous work with this species. Previous experiments in which the exploratory behavior of Acomys was compared with that of Mus had suggested that each species had a characteristic pattern of emergence and exploration. The present experiment addressed the question of whether the exploratory patterns of Acomys could be predicted from patterns of emergence as suggested by earlier experiments. Data are presented which indicate that the exploratory behavior of Acomys in a large, novel arena is reasonably predictable. The data presented include measures of the animal's responses to different stimuli within the novel environment, including novel, conspicuous objects, food sources, and the holding cage to which the animal could return. In addition, the patterns of movement through different areas of the environment were recorded in relation to the behavior of the animal when it was first given access to the arena. The data indicate that there are two types of strategy, or patterns, by which Acomys begin to explore a novel environment. The first type consists of a delayed emergence into the arena, followed by brief excursions into the area immediately adjacent to the holding cage, interspersed with longer periods of returns to the holding cage. The second type involves immediate emergence, followed by rapid "dashes" around the periphery of the arena. Which of the two strategies is adopted appears to depend upon the animal's behavior at the time of initial access. Two subsequent experiments considered these strategies further. Experiment 2 indicated that Type I was more characteristic of males and Type II more characteristic of females, although there were no differences related to the female estrous cycle. In Experiment 3, the patterns of exploration over four consecutive tests were investigated. It was found that the strategy adopted by an individual is likely to be consistent across tests. PMID- 3954719 TI - [Detection of saxitoxin by bioassay]. PMID- 3954720 TI - [Torticollis in the rabbit: etiology, pathology, diagnosis and therapy]. PMID- 3954721 TI - [Mechanisms of the pathogenicity of Salmonellae]. PMID- 3954722 TI - [Leukosis in the horse. 3. Hematology and clinical chemistry]. PMID- 3954723 TI - The effect of metabolic acidosis on the synthesis and turnover of rat renal phosphate-dependent glutaminase. AB - Regulation of the mitochondrial phosphate-dependent glutaminase activity is an essential component in the control of renal ammoniagenesis. Alterations in acid base balance significantly affect the amount of the glutaminase that is present in rat kidney, but not in brain or small intestine. The relative rates of glutaminase synthesis were determined by comparing the amount of [35S]methionine incorporated into specific immunoprecipitates with that incorporated into total protein. In a normal animal, the rate of glutaminase synthesis constitutes 0.04% of the total protein synthesis. After 7 days of metabolic acidosis, the renal glutaminase activity is increased to a value that is 5-fold greater than normal. During onset of acidosis, the relative rate of synthesis increases more rapidly than the appearance of increased glutaminase activity. The increased rate of synthesis reaches a plateau within 5 days at a value that is 5.3-fold greater than normal. Recovery from chronic acidosis causes a rapid decrease in the relative rate of glutaminase synthesis, but a gradual decrease in glutaminase activity. The former returns to normal within 2 days, whereas the latter requires 11 days. The apparent half-time for glutaminase degradation was found to be 5.1 days and 4.7 days for normal and acidotic rats respectively. These results indicate that the increase in renal glutaminase activity associated with metabolic acidosis is due primarily to an increase in its rate of synthesis. From the decrease in activity that occurs upon recovery from acidosis, the true half life for the glutaminase was estimated to be 3 days. PMID- 3954724 TI - The acceleration of the inhibition of platelet prothrombinase complex by heparin. AB - The influence of heparin on the inhibition of factor Xa has been studied under conditions where factor Xa is bound to collagen-thrombin-stimulated platelets to form the prothrombinase complex. Unfractionated heparin was found to cause a concentration-dependent acceleration of the inhibition of the platelet prothrombinase complex up to a maximum rate constant of 4.1 X 10(7) M-1 X min-1 at heparin concentrations of 0.2 microM and above. This is equivalent to a 4800 fold acceleration over the rate constant for the inhibition in the absence of heparin, and is 6.8-fold lower than the rate constant for the inhibition of uncomplexed factor Xa in the presence of saturating concentrations of heparin which was determined as 2.8 X 10(8) M-1 X min-1. The effects of three Mr fractions of heparin were also studied. These were a gel-filtered heparin of Mr 15000, a gel-filtered heparin of Mr 6000 and a heparin oligosaccharide (primarily 8-10 monosaccharide units) prepared by nitrous acid depolymerization, each with high affinity for antithrombin III. These fractions all accelerated the rate of the antithrombin III inhibition of the platelet prothrombinase complex, with maximum rate constants of 6.8 X 10(7), 1.4 X 10(7) and 9.8 X 10(6) M-1 X min-1, respectively. On comparison with the effect of these heparin fractions on the rate of inhibition of uncomplexed factor Xa a progressively increasing disparity between the rate of inhibition of uncomplexed and complexed factor Xa was observed, rising from 1.7-fold with the oligosaccharide to 6.8-fold with the unfractionated heparin. A possible mechanism for this differential activity between uncomplexed and complexed factor Xa with the various heparin fractions is discussed in terms of an involvement of heparin binding to factor Xa. PMID- 3954725 TI - Purification and partial sequence analysis of insulin-like growth factor-1 from bovine colostrum. AB - Growth-promoting activity in bovine colostrum has been detected as the capacity to stimulate protein synthesis in L6 myoblasts. By using this assay as a measure of bioactivity, a growth factor has been purified to near homogeneity from centrifuged colostrum by a series of steps including acid extraction, chromatography on sulphopropyl-Sephadex, followed by adsorption to, and elution from, C18 columns using acetonitrile and propan-1-ol gradients. The purified growth factor has a low solubility at neutral and alkaline pH and has an Mr of 7800 by gel-permeation chromatography. Sequence analysis of the first 30 amino acids from the N-terminus indicated complete identity in this region with human insulin-like growth factor-1. Accordingly we conclude that the purified growth factor is bovine insulin-like growth factor-1. PMID- 3954727 TI - First-pass hepatic uptake and utilization of glucose in the rat. AB - First-pass hepatic retention of glucose had previously been measured indirectly from the appearance of ingested labelled glucose into the systemic circulation. To determine the accuracy of the procedure, results obtained by this indirect method were compared with those of direct measurement of hepatic retention of labelled glucose given by instantaneous injection into the portal vein. In the rat, the indirect procedure gave a value of 13.7 +/- 2.3%. In the direct method, [14C]glucose was injected intraportally together with [3H]sucrose as a marker of extracellular distribution. Hepatic content of both labels was maximal immediately after administration; the content of sucrose fell to basal values by 15 s, indicating that the injected bolus had passed through the liver; the content of [14C]glucose continued to fall for 90 s. The difference in tissue retention between glucose and sucrose, representing intracellular glucose, was constant from 90 to 180 s, and indicated a first-pass retention of 13 +/- 0.7%. Thus the indirect procedure gives a reliable estimate of hepatic uptake and retention of glucose. Comparison of the time courses of hepatic content of [14C]glucose, [2-3H]glucose and [3H]sucrose indicated that 50% of portal-vein glucose enters the hepatic cells; subsequently 15% traverses the glucose/glucose 6-phosphate futile cycle, 22% is released without undergoing metabolic change and 13% is retained for metabolic purposes. PMID- 3954726 TI - Binding properties and biological potencies of insulin-like growth factors in L6 myoblasts. AB - Protein synthesis in rat L6 myoblasts is stimulated and protein breakdown inhibited in a co-ordinate manner by insulin-like growth factors (IGF) or insulin. For both processes, bovine IGF-1 was somewhat more potent than human IGF 1, which was effective at a tenth the concentration of insulin, rat IGF-2 or human IGF-2. A similar order of potency is noted when DNA synthesis or protein accumulation is monitored over a 24 h period, but between 20- and 50-fold higher concentrations of each growth factor are required than those needed to produce effects in the 4 h protein-synthesis or -breakdown measurements. Binding experiments with labelled human or bovine IGF-1 as ligand demonstrated competition at concentrations of IGF-2, especially human IGF-2, lower than that of either IGF-1 preparation. This pattern was much more pronounced when the radioligand was either human IGF-2 or rat IGF-2. Insulin competed 10-15% for the binding of labelled IGF-1, but not at all with labelled IGF-2. Ligand-receptor cross-linking experiments showed that labelled bovine IGF-1 bound approximately equally to the type 1 IGF receptor (Mr 130000 after reduction) and to the type 2 IGF receptor (Mr 270000 after reduction), and that unlabelled IGF-1 competed equally with radioligand binding to both receptors. On the other hand, rat IGF-2 competed more effectively for binding to the type-2 receptor, and insulin competed only for binding to the type-1 receptor. Further cross-linking experiments with rat IGF-2 as radioligand demonstrated binding only to the type-2 receptor and to proteins with Mr values after reduction of 230000 and 200000. This binding was prevented by high rat IGF-2 concentrations, less effectively by bovine IGF-1 and not at all by insulin. The apparently conflicting biological potencies and receptor binding of the different growth factors can be explained if all the biological actions are mediated via the type-1 IGF receptor, rather than through the abundant type-2 receptor. PMID- 3954728 TI - Haemocyanin mRNA from arthropod and mollusc origin. Evidence for a multi-unit structure in mollusc haemocyanin mRNA. AB - mRNA from two molluscs, the snail Levantina hierosolima and the cuttlefish Sepia officinalis, and one arthropod, the scorpion Leiurus quinquestriatus, were found to contain species that hybridize with an oligodeoxynucleotide sequence corresponding to the six-amino-acid sequence His-His-Trp-His-Trp-His postulated to carry binuclear copper in arthropod haemocyanins. The duplexes formed between the oligodeoxynucleotide and mRNA from Leiurus and Levantina had similar 'melting' temperatures, namely 46.5 and 44.5 degrees C respectively. The hybridizable mRNA species were identified with mRNA that codes for haemocyanin, Hc mRNA. Electrophoresis under denaturing conditions of Leiurus Hc mRNA gave a single band corresponding to 2.3 kb (kilobases), consistent with the value of 75 000 reported for the Mr of the polypeptide chain of arthropod haemocyanin. Electrophoresis of mollusc Hc mRNA yielded RNA bands corresponding to 9.4, 6.7, 4.0 and 1.7 kb for Levantina and 9.5, 2.8 and 1.7 kb for Sepia. The 9.4 and 9.5 kb species represent authentic Hc mRNA and are consistent with an Mr of 350 000 for molluscan haemocyanin polypeptide chain. The faster-moving RNA bands are attributed to Hc mRNA cleavage by nucleases during isolation of mRNA. Analysis of the electrophoretic band pattern indicates a multi-unit structure for mollusc Hc mRNA. PMID- 3954730 TI - Trans-stimulation and trans-inhibition of uridine efflux from human erythrocytes by permeant nucleosides. AB - The ability of nucleoside permeants to accelerate the efflux of uridine from human erythrocytes has been compared. In contrast to uridine, 2-chloroadenosine acted as a trans-inhibitor of uridine efflux from fresh human erythrocytes, and adenosine had little effect. These results are consistent with the lower maximum velocity for influx of 2-chloroadenosine and adenosine as compared with uridine and demonstrate that trans acceleration experiments do not discriminate between transported and non-transported permeants for the human erythrocyte nucleoside carrier. PMID- 3954729 TI - The inhibition of parathyroid-hormone actions on gluconeogenesis and phosphate transport by 3-mercaptopicolinate in rabbit renal proximal tubules. AB - By using a glucose microassay and the technique for isolated renal-tubule perfusion in vitro, the addition of 3-mercaptopicolinate, a gluconeogenesis inhibitor which inhibits phosphoenolpyruvate carboxykinase specifically, was found to abolish the effects of parathyroid hormone on gluconeogenesis and phosphate-transport rate in isolated rabbit renal proximal straight tubules, suggesting that these parathyroid-hormone actions may share some unknown, yet 3 mercaptopicolinate-inhibitable, intracellular processes. PMID- 3954731 TI - Iron mobilization from ferritin using alpha-oxohydroxy heteroaromatic chelators. AB - Several alpha-oxohydroxy heteroaromatic chelators have been shown to mobilize iron from horse spleen ferritin. Although the reactions were slow, taking up to 3 days to reach completion, the amounts of iron mobilized were higher than those reported for other chelators. These results increase the prospects for the clinical use of alpha-oxohydroxy chelators in the treatment of iron overload. PMID- 3954732 TI - Inactivation of wheat-germ aspartate transcarbamoylase by the arginine-specific reagent phenylglyoxal. AB - Wheat-germ aspartate transcarbamoylase (EC 2.1.3.2) was inactivated by phenylglyoxal in a first-order process, provided that the inactivation time did not exceed 10 min. Apparent first-order rate constants were linearly dependent on phenylglyoxal concentration, indicating a bimolecular reaction between a single active-centre residue and phenylglyoxal, with second-order constant of 0.023 mM-1 X min-1. A plot of apparent first-order rate constant versus pH showed a steep rise above pH 9.5, indicating that the essential residue has a pKa value of 10.5 or higher, consistent with an arginine residue. Saturating concentrations of the following ligands provided a degree of protection (percentages in parentheses) against 1 mM-phenylglyoxal: N-phosphonoacetyl-L-aspartate, a bisubstrate analogue (94%); carbamoyl phosphate (75%); UMP, an end-product inhibitor (53%). Succinate (an analogue of L-aspartate) alone gave no protection, but in combination with carbamoyl phosphate raised the protection to 92%, in agreement with the known binding order of the two substrates. These results indicate that the essential arginine residue is close to the carbamoyl phosphate site, probably oriented towards the aspartate site. Attempts to desensitize the UMP-binding site by reaction with phenylglyoxal, while protecting the active centre, were unsuccessful. The essential active-centre arginine residue is compared with a similar residue in the Escherichia coli enzyme. PMID- 3954733 TI - Dicyclohexylamine is not an inhibitor of spermidine synthase. PMID- 3954734 TI - A bovine epithelial membrane protein that binds polymeric immunoglobulin and has a structure related to that of bovine secretory component. AB - A protein of Mr 94000 was isolated from detergent-solubilized bovine intestinal, liver and mammary-gland membranes. It binds immunoglobulin M and also undergoes proteolytic fragmentation in a similar manner to bovine secretory component (Mr 74000). The affinity-purified membrane protein is therefore most likely to be the bovine epithelial receptor for polymeric immunoglobulin. A structural model is proposed. PMID- 3954735 TI - Purification and comparison of the structures of human liver acidic alpha-D mannosidases A and B. AB - Human liver alpha-D-mannosidases A and B were purified 11 500-fold and 2000-fold respectively. Both showed microheterogeneity when analysed by isoelectric focusing. Alpha-D-Mannosidases A and B are immunologically identical but differ in their range of pI values, molecular masses, uptake into fibroblasts and subunit compositions. Alpha-D-Mannosidase A consists of equimolar proportions of subunits of molecular masses 62 kDa and 26 kDa, which are linked by disulphide bridges in the intact enzyme. Alpha-D-Mannosidase B also contains a small subunit, of molecular mass 26 kDa, and a variable mixture of larger subunits, of molecular masses 58 kDa and 62 kDa. The 62 kDa and 58 kDa subunits, but not the 26 kDa one, contain concanavalin A-recognizing glycans. The 58 kDa subunit has a lower pI, contains less high-mannose glycans but probably contains more mannose 6 phosphate than the 62 kDa subunit. It is postulated that the differences in structure and properties of alpha-D-mannosidases A and B are due to differences in the state of processing of the large subunit. This suggestion is consistent with a single locus on chromosome 19 for lysosomal alpha-D-mannosidase. PMID- 3954736 TI - Purification and characterization of human platelet proteoglycan. AB - Freshly prepared platelets were shown to contain glycosaminoglycans equivalent to 530 micrograms of hexuronate/10(11) platelets. When the platelets were extracted with 4 M-guanidinium chloride containing proteinase inhibitors, and the extract was dialysed extensively against 7 M-urea solution, almost all of proteoglycan was recovered in the urea-soluble fraction. The proteoglycan was purified from the urea-soluble fraction with a yield of 47% by DEAE-Sephacel chromatography, CsCl-density-gradient centrifugation, Bio-Gel A-15m gel filtration and then rechromatography on DEAE-Sephacel. The purified proteoglycan contained 30% glucuronic acid, 32% N-acetylgalactosamine, 14% sulphate and 15% protein. Serine, glutamic acid, glycine, aspartic acid and leucine accounted for 64% of the total amino acids. The Mr of the proteoglycan was assessed to be approx. 136000 by sedimentation-equilibrium methods. The galactosaminoglycan released by alkaline borohydride treatment of the proteoglycan was converted stoichiometrically into 4 sulphated unsaturated disaccharide by digestion with chondroitinase AC-II, indicating that the galactosaminoglycan was fully sulphated chondroitin 4 sulphate. The apparent Mr of the chondroitin sulphate was assessed to be 28000 by gel filtration on Bio-Gel A-0.5m (KD 0.18). On two-dimensional electrophoresis on a cellulose acetate membrane, the chondroitin sulphate gave a single compact spot co-migrating with a reference chondroitin sulphate, indicating that the chondroitin sulphate chains were homogeneous in both length and charge density. On the basis of these results, the proteoglycan in human platelets was concluded to be a macromolecule of Mr 136000 containing four chondroitin 4-sulphate chains each with the apparent Mr of 28000. PMID- 3954737 TI - Host zinc metabolism and the Ehrlich ascites tumour. Zinc redistribution during tumour-related stress. AB - Zinc redistribution between plasma and liver has been examined in mice injected with Ehrlich-ascites-tumour cells. Within 24 h of injection plasma Zn levels decrease and Zn appears in newly synthesized liver metallothionein. This response is dependent upon the number of tumour cells injected into the host. Uptake of Zn into liver and its specific accumulation in a Zn-binding protein, identified as metallothionein, continues for a number of days and reaches a plateau as tumour growth ceases. Over this time period, plasma copper rises. This redistribution also occurs in mice pretreated with cadmium in their drinking water for 1 month at levels of 20, 50, and 100 micrograms/ml. However, in each case there is a lag of 3 days before Zn increases in the livers of these animals which already contain substantial amounts of Cd/Zn-metallothionein. When Ehrlich cells are injected into mice previously placed on a Zn-deficient diet for several days, plasma Zn is already low and no net uptake of Zn into liver metallothionein is apparent. Finally, it is shown that ascites fluid can itself stimulate a transient shift of host of Zn into liver. Heat-inactivated fluid loses this property. It is suggested that, in the peritoneum, tumour cells initiate a stress response mediated by an ascites-fluid factor. PMID- 3954738 TI - Suppression of high-affinity ligand binding to the major glutathione S transferase from Galleria mellonella by physiological concentrations of glutathione. AB - The major glutathione S-transferase from larvae of Galleria mellonella binds a number of synthetic triphenylmethane dyes with dissociation constants of the order of 10(-6) M or less. The organ distribution of the enzyme activity does not parallel the uptake of such dyes by the insect's organs in vivo. The affinity of the protein for such dyes is decreased by about an order of magnitude by the presence of glutathione in normal physiological concentration. This appears to be the cause of this protein's lack of efficacy as a 'ligandin' in vivo. The dyes appear to be acting as ineffective substrate analogues, binding at the catalytic site and impeding, in a reciprocal fashion, the binding of glutathione. Fluorescence-quenching titration and kinetic experiments together indicate the existence of a single ligand-binding and catalytic site per dimeric enzyme molecule. PMID- 3954739 TI - Mechanistic origin of the sigmoidal rate behaviour of glucokinase. AB - Model studies are presented which demonstrate that reactions proceeding by a random ternary-complex mechanism may exhibit most pronounced deviations from Michaelis-Menten kinetics even if the reaction is effectively ordered with respect to net reaction flow. In particular, the kinetic properties and reaction flow characteristics of glucokinase can be accounted for in such terms. It is concluded that insufficient evidence has been presented to support the idea that glucokinase operates by a 'mnemonical' type of mechanism involving glucose binding to distinct conformational states of free enzyme. The sigmoidal rate behaviour of glucokinase can presently be more simply explained in terms of glucose binding to differently ligated states of the enzyme. PMID- 3954740 TI - Proteins of the human placental microvillar cytoskeleton. alpha-Actinin. AB - The human placental syncytiotrophoblast microvilli are supported by an underlying cytoskeleton consisting mainly of actin microfilaments. The major proteins associated with the actin have Mr values of 105 000, 80 000 and 68 000. The 105 000-Mr protein is recognized by an antibody preparation raised to purified chicken gizzard alpha-actinin. Electron microscopy has shown that the human placental protein has dimensions similar to those reported for muscle alpha actinin. About half of the placental microvillar alpha-actinin is released from the cytoskeleton in the presence of Ca2+. This effect occurs at concentrations of Ca2+ greater than 0.3 muM and has been used as the basis of a method for the purification of the placental alpha-actinin. This sensitivity to Ca2+ is not affected by trifluoperazine and is therefore likely to be a property of the alpha actinin as such rather than being mediated via calmodulin. PMID- 3954741 TI - Quantitative analysis of type X-collagen biosynthesis by embryonic-chick sternal cartilage. AB - We have performed a quantitative analysis of the various collagens biosynthesized by organ cultures of whole embryonic-chick sternum and its separate anatomical regions corresponding to the zones of permanent hyaline and presumptive calcification cartilages. Our studies demonstrated that embryonic-chick sternum devotes a large portion of its biosynthetic commitment towards production of Type X collagen, which represented approx. 18% of the total newly synthesized collagen. Comparison of the collagens biosynthesized by the permanent hyaline cartilage and by the cartilage from the presumptive-calcification zone demonstrated that Type X-collagen production was strictly confined to the presumptive-calcification region. Sequential extraction of the newly synthesized Type X collagen demonstrated the existence of two separate populations. One population (approx. 20%) was composed of easily extractable molecules that were solubilized with 1.0 m-NaCl/50 mM-Tris/HCI buffer, pH 7.4. The second population was composed of molecules that were not extractable even after repeated pepsin digestion, but became completely solubilized after treatment with 20 mM dithiothreitol/0.15 M-NaCl buffer at neutral pH. These results suggest that most of the Type X collagen normally exists in the tissue as part of a pepsin resistant molecular aggregate that may be stabilized by disulphide bonds. Quantitative analysis of the proportion of Type X collagen relative to the other collagens synthesized in the cultures indicated that this collagen was a major biosynthetic product of the presumptive-calcification cartilage, since it represented about 35% of the total collagen synthesized by this tissue. In contrast, the permanent hyaline cartilage did not display any detectable synthesis of Type X collagen. When compared on a per-cell basis, the chondrocytes from the presumptive-calcification zone synthesized approx. 33% more Type X collagen than the amount of Type II collagen synthesized by the chondrocytes from the permanent-hyaline-cartilage zone. Subsequently, it was demonstrated that Type X collagen is a structural component of chick sternum matrix, since quantitative amounts could be extracted from the region of presumptive calcification of 17-day old chick-embryo sterna and from the calcified portion of adult-chick sterna. The strict topographic distribution in the expression of Type X collagen biosynthesis to the zone of presumptive calcification suggests that this collagen may play an important role in initiation or progression of tissue calcification. PMID- 3954742 TI - Cell-cell recognition of host surfaces by pathogens. The adsorption of maize (Zea mays) root mucilage by surfaces of pathogenic fungi. AB - The adsorption of radioactive mucilage by pathogenic fungi was shown to be dependent upon time, the composition of mucilage, the type of fungal surface (conidia, hyphae, hyphal apices), fungal species, pH and bivalent cations. All fungal adhesins were inactivated by either proteinase or polysaccharase treatments. Adsorption was not inhibited by the numberous mono-, di- and oligo saccharides that were tested individually, but it was inhibited absolutely by several polysaccharides. This suggested that adsorption of mucilage by pathogens involved conformational and ionic interactions between plant and fungal polymers but not fungal lectins bound to sugar residues of mucilage. Several fractionation schemes showed that pathogens bound only the most acidic of the variety of polymers that comprise mucilage. There was not any absolute distinction between ability to bind radioactive mucilage and type of pathogen or non-pathogen. However, there were notable differences in characteristics of adsorption between two types of pathogen. Differences were revealed by comparison of the adsorption capacities of conidia and germinant conidia and chromatography of radioactive mucilage on germinant conidia. An ectotrophic root-infecting fungus (a highly specialized pathogen) bound a greater proportion of mucilage than did a vascular wilt fungus (of catholic host and tissue range) with more than one class of site for adsorption. In contrast with the vascular-wilt fungus, sites for adsorption on the specialized pathogen were present solely on surfaces formed by germination. PMID- 3954743 TI - Inhibition of hepatic and extrahepatic glutathione S-transferases by primary and secondary bile acids. AB - Glutathione S-transferases are a complex family of dimeric proteins that play a dual role in cellular detoxification; they catalyse the first step in the synthesis of mercapturic acids, and they bind potentially harmful non-substrate ligands. Bile acids are quantitatively the major group of ligands encountered by the glutathione S-transferases. The enzymes from rat liver comprise Yk (Mr 25 000), Ya (Mr 25 500), Yn (Mr 26 500), Yb1, Yb2 (both Mr 27 000) and Yc (Mr 28 500) monomers. Although bile acids inhibited the catalytic activity of all transferases studied, the concentration of a particular bile acid required to produce 50% inhibition (I50) varies considerably. A comparison of the I50 values obtained with lithocholate (monohydroxylated), chenodeoxycholate (dihydroxylated) and cholate (trihydroxylated) showed that, in contrast with all other transferase monomers, the Ya subunit possesses a relatively hydrophobic bile-acid-binding site. The I50 values obtained with lithocholate and lithocholate 3-sulphate showed that only the Ya subunit is inhibited more effectively by lithocholate than by its sulphate ester. Other subunits (Yk, Yn, Yb1 and Yb2) were inhibited more by lithocholate 3-sulphate than by lithocholate, indicating the existence of a significant ionic interaction, in the bile-acid-binding domain, between (an) amino acid residue(s) and the steroid ring A. By contrast, increasing the assay pH from 6.0 to 7.5 decreased the inhibitory effect of all bile acids studied, suggesting that there is little significant ionic interaction between transferase subunits and the carboxy group of bile acids. Under alkaline conditions, low concentrations (sub-micellar) of nonsulphated bile acids activated Yb1, Yb2 and Yc subunits but not Yk, Ya and Yn subunits. The diverse effects of the various bile acids studied on transferase activity enables these ligands to be used to help establish the quaternary structure of individual enzymes. Since these inhibitors can discriminate between transferases that appear to be immunochemically identical (e.g. transferases F and L), bile acids can provide information about the subunit composition of forms that cannot otherwise be distinguished. PMID- 3954744 TI - Hepatic mitochondrial inner-membrane properties, beta-oxidation and carnitine palmitoyltransferases A and B. Effects of genetic obesity and starvation. AB - Hepatic mitochondrial carnitine palmitoyltransferase (CPT) properties, beta oxidation of palmitoyl-CoA and membrane polarization were measured in lean and obese Zucker rats. The Vmax. of the 'outer' carnitine palmitoyltransferase ('CPT A') increased with starvation, with no change in the Km for either carnitine or palmitoyl-CoA. The Ki for malonyl-CoA increased with starvation in lean rats, but not in obese rats. The Vmax. of the 'inner' enzyme ('CPT-B'), as measured by using inverted submitochondrial vesicles, increased with starvation in obese rats only, with no change in the Km for either carnitine or palmitoyl-CoA. The Ki for malonyl-CoA was 2-5-fold higher in inverted vesicles than in intact mitochondria, and showed no alteration with starvation. The activities of both enzymes correlated positively with each other and with beta-oxidation, and inversely with membrane polarization. Malonyl-CoA had little effect on gross membrane fluidity in the Zucker rat, as reflected by diphenylhexatriene fluorescence polarization. The results indicate that both enzymes are related and respond similarly to alterations in membrane fluidity. Membrane fluidity may provide a mechanism for co-ordinated control of CPT activity on both sides of the mitochondrial inner membrane. PMID- 3954746 TI - An extended-X-ray-absorption-fine-structure investigation of diferric transferrins and their iron-binding fragments. AB - Iron K-edge extended-X-ray-absorption-fine-structure (e.x.a.f.s.) spectra were recorded for diferric human and rabbit serum transferrins and for diferric chicken ovotransferrin in aqueous solution; for ovotransferrin e.x.a.f.s. spectra from the N-terminal and C-terminal domain fragments were also measured. The overall spectral profiles closely resemble one another, indicating similar iron binding sites. The simulation of the diferric ovotransferrin spectrum suggests a first co-ordination shell consisting of six low-Z ligands (nitrogen/oxygen), two ligands at a distance of approx. 0.185 nm (1.85 A) and four ligands at approx. 0.204 nm (2.04 A). The two shorter distances may correspond to Fe-O (tyrosine), whereas the longer distance is consistent with Fe-N (histidine) and Fe-O (water). Detailed analysis of the spectra of the N-terminal and C-terminal fragments indicates a difference in the short ligand distance. PMID- 3954745 TI - Organotin-protein interactions. Binding of triethyltin bromide to cat haemoglobin. AB - Triethyltin binds to native cat and rat haemoglobin but not to their denatured forms or to other animal haemoglobins. Two molecules of the organotin bind to one molecule of R-state cat haemoglobin with affinity constants of about 1 X 10(5) M 1. Little or no triethyltin is bound to the deoxygenated (T-state) protein. Binding appears to be dependent upon the existence of a specific three dimensional configuration of cysteine and histidine residues. The properties of the triethyltin-cat haemoglobin complex are consistent with those of a haemoglobin conformer whose allosteric equilibrium is displaced toward the R state. Its oxygen affinity and rate of oxidation by nitrite is increased, and the rate of reduction of the methaemoglobin derivative by ascorbate is decreased. These effects of triethyltin are opposite and antagonistic to the effects of inositol hexaphosphate. They are exerted on the alpha- as well as beta-haem groups, even though triethyltin is bound at sites on alpha-globin far removed from the haem groups. PMID- 3954747 TI - Ketone-body metabolism in tumour-bearing rats. AB - During starvation for 72 h, tumour-bearing rats showed accelerated ketonaemia and marked ketonuria. Total blood [ketone bodies] were 8.53 mM and 3.34 mM in tumour bearing and control (non-tumour-bearing) rats respectively (P less than 0.001). The [3-hydroxybutyrate]/[acetoacetate] ratio was 1.3 in the tumour-bearing rats, compared with 3.2 in the controls at 72 h (P less than 0.001). Blood [glucose] and hepatic [glycogen] were lower at the start of starvation in tumour-bearing rats, whereas plasma [non-esterified fatty acids] were not increased above those in the control rats during starvation. After functional hepatectomy, blood [acetoacetate], but not [3-hydroxybutyrate], decreased rapidly in tumour-bearing rats, whereas both ketone bodies decreased, and at a slower rate, in the control rats. Blood [glucose] decreased more rapidly in the hepatectomized control rats. Hepatocytes prepared from 72 h-starved tumour-bearing and control rats showed similar rates of ketogenesis from palmitate, and the distribution of [1-14C] palmitate between oxidation (ketone bodies and CO2) and esterification was also unaffected by tumour-bearing, as was the rate of gluconeogenesis from lactate. The carcinoma itself showed rapid rates of glycolysis and a poor ability to metabolize ketone bodies in vitro. The results are consistent with the peripheral, normal, tissues in tumour-bearing rats having increased ketone-body and decreased glucose metabolic turnover rates. PMID- 3954748 TI - Transport of the aromatic amino acids into isolated rat liver cells. Properties of uptake by two distinct systems. AB - The transport of the aromatic amino acids into isolated rat liver cells was studied. There was a rapid and substantial binding of the aromatic amino acids, L alanine and L-leucine to the plasma membrane. This has important consequences for the determination of rates of transport and intracellular concentrations of the amino acids. Inhibition studies with a variety of substrates of various transport systems gave results consistent with aromatic amino acid transport being catalysed by two systems: a 2-aminobicyclo(2,2,1)heptane-2-carboxylic acid (BCH) insensitive aromatic D- and L-amino acid-specific system, and the L-type system (BCH-sensitive). The BCH-insensitive component of transport was Na+-independent and facilitated non-concentrative transport of the aromatic amino acids; it was unaffected by culture of liver cells for 24 h, by 48 h starvation, dexamethasone phosphate or glucagon. Kinetic properties of the BCH-inhibitable component were similar to those previously reported for the L2-system in liver cells. The BCH insensitive component was a comparatively low-Km low-Vmax. transport system that we suggest is similar to the T-transport system previously seen only in human red blood cells. The results are discussed with reference to the importance of the T- and L-systems in the control of aromatic L-amino acid degradation in the liver. PMID- 3954750 TI - The mechanism of action of beta-bungarotoxin at the presynaptic plasma membrane. AB - The beta-bungarotoxin-induced depolarization of the synaptosomal plasma membrane monitored by the efflux of 86Rb+ is potentiated by raising the albumin in the incubation, is Ca2+-dependent and is due neither to inhibition of the (Na+ + K+) dependent ATPase nor to activation of the voltage-dependent Na+ channel. Occupancy of the beta-bungarotoxin-binding site by dendrotoxin inhibits partially the action of beta-bungarotoxin. The efflux of 86Rb+ is parallelled by a release of lactate dehydrogenase from the synaptosome, and the two processes are maximal with 2 nM-toxin. Digitonin induces a release of 86Rb+ and lactate dehydrogenase closely similar to that seen with beta-bungarotoxin. It is concluded that the toxicity of beta-bungarotoxin for mammalian nerve terminals can be largely accounted for by specific site-directed phospholipase A2-induced permeabilization of the plasma membrane. PMID- 3954749 TI - Phosphopeptide analysis of phenylalanine hydroxylase isolated from liver cells exposed to hormonal stimuli. AB - Hormonal control of the phosphorylation of phenylalanine hydroxylase was studied by using rat liver cells incubated with [32P]Pi. After immunoprecipitation from cell extracts, the hydroxylase was subjected to proteinase digestion and subsequent sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. V8 proteinase digestion yielded one major 32P-labelled fragment, of approx. 9 kDa. Chymotrypsin digestion gave five 32P-labelled fragments ranging from approx. 39 kDa to approx. 10 kDa. Noradrenaline (10 microM) and glucagon (0.1 microM) enhanced the 32P content of all peptide fragments uniformly. Phorbol ester, in contrast with ionophore A23187, did not stimulate enzyme phosphorylation or enhance phenylalanine metabolism in liver cells. These results are discussed in relation to the nature of the protein kinase(s) that mediate phosphorylation of phenylalanine hydroxylase in liver cells. PMID- 3954752 TI - The purification and some equilibrium properties of the nitrite reductase of the bacterium Wolinella succinogenes. AB - The bacterium Wolinella succinogenes produces a nitrite reductase enzyme that can be purified to homogeneity in high yield by a combination of detergent extraction, hydroxyapatite chromatography and Mr fractionation. Nitrite reductase activity is found to be present in both a high- and a low-Mr fraction. The high Mr fraction has been shown to consist of the low-Mr nitrite reductase enzyme associated with a hydrophobic 'binding protein'. The amino acid composition for both proteins is reported. The nitrite reductase enzyme shows spectral characteristics indicative of the presence of c-type haem groups. Measurements at 610 nm indicate the presence of some high-spin haem groups at neutral pH. This haem subgroup undergoes a pH-linked high-spin - low-spin transition at alkaline pH. Approximately two of the six haem groups present within the enzyme bind CO with low affinity (KD = 0.4 mM). The enzyme also shows a range of redox activities with various inorganic reagents. The enzyme has been shown to exhibit dithionite reductase, oxygen reductase and CO2 reductase activities. PMID- 3954751 TI - Simultaneous induction of Pb-metallothionein-like protein and Zn-thionein in the liver of rats given lead acetate. AB - Administration of a sublethal dose of lead acetate to rats induced the simultaneous synthesis of a Pb-metallothionein (Pb-MT)-like protein (Pb-BP) and Zn-thionein (Zn-BP) in the liver. The Pb-BP had an apparent molecule mass of 6900 Da and seemed to bind preferentially to lead in the liver cytosol. The Zn-BP was identified by comparison of the Mr, elution profiles from Sephadex G-75 and DEAE Sephadex A-25 columns, and polyacrylamide-gel-electrophoretic mobility, with those of rat liver Zn-MT-II. The Pb-BP accumulated in the liver to a maximum 6 h after the intraperitoneal injection of lead acetate and accounted for about 60% of the lead in the liver cytosol at this stage. However, after that, it gradually decreased in the liver, until it was close to the basal amount 24 h after the induction. In contrast, the amount of Zn-MT increased gradually, reached a maximum 12 h after the administration of lead acetate and maintained a constant value until at least 24 h after the induction. Amino acid analysis of the Pb-BP indicated that it contained about 28% half-cysteine. These results strongly suggest that lead acetate induces the synthesis of Pb-MT as well as Zn-MT in rat liver. PMID- 3954753 TI - Kinetic studies on the nitrite reductase of Wolinella succinogenes. AB - The six haem groups of the nitrite reductase enzyme isolated from Wolinella succinogenes are rapidly reduced by the addition of dithionite (S2O4(2-)). The reduction, however, is not homogeneous. Two of the haem groups, namely those that show spectral characteristics typical of five-co-ordinated haem groups, are reduced in a dithionite-concentration-dependent fashion with a rate limit of 1.5 S-1. The other four haem groups, which show spectral characteristics very similar to those of normal six-co-ordinate c-haem groups, reduce in a linear dithionite concentration-dependent manner with a second-order rate constant of 150 M-1/2 X S 1. The ratio of the amplitudes of the two reduction phases observed in stopped flow studies is found to be dependent on the concentration of dithionite used. A model is proposed to account for these observations, and computer simulations show that the model represents a good fit to the experimental data. The two haem groups with five-co-ordinate spectral characteristics bind CO. Flash photolysis of the CO complex exhibits one major recombination process with a linear dependence in rate on CO concentration with a second-order rate constant of 2 X 10(6) M-1 X S-1. By contrast, stopped-flow mixing of the reduced protein with CO shows a very complex pattern of combination, with most of the observed absorbance change associated with a concentration-independent step. These findings are rationalized in terms of structural changes in the protein consequent to ligand binding. PMID- 3954754 TI - Is the availability of substrate for the tricarboxylic acid cycle a limiting factor for uncoupled respiration in sycamore (Acer pseudoplatanus) cells? AB - Protoplasts obtained from sycamore (Acer pseudoplatanus) cell suspensions were found to be highly intact and to retain a high rate of O2 consumption. If the protoplasts were taken up and expelled through a fine nylon mesh, all the protoplasts were ruptured, leaving the fragile amyloplasts largely intact. Distribution of enzymes of glycolysis in plastids and soluble phase of sycamore protoplasts indicated that the absolute maximum activity for each glycolytic enzyme under optimum conditions exceeded the estimates of the maximal rate at which sycamore cells oxidize triose phosphate. Passage of protoplasts through the fine nylon mesh produced a 3-5-fold decrease in O2 consumption. However, addition of saturating amounts of respiratory substrates and ADP restored an O2 consumption equal to that observed with uncoupled intact protoplasts. Taken together, these results demonstrated that neither the overall capacity of the glycolytic enzymes in sycamore cells nor the availability of respiratory substrates for the mitochondria is ultimately responsible for determining the rate of uncoupled respiration in sycamore cells. PMID- 3954755 TI - Binding of [14C]malonyl-CoA to rat liver mitochondria after blocking of the active site of carnitine palmitoyltransferase I. Displacement of low-affinity binding by palmitoyl-CoA. AB - The active site of the overt activity of carnitine palmitoyltransferase (CPT I) in rat liver mitochondria was blocked by the self-catalysed formation of the S carboxypalmitoyl-CoA ester of (-)-carnitine, followed by washing of the mitochondria. CPT I activity in treated mitochondria was inhibited by 90-95%. Binding of [14C]malonyl-CoA to these mitochondria was not inhibited as compared with that of control mitochondria. When CPT I activity was inhibited, palmitoyl CoA could markedly displace [14C]malonyl-CoA binding from the low-affinity site for the inhibitor [Zammit, Corstorphine & Gray (1984) Biochem. J. 222, 335-342], but not from the high-affinity site for malonyl-CoA binding. The saturation characteristics of the malonyl-CoA-binding component lost in the presence of palmitoyl-CoA were sigmoidal, and thus suggestive of co-operative binding at this site. It is suggested that the site hitherto considered to be a low-affinity malonyl-CoA-binding site may be effectively a second, allosteric, acyl-CoA binding site on CPT I under conditions that prevail in vivo, whereas the high affinity site for malonyl-CoA may be exclusive to the inhibitor. The possibility that the competitive-type interactions of malonyl-CoA and acyl-CoA on CPT I activity could arise from the effects of separate malonyl-CoA and acyl-CoA allosteric sites is considered. The possible significance of the large difference in the capacity of the two sites and their different saturation kinetics is also discussed. PMID- 3954756 TI - Stimulation of mouse liver glutathione S-transferase activity in propylthiouracil treated mice in vivo by tri-iodothyronine. AB - Female C57Bl/6J mice were given drinking water containing 0.05% propylthiouracil to induce a hypothyroid condition. Mitochondrial glycerol-3-phosphate dehydrogenase activity, used as an index of hypothyroidism, was 57.1 +/- 4.5 and 29.4 +/- 3.8 nmol/min per mg of protein for control and propylthiouracil-treated animals respectively. Administration of tri-iodothyronine resulted in an approx. 4.5-fold increase in dehydrogenase activity in propylthiouracil-treated animals. A dose-dependent increase in hepatic GSH S-transferase activity in propylthiouracil-treated animals was observed at tri-iodothyronine concentrations ranging from 2 to 200 micrograms/100 g body wt. This increase in transferase activity was seen only when 1,2-epoxy-3-(p-nitrophenoxy)propane was used as substrate for the transferase. Transferase activity with 1-chloro-2,4 dinitrobenzene and 1,2-dichloro-4-nitrobenzene as substrate was decreased by tri iodothyronine. Administration of actinomycin D (75 micrograms/100 g body wt.) inhibited the tri-iodothyronine induction of transferase activity. Results of these studies strongly suggest that tri-iodothyronine administration markedly affected the activities of GSH S-transferase by inducing a specific isoenzyme of GSH S-transferase and suppressing other isoenzymic activities. PMID- 3954758 TI - Structural analysis of the asparagine-linked oligosaccharides of human complement component C3. AB - The asparagine-linked oligosaccharides of human C3 were characterized. The C3 oligosaccharides were released by endo-beta-N-acetylglucosaminidase H and were analysed by lectin affinity chromatography and h.p.l.c. The released oligosaccharides bound tightly to concanavalin A-Sepharose and were not retained by agarose-bound wheat-germ agglutinin, indicating that they were only of high mannose type. Two major oligosaccharide structures were separated from both the alpha- and beta-chains of C3 by h.p.l.c. on Micropak AX-5, calibrated with high mannose-type oligosaccharides of known structures. The oligosaccharide structures on the alpha-chain have the compositions (Man)9(GlcNAc)2-Asn and (Man)8 (GlcNAc)2 Asn, and those on the beta-chain have the compositions (Man)6(GlcNAc)2-Asn and (Man)5(GlcNAc)2-Asn. PMID- 3954757 TI - Enzyme kinetic studies from progress curves. AB - A method is described for fitting the velocities obtained from progress curves to a steady-state rate equation. It is based on the method of Markus & Plesser [(1981) in Kinetic Data Analysis: Design and Analysis of Enzyme and Kinetic Data (Edrenyi, ed.), pp. 317-339, Plenum Press, New York]. The obstacle of needing good initial estimates of kinetic parameters is removed by using the parameters provided graphically by a minor modification of the method of Yun & Suelter [(1977) Biochim, Biophys. Acta 480, 1-13]. This progress-curved-based method allows the same discrimination among rival models as do the initial-velocity based methods, with a great saving of experimental time. The BASIC and FORTRAN 77 programs are deposited as Supplementary Publication SUP 50132 (17 pages) at the British Library (Lending Division), Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1986) 233, 5-6. PMID- 3954759 TI - Expression of c-myc oncogene in human fibroblasts during in vitro senescence. AB - Expression of the c-myc oncogene was determined in pre-confluent early and late passage human (IMR-90) fibroblast by dot blot analysis of cellular mRNA. Significant decreases in c-myc levels were found in late passage when compared to levels found in early passage cells. Cells restimulated with serum after serum restriction also showed reduced levels of c-myc in late passage. Confluent cells expressed levels of c-myc similar to that of pre-confluent cells, when serum stimulation was the same in both cases. Southern blots of Eco R1 digested DNA showed 2 fragments of similar size hybridizing to c-myc sequences in both early and late passage cells. PMID- 3954761 TI - Salvage of 5'-deoxy-5'-methylthioadenosine and L-homocysteine into methionine in cells cultured in a methionine-free medium: a study of "methionine-dependence". AB - The metabolism of the two methionine precursors, L-homocysteine and 5'-deoxy-5' methylthioadenosine was compared to the ability of these compounds to support cell growth in a Met-free medium, in the following mammalian cell lines: Raji, CCL 39 and BHK cells. These three cell lines metabolized L-homocysteine and 5' deoxy-5'-methylthioadenosine into methionine, S-adenosyl-L-methionine and proteins. However there was a discrepancy between metabolic and growth studies: Raji cells could grow on L-homocysteine and on 5'-deoxy-5'-methylthioadenosine, BHK cells could grow on L-homocysteine but not on 5'-deoxy-5' methylthioadenosine, and CCL 39 cells could not grow either on L-homocysteine or on 5'-deoxy-5'-methylthioadenosine. The metabolism of exogenous methionine, and of methionine endogenously synthesized from 5'-deoxy-5'-methylthioadenosine was studied in CCL 39 and Raji cells, incubated with 25 microM [methyl-14c] methionine + 25 microM 5'-deoxy-5'-methylthioadenosine or 25 microM [methyl-14c] 5'-deoxy-5'-methylthioadenosine + 25 microM methionine: there was no difference between the metabolism of exogenous and endogenous methionine in either type of cell. Our results indicate that i) "methionine dependence" initially described for L-homocysteine [Hoffman, R.M. and Erbe, R.W. (1976) Proc. Natl. Acad. Sci. USA 73, 1523], can also be observed with the other precursor of methionine, ie 5' deoxy-5'-methylthioadenosine; ii) "methionine-dependence" can not be considered as the inability of a cell to grow on methionine endogenously synthesized from a precursor, but depends on the precursor used, and possibly, on a toxic effect of the precursor in the absence of methionine. PMID- 3954760 TI - Decrease of NADH in HeLa cells in the presence of transferrin or ferricyanide. AB - The short-term incubation of HeLa cells in the presence of diferric transferrin or ferricyanide, which are reduced externally by the transplasma membrane reductase, produces a stoichiometric decrease in NADH and increase in NAD+, which is stimulated by insulin. The NADP/NADPH ratio does not change during 15 min incubation with the oxidants. The total pyridine nucleotide pool of HeLa cells is not affected. Incubation with apotransferrin and ferrocyanide, which cannot act as oxidants for transmembrane electron transport, does not change the pyridine nucleotide concentrations in the cells. Our results show that NADH can act as the internal electron donor for the reduction of external oxidants by the transmembrane reductase. It appears that oxidation of NADH by the transmembrane electron transport using ferricyanide or iron transferrin as external electron acceptors is sufficient to stimulate growth in HeLa cells. PMID- 3954762 TI - Tissue distribution of leukotriene A4 hydrolase activity in guinea pig. AB - The distribution of the activity of leukotriene A4 hydrolase, an enzyme catalyzing hydrolysis of the allylic epoxide leukotriene A4 to the dihydroxy acid leukotriene B4, was determined in various tissues of guinea pig by using the supernatant fraction (100,000 X g, 60 min) of the homogenates. The activity was ubiquitously distributed in all tissues examined, and the highest specific activity was found in small intestine, followed by lung, aorta, colon, and spleen, in this order. The specific activity in these tissues was higher than that of leukocytes. The physiological roles of this compound in these organs deserve reexamination in this context. PMID- 3954763 TI - Identification of the amino acid bound to the labile adduct formed during inactivation of monoamine oxidase by 1-phenylcyclopropylamine. AB - Three reactions are carried out on the reversible adduct formed when 1 phenylcyclopropylamine (1-PCPA) inactivates monoamine oxidase (MAO) in order to determine the identity of the amino acid involved in reversible adduct formation. Raney nickel treatment yields trans-beta-methyl[14C]styrene, the compound that would result from carbon-sulfur bond reduction of a (3-hydroxy-3-phenyl propyl)cysteine adduct. A 5,5'-dithiobis(2-nitrobenzoic acid) assay for cysteine residues indicates that upon reversible inactivation of MAO by 1-PCPA, one cysteine is lost. The third reaction involves sodium periodate and hydrogen peroxide oxidation, but no definitive result is obtained. The first two reactions provide evidence that the amino acid residue involved in reversible adduct formation is a cysteine. PMID- 3954764 TI - Inhibition of macrophage secretion by tetanus toxin is not directly linked to cytosolic calcium homeostasis. AB - Tetanus toxin (TT) inhibits secretion of neurotransmitters from neurons and lysozyme from human macrophages (Mphi). Because these secretory events are associated with changes in cytosolic free calcium [Ca2+]i, we examined the effect of TT on Mphi calcium homeostasis and secretion in response to ionomycin and phorbol myristate acetate (PMA). Using Quin 2 to report [Ca2+]i, basal [Ca2]i was similar for control cells (133 nM) and Mphi treated with TT (127 nM). In response to ionomycin (50 nM) [Ca2+]i increased to 548 +/- 74 nM in control cells and to 357 +/- 36 nM in TT-treated Mphi (p less than 0.02, N = 12). Despite this rise in [Ca2+]i, neither control Mphi nor TT-treated Mphis secreted the lysosomal enzyme lysozyme in response to this concentration of ionomycin (50 nM). In both control and TT-treated Mphi, stimulation with a higher concentration of ionomycin (1000 nM) caused saturation of the quin 2 fluorescence signal. However, lysozyme secretion from TT-Mphi was inhibited. In response to the phorbol ester, PMA (3 uM), [Ca2+]i did not increase in either control Mphi or TT-treated Mphi. However, secretion of lysozyme from TT-treated Mphi was also inhibited in response to this stimulus (70.8% of control, p less than 0.02, N = 3). These data indicate that the ability of TT to inhibit secretion from Mphi is not directly linked to alterations of cytosolic calcium homeostasis. PMID- 3954765 TI - Glucocorticoids and the isolated rat hepatocyte. AB - Following incubation at 37 degrees C with tritiated glucocorticoids isolated hepatocytes prepared from non-adrenalectomized rats show rapid uptake of label. Uptake is non-saturable, and non-linear over the first 60 sec of exposure to steroids. HPLC separation of aqueous extracts of cells and incubation medium shows that polar metabolites of the natural steroid, corticosterone, appear within 10 sec, whereas the synthetic glucocorticoid, dexamethasone, is not altered. Our results suggest that diffusion is the most important process by which glucocorticoids enter liver cells, and that the predominant fate of corticosterone is rapid metabolism. PMID- 3954766 TI - An evidence of the peroxidase-dependent oxygen transfer from hydrogen peroxide to sulfides. AB - Horseradish- and chloro-peroxidase catalyzed oxidation of sulfides have been investigated. Thioanisoles were oxygenated to the corresponding sulfoxides by such peroxidases at the expense of H2O2. Dealkylation was observed only in the chloroperoxidase-dependent oxidations of p-methoxy- and p-iso-propoxy thioanisoles. The experiments with 18O-labeled H2O2 indicated that an oxygen atom of H2O2 is incorporated into the sulfoxides. These research lead to the conclusion that compound I or II is capable of acting as an oxygen donor as well as an electron acceptor. PMID- 3954767 TI - Histamine activates H1-receptors to induce cytosolic free calcium transients in cultured vascular smooth muscle cells from rat aorta. AB - Using an intracellularly trapped dye, quin 2, the effects of histamine on cytosolic free calcium concentrations in rat aortic vascular smooth muscle cells in primary culture were recorded, microfluorometrically. When the cells were exposed to histamine, both in the presence and the absence of extracellular Ca2+, there was a rapid, transient and dose-dependent elevation of cytosolic Ca2+ concentrations, with a similar time course. This elevation of cytosolic Ca2+ was dose-dependently inhibited by mepyramine, but not by cimetidine. Thus, histamine activates H1- but not H2- receptors to mediate a release of Ca2+ from the store sites, and there is a rapid and transient elevation of cytosolic Ca2+. PMID- 3954768 TI - Isolation, characterization and thiol exchange reaction of penicillamine selenotrisulfides. AB - Penicillamine selenotrisulfides formed by the reaction of selenite with D-, L-, and DL-penicillamines in the aqueous solution have been isolated and submitted to the spectroscopic and chromatographic analyses. FAB-MS spectra indicated the molecular ion peak (M+1)+ at m/z 377, which confirmed the molecular formula (C10H20N2O4S2Se) for all these selenotrisulfides. The [77Se]NMR and HPLC results showed that symmetric selenotrisulfides (DD and LL) were formed from D- and L penicillamines, respectively, while asymmetric selenotrisulfide (DL) in addition to symmetric ones was formed from DL-penicillamine. The occurrence of thiol exchange reaction of selenotrisulfides was verified. PMID- 3954769 TI - Undesirable feature of safranine as a probe for mitochondrial membrane potential. AB - This communication describes experiments showing that safranine, at the concentrations usually employed as a probe of mitochondrial membrane potential, causes significant undesirable side effects on Ca2+ transport by liver mitochondria. The major observations are: (i) safranine potentiates the spontaneous Ca2+ release from liver mitochondria induced by phosphate or acetoacetate. This is paralelled by potentiation of the release of state-4 respiration and of the rate of mitochondrial swelling, indicating a generalized effect of the dye on the mitochondrial membrane; (ii) the efflux of mitochondrial Ca2+ stimulated by hydroperoxide is irreversible in the presence of safranine even if membrane stabilizers such as Mg2+ and ATP are present. It is concluded that the use of safranine to monitor the changes in membrane potential during Ca2+ transport by mitochondria should be avoided or special care be taken. PMID- 3954771 TI - Inactivation of B12 and folate coenzymes by butyl nitrite as observed by NMR: implications on one-carbon transfer mechanism. AB - The effects of butyl nitrite, a frequently used recreational drug, on methyl cobalamin and 5-methyl tetrahydrofolate were investigated by using 1H and 31P NMR spectroscopies. While no effect could be observed in organic solvents, strong interactions of butyl nitrite with the methyl cobalamin and 5-methyl tetrahydrofolate were found to occur in water. Butyl nitrite decomposes in water generating H+ and NO-2. The former protonates to give the "base-off" configuration of methyl cobalamin while the Co-CH3 bond is cleaved. Similarly, the methyl group at the 5N position and the pyrazine ring of 5-methyl tetrahydrofolate were found to be affected by butyl nitrite. The overall interaction of butyl nitrite with both coenzymes shows displacement of the methyl group and derivatization or destruction of the coenzymes that may lead to deficiencies of both B-12 and/or folates. PMID- 3954770 TI - Protein kinase activation of heparin-releasable lipoprotein lipase in rat heart. AB - An attempt was made to activate the capillary-bound fraction of lipoprotein lipase (LPL) with cAMP-dependent protein kinase catalytic subunit (PKC). Following a 30s washout period, hearts were perfused for 1 min with buffer containing heparin. Medium was collected during the second 30s of heparin perfusion. Addition of PKC+Mg-ATP to this capillary bed perfusate increased LPL activity from 6.84 +/- 0.72 nmol/ml/min to 13.76 +/- 1.12 nmol/ml/min (P less than 0.001). A similar 2-fold increase in activity was observed when results were expressed on a mg protein basis. Removal of serum from, or addition of 1.0M NaCl to, the assay system inhibited PKC-stimulated LPL activity approximately 85%. These results indicate that capillary alkaline LPL can be activated by PKC assayed under experimental conditions free of other TG lipases. Moreover, these findings suggest that the intracellular fraction of LPL can be activated by cAMP and that this activation is mediated through protein phosphorylation by cAMP dependent protein kinase. PMID- 3954772 TI - An efficient and prolonged in vitro translational system from isolated cucumber etioplasts. AB - Etioplasts were isolated from dark grown cucumber cotyledons pretreated with kinetin and gibberellic acid. When incubated in a cofactor enriched medium these etioplasts incorporated [35S] methionine into a hot trichloroacetic acid insoluble fraction; this incorporation was linear for 8 h of incubation and was inhibited by chloramphenicol but not by cycloheximide. Over the same time period, the etioplasts showed continued linear synthesis of the chlorophyll precursors protochlorophyllide, Mg-protoporphyrin and protoporphyrin IX. Analysis of products of in vitro protein synthesis by etioplasts and cotyledons showed the thylakoid membrane polypeptide profiles to be identical. Continued incorporation of [35S] methionine into the large subunit of ribulose bisphosphate carboxylase/oxygenase (RuBisCO) for 8 h has been confirmed further by immunoprecipitation with anti-spinach RuBisCO. This competent in vitro translation system should be useful for future studies of chloroplast protein synthesis and gene expression. PMID- 3954773 TI - Identification of a dephosphorylated oxidation product of the molybdenum cofactor as 2-(1,2-dihydroxyethyl)thieno[3,2-g]pterin. AB - A new method was developed for the synthesis of 2-(1,2-dihydroxyethyl)thieno[3,2 g]pterin and related 2-substituted thienopterins. A dephosphorylated fluorescent oxidation product of the molybdenum cofactor isolated from xanthine oxidase (EC 1.2.3.2) was identified as 2-(1,2-dihydroxyethyl)thieno[3,2-g]pterin by comparison of electronic and fluorescence spectra and TLC behaviors with those of the synthetic compound. PMID- 3954774 TI - Multiple forms of sulfmyoglobin as detected by 1H nuclear magnetic resonance spectroscopy. AB - The proton nuclear magnetic resonance spectrum of sulfmyoglobin prepared in standard fashion reveals the presence of three forms, A, B, and C, with different chemical reactivity. Conditions for some interconversions of these forms are given. The 1H NMR spectra of the different forms show similar patterns. It appears that the differences between forms involve chemical modification on the porphyrin periphery. The altered heme can be extracted from FeIII(CN) sulfmyoglobin C to give a stable green substance. PMID- 3954775 TI - Proteins encoded by ras oncogenes stimulate or inhibit phosphorylation of specific mitochondrial membrane proteins. AB - We have examined the effects of a series of purified p21 proteins encoded by ras oncogenes and synthesized in E. coli via recombinant DNA methods, on the phosphorylation of proteins associated with isolated rat liver mitochondria. We find that these proteins markedly enhance the phosphorylation of a 36KD protein and inhibit phosphorylation of a 17KD protein. The phosphorylated residues on the 36KD protein are hydrolyzed by mild acid, suggesting that they involve phosphoamide bonds. These results suggest that p21 proteins may play a role in vivo by altering the phosphorylation of certain proteins. PMID- 3954776 TI - The interaction of calmodulin with rat liver plasma membrane. AB - Rat liver plasma membranes contain relatively high amounts of EGTA-insensitive calmodulin which seems to interact with cytoskeletal proteins. Calmodulin is particularly enriched in a subplasmamembrane fraction containing basolateral membranes. Two calmodulin-binding proteins with apparent Mr of 240 KDa and 145 KDa have been found associated with the purified plasmamembranes. PMID- 3954777 TI - The glucocorticoid dexamethasone and the tumor-promoting artificial sweetener saccharin stimulate protein kinase C from T51B rat liver cells. AB - Diacylglycerols, such as 1,2-diolein, and tumor-promoting phorbol compounds, such as TPA (12-0-tetradecanoyl phorbol-13-acetate), stimulate the Ca2+/phospholipid dependent protein kinase C from T51B rat liver cells, probably by sensitizing it to activation by Ca2+, and they reduce the liver cells' content of EDTA extractable (i.e., soluble) protein kinase C activity. Evidence is presented that indicates that the glucocorticoid, dexamethasone, and the tumor-promoting artificial sweetener, saccharin, also trigger a Ca2+-dependent increase in the activity of the protein kinase C from T51B liver cells and reduce the cells' content of EDTA-extractable protein kinase C activity. However, these novel stimulators do not activate the enzyme by binding to the same site as diacylglycerols and TPA, although they do alter this site as indicated by an increase in the binding of the TPA analogue PDBu (phorbol 12,13-dibutyrate). PMID- 3954778 TI - Prevention of doxorubicin-induced killing of MCF-7 human breast cancer cells by oxygen radical scavengers and iron chelating agents. AB - This study investigated the effect of oxygen radical scavengers and iron chelating agents on the toxicity of doxorubicin for MCF-7 human breast cancer cells. Superoxide dismutase and catalase, but not the heat-inactivated enzymes, the hydroxyl radical scavenger N-acetylcysteine, and the organoselenium compound 2-phenyl-1-2-benzisoselenazol-3(2H)-one, which possesses glutathione peroxidase like activity, significantly reduced or abolished tumor cell killing by doxorubicin. Similar protective activity was found only for those iron chelating agents capable of penetrating the tumor cell plasma membrane. These experiments suggest that an iron-dependent oxygen radical cascade contributes to the antineoplastic action of the anthracycline antibiotic doxorubicin. PMID- 3954779 TI - Hexapeptide repeat structure in Dictyostelium spore coat protein. AB - The sequences of the NH2-termini of two spore coat proteins of Dictyostelium discoideum have been determined. One of them (SP60) consists of perfect hexapeptide repeats of the sequence Gly-Asp-Trp-Asn-Asn-Asx-. The sequence has some homology to the parvovirus capsid protein which does not display periodicity. The NH2-terminal sequence of the second protein, SP70, contains a modified amino acid in two positions and like SP60 is highly hydrophilic and acidic. PMID- 3954780 TI - Antiprogestin-receptor complexes: differences in the interaction of the antiprogestin RU38,486 and the progestin R5020 with the progesterone receptor of human breast cancer cells. AB - In order to understand the molecular basis for antiprogestin action, we have compared the interaction of the antiprogestin [3H]RU38, 486 (RU486) and the progestin [3H]R5020 with the progesterone receptor (PR). In both MCF-7 and T47D human breast cancer cells, we have observed marked differences in the sedimentation properties of the PR on high salt sucrose gradients: while the R5020-receptor complexes sediment at approximately 4 S (4.4 +/- 0.1 S), the RU486 receptor sediments as a prominent 6 S species as well as a 4 S species. This binding is abolished by excess unlabelled R5020, RU486 or progesterone, but is unaffected by excess unlabelled hydrocortisone or dexamethasone, indicating that both the 4 S and 6 S species represent the PR and not glucocorticoid receptor. Although the relative distribution of 4 S and 6 S forms is not altered by treatment with DNAse or RNAse, exposure to 10 mM thioglycerol or to 3 M urea results in conversion of the 6 S to the 4 S form, suggesting that disulfide bonds and hydrophobic interactions are important in maintaining the integrity of the 6 S form. These findings suggest that the 6 S antiprogestin complex is formed as a result of the interaction of PR units with each other or with a different protein. This change in receptor association state may be an important aspect of the antiprogestin activity of RU486. PMID- 3954781 TI - Progestin-induced down regulation of nuclear estrogen receptor in uterine decidual cells: analysis of receptor synthesis and turnover by the density-shift method. AB - The density-shift method was used to study the effect of the synthetic progestin, R5020, (17,21-dimethyl-19-nor-4,9-pregnadiene-3,20-dione) on the turnover and synthesis of nuclear estrogen receptor in hamster decidual cells. Newly synthesized receptor was labeled with dense [2H, 13C, 15N] amino acids and separated from pre-existing receptor by density-gradient centrifugation. Progestin increased receptor turnover within 3 h of treatment and blocked estradiol-induced receptor synthesis at 6 h and 9 h. Thus, progestin down regulates estrogen receptor by increasing receptor turnover and inhibiting estrogen-induced receptor replenishment. PMID- 3954782 TI - Mechanism of potentiation of antitumor activity of 5-fluorouracil against adenocarcinoma 755 by L-cysteine. PMID- 3954783 TI - In vitro studies on the reactivation by oximes of phosphylated acetylcholinesterase--I. On the reactions of P2S with various organophosphates and the properties of the resultant phosphylated oximes. AB - The rates of formation and decomposition of a series of phosphylated oximes derived from P2S (2-hydroxy-iminomethyl-1-methylpyridinium methane-sulphonate) have been measured. The rates of inhibition of AChE by these phosphylated oximes and the parent (and related) organophosphates have also been measured. Possession of these rate data now permits a detailed analysis of the reactivation of phosphylated AChE by P2S to be made (see following paper). PMID- 3954784 TI - In vitro studies on the reactivation by oximes of phosphylated acetylcholinesterase--II. On the formation of O,O-diethyl phosphorylated AChE and O-ethyl methylphosphonylated AChE and their reactivation by PS2. AB - The in vitro reactivation profiles of O,O-diethyl phosphorylated AChE and O-ethyl methyl phosphonylated AChE by P2S (2-hydroxy iminomethyl-1-methyl-pyridinium methane sulphonate) have been determined. Whilst reinhibition of the reactivated AChE by phosphorylated oxime (POX) is not important in determining the reactivation profile of O,O-diethyl phosphorylated AChE, reinhibition of the reactivated AChE by phosphonylated oxime can, however, be important in determining the reactivation profile of O-ethyl methylphosphonylated AChE and the extent of this reinhibition is determined by the initial concentration of phosphonylated AChE. Kinetic analysis of the reactivation profiles demonstrated that the generally accepted scheme for this reactivation process is incorrect and that phosphylated AChE cannot be considered as a single species although an adequate description of the present data is afforded by a model using a 1:1 mixture of two species each with its own rate of reactivation. In the case of O,O diethyl phosphorylated AChE the main kinetic difference between these two species is found not in the formation or stability of the phosphorylated AChE-P2S complex but in its subsequent reaction. From results with O-ethyl methylphosphonylated AChE prepared from two pairs of enantiomers as well as from the racemic fluoridate it was concluded that phosphonylation of AChE may not always occur via a mechanism involving inversion of configuration at phosphorus but can also occur with retention of configuration. Reactivation by P2S of O-ethyl methylphosphonylated AChE prepared from (S) organophosphates proceeds with inversion of configuration at phosphorus. Inversion also occurs in the reinhibition of AChE by the POX produced in the initial reactivation. PMID- 3954785 TI - Defective bile acid transport in an animal model of defective debrisoquine hydroxylation. AB - Bile acid transport in female DA (dark Aguti) rats, a model for debrisoquine hydroxylation deficiency in man, was investigated. Compared to hydroxylation competent male DA and Sprague-Dawley rats of either sex, the female DA rat had a significantly lower taurocholate maximal secretory rate in vivo. Studies in the perfused liver showed this to be due to a decreased extraction efficiency during exogenous taurocholate loading. To characterize further the defect, taurocholate uptake velocity into isolated hepatocytes was studied. This showed a decreased maximal uptake velocity in the female DA rat (P less than 0.02). Whether this defect in bile acid uptake is related to the defective debrisoquine hydroxylation, remains to be established. PMID- 3954786 TI - Action of zinc on bone metabolism in rats. Increases in alkaline phosphatase activity and DNA content. AB - The effects of zinc on the enzymes of femoral tissue were investigated in weanling rats that had been given zinc sulfate (1.0 mg Zn2+/100 g body wt) p.o. for 3 days. Administration of zinc caused a marked elevation of alkaline phosphatase and acid phosphatase activities, whereas it did not cause significant changes in succinate dehydrogenase, 5'-nucleotidase, ATPase, pyrophosphatase and beta-N-acetylglucosaminidase activities. The effect of zinc was greater on alkaline phosphatase of the femoral diaphysis. Zinc content of the femoral diaphysis was raised significantly by administration of zinc. The addition of zinc in concentrations of 10(-2)-10(2) microM did not produce a significant increase in alkaline phosphatase activity in the femoral diaphysis, indicating that zinc could not activate the enzyme. Administration of cycloheximide or actinomycin D completely inhibited the increase in alkaline phosphatase activity produced by administration of zinc. DNA content of the femoral diaphysis, but not epiphysis, was increased markedly by administration of zinc. The increases in both alkaline phosphatase activity and DNA content of the femoral diaphysis were not caused by administration of copper, manganese, cobalt, nickel and chromium(III). The present investigation suggests that zinc may induce the increase in alkaline phosphatase related to DNA synthesis and, as a result, stimulate bone growth. PMID- 3954788 TI - Aspects of metabolism of tamoxifen by rat liver microsomes. Identification of a new metabolite: E-1-[4-(2-dimethylaminoethoxy)-phenyl]-1, 2-diphenyl-1-buten-3-ol N-oxide. AB - Metabolism of tamoxifen N-oxide by phenobarbitone-induced rat liver microsomes gave a major metabolite which was identified as E-1-[4-(2 dimethylaminoethoxy)phenyl]-1, 2-diphenyl-1-buten-3-ol N-oxide (alpha hydroxytamoxifen N-oxide) by comparison of mass spectral properties with synthetic material. This new metabolite was also formed from tamoxifen. Tamoxifen epoxide was synthesised; its microsomal metabolism gave the corresponding N oxide. Neither tamoxifen epoxide nor its N-oxide was detected as a product of tamoxifen metabolism. PMID- 3954787 TI - Studies on the uptake and release of propranolol and the effects of propranolol on catecholamines in cultures of bovine adrenal chromaffin cells. AB - Uptake and release of [3H]l-propranolol and the effects of propranolol on the uptake and release of [3H]norepinephrine were studied in cultures of isolated bovine adrenal chromaffin cells. [3H]l-Propranolol uptake increased with increasing [3H]l-propranolol concentration from 10(-7) M to 10(-3) M and was not saturable in this concentration range. [3H]l-Propranolol uptake was equally inhibited by l- and d-propranolol, indicating that the uptake is not stereoselective. [3H]l-Propranolol uptake differed from [3H]norepinephrine uptake in two respects: [3H]l-propranolol uptake was 44-50 times greater than [3H]norepinephrine uptake at early non-equilibrium time periods, and [3H]l propranolol uptake was not Na+ dependent and was not inhibited by desipramine, indicating that [3H]l-propranolol is not taken up by the biogenic amine transport system. In cells preloaded with [3H]l-propranolol, two agents, veratridine and tyramine, stimulated an increased release of [3H]l-propranolol into the medium. However, veratridine-induced [3H]l-propranolol release was inhibited only slightly by the Na+ channel blocker tetrodotoxin, and tyramine-induced [3H]l propranolol release was not inhibited by desipramine. In addition, K+, carbachol and the physiological mediator of adrenal catecholamine release, acetylcholine, failed to evoke [3H]l-propranolol release. Therefore, it is unlikely that propranolol is released in response to physiological stimulation of adrenal chromaffin cells in animals administered propranolol in vivo. l-Propranolol inhibited [3H]norepinephrine uptake by chromaffin cells with an IC50 for l propranolol of 5 X 10(-6) M; d-propranolol was equally potent for this effect at lower propranolol concentrations. By themselves, neither l- nor d-propranolol had any effect on [3H]norepinephrine release from the cells. However, l-propranolol inhibited carbachol-induced [3H]norepinephrine release with an IC50 for l propranolol of 5 X 10(-7) M to 10(-6) M. At these lower concentrations, d propranolol had no effect on carbachol-induced [3H]norepinephrine release, indicating that the inhibition by l-propranolol may be mediated via beta adrenoceptors on chromaffin cells. PMID- 3954789 TI - Selective inhibition and selective induction of multiple microsomal epoxide hydrolases. AB - The inhibition in vitro and induction in vivo of microsomal trans-stilbene oxide hydrolase have been studied. This microsomal epoxide hydrolase activity is distinguishable from the previously well-defined microsomal arene oxide hydrolase by a number of catalytic criteria. Two substituted chalcone oxides, 4 phenylchalcone oxide and 4'-phenylchalcone oxide, are potent inhibitors of microsomal trans-stilbene oxide hydrolase, but have no apparent activity against benzo[a]pyrene 4,5-oxide hydrolase. Conversely, compounds that are potent inhibitors of benzo[a]pyrene 4,5-oxide hydrolase, including styrene oxide, cyclohexene oxide, and trichloropropene oxide, inhibit microsomal trans-stilbene oxide hydrolase only at very high (millimolar) concentrations. The chalcone oxides inhibit microsomal trans-stilbene oxide hydrolase noncompetitively, and have micromolar or nanomolar affinity constants for the enzyme. Attempts were made to induce microsomal trans-stilbene oxide hydrolase in vivo. Compounds that induced microsomal benzo[a]pyrene 4,5-oxide hydrolase levels in mice did not simultaneously induce trans-stilbene oxide hydrolase levels. Clofibrate was an exception; it induced levels of both enzymes to a small but statistically significant degree. The two microsomal hydrolase activities have, therefore, very different catalytic sites and appear to be under separate genetic control. 4 Phenylchalcone oxide and 4'-phenylchalcone oxide are selective inhibitors of microsomal trans-stilbene oxide hydrolase and may prove to be very useful in assessing the involvement of this enzyme in the metabolism of endogenous or xenobiotic epoxides. PMID- 3954791 TI - Evidence for distinct consecutive steps in the neutral to base transition of human serum albumin. AB - The neutral to base transition in human serum albumin has been studied by means of circular dichroism and equilibrium dialysis using nitrazepam as the non covalently bound circular dichroic probe. Spectroscopically two transitions were observed over the pH range 5.5-8.5, whereas dialysis data point to only one transition occurring in the latter part of the pH region studied. Both pH dependences could only be correlated if it is assumed that the neutral to base transition consists of at least two distinct consecutive steps. PMID- 3954790 TI - In vitro [3H]-erythromycin binding to Staphylococcus aureus. AB - Characteristics of erythromycin binding to Staphylococcus aureus were determined by using kinetics and equilibrium binding experiments. Both methods yielded identical values of the dissociation constant, i.e. 0.1 muM. This value was in accord with that found with a bacterial extract of ribosomes which are the organelles where erythromycin exerts its action. This good agreement shows that the dissociation constant of erythromycin determined with intact bacteria is a good reflect of specific bacterial receptors of macrolides, i.e. ribosomes. In addition, mechanism of uptake of the antibiotic by Staphylococcus aureus was investigated. Passive diffusion process was shown to be mainly responsible for this phenomenon. PMID- 3954792 TI - Stereospecific deuterium substitution at the alpha-carbon position of dopamine and its effect on oxidative deamination catalyzed by MAO-A and MAO-B from different tissues. AB - Stereospecific replacement of deuterium in the alpha-carbon side chain position of dopamine (DA) was achieved by decarboxylation of L-3,4-dihydroxyphenylalanine (L-dopa) using hog kidney aromatic aminoacid decarboxylase. The S[alpha-2H1]DA enantiomer was obtained by decarboxylation of L-[alpha-2H1]dopa in H2O, while the R[alpha-2H1]DA enantiomer was obtained by decarboxylation of unsubstituted L-dopa in 2H2O. An inverse solvent isotope effect of L-dopa decarboxylation was observed in 2H2O. The deaminated aldehyde products of the four DA analogues, i.e. undeuterated DA, [alpha, alpha-2H2] DA, R[alpha-2H1]DA and S[alpha-2H1]DA, have been analyzed by the gas chromatography-mass spectrometry (GC-MS) method. It is evident that monoamine oxidase (MAO) catalyzes the stereochemical removal of only R-deuterium and that S-deuterium was maintained at the alpha-carbon atom of 3,4 dihydroxyphenylacetaldehyde. The steady-state kinetics of the oxidative deamination of undeuterated, [alpha, alpha-2H2], R[alpha-2H1], and S[alpha-2H1] dopamine were assessed by determination of the aldehyde products directly by high performance liquid chromatography (HPLC) using electrochemical detection (ECD). MAO-A from rat liver mitochondria (deprenyl-treated) and from human placenta, as well as MAO-B from rat liver (clorgyline-treated) and from human platelet were used in this study. The apparent isotope effects, i.e. (V/K)H/(V/K)D ratios of [alpha, alpha-2H2]DA and R[alpha-2H1]DA, were quite similar (2.34 and 3.13) with respect to both MAO-A and MAO-B. S[alpha-2H1]DA exhibited a slight secondary isotope effect. Formula: see text. PMID- 3954793 TI - Breakdown of small enkephalin derivatives and adrenal peptide E by human plasma. AB - To provide information concerning the fate of opioid peptides introduced into the circulation of man, we have investigated the breakdown of the following peptides when incubated in human plasma: [Met]enkephalin, [Met]enkephalyl-Arg6-Phe7, [Met]enkephalyl-Arg6-Gly7-Leu8, [Met]enkephalyl-Arg6-Arg7-Val8-NH2 and the complex opioid, peptide E. We used a radioimmunoassay recognizing the amino terminus of opioid peptides (assay for total opioid peptide-like immunoreactivity). The three small enkephalin derivatives were broken down considerably faster than the enkephalins themselves. The rate of loss of immunoreactivity was considerably reduced by bacitracin. When peptide E was incubated in human plasma, a relatively sustained level of opioid peptide-like immunoreactivity was seen. This was shown to be due, not only to the relatively slow aminopeptidase attack of the larger peptide, but also to the generation during breakdown of peptide E of [Leu]enkephalin and [Met]-enkephalin. PMID- 3954794 TI - Effect of in vivo anticonvulsant drugs on pineal gland indol metabolism organ culture. PMID- 3954795 TI - Effects of kainic acid analogues on the high affinity uptake of D-[3H] aspartate into rat cerebellar homogenates. PMID- 3954796 TI - Enzymatic cleavage of 5-substituted-2'-deoxyuridines by pyrimidine nucleoside phosphorylases. PMID- 3954797 TI - The hydrolysis of succinyldithiocholine and related thiocholine esters by human plasma and purified cholinesterase. AB - The kinetic properties of cholinesterase (ChE) present in plasma were compared with those of purified human ChE using the substrates succinyldithiocholine (SDTCh), acetylthiocholine (AcTCh) and butyrylthiocholine (BuTCh). SDTCh was hydrolysed at two sites; a site with a low Km (Km1 11.4 +/- 3.3 microM) with a Vmax of 0.06 mumol/min/ml and a site with a high Km (Km2 132.4 +/- 14.8 microM) and a Vmax of 0.107 mumol/min/ml. The Km2 site was absent in the sample of purified ChE. The related thiocholine esters, AcTCh and BuTCh were hydrolysed at two sites by both plasma and purified ChE. This indicated that the Km2 site which hydrolysed SDTCh was not ChE. The identity of this component in plasma remains unknown but it was shown not to be albumin. The anticholinesterase agents soman and pyridostigmine were used to demonstrate the direct relationship between inhibition of plasma ChE and hydrolysis of SDTCh at the low concentrations present clinically (20 microM). Whereas high concentrations of SDTCh (200 micron) could be partly hydrolysed by an enzyme present in plasma which is insensitive to ChE inhibitors. In a limited study on the plasma from two "atypical" individuals (Dibucaine number less than 20) all three substrates were hydrolysed at a single site with a higher Km than the Km2 site present in normal plasma. The clinical implications of these results are discussed. PMID- 3954798 TI - Charge-independent effects of drugs on erythrocyte morphology. AB - The effects of chlorpromazine, tetracaine, indomethacin, barbitone and benzyl alcohol on human erythrocyte shape have been examined. Cationic and anionic drugs produced stomatocytes and echinocytes respectively as expected for cells in isotonic saline. Particular attention has been directed here to some features of drug induced morphology change which are independent of the charge of the drug. It was found that (i) the direction (increase or decrease) of the extent of morphological change as temperature was increased from 20 to 37 degrees, (ii) the exposure time for maximum shape change (0-2 min), and (iii) the time course of cell morphology (0-30 min) were different for similarly charged drugs. The influence of low concentrations of the drugs on the thermal fragmentation patterns of the cells has been determined. A single index has been derived which allows comparison of the morphological effects of cationic and anionic drugs. It was concluded that, while the type (stomatocyte or echinocyte) of shape change observed was dependent on the charge of the drug, cell morphology at drug concentrations high enough to produce marked shape change at 37 degrees was strongly influenced by charge independent drug-specific effects. PMID- 3954799 TI - The binding protein of erythromycin in human serum. AB - Erythromycin binding to human serum albumin and to alpha 1-acid glycoprotein was measured under conditions of binding equilibrium. At therapeutical concentrations of erythromycin the binding to albumin is not saturable. The fraction of total erythromycin bound to alpha 1-acid glycoprotein is proportionally related to the protein concentration and is bound to a single class of binding sites with an apparent association constant Ka = 0.16 X 10(6) M-1 (38 degrees). About one mole of erythromycin is bound per mole of alpha 1-acid glycoprotein. The binding affinity can be enhanced and vice versa lowered by increasing the concentrations of NaCl and urea, respectively. The semilogarithmic plot of bound/free ratios vs log concentration of NaCl or urea exhibits linear relationships. Erythromycin binding can be competitively inhibited by mersalyl (Ki = 11-16 microM) but not by other SH-reagents or by neuraminidase treatment. A marked reduction of erythromycin binding to alpha 1-acid glycoprotein is seen with dithiothreitol. alpha 1-acid glycoprotein is the main erythromycin binding protein in human serum. PMID- 3954800 TI - Effect of the antidepressant minaprine on both forms of monoamine oxidase in the rat. AB - The antidepressant minaprine (3-(2-morpholino-ethylamino) 4-methyl 6-phenyl pyridazine, dihydrochloride) and its main metabolites were examined for their monoamine oxidase (MAO) inhibitory effects in the rat. In our experimental conditions, minaprine displayed in vitro a very weak affinity for brain MAO A and B with IC50S close to 1 mM. However, ex vivo, after intraperitoneal administration, this drug behaved as a specific and short-acting type A MAO inhibitor (MAOI) of mild potency (ED50 = 12.8 mg/kg). In comparison, the reversible type A MAOIs, moclobemide and cimoxatone, were respectively 14 and 15 times more potent. When administered orally, minaprine proved to be considerably less active. The results presented in this study suggest that minaprine inhibits MAO A mainly after being converted into active metabolites. However, the chloroform extractable metabolites were found inactive in vitro towards this enzyme, suggesting that MAO inhibitory activity is mediated by one or more other non-identified metabolites. PMID- 3954801 TI - [Molecular organization of the reductase complex in adrenal cortex mitochondria. Study using bifunctional reagents]. AB - The water-soluble carbodiimide, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide, homobifunctional reagent 3,3'-dithiobis (succinimidyl propionate), and heterobifunctional reagent N-succinimidyl 3-(2-pyridyldithio) propionate have been used to cross-link adrenodoxin reductase and adrenodoxin, components of steroidogenic electron transfer system. Though maximal yield of the cross-linked complex was achieved with the water-soluble carbodiimide, this complex was inactive in the electron transfer from NADPH to cytochrome P-450. The functionally active complex was formed with N-succinimidyl 3-(2-pyridyldithio) propionate. The complex was purified to the apparent homogeneity and shown to be able to mediate the electron transfer. The data obtained indicate existence of different binding sites on adrenodoxin responsible for the adrenodoxin reductase and cytochrome P-450scc binding and do not contradict to the model of the steroidogenic electron transfer in an organized complex. PMID- 3954802 TI - [Mutagenesis directed by phosphotriester analogs of oligonucleotides]. AB - 20-mer oligodeoxyribonucleotides d-ACGACGG (R') CCAG (R'') TGATCCGTA, where R' = R'' = H (20), F' = Et, R'' = H (20-Et), or R' = R'' = Et (20-Et2) were synthesized by modified triester method. Ethylated dinucleotide blocks were prepared by transesterification method from chlorophenyl derivatives. Structures of oligonucleotides were confirmed by Maxam - Gilbert method. Mutagenesis induced by oligonucleotides was studied on DNA of M13mpB phage. Oligonucleotides were not totally complementary to this DNA in the region of 4-11 codons of Z'-gene. They all were shown to direct the formation of the designed deletion mutants, phosphotriester analogues (20-Et) and (20-Et2) being more effective mutagens. The specificity of oligonucleotides: DNA binding and mutant DNA structure were shown by Sanger method. PMID- 3954804 TI - Nailfold capillary microscopy in mixed connective tissue disease. Comparison with systemic sclerosis and systemic lupus erythematosus. AB - Nailfold capillary microscopy patterns in 22 patients with mixed connective tissue disease (MCTD) were compared with those of 21 patients with systemic lupus erythematosus (SLE) and 30 patients with systemic sclerosis (scleroderma [SD]). Microvascular data were classified blindly as follows: normal, nonspecific abnormalities, SD pattern, and SLE pattern, with special attention to the presence of dystrophic, branched "bushy" capillary formations. Of the 22 patients with MCTD, 63.6% had an SD pattern, 22.7% had an SLE pattern, 13.6% had nonspecific abnormalities, and 72.7% had bushy capillary formations. Compared with SLE microangiopathy, MCTD microangiopathy exhibited significantly greater capillary loss (P less than 0.05), more frequent SD patterns (P less than 0.001), and more frequent bushy capillaries (P less than 0.001). Compared with SD patients, MCTD patients displayed less frequent SD patterns (P less than 0.02) and more frequent bushy capillary formations (P less than 0.01). The presence of bushy capillaries was suggestive of MCTD. For diagnostic purposes, bushy capillaries displayed 72% sensitivity, 80% specificity, and 87.2% negative predictive value. The quantitative and qualitative expressions of microangiopathy were different in MCTD and SLE, respectively. This supports the hypothesis that each disease is a distinct entity. Nevertheless, there were many resemblances between MCTD and SD, which implies that MCTD is possibly a clinical form of SD. PMID- 3954803 TI - Phagocytosis and intracellular killing of Staphylococcus aureus by polymorphonuclear cells from synovial fluid of patients with rheumatoid arthritis. AB - The phagocytosis and intracellular killing by synovial fluid (SF) polymorphonuclear cells (PMN) of 10 patients with rheumatoid arthritis was studied. PMN phagocytosis was assessed by morphologic and microbiologic methods and intracellular killing was measured independently of continuous phagocytosis of Staphylococcus aureus. Phagocytosis of S aureus by SF PMN or peripheral blood (PB) PMN was as effective in the presence of synovial fluid as in the presence of serum. On average, SF PMN ingested S aureus opsonized with synovial fluid and serum more efficiently than patient or donor PB PMN did. Enhanced ingestion of S aureus was associated with increased expression of C3 receptors on the membrane of SF PMN. In the presence of heat-inactivated synovial fluid, the capacity of SF PMN to ingest S aureus was greater than that of patient or donor PB PMN. Under these conditions, phagocytic activity was correlated with Fc receptor expression. SF PMN was found to be as active in killing S aureus as PB PMN from healthy donors. PMID- 3954805 TI - POEMS syndrome. Study of a patient with proteinuria, microangiopathic glomerulopathy, and renal enlargement. AB - We studied a patient with POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal [M]-protein, skin changes) who was also found to have renal enlargement and microangiopathic glomerulopathy. The latter finding is unusual in POEMS syndrome patients, and the associated symptoms can lead to confusion in diagnosis. We emphasize the importance of considering POEMS syndrome in the differential diagnosis of patients who have unexplained neuropathy, scleroderma-like skin changes, and/or monoclonal gammopathy. PMID- 3954806 TI - Naturally occurring antibody response to DNA is associated with the response to retroviral gp70 in autoimmune New Zealand mice. AB - The spontaneous occurrence of retroviral gp70 immune complexes (ICs) in the blood of autoimmune New Zealand black and (New Zealand black X New Zealand white)F1 ([NZB X NZW]F1) mice is determined by a single dominant locus of the NZB strain (provisionally designated Agp-1). A combined effect of 2 unlinked dominant NZB loci (Ads-1 and Ads-2) is required for the production of anti-double-stranded DNA (anti-dsDNA) antibodies in these mice. The present genetic studies using (NZB X NZW)F1 X NZW backcross mice and their second through fourth generation progeny revealed that Agp-1 and Ads-1 exist in common or are closely linked on chromosome 17 of NZB mice and are related to the occurrence of renal disease. The renal disease and the serum level of both anti-dsDNA antibodies and gp70 ICs were more intense in (NZB X NZW)F1 hybrids than in NZB mice, indicating the contribution of NZW genes. In (NZB X NZW)F1 mice, a single dominant locus from the NZW strain, Agp-3, intensified the magnitude of gp70 IC formation, and a combined effect of 2 unlinked dominant loci from the NZW strain, Ads-3 and Ads-4, acted to increase the serum titers of anti-dsDNA antibodies. This study clearly indicates that the NZW loci Agp-3 and Ads-3 exist in common or are tightly linked on chromosome 17, are closely linked to the H-2 complex, and are associated with the severity of renal disease in (NZB X NZW)F1 hybrids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954807 TI - Experimental osteoarthritis induced by selective myectomy and tendotomy. AB - A new model of osteoarthritis has been developed that utilizes an extraarticular surgical technique to alter gait and weight-bearing capabilities in the hind limbs of experimental animals. Guinea pigs, averaging 650 gm in weight, were subjected to unilateral resection of a segment of the gluteal muscles at the sacral origin, to section of the infrapatellar ligament, or to both procedures. Progressive changes consistent with osteoarthritis developed over 10-24 weeks as judged by gross, radiologic, and microscopic findings. In addition, an increase in mean cartilage water content and 35SO4(-2) incorporation into proteoglycans by 10 and 14 weeks, respectively, were consistent with the chemical changes observed in early osteoarthritis. Abnormalities developed not only in the operated hind limb, but in the contralateral, unoperated hind limb at a slightly later time. Thus, this animal model provided the opportunity to evaluate a mild gait abnormality and other biomechanical influences on the evolution of osteoarthritis which is uninfluenced by any intraarticular joint trauma. PMID- 3954808 TI - Colonic telangiectasias in a patient with progressive systemic sclerosis. PMID- 3954810 TI - Explaining the term "arthritis". PMID- 3954809 TI - Destructive spondylarthropathy in hemodialyzed patients: possible role of amyloidosis. PMID- 3954811 TI - Water-soluble gels in narrowfield nailfold capillary microscopy. PMID- 3954812 TI - Total body water as an index for predicting body fat in rats. AB - The determinations of total body water, body density, surface area and Lee index were carried out on 15 live Sprague-Dawley rats. The rats were subsequently sacrificed and subjected to carcass analysis by desiccation, gravimetry and ether extraction of body fat. The results of multiple regression using the maximum R2 improvement technique indicated that a strong correlation existed only between body fat and total body water which was statistically significant (P = 0.0001). The regression equation representing such a relationship was % of body fat = 83.167-1.067 X (% total body water). The % body fat computed from density, multiple regression models, and the actual fat content of carcass were not significantly different by the Newman-Keuls range test. The validation of the predicting equation was done using lean and obese Zucker rats. It was found that the predicting equation overestimated body fat by 0.67% for lean rats and underestimate 1 body fat of obese Zucker rats by 3.57%. PMID- 3954813 TI - A new procedure to immobilize polyriboinosinic-polyribocytidylic acid (poly I:C) on the surface of polymethylmethacrylate and the use of poly I:C in clinical hemoperfusion. AB - A new procedure for covalent immobilization of polyriboinosinic-polyribocytidylic acid (poly I:C) on the surface of polymethylmethacrylate (PMMA) is described. Carboxyl groups are generated on the PMMA surface and react with primary amino groups of cytosine. These amino groups are made accessible by heating. The original polynucleotide structure is partly reformed on cooling. An extracorporeal chamber for in vivo whole blood perfusion made from PMMA has been previously described. Such chambers activated as described above by poly I:C have been used clinically. Considerable increase of cytotoxicity activity was observed and was long-lasting. No significant toxic side effects occurred and no refractoriness ensued during intermission between treatment periods. The same poly I:C chamber could be used several times in the same patient without loss of activity. Controls showed no leakage from the poly I:C mono-layer on the PMMA surfaces. PMID- 3954814 TI - [Intracellular effects of josamycin]. AB - Josamycin (Wilprafen) is accumulated in human polymorphonuclear leucocytes and monocytes (macrophages) by a factor of 12-20fold, in comparison with extracellular fluid. The uptake of the antibiotic by lymphocytes and erythrocytes is much less than with the two types of phagocytic cells. The distribution of 14C josamycin was measured after lysing the polymorphonuclear leucocytes and the results confirmed that the antibiotic penetrates through the cell membrane and accumulates in the cytoplasm. The results indicate that josamycin is taken up into the cell by an active transport mechanism. It is significant for the clinical application of josamycin that the active drug is present inside the cells and can thus support the bactericidal activity of polymorphonuclear leucocytes or monocytes against intracellularly localized microorganism. This localization of the antibiotic in the two types of phagocytosing cells of the defense system could be important for the treatment of several infectious diseases. PMID- 3954815 TI - Influence of tasuldine and acetylcysteine on mucociliary clearance in patients with chronic airways obstruction. AB - In a single-blind intraindividual cross-over comparative study the influence of two systemic-mucolytic agents, 2-(pyridyl-3-methylthio)pyrimidine (tasuldine, HE 10004-succinate) vs. N-acetyl-L-cysteine (acetylcysteine) on the mucociliary clearance and lung function was investigated in 15 patients with chronic obstructive respiratory disease. The overall treatment period was 14 days with the drug being changed after 7 days in each group. Under tasuldine and acetylcysteine treatment a tendency to an improvement of mucociliary clearance was observed compared with the control pointing to an increase in adoral velocity. The direct comparison between both drugs revealed that 120 min after medication mucociliary clearance was stimulated significantly stronger by intake of tasuldine than by acetylcysteine. There was no influence on lung function. PMID- 3954816 TI - The influence of diuretics on the excretion and metabolism of doping agents. II. Phentermine. AB - The urinary excretion of phentermine in humans was followed over a period of several days after the oral administration of two formulations. The intake of phentermine in a capsule generally resulted in an excretion peak 4 h after the administration followed by a second peak 12 or 24 h post dosing. The total amount excreted during 72 h varied from 62.7 to 84.8%. Concerning the administration of Ionamine 15, a sustained release formulation, the maximal excretion rate was spread over 3-9 h, while more than 85% of phentermine were excreted after 72 h. The excretion was affected by urinary pH. The intake of acetazolamide shortly after phentermine resulted in a decrease of the phentermine excretion during one day and in one subject in a suppression below the detection limit 4 h post dosing. The administration of furosemide or bumetanide produced only a diluting effect during 2 h. PMID- 3954817 TI - [Pupillometry in psychopharmacologic experiments]. AB - Considering data of various clinical pharmacological studies, in which computer assisted pupillometry was utilized, we investigated the following questions: What are the effects of drugs of 7 psychopharmacological classes on the human pupil? Do dose-efficacy and time-efficacy curves based on pupillary variables provide cues about pharmacodynamic properties of psychotropic substances? Is there a relationship between pupillometric and critical flicker frequency measures? Is there a relation between pupillometric and quantitative electroencephalographic changes? Are there correlations between static pupillometric and pharmacokinetic (e.g. blood levels) variables? Our investigations demonstrated that static pupillometry-utilized in the described manner and under certain experimental conditions - provide valuable information about effects of psychotropic drugs on the central and autonomous nervous system. PMID- 3954818 TI - The relationship between dapsone dose, serum concentration and disease severity in dermatitis herpetiformis. AB - 20 patients with dermatitis herpetiformis maintained on once daily dosing of dapsone were studied to investigate the pharmacodynamics of dapsone in suppressing clinical disease. Multiple correlation analysis was performed on variables including dosage requirements, serum concentration of dapsone and monoacetyl dapsone, acetylation ratio, IgA-containing circulating immune complexes, adherence to a gluten-free diet, and clinical disease severity. It was found that: 1. dapsone exhibits good bioavailability in dermatitis herpetiformis with absorption being unaffected by presumed gluten-sensitive enteropathy; 2. there is wide variation in serum concentrations of dapsone and monoacetyl dapsone with no specific "therapeutic level"; 3. acetylator phenotype was unrelated to dapsone dose requirement; 4. serum dapsone concentration had only a weak correlation with disease severity; and 5. there was poor correlation between IgA circulating immune complexes and dapsone serum concentration. The use of daily dapsone dose requirements or dapsone serum concentration necessary for disease suppression as an indicator of disease severity in the research setting is inappropriate. Measurements of serum concentration of the parent drug (dapsone) or principal metabolite (monoacetyl dapsone) do not serve as a useful guide to therapeutic management. PMID- 3954819 TI - Chemical and pharmacological studies of 2-(amino-methyl)acrylophenones. AB - The structure-activity relationships of nine products of the acrylophenone family have been studied. In a previous report 2-(4-methyl-1 piperazinylmethyl)acrylophenone was shown to be an antimicrotubular drug. The effects of these drugs on the bovine brain tubulin polymerization were determined by a turbidimetric assay. The median inhibitory concentrations (ID50) ranged from 1.5 X 10(-5) to 5 X 10(-5) mol/l. Their action on the inhibition of 3H-colchicine binding to tubulin was determined by DEAE (diethylaminoethyl)cellulose filter assay. These compounds are weak inhibitors of colchicine binding. Pharmacological studies of these drugs revealed a strong inhibition of the human ADP-induced platelet aggregation. Moreover, they markedly decreased the serum cholesterol, triglycerides and phospholipids levels of rats after injection of Triton WR 1339 (4-(1,1,3,3-tetramethylbutyl)phenol polymer with formaldehyde and oxirane). They inhibited Candida albicans, Penicillium notatum and Aspergillus versicolor growth. Thus, these nine compounds possess interesting pharmacological properties which are very likely to be related to the acrylic moiety of the molecules. PMID- 3954820 TI - Penetration into and elimination from the cerebrospinal fluid of diltiazem, a calcium antagonist, in anesthetized rabbits. AB - Penetration into and elimination from the cerebrospinal fluid (CSF) of diltiazem were studied following intravenous (i.v.) or intra-cisternal (i.c.) administration of 14C-diltiazem to anesthetized rabbits. 14C-Diltiazem rapidly penetrated into the CSF through the blood-CSF barrier after i.v. injection (1 mg/kg). A CSF level of the radioactivity attained the peak (0.13 microgram eq./ml) 5 min after i.v. injection and declined bi-exponentially with rapid initial half-life of 3.8 min (5-15 min) and second half-life of 2.7 h (15 min-8 h). A CSF/plasma ratio was 0.05-0.2 throughout the observation period. After i.c. administration (100 micrograms/body), the CSF level of the radioactivity decreased with a half-life of 7.5 min up to 1 h. The CSF level was maintained above 10(-7) mol/l until 2-3 h. Elimination half-life of 14C-diltiazem after i.c. injection was much more similar to that of 3H2O than 14C-inulin, indicating that the main elimination route of this compound from the CSF is diffusion into the brain, followed by rapid diffusion into the cerebral capillary, rather than filtration from the sub-arachnoid villi. An autoradiographic investigation supported the above route of elimination. PMID- 3954821 TI - Hemodynamic profile of N-(2,5-dimethyl-1H-pyrrol-1-yl)6-(4-morpholinyl)-3 pyridazinamine hydrochloride in conscious dogs. AB - The effects of N-(2,5-dimethyl-1H-pyrrol-1-yl)6-(4-morpholinyl)-3-pyridazinamine hydrochloride (MDL-899) on systemic, pulmonary, renal and coronary circulation and on myocardial contractility have been investigated in conscious dogs treated orally. The compound induced a decrease in systemic arterial blood pressure, slow in onset (peak effect at 4 h) and long-lasting (more than 7 h), by reducing total peripheral resistance, while the heart rate, cardiac output, cardiac work and myocardial contractility increased because of the reflex increase in sympathetic drive evoked by the blood pressure fall. Coronary and renal blood flows were increased for a long time. Pulmonary resistance was markedly decreased, but the pulmonary pressure was increased, probably due to the hyperkinetic activity triggered by the increases of cardiac output and heart rate. The hemodynamic changes induced by MDL-899 are qualitatively similar to those induced by hydralazine. The results suggest that the compound belongs to the class of vasodilators that act primarily on systemic arterioles to produce arteriolar dilation. PMID- 3954822 TI - Effect of etofibrate and its metabolites on atheromas of rabbits and on smooth muscle cell cultures. AB - In rabbits electrodes were implanted on either side of a carotid artery wall in a way such that transmural electrical stimulation could be performed on the unrestrained animal. Daily repetition of stimulation (100 microA, 10 Hz, 10 ms/imp), 30 min in the morning and 15 min in the afternoon, causes a fibromuscular intimal proliferate below the anode. With additional feeding of a cholesterol-rich diet the proliferate develops into a typical atheroma. The use of defined intensity of the stimuli and a constant period of stimulation (4 weeks) allows a standardization of the plaque development and thus the study of the effects of growth promoting or growth suppressing drugs. The in vivo experiments were supplemented with a study of the effects of the same drugs on the growth of vascular smooth muscle cells and fibroblasts in cell cultures. This combination of experiments increased the value of either results given that the drugs show similar effects in both types of experiments. 2-[2-(p-Chlorophenoxy)-2 methylpropionoxy]ethyl nicotinate (etofibrate, Lipo-Merz) was seen to inhibit the growth of atheromas to a certain degree in vivo. A dose dependent suppression of the rate of mitoses of vascular smooth muscle cells (SMC) and of fibroblasts was observed in vitro. Etofibrate caused a slight decrease in the serum cholesterol and a significant increase in serum high density lipoproteins in the animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954823 TI - Characteristics of clinical services provided by ASHA members. PMID- 3954824 TI - Functions and malfunctions of theories in therapies. PMID- 3954825 TI - Contrasting binge and continuous alcoholic drinkers using demographic and drinking history variables. AB - While it is quite common for researchers and clinicians to categorize alcoholics as binge or continuous drinkers, relatively little is known about the characteristics of these two potentially distinct clinical populations. In the present study, binge and continuous alcoholics were evaluated on a number of demographic and drinking history variables. Binge drinkers were found to be significantly more likely than continuous drinkers to have been treated for liver problems and more likely to have reported parental alcoholism. They also tended to describe a greater number of alcohol-related arrests and hospitalizations. Six of the variables taken together yielded a discriminative function that was only moderately successful in classifying these drinkers. The potential clinical importance of objectively identifying binge versus continuous drinkers is discussed. PMID- 3954826 TI - Alcohol consumption and psychological distress among U.S. Anglos, Hispanics and Blacks. AB - Data from the Health and Nutrition Examination Survey Augmentation Component of the U.S. National Center for Health Statistics were analysed to assess differences between Anglos (N=5546), Blacks (N=872), less-acculturated Hispanics (N=182), and more-acculturated Hispanics (N=58) with regard to alcohol use, psychological distress, and alcohol consumption-psychological distress relationships. Alcohol consumption differences were more notable for quantity rather than frequency, with Hispanics reporting significantly higher quantity than Anglos or Blacks. Drinkers were more depressed than non-drinkers among Anglos and Blacks; an opposite, though insignificant, pattern emerged among Hispanics. Higher quantity of alcohol use was generally associated with greater depressive symptomatology and lower well-being. More frequent drinking was generally associated with lower depressive symptoms and higher well-being. Additional findings that pointed to negative relationships between quantity and both reported nervous breakdowns and help-seeking for emotional problems among less-acculturated Hispanics suggest a greater use of alcohol as a coping mechanism in this group. PMID- 3954827 TI - A comparative study of cytological and physiological parameters of semen obtained from alcoholics and non-alcoholics. AB - Sixty subjects between the ages of 18 and 50 were used in this study. Thirty of these were known alcoholics undergoing detoxification and treatment while the remainder were non-alcoholics of known fecundity. Semen samples from each subject were evaluated for volume, pH, and sperm viability, motility and concentration. While semen volume was significantly greater in the alcoholic group, the other parameters were similar in the two groups. Complete seminal cytological profiles were obtained for the men in both groups; the alcoholic group was found to contain nearly 30% fewer normal cells than the controls. Cytological aberrancies present in the greatest numbers included coil-tailed sperm, immature testicular cells and amorphous cells, all of which were present in significantly greater ratios in the semen of the alcoholics. In addition, when all other observed spermatozoan aberrations were grouped into one category this group, too, was significantly greater in the alcoholics. PMID- 3954828 TI - Effect of 1-methyl-tetrahydro-beta-carboline on voluntary alcohol intake in rats: lack of increase with fixed alcohol concentrations. AB - Intracerebroventricular infusion of 1-methyl-1,2,3,4-tetrahydro-beta-carboline (1 Me-THBC, tetrahydroharmane) in our earlier studies increased voluntary alcohol intake by rats when increasing ethanol concentrations were offered. We have now studied the possibility that, by using two fixed ethanol concentrations (11 and 20%, w/w), alcohol intake could also be increased. We find that 1-Me-THBC (1.13 mumol/day) does not increase alcohol intake. The animals appear unable to recognize the increase in ethanol concentration. PMID- 3954829 TI - Is a co-ordinated prevention policy really feasible? PMID- 3954831 TI - Red blood cell 2,3-diphosphoglyceric acid following ethanol consumption in man. AB - The red blood cell 2,3-diphosphoglycerate (DPG) concentration is reported in 33 ethanol abusers, 16 healthy ethanol users and 14 non-users. The results demonstrate an ethanol-associated increase in DPG content which returns to normal exponentially in the week following alcohol withdrawal. As well as implying a significant degree of hypoxia in association with quite moderate drinking, the fact that ethanol is not catabolized in red cells indicates that this effect is transmitted there, and hence to the rest of the organism, by some other agent. Carbon dioxide in subnormal quantities has the necessary characteristics. PMID- 3954830 TI - Observations on the biochemical basis of ethanol metabolism by human macrophages. AB - The metabolism of ethanol (0.1 and 1.0 mg/ml) to acetate by blood-monocyte derived macrophages was only slightly inhibited by pyrazole, 4-iodopyrazole and 3 amino-1,2,4-triazole indicating that it was largely independent of alcohol dehydrogenase and catalase. By contrast, 50-87% of the oxidation of ethanol by these cells was inhibited by carbon monoxide, metyrapone and SKF-525A, all three of which are known to inhibit various species of microsomal cytochrome P-450. The data suggest that most of the ethanol metabolism by blood-monocyte-derived macrophages is mediated via the cytochrome-P-450-dependent microsomal ethanol oxidising system. PMID- 3954832 TI - Autonomic dysfunction in long-standing alcoholism. AB - Twenty-eight male alcoholics were studied for peripheral sensory-motor and autonomic neuropathy. The patients were examined neurologically and neurophysiologically after a period of withdrawal treatment in hospital. The function tests of the autonomic nervous system performed were: measurement of the variation of the heart rate at rest and during maximal breathing, Valsalva manoeuvre, postural pulse and blood pressure reactions, and isometric test. Slight abnormalities in the peripheral nervous system were observed in 8 patients, but a frank clinical polyneuropathy supported by neurophysiological findings could be diagnosed only in 2. All of the parameters which reflect the function of the parasympathetic division of the autonomic nervous system were lower in the alcoholics compared with the controls. The most sensitive variables were the heart rate variation at rest, and the postural pulse reaction. The functions mediated by the sympathetic nervous system were not abnormal among this group of alcoholics. PMID- 3954833 TI - Diet and diuretics in the reduction of voluntary alcohol drinking in rats. AB - Three rats were trained and given extensive experience with an operant conditioning model of alcohol self-administration which produces pharmacologically significant drug intake. In this model, lever presses on a fixed ratio (FR) schedule of reinforcement allowed the animal brief access to an 8% (w/v) alcohol solution. Drug intake was then assessed when the animals were given a low-sodium diet and a low-sodium diet in combination with injections of the salt-losing diuretic furosemide (Lasix). In all cases, the low-sodium diet/furosemide treatment produced a substantial reduction in drug self administration without changing water self-administration. In one case, introducing furosemide into the home-cage drinking water without a change of diet also brought about a decrease in alcohol self-administration. The low-sodium diet alone was ineffective in this regard. These findings corroborate earlier work using this form of treatment and are discussed in terms of the possible functional mode(s) of action of the treatment. The viability of this treatment for human drug-taking is also considered. PMID- 3954834 TI - Alcohol enhances vitamin C excretion in the urine. AB - Urinary ascorbic acid excretion was measured on four consecutive days in 9 normal male volunteers for 4 hr before and after drinking nothing (control), 0.58 g alcohol/kg body wt as whisky or lager or water (11./70 kg body wt). The normal reduction in ascorbic acid excretion under control conditions was abolished by drinking water. Alcohol in either form produced a 47% increase in urinary ascorbic acid excretion. A similar ascorbiuresis in chronic alcoholics would be an additional factor in the causation of vitamin C deficiency in these patients. PMID- 3954835 TI - Alcohol-dependent individuals sixteen years on. AB - Fifty-seven married individuals were followed up 16 years after treatment for alcohol dependence in 1965. The tracing located 96% of subjects. At interview an assessment of past alcohol-related problems between 1965 and 1981, and of recent possible alcohol dependence was made. No current psychiatric morbidity was found in 54% of interviewees. Fewer alcohol-related problems between 1965 and 1981 were experienced by older individuals and those of higher social class. Subjects classified as problem drinkers (non-alcohol-dependent individuals with significant alcohol-related problems) by 1981 had experienced more alcohol related accidents during follow-up than those of other outcome groups. Individuals classified as bout drinkers in 1965 had the poorest 1981 outcomes. Outcome classification and results involved 14.5% abstinent, 20% controlled drinkers 7.4% problem drinkers, 14.5% alcohol-dependent and 43.6% deceased. The observed to expected mortality ratio of the subjects was 1.6, with the female ratio twice that of the males. PMID- 3954836 TI - Are nonsteroidal anti-inflammatory drugs indicated in the treatment of osteoarthrosis? PMID- 3954837 TI - The treatment of idiopathic osteonecrosis of the medial femoral condyle with arthroscopic debridement. AB - Five patients with idiopathic osteonecrosis underwent arthroscopic debridement with instruments designed for arthroscopic abrasion arthroplasty. Each lesion was large enough to require total knee or tibial osteotomy using criteria previously published by other authors. Using the Hospital for Special Surgery Rating System, four of five patients were rated good postoperatively (average rating: preop 52 points and postop 82 points). Biopsies of two patients at repeat arthroscopy showed that fibrocartilage fills in the defects created by the debridement. Average follow-up was 31 months. PMID- 3954838 TI - Arthroscopy and stability testing of the shoulder joint. AB - A consecutive series of 32 patients with shoulder problems was examined with arthroscopy. Seventeen of these patients with suspected unstable shoulders were also tested for instability under fluoroscopic control. Results were analyzed for two age groups and with reference to preoperative diagnosis. Stability testing was of more value than arthroscopy in the treatment of younger patients with shoulder instability. Arthroscopy was of some value in choosing treatment in the older age group of patients. PMID- 3954839 TI - Abrasion chondroplasty. PMID- 3954840 TI - Arthroscopic abrasion arthroplasty historical and pathologic perspective: present status. AB - Arthroscopic abrasion arthroplasty is a modification of open Magnusson "housecleaning" arthroplasty. The arthroscopic approach decreases incision size enhancing postoperative rehabilitation. Arthroscopic techniques enhance the accuracy of diagnosis and provide accuracy of limiting debridement only to diseased tissue in various other dimensions of arthroplasty. The abrasion of a sclerotic lesion superficially removes dead bone, exposes vascularity providing a tissue bed for blood clot attachment. Postoperative joint protection provides an environment for clot organization and fibrous tissue formation. Subsequent fibrocartilage formation has maintained integrity for up to 6 years, the extent of experience. The clinical indication is pain. The patient benefit, therefore, is also subjective. Objective evidence of healing response is demonstrated by second-look arthroscopy, biopsy, and comparison x-ray films. If nothing else, these clinical and pathological observations have challenged "established concepts" and opened new vistas for investigation. PMID- 3954841 TI - MicroTICAS. The design of an inexpensive video-based microphotometer/computer system for DNA ploidy studies. AB - A description is presented of the microTICAS video-based microphotometer/computer system, which has been designed and implemented to provide an inexpensive means for the rapid assessment of DNA ploidy patterns. The design goal was to provide a low-cost, easily serviced unit capable of providing useful clinical results and that would be easy and convenient to use. The resulting system achieves those ends as well as providing a flexible research tool that can be extended with appropriate programming to perform a wide range of tasks. The major parts of the microTICAS system are the microscope/optical system, the video camera with its control unit, the video data digitizer, the frame buffer and display monitor and the small host computer. Commercially available components were chosen for these system components and have been assembled into a system with only a minimum of modifications. The resulting system can be configured to be compatible with both North American and European standards. PMID- 3954842 TI - Investigation of the visual cytoscreening of conventional gynecologic smears. I. Analysis of slide movement. AB - In order to elucidate the process of visual cytoscreening, graphic and electronic recordings of the stage movements in visual screening of conventional gynecologic smears were carried out. More than 400 recordings have been evaluated. The screening consisted of alternating movements, with a mean duration of 180 milliseconds, and stops of about 230 milliseconds. Variations of the screening pattern due to the specimen diagnosis were hidden behind the rather obvious individual behavior and reactions to inhomogenity of material distribution. The detection threshold was found to vary with the diagnostic situation. A lowering of the detection threshold was especially reflected by an increase of the overlap in screening direction and an increased number of fields of view with stop times of more than 350 milliseconds. A substantial part of the specimen was only seen during movements; the fraction of the specimen area covered during the stops was found to vary between 41% and 93% for screenings in the daily routine work. PMID- 3954843 TI - Further evaluation of the practical applicability of nuclear morphometry for the prediction of the outcome of atypical endometrial hyperplasia. AB - A previously developed morphometric classification rule has been shown to be successful in identifying approximately 30% of patients with atypical hyperplasia of the endometrium in whom the finding does not imply a progression to malignancy. The reproducibility of the nuclear classification rule was tested in blind, duplicate morphometric assessments by different technicians. The results showed a satisfactorily high degree of consistency and reproducibility, with only one of ten cases classified differently. In a second series of experiments, the nuclear classification rule was applied to samples from 101 nonmalignant cases (39 proliferative endometriums, 7 secretory endometriums, 55 mildly atypical hyperplasias), 8 markedly atypical hyperplasias and 43 malignant cases (20 well differentiated adenocarcinomas and 23 moderately to poorly differentiated adenocarcinomas of the endometrium). Ideally, the rule should classify all nonhyperplastic and mildly hyperplastic cases as nonprogressive and all carcinomas as progressive; there were, however, a considerable number of false positives and false negatives based on application of the classification rule to these cases. Therefore, the sensitivity and specificity of nuclear morphometry using the classification rule developed for atypical hyperplasias is too low to allow its random application. This emphasizes the selective nature of diagnostic morphometry, in which the full diagnostic capacity of the pathologist must be used in selection of the proper cases to be studied. PMID- 3954844 TI - Chromatin activation of blood lymphocytes detected by polarization microscopy and cytophotometry. AB - Blood lymphocytes exhibit chromatin activation upon incubation with substances to which a person is allergic. Chromatin activation can be detected by polarization microscopy. In this work, different methods of evaluating lymphocyte chromatin activation were compared in nine drug-allergic and in eight control subjects. All drug allergics had skin or mucosal involvement, ranging from localized minor herpetic lesions and purpurae through wheal and circumscribed bullous lesions to serum sickness as the most severe form. The mean path difference as the measure of nuclear birefringence was obtained by a polarization microscope using both white light and 551 +/- 7 nm monochromatic light. The equation of Brace-Kohler for converting compensation into path difference for each single cell was used in calculator programs. The values were compared with readings of a cytophotometer operated in transmission mode. Allergy "scores", deriving from the analysis of chromatin activation kinetics due to serial drug dilutions, were also compared using both methods. The results indicate a linear relationship between monochromatic and white light compensation readings and an exponential relationship between mean path difference and mean transmission values at different background amplifications. Operation of the photometer at 25.8% background amplification gave the best correlating results. The two methods gave identical results for the presence (ten tests) or absence (eight tests) of allergy. PMID- 3954845 TI - On the estimation of the expected number of accidents. AB - We show that similar entities (drivers, intersections, bus companies, rail crossings) which in one period recorded "x" accidents do not have, on the average, "x" accidents in the subsequent period. The difference is large and systematic. This leads us to conclude that in circumstances in which only the safety estimates in these two periods matter, use of "x" to estimate the expected number of accidents has definite shortcomings. Better estimators are suggested, explored and their use is illustrated. We note that the suggested estimators are similar to what is used when estimation is based on a "treatment-control" type experimental design. It is hoped that the suggested estimators will alleviate some practical problems in the structuring of controlled experiments in safety research, eliminate bias-by-selection from uncontrolled studies and in general enhance the accuracy of safety estimates. PMID- 3954846 TI - A comparison of two methods for estimating the effect of a countermeasure in the presence of regression effects. AB - The report studies the problem of estimating in a non-experimental before-and after investigation the effect of a countermeasure on the number of traffic accidents at road junctions. The accidents are assumed to occur according to a Poisson process with different intensities at different junctions. The junctions studied in this investigation are assumed to have been selected with the blackspot-technique, i.e. junctions with high numbers of accidents during the before-period have been chosen for the investigation. In the mathematical model this has the consequence that the number of accidents occurring during the before period at a selected junction has a truncated Poisson distribution. During the after-period the number of accidents has a Poisson distribution (without restrictions), so that the number of accidents on the average decreases between the periods even if the countermeasure has no effect. The magnitude of this regression effect is studied in the report. The observed numbers of accidents during the before and after period are used to estimate the pure effect of the countermeasure both with an intuitive method and with the maximum likelihood method. The characteristics of the two methods of estimation are illustrated with the aid of simulation studies. In general the maximum likelihood method appears preferable, mainly because it produces estimates with higher precision. PMID- 3954847 TI - Childhood pedestrian injury: a pilot study concerning etiology. AB - For U.S. children of preschool and school age, fatal pedestrian injury is more common than fatal passenger injury, but there is no agreement on preventive approaches and their efficacy. Development of preventive measures requires understanding of how and why such injuries occur, which in turn requires better methods to sort out the many factors which appear to contribute to the problem. In an attempt to develop the broadest possible picture of the dynamics of child pedestrian injury, a multidisciplinary process was developed to collect and interpret medical, traffic, social, psychological and behavioral information concerning specific injury events. In a pilot study, the process was used to study six pedestrian injuries. The pilot study indicated that: the multidisciplinary approach identified possible etiologic factors missed without it; this approach requires the availability of high quality medical information and police accident records; biological, psychological, and social characteristics of victims, victim families and communities appear to affect the occurrence of child pedestrian injuries; and, such victim factors must be considered in development of countermeasures. It is concluded that the technique of multidisciplinary analysis merits further application as a productive way to generate quantitatively testable hypotheses concerning childhood pedestrian injury causality and potential countermeasures. PMID- 3954848 TI - Safety improvements and driver perception. AB - The paper deals with potential influences of engineering standards on driver perception. The argument is advanced that, in certain cases, the common belief that simplification of the driving task increases safety might be misleading. This might be the situation following engineering improvements. Driver confidence in the system may then be increased and driving task difficulties may be underestimated. As a result, decision criteria will be biased and driver attention level decreased. The overall effect is a degradation in driver performance which is due to a poorer detection of relevant cues and to poorer criteria. This degradation ultimately leads to an increase in accidents. The challenge of road engineering, therefore, should be to find the optimal balance between environmental demands (e.g. engineering standards and design levels) and drivers' perception of task difficulties. PMID- 3954849 TI - Voluntary seat belt use among U.S. drivers: geographic, socioeconomic and demographic variation. AB - Although voluntary seat belt use rates are low, they are not uniform among different populations of U.S. drivers. In detailed analyses of 1982 data from 12 of the 19 cities in the National Highway Traffic Safety Administration's national seat belt survey and from three of the National Accident Sampling System regions, belt use rates varied greatly by geographic region, socioeconomic status and demographic group. These factors also moderated the effects of other factors such as car size and origin of manufacture. Nevertheless, all together, the factors included in the study explained less than 5% of the variation in voluntary seat belt use, and no subpopulation was identified in which seat belts were used by a majority of the members. PMID- 3954850 TI - Does periodic vehicle inspection prevent accidents? AB - The hypothesis that periodic motor vehicle inspection (PMVI) has no safety effect was tested using accident involvement rates analysed by "vehicle age" and "time since the most recent inspection." The alternative of interest was that the probability of accident is lowest (ceteris paribus) immediately after an inspection, and subsequently increases over time. Two types of adjustment for exposure variations by time since last inspection were made, yielding two kinds of accident involvement rate. The first accident rate was the proportion of accident-involved vehicles having "preventable" defects which could possibly have helped to cause the accident. The second accident rate was the number of accident involved vehicles divided by the number of inspected vehicles, and amounted to an adjustment for premature re-inspection. The observed probability of accident involvement (as measured by either rate) was found to increase with time since last inspection. This result supports the alternative hypothesis that a mandatory safety inspection has an immediate safety benefit which decreases over time. In neither analysis was there an interaction between vehicle age group and "week since inspection." PMID- 3954852 TI - [Strategic position in normative instances]. PMID- 3954851 TI - Relating the effect of safety measures to expected number of accidents. AB - Traffic engineers have long believed that the effectiveness (percentage reduction in accidents) of a safety measure is greater at locations which had many accidents than at those which had few. That this type of belief has often translated into warrants is evidence of the strength of this belief. Recent research has raised doubts as to whether this phenomenon is real or merely a manifestation of regression-to-the-mean. This paper addresses this issue in the context of an examination of the safety effect of converting 222 intersections in Philadelphia, PA, U.S.A. from two-way to all-way stop control. The results indicate that the conversions were more effective at intersections expected to have many accidents than at the relatively safe intersections. One of the important implications of this finding is that, for measures for which this phenomenon exists, effectiveness cannot be specified as a single accident reduction factor as is currently the practice. PMID- 3954854 TI - [Normal values for hemoglobin and hematocrit in healthy children 9-12 years of age in the city of Hermosillo, Sonora, Mexico]. PMID- 3954853 TI - [Nutritional state of the infant hospitalized for respiratory and digestive disease. Prospective study]. PMID- 3954855 TI - [The newborn infant of the mother with essential arterial hypertension ]. PMID- 3954856 TI - [Pneumonectomy in children. Postoperative, clinical and functional evaluation]. PMID- 3954857 TI - [Spastic infantile cerebral paralysis. Surgery of the lower extremities in severe spastic quadriplegia]. PMID- 3954859 TI - [Diseases of bacterial origin observed at necropsy]. PMID- 3954858 TI - [Obesity in childhood and adolescence: risk factors]. PMID- 3954860 TI - [Alkaptonuria. Presentation of a case in a 2-year-old child]. PMID- 3954862 TI - [A pediatric response to children who were victims of the earthquake]. PMID- 3954861 TI - [Epidermoid cyst of the spleen]. PMID- 3954863 TI - Interactions between response stereotypy and memory strategies on the eight-arm radial maze. AB - Three groups of water-deprived rats collected water from the ends of the 8-arm radial maze. Sighted subjects, and subjects blinded either with or without pre enucleation experience on the radial maze, all retrieved the water efficiently. Most of the subjects exhibited the same response stereotypy, regularly choosing 8 adjacent arms of the maze, then stopping in the center of the maze. The strategies underlying this performance were analysed by interrupting trials and rotating the maze 180 degrees after the subject had made 3 choices. Sighted subjects depended on extramaze stimuli, naive-blind subjects depended on intramaze stimuli and experienced-blind subjects ignored their initial 3 choices after the trial was interrupted. Choice accuracy was equally good whether the subject was returned to the position from which it had been removed, or returned to the opposite side of the central platform. All 3 groups of subjects maintained their stereotyped adjacent-arm responding only as long as such responding was consistent with high choice accuracy. Response stereotypy was prevalent on the radial maze, but response strategies were secondary to memory strategies. PMID- 3954864 TI - The influence of estrogen on nigrostriatal dopamine activity: behavioral and neurochemical evidence for both pre- and postsynaptic components. AB - The results of 3 experiments examining the influence of estrogen on the nigrostriatal dopamine (DA) system are reported. In two experiments the influence of hormonal manipulations on amphetamine (AMPH)-induced rotational behavior was investigated using rats with unilateral 6-hydroxydopamine lesions of the substantia nigra. It was found that: (1) female rats in estrus make more rotations than ovariectomized (OVX) rats; and (2) estrogen treatment (5 micrograms estradiol benzoate, daily for 4 days) in OVX rats enhances AMPH induced rotational behavior 4 h and 4 days after estrogen treatment. During the intervening period, at 24 h after cessation of estrogen treatment, control and hormone-treated animals did not differ. In a third experiment, the effect of estrogen treatment on the release of endogenous DA from striatal tissue slices in superfusion was examined. Estrogen enhanced AMPH-stimulated striatal DA release 4 h after the last treatment relative to OVX controls. However, 24 h and 4 days after estrogen treatment DA release had returned to control levels. It is suggested that estrogen has an immediate potentiating effect on striatal DA release, and this may be responsible for the increased behavioral response to AMPH 4 h after estrogen treatment. The previously demonstrated increase in postsynaptic striatal DA receptors may be responsible for the second increase in AMPH-induced rotational behavior, that occurs 4 days after estrogen treatment. PMID- 3954865 TI - Depression of postejaculatory ultrasonic vocalization by (+)-bicuculline. AB - The male rat emits ultrasonic (22 kHz) vocalizations after ejaculation and behavioural and electrophysiological evidence suggests that this vocalization reflects an inhibitory state underlying and determining the postejaculatory refractory period (PEI). Present results show that injection into the preoptic anterior hypothalamic area of (+)-bicuculline methiodide, a GABA antagonist, shortens the PEI and reduces ultrasonic vocalization. It is suggested that the suppression of ultrasonic vocalization following bicuculline treatment reflects a depression of an inhibitory state normally produced by ejaculation. PMID- 3954866 TI - Spatial contrast and flicker sensitivity following medial thalamic or visual cortex lesions in hooded rats. AB - In rats, lesions of the medial thalamus that involve the intralaminar nuclei produce a number of visual impairments similar to those obtained with visual cortex ablation, suggesting that the former functionally disrupt visual cortex. This was tested by a direct comparison between the two lesions on spatial contrast and flicker sensitivity, using behavioural techniques. Both lesions depressed spatial contrast sensitivity, visual cortex damage more than thalamic lesions. Only medial thalamic lesions produced statistically significant changes in flicker sensitivity. This dissociation suggests that medial thalamic and visual cortex lesions are disrupting different mechanisms. Alternative explanations of the thalamic deficit are discussed. PMID- 3954867 TI - Influence of atropine microinjection into nucleus reticularis thalami on activity of lateral geniculate nucleus neurones in freely moving rats. AB - The influence of the microinjection of atropine into the visual part of the nucleus reticularis thalami (TR) on flash-evoked unit responses of the dorsal lateral geniculate nucleus (dLGN) was investigated in freely moving rats. Atropine induced a significant prolongation and accentuation of the postexcitatory inhibitory phases in water-deprived trained rats, to which light flashes acted as conditioned stimuli and initiated a drinking behaviour. In satiated relaxed rats atropine did not change the unit activity significantly. Acetylcholine injected into TR caused a facilitation of the dLGN transmission. Since the decrease of flash-evoked excitatory response phases in thirsty, trained rats as compared to satiated ones could not be blocked by atropine, not all behaviourally dependent changes are mediated by a disinhibitory action of cholinergic fibres on TR. PMID- 3954868 TI - Eye and brain growth in the Mongolian gerbil (Meriones unguiculatus). AB - Eye and brain growth were evaluated by measures of weight and surface dimensions at 11 ages spanning the period from birth to 150 days of age in the Mongolian gerbil (Meriones unguiculatus). Brain weight was found to increase very rapidly until day 18, followed by a more gradual increase to asymptote by 70 days of age. Eye growth follows overall body growth more closely than brain growth. Eye shape was found to change from ovoid to spherical over the first 70 days of life. The possible relationship between eye growth and retinal specialization is considered, and brain growth is compared across several rodent species. PMID- 3954869 TI - Visual texture segmentation in cats. AB - The segmentation of visual images on the basis of textural discontinuity was studied in cats using two behavioural paradigms. The first task (Experiment 1) required the animals to detect the presence of a target square of one texture embedded in a background of a second texture. The second task (Experiment 2) required the cats to discriminate between two forms (square and triangle) both of which were defined by texture-texture boundaries. Both detection and discrimination tasks were presented in a transfer paradigm in which the animals first learned a luminance-based form of the same problem. The results indicate that cats are able to segment a visual array on the basis of textural discontinuity in the absence of global luminance differences between figure and ground, and that they are able to use the contour information provided by texture texture boundaries as a basis for form discrimination. PMID- 3954870 TI - Feeding patterns and operant responding by wild and domesticated rats in self maintenance conditions. AB - The feeding activity of domesticated and wild rats was studied. The rats obtained all their food by lever pressing in two-lever operant chambers. Concurrent variable interval (VI) and concurrent variable ratio (VR) schedules operated continuously for successive 4-day periods. Feeding occurred as regular, discrete meals, mostly during the night. The schedules did not affect the number or size of meals or the total amount eaten. The interval schedules significantly extended the duration of meals and reduced intermeal intervals. Lever pressing was characterised on concurrent VI schedules by low response rates and frequent alternation and that on concurrent VR schedules by higher response rates confined to one lever. The wild rats ate significantly more than the domesticated rats by increasing the number but not the size of meals, primarily during the night. Feeding behaviour and operant responding are discussed in relation to the effects of domestication and economy of effort in food-seeking. The inhibition caused by handling and food deprivation, which impairs the performance of wild rodents in short sessions is avoided by providing self-maintenance conditions. PMID- 3954871 TI - Social stress increases [14C]2-deoxyglucose incorporation in three rostral forebrain areas of the young chick. AB - The 2-deoxyglucose method and EEG-recordings were used to compare forebrain activities between socially reared chicks, one remaining in the group the other being separated with preserved visual and auditory contact. During 30% of the test period, separated chicks produced distress calls and showed a typical EEG arousal pattern. The 9 Hz band of the EEG spectrum and the duration of distress calling were found to be significantly different from grouped chicks. Increased 2 deoxyglucose incorporation were found in 3 rostral forebrain areas of separated chicks, namely the hyperstriatum accessorium/hyperstriatum dorsale, the lateral neostriatum/hyperstriatum ventrale and the medial neostriatum/hyperstriatum ventrale. These same areas were previously reported to increase metabolic activity in imprinted Guinea fowl chicks, when they heared the imprinting stimulus during the 2-deoxyglucose experiment. It is argued that high metabolic activity in these areas reflects arousal and attention to relevant auditory or visual stimuli. PMID- 3954872 TI - Motor responses measured by brain electrical activity mapping. AB - The brain electrical activity of right-handed normal subjects was studied while they were exposed to motor performance tasks that were of increasing difficulty. Each task lasted 45-60 s, and a 30-s period of each task was analyzed by a spectrum analyzer. Data are presented in topographic maps showing the electrical activity for each task, in delta (1-4 cycles [c]/s), alpha (8-12 c/s), and beta 2 (18-24 c/s). The results showed a bilateral decrease in amplitude in sensorimotor areas relative to baseline, for a single hand movement. Tasks that required the programming of movement showed baseline/task differences in amplitude in additional areas; the right frontal area, the prefrontal area, the posterior parietal area, and the left temporal area. The results obtained suggest that different topographical areas are involved in motor tasks that require increased level of programming. PMID- 3954873 TI - Lesions of the amygdala, but not of the cerebellum or red nucleus, block conditioned fear as measured with the potentiated startle paradigm. AB - Rats were given 10 light-shock pairings on 2 successive days. At 24-48 hr following training, groups of rats received bilateral transection of the cerebellar peduncles, bilateral lesions of the red nucleus (which receives most of the cerebellar efferents), or bilateral lesions of the central nucleus of the amygdala. Control rats were sham operated. At 3-4 days after surgery, the rats were tested for potentiated startle (increased acoustic startle in the presence of the light previously paired with shock). Potentiated startle was blocked by lesions of the central nucleus of the amygdala. Transection of the cerebellar peduncles or lesions of the red nucleus did not block potentiated startle. A second experiment in which a visual prepulse test was used indicated that the blockade of potentiated startle observed in the animals with amygdala lesions could not be attributed to optic tract damage. A third experiment demonstrated that the absence of potentiation in the animals with amygdala lesions was not simply due to a lowered startle level ceiling, because these animals could show increased startle with increased stimulus intensity and with administration of strychnine, a drug that increases startle. Taken together, the results are consistent with the hypothesis that the amygdala is involved in fear conditioning, because potentiated startle is a measure of conditioned fear. PMID- 3954874 TI - Ovarian steroid manipulation of the antidipsogenic and thermogenic responses of rats to central administration of prostaglandin E1. AB - Intracerebroventricular (icv) injection of prostaglandin E1 (PGE1) increases arterial pressure, suppresses water intake, and elevates core temperature of rats. Treatment of ovariectomized rats with estradiol or progesterone results in an attenuation of the pressor response to PGE1. This work addressed the effects of daily subcutaneous injection of estradiol (1 microgram), progesterone (5 mg), or oil vehicle on the antidipsogenic and thermogenic response to icv PGE1 of ovariectomized rats. The change of core temperature induced by the PGE treatment was significantly correlated with antidipsogenesis for ovariectomized rats receiving daily oil injections. Although neither the suppression of water intake nor the increase of core temperature in response to icv PGE1 was affected significantly by ovarian steroid treatment, the linear relation between the thermogenic and antidisogenic actions of the icv PGE1 was abolished by either estradiol or progesterone administration. Thus, although the pressor, antidipsogenic, and thermogenic effects of icv PGE1 tend to occur in concert, they may be differentially affected by ovarian steroid administration, which suggests that the mechanisms underlying these varied effects of icv PGE1 may be independent. PMID- 3954875 TI - Separation of taste-aversion-prone and taste-aversion-resistant rats through selective breeding: implications for individual differences in conditionability and aversion-therapy alcoholism treatment. AB - Both rats and alcoholic humans display considerable variability in acquisition of illness-induced consummatory aversions. Differential conditionability may be a significant modulator of outcome in alcoholics who elect taste aversion (TA) approaches to abstinence facilitation. This is a report of the ongoing development of rat strains suitable for studies of biological bases of individual differences in TA conditionability. Sprague-Dawley-derived rats have been selectively bred over seven generations as strong or weak learners of a cyclophosphamide-induced saccharin aversion. Efficiency of aversion acquisition is a selectable propensity, as indicated by progressively divergent strain separation that attained significance in the second selected generation. Subjects have also been studied with respect to shock-motivated environmental avoidance (SMEA), but efficiency of SMEA performance has not been a selection factor. Results have produced an unexpected trend across generations indicative of a within-strain reversal of TA and SMEA learning efficiency. Continuation of this reversal in subsequent generations could have important implications for studies of genetic contributions to different learning capacities and for the selection of biologically appropriate noxious stimuli for aversive therapy treatments of various target problems. PMID- 3954876 TI - Pilocarpine and physostigmine attenuate spatial memory impairments produced by lesions of the nucleus basalis magnocellularis. AB - The effects of bilateral ibotenic acid-induced lesions of the nucleus basalis magnocellularis (nBM) on the acquisition and retention of several spatial memory tasks were studied in the rat. Maintenance of spatial memory in a food search task was impaired following nBM lesions. Acquisition of spontaneous alternation and reinforced alternation in a T-maze was also significantly impaired in animals with these lesions. In contrast, the animals with nBM lesions were not impaired in the acquisition of a position habit in a T-maze. In several of the tasks there was evidence of some learning in the lesion animals after substantial training, although they were significantly deficient when compared with the controls. Administration of the cholinergic agonists physostigmine sulfate or pilocarpine nitrate prior to behavioral testing resulted in a rapid and significant improvement in the performance of the lesion animals. The ibotenate-induced lesions significantly reduced the activity of choline acetyltransferase (CAT) in the anterior and the posterior neocortex. Hippocampal CAT activity was not changed. The results indicate that the cholinergic projections originating in the nBM are involved in the learning and memory of spatial tasks. PMID- 3954877 TI - Lateral subthalamic area as mediator of classically conditioned bradycardia in rabbits. AB - This study was conducted to examine whether a central efferent pathway passing through the lateral zona incerta (LZI) of the subthalamus selectively mediates the bradycardia conditioned response (CR) in rabbits. Electrodes were implanted bilaterally in LZI or in control sites just dorsal or ventral to LZI. Two days following surgery, animals were subjected to Pavlovian conditioning or to pseudoconditioning. Subsequent bilateral electrolytic lesions did not influence the heart rate (HR) orienting response, unconditioned response, baseline, or lack of response to pseudoconditioning. Bilateral LZI lesions alone abolished the HR CR. In a follow-up experiment, the corneoretinal potential (CRP) CR and HR were recorded. Bilateral LZI lesions following conditioning to a criterion of 65% CRP CRs abolished the HR CR without affecting CRP CRs. The present findings indicate that LZI is part of an efferent pathway that selectively mediates the HR CR in rabbits. PMID- 3954878 TI - Habituation, prepulse inhibition, fear conditioning, and drug modulation of the acoustically elicited pinna reflex in rats. AB - A reliable component of the acoustic startle response in animals is a flexion of the ears, the pinna reflex. One goal of the present investigation was to develop a preparation and apparatus suitable for analyzing the pinna reflex in the awake rat. A second goal was to examine the pinna reflex under behavioral and pharmacological conditions known to affect other response systems, such as whole body startle, and determine whether the pinna response is a valid model for analyzing behavioral plasticity. The amplitude of the pinna reflex in spinally transected rats was directly related to stimulus intensity and exhibited short term habituation, prepulse inhibition, and enhancement by prior fear conditioning. Also, pinna response amplitude increased following systemic administration of strychnine and was decreased following clonidine. It is concluded that this preparation and response system are valid for studying various forms of behavioral modification. Implications of these findings are discussed in terms of the potential utility of this response system in investigating the cellular correlates of behavioral plasticity in mammals. PMID- 3954879 TI - Localization of telencephalic regions concerned with habituation of cardiac and ventilatory responses associated with arousal in the goldfish (Carassius auratus). AB - Goldfish (Carassius auratus) were presented with a "light-on" stimulus at 2-min intervals, and their cardiac and ventilatory responses were monitored. Normal fish, fish with sham operations for telencephalic lesions, and fish with bilateral electrolytic lesions of the telencephalon (anterior commissural and posterior telencephalic groups) were compared for responsiveness and habituation to regularly presented stimuli. There was no evident difference in responsiveness between the four groups, though 3 fish with lesions in the regions ventralis pars dorsalis and ventralis pars ventralis gave fright responses to novel stimuli. Lesions in posterior telencephalic regions dorsalis pars centralis and ventralis pars intermedialis and at the telencephalic/diencephalic border close to the habenula caused significant impairment of habituation. PMID- 3954880 TI - Androgens and imprinting: differential effects of testosterone on filial preference in the domestic chick. AB - The relation between testosterone and imprinting was investigated in domestic chicks. After hatching, chicks received either testosterone enanthate in oil or oil alone (controls). The chicks were then trained by exposing them to a rotating imprinting stimulus, either a red box or a stuffed jungle fowl. A preference score was then determined, providing a measure of the strength of imprinting. Plasma testosterone concentration after testing did not differ significantly between males and females and was unaffected by the type of training stimulus. In fowl-trained chicks, but not in box-trained chicks, preference score was positively correlated with plasma testosterone concentration. Furthermore, the mean preference score of the fowl-trained chicks that had received exogenous testosterone was significantly higher than that of their controls; no such effect was found in box-trained chicks. A previous study showed that imprinting with the box, but not the fowl, is profoundly impaired by a noradrenergic neurotoxin. The results taken together suggest that some of the neural systems supporting the preference for the red box, a simple artificial object, are different from some of those supporting the preference for the stuffed jungle fowl. PMID- 3954881 TI - Sham feeding in rats after ventromedial hypothalamic lesions and vagotomy. AB - Sham feeding was examined in female rats with ventromedial hypothalamic (VMH) lesions with or without abdominal vagotomy. In Experiment 1, intact rats consumed more than twice as much sweet milk during 1-hr tests of sham feeding (M = 13.0 ml) as they did when feeding normally (M = 5.5 ml). Rats with VMH lesions showed exaggerated sham feeding, which was elevated almost fourfold (M = 56.6 ml) over their already high normal feeding baseline (M = 15.1 ml). In Experiment 2, vagotomy substantially reduced sham feeding in rats with VMH lesions. After vagotomy, VMH rats sham fed half as much (M = 23.7 ml) as nonvagotomized VMH rats did (M = 46.8 ml). Vagotomy did not, however, reduce sham feeding to control levels (M = 13.1 ml). These results are consistent with the hypothesis that VMH hyperphagia arises from exaggeration of orosensory responsiveness, which is, in part, a consequence of perturbed vagal function. PMID- 3954883 TI - Histamine H2 receptors mediate morphine-induced locomotor hyperactivity of the C57BL/6J mouse. AB - Morphine-induced locomotor hyperactivity of the C57BL/6J mouse was challenged with intracranial injections of antihistamines or the opiate antagonist naloxone. When cimetidine (H2 receptor blocker) was injected into the nucleus accumbens/stria terminalis, it significantly reduced opiate-stimulated locomotion. However, ventricular injections of cimetidine did not significantly alter either morphine or amphetamine hyperactivity, nor did cimetidine depress spontaneous locomotion. Although naloxone eliminated morphine-induced locomotion when injected into either the nucleus accumbens or the ventricles, chlorpheniramine (H1 receptor blocker) failed to reduce this behavior. These data suggest that opiate-stimulated locomotion of the C57BL/6J mouse may be partially mediated by histamine H2 receptors of the nucleus accumbens or closely adjacent structures. PMID- 3954882 TI - Effects of endocrine state on sociosexual behavior of female rats tested in a complex environment. AB - The influence of both natural and artificially induced endocrine states on sociosexual behavior of the female rat was examined during 15-min behavioral observations in a complex testing apparatus that allowed the test females to control their contacts with sexually active and passive males and ovariectomized (OVX) females. Factor analysis of the behavioral measures for all test females indicated separate loadings on a lordotic behavior factor; a factor for the test females' preference for proximity to OVX females or passive males; and a factor for the test females' locomotion between portions of the testing apparatus. Behavioral variables loading on these factors were influenced by endocrine state, but the nature of the relation between behaviors and endocrine state varied between factors. The utility of the present testing situation in investigations of the neuroendocrine substrates underlying the motivational aspects of feminine reproductive behavior is examined. PMID- 3954884 TI - Mouse strain differences in apomorphine-induced behavior: an empirical and methodological study. AB - The behavioral response to 0.5-32.0 mg/kg apomorphine was evaluated in BALB/cJ, CBA/J, and C57BL/6J mice. Dose-response curves for each component of the drug induced behavioral repertoire were derived, and ED50 (the dose at which 50% of the subjects meet or exceed a given rating) and slope were calculated for each. This method of analysis allows for a more quantitative estimate of drug sensitivity. Although some strain differences were observed in the qualitative characteristics of the response, differences in actual drug sensitivity (ED50s) were significant only at the higher ratings. PMID- 3954885 TI - Localization of tones by horses: use of binaural cues and the role of the superior olivary complex. AB - The ability of horses to use binaural time and intensity difference cues to localize sound was assessed in free-field localization tests by using pure tones. The animals were required to discriminate the locus of a single tone pip ranging in frequency from 250 Hz to 25 kHz emitted by loudspeakers located 30 degrees to the left and right of the animals' midline (60 degrees total separation). Three animals were tested with a two-choice procedure; 2 additional animals were tested with a conditioned avoidance procedure. All 5 animals were able to localize 250 Hz, 500 Hz, and 1 kHz but were completely unable to localize 2 kHz and above. Because the frequency of ambiguity for the binaural phase cue delta phi for horses in this test was calculated to be 1.5 kHz, these results indicate that horses can use binaural time differences in the form of delta phi but are unable to use binaural intensity differences. This finding was supported by an unconditioned orientation test involving 4 additional horses, which showed that horses correctly orient to a 500-Hz tone pip but not to an 8-kHz tone pip. Analysis of the superior olivary complex, the brain stem nucleus at which binaural interactions first take place, reveals that the lateral superior olive (LSO) is relatively small in the horse and lacks the laminar arrangement of bipolar cells characteristic of the LSO of most mammals that can use binaural delta I. PMID- 3954886 TI - Interactions between lectins and other components of leguminous protein bodies. AB - Previous work from this laboratory had shown that Leguminosa seed extracts contain lectin-bound proteins. In the present paper, the isolation of protein bodies from the seeds of 7 Leguminosa species (Canavalia ensiformis, Lens culinaris, Pisum sativum, Glycine max, Sophora japonica, Wisteria floribunda and Phaseolus vulgaris) is described. Protein bodies were characterized microscopically and by their constituents, storage proteins, lectins and some glycosidases. From the protein bodies, lectin-bound proteins were isolated and were shown to be identical with those from whole seed extracts. This indicates a common localization of lectin-bound proteins and of lectins. Lectin-bound proteins belong to the storage proteins and to the proteins with glycosidase activity. The common localization of these proteins and interactions between them suggest a biological role of seed lectins: during maturation they may act as a packaging aid for storage proteins and enzymes into developing protein bodies. Lectins thus may contribute to an ordered construction and degradation of protein bodies. PMID- 3954887 TI - Isolation, resolution and partial characterization of two Robinia pseudoacacia seed lectins. AB - Two lectins from the seeds of Robinia pseudoacacia were isolated and resolved in a single affinity chromatography run using immobilized ovomucoid by successive elution with different buffers. The lectins were characterized by their subunit sizes, total molecular masses and isoelectric points as well as by their ability to bind to ConA-Sepharose and to stimulate mitosis in murine lymphocytes. PMID- 3954888 TI - The cell surface glycoprotein of Halobacterium halobium. Physico-chemical characterization in the absence and presence of salt. AB - The cell surface glycoprotein of Halobacterium halobium is soluble in dilute buffer at neutral pH. At low counterion concentrations, the protein is monomeric (Ms,D = 209 kDa) and exhibits the characteristics of a highly charged polyelectrolyte. Evidence obtained from intrinsic fluorescence and far-UV circular dichroism shows that the monomer at low salt loses both its native conformation and its inherent tendency to form high molecular mass assemblies. In 4M NaCl, 25 mM KCl, and in the presence of divalent ions (greater than or equal to 50mM Mg2+ or Ca2+), association to well-defined assemblies of up to approximately 4 X 10(6) Da occurs. At low Mg2+ concentration and in the presence of Ba2+, a wide size-distribution of aggregates is observed. The assembly pattern of the protein may be correlated with salt-dependent alterations in the morphology of the bacterium. PMID- 3954889 TI - Reciprocal influence of glucose anomers upon their respective phosphorylation by hexokinase. AB - The phosphorylation of D-glucose (1.0mM) was measured in homogenates of tumoral islet cells incubated at 7 degrees C in the presence of labelled alpha- and/or beta-D-glucose, with or without exogenous glucose 6-phosphate. The close-to maximal reaction velocity of hexokinase was higher with beta- than alpha-D glucose. The latter anomer inhibited beta-D-glucose phosphorylation more than the beta-anomer decreased the phosphorylation of alpha-D-glucose. This behaviour was accounted for by the higher affinity of hexokinase for alpha- than for beta-D glucose. These direct measurements of the relative contribution of each anomer to the overall rate of glucose phosphorylation in the presence of mixed populations of alpha- and beta-D-glucose validate the concept that the phosphorylation of D glucose displays anomeric specificity even when the hexose is used at anomeric equilibrium. Glucose 6-phosphate inhibited the phosphorylation of the two anomers more severely when alpha-D-glucose rather than beta-D-glucose was the most abundant anomer. PMID- 3954890 TI - [Primary structure of hemoglobin of the polar bear (Ursus maritimus, Carnivora) and the Asiatic black bear (Ursus tibetanus, Carnivora]. AB - The adult Polar and Asiatic Black Bear have one hemoglobin component each. The complete amino-acid sequences of their alpha- and beta-chains are presented. Their primary structures were determined by sequencing the tryptic and prolyl peptides. The alignment of these peptides was deduced from homology to human hemoglobin chains. The hemoglobin sequences of the two species proved to be identical. The evolutionary aspects of this result are discussed. A table of identical hemoglobin sequences from different species is given. PMID- 3954892 TI - Indications for adenotonsillectomy. PMID- 3954891 TI - Carnitine metabolism in isolated rat kidney cortex tubules. AB - Renal carnitine metabolism was studied in isolated kidney cortex tubules from fed rats. The tubular distribution of free carnitine (C), acid-soluble short chain acylcarnitine (AcC), and total acid-soluble carnitine was measured. The content of the last-mentioned in rat cortical tubule suspensions was 2.85 +/- 0.15 nmol/mg protein, 46% representing AcC. In the absence of metabolic substrates the AcC/C ratio declined from 0.84 to 0.48 during incubation. The administration of 2mM acetoacetate or 2mM 3-hydroxybutyrate caused an increase in AcC by 45% and 51%, respectively. The rise in AcC was paralleled by a decrease in C, resulting in an increase of the tubular AcC/C ratio to 1.69 and 1.85, respectively. In the presence of 1 mM exogenous L-carnitine 35 +/- 6 nmol AcC/(mg protein X h) was formed. The addition of acetoacetate and 3-hydroxybutyrate led to a 3.5 to 3.8 fold rise in AcC formation. Other substrates which are likewise metabolized by proximal tubules were less effective. More than 90% of the formed AcC was recovered in the extracellular fluid. The results suggest that proximal renal tubule cells are the intrarenal site of carnitine acylation and may be involved in the regulation of blood and/or urinary carnitine acylation state. PMID- 3954893 TI - Unilateral degloving injuries of the arytenoid cartilage. AB - Arytenoid cartilage dislocations and avulsions are often seen as a part of severe laryngeal injuries due to blunt trauma. An uncommon type of injury is the unilateral degloving of an arytenoid cartilage following laterally directed trauma to the thyroid cartilage. It may occur without additional cartilaginous or mucosal damage. The arytenoid cartilage is squeezed between the thyroid ala and the cervical spine and stripped of its mucosal covering. It may retain mobility and be exposed only on adduction, or it may lose mobility due to dislocation and be tipped into the laryngeal lumen. Prognosis for vocal cord mobility and voice production is good for the degloving injury alone, but poor if the arytenoid cartilage is also dislocated. Cases are discussed to illustrate the mechanism, treatment, and outcome of such injuries. PMID- 3954894 TI - Glottic cancer. Surgical salvage for radiation failure. AB - Radiation therapy is a well-established treatment for early squamous cell carcinoma of the glottic larynx. However, the management of patients suspected to have persistent or recurrent disease may present both diagnostic and therapeutic dilemmas, particularly when laryngeal edema persists months after conclusion of radiation therapy. We reviewed the outcome of 212 patients with T1s, T1, and T2NOMO carcinoma of the glottic larynx who had been treated for cure with radiation therapy, with surgical salvage reserved for radiation failures. Twenty four patients (11%) had recurrences after radiation therapy, 13 (59%) of whom had successful salvage by surgery. The five-year, recurrence-free survival in this series was 92% for T1s and T1 and 69% for T2. We conclude that T1s, T1, T2NOMO carcinoma of the glottic larynx is effectively managed by radiation therapy and surgical salvage for radiation failure. Total laryngectomy usually was necessary for surgical salvage. PMID- 3954895 TI - Defective monocyte chemotaxis in patients with head and neck cancer. Restoration after treatment. AB - Monocyte chemotactic responsiveness (MCR), as measured by the monocytes' capacity to migrate through polymer (Millipore) membranes toward the chemoattractant casein, is impaired in all patients with head and neck cancer thus far examined. Using a more rapid and sensitive test system, the polarization assay, we tested the MCR in 24 patients with head and neck cancer and 31 controls and compared it with the outcomes of the well-established Boyden chamber method. The results of both methods correlated well. All patients showed a seriously depressed monocyte chemotaxis before treatment when tested in the polarization assay. Nine patients were reexamined after surgery, and in seven patients the defective MCR was restored. This illustrates that tumor-derived factors are probably responsible for the inhibitory effect on monocyte chemotaxis. The polarization assay has the potential for predicting early relapse. PMID- 3954896 TI - Natural killer cell response to regional lymph node metastases. AB - A determination of natural killer cell activity was performed in 67 individuals with advanced head and neck cancer. The mean activity of 28 patients clinically staged T3 NO or T4 NO was 81 +/- 11 lytic units (LU), significantly higher than 39 patients with palpable lymph node metastases (54 +/- 5 LU). Assessing patients by extent of nodal disease revealed that activity actually increased, though not significantly, with progressive N-staging. A major determinate of increased natural killer cell cytotoxicity in patients with lymph node metastases was extranodal cancer within the neck. The mean activity of nine patients whose tumor was fixed to underlying structures or adherent to skin was 87 +/- 15 LU, significantly higher than the 45 +/- 4 LU mean value of the remaining patients with clinically determined regional nodal disease. The potential clinical implications of these findings are discussed. PMID- 3954897 TI - Spontaneous encephalocele of the temporal bone. AB - Postsurgical and posttraumatic encephaloceles of the tegmen tympani and tegmen mastoideum are well-recognized occurrences. Less frequently recognized, however, is the spontaneous occurrence of an encephalocele associated with cerebrospinal fluid otorrhea or rhinorrhea. This cerebral herniation into the middle ear and the mastoid cavity in adults is associated with a loss of both bony and dural support, and surgical management must deal with both the cerebrospinal fluid leak and herniation of the brain. PMID- 3954898 TI - Alkaline battery foreign bodies of the ear and nose. AB - Button batteries as foreign bodies are dangerous because of their ability to cause liquefaction necrosis on contact with moist tissue. We treated two patients with disk batteries in the ear and nose. Both patients had severe local reactions, necessitating prolonged treatment. Prompt identification and rapid removal of these foreign bodies is recommended. PMID- 3954899 TI - Markedly delayed postoperative malignant hyperthermia. AB - Malignant hyperthermia (MH) may be triggered by exposure to commonly employed anesthetic agents and muscle relaxants, and often manifests itself during the period of anesthesia. Delayed-onset MH occurring one to four hours postoperatively has been described in isolated case reports. A case of delayed onset MH occurred 11 hours following routine tonsillectomy and adenoidectomy. The patient demonstrated tachypnea, tachycardia, hyperthermia, and metabolic acidosis. Prompt intravenous administration of dantrolene sodium was therapeutic. Serial serum creatine phosphokinase evaluation verified the diagnosis of MH. The implications of delayed-onset MH and the importance of preoperative screening for potentially susceptible individuals are discussed. PMID- 3954900 TI - Pathologic quiz case 1. Polymorphous low-grade adenocarcinoma (PMLGA) of the minor salivary gland. PMID- 3954901 TI - Pathologic quiz case 2. Pleomorphic lipoma. PMID- 3954902 TI - The lateralization of lip-read sounds: a first look. AB - Two tachistoscopic studies on the lateralization of lip-read still photographs in normal right handers are reported. In the first, subjects matched a still lip photograph with a heard speech sound. A clear right hemisphere (LVF) advantage emerged, despite the phonological requirements of this task. This pattern of laterality failed to interact with the type of response (same/different) or with the status of the heard phoneme; both consonant and vowel matching showed the same pattern of LVF advantage, despite the significantly greater difficulty of consonant than vowel matching in this particular task. In the second study subjects were required to speak the sound they saw being spoken by a centrally displayed face photograph. The displayed face was chimeric; that is, one side of the face was seen saying one sound, one side another. Here, a rather complex pattern of results ensued. For the speakers seen a clear expressor asymmetry emerged; speech sounds were judged more accurately when they issued from the right side of the speaker's face. However, in the LVF, and only the LFV, accuracy in reporting chimeric face sounds correlated with speed in learning to lip-read, suggesting that the LVF is systematically involved even when task demands (speaking the response, phonological analysis, small, more central displays) do not, at first sight, suggest that they should. Taken together, these studies suggest that the right hemisphere could support some aspects of the processing of seen speech in normally hearing, normally lateralized individuals. PMID- 3954903 TI - Semantic encoding deficits in frontal lobe disease and amnesia. AB - The relationship between semantic encoding deficits and memory dysfunction was evaluated for the following groups: amnesic patients with bilateral frontal lobe lesions; nonamnesic patients with bilateral frontal lesions; and alcoholic Korsakoff patients. Semantic encoding was assessed using the Wickens' release from proactive interference (PI) paradigm. Korsakoff patients and the poor memory frontal lobe patients failed to show automatic PI release, while good memory frontal patients did show a release. These results support the view that an encoding disability is a contributor to amnesics' memory disorder and they suggest a possible neuroanatomical correlate for impaired semantic encoding. PMID- 3954904 TI - Brain asymmetry: facts and fallacies in statistical inference. AB - In a recent article, C. M. Clark, R. Kessler, and R. Margolin (1985, Brain and Cognition, 4, 7-12) argue that standard statistical tests should not be applied to measures of regional cerebral metabolism. They offer no evidence that such measures uniquely escape the mathematical foundations of statistical inference but, instead, merely note the definitional relations among various descriptive and inferential statistics. They falsely claim that these relations invalidate conclusions drawn from statistical tests, and in making this claim, they commit several quite serious logical fallacies. These fallacies are examined. PMID- 3954905 TI - Effortful processing deficits in children with reading and/or attention disorders. AB - Three groups of educationally troublesome boys were contrasted with adequate students on several tasks tapping effortful processing. The nonhyperactive reading disabled (RD) group differed both from controls and two attention deficit disorder (ADD) groups, one with and one without hyperactivity (H), on aspects of a memory task involving acoustic and semantic associations. All three clinical groups differed from controls in memory for low-imagery as opposed to high imagery words and in computational efficiency. A stepwise regression analysis to predict reading grade level showed age and WISC-R IQ to account for 38% of the variance with an additional 28% explained by the effortful task variables (multiple R = .83). It is theorized here that attentional disorder impedes automatization of number facts; and, inasmuch as RD children receive adverse attention ratings, even if not considered hyperactive, they, as well as ADD and H/ADD boys, exhibit this deficiency. PMID- 3954906 TI - On drawing inferences about the structure of normal cognitive systems from the analysis of patterns of impaired performance: the case for single-patient studies. AB - An analysis of the logic of valid inferences about the structure of normal cognitive processes from the study of impaired cognitive performance in brain damaged patients is presented. The logic of inferences from group studies and single-case studies is compared. It is shown that given certain assumptions, only the single-case method allows valid inferences about the structure of cognitive systems from the analysis of impaired performance. It is also argued that although the single-case approach is not entirely problem-free, the difficulties encountered are relatively minor. PMID- 3954907 TI - High dose intravenous streptokinase in acute myocardial infarction--short and long term prognosis. AB - Streptokinase (1 million international units) was given intravenously over 30 or 60 minutes to 50 patients four hours or less after the onset of acute myocardial infarction. All were aged less than or equal to 70 years and had 4 mm or greater ST segment elevation in anterior or inferior leads. Rapid (mean 95 min) ST segment resolution, which was taken to indicate reperfusion of the myocardium, occurred in 36 (72%) patients. In these 36 the average time from onset of symptoms to peak creatine kinase, creatine kinase MB, and myoglobin was 9.45 hours, whereas it was 17 hours in the 14 patients in whom indirect criteria did not indicate reperfusion. Reperfusion arrhythmias were invariably present and ventricular tachycardia developed in five patients and ventricular fibrillation in two. The infarct related artery was seen to be open in 28 (70%) of the 40 patients who had delayed coronary arteriography. The frequency of patency in the infarct related artery was no different in patients given streptokinase less than 2 hours or between 2-4 hours from onset of symptoms nor did it differ when streptokinase was infused over 30 or 60 minutes. Mean left ventricular ejection fraction was 57% in those with a patient infarct related artery and 48% in those with an occluded vessel. Eight patients subsequently underwent elective percutaneous transluminal coronary angioplasty after successful thrombolysis and six had coronary artery bypass grafting. There were nine in-hospital reocclusions of the infarct related coronary arteries. Two bleeding episodes occurred; one required transfusion. Five of the 50 patients died in hospital. All of them had had an anterior myocardial infarction; four had bifascicular block and one had right bundle branch block. During follow up, four patients died, two suddenly and two from reinfarction. During follow up (mean 15 months) the frequency of reinfarction, dyspnoea, and angina was low and there was no difference in the proportions of patients returning to work between those with an open infarct related artery and those with a closed infarct related artery. Intravenous administration of high dose streptokinase to selected patients during the acute phase of myocardial infarction is a safe, effective, and practical method of thrombolysis. It must, however, be followed by coronary arteriography to select those patients in whom percutaneous transluminal coronary angioplasty or coronary artery bypass grafting will be helpful. PMID- 3954908 TI - Left ventricular function during isometric hand grip and cold stress in normal subjects. AB - Both isometric exercise and cold stress have been suggested as alternatives to dynamic exercise for the detection of obstructive coronary artery disease. A non imaging nuclear probe was used to measure left ventricular ejection fraction and relative left ventricular volumes continuously during both of these stress tests in 24 normal subjects. There was a significant fall in left ventricular ejection fraction within 15 seconds of subjects starting a two minute isometric hand grip test at 50% maximal voluntary contraction, with a mean (SE) maximal fall of 10% (1.8) after 90 seconds. During two minutes immersion of the hand and wrist in iced water left ventricular ejection fraction fell significantly within 30 seconds with a mean maximal fall of 7% (1.7) after one minute. Nine subjects underwent repeat tests under identical conditions approximately two weeks later. The standard error of the change in ejection fraction on two occasions was 5.4% at rest, 7.0% at the peak of isometric exercise, and 4.8% at peak cold stress. These results indicate that the reproducibility of both of these stress tests is acceptable when they are performed under carefully controlled conditions. The resulting changes in ejection fraction are transient, however, and moreover depend upon the choice of stress protocol. The discrepancies between published reports of such studies in coronary artery disease may be mainly due to methodological differences, and neither test is likely to be of sufficient discriminative ability to distinguish between individuals with obstructive coronary artery disease and normal subjects. PMID- 3954909 TI - Non-invasive grading of aortic regurgitation by Doppler ultrasonography. AB - Doppler ultrasound without concomitant echocardiographic imaging was used to grade isolated aortic regurgitation in 21 patients. The severity of aortic regurgitation was subsequently graded (from 0 to IV) angiographically. A 2 MHz continuous wave Doppler transducer was placed over the apex of the heart and the beam was aimed parallel to the mitral flow by means of acoustic guidance. Mitral pressure half time was calculated from the analogue maximum velocity tracing and it was less than or equal to 60 ms in 10 controls; 50-120 ms in five patients with grade II, 120-160 ms in nine patients with grade III, and greater than or equal to 160 ms in seven patients with grade IV aortic regurgitation. These results indicate that a semi-quantitative grading of aortic regurgitation may be obtained non-invasively with non-imaging Doppler ultrasonography in patients without concomitant mitral valve disease. PMID- 3954910 TI - Comparative aspects of the dual role of the human atrioventricular node. AB - As well as transmitting the impulse from the atria to the ventricles the atrioventricular node has two other important functions namely: synchronisation of atrial and ventricular contractions by a varying delay; and protection of the ventricles from rapid atrial arrhythmias. The relative importance of these two functions appears to differ in large and small mammalian hearts. In small mammals synchronisation of atrial and ventricular contractions is the major function of the atrioventricular node, whereas protection from rapid atrial arrhythmias may be its most important function in large mammals. Atrioventricular conduction time in sinus rhythm is ten times longer in the whale (500 ms) than in the rat (50 ms). A whale heart, however, is about 100 000 times heavier than a rat heart. During atrial fibrillation the ventricular rate in a dog heart is only three times faster than in a horse, whereas a horse heart may be 40 times as heavy as that of a dog. Hence there is a considerable discrepancy between the size of the mammalian heart and the functions of its atrioventricular node. Analysis of several anatomical and functional aspects of atrioventricular conduction systems in mammals of all sizes showed that the importance of the delaying role of the atrioventricular conduction system diminishes as the size of the mammal increases, whereas the protective role of the atrioventricular node probably increases. The function of the human atrioventricular node seems to be intermediate between that of of the small and large mammals. PMID- 3954911 TI - Treatment of paroxysmal supraventricular tachycardia with intravenous injection of adenosine triphosphate. AB - Intravenous adenosine triphosphate rapidly terminated all 11 episodes of paroxysmal supraventricular tachycardia in 10 patients. Eight patients reported side effects but these resolved within 20 seconds and did not require treatment. Adenosine triphosphate is a suitable agent for the rapid termination of paroxysmal supraventricular tachycardia. PMID- 3954912 TI - Socioeconomic factors and physical activity in relation to cardiovascular disease and death. A 12 year follow up of participants in a population study of women in Gothenburg, Sweden. AB - In a prospective population study of middle aged women socioeconomic factors and physical activity as initially reported were related to the 12 year incidence of ischaemic heart disease and to total mortality. There was a significant age specific correlation between low socioeconomic status according to the husband's occupation and myocardial infarction. No such association was seen between the socioeconomic status of the women themselves and myocardial infarction. Women with a low educational level had a significantly increased age specific incidence of angina pectoris. There was no significant correlation between marital status or number of children and incidence of ischaemic heart disease or overall mortality. Women who initially reported low physical activity at work during the last year had a significantly increased age specific 12 year incidence of stroke and death, as did those who reported low physical activity during leisure hours in whom the incidence of myocardial infarction and electrocardiographic changes indicating ischaemic heart disease were also increased. Multivariate analyses showed that the association between low educational level and incidence of angina pectoris was independent of socioeconomic group, smoking habits, systolic blood pressure, indices of obesity, serum triglycerides, and serum cholesterol. Similarly, low physical activity during leisure hours seemed to be an independent risk factor for stroke, and low physical activity at work was an independent risk factor for overall mortality. PMID- 3954913 TI - Dissecting aneurysm of the thoracic aorta presenting as right atrial obstruction. AB - A patient with a dissecting thoracic aortic aneurysm presented with acute low output cardiac failure due to right atrial obstruction. Five years earlier she had had her aortic valve replaced because of aortic regurgitation. Obstruction of the superior vena cava and pulmonary artery has been reported elsewhere as a complication of compression by thoracic aortic dissecting aneurysm. This case was unusual in presenting as right atrial obstruction. PMID- 3954914 TI - Left atrial rhabdomyosarcoma and the use of digital gated computed tomography in its diagnosis. AB - A case of left atrial rhabdomyosarcoma presenting in a patient with known mitral stenosis is described. Computed tomography of the left atrium, gated to the electrocardiogram cycle, was used to visualise the site and extension of the tumour. PMID- 3954915 TI - QT prolongation after ampicillin anaphylaxis. AB - Tall T waves and pronounced prolongation of the QT interval developed 24 hours after an apparently complete recovery from an acute anaphylactic reaction to oral ampicillin in a previously healthy woman of 29. These electrocardiographic abnormalities gradually subsided over five days. The prolongation of the QT interval has not previously been reported after anaphylaxis. PMID- 3954916 TI - Staffing and facilities in cardiology in the United Kingdom 1984. Third biennial survey. PMID- 3954917 TI - Death for anaesthesia in the general and community dental service? PMID- 3954918 TI - Isoflurane and halothane for outpatient dental anaesthesia in children. AB - A trial was undertaken in children to compare the use of halothane and isoflurane in outpatient dental anaesthesia. A wholly inhalation technique was chosen and nitrous oxide in oxygen was delivered from a Boyle's machine via a coaxial (Bain) breathing system and was supplemented with either halothane or isoflurane. Isoflurane produced significantly fewer arrhythmias than halothane but the induction of anaesthesia took longer and proved more difficult. PMID- 3954919 TI - Comparison of isoflurane and halothane in outpatient paediatric dental anaesthesia. AB - Isoflurane was compared with halothane as the sole supplement to anaesthesia with nitrous oxide and oxygen for outpatient dental extractions in 80 children. Induction and maintenance of anaesthesia were satisfactory with both agents, although there was a higher incidence of coughing, salivation and laryngospasm in the group receiving isoflurane. However, in contrast to predictions from the physical properties of isoflurane and halothane, immediate recovery was significantly slower in patients who had received isoflurane. Recovery was complicated by coughing in a significant number of patients in the isoflurane group. The incidence of reported complications during later recovery was similar with both agents, apart from the complaint of non-specific postoperative aches in a significant number of patients to whom isoflurane was administered. PMID- 3954920 TI - Comparison of the incidence and nature of cardiac arrhythmias occurring during isoflurane or halothane anaesthesia. Studies during dental surgery. AB - Seventy-six Chinese patients aged between 15 and 30 yr, undergoing 3rd molar extraction, were randomly allocated to two groups. One group received halothane and the other isoflurane. The incidence of arrhythmia during surgery under anaesthesia with isoflurane was significantly less than with halothane. Sinus tachycardia was a significant feature under anaesthesia with isoflurane. Under anaesthesia with halothane, the arrhythmias occurring most frequently during surgery were ventricular ectopics, the commonest being ventricular bigeminy. The frequency and nature of arrhythmias during surgery on right and left sides were similar. In three patients a slight decrease in arterial pressure was recorded in association with the arrhythmia, but on stopping the stimulus, both rhythm and arterial pressure returned to normal. The incidence of arrhythmia with halothane in the Chinese population in this study was significantly higher than that reported previously in non-Chinese patients. PMID- 3954921 TI - Effects of fentanyl-diazepam-nitrous oxide anaesthesia on arterial baroreflex control of heart rate in man. AB - The effects of fentanyl 7.5 micrograms kg-1 (group I), 10.0 micrograms kg-1 (group II) and 12.5 micrograms kg-1 (group III) with diazepam 0.25 mg kg-1 and 70% nitrous oxide on baroreflex control of heart rate in humans were investigated. Phenylephrine (the pressor test), sodium nitroprusside (the depressor test) and graded neck suction provoked baroreflex responses. In group I the pressor, depressor and neck suction baroreflex slopes decreased during anaesthesia. In groups II and III the depressor test slopes were also decreased during anaesthesia. However, the slopes derived from the pressor and neck suction tests did not decrease. These data suggest that baroreflex control of heart rate is attenuated during low doses of fentanyl (7.5 micrograms kg-1). Baroreflex mediated tachycardia is decreased by higher doses of fentanyl (10.0 and 12.5 micrograms kg-1). However, baroreflex-mediated bradycardia is maintained during the higher doses of fentanyl. We suggest this effect is the result of enhanced vagal efferent activity mediated by fentanyl. PMID- 3954922 TI - Restoration of baroreflex control of heart rate during recovery from anaesthesia. AB - The effects on baroreflex control of heart rate of halothane or methohexitone used to supplement 67% nitrous oxide in oxygen have been studied in 21 patients. Stable anaesthesia with either agent caused depression of baroreflex sensitivity by more than 50%. The set point of the reflex was also changed by both agents, but in opposite directions. Halothane administration resulted in slower heart rates at lower arterial pressures, whereas the infusion of methohexitone caused faster heart rates at lower arterial pressure. During recovery from anaesthesia, there was a rapid return of baroreflex sensitivity to normal and this was achieved before the patients regained consciousness, with no difference between the two groups. The reflex was reset rapidly and repeatedly during the recovery phase. PMID- 3954923 TI - Selective effect of althesin on the auditory evoked response in man. AB - The auditory evoked response (AER) has been studied in six patients before the induction of general anaesthesia, during anaesthesia with nitrous oxide in oxygen and mechanical ventilation, then with a stepwise increasing rate of infusion of Althesin ranging from 18 micrograms kg-1 min 1 to 90 micrograms kg-1 min-1. The sections of the AER examined in this study were the brainstem waves I, III and V and the early cortical waves Pa and Nb. There were dose-related changes in latency and amplitude of waves Pa and Nb, latency increasing and amplitude diminishing with increasing concentrations of alphaxalone as measured in venous blood. In contrast, there were no changes in either latency or amplitude of the brainstem waves. This is consistent with other work suggesting that Althesin has little effect on neuronal function below the level of the superior colliculus. PMID- 3954924 TI - Suxamethonium chloride and malignant hyperpyrexia. AB - Pure suxamethonium chloride does not produce in vitro contracture of skeletal muscle from swine which are susceptible to malignant hyperpyrexia (MH), but does induce MH in vivo. It is suggested that suxamethonium chloride induces MH because the fasciculations which it causes lead to an increase in the myoplasmic calcium concentration. PMID- 3954926 TI - Microcomputer-based haemodynamic monitoring during continuous extradural analgesia. AB - A system for monitoring, recording and storing arterial pressure and heart rate during continuous extradural analgesia has been developed using an Apple II microcomputer and a Dinamap 1846 non-invasive arterial pressure monitor. The administration of local anaesthetic (or vasopressor) was recorded using a light pen. The computer was programmed to recognize this, and to initiate automatically more frequent measurements of heart rate and arterial pressure. The results of a study using this equipment are reported. The commands for computer control of the Dinamap 1846 are described. PMID- 3954925 TI - Reversal of nitrous oxide-induced depression of hypoxic pulmonary vasoconstriction by lignocaine hydrochloride during collapse and ventilation hypoxia of the left lower lobe. AB - The blood flow to the left lower lobe (QL), and total (QT) pulmonary blood flow, were measured in 10 open-chest dogs using electromagnetic flowmeters. Ventilation of the left lower lobe with 7% oxygen in nitrogen produced a greater reduction in QL/QT (41%) than lobar ventilation with 7% oxygen in nitrous oxide (33%). Lobar collapse reduced QL/QT by 65%, but there was no change in QL/QT when 50% nitrous oxide was administered to the right lung. The i.v. infusion of lignocaine hydrochloride during ventilation of the lobe with 7% oxygen in nitrogen produced no change in QL/QT. However, lignocaine infusion during lobar ventilation with 7% oxygen in nitrous oxide produced a further reduction in QL/QT to a value which was not significantly different from that observed during ventilation with 7% oxygen in nitrogen. Lignocaine had no effect on QL/QT during lobar collapse whether the right lung was ventilated with 50% oxygen in nitrogen or 50% oxygen in nitrous oxide. It is concluded that lignocaine reverses the depression of hypoxic pulmonary vasoconstriction produced by lobar ventilation with nitrous oxide. PMID- 3954928 TI - Infusion thrombophlebitis. PMID- 3954927 TI - Cardiopulmonary bypass in patients with malignant renal neoplasms. AB - A case report of a patient with malignant renal neoplasm who underwent emergency pulmonary embolectomy during operation is presented. Knowledge of degree of venous extension, appropriate operative positioning of the patient and consideration of elective cardiopulmonary bypass are suggested ways to reduce morbidity and mortality from massive pulmonary emboli in these patients. PMID- 3954929 TI - Extradural blood patch. PMID- 3954930 TI - Effects of locally administered anticholinesterase agents on the secretory response of human eccrine sweat glands to acetylcholine and carbachol. AB - The effects of locally administered physostigmine and di isopropylphosphorofluoridate (DFP) were compared on the secretory response of sweat glands to intradermally injected acetylcholine and carbachol in healthy male volunteers (physostigmine: six subjects; DFP: one subject). The response to acetylcholine reached its peak within 10 s of injection and then rapidly declined, whereas the response to carbachol increased steadily reaching a peak between 5 and 7 min after injection. The response to acetylcholine was potentiated in the presence of both physostigmine and DFP, whilst the response to carbachol was not significantly affected by either of these drugs. The difference in the time-course of responses to acetylcholine and carbachol may be attributed to differences in the susceptibility of the two drugs to metabolism by acetylcholinesterase; carbachol, unlike acetylcholine, being virtually immune to metabolism by this enzyme. It is concluded that the response to carbachol is mediated by a direct stimulatory action on post-synaptic muscarinic receptors rather than by activation of pre-synaptic nicotinic receptors leading to the release of endogenous acetylcholine. PMID- 3954931 TI - Plasma and synovial fluid kinetics of flurbiprofen in rheumatoid arthritis. AB - Clinical assessment, plasma and synovial fluid kinetics were studied in 29 rheumatoid patients receiving 100 mg flurbiprofen twice daily. Clinical assessment and pharmacokinetic measurements varied widely within the group of patients. The average values for plasma clearance, volume of distribution and elimination halflife of flurbiprofen were 0.65 +/- 0.24 ml min-1 kg-1, 0.160 +/- 0.093 l kg-1 and 3.1 +/- 1.7 h, respectively. Synovial fluid drug concentrations peaked later and were lower than corresponding plasma concentrations: 5.2 h and 4.4 mg l-1 as against 1.49 h and 12.5 mg l-1, respectively. At 48 h after an oral dose of flurbiprofen, all the drug had been cleared from the synovial fluid. Synovial fluid drug concentrations were not related to synovial fluid albumin concentration or pH. There was a weak relationship between synovial fluid drug concentration and the thermographic measurements of disease activity. The fractions of flurbiprofen not bound to protein in synovial fluid and plasma were not significantly different. A simple model is proposed to account for the plasma and synovial fluid pharmacokinetics. PMID- 3954932 TI - Inability of ibuprofen to alter single dose phenytoin disposition. AB - The effect of ibuprofen treatment (1600 mg day-1 per os for 7 days) on single dose (300 mg per os) dispositional parameters of phenytoin (DPH) was evaluated in 10 healthy males. Ibuprofen slightly increased the free fraction of DPH from mean (+/- s.d.) value of 6.9 (+/- 0.7)% to 7.8 (+/- 0.3)% (P less than 0.01). DPH total clearance (CL/F) was not significantly changed going from a value of 0.027 (+/- 0.009) 1 h-1 kg-1 to 0.032 (+/- 0.014) 1 h-1 kg-1 (0.05 less than P less than 0.1). Intrinsic unbound DPH clearance (CLuint/F) was unaffected by ibuprofen treatment. Neither DPH's apparent volume of distribution (V/F) nor the apparent volume of distribution of unbound DPH (Vunb/F) were significantly altered by ibuprofen treatment. The slight changes in DPH plasma protein binding that are due to concurrent ibuprofen treatment in doses of 1600 mg day-1 are not likely to produce important changes in DPH dispositional parameters. PMID- 3954933 TI - Intra- and inter-individual variation in pharmacokinetics of intravenously infused amoxycillin and ampicillin to elderly volunteers. AB - The purpose of this study was to investigate the disposition of two aminopenicillins and their intra- and inter-individual variation in pharmacokinetic parameters in healthy, elderly volunteers. Two groups, each of 12 active, community-dwelling volunteers between 69 and 83 years of age participated. One group was given 500 mg of amoxycillin, the other group 500 mg of ampicillin as single i.v. infusions. Within the drug groups each volunteer was given the infusion at two different occasions separated by a time-period of 1 week. Amoxycillin and ampicillin were determined in plasma and urine by modern column liquid chromatographic methods. The mean plasma clearance was about 200 ml min-1 1.73 m-2 for both drugs and renal clearance accounted for approximately 80% of this. As expected, drug clearance was correlated to renal function as determined by 51Cr-EDTA. The volume of distribution at steady-state (Vss) was about 0.3 l kg-1 for both drugs. Compared to our previous results in younger subjects, plasma and renal clearances were essentially similar in this study, but slightly longer half-lives and higher Vss were seen for amoxycillin and ampicillin. The intra-individual variation, expressed as the error of a single determination (CV), was small, for plasma clearance 3.7% and 6.4% after amoxycillin and ampicillin. The corresponding inter-individual variation in clearance was higher, 14.4% after amoxycillin, and 11.9% after ampicillin. The results confirm a higher relative efficiency of a crossover vs a completely randomized parallel groups design in parenteral studies of these penicillins. In our elderly subjects there was only an approximately 30% decrease in renal function. This was not enough to reduce the drug clearance and offers an explanation for the similarity between our present results in the elderly and our previous results in younger subjects. Elderly volunteers may be different from patients with disease as a confounding factor. Studies on elderly active and community-dwelling volunteers, as in this study, may therefore be more representative as to the effect of age per se on drug kinetics. PMID- 3954934 TI - The dose-dependent systemic availability of prednisone: one reason for the reduced biological effect of alternate-day prednisone. AB - An analysis of the literature was performed, revealing that in many studies both the desired and the undesired effects are decreased in alternate-day prednisone regimens as compared with the daily regimens. In the present report evidence is given that part of the diminished biological effect of dose-spacing regimens is attributable to a decreased total exposure to prednisolone. Following a high dose of 0.8 mg kg-1 of oral prednisone or prednisolone the plasma concentration vs time curves of total prednisolone, unbound prednisolone and prednisolone bound to albumin or transcortin were always less than four times higher than following a low dose of 0.2 mg kg-1 of prednisone or prednisolone. This dose-dependent systemic availability of prednisolone explains partly the diminished biological effect when the same total amount of prednisone or prednisolone is divided into several small doses as opposed to a single oral dose. PMID- 3954935 TI - Alterations in isoprenaline sensitivity in patients with cirrhosis: evidence of abnormality of the sympathetic nervous activity. AB - Isoprenaline sensitivity and plasma catecholamine concentrations were studied to assess the sympathetic nervous activity in 13 patients with alcoholic cirrhosis and were compared with five controls. In patients with cirrhosis, the dose of isoprenaline required to increase the resting heart rate by 25 beats min-1 (chronotropic dose 25 or CD25) ranged from 2.50 to 34.73 micrograms (median: 4.47 micrograms) and was significantly higher than in controls (range: 0.66 to 2.76 micrograms, median: 1.34 micrograms). In cirrhotic patients, CD25 values were significantly correlated with plasma albumin concentration, resting heart rate and wedged hepatic venous pressure. In patients with cirrhosis, plasma noradrenaline concentrations ranged from 192 to 978 pg ml-1 (median: 444 pg ml-1) and adrenaline concentrations ranged from 5 to 183 pg ml-1 (median: 47 pg ml-1). No correlation was found between noradrenaline or adrenaline concentrations and CD25 values in cirrhotic patients. In conclusion, in patients with cirrhosis, beta-adrenoceptor responsiveness assessed by isoprenaline sensitivity is altered. PMID- 3954936 TI - Kinetic and dynamic interaction of brotizolam and ethanol. AB - Thirteen healthy male volunteers ingested a single 0.25 mg dose of the thienodiazepine hypnotic, brotizolam, on two occasions: once with a typical social cocktail (containing 60 ml of vodka), and in a second trial with an 'ethanol-placebo' cocktail. Brotizolam kinetics were determined from multiple plasma concentrations measured during the 24 h after dosage. Coadministration of brotizolam with ethanol, as opposed to the placebo cocktail, slightly imparied brotizolam clearance (1.85 vs 2.19 ml min-1 kg-1 P less than 0.005), increased peak plasma concentrations (5.3 vs 4.3 ng ml-1, P less than 0.05), and prolonged elimination half-life (5.2 vs 4.4 h, P less than 0.05). There was evidence of impairment of performance, although not statistically significant, for the first 4-6 h after brotizolam dosage in the reaction time test, the digit-symbol substitution test, and a tracking task. None of these was enhanced by ethanol. In both trials, brotizolam produced significant increases in self-rated perceptions of sedation, fatigue, feeling 'spaced-out', and thinking slowed down. These effects were more intense during the brotizolam-ethanol as compared to brotizolam placebo. In both trials, recovery was essentially complete by 6-8 h after dosage. Coadministration of brotizolam with ethanol produces a small but significant impairment of brotizolam clearance. Brotizolam produced self-rated perceptions of sedation and fatigue during 4-6 h after dosage, but objective impairment of psychomotor performance was minimal. Subjective perceptions of sedation were enhanced by ethanol coadministration, but the effects on psychomotor performance were not. PMID- 3954937 TI - Hypnotic activity of an imidazo-pyridine (zolpidem). AB - Effects of an imidazo-pyridine (zolpidem: 10, 20 and 30 mg) on overnight sleep and on performance the next day were studied in young adults and in middle aged individuals. The young adults were used particularly as an homogenous group to establish any possible adverse effects of the drug on sleep and on performance the next day, and the middle aged subjects with their less restful sleep were used to study efficacy. In the young adults zolpidem led to a marked increase in slow wave sleep with a reduction in stage 2 sleep. There were no significant changes in REM sleep, though there was a tendency for REM sleep to be delayed. In the middle aged there was a reduction in awake activity and drowsy sleep with an increase in stage 2 sleep. The latency to REM sleep was increased but the duration of REM sleep over the whole night was not reduced. Digit symbol substitution and a complex reaction time task were used to study performance, but there were no residual effects with zolpidem (9 h after ingestion). Zolpidem is likely to prove useful in the management of transient and short-term insomnia in healthy middle aged individuals when impaired performance the next day is to be avoided. PMID- 3954938 TI - Subclinical impairment of colour vision in patients receiving ethambutol. AB - Colour discrimination was assessed by means of the Farnsworth-Munsell 100-Hue test in 54 patients being treated for tuberculosis with ethambutol and 50 patients who were treated for tuberculosis by drugs other than ethambutol. The ethambutol group showed significantly more errors than controls along the deuteran axis. The sub-group of ethambutol treated patients who had been taking the drug for more than 2 months showed significantly more errors along the tritan axis. It is concluded that subclinical colour discrimination impairment is relatively common in patients receiving ethambutol and that a deuteran type of defect is an early and a tritan type of defect is a later manifestation of ethambutol toxicity. PMID- 3954939 TI - Intravenous adenosine in the treatment of supraventricular tachycardia: a dose ranging study and interaction with dipyridamole. AB - Increasing doses of adenosine were given by rapid intravenous bolus to seven patients with spontaneous supraventricular tachycardia. Adenosine restored sinus rhythm in 10 of 14 episodes of narrow complex tachycardia. In those patients in whom adenosine produced only transient ventricular slowing the underlying rhythm was atrial flutter. Transient dyspnoea occurred in all patients. In two patients taking dipyridamole the mean dose of adenosine which produced an electrophysiologic effect (restoration of sinus rhythm or ventricular slowing to under 100 beats min-1) was 1.0 +/- 0.52 mg, whereas in other patients the mean dose was 8.8 +/- 2.6 mg, suggesting potentiation of the action of adenosine by dipyridamole. PMID- 3954940 TI - Arbaprostil (15(R)-15-methyl PGE2): lack of effect on theophylline metabolism. PMID- 3954941 TI - The warfarin-cimetidine interaction: stereochemical considerations. PMID- 3954942 TI - Localisation of gastrointestinal cancer with a 131 I labelled monoclonal antibody to CEA. AB - The localisation of tumour deposits by a 131 I labelled monoclonal antibody to carcinoembryonic antigen (CEA) has been evaluated in 24 patients with primary gastric, oesophageal and colorectal cancer and in 26 patients with clinically suspected recurrent gastric and colorectal cancer. Seventeen of 20 primary sites and 6/15 associated secondary sites were correctly identified by external scanning. Measurement of radiolabelled antibody in the resected specimens demonstrated a 2.6-3.3 fold increase in comparison with the surrounding normal tissue (P less than 0.01). The antibody scans were compared with computerised tomography (CT) in the detection of recurrent disease. The respective sensitivities and specificities for the two investigations were 61% and 33% for antibody scanning and 64% and 100% for CT. Assessment of the distribution of labelled antibody demonstrated rapid clearance with less than 2% detectable in serum samples at 24 h. The implications of these findings together with the mechanisms of excretion are discussed. PMID- 3954943 TI - Quantitative cytospectrophotometric studies on protein thiols and reactive protein disulphides in samples of normal human uterine cervix and on samples obtained from patients with dysplasia or carcinoma-in-situ. AB - Quantitative microspectophotometric studies have been made on sections of human cervix after staining for reactive protein thiol-groups (PSHr), and the sum of protein thiols with so-called reactive protein disulphides (together abbreviated as TRPS). Measurements were made on normal epithelium, apparently normal epithelium adjacent to a pathological lesion, dysplastic epithelium, carcinoma-in situ, and adjoining stroma. The numbers of cases studied were: normal healthy controls (53); patients with dysplasias (34) and patients with carcinoma-in-situ (29). In the normal control sections the ratio of PSHr in epithelium:stroma was approximately 2.7 and this ratio was strongly decreased in dysplasias (1.6) and carcinoma-in-situ (1.5); the 3 populations of values had sufficient overlap to prevent this measurement being an effective discriminator. No significant variations were observed with TRPS-values except with changes in the stroma adjacent to apparently normal epithelium. However, the ratio of PSHr:TRPS was effectively discriminatory when this double-staining ratio was calculated for epithelial values:stromal values. These results are discussed in relation to the importance of thiol-groups in cell division and cancer, and the biological implications of similar changes observed in neighbouring apparently normal epithelium. PMID- 3954944 TI - The relation of ras family oncogene expression to conventional staging criteria and clinical outcome in colorectal carcinoma. AB - The elevated levels of ras-related cellular RNA in a series of colorectal carcinomata (n = 12) was correlated with conventional staging criteria (tumour morphology and Dukes' staging) and with clinical outcome with particular reference to the development of metastatic disease. No direct relationship was evident between these parameters suggesting that although abnormal expression of ras oncogenes may be critical in the development of malignancy, variations in the level of their expression do not appear to be directly related to clinically evident phenotypic differences. PMID- 3954946 TI - Abortion before first livebirth and risk of breast cancer. AB - The present study examined the association between abortion prior to a first livebirth and breast cancer risk among a cohort of 3,315 women who had been delivered of liveborn children between 1946 and 1965 in a group of private gynaecology practices in Connecticut and followed through 1980 for the incidence of cancer. Among women with one livebirth at the time of cohort identification, a spontaneous abortion before this livebirth was associated with a 3.5-fold increase in the risk of breast cancer. The elevation in risk was independent of some of the major risk factors of breast cancer and became more pronounced as the number of years since the abortion increased. PMID- 3954945 TI - Emergence of nitrosourea resistant sublines of Lewis lung tumour following MeCCNU treatment in vivo. AB - Several different drug retreatment protocols were employed to examine the emergence of resistance to MeCCNU in Lewis lung tumours. Previous studies suggested that although the majority of cells in untreated Lewis lung tumours were sensitive to MeCCNU, there was a very small proportion of resistant cells (approximately 0.001%) that limited "tumour cure' with that drug. If such cells were inherently drug resistant then it should be possible to derive highly resistant tumours by repeated drug treatment. In the first experiment tumours were treated with a single high dose of MeCCNU (35 or 40 mgkg-1) and on regrowth, transplanted into fresh mice and tested for drug sensitivity. Using both excision cell survival and growth delay endpoints, only approximately 25% of tumours were significantly resistant to the test dose, suggesting that many tumours resist the effects of the drug for reasons other than the presence of inherently drug resistant cells. One of the tumours (R4), that regrew after the initial treatment and appeared to be resistant to the test treatment, was retreated with a further 30 mgkg-1 MeCCNU and became more resistant. This line, designated R4/1, was cross resistant to the other nitrosoureas, BCNU and CCNU, but not to cyclophosphamide, melphalan, cis-platinum or ionising radiation. The effect of treatment dose on the kinetics of MeCCNU resistance development was also studied in a retreatment regimen where the tumours were allowed to regrow and then transplanted into fresh hosts for the next treatment. Resistance developed more quickly at an intermediate dose of 15 mgkg-1 than at 7.5 mgkg-1 where the selective pressure was lower, or at 30 mgkg-1 where there was probably extinction of partially resistant cells. Resistance to MeCCNU developed even more quickly when tumours were retreated several times in the same host, although in a similar experiment with cyclophosphamide no resistance occurred. PMID- 3954948 TI - On the monoclonality of tumours. PMID- 3954949 TI - The stability and classification of specific reading retardation: a longitudinal study from age 7 to 11. PMID- 3954947 TI - Pre-existing anti-mouse immunoglobulin in a patient receiving 131I-murine monoclonal antibody for radioimmunolocalisation. PMID- 3954950 TI - The effects of an aromatic retinoid (etretinate) on epidermal cell production and metabolism in normal and ichthyotic patients. AB - Normal subjects and ichthyotic patients were biopsied before and after etretinate (Tigason) therapy. Histometric and cell kinetic measurements showed minimal changes following treatment. The metabolic activity across the epidermis was measured by a novel approach using the Quantimet 720 image analyser, and was significantly increased in the normal subjects as demonstrated by glucose-6 phosphate dehydrogenase (G6PDH), succinic dehydrogenase (SDH) and non-specific esterase (NSE) activities. In the ichthyotics studied the levels of G6PDH and SDH activity were significantly lowered following etretinate therapy, to levels similar to those demonstrated in normal subjects. In contrast, the activity of NSE was increased in the ichthyotics after etretinate therapy. It is suggested that the effect of retinoids is to 'normalize' the process of epidermal differentiation when it is abnormal. PMID- 3954951 TI - Cold urticaria and virus infections: a clinical and serological study in 39 patients. AB - Thirty-nine patients with cold urticaria seen over a 12-year-period were re examined. All but 12 still had positive skin tests for cold and only five of these had shown a spontaneous cure. Fourteen patients were prone to collapse on cold exposure. The incidence of atopy in this group was comparable to that in control groups. Cold urticaria is an extremely chronic disease. The mean disease duration was 9.3 years. Serum antibodies to Epstein-Barr virus, measles virus, cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), Chlamydia psittaci and Mycoplasma pneumoniae were determined in all 39 patients and compared with control groups. The EBV-antibody patterns (heterophile antibodies and different types of EBV-specific antibodies) showed no evidence of current or of recent primary or secondary infection with EBV. Complement fixing antibody titres to measles virus, CMV, HSV and Mycoplasma pneumoniae were significantly higher in cold urticaria patients than in controls. The existence of a basic immuno-regulatory defect responsible for both the cold urticaria and the elevated antibody levels is proposed. PMID- 3954952 TI - Photoageing: the role of UVB, solar-simulated UVB, visible and psoralen UVA radiation. AB - We have studied the morphological and histological effects of chronic exposure of two strains of haired mice (albino Balb/c and pigmented C3H-) to various types of radiation. UVB (280-320 nm) radiation from unfiltered sunlamp bulbs for 20 and 30 weeks produced marked epidermal acanthosis and dyskeratosis which was reversible in mice exposed for 20 weeks followed by a 20-week rest. In the dermis the elastic fibres were altered and in the pigmented mice these changes had almost completely reversed 29 weeks after cessation of exposure. Cellulose acetate filtered sunlamp bulbs (greater than 289 nm) produced similar but less marked changes. Chronic exposure to UVA (320-400 nm) radiation produced minimal alterations in the dermis while the epidermis was normal. Visible (greater than 400 nm) radiation in large doses produced no degenerative changes. Methoxsalen/UVA radiation produced epidermal acanthosis, dermal sclerosis, and alteration of elastic fibres, which was prominent in both strains at 40 weeks. These findings suggest that the UVB component of sunlight is largely responsible for photoageing of the skin. Furthermore, chronic exposure to methoxsalen/UVA therapy is likely to potentiate solar-induced photoageing. PMID- 3954953 TI - Light and scanning electron microscopic studies on wrinkles in aged persons' skin. AB - Wrinkles in six aged persons (67-82 years of age) have been investigated by light microscopy (LM) and scanning electron microscopy (SEM). There are two types of wrinkles. One is a deep wrinkle which develops on the sun-exposed skin and does not disappear on stretching (permanent wrinkle). The LM and SEM showed less elastotic change in the upper dermis in the area of wrinkle than in that of the surroundings. The other type is a shallow wrinkle which develops on sun-protected skin and disappears on stretching (temporary wrinkle). The LM and SEM showed the decrease or loss of the elastic fibres in the papillary dermis as seen in ageing skin. PMID- 3954954 TI - Alopecia areata: alterations in the hair growth cycle and correlation with the follicular pathology. AB - A histopathological study was performed in 17 patients with alopecia areata to elucidate the changes in hair cycle dynamics. The findings confirm the view that the initial event in alopecia areata is the premature entry of anagen follicles into telogen, although some follicles survive for a time in a dystrophic anagen state. However, after re-entry into anagen takes place, growth appears to be halted in anagen III rather than anagen IV, as has previously been suggested. Follicles then return prematurely to telogen and these truncated cycles are repeated until the disease activity subsides. A new pathogenic hypothesis is presented which relates alterations in hair cycle dynamics to pathological changes within the anagen follicle and also provides an explanation for the formation of exclamation mark hairs and the non-destructive nature of the disease. PMID- 3954955 TI - Pachyonychia congenita Jackson-Lawler type: a distinct malformation syndrome. AB - A family with three members in two generations affected by pachyonychia congenita, hyperkeratosis and hyperhidrosis of the palms and soles, follicular keratosis, neonatal teeth and epidermoid cysts (Jackson-Lawler syndrome) is described. The nosological autonomy of this condition is proposed and a further heterogeneity is suggested on the basis of histopathological changes in the subcutaneous cysts. PMID- 3954956 TI - Bone dependent nail formation. AB - Two sporadic cases with congenital anonychia and hypoplastic nails combined with ectrophalangia or hypoplastic phalanges are reported. It is suggested that congenital anonychia and hyponychia may be 'bone territory' dependent disorders. PMID- 3954957 TI - The development of lichen sclerosus et atrophicus in monozygotic twin girls. AB - The development of vulval lichen sclerosus et atrophicus in monozygotic twins is described. This is the first report of the occurrence of lichen sclerosus et atrophicus in two genetically identical individuals, and is considered to provide further evidence that inherited factors are of relevance in the aetiology of this disorder. PMID- 3954958 TI - Collagen and elastin changes in D-penicillamine-induced pseudoxanthoma elasticum like skin. AB - A patient with cystinuria who was treated with large doses of D-penicillamine for 19 years developed skin abnormalities resembling those seen in pseudoxanthoma elasticum. Biochemical and histological examination of the dermis showed that the collagen content, the ratio of the major genetic forms of collagen and the distribution of collagen types was normal. Light microscopy demonstrated the presence of vastly increased amounts of elastin in the dermis, and the individual elastin fibres were shown by electron microscopy to be abnormal; chemical analysis showed the elastin to be poorly cross-linked. Some of the collagen also appeared structurally abnormal, and biochemically resembled that seen in the dermis of a young child with respect to cross-linking and hexosyl-lysine content. The therapy led to an increased deposition of collagen and elastin fibres which appeared abnormal, and resulted in an increase in total skin surface area. These data indicate that D-penicillamine was not fully effective in inhibiting collagen and elastin cross-linking, and appeared to prevent or inhibit the natural maturation process of the collagen. PMID- 3954959 TI - Atypical malignant melanoma of the nail apparatus. AB - Malignant melanoma of the nail is a serious disease with a five year survival rate of between 21% (Booher & Pack, 1957) and 50% (Graham, 1973). The diagnosis of atypical cases ultimately depends on interpreting histological material. We report here a case in which two initial biopsies of the affected nail failed to show malignant melanoma. The diagnosis was eventually made by formal longitudinal nail biopsy including matrix tissue proximal to the dystrophic area, and examination of sections cut at several levels. PMID- 3954960 TI - Neutrophilic urticaria. PMID- 3954961 TI - Erythema nodosum associated with invasive amoebiasis and giardiasis. PMID- 3954962 TI - Lichen aureus. PMID- 3954963 TI - Longitudinal melanonychia during photochemotherapy. PMID- 3954964 TI - An identical translocation between chromosome 1 and 15 in two patients with myelodysplastic syndromes. AB - An identical translocation between the long arm of chromosome no. 1 and the short arm of chromosome no. 15 was found in two unrelated patients with refractory anaemia type I, according to the FAB classification of myelodysplastic syndromes. In the first patient the typical translocation was associated with anomalies commonly found in preleukaemic states, i.e. a 5q- and a 20q- chromosome. Furthermore, in both patients the long arm of chromosome no. 1 was trisomic. Cytogenetic follow-up in the second patient demonstrated a proliferative advantage of the cells bearing a t(1;15) translocation over the cells with trisomy 8 as well as over normal cells. This karyotypic evolution, however, was not accompanied by a transformation of the haematological disorder into acute leukaemia. PMID- 3954965 TI - Intracellular forms of iron during transferrin iron uptake by mitogen-stimulated human lymphocytes. AB - Transferrin receptors expressed by mitogen stimulated human lymphocytes mediate the uptake of transferrin iron into haem, ferritin and a non-haem, non-ferritin component. In spite of different rates of iron uptake by cells from different individuals, the proportional incorporation of 59Fe into these components was similar, suggesting that there was an obligatory relationship between the different forms of iron in the cells. By 3 h over 60% of the iron taken up was incorporated into ferritin while less than 10% was found in haem. Initially (10 min) non-haem, non-ferritin iron comprised 70% of total iron and this diminished to 30% by 3 h. At 10 min 80% of iron in the non-haem, non-ferritin component was retained by anti-transferrin affinity columns indicating it was transferrin bound. The proportion retained fell to reach a steady state level of 50% by 60 min. These results indicate that 10-20% of the iron in the cells was not recognized as transferrin, ferritin or haem iron. The finding that iron incorporation into this unidentified pool reached equilibrium while that into haem and ferritin increased suggests the iron may act as a precursor for functional and storage compounds. PMID- 3954966 TI - Complete remission in plasma cell leukaemia. AB - Two patients with primary plasma cell leukaemia who achieved complete remission are reported. They were treated with induction therapy consisting of a multipeptide derivative of sarcolysin, Peptichemio, given intravenously, combined with vincristine and/or prednisone, followed by conventional melphalan-prednisone therapy. 5-7 months following the beginning of therapy, both patients attained a complete remission which lasted 23 and 6 months; second remission was not achieved. Survival from starting therapy was 57 and 16 months respectively. These cases indicate that intravenous alkylating agents can induce a complete remission in plasma cell leukaemia similar to that achieved in other acute leukaemias. PMID- 3954968 TI - Lymphocyte doubling time in chronic lymphocytic leukaemia: analysis of its prognostic significance. AB - In 100 untreated patients with chronic lymphocytic leukaemia (CLL) lymphocyte doubling time (LDT) has been investigated in relationship with clinical stages, bone marrow histological patterns, treatment-free period and survival. Although partially correlated with clinical stages and bone marrow patterns, LDT has a clear prognostic significance by itself: whereas a LDT of 12 or less months identifies a population of patients with poor prognosis, a LDT higher than 12 months is indicative of good prognosis as substantiated by a long treatment-free period and survival. This simple parameter can be useful in the clinical management of CLL patients. PMID- 3954967 TI - Use of leucocyte-poor blood components and HLA-matched-platelet donors to prevent HLA alloimmunization. AB - Recent studies have shown that the incidence of alloimmunization due to repeated platelet transfusions from random donors may be reduced by the use of leucocyte poor blood components. These results were confirmed by this study, where 16% of patients with acute leukaemia undergoing initial chemotherapy and receiving leucocyte-poor blood components developed lymphocytotoxic antibodies, compared with 48% of patients in a control group receiving standard (non-leucocyte depleted) blood components. In a third group, who received leucocyte-poor blood components and HLA-matched platelets, none of the patients developed lymphocytotoxic antibodies. There was a low incidence of platelet-specific antibodies (8%) but no difference between the three groups. Improved methods of removing leucocytes from blood components appear to offer the best approach for minimizing HLA alloimmunization, as the provision of HLA-matched platelet donors for prophylactic platelet support of all patients is not feasible. PMID- 3954970 TI - Increased vascularity of bone marrow in myelofibrosis. PMID- 3954971 TI - Increased ratio of granulocyte/macrophage progenitor cells (CFU-GM) to multilineage progenitor cells (CFU-mix) in the peripheral blood from patients acute non-lymphoblastic leukaemia in very early remission. PMID- 3954969 TI - Blood cell phosphogluconolactonase: assay and properties. AB - 6-Phosphogluconolactonase (6-PGL) catalyses the second reaction of the hexosemonophosphate pathway. Although the delta-lactone of 6-phosphogluconic acid is the natural substrate for this enzyme, the more stable gamma-lactone may also be used. We prepared the gamma-lactone of 6-phosphogluconic acid from 6 phosphogluconate. When stored in dimethylsulfoxide, this material was found to be stable in liquid nitrogen for several months. A method for measuring 6 phosphogluconolactonase (6-PGL) using the gamma-lactone as substrate has been developed, after defining conditions under which spontaneous hydrolysis of the lactone is relatively slow and the enzymatic velocity is relatively rapid. The enzyme had no divalent cation requirement and was not significantly inhibited by a 50-fold excess of gluconolactone. It was distinct, therefore, from gluconolactonase. At 25 degrees C normal human red cells were found to contain approximately 50 IU of 6-phosphogluconolactonase/g Hb. The activity of the enzyme was independent of red cell age. Based on protein content, human lymphocytes, monocytes, granulocytes and platelets, contained approximately 10 times the activity of red blood cells. The activity of 6-PGL was stable for at least 6 d in red cells stored at 22 degrees C and for at least 20 d in red cells stored at 4 degrees C. PMID- 3954972 TI - The peripheral blood CFU-mix:CFU-GM ratio during very early remission from acute non-lymphoblastic leukaemia. PMID- 3954973 TI - Oral vitamin E supplements can prevent the retinopathy of abetalipoproteinaemia. AB - Six patients with abetalipoproteinaemia are described who received large doses of oral vitamin E for between 12 and 18 years in addition to a low fat diet and supplements of the other fat soluble vitamins. The progressive retinopathy observed in untreated abetalipoproteinaemia was substantially modified and most probably prevented by this therapy. Angioid streaks were noted in one patient. Treatment with vitamin A alone did not prevent or arrest the progression of the retinal lesion. PMID- 3954974 TI - Orbital cellulitis. AB - Forty-nine cases of orbital cellulitis were reviewed. The average age of patients at presentation was 31 years. The onset of symptoms varied from seven days or less in 28 patients, one to four weeks in 17 patients, and more than four weeks in four patients. The leucocyte count, available in 33 patients, was greater than 10 X 10(9)/l in only nine. Abnormal sinuses were noted radiographically in 61%. Computed tomography scans, performed on nine patients, revealed non-localised inflammation in three and an orbital mass in six. Cultures, in general, were disappointing. Seventeen surgical procedures were performed on 14 patients. The complications of orbital cellulitis, occurring in five patients, included osteomyelitis of the maxillary bone, strabismus, afferent pupillary defect, chronic draining sinus, and scarred upper eyelid. Usually the treatment of orbital cellulitis requires aggressive parenteral antibiotic therapy and judicious surgical intervention. PMID- 3954975 TI - Hydrogel keratophakia: a freehand pocket dissection in the monkey model. AB - High water content hydrogels can be made with water and solute permeabilities comparable to those of the corneal stroma, thus making them feasible as intrastromal implants for refractive keratoplasty. The materials have been shown to be compatible with the cornea tissue, but for a lenticule of hydrogel to be effective in a refractive keratoplasty procedure it must alter the anterior curvature of the cornea. In this investigation hydrogel lenticules were implanted by a free-hand pocket dissection in eight Macaca mulatta (rhesus) and two Macaca nemestrina (pigtail) primate eyes. The results of pre- and postoperative keratometry and subjective retinoscopy as well as biomicroscopy were recorded. The alteration in refractive power was calculated in relation to the hydrogel lenticule parameters such as base curve, refractive index, etc. The corneal refractive change had a yield of +3 +/- 27% (+/- SD). The central keratometric change had a yield of +6 +/- 16%. The hydrogel plus power lenticule implanted in a free-hand intrastromal pocket created no significant steepening of the anterior cornea surface and therefore little change in refraction. PMID- 3954976 TI - Hydrogel keratophakia: a microkeratome dissection in the monkey model. AB - High water content intracorneal implants were fabricated from Vistamarc hydrogel (Vistakon, Inc.) at 58%, 68%, and 72% water content and a range of powers from +7.25 to +17.00 dioptres. The Barraquer microkeratome technique was used to implant the lens at 59.0 +/- 9% (+/- SD) depth in the corneas of 14 rhesus monkey eyes. The contralateral eye served as a control. Three eyes were lost to the study because of complications. The remaining 11 animals were followed up for 51 +/- 2 weeks with the refractive yield being 118 +/- 34% and the keratometric yield being 92 +/- 30%. The measured and theoretically expected refractive changes have a linear regression line correlation coefficient of 0.74, whereas the respective keratometric data had a correlation coefficient of 0.04. The measured refraction became stable within 2 to 3 dioptres after 20 postoperative weeks. The hydrogels were well tolerated within the corneal tissue. There was a minimum of interface problems except along the edge of the implant. Implants with abruptly cut edges versus a fine wedge tended to have more light scattering collagen at the implant margin. PMID- 3954977 TI - Oxybuprocaine keratopathy: a preventable disease. AB - Topically applied anaesthetics may lead to a serious keratopathy. Three patients presented to us with disciform keratitis, peripheral corneal ring, and stromal infiltration following the topical use of oxybuprocaine. All three patients developed marked decrease in vision secondary to corneal scarring. In all three patients oxybuprocaine was dispensed over the counter by a pharmacist. Legislation for the restriction of over-the-counter sale of topical anaesthetics, steroids, and antibiotics is essential in the prevention of many of the self induced ocular disorders seen in developing countries. PMID- 3954978 TI - Slit-lamp measurement of the anterior chamber depth. AB - A technique is proposed which allows assessment of the anterior chamber depth with a standard table slit-lamp without any extra attachments. A final approximation is made which suggests that a 1 degree change in the angle between the observation and illumination systems of the slit lamp when the end point is reached indicates a change in anterior chamber depth of 0.1 mm. PMID- 3954979 TI - Macular dazzling test on normal subjects. AB - The macular dazzling test was performed on 240 healthy eyes, classified into six groups according to the ages of the subjects. The test was used to assess both long distance and short distance vision with a simultaneous study of the influence of mydriasis and miosis. The MDT is a test easy to perform, requires a minimum of co-operation by the subject, and gives repeatable results. The MDT values increase significantly as the age of the subject increases. The sex of the subject has no influence on it, and there are no significant differences between a subject's right and left eyes. Mydriasis does not affect the MDT, but miosis reduces the recovery period. All the values are statistically greater for long distance vision than for short distance vision. PMID- 3954980 TI - Effects on perceptual development of visual deprivation during infancy. AB - We measured three aspects of vision in children treated for unilateral congenital cataract: visual resolution, the symmetry of optokinetic nystagmus (OKN), and peripheral vision. Good visual resolution was achieved by children who had had the earliest treatment and who had had the normal eye patched close to 50% of the waking time throughout early childhood. All children treated for unilateral congenital cataract showed a marked asymmetry of OKN regardless of the age of treatment. One child with early treatment who could be tested with the Goldmann perimeter also showed especially poor sensitivity in the nasal visual field of her aphakic eye. We found no such deficits in the vision of children who had had normal visual experience during early infancy and then later developed cataracts in one or both eyes. The limitations observed in children treated for congenital cataract are similar to those reported in normal human infants, in normal kittens, and in cats which were visually deprived early in life. PMID- 3954981 TI - Critical evaluation of the NR-1000F Auto Refractometer. AB - The manifest (dry) refractions of 165 eyes of 86 patients, aged 6 to 75 years, were studied on the Nikon Auto Refractometer NR-1000F. The results obtained were compared with the clinical refractive data, and they were analysed for degree of agreement of various refractive components in different types and grades of refractive errors in the separate age groups. On the NR-1000F the spherical and cylindrical components and spherical equivalents skewed towards more minus (or less plus), especially so in emmetropes, low hypermetropes, and low myopes. This error declined with increasing age over 40 years and was also significantly lower in aphakia and mixed astigmatism. Determination of cylinder axis was found to be reliable on the NR-1000F. In spite of the obvious utility of the device its inbuilt automatic fogging system does not seem adequately to neutralise the patient's accommodative efforts, as the fixation target probably induces instrument myopia. PMID- 3954982 TI - Subconjunctival emphysema due to trauma by compressed air tube. PMID- 3954983 TI - Morning glory syndrome: clinical and electrofunctional study of three cases. AB - Three cases of morning glory syndrome are described and some new electrofunctional and tomodensitometric findings are reported. The amplitude of the waves of the electroretinogram is reduced and correlates with the extension of the retinal changes. The visually evoked potentials elicited with bright flashes have normal latencies but generally subnormal amplitudes. The amplitude of the potentials probably depends on the degree of involvement of the optic nerve. The computerised tomography performed in one patient disclosed undescribed changes in the retrobulbar optic nerve. PMID- 3954984 TI - Measurement of an individual rate constant in the presence of multiple exchanges: application to myocardial creatine kinase reaction. AB - Forward [creatine phosphate (CP)----adenosine 5'-triphosphate (ATP)] and reverse (ATP----CP) fluxes of myocardial creatine kinase (CK) measured by using 31P nuclear magnetic resonance (NMR) and conventional saturation transfer (CST) methods are unequal; this is a paradoxical result because during steady state fluxes into and out of the CP pool must be the same. These measurements, however, treat the CK reaction as a two-site exchange problem and ignore the presence of the ATP gamma in equilibrium Pi exchange involving the ATPases. We have applied a method [Ugurbil, K. (1985) J. Magn. Reson. 64, 207] based on the saturation of multiple resonances, by which a single unidirectional rate constant can be measured unequivocally in the presence of multiple exchanges, to the measurement of CK fluxes in isovolumic rat hearts perfused under three different conditions; two of the three perfusion conditions showed a large discrepancy in the CK fluxes determined by CST, and one did not. In contrast, when the effect of the ATP gamma in equilibrium Pi exchange on the CK rate measurements was eliminated, multiple saturation transfer (MST) measurements on the same hearts yielded equal forward and reverse fluxes in all cases. The rate constant for the ATP gamma----CP conversion measured by MST was larger than the value obtained by the conventional methodology whereas both methods gave the same rate constant in the CP----ATP direction. These results demonstrate that the cause of the paradoxical data obtained by CST measurements of CK kinetics is the ATP gamma in equilibrium Pi exchange and that CK rates when determined rigorously are consistent with the CK reaction being in equilibrium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954985 TI - Active streptokinase from the cloned gene in Streptococcus sanguis is without the carboxyl-terminal 32 residues. AB - The streptokinase expressed by the cloned gene in Streptococcus sanguis has a molecular weight of about 44 000 [Malke, H., Gerlach, D., Kohler, W., & Ferretti, J.J. (1984) MGG, Mol. Gen. Genet. 196, 360-365] while the molecular weight of the native streptokinase is 47 000. The structural and activity differences of the cloned streptokinase (cSK) as expressed by S. sanguis and the native streptokinase (nSK) were investigated. From a partially purified cSK, two active fractions were obtained by reversed-phase HPLC. The minor fraction cSKL was nearly as active as SK in plasminogen activation. The major fraction cSKs had only about one-fourth of the specific activity. The structures of cSKL and cSKs were studied and compared to the known amino acid sequence of SK [Jackson, K. W., & Tang, J. (1982) Biochemistry 21, 6620-6625]. From the NH2- and COOH-terminal sequences and amino acid composition of the cyanogen bromide (CNBr) fragments, it could be deduced that cSKL and cSKs are without 31 and 32 residues, respectively, from the COOH-terminal end of SK. Since the cloned gene contained the full SK structure, the missing structures must have been due to posttranslational proteolysis. An SK fragment similar in size to cSK was observed from a chymotryptic digest of SK. PMID- 3954986 TI - Fractional diffusion-limited component of reactions catalyzed by acetylcholinesterase. AB - The values of kcat/Km for the reactions of four substrates, p-nitrophenyl acetate (PNPA), propionyl-beta-methylthiocholine (PrMSCh), 3,3-dimethylbutyl thioacetate (DBTA), and acetylthiocholine (AcSCh), with acetylcholinesterase were determined as a function of increasing viscosity (eta rel) in sucrose-containing and in glycerol-containing buffers. Glycerol, or possibly some contaminant of it, was found to be a nonspecific inhibitor and sucrose a nonspecific activator of the enzyme as reflected in the dependence of kcat/Km values measured for PNPA and PrMSCh upon the concentration of these reagents. The rates of reactions of these two substrates, the first neutral and the second cationic, are chemically limited rather than diffusion limited, and they thus serve as quantitative controls or internal standards to monitor the effects of the viscosogens on the enzyme, which are not related to diffusion. The additional effect on kcat/Km over the controls observed for the rapidly reacting substrates AcSCh (cationic) and DBTA (neutral) serves as a measure of the extent to which these values of kcat/Km measure diffusion-controlled processes. The reaction rate of DBTA with the enzyme is 24% diffusion controlled as measured in glycerol-containing buffers and 16-20% as determined in sucrose-containing buffers, while that for AcSCh is 100% (in glycerol) and 24-40% (in sucrose) diffusion controlled. PMID- 3954987 TI - Evidence for nystatin micelles in L-cell membranes from fluorescence photobleaching measurements of diffusion. AB - Diffusion of a nitrobenzoxadiazole derivative of the polyene antibiotic nystatin in the membranes of L cells is found to depend on the concentration of nystatin in the membrane. Its diffusion coefficient measured by fluorescence photobleaching decreases hyperbolically as the concentration of nystatin is increased. This behavior is reproduced when the concentration of the derivative is increased. In contrast, diffusion of a nitrobenzoxadiazole derivative of a phospholipid is insensitive to the nystatin concentration under these conditions. The nystatin-specific diffusion changes can be understood if nystatin exists in a monomer-micelle equilibrium within the membrane but cannot be accounted for by binding or phase partitioning. PMID- 3954988 TI - Bacteriophage P22 Cro protein: sequence, purification, and properties. AB - The DNA sequence of part of the bacteriophage P22 early regulatory region, including genes cro and c1, was determined. The protein product of the cro gene consists of 61 amino acid residues, and that of c1, 92 amino acid residues. Both genes were placed separately in plasmids from which they are expressed from a controllable promoter in vivo. Induced cells bearing the cro-expressing plasmid were used as a source for purifying and characterizing the Cro protein. The amino terminal sequence of this protein was found to be as predicted by the DNA sequence; close agreement was also observed between its predicted and experimentally determined amino acid composition and molar extinction coefficient at 280 nm. In gel filtration experiments, Cro protein at concentrations around 10(-5) M appears to have a molecular weight of 8600, which is more consistent with monomers (6800) than with dimers (13 600). Cro protein binds specifically to the three repressor binding sites in the P22 right operator; in order of decreasing affinity, these are OR3, OR1, and OR2. PMID- 3954989 TI - Fusion of influenza virus with cardiolipin liposomes at low pH: mass action analysis of kinetics and extent. AB - The kinetics and extent of low pH induced fusion between influenza virus and large unilamellar cardiolipin liposomes were investigated with an assay for lipid mixing based on fluorescence resonance energy transfer. The results were analyzed in terms of a mass action kinetic model, which views the overall fusion reaction as a sequence of a second-order process of virus-liposome adhesion or aggregation followed by the first-order fusion reaction itself. The fluorescence development during the course of the fusion process was calculated by numerical integration, employing separate rate constants for the initial aggregation step and for the subsequent fusion reaction. Analytical solutions were found for several limiting cases. Deaggregation of virus--liposome aggregates was explicitly taken into account but was found to be a minor effect under the conditions studied. The calculations gave good simulations and predictions for the kinetics and extent of fusion at different virus/liposome concentrations and ratios. At pH 5.0 and 37 degrees C, very high rate constants for aggregation and fusion were obtained, and essentially all of the virus particles were involved in the fusion process. Experiments at different virus/liposome ratios showed that fusion products may consist of a single virus particle and several liposomes but not of a single liposome and several virus particles. At pH 6.0, the rate constant for aggregation was the same as at pH 5.0, but the rate constant of fusion was about 5-fold lower, and only 25-40% of the virus particles were capable of fusing with the liposomes. The analytical procedure presented enables elucidation of the crucial role of the composition of target membrane vesicles in the initial adhesion and subsequent fusion of the virus at various pH values. PMID- 3954990 TI - Purification and characterization of two new high molecular weight forms of DNA polymerase delta. AB - Two high molecular weight DNA polymerases, which we have designated delta I and delta II, have been purified from calf thymus tissue. Using Bio Rex-70, DEAE Sephadex A-25, and DNA affinity resin chromatography followed by sucrose gradient sedimentation, we purified DNA polymerase delta I 1400-fold to a specific activity of 10 000 nmol of nucleotide incorporated h-1 mg-1, and DNA polymerase delta II was purified 4100-fold to a final specific activity of 30 000 nmol of nucleotide incorporated h-1 mg-1. The native molecular weights of DNA polymerase delta I and DNA polymerase delta II are 240 000 and 290 000, respectively. Both enzymes have similarities to other purified delta-polymerases previously reported in their ability to degrade single-stranded DNA in a 3' to 5' direction, affinity for an AMP-hexane-agarose matrix, high activity on poly(dA) X oligo(dT) template, and relative resistance to the polymerase alpha inhibitors N2-(p-n butylphenyl)dATP and N2-(p-n-butylphenyl)dGTP. These two forms of DNA polymerase delta also share several common features with alpha-type DNA polymerases. Both calf DNA polymerase delta I and DNA polymerase delta II are similar to calf DNA polymerase alpha in molecular weight, are inhibited by the alpha-polymerase inhibitors N-ethylmaleimide and aphidicolin, contain an active DNA-dependent RNA polymerase or primase activity, display a similar extent of processive DNA synthesis, and are stimulated by millimolar concentrations of ATP. We propose that calf DNA polymerase delta I, which also has a template specificity essentially identical with that of calf DNA polymerase alpha, could be an exonuclease-containing form of a DNA replicative enzyme. PMID- 3954991 TI - Raman spectra of single crystals of r(GCG)d(CGC) and d(CCCCGGGG) as models for A DNA, their structure transitions in aqueous solution, and comparison with double helical poly(dG).poly(dC). AB - The self-complementary oligonucleotides [r(CGC)d(CGC)]2 and [d(CCCCGGGG)]2 in single-crystal and solution forms have been investigated by Raman spectroscopy. Comparison of the Raman spectra with results of single-crystal X-ray diffraction and with data from polynucleotides permits the identification of a number of Raman frequencies diagnostic of the A-helix structure for GC sequences. The guanine ring frequency characteristic of C3'-endo pucker and anti base orientation is assigned at 668 +/- 2 cm-1 for both dG and rG residues of the DNA/RNA hybrid [r(GCG)d(CGC)]2. The A-helix backbone of crystalline [r(GCG)d(CGC)]2 is altered slightly in the aqueous structure, consistent with the conversion of at least two residues to the C2'-endo/anti conformation. For crystalline [d(CCCCGGGG)]2, the Raman and X-ray data indicate nucleosides of alternating 2'-endo-3'-endo pucker sandwiched between terminal and penultimate pairs of C3'-endo pucker. The A-A-B-A-B-A-A-A backbone of the crystalline octamer is converted completely to a B-DNA fragment in aqueous solution with Raman markers characteristic of C2'-endo/anti-G (682 +/- 2) and the B backbone (826 +/- 2 cm-1). In the case of poly(dG).poly(dC), considerable structural variability is detected. A 4% solution of the duplex is largely A DNA, but a 2% solution is predominantly B DNA. On the other hand, an oriented fiber drawn at 75% relative humidity reveals Raman markers characteristic of both A DNA and a modified B DNA, not unlike the [d-(CCCCGGGG)]2 crystal. A comparison of Raman and CD spectra of the aqueous [d(CCCCGGGG)]2 and poly(dG).poly(dC) structures suggests the need for caution in the interpretation of CD data from G clusters in DNA. PMID- 3954992 TI - Hydrogen-1 nuclear magnetic resonance investigation of Clostridium pasteurianum rubredoxin: previously unobserved signals. AB - Previously unobserved signals were located in the 470-MHz 1H NMR spectra of oxidized and reduced rubredoxin (Rd) from Clostridium pasteurianum. When the protein was oxidized, some of the resonances broadened beyond detection. Longitudinal relaxation (T1) measurements identified a number of these peaks as arising from residues close to the paramagnetic iron; these resonances exhibited short T1 values attributable to the dominant electron-nuclear dipolar relaxation mechanism. The chemical shifts of these peaks were not strongly dependent on the oxidation state of the protein, although relative ratios of line widths of several peaks in the spectra of oxidized and reduced Rd suggested localized conformational changes of the protein as a result of oxidation. Furthermore, spectra of the oxidized protein collected in the range 8-60 degrees C revealed no appreciable changes in the chemical shifts of these peaks with temperature. These results seem to point out a negligible dipolar contribution, due to either magnetic anisotropy or zero field splitting, to the observed shifts in the spectrum of oxidized Rd. Resonances were assigned to tyrosine-11 or phenylalanine 49 (but not to either specifically) on the basis of their T1 values and the X-ray diffraction data of the protein molecule [Watenpaugh, K. D., Sieker, L. C., Herriott, J. R., & Jensen, L. H. (1973) Acta Crystallogr., Sect. B: Struct. Crystallogr. Cryst. Chem. B29, 943-956; and a further refinement deposited with the Protein Data Bank]. An upfield-shifted peak at about -1.1 ppm in the spectra of both oxidized and reduced Rd was assigned to a methyl group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954993 TI - Resolution of highly purified toxic-shock syndrome toxin 1 into two distinct proteins by isoelectric focusing. AB - Highly purified toxic-shock syndrome toxin 1 (TSST-1) was prepared by differential precipitation with ethanol and resolubilization in water followed by successive electrofocusing in pH gradients of 3-10, 6-8, and 6.5-7.5. TSST-1, thus isolated, migrated as two distinct protein bands with isoelectric points of 7.08 (TSST-1a) and 7.22 (TSST-1b). When tested by sodium dodecyl sulfate polyacrylamide gel electrophoresis, both toxins migrated as homogeneous bands with molecular weights of 22 000. The gel bands were visualized by silver staining. The two toxins have nearly identical amino acid compositions and are immunologically identical as shown by Ouchterlony reactivity against TSST-1 hyperimmune serum. TSST-1a and TSST-1b have the same biological activities as TSST-1: the capacity to induce fever, enhancement of host susceptibility to lethal endotoxin shock, nonspecific T lymphocyte mitogenicity, and suppression of immunoglobulin M synthesis against sheep erythrocytes. These two proteins have been isolated from several different TSS-associated Staphylococcus aureus strains. The data suggest that the differences in isoelectric point result either from the presence of a cofactor or from alternative conformations. Since only two bands appear, microheterogeneity as a result of deamination or acetylation is unlikely. PMID- 3954994 TI - Hydrogen-1 nuclear magnetic resonance investigation of high-potential iron-sulfur proteins from Ectothiorhodospira halophila and Ectothiorhodospira vacuolata: a comparative study of hyperfine-shifted resonances. AB - Proton NMR spectra of the oxidized and reduced forms of high-potential iron sulfur proteins (HiPIPs) were recorded at 200 MHz. The proteins studied were the HiPIPs I and II from Ectothiorhodospira halophila and Ectothiorhodospira vacuolata. Hyperfine-shifted peaks in spectra of the oxidized proteins were assigned to some of the protons of the cysteinyl ligands and aromatic residues at the active site on the basis of their chemical shifts, longitudinal relaxation times, and temperature-dependent behavior. The cysteinyl C beta-H protons were found to resonate downfield (about 100 ppm) and the C alpha-H protons upfield (about-25 ppm). This hyperfine shift pattern is consistent with the observed isotropic shift being contact in origin; it probably results from a pi-spin transfer mechanism. The large magnitudes of the chemical shifts of peaks assigned to aromatic residues suggest that these residues interact with the iron-sulfur cluster via pi-pi overlap. Some of the hyperfine-shifted peaks observed in water were found to disappear in 2H2O solution. Such resonances probably arise from exchange-labile hydrogens of amino acid residues directly hydrogen bonded to the iron-sulfur cluster. In the case of HiPIPs I and II from E. vacuolata, whose spectra are similar except for the number of such peaks, the relative number of hydrogen bonds inferred to be present in the oxidized and reduced proteins qualitatively explains the difference between their midpoint redox potentials. On the other hand, for E. halophila HiPIPs I and II, consideration of the inferred number of hydrogen bonds alone fails to predict the sign of the difference between their midpoint redox potentials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954995 TI - 31P NMR saturation transfer measurements of phosphorus exchange reactions in rat heart and kidney in situ. AB - 31P NMR spectra of rat kidney and heart, in situ, were obtained at 97.2 MHz by using chronically implanted radio-frequency coils. Previous investigators have used magnetization transfer techniques to study phosphorus exchange in perfused kidney and heart. In the current experiments, saturation transfer techniques were used to measure the steady-state rate of exchange between inorganic phosphate (Pi) and the gamma-phosphate of ATP (gamma ATP) in kidney, and between phosphocreatine (PCr) and gamma ATP, catalyzed by creatine kinase, in heart. The rate constant for the exchange detected between Pi and gamma ATP in kidney, presumably catalyzed by oxidative phosphorylation, was 0.12 +/- 0.03 s-1. This corresponds to an ATP synthesis rate of 12 mumol min-1 (g wet weight)-1. Comparison of previously published O2 consumption and Na+ reabsorption rates for the intact kidney with the NMR-derived rate for ATP synthesis gave flux ratios of JATP/JO2 = 1.6-3.3 and JNa+/JATP = 4-10. The rate constants for the creatine kinase reaction, assuming a simple two-site exchange, were found to be 0.57 +/- 0.12 s-1 for the forward direction (PCr----ATP) and 0.50 +/- 0.16 s-1 for the reverse direction (ATP----PCr). The forward rate (0.78 +/- 0.18 intensity unit/s) was significantly larger (p less than 0.05) than the reverse rate (0.50 +/- 0.16 intensity unit/s). This difference between the forward and reverse rates of creatine kinase has been previously noted in the perfused heart. The difference has been attributed to participation of ATP in other reactions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954997 TI - Kinetic analysis by stopped-flow radiationless energy transfer studies: effect of anions on the activity of carboxypeptidase A. AB - We have utilized a highly sensitive radiationless energy transfer (RET) assay to investigate the effect of anions on the activity of carboxypeptidase A (CPD-A). The RET kinetic method visualizes the ES complex directly and thus enables both the mode of action of anions and the quantitation of their effect to be determined at a single substrate concentration. In marked contrast to the activating effect of anions on the closely related metalloprotease, angiotensin converting enzyme, Cl-, and other anions inhibit CPD-A catalysis. NaCl inhibits the hydrolysis of Dns-Ala-Ala-Phe throughout the pH range 6-10. Other di- and tripeptides are similarly inhibited while their ester analogues are affected only slightly. Changes in the type of cation [e.g., Na+, Li+, K+, Ca2+, and (CH3)4N+] at a constant [Cl-1] of 0.1 M showed no difference in the extent of inhibition, whereas with anion substitution the differences were marked. In all cases, the inhibition was partially competitive. At pH 5.9, the Ki values for the free enzyme are 51 (Cl-), 17 (N3-), 2.1 (SO4(2-)), and 0.21 mM (H2PO4-), and for the ES complex, the KI' values are 1000, 720, 42, and 13 mM, respectively. The other anions were shown to act at the chloride site. The results indicate that investigations of anion inhibition in 1 M NaCl, a typical assay condition, may be greatly hindered by the presence of Cl-. Thus, the competitive binding mode of phenylacetate toward peptide hydrolysis is greatly decreased by the presence of 1 M Cl- ion while its noncompetitive component is unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3954996 TI - Metal ion binding properties of hen ovalbumin and S-ovalbumin: characterization of the metal ion binding site by 31P NMR and water proton relaxation rate enhancements. AB - In this study, water proton relaxation rate (PRR) enhancements have been used to characterize the binding of metal ions to native ovalbumin, ovalbumin in which phosphate has been enzymatically cleaved from one or both of the two protein phosphoserines, and a heat-stabilized form of the protein (S-ovalbumin). With Scatchard plots constructed from water PRR enhancements, it was found that native ovalbumin and S-ovalbumin had one strong binding site for Mn2+ ion (KD approximately equal to 6.0 X 10(-4) M). Alkaline phosphatase treated ovalbumin, a protein having a single phosphoserine, had one Mn2+ binding site of slightly weaker affinity (KD approximately equal to 8.3 X 10(-4) M), while acid phosphatase treated ovalbumin, a dephosphorylated protein, had two much weaker Mn2+ ion binding sites (KD approximately equal to 1.3 X 10(-3) M). Competitive binding studies on the native protein suggested that Zn2+ ion competes with Mn2+ for the single strong-affinity site (KD approximately equal to 6.1 X 10(-3) M) while Mg2+ and Ca2+ do not. In a second set of experiments, the paramagnetic contribution to the 31P spin-lattice (T1P) and spin-spin (T2P) relaxation times at three separate magnetic field strengths was measured. Correlation times tau c characterizing Mn2+-31P dipolar relaxation were estimated from the ratios of T1P/T2P at a single field and from the ratios of spin-lattice relaxation rates at three different field strengths. The correlation times so obtained, ranging from about 0.7 to 7.7 ns at the three field strengths, were used in calculating distances from the bound Mn2+ ion to the phosphoserines of native ovalbumin, S ovalbumin, and alkaline phosphatase treated ovalbumins. It was determined that the phosphate of phosphoserine-68 was 5.95 +/- 0.26 and 6.29 +/- 0.18 A from the Mn2+ in the native and alkaline phosphatase treated protein, respectively, and 6.99 +/- 0.30 A away from the Mn2+ in S-ovalbumin. The phosphate of phosphoserine 344 was determined to be 5.31 +/- 0.20 and 5.75 +/- 0.10 A from the Mn2+ ion in native ovalbumin and S-ovalbumin, respectively. The 13C nucleus of [1 13C]galactose enzymatically transferred to the nonreducing end of the ovalbumin oligosaccharide chain was not found to be significantly relaxed by Mn2+ bound to the protein, even at 1:1 stoichiometric ratio of metal:protein. Using this, we estimate the nonreducing terminal of the ovalbumin oligosaccharide to be at least 39 A from the metal ion binding site on the protein. PMID- 3954998 TI - Destabilization of phosphatidylethanolamine liposomes at the hexagonal phase transition temperature. AB - We have examined whether there is a relationship between the lamellar-hexagonal phase transition temperature, TH, and the initial kinetics of H+- and Ca2+ induced destabilization of phosphatidylethanolamine (PE) liposomes. The liposomes were composed of dioleoylphosphatidylethanolamine, egg phosphatidylethanolamine (EPE), or phosphatidylethanolamine prepared from egg phosphatidylcholine by transesterification (TPE). These lipids have well-spaced lamellar-hexagonal phase transition temperatures (approximately 12, approximately 45, and approximately 57 degrees C) in a temperature range that allows us to measure the initial kinetics of bilayer destabilization, both below and above TH. The liposomes were prepared at pH 9.5. The TH of EPE and TPE was measured by using differential scanning calorimetry, and it was found that the TH was essentially the same at low pH or at high pH in the presence of 20 mM Ca2+. At temperatures well below TH, either at pH 4.5 or at pH 9.5 in the presence of Ca2+, the liposomes aggregate, leak, and undergo lipid mixing and mixing of contents. We show that liposome/liposome contact is involved in the destabilization of the PE liposomes. The temperature dependence of leakage, lipid mixing, and mixing of contents shows that there is a massive enhancement in the rate of leakage when the temperature approaches the TH of the particular PE and that lipid mixing appears to be enhanced. However, the fusion (mixing of aqueous contents) is diminished or even abolished at temperatures above TH. At and above the TH, a new mechanism of liposome destabilization arises, evidently dependent upon the ability of the PE molecules to adapt new morphological structures at these temperatures. We propose that this destabilization demarks the first step in the pathway to the eventual formation of the HII phase. Thus, the polymorphism accessible to PE is a powerful agent for membrane destabilization, but additional factors are required for fusion. PMID- 3954999 TI - A subtransition in a phospholipid with a net charge, dipalmitoylphosphatidylglycerol. AB - Suspensions of dipalmitoylphosphatidylglycerol (DPPG) have been analyzed by differential scanning calorimetry, equilibrium and differential scanning dilatometry, and X-ray diffraction techniques. After the DPPG suspensions are stored several days at 2 degrees C, a new phase transition is observed at a lower temperature than either the main transition or the pretransition. This subtransition has an enthalpy of about 6 kcal/mol and occurs at about 20 degrees C, the exact temperature depending on the buffer used. The lipid partial specific volume increases by 0.035 mL/g upon warming through the subtransition. X-ray diffraction patterns from suspensions in the subgel phase contain orders of a lamellar repeat and several additional sharp and broad wide-angle reflections between 8 and 2 A. As the water content in the specimen is reduced, the lamellar repeat period decreases, whereas the spacings and intensities of these additional wide-angle reflections are unchanged. These data indicate that on incubation at 2 degrees C the lipid molecules crystallize in the plane of each bilayer. X-ray experiments also show that this subgel phase converts to the normal L beta' gel phase above the subtransition. PMID- 3955000 TI - Structure of the crystalline bilayer in the subgel phase of dipalmitoylphosphatidylglycerol. AB - The structure of the subgel phase of dipalmitoylphosphatidylglycerol (DPPG) has been analyzed by X-ray diffraction techniques. Diffraction recorded from highly oriented DPPG specimens in the subgel phase extends to 2-A resolution. There are sharp lamellar reflections on the meridian, and other reflections lie on a series of wide-angle lattice lines parallel to the meridian and crossing the equator in the range of 8-2 A. The wide-angle lattice lines consist of radially sharp reflections centered on the equator of the X-ray film and also a series of broader, off-equatorial maxima. The lattice lines indicate that the DPPG molecules in each bilayer crystallize in a two-dimensional oblique lattice with dimensions a = 5.50 A, b = 7.96 A, and gamma = 100.5 degrees. These oblique lattices are not regularly aligned from bilayer to bilayer. Analysis of the lamellar diffraction shows that the bilayer has about the same thickness in the subgel and gel (L beta') phases. In the direction normal to the hydrocarbon chains, the chains are significantly closer together in the subgel phase as compared to the normal L beta' gel phase but have about the same separation as the chains in polyethylene and the crystalline n-alkanes. The bilayer thickness, area per lipid molecule, and intensity distribution along the lattice lines all indicate that in the subgel phase the hydrocarbon chains are tilted between 30 and 35 degrees from the normal to the bilayer plane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955001 TI - 1-Phenylcyclobutylamine, the first in a new class of monoamine oxidase inactivators. Further evidence for a radical intermediate. AB - 1-Phenylcyclobutylamine (PCBA) is shown to be both a substrate and a time dependent irreversible inactivator of monoamine oxidase (MAO). Inactivation results in attachment to the flavin cofactor. For every molecule of PCBA leading to inactivation, 325 molecules are converted to product. The first metabolite formed is identified as 2-phenyl-1-pyrroline; then after a lag time, 3 benzoylpropanal and 3-benzoylpropionic acid are generated. The 3-benzoylpropanal is a product of MAO-catalyzed oxidation of 2-phenyl-1-pyrroline (presumably, of its hydrolysis product, gamma-aminobutyrophenone). The aldehyde is nonenzymatically oxidized by nascent hydrogen peroxide to the carboxylic acid. These results are consistent with a one-electron oxidation of PCBA to the amine radical cation followed by homolytic cyclobutane ring cleavage. The resulting radical can partition between cyclization (an intramolecular radical trap) to the 2-phenylpyrrolinyl radical and attachment to the flavin. The cyclic radical can be further oxidized by one electron to 2-phenyl-1-pyrroline. PCBA represents the first in the cyclobutylamine class of MAO inactivators and strongly supports involvement of a radical mechanism for MAO-catalyzed amine oxidations. PMID- 3955003 TI - Mechanism of alpha-amino-epsilon-caprolactam racemase reaction. AB - alpha-Amino-epsilon-caprolactam racemase catalyzes the exchange of the alpha hydrogen of the substrate with deuterium during racemization in deuterium oxide. The rate of the hydrogen exchange measured by 1H NMR is lower than that of racemization in deuterium oxide for both the enantiomers. Both the enantiomers of alpha-amino-epsilon-caprolactam show an overshoot of the optical rotation during the enzymatic racemization in deuterium oxide (but not in water). This phenomenon may be attributable to a primary deuterium isotope effect at the alpha-position: alpha-deuterium isotope effects of 3.6 and 2.0 were observed for the racemization of the D and L enantiomers of alpha-amino-epsilon-caprolactam, respectively. Results of tritium-labeling experiments showed that the enzyme catalyzes both retention and inversion of configuration of the substrate with a similar probability in each turnover. Conversion of [alpha-2H]-D-alpha-amino-epsilon caprolactam in water and unlabeled D-alpha-amino-epsilon-caprolactam in deuterium oxide into the L isomer under nearly single turnover conditions with the enzyme showed significant internal return of the alpha-hydrogen. These results support a single base mechanism for the racemization reaction catalyzed by the enzyme. PMID- 3955002 TI - Ligand and halide binding properties of chloroperoxidase: peroxidase-type active site heme environment with cytochrome P-450 type endogenous axial ligand and spectroscopic properties. AB - Equilibrium binding studies of exogenous ligands and halides to the active site heme iron of chloroperoxidase have been carried out from pH 2 to 7. Over twenty ligands have been studied including C, N, O, P, and S donors and the four halides. As judged from changes in the optical absorption spectra, direct binding of the ligands to the heme iron of ferric or ferrous chloroperoxidase occurs in all cases; this has been ascertained for the ferric enzyme in several cases through competition experiments with cyanide. All of the ligands except for the halides, nitrate, and acetate form exclusively low-spin complexes in analogy to results obtained with the spectroscopically related protein, cytochrome P-450-CAM [Sono, M., & Dawson, J.H. (1982) J. Biol. Chem. 257, 5496-5502]. The titration results show that, for the ferric enzyme, (i) weakly acidic ligands (pKa greater than 3) bind to the enzyme in their neutral (protonated) form, followed by deprotonation upon ligation to the heme iron. In contrast, (ii) strongly acidic ligands (pKa less than 0) including SCN-, NO3-, and the halides except for F- likely bind in their anionic (deprotonated) form to the acid form of the enzyme: a single ionizable group on the protein with a pKa less than 2 is involved in this binding. For the ferrous enzyme, (iii) a single ionizable group with the pKa value of 5.5 affects ligand binding. These results reveal that chloroperoxidase, in spite of the previously established close spectroscopic and heme iron coordination structure similarities to the P-450 enzymes, clearly belongs to the hydroperoxidases in terms of its ligand binding properties and active site heme environment. Magnetic circular dichroism studies indicate that the alkaline form (pH 9.5) of ferric chloroperoxidase has an RS-ferric heme-N donor ligand coordination structure with the N donor likely derived from histidine imidazole. PMID- 3955004 TI - Stopped-flow fluorescence studies on binding kinetics of neurotoxins with acetylcholine receptor. AB - Acetylcholine receptor from Narke japonica electroplax exhibits a fluorescence change upon binding of snake neurotoxins. This fluorescence change primarily arises from the conformational change of the acetylcholine receptor and reflects the binding process of the toxin with the receptor. The time dependence of the fluorescence change has been monitored for 28 short neurotoxins and 8 long neurotoxins by using a stopped-flow technique. The steady-state fluorescence change is of the same order of magnitude for the short neurotoxins but varies among the long neurotoxins. Nha 10, a short neurotoxin with weak neurotoxicity, causes no fluorescence change in the receptor but can still bind to the receptor with sufficiently high affinity. The substitution of the conserved residue Asp-31 to Gly-31 in Nha is probably responsible for the reduced neurotoxicity. The rate constants for the binding of the neurotoxins to the receptor have been obtained by analyzing the transient fluorescence change. The rate constants show surprisingly a wide range of distribution: (1.0-20.5) X 10(6) M-1 s-1 for short neurotoxins and (0.26-1.9) X 10(6) M-1 s-1 for long neurotoxins. Examination of the relationship between the rate constants of fluorescence change of the short neurotoxins and their amino acid sequences, thermal stability, hydrogen-deuterium exchange behavior, overall net charge, etc. reveals the following. Positive charges on the side chains of residues 27 and 30 and overall net charge of the neurotoxin govern the magnitude of the binding rate of the neurotoxin with the receptor. PMID- 3955005 TI - Actin-fragmin interactions as revealed by chemical cross-linking. AB - A one to one complex of actin and fragmin (a capping protein from Physarum polycephalum plasmodia) was cross-linked with 1-ethyl-3-[3-(dimethylamino)propyl] carbodiimide. The cross-linking reaction generated two cross-linked products with slightly different molecular weights (88 000 and 90 000) as major species. They were cross-linked products of one actin and one fragmin. The cross-linking site of fragmin in the actin sequence was determined by peptide mappings [Sutoh, K. (1982) Biochemistry 21, 3654-3661] after partial chemical cleavages of cross linked products with hydroxylamine. The results indicated that the N-terminal segment of actin spanning residues 1-12 participated in cross-linking with fragmin. The cross-linker used in this study covalently bridges lysine side chains and side chains of acidic residues when they are in direct contact. Therefore, it seems that acidic residues in the N-terminal segment of actin (Asp 1, Glu-2, Asp-3, Glu-4, and Asp-11), at least some of them, are in the binding site of fragmin. It has already been shown that the same acidic segment of actin is in the binding site of myosin or depactin (an actin-depolymerizing protein isolated from starfish oocytes). We suggest that the unusual amino acid sequence of the N-terminal segment of actin makes its N-terminal region a favorable anchoring site for various types of actin-binding proteins. PMID- 3955006 TI - High-multiplicity spin states of 2[4Fe-4Se]+ clostridial ferredoxins. AB - The electron paramagnetic resonance (EPR) spectra of the reduced selenium substituted 2-[4Fe-4Se]+ ferredoxins from three bacteria of the Clostridium genus display low-field signals at g = 5.17, g = 10.11, and g = 12.76. The positions, shapes, and temperature dependencies of these signals have allowed their assignments to the three excited states of an S = 7/2 spin multiplet, the fundamental state of which is observed as unusual features in low-temperature (T less than or equal to 20 K) Mossbauer spectra. The S = 7/2 spin state is present in 2[4Fe-4Se]+ clostridial ferredoxins together with the classical S = 1/2 state and with a S = 3/2 state, the fundamental doublet of which is observed as a broad signal in the g = 3-4 region. The relative intensities of the EPR signals corresponding to these spin states depend on the species of Clostridium that the ferredoxin is extracted from. In contrast with clostridial ferredoxins, the reduced selenium-substituted ferredoxin from Bacillus stearothermophilus, which differs significantly from the clostridial proteins by its primary structure and by its containing only one tetranuclear cluster, displays only the S = 1/2 state. Thus, the high-multiplicity spin states arise from a specific interaction between the clostridial ferredoxin polypeptide chain and the reduced [4Fe-4Se]+ clusters. PMID- 3955007 TI - Active site directed inactivation of rat mammary gland fatty acid synthase by 3 chloropropionyl coenzyme A. AB - 3-Chloropropionyl coenzyme A (CoA) irreversibly inhibits rat mammary gland fatty acid synthase. Enzyme inactivation proceeds with first-order kinetics. NADPH (150 microM) as well as acetyl-CoA (500 microM) affords protection against inactivation, suggesting that the inhibitor is active site directed. In contrast, malonyl-CoA (500 microM) offers little protection. With chloro [1-14C]propionyl CoA, stoichiometries of modification that approach one per enzyme protomer (240 kilodaltons) have been measured. When chloropropionyl-[3'-32P]CoA is used for inactivation, modification stoichiometries are less than 10% of the value observed in the 14C labeling experiments, suggesting that acylation of the enzyme occurs. Radioactivity remains associated with the 14C-labeled protein after performic acid oxidation, indicating that another linkage, in addition to the thio ester adduct, is formed during inactivation. Recovery of [( 14C]carboxyethyl)cysteine from digests of the inactivated enzyme indicates that alkylation of an active site cysteine occurs. The cysteamine sulfhydryl of the acyl carrier peptide is clearly not the site of modification. Loss of overall enzyme activity is tightly linked to decreases in the ketoacyl synthase partial reaction. This observation, coupled with the differential protection measured with acetyl-CoA and malonyl-CoA, suggests that the reagent modifies a residue at the active site involved in condensation. While inactivated enzyme shows good ketoacyl reductase activity when S-(acetoacetyl)-N-acetylcysteamine is used as a substrate, only poor activity for this partial reaction is measured when acetoacetyl-CoA is the substrate. This implies that the function of the acyl carrier peptide (ACP) is impaired during the inactivation process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955008 TI - Preribosomal ribonucleoprotein particles are a major component of a nucleolar matrix fraction. AB - Biochemical and morphological studies were performed on Novikoff hepatoma ascites cell nucleolar matrix fractions prepared by deoxyribonuclease I digestion and high-molarity salt extractions essentially according to a published method [Berezney, R., & Buchholz, L. A. (1981) Exp. Cell Res. 20, 4995-5002]. The nucleolar matrix fraction was enriched in polypeptides of molecular mass of 28, 37.5, 40, 70, 72, 110 (protein C23), and 160 kDa, compared to the nuclear fraction in which polypeptides of molecular mass of 31, 33.5, 43.5, 46, 50, 56, and 59 kDa were predominant. About one-fourth of the protein, half of the RNA, and less than 4% of the DNA originally present in the nucleoli remained in the matrix fraction. Addition of single agents such as ethylenediaminetetraacetic acid, ribonuclease A, or mercaptoethanol during preparation had no significant effect on the polypeptide composition of the nucleolar matrix fraction. However, the combination of mercaptoethanol and ribonuclease A caused most of the RNA and protein to be removed, including protein C23 and the 160-kDa polypeptide, with polypeptides in the range of Mr 30 000-50 000 remaining. Electron microscopy of nucleolar matrix fractions revealed the presence of particles similar in size to the granular elements of nucleoli. However, when ribonuclease A and mercaptoethanol were included in the procedure, only amorphous material remained. Many proteins of nucleolar preribosomal RNP particles were also associated with the nucleolar matrix fraction. RNA from the nucleolar matrix fraction was enriched in sequences from 18S and 28S ribosomal RNA. These results indicate that preribosomal RNP particles are major constituents of a nucleolar matrix fraction prepared by the deoxyribonuclease I-high-molarity salt method. PMID- 3955009 TI - In nondividing cells, histone H1(0) is synthesized and deposited onto chromatin without accompanying phosphorylation. AB - The phosphorylation of H1 histone subfractions was measured in mouse neuroblastoma cells stopped from dividing by three treatments that block cell division: 5 mM butyrate, 2% dimethyl sulfoxide, and serum withdrawal. H1 histone phosphorylation decreased in response to all three treatments, but the response differed in its timing and its extent for the different H 1 subfractions. The different decreases in phosphorylation correlated well with the differential decreases in biosynthesis of the individual H1 subfractions; however, an exception to this parallel decrease in synthesis and phosphorylation was observed in the case of histone H1(0). Phosphorylation of H1(0) was absent in each of the three treatments after 2 days, despite the continued synthesis and deposit of H1(0) on the chromatin. Thus, despite the fact that H1(0) was being synthesized and that the other newly synthesized H1 subfractions were phosphorylated at this time, the phosphorylation of H1(0) became uncoupled from its synthesis after prolonged treatments blocking cell division. PMID- 3955010 TI - Chromatin structure of the chicken lysozyme gene domain as determined by chromatin fractionation and micrococcal nuclease digestion. AB - The chromatin structure encompassing the lysozyme gene domain in hen oviduct nuclei was studied by measuring the partitioning of coding and flanking sequences during chromatin fractionation and by analyzing the nucleosome repeat in response to micrococcal nuclease digestion. Following micrococcal nuclease digestion, nuclei were sedimented to obtain a chromatin fraction released during digestion (S1) and then lysed in tris(hydroxymethyl)aminomethane (ethylenedinitrilo)tetraacetic acid-[ethylenebis(oxyethylenenitrilo)]tetraacetic acid and centrifuged again to yield a second solubilized chromatin fraction (S2) and a pelleted fraction (P2). By dot-blot hybridization with 14 specific probes, it is found that the fractionation procedure defines three classes of sequences within the lysozyme gene domain. The coding sequences, which partition with fraction P2, are flanked by class I flanking sequences, which partition with fractions S1 and P2 and which extend over 11 kilobases (kb) on the 5'side and probably over about 4 kb on the 3' side. The partitioning of class II flanking sequences, which are located distal of class I flanking sequences, is different from that of class I flanking sequences. Coding sequences lack a canonical nucleosome repeat, class I flanking sequences possess a disturbed nucleosome repeat, and class II flanking sequences generate an extended nucleosomal ladder. Coding and class I flanking sequences are more readily digested by micrococcal nuclease than class II flanking sequences and the inactive beta A-globin gene. In hen liver, where the lysozyme gene is inactive, coding and class I flanking sequences fractionate into fractions S2 and P2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955011 TI - Secondary structure of halorhodopsin. AB - Ultraviolet circular dichroism (CD) spectroscopy in the interval from 190 to 240 nm has been used to estimate the secondary structural content of halorhodopsin (hR), a light-driven chloride pump isolated from the membranes of Halobacterium halobium. Least-squares curve fitting of the CD spectrum for hR solubilized with octyl glucoside yields an alpha-helical content of approximately 50% and a beta structure content of approximately 30%. The CD spectrum of hR is unaffected by the absence or presence of chloride ions or by the ionic strength of the medium. The CD spectrum of halorhodopsin is very similar to that of bacteriorhodopsin, indicating that these light-driven pumps possess nearly identical fractions of alpha- and beta-secondary structures. PMID- 3955012 TI - Fusion of liposomes induced by a cationic protein from the acrosome granule of abalone spermatozoa. AB - Lysin, a protein of Mr 16 000 from the acrosome granule of the abalone, is responsible for the dissolution of the egg vitelline layer. The primary structure of this cationic protein projects some hydrophobic domains in the secondary structure. Lysin was found to associate nonselectively with phospholipid bilayers and cause a spontaneous release of encapsulated carboxyfluorescein in liposomes. The association of lysin with phosphatidylcholine liposomes suggests that there is a hydrophobic interaction between lysin and lipid bilayers. Binding of lysin to phospholipid resulted in the aggregation of phosphatidylserine-containing liposomes, but aggregation was not observed in neutral phosphatidylcholine liposomes. Resonance energy transfer and dequenching of fluorescent 1-palmitoyl-2 cis-parinaroylphosphatidylcholine were both used to determine the fusogenic activity of lysin in aggregated liposomes. Results from both assays are consistent. Lysin-induced fusion was observed in all the phosphatidylserine containing liposomes, and the general trend of fusion susceptibility was phosphatidylserine/phosphatidylcholine (1:2) approximately equal to phosphatidylserine/phosphatidylcholine/phosphatidylethanolamine (1:1:1) greater than phosphatidylserine/phosphatidylethanolamine (1:2). Cholesterol up to 30% did not affect the intrinsic fusion susceptibility. A hydrophobic penetration by protein molecules and the packing of phospholipid bilayers are used to interpret the fusion susceptibility. Lysin-induced liposome aggregation was highly independent of the state of self-association of lysin in ionic medium. However, the fusogenic activity of self-associated lysin was found to be much less than the monodispersed one. Liposomes preincubated with Ca2+ did not fuse initially as readily as those without Ca2+ treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955013 TI - Biosynthesis of cyclosporin A: partial purification and properties of a multifunctional enzyme from Tolypocladium inflatum. AB - An enzyme fraction most probably involved in the biosynthesis of cyclosporin A was purified 540-fold from Tolypocladium inflatum. The enzyme was capable of forming covalent enzyme-substrate complexes and catalyzed the ATP-pyrophosphate exchange reactions dependent on the unmethylated constituent amino acids of cyclosporin A. Evidence was obtained that covalent binding of substrate amino acids occurred via thioester linkage. Furthermore, the N-methylation of thio esterified valine, leucine, and glycine residues with S-adenosyl-L-methionine was demonstrated. De novo synthesis of cyclosporin A was not observed but the formation of the diketopiperazine cyclo-(D-Ala-MeLeu) from D-alanine and L leucine under the consumption of ATP and S-adenosyl-L-methionine. This cyclodipeptide represents a partial sequence of cyclosporin A. Molecular mass determinations revealed the enzyme activity to be lying in the range of about 700 kDa. PMID- 3955014 TI - Fluorescence studies on a membrane-embedded peptide from the carboxy terminus of lipophilin. AB - Fluorescence of an intramembranous polypeptide (T-3) derived from the carboxy terminal sequence of lipophilin was studied in aqueous solution, detergent micelles, and lipid vesicles. In all cases, the fluorescence of the only Trp (211) was indicative of a hydrophobic, buried residue. Addition of lysophosphatidylcholine (LPC) or phosphatidylcholine (PC) gave Trp-211 a more hydrophobic, less quenching environment as compared to that in aqueous solution. Energy transfer between Trp and Tyr observed in aqueous solution was decreased by the addition of lipid or detergent. There was limited quenching by acrylamide both in the aqueous and in the lipid or detergent environments. However, PC or LPC further decreased this quenching. Cs+ and I- were even less accessible than acrylamide to Trp, further proving that the Trp was located inside the lipid bilayer. The quenching indicated that I- binds to positive charges of the protein located on the surface of the membrane. This, combined with knowledge of the sequence of lipophilin, suggested that Trp-211 was located within the membrane but was close to amino acid residues that are external to the bilayer. PMID- 3955015 TI - A calcium-43 NMR study of calcium binding to an acidic proline-rich phosphoprotein from human saliva. AB - The 43Ca NMR line width measured for Ca2+ bound to protein A, an acidic proline rich salivary protein, is 1 order of magnitude narrower than has previously been observed for other proteins of similar molecular weight. The correlation times, quadrupole coupling constants, and chemical shifts estimated for Ca2+ ions bound to the intact protein (Mr approximately 10 000) and its 30 amino acid residue long acidic N-terminal TX peptide were indistinguishable within experimental error. These results--as well as the outcome of 1H NMR relaxation rate measurements--are indicative of extensive motions for the protein residues, which in turn give rise to a high degree of flexibility for the protein-bound Ca2+. Ca2+ titration and pH-dependent measurements on protein A, the TX peptide, and the dephosphorylated TX peptide established the importance of the two phosphoserine residues in the binding of Ca2+. Moreover, a comparison of the 43Ca NMR parameters with those obtained for other Ca2+-binding proteins suggests the presence of Ca2+-binding sites of similar symmetry in all these proteins. No evidence was found for a proposed interaction between the highly acidic N terminal and the weakly basic C-terminal regions of protein A. In contrast, the high pH inflection that was observed in the pH titration curve for the intact protein was also found for the phospho and dephospho TX peptides, thus suggesting that basic moieties in the N-terminal region rather than those in the C-terminal region may be responsible for this observation. PMID- 3955016 TI - Time-resolved fluorescence and 1H NMR studies of tyrosine and tyrosine analogues: correlation of NMR-determined rotamer populations and fluorescence kinetics. AB - The time-resolved fluorescence properties of phenol and straight-chained phenol derivatives and tyrosine and simple tyrosine derivatives are reported for the pH range below neutrality. Phenol and straight-chained phenol derivatives exhibit single exponential fluorescence decay kinetics in this pH range unless they have a titratable carboxyl group. If a carboxyl group is present, the data follow a two-state, ground-state, Henderson-Hasselbalch relationship. Tyrosine and its derivatives with a free carboxyl group display complex fluorescence decay behavior as a function of pH. The complex kinetics cannot be fully explained by titration of a carboxyl group; other ground-state processes are evident, especially since tyrosine analogues with a blocked carboxyl group are also multiexponential. The fluorescence kinetics can be explained by a ground-state rotamer model. Comparison of the preexponential weighting factors (amplitudes) of the fluorescence decay constants with the 1H NMR determined phenol side-chain rotamer populations shows that tyrosine derivatives with a blocked or protonated carboxyl group have at least one rotamer exchanging more slowly than the radiative and nonradiative rates, and the fluorescence data are consistent with a slow-exchange model for all three rotamers, the shortest fluorescence decay constant is associated with a rotamer where the carbonyl group can contact the phenol ring, and in the tyrosine zwitterion, either rotamer interconversion is fast and an average lifetime is seen or rotamer interconversion is slow and the individual fluorescence decay constants are similar. PMID- 3955017 TI - Time-resolved fluorescence and 1H NMR studies of tyrosyl residues in oxytocin and small peptides: correlation of NMR-determined conformations of tyrosyl residues and fluorescence decay kinetics. AB - Steady-state and time-resolved fluorescence properties of the single tyrosyl residue in oxytocin and two oxytocin derivatives at pH 3 are presented. The decay kinetics of the tyrosyl residue are complex for each compound. By use of a linked function analysis, the fluorescence kinetics can be explained by a ground-state rotamer model. The linked function assumes that the preexponential weighting factors (amplitudes) of the fluorescence decay constants have the same relative relationship as the 1H NMR determined phenol side-chain rotamer populations. According to this model, the static quenching of the oxytocin fluorescence can be attributed to an interaction between one specific rotamer population of the tyrosine ring and the internal disulfide bridge. PMID- 3955018 TI - Four- and five-coordinate species in nickel-reconstituted hemoglobin and myoglobin: Raman identification of the nickel-histidine stretching mode. AB - Nickel(II)-reconstituted hemoglobin (NiHb) and myoglobin (NiMb) and model Ni porphyrins have been investigated by Soret-resonance Raman difference spectroscopy. Two sets of frequencies for the oxidation-state and core-size marker lines in the region from 1300 to 1700 cm-1 indicate two distinct sites in NiHb. Only one of these sites is evident in the Raman spectra of NiMb. This result is consistent with the UV-visible absorption spectrum of NiHb, which shows two Soret bands at 397 and 420 nm and one Soret at 424 nm for NiMb. Excitation at the blue Soret component of NiHb with 406.7-nm laser radiation preferentially enhances the set of Raman marker lines typical of Ni-protoporphyrin IX [Ni(ProtoP )] in noncoordinating solvents. The wavelength of the blue Soret component and the Raman spectrum indicate four-coordination for this site in NiHb. Laser excitation in the red Soret band enhances a set of lines whose frequencies are compatible with neither four- nor six-coordinate frequencies but are intermediate between the two. The red Soret band of the proteins is also considerably less red shifted than six-coordinate Ni-porphyrin models. These results suggest that Ni in the second site possesses a single axial ligand. Raman spectra of 64Ni reconstituted and natural abundance Ni-reconstituted hemoglobins, obtained simultaneously in a Raman difference spectrometer, have identified the Ni-ligand stretch at 236 cm-1. The line shifts to 229 cm-1 for the 64Ni-reconstituted Hb. For a pure Ni-ligand stretch a 10-cm-1 shift would be predicted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955019 TI - A new trophoblast-derived growth factor from human placenta: purification and receptor identification. AB - This paper describes the identification and characterization of a new peptide growth factor. The peptide was isolated from trophoblastic brush border membranes of human placenta. The purified preparation was homogeneous and consisted of a single polypeptide of Mr 34 000 with a pI of about 6.0. This peptide stimulated DNA replication in cultured fibroblasts. The following association was seen between activity and protein: During DEAE-cellulose chromatography, both the 34 kilodalton (kDa) protein and the mitogenic activity displayed identical binding and salt dependence of elution. Nondenaturing electrophoresis at pH 8.3 revealed a comigration of the 34-kDa protein and the DNA replication stimulatory activity. Identical electrophoretic mobilities were displayed for both activity and protein at pH 7.0. These results demonstrate that the preparation is homogeneous and show that growth factor activity is intrinsic to the 34-kDa polypeptide. Binding of the 125I-labeled 34-kDa mitogen to target fibroblastic cells was specific; i.e., nanomolar concentrations of the unlabeled 34-kDa protein competed effectively with the labeled protein, whereas a variety of well-characterized growth factors and hormones were unable to compete even at micromolar levels. Thus the 34-kDa protein interacts with target cells through highly specific surface receptors. Chemical cross-linking techniques were used to investigate the identity of the receptor for the 34-kDa mitogen. Cross-linking of fibroblastic cells containing bound 125I-labeled 34-kDa protein generated a radiolabeled complex of 86 kDa in all four cell types examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955020 TI - Elucidation of the chemical nature of the steady-state intermediates in the mechanism of carboxypeptidase A. AB - Cryospectrokinetic studies of zinc and cobalt carboxypeptidase A disclosed two intermediates in the hydrolysis of both peptides and depsipeptides and furnished all the rate and equilibrium constants for the reaction scheme E + S in equilibrium ES1 in equilibrium ES2---E + P [Auld, D. S., Galdes, A., Geoghegan, K. F., Holmquist, B., Martinelli, R. A., & Vallee, B. L. (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 5041-5045]. Since the ES2 intermediate is the predominate enzyme species present at steady state, its chemical nature is deducible from subzero chemical quench studies done after steady state is established. Extrapolation of the product concentration to zero time, [P0], measures the concentration of the enzyme species in which bond cleavage has occurred. For peptides, the [P0]values are zero, indicating that no product is generated prior to turnover and therefore the ES2 intermediate involves a complex between enzyme and intact peptide substrate. For depsipeptides, [P0] values are 1 mol of produce per mole of enzyme over the entire temperature range -20 to -50 degrees C, indicating cleavage of the ester bond occurs prior to the rate-limiting step so that ES2 is more properly denoted by EP1P2, where P1 and P2 are the substrates for the reverse reaction. The rate-limiting step for depsipeptides thus involves release of the products which may occur directly or through a mandatory conformational change followed by rapid product release. PMID- 3955021 TI - Autophosphorylation of glyceraldehydephosphate dehydrogenase and phosphorylation of protein from skeletal muscle microsomes. AB - Glyceraldehydephosphate dehydrogenase purified from rabbit skeletal muscle is auto-phosphorylated with MgATP. Half-maximal phosphorylation is achieved around 0.3 mM. The phosphorylation is Ca2+ independent. The phosphoenzyme complex is labile in alkaline conditions and stable in moderately acid media. The complex is readily hydrolyzed by 0.1 M neutral hydroxylamine, indicating the complex formed is a high-energy acyl phosphate. The phosphorylation is reduced by nicotinamide adenine dinucleotides, reduced form (NADH), glyceraldehyde 3-phosphate, and nicotinamide adenine dinucleotide (NAD+). The enzyme is also dephosphorylated by these metabolites although to a lesser extent by NAD+. Calsequestrin isolated from rabbit skeletal muscle inhibits the phosphorylation of the enzyme. The phosphoenzyme behaves as a kinase catalyzing the phosphorylation of proteins of Mr 80 000 and 72 000 found in the skeletal muscle terminal cisternae/triad preparation. This reaction is enhanced by NADH. The phosphate found in the protein substrate has been shown to be the same phosphate initially involved in the phosphorylation of glyceraldehydephosphate dehydrogenase. PMID- 3955022 TI - Role of substrate conformational features in the stereospecificity of aromatase. AB - Hydroxylation of 19-hydroxyandrost-4-ene-3,17-dione (19OHA) by aromatase occurs at the 19-pro-R hydrogen, suggesting that the C19 group has a preferred conformation in the enzyme active site. X-ray crystallographic studies have led to a postulate that the steroid plays a role in determining this conformation. In an effort to quantitate the steroid's role, we estimated conformational constraints about the C10-C19 bond of 19OHA using molecular mechanics calculations. Rotational barriers less than or equal to 6 kcal/mol and energy differences between conformers less than or equal to 1 kcal/mol were found. We perturbed these conformational constraints by preparing an altered substrate, 19 hydroxyandrosta-4,6-diene-3,17-dione (19OHAD). The stereospecificity of aromatization for 19OHA and 19OHAD was found to be the same. Thus, theoretical and experimental approaches both indicate that conformational constraints intrinsic to 19OHA cannot be a major determinant in the sterospecificity of its oxidation by aromatase. PMID- 3955023 TI - Illumination of bovine photoreceptor membranes causes phosphorylation of both bleached and unbleached rhodopsin molecules. AB - Bovine rod outer segments were given a series of flashes, each bleaching from 0.1% to 0.4% of the rhodopsin present. 9-cis-Retinal was then added, regenerating the bleaching pigment to isorhodopsin. The phosphorylated pigment species having either four and five or six and eight phosphates were isolated by chromatofocusing. The amounts of rhodopsin and isorhodopsin present in the phosphorylated species were determined spectrally. The species with four and five phosphates per rhodopsin were approximately 50% rhodopsin-50% isorhodopsin. The more highly phosphorylated species were almost entirely isorhodopsin. Presumably, the phosphorylated rhodopsin was phosphorylated without having been bleached. At a 4% bleach level, approximately 0.5 rhodopsin was phosphorylated with four to five phosphates for each rhodopsin that was bleached and phosphorylated. PMID- 3955024 TI - Fluorescence-detected circular dichroism of ethidium bound to poly(dG-dC) and poly(dG-m5dC) under B- and Z-form conditions. AB - The equilibrium binding of ethidium to poly(dG-dC) and poly(dG-m5dC) under conditions favoring B and Z forms was investigated with fluorescence-detected circular dichroism (FDCD) and optical titration methods. FDCD spectra indicate a similar geometry for the intercalated ethidium under both B- and Z-form conditions, even at low levels of bound ethidium. The magnitude of the 310-330-nm FDCD band as a function of the bound drug to base pair ratio (r) indicates ethidium binds to poly(dG-dC) in 4.4 M NaCl and to poly(dG-m5dC) in 25 mM MgCl2 by clustering. Under these conditions, circular dichroism spectra indicate the polymer is largely Z form. Thus, it appears ethidium clusters into regions it has induced into a right-handed form. For all conditions studied, the FDCD spectra provided no evidence for a left-handed binding site. Under B-form conditions, binding is random. PMID- 3955025 TI - Resonance Raman spectroscopic studies of adriamycin and copper(II)-adriamycin and copper(II)-adriamycin-DNA complexes. AB - Characteristic resonance Raman spectra are observed on ionization of the phenolic groups in adriamycin. On the basis of these results, vibrational assignments for the Raman bands of adriamycin are reported. Distinct Raman spectra are observed for Cu(II)-adriamycin complexes at pH approximately 5 and pH approximately 13. The data indicate that at lower pH a bis complex of Cu(II) is formed, which transforms to a polymeric Cu(II) chelate at higher pH. Upon interaction of the metal-drug complex with calf thymus DNA at pH approximately 5, a ternary complex is formed in which the Cu(II)-complexed adriamycin is intercalated into DNA. PMID- 3955026 TI - Effect of nucleotide on the binding of N,N'-p-phenylenedimaleimide-modified S-1 to unregulated and regulated actin. AB - In our previous study [Chalovich, J. M., Greene, L. E., & Eisenberg, E. (1983) Proc. Natl. Acad. Sci. U.S.A. 80, 4909-4913], myosin subfragment 1 that was modified by having its two reactive thiol groups cross-linked by N,N'-p phenylenedimaleimide (pPDM) was found to resemble the myosin subfragment 1 adenosine 5'-triphosphate (S-1.ATP) complex in its interaction with actin. In the present study, we examined the effect of actin on adenosine 5'-diphosphate (ADP) trapped at the active site of pPDM.S-1. Our results indicate first that, in the presence of actin, ADP is no longer trapped at the active site but exchanges rapidly with free nucleotide. Different pPDM.S-1.nucleotide complexes were then formed by exchanging nucleotide into the active site of pPDM.S-1 in the presence of actin. The binding of pPDM.S-1.ATP or pPDM.S-1.PPi to actin is virtually identical with that of unmodified S-1 in the presence of ATP. Specifically, at mu = 18 mM, 25 degrees C, pPDM.S-1.ATP or pPDM.S-1.PPi binds to unregulated actin with the same affinity as does S-1.ATP, and this binding does not appear to be affected by troponin-tropomyosin. On the other hand, pPDM.S-1.ADP and pPDM.S-1 with no bound nucleotide both show a small, but significant, difference between their binding to actin and the binding of S-1.ATP; pPDM.S-1 and pPDM.S-1.ADP both bind about 2- to 3-fold more strongly to unregulated actin than does S 1.ATP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955027 TI - Bis(8-anilinonaphthalene-1-sulfonate) as a probe for tubulin decay. AB - The fluorescent apolar probe bis(8-anilinonaphthalene-1-sulfonate) (Bis-ANS) has been used to detect structural correlates of the well-known but poorly understood decay of tubulin function, by which tubulin loses its ability to polymerize and bind drugs in a complex, time-dependent way. The present results indicate that the decay of tubulin is accompanied by the appearance of hydrophobic areas, which bind a total of six Bis-ANS molecules with a dissociation constant of 19 microM. This binding seems to be a result of localized structural changes that are taking place in the tubulin molecule and can be used as a probe for these changes. In particular, circular dichroism measurements revealed no significant changes in the average secondary structure of the protein during the time required for complete binding of the Bis-ANS molecules. Preincubation of tubulin with the antimitotic drugs colchicine, podophyllotoxin, and vinblastine slows the rate of appearance of the hydrophobic region. Vinblastine has the maximal effect followed by colchicine and podophyllotoxin. In contrast, preincubation with maytansine has no effect. In addition, lowering the temperature decreases the rate of appearance of this region. These results correlate with the effect of drugs on the alkylation of tubulin sulfhydryl groups by iodoacetamide [Luduena, R.F., & Roach, M.C. (1981) Biochemistry 20, 4444-4450] and with the ability of inhibitors of microtubule assembly to permit the polymerization of tubulin into nonmicrotubule structures. PMID- 3955028 TI - Spatial organization of the cytochrome b6-f complex within chloroplast thylakoid membranes. AB - The spatial distribution of the chloroplast thylakoid protein complex comprised of cytochromes f and b-563, and the Rieske iron-sulfur protein (Cyt b6-f) has been controversial because of conflicting results obtained by different techniques. We have combined the following biochemical and immunochemical techniques to approach this question: (1) French press disruption of thylakoids, followed by repeated two-phase aqueous polymer partitioning to separate inside out grana from right-side-out stroma membrane fragments; (2) electrophoretic analysis followed by the 3,3',5,5'-tetramethylbenzidine stain for cytochrome hemes; (3) electroblot analysis with anti-Cyt b6-f antibodies; (4) agglutination of membrane fragments with anti-Cyt b6-f antibodies; and (5) post-embedment thin section immunolabeling of chemically fixed or ultrarapidly frozen chloroplasts with anti-Cyt b6-f antibodies. Our results indicate that the complex is present in both of the isolated membrane fragment populations in similar amounts, with the bulk of the immunoreactive sites exposed to the thylakoidal lumen. Direct immunolabeling of thin-sectioned chloroplasts resulted in localization of the complex throughout the thylakoids, without specialized compartmentation. These results provide both the temporal and spatial resolution necessary for accurate localization of the complex. We concur with models proposing distribution of Cyt b6-f throughout all thylakoid membranes. PMID- 3955029 TI - pH-sensitive transport of Fe2+ across purified brush-border membrane from mouse intestine. AB - Recent studies of Fe2+ uptake by mouse proximal intestine brush-border membrane vesicles revealed low-affinity, NaCl-sensitive and high-affinity, NaCl insensitive, components of uptake (Simpson, R.J. and Peters, T.J. (1985) Biochim. Biophys. Acta 814, 381-388). In this study, the former component is demonstrated to show a strong pH dependence with an optimum of pH 6.8-6.9. Studies at pH 6.5, where the low affinity component is inhibited by more than 25-fold compared with pH 7.2, suggest that the pH-sensitive component represents transport across the brush-border membrane followed by intravesicular binding. Cholate extracts of brush-border membrane vesicles contain pH- and NaCl-sensitive Fe2+ binding moieties which may be involved in the transfer of Fe2+ across the intestinal brush-border membrane and subsequent binding inside the vesicles. Fe2+ uptake by brush-border membrane vesicles from the duodenum of hypoxic mice is higher than uptake by vesicles from control-fed animals, suggesting the existence of a regulable brush-border membrane Fe2+ carrier. PMID- 3955030 TI - Mouse intestinal Fe3+ uptake kinetics in vivo. The significance of brush-border membrane vesicle transport in the mechanism of mucosal Fe3+ uptake. AB - Initial rates of mucosal uptake of Fe3+ from luminal Fe3+-nitrilotriacetate solutions by tied segments of mouse intestine in vivo have been measured. Duodenal uptake showed an approximately hyperbolic dependence of uptake on Fe3+ complex concentration (Km(app) 66 microM, Vmax 6.2 pmol/min per mg intestine) with little dependence on nitrilotriacetate:Fe3+ ratio or on added Ca2+. Duodenal uptake was greatly stimulated by hypoxic treatment of mice. Uptake rates by distal ileum were lower than by duodenum and more sensitive to added Ca2+. These results show that isolated duodenal brush-border membrane Fe3+ transport characteristics (Simpson, R.J. and Peters, T.J. (1984) Biochim. Biophys. Acta 772, 220-226) are inadequate to explain duodenal Fe3+ uptake in vivo. However, ileal uptake can be explained by the properties of isolated ileal brush-border membrane (Simpson, R.J., Raja, K.B. and Peters, T.J. (1985) Biochim. Biophys. Acta 814, 8-12). PMID- 3955031 TI - Interaction of 5-iminodaunorubicin with Fe(III) and with cardiolipin-containing vesicles. AB - 5-Iminodaunorubicin is an anthracycline derivative exhibiting promising antitumor activity. Using potentiometric and spectroscopic measurements we have shown that 5-iminodaunorubicin forms with Fe(III) a complex in which three molecules of drug are bound to one Fe(III) ion. Each molecule is chelated through the C-12-carbonyl and the C-11-phenolate oxygen atoms. The stability constant is 1.6 X 10(34). Using circular dichroism measurements we have studied the interactions of 5 iminodaunorubicin with cardiolipin-containing vesicles. We have shown that cardiolipin could bind one molecule of drug without penetration of the dihydroanthraquinone moiety into the bilayer. PMID- 3955032 TI - Conformation of fatty acyl chains in alpha- and beta-phosphatidylcholine and phosphatidylethanolamine derivatives in sonicated vesicles. AB - Mono- and dimethylated derivatives constitute important intermediates in the conversion of phosphatidylethanolamine (PE) to phosphatidylcholine (PC) in eucaryote membranes. 1H-NMR techniques were utilized to examine the conformation of the region of the fatty acyl chains that is close to the polar group in the series of alpha-phospholipids: PE, N-methyl-PE, N,N-dimethyl-PE, and PC. The same series of polar groups, but on phospholipid containing sn-1 and/or sn-3 fatty acyl chains (beta-phospholipids) were also examined. All of the phospholipids were in the form of small sonicated vesicles which are widely utilized as membrane models. The alpha-methylene group of the sn-1 and sn-2 fatty acyl chains of the alpha-phospholipids give rise to separate signals due to the non equivalency of these chains with respect to the glycerol phosphate backbone on all alpha-phospholipids tested. Additionally, differences in the environment of the PC molecules as well as N-methyl-PE, and N,N-dimethyl-PE, but not PE itself on the inside and outside of the vesicles are reflected in the chemical shift of the alpha-methylene protons. On the other hand, all of the beta-phospholipids (including beta-PE) were found to reflect the inside/outside packing differences in their alpha-methylene groups. The bilayer packing does not induce any nonequivalence in the chemically equivalent acyl chains. In mixed micelles with detergents, beta-phospholipids showed one alpha-CH2 signal for all phospholipids. These results are consistent with a common conformational arrangement for the fatty acyl chains in all alpha-phospholipids that have been investigated no matter what aggregated form. The conformational arrangement in the beta phospholipids is different, but again is similar for all of the compounds tested in various aggregated forms. PMID- 3955033 TI - Calcium movements accompanying the transport of sugar or amino acid by rabbit enterocytes. AB - Isolated rabbit enterocytes can be loaded with radioactive calcium most of which is presumably in intracellular stores. In the presence of sugar or amino acid there is a transient loss of calcium, followed by replenishment. It is suggested that this movement might be related in the signalling leading to increased potassium permeability observed in enterocytes transporting sugar and amino acids. PMID- 3955034 TI - Influence of the phospholipid structure on the stability of liposomes in serum. AB - The effect of serum on the structural integrity of liposomes consisting of ether and/or carbamyl analogs of 1,2-diester phosphatidylcholine (PC) has been evaluated by measuring both the efflux of the entrapped 6-carboxyfluorescein and the lipid transfer to serum proteins, and the results have been compared with the egg PC liposomes. Replacement of the C-1 ester bond in PC by an ether linkage did not significantly enhance the liposome stability, but it was markedly increased upon introducing further structural changes in the C-2 ester region of the resulting 1-ether-2-ester PC. However, the stability was not influenced by altering the steric configuration of the latter phospholipid. These results strongly suggest that lysis of liposomes in serum can be prevented by structurally modifying the ester bond(s) in the phospholipid component of liposomes. PMID- 3955035 TI - An Na+-stimulated Mg2+-transport system in human red blood cells. AB - The initial rate of net Mg2+ efflux was measured in human red blood cells by atomic absorption. In fresh erythrocytes incubated in Na+,K+-Ringer's medium this rate was 7.3 +/- 2.8 mumol/l cells per h (mean +/- S.D. of 14 subjects) with an energy of activation of 13 200 cal/mol. Cells with total Mg2+ contents ([ Mg]i) ranging from 1.8 to 24 mmol/l cells were prepared by using a modified p chloromercuribenzenesulphonate method. Mg2+ efflux was strongly stimulated by increases in [Mg]i and in external Na+ concentrations ([ Na]o). A kinetic analysis of Mg2+ efflux as a function of [Mg]i and [Na]o revealed the existence of two components: an Na+-stimulated Mg2+ efflux, which exhibited a Michaelian like dependence of free internal Mg2+ content (apparent dissociation constant = 2.6 +/- 1.4 mmol/l cells; mean +/- S.D. of six subjects) and on external Na+ concentration (apparent dissociation constant = 20.5 +/- 1.9 mM; mean +/- S.D. of four subjects) and a variable maximal rate ranging from 35 to 370 mumol/l cells per h, and an Na+-independent Mg2+ efflux, which showed a linear dependence on internal Mg2+ content with a rate constant of (6.6 +/- 0.7) X 10(-3) h-1. Fluxes catalyzed by the Na+-stimulated Mg2+ carrier were partially dependent on the ATP content of the cells and completely inhibited by quinidine (IC50 = 50 microM) and by Mn2+ (IC50 = 0.5-1.0 mM). PMID- 3955036 TI - A 2H-NMR study on the interactions of the local anesthetic tetracaine with membranes containing phosphatidylserine. AB - The interaction of the local anesthetic tetracaine with phosphatidylserine containing model membranes has been studied by 2H-NMR. Charged tetracaine exhibited an unusually large partition coefficient into multilamellar dispersions of phosphatidylserine. The 2H-NMR spectra consisted of a Pake doublet and a narrow line, with the former corresponding to tetracaine in the bilayer and the latter to tetracaine free in solution. A strong pH dependence of the quadrupole splittings indicated different membrane locations for charged and uncharged tetracaine. In equimolar mixtures of phosphatidylserine and phosphatidylcholine the partition coefficients and 2H-NMR spectra were much more like those observed in neat phosphatidylcholine than in neat phosphatidylserine. Dilution studies at pH 5.5 indicated that in phosphatidylserine/phosphatidylcholine mixtures tetracaine experiences a three-site exchange similar to that found earlier for tetracaine in phosphatidylcholine. Tetracaine is in fast exchange between sites weakly bound to membrane and free in solution, and in slow exchange with a strongly bound site in the membrane. PMID- 3955037 TI - Lytic effects of melittin and delta-haemolysin from Staphylococcus aureus on vesicles of dipalmitoylphosphatidylcholine. AB - The effects of the lytic peptides, melittin and delta-haemolysin, are compared in vesicles of gel-phase dipalmitoylphosphatidylcholine (DPPC), using calcein as trapped marker. At low concentration, both toxins cause vesicles to lose contents in 5 mM phosphate buffer near neutral pH, with melittin being the more active. As phosphate concentration is increased, the kinetics of melittin-induced leakage change from a slow, sustained loss to a rapid 'burst' of leakage when melittin is present mainly as tetramer in solution, under conditions where it is reported to lose haemolytic activity towards erythrocytes. At low phosphate concentration, the leakage induced by delta-haemolysin is preceded by a lag phase, though fluorescence measurements show that binding of toxin is rapid. At higher phosphate concentration, the toxin binds rapidly to vesicles, but causes no leakage of entrapped calcein. Steady-state fluorescence spectra show no obvious differences in tryptophan emission for delta-haemolysin bound to lipid in high- or low-phosphate buffer. Spin-label fluorescence-quenching studies show that the single tryptophan residue of delta-haemolysin is buried within the lipid bilayer at all phosphate concentrations used. In gel-phase DPPC, delta-haemolysin shows no tendency to cause vesicle aggregation over several hours, as judged by light scattering, though a slow non-linear effect is seen above the lipid phase transition temperature. These effects are contrasted with those of melittin under similar conditions. PMID- 3955038 TI - Lipid composition of subcellular particles from sheep platelets. Location of phosphatidylethanolamine and phosphatidylserine in plasma membranes and platelet liposomes. AB - The lipid composition of whole sheep platelets and their subcellular fractions was determined. The basic lipids show similar distributions in granules, microsomes, plasma membranes and whole platelets. Phospholipid (about 70% of total lipids) and cholesterol (25% of total lipids) are the principal lipid components. Free cholesterol represents about 98% of the total, whereas cholesteryl ester is a minor component. The phospholipid composition found in intact platelets and their subcellular particles is about: 35% phosphatidylethanolamine (PE), 30% phosphatidylcholine (PC), 20% sphingomyelin and 15% phosphatidylserine (PS). We also investigated aminophospholipid topology in intact platelet plasma membranes and platelet liposomes by using the nonpenetrating chemical probe trinitrobenzenesulfonic acid (TNBS), because they are the major components of total lipids. In intact platelets, PS is not accessible to TNBS during the initial 15 min of incubation, whereas 18% PE is labelled after 15 min. In contrast, in phospholipid extracted from platelets 80% PE and 67% PS react with TNBS within 5 min, while 27 and 25% PE and 15 and 19% PS from liposomes and isolated plasma membranes, respectively, were modified after 15 min of incubation. In view of this chemical modification, it is concluded that 22% of PE and less than 1% of PS are located on the external surface of intact platelet plasma membranes. The asymmetric orientation of aminophospholipids is similar between liposomes and isolated plasma membrane. PS (23 and 28%) and PE (34 and 31%) are scarcely represented outside the bilayer. The data found are consistent with the nonrandom phospholipid distribution of blood cell surface membranes. PMID- 3955039 TI - Temperature-dependent specificity of cis-trans isomeric fatty acid interaction with the erythrocyte membrane. AB - Stabilization of red cells against hypotonic haemolysis by cis-trans isomeric free C18 fatty acids occurs with pronounced specificity which is strongly temperature-dependent, but in a distinctly different manner for the two configurational isomers. Oleic acid (cis-18:1) stabilizes very efficiently at 0 degrees C, even at the highest concentrations. Elaidic acid (trans-18:1) causes neither stabilization nor haemolysis at this temperature. At room temperature (23 degrees C), elaidic acid acquires the ability to protect, without turning haemolytic at high concentrations. At 37 degrees C elaidic acid also becomes haemolytic. The protecting effect of oleic acid at 0 degrees C is the result of a rapid reaction. The characteristic, temperature-dependent specificity of cis trans isomeric C18 fatty acid interaction with the red cell membrane appears to be a general phenomenon, since it was observed alike with erythrocytes of different species. PMID- 3955040 TI - Determination of kinetic parameters of a carrier-mediated transport in the perfused intestine by two-dimensional laminar flow model: effects of the unstirred water layer. AB - The kinetic parameters of a carrier-mediated transport for D-glucose and for taurocholate were determined from rat in situ intestinal single perfusion experiments. The true parameters were obtained by the two-dimensional laminar flow model, in which the solute concentration at the aqueous-intestinal membrane interface can be calculated numerically without assuming the aqueous diffusion layer, discriminating the effects of the unstirred water layer. The true Michaelis constant was 4.5 mM for D-glucose and 1.5 mM for taurocholate. The true maximal transport velocity was 3.4 nmol/s per cm2 for D-glucose and 0.29 nmol/s per cm2 for taurocholate. The apparent Michaelis constant was raised by the factor of 6.6 for D-glucose and 3.6 for taurocholate due to the effects of the unstirred water layer. The maximal transport velocity was relatively unaffected by the unstirred water layer in both compounds. The values of the effective (operational) thickness of the unstirred water layer were compatible with those reported previously by employing various experimental methods. The kinetic parameters obtained in vitro everted sacs, for comparison, almost coincided with the true ones in situ. Therefore, the two-dimensional laminar flow model is shown to be valid not only for determining the kinetic parameters of a carrier-mediated transport in situ but also for predicting the absorption rate in situ from the uptake rate in vitro. PMID- 3955041 TI - Estimation of the phospholipid distribution in the human platelet plasma membrane based on the effect of phospholipase A2 from Naja nigricollis. AB - Human platelets in three physiological states were prepared. These states were the gel-filtered, the thrombin-induced shape-changed, and the thrombin-activated platelets. The phospholipid distributions in these three types of membrane were probed by using the basic phospholipase A2 of Naja nigricollis. This enzyme could penetrate through these membranes to hydrolyze all of their accessible phospholipids and to cause cell lysis. The hydrolytic time-courses displayed three phases. The state of platelet in each lipid hydrolytic phase was examined by: (1) measuring the leakage of lactate dehydrogenase; (2) analyzing the morphology by both scanning and transmission electron microscopy (scanning EM and transmission EM); and (3) estimating the hydrolysis of the [32P]phosphate-labeled platelets. The existence of these three hydrolytic phases may signify that the phospholipase A2 sequentially hydrolyzed its substrates in the membrane outer leaflet, in the inner one, and in the cytosol. The content and the distribution of each phospholipid class in the plasma membranes of the resting and of the shape-changed platelets were similar. These membrane surfaces consisted mainly of phosphatidylcholine (PC) and phosphatidylethanolamine (PE). Phosphatidylserine (PS) was not exposed on the surface of the shape-changed platelet. The content of each lipid class in the activated platelet membrane was 10% more than that in the resting platelet. PS was found on the activated platelet cell surface. This implies that PS is exposed only during platelet secretion. PMID- 3955042 TI - Isolation and characterization of brush-border membrane from trout intestine. Regional differences. AB - The isolation of brush-border membranes from trout enterocytes is described for both middle and posterior intestine. Both procedures are based on differential centrifugations combined with calcium precipitation. Classical marker enzymes are quantified and indicate a valuable purification of the membranes (13-18-fold). No difference appears when comparing the relative amounts of phospholipids, cholesterol and proteins in microvillus membranes isolated from either middle or posterior intestine. In contrast, the membranes isolated from middle intestine are more unsaturated than those from the posterior one, and their sphingomyelin/phosphatidylcholine ratio is lower. These differences are reflected by fluorescence anisotropy studies with diphenylhexatriene as lipid fluorophore which indicate a higher fluidity of the microvillus membranes from the middle intestine as compared with those from the posterior intestine. These results point out the importance of the fatty acyl chains and that of the relative amounts of phosphatidylcholine and sphingomyelin in controlling the fluidity of biological membranes in relation with their transport properties. PMID- 3955043 TI - Partition of chlorpromazine into lipid bilayer membranes: the effect of membrane structure and composition. AB - Partition coefficients, kp, of chlorpromazine between the aqueous phase and lipid bilayer vesicles were determined as function of drug concentration, lipid chain length, cholesterol content and temperature encompassing the range of the lipid phase transition. Radioactivity and absorption measurements were performed to determine the kp values. Up to a concentration of 3 . 10(-5) M, the partition coefficient is independent of chlorpromazine concentration, whereas it decreases drastically at higher chlorpromazine concentrations, at which membrane lysis is observed. Membrane structure is not disturbed at less than 3 . 10(-5) M chlorpromazine, as was concluded from electron paramagnetic resonance studies measuring TEMPO partitioning and order degree. However, the lipid phase transition temperature decreases and is broadened at higher chlorpromazine concentrations. From fluorescence measurements, we conclude the formation of chlorpromazine micelles at concentrations higher than 5 . 10(-5) M in chlorpromazine in the absence of lipids and the formation of mixed micelles in the presence of lipids. The effect of lipid chain length on kp values was investigated. The partition coefficient decreases from 8100 in dilauroyl- to 3400 in dipalmitoylphosphatidylcholine vesicles, both at 50 degrees C, that is, above their corresponding phase-transition temperature tt. At t less than tt the kp values are strongly reduced, by at least a factor of 10, depending on lipid chain length and membrane composition. It is possible to establish a lipid phase transition curve from the temperature-dependent measurements of the kp values. Cholesterol within the lipid membrane strongly decreases kp. At 20 mol% cholesterol in dipalmitoylphosphatidylcholine membranes, the partition coefficient is reduced from 3400 to 2300. This value is well comparable to the kp value obtained in erythrocyte ghosts. In contradiction to earlier experiments by Conrad and Singer (Biochemistry 20 (1981) 808-818), this value in a biological membrane could be obtained by the hygroscopic desorption as well as the centrifugation method. From our experiments we are justified in further considering artificial bilayer membranes as models for biological membranes. PMID- 3955044 TI - Phospholipid structure determines the effects of peptides on membranes. Differential scanning calorimetry studies with pentagastrin-related peptides. AB - The effect of phospholipid structure on the interaction between small peptides and phospholipid membranes has been studied by high-sensitivity differential scanning calorimetry. The peptides used, N-Boc-beta-Ala-Trp-Met-Arg-Phe-NH2 and N Boc-beta-Ala-Trp-Met-Lys-Phe-NH2, are basic analogs of the hormone pentagastrin. These peptides split the gel-to-liquid crystalline phase transition of synthetic phosphatidylcholines into two components. For dimyristoyl (DMPC), dipalmitoyl (DPPC) and 1-stearoyl-2-oleoyl (SOPC) phosphatidylcholines, one component remains at the temperature corresponding to that of pure lipid and the other one is shifted towards higher temperatures. With increasing peptide concentration there is a gradual increase in the enthalpy of the high-temperature component at the expense of the low-temperature one, and there is also an increase in the total enthalpy of the transition. A mixture of the peptide with distearoylphosphatidylcholine (DSPC) behaves differently, with the transition occurring at a temperature below that of the pure lipid increasing with peptide concentration. The susceptibility of various phosphatidylcholines to perturbation by the peptides increases in the order DMPC greater than SOPC greater than DPPC greater than DSPC. The effect of these peptides on the phase transitions of acidic phosphatidylglycerols is generally greater than with the corresponding phosphatidylcholines, but the dependence on the length of lipid hydrocarbon chains is similar. Perturbation of the thermotropic phase transition is strongest for dimyristoylphosphatidylglycerol, followed by the dipalmitoyl and the distearoyl analogs. The effect of the peptides on the phase transition of dimyristoylphosphatidylserine is significantly smaller compared to that observed with dimyristoylphosphatidylglycerol and it is further reduced for dimyristoylphosphatidic acid. The phase transition of this latter lipid remains virtually unchanged, even in the presence of high concentrations of the peptide. Similar resistance to the perturbation of the phase transitions by the peptides is observed for synthetic phosphatidylethanolamine. The different susceptibility of various phospholipids to perturbation by the peptides is suggested to be related to different degrees of intermolecular interaction between phospholipid molecules, and particularly to different abilities of phospholipids to form intermolecular hydrogen bonding. PMID- 3955045 TI - Modulation of salt permeabilities of intestinal brush-border membrane vesicles by micromolar levels of internal calcium. AB - A possible modulation of ion permeabilities of rat intestinal brush-border membrane vesicles by Ca2+, a putative second messenger of salt secretion, was explored by three independent methods: (1) measurements of [3H]glucose accumulation driven by a Na+ gradient; (2) stopped-flow spectrophotometry of salt induced osmotic swelling; (3) 86Rb+, 22Na+ and 36Cl- flux measurements. Cytoskeleton-deprived membrane vesicles were prepared from isolated brushborders by thiocyanate treatment. Intravescicular Ca2+ levels were varied by preincubating vesicles in Ca-EGTA buffers in the presence of the Ca2+-ionophore A23187. At Ca2+free greater than 10(-5) M, initial Na+-dependent glucose uptake in the presence of a 0.1 M NaSCN gradient (but not in its absence) was inhibited by about 50 per cent as compared to EGTA alone (ED50 approximately equal to 10( 6) M Ca2+). By contrast, initial rates of 22Na+ uptake and reswelling rates of vesicles exposed to a NaSCN gradient were increased at least 2-fold by 10(-5) M Ca2+free. Both observations are compatible with a Ca2+-induced increase of the Na+-permeability of the vesicle membrane. The modulation of ion transport was fully reversible and critically dependent on internal Ca2+, suggesting a localization of Ca2+-sensor sites at the inner surface of the microvillous membrane. As shown by radiotracer and osmotic swelling measurements, micromolar Ca2+ additionally increased the flux rate of K+, Rb+, Cl- and NO-3 but did not change the membrane permeability for small uncharged molecules, including glucose and mannitol. The effect of Ca2+ on ion permeabilities could be blocked by Ba2+ (10(-3) M) or Mg2+ (10(-2) M), but not by amiloride (10(-3) M), apamin (2 X 10( 7) M), trifluoperazine (10(-4) M) or quinine (5 X 10(-4) M). At present it is unclear whether Ca2+ activates a nonselective cation and anion channel or multiple highly selective channels in the vesicle membrane. PMID- 3955046 TI - Calcium binding properties of purified zymogen granule membrane of pig pancreas. Evidence for calcium binding proteins. AB - Ca2+ binding properties of purified zymogen granule membranes of pig pancreas have been measured: Binding increased linearly with Ca2+ concentration in the medium up to the micromolar range; in the millimolar range a sharp rise in binding capacity was observed. Binding increased with pH both at low and high concentrations of Ca2+. It was insensitive to Na+ and K+ ions at concentrations up to 100 mM. Mg2+ was inhibitory in the millimolar range whereas La2+ and Tb3+ were inhibitory in the micromolar range. The Ca2+ binding components of zymogen granule membranes were identified by two methods: (1) by measuring 45Ca2+ binding after counter-ion electrophoresis and (2) by Stain's-all (forms a complex with Ca2+ binding proteins absorbing maximally at 600 nm), after SDS-polyacrylamide gel electrophoresis. The first method, counter-ion electrophoresis, indicated that most of the 45Ca2+ was associated with an acidic band which could be subsequently subfractionated by SDS-polyacrylamide gel electrophoresis in five bands: 66, 57, 30, 27 and 22.5 kDa. The second method, Stain's-all, revealed six positive polypeptides after SDS-polyacrylamide gel electrophoresis of native zymogen granule membranes' two were unreactive after neuraminidase treatment (130 and 92 kDa, respectively), whereas four other bands were still reactive (66, 57, 43, 30 kDa, respectively.) Ca2+ binding was also measured on intact zymogen granules: the binding capacity was higher than for zymogen granule membranes. Among the Ca2+ binding proteins of the zymogen granule membrane only one is apparently located on the granule external surface: the 30 kDa polypeptide. If Ca2+ directly facilitates fusion of zymogen granules with plasma membrane by a Ca2+-protein interaction, then this protein is a presumptive candidate to play such a key role. PMID- 3955047 TI - Biotin uptake by isolated rat intestinal cells. AB - Isolated intestinal mucosa cells of rats were used to investigate the intestinal transport of biotin. This method utilizing a double-label isotope technique showed that uptake could not be saturated, even in a wide range of biotin concentrations (0.01-2 microM). A metabolic inhibitor (antimycin A) did not prevent cell uptake of biotin. The transport mechanism was independent of temperature (Q10 = 1.04). When excess biotin was added to the incubation medium, there was no efflux of the vitamin from intestinal cells. The results also showed that the cells did not concentrate the vitamin, regardless of its concentration in the incubation medium. The mechanism of biotin uptake by rat cells at physiological concentrations is thus a passive diffusion phenomenon. PMID- 3955048 TI - Electrophysiology of phagocytic membranes. Role of divalent cations in membrane hyperpolarizations of macrophage polykaryons. AB - The electrophysiological properties of the membrane of mouse peritoneal macrophage polykaryons are studied. Slow hyperpolarizations can be elicited by iontophoretic injections of either Ca2+ or Sr2+ into the cytoplasm. The effect of both cations is identical, since: it is invariably triggered by the cation injection, the amplitude is dependent on the K+ gradient, quinine blocks reversibly the response to both cation injections. Mg2+, Ba2+ and Mn2+ did not elicit responses when injected into the cytoplasm. Ca2+ induced slow hyperpolarizations were reversibly blocked by the addition of Ba2+ to the external saline, but were not affected by the presence of external tetraethylammonium chloride. Cells maintained in saline containing high concentrations of Ca2+, Sr2+ or Mn2+ exhibited sustained hyperpolarizations. Quinine blocked the hyperpolarization induced by high Ca2+ or Sr2+, but was ineffective for the case of Mn2+. Cells hyperpolarized by external Mn2+ frequently exhibited nonlinear, voltage-current characteristics. Similar patterns could also be observed in a small fraction (less than 10%) of the cells in control conditions. Current-induced shifts between two stable membrane potentials were seen either in high Ca2+ or normal medium. The great variability of the responses described for this phagocytic membrane is discussed. The evidence supports the assumption that Ca2+ and Sr2+ can induce transient or persistent hyperpolarized states by activating a potassium permeability. External Mn2+ may act in part by reducing impalement-related current leakage from the phagocytic membrane. PMID- 3955049 TI - Ultrastructural and cytochemical characterization of adrenal medullary plasma membrane vesicles and their interaction with chromaffin granules. AB - Plasma membrane vesicles obtained by density gradient centrifugation of bovine adrenal medullary homogenates were analyzed by electron microscopic methods, including negative staining, ultrathin sections and freeze-fracture replicas. Rapid freezing showed the intramembrane structure of plasma membrane vesicles to be distinct from that of other organelle membranes, such as chromaffin granules. Cytochemical demonstration of acetylcholinesterase (EC 3.1.1.7) activity on most membrane profiles confirmed that plasma membrane vesicles are derived predominantly from plasma membranes. About half of the plasma membrane vesicles were smaller than 0.15 micron and almost none larger than 0.55 micron. Practically all were composed of single shells. Most vesicles were impermeable to cytochemical markers of the size of Ruthenium red (Mr 800) and none were permeable to markers larger than 40 kDa. Surface charge probes, concanavalin A binding and endogenous actin decoration with heavy meromyosin indicated that the major fraction of plasma membrane vesicles is oriented right-side-out. A minor population with opposite orientation could also be detected. Isotonic ionic media caused vesicle aggregation in suspensions of plasma membrane vesicles and chromaffin granules. Freeze-fracturing always revealed clusters of membrane intercalated particles at the sites of contact between aggregated membranes. PMID- 3955050 TI - Effects of dimethylsulfoxide on membrane currents of neuroblastoma x glioma hybrid cell. AB - Giga-ohm seal whole cell recording technique was used to examine ionic currents changes induced by dimethylsulfoxide (DMSO) in neuroblastoma X glioma hybrid NG 108-15 cells. DMSO (0.5-1%) reversible blocks sodium, potassium and calcium currents and shifts by about 6 mV the sodium inactivation curve towards more negative voltages. PMID- 3955051 TI - Sequence signals in eukaryotic upstream regions. AB - In eukaryotes, as in prokaryotes, evidence is accumulating showing that transcription factors recognize and bind to certain promoter elements. Sequence and chromatin structure perturbation specify the transcription initiation site and govern its efficiency. Two oligomers have been implicated in these processes: the TATAAATA and CCAAT. In the present work, all mammalian, non-mammalian vertebrate and invertebrate sequences accumulated in the database have been aligned by their mRNA start positions and scanned for recurrences of the 32 complementary triplets. The more significant signals are summarized here. In particular, TAT/ATA recurs very frequently further upstream, at -275, in addition to the 'classical' -40 position. Downstream their level is very low. The CAAT box complementary triplet components are not among the more striking signals. Closer examination of the -275 region indicates that to a large extent the signal is due to both the ATAT and the TATA quartets. Comparison of the frequencies of these quartets at -275 with the CAAT quartet at -80 suggests that the former signal is twice the strength of the latter. The oligomers' distribution charts support notions that several components are involved in recognition, making the regulatory regions more robust and less sensitive to mutations. PMID- 3955052 TI - Substrate preferences of human placental DNA methyltransferase investigated with synthetic polydeoxynucleotides. AB - A DNA methyltransferase partly purified from human placenta has been tested on a variety of synthetic polydeoxynucleotides. The results showed that: the enzyme is most active as a 'maintenance' or 'hemi-' methylase but also has some de novo methylating activity; the presence or absence of A or T in the substrate strand has little influence on maintenance or de novo activity, while polymers containing C but not G in the same strand are poor de novo substrates and bind poorly to the enzyme; single-stranded polymers are about as good substrates as double-stranded ones, and the effects of nucleotide composition (particularly G and mC content) on enzyme activity with single strands are similar to those with double-stranded polymers; strands in which all the cytosines are methylated bind the enzyme well. A mechanism is suggested involving two different sites on the enzyme that recognize CG and mCG, and which rationalizes the activity of eukaryotic DNA methyltransferases towards single-stranded DNA. PMID- 3955053 TI - Kinetics of inhibition of rat liver and kidney arginases by proline and branched chain amino acids. AB - The effects of proline, leucine, isoleucine and valine on kidney and liver arginases were studied. At pH 7.5 and at nearly physiological concentrations, the branched-chain amino acids caused a significant inhibition of liver arginase A1 and only minor effects on kidney arginase A4. Kidney arginase was, however, much more sensitive to inhibition by proline than the liver enzyme. The inhibition of liver and kidney arginases by branched-chain amino acids was partial, indicating the existence of allosteric sites on both enzymes. The function of kidney arginase in proline biosynthesis and a possible role of branched-chain amino acids in the hydrolysis of arginine in liver is discussed. PMID- 3955054 TI - Determination of rate constants for the irreversible inhibition of acetylcholine esterase by continuously monitoring the substrate reaction in the presence of the inhibitor. AB - The kinetics of the irreversible inhibition of acetylcholinesterase (acetylcholine acetylhydrolase, EC 3.1.1.7) by diisopropyl fluorophosphate and paraoxon have been studied by the approach of following the substrate reaction continuously in the presence of both the substrate and the inhibitor based on kinetic equations previously derived (Tsou, C.-L. (1965) Acta Biochim. Biophys. Sinica 5, 387-417). From determinations of the effects of different concentrations of substrate and the inhibitors on the apparent rate constants for the irreversible inhibition reactions it can be shown that these inhibitors are of the competitive complexing type. Both the reversible dissociation constant for the enzyme inhibitor complex and the rate constant for the subsequent phosphorylation step can be obtained from suitable plots of the experimental data. PMID- 3955055 TI - Thrombin-reactive polypeptides of platelets may regulate inhibition of thrombin by antithrombin. AB - The central enzyme involved in blood coagulation and activation of platelets is the serine proteinase thrombin. The principal inhibitor of this proteinase in plasma is antithrombin. The mechanism of regulation of the thrombin-antithrombin reaction remains unknown. Two polypeptides of 74 and 55 kDa present on the platelet surface and in plasma are known to specifically enhance the activity of thrombin on different substrates. This study was undertaken to assess the effects of these platelet proteins on thrombin-antithrombin interaction. Direct measurements of residual thrombin activity in mixtures of thrombin and antithrombin, in the presence or absence of the platelet proteins, were made utilizing a specific chromogenic substrate. Under these conditions, when 60% of thrombin activity was inhibited by antithrombin in controls, 100% of enzyme activity was retained in the presence of the platelet proteins. When heparin was used in these assays, the rate of inhibition of thrombin by antithrombin was much more rapid and 62% of thrombin activity remained after 1 min. Under these conditions, the platelet proteins continued to protect thrombin from inactivation with 98% activity remaining at 1 min and 85% activity at 5 min. In contrast, the inhibition of trypsin by antithrombin was not affected by the platelet proteins. Additional studies in platelet aggregation showed that the platelet polypeptides have two effects on thrombin: (i) protection of the enzyme inhibition by antithrombin and (ii) stabilization of thrombin from loss of activity due to aging. The results suggest a novel role for the platelet proteins in hemostasis - regulation of the inhibition of thrombin by antithrombin. PMID- 3955056 TI - Studies on the structural polymorphism of the alpha-II domain of human erythrocyte spectrin. AB - Following restricted tryptic digestion at 4 degrees C, a structural polymorphism affecting the alpha-chain of human spectrin, the major erythrocyte membrane skeleton protein, has recently been described in American blacks (Knowles, W.J., Bologna, M.L., Chasis, J.A., Marchesi, S.L. and Marchesi, V.T. (1984) J. Clin. Invest 73, 973-979). Four variants affecting the alpha-II domain or its tryptic products have been characterized, depending on changes in molecular weight and/or isoelectric point. One variant of the alpha-II domain (Type 2) shows an increase in apparent molecular weight and basic shift in pI. It contains a limit chymotryptic peptide showing a change in chromatographic mobility on two dimensional electrophoresis which is thought to reflect a sequence alteration associated with the increase in apparent molecular weight. We find that this altered limit chymotryptic peptide is not unique to the Type 2 variant, but is also present in a variant (Type 4) showing only the same basic shift in pI as the Type 2 variant. It is not found in a variant (Type 3) showing only an increase in apparent molecular weight. The most likely explanation for these findings is that the altered limit chymotryptic peptide common to both the Type 2 and Type 4 variants is responsible for the change in isoelectric point which is common to both these variants. An as yet unidentified change elsewhere in the polypeptide chain must be responsible for the observed alteration in molecular weight of the Types 2 and 3 variants. PMID- 3955058 TI - Examination of folding patterns for predicting protein topologies. AB - From the prediction of protein secondary structures, formation energies may be estimated for each incipient nucleus of the folding process. The averaging which may be performed on large families of distantly related proteins improves the accuracy of measurement of these energies and the efficiency of the prediction of the different steps involved in the protein folding (secondary structures, domain boundaries, topologies, etc.) and allows the description of new folding patterns. PMID- 3955057 TI - Inhibition by glutathione derivatives of bovine liver glyoxalase II (hydroxyacylglutathione hydrolase) as a probe of the N- and S-sites for substrate binding. AB - The nature of the binding determinants used in the interaction of glutathione based derivatives and bovine liver glyoxalase II (S-(2-hydroxyacyl)glutathione hydrolase, EC 3.1.2.6) has been investigated. Linear competitive inhibition was observed for S-blocked and S,N-blocked glutathiones with bovine liver glyoxalase II (molecular weight 22 500 by sodium dodecyl sulphate polyacrylamide gel electrophoresis; pI = 7.48 by analytical isoelectric focussing). There is a significant hydrophobic region on the enzyme to bind substituents around the sulphydryl-derived moiety of the substrate--a hydrophobic S-site. However, there is no evidence for binding of the N-site of the substrate (or inhibitor) to glyoxalase II. In contrast to glyoxalase I, there is no linkage between binding forces used at the S- and N-sites. Binding of S,N-dicarbobenzoxyglutathione is pH dependent, showing dependence on an ionisation with pKapp approximately equal to 7.2 (binding more tightly at higher pH), as is the kcat value (pKapp approximately equal to 7.8) for S-D-lactoylglutathione. PMID- 3955059 TI - Effects of iron deficiency and chronic iron overloading on mitochondrial heme biosynthetic enzymes in rat liver. AB - The effects of iron deficiency and iron overloading on the mitochondrial enzymes involved in heme synthesis were studied in rat livers. The in vitro activities of several of the enzymes in this pathway were differentially influenced by the in vivo iron status of the animals. delta-Aminolevulinic acid synthase was slightly increased in iron-overloaded animals, but remained normal in iron-deficient animals (0.58 +/- 0.09, 0.91 +/- 0.19 and 0.61 +/- 0.12 nmol delta-aminolevulinic acid/mg per h). Copro- and protoporphyrinogen oxidase activities were increased (20 and 60% above controls) in iron-deficient animals. In contrast, coproporphyrinogen oxidase was decreased by 20%, while protoporphyrinogen oxidase remained unchanged in iron-overloaded rats. These variations of activities were not due to changes in the affinity of these enzymes toward their substrates, as coporphyrinogen had the same Km in each case (0.62 +/- 0.05 M) as did protoporphyrinogen (0.22 +/- 0.035 M). Thus, the Km did not vary with the treatment received by the animals. Ferrochelatase activity was measured by both the pyridine hemochromogen method and by measurement of zinc protoporphyrin with endogenous zinc as substrate. In all cases, ferrochelatase was found to be able to synthesize zinc protoporphyrin with endogenous zinc as substrate. However, the apparent Km of zinc chelatase for protoporphyrin was significantly different in the three groups of animals with Km,appProto, app = 2.4 +/- 0.1 10(-7), 4 +/- 0.3 10(-7) and 9.10 +/- 0.05 10(-7) M in iron-overloaded, control and iron-deficient animals, respectively. When ferrochelatase activity was measured by pyridine hemochromogen, identical results were observed in iron-deficient and control animals but decreased by 45% in iron-overloaded animals. The mitochondrial heme content was also decreased by 40% in iron-overloaded rats but unchanged in either iron-deficient or control rats. PMID- 3955060 TI - Behavior of chymotrypsinogen during low pH gel electrophoresis is altered by persulfate. AB - Chymotrypsinogen was observed to have two bands in a low-pH gel electrophoresis system, though the protein was pure by other criteria. Other proteins have also been reported to give artifacts under these conditions. Removal of persulfate from the gel by pre-electrophoresis or by substituting riboflavin eliminated the artifacts. The affected amino acid residue was identified as tryptophan by titration of persulfate-treated proteins with 2-hydroxy-5-nitrobenzyl bromide and by the spectral method of Edelhoch. Persulfate-treated chymotrypsinogen had the same mobility as the artifact, while oxidation of Met-192 with hydrogen peroxide produced a protein with a different mobility. PMID- 3955061 TI - Cytochrome P-450 deficiency and resistance to t-butyl hydroperoxide of hepatoma microsomal lipid peroxidation. AB - Lipid peroxidation of microsomes from rat liver and Morris hepatoma 9618A was induced by means of tert-butyl hydroperoxide (t-BuOOH). In rat liver microsomes t BuOOH stimulated an early formation of lipid hydroperoxides (LOOH) and an increasing accumulation of malondialdehyde; t-BuOOH was completely consumed and cytochrome P-450 was rapidly destroyed. In hepatoma microsomes (60% deficiency of cytochrome P-450) a remarkable inhibition of both malondialdehyde and LOOH was observed; t-BuOOH was consumed only partially and cytochrome P-450 was destroyed slowly. In the presence of aminopyrine, malondialdehyde production was inhibited to the same extent (about 70%) in normal and tumour microsomes. The concentration of t-BuOOH required to achieve half-maximal velocity of malondialdehyde accumulation was comparable in the two microsome types. It is proposed that the deficiency of cytochrome P-450 limits the activation of t-BuOOH to the free radical species which initiate lipid peroxidation. Low cytochrome P-450 content would also affect the LOOH-dependent propagation of lipid peroxidation. PMID- 3955062 TI - Hydrolysis of lipid monolayers and the substrate specificity of hepatic lipase. AB - The substrate specificities of the phospholipase and triglyceridase activities of purified rat liver hepatic lipase were compared using lipid monolayers so that the substrates were presented to the enzyme in a controlled physical state. The rate of hydrolysis of 14C-labeled lipid at constant surface pressure in the presence of hepatic lipase and fatty acid-free bovine serum albumin at 33 degrees C was determined by monitoring the decrease of surface radioactivity. In monolayers of sphingomyelin/cholesterol (2:1, mol/mol) containing either 1 mol% triacylglycerol, 1 mol% phosphatidylethanolamine, or 10 and 20 mol% phosphatidylcholine, hepatic lipase clearly showed a preference for unsaturated over saturated lipids. In addition, with a sphingomyelin/cholesterol (2:1) monolayer containing 1 mol% of lipid substrate, hepatic lipase showed the following preference: triolein = dioleoylphosphatidylethanolamine much greater than dioleoylphosphatidylcholine; the respective rates of hydrolysis were 15.3 +/ 1.2, 14.9 +/- 0.8, and 0.5 +/- 0.1 mumol fatty acid produced/h per mg hepatic lipase. Overall, it appears that when comparing rates of hydrolysis of molecules within a given lipid class, hydrocarbon chain interactions are important. However, when comparing different lipid classes such as phosphatidylcholines and phosphatidylethanolamines, it is apparent that the polar group has a significant influence on the rate of hydrolysis. The rate of [14C]triolein hydrolysis, when mixed at surface concentrations of up to 2 mol% in a sphingomyelin/cholesterol (2:1) monolayer, was significantly faster than when triolein was present in a 1 oleyl-2-palmitylphosphatidylcholine monolayer; the rates of hydrolysis were 47.7 +/- 5.4 and 8.9 +/- 0.8 mumol fatty acid produced/h per mg hepatic lipase, respectively. The monolayer physical state and the miscibility of the substrate in the inert matrix influence the presentation of the substrate to the enzyme, thereby affecting the hydrolysis rate. PMID- 3955063 TI - Effect of combined lipase deficiency (cld/cld) on hepatic and lipoprotein lipase activities in liver and plasma of newborn mice. AB - Combined lipase deficiency (cld/cld) is a recessive mutation in mice which results in massive hyperlipemia and death within 3 days after birth. We studied the effect of this deficiency on lipolytic activities in liver and in pre- and postheparin plasma of mice less than 2 days old. Anti-hepatic lipase serum inhibited more than 85% of the lipolytic activity in liver and plasma of normal newborn mice when assayed in high-salt medium, validating the use of this medium for measuring hepatic lipase activity in mice. Anti-lipoprotein lipase serum, in contrast, inhibited only two-thirds of the lipolytic activity in liver and plasma when assayed in serum low-salt medium, and anti-hepatic lipase serum inhibited the rest. This indicates that assay with serum low-salt medium alone is not specific for lipoprotein lipase activity in mice. Therefore, immunoinhibition was used, as needed, for measuring lipoprotein lipase activity. The livers of unaffected newborn mice contained high levels of both hepatic and lipoprotein lipase activities, 228 and 187 mU/g, respectively. The plasma of unaffected mice contained a high level of hepatic lipase activity, 244 mU/ml, but practically no lipoprotein lipase activity. Heparin injected intraperitoneally increased plasma lipoprotein lipase activity to 152 mU/ml, but had no effect on plasma hepatic lipase activity, in unaffected mice. Hepatic lipase activity was virtually absent from both liver and plasma of cld/cld mice. Lipoprotein lipase activity was present in the liver at a surprisingly high level, 40% of that in normals, but was barely detectable in plasma. Heparin injection increased plasma lipoprotein lipase activity in cld/cld mice, but the increment was less than 10% of that in unaffected mice. Heparin had no significant effect on plasma hepatic lipase activity in defective mice. These findings confirm preliminary observations that hepatic lipase activity in liver and plasma and lipoprotein lipase activity in plasma are markedly reduced in combined lipase deficiency. The unexpected high level of lipoprotein lipase activity in liver of cld/cld mice suggests that regulation of lipoprotein lipase activity in liver of neonatal mice is different from that in other tissues. PMID- 3955064 TI - Nutritional regulation of lipoprotein lipase in guinea pig tissues. AB - Glucose transport in guinea pig adipocytes has been shown to be markedly resistant to stimulation by insulin. Lipoprotein lipase is another transport catalyst in adipose tissue which is believed to be regulated by insulin. We have therefore studied how feeding-fasting affects lipoprotein lipase activity in guinea pig tissues. There was an even more marked decrease in adipose tissue lipoprotein lipase activity on fasting in guinea pigs (10-20 fold) than in rats or mice (4-5 fold). In adipocytes, the activity decreased only 2.5-4.5 fold; most of the change was in extracellular lipoprotein lipase. On glucose refeeding, the activity was rapidly restored. In the first 4 hours after glucose administration extracellular lipoprotein lipase activity increased to more than 10 times the amount present in adipocytes. After cycloheximide, lipoprotein lipase activity decreased with a half-life of 22 min. It is concluded that lipoprotein lipase is rapidly produced and turned over in guinea pig adipose tissue, and that the system is quite sensitive to feeding-fasting. In contrast to adipose tissue, there was no significant change in lipoprotein lipase activity in any other tissue on fasting. There was a strong correlation between the activities in heart and diaphragm muscle, but this correlation was independent of feeding-fasting. PMID- 3955065 TI - The effect of clofibrate on the phospholipid composition of the peroxisomal membranes in mouse liver. AB - Membranes were prepared from peroxisomes which had been isolated from the livers of normal mice and from mice treated with clofibrate (a hypolipidemic drug and peroxisome proliferator). Phospholipid analysis of these membranes revealed that clofibrate treatment resulted in a decrease in the membrane content of phosphatidylcholine, the most abundant phospholipid, and a concomitant increase in the amount of lysophosphatidylcholine, this latter component reaching a level of almost 6% of the total membrane phospholipid. The concentrations of other phospholipids in these membranes were not significantly altered. The parallel analysis of microsomal membranes demonstrated an analogous increase in the level of lysophosphatidylcholine following clofibrate treatment. In control experiments with microsomal membranes employing quinacrine, an inhibitor of phospholipase A2, the increased lysophosphatidylcholine concentration was still observed in clofibrate-treated animals. As well, a decrease in the proportion of microsomal phosphatidylcholine with clofibrate treatment was seen when quinacrine was used. Fatty acid analysis of the phosphatidylcholines from peroxisomal membranes showed some minor changes, including an increase in one component tentatively identified as docosahexaenoic acid, in clofibrate-treated animals. Overall, these data demonstrate that clofibrate causes a marked perturbation of the phospholipid composition of peroxisomal membranes, and are interpreted as indicating that the main site of action of the drug is the deacylation-reacylation cycle between phosphatidylcholine and lysophosphatidylcholine. PMID- 3955066 TI - Low-density lipoprotein receptor activity in the guinea pig adrenal cortex. II. Zonal response to aminoglutethimide and 17 alpha-ethinylestradiol. AB - Low-density lipoprotein (LDL) receptor activity and the concentration of cholesterol were measured in the outer (glomerulosa/fasciculata) and inner (reticularis) zones of the adrenal cortex of the guinea pig to examine the relation between cholesterol content and LDL receptor activity. While the concentration of cholesterol was 2-3-times higher in the outer cortical zone, the maximum high-affinity binding capacity for LDL was essentially the same for the two zones, or slightly higher for the inner zone. Adrenocorticotrophic hormone (ACTH) caused a significant increase in LDL receptor activity only in the outer zone, but led to a reduction in the cholesterol content in both adrenocortical zones. The treatment of animals with 17 alpha-ethinyl-estradiol also resulted in a reduction of cholesterol in both adrenocortical zones, but an increase in LDL receptor number only in the outer zone. The latter effect was partially reversed by the administration of dexamethasone. Aminoglutethimide, which was used in a dose that did not block steroidogenesis but did block the hydrolysis of cholesteryl esters in response to ACTH, did not prevent the ACTH-induced increase in LDL receptor number in the outer zone. Thus, the number of LDL receptors was increased in the zona fasciculata by ACTH in the absence of a reduction in cellular cholesterol content, while the number of LDL receptors in the zona reticularis was not increased by ACTH even in the face of a reduction in cellular cholesterol. Exclusive of the experiments employing aminoglutethimide, when the cellular cholesterol content was plotted against LDL binding activity, an excellent inverse correlation was revealed for the zona fasciculata, but essentially no correlation was noted for the zona reticularis. It is concluded that the outer and inner cortical zones of the guinea pig adrenal are quite distinct in the nature of their LDL receptor activity and regulation: the LDL receptor of the outer zone appears to function in a way similar to what has been reported for the whole adrenal cortex of other species in that receptor number correlates with tissue cholesterol content and is primarily regulated by ACTH; the LDL receptor number of the inner zone, however, does not correlate with tissue cholesterol content and is apparently not regulated by ACTH. PMID- 3955067 TI - Hormone-sensitive lipase and monoacylglycerol lipase are both required for complete degradation of adipocyte triacylglycerol. AB - The respective roles of monoacylglycerol lipase and hormone-sensitive lipase in the sequential hydrolysis of adipose tissue triacylglycerols have been examined. An adipose tissue preparation, containing both lipases in approximately the same proportion as in the intact tissue, hydrolyzed emulsified tri- or dioleoylglycerol to fatty acids and glycerol, with little accumulation of di- or monooleoylglycerol. Selective removal of the monoacylglycerol lipase by immunoprecipitation markedly reduced the glycerol release. Isolated hormone sensitive lipase hydrolyzed acylglycerols with a marked accumulation of monoacylglycerol in accordance with the positional specificity of this enzyme (Fredrikson, G. and Belfrage, P. (1983) J. Biol. Chem. 258, 14253-14256). Addition of increasing amounts of isolated monoacylglycerol lipase led to a corresponding increase in glycerol release, due to hydrolysis of the monoacylglycerols formed. The reaction proceeded to completion when the relative proportion of the two lipases was similar to that in the intact tissue. These findings indicate that hormone-sensitive lipase catalyzes the hydrolysis of triacylglycerol in the rate-limiting step of adipose tissues lipolysis, and of the resulting diacylglycerol, whereas the action of monoacylglycerol lipase is required in the final hydrolysis of the 2-monoacylglycerols produced. PMID- 3955068 TI - Protection of vitamin E from oxidation by increased ascorbic acid content within Plasmodium vinckei-infected erythrocytes. AB - Erythrocytes isolated from mice at a late stage of infection with the malarial parasite Plasmodium vinckei contained increased levels of vitamin E, but neither control nor infected erythrocytes contained detectable levels of alpha tocopherolquinone, an oxidation product of vitamin E. Total levels of the antioxidant, vitamin C, were more than doubled in the same populations of highly parasitized erythrocytes. These observations, and the lower ratio of oxidized to reduced forms of ascorbic acid in parasitized compared to nonparasitized erythrocytes, raise the possibility that increased redox-cycling between the two vitamins may account for the failure to detect alpha-tocopherolquinone. Thus, late in infection of mice with the lethal parasite P. vinckei, the content and redox state of erythrocytic ascorbic acid is altered so that it protects vitamin E, and presumably the parasitized red cell and its contents, from oxidative damage. PMID- 3955069 TI - Mitochondrial Ca2+ fluxes: role of free fatty acids, acyl-CoA and acylcarnitine. AB - It has been suggested that accumulation of lipid metabolites, such as fatty acids, fatty acyl-CoA and acylcarnitine, in the ischaemic myocardium, may be responsible for disturbances in mitochondrial Ca2+ fluxes. In view of the presence of an intracellular fatty acid binding protein, the question arose whether these intermediates affect mitochondrial Ca2+ uptake and release similarly in vivo. In this study the effects of linoleic acid, palmitic acid, palmitoyl-CoA and palmitoylcarnitine were studied on mitochondrial Ca2+ fluxes in the absence and presence of albumin, an avid binder of fatty acid derivatives. Albumin reversed the effects of the above compounds on mitochondrial Ca2+ uptake and release, suggesting that the presence of an intracellular fatty acid binding protein may protect the ischaemic myocardial cell against the deleterious effects of accumulated fatty acid derivatives. PMID- 3955070 TI - Effects of ethanol on steroid profiles in the rat testis. AB - The effects of ethanol on the concentrations of steroids in testis was studied in adult rats. Testosterone, seven of its potential precursors, three of its metabolites, and estradiol were analyzed by gas chromatography-mass spectrometry of samples from testes removed 2 h after intraperitoneal administration of ethanol, 1.2 g/kg body weight. The same analyses were made on samples from control rats. Ethanol gave a marked increase of all 3 beta-hydroxy-delta 5 steroids analyzed: pregnenolone (60%), 17-hydroxypregnenolone (480%), dehydroepiandrosterone (430%) and 5-androstene-3 beta, 17 beta-diol (60%). This resulted in highly significant increases of the 3 beta-hydroxy-delta 5/3-oxo delta 4 steroid ratios for all steroid couples analyzed. An analogous increase of the ratio between 5 alpha-androstane-3 beta, 17 beta-diol and dihydrotestosterone was also observed, whereas the ratio between androstenediol and dehydroepiandrosterone was decreased by ethanol. The concentration of estradiol was not affected. The results indicate that moderate doses of ethanol inhibit the conversion of 3 beta-hydroxy-delta 5 to 3-oxo-delta 4 steroids. This may be one mechanism by which ethanol decreases the production of testosterone. PMID- 3955071 TI - Effects of chronic ethanol ingestion on steroid profiles in the rat testis. AB - Testosterone, seven of its potential precursors, three of its metabolites and estradiol were analyzed in testes from rats given ethanol for 23 days in a nutritionally adequate liquid diet. The results were compared to those obtained with pair-fed control rats. The concentrations of pregnenolone, progesterone, 17 hydroxyprogesterone, androstenedione and testosterone were markedly lowered in four of the five rats given ethanol. The concentrations of the other 3 beta hydroxy-delta 5 steroids and estradiol were unchanged, resulting in significantly increased ratios between 17-hydroxypregnenolone and 17-hydroxyprogesterone (P less than 0.025) and between androstenediol and testosterone (P less than 0.025) in the ethanol-treated rats. The results indicate that chronic ethanol administration reduces formation of testosterone by affecting a step prior to pregnenolone. There may also be an effect on the conversion of some 3 beta hydroxy-delta 5 to the corresponding 3-oxo-delta 4 steroids. The levels of testosterone and three other steroids in testes of rats given the liquid diet were significantly lower than those in testes of animals fed a standard rat chow. This indicates a dietary influence on testicular steroid concentrations. PMID- 3955073 TI - 5'-Haloacetamido-5'-deoxythymidines: novel inhibitors of thymidylate synthase. AB - 5'-Bromoacetamido-5'-deoxythymidine (BAT), 5'-iodoacetamido-5'-deoxythymidine (IAT), 5'-chloroacetamido-5'-deoxythymidine (CAT) and [14C]BAT were synthesized and their interactions with thymidylate synthase purified from L1210 cells were investigated. The inhibitory effects of these compounds on thymidylate synthase were in the order BAT greater than IAT greater than CAT, which is in agreement with their cytotoxic effects in L1210 cells. In the presence of substrate during preincubation, the concentration required for 50% inhibition of the enzyme activity by these inhibitors was 4-8-fold higher than it was in the absence of dUMP. The I50 values for BAT were 1 X 10(-5) M and 1.2 X 10(-6) M in the presence and absence, respectively, of dUMP during preincubation. These results were in agreement with the observed inhibition of thymidylate synthase by BAT in intact L1210 cells. A Lineweaver-Burk plot revealed that BAT behaved as a competitive inhibitor. The Km for the enzyme was 9.2 microM, and the Ki determined for competitive inhibition by BAT was 5.4 microM. Formation of a tight, irreversible complex is inferred from the finding that BAT-inactivation of thymidylate synthase was not reversible on prolonged dialysis and that the enzyme-BAT complex was nondissociable by gel filtration through a Sephadex G-25 column or by TSK-125 column chromatography. Incubation of thymidylate synthase with BAT resulted in time-dependent, irreversible loss of enzyme activity by first-order kinetics. The rate constant for inactivation was 0.4 min-1, and the steady-state constant of inactivation, Ki, was estimated to be 6.6 microM. The 5'-haloacetamido-5' deoxythymidines provide specific inhibitors of thymidylate synthase that may also serve as reagents for studying the enzyme mechanism. PMID- 3955072 TI - Sialylation of lacto-N-neohexaosylceramide by sialyltransferase from embryonic chicken muscle. AB - A sialyltransferase which catalyzes the in vitro biosynthesis of N acetylneuraminosyllacto-N-neohexaosylceramide from lacto-N-neohexaosylceramide and CMP-NeuAc has been examined in embryonic chicken breast muscle. The maximum enzyme activity was observed in 11-12-day-old embryos. The enzyme has optimum activity at pH 6.8 in the presence of Triton CF-54 and Mg2+. The apparent Km values for lacto-N-neohexaosylceramide and CMP-NeuAc were 0.9 and 0.67 mM, respectively. The enzymic product was characterized by TLC, neuraminidase hydrolysis and permethylation analysis. The structure was identical to authentic N-acetylneuraminosyllacto-N-neohexaosylceramide from chicken muscle. In addition, a disialo derivative has been detected that constitutes 15% of the total radioactivity incorporated. The two sialic acids connected by sialosyl-sialosyl linkage were attached to the terminal galactose residue. To our knowledge, this is the first report of biosynthesis of this disialo compound. PMID- 3955075 TI - Occurrence of adenosine 2',5'-bisphosphate in rat liver. AB - Adenosine 2',5'-bisphosphate (pAp) is present in liver from 2-day-fasted rats, at a concentration of around 1 microM. pAp was obtained through perchloric acid extraction of the liver followed by two successive DEAE-cellulose chromatographies and an ion-pair high-pressure liquid chromatography. Both pAp extracted from liver and that obtained from a commercial source showed the same pattern of hydrolysis by alkaline phosphatase, i.e., more 5'-AMP than 2'-AMP was obtained as an intermediate of the reaction. PMID- 3955074 TI - Collagen in human aorta. Changes in the type III/I ratio and concentration of the reducible crosslink, dehydrohydroxylysinonorleucine in ascending aorta from healthy subjects of different age and patients with annulo-aortic ectasia. AB - The type III/I + III collagen ratio was studied in intima-medial samples of ascending aortas obtained from patients with the Marfan syndrome or other annulo aortic ectasia (dilatation of the ascending aorta) and from control subjects, using electrophoretic analysis of cyanogen bromide peptides. The [3H]borohydride reduced crosslinks of collagens were analysed by ion-exchange chromatography. Type III/I + III collagen ratios were twice as high in adult aortas as those found in skin samples of the same age. This ratio was lower in fetal and very young aortic samples and in 6-8 out of 12 pathological aortas (including one sample from a Marfan patient) when compared with adult controls. In contrast, the type III/I + III collagen ratio was high in fetal or very young skin and the values obtained from several patients did not differ from those of the control skin samples. In one pathological aorta out of six studied, the concentration of the reducible crosslink, dehydrohydroxylysinonorleucine, was higher than in controls, suggesting increased collagen synthesis or impaired maturation of collagen. These changes point to altered collagen metabolism in aortas of patients with annulo-aortic ectasia. PMID- 3955076 TI - N1-acetylspermidine is not a substrate for N-acetylspermidine deacetylase. AB - The specificity of N-acetylspermidine deacetylase from rat liver for the two naturally occurring forms of monoacetylated spermidine was studied. N8 Acetylspermidine is the preferred substrate in vitro for this enzyme, and, in fact, N1-acetylspermidine did not undergo deacetylation under the conditions used in this study. Thus N8-acetylspermidine is the more appropriate substrate for assaying N-acetylspermidine deacetylase activity. PMID- 3955077 TI - Human neutrophils permeabilized with digitonin respond with lysosomal enzyme release when exposed to micromolar levels of free calcium. AB - We have recently reported that human neutrophils can be permeabilized with the cholesterol complexing agent saponin and that these cells can be induced to secrete the granule enzyme lysozyme in response to micromolar levels of free calcium. We now report that digitonin can be used in place of saponin and that it has several advantages. Permeabilization of human neutrophils was accomplished with 10 micrograms/ml digitonin in a high potassium medium. Normally impermeant solutes such as [14C]sucrose and inulin [14C]carboxylic acid gained access to one half of the intracellular water space marked with [3H]H2O. Between 30 and 100% of the cytoplasmic enzyme, lactate dehydrogenase, leaked from the intracellular space. The permeabilization process and calcium-triggered granule secretion were critically dependent upon temperature, time and digitonin concentration. Permeabilized neutrophils secreted beta-glucuronidase, lysozyme and vitamin B-12 binding-protein, constituents of both azurophil and specific granules, when exposed to micromolar levels of free calcium. Release of specific granule constituents appeared to be more sensitive to free calcium than release from azurophil granules. Although the amount of permeabilization varied considerably with each batch of cells, release of these granule markers was a consistent finding. Release of granule markers was accompanied by resealing of the cells to high-molecular-weight (Mr greater than 5000) solutes. Electron microscopic evidence also suggested that granule and plasma membranes were intact following digitonin treatment and that fusion of these membranes occurred in response to calcium. These results suggest that elevation of intracellular free-calcium levels is a sufficient condition for lysosomal enzyme release. PMID- 3955079 TI - The effects of amino acids on protein degradation and translocation of non histone proteins to the nucleus in lymphocytes. AB - Tryptophan, phenylalanine and leucine have two parallel effects in cultured lymphocytes, they inhibit cellular proteolysis and increase the translocation of non-histone proteins to the nucleus. The latter is associated with an increased cellular binding of [3H]actinomycin D, indicating an altered structure of chromatin. The amino acids also inhibit the cellular uptake of [3H]chloroquine, suggesting that inhibited protein degradation is lysosomal. Several amine catabolites of tryptophan and phenylalanine, some of which are known to play a role as biogenic amines, have similar actions, and can explain, at least in part, the effects of their parent amino acids. Fractionation of the nuclear 3H-labeled non-histone proteins according to pH 2.5-6.5 shows that such proteins with a high rate of degradation in untreated cells correspond to the 3H-labeled non-histone proteins with a high rate of translocation in tryptophan treated cells. These data suggest that the degradation and the translocation of the non-histone proteins are linked and that the increased translocation of the non-histone proteins to the nucleus may be the consequence of inhibited lysosomal degradation of these proteins by the amino acids. PMID- 3955078 TI - The mechanism of in vitro formation of irreversibly sickled cells and modes of action of its inhibitors. AB - When red blood cells from sickle-cell patients were exposed to repeated cycles of deoxygenation and reoxygenation (one cycle was 5 min), dehydration of the cells was observed after several cycles of the sickling-desickling process. These dehydrated cells still maintained a biconcave form after 1 h of such cycling, but they started to take the form of irreversibly sickled cells after several hours. If red cells were simply kept deoxygenated for 16 h, neither dehydrated cells nor irreversibly sickled cells were formed. The formation of dehydrated cells was inhibited either by elimination of Ca2+ from the medium, or by the increase of K+ concentration in the medium. Under conditions in which dehydrated cells were not formed, i.e., deoxygenation incubation (either in the absence or presence of Ca2+) or the deoxygenation-reoxygenation cycling in the absence of Ca2+, 15-25% of cellular K+ leaked out during 4 h of incubation. When dehydrated cells were formed in deoxygenation-reoxygenation cycling in the presence of Ca2+, 40-50% of K+ was lost in 4 h. Two different types of inhibitor were found. The first type includes inhibitors of the Ca2+-activated K+ efflux, such as quinine, quinidine or tetraethylammonium chloride. These compounds suppressed both the K+ efflux and the formation of dehydrated cells. The second type includes calmodulin interacting drugs. For example, chlorpromazine (20 microM) inhibited the formation of dehydrated cells almost completely, even though it did not inhibit the K+ efflux remarkably. Several other calmodulin-binding drugs were found to inhibit the formation of dehydrated cells similarly, and the potency of these drugs to inhibit the formation seems to be related to the binding affinity of these drugs to calmodulin. PMID- 3955080 TI - Mechanism for the oleate stimulation of gluconeogenesis from dihydroxyacetone by hepatocytes from fasted rats. AB - Oleate stimulates glucose production and concomitantly decreases lactate and pyruvate production by rat hepatocyte suspensions incubated with dihydroxyacetone as substrate. The actions of oleate could be blocked by D-(+)dodecanoylcarnitine, which inhibits transport of the fatty acid into the mitochondria and the subsequent oxidation. beta-Hydroxybutyrate, but not acetoacetate, also stimulated glucose synthesis and inhibited lactate and pyruvate production. Furthermore, both beta-hydroxybutyrate and oleate stimulated oxygen consumption to the same extent. This suggests that oleate stimulates glucose production by the provision of energy subsequent to mitochondrial beta-oxidation of the fatty acids. The content of ATP itself did not appear to be responsible for the effects of oleate. Crossover analysis of the gluconeogenic intermediates implicated a site of oleate action between fructose 1,6-bisphosphate and fructose 6-phosphate, suggesting phosphofructokinase and/or fructose-bisphosphatase as possible regulatory sites. Coupled with the finding that intracellular citrate accumulates upon addition of oleate or beta-hydroxybutyrate, but not acetoacetate, the results suggest that citrate inhibition of phosphofructokinase accounts for the redirection of carbon flow from lactate and pyruvate formation and towards that of glucose. PMID- 3955082 TI - Characterization of oxysterol-binding protein in rat embryo fibroblasts and variations as a function of the cell cycle. AB - A cell-free system assay involving cell freeze-thawing and protein fractionation by ammonium sulfate precipitation was developed to characterize a cytosol binding protein specific for oxysterols in rat embryo fibroblasts. This protein shared common characteristics with the oxysterol-binding protein described in L cells and in normal human lymphocytes: 8 S sedimentation coefficient, sterol-protein complex of Mr 160 600, saturability, high affinity (Kd in the range of 10(-9) M) and specificity for cholesterol derivatives oxidized on the side chain. These compounds were better inhibitors of DNA synthesis than the compounds oxidized on the nucleus, whereas no difference was found between sterols oxygenated either on the side chain or on the nucleus, as far as inhibition of hydroxymethylglutaryl CoA reductase (HMG-CoA reductase) was concerned. Macromolecular components capable of specifically binding 25-hydroxycholesterol were also detected in the fibroblast nucleus. The cytosol oxysterol-binding protein showed a sharp increase (5-fold) in the G2M phase of the cell cycle and in exponentially growing cells (maximal binding site number/cell: 43 500, versus 8850 in confluent cells). Neither the affinity nor the sedimentation coefficient of the protein changed in either situation. The quantitative (but not qualitative) variations of oxysterol binding protein could be related to the inhibitory effect of 25 hydroxycholesterol on DNA synthesis, which becomes critical when this sterol is added in the G2M phase of the cell cycle. PMID- 3955081 TI - Hormonal and pharmacological alteration of angiotensinogen secretion from rat hepatocytes. AB - Isolated hepatocytes were prepared from rat liver by collagenase perfusion and density gradient centrifugation. The hepatocyte preparation released angiotensinogen at a basal rate of 50-120 pmol/g wet weight per h. Release was linear with time for at least 4 h. Angiotensinogen secretion was reduced in the presence of actinomycin D, and inhibited by cycloheximide, puromycin, colchicine and vinblastine. In the presence of tunicamycin, an inhibitor of N-glycosylation, the secretion of angiotensinogen as well as total protein and albumin secretion were diminished. Hepatocytes from nephrectomized rats exhibit an increased secretion rate of angiotensinogen, whereas total protein secretion was unaltered. Preincubation of hepatocytes with hydrocortisone (0.1 mM) or angiotensin II (10 nM) induced an increase of angiotensinogen release. There was no concomitant increase of total protein or albumin secretion, indicating that these effects are not the expression of a general stimulation of protein synthesis and secretion. PMID- 3955083 TI - [Free radical oxidation of lipids and thiol groups in the formation of a cataract]. AB - Content of primary (diene conjugates), secondary (ketodienes), end (Schiff's bases) products of free radical oxidation (FRO) of lipids was determined, as well as content of total and non-protein-bound thiols in human lens at different stages of cataractogenesis. Lens opacity was estimated by quantitative morphometric analysis. Participation of FRO of lipids in lens opacity is proved. It is shown that total thiols of lens fibres are rapidly inactivated when the intensity of lipid FRO is increased at the expense of the fall of glutathione level. These processes promote the formation of high molecular protein aggregates in the lens and cataract development. Coefficients of linear correlation between the indicated parameters are presented. A conclusion is drawn concerning possible prevention of cataract development by decreasing the level of accumulation of lipid peroxides and by maintaining high concentration of reduced glutathione in the lens. PMID- 3955084 TI - [Optimum geometric parameters of the dendrite process]. AB - Optimal radius of dendritic spine steam is calculated under constant synaptic excitation using three criteria: maximum of excitatory postsynaptic potential (EPSP), maximal rate of EPSP change due to little change of spine steam radius and maximal rate of EPSP change due to little change of synaptic conductance. PMID- 3955085 TI - [Interaction between the otolithic organ and semicircular canals of the vestibular apparatus in the system of directional orientation of man in space]. AB - A mathematical model is suggested of the biological system of angular stabilization in space relative to the local vertical using measures whose parameters are near to the parameters of the semicircular canals and otolithic organ of the man. On the basis of computer simulation for physiologically adequate external stimulations contribution of each of measures to the total process of angular stabilization is evaluated. PMID- 3955086 TI - [A model of control of the movement of the multiarticular extremity]. AB - A model for coordinated execution of multijoint goal-directed limb movements is suggested from the following principles. (1) Central control signals for a single limb joint are individually formed, proceeding from its ability to bring the limb nearer to the target and leaving control signals directed simultaneously to other joint out of account. The joints thereby behave as a set of Tsetlin's abstract automata [11], each functioning independently and guided by a common, collective effect. (2) Neither levels of muscle activation, nor force and kinematic variables are directly specified by the command signals. They only modify the system's parameters that affect equilibrium joint positions, and thus make the limb to move to the goal. A concrete model based on the above principles is described and its behavior is compared with actual goal-directed movements in man and spinal frogs. Various control strategies for multiarticular movements in living organisms are discussed. PMID- 3955087 TI - [Changes in the microviscosity of lipid bilayer membranes of various malignant cells and tumor transplantability]. AB - It is shown that cholesterol incorporation into the membranes of Zajdel hepatoma cells, lymphoblast leukemia cells L1210 and into those of ovary tumour causes an increase in the membrane phospholipid bilayer microviscosity measured by pyrene as fluorescent probe. The increase in the membrane lipid microviscosity resulted in a decrease in the activity of Na,K-ATPase and 5-nucleotidase of the tumour cells. After the injection of tumour cells with an increase of cholesterol/phospholipid ratio we observed an increase of the life-span of experimental animals as compared to the control groups. PMID- 3955088 TI - [Study of the structure of model and biological membranes by neutron diffraction]. AB - A model multilamellar structure of dipalmitoyl lecithin was studied with neutron time-of-flight diffractometer. The acquired data permit determination of structure factors and calculation of the bilayer density profile. PMID- 3955089 TI - [Structural transitions associated with changes in the thickness and density of phospholipid bilayers]. AB - Relationship between a change of bilayer density and thickness and dissociation degree of the polar groups of phospholipid molecules was studied. It has been stated that with a decrease of ionization level a transition of bilayer from liquid to ordered state should occur. The latter is accompanied by a decrease of thickness and increase of density of the bilayer. PMID- 3955090 TI - [Conductivity and structural transitions in bilayer lipid membranes]. AB - 5 structural transitions were found in bilayer lipid membranes (BLM) from egg lecithin (EL) within the temperature range 14-44 degrees C. In the transition zone BLM conductivity abruptly increases, in some cases current fluctuations of the order 150 pC of the channel type are initiated. The transition temperatures observed in BLM from EL coincide with those in biological membranes. The cause of this phenomenon is discussed, as well as possible use of these BLM in the region of structural transition as a model of cellular receptor to electromagnetic fields. PMID- 3955091 TI - [Conductivity of bilayer lipid membranes in phase transition: the role of intramolecular phosphate-phosphate hydrogen bonds]. AB - pH effect on phase transition measured by jump of conductance in the BLM formed from DPPA and thio-DPPA was studied. The difference of pH dependence for these two lipids was shown. The corresponding calculation discovered significance of intermolecular phosphate-phosphate hydrogen bonds in induced conductance of BLM. PMID- 3955092 TI - [Structure and permeability of the contact zone of 2 artificial lipid-lipoprotein membranes]. AB - Contact interaction of two flat artificial lipid-proteolipid membranes (LPLM) obtained from lipid-proteolipid mixture of cattle brain white matter was studied. Investigation of the optical structure of the contact region revealed existence of fused proteolipid (PL) nodes and bilayer lipid areas. The lipid bilayers are fixed at stationary distance--30-40 nm, irrespective of ionic composition and ionic strength of the aqueous medium. Apparently, the maximal thickness of proteolipid regions at the two sides of the lipid framework of single LPLM reaches 15-20 nm, and LPLM after putting into contact fused in the region of PL nodes. It prevents the lipid areas from further drawing together. Conductance of the contact zone of two LPLM in NaCl solutions (10 and 100 mM) corresponds to that of single LPLM, but in KCl solutions it decreases 3.5 times, remaining in all the cases 1-2 orders above the conductance of single bilayer lipid membrane (BLM) or the contact zone of two BLM. Conductivity of single as well as of two contacting LPLM is higher for K+, than for Na+. The data obtained suggest that PL areas of the contact zone of two LPLM, likewise a single LPLM, are adjacent to the aqueous medium forming together with the bound lipids the zones of high conductivity. PMID- 3955093 TI - [Determination of electrical characteristics of synaptosomal membranes of the brain]. AB - A correct method for evaluating the potential differences across plasma membranes of synaptosomes from the brain is presented. It takes into consideration the multicompartment synaptosome organization and is based on the accumulation of the radioactive permeant cation [3H]tetraphenylphosphonium. It is shown that upon potassium depolarization of the synaptosomes to about -5 mv there is a sharp decrease in the ion selectivity of the synaptic membranes. PMID- 3955094 TI - [Various parameters of the structure of F-actin filaments of the normal and athyreotic myocardium]. AB - A comparative analysis of optical diffraction of electron micrographs of F-actin from normal and athyreosic myocardia showed abrupt changes of relative intensities of the reflexes nearest to the meridian in the athyreosic actin pattern. It indicates that under athyreosis changes in the actin globules or in their location in the fibril take place. PMID- 3955095 TI - [Stimulus-measuring mechanism of receptor cells]. AB - A model is proposed of stimulant-measuring mechanism of receptor cells. Its mathematical description is presented. The model and formulae in a general form are plotted for thermo- mechano-, electro- and olfactory receptor cells and describe the measurings of the stimulating energy supplied to the cell and the result of the value of the receptor potential. PMID- 3955096 TI - [The effect of cosmo-helio-geophysical factors on the agglutination of bacteria in vitro]. AB - A correlation between intensity of neutronal component of cosmic rays and typhoid bacteria agglutination was revealed. Agglutination speed dependence on season, polarity of interplanetary magnetic field, geomagnetic storms, Sun's revolution was shown. An assumption is made about an important role of the magnetic fields in the phenomena observed. PMID- 3955097 TI - An intrinsic mechanism for the oscillatory contraction of muscle. AB - A new model based on the theory of dynamical systems is proposed for the intrinsic random or systems is proposed for the intrinsic random or pseudo-random mechanism underlying certain types of muscular tremor. The active length-tension curve of the individual sarcomere, in conjunction with the passive length-tension relation is a map from length to tension with an observed time delay between length change and resulting tension change. The passive length tension relation is assumed to instantaneously relate this tension change back to a change in length. The stability properties of this iterated interval map are investigated by means of computer simulation and computation of the Lyapunov exponent and the bifurcation tree. The resulting analysis is related to experimental tremor data in the literature in terms of period doubling, bifurcation points, and "chaotic" behavior. The model appears to have its most fruitful application in understanding the insect type and isometric mammalian types of tremor. PMID- 3955098 TI - The relationship between signal response selectivity and the functional structure of complex retinal neural networks. AB - In this paper we simulate the simultaneous responses of 45 neurones within a hypothetical retina to a variety of spatio-temporal signals. Our results demonstrate how specific convergent and divergent excitatory and inhibitory connections are sufficient to determine signal response selectivity of specific ganglion cells and so delimit the known types of center-surround receptive fields. PMID- 3955099 TI - An inverse problem in neural processing. AB - Any neural network aimed at the coding sensory events must contain computational properties which generally allow the organism to reconstruct the input signals with some degree of accuracy--else the association between stimulus and response would, at best, be uncertain. In this paper we investigate the problem of reconstructing external input signals to neural networks when the activity profiles of only some of its member cells are known. The evolution and activities of such cells are defined by an earlier formulation of one of us (Oguztoreli 1979) and, here, we restrict our application to local circuits within the vertebrate retina. Solutions to this inverse coding problem are presented for specific network equations and exemplified with 1, 3, and 5 neuron cases. PMID- 3955101 TI - Associative recall properties of the trion model of cortical organization. AB - We developed a cooperative model of the cortical column incorporating an idealized subunit, the trion (which represents a localized group of neurons), and a discrete time step for firing. We found that networks composed of a small number of trions (with symmetric interactions) supported up to thousands of quasi stable, periodic firing patterns (MPs) which could be selected out with only small changes in interaction strengths using a Hebb-type algorithm. Here we report a study of the associative recall properties showing striking features: By considering all possible initial firing patterns (for a given set of network connections), we find 1) It takes on the average only 2-5 time steps to recall an MP. 2) Many of the MPs can be individually accessed by thousands of different initial patterns. The variety of examples presented illustrate the rich, general nature of the model. PMID- 3955100 TI - A stochastic theory of phase transitions in human hand movement. AB - The order parameter equation for the relative phase of correlated hand movements, derived in a previous paper by Haken et al. (1985), is extended to a time dependent stochastic differential equation. Its solutions are determined close to stationary points and for the transition region. Remarkably good agreement between this theory and recent experiments done by Kelso and Scholz (1985) is found, and new predictions are offered. PMID- 3955102 TI - [Binding of triiodothyronine to the nuclear matrix of the rat liver. The effect of thyroid hormones on the phosphorylation of nuclear matrix proteins]. AB - The interaction of thyroid hormones with rat liver nuclear matrix proteins was studied. It was shown that the nuclear matrix contains the sites which bind triiodothyronine with a high affinity (Ka = 1.07 X 10(9) M-1) and limited capacity (maximal binding capacity--28.5 fmol triiodothyronine/100 micrograms protein). Electrophoretic analysis of triiodothyronine-binding matrix proteins revealed that the molecular mass of the major triiodothyronine-binding fraction is 50 000-52 000 Da. Injections of triiodothyronine to thyroidectomized animals stimulated the phosphorylation of all protein fractions of the nuclear matrix. PMID- 3955103 TI - [Effect of lipids and substrates on the kinetics of binding of ferrocytochrome P 450 to CO]. AB - Using the flash photolysis technique, it was found that the kinetics of recombination of carbon monoxide with ferrocytochrome P-450 LM-2 can be approximated by the sum of three exponents. Incorporation of cytochrome P-450 into liposomes prepared from microsomal lipids leads to the reduction of the number of steps to two as well as to essential changes in rate constants. Addition of type I substrates (Triton N-101, albumin) cause similar changes in the reaction kinetics. NADPH-cytochrome P-450 reductase has no effect on this process. The multistep kinetics of CO recombination with cytochrome P-450 LM-2 may be accounted for by the presence of some protein conformers. The experimental results suggest that the activity and structure of cytochrome P-450 conformers is affected by the lipid microenvironment, type I substrates and Triton N-101. PMID- 3955104 TI - [Characteristics of thiamine thiazolone diphosphate-induced inhibition of a pyruvate dehydrogenase complex in vitro and in intact mitochondria]. AB - Thiamine thiazolone diphosphate (TTPP) was capable of penetrating through the mitochondrial membrane and of inhibiting the pyruvate dehydrogenase complex (PDC) in intact mitochondria. TTPP depressed the activity of mammalian PDC in a mixed manner (Ki = 5.10(-8) M) and yeast pyruvate decarboxylase (Ki = 5.10(-6) M) via a competitive mechanism with respect to thiamine diphosphate. It was shown that decarboxylation of pyruvate in intact and disrupted mitochondria of rat liver and brain is less inhibited by TTPP than the overall activity of PDC determined by the formation of acetyl-CoA. It was assumed that TTPP as a transition state analog participates only in oxidative reactions (but not in simple decarboxylation of pyruvate). PMID- 3955105 TI - [Isolation of neutral proteinase of ribosomes (cathepsin R)]. AB - A method for isolation of cathepsin R from rat liver ribosomes allowing for a 264 fold increase of specific activity is described. The purification procedure includes enzyme extraction from ribosomes with 2-4 M LiCl and two-step affinity chromatography on Sepharose with immobilized soy bean trypsin inhibitor and trypsin-Sepharose. PMID- 3955106 TI - [Vitamin A and lipid peroxidation: effect of retinol deficiency]. AB - The effect of alimentary vitamin A deficiency on some parameters of lipid peroxidation (LPO) in young rats was studied. It was found that under vitamin A deficiency the content of diene conjugates in liver homogenates and microsomes diminishes, whereas that of malonic aldehyde in small intestinal mucosa, liver and testis homogenates is unaffected. However, the malonic aldehyde production in liver homogenates and microsomes decreases after 60 min incubation at 37 degrees C without addition of prooxidants. At the same time, enzymatic NADPH-dependent and nonenzymatic ascorbate-dependent LPO in liver microsomes of vitamin A deficient rats does not change significantly. The decrease of LPO intensity in vitamin A-deficient animals may be due to the reduced content in liver microsomes of the main LPO substrates, i.e., arachidonic and linoleic acids, as well as to the decrease of cytochrome P-450 level in rat liver. PMID- 3955107 TI - [Effect of different levels of thyroid hormones on the fatty acid composition of lipids from rat liver mitochondria]. AB - The abundance or deficiency of thyroid hormones in rat organism influence the unsaturation and desaturation indices of total lipid fatty acids and phospholipids in liver mitochondria. The most conspicuous changes were observed in the fatty acid composition of the phospholipid fraction. The changes in the structure and function of rat liver mitochondria are considered to be due to alterations in the fatty acid composition of mitochondrial phospholipids. PMID- 3955108 TI - Teratogenic effect of semicarbazide in Wistar rats. AB - Five groups of pregnant Wistar rats were injected intraperitoneally with a single dose of semicarbazide (SC) on day 5, 7, 10, 13, or 15 of gestation. The lots in each group received either 50, 75, 100 or 150 mg/kg SC. A sixth group received 17 mg/kg of the drug during the entire course of pregnancy. SC produced a significantly smaller number of live fetuses with respect to controls. This toxic effect after injection at days 7 and 10 of gestation was highest for all single doses. The mean of fetal weight decreased with respect to controls with almost all of the SC treatment studied. The number of implantations and live fetuses was significantly decreased in the rats receiving the continuous treatment. Most abnormalities in the 21-day-old fetuses were found in the brain, kidney, intestines and liver; skeletal anomalies were seen in the skull, sternum and ribs. SC also produced high postnatal mortality rates during the first month of life with the single doses as well as with the continuous treatment. Thus, SC produced signs of toxicity and/or teratogenic effects in rats with all doses administered. PMID- 3955109 TI - Placental blood flow and fetal weight following uterine artery ligation. Temporal aspects of intrauterine growth retardation in the guinea pig. AB - Placental blood flow (microsphere distribution), placental weight and fetal weight were examined at three stages of gestation following unilateral uterine artery ligation at days 30-32 in 23 guinea pigs. Placental blood flow and placental weight were reduced in the ligated horn at days 45, 55, and 65. The fetal weight was decreased at days 55 and 65. We suggest that ligation of the uterine artery reduces placental blood flow which, in turn, restricts placental growth without any significant effect on fetal weight before day 45. At this stage of gestation no correlation was found between fetal weight and placental blood flow. Later in gestation, however, fetal growth becomes limited by placental blood flow, and between days 45 and 55 ligation impedes the increase in blood flow, and consequently the fetal growth rate declines. PMID- 3955110 TI - Research support: who's the enemy? PMID- 3955111 TI - Acute and chronic effects of haloperidol on plasma and brain homovanillic acid in the rat. AB - The effects of acute and chronic administration of haloperidol on homovanillic acid (HVA) in plasma and the brain were examined in the rat. Acute haloperidol treatment (1 mg/kg) resulted in highly significant elevations in HVA within 30 min and produced a maximal increase of HVA in 3-6 hr in both plasma and the whole brain. The response of brain HVA to increasing doses (0.05-30 mg/kg) of haloperidol showed an inverted U pattern. Plasma HVA showed a very flat response to lower doses (less than or equal to 5 mg/kg) of haloperidol and a dramatically elevated one to higher doses (greater than or equal to 10 mg/kg). Haloperidol produced a parallel increase in plasma and brain HVA at lower doses (less than or equal to 2 mg/kg) only. After chronic administration of haloperidol for up to 28 days, the response of HVA in plasma correlated mainly with, but tolerated later than, those in the whole brain and the olfactory tubercle. PMID- 3955112 TI - Saccadic eye movements in tracking, fixation, and rest in schizophrenic and normal subjects. AB - Horizontal eye movements were recorded electrooculographically during two different eye fixation tasks, during an eyes-closed waking state, and during eye tracking on a sinusoidally moving target in 16 chronic schizophrenics and in 12 normal subjects. The relationship between saccadic eye movements during tracking and in the other experimental situations was investigated. The intensities of eye fixation were successively decreased from Experiment I (eye fixation on a stationary target) through Experiment II (eye fixation on an imagined spot in the dark) to Experiment III (eyes closed in the dark, no cue for eye fixation), in that order. The frequency of saccades increased as the intensities of fixation decreased from Experiment I to Experiment III in both schizophrenic and normal groups. It was demonstrated that the frequency of saccades was higher in schizophrenics than in normal subjects in all of the experimental conditions. Some correlations were found between the increased frequency of saccades seen during eye tracking and the similar increases seen in eyes-fixated or eyes-closed states in schizophrenic subjects. It is suggested that the increased saccades seen during eye tracking and in other experimental conditions in schizophrenics are related to a deficit of nonvoluntary attention, due to a failure of an inhibitory mechanism. PMID- 3955113 TI - The dexamethasone suppression test (DST) and platelet monoamine oxidase (MAO) activity as predictors of psychosis in depression. PMID- 3955114 TI - AIDS encephalitis mimicking alcohol dementia and depression. AB - The authors report a case of encephalitis occurring in a setting consistent with acquired immune deficiency syndrome (AIDS). They point out that AIDS and its complications can mimic psychiatric syndromes, including depression and dementia, or delirium related to illnesses such as alcoholism. Acting out behavior, seen in the present case, may also be mistaken as a symptom of sociopathy. PMID- 3955115 TI - Persistent supersensitivity vomiting following neuroleptic withdrawal in an adolescent. PMID- 3955116 TI - Oscillations in apomorphine-induced stereotypies during 1 year of apomorphine administration. PMID- 3955117 TI - Effects of morning versus evening bright light exposure on REM latency. PMID- 3955118 TI - Prefrontal cortex: possible site of antipsychotic action of haloperidol. PMID- 3955119 TI - Triiodothyronines, depression, and fasting. PMID- 3955120 TI - Effect of lithium on RBC water permeability. PMID- 3955122 TI - ECT, opioids, and motility in Parkinson's disease. PMID- 3955121 TI - DST, depression, and anxiety. PMID- 3955123 TI - Plasma vasopressin concentrations and serum vasopressinase activity in pregnant and nonpregnant women. AB - Vasopressin (AVP) concentration was measured by radioimmunoassay from unextracted plasma of nonpregnant women and during first and third trimester of pregnancy. In nonpregnant state it was 3.5 +/- 0.6 pg/ml, in first trimester 4.3 +/- 1.8 pg/ml, but in third trimester 6.5 +/- 0.4 pg/ml and significantly (p less than 0.001) higher than in nonpregnant state. AVPase activity was investigated by in vitro method whereby the decrease of AVP concentration during incubation was measured. In first trimester pregnancy, the AVPase activity was 3-fold and in third trimester 20-fold when compared with nonpregnant level. PMID- 3955124 TI - Vascular resistance, metabolism and EEG within cerebral grey and white matter during hypoxia in neonatal piglets. AB - To study unsolved problems of the causal chain of neonatal hypoxic brain damage in 31 hypoxic newborn non-anesthetized piglets cerebro-vascular, metabolic and EEG reactions were investigated (FiO2: 0.06-0.10, 1 h). Only in artificially ventilated newborn piglets this acute hypoxic hypoxia provoked a vital decompensation by critical depression of mean arterial blood pressure (less than or equal to 4.67 kPa [35 mmHg]) and/or a critical increase of vascular resistance (Rc) in the cerebral white matter (greater than 50%). Spontaneously breathing piglets survived always showing hyperventilation, higher pHa and an increase of cerebral O2-consumption in cerebral grey matter, partly also in white matter. This critical increase of Rc was related to a critical decrease of O2-consumption in the white matter and an insufficient decrease of Rc of the grey matter. The observed strong metabolic and hemodynamic differences between these two brain compartments can explain the evaluated special morphological vulnerability of cerebral white matter in ventilated animals. PMID- 3955125 TI - Studies on the kinetics and distribution of dihydralazine in pregnancy. AB - Plasma kinetics of dihydralazine (50 mg p.o.) was studied in 11 women in late pregnancy. The distribution pattern between maternal and umbilical plasma was investigated in 12 patients who received 75-100 mg dihydralazine per day. In one patient amniotic fluid concentration and in another breast milk levels could be evaluated twice. Plasma concentrations of dihydralazine were very low. Continuous plasma level curves could be estimated in only four of the examined patients. In every case dihydralazine concentrations were higher in umbilical blood than in maternal plasma. Concentrations found in breast milk were clinically negligible. PMID- 3955126 TI - Metrial gland: structure, origin, differentiation and role in pregnancy. AB - Metrial gland is a separate class of cells associated with decidualization. These granulated cells, which are early detectable in the endometrium at implantation sites, become more prominent in the mesometrial triangle of rats as pregnancy advances. Typical ultrastructural features which include the presence of pleomorphic granules characterize these cells and recent observations indicate differentiation of these cells from lymphocyte-like precursors. Presence of IgG in the cytoplasm of metrial gland cells and their origin from bone marrow suggest an immune function. PMID- 3955127 TI - Effects of pregnancy on the inter-individual variations in blood levels of lead, cadmium and mercury. AB - Blood samples to be analysed for lead, cadmium and mercury were taken from 417 pregnant women not occupationally exposed to these metals. Each subject was paired with a non-pregnant woman of the same age (+/- 2 years), socio-economic status, alcohol and tobacco status. Most of the inter-individual variations observed in earlier studies were confirmed in the control group. Among the pregnant women, however, such variations in blood metal levels appeared to be somewhat different compared to the control women according to the parameters studied: age of the women, alcohol and tobacco consumption. Furthermore, the study of the evolution of blood levels of lead, cadmium and mercury throughout pregnancy revealed a significant decrease in cadmium levels during the first half of pregnancy. A similar tendency was observed for lead but this did not attain statistical significance. PMID- 3955128 TI - Unidirectionality of the water exchange between mother and 19-day fetus in the rat. AB - Tritiated water was injected into 19-day pregnant rats and the rate of incorporation into their fetuses was estimated. The transfer of tritiated water from mother to fetus and then to the surrounding uterus was estimated by measuring the appearance of radioactivity in an albumin-saline solution that bathed externally one conceptus freed of its surrounding uterus except for the placental attachment. There was a very significant transfer of tritium water, even before isotopic equilibration of the fetus, estimated at more than 1.5 ml/h. The reverse, the transfer of tritium from the saline solution towards the mother, resulted in only a small fraction of that figure. The results suggest the existence of unidirectional water circulation in the materno-fetal unit: maternal arterial blood----placenta----fetal circulation----amniotic fluid----amniotic membranes----endometrium----maternal venous blood. PMID- 3955130 TI - Effects of the environment upon fetal development: concepts and design. AB - A brief description is presented on the known causes of development defects in humans. The definition of "teratogen" is expanded to include other aspects of developmental toxicity and the techniques used to assess environmental effects are discussed. A method for assessing human risk with a potential developmental toxin is presented and some of the frustrations confronting developmental toxicologists are outlined. PMID- 3955131 TI - Induction of the acrosome reaction in sea urchin spermatozoa by the volatile anesthetic halothane. AB - The volatile anesthetic halothane rapidly and dose-dependently induces the acrosome reaction in sperm of the sea urchin Lytechinus variegatus. The reaction occurs equally well in artificial sea water containing 10 mM Ca2+ and in low (less than 100 microM)-Ca2+ media. The anesthetic-induced acrosome reaction can be prevented by pretreating sperm with EGTA, lanthanum, or procaine. In contrast, the Ca2+ channel blockers D-600, verapamil, diltiazem, and nitrendipene do not prevent the reaction. Acrosomal processes induced by halothane are ultrastructurally identical to those induced by egg jelly, the natural inducer of the acrosome reaction. These results suggest that Ca2+ in low quantity is required for the anesthetic-induced acrosome reaction and may be derived from internal sources. Enflurane, isoflurane, and methoxyflurane also induce the acrosome reaction, indicating that volatile anesthetics may be useful in studying ion changes accompanying sperm activation. PMID- 3955129 TI - Absence of estrogenic activity in some drugs commonly used during pregnancy. AB - Treatment of pregnant women with estrogenic compounds such as diethylstilbestrol (DES) has been associated with genital tract abnormalities in their male and female offspring. Since these data suggest the developing fetus is highly susceptible to the tumorigenic and dysmorphogenic effects of estrogenic substances, knowledge of the estrogenic activity of some drugs commonly used during pregnancy is important. Based on structural similarities to other known estrogenic compounds and to the frequency of use among pregnant women, phenobarbital, saccharin and acetaminophen were assayed for estrogenic activity; DES was used as a positive control. Using a competitive receptor binding assay, these compounds did not show appreciable binding to a soluble uterine receptor preparation while DES showed strong binding interactions. Analysis of the compounds in an in vivo uterotropic bioassay using immature female mice showed that, over the dose range used (5 micrograms/kg-50 micrograms/kg), only DES had any estrogenic activity while the other compounds were negative. Therefore, phenobarbital, saccharin and acetaminophen did not display estrogenic activity under the conditions of test. PMID- 3955132 TI - Assessment of spermatozoal function using dual fluorescent staining and flow cytometric analyses. AB - Spermatozoa from bulls, boars, dogs, horses, mice, and men were examined using a fluorogenic stain consisting of the membrane-permeant substrate carboxyfluorescin diacetate (CFDA) and the relatively membrane-impermeant nuclear stain propidium iodide (PI). Three distinct populations of spermatozoa were discernible in samples from each species upon microscopic examination. Individual spermatozoa, presumed to be viable because of their motility, retained products of the fluorescein chromophore throughout the cell. A second population of spermatozoa in which the nuclei stained red with PI retained the green fluorescein fluorophore mainly in the acrosome. A third population, presumed to be degenerate spermatozoa, possessed only red fluorescent nuclei. These populations were quantified using dual parameter flow cytometry in 14 samples of cryopreserved bovine spermatozoa for which fertility and seminal quality data were available. Flow cytometric analyses were highly correlated with other seminal quality measurements. Sequential flow cytometric analyses provided the ability to rapidly quantitate changes in specific fluorescently stained populations. The ability to make rapid quantitative measurements should allow development of new and presumably more reliable information on the functional aspects of spermatozoa. PMID- 3955133 TI - Critical components of testicular function and sensitivity to disruption. AB - Toxic agents can interfere with the male reproductive system at many targets. Radiation and cancer chemotherapeutic drugs represent one class of toxins the sterilizing effects of which can be analyzed qualitatively and quantitatively in terms of testicular cell kinetics. The cells most sensitive to killing by these agents are the rapidly dividing, differentiating spermatogonia. Cells past the DNA-synthetic stages, including spermatocytes, spermatids, and nongerminal cells, are generally resistant. The slow cycling stem spermatogonia show an intermediate sensitivity, but appear to be the critical targets for the resulting long-term oligo- or azoospermia and infertility. The extent of recovery of spermatogenesis and the duration of infertility can be predicted on the basis of stem cell survival alone, independent of the antineoplastic agent used. When murine stem cells are killed, regeneration of their number and repopulation of the seminiferous epithelium begin almost immediately. In man, recovery can be delayed for years after exposure to agents that kill stem cells. This is a result of the regulation of stem cell regeneration and differentiation in man, the mechanisms of which are unknown. This regulation can explain quantitative differences in interspecies sensitivities to toxic agents. For example, man is much more sensitive than the mouse to reduction in sperm count by radiation at short times after exposure, but not when sufficient recovery times are allowed. PMID- 3955134 TI - Failure of acrosome assembly in a male sterile mouse mutant. AB - Blind-sterile (bs) is a new autosomal recessive mutation of the mouse that causes sterility in males and bilenticular cataracts in both sexes. Sterile bs/bs males exhibited normal copulatory behavior, reduced testis weights, and few or no epididymal sperm. The effects of the bs mutation on spermatogenesis were examined by light and electron microscopy. All sperm present were morphologically abnormal with aberrant head shape. Adult bs/bs testes were characterized by germ cell depletion that resulted in profound alterations of the typical germ cell associations. Only 30% of the tubules contained relatively normal germ cell associations while 39% were extensively depleted, showing only Sertoli cells or Sertoli cells and spermatogonia. The most striking effect of the bs mutation on spermiogenesis was the failure of acrosome formation. Disorganized proacrosomic granules were detected up to step 3 of spermiogenesis by both periodic acid Schiff staining and ultrastructural analysis. In over 3500 spermatids scored past steps 3-4 of spermiogenesis not a single acrosomal cap or fully developed acrosome was detected. Electron microscopy revealed a thickening of the nuclear envelope of elongating spermatids in the region where the acrosome should have been located; however, no acrosome was present. Chromatin condensation and nuclear elongation did occur in these acrosomeless spermatids, suggesting that caudal growth of the acrosome is not a mechanistic factor in these events. PMID- 3955135 TI - ATP-induced reactivation of ram testicular, cauda epididymal, and ejaculated spermatozoa extracted with Triton X-100. AB - It was possible to demembrante and reactivate not only freshly collected testicular, cauda epididymal, and ejaculated ram sperm but also sperm that had been stored for several days at 0 degrees C and for several months at -196 degrees C in rete testis fluid or egg yolk citrate media. Sperm were usually washed free of seminal plasma before demembranation, but this was not essential for reactivation. Bovine serum albumin (1.0%) in the wash medium increased the survival of sperm, but more than 0.25% in the extraction medium decreased reactivation. A macro-molecular component of cauda epididymal fluid also inhibited the reactivation of testicular sperm. Triton X-100 concentrations between 0.01% and 1.00% in the extraction medium were satisfactory for demembranating the sperm. Rapid cooling (i.e., cold shock) mimicked the effect of detergent in making the sperm responsive to added ATP and demonstrated that damage to ram sperm in cold shock does not involve the axoneme. Ejaculated and cauda sperm were reactivated immediately on addition of ATP and activity persisted for up to 10 min. Testicular sperm, on the other hand, required about 4 min to become fully reactivated. The optimal ATP concentration for activation of sperm was 0.1-1.0 mM. Magnesium ions (0.1-1.0 mM) were important for reactivation, and testicular sperm required a higher magnesium concentration than did cauda or ejaculated sperm. Manganese ions were almost as effective as magnesium for reactivating cauda epididymal and ejaculated sperm. Cobalt and cadmium ions were much less active for cauda and ejaculated sperm and none of these ions were effective for testicular sperm. Fluoride (25-50 mM) inhibited reactivation. The presence of 50 microM cAMP in the extraction medium or preincubation of testicular sperm with theophylline or caffeine increased low levels of activation, but this was not evident with ejaculated or cauda sperm. We conclude that the motor apparatus is already functionally assembled in spermatozoa on leaving the testis, but some fine adjustment must take place during maturation in the epididymis. PMID- 3955136 TI - Isolation and biochemical studies of enriched populations of spermatogonia and early primary spermatocytes from rat testes. AB - A method to obtain several highly enriched populations of testis cell types from rats of a single age is described. Single cell suspensions from immature rat testes were prepared after enzymatic removal of interstitial cells. Cells were separated on the basis of size into four fractions (bulk preparations) or eight fractions (analytical preparations) by centrifugal elutriation. These elutriator fractions were further separated by equilibrium density centrifugation in Percoll gradients. In this manner, populations of 2 X 10(7) type A spermatogonia (51% purity), 3 X 10(7) type B spermatogonia (76% purity), 5 X 10(7) zygotene/early pachytene spermatocytes (56% purity), 3 X 10(7) midpachytene spermatocytes (70% purity), and 4 X 10(7) Sertoli cells (89% purity) could be obtained from 50 immature rats within 6 h after killing. Purities, determined by examination of cytologic smears, were verified by Coulter volume and flow cytometric DNA determinations. These separation methods were used to obtain cell populations for characterization of levels and synthesis of high mobility group proteins in the early stages of spermatogenesis. PMID- 3955137 TI - Cyclic endocytic activity and kinetics of lysosomes in Sertoli cells of the rat: a morphometric analysis. AB - Native ferritin was injected into the rete testis of rats, and seminiferous tubules infused with the tracer were collected 6 h later and prepared for electron microscopic analysis. As a result of internalization of the tracer by Sertoli cells, label was found within 12-66% of the secondary lysosomes, depending on the stage of the cycle of the seminiferous epithelium. The Zeiss MOP 3 instrument was used on selected electron microscope photographs to measure a number of morphometric parameters. Applying appropriate formulae and a computerized program, it was possible to determine the absolute numbers of labeled and unlabeled secondary lysosomes per Sertoli cell for each one of the 14 stages of the cycle. Knowing the duration of these stages, it was also possible to evaluate the turnover kinetics and life span of lysosomes for each stage of the cycle. The percentage of ferritin-labeled lysosomes, regarded as an index of the endocytic activity of Sertoli cells, remained low in stages II to VIII, increased abruptly during stage IX, stayed high during stages X to XIV, and decreased to a low level during stage I of the following cycle. Correspondingly, the turnover of secondary lysosomes was relatively slow and their life span relatively long during stages II through VIII, while the turnover of lysosomes was faster and their life span shorter during stages X through XIV-I of the cycle. During stage IX, there was a sharp drop in the number of lysosomes per Sertoli cell associated with a fast rate of disappearance and a remarkably short life span of less than 4 h for the lysosomes. These features, characteristic of stage IX, are explained by the rapid fusion of lysosomes with residual bodies, which are phagocytosed by Sertoli cells at this particular stage of the cycle. The accelerated endocytosis taking place during stages IX through XIV of the cycle may explain the reduction of the surface area of the adluminal plasma membrane of Sertoli cells as well as the reduction in volume of the tubular lumen observed during these stages. Thus, the demonstrated cyclic endocytic activity of Sertoli cells and several other cyclical events taking place within seminiferous tubules correlate well. PMID- 3955138 TI - Patterns of [3H] thymidine incorporation differ in immature rats and mature, cycling rats. AB - By the time follicular development has progressed to the preovulatory stage, granulosa cells abutting the basement membrane no longer incorporate [3H] thymidine (3H-TdR). The purpose of this experiment was to determine when, during the course of follicular growth, cell proliferation in these mural granulosa cells ceases. Autoradiographs were prepared following continuous 3H-TdR infusion in vivo, or incubation with 3H-TdR in vitro. In cycling rats, the concentration of silver grains over mural regions of the granulosa layer was lower than over antral regions of most follicles with greater than 1000 cells in the largest cross section (LCS). This centripetal labeling pattern became more striking as follicular size increased. By proestrus, only the cells of the discus proligerus (cumulus and the portion of the follicular wall supporting the cumulus oocyte complex) continued to incorporate 3H-TdR. In contrast to cycling rats, centripetal labeling patterns were not seen in ovaries of prepubertal rats, even in follicles of the same size. The difference in follicular growth patterns between these two types of animals suggests an influence of cyclic gonadotropin surges on the control of granulosa cell proliferation. PMID- 3955139 TI - Olfactory environment and coitus-induced ovulation and/or luteinization in the cyclic female rat. AB - The role of pheromones in the process of ovulation and/or luteinization induced by coitus was studied in female rats primed with estradiol benzoate (EB) and early mated during 4-day cycles. The effects of coitus were evaluated by using 1) the proportion of females displaying postovulatory corpora lutea (POCL) and/or luteinized unruptured follicles (LUF), and 2) the ovulation coefficient (OC) computed in each female by dividing the number of POCL by the total number of POCL and LUF. A greater proportion of females displayed ovulation and/or luteinization following coitus than those given EB only. This proportion was slightly but significantly increased when females were exposed to bedding soiled with 5 ml of male urine prior to mating, an effect prevented by complete olfactory bulbectomy. However, in the females given EB only, the pheromonal stimulus remained inefficient. Weak ovulatory effects of coitus, as assessed by low OC values, were noted whether the females were exposed or not to male urine. An increase in the frequency of lordosis occurred after olfactory bulbectomy, but no significant changes in OC values were observed in this experimental group. It was concluded that pheromones, act as a primer on the neuroendocrine mechanisms governing ovulation in the cyclic female rat, as in other species of rodents. PMID- 3955140 TI - Environmental stress and ovarian function. AB - The female reproductive system is exposed to a great variety of environmental stresses. These include many noxious chemicals consumed either intentionally in the form of therapeutic and recreational drugs, or unwittingly as residues in the food we eat or pollutants in the air we breathe. These stresses and noxious agents influence ovarian function through actions at a number of sites and by diverse mechanisms. Sites of action include: the hypothalamo-hypophyseal system, resulting in disruption of the normal pattern of gonadotropin secretion; the ovary, resulting in direct destruction of the oocyte (ovotoxicity) or genetic damage (mutagenicity); and other organs, leading indirectly to altered ovarian function, e.g., through metabolic alterations that change the balance of feedback control of the hypothalamo-pituitary-ovarian system. Susceptibility of the ovaries to the different classes of agents depends on the stage of development at which exposure occurs. Consequences may be temporary and reversible when the source of the "stress" is removed, or permanent if exposure occurs at a "critical stage" in ovarian or hypothalamic differentiation. PMID- 3955141 TI - Assessment of reproductive risks. AB - In the regulatory process, the hazards posed by potentially toxic agents to the female and male reproductive systems and to developing young are evaluated by risk assessment procedures. In this paper, toxicity testing and the regulatory process are discussed, with emphasis on risk assessment. The suggested testing protocols of the Pesticide Assessment Guidelines (U.S. EPA) are presented as an example of testing that might be done to produce toxicity data for an agent. Protocols and end points that are utilized in testing for reproductive effects are described. Included are acute, subchronic, chronic, and short-term tests. The four components of reproductive risk assessment (hazard identification, dose response assessment, exposure assessment, and risk characterization) are examined. Effects of dibromochloropropane on rabbit testicular parameters are used to demonstrate approaches that could be taken in doing a reproductive risk assessment. Research needs for screening methods, adequate dose-response testing, toxicokinetics, end point development, and extrapolation methods are identified. Finally, this paper discusses selected areas in which changes in reproductive risk assessment are anticipated, as well as the mechanism for influencing the nature and extent of those changes. PMID- 3955142 TI - Rat testicular dolichols: distribution and accumulation with age. AB - Dolichols, linear isoprenoids essential in the biosynthesis of N-glycosylated glycoproteins, are abundant in testicular tissue. This study investigated the distribution of dolichols among testicular cell and subcellular fractions. In addition, the accumulation of dolichol within the rat testis as a function of age was investigated. Dolichol content expressed either as total dolichol/testicle or as dolichol/mg protein exhibited a marked and continuous increase between 14 and 60 days of age. The 4-, 6-, 9-, and 12-mo-old animals exhibited only minor increases in testicular dolichol content. Mean value for retired breeders was 279 ng dolichol/mg protein. Although previous studies have suggested that dolichol synthesis occurs primarily within the spermatogenic cell, elutriation-purified spermatogenic cell fractions showed very low concentrations of dolichol. Pachytene spermatocyte and round spermatid fractions contained 25.8 and 36.5 ng dolichol/mg protein, respectively. Washed epididymal sperm also had a very low dolichol content (18.8 ng dolichol/mg protein). Recovery studies during elutriation purification of spermatogenic cells showed that the majority of dolichol was contained within the Sertoli-rich tubular fragments. Microsomal fractions isolated from whole testis exhibited a small enrichment (1.6-fold) in dolichol content, whereas Golgi apparatus fractions exhibited a large (12-fold) enrichment over that of the initial homogenate. These studies suggest that, although dolichols may be synthesized within the spermatogenic cell, they accumulate within the Sertoli cell. PMID- 3955143 TI - Plasma and pineal melatonin levels in female ferrets housed under long or short photoperiods. AB - Ovohysterectomized female ferrets were housed in controlled environment rooms in which the daily lighting schedule was either 15L:9D (long days) or 9L:15D (short days). After 2 weeks some ferrets in each group were given an intrajugular catheter: beginning 1 week later, a blood sample was taken daily at one of eight different clock times over an 8 to 10 day period. One additional blood sample plus the pineal gland were collected from these animals and from uncathetarized animals in each group after decapitation at different clock times. Both plasma melatonin concentrations and pineal melatonin content were elevated in a square wave pattern during the dark hours, with the duration of elevation being longer in ferrets kept under the short days. These results suggest that differences in the duration of nocturnal increments in melatonin secretion may mediate the stimulatory and inhibitory effects of long and short days, respectively, on ovarian activity in female ferrets. PMID- 3955145 TI - An in vitro study of LH release, synthesis and heterogeneity in pituitaries from proestrous and short-term ovariectomized rats. AB - It is known that acute ovariectomy (OVX) greatly attenuates the pituitary luteinizing hormone (LH) response to gonadotropin-releasing hormone (GnRH) in vitro. The present study evaluated possible quantitative and/or qualitative differences in the biosynthesis and secretion of LH in pituitaries from proestrous and acutely (72 h) OVX rats. Paired anterior pituitary glands were incubated for 4 h in a medium containing +/- 10 nM GnRH. Pituitary and secreted LH were measured by radioimmunoassay with differences in total LH (tissue plus medium) +/- GnRH being indicative of GnRH-stimulated LH synthesis. Qualitative changes in LH were evaluated by isoelectrofocusing (IEF). The results show that the major form of LH stored in and released from the pituitaries consisted of LH molecules with an isoelectric point (pI) in the alkaline pH range (alkaline LH), and a lesser amount (approximately 30%) of LH molecules in the acidic pH range (acidic LH). The ratio of alkaline/acidic LH observed in the pituitary and medium was similar in the proestrous and OVX groups, although the amount of alkaline and acidic LH release in response to GnRH was 2-3 times greater in the proestrous group. In both groups, the alkaline/acidic LH ratio of secreted LH was higher in the presence of GnRH than in its absence. Alkaline LH synthesis was increased by GnRH in both groups, with the response being greater in the proestrous than in the OVX group; GnRH-stimulated acidic LH synthesis was observed only in the proestrous group. In both groups, the amount of LH synthesized was about 60% of the amount released, which suggests that LH synthesis does not fully account for differences in GnRH-stimulated LH release. Treatment of pituitary extracts with neuraminidase decreased acidic LH, and proportionately increased alkaline LH. These results suggest that the quality of LH stored in and secreted from pituitaries of proestrous and OVX rats is similar, and that there is a preferential release of the major alkaline LH isoform in response to GnRH. The ovarian steroid environment, presumably estradiol, proportionately increases the amount of alkaline and acidic LH released, and differentially affects the amounts of the various isoforms synthesized in response to GnRH. The charge heterogeneity of alkaline and acidic LH may be related to the sialic acid content of the LH molecule. PMID- 3955144 TI - Melatonin and photorefractoriness: loss of response to the melatonin signal leads to seasonal reproductive transitions in the ewe. AB - Experiments were conducted to examine whether the refractoriness of the Suffolk ewe to the reproductive effects of day length is associated with a deficit in the generation of the circadian rhythm of melatonin secretion or in the postpineal processing of this photoperiodic message. Using serum luteinizing hormone (LH) concentrations in ovariectomized ewes bearing constant-release estradiol implants as a marker of reproductive induction, ewes with intact pineal glands were found to become unresponsive to fixed artificial photoperiods that initially had been either inductive (short days) or inhibitory (long days). The loss of the photoperiodic response was not associated with notable changes in the 24-h secretory pattern of melatonin, which remained characteristically low throughout the day and rose at night. In pinealectomized ewes, nightly infusion of a stimulatory pattern of melatonin (simulating that seen on short days) initially provoked reproductive induction; this response then lessened over much the same time course that pineal intact ewes became refractory to short days. These results support the hypothesis that photorefractoriness reflects a deficit in the postpineal processing of the photoperiodic message. Further, in view of recent evidence that photorefractoriness normally leads to both onset and cessation of the breeding season in Suffolk ewes maintained outdoors, these findings suggest that the loss of response to the melatonin signal contributes to at least one of these reproductive transitions, the cessation of the breeding season, under natural environmental conditions. PMID- 3955146 TI - Age at puberty and first litter size in early and late paired rats. AB - The rate of sexual maturation among female Sprague-Dawley rats was measured in a variety of intraspecific social environments. It was found that females of this strain differ from at least one other strain of laboratory rat in that neither age at vaginal perforation nor age at first estrus was affected in Sprague-Dawley females by the presence or absence of male, regardless of his age or breeding history. Sizes of first litter among females who mated at their first estrus were compared with those among females who were first inseminated at older ages. On average, females bred at first estrus produced litters that contained more than 3 fewer pups than females mated at older ages. This observation suggests that female Sprague-Dawley rats do not attain full reproductive competence until sometime after the onset of puberty. PMID- 3955148 TI - Pelvic development as affected by relaxin in three genetically selected frame sizes of beef heifers. AB - Purified porcine relaxin was administered into the cervical os on Day 278 of gestation to determine its effects on pelvic development in three genetically selected frame sizes of primiparous beef heifers. Heifers were categorized as small, medium and large frame based upon their genetic composition. Pelvic height, pelvic width and cervical dilatation were determined from Day 270 to 2 days postpartum. On Day 270, heifers were assigned at random to one of three treatments: vehicle control, n = 16; relaxin once (3,000 U), n = 14; and relaxin twice (2 times 3,000 U 12 h apart), n = 17. Each heifer-frame size was represented in each treatment. Relaxin caused marked increases in pelvic height and width, as well as in the rate of linear increase (cm/day) of these parameters (p less than 0.05). These linear increases in pelvic height were 510, 264 and 204%, and pelvic width, were 280, 213 and 204% of the respective pretreatment rates for small, medium and large heifers. The rate of linear increase in pelvic width was greater than pelvic height in all heifers, but maximal in small-frame heifers; relaxin attenuated these intrinsic differences. For small heifers, the rate of linear increase in pelvic width was 121 and 145% of increases for medium and large heifers, respectively, before treatment, and 160 and 200% after treatment. The rate of postpartum involution of pelvic width was -0.03, -0.36 and -0.50 cm/day and, for pelvic height, -0.02, -0.27 and -0.29 cm/day in small, medium and large heifers, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955147 TI - Inhibin-like activity in ovarian venous serum after unilateral ovariectomy in prepubertal gilts. AB - To examine a role for inhibin in compensatory ovarian hypertrophy after unilateral ovariectomy (ULO) of prepubertal gilts, changes in inhibin activity in ovarian venous blood were estimated by bioassay. Three groups of 130-day-old gilts were unilaterally ovariectomized after collecting blood from an ipsilateral ovarian vein (Day O); blood samples were obtained from the remaining ovary on Day 2, 4, or 8. Coetaneous gilts underwent sham ovariectomy on Day 0, and venous blood was collected from both ovaries on Day 2, 4, or 8. An assay for inhibin activity, which measured inhibition of secretion of follicle-stimulating hormone (rFSH) by rat pituitary cells in culture, was validated for serum samples. Presumptive inhibin activity was always greater in ovarian venous serum than in peripheral serum samples. In the ULO groups, inhibin activity (in terms of a house reference preparation) in ovarian venous serum was 55 +/- 13 micrograms/ml (means +/- SE, n = 13) on Day 0, 251 +/- 79 (n = 5) on Day 2, 275 +/- 111 (n = 4) on Day 4, and 68 +/- 14 micrograms/ml (n = 4) on Day 8. The five-fold increases on Days 2 and 4 were significant (p less than 0.05). In contrast, no significant differences in inhibin activity were detected between ovarian venous serum (within gilts) or between Days 2, 4, and 8: 82 +/- 29, 73 +/- 30, and 99 +/- 48 micrograms/ml (n=4/day) in control groups. These results demonstrate that, in prepubertal gilts, the remaining ovary's response to ULO includes a major increase in release of inhibin-like activity. PMID- 3955150 TI - Increased uterine vascular permeability at the time of embryonic attachment in the pig. AB - The temporal relationship between embryonic attachment and endometrial vascular permeability was investigated in the gilt. Light and electron microscopy failed to reveal structural differences between Day 10 cycling and pregnant maternal epithelia, including evidence of blastocyst contact. Chorionic adhesion was preserved at mesometrial regions in 3 of 5 Day 13 pregnant animals and appeared to be related to localized differentiation of the underlying maternal epithelium. In order to study uterine vascular permeability, 44 gilts between Days 11 and 19 of the cycle and pregnancy were injected i.v. with a 0.5% solution of Evans Blue (2.5 ml/kg body weight). Examination of excised uteri under ultraviolet light revealed a well-defined zone of endometrial fluorescence corresponding to extravascular content of the dye. Exclusive to pregnant gilts, this response appeared in conjunction with blastocyst elongation at Day 12, and was consistently confined to areas of embryonic membrane contact thereafter. The changes in endometrial morphology and vascular permeability suggest involvement of some embryonic factor(s) acting in a localized manner. Increased histotrophe production is probably facilitated by the flux of plasma constituents to maternal epithelial cells. Coincidence of increased uterine vascular permeability at the site of attachment with elevated blood flow would enhance transport of nutrients toward the conceptus and allow access of blastocyst-induced products to the maternal circulation. PMID- 3955149 TI - Changes in the organization of the lipid bilayer of the plasma membrane during spermatogenesis and epididymal maturation. AB - Ram, bull, and mouse sperm cells were stained with several fluorescent membrane probes. In contrast to nonspecific probes, merocyanine 540 (MC540), which displays preferential binding to loosely packed phospholipids in model membranes, was specifically localized to the anterior portion of the head and the midpiece of mature sperm. To establish when during development this distinctive staining pattern was acquired, germ cells from prepubescent and adult mouse testes as well as sperm from the caput, corpus, and cauda epididymides were isolated and examined. Localized staining with MC540 was not observed until sperm reached the corpus epididymidis, where those cells with a completely translocated (i.e., distally located) cytoplasmic droplet fluoresced. Likewise, when sperm were stained with fluoresceinated concanavalin A (fl-ConA), a localized pattern of fluorescence with lectin restricted to the anterior portion of the head was not observed until the corpus epididymidis was reached. However, in contrast to MC540 staining, only a fraction of sperm with completely translocated droplets exhibited this localized staining with fl-ConA, the remainder exhibiting diffuse fluorescence over the entire cell as seen on caput epididymal sperm. These developmental changes in staining patterns are specific to murine cells, since no change in the pattern of staining by either MC540 or fl-ConA was seen on epididymal sperm of the ram. These results are discussed with respect to: 1) species-to-species differences in sperm membrane features; and 2) the hypothesis that domains of loosely packed lipids may be involved in the regionalization of membrane proteins that occurs during sperm development. PMID- 3955151 TI - Morphological changes in the blastocyst of the western spotted skunk during activation from delayed implantation. AB - Blastocysts collected from the spotted skunk during delay of implantation, early activation and late activation demonstrate three-tiered growth and developmental changes. The slow-growing blastocyst from the several months of delay is small (less than 1.1 mm) with a rounded inner cell mass consisting of clusters of rounded, lipid-filled cells. During the several days of early activation, the lipid in both inner cell mass and trophoblast diminishes, polyribosomes increase in number, and the endodermal layer differentiates as the blastocyst grows (1.2 1.6 mm). At activation the inner cell mass flattens, becomes uncovered by polar trophoblast, and forms a disc of columnar epiblast cells. The blastocyst expands rapidly during the last 24-48 h prior to implantation to 1.7-2.0 mm, and the trophoblast becomes cuboidal with a marked endocytotic apparatus. The morphological evidence, together with previous studies of protein and RNA synthesis, suggests a tooling-up period during early activation with progressive increases in rates of growth and differentiation in the last hours as implantation approaches. PMID- 3955152 TI - Evaluation of the biocompatibility of polymers implanted into bone using titanium mosaic on bone cement. AB - A method for high-resolution study of the interaction of bone and polymeric materials is described. By creating a 'mosaic' surface of polymer and pure titanium, using the titanium as an internal control, the tissue influence of the polymer surface can be deduced. PMID- 3955153 TI - The effect of the surface finish of alumina and stainless steel on the wear rate of UHMW polyethylene. AB - The effect of the surface finish of medical grade alumina and stainless steel on the wear rate of ultra-high molecular weight (UHMW) polyethylene was studied in a six station pin-on-plate wear screening device using bovine serum as lubricant. The wear rate decreased as the surface finish of alumina improved from 0.10 to 0.015 micron Ra, with no evidence of an increasing wear rate below a particular value of surface finish. Tests with surgical grade stainless steel showed a similar polyethylene wear rate around the 0.025 micron Ra level, but there was evidence of a higher wear rate with stainless steel than with alumina between approx. 0.035 and 0.075 micron Ra. PMID- 3955154 TI - The in vitro toxicity of cobalt-chrome-molybdenum alloy and its constituent metals. AB - Cobalt-chrome-molybdenum alloys are widely used in orthopaedic implants. Although they are relatively well tolerated, complications (including loosening and tissue necrosis) still occur and sometimes appear to be due to incomplete biocompatibility of the alloy. To investigate the local effect of the alloy on cells derived from the musculo-skeletal system, primary lines of fibroblastic cells from newborn rats were exposed to powders of cobalt-chrome-molybdenum alloy and its main constituents cobalt, chromium nickel and molybdenum. The toxicity of the metals was determined by counts of total cell number and of abnormal cells at intervals from 2 to 12 d. The alloy was much less toxic than cobalt or nickel and the pattern of toxicity was different for each metal. The results emphasize the difficulty of devising a single tissue culture test of toxicity which will measure the toxicity of any potential implant material. PMID- 3955155 TI - Collagen-based wound dressing: effects of hyaluronic acid and fibronectin on wound healing. AB - Our previous studies have shown that a collagen-based wound dressing induces the spatial deposition of wound tissue. This study was conducted to determine the effects of hyaluronic acid and fibronectin on wound healing. These macromolecules play an important role in wound healing, embryonic development and cellular migration in vitro. The effects of the addition of varying levels of fibronectin and hyaluronate to a collagen sponge were studied. Low levels of both hyaluronate and fibronectin modified the structure of the implant, and resulted in increased chemoattraction, replication and collagen deposition in an in vivo wound healing model. PMID- 3955156 TI - The biological response to titanium and titanium-aluminium-vanadium alloy particles. I. Tissue culture studies. AB - One aspect of the biological response to titanium and titanium-aluminium-vanadium alloy was investigated by exposing primary cultures of human synovial fibroblasts and mouse peritoneal macrophages to particulate preparations of these materials. Both cell types appeared to be unaffected by either material as judged by microscopical examination. A small but significant release of lactate dehydrogenase was detected from both cell types in response to their exposure to the particulate material indicating that some cell damage occurred. Macrophages also exhibited a small release of the two lysosomal enzyme markers beta glucuronidase and N-acetyl-beta-D-glucosaminidase. This indicates that these materials may have a mild inflammatory potential. No soluble metal could be shown to have dissolved from the particulate alloy or from pure titanium. PMID- 3955157 TI - The biological response to titanium and titanium-aluminium-vanadium alloy particles. II. Long-term animal studies. AB - The long-term tissue reactions to particulate titanium and titanium-aluminium vanadium alloy were investigated by the intra-articular injection of material into the knee joints of mice. The tissue response was studied over a period of 2 to 52 weeks. In general, both materials were well tolerated, there was no evidence of necrosis and only a slight thickening of the synovium occurred around particles. Multinucleated giant cells were only rarely seen and no palpable tumours formed in any animal at any site. PMID- 3955158 TI - Visco-elastic properties of dental elastomeric impression materials. AB - The visco-elastic properties of a number of set elastomeric impression materials were determined using a torsional pendulum apparatus, i.e. the real (G1) and imaginary (G2) parts of the complex shear modulus and the mechanical loss tangent (Tan delta). Comparison with published data on tension and compression set for these materials showed that whilst there was no correlation between Tan delta and tension set, there was significant (greater than 99%) correlation with compression set. Treating a permanent set test as the application of a rectangular stress pulse of duration tau, and assuming (i) linear visco elasticity theory and (ii) that G1 and G2 are independent of frequency. Fourier integral analysis predicts that Tan delta should be proportional to permanent set. Tension set does not conform to this prediction because the deformation is nonlinear. The compression set test is shown to involve shear strains and elastomers generally are Hookean in shear. Whilst the theoretical treatment applies qualitatively, there are major quantitative disparities, the reasons for which are discussed. PMID- 3955159 TI - An evaluation of the significance of the impinging jet method for measuring the acid erosion of dental cements. AB - An extensive review has been made of the impinging jet method for evaluating the durability of dental cements. A comprehensive range of 28 dental cements was examined. The initial rate of erosion was found to be essentially constant. Zinc oxide cements were found to be markedly less durable than alumino-silicate cements. Results broadly correlate with those found in clinical studies. PMID- 3955160 TI - Phagocytosis of latex particles by leucocytes. I. Dependence of phagocytosis on the size and surface potential of particles. AB - A series of latex particles, having different sizes and surface structures, were prepared and the dependence of phagocytosis of latex particles by leucocytes on the particle size and surface potential was investigated by measuring the oxygen consumption of leucocytes. Most of the phagocytic behaviour in the initial stages can be explained by susceptibility of particles to heterocoagulation i.e. attachment of small particles (latex particles) onto large particles (leucocytes) by the colloidal attractive force between the two kinds of particles. Specific behaviour for fine particles seems to be attributed to the contribution of steric stabilization by the hydrated layer on the particle surface and to the inability for the leucocytes to recognize very fine particles as foreign materials. PMID- 3955161 TI - Implant-fixed, dental bridges from carbon/graphite fibre reinforced poly(methyl methacrylate). AB - Conventional bridge frameworks of gold alloys are expensive. A method for preparing bridges from carbon/graphite reinforced poly(methyl methacrylate) on titanium implants is described. After a separate in vitro investigation of both heat- and auto polymerized systems with different quantities of carbon/graphite fibres, the material system was selected. Clinical data on 11 patients with observation periods from 11 to 24 mnth indicated that the carbon/graphite fibre reinforced polymer bridges functioned satisfactorily. PMID- 3955162 TI - Protein adsorption on soft contact lenses. III. Mucin. AB - Adsorption of bovine submaxillary mucin (BSM) on three different soft contact surfaces, lathe cut (LC) and spin cast (SC) crosslinked poly-2 hydroxyethylmethacrylate and spin cast poly(2 hydroxyethylmethacrylate/methacrylic acid) (PHEMA/MAA), was studied. The in vitro process was followed by attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR). A three-layer structure is envisaged for the adsorbed BSM: a very thin surface layer of strongly bound and conformationally altered mucin constitutes the surface layer. A random to beta-sheet structural transition activated by the hydrogel surface is proposed for this layer. Glycoprotein hydrogen-bonding with the polymer hydroxyls and interaction of charged and hydrophobic groups with hydrogel surfaces are important in stabilizing this layer. Most of the adsorbed BSM (99%) is found in the middle and top layers which are formed by a different degree of associated BSM (their conformation is minimally changed or not changed at all, respectively) and are weakly adsorbed to the lens surfaces. Surface morphology and chemical composition of the lenses are important adsorption parameters only for the reversibly adsorbed BSM. PMID- 3955163 TI - [Effect of the mixing conditions of PMMA bone cements on their properties. 2: Analysis of the mixing procedure]. PMID- 3955164 TI - [Portable system for measuring pressure distribution in biomechanical gait analyses]. PMID- 3955166 TI - Macromolecular assembly analyzed by converging structural techniques. Airlie, Virginia, 10-13 November 1985. PMID- 3955165 TI - [Electrolyte analysis of body fluids with ion sensitive sensors (II)]. PMID- 3955167 TI - Resolving pathways of functional coupling within protein assemblies by site specific structural perturbation. AB - Site-specific structural modification is a powerful tool for studying functional mechanisms in proteins where the structures may be manipulated by direct chemical modification, by selection of naturally-occurring mutants, or by site-directed mutagenesis. Here, we present a general strategy for such studies, which we term "mapping by structure-function perturbation." A series of functional perturbations (i.e., deviations of functional behavior from that of the native protein) are mapped against the structural locations of the modified sites, obtained over a range of locations. The modifications are treated as arbitrary perturbations of structure at specific locations, in contrast to the conventional approach of trying to interpret their local stereochemistry. The map yields information on structural locations of functional events and pathways of coupling within protein assemblies. We have applied this approach to the ligand-linked subunit assembly of human hemoglobin, using both chemically-modified heme sites (CN-met), and amino acid residues altered by mutation and chemical modification. PMID- 3955168 TI - Simulation of biomolecular diffusion and complex formation. AB - Diffusion is a phenomenon of very widespread importance in molecular biophysics. Diffusion can determine the rates and character of the assembly of multisubunit structures, the binding of ligands to receptors, and the internal motions of molecules and assemblies that involve solvent surface displacements. Current computer simulation techniques provide much more detailed descriptions of diffusional processes than have been available in the past. Models can be constructed to include such realistic features as structural subunits at the submolecular level (domains, monomers, or atoms); detailed electrostatic charge distributions and corresponding solvent-screened inter- and intramolecular interactions; and hydrodynamic interactions. The trajectories can be analyzed either to provide direct information on biomolecular function (e.g., the bimolecular rate constant for formation of an electron-transfer complex between two proteins), or to provide or test models for the interpretation of experimental data (e.g., the time dependence of fluorescence depolarization for segments of DNA). Here, we first review the theory of diffusional simulations, with special emphasis on new techniques such as those for obtaining transport properties of flexible assemblies and rate constants of diffusion-controlled reactions. Then we survey a variety of recent applications, including studies of large-scale motion in DNA segments and substrate "steering" in enzyme-substrate binding. We conclude with a discussion of current work (e.g., formation of protein complexes) and possible areas for future work. PMID- 3955169 TI - Principles in the assembly of annelid erythrocruorins. AB - Erythrocruorins are giant extracellular respiratory proteins found freely dissolved in the blood of annelids. We present here results from our ultracentrifugation, electron microscopy, spectroscopy, and diffraction experiments on these erythrocruorins. These data are rationalized in terms of a three-dimensional model of the quaternary structure. The proposed structure is arranged in a hierarchy of symmetry. The implications of this structure for the assembly process are considered with special attention to uniqueness and self limitation. The hypothesis is consistent with observations not used in its construction and it serves as a working hypothesis to focus further experimentation. PMID- 3955170 TI - Recognition and interactions controlling the assemblies of beta barrel domains. AB - We present a qualitative computer graphics approach to the characterization of forces important to the assembly of beta domains that should have general utility for examining protein interactions and assembly. In our approach, the nature of the molecular surface buried by the domain contacts, the specificity of the residue-to-residue interactions, and the identity of electrostatic, hydrophobic, and hydrophilic interactions are elucidated. These techniques are applied to the beta barrel domains of Cu, Zn superoxide dismutase (SOD), immunoglobulin Fab, and tomato bushy stunt virus coat protein (TBSV), a plant viral capsid protein. By looking at a set of proteins having different numbers of interacting beta domains, we have been able to see some of the variety and also some of the patterns common to these assembled domains. Strong beta domain interactions (identified by their biochemical integrity) are apparently due to chemical, electrostatic, and shape complementarity of the molecular surfaces buried from interaction with solvent molecules. Although the amount of hydrophobic buried surface area appears to correlate with the strength of the interaction, electrostatic forces appear to be important in both stabilizing and destabilizing specific contacts. In TBSV, analysis of electrostatic interactions may help explain mechanisms of subunit accommodation to different environments, particle expansion, and pathways of assembly. The possible molecular basis for observed differences in the stability and flexibility of the domain complexes is discussed. PMID- 3955171 TI - Structure of the crystalline complex between ribonuclease A and D(pA)4. AB - Crystals of a complex formed between ribonuclease A and d(pA)4 were grown and their structure determined by a combination of multiple isomorphous replacement (MIR) and molecular replacement techniques. The known structure of ribonuclease A in the correct orientation in the unit cell yielded a conventional crystallographic R factor of 0.32 at 2.8 A resolution when refined as a rigid body. Difference Fourier syntheses permitted determination of the disposition of the DNA in the unit cell. Refinement of both protein and DNA by constrained restrained least squares procedures resulted in an R factor of 0.22 at 2.5 A resolution. The structure of the crystalline complex is comprised of four ordered oligomers of d(pA)4 associated with each molecule of RNAse. If the sites of interaction between protein and d(pA)4 fragments are mapped on the surface of the protein, they describe an essentially continuous path into and through the active site, across the surface of the enzyme and finally into the basic amino acid cluster on the opposite side of the protein. PMID- 3955172 TI - Assembly of chromatin fibers into metaphase chromosomes analyzed by transmission electron microscopy and scanning electron microscopy. AB - The higher-order assembly of the approximately 30 nm chromatin fibers into the characteristic morphology of HeLa mitotic chromosomes was investigated by electron microscopy. Transmission electron microscopy (TEM) of serial sections was applied to view the distribution of the DNA-histone-nonhistone fibers through the chromatid arms. Scanning electron microscopy (SEM) provided a complementary technique allowing the surface arrangement of the fibers to be observed. The approach with both procedures was to swell the chromosomes slightly, without extracting proteins, so that the densely-packed chromatin fibers were separated. The degree of expansion of the chromosomes was controlled by adjusting the concentration of divalent cations (Mg2+). With TEM, individual fibers could be resolved by decreasing the Mg2+ concentration to 1.0-1.5 mM. The predominant mode of fiber organization was seen to be radial for both longitudinal and transverse sections. Using SEM, surface protuberances with an average diameter of 69 nm became visible after the Mg2+ concentration was reduced to 1.5 mM. The knobby surface appearance was a variable feature, because the average diameter decreased when the divalent cation concentration was further reduced. The surface projections appear to represent the peripheral tips of radial chromatin loops. These TEM and SEM observations support a "radial loop" model for the organization of the chromatin fibers in metaphase chromosomes. PMID- 3955174 TI - Contact x-ray microscopy. A new technique for imaging cellular fine structure. AB - Contact x-ray microscopy potentially allows living, wet cells to be visualized at a resolution of up to 100 A. Furthermore, differential absorption by specific elements permits the study of the distribution of those elements in biological specimens. In contact x-ray microscopy, soft x-rays (10 A to 100 A) pass through a biological sample and expose an underlying x-ray sensitive polymer (resist), producing an image that reflects the photon absorbance within the specimen. The high penetrating power of soft x-ray enables images to be obtained from specimens up to several microns thick. In this paper, the technique is described, some of the areas currently under study are considered, and biological examples of the use of contact x-ray microscopy are given. PMID- 3955173 TI - Chromatin fibers are left-handed double helices with diameter and mass per unit length that depend on linker length. AB - Four classes of models have been proposed for the internal structure of eukaryotic chromosome fibers--the solenoid, twisted-ribbon, crossed-linker, and superbead models. We have collected electron image and x-ray scattering data from nuclei, and isolated chromatin fibers of seven different tissues to distinguish between these models. The fiber diameters are related to the linker lengths by the equation: D(N) = 19.3 + 0.23 N, where D(N) is the external diameter (nm) and N is the linker length (base pairs). The number of nucleosomes per unit length of the fibers is also related to linker length. Detailed studies were done on the highly regular chromatin from erythrocytes of Necturus (mud puppy) and sperm of Thyone (sea cucumber). Necturus chromatin fibers (N = 48 bp) have diameters of 31 nm and have 7.5 +/- 1 nucleosomes per 10 nm along the axis. Thyone chromatin fibers (N = 87 bp) have diameters of 39 nm and have 12 +/- 2 nucleosomes per 10 nm along the axis. Fourier transforms of electron micrographs of Necturus fibers showed left-handed helical symmetry with a pitch of 25.8 +/- 0.8 nm and pitch angle of 32 +/- 3 degrees, consistent with a double helix. Comparable conclusions were drawn from the Thyone data. The data do not support the solenoid, twisted ribbon, or supranucleosomal particle models. The data do support two crossed linker models having left-handed double-helical symmetry and conserved nucleosome interactions. PMID- 3955175 TI - Spectrin, human erythrocyte shapes, and mechanochemical properties. AB - Physical studies of human erythrocyte spectrin indicate that isolated spectrin dimers and tetramers in solution are worm-like coils with a persistence length of approximately 20 nm. This finding, the known polyelectrolytic nature of spectrin, and other structural information about spectrin and the membrane skeleton molecular organization have lead us to the hypothesis that the human erythrocyte membrane skeleton constitutes a two-dimensional ionic gel (swollen ionic elastomer). This concept is incorporated in what we refer to as the protein gel lipid bilayer membrane model. The model accounts quantitatively for red elastic shear modulus and the maximum elastic extension ratio reported for the human erythrocytes membrane. Gel theory further predicts that depending on the environmental conditions, the membrane skeleton modulus of area compression may be small or large relative to the membrane elastic shear modulus. Our analyses show that the ratio between these two parameters affects both the geometry and the stability of the favored cell shapes and that the higher the membrane skeleton compressibility the smaller the values of the gel tension needed to induce cell shape transformations. The main virtue of the protein gel-lipid bilayer membrane model is that it offers a novel theoretical and molecular basis for the various mechanical properties of the membrane skeleton such as the membrane skeleton modulus of area compression and osmotic tension, and the effects of these properties on local membrane skeleton density, cell shape, and shape transformations. PMID- 3955176 TI - Image reconstruction using electron micrographs of insect flight muscle. Use of thick transverse sections to supplement data from tilted thin longitudinal sections. AB - Three-dimensional reconstruction using electron micrographs of thin sections is a powerful technique for determining cross-bridge structure. Tilt restrictions in the electron microscope prevent data collection beyond tilt angles of 60 degrees, giving rise to a "missing cone" of transform data. We show here how much of this data can be obtained using micrographs of thick transverse sections, and the effect this data has on reconstructed images of the insect flight muscle MYAC layer. As a byproduct, the analysis showed that section thinning resulting from prolonged electron irradiation had occurred in the thin longitudinal section used for the previously published MYAC layer reconstruction (Taylor et al., 1984). Comparison of projection density maps calculated from the thin longitudinal section reconstruction and the thick section data show that the data within the missing cone that is not accessible by tilting sharpens the boundaries of the components, flattens the density profile across the thick filament, and enlarges the molecular envelope of the thin filament. We conclude that the reconstructed images of the MYAC layer provide a picture of the structural principles underlying the system but that transform data within the missing cone are necessary to describe accurately the envelopes and profiles of these structural elements. PMID- 3955177 TI - Rotation of dielectrics in a rotating electric high-frequency field. Model experiments and theoretical explanation of the rotation effect of living cells. AB - Model experiments are carried out to clarify the mechanism of rotation of living cells in a rotating electric field. According to classical investigations of the rotation of macroscopic bodies in external fields, the rotation of spherical glass vessels or metal cylinder filled with electrolyte solutions was investigated. The relation of the calculations of Lertes (1921a,b) to the recent paper of Arnold and Zimmerman (1982) and our new derivations lead to equations explaining the rotation of objects. The results are compared with measurements using mesophyll protoplasts and data from the literature. PMID- 3955179 TI - Use of a membrane-bound fluorophore to characterize diffusion boundary layers around human erythrocytes. AB - A novel method is used to demonstrate the presence of diffusion boundary layers around erythrocytes following rapid mixing in a stopped-flow spectrophotometer and to estimate the apparent dimensions of the diffusion boundary layers. Pink erythrocyte ghosts labeled on their external surfaces with tetramethyl rhodamine isothiocyanate (TRITC) were mixed in a stopped-flow apparatus with 50 mM NaI in Ringer's solutions. I- is an effective collisional quencher of TRITC fluorescence. TRITC fluorescence after flow stopped decreased monoexponentially with time. The concentration of I- at the cell surface as a function of time was estimated from the dependence of TRITC fluorescence on I- concentration in steady state experiments. The kinetics of the increase in I- concentration at the cell surface was fit to two diffusional models: a planar erythrocyte ghost bounded by planar diffusion boundary layer and a spherical erythrocyte surrounded by a spherical shell diffusion boundary layer. The planar model best fits the experimental data with a diffusion boundary layer 4.68 microns thick. Using the spherical model the experimental data is best fit by a 6.9 microns diffusion boundary layer. PMID- 3955178 TI - Stiffness and force in activated frog skeletal muscle fibers. AB - Single fibers, isolated intact from frog skeletal muscles, were held firmly very near to each end by stiff metal clasps fastened to the tendons. The fibers were then placed horizontally between two steel hooks inserted in eyelets of the tendon clasps. One hook was attached to a capacitance gauge force transducer (resonance frequency up to approximately 50 kHz) and the other was attached to a moving-coil length changer. This allowed us to impose small, rapid releases (complete in less than 0.15 ms) and high frequency oscillations (up to 13 kHz) to one end of a resting or contracting fiber and measure the consequences at the other end with fast time resolution at 4 to 6 degrees C. The stiffness of short fibers (1.8-2.6 mm) was determined directly from the ratio of force to length variations produced by the length changer. The resonance frequency of short fibers was so high (approximately 40 kHz) that intrinsic oscillations were not detectably excited. The stiffness of long fibers, on the other hand, was calculated from measurement of the mechanical resonance frequency of a fiber. Using both short and long fibers, we measured the sinusoids of force at one end of a contracting fiber that were produced by relatively small sinusoidal length changes at the other end. The amplitudes of the sinusoidal length changes were small compared with the size of step changes that produce nonlinear force extension relations. The sinusoids of force from long fibers changed amplitude and shifted phase with changes in oscillation frequency in a manner expected of a transmission line composed of mass, compliance, and viscosity, similar to that modelled by (Ford, L. E., A. F. Huxley, and R. M. Simmons, 1981, J. Physiol. (Lond.), 311:219-249). A rapid release during the plateau of tetanic tension in short fibers caused a fall in force and stiffness, a relative change in stiffness that putatively was much smaller than that of force. Our results are, for the most part, consistent with the cross-bridge model of force generation proposed by Huxley, A. F., and R. M. Simmons (1971, Nature (Lond.), 213:533-538). However, stiffness in short fibers developed markedly faster than force during the tetanus rise. Thus our findings show the presence of one or more noteworthy cross-bridge states at the onset and during the rise of active tension towards a plateau in that attachment apparently is followed by a relatively long delay before force generation occurs. A set of equations is given in the Appendix that describes the frequency dependence of the applied sinusoid and its response. This model predicts that frequency dependent changes can be used as a measure of a change in stiffness. PMID- 3955180 TI - The intrinsic pKa values for phosphatidylserine and phosphatidylethanolamine in phosphatidylcholine host bilayers. AB - Potentiometric titrations and surface potential measurements have been used to determine the intrinsic pKa values of both the carboxyl and amino groups of phosphatidylserine (PS) in mixed vesicles of PS and phosphatidylcholine (PC), and also of the amino group of phosphatidylethanolamine (PE) in mixed PE-PC vesicles. The pKa of the carboxyl group of PS in liposomes with different PS/PC lipid ratios measured by the two different methods is 3.6 +/- 0.1, and the pKa of its amino group is 9.8 +/- 0.1. The pKa of the amino group of PE in PE-PC vesicles, determined solely by surface potential measurements, is 9.6 +/- 0.1. These pKa values are independent of the aqueous phase ionic strength and of the effect of the liposome's surface potential due to the presence of these partially charged lipids. PMID- 3955181 TI - Electrophoretic mobility of human erythrocytes. On the applicability of the charged layer model. AB - The limitations of previous linear electrokinetic theories are discussed. A special model of the surface charge distribution, based on the minimum condition of the interfacial electrostatic free energy, is introduced. The model describes the electrophoretic mobility, taking into account the electroosmotic flow through the surface macromolecular layer and the surface conductivity. This nonlinear electrophoretic theory describes experimental data obtained with human erythrocytes. Numerical results for an uniformly distributed space charge are also presented. PMID- 3955182 TI - Thermodynamics of cell adhesion. II. Freely mobile repellers. AB - The equilibrium adhesion of a cell or vesicle to a substrate is analyzed in a theoretical model in which two types of mobile molecules in the cell membrane are of interest: receptors that can form bonds with fixed ligands in the substrate and repellers that repel the substrate. If the repulsion between the repeller molecule and substrate is greater than kT, there is substantial redistribution of the repellers from the contact area. Coexisting equilibrium states are observed having comparable free energies (a) with unstretched bonds and repeller redistribution and (b) with stretched bonds and partial redistribution. PMID- 3955183 TI - Fine structure in near-field and far-field laser diffraction patterns from skeletal muscle fibers. AB - Regions of muscle fibers that are many sarcomeres in length and uniform with regard to striation spacing, curvature, and tilt have been observed by light microscopy. We have investigated the possibility that these sarcomere domains can explain the fine structure in optical diffraction patterns of skeletal muscle fibers. We studied near-field and far-field diffraction patterns with respect to fiber translation and to masking of the laser beam. The position of diffracted light in the near-field pattern depends on sarcomere length and position of the diffracting regions within the laser beam. When a muscle fiber was translated longitudinally through a fixed laser beam, the fine structural lines in the near field diffraction pattern moved in the same direction and by the same amount as the fiber movement. Translation of the muscle fiber did not result in fine structure movement in the far-field pattern. As the laser beam was incrementally masked from one side, some fine structural lines in both the near-field and far field diffraction patterns changed in intensity while others remained the same. Eventually, all the fine structural lines broadened and decreased in intensity. Often a fine structural line increased in intensity or a dark area in the diffraction pattern became brighter as the laser beam was restricted. From these results we conclude that the fine structure in the laser diffraction pattern is due to localized and relatively uniform regions of sarcomeres (domains) and to cross interference among light rays scattered by different domains. PMID- 3955184 TI - The membrane dipole potential in a total membrane potential model. Applications to hydrophobic ion interactions with membranes. AB - The total potential energy profile for hydrophobic ion interactions with lipid bilayers can be written as the sum of four terms: the electrical Born, image and dipole contributions, and a neutral energy term. We introduce a specific model for the membrane dipole potential, treating it as a two-dimensional array of point dipoles located near each membrane-water interface. Together with specific theoretical models for the other energy terms, a total potential profile is developed that successfully describes the complete set of thermodynamic parameters for binding and translocation for the two hydrophobic ion structural analogues, tetraphenylphosphonium (TPP+) and tetraphenylboron (TPB-). A reasonable fit to the data is possible if the dipole potential energy has a magnitude of 5.5 + 0.5 kcal/mol (240 + 20 mV), positive inside, and if the neutral energy contribution for TPP+ and TPB- is -7.0 + 1.0 kcal/mol. These results may also have important implications for small ion interactions with membranes and the energetics of charged groups in membrane proteins. PMID- 3955185 TI - Order of proton uptake and release by bacteriorhodopsin at low pH. AB - The order of proton uptake and release in an aqueous suspension of purple membrane in response to a light flash has been investigated at lowered pH. pH indicator dyes and a flash spectrophotometer were used for the study. At pH 6.6 it was found that the release of protons from the purple membrane precedes uptake, as reported by other investigators. At pH 5.9, 4.9, and 4.1 it was also found that release precedes uptake. These results are not in agreement with those of previous investigators. PMID- 3955186 TI - A new approach to understanding the initial step in visual transduction. AB - Data from picosecond spectroscopic studies of the formation kinetics of bathorhodopsin upon photolysis of rhodopsin and isorhodopsin was analyzed in terms of the Englman-Jortner theory of radiationless transitions. It was found that low frequency vibrations of the protein and/or chromophore are important in coupling bathorhodopsin to its precursor. The results were consistent with a mechanism for bathorhodopsin formation involving only a simple chromophore isomerization. A similar analysis of the formation kinetics of the K state of bacteriorhodopsin showed that different low frequency vibrations than those calculated for rhodopsin couple it to its precursor. The frequency of these vibrations increases upon deuteration for rhodopsin, while it decreases upon deuteration for bacteriorhodopsin. This points out the importance the specific protein matrix has on the primary photolysis reaction. PMID- 3955188 TI - Measurements of a large anisotropy in the swelling of oriented DNA films in aqueous solution. PMID- 3955187 TI - UV-induced reduction of Cu(II) in DNA complex studied by Cu-K-edge XANES. PMID- 3955189 TI - Conformational properties of gastrin peptides: synthesis, biological activity, and preliminary CD characterization of the (Asp)5 analog of des-Trp1, Leu12 Minigastrin. PMID- 3955190 TI - Temperature dependence of dielectric constant at 10 GHz of Na-DNA gels. PMID- 3955191 TI - Hydrogen-bonding preferences in 2,6-diaminopurine: uracil (thymine) and 8-methyl adenine:uracil (thymine) complexes. PMID- 3955193 TI - Dependence of oxygen quenching of intercalated methylene blue triplet lifetime on DNA base-pair composition. PMID- 3955192 TI - The effect of solvent viscosity and temperature on DNA viscoelastic behavior. PMID- 3955194 TI - The growth of large single crystals of lysozyme. PMID- 3955195 TI - The properties of calmodulin at physiological temperature. PMID- 3955196 TI - Effects of phenobarbital steady state levels on antipyrine clearance and distribution in the rat. AB - A group of 15 rats received two intravenous bolus doses of antipyrine (15 mg/kg) separated by a 57 hour infusion (with bolus dose) of phenobarbital. Phenobarbital bolus doses and infusion rates were based on a preliminary pharmacokinetic study (7 rats) and were varied to achieve a broad range of steady state levels. Antipyrine and phenobarbital blood levels were measured by high pressure liquid chromatography. Antipyrine kinetics obeyed first order monoexponential decay, and the parameters (clearance, volume, half-life) were determined. Antipyrine clearance increased in all animals during phenobarbital infusions with a per cent increase ranging between 54.6 and 269 per cent. However, no significant correlation was found between the per cent increase in antipyrine clearance and phenobarbital concentration (r = 0.19). The volume of distribution of antipyrine increased in 14 of 15 animals with increases ranging between 7.7 and 45.8 per cent. PMID- 3955197 TI - Acetylsalicylic acid metabolites in blood and urine after plain and enteric coated tablets. AB - Acetylsalicylic acid (ASA) was administered orally as a single dose to 7 healthy male volunteers as plain or enteric-coated (Entrophen) tablets using a crossover design. Blood and urine samples were collected and analysed for ASA metabolites by high performance liquid chromatography. Labile and stable glucuronide conjugates of salicylic acid (SA) were measured in urine after differential hydrolysis with glucuronidase. Plasma kinetic parameters for the ASA metabolites SA and salicyluric acid were not different for the 2 formulations, apart from the delayed appearance after the enteric-coated tablets. Total urinary recovery, and recovery of salicyluric acid and the two SA glucuronides were not different, thus confirming the equivalent bioavailability and metabolite profile of the 2 ASA formulations. PMID- 3955198 TI - Evaluation of two new megestrol acetate tablet formulations in humans. AB - The bioequivalence of two new investigational 160 mg tablets, one containing the regular form and the other a micronized form of megestrol acetate, was determined relative to a commercially available 40 mg tablet (Megace). The tablets were administered to 24 male subjects in a three-way cross-over study, balanced for sequence, with a week between administrations. The 40 mg tablets were administered q.i.d. at 08.00, 12.00, 18.00 and 22.00 h, while the 160 mg tablets were administered once at 08.00 h. Plasma samples were collected at appropriate times out to 96 h after administration and were analysed for megestrol acetate with a validated high performance liquid chromatographic procedure. Based on the times to maximum plasma concentrations (2.5 to 2.8 h), the absorption rate constant was the same for each of the tablets. Relative to the 40 mg q.i.d. dose, the 160 mg regular and the 160 mg micronized tablets had mean relative bioavailabilities of 97 per cent and 118 per cent, respectively. PMID- 3955199 TI - The pharmacokinetics of oral and intravenous prenalterol in young, healthy volunteers. AB - The pharmacokinetics of prenalterol in healthy young volunteers after i.v. and oral dosing has been studied. There is evidence of non-linearity following the i.v. dosing. Evidence of dose-dependent pharmacokinetics following i.v. dosing has been obtained. The sustained-release formulation is very effective: almost 12 h were needed to achieve 50 per cent of the total AUC. PMID- 3955201 TI - The non-linear pharmacokinetics of prednisone and prednisolone. I. Theoretical. AB - Three simple linear and three simple non-linear pharmacokinetic models are presented which incorporate the reversible metabolism that occurs between prednisone and prednisolone. Under steady-state conditions it is possible to not only distinguish between the linear and non-linear models but also to determine which particular model of each group applies to a given set of data. While the non-linear conversion of prednisolone to prednisone is important in explaining the pharmacokinetics of prednisone in all three non-linear models, the same is not true for prednisolone. PMID- 3955200 TI - The effect of administration of propranolol on the pharmacokinetics of isoxicam. AB - In order to examine a potential interaction between isoxicam and propranolol, single 200 mg doses of isoxicam were administered to ten healthy male volunteers before and during treatment with propranolol, gradually attaining a dose of 80 mg t.i.d. for 11 days. The pharmacokinetic profiles of the isoxicam plasma concentration/time data obtained over 96 h following the doses of isoxicam before and during propranolol administration were compared. No significant change was found in any of the pharmacokinetic parameters determined. These results suggest that propranolol has no effect on the metabolic disposition of isoxicam. PMID- 3955202 TI - [Reactivity of the cholinoceptive cortical neurons to the repeated action of acetylcholine]. AB - Three groups of sensorimotor cortical cholinoceptive neurons have been established in albino rats according to the dynamics of reactivity to repeated action of acetylcholine. There are neurons with decreased, increased or unchanged response to transmitter microintophoretic application. Dependence of the dynamics of background and evoked activity on the duration of excitatory reaction component induced by transmitter has been discovered. It was concluded that the duration of the given component is a significant and informative functional parameter of cortical neurons. PMID- 3955203 TI - [Effect of calcium on the force-frequency ratio and resting potentiation in the myocardium of mature and old rats]. AB - The studies on the isolated papillary muscles have shown age-dependent differences in the tension developed, the rate of its development and decline in adult (10 months) and old (27 months) rats at 0.1 Hz stimulation frequency and different concentrations of external calcium (0.3, 1.25, 5.0). With 0.3 mM of Ca2+ in the solution, the negative inotropic frequency effect, and resting potentiation of contractions (interstimulus interval 30 s) in the myocardium of old rats were considerably lower than those in adult animals. Calcium level elevation (5.0 mM) resulted in elimination of frequency inotropic effect and resting potentiation in the rat myocardium in both age groups. The abnormalities of chronoinotropic relations in the myocardium during aging can probably be explained by the changes in Ca2+ transport. PMID- 3955204 TI - [Microelectrophysiological analysis of the fiber components of the rat digastric muscle]. AB - Membrane potential at rest (MP), action potential (AP), critical level of depolarization (CLD) and latent period (LP) of different muscle fibers were studied in two bellies of digastric muscle. Even and chaotic distribution of different muscle fibers was observed in the anterior and posterior belly, respectively. It is believed that electrophysiological data correspond to the results of histological analysis of muscle fibers in digastric muscle. PMID- 3955205 TI - [Seasonal characteristics of the effect of melatonin on thyroid function]. AB - Changes in pituitary-thyroid axis sensitivity to bioactive component of pineal gland, melatonin, have been detected. In winter (short days) melatonin (100 micrograms/100 g of rat body weight) decreased T3 T4, TSH content and 131I uptake by thyroid tissue. However, it was noted that in summer (long photoperiod) the same injection caused suppression of T3 plasma level and 131I uptake ability of the thyroid gland, with T4 and TSH blood levels remaining significantly increased. PMID- 3955206 TI - [Reaction of the nodose ganglion neurons to myocardial ischemia complicated by ventricular fibrillation]. AB - Standard microelectrode techniques were used to study the impulse activity of different types of nodosal ganglion neurons. Differences in electrical activity of cardiovascular neurons were observed in myocardial ischemia both complicated and not complicated by fibrillation. In these conditions rhythmic activity of cardiopulmonary, late inspiratory and inspiratory-expiratory neurons is quite similar. PMID- 3955207 TI - [Catecholamine and serotonin content in the lymph nodes following deafferentation]. AB - Using Falck fluorescent technique in combination with microspectrofluorometry the measurement of catecholamine and 5-hydroxytriptamine level was performed in popliteal lymph nodes of normal dogs and 2 weeks after deafferentation. Maximal catecholamine and 5-hydroxytriptamine content was observed in adrenergic nerve fibers, elements of trabecular-elastic complex and monoaminocytes of medullary substance of intact animals. Biogenic amine level decreased deafferented limb lymph nodes. Monoamine imbalance according to divergent type was registered in a colateral limb, i. e. 5-hydroxytriptamine level was increased and catecholamine level was decreased. PMID- 3955208 TI - [Structural-functional aspects of the postischemic recovery of the hepatocyte endoplasmic network in rats]. AB - The experiments on rats have shown that total hepatic ischemia reduces the content of microsomal cytochromes P-450 and b5 and causes amidopyrine and aniline disturbances over a 2-3-week post-ischemic period. The analysis of hepatocyte ultrastructure has revealed the interdependence of structural and functional changes in endoplasmic reticulum during recovery period. The damage of monooxygenase inducibility correlated with stable decline in the number of fixed ribosomes in post-ischemic period. PMID- 3955209 TI - [Role of middle-molecule blood peptides in the development of cardiac depression in thermal burns]. AB - Using ultrafiltration and subsequent gel filtration a fraction of middle mass peptides (MMP) possesing cardiodeppressing activity, has been isolated from the blood plasma of dogs exposed to burn injury. In contrast to the corresponding MMP fraction from healthy animal blood, this fraction suppressed contractility of the isolated rat's papillary muscle. Moreover, the active MMP fraction caused an appreciable bradycardia when administered subarachnoidally. The same phenomenon is typical of the corresponding MMP fraction from intact dog's blood, but the rate of bradycardia is significantly lower than that obtained for the fraction from the blood of injured animals. The possibility of local and central-mediated influence of the active fraction on heart functions is discussed. Central mediated action of the active MMP fraction is confirmed by the ability of other MMP fractions from the blood of injured animals to enhance the blood-brain barrier permeability. PMID- 3955210 TI - [Therapeutic effect of the transfusion of UV-irradiated donor plasma in mechanical jaundice]. AB - The method of intravenous administration of UV-irradiated donor plasma to patients with jaundice of different genesis has been tested in the experiments on rats and used clinically in 20 patients. Biochemical and morphological studies have shown that such treatment causes stable improvement in the liver functional state. PMID- 3955212 TI - [Oxygen consumption in the lungs of dogs with a closed thoracic injury]. AB - The experiments on dogs have demonstrated that lung contusion and injury of the rib cage cause the increase in overall oxygen consumption and lung oxygen consumption within the first hours after trauma. During the next week in dogs with contusion lung gradual recovery of the initial levels is observed. In convalescents with rib cage injury the indices in this period remain increased, reaching maximal level in animals with fatal outcome several hours before death. The authors believe that the early posttraumatic period in closed chest trauma is characterized by the increase in the lung oxygen consumption. PMID- 3955211 TI - [Effect of enkephalins on the function of the calcium-regulating endocrine glands in shock]. AB - The experiments on white rats weighing 180-220 g have shown that in traumatic and hemorrhagic shock the initial increase in parathyroid hormone blood concentration is followed by the decrease of functional activity of parathyroid glands. Calcitonin concentration is found to increase during the first hours of shock. The changes in calcium-regulating gland function result in significant disturbances of calcium exchange during shock. The injection of synthetic leu enkephalin analogs to rats with shock leads to normalization of calcium regulating endocrine glands function. PMID- 3955213 TI - [Effect of psychotropic substances on the development of alcoholic motivation in noninbred white rats]. AB - The experiments have shown the capacity of antidepressant amitriptylin (0.5 mg/kg, i. p.) and tranquilizer phenazepam (0.1 mg/kg i. p.) to normalize the adaptive behaviour and almost completely prevent the development of alcohol motivation in animals with insufficient adaptive behaviour. It was established that in animals initially rejecting alcohol, chronic treatment with these drugs as well as d-amphetamine promoted alcohol motivation. The results obtained have proved our earlier hypothesis that preclinical search for drugs for the prevention and treatment of early stages of alcoholism is possible only in animals pre-selected according to their inclination to experimental alcoholism. PMID- 3955214 TI - [High-frequency electrospectroscopy of human whole blood with different degrees of oxygen saturation]. AB - The electric properties of normal human blood were measured at 1.0-2.0 MHz frequency range. The dependence of relaxation time of the erythrocyte membranes on the degree of hemoglobin molecules saturation with oxygen was obtained. PMID- 3955215 TI - [Keto acids as regulators of hemoglobin reversible oxygenation]. AB - Several ketocarbonic acids covalently attached to the protein moiety of hemoglobin were tested as reversible oxygenation regulators. Two monocarbonic acids (glycoxylic and piruvic) and bicarbonic--alpha-ketoglutaric-acid were used for remoglobin modification. Functional properties and isoelectrical characteristics of modified hemoglobin were recorded. The binding of these acids to hemoglobin was shown to affect the net charge of hemoglobin molecule and the nature of its interaction with allosteric effectors (O2; CI-; H+). Under the influence of glyoxylic acid, the gas-transporting characteristics of hemoglobin underwent most distinct changes approaching those of the human whole blood. PMID- 3955216 TI - [Effect of ethanol on the DNA-polymerase activity in the liver subcellular fractions of adult and old rats]. AB - The effect of 5% ethanol on DNA polymerase activity in nuclei, mitochondria, microsomes and cytosol of intact and regenerating liver of adult and old rats has been studied. No changes in DNA polymerase activity were detected in subcellular fractions of adult rat liver. On the contrary, the increased activity of intact liver nuclei and decreased activity of regenerating liver microsomes was observed with ageing. These age-dependent peculiarities of DNA polymerase activity in response to 5% ethanol may be related to changes in the enzyme molecules or microenvironment associated with ageing. PMID- 3955217 TI - [Enkephalin content in sections of the brain of rats undergoing intrauterine exposures to ethanol]. AB - Leu- and met-enkephalin concentration in the brain structures of rat offsprings prenatally exposed to ethanol (4-5 g/kg) was investigated by radioimmunoassay. Regional and sex differences in enkephalin levels of the investigated brain structures have been shown. In experimental animals that had been exposed to ethanol leu- and met-enkephalin concentration in the hemispheric cortex and hippocump was similar to that in the controls, while in the pituitary body it was significantly decreased. The mechanisms of ethanol effect on endogenous opioid system in the developing brain are discussed. PMID- 3955218 TI - [Specificity of the action of piracetam, encephabol and Cleregil on the transcallosal evoked potential]. AB - The influence of some drugs having nootropic effect on transcallosal evoked potential was studied in the experiments on non-anesthetized rabbits. Pyracetam, pyritinol and cleregil have been established to increase the amplitude of transcallosal evoked potential. Each of these drugs was found to exert specific effects on this neurophysiological phenomenon. The authors suggest that transcallosal evoked potential can prove helpful in the detection of new drugs with possible nootropic effect. PMID- 3955219 TI - [Pharmacokinetics of a water-soluble antioxidant from the class of 3 hydroxypyridines]. AB - The study of pharmacokinetics of water-soluble 2-ethyl-6-methyl-3-hydroxypyridine salt (EM-3-HP) in rats has shown this substance to be quickly absorbed from the abdominal cavity of animals. Its maximal concentrations in the plasma, brain and liver were determined 2-3 hours later, with the following monoexponential decrease in EM-3-HP level with the elimination half-life of 2-6 hours observed. Considerable EM-3-HP tropism to membranes of endoplasmic reticulum in the liver and brain cells is suggested to cause its membranomodulatory effect and to facilitate its pharmacological activity. PMID- 3955220 TI - [Effect of sex hormones on the 1,2-dimethylhydrazine metabolic activity in the kidneys of CBA-strain mice]. AB - 1,2-dimethylhydrazine (DMH) metabolizing activity of kidney microsomes was shown to be two times higher in male, than in female CBA mice. Castration decreased DMH metabolizing activity of male kidney microsomes to the females' level. DMH metabolizing activity of castrated males treated with testosterone propionate was identical to that of intact males. The incorporation of 14C-DMH into kidney DNA was also higher in male, than in female CBA mice. PMID- 3955221 TI - [Clonogenic fibroblasts from the hematopoietic organs of the human embryo and fetus at different gestational ages]. AB - Fibroblast precursors of hemopoietic organs of 72 embryos and fetuses 5-27 weeks of age have been studied. The study has shown that the increase in the number of clonogenic fibroblasts took place in the bone marrow and spleen 2-3 weeks before the beginning of hemopoiesis, that is during the period of the highest hemopoietic stem cell concentration. These data suggest possible participation of stromal fibroblasts of hemopoietic organs in the formation of microenvironment for hemopoietic stem cell functioning. PMID- 3955222 TI - [Hormonal activity of the hypophysis-gonadal system in male hamadryas baboons in relationship to their hierarchical position]. AB - Hierarchic status-dependent hormonal activity of pituitary-gonadal system was studied in an isolated group of hamadryas baboons. Testosterone level was higher in dominating males. The level of sex hormone was higher in aged animals with great muscle mass. No correlation was observed between hierarchic status of hamadryas baboon males and the blood level of luteinizing hormone. PMID- 3955223 TI - [Acid phosphatase distribution in the liver in cirrhosis]. AB - The distribution of acid phosphatase in liver cirrhosis, as well as in its reverse development, was investigated in mice using histochemistry and electron histochemistry methods. Histochemistry demonstrated a sharp activity increase of acid phosphatase (as compared with the same in the material of partial hepatectomy) in liver cells (especially hepatocytes) during liver cirrhosis regression 10 days after a partial hepatectomy. Electron histochemistry has shown the enzyme withdraw out of hepatocytes and connective tissue cells of fibrotic stratum in the extra-cell medium. The reaction product localized on the neighbouring collagen fibres giving evidence that during reverse development of liver cirrhosis the lisosomal enzyme release from specified cells by means of exocytosis and they are involved in the lysis of collagen. PMID- 3955224 TI - [Morphometric analysis of the regression in the changes occurring in the adrenal cortex in experimental hypercholesterolemia]. AB - Morphometric, histochemical and biochemical methods were used to study the adrenal cortex of rabbits given cholesterol over 60 days' period and killed 5.5 months after the treatment was discontinued. Cholesterol-induced changes were found to undergo considerable regression 5.5 months after the treatment withdrawal. PMID- 3955225 TI - [Adhesion of the vitreous body to cured polymers]. AB - The adhesive activity of several polymers as regard to vitreous body (VB) was examined by drying out the vitreous body on the surface of the materials under study. 3 types of polymers were compared with glass (silicon, polyurethan, polymethylmetacrilate). According to the reduction in adhesive activity as regard to VB the substances were ranged from silicon to glass. The authors believe that the mechanism of VB adhesion to polymers is linked to the absorption of gialuronic acid on their surface, which is part of VB. The above method is suggested for the selection of polymers used in the manufacturing of intraocular lenses. PMID- 3955226 TI - [Method for the quantitative evaluation of the effect of drugs and other factors on the viability of an ischemic skin flap]. AB - The use of a skin graft from the leg or back of mice or rats (10 X 20 mm) or rats (12 X 52 mm) with its further packing results in the 50 +/- 10% ruin of the distal part. The effect of different factors on necrosis change in size is quantitatively evaluated. PMID- 3955227 TI - Assessing the delivery of neutrophils to tissues in neutropenia. AB - Studies of neutrophil kinetics in neutropenic individuals, as well as clinical observations of variability in the occurrence of infection among patients with neutropenia, have suggested that blood neutrophil counts may not uniformly reflect the effective delivery of neutrophils to extravascular tissues where the cells perform their principal host defense functions. To evaluate this possibility we developed a sensitive, reproducible method of measuring the extravascular delivery of neutrophils to a normal mucosal site of neutrophil turnover. This method is based upon the quantification of neutrophils recoverable from saline mouth wash specimens. Twenty-five mL specimens, obtained in a controlled manner from neutropenic patients and normal subjects, were centrifuged and the sediments resuspended in 1.0 mL Hank's buffer with 2 micrograms acridine orange, incubated at 37 degrees C for 15 minutes, and then examined in a hemocytometer chamber by fluorescence microscopy. Neutrophils could be clearly distinguished by their characteristic fluorescence and were counted. With this method as few as 1,500 neutrophils were detected reliably in mouth wash specimens. Mucosal neutrophil counts varied less than 10% with repeated sampling of individual subjects over 5-day periods and were consistently greater than 1.3 X 10(5)/specimen in non-neutropenic individuals. Although profound neutropenia was generally reflected by lower than normal oral mucosal neutrophil counts, these counts were significantly higher in individuals with chronic severe neutropenia (blood neutrophils less than 300/mm3) than in patients with acute neutropenia of comparable severity that had developed following chemotherapy. Also, in individuals recovering from profound neutropenia, neutrophils usually reappeared earlier in mouth wash specimens than in blood, and oral mucosal neutrophil counts attained recovery levels more rapidly than did blood counts. This phenomenon was particularly evident in an individual with cyclic neutropenia. Moreover, mucosal neutrophils could occasionally be detected in profoundly neutropenic patients when neutrophils were not present in blood samples. These findings indicate that mucosal neutrophil counts in individuals with neutropenia provide information about the delivery of neutrophils to tissues that may not be apparent from blood neutrophil counts alone. PMID- 3955228 TI - The chemokinetic response of human neutrophils. AB - A computer-assisted single cell assay that allows quantification of the locomotive behavior of individual cells and a flow-through system that allows study of response of individual cells to stimulation were utilized to study the chemokinetic response of neutrophils. The range of basal mean rate of locomotion (mROL) and chemokinetic response to 10(-9) mol/L formylmethionyl leucyl phenylalanine (FMLP) was determined for neutrophils of eight normal adults. The basal mROL was 8.2 +/- 1.5 um/min and 6.2 +/- 1.0 um/min; the rate after 10(-9) mol/L fMLP was 12.1 +/- 2.1 and 9.5 +/- 1.8 um/min in 2.0 g% and 0.05 g% HSA, respectively. The mean increase in ROL for neutrophils was 50%. Assay with the flow-through system shows that the chemokinetic response--increase in mROL of a population of neutrophils in response to 10(-9) mol/L--is due to an increase in ROL when cells are actively moving and not due to a decrease in the amount of time the cell spends inactive. Studies of individual cells within the populations show that chemokinetic response to 10(-9) mol/L fMLP is highly variable. The majority of cells (77%) respond with an increase in ROL; the minority (23%) are nonresponders that characteristically move at ROL greater than or equal to 14 um/min prior to stimulation and do not change ROL or exhibit a net decline in ROL in response to 10(-9) mol/L fMLP. The dose response of a population of neutrophils and of individual neutrophils to serial addition of 10(-10) to 10(-6) mol/L fMLP shows that the fMLP dose dependence for maximal chemokinetic response is highly variable among individual cells. Seventeen percent of cells do not respond to any fMLP concentration; 25% of neutrophils exhibit maximal response to 10(-10) mol/L fMLP, while 50% and 25% of cells showed peak chemokinetic response to 10(-9) mol/L and greater than or equal to 10(-8) mol/L fMLP, respectively. These studies document the variability in the locomotive responses of peripheral blood neutrophils. Understanding the causes of variability in the chemokinetic responsiveness of individual neutrophils may improve our understanding of how the cellular inflammatory response in man can be modulated. PMID- 3955229 TI - Radiobiological properties of the human hematopoietic microenvironment: contrasting sensitivities of proliferative capacity and hematopoietic function to in vitro irradiation. AB - We describe the effects of in vitro irradiation on the proliferative capacity and hematopoietic supportive function of human marrow stromal cells. To assess the effects on the proliferative capacity of stromal progenitors and differentiated fibroblasts, marrow cell suspensions and trypsin-dispersed marrow fibroblasts were treated with a single dose of gamma radiation at 100 rad/min. Fibroblastic progenitors (CFU-F) showed an exponential decrease in colony formation with increasing doses of irradiation, with a Do slightly higher than that of granulomonopoietic progenitors (CFU-GM); Do values for CFU-F and CFU-GM were 130 and 115, respectively. However, although the CFU-F survival curve exhibited a shoulder (n = 1.3), the CFU-GM curve did not (n = 1.0), indicating that only fibroblastic progenitors have the potential to repair irradiation-induced damage. Passaged marrow fibroblast colony-forming cells also showed a shouldered exponential survival curve with a Do of 110 and n value of 1.4. Marrow stromal progenitors giving rise to adherent layers in long-term marrow cultures also demonstrated a highly radiosensitive proliferative capacity. Stromal layers derived from irradiated marrow suspensions failed to establish adherent layers after relatively low doses of irradiation (over 240 rad) in a dose-response manner. To assess any functional damage in stromal progenitors surviving irradiation, stromal layers derived from marrow suspensions irradiated up to 240 rad were cocultured with freshly isolated autologous hematopoietic cells and assayed for their capacity to support prolonged CFU-GM production. Confluent stromal layers derived from irradiated marrow suspensions sustained CFU-GM production as well as controls. To study the effects of irradiation on the hematopoietic supportive capacity of established marrow-derived stromal layers, 4 to 6-week-old adherent layers were irradiated as described and cocultured with autologous marrow cells enriched for colony-forming cells. Stromal layers irradiated up to 1,320 rad sustained prolonged CFU-GM production, indicating that the hematopoietic supportive function remained intact at this dose of irradiation. In conclusion, we demonstrated that the proliferative capacity of human marrow stromal progenitors, as well as that of their differentiated descendants, is quite sensitive to in vitro radiation, while the hematopoietic supportive function of differentiated stromal cells is relatively resistant to the effects of radiation. PMID- 3955230 TI - Red cell rheology in stomatocyte-echinocyte transformation: roles of cell geometry and cell shape. AB - The influence of the shape of the red blood cell during stomatocyte-echinocyte transformation on its deformability was studied by microsieving through pores with diameters of 2.6, 4.5, and 6.9 micron. A stomatocytic transformation was produced by chlorpromazine (0.02, 0.1, and 0.5 mmol/L) and an echinocytic transformation by sodium salicylate (7.5, 30, and 120 mmol/L). For spherostomatocytes, an increase in filtration resistance through 2.6 and 4.5 micron pores was observed, whereas for spheroechinocytes, a decrease in filtration resistance through 2.6 micron pores was found. Larger pores (6.9 micron) were not sensitive to those shape changes. The changes in deformability can be explained by the fact that the surface area of (sphero)-stomatocytes decreased, whereas that of (sphero)-echinocytes increased; the cell volume remained essentially constant. Echinocytes produced by 24-hour adenosine triphosphate depletion differed from drug-induced echinocytes: they had an increased cell volume at constant surface area and consequently an increased filtration resistance through 2.6- and 4.5-micron filter pores. Shape changes with spicule formation are therefore not a homogeneous entity, and cell geometric factors (eg, surface area and volume) must be assessed with care. The viscosity of red cell suspensions at a hematocrit level of 45% was higher for drug-induced echinocytes than discocytes or stomatocytes at all shear rates tested. We conclude that the normal discocyte represents an optimum shape for the flow in vivo since a stomatocytic transformation could impair the passage through the microcirculation (decrease in cell filterability) and an echinocytic transformation could impair the flow in larger vessels (increase in blood viscosity). PMID- 3955232 TI - Reevaluation of cytochrome b and flavin adenine dinucleotide in neutrophils from patients with chronic granulomatous disease and description of a family with probable autosomal recessive inheritance of cytochrome b deficiency. AB - Chronic granulomatous disease (CGD) is a genetically heterogeneous syndrome characterized by a microbial killing defect of polymorphonuclear leukocytes (PMNs) due to lack of superoxide O2-. 2 generation. Recent studies indicate that the neutrophil O2-.-generating system consists of at least two components, flavoprotein--flavin adenine dinucleotide (FAD)--and cytochrome b. We evaluate the cytochrome b and FAD content in PMN from 30 CGD patients. The method for quantitating cytochrome b was modified by using PMN sonicates incubated with azide plus hydrogen peroxide. With this approach, several absorption peaks corresponding to myeloperoxidase and eosinophil peroxidase, which overlap with peaks of cytochrome b, were obliterated from reduced-minus-oxidized spectra, whereas the peaks of cytochrome b were not and could be readily quantitated. Cytochrome b was detected in PMNs from all 24 normal adults (47.4 +/- 2.9 pmol/7.5 X 10(6) cells), was absent in PMNs from 11 male CGD patients and one female CGD patient but was present in normal amounts in PMNs from nine male and nine female CGD patients. Stimulated nitroblue tetrazolium (NBT) tests performed on PMNs from mothers of CGD patients indicated that cytochrome b deficiency was associated with X-linked inheritance, except in one case in which probable autosomal recessive inheritance was demonstrated. The PMN NBT test of the mother of another male patient without cytochrome b deficiency suggested an X-linked form of inheritance. In related studies, the FAD content in PMN particulate fractions was reduced in 4 of 28 CGD patients studied. All four CGD patients with reduced FAD lacked cytochrome b. However, three patients with cytochrome b deficiency had normal FAD. Thus, the results indicate that PMN cytochrome b deficiency is observed in most X-linked and in some autosomal recessive CGD, that cytochrome b deficiency may be associated with FAD deficiency, and that cytochrome b and FAD are normal in most patients with non-X-linked CGD. PMID- 3955231 TI - Evaluation by quantitative acid elution and radioimmunoassay of multiple classes of immunoglobulins and serum albumin associated with platelets in idiopathic thrombocytopenic purpura. AB - Immunoglobulins (Igs) and serum albumin were eluted from normal platelets and platelets from patients with idiopathic thrombocytopenic purpura (ITP) with a quantitative acid elution procedure followed by solid-phase radioimmunoassay (SPRIA). Acid elution was shown to release a reproducible fraction of platelet associated Igs, and the amounts released per platelet were independent of the platelet concentration over a wide range of concentrations. This procedure is suitable for sensitive, reproducible, and specific quantitation of large numbers of samples. Washed platelets from 13 normal donors contained the following components (expressed in femtograms per platelet, mean +/- 2 SEM): IgG, 1.40 +/- 0.26; IgA, 0.72 +/- 0.36; IgM 0.078 +/- 0.036; albumin 7.7 +/- 1.5. Immunoglobulins and albumin eluted from the platelets of ten ITP patients (two in remission), expressed as femtograms per platelet, mean (range), were: IgG 104 (0.3 to 750); IgA 90 (0.9 to 715); IgM 162 (1.2 to 1,300); and albumin 34 (6.8 to 199). All platelet-associated Igs from thrombocytopenic ITP patients were found to be elevated twofold to 2,300-fold with one Ig class occasionally elevated 50 fold to 100-fold higher than the others. A similar group of ten thrombocytopenic ITP patients was found to have twofold to 26-fold elevations of platelet associated albumin. This demonstration of increases in multiple classes of Igs as well as serum albumin associated with platelets from ITP patients suggests that some nonimmune process may be contributing to the phenomenon of increased platelet-associated proteins in ITP. PMID- 3955233 TI - On the interaction of rabbit antithrombin III with the luminal surface of the normal and deendothelialized rabbit thoracic aorta in vitro. AB - Pure rabbit antithrombin III was isotope labeled (with 125I or 3H) by two different methods; neither procedure caused a loss of antithrombin activity although both methods affected the affinity of the protein for Sepharose-heparin. From segments from freshly excised rabbit aorta, the uptake of isotope-labeled antithrombin III by the endothelium was rapid and saturable, although relatively small compared to the uptake of thrombin; binding of 3H-antithrombin III to the endothelium resembled that of 125I-antithrombin III. Transendothelial passage of antithrombin III into the subendothelial layers (intima-media) was slow and progressive. Endothelium binding was not affected by pretreating the vessel with either heparin, thrombin, or glycosaminoglycan-specific enzymes. Endothelium bound antithrombin III was not selectively displaced by either heparin or thrombin. In contrast, endothelium-bound thrombin was rapidly dislodged by antithrombin III as a thrombin-antithrombin III complex. The surface of the deendothelialized aorta (ie, subjected to a balloon catheter) bound antithrombin III avidly. Pretreatment of the deendothelialized vessel with glycosaminoglycan specific enzymes, particularly heparitinase, decreased intima-media binding by up to 80%. 125I-antithrombin III, when bound to the deendothelialized vessel surface, was actively displaced by either heparin, thrombin, or by unlabeled antithrombin III. The relatively poor binding of antithrombin III compared with that of thrombin by the endothelium in vitro supports an earlier proposal (Lollar P, Owen WG: J Clin Invest 66:1222-1230, 1980) that thrombin bound to high affinity sites, possibly pericellular proteoglycan, of the endothelium is inactivated by plasma antithrombin III in vivo. Such a situation probably holds for large arteries at least. PMID- 3955234 TI - Ionic strength dependence of the polymer solubilities of deoxyhemoglobin S + C and S + A mixtures. AB - Factors contributing to the clinical differences between sickle cell-hemoglobin C disease (SC) and the benign sickle cell trait (AS) include the higher proportion of hemoglobin (Hb) S and the higher cell Hb concentrations in SC compared with AS red cells. Reports differ, however, about whether Hb C copolymerizes more than Hb A with Hb S when measured by minimum gelling concentrations (MGCs) and polymer solubilities of the deoxy-Hb mixtures. We now show that the MGCs and solubilities of equimolar mixtures of Hb S + Hb C vary much more with the ionic strength (mu) of the solution than those of Hb S + Hb A mixtures. At mu less than or equal to 0.20, but not at mu greater than 0.25, Hb S + Hb C solubilities were significantly lower than those of Hb S + Hb A. These differences which may reflect a greater effect of the beta 6Lys+ in Hb C at lower mu, can account for the reported discrepancies. The solubility differences were similar in the presence or absence of asymmetric hybrids, and since the intratetramerically cross-linked hybrids alpha 2 beta s beta A and alpha 2 beta s beta c had similar solubilities, they did not indicate the usual mechanism, involving greater incorporation of alpha 2 beta s beta c into the polymers. The small solubility differences between the two Hb mixtures at physiologic (red cell) concentrations of Hb and 2,3-diphosphoglycerate probably play a minor role in the clinical differences between SC and AS states. PMID- 3955235 TI - Separation of the acetylcholinesterase-deficient red cells in paroxysmal nocturnal hemoglobinuria. AB - Blood of patients with paroxysmal nocturnal hemoglobinuria (PNH) most often contains two or more populations of erythrocytes--one population with normal sensitivity to lysis by complement (PNH I cells) and a second population of moderately abnormal cells (PNH II cells) or markedly abnormal cells (PNH III cells). PNH II and III cells exhibit moderately and markedly increased sensitivity to lysis by complement, respectively, as well as other membrane defects. We have devised a method for isolating pure, intact PNH II and III cells from mixed populations by use of monoclonal antibodies and cell affinity chromatography. Study of purified cell populations has led to the identification of a further subtype, PNH IIIb, of PNH erythrocytes. PNH IIIb erythrocytes are less sensitive to complement lysis than PNH IIIa cells but are lysed by fluid phase activation of complement, unlike PNH II erythrocytes. PMID- 3955237 TI - Aggressive natural killer cell leukemia in an adult with establishment of an NK cell line. AB - There have been many reports of cases in which chronic increases in the numbers of natural killer (NK) cells have been reported. Whether this is reactive or neoplastic in nature has been debated. We report the first case of an aggressive NK cell leukemia in an adult with establishment of an NK cell line. A 70-year-old man had two spontaneous episodes of jejunal perforation and one month later developed a severe febrile illness with moderate splenomegaly. Hemoglobin was 13.1 g/L, and WBC count was 1.8 X 10(9)/L with 2% large granular lymphocytes (LGLs). Platelet count was 143 X 10(9)/L; prothrombin time (PT) and partial thromboplastin time (PTT) were normal. Bone marrow was infiltrated with 25% to 30% LGLs; serum lysozyme was normal. Serum LDH was initially 1,191 U/L and rose to 6,408 (normal 240 to 525 U/L). Ten days later, the WBC count increased to 99.9 X 10(9)/L with 70% LGL cells; the PT and PTT increased, and the platelet count dropped. No bacterial or viral cause of fever was identified. The cells from peripheral blood were LGLs that stained positively for acid phosphatase. All of the LGLs reacted with a monoclonal antibody reactive with NK cells (LEU-11b). Functionally, the patient's peripheral blood mononuclear cells (PBMs) demonstrated 100 times more lytic activity against K562 tumor cell lines than did normal PBMs. The patient's PBMs were propagated in vitro. The cultured cells showed the morphological, cytochemical, immunological, and functional characteristics of NK cells. In addition, partial trisomy involving chromosome 1 q with duplication in regions of q21 through q31 was observed in all metaphases analyzed. The extra chromosome 1q with duplication in regions q21 through q31 was translocated to the p-terminal of chromosome 5. One percent to 5% of normal PBMs comprise NK cells; in most cases, leukemias arise from normal phenotypic counterparts. This case demonstrated that aggressive NK cell leukemia may occur in adults. In addition, the chromosomal abnormalities suggest that this is not a reactive process but a malignancy. PMID- 3955236 TI - Partial spectrin deficiency in hereditary pyropoikilocytosis. AB - Hereditary pyropoikilocytosis (HPP) is a severe hemolytic anemia in which an instability of the red cell membrane skeleton has been correlated with structural and functional defects of spectrin. We now report that 13 unrelated HPP subjects have approximately 30% less spectrin than normal as evidenced by a decreased spectrin/band 3 ratio. We also examine the role of spectrin degradation as an underlying cause of this partial spectrin deficiency. Our studies demonstrate that the reduced spectrin content of HPP red cells remains constant during in vivo aging of the cells in the peripheral blood, as well as during in vitro incubation. Furthermore, immunoblotting experiments using an affinity-purified antispectrin antibody indicate that there is no loss of spectrin during membrane preparation and also that neither whole HPP red cells nor ghosts nor cytosol contains any abnormal spectrin degradation products. These data suggest that spectrin is not degraded and that it is stable on the membrane of the circulating HPP red cell. In contrast, however, incubation of free spectrin with a lysate of nucleated erythroid precursor cells indicates that HPP alpha I/46 spectrin, but not HPP alpha I/74 spectrin, is more susceptible to proteolytic degradation than a control. These data imply that the decreased spectrin content of HPP is not due to a single defect but that a more complex mechanism is involved. In HPP Sp alpha I/46 subjects, an increased proteolytic degradation in bone marrow erythroid precursors of cytosolic spectrin, prior to its assembly on the membrane, could contribute toward the partial spectrin deficiency. PMID- 3955238 TI - Homozygous hemoglobin Knossos (alpha 2 beta 227(B9) Ala----Ser): a new variety of beta (+)-thalassemia intermedia associated with delta (0)-thalassemia. AB - Hb Knossos (beta 27 (B9) Ala----Ser) is a recently discovered hemoglobin variant endowed with beta-thalassemic properties (1,2) We present the first homozygous cases. The propositus, a 19-year-old man is originally from northeast Algeria, but is unrelated to other Algerians who have hemoglobin Knossos. He has a beta(+) thalassemia intermedia syndrome, including microcytic, hypochromic anemia, enlargement of the spleen, and an increase in the number of reticulocytes. The reduction of beta-chain synthesis is pronounced (alpha/non alpha:2.76). Whole cells containing Hb Knossos have a dramatically low oxygen affinity (P50:38 mm Hg). The propositus also has homozygous delta(0)-thalassemia. The chromosome carrying these mutations is characterized by the DNA haplotype I. PMID- 3955239 TI - Defective erythroid progenitor differentiation system in congenital hypoplastic (Diamond-Blackfan) anemia. AB - To explore the etiology of congenital hypoplastic or Diamond-Blackfan anemia (DBA) we investigated in vitro erythropoiesis in nine patients. Of the nine, seven were clinically responsive to prednisone. Four were infants evaluated at the time of diagnosis. Six were never or were only minimally transfused. Those for whom prednisone had been prescribed had discontinued the drug a minimum of five months prior to study. The bone marrows of these nine patients were compared with those of hematologically normal individuals and with those of four patients with transient erythroblastopenia of childhood (TEC) whose erythroid aplasia was as severe as that of the patients with DBA. Using the plasma clot semisolid culture technique to enumerate erythroid progenitors and to evaluate the growth characteristics of the colonies to which they give rise, we concluded that at the onset of DBA: (a) erythroid progenitor frequency does not correlate with the degree of anemia and erythroblastopenia; (b) erythroid progenitor differentiation may in some cases be abnormally insensitive to crude preparations of erythropoietin; and (c) progenitor erythropoietin insensitivity in vitro does not necessarily indicate prednisone insensitivity in vivo. Thus, DBA does not appear to be solely the result of deficient formation of erythroid progenitors but is, in addition, a disorder that is due to defective progenitor differentiation in vivo. PMID- 3955240 TI - Measurement of epididymal sperm motility as a test variable in the rat. PMID- 3955241 TI - Subacute atrazine treatment effects on rat renal functions. PMID- 3955242 TI - Nephrotoxic and hepatotoxic effects of chromium compounds in rats. PMID- 3955243 TI - Some effects of multiple, sublethal doses of monosodium methanearsonate (MSMA) herbicide on hematology, growth, and reproduction of laboratory mice. PMID- 3955245 TI - Metabolism and excretion of orally administered arsenobetaine in the hamster. PMID- 3955244 TI - Effect of cadmium chloride on cell division and chromosomes in Chinese hamster ovary cells. PMID- 3955247 TI - Environmentally significant volatile organic pollutants in human blood. PMID- 3955246 TI - Lactose and milk replacer influence on lead absorption and lead toxicity in calves. PMID- 3955248 TI - Cadmium in smoke particulates of regular and filter cigarettes containing low and high cadmium concentrations. PMID- 3955249 TI - Trace elements in sediments, water, and American coots (Fulica americana) at a coal-fired power plant in Texas, 1979-1982. PMID- 3955251 TI - Contamination of meat products by trace quantities of nitrosodiethanolamine (NDELA). PMID- 3955250 TI - Hydrogen oxidation soil bioassay using the single laboratory method. PMID- 3955252 TI - Levels of chemical versus biological methylation of mercury in sediments. PMID- 3955253 TI - Mercury resistant bacteria isolated from sediment. PMID- 3955254 TI - Effect of endosulfan, malathion, and permethrin on sexual life cycle of Chlamydomonas reinhardtii. PMID- 3955255 TI - Ozone and sulfur dioxide effects on the ultrastructure of the chloroplasts of hybrid poplar leaves. PMID- 3955257 TI - Bioaccumulation of 14C-hexachlorobenzene in eggs and fry of Japanese medaka (Oryzias latipes). PMID- 3955256 TI - Metabolites of xenobiotics in the bile of fish in waterways polluted by pulpmill effluents. PMID- 3955258 TI - Evaluation of metabolic responses of Artemia salina to oil and oil dispersant as a potential indicator of toxicant stress. PMID- 3955260 TI - Acid phosphatase activity in the intestine and caeca of bluegill, exposed to methyl mercuric chloride. PMID- 3955259 TI - Nonaccumulation of chlorinated dioxins and furans by goldfish exposed to contaminated sediment and flyash. PMID- 3955261 TI - Variable sensitivity of rainbow trout (Salmo gairdneri) eggs and alevins to heavy metals. PMID- 3955262 TI - Cellular basis of bronchial hyperresponsiveness. International workshop. Lunteren, The Netherlands, January 24th and 25th, 1985. PMID- 3955263 TI - Oxygen radicals and their production by leucocytes from children with asthma and bronchial hyperresponsiveness. PMID- 3955264 TI - Cellular basis of bronchial hyperresponsiveness. Control mechanisms: introduction. PMID- 3955265 TI - Pathology of the airway epithelium in asthma. PMID- 3955266 TI - Biochemistry of airway smooth muscle. PMID- 3955267 TI - Inflammation and the late phase reaction in asthma: the effect of polymorphonuclear leukocyte depletion on airways obstruction and bronchial hyperreactivity in an animal model. AB - Increases in airway reactivity noted after antigen exposure in which a late asthmatic response (LAR) develops may be related to pulmonary inflammation. Employing an animal model of the LAR developed in our laboratory, we conducted experiments to determine if depletion of polymorphonuclear leukocytes (PMLs) would ablate the LAR and inhibit subsequent increases in airways reactivity. Four groups of ten animals each were studied. The first group was given immune sera (I) containing anti-ragweed IgE. The second group received non-immune sera (NI). A third group of animals received immune sera plus nitrogen mustard (I + NM), while a fourth group received non-immune sera plus nitrogen mustard (NI + NM). Airways reactivity to histamine and the evaluation of different cell types in bronchoalveolar lavage fluid (BALF) were determined three days before and three days after bronchial challenge with ragweed extract (RWE). No control rabbit (NI or NI + NM) developed either an immediate asthmatic response (IAR) or an LAR, and no significant increases occurred in their airways reactivity or cells in lavage fluid after bronchial challenge with RWE. In contrast, the sensitised rabbits not given nitrogen mustard developed an LAR and airways reactivity increased markedly three days later. Those animals receiving immune sera and nitrogen mustard developed an IAR; however, no LAR occurred and no significant change in airways reactivity ws observed. BALF analysis seventy-two hours after ragweed challenge in the animals that received immune sera showed a significant increase in PMLs. However, there was no significant increase on BALF PMLs in the animals receiving immune sera and nitrogen mustard.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955268 TI - The role of the eosinophilic leukocyte in bronchial asthma. PMID- 3955269 TI - Paf-acether (platelet-activating factor). PMID- 3955270 TI - Total deafness: the need and possibility for a working definition. AB - There is an urgent need for a definition of total deafness or total hearing loss which would appear to be feasible in terms of audiometric threshold. Considerable care must be taken in providing appropriate instrumentation for measuring the hearing loss of profoundly deaf people, particularly with regard to sufficient acoustic output. Proposals are made for values for the maximum outputs of audiometers. The practical benefit in the management of profoundly deaf people that can be obtained by the introduction of an agreed definition is described. PMID- 3955271 TI - An experimental study of the effectiveness of different techniques of questioning mentally handicapped child witnesses. AB - In response to recent changes in the Home Office recommendations concerning police interviewing of mentally handicapped persons, an experiment was carried out to investigate the usefulness of different interviewing techniques with mildly mentally handicapped children. Previous research carried out with children of normal intelligence (Dent & Stephenson, 1979) indicated that their recall of an incident was most accurate when unprompted. Theoretical research in the field of mental handicap suggested that such children's recall would be poorest when either unprompted or when heavily prompted, and that some form of intermediate cueing of recall may prove optimal. The experiment described here investigated the accuracy of recall of a live incident by a group of children with IQs ranging from 50 to 70 points in response to one of the following methods of elicitation: free recall, general questions and specific questions. As predicted, the general questions produced recall that was optimal in terms of completeness and accuracy. PMID- 3955272 TI - Evaluation of a self-help manual for media-recruited problem drinkers: six-month follow-up results. AB - A total of 785 individuals responded to a newspaper advertisement offering free help to cut down drinking and were sent alternately either a self-help manual based on behavioural principles or a general information and advice booklet. Of these, 247 (31.3 per cent) returned assessment questionnaires or agreed to be interviewed by telephone and 132 of these respondents (53.4 per cent) were successfully contacted at six-month follow-up. Those lost to follow-up were more 'socially stable' on initial measures than those successfully contacted. Results showed a greater reduction in previous week's consumption in the group receiving the manual than in the control group. In addition, respondents interviewed by telephone showed a greater reduction on a measure of alcohol-related problems and a higher proportion reducing drinking than those contacted only by post. There was no evidence that reductions in consumption were confined to relatively low consumers or to those showing only early signs of dependence on alcohol, irrespective of which type of material was received. PMID- 3955273 TI - Patients' conceptions of psychological adjustment in the normal population. AB - This study concerned patients' ability to predict a 'normal' response on two self report inventories. There has been a great deal of research on normal subjects' ability to 'fake good, bad, mad' but very little study of psychiatric patients' conceptions of normality. Two groups of psychiatric patients--anxiety state or depressed--and a normal control group filled in two questionnaires twice: first responding honestly and then as they believed a normal person might. The results showed that whereas 'normal' people tend to see other normals as much the same if not slightly less well adjusted than themselves, patients see themselves as less well adjusted than the ordinary person. The controls were not significantly more able to predict the normal response to these measures than the patient groups were. However, the depressed and anxious groups differed in the accuracy of their estimates and in their conceptions of normal functioning. PMID- 3955274 TI - The relationship between alternative assessments of self-care ability in the elderly. AB - The self-care performance of 126 residents of old people's homes was assessed by self-report, informant rating and performance test. Scores on all three scales were related but associations were low and gross disagreements between measures were found in almost half of the cases. The associations between self-report and the other two measures were significantly lower than those between informant and performance ratings. There was no evidence of systematic bias in self-report related to cognitive or to affective impairment. It is probable that the three scales measure different aspects of dependency. PMID- 3955275 TI - Attitudes to food, eating and weight in acutely ill and recovered anorectics. AB - A between-groups experimental design was used to test groups of acutely ill anorectics (n = 15), former anorectic patients who had been judged recovered at discharge (n = 14), psychiatric controls (n = 10) and normals (n = 24) on the Eating Attitudes Test (EAT). It was hypothesized that both acutely ill and recovered anorectics would show significantly greater distorted attitudes to food, eating and weight than controls, as assessed by the EAT. Results supported the hypothesis and suggest that anorectics may continue to show distorted attitudes to food, eating and weight after they have recovered from the gross physical and behavioural features of the disorder, although these attitudes appear to be somewhat less extreme than during the acute phase. It is concluded that an important aspect of anorexia nervosa appears to be largely unaltered by present treatment. PMID- 3955276 TI - Chord perception in schizophrenia. AB - Groups of acute schizophrenics and normal controls were presented with two tasks involving the perception of musical chords. There were no significant differences in performance due to ear of presentation (left, right or both). Taking performance over all conditions, the schizophrenic group was not significantly different from the controls on one of the two tasks although it was significantly worse on the other. These findings contrast with earlier results using a story comprehension task which suggests that the schizophrenic deficit in performance found in those studies may be specific to the processing of verbal information. PMID- 3955277 TI - The retention of new information in senile dementia. AB - Paired associate learning performance of demented patients was assessed repeatedly over six months. Patterns of change of performance for repeated and for changing items were compared. Performance on changing items progressively declined, performance on repeated items was maintained at initial levels. This difference was significant and indicates that these patients are able to retain same information over one- and two-month intervals. PMID- 3955278 TI - Clinical diagnosis of the as-if personality disorder. PMID- 3955279 TI - The borderline patient and affirmative interpretation. PMID- 3955280 TI - A comparison and critique of Mann's time-limited psychotherapy and Davanloo's short-term dynamic psychotherapy. PMID- 3955281 TI - Doris Lessing: the "good" neurotic personality of our time. PMID- 3955282 TI - Crisis intervention techniques designed to prevent hospitalization. PMID- 3955283 TI - The radiology of incontinence. AB - Incontinence is defined by the International Continence Society (Bates et al, 1979) as an involuntary loss of urine which can be objectively demonstrated and causes a social or hygienic problem. It is therefore both a symptom and a sign. Medical and surgical treatments are available and radiological investigation is helpful in many patients. PMID- 3955284 TI - The postmenopausal bladder. AB - Following the last menstrual period, a woman's "genital organs are sealed with the signet of sterility" (De L'Isere, 1850) and the ensuing hypo-oestrogenism, a consequence of ovarian failure, results in major metabolic disturbances. These include osteoporosis, thin skin, and an increased propensity for myocardial ischaemia. In association with these changes, lower urinary tract dysfunction occurs, also related to lower levels of circulating oestrogen. PMID- 3955285 TI - Hormonal contraception and cancer. AB - The natural menstrual cycle can influence the development of some cancers. Combined oral contraceptives, which replace normal hormonal fluctuations with steadier levels of artificial sex hormones, appear to protect against cancers of the endometrium and ovary, but their effect on carcinomas of the breast and cervix remains uncertain. PMID- 3955286 TI - Pseudomembranous colitis in children and adults. AB - Pseudomembranous colitis remains a potentially lethal complication of antibiotic usage. Identification of Clostridium difficile as the major pathogen has led to a rational successful approach to therapy and has widened the spectrum of associated disease. The frequent asymptomatic colonization of healthy neonates by C. difficile remains an enigma. PMID- 3955287 TI - Anaesthesia and severe pulmonary disease. AB - The key to the management of anaesthesia in patients with severe pulmonary disease lies in predicting the requirement for support of ventilation and/or oxygenation in the postoperative period, and the provision of effective pain relief in such a way as to allow the patient to maintain adequate spontaneous ventilation. This in turn depends on understanding the influence of the relevant surgical intervention on the patient's ability to sustain his normal breathing requirements, to breathe deeply, and to cough. PMID- 3955288 TI - Psychological care of the chronically physically ill. AB - Disease prevalence and health priorities have changed, with increasing emphasis on chronic degenerative problems. Health care for the chronically physically ill needs to focus on realistic and often modest goals. This article presents the case for greater consideration of psychological factors, and outlines an example of a system of psychological care. PMID- 3955289 TI - Geriatrician: a specialist and proud. PMID- 3955290 TI - Transthoracic sympathectomy. AB - Excision of the upper thoracic sympathetic chain can be performed effectively and safely by a transthoracic approach. The most valuable indication is for severe idiopathic hyperhidrosis of the hands for which it produces a most satisfactory and lasting relief. It is also indicated for severe Raynaud's phenomenon that does not respond to conservative measures but here there is a tendency to progressive relapse following surgery so that only about half the patients show improvement several years later. PMID- 3955291 TI - Clinical diagnosis of disorders of puberty. AB - The authors emphasize the orderly sequence of events (consonance) characteristic of normal puberty. Loss of consonance of normal puberty indicates an underlying endocrine disorder. PMID- 3955292 TI - Valueless treatment of Reye's syndrome. PMID- 3955293 TI - Frontal sinus abscess and secondary orbital cellulitis. PMID- 3955294 TI - Outpatient waiting lists: the fourth solution. PMID- 3955295 TI - Geriatrician: a voice for integration. PMID- 3955296 TI - The ageing bladder. AB - The urinary bladder is a target for disorders in many systems--neurological, psychological, structural, infective and neoplastic. Most of these disorders become more prevalent as age advances and to them must be added the effects of biological ageing. PMID- 3955297 TI - A comparison of motor behaviours in groups of rats distinguished by their climbing response to apomorphine. AB - Administration of apomorphine hydrochloride (0.5 mg kg-1 s.c.) to adult male or female Wistar rats previously acclimatized to the test environment induced climbing behaviour in approximately 50% of animals examined. The proportion of animals climbing was related to age, being maximal at 8-9 weeks. Those animals showing an initial climbing response to apomorphine (0.5 mg kg-1 s.c.), climbed when challenged with this dose of apomorphine on subsequent occasions. In 'climbing' animals the intensity of response was related to the dose of apomorphine administered; no dose-response relationship was observed in 'non climbing' animals. No overall differences in the spontaneous motor behaviour of 'climbing' and 'non-climbing' animals were apparent as assessed by measurement of spontaneous climbing behaviour, by holeboard activity, and by locomotor activity measured in either photocell cages or in a treadwheel. There was no overall difference in the ability of apomorphine to induce locomotor activity or stereotyped behaviour in 'climbing' and 'non-climbing' animals. However, the administration of apomorphine induced rearing and treadwheel activity only in those animals classified as 'climbers'. There was no difference between the number (Bmax) of specific [3H]-spiperone binding sites or the dissociation constant (KD) in striatal or mesolimbic tissue preparations for 'climbing' and 'non-climbing' rats. The ability of an animal to climb in response to apomorphine appears to be dependent on an ability to orient vertically, since this is a component of behaviour common to climbing, rearing, and treadwheel activity. The ability to climb does not appear to be related to differences in dopamine receptor numbers in brain or to the penetration of apomorphine into brain. PMID- 3955298 TI - Effects of calcium entry blockers on tension development and calcium influx in rat uterus. AB - Spontaneous and potassium chloride (KCl)-induced tension development of strips of whole uterus from the day-22 pregnant rat was reduced when the tissues were incubated in a calcium ion (Ca2+)-free medium. Strips of whole uterus, in an initially Ca2+-free medium, responded to the cumulative addition of Ca2+ with graded phasic tension development and associated rapid electrical discharges. The spasms were inhibited by gallopamil (100 nM) and diltiazem (1 microM). Strips of whole uterus in a depolarizing (40 mM K+) medium, which was initially Ca2+-free, responded to the cumulative addition of Ca2+ with graded tonic tension development without associated electrical discharges. These spasms were inhibited by calcium entry blockers with a rank order of potency of nifedipine = gallopamil greater than diltiazem greater than cinnarizine. KCl-induced tension development in endometrium-free uterine strips was antagonized by calcium entry blockers with a rank order of potency of nifedipine greater than gallopamil greater than diltiazem greater than cinnarizine. Ca2+ influx into endometrium-free uterine strips was assessed by means of the 'lanthanum method'. KCl induced a concentration-dependent increase in 45Ca2+ influx which was suppressed or abolished by nifedipine (2.5 nM), gallopamil (100 nM), diltiazem (500 nM) or cinnarizine (5 microM). It is concluded that spontaneous and KCl-induced tension development of rat uterus involves Ca2+ influx from the extracellular medium into the myometrial cell. These results support the hypothesis that nifedipine, gallopamil, diltiazem and cinnarizine inhibit Ca2+- and KCl-induced tension development of rat uterus by reduction of Ca2+ influx. PMID- 3955299 TI - Carbachol-induced contraction in the circular muscle of guinea-pig stomach in calcium-free solution. AB - In the circular muscle of the fundic part of the guinea-pig stomach, a small tonic contraction could be repeatedly produced by carbachol in Ca-free solution containing 2 mM EGTA. The carbachol-induced response was gradually increased during prolonged exposure to Ca-free solution for 50 h, whereas a short treatment with 0.1-0.2 mM Ca suppressed the subsequent carbachol response in Ca-free solution. The response was not essentially modified by increasing the external K+ concentration to 40 mM. Calmodulin antagonists, N-(6-aminohexyl)-5-chloro-1 naphthalene sulphonamide (W-7) and trifluoperazine selectively suppressed the carbachol response in the presence of Ca (0.05 mM) and the contraction induced by Ca (0.1 mM), but they had little effect on the response to carbachol in Ca-free solution at a concentration of less than 10 microM. A vasodilator agent, N-(2 guanidinoethyl)-5-isoquinoline sulphonamide (HA-1004), inhibited the carbachol response both in the presence and absence of Ca, as well as the Ca-induced contraction, to a similar extent, provided that the external Ca concentration was less than 0.1 mM. These results led us to propose that the contraction evoked by carbachol in the absence of external Ca is mediated by a process independent of the Ca-calmodulin system. PMID- 3955300 TI - Oestrogenic and antioestrogenic actions in a series of triphenylbut-1-enes: modulation of prolactin synthesis in vitro. AB - The oestrogenic and antioestrogenic activities of a series of substituted derivatives of 1,1,2 triphenylbut-1-ene have been determined using primary cultures of rat pituitary gland cells to monitor prolactin synthesis in vitro. The relative binding affinity of the agonists for the oestrogen receptor was consistent with their oestrogenic potency. Bis para substitution at C1 of 1,1,2 triphenylbut-1-ene with either phenolic or acetoxy groups produced partial agonists. The antioestrogenic properties were reversible by the incubation of cells with increasing concentrations of oestradiol. The results lend support to a hypothetical single binding site model of oestrogen action, based upon an adaptation of Belleau's macromolecular perturbation theory. PMID- 3955301 TI - Evidence for the existence of 5-hydroxytryptamine receptors, which are not of the 5-HT2 type, mediating contraction of rabbit isolated basilar artery. AB - In the rabbit isolated basilar artery the contractile action of 5 hydroxytryptamine (5-HT) was little affected by high concentrations of ketanserin (1.0 X 10(-6) M) indicating that 5-HT-receptors other than those of the 5-HT2 type were involved. The contractile action of 5-HT was mimicked by methysergide and 5-carboxamidotryptamine (5-CT) with equipotent concentration ratios (5-HT = 1) of about 22 and 0.6 respectively. This profile is characteristic of that in the dog saphenous vein which contains a 5-HT receptor type that may be described as '5-HT1-like'. PMID- 3955302 TI - The action of excess potassium and calcium on ouabain-evoked [3H]-noradrenaline release from the rabbit pulmonary artery. AB - [3H]-noradrenaline [( 3H]-NA) release from the main pulmonary artery of the rabbit has been measured in the presence of neuronal (cocaine, 3 X 10(-5) M) and extraneuronal (corticosterone, 5 X 10(-5) M) uptake blockers. Removal of K from the external medium increased the [3H]-NA release. In the absence of external K, ouabain (10(-4) M) further enhanced the neurotransmitter release. The 'K-free' stimulated [3H]-NA release was inhibited by an increase of external Ca (7.5 mM), an action antagonized by ouabain. After preperfusion of the preparations for 30 min with either excess K (23.6 mM) or excess Ca (7.5 mM), the ouabain-stimulated [3H]-NA release was inhibited by about 50%; the rates of inhibition did not differ significantly from each other. However, the characteristic initial delay before ouabain-evoked neurotransmitter release was shortened in excess K, and prolonged in excess Ca-containing solution. When both excess K and Ca were applied together 30 min before ouabain perfusion, the action of ouabain in releasing neurotransmitter was also inhibited but the rate of inhibition did not differ significantly from that seen when K or Ca were applied separately. The action of K in shortening the initial delay was partly antagonized by Ca. Excess Ca antagonized the inhibition of ouabain-stimulated [3H]-NA release caused by excess K when Ca and ouabain were applied together after 30 min preperfusion with excess K-containing solution. Again excess Ca failed to inhibit the ouabain evoked neurotransmitter release if ouabain and excess K were applied together after excess Ca preperfusion (30 min). In both cases the initial delay of ouabain action was greatly shortened. 6 The results suggest a Na-Ca competition at the external activation site of the nerve terminal sodium-pump similar to that of Na K competition. Furthermore it seems that there is a sort of K-Ca competition as well, suggested by the finding that excess Ca prevented the inhibition caused by excess K of ouabain-evoked noradrenaline release and vice versa. PMID- 3955303 TI - Electrophysiological effects of amoxapine in untreated and in amoxapine pretreated rat atria. AB - The effects of amoxapine (10(-7)-10(-4) M) have been studied in rat atrial fibres obtained from untreated animals and animals pretreated for 28 days with amoxapine (10 mg kg-1, i.p.). In untreated atria amoxapine reduced atrial rate, contractile force and df/dtmax, prolonged the sinus node recovery time and decreased atrial excitability. Amoxapine also decreased amplitude and Vmax of the upstroke, prolonged the duration of the action potential (APD) and effective refractory period (ERP) and reduced the resting membrane potential. During the treatment with amoxapine behavioural and cardiovascular adverse effects, including hypotension, tachycardia and prolongation of the Q-Tc, were observed. However, with the exception of the ERP which was significantly prolonged in pretreated atria, pretreatment with amoxapine did not modify the control values of the measured parameters compared to those obtained in untreated atria. Further addition of amoxapine produced similar changes in both pretreated and untreated atria. However, in contrast to untreated atria, in pretreated atria the prolongation of the ERP produced by amoxapine exceeded the prolongation of the APD and thus, the ERP/APD ratio increased. The decrease in atrial excitability was also more marked in pretreated than in untreated atria. Amoxapine inhibited the slow action potentials and contractions induced by isoprenaline in K depolarized atria. It is concluded that the electrophysiological effects of amoxapine on rat atrial fibres are similar to those described for other tricyclic antidepressants. Possible explanations for the lower cardiodepressant activity of amoxapine are discussed. PMID- 3955304 TI - Identification of 6-oxo-prostaglandin E1 as a naturally occurring prostanoid generated by rat lung. AB - The spontaneous release of prostanoids from rat isolated perfused lungs was studied after acid/organic extraction of perfusates by bioassay, radioimmunoassay, thin layer and high performance liquid chromatographic methods and by gas chromatography-negative ion mass spectroscopy (g.c.n.i.m.s.). An acid/organic extractable anti-aggregatory vasodilator prostaglandin which inhibited the twitch response of the field-stimulated guinea-pig vas deferens was released from the Krebs-perfused rat lung in nanogram amounts similar to those of other detected prostanoids. Parallel biological assay suggested that this prostaglandin had very closely similar pharmacological activity to authentic 6 oxo-prostaglandin E1 (6-oxo-PGE1), a metabolite of prostacyclin (PGI2) generated by the action of the enzyme 9-hydroxyprostaglandin dehydrogenase (9-PGDH). 6-oxo PGE1 was identified conclusively in extracts of rat lung perfusate by thin layer chromatography, high performance liquid chromatography and g.c./m.s. combined with bioassay (inhibition of platelet aggregation), and its covalent structure was defined by g.c. negative ion chemical ionization mass spectroscopy. The rank order of spontaneous release of prostanoids (measured by radioimmunoassay) from the perfused rat lung was 6-oxo-PGF1 alpha greater than thromboxane B2 (TXB2) greater than PGE2 greater than 6-oxo-PGE1 (measured biologically) greater than PGF2 alpha. Release of all five prostanoids was inhibited by indomethacin, but only that of 6-oxo-PGE1 was inhibited by naringenin. Rat lung 100,000 g cytosolic supernatants contained 9-PGDH activity capable of removing 9 beta-tritium from labelled prostacyclin and forming an acid/organic extractable 6-oxo-PGE1-like anti-aggregatory substance. This 9-PGDH activity was inhibited by naringenin (IC50 10.3 microM). 6 The relevance of these findings to the possible physiological role of 6-oxo-PGE1 in the lung is discussed, and we propose that 6 oxo-PGE, should be accorded the status ofa physiologically relevant, naturally occurring metabolite of arachidonic acid. PMID- 3955305 TI - The effects of thyroxine treatment of rats on neuronal and extraneuronal uptake and metabolism of catecholamines in the heart. AB - The effects of thyroxine (T4) treatment of rats on the neuronal and extraneuronal uptake and subsequent metabolism of catecholamines in the heart were examined, to determine whether changes in the local dissipation of catecholamines might contribute to the enhanced sympathetic cardiac responses that occur when thyroid hormone levels are elevated. T4-treated rats were injected subcutaneously with L thyroxine sodium 1 mg kg(-1) on days 1, 3 and 5, and controls were injected with the normal saline vehicle on the same days. The experiments on isolated, perfused hearts were carried out on day 8. The T4-treated rats had only 50% of the growth rate of the controls and their heart weights were 18% greater than the controls. The experimental data were adjusted to allow for the increase in heart weight caused by the T4 treatment. The initial rates of neuronal uptake of noradrenaline and of extraneuronal uptake of noradrenaline and isoprenaline in the hearts from T4-treated rats were not significantly different from those in hearts from control rats. The steady-state rates of extraneuronal O-methylation of isoprenaline and of extraneuronal deamination of noradrenaline in hearts from T4 treated rats were not significantly different from those in hearts from control rats. The steady-state rate of neuronal deamination of noradrenaline was significantly lower and the accumulation of unmetabolized noradrenaline in the hearts was significantly greater in T4-treated rats than in the controls. These findings could be explained by a decrease in neuronal monoamine oxidase activity or by an increase in intraneuronal binding of noradrenaline in hearts from T4 treated rats. 6 The study has shown that it is unlikely that increased plasma thyroid hormone levels cause cardiac supersensitivity to catecholamines by affecting the local dissipation processes for those amines in the heart. PMID- 3955306 TI - The inhibitory action of 5-hydroxytryptamine on gastric secretory function in rats. AB - The inhibitory action of 5-hydroxytryptamine (5-HT) on gastric function was studied in vagotomized rats. 5-HT (0.6, 1 or 5 mgkg-1, s.c.) dose-dependently reduced gastric acid secretion evoked by histamine, pentagastrin or methacholine. Pepsin secretion induced by pentagastrin or methacholine was also depressed by 5 HT. Basal secretion of both acid and pepsin was not significantly affected by any of the three 5-HT doses. Indomethacin pretreatment, which significantly decreased gastric mucosal prostaglandin E2 content, did not modify the inhibitory effects of 5-HT on histamine-induced acid secretion, nor did phentolamine or propranolol. This study suggests that 5-HT inhibits gastric secretory function through mechanisms other than by sympathetic influence or increased prostaglandin synthesis. The inhibitory action appears not to be vagus-dependent. Other mechanisms of action are discussed. PMID- 3955307 TI - Changes in mechanical responses of vascular smooth muscles to acetylcholine, noradrenaline and high-potassium solution in hypercholesterolemic rabbits. AB - Mechanical responses produced by high potassium solution (high-[K]), noradrenaline (NA) and acetylcholine (ACh) were observed in the thoracic aorta and the main pulmonary artery isolated from control and hypercholesterolemic rabbits. In the hypercholesterolemic rabbit, these tissues showed increased contractile sensitivity to high-[K], in comparison with those from the control rabbit. In tissues from the control rabbit, mechanical removal of the endothelium did not change the contraction to high-[K]. The amplitudes of the contractions produced by NA were decreased in tissues from the hypercholesterolemic rabbit, while they were enhanced after removal of the endothelium in tissues from the control rabbit. The endothelium-dependent relaxant response to ACh observed in tissues from the control rabbit was diminished, abolished or changed to a contraction in tissues from the hypercholesterolemic rabbit. It is concluded that in vascular tissues from the rabbit, an increase in contractile sensitivity to high-[K], a decrease in sensitivity to NA and dysfunction of the endothelium to ACh are induced by feeding a high-cholesterol diet and these changes in the vascular tissues may thus be involved in the hypertension observed during diet induced atherosclerogenesis. PMID- 3955309 TI - Investigation into the cardioregulatory properties of the alpha 1-adrenoceptor blocker indoramin. AB - The cardioregulatory properties of the alpha 1-adrenoceptor blocker indoramin have been compared with those of prazosin in the anaesthetized rat. The effects of autonomic blockade on heart rate responses evoked by these two agents and their effects on blood pressure and heart rate after peripheral or central administration have been compared. Cumulative administration of indoramin (0.8 25.6 mg kg-1 i.v.) evoked significant decreases in arterial blood pressure and a concomitant bradycardia. Pithing or autonomic blockade, by pretreatment with a combination of practolol and bilateral vagotomy, prevented the bradycardia evoked by indoramin (0.8-3.2 mg kg-1 i.v.). Atropine sulphate pretreatment abolished the bradycardia until a cumulative dose of 25.6 mg kg-1(i.v.) of indoramin had been reached. Bilateral vagotomy, intravenous administration of atropine methylnitrate or practolol pretreatment attenuated the bradycardia. Prazosin (0.02-0.64 mg kg-1 i.v.) evoked a fall in arterial blood pressure of similar magnitude to that observed following indoramin. A bradycardia was evoked only at a relatively high dose (0.64 mg kg-1 i.v.). Intracisternal injection of indoramin or prazosin evoked bradycardia and hypotension at a dose which had no effect after intravenous injection (25 micrograms). Intracerebroventricular injection of indoramin (25 micrograms) had no significant effect on heart rate or blood pressure compared to control values, whereas prazosin (25 micrograms) evoked a significant tachycardia and hypotension. It is concluded that the bradycardia evoked by indoramin in the rat is not due to a direct action on the heart except possibly at high doses. Central alpha 1-adrenoceptor blockade, possibly in the brainstem region, results in a bradycardia and this may explain the lack of reflex tachycardia following the administration of indoramin. PMID- 3955308 TI - Attenuation by isosorbide dinitrate of coronary occlusion-induced acidosis in the dog myocardium. AB - In dogs anaesthetized with pentobarbitone, the thorax was opened and myocardial pH measured continuously by the use of a glass pH electrode inserted in the left ventricular wall. The left anterior descending coronary artery (LAD) was partially occluded so that the LAD flow could be reduced to a half or one-third of the original flow (partial occlusion). LAD partial occlusion was continued for 90 min, drug or saline being infused for the last 60 min of this period. LAD occlusion decreased myocardial pH significantly by 0.41 to 0.67 pH units, and increased ST segment of the surface electrocardiogram from 11.7 to 12.1 mV. In dogs with non-ischaemic normal hearts, isosorbide dinitrate (ISDN; 1 mg kg-1) did not change markedly either the LAD flow, myocardial pH or heart rate, whereas it decreased myocardial contractile force (determined by a strain gauge arch) slightly and both the systolic and diastolic blood pressure markedly. In dogs with partial LAD occlusion, ISDN (1 mg kg-1) increased myocardial pH significantly and decreased blood pressure, but did not change ST segment elevation in an epicardial lead. These results indicate that ISDN attenuates ischaemia-induced acidosis without attenuating ischaemia-induced ST elevation in the dog myocardium. PMID- 3955311 TI - True auditory hallucinations as a conversion symptom. PMID- 3955310 TI - Proceedings of the British Pharmacological Society. 18th-20th December 1985. Abstracts. PMID- 3955312 TI - Hypomania following cognitive therapy. PMID- 3955313 TI - Erotomania in an Arab. PMID- 3955314 TI - Cavernosal alpha blockade: a treatment for erectile impotence. PMID- 3955315 TI - Life events and schizophrenia: a Saudi Arabian Study. AB - Using an Arabic version of the PSE, supplemented by CATEGO, we selected 48 patients with acute schizophrenia from the population of the Najd region of Saudi Arabia. Their life-event histories for the six months before onset or relapse were compared with those of 62 control subjects. A positive association between events and onset was established only for married women, although there was a parallel trend for men and single women suffering their first schizophrenic episode. The observed impact of life events was limited to the three weeks before onset. These findings are discussed in the light of Saudi culture. PMID- 3955316 TI - A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. AB - A validity study of the Self-Report Questionnaire (20 item version, Harding et al, 1980) against the criterion of a standardised psychiatric interview (Goldberg et al, 1970) was carried out at three primary care clinics in Sao Paulo; 875 patients filled in the SRQ-20 questionnaires and a subsample of 260 was interviewed by the psychiatrist. The SRQ-20 was shown to be a feasible screening instrument for psycho-emotional disturbance in these settings. Sensitivity was 83% and specificity 80%, and the questionnaire was a good indicator of morbidity. A correlation was found between questionnaire total scores and independent clinical judgment (r = +0.70). A sex difference in the validity coefficients is described. PMID- 3955317 TI - A baseline study on mental disorders in Guine-Bissau. AB - Adults attending general health facilities in Guine-Bissau were screened for the presence of mental disorder; minimum estimate of definite mentally ill cases was found to be 12%. The proportion correctly identified by general health workers was low: only one of every three patients with a mental disorder was recognised and of every 100 non-cases 12 patients were wrongly diagnosed by the health worker as suffering from psychiatric illness. On the basis of these results health workers are now being taught how to detect mental illness. PMID- 3955318 TI - Outcome of patients committed to hospital under the Mental Health (Scotland) Act 1960. AB - All patients formally detained in a Scottish psychiatric hospital between 1974 and 1979 were identified and their outcome determined 2 1/2-8 1/2 years later. A matched group, detained under Emergency Orders only, were also followed-up. Those formally detained had more previous psychiatric contact: functional psychoses were significantly more common in them. They remained in hospital longer, and required extensive community support when discharged. Those detained under Emergency Orders only, consisted of two sub-groups--one who left the area within two years of admission and could not be traced, and the remainder, who continued to require hospital treatment but for shorter times and with less continuous support. Amongst those detained, lack of insight was a predominant feature, which may create difficulty with regard to informed consent to treatment, given the present Amendments to the Mental Health Acts. PMID- 3955319 TI - Mydriatic response to topical naloxone in opiate abusers. AB - Naloxone hydrochloride eyedrops 1 mg/ml dilated the pupils of 36 out of 47 opiate addicts on methadone maintenance treatment, without precipitation of acute withdrawal effects, but not those of healthy unmedicated subjects. The response in addicts was attenuated by certain ancillary treatments and by withdrawal of methadone treatment. The size of the response suggests some potential clinical use for topical naloxone as a diagnostic test of current opioid influence and possibility of physical dependence. The local mydriatic response, which was restricted to the treated eye, indicates that the effect of opiates on the pupil in man is determined, at least in part, by a peripheral action. PMID- 3955320 TI - Raised plasma cortisol concentrations a feature of drug-free psychotics and not specific for depression. AB - To determine whether high plasma cortisol concentrations are a distinctive feature of depression or whether plasma cortisol is also elevated in other forms of psychosis, cortisol concentrations were measured in 59 patients with acute functional psychoses, six non-psychotic depressed patients and 37 control subjects, all free of antidepressant and neuroleptic drugs for at least three months. Patients with schizo-affective disorder, manic type, had the highest concentrations throughout the day and those with major depressive disorder, psychotic sub-type had higher concentrations than controls in the afternoon and evening. Manic and schizophrenic patients had cortisol concentrations above controls in the afternoon only. Elevated concentrations were not related to the presence of depressed mood or to duration of stay in hospital, and a return to normal occurred irrespective of the type of treatment used. Thus raised plasma cortisol concentrations are a feature of psychotic illness, but in drug-free patients are not specific for severe depression. PMID- 3955321 TI - Dexamethasone concentrations and the dexamethasone suppression test in psychiatric disorders. AB - The dexamethasone suppression test (DST) has been widely used in psychiatry as a laboratory aid for the diagnosis of endogenous depression; failure to suppress serum cortisol levels is interpreted as confirming a clinical diagnosis of endogenous depression. We found that serum dexamethasone concentrations in this test vary widely and are determinants of the DST response: non-suppression of serum cortisol levels is associated with low serum dexamethasone concentrations, and suppression is associated with high concentrations. PMID- 3955322 TI - Depression, urinary free cortisol excretion and lymphocyte function. AB - An impairment in lymphocyte response to mitogen stimulation, a correlate of cell mediated immunity, has been reported in patients with depressive illness. To investigate whether such impairment in lymphocyte function is related to excessive secretion of cortisol, an immunosuppressive hormone, we compared mitogen-induced lymphocyte proliferation in three groups of subjects: depressed patients with elevated 24-hour urinary free cortisol (UFC) excretion; depressed patients with normal UFC excretion; and normal controls. Depressed patients in both groups showed significant reductions in lymphocyte mitogenic activity, in comparison with the normal controls, but the two depressive groups did not significantly differ from each other in their lymphocytic responses to any of the mitogens used. Furthermore, no significant correlations were found, within depressed patients, between UFC excretion and lymphocyte mitogenic responses. Depression is therefore associated with an impairment in lymphocyte function that cannot be explained solely on the basis of increased cortisol secretion. PMID- 3955323 TI - Hormones, mood and sexuality in lactating women. AB - Of 25 primiparous women, investigated prospectively for six months post-partum, 19 persisted with breast feeding and six changed to artificial during the first six weeks. Sexual activity, mood, and feeding patterns were recorded in weekly diaries. Hormones were measured from weekly urine samples (oestrogen and pregnanediol) and fortnightly blood samples (prolactin, testosterone, androstenedione, and sex hormone binding globulin). In breast-feeding women, testosterone and androstenedione levels were significantly lower in those who reported severe reduction in sexual interest. Changes in sexuality or mood were not related to levels of prolactin or oestrogen, or to the return of follicular activity, which was delayed in persistent breast feeders. The relationships of mood, sexuality, and hormones are discussed. PMID- 3955324 TI - Pseudodementia: facts and figures. AB - The historical and conceptual aspects of the pseudodementia state are briefly touched upon. A "collective sample", composed of 61 cases culled from the literature, is analysed and compared with the "Fulbourn sample" consisting of 22 cases reported for the first time. Two sub-types of pseudodementia emerge, one associated with depressive illness and the other with delirium. A follow-up of the Fulbourn sample (1-4 years after discharge) showed 14 patients to be alive and 8 to show no signs of dementia. No variable except the diagnosis "non specific psychosis" correlated with death during the follow-up period. PMID- 3955325 TI - Should plasma or urinary MHPG be measured in psychiatric research? A critical comment. PMID- 3955326 TI - Short term intensive psychotherapy--a case history. PMID- 3955327 TI - The biology of intelligence? AB - The idea that there is a biological basis for intelligence in people has been translated into two beliefs about IQ tests: first, that measured IQ is genetically determined and that differences in IQ between different groups are partly or largely caused by genetic differences between them; secondly, that IQ reflects some presumed fundamental property of the brain such as efficiency or speed of neural transmission, that can be measured by recording evoked potentials or by the speed with which a person performs some very simple task. Measured IQ may well have a significant heritable component, but there is very little evidence that average differences in IQ between, say, different ethnic groups are genetic in origin. In Great Britain, moreover, differences in IQ between white, West Indian, Indian or Pakistani children are closely correlated with differences in their social circumstances. It should be stressed, however, that there is equally little evidence that IQ tests significantly underestimate the academic attainments of children from ethnic minorities or that such children fall progressively further behind as they go through school. The search for simple, physiological or behavioural correlates of IQ has met with no more than modest success. Recent reports of highly significant correlations between IQ and measures of evoked potentials have not always been replicated and the past history of failures of replication in this general area counsels caution. Reports of very high (greater than 0.60) correlations between IQ and measures of timed performance have not been substantiated and can usually be attributed to the inclusion of disproportionate numbers of retarded subjects in the samples. There is quite good evidence of moderate correlations (in the range 0.20 to 0.40) with those measures, but it is not even clear how they should be interpreted. One possibility is that they reflect differences in concentration or sustained attention. If we want higher correlations with IQ we will probably need to look to more sophisticated tasks. PMID- 3955328 TI - Peripheral vision and the aetiology of child pedestrian accidents. AB - Three experiments examined whether age and sex differences in pedestrian accidents might be partly attributable to differences in the visual perception of peripheral stimuli. Primary schoolchildren and adults responded individually to the presentation of lights at retinal eccentricities of 2 degrees, 20 degrees and 40 degrees. Experiments 1 and 2 measured reaction times and Expt 3 measured subjects' expectations of foveal and peripheral events. There were no age or sex differences in expectations. Lights were detected fastest in the 20-40 degrees range. Movement times were not variable across eccentricities. As expected, adults' and 11-year-olds' detections were faster than eight- and six-year-olds'. A case is made for more problem-analytic and multi-theoretical research in the area of the child pedestrian accidents. PMID- 3955329 TI - The effects of induced frontalis tension variation on aspects of cognitive efficiency. AB - Sixteen subjects performed a serial reaction-time task while varying frontalis tension levels. There were three levels of induced tension variation: high, moderate and low. Results indicated that reaction times were differentially affected across the three tension levels, and the slow response end of the reaction-time distribution was slightly more sensitive to frontalis tension changes than the median. The relative importance of errors of omission and errors of commission may determine which tension level is optimal for task performance, but the results reported here indicate that attempts to reduce frontalis tension levels may be inappropriate in situations requiring sustained alertness. PMID- 3955331 TI - Alzheimer's disease and related disorders. PMID- 3955330 TI - Reproduction of complex movements: the effects of the presence of vision during encoding or at recall. AB - This study investigated the role of vision in the encoding and reproduction of movement. Kinaesthetic reproductions of a kinaesthetically presented two dimensional movement were compared with reproductions where vision was present either during the standard or at reproduction. The main finding was that the presence of vision during the standard resulted in poorer accuracy and greater underestimation of movement size than when it was absent throughout or present during reproduction. The presence of vision during the standard, however, resulted in less distortion of the linear components of movement shape although no such effect was found for the angular components. The initial direction of movement was reproduced more accurately where visual experience of the movement was given, either during the standard or during reproduction. PMID- 3955332 TI - Observations on the genesis of the stretch reflex in Parkinson's disease. AB - Using surface electromyography the reflex response of flexor carpi radialis elicited by forcibly dorsiflexing the wrist was compared with that elicited by applying vibration percutaneously to its tendon. This was done both in patients with Parkinson's disease and in normal subjects. The reflexes were elicited on top of a pre-existing voluntary contraction of the muscle of about 20 per cent maximum. The responses in parkinsonism were qualitatively similar to the normal, but differed quantitatively in certain respects. The response to 'stretch' of the muscle by wrist dorsiflexion normally continued at a high level up to at least 80 ms from the beginning of the movement, commonly with an apparent separation into 'short' and 'long' latency responses. On average, the later components of the response were enhanced in parkinsonian patients in comparison with the normals, confirming other workers' findings; they were also prolonged. The short-latency responses were unchanged. Vibration, in contrast, elicited solely a short-latency response with the initial reflexly-evoked augmentation of EMG activity coming to an end 40 to 50 ms from the beginning of the stimulation, even though the vibration was continuing. Such an absence of the later components that were so prominent with stretch was found whatever the size of the initial short-latency response evoked by vibration, including when it was comparable to that evoked by stretch in the same subject. This purely short-latency vibration response was on average unchanged in parkinsonism. The findings support the hypothesis, already advanced for the long flexor of the thumb, that the long-latency components of response are largely attributable to a spinal excitatory action of the spindle group II afferents with the delay arising from the slowness of their conduction. They are not readily compatible with either of the two major alternative hypotheses, namely the 'long-loop' (or transcortical) hypothesis and the 'resonance' hypothesis, both of which attribute the late response, as well as the initial response, to the spindle Ia afferents. The enhancement of the later components of response in parkinsonism thus now seems likely to be due to an increase in the postulated spindle group II excitatory action, possibly related to a reduction in opposing inhibition, rather than to any change in the reflex excitability of the higher centres on Ia activation. However, the rigidity of parkinsonism cannot be uniquely ascribed to an enhancement of group II action, because over the population as a whole clinically similar degrees of rigidity could be accompanied by quite different long-latency responses, and vice versa. PMID- 3955333 TI - Transient global amnesia triggered by mild head trauma. AB - In 9 patients, aged 11 to 28 years, minor head injury triggered an amnesic attack grossly disproportionate to the degree of trauma. During these attacks, patients were unable to form new memories for 2 to 24 hours, had extensive retrograde amnesia, voiced repetitive queries and were disorientated for time, but were otherwise intact neurologically. We suggest that these episodes were attacks of transient global amnesia triggered by the mild blows to the head. We also suggest that they constitute a previously unrecognized variety of traumatic migraine. PMID- 3955334 TI - Computer-assisted myelography in cervical spondylotic myelopathy and radiculopathy. Clinical correlations and pathogenetic mechanisms. AB - A total of 53 patients with cervical spondylotic myelopathy and/or radiculopathy were studied with computer-assisted myelography following metrizamide myelography. Cervical cord deformities resulting from spondylotic protrusions were classified into four groups. The A shape (anterior central concavity) is the commonest and is often associated clinically with bilateral anterolateral and posterior column deficits. In the B shape (lateral deformity on one side), unilateral anterolateral column and root signs, usually mild, predominate. The symptomatology of the C shape (lateral deformity on both sides) and the D shape (flattened anterior surface) is bilateral, although not often symmetrical, and includes anterolateral and posterior column disturbances and root signs. Radiculopathy may, however, occur in the absence of cord deformity if the spondylotic lesion is close to or inside the intervertebral foramen. As there is some relationship between cord shapes and symptomatology, the decision as to whether a particular deformity is responsible for the clinical presentation may be made with more confidence. Moreover, the degree of cord deformity correlates well with the severity of symptomatology. Those with mild deformity had relatively few or mild cord signs, whereas in those with severe deformity cord signs were numerous and severe. Certain observations on cord deformity in vivo support the view that compression is an important pathogenetic mechanism in cervical spondylotic myelopathy. Most patients had anterior cord compression and the anterolateral signs were more frequent and marked. Severity of cord signs is associated with the degree of compression. Removal of the compression is followed by re-expansion of the cord and clinical improvement. In a small number of cases where cord compression by osteophytic protrusion was mild, and where clinical improvement followed the removal of the protrusion, the theory of cord traction and friction appears to apply. The contribution of other mechanical factors and of ischaemia to cord damage is also discussed. PMID- 3955335 TI - Parkinson's disease and depression. A critical re-evaluation. AB - The possibility of an 'organically' based depression intrinsic to the pathophysiology of Parkinson's disease (PD) and comparable to endogenous depression (Major Depressive Episode) has been raised. It has also been argued that signs of depression observed in PD are merely the natural reaction of the patients to their progressive and inevitable physical limitations and loss of independent function. Because conventional depression rating scales are limited in scope, a psychometric investigation of depression in PD was pursued. Based on the known impairment of short-term memory (STM) in endogenous depression, which was confirmed in a group of psychiatric patients in the present study, measures of STM were also obtained in groups of depressed and nondepressed PD patients and in 15 normal control subjects. Regardless of depression severity, PD patients performed as well as control subjects and both these groups consistently obtained scores significantly better than those of the endogenously depressed patients. A relative weakness in the PD patients on order-dependent STM tests was further explored and interpreted as an indication of mild frontal lobe dysfunction. It was concluded that PD patients are frequently depressed when confronted with their behavioural limitations and that this reaction may be exacerbated by a form of emotional liability related to pathophysiological processes which may involve prefrontal cortical areas. PMID- 3955336 TI - Hypometria with hemispatial and limb motor neglect. AB - A patient with a haemorrhage in the right mesial frontal lobe exhibited hypokinesia, bradykinesia and a hypometric movement disorder of his contralateral limbs. This movement disorder was characterized by reduced amplitude of otherwise normally formed movements (hypometria). In addition, the left limb hypokinesia improved with placement of the left forelimb into right hemispace (hemispatial motor neglect). We postulate that the hypokinesia, bradykinesia and hypometria were induced by reduction in activation of forebrain dopaminergic and basal ganglion motor systems, which in conjunction with the supplementary motor area are critical for setting the activational level for motor output. PMID- 3955337 TI - Atrial demand pacing to protect against vagal overactivity in sympathetic autonomic neuropathy. AB - The clinical features, investigation and management of a patient with a subacute autonomic neuropathy are described. A series of physiological and biochemical studies indicated severe but selective sympathetic cardiovascular dysfunction, associated with bradycardia. The bradycardia was enhanced by raising blood pressure but there was no other evidence either of cardiac vagal impairment or hyperreactivity. Oral atropine prevented the bradycardia but had to be withdrawn because of intolerable side effects. An atrial demand pacemaker was implanted to elevate basal heart rate and prevent bradycardia. The pacemaker alone did not improve postural hypotension but it enabled the blood pressure to be readily and safely controlled by a combination of drugs. PMID- 3955338 TI - Subcortical coordination of hemisphere activity in commissurotomized patients. AB - Despite their commissurotomy, 'split-brain' patients behave as unified individuals and seldom display signs of hesitation and dissociation in their activities. Yet our current understanding of the callosal disconnection syndrome suggests that the two isolated hemispheres cannot work in parallel and that only one hemisphere at a time is responsive to bilateral stimulation. To examine this divergence, the two hemispheres of complete forebrain commissurotomy patients were simultaneously presented with colour stimuli associated with opposite responses, and the patients had to produce a single finger response whose accuracy depended on their capacity to resolve the conflicting information. Although the two patients differed in their efficiency, they were capable of accurate performance in the bilateral conflict condition, but could not correctly cross-compare the information received by each hemisphere. This performance suggests that the two disconnected hemispheres can work in parallel and process the incoming information efficiently. The outcome of these hemispheric operations may be integrated in subcortical 'centrencephalic' areas that coordinate the activities of the two sides of the brain and maintain some unity within cerebral structures. PMID- 3955339 TI - Semantic classification in aphasia: a study of basic, superordinate, and function relations. AB - Nonfluent and fluent aphasics were given classification tasks that required the aphasics to identify three kinds of relations: same basic level category, same superordinate level category, and same function. The subjects received the items in word and picture form. In addition the aphasics were required to name the items they were asked to classify. The results showed that the ability to classify is more disrupted in fluent aphasia than in nonfluent aphasia. Within fluent aphasia, the degree to which classification is disrupted is dependent upon the type of relation being tested. While the overall performance of the fluent aphasics was depressed in comparison to nonfluent aphasics, it was significantly more depressed on function relations. The ability to name an item had a significant effect on the ability to classify only for basic level items. PMID- 3955340 TI - Event-related potential indices of ambiguous sentence processing. AB - An event-related potential (ERP) probe was used to examine various models of ambiguous sentence processing. ERPs to light flashes were recorded during and immediately after auditorily presented ambiguous and unambiguous target sentences. Each target sentence was preceded by either a relevant or a neutral context sentence. Principal component analyses of the ERPs indicated that although certain components varied as a function of ambiguity, none of the components varied as a function of preceding context. These findings provided some support for a postdecision model of ambiguity processing which suggests that both meanings of an ambiguity are always processed, even when prior disambiguating context is available. PMID- 3955341 TI - Severe stuttering associated with right hemisphere lesion. AB - Following a right hemisphere stroke, a right-handed, 50-year-old male experienced a permanent dysfluency characterized by phoneme and syllable reiterations and, to a lesser extent, word and phrase reiterations. The reiterations occurred in initial, medial, and final positions and for all sentence elements (e.g., subject nouns, object nouns, verbs, modifiers). There was a notable loss of verbal automatisms (poems, songs, etc.). The patient's symptoms conform to the acquired stuttering syndrome described by A. Helm, R. Butler, and D.F. Benson (1978, Neurology, 28, 1159-1165). PMID- 3955342 TI - Language and speech in a patient with a clinical diagnosis of progressive supranuclear palsy. PMID- 3955343 TI - Linguistic semantic agraphia: a dissociation of the lexical spelling system from semantics. AB - Two spelling systems have been described. The phonological system transcodes speech sounds to letters and is thought to be useful for spelling regular words and pronounceable nonwords. Although the second system, the lexical-semantic system, is thought to use visual word images and meaning to spell irregular words, it is not known if this system is dependent on semantic knowledge. We used a homophone spelling test to examine the lexical-semantic system in five patients. The patients were asked to spell individual homophones (doe or dough) using the context of a sentence. Semantically incorrect and correct homophones were spelled equally well, whether they were regular or irregular. These results demonstrate that an irregular word may be spelled without knowledge of the word's meaning. Therefore, the lexical system can be dissociated from semantic influence. PMID- 3955345 TI - Performance of normal elderly on the Boston Naming Test. AB - The Boston Naming Test has enjoyed increasing use in many research studies since its introduction. However, there is little normative data on the age group above 60 years of age. This study presents data from a sample of 58 well-defined healthy elderly males and females between the ages of 60 and 85. In comparison with published normative data, our sample has higher means, smaller standard deviations, and narrower ranges. These results suggest that aging alone does not significantly alter recognition-cued word-finding ability as defined by the Boston Naming Test. Also there is remarkably consistent performance throughout our age range. PMID- 3955344 TI - Inference deficits in right brain-damaged patients. AB - The inferential reasoning ability of right hemisphere-damaged (RHD) patients was tested by presenting pairs of sentences which were to be treated as single, integrated units. The two sentences treated together made one interpretation likely (a correct inference); one of the sentences in isolation encouraged a different interpretation (an incorrect inference). The position of the misleading sentence was systematically varied. Results showed that, in contrast to normal controls, RHD patients have more trouble answering inference questions, especially those concerning incorrect inferences, than answering questions about the factual content of the passages. Also, RHD patients made significantly more errors when the misleading information was contained in the first rather than in the second sentence; this finding indicates that these patients have difficulty revising previously acquired knowledge in light of new information. These results suggest the impairment of several components of normal discourse processing subsequent to right hemisphere brain damage. PMID- 3955346 TI - Tree structures, the work of listening, and schizophrenic discourse: a reply to Beveridge and Brown. AB - A. W. Beveridge and K. Brown (Brain and Language, 24, 174-181) have criticized a study reported by R. Hoffman, L. Kirstein, S. Stopek, and D. Cicchetti (Brain and Language, 15, 207-233), which examined processing tasks imposed upon listeners by schizophrenic speech. The authors argue that our discourse analysis was not sufficiently objective since different discourse structures can at times be generated on the basis of a particular deviant speech segment. However, the analysis which we described does not purport to yield an "objective" structure of schizophrenic texts but rather attempts to reflect representations that individual listeners generate in processing speech; our model only requires that different interpretations of a particular segment generate different discourse structures. Deficiencies in hierarchical structure associated with schizophrenic speech increase processing requirements for listeners and may cause interpretive variability. Incoherence scores generated on the basis of our analysis were used to estimate the amount of extra "work of listening" that particular speech segments require. Because these incoherence scores were blindly and reliably determined, they can be used to make statistical inferences about the prevalence of structural deficiencies of schizophrenic speech compared to the speech of controls. PMID- 3955347 TI - Effect of clonidine and gamma-aminobutyric acid on the discharges of medullo spinal sympathoexcitatory neurons in the rat. AB - Single-unit recordings of 50 pressure-sensitive neurons with axonal projections to the thoracic spinal cord were obtained in the retrofacial portion of nucleus paragigantocellularis lateralis of halothane-anesthetized rats. Two types of cells were distinguished on the basis of their axonal conduction velocities: a slow-conducting (mean 0.6 m/s, group I) and a fast-conducting one (group II, mean 3.3 m/s). Both cell types were completely silenced by elevating mean arterial pressure above 160 mm Hg by means of aortic constriction and exhibited a plateau of high spontaneous activity below 70 mm Hg. Only group I neurons were significantly inhibited by the administration of clonidine in a dose producing 90% of its maximum hypotensive effect (11.5 micrograms/kg, i.v.). Hypotensive doses of clonidine administered into the fourth ventricle also produced a selective inhibition of group I neurons, while the others were unaffected. Iontophoretic applications of clonidine and norepinephrine produced an inhibition of the discharges of group I neurons qualitatively and quantitatively identical to that observed following administration of clonidine by the i.v. or i.c.v. route. Once more, group II cells were unaffected. In contrast, iontophoretically applied gamma-aminobutyric acid exerted a powerful inhibition of both cell types, an effect which was totally prevented or reversed by the gamma-aminobutyric acid antagonist bicuculline. Anatomical experiments were performed to uncover the potential source of catecholaminergic innervation of the area in which recordings were obtained. This area contains a large number of adrenaline-synthesizing neurons and receives a selective noradrenergic input from the A5 pontine group with no contribution from the A1, A2, A6 and A7 brainstem clusters of noradrenergic cells. PMID- 3955348 TI - Two opioid forms of stress analgesia: studies of tolerance and cross-tolerance. AB - We have previously reported that stress analgesia sensitive to and insensitive to opiate antagonists can be differentially produced in rats by varying the severity or temporal pattern of inescapable footshock. In these studies, we give further evidence for the opioid and non-opioid bases of these paradigms of stress analgesia. We find that naloxone-sensitive analgesia demonstrates tolerance with repeated stress and cross-tolerance with morphine, whereas naloxone-insensitive analgesia demonstrates neither of these characteristics. Moreover, different forms of opioid, but not non-opioid, stress analgesia manifest cross-tolerance with each other. These data are discussed in terms of the similarities and differences between two forms of opioid stress analgesia. PMID- 3955349 TI - Distribution of 'non-specific' cholinesterase-containing neurons in the dorsal thalamus of the rat. AB - This report describes the distribution of histochemically identified 'non specific' cholinesterase (ChE)-containing neurons in the dorsal thalamus of the rat. Juvenile or young adult Long-Evans or Sprague-Dawley rats were sacrificed by formalin perfusion. Some animals received systemic injections of 1.5-2.0 mg/kg DFP 4-24 h prior to sacrifice. Separate series of 50 micron frozen sections were processed for cholinesterase histochemistry using acetylthiocholine, butyrylthiocholine, or propionylthiocholine as substrates. Adjacent sections processed with each of the 3 substrates allowed comparison of the distributions of neurons containing the histochemical reaction products. Neurons containing moderate to high concentrations of ChE reaction product were found in 3 distinct regions of the dorsal thalamus. First, neurons staining intensely for ChE were found in a cluster that corresponds to the thalamic reuniens nucleus. Second, a cluster of neurons staining intensely for ChE was found in a region that included the lateral part of the central lateral nucleus and extended laterally into the ventral-lateral part of the lateral dorsal nucleus. Third, moderate ChE staining was observed in the neurons of the anterior dorsal nucleus. Of these regions, only the anterior dorsal nucleus shows moderate to high levels of acetylcholinesterase. The function of ChE in normal brain function is unknown. It is particularly interesting, however, that the thalamic nuclei containing ChE positive neurons send thalamocortical projections to the medial limbic cortex, including cingulate, retrosplenial and subicular cortices. PMID- 3955350 TI - Modulating effects of posttraining epinephrine on memory: involvement of the amygdala noradrenergic system. AB - These experiments examined the effects, on retention, of posttraining intra amygdala administration of norepinephrine (NE), and propranolol. Rats were trained on a one-trial step-through inhibitory avoidance task and tested for retention 24 h later. Injections were administered bilaterally (1.0 microliter/injection) through chronically-implanted cannulae. Low doses of NE (0.1 or 0.3 microgram) administered shortly after training enhanced retention while higher doses (1.0 or 5.0 micrograms) were ineffective. Retention was not affected by NE administered 3 h after training. The effect of intra-amygdala NE on retention is blocked by simultaneous administration of propranolol (0.2 microgram). This finding suggests that the memory-enhancing effect of NE may be mediated by beta-receptors. Posttraining intra-amygdala NE also attenuated the retention deficit produced by adrenal demedullation. Further, intra-amygdala injections of propranolol (0.2 microgram) blocked the enhancing effect, on retention, of posttraining s.c. injections of epinephrine. These findings suggest that activation of noradrenergic receptors in the amygdala may be involved in memory processing and may play a role in the memory-modulating effect of peripheral epinephrine. PMID- 3955351 TI - Regrowth of retinal axons after lesions of the brachium and pretectal region in the rat. AB - Suction lesions of the left rostral superior colliculus (SC) and pretectal area were made in young rats. One to 50 days later, the right eye of each animal was injected with horseradish peroxidase (HRP). Animals were subsequently perfused and the brains processed with tetramethylbenzidine. In many older animals, lesioned areas were covered with thin membranes composed of glial and connective tissue cells. HRP-labelled optic axons were traced running through these membranes for up to 3 mm. On occasion, regrowing retinal fibres reached the rostral border of the remaining SC but did not grow into the tectal neuropil. PMID- 3955352 TI - Dendritic patterns of granule cells in organotypic explants of fetal and neonatal mouse hippocampal formation. AB - Granule and granule-like neurons were labeled by Golgi and HRP techniques in the dentate area of fetal and neonatal organotypic hippocampal explants after 1 day-8 weeks in vitro. These cells resembled granule cells labeled in situ with similar techniques, although the dendritic pattern and spine development were not as elaborate as observed on granule cells from adult rodents. Many of these neurons retained basilar or multiple dendrites after 8 weeks in culture, a characteristic often associated with immature granule cells, granule cells in the reeler mutant mouse and tissues removed from human epileptic foci. PMID- 3955354 TI - Asymmetrical distribution of aminopeptidase activity in the cortex of rat brain. AB - The levels of soluble aminopeptidase (AP) activity were measured in the right and left frontal (FC), parietotemporal (PTC) and occipital (OC) cortex of male albino rat brains. The results showed more AP activity in the left cortex than in the right. Analyzing these results further, we found that the differences are significant for frontal cortex but not for parietotemporal nor occipital cortex. However, 76% of the rats were left-predominant for AP activity in the 3 cortical areas studied. PMID- 3955353 TI - Visual field defects in cats with neonatal or adult immunological loss of retinal ganglion cells. AB - Behavioral perimetry methods were used to assess the monocular visual fields of 12 cats that had received intraocular injections of antibodies against large (alpha/Y) retinal ganglion cells. The antibodies produced defects in head and eye orientation responses to stimuli presented in the nasal visual field of the treated eye; responses to stimuli in the temporal visual hemifield were normal. Similar results were seen in cats that received antibody injections at 4 weeks of age or as adults. In the context of previous results, these findings suggest that a loss of Y cells in the lateral geniculate nucleus is sufficient to reduce geniculocortical function for head and eye orientation to visual stimuli in the nasal visual field. PMID- 3955355 TI - Destruction of intrinsic neurons in the lateral hypothalamus disrupts the classical conditioning of autonomic but not behavioral emotional responses in the rat. AB - The present study examined whether destruction of intrinsic neurons in the lateral hypothalamus of the rat would disrupt the acquisition of classically conditioned changes in arterial pressure. Ibotenic acid, a cellular toxin which spares axons of passage, was injected bilaterally in the hypothalamus either medial or lateral to the fornix. After 2 weeks the animals were subjected to classical fear conditioning trials involving the presentation of a tone in association with footshock. The next day changes in arterial pressure and emotional behavior elicited by the tone alone were measured. Destruction of intrinsic neurons in the lateral hypothalamus prevented the normal establishment of the arterial pressure conditioned response but did not affect the behavioral response. Unconditioned arterial pressure responses elicited by the tone and shock were not affected. Medial hypothalamic injections had no effect on any of the responses. The location of the lateral hypothalamic cell loss overlapped with the neurons projecting to the autonomic region of the spinal cord. Intrinsic neurons in the lateral hypothalamus therefore appear to be specifically involved in mediating learned cardiovascular adjustments. PMID- 3955356 TI - The intracellular chloride activity of glomus cells in the isolated rabbit carotid body. AB - The resting membrane potential (EM) and intracellular chloride activity (ai(CI] of glomus cells were measured in isolated rabbit carotid bodies using conventional and chloride-selective microelectrodes. EM and ai(CI) were -25.9 +/- 1.4 mV (mean +/- S.E.M., n = 13) and 20.9 +/- 1.9 mV (mean +/- S.E.M., n = 13), respectively. When the chloride equilibrium potential (ECI) was shifted in a positive direction, EM depolarized. It is concluded that chloride ions are not passively distributed across the glomus cell membrane and that they play an important role in determining EM. PMID- 3955357 TI - The effect of analgesic doses of morphine on regional cerebral glucose metabolism in pain-related structures. AB - The effect of morphine on regional cerebral glucose metabolism was measured in rats using high resolution [14C]2-deoxyglucose autoradiography with concurrent confirmation of morphine-induced analgesia measured by tail-flick latency to noxious heat. Within the limits of resolution of this technique, doses of morphine sufficient to inhibit the tail-flick reflex had no significant effect on glucose metabolism in structures implicated in the modulation of pain. PMID- 3955358 TI - Chronic ethanol treatment uncouples striatal calcium entry and endogenous dopamine release. AB - Chronic ethanol treatment resulted in a marked reduction in the release of dopamine from striatal synaptosomes in response to depolarization. Calcium entry into the same synaptosomal preparations was not altered. Calculation of the ratio of calcium entry vs dopamine release showed that, under control conditions, approximately 15 calcium ions were required to cause the release of 1 dopamine molecule. Chronic ethanol treatment increased this ratio to more than 80:1, suggesting that chronic ethanol administration altered the coupling between calcium entry and dopamine release. Addition of ethanol in vitro to synaptosomes isolated from chronic ethanol-treated rats returned this ratio to approximately 20:1. These results suggest that chronic ethanol treatment results in dependence which is reflected biochemically in striatum through changes in the coupling between voltage-dependent calcium entry into nerve endings and subsequent neurotransmitter release. PMID- 3955359 TI - Retinal ganglion cell dendritic fields in old-world monkeys are oriented radially. AB - We analyzed the dendritic field morphology of 297 ganglion cells from peripheral regions of monkey retina. Most of the dendritic fields were elongated, and there was a significant tendency for the dendritic fields to be oriented radially, i.e., like the spokes of a wheel with the fovea at the hub. An overrepresentation of radial orientations in the peripheral retina of primates might explain why humans are best able to detect stimuli which are oriented radially using peripheral vision. PMID- 3955360 TI - Spatial distribution of evoked potentials in the inferior olivary nucleus by stimulation of the visual afferents in the rat. AB - Visual pathways (optic disc, optic nerve and pretectal regions) were electrically stimulated and evoked potentials were explored throughout the inferior olive in the anesthetized rat. Responsive areas were identified as the caudal half of the dorsal cap, nucleus beta and the most caudal region of subnucleus c of the medial accessory olive. No field potentials were identified in the rostral half of the dorsal cap, its ventrolateral outgrowth or the dorsomedial cell column. Contralateral retinal afferents were only effective all over the responsive areas. PMID- 3955361 TI - Correlations between EEG state and spontaneous and evoked axial muscle EMG. AB - The occurrence of changes in the spontaneous EMG activity of the axial muscle lateral longissimus (LL) is highly correlated (P less than 0.001) with the occurrence of changes in EEG state in urethane-anesthetized rats. There is also a highly significant correlation (P less than 0.001) between the desynchronized EEG state and pudendal nerve evoked multi-unit EMG activity in LL. It is suggested that reticular activation upon pudendal nerve stimulation could facilitate subsequent lumbar axial motoneuron responses to this stimulation. PMID- 3955362 TI - The projection pattern of the suprageniculate nucleus to the caudate nucleus in cats. AB - The suprageniculate nucleus of the posterior thalamus is a source of non intralaminar thalamic nucleus which projects selectively to the medial and intermediate regions of the caudate nucleus in cats. PMID- 3955363 TI - Localization of monoamine oxidase (MAO) in the rat peripheral nervous system- existence of MAO-containing unmyelinated axons. AB - Using a new coupled peroxidation method modified by adding nickel ammonium sulfate, we demonstrated the localization of monoamine oxidase (MAO) in the rat peripheral nervous system. MAO was localized in the endothelial cells of endoneurial vessels, in Schwann cell cytoplasm encircling myelinated axons, and in some unmyelinated axons. The morphometric ratio of these MAO-containing axons to the total unmyelinated axons was 10-13%. These MAO-containing unmyelinated axons were assumed to coincide with postganglionic sympathetic noradrenergic ones passing in the sciatic nerve. Histochemical MAO staining may be utilized to identify the postganglionic sympathetic nerves in normal and pathological conditions at the electron microscopic level in particular. PMID- 3955364 TI - Intracellular currents of interictal penicillin spikes: evidence from neuromagnetic mapping. AB - To analyze the net intracellular current produced by interictal spikes, we mapped the extracranial magnetic fields of the rat brain following application of penicillin to the right or left medial cingulate cortex. Averaged interictal spikes in both the magnetoencephalogram (MEG) and in the electrocorticogram (ECoG) were composed of 4 temporal components, a biphasic spike and slow wave. Magnetic field maps for each of these components indicated a source at the location of penicillin application, with intracellular currents oriented perpendicular to the surface of the cingulate cortex, along the axis of the major pyramidal cells. The polarity of the magnetic fields for each of the components was reversed between the two cingulate groups, reflecting the respective orientation of pyramidal cells between the juxtaposed faces of the medial cingulate cortex. This neuromagnetic study of net intracellular current complements and extends the analysis of extracellular currents within the penicillin focus obtained using laminar electrodes. These data also demonstrate how animal neuromagnetometry may provide an empirical foundation for the neurogenesis of the MEG and a new unique method for the non-invasive study of population cell physiology. PMID- 3955366 TI - Sensory-specific satiety: food-specific reduction in responsiveness of ventral forebrain neurons after feeding in the monkey. AB - It has been shown previously that some neurons in the lateral hypothalamus and substantia innominata respond to the sight of food, others to the taste of food, and others to the sight or taste of food, in the hungry monkey. It is shown here that feeding to satiety decreases the responses of hypothalamic neurons to the sight and/or taste of a food on which the monkey has been satiated, but leaves the responses of the same neurons to other foods on which the monkey has not been satiated relatively unchanged. This suggests that the responses of these neurons in the ventral forebrain are related to sensory-specific satiety, an important phenomenon which regulates food intake. In sensory-specific satiety, the pleasantness of the sight or taste of a food becomes less after it is eaten to satiety, whereas the pleasantness of the sight or taste of other foods which have not been eaten is much less changed; correspondingly, food intake is greater if foods which have not already been eaten to satiety are offered. PMID- 3955365 TI - Effects of naloxone and pimozide on initiation and maintenance measures of free feeding. AB - Latency to initiate and duration of eating of 18 daily 5-pellet meal segments was measured in 22-h food-deprived rats under conditions of pimozide (1 mg/kg, i.p.) and naloxone (2.5, 5.0 and 10.0 mg/kg, i.p.) pretreatment. Neither drug increased latency on the first or second day of testing; pimozide increased mean latency slightly on the third test. Both drugs slowed duration scores dramatically; the slowing was progressive both within and across test sessions in the case of pimozide; it was dose-dependent and progressive within (but not across) sessions in the case of naloxone. In each case, shifts in mean duration scores. In each case, shifts in mean duration score reflected an increase in score variance caused by an increase in the number and extremity of long duration scores. In each case best scores under the drug condition were equal to best scores under control conditions; indeed, very fast latency scores were slightly more frequent under each drug on the first day of testing. Thus each drug decreased the probability of moderate scores but neither drug caused a simple change in the ability to make occasional fast responses. While the effects of the two drugs were similar in some ways, naloxone, unlike pimozide, did not completely suppress feeding. PMID- 3955367 TI - Correlation between the morphology and the lipid and protein compositions in the peripheral nervous system of individual 8-day-old normal and trembler mice. AB - The hereditary, hypertrophic interstitial neuropathy which afflicts the trembler mouse manifests itself about two weeks after birth. Consequently, the identification of these mutant mice was not possible before this age, except when double mutants were available. We show that the trembler mice can be easily distinguished from their normal littermates before the clinical symptoms appear by using an HPTLC/densitometry technique that allows the simple and rapid analysis of the polar lipids extracted from one sciatic nerve. The results presented in this paper demonstrate important differences between the polar lipid compositions of sciatic nerves from 8-day-old normal and trembler littermates, whose phenotypes were confirmed by the morphological analysis of the contralateral sciatic nerves. The small amount of material that is needed for this identification makes it possible to use the remaining nerve material for other studies. Furthermore, important differences between the sciatic nerve protein compositions of normal and trembler mice, identified according to their polar lipid composition, were also observed and these differences can, therefore, also be employed for the identification of the mutants before the manifestation of the clinical symptoms of the trembler neuropathy. PMID- 3955368 TI - A quantitative developmental study of the peripheral nerve lipid composition during myelinogenesis in normal and trembler mice. AB - The quantitative evolution of 10 polar lipids was examined in the sciatic nerves of normal and trembler mice between the ages of 3 days and 60 days. In normal nerves, the polar lipids accumulated slowly until the age of 9 days. A period of rapid accumulation then took place until 18 days of age, after which the phospholipids plateaued, while the glycolipid content continued to increase at a slower rate. The results obtained for the sciatic nerves of trembler mice show that the accumulation of all the polar lipids studied, except phosphatidylcholine and hydroxysulfatides, is abnormal from the earliest stages of postnatal development, and strongly support the view that the primary disorder in the trembler peripheral nervous system is one of dysmyelination. With the exception of cardiolipin, all the lipids in the trembler nerves stopped accumulating at the age of 18 days. The cerebrosides were the lipids the most affected severely at all ages. PMID- 3955369 TI - An automated colorimetric microassay for neuronotrophic factors. AB - A microassay is described for determining the number of neurons surviving after 24 h in response to added neuronotrophic factors. Neuronal cultures in 96-well microtiter plates are supplied with a yellow tetrazolium derivative, MTT (3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide), which is taken up selectively by viable neurons and converted to a blue formazan product. The amount of blue color development can be rapidly quantified using an automatic microplate spectrophotometer. The resulting optical density is directly proportional to the number of viable neurons. The spectrophotometer has been interfaced with a computer allowing a print out of individual absorbance values and calculation of half-maximal (one trophic unit) neuronal survival. The assay has been used for the quantification of the trophic activities of nerve growth factor and ciliary neuronotrophic factor using, respectively, dorsal root and ciliary ganglionic neurons from 8-day chick embryos. Assay parameters were optimized so that about 2000 individual cultures of ganglionic neurons can be set up and analyzed each day, thus allowing the serial titration in duplicate of 80 120 separate samples. The determination of neuronal number and titer calculation steps now requires about 2 min per microplate (96 cultures), a 50-fold reduction in time over existing methods. PMID- 3955370 TI - Primary culture of rat ependymal cells in serum-free defined medium. AB - We have developed a serum-free chemically defined medium which allows the obtainment of a primary culture highly enriched in ciliated ependymal cells. Serum was never used. Mechanically dissociated neonatal rat brain hemisphere cells were seeded on a fibronectin substratum. Culture medium was minimum Eagle's medium until day 14 in vitro and Waymouth's MD 705/l medium thereafter. Both media were supplemented with insulin (5 micrograms/ml), transferrin (10 micrograms/ml) and fatty acid-free bovine serum albumin (0.5 mg/ml). In these conditions, without addition of growth factors, the culture was enriched in ependymal cells; with the addition of thrombin cell growth was stimulated and moreover a nearly pure culture of ependymal cells was obtained. In this very simple culture medium, cells looked healthy up to two months after seeding and about 75% of the cells were ciliated. In a fraction of these cells the glial fibrillary acidic protein, a protein specific for astroglial cells in the central nervous system, was immunohistochemically revealed. The availability of an almost pure primary culture of ependymal cells will make many studies possible on this cell type, particularly studies on the development of these cells, on the regulation of their genetic expression and on their physiological function. PMID- 3955371 TI - The effect of neuronal activity on the competitive elimination of neuromuscular junctions in tissue culture. AB - The number of functional contacts between neurones of explanted ciliary ganglia and cultured muscle cells of the chicken, was determined electrophysiologically. After one week in culture the average muscle cell in the vicinity of a ganglion appeared to have contact with 2.5 neurones. This innervation remained unchanged during the next week. Electrophysiological measurements and a morphological study showed that the initial polyneuronal innervation was not confined to one site on the muscle cell, junctions were often found at a distance of 100 micron from one another. 'Phasic' stimulation (intermittent 2-s trains of 60 stimuli) of the neurones of a ganglion during one day or more caused most muscle cells to become mononeuronally innervated. Some muscle cells lost all functional contacts with the neurones. 'Tonic' stimulation, however (3 or 6 Hz continuously), even during one week and with the same total number of stimuli as the 'phasic' stimulation, produced no alteration in the distribution of the contacts. If two ganglia innervated the same muscle cells, after one week in culture twice as many neuronal contacts were found per muscle cell, equally divided over both ganglia. 'Phasic' stimulation of one of a pair of two ganglia eliminated nearly all functional contacts with the non-stimulated ganglion, whereas the innervation from the active ganglion became mononeuronal on most muscle cells. It is concluded that in tissue culture activity related mechanisms have a decisive influence upon the development of either polyneuronal or mononeuronal innervation of muscle cells. The results demonstrate that the signal for the elimination of supernumerary synapses in tissue culture is mediated by the postsynaptic cell, a mechanism which may also act in vivo. It is suggested that this signal may be the local depolarization around the surviving synapse. PMID- 3955373 TI - A quantitative developmental study of neutral lipids during myelinogenesis in the peripheral nervous system of normal and trembler mice. AB - The quantitative accumulation of neutral lipids during the period of myelination in the peripheral nervous system was studied in normal and trembler mouse sciatic nerves, between the ages of 5 and 27 days. Neutral lipids were resolved by high performance thin-layer chromatography, using the solvent mixture hexane/diethyl ether/acetic acid (90:15:2, v/v/v). The lipids were quantitated, after copper acetate/phosphoric acid charring, by densitometric scanning, using an external standard technique. Cholesterol and triacylglycerols accumulated in normal nerves throughout the period studied, while cholesteryl esters were not observed at any age. In trembler nerves, the accumulation of cholesterol took place at a much lower rate than in normal nerves and this lipid was deficient from the earliest stages of development. Triacylglycerols were not significantly deficient in trembler nerves during the first 2-3 weeks, but, after the age of 18 days, their quantity diminished significantly. Cholesteryl esters were first detected in the mutant nerves at the age of 18 days. These results, in agreement with those of a previous developmental study of the polar lipids, are strongly in favour of the view that the trembler mutation directly induces a process of dysmyelination and that demyelination is a secondary event. PMID- 3955372 TI - The developmental appearance of alpha-bungarotoxin binding sites on rodent spinal cord neurons in cell culture. AB - [125I]alpha-Bungarotoxin specifically binds to a subpopulation of rodent spinal cord neurons in vitro. Binding first becomes apparent between 1 and 2 weeks in culture and then increases dramatically after 3 weeks. Similarly, cell suspensions from freshly dissociated embryonic spinal cords do not bind toxin whereas cell suspensions from 1 week old neonates demonstrate specific binding of [125I]alpha-bungarotoxin. In vitro, binding is inhibited more effectively in the presence of nicotinic rather than muscarinic agents. Autoradiography of [125I]alpha-bungarotoxin binding to 4-week-old cultures revealed a uniform labeling pattern over cell somas and processes. Although the relation of toxin binding to functional acetylcholine receptors is not known, the appearance of toxin binding sites may have some developmental significance for the maturation of cholinergic transmission or the maintenance of synaptic connections. PMID- 3955374 TI - Effect of hypoxia on brainstem concentration of biogenic amines in postnatal rabbits. AB - The effects of hypoxia FiO2 = 0.10 on concentration of biogenic amines in specific brainstem nuclear groups were investigated in 3-and 21-day-old rabbits. The rabbit pups were confined to temperature-controlled water-jacketed chambers and exposed to 6h of 21% O2 or to one of 3 combinations of 21% O2 and 10% O2. These 3 combinations were either intermittent hypoxia, or 4 h of normoxia followed by 2 h constant hypoxia, or 2 h of hypoxia followed by recovery for 4 h in normoxia. Radioenzymatic assays were used to determine the concentration of dopamine, norepinephrine and serotonin in the following brainstem nuclei: substantia nigra, locus coeruleus, dorsal raphe and the nucleus reticularis pontis oralis. Compared with control, hypoxia did not affect dopamine levels at either age. The concentration of norepinephrine was inconsistently affected by hypoxia at either age. In contrast, in the 3-day-old rabbits serotonin was consistently reduced in each of the nuclei. In the 21-day-old rabbits, serotonin was either unchanged or increased following hypoxia. Our results show that hypoxia alters the concentration of serotonin in an age-specific manner. This change in serotonin concentration may reflect altered serotonin metabolism and suggests a possible mechanism by which hypoxia disrupts physiologic homeostasis in newborns. PMID- 3955375 TI - Morphogenesis of the mossy fiber synapses in the hippocampus of the rhesus monkey. AB - Morphogenesis of the hippocampal mossy fiber synapses (MFSs) in fetal and postnatal rhesus monkeys was examined by electron microscopy. Typical invaginated MFSs were absent on gestation days 90 and 109 and were detected infrequently on day 132. In older fetuses and postnatal animals of 16 days and 9 months of age, the percentage of invaginated MFSs increased and the synapses exhibited increases in the number of invaginated spines and density of synaptic vesicles and greater maturity of the spines. At all ages, MFSs exhibited a wide range of maturity which may be correlated with the reported protracted generation of dentate granule cells in the rhesus monkey. The pattern of morphogenesis of MFSs in the monkey suggests that as in the rat, it is very likely that the mossy fibers contact pyramidal cells prior to the emergence of the 'thorny excrescences' and that this is followed by progressive maturation of the MFSs. The time-course of major morphogenetic modifications in MFSs in the rhesus monkey corresponds to the period of elaboration of complex spines and synapses in the dentate molecular layer. On this basis, it is suggested that these two processes are interrelated developmental events. PMID- 3955376 TI - Does axonal branching contribute to the overproduction of optic nerve fibers during early development of the cat's visual system? AB - The number of axons within the optic nerve of the fetal cat was found to be no greater near the chiasm than near the eye. This suggests that the overabundance of axons present in the developing nerve results from a corresponding excess of retinal ganglion cells, and that the elimination of optic fibers that occurs during normal development is principally due to the loss of ganglion cells and not to the elimination of axonal branches. PMID- 3955377 TI - Numbers of rat dorsal root axons and ganglion cells during postnatal development. AB - The present study demonstrates that T4 and S2 rat dorsal root axons decrease significantly from birth to adulthood with almost all of the decrease occurring in the first two weeks of life. Dorsal root ganglion cell numbers do not change during this time period. This is thus an example of postnatal axon elimination not associated with death of the cells that give rise to the axons. Presumably this regressive process is important in the formation of the normal adult nervous system. In addition, these findings raise the possibility that certain types of neonatal denervation may increase adult axon numbers by stopping a regressive process, the loss of axons, rather than initiating a progressive process, the formation of new axons. PMID- 3955378 TI - Somatotopic analysis of fibre and terminal distribution in the primate corticospinal pathway. AB - This is an anatomical study of the precision of fibre and terminal orderliness in the direct corticospinal projection. It was conducted to assess the degree of somatotopy in this projection in primates and to deduce the mechanism(s) possibly responsible for guiding fibres to their segmental destinations in development. As fibres leave the cortex they are grouped in an orderly way so as to be placed (within the pathway cross-section) according to their points of origin. Systematic neighbourhood relations are rather abruptly broken down as the descending pathway traverses the pons. Fibres are randomly distributed within each medullary pyramid and this disorderliness is maintained throughout the spinal pathway in the dorsolateral columns. Nonetheless, fibres exciting thumb movements end selectively at cervical levels. Fibres exciting foot movements end preferentially at lumbar levels but also show a secondary maximum of terminations in cervical segments, with relatively few terminations at intervening thoracic levels. These two sets of fibres ('thumb', 'foot') are derived from distinct, separate subareas of motor cortex and pass through exclusive, separate zones of the internal capsule. Thus, developmental contact guidance between somatotopically originating neighbours is inadequate to account for the observed specificity of corticospinal fibre destinations. Fibres must be observing distinctive local segmental cues (perhaps of cytochemical nature) and/or utilising somatotopically distinctive arrival sequencing (i.e. securing specific destinations without neuronal recognition). PMID- 3955379 TI - Estrogen treatment enhances survival of cultured fetal rat amygdala neurons in a defined medium. AB - Effects of estradiol on the survival of cultured fetal rat amygdala neurons were estimated to assess a possible organizational action of the sex steroid on the developing amygdala tissue. Dissociated 17-day fetal amygdala cells were cultivated initially in a serum-containing and then in a serum-free defined medium. The survival of the cells in the serum-free medium was highly enhanced when supplemented with estradiol at the concentration of 10 ng/ml. Predominant cell populations of the culture were identified as neuronal cells by the tetanus toxin labeling method. The results support the idea that sex steroids play a role in the brain sexual differentiation by enhancing the neuronal survival in the developing amygdala tissue. PMID- 3955380 TI - Quantitative analysis of dendritic protrusions in the medial preoptic area during postnatal development. AB - Dendritic architecture and distribution of dendritic protrusions were studied on Golgi-impregnated neurons in the medial preoptic area (MPOA) of infant rats (7 and 20 days old), of animals at puberty (34 days old) and of postpubertal rats (90 days old) using computerized image analysis. The protrusions showed a peak distribution on the proximal portion of the dendritic tree in infant rats. At puberty and in postpubertal animals protrusions disappeared almost completely along the most proximal portion of the dendritic tree. The data suggest that differentiation of certain MPOA neurons is still in progress at puberty. PMID- 3955381 TI - A quantitative analysis of the ipsilateral cerebellothalamic projection following hemicerebellectomy in neonatal rats. A retrograde HRP study. AB - Anatomical and physiological studies in adult rats following neonatal hemicerebellectomy reveal that the intact half of the cerebellum is capable of remodeling its connections to the ipsilateral thalamus. The present study investigates to what extent additional cerebellar neurons project to the ipsilateral thalamus in the remodeled pathway using a retrograde horseradish peroxidase (HRP) technique. Left hemicerebellectomies were performed on Sprague Dawley rats within 24 h after birth. An injection of HRP was made into the right thalamus when the animals reached adult size. Unoperated control animals were similarly injected with HRP. Labeled cells were counted in the following ipsilateral cerebellar nuclei: fastigial nucleus (FN), anterior interpositus nucleus (AIN), posterior interpositus nucleus (PIN), dorsal lateral hump (DLH) and dentate nucleus (DN). Total cell counts revealed a 4-fold increase in the number of labeled cells in the experimental group vs the control group. Significant increases in the number of labeled cells were observed in the AIN, PIN, DLH and DN; however, the number of labeled cells in the FN did not differ between the two groups. Comparison of the proportional amount of labeling, relative to each nucleus, indicates that there is a decrease in the FN and an increase in the AIN, PIN, DLH and DN. These numerical data are supported by statistical analysis (Mann-Whitney U-test and Student's t-test, P less than 0.05). The data are supportive of the original hypothesis that the ipsilateral cerebellothalamic projection increases following neonatal hemicerebellectomy. The results also suggest that the reorganized pathway attempts to mirror the normal contralateral cerebellothalamic projection. PMID- 3955382 TI - Vasopressin and oxytocin in the developing rat brain as shown by isoelectric focusing of radioimmunoassayable peptides. AB - Vasopressin and oxytocin content were measured by radioimmunoassay in tissue extracts from rat pituitary, hypothalamus and the extrahypothalamic brain from gestational day 14 until postnatal day 14. Assayable compounds were subsequently characterized by isoelectric focusing in gels. Fetal day 14 extracts contained only low amounts of both hormones (around 1-2 pg per fetus). Vasopressin content rapidly increased to levels of 41 ng in pituitary, 20 ng in hypothalamus, 0.3 ng in extrahypothalamic brain on postnatal day 14. Oxytocin content showed only measurable amounts around day 20 prenatally, reaching levels of, respectively, 10, 0.5 and 0.2 ng on postnatal day 14. The presence of radioimmunoassayable vasopressin in the extrahypothalamic brain on fetal day 14 (around 2 pg) confirms the early ontogeny of vasopressinergic innervation of the brain. Whenever measurable, immunoreactivity had an isoelectric point similar to that of synthetic vasopressin or oxytocin. The possibility that the detected amounts of vasopressin were due to vasotocin, which had been claimed to be present in fetal brain, was excluded by comparison of the regression coefficients of serial dilutions of the extracts in the radioimmunoassay with those of synthetic vasotocin or vasopressin. PMID- 3955383 TI - Newborn rat retinal cells transplanted into a retinal lesion site in adult host eyes. AB - We report the successful grafting of embryonic (newborn) rat retina into a lesion site (die-back zone) of an adult retina with a corresponding 90-100% survival rate. A penetrating lesion was made through the sclera, choroid and retina on the superior surface of the host eye and closed with microsutures. The lesion site was either allowed to stabilize for 5 weeks or immediately received a retinal graft. Retinas were removed from 1-day-old neonate donors, drawn through a small gauge needle and injected into the fresh or stabilized lesion site. Host animals were sacrificed and the eyes processed for light, scanning- and transmission electron microscopic analysis at 1, 2, and 4 weeks after grafting. Analysis of sections through grafted tissue within the lesion site revealed that the neonatal cells not only survived at all times examined but also continued their development reminiscent of normal littermate controls. Examination of 4-week grafts revealed a laminar pattern similar to adult ganglion cell, inner plexiform, inner nuclear, and outer plexiform layers as well as developing photoreceptor neurons. The grafted tissue could easily be delivered into the retinal lesion site where it established a pattern of retinal layers within the die-back zone. In addition, the plexiform areas of the graft appeared to integrate with those of the host. The age of the adult retina lesion transplantation site had little effect on the graft/host integrative phenomenon. These studies show for the first time a method utilizing immature retinal grafts to fill and/or bridge the wound area of the lesioned adult mammalian retina. These observations also demonstrate the utility of using this model for the study of numerous retinal developmental phenomena. PMID- 3955384 TI - The sialagogue response of striatal dopamine receptors to L-dopa is not influenced by castration or chronic estrogen treatment. AB - The secretory response of salivary glands to L-dopa, elicited by stimulation of dopamine receptors in the striatum and the circling behavior induced by apomorphine in animals bearing a unilateral kainic lesion of the entopeduncular nucleus, was studied in intact and ovariectomized female rats. Castration did not modify the sialagogue response to L-dopa, while the turning behavior was significantly increased. Daily administration of 17-beta-estradiol benzoate during 7 days to ovariectomized rats decreased the circling activity to the level of intact female rats, while the salivary secretion to L-dopa was unaffected. The above findings suggest that the sialagogue response induced by L-dopa may be due to the interaction of this agonist with D1 striatal receptors, whose activity is not influenced by estrogens. However, we cannot rule out any possible alteration in the metabolism and/or presynaptic conversion of L-dopa to dopamine by estrogen treatment. The changes in turning behavior may be attributed to an antidopaminergic effect of estrogens and/or, like L-dopa, to modifications in the metabolism of apomorphine induced by the hormone. PMID- 3955385 TI - Comparison of rostro-caudal brain stem influence on preoptic neurons and cortical EEG. AB - The changes in activity of preoptic area (POA) neurons, and cortical EEG, upon stimulation of the caudal brain stem reticular formation (CBS) and the rostral brain stem reticular formation (RBS) are compared in this study. Low frequency (LF) stimulation of the CBS (which induced EEG synchronization) and the RBS (which generally did not affect the EEG) had an excitatory influence on a majority of the affected neurons of the POA. In contrast, high frequency (HF) stimulation of the CBS (which produced EEG desynchronization in many instances) and the RBS (which induced EEG desynchronization in all instances) resulted in inhibition of a majority of the affected POA neurons. A larger number of neurons responded to HF stimulation of both brain stem regions, as compared to LF stimulation. The changes induced in the POA neurons, upon stimulation of the two brain stem reticular structures, were not dependent on simultaneous changes in the cortical EEG, except during some cases of stimulation-induced EEG desynchronization. PMID- 3955386 TI - An automatic device for determining threshold variations in antidromically activated neurons. AB - A device was designed and constructed with the purpose of evaluating threshold variations for antidromic invasion of extracellularly recorded neurons. Identification of a neuron is carried out by two procedures, an amplitude discriminator, which isolates the spike from the baseline noise, and by a latency window which is set accordingly to the neuron's antidromic latency. During threshold evaluation, the duration of an electric pulse applied to the neuron's axon is automatically varied depending on the presence or not of an action potential. For a given spike, the stimulus is progressively decreased (-delta i) up to a point where the neuron ceases to respond and thereafter, the stimulus amplitude is progressively increased (+delta i) until slightly suprathreshold values are obtained. The procedure guarantees a discharge probability of the neuron equivalent to 50% of all applied stimuli, and the simple monitoring of the stimulus amplitude is enough to obtain the threshold value for a predetermined intensity. The reliability of this device was checked in studies related to threshold variations in neurons antidromically driven in prefrontal cortex following stimulation of the ipsi and contralateral olfactory bulb. Variations in excitability were found during and following tetanic stimulation and throughout the axon's supernormal conduction period. This technique allows the assessment of threshold variations in antidromic driving, not only in the present experimental design, but also in other conditions induced by changes in extracellular ionic concentrations, drug applications or in those produced by excitatory or inhibitory synaptic activity on the neuron under study. PMID- 3955387 TI - Role of bar press-related neurons in the dorsolateral prefrontal cortex during task performance by monkey. AB - Extracellular single neuron activity of the dorsolateral prefrontal cortex (DL) was recorded in the monkey, during bar pressing for reward. The bar press-related neurons which exhibited excitation or inhibition during the bar press period were found to be scattered diffusely in the DL. Activity changes that arose during the bar press period also appeared when the experimenter pressed the bar for the monkey. When delivery of food was delayed for a random time after cue tone on, bar press responses were still confined to the bar press period and did not extend beyond the cue tone. These results, together with the lesion studies, suggest that bar press-related neurons are involved in the animal's concentration during the bar press period. PMID- 3955388 TI - Activation of specific central dopamine pathways: locomotion and footshock. AB - The present study examined whether neostriatal monoamine biochemistry was activated in a bilaterally symmetrical fashion during a non-lateralized forward locomotor task, and whether specific midbrain dopamine (DA) neuronal systems were influenced selectively by specific behavioral tasks. Monoamine concentrations (DA, serotonin and their metabolites) were measured, using high pressure liquid chromatography, in the neostriatum, nucleus accumbens, and medial prefrontal cortex in rats that were either induced to walk forward in a motorized rotating wheel (two speeds) or were exposed to footshock stress (two shock intensities). Our results demonstrate that during locomotor behavior there is an increase in neostriatal DA metabolism, but not in serotonin metabolism. Furthermore, the increase in DA metabolism was found: (a) in both right and left neostriatal nuclei, but with significantly less asymmetry than occurred in non-locomoting control rats; and (b) within the neostriatum at both speeds and also in the nucleus accumbens at the higher speed. Locomotion had no effect on DA metabolism in the prefrontal cortex. With both shock intensities there was increased DA metabolism in the prefrontal cortex, whereas during the low shock intensity there was also an increased DA metabolism in the nucleus accumbens. At the high level of footshock, which evoked jumping and running escape behavior, there was also an increase in neostriatal DA metabolism. These data indicate that a non-lateralized forward locomotor task activates DA metabolism primarily in the less metabolically active hemisphere. Secondly, we found that specific subgroups of midbrain DA neurons can be selectively activated by specific behavioral tasks. PMID- 3955389 TI - Localization of responses in the somatosensory thalamus of the rat. AB - In the monkey and cat electrophysiological studies have indicated that unit response characteristics can be correlated with anatomical divisions in the somatosensory thalamus. In the rat, however, one study has suggested that the ventrobasal (VB) and posterior (PO) complexes are not functionally distinct [7]. In the present study, therefore, an attempt was made to correlate anatomical localization and unit response characteristics in the rat. We found that in the VB complex, units responding to light touch (LT) were more common than in the PO complex (45% vs. 9%), while in the PO complex, nociceptive units were more numerous than in the VB complex (55% vs. 38%). In the VB complex LT units had a somatotopic organization; in the PO complex they did not. Within the VB complex all LT units in the ventral posteromedial nucleus had receptive fields on the head; most ventral posterolateral nucleus LT units had receptive fields on the body. These results indicate that a correlation between unit response characteristics and localization does exist in the rat. PMID- 3955390 TI - Increased vasopressinergic activity following DOCA administration in the rat. AB - The dynamics of hypothalamic arginine vasopressin (AVP) release was examined during the development of hypertension in rats with deoxycorticosterone (DOCA) NaCL induced hypertension. Experiments were performed in four groups of uninephrectomized Sprague-Dawley rats 3, 7, 14 and 21 days after treatment with: (I) DOCA and 1% saline (DOCA-NaCl); (II) DOCA, regular chow, and tap water (DOCA R-H2O); (III) regular chow and 1% saline (NaCl); and (IV) regular chow and tap water (H2O). Systolic blood pressure (BP) was significantly elevated in DOCA-NaCl and DOCA-R-H2O (183 +/- 5 and 155 +/- 4 mm Hg, respectively) but not in an additional control group which received DOCA and a low NaCl diet (119 +/- 2 mm Hg). Plasma AVP and hypothalamic AVP release were increased in all DOCA treated groups at each time point studied, while plasma osmolality was similar in each group. These studies demonstrate increases in the hypothalamic release of AVP in DOCA-NaCl hypertensive animals, but suggest that they are due to the mineralocorticoid and are independent of blood pressure and NaCl intake. PMID- 3955391 TI - [The teaching of mental hygiene in the medical curriculum]. PMID- 3955393 TI - [Motor activity and blood cortisol]. PMID- 3955392 TI - [Comparison of the dopaminergic activity of the new Czechoslovak ergoline derivate transdihydrolisuride (Tergurid Spofa) with lisuride]. PMID- 3955394 TI - [Changes in the levels of fatty acids in the plasma during hypokinesis]. PMID- 3955395 TI - [The effect of methaqualone on the agonistic behavior of laboratory mice]. PMID- 3955396 TI - [Toxic effect of cisplatin and certain platinum complexes of the 2d generation (CHIP, oxoplatina) on the gastrointestinal tract in rats]. PMID- 3955397 TI - [Supraventricular paroxysmal tachycardia in children]. PMID- 3955398 TI - [Etiologic factors in habitual spontaneous abortions in the 1st pregnancy trimester]. PMID- 3955399 TI - [Decompressionless hyperbaric exposure in diving practice]. PMID- 3955400 TI - [Fat embolism in experimental hemorrhagic shock in rabbits]. PMID- 3955401 TI - [Preclinical study of the pharmacodynamic and toxicologic effects of the antiarrhythmic agent, mexiletine]. PMID- 3955402 TI - [Pharmacokinetics and biological availability of drug forms of mexiletine in dogs]. PMID- 3955403 TI - [Morphologic changes in L-fibroblasts induced by heptacaine and studied by scanning electron microscopy]. PMID- 3955404 TI - [Selected immunologic parameters in peripheral blood and bronchoalveolar lavage in various forms of pulmonary fibrosis]. PMID- 3955405 TI - [Preliminary results of toxoplasmosis screening in selected population groups]. PMID- 3955406 TI - [Estimation of pathogenic factors in mental disorders by medical students and psychiatrists]. PMID- 3955407 TI - [New approaches in genetic toxicology]. PMID- 3955408 TI - [The effect of catecholamines and histamine on liver circulation]. PMID- 3955409 TI - [The effect of DH 1011 (Stobadin) on myocardial circulation and the size of the infarct after experimental coronary occlusion]. PMID- 3955411 TI - [The effect of sex hormones on passive resistance of the coronary vascular bed in rats exposed to long-term training]. PMID- 3955410 TI - [Protective effect of Stobadin (DH 1011) on the ischemic myocardium in rats]. PMID- 3955412 TI - [Interaction of togaviruses with cultured pancreatic tissue of experimental animals as a criterium of its viability]. PMID- 3955413 TI - [Personal experience with monitoring the effects of heparin during cardiosurgical operations using artificial blood circulation]. PMID- 3955414 TI - [Biological characteristics of bacteria of the Pseudomonas strain with emphasis on their toxigenic properties]. PMID- 3955415 TI - [Possibilities of using low-ionic solutions in immunohematology]. PMID- 3955416 TI - [The significance of computerized tomography in studying radiographically contrasted bodies in the knee]. PMID- 3955417 TI - Nonpalpable, needle-localized mammographic abnormalities: pathologic correlation in 219 patients:. AB - The mammographic findings and pathologic results in 219 patients biopsied after preoperative needle localization for nonpalpable breast lesions are reviewed here. Microcalcifications and masses of varying configuration are evaluated. Smooth masses showed no evidence of malignancy. Microcalcifications of five or more and stellate masses had a high incidence of malignancy. Masses with minimal irregularity not associated with microcalcifications had a low incidence of malignancy. In 63 patients in whom a breast cancer was found, excluding two initially examined because of known metastatic disease, 88% were later found to be free of disease in axillary lymph nodes. PMID- 3955418 TI - Tissue deposition of bisantrene in B16 melanoma tumor-bearing mice. AB - Single doses of 14C-labeled bisantrene, a new antitumor agent, were administered intravenously at 10 and 100 mg/kg to mice bearing intraperitoneally implanted B16 melanoma. At 24 hr after dosing, the tumors contained relatively high drug concentrations as compared to most of the other tissues. The concentrations averaged 2.4 and 28.3 micrograms/g tumor and the tumor/blood concentration ratios were 40/1 and 29/1 for the low and high doses, respectively. PMID- 3955419 TI - Selective modifications of cellular proteins in intratumoral subpopulations of human colonic carcinoma cells. AB - Molecular alterations of cellular proteins were assessed in three previously described subpopulations of human colon carcinoma cells that were originally isolated from a single human primary colon carcinoma. The subpopulations designated HCT 116b, HCT 116, and HCT 116a exhibited significant differences in their expression of several biological properties. Immunoautoradiographic analysis of membrane components, fractionated by SDS-PAGE and electrophoretically transferred onto nitrocellulose sheets, distinguished the most aggressive tumor cell subpopulation from the intermediate and least aggressive subpopulations. An elevated expression of antigens of molecular weight in the range of 116-120 kd, 92 kd, 55-66 kd, and 31 kd was found to be associated with the most aggressive subpopulation of HCT 116a cells. The binding pattern of RCA I and WGA lectins to membrane components, fractionated by SDS-PAGE and fixed on nitrocellulose, also distinguished the three subpopulations of cells. Elevated bindings of RCA I to 80 92 kd components of HCT 116b cells and elevated bindings of WGA to 120 kd components of HCT 116a cells distinguished the three subpopulations from one another. Analysis of cellular phosphoprotein profiles, following labeling of the cells with 32Pi in the presence of phosphate-free medium, further distinguished the most aggressive subpopulation from the intermediate and least aggressive subpopulations. High level of phosphorylation of 120 kd and 250 kd nuclear components, 30 and 90 kd cytosolic components, and low level of phosphorylation of lower molecular weight membrane components were found to be associated with the most aggressive subpopulation. It is concluded that differences in the expression of membrane antigens, differences in the glycosylation of membrane components, and the selective phosphorylation and/or dephosphorylation of cellular proteins exist in subpopulations of intratumoral colonic carcinoma cells with different biological properties. These biochemical alterations of cellular proteins may play an important role in the generation of phenotypic diversity and heterogeneity of malignant cells. PMID- 3955420 TI - The use of the colposcope in the diagnosis of sexual abuse in the pediatric age group. AB - This brief communication by Woodling and Heger on the use of colposcopy in the assessment of children who may have been sexually exploited raises some interesting and exciting new dimensions to our diagnostic approach. These are presented by the authors as early findings. The readers should note that standards have not yet been established completely, and findings in normal children need to be further delineated, especially for young girls who are athletically inclined, e.g., gymnists as well as victims of accidental genital trauma. Our field urgently awaits these data. PMID- 3955421 TI - Combating child abuse and neglect in developing and newly industrializing countries: a unique primary health care approach. PMID- 3955422 TI - Parents anonymous: helping clients to accept professional services, a personal opinion. PMID- 3955423 TI - Munchausen syndrome by proxy. PMID- 3955424 TI - A clinical-demographic study of sexually abused children. AB - Forty-five children who had been sexually abused were psychologically evaluated. Parents or guardians of the children completed symptom checklists. Results indicated that the majority of children (71%) were abused 4 or fewer times. In addition, genital manipulation and/or fondling was the most common form of abuse. In 82% of the cases, there were no marital separations or family breakups of any kind within six months before or six months after the abuse. Many children (69%) displayed psychological symptoms. The most frequent were nightmares, bedwetting, clinging behavior, inappropriate sexual behavior, anxiety and sadness. Results of this study are largely inconsistent with popular notions about the nature of child sexual abuse. The major methodological shortcoming of the investigation was the lack of a systematic control group. PMID- 3955425 TI - Scarring for life: abuse with electric cords. AB - The authors studied 78 cases of child abuse in which electric cords were used to discipline children. Abuse was usually chronic, and body scars and/or lacerations, usually linear or looped in shape, were found on 95% of these children. Black children over age 5 years were most often the victims. The most commonly injured and/or scarred body sites were the arms, thighs, and back. The majority of perpetrators were single female heads of household raising more than one child, who did not perceive their use of electric cords to discipline children as inappropriate. PMID- 3955426 TI - Munchausen syndrome by proxy. AB - Munchausen syndrome by proxy is a form of child abuse in which a disorder of the child is fabricated by a parent. Although often considered rare, it may have been overlooked frequently in the past. The reported cases of children with Munchausen syndrome by proxy range in age from infancy to 8 years. Their "illnesses" consist of fabricated histories, inflicted physical findings, altered laboratory specimens, and induced disorders. The perpetrator usually is the child's mother, who may have Munchausen syndrome. Consequences of the syndrome may include painful tests, frequent hospitalizations, potentially harmful treatment, and death. The diagnosis can be made when medical and social histories are characteristic of the syndrome and clinical findings are absent, suggestive of induced illness, or resolve upon separation of the child and parent. Suspicion of the syndrome should be discussed with the family once the safety of the child is insured, and the case should be reported under the child abuse reporting law of the state. Social, family, and medical histories must be obtained and verified, and court intervention should be considered. Four patients who illustrate typical features of the syndrome are described. PMID- 3955427 TI - Right to healthy birth: medico-legal issues in phencyclidine ingestion. AB - Child abuse is a multifaceted issue which requires a multidisciplinary approach. To date, child abuse has dealt only with the born child. With the panepidemic abuse of phencyclidine (PCP), and the knowledge that it will remain in the body greater than one year, the concept of child abuse in utero and preconception must be considered. This paper addresses this topic. Legal intervention concerning "wrongful birth and wrongful life" is raised. Legislative solutions permitting further research as well as assisting the healthy birth of viable fetuses on phencyclidine are also recommended. PMID- 3955428 TI - [Evaluation in primary prevention: an obligation, I. The obstetrical point of view]. AB - Evaluation of research in primary prevention is often complicated. Various objections and difficulties are discussed: imprecision or lack of practical definition of the child abuse syndrome, definition of primary prevention, lack of epidemiological data, and the existence of ethical problems. Obstetrical models of evaluation are proposed: evaluation of screening methods, postpartum follow-up and contraception, action against prematurity, and unfollowed pregnancies. Results of a four-year antenatal program are presented as indicators and may be served to determine the efficiency of preventive action. Therefore, evaluation of antenatal prevention is possible for at-risk parents. PMID- 3955429 TI - The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women. AB - The purpose of the present study was to explore the relationship of childhood sexual abuse with later psychological and sexual adjustment. Subjects were 383 female college students recruited from undergraduate psychology classes. Each was asked to complete a packet which contained a victimization questionnaire as well as measures of adjustment. A number of small, but significant, relationships were found between a history of childhood sexual abuse and measures of later psychological and sexual adjustment. In light of the relationship between family background and sexual abuse, however, it was questioned whether these associations were due to the sexual abuse per se, or were due to the confounding of sexual abuse with family background. Indeed, once parental supportiveness was controlled, very few significant relationships emerged. There was a trend, however, for the significant correlations to involve the sexual measures rather than the more general adjustment measures. The implications of the current findings, particularly for future research, were discussed. PMID- 3955430 TI - [Evaluation in primary prevention: a must, II, The child psychiatry point of view]. AB - The evaluation of any antenatal prevention program of child abuse and neglect is limited for statistical and ethical reasons, as shown in the first part of the present study (cf., The obstetrical viewpoint by G. Soumenkoff). The authors propose a child psychiatry model of evaluation. Use of the model is illustrated by a 4-year survey of 374 selected high-risk pregnant women followed in the antenatal out-patient department of St. Pieters Hospital in Brussels. A child psychiatrist worked together with several gynecologists, supporting the high-risk couples as well as their children. Several indirect evaluation methods of the quality of screening and the efficiency of the work are analyzed. Long-term evaluation of the children is an absolute necessity. In order to evaluate this type of approach, a simple questionnaire concerning the quality of life of the children under study was derived from a model used in pediatric oncology by the EORTC and adapted to the problems of abused children. One part was answered by the parents which allowed the researchers to evaluate their perception of the child. The second part was filled out by the sociomedical professionals who followed the child. The combination of these two views is rich in information concerning the patient as well as the parents' attitude toward their child. PMID- 3955431 TI - The psychosocial adjustment of maltreated children: methodological limitations and guidelines for future research. AB - Several empirical studies on the impact of maltreatment on children's psychosocial adjustment were recently reviewed in this journal [1]. Following a brief overview of the findings from that article, the present paper summarizes the methodological limitations of the studies reviewed and discusses guidelines for future research in this area. In order to advance knowledge of child maltreatment sequelae, we suggest future studies should include the following: precise operational definitions of maltreatment; adequate verification of the absence of maltreatment in the control groups; identification and control of maltreatment covariates; and consideration of subjects' age in group assignment. Future investigations should also employ more longitudinal research designs and give more attention to the treatment needs of the child. PMID- 3955433 TI - Evaluation of a brief intervention for educating school children in awareness of physical and sexual abuse. AB - The development and evaluation of procedures for imparting information to children regarding inappropriate treatment by adults is a challenging task that warrants increased methodological sophistication. The present study was conducted to evaluate proximal changes in fourth and fifth graders' knowledge and attitudes of physical and sexual abuse following brief skits and focal discussion in the classroom. The study used a control group of children that did not receive the intervention, which permitted a more accurate understanding of the program's effectiveness. Relative to controls, children who received the program showed an overall increase in knowledge of correct actions to take in the event of potential or actual abuse. Limitations of the study, as well as suggestions for broadening the scope and impact of child abuse prevention programs for children are discussed in relation to these findings. PMID- 3955432 TI - Clinical data used by pediatric residents to assess parenting. AB - To determine how pediatricians assess parenting at well-child visits, pediatric residents were interviewed following the well-child visit of a child less than 24 months of age. Using a structured format, the residents were interviewed about their judgments concerning the characteristics of the mother just seen and the data used to make these judgments. In addition, ratings were made of the quality of the descriptions of the parents. Fifty interviews, 2 each with 25 residents, were completed. Residents described the parenting abilities of 82% of the mothers in predominantly positive terms and 18% in negative terms. To make these judgments, residents relied on one or more of five categories of data: how mothers used the medical system (98%); observations during the office visit of the mother-child interactions (96%), of the child (74%), and of the mother (68%); and information obtained by interview about the mother's caregiving skills and her feelings toward the child (50%). In 30% of cases the residents' descriptions of the mother contained only minimal information. We conclude that residents rely more on observational data than data acquired during the interview. These findings suggest that residency training programs should sharpen the residents' ability to make behavioral observations and teach more effectively the process of interviewing so that residents will be able to make appropriate assessments of parenting skills. PMID- 3955434 TI - Child abuse in institutions: the case of day-care centers in Nigeria. AB - The authors examine the day-care center in Nigeria as a potential locus for child abuse and neglect by reanalyzing the data from available studies which were originally designed to assess quality of care in centers and not child abuse or neglect. A slightly modified version of the categories of abuse and neglect, delineated by Giovannoni and Becerra, is employed. Preliminary results suggest that substance abuse, verbal abuse and aspects of physical neglect related to housing and cleanliness of the facility may be the categories where research should be focused. The authors note the lack of normative data with reference to determining abuse and neglect in the Nigerian context. PMID- 3955435 TI - Identifying, screening and engaging high-risk clients in private non-profit child abuse prevention programs. AB - Child abuse prevention programs rely on varied strategies to identify, screen, obtain referrals of, and engage high risk parents. Available literature on community-based child abuse prevention projects is not conclusive about project outcomes nor sufficiently descriptive about implementation. From the literature, experience and interviews with staff from more than 20 programs, barriers to implementation are identifiable. Barriers arise during identifying and screening at-risk families, referral, continued collaboration with referrers, and engaging clients in services. The paper describes a diverse set of strategies for surmounting these barriers. Staff characteristics and concrete services partially predict the success of program implementation. So does the program's relationship to other agencies. Child abuse prevention programs assume independent, interdependent, and dependent relationships with other agencies and referrers. Interdependent programs appear to have the best chance of obtaining referrals and maintaining clients who match their program's intent. PMID- 3955436 TI - The ocular ischemic syndrome. PMID- 3955437 TI - Pars plana vitrectomy and intravitreal silicone oil injection in eyes with rubeosis iridis. AB - We postoperatively evaluated the data from 10 patients who underwent pars plana vitrectomy and intravitreal silicone oil injection for complications of proliferative diabetic retinopathy and rubeosis, or for proliferative vitreoretinopathy and rubeosis. There was no change in the zone of iris affected by the rubeosis or in the calibre of rubeotic vessels. Visual acuity improved in two patients and stayed the same in eight. Retinas were completely attached in 50% and partially attached in 30% of the patients on the last follow-up visit. The use of silicone oil in these patients caused no untoward effects in these severely diseased eyes. PMID- 3955438 TI - Electroretinographic recovery from controlled total ischemia. AB - Three groups of animals were studied during the four-hour period following their recovery from total occlusion of retinal circulation for periods of 30, 60 and 90 minutes. During incremental increases of ischemia, recovery followed a pattern that is the reverse of that previously reported, inasmuch as wave amplitude is concerned. From total extinction, ERGs recovered and showed hyperresponses. Delays, however, behaved differently: they increased with recovery time--the opposite of what was expected. All signs were inversely proportional to the duration of ischemia. Sixty minutes of occlusion appears to be a threshold beyond which ERGs do not recover as well. PMID- 3955439 TI - A composite nature for the photopic b-wave of the human electroretinogram as evidenced by the use of the 60 Hz notch filter. AB - The impact of the 60 Hz notch (rejection) filter was examined in typical photopic electroretinograms recorded with two different bandwidths: 1-1000 Hz and 100-1000 Hz. The peak times of the major ERG components (a- and b-waves) are not modified by the line filter. The amplitude of the b-wave decreases by 30%, and the morphology of the ERG wave changes slightly. Segmental analysis of the ascending limb of the b-wave reveals that the sole reduction in the amplitude of its first step (from the a-wave trough to the peak of the first oscillatory potential) accounts for more than 70% of the overall reduction measured for the b-wave. Similar results are also found in ERGs recorded with the 100-1000 Hz bandwidth. The data suggests that the b-wave of the ERG should be considered as a composite of potentials rather than as a single potential. PMID- 3955440 TI - Magnetic resonance imaging. PMID- 3955441 TI - Check ligaments: surgical effects in infantile esotropia. AB - In a prospective randomized study, we compared the results of surgical treatment of 25 patients with infantile esotropia, using bilateral medial rectus muscle recession of a graded amount without severing the check ligaments, to results obtained with a similar group of 23 patients in whom check ligaments were severed at the time of bimedial surgery. No significant difference could be found in the immediate postoperative and 6-month postoperative ocular alignment of the two groups. PMID- 3955442 TI - Changes in colonic myoelectric spiking activity during stimulation by bisacodyl. AB - The purpose of this study was to determine some relationships between colonic myoelectric spiking activity and intraluminal propulsion when colonic peristalsis was stimulated by bisacodyl. Myoelectric recordings were obtained in 12 subjects by means of a 50 cm long Silastic tube equipped with four bipolar electrodes fixed at 10-cm intervals. The tube was introduced into the left colon by flexible sigmoidoscopy and the electrodes were located at 50, 40, 30, and 20 cm from the anal verge. A small polyethylene catheter opening at the proximal end of the Silastic tube was used for introducing the laxative into the colon. One hour recording sessions were obtained before and after bisacodyl administration (5 mL of 0.4% solution). The control tracings showed that colonic spiking activity was made of rhythmic stationary bursts that occurred at only one electrode site and of sporadic bursts that were either propagating over the whole colonic segment or nonpropagating. Administration of bisacodyl was followed by complete suppression of the rhythmic stationary activity; a considerable increase in the sporadic spiking activity, propagating as well as nonpropagating; the occurrence of abdominal cramps and urgency to defecate, both associated with the propagating sporadic spike bursts. It is concluded that colonic propulsion induced by bisacodyl may be dependent upon the production of the sporadic bursts, particularly the propagating ones, while the rhythmic stationary bursts do not seem to play a significant role in colonic transit. PMID- 3955443 TI - Effect of length changes on sensitivity of helical artery strips to adenosine. AB - The relationship between length and the responses of helical strips of rabbit femoral and coronary arteries to vasoactive agents was investigated by conducting concentration--response determinations at the length for maximum active force (Lmax) and a shorter length. The mean effective dose (ED50) values for norepinephrine (NE) were smaller when femoral artery strips were set at Lmax, in comparison to the values at the shorter length. Maximal relaxation of femoral artery strips by adenosine was greater when the strips were set at Lmax. However, adenosine ED50 values were smaller at Lmax only in groups of strips in which responses at Lmax were obtained prior to those at the shorter length. Experiments with coronary artery strips did not demonstrate consistent relationships between strip length and ED50 values for acetylcholine (ACh) or adenosine. The results of experiments with artery strips from normotensive and those from one-kidney, one clip hypertensive rabbits were similar. Thus, the femoral artery data indicate that helical artery strip preparations may exhibit length-dependent sensitivity to a vasodilator agent as well as vasoconstrictor agents under certain experimental conditions. However, the coronary artery data suggest that length may not affect sensitivity of isolated artery preparations from all vascular beds in the same manner. PMID- 3955444 TI - Effect of acetylcholine and secretin on medullary collecting duct function in the rat. AB - Microcatheterization was used to study the effect of renal arterial infusion of acetylcholine or secretin on medullary collecting duct function in anaesthetized rats. Acetylcholine infusion was associated with natriuresis and increased sodium delivery to, and decreased reabsorption in, the collecting duct. No changes from control function were found with secretin. Renal blood flow was increased with acetylcholine (+82%, p less than 0.001), but unchanged with secretin (+15%, nonsignificant). We conclude that acetylcholine natriuresis is due to inhibition of tubular reabsorption of sodium in the medullary collecting duct, as well as in upstream nephron segments. While the latter may be hemodynamically mediated, the former indicates a direct transport effect of the hormone in the terminal nephron segment. PMID- 3955445 TI - Acute effect of salmon calcitonin on renal magnesium transport in the magnesium loaded rat. AB - The present studies were undertaken to examine whether salmon calcitonin, by increasing magnesium reabsorption in the thick ascending limb, and presumably the tubulointerstitial magnesium concentration gradient, would lead to an increase in fractional magnesium delivery to the end-descending limb (magnesium secretion) in magnesium-loaded rats. Thyroparathyroidectomized, postprandial Munich--Wistar rats were prepared for micropuncture of papillary end-descending limbs and of superficial end-accessible proximal tubules. Group 1 served as clonidine-water diuresis time controls; group 2 was treated as group 1 but also received synthetic salmon calcitonin (10 mU/min); and group 3 was treated as group 2 but also received calcium chloride intravenously. Calcitonin, alone or with calcium, produced a significant fall in fractional magnesium excretion. A significant relationship was also observed between fractional magnesium excretion and urine flow rate (r = 0.56, p less than 0.01). Calcitonin did not modify fractional magnesium delivery to the end-descending limb. A highly significant relationship was observed between tubule fluid-to-ultrafiltrate magnesium ratio and tubule fluid-to-plasma inulin ratio (r = 0.88, p less than 0.001). Within each group, fractional magnesium delivery to the end-descending limb was similar to the corresponding value in the superficial end-accessible proximal tubule. Our results suggest that despite intense magnesium reabsorption, presumably in the thick ascending limb, magnesium secretion does not occur in the juxtamedullary pars recta and (or) thin descending limb. PMID- 3955446 TI - Acetaminophen in the guinea pig: metabolite identification in blood, urine, and bile. AB - The biotransformation of single acute oral doses of acetaminophen (100 mg/kg body weight) in adult male guinea pigs was studied by collecting serial blood, urine, and bile samples post-treatment and identifying and quantitating the concentrations of parent drug and excretory products by high performance liquid chromatography. The plasma half-life (beta t/2) (mean +/- SD) of acetaminophen was 1.87 +/- 0.30 h, while that of the only metabolite detected in plasma, the glucuronide, was 2.41 +/- 0.64 h. In 24-h urine samples, the predominant product was the glucuronide (90%) with a small amount of the sulphate conjugate (7.0%) and approximately 3.0% acetaminophen. In bile, the glucuronide was the major metabolite detected initially but, with time, this product decreased concomitantly with an increase in the cysteinyl conjugate. No sulphate was detected in bile but two unidentified metabolites were detected, having distinct column retention times and comprising approximately 6-10% of the total excretory products. The results demonstrated that glucuronidation is a high capacity biotransformation pathway for acetaminophen in this species, only small amounts of other conjugated products being detectable under usual circumstances. PMID- 3955447 TI - Adaptive changes in rat liver plasma membranes after chronic alcohol administration and its subsequent withdrawal. AB - Rat hepatic plasma membranes isolated after chronic alcohol feeding displayed a different buoyant density range with a significantly increased peak density value when spun isopycnically in a 30-50% sucrose (w/w) gradient. This change persisted up to 48 h of withdrawal from alcohol. Analysis of membrane lipids revealed certain significant alterations in the phospholipids as well as the fatty acyl composition in individual phospholipids of the experimental plasma membranes. During withdrawal of alcohol for 48 h, all the alcohol-induced changes in the phospholipids returned to normal. Most initial changes in fatty acids reverted to the control composition during this time, but new changes in fatty acyl distribution were also observed. These were interpreted to represent readaptation to the withdrawal of the alcohol. It is not established how long this readaptation period lasts. PMID- 3955448 TI - Distal pressure-flow relations during in vivo distal microperfusion in the rat. AB - Distal convoluted tubule reabsorptive fluxes for various substances have been measured using the technique of in vivo microperfusion with quantitative sampling of the perfusate after it traverses a known length of tubule. It is unclear, a priori, whether physiologic pressures can be maintained under these sampling conditions. The present experiments were designed to monitor these pressure changes continuously by means of a microtransducer. We have found that over the range of 10-20 nL/min, during repeat sampling, the rise in pressure is 0.11 mmHg X nL-1 X min-1 (1 mmHg = 133.322 Pa) a value which is similar to 0.15 mmHg X nL-1 X min-1 obtained without sampling. This small rise in pressure over the microperfusion range supports the view that this technique does not introduce unphysiologic pressure effects. The present study also provides for the first time directly measured in vivo distal tubule pressure values over a wide flow range without changing whole kidney urine flow. PMID- 3955449 TI - Decreased velocity of shortening in arterial smooth muscle from older (28- to 31 week-old) spontaneously hypertensive rats. AB - An increased maximum velocity of shortening (Vmax) and increased shortening ability (delta Lmax) have been reported for caudal arterial smooth muscle from 16 to 18-week-old spontaneously hypertensive rats (SHR) compared with age-matched Wistar-Kyoto (WKY) control rats. It is known that hypertension results in hypertrophy of vascular smooth muscle. It is plausible that the faster Vmax of 16 to 18-week-old SHR arterial smooth muscle may slow down with age due to hypertrophy. The force-velocity (F-V) study done previously on caudal arterial strips from 16- to 18-week-old SHR and WKY rats was repeated on preparations from 28- to 31-week-old rats. An electromagnetic muscle lever was employed in recording force-velocity data. Analysis of these data revealed that the 28- to 31 week-old SHR (n = 7) mean F-V curve was not different from the 28- to 31-week-old WKY (n = 5) mean F-V curve (p greater than 0.05), and the shortening ability of 28- to 31-week-old SHR arterial muscle was significantly depressed compared with 28- to 31-week-old WKY arterial muscle (p less than 0.01). In conclusion, (i) although Vmax is faster in younger (16- to 18-week-old) SHR compared with age matched WKY caudal arterial smooth muscle, SHR Vmax is not different from WKY Vmax in the older (28- to 31-week-old) rats. (ii) Shortening ability is greater in 16- to 18-week-old SHR caudal arterial strips compared with 16- to 18-week-old WKY strips, but is significantly depressed in 28- to 31-week-old SHR compared with 28- to 31-week-old WKY preparations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955451 TI - Prevalence of multiple sclerosis in British Columbia. AB - A province wide prevalence study on multiple sclerosis (MS) was conducted in British Columbia (B.C.). The prevalence date was July 1, 1982. The major portion of this study was a review of all the files of neurologists practicing in B.C. as this was judged to be the most accurate source for identifying MS patients. 239,412 neurologists' files were hand searched by one researcher using modified Schumacher criteria for classification. Other sources used during the study for identifying MS patients were the MS Clinic, general practitioners, ophthalmologists, urologists, specialized facilities such as long term care facilities and rehabilitation centres, and patient self-referrals. A total of 4,620 non-duplicated cases were identified and classified. 4,112 of these (89%) were classified according to information contained in neurologists' records. The prevalence estimate for definite/probable MS in B.C. was 93.3/100,000 population. This increased to 130.5/100,000 population if possible MS and optic neuritis were also included. These rates are among the highest reported in Canada or elsewhere. The cooperation of B.C. neurologists made this study unique in its scope and accuracy of diagnosis. PMID- 3955450 TI - Unusual vascular events in the territory of the posterior cerebral artery. AB - There is an unusual type of vascular episode in the territory of the posterior cerebral artery which remains relatively unknown. Ten cases are presented in which a posterior cerebral artery deficit developed suddenly in dramatic fashion with headache, visual symptoms, sensory and motor deficits and signs of third nerve involvement. Nine of the patients were female and one was male. Seven were under the age of 33. In all instances there was a permanent neurologic sequela, usually a hemianopia. A similar case was described in 1901. The nature of the underlying process remains obscure, but the evidence favors accompanied migraine in which a particularly severe attack results in permanent damage. The term "catastrophic migraine" is suggested. PMID- 3955452 TI - Nitrazepam for periodic movements in sleep (sleep-related myoclonus). AB - In a follow-up study (mean, approximately six months), nitrazepam was helpful in suppressing periodic movements in sleep (sleep-related myoclonus) and improving disturbed sleep physiology and daytime symptoms of 13 patients (mean age - 53 yr). PMID- 3955453 TI - Primary lymphoma of the central nervous system: Manitoba experience and literature review. AB - We describe eight cases of primary cerebral lymphoma seen in Manitoba from 1980 to 1985. The clinical presentation is similar to other primary brain tumors. The diagnosis should be considered when single or multiple, often deep lesions, show dense enhancement on computerized tomographic (CT) scan, but are avascular at angiography. These tumors are histologically indistinguishable from non-Hodgkins lymphomas arising outside the CNS. The prognosis is poor. However, radiotherapy with or without surgery may offer significant palliation. Although there is no consensus on the value of chemotherapy, corticosteroids alone or multiagent chemotherapy have shown promise in a few cases. For these reasons, histologic diagnosis should be sought in all cases and surgery, radiotherapy, and chemotherapy should be considered, as prolonged survival is possible. PMID- 3955454 TI - Dorsal midbrain syndrome in multiple sclerosis with magnetic resonance imaging correlation. AB - We describe the clinical characteristics and a series of magnetic resonance imaging (MRI) studies in a patient with the features of dorsal midbrain syndrome occurring in the setting of multiple sclerosis. A T2-weighted MRI study revealed a discrete abnormality in the tectum of the midbrain whereas a high volume delayed computed tomography (CT) scan was uninformative. In parallel with remission of the clinical findings, the MRI abnormality diminished over time and was no longer visible at one year suggesting that some MRI detected MS lesions can completely disappear with time. This report demonstrates the use of MRI to detect and to follow sequentially sites of known disease activity in MS. PMID- 3955455 TI - The concurrence of multiple sclerosis and amyotrophic lateral sclerosis. AB - We report the clinical and pathological findings of the unusual combination of two idiopathic central nervous system diseases, multiple sclerosis and amyotrophic lateral sclerosis in a 56 year old physician with a twenty-seven year history of a disease initially characterized by relapses and remissions, followed by an eight year quiescent period. During the last year of life there was rapid deterioration with development of generalized weakness, atrophy, weight loss and fasciculations of body and tongue, and associated difficulty with swallowing and sudden respiratory failure. The autopsy confirmed characteristic "burned out" plaques of multiple sclerosis and anterior horn cell and axonal degeneration of amyotrophic lateral sclerosis. PMID- 3955456 TI - Hypopituitarism resulting from an intrasellar carotid aneurysm. AB - We report a 74 year old lady who presented with an exceedingly rare combination of an internal carotid artery aneurysm which was almost entirely intrasellar and associated with hypopituitarism but no neurological deficits. Such a lesion could be misdiagnosed as a pituitary tumour with serious consequences, if surgery is attempted without prior carotid angiography. PMID- 3955457 TI - Rapid reversal of ergotamine-induced vasospasm. AB - Peripheral ischemia, secondary to ergotamine tartrate and caffeine suppositories is reported in a 48-year-old female. Lower extremity pre-gangrenous changes were unresponsive to surgical sympathectomy, calcium channel blockade, intra-arterial vasodilators and systemic anticoagulation. A dramatic clinical and radiological reversal of the vasospasm was obtained with intravenous sodium nitroprusside when surgical amputation appeared inevitable. PMID- 3955458 TI - Chondromalacia of the fabella: a case report. AB - A 46-year-old man suffered from chondromalacia of the fabella after minor trauma to the back of the knee. The condition was misdiagnosed initially as fasciitis, tendinitis, a Baker's cyst and a herniated lumbar intervertebral disc. Pathognomonic signs were pain behind the lateral femoral condyle on palpation and compression of the fabella and also on passive extension of the knee. Conservative management was unsuccessful. Excision of the fabella gave quick and lasting relief. PMID- 3955459 TI - Posterior sternoclavicular dislocations. AB - Twelve cases of posterior sternoclavicular dislocation were seen over 15 years at the Victoria General Hospital and the Izaak Walton Kiliam Hospital for Children in Halifax, NS. Two patients required open reduction of the dislocation but the rest were treated by closed reduction. One of the former group required threaded K wires for stability, but all other dislocations were deemed stable after reduction and application of a figure-of-eight bandage and an arm sling. There were no failures of reduction and no recurrent dislocations; the authors have been successful even in late closed reduction (up to 5 days) and therefore recommend it highly as the primary treatment. Open reduction is much more difficult and hazardous. PMID- 3955460 TI - Nontraumatic spontaneous rupture of the urinary bladder. AB - Rupture of the urinary bladder without a history of recent trauma or instrumentation is rare; it is usually associated with bladder disease or outlet obstruction. The patient is usually seen as an emergency case and has an atypical clinical picture. The four patients in this report were initially seen and treated by a general surgeon; in only two was the diagnosis established preoperatively and confirmed by retrograde cystography. Awareness on the part of the consulting surgeon that bladder rupture is possible in a predisposed patient may lead to a correct preoperative diagnosis. In this series, early operation- removing urine from the peritoneal cavity or retropubic space, closing the rupture and securing good vesical drainage--resulted in resumption of vesical function in all four patients and there were no deaths. PMID- 3955462 TI - White clot syndrome: a rare complication of heparin therapy. AB - A case of white clot syndrome in a 61-year-old man is reported. The patient suffered simultaneous aortic and vena caval thromboses while receiving heparin therapy for pulmonary embolism. Thrombocytopenia was noted. Thrombectomies successfully relieved the thromboses. Apart from heparin, no factors predisposing to aortic thrombosis were evident, and the patient remained well in the succeeding 7 years since. A brief review of the literature on the white clot syndrome suggests that the entity remains poorly defined, regarding both the mechanism of heparin-induced thrombocytopenia and its relation to thrombosis. PMID- 3955461 TI - Tetracycline instillation for recurrent cystic thyroid nodules. AB - Ten patients, 5 with recurrent pure cystic and 5 with recurrent mixed cystic solid thyroid nodules, were studied. When repeated needle aspirations failed to decrease reaccumulation of fluid, tetracycline was injected directly into the cysts. As a result, all the pure cysts resolved completely, and four of the five mixed cystic-solid nodules diminished in size and fluid did not reaccumulate. Follow-up ranged from 12 to 20 months (mean 15 months). The procedure was generally well tolerated. It is concluded that instillation of tetracycline into both recurrent pure cystic and mixed cystic-solid thyroid lesions is a simple, safe and effective treatment. PMID- 3955463 TI - Chronic ileal obstruction in adults due to peri-ileal vitelline vascular remnants. AB - Two young adults had distal ileal obstruction at sites where a fold of mesentery extended from its posterior leaf to the antimesenteric border of the bowel. No Meckel's diverticulum or mesoumbilical band was present in either case. Clinical, gross and microscopic findings suggested that the mesenteric fold represented a remnant of vitelline vessel that persisted in the peri-ileal portion of its course. Chronic ileal obstruction was apparently due to disordered peristalsis caused by the fold tethering the adjoining posterior bowel wall. In one patient, a chronic ulcer at the site of obstruction was interpreted as being an additional complication of the congenital lesion. PMID- 3955465 TI - Gastric cancer: seeking the chance to cure. PMID- 3955464 TI - Right hemothorax: an unusual presentation of ruptured infrarenal abdominal aortic aneurysm. AB - The authors describe what they believe is the first reported case of rupture of an infrarenal abdominal aortic aneurysm into the right pleural cavity. A 75-year old woman presented simultaneously with two common causes of severe abdominal pain and hypotension: perforated duodenal ulcer and ruptured abdominal aortic aneurysm. The absence of an infrarenal retroperitoneal hematoma delayed the diagnosis of rupture of the abdominal aortic aneurysm and the terminal event was exsanguination into the right pleural cavity through an erosion in the right hemidiaphragm. PMID- 3955466 TI - A tale of two women: the concept of good and bad disease in breast cancer. PMID- 3955467 TI - Acalculous cholecystitis in burned patients. PMID- 3955468 TI - Radiation exposure to the surgeon during Ender's nailing. PMID- 3955470 TI - Liability insurance: the costs. PMID- 3955469 TI - Splenic abscess--percutaneous drainage. PMID- 3955471 TI - Cardiac mortality and morbidity after vascular surgery. AB - To determine the clinical, hemodynamic and pathological features that contribute to major cardiac complications after vascular surgery, six patients with early postoperative cardiogenic shock (group 1) were analysed retrospectively and compared to nine patients without complications (group 2) who were carefully analysed prospectively. Four group 1 patients had elective repair of an abdominal aortic aneurysm, one had repair of a false iliac artery aneurysm and one had a femoropopliteal graft inserted. Four group 2 patients had elective repair of an abdominal aortic aneurysm and five had aortobifemoral reconstruction. The Goldman multifactorial index was similar in both groups and indicated an expected death rate of 2% and a morbidity rate of 5%. In group 1, the earliest sign of cardiovascular compromise was an elevated pulmonary wedge pressure during operation. Postoperatively, electrocardiographic evidence of myocardial ischemia was present in all six patients and preceded cardiogenic shock. Autopsy of the four patients who died demonstrated triple-vessel disease in all but recent occlusion in only one patient. There was evidence of extensive subendocardial infarction in all four. Angiography of the two survivors in group 1 also demonstrated triple-vessel disease. The authors conclude that by using ordinary clinical methods it is difficult to identify patients likely to have major complications postoperatively. Elevated pulmonary wedge pressures or electrocardiographic evidence of myocardial ischemia may be early warning signs of impending cardiac catastrophe and should be treated aggressively. The underlying pathophysiology appears to be perioperative stress in a setting of severe triple-vessel coronary artery disease. PMID- 3955472 TI - Sensitivity of the Hemoccult II slide test in detecting colonic neoplasms. AB - It is common clinical practice to test stools for occult blood and to rely heavily upon the result in deciding whether to investigate further. Because the accuracy of such testing has been questioned, a study was conducted to estimate the sensitivity of the Hemoccult II slide test in detecting colonic carcinoma and polyps. Patients with lesions demonstrated on barium enema roentgenography had their stools examined for occult blood. One to 2 weeks before colonoscopy, stool specimens were collected for 3 consecutive days according to the manufacturer's instructions. The sensitivity of occult blood testing was 38% for patients with benign polyps and 64% for patients with polypoid carcinomas. Thus, the authors conclude that the Hemoccult II test is not reliable as a diagnostic tool and that a negative test result does not exclude the presence of a colonic neoplasm in any patient. PMID- 3955473 TI - Scarves and skiing. PMID- 3955474 TI - Postgraduate training for family practice and the specialties. PMID- 3955475 TI - Upholding the sanctity of life. PMID- 3955476 TI - Abortion: an issue that won't go away. PMID- 3955477 TI - Physician heal thyself. PMID- 3955478 TI - Treatment of "20th-century disease". PMID- 3955479 TI - Improving clinical teaching: a sporadic or sustained effort. PMID- 3955480 TI - The sociology of cigarette smoking. PMID- 3955481 TI - Hepatitis B: update on perinatal management. Infectious Diseases and Immunization Committee, Canadian Paediatric Society. AB - Infants of women infected with hepatitis B virus (HBV) are at risk of acquiring hepatitis B, usually at the time of delivery but occasionally in utero or after delivery. Perinatally acquired HBV infections are noteworthy for their tendency to persist throughout life, predisposing victims to cirrhosis and hepatocellular carcinoma. In most instances perinatal infection can be prevented by combined passive-active immunization of infants at risk. It is recommended that attempts be made to identify pregnant women infected with HBV and that their infants be given hepatitis B immune globulin soon after birth, then be actively immunized with HBV vaccine. This approach is effective and safe and is subsidized in many provinces. PMID- 3955482 TI - Measuring disease-specific quality of life in clinical trials. AB - While measurement of quality of life is a vital part of assessing the effect of treatment in many clinical trials, a measure that is responsive to clinically important change is often unavailable. Investigators are therefore faced with the challenge of constructing an index for a specific condition or even for a single trial. There are several stages in the development and testing of a quality-of life measure: selecting an initial item pool, choosing the "best" items from that pool, deciding on questionnaire format, pretesting the instrument, and demonstrating the responsiveness and validity of the instrument. At each stage the investigator must choose between a rigorous, time-consuming approach to questionnaire construction that will establish the clinical relevance, responsiveness and validity of the instrument and a more efficient, less costly strategy that leaves reproducibility, responsiveness and validity untested. This article describes these options and outlines a pragmatic approach that yields consistently satisfactory disease-specific measures of quality of life. PMID- 3955484 TI - A successful formula for ward rounds. AB - To develop guidelines for conducting ward rounds, all trainees in the Department of Medicine residency program at Montreal General Hospital were asked to identify the clinical instructors who were most successful at conducting rounds. The nine instructors mentioned most often were asked to write a description of how they conducted ward rounds. The common characteristics were empathy to the needs of trainees, interest in being with and facilitating the learning of trainees at all levels, and accessibility. Implementation of the guidelines resulted in heightened awareness of the importance of the teaching function of clinical ward rounds as well as increased emphasis on making rounds useful and enjoyable. PMID- 3955483 TI - Prevalence of hepatitis B virus infection in pregnant women in the Montreal area. AB - From January 1982 to June 1984, 30,315 serum specimens from pregnant women at nine hospitals in the Montreal area were screened for hepatitis B surface antigen (HBsAg). Of the specimens 103, from 98 women, were positive, a prevalence rate of 3.4 per 1000. The ethnic origin of the 98 women and the number who were also positive for e antigen (HBeAg) were as follows: French-Canadian, 29 (3 HBeAg positive); Asian, 28 (14); Haitian, 32 (0); other, 7 (0); and unknown, 2 (0). The prevalence rates of HBsAg positivity according to ethnic origin at one of the hospitals were 73.9 in Asians, 33.1 in Haitians, 0.9 in French Canadians and 8.0 in women of other extraction. If the prevalence rate found in this study is true for the 95 000 live births that occur yearly in the province of Quebec, there are an estimated 323 infants at risk for hepatitis B virus (HBV) infection each year in the province. Screening programs for detecting HBV carriage in pregnant women should be instituted, since recent studies have shown combined active-passive immunization to be effective in preventing perinatal transmission of HBV infection. PMID- 3955486 TI - Nosocomial outbreak of Pseudomonas aeruginosa folliculitis associated with a physiotherapy pool. AB - Outbreaks of community-acquired Pseudomonas aeruginosa folliculitis have recently been described in association with health spa whirlpools. In February 1984 we detected an outbreak of Pseudomonas folliculitis among hospital staff and patients using a swimming pool in a newly constructed physiotherapy unit. A rash developed in 5 (45%) of the 11 physiotherapists who had used the pool, as compared with 0 of the 17 who had not (p less than 0 005). Pseudomonas folliculitis also developed in 6 (21%) of 29 outpatients and 4 (33%) of 12 inpatients who had used the facility; Pseudomonas infection of a surgical wound also developed in 1 of the 4 inpatients. The epidemic curve was consistent with a continuing common-source outbreak. P. aeruginosa, serotype O:10, was isolated from three physiotherapists, the patient with an infected surgical wound and the pool. A case-control study of pool users did not identify risk factors for infection, although the physiotherapists had spent longer in the pool than had the patients. After hyperchlorination and structural repairs to the pool, no further cases were identified among pool users. This outbreak is the first reported nosocomial outbreak of Pseudomonas folliculitis. Further investigation is needed to determine the risk of serious Pseudomonas infections in hospitalized patients using physiotherapy pools. PMID- 3955485 TI - Lack of evidence of hepatitis D (delta) infection in Newfoundland and Labrador. AB - Epidemiologic knowledge of hepatitis D virus (HDV) infection is limited. A seroepidemiologic study was undertaken to determine the prevalence of the infection in Newfoundland and Labrador. Between October 1983 and October 1985 over 200 people were recognized through routine serodiagnosis and screening as having hepatitis B seromarkers. A total of 223 serum samples from 186 of these people were tested for anti-HDV. The subjects were mainly asymptomatic carriers of hepatitis B surface antigen or patients with acute or chronic hepatitis B from the native Indian and Inuit and the non-native populations. None of the serum samples were positive for anti-HDV. The absence of anti-HDV in a substantial number of people in the province who are infected with hepatitis B virus is strong evidence that HDV infection is not prevalent in the local population, including native people. PMID- 3955487 TI - Splenic rupture: an unusual late complication of colonoscopy. PMID- 3955488 TI - Procuring donor organs: firm but friendly encouragement required. PMID- 3955489 TI - Triathlons and medicine: the race to catch up. PMID- 3955490 TI - Runaways often sexually abused: symposium. PMID- 3955491 TI - Geriatric medicine and social policy. PMID- 3955492 TI - Evaluation of placement and coordination of geriatric services using a health program evaluation grid. AB - This article describes how the Health Program Evaluation Grid method of clarifying program objectives was applied to an innovative program (PCS) set up to assist the placement of the elderly into appropriate long-term care programs/agencies. The advantages and disadvantages of the Grid method are outlined in terms of how the Grid may be used by program managers as their first step in evaluation of a health program for which they are responsible. The Grid method provided a basis for setting evaluation priorities for PCS, and methods of executing the highly ranked evaluation priorities were discussed. The use of the Grid in development of objectives for three other Ontario health programs assisted by the Department of Clinical Epidemiology and Biostatistics of McMaster University has shown further the usefulness of the approach. PMID- 3955493 TI - The use of color in the environment of the elderly to enhance function. AB - Empirical evidence suggests that the functional level of the institutionalized elderly is favorably affected by enriching the environment with the specific use of color and light. Evidence of the validity of this supposition would form a worthwhile contribution to geriatric rehabilitation by promoting the independence of the elderly in the area of activities of daily living. The quality of literature on the appropriate use of environmental color for an institutionalized geriatric population is limited, being primarily descriptive in nature. In general, visual enhancement by the selective use of color is advocated to minimize the adverse effects of sensory deprivation and to enhance mood, whereas color coding and cueing are directed toward improving function. Faced with a variable literature base and a scarcity of studies that scientifically approach the question of what effect visual enhancement might have on function in the elderly, the authors of this paper are conducting a pilot study with the following objectives: To demonstrate that color cueing (in the form of color contrast applied to key objects in the environment) and increased lighting can enhance the performance of activities of daily living in an institutionalized elderly population. To study the concept that improvement in activities of daily living corresponds with improvement in the patient's mood and feelings of self worth. To evaluate the effect of color and lighting changes in the environment on various aspects of behavior. It is hypothesized that improvement in behavior will accompany increased functional independence. Thus, we would expect to see a relationship between aspects of behavior and those aspects of mood and activities of daily living currently under investigation. PMID- 3955495 TI - A pilot home-based geriatric health screening project in primary care. AB - Regular multidimensional screening of the elderly for undetected health problems has the potential for delaying functional deterioration and improving the quality of life, but has not been evaluated rigorously. This pilot study examined the amount and type of unmet health care need discovered by home-based screening of 100 family practice patients aged 75 and over. Although 96 per cent of patients had some health problems, only 71 per cent had problems that needed further intervention. Of these, the majority were problems in the area of psychosocial function, independence, and lifestyle. Age, sex, and frequency of attendance at the practice in the previous year were not found to be useful markers for targeting screening efforts. Although it is potentially beneficial for detecting unmet need, home-based screening is resource-intensive and requires further examination in randomized trials in the North American context. PMID- 3955494 TI - Quality-of-life judgments, treatment decisions, and medical ethics. AB - Treatment of the elderly should rest on criteria that are morally different from those applied to the rest of the population. These criteria depend on perceptions about life and the quality of life that the elderly are more likely to hold than younger citizens. Six treatment axioms are proposed for avoiding subjective and often capricious quality-of-life judgments about the care of the elderly. These axioms rest on an explication of the moral difference between the elderly and the rest of the population. PMID- 3955496 TI - Direct effects of the hypoxic cell sensitizer misonidazole on colony formation in a human tumor cloning assay. AB - The human tumor cloning assay as described by Hamburger and Salmon was utilized to study the direct antitumor effects of the hypoxic cell sensitizer misonidazole (MISO). Cells from 106 tumor specimens directly obtained from patients were exposed to MISO at clinically achievable drug concentrations (0.5 mM). Of 30 evaluable tumors, seven specimens (23%) showed a less than or equal to 50% decrease of TCFU's. In vitro sensitivity to MISO was noted in human breast cancer, renal cancer, non small-cell lung cancer, and adenocarcinoma of unknown primary site. A dose response relationship was demonstrated in a subset of experiments including 6 patient's tumors and one human breast cancer cell-line. An analysis relating MISO sensitivity or resistance to the results obtained with other, simultaneously tested standard anticancer drugs indicated that tumors exhibiting a less than or equal to 50% decrease of TCFU's in the presence of MISO were also likely to be sensitive to other cytotoxic drugs. In summary, our data suggest that the 'nitroimidazoles' may exert clinically significant direct antitumor effects in individual tumors. The human tumor cloning assay may have potential to evaluate these direct effects of MISO-analogues and other new radiosensitizers currently being tested in clinical trials. PMID- 3955498 TI - Abstracts. First International Congress on Neo-Adjuvant Chemotherapy. November 6 9, 1985, Paris, France. PMID- 3955497 TI - 131-I coupled to monoclonal antibodies as therapeutic agents for neuroectodermally derived tumors: fact or fiction? AB - It has been suggested that monoclonal antibodies may be useful in targeting cytotoxic compounds to tumor cells. We have explored their use in targeting 131-I to highly radiosensitive primitive neural tumors such as neuroblastoma and pineoblastomas. Two routes of administration have been employed, intravenous and intrathecal. Our current experience in using radiolabelled antibodies is described, indicating toxicities seen and any therapeutic benefit observed. The results of the study suggest that if targeted radiation has a role in the treatment of these malignancies, it will be restricted to the eradication of small tumor masses from the body. PMID- 3955500 TI - Adult respiratory distress syndrome after limited thoracic radiotherapy. AB - The authors report three patients who developed fatal respiratory failure after limited or unilateral thoracic radiation therapy for neoplasms. The respiratory failure was characteristic of the adult respiratory distress syndrome (ARDS) with refractory hypoxemia and diffuse bilateral infiltrates including areas of lung well outside of the radiation ports. No patient received drugs known to cause lung injury, and cardiogenic edema and infections were excluded. At autopsy the lungs exhibited interstitial fibrosis, Type II alveolar cell hyperplasia, inflammatory infiltrates, and squamous metaplasia. The etiology of the pulmonary injury is unclear. PMID- 3955499 TI - Comparison of two methods of treating primary malignant melanomas Clark IV and V, thickness 1.5 mm and greater, localized on the extremities. Wide surgical excision with and without adjuvant regional perfusion. AB - A comparative retrospective study of patients with primary malignant melanomas of the extremities, Clark level IV/V and tumor thickness greater than or equal to 1.5 mm, was performed in Sydney (Australia) and Groningen (The Netherlands). The efficacy of wide local excision combined with adjuvant regional perfusion (Groningen) was compared with that of wide surgical excision only (Sydney). Patients were classified by sex and tumor location. There were only sufficient numbers of female patients with a tumor of the lower extremity available for this comparative study. All patients were stage I and none received prophylactic lymph node dissection. Age, tumor location, tumor thickness, depth of infiltration and ulceration were taken into account and the factors studied within this group were 10-year disease-free rate, 10-year survival rate, and local and regional recurrences. Women with a melanoma of the leg (excluding the foot) who had been treated by excision and adjuvant regional perfusion, had a significantly better 10-year disease-free rate (P less than 0.0005), a significantly higher 10-year survival rate (0.010 less than P less than 0.025) and significantly fewer local/regional recurrences (P less than 0.0005) than women treated by wide local excision only. For tumors of the foot, however, no significant differences in 10 year disease-free rate, 10-year survival rate or local/regional recurrences were observed after perfusion. PMID- 3955501 TI - Pulsed arterial infusions. Chemotherapeutic implications. AB - To simulate the intra-arterial infusion of chemotherapy, ink was infused at a steady rate through a vascular catheter inserted in a transparent tube carrying water at a rate similar to that of arterial blood. The ink ran in one or two discrete streams for 10 to 15 cm before mixing with the water, and there were substantial differences in the concentrations of ink in the water collected from side holes made at various distances from the catheter tip. If the ink was delivered in short pulses, however, it mixed with the water 2 to 3 cm beyond the catheter tip, and the samples collected from the side holes showed similar concentrations of ink. A similar situation may be encountered when chemotherapeutic agents are infused into patients. Therefore, pulsation may produce a more homogeneous drug distribution in the infused tissue. The in vitro data was substantiated in patients by the following: (1) the intra-arterial administration of technetium 99m(99mTc)labeled macroaggregated albumin (MAA) by both steady and pulsed infusions; and (2) changes in the severity of inflammatory skin reactions frequently associated with intra-arterial chemotherapy of the extremities. Improved isotope distribution was noted in 19.3% of the liver and 40% of the extremity studies. Reduced skin reactions were observed in approximately 90% of the extremities receiving pulsed chemotherapeutic infusions. PMID- 3955503 TI - Semen analysis in Hodgkin's disease before the onset of treatment. AB - A spermogram was performed before treatment in 57 young patients with Hodgkin's disease. The mean results were normal, and similar to those reported in fertile populations. Nineteen patients had an abnormal spermogram; 12 of these men had had fever recently or were febrile at the time of the exam. When the temperature was below 38.5 degrees C, there was only asthenospermia. With a higher temperature, semen anomalies were more severe, with oligoasthenospermia or even azoospermia. Only five febrile men had a normal spermogram, and all had slight fevers. Therefore, semen anomalies noted in about one third of patients with Hodgkin's disease are probably not due to a disease specific gonadal alteration, but can be attributed to fever which gonadal effects have been recognized for a long time and are well-documented. PMID- 3955502 TI - Toxicity and complications of vascular isolation and hyperthermic perfusion with imidazole carboxamide (DTIC) in melanoma. AB - The authors have used imidazole carboxamide (DTIC) in vascular isolation and hyperthermic perfusion for melanoma. The regional and systemic toxicity and complications of this procedure were studied in 40 cases with Stage III (15) and Stage I (25) melanoma. Technetium 99m-labelled serum albumin crossover and pharmacokinetic studies were done simultaneously to see if these correlate with toxicity. Local toxicity on muscles, nerves, skin, and arteries was conspicuously absent despite using dosages of 2 g/m2 (40-45 mg/kg) for the lower extremity and 1.2 g/m2 (24-28 mg/kg) for the upper extremity. Skin and core temperature were raised to 39 degrees C to 40 degrees C. Deep vein thrombosis was noted in three patients. No death or gangrene of the extremities occurred. Local infection was noted in only one patient. Fourteen patients (35%) manifested bone marrow toxicity (leukocyte count of 4000/mm3 or platelets of 100,000/mm3) in the second or third week after perfusion. Severe hematologic toxicity was seen in two instances. Dosages of DTIC greater than 40 mg/kg were associated with toxicity in 65% of the patients. No bleeding complications occurred in seven patients with thrombocytopenia. Measurement of crossover and recovery of radionuclide were not reliable indicators of subsequent systemic toxicity. Perfusion fluid balance data also were of no predictive value. Forty-seven percent of the administered DTIC was recovered in washout fluid. Of this, less than 2% was converted to its metabolites, that is aminoimidazole carboxamide and 2-azahypoxanthine. Thirty five of 40 patients experienced mild nausea and vomiting. Transient and mild hepatotoxicity was noted in seven patients. It appears that DTIC hyperthermic isolation perfusion is a safe procedure, however, the total dosage should be below 40 mg/kg to avoid hematologic toxicity. PMID- 3955504 TI - Acinic cell carcinoma arising in a lacrimal gland. First case report. AB - Acinic cell carcinoma is a rare neoplasm nearly always observed in the salivary glands. Our experience documents a case of this pathology, occurring in the lacrimal gland, never reported in the literature before. A 59-year-old white woman was admitted with reduced vision and a painless swelling in the area of the right lacrimal gland. Computerized axial tomography showed an intraorbital radio opaque mass compressing the eyeball from behind. The patient underwent right temporal orbitotomy and total removal of the lesion. The surgical specimen was constituted by a cystic mass containing citrine liquid. Microscopic examination proved the lesion to be an acinic cell carcinoma. Differential diagnostic problems and similarity to salivary gland acinic tumors are discussed. PMID- 3955506 TI - Adenocarcinoma of the uterine cervix. AB - Fifty patients with adenocarcinoma of the uterine cervix were evaluated retrospectively. Treatment was based on the stage and size of tumors and the overall medical condition of the patient. Radical surgery or surgery in combination with radiation therapy was employed whenever possible. The overall survival rate was 50%, with Stage IB survival 74%. Survival in Stage IB patients was adversely affected by increasing tumor grade and size. This closely correlated with a tendency of the tumors to dedifferentiate as they increased in size. Lymph node involvement increased with increasing grade of tumor as well. Survival in patients with advanced disease was dismal. Survival increased with aggressive management which should, if possible, include surgery in Stage I and II disease. PMID- 3955505 TI - Androgen receptor in human normal and malignant pancreatic tissue and cell lines. AB - Estrogen and progestogen receptors have been demonstrated in human pancreatic adenocarcinoma tissue. Tumor growth as xenografts in nude mice is promoted by testosterone and retarded by cyproterone acetate but is not influenced by estrogens, progestogens, or their antagonists, although estrogen receptors were demonstrated in xenograft cytosol. A new sensitive microassay technique for sex steroid receptors which relies on affinity chromatography was used in this study. With this assay, androgen receptors were detected in five fresh human pancreatic adenocarcinoma specimens (three male), two pancreatic cancer cell lines (Mia PaCa 2 and Ger), one xenograft tumor which responded to androgens, five specimens of normal adult pancreas (two male), and a pool of fetal pancreatic tissue. The similarity of the androgen receptor in pancreatic carcinoma to that of classical androgen target organs was demonstrated by sedimentation behavior and competitive binding studies. The improved sensitivity of the microassay allowed low levels of estrogen, androgen, and progesterone receptors to be detected in normal adult pancreatic tissue. PMID- 3955507 TI - Epithelial tumors metastatic to the uterine cervix. A study of 33 cases and review of the literature. AB - Thirty-three cases of true distant metastasis to the uterine cervix from primary tumors in extragenital or intragenital sites have been studied. The group comprised 12 ovarian tumors, 10 colonic tumors, 5 gastric tumors, 4 mammary tumors, 1 renal cell carcinoma, and 1 transitional cell carcinoma of the renal pelvis. Data of mode of presentation, interval between diagnosis of primary tumor and diagnosis of cervical metastasis, and subsequent survival are presented. The literature is reviewed with consideration of the problems of clinical and pathologic diagnosis. PMID- 3955508 TI - Malignant peripheral nerve sheath tumor arising in an adrenal ganglioneuroma in an adult male homosexual. AB - The authors report a case of malignant peripheral nerve sheath tumor arising in an adrenal ganglioneuroma in an adult. This is the first such case occurring in the absence of a history of childhood neuroblastoma treated with radiation, and provides evidence that such a transformation can occur spontaneously. The neoplasm demonstrated a highly malignant biologic behavior with rapid growth, local recurrence, and metastasis. PMID- 3955509 TI - Squamous cell carcinoma in congenital ichthyosis with deafness and keratitis. A case report and review of the literature. AB - The first case of invasive squamous cell carcinoma (SCC) arising in the skin of a patient afflicted with keratitis, ichthyosis, and deafness (KID) syndrome is reported. A 35-year-old man, diagnosed as having KID syndrome in early childhood, developed bilateral fungating lesions on his feet. The entire left foot became involved with a multinodular fungating mass which proved to harbor a SCC, necessitating a left below-knee amputation. Although rare, KID syndrome can be associated with SCC of the skin. PMID- 3955510 TI - Giant cell tumors of synovium (Pigmented villonodular synovitis) involving the vertebral column. AB - Giant cell tumors of synovium (pigmented villonodular synovitis) involving the vertebral column recently have been seen in two women: the third and fourth cases to be reported in the English-language literature. Unlike the previously reported cases, both these tumors grew outside the dura and produced symptoms of spinal cord compression. The first case involved lumbar vertebrae 5 and 6; the second, lumbar vertebrae 2 and 3. Even though initial resection of both tumors was incomplete, the patients improved postoperatively. One tumor was known to be unresectable at the time of surgery. In the other patient, a recurrence of symptoms required second and third resections 4 and 8 months after the first, respectively. Although synovial giant cell tumors rarely metastasize, the rate of local recurrence is high, especially if excision is incomplete. For this reason, close follow-up of patients with lesions in the spinal column is indicated. Increased physician awareness that synovial giant cell tumors can occur in the spine will help to ensure that these tumors are not misdiagnosed in this location. PMID- 3955511 TI - Quick diagnosis of malignant melanoma with the touch-fluorescence method during operation. AB - Nine cases of primary melanotic melanoma, three cases of metastatic amelanotic melanoma, and 26 cases of pigmented and unpigmented tumors other than melanoma were examined with the touch-fluorescence method using preparations from the cut surface of the lesions. Fluorescent melanoma cells were easily detected with a fluorescence microscope in all the cases of malignant melanoma whether the melanoma was melanotic or amelanotic. The fluorescent melanoma cells could be divided into three types by configuration: round, spindle-shaped, and pleomorphic. The main cell type of superficial spreading melanoma was round and that of nodular melanoma and acral lentiginous melanoma was chiefly pleomorphic. Fluorescent tumor cells were not seen in pigmented and unpigmented tumors other than melanoma, except in pigmented basal cell epithelioma; this fact made it possible to apply this method routinely for quick diagnosis of malignant melanoma during operation. PMID- 3955512 TI - Spontaneous remission in diffuse large cell lymphoma. AB - A case of spontaneous remission in a Stage IIA diffuse large cell lymphoma is presented. Review of the literature suggests that whereas spontaneous regressions are a well-recognized phenomenon in indolent lymphomas, it is extremely rare in lymphomas of aggressive histologic subtype. PMID- 3955513 TI - Prediction of splenic involvement in children with Hodgkin's disease. Significance of clinical and intraoperative findings. A retrospective statistical analysis of 154 patients in the German therapy study DAL-HD-78. AB - In 154 splenectomized children and adolescents with histologically proven Hodgkin's disease in the therapy study DAL-HD-78, the incidence of splenic involvement was 39%. In single-parameter analyses 6 of 16 examined pre- and intraoperative findings showed significant correlation to splenic involvement: B symptoms, palpable splenic enlargement, mediastinal/lung hilus involvement, nodular changes of splenic surface, enlarged lymph nodes at splenic hilus/pancreatic tail, or enlargement of other upper-abdominal lymph nodes. The results of multivariant analyses (Cox regression model) of these six parameters showed that the two most significant intraoperative parameters--changes of splenic surface and enlargement of lymph nodes at splenic hilus/pancreatic tail gave almost all of the information which can be obtained about splenic involvement. With these two parameters, an intraoperative decisional strategy for selective splenectomy has been developed which allows the omission of splenectomy in about two thirds of children with Hodgkin's disease while still obtaining detailed information about infradiaphragmatic spread of disease. Since minor splenic involvement remains undetected in about 10% of the nonsplenectomized patients (i.e., 6% of all patients), this method should be used only in combination with chemotherapy. PMID- 3955514 TI - Catheter tract seeding after percutaneous biliary drainage for pancreatic cancer. AB - Percutaneous biliary drainage is frequently used to decompress obstruction of a malignant origin. The development of a tumor along the drainage tract is rare and has been reported only where the catheter has transgressed the obstruction. The authors report seeding of a percutaneous drainage tract after short-term decompression of obstructive jaundice in a patient who underwent curative resection for pancreatic carcinoma and in whom the catheter was not passed through the tumor. Exfoliated cancer cells in the bile duct are believed to be responsible. Caution is suggested in the use of percutaneous biliary drainage for temporary drainage in the patient who is a candidate for curative resection. PMID- 3955515 TI - Late effects after treatment of twenty children with soft tissue sarcomas of the head and neck. Experience at a single institution with a review of the literature. AB - Twenty children with soft tissue sarcomas of the head and neck, treated at the Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania from 1972 to 1981, were evaluated for the late deleterious effects of treatment. All patients received radiation therapy and combination chemotherapy with vincristine, dactinomycin, and cyclophosphamide; certain patients also received Adriamycin (doxorubicin). All had ophthalmologic, otologic, growth, and cosmetic evaluations; 15 also had dental and maxillofacial examinations. The median age at diagnosis was 6 years (range, 7 months-13 years). Median follow-up from time of diagnosis was 5.5 years with a minimum of 3 years in all but four patients. The major problems encountered were related to the eyes (xerophthalmia and cataracts), ears (hearing loss), teeth (maleruption and caries), glandular structures (xerostomia, hypopituitarism), and development (craniofacial deformity). It is concluded that children treated for soft tissue sarcomas of the head and neck with combined modality therapy, including radiation enhancers, may show a variety of late treatment-related adversities. These children require close multidisciplinary follow-up for detection of late effects in order that appropriate prophylactic or symptomatic treatment can be instituted to minimize their consequences. PMID- 3955516 TI - Familial heterogeneity of colon cancer risk. AB - The authors have assembled detailed family histories of cancer on 857 cancer probands, of whom 180 manifested colorectal carcinoma. This study determines if some families had a greater risk for colorectal cancer than others, and if so, what factors were associated with an increase in risk. To test for the possibility of heterogeneity of risk, a parameter called the Z-score, was calculated for each family. The Z-score is a measure of the number of cancer cases in the family adjusted for the number of expected cases. A permutation test was employed to test whether or not the variance of Z-scores from the sample was greater then expected by random chance. The variance for families ascertained through colon cancer probands, but not in any of the other groups, was significantly increased. Of the colon group, 10.6% fell into a high-risk category, as did 5.56% of the rectal cancer families, but only 3.95% of the other groups combined were at high risk. Anatomic sites (in the proband) with the highest Z-score variances were sigmoid and transverse colon, whereas lower variances were seen for cecum and descending colon. Risk status therefore may be partially dependent upon exact anatomic sites within the colon. The effect of proband's age of diagnosis was not significant, but did show the possibility of an effect on heterogeneity of risk for both the younger and older groups. PMID- 3955517 TI - Familial clustering of salivary gland carcinoma in Greenland. AB - Salivary gland carcinoma (SGC) occurs at an increased frequency in the Eskimo population. In Greenland the incidence of SGC is 4.5-fold higher for men and 9 fold higher for women as compared with European incidence. The increased incidence is caused by low-differentiated carcinoma. Unusual familial clustering of SGC is reported among two families (five siblings). Peculiar aspects of racial and geographical distribution and possible role of genetic and environmental factors in the etiology of this relatively uncommon tumor are briefly discussed with special emphasis on the recently detected association between the Eskimos' SGC and the Epstein-Barr virus. PMID- 3955518 TI - Late effects of therapy in orbital rhabdomyosarcoma in children. A report from the Intergroup Rhabdomyosarcoma Study. AB - Late effects of therapy were evaluated in 50 children surviving orbital rhabdomyosarcoma following treatment on Intergroup Rhabdomyosarcoma Study I. All patients had microscopic or gross tumor present following surgery and subsequently received radiotherapy and various combinations of chemotherapeutic agents. Problems in the eye included infections and functional and structural changes. Decreased vision in the treated eye was the most common functional problem and in most patients related to cataract formation, which occurred in 90% of eyes. Changes in the cornea and retina were also seen. Bony hypoplasia of the orbit and facial asymmetry were present in one half of the children. Gonadal development was normal. Statural growth was retarded in 61% of the patients. All children were in school, with five having learning or behavioral problems. One child developed acute myeloblastic leukemia. The excellent survival in patients with orbital rhabdomyosarcoma provides support for treatment programs that use multiple-agent chemotherapy and radiotherapy and do not include orbital exenteration initially. PMID- 3955519 TI - Conservative treatment (chemotherapy/radiotherapy) of locally advanced breast cancer. AB - Once treated almost exclusively by radical surgery, locally advanced breast cancers (Stages III, IV; MO) were later treated solely by irradiation, but local results (cosmesis and recurrences) remained poor. Since 1977, we have used induction chemotherapy in an attempt to treat subclinical metastatic disease while allowing better quality mammary conservation in a greater number of patients. From 1977 to 1980, 25 patients (Stages III, IV; MO) were treated by a sequential association of chemotherapy (Adriamycin [doxorubicin], vincristine, cyclophosphamide, 5-fluorouracil; 3 cycles) followed by irradiation (45 Gy to the breast and nodal areas; 15-30 Gy mammary boost dose). Responses of 50% or more were observed in 86% of the breast lesions and in 80% of nodal lesions. This sequential treatment was always well tolerated. Local recurrences occurred in six patients (24%) who underwent mastectomy without any complications. The survival rate at 4 years is 55%. PMID- 3955520 TI - Endobronchial involvement with non-Hodgkin's lymphoma. A clinical-radiologic analysis. AB - Based on experience with three cases of endobronchial non-Hodgkin's lymphoma and a review of cases previously reported, two patterns of lymphomatous involvement of airways are described. The Type 1 pattern is characterized by diffuse submucosal infiltrates occurring in the presence of intra- and extrathoracic lymphoma. In Type 2 cases, central airways are involved by a solitary mass in the absence of clinically apparent systemic lymphoma. The clinical-radiologic picture is characterized by signs of pneumonitis in Type 1 cases, while in Type 2 cases, signs of airway obstruction uniformly occur. PMID- 3955522 TI - Endometrial carcinoma in Nigerians. A pathologic study. AB - Endometrial carcinoma is an uncommon disease in the Nigerian female and its ratio to carcinoma of the cervix could be as low as 1:40, compared with the about 1:2 ratio for the temperate climates. In the 10-year period under review (1973-1982), only 10 cases could be clearly established. Nine tumors were adenocarcinomas, with most of these exhibiting a papillary pattern, while the tenth case was an adenosquamous carcinoma. One of the papillary adenocarcinomas contained clear cells. Most lesions were Grade I or Grade II. The youngest patient was 42 years of age while the oldest patient was aged 78 years (mean age, 58.9 years). A more favorable grade and lesser degree of myometrial invasion characterized the neoplasms in the younger patients. PMID- 3955521 TI - Malignant potentiality of squamous cell carcinoma of the esophagus predictable by DNA analysis. AB - Cell nuclear deoxyribonucleic acid (DNA) content was microspectrophotometrically determined in biopsy specimens from 75 patients with squamous cell carcinoma of the esophagus. The relationships among DNA distribution patterns, pathohistologic features, and prognosis were investigated. In patients with a high hyperploid DNA content (type IV), there was a high frequency of lymph node metastasis and lymphatic invasion, as compared with those exhibiting the near diploid DNA content (type II). In the type IV group, 22 of 23 patients died within 2 years, whereas patients with type II had a good clinical course and the 5-year survival rate was 60%. The DNA distribution pattern, determined by a multivariate Cox model analysis, was one of independent and significant prognostic variables. As these findings suggest that the DNA distribution pattern reflects the malignant potentiality of the tumor, the preoperative determinations of the DNA pattern in biopsy specimens of the esophageal carcinoma should provide a valuable parameter for predicting the prognosis. PMID- 3955523 TI - Idiopathic deep vein thrombosis in an apparently healthy patient as a premonitory sign of occult cancer. AB - An association between migratory venous thrombosis or acute pulmonary embolism and occult cancer has been previously suggested. The relationship between the commoner deep venous thrombosis (DVT) in an otherwise healthy individual and occult cancer is not known. The incidence of cancer in 35 otherwise healthy patients with idiopathic DVT (group A) was compared to 48 patients with DVT due to a known etiology, excluding cancer (group B). In 12 patients of group A (34%), a diagnosis of cancer was established 4-68 months after the DVT episode, compared to 2 patients of group B (4%) (P = 0.001). The origin of the earliest discovered cancer (up to 8 months) was the reproductive organs (ovary, endometrium, prostate, breast), while the later discovered malignancies were of colon, pancreas, lung and a lymphoma. At the initial idiopathic DVT episode, patients found subsequently to have cancer, were older than the control group (P less than 0.01), had hemoglobin concentration lower than 12.4 g/dl (P less than 0.02), and had eosinophil counts higher than 3% (P less than 0.01). A score devised from these parameters could identify 83% of the patients with cancer and 91% of those without malignancy (P = 0.00003). These findings indicate that there is a correlation between idiopathic DVT and occult cancer and that the majority of the patients at risk may probably be identified early by the score devised. PMID- 3955524 TI - Hodgkin's disease involving the breast and chest wall. AB - Eighteen patients with Hodgkin's disease involving the breast or chest wall were identified from the M. D. Anderson Hospital and Tumor Institute pathology files from 1962 through 1984. All of these cases were nodular sclerosing Hodgkin's disease. Nine of the 18 patients had Hodgkin's disease involving the breast or chest wall at initial presentation. The remaining nine cases represented recurrences involving the breast or chest wall. Breast or chest wall involvement represented extranodal extension and/or involvement of another supradiaphragmatic lymph node group. No marked difference in survival was found between the initial and recurrent groups. Those patients with breast involvement had a better prognosis than those with chest wall involvement. Hodgkin's disease involving the breast or chest wall as an initial presentation or a recurrence does not necessarily indicate an accelerated phase of the disease. Breast or chest wall involvement is probably due to Hodgkin's disease involving the intramammary or internal mammary lymph nodes, or is due to direct mediastinal extension into the chest wall. PMID- 3955525 TI - Sexual dysfunction and signs of gynecologic cancer. AB - Forty-one women recently diagnosed with early-stage cervical or endometrial cancer and a matched group of healthy women in no gynecologic distress, participated in a detailed assessment of their sexual functioning. Data included the range and frequency of sexual behavior, level of sexual responsiveness, and the presence of sexual dysfunction. Multivariate analyses of variance indicated that prior to the onset of cancer signs/symptoms the gynecologic cancer patients reported similar patterns of sexual activity and responsiveness as the healthy sample. With the appearance of disease signs, however, the gynecologic cancer patients reported experiencing significant sexual dysfunction symptoms. While sexual morbidity is typically conceptualized as occurring after the diagnosis and treatment of cancer, these data indicate that such changes are a major source of variation in describing the prediagnosis sexual status of the gynecologic cancer patient. PMID- 3955526 TI - Familial neuroblastoma. Case reports, literature review, and etiologic considerations. AB - The phenomenon of familial neuroblastoma is discussed in the context of case reports describing disseminated neuroblastoma in two of three half-brothers who share a common unaffected mother and who each have a different father. This family's cytogenetics proved to be unremarkable; also, the mother's peripheral blood DNA did not show tumorigenic capacities in transfection-nude mice experiments. An analysis of reported cases permits an updated examination of the clinical features of this entity and defines the limits of genetic counseling of families of all neuroblastoma patients. Multiple primaries are a hallmark of familial neuroblastoma. Most diagnoses are made in the first 18 months of life and at ages that fall within 12 months of the age of diagnosis of the other affected family member. Difficulties in determining the incidence and penetrance of an inherited susceptibility to neuroblastoma derive from undiagnosed tumors that have undergone regression or spontaneous maturation to benign ganglioneuroma, as well as from early deaths or long-term treatment complications that preclude reproduction and multigenerational pedigrees. Nevertheless, the risk of neuroblastoma in siblings or offspring of the large majority of persons with neuroblastoma appears to be less than 6%. Recent observations concerning chromosomal aberrations and oncogenes in embryonal malignancies are presented in an integrated model of tumorigenesis that corresponds to clinical experience. PMID- 3955527 TI - Carcinoma of the stomach in atomic bomb survivors. A comparison of clinicopathologic features to the general population. AB - The results of surgical treatment of gastric cancer were reviewed retrospectively for 135 atomic bomb survivors and 377 control patients. The mean age was significantly higher in the survivors than in the controls. Otherwise, both groups were quite comparative especially in terms of the stage of the disease. Histopathologically, the rates of poorly differentiated or undifferentiated types of carcinoma and secondary lymph node involvements were significantly lower in the survivors than in the controls. There were no significant difference between the two groups in postoperative morbidity and mortality rates and long-term survival rate. The incidence of second primary malignancies, however, was apparently higher in the survivors than in the controls. PMID- 3955528 TI - Translocation (13;22) in a hemangiopericytoma. AB - Cytogenetic studies on primary hemangiopericytoma tumor cells from a 28 year old woman showed a single karyotypic change: t(13;22)(q22;q11). The relationship of this aberration to previously described abnormalities of chromosome #22 in other solid tumors is discussed. PMID- 3955529 TI - Cytogenetic findings in nodular paragranuloma (Hodgkin's disease with lymphocytic predominance; nodular) and in progressively transformed germinal centers. AB - Cytogenetic studies were performed in a case of progressively transformed germinal centers (PTGC), and in a case of nodular paragranuloma (NP; Hodgkin's disease with lymphocytic predominance, nodular type). No cytogenetic abnormalities were detected in PTGC. Chromosomal aberrations (hyperdiploidy, 6q-, +21, and several unidentified markers) were found in NP. The results support the proposal that PTGC are reactive in nature and NP is a neoplasm. Chromosomal analysis could provide practical diagnostic aids in the differential diagnosis of PTGC and NP. PMID- 3955530 TI - Acute eosinophilic leukemia with a translocation (10p+;11q-). AB - Eosinophilic leukemias are difficult to individualize amid the hypereosinophilic syndromes. Chromosomal abnormalities when present within the eosinophils are of critical value in the diagnosis of a malignancy. We report here the case of a 27 year-old woman who had been healthy, until recently when she suddenly developed hepatosplenomegaly and lymph node enlargement, and considerable eosinophilia in blood and bone marrow. The morphologically abnormal cells (large pseudo Pelger eosinocytes) predominated in the cytology. The establishment in these cells of a clonal chromosomal anomaly, t(10;11)(p14;q21), favored the malignancy and diagnosis of acute eosinophilic leukemia. PMID- 3955531 TI - Hydatidiform moles: methods for culture and cytogenetic analyses. AB - Placental tissue with macroscopic visible vesicles was processed for chromosome analysis. Enzymatic tissue dissociation, culture initiation in Chang's medium, and final culture in a medium with high glucose content were used, which increased the success rate for karyotyping from 55% to 93%. Median culture time necessary for obtaining a karyotype decreased to about 1 week, irrespective of the chromosomal constitution. This was achieved in spite of increasing time for transportation. The metaphases obtained permitted detailed analysis of chromosomal polymorphisms. In 8 of 44 cases, the karyotype was established on short-term culture alone, which proved to be a valuable supplement in this study. PMID- 3955532 TI - Translocation t(1;3)(p36;q21) in malignant myeloid stem cell disorders. AB - A t(1;3)(p36;q21) translocation was found in bone marrow samples of two patients with hematologic disorders. One patient had a myelodysplastic syndrome evolving into acute nonlymphocytic leukemia (ANLL) M1 and the second patient had ANLL-M6 secondary to treatment for Hodgkin's disease. Because myelodysplastic syndromes and secondary leukemia are stem cell disorders, the t(1;3)(p36;q21) appears to be a chromosome abnormality in malignant myeloid stem cells. PMID- 3955533 TI - Recurrent chromosome translocations in liposarcoma. PMID- 3955534 TI - Increase in the levels of N-nitrosoproline, N-nitrosothioproline and N-nitroso-2 methylthioproline in human urine by cigarette smoking. AB - The effects of cigarette smoking on the urinary excretions of N-nitrosoproline (NPRO) and the sulfur-containing N-nitrosamino acids, N-nitrosothioproline (NTPRO) and N-nitroso-2-methylthioproline (NMTPRO), in a male volunteer were examined. This subject smoked for 20 non-consecutive days and did not smoke for another 20 non-consecutive days during a 4-month-period, and 24-h urine samples were collected. On the days of urine collection, he was given a fixed diet. On the smoking days, the urinary levels of NPRO, NTPRO and NMTPRO increased significantly from 1.1 +/- 0.5 (mean +/- S.D.) micrograms/day to 1.8 +/- 0.9 (P less than 0.01), from 3.9 +/- 1.1 to 8.7 +/- 4.6 micrograms/day (P less than 0.001), and from 5.6 +/- 1.9 to 8.5 +/- 4.1 micrograms/day (P less than 0.01), respectively. Thus, the total amount of these 3 N-nitrosamino acids in the urine also increased significantly by smoking from 10.6 +/- 2.8 to 19.0 +/- 6.5 micrograms/day (P less than 0.001). These results indicated that NOx in cigarette smoke can contribute to in vivo formation of N-nitroso compounds. PMID- 3955535 TI - The effect of dietary or intraperitoneally injected seaweed preparations on the growth of sarcoma-180 cells subcutaneously implanted into mice. AB - Sixteen preparations from 9 edible seaweeds including powdered weed (P), hot water extract (E), the non-dialyzable fraction (I) of E and the residue (R) of hot-water extraction were incorporated into a basic diet, and they were given to mice implanted with Sarcoma-180 cells s.c., for 5 weeks. Consequently, diets with 6 preparations, E of Laminaria angustata, P and E of Laminaria angustata var. longissima, and P, E and R of Laminaria japonica var. ochotensis, were found to be effective, with inhibition ratios ranging from 70.3% to 83.6%. Intraperitoneal injection of 10 preparations from 6 edible seaweeds, including the above 3 weeds, were also noted to be effective in the same test system, with inhibition ratios ranging from 61.9% to 95.2%. PMID- 3955536 TI - Beta-carotene levels in exfoliated human mucosa cells following its oral administration. AB - Beta-carotene levels of exfoliated oral mucosa cells can be increased severalfold by the oral administration of this provitamin. Beta-carotene was estimated by HPLC analysis in pronase-treated exfoliated cells obtained by brushing the entire oral mucosa with a toothbrush. A small percentage of individuals did not respond with an increase of beta-carotene in their mucosa cell in spite of a relatively large intake of the provitamin (360 mg in 4 days, or 2880 mg in 16 weeks, respectively). Levels of beta-carotene in the mucosa cells are affected by the concurrent administration of vitamin A: 0.27 ng beta-carotene per 10(6) cells in the placebo group, 1.79 ng following the intake of beta-carotene (180 mg/week for 16 weeks), and 4.29 ng after beta-carotene (180 mg/week for 16 weeks) plus vitamin A (100,000 IU/week for 16 weeks) consumption. The considerable variations in tissue levels of beta-carotene following its oral administration must be taken into account when cancer intervention trials using this agent are designed and evaluated. PMID- 3955537 TI - Effects of four antioxidants on N-methyl-N'-nitro-N-nitrosoguanidine initiated gastric tumor development in rats. AB - The effects of antioxidant administration during the post initiation phase of gastric tumor development were investigated in male Wistar rats treated with N methyl-N'-nitro-N-nitrosoguanidine (MNNG). Animals (20/group) were given MNNG in the drinking water (100 mg/l) for 8 weeks, and for the duration of this treatment were also fed on diet supplemented with 10% sodium chloride. Thereafter, they were divided into 6 groups and were maintained on diet containing either 2% butylated hydroxyanisole (BHA), 1% BHA, 1% butylated hydroxytoluene (BHT), 1% ethoxyquin (EQ) or 1% DL-alpha-tocopherol (alpha-TP) for 32 weeks. A carcinogen control group was fed the basal diet without antioxidant supplementation. The experiment was terminated 40 weeks after the beginning of administration of MNNG and development of gastroduodenal tumors was determined histopathologically. EQ significantly increased the incidence of tumors in the glandular stomach. No modification of tumor development in this region of the organ were observed with 2% BHA, 1% BHA, 1% BHT or 1% alpha-TP, although both 2% BHA and 1% BHA induced and/or promoted tumor development in the forestomach. In addition, nephrocalcinosis was identified only in the kidneys of rats given EQ after MNNG treatment. PMID- 3955538 TI - Combined effects of butylated hydroxyanisole and other antioxidants in induction of forestomach lesions in rats. AB - The possibility that changes in the forestomach of rats induced by butylated hydroxyanisole (BHA) are caused by inductions of free radicals and their reactions with macromolecules was examined. Groups of five male F344 rats were pretreated with 1% alpha-tocopherol, 1% ellagic acid, 1% propyl gallate, 0.25% ethoxyquin, 0.5% glutathione, 1% sodium L-ascorbate or 1% 3,3'-thiodipropionic acid for 1 week, then treated with the same antioxidant plus 1% BHA for 1 week, and then killed. Histological examination showed that BHA induced epithelial hyperplasia of the forestomach. This induction of hyperplasia was not inhibited, but increased by the antioxidants, particularly propyl gallate and ethoxyquin. Thus the induction of hyperplasia by BHA may not be related to a free radical reaction. PMID- 3955539 TI - Changes in lymphoma development in female SJL/J mice as a function of the ratio in low polyunsaturated/high polyunsaturated fat diet. AB - A diet of low polyunsaturated-to-saturated fatty acid (P/S) ratio known to alter fatty acid composition of lymphocyte membranes and retard the progressive changes which result in loss of suppressor capacity in SJL/J female mice, was fed to these mice from conception to study its effect on the development of lymphoma. Between 12 and 14 months, at a time when 100% of mice on a diet of high polyunsaturated-to-saturated fatty acid ratio showed lymphoma, only 70% of the mice fed the low P/S diet had developed lymphoma. Dietary fatty acid levels would appear to have a significant effect on the rate of progression of lymphoma in SJL/J female mice. PMID- 3955540 TI - Cisplatin and nifedipine: synergistic cytotoxicity against murine solid tumors and their metastases. AB - Calcium channel blockers of 3 chemical classes and calmodulin antagonists have recently been shown to enhance the cytotoxicity of conventional cancer chemotherapeutic agents. We tested the ability of nifedipine, a dihydropyridine class calcium channel blocker, to enhance the cytotoxicity of cisplatin, the current chemotherapeutic of choice against human head and neck tumors and testicular carcinoma. Both in vitro and in vivo, combination therapy with nifedipine and cisplatin resulted in synergistic inhibition of tumor cell proliferation, primary tumor growth and appearance of spontaneous pulmonary metastases. This combination also significantly increased the survival of mice bearing cisplatin-resistant tumors. This is the first indication that calcium channel blockers can enhance the cytotoxicity of cisplatin as well as the first demonstration that calcium channel blockers can enhance cytotoxicity of chemo therapeutic agent against a solid tumor and its metastases. PMID- 3955541 TI - Updating lung cancer mortality among a cohort of man-made mineral fibre production workers in seven European countries. AB - A historical cohort of 21,967 workers ever employed in 13 European factories manufacturing various types of man-made mineral fibres (MMMF) was observed until 1982. Overall there were 2719 deaths (standardised mortality ratio (SMR) = 111) of which 189 were from lung cancer (SMR = 125). For the glasswool and rockwool/slagwool production subcohorts the lung cancer SMRs rose with time since first exposure, exceeding 170 for the period of 30 or more years. Adjustment for regional variations in mortality substantially reduced the excess in the glasswool group, but not in the rockwool/slagwool. In neither subgroup was there any relationship of lung cancer mortality with length of employment. During the early years of rockwool/slagwool production there was the potential for much higher fibrous dust exposure than at present, because of the absence of dust suppressing oil and/or the use of a batch production process. In addition slag was widely used as a raw material. Amongst workers employed during the early phase, there were 10 lung cancer deaths giving SMRs of 270 and 244 for the periods 20-29 and 30 or more years since first exposure. This group accounts for most of the absolute excess of lung cancer for the rockwool/slagwool plants. PMID- 3955542 TI - Elevated serum alpha(1----3)-L-fucosyltransferase activity with synthetic low molecular weight acceptor in human ovarian cancer. AB - Serum alpha(1----3)-L-fucosyltransferase activity was measured in 29 ovarian cancer patients with active disease, 26 ovarian cancer patients with no clinical evidence of disease and 23 healthy females. N-Acetyl-2'-O-methyl-lactosamine was used as the acceptor for the enzyme. The level of the enzyme activity was significantly (P less than 0.05) higher in the serum of patients with known tumor when compared to healthy controls and patients with no clinical evidence of disease. PMID- 3955543 TI - In vitro assay demonstrates similar invasion profiles for B16F1 and B16F10 murine melanoma cells. AB - The variants of the B16 murine melanoma cell line were assayed for their invasive characteristics in the membrane invasion culture system (MICS) and concomitantly tested for their ability to form lung metastases in vivo. Specifically, the B16F1 (low metastatic variant) and the B16F10 (high metastatic variant) murine melanoma cell lines were examined for their ability to invade human amniotic basement membranes (BMs) in vitro and simultaneously examined for lung colony formation in vivo. The B16F1 and B16F10 cell lines both demonstrated similar invasion profiles over 72 h with the total percent invasion through the BMs for both cell lines not exceeding 5.0%. In vivo observations reconfirmed the significant difference in the metastatic capabilities of the 2 variants. These data suggest that tumor cells with differing metastatic propensities can invade an amniotic BM at similar rates, but their survival and metastatic lesion forming capabilities in vivo may vary considerably. PMID- 3955544 TI - Cisplatin and vinblastine chemotherapy for metastatic non-small cell carcinoma followed by irradiation in patients with regional disease. AB - Forty-four patients with non-small cell carcinoma of the lung were treated every 3 weeks with vinblastine (4 mg/m2/day iv X 2) and cisplatin (20 mg/m2/day iv X 3). Of the 28 patients with metastatic disease, eight (29%; 90% confidence interval of true response, 17%-47%) achieved objective response, for a median duration of 27 weeks. Median survival in this group was 47 and 28 weeks for responders and nonresponders, respectively. Of the 16 patients with advanced regional disease, 11 (69%; 90% confidence interval of true response, 49%-86%) achieved objective response. Thirteen of these patients received consolidation radiotherapy (4500 cGy/25 fractions/5 weeks), with a boost of 1000 cGy/5 fractions/1 week in those patients who achieved response. In the three patients who did not receive radiotherapy, two died during the induction phase, one from grade 4 leukopenia and sepsis and the second from unrelated factors. The third patient had systemic progression of disease during induction chemotherapy. Six patients experienced overall improvement in their chemotherapy response from the radiotherapy. Two patients who did not respond to the chemotherapy achieved partial response with irradiation. Four patients who had partial response to the chemotherapy achieved complete response with irradiation, and seven patients had no further change in their degree of response to irradiation. The overall median survival of this group was 81 weeks. Maintenance chemotherapy was not given. After radiotherapy, the site of first failure was outside the radiation field in nine of 13 patients (69%). Hematologic toxicity was dose-limiting. Other toxic effects that were not dose-limiting included nephrotoxicity, neurotoxicity, and acute nausea and vomiting. In the patients with advanced regional disease, there was no increase in the radiation toxicity attributable to the chemotherapy. We conclude that: (a) this dose schedule of vinblastine and cisplatin has reproducible activity in non-small cell carcinoma of the lung; (b) the response and median survival of patients with advanced regional disease are superior to those of patients with metastatic disease; and (c) in patients with advanced regional disease, treatment with chemotherapy followed by radiotherapy yielded an overall response rate of 81% (90% confidence interval of true response, 60%-93%) and improved survival compared to a similar group of patients studied by others receiving radiotherapy alone. We recommend further testing of this concept. PMID- 3955545 TI - Combination chemotherapy with vindesine, etoposide, and cisplatin in non-small cell lung cancer: a pilot study of the Southeastern Cancer Study Group. AB - Ninety-two patients with advanced non-small cell lung cancer were treated with a combination chemotherapy regimen containing cisplatin, vindesine, and etoposide. Eighteen patients (20%) achieved major responses to therapy (three complete responders and 15 partial responders). Response rates were similar in each histologic subtype. Initial performance status was an important determinant of response; 42% of the patients with a Karnofsky performance status greater than or equal to 70% responded versus 5% of those with a performance status less than 50%. The median duration of partial response was 21 weeks; complete responders had a median response duration of 50 weeks. The median survival for the entire group was 23.5 weeks. Toxicity with this regimen was acceptable; myelosuppression was the major toxic effect and was severe in only 10% of the patients. This regimen produced response rates comparable to those reported with other combinations containing cisplatin. Survival advantage in patients receiving this treatment is not established. PMID- 3955546 TI - Electrocardiographic monitoring of patients receiving phase I cancer chemotherapy. AB - Previous reports have characterized the various non-drug-induced cardiac disorders in cancer patients as well as the cardiotoxicity of commonly used anticancer agents. This study was conducted to determine the non-drug-related incidence of arrhythmias in patients receiving phase I antineoplastics. Twenty four-hour Holter monitors were placed on 36 consecutive patients about to receive phase I agents. A 1-4-hour baseline was obtained before treatment was begun. Sixty-four percent of the patients observed had a wide variety of ventricular and supraventricular dysrhythmias which did not increase during or after chemotherapy. Eighty-four percent of these arrhythmias were not detected during routine monitoring consisting of baseline 12-lead ECGs and 1-minute rhythm strips prior to, during, and after treatment, but were detected with the Holter monitor. Thirty-six percent of the dysrhythmias detected by the Holter monitor were considered potentially treatable arrhythmias requiring further evaluation and possible therapeutic intervention. During the early development of phase I agents, careful evaluation should be exercised so as not to confuse pre-existing, undiagnosed arrhythmias with drug-induced changes. To more accurately determine the true arrhythmogenic potential of phase I agents, Holter monitoring should be considered as a standard part of patient assessment prior to entry of a patient in phase I trials. PMID- 3955547 TI - Disposition of tricyclic nucleoside-5'-monophosphate in blood and plasma of patients during phase I and II clinical trials. AB - Tricyclic nucleoside-5'-monophosphate (TCN-P) and its dephosphorylated metabolite tricyclic nucleoside (TCN) have been measured in the blood and plasma of patients receiving TCN-P by rapid iv infusion in a phase I trial at daily doses of 24-55 mg/m2 for 5 days and in patients receiving TCN-P in a phase II trial at a single dose of 250 mg/m2. TCN-P was rapidly accumulated by rbcs and had an initial half life in blood of 6.1 hours and a terminal half-life of 89.2 hours. Total-body blood clearance of TCN-P was 2.6 ml/minute/m2. The concentration of TCN-P in blood was not related to the dose of TCN-P and did not increase over 5 days' administration in the phase I patients. Plasma contained little detectable TCN-P even 5 minutes after administration. Plasma contained low concentrations of TCN, up to 0.4 microgram/ml, which were maintained over several days. TCN did not accumulate in the plasma with repeated administration of TCN-P in the phase I patients. No other metabolites of TCN-P, apart from TCN, were detected in blood or plasma. No relationship was detected between pharmacokinetics and toxic response of TCN-P in the phase II patients. PMID- 3955548 TI - Phase II studies of homoharringtonine in patients with advanced malignant melanoma; sarcoma; and head and neck, breast, and colorectal carcinomas. AB - Five phase II trials of the antitumor agent homoharringtonine were conducted in 80 patients who had advanced solid tumors. The five categories of solid tumors included malignant melanoma; sarcoma; and head and neck, breast, and colorectal carcinomas. The starting dose of homoharringtonine was 3.0-4.0 mg/m2 by short iv infusion daily X 5 days every 21 days. Seventy-eight of 80 patients had had prior chemotherapy and 49 had had prior radiation therapy. Among the 74 evaluable patients in the five tumor categories, there were no complete or partial remissions. Homoharringtonine was generally well-tolerated. Nausea and vomiting, diarrhea, and fever and chills were the most common side effects. Serious reversible cardiovascular toxicity, which occurred in three patients, included symptomatic hypotension in two and short runs of ventricular tachycardia in one. The investigations thus conclude that homoharringtonine given by intermittent schedule is an inactive drug against these solid tumors previously exposed to chemotherapy. PMID- 3955549 TI - Effect of tamoxifen on immune functions. AB - Tamoxifen (20 mg twice daily) was given to ten patients with breast cancer whose immune functions were determined prior to and 3, 6, and 12 months after starting tamoxifen therapy. No consistent changes could be observed in erythrocyte rosette forming cell counts, erythrocyte antibody rosette-forming cells, active erythrocyte rosette-forming cells, theophylline-resistant rosette-forming cells, surface immunoglobulin-positive cells, and responses to mitogens phytohemagglutinin and concanavalin A. Erythrocyte antibody rosette-forming cells decreased significantly, however, at 6 months and active erythrocyte rosette forming cells at 12 months after starting tamoxifen. We conclude that no change in the immune capacity could be detected during tamoxifen treatment. PMID- 3955550 TI - Metalloporphyrin contrast agents for magnetic resonance imaging of human tumors in mice. AB - Enhanced contrast of transplanted human colon carcinoma in athymic mice is seen in magnetic resonance images upon iv injection of the complexes of Mn(III) with two water-soluble porphyrins, tetra (4-sulfonatophenyl) porphyrin and tetra (N methyl-4-pyridyl) porphyrin. PMID- 3955551 TI - Minimal surgical debridement for the treatment of chemotherapeutic agent-induced skin extravasations. AB - A rat model was employed to determine the efficacy of early minimal debridement in decreasing the size of chemotherapeutic agent-induced skin ulcers. After receiving bilateral flank injections of doxorubicin in a concentration comparable to that received by humans, the right injection site underwent minimal debridement 1, 24, or 72 hours after the injection. The left side of each animal was not operated upon and served as a control. Three subgroups of the 1-, 24-, and 72-hour debridement groups were treated as previously described, except that any residual necrotic tissue was debrided 1 week after the original debridement. All minimal debridement and redebridement groups produced significant decreases in ulcer size compared to controls. Comparing minimal debridement and redebridement groups to controls, it was found that surgery produced reductions in the number of persistent ulcers in all groups. Minimal debridement followed by redebridement was significantly more effective than minimal debridement alone in decreasing ulcer size acutely. One case is presented in which an extravasation of dactinomycin was treated by early minimal debridement. The patient had an uncomplicated postoperative course, and at follow-up 21 months after surgery had excellent functional and cosmetic results. Based upon animal studies and human experience, early surgical debridement appears to be a promising new method for the treatment of clinically significant vesicant extravasations in humans. PMID- 3955552 TI - Phase II evaluation of doxorubicin plus cisplatin in advanced thyroid cancer: a Southeastern Cancer Study Group Trial. AB - Twenty-two evaluable patients with all cell types of advanced thyroid cancer were treated with the combination of doxorubicin (60 mg/m2) plus cisplatin (60 mg/m2). There were two brief partial remissions (9.1%). There was considerable toxicity, with one drug-related death. Combination chemotherapy as given in this study was not effective for this patient population. PMID- 3955553 TI - Lack of synergy between cisplatin and cytarabine against ovarian carcinoma in vitro. AB - Synergy has been reported for the combination of cisplatin and cytarabine in a murine model and in several human cell lines in vitro. Clinical trials are under way with this combination. However, we were unable to demonstrate any significant synergistic interaction between these two agents in two human ovarian carcinoma cell lines with either 4-hour or continuous concurrent exposure in vitro at drug concentration producing 1-2 logs of cell kill. Synergy between these two drugs may be limited to unique cell lines and tumors. PMID- 3955554 TI - Effect of 1-methyl-5-sulfonamide-4-nitroimidazole and 1-methyl-5-bromide-4 nitroimidazole on the radiosensitivity of EMT6 tumor cells. AB - The compounds 1-methyl-5-sulfonamide-4-nitroimidazole and 1-methyl-5-bromide-4 nitroimidazole are extremely effective radiosensitizers of hypoxic cells in vitro. Preincubation of hypoxic cells with these and related drugs produces greater sensitization than is obtained with short incubations or is expected from the electron affinities of the compounds. The experiments reported here were undertaken to determine whether these agents were effective in sensitizing the naturally occurring hypoxic cells of solid tumors in mice. Neither of the 4 nitroimidazoles produced significant radiosensitization of the hypoxic cells of EMT6 mouse mammary tumors in vivo with any of the single- or multiple-injection regimens tested. PMID- 3955555 TI - Cisplatin in patients with gastric cancer: a Cancer and Leukemia Group B phase II study. PMID- 3955556 TI - Phase II trial of aminothiadiazole in advanced non-small cell lung cancer. PMID- 3955557 TI - Phase II study of sequential methotrexate and 5-FU combination in the treatment of advanced colorectal cancer. PMID- 3955558 TI - Phase II trial of bisantrene in previously treated patients with ovarian carcinoma: a Southwest Oncology Group Study. PMID- 3955559 TI - Phase II trial of diaziquone in malignant mesothelioma. PMID- 3955560 TI - Cardiotoxicity associated with 4'-deoxydoxorubicin. PMID- 3955561 TI - A new synthesis of lipid Y by the use of chemoselective debenzylation as a key step. PMID- 3955562 TI - Identification of pyruvated monosaccharides in polysaccharides by gas-liquid chromatography mass spectrometry. AB - Twelve bacterial polysaccharides of known structure containing a representative range of pyruvated monosaccharides, were methanolysed, trimethylsilylated, and analysed by g.l.c. and g.l.c.-m.s. Except for 3,4-O-(1-carboxyethylidene)-L rhamnose, which was unusually labile, the pyruvic acid substituents were largely retained during methanolysis and the Me3Si derivatives of the resulting pyruvated methyl glycosides gave distinctive g.l.c. peaks with characteristic mass spectra. The pyranose rings of 4,6-O-(1-carboxyethylidene)-D-glucose, 4,6-O-(1 carboxyethylidene)-D-mannose, 4,6-O-(1-carboxyethylidene)-D-galactose, and 3,4-O (1-carboxyethylidene)-D-galactose survived the methanolysis, but that of 2,3-O-(1 carboxyethylidene)-D-glucuronic acid was cleaved to give the methyl ester of 2,3 O-(1-carboxyethylidene)-aldehydo-D-glucuronic acid dimethyl acetal. In the case of 2,3-O-(1-carboxyethylidene)-D-galactose, cleavage of the pyranose ring was less complete; under the conditions used in these experiments two-thirds of the pyranose rings were intact while one-third were cleaved to give the methyl ester of 2,3-O-(1-carboxyethylidene)-aldehydo-D-galactose dimethyl acetal. A very small amount of 3,4-O-(1-carboxyethylidene)-L-rhamnose from one polysaccharide retained its pyruvic acid substituent after gentle methanolysis to give the methyl ester of 3,4-O-(1-carboxyethylidene)-aldehydo-L-rhamnose dimethyl acetal. Susceptibility to cleavage of the pyranose ring during methanolysis appears to be a property of pyruvated monosaccharides with trans-fused 1,3-dioxolane rings. PMID- 3955564 TI - N.m.r. spectroscopic observations related to the function of sulfate groups in heparin. Calcium binding vs. biological activity. AB - Chemically-modified heparins containing different combinations of N- and O sulfate groups were prepared. Characterized by high field 1H- and 13C-n.m.r. spectroscopy, the polymers exhibited chemical shift variations in general accord with shielding differences expected on removal of sulfate substituents, and additional variations that probably arose from conformational changes in the polymers. Whereas the anticoagulant activity of heparins, as measured by USP, anti-Xa, and thrombin-time assays, was invariably reduced by the chemical transformations effected, the ability of heparin to bind calcium ions was found to be dependent on retention of the 2-sulfamino group, whether or not O-sulfate groups were present. The results suggest that the 2-sulfamino group is essential for maintaining a molecular conformation consistent with the ability for the L iduronic acid residues to complex with calcium ions. Also, they show that although the anticoagulant and calcium-binding properties of heparin may be interdependent, they are not determined by the same structural entities in the polymer. PMID- 3955563 TI - Location and identity of the acyl substituents on the extracellular polysaccharides of Rhizobium trifolii and Rhizobium leguminosarum. AB - The basic structures of the extracellular polysaccharides of Rhizobium leguminosarum and Rhizobium trifolii were found to be identical, but their acylation patterns differ. Liquid hydrogen fluoride at -40 degrees degrades the two polysaccharides to a series of oligosaccharides representing the repeating units of the polysaccharides and their higher homologs. At -23 degrees, it degrades the polymers to a mixture of oligosaccharides from which a tetrasaccharide constituting a unit of the backbone of the polysaccharide, and a trisaccharide representing all but the non-reducing terminus of the side chain, could be readily purified. The location and identity of the acyl substituents were determined by 1H-n.m.r. spectroscopy, methylation analysis, and f.a.b. mass spectrometry. The unusual substituent D-3-hydroxybutanoate was found esterified to O-3 of a terminal 4,6-O-pyruvic acetylated D-galactose in both strains of R. leguminosarum, and in one of the three strains of R. trifolii tested. All of the strains tested contained a 3-O-acetyl substituent on the (1----4)-beta-D glucopyranosyl residues in the backbone of the polysaccharide. Only the R. leguminosarum polysaccharides contained a combination of 2- and 3-O-acetyl groups on the branching sugar of the backbone of the polymer. PMID- 3955566 TI - Isolation and characterization of two sialyloligosaccharides containing N acetyllactosamine from pregnancy urine. PMID- 3955565 TI - Synthesis of 2,3-epoxypropyl O-beta-D-galactopyranosyl-(1----6)-beta-D galactopyranoside. PMID- 3955567 TI - F.t.-i.r. and laser-Raman spectra of cytosine and cytidine. AB - Fourier-transform infrared (F.t.-i.r.) and laser-Raman spectra of cytosine and cytidine in the solid state have been recorded and assignments of the frequencies made. Comparison of the observed frequencies for cytosine with those for cytidine permits identification of the bands characteristic of the sugar on the one hand, and of the pyrimidine base on the other. PMID- 3955568 TI - [Glycoside synthesis of N-acetylneuraminic acids with secondary hydroxyl groups]. PMID- 3955569 TI - F.t.-i.r. and laser-Raman spectra of guanine and guanosine. AB - Fourier-transform infrared (F.t.-i.r.) and laser-Raman spectra have been obtained for solid guanine. The F.t.-i.r. spectrum of guanosine in the solid state was also recorded. Assignments are proposed for the i.r. bands. The molecular basis of the spectral differences between guanine and guanosine are discussed. PMID- 3955570 TI - X-ray crystal structure of galabiose, O-alpha-D-galactopyranosyl-(1---4)-D galactopyranose. AB - O-alpha-D-Galactopyranosyl-(1---4)-D-galactopyranose, C12H22O11, Mr = 342.30, crystallises in the orthorhombic space group P2(1)2(1)2(1), and has alpha = 5.826(1), b = 13.904(3), c = 17.772(4) A, Z = 4, and Dx = 1.579 g.cm-3. Intensity data were collected with a CAD4 diffractometer. The structure was solved by direct methods and refined to R = 0.063 and Rw = 0.084 for 2758 independent reflections. The glycosidic linkage is of the type 1-axial-4-axial with torsion angles phi O-5' (O-5'-C-1'-O-1'-C-4) = 98.1(2) degrees, psi C-3 (C-3-C-4-O-1'-C 1') = -81.9(3) degrees, phi H (H-1'-C-1'-O-1'-C-4) = -18 degrees, and psi H (H-4 C-4-O-1'-C-1') = 35 degrees. The conformation is stabilised by an O-3 . . . O-5' intramolecular hydrogen-bond with length 2.787(3) A and O-3-H . . . O-5' = 162 degrees. The glycosidic linkage causes a folding of the molecule with an angle of 117 degrees between the least-square planes through the pyranosidic rings. The crystal investigated contained 56(1)% of alpha- and 44(1)% of beta-galabiose as well as approximately 70% of the gauche-trans and approximately 30% of the trans gauche conformers about the exocyclic C-5'-C-6' and C-5-C-6 bonds. The crystal packing is governed by hydrogen bonding that engages all oxygen atoms except the intramolecular acceptor O-5' and the glycosidic O-1' oxygen atoms. PMID- 3955571 TI - Catalytic versatility of trehalase: synthesis of alpha-D-glucopyranosyl alpha-D xylopyranoside from beta-D-glucosyl fluoride and alpha-D-xylose. AB - Trehalase was previously shown (see ref. 5) to hydrolyze alpha-D-glucosyl fluoride, forming beta-D-glucose, and to synthesize alpha, alpha-trehalose from beta-D-glucosyl fluoride plus alpha-D-glucose. Present observations further define the enzyme's separate cosubstrate requirements in utilizing these nonglycosidic substrates. alpha-D-Glucopyranose and alpha-D-xylopyranose were found to be uniquely effective in enabling Trichoderma reesei trehalase to catalyze reactions with beta-D-glucosyl fluoride. As little as 0.2mM added alpha D-glucose (0.4mM alpha-D-xylose) substantially increased the rate of enzymically catalyzed release of fluoride from 25mM beta-D-glucosyl fluoride at 0 degrees. Digests of beta-D-glucosyl fluoride plus alpha-D-xylose yielded the alpha, alpha trehalose analog, alpha-D-glucopyranosyl alpha-D-xylopyranoside, as a transient (i.e., subsequently hydrolyzed) transfer-product. The need for an aldopyranose acceptor having an axial 1-OH group when beta-D-glucosyl fluoride is the donor, and for water when alpha-D-glucosyl fluoride is the substrate, indicates that the catalytic groups of trehalose have the flexibility to catalyze different stereochemical reactions. PMID- 3955572 TI - Cyclic platelet-activating factor analogues derived from 2-deoxy-D-erythro pentose. AB - A method for the synthesis of chiral cyclic analogues of platelet-activating factor (PAF) is reported. Treatment of suitably substituted derivatives of 2 deoxy-D-erythro-pentose with phosphorus oxychloride, followed by choline p toluenesulfonate generates cyclic phospholipids in good yield. Further chemical modification produces other compounds including optically active gamma butyrolactones such as 2-deoxy-5-O-hexadecyl-3-O-phosphocholyl-D-erythro-pentono 1, 4-lactone and 2-deoxy-3-O-hexadecyl-5-O-phosphocholyl-D-erythro-pentono-1, 4 lactone. All phospholipids were poor antagonists of PAF-induced aggregation of human platelets, and two analogs were poor agonists. The chemistry presented should be useful for the syntheses of other conformationally restricted analogues of PAF. PMID- 3955573 TI - Synthesis of N-trifluoroacetyl-L-acosamine, N-trifluoroacetyl-L-daunosamine, and their 1-thio analogs. AB - A simple and efficient route to N-trifluoroacetyl-L-acosamine (13), N trifluoroacetyl-L-daunosamine (12), and their 1-thio analogues (18 and 20) is described. Stereoselective reduction of oxime 5 with borane, followed by trifluoroacetylation resulted in the arabino methyl glycoside (8), which, on mild acid hydrolysis gave N-trifluoroacetyl-L-acosamine (13) in an overall yield of 33%, based on L-rhamnal (1). Upon oxidation of the C-4 hydroxyl group and stereoselective reduction of the resulting ketone 11, compound 8 of L-arabino configuration was converted into N-trifluoroacetyl-L-daunosamine (12) in a one flask sequence with an overall yield of 28% calculated for 1. Benzyl 1-thio-N trifluoroacetyl-alpha-L-acosaminide (18) was synthesized from enone 2 on Michael type addition of phenylmethanethiol, followed by oximation, stereoselective reduction with borane and subsequent trifluoroacetylation. 4-O-Acetyl-1-S-acetyl N-trifluoroacetyl-1-thio-beta-L-daunosamine 20 was prepared from 12 via the corresponding glycosyl chloride derivative. PMID- 3955574 TI - Purification and saccharide-binding characteristics of a rice lectin. AB - A lectin was purified from rice flour by aqueous extraction followed by precipitation by ammonium sulfate and affinity chromatography on p-aminobenzyl 2 acetamido-2-deoxy-1-thio-beta-D-glucoside-succinyl-aminohexylaminyl -Sepharose 4B. The molecular weight of the lectin is approximately 36,000, as determined by sedimentation-equilibrium analysis. It is a tetramer consisting of two different subunits (Mr = 12,000 +/- 1,000 and 9,000 +/- 1,000). Amino acid analysis indicated that the lectin contains very high proportions of half-cystine, glycine, and glutamic acid. All of the half-cystines are present as -S-S- bridges. The lectin agglutinates human A, B, AB, and O erythrocytes, rabbit erythrocytes, human leukocytes, and is mitogenic to human lymphocytes. The hemagglutinating activity of rice lectin is inhibited by 2-acetamido-2-deoxy-D glucose, methyl 2-acetamido-2-deoxy-beta-D-glucoside, chitobiose, and chitotriose. N-Acetylneuraminic acid was a noninhibitor, but N-acetylneuramin-(2- --3)-lactose showed weak inhibition. The agglutinating activity was also inhibited by various sialoglycoproteins. The immobilized rice-lectin bound glycophorin, alpha 1-acid glycoprotein, and fetuin. Asialoglycophorin, asialofetuin, ovomucoid, and human chorionic gonadotropin were bound only partially to the column. PMID- 3955575 TI - 3-Methoxy-4-(2-nitrovinyl)phenyl glycosides as potential chromogenic substrates for the assay of glycosidases. AB - Selective glycosidation of 2,4-dihydroxybenzaldehyde with either 2,3,4, 6-tetra-O acetyl-alpha-D-glucopyranosyl bromide, 2-acetamido-3,4,6-tri-O-acetyl-alpha-D glucopyranosyl chloride, or 2,3,4,6-tetra-O-acetyl-alpha-D-galactopyranosyl bromide afforded the corresponding 4-O-glycosyl derivatives. Subsequent O methylation, O-deacetylation, and condensation with nitromethane afforded the appropriate beta-glycoside of 3-methoxy-4-(2-nitrovinyl)phenol. The phenol is highly coloured at alkaline pH so that these glycosides may be suitable as chromogenic substrates for the assay of glycosidases. PMID- 3955577 TI - A convenient synthesis of apiose. PMID- 3955576 TI - Bioactive chitin derivatives. Activation of mouse-peritoneal macrophages by O (carboxymethyl)chitins. AB - The effect of O-(carboxymethyl)chitins (CM-chitins) on the activation of mouse peritoneal macrophages in vivo and their mitogenic activity on mouse spleen-cells were investigated. The induction of cytotoxic macrophages is enhanced by an increase of negative charge at O-6 and decreased by further modification at O-3 of the GlcNAc residue. CM-Chitins had a minor effect on mitogenic activity that was independent of the site of modification; partially N-deacetylated chitins had little activity. Although there was remarkable enhancement of accessibility to lysozyme upon modification at O-6 of the GlcNAc residue, the accessibility was decreased by further substitution at O-3. PMID- 3955578 TI - Application of n.m.r. spectroscopy, including n.O.e. studies, to the O-specific polysaccharide from Pseudomonas cepacia strain IMV 3181. PMID- 3955579 TI - Echocardiographic diagnosis of anatomically corrected malposition of the great arteries. AB - In anatomically corrected malposition of the great arteries, the great arteries are abnormally related to one another and to the ventricles but arise from their normal ventricles. We present here a case in which this diagnosis was made by echocardiography and confirmed by cardiac catheterization. PMID- 3955580 TI - Recurrent preexcited reciprocating tachycardia, concealed ventricular preexcitation and conduction disturbances in the normal atrioventricular pathway in a newborn. AB - We describe a newborn infant with concealed ventricular preexcitation in sinus rhythm on the early ECGs, and who developed recurrent episodes of preexcited reciprocating tachycardia. Manifestation of the ventricular preexcitation and initiation of the tachycardias were dependent on the presence of severe conduction disturbances in the normal atrioventricular pathway, probably in the atrioventricular node. PMID- 3955581 TI - Atypical Wenckebach block and concealed conduction. AB - Following exercise testing, a 71-year-old man developed atrial tachycardia with a unusual form of conduction disturbance: 4:2 atrioventricular (A-V) block. This pattern of A-V block is explainable by two different mechanisms of concealed conduction: two different levels of block in the A-V nodal region and dual A-V nodal pathways with concealed retrograde conduction of P waves. These concepts can also explain a variety of other unusual conduction disturbances. PMID- 3955582 TI - Transcapillary exchange in the hindlimb and intestine of dogs with right heart failure. AB - The effects of chronic right ventricular volume overload, congestive heart failure (HF) on transcapillary exchange of lipid-insoluble solutes in the hindlimb and small intestine were studied in anesthetized dogs. Using the single injection indicator diffusion method, extractions (E), capillary clearances (C), and capillary permeability surface area products (PS) of urea, sucrose, and inulin were measured in the hindlimb and small intestine of 16 control and 14 HF dogs. Right HF was caused by surgically produced tricuspid insufficiency. The HF dogs exhibited increased central venous pressures, right ventricular end diastolic pressure, and heart rates as well as gross ascites and pleural effusion. The small intestine of the HF dogs demonstrated increased E, C and PS values for all three solutes, while no changes were seen in the hindlimb. These changes in the capillary bed of the small intestine could be due to an increase in capillary permeability, and/or capillary surface area. PMID- 3955583 TI - Postoperative evaluation of endomyocardial fibrosis. AB - 25 patients with angiographic features suggestive of endomyocardial fibrosis underwent endocardiectomy and atrioventricular valve replacement. There were 8 deaths. 17 survivors were reevaluated after a mean follow-up of 13.5 months. 8 had right ventricular endomyocardial fibrosis (RVEMF) 5 had left ventricular endomyocardial fibrosis (LVEMF) and 4 had biventricular disease (BVEMF). The survivors showed a significant improvement in their clinical features and functional status. There was a significant reduction in atrial size in X-ray. Hemodynamic data showed a significant fall in right heart filling pressure, right ventricular systolic pressure and pulmonary artery mean pressure, and a significant fall in left heart filling pressure in patients with left ventricular disease either alone or as a part of biventricular disease. In ventriculogram, while there was no change in right ventricular shape after endocardiectomy, left ventricular shape was restored to near normal. The significant improvement is mostly due to the correction of the regurgitant lesion and to some extent due to restoration of ventricular compliance. PMID- 3955584 TI - Relationship between serum enzyme activity in acute myocardial infarction and morbidity during a 2-year follow-up. AB - In 585 patients with a first myocardial infarction the enzymatically estimated infarct size was related to the clinical course during a 2-year follow-up. Infarct size was estimated from maximum heat-stable lactate dehydrogenase activity. A higher maximum serum activity was associated with a higher mortality rate, more treatment with diuretics, digitalis and antiarrhythmics and a lower frequency of return to work. Patients with smaller infarcts according to maximum serum activity, however, had a higher incidence of angina pectoris and a higher reinfarction rate. We conclude that although there is a strong association between serum enzyme activity and mortality during a 2-year follow-up, the relation with morbidity appears to be more complex. PMID- 3955585 TI - Quantification of thallium-201 myocardial uptake using serial dynamic imaging at rest and during exercise. AB - The thallium-201 myocardial uptake ratio was measured using serial dynamic imaging of the initial uptake phase following an intravenous bolus injection. It revealed no significant difference at rest between non-coronary heart disease and coronary artery disease, while it was greater in cases with left ventricular hypertrophy. With exercise loading, this value significantly increased in non coronary heart disease, whereas less increase was observed in coronary artery disease. This increasing capability was lower in multivessel disease compared with single-vessel disease. PMID- 3955586 TI - [Study of cardiovascular diseases in developing countries supported by the World Health Organization. Experience in Ghana 1972-1982]. PMID- 3955587 TI - [Preoperative evaluation of patients using hand-propelled ergometry before aortofemoral and aortoiliac bypasses]. PMID- 3955588 TI - [Rupture of the papillary muscle in acute myocardial infarct]. PMID- 3955589 TI - [What do you consider to be the greatest problem in modern geriatrics?]. PMID- 3955590 TI - [What do we know and not know about Alzheimer's disease]. PMID- 3955591 TI - [Cerebral blood circulation in organic psycho-syndromes]. PMID- 3955593 TI - [A simple physical method for the detection of geoanomalous zones]. PMID- 3955592 TI - [Glucose in the saliva of diabetics]. PMID- 3955594 TI - [Genetic basis of autoimmunity]. PMID- 3955595 TI - [HLA compatibility and transfusion of a platelet concentrate--a necessary prerequisite for the successful transfusion of platelet concentrates in patients with HLA antibodies]. PMID- 3955596 TI - [HLA and malignant lymphogranuloma]. PMID- 3955597 TI - [Conduction disorders in the bundle of His]. PMID- 3955598 TI - [Disorders of blood flow in the lower leg in diabetics]. PMID- 3955599 TI - [Right-heart catheterization in ankylosing spondylitis]. PMID- 3955600 TI - [Adenolysis of the hypophysis using transnasal puncture in patients with pain due to malignant tumors]. PMID- 3955601 TI - [Clinical significance of the determination of the terminal carboxyl region of the parathormone molecule in serum using radioimmunoanalysis]. PMID- 3955602 TI - [Changes in HDL-cholesterol and LDL-cholesterol in the blood in patients with thyrotoxicosis and its relation to atherogenesis]. PMID- 3955603 TI - [Initial experimental findings on the disruption of gallstones using focused shock waves]. PMID- 3955604 TI - [Why not consult Balint?]. PMID- 3955605 TI - [The effect of furosemide on vitamin C excretion in urine in chronic kidney failure]. PMID- 3955606 TI - [Significance of monitoring the number of circulating platelet aggregates in clinical practice]. PMID- 3955607 TI - [An unusual case of the elimination of a man from the paternity of 6 children using the HLA system and the determination of 3 actual fathers]. PMID- 3955608 TI - [The increase in resistance to antimalarials]. PMID- 3955609 TI - [The relationship between the older person and the therapist]. PMID- 3955610 TI - [Psychological approach to patients in ambulatory practice. Acceptance, authenticity, empathy]. PMID- 3955611 TI - [Na+ and K+ transport by erythrocytes in normotensive children of patients with essential hypertension]. PMID- 3955612 TI - [Determination of the severity of aortic stenosis using a one-dimensional ultrasonic method]. PMID- 3955613 TI - [The unity of medical and social priorities in health care]. PMID- 3955615 TI - [Repeated use of dialyzers in the Czechoslovak Dialysis Program]. PMID- 3955614 TI - [Calcium antagonists and the peripheral circulation]. PMID- 3955616 TI - [Dermatoglyphic findings in families with spontaneous abortions]. PMID- 3955617 TI - [Herpetic encephalitis]. PMID- 3955618 TI - [Calcium ion antagonists and cerebral resuscitation after heart arrest]. PMID- 3955619 TI - [Psychological factors in the health status of the population]. PMID- 3955620 TI - [Successful use of prostaglandin E1 in severe progressive arteritis]. PMID- 3955621 TI - [The effect of physical stress on the repair of isoprenaline damage to the myocardium]. PMID- 3955623 TI - [Do calcium ion antagonists affect calmodulin activity?]. PMID- 3955622 TI - [Incidence of Hbs antigens at an internal medicine department and in diabetics. Contribution to the problem of the transmission of viral hepatitis B]]. PMID- 3955624 TI - [Thoughts on the present status and the future of Czechoslovak diabetology]. PMID- 3955625 TI - Mathematical model for human myeloma relating growth kinetics and drug resistance. AB - We present a computer-based mathematical model that can simulate characteristic features of the clinical time course of human myeloma. It asserts that therapy resistance in myeloma cells is an inherited trait associated with the longer inter-mitotic times of some cells and that the strength of this trait affects tumour growth characteristics. These kinetic differences within the malignant cell clone may also influence therapeutic efficacy. In the model, the same total therapy, administered in different time-dose fractions, could be 'curative' or 'minimally effective' depending on kinetic properties. For example, as others have shown, in myeloma pulsed intermittent therapy is often more effective than low dose continuous therapy. According to our model this finding is compatible with a high coefficient of inheritability of resistance from one cell generation to the next. The model also suggests that if there are subclones of varying resistance, a therapy must have some effect on each of them if it is to be employed in a curative fashion. While many aspects of the model are not yet clinically testable, exploration of its concepts might increase knowledge about fundamental neoplastic mechanisms. PMID- 3955626 TI - Growth fraction of myelocytes in normal human granulopoiesis. AB - The labelling index (LI) of myelocytes (M) after flash labelling of normal human bone marrow cells with [3H]-thymidine ([3H]TdR) is always lower that the LI obtained for myeloblasts (MB) and for promyelocytes (PM). This fact can be interpreted in two ways: it may mean that the duration of the G1 phase of the cell cycle is longer in M than in MB or PM, or it may mean that the proportion of cells in cycle, i.e., the growth fraction (GF), is lower in the M population than in MB or PM. The evolution of the LI and of the mean number of grains per cell was monitored in [3H]TdR-labelled normal bone marrow during in vitro incubation for 50 hr. The generation time, measured by the halving time of the mean number of grains per cell after flash labelling, was similar for M to that for MB and PM. During continuous labelling, the LI of MB and PM reached 1 and the LI value for M never rose to more than 50% of the values recorded for MB and PM after 30 hr. These findings give support to the second hypothesis, i.e., a lower GF in the M population. Good correlation was found between the LI of M and the proportion of mature polymorphonuclear cells in the bone marrow of normal subjects and of patients with chronic benign neutropenia or hyperleucocytosis. Variations in the M growth fraction could be a medium-term (2-3 days) regulatory factor in granulocyte production. PMID- 3955627 TI - Multiple-transition cell cycle models that exhibit transition probability kinetics. AB - Cell cycle models that allow multiple random transitions and asymmetric cell division may exhibit a property that has been used to support the transition probability model of the cell cycle: that the absolute value of the difference between sibling cell inter-mitotic times varies from one sibling pair to another and is described by an exponential statistical distribution. Three models that show this property are described, each of which postulates the existence of objects that are partitioned between daughter cells during cell division and whose number influences the duration of the subsequent cell cycle, e.g., surface receptors for growth factors or transcriptional complexes that are carried by sister chromatids. In the first model, sibling cells receive identical numbers of the objects, which are used to perform multiple random transitions that constitute part of the cell cycle. The second model is like the first, except that the partitioning of objects between the newly-formed sibling cells is random. The third model is also like the first, except that all of the objects are passed to one of the sibling cells. These results show that the general mechanisms that are responsible for the dispersion of inter-mitotic times, the correlation between sibling generation times and the apparently exponentially distributed difference between sibling generation times, could be a combination of unequal cell division, multiple random cell cycle transitions and heterogeneity of mitotic cells. PMID- 3955629 TI - Reparative growth in the rat thyroid: effect of TSH suppression. AB - Previous investigations have shown that thyroid incision leads to a dramatic burst of follicular cell mitotic activity in cells adjacent to the wound edge in both normal rats and rats made hypothyroid by chronic goitrogen administration. Wound-induced thyroid mitotic activity therefore, is seen in rats with either normal or supranormal levels of circulating thyrotropin (TSH). This study was designed to investigate the thyroid mitotic response to wounding in the absence of detectable levels of circulating TSH. Rats were injected with large doses of L thyroxine twice daily to render circulating TSH undetectable. Thyroids were incised and follicular cell mitotic activity, in relation to distance from the incision, determined at 24, 48 and 72 hr after incision. A mitotic response to wounding was maintained in L-thyroxine treated rats, even though circulating TSH was undetectable. The peak of activity was at 48 hr, but was only 50% of that found in the incised normal rat thyroid. The spatial distribution of the response suggests that there are two components of the wound response in the normal thyroid, one dependent on the presence of circulating TSH, the other TSH independent. The results are discussed in relation to current understanding of cellular growth control. PMID- 3955628 TI - Effects of extremely low frequency (ELF) electric fields on cell growth and DNA repair in human skin fibroblasts. AB - A number of physical and chemical agents in the environment have been studied for their ability to induce or alter DNA repair mechanisms in human cells. We have investigated the effects of 60 Hz, 1000 V/cm electric fields on DNA repair in normal human fibroblasts in vitro. An examination was done on the ability of electric fields suspected to cause damage which could be repaired by thymine dimer excision and measurable by the bromodeoxyuridine photolysis assay. The thymine dimer assay with enzyme-sensitive site analysis was used to measure the cells' capacity for removing ultraviolet light (u.v.)-induced pyrimidine dimers; during exposure to electric field 24 hr before u.v. irradiation; 24 hr after u.v. irradiation; and up to 48 hr continuously after u.v. irradiation. Cell growth and cell survival following electric field exposure were also studied. Within the limits of these experiments, it was found that exposure to such electric fields did not alter cell growth or survival, and no DNA repair or alteration in DNA excision repair capacity was observed as compared with unexposed control cultures. PMID- 3955630 TI - Growth rate regulation and random transition. A study performed on embryonal carcinoma cell lines. I. AB - Analyses of cell-cycle characteristics of the three embryonal carcinoma (EC) cell lines F9, PCC3 N/1 and PCC4 Azal, have been performed. The three lines reflect successive stages in early mouse embryogenesis as regards cell surface antigens and cell-cycle characteristics. In an attempt to understand changes in cell-cycle characteristics occurring during early embryogenesis, the two-random transition probability (TP) model was applied to the EC-cell system--and particularly to the F9 line. By utilizing an intraclonal heterogeneity in intermitotic times found in these EC lines, a growth-regulating point was introduced as a modification of the two-random TP model. The modified model was found to be very useful when demonstrating the cell-cycle growth kinetics of the F9 line. The model is used in an accompanying paper to extend the analysis of cell-cycle characteristics in undifferentiated EC cells. PMID- 3955631 TI - Cell growth and cell division: dissociated and random initiated? A study performed on embryonal carcinoma cell lines. II. AB - The 'random transition probability' cell-cycle models have so far failed to convincingly link the transition events with phenomena describable by biochemical methods. The study presented was carried out on the F9 and PCC3 N/1 embryonal carcinoma (EC) cell lines. We now report an extended analysis of the two-random transition probability (TP) model and preliminary results are presented showing that the deterministic L period in that model can be regarded as reflecting the 'cell-growth cycle'. Evidence is presented that suggests that the 'cell-growth cycle' is a supramitotic deterministic phase--i.e. starting in one cell cycle and being completed in the next following G1 period and dissociated from the 'DNA division cycle'. This phenomenon makes an interesting contribution to the old knowledge of a stepwise G1 prolongation during early embryogenesis in yielding a mechanism by which the cell can alter the ratio of nucleus to cytoplasm prior to the onset of gene expression. PMID- 3955632 TI - Effect of diabetes on the rhythm of [3H]thymidine incorporation in Con-A stimulated mice splenocytes. AB - The chronogram of hyperglycaemia in alloxan-induced diabetic DBA/2 mice (living under conditions standardized for light-synchronized periodicity and fed ad libitum) presented an ultradian rhythm (during spring) different from the circadian blood glucose chronogram of normal control mice. Simultaneously, the [3H]thymidine ([3H]TdR) incorporation chronogram of diabetic mouse splenocytes, stimulated or unstimulated with Concanavalin-A (Con-A), was changed and unbalanced, compared to that of normal control mice. Previous experiments showed that the [3H]TdR incorporation chronogram of stimulated or non-stimulated splenocytes of normal DBA/2 mice presented seasonal variations. They were characterized generally by an ultradian rhythm. Yet, during spring, they exhibited a circadian rhythm because one phase was advanced and superimposed on the other, the latter being typically unvarying. It seems probable that the unbalanced rhythm of [3H]TdR incorporated in diabetic mouse splenocytes, stimulated or not, was responsible for a dysfunction of that population in diabetes. PMID- 3955633 TI - The morphological basis of fluid balance in the interstitium of the juxtaglomerular apparatus. AB - The morphological basis of fluid balance in the interstitium of the juxtaglomerular apparatus (JGA) was reevaluated in rats, mice and Tupaia. Three ultrastructural features in the region of the vascular pole of the renal corpuscle are described that may be important for the fluid balance in this region: (1) podocyte foot processes in the parietal layer of Bowman's capsule, (2) endothelial fenestrations in the wall of the incoming afferent arteriole, both facing Goormaghtigh and epithelioid cells, and (3) the mesangial-type lining of the glomerular stalk. With respect to the relevant pressure gradients, this morphology may provide the basis of bulk-fluid flow directed to the interstitium of the JGA including the Goormaghtigh cell field. Thus, the fluid balance in the lacis area and, consequently, the tubulo-glomerular feedback mechanism, probably does not solely depend upon the reabsorptive transport of the macula densa. Similar considerations may be valid for the humoral control of renin secretion from juxtaglomerular epithelioid cells. PMID- 3955634 TI - Alkaline phosphatase activity at unusual sites of human foetal kidney. AB - Frozen sections of human foetal kidneys were treated by the lead citrate method in order to demonstrate alkaline phosphatase (ALP) activity. Unexpectedly, ALP activity was observed over the parietal layer of Bowman's capsule, in addition to usual localization in proximal tubules and blood vessels. The enzyme was confined to the membrane of microvilli belonging to tall columnar cells. Normally, in the mature nephron, these high cells are absent from the parietal layer that is instead entirely composed of squamous epithelium. ALP activity was also revealed at another unusual site in the kidney medulla. A collar of mesenchymal cells encapsulating groups of tubules and calyces gave an intense enzymatic reaction. The activity was present over the membrane of long cytoplasmic processes. The cytoplasm showed a well developed rough endoplasmic reticulum, an indication of a high rate of protein synthesis. The nearby presence of numerous collagenous fibrils is concordant with this assumption. Moreover, these ALP-positive cells might represent an intermediary stage through which cells have to pass before differentiating. PMID- 3955635 TI - Relation of actin fibrils to energy metabolism of endothelial cells. AB - The physiological significance of the association of glycolytic enzymes with actin fibrils was investigated in cell culture. Cytochalasin D (CD) was used to induce the known actin-based sequence of events in a culture of an endothelial cell line (XTH-2) derived from hearts from tadpoles of Xenopus laevis. 1 min following addition of CD, ruptures in the cortical fibrillar meshwork and in stress fibres are seen. At the same time the cellular ATP level decreases by ca. 25%. This and the following reactions resulting in a kind of arborization depend on a continuous supply with metabolic energy. As shown by measurements of oxygen consumption, cells with intact energy metabolism provide the ATP needed from glycolysis; ATP produced by oxidative phosphorylation is not utilized as long as lactate dehydrogenase (LDH) reoxidizes NADH2. After inhibition of LDH, respiration in XTH-2 cells doubles. CD treatment induces a transient increase in oxygen consumption, indicating an increased energy supply by respiration. From these results we conclude: The energy needed by the actomyosin system is - under normal metabolic conditions -supplied from ATP phosphorylated in glycolysis. The processes of energy metabolism seem to be highly compartmentalized; ATP is not a parameter that is kept constant in time intervals of minutes up to one hour. PMID- 3955637 TI - Quantitative changes in the lysosomal vacuolar system of rat hepatocytes during short-term starvation. A morphometric analysis with special reference to macro- and microautophagy. AB - Ultrastructural morphometric analysis was used to study time-dependent variations in macro- and microautophagy in rat hepatocytes. Except during periods of short term starvation for up to 24 h, animals were kept under standardized conditions of food intake. In hepatocytes of meal-fed rats the volume fraction of macroautophagic vacuoles is significantly higher at 23:00 h, i.e., immediately before food intake, compared to 11:00 h, i.e., 12 h following feeding. During fasting, macroautophagy drops to a low level. Microautophagic vacuoles in hepatocytes of meal-fed rats, sacrificed at 11:00 or 23:00 h respectively, do not show any significant quantitative differences. However, during 12 h of starvation, the volume fraction of microautophagic vacuoles rises significantly, whereas the numerical density remains constant. Subsequently, during the second 12-h period of fasting, the volume fraction of microautophagic vacuoles remains unchanged, but the numerical density increases. Over a period of 24 h of starvation the volume fraction of the total lysosomal system does not change significantly, whereas the numerical density rises. The time-dependent changes of the macroautophagic vacuolar system correlate with the circadian, food-related variations in the protein content of individual hepatocytes from meal-fed animals. The increase in volume fraction and thereafter in number of microautophagic vacuoles, as observed during starvation, coincides with a large decrease in protein content of individual hepatocytes. PMID- 3955636 TI - Maturation of adult rat peritoneal and mesenteric mast cells. A morphological and histofluorescence study. AB - Repopulation and maturation of rat mesenteric and peritoneal mast cells were studied after mast cell depletion by intraperitoneal injection of distilled water. Immature mast cells were first identified in the mesentery and peritoneal fluid 5 and 6 days, respectively, after water injection. The most immature mast cells that could be identified contained a few orthochromatic granules. Upon maturation, the granules became metachromatic and increased in size and number. Heparin, revealed by toluidine blue staining and berberine sulfate fluorescence, appeared simultaneously with orthophthaldialdehyde (OPT)-induced histamine fluorescence. Paraformaldehyde-induced serotonin fluorescence appeared somewhat later. Repopulation of mesentery and peritoneal fluid by mast cells seemed to be independent of each other and to occur from undifferentiated precursor cells. PMID- 3955639 TI - The use of monoclonal antibodies for the species and tissues distribution of phospholamban. AB - Monoclonal antibodies have been raised against canine phospholamban. Two antibodies have been used in the study of phospholamban distribution in tissues, and in different animal species. The antibodies recognized the three different forms of phospholamban: non-phosphorylated, phosphorylated, and dissociated forms. A survey of nine rabbit tissues revealed that phospholamban is a cardiac muscle specific protein. Phospholamban from different mammalian hearts were found to be identical with respect to molecular weight and antigenicity. PMID- 3955638 TI - The secretory activity of rat nasal glands and the effect of cholinergic drugs. AB - The secretory behaviour of rat nasal glands, under normal conditions and after the application of cholinergic drugs, has been studied using morphological and radiobiochemical techniques. Autoradiography and electrophoresis provide evidence for the selective incorporation of 3H-arginine into the glycoprotein-containing fraction of the nasal glandular secretion. Radiobiochemical experiments show that labelled arginine is rapidly incorporated into the acinar cells of unstimulated glands, although it takes approximately 4 h before the labelled secretory proteins leave the cells. The secretion of proteins is stimulated by the parasympathetic agonist pilocarpine, whose main action is to promote discharge. Histological sections show a depletion of secretory granules after pilocarpine treatment. The cholinergic antagonist atropine inhibits the secretion; the acinar cells are completely filled with secretory granules following this treatment. The time course of the events following atropine administration suggests that there is no feed-back system controlling glycoprotein synthesis. The techniques employed here therefore appear to be useful for studying the effects of drugs that interfere with the secretory activity of the nasal glands. PMID- 3955640 TI - Transient visual disturbance during cardiac catheterization with angiography. AB - The occurrence of visual disturbances following cardiac catheterization with angiographies was studied in a prospective study of 2,006 consecutive adult patients. The overall incidence of visual disturbances was 1.0% and of complete blindness 0.2%. Women had higher incidence than men (2.0 versus 0.6%, p less than 0.01) and patients with a history of angina pectoris with normal coronary arteries had higher incidence than those with coronary artery stenosis (3.7 versus 0.8%, p less than 0.02). Thirteen of twenty patients also had signs of mental confusion. An abnormal electroencephalogram was found in 8 of 13 patients studied. Other neurological findings were observed in one patient only. All patients had complete recovery within 24 hours. Thus, the incidence of visual disturbances is found to be higher than earlier reported, but the visual loss is transient with a benign course. PMID- 3955641 TI - Portable intraaortic balloon counterpulsation: clinical experience and guidelines for use. AB - Intraaortic balloon (IAB) counterpulsation is a proven treatment for patients with refractory ischemia or cardiogenic shock; however its use has been largely limited to tertiary centers due to the difficulties and risks encountered in transporting patients with this device in place. We report our initial experience with 11 patients who underwent IAB counterpulsation at a community hospital utilizing a portable transport IAB system. All 11 patients had successful IAB insertion, resulting in prompt stabilization. Immediate transportation during uninterrupted IAB counterpulsation was successfully accomplished in each case using routine ambulance vehicles, allowing for the prompt initiation of further tertiary care. The role of portable IAB counterpulsation in the community hospital and guidelines for the implementation of this portable IAB system are outlined. PMID- 3955642 TI - Inadvertant balloon extrusion through a side hole in a guiding catheter. AB - A patient presented with an acute inferior myocardial infarction. Coronary angiography in the acute stage revealed total occlusion of the right coronary artery. Reperfusion was obtained after intracoronary infusion of 250,000 units of streptokinase. Angioplasty was subsequently performed because of a high grade residual stenosis. An 8-French right Judkins guiding catheter with a single side hole (USCI), a 3.0 mm balloon dilatation catheter (ACS), and a 0.018 high torque floppy guide wire (ACS) were used. After successful angioplasty angiography was repeated with the guide wire in the RCA, but the balloon was withdrawn into the guiding catheter. After injection of contrast, it was impossible to withdrawn the balloon catheter out of the guiding catheter. Fluoroscopy revealed extrusion of the balloon through the side hole in the guiding catheter. PMID- 3955643 TI - Isolated coronary ostial stenosis. AB - We have examined 5 patients with typical angina pectoris and found them to have left coronary ostial stenosis without evidence of any other coronary arterial disease and without evidence of aortic disease (Takayasu aortitis, syphilitic aortitis, or familial hypercholesterolaemia). All five patients were female aged between 38 and 53 years, a striking difference from the normal 7:1 male:female ratio for atherosclerotic coronary artery disease. It may be that these patients represent a rare but distinct syndrome. The angiographic diagnosis can be difficult but a pressure drop as the catheter tip engages the ostium and lack of spill-over of contrast into the sinus of Valsalva are findings that should lead the angiographer to suspect ostial stenosis. PMID- 3955644 TI - Atypical phasic coronary artery narrowing. AB - Four unusual cases of phasic (occurring only in systole or only in diastole) coronary artery narrowing are reported. In two cases, diastolic compression of the left anterior descending coronary artery was due to tight pericardial adhesions in patients with aortic insufficiency; in the third case, systolic compression of two right ventricular coronary branches was associated with hypertrophic cardiomyopathy and a normotensive right ventricle; and in the fourth case, a large aneurysm of the inferior wall of the left ventricle caused systolic compression of the posterior descending coronary artery, which was epicardial. The diagnostic and pathophysiologic characteristics of each case are discussed. PMID- 3955645 TI - Myocardial ischemia in a patient with anomalous origin of the left main coronary artery. PMID- 3955646 TI - Right ventricular inflow and outflow obstruction due to adrenal cell carcinoma. AB - A 48-year-old man with surgically removed adrenal cell carcinoma presented with shortness of breath and fatigue. Physical examination revealed neck vein distention and a new systolic murmur. Echocardiography showed a right ventricular mass causing inflow and outflow tract obstruction. These findings were confirmed at surgery. PMID- 3955647 TI - Fluoroscopic diagnosis of stuck tricuspid valve. PMID- 3955648 TI - Thrombolytic therapy in the coronary care unit. PMID- 3955649 TI - Noninvasive determination of valve area in adults with aortic stenosis using Doppler echocardiography. AB - Doppler ultrasound has been used to determine the pressure gradient P1-P2 across the valve in patients with aortic stenosis (AS), but since the gradient varies over time and may be deceptively low in patients with impaired cardiac output, the key parameter to obtain is the orifice area (A). By calculating stroke volume (SV) from the modal flow velocity [Vmode(t)] over the systolic ejection period (sep) or diastolic filling period (dfp), wherever laminar flow exists in the heart across an area of known diameter D, (pulmonary artery or atrioventricular valves), and by substituting P1-P2 = 4Vmax2, (Vmax = peak velocity in the aortic jet), the Gorlin formula becomes: (Formula: see text) where theta = flow intercept angle at D. This approach was applied in nine adult patients with AS (age 64 +/- 8 years) in whom recent catheterization data was available for comparison. Close correlation was found between the calculated areas: A(Doppler) = 0.82 A(Cath) + 0.17 (r = 0.94, p less than 0.001). Two patients with Doppler gradients of less than 40 mmHg were shown by this Doppler method nevertheless to have severely narrowed orifice areas of less than or equal to 0.78 cm2. Although there is a tendency to overestimate slightly the valve area, Doppler ultrasound assessment using this technique adds valuable noninvasive information concerning the degree of aortic valve disease. PMID- 3955650 TI - The H-Y antigen and sex reversal. PMID- 3955651 TI - Genetic control of programmed cell death in the nematode C. elegans. AB - The wild-type functions of the genes ced-3 and ced-4 are required for the initiation of programmed cell deaths in the nematode Caenorhabditis elegans. The reduction or loss of ced-3 or ced-4 function results in a transformation in the fates of cells that normally die; in ced-3 or ced-4 mutants, such cells instead survive and differentiate, adopting fates that in the wild type and associated with other cells. ced-3 and ced-4 mutants appear grossly normal in morphology and behavior, indicating that programmed cell death is not an essential aspect of nematode development. The genes ced-3 and ced-4 define the first known step of a developmental pathway for programmed cell death, suggesting that these genes may be involved in determining which cells die during C. elegans development. PMID- 3955652 TI - Migratory and postmigratory mouse primordial germ cells behave differently in culture. AB - In all vertebrate groups, the progenitors of the germ line, the primordial germ cells (PGCs) arise extragonadally and move to the developing gonad early in embryonic development. We have examined the behavior of isolated pregonadal and gonadal PGCs in vitro on feeder layers of an embryo-derived cell line. Histochemically and serologically identified pregonadal germ cells are found to be actively motile in vitro and, furthermore, show behavior characteristic of invasive cells. PGCs isolated from the developing gonad, however, show little locomotory activity and are not invasive on the same cellular substrate. These observations suggest that PGCs undergo a major change in phenotype at the time of their entry into the gonad anlagen. PMID- 3955653 TI - Homologous interactions of lambda repressor and lambda Cro with the lambda operator. AB - Lambda repressor and lambda Cro bind to the same six sites on the phage chromosome but with different relative affinities. Nucleotides at certain positions in the operator are conserved in all sites, as are amino acids at certain positions in the recognition alpha-helices of repressor and Cro. Here we focus on one of the conserved amino acids, a serine found at position 2 of each recognition helix. We show that, contrary to a previous model, both serines contact the same conserved position in the operator, position 4. We suggest a simplified view of how repressor and Cro recognized similar operator sites but distinguish differently among them. PMID- 3955654 TI - Regulatory interactions between the segmentation genes fushi tarazu, hairy, and engrailed in the Drosophila blastoderm. AB - The genetic loci fushi tarazu (ftz), hairy (h), and engrailed (en) must be expressed during embryogenesis for the correct segmental organization of the Drosophila embryo to be established. Transcripts from these genes accumulate in periodic patterns at the blastoderm stage of development. We demonstrate that generation of the normal pattern of ftz RNA requires the h+ function whereas formation of the h pattern does not require the ftz gene. In addition, we show that the en pattern is altered in both h and ftz mutant embryos. The nature of these changes and the cuticular phenotype of h mutant larvae suggest that both h and ftz phenotypes are a consequence of incorrect compartmentalization and that the effect of h is mediated via ftz and other genes. PMID- 3955655 TI - Nuclear transplantation in the mouse: heritable differences between parental genomes after activation of the embryonic genome. AB - Paternal and maternal genomes apparently have complementary roles during embryogenesis in the mouse, and both are essential for development to term. However, there is no direct evidence to show that functional differences between parental genomes remain intact after activation of the embryonic genome at the 2 cell stage. In this study we demonstrate that transfer of paternal or maternal nuclei from early haploid preimplantation embryos back to fertilized eggs from which one pronucleus was removed resulted in development to term, but only if the remaining pronucleus was of the parental type opposite to the donor nucleus. Hence, functional differences between parental chromosomes are heritable and they survive activation of the embryonic genome and probable reprogramming of donor embryonic nuclei by epigenetic factors in the egg cytoplasm. PMID- 3955656 TI - cdc25+ functions as an inducer in the mitotic control of fission yeast. AB - In the fission yeast S. pombe the cdc25+ gene function is required to initiate mitosis. We have cloned the cdc25+ gene and have found that increased cdc25+ expression causes mitosis to initiate at a reduced cell size. This shows that cdc25+ functions as a dosage-dependent inducer in mitotic control, the first such mitotic control element to be specifically identified. DNA sequencing of the cdc25+ gene has shown that it can encode a protein of MW 67,000. Evidence is described showing that cdc25+ functions to counteract the activity of the mitotic inhibitor wee1+, and indicating that both mitotic control elements act independently to regulate the initiation of mitosis. PMID- 3955658 TI - The presence of nucleosomes on a DNA template prevents initiation by RNA polymerase II in vitro. AB - RNA was synthesized in vitro using HeLa cell nuclear extracts and circular DNA templates onto which varying numbers of nucleosomes had been reconstituted with Xenopus oocyte extracts. We found that fully reconstituted templates supported no specific initiation by RNA polymerase II; however, DNA exposed to the reconstitution extracts under conditions which did not allow nucleosome deposition was transcribed normally. A set of successively less reconstituted templates was also transcribed. No initiation occurred on reconstitutes with more than two-thirds of the physiological nucleosome density; reconstitutes with less than one-third of the physiological nucleosome density were transcribed as efficiently as naked DNA. PMID- 3955657 TI - The J.D. mutation in familial hypercholesterolemia: amino acid substitution in cytoplasmic domain impedes internalization of LDL receptors. AB - Genomic DNA encompassing the terminal exons of the gene for the low density lipoprotein (LDL) receptor was isolated from J.D., a patient with familial hypercholesterolemia whose receptor fails to cluster in coated pits. The DNA sequence revealed a substitution of a cysteine codon for a tyrosine codon at residue 807 in the cytoplasmic domain of the receptor. We reproduced this substitution through oligonucleotide-directed mutagenesis of the normal human receptor cDNA. Upon transfection into receptor-deficient hamster cells, the cDNA specified a receptor that bound LDL normally, but entered the cell slowly. Electron microscopy showed that this receptor was distributed diffusely over the cell surface, whereas the receptor produced by the normal cDNA was concentrated in coated pits. These results support the hypothesis that cytoplasmic domains direct receptors to coated pits, thereby determining the high rate of receptor internalization in animal cells. PMID- 3955659 TI - Effects of various ammonium salts, amines, polyamines and alpha-methylornithine on rRNA synthesis in neurula cells of Xenopus laevis and Xenopus borealis. AB - Xenopus neurula cells were cultured in a medium that contained ammonium salts, amines, polyamines or alpha-methylornithine, and their rRNA synthesis was examined. All the ammonium salts and amines, but not polyamines, were strong and selective inhibitors of rRNA synthesis at 1.25-5.0 mM. alpha-Methylornithine did not inhibit rRNA synthesis, although it inhibited ornithine decarboxylase, an enzyme claimed to be a direct stimulator of rRNA synthesis. During the treatment ammonium ions and monomethylamines were accumulated within the treated cells. However, monomethylamines did not induce the accumulation of ammonium ions, and vice versa. Ammonium salts and amines also selectively inhibited rRNA synthesis in Xenopus borealis neurula cells. PMID- 3955660 TI - Macrophages in the urogenital ridge of the mid-gestation mouse fetus. AB - Isolated urogenital ridges from mouse embryos 11 1/2-16 1/2 days post coitum were separated into genital ridge and mesonephric areas; the latter were then cut into small fragments and cultured as explants on glass or plastic. The explants soon became surrounded by flat outgrowths of cells, followed by a population of large round granular cells. The behaviour of these cells, first on the outgrowth and then on the glass is described. Evidence is presented that they are fetal macrophages. PMID- 3955661 TI - Response to heat shock of different sea urchin species. AB - It is demonstrated that sea urchin embryos of the species Sphaerechinus granularis are able to respond to heat shock by producing heat shock proteins at the same stage as embryos of Paracentrotus lividus, i.e. after hatching. Arbacia lixula embryos are able to synthesize heat shock proteins already at the stage of 64-128 blastomeres. Embryonic survival is observed if the embryos are heated at the stages at which they can synthesize the heat shock proteins. The inhibition of the bulk protein synthesis after heating at 31 degrees C is never less than 50%. PMID- 3955662 TI - Effect of serum on autologous cell recognition by macrophages. AB - The non-immune mechanisms of recognition of self and non-self substances by macrophages has not yet been clarified. In this work, we report the ability of mouse peritoneal macrophages to attach to and phagocytize in vitro autologous and homologous erythrocytes in proportions as high as those for certain heterologous red blood cells. This ability was abrogated by autologous or homologous serum but not by heterologous serum or a serum-free supplement. This effect of serum was dose dependent and did not affect the phagocytosis of homologous "old" red cells. Procedures for the identification of this serum factor indicated that it was dialyzable (10 kD cut off) and was excluded by filtration in Sephadex G-25. We conclude that this finding supports the possibility that macrophages do not selectively phagocytize foreign particles or senescent cells but, rather, that they do phagocytize all particles or cells indiscriminately and this serum factor may prevent phagocytosis of normal self cells. PMID- 3955663 TI - Calcium current in mouse eggs recorded with the tight-seal, whole-cell voltage clamp technique. AB - The tight-seal, whole-cell recording technique has been used to voltage-clamp unfertilized eggs of the mouse. Good seal formation was obtained in a solution containing 20 mM Ca2+ and the transient inward Ca2+ current recorded. This technique offers several advantages over the conventional, two-microelectrodes voltage-clamp: improved signal to noise ratio; larger membrane-pipette seal resistance; possibility of very stable, long duration, recordings and possibility of controlling the intracellular medium. The main disadvantage of the technique, namely the rundown of channels due to loss of intracellular components, was not encountered in this preparation. PMID- 3955664 TI - Positioning and stability of mitotic spindle orientation in the neuroepithelial cell. AB - To verify non-random positioning and to define the stability of the mitotic spindle orientation in neuroepithelial cells of mouse foetuses, computer - assisted morphometric analysis at the light microscopy level was performed. It was confirmed that the mitotic spindle axis is positioned non-randomly in relation to the cell polarity axis and could be displaced only within a narrow range. This orientation was found to be attained at metaphase and it does not change until telophase is completed. However, in relation to the long axis of the neural tube the mitotic spindle axis was found to be positioned randomly. In the light of these findings centrosome movement and positioning are discussed. PMID- 3955665 TI - A heat shock-resistant variant of Chinese hamster cell line constitutively expressing heat shock protein of Mr 90,000 at high level. AB - A heat shock-resistant variant of Chinese hamster cell line (CHO) was isolated from ethane methane sulfonate-treated CHO cells through selection by repeated exposures to elevated temperature. The variant, designated HR-01, was one to two order of magnitudes more resistant to lethal heat shock (46.0 degrees C) than the parental CHO strain (p-CHO). The heat shock resistance characteristic of this variant was stable. In addition, the HR-01 variant showed more elongated cell morphology, and was more adherent to substrate than p-CHO. When total proteins of p-CHO and HR-01 cells were compared in two-dimensional polyacrylamide gel electrophoresis, HSP90, a heat shock protein of Mr 90,000, was found to be the only protein that was expressed at a significantly higher level in HR-01 cells than in p-CHO cells. Because of the known intriguing molecular properties of HSP90, the HR-01 variant would be useful for further investigation of functions of HSP90 as well as the mechanism of acquiring heat shock resistance in mammalian cells. PMID- 3955666 TI - A replica method useful in the isolation of mutants of FM3A, a non-adherent cell line from mouse mammary carcinoma. AB - Existing replica methods designed for adherent somatic cells are not applicable to non-adherent cells of tumor origin. We have developed a new, efficient replica method for the negative selection of mutants of non-adherent mouse FM3A cells. Mutagenized cells are grown clonally on soft-agar plates then allowed to proliferate upwards through layered polyester disks, thus producing replicas with the same colony patterns. Isolation of mutants with increased requirements for myo-inositol by this method is described. PMID- 3955667 TI - Injuries to the spine. PMID- 3955668 TI - Neck injuries in football players. AB - Understanding neck injuries in football players starts with understanding how the game is played--not the strategy, but the training techniques and requirements of the game. Neck injuries are an unavoidable part of the game. What can be improved are the preventative measures, the treatment techniques, and some standardization of risk factors in playing after a neck injury. Prevention starts with decreasing the use of the head as an offensive weapon and with proper shoulder pads. Treatment begins with proper on-field evaluation and transportation techniques and is completed by good consultation services. Proper evaluation of risk demands open discussions with the patient of all factors involved. Clear advice is given to players and to the team through their medical staff. PMID- 3955670 TI - Plain roentgenograms of the spine in the injured athlete. AB - The valued techniques and types of plain roentgenograms of the cervical spine and the lumbar spine in athletic injuries are discussed. A considerable number of injury types exist, as well as a large number of various roentgenographic views that the physician may order. In approaching the athlete with an injured spine, the physician depends on the length of symptoms, associated physical findings such as neurologic deficit, and clinical information available for both the cervical and lumbar spine injury. PMID- 3955669 TI - Neck and low back injuries in wrestling. AB - Drs. Wroble and Albright review the neck and low back injuries of the University of Iowa wrestling teams over the last 8 years with respect to diagnosis, mechanism of injury, time lost from wrestling, and recurrence. They describe examination of the low back and treatment of low back injuries. Examination of the neck is reviewed in detail and common neck injuries are discussed. Emergency management of acute neck injuries is outlined. Various aspects of prevention of neck injuries are presented. PMID- 3955671 TI - Cervical spine injuries. AB - Drs. Jackson and Lohr review such skeletal injuries as fractures, dislocations and subluxations, cervical disk herniation, degenerative disks, and "stingers." Cervical strains and sprains are also discussed, and evaluation of cervical injuries and immobilization and transportation of the injured player are other topics covered. PMID- 3955672 TI - [Antibacterial activity of thiobenzamide]. PMID- 3955673 TI - [Determination of antipyrine in human blood and saliva using high performance liquid chromatography]. PMID- 3955674 TI - [Enzyme inhibitors and drugs]. PMID- 3955675 TI - [The significance of glutathione transferase. I. Forms, classification, nomenclature and factors controlling its activity]. PMID- 3955676 TI - [The effect of pregnancy on the occurrence of cholelithiasis]. PMID- 3955677 TI - [Mycotic colpitis in pregnant and non-pregnant women (diagnosis and therapy)]. PMID- 3955678 TI - [Evaluation of vaginal microflora in chronic inflammation of the adnexa]. PMID- 3955679 TI - [Profilometry in relation to lateral radiographic urethrocystography in women with urinary stress incontinence]. PMID- 3955680 TI - [The cervical factor and the Sims-Huhner test]. PMID- 3955681 TI - [Clinical experience with the Tesla LDF 280 Czechoslovak cardiotocograph]. PMID- 3955682 TI - [Extra-uterine pregnancy--a constant gynecologic problem]. PMID- 3955683 TI - [Pregnancy after ligation of the hypogastric artery]. PMID- 3955684 TI - [Comment on the biological heterogeneity and phylogenic purpose of the hymen]. PMID- 3955685 TI - [Postcoital contraception]. PMID- 3955686 TI - [Premenstrual syndrome. II]. PMID- 3955687 TI - [Population status and fertility control worldwide]. PMID- 3955688 TI - [Consideration of the task of national plan P 12-333-012-02 for the technical development of perinatology 1986-1990 (the UMPD Prague-Podoli coordinating agency)]. PMID- 3955689 TI - [Echocardiographic examination in pregnant women with cardiovascular diseases]. PMID- 3955690 TI - [Amniotic lecithin--fetal maturity and chronic fetal distress]. PMID- 3955691 TI - [Low birth-weight infants]. PMID- 3955692 TI - [Treatment of urgency urinary incontinence in women using clenbuterol]. PMID- 3955694 TI - [Prenatal development of the human oocyte. I. The beginning phases of meiosis]. PMID- 3955693 TI - [The climacteric in active women athletes within the framework of anthropometry and somatotype]. PMID- 3955695 TI - [Dystocia of the shoulders--an acute incident during labor]. PMID- 3955696 TI - [Early results of the Marshall-Marchetti-Krantz operation at the First Gynecologic-Obstetrical Clinic in Brno]. PMID- 3955697 TI - [Muscle contractile proteins]. PMID- 3955698 TI - [Cosmic pathophysiology]. PMID- 3955699 TI - [Preservation of dog blood and its experimental use]. PMID- 3955700 TI - [Diagnosis and present possibilities of treatment of pseudoexfoliative glaucoma]. PMID- 3955701 TI - [Pars plana vitrectomy in severe eye injuries]. PMID- 3955702 TI - [Changes in ERG potentials in unilateral cataracts]. PMID- 3955703 TI - [Diagnostic and therapeutic problems in Behcet's disease]. PMID- 3955705 TI - [Ocular findings in a mass poisoning with methyl alcohol]. PMID- 3955704 TI - [Diffuse retinal pigment epitheliopathy]. PMID- 3955706 TI - [Implantation of the first 50 Fedorov-Zakharov iris-clip intraocular lenses]. PMID- 3955707 TI - [Total destruction of the intraocular circulation in diffuse scleroderma]. PMID- 3955709 TI - [Carpal and navicular acupuncture in otorhinolaryngology]. PMID- 3955708 TI - [Superficial fibrosarcoma of the face]. PMID- 3955710 TI - [Results of surgical and combined therapy of cancer of the larynx treated at the ORL Clinic in Hradec Kralove 1958-1977]. PMID- 3955711 TI - [Objective BERA audiometry in the evaluation of occupational hearing loss]. PMID- 3955712 TI - [Tympanic ventilation tubes in the so-called "glue ear"]. PMID- 3955713 TI - [Treatment of maxillary sinusitis in children using punctures]. PMID- 3955714 TI - [Diagnostic significance of curettage of the nasopharynx]. PMID- 3955715 TI - [Changes in the lungs in bronchopulmonary dysplasia in infants]. AB - Microscopical and some electronmicroscopical findings were presented from 6 small children having died of bronchopulmonary dysplasia. The disease was connected with intensive long-term administration of concentrated oxygen in respirator. Lesions of various intensity were found in mucosa, connective tissue and vessels in the distal parts of lungs according to the severity of disease. Fibroproductive changes in honeycomb lung characterized the most serious form developing into an interstitial fibrosis. PMID- 3955717 TI - [The significance of Lauren's classification of gastric carcinoma]. AB - A reclassification of 142 cases of gastric carcinoma was carried out into Lauren's intestinal and diffuse types. It failed to confirm a convincing correlation of the type of carcinoma with sex, age distribution and patients survival. PMID- 3955716 TI - [Aneurysmal bone cyst of a rib]. AB - Aneurysmatic bone cyst is rare in ribs; only 37 cases were found in literature up to 1984. In a group of 21 children suffering from aneurysmatic bone cyst only one 13 year-old girl had the lesion in sternal part of the 2nd rib. PMID- 3955718 TI - [Thin-needle puncture aspiration cytology in the diagnosis of lymph node tumors]. AB - 356 patients were studied suffering from lymph node swelling of the neck, supraclavicular region, axilla and groin. A primary or secondary malignant process was confirmed in 196 cases, reactive or granulomatous changes were found in 151 cases, in 64 smears there were only a few lymphocytes and connective tissue. The last group was the source of 11 false negative results. Not a single false positive diagnosis was established. Histological correlation was made in 85 cases. PMID- 3955719 TI - [Generalized infection caused by coagulase-negative staphylococci]. AB - The pathogenicity of coagulase-negative staphylococci was shown in two patients- one died on bacterial endocarditis, the second was a diabetic woman after gastroectomy. PMID- 3955720 TI - [Alcoholic myopathy]. AB - Six cases of alcoholic myopathy (two acute and four chronic) are reported. Histologically, cases of acute alcoholic myopathy showed dystrophic changes of the sarcoplasm (especially in the muscles of lower extremities), ending with total rhabdomyolysis. In chronic cases, histology revealed selective atrophy of muscle fibers of the 2nd type. Both direct and indirect effects of alcohol are discussed in the pathogenesis as well as the metabolic disturbances caused by acetaldehyde, a metabolic product of ethanol. Possible predisposition factors are taken into consideration and the differential diagnosis mainly between alcoholic myopathy and the clinically heterogeneous group of myopathies is surveyed. PMID- 3955722 TI - [Amyloidosis in carcinoma of the kidney]. AB - Secondary amyloidosis was found in a 72-year-old woman suffering from renal carcinoma with fatal nephrotic syndrome. The frequency of secondary amyloidosis accompanying renal carcinoma was 2.9% according to 238 postmortems of renal carcinoma between 1961 and 1975 years. PMID- 3955721 TI - [Micromorphometric study of changes in the gastric mucosa after proximal selective vagotomy in rats]. AB - Micromorphometry produced a graphic hardware for computer in a study of gastric mucosal hyperemia in rats after proximal selective vagotomy. Hyperemia was found in intervals of 1 day and 7 days after operation in gastric body, whereas lasted only 1 day in pyloric antrum [after 7 days the picture was similar to the sham operated animals]. Histology did not help to distinguish between a passive and active hyperemia. PMID- 3955724 TI - [1st Czechoslovak seminar of young neurologists. Vratna, 11-13 April 1985. Abstracts]. PMID- 3955723 TI - [Histopathologic classification of skin inflammations (a review of problems)]. PMID- 3955725 TI - [Hypofunction of the central cholinergic neurons is the cause of stimulus sensitive myoclonus in the baboon Papio papio]. PMID- 3955726 TI - [The cholinergic system in the pathophysiology of infantile spasms (West syndrome)]. PMID- 3955727 TI - [The effect of clonazepam on physiological tremor]. PMID- 3955728 TI - [Modern trends in the pathogenic therapy of epilepsy]. PMID- 3955730 TI - [Automatic analysis of action potentials of motor units. Determination of norms and sources of variation in the normal population]. PMID- 3955729 TI - [The myasthenic syndrome and its EMG diagnosis]. PMID- 3955731 TI - [Respiration disorders in comatose states]. PMID- 3955732 TI - [The electrocardiogram in comatose patients]. PMID- 3955733 TI - [Alzheimer's disease--synaptic dementia]. PMID- 3955734 TI - [Paranoid hallucinatory syndrome in patients with metastatic carcinoma of the occipital lobe]. PMID- 3955735 TI - [Perception of verbal units without semantic content in psychotic and nonpsychotic persons. A pilot study]. PMID- 3955736 TI - [Principles of music therapy at the Jesenik Spa in Czechoslovakia]. PMID- 3955737 TI - [Strategy for individual short-term psychotherapy in ambulatory care]. PMID- 3955738 TI - [Meningiomas in psychiatry]. PMID- 3955739 TI - [Cardiotoxicity of tricyclic antidepressants]. PMID- 3955740 TI - [Czech psychiatrist-writers]. PMID- 3955741 TI - [The effect of breast feeding on the health of the child]. PMID- 3955742 TI - [Urate nephropathy--complication of cytostatic therapy]. PMID- 3955743 TI - [The mission of the weekly nurseries today]. PMID- 3955744 TI - [Phospho-calcium metabolism in breastfed and non-breastfed children]. PMID- 3955745 TI - [Abnormalities of lymphocytes and lymphocyte populations detected in children with idiopathic nephrotic syndrome of the minimal lesion type]. PMID- 3955746 TI - [Ultrastructure of cilia in diseases of the respiratory organs]. PMID- 3955747 TI - [Oxyuriasis and appendicitis]. PMID- 3955748 TI - [Primary chylopericardium in a child]. PMID- 3955749 TI - [Personal experience with therapy of the asthmatic state in children]. PMID- 3955750 TI - [The current concept of the ontogenesis of immunity in children]. PMID- 3955751 TI - [Comments on the general theory of human health]. PMID- 3955752 TI - [Factors affecting personality development of the socialist physician at medical schools]. PMID- 3955754 TI - [The effect of a general physician on improving work capacity evaluation by an ambulatory care team]. PMID- 3955753 TI - [Risk of a stay in a tuberculosis or respiratory disease ward under the present epidemiologic conditions of tuberculosis]. PMID- 3955756 TI - [Requirements for laundry service capacity in the Institutes of Health in Czechoslovakia]. PMID- 3955755 TI - [Conceptual suggestion for an automated management system within the area of education]. PMID- 3955757 TI - [Analysis of the relation of total specific mortality to various conditions of the economic and social environment]. PMID- 3955758 TI - [The legal and ethical problems associated with the birth of a severely malformed individual]. PMID- 3955759 TI - [The role of psychology in the administration of health care and health care services]. PMID- 3955760 TI - [A survey of the level of job satisfaction and the management style of managers in the health services]. PMID- 3955762 TI - [Intensifying the social character of health care]. PMID- 3955761 TI - [Aspects of cooperation between general and occupational medicine]. PMID- 3955763 TI - [Angiography of hemangiomas in the facial area]. PMID- 3955764 TI - [Angiographic projections in children with congenital heart defects. Experience with the use of the adjustable C arm]. PMID- 3955765 TI - [Interventricular septal defect in a double-outlet ventricle. Comparison of angiocardiographic findings with autopsy results]. PMID- 3955766 TI - [Radiographic picture of lung cancer in persons enrolled in a screening program]. PMID- 3955767 TI - [Whole-body skeletal response in a patient with metacarpal epithelioid hemangioendothelioma]. PMID- 3955768 TI - [Response of superficial basaliomas of the skin to local hyperthermia]. PMID- 3955769 TI - [Tumor vascularization--a critical parameter of the radiation response]. PMID- 3955770 TI - [Determination of criteria for the accuracy required in clinical dosimetry]. PMID- 3955771 TI - [Periosteal ganglion]. PMID- 3955772 TI - [Narrowing of the hip joint cavity]. PMID- 3955773 TI - [Primary megaureter in children and adults with coexisting vesico-ureteral reflux. Case report]. PMID- 3955774 TI - [Angiography and dynamic scintigraphy in the diagnosis of occluded cerebral arteries]. PMID- 3955775 TI - [The significance of the radionuclide examination of the skeleton in clinical practice]. PMID- 3955776 TI - Susceptibility of Candida species strains to five antifungal agents: comparison between agar dilution and disk diffusion tests. AB - The in vitro activity of five antifungal agents were compared against 180 Candida strains. The drugs were: two imidazoles (miconazole and ketoconazole), nystatin, 5-fluorocytosine and amphotericin B. Agar dilution and disk diffusion methods were used. Nystatin, miconazole and amphotericin B were the most active agents. 5 fluorocytosine had high activity except against C. albicans serotype B, of which a high percentage were resistant. Finally, a good correlation between the two methods was observed. PMID- 3955777 TI - Ketoconazole: clinical evaluation in severe fungal infections. AB - Ketoconazole, a new imidazole-derivative antifungal agent, has been studied in sixteen patients with systemic fungal infections. Seven patients had deep localized infections (three cases with pneumonia and one case each with urinary infection, osteomyelitis, endophthalmitis and peritonitis); three patients suffered from granulomatous or acute mucocutaneous infections and six patients had fungal septicemia. All patients suffered from severe underlying diseases and/or predisposing factors such as antibiotic treatment, immunosuppressive therapy or indwelling catheters. Candida albicans was isolated in 13 cases, C. parapsilosis (septicemia), Aspergillus (ophthalmitis) and Mucor (pneumonia) in the other three cases. Ketoconazole was administered orally at daily dosages of 400-800 mg; 5-fluorocytosine was associated in four cases. Out of the ten patients with localized infections, seven were cured and three improved. Two of the six septic patients were cured, one improved who subsequently died from Pseudomonas septic shock and three patients showed no improvement. Two relapses were recorded, both followed by further eradication. The tolerance of the drug was always excellent. Ketoconazole proved a very effective and well-tolerated drug in systemic infections, caused by opportunistic fungi in high-risk patients. PMID- 3955778 TI - Ciclopiroxolamine: clinical and microbiological considerations. Preliminary data. AB - Ciclopiroxolamine's action has been evaluated in 20 cases of dermatophytosis. The minimum inhibitory concentrations (MIC) for the strains was determined in vitro before treatment (To), after the 4th day (T4), and after the 7th day (T7) of treatment, in relation with the drug's fungicide effect. No significant variation was observed among the MIC values. By comparing the MIC of T4 versus the MIC of To a 0.93 coefficient of linear correlation was obtained while in comparing T7 versus T4 the coefficient was equivalent to 1.0. After 7 days of treatment 5 patients clinically recovered, 11 improved and 4 showed no improvement. Drug tolerance was excellent except for one case. PMID- 3955780 TI - Alterations due to ampicillin and rifampicin in S. sanguis and S. aureus isolated from dental plaque. An electron microscopic study. AB - In this work we analysed the ultrastructural changes in S. aureus and S. sanguis after exposure to rifampicin and ampicillin respectively. S. aureus grown in the presence of rifampicin showed ultrastructural changes that can be summarized as follows: the peripheral cell-wall increased to three to five times the normal thickness; the cross-walls were considerably (two to ten times) thicker than normal; after 8 h of exposure a complete lysis occurred. S. sanguis grown in the presence of ampicillin showed ultrastructural changes that can be summarized as follows: aggregation and condensation of ribosomes; alterations of division with the presence of asynchronous septa; in some bacterial cells a prominent bulge was observed at one pole of the cell; after 8 h of exposure a complete lysis occurred. PMID- 3955779 TI - Comparative clinical evaluation of ceftriaxone in treating lower respiratory tract infections. AB - To evaluate the clinical and microbiological efficacy and safety of ceftriaxone in comparison with cefotaxime in treating acute lower respiratory tract infections two open randomized trials were performed. Sixty-two adult hospital in patients were entered and 58 completed the study. The patients suffered from either acute (broncho-)pneumonia (19pts) or severe exacerbation of chronic bronchopneumonia (39 pts). Forty-one of the patients had severe underlying or concurrent diseases. Diagnoses were in all cases confirmed by isolation of the causative pathogen(s) from bronchial brushing or washing under fiberoptic bronchoscopy. Twenty-eight patients were administered at random with either a single 2g daily dose of ceftriaxone or 2g twice daily dose of cefotaxime (1st trial). Successively (2nd trial) ceftriaxone was administered at a dose of 1g once daily either i.v. or i.m. The duration of treatment ranged from 7 to 12 days. A satisfactory response was observed in all patients suffering from acute pneumonia or bronchopneumonia; the eradication rate of the causative pathogen was 73% and 62% for ceftriaxone and cefotaxime, respectively. Concerning the exacerbation of chronic bronchopneumonia (39 patients) an overall satisfactory response to both treatments was registered in about 80% of cases. No significant differences between the 1g and 2g single daily dosing regimens of ceftriaxone appeared. Both ceftriaxone and cefotaxime were well tolerated: no or minimal changes in laboratory values were noticed. It is concluded that a 1g or 2g single daily dose of ceftriaxone were at least as effective as a 2g twice daily dose of cefotaxime in treating acute lower respiratory tract infections due to susceptible pathogens. PMID- 3955781 TI - Short-term antibiotic therapy with clindamycin phosphate in patients with malignant epithelial tumors: an immunological evaluation. AB - The authors evaluated the results of a study using clindamycin phosphate plus gentamicin in short-term therapy in patients with tumors submitted to surgery for removal of the primary lesion. Only 6.6% of these patients became infected, and these good results are most likely due to the synergic activity of clindamycin with the physiological immune response. This agent, in fact, was able to interfere with IgM/IgA immunoregulatory balance by enhancing IgM production and, consequently, phagocytic mechanisms. PMID- 3955782 TI - Amino acid membrane transport properties of L1210 cells resistant to cisplatin. AB - A mouse L1210 leukemia cell line was made 18-fold resistant to the chemotherapeutic agent cisplatin. The drug resistant cells exhibited changes in morphologic and biochemical properties from the sensitive cells. Uptake of labeled cisplatin was only slightly decreased in the resistant cells. However, the exogenous methionine requirement for these cells was 18-fold less than for parent cells. This decrease in the methionine requirement was also associated with differences in both methionine metabolism and transport. Membrane transport analysis revealed different Kt and Vmax properties for methionine and a nonmetabolizable amino acid analogue between the two cell lines. In L1210 cells resistant to cisplatin, decreases in amino acid transport, plus changes in amino acid substrate specificities, may be related to a drug-membrane phenomenon which could be one mechanism of resistance to chemotherapeutic agents. PMID- 3955783 TI - Perioperative chemotherapy in the treatment of carcinoma of the uterine cervix. AB - Two hundred forty-eight women from 1969-71 who underwent surgery for carcinoma of the cervix and were treated with triaziquone (0.2 mg i.v. daily) from day 2-5 after the operation, are compared to a group of 301 conventionally treated patients examined over the 3 following years. Survival rates after 5 years did not differ significantly between the 2 groups of patients, considered either globally or divided according to their clinical or surgical-pathological stage. The incidence of complications in the "treated" patients was not significantly higher, particularly considering local and general post-operative recovery. A prospective randomized study using drugs with a high cytotoxic activity in patients with tumors limited to the cervix and unfavorable prognostic factors, could in the future help evaluate the possibility of using surgical adjuvant chemotherapy in carcinoma of the cervix. PMID- 3955785 TI - Development of laboratory hormone tests and their application in the monitoring of cancer patients. AB - In the endocrinologic study of dysplastic and neoplastic pathologies of hormone dependent organs we propose the determination not only of the plasma levels of the "total" hormone but also those of the free hormone as well as the plasma/hormone binding capacity and the kinetics of the plasma/steroid interaction. PMID- 3955786 TI - Modulated chemo-hormonotherapy in advanced breast cancer. A pilot study. AB - Twenty-two patients with advanced breast cancer have been treated with sequential chemo-hormonotherapy consisting of tamoxifen 20 mg/day orally for 14 consecutive days, followed by no therapy for ten days, then estrogen 0.625 mg/day orally for three days; the next day methotrexate 200 mg/m2 i.v. and cyclophosphamide 600 mg/m2 i.v.; after 24 hours folinic acid 200 mg/m2 i.v. and 5-fluorouracil 600 mg/m2 i.v. Fifteen patients were evaluable for response, 22 were evaluable for toxicity. All but one were heavily pretreated with chemo and/or hormonotherapy. Nine of 15 had previously received palliative CMF (cyclophosphamide, methotrexate, 5-fluorouracil) (mean 9 cycles), and one patient 12 cycles adjuvant CMF. Thirteen of 15 previously received tamoxifen (median treatment of 18 months). Six patients had multiple metastatic disease, while five had visceral involvement. They were all postmenopausal, with median age 57 years, and median disease-free interval 31 months. ER status was not known and the median ECOG performance status was 1. Overall response rate was 20%. Only one patient attained complete remission; 46.6% were stable disease and 33.3% progressive disease. Accepting that the response rate is very low in pretreated patients, this 20% can be significant. Ninety cycles were administered to 22 patients and the treatment was very well tolerated: both hematologic and nonhematologic toxicities were mild. PMID- 3955784 TI - MACC (methotrexate, doxorubicin, cyclophosphamide and lomustine) versus cis platinum and etoposide in the treatment of advanced non-small cell lung cancer. AB - From June, 1982 to December, 1984, 35 consecutive patients with histologically proven non-small cell lung cancer (NSCLC) were treated either with methotrexate, adriamycin, cyclophosphamide and CCNU (MACC regimen) or cis-platinum and etoposide (DDP-VP16). The rates of objective responses were, respectively, 15% (3 partial responses out of 20 patients) and 13 (2 out of 15). Times to progression were significantly prolonged in the DDP-VP16 group (median: 29 weeks vs 11), with a trend to improvement in the median survival time (30 weeks vs. 17, P less than 0.1). Except for life-threatening leukopenia in 15% of the MACC patients and intractable vomiting in 47% of patients on cis-platinum based chemotherapy, no serious toxicity was observed. The DDP-VP16 combination seems to be more effective, but less well tolerated, than the MACC regimen and can be recommended for compliant patients with good prognostic factors. PMID- 3955787 TI - Pleural effusion in breast cancer: influence upon clinical course and survival. AB - The clinical course and outcome of 31 women suffering from breast carcinoma with documented pleural involvement was reviewed retrospectively. These 31 patients represent 14% of all patients with metastatic breast cancer seen in our Institution between 1977 and 1982. Most effusions were unilateral and ipsilateral to the affected breast, and the median interval from diagnosis of breast cancer to detection of pleural effusion was 32 months (range 0 to 84). In 55% of the patients, the effusion represented the first site of failure; in patients with known metastatic disease, the median interval from initial failure to the development of pleural effusion was 12 months. Local recurrence in the affected breast or chest wall very frequently preceded the onset of an ipsilateral effusion. Once pleural fluid developed, spread to other visceral organs was common. Treatment regimens were far from uniform and included systemic chemotherapy, hormone therapy or both, as well as intrapleural treatment; 10 of 22 patients (45%) given any form of therapy other than thoracentesis had a significant decrease in the amount of the effusion, including 3 patients with a complete response. The median survival of all patients from the onset of the effusion was 7 months (1-72); complete responders survived a median of 15 months whereas progressors had a median survival of 5 months only. Prognostic characteristics associated with a prolonged survival were: a unilateral effusion, ipsilateral to the primary tumor; effusion as first site of relapse, and mainly, an objective response to therapy. Although this is a small series, patients given both systemic and intracavitary treatment achieved best results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955788 TI - Unique properties of NADPH- and NADH-dependent metabolism of p-nitroanisole catalyzed by cytochrome P-450 isozyme 2 in pulmonary and hepatic microsomal preparations from rabbits. AB - Approximately 90% of the NADPH- and NADH-dependent O-demethylation of p nitroanisole (PNA) in the hepatic microsomal fraction from phenobarbital (PB) treated rabbits and in the pulmonary microsomal fraction from untreated rabbits is catalyzed by the same isozyme of cytochrome P-450. This isozyme of cytochrome P-450 catalyzes less than 60% of this reaction in the hepatic microsomal fraction from untreated rabbits. Antibodies to NADPH-cytochrome P-450 reductase inhibit NADPH-dependent metabolism of p-nitroanisole by about 90% but have no effect on NADH-dependent metabolism. Hepatic NADPH-dependent metabolism of pNA and reduction of cytochrome c are inhibited to the same extent with varying amounts of antibodies to NADPH cytochrome P-450 reductase. The same relationship between inhibition of monooxygenase and reductase activities is observed for the hepatic and pulmonary metabolism of benzphetamine and 7-ethoxycoumarin. In contrast, the relationship between inhibition of the pulmonary NADPH-dependent metabolism of pNA and reductase activity is biphasic; at 75% inhibition of reductase activity, metabolism of pNA is inhibited by less than 25%. For NADH-dependent metabolism of pNA, our results indicate that both electrons are transferred to cytochrome P-450 from cytochrome b5. PMID- 3955789 TI - Potential antiradiation drugs containing no nitrogen, and related compounds. AB - Capabilities are reported of di- and higher sulfides (RSnR') terminated by sulfinate functions [-S(O)O-] for protecting mice against otherwise lethal effects of ionizing radiation. With the use of congeners, structure-activity correlations are developed for the effects of esterification of the sulfinate function, of changing the length of the chain of sulfur atoms, of reduction to a mercapto sulfinate, and of changing the substituents R and R' to chiral and other types of groups. Neither a trisulfide nor a sulfinate by itself was significantly radioprotective. The key requirement for radio-protection in the series appears to be the presence of a sulfur function (-Sn-) from which a thiol can be engendered by a neighboring-group effect of an electron-donating group; sulfoxide functions may afford alternatives to sulfinate functions as such neighboring groups. The relevance of structure-activity relations to the chemical and biological mechanisms involved in the radioprotective activities is discussed. PMID- 3955790 TI - Lack of effect of glutathione depletion on cytotoxicity, mutagenicity and DNA damage produced by doxorubicin in cultured cells. AB - Since endogenous glutathione (GSH), the main non-protein intracellular thiol compound, is known to provide protection against reactive radical species, its depletion by diethylmaleate (DEM) was used to assess the role of free radical formation mediated by doxorubicin in DNA damage, cytotoxicity and mutagenicity of the anthracycline. Subtoxic concentrations of DEM that produced up to 75% depletion of GSH did not increase doxorubicin cytotoxicity in a variety of cell lines, including Chinese hamster ovary (CHO) and lung (V-79) cells, LoVo human carcinoma cells and P388 murine leukemia cells. Similarly, the number of doxorubicin-induced DNA single strand breaks in CHO cells and the mutation frequency in V-79 cells were not affected by GSH depletion. The results obtained suggest that mechanisms other than free radical formation are responsible for DNA damage, cytotoxicity and mutagenicity of anthracyclines. PMID- 3955791 TI - Microbial metabolism of pyrene. AB - The isolation and identification of pyrene metabolites formed from pyrene by the fungus Cunninghamella elegans is described. C. elegans was incubated with pyrene for 24 h. Six metabolites were isolated by reversed-phase high-performance liquid (HPLC) and thin-layer chromatography (TLC) and characterized by the application of UV absorption, 1H-NMR and mass spectral techniques. C. elegans hydroxylated pyrene predominantly at the 1,6- and 1,8-positions with subsequent glucosylation to form glucoside conjugates of 1-hydroxypyrene, 1,6- and 1,8-dihydroxypyrene. In addition, 1,6- and 1,8-pyrenequinones and 1-hydroxypyrene were identified as metabolites. Experiments with [4-14C]pyrene indicated that over a 24-h period, 41% of pyrene was metabolized to ethyl acetate-soluble metabolites. The glucoside conjugates of 1-hydroxypyrene, 1,6- and 1,8-dihydroxypyrene accounted for 26%, 7% and 14% of the pyrene metabolized, respectively. Pyrenequinones accounted for 22%. The results indicate that the fungus C. elegans metabolized pyrene to non toxic metabolites (glucoside conjugates) as well as to compounds (pyrenequinones) which have been suggested to be biologically active in higher organisms. In addition, there was no metabolism at the K-region of the molecule which is a major site of enzymatic attack in mammalian systems. PMID- 3955792 TI - The formation of 6,7-dihydro-7-hydroxy-1-hydroxy-methyl-5H-pyrrolizine, a metabolite of pyrrolizidine alkaloids. AB - In vitro metabolism of senecionine with rat hepatic microsomes was studied. The main pyrrolic metabolite, 6,7-dihydro-7-hydroxy-1-hydroxy-methyl-5H-pyrrolizine was isolated by preparative high performance liquid chromatography (PRP-1 column) and examined by mass spectrometry. Results of the incubation performed in the presence of H218O indicated that both hydroxyl groups of the metabolite came from the solvent. Thus, formation of the pyrrolic metabolite is accomplished by alkyl oxygen fission of both bonds C7-O and C9-O of the dehydroalkaloid, an intermediate supposedly formed during metabolic transformation of pyrrolizidine alkaloids (PAs). PMID- 3955793 TI - Bioalkylation of dibenz[a,b]anthracene in rat liver cytosol. AB - Previous studies by other investigators have established that L-region methyl derivatives of dibenz[a,h]anthracene (DBA) were more carcinogenic than the parent hydrocarbon. The bioalkylation of DBA was investigated by incubating the hydrocarbon with rat liver cytosol fortified with S-adenosyl-L-methionine (SAM) in 0.1 M phosphate buffer (pH 7.4) for 1 h at 37 degrees C in air. The reaction was stopped by the addition of cold acetone and the mixture extracted with ethyl acetate and washed with water. The organic phase was evaporated and the residue dissolved in methylene chloride for analysis by reverse phase high performance liquid chromatography (HPLC) and gas chromatography/mass spectroscopy GC/MS. Products were found that were indistinguishable from 7-methyl-DBA and 7,14 dimethyl-DBA, 7-hydroxymethyl-DBA, 7-hydroxymethyl-14-methyl-DBA, and 7,14 dihydroxymethyl-DBA. The results suggest that unsubstituted carcinogenic hydrocarbons are preprocarcinogens that react with SAM in liver cytosol preparations, to form alkyl substituted procarcinogens, which are more potent than the corresponding preprocarcinogens. PMID- 3955794 TI - The Warnock 15%. PMID- 3955795 TI - Preventive education and birth order as co-determinants of IQ in disadvantaged 5 year-olds. AB - The effects of preventive education and birth order on IQ scores of 95 economically disadvantaged children at risk for retarded intellectual development were studied. Experimental first- and later-born children participated from birth in a 5-year programme of systematic educational intervention. An equal number of children served as controls and received no systematic intervention. First-borns prevailed as the brighter children in both the educational treatment group and the control group when Wechsler Preschool and Primary Scale of Intelligence (WPPSI) full scale and verbal IQ scores were compared. Furthermore, mothers of first-borns (70% of whom were only-born at age 5) achieved significantly higher WAIS scores than did mothers of later-born children. Results suggest that later born disadvantaged children are at greatest risk for developmental retardation. PMID- 3955796 TI - Consent to treatment by parents and children. Working Group of the Northern Health Region in Current Medical/Ethical Problems. PMID- 3955797 TI - The efficacy of teaching dyslexics. AB - A survey of remedial teaching based on a particular method and carried out in an NHS clinic over 2 years has been presented. The findings suggest a differential pattern of improvement both for reading and spelling as well as for type of learning difficulty, whether 'backward' or 'specifically retarded'. A plea for early recognition of specific learning difficulties and the provision of appropriate remedial teaching is made as the present findings suggest that a structured method of teaching can lead to improvement in both reading and spelling. PMID- 3955798 TI - Pneumococcus-specific immunoglobulin E in cigarette smokers. AB - A relationship between elevated serum immunoglobulin E levels and smoking has been demonstrated in epidemiological studies. Allergy skin test data suggest that the excess immunoglobulin E of smokers is not specific for aeroallergens. It is possible that the excess immunoglobulin E is specific for microorganisms that often infect the lower respiratory tract of smokers. To investigate this possibility we utilized a radioallergosorbent test assay for detecting serum immunoglobulin E specific for Streptococcus pneumoniae, an organism commonly isolated from the respiratory tract of smokers with chronic bronchitis. We assayed sera of thirty smokers and thirty nonsmokers for immunoglobulin E specific for Streptococcus pneumoniae. Individual sera were considered positive for pneumococcus-specific immunoglobulin E if the binding was at least twice the non-specific binding at the total immunoglobulin E concentration of the particular serum. Eleven of the thirty sera of smokers and two of the thirty nonsmokers were positive for pneumococcus-specific immunoglobulin E. By chi square analysis of these data, the prevalence of pneumococcus-specific immunoglobulin E was significantly greater in the smoking group compared with the non-smoking group (P less than 0.02). These results suggest that the excess immunoglobulin E of smokers is, at least in part, specific for microorganisms that infect the airways. PMID- 3955799 TI - Use of liquid nitrogen in the control of house dust mite populations. AB - Laboratory and field studies on the use of liquid nitrogen as an acaricide, combined with vacuum cleaning, demonstrated this inert freezing agent to be extremely efficient in reducing the number of live mites in mattresses when compared to vacuum cleaning only. Preliminary observations suggest this treatment does no physical damage to mattresses. Any strategy in the control of house dust mites should incorporate procedures both for the reduction of the mite population and the removal of the allergen pool of faecal pellets and dead mites. PMID- 3955800 TI - Skin reactivity and specific IgE levels in the evaluation of allergic sensitivity to common allergens for epidemiological purposes. AB - An investigation was conducted to test the validity of the skin-prick test (SPT) with eleven common allergens (Lofarma series proposed by Italian National Research Council for epidemiological studies) as a method for predicting the presence of specific antibodies in serum. The relationship between SPT, evaluated by two different methods (MWD = mean weal diameter, AHWR = allergen histamine weal ratio), and specific IgE levels (RAST) has been investigated in 101 patients tested consecutively for suspected allergic disease. Sensitivity, specificity and overall efficiency were assessed for different criteria of SPT positivity (greater than or equal to 4 mm or greater than or equal to 5 mm using MWD; ++ or using AHWR). For pollens and moulds, a weal diameter greater than or equal to 5 mm gave better results than 4 mm, whereas for mites a MWD greater than or equal to 4 mm showed a better sensitivity and overall efficiency than 5 mm. Danders showed low sensitivity when either 5 or 4 mm criterion was considered. AHWR evaluation gave no better results, except for animal danders. Correlation coefficients between weal size and RAST class showed a good relationship for mites and pollens using both methods of SPT evaluation; a moderate relationship was observed with MWD criterion for moulds and with AHWR for danders. We conclude that a weal diameter greater than or equal to 5 mm can be assumed to to predict RAST positivity for pollens and moulds, and for mites, a weal greater than or equal to 4 mm can be a more accurate criterion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955801 TI - Evaluation of the direct potentiometric method for serum chloride determination- comparison with the most commonly employed methodologies. AB - A new instrument (NOVA 4 + 4) designed to measure serum chloride by ion-selective electrode (ISE)-direct potentiometry (without sample dilution) was evaluated and compared with two widely used methodologies for chloride determination. Mean values obtained with the Nova were significantly higher than those obtained by a colorimetric method and by coulometric titration. Unlike these procedures, which are performed after sample dilution, direct potentiometry was unaffected by changes in plasma water caused by hyperlipemia and/or high protein concentrations. The only important interference was falsely high choride caused by administered bromide or iodide. Therefore, the direct potentiometric method should be more accurate than the colorimetric or coulometric procedures, especially when plasma lipids or proteins are very high. PMID- 3955802 TI - Colorimetric determination of non-enzymatically glycated albumin. AB - A colorimetric method was developed for the determination of nonenzymatically glycated albumin and adapted to a Flexigem centrifugal analyzer. Albumin was separated from serum or plasma using Sepharose-blue dextran affinity chromatography. The stable ketoamine linkage in glycated albumin reduced a tetrazolium salt to its colored formazan. Glycated human serum albumin was used as the standard and optimum conditions for the assay were established. Recovery of glycated albumin was quantitative. The coefficients of variation for within run and day-to-day precision were 4.6% and 8.5%, respectively. The labile aldimine fraction, lipemia, icterus, hemolysis and type of anticoagulant used did not affect the results. The non-diabetic reference interval for this method was 7.9-11.6% glycated albumin, and normal and diabetic populations can be clearly discriminated (p less than 0.005). Values obtained with this method correlated well with a thiobarbituric acid assay (r = 0.974) but less so with those for glycated hemoglobin (r = 0.35). PMID- 3955803 TI - Immunoturbidimetric assay of transferrin: effect of iron and need for serum blanks. AB - The introduction of specific antisera has led to the replacement of total iron binding capacity assays with direct immunochemical measures of transferrin. However, some controversy exists over the effect of the degree of iron saturation on antigen-antibody interactions in these immunochemical assays. This study describes a simple automated immunoturbidimetric assay of transferrin, and includes a reference range and an evaluation of the effects of common potential interferents, including iron, bilirubin, lipemia, and hemoglobin. The measured and the calculated TIBC are also compared for 78 healthy individuals and 51 patients with anemia. PMID- 3955804 TI - The organization of a 24-hour blood alcohols (volatiles) screening service in a hospital laboratory. AB - We describe the organization that evolved in the Clinical Biochemistry Department of a tertiary-care hospital for handling blood (serum) alcohol (volatiles) determinations. We use a microprocessor-controlled capillary gas chromatography system which will detect and quantitate methanol, ethanol, isopropanol and acetone. Minimal operator intervention is required, allowing operation of the system 24 hours each day, thus permitting timely detection of these volatiles. A Specimen Trace Card has been devised to document continuity of sample handling from the time of blood collection until completion of the analysis. This has proved of value when laboratory records are used for legal purposes. PMID- 3955805 TI - Mid-molecule parathyroid hormone assay comparison. AB - Parathyroid hormone (PTH) assays are becoming available to clinical chemistry laboratories for in-house use. We evaluated the clinical utility of two mid molecule PTH assays in comparison to a sensitive but technically demanding component assay. A normal reference population, and an abnormal population including cases of primary and secondary hyperparathyroidism, hypoparathyroidism, and humoral hypercalcemia of malignancy were tested. PTH determinations with each assay system and total serum calcium determinations were done on all specimens. The Endocrine Metabolic Center (EMC) kit assay and the Immuno Nuclear Corp. (INC) kit assay demonstrated adequate standard curve reproducibility and precision for clinical use. With the aid of calcium determinations each assay performed well in the separation of abnormal patient groups, and in the separation of abnormal from normal PTH-calcium homeostasis. PTH values for the reference population differed among the three assays. The component assay and the EMC assay had a negative correlation with serum calcium, but the INC assay had a positive correlation with serum calcium. PMID- 3955806 TI - The influence of anatomical site and hormonal status on the copper and zinc levels of human uterine smooth muscle. AB - Copper and zinc levels were measured in smooth muscle from 47 uteri. Results were obtained for myocervix, isthmus and corpus in the secretory and proliferative phases and also from post-menopausal subjects. The levels were found to vary both with site sampled and the physiological state of the uterus. PMID- 3955807 TI - Role of serum androgens and sex hormone binding globulin capacity in the evaluation of hirsutism in women. AB - Serum samples from 23 hirsute women and 23 non-hirsute women matched for age and deviation from ideal weight were analyzed for total testosterone (T), percent free testosterone (% FT) and sex hormone binding globulin capacity (SHBG). The % FT was assayed by 2 methods, using diluted serum in equilibrium dialysis (EQD) and using undiluted serum in centrifugal ultra-filtration (UF). SHBG was measured by a DEAE cellulose filter assay and T by radioimmunoassay. The two methods for determining % FT correlated well. There was considerable overlap between the hirsute and control groups for all of the measured parameters. The discrimination between the 2 groups provided by the indirect estimate of free testosterone obtained from the ratio of T to SHBG was at least as good as that provided by the free testosterone derived from ultrafiltration or dialysis. PMID- 3955808 TI - Evaluation of absorption and first- and second-derivative spectra for simultaneous quantification of bilirubin and hemoglobin. AB - We discuss the relative merits of absorption and first- and second-derivative spectra for the simultaneous quantification of bilirubin and hemoglobin, and evaluate single-, two-, and multiwavelength methods. Although both species can be quantified from single- or two-wavelength absorption data, lipids or other absorbing or light-scattering components introduce systematic errors that can be substantially decreased by using first- or second-derivative spectra. Multi wavelength data-processing methods with derivative spectra permit quantification of components with overlapping spectra and decrease the random error usually associated with derivative methods. A typical least-squares equation for quantifying bilirubin in the presence of hemoglobin and bovine serum albumin from multi-wavelength second-derivative data is y(computed) = 0.999x(prepared) + 0.00 mg/L. PMID- 3955809 TI - Screening for thyroid disease in women greater than or equal to 50 years of age seeking hospital care: influence of common nonthyroidal illness on serum free thyroxin as determined by analog radioimmunoassay. AB - We determined free thyroxin (fT4; analog radioimmunoassay) and thyrotropin in serum of women greater than or equal to 50 years of age who were attending a medical casualty ward (n = 363) or a medical outpatient clinic (n = 496), in order to estimate the prevalence of low fT4 results associated with nonthyroidal illness and to screen for previously unknown thyroid disease. Individuals with results outside stated limits were followed up within two to four weeks. Only about 5% of the women seeking acute medical care showed a decrease in fT4 concentration in association with a normal thyrotropin concentration. As expected, this combination was even less common in outpatients. We found a prevalence of previously undiagnosed thyroid disease of clinical significance of 0.8% in medical acute-care cases, 1.8% in medical outpatients. For this clinical setting we regard the simple analog technique as acceptable in spite of the low values reported for some hospitalized patients with nonthyroidal illness. PMID- 3955810 TI - Accuracy and comparability of long-term measurements of cholesterol. AB - Laboratories of the Lipid Research Clinics Program (LRC) maintained the accuracy of their measurements of total cholesterol by using seven pooled serum calibrators supplied by the Centers for Disease Control (CDC). Over the 11-year life of the LRC, each calibrator was prepared in succession and a target value was assigned by the CDC reference method for cholesterol. The results of a special experiment in which six of the seven calibrators were analyzed simultaneously demonstrated that the target values were accurately assigned. Deviations of the target values from the experimental means ranged from zero to 1.7% of the original target value. The experiment revealed no evidence of drift in the bias of the reference method over the life of LRC and demonstrated the accuracy, consistency, and the comparability of the values assigned to the successive calibrator pools used by the LRC laboratories during more than eight years. It demonstrated the reliability of a reference method and the suitability of frozen serum pools for maintaining an accurate measurement base for serum cholesterol. PMID- 3955811 TI - Effect of phytohemagglutinin on concentrations of glucocorticoid receptors in lymphocytes from patients with connective tissue diseases. AB - We examined the effect of phytohemagglutinin (PHA) on glucocorticoid receptors in lymphocytes, using peripheral mononuclear leukocytes from patients with connective tissue diseases. Glucocorticoid receptor concentrations and dissociation constants (Kd) for [3H]dexamethasone binding to lymphocytes from patients with rheumatoid arthritis, Sjogren's syndrome, and other connective tissue diseases did not differ significantly from values for normal volunteers. Kd values correlated positively with glucocorticoid receptor concentrations after PHA stimulation both in normal volunteers and in patients with connective tissue diseases. The correlations (r values) for the control group and patients were not significantly different. PMID- 3955812 TI - Lactate dehydrogenase isoenzyme-1/total ratio: accurate for determining the existence of myocardial infarction. AB - We have gradually revised our medical protocols for measuring creatine kinase MB isoenzyme (CK-MB) and lactate dehydrogenase isoenzyme-1 (LD-1) because of identifiable problems in the use of an interpretation of CK-MB isoenzyme associated with slowly evolving or small myocardial infarct, the use of thrombolytic therapy, or burn and trauma, each of which affects the rate of appearance and composition of isoenzymes present. Despite recent evidence of the efficacy of LD-1 isoenzyme measurement in the first 12 to 24 h of myocardial infarction, this test is not widely used because of overstated assumptions about the value of CK-MB. Here we studied the adequacy of the current isoenzyme assays by determining the value of CK-MB and LD-1 at optimum serum sampling times and establishing the contribution of individual and combined predictors to diagnostic efficiency. We conclude that the LD-1/total LD activity ratio in serum is superior to measurement of CK-MB or LD-1, or both, in the diagnosis of acute myocardial infarction. Moreover, this ratio is most valuable when interpretation of the result for CK-MB isoenzyme is equivocal in patients with small or evolving myocardial infarcts. PMID- 3955813 TI - Isolation and characterization of an abnormal alpha slow-moving high-density lipoprotein subfraction in serum from children with long-standing cholestasis. AB - An abnormal high-density lipoprotein (HDL) subfraction, detected during periods of mild jaundice in the serum of seven children with chronic cholestasis from birth, was isolated and characterized. This fraction, identified by its slow alpha electrophoretic migration, is present in addition to normal HDL and differs from the abnormal HDL previously described in cholestatic syndromes. It is devoid of apolipoprotein B but is precipitated by phosphotungstate-MgCl2. These properties allowed its isolation by double selective precipitation. This subfraction is undetectable with this procedure in the serum of healthy subjects, is rich in cholesterol, and contains a large amount of apolipoprotein E, which may explain its precipitation by phosphotungstate-MgCl2. These apo E-containing HDL may play a major role in the lipid metabolism of patients with long-standing cholestasis during periods of mild jaundice. PMID- 3955815 TI - Simultaneous determination of trace elements in lavage fluids from human bronchial alveoli by energy-dispersive x-ray fluorescence. 2: Determination of abnormal lavage contents and verification of the results. AB - We applied energy-dispersive x-ray fluorescence to the determination of abnormally present elements or abnormal concentrations of elements in human broncho-alveolar lavage fluids. The low detection limits and the ability to perform multi-elemental analysis permit one to establish or confirm occupational exposure of workers. We also describe different methods used to check our method and our results. We report examples of abnormal compositions of broncho-alveolar lavages containing W, Ce, La, Nd, I, Fe, or Ni. We discuss the limits of the method for characterizing silicosis or asbestosis. PMID- 3955814 TI - Direct measurement of creatine kinase-MB activity in serum after extraction with a monoclonal antibody specific to the MB isoenzyme. AB - Fusion of splenocytes from A/J mice immunized by creatine kinase (EC 2.7.3.2)-MB isoenzyme (CK-MB) with SP2/0-Ag14 myeloma cell line generated hybridomas producing monoclonal antibodies specific to CK-MB. One of these monoclonal antibodies ("Conan-MB") was used to develop a direct assay for CK-MB activity. In the assay, serum is incubated for 30 min at room temperature with "Conan-MB" immobilized on latex beads. The beads are then washed, and CK-MB activity bound to the antibody is measured after incubation with CK enzyme reagent for 30 min at 37 degrees C. Results with the assay correlated well (r = 0.997) with those for CK-MB concentration as measured by a two-site immunoassay. Neither CK-MM, CK-BB, mitochondrial CK, nor a hemolysate of erythrocytes interfered. Use of this unique monoclonal antibody allows rapid, precise, and direct determination of CK-MB activity. PMID- 3955816 TI - Ascorbic acid interference in reagent-strip reactions for assay of urinary glucose and hemoglobin. AB - Vitamin C (ascorbic acid), commonly taken as a dietary supplement and excreted in the urine, can interfere with peroxidase redox indicator systems such as those used in reagent-strip tests for urinary glucose and hemoglobin. We investigated whether the concentrations of ascorbic acid in urine after modest supplementary doses of vitamin C are high enough to interfere with such dipstick tests. After adding glucose or hemoglobin to urine collected from persons not taking vitamin C and from persons taking 350 to 1000 mg of vitamin C daily, we tested four reagent strips for interference and found that these commonly taken doses did frequently interfere with all test systems examined. PMID- 3955817 TI - Simple method for preparing the cellular intermediate EAC14, and its use for estimation of the second component of complement. AB - Sensitized erythrocytes carrying the first and fourth components of complement (EAC14) were prepared by incubating optimally sensitized sheep erythrocytes with normal serum appropriately diluted in Mg2+-free diethylbarbiturate buffer containing Ca2+. EAC14 cells so prepared were found to be suitable for use in estimating the second component of complement (C2) in human serum, and the method is described here. PMID- 3955818 TI - Assessment of a time-resolved fluoroimmunoassay for thyrotropin in routine clinical practice. AB - We assessed the use of a dissociation-enhanced lanthanide fluoroimmunoassay (DELFIA) system to measure thyrotropin (thyroid-stimulating hormone, TSH) in routine clinical practice. The assay is simple and precise, with intrabatch CV of less than 10% down to 0.1 milli-int. unit/L. When compared with free thyroxin, total thyroxin, and triiodothyronine measurements in 142 patients, the present assay most sensitively indicated hyperthyroidism and, in conjunction with free thyroxin, most sensitively indicated hypothyroidism. Free thyroxin was the most specific assay (lowest number of falsely increased or decreased results) in detecting thyroid disorders, with a specificity of 93.6% as compared with 85.1% for TSH, 81.9% for thyroxin, and 77.6% for triiodothyronine. PMID- 3955819 TI - Creatine kinase variant type I in children with anoxic insult. AB - We evaluated 31 consecutive patients, including 11 children, with creatine kinase variants (CKV) in our laboratory during a year. All had a clinical history of central hypotonia with myocardial damage resulting in severe central hypoxia. Seven of the 11 were neonates and had Apgar scores of 2.8 (SD 2.3) at 1 min and 4.8 (SD 2.4) at 5 min, which reflected their severe birth hypoxia. For the seven neonates, the mean value for total serum creatine kinase (EC 2.7.3.2; CK) was 773 (SD 553) U/L. The mean percentage CKV was 20.7% (SD 12.5%). The other four children were being evaluated for failure to thrive; all had birth asphyxia with residual cerebral palsy and seizure activity. These older children had a lower percentage of CKV (7.3%, SD 1.01%) than did the neonates, but the total CK (725, SD 1335 U/L) was not significantly different. In four neonates there was a three- to 20-day delay in the appearance of CK variant, which followed a marked increase in total CK activity. Tissue necrosis is apparently an important factor in the pathogenesis of Type I CK variant. PMID- 3955820 TI - Determination of vanillylmandelic acid with ion-pair chromatography and fluorescence detection. AB - We describe a chromatographic procedure for sensitive (2.0 mumol/L), specific quantification of vanillylmandelic acid (VMA) in urine with iso-VMA as an internal standard. After rapid extraction from urine, the VMA is determined by isocratic reversed-phase ion-pair chromatography on a bonded C8 column and detection of the native fluorescence on excitation at 285 nm. The fluorescence signal is quite dependent on the pH of the mobile phase. Results by the method vary linearly with VMA concentration up to 320 mumol/L and correlate well (r = 0.9880) with those obtained by conventional ultraviolet spectrophotometry. The mean 24-h excretion of VMA from 29 healthy volunteers was 21.4 (SD 5.4) mumol. PMID- 3955821 TI - A case of IgE myeloma. PMID- 3955822 TI - Magnesium, surfactants, and centrifugal analyzers. PMID- 3955823 TI - Effects of needle size and storage temperature on measurements of serum potassium. PMID- 3955824 TI - Modified enzymatic assay for acetaminophen. PMID- 3955825 TI - Effect of heparin on free thyroxin as measured by equilibrium dialysis and ultrafiltration. PMID- 3955826 TI - Quantification of cyclosporin G (NVa2 cyclosporin) by radioimmunoassay. PMID- 3955827 TI - CK-MB assay in the Ames Seralyzer. PMID- 3955828 TI - Downstream specimen interaction--an unusual viscosity effect on continuous-flow analysis. PMID- 3955829 TI - Rapid column-chromatographic analysis of chloramphenicol in serum. PMID- 3955830 TI - Measurement of serum testosterone: results of the "Farmos" SHBG IRMA kit and the "Coat-A-Count" free testosterone kit compared with salivary testosterone. PMID- 3955831 TI - Modifications in a method for vanillylmandelic acid in urine. PMID- 3955832 TI - Oligoclonal bands are found in electrophoretograms of serum of patients with multiple sclerosis. PMID- 3955833 TI - Poor performance of the Baker nephelometer and reagents. PMID- 3955834 TI - Reference interval for urinary glucose in elderly subjects. PMID- 3955835 TI - In situ monitoring by reflectance spectrophotometry. PMID- 3955836 TI - Significance of low creatine kinase in intensive-care patients. PMID- 3955837 TI - Proteinuria with analbuminuria. PMID- 3955838 TI - Development of a radioimmunoassay for human deoxyribonuclease I. AB - A reliable radioimmunoassay (RIA) for human deoxyribonuclease I (DNase I) is described. Using delayed addition of tracer antigen, the method is sensitive (9.5 reproducible and specific. A good parallel relationship was observed between the standard curve and dilution curves for human urine and human pancreatic juice. G actin, a naturally occurring DNase I inhibitor, caused no change in the immunoreactivity of DNase I. In healthy individuals, aged 11-90 yr, the mean serum DNase I was 18.4 ng/ml (SD 6.7 ng/ml). Increased serum DNase I occurred in patients with acute pancreatitis, renal failure, and in about one-third of patients with various malignant tumors. PMID- 3955839 TI - Clarifying lipemic samples with an air-driven ultracentrifuge for determination of high-density lipoprotein cholesterol. PMID- 3955840 TI - Prenatal diagnosis of GM2 gangliosidoses using a fluorogenic sulfated substrate. PMID- 3955841 TI - Diagnosis and characterization of GM 2 gangliosidosis type II (Sandhoff disease) by analysis of the accumulating N-acetyl-glucosaminyl oligosaccharides with high performance liquid chromatography. AB - The N-acetyl-glucosaminyl oligosaccharides excreted in urine and accumulating in tissues of Sandhoff disease patients have been analyzed and characterized using a combination of high performance liquid chromatography and 500 MHz proton magnetic resonance spectroscopy. Delineation between infantile and juvenile onset forms of the disease was possible, as the latter forms had 6- to 13-fold lower levels of urinary oligosaccharides. Patients from a geographically isolated population deme in the La Rioja region of Argentina had urinary oligosaccharides similar to unrelated non-Argentinean patients with identical clinical phenotype. Together, these results indicate that the urinary oligosaccharides serve as useful indicators of the mutation differences or clinical heterogeneity within this disease only in cases of markedly differing clinical presentation. Analysis of the accumulating metabolites in liver, kidney, pancreas, lung and spleen, showed a similar oligosaccharide pattern which differed dramatically from brain. These results suggest the possibility of tissue specific regulation of oligosaccharide biosynthesis since there are notable differences between neural and visceral tissues. PMID- 3955842 TI - Aminoterminal procollagen III peptide elevation in alcoholics who are selenium and vitamin E deficient. AB - Serum aminoterminal procollagen III peptide (PIIIP) was measured in 36 alcoholic subjects. There was a significant elevation of PIIIP in subjects with proven liver disease (median 17.5 ng/ml, n = 24) compared to those without liver disease (median 4.7 ng/ml, n = 12). Those subjects with raised serum transaminase values (AST) had elevated PIIIP values (median 13.7 ng/ml, n = 22) compared to those with normal transaminase values (median 3.7 ng/ml, n = 14). In those alcoholic subjects who were deficient in both selenium and vitamin E there was a significant elevation (p less than 0.01) of PIIIP values (median 26.4 ng/ml, n = 7) compared to subjects with normal levels (median 7 ng/ml, n = 11). Subjects deficient in selenium alone had PIIIP values in an intermediate range. Selenium and vitamin E, as important free radical scavengers, may protect the liver in alcoholic subjects from oxidative damage leading to hepatic fibrosis. PMID- 3955843 TI - The analysis of data from breast cancer estrogen and progesterone receptor assays: Scatchard plots are inferior to direct fitting by computer. AB - The advantages are illustrated of analyzing breast cancer estrogen and progesterone receptor assays by fitting a receptor-ligand binding model directly to experimental data, rather than using the common graphical transformation known as the 'Scatchard plot'. Analysis of laboratory experiments and the use of simulation show that while both methods give equivalent results, the direct approach has definite advantages. In particular, results are more reliable in the face of increasing experimental error, it is possible to quantify non-specific binding from the primary data rather than having to measure it separately, and the methodology readily lends itself to optimizing the design of experiments. PMID- 3955845 TI - Use of selective media for distinguishing variant forms of hypoxanthine phosphoribosyl transferase. AB - Growth properties of cultured fibroblasts in selective media were used to characterize the HPRT enzyme of a patient with a new variant of hypoxanthine phosphoribosyl transferase (HPRT) with deficient activity. The clinical phenotype of the patient was typical of the Lesch-Nyhan syndrome. However, cells of the patient were not selected for by growth in either 8-azaguanine or 6-thioguanine. Assay of the activity of the enzyme in erythrocyte lysates revealed values of approximately zero, while in the intact fibroblast assay the level of activity was 1.4% of normal. The heterozygous mother of the patient, unlike heterozygotes for the classic Lesch-Nyhan enzyme, had a level of activity in erythrocyte lysates that was 45% of control. In the presence of selective agents in vitro the cells of the patient retained sufficient HPRT activity to permit a degree of toxicity indistinguishable from that observed in normal cells although the degree of the deficiency was so great that it led to the complete Lesch-Nyhan phenotype. These findings call into question the use of selective agents for the identification of HPRT- cells in the detection of heterozygosity. PMID- 3955846 TI - Determination of lithium in blood serum--a comparison between molecular absorption spectrophotometry and emission flame spectrometry. PMID- 3955844 TI - Source of increased serum aspartate and alanine aminotransferase: cycloheximide effect on carbon tetrachloride hepatotoxicity. AB - Repeated doses of the protein synthesis inhibitor cycloheximide prevented the increases in rat liver mitochondrial and cytosolic aspartate aminotransferase, in alanine aminotransferase and in protein content observed 24 h after a single carbon tetrachloride injection. Serum aminotransferase activity increases induced by carbon tetrachloride were also decreased as much as 75.7% with cycloheximide. Increased synthesis is, therefore, suggested as an important and sometimes major source of increased serum aminotransferases in hepatocellular injury. This effect of cycloheximide lends support to the hypothesis that the liver enzyme increases after CCl4 are probably due to increased synthesis, in addition to the classically held mechanisms of leakage from necrotic or damaged hepatocytes. This explanation of the mechanisms of release of aminotransferases in rat liver injury would clarify many clinical observations if the same phenomenon were to occur in humans in response to hepatic injury. These data suggest that increased serum aminotransferase activities represent a healing, in addition to a degenerative, process. PMID- 3955847 TI - Interference by monoclonal proteins in the o-phthalaldehyde method for blood urea nitrogen. PMID- 3955848 TI - Solvolysis of mono- and disulfated bile acids by ethereal HCl, prepared by a simple technique. PMID- 3955849 TI - The effect of storage conditions on the stability of carbamazepine and carbamazepine-10,11-epoxide in plasma. PMID- 3955850 TI - Bilirubin interference in the colorimetric assay of plasma vitamin E. PMID- 3955851 TI - Correlation between integrated delta and spindle components during nocturnal sleep in mentally retarded children. AB - The correlation between the integrated delta and spindle components in 81 mentally retarded children (from 3 months to 12 years of age) was studied throughout nocturnal sleep. In 57 (70%, Group A) out of 81 subjects, periodic changes of delta and spindle rhythm powers were noted in the sleep EEG. In 17 subjects (21%, Group B), delta and no-spindle rhythm powers were found, and in the remaining 7 (9%, Group C) no-delta and no-spindle rhythm powers were found throughout nocturnal sleep. A significant increase in abnormal clinical EEGs was found in groups B and C as compared to group A. A significant decrease in DQ was found in groups B and C as compared to group A. A significant decrease in DQ was also found in group C as compared to group B. PMID- 3955852 TI - Periodic lateralized epileptiform discharges (PLEDs): a possible role for metabolic factors in pathogenesis. AB - Periodic, lateralized, epileptiform discharges (PLEDs) in the electroencephalogram have been reported in association with a variety of structural lesions of the brain. Although a great deal of attention has been directed to the neuropathological basis of PLEDs, little emphasis has been placed on the functional basis of this EEG syndrome. In this paper, we reported a patient with multiple systemic problems whose EEG showed PLEDs. However, radiological and pathological studies revealed no neuropathological basis for the occurrence of this EEG syndrome. Thus, we presented evidence that metabolic factors may play a part in the pathogenesis of PLEDs. PMID- 3955853 TI - Familial occurrence of the mu rhythm. AB - EEGs of the close relatives of patients and normal volunteers with the mu rhythm were investigated. EEGs were recorded from 14 families which included 12 fathers, 14 mothers and 9 siblings. In nine families, at least one nonproband family member had the mu rhythm. The mu rhythm was found in 13 (37.1%) of the 35 relatives. This incidence is much higher than that in a general population. These data suggest that the mu rhythm is genetically determined in most cases. The mode of inheritance might be autosomal dominant. PMID- 3955854 TI - False negative intraoperative somatosensory evoked potentials with simultaneous bilateral stimulation. AB - A 43 year old man underwent spinal cord surgery for removal of filum terminale lipoma. Intraoperative somatosensory evoked potentials (SSEP) monitoring showed a transient loss of response on simultaneous bilateral posterior tibial nerve (PTN) stimulation that recovered within 20 minutes. The patients exhibited paralysis and abnormal proprioceptive perception in the right leg postoperatively, when SSEP recordings revealed abnormal response to right PTN and normal response to bilateral PTN stimulation. In order to avoid false negative intraoperative responses, stimulation of each leg independently in an alternative fashion is recommended. PMID- 3955856 TI - Paediatric gastroenterology. PMID- 3955855 TI - Paracrine control. PMID- 3955857 TI - Disorders of the cytoskeleton of the enterocyte. PMID- 3955858 TI - Emotional sequelae of chronic inflammatory bowel disease in children and adolescents. AB - It is clear that further study needs to be made of the link between emotional disorder and chronic inflammatory bowel disease in children. It is commonly accepted that such a link exists in ulcerative colitis and although there is at present no proof in either direction it seems highly probable that such a relationship is also present in Crohn's disease. We have seen that the families of children with Crohn's disease appear to find it much more than ordinarily difficult to accept such a relationship, but an objective study is projected to explore the presence of psychiatric illness in our patients and their families. Such a study will be extremely time consuming, requiring the services of a part time research worker, and the exigencies of clinical service have so far prevented its being set in motion. We feel that our experience in St Bartholomew's Hospital during the past seven years has very clearly demonstrated the value of close liaison between the Child Psychiatry Unit and the Paediatric Inflammatory Bowel Disease Clinic, and the much greater efficacy of such a liaison as against referrals made to a separate Psychiatric Unit. It should be emphasized, however, that a liaison of this sort is time consuming, and in our experience has involved child psychiatrists, social workers, child psychotherapists and behaviour therapists. Thus the provision of such a service is expensive both in time and money. Where a new Paediatric Inflammatory Bowel Disease Clinic is being projected there must be very careful forward planning, looking particularly at financial implications if a psychiatric liaison team is to be included. PMID- 3955859 TI - Chorion in culture. AB - This study is based on the processing of 115 samples of pure chorion. The different types of colony morphology, together with cytogenetic analysis, indicate the predisposition of chorion cells to artefacts of culture. Chorion survives longer than other foetal tissues and can be cultured when those are dead or contaminated (e.g. in macerated foetuses and missed abortions) making it a suitable and popular tissue for cytogenetic purposes. However, our results indicate that it is slow in culture and prone to chromosome variation so that pseudomosaicism frequently arises and may lead to misdiagnosis. We therefore suggest that cytogenetic analysis of spontaneous abortion material is interpreted with caution in cases where chorion is the only tissue cultured, especially when mosaicism is found. PMID- 3955860 TI - Cytogenetic heterogeneity of translocations associated with Duchenne muscular dystrophy. AB - Lymphoblastoid cell lines have been established from nine female patients with Duchenne muscular dystrophy who had previously been reported to have chromosome translocations with breakpoints in the Xp21 region. A detailed cytogenetic comparison of prometaphase chromosomes in these cell lines revealed that six of the translocations had X chromosome breakpoints in the sub-band Xp212 and that one further breakpoint could be assigned to either Xp212 or Xp213. These findings confirm and extend previous observations and provide strong evidence for Xp212 as the site of the Duchenne and Becker loci. For the remaining two translocations the simplest explanation for the observed banding pattern is that the X chromosome breakpoint lies a few thousand kilobases away, in the sub-band Xp211. Other explanations which assume breaks in Xp212 combined with complex local chromosome rearrangements are also presented. It is also possible that the altered banding pattern in these two cases is due to the influence of local sequences on the staining or uncoiling properties of the chromatin. PMID- 3955861 TI - Evidence for preferential involvement of chromosome bands 6p21 and 13q14 in amniotic fluid cell balanced translocation pseudomosaicism. AB - Chromosome rearrangement is a relatively common finding in cultured amniotic fluid cells. When cytogenetic abnormalities are confined to one cell or cells from a single culture, they are generally assumed to have arisen in culture (pseudomosaicism). To determine whether or not there might be some specificity in chromosome break-points in balanced translocation multiple cell pseudomosaicism, data has been pooled for 18 cases studied at PDL and 30 cases from the U.S. survey on mosaicism and pseudomosaicism (Hsu & Perlis 1984). Out of a total of 97 break-points, 87 were assigned to Giemsa-staining light bands and 12 to Giemsa staining dark bands. An excess of break points (29%) were assigned to terminal bands. Two loci appeared to be preferentially involved in rearrangement: six break-points (4 PDL cases and 2 others) were assigned to band 6p21; the region to which the major histocompatibility complex (HLA) has been assigned; Four break points (all PDL cases) were assigned to 13q14, the region associated with the retinoblastoma locus. This preliminary evidence for specific break-points needs confirmation and long-term follow-up information is needed to determine whether or not there is any clinical significance to these observations. PMID- 3955862 TI - A simple technique for recording and counting sweat pores on the dermal ridges. AB - A simple method was devised for recording dermatoglyphics in a form suitable for sweat pore counting. Fifteen members of a family with a hypohidrotic X-linked ectodermal dysplasia made their own hand prints using our method and mailed the results to us for interpretation. The simplicity of the technique also makes it practical to use on new-born males at risk for the condition, or where dermatoglyphic records are required for other purposes. Preliminary data suggest that patchiness of sweat pore distribution on the fingers and palms may be useful in the discrimination of heterozygotes. PMID- 3955863 TI - Clinical and genetic studies of muscular dystrophy in young girls. AB - During the years 1971-81, we treated 7 girls with clinical features suggestive of Duchenne dystrophy. Muscle weakness developed at 1.5 or at 5-8 years and progressed rapidly. Two girls were in wheel-chairs in their teens. Muscle atrophy began in the proximal parts of the lower extremities and pseudohypertrophy of the calf occurred in all patients. Serum creatine phosphokinase (CPK) activity was moderately to highly elevated in all cases and EMG showed a moderate to marked myopathic pattern. Chromosomal studies showed normal finding in the five examined. Mental retardation (IQ 37-73) was present in four. Consanguinity was present in 3 out of the 7 cases. Two mothers showed elevated levels of CPK and myopathic patterns on EMG. In addition, one mother had slight muscle weakness at the age of 42 and another had prominent pseudohypertrophy of the calf. Sex-linked recessive inheritance might be considered here, because carriers of autosomal recessive type never showed elevated levels of CPK or mild myopathic symptoms. The other five of our seven might be cases of autosomal recessive inheritance, because the mothers had normal serum CPK levels and in 2 families there was a consanguinity. PMID- 3955864 TI - A de novo translocation in a family with a balanced reciprocal chromosomal translocation. AB - A carrier of a reciprocal translocation between chromosomes 10 and 18 had a child with a reciprocal translocation involving different segments of the same chromosomes. The categories of possible meiotic errors in carriers of balanced rearrangements must, therefore, be expanded to include new reciprocal translocations. PMID- 3955865 TI - A family with congenital suprabulbar paresis (Worster-Drought syndrome). AB - A three generation family is described in which four members were found to have congenital suprabulbar paresis (Worster-Drought syndrome). It is suggested that some cases of congenital suprabulbar paresis are inherited as an autosomal dominant trait with variable expression and penetrance. PMID- 3955866 TI - X-linked short stature with skin pigmentation: evidence for heterogeneity of the Russell-Silver syndrome. AB - A family is described with a syndrome of short stature, abnormal pigmentation of the skin and mild facial dysmorphism. The short stature and pigmentary anomalies were more marked in the males than the females. The pattern of inheritance appeared X-linked. In 2 young brothers the clinical picture mimicked that of the Russell-Silver syndrome. It is suggested that the Russell-Silver syndrome is heterogeneous and that the criteria for its diagnosis need re-evaluation. PMID- 3955867 TI - An infant with thanatophoric dwarfism surviving 169 days. AB - A female infant with thanatophoric dwarfism surviving 169 days is described. The genetics of the entity are briefly discussed. PMID- 3955868 TI - Long term survival of a patient with the cerebro-hepato-renal (Zellweger) syndrome. AB - A 13-year-old girl with severe mental retardation, tapetoretinal degeneration, an extinguished electroretinogram and sensoneurinal hearing loss is described. In early life the diagnosis of Zellweger (cerebro-hepato-renal) syndrome was considered because of hypotonia, craniofacial dysmorphia, abnormal liver functions and pipecolic aciduria. Biochemical studies in fibroblasts from the patient revealed a general peroxisomal dysfunction comparable to the findings in Zellweger Syndrome. As the clinical presentation of this patient is essentially different from that in classical Zellweger patients, who usually die early in life, we recommend the study of peroxisomal functions in all patients with severe mental retardation, tapetoretinal degeneration and sensoneurinal hearing loss. PMID- 3955869 TI - Isolated congenital bowed long bones. AB - An infant with prenatal bowed long bones is reported. History of bowed leg bones in the mother during her infancy and improvement of the bowed bones in the child and mother support benign nature of the condition and probable A.D. inheritance. PMID- 3955870 TI - Pierre Robin anomaly with an accessory metacarpal of the index fingers. The Catel Manzke syndrome. AB - A two-year-old female with the Pierre Robin anomaly and bilateral index finger malformations is described. Hypertelorism, full cheeks, posteriorly rotated ears with prominent antihelix, short neck, simian creases, bilateral fifth finger clinodactyly, and short toes with hypoplastic small nails were also present. Her mother had a subsequent pregnancy that resulted in the delivery at 26 weeks, of a stillborn female fetus with cleft palate, index finger anomalies and congenital heart disease. These two patients are the first females reported with this group of anomalies. The etiology of this combination of malformations, the Catel-Manzke syndrome, is unknown. PMID- 3955872 TI - Cerebral gigantism with hydronephrosis: a case report. AB - A case of cerebral gigantism with hydronephrosis in a 20-month-old boy is described. Hydronephrosis is believed to be an additional association of the syndrome not hitherto reported. PMID- 3955871 TI - Thymus deficiency in an infant with a chromosome t(18;22)(q12.2;p11.2)pat rearrangement. AB - The finding of an unbalanced t(18;22)pat chromosome rearrangement in a boy with multiple anomalies including apparent absence of the thymus is described. The observation is of interest because of the reported association of chromosome 22 rearrangements with the DiGeorge sequence. In contrast to previous reports of this association, the deletion involving chromosome 22 is confined to the short arm. PMID- 3955873 TI - Pericentric inversion 16 in man--a second case. AB - A second case of a pericentric inversion of the heterochromatic region in chromosome 16 is described. This extremely rare polymorphism was not associated with any anomalies. PMID- 3955874 TI - Names in genetics: ban on partial trisomy, tetrasomy and monosomy. PMID- 3955875 TI - Osteoporosis-pseudoglioma or osteogenesis imperfecta? PMID- 3955876 TI - Determination of the acetylator phenotype in a Turkish population. PMID- 3955877 TI - Ocular osteogenesis imperfecta. PMID- 3955878 TI - Guidelines for the diagnosis of fragile X. PMID- 3955879 TI - Population cytogenetics of autosomal fragile sites. AB - The present investigation deals with a population chromosomal survey for autosomal fragile sites under conditions of folate deprivation in 405 mental retardates. A total of 13 ascertainments of folate sensitive autosomal fragile sites is observed, of which 10q23 fragility appears to be the most frequent. Further cytogenetic studies of normal and retarded individuals are required to help elucidate the possible phenotypic effect of these autosomal sites and mental retardation. PMID- 3955880 TI - IgG2 subclass restriction of antibody to pneumococcal polysaccharides. AB - Studies in experimental animals suggest that antibody responses to certain polysaccharide antigens may be restricted in IgG subclass distribution. To determine if human antibodies to pneumococcal polysaccharides are similarly restricted we measured the IgG subclass specific response to immunization with purified polyvalent pneumococcal polysaccharide vaccine. For the type 3 pneumococcal antigen, the geometric mean titre of IgG2 antibody was significantly greater than that of IgG1, IgG3 or IgG4, in both pre-immunization and post immunization sera. A significant rise in mean titre, comparing pre- to post immunization sera was observed only for IgG2 antibody. Similar predominance of IgG2 antibody was found for pneumococcal polysaccharides types 6, 18, 19 and 23. In contrast, antibody to the protein antigen tetanus toxoid was exclusively of the IgG1 subclass. Patients with IgA/IgG2 deficiency demonstrated a normal IgG response to tetanus, a normal IgM response to pneumococcal polysaccharides, but no IgG antibody to pneumococcal antigens. IgG2 subclass restriction of antibody to pneumococcal polysaccharides suggest that these antigens may elicit an immune response analogous to the murine type 2 T-cell independent immunogens which show IgG subclass restriction and the requirement of a mature B cell subset defined by the Lyb5+ alloantiserum. Our findings support the possibility of subclass specific inducing or regulating mechanisms for human responses to carbohydrate or polysaccharide antigens. PMID- 3955882 TI - Human lymphocyte, monocyte and polymorphonuclear leucocyte mediated antibody dependent cellular cytotoxicity against varicella-zoster virus-infected targets. AB - The ability of lymphocytes, monocytes and polymorphonuclear leucocytes (PMN) to mediate antibody-dependent cellular cytotoxicity (ADCC) against varicella-zoster virus (VZV) infected fibroblasts was tested in 51Cr release and single-cell assays. Lymphocytes had the greatest lytic activity, monocytes were intermediate in activity and PMN were the least active. Lymphocyte-mediated ADCC was complete by as early as 4 h, while maximal monocyte and PMN-mediated ADCC required 18 h. In single-cell assays, monocytes formed conjugates with both uninfected and VZV infected targets, but did not cause lysis. PMN failed to bind or lyse either target. Few lymphocytes formed conjugates with uninfected targets, while a higher percentage bound to VZV-infected targets and caused lysis. In the presence of human antibodies to VZV conjugate formation and lysis of VZV-infected targets was significantly increased with each of the effector-cell populations. Lymphocytes had the highest lytic activity in single-cell assays as well as in 51Cr release assays, and were responsible for most of the ADCC detected in adult peripheral blood against VZV-infected targets. PMID- 3955881 TI - Lectin-dependent cell-mediated cytotoxicity and blastogenesis by large granular enriched and depleted lymphocytes. AB - The role of larger granular-enriched and depleted lymphocytes was studied in lectin-dependent cell-mediated cytotoxicity (LDCC) against adherent HEp-2 human epipharynx carcinoma target cells. LDCC was evaluated by detachment from the monolayer of 3H-thymidine-prelabelled HEp-2 cells in a 24 h assay at effector target cell ratios of 25:1 and 50:1 in the presence of 25 micrograms/ml concanavalin A (Con A). Under the aforementioned conditions but in the absence of Con A natural cell-mediated cytotoxicity (NCMC) was not found. However, cytotoxicity was significantly augmented in the presence of Con A (= LDCC) using human peripheral blood mononuclear cells (PBMC) as effectors. Large granular lymphocytes (LGL), which show high natural killer (NK) activity to K 562 target cells, failed to be cytotoxic against HEp-2 targets similar to large granular depleted lymphocytes (LGL-DL). On the other hand, LGL caused only a slight LDCC; whilst LGL-DL induced strong LDCC activity towards HEp-2 targets. In comparison to LDCC using LGL-DL as effector cells, LGL and LGL-DL mixed at a ratio of 1:2, and added to target cells, had no major effect on LDCC, while a lower level of LDCC was observed at LGL/LGL-DL ratios of 1:1, and 2:1, suggesting the dilution of LGL-DL, potential effectors of LDCC to HEp-2 cells, rather than a specific regulatory role of LGL in LDCC. In parallel studies, the proliferation of LGL-DL in response to Con A was less than that observed with PBMC or LGL. The response could be restored by replacing half of LGL-DL per culture with an equal number of LGL, or by the addition of 10% monocytes. Significant functional differences between LGL and LGL-DL in LDCC as well as in Con A-induced blastogenesis are suggested. PMID- 3955883 TI - Humoral immune response in patients with IgA and IgM glomerulonephritis. AB - A single dose of inactivated mumps virus vaccine was administered to male patients with IgA glomerulonephritis (IgA-GN), IgM glomerulonephritis (IgM-GN) and to healthy males. Antibodies to mumps virus were determined using an enzyme linked immunosorbent assay. Patients with IgA-GN showed a higher and more sustained IgG and IgA antibody response compared to patients with IgM-GN or healthy controls. Before vaccination, patients with IgM-GN had higher levels of IgG antibodies than the controls or those with IgA-GN. However, the IgA antibody and IgG responses after vaccination were low. IgM antibody responses did not vary among the groups studied. It is concluded that patients with IgA-GN are high responders for IgA and IgG antibody production. Patients with IgM-GN are low responders, especially for IgA antibody. PMID- 3955884 TI - Serum immunoglobulin G subclass dysbalances in the lymphadenopathy syndrome and acquired immune deficiency syndrome. AB - Serum IgG subclass levels were measured by an indirect competitive immunoenzymatic assay with monoclonal antibodies in 61 adult patients of different geographic origins affected either with the lymphoadenopathy syndrome (LAS, 46 cases) or with the acquired immune deficiency syndrome (AIDS, 15 cases). In spite of considerable variations from patient to patient, IgG-1 and IgG-3 levels were higher than in normal Caucasians, with IgG-1 levels much more elevated in LAS than in AIDS patients. In Caucasians with AIDS or LAS, IgG-4 levels were low. IgG-2 levels tended to be low and correlated negatively with IgG 1 levels. IgG subclass imbalances were especially striking in patients with lymphoid interstitial pneumonitis. The results suggest that the IgG increase predominantly affects the less T-dependent subclasses. The low levels of the more T-dependent isotypes do not appear to play a clear role in the occurrence of pyogenic infections in certain patients. PMID- 3955885 TI - Eosinophilic lung disease: immunological studies of blood and alveolar eosinophils. AB - Five patients with eosinophilic lung diseases and blood hypereosinophilia (PIE syndrome) were investigated clinically and by bronchoalveolar lavage (BAL). Comparative studies on blood and alveolar eosinophils were carried out after purification and selection of eosinophil subpopulations according to their density. A predominant 'hypodense' alveolar eosinophil population was found in BAL fluids of active chronic eosinophilic pneumonia (CEP). In addition, supernatants of alveolar macrophages obtained from CEP are able to enhance spontaneously the generation of eosinophil oxygen metabolites. Such eosinophil stimulation emphasizes a probable tissue cell cooperation. In addition, BAL permitted the study of membrane immunological markers on eosinophilic inflammatory cells endowed with migratory properties. An increase in eosinophils carrying surface IgE was demonstrated in alveolar cells from PIE Syndrome particularly with hypodense eosinophils from CEP patients. Although no specific stimulus is known at the present time, this work underlines the potential implication of IgE-mediated hypersensitivity processes in the pathogenesis of eosinophilic lung diseases. PMID- 3955886 TI - Some side effects of intravenous 7S-immunoglobulins are due to immune complexes and can be prevented by 5S-immunoglobulin given prior to 7S treatment. PMID- 3955887 TI - Photosensitivity diseases. PMID- 3955888 TI - Photosensitivity. Classification. AB - Light is a heterogeneous moiety that is vital for the perception and maintenance of all life on earth. Specific advantages as well as adverse effects are associated with particular wavelengths of light. An etiologic classification of the adverse responses or "photosensitivity disease" is presented as an introduction to this issue. PMID- 3955889 TI - Photobiology. Basic science. AB - Photobiology is the study of the effects of nonionizing radiation on biologic systems. The biologic effect varies with the wavelength region of the radiation. The radiation is absorbed by molecules in skin such as DNA, protein or certain drugs. The molecules are changed chemically into products that initiate biochemical responses in the cells. PMID- 3955890 TI - Sunburn. AB - UV erythema or sunburn is a common sequela of modern man's pursuit of leisure activities. The dermatologist is frequently confronted with this painful cutaneous inflammatory response. The pathogenesis of sunburn is examined in terms of individual genetic sensitivity, environmental exposure, spectral variability, and the proposed mechanisms of its production and inhibition. PMID- 3955891 TI - Tanning. AB - Cutaneous pigment responses to ultraviolet radiation are outlined in this article. The responses induced by different wavebands are compared, and the protection against further exposure that is conferred by different types of tanning is discussed. The term "tanning" is used here to denote the spectrum of adaptive changes in the skin resulting from ultraviolet exposure and is not applied exclusively to increased melanin pigmentation. PMID- 3955892 TI - Artificial light sources. AB - A wide variety of artificial light sources exists for use in the diagnosis and treatment of photosensitivity disorders. A discussion of the advantages and disadvantages of these light sources (including gas discharge arcs, fluorescent lamps, and other apparatus) illustrates the importance of matching the emission spectrum of the light source, the spectral response of the radiometer, and the photobiologic action spectrum. Environmental and occupational exposure to artificial light sources may contribute to photosensitivity disorders. PMID- 3955893 TI - Photoirritation (phototoxicity) from topical agents. AB - Research with phototoxic agents relevant to man has been usually related to their clinical toxicity potential (bergamot dermatitis) or attempts to harness their toxic properties for the therapy of vitiligo and psoriasis. This review is concerned mainly with the former. Our insights are related mainly to information gained from bergamot, an obvious form of clinical toxicity that long awaited simply animal or human models for experimental study. Are there other forms of phototoxicity that are less obvious? Are any melanodermas or chloasmas due to phototoxicity originating from undelineated chemicals? Will other forms of clothing dermatitis (such as bikini dermatitis) be demonstrated as being caused by phototoxic agents? Those questions should be answered by the alert investigator. The experimental tools are available and await the use of the inquisitive mind. PMID- 3955894 TI - Polymorphous light eruption. AB - The polymorphous light eruptions are idiopathic photodermatoses characterized by various clinical patterns ranging from small papules and papulovesicular lesions to large papules that coalesce to form plaques. The eruptions may begin at any time of life from young childhood to old age, and any race may be afflicted. However, they are particularly prevalent in the North American and Latin American Indian and the Finnish populations. In these two populations there appears to be a genetic (dominant) predisposition to develop the problem. The results of phototesting procedures indicate that the UVB rays make up the action spectrum for reproducing the lesions. However, some patients react to UVA wavelengths as well, and two reports suggest that certain patient populations will react abnormally only to UVA rays. The mechanism of the response is unclear, although the clinical picture, delayed reaction time, and histology suggest that at least some of these responses are due to a cell-mediated hypersensitivity reactivity. Therapy varies with degrees of sensitivity. Protection with clothes, strong sunscreens, and avoidance of the noonday sun may be essential for exquisitely sensitive patients. Topical and systemic corticosteroids may be needed for acute exacerbations. Systemically the 4-aminoquinoline antimalarial drugs are quite effective for less sensitive patients with the large papule and plaque variety. Thalidomide has proved to be most effective in the American Indian form of the disease, and PUVA has been found to be most effective in treating and preventing the process in even very sensitive patients. Most recently, the systemic use of Imuran has proved to be of great value in middle- to older-aged individuals with a severe eczematous form of the disease. PMID- 3955895 TI - Solar urticaria. AB - Solar urticaria is a rare disorder in which patients develop urticarial lesions after exposure to light from the sun or other sources. The etiology is unknown: some cases appear to be mediated by IgE, but other mechanisms may ultimately be found to be more significant. This disease typically persists for years, but may resolve spontaneously. Although fatalities have not yet been reported, episodes of solar urticaria have produced near-fatal accidents. At best, treatment is difficult, but some techniques have afforded some patients substantial or total relief, even if only temporarily. PMID- 3955896 TI - Chronic photosensitivity. AB - Chronic photosensitivity is an incompletely understood syndrome that is difficult to diagnose and treat. Persistent light reaction, actinic reticuloid, and photosensitive eczema most commonly occur in middle-aged and elderly patients and have overlapping features. These conditions may all be persistent light reactions to known and unknown photosensitizers. Actinic prurigo usually occurs in childhood but may be delayed in onset to adult life; it is frequently associated with atopy. The diagnosis of these conditions requires a detailed history, histologic examination of the skin, phototesting, and photopatch testing. A conservative approach to therapy consists of avoidance of the activating wavelengths and use of topical corticosteroids. However, this treatment is often unsuccessful, and PUVA therapy is an effective alternative approach. PMID- 3955897 TI - Lupus erythematosus. AB - Lupus erythematosus represents a wide spectrum of diseases. Within this heterogeneity, however, several clinically relevant subsets have been found that may unite differing aspects of the disease and that may have pathogenic implications for the problem as a whole. Exciting links between genetic phenotypes, certain immune responses, and related cutaneous findings in neonatal, complement-deficient, subacute cutaneous, and ANA-negative lupus erythematosus and Sjogren's syndrome have been found. The increased frequency of the anti Ro(SSA) antibody in these groups is notable. The ultraviolet light-altered immune system found in vivo and in vitro may also be relevant to disease pathogenesis. Even if the mechanisms elaborated are not the precise aberrations in lupus erythematosus, they may serve as an operational model for further research. Continued investigations into mechanisms of photoexacerbations in lupus erythematosus, as well as into genetically mediated immune response, may further our understanding of these disorders. PMID- 3955898 TI - Porphyria. Basic science aspects. AB - The porphyrias are a heterogeneous group of clinical disorders that share a common etiologic background in that each manifests a major metabolic defect in the synthesis of heme. The porphyrias represent an important category of human disease, perhaps as much for what they can teach us about how metabolic abnormalities are translated into clinical manifestations as they are as diseases per se. In this discussion an effort is made to describe, in some detail, the metabolic steps involved in the synthesis of heme and to correlate known abnormalities in this sequence of reactions that are associated with human porphyria. PMID- 3955899 TI - The erythropoietic porphyrias. AB - There are two well-characterized disorders of porphyrin-heme metabolism in which the bulk of the porphyrins that accumulate in excess are formed chiefly within juvenile erythroid elements of the bone marrow. The first is most often termed congenital erythropoietic porphyria, and the second is most often termed erythropoietic protoporphyria. The former is a rare disorder, whereas the latter is one of the two most common porphyrias (along with porphyria cutanea tarda) and has a good probability of being encountered in general dermatologic practice. Both are determined genetically, cause cutaneous photosensitivity and systemic complications of importance, and are amenable to various forms of therapy. PMID- 3955900 TI - Porphyria cutanea tarda. Diagnosis, management, and differentiation from other hepatic porphyrias. AB - Porphyria cutanea tarda is a photocutaneous syndrome characterized clinically by cutaneous fragility, bullae, hypertrichosis, pigmentary changes, and sclerodermoid plaques and characterized biochemically by hepatic overproduction and storage of excessive amounts of porphyrins. Porphyria cutanea tarda, the most common disorder of porphyrin metabolism, must be differentiated from variegate porphyria, hereditary coproporphyria, bullous dermatosis of hemodialysis, and drug-related pseudoporphyria. PMID- 3955901 TI - Photosensitivity in infants and children. AB - Childhood photosensitivity diseases may encompass many of the diseases seen in adults. In addition, there are a number of photosensitivity diseases that are exclusive to children, including both acquired and congenital or genetic syndromes. These syndromes and their etiologies, when known, are discussed. PMID- 3955902 TI - Systemic photoprotection. AB - At present, three classes of compounds are used as systemic photoprotective agents, but only for specific indications, not for general use in healthy individuals. Beta-carotene prevents or lessens photosensitivity in most patients with erythropoietic protoporphyria and in some patients with other photosensitivity diseases. The antimalarial drugs can clear up skin lesions in patients with polymorphous light eruption and solar urticaria who cannot obtain relief with topical sunscreens and in some patients with porphyria cutanea tarda. Oral psoralens and controlled exposure to sunlight or artificial sources of UVA radiation can increase tolerance to sunlight in fair-skinned individuals and in certain patients with vitiligo or polymorphous light eruption. PMID- 3955903 TI - Progression of chronic renal failure in man is retarded with more frequent clinical follow-ups and better blood pressure control. AB - In 17 patients with chronic renal failure (creatinine clearance 12-66 ml/min) who entered a prospective study, clinical and laboratory check-ups were made once a month. This was much more frequent than during the preceding 2-year period. The progression rate of renal failure evaluated from the change with time in the reciprocal of serum creatinine and creatinine clearance, respectively, was significantly slower after entering the study than before, without any dietary intervention having been instituted. The retardation of progression was associated with improved blood pressure control. We conclude from this study that the frequency and presumably the quality of the clinical check-ups, especially with regard to control of hypertension, may favorably influence the progression of chronic renal failure, independently of the protein intake. This may have important implications for the design of randomized studies, aimed at assessing whether a lowering of protein intake may retard progression. PMID- 3955904 TI - The natural history of IgA nephritis in Singapore. AB - The clinical and histological features of 151 patient with IgA nephritis were analyzed to determine the prognostic features of the disease. The mean duration of follow up examinations was 50 +/- 34 months (range 6 to 168 months). The majority of the patients were young males and showed no signs of IgA nephritis. The disease was detected by routine screening before induction into national service. The plot of the reciprocals of serum creatinine against time in the patients with progressive disease showed that the patients ran two different courses when they developed renal impairment; one was a slow progressive course over an average of 7.7 years before reaching end stage renal failure (ESRF), while the other was a more rapid decline to ESRF within an average of 3.3 years in which severe uncontrolled hypertension seemed to be the major adverse factor. Hypertension was present in 23% of patients. Nine percent had renal impairment at the end of the follow up period while 5% progressed to ESRF. The cumulative renal survival was 91% after 6 years with no further development of renal failure up to 14 years. Unfavorable long term prognostic indices were proteinuria of more than 2 gm, hypertension and presence of crescents on renal biopsy. PMID- 3955905 TI - Diagnostic value of creatine kinase and creatine kinase MB isoenzyme in chronic hemodialysis patients: a longitudinal study. AB - Serial measurements of total creatine kinase (CK) and the MB isoenzyme of CK (CK MB) were performed on 18 stable hemodialysis patients over a 36 month interval in a longitudinal study designed to examine CK and CK-MB variability. Total CK was measured by the DuPont ACA pack procedure. CK-MB was quantitated by the ACA CK-MB ion exchange pack procedure, and by electrophoresis. The mean CK level was 242 +/ 179 IU/l (+/- SD). The mean CK-MB level was approximately 8% of the total CK. Seventy-two percent of the patients had at least one elevated CK level during the course of this study. Depending upon the method of analysis, 88 to 100% of the patients had at least one elevated CK-MB level. Marked and sporadic variations in both total CK and CK-MB levels were apparent, but were not related to the assay. Patients receiving long-term intramuscular androgens had higher CK, but not CK MB, than did hemodialysis patients not receiving these agents. Discontinuation of the intramuscular androgens for four weeks led to a fall in CK in only one of four patients. Therefore there appears to be a biological effect of exogenous androgens which may play a role in elevating CK in hemodialysis patients. PMID- 3955906 TI - Infantile polycystic disease of the liver and kidneys. AB - Kidney and liver tissue from eleven patients with recessively inherited infantile polycystic disease (IPCD) were examined to document the extent of renal tubular cyst formation and hepatic fibrosis, to assess survival, and to examine the usefulness of current classifications. Four infants with 90% or more cystic renal change did not survive beyond twenty days. In contrast five of the seven less severely diseased patients with a 20-75% range of cystic change are still alive at six to twenty-one years of age. Liver samples showed hamartomatous bile duct proliferation in all patients studied with the most prominent portal fibrosis in the oldest patient. In both families with two affected siblings, the clinical course and pathological expression of renal disease were dissimilar. Tissue analysis from these cases is consistent with the idea that IPCD has a spectrum of phenotypic expression with prognostic implications from tissue diagnosis in the individual patient, but not necessarily as four genetically determined rigidly defined subgroups. It is concluded that each affected child with IPCD must be evaluated separately. PMID- 3955907 TI - Participation of extracapillary lesions (ECL) in progression of IgA nephropathy. AB - To clarify long-term prognosis and risk factors of IgA nephropathy, 205 patients with the disease were followed up for a period of 1 to 22 years with a mean of 7.9 years. According to the percentage of glomeruli involved with extracapillary lesions (ECL), which were defined by crescents and fibrous adhesion of glomerular tufts to Bowman's capsule, the patients were divided into four groups: group 1 absence of ECL; group 2-less than 25%; group 3-25-50%; group 4-more than 50%. During the follow-up period, 26 patients progressed to chronic renal failure requiring hemodialysis, and one patient died of acute peritonitis. The actuarial kidney survival rate was 90.4% for 5 years and 86.0% for 10 years. Ten-year survival rates were 100% in group 1, 94.3% in group 2, 81.8% in group 3 and 25.5% in group 4. Re-biopsy specimens, observed in 31 patients after intervals of 1.4 to 13.4 years, revealed an increase of ECL in 20 patients concomitant with an apparent reduction of renal function in 13, whereas in the other 11 patients with no increase, renal function remained unchanged. These results strongly suggest that ECL plays an important role in the progression of IgA nephropathy, and renal function could be impaired by repeated formation and accumulation of these lesions. PMID- 3955908 TI - Plasma vitamin E levels in a chronically hemolyzing group of dialysis patients. AB - Plasma vitamin E levels and the ascorbate cyanide test were assessed in 15 chronic hemodialysis (HD) patients (group A) exposed to persistently elevated chloramine levels in the dialysis water. The vitamin E levels in these patients, who had evidence of oxidant induced hemolytic anemia, were compared to 15 chronic HD patients exposed to low chloramine levels (group B) and 17 controls (group C). Vitamin E levels were found to be significantly lower in group A than in either groups B or C (p less than 0.001). Within group A, levels were lower in those patients who had a positive ascorbate cyanide test (p less than 0.05). Upon removal of chloramines from the dialysis water, vitamin E levels in group A were no longer significantly different from those found in groups B or C. PMID- 3955909 TI - The contemporary onset of Reiter's disease and of IgA glomerulonephritis. PMID- 3955910 TI - Subclavian vein thrombosis with single-lumen venous catheters for hemodialysis. PMID- 3955911 TI - Acute obstruction of renal artery: results of medical treatment. PMID- 3955912 TI - Hypoxemia and symptomatic hypotension during hemodialysis. PMID- 3955913 TI - Survival in idiopathic membranous glomerulonephritis. AB - Sixty-seven patients with idiopathic membranous glomerulonephritis (iMGN) were analyzed clinically. Their mean age was 39.3 years, and 47 (70%) of them were male. Fifty (74.6%) showed nephrotic syndrome (NS) initially and five (7.5%) had additionally chronic renal failure. Hypertension was present in 27%. During the follow-up (mean 6.7 years) renal death occurred in four patients 12-151 (mean 84.2) months after the diagnosis of iMGN. Four patients died of non-renal causes. The actuarial life-table survival at 5, 10 and 15 years was 94%, 83% and 69%, respectively. To some extent renal function deteriorated in 13 patients (19%). These patients were older (49.9 vs. 36.8 years, p less than 0.01) than those with preserved renal function, and many of them had serum creatinine levels of 125 mumol/l or more initially. Sex did not correlate with the development of renal insufficiency. Patients with slight proteinuria never showed loss of renal function. The retrospective comparison of survival in patients who did (N = 31) or did not (N = 19) receive corticosteroids and/or immunosuppressive drugs for the treatment of NS revealed no evident difference at 5 or 10 years. This clinical analysis emphasizes the fairly favorable outcome of patients with iMGN. Hence a reserved view must be taken when treatment with potentially dangerous agents is considered in a disease with unknown etiology and pathogenesis. PMID- 3955914 TI - Tuberculosis in renal failure: a high incidence in patients born in the Third World. AB - We report 11 cases of tuberculosis among patients with chronic renal failure being treated in our unit. All were born outside the United Kingdom, and represent 25% of the non-europid patients in the unit. This is about a seventy fold increased incidence of tuberculosis in this group. Diagnosis is difficult and mortality high if the diagnosis is delayed. Culture of tissue biopsies is the most reliable investigation and chemotherapy should be commenced promptly or a therapeutic trial considered in doubtful cases. Chemoprophylaxis may be beneficial in patients from these ethnic groups or in any uremic patient with evidence of old tuberculosis. Three patients with advanced disease died despite antibiotic treatment, but in the remainder, triple therapy with normal doses of rifampicin, isoniazid and pyrazinamide proved safe and effective. PMID- 3955915 TI - Parathyroid function and pituitary-gonadal axis in male uremics; effects of dietary treatment and of maintenance hemodialysis. AB - Parathyroid and pituitary-gonadal secretions were studied in 18 male uremics following a low protein diet supplemented with essential amino acids and ketoanalogues (SD), and in 8 subjects on maintenance hemodialysis (MHD). SD corrected high serum PTH and low serum testosterone (sT) levels, while pituitary hormones (LH, FSH, PRL) were elevated and did not change. Patients on MHD had very high siPTH, PRL and LH levels, while sT was markedly low. These data suggest that PTH is a prominent cause of sexual dysfunction in male uremics, since SD can restore sT secretion by correcting PTH levels, without improving pituitary dysfunctions. In dialyzed patients secondary hyperparathyroidism worsens and is an important cause of low sT secretion, but also a severe hyperprolactinemia develops, which may further impair gonadal function. PMID- 3955916 TI - Monozygotic twins non-concordant for oligomeganephronic renal hypoplasia: artery vein placental shunting as a possible pathogenetic mechanism. AB - The etiology and pathogenesis of oligomeganephronic renal hypoplasia (OMN) are not known. In the present paper a second case of monozygotic twins non-concordant for OMN is described. It is hypothesized that one of the mechanisms which have been proposed to explain structural defects in monozygotic twins, namely placental artery-vein shunting, may have been involved in the pathogenesis of OMN in these patients. In OMN in general vascular abnormalities may have to be considered as a pathogenetic mechanism. PMID- 3955917 TI - Basophil/mast cell precursors in mast cell proliferative disorders. AB - Mast cell proliferative disorders include urticaria pigmentosa, localized to the skin, and systemic mastocytosis, with progression from urticaria pigmentosa to systemic mastocytosis in some adults. We have evaluated the presence of basophil/mast cell precursors in urticaria pigmentosa and systemic mastocytosis using an in vitro assay for cells which form histamine-positive peripheral blood granulocyte colonies in methylcellulose. In 17 cultures from 10 patients with mast cell proliferative disorders (6 urticaria pigmentosa, 4 systemic mastocytosis), the frequency of histamine-positive granulocyte colonies was significantly higher in systemic mastocytosis (40% colonies picked) than in urticaria pigmentosa (15%, p less than 0.002). The mean histamine content per cell of urticaria pigmentosa patient colonies was less than or equal to 0.1 pg compared to 0.7 +/- 0.1 pg in systemic mastocytosis patient colonies. Precursor assays done serially at different times in individual patients appeared to reflect clinical extent of disease. In one patient with urticaria pigmentosa, a repeatedly normal number of histamine-positive colonies paralleled no change in clinical course, while in 2 others (1 systemic mastocytosis, 1 urticaria pigmentosa) increasing skin lesions, leukopenia, increased urinary histamine or refractoriness to therapy was accompanied by an increase in the frequency of basophil/mast cell precursors. Using an index of disease activity, the frequency of histamine-positive colonies was significantly higher in active, versus inactive, mast cell proliferative disorders (p less than 0.0001). These studies confirm the biologic relevance of mast cell proliferation in mast cell proliferative disorders, and suggest that precursor assays using histamine content of granulocyte colonies may be useful in predicting extent of disease. PMID- 3955918 TI - Risk of fatty infiltration or cirrhosis of the liver in relation to ethanol consumption: a case-control study. AB - A case-control study was conducted to investigate the risk of either fatty infiltration of the liver or cirrhosis, in males and females, in relation to varying levels of ethanol consumption. Male and female cases of fatty infiltration of the liver (47 males and 43 females) and male and female cases of cirrhosis (85 males and 66 females) were identified during 1981-1982 as part of a liver biopsy study in 6 teaching hospitals in Toronto. All cases were confirmed by biopsy. Male and female controls (394 males and 225 females) were obtained from 7 different local industries during the same period as part of a study for the early detection of liver disease. Cases and controls were interviewed by a nurse practitioner using a standard questionnaire designed to elicit data on daily and cumulative alcohol consumption. In both males and females, a dose response effect between increasing levels of both daily and cumulative alcohol consumption and increasing risk of either fatty liver or cirrhosis was demonstrated and was independent of effects of age and duration of consumption. In males, risk for fatty liver was 1.37 (95% CL = 0.47, 4.0) for those consuming 40-59 g absolute alcohol/day compared to males consuming less than 40 g/day, rising to 50 (95% CL = 15.0, 170.7) for males consuming 80 or more g/day. In females, risk for fatty liver appeared at lower levels and was 2.82 (95% CL = 1.02, 7.82) for females consuming 20-59 g/day compared to females consuming less than 20 g/day, rising to 8.53 (95% CL = 2.12, 34.31) for females consuming 60 or more g/day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955919 TI - Extended phase I study of human beta-interferon in human cancer. AB - Ten patients with advanced cancer were treated with weekly intravenous escalating doses of human beta-interferon (HuIFN beta) 4 days each week. The starting dose of HuIFN beta was 3.0 X 10(6) units/m2 and the dose was doubled each week until dose-limiting toxicity was observed. Subjective toxicity included mild fevers and chills, malaise and flu-like symptoms. The lowest dose which caused suppression of the platelet and/or white cell count was 64 X 10(6) units daily, and the maximum dose given was 320 X 10(6) units daily. Both subjective and objective toxicity were not dose-related, easily managed and reversible. Serum interferon levels and the duration of measurable interferon activity on natural killer cells was in general dose-dependent. Two patients had an objective partial response, and two others showed stable disease while receiving HuIFN beta. PMID- 3955920 TI - Sodium fluoride in the treatment of osteoporosis. AB - Twenty-five patients treated with sodium fluoride, calcium, and Vitamin D (183 person-years of observation) and 24 patients treated with calcium and Vitamin D alone (107 person-years of observation) were compared. The incidence of vertebral fracture was reduced (p less than 0.01) only in the 8 fluoride treated patients who developed radiographic fluorosis. These 8 patients were younger and closer to menopause than those who did not develop fluorosis. Femoral fracture could not be shown to be related to fluoride treatment, but interval from menopause and fall in metacarpal index were found to be useful predictors of this event. PMID- 3955921 TI - Absorptive hyperoxaluria: a new clinical entity--successful treatment with hydrochlorothiazide. AB - This report describes studies performed over an 11 year period in a 13 year old girl with hyperoxaluria and calcium oxalate nephrolithiasis who did not have primary hyperoxaluria or any of the recognized causes of secondary hyperoxaluria. The patient also had increased urinary excretion of calcium and magnesium and hyperabsorption of dietary calcium and magnesium. It is suggested that the hyperoxaluria resulted from hyperabsorption of dietary oxalate secondary to hyperabsorption of dietary calcium. Hyperabsorption of dietary magnesium and increased urinary magnesium excretion have not previously been reported in this context. Stone formation ceased and urinary oxalate excretion gradually fell to normal during long term thiazide therapy but hyperoxaluria recurred when orthophosphate therapy was substituted for the hydrochlorothiazide. This is the first report of normalization of urine oxalate excretion during thiazide therapy in a patient with frank hyperoxaluria. PMID- 3955923 TI - Intrapartum fetal monitoring. PMID- 3955922 TI - Science and politics: two solitudes. PMID- 3955924 TI - Human in-vitro fertilization. PMID- 3955925 TI - Candidate selection and psychosocial considerations of in-vitro fertilization procedures. AB - The psychological impact of the new reproductive technology should not be understated. The history of infertility treatment and failure to achieve pregnancy that most couples bring to the program, along with their hopes and expectations for success, makes them extremely vulnerable to anxiety, unrealistic expectations, and grief reactions. When a cycle of IVF fails, the intensity of the experience and the disappointment may be overwhelming for a while, but most couples are willing to try it again. One patient wrote about her feelings after IVF treatment after having read comments in a popular magazine which implied that medical science was taking control of reproduction. Those of us who go through in vitro fertilization think long and hard about what we are doing. Most of us weigh the pros and cons very thoroughly. We weigh the risks to our potential children just as people who have genetically linked diseases do before they conceive. (Our fetuses are not "bombarded" by ultrasound procedures any more than many other pregnant women's fetuses are these days.) Most of us are thankful that the technology is now available to us, if we choose to participate. Physicians who work with IVF patients do realize that the procedure is stressful. Often the stress is viewed as primarily the patients', and we are asked to study the level of stress. To a large extent that is the subject matter of this chapter. Nevertheless, the stress is perceived because the physicians and staff are also under stress. The failure of an IVF cycle is immediately known to the health care givers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3955926 TI - FHR tracing characteristics that jeopardize the diagnosis of fetal well-being. PMID- 3955928 TI - The fetus as the final arbiter of intrauterine stress/distress. PMID- 3955927 TI - Legal and ethical aspects of new reproductive technologies. PMID- 3955929 TI - Fetal heart rate characteristics that provide confidence in the diagnosis of fetal well-being. AB - Fetal heart rate monitoring was first used as a clinical tool for the assessment of fetal danger and well-being. In the past decade, basic research has demonstrated the physiologic events associated with most heart rate changes. This review has demonstrated that study and semiquantification of the five analyzable features of an FHR recording can provide a strong reassurance of fetal health. The method has not proven as predictable for defining fetal disease, so additional parameters are needed to define clearly the significance of an abnormal FHR tracing. PMID- 3955930 TI - Intrauterine versus extrauterine management/resuscitation of the fetus/neonate. PMID- 3955932 TI - Aspects of FHR tracings as warning signals. AB - We have reviewed several different groups of common clinical problems with an eye toward their effects on FHR tracings. Although argument exists in the literature concerning the universal applicability of continuous EFM, most authors agree that continuous EFM is desirable, if not imperative, within these subgroups. Schifrin said, "It appears that potential benefits accrue when EFM and scalp sampling are employed with understanding and adequate training." With appropriate training, EFM and pH analysis can help the clinician to quickly and accurately assess fetal condition and to make necessary decisions regarding labor and delivery. The interpretation of fetal monitoring patterns necessitates consideration of gestational age and maternal condition as a starting point in analysis. The many other components of fetal-maternal interactions that occur with labor and delivery can be assessed satisfactorily only in this light. PMID- 3955931 TI - The clinical and biological significance of the bottom line. PMID- 3955933 TI - The variable deceleration, prolonged deceleration, and sinusoidal fetal heart rate. PMID- 3955934 TI - The abnormal fetal heart rate baseline. PMID- 3955935 TI - Fetal death. PMID- 3955936 TI - Open treatment for displaced articular fractures of the distal radius. AB - Fifteen patients with severely displaced Type 4 articular fractures of the distal radius required open treatment for the reduction and fixation of disrupted articular surfaces and for the repair of associated nerve, tendon, or arterial injuries. These patients were predominantly young men whose wrists had been exposed to violent compression forces. Five cases were rated excellent, nine good, and one fair according to the McBride and Lidstrom systems of evaluation. In this study, distal radial fractures with wide displacement or rotation of the articular surfaces were treated by prompt and precise repair of skeletal and soft tissue damage. PMID- 3955937 TI - The unreduced carpal dislocation. A method of treatment. AB - Unreduced lunate, perilunate, and transscaphoid perilunate dislocations present a difficult and challenging surgical problem. The authors feel that all efforts should be made to obtain a reduction of the old dislocation. They support a combined dorsal and palmar approach, open reduction, and internal fixation of scaphoid with a Herbert screw to obtain midcarpal stability. A carpal tunnel decompression should be performed if symptoms suggest median nerve entrapment. When the dislocation is unable to be reduced, the authors favor limited wrist arthrodesis or a proximal row carpectomy in the absence of significant arthritis. PMID- 3955938 TI - Correction of alignment deformities during total knee arthroplasties: staged soft tissue releases. AB - Preoperative evaluation consists of a series of radiographs and a careful analysis of the gait in order to estimate the amount of bone resection and soft tissue release needed for successful arthroplasty. Graduated, surgical soft tissue releases were used for realigning arthritic knees during arthroplasty. Medial, lateral, anterior, and posterior releases provide step-by-step correction for realigning markedly deformed joints. The procedure prevents "over-releasing" leading to ligamentous instability. At surgery the mechanical axis of the limb was used for knee realignment by use of a towel clip over the hip joint and palpation of the malleoli at the ankle; the center of the hip, knee, and ankle should be in a straight line. Elimination of abnormal moment (the tendency to produce motion about the normal axis) at the knee with weight-bearing was the goal for realignment. Proper alignment is the key to success and longevity in knee arthroplasty. Soft-tissue releases should be used with any type of instrumentation the surgeon desires. The patella must also be realigned. PMID- 3955939 TI - On resection of the proximal carpal row. AB - Thirty-one patients (30 men and one woman) ranging from 19 to 64 years of age underwent proximal row carpectomy for posttraumatic arthrosis of the carpus. The injuries included transscaphoid perilunate dislocations with late subluxation and arthritis, ununited scaphoid fractures with arthritis, scapholunate dissociations with arthritis, and acute carpal injuries, including dislocations and comminuted fractures. The follow-up period ranged from two to 12 years. Wrist motion and grip strength were satisfactory. There were two failures, both of which converted to wrist arthrodesis. PMID- 3955940 TI - Roentgenographic evaluation of geometric total knee arthroplasty with a six-year average follow-up period. AB - The geometric total knee prosthesis was used in the reconstruction of 70 damaged knee joints in 56 patients from November 1973 through March 1979. The average follow-up period extended to six years and seven months. Eleven patients had died and four could not be located. Eighty-one percent of the remaining knees had little or no pain at the time of the review. Pain in the patellofemoral joints was an insignificant problem in this series. The femorotibial shaft angle ranged from 0 degrees to 10 degrees of valgus in 43 (82.7%) of 52 knees. Six knees showed varus deformity at the time of follow-up examination. Stress fracture of the medial condyle of the tibia was found in two of these six knees. The absence of a radiolucent zone at the tibial cement-bone interface was noted in only ten (19.2%) of the 52 knee roentgenograms. New formation or progression of a radiolucent zone from six to 12 months after the operation was found in 36.5%. Positional abnormality of the marker wires seen in serial roentgenograms existed in 51.9% of the knees. Nine knees (17.3%) disclosed a gap between the metallic articular surface and the tibial component and also showed the collision of the tibial intercondylar eminence against the femur in the standing position. The tibial component of the prosthesis was fractured in one knee. PMID- 3955941 TI - The significance of early motion in the treatment of tibial plateau fractures. AB - Although the trend in management of tibial plateau fractures has been toward early motion, the period of immobilization that can be tolerated safely is open to question. In the present study, 160 acute tibial plateau fractures were reviewed in an effort to answer this question. The 112 fractures that were suitable for analysis were divided into undisplaced fractures, displaced fractures treated nonoperatively, and displaced fractures treated operatively. Among these groups, results were compared based on the period after injury that the knee was immobilized. Undisplaced fractures and displaced fractures that were treated nonoperatively regained full knee motion when immobilized up to six weeks. Fractures treated operatively tended to develop knee stiffness with only two weeks of immobilization. Loss of fracture reduction tended to occur in patients who were immobilized for relatively short periods. Immediate knee motion was correlated with prolonged hospitalization. Based on these results, knee mobilization following tibial plateau fractures is determined by the degree of fracture displacement, method of treatment, and quality of aftercare. PMID- 3955942 TI - Synovectomy in hemophilic arthropathy. A retrospective review of 17 cases. AB - Seventeen patients with severe hemophilic synovitis were reviewed for an average of 59.6 months after surgical synovectomy to record radiographic progression of arthropathic changes, frequency of hemarthroses, and range of motion. There were 12 knees and five elbows in the study. Most joints showed some radiographic progression of the arthropathy. In aged patients, two knees progressed to end stage disease. The frequency of hemarthroses was greatly decreased in all joints and especially in the elbow. Range of motion was preserved for most knees but was reduced significantly for the elbow. Three of five elbows had additional procedures. This factor may be responsible, in part, for lost motion in the elbow as compared to the relatively good results in the knee having had true synovectomy. While the incidence of bleeding is significantly decreased after surgical synovectomy, it is not necessarily associated with a cessation of the progression of joint pathology. Reduced incidence of bleeds following postsurgical synovectomy may serve to delay reconstructive operations until a later period in life. Eventually, the disease proceeds to end-stage arthropathy as joint function correspondingly decreases with age. Early surgical synovectomy for intractable chronic synovitis is recommended as a useful measure in the management of hemophilic arthropathy. Patients should be treated conservatively with therapeutic doses of factor concentrate replacement for a reasonable period of time in an effort to obviate surgical treatment. PMID- 3955943 TI - The mechanism of the carpal joint. AB - The morphologic features of the carpal bones and their contacts play a highly significant role in the mechanism of the wrist joint. Displacements of the proximal carpal bones in both flexion and deviation of the hand take place in longitudinal articulation chains that are linked one to another. This concept is supported by the following observations: differences in curvature between the facets of the proximal carpals at the radiocarpal level suggest that simultaneous movements occur at the midcarpal level; the position of the proximal carpal bones is determined by their position with respect to both the distal carpal bones and the radius; displacements of the proximal carpal bones to the distal carpals result in swerving motions in the transverse plane in addition to dorsopalmar rotation (as a result, the volar rotated position of a proximal carpal in the volar flexed hand will differ from its position in the radial deviated hand and the positions of the proximal carpals in the dorsiflexed hand will differ from these in the ulnar deviated hand); and the three articulation chains, radial, central, and ulnar, cannot function on their own, since the linkage in the longitudinal direction is associated to a transverse linkage by the mutual joint contacts between the chains and by ligamentous interconnections. PMID- 3955944 TI - Leg length inequality after total hip arthroplasty. AB - Leg length inequality (LLI) in 55 patients with cemented total hip arthroplasty (THA) was measured from weight-bearing anteroposterior (AP) hip radiographs. The mean radiologic LLI was 8.7 mm in unilateral and 11.6 mm in bilateral THA, differing significantly from the clinically measured values (2.8 mm and 4.2 mm, respectively). LLI as a cause of aseptic loosening and unexplained pain warrants investigation in THA patients. PMID- 3955945 TI - Hemophilic arthropathy resulting in a locked shoulder. AB - A 14-year-old boy with severe hemophilia had a swollen immobile left shoulder joint. A roentgenogram showed a severely deformed humeral head that had interlocked onto the glenoid ring. After manipulation, the motion promptly returned. Incongruency of the shoulder in adolescence poses a serious therapeutic problem. PMID- 3955946 TI - Reconstruction of chronic massive rotator cuff tears with synthetic materials. AB - Synthetic materials for repairing experimental massive rotator cuff tears were investigated in 60 rats. The same materials were investigated for massive rotator cuff ruptures in 25 patients. The materials were well tolerated when used for repair of torn segments of the musculotendinous cuff. Of 25 patients with massive rotator cuff tears, 23 had satisfactory functional results. The muscle strength tests on tendons repaired with Teflon felt (which was thicker than the other materials) were superior to results of repairs with other materials; 3-5 mm proved to be the optimum thickness of Teflon felt used for repair of the musculotendinous cuff. PMID- 3955947 TI - The acromioclavicular joint cyst. An unusual presentation of a rotator cuff tear. AB - An unusual presentation of a full-thickness tear of the rotator cuff is the acromioclavicular (AC) joint cyst. This is formed when glenohumeral joint fluid leaks through the full-thickness cuff tear and into a diseased AC joint, eventually distending the superior capsule. Often, communication between the cyst and the glenohumeral joint can be demonstrated on shoulder arthrogram. It is essential to recognize that the presenting cyst is usually indicative of an underlying full-thickness rotator cuff tear, which is often massive and which will be difficult to reconstruct. This clinical finding is reported in the following two cases to emphasize the important relation between AC joint disease and rotator cuff abnormalities. Attempted excision of this cyst without recognition of its pathogenesis usually leads to cyst recurrence and unimproved symptoms. PMID- 3955948 TI - Familial congenital muscular torticollis: case report and review of the literature. AB - A family history of congenital muscular torticollis is uncommon. Only a small number of cases have been reported in the English literature. This is a report of five female children who are interrelated and have congenital muscular torticollis. Three of the children are sisters, and four are the offspring of consanguineous matings. No environmental factor could be identified that would predispose the children to congenital muscular torticollis. In this family, it is apparent that genetic factors are influencing the development of this condition. The cause of congenital muscular torticollis is unknown, but heredity may play a more important role than has previously been suspected. PMID- 3955950 TI - "Idiopathic" scoliosis associated with congenital upper-limb deficiency. AB - Sixty patients with congenital upper-limb deficiency were evaluated for scoliosis in 1972. Twenty-one patients had scoliosis of 5 degrees or more and 15 had scoliosis of 10 degrees or more. Fifteen of these patients had long-term follow up periods. Thirteen patients had idiopathic scoliosis. Idiopathic scoliosis associated with congenital upper-limb deficiency could be divided into three groups, and the progression of scoliosis was predictable within each group. All but one of these patients had a relatively benign course and did not require treatment. Double curves with rotation progressed throughout the growth period. Double curves with Grade 0 rotation tended not to be progressive. Single curves did not have rotation deformity and resolved spontaneously or remained stable. Magnitude of limb deficiency did not correlate with the curve magnitude, progression, or pattern. Muscle imbalance did not appear implicated as a cause for the scoliosis in these patients. Young age at discovery of the curve did not correlate with progression of the curve. PMID- 3955949 TI - Comminuted intraarticular fractures of the distal humeral condyles. Surgical vs. nonsurgical treatment. AB - Forty-two comminuted intraarticular fractures of the humeral condyles treated between 1975 and 1981 were analyzed in order to compare the results of operative versus nonoperative management. Twenty-nine patients were treated by open reduction and internal fixation; the remainder were treated by nonoperative techniques. Functional results were evaluated by the method of Bickel and Perry. Of the patients treated by open reduction and internal fixation, 76% had an excellent or good result. Of the nonsurgically-treated patients, only eight percent had a satisfactory result. Anatomic restoration by open reduction and rigid internal fixation in conjunction with early motion was associated with satisfactory results. The preferred surgical exposure was a posterior "U" incision with extraarticular olecranon osteotomy. This provided good visualization and facilitated anatomic restoration in these complex fractures. PMID- 3955952 TI - Fracture of the os peroneum with rupture of the peroneus longus tendon. A case report and review of the literature. AB - Subcutaneous rupture of the peroneus longus tendon occurring through a fracture of the os peroneum sesamoid in the foot, confirmed at surgery, is a rare injury, possibly with only one previously reported case. In the present case, the patient fell from a curb with the foot and ankle in supination; to prevent the fall, the patient forcibly everted the foot and ankle. Differential diagnosis of the injury includes chronic ankle ligament sprains, avulsion of the bony insertion of the peroneus brevis tendon, peroneal tendon subluxation, trauma to a congenitally multipartite os peroneum, and calcific tendonitis of the peroneus longus tendon. Primary repair with surgical approximation of the fractured os peroneum was performed with a satisfactory outcome. PMID- 3955951 TI - Spinal deformities in patients with Charcot-Marie-tooth disease. A review of 12 patients. AB - Twelve patients with Charcot-Marie-Tooth disease and scoliosis, seven girls and five boys (average age at presentation, ten years), were investigated for an average of 49 months. All but one of the patients were ambulatory. The curve patterns were thoracic in two, thoracolumbar in four, and double thoracic and lumbar curves in six. There was an associated kyphosis in six. Three patients had brace treatment with curve control in two. Four patients underwent posterior spinal fusion with Harrington instrumentation, one with segmental sublaminar wires. Post-operative management consisted of a cast for one patient and a brace for the remaining three. Follow-up period in the surgical patients ranged from 19 to 45 months (average, 32 months). One patient had a superior mesenteric artery syndrome and two had a pseudarthrosis. PMID- 3955953 TI - Corynebacterium JK (Johnson-Kay strain) infection of a Kuntscher-nailed tibial fracture. AB - A slow-growing Corynebacterium was isolated in pure culture from pus of a Kuntscher-nailed tibial fracture. The strain was identified as Johnson-Kay strain or corynebacterium JK (CJK). This bacterium has been discovered recently and recognized as the cause of serious infections, especially in immunocompromized patients, polytraumatized patients, and patients with cardiac valve replacement. Superficial wounds can be colonized and hemocultures contaminated with CJK. Nosocomial spreading can occur. This microorganism is usually highly resistant to antimicrobial agents and requires therapy with vancomycin. This case was different from classic infections with "CJK" in several aspects. The infection occurred in a patient without underlying disease and the strain was sensitive to the antibiotic. The patient responded well to cephazolin treatment. Being part of the normal skin flora, Corynebacteria are often discarded as contaminants. A critical review of all clinical and laboratory data is necessary for the recognition of the infections and is important especially when a resistant strain is encountered. PMID- 3955954 TI - Primary septic arthritis of the manubriosternal joint in a heroin user. AB - A 20-year-old heroin user developed staphylococcus septic arthritis of the manubrium joint. The diagnosis was established by a culture of the infected tissue and blood culture. The clinical impression was aided by 99mTc radionuclide scintimetry. Early diagnosis localized the infection. Immediate antibiotic therapy solved a problem in the sternum that seems not to have been reported in the English literature. PMID- 3955955 TI - Alternative method for removing an impacted AO intramedullary nail. AB - An intramedullary femoral nail became impacted after approximately one third of it had been removed by standard AO technique in a 28-year-old man. Vise-grip pliers were used to twist the nail into a cigar-wrapper shape. While the standard nail removal should always be tried first, this method, although arduous and time consuming, should be considered when faced with the possibility of having to split the femur or saw through the impacted nail. PMID- 3955956 TI - Three-dimensional imaging of bone from computerized tomography. AB - An automatic computer technique was designed to produce three-dimensional (3D) images of bony anatomy on a cathode ray tube (CRT) from computerized tomography (CT) data. The authors transferred CT scan data of a cadaver and 11 patients to a computer system via magnetic tape. An automatic edge extraction algorithm generated an outline of bone specified by a range of CT numbers for each scan slice. These outlines were stacked in the computer and various graphics options used to represent the 3D anatomy of bone on a high-resolution CRT screen. The 3D image data were interfaced with a three-axis computer numerically controlled milling device to produce solid models of these bone images. Comparison of the dimensions of the solid models of the femur, hemipelvis, and femoral medullary canal to the actual cadaver specimen demonstrated that the models were accurate in size to within 1-3 mm. These 3D images and solid models will be helpful for preoperative diagnosis, surgical planning, and customized prosthesis manufacture in complex orthopaedic cases. PMID- 3955957 TI - Computed tomography of extraosseous ganglia. AB - Computed tomography (CT) was performed in six patients with painful soft-tissue masses where sarcoma was suspected. Incisional or excisional biopsy proved all to be extraosseous ganglia. CT delineated the anatomic relationships of the masses. The CT density of four of the ganglia was 18 Hounsfield Units (HU), consistent with that of fluid-filled lesions. Contrast medium did not enhance the lesions on CT. Angiography was performed in four cases and demonstrated hypovascular masses with no vessel displacement. Plain radiographs and technetium bone scintigrams were nonspecific. CT was the best preoperative confirmation of the diagnosis of benign extraosseous ganglia and the best method of localizing the lesions with respect to surrounding bone and soft tissues. PMID- 3955958 TI - A modified knee disarticulation. A case report. AB - A 36-year-old man with posttraumatic transarticular knee (TK) amputation illustrates the difficulties of prosthetic fitting. The excessively long and deformed stump was successfully overcome by an unusual surgical technique consisting of the shortening of the femoral bone by an osteotomy and plate fixation with preservation of the integrity of the condyles to correct the deformity. A short review of the literature concerning the advantages and limitations of TK amputations demonstrates some of the previously-reported surgical techniques. PMID- 3955959 TI - Epiphyseal traction to correct acquired growth deformities. An animal and clinical investigation. AB - In a canine model with a transepiphyseal distal femoral fracture, varus deformity was corrected and the arrested limb was lengthened using transphyseal traction (turnbuckle). Correction was possible without removing the transphyseal bone bridge operatively. Subsequent growth was not adversely affected in most animals. Based on this study, two patients with significant growth deformities secondary to an enchondroma were treated by epiphyseal traction. Although correction was achieved initially, both lost the length previously gained because of premature removal of the external fixator and/or subsequent early growth plate closure. PMID- 3955960 TI - Kinematic considerations of the wrist. AB - Mechanically the wrist is the most complex joint in the body, providing a large range of motion in the flexion-extension and radial-ulnar deviation planes. By virtue of the constraints at the radiocarpal level, strong torque may be delivered to the grasping hand for work in the grasping mode through the rotational axis of the forearm. The intrinsic forces acting on the wrist are well distributed around the perimeter, while the extrinsic forces for the fingers are centralized to affect wrist position minimally. The stability of the wrist in which the proximal carpal row presents an inherently unstable intercalated segment is provided by a complex osseoligamentous arrangement. The scaphoid performs a unique function as a mechanical link between the carpal rows, interacting with two arcs of oblique ligamentous support for the radiocarpal area. This allows synchronous angulation of the proximal and distal carpal rows and, by virtue of conjunct angulation, adaptive geometric change to encourage radial-ulnar deviation. The distal radioulnar joint functions both as the support of the carpus on the ulnar aspect of the joint and as a primary pivot for forearm rotation through a unique anatomic arrangement. PMID- 3955961 TI - Biomechanical effects of intramedullary reaming and nailing on intact femora in rats. AB - In order to study the effects of intramedullary reaming and nailing on bone mechanics, the left femur of male Wistar rats was reamed after circular periosteal stripping of the middle part as if for osteotomy. Osteotomy was, however, not performed. The rats were allocated into three groups: the first group had no nailing, the second group received flexible intramedullary polyacetal nails, and the third group was nailed with solid stainless-steel nails. Ten animals from the first group were sacrificed on the day of surgery. At four, eight, 16, and 24 weeks after operation, ten animals from each of the three groups were sacrificed. Both femora were tested mechanically and examined histologically. Intramedullary reaming resulted in the following immediate reductions in mechanical properties compared to the unoperated right femur: strength, 15%; stiffness, 20%; toughness, 7%; and resilience, 15%. From four weeks on, strength and energy absorption values were always lowest in the group with steel nails. The differences between groups were significant at four, 16, and 24 weeks. The lower values for mechanical properties of the femora with steel nails is interpreted as a result of stress shielding by the rigid nails. Flexible nails did not interfere with the ultimate restoration of mechanical properties of bones initially weakened by reaming. PMID- 3955962 TI - Congenital malformations of the flipper in three West Indian manatees, Trichechus manatus, and a proposed mechanism for development of ectrodactyly and cleft hand in mammals. AB - Three cases of congenital ectrodactyly of the flipper in the manatee are described, including one case of bilaterally-symmetrical cleft hand. A hypothesis assumes that a defect in the apical ectodermal ridge (AER) in the developing hand plate of the early embryo is the initiating factor in the development of ectrodactylous and cleft hand malformations in man and other mammals. Variations in the site, extent, and time of the AER defect will account for many of the morphologic variations observed in these congenital malformations. PMID- 3955963 TI - A device to measure X-ray magnification in preoperative planning for cementless arthroplasty. AB - Non-cemented press fit prostheses require a high degree of surgical precision for success. Since components vary in size by millimeters, the optimum preoperatively determined size becomes a vital factor in selecting the correct size at the time of surgery. The preoperatively-determined component size is useful only if the information is obtained in a reliable and reproducible manner. The proper sequence combines X-rays of known magnification and templates of corresponding magnification. X-ray magnification is not a constant value even if the X-ray tube is maintained at a standardized height. Variables such as patient size and positioning make magnification measurements a necessity for every X-ray taken. A dense lead plate was designed for this purpose because commercially-available devices are over-penetrated by the X-ray exposures routinely used for hip roentgenograms. Manufacturers can provide templates in varying magnifications. This makes it possible to obtain a high correlation between the preoperative choice and the actual size chosen at surgery. PMID- 3955964 TI - Stem fractures of extra-heavy cobra femoral hip prostheses. PMID- 3955965 TI - Factors influencing the intrusion of methylmetacrylate in human tibiae. PMID- 3955966 TI - Internal fixation of fractures in children and adolescents. PMID- 3955967 TI - Efficacy of a topical antibiotic irrigant in decreasing or eliminating bacterial contamination in surgical wounds. PMID- 3955968 TI - Pulmonary thromboembolism and venous thrombosis in the Chinese. PMID- 3955969 TI - Radiography of the wrist. AB - The painful wrist frequently poses a diagnostic dilemma. Although increased understanding of normal carpal motion has led to more constructive use of roentgenography, the diagnostic acumen of the examiner is greatly enhanced by the standardization of radiographic views as well as by the use of special projections and when indicated, arthrograms. PMID- 3955971 TI - Kienbock's disease. AB - Kienbock's disease (lunate malacia) is an unusual but not rare cause of wrist pain. It is manifested by avascular necrosis and subsequent disintegration of the lunate. Despite recognition of this disease entity for the past 70 years, its cause is still debated. Most investigators relate it to a stress fracture that leads to devascularization of the major segment of the lunate if the lunate is supplied by one volar vessel. The classification of Kienbock's disease is based on its roentgenologic appearance. Stage 1 consists of small fracture lines. Stage 2 is rarification along the fracture line, usually on the volar pole. Stage 3 shows sclerosis of the bone dorsal to the fracture site. Stage 4 shows sclerosis of the bone dorsal to the fracture site, and collapse and secondary fracture with loss of architectural integrity of the lunate. Stage 5 shows secondary arthritic changes of the radius. Treatment is categorized into two general types. The first is an attempt to allow revascularization of the lunate be relieving the compression forces. This is accomplished by lengthening the ulna and/or shortening the radius, with capitate-hamate fusion; or by shortening the capitate and fusing the capitate and hamate. These procedures are performed in the early stages of Kienbock's disease. The second type of treatment, used in more advanced cases, includes excision of the lunate: replacement of the lunate by prosthesis, with or without capitate shortening and/or capitate-hamate fusion; and various types of intercarpal fusion. PMID- 3955970 TI - Evolution of arthritis of the wrist. AB - Degenerative arthritis of the wrist follows very specific patterns from onset to terminal severe bone and joint destruction. About 95% of them occur as periscaphoid area problems: SLAC (scapholunate advanced collapse pattern) wrist (55%), triscaphe arthritis (26%), and a combination of the two (14%). In SLAC wrist, the repeating sequence of degenerative change is based on and caused by articular alignment problems between the scaphoid and the radius. Changes then progress between the capitate and the lunate that are secondary to carpal collapse. In triscaphe arthritis, the degenerative change is limited to between the trapezium, trapezoid, and distal scaphoid. SLAC procedure (fusion of the capitate, lunate, hamate, and triquetrum along with silastic scaphoid implant) for SLAC wrists and triscaphe arthrodesis (fusion of the scaphoid, trapezium, and trapezoid) for triscaphe arthritis, are designed to make maximum use of undamaged structures and to maintain full-power, painless, mobile human wrists. PMID- 3955972 TI - Use of the Herbert bone screw in surgery of the wrist. AB - The Herbert bone screw is a new device, designed to produce compression and rigid fixation of small cancellous bone fragments. Being completely buried within the bone, it may be introduced through the articular surface of the joint. A second operation to remove the implant is not required. Although originally developed for fixation of scaphoid fractures, its use has been extended to other carpal bones and small joint fusions in the hand and wrist. The author's experience with this technique shows that excellent results may be achieved when rigid internal fixation allows for early mobilization of the wrist and hand. PMID- 3955973 TI - Comparison of lumbosacral fixation devices. AB - Fusion of L4 and L5 to the sacrum has a high incidence of success. Using conventional methods, nonunion is common when long scoliosis fusions are extended to the sacrum. Three methods of instrumentation for fusing the lumbar spine to the sacrum were compared on a spine simulator test stand. Harrington distraction rods from the sacral ala to L1, Luque rods from L1 to the sacrum, and Harrington compression rods from L1 to the sacrum were tested. The use of a spine instrumentation test stand discounted biologic variation in spinal structure. Sequential loading of each test stand-instrumentation construct in torsion, flexion, extension, and lateral bending gave stiffness constants (Ks) for each test mode. Test values had reproducibility of greater than 94%. Ks illustrates the inability of Harrington distraction rods to the sacrum to resist flexion and torsion, but the ability to resist lateral bend and extension. Harrington compression rod and Luque rod constructs have equivalent stiffness in flexion and torsion. Harrington compression rods efficiently resist extension, and Luque rods resist lateral bending. Harrington distraction rods have limited use in lumbosacral junction fixation other than to correct and resist lateral bending. PMID- 3955974 TI - Segmental spinal instrumentation of the lumbar spine. AB - Obtaining an arthrodesis of the lumbar spine has always been a problem, especially in the presence of severe disease. The understanding of the segmental character of the lesions and the application of sound orthopedic principles toward low-back spine pathology has led the way to improving arthrodesis with rigid internal fixation. For about eight years, segmental spinal instrumentation has been used in 352 cases to "stabilize" the spine. Many modifications have taken place and knowledge of the biomechanics of abnormal spine has increased through designs of new methods for different disorders. Fixation of low back, when indicated, should be rigid. The rectangular or rhomboid-shaped rod, bent to conform to the lamina cephalad and caudad, and fixed segmentally, proves to be the most rigid. It is contoured to maintain lordosis, sometimes in distraction, sometimes in compression. Fixation is not a substitute for correction of bony deformity or a good surgical arthrodesis. The objective is to maintain correction and promote prompt bony fusion. PMID- 3955975 TI - Internal fixation of the lumbar spine. The Hartshill rectangle. AB - The Hartshill rectangle fixation is a modification of the Luque system of segmental spinal instrumentation. The rectangle is formed from a 3/16-in stainless steel rod and incorporates a roof that allows it to fit snugly against the lamina and provides good rotational stability. The rectangle is secured to the spine by means of doubled 0.91-mm-diameter stainless steel wires. The technique of the Hartshill system in the lumbar spine is described in detail. The system has been used in 71 patients with good relief of pain and without major complication. In the first 45 cases, a simple, flat, unwelded rectangle was used, and in the last 26 the Hartshill rectangle was employed. PMID- 3955976 TI - Follow-up study of medial facetectomies and posterolateral fusion with instrumentation in unstable degenerative spondylolisthesis. AB - From 1978 to 1983, 54 consecutive patients with unstable degenerative spondylolisthesis were treated by medial facetectomies and posterolateral fusion with combined distraction and compression rod instrumentation. The average period of follow-up observation was 30 months. Twenty-five patients had a combination of disc herniation or instability, excluding olisthesis. Single-level fusion was performed in 29 patients, two-level in 23, and three-level in two. Preoperative low-back pain in 87.0% and sciatica in 66.7% were reduced to 7.5% and 5.6%, respectively, at follow-up treatment. Preoperative neurogenic intermittent claudication in 63.0% and neurogenic bladder in 11.1% disappeared completely in all patients at follow-up examination. The solid fusion rate was 96.3%. Difference between the values of %-slip and slip-angle before surgery and those at follow-up examination was not statistically significant. Rod breakage occurred in two patients with pseudarthrosis. The overall clinical results were satisfactory relief of clinical symptoms and regression of physical signs, with a high rate of solid fusion. PMID- 3955977 TI - Nylon sublaminar straps in segmental instrumentation for spinal disorders. AB - A new modification of segmental spinal instrumentation is in an early stage of research and development. Preliminary evidence is most encouraging with respect to the advantages of the relative safety of insertion of the nylon strap around the neural arch. The facility with which the insertion and tightening of the strap can be employed reduces the operation time significantly. PMID- 3955978 TI - Hex-nut loosening following compression instrumentation of the spine. AB - Two cases of failure of compression instrumentation using the slotted hook and bushing (SHB) system due to back-off of the hex nut and loosening of the SHB. Laboratory tests on compression assemblies demonstrated that: hex-nut loosening can be produced in the laboratory by the cyclical loading of compression assemblies; crimping of the threads of the rod prevented hex-nut back-off and loosening of the SHB; crimping of the threads of the rod with the described rod crimper applied at a 90 degree angle did not damage the core of the rod or compromise its ability to withstand cyclical or tension loads; and crimping of the threads of the rod at angles other than 90 degrees damaged the core of the rod and significantly altered its ability to withstand cyclical loading. With subsequent clinical application of these principles, failure of compression instrumentation because of loosening of the SHB seems not to have been reported in the literature. PMID- 3955979 TI - Internal fixation with Knodt's rods. AB - Knodt's rods are an effective distraction internal fixator for promoting fusion for lumbar spine surgery. The chief disadvantage in 92 cases was a removal rate of about one third. The 93% fusion rate, and instant mobilization of the patient are reasonable trade-offs for the disadvantages of a second operation for removal of the rods. PMID- 3955980 TI - Fusion of the lumbar and sacral spine by internal fixation with screw plates. AB - From 1972 to 1982, 455 patients had arthrodesis and other operations with screw plate internal fixation of the lumbosacral spine. Of these 455 patients, 440-413 of whom had had spinal fusion and 27 of whom had undergone pars interarticularis reconstruction--were evaluated for a mean follow-up period of 31.6 months. The principal indications for single-stage posterior fusion, which was performed in 266 cases, were severe degenerative joint disease and painful spondylolysis, while the primary indications for combined anterior and posterior repair, which was undertaken in 145 cases, were spondylolisthesis and malignant tumors. Two cases had single-stage anterior fusion. Initial anterior surgery was performed to achieve reduction of vertebral displacement, while the posterior approach was carried out to allow for fusion of the posterior joints and for osteosynthesis; specially-designed screw plates were attached to the pedicle for this purpose. The rate of solid fusion was 97.4% in the single-stage posterior procedures and 100% in patients who had been treated by a combined approach. Only five neurologic complications were encountered out of the combined approach (two regressive cauda equina syndromes and three regressive L5 nerve root pareses), and these occurred early in the investigation, when the technique was still being refined. Only six cases of single-stage posterior approach sustained a monoradicular lesion that subsided after the offending bone screw was removed. Such complications can be avoided if the surgeon is thoroughly familiar with the techniques described. PMID- 3955981 TI - Lumbosacral fusions with Harrington rods and intersegmental wiring. AB - Harrington rods are a valuable adjunct for fusion of the lumbosacral spine. Major limits of distractions are achieved with these rods. Greater amounts of decompression are possible. Decompression, alignment, and stability are maintained. Intersegmental wiring increases security and eliminates the problem of hook and rod displacement and loss of lumbar lordosis. A variety of methods are available for sacral fixation to avoid neurologic complications from the distal hooks. Three- and four-level Harrington rod distraction lumbosacral fusions have proven to be successful in returning severely-disabled spinal stenotic, obese, and osteoporotic patients to normal activities. PMID- 3955982 TI - Total vertebral body and pedicle arthroplasty. AB - Two new spinal procedures, a total vertebral body replacement using a one-stage posterior approach, and artificial pedicle replacement for extensive decompression laminectomies, are performed with the aid of a special segmental spine plating system. These spine plates, with their unique individual pedicle screw placement, create immediate and totally-rigid fixation as well as segmental control of each vertebral body. Surgeons are now free to perform laminectomies to their fullest extent without the consequence of an uncorrected, unstable back. The purpose of the procedure is to permit the patient to recover without immobilization or prolonged bed rest, and to return to normal activity and work without pain. Three cases are presented to demonstrate potential surgical indications and techniques. PMID- 3955983 TI - Instrumentation of the lumbar spine. An overview. AB - The use of any implant system to promote arthrodesis of any segment of the spine is only as good as the technique of surgical arthrodesis. The success of the implant depends, in short, on the success of the arthrodesis. A successful arthrodesis depends on meticulous soft-tissue debridement, decortication, and copious iliac bone grafting or allograft bone grafting if autogenous graft is deficient. If the anterior approach is used, complete and thorough debridement of the intervertebral disc and cartilaginous end-plates with meticulous bone grafting of the interspace is essential for a successful fusion. A pseudarthrosis in the presence of an implant will eventually lead to implant failure. In implants placed anteriorly, this may lead to severe consequences and complications. If implants are used anteriorly and anterior arthrodesis is not achieved, a posterior spinal fusion should be carried out. All implants used anteriorly should be placed laterally away from great vessels, particularly the femoral artery. If separation from the vessels and the implant is not possible, the implant should either be removed or the vessels should be protected with a Dacron graft placed over any protuberant metal. PMID- 3955984 TI - Techniques of internal fixation for degenerative conditions of the lumbar spine. AB - The indications and techniques for internal fixation of the lumbar spine in degenerative conditions have changed drastically since internal fixation was first applied to the spine almost 100 years ago. Anterior instrumentation and fusion may be used for repair of pseudarthrosis after posterolateral fusion; symptomatic lumbar scoliosis associated with degenerative disc disease; late pain secondary to posttraumatic kyphosis; postlaminectomy instability; and lumbar pain secondary to thoracolumbar kyphosis. Posterior instrumentation and fusion has been performed with Luque instrumentation over 3-4 levels in cases of multilevel instability. Combined anterior and posterior instrumentation and fusion are required for lumbosacral fusion in lumbar scoliosis with degenerative disease, and surgical correction of postsurgical lumbar kyphosis (flat-back syndrome). The techniques are demanding but with attention to detail can be performed with acceptably low-complication rates. PMID- 3955985 TI - Osteoarthritis of the hand and osteoporosis. AB - The relationship between osteoarthritis and osteoporosis of the hand was examined in a random sample of the Jewish population in Jerusalem. It was found that osteoporosis and osteoarthritis of the hand showed differing prevalences, only rarely coexisted, and that there was neither a positive nor a negative correlation between them (p greater than 0.05). This would strengthen the contention that these are two independent and unrelated disease processes. PMID- 3955986 TI - Indication, surgical technique, and results of 100 surgically-treated fractures and fracture-dislocations of the cervical spine. AB - The results of 100 cervical spinal injuries in 67 men and 33 women (20 upper and 80 lower cervical spinal injuries), which were treated operatively, were analyzed. Fifty-three of the patients were less than 30 years old. The period of observation was a minimum of one year. Ninety-three percent of patients were transported to a hospital where first treatment was given within six hours after the accident. Only 25% of these patients had a closed manual or open reduction within these first six hours. One third of all patients improved neurologically. The majority (75%) of the patients with neurologic improvement were reduced within six hours after the accident. Fifty patients were treated by an anterolateral, 40 by a posterior, and ten by a combined anterior/posterior surgical exposure. Complications attributable to technical difficulties were only occasional and were never of significance for the further outcome. The duration of immobilization was a maximum of six weeks or less in more than 85% of all cases. The duration of hospitalization could not be reduced in the group of tetraplegic patients. Immediate reduction of the injury is more important for the further neurologic outcome than improved surgical techniques. PMID- 3955987 TI - Pathologic fracture of the humerus. AB - Review of patients with pathologic fracture of the humerus disclosed that closed treatment resulted in a high incidence of pain, disability, and failure to heal. The most common cause of pathologic fracture of the humerus is breast cancer. A review of records of 103 patients with persistent disease after initial treatment for breast cancer revealed that 19 had humeral metastases (18.5%); of those with humeral metastases, two patients (10%) had pathologic fractures. Prophylactic internal fixation of humeral metastases is not routinely recommended, but operative treatment for pathologic fracture of the humerus is generally superior to nonoperative methods of fracture management. PMID- 3955988 TI - The symphysis pubis. Anatomic and pathologic considerations. AB - The symphysis pubis is a nonsynovial amphiarthrodial joint that is situated at the confluence of the two pubic bones. A thick intrapubic fibrocartilaginous disc is sandwiched between thin layers of hyaline cartilage. The inferior pubic ligament provides most of the joint's stability. Anatomic sections demonstrate a symphysis by the end of the second month of gestation. Thick cartilaginous end plates are present at birth but become thin by the time of skeletal maturity. Congenital diseases resulting in failure of symphysis formation include exstrophy of the bladder and cleidocranial dysostosis. Both pyogenic and tuberculous infectious diseases involve the symphysis. Metabolic disease, such as renal osteodystrophy, produces widening, while ochronosis results in calcific deposits in the symphysis. Inflammatory disease, such as ankylosing spondylitis, results in bony fusion of the symphysis. Osteitis pubis, the most common inflammatory disease, is treated with anti-inflammatory medication and rest. Degenerative joint disease of the symphysis, which can cause groin pain, results from instability or from abnormal pelvic mechanics. As is the case with most joints, the symphysis serves as a barrier to tumor invasion. The patterns of trauma include diastasis, straddle fracture, intraarticular fracture and overlapping dislocation, and combinations of injuries. PMID- 3955989 TI - Prevalence of primary coxarthrosis in siblings of patients with primary coxarthrosis. AB - The prevalence of primary coxarthrosis was investigated in 289 siblings of 184 patients treated by total hip replacement. Age and sex-matched persons from the city files of Malmo, Sweden, were selected as controls. The prevalence of presenting symptoms (initiating a hip roentgen examination) of primary coxarthrosis in the siblings was 8%, compared to 3.8% in the controls (p less than 0.05). The type and localization of primary coxarthrosis was evenly distributed between the two groups. Conversely, the prevalence of gonarthrosis did not differ between the two groups. The prevalence of primary coxarthrosis in the siblings suggests the influence of a hereditary factor in the etiology of primary coxarthrosis. PMID- 3955990 TI - Missed or developmental dislocation of the hip. AB - In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increased acetabular index, subluxation, and early dislocation may not always be detected on physical examination. Delayed diagnosis of dislocation is not evidence that an inadequate physical examination was performed. An increased acetabular index may allow the femoral head to move laterally out of the acetabulum and become a delayed dislocation. The delayed subluxed or dislocated hip constitutes an entity not necessarily related to the neonatal subluxable or dislocatable hip. PMID- 3955991 TI - Metastatic breast cancer in the femur. A search for the lesion at risk of fracture. AB - Clinical records and radiographs of 203 female patients with 516 metastatic breast lesions located in the proximal femur were examined retrospectively to determine: the dimensions of those lesions that were at risk of fracture; and the relationship of other variables (bone pain, body habitus, age, and radiation treatment) with the occurrence of a pathologic fracture. Twenty-three patients sustained 26 pathologic fractures. Their average age, height, and weight were not significantly different from the 180 patients without fractures. Similarly, moderate to severe bone pain was experienced by a great majority of the total patient population, yet only 11% sustained fractures. Fifty-six patients received radiation treatment of a femoral metastasis. Ten of these patients subsequently sustained fractures. Radiation treatment relieved bone pain but did not have any consistent curative effect on the lesion itself. Finally, the authors were unable to identify either a specific percent involvement of the bone or a critical diameter for metastases that fractured because: 296 (57%) of the 516 metastases were permeative lesions and unmeasurable; 14 (54%) of the 26 pathologic fractures observed occurred through unmeasurable lesions; and the 12 measurable lesions that fractured had the same range of percent involvement as the 208 measurable lesions that did not fracture. Breast metastases at risk of fracture cannot be identified by measurements obtained from standard radiographs alone. PMID- 3955992 TI - Ambulatory containment treatment in Perthes' disease. AB - The results of four different ambulatory methods used in the treatment of 248 patients with Perthes' disease were compared in five different hospitals. In each hospital the patient population was selected for the era of treatment policy. Seventy-two patients were treated with crutches alone, 58 with a Scottish Rite orthosis, 48 with a Newington abduction orthosis (a bilateral long-leg brace holding the hips in abduction and internal rotation), and 70 with proximal femoral osteotomy. The end results of treatment were rated according to head sphericity using the MOSE method. Prognostic indicators were recorded, including age of onset of disease, Catterall type, and femoral subluxation. Patients with partial-head involvement under eight years of age at disease onset with minimal lateral subluxation (less than 1.5 lateral subluxation ratios) and no proximal subluxation fared equally well with crutch walking or any of the three ambulatory containment treatments studied. With greater degrees of subluxation, all three containment groups were superior to crutch walking and all were equally effective. In partial-head involvement, patients between eight and 12 years of age, with or without lateral or proximal subluxation, all three ambulatory containment methods were superior to crutch walking. Femoral osteotomy and the Newington abduction orthosis were equally effective. Only five Scottish Rite patients were in this age group, too small a number to compare with the other treatment methods. Patients with partial-head involvement over 12 years of age at disease onset had poor results. For patients with total-head involvement under eight years of age at disease onset, femoral osteotomy was correlated with a lesser degree of femoral head flattening than either brace or crutch treatment. In whole-head involvement patients over eight years old at disease onset, all three ambulatory containment methods were equally effective and superior to crutch walking; however, there were few crutch walking and Newington abduction arthrosis patients in this age group. PMID- 3955993 TI - The effects of immobilization on the ultrastructure and mechanical properties of the medial collateral ligament of rats. AB - Rat medial collateral ligaments from one group of animals were tensile tested following immobilization. Ligaments from a second group of animals were examined using transmission electron microscopy to determine collagen fibril cross sectional area and density. Immobilized and contralateral control ligaments were compared to determine the effect of immobilization on these parameters. There was a significant decrease in the linear stress, maximum stress, and stiffness of immobilized ligaments. There was no significant difference in the strain values reported. There was a significant decrease in the proportion of smaller, cross sectional area fibrils (0-10,000 nm2) following immobilization. There was also a significant increase in the proportion of larger (30,000-40,000 nm2 and 40,000 50,000 nm2) fibrils following immobilization. This finding was attributed to a decreased synthesis and decreased degradation of collagen during immobilization; post-immobilization, the density of collagen fibrils in the ligament decreased. There may be a relationship between ultrastructural and mechanical alterations following immobilization. Significant clinical implications are apparent in the altered mechanical properties following immobilization. PMID- 3955994 TI - Combined Coventry-Maquet procedure for two-compartment degenerative arthritis. PMID- 3955995 TI - The surgical reduction of spondylolisthesis. AB - The Schnollner operation for reduction of spondylolisthesis was performed through a transversal incision. After removal of the disc, two pedunculus screws with two different threads are inserted. Over these screws the reduction is performed against a slotted sacral plate. The operations were performed at the following levels: 48 at L5-S1, seven at L4-L5, and two at both levels. 70.8% of the patients had preoperative lumboischialgia, 23.3% lumbalgia. Postoperatively, 92.1% were without pain. Twenty-seven patients had preoperative sensory disturbances, while only five had such disorders five years after operation. New sensory disturbances occurred after operation in 11 patients, seven of these persisted. Before operation, 27 patients had pareses of the foot and toe extensors; after operation, ten of them. Paresis occurred in 12 cases, of which three persisted. In 13 cases the reposition was complete, in 17 cases the displacement after operation ranged from 11% to 30%. The lumbosacral angle was markedly diminished. PMID- 3955996 TI - Segmental spine plates with pedicle screw fixation. A new internal fixation device for disorders of the lumbar and thoracolumbar spine. AB - A new segmental spine plate fixation system, utilizing a posterior approach and screw fixation, has been developed for disorders of the lower thoracic or lumbar spine. The indications are significant instability and severe pain relieved by immobilization. This new system uses multiple segmental fixation points through the pedicle "force nucleus" of the vertebral body. The spine plates can be contoured for anatomic positioning, reduction, and rigid stabilization to enhance graft consolidation and fusion. The surgical fixation technique is demonstrated in five case presentations illustrating the application and versatility of the method. PMID- 3955997 TI - Interpeduncular segmental fixation. AB - Attempts at segmental correction and fixation of the vertebral column usually result in biomechanical instability, defined as an alteration of any two of the longitudinal mechanical columns. This leads to a system that involves all three columns to restore stability to the spine. The use of specially-designed interpeduncular screws bilaterally and segmentally permits firm attachment of each vertebra through the pedicle and into the vertebral body, thus covering all three biomechanical columns. By attaching coupling screw drivers to each set of transpedicular screws, lordosis, kyphosis, and rotation can be corrected segmentally within the tolerance of disc elasticity. The correction of lateral deviation is accomplished in a segmental manner. As a preliminary report, 20 cases are presented between the ages of 15 and 55 years with a variety of spine pathology. All were treated with interpeduncular screw fixation (ISF) and arthrodesis. The average follow-up period is 15 months, so no conclusion of the rate of pseudoarthrosis can be made. The correction of pathology is 80% with balance and maintenance of physiologic saggital curves. There have been no complications in this group of patients. PMID- 3955998 TI - Anthropometric studies of the human sacrum relating to dorsal transsacral implant designs. AB - The sacrum offers several possibilities for fixation that, when combined, appear to provide a secure foundation for a dorsally-placed, transsacrally-fixed implant. The dorsal sacral landmarks, particularly the first and second dorsal foramina, are readily identifiable and relate in a consistent manner both qualitatively and quantitatively to the major mass of sacral bone, which is located ventrally to the vital structures of the sacrum. The authors have utilized these findings in the design of a new implant for direct sacral fixation. PMID- 3955999 TI - Internal fixation of the lumbar spine with pedicle screw plating. AB - The results and complications of pedicle screw plate (PSP) stabilizations were investigated in lumbar fresh fractures, malunions, lumbar metastases, primary tumors, lumbosacral fusions, and highgrade spondylolisthesis. The low incidence of neurologic complications of PSP is noteworthy, and a reason for recommending the method. PMID- 3956000 TI - An internal fixator for posterior application to short segments of the thoracic, lumbar, or lumbosacral spine. Design and testing. AB - A new spinal implant has been designed and biomechanical testing completed, intended for application to "short-segment" spinal defects such as disc degeneration, fracture, spondylolisthesis, or tumor. Major improvements over currently available devices include: only 2-3 vertebrae are spanned, not 5-7 as with Harrington rods; true three-dimensional fixation is achieved, preventing such problems as hook or rod dislocation; three-dimensional adjustment is easily accomplished, allowing fracture or spondylolisthesis reduction to be readily performed; attachment to vertebrae is by means of transpedicular screws eliminating deliberate encroachment into the spinal canal, such as Luque wires or Harrington hooks; no special alignment between screws is needed (such as with holes or slots in a plate), allowing screw placement to fully conform to anatomic structures; and laminectomy sites and lumbosacral junction are readily instrumented. Background investigations presented here for design of this device include: CT-defined pedicle morphometry showing that screws may be larger than those currently used; effect of pitch, minor diameter, and tooth profile on screw pull-out strength; mechanical testing of a compact, three-dimensionally adjustable, strong, nonloosening articulating clamp; and establishing of the relationship between depth of penetration and strength of fixation of transpeduncular screws. PMID- 3956001 TI - A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine. AB - This laboratory experiment was undertaken to identify factors contributing to intrapeduncular screw fixation in the vertebra. Testing was performed in axial pull-out and cyclic loading modes using multiple screw designs inserted to various depths into fresh human lumbosacral vertebra. The degree of osteoporosis played a major role in pull-out strength. Larger diameter, full-threaded screws inserted deep enough to engage the anterior vertebral cortex resulted in the most secure fixation. In the sacrum, the second sacral pedicle was the weakest location of insertion. Screws aimed laterally into the ala at 45 degrees or medially into the first sacral pedicle resisted larger axial pull-out loads than those inserted straight anteriorly into the ala. Methyl methacrylate was found to restore secure fixation in previously-loosened screws and pressurization of cement doubled the pull-out force. In cyclic load tests, deeper-inserted screws were found to withstand a greater number of cycles before loosening. Measurements of pedicle outer cortical diameters were found in many specimens to be smaller than both the 4.5-mm and 6.5-mm diameter screws. PMID- 3956002 TI - Nonmetastatic Ewing's sarcoma of bone: the role of surgical therapy. AB - The role of the orthopedic oncologist in the management of patients with Ewing's sarcoma (ES) is increasingly demanding. The initial radiographic evaluation demands a minimum sophistication of a current generation computed tomography (CT) evaluation of the chest and primary lesion followed by appropriate biopsy and pathology support. After completion of induction chemotherapy, radiographic reevaluation and restaging are followed by either "tailored port" or standard radiation therapy techniques, or surgical resection, as indicated in selected patients. Improvement of the care of ES patients requires the cooperation of physicians, surgeons, technicians, and social workers with appropriate training and skill. PMID- 3956003 TI - Chondrosarcoma. AB - Chondrosarcoma is a malignant cartilage-forming tumor that affects predominently the middle-aged population. There are three histologic grades, but differentiation of Grade I tumors from enchondromas can be difficult. The measurement of polypoidy (augmented chromosomal content per cell) appears to offer a method of segregation of benign from low-grade from high-grade tumors. With the exception of the high-grade spindle elements, current chemotherapy does not appear to affect chondrosarcomas. Retinoic acid, however, by enhancing lysosomal enzyme release, may be a potential efficacious therapeutic agent. Enhanced tumor staging as provided by the computed tomographic (CT) scan has demonstrated the boundaries for wide surgical excisions, most notably internal hemipelvectomies for low- and moderate-grade pelvic chondrosarcomas. Currently, low-grade chondrosarcomas have an overall five-year survival of 65%--85% in contradistinction to 15% for the highest grade chondrosarcomas. PMID- 3956005 TI - Cauda equina syndrome: a complication of lumbar discectomy. AB - Six cases of acute postdiscectomy cauda equina syndrome (C.E.S.) following lumbar discectomy were reviewed retrospectively in a series of 2842 lumbar discectomies over a ten-year period. Five cases had coexisting bony spinal stenosis at the level of the disc protrusion. The bony spinal stenosis was not decompressed at the time of discectomy. Inadequate decompression played a role in the neurologic deterioration postoperation. The cause of the sixth case is unknown. Bowel and bladder recovery was good when the cauda equina decompressed early; sensory recovery was universally good, and motor recovery was poor if a severe deficit had developed before decompression. Careful review of the preoperative myelogram to rule out spinal stenosis and decompression of bony stenosis at discectomy are recommended for prevention of postoperative C.E.S. Urgent decompression of postoperative C.E.S. is advisable if compression of the cauda equina is confirmed radiographically. PMID- 3956004 TI - Chordomas. AB - Chordomas constitute between 1% and 4% of primary malignant bone tumors. Approximately 50% originate in the sacrum, 35% at the base of the skull, and 15% in the true vertebrae. The majority of tumors are encountered from the fifth through seventh decades, with a male preponderance. The clinical symptoms and signs are nonspecific and lead to frequent errors in clinical diagnosis. Radiographic findings include nonspecific destruction of the vertebral body, with reactive sclerosis; calcification is more often seen in sacral tumors. Computed tomography (CT) frequently reveals an anterolateral soft-tissue mass, which is often more extensive than the osseous involvement. The optimal treatment for sacral tumors should be en bloc resection of the tumor performed through intact bone a level above (wide local excision); for vertebral lesions, an anterior surgical approach with resection of the vertebral body should be performed. While conventional radiation has little efficacy in this tumor, a variety of innovative newer approaches may prove more effective in the future. Conventional chemotherapy has not proved effective in this tumor. With early diagnosis, and more effective surgical therapy, the current disease-free survival at five years should be between 30% and 50%. PMID- 3956006 TI - Humeral shaft fracture with brachial artery injury. AB - The management of ten patients with fracture of the humeral diaphysis and concomitant injury to the brachial artery was analyzed retrospectively for examination of the factors contributing to preservation of limb viability and function. Of ten treated fractures, eight were rigidly stabilized with either a plate or an external fixation device. Seven of the vascular injuries required an interpositional graft. Three arteries were repaired with an end-to-end anastomosis. Two of these repairs failed in patients whose fractures were not rigidly stabilized, and one of these patients required amputation. Fasciotomy was performed in five cases. Seven patients retained normal or functional extremities despite ligation of the brachial artery in two individuals. Preoperative arteriography was of equivocal value, and it doubled the patient's transit time from the emergency room to surgery. The use of a temporary intraluminal vascular shunt to perfuse the limb at surgery and the semi-invasive rigid stability afforded by contemporary external fixators are important advances in the management of these complex injuries. In civilian practice, the prioritized guidelines the authors suggest for care of combined major skeletal and vascular trauma to the arm are: resuscitation of the patient; arteriogram, which is nonessential in open injuries but helpful in closed trauma; intraoperative perfusion of the limb with a temporary shunt; rigid bony stabilization; wound debridement; vascular repair with an autogenous vein graft; neurorrhaphy; and assessment of the need for fasciotomy. PMID- 3956007 TI - Treatment of recurrent anterior dislocation of the shoulder by duToit Staple capsulorrhaphy. Results of long-term follow-up study. AB - DuToit Staple Capsulorrhaphy was performed on 79 patients during a period of ten and one-half years. Sixty-five patients were followed for an average period of nine years (26 months to ten and one-half years). Separation of the glenoid labrum from the glenoid rim was noted in 94% of the cases. A markedly lax and redundant capsule was noted in 6% of the cases. A bucket-handle tear of the glenoid labrum was noted in 4% of the cases. Fracture of the anterior rim of the glenoid was noted in 6% of the cases. There was one recurrence of dislocation (1.78%); 94% were rated as excellent; 4% were rated good; and 2% were rated poor. Out of 70% of the patients who were participating in athletic activities, 58% returned to athletic activities after surgical repair. Stapling the glenoid labrum to the glenoid is an effective method of treatment of recurrent anterior dislocation of the shoulder. PMID- 3956008 TI - Update on external fixators in the treatment of wrist fractures. AB - Fifty fractures of the distal radius in 49 patients were treated by either a Roger Anderson device or a Hoffman C-series external fixator. The radiographic and clinical results were evaluated for comparison of the use of the two fixators. The follow-up period for the entire group averaged 15.9 months. For 12 patients personally examined and 12 returning a questionnaire, the follow-up period averaged 27.7 months. The Hoffman fixator and Roger Anderson device gave predictably good results in the treatment of comminuted intra-articular fractures of the distal radius when used in the active age group. Neither was found to yield superior functional results over the other, although the Hoffman fixator had a more rigid configuration. Serious complications may result from the use of external fixators, but these can be minimized by proper technique and care. PMID- 3956009 TI - The University of California Biomechanics Laboratory four-bar polycentric knee linkage. A clinical trial in 20 active above-knee amputees. AB - A four-bar polycentric prosthetic knee linkage developed by the University of California Biomechanics Laboratory (UCBL) was tested clinically in 20 active veteran above-knee amputees. The mean follow-up period was 12.3 months. At final follow-up evaluation, positive subjective responses were reported by 80% of the amputees. More than one-third reported that the device was superior to any that they had used previously. Almost all subjects found that prior levels of daily activity and the ability to perform specific activities were maintained or enhanced. The increase in knee flexion afforded by the mechanism was found to be an advantage. There was no significant change in various fundamental gait parameters. Problems caused by excessive wear of anodized aluminum linkage pins and by air leaks in the pneumatic swing-phase control unit were corrected easily. These preliminary results encourage further clinical application and study of the UCBL four-bar polycentric knee. PMID- 3956010 TI - Experimental instability of the ankle. A radiographic investigation. AB - For determination of the optimal position in examining the ankle joint for anterior drawer sign and talar tilting, 12 legs freshly amputated above the knee were radiographically examined after successive transection of the lateral ankle ligaments in three different sequences. Apparatuses secured the position of the ankle joint in 25 degrees of inward rotation and 10 degrees and 30 degrees, respectively, of plantarflexion. Examination for anterior drawer sign gave significantly greater displacement with the foot in 10 degrees than with the foot in 30 degrees of plantarflexion and was most pronounced after the cutting of the anterior talofibular ligament. Examination for talar tilt gave a non significantly greater displacement at 10 degrees of plantarflexion, except when cutting both the posterior talofibular and the anterior talofibular ligament. Isolated cutting of the calcaneofibular ligament gave only little displacement irrespective of the method used. Radiographic examination should be performed with 10 degrees of plantarflexion to obtain maximal displacement and 25 degrees of inward rotation of the leg to obtain a free ankle mortise in the anteroposterior projection and concentric arcs of the joint surfaces in the side projection. PMID- 3956011 TI - Greenfield vena caval filter for management of selected cases of venous thromboembolic disease following hip surgery. A report of five cases. AB - The use of the Greenfield vena caval filter for thromboembolic disease following major hip surgery is an important part of the orthopedist's armamentarium for treatment of complications or contraindications to standard anticoagulation therapy. The authors report five cases in which a Greenfield vena caval filter was employed for treatment of a femoral thrombus or pulmonary embolism in postoperative hip patients who developed bleeding complications from heparin, had a recurrent embolism while on heparin, or who had had a contraindication to anticoagulation therapy. PMID- 3956012 TI - Articular sporotrichosis. AB - Sporotrichosis is a fungal disease caused by Sporothrix schenckii, which is seen worldwide. Infection usually involves cutaneous and subcutaneous tissues. Articular involvement is rare. A 29-year-old man with ankle sporotrichosis is reported to demonstrate the differential diagnosis and treatment. PMID- 3956013 TI - Unicameral and aneurysmal bone cysts. AB - One hundred and seventy-eight cases of unicameral bone cysts (UBC) treated with curettage and bone grafting were compared to 141 cases treated with cortisone injections. The end results were comparable in the two groups. Local recurrence risk factors in the surgical group were active cyst and previous operations. In the other group they were multilocation of the cyst, active cyst, and size of cyst. A new radiographic classification of aneurysmal bone cyst (ABC) is proposed in a report of 198 cases of ABC. The treatment of choice in ABC is surgical and the type (curettage, curettage plus phenole or cryosurgery, resection or hemiresection) is selected on the basis of the radiographic aspect and the rate of growth of the cyst. Radiotherapy is only indicated in inoperable ABC cases. PMID- 3956014 TI - Titanium fibermetal segmental replacement prostheses. A radiographic analysis and review of current status. AB - Thirteen patients with titanium fibermetal segmental bone/joint prostheses at a minimum follow-up period of six months were reviewed. Detailed radiographic data were analyzed quantitatively in terms of stem/bone interface radiolucency and bone bridging over the segmental portion of the prosthesis at predefined zones. Although stem radiolucent lines were common in this series, only one case had clinical loosening and required reoperation. There were two cases of stem fracture; one achieved extracortical bone union without revision, and the other case required implant removal and revision. Analysis of the retrieved specimen revealed histologic evidence of bony ingrowth. The use of a long side plate for initial implant fixation might have been partially responsible for this complication because of inhibition of new bone formation over the porous-coated segment. Sequential study of radiograms at different follow-up time periods with the same zonal analysis criteria revealed that no progression of radiolucency occurred at the bone/prosthesis interface, and bone formation over the segmental portion either increased or stabilized with time. The patients' functional results and implant performance seemed to indicate that the porous-coated segmental prosthetic system was effective in bridging skeletal/joint defects. However, further improvements are needed in prosthetic design and implant quality control in order to minimize device-related complications. PMID- 3956015 TI - The evaluation of patellofemoral pain using computerized tomography. A preliminary study. AB - There are well-recognized limitations of conventional axial radiographs of the patellofemoral joint in assessing patients with peripatellar pain, particularly in the first 20 degrees of knee flexion. Computerized tomography (CT) was used, therefore, to evaluate 20 patients with persistent patellofemoral pain and ten asymptomatic volunteers. Multiple midpatellar images were obtained between zero degrees and 30 degrees -40 degrees (sometimes 40 degrees) of flexion, with and without maximal quadriceps contraction. Three distinct patterns of malalignment were identified. When compared to controls, 11 patients had lateralized patellae based on high-congruence angles in extension. With progressive flexion to 30 degrees, all but one reduced into the trochlea. This group was subdivided into those lateralized with or without associated patellar tilting. There were seven patients whose patellae progressively tilted between zero degrees and 30 degrees of flexion while remaining centered in the trochlea. Anatomic differences demonstrated by CT appear to be a factor in distinguishing these groups. Computerized tomography may be the optimal method of radiographically evaluating the patellofemoral joint. Patients have been identified with lateralized patellae in extension that subsequently become congruent by 30 degrees of flexion and therefore may not be appreciated on traditional radiographs. An awareness of different patterns of malalignment is a significant advantage of computerized tomography when planning selective surgical realignment for these patients. PMID- 3956016 TI - Microcirculation of the juvenile knee in chronic arthritis. AB - In order to investigate pathogenetic factors in growth abnormalities of the knee in hemophilic arthropathy and juvenile rheumatoid arthritis, the hemodynamic changes of the knee following chronic synovial inflammation and elevated joint pressure were studied in puppies. Unilateral arthritis was induced by intraarticular injections of carrageenan solution. Regional blood flow (RBF) was measured by tracer microsphere technique. Microvascular volume (VV) was estimated from the distribution volumes of Cr51-labelled erythrocytes and I125 fibrinogen. Mean transit times (TT) of blood components were calculated from volume/flow ratios. The arthritic joint capsules were characterized by high RBF rates, increased VV, low tissue hematocrit (HCT) and short TT of blood. In the juxtaarticular epiphyses and the patella, RBF was largely unchanged, whereas VV was significantly elevated and TT of blood prolonged. The growth plates formed borders for the extension of these changes. The increased permeability and surface area between blood and bone in arthritis may accelerate the resorption and subsequent destruction of subchondral bone in chronic arthropathies of the juvenile knee. PMID- 3956017 TI - Electrical stimulation of bone growth with direct current. AB - Electrical stimulation of osteogenesis was studied in rabbit femora in: (A) a transcortical electric field with a cortex-depolarizing or hyperpolarizing orientation derived from an intramedullary electrode and a ring-shaped counter electrode encircling the femoral shaft; and (B) an electric field derived from an electrode located in the medullary canal and the counter electrode in the abdominal wall. Electrodes were made of platinum. A direct current of 20 microA was applied during six weeks. Contralateral femora with dummy electrodes served as controls. Results were analyzed by optical densitometry of roentgenograms and histomorphometry of histologic slides. Under the conditions of these experiments bone growth was not stimulated by applying a cortex-depolarizing electric field. Significant stimulation of bone growth was only observed at an intramedullary cathode, when the anode was placed at a distance. PMID- 3956018 TI - Eosinophilic granuloma of bone. AB - Eosinophilic granuloma of bone as a component of the syndrome histiocytosis X is discussed with respect to clinical, pathologic, and radiologic diagnostic biases and discrepancies employing illustrative case material. The subject is reviewed in historical perspective selectively, with emphasis on those features that may serve as a valuable resource in evaluating initial patient presentations and subsequent follow-up evaluation. Salient pathologic and pathogenetic considerations especially germane to clinical phenomena are reviewed, and current therapeutic modalities are summarized. PMID- 3956019 TI - Osteoid osteoma and osteoblastoma. Current concepts and recent advances. AB - Osteoid osteomas are common lesions, constituting one-eighth of the benign bone tumors. Their size (less than 1.5 cm) and characteristic radiographic and clinical presentation are usually diagnostic. Response to salicylates is quite variable and not a reliable sign. Extremely high levels of prostaglandin metabolites have been found in osteoid osteomas and may explain the inflammatory features of the lesions. Preoperative localization with computed tomography (CT) scans and intraoperative confirmation of location and resection with radioscintigraphy have dramatically reduced the recurrence rate in the last 26 patients. Complete excision, even if accomplished by intralesional technique, is successful in eradicating the tumor. Osteoblastomas constitute 1% of bone tumors. Although their histology differs minimally from osteoid osteomas, they achieve a larger size and behave more aggressively. Commonly occurring in the spine, they require careful anatomic delineation with CT scans and myelography. Complete excision eliminates the lesion. PMID- 3956020 TI - Plasma cell tumors. AB - Multiple myeloma and solitary plasmacytoma are common reticuloendothelial diseases. They involve primarily the bone marrow but have occasional extramedullary components. Numerous complications have been reported with these diseases. Despite modern modes of therapy, the prognosis remains grim. Myeloma and plasmacytoma are part of the continuum of B-Cell lymphoproliferative disorders. Patients are generally between 50 and 70 years old and usually present because of pain. The diagnosis is established by laboratory methods, routine skeletal survey findings, and bone marrow or lesion biopsy. Treatment is primarily medical, with radiation therapy and surgery being used for local control of specific lesions as well as for the treatment of complications or associated lesions. Although the prognosis remains poor, the ability to treat the painful and disabling components of the disease has improved. The surgeon, although unable to cure, can aid the myeloma patient by providing the opportunity for a more productive, pain-free survival. PMID- 3956021 TI - Diagnosis and treatment of a carcinoid tumor using iodine-131 meta iodobenzylguanidine. AB - Scintigraphy using I-131 meta-iodobenzylguanidine has been introduced as an effective method to detect pheochromocytomas and neuroblastomas, and the radiopharmaceutical also is applied in therapy of these tumors. The authors present a case of a metastatic gastric carcinoid tumor, another neural crest tumor, concentrating I-131 MIBG, which was documented by conventional scintigraphy and SPECT in correlation with CT scans and colloid scintigrams of the liver. Two therapeutic attempts in this patient, using I-131 MIBG, are described. The metabolic basis of this phenomenon is discussed, and the importance of I-131 MIBG imaging in the detection of neural crest tumors is underlined. PMID- 3956022 TI - Scintigraphic demonstration of splenosis. AB - A case of splenosis, or the autotransplantation of splenic tissue following trauma, was encountered unexpectedly on a routine liver scan performed in the workup of alcoholic liver disease. Confirmatory scintigraphic images using Tc-99m labeled, heat-damaged, autologous erythrocytes are presented with CT scans of the abdomen. PMID- 3956023 TI - Utility of gallium imaging in the diagnosis of Mycobacterium avium-intracellulare infection in patients with the acquired immunodeficiency syndrome. AB - Whole body Ga-67 scans revealed increased uptake in lymph nodes accessible for biopsy in three patients with the acquired immunodeficiency syndrome (AIDS) infected by Mycobacterium avium-intracellulare (MAI). In diagnostically difficult cases where the usual methods for diagnosing MAI are not helpful, Ga-67 studies may be of value. PMID- 3956024 TI - Applications of condensed dynamic images. AB - In appropriate cases, information from a dynamic series of nuclear images may be condensed into a single image with one spatial and one temporal dimension. A useful elaboration of the method consists of the masking out of undesired spatial regions. The versatility of such condensed dynamic images is illustrated by examples derived from gastroesophageal and pulmonary studies. Advantages of the method include obviating the need to examine and comprehend multiple images as well as enabling economical archiving of image data. Its diagnostic potential is particularly evident in esophageal transit and infant gastroesophageal reflux studies. PMID- 3956025 TI - Radiocolloid liver imaging in hepatic steatosis. AB - In a review of 60 patients with fatty infiltration of the liver documented by Xe 133 imaging, 43% had normal radiocolloid liver images, and 57% had abnormal images with various combinations of hepatomegaly, mottling, splenomegaly, and splenic shift of radioactivity. None, however, showed focal defects. Fatty infiltrates do not simulate mass lesions on the radiocolloid study of the liver, and an area of photon deficiency in the presence of hepatic steatosis points to an additional pathologic process. The interpretation of the radiocolloid liver image is unhindered by fatty infiltration when searching for discrete space occupying lesions. PMID- 3956026 TI - "Photopenic" bone lesion secondary to erector spinae muscle infiltration by breast carcinoma. AB - A bone image demonstrating a "photopenic" vertebral lesion was found to be caused by tumor infiltration of adjacent muscle and probable secondary osseous ischemia. Magnetic resonance imaging was valuable in detecting the muscle abnormality. PMID- 3956027 TI - Abnormalities of the ascending aorta detected by gated blood pool imaging. AB - Radionuclide angiography has been used for visualization of aortic arch pathology. Gated blood pool scintigraphy generally has been reserved for the evaluation of ventricular function. By observing the aorta in relation to other cardiac structures, additional information about relative size and shape is available, and can be integrated with ventriculographic observations. This may enhance understanding of the mechanism of disease in the individual patient. Five selected case histories illustrating this point are presented. The last example demonstrates the ability of the technique to uncover unsuspected thoracic aorta pathologic findings. The sensitivity and specificity of this technique to diagnose aortic disease requires further study. PMID- 3956028 TI - Bone imaging showing incidental radionuclide exudate. PMID- 3956029 TI - Multiple anaerobic hepatic abscesses demonstrated on hepatobiliary scintigraphy. PMID- 3956030 TI - Scintigraphic demonstration of viable splenic autotransplant. PMID- 3956031 TI - Thallium-201 imaging in pericardial effusion. PMID- 3956032 TI - Thallium-201 uptake by the sternum. PMID- 3956033 TI - Partial biliary obstruction due to adenomyoma of the terminal common bile duct. PMID- 3956034 TI - Technetium-99m MDP activity in unsuspected necrotizing fasciitis. PMID- 3956035 TI - "Short pants" finding on bone images in Paget's disease with paralysis. PMID- 3956036 TI - Photon scatter from asymmetric bladder activity. PMID- 3956038 TI - False-normal bone imaging in spinal tuberculosis. AB - Tc-99m MDP bone imaging in spinal tuberculosis usually shows increased radioactivity at the sites of involvement. Uncommonly, the bone scan can be normal if the infection is low grade, indolent, or severely destructive. Two cases of spinal tuberculosis with normal bone imaging are reported. A normal bone image does not exclude tuberculous spondylitis. If there is clinical suspicion of this disease, further investigations, including tissue specimens, should be obtained. PMID- 3956037 TI - Arthroscintigraphic evaluation of the painful total hip prosthesis. AB - Arthroscintigraphy was performed in 19 patients with a painful total hip prosthesis by injecting both Tc-99m sulfur colloid and iodinated radiographic contrast material intra-articularly. Scintigraphic and radiographic results correlated exactly in 15 patients, with one false-negative scintigram, one false positive scintigram, and one false-negative arthrogram. One patient was evaluated by scintigraphy alone. Although arthroscintigraphy is potentially more sensitive than conventional arthrography in the detection of femoral component loosening, acetabular component loosening cannot be evaluated by scintigraphy alone. A combination of scintigraphy and conventional arthrography appears to be the most accurate imaging method in the evaluation of hip prosthesis loosening. PMID- 3956039 TI - Flip-flop phenomenon and dissection of extracranial carotid artery. AB - A case of extracranial carotid artery dissection investigated both by conventional brain imaging and by arteriography is presented. The radionuclide angiogram showed a flip-flop phenomenon on the left hemisphere. The implications, including clinical features, pathogenesis, diagnosis, and treatment are discussed. Dissection of extracranial carotid artery is a cause of carotid hypoactivity, and this phenomenon is associated directly with a flip-flop phenomenon on brain imaging. PMID- 3956041 TI - Visualization of the left hepatic lobe during radioisotopic venography/lung imaging with technetium-99m MAA. AB - An unusual case of uptake of radioisotope by the liver during radioisotope venography/lung imaging with Tc-99m MAA is presented. Abnormalities in venous circulation of the lower extremities and abdomen, perfusion of the lung, and structure of the liver were detected, and correlated with other studies performed on a single patient. The mechanisms of uptake of Tc-99m MAA by the liver are discussed, with special attention paid to the mechanism believed to be present in this case. PMID- 3956040 TI - Diffuse thoracoabdominal radioactivity seen in bone imaging. AB - Diffusely increased radioactivity in the thoracoabdominal region (lower thorax and/or upper abdomen) occasionally has been observed when performing Tc-99m phosphonate bone studies. To assess the significance of activity in this finding, 1100 bone scintigrams were reviewed and the clinical data and other diagnostic imaging procedures were evaluated in these cases. With the exclusion of Tc-99m sulfur colloid liver-spleen scans 18 patients were found to have mild but diffuse increased radioactivity in the thoracoabdominal region either on the right or left. Clinical findings in these cases with abnormal uptakes were pleural effusions (six cases), hepatic colonic metastases (six cases), splenic metastases from bronchogenic carcinoma (one case), abdominal and peritoneal colonic metastases (one case), a massive metastatic squamous cell carcinoma (from lung) in the right lower chest (one case), and defective radiopharmaceuticals (three cases). Since the defective radiopharmaceuticals contained 5% of hydrolyzed reduced Tc-99m colloid by thin-layer chromatography, each of three patients received approximately 740 mu Ci of Tc-99m sulfur colloid. Factors to be considered in the interpretation of diffuse thoraco-abdominal activity from a bone agent should include splenic or hepatic metastases, a Tc-99m sulfur colloid splenic or hepatic metastases, a Tc-99m sulfur colloid study within the previous 24 hours, pleural effusion, faulty radiopharmaceuticals, and abdominal and peritoneal colonic metastases. PMID- 3956042 TI - Congenital spleen thinning mimicking a space-occupying lesion. AB - By splenic imaging, a large focal defect was demonstrated in a symptomatic South American immigrant with simultaneous parasitic infestation of strongyloidiasis and entamebiasis. The CT scan also was thought to be abnormal. Pathologic findings reported a variation in splenic configuration. Unusual splenic configuration should be considered in the differential diagnosis of abnormal scans. PMID- 3956043 TI - Indium-111 leukocyte scanning. False-negative study in a renal abscess. AB - A 33-year-old man had clinical features of a right renal abscess. Results of excretory urography and ultrasonography showed a focal complex mass lesion in the right kidney. An In-111 leukocyte scan failed to detect the right renal abscess, which later was aspirated under CT guidance and explored surgically. The role of In-111 leukocyte imaging in the detection of intra-abdominal abscesses, with limitations of the procedure, is discussed. PMID- 3956044 TI - Scintigraphic findings in a case of hydatid cyst of the liver communicating with the biliary system. PMID- 3956045 TI - Arteriovenous fistula secondary to renal biopsy. AB - Renal imaging and biopsy are used in the management of patients with renal disease. The scintigraphic detection of an arteriovenous fistula, an infrequent but significant complication of renal biopsy, is the subject of this report. PMID- 3956046 TI - Introduction of bone imaging agent into the pleural space. AB - Tc-99m MDP injected into a central venous catheter showed a pattern corresponding to the left pleural space. The catheter had perforated into this locale. PMID- 3956047 TI - Bone imaging appearance of Pelligrini Stieda syndrome. AB - In a bone scan performed on a patient with Pelligrini Stieda syndrome of the left knee, abnormal tracer uptake was noted. Pelligrini Stieda should be added to the list of benign abnormalities on bone images. PMID- 3956048 TI - A novel pharmacokinetic method for analysis of placental transfer of latamoxef in humans. AB - A novel pharmacokinetic method was developed for analysing the behaviour of a drug in tissues. The absolute transfer ratio of a drug to a tissue was defined using the pharmacokinetic parameters obtained by this method. Composite data of latamoxef (moxalactam) concentration in maternal blood, umbilical cord blood and amniotic fluid following a 2g intravenous injection to pregnant women at delivery were analysed by this method to study the drug behaviour in pregnant women, fetuses and amniotic fluid. Latamoxef kinetics in pregnant women at full term were generally similar to that in previously reported healthy subjects. The concentration of latamoxef in umbilical cord blood peaked about 2 hours after dosing then decreased in parallel with the maternal blood concentration. The amniotic fluid concentration peaked about 7 hours after administration, then decreased slowly. The absolute transfer ratios to fetus and amniotic fluid were calculated to be about 2.5 and 0.37% respectively. PMID- 3956049 TI - Nomogram for drug dosage adjustment in patients with renal failure. AB - A nomogram is presented for the rapid determination of the dosage adjustment factor for drugs eliminated in part by the kidneys in patients with reduced renal function. This nomogram method is based on knowledge of the fraction of a dose of the drug of interest eliminated by the kidneys in subjects with normal renal function and an estimation of the renal function of the patient in question. It assumes that there is no reduction in the liver metabolism of the drug in patients with reduced renal function. The dosage adjustment factor thus derived can be used to change the dosage regimen of the drug in patients with reduced renal function. PMID- 3956051 TI - Symposium on perinatal nutrition. PMID- 3956050 TI - Salivary antipyrine half-life during injectable progestagen contraception. AB - Antipyrine pharmacokinetics were studied in 6 healthy women before and 2, 8 and 12 weeks after administering the injectable progestagen (progestin), norethisterone (norethindrone) enanthate 200mg intramuscularly. Additionally, antipyrine kinetics in 5 women who had previously used the injectable contraceptive for 8 to 14 months were compared with values obtained in 14 non users. Antipyrine was measured in saliva using a spectrophotometric method, following an oral dose of 18 mg/kg bodyweight. In the 6 women studied prospectively the mean salivary antipyrine half-life was 14.91 +/- 1.5 hours (SEM) before administering the injection, and 13.56 +/- 0.73 at 2 weeks, 15.13 +/ 1.86 at 8 weeks and 15.21 +/- 2.46 hours at 12 weeks after the injection. The mean antipyrine half-life in the 5 long term users of injectable progestagen was 14.21 +/- 2.53 hours compared with 13.66 +/- 0.98 hours in non-users. The results of this study suggest that - in contrast to published data on combined oral contraceptives - neither short nor long term use of parenteral norethisterone enanthate in Indian women is associated with significant alterations in antipyrine clearance. PMID- 3956053 TI - Amitriptyline metabolism: association with debrisoquin hydroxylation in nonsmokers. AB - Eleven healthy nonsmokers with wide variation in the ability to hydroxylate debrisoquin (D) were given single oral doses of amitriptyline and nortriptyline on different occasions. The urinary D/4-hydroxy-D ratio correlated significantly (P less than 0.01) with all three parameters of amitriptyline disposition measured (total plasma clearance, clearance by demethylation, and clearance by pathways other than demethylation), with rs = -0.89, -0.78, and -0.83, respectively. In contrast, we failed to demonstrate such correlations in a previous sample of smokers. Our data suggest that there may be a common regulation of the hydroxylation of D and the oxidative metabolism of amitriptyline in nonsmokers. It is hypothesized that an additional demethylase/hydroxylase is induced in smokers that is not involved in D hydroxylation. PMID- 3956052 TI - Comparison of four beta-blockers as assessed by 24-hour ECG recording. AB - beta-Blockers are used as if they were equivalent. With ECG recordings in 42 patients we investigated the effect on sinus heart rate of four beta-blockers given at three successive daily doses. Heart rate was dose-dependently decreased by all drugs except acebutolol, the effect of which decreased at a higher dosage. The maximal effects of metoprolol, nadolol, and propranolol were similar but the drugs differed in potency (dosage producing 50% of maximal effect, calculated from the dose-effect relationships; nadolol, 0.3 mg/day; metoprolol, 120 mg/day; propranolol, 47 mg/day). Similar relationships were found with drug plasma concentrations (concentration producing 50% of maximal effect: nadolol, 3.5 ng/ml; metoprolol, 21 ng/ml; propranolol, 36 ng/ml) and with supine or upright heart rates and blood pressures. However, the drugs were not equivalent: In addition to its greater potency, nadolol differed from propranolol and metoprolol in the slope of its dose-response curve. We conclude that beta-blockers can be compared by ECG recordings and that nadolol is different from the other beta blockers without intrinsic sympathomimetic activity. PMID- 3956054 TI - Metabolism of nomifensine after oral and intravenous administration. AB - The metabolism of nomifensine was studied after single oral and intravenous administration and after 2 weeks of oral dosing. The three principal metabolites reached maximum plasma concentrations rapidly (in 1 to 1.5 hours) after nomifensine administration. Less than 10% was detected as a free, unconjugated form. All three metabolites were eliminated rapidly (elimination t1/2 values between 6.8 and 9.0 hours). Only very low concentrations of free metabolites were found in plasma after 24 hours of nomifensine administration. AUC values for free metabolites were between 0.27 to 0.46 hr X mumol/L after all nomifensine schedules. Two weeks of dosing had no significant influence on the elimination t1/2 or AUC values of the metabolites, indicating no change in the hydroxylation and methylation reactions. In addition, there were no changes in the conjugation reactions during prolonged nomifensine dosing. Nomifensine has a very short t1/2 and no tendency for accumulation after repeated doses. We conclude that nomifensine's clinical pharmacokinetic profile is not significantly changed by the kinetic behavior of its three main metabolites after the usual maintenance doses. PMID- 3956055 TI - Disposition of nomifensine after acute and prolonged dosing. AB - The pharmacokinetics of nomifensine were studied after single oral and intravenous doses. The effect of prolonged oral dosing on the pharmacokinetics of nomifensine was also evaluated. Nomifensine was rapidly absorbed from the gastrointestinal tract. The peak concentration of free nomifensine (0.18 mumol/L) was reached at 1.13 hours after dosing. The highest concentration after the intravenous dose was 1.21 mumol/L. The elimination t1/2 after a single dose was about 4 hours regardless of the route of administration. Nomifensine was extensively distributed in body fluids and tissues, with an apparent volume of distribution of 8.69 L/kg. The AUC of free nomifensine after oral dosing was only 26.5% of that after intravenous infusion. Absorption from the gastrointestinal tract was complete, and the AUCs of total nomifensine were equal after all treatments. The main reason for limited bioavailability seems to be extensive first-pass metabolism during the absorption process. The AUC of free nomifensine decreased substantially (from 0.78 to 0.32 hr X mumol/L) and the elimination t1/2 was shortened (from 4.39 to 2.11 hours) after a 2-week dosing period. These effects suggest marked induction of the metabolizing enzymes. An increase in nomifensine dosage may be needed in some patients to maintain a full therapeutic effect. PMID- 3956056 TI - Cardiovascular effects of enprofylline and theophylline. AB - The cardiovascular effects of enprofylline (with no adenosine receptor antagonism) and of theophylline (with adenosine receptor antagonism) were compared in six normal subjects in a double-blind trial at steady-state concentrations of theophylline (12.5 +/- 1.6 mg/L) and enprofylline (2.7 +/- 0.3 mg/L). The mean (+/- SD) recumbent heart rate (HR) was higher (P less than 0.04) after enprofylline (70 +/- 14 bpm) than after theophylline (58 +/- 13 bpm) or saline solution (57 +/- 10 bpm). Forearm arterial resistance determined by plethysmography was lowered (P less than 0.01) by theophylline (-37% +/- 14%) and enprofylline (-43% +/- 24%) but not by saline solution (-6% +/- 16%). In the semiupright position, the mean arterial pressure was lower (P less than 0.01) after enprofylline (93 +/- 15 mm Hg) than after theophylline (108 +/- 16 mm Hg). The cardiac index (CI) and left ventricular ejection fraction (LVEF) determined by radionuclide angiocardiography and the left ventricular end-systolic pressure/volume ratio were not different for any regimen. During maximal exercise, HR was higher (P less than 0.01) after both enprofylline (176 bpm) and theophylline (175 bpm) than after saline solution (161 bpm), but the increases in mean arterial pressure (18% to 32%), CI (153% to 167%), and LVEF (34% to 74%) were similar for all three regimens. Both theophylline and enprofylline lowered forearm arterial resistance without an increase in CI, LVEF, or cardiac inotropy, although enprofylline tended to cause a lower blood pressure and higher HR than did theophylline. PMID- 3956057 TI - Salsalate kinetics in patients with chronic renal failure undergoing hemodialysis. AB - A 1500 mg dose of salsalate (SSA) was given to five patients undergoing chronic hemodialysis on an interdialytic day and again before dialysis. Compared with control subjects, patients undergoing dialysis had a lower peak plasma SSA level (17 +/- 3 vs. 45 +/- 2 micrograms/ml; P less than 0.01) that occurred slightly later. In contrast, plasma salicylic acid (SA), the active SSA metabolite, had a similar but later peak level that remained substantially higher. Therefore, the AUC for SA was increased by 50% and the SA t1/2 was prolonged in the patients receiving dialysis (8.1 +/- 0.7 vs 3.8 +/- 0.2 hours; P less than 0.01). During a single treatment, dialysis clearance reduced plasma SA levels, removed 18% of total body SA, and returned the SA t1/2 to nearly normal. Because the elimination of SA is impaired in patients undergoing dialysis, the interdialytic SSA dosage should be reduced. Hemodialysis improves SA kinetics and may be followed by a normal SSA replacement dose. However, periodic monitoring of plasma SA levels is recommended when SSA dosing is begun in patients receiving dialysis. PMID- 3956059 TI - Present status and future directions of clinical pharmacology. PMID- 3956058 TI - Marked alterations in dose-dependent prednisolone kinetics in women taking oral contraceptives. AB - Six healthy women chronically (greater than 6 months) using oral contraceptives were age- and weight-matched with female controls. Each subject received prednisolone, 0.53 and 0.14 mg/kg iv. In the subjects taking oral contraceptives there were significant decreases in total clearance, unbound clearance, and volume of distribution at steady state for total drug, and significant increases in total and unbound prednisolone t1/2 and hydrocortisone concentrations compared with control subjects at both the high and low prednisolone doses. Both the oral contraceptive group and the control group had significantly higher total clearance, volume of distribution for total drug, and unbound fraction for the high dose compared with the low dose. Data suggest that chronic low-dose contraceptive steroid use results in a marked decrease in prednisolone clearance; however, dose-dependent changes in kinetics are still observed. PMID- 3956060 TI - Symposium: The Anglo-American Workshop on Clinical Pharmacology. Airlie, Virginia, May 15-18, 1984. PMID- 3956061 TI - A description of clinical pharmacology and the clinical pharmacologist. PMID- 3956062 TI - The public need for clinical pharmacology in the United Kingdom. PMID- 3956063 TI - The public need for clinical pharmacology in the United States. PMID- 3956064 TI - Current status of clinical pharmacology in the United Kingdom. PMID- 3956066 TI - Clinical pharmacologists for the future in the United Kingdom. PMID- 3956065 TI - Current status of clinical pharmacology training in the United States. PMID- 3956067 TI - Clinical pharmacologists for the future in the United States. PMID- 3956069 TI - Academic pursuits in clinical pharmacology. Research emphasis. PMID- 3956068 TI - Clinical pharmacology teaching, training and career development. PMID- 3956070 TI - Health care and patient services. PMID- 3956071 TI - Present status and future directions of clinical pharmacology: fiscal support. PMID- 3956072 TI - Metal metabolism and disease. National Academy of Clinical Biochemistry. 9th annual meeting. Atlanta, Ga., July 19-20, 1985. PMID- 3956073 TI - Selenium metabolism and function. AB - Selenium like many other elements has a bimodal effect. At lower concentrations selenium is an essential trace element necessary for the growth of man and animals. However, at higher concentrations, selenium has toxic properties for man and animals. The biochemistry of selenium as a component of glutathione peroxidase and the analytical properties of selenium are also outlined. PMID- 3956075 TI - Advances in burn care. PMID- 3956074 TI - Iron overload syndromes. AB - Iron overload is relatively common and is now detected more frequently because of inclusion of serum iron measurement in automated clinical chemistry panels. Secondary hemosiderosis and hemochromatosis result from increased iron absorption associated with increased erythropoiesis compensating for hemolysis, increased dietary iron, inappropriate prolonged oral iron therapy or chronic multiple transfusions. Primary hemochromatosis is a genetic metabolic disorder associated with the HLA locus on chromosome 6 resulting in increased iron absorption, though erythropoiesis and dietary iron are normal, and abnormal diversion of iron from reticuloendothelial (RE) to parenchymal cells. A genetic increase of intracellular iron carrier is a proposed basic mechanism. Only in the cirrhotic stage of primary hemochromatosis do RE iron and serum ferritin increase. Since both serum iron and serum ferritin may remain normal in the precirrhotic stage and may be falsely positive in the absence of iron overload, direct measurement of body iron stores is often useful. Measurement of tissue iron in liver biopsy specimens is widely used. However, quantitation of total mobilizable body iron by measurement of a 6-hour urine collection after intravenous injection of 59Fe-DTPA is noninvasive, sensitive, relatively accurate, and together with other laboratory and clinical data provides a practical means of establishing the correct diagnosis and therapy early enough to minimize organ damage. PMID- 3956077 TI - Composite tissue transfer in burn patients. AB - The advent of microsurgery has presented many advantages to the reconstructive surgeon in the treatment of burns and their resultant deformities. The skilled microsurgeon has a vast armamentarium from which to choose. The best method of reconstruction requires a thorough knowledge of flap alternatives and careful patient individualization. Five clinical cases are presented. PMID- 3956076 TI - The care of burned upper extremities. AB - Two sets of factors will ultimately influence the outcome of the burned upper extremity. The first set of factors is the depth and severity of the burn. The second set is the group of complications of the burn injury attributable to edema, inflammation, immobility, and malposition. An awareness of the potential pitfalls that follow burn injury has resulted in improved primary care and a lessening of deformity. Progressive acute care with topical chemotherapy, early motion, thoughtful splinting, and timely burn wound closure are essential to reduce the need for secondary operations. Reconstructive efforts should be tailored to the individual needs of the patient. These procedures should be carefully planned with a view toward balancing aesthetic and functional considerations and minimizing the time required for rehabilitation. PMID- 3956078 TI - Rehabilitation of the burn patient. AB - A successful outcome to the management of the significantly burned patient requires a team approach. Although at one time survival alone was considered a sufficient indicator of success, the quality of that survival now must be closely assessed prior to self-congratulations. The burn team, in addition to the usual medical personnel, requires occupational and physical therapy, as well as rehabilitation medical specialists, whose goals are to preserve function and restore independence. Burn care that does not emphasize these goals from the first day of injury, and extended well beyond initial discharge from the hospital, does not match contemporary standards of excellent care. PMID- 3956079 TI - Horizons in burn care. AB - The renaissance of burn care began during World War II. From 1960 to the present there has been a rapid advance in burn medicine that has resulted from a better understanding of the emotional, physical, and physiologic problems occurring in the severely burned individual. Now, even the most severely burned have an excellent chance of returning to a functioning, useful place in society. We foresee continued improvements in the organization and delivery of burn care and the results therefrom. PMID- 3956080 TI - Monitoring of the burn patient. AB - Technologic advances have made routine use of some form of monitoring mandatory in modern burn care. Nevertheless, not all patients require all forms of monitoring. Patients with minimal burns require only minimal monitoring (vital signs, 24-hour urine output, biochemical and hematologic profile). Larger burns, associated injuries, or underlying disease necessitate more aggressive monitoring and may justify invasive monitoring with its attendant risks of infection. Very large burns, severe cardiac dysfunction, and inhalation injury mandate vigorous invasive monitoring including pulmonary artery catheters. PMID- 3956081 TI - Respiratory care of the burn patient. AB - The vast majority of respiratory disorders in thermally injured patients arise from associated inhalation injuries. The major forms of these injuries are carbon monoxide poisoning, injury to the upper airway, and pulmonary parenchymal damage. One hundred per cent oxygen, initiated at the scene of the accident, is the single most effective treatment of carbon monoxide toxicity, which must be assessed by carboxyhemoglobin determinations. Respiratory tract damage is identified by fiberoptic bronchoscopy and xenon ventilation-perfusion scintigrams. The compromised airway is protected by tracheal intubation, and respiratory failure is treated with assisted ventilation and supplemental oxygen. Pulmonary infection requires specific antibiotics based on isolated organisms and their sensitivities to antimicrobials. The upper respiratory tract of patients requiring long-term intubation should be assessed by fiberoptic bronchoscopy and other modalities to prevent fatal late airway occlusion. PMID- 3956082 TI - Infection control in burn patients. AB - The article primarily deals with infection control practices relating to the burn patient. Burn infections have an endogenous origin rather than an exogenous one. Infection control practices are similar to routine infection surveillance but are also distinctly different. PMID- 3956083 TI - Electrical burns. AB - Electrical injury is unlike other burns because of extensive local destruction of tissue at the points of entrance and exit. Artz likened it to a severe muscle crush injury, whereas Hunt showed that the deep-tissue loss is secondary to extremely high temperatures from resistance of the tissues (skin and bone) to the passage of electric current. Although Joule's equivalent explains the heat exchange (often in thousands of degrees of centigrade) with many variables to be considered, it is usually the voltage that can be determined and probably is the most important factor. High tension (more than 1000 volts) and low tension (less than 1000 volts) and direct and indirect currents all exert differing effects. Arc burns can occur without the patient contacting the electrical source but can be quite destructive. Electrical injury can affect many organ systems, depending on the path of the current. The volume conductor theory explains why extremity burns are much worse than torso burns and why extensive debridement (particularly of periosseus muscle) is usually necessary. The progressive destruction of tissue is probably best explained by small vessel occlusion and possibly also by elevated levels of arachidonic acid in areas of greatest heat production. Antithromboxane agents have halted the progression in experimental animals; muscle biopsies and an increased uptake of technetium Tc 99m pyrophosphate help to determine nonviable tissue that must be debrided. Resuscitation must be aggressive to provide adequate circulatory volume. Normal vital signs should be maintained along with a urine output of 100 ml per hour to overcome the destructive renal tubular effect of myoglobin and hemoglobin products. Control of sepsis and its complications through aggressive wound management is critical for survival. Long-term problems from electrical injury are possible, and efforts at prevention may save life and limb. PMID- 3956084 TI - Nonsurgical management of burns to the lips and commissures. AB - Our results indicate that the nonsurgical approach in the treatment of burns of the mouth should be considered. The nonsurgical approach is less costly and less traumatic, and it yields a favorable result that is shown to be predictable. PMID- 3956085 TI - Evaluation of blood glucose measurement techniques: locating sources of error. AB - Researchers evaluating the accuracy of rapid blood glucose monitoring (RBGM) techniques have often concluded that RBGM was sufficiently accurate for clinical use. However, investigators of patients' use of RBGM have more often reported unacceptable levels of accuracy and have shown individual differences between patients in the level of accuracy attained. Responsibility for excessive errors has commonly been attributed to patients' inadequacy in using RBGM. The logic of such attributions is questioned. Data are presented which indicates that errors attributed to patient inaccuracy may actually be due to (a) inaccuracy of reference blood glucose determinations used to evaluate patients' accuracy and (b) variable accuracy of RBGM techniques dependent on the range of blood glucose levels: some patients may appear to be less accurate than others simply because their blood glucose levels fall into a range less accurately measured by the RBGM technique. Furthermore, data presented reveal batch to batch variation in accuracy of the particular reagent strips used. Such variation between batches may help to account for inconsistencies between RBGM evaluation studies in which apparently identical reagent strips were used. PMID- 3956087 TI - Change, challenge and responsibility in medicine. PMID- 3956086 TI - Immunoregulatory leucocyte subset typing and PHA response in relation to the nutritional state in cancer patients with gastrointestinal neoplasia. AB - Cancer patients are frequently immunodepressed and this could be related to undernutrition, particularly in gastrointestinal (GI) neoplasia. We therefore looked for correlations between different leucocyte subsets' (T11+, T4+, T8+, B1+, and Mo2+) cells in the peripheral blood of these patients and their nutritional state. Significant alterations were found in absolute number/ml of T11+, T4+, B1+, and Mo2+ cells. Malnourished cancer patients were more affected than those appearing well-nourished, exhibiting a decrease of 50% in the number of T11+, T4+, and B1+ cells as compared with healthy controls. The phytohemagglutinin A (PHA) stimulation index (SI) was also significantly decreased in the malnourished group. Linear regression analysis between SI and these leucocyte subsets revealed that only the T4+ cells offered a significant correlation (r = 0.6169 p less than 0.01). These results suggest that the absolute number/ml of T4+ cells reflects the nutritional state of patients bearing GI tumors. PMID- 3956088 TI - Direct multiplanar computed tomography in planning radiotherapy for malignant tumours of the nasopharynx. AB - A method of direct computed tomography (CT) scanning for planning radiotherapy of malignant nasopharyngeal tumours is described. Direct multiplanar CT scanning is the imaging method of choice for the diagnosis and definition of the target volume of these tumours. The patient is positioned for treatment precisely as for direct axial model CT. By integrating the information generated by high definition scout views, direct axial mode, and, occasionally, direct coronal mode CT, the anatomical points of reference are identified. These are then translated to the surface anatomy of the patient to define the fields accurately prior to radiotherapy treatment. PMID- 3956089 TI - The value of lymphography in the management of carcinoma of the cervix. AB - Lymphography has been used to evaluate the pelvic and para-aortic nodes in 205 patients with carcinoma of the cervix treated between 1970 and 1979. The incidence of positive nodes was found to be 17% for Stage I, 24% for Stage II, 52% for Stage III and 100% for Stage IV. Of 73 patients who had lymphograms before Wertheim's hysterectomy, four out of 59 patients (7%) with negative lymphograms had histologically positive nodes; four out of 14 (28%) with positive lymphograms had negative nodes. Within each FIGO stage a positive lymphogram indicated a poor prognosis. The actuarial 5-year survival rates for patients with negative and positive lymphograms were 94% and 55% respectively for Stage I, 72% and 64% for Stage II, and 34% and 17% for Stage III. Of 39 patients with positive lymphograms who died of tumour, 31 out of 39 (80%) had distant metastases, compared with nine out of 29 patients (31%) with negative lymphograms. It is concluded that lymphography is a valuable method of evaluating lymph node status in carcinoma of the cervix. PMID- 3956090 TI - Improved control of primary vaginal tumours by combined external-beam and interstitial radiotherapy. AB - In 20 years we have seen only 78 cases of primary vaginal cancer. 61 patients had squamous carcinoma, three had adenocarcinoma, 10 had clear-cell carcinoma, four of which may have been metastatic from carcinoma of the kidney, and four had malignant melanoma. The actuarial 5-year survival of patients with squamous cancer was: Stage I, 68%; Stage II, 34%; Stage III, 29% and Stage IV, 14%. Patients treated by combined external and intracavitary or interstitial radiotherapy had increased local control and superior survival to those treated by interstitial methods alone. The improved tumour control offered by combination treatment may be due to the elimination of small tumour deposits in lymph nodes within the treated volume and the sterilisation of carcinoma in situ in the vagina some distance from obvious tumour. PMID- 3956091 TI - An afterloaded applicator for the interstitial irradiation of brain tumours. AB - A stereotactically implanted afterloaded system for the interstitial radiotherapy of brain tumours is described. The technique has the advantages of accuracy of dosimetry, no radiation hazard in the operating theatre and ease of afterloading with a source which may be inserted and removed at will. Caesium-137 is used, but the system could equally well be used with other isotopes. PMID- 3956092 TI - The daily reproducibility of large, complex-shaped radiotherapy fields to the thorax and neck. AB - A series of patients treated with complex fields to the thorax and neck utilising individually tailored shielding blocks made from low-melting-point alloy (LMPA), were investigated using treatment verification film to identify field placement errors. A total of 19 patients yielded 171 machine verification films, which were analysed. It was found that on 21% of occasions the intended treatment volume was partially shielded, by more than 1 cm, by the lead blocks prescribed to protect the lungs. On half of these occasions (11% of the total), the areas erroneously shielded contained known disease. Suggestions are made for minimising such errors in the future. PMID- 3956093 TI - An investigation into the daily reproducibility of patient positioning for 'mantle' treatments. AB - Three patients treated for Hodgkin's disease by mantle radiotherapy have been studied in detail to quantify day-to-day variation in treatment position. The value of routine treatment verification films is again emphasised, this time to avoid underdosage or overdosage at field junctions in any subsequent treatment. PMID- 3956094 TI - Systemic radiation and split-course radiotherapy for non-small-cell bronchial carcinoma. AB - One hundred and thirty-eight patients with inoperable non-small-cell bronchial carcinoma, Stage III, have been treated with systemic radiation and radical radiotherapy by a split-course technique. Systemic radiation has been used as an adjuvant therapy to deal with micrometastases or subclinical disease. A historical comparison has been made with a similar group of patients treated radically by split-course radiotherapy alone. It is shown that the incidence of distant metastases has decreased and the disease-free survival rate has improved. There were 26% of patients who survived 4 years disease-free, as compared with 7% in the group where no systemic radiation therapy was given. In view of a higher incidence of brain metastases and radiation pneumonitis, the technique and dosage of systemic radiation therapy have been modified. PMID- 3956095 TI - Unexpected anterior urethral diverticula. AB - Most anterior urethral diverticula present in infancy with urinary obstruction or retention. When they present after infancy they do so with recurrent urinary tract infections or dribbling of urine. Three boys with late-presenting diverticula are described. Unless good oblique radiographs are specifically taken, with a fast flow, then the diagnostic arcuate filling defect of the proximal lip of the diverticulum can be missed. There may be few signs of obstruction. With diagnostic radiographs the urologist must be urged to repeat a negative cystoscopy. Diverticula must be differentiated from strictures or acquired diverticula following trauma. PMID- 3956096 TI - Radiological assessment of aluminium-related bone disease. AB - Two hundred and fifty-nine radiological skeletal surveys were reviewed in 67 cases of end-stage renal failure. Fractures were identified in 16 patients, of whom 12 (17.9% of total) had aluminium-related bone disease. Moderate or severe fracturing osteopathy with more than five fractures not explained by trauma was 100% specific for aluminium intoxication. It is sufficient to perform radiological skeletal surveys in the assessment of renal osteodystrophy annually. They should include radiographs of the fingers, a lateral view of the lumbar spine and oblique views of the ribs. The primary aim of reporting on such surveys should be to grade the severity of fracturing osteopathy and of subperiosteal erosions. PMID- 3956097 TI - Computed tomography in spinal trauma. AB - In a retrospective study of 65 patients with spinal trauma, computed tomography was found to add to plain radiography clinically relevant information in 47 patients. It was most helpful in identifying unsuspected neural arch fractures and in assessing spinal canal narrowing. Computed tomography is of great value in pretreatment evaluation and in follow-up of the patient with significant spinal trauma. PMID- 3956098 TI - The radiological appearance of the post-Caldwell-Luc maxillary sinus. AB - A review of the radiographic findings in 19 patients who had undergone unilateral or bilateral Caldwell-Luc procedures for chronic maxillary sinusitis revealed improvement in the radiographic appearance of the sinuses in 13 and lack of improvement, progression or recurrence of disease in six. Eight of the patients had changes which could be attributed directly to surgery. These included fibro osseous proliferation in five, antral contraction in four and compartmentalisation in two. Follow-up studies, including pluridirectional tomography and computed tomography, can reliably distinguish post-operative changes from recurrent disease in the patient who has undergone this type of radical maxillary antrostomy. PMID- 3956099 TI - Irritable bowel syndrome: is a barium enema necessary? AB - A retrospective analysis was made of 114 new patients attending a gastroenterology clinic, in whom the initial clinical diagnosis was irritable bowel syndrome. Barium enemas were performed in 84 patients (74%), 15 of whom were found to have significant other disease. In each case this would have been suspected from the routine haematological and biochemical screening tests. It is suggested that, in the investigation of patients under 50 years of age presenting to a gastroenterology clinic with a typical history of irritable bowel syndrome, a barium enema should only be performed if the clinical examination, sigmoidoscopy, rectal biopsy or routine blood tests are abnormal. This policy would reduce substantially the number of normal barium enemas performed. PMID- 3956100 TI - Barium enema after biopsy: current practice and opinion. AB - Current research shows that sigmoidoscopy or endoscopy together with a superficial mucosal biopsy taken with a fibreoptic-type instrument should not delay the subsequent performance of a barium enema. Rigid biopsy instruments are less controllable and may take 'deep', full-thickness bites when superficial biopsies are attempted. After such a biopsy, an enema should be delayed at least 7 days to allow re-epithelialisation. Neither of these two approaches is common practice as shown in our survey of British radiologists and clinicians. The radiologist should be responsible for performing the barium enema but the survey shows that there is a difference of opinion over who should be responsible for any complications arising from it. Close contact between the referring clinician and radiologist should be maintained at all times. PMID- 3956101 TI - Magnetic resonance imaging of the pituitary gland. AB - Magnetic resonance imaging (MRI) was performed on 22 patients with a wide spectrum of pituitary disease and on 17 control subjects, in order to determine whether MRI is useful in localising and determining the extent of involvement of large and small pituitary tumours. The results indicate that MRI, with an 0.5 T superconducting magnet (Elscint, Israel), can be used to visualise large pituitary tumours and to determine the extent of parasellar and suprasellar involvement. The 'empty sella' syndrome can also be easily and confidently diagnosed. Some microadenomas can be visualised despite the relatively thick slices (0.7 cm) used in this study. These findings suggest that MRI in its current state of development is very useful in evaluating large pituitary lesions. With further technical refinements, improving the spatial resolution and decreasing slice thickness, this technique may come to be of some importance in the evaluation of pituitary microadenomas. PMID- 3956102 TI - Case report: Erdheim-Chester disease: polyostotic sclerosing histiocytosis. AB - Erdheim-Chester disease is characterised by diffuse metaphyseal and diaphyseal sclerosis of long tubular bones of the appendicular skeleton. In addition, there is an inconstant tendency to visceral involvement by lipo-granulomatous infiltration. Histologically, this condition has marked similarities to Hand Schuller-Christian disease. A further case is presented which supports the view that Erdheim-Chester disease is part of the spectrum of histiocytoses and not a distinct pathological entity. Polyostotic sclerosing histiocytosis would be an appropriate alternative label for this condition. PMID- 3956103 TI - Case report: adrenal haemangioma coexisting with malignant haemangioendothelioma. AB - A 71-year-old man presented with an unusual adrenal tumour. Computed tomography and echography showed a large, necrotic mass with multiple calcifications. Preoperative angiography demonstrated pooling of contrast medium within the mass, strongly suggestive of a diagnosis of haemangioma. PMID- 3956104 TI - Borderline maintenance of erythrocyte 2,3-diphosphoglycerate concentrations in normoxic type 1 (insulin dependent) diabetic subjects. AB - Erythrocyte 2,3-diphosphoglycerate and haemoglobin A1c concentrations were measured in 26 clinically normoxic patients with type 1 (insulin dependent) diabetes mellitus. The concentration of 2,3-diphosphoglycerate theoretically required to maintain normal erythrocyte oxygen delivery function in each subject was calculated and compared with the measured concentrations. In the majority of diabetic patients 2,3-diphosphoglycerate concentrations were sufficient to keep the erythrocyte oxygen dissociation curve within the normal range under otherwise normal blood conditions. There was, however, a minority of patients in which this was not true. It is concluded that the increased erythrocyte 2,3 diphosphoglycerate concentrations in clinically normoxic diabetic subjects are generally less than compensatory for the effect of haemoglobin A1c formation on the haemoglobin-oxygen dissociation curve. PMID- 3956105 TI - The measurement of breathlessness induced in normal subjects: individual differences. AB - Normal subjects show wide variability in their sensory scaling of breathlessness for equivalent degrees of ventilatory stimulation and behave "characteristically' irrespective of stimulus type. Observed differences are not explained by physical characteristics, ventilatory sensitivity or pattern of breathing although there is a weak association with the degree of physical fitness. Differences are seen when scaling is performed with reference to both rigidly defined extremes of breathlessness (visual analogue scaling) and a subject's own relative changes in the intensity of this sensation (magnitude estimation). These findings may explain the common observation, in patients with respiratory disease, of dyspnoea out of proportion to the pathophysiological state. PMID- 3956106 TI - Abnormalities of peripheral venous tone in women with pregnancy-induced hypertension. AB - Forearm venous tone was measured in two groups of pregnant women: one group with pregnancy-induced hypertension and the other group with normal blood pressure. The women with pregnancy-induced hypertension were venoconstricted in the forearm (P less than 0.01) compared with the pregnant women with normal blood pressure. However, there was no difference in venous tone between the women with pregnancy induced hypertension and non-pregnant women. There was an inverse correlation between mean arterial blood pressure and forearm venous tone (r = -0.581, P less than 0.001) for all the pregnant women studied. Further evaluation of peripheral venous tone may provide valuable information about the pathophysiology and treatment of women with pregnancy-induced hypertension. PMID- 3956107 TI - Haemodynamic effects of vasopressin in man are related to posture. AB - Ten healthy volunteers received intravenous infusions of arginine vasopressin (AVP) at 0.1 m-unit min-1 kg-1 and 5% D-glucose on separate days. AVP caused a small fall in forearm blood flow and small rises in mean arterial pressure and systemic vascular resistance. Cardiac output was unaffected. When subjects were tilted to 50 degrees the fall in forearm blood flow was much greater, mean fall being 44.8% with AVP compared with 18.2% with D-glucose. Cardiac output also fell significantly more with AVP, and diastolic pressure, mean arterial pressure and systemic vascular resistance rose significantly more on tilting during AVP infusion than with D-glucose. Six of the same volunteers were given sequential infusions of 'low dose' (0.0125 m-unit min-1 kg-1) and 'high dose' (0.3 m-unit min-1 kg-1) AVP on a third occasion. Tilting still produced a mean fall in forearm blood flow of 41.2% during low dose infusion, despite a mean plasma AVP level of only 1.9 pg/ml, which is well within the physiological range. When the AVP concentration was increased 24-fold to the high dose, forearm blood flow fell only a further 8.8%. The low dose infusion was also associated with a marked fall in cardiac output on tilting and a rise in systemic vascular resistance. We conclude that AVP has profound haemodynamic effects in man at physiological concentrations. Although these effects are modest in the supine position, they become marked on tilting, suggesting a possible role for AVP in the postural control of blood pressure. PMID- 3956108 TI - Age-dependent blood pressure response to increased salt intake in rats influenced by a transient renal ischaemia. AB - The influence of renal dysfunction (induced by ischaemic injury) on the development of salt hypertension was studied in rats which were exposed to 60 min of renal ischaemia when either immature or adult. Saline-drinking age-matched animals served as controls. The blood pressure, plasma urea concentration, extracellular fluid volume (ECFV) and renal mass were measured 21 and 50 days after renal ischaemia. Increments of plasma urea concentration and ECFV were considered to be indicators of renal dysfunction. Increased renal mass was used as an estimate of the degree of renal injury. In adult rats, both plasma urea concentration and ECFV were increased 3 weeks after renal ischaemia. This correlated with a pronounced increase of renal mass. A similar relation of renal mass to ECFV was still present 50 days after renal ischaemia. In rats treated when immature the increment of plasma urea concentration was much smaller and ECFV did not differ significantly from the control volumes. A mild salt hypertension developed only in those rats which were treated when immature. On the other hand, the blood pressure tended to decrease in animals treated when adult. It is concluded that mild renal dysfunction facilitates the development of salt hypertension in immature rats. This is in contrast with the reversed effects of extensive renal dysfunction in adult animals. It is suggested that the age of animals is more important for the induction of salt hypertension than the degree of renal dysfunction. PMID- 3956109 TI - Contribution of vasopressin to the maintenance of blood pressure in deoxycorticosterone-salt induced malignant hypertension in spontaneously hypertensive rats. AB - In the present study, deoxycorticosterone (DOC) and salt was administered to Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) by using silicone-rubber implants (DOC acetate, 100 mg/kg) and 0.9% NaCl as drinking water. SHR treated with DOC-salt for 4 weeks showed the characteristics of malignant hypertension including marked increases in blood pressure and left ventricular weight with typical histological changes in the kidney. DOC-salt treatment increased plasma vasopressin levels in WKY (from 6.1 +/- 0.5 to 8.9 +/- 0.8 pmol/l) but significantly more in SHR (from 5.0 +/- 0.6 to 15.8 +/- 1.2 pmol/l). Intravenous administration of the specific antagonist to the pressor effect of vasopressin, d(CH2)5Tyr(Me)AVP (10 micrograms/kg), decreased mean arterial pressure of DOC-salt treated WKY and SHR by 6.6 +/- 0.9 mmHg (P less than 0.05) and 9.7 +/- 1.7 mmHg (P less than 0.05) respectively. DOC-water treatment also increased plasma AVP levels in SHR to 10.5 +/- 0.8 pmol/l, but the vasopressin antagonist had little effect on blood pressure in these rats. Plasma levels of vasopressin were significantly correlated with both mean arterial pressure (r = 0.64) and left ventricular weight (r = 0.74). This suggests a close relationship between plasma AVP and severity of hypertension. The results of the present experiment demonstrate that vasopressin is part of the overall pressor mechanism which contributes to the maintenance of blood pressure in DOC-salt induced malignant hypertension in SHR, but the small fall in pressure produced by the AVP antagonists suggests that the contribution is of only minor importance. PMID- 3956110 TI - Cardiovascular and metabolic responses to low dose adrenaline infusion: an invasive study in humans. AB - Cardiovascular and metabolic responses to intravenous infusions of adrenaline (ADR), which raised arterial plasma ADR in a stepwise fashion from 0.3 to 1.3, 2.3 and 6.0 nmol/l, were studied in 11 healthy volunteers. ADR evoked marked and concentration-dependent increases in stroke volume and cardiac output (thermodilution), as well as decreases in the vascular resistances of the systemic circulation, calf and adipose tissue. These changes were significant from 1.3 nmol/l ADR. Less marked effects were found on blood pressure and heart rate. Significant arterial ADR concentration-effect relationships were found for cyclic AMP, glycerol, glucose, lactate and noradrenaline, but not for insulin. Cyclic AMP and glycerol were significantly elevated at 1.3, glucose at 2.3, but lactate not below 6.0 nmol/l ADR. Increases in adipose tissue blood flow and arterial glycerol levels were correlated (P less than 0.001), suggesting a metabolic component in the blood flow response of adipose tissue. Invasive haemodynamic measurements revealed that ADR at arterial concentrations within the lower physiological range had considerable effects on cardiac output and vascular resistances, despite moderate changes in the conventional non-invasive haemodynamic variables blood pressure and heart rate. ADR elicited clear-cut responses at arterial plasma concentrations attained during various kinds of mild to moderate stress. PMID- 3956111 TI - Activation of human muscle pyruvate dehydrogenase with activity and immobilization. AB - The activity of pyruvate dehydrogenase (PDH) was measured in samples of triceps muscle obtained in 15 males, before and after immobilization for 5 weeks and 5 months of strength training carried out in random order with cross-over of treatment. Although the total PDH activity was unchanged at 300 nmol min-1 g-1, the proportion in the active form increased after strength training (62 +/- 10.1%) and decreased after immobilization (12 +/- 2.3%) compared with control (36 +/- 3.4%). In six subjects measurements were repeated after 10 min maximal exercise (arm ergometer). The proportion of PDH in the active form increased least after immobilization (to 52 +/- 13.6%), compared with control (95 +/- 11.7%) and post-training (98 +/- 6.6%). After exercise muscle glycogen fell to the greatest extent and lactate rose the least in the post-training state, with opposite findings post-immobilization, suggesting that PDH activation contributes to the control of lactate formation in muscle during heavy exercise, and that the effects of training and immobilization are mediated at least in part through changes in the activation of this regulatory enzyme. PMID- 3956112 TI - Plasma adrenaline measurements. PMID- 3956113 TI - Are orthostatic hypotension and impaired blood pressure control common features of the alcohol withdrawal syndrome? PMID- 3956114 TI - Wegener's granulomatosis with bilateral necrotizing scleritis, polyarthritis and renal failure efficiently treated with immunosuppressive therapy. AB - A case report of a female patient with Wegener's granulomatosis is presented. After an initial involvement of the upper respiratory tract in the form of a sinusitis, there followed a severe necrotizing bilateral scleritis necessitating the enucleation of the left eye ball. Renal involvement developed as late as 24 months after the onset of the disease and led to renal failure within three months. Throughout the duration of her disease, the patient had joint symptoms in the form of episodes of migratory nondeforming polyarthritis. The administration of corticosteroids alone in daily doses up to 60 mg prednisone failed to control the progression of the disease, while immunosuppressive therapy with cyclophosphamide combined with methylprednisolone pulse therapy and haemodialysis resulted in a marked improvement of renal function and in the subsidence of the ocular and articular symptoms. PMID- 3956115 TI - Influence of previous gold treatment and other patient variables on outcome of treatment with disease modifying anti-rheumatic drugs (DMARD) in patients with rheumatoid arthritis. AB - Based on a 2-year controlled double-blind trial of levamisole, penicillamine, and azathioprine (L, P, and A), a computer aided search for predictive factors of outcome was instituted. Already at month 4 several indicators of synovitis activity were able to discriminate between patients staying in the trial for 24 months and patients whose treatment was discontinued before that time. Patients who had previously received gold therapy responded less favourably to L, P, and A than those who had not received gold. This reduction of response was more pronounced in gold resistant patients than in patients whose gold treatment had been discontinued for other reasons. The only phase protein (of several) with a predictive value was haptoglobin. If, after 4 months of treatment, haptoglobin did not normalize, this finding indicated a lack of response to treatment or a deterioration of synovitis activity during the following 4 months. The response to treatment was not influenced by HLA-types, sex, age, or clinical synovitis, disease duration, functional or anatomical aberrations at the start of treatment. The shape of the response curve as reflected by means of monthly measurements of serum-albumin and ESR was not related to disease duration, HLA-types, or previous gold treatment. PMID- 3956116 TI - A double-blind study on the effect of discontinuation of gold therapy in patients with rheumatoid arthritis. AB - To assess the benefit of further gold treatment of rheumatoid arthritis (RA) patients who had already received more than 6 g of this metal, 24 such patients were included in a double-blind trial. Besides this "gold group" comprising 11 patients who received gold (Auromyose) in the same dosage schedule as before the study, the trial included a "placebo group" comprising 13 patients who received gold in a suspension diluted 1/100. In either group clinical, laboratory, and radiological data did not differ after 6 and 24 months in relation to the results at entry except for the serum gold concentrations, which were lower in the placebo group. We conclude that discontinuation of the treatment in RA patients who have received more than 6 g gold is not harmful to the patients for at least two years after withdrawal. PMID- 3956117 TI - Multisystemic disease with intracranial hypertension and autoimmune cytopenia in chronic active hepatitis. AB - A 14-year-old girl with postinfectious chronic hepatitis developed a life threatening autoimmune multisystemic illness with arthralgias, intracranial hypertension, Coomb's positive hemolytic anemia and hemorrhagic diathesis (due to antiplatelet and antifactor X antibodies). Mannitol and immunosuppressive therapy abolished acute symptoms. During the first year of follow-up, two attempts of decreasing prednisone below 15 mg/day caused recurrence of the hemolytic anemia and appearance of low titer antinuclear antibodies, while doses above 15 mg/day caused an increase in transaminase levels. Daily prednisone dose was therefore fixed at 15 mg. The patient was well and, although signs of mild hemolysis persisted, there was no anemia. Transaminases were found greatly elevated on two occasions. An autoimmune multisystemic steroid sensitive disease was seemingly initiated by a postinfectious steroid irresponsive chronic hepatitis. PMID- 3956118 TI - Pressure-diameter relationships of segments of human finger arteries. AB - Pressure-diameter relationships of segments of human finger arteries, aged 57-85 years, were measured in vitro. The arteries, obtained at autopsy within 48 h after death, were stored in glucose-free Tyrode at 4 degrees C. Experiments began within 40 h after autopsy. The diameter responses to various transmural pressure changes, with and without the addition of noradrenaline to the Tyrode solution in the specimen chamber, were compared with the responses of freshly excised rat tail arteries. In general, pressure-diameter relations of human finger artery segments were similar to those of rat tail artery segments, with a steep slope in the collapse region near zero pressure. Also, spontaneous rhythmic contractions and myogenic activity induced by high transmural pressures were similar to those observed in the fresh rat tail arteries. Human finger arteries, however, could contract to complete closure both spontaneously and after addition of noradrenaline, while rat tail arteries did not. The diameter changes of the arterial segments during forced 1 Hz oscillations of 20-50 mm Hg (2.7-6.7 kPa) amplitude superimposed on a mean transmural pressure were substantially smaller than those during quasi-steady inflation-deflation ramps over the same pressure range, indicating the presence of a strong viscous wall component. PMID- 3956119 TI - NMR characterisation of healthy rat tissues in vivo. AB - This study using healthy rats has shown that the prospects for quantitative tissue characterisation using NMR parameters are very encouraging. Imaging allowed the relaxation rates of six rat tissues to be obtained in vivo. On the same imaging system and using identical experimental conditions the variation in T**1 (T1 evaluated assuming a monoexponential decay) of a tissue across up to 20 rats of the same age, sex and species was less than 7%. When individuals of different ages, sex and strain were used a similar small variation was observed. Further, we believe that any inherent biological variation in T**1 and T**2 values has not yet been detected in our studies. PMID- 3956120 TI - Amitriptyline for pain of cortical origin. PMID- 3956121 TI - Orofacial dyskinesia induced by baclofen in a patient with hypothyroidism. PMID- 3956122 TI - Aminoglycoside pharmacokinetics in patients with spinal cord injury. PMID- 3956123 TI - Continuous infusion of metoclopramide for prevention of chemotherapy-induced emesis. PMID- 3956124 TI - Absorption of polyethylene glycol after administration of a PEG-electrolyte lavage solution. PMID- 3956125 TI - Salt substitute as potassium replacement in hypertensive patients. PMID- 3956126 TI - Rapid diagnostic tests for streptococcal pharyngitis. PMID- 3956127 TI - Treatment of I. belli enteritis in patients with AIDS. PMID- 3956128 TI - Reservoir aerosol delivery systems. PMID- 3956129 TI - Pharmacokinetics of endotracheally administered lidocaine. PMID- 3956131 TI - Safety of prolonged, high-dose infusion of naloxone hydrochloride for severe methadone overdose. PMID- 3956130 TI - Bioavailability of sustained-release aspirin preparations. PMID- 3956132 TI - Indomethacin for nephrogenic diabetes insipidus in a four-week-old infant. PMID- 3956133 TI - Relationship between pulse amplitude and thermal exchange in the finger: the effect of smoking. AB - In 24 healthy volunteers finger pulse amplitude and heart rate (HR) were monitored by pulse plethysmography and thermal exchange from the finger and were compared before and after the smoking of a single cigarette. Thermal exchange was measured using a direct calorimeter consisting of a recording bath and a reference bath, both of which were filled with water at 18 degree C. The subject immersed the two distal phalanx of a finger into the recording bath. The water thermal gradient between both baths after 4 min of finger immersion and the maximal value of heat loss from the finger to the water were recorded. Decreases in the water thermal gradient (from 6.06 to 5.33 degrees C, P less than 0.05) in maximal value of heat loss (from 22.5 to 18.75 w.m-2, P less than 0.01) and in plethysmographic wave amplitude (from 25.8 to 14.6 mm, P less than 0.01) and increased HR (from 72 to 83 beats min-1) were observed in smokers. These changes were not statistically significant in non-smokers. Water thermal gradient and maximal value of heat loss correlated with plethysmographic wave amplitude before and after smoking but not with HR in the 24 subjects studied. The present study shows a good relationship between vascular phenomena and thermal exchange in the fingers. The variations of finger pulse amplitude provide an adequate and sensitive adjustment of thermal exchange since the effects of smoking a single cigarette can be detected by both PWA and calorimetric measurements in the finger. PMID- 3956134 TI - Intercrural differences of arterial blood-pressure and blood-flow in new-born infants. AB - Intercrural systolic blood-pressure differences did not exceed 10 mmHg in 22 healthy infants who were term, pre-term or small for their gestational age (three); as measured simultaneously in both legs with 3-cm wide thigh cuffs and mercury-in-silastic strain gauges around the calves. In 13 infants with indwelling umbilical artery catheter and normal angiographic findings in both legs, blood-pressure differences were similarly low in a majority of the infants, but in three of these intercrural differences of 15-20 mmHg were found. Resting and submaximal arterial leg blood-flow, measured with venous occlusion plethysmography, showed larger intercrural differences than blood-pressure, and did not add further information. The results indicate that simultaneous systolic blood-pressure measurements in the legs, with strain gauge plethysmography, is a simple and risk-free noninvasive method, suitable, for example, for diagnosing thromboembolism in infants. An indwelling umbilical artery catheter seems to interfere very little with the arterial circulation in the catheterized leg. PMID- 3956135 TI - Peptococcaceae bacteremia. AB - Bacteremia with Peptococcaceae is an uncommon clinical manifestation of infection with this family of microorganisms. A 20-month review of 12 patients with bacteremic infections due to anaerobic gram-positive cocci revealed that obstetrical patients during the peripartum period constitute the group at greatest risk for the development of such infections. Eight of the 12 patients were young women hospitalized on the obstetrical service. Seven patients had postpartum endometritis and one patient had chorioamnionitis. The remaining four patients include a single patient each with pylephlebitis and microabscesses of the liver, ascending cholangitis, thoracic empyema, and necrotizing soft-tissue infection. Bacteriologic identification of the microorganisms revealed the following: Peptostreptococcus micros (5 patients), Peptostreptococcus asaccharolyticus (5 patients), Peptostreptococcus magnus (1 patient), and Peptococcus species (1 patient). Eleven of the 12 patients received appropriate antibiotic therapy. All patients did well and there were no major sequelae. PMID- 3956136 TI - In vitro evaluation of clindamycin in combination with oxacillin, rifampin, or vancomycin against Staphylococcus aureus. AB - In a study of antibiotic combinations of clindamycin with rifampin, oxacillin, or vancomycin using the time kill-curve method, the combination of clindamycin and rifampin were sometimes synergistic (5 of 15 times), otherwise indifferent and always enhanced killing of fifteen tested Staphylococcus aureus isolates. In contrast, vancomycin and clindamycin or oxacillin and clindamycin were either indifferent or antagonistic (approximately 50%). Vancomycin alone, however, was generally as effective as the combinations of clindamycin and rifampin. PMID- 3956137 TI - Mycobacterium fortuitum peritonitis in a patient undergoing chronic peritoneal dialysis. AB - Peritonitis, due to Mycobacterium fortuitum, developed in a 15-yr-old young man undergoing chronic peritoneal dialysis. Although of low pathogenic potential, this rapidly growing non-tuberculous mycobacterium does cause human disease particularly in the compromised host and should be considered as a potential cause of peritonitis in the chronic peritoneal dialysis patient. PMID- 3956138 TI - Corynebacterium pseudodiphtheriticum pneumonia in an immunologically intact host. AB - Corynebacterium pseudodiphtheriticum, a gram-positive bacillus commonly found in the human oropharynx, has been reported as a rare cause of infection in compromised hosts. We report herein a case of lower respiratory tract infection with Corynebacterium pseudodiphtheriticum in a previously healthy 29-yr-old trauma victim. The organism was the predominant bacterial isolate from two endotracheal aspirates and a specific humoral response was demonstrated by enzyme linked immunosorbent assay. PMID- 3956139 TI - Use of the leukocyte esterase and nitrite tests to determine the need for culturing urine specimens from a pediatric and adolescent population. AB - Using a commercially available dip stick 601 urine specimens were screened for leukocytes and bacteria by testing for the presence of leukocyte esterase and nitrite. The screening method was found to have a sensitivity of 88.7% and a predictive value of negative results of 98.5%. PMID- 3956140 TI - Application of a serum-free medium in the growth and differentiation of human peripheral blood lymphocytes. AB - To eliminate variability due to nonspecific stimulation or inhibition by different lots of fetal bovine serum, the activation of human peripheral blood mononuclear cells in a modification of Iscove's medium (medium C-IMDM) was compared with the routinely used Roswell Park Memorial Institute (RPMI)-1640 medium containing 15% fetal bovine serum. Stimulation of peripheral blood mononuclear cells was enhanced and occurred at lower mitogen concentrations in C IMDM compared with cells grown in RPMI-1640 supplemented with fetal bovine serum. Maximum incorporation of [3H]thymidine following stimulation by concanavalin A, phytohemagglutinin, and pokeweed mitogen was more than twice the peak values obtained in RPMI-1640 supplemented with fetal bovine serum. Concentrations of concanavalin A and phytohemagglutinin required for maximum stimulation were 0.5 and 15 micrograms/ml, and 0.3 and 1.0 micrograms/ml . 5 X 10(5) cells in C-IMDM and RPMI-1640, respectively. Cells grown in C-IMDM responded to lower concentrations of pokeweed mitogen and optimal growth in the serum-free medium required 0.4 micrograms/ml . 5 X 10(5) cells. The stimulation of immunoglobulin producing cells in C-IMDM was enhanced and occurred at lower concentrations of pokeweed mitogen. Less variability of growth (i.e., incorporation of [3H]thymidine) and immunoglobulin synthesis occurred in peripheral blood mononuclear cells cultured in different preparations of C-IMDM than that reported for cells cultured in RPMI-1640 supplemented with different lots or batches of fetal bovine serum. These data suggest that C-IMDM may be an alternative to media supplemented with fetal bovine serum. PMID- 3956141 TI - Reliability of exoantigens for differentiating Blastomyces dermatitidis and Histoplasma capsulatum from Chrysosporium and geomyces species. AB - A recent study suggested that Chrysosporium species have the same diagnostic antigens as Histoplasma capsulatum and Blastomyces dermatitidis and, thus, compromise the antigenic identification of these pathogens. In light of these findings, studies were undertaken to determine the reliability of the exoantigen tests for identifying B. dermatitidis and H. capsulatum organisms from cultures. Sixty-three slant or shake culture extracts, or both, were derived from C. asperatum, C. keratinophilum, C. parvum, C. pruinosum, C. parvum var. crescens, Geomyces (Chrysosporium) pannorus, B. dermatitidis, and H. capsulatum. These were analyzed by use of a commercial exoantigen kit and exoantigen test reagents obtained from a commercial source. The results of these analyses were compared with those obtained with Centers for Disease Control reagents. Many of the extracts derived from nonpathogenic fungi produced nonspecific precipitin bands when reacted with the kit and reference antisera, particularly the B. dermatitidis antisera. None, however, produced antigens identical to the specific B. dermatitidis A and H. capsulatum H and M antigens. Our findings indicate that the properly controlled immunoidentification procedure is 100% specific for B. dermatitidis and H. capsulatum, and that cross-reacting antigens derived from morphologically similar saparophytic fungi do not pose identification problems. PMID- 3956142 TI - Six-year retrospective survey of the resistance of Bacteroides fragilis group species to clindamycin and cefoxitin. AB - Two hundred and forty-six strains of the Bacteroides fragilis group, all clinical isolates, collected at the Wadsworth Veterans Administration Medical Center from 1977 to 1982, were tested for susceptibility to clindamycin and cefoxitin. There was no significant change in resistance to either clindamycin or cefoxitin over the time period tested for any individual species, nor for the B. fragilis group in toto. Striking differences in susceptibility to the two drugs were seen among species of the B. fragilis group. B. fragilis displayed resistance to cefoxitin (32 micrograms/ml) and clindamycin (8 micrograms/ml) of 0.0% and 0.8%, respectively, whereas B. thetaiotaomicron showed resistances of 12.7% to cefoxitin (32 micrograms/ml) and 9% to clindamycin (8 micrograms/ml). B. thetaiotaomicron, B. distasonis, and B. ovatus are distinctly more resistant to cefoxitin than B. fragilis and B. vulgatus. Similarly B. thetaiotaomicron and B. distasonis are much more resistant to clindamycin than are the other B. fragilis group species. It is apparent that determination of species within the B. fragilis group is important in evaluating a potential therapeutic regimen. PMID- 3956143 TI - Group G streptococcal sacroiliitis. AB - We describe herein an unusual case of recurrent pyogenic sacroiliitis in an intravenous drug abuser. Blood cultures grew group G streptococcus. The patient was treated effectively with 7 wk of penicillin G. Group G streptococci are emerging as important pathogens of serious infections. PMID- 3956144 TI - Pneumonia in infants and children. AB - The diagnosis of pneumonia in infants and children is commonly made despite the lack of a definitive test or screening procedure to aid the clinician. Treatment decisions are usually based upon the knowledge of the most likely causative pathogens important in the individual patient's age group. Morbidity due to pneumonia is, in most cases, mild, so that most children can be managed at home. PMID- 3956145 TI - Advances in cystic fibrosis. PMID- 3956146 TI - Food protein-induced enterocolitis of infancy: differential diagnosis and management. PMID- 3956147 TI - Depression and suicide in children and adolescents. PMID- 3956148 TI - Adolescent personality traits that predict young adult drug use. PMID- 3956149 TI - Current status of neonatal screening for congenital hypothyroidism. PMID- 3956150 TI - Tuberculin testing in the young. AB - The child with a positive tuberculin reaction or uncomplicated primary tuberculosis rarely has symptoms. Since INH prophylaxis for one year will practically always prevent the severe forms of tuberculosis, early diagnosis is essential. An annual or biennial tuberculin test is recommended, and is always indicated when there has been known contact with a tuberculous adult. The Mono Vacc test is a satisfactory screening device. PMID- 3956151 TI - Comparative study on mucus glycoproteins in rat stomach and duodenum. AB - The density of mucus glycoprotein compared to that of the corpus, antrum and duodenum was; 1.52, 1.49 and 1.57 g/ml respectively. Carbohydrate composition of gastrointestinal mucus glycoprotein consisted of N-acetylgalactosamine, N acetylglucosamine, galactose, fucose and sialic acid. Ratios of carbohydrate composition among corpus, antral and duodenal mucus glycoproteins differed. The average length of an oligosaccharide was found to be about 12-13, 14 and 10 sugars in the corpus, antrum and duodenum, respectively. In the corpus, the amino acid content was found to have the following quantitative order: Thr greater than Ser greater than Glx = Pro; in the antrum: Thr greater than Ser greater than Glx; and in the duodenum: Thr greater than Ser greater than Pro. Corpus, antral and duodenal mucus glycoproteins have the blood-group A antigen; antral mucus glycoprotein in particular exhibited strong blood-group A activity. PMID- 3956152 TI - Effect of diets containing different oils on brain fatty acid composition in sea bass (Dicentrarchus labrax L.). AB - Four groups of adult sea bass were given diets containing about 8% of one of four different oils having a different fatty acid composition: linseed oil, grape-seed oil, containing high amounts of linolenic and linoleic acids respectively, hydrogenated coconut oil, mainly containing saturated fatty acids, and cod liver oil which was considered as reference. Total lipid, phospholipid and polar lipid contents of the brain of the different groups of sea bass were unaffected. The fatty acid composition of the brain agreed with the dietary history of sea bass: thus adult sea bass brain is capable of incorporating dietary fatty acids. Sea bass brain and structural lipids of the liver appeared to be similarly sensitive to the dietary input in contrast with mammalian brain which was reported to be more resistant than other tissues. The more striking dietary effect on liver total lipid fatty acid composition is ascribed to the incorporation of dietary fatty acids in depot fats. PMID- 3956153 TI - Tissue vitamin B12 levels in bat sucklings (Rousettus aegyptiacus) born of vitamin B12 deficient mothers. AB - The weights of the brains of vitamin B12-deficient baby bats (Rousettus aegyptiacus, 4-20 day old) were slightly lower than those of B12-replete infant bats. Liver and kidney organ weights were similar in the two groups. Brain and liver B12 levels of B12-deficient baby bats were significantly lower than those of replete controls. Kidney B12 levels in deficient babies were about one quarter those of the replete babies. Brain vitamin B12 levels in B12-deficient sucklings were significantly lower than those of B12-deficient adult bats (P less than 0.01). These findings reinforce the need for adequate vitamin B12 nutrition in pregnant and lactating animals. PMID- 3956154 TI - Temperature-induced changes in fatty acid composition of myelinated and non myelinated axon phospholipids. AB - The olfactory (non-myelinated) and trigeminal (myelinated) nerve axons of garfish show changes in phospholipid fatty acid composition when these fish are acclimated to temperatures ranging from 11 to 35 degrees C. Myelinated and non myelinated nerve axons show similar changes in the percent saturated, percent 16 carbon, percent 18-carbon, and percent 20-carbon-and-greater unsaturated fatty acids. The observed changes in phospholipid fatty acid composition fit a linear regression model suggesting a gradual change in axonal phospholipid fatty acid composition with temperature. The temperature-induced changes in garfish nerve phospholipid fatty acid composition are consistent with the general observation of increased saturated fatty acid residues in plasma membrane phospholipids of organisms acclimated to higher environmental temperatures. The garfish data are similar to data previously obtained for goldfish tissues and Tetrahymena. PMID- 3956155 TI - Characteristics of the asparagine-linked oligosaccharide from honey-bee venom phospholipase A2. Evidence for the presence of terminal N-acetylglucosamine and fucose in an insect glycoprotein. AB - Eighty-eight % of phospholipase A2 from honey-bee (Apis mellifica) venom is glycosylated. Its single oligosaccharide exists in several structural variants, which represent consecutive stages of the "N-glycan processing pathway". The carbohydrate carries terminal fucosyl and N-acetyl-glucosaminyl residues. This is in contrast to earlier reports which suggest the lack of respective glycosyl transferases in insects. PMID- 3956156 TI - Precocious expression of the final larval instar developmental pattern in larvae of Trichoplusia ni pseudoparasitized by Chelonus spp. AB - The present study has used a number of electrophoretic approaches to analyze the proteins in normal Trichoplusia ni larvae and those pseudoparasitized by Chelonus spp. A number of feeding-stage, hemolymph proteins appear or increase dramatically only during the final larval stadium. Other proteins highly abundant only during the penultimate stadium disappear or decrease dramatically during the final stadium. The comparative protein profiles of penultimate instar, pseudoparasitized larvae are very similar to those of last instar larvae. These changes in hemolymph proteins are seen on gels resulting from electrophoresis, isoelectric focusing (wide range and narrow range Ampholine and very narrow range Immobiline gels) and SDS-disc electrophoresis. It is concluded that the entire last instar developmental pattern of protein gene products is occurring precociously in pseudoparasitized larvae. PMID- 3956157 TI - Thermodynamics of carp metmyoglobin unfolding. AB - The conformational free energy of carp lateral muscle metmyoglobin at 25 degrees C pH 8 is 9.0 +/- 0.5 kcal/mol as estimated from isothermal unfolding by both urea and guanidinium chloride. A novel procedure for the simultaneous analysis of acid and guanidinium chloride unfolding data is described. Acid denaturation data suggest that binding of five protons to histidyl residues occurs on unfolding. Correlation of sequences and conformational stabilities of several myoglobins according to the tertiary structure of sperm whale myoglobin suggests an evolutionary turnover of side chain-side chain interactions. PMID- 3956158 TI - Lactate dehydrogenase X, malate dehydrogenase and total protein in rat spermatozoa during epididymal transit. AB - Lactate dehydrogenase isozyme X (LDH X), malate dehydrogenase (MDH) and total soluble protein have been determined in lysates of spermatozoa isolated from caput, corpus and cauda of rat epididymis. Transit of spermatozoa through epididymis is accompanied by a reduction of LDH X, MDH and total protein per cell in sexually rested animals. The profiles of reduction along epididymal segments are different for the three variables studied. Mating with receptive females during the 5 days prior to determinations increases significantly the levels of MDH in spermatozoa from all sections of epididymis and produces increase of total soluble protein in the cells contained in cauda. PMID- 3956159 TI - The effect of long-term fasting on ketone body metabolism in the dog. AB - Ketone-body metabolism was studied in overnight-fasted and in 10-days fasted dogs by a ketone-body tolerance test and by infusing [14C]ketone bodies. Clearance of ketone bodies from the blood was significantly decreased after 10 days of fasting. The utilization of ketone bodies was, however, significantly higher in the fasted animals due to the increase in blood ketone-body concentrations. It is concluded that the low level of ketone bodies, which is characteristic for fasting dogs, results from an efficient peripheral utilization. The contribution of ketone bodies to the daily energy requirement of the dog has been tentatively estimated to increase from 7% in the overnight-fasted state to 13% after 10 days of starvation. PMID- 3956161 TI - Temperature and pH effects on the total white muscle LDH of Oreochromis niloticus (Pisces: Cichlidae). AB - The total lactate dehydrogenase enzyme activity of white muscle from O. niloticus shows positive thermal modulation. There is a tendency towards conservation of binding capacity for substrate at physiologically changing pH conditions. Inhibition by excess pyruvate is influenced by temperature and pH, but this phenomenon is not considered to be important in anaerobic glycolysis. PMID- 3956160 TI - Rat coagulation factor V purification and production of the monospecific antiserum. AB - An original method was applied to purify rat factor V. The final preparation had a sp. act. of 45 U/ml for a 2500-fold purification with a yield of 43%. The final product is partially activated since it is 4.7-fold activable by RVV-VAE vs 6.3 in plasma. It can explain the presence of some of the four slightly stained additional bands found in SDS-electrophoresis. Finally, results of the purification suggest that rat factor V is a 338,000 single chain glycoprotein with a strong molecular asymmetry. A factor V deficient fraction was produced and used to adsorb an anti-factor V antiserum. This adsorbed antiserum was found monospecific against purified rat factor V. PMID- 3956163 TI - Multiple hemoglobins in Triturus cristatus: their study by analytical isoelectrofocusing. AB - Electrophoretic separation of the hemoglobin of healthy adult Triturus cristatus reveals four components. Isoelectric focusing of the same hemolysates in various commercial ampholytes of different chemical composition and pH range results in the separation of eight individual hemoglobin bands. The bands obtained by electrophoresis are not homogeneous as revealed by individual gel electrofocusing. They finally separate into the same eight components, as in the whole hemolysate. From the above findings it is concluded that this species has not four but eight individual hemoglobin molecular forms. Our results demonstrate lack of hemoglobin polymorphism in this species. PMID- 3956162 TI - Effects of sucrose feeding and injection of lipid transfer protein on rat plasma lipoproteins. AB - Sucrose feeding increased rat plasma very-low-density lipoprotein (VLDL) triacylglycerol concentration and decreased the cholesterol level in high-density lipoprotein (HDL). Gel filtration chromatography cholesterol profiles of both normal-fed and sucrose-fed plasma lipoproteins showed a small peak of VLDL and a large peak of HDL. Injection of a partially purified human lipid transfer protein preparation into normal-fed rats did not alter the concentration of cholesterol in either VLDL or HDL to a great extent, but there was a disappearance of the larger HDL particles. Injection of lipid transfer protein into sucrose-fed rats resulted in an overall 35% reduction in the concentration of HDL cholesterol, a more dramatic loss of larger HDL particles and a slight decrease in the mean particle size of the major HDL population. PMID- 3956164 TI - Proline hydroxylation of collagens synthesized at different temperatures in vivo by two poikilothermic species. AB - Extent of prolyl hydroxylation in newly synthesized viper collagen is decreased at 10 degrees C to approximately 23% of normal on skin and to approximately 57% of normal in bone collagen. At 20 degrees C, prolyl hydroxylation is approximately 50% of normal in skin and normal in bone. At 10 degrees C and 20 degrees C, prolyl hydroxylation is decreased approximately 32% in the skin collagen of carp. In contrast, prolyl hydroxylation is unchanged at 10 and 20 degrees C in bone, scale and lepidotrichia. Prolyl hydroxylation of cartilaginous endoskeleton showed an approximately 25% decrease at 20 degrees C. PMID- 3956165 TI - Vitellogenin levels in male and female rainbow trout (Salmo gairdneri Richardson) at various stages of the reproductive cycle. AB - The immunoassayable vitellogenin (VTG) in plasma from male rainbow trout had the same molecular weight as authentic VTG from female fish. The VTG level in male trout was low (usually nanograms, occasionally up to a few micrograms, per ml) and did not correlate with the stage of sexual maturity. The plasma VTG level of female trout that were two years from first spawning was 200-fold higher than males of the same strain and age. The plasma VTG level of female rainbow trout rose approximately a million-fold during the two or three years required to attain sexual maturity. PMID- 3956166 TI - Fatty acid metabolism and mitochondrial proteins in the C57BL/6J-dy2Jdy2J dystrophic mice. AB - Measurements of [1-14C]oleoyl CoA oxidation in homogenates and isolated mitochondria of skeletal muscles, hearts and livers from dystrophic C57BL/6J mice and unaffected litter-mates indicate that rates are lower in dystrophic mitochondria, but are comparable in whole homogenates. These findings are not due to differences in the endogenous concentrations of the fatty CoA esters. Qualitative and quantitative differences in the molecular weight distribution of the proteins in the mitochondria and post-mitochondrial supernatants are found in the skeletal muscles with increases in the post-mitochondrial supernatant and decreases in the mitochondria in dystrophic samples. We suggest that these results are due to increased leakiness of the mitochondrial membranes in dystrophic muscles. Such differences were not observed in preparations from normal animals. PMID- 3956167 TI - Relationships between bile salts hydrophilicity and phospholipid composition in bile of various animal species. AB - Bile salts and phospholipids from bile of chicken, dog, sheep, rat, ox, pig, guinea-pig and man were analyzed by high-performance liquid chromatography. Bile salts showed marked differences in their hydrophilic properties, owing to hydroxyl structure and type of conjugation. Phospholipids were generally similar, containing 90-95% of phosphatidylcholine which was made of molecular species containing palmitic acid in the sn-1 position. The comparative analysis of bile salts and phosphatidylcholines profile demonstrated that bile salts hydrophilicity influences the quantity of phosphatidylcholine in bile but not the quality. PMID- 3956168 TI - Proteins in cerebrospinal fluid and plasma of the pouch young tammar wallaby (Macropus eugenii) during development. AB - The concentrations of total protein and albumin in cerebrospinal fluid (CSF) and plasma of tammar wallaby pouch young (Macropus eugenii) from birth until leaving the pouch have been measured. Total protein in CSF increased from birth (about 240 mg/100 ml) to 15-20 days postnatal (about 400 mg/100 ml) after which it declined. Albumin showed a proportionately greater increase from around 40 mg/100 ml to over 130 mg/100 ml, followed by decline after 75 days. Total protein and albumin in plasma increased throughout the period studied. Other proteins identified in CSF and plasma were: fetuin, alpha 2-macroglobulin, transferrin, alpha-lipoprotein, beta-lipoprotein, immunoglobin G and fibrinogen. One protein was only present in early pouch young (up to about 40 days) and was presumed to be the tammar equivalent of alpha-fetoprotein. PMID- 3956169 TI - Electrophoretic markers of Andalusian horses: comparison of Spanish and Lusitanian lineages. AB - Genetic variants at eight blood loci were analysed, disclosing in Andalusian breed six rare markers: variants J of transferrin, H of esterase, D and S of Xk, M and W of prealbumin. Two of these, TfJ and PrM appear as characteristic markers of Andalusian breed. Allelic frequencies showed minor differences between Spanish (300 horses) and Lusitanian (100 horses) populations. Comparison was established with historically related breeds, Thoroughbreds or Connemara, and with Arab horses because of a presumed relationship. No visible similarities in genetic profiles were found with two former breeds, nor with Arab horses. Unpredicted similarities were found however between Tarpans and Andalusian horses, appearing rather as convergences than witnessing a common ancestry. PMID- 3956170 TI - Increased susceptibility to lipid peroxidation in rabbit kidneys: a consequence of warm ischaemia and subsequent reperfusion. AB - Rabbit kidneys were clamped and rendered warm ischaemic (WI) in situ for 60 and 120 min. They were then either removed immediately after the ischaemic insult or after reperfusion with blood for 60 min or 24 hr. Homogenates were assayed for phospholipid-Schiff base fluorescence (Ex. 360 nm, Em. 435 nm) and for diene conjugate formation by u.v. spectrophotometry (240 nm) as indices of lipid peroxidation. No alteration in tissue levels of Schiff base was evident immediately after WI but when the homogenates were incubated at 37 degrees C for 90 min, the rate of peroxidation was significantly elevated compared to controls (P less than 0.02 after WI of 60 min and P less than 0.001 after 120 min of WI). These values were still further elevated after reperfusion with blood for 60 min and 24 hr (P less than 0.001). Diene conjugates were raised after WI alone and further still after reperfusion. Thus an early index of lipid peroxidation (diene conjugation) suggested peroxidative damage during the warm ischaemic period itself, whilst detection of Schiff bases was only possible after in vitro incubation of the tissue. Both indices of oxygen-derived free radical damage were increased after reperfusion in vivo with blood and may relate to the degree of tissue damage sustained during ischaemia and reflow. PMID- 3956171 TI - In vivo lipogenesis in genetically fat and lean chickens of various ages. AB - Lipogenesis was studied in vivo in genetically fat and lean male chickens at 2, 5 and 15 weeks of age using tritiated water. At 2 and 5 weeks of age, the liver was the major site of de novo fatty acid synthesis rather than the carcass. Per 100 g of tissue lipogenesis was greater in the carcass at 15 weeks of age than at 2 or 5 weeks. Lipogenesis in the liver did not vary according to age. At 15 weeks of age there was no observable exaggeration in the degree of fattening (as in genetically obese rodents) of fat line chickens. The regulation of fattening in fat line chickens, at least at the onset of sexual maturity, appears to be different to that in genetically obese rodents. PMID- 3956172 TI - Purification and characterization of creatine kinase isozymes from the nurse shark Ginglymostoma cirratum. AB - Creatine kinase from nurse shark brain and muscle has been purified to apparent homogeneity. In contrast to creatine kinases from most other vertebrate species, the muscle isozyme and the brain isozyme from nurse shark migrate closely in electrophoresis and, unusually, the muscle isozyme is anodal to the brain isozyme. The isoelectric points are 5.3 and 6.2 for the muscle and brain isozymes, respectively. The purified brain preparation also contains a second active protein with pI 6.0. The amino acid content of the muscle isozyme is compared with other isozymes of creatine kinase using the Metzger Difference Index as an estimation of compositional relatedness. All comparisons show a high degree of compositional similarity including arginine kinase from lobster muscle. The muscle isozyme is marginally more resistant to temperature inactivation than the brain isozyme; the muscle protein does not exhibit unusual stability towards high concentrations of urea. Kinetic analysis of the muscle isozyme reveals Michaelis constants of 1.6 mM MgATP, 12 mM creatine, 1.2 mM MgADP and 50 mM creatine phosphate. Dissociation constants for the same substrate from the binary and ternary enzyme-substrate complex do not differ significantly, indicating limited cooperatively in substrate binding. Enzyme activity is inhibited by small planar anions, most severely by nitrate. Shark muscle creatine kinase hybridizes in vitro with rabbit muscle or monkey brain creatine kinase; shark brain isozyme hybridizes with monkey brain or rabbit brain creatine kinase. Shark muscle and shark brain isozymes, under a wide range of conditions, failed to produce a detectable hybrid. PMID- 3956173 TI - Isolation and characterization of nerve growth factor from Vipera berus berus (common viper) venom. AB - Nerve growth factor from Vipera berus berus venom was purified by gel filtration on Sephadex G-100 (superfine), ion-exchange-chromatography on DEAE-Sephadex A-50 and chromatofocusing on PBE 118. The Vipera berus berus venom NGF consists of multiple molecular forms with pls in the interval 9.1-9.7. All isoforms have identical mol. wts approximately 35,000 +/- 3000 (in gel filtration) and 17,000 +/- 2000, 15,000 +/- 2000 (by SDS electrophoresis with beta-mercaptethanol). V. berus berus venom NGF reacted with monoclonal antibodies against Viper lebetina NGF and caused differentiation of pheochromocytoma PC12 cells. PMID- 3956174 TI - Electrophoretic analysis of the polypeptides of Leishmania amastigotes and promastigotes. AB - The polypeptides of Leishmania mexicana mexicana (M379), L. m. amazonensis (LV78), L. major (LV39) and L. d. donovani (LV39) amastigotes and cultured promastigotes have been analysed by SDS-polyacrylamide gel electrophoresis. The polypeptide banding patterns of the promastigotes of the four species were quite similar, but distinct differences were detected between those of amastigotes. The results suggest that the various species of Leishmania are adapted differently for survival and growth in the mammalian host. The polypeptides of L. m. mexicana amastigotes were very rapidly hydrolysed unless protected by the cysteine proteinase inhibitor leupeptin. PMID- 3956175 TI - Lipid composition of bloodstream forms of Trypanosoma brucei brucei. AB - The qualitative and quantitative lipid composition of bloodstream forms of Trypanosoma brucei brucei S42 was compared with that of rat plasma and erythrocytes. The concentrations of lipid-bound phosphate and lipid-bound sialic acid in the trypanosomes were markedly higher than those of the rodent tissues. There was no trace in the trypanosomes of dolichol or dolichol phosphate. Trypanosomes contained two unidentified lipids: an acidic phospholipid and a highly polar glycolipid. PMID- 3956176 TI - Biological aspects of Amazonian fishes--VI. Hemoglobins and whole blood properties of Semaprochilodus species (Prochilodontidae) at two phases of migration. AB - Electrophoretic patterns of hemoglobins, red blood cell phosphates, Bohr effect of blood and stripped hemoglobin, ATP and GTP modulation of Hb-O2 affinity of two species belonging to the genus Semaprochilodus (S. insignis and S. taeniurus- jaraquis), captured at two different locations in Rio Negro, near Manaus (Amazonas), are described. High Bohr effect values were found in these two species and in jaraqui-acu (a possible hybrid between them). In S. insignis a higher Bohr effect for migrating individuals was observed, while S. taeniurus showed the reverse. The main erythrocytic phosphates found in these two species are ATP and GTP. They have a large influence on the O2-Hb binding properties in both species. The GTP/ATP ratio showed large differences between catching places. The two species have different electrophoretic patterns. Semaprochilodus insignis showed four anodal components which showed quantitative variation between catching places; S. taeniurus had three anodal components and a similar quantitative variation. PMID- 3956177 TI - Systematic position of fish species and ganglioside composition and content. AB - The ganglioside content in brain of cartilaginous and bony fishes studied varies from 110 to 581 and from 104 to 595 micrograms sialic acid per g of wet weight respectively. A high degree of alkali lability and the predominance of C18 sphingosine and N-acetylneuraminic acid are typical of fish brain gangliosides. A high content of oligosialogangliosides with four and more residues of sialic acid and the predominance of gangliosides with gangliotetraosyl carbohydrate chain are characteristic for teleost brain. No pronounced difference was revealed in ganglioside composition and content of clupeomorphs and percomorphs. Gangliosides with short (lactosyl and gangliotriaosyl) carbohydrate chain predominate in brain of all cartilaginous fishes studied. A statistically significant difference was found in ganglioside content, relative oligosialoganglioside content and ganglioside fatty acid composition of squalomorphs and rajiformes, on one hand, and dasyatiformes and galeomorphs, on the other hand. PMID- 3956178 TI - Myosin isoenzymes of amphibian hearts. AB - Cardiac myosins of 10 amphibian species were analysed by electrophoresis. Depending on the species, ventricles and atria contained one or two isomyosins. There were components similar to V2 or V1 of the rat and migrating faster. In the same heart, ventricular and atrial isomyosins were similar or tissue specific. It is suggested that the presence of multiple molecular forms of myosin in the heart is a common property of all vertebrates. PMID- 3956179 TI - Effect of triiodothyronine on intestinal and kidney isoenzymes of alkaline phosphatase and on vitamin D metabolism in adult female rats. AB - Adult female Wistar rats receiving normal or vitamin D restricted diet were made thyrotoxic by subcutaneous injection of T3. T3 treatment enhanced intestinal alkaline phosphatase activity and augmented the stimulatory effect of vitamin D on the enzyme in this tissue. In kidney, T3 treatment lead to a decrease in alkaline phosphatase activity in normal, vitamin D restricted and vitamin D repleted rats. The conversion of 25OHD3 to 24,25(OH)2D3 in vivo was enhanced in thyrotoxic rats. These results suggest an interaction between the thyroid and vitamin D endocrine systems. PMID- 3956180 TI - Pyruvate kinase of sea bass liver: interrelationship in regulating properties. AB - Pyruvate kinase of sea bass liver show a joint modulation of both pH and temperature for PEP substrate. The effect of F-1,6-P2, alanine and ATP is not fundamentally affected by a variation in pH. The kinetic constants in the presence of ATP are not affected, but the intensity of its inhibitor effect varies with temperature. A study of different buffers: Tris-HC1, Tris-maleic and phosphate, on this enzymatic activity with or without effectors has been made. PMID- 3956181 TI - Changes in the lipid composition of erythrocytes during prolonged fasting in lizard (Tropidurus torquatos) and rat (Rattus norvegicus). AB - During prolonged fasting in lizard and rat, plasma levels of unesterified cholesterol (UC) and phospholipids (TPL) decreased and there were reductions and increases, respectively, in the molar ratios of lecithin (PC) to sphingomyelin (SPH) and UC to TPL. Plasma lecithin: cholesterol acyltransferase (LCATase) activity in lizard and rat plasma was reduced during prolonged fasting. Erythrocyte lipid composition for fasted animals was also characterized by a reduction in the molar ratio PC/SPH and an increase in UC/TPL, and in both species there were positive correlations between these molar ratios in red cells and those in plasma. In both species these were changes in the morphology of the erythrocytes, and those from fasted rats showed alterations in osmotic fragility and permeability which correlated with alterations in lipid composition. These results suggest that changes in plasma lipoprotein lipid composition, linked to reduced LCATase activity, may cause similar alterations in the lipid composition of red cell membranes leading to altered membrane properties. PMID- 3956182 TI - Variations in the serum esterases of chimpanzees. AB - Seventy chimpanzees, representing Pan paniscus (the pygmy chimp) and all four races of the common chimpanzee (Pan troglodytes), were examined for electrophoretic variation in their serum esterases. Only three variant electromorphs were observed at these six loci. One of these was at the albumin associated esterase locus, and the other two were at esterase 4. This is the first report of any variation in an esterase or albumin in chimpanzees. PMID- 3956183 TI - Automated reminders do not always improve follow-up of abnormal test results. AB - In an attempt to increase the rate of documented follow-up of abnormal lab test results, an automated one-week-later reminder module was added to our lab data system. Provision of reminders to providers did not produce the expected improvement. It appears that in clinics with difficult access to conventional patient records, reminders do not improve documentation, and may elicit resistance and resentment. PMID- 3956184 TI - A semi-automated system for quantitative densitometry of autoradiographs. AB - We describe a semi-automatic, computerized method of quantitative densitometry for regional analysis of whole brain autoradiographs. The technique features menu driven software and verbal prompting for data via a speech synthesizer. Advantages over manual methods include an 80% reduction in the time required for data collection, easy retrieval and statistical analysis of data, and the production of a large data base for future use. The application of this system to the [14C]2-deoxy-D-glucose autoradiographic method for measurement of local cerebral glucose utilization is described. This system makes available computerized densitometry at a modest cost. PMID- 3956185 TI - Magnetic resonance imaging of systemic venous anomalies. AB - Seven cases of anomalous development of the systemic great veins were found in the first 18 months of adult body imaging with a 0.15 T resistive magnetic resonance unit. Comparison was made with CT. In most cases, CT and MRI were equivalent in demonstrating the abnormality. In one case, MRI was superior to a drip-infusion CT. MRI was less successful when the low signal abnormal vein was adjacent to normal structures of low signal. Awareness of the MRI appearance of venous anomalies will aid their recognition as incidental findings. PMID- 3956186 TI - Simulation of CT reconstruction artifacts associated with multiple-rotation fan beam data collection. AB - Artifacts in reconstructed image caused by the errors in projection data depend on the source of the error itself, on the data collection mode and on the reconstruction algorithm. The effect of the multiple-rotation fan-beam data collection modes and corresponding reordered parallel convolution-backprojection algorithms on reconstruction artifacts of this type is analysed. PMID- 3956187 TI - Computed tomographic evaluation of surgical clip artifact: tissue phantom and experimental animal assessment. AB - Surgical clips in postoperative patients create streak artifact on computed tomographic (CT) studies which often significantly degrade image quality. We have evaluated three types of surgical clips: tantalum, stainless steel, and titanium in a phantom and animal model to assess their relative CT artifact. Tantalum clips showed the greatest artifact, stainless steel intermediate, and titanium the least artifact. Artifact could be reduced with the use of faster scan times. The type of clip used may enter into surgical decision making depending upon the need for high resolution scanning to detect small pathological processes in the area of surgical clips. PMID- 3956188 TI - Computed tomography of acute renal abscess due to Salmonella chester. AB - A case of renal abscess caused by an unusual Salmonella serotype is presented in which the clinical presentation was suggestive of renal neoplasia. The CT findings of renal abscesses and neoplasm are discussed as well as a brief discussion on the epidemiology of Salmonella infections. PMID- 3956189 TI - An unusual presentation of thyroid papillary carcinoma: enlargement of a cervical intervertebral foramen. AB - Isolated enlargement of the cervical intervertebral foramen is frequently associated with dumbbell neurogenic tumors. We present an unusual case of isolated enlargement of a cervical intervertebral foramen in a 77-year-old male with an aggressive papillary thyroid carcinoma. To our knowledge, this represents the first case describing a thyroid process as a cause of foraminal enlargement. PMID- 3956190 TI - Hemangioendothelial sarcoma of the sacrum: CT findings. AB - A hemangioendothelial sarcoma (angiosarcoma) of the sacrum was discovered by computed tomography (CT) in a patient with a fever of undetermined origin. A CT directed fine needle biopsy of the lesion helped establish the diagnosis. Plain radiographs revealed only very subtle changes in the sacrum and a bone scan was negative. A literature search revealed no previous descriptions of the CT appearance of this rate primary bone neoplasm. PMID- 3956191 TI - Spontaneous hemorrhage in previously ischemic (pale) cerebral infarcts. AB - Spontaneous bleeding into a pale cerebral infarct is documented in 2 patients. Neither patient had received anticoagulants or was hypertensive. The development of the hemorrhage was associated with neurological worsening. Initial CT scans showed a hypodense lesion in an arterial distribution representing infarction; subsequent CT scans showed multiple areas of hemorrhage within the hypodense lesion. The size of the hemorrhages and their location in gray and white matter differ from the pattern of hemorrhagic infarction and primary intracerebral hemorrhage as visualized on CT scan and at autopsy. PMID- 3956192 TI - The cranial computed tomographic findings in patients with neurologic manifestations of systemic lupus erythematosus. AB - The clinical and computed tomographic (CT) findings in 17 patients with neurological manifestations of systemic lupus erythematosus were analyzed. Two patients presented with stroke syndromes; they did not have systemic manifestations of SLE at the time the neurological disturbances developed. Of 15 patients with prominent systemic evidence of SLE, 9 presented with stroke syndromes or seizures. CT showed a hypodense lesions representing infarction (7 cases) or hyperdense lesions representing intracerebral hematomas (2 cases). Six patients with gradual onset of neurobehavioral symptoms showed cerebral atrophy without infarction or hemorrhage. PMID- 3956193 TI - Psychopathology in hospitalized developmentally disabled individuals. PMID- 3956194 TI - Marital problems in chronically depressed and physically ill patients and their spouses. PMID- 3956195 TI - Demoralization and social support in Soviet-Jewish immigrants to the United States. PMID- 3956196 TI - Psychiatric disorders in high-risk pregnancy. PMID- 3956197 TI - Case identification for category validation: the challenge of disorder-specific assessment. PMID- 3956198 TI - The use of non-steroidal anti-inflammatory drugs in the treatment of pain. PMID- 3956199 TI - AMA diagnostic and treatment guidelines concerning child abuse and neglect. AMA Council on Scientific Affairs. PMID- 3956200 TI - The liability insurance crisis. PMID- 3956201 TI - Borderline ovarian tumors. PMID- 3956202 TI - Radiation therapy of carcinoma of the prostate. Experience at a community hospital. PMID- 3956203 TI - Battered women: a concern for the medical profession. PMID- 3956204 TI - Human seminal antiliquefying agents--a potential approach towards vaginal contraception. AB - One-hundred-one natural and synthetic enzyme inhibitors or inactivators were screened in vitro against the liquefaction property of human ejaculates with a view to develop antiliquefying agents for vaginal contraception. Of those compounds, 27 demonstrated no effect, 36 quickened and 20 delayed the process of liquefaction, while 18 agents stopped it completely. The highly effective antiliquefying agents also showed spermicidal property and were found to coagulate even the liquid ejaculates. Compounds having antiliquefying property, together with coagulating and spermicidal activities, will offer a highly promising approach towards vaginal contraception. PMID- 3956205 TI - Platelet and coagulation functions during triphasic oestrogen-progestogen treatment. AB - The purpose of this investigation was the longitudinal evaluation of the hemostatic system before and after 1, 3, and 6 months of treatment with a triphasic oestrogen-progestogen combination. No changes of circulating platelet aggregates, as an index of in vivo platelet aggregability, and of megathrombocytes, an indirect evaluation of accelerated thrombocytopoiesis, were observed. A very slight, but significant, increase of Fibrinopeptide A (FPA), a reliable index of thrombin formation, was found only after 1 month of treatment; after 3 and 6 months, the increase of FPA was not homogeneous and not significant. Antithrombin III activity (AT III) showed no modifications after the first month; after 3 months AT III increased to a small extent, and after 6 months it was similar to basal values. Our findings indicate that the triphasic combination does not modify platelet functions and induces a low-degree activation of coagulation counteracted by an increased activity of the physiological inhibitors of blood clotting. PMID- 3956206 TI - Chemical occlusion of vas with MCA in rhesus monkey. AB - A single injection of MCA (methyl cyanoacrylate), a tissue adhesive, into the vasal lumen of adult male rhesus monkey resulted in complete vas deferens occlusion at 60 days. PMID- 3956207 TI - Post-coital contraception by estrogen/progestagen combination or IUD insertion. AB - Five-hundred-thirty-eight patients received a complete follow-up to the first menses after post-coital contraception (PCC). Hormonal contraception (pill) was used in 436 women and mechanical contraception (IUD) was used in 102 women. No pregnancies were observed in the IUD group, while 8 pregnancies were found in the hormonal group. A comparative evaluation of the effectiveness and side effects of the two methods was made. The usefulness of PCC after an unprotected intercourse in order to avoid a pregnancy is confirmed. PMID- 3956208 TI - Monitoring boundaries for adverse effects in long-term clinical trials. AB - The typical long-term trial has a data monitoring committee. A primary responsibility of this committee is maintenance of patient safety. In this role, this committee is likely to recommend stopping a trial when a new treatment appears worse than the control even when the difference is not statistically significant or if it appears that the new treatment will not be clearly beneficial. Several approaches, including the use of conditional power, can be used to help the monitoring committee decide if a study should be stopped early because of a harmful or insufficiently effective treatment. These monitoring approaches have altered the way in which we view one-sided or two-sided tests of significance. PMID- 3956209 TI - Confidence intervals following group sequential tests. AB - A procedure is proposed for obtaining confidence intervals for the probability of response following completion of a group sequential phase II trial. Numerical examples showed that, by ordering the sample space using the likelihood principle, we are able to shorten the length of the intervals and to obtain more accurate coverage of probability relative to previously proposed methods. The method may also be used for interval estimation following phase III trials. PMID- 3956210 TI - Data quality in a distributed data processing system: the SHEP Pilot Study. AB - The Systolic Hypertension in the Elderly Program (SHEP) Pilot was a collaborative clinical trial that distributed to the clinics all data processing tasks except for randomization assignment codes and morbidity and mortality data. The clinics used customized programs to enter and verify data interactively, to maintain their own local master files, and to transmit the data electronically to the Coordinating Center. We measured quality control based on criteria from centralized as well as distributed models: the error rate for baseline forms was 0.5 per 1000 items. Ninety-eight percent of the forms were query-free, and a central reentry of the data in a 5% sample yielded a miskey rate of 2 per 1000 items. The potential problems of distributed data processing are vulnerability of the local master files and the time demands on Coordinating Center programmers for maintaining clinic computer systems. The advantages are the active involvement of clinic staff in their own quality control, the functional accessibility of the clinics to the Coordinating Center in controlling protocol decisions and data monitoring, and the level of accuracy, completeness, and timeliness of the data that can be achieved. PMID- 3956211 TI - Functional equality of coordinating centers in a multicenter clinical trial. Experience of the International Mexiletine and Placebo Antiarrhythmic Coronary Trial (IMPACT). AB - The International Mexiletine and Placebo Antiarrhythmic Coronary Trial (IMPACT) included clinical centers in both Europe and North America. The clinics were monitored by two Regional Coordinating Centers: one located in Baltimore, Maryland, for North American clinics; the other in Lyon, France, for European clinics. These coordinating Centers were in turn monitored by an independent Data Audit Center located in Chicago, Illinois. This article describes how computer systems and operational procedures were developed to allow the three IMPACT centers to exchange processed files for a common analysis by the two Regional Coordinating Centers. The problems encountered and the advantages of this organization are described and discussed. PMID- 3956212 TI - Monitoring clinical trials: conditional or predictive power? AB - At an interim point in a clinical trial, trial organisers may wish to use the data on the initial series of patients to judge the likely consequences of further patient accrual. Halperin and colleagues (Controlled Clin Trials 3:311 323, 1982) have suggested calculating the power of a continued trial, conditional on the data observed so far and the null and alternative hypothesis specified at the start of the trial. Here we argue that this idea should be extended to obtain the predictive power of the trial, derived by averaging the conditional power with respect to the current belief about the unknown parameters. Although numerical methods are generally required for evaluating the necessary integrals, the results may be presented graphically and enable the statistician to answer the question: "With the data so far, what is the chance that the trial will end up showing a conclusive result?" PMID- 3956213 TI - Nosocomial pulmonary infection: possible etiologic significance of bacterial adhesion to endotracheal tubes. AB - Biomaterials are essential for life support and monitoring of critically ill patients, but their use increases the risk of nosocomial infection. Of the various plastics used for life support and monitoring devices, polyvinylchloride is one to which bacteria most readily adhere. Through the use of qualitative culture techniques and scanning and transmission electron microscopy, we studied the surfaces of polyvinylchloride endotracheal tubes removed from 25 ICU patients, to determine if bacterial adhesion to those tubes was sufficient to provide a possible source for repeated contamination of the tracheobronchial tree. Of the surfaces studied, 16% were partially covered and 84% were completely covered by an amorphous bacteria-containing matrix. Some biofilm-enclosed bacterial aggregates projected from the matrix into the lumen of the tube. The mechanism by which endotracheal tubes repeatedly inoculate the lungs of intubated patients may prove to be dislodgment of such aggregates by suction apparatus. PMID- 3956214 TI - Outcome of pediatric patients with multiple organ system failure. AB - The association of multiple organ system failure (MOSF) with mortality was investigated in 831 consecutive admissions to a pediatric ICU. The incidence of MOSF (at least two organ system failures, OSF) was 27%. Of the 62 nonsurvivors, 60 (97%) had MOSF. The mortality for patients with MOSF was 54%, compared to a mortality of 0.3% for patients without MOSF. Mortality increased directly with increasing number of OSF (p less than .0001). The mortality was 1% for one OSF, 11% for two OSF, 50% for three OSF, and 75% for four OSF. Comparison of these results with data from adult ICU patients indicates that the mortality and clinical course of MOSF in children is distinct from adults. MOSF is significantly associated with mortality in pediatric patients; however, it is not sufficiently discriminating to determine continuation or withdrawal of ICU support. PMID- 3956215 TI - Significance and management of intractable supraventricular arrhythmias in critically ill patients. AB - In a heterogeneous group of 23 critically ill patients with recurrent and intractable bouts of supraventricular arrhythmia, increases in pulmonary artery wedge pressure significantly decreased cardiac output and exacerbated respiratory failure. Most patients were eventually stabilized on a long-term iv infusion of the calcium antagonist verapamil which, with appropriate monitoring, was well tolerated. We suggest that the use of verapamil infusion may play a significant role in the management of such patients and that further studies are justified. PMID- 3956217 TI - Comparison of three methods for measuring central venous pressure. AB - We used a digital display value, a recorded pressure curve, and manometric measurements to determine CVP in 35 ICU patients who had either a central venous line or a pulmonary artery catheter. CVP was measured by each method up to five times per patient, for a total of 107 data sets. Display values compared well to those from the recorded pressure curve. Manometric measurements, however, poorly matched electronically determined values. Factors influencing these results are discussed. PMID- 3956216 TI - Use of constant-infusion verapamil for the treatment of postoperative supraventricular tachycardia. AB - The effects of constant-infusion verapamil were studied in ten postoperative ICU patients who developed supraventricular tachycardia (atrial fibrillation) with rapid ventricular response rates. A 5-mg iv bolus dose of verapamil was followed by a 5-mg/h infusion that continued for 8 h. Ventricular rates were significantly (p less than .005) reduced from a pretreatment mean of 156 +/- 14 (SD) to 104 +/- 9 beat/min on constant-infusion therapy. This therapy was well tolerated without observed side-effects. Moreover, constant-infusion verapamil might avoid the hypotension and wide range of ventricular rates frequently encountered with repeated bolus doses of verapamil. PMID- 3956218 TI - Comparison between ultrasonic and thermodilution cardiac output measurements in intensive care patients. AB - The reliability of ultrasonic cardiac output measurement was assessed using a commercial device that combines A-mode aortic root diameter determination and continuous wave (CW) Doppler flow velocity measurement in the ascending aorta. We compared this method with thermodilution (TD) cardiac output in 41 intensive care patients. Aortic root diameter measurement with A-mode was not possible in four (10%) patients. Using strictly defined criteria based upon our initial experience, we could not obtain acceptable CW Doppler flow signals in nine (22%) patients. Thus, ultrasonic cardiac output measurement was possible in 28 (68%) patients in whom there was an excellent correlation with cardiac output (r = 0.97; p less than .001). This study demonstrates that the transcutaneous CW Doppler method for measuring cardiac output is accurate and reliable in a limited percentage of ICU patients. Combining the CW Doppler with B-mode echocardiogram increases the applicability when an A-mode measurement is not possible. PMID- 3956219 TI - Transcutaneous PO2 recording using two sensors in a neonate with preductal coarctation of the aorta. AB - Simultaneous transcutaneous PO2 (PtcO2) recordings, done on a neonate having preductal coarctation of the aorta, showed markedly lower PtcO2 values in the lower abdominal quadrant (representing postductal blood) than in the subclavicular area (representing preductal blood). Two-sensor PtcO2 recordings are valuable in documenting pathologic ductal shunts commonly associated with disturbed transitional circulation or cardiac malformation in newborn infants. PMID- 3956220 TI - Hyperkalemia during cardiac arrest and resuscitation in the canine model. AB - Although recent clinical reports have noted hypokalemia after resuscitation from cardiac arrest, extensive animal work indicates that potassium is released from cells during ischemia. This study was undertaken to define the changes that occur in serum potassium ion during cardiac arrest and resuscitation in a canine model. Fourteen dogs were subjected to 5 min of cardiac arrest followed by 30 min of closed-chest CPR (CCPR). Resuscitation was performed according to a standardized protocol. Serum potassium increased significantly (p less than .001) from baseline, remained elevated 5 min after return of spontaneous circulation (ROSC), but declined to baseline levels at 15 min post-ROSC. Increases in interstitial potassium would be expected to be even greater due to the poor exchange between interstitial and intravascular compartments during CCPR. Interstitial hyperkalemia may play a role in the genesis of wide-complex electromechanical dissociation and may explain the reported success of calcium chloride in treating this problem. PMID- 3956221 TI - Pericardial tamponade after removal of an epicardial pacemaker wire. AB - Pericardial tamponade may arise from multiple traumatic and nontraumatic etiologies, resulting in unrecognized rapid deterioration and often death. A previously unreported case of pericardial tamponade after removal of an epicardial pacemaker wire is presented, demonstrating the everpresent potential for serious complications from seemingly innocuous invasive procedures. PMID- 3956222 TI - Position of right internal jugular vein catheter affected by head position. PMID- 3956223 TI - Simplified bedside calculation of inspired and alveolar oxygen pressures. PMID- 3956224 TI - Monitoring of effective compliance. PMID- 3956225 TI - Prediction model for hospital mortality. PMID- 3956226 TI - The relevance of cryoprotectant "toxicity" to cryobiology. AB - Cryoprotective agents are essential for the cryopreservation of almost all biological systems. These additives, however, do not usually permit 100% survival after freezing and thawing, though from a theoretical point of view they should be able to fully suppress all known types of freezing injury. In view of the known biological and physicochemical effects of cryoprotectants, it is suggested that the toxicity of these agents is a key limiting factor in cryobiology. Not only does this toxicity prevent the use of fully protective levels of additive, but it may also be manifested in the form of cryoinjury over and beyond the cryoinjury due to classical causes. Evidence for this extra injury ("cryoprotectant-associated freezing injury") is reviewed. It is suggested that better suppression of toxicity is possible and will lead to advances in cryopreservation. PMID- 3956227 TI - Effects of cryoprotectants on enzyme structure. AB - The interaction between organic cosolvents and proteins is considered, especially from the point of view of effects on protein stability. It is concluded that each protein-cosolvent system constitutes a unique situation, making generalized predictions of expected effects difficult. Two classes of cosolvents are distinguished, based on the nature of their interactions with the protein surface. The thermodynamic instability to the system introduced by the presence of the cosolvent can be accommodated (i) by preferential exclusion of the cosolvent from the vicinity of the protein, (ii) by major structural changes of the protein, or (iii) by aggregation. Polyols tend to undergo preferential exclusion due to unfavorable interactions with nonpolar surface groups, whereas monohydric alcohols and other more hydrophobic cosolvents may undergo preferential exclusion due to adverse interactions with charged groups on the protein surface. Typical cosolvent effects on the structural and catalytic properties of enzymes are illustrated with data for ribonuclease and beta lactamase with alcohol cosolvents. The relative hydrophobicity of the cosolvent is the major determinant of the effect of a cryosolvent on the enzyme stability and properties. Thus the position of the unfolding transition in cryosolvent will be decreased more by a more nonpolar cosolvent. Different cosolvents can have significantly different effects on the catalytic and structural properties of the same enzyme. Conversely the same cosolvent can have significantly different effects on similar proteins. The number and distribution of the nonpolar and charged groups on the protein's surface probably are the major determinants of the protein contribution to the solvent-protein interaction. The large temperature dependence of the rates of protein unfolding and refolding can be beneficially utilized in cryoprotectant studies of living cells. PMID- 3956228 TI - Interactive effects of cryosolvents, ionic and macromolecular solutes on protein structures and functions. AB - Surprisingly, cryosolvents may mimic the effects of ionic solutes on the structures and functions of macromolecular assemblages, showing additive or opposite effects depending on the respective concentrations. These interactive effects are hard to analyze precisely because they may result from so many possible contributions. However, studies on model systems clearly show the nature of the interactive effects and bring about useful information concerning the mechanism of action of cryosolvents and ions and the response of enzyme systems. Such results suggest new studies on the interaction of biopolymers and water and their possible impact on the cryobehavior of highly organized and living systems. PMID- 3956229 TI - Cryopreservation of hemopoietic tissue aimed at reducing immunological reactivity. AB - A method has been developed of decreasing immunologic activity of lymphocytes from spleen, lymph nodes, and bone marrow (freshly collected or frozen) with a high percentage of intact stem cells. In experiments in vivo on lethally irradiated mice, it was demonstrated that during combined transplantation to the recipients of preserved bone marrow from two genetically different donors, a rapid decrease or absence of the effect of inactivation of hemopoietic stem cells under the influence of allogeneic lymphocytes was observed in the mixed graft. When it is necessary to transplant large quantities of bone marrow from several genetically different donors, the use of cryopreserved bone marrow is preferable to freshly drawn marrow due to the higher proliferative activity and the decreased risk in the development of immunological reactions. PMID- 3956231 TI - Retention of bone cell viability in mouse calvarial explants after cryopreservation. AB - Newborn mouse calvaria, cyropreserved at -196 degrees C in serum-free medium containing dimethyl-sulfoxide, were compared to unpreserved explants for bone cell viability by [3H]thymidine uptake. Other explants were studied using autoradiography to compare the histological appearance of the cryopreserved and control unpreserved explant sites of cellular localization of [3H]thymidine. After short-term cryopreservation, calvarial bone cells, including less differentiated osteoprogenitor cells, survived as indicated by their incorporation of the DNA precursor. With culture continuing for up to 24 hr after thawing and in the continuous presence of [3H]thymidine, additional labeled thymidine was incorporated, indicating that the proliferative ability of explant cells persists after cryopreservation. Cryopreserved bone explants did not, however, incorporate the same amount of labeled thymidine as did controls at each time point studied. These events, as measured quantitatively and observed by autoradiography of the tissue, indicate that newborn calvarial bone cell proliferation in vitro continues after cryopreservation. The large surface:mass ratio of the tissue and its proportionate volume of calcified matrix apparently permits it to behave as an isolated cell population with regard to the diffusion of the cryoprotectant and thermal conductivity, thus permitting the retention of explant viability. PMID- 3956230 TI - Cold exposure as a potentiating factor of pineal actions in nonhibernating mammals. AB - Twenty-eight-day-old male rats were used in three experiments to study whether cold exposure potentiates pineal actions in nonhibernating mammals. The following questions were considered: (a) Can cold exposure increase the antigonadal effects of light deprivation? (b) Are the effects induced by blindness plus cold exposure pineal dependent? (c) Can cold exposure modify the response of the endocrine reproductive axis to exogenously administered melatonin? Blind cold-exposed rats showed a significant loss in body weight as well as in weights of pituitary and reproductive tract organs compared with either intact or blind animals kept at 22 degrees C, or intact rats exposed to cold; serum testosterone levels were also lowest in blind cold-exposed rats. These effects were not present in blind cold exposed animals that were pinealectomized at the beginning of the experiment. When intact animals placed at 22 or 10 degrees C were treated with daily injections of melatonin (50 micrograms) there was a reduction of body weight and weights of the hypophyso-gonadal axis organs. Those effects of melatonin were, however, significantly greater in cold-exposed rats than in rats placed at 22 degrees C. These results suggest that cold exposure should be considered as another state which potentiates the pineal-dependent actions of light deprivation. Cold exposure probably acts by increasing the sensitivity of sites at which pineal melatonin exerts its actions. PMID- 3956232 TI - Comparison with the theory of the kinetics and extent of ice crystallization and of the glass-forming tendency in aqueous cryoprotective solutions. AB - The glass-forming tendency and stability of the wholly amorphous state of various cryoprotective solutions has been studied in recent years (5-10, 20). A lot of experimental data including heats of ice crystallization at various cooling rates and devitrification temperatures have been given. In this article these data have been compared with analytical expressions using a semiempirical model. The theoretical variation of the total quantity of ice crystallized with the cooling rate fits very well with the experimental data, adjusting only one parameter. Using the same model, theoretical differential scanning calorimeter (DSC) crystallization peaks have been obtained for cooling or rewarming. The general shape, height, and width of the theoretical peaks are very similar to those of the experimental peaks. The differences are comparable to the random variations of the experimental peaks from one experiment to another. The analytical expressions obtained here could be used to study the relationship between the kinetics of ice crystallization and cell damage when ice crystallizes incompletely inside or outside the cells. These expressions have been applied to ice crystallization for applications in cryobiology. But they could also probably be used in other fields of research such as crystallization from silicates or other mineral or organic glasses. PMID- 3956233 TI - Electron microscopic features of never-worn soft contact lenses: deposits or artifacts? AB - Since scanning electron microscopy (SEM) is commonly used to evaluate hydrophilic lens deposits, it is important to know what artifacts are induced by the various techniques used to process the lenses. We performed scanning electron microscopy (SEM) using never-worn lenses with hydrations from 38.6% to 71%. Each lens was taken from its vial of factory-sealed, sterile-preserved saline and processed for SEM examination using liquid CO2, freon critical point drying, or air drying with or without alcohol dehydration. The lenses revealed abnormal surface structures occasionally resembling deposits reported on worn soft contact lenses. Varying degrees of gas pockets and surface wrinkling were seen. Individual polymers and lens hydration reacted differently to the various techniques of processing. Of the four methods evaluated, air drying without alcohol dehydration induced the least artifacts. PMID- 3956234 TI - The alteration of lipid peroxide in glucocorticoid-induced cataract of developing chick embryos and the effect of ascorbic acid. AB - The level of lipid peroxide (LPO) in glucocorticoid-induced cataractous lenses was measured by using thiobarbituric acid. When 0.25 mumol of hydrocortisone hemisuccinate sodium (HC) were administered to 15-day-old chick embryos, the level of LPO in the lens increased to approximately 1.4-fold of the control level at 24 to 48 hr after HC treatment. However, the level returned to the control level by 96 hr with the disappearance of opacity in the lens. A triple application of ascorbic acid (20 mumol/egg) at 3, 10 and 20 hr after HC treatment prevented cataract formation and elevation in the level of LPO in 60% of the lenses. In 40% of the eggs treated with HC plus ascorbic acid, the results were no different than HC alone. Treatment with prednisolone hemisuccinate sodium (0.25 mumol/egg) produced an elevation in the level of LPO in the lens but that with cortisone hemisuccinate sodium or cortexolone hemisuccinate sodium did not change the level of LPO in the lens. The phenomena of the cataract formation and the elevation of LPO in the lens caused by HC seemed to be related to each other and due to its glucocorticoid activities. PMID- 3956235 TI - A new HPLC method to determine glutathione-protein mixed disulfide. AB - A sensitive method for measuring glutathione-protein mixed disulfides is described. The method is based on cleavage of the protein disulfides with performic acid followed by reaction with dinitrofluorobenzene and HPLC analysis with a Bondapak-amine column. Samples containing 0.1 nmoles or more of glutathione-protein mixed disulfide can be detected. The method has been used to demonstrate (a) the presence of low levels of glutathione mixed disulfide in gamma crystallin isolated from bovine lenses, (b) a dramatic increase in such mixed disulfides after exposure of denatured gamma crystallin to O2 in the presence of glutathione, and (c) the formation of glutathione-protein mixed disulfide in lens epithelial cells exposed to 0.6 mM H2O2 for one hour. PMID- 3956236 TI - Selenite-induced epithelial damage and cortical cataract. AB - The purposes of these experiments were 1) to measure microscopic changes in the epithelium associated with selenite cataract, and 2) to describe the formation and subsequent clearing of selenite cortical cataract. Fourteen-day old suckling rat pups received a single subcutaneous injection of an overdose of sodium selenite at 2.25 mg Se/kg b.w. Development of cortical cataract was observed by biomicroscopy, and changes in epithelium were studied by light microscopy of flat mounted lens epithelia. Selenite administration caused cortical cataract 15-30 days after injection in addition to previously characterized nuclear cataract. The cortical cataract progressed through equatorial vacuolization, opacity, and finally clearing of the cataract. Mitosis was suppressed and karyorrhexis was observed in the germinative zone of the epithelium 5 hours after selenite injection. Pathological disorganization of the epithelium followed. Changes included vacuolization, loss of meridional rows, and defective fiber formation. Restoration of epithelial morphology was associated with clearing of cortical opacity. Epithelial damage at 5 hours was the earliest change yet recorded for selenite cataract, and these data are consistent with our working hypothesis that the initial site of attack of selenium in both cortical and nuclear cataract is the lens epithelium. PMID- 3956237 TI - Further studies on the effect of retrobulbar epinephrine injection on ocular and optic nerve blood flow. AB - The effect of retrobulbar epinephrine administration on ocular and optic nerve blood flow was studied in phakic rabbit eyes using a radioactive microsphere (85Sr) technique. Blood flow measurements were performed either 5 minutes or 30 minutes after retrobulbar injection of 10 microliter of a 2% (base) epinephrine bitartrate solution to the right eye of each rabbit. Blood flow was determined for the iris, scraped ciliary processes, choroid, retina, and optic nerve. Five minutes after retrobulbar injection, there was no statistically significant (P greater than 0.05) difference in epinephrine-treated eyes compared to contralateral control eyes that received 10 microliters of retrobulbar saline. Thirty minutes after injection, eyes receiving retrobulbar epinephrine had a statistically significant (P less than 0.05) fall in blood flow to the iris and scraped ciliary processes, but not to the choroid, retina, or optic nerve. PMID- 3956238 TI - Ornithine decarboxylase activity during formation of experimental epiretinal membranes. AB - This study demonstrates in a rabbit model of epiretinal membrane formation that retinal-associated ODC activity increases during this pathological process. These changes in retinal-associated ODC activity most likely occur in relationship to the proliferative lesion itself, since the retina consists primarily of nonproliferative tissues. Further knowledge of intraocular polyamine metabolism during epiretinal membrane formation which can result in retinal detachment may lead to the development of an effective pharmacological treatment. PMID- 3956239 TI - Human lens enzyme alterations with age and cataract: glyceraldehyde-3-P dehydrogenase and triose phosphate isomerase. AB - The isoelectric point distribution of G-3-P DH and TPI from human lenses was examined as a function of age and cataract formation. Both enzymes exhibited progressive heterogeneity with age and a shift towards an acidic charge. Little qualitative differences in the pI profiles of G-3-P DH and TPI were found to distinguish mixed cataracts from age comparable normal lenses. While the most alkaline form of G-3-P DH required less HAsO4= for optimal activity, no other kinetic property, i.e. Km substrate, cofactor and inhibitors distinguished any of the charge forms of G-3-P DH. All metaor isozyme forms of TPI had the same Km substrate in the forward and reverse reaction direction. The most acidic forms of G-3-P DH and TPI were less stable to increased temperatures than their more alkaline counterparts suggesting a decreased stability. PMID- 3956240 TI - Changes in lens protein in concentric fractions from individual normal human lenses. AB - The water soluble (WS), urea soluble (US) and urea insoluble (UI) fractions from individual human lenses 1.8 to 65 years of age were isolated from concentric fiber layers. In lenses younger than 19 years, a uniform distribution in the amount of WS, US and UI fractions was found throughout the entire lens. These fractions represent 83, 11.5 and 5.5%, respectively, of the lens dry weight. This composition was observed with the cortical fibers of all lenses examined up to the 65-year old. In the nuclear fiber layers, the proportion of US protein gradually increases in the third to fourth decade of lens growth and appears to have reached a maximum representing 22-24% of the nuclear fiber mass in 50-year and older lenses. A large increase in the amount of the UI fraction to 30% of the fiber mass was observed in lenses between the 5th and 6th decade of lens growth. The change from the cortical to nuclear composition occurs in a narrow region of the lens which becomes more peripheral with aging. The cortical WS fractions were characterized by well defined polyacrylamide gel bands in sodium dodecyl sulfate (SDS). Those of the nuclear fibers were broadened, especially in the 27/29 and 16/18 kilodalton (KD) region. The disappearance of the 20/22 KD bands in the inner cortical and nuclear fibers cannot be accounted for by the small increase in protein insolubilization in these regions of lenses 40 years or younger. PMID- 3956242 TI - Ultrastructure of conjunctival epithelium replacing corneal epithelium. AB - After corneas of mice had been totally denuded of their epithelium by the application of n-heptanol, the new epithelium which grew over the corneas was studied by electron microscopy at intervals up to 7 months. The purpose was to compare the basal attachment of the new cells, derived from conjunctiva, with that of true corneal epithelial cells growing on the same type of substratum, and studied previously. Goblet cells appeared after 2 weeks amid the squamous type of epithelial cells which had resurfaced the cornea in about 1 week. Goblet cells increased up to at least 6 weeks, but had decreased by 3 months. They persisted, however, for the entire 7 months of the study. Goblet cells had only a small area of contact with the basal lamina, and they had few desmosomes or hemidesmosomes. Basal cells of the squamous type had complex features of their basal attachment quite different from those of normal or repairing corneal epithelial cells studied previously. Flat cytoplasmic extensions of squamous cells underlay most of the goblet cell basal pole which therefore had only a small area on the basal lamina. Numerous filaments inserted into desmosomes and hemidesmosomes of squamous cells, and prominent bundles of these filaments lay just above the basal plasma membrane. They were orientated parallel to the radial axis of the cornea. Closely spaced corrugations of the basal plasma membrane were also orientated in this axis, as well as rows of hemidesmosomes. Even after a period of 7 months, the morphological features of conjunctival cells did not come to resemble those of normal corneal epithelium. The radial arrangement of fibers, hemidesmosome rows, and corrugations is interpreted as a reflection of the continued centripetal migration of the epithelium. PMID- 3956241 TI - The effects of dim cyclic light on pigment epithelial function in the albino rat. AB - Most pathologies of the outer retina include physiological and morphological changes in the pigment epithelium. The question of pigment epithelial involvement in retinal light damage caused by low intensities of light is still unresolved. In the present study, we investigated the effects of low intensity cyclic light on pigment epithelial function in albino rats. The functioning of the pigment epithelium was assessed electrophysiologically from d.c. recordings of ERG c waves and sodium azide induced changes in the resting potential. Responses obtained from albino rats raised under low intensity cyclic light (0.63 ft cd. 12:12 L:D) were compared to those obtained from albino rats raised under minimal light exposure conditions (dark-reared) and pigmented rats housed under low intensity cyclic light. We report, for the first time, that albino rats raised from birth under low intensity cyclic light possess c-waves. Their responses were comparable in amplitude and latency to those recorded from pigmented rats housed under similar conditions, but were significantly smaller than those recorded from dark-reared albino rats. The reduction in the amplitudes of the c-waves recorded from cyclic light-reared albino rats was probably not due to retinal light damage. Comparisons of the amplitudes and latencies of ERG b-waves recorded from cyclic light-reared and dark-reared albino rats did not suggest that the retinas of the cyclic light-reared albino rats had been damaged by light. Light microscopic examination of these retinas also provided no evidence for light damage. The transient, positive potential changes recorded from cyclic light reared albino rats in response to bolus injections of sodium azide were significantly smaller than those recorded from either dark-reared albino rats or pigmented rats housed under low intensity cyclic light. The results of these experiments suggest that the pigment epithelium of albino rats is functionally altered by extremely low intensities of cyclic light. PMID- 3956243 TI - Isolation and identification of sialic acids from the gangliosides of human cataracts. AB - The sialic acid components of gangliosides isolated from human cataracts are verified and confirmed to be N-acetylneuraminic acid by combined thin-layer and gas-liquid chromatography techniques. PMID- 3956245 TI - The midget bipolar cells in the chick retina. AB - This paper reports the existence of midget bipolar cells on the chick retina, as determined by the staining methods of Golgi-Stensaas and Golgi-Colonnier. We date the appearance of these cell types at days 13 (HH-39) and 14 (HH-40) of incubation and describe them morphologically throughout their development until the time of hatching, at which time the cells show an adult structure. As an adjunct to this work we classify the midget bipolar cells into four groups. PMID- 3956246 TI - Commitment and instability in cell differentiation. PMID- 3956244 TI - Experimental hypercupremia does not result in increases in copper in lens, iris, or ocular fluids. AB - Rabbits were continuously administered copper sulfate via subcutaneously implanted osmotic pumps. After one month, plasma, liver, ocular tissues and fluids were analyzed for copper by atomic absorption spectrophotometry. No elevation in copper content of the ocular fluids, lens or iris was noted although, dose-related increases were seen in the plasma and liver indicating that the copper was absorbed and disseminated systemically. It is likely that excess copper, like that which is normally ingested and absorbed, is largely protein-bound in the circulation, preventing crossing of the blood-ocular barrier. PMID- 3956247 TI - Cirrhosis and hypersplenism: clinical and hemodynamic correlates. PMID- 3956248 TI - The clinical utility of indium-111-labeled leukocyte imaging in the surgical patient. PMID- 3956249 TI - Metabolism in isolated closed-head injury: stress or bedrest? PMID- 3956250 TI - Pulsatile left atrial-femoral artery bypass plus reperfusion after acute myocardial ischemia permanently lessens infarct size and reperfusion injury. PMID- 3956252 TI - Selective management of arterial occlusion with low-dose streptokinase. PMID- 3956251 TI - Reticuloendothelial function following infusion of bacterial and non-bacterial particulates: relation to plasma fibronectin. PMID- 3956253 TI - Aloe vera, fiction or fact. PMID- 3956254 TI - Cutaneous consequences of accelerated thyroid function. AB - General and specific cutaneous findings associated with hyperthyroidism are reviewed. Familiarity with these findings may aid the practitioner in the early diagnosis of thyroid diseases. Several normally idiopathic cutaneous diseases can occasionally be controlled if underlying thyroid disease is considered as a cause, and appropriate testing performed. PMID- 3956255 TI - Topical zinc in the treatment of herpes simplex. PMID- 3956256 TI - Familial lichen planus. AB - We observed the simultaneous occurrence of generalized lichen planus in a woman and her mother. Both patients improved after therapy with topical steroid and salicylic acid ointment. Of the eighty-one cases of familial lichen planus previously reported, the vast majority (89 percent) occurred in blood relatives. The intervals of onset between familial cases were long, ranging from six weeks to thirty years (mean 73.4 months). These observations suggest that familial lichen planus may result from genetic predisposition, rather than from an infectious cause. PMID- 3956257 TI - Cutaneous lesions: correlations from microscopic to gross morphologic features. PMID- 3956258 TI - Digital myxoid cysts: a review. PMID- 3956259 TI - Lamellar ichthyosis with episodic psoriasiform reaction pattern. AB - The skin of a girl born with the typical appearance of "collodion baby," evolved into an exfoliative erythroderma that clinically was lamellar ichthyosis. However, biopsy specimens done in early infancy showed psoriasis. Over the ensuing sixteen years she has continued to have clinical lamellar ichthyosis with rare occasions of febrile episodes and superficial pustules. Some biopsy specimens have been diagnosed as showing lamellar ichthyosis, while others have again shown psoriasis. PMID- 3956260 TI - Discrete palmar and plantar symptoms in children with dermatitis herpetiformis Duhring. AB - Unusual, discrete palmar and plantar symptoms observed in thirty of forty-seven children with dermatitis herpetiformis are described. The diagnosis was verified in every case by the demonstration of granular IgA deposits in the skin. Forty five of the children showed villous atrophy in jejunal biopsy specimens. In four cases extensive, exudative, bullous palmar symptoms, similar mild plantar changes, and healing with desquamation were observed. At least once during treatment we found very discrete, reddish-brown spots or small blisters on the flexor surface of the fingers and on the palms in thirty patients. Similar lesions occurred on the soles and plantar surface of the toes in only three patients. In asymptomatic patients and those treated with either a gluten-free diet or sulfone/sulfapyridine, the phenomenon was not manifest. PMID- 3956261 TI - Detailed, controlled, and documented self-experimentation in dermatology. AB - Because the skin is easily available, the combination of frequent periods of critical observation, the dermatologist's clinical experience, and carefully controlled documentation of these observations allow for self-experimentation in dermatologic disorders on the part of clinicians. The practical value of such self-experimentation has been shown over many years, especially by the use of skin surface microscopy at moderate magnification to examine various lesions; to document sensitization experiments with nickel, Japanese lacquer, and nitrogen mustard; to examine prolonged use of topical fungicides for the treatment of onychomycoses; and to contribute to extensive and continuing experiments in laser medicine. PMID- 3956262 TI - Papular leukemids. AB - Skin lesions occurring in patients with leukemia may represent specific leukemic infiltrates or may manifest as nonspecific lesions not related to leukemic cell infiltration. Included in the latter are a number of nonspecific papular and nodular lesions generally called "leukemids." We present two patients with lesions we have categorized as papular leukemids. PMID- 3956263 TI - Suppression of tumorigenicity in somatic cell hybrids. III. Cosegregation of human chromosome 11 of a normal cell and suppression of tumorigenicity in intraspecies hybrids of normal diploid x malignant cells. AB - Tumorigenicity assays of 48 intraspecies hybrids between human carcinoma-derived cells of the D98AH2 (HeLa) cell line and normal human diploid cells revealed that most are nontumorigenic in nude mice. Chromosome analysis revealed that these hybrids contained four chromosomes 11, presumably two from each parental cell. Their tumorigenic segregants sometimes, and their tumors always, had lost one or two copies of chromosome 11 (Klinger and Kaelbling, 1986). In this report we present evidence from analyses of DNA restriction fragment length polymorphic (RFLP) markers for the parental cell origin of the 11 which confirms that the four chromosomes 11 of the nontumorigenic hybrids consisted of two from each cell parent, and most notably, that one No. 11 of the diploid parental cell is always absent in cells of tumors that arise when the tumorigenic hybrids are injected into nude mice. We also found that both Nos. 11 of the D98 cells are identical at many RFLP sites on the short arm suggesting that loss of heterozygosity of the 11, or at least of the short arm of the 11, had occurred. Chromosome 11 of the diploid cells thus appears to carry alleles that suppress the tumorigenic potential of the D98 cells when present in two copies, but not in one. It remains to be seen if other chromosomes of the diploid cell effect suppression in concert with the 11. PMID- 3956264 TI - A human 9;20 reciprocal translocation associated with male infertility analyzed at prophase and metaphase I of meiosis. AB - Details are given of a meiotic prophase analysis, carried out by spreading, of a human 9;20 reciprocal translocation ascertained in a subfertile, oligospermic male. Air-dried meiotic preparations revealed the presence of translocation quadrivalents at metaphase I. Germ-cell degeneration was evident from the early prophase of meiosis onward. Associations between the translocation quadrivalent and XY bivalent at pachytene were seen in only 20% of the cells and seemed not to be the prime cause of germ-cell failure. Pairing disruption around the breakpoints of the translocation at pachytene and/or pairing failure in one arm of the pachytene cross was observed in a total of 87% of all cells analyzed. This could have contributed significantly to germ-cell atresia. PMID- 3956265 TI - Meiotic studies of Robertsonian heterozygotes from natural populations of the common shrew, Sorex araneus L. AB - Adult male common shrews, both Robertsonian heterozygotes and homozygotes, were collected from Oxford and elsewhere in Britain. In both simple Robertsonian heterozygotes and Robertsonian heterozygotes with monobrachial homology, regular chain configurations were observed at meiosis I; only 1-2% were incomplete such that univalents were observed. On the average, there was one chiasma per chromosome arm among those that displayed Robertsonian variation, including both chain configurations and bivalents. According to one hypothesis, a single chiasma per chromosome arm may facilitate proper disjunction of chain trivalents of simple Robertsonian heterozygotes. Based on metaphase II counts, anaphase I nondisjunction frequency can be estimated as 1.0% per heterozygous individual and 0.7% per heterozygous arm combination. PMID- 3956266 TI - Preferential X-chromosome activity in human female placental tissues. AB - Preferential inactivation of the paternally derived X chromosome in extraembryonic membranes of female rodents has been clearly demonstrated, but the mode of X-chromosome inactivation in the human placenta has not been so clearly defined. We examined A and B variants of the X-linked enzyme glucose-6-phosphate dehydrogenase (G6PD) in 42 informative placentae to investigate whether the earliest differentiating human female embryonic cells exhibit preferential inactivation of the paternally inherited X. Contamination of villi with fetal blood was eliminated through culture of villous tissues, and maternal cell contamination was eliminated by careful dissection. Both fresh and cultured amnion and chorion, as well as cultured villi, revealed preferential maternal allele expression. PMID- 3956267 TI - Synaptonemal complex analysis in spermatocytes and oocytes of tertiary trisomic Ts(512)31H mice with male sterility. AB - Whole-mount preparations of silver-stained spermatocytes and oocytes from Ts(512)31H mice were examined in the electron microscope. The 5(12) chromosome was associated with the XY bivalent in the large majority of spermatocytes, whereas in about one-half of the oocytes, the 5(12) was associated with either unpaired chromosomes or heterochromatic parts of chromosomes or showed self synapsis. There was a tendency for 5(12) chromosomes to be more fully heterochromatic in oocytes than in spermatocytes. A large proportion of oocytes (50%) and a much smaller proportion of spermatocytes exhibited various errors of chromosome pairing, but these proportions were only marginally greater than in control gametocytes from mice with normal karyotypes. It is concluded that the observed errors of pairing bear no simple relation to the almost complete breakdown of spermatogenesis and the marked impairment of oogenesis that occur in tertiary trisomic Ts(5(12))31H mice. PMID- 3956268 TI - Reduced oocyte numbers in tertiary trisomic mice with male sterility. AB - Oocyte counts carried out in 3- to 5-day-old tertiary trisomic Ts(5(12))31H mice revealed a mean reduction of 71% in the number of oocytes as compared with that of normal littermates. The pool of small oocytes was reduced by 75%, and the number of growing oocytes by 8%. The sperm count of the trisomic males was less than 1% of normal, with most spermatozoa being abnormal (Beechey et al., 1980). These results indicate that the presence of the extra 5(12) chromosome, which causes male sterility, also has a marked effect on oogenesis. Possible reasons for the difference in severity of the gametogenic impairment in males and females are discussed. PMID- 3956269 TI - An improved fixation method for chromosome preparation of Chinese hamster, Chinese hamster-human hybrid, and mouse cell lines. AB - Lowering the proportion of acetic acid in the standard 1:3 acetic acid:methanol chromosome fixative used both during initial fixation and subsequent washing produced up to a 20-fold increase in the yield of intact metaphases from cultures of several permanent cell lines. Although this inhibited chromosome spreading, addition of various acetic acid-methanol mixtures immediately after the cell suspension was dropped onto slides increased the degree of spreading and resulted in well-spread, cytoplasm-free metaphases. PMID- 3956270 TI - Close linkage of MT2P1 with GC on chromosome 4. PMID- 3956271 TI - Linkage between the cystic fibrosis locus and markers on chromosome 7q. PMID- 3956272 TI - The human thymus. Histophysiology and pathology. PMID- 3956273 TI - Training in resuscitation. Is it worthwhile? PMID- 3956274 TI - Mitral valve prolapse diagnosed by echocardiography? PMID- 3956275 TI - Suppression of gastric H2-receptor mediated function in patients with bronchial asthma and ragweed allergy. AB - We have previously demonstrated a depression of airway, vascular, and cutaneous H2-histamine receptor function in sheep with experimental allergic asthma. In the present investigation, we wished to determine if there is a depression of gastric H2-receptor function in subjects with allergic bronchial asthma. In eight normal subjects and seven subjects with allergic bronchial asthma and bronchial reactivity to ragweed antigen, gastric H2-receptor function was assessed by measuring basal and maximal stimulated acid output following pretreatment with a placebo or the H2-antagonist, cimetidine. Maximal stimulated acid output was defined as the peak acid output (PAW mEq/hr) of hydrochloric acid following a subcutaneous injection of histalog (1.5 mg/kg), and selective H2-stimulation as delta PAO = PAOplacebo-PAOcimetidine. While basal acid output was not different between the two groups, mean (+/- SD) PAO was significantly lower in the asthmatic group (14.0 +/- 8.2 mEq/hr) than the normal group (27.9 +/- 9.4 mEq/hr) (p less than 0.01). Mean PAO expressed as percent of predicted maximum was 112 +/ 36 percent in the normal group and 61 +/- 34 percent in the asthmatic group (p less than 0.01). Mean delta PAO was significantly higher in the normal group (17.1 +/- 4.8 mEq/hr) than in the asthmatic group (7.0 +/- 5.3 mEq/hr) (p less than 0.005) indicating suppressed selective H2-receptor stimulation in the latter. We conclude that in subjects with bronchial asthma and marked bronchial hyperreactivity to ragweed antigen, there is a depression of gastric H2-histamine receptor function. PMID- 3956276 TI - Granulomatous myocarditis. Diagnosis by endomyocardial biopsy and response to corticosteroids in two patients. AB - Granulomatous involvement of the myocardium is of uncertain etiology, rarely diagnosed premorbidly, and the response to therapy is unknown. We report two patients with granulomatous disease apparently isolated to the myocardium, one presenting with cardiac arrest secondary to ventricular tachycardia, one with heart block. In both cases, the clinical rhythm was substantiated by electrophysiologic studies and neither case had evidence of significant myocardial dysfunction. In both, treatment was instituted with orally administered prednisone. One patient died suddenly two months following onset of therapy. Limited autopsy demonstrated no evidence of granulomatous involvement of the myocardium. The other patient is alive without clinical arrhythmias on amiodarone therapy; however, inducible ventricular tachycardia persists. Repeat endomyocardial biopsy in this patient demonstrated no granulomatous disease. These cases are discussed and the literature reviewed. PMID- 3956277 TI - Benefits of training physicians in advanced cardiac life support. AB - Unexpected cardiopulmonary arrests occur commonly both in the prehospital setting and in the course of hospital care. Survival after prehospital arrest is improved if bystanders and paramedics are trained in basic and advanced cardiac life support. However, within the hospital, the bystanders are the physicians; it is not known if life support training of these hospital-based physician bystanders leads to improved survival. Therefore, we reviewed the outcome of resuscitation attempts in a teaching hospital during two matching six-month periods, before (period 1) and after (period 2) institution of a mandatory course in Advanced Cardiac Life Support (ACLS) for medical houseofficers. It was concluded that survival after inhospital cardiopulmonary arrest is significantly increased if house officers who staff the Code teams are trained in ACLS. PMID- 3956278 TI - Ear oximetry to detect apnea and differentiate rapid eye movement (REM) and non REM (NREM) sleep. Screening for the sleep apnea syndrome. AB - Ear oximetry is commonly employed in screening patients for the sleep apnea syndrome, but the lack of objective information regarding the duration of sleep, including the presence of rapid-eye-movement (REM) sleep, is a major limitation. Based on the premise that both apnea and sleep-state-dependent changes in ventilation give rise to distinctive patterns in the arterial oxygen saturation, we developed a systematic technique to analyze ear oximetric tracings for wakefulness, REM sleep, and non-REM (NREM) sleep. Fifty-four patients were studied by both all-night polysomnography and ear oximetry. A careful comparison of ear oximetric data for sleep states and apnea was then made, using polysomnography as the correct classification to determine sensitivity, specificity, predictive value positive, and predictive value negative of the ear oximetric tracings. When classification of sleep state was compared, ear oximetry correctly classified 280.5 (82 percent) of 340.9 hours of sleep that was either REM or NREM sleep. The sensitivity for classifying NREM sleep was 0.85, for REM sleep was 0.70, and for wakefulness was 0.49. The sensitivity by ear oximetry for apnea was 0.80, with a predictive value negative of 0.87. We conclude that although polysomnography must be performed for definitive evaluation, ear oximetry is a valuable screening test for sleep apnea because the presence or absence of apnea can be determined, total duration of sleep can be estimated, and NREM vs REM sleep can be differentiated. PMID- 3956279 TI - Range of accuracy of two wavelength oximetry. AB - Earlier reports of a two wavelength oximeter suggested a tendency toward overestimation of arterial oxygen saturation (SaO2) at the lowest values examined. To investigate this possible inaccuracy, we compared oximeter readings to SaO2 over a wider range of laboratory-induced steady-state hypoxia than has previously been reported. For values of SaO2 greater than 75 percent, oximeter readings were linearly related to SaO2 such that y = 0.94 SaO2 + 8.7 (r = 0.96) and the mean difference between oximeter reading and SaO2 was 0.09 percent. However, when SaO2 was less than 75 percent, the instrument readings were progressively higher than the SaO2 so that when SaO2 was approximately 50 percent, the oximeter reading was approximately 65 percent. These data show that the two wavelength oximeter displays falsely elevated readings when the arterial saturation falls below 75 percent. PMID- 3956280 TI - Transcutaneous oxygen monitoring during fiberoptic bronchoscopy. AB - A transcutaneous oxygen sensor was used to detect the development of hypoxemia in patients undergoing fiberoptic bronchoscopy. Measurements of transcutaneous PO2 (tcPO2) correlated well with arterial PO2 (PaO2), and correctly detected all instances when PaO2 was less than 65 mm Hg. The sensor was noninvasive and caused no adverse effects. PMID- 3956281 TI - Effect of InspirEase on the deposition of metered-dose aerosols in the human respiratory tract. AB - A radiotracer technique has been used to assess the effects of a 700-ml collapsible holding chamber (InspirEase, Key Pharmaceuticals Inc.) on the deposition of metered-dose aerosols in ten patients with obstructive airways disease (mean forced expiratory volume in one second [FEV1], 64.5 percent of predicted). Patterns of deposition obtained by patients' usual techniques with the metered-dose inhaler (MDI) were compared with those by correct MDI technique (actuation coordinated with slow deep inhalation and followed by ten seconds of breath-holding) and with those by InspirEase. Deposition of aerosol was assessed by placing Teflon particles labelled with 99mTc inside placebo canisters, and inhaling maneuvers were monitored by respiratory inductive plethysmography (Respitrace). Nine of the ten patients had imperfect technique with the MDI, the most prevalent errors being rapid inhalation and failure to hold their breath adequately. With patients' usual MDI techniques, 6.5 +/- 1.2 percent (mean +/- SE) of the dose reached the lungs. This was increased to 11.2 +/- 1.3 percent (p less than 0.02) with correct technique and increased further to 14.8 +/- 1.4 percent (p less than 0.05) with InspirEase. Oropharyngeal deposition exceeded 80 percent of the dose for the MDI alone but was only 9.5 +/- 0.9 percent with InspirEase (p less than 0.01); 59.2 +/- 2.1 percent of the dose was retained within InspirEase itself. It is concluded that InspirEase gives whole lung deposition of metered-dose aerosols greater than that from a correctly used MDI, while oropharyngeal deposition is reduced approximately nine times. PMID- 3956282 TI - Wedensky facilitation. Electrotonic potentiation during complete A-V block. AB - The electrocardiogram recorded from a patient with third degree A-V block reflected almost regular A-V junctional escape rhythm. Some of the R-R cycles were slightly shorter than the basic escape cycle. A QRS complex ending such a relatively short R-R interval was always preceded by a sinus P wave, and had a QRS configuration which was minimally different from that of the escape complexes. The His bundle recording demonstrated that these minimally premature complexes were associated with an H-V interval which was shorter than that of the escape complexes. This indicates that the premature QRS complex could not be a capture beat. The relationship between the slightly premature QRS complex and the preceding sinus P-waves is explained on the basis of electrotonic potentiation or modulation to due Wedensky facilitation. PMID- 3956283 TI - Dyspnea and stridor in a young woman. Cervicomediastinal cystic hygroma. PMID- 3956284 TI - Presidential address. Hippocrates' blessing or Osler's warning? PMID- 3956285 TI - Some neglected aspects of respiratory function in pleural effusions. The diaphragmatic arch. PMID- 3956286 TI - Breath-taking skin nodules. Sarcoidosis. PMID- 3956287 TI - Pulmonary tuberculosis and bronchocentric granulomatosis. AB - Bronchocentric granulomatosis (BG) is an uncommon inflammatory lesion of unknown etiology defined on morphologic grounds by the presence of necrotizing granulomata centered on bronchi and bronchioles. We report the typical pathologic features of BG in a patient with tuberculosis. Mycobacterial and other types of infection should be excluded by appropriate stains and cultures in all patients with BG on lung biopsy, especially those who are nonasthmatic. PMID- 3956288 TI - Aortic root abscess. Initial experience using magnetic resonance imaging. AB - The detection of aortic root abscess by magnetic resonance imaging has not been described previously. We report a patient with an aortic root abscess that was successfully diagnosed by magnetic resonance imaging and echocardiography. Computed tomography failed to detect the abscess. The patient recovered with antibiotic therapy. Based on this case and other reports in the literature, we advocate treating similar patients without surgery. We recommend magnetic resonance imaging as an investigational method where the diagnosis of aortic root abscess is ambiguous. PMID- 3956290 TI - Verapamil in tachycardia therapy. PMID- 3956289 TI - Sarcoidosis in an apparently healthy volunteer. AB - As previously reported in this journal, alveolitis may occur in asymptomatic individuals exposed to antigens known as causative agents in hypersensitivity pneumonitis. We found an alveolitis, probably of sarcoid origin, in an apparently healthy volunteer. PMID- 3956291 TI - Evaluation of serum theophylline measurement using a test-strip. PMID- 3956292 TI - Treadmill exercise test performance index. PMID- 3956293 TI - Immunoglobulin abnormalities in bronchoalveolar lavage specimens from amiodarone treated subjects. PMID- 3956294 TI - Association of ulcerative colitis and sarcoidosis? PMID- 3956295 TI - Embryology of bronchial atresia. PMID- 3956296 TI - Hypokalemia from usual salbutamol dosage. PMID- 3956297 TI - IV World Conference on Lung Cancer. Toronto, Canada, August 25-30, 1985. PMID- 3956298 TI - International control of smoking and the US experience. AB - International data demonstrate convincingly that lung cancer death rates follow and parallel cigarette smoking prevalence rates in both men and women. Effective control of lung cancer and the many other diseases associated with smoking can be achieved only by continued reductions in smoking prevalence in developed countries and the arrestment of smoking in developing countries. Smoking control strategies can take the form of prevention programs, cessation programs, regulatory and legislative measures, and modifications in tobacco product composition. Because of uncertainties surrounding the efficacies of specific smoking control approaches, the National Cancer Institute recently initiated a major intervention research program to identify and assess the most promising strategies to reduce smoking prevalence in the general public and high-risk populations; heavy smokers, blacks, Hispanics, women, youth, and smokeless tobacco users. By 1990, trial results will be available to allow systematic application of smoking control strategies (demonstrations) using physicians and dentists, mass media, school programs, self-help materials, and the community as a laboratory. For a number of reasons, such approaches are strongly recommended over efforts to reduce cigarette tar and nicotine levels as the primary focus of lung cancer control. PMID- 3956299 TI - Magnetic resonance imaging in lung cancer. PMID- 3956300 TI - Environmental carcinogenesis. PMID- 3956301 TI - Correlative anatomy, pathology and imaging (lung cancer). PMID- 3956302 TI - Screening (lung cancer). PMID- 3956303 TI - The diagnosis of peripheral nodules. PMID- 3956304 TI - Pulmonary resections. PMID- 3956305 TI - Surgery for N2 disease. PMID- 3956306 TI - Supportive care of patients. PMID- 3956307 TI - Asbestos related disease. PMID- 3956308 TI - The role of licensing in child placement and protection. AB - Regulation of child residential care facilities requires licensors who have professional experience in child welfare. Licensing requirements must be applied within a context of professional knowledge and experience, particularly in regard to child placement and child protective services. The licensing of facilities for out-of-home care of vulnerable children generally has not been viewed as a mainstream social service or child welfare function. Although licensing differs from placement services and protective services in that licensing is basically a nonservice approach to protection each of the three elements forms a triangle of comprehensive protection for vulnerable children. Recognition of both the similarities and the distinguishing characteristics of the three elements reduces individual and organizational role conflict and, furthermore, holds promise for mature and effective coalitions in achieving the common goal of protection for vulnerable children in out-of-home care. The strength of a statewide licensing program is founded in centralized organizational and supervisory structure. Licensing must fulfill its partnership role in coordination with child placement and child protective services to achieve genuine community protection for vulnerable children. PMID- 3956309 TI - Court-ordered foster family care reform: a case study. AB - The authors examine the implications of G. L. v. Zumwalt, a case that resulted in a far-reaching consent decree that mandates specific reforms in policy and practice to be implemented by a public social welfare agency in its delivery of services to foster children and their families. PMID- 3956310 TI - Developing positive self-concepts in institutionalized children with severe behavior disorders. AB - This study investigated the capacity of one intervention--a modified creative dramatics program--for development of positive self-concept and creative expression in children. Using a sample of both institutionalized (n = 44) and noninstitutionalized (n = 38) children, the study indicated that the intervention group significantly improved on both self-concept and creative expression measures. The most improvement, moreover, was noted in subjects who were both institutionalized and behavior-disordered. PMID- 3956311 TI - Cooperative adoption: an alternative to independent adoption. AB - This description of an agency-supported independent adoption program may have significance for other adoption programs and policies. Program assumptions and goals, key design features, and problems experienced in implementing the program are described. The program's impact upon an agency's traditional adoption program is discussed, as well as concerns that have long been raised about the ethicality of independent adoption practices. PMID- 3956312 TI - Continuity in mental development from infancy. AB - In this essay we document moderate continuity in mental development beginning in infancy and extending into childhood. Psychological opinion in the past has tended to favor discontinuity theories of cognitive development from infancy. In recent years, however, the foundations on which discontinuity positions were originally established have themselves come under question and new findings grounded in new assessment procedures have appeared, necessitating revision of opinion on this significant psychological and developmental issue. Our essay has several aims. We first review briefly the bases for contemporary discontinuity theories of mental development. Second, we present current findings that support the alternative proposition of continuity: Recent research demonstrates that infants who more efficiently encode visual stimuli or more efficiently recollect visual or auditory stimuli tend to perform more proficiently on traditional psychometric assessments of intelligence and language during childhood. Third, we scrutinize the assessment methods from which these continuity results derive. Fourth, we offer several models that help to explain the continuity findings. Fifth, we discuss critically the origins and the maintenance of continuity in mental development as it is coming to be conceptualized currently. Finally, we reflect on implications of continuity for the future of infant assessments specifically and for theories of early mental development generally. PMID- 3956313 TI - Infants' attentional responses to frequency modulated sweeps. AB - In 3 experiments, the attentional responses of 4-month-old infants to frequency modulated (FM) sweeps corresponding to the frequency range of adult-to-infant and adult-to-adult intonation patterns were assessed. In Experiment 1, infants were observed to discriminate "exaggerated" (i.e., adult-to-infant) FM sweeps from "normal" (i.e., adult-to-adult) FM sweeps in a habituation-dishabituation paradigm but did not selectively attend to one over the other. In Experiment 2, where the same stimuli were used in a paired-comparison paradigm, again no differential attention was observed. In Experiment 3, the most exaggerated sweep was paired against a continuous, monotonic pure tone, but again no difference in salience was observed. These data suggest that the extent of modulation or intonation of an auditory stimulus per se does not constitute a salient cue for infants' attention to sound. PMID- 3956314 TI - Kinetic contours in infants' visual perception. AB - 3-month-old infants' perception of "camouflaged" forms that are only visible when moving was studied. Displays were used in which figure and ground had an identical random dot texture, and no edge indicated the form of the figure. The form was invisible when stationary. Discrimination of 2 different forms was tested (a) when the forms were visible only through motion, and (b) when the forms appeared as stationary white figures on black ground. The babies discriminated the forms in both conditions. Furthermore, when infants were habituated to one of the moving forms and subsequently presented with the same and a new static form, they looked longer at the new form. This indicates that they recognized the static form as either the same or different from the moving form seen before, although the optical sources of information were completely different. At 3 months, infants can therefore effectively use kinetic information to organize the visual input in higher-order structures. PMID- 3956315 TI - Prematurity stereotyping: effects on mother-infant interaction. AB - The possibility that the self-fulfilling prophecy process can adversely affect the caregiving environment of premature infants was explored in this study. A portion of this process was investigated experimentally by assessing cognitive and behavioral reactions of 27 mothers to unfamiliar full-term infants who were labeled either full-term or premature. Infants who were described as premature were touched less and given a more immature toy to play with, were rated as smaller, finer-featured, and less cute, and were liked less than infants who were labeled full-term. In turn, infants labeled premature were less active during the interaction than infants labeled full-term. College students who later observed the videotapes made of the mother-infant interactions were able to accurately guess which label was assigned to the infants. The results of this study further support the existence of a prematurity stereotype and the impact of expectations on perceptions and behavior. PMID- 3956316 TI - Emotion socialization and expressive development in preterm and full-term infants. AB - The expressive behaviors of full-term and preterm infants and their mothers were examined during face-to-face interaction when the infants were approximately 2 1/2, 5, and 7 1/2 months old. Videotapes of the sessions were coded on a second to-second basis using Izard's discrete emotion coding system. Overall, infants showed a linear increase in positive effect, especially interest and joy, and a corresponding decrease in negative affect, especially pain and knit brow, with age; decrease in negative affect was accounted for largely by the preterm infants. In terms of maternal responses, there was an increase in contingent responding to infant interest expressions and a decrease in contingent responding to infant pain expressions over time, especially in the case of the preterm infant. The data set as a whole was examined further to establish the directionality of influence between mothers and infants in change patterns over time. There was evidence of learning effects in infants as a function of maternal modeling and contingency patterns. Anomalies in maternal responses to preterm infant affect expressions were observed. Mothers of these infants displayed significantly less matching or imitation of their infant's facial expressions, showed random rather than contingent responsiveness to sadness, and a significant ignoring response to infant anger. These differences were attributed to differences in gazing patterns and negative emotion expression in preterm infants. The results are discussed within a framework of emotion socialization that recognizes bidirectionality of influence in the emotional patterns of mothers and infants. PMID- 3956317 TI - Consistency and change in mothers' behavior toward young siblings. AB - Siblings differ markedly in behavioral development, and it has been suggested that differential maternal treatment may contribute significantly to these differences. The question of how consistently mothers treat their different children was examined in a study of 45 sibling pairs from the Colorado Adoption Project, in which each child at 24 months of age was videotaped at home with the mother. The results showed mothers to be consistent in affection and verbal responsiveness but to differ in their controlling behavior toward the 2 siblings. Comparison of the same mother's behavior to the 2 siblings at 12 months and at 24 months showed little stability in maternal behavior to the same child over this age period. PMID- 3956319 TI - Children's reasoning about social, physical, and logical regularities: a look at two worlds. AB - In 2 studies, 6-, 8-, and 10-year-old children were interviewed about 3 different types of regularities or rules: social conventions, physical laws, and logical necessities. In the first study, children were asked if regularities could be changed (by consensus) and/or be different in another world. In the second study, children were asked if regularities could be different in another country (on Earth) or on a different planet. Results showed that social regularities were distinguished from the other types, but physical and logical regularities were treated similarly. While the evidence for age differences was equivocal, it was clear that even first graders did not judge physical items as alterable on Earth. This fails to replicate a previously reported finding that children pass through a stage where all items are seen as alterable. Finally, a sex difference emerged, with boys more willing to judge physical and logical regularities to be alterable in another world. PMID- 3956318 TI - Ethnic, gender, and age preferences among deaf and hearing preschool peers. AB - The present study concerns ethnic, age, and gender playmate preferences of deaf and hearing preschoolers who were observed during outdoor free play at their respective schools over a 7-month period. Hispanic, black, and white children were included. It was hypothesized that peer preferences would be less apparent among deaf children than among hearing children if these preferences were based on (a) language differences between ethnic groups (e.g., Spanish-English differences), age groups (e.g., verbal fluency differences), or gender groups; or (b) cultural values communicated by speech. Both deaf and hearing children preferred to play with children of the same ethnicity, gender, and age as themselves. In addition, play among children of the same ethnicity, gender, and age was qualitatively different from play among children of different ethnicity, gender, and age. The only effect of deafness was to decrease the amount of gender segregation that occurred. The results suggest that the development of ethnic, gender, and age playmate preferences is not dependent on intergroup language differences or spoken cultural messages. Several nonlinguistic factors that might contribute to early peer preferences are discussed. PMID- 3956320 TI - Humor and competence in school-aged children. AB - Multiple aspects of humor were evaluated in children between the ages of 10 and 14 and related to several areas of competence manifested at school. Humor measures assessed appreciation (including mirth, subjective ratings, and response sets), comprehension, and production, while competence measures included teacher ratings of classroom behavior, peer reputation, and achievement. Humor was related to competence in several ways consistent with previous theory and research: (1) through the manifestation of intellectual ability both in humor behaviors and in competent functioning; (2) through the role of mastery motivation enhancing both types of functioning; and (3) through peer relations, resulting from the effects of humor on peer acceptance or the effects of peer relations on humor behaviors. Ideas for further research relating humor to social competence, social cognition, and mastery motivation are discussed. PMID- 3956321 TI - Sex differences in moral reasoning: response to Walker's (1984) conclusion that there are none. AB - Data from the Family Socialization and Developmental Competence Project are used to probe Walker's conclusion that there are no sex differences in moral reasoning. Ordinal and nominal nonparametric statistics result in a complex but theoretically meaningful network of relationships among sex, educational level, and Kohlberg stage score level, with the presence and direction of sex differences in stage score level dependent on educational level. The effects on stage score level of educational level and working status are also shown to differ for men and women. Reasons are considered for not accepting Walker's dismissal of studies that use (a) a pre-1983 scoring manual, or (b) fail to control for education. The problems presented to Kohlberg's theory by the significant relationship between educational and stage score levels in the general population are discussed, particularly as these apply to the postconventional level of moral reasoning. PMID- 3956322 TI - [Stabilizing operations of the thorax]. PMID- 3956323 TI - [Stabilizing operations of the pelvis]. PMID- 3956324 TI - [A so-called atypical adenoma of the thyroid in an endemic struma area]. AB - In view of the benign clinical course of the atypical adenoma and the high diagnostic accuracy of our frozen sections we feel that subtotal strumectomy with in toto removal of the adenoma and closely spaced follow-ups constitutes an adequate treatment of this thyroid neoplasm. In our opinion primary lobectomy means unnecessarily exposing a disproportionately high percentage of patients to the higher complication risk of this more radical surgery. From 1977 to 1982 there were 47 cases of atypical adenoma among our patients. The ratio men: women was 1:3.7, the mean age of the patients was 44 years. The patients underwent subtotal strumectomy. In the period under review "atypical adenoma" diagnosed on the basis of frozen sections turned out to be carcinoma in 5 instances. The follow-up period of the 47 patients that underwent surgery ranges from 1 1/2 to 7 years. None of the patients has had tumor regrowth so far. PMID- 3956325 TI - [Chronic subileus caused by multiple enteroliths]. PMID- 3956326 TI - [Mediastinal pancreatic pseudocyst]. PMID- 3956327 TI - [Paramediastinal lesion with change of form on the chest x-ray image: sliding Morgagni hernia]. PMID- 3956328 TI - Symptomatic ectopic gastric epithelium of the cervical esophagus. Demonstration of acid production with Congo red. AB - Four patients were found with patches of gastric fundal type epithelium just distal to the cricopharyngeus, separated from the gastroesophageal junction by 15 20 cm of normal squamous epithelium. Three of the four had symptoms of dysphagia localized to the area of the esophagus containing the epithelium. Congo red dye (a pH indicator) applied to the mucosa during endoscopy revealed acid production by the mucosa after stimulation with pentagastrin. Interestingly, the patients' symptoms decreased during treatment with cimetidine only to return on cessation of therapy. PMID- 3956329 TI - Gastric emptying and gastrointestinal absorption of alcohol ingested with a meal. AB - We have measured, by an intubation method, gastric evacuation and gastrointestinal absorption of alcohol ingested with a meal in seven healthy nonalcoholic subjects. A homogenized meal containing [14C]PEG and ethanol (1 g/kg body wt) was given intragastrically while saline containing [57CO]vitamin B12 was perfused into the duodenum. Of the ingested alcohol, 39.4 +/- 4.1% was absorbed through the stomach wall during the first postprandial hour and 73.2 +/- 4.2% during the total postcibal period, whereas only 24 +/- 3% was absorbed during the same time in the duodenum. Thus alcohol ingested with a meal is mainly and rapidly absorbed in the stomach; the contribution of the small intestine below the angle of Treitz to alcohol absorption is negligible. PMID- 3956331 TI - Glucagon-(1-21)-peptide. Study of its action on sphincter of Oddi function by endoscopic manometry. AB - The amino acid sequence (1-21) of glucagon has been shown to have full spasmolytic action in animal studies but no metabolic effect. The motor activity of the sphincter of Oddi was measured during ERCP with manometric recordings of sphincter pressure. Then glucagon-(1-21)-peptide was given as a bolus intravenous injection; serial blood samples were taken to determine glucagon-like immunoreactivity. The spasmolytic effect of glucagon-(1-21)-peptide began 15 sec after injection and lasted up to 22 min at the higher doses. The basal pressure of the sphincter of Oddi was decreased by 31-56% after administration of glucagon (1-21)-peptide. Phasic sphincter of Oddi pressure and wave frequency were also affected. In conclusion, glucagon-(1-21)-peptide has a relaxing effect on the human sphincter of Oddi and might emerge as an alternative to glucagon or other spasmolytic drugs for obtaining selective relaxation of the biliary tract. PMID- 3956330 TI - Dopamine-induced migrating myoelectrical complex-like activity in human duodenum. AB - The effect of dopamine on human gastric and small intestinal interdigestive motility was investigated in 12 subjects. Intestinal motility was recorded by means of a four-lumen polyvinyl probe with four open tips located 15 cm apart, continuously perfused with distilled water. In each subject during the same study, after recording two consecutive spontaneous phase III of migrating myoelectrical complexes and when a phase II appeared, dopamine was infused intravenously twice in a dose of 5 micrograms/kg/min for 15 min with an interval of 20 min between each infusion. In six subjects, the second dopamine infusion was preceded by a treatment with sulpiride (10 mg, intravenously, as bolus) or domperidone (10 mg, intravenously, as bolus), each considered a highly selective dopamine antagonist. The results show that dopamine stimulates duodenal motility producing a pattern similar to that observed in phase III of spontaneously occurring migrating myoelectrical complexes. The second dopamine infusion reproduced in all cases the same pattern of motility as observed during the first infusion. Sulpiride and domperidone prevented the effect of dopamine in all cases. It is therefore suggested that dopamine-induced duodenal motility may involve specific dopaminergic receptors. PMID- 3956332 TI - Biliary excretion of radioactivity after intravenous administration of [3H]25 hydroxyvitamin D3 in man. AB - The biliary excretion of radioactivity after intravenous [3H]25-hydroxyvitamin D3 was studied in nine patients with T-tube bile drainage. The mean +/- SD 24-hr radioactivity excretion in T-tube bile expressed as a percentage of the administered dose was 6.7 +/- 2.9%; after correction for incomplete bile collection, the value obtained was 16.0 +/- 11.1%. Chloroform solubility of biliary radioactivity increased from 27.4 +/- 8.9% to 72.9 +/- 10.1% following incubation with beta-glucuronidase. High-performance liquid chromatographic analysis of chloroform extracts of bile revealed that most of the eluted radioactivity was more polar than [3H]25-hydroxyvitamin D3. No free [3H]25 hydroxyvitamin D3 was demonstrated. Thus in man, most of the biliary radioactivity excreted following [3H]25-hydroxyvitamin D3 is in the form of water soluble compounds, mainly glucuronides. However, our results suggest that glucuronides of metabolites other than 25-OHD3 are predominantly formed. PMID- 3956333 TI - New method of testing for carbohydrate absorption in man. Xylose and sucrose absorption; effects of sucrase inhibition. AB - Absorption of carbohydrate was quantitated in 49 subjects without disease of the small bowel using a new technique for ileal perfusion. A double-lumen tube with an attached balloon was inserted retrograde through the colon and used to quantify arrival in the ileum of D-xylose and a nonabsorbable marker which had been taken orally. In the same way, absorption of sucrose and the effects of an inhibitor of alpha-glucosidase were also studied. Insertion of the assembly through the colon and intubation of the terminal ileum was usually possible within 30 min; we have designated the technique, endoscopic retrograde bowel insertion (ERBI). The test meals were 500 ml of water containing either 25 g D xylose and 5 g polyethylene glycol (PEG 4000), or 100 g sucrose with 5 g PEG. Sucrose meals also contained 0, 100, or 200 mg of an inhibitor of alpha glucosidase (BAYg5421). At the end of a 5-hr test period, the ratio of recovery of D-xylose relative to that of PEG indicated that 69% of D-xylose was absorbed. Five-hour urinary excretion of D-xylose was 31% of that ingested, or 45% of the D xylose which was absorbed. Sucrose was recovered in ileal samples only when administered together with inhibitor. Rates of sucrose absorption with BAYg5421, 100 and 200 mg, were 75% and 65%, respectively. The perfusion technique of ERBI is a rapid and reproduceable approach to the distal small intestine of man which could be of value in the investigation of intestinal absorption. PMID- 3956334 TI - Dysphagia aortica. Clinical, radiological, and manometric findings. AB - Three patients with dysphagia caused by compression of the distal esophagus by a tortuous nonaneurysmal atherosclerotic aorta are described. All three patients were elderly women; systemic hypertension and cardiomegaly were present in two patients. Barium studies of the esophagus showed displacement and compression of the distal esophagus by the thoracic aorta. Debilitating dysphagia was treated surgically in one patient. The other two patients had milder symptoms and were managed conservatively. Esophageal manometry in these three patients showed superimposed pulsations and elevated intraluminal pressure just proximal to the lower esophageal sphincter. To evaluate the significance of these manometric findings and their correlation with clinical symptoms, we reviewed manometric tracings in 47 normal subjects. Ten of these subjects had an elevation of baseline intraluminal esophageal pressure as a result of superimposed vascular pulsations. We conclude that compression of the distal esophagus by a tortuous atherosclerotic aorta in the appropriate setting can lead to clinically significant dysphagia and a manometric finding of vascular compression of the esophagus does not necessarily correlate symptomatic dysphagia. PMID- 3956335 TI - Pathogenesis of compound 48/80-induced gastric lesions in rats. AB - Intraperitoneal administration of 0.75 mg/kg of compound 48/80 (a mast cell degranulator) once daily for four days induced extensive gastric lesions in rats. Oral administration of tripelennamine (histamine H1-receptor antagonist) and cimetidine (histamine H2-receptor antagonist) twice daily for four days had little or no effect on the lesion formation. Oral administration of methysergide and cyproheptadine (serotonin antagonists) and FPL-52694 (a mast cell stabilizer) potently inhibited the compound 48/80-induced lesions. Intraperitoneal administration of histamine plus serotonin, or serotonin alone, induced gastric lesions which resembled those induced by compound 48/80. These lesions were potently inhibited by methysergide and cyproheptadine, but not by tripelennamine, cimetidine, and FPL-52694. Single or repeated administration of compound 48/80 significantly increased serum histamine and serotonin levels. After a single administration of compound 48/80, the increased histamine levels rapidly returned to normal levels, but serotonin levels remained high for 7 hr. Histamine and serotonin levels in the gastric mucosa were transiently increased after a single administration of compound 48/80, but remained normal after repeated administration. Single or repeated administration of compound 48/80 had little effect on arterial blood pressure. The compound 48/80-induced gastric lesions appear to be caused primarily by the release of serotonin, but not histamine, from extragastric sources. PMID- 3956336 TI - Prostaglandin requirements are greater for protection in cold restraint-induced than alcohol-induced gastric mucosal injury. AB - Exogenous prostaglandins inhibit visible gastric mucosal lesions produced by both absolute ethanol and cold restraint in the rat. Pretreatment with "mild irritants" significantly reduces the magnitude of ethanol-induced lesions presumably by stimulating endogenous prostanoid production. The effect of mild irritant pretreatment on cold restraint-induced lesion formation has not been previously reported. This study was designed to compare the protective effect of pretreatment with two "mild irritants," 4% NaCl and 0.35 M HCl, and the synthetic prostanoid, 16,16 dimethyl PGE2(16,16-dm PGE2), on lesions produced by cold restraint or absolute ethanol. Pretreatment with both mild irritants produced complete visible protection against ethanol-induced injury but had variable effects against cold restraint-induced injury. Whereas 5 micrograms/kg 16,16 dmPGE2 provided complete visible protection against ethanol-induced injury, 20 micrograms/kg 16,16-dmPGE2 was required for complete visible protection against cold restraint-induced injury. We conclude that prostaglandin requirements for protection against cold restraint injury are greater than for protection against ethanol-induced gastric mucosal injury. PMID- 3956338 TI - Effect of sham feeding on gastric emptying of liquids in dogs. AB - The effects of sham feeding and of cimetidine, an inhibitor of gastric acid secretion, used alone or in combination on the gastric emptying of liquids were studied in four dogs fitted with a gastric fistula and a Komarov esophagostomy. Gastric emptying of a 290-ml water meal was slowed by sham feeding but not by cimetidine. Our experiments indicate that, in dogs, sham feeding slows gastric emptying of liquids by a mechanism independent of the acid secretion induced by vagal stimulation. PMID- 3956337 TI - Neural pathways involved in intracisternal bombesin-induced inhibition of gastric secretion in rats. AB - Possible humoral and neural components mediating intracisternal bombesin (500 ng) induced inhibition of gastric secretion were studied in rats. Intracisternal bombesin induced a marked rise in gastric pH from 2.0 +/- 0.5 up to 6.5 +/- 0.6 whereas gastric secretion in parabiotic saline-treated partners was not modified. Bombesin inhibited pentagastrin-stimulated gastric acid output by 88 +/- 5% in intact rats and 71 +/- 7% in vagotomized animals. Spinal cord transection at the level of the 5th or 7th cervical but not the 8th or 13th thoracic vertebrae significantly reversed the rise in pH and the decrease in acid concentration induced by bombesin and abolished the hyperglycemic effect of the peptide. These results suggest that bombesin inhibitory action on gastric secretion is not mediated through humoral factors but through neural pathways in part related to the sympathetic nervous system along the spinal cord, whereas the parasympathetic outflow from the vagus or the sacral spinal nerves does not seem to play an important role. PMID- 3956339 TI - Component quantitation of rat ileum. AB - Precise and accurate light microscopic morphometric analyses of biological tissue can be achieved utilizing component quantitative techniques. Component quantitation refers to measurements of the relative volumes of components in tissue sections. Such an assessment is predicated upon the mathematically verifiable assumption that direct quantitative relationships exist between an aggregate of profiles of a component contained per unit area in multiple sections and an aggregate of profiles contained per unit volume. A linear scanning device (micrometer component quantitator) was initially employed for quantitative analyses of pancreas. This quantitative technique has subsequently been applied to normal rat ileum conventionally processed for light microscopy, and the requisite sampling parameters have been defined. An identical technique was then applied to physiologically manipulated rat ileum--a gnotobiotic group, a group with ileal self-filling blind loops, and a group with ileal Thiry-Vella loops. The results observed support the following conclusions. The volume percentage of the various components of the rat ileal wall of control animals was defined utilizing the micrometer component quantitator. Hypertrophy of the ileal muscularis externa within the ileal self-filling blind loops was observed, probably secondary to mechanical obstruction. Atrophy of the ileal epithelium within the gnotobiotic group and within the Thiry-Vella loops was observed, possibly secondary to an altered endogenous microbial flora. Recognition of quantitative variations among the histological components of the intestinal wall in association with physiological manipulations or pathologic states was (is) feasible by utilization of this component quantitative technique. PMID- 3956340 TI - Squamous cell carcinoma of esophagus presenting as multiple pedunculated polyps. PMID- 3956341 TI - Esophagus and toxic oil syndrome. PMID- 3956342 TI - Oral methotrexate. PMID- 3956343 TI - Pancreas divisum. PMID- 3956344 TI - Developmental pharmacology and therapeutics of piperacillin in gram-negative infections. AB - Twenty children ranging in age from 1 week to 19 years with documented or suspected bacterial infections arising outside the central nervous system were studied. Pharmacokinetic analysis was possible in 15 children; 8 after the first dose, 6 during steady-state conditions, and 4 on both occasions. Data were obtained utilizing noncompartmental pharmacokinetic methods. Peak piperacillin serum concentrations ranged from 51 to 232 mg/l and correlated directly (r = 0.75) with the dose administered. In children with normal renal function, there was an age-dependent decrease in elimination half-life and apparent steady-state volume of distribution, whereas plasma clearance increased logarithmically. All but 1 child responded favorably to piperacillin therapy, and 1 child with a urinary tract infection relapsed 10 days after discontinuation of the therapy. Although improved clinically, piperacillin monotherapy failed to eradicate pathogens in 2 children. No adverse clinical or biochemical effects were observed in any child. PMID- 3956345 TI - Ontogeny of plasma-free thyroxine and triiodothyronine concentrations during the perinatal period and maternofetal transfer of thyroid hormones in the rabbit. AB - Although rabbit has been used as a convenient animal model in understanding the role of thyroid hormones during the perinatal development, ontogenetic changes in plasma-free thyroxine or triiodothyronine concentration has not been studied in this species. We delineated the ontogeny of immunoreactive plasma-free thyroxine and triiodothyronine concentration during the perinatal period. It is generally believed that thyroid hormones do not cross the placenta from the mother to the fetus in sufficient concentrations to exert biological effects in the fetus. We administered 250 micrograms/kg of thyroxine (T4) or 125 micrograms/kg of triiodothyronine (T3) intramuscularly to the rabbit doe on the 25th and 26th day of gestation. Maternal and fetal plasma-free T4, T3 and glucose concentration and fetal liver glycogen content were quantitated on the 27th day of gestation. Maternal and fetal plasma-free T4 and T3 concentration was significantly higher than the control in T4-treated animals. Maternal and fetal plasma T3 concentration was higher and free T4 concentration lower than the control in T3 treated animals. T3 or T4 treatment resulted in fetal hyperglycemia and depletion of fetal hepatic glycogen content. We conclude that T4 or T3 cross the rabbit placenta and exert thyromimetic effects in the fetus. A convenient animal model to investigate in utero effects of T4 or T3 in mammalian fetal development is proposed. PMID- 3956346 TI - Reduced binding of basic somatomedin by mouse placental membranes following maternal alcohol administration. AB - The effects of 3 days of maternal ethanol administration on the placenta and on basic somatomedin (B-SM) were investigated in the mouse. Following administration of aqueous ethanol by gavage on days 13, 14 and 15 of gestation, there was no treatment-related difference in embyonic growth or placental weight as seen on day 15. There was a significant reduction in the specific binding of [125I]B-SM by day 15 placental membranes, but no difference in serum B-SM concentrations or in the frequency or severity of degenerative changes in the placenta. We have shown that changing levels of serum B-SM over the normal course of pregnancy correspond closely to patterns of cellular proliferation and aging in the placenta. It is possible that impairment in the binding activity of B-SM receptors contributes to the premature aging observed in term placentas exposed to alcohol during pregnancy in the rodent. PMID- 3956348 TI - Transient plasma cholinesterase deficiency in preterm infants. AB - Plasma cholinesterase (ChE) activity was determined shortly after birth in 39 healthy preterm and 20 term infants using a commercially available screening assay. 40 samples of adult blood were analyzed for comparison purposes. There were no statistically significant differences in abnormally low enzyme levels in preterm or term infants and adults. Furthermore, in the preterm infants, ChE activity could not be correlated to gestational age, sex or race. Initially low ChE levels rose to normal adult levels within 2 weeks in all but 2 preterm infants. When muscle relaxant use is deemed necessary in hospitalized preterm infants, measurement of enzyme activity or use of drugs other than succinylcholine may be indicated on the basis of transient ChE deficiency. PMID- 3956347 TI - An extracorporeal hollow-fiber reactor for phenylketonuria using immobilized phenylalanine ammonia lyase. AB - A hollow-fiber hemodialyzer with immobilized phenylalanine ammonia lyase was tested in vitro for depletion of blood phenylalanine in a recirculating system. A sustained reduction of phenylalanine was obtained in less than 1 h. The product of phenylalanine deamination, trans-cinnamic acid, is a nontoxic compound metabolized to benzoic acid by the liver and eliminated in the urine as hippuric acid. As a model, this reactor may be relevant not only for the short-term management of hyperphenylalaninemia (particularly in pregnant phenylketonuric mothers), but for other metabolic diseases as well, provided that a biocatalyst effective on the accumulating substance is available. PMID- 3956350 TI - Program and abstracts from the Sixth Annual Congress for Recombinant DNA Research. January 26-29, 1986, Baltimore, Maryland. PMID- 3956349 TI - Pharmacodynamic determinants of furosemide diuretic effect in children. AB - The pharmacodynamics of 1 or 2 mg/kg of furosemide administered as a single dose orally or intravenously were studied in 34 hospitalized children (ranging in age from 9 days to 16.5 years) with normal renal function. These patients were divided into 3 groups: infants (furosemide 1 mg/kg, intravenously); children with steroid-responsive nephrotic syndrome (furosemide 2 mg/kg, orally and intravenously); patients with urinary tract infections and mild hypertension (furosemide 2 mg/kg, orally). A statistically significant positive linear relationship was found in these groups between the furosemide urinary excretion rate and urine flow rate, but log dose-response curves to furosemide were found to vary between the groups of patients studied. This variability reflects differences in the relationship between the amounts of furosemide reaching active sites and the pharmacodynamic effect of the drug. No sigmoid-shaped log dose response curve (i.e., one approaching a zero response at very low furosemide urinary excretion rates, and a maximum response at very high excretion rates) was attained in this study. This suggests that the capacity of the kidney tubules to respond diuretically to the administered doses of furosemide was not exceeded in the studied patients. However, in the infants, a very steep log dose-response curve to a 1 mg/kg intravenous dose of furosemide suggests that higher doses may not result in a significant increase in diuretic response in infants with reasonably normal renal function. The lowest mean furosemide urinary excretion rate associated with significant diuresis was 0.58 +/- 0.33 micrograms/kg/min. Also, a significant correlation was found between the amount (in milligrams), of furosemide excreted in the urine during the first 6 h after administration and the urine volume collected during that time (r = 0.71; p less than 0.001; number of measurements = 43). PMID- 3956351 TI - Hereditary retinal degenerative diseases. 22nd symposium of the International Society for Clinical Electrophysiology of Vision (ISCEV). Stockholm, Sweden, May 28-31, 1984. PMID- 3956352 TI - Acuity estimated by visually evoked potentials is affected by scaling. AB - Seven subjects whose corrected Snellen acuities were normal had their monocular acuities (14 eyes) tested by visually evoked potentials (VEPs) elicited by eight checkerboard patterns which reversed 15 times per second. Check size ranged from 20 to 3.4 min. arc. Monocular VEP acuities were determined by least squares regression with linear or logarithmic scales of amplitude and pattern size. Pattern size was measured as arc minutes (horizontal size) or fundamental spatial frequency of the checkerboard. The extrapolated VEP acuities were obtained by analyses of variance and post hoc tests. The presence of statistically significant differences in VEP acuity which result from varying combinations of stimulus and response scales indicates a need for caution in selecting scales for VEP estimates of visual acuity. PMID- 3956353 TI - Minimum procedures for visual electrodiagnostic testing. AB - A set of procedures for the electroretinogram, electrooculogram, and pattern and luminance visual evoked cortical potentials was defined by representatives from all Dutch University Eye Clinics in order to promote standardization of procedures for routine diagnostic testing. The procedures have been selected to obtain an answer to most electrodiagnostic questions of frequent occurrence with a minimum of equipment and examination time. An individual examiner may add other procedures to the proposed program to extend and diagnostic possibilities. PMID- 3956354 TI - ERG and EOG in progressive paravenous retinochoroidal atrophy. AB - A case of paravenous retinochoroidal atrophy was followed over a period of more than 2 years. Rapid progression of the disease was reflected in the deterioration of visual acuity and fields. Electroretinographic recordings revealed reduced photopic and scotopic amplitudes according to the extent of the retinal lesions. In electrooculography virtually no slow and no fast light-induced oscillations could be recorded. These results suggest an involvement of the entire retinal pigment epithelium. PMID- 3956355 TI - Early receptor potential recordings for clinical routine. AB - An apparatus and an electrode for early receptor potential recordings in clinical routine are introduced. One-hundred and eighty normal eyes were compared with cases of diffuse and localized retinal diseases. In retinitis pigmentosa patients a decrease in R1 and R2 amplitudes and in some cases a much faster time course was found. Eyes with circumscribed retinal affectations produced a wide variety of amplitudes, overlapping with the range of normals. In cases of monochromatism, the ERP recording established the diagnosis because of an absent R1 wave. PMID- 3956356 TI - The influence of intravitreously injected silicone oil on electrophysiological potentials of the eye. AB - In a prospective study the effect of silicone oil injected in the vitreous cavity was monitored electrophysiologically in six patients who were treated for retinal detachment. Electroretinograms (ERG) and electrooculograms (EOG) were recorded before, shortly after, and up to four months following the removal of the oil. An evident increase of the standing potential could be observed in all eyes after removal of the silicone oil. In some patients the ERG amplitudes increased also. No fast oscillations and virtually no slow oscillations could be recorded in the EOG. Follow-up studies did not show a significant recovery of the bioelectric activity. Intravitreal silicone oil appears to cause an insulation effect which interferes with the propagation of electrical potentials. The result of the present study do not provide information concerning possible retinotoxic effects of silicone oil. PMID- 3956357 TI - Effects of ethyl alcohol on VECP. AB - Previous studies have demonstrated that ethyl alcohol ingestion affects the clinically recorded visually evoked cortical potential (VECP). However these studies have not related the possible relevance of such alcohol-induced VECP changes to visual performance. We studied the flash and pattern-reversal monopolar VECP recorded at the occiput before and after alcohol ingestion and compared the recordings with psychophysical parameters (e.g. contrast sensitivity) also measured before and after alcohol intake. Results are presented, and the potential usefulness of VECP alterations in predicting alcohol induced effects on visual performance is evaluated. We found no clear, consistent effect of blood alcohol levels ranging from 0.05% to 0.15% on the parameters tested. PMID- 3956358 TI - Cone function and cone interaction in hereditary degenerations of the central retina. AB - Spectral sensitivity functions and the transient decrease of sensitivity to short wavelengths after the offset of yellow light (transient tritanopia) were measured by increment threshold techniques in patients suffering from hereditary macular degenerations. Color vision defects were determined by arrangement tests and the anomaloscope. Central areolar choroidal dystrophy was found to produce a mild protan defect and to reduce foveal spectral sensitivity throughout the visible spectrum by a factor of 100; it also abolishes transient tritanopia. Electroretinogram (ERG) was normal, electrooculogram (EOG) subnormal. Stargardt's disease, despite numerous fluorescent macular spots, does not abolish transient tritanopia nor does it reduce spectral sensitivity, although scotopic matches were performed on the Nagel anomaloscope. Only in severe, advanced cases was transient tritanopia reduced and spectral sensitivity found to follow the absorption spectrum of rods. Routine ERGs and EOGs were normal. Vitelliform macular degeneration, despite the ophthalmoscopically pronounced dystrophic macula, produced only very small changes in spectral sensitivity and transient tritanopia, although a widened matching range on the Nagel anomaloscope and electrophysiological abnormalities were found. Apparently damage of the retinal circuit which connects long and short wavelength-sensitive cones, caused by hereditary conditions, is different from that caused by retinotoxic drugs. PMID- 3956359 TI - The pattern electroretinogram in patients with optic nerve disease. AB - We analyzed the electroretinogram elicited by pattern stimuli (PERG) in 29 patients with unilateral optic nerve disease. The normal fellow eyes served as a control. When the normal fellow eye was covered and the patient was asked to watch the center of the pattern stimuli with the affected eye, the poor fixation often caused irregular eye movements which resulted in a poor reproducibility of the response. In such instance we opened the normal fellow eye for fixation, which helped to stabilize the affected eye being examined even when visual acuity was extremely poor. The cross-talk phenomenon of the ERG and the reflection of the VER from the normal fellow eye were proved negligible in this recording condition. We analyzed PERGs in comparison with the visual acuity and the degree of optic atrophy. Unlike the results of many previous authors, little correlation was observed between PERG and these two factors. Most patient showed normal or only slightly abnormal PERG, even when the visual acuity was extremely poor and the optic disc was completely atrophic. Our results suggest that, at least with our method, PERG has extremely limited value in detection of optic nerve disease. PMID- 3956360 TI - Clinical patterns and electrophysiological findings in retinal pigment epithelium diseases. Does a correlation exist? AB - At present it is difficult to distinguish those human chorioretinal diseases in which the retinal pigment epithelium (RPE) is the primary site of dysfunction. This difficulty is caused by several factors such as scarcity of biochemical and histological information and a lack of correlation of basic science information available with the clinical body of knowledge. In the present study we examined 134 eyes at early or late stages of hereditary diseases involving the RPE. We tried to distinguish primary RPE involvement by using standard ERG (a- and b wave) and EOG testing. We conclude that in general primary RPE damage can be better assessed by current electrophysiology in those diseases which seem to remain localized at the RPE level for a long time. PMID- 3956361 TI - Visual evoked cortical and subcortical potentials in human albinos. AB - Albinism is a congenital condition in which hypopigmentation occurs. In addition to this abnormality there is a misrouting of the optic nerve fibers, with some fibers from the temporal retina following a crossed route at the chiasma and terminating in the contralateral cortical hemisphere. This contralateral preponderance of fibers from each eye should be recognizable from recording the visual evoked cortical potential over each hemisphere on monocular stimulation. Such a technique should produce evidence of responses of either increased amplitude or shorter latency over the contralateral hemisphere. Twenty-five human albinos (twenty-three oculocutaneous, two ocular) have been examined. Pattern appearance-disappearance visual evoked cortical potentials were used, but only on bioccipital derivations did these show clear lateralization. With the flash response the P2 component has a consistently shorter latency over the contralateral hemisphere to the eye stimulated. The visual evoked subcortical potential shows contrasting lateralization. The implications of these findings are discussed. PMID- 3956362 TI - The flash and pattern VEP as a diagnostic indicator of dementia. AB - Ninety-one patients with forgetfulness, confusion and depression were referred for visual evoked potential and electroencephalographic investigation. The patients were subdivided, on clinical symptoms alone, into a group of 41 with evidence of dementia and a patient control group of 50 with effective disorders. A second control group of 30 normal volunteers of equivalent age was used. In dementia the P2 component of the flash visual evoked potential is delayed, while the pattern reversal P100 component is of normal latency. This unusual combination of results from the two different visual stimuli is shown to be more specific than either the electroencephalogram or computerised tomography in the diagnosis of dementia. PMID- 3956365 TI - Active blockage and rest position nystagmus: electromyographic demonstration of two types of ocular induced head-turn. AB - A differentiation of two types of head-turns due to nystagmus, by means of electromyography (EMG) is demonstrated in this paper. The first type is represented by patients who actively block the nystagmus, by means of an increase of discharge of the extraocular muscles who are synergistic and responsible for the head-turn. This block has the same features of the block of nystagmus in convergence and usually exceeds 10-15 degrees from the primary position. The second type is made out of patients whose head-turn is explained with the null position of Kestenbaum. Here the nystagmus simply disappears in the position of head-turn, which usually is of no more than 10-15 degrees. Both types of patients show the same electronystagmographic features in the position of head-turn. This differentiation is useful from the clinical standpoint. In fact, only the first type of head-turn may require, besides a classical Anderson or Kestenbaum procedure, also a posterior fixation suture according to Cuppers. This operation would be useless in the second type of head-turn. Clinical signs useful for differentiating these two types of head-turn are presented as well. PMID- 3956363 TI - Source derivation of the visually evoked potential. AB - There has been much recent conjecture over the apparent source location of the visually evoked potential, particularly in considering the lateralization found in halffield pattern reversal stimulation. This paper presents an alternative by directly identifying the sinks or sources present in the scalp current flow as these correspond to the maximal current flow into or out of the cortex (Nunez, 1981). Hjorth (1975) introduced a practical procedure for source derivation which has proved useful in the interpretation of the electroencephalogram (Wallin and Stalberg, 1980). We have applied source derivaton to cortical evoked potentials and present results obtained from right and left half-field stimulation, (Clement, Flanagan and Harding, 1985) and upper and lower field stimulation in normal subjects and patients with visual deficits. PMID- 3956364 TI - Radial keratotomy and glare effects on contrast sensitivity. AB - After radial keratotomy (RK) to correct myopia, some patients complain of 'glare'. Effects of a glare source on contrast sensitivity were measured in fifteen patients after unilateral RK. With each eye, determinations were made of the contrast required for detection of steady gratings (spatial frequencies of 0.7 and 2.9 cycles/deg), and for detection of flicker (unpatterned field flickering at rates of 8, 16, and 32 Hz). Grating or flicker was presented on a centrally fixated 4 deg test target (34 cd/m2 mean luminance), surrounded by a diffuse glare source (1700 cd/m2 mean luminance). For each stimulus, contrast thresholds were determined with glare-source off and with glare-source on. 'Glare loss' was defined as the decrement in contrast sensitivity measured with the glare source on. Significant findings were: (1) Both eyes showed glare losses for detection of gratings and for detection of flicker; (2) Spectacle lenses increased glare losses both for gratings and for flicker; (3) The RK eye showed a larger glare loss for flicker than the unoperated eye, but a smaller glare-loss for gratings; (4) For both flicker and gratings, glare loss tended to be greater in the RK eye, compared to the unoperated eye, in subjects who had larger pupil diameters in the testing situation; (5) The psychophysical measurements obtained in this study were not significantly correlated either with a questionnaire index of glare complaints or with the score obtained with the Miller-Nadler GlareTester. PMID- 3956366 TI - The prevalence of diabetes mellitus in the family history of patients with primary glaucoma. AB - The prevalence of diabetes mellitus in the family history of 371 patients with primary glaucoma--closed-angle glaucoma, ocular hypertension and open-angle glaucoma--and 85 age- and sex-matched control subjects was determined. There was a significantly-increased prevalence of familial type 2 diabetes mellitus (non insulin dependent diabetes mellitus) in patients with closed-angle glaucoma (p = 0.004) and ocular hypertension (p = 0.02). Primary glaucoma was not associated with familial type 1 diabetes mellitus (insulin dependent diabetes mellitus). The implications are discussed. PMID- 3956367 TI - Static vergence and accommodation: population norms and orthoptics effects. AB - The steady-state characteristics of the accommodation and vergence systems can be described by a model with six major oculomotor parameters. These include the system biases (tonic vergence and accommodation) and forward-loop gains (vergence and accommodative gains), as well as the interactive system gains (AC/A and CA/C ratios). We investigated these parameters in two populations: (1) 22 visually normal asymptomatic individuals, and (2) 21 visually-abnormal symptomatic individuals before and after conventional orthoptic therapy. Two parameters related to system gain differentiated between the symptomatic and asymptomatic individuals: the slope of the fixation disparity curve with accommodation open looped and the slope of the accommodative response/stimulus curve. Following orthoptic therapy, 4 static model parameters and 1 dynamic clinical parameter showed changes toward the normal mean; this included tonic accommodation, slope of the fixation disparity curve with accommodation closed-loop (2.5D), slope of the accommodative response/stimulus curve, the CA/C ratio, and the +/- 2D monocular accommodative flipper rate. PMID- 3956368 TI - On the recovery of the electroretinogram of rats after removal of intravitreal lead particles. AB - Lead particles (1.4 mm2) were implanted into the vitreous body of rats (16 animals) for 10 days and the recovery rate of the ERG was measured over an observation time of 190 days. After extraction of the lead particles the a- and b wave amplitudes show a recovery from about 60% to 87% in comparison to those of the intact fellow eyes between the 60th and 90th day of observation. In earlier experiments the mechanical damage was measured using glass splinters. The differences between these values and the above mentioned recovery rate after lead extraction correspond to the irreversible component of the metal intoxication. In another group of rats (16 animals) the lead particle was not removed before the end of the observation time of 190 days. Subtracting these ERG values from those of the first group of rats after lead extraction one gets small differences which correspond to the reversible component of the metal intoxication. The irreversible lead intoxication is much less than that of intravitreal iron particles as we found under the same conditions. The lead particles we used, are larger than those we have to handle in clinical cases taking the relation of surface area size of the particle to the total bulbus weight. The ophthalmoscopical findings are described. PMID- 3956370 TI - [Detection of two forms of cytochrome P-450 participating in the oxidation of n alkanes by Candida yeasts]. PMID- 3956369 TI - The interpretation of the differential threshold in the central visual field. AB - Computer assisted perimetry has revolutionised the investigation of the visual field. Experience of central field assessment with the Octopus Automated Perimeter shows that sensitivity recorded with target size 3 across all age groups can frequently be greater than the published normative values. Use of the latter values can therefore provide a serious underestimation of field loss. Inter-individual variation in sensitivity is found within and between age groups. The limitations associated with the use of the measurement error to define abnormality and the additional problems of hypernormal thresholds and resolution of the blind spot are discussed. It is suggested that methods should be developed to evaluate sensitivity on an intra-individual basis. PMID- 3956372 TI - [Kinetics of inactivation of rabbit muscle lactate dehydrogenase under high hydrostatic pressure]. PMID- 3956373 TI - [Membrane function of brain enolase]. PMID- 3956371 TI - [Possible regulation of the basic metabolism by thyroid hormones through changes in the sensitivity of mitochondria to cytoplasmic glycopeptide which induces electrogenic anion transport]. PMID- 3956374 TI - [Changes in the steady potential in various structures of the rat brain induced by focused ultrasound]. PMID- 3956375 TI - [Phase responses of neuronal microsystems during brain activation and their extinction after repetition of indifferent stimuli of various modality]. PMID- 3956376 TI - Postgraduate pharmacy fellowships (1985-86). AB - During August and September 1985, the Brigham & Women's Hospital Pharmacy Services Department conducted its fifth annual nationwide survey of postgraduate pharmacy fellowships. There are 115 fellowships offered with 89 fellows at 33 sites. PMID- 3956378 TI - Underpinning the clinical pharmacist. PMID- 3956377 TI - Contrast in pharmacy manpower planning between the United States and northern European countries. PMID- 3956379 TI - The use of subtherapeutic antibiotics in animal feed and its implications on human health. AB - Antibiotics were approved for use as animal feed additives in 1950 after it was discovered that their use increased growth rate, improved feed utilization, and reduced mortality and morbidity from clinical and subclinical infections in animals. Subtherapeutic use of antibiotics in animal feed grew extensively and concern has arisen that this "indiscriminate" use of antibiotics could lead to increased numbers of antimicrobial-resistant bacteria and ultimately compromise treatment of human bacterial infections. Three recently published studies seem to indicate that animal-to-man transmission of antimicrobial-resistant bacteria is possible. Increased debate on the continuing allowance of antibiotic feed additives has ensued. The National Resources Defense Council has recently petitioned the FDA to disallow penicillin and tetracycline use in animal feed, and legislation has been introduced in the U.S. House of Representatives that would limit the subtherapeutic use of antibiotics in animal feed. Experts have predicted that meat prices would increase and meat quality would decrease if antibiotics are disallowed as a feed additive. It is the opinion of the authors that there is no conclusive evidence at this time to support the premise that subtherapeutic use of antibiotics in animal feed poses a greater threat to human health than if antibiotic feed additives were banned. PMID- 3956380 TI - Cefadroxil-induced ampicillin-exacerbated pemphigus vulgaris: case report and review of the literature. AB - A 77-year-old patient is described who developed pemphigus vulgaris temporally with the administration of cefadroxil. The disease improved when the drug was discontinued but was exacerbated with the administration of ampicillin. This may be the first case of possible cefadroxil-induced and only the second case of ampicillin-induced pemphigus vulgaris reported. The pathophysiology, diagnosis, and treatment of pemphigus vulgaris is briefly described. Drug-induced pemphigus is reviewed. By far the most incriminated drug has been penicillamine. It is postulated that the sulfhydryl group of penicillamine alters the intercellular cement substance into an antigenic structure with subsequent antibody formation. The chemical similarity between penicillamine, the penicillins, and the cephalosporins is alluded to and the potential for cross-sensitivity between the penicillins and cephalosporins is emphasized. Although the pemphigus vulgaris could have occurred by chance, it seems probable that it was drug-induced. PMID- 3956381 TI - Moxalactam myoclonus, seizures, and encephalopathy. AB - Severe myoclonus, generalized seizures, and marked stupor occurred in a 39-year old woman with chronic renal insufficiency after one week of moxalactam 2 g iv q8h. Moxalactam serum levels far exceeded the recommended therapeutic range. The drug half-life was 17 hours (normal 1.9). Excessively high levels of moxalactam, which penetrates the blood-brain-barrier relatively easily, may provoke seizures and encephalopathy. PMID- 3956382 TI - Elevated serum creatinine levels in three patients treated with phenacemide. AB - Three adolescent patients with severe seizure disorders were treated with phenacemide. All three patients showed elevated serum creatinine and normal blood urea nitrogen values while on phenacemide. Simultaneous urea and creatinine clearance studies performed on each patient demonstrated normal urea clearances and decreased creatinine clearances. Inulin clearance performed in one patient was normal. The medication was discontinued in two of the patients because of co existing neutropenia. Serum creatinine values returned to normal after phenacemide treatment was terminated. The elevation in serum creatinine values with phenacemide appears to be dose related, reversible, and unrelated to impairment of glomerular filtration. PMID- 3956383 TI - Compliance problems and the older patient: assessing functional limitations. AB - A procedure to assess functional abilities that can make compliance difficult for the older individual is described. The test can be constructed from items commonly found in the pharmacy. It has been designed to assist the pharmacist in identifying problems older individuals will have in taking their medications. The problems include label-reading, color vision, child-resistant containers, short term memory, and label interpretation. The procedure identified more functional limitations in a sample of 14 older individuals than in a sample of younger individuals. PMID- 3956384 TI - Cimetidine influence on gastric emptying time in neonates. PMID- 3956385 TI - Comment: Alpha-interferon in treating chronic hepatitis B virus infection. PMID- 3956386 TI - Comment: Ceforanide half-life. PMID- 3956387 TI - Effect of chlorthalidone on zinc levels, testosterone, and sexual function in man. AB - This study was designed to test the hypothesis that chlorthalidone, a diuretic used to treat hypertension, depletes body zinc enough to interfere with testosterone production and thereby cause sexual dysfunction. Serum and hair zinc, serum testosterone, and sexual function were measured in 19 middle-aged hypertensive men who had been taking chlorthalidone in average daily doses of between 11 and 50 mg per day for at least 6 months, and a control group of 31 unmedicated middle-aged normotensive men. Although the medicated group had a higher incidence of sexual dysfunction (42% as compared to 16% in the control group), use of chlorthalidone did not significantly affect serum testosterone levels. When other variables were controlled for, medicated men had significantly higher serum zinc levels, and men on the highest dosage of chlorthalidone had higher hair zinc levels than all other men. There was no significant correlation between hair zinc, serum zinc, testosterone, and sexual function. Serum zinc decreased significantly with age (p = 0.043) and with ethanol intake after controlling for age (p = 0.032). Sexual dysfunction occurred more often in older men (p = 0.002). In the unmedicated controls, prevalence of dysfunction increased slightly with increasing serum potassium levels. PMID- 3956388 TI - Effect of chronic alcohol ingestion on fecal and urinary excretion of calcium and magnesium in the rat. AB - The effect of chronic ethanol ingestion on fecal and urinary excretion of calcium and magnesium was determined in male rats. The rats were given either 30% ethanol in drinking water and Purina Rat Chow ad libitum (alcohol group) or were pair-fed to the alcohol group, with starch substituted isocalorically for ethanol (pair fed group). The animals were housed individually in metabolic cages and urine and feces collection was carried out over a period of ten days. Alcohol feeding slightly decreased and pair-feeding slightly increased body weight over the ten day period, but the differences in body weights were not statistically significant. The fecal calcium excretion was significantly higher and the fecal magnesium excretion was significantly lower in the alcohol group than in the pair fed controls. The urinary losses of calcium and magnesium were not significantly affected by alcohol intake. The results indicate that chronic administration of alcohol to rats in their drinking water as a sole source of fluid increases fecal calcium excretion, which could result in calcium depletion. PMID- 3956390 TI - Effect of cephalexin and tetracycline on galactose absorption in rat small intestine. AB - The effects of cephalexin and tetracycline HCl on D-galactose absorption in rat small intestine were investigated. Both antibiotics inhibited D-galactose uptake into isolated intestinal mucosa in a dose-dependent fashion. In vivo studies showed that cephalexin and tetracycline HCl reduced D-galactose absorption and that the transport defect was not reversible on cessation of antibiotic perfusion. Both the active and passive components of D-glactose absorption were inhibited by the antibiotics tested. Furthermore, both drugs reduced mucosa O2 consumption and inhibited D-galactose absorption when they were perfused in a contiguous loop. We conclude that the diminished D-galactose transport by rat small intestine after tissue exposure to either cephalexin or tetracycline HCl appears to be in part due to an insufficient energy supply. PMID- 3956389 TI - Effect of protein deficiency and Tween 60 on the pharmacokinetics of butylated hydroxyanisole and metabolites in male Sprague-Dawley rats. AB - Radioactive 3H-butylated hydroxyanisole (BHA) at dosages of 250 or 2,500 mg/kg body weight was administered to rats either orally (po) or intraperitonealy (ip) with or without 500 mg Tween 60/kg. The pharmacokinetics of 3H-BHA were evaluated in both control and protein-deficient animals. Blood or urine and feces were collected and analyzed for 3H-BHA equivalents. Using the Autoan/Nonlin69 computer program, most pharmacokinetic profiles of BHA (250 mg/kg) were fit to one compartment open models with first-order absorption. The exception was the model for ip administration, which resulted in a two-compartment open model with first order absorption. Increasing the dose of BHA to 2,500 mg/kg altered pharmacokinetics of BHA; no decline in blood levels was observed 48 hours post injection. Protein deficiency and Tween 60 in combination increased the rate of absorption of BHA. Excretion of 3H-BHA and/or its metabolites in urine and feces was complete 6.5 days after administration of 2,500 mg/kg 3H-BHA. PMID- 3956391 TI - Selenium deficiency and detoxication functions in the rat: short-term effects of cadmium. AB - Weanling rats were fed a Torula yeast-based selenium-deficient diet with or without supplementation of sodium selenite (0.2 ppm selenium) in the drinking water. After 5-6 weeks on the diet regimens, the liver glutathione peroxidase activity of the selenium-deficient groups had decreased to about 1% of the supplemented groups, and the rats were then used in experiments. Cadmium-induced effects on the drug-metabolizing system of the liver were measured as the microsomal capacity to perform N- and C-oxygenation of N, N-dimethylaniline. Cadmium in vitro caused a decrease of the cytochrome P-450-dependent C oxygenation. This effect tended to be more prominent in the selenium-deficient groups. On the other hand, N-oxygenation was increased when cadmium was added in vitro, and no significant difference was found between selenium-deficient and supplemented groups. However, as was found for the capacity to perform C oxygenation, there was a tendency for lower N-oxygenation in the selenium deficient rat. Lipid peroxidation, measured as thiobarbituric acid reactive substances in liver homogenates, was higher in selenium-deficient groups after in vivo treatment or in vitro addition of cadmium, and preincubation or phenobarbital induction enhanced this selenium-dependent difference. Although, the selenium-deficient rat seems more susceptible to cadmium-induced disturbances, 5-6 weeks of selenium deficiency was not enough to cause prominent impairment on the drug-metabolizing system as measured here and with the doses used in the present study. PMID- 3956392 TI - [Occupational cancer study of asbestos: possibilities and limits of epidemiologic studies on the causes of death in West Germany]. AB - The study is based on 3990 men and women exposed to asbestos dust for at least three years at their place of work, and prospectively and epidemiologically examined since 1 January, 1977. By 31 December, 1983, 336 had been registered as having died. Calculation of standard mortality rates indicates that the incidence of malignant tumour as cause of death was much higher than in the general population of the FRG, that of fatal mesothelioma about 100 times as high. Standard mortality rate for lung cancer was increased by 48% and 175%, respectively, depending on whether exposure to asbestos dust had ended after (subgroup I) or before (subgroup II) 1 January, 1972. Proportional mortality rate of 43% of tumours at all locations, with about 14% lung cancer and about 9% fatal mesothelioma cases in subgroup II, approaches the internationally recognized frequency of asbestos-associated tumours. PMID- 3956393 TI - [Percutaneous valvuloplasty of the aortic valve in adults]. AB - In a 23-year-old patient with congenital stenosis of the aortic valve the pressure gradient could be reduced from 80 to 35 mm Hg using percutaneous balloon aortic valvuloplasty. The systolic pressure in the left ventricle fell from 200 to 165 mm Hg. A pre-existing mild aortic insufficiency did not worsen. In a 44 year-old female patient retrograde passage of a balloon catheter across the aortic valve failed due to technical reasons. At the present time percutaneous balloon aortic valvuloplasty in adults is more difficult than pulmonary valvuloplasty. It can, however, be considered, prior to surgery, in suitable patients with noncalcified valves. PMID- 3956394 TI - [Therapy of myasthenia gravis]. PMID- 3956395 TI - [The cancer hazard in the work place--an interdisciplinary challenge]. PMID- 3956396 TI - [Malignant peritoneal mesothelioma]. PMID- 3956397 TI - [Acute or chronic pancreatitis--a continuing question of interpretation or definition?]. PMID- 3956398 TI - [Occult papillary thyroid carcinoma. Clinical significance and morphology of a common tumor]. AB - In a systematic analysis of surgical specimens of 388 carcinomas of the thyroid 34 occult papillary tumours were revealed. In 18 of the 34 patients cervical lymph-node metastases were demonstrated, which in 16 had been the indication for operation. In 15 patients the tumour was a chance finding in a thyroid resected for other reasons. Postoperative follow-up over an average of ten years demonstrated a uniformly favourable course in all, regardless of tumour size or type, age, sex or lymph-node status. There were no local recurrences or metastases beyond those known at time of thyroidectomy. PMID- 3956399 TI - [Therapy of deep venous thromboses of the legs]. PMID- 3956400 TI - [Recent legal decisions on the medical fee law]. PMID- 3956401 TI - [Diagnosis of early stomach cancer]. PMID- 3956402 TI - [Elevated cyclosporin A level during simultaneous therapy with danazol]. PMID- 3956403 TI - [Transfemoral catheter-laser thromboendarterectomy of the carotid artery]. AB - Argon laser irradiation via a transfemorally introduced catheter successfully vapourized both fresh thrombi and stenosing plaques in the carotid artery of seven cadavers and two patients. Fresh thrombi were recanalized throughout their length, while the arteriosclerotic plaques were partially reduced. No particles larger than 7 micron were demonstrated in the eluant flushing fluid, indicating that peripheral emboli need not be feared with this technique. PMID- 3956404 TI - [How frequently is a headache the expression of endogenous depression?]. AB - In a period of nine months, all patients referred for purely neurological assessment of headache were fully examined both neurologically and psychiatrically. In 68 of 148 patients the cardinal symptom of headache was found to be the expression of an endogenous depression (46%). This diagnosis was based on the presence of an endogenomorphic-depressive axis syndrome (as classified by Berger), follow-up observations, and the efficacy of antidepressive drug treatment. Neurological and other physical underlying illness was excluded. PMID- 3956405 TI - [Past and current problems in tumor research]. PMID- 3956406 TI - [Fibrinolysis in massive lung embolism following cholecystectomy]. PMID- 3956408 TI - [Activation of human endogenous retrovirus genes in tumors and in reproductive tissues]. PMID- 3956407 TI - [Acute abdomen caused by Anisakis larvae]. PMID- 3956409 TI - [Family assessment in child psychiatry]. PMID- 3956410 TI - [Prolonged QT(U) interval: association with disease and use of drugs]. PMID- 3956411 TI - [Late infection following total hip arthroplasty]. PMID- 3956412 TI - Practical surgical anatomy of the skull base. PMID- 3956413 TI - Anesthetic considerations in skull-base surgery. PMID- 3956414 TI - Uses and modifications of the infratemporal fossa approach to skull-base tumors. PMID- 3956415 TI - Sublabial transseptal transsphenoidal approach to the skull base. PMID- 3956416 TI - Surgical approach to the anterior skull base. PMID- 3956417 TI - Anterior mandibular-splitting approach to the skull base. PMID- 3956418 TI - Alveolar development in the human fetus and infant. AB - The lungs from 29 infants aged from 29 weeks of gestation to 18 weeks postnatal age were studied using morphometric analysis; total DNA was estimated in 12 of these. Alveoli could first be counted and measured at 29 weeks gestation; with increasing age they became more mature in appearance as the walls elongated and thinned, and they gradually increased in diameter. Lung volume increased 4-fold between 29 weeks and term, and further doubled in the 4 months after birth. Lung volume, alveolar surface area and DNA all increased linearly with age and weight. Alveolar number showed a curvilinear increase with age and DNA, but a linear relationship to body weight. At birth the lungs had an average of 150 million alveoli, half of the expected adult number. There was a wide normal range. The surface area was between 3 and 5 m2 at birth, one twentieth of the adult value. PMID- 3956419 TI - Blood flow in the ascending and descending aorta in term newborn infants. AB - The combination of 2-dimensional real-time and pulsed Doppler echocardiography provides a noninvasive method of measuring blood flow and has been used to study blood flow at the lower thoracic level in the descending aorta of the human fetus. Using these techniques, we evaluated the proportion of cardiac output distributed through the descending aorta in 20 healthy term newborn infants at 1 6 days of age. Blood flow in the ascending aorta was 759 +/- 135 ml/min (mean +/- S.D.) and in the descending aorta 482 +/- 92 ml/min indicating that 63.8% of the left ventricular output is distributed through the descending aorta. Peak systolic and mean blood flow velocities were comparable at the two sites, whereas the diameter of the descending aorta was 19% smaller than that of the ascending aorta. The changes in aortic blood flow were correlated with the changes in aortic diameter. PMID- 3956420 TI - Growth and proportionality in early childhood. I. Within population variations. AB - Data on the postnatal growth patterns of 238 small-for-gestational age (SGA) and 241 large-for-gestational age (LGA) babies are presented. Three proportionality ratios were selected; and their changes in shape, by these indices, during the first 7 years are compared with a random sample of 284 children drawn from the same population. Highly significant differences (P less than 0.001) were found between the mean head-chest and head-length ratios for both sexes at birth; but mean chest-length ratios did not differ. Our findings show that these three measures of proportionality differ in their patterns of change over time; in the influence of birthweight group on their absolute values at each age; and the influence of sex within birthweight groups. At 7 years SGA children still had the highest and LGA children the lowest head-chest and head-stature ratios, and the differences were significant (P less than 0.01) for girls. This was mainly due to the relatively small heads of LGA girls. 46% of our sample had a head-chest ratio above unity at the age of 2 years. The "rule of thumb" criterion for the identification of malnourished children, based on the general principle that mean chest circumference overtakes head circumference by the age of 12 months, should not be too strictly applied. PMID- 3956421 TI - Circulating insulin-like growth factor I levels in newborn premature and full term infants followed longitudinally. AB - Longitudinal circulating levels of insulin-like growth factor I (IGF-I) were measured by radioimmunoassay after acid/ethanol extraction of serum or plasma in 44 appropriate-for-gestational age (AGA) premature infants, 7 small-for gestational age (SGA) premature infants and 9 AGA full-term infants. The subjects were divided into cohorts with gestational age at birth 26-29 weeks, 30-33 weeks, 34-37 weeks and 38-42 weeks (full-term). The premature infants in this study exhibited diminished growth as compared with normal intrauterine growth. In all but the earliest premature infant cohort there was an immediate fall from the mean fetal IGF-I level, as reflected by the cord value, to a basal postnatal circulating level of IGF-I. The basal level of circulating IGF-I in premature infants was related only to gestational age. It increased slowly from 25 weeks gestation until four weeks after full-term equivalent and was independent of time of birth. Full-term infants were distinguished from early premature infants by the occurrence of a prominent postnatal surge in circulating IGF-I levels that was characterised by a significant (P less than 0.02) increase between day 1 and days 10-15. The SGA and AGA infants in the 34-37 week cohort showed similar profiles of circulating IGF-I with no significant difference in cord values between the two groups. PMID- 3956422 TI - Changes in the concentration of ferritin in the serum during fetal life in singletons and twins. AB - Concentration of serum ferritin was analyzed in cord blood samples of 34 preterm and 24 full-term subjects, 10 fetuses which were aborted by laparotomy at 14-20 weeks of gestation, and 20 pairs of twins. The findings indicated that the fetal amount of storage iron gradually increases as the gestational age increases, it is similar in singletons and twins, within the pairs of twins, and slightly lower in some small-for-dates newborns. There was no correlation between fetal ferritin and maternal iron status. Our data suggest that the accumulation of fetal iron stores is not regulated by the fetus itself, or by maternal iron metabolism. Thus, we speculate that the placenta may have a role in this regulation. PMID- 3956423 TI - Fatty acid composition of plasma and erythrocyte phospholipids in preterm infants. AB - Erythrocyte and plasma phospholipid fatty acids were determined in preterm babies at 0, 6 and 10 weeks. There were highly significant changes in fatty acid composition between birth and 6 weeks in both plasma and erythrocyte phospholipids, the changes being more numerous and quantitatively greater in phosphatidyl choline. There was little further change by 10 weeks. Linoleic acid increased by approximately 100% at 6 weeks in plasma phosphatidyl ethanolamine and 200% in phosphatidyl choline. In erythrocyte phosphatidyl ethanolamine, linoleic acid increased by approximately 150% at 6 weeks and in phosphatidyl choline increased 170%. Arachidonic acid decreased by 54%. The essential fatty acid status of the preterm babies studied using contemporary feeding regimes was satisfactory and by 6 weeks phospholipid fatty acid profiles were comparable with published data for normal healthy breast-fed infants. PMID- 3956424 TI - First-month variations in total iodine content of human breast milks. AB - In 183 samples of breast milk from 23 young mothers we found the mean total iodine content to be 47 ng/ml, a value that is not dependent on length of gestation. There is a progressive increase in iodine concentration from colostrum to transitional and mature milk. The results show that breast milk sometimes contains an amount of iodine barely necessary to make thyroid hormones, which is around 10 micrograms in the first days of life rising to about 15-20 micrograms after four weeks. Secondly, nursing mothers should be watched, because if their daily breast milk contains more than 50 micrograms iodine for several consecutive days, they may be on a negative balance. PMID- 3956425 TI - Evaluation of a special low birth weight formula, with and without the use of medium chain triacylglycerols. AB - A special low birth weight formula containing 1.8 g/100 ml of medium chain triacylglycerols (Nenatal) was compared with 'modified' Nenatal (medium chain triacylglycerols (MCT) replaced by long chain triacylglycerols (LCT)) and standard modified baby milk (Cow and Gate Premium). 22 infants of birth weight less than 1500 g and gestational age less than 33 weeks were studied for three weeks when enteral feeds were well tolerated. Nenatal was given to all infants for the first and third weeks, during the middle week 11 infants received Premium and 11 infants received modified Nenatal. On Nenatal there was a significant elevation of serum beta-hydroxybutyrate and small amounts of medium chain fatty acids were detected in the serum. Glucose and long chain triacylglycerol levels were similar on all feeds. Incremental weight gain and energetic efficiency of weight gain was significantly greater on Nenatal than on Premium, but there was no difference in this respect between Nenatal and modified Nenatal. We conclude that the use of a special low birth weight formula is associated with increased weight gain, but this is not dependent on the presence of MCT in the feed. Therefore although feeds containing MCT are well tolerated, there seems little advantage in including MCT in the formulation of low birth weight feeds. PMID- 3956426 TI - Effects of pH on the acute toxicity and uptake of [14C]pentachlorophenol in the midge, Chironomus riparius. AB - The acute toxicity of pentachlorophenol (PCP) was determined at pH levels 4, 6, 9 to the midge, Chironomus riparius, with the findings that PCP is of greatest toxicity at pH 4 and of least toxicity at pH 9. This differential toxicity is attributable to variations in uptake levels at the respective pH levels. At pH 4, PCP is fully protonated and therefore highly lipophilic. The amount of [14C]PCP present in the midges at 24 hr is thus highest at pH 4. Conversely, at pH 9, the compound is completely ionized. The reduction in lipophilicity at pH 9 decreases the ability of the compound to penetrate into the midge, thereby decreasing the observed toxicity of the compound. PMID- 3956427 TI - Cytotoxicity of citrinin in cultured kidney epithelial cell systems. AB - Cytotoxicity of citrinin, a fungal metabolite and a common food contaminant, was evaluated in an established cell line, Madin-Darby bovine kidney (MDBK) cells and primary fetal bovine kidney (PFBK) cells. Citrinin is a known nephrotoxicant but produced a low order of cytotoxicity in cultured renal cells. A dose-dependent cytotoxic effect was observed at millimolar concentrations of the toxin. MDBK cells were more sensitive than the PFBK cells. The primary effect of this chemical was on the adherence of MDBK cells to the culture dish. Microscopic evaluation of morphologic changes indicated that cells elongated, flattened, swelled, and became rounded. The appropriateness of toxicity evaluation in culture systems in vitro is considered. PMID- 3956428 TI - Aerobic and anaerobic biodegradation of nitrilotriacetate in subsurface soils. AB - Studies were conducted to characterize mineralization of nitrilotriacetate (NTA) in subsurface soils under aerobic and anaerobic conditions. Chemical (redox indicator, resazurin) and biological (dentrification) markers were used as indicators of anaerobic conditions in the test system. The indigenous microflora in subsurface soils previously exposed to septage containing NTA were able to rapidly mineralize NTA under aerobic and anaerobic conditions. The half-lives (t1/2) of mineralization for NTA in aerobic soils ranged from 87 to 160 hr. Biodegradation of NTA under anaerobic conditions where NO3- indicates that a mechanism exists for the anaerobic biodegradation of this substrate. NTA biodegradation can occur readily in the absence of molecular oxygen and the NTA monooxygenase which are required for the aerobic mineralization of this substrate. These results provide the first evidence that the indigenous microflora in subsurface soils of septic tank tile fields can rapidly degrade NTA under anaerobic conditions. PMID- 3956429 TI - Tolerance to cadmium and cadmium-binding ligands in Great Salt Lake brine shrimp (Artemia salina). AB - Information on the accumulation of cadmium in cytosolic proteins of Great Lake brine shrimp (Artemia salina) was obtained from animals collected directly from the lake and also from animal hatched and maintained in three sublethal concentrations of cadmium (0.5, 2.0, 5.0 ppm) in saltwater aquaria. Brine shrimp growth under these conditions was monitored by measuring body lengths during a 7 day exposure period. Heat-stable, cadmium-binding ligands were isolated and identified by Sephadex G-75 chromatography and atomic absorption spectrophotometry. Cadmium was found to be equally distributed between high and low molecular weight proteins in animals collected from the lake and the 0.5 ppm cadmium group. There was also a slight growth stimulation noted in the 0.5-pm group. Higher cadmium incorporation was noted in low molecular weight fractions with increasing cadmium concentration in the exposure media. Low molecular weight fractions were also found to have high uv absorption characteristics at 250 nm and low absorption at 280 nm. Molecular weight of the cadmium-binding ligands was found to be 11,000 as estimated by the gel filtration method. De novo synthesis of this protein was increased as a function of cadmium concentration in the media. However, slow accumulation of cadmium in other protein fractions was also noticed in higher cadmium exposure groups, suggesting the existence of possible tolerance mechanisms in brine shrimp exposed to suspected acute cadmium concentrations. PMID- 3956430 TI - The histological and biochemical effects of cadmium exposure in the bluegill sunfish (Lepomis macrochirus). AB - Cadmium effects on the bluegill sunfish (Lepomis macrochirus) were assessed histologically and biochemically and the effects were compared with effects on the ecologically relevant parameters of growth and survival. Growth and survival were monitored and tissues were removed for histopathological assessment of toxicant effects in a 163-day chronic exposure. The biochemical effects of cadmium were determined in a 32-day subchronic exposure. Exposure of fish to cadmium in hard water (363 mg Cd/liter) caused significant reductions in growth at 3.9 and 12.7 mg Cd/liter. Mortality was significantly increased over controls at 12.7 mg Cd/liter. Histopathological lesions were observed in gill tissue from fish exposed to 3.9 and 12.7 mg Cd/liter at all times during the chronic exposure. No histopathological lesions were observed in any internal organ during this exposure. In a 32-day subchronic exposure, cadmium caused significant increases in serum acid phosphatase and N-acetyl-beta-d-glucosaminidase activities. Serum aspartate and alanine transaminase and lactate dehydrogenase activities were not increased by cadmium exposure. Liver lysosomal membranes were destabilized by cadmium exposure. This indicates an alteration in lysosome function. The utility of biochemical and histological procedures for estimating safe concentrations of environmental pollutants are discussed. PMID- 3956431 TI - Ecotoxicological profile of xylenes. Working Party on Ecotoxicological Profiles of Chemicals. AB - The xylenes (o, m, p), which are produced in large amounts and widely used, must be considered as environmental contaminants, as they have been identified in the atmosphere of many countries. Their acute and chronic toxicity in mammals is moderate. Mutagenic and teratogenic properties can be excluded. Carcinogenic potential has been at present inadequately studied. In man some disturbances are evident at the concentration of 45 ppm. Hepatic metabolism is a valid process of detoxification and its high rate limits the risk of accumulation of the xylenes in adipose tissue. Ecotoxicological data refer almost exclusively to water. No long-term tests have been made. However, the high volatility, elevated elimination, and the low factor of accumulation suggest the impact on aquatic environment should be limited. Xylenes are easily biodegraded by many microorganisms. Photoxydation is one of the main degradation processes, responsible for the disappearance of the xylenes from the atmosphere. PMID- 3956432 TI - Effects of pH on the environmental fate of [14C]aldicarb in an aquatic microcosm. AB - The role of pH in determining the environmental fate of [14C]aldicarb was examined in an aquatic microcosm. Only minor amounts of the radiochemical were absorbed by aquatic organisms at any pH. Of the radioactivity absorbed, greater than 75% was rapidly metabolized and incorporated into tissues. Minor differences in the in vivo spectrum of aldicarb and metabolites as a function of pH were discerned for fish; the quantitative and qualitative distribution of aldicarb and its metabolites was identical for the other organisms across the pH levels. The most notable difference in metabolite spectrum appearing in the water as a function of pH was the absence of aldicarb sulfone at pH 4 on Day 6. In contrast, aldicarb sulfoxide was found as the major metabolite and aldicarb was completely lacking at all three pH levels. Since aldicarb sulfoxide is biologically active, disappearance of the parent compound does not eliminate hazard. The general effects of pH on the environmental fate of aldicarb are negligible on Day 6 but may be more pronounced at other time periods. PMID- 3956433 TI - Effects of metal salt mixtures on Daphnia magna reproduction. AB - Three binary metal experiments were conducted using a "complete block design"; testing the chlorides of Cd, Hg, and Zn individually and in combinations of Cd Hg, Cd-Zn, and Zn-Hg on Daphnia magna reproduction. These mixtures were tested at one-half, once, and twice the 16% reproductive impairment concentration previously determined for individual metals. The Cd-Hg, Cd-Zn, and Zn-Hg mixtures all showed significant reductions in reproduction at concentrations where the metal salts alone caused no significant effect. PMID- 3956434 TI - In vitro cytotoxicity testing of aquatic pollutants (cadmium, copper, zinc, nickel) using established fish cell lines. AB - The cytotoxicity of cadmium toward cultured bluegill fry (BF-2) cells was determined using several assay endpoints. The concentrations of cadmium causing a 50% decrease in colony formation, cell replication, uptake of neutral red, population growth (as determined by protein analysis), and uptake of [3H]uridine and 50% detachment of cells (as determined by protein analysis) were 0.03, 0.04, 0.08, 0.09, 0.12, and 0.21 mM cadmium, respectively. The neutral red assay was used to compare the relative sensitivities of bluegill BF-2 cells and RTG-2 cells, derived from the rainbow trout, toward four metals. The concentrations of cadmium, zinc, copper, and nickel causing a 50% reduction in the uptake of neutral red were 0.08, 0.19, 0.55, and 2.0 mM, respectively, with the BF-2 cells and 0.18, 0.64, 1.45, and greater than 10.0 mM, respectively, with the RTG-2 cells. The RTG-2 cells were less sensitive to the metals, in particular to nickel. The less stringent temperature requirements for growth, their greater sensitivity to pollutants, and their markedly shorter doubling time in vitro make the BF-2 cells the preferable cell line for ecotoxicity screening of aquatic pollutants. PMID- 3956436 TI - Endoscopic study of the stomach after selective proximal vagotomy in patients with duodenal ulcer. AB - Forty patients with duodenal ulcer who underwent selective proximal vagotomy (SPV) with pyloroplasty were examined of intestinal metaplasia before operation, with no increase staining methods, before and after operation. Follow-up periods were between 2 and 9 years after SPV. Reduction rates of acid secretion by SPV were 79% in BAO and 62% in MAO. Five patients were observed to have a slight degree of intestinal metaplasia before operation, with no increase after operation. In the remaining 35 patients, staining areas were not observed either before or after operation. The acid-secreting area demonstrated by endoscopic congo red staining tended to become atrophic after SPV. It can be concluded that the reduction of gastric secretion by SPV does not result in rapid development or progress of intestinal metaplasia of the gastric mucosa. PMID- 3956435 TI - Oesophageal ulceration after sclerotherapy--a complication or an accompaniment? AB - Forty eight patients with oesophageal varices were serially endoscoped over a period of 3 weeks for the presence of oesophageal ulcers after the first course of sclerotherapy with absolute alcohol. Post-sclerotherapy oesophageal ulcers were seen in 94% patients on day 1, in 69% patients at 1 week and in only 12.5% patients at the end of 3 weeks. A strong correlation (r = + 0.88) was observed between the incidence of ulceration and the amount of sclerosant injected. In fact, all patients who received 3 ml or more of the sclerosant showed development of oesophageal ulcers. It can be concluded that oesophageal ulcers are probably a necessary accompaniment of sclerotherapy and should not be considered an avoidable complication. PMID- 3956437 TI - Transpapillary biopsies and brush cytology from the common bile duct. AB - This study comprises 29 patients with a stricture of the common bile duct of unknown etiology, in whom an attempt was made endoscopically to take a biopsy from the ductal wall, in order to establish the diagnosis. Biopsies were obtained from all patients. Follow-up permitted definite diagnosis in 17 patients, from surgery or biopsy. The endoscopic biopsy diagnosis (malignant/benign) proved to be correct in 10 patients, falsely negative in 4. Two were "uncertain malignant" and 1 "not representative". No false positives were seen. Brush cytology provided no additional information. No complications due to the procedure were seen. The results imply that the procedure might be helpful in the evaluation of these patients. PMID- 3956438 TI - Non-surgical biliary drainage: endoscopic conversion of percutaneous transhepatic into endoprosthetic drainage. AB - Percutaneous transhepatic drainage (PTD) is associated with many long-term complications. Therefore a large-diameter endoscopic endoprosthesis is preferentially employed to bridge a malignant obstruction of the biliary tract. Only if the placement of an endoprosthesis fails, must PTD be established. We present a simple method for converting PTD into a large endoprosthesis (14 F) with the aid of endoscopy. We have performed this conversion successfully in 8 patients without complications. PMID- 3956439 TI - The 'safety snare'--a ligature-placing snare to prevent haemorrhage after transection of large pedunculated polyps. AB - A modified snare has been fabricated in prototype form which permits the placement of a tightenable nylon loop ligature around the stalk of large polyps, which is then left in situ after withdrawal of the snare handle and endoscope. The clinical application of the safety snare is likely to be the prevention of immediate or delayed haemorrhage from the stalks of unusually large polyps, or after polypectomy in patients with bleeding diathesis. The use of the snare has proved practicable in preliminary clinical trials. PMID- 3956440 TI - Esophageal lesions in intestinal Behcet's disease. AB - Esophageal lesions are rarely seen in patients with intestinal Behcet's disease. Three patients with esophageal lesions (dissection of esophageal mucosa, esophageal ulcer, esophageal varices) were observed among 15 patients with intestinal Behcet's disease or non-specific simple ulcer (1974-1984). Two-thirds of these fifteen patients had fully developed or suspected Behcet's disease, and one-third had no symptoms typical of Behcet's disease. They are classified as non specific simple ulcer. The average age of the 15 patients was 43 years, all patients but one were male. The recurrence rate after surgical treatment was 70%, that of medical treatment was 90%. PMID- 3956441 TI - Extrahepatic biliary obstruction by a common bile duct inflammatory polyp in association with a gallstone, and treatment by endoscopic sphincterotomy. AB - After a two-year history of recurrent abdominal pain, an 84-year-old man presented with acute pancreatitis and obstructive jaundice. An endoscopic retrograde cholangiogram demonstrated two filling defects approximately 1.0 cm in diameter, in a dilated common bile duct. Endoscopic papillotomy was performed which resulted in a polypoid tumour delivering itself into the wound followed by a free flow of bile. In addition, a single 1.0 cm gallstone was removed from the common bile duct, above the tumour, using a Dormia basket. The patient recovered completely. Histological examination of biopsies of the tumour taken on three subsequent occasions showed it to consist only of inflammatory tissue (an inflammatory polyp) and later, regenerating bile duct mucosa. After six months this tumour had completely regressed. PMID- 3956442 TI - Common bile duct compression by an abdominal aortic aneurysm. AB - A 76-year-old female was admitted to the hospital with oral bleeding. Laboratory findings were suggestive of disseminated intravascular coagulation. An endoscopic cholangiography was performed in order to rule out a biliopancreatic tumor. A symmetrical stenosis of the lower part of common bile duct was observed. This extrinsic compression was due to a calcified abdominal aortic aneurysm. CT scan confirmed the close relation between the common bile duct and the aortic aneurysm. No cholestasis was described. PMID- 3956443 TI - A technique for foreign body removal from the airway. AB - We report a case in whom a foreign body was retrieved from the peripheral airway using a fibreoptic bronchoscope and a modified suction tube. PMID- 3956444 TI - Quenching by acrylamide and temperature of a fluorescent probe attached to the active site of ribonuclease. AB - The fluorescence properties of ribonuclease labelled at its active site with N (iodoacetylamino)-ethyl-5-naphthylamine-1-sulfonic acid have been studied at different temperatures and in the presence of acrylamide. The rate constant for the quenching of the fluorescence of labelled ribonuclease by acrylamide is apparently not limited by the "accessibility" of the probe: similar values are obtained for the native and denatured states of the protein. Instead, acrylamide seems to be a rather inefficient quencher of this fluorescent group [acetamidoamino)ethyl-5-naphthylamine-1-sulfonic acid), as shown by non-linear Stern-Volmer representations, biphasic decay kinetics, and a low value of the rate constant. The fluorescence intensity of the native state of the labelled protein is highly sensitive to temperature and exhibits a 20% decrease for an increase of temperature of from 10 degrees C to 30 degrees C, independent of solvent viscosity. This thermal quenching is specific for the native conformation and disappears when the protein is unfolded. When the fluorescence lifetime of the label is shortened by addition of acrylamide, the effect of temperature becomes identical for native and unfolded structures. This suggests that the cause of the thermal quenching is the presence of conformational fluctuations within the native protein which apparently take place in the time range from 35 to 200 ns. PMID- 3956446 TI - The superstructure of chromatin and its condensation mechanism. II. Theoretical analysis of the X-ray scattering patterns and model calculations. AB - Model calculations on the superstructure of uncondensed and condensed chromatin are presented. It is found that agreement between the calculated X-ray solution scattering patterns and the experimental observations can be reached with the assumptions that: a) The uncondensed chromatin fibre in solution has a helix-like structure, with a pitch of ca. 33.0 nm, a helical diameter of ca. 20.0 nm and 2.75-3.25 nucleosomes per turn. b) The most condensed state of the chromatin fibre in solution is best represented by a helix-like structure with ca. 2.56 nucleosomes per turn, a pitch of ca. 3.0 nm and a helical diameter of ca. 27.0 nm. PMID- 3956445 TI - The superstructure of chromatin and its condensation mechanism. I. Synchrotron radiation X-ray scattering results. AB - Synchroton radiation X-ray scattering experiments have been performed on chicken erythrocyte chromatin fibres over a wide range of ionic conditions and on various states of the fibres (i.e. "native" in solution, in gels and in whole nuclei; chromatin depleted of the H1 (H5) histones and chromatin with bound ethidium bromide). A correlation between the results obtained with the various chromatin preparations provides evidence for a model according to which at low ionic strength the chromatin fibre already possesses a helical superstructure, with a diameter comparable to that of condensed chromatin, held together by the H1(H5) histone. The most significant structural modification undergone upon an increase of the ionic strength is a reduction of the helix pitch, this leads to condensation in a manner similar to the folding of an accordion. The details of this process depend on whether monovalent or divalent cations are used to raise the ionic strength, the latter producing a much higher degree of condensation. Measurements of the relative increase of the mass per unit length indicate that the most condensed state is a helical structure with a pitch around 3.0-4.0 nm. In this paper we give a detailed presentation of the experimental evidence obtained from static and time-resolved scattering experiments, which led to this model. PMID- 3956447 TI - Chronic effects of nitrogen dioxide on cilia in hamster bronchioles. AB - Nitrogen dioxide has been shown to have a deleterious effect on the structure and function of respiratory cilia. This study focuses on both the alterations of cilia morphology, and the ciliated cell response induced by nitrogen dioxide, in order to determine the mechanism(s) leading to ciliary dysfunction. Ciliated cells of the respiratory airways of hamsters, exposed to 30 ppm nitrogen dioxide for 5 months, 7 days/week, 22 hours/day, were examined ultrastructurally using Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) of thin sections, freeze-fracture replicas, and thin sections of tissues treated with cationized ferritin. SEM and TEM preparations appeared to show a generalized reduction in number and length of cilia. It was common to see basal bodies with no ciliary shaft and many cilia at different stages of growth. It was also apparent that the cilia were most fragile just below the ciliary necklaces. After breakage, the plasma membranes of the remaining ciliary stubs covered the exposed basal bodies. During the early stages of ciliary regeneration, freeze fracture replicas showed the emergence of membrane particles which appeared to correlate with cationized ferritin binding sites. As the cilia increased in length, the particles assembled into a necklace-like arrangement, varying in ring number and particle distribution as compared to the 5 to 7 well organized rings observed in controls. In corresponding thin sections, cationized ferritin appeared bound to sites in the region of the ciliary necklace particles. As the cilia developed further, the cationic ferritin binding at these sites diminished. This data suggests that nitrogen dioxide had an affect on the plasma membranes of ciliated cells. One of the major sites affected by the nitrogen dioxide was the ciliary necklace region. Exposure to nitrogen dioxide appeared to lead to increased ciliary fragility, stunted ciliary growth, and loss of ciliary motility. The rings of ciliary necklace particles exhibited an 8.4 degrees +/- 1.3 degree angle of pitch to a perpendicular through the longitudinal axis of the cilium. The measurable pitch and the identification of ciliary necklace "free ends" proximally and distally lead us to hypothesize that the particle arrangement of the ciliary necklace is that of a single spiral and not separate rings. PMID- 3956448 TI - Comparison of in vitro and in vivo rates of collagen synthesis in normal and damaged lung tissue. AB - The rate of collagen synthesis was measured in vivo and in vitro in both normal and damaged mouse lung tissue. Acute lung damage was induced by the administration of butylated hydroxytoluene (BHT). The production of labeled hydroxyproline, following the administration of labeled proline, was used as an index of collagen production. Total and labeled hydroxyproline in normal and damaged lung tissue were solubilized equally following digestion with purified collagenase. Assuming that the extent of hydroxylation was not altered, this indicated that hydroxyproline was an accurate index of collagen content and production in damaged as well as normal lung tissue. The quantities of hydroxyproline formed at various times both in vivo and in vitro were calculated from the specific activity of free proline in lung tissue. The specific activity of free proline in normal and damaged lung tissue remained constant in vivo for at least 90 minutes after the intravenous injection of labeled proline. Hydroxyproline production was a linear function of time for up to 90 minutes in vivo and three hours in vitro. The in vivo rate of hydroxyproline production was significantly greater than the in vitro rate in lung tissue from similarly treated mice. The difference ranged from five-fold in normal lung tissue to eight fold in lung tissue damaged by the administration of BHT. Comparable differences were seen between the in vivo and in vitro rates of non-collagen protein synthesis. Despite these differences in rates, the percentage of total protein synthesis committed to collagen in vivo was the same as in vitro in normal lung, and identical increases were seen in damaged lung. These data show that in vivo rates of both collagen and non-collagen protein synthesis are significantly higher than those measured in mouse lung tissue in vitro. Although the relative increases in collagen synthesis that occur in response to lung damage are larger in vivo, measurements of collagen synthesis in vitro do accurately reflect the general changes that accompany acute lung damage. PMID- 3956449 TI - Estrogen alters the acquisition of seizures kindled by repeated amygdala stimulation or pentylenetetrazol administration in ovariectomized female rats. AB - Ovariectomized female rats received estradiol (E2) replacement by means of subcutaneous silastic capsules (10% E2 in cholesterol). E2-replaced rats required fewer daily amygdala stimulations to develop fully kindled seizures as compared with ovariectomized rats implanted with cholesterol-only capsules. Other rats were injected with pentylenetetrazol (PTZ), 40 mg/kg i.p., every 48 h. E2 replaced rats showed a progressive increase in convulsive severity from minimal responses after the first injection to tonic convulsions after eight injections. Most rats without E2 replacement failed to progress past clonic convulsive responses after 22 injections. The results support a marked influence of E2 on seizure processes as demonstrated in two different models of seizure acquisition. PMID- 3956450 TI - Extracellular (36Cl) space, electrolyte, protein, and DNA content in brain of DBA and C57 mice: effects of age. AB - DBA/2J (DBA) mice are susceptible to audiogenic seizures (AGSs) in an age dependent manner, susceptibility being maximal at 21 days and absent at 110 days of age. Previous studies have demonstrated that there is a decrease in anion transport and an increase in carbonic anhydrase (CA) activity in brain from DBA mice as compared with C57BL/6J (C57, non-AGS) mice at 21 days. Since these results suggest that there are alterations in cellular and electrolyte composition of brain from DBA mice, the present work was directed toward determining electrolyte content, extracellular space, and DNA content of brain from DBA and C57 mice at 21 and 110 days of age. There was a decrease in intracellular chloride and sodium content, and an increase in intracellular potassium content in cerebral cortex, cerebellum, and brainstem from DBA mice at both 21 and 110 days. Also, extracellular space was larger in these three brain tissues from DBA mice at both ages. DNA content, not different between the strains at 21 days, was significantly lower in cerebellum from DBA mice at 110 days. These findings give further evidence of alterations in the transport of ions in brain from DBA mice. In addition, they demonstrate that there are alterations in the intracellular and extracellular space values, an indication of changes in cellular composition of brain in these mice. Such changes may contribute to AGS susceptibility by disrupting the balance that normally exists in the neuronal microenvironment of the central nervous system. PMID- 3956451 TI - A comparative study of the cognitive effects of phenytoin and carbamazepine in new referrals with epilepsy. AB - This study compares cognitive function in new referrals with epilepsy well controlled on single drug therapy with either phenytoin or carbamazepine with that in an untreated control group. Patients receiving phenytoin performed consistently less well on memory tasks than did those untreated or receiving carbamazepine. Although patients on phenytoin overall showed a trend towards poorer performance on a tracking task, higher blood levels of this drug were correlated with better tracking performance. The correlation between blood levels of carbamazepine and tracking performance was the opposite from that of phenytoin. Blood levels of carbamazepine were negatively correlated with measures of anxiety, depression, and fatigue. These findings have implications for the choice of drug in the management of epilepsy and also for the reported claims of a psychotropic effect of carbamazepine. PMID- 3956452 TI - Epilepsy in the elderly: incidence, social function, and disability. AB - The incidence of epilepsy in persons greater than or equal to 60 years was studied during a 5-year period in an urban area. The incidence of patients with definite epilepsy was 77 new cases per year per 100,000 citizens greater than 60 years of age, with a significant excess of male patients. Generalized and partial seizures each accounted for about half of the seizures, but the majority of patients experienced generalization at least once. Of 163 patients with onset of epilepsy during the study period, 152 could manage in their own home, but 97 of these required permanent home help. Marital status, dementia, and focal neurological signs, but not age, influenced patients' social function. A group of patients of the same age with established epilepsy before the study period managed as well or even better, indicating that epilepsy did not significantly influence social function. For both groups, too many patients as compared with the population at risk were economically inactive at the time of admission. Judging from patients' previous occupation, it seems as if patients predominantly came from the lower social classes, indicating that occupational risks may be of ethiological importance. PMID- 3956453 TI - Prolactin secretion in epileptic subjects treated with phenobarbital: sex differences and circadian periodicity. AB - Circulating basal prolactin (PRL) levels were evaluated in 126 subjects of both sexes with partial or generalized epilepsy, who were treated with phenobarbital (PB) alone or in combination with either phenytoin or benzodiazepines. A significant increase in PRL levels was observed in male, but not in female, patients compared with a sex- and age-matched healthy volunteer group. Circadian PRL secretion, studied in six male epileptic patients on PB monotherapy and in nine normal subjects, showed comparable 24-h PRL mean values and a preserved PRL surge during the night in both groups; however, a statistically significant additional peak was found in male epileptic subjects during the late afternoon. The cosinor analysis of the data, used to evaluate PRL rhythmicity, showed a disruption of the 24-h periodicity in epileptic subjects, while the 12-h periodicity was maintained. These results indicate that central and/or peripheral mechanisms involved in PRL secretion control are more sensitive to PB alone or in combination with other antiepileptic drugs in male than in female subjects. However, the changes of PRL secretion we found were small and unrelated to the different clinical conditions. PMID- 3956454 TI - A comparison of the toxicity effects of the anticonvulsant eterobarb (antilon, DMMP) and phenobarbital in normal human volunteers. AB - Renewed corporate interest in the anticonvulsant drug eterobarb justified renewed clinical and experimental interest in this drug. The unique and clinically intriguing feature of eterobarb is that while sharing the anticonvulsant properties of other barbiturates, the hypnotic side effects usually associated with barbiturates appear to be absent in animal studies and greatly reduced in clinical trials. This study was designed to compare the hypnotic effects of eterobarb with those of phenobarbital in healthy normal human volunteers using a double-blind, placebo-controlled design. Both clinical and neuropsychological parameters of toxicity were measured, while blood barbiturate levels were monitored to correlate neurobehavioral changes with total barbiturate level. As expected, there is a linear relationship between the degree of toxicity and the barbiturate level, but much higher barbiturate levels were tolerated without toxicity by subjects taking eterobarb. For ethical reasons, subjects were not maintained at high levels of toxicity over the 14-week trial. However, both eterobarb and phenobarbital recipients failed to show significant improved performance on Digits Total, a test of mental flexibility (Digit Symbol Substitution). In addition, phenobarbital recipients showed the only significant decrement of performance on Digits Total, and they failed to improve significantly on Trails-Part A, in which all other groups improved. This study confirms that eterobarb has less hypnotic side effects and less neurotoxicity than does phenobarbital. PMID- 3956455 TI - Eating seizures. AB - An 18-year old man had a cluster of three seizures in a few hours and then remained seizure-free without medication; his mother has experienced seizures induced by movement. A 29-year-old man has had recurrent seizures for six years. In both cases, seizures were partial motor seizures induced by chewing. They are considered to be a particular variety of movement-induced seizures triggered by proprioceptive afferents of muscular origin. This explanation does not account for the great majority of the 63 published cases of seizures precipitated by eating. Eating seizures represent a heterogeneous group of seizures with discrete electroclinical signs and mechanisms. The term "eating seizures" should be preferred to the term "eating epilepsy." PMID- 3956456 TI - Liposome-entrapped gamma-aminobutyric acid inhibits isoniazid-induced epileptogenic activity in rats. AB - Sprague-Dawley rats with interictal and ictal spike activity induced by intraperitoneally injected isoniazid (INH) were treated, 5 min before or 30 min later, with liposome-entrapped gamma-aminobutyric acid (GABA) (LEG) or GABA or phosphatidylserine. Crossover injections were given in random sequence and INH alone ws also injected in every animal as a control. LEG inhibited either seizures or interictal spikes in both groups. No decrease of epileptogenic activity was seen after GABA or phosphatidylserine treatment alone. It is suggested that LEG could contribute to the reconstitution of the GABA pool decreased by INH. PMID- 3956457 TI - Occurrence of elevated protoporphyrin levels in relation to lead burden in infants. AB - Simultaneous blood lead (PbB), erythrocyte protoporphyrin (EP), and hematocrit measurements were made semiannually in 232 normal infants from 6 to 24 months of age. The PbB averaged 7 (SD = 5) and ranged from 0 to 64 micrograms/dl. The incidence of elevated EP, a marker for deranged heme synthesis, was unrelated to PbB at levels below 15 micrograms/dl but was fourfold greater among the infants with PbB above 15 micrograms/dl. This relationship persisted even after eliminating the 31 (4%) anemic (hematocrit less than 33%) samples. The confounding effects of iron deficiency are discussed. PMID- 3956458 TI - Comparison of local and systemic immunity after intratracheal, intraperitoneal, and intravenous immunization of mice exposed to either aerosolized or ingested lead. AB - The humoral immunity of newborn mice exposed for 28 days to 2.5 mg/m3 aerosolized Pb(NO3)2 (Pb28-aero) or of 2-week-old mice similarly exposed for 14 days (Pb14 aero) was compared with that of both 2-week-old mice given 125 micrograms Pb(NO3)2/day by gastric intubation for 14 days (Pb14-oral) and of 4-week-old nonexposed controls. Mice from each group were immunized with 10(8) sheep red blood cells by intravenous (i.v.), intraperitoneal (ip), or intratracheal (it) routes of immunization. Immunity was assessed by both hemagglutination and the enumeration of antibody-forming cells from the spleen and thoracic lymph nodes. All treatment groups had decreased thymus/body weight and spleen/body weight ratios whereas only Pbaero groups had enlarged livers. The most significant immunosuppression occurred in the ip-immunized Pb28-aero group. A significant suppression of humoral immunity was also observed in thoracic lymph node samples from Pbaero groups immunized it or iv. There was no apparent immunosuppression in any treatment group after iv immunization. These results indicate that aerosolized lead is more immunosuppressive than equivalent amounts of ingested lead. This is most likely due to the greater absorption of inhaled lead and the subsequent cytotoxicity of lead for cells in the draining lymph nodes. PMID- 3956459 TI - The uptake of cadmium from a dietary and soluble source by the crustacean Daphnia magna. AB - Daphnia were exposed to radioactively labeled cadmium in solution and in the presence of Chlorella which had been preloaded with the metal to varying extents. Illuminated algal cells retained the cadmium and greatly reduced its availability to the daphnids. Autoradiographic evidence was obtained which implicated the exoskeleton as a major sink for the cadmium taken up from solution. Cadmium in solution at a concentration close to the 48 hr LC50 level did not affect respiration during the first 6 hr of exposure. Retention patterns were similar, regardless of the source of cadmium, but ecdysis resulted in a considerable loss of body burden provided that this had been acquired via a predominantly soluble route. PMID- 3956460 TI - Simultaneous multi-instrumental monitoring of vapors in sewer headspaces by several direct-reading instruments. AB - Simultaneous monitoring of the vapors in several sewer headspaces by three direct reading instruments, the Century OVA flame ionization detector, a 10.2 eV H-Nu Photoionization Detector, and a Hydrogen Sulfide Ecolyzer revealed that the majority of condensable organic vapors in areas of the Metropolitan Sewer District of Cincinnati appeared to be saturated aliphatic organics, except during short, unpredictable episodes. The monitoring was performed in the wet well of a sewage treatment plant, in sewers near two chemical plants, and in three other different sewers. The approach outlined in this paper does not require the use of gas chromatography-mass spectrometry (GC-MS) analysis. PMID- 3956461 TI - Changes in the molecular structure of mouse fetal astrocyte nucleosomes produced in vitro by methylmercuric chloride. AB - The fluorescent probe N-(3-pyrene)maleimide, which specifically labels the cysteine residues of histone H3 within the nucleosome, was used to monitor changes in the nucleosomal structure of mouse fetal astrocytes exposed to varying concentrations of methylmercuric chloride. Methylmercuric chloride treatment (10 microM) for 6 hr produced a significant decrease in the degree of fluorescence of the probe. The decrease was much smaller following a 4-hr incubation period. These results correlate with recent observations showing that significant changes in the thymidine labeling index occur following 4-6 hr of exposure to methylmercury (MeHg). It is hypothesized that MeHg enters the cells during the growth phase and attaches to the protein moiety of the nucleosome in or near the cysteine groups of histone H3, thus diminishing the binding capacity of the fluorescent probe. Addition of a detergent (sodium dodecyl sulfate) resulted in only a small increase in the degree of fluorescence of the treated nucleosomes as compared to controls, showing that the interaction of MeHg with the nuclear proteins was not dissociated by detergent. In view of the strong interaction between DNA and the histone dimer H3-H4 and the potential importance of the latter in gene regulation, these results suggest an additional means by which MeHg may exert its toxic effects. PMID- 3956462 TI - Cadmium acclimation and hormesis in Fundulus heteroclitus during fin regeneration. AB - We have previously demonstrated that exposure to cadmium at 0.1 and 0.5 mg/liter will retard the rate of fin regeneration in Fundulus heteroclitus. Since there is a body of literature indicating that preexposure to low levels of metals may increase tolerance during subsequent exposure, these experiments were designed to investigate the effects of preexposure to cadmium, using fin regeneration as the parameter of effect. Fish were exposed for 1 week to 0, 0.01, or 0.05 mg/liter Cd. Following this preexposure, the lower third of the caudal fin was amputated, and regrowth of the fins measured by ocular micrometer twice weekly for 2 weeks. During regeneration fish were maintained in either clean water (25% S, 23-25 degrees C) or in water with 0.1 mg/liter Cd. Fish newly placed in Cd (C----0.1 Cd) regenerated at the slowest rate, while the 0.01----0.1 Cd group approached the growth of control fish regenerating in clean water, indicating a protective effect or acclimation brought about by the preexposure. The 0.05----0.1 Cd group regenerated even more rapidly than controls, a phenomenon which has been termed "hormesis" and is believed to be due to an overcompensation by homeostatic regulatory mechanisms. In a second set of experiments in which regeneration took place in 0.5 mg/liter rather than 0.1 mg/liter, a protective effect of preexposure was again seen, but no hormesis was observed. Uptake data indicated that preexposed groups took up less Cd than the groups not preexposed. PMID- 3956464 TI - Rabbit alveolar macrophages after inhalation of hexa- and trivalent chromium. AB - Rabbits inhaled aerosols of hexavalent chromium (Na2CrO4) and trivalent chromium (Cr(NO3)3) at concentrations of 0.9 and 0.6 mg/m3 of the metal, respectively, for 4-6 weeks (5 days/week and 6 hr/day). Significantly more macrophages were obtained from the lungs of rabbits exposed to Cr(VI) but not from rabbits exposed to Cr(III) as compared with the controls. Macrophages from rabbits exposed to Cr(III) showed several conspicuous changes. About one-third of the macrophages contained round dark inclusions, 0.5-1.5 micron diameter, rich in chromium. Most cells had very large lysosomes which contained membranous fragments of different sizes surrounded by a more homogeneous matrix. Laminated inclusions similar to the lamellar bodies in the type II cells increased in number as did the percentage of cells with a smooth cell surface. Also macrophages from rabbits exposed to Cr(VI) showed morphological changes. The most pronounced one was enlarged lysosomes which contained short lamellae and electron-dense patchy inclusions. Only Cr(III) produced functional changes of the macrophages. The metabolic activity measured by reduction of nitroblue tetrazolium was increased and the phagocytic activity reduced. PMID- 3956463 TI - Pathogenic and free-living protozoa cultured from the nasopharyngeal and oral regions of dental patients: II. AB - Protozoa of the nose, mouth, and pharynx of 30 randomly chosen male caries patients at an odontological clinic of the National Autonomous University of Mexico, in Mexico City, were surveyed by culture from swabs. Culture tubes from swabs were observed every other day for 5 weeks. Pathogens found included Entamoeba histolytica, Naegleria fowleri, Acanthamoeba castellanii, A. culbertsoni, A. polyphaga, and Giardia lamblia. Such isolations of pathogens suggest that patients may be healthy carriers of cysts and trophic forms of protozoa responsible for several human diseases. Amoebae responsible for primary amoebic meningoencephalitis were well represented in the samples. Small pathogenic free-living amoebae have not been isolated before from healthy males in Mexico. Many species of free-living cyst-forming protozoa and some commensals without cysts were also cultured from swabs. PMID- 3956465 TI - Emerging issues in extremely-low-frequency electric and magnetic field health research. AB - Concern has increased over potential consequences of exposure to electric and magnetic fields of extremely low frequency (0-100 Hz), particularly from power transmission and distribution. Also at issue are electrical environments in homes and workplaces. Until recently, research focused on the electric, rather than the magnetic, field; now, both are under extensive investigation. A review of research to date indicates the following: Electric and magnetic fields can produce effects in vitro, with the locus of field interaction believed to be at the cell membrane. Chronic in vivo electric field exposure fails to produce effects except in behavior, neurophysiology, endocrinology, and, possibly, fetal development. The extrapolation of these animal data to humans requires further research. The epidemiological literature has, in some cases, reported an association between increased cancer rates and putative field exposure. Exposure assessments indicate that, in all likelihood, human exposures to 60-Hz electric fields of the magnitudes found under transmission lines are very infrequent; assessments are continuing to characterize exposure to 60-Hz magnetic fields and to measure the field frequency spectra found in residential and workplace settings. The public health issues emerging from this research focus on fetal development and on the initiation or promotion of cancer. It is critical to reduce existing uncertainties in order to enable valid risk assessment. PMID- 3956466 TI - Effects of coal-fired thermal power plant discharges on agricultural soil and crop plants. AB - The physicochemical properties of the upstream and downstream waters from the Upper Ganga canal, discharged cooling tower water, machine washings, and scrubber and bottom ash effluents of a 530 MW Kasimpur coal-fired thermal power plant have been determined, and their effects directly on fertile soil and indirectly on pea (Pisum sativam) and wheat (Triticum aestivum) crops have also been studied. The effluents were found to be alkaline in nature. The scrubber and bottom ash effluent was found to contain large amounts of solids and had high biochemical and chemical oxygen demands. All the effluents were found to be responsible for altering the chemical composition of the soil. The soils irrigated with the different effluents exhibited an increase in pH, organic matter, calcium carbonate, water-soluble salts, cation exchange capacity, electrical conductivity, and nitrogen and phosphorus contents while potassium content decreased, probably due to being leached to the lower layers of the soil. The effects of 100, 50, and 0% (tap water control) dilutions of cooling tower, machine washings, and scrubber and bottom ash effluents on the germination and growth of pea and wheat crops were also monitored. Using the undiluted effluents, there was 100% germination for both the crops when the irrigation was done with cooling tower effluent. The germination was restricted to 90% for the two crops when irrigated with machine washings effluent, and to 80 and 70% for pea and wheat, respectively, when irrigated with scrubber and bottom ash effluent. The samples of upstream and downstream canal water were also used for irrigating soils with and without crop plants in order to ascertain the impact of the effluents on the canal water and its subsequent effect on the crops. The soils irrigated with downstream canal water were found to contain slightly more calcium carbonate, phosphorus, and ammonia-nitrogen than those receiving upstream canal water. Though 100% germination was obtained in both the cases, the growth of the plants irrigated with the downstream canal water was found to be slightly reduced. PMID- 3956467 TI - Japanese-American pulmonary reference values: influence of environment on anthropology and physiology. AB - Anthropometric measurements and pulmonary function (volumes, flows, and flow volume curves) were evaluated in a community study of 59 male and 59 female, nonsmoking, healthy Japanese-American volunteers uniformly distributed in decades from 20 to 80 years. A control group of 36 Caucasians was similarly constituted. One technologist performed all tests. Techniques and equipment matched American Thoracic Society recommendations. A cohort effect was demonstrated for anthropometric measurements in the Japanese-Americans. They were smaller and lighter than the Caucasians but taller and heavier than the Japanese of Japan. The differences from whites diminished with youth. Although the group mean volumes and flows differed little from white reference series of Crapo et al. (1981, 1982), there was a difference in the older subjects. Flow-volume curves were increased in all Japanese-Americans. Prediction equations for pulmonary function have been prepared using standing height, age, and sex. More precise formulae would need to include skinfolds, lean body weight, and span. Our Caucasians did not differ anthropometrically or in their pulmonary function from those of the mainland. In conclusion, Japanese-American anthropometry and pulmonary function in Hawaii shows a gradation from that of Japanese to Caucasians, the extent depending on the age. This is secondary to an environmental influence on anthropometry and physiology. As a consequence race specific reference values for volumes, flows, and flow-volume curves are necessary in evaluating pulmonary function of individual Japanese-Americans. PMID- 3956468 TI - Effect of orally administered dioctyltin dichloride on murine immunocompetence. AB - The immunotoxicological effects of di(n-octyl)tin dichloride (DOTC) in the mouse were measured using a well-defined system to monitor alterations in immune responsiveness towards both self and heterologous cell membrane components. Oral weekly administration of DOTC caused a suppression of the anti-self erythrocyte antibody response. The humoral response against rat erythrocytes was also diminished. Although humoral responsiveness was affected only at a dose level which caused thymic atrophy (500 mg/kg body wt) the delayed type hypersensitivity reaction to oxazolone, a measure of cell-mediated immunity, was not affected. These data indicate that DOTC can suppress specific aspects of murine immunocompetence and may be relevant in designing studies for assessing possible hazards associated with environmental chemicals. PMID- 3956469 TI - Mercuric chloride-induced physiological dysfunction in Notopterus notopterus. AB - The freshwater fish Notopterus notopterus were exposed to various sublethal concentrations (0.088, 0.044, 0.029, 0.022, and 0.017) of mercuric chloride (HgCl2) mg/liter for 15, 30, 45, and 60 days, and their effects on glucose, lactate, cholesterol, plasma glutamic oxalacetic transaminase (PGOT) and plasma glutamic pyruvic transaminase (PGPT) of the blood were observed. Lactate increased significantly (P less than 0.05; P less than 0.01; P less than 0.001) and glucose. PGOT, and PGPT increased significantly (P less than 0.05; P less than 0.01). However, cholesterol decreased significantly (P less than 0.05; P less than 0.01; P less than 0.001) in the blood of N. notopterus. PMID- 3956471 TI - Coping strategies used by nurses on night duty. PMID- 3956470 TI - Vasospastic tendency and Raynaud's phenomenon in smelter workers exposed to arsenic. AB - The long-term drinking of water with a high content of inorganic arsenic can lead to Raynaud's phenomenon, acrocyanosis, and gangrene of the lower legs ("black foot disease"). We have measured the systolic blood pressure in the finger after local cooling in 47 workers from a copper smelter who were habitually exposed to moderate amounts of arsenic dust. The controls were 48 workers not exposed to arsenic. The concentration of inorganic arsenic including its metabolites in urine was determined. We found a difference between As-exposed workers and the controls in the finger systolic pressure at skin temperatures of 10 degrees C and/or 15 degrees C expressed as a percentage of the pressure at 30 degrees C (FSP%), P less than 0.01; and the prevalence of Raynaud's phenomenon, P less than 0.05. A low FSP% was taken to indicate vasospastic tendency. There was a covariation between the duration of exposure to arsenic and the decrease in finger systolic pressure between the measurements at 30 and 10 degrees C (P less than 0.05). The uptake of arsenic at the time of the study probably did not exceed 300 micrograms/day. This was confirmed by estimation of the urinary excretion. The average total arsenic uptake was estimated to be about 4 g over 23 years, which is less than the total uptake of 20 g of arsenic by subjects who developed black foot disease. Increased vasospastic reactivity in the fingers and Raynaud's phenomenon in smelter workers seems to be due to functional alterations in the vessels caused by inhalation of arsenic. PMID- 3956472 TI - Frequency characteristics of the smooth pursuit component in tracking eye movements. PMID- 3956473 TI - Perception of draught in ventilated spaces. PMID- 3956474 TI - Reliability of the psychophysical approach to manual lifting of liquids by females. PMID- 3956475 TI - Vibration and comfort: vertical and lateral motion in the range 0.5 to 5.0 Hz. PMID- 3956476 TI - Exercise and cardiorespiratory fitness. PMID- 3956477 TI - Characterizing the anthropometric extremes of the population. PMID- 3956478 TI - Arm strength and impulse generation: initiation of wheelchair movement by the physically disabled. PMID- 3956479 TI - Electron microscopy of the low pH structure of influenza virus haemagglutinin. AB - Influenza virus haemagglutinin mediates infection of cells by fusion of viral and endosomal membranes, triggered by low pH which induces a conformational change in the protein. We report studies of this change by electron microscopy, neutron scattering, sedimentation and photon correlation on X-31 (H3N2) haemagglutinin, both intact and bromelain cleaved, in various assemblies. HAs in all preparations showed a thinning at low pH, and a marked elongation which was removed on tryptic digestion, revealing altered features in the remaining stem portion of the molecule. A tentative model of the change is proposed, with reference to the known X-ray structure at neutral pH, in which major changes occur in the stem tertiary structure, while the top portion is only affected in its quaternary structure. PMID- 3956480 TI - Selection of Dictyostelium mutants defective in cytoskeletal proteins: use of an antibody that binds to the ends of alpha-actinin rods. AB - A monoclonal antibody, mAb 47-19-2, was used to study the subunit topology of the rod-shaped alpha-actinin molecules of Dictyostelium discoideum and to screen for mutants defective in the production of alpha-actinin. Electron microscopy of rotary-shadowed alpha-actinin-antibody complexes showed binding of mAb 47-19-2 to both ends of the alpha-actinin rods and cleavage of the rods into its subunits, indicating that the two subunits of alpha-actinin extend in an anti-parallel mode through the whole length of the rod. The antibody binding sites were located in close proximity to the sites responsible for actin cross-linking, which is consistent with the blocking activity of the antibody. In a mutant, HG1130, no antibody label was detected in colony blots, and by immunoblotting of mutant proteins separated by SDS-PAGE, only trace amounts of alpha-actinin were found. The mutant showed normal binding of antibodies directed against the actin-binding proteins severin and capping protein. The mutation responsible for the alpha actinin defect was recessive and located on linkage group I of the genetic map of D. discoideum. HG1130 cells grew on bacteria at a normal rate and also axenically like cells of the parent strain AX2. After starvation the mutant cells expressed the contact site A glycoprotein, a marker of the aggregation-competent stage, and reacted chemotactically to cyclic AMP. The aggregation patterns and fruiting bodies of the mutant appeared to be normal. Patching and capping on the surface of HG1130 cells was induced by antibodies against the contact site A glycoprotein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956481 TI - Phosphorylation of an acidic mol. wt. 80 000 cellular protein in a cell-free system and intact Swiss 3T3 cells: a specific marker of protein kinase C activity. AB - Activation of the endogenous Ca2+-activated phospholipid-dependent protein kinase (protein kinase C) by Ca2+, phosphatidylserine (PS) and phorbol dibutyrate (PBt2) in detergent-solubilized extracts of Swiss 3T3 cells resulted in a very rapid increase (detectable within seconds) in the phosphorylation of an 80 000 mol. wt. protein (termed 80 K). Neither cyclic AMP nor Ca2+ had any effect on 80 K phosphorylation. The 80 K phosphoproteins generated after activation of protein kinase C, both in cell-free conditions and in intact fibroblasts, are identical as judged by one and two-dimensional polyacrylamide slab gel electrophoresis and peptide mapping. Prolonged treatment of cells with phorbol esters causes a selective decrease in protein kinase C activity and prevents the stimulation of 80 K phosphorylation in intact fibroblasts. We now show that extracts from PBt2 treated cultures fail to stimulate 80 K phosphorylation after the addition of the protein kinase C activators. This effect was due to the lack of protein kinase C activity since the addition of exogenous protein kinase C from mouse brain stimulated 80 K phosphorylation in both control and PBt2-treated preparations. The 80 K phosphoprotein generated by activation of endogenous and exogenous protein kinase C yielded similar phosphopeptide fragments after peptide mapping by limited proteolysis. We conclude that the detection of changes in the phosphorylation of 80 K provides a useful approach to ascertain which extracellular ligands activate protein kinase C in intact cells. PMID- 3956482 TI - Acid Bohr effect of a monomeric haemoglobin from Dicrocoelium dendriticum. Mechanism of the allosteric conformation transition. AB - The dioxygen affinity of Dicrocoelium dendriticum haemoglobin was determined as a function of pH with a thin-layer diffusion technique. From the oxygen dissociation and association curves Hill coefficients h equal 1 were obtained throughout. Ultracentrifugation studies prove this haemoglobin to be monomeric irrespective of pH and ligation state. Thus, Dicrocoelium haemoglobin is a non cooperative monomer. It has the highest O2 affinity so far known for any monomeric haemoglobin: its half-saturation pressure, p50 value, ranges at 25 degrees C from 0.016 mm Hg to 0.15 mm Hg (2.13-20.0 Pa) dependent on pH. Dicrocoelium haemoglobin shows an acid Bohr effect only and as such it constitutes a new class of haemoglobins. Its log p50 versus pH plot (Bohr effect curve) is characterized by a large amplitude, delta log p50 = 0.96, and an inflection point (Bohr effect pK) at pH 5.0. A model for the acid Bohr effect of D. dendriticum haemoglobin is proposed. By generalization, both the alkaline and the acid Bohr effect in various monomeric haemoglobins may arise from a single Bohr group complex (salt bridge). PMID- 3956483 TI - Structure of neutral oligosaccharides derived from mucus glycoproteins of human seminal plasma. AB - The primary structures of nine major saccharide alditols in the fraction of neutral carbohydrates derived from human seminal plasma mucin have been established on the basis of fast atom bombardment and electron impact mass spectrometry combined with methylation analysis, exoglycosidase digestion, and CrO3 oxidation, as follows. Formula: see text. PMID- 3956484 TI - L16, a bifunctional ribosomal protein and the enhancing effect of L6 and L11. AB - L16 exhibits both peptide bond and transesterification activities when reconstituted into 2 M LiCl core particles. L6 and L11, when reconstituted in a similar manner in the absence of L16, manifest significant transesterification activity. Both L6 and L11 enhance the transesterification activity of L16; L11 being more active than L6 in this respect. However, both L6 and L11 have minimal effect on peptide bond formation when reconstituted with L16 at concentrations more than 2.5 M equivalents. Both L6 and L11 exhibit a differential effect on transesterification. The affinity-labelling agents, like PhCH2SO2F, diisopropylfluorophosphate and ethoxyformic anhydride, have been used to explore the role of residues in peptide bond formation and transesterification. It is proposed that the Ser-Phe combination present in L16, L11 and L6 is involved in transesterification in addition to the single histidine in L16. The single histidine in L16 appears to be important in the catalysis of peptide bond formation and transesterification. PMID- 3956485 TI - Differential effects of defined chemical modifications on antigenic and pharmacological activities of scorpion alpha and beta toxins. AB - Specific chemical modifications of scorpion alpha and beta toxins have been used to study the involvement of particular residues in both the pharmacological and the antigenic sites of these toxins. Modification by 1,2-cyclohexanedione of arginine-27 of a beta toxin, Centruroides suffusus suffusus toxin II, drastically decrease the antigenic activity without any influence on the pharmacological activity. Conversely, modification by the same reagent of arginine-2 of an alpha toxin, Androctonus australis Hector toxin III, led to a 100-times less pharmacologically potent derivative and did not induce a significant loss of antigenic activity. Excision of the N-terminal pentapeptide of another alpha toxin, Buthus occitanus mardochei toxin III, by pepsin digestion led to a non toxic derivative retaining full antigenic activity. Thus, the N-terminal part of the conserved hydrophobic surface of the toxin is highly implicated in the pharmacological activity, whereas the region of arginine-27, located in the alpha helix situated on the back surface, opposite the conserved hydrophobic region, is fully implicated in the antigenic activity and is far from the pharmacological site. These results are good arguments in favor of the idea that in scorpion toxins the surfaces implicated in the pharmacological and the antigenic activities do not overlap. Since the antigenic sites are present in highly variable sequence the development of an efficient polyvalent serotherapy is questionable. PMID- 3956486 TI - Temperature dependence of dihydropteridine reductase activity. AB - The kinetic parameters Km and kcat of dihydropteridine reductase with a mixture of 6R and 6S quinonoid 7,8(6H)-dihydrobiopterin were determined at several temperatures in the range 20-37 degrees C. Both Km and kcat increased with temperature. Thermodynamic activation parameters were calculated and compared with those for the non-enzymic reduction of quinonoid 7,8(6H)-dihydrobiopterin by NADH. The temperature coefficients of the enzyme catalysed and uncatalyzed reactions are 3.3 and 1.67 respectively. The results are consistent with an ordered bi-bi enzyme mechanism, in which the rate-determining step is an isomerisation of the ternary complex. This isomerisation involves a positive entropy of activation, which overcomes an enthalpy of activation that is significantly higher for the enzymic than for the non-enzymic reaction. PMID- 3956487 TI - The time-dependent inactivation of human brain dihydropteridine reductase by the oxidation products of L-dopa. AB - Dihydropteridine reductase (DHPR) was irreversibly inactivated in a time dependent way by incubation with 3,4-dihydroxyphenylalanine (L-dopa). The inactivation was oxygen-dependent; incubation under nitrogen gave partial protection. The inactivation was stimulated by the presence of horse-radish peroxidase/hydrogen peroxide. L-Dopa itself was not an inhibitor of DHPR although dopachrome, the aminochrome formed following oxidation of L-dopa, was a reversible inhibitor of DHPR with an I50 of 0.60 mM. The quinone products of oxidation of L-dopa were responsible for the time-dependent inactivation of DHPR. Adrenochrome also demonstrated a time-dependent inactivation of DHPR. Inactivation by adrenochrome demonstrated a saturation effect suggesting the reversible formation of a complex preceding inactivation. No radiolabel was incorporated into DHPR following inactivation by L-[14C]-dopa. Sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE) demonstrated the presence of a dimer of DHPR. A mechanism of inactivation involving the oxidative coupling of essential thiol groups was proposed to explain inactivation. PMID- 3956488 TI - Enzymic synthesis of isoflavones. AB - The NADPH and oxygen-dependent conversion of (2S)-naringenin to genistein catalyzed by a microsomal preparation from elicitor-treated soybean cell suspension cultures has been resolved into two steps. In the first step (2S) naringenin is converted to a product (P-2) which yields genistein in a second step. The chemical behaviour of P-2 and its ultraviolet and mass spectral data are consistent with a 2-hydroxyisoflavanone structure. The conversion of (2S) naringenin to P-2 requires NADPH, oxygen and cytochrome P-450. The participation of cytochrome P-450 was demonstrated by CO inhibition of the reaction and its partial reversal by light, and by inhibition with typical cytochrome P-450 inhibitors. On a Percoll gradient the membrane fraction which catalyzes P-2 formation coincides with marker enzymes for the endoplasmic reticulum and with the position of cytochrome P-450. Enzymatic activity for conversion of P-2 to genistein is mainly present in the supernatant of the 160 000 X g fraction. This reaction, formally a dehydration, does not require NADPH or oxygen. PMID- 3956490 TI - A model for the architecture of the hemocyanin from the arthropod Squilla mantis (Crustacea, Stomatopoda). AB - Squilla mantis hemocyanin is composed of two hexameric subunits but has electron microscopic profiles different from other bis-hexameric hemocyanins, e.g. Astacus and Homarus. We distinguished three different electron microscopic profiles of S. mantis hemocyanin: two sideviews and a topview. These profiles were studied using computer image alignment and correspondence analysis [Van Heel, M. and Frank, J. (1981) Ultramicroscopy 6, 187 - 194]. With the results of this analysis we were able to build a three-dimensional model for the quaternary structure of this hemocyanin. In this model the two hexamers are stacked in such a way that their hexagonal surfaces overlap to about 60% of their width. In the overlap area four subunits are arranged in two different interhexameric pairs, each forming a bridging area between the two hexamers. PMID- 3956489 TI - Optimization of protein synthesis in isolated higher plant chloroplasts. Identification of paused translation intermediates. AB - Protein synthesis in isolated, intact pea chloroplasts was optimized and compared to translation within chloroplasts in vivo. Many polypeptides labeled with [35S]methionine in isolated intact chloroplasts did not comigrate with polypeptides which were labeled within chloroplasts in vivo. Antibodies to the large subunit of ribulose-1,5-bisphosphate carboxylase-oxygenase (EC 4.1.1.39) immunoprecipitated [35S]-labeled large subunit plus several lower-molecular-mass translation products of isolated chloroplasts. The lower-molecular-mass soluble translation products synthesized in pulse-labeled chloroplasts were converted into full-length large-subunit polypeptides during a subsequent chase period. This result suggests that many of the polypeptides observed in pulse-labeled chloroplasts are incomplete translation products which are the result of ribosome pausing at discrete points along chloroplast mRNAs. The pulse-chase technique was used to follow synthesis of the 34.5-kDa precursor of the psb A gene product and its processing to the mature 32-kDa polypeptide in isolated chloroplasts. Chloroplast translation profiles obtained using the pulse-chase assay were very similar to translation profiles obtained in vivo thus extending the utility of protein synthesis in isolated chloroplasts. PMID- 3956491 TI - Proton magnetic resonance spectroscopic studies of the interaction of ubiquinone 10 with phospholipid model membranes. AB - Proton magnetic resonance spectra of ubiquinone-10 and ubiquinone-10 dispersed with dipalmitoylglycerophosphocholine or egg phosphatidylcholine in aqueous medium have been obtained. The dispersions are in the form of multilamellar liposomes as judged by 31P-NMR spectra and the thermal history of the samples have ensured that ubiquinone not incorporated into the phospholipid structure only gives rise to a broad-line NMR proton spectrum. A high-resolution proton spectrum of ubiquinone is observed with upfield shifts of the O-methyl protons of the benzoquinone rings, indicating close proximity of the molecules but with an arrangement different from the pure liquid ubiquinone. Spectra obtained in the presence of the lanthanide shift reagents, dysprosium fluorooctanedionate and Dy(NO3)3, which have a preferred location in the hydrophobic and hydrophilic domains, respectively, of ubiquinone/phospholipid codispersions, are consistent with the partitioning of ubiquinone into a hydrophobic phospholipid environment remote from the aqueous phase. The type of arrangements of ubiquinone that could be accommodated within bilayers of phospholipid are discussed. PMID- 3956492 TI - Stimulation of the adenylate cyclase activity of rabbit bone marrow immature erythroblasts by erythropoietin and haemin. AB - The effect of two agents of erythroid cell differentiation on the adenylate cyclase activity of fractionated rabbit bone marrow erythroblasts has been investigated. Addition of 0.2U/ml erythropoietin to cell cultures causes a transient increase in the activity of plasma membrane adenylate cyclase, which is maximal by 20 min and disappears within 4 h. The magnitude of the response to hormonal stimulation depends on the stage of erythroid cell development and is greater in the more immature cells. Addition of 50 microM haemin to cultures of erythroblasts also causes an increase in the activity of adenylate cyclase, which differs from the effect of erythropoietin in kinetics and specificity of target cells. With immature cells the haemin-induced stimulation starts after the first hour and continues to increase up to 20 h of culture. Erythropoietin but not haemin can stimulate the basal activity of adenylate cyclase in an in vitro assay containing plasma membranes of immature erythroid cells. The degree of activation depends on the concentration of erythropoietin and is maximal with 0.2-0.5 U/ml hormone (5-12 nM). In the presence of guanine nucleotides the activation of adenylate cyclase by erythropoietin is increased further but the effect is not additive. With respect to the basal and the guanine-nucleotide-stimulated activities of adenylate cyclase erythropoietin acts differently from the beta agonist l-isoprenaline. The in vitro effect of erythropoietin is abolished by the beta-thio analogue of GDP, GDP[beta S], and extensive washing of membranes makes hormone action GTP-dependent. The stimulation of adenylate cyclase by the addition of erythropoietin to the reaction mixture is inversely related to the extent of previous hormonal stimulation of the cells from which the membranes were prepared. This loss of hormonal responsiveness is due to desensitization or receptor down-regulation and persists for up to 20 h. We conclude that in immature erythroblasts erythropoietin acts via a receptor and a guanine nucleotide-binding protein with high affinity for GTP (EC50 less than 10 nM), whereas haemin appears to activate adenylate cyclase indirectly, as a consequence of progressive perturbations of the plasma membrane. PMID- 3956493 TI - Hypermodified nucleoside carboxyl group as a target site for specific tRNA modification. AB - The free carboxyl group of hypermodified nucleosides N6-methyl-N6 (threoninocarbonyl)adenosine (mt6A37) and 3-(3-amino-3-carboxypropyl)uridine (acp3U20:1) in tRNAmMet (yellow lupine), and N6-(threoninocarbonyl)adenosine (t6A37) in tRNAiMet (yellow lupine) can be converted quantitatively and under very mild conditions into the respective anilides in a reaction with aniline and a water-soluble carbodiimide. The tRNA reactions proceed with rates very similar to that reported previously for t6A nucleoside. Detailed analysis of the products of tRNA modification with [3H]aniline on tRNA (chromatography on BD-DEAE cellulose), oligonucleotide (polyacrylamide gel electrophoresis) and nucleoside (HPLC on Aminex A6) levels clearly indicates that only the hypermodified nucleoside residues undergo the reaction. The site of modification is confirmed for mono-modified (at mt6A37) and bis-modified (at mt6A37 and acp3U20:1) tRNAmMet, and for mono-modified (at t6A37) tRNAiMet by sequence analysis using 5'end 32P-labeled tRNAs. The modification procedure seems to be universally applicable for all hypermodified nucleosides bearing a free carboxyl group and for different amine reagents designed for the studies on tRNA function. PMID- 3956494 TI - Covalent linking of poly(ethyleneglycol)-bound NAD with Thermus thermophilus malate dehydrogenase. NAD(H)-regeneration unit for a coupled second-enzyme reaction. AB - Poly(ethyleneglycol)-bound NAD (PEG-NAD) was covalently linked to Thermus thermophilus malate dehydrogenase with a bifunctional reagent, 3,3'-(1,6-dioxo 1,6-hexanediyl)bis-2-thiazolidinethione. The covalently linked malate dehydrogenase--PEG--NAD complex (MDH-PEG-NAD) was purified by DEAE-Sephadex column chromatography to remove unbound PEG-NAD, and fractionated by blue Sepharose column chromatography into four preparations: MDH-PEG-NAD I, MDH-PEG NAD II, MDH-PEG-NAD III and MDH-PEG-NAD IV. The average numbers of NAD moieties covalently bound per subunit of MDH-PEG-NAD I, MDH-PEG-NAD II, MDH-PEG-NAD III and MDH-PEG-NAD IV were 1.2, 1.2, 0.8 and 0.5, respectively, and the values were confirmed by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. 60-80% bound NAD moiety of these preparations of MDH-PEG-NAD was reduced by the enzyme moiety in the presence of L-malate, and the specific activity of the enzyme moiety of the preparations was more than 80% that of the native enzyme. MDH-PEG NAD I has the following properties. The Km value for exogenous NAD is three times that of the native enzyme. The coenzyme activity of its NAD moiety is 20-40% that of native NAD for alcohol and lactate dehydrogenases. The complex catalyzes the oxidation of L-malate in the presence of the redox system of 5-ethylphenazinium ethyl sulfate and a tetrazolium salt with a rate constant of 0.11 s-1. The coenzyme moiety of the complex can also be recycled by coupled reactions of the active site of the same complex and alcohol dehydrogenase. These results indicate that MDH-PEG-NAD works as an NAD(H)-regeneration unit for coupled reactions. PMID- 3956495 TI - Inhibition of dolichyl phosphate biosynthesis by compactin in cultured rat hepatocytes. AB - Isolated rat hepatocytes were cultured in monolayer for about 24 h. During this period the cells exhibited constant protein and lipid synthesis. When the culture medium contained compactin, a competitive inhibitor of the 3-hydroxyl-3 methylglutary-coenzyme-A reductase, dolichyl-P synthesis was inhibited by 91% at the end of the incubation, as estimated by the incorporation of [3H]acetate and by 77% as estimated by the incorporation of 32Pi. These results indicate that in primary cultures of rat hepatocytes dolichyl monophosphate is mainly synthesized through a de novo process, while phosphorylation through the CTP-mediated kinase is of limited functional importance. PMID- 3956496 TI - Structural studies on the minor teichoic acid of Bacillus coagulans AHU 1631. AB - The minor teichoic acid linked to glycopeptide was isolated from lysozyme digests of Bacillus coagulans AHU 1631 cell walls, and the structure of the teichoic acid moiety and its junction with the peptidoglycan were studied. Hydrolysis of the teichoic-acid--glycopeptide complex with hydrogen fluoride gave a nonreducing oligosaccharide composed of glucose, galactose and glycerol in a molar ratio of 3:1:1 which was presumed to be dephosphorylated repeating units of the polymer chain. From the results of structural analysis involving NaIO4 oxidation, methylation and acetolysis, the above fragment was characterized as glucosyl(beta 1----3)glucosyl(beta 1----6)galactosyl(beta 1----6)glucosyl(alpha 1--- 1/3)glycerol. In addition, the Smith degradation of the complex yielded a phosphorus-containing fragment identified as glycerol-P-6-glucosyl(beta 1--- 1/3)glycerol. These results led to the most likely structure for the repeating units of the teichoic acid, -6[glucosyl(beta 1----3)]glucosyl(beta 1--- 6)galactosyl(beta 1----6)glucosyl(alpha 1----1/3)glycerol-P-. The minor teichoic acid, just like the major teichoic acid bound to the linkage unit, was released by heating the cell walls at pH 2.5. The mild alkaline hydrolysis of the minor teichoic acid after reduction with NaB3H4 gave labeled saccharides characterized as glucosyl(beta 1----6)galactitol and glucosyl(beta 1----3)glucosyl(beta 1--- 6)galactitol, together with a large amount of the unlabeled repeating units of the teichoic acid chain. Thus, the minor teichoic acid chain is believed to be directly linked to peptidoglycan at the galactose residue of the terminal repeating unit without a special linkage sugar unit. PMID- 3956497 TI - Properties of catalase purified from a methanol-grown yeast, Kloeckera sp. 2201. AB - Catalase, a marker enzyme of peroxisomes, was purified to homogeneity from whole cells of Kloeckera sp. 2201 (a strain of Candida boidinii) grown on methanol by means of ammonium sulfate fractionation followed by hydroxyapatite, Sephacryl S 300 and DEAE-Sepharose column chromatographies. Crystallized catalase was brown coloured and needle-like. The molecular mass of the enzyme was about 240 000 daltons consisting of four identical subunits of 62 000 daltons. The minimum size of catalase molecule was estimated to be about 6 X 10 nm from an electron micrograph. Judging from the absorption spectrum, the enzyme seemed to belong to a group of T-type catalase. The Km value of the enzyme for hydrogen peroxide (catalatic activity) was 25 mM, while that for methanol (peroxidatic activity) was 83 mM. Catalase from Kloeckera sp. cells showed a certain degree of similarity to the enzyme purified from alkane-grown Candida tropicalis [T. Yamada et al. (1982) Eur. J. Biochem. 125, 517-521 and 129, 251-255] in its immunochemical properties. PMID- 3956498 TI - Translocation of proteins into rat liver mitochondria. The precursor polypeptides of a large subunit of succinate dehydrogenase and ornithine aminotransferase and their imports into their own locations of mitochondria. AB - The precursor polypeptides of a large subunit of succinate dehydrogenase and ornithine aminotransferase (the enzymes which are located in the mitochondrial inner membrane and matrix respectively) were synthesized as a larger molecular mass than their mature subunits, when rat liver RNA was translated in vitro. These precursor polypeptides were also detected in vivo in ascites hepatoma cells (AH-130 cells). When the 35S-labeled precursor polypeptides were incubated with isolated rat liver mitochondria at 30 degrees C in the presence of an energy generating system, these two precursors were converted to their mature size and the 35S-labeled mature-size polypeptides associated with mitochondria. Furthermore, these mature-size polypeptides were recovered from their own locations, the inner mitochondrial membrane and the matrix. The precursor of ornithine aminotransferase incubated with rat liver mitochondria at 0 degree C was specifically and tightly bound to the surface of the mitochondria even in the presence of an uncoupler of oxidative phosphorylation. This precursor, bound to the mitochondria, was imported into the matrix when the mitochondria were reisolated and incubated at 30 degrees C in the presence of an energy-generating system, suggesting that a specific receptor may be involved in the binding of the precursor. The processing enzyme for both precursor polypeptides seemed to be located in the mitochondrial matrix and was partially purified from the mitochondria. A metal-chelating agent strongly inhibited the processing enzyme and the inhibition was recovered by the addition of Mn2+ or Co2+. PMID- 3956500 TI - Soluble fibrin consists of fibrin oligomers of heterogeneous distribution. AB - Soluble fibrin is observed in patients with intravascular coagulation and represents an intermediary product of conversion of fibrin monomers into a fibrin clot whereby the presence of fibrinogen may suppress fibrin clot formation. The interactions between fibrin and fibrinogen and the occurrence of fibrin oligomers in soluble fibrin were studied by sucrose density ultracentrifugation. Different concentrations of soluble fibrin, prepared by mixing 125I-fibrin (24 nM - 1.5 microM) with a constant concentration of 131I-fibrinogen (6 microM) were analyzed at 37 degrees C in stable linear sucrose density gradients containing a uniform concentration of unlabelled fibrinogen (6 microM) and calcium ions in order to mimic the physiological situation. At any fibrin concentration, 125I-fibrin sedimented faster than 131I-fibrinogen through 5-30% (w/v) sucrose gradients. Sedimentation rates of fibrin increased from 9 S to 23 S depending on the initial fibrin concentration. The relative amount of residual fibrin monomer not incorporated into oligomers was calculated from the sedimentation profiles. At any fibrin concentration, the portion of free monomer was always more than twofold higher for batroxobin-generated (desAA-) fibrin than for thrombin generated (desAABB-) fibrin. Apparent association constants for desAABB-fibrin were 3-10 times higher than those for desAA-fibrin indicating a stronger interaction between monomers of the former type of fibrin. In the presence of excess fibrinogen the predominant species in soluble desAA-fibrin were monomers and dimers, whereas dimers, trimers and higher-molecular-mass oligomers were present in soluble desAABB-fibrin. Strong interactions between both types of fibrin were demonstrated from their cosedimentation, whereby the size of these copolymers were shown to be governed by the oligomer size of the desAABB-fibrin type. These results provide evidence for the occurrence of differently sized oligomers of fibrin in soluble fibrin and for the concept of a cooperative polymerization process between both types of fibrin devoid of any stable complexes between fibrin and fibrinogen. PMID- 3956499 TI - The malate/aspartate shuttle and pyruvate kinase as targets involved in the stimulation of gluconeogenesis by phenylephrine. AB - The mechanisms responsible for the stimulation by phenylephrine of gluconeogenesis from dihydroxyacetone and glycerol were studied in perifused rat hepatocytes. The stimulation by phenylephrine of glucose formation from dihydroxyacetone was biphasic. Transient stimulation of about 25% after 3 min was followed by a stable stimulation of about 15% 7 min later. Concomitantly there was a transient inhibition by phenylephrine of pyruvate kinase flux during the first few minutes followed by a more stable inhibition after about 10 min. The stable inhibition could quantitatively account for the stable stimulation of gluconeogenesis by the hormone when dihydroxyacetone was the gluconeogenic substrate. The effects of phenylephrine were independent of cAMP. With the reduced gluconeogenic substrate, glycerol, a transient aminooxyacetate-sensitive stimulation of gluconeogenesis occurs, followed by a stable stimulation of smaller magnitude [Leverve, X. M., Groen, A. K., Verhoeven, A. J. and Tager, J. M. (1985) FEBS Lett. 181, 43-46]. This transient phase of stimulation was abolished by addition of low concentrations of pyruvate, in accordance with our previous proposal that phenylephrine transiently accelerates the mitochondrial oxidation of cytosolic NADH via the malate/aspartate shuttle. The transient stimulation of gluconeogenesis from glycerol was accompanied by a transient increase in the cytosolic/mitochondrial aspartate concentration gradient. Phenylephrine caused a transient stimulation of mitochondrial aspartate efflux in two other systems dependent on the operation of the malate/aspartate shuttle, i.e. gluconeogenesis from lactate and the oxidation of ethanol. It is proposed that addition of phenylephrine to hepatocytes brings about a transient increase in the mitochondrial membrane potential and hence an increased rate of transport of aspartate from the mitochondria to the cytosol. PMID- 3956501 TI - NADPH/NADH-dependent cold-labile glutamate dehydrogenase in Azospirillum brasilense. Purification and properties. AB - A cold-labile glutamate dehydrogenase (GDH, EC 1.4.1.3) has been purified to homogeneity from the crude extracts of Azospirillum brasilense. The purified enzyme shows a dual coenzyme specificity, and both the NADPH and NADH-dependent activities are equally cold-sensitive. The enzyme is highly specific for the substrates 2-oxoglutarate and glutamate. Kinetic studies with GDH indicate that the enzyme is primarily designed to catalyse the reductive amination of 2 oxoglutarate. The NADP+-linked activity of GDH showed Km values 2.5 X 10(-4) M and 1.0 X 10(-2) M for 2-oxoglutarate and glutamate respectively. NAD+-linked activity of GDH could be demonstrated only for the amination of 2-oxoglutarate but not for the deamination of glutamate. The Lineweaver-Burk plot with ammonia as substrate for NADPH-dependent activity shows a biphasic curve, indicating two apparent Km values (0.38 mM and 100 mM) for ammonia; the same plot for NADH dependent activity shows only one apparent Km value (66 mM) for ammonia. The NADPH-dependent activity shows an optimum pH from 8.5 to 8.6 in Tris/HCl buffer, whereas in potassium phosphate buffer the activity shows a plateau from pH 8.4 to 10.0. At high pH (greater than 9.5) amino acids in general strongly inhibit the reductive amination reaction by their competition with 2-oxoglutarate for the binding site on GDH. The native enzyme has a Mr = 285000 +/- 20000 and appears to be composed of six identical subunits of Mr = 48000 +/- 2000. The GDH level in A. brasilense is strongly regulated by the nitrogen source in the growth medium. PMID- 3956502 TI - Metabolic control analysis of moiety-conserved cycles. AB - Moiety-conserved cycles are metabolic structures that interconvert different forms of a chemical moiety (such as ATP-ADP-AMP, the different forms of adenylate), while the sum of these forms remains constant. Their metabolic behaviour is treated within the framework of control analysis [Kacser, H. & Burns, J.A. (1973) Symp. Soc. Exp. Biol 27, 65-104]. To explain the importance of the conserved sum of cycle metabolites as a parameter of the system, the cycle is first regarded as a 'black box'. The interactions of the cycle with the rest of the system are expressed in terms of 'cycle elasticities' and 'cycle control coefficients' by the usual connectivity properties. The conserved sum is seen to be an 'external' parameter in the sense that its effect is described by a combined response expression. All cycle coefficients can be written in terms of elasticities and concentrations of cycle metabolites. The treatment shows how connectivity expressions should be modified when moiety-conserved cycles are present and establishes new summation and connectivity properties. The analysis is applied to a two-member moiety-conserved cycle and its general application is discussed. PMID- 3956503 TI - Purified pyruvate kinases type M2 from unfertilized hen's egg are substrates of protein kinase C. AB - To characterize pyruvate kinase isoenzymes from cells with the capability to proliferate, this enzyme was purified from yolk and vitelline membrane of unfertilized hen's egg. Pyruvate kinase type M2 from vitelline membrane was obtained in a homogeneous form after a 1150-fold purification to a specific enzymatic activity of 450 mumol X min-1 X mg-1. It was saturated half-maximally with phosphoenolpyruvate at KPPrv0.5 = 0.36 mM phosphoenolpyruvate and was activity by fructose 1,6-bisphosphate and L-serine at suboptimal substrate concentrations. After 11 000-fold purification to a specific enzymatic activity of 60 mumol X min-1 X mg-1, the pyruvate kinase isoenzymes type M2 (KPPrv0.5 = 0.32 mM) and M1 (KPPrv0.5 = 0.04 mM) were obtained from the yolk substance. Kinetic differences were noted between the pyruvate kinase type-M2 isoenzymes from vitelline membrane and yolk. A comparison of the amino acid composition of the purified pyruvate kinase isoenzymes from hen's egg revealed that all isoenzymes were related to pyruvate kinase type M1 from chicken breast muscle. The M2-type isoenzyme from vitelline membrane was related to the M2-type isoenzyme from chicken tumors, but was not related to the M2-type pyruvate kinase from chicken lung or liver. Protein kinase C from chicken oviduct phosphorylated in vitro both pyruvate kinase M2 isoenzymes from the unfertilized hen's egg preferably at serine and less at threonine residues. Pyruvate kinase type M1 from egg yolk was a weak substrate of protein kinase C. An activation of pyruvate kinase type M2 from vitelline membrane was observed at suboptimal concentrations of phosphoenolpyruvate under the conditions of phosphorylation, in the presence of phosphatidylserine. PMID- 3956504 TI - Isolation and primary structure of novel neurointermediate pituitary peptides derived from the C-terminal of the rat vasopressin-neurophysin precursor (propressophysin). AB - Four novel peptides were isolated from rat neurointermediate lobes by gel filtration and high-pressure liquid chromatography. Analyses of amino acid composition and sequence showed that all four peptides were derived from the C terminal portion of propressophysin (CPP); they were identified as the glycopeptides CPP 1-19, CPP 1-20, CPP 22-37 and CPP 22-39. Processing of CPP 1-39 could thus produce the four isolated peptides by specific post-Arg or post-Leu cleavages. PMID- 3956505 TI - Structuring of H1 histone. Evidence of high-affinity binding sites for phosphate ions. AB - Circular dichroism studies show that low concentrations of phosphate ions induce folding of the H1 histones. Sulfate and perchlorate anions have effects similar to phosphate indicating the presence on H1 histones of binding sites with high affinity for ions with tetrahedral geometry. In fact, the structuring efficiency of different ions, as determined by the midpoint value of the effect/concentration curve, is 0.05 M for NaCl, 0.005 M for NaClO4, 0.001 M for sodium phosphate and 0.0003 M for sodium sulfate on H1 histone from Chaetopterus variopedatus sperm chromatin. Phosphate shows similar folding efficiency also on calf thymus and on sea-urchin sperm H1 histones. The effect of phosphate ions on the H1 molecule is observed also by differential absorption spectroscopy in the region of absorption of amino acid side-chains. Binding studies by gel filtration chromatography on Sephadex columns show that phosphate binding occurs in the presence of structuring concentrations of sodium chloride. About 9 ATP molecules bind to H1 histones derived from non-active cell chromatins while only 3.5 ATP molecules bind to H1 derived from active somatic chromatins. The fluorescence of the tyrosine residues of Chaetopterus sperm H1 is enhanced by chloride ions and heavily quenched by phosphate ions in correlation with structuring of the molecule, demonstrating direct interactions between tyrosine residues and phosphate ions. The defined and limited number of phosphate groups bound per histone molecule, the high affinity of the interaction and the effect on the structure of the histone suggest the participation of phosphate groups in the binding of H1 histones to DNA. PMID- 3956506 TI - Low apparent affinity for low-density lipoprotein of receptors expressed by human macrophages maintained with whole serum. AB - Normal human monocyte-derived macrophages maintained in medium containing whole serum exhibited saturable degradation of low-density lipoprotein (LDL) that was mediated by LDL receptors. This degradation required a higher concentration of LDL to achieve one-half saturation than that in cells preincubated with lipoprotein-deficient serum (LPDS). Studies of short-term uptake and of heparin releasable binding of LDL showed that binding to the surface receptors was the limiting factor for degradation under both conditions and that the LDL receptors expressed by cells in whole serum had a significantly lower affinity for LDL than those in cells pre-incubated in LPDS. LDL receptors in monocyte-macrophages could mediate the uptake and degradation of complexes between apolipoprotein E (apoE) and phospholipid. The receptors in cells pre-incubated in LPDS bound the complexes and LDL with apparently the same affinity and in approximately the same molar ratio. Receptors in cells maintained with whole serum did not have a lower affinity for the complexes than cells pre-incubated in LPDS, although the molar ratio of maximum degradation of LDL to that of complexes was greater. PMID- 3956507 TI - Characterization of microtubule-associated proteins isolated from bovine adrenal gland. AB - We investigated the biochemical characteristics of microtubule-associated proteins (MAPs) of both the adrenal medulla and the cortex. The major constituents of the adrenal MAPs isolated by the taxol-dependent procedure [Vallee, R. B. (1982) J. Cell. Biol. 92, 435-442] were several polypeptides in the high-molecular-mass region (high-Mr MAPs) and a 190000-Mr polypeptide (190 kDa MAP). In the cortex MAP fraction, the most prominent component was 190-kDa MAP, while the medulla MAP fraction was rich in high-Mr MAPs. Twice-cycled microtubule proteins prepared without taxol from the same sources also contained high-Mr MAPs and 190-kDa MAP. High-Mr MAPs contained protein species identical to MAP1 and MAP2 of mammalian brain as judged from electrophoretic mobility, heat stability and immunoreactivity. 190-kDa MAP was classified as MAP subspecies distinct from high-Mr MAPs by several criteria. The MAP fractions had the ability to polymerize purified tubulin into microtubules, and the major MAP species (high Mr MAPs and 190-kDa MAP) were found to cosediment with reconstituted microtubules. Tau factor, one of the major MAPs in the mammalian brain, appeared to be a minor species in the adrenal gland. PMID- 3956508 TI - Cross-linking of elongation factor 2 to rat-liver ribosomal proteins by 2 iminothiolane. AB - Complexes containing rat liver 80S ribosomes treated with puromycin and high concentrations of KCl, elongation factor 2 (EF-2) from pig liver, and guanosine 5'-[beta, gamma-methylene]triphosphate were prepared. Neighboring proteins in the complexes were cross-linked with the bifunctional reagent 2-iminothiolane. Proteins were extracted and then separated into 22 fractions by chromatography on carboxymethylcellulose of which seven fractions were used for further analyses. Each protein fraction was subjected to diagonal polyacrylamide/sodium dodecyl sulfate gel electrophoresis. Nine cross-linked protein pairs between EF-2 and ribosomal proteins were shifted from the line formed with monomeric proteins. The spots of ribosomal proteins cross-linked to EF-2 were cut out from the gel plate and labelled with 125I. The labelled protein was extracted from the gel and identified by three kinds of two-dimensional gel electrophoresis, followed by autoradiography. The following proteins of both large and small subunits were identified: L9, L12, L23, LA33 (acidic protein of Mr 33000), P2, S6 and S23/S24, and L3 and L4 in lower yields. The results are discussed in relation to the topographies of ribosomal proteins in large and small subunits. Furthermore we found new neighboring protein pairs in large subunits, LA33-L11 and LA33-L12. PMID- 3956509 TI - Human sperm protamines. Amino-acid sequences of two forms of protamine P2. AB - Human protamine P2 was purified to homogeneity by solubilizing whole spermatozoa in guanidinium X HCl containing 2-mercaptoethanol, alkylating the resulting protamine thiols with vinylpyridine, removing acid-insoluble material by acid dialysis and using CM-cellulose chromatography to remove non-protamine basic proteins and separate protamines P1 and P2. The P2 preparation contained two components, P2a and P2b, which were sequenced completely without being separated. The peptides obtained from thermolysin and endoproteinase Lys-C digestions were purified by reverse-phase high-pressure liquid chromatography and sequenced using a gas-phase sequencer. P2a contains 57 amino acids and has a relative molecular mass of 7636 while P2b contains 54 amino acids, which are identical to residues 4 57 of P2a, and has a relative molecular mass of 7242. Protamine P2a is approximately 50% homologous with human protamine P1. The amino acid sequence of P2a is: (sequence; see text) PMID- 3956510 TI - Studies on naturally occurring proteinous inhibitor for transmethylation reactions. AB - An inhibitor for S-adenosyl-L-methionine (AdoMet)-dependent methyltransferases has been purified from rat liver particulate fraction to apparent homogeneity, as judged by high-performance liquid chromatography, two-dimensional paper electrophoresis and isoelectric focusing chromatography. This inhibitor molecule, which is composed of 27 amino acid residues with an additional fluorescent chromophore, is rich in glycine, contains no basic amino acid, and has an isoelectric point (pI) of 3.70. A single absorption peak was observed at 248 nm in acidic as well as in neutral media, while two peaks were detected in alkaline medium at 206 nm and 248 nm. The former peak was found to be quite labile. The fluorescent spectra with excitation peak at 285 nm and emission peak at 358 nm are greatly influenced by the pH, being the highest in alkaline medium. The purified inhibitor inhibits all the AdoMet-dependent methyltransferases examined. PMID- 3956511 TI - Nifedipine reversibly arrests mitosis in stamen hair cells of tradescantia. AB - Mitotic stamen hair cells of Tradescantia virginiana (cv. Zwanenburg Blue) become arrested in metaphase following a 30-min treatment with 10 to 100 microM nifedipine, a Ca2+-channel entry blocker. The time interval between nuclear envelope breakdown and anaphase onset in untreated cells is approximately 33 min +/- 4 min; nifedipine extends this "metaphase transit time" beyond 70 min. Nifedipine can be photoreversed in situ by exposure to 365 nm light. UV illumination inactivates the drug, its inhibitory effect on Ca2+ is abolished, and cells arrested in metaphase enter anaphase within 3 to 18 min of UV exposure if CaCl2 is present in the medium. The interval between UV illumination and anaphase onset is inversely related to the extracellular concentration of CaCl2. If CaCl2 is not added to the medium, the interval between UV exposure and anaphase onset is usually longer than 18 min. The sole addition of 100 microM CaCl2 to the medium is insufficient to reverse nifedipine inhibition; unless the cells are exposed to UV light, anaphase will not commence. The threshold concentration of free Ca2+ for rapid anaphase onset (less than 10 min after UV photoreversal) is between 1 and 10 microM. These results suggest that an influx of Ca2+ from the extracellular medium to the cytosolic compartment is necessary for normal progression from metaphase to anaphase and that this influx may serve as a trigger for chromosome separation. PMID- 3956512 TI - Transient expression of a plasmid gene, a tool to study DNA repair in human cells: defect of DNA repair in Cockayne syndrome; one thymine cyclobutane dimer is sufficient to block transcription. AB - Transfected recombinant DNA with regulatory elements such as eukaryotic promoter and termination sites is transiently expressed in human fibroblast cells. Utilizing an expression vector containing the simian virus 40 (SV 40) early control region followed by the E. coli chloramphenicol acetyltransferase (CAT) gene, we investigated the ability of normal, Xeroderma pigmentosum and Cockayne Syndrome cells to repair UV lesions in transfected DNA. Fibroblasts from Xeroderma pigmentosum patients which cannot excise pyrimidine cyclobutane dimers were unable to restore expression of UV irradiated CAT gene. An UV dose inducing one thymine cyclobutane dimer in the transcribed strand of the CAT gene blocked its transcription in these repair deficient cells. Normal cell were able to repair the lesions in transfected DNA during an incubation period of about 40 h and in this way could overcome the UV block. In several fibroblast cell lines from patients suffering from Cockayne Syndrome expression of UV damaged CAT gene was restored significantly less than in normal fibroblasts, indicating that Cockayne Syndrome is associated with a UV repair defect. PMID- 3956513 TI - Morphological characterization of actively fusing L6 myoblasts. AB - We have characterized morphologically the surface of L6 myoblasts at the time of active cell fusion using transmission electron microscopy. Two subclones of the L6 line were used in these studies: the L6Cl55 line that fuses to form multinucleated syncytia and the NF44 non-fusing variant. Ultrastructural analysis revealed an electron-opaque material at localized points of cell-cell apposition in actively fusing L6Cl55 cells. This material may be transported by and secreted from smooth-surfaced cytoplasmic vesicles with an electron-dense core. In contrast to L6Cl55 cells, the electron-dense plaques were seen infrequently in cultures of the NF44 non-fusing variant. This previously unidentified substance may be associated with cell-cell recognition or adhesion, both necessary prerequisites for myoblast membrane fusion. Alternatively, the electron-dense plaques may be directly involved in the fusion event. PMID- 3956514 TI - Structural implications of kinetochore function in sucrose-treated PtK1 cells. AB - Treatment of PtK1 cells during metaphase with solutions containing hyperosmotic concentrations of sucrose resulted in an alteration of kinetochore structure and function in a concentration-dependent manner. This alteration in kinetochore morphology was shown to be rapidly reversible upon removal of the sucrose containing tissue culture medium. A 10-min treatment with both 0.2 M and 0.4 M sucrose resulted in a concentration-dependent aggregation of spindle fibers into bundles, loss of trilaminar kinetochore morphology as judged by electron microscopy, and induction of anaphase B-like spindle elongation as previously described. Electron microscopy showed that a 10-min treatment of metaphase cells with hyperosmotic concentrations of sucrose changed the trilaminar kinetochore structure to one of a single lamina, with an amorphous, lightly staining material distally associated with it. Sucrose-induced bundles of microtubules could usually be seen embedded or tangentially associated with this material. Rate and extent of spindle elongation in sucrose-treated metaphase cells were greater in the higher concentrations of sucrose employed. The degree of microtubule bundling was also concentration dependent, with reduced bundling occurring at lower sucrose concentrations. Within 2 min after sucrose removal kinetochores returned to a bi- or trilaminar morphology with reduction in the amount of amorphous material. Reformation of the kinetochore trilaminar structure resembled that of the normal maturation process which occurs from prophase through anaphase. These rapid changes in kinetochore morphology following release from sucrose treatment were temporally associated with restoration of spindle function and suggested that kinetochore integrity was necessary for the expression of spindle forces responsible for spindle shortening. These forces are probably generated or transduced by the continuum formed between the two spindle poles, the kinetochore microtubules, and the sister chromatids. PMID- 3956515 TI - Role of non-kinetochore microtubules in spindle elongation in mitotic PtK1 cells. AB - PtK1 metaphase cells were treated with varying concentrations of nocodazole to reduce spindle microtubule number and spindle length. The range of concentrations employed reduced spindle length from approximately 47% to 82% of the original pole-pole distance. Electron microscopy of cells treated with the lowest concentration of nocodazole employed (0.01 microgram/ml) showed a small decrease in the number of non-kinetochore microtubules (nkMTs), particularly evident in the astral region, with no significant effect on kinetochore microtubule number. Metaphase cells treated with 1 microgram/ml nocodazole for 2 min demonstrated a reduction in spindle length and loss of most non-kinetochore microtubules with little effect on the number and arrangement of the kinetochore class of microtubules. Following nocodazole treatment, the cells were perfused with 0.5 M sucrose dissolved in tissue culture medium, a treatment which has previously been shown to induce spindle elongation in metaphase cells. In cells where nocodazole effected a large decrease in non-kinetochore microtubule number with a concomitant decrease in spindle length, sucrose treatment had a reduced effect in inducing spindle elongation. In cells treated with lower concentrations of nocodazole, where numerous non-kinetochore microtubules remained, sucrose had a greater effect in inducing spindle elongation. These data suggest that the non kinetochore population of microtubules is responsible for the extent of sucrose induced spindle elongation. An explanation of these data is provided which suggests that the role of non-kinetochore microtubules is to trap energy in the developing spindle, such that it can be used to separate spindle poles during anaphase B. PMID- 3956517 TI - Formation of intracellular lumina in dispersed pig thyroid cells. AB - Intracellular cavities characterized by the presence of microvilli have been identified in dispersed thyroid cells. These structures resembling follicular lumina were called intracellular lumina or ICL. Freshly dispersed cells did not contain ICL. At 37 degrees C, ICL formation was a rapid process. After 60 min of incubation, ICL were present in 15 to 20% of the cells; the number of ICL remained rather constant during 3 to 4 h of incubation. In the presence of thyrotropin, the number of ICL increased with time to reach a value ranging from 40 to 60 ICL per 100 cells after 4 h of incubation. ICL formation was also increased in the presence of dibutyryl cyclic AMP (2 mM). Vinblastine (30 microM), a microtubule-disrupting agent and monensin (30 microM), an ionophore inhibiting Golgi functions blocked the formation of ICL in control and thyrotropin-stimulated cells. Cycloheximide (0.5 mM) and puromycin (0.5 mM) did not inhibit ICL formation in either control or thyrotropin stimulated cells. The iodination capacity of ICL was studied by quantitative electron microscopic autoradiography after incubation of thyroid cells with 125 I-iodide for 2 to 60 min. Radioiodinated products appeared first in ICL. After 1 h of labeling autoradiographic grains were found mainly in ICL (60-70%) and over the cytoplasm. The labeling of ICL was heterogeneous; ICL contained either few or numerous overlapping grains. Whatever the labeling time, a high proportion of ICL (70-80%) were labeled. The labeling of ICL as well as the labeling over the cytoplasm was increased in the presence of thyrotropin and almost completely inhibited in the presence of an iodide trapping inhibitor: sodium perchlorate. Pulse-chase experiments revealed that thyrotropin stimulated the discharge of 125 I-labeled material from ICL. PMID- 3956516 TI - Secretion of sulfated thyroglobulin. AB - Thyroid follicle cells from various mammalian species incorporate 35-SO4(2-). Light and electron microscopic autoradiographs show that the Golgi complex is the predominant site of sulfate incorporation and that the secretory product accumulating in the follicle lumen is sulfated. In order to determine which components of the luminal content carry the sulfate residues, inside-out follicles from pig thyroid glands were incubated in the presence of 35-SO4(2-) and the secretory product released into the culture medium was analyzed by polyacrylamide gel electrophoresis. The observations show that the secretory product consists of sulfated thyroglobulin and that approximately 13 sulfate residues are bound covalently to 1 molecule of dimeric thyroglobulin. Digestion of 35-SO4(2-)-thyroglobulin with endoglycosidase H removes 20 to 30% of the radioactivity, indicating that the high mannose carbohydrate side chains carry sulfate residues. The complex carbohydrate side chains are apparently free of sulfate since treatment with endoglycosidase D did not alter the sulfate content. About 2/3 of the sulfate is cleaved by hydrolysis with 1 M HCl (5 min, 95 degrees C) indicating the presence of tyrosine sulfate. Part of the sulfate is exposed and presumably located on the surface of the thyroglobulin molecule as suggested by the direct accessibility of 35-SO4(2-)-thyroglobulin to digestion with sulfatases. The sulfate residues contribute to the anionic state of thyroglobulin. It is postulated that the sulfate residues operate in the regulation of thyroglobulin transport in the cell and in the tight packaging of thyroglobulin in the follicle lumen. PMID- 3956518 TI - Preparation of apical plasma membranes from cells grown on coverslips. Electron microscopic investigations of the protoplasmic surface. AB - We introduce here a simple method which permits an efficient isolation of apical plasma membranes from tissue culture cells and the electron microscopic examination of their protoplasmic surfaces by use of the platinum/carbon replica technique. Different procedures were tested with regard to the efficiency of isolation and preservation of ultrastructure. Best results were obtained by prestabilization of cell surfaces with low concentrations of tannic acid prior to isolation. To demonstrate the possible applications and versatility of the method, studies were done on virus-infected cells in combination with immunocytochemical labeling. With this model system, we show that it is possible to correlate the structures seen on the cytoplasmic surface of the plasma membrane with the distribution of virus antigens at the cell surface labeled with immunogold markers prior to preparation. PMID- 3956519 TI - Distribution of microtubules within the intestinal terminal web as revealed by quick-freezing and cryosubstitution. PMID- 3956520 TI - Relationship between the degree of coronary artery disease and of left ventricular function and the duration of the QT-interval in ECG. AB - Advanced coronary artery disease (CAD), impaired left ventricular function and prolongation of the QT-interval are considered risk factors for sudden cardiac death in CAD-patients. So far, however, there are no studies investigating in detail whether there is a correlation between the QT-interval and changes in coronary anatomy or changes in left ventricular function. Therefore, coronary angiographic data were related to QT-intervals in 304 patients, who were catheterized because of suspected coronary artery disease. QT-intervals were expressed as QTc = QT/square root RR (Bazett's correction for heart rate), left ventricular function was assessed by the ejection fraction of the ventricular angiogram, and coronary angiograms were classified according to the Gensini score as well as into 1-, 2- and 3-vessel disease (stenoses greater than or equal to 50%). A multidimensional linear regression model was employed to eliminate the effects of varying mean rates still present after application of Bazett's formula. In patients with 1-, 2- and 3-vessel disease, significant changes of QTc were observed only in patients with impaired left ventricular function (EF less than 60%). In these patients the QTc-interval increased significantly from 1- to 3-vessel disease. If the critical degree of coronary stenosis was changed from greater than or equal to 50% to greater than or equal to 90% further prolongations of QTc were noted. In patients with 1-, 2- and 3-vessel disease the QTc-duration difference was further enhanced if either the proximal part of the descending branch of the left coronary artery (LAD) or the left main stem were affected (stenoses greater than or equal to 50%). The data reveal that prolongation in the duration of electrical systole correlates with known cardiac risk factors for sudden death, i.e. 3-vessel-disease, proximal LAD or left main stem stenosis and impaired left ventricular function. In the individual patient, however, the prognostic value of a single QTc-determination is limited because of a large interindividual variation of the data. PMID- 3956521 TI - Intrinsic sympathomimetic activity (ISA) of pindolol in patients with sinus node dysfunction. AB - The effects of pindolol treatment on mean heart rate (MHR) and the number of paced heart beats were investigated in a group of 12 patients, with frequency programmable pacemakers implanted to control symptomatic bradyarrhythmias resulting from sinus node dysfunction. In a randomized double blind cross over experiment the patients were treated with pindolol (5 mg t.i.d.) or with placebo. Before the study the pacemaker was programmed to its lowest frequency in the demand mode. In the pretreatment period and after 2 weeks treatment with either pindolol or placebo a 24-hour ambulatory ECG was recorded. MHR during the night (24.00-8.00) was slightly but significantly increased by pindolol treatment by 6.0% when compared to placebo (P less than 0.05). There was no difference in the daytime MHR during either treatment period. During pindolol treatment the number of paced beats was reduced in 8/12 patients and in 4 of these the reduction exceeded 98%. In 2 patients the number of paced beats increased. The results indicate that in some patients with sinus node dysfunction pindolol can effectively reduce the number of paced beats thereby preserving the atrial contribution to pump function. PMID- 3956522 TI - Effect of sotalol, aprindine and the combination aprindine-sotalol on monophasic action potential duration. AB - The effects of sotalol, aprindine and the combination aprindine-sotalol in the intact dog heart were evaluated during constant atrial pacing with the use of monophasic action potential (MAP) recording. A first group of five dogs was given 1.5 mg kg-1 body weight of sotalol, followed by a second infusion of 1.5 mg kg-1 30 min later. Both doses of sotalol produced a statistically significant increase in right atrial MAP duration at 50% of repolarization (RAMAP50) and right ventricular MAP duration at 90% of repolarization (RVMAP90). To a second group of six dogs aprindine 1 mg kg-1 and aprindine 2 mg kg-1 were administered intravenously. The infusion of aprindine did not alter right atrial and right ventricular MAP duration. The addition of 1.5 mg kg-1 of sotalol to the dogs pretreated with aprindine 2 mg kg-1 resulted in a 25% increase in RAMAP50 and a 21% prolongation of RVMAP90. In summary, sotalol lengthens atrial and ventricular monophasic action potential duration and still prolongs repolarization of monophasic action potentials after previous administration of aprindine. A combination of sotalol, a beta-adrenergic blocker possessing class III efficacy, with a class I antiarrhythmic agent may be useful with respect to their electro physiological action. PMID- 3956523 TI - Felodipine in ventricular dysfunction. AB - The systemic and coronary haemodynamic effects of felodipine were evaluated at rest and during stress induced atrial pacing in fourteen patients with chronic cardiac failure, secondary to coronary heart disease. Felodipine was an effective arteriolar vasodilator producing increases in cardiac index from 2.6 +/- 0.1 to 3.5 +/- 0.2 l min-1 m-2 (P less than 0.001) and stroke volume 35.3 +/- 2.7 to 41.4 +/- 2.4 ml beat-1 m-2 (P less than 0.002). Coronary venous flow also increased significantly (126 +/- 8 to 168 +/- 13 ml min-1) (P less than 0.005) and this did not appear to be accompanied by an increase in myocardial oxygen usage, as myocardial oxygen consumption was essentially unchanged. When the myocardium was stressed by atrial pacing the increase in cardiac output and stroke volume was maintained--25% and 23%, respectively (P less than 0.01). These results suggest that felodipine may well have a significant role in the management of patients with congestive cardiac failure. PMID- 3956524 TI - An implantable antitachycardia pacemaker with back-up pacing and scanning burst mode. AB - We used an automatically triggered antitachycardia device (PASAR 4171) which is able to provide up to 7 stimuli in the atrium of three patients with AV-nodal tachycardia. A PASAR 4172 was implanted in a patient with WPW which gave two stimuli in the right ventricle. One revision was needed due to exit block. Temporary undersensing occurred in one patient. Atrial fibrillation occurred for the first time postoperatively in the WPW patient, without major side-effects. Treatment with low dosage amiodarone was initiated to prevent recurrence. At follow-up, magnet application was useful to induce supraventricular tachycardia in the three 4171 patients with 4171 devices, proving effective termination of tachycardia. Back-up pacing or concertina mode were used in 3 of 4 patients. PMID- 3956525 TI - Lactate release during the recovery period of pacing-induced angina in assessment of myocardial ischaemia. AB - Myocardial lactate (L) metabolism was tested in 27 stable angina patients during atrial pacing (AP) and in the recovery period (R) from AP-induced angina pectoris. The recovery period was assessed in order to evaluate the changes in the rate of L release and detect possible relationships with the severity of ischaemic damage. The following variables were assessed: coronary sinus blood flow (CSBF), left ventricular end-diastolic pressure (LVEDP), lactate extraction ratio (L%), lactate extraction or release rate (LR) and myocardial oxygen consumption (MVO2) at the onset of AP (AP1), during angina (AP2), and 30 s, 2 and 4 min (R1, R2 and R3) after AP ceased. At Ap2, negative L% and LR values (-39.37 +/- 43.3, -3.2 +/- 2.9) were found, in spite of a rise in CSBF (+86%, P less than 0.001). Furthermore, LVEDP showed its maximal increase in AP2 (+27%, P less than 0.001). Compared to AP2, L% resulted unchanged in R1, while LR showed a mild decrease (from -3.2 +/- 2.9 to +2.06 +/- 2.93). Lactate production was converted to extraction in R3 only. Since lactate production and release are progressively reduced with increasing severity of ischaemic damage, AP2 coronary sinus lactate release should largely arise from the less damaged areas (i.e. the outer myocardial layers) and the contribution of the more damaged areas (i.e. the inner myocardial layers) should be more limited. After AP ceases, the mild ischaemic areas should recover more rapidly than the severely ischaemic areas, where the damage only declines, leading to a temporary increase in lactate production and release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956526 TI - Detection of right-coronary-artery disease using stress thallium scintigraphy: importance of considering the right ventricle. AB - Retrospective analyses of the stress thallium studies of 51 patients with a history of previous infarctions or definite stable angina were performed in order to determine the extent of the coronary-artery disease (CAD). The results were correlated with recent coronary-angiography findings in order to assess the effect of including right-ventricule (RV) visualization on the accuracy of the detection of right coronary-artery (RCA) disease, as well as the effect of graded stenosis or occlusion of the RCA and the presence of disease of the other coronary vessels on the visualization of the RV. Eight patients had normal coronary arteries. The other 43 patients had CAD, only 5 of whom had single vessel RCA disease. With regard to the RV, 6 patients had nonvisualization, 30 had patchy visualization, and 15 had normal visualization in the stress thallium studies. Nonvisualization indicated 100% occlusion of RCA in 6 out of 6 patients. Patchy visualization indicated significant occlusion of the RCA in 25 out of 30 patients (83%), while normal visualization indicated a normal RCA in 13 out of 15 patients(86%). Normal visualization did not mean that the possibility of RCA disease could be excluded. When RV visualization data were added to LV images, the sensitivity for detecting RCA increased from 66% to 94% (P less than 0.05), the specificity decreased from 89% to 72% (P less than 0.1), and the predictive accuracy increased from 75% to 86% (P greater than 0.1). PMID- 3956527 TI - Radioiodinated peanut lectin: clinical use as a tumour-imaging agent and potential use in assessing renal-tubular function. AB - Peanut lectin (PNA) has been shown to have a high affinity for Thomsen Friedenreich (T) antigen, which is associated with the membrane of many solid tumour cells. PNA labelled with 131I was used as a tumour-imaging substance in patients with known metastatic cancer. Serial gamma scintiscans were obtained in 17 patients following a single injection of 131I-labelled PNA. Only in 1 patient was this technique able to reveal a known metastasis at analogue imaging. In the remaining patients, no visible uptake of 131I-PNA could be demonstrated at sites of known metastases. PNA is rapidly excreted through the kidneys and localizes in the renal tubules. As a tumour-imaging agent, 131I-PNA appears to be without value, but its renal-excretory characteristics make it a potentially useful agent for the in vivo assessment of renal-tubular disorders. PMID- 3956528 TI - The present state of NMR tomography and its future. AB - The use of nuclear magnetic resonance (NMR) tomography requires close co operation between radiologists and doctors working in nuclear medicine, so that experience gained in computed tomography and diagnostic function programmes can be exchanged. With regard to the technology of the magnets, the main demand at the moment is for imaging. In this area, special magnetic-field strengths, spools and evaluation procedures should be developed and optimised for the various applications. A list of guidelines must be worked out, and a strategy for the application of NMR tomography within general diagnostic procedures must be drawn up. Further progress will be brought about by developments such as breath and cardiac gating, as well as by the introduction of contrast media. In order to keep the cost of examinations within certain limits, it is necessary that plans are made to install an appropriate number of NMR devices. PMID- 3956529 TI - Fast, low-temperature preparation of carrier-free 17-123I-heptadecanoic acid applied for liver and heart scintigraphy. AB - A high-yield method for labelling 17-I-heptadecanoic acid with 123I is described, and a clinical evaluation of the radiopharmaceutical is given. The labelling procedure is based on the use of a conventional ultrasonic bath. It was found that the addition of thiosulphate to the reaction medium avoids the formation of labelled side products and increases the yield considerably. The carrier-free 17 123I-heptadecanoic acid (2 mCi) in 6% human serum albumin was injected IV for heart and liver studies on selected patients with cirrhosis (alcoholic, post necrotic) and diabetes. PMID- 3956530 TI - Scintigraphic assessment of persistent venous occlusion after primary axillary vein thrombosis. AB - A patient with persistent deep vein occlusion after primary axillary vein thrombosis is described. The patient underwent radionuclide venography about 16 months after thrombosis of the axillary vein had been diagnosed using X-ray venography. Prior to the study, the patient had been treated with anticoagulants. Persistent vein occlusion after thrombosis in patients with conservative management is a frequent occurrence. The possibility of using radionuclide venography in the follow-up of patients with axillary vein thrombosis is discussed. PMID- 3956531 TI - Glomerular filtration rate: calculation from blood samples alone. PMID- 3956532 TI - A mitochondrial encephalomyopathy: the first case with an established defect at the level of coenzyme Q. AB - A patient is presented who had therapy-resistant epileptic seizures from the 7th day of life. Examination at the age of 17 months revealed a mentally retarded boy with epileptic seizures, generalised myoclonic contractions, and abnormal ocular movements. A cerebral CT scan showed central and cortical atrophy. Lactate levels in serum, cerebrospinal fluid and urine were elevated, the pyruvate level was raised in serum. A quadriceps muscle biopsy revealed aspecific morphologic signs of a myopathy. Biochemical analysis showed decreased substrate oxidation rates in the mitochondria associated with low rates of ATP production. Total and free carnitine levels were decreased. Investigation of the respiratory chain revealed a defect in the proximal part of respiratory chain involving the region of coenzyme Q. Based on clinical and chemical data it is likely that the patient is suffering from a multi-system disorder. PMID- 3956534 TI - In vitro CFU-E and BFU-E responses to androgen in bone marrow from children with primary hypoproliferative anaemia: a possible therapeutic assay. AB - The effects of natural and synthetic androgens on erythroid colony formation in children's bone marrow cultures were studied using a methylcellulose microculture assay. In an attempt to predict the clinical response to androgens in two children with Fanconi anaemia (FA) and two children with Diamond-Blackfan syndrome (DB), we tested the hormonal stimulation of testosterone, nortestosterone and etiocholanolone on CFU-E, BFU-E and uroporphyrinogen I synthase activity (UROS). We observed that colony formation and UROS activity were reduced when compared to values obtained with normal children's bone marrow cultures. The addition of steroids to the cultures significantly enhanced the numbers of CFU-E and BFU-E derived colonies and their UROS activity in marrow from patients with FA and one patient with DB. The strong depletion of marrow progenitor cells in the unresponsive marrow from child 4 with DB could explain the absence of hormonal response. Whereas the responsiveness to steroids varied according to the individual, the in vitro testing of erythroid differentiation in the presence of androgens theoretically may lead to an effective prediction of response to therapy in children with hypoplastic anaemia. PMID- 3956533 TI - The response to L-carnitine and glycine therapy in isovaleric acidaemia. AB - The profound metabolic disturbances which occur in isovaleric acidaemia are due to the intramitochondrial accumulation of isovaleryl coenzyme A (CoA) with a consequent reduction in the availability of free CoA. Secondary carnitine insufficiency is also a feature of this and other disorders of organic acid metabolism. A patient who presented at 2.5 years of age was diagnosed using capillary GC-MS as having isovaleric acidaemia. She showed the full spectrum of abnormal organic acids previously associated with the 'neonatal' form of the disease despite her late presentation, indicating that it is inappropriate to refer to acute early and late onset forms of isovaleric acidaemia. Instead, a spectrum of disease exists, determined by environmental factors, residual enzyme activities and modifying effects of different phenotypes in different individuals. She also showed evidence of carnitine insufficiency. An oral challenge with L-carnitine resulted in the excretion of large amounts of urinary acylcarnitines which were shown by use of fast atom bombardment mass spectrometry to be primarily isovalerylcarnitine. Regular glycine supplementation caused no significant increase in urinary isovalerylglycine and had to be stopped because of side-effects after 5 days. An oral L-carnitine challenge during glycine supplementation resulted in a marked increase in isovalerylglycine excretion, again associated with the excretion of large amounts of isovalerylcarnitine. Carnitine acts by removing (detoxifying) intramitochondrial isovaleryl groups and, in the presence of glycine, it promotes the formation of isovalerylglycine. We believe L-carnitine supplementation is of value in the treatment of isovaleric acidaemia and that, in the present case, L-carnitine together with a moderate dietary restriction has proved to be the optimum form of therapy. PMID- 3956535 TI - Hepatic artery embolisation; successful treatment of multinodular haemangiomatosis of the liver. AB - A patient with multinodular haemangiomatosis of the liver, rapidly deteriorating in the first weeks of life due to severe progressive congestive heart failure, was successfully treated by hepatic artery catheter embolisation at the age of 6 weeks. PMID- 3956536 TI - Acute renal failure in children: prognostic features after treatment with acute dialysis. AB - A 12-year review (1972-1983) is presented of 76 children who were dialysed because of acute renal failure. The causes of acute renal failure were mainly the haemolytic-uraemic syndrome (53%), trauma (16%) and operation (13%). Fifty-eight children (76%) survived, 18 children (24%) died. Fifty-two children, the majority suffering from haemolytic-uraemic syndrome, regained complete or partial renal function after a period of dialysis lasting between 1 and 57 days. One to 7.7 years after dialysis, clearance studies with inulin (CIn), p-aminohippuric acid (CPAH) and phosphate (Tp/CIn) for staging renal function were carried out. The results of this investigation show a significant inverse correlation between the glomerular function regained and the duration of intermittent dialysis. PMID- 3956537 TI - Rib fractures as a cause of immediate neonatal tachypnoea. AB - Two macroscopic term neonates are described who presented with uncomplicated tachypnoea immediately following vaginal delivery. The tachypnoea was not associated with lung injury, metabolic, endocrine or cardio-respiratory disease but with multiple unilateral posterior rib fractures. The neonatologist should be aware that neonatal tachypnoea immediately after vaginal term delivery, especially in macrosomic infants, may be caused by the pain of fractured ribs. The diagnosis can be made only by careful inspection of the ribs on chest X-ray. PMID- 3956538 TI - Significance of Clostridium difficile and its cytotoxin in children. AB - Stools of 147 children belonging to different age groups were examined for the presence of Clostridium difficile, its cytotoxin and other enteric pathogens. None of the 31 full-term neonates, 5 (16%) of the 32 premature neonates, 27 (46%) of the 59 infants and 1 (4%) of the 25 older children excreted C. difficile in their stools. Faecal cytotoxin was only detected in four infants (7%). There was no correlation with diarrhoea, previous antibiotic therapy, type of diet, or the concomitant presence of other intestinal pathogens. We conclude that colonisation of the intestine by C. difficile is probably acquired from environmental sources and that it cannot be regarded as a significant cause of diarrhoea in children. PMID- 3956540 TI - A case of perineal hypospadias with paracentric inversion of chromosome 14. AB - Abnormalities of chromosome 14 are encountered infrequently in clinical cytogenetics and only few studies of paracentric inversion have been published. This paper reports the first case of hypospadias associated with paracentric inversion of chromosome 14. PMID- 3956541 TI - Combined treatment modalities of orbital rhabdomyosarcoma in children. PMID- 3956539 TI - Lymphocytic meningoradiculitis (Garin-Bujadoux Bannwarth): from syndrome to disease? AB - In two children with lymphocytic meningoradiculitis (Bannwarth's syndrome), IgG and IgM antibodies to Borrelia burgdorferi were demonstrated. Clinical and laboratory parameters of the syndrome are described and recent bacteriological and serological findings that link the syndrome to the American Lyme disease are discussed, as well as the effects of antibiotic treatment. PMID- 3956542 TI - Campylobacter jejuni and infantile traveller's diarrhoea. PMID- 3956543 TI - Familial tumor of the testis. AB - A survey of the literature since 1928 yields reports on 100 patients with testicular tumor occurring in families. From our own case material we present clinical data on 11 additional patients. Non-twin brothers are most often involved. Presently available data are too limited to assess the impact of a possible genetic disposition on the development of malignoma of the testis. Additional case reports and register studies are needed. Equally undecided is the question if sperm banking of testicular tumor patients prior to therapy carries any genetic risk to the progeny. PMID- 3956545 TI - Malakoplakia of the urinary tract. AB - The authors report 4 cases of urinary tract malakoplakia. This rare disease of unknown etiopathogenesis can present with a benign character in the bladder, but when the upper urinary tract is affected, loss of renal function can occur. Treatment aims to control the primary infection, as well as enhance intracellular bactericidal activity, which seems to be compromised in these cases. Cytoreductive surgery may be indicated when this treatment fails. PMID- 3956544 TI - Selective effect of nortriptyline on smooth muscle as an anticholinergic drug: a pharmacological and clinical study. AB - The anticholinergic potency of nortriptyline was studied on muscle strips from human bladder and ileum. Concurrently the effect of nortriptyline low dosage therapy was studied in 21 women suffering from motor or sensory urgency and urge incontinence. Analysis of the results by the dose ratio method showed a significant difference in the affinity of the anticholinergic receptors to the antagonist. The Ki values were 0.298 microM for the bladder and 0.938 microM for the ileum. In the clinical study, the condition of 15 (71.4%) women treated with notriptyline improved considerably. The higher affinity of the drug to the receptors in the bladder than to those in the ileum may explain the positive therapeutic effect of a relatively low dose of nortriptyline in over 70% of the patients treated. PMID- 3956546 TI - Increased plasminogen activator enzymes of the tunica vaginalis in long-standing idiopathic hydrocele. AB - Previous research has shown increased fibrinolytic activity of the serous membranes as a reaction to stimuli that did not destroy their mesothelium. Large amounts of fluid remarkably stretch and chronically stimulate the tunica vaginalis in long-standing idiopathic hydrocele. For these reasons, a prospective controlled study was carried out in 30 male patients in order to investigate the possible alterations of the fibrinolytic capacity of this serosa by a method suitable for measuring plasminogen activator content of a single layer of cells. A possible role of plasminogen activator enzymes as a protective barrier against incidental absorption of fibrin/fibrinogen from the hydrocele fluid into vaginal tissues is considered. PMID- 3956547 TI - Functional pattern of sacral root stimulation: III. Erection. AB - The mechanism of canine penile erection was studied in 6 'chronic' and 15 'acute' male dogs by means of sacral root stimulation combined with pharmacologic studies. The basic mechanism of erection cannot be explained by a pure increase in arterial perfusion of the cavernous spaces due to neural vasomotor regulation. The vasomotor mechanism, whether pure arteriolar vasodilation, or venous drainage impairment, or secondary to as yet undefined behavior of the corporal smooth muscle, can be activated by stimulation of the parasympathetic outflow. Those preganglionic fibers may synapse to noncholinergic and non-beta-adrenergic neurons, which release a yet unidentified vasodilator neurotransmitter mediating the neurovascular effect. PMID- 3956548 TI - Urethro-thigh fistula. Report of 2 cases. AB - Two rare cases of urethro-thigh fistula are described. Both of them occurred following pelvic trauma. We suggest that trauma, hematoma and infection, suppuration, are the etiology for the development of fistula from a torn urethra to the thigh. A review of the English literature failed to reveal other cases of such an unusual complication. PMID- 3956549 TI - Evaluation of renal damage in extracorporeal lithotripsy by shock waves. AB - Lithotrispy by shock waves is an alternative treatment to renal lithiasis surgery. On destruction of the stone, the pressure of shock waves produces renal microdamage. According to the current knowledge of renal physiopathology, we studied the variations of lactate dehydrogenase (LDH) and N-acetylglucosaminidase (NAG) levels in blood and urine of 44 patients with renal lithiasis (pelvic or calyceal) before and after treatment. We found a significant LDH and NAG increase in blood and an LDH increase in urine after lithotripsy. There was no correlation between the number of applied waves and enzymatic increase. PMID- 3956550 TI - Iodine-125-seed implantation combined with external radiotherapy under potentially curative intention in patients with advanced stage-C prostatic cancer. AB - We report on 18 patients, aged 43-77 years, with clinical stage-C adenocarcinoma of the prostate, primarily treated by pelvic lymphadenectomy and 125I-seed implantation. After lymphadenectomy, the staging assessment differed from the preoperative diagnosis as follows: 4 patients were classified as stage C; 6 as D1, and 8 as D2 (distant nodal metastases). The 4 patients, classified postoperatively as stage C, received no further treatment. 11 patients with a postoperative classification of stage D had additional external beam radiation to the pelvic and paraaortic lymph nodes with shielding of the implanted prostatic region. In addition, 8 of these 11 patients had hormonal therapy. The remaining 3 patients have been treated by combining interstitial irradiation with preoperative external beam radiotherapy; postoperative irradiation was supplemented when the lymph nodes were positive. PMID- 3956552 TI - Xanthogranulomatous pyelonephritis: clinical experience with 62 cases. AB - A review of 62 patients who underwent surgical treatment for xanthogranulomatous pyelonephritis is presented. Polar resection was performed in 3 cases with localized disease, while the remaining 59 patients were treated by nephrectomy. Preoperative diagnosis is still tentative, but the recent advances in imaging techniques and urinary cytology will provide greater accuracy in the future. PMID- 3956551 TI - Local excision of urothelial cancer of the upper urinary tract. AB - In 9 of 93 patients (9.7%) with urothelial cancer of the upper tract (7 renal pelvis tumors, 3 ureteral tumors), conservative surgery was employed using a free peritoneal autotransplant for replacement of the renal pelvis in 5 kidneys. Absolute indications for conservative surgery were solitary kidneys/nonfunctioning contralateral kidneys in 4 patients and bilateral tumors in 1 patient. Local recurrences developed 1-3 years after operation in 4 of 6 kidneys (3 patients), 3 of which had grade-2 and grade-3 primary lesions. All patients were treated successfully by repeated local excision. In the presence of a normal contralateral kidney, local tumor excision was done electively in 4 patients (3 low-grade/low-stage lesions, 1 high-risk patient), none of these patients developed recurrences. Two patients died without evidence of tumor recurrence, 7 patients are free of tumor at an average follow-up of 23 months (range 5-65 months). Local excision of urothelial cancer should be considered not only for solitary kidneys, bilateral tumors and cases with renal failure, but also for low-stage/low-grade localized tumors, leaving the patient better prepared for later treatment of a possible recurrence due to the well recognized chance of a multiplicity of tumors in time and space. PMID- 3956553 TI - Effect of tamoxifen on steroid hormone receptors and creatine kinase activity in human endometrial carcinoma. AB - Estrogen receptor (ER), progesterone receptor (PR) and creatine kinase (CK) were measured in cancerous tissue from 29 post-menopausal patients with endometrial carcinoma under basal conditions and after a short course of tamoxifen treatment. ER and PR were detected in nearly all tumors. CK was detected in all of the tumors examined. After tamoxifen, PR and CK increased simultaneously in 26% of cases, while they were either enhanced, decreased or unmodified in the remainder. No correlation could be found between increase of PR and tumor differentiation. CK, however, was enhanced only in the more differentiated cancers. These results indicate that only a percentage of endometrial cancers are responsive to tamoxifen. It is hypothesized that patients bearing these tumors are those likely to benefit from endocrine therapy. PMID- 3956554 TI - Progesterone levels in breast duct fluid. PMID- 3956555 TI - Topical administration of cisplatin in far-advanced squamous cell carcinoma of the head and neck. PMID- 3956556 TI - Tissue glycolytic enzymes in primary breast cancer patients receiving adjuvant chemotherapy. AB - Primary breast cancers from 85 patients undergoing post-surgical adjuvant chemotherapy were analyzed for five glycolytic enzymes: lactate dehydrogenase (LDH); phosphohexose isomerase (PHI); glucose-6-phosphate dehydrogenase (G-6PD); pyruvate-kinase (PK); and 6-phospho-gluconate dehydrogenase (6-PGD). The purpose of this study was to determine whether biochemical parameters could offer a prognostic index to determine outcome of therapy. The patients were followed up to a maximum of 54 months; during this period 30 of them developed recurrent or metastatic disease. The enzyme activities were expressed by the three following reference parameters: units/g proteins, units/g tissue weight and units/mg DNA. Two methods of analysis were compared: firstly, univariate analysis using life tables; and secondly, multivariate analysis using the Cox's model, where enzyme levels were tested for each mode of expression in addition to node status, histological features, receptor and menopausal status. Life table analyses appear limited when subsets of patients were studied because the sample size tends to become too small to warrant firm conclusions. Using the Cox's model, a prognostic index 1 was proposed, including the number of involved nodes and the product of logarithms of G-6PD and 6-PGD expressed as units/mg DNA. Compared to the number of involved nodes, this index gives a slightly better discrimination of the patients at 2 yr after mastectomy. PMID- 3956557 TI - Evaluating and designing cancer chemotherapy treatment using mathematical models. PMID- 3956558 TI - Extradural and parenteral pethidine as analgesia after total hip replacement: effects and kinetics. A controlled clinical study. AB - Twenty-one patients who had undergone total hip replacement were randomly assigned to one of three groups in order to compare a single dose of 1 mg/kg of pethidine im (I) and 20 mg (II) or 60 mg of extradural pethidine (III) in a double-blind design. The degree of analgesia, the adverse effects, and the kinetics were studied for 18 h. Pain was monitored using a visual analogue scale (VAS). Supplementary doses of oxycodone if required were given no earlier than 0.75 h after pethidine. Plasma concentrations of pethidine were measured with gas chromatography mass spectrometry (GCMS). Hypoalgesia to pin prick test was evaluated. Low pain scores were observed in the extradural groups between 0.25 and 1.5 h after the dose. A significant difference in pain score compared with the im group was found after the higher extradural dose only between 0.5 and 1 h (p less than 0.05). The area under the curve (AUC) of pain score versus time (0 18 h) was not significantly different between groups. The recorded adverse effects were minor in all three groups. The terminal half-lives and plasma clearances of pethidine, and the time to peak concentration were not different between the groups. Single patients in the extradural groups showed hypoalgesia to pin prick in parallel to the effect. The present study shows that extradural pethidine produces shortlived analgesia, in contrast to the long-lasting effect of morphine found in other studies. PMID- 3956560 TI - Pharmacokinetics and effects on blood pressure of a single oral dose of milrinone in healthy subjects and in patients with renal impairment. AB - Milrinone, a new, nonglycosidic inotropic agent with peripheral vasodilating properties, was given as a single oral 5 mg dose to 7 healthy subjects, 7 patients with moderate renal impairment (CRI I, creatinine clearance 30-63 ml/min) and 7 patients with severe renal impairment had hypertension. The mean urinary recovery of milrinone was 82% in healthy subjects, the renal clearance was 288 ml/min and the plasma half-life (t1/2) was 0.94 h. In CRI the mean plasma t1/2 was prolonged (CRI I 1.78 h, CRI II 3.24 h). There was a significant linear relationship between creatinine clearance and the elimination rate constant, and between creatinine clearance and the renal clearance of milrinone. During the study day there was a tendency to a decrease in supine BP from 1 to 6-8 h after dosing, with the maximal decrease at 2-3 h (healthy subjects 118/71----107/56, CRI 159/95----136/79 mmHg). The same degree of change was seen in standing BP. A slight rise in standing HR was seen from 2-6 h after dosing. Changes in BP and HR are difficult to evaluate since the study was not placebo-controlled. The plasma elimination rate of milrinone was decreased in CRI and dose adjustment may be necessary. Placebo-controlled studies of milrinone in hypertensive patients would be required to validate its possible antihypertensive effect. PMID- 3956559 TI - The development of reliable compliance tests for antihypertensive drugs. AB - Many tests for measuring compliance have been proposed, but in most cases compliance rates have been determined without taking into account the factors influencing the interval during which a drug can be detected by a qualitative test after having been taken by the patient. The drug half-life, often used for determining the time at which the sample is collected, is inadequate for obtaining conclusive test results. A procedure is described for the determination of urine collection intervals during which reliable information on compliance can be obtained, using oxprenolol, hydrochlorothiazide, and pindolol as examples. PMID- 3956561 TI - Penbutolol Pharmacokinetics: the influence of concomitant administration of cimetidine. AB - A possible interaction of penbutolol and cimetidine was investigated in healthy volunteers treated orally for 7 days. The plasma levels of unmetabolized penbutolol showed a slight but non-significant increase. The biphasic elimination kinetics of penbutolol (half-lives 0.8 and 17 h) was not affected by coadministration of cimetidine. Plasma levels of penbutolol were not significantly altered by chronic treatment with cimetidine, whereas the levels of 4-hydroxypenbutolol and 4-hydroxypenbutolol glucuronide were significantly reduced. PMID- 3956563 TI - The pharmacokinetics of timegadine and two of its metabolites after multiple oral dosing, and the effects of concomitant administration of ibuprofen. AB - A 250 mg tablet of timegadine was given twice daily for 15 days to 13 healthy volunteers. On Day 16 a single morning dose of timegadine was supplemented by two 200 mg tablets of a proprietary brand of ibuprofen. Serum concentrations of timegadine were measured by high pressure liquid chromatography, and steady state was achieved between Days 5 and 8. Serum concentrations of two metabolites of timegadine, MI and MII were measured by thin layer chromatography by Leo Pharmaceutical Products, Denmark. Ibuprofen did not significantly affect the serum half-time of timegadine, but did reduce the maximum measured serum timegadine concentration, the area under the serum concentration versus time curve and the time to achieve maximum measured serum concentration. Serum liver enzymes remained within the normal ranges and there were no changes in hepatic microsomal enzyme activity as assessed by urinary excretion of D-glucaric acid. PMID- 3956564 TI - Phenprocoumon metabolites in human plasma; characterization by HPLC and GC-MS. AB - Pooled plasma from patients receiving phenprocoumon anticoagulant therapy was extracted and the following substances were characterized: phenprocoumon, and its 7-hydroxy,4'-hydroxy and 6-hydroxy derivatives; they were identified by HPLC and after methylation by quartz capillary GC-MS using the electron impact and selective ion monitoring modes. This is the first occasion when phenprocoumon metabolites have been identified in plasma; they were unconjugated and in much lower concentrations (43.2 and 2 ng/ml for the 7,4' and 6-hydroxy derivatives, respectively) than the original compound (2000 ng/ml). PMID- 3956562 TI - Cardiovascular regulation during administration of co-dergocrine to normal subjects. AB - Whether and to what extent activation of peripheral presynaptic dopamine2 receptors may modulate the release of norepinephrine (NE) and so affect blood pressure (BP) in normal or hypertensive man is not clear. The hydrogenated ergotoxine derivative, co-dergocrine, given in effective antihypertensive rather than excessive experimental doses, has recently been shown to act predominantly as a peripheral dopamine2-receptor agonist in several species. Accordingly, BP regulation assessed has been in 8 normal men on placebo and after 3 weeks on codergocrine 4 mg/day. Co-dergocrine significantly reduced urinary NE excretion from 43 to 33 micrograms/24 h, supine and upright plasma NE 21 to 16 and 49 to 36 ng/dl, respectively, heart rate (-8 and -5%, respectively) and upright systolic BP, 115 to 102 mm Hg; upright diastolic BP also tended to be lower. A standard pressor dose of infused NE was lowered from 131 to 102 ng/kg/min, and the relationship between NE-induced changes in BP and concomitant NE infusion rate or plasma NE concentration was displaced to the left. Exchangeable sodium and plasma volume tended to be slightly decreased. Plasma and urinary electrolytes and epinephrine, plasma renin activity and aldosterone levels, pressor responsiveness to angiotensin II, the chronotropic responses to isoproterenol, and the NE induced rise in BP, plasma clearance of NE, glomerular filtration rate and effective renal plasma flow were not consistently modified. The findings are consistent with effective peripheral dopamine2-receptor agonism by co-dergocrine in humans. Peripheral presynaptic dopaminergic activation may modulate sympathetic activity and BP in normal man. PMID- 3956565 TI - Pharmacokinetics of a long-acting bromocriptine preparation (Parlodel LA) and its effect on release of prolactin and growth hormone. AB - The pharmacokinetics and endocrine actions of a long-acting form of bromocriptine (Parlodel) were examined in a controlled study in 10 healthy volunteers receiving a single i.m. injection of 50 mg. Six further subjects took bromocriptine 1.25 mg t.i.d. for 3 days p.o. In the subjects given the slow release preparation, the plasma bromocriptine concentrations increased sharply to a maximum of 1.65 mg/l 2 h after injection. This fast release process was followed by slow clearance with a half-life of 16 days. The substance was still detectable in plasma 35 days postinjection. Plasma prolactin (PRL) fell rapidly from a mean of 5.6 ng/ml to reach significantly lower levels at 60 and 120 min. Inhibition was maintained for up to 35 days, when plasma PRL was still significantly below the values recorded at baseline and in the control group. Plasma GH peaked at 3.6 ng/ml at 120 min and subsequently declined slowly to stabilize between 1.4 and 2.2 ng/ml for about 12 h, falling to below the 1 ng/ml limit for the remainder of the study period. In contrast, individuals receiving oral bromocriptine exhibited a significant elevation following the first dose and an equivalent increment after the morning dose on Day 3. Thus, the results show a prolonged inhibitory effect on PRL of this long-acting bromocriptine preparation in parallel with its slow plasma clearance. The stimulant effect on GH secretion is short lived, presumably due to desensitisation of specific receptors. PMID- 3956566 TI - Pharmacokinetics of terbutaline during pregnancy. AB - Terbutaline in plasma was determined in three groups of women by gas chromatography-mass spectrometry. Eight women received a single i.v. dose of 0.25 mg terbutaline sulphate during pregnancy and 3-6 months after delivery. Mean plasma clearance was 29% higher during pregnancy than after delivery. There was a subsequent decrease in mean terminal half-life from 5.3 to 3.7 h and in mean residence time from 5.3 to 3.4 h. There was no change in volume of distribution. A second group of pregnant women in premature labour (n = 8) received oral terbutaline 5 mg t.d.s. The dosing was repeated after delivery. The mean steady state plasma concentration of terbutaline was about 30% lower during pregnancy than after delivery. A third group of women in preterm labour (n = 8) was treated with an i.v. infusion of terbutaline. The concentrations of terbutaline found on cessation of uterine contractions ranged between 12.8 and 31.5 ng/ml. At present there is no basis for formulation of a "therapeutic plasma level" of terbutaline for the treatment of preterm labour. PMID- 3956567 TI - Single dose prophylaxis with metronidazole in infants during abdominal surgery: a pharmacokinetic study. AB - Plasma metronidazole was measured following a single intravenous dose of 20 mg/kg (Flagyl 5 mg/ml) in 12 infants less than 1 year of age undergoing abdominal surgery. In all patients sufficient plasma concentrations, well above the MIC values for anaerobic bacteria, were found for at least 16 h. A prolonged half life was demonstrated in the group less than 8 weeks of age (t1/2/18.4 h). The group over 8 weeks of age demonstrated a t1/2 comparable to that seen in adults (t1/2 7 h). PMID- 3956568 TI - Inhibition of prolactin and aldosterone secretion by the dopamine derivative ibopamine. AB - In 7 patients with congestive heart failure acute oral administration of ibopamine, a new dopamine derivative, induced a significant decrease in serum prolactin and aldosterone without affecting serum growth hormone or cortisol. The Metoclopramide-induced secretion of prolactin and aldosterone was blunted in 6 patients pretreated with 200 mg ibopamine. The data are consistent with a dopaminergic effect of ibopamine due to a peripheral action, probably on D-2 receptors. PMID- 3956569 TI - Pharmacokinetics of netilmicin in premature infants. AB - The pharmacokinetics of netilmicin were studied in 12 premature infants with proven or presumed sepsis during the first month of life. Eleven of 12 patients received netilmicin 2.5 mg/kg intravenously every 12 h while one 770-gram birth weight infant received 2.5 mg/kg every 18 h. Mean steady-state peak and trough concentrations were 8.9 micrograms/ml and 2.8 micrograms/ml, respectively. Of twelve patients, 11 had trough serum concentration above 2 micrograms/ml and four had trough serum concentrations above 3 micrograms/ml. Mean total body clearance of netilmicin was 0.84 ml/min/kg. The mean clearance of 0.72 ml/min/kg was substantially lower in patients with a mean postnatal age of 2.7 days than the clearance of 1.10 ml/min/kg in patients with a mean postnatal age of 23 days. The mean apparent volume of distribution was 0.63 l/kg; and the mean elimination halflife was 8.6 h. A three-fold interpatient variation in pharmacokinetic parameters was seen. These data suggest the need for careful monitoring of netilmicin serum concentration in premature infants. PMID- 3956570 TI - Transfer of immune complexes from lymphocytes to follicular dendritic cells. AB - Antigens in the form of immune complexes are retained on the membranes of follicular dendritic cells (FDC) for long periods of time. To examine how immune complexes reach germinal centers, where FDC are located, we injected mice with anti-2,4-dinitrophenyl (DNP) antibodies complexed to DNP-myoglobin-coated gold particles. The distribution of the particles in spleens or draining lymph nodes was then determined with the electron microscope. The vast majority of the particles were cell bound. Shortly after injection they were phagocytized by macrophages or fixed on lymphocytes. The latter were found even in the corona of lymph follicles but not in germinal centers. Already 30 min after injection, FDC in contact with the corona were faintly positive but were negative in the center. FDC precursor cells were occasionally observed but in too small a number to account for the transport of immune complexes to the germinal centers. Twenty four hours after injection colloidal gold particles were found in phagolysosomes of macrophages or on cytoplasmic extensions of FDC in all parts of the germinal centers. Experiments performed on isolated FDC showed that they are not only able to take up free immune complexes but are also able to adsorb immune complexes from pulsed lymphocytes. These results strengthen the idea that lymphoid cells binding immune complexes by their Fc receptors may transport these complexes inside germinal centers. PMID- 3956571 TI - Pharmacological characterization of histamine receptors in the rabbit renal artery. AB - Histamine receptors were characterized pharmacologically in the rabbit renal artery. Histamine concentration-dependent contractions were blocked by chlorpheniramine (pA2 = 8.25 +/- 0.16) and mepyramine (pA2 = 9.80 +/- 0.22). A low concentration of metiamide (0.5 microM) enhanced significantly the effect of histamine. Higher concentrations either had no effect or reduced the contractile response to histamine. Impromidine, dimaprit and, in the presence of chlorpheniramine or mepyramine, histamine (at the concentrations that produced contractions) relaxed the precontracted vessel. The relaxant effect of histamine was quantitatively greater in the presence of mepyramine than it was in the presence of chlorpheniramine. Endothelial removal did not influence the contractile response to histamine but enhanced the relaxation suggesting the presence of histamine receptors mediating contraction in the intima. Relaxation responses to histamine and dimaprit were blocked competitively by cimetidine (pA2 = 6.65 +/- 0.10 and 6.60 +/- 0.05 respectively). It is concluded that there are two types of histamine receptors in the renal artery of the rabbit; H1-receptor mediating contraction and H2-receptor mediating relaxation. Both types of receptors are present in the media: some excitatory receptors may be present in the intima. PMID- 3956572 TI - Evidence that the intracellular effects of adenosine in the guinea-pig aorta are mediated by inosine. AB - Previous studies have demonstrated that high concentrations of adenosine interact with both a cell surface receptor and with an intracellular site to evoke relaxation of the guinea-pig aorta. The intracellular action of adenosine was investigated in the present study. The purine sensitive 'P-site' did not appear to be involved since other P-site agonists did not consistently evoke relaxation. A major interaction with intracellular S-adenosylhomocysteine hydrolase also appeared unlikely since 1-homocysteine had only minor effects on adenosine-evoked responses. Inhibition of adenosine deaminase attenuated responses evoked by high concentrations of adenosine. The deaminated metabolite of adenosine, inosine, also evoked aortic relaxation. These responses were mediated solely via an intracellular site since they were blocked by an inhibitor of nucleoside facilitated diffusion but were unaffected by an adenosine receptor antagonist. These results indicate that a major part of the intracellular effect of adenosine is mediated by its deaminated metabolite inosine. PMID- 3956573 TI - Behavior performed at onset of drug action and apomorphine stereotypy. AB - This study tests the hypothesis that stereotyped behavior induced by apomorphine reflects strengthening of behavior observed at the onset of drug action. Rats (n = 26) were injected with apomorphine (1.25 mg/kg) while being engaged in copulation. Contrary to the hypothesis, apomorphine did not strengthen ongoing copulation but arrested it. Instead of mating the males became engaged in behavior typically exhibited by rats injected with the drug. It is speculated that stereotyped behavior may be an expression of a drug-induced shift of attention or responsiveness to some particular range of stimuli. PMID- 3956574 TI - Etorphine inhibition of pancreatic exocrine secretion in rats: comparison with methadone. AB - The effects of etorphine, a potent opiate agonist without preferential affinity for mu, delta or kappa receptors, on exocrine pancreatic secretion were studied in rats fitted with chronic or acute pancreatic fistulas and compared to those of methadone, a well-documented mu agonist. In conscious rats etorphine (3 micrograms/kg s.c.) inhibited basal pancreatic secretion by about 50% for volume and bicarbonate output and by 70% for protein output. Pancreatic secretion returned to its basal level within 2 h. Methadone (5 mg/kg s.c.) was about equipotent but the inhibition lasted longer. The effects of both etorphine and methadone were completely antagonized by naloxone (1 mg/kg s.c.) and to a lesser extent by diprenorphine (10 microgram/kg s.c.). Yohimbine did not suppress the inhibitory effect of etorphine on protein output but showed some antagonism against the effects of etorphine on water and bicarbonate output. In anaesthetized rats etorphine (3 micrograms/kg) inhibited the pancreatic secretion stimulated by 2-deoxy glucose, a centrally acting vagal stimulatory agent, by 50 60% for volume and bicarbonate output and totally for protein output. The same dose of etorphine did not inhibit the pancreatic secretion evoked by vagal electrical stimulation, a peripheral stimulus. Methadone (5 mg/kg) inhibited the pancreatic secretion stimulated by 2-deoxy glucose to the same extent, but for a longer time than etorphine, and at the same dose did not suppress the pancreatic pancreatic response to vagal electrical stimulation. The inhibitory effects of etorphine and methadone in anaesthetized rats were completely suppressed by naloxone (1 mg/kg s.c.) and only reduced by diprenorphine (10 micrograms/kg s.c.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956575 TI - Evidence for a central sympathoinhibitory action of prazosin and indoramin. AB - The effect of 1 h infusion of prazosin or indoramin was investigated on thoracic preganglionic sympathetic nerve activity in vagotomized and carotid sinus nerve activity in nonvagotomised anaesthetised, paralysed cats. Recordings were also made of blood pressure, heart rate and femoral arterial conductance. Prazosin and indoramin caused decreases in preganglionic sympathetic and carotid sinus nerve activity along with blood pressure and an increase in femoral arterial conductance. In the vagotomised cats there was only a small but non-significant fall in heart rate. These results indicate that the sympathoinhibitory action of prazosin and indoramin is not due to stimulation of baroreceptor afferents but is due to a central action. PMID- 3956576 TI - Electrophysiological actions of mexiletine on rabbit sinoatrial node cells. AB - The effects of mexiletine (1-100 microM) were examined on membrane potential and current of rabbit sinoatrial node cells by means of conventional microelectrode and double microelectrode voltage clamp techniques. Mexiletine decreased, in a dose-dependent manner, the maximum rate of depolarization of the action potential and the action potential amplitude, and increased the spontaneous cycle length. The slope of the diastolic depolarization (phase 4) was also reduced. In the voltage clamp experiment, mexiletine (40-100 microM) reduced the slow inward current (Isi), the potassium outward current (IK) and the hyperpolarization activated current (Ih). The kinetic variable of IK was not altered by the drug. These results suggest that mexiletine does not have a specific effect on a single current system, but that relatively high concentrations of mexiletine exert an inhibitory effect on the electrical activity of the sinoatrial node cells. PMID- 3956577 TI - Calcium entry blocking activity of dilazep and other adenosine potentiating compounds in guinea-pig atria. AB - In potassium-depolarized guinea-pig left atria treated with isoproterenol, calcium entry blocking activities of adenosine and its potentiating compounds, dipyridamole, lidoflazine and dilazep were studied and compared to verapamil and diltiazem. pA2 values for various drugs were calculated using concentration response curves for calcium (parallel shift to the right). The order of potency for the calcium entry blocking effect was: verapamil greater than diltiazem greater than adenosine greater than lidoflazine = dilazep greater than dipyridamole. Adenosine caused negative inotropic effects in depolarized left atria. The negative inotropic effect of adenosine was very quick in onset and was potentiated by erythro-6-amino-9(2-hydroxy-3-nonyl)-purine hydrochloride (EHNA), an adenosine deaminase inhibitor, suggesting that adenosine was being degraded. The effect of adenosine was quickly abolished by adenosine deaminase (ADA) and antagonized by 8-phenyltheophylline (8-PT), suggesting that the action of adenosine was most likely through the surface membrane receptor sites. The negative inotropic effects of dilazep and dipyridamole were only partially reversed by ADA and 8-PT, while that of lidoflazine was not affected by these agents. These findings suggest that the mechanism(s) of negative intotropic effect of lidoflazine was different from that of dilazep and dipyridamole. These data suggest that the negative intropic effect of dilazep is most likely due to a direct calcium entry blocking effect and in part due to its adenosine potentiating effect. However, the calcium entry blocking effect of lidoflazine is independent of adenosine. PMID- 3956578 TI - Morphine enhances gastric mucus synthesis in rats. AB - The effect of morphine on gastric mucus synthesis was studied in conscious rats, using the method of staining mucus with alcian blue then destaining it with magnesium chloride. It was found that morphine significantly enhanced gastric mucus synthesis, as did fentanyl, a non-histamine-liberating opioid. The effects of the opioids on mucus synthesis were significantly attenuated by pretreatment with naloxone 8 mg/kg or cimetidine 100 mg/kg. Cimetidine itself significantly suppressed gastric mucus production in saline-treated rats. These findings suggest that the increased gastric mucus synthesis caused by morphine is due to activation of opiate receptors and not to histamine release. It appears that cimetidine may counteract rather than block the receptor effects of the opioids by a direct action on the mucus-secreting glands. PMID- 3956579 TI - Lysosomal uptake of isolated cell organelles microinjected into HeLa cells. AB - Lysosomes and microsomes were isolated from rat liver and microinjected into the cytoplasm of HeLa cells. The fate of the transplanted organelles and their effects on the recipient cells were followed in the electron microscope at various time intervals after administration. Needle injection with buffer or sucrose did not seem to evoke any ultrastructural alterations, such as induced autophagy or other signs of sublethal cell injury. Recipients of microinjected cell organelles elicited a rapid and conspicuous increase in membrane-bounded cytoplasmic vacuoles, concomitant with the disappearance of the injected material. Golgi complexes became abundant with many small vesicles clustering around their cisternae. The volume density of the lysosomal compartment increased 2-3-fold after organelle injection as compared with control-injected (0.3 M sucrose) or noninjected cells. Our preliminary results show that isolated cell organelles can be microinjected into cells n culture and indicate that the microinjected organelles were segregated from the cytoplasm into membrane-bounded vacuoles probably through autophagolysosome formation. Thus, this technique offers an additional approach for studies on the segregation and degradation of cell organelles in somatic cells and may enable more detailed analyses on the mechanisms of autophagic sequestration of specific cell organelles. PMID- 3956580 TI - Distinction of G0 cells from senescent cells in cultures of non-cycling human fetal lung fibroblasts by anti-MAP-1 monoclonal antibody staining. AB - On staining with a monoclonal antibody raised against microtubule-associated protein-1 (MAP-1), dot-like structures were seen in the nuclei of interphase cells, but not in those of non-cycling G0-arrested cells. Dots were also not seen in the nuclei of non-cycling senescent human cells (IMR-90). A SV40-DNA transformed subline of IMR-90 with a limited growth potential showed progressive decrease of cells with nuclei containing dots in the final stage of their lifespan. The dots appeared in G0-arrested IMR-90 cells when these cells were incubated in medium of high osmotic pressure for 3 min. In contrast, no dots appeared in senescent cells or X-ray-irradiated young cells when they were incubated in medium of high osmotic pressure. Thus irreversibly non-cycling cells could be distinguished from G0-phase cells on the level of whole cultures. The results suggest that senescent cells lose their division potential by entering an irreversible cell-cycle stage differing from G0. PMID- 3956582 TI - Ataxia-telangiectasia cell extracts confer radioresistant DNA synthesis on control cells. AB - We have investigated in greater detail the radioresistant DNA synthesis universally observed in cells from patients with ataxia-telangiectasia (A-T). The approach employed in this study was to permeabilize cells with lysolecithin after gamma-irradiation and thus facilitate the introduction of cell extract into these cells. This permeabilization can be reversed by diluting the cells in growth medium. Cells treated in this way show the characteristic inhibition (control cells) or lack of it (A-T cells) after exposure to ionizing radiation. Introduction of A-T cells extracts into control cells prevented the radiation induced inhibition of DNA synthesis normally observed in these cells. A-T cell extracts did not change the level of radioresistant DNA synthesis in A-T cells. Control cell extracts on the other hand did not influence the pattern of inhibition of DNA synthesis in either cell type. It seems likely that the agent involved is a protein because of its heat lability and sensitivity to trypsin digestion. It has a molecular weight (MW) in the range 20-30 000 D. The development of this assay system for a factor conferring radioresistant DNA synthesis on control cells provides a means of purifying this factor, and ultimately an approach to identifying the gene responsible. PMID- 3956581 TI - Trifluoperazine and W-7 inhibit mating in Chlamydomonas at an early stage of gametic interaction. AB - Gametic mating by Chlamydomonas reinhardi is inhibited in a dose-dependent and reversible manner by the calmodulin antagonists trifluoperazine (TFP) and W-7, but not by W-5, an analog of W-7 having lower affinity for calmodulin. Quantitation of the sequential steps of mating showed that TFP and W-7 both allow normal levels of flagellar agglutination but prevent all subsequent steps. Gametes agglutinate aberrantly and do not form mating pairs. Further, both of these drugs prevent the translocation of latex beads along the flagellar surface. Our observations suggest that calmodulin may play an integral role in the translocation of flagellar adhesion sites during the tip-locking stage of the Chlamydomonas mating reaction. Flagellar surface motility may be crucial to the transduction of signals during mating and may share regulatory mechanisms with other forms of surface motility. PMID- 3956583 TI - DNA synthesis studies in pre-meiotic mouse oogenesis. AB - DNA fiber autoradiography was used in mouse oogenesis to test Callan's hypothesis that a longer S phase results from a reduction in the number of active initiation sites. The data indicated that the premeiotic increase in the duration of S phase in mouse oogenesis was characterized by a rapid initial rate of chain growth and a larger replicon size when compared with replicating DNA of somatic mouse cells. These findings were at variance with those in mouse spermatogenesis and also did not support the Callan hypothesis of activation site repression. PMID- 3956584 TI - Conversion of replicative intermediates in human DNA-repair defective cells. AB - We have examined the conversion of intermediates of DNA replication in normal human skin fibroblasts and fibroblasts isolated from patients with genetic diseases caused by putative DNA repair defects. Experiments were performed in non transformed, unchallenged cells using alkaline sucrose sedimentation analysis to demonstrate precursor low molecular weight (LMW) DNA molecules which converted into high molecular weight (HMW) DNA with time. Analyses of conversion of replicative intermediates were conducted in cells from patients with ataxia telangiectasia (AT), Fanconi anemia (FA), Bloom syndrome (BS), Cockayne syndrome (CS) and xeroderma pigmentosum (XP). Our studies show that conversion of replicative intermediates occurs in all cell strains examined. However, XP cells (complementation groups A and E) show evidence of abnormalities in the conversion of LMW replicative intermediates, with the most dramatic alterations shown by cells from complementation group A. PMID- 3956585 TI - A lens fibre differentiation factor from calf neural retina. AB - During growth of the eye lens, epithelial cells differentiate into fibre cells under the influence of neural retina. The fibre differentiation factor (FDF) was partially characterized from calf retina-conditioned medium, using lens epithelial explants from young rats, to provide a bioassay for differentiation. FDF was associated with large-protein aggregates, the smallest of which eluted at approximately 500-600 kD on Sephacryl S-300 columns and migrated as a single protein band near 600 kD on gradient gels. This protein resolved into nine major peptides on SDS-polyacrylamide gels, ranging between 23 and 27 kD. Eight of these peptides were present oa four doublets, but did not appear to contain specific carbohydrate residues. The approximately 500-600 kD complex could be slightly disrupted by trypsin or heat treatment to release a less stable 90 kD component. Fractionation of FDF invariably led to loss of activity, possibly due to gradual dissociation into less active and/or less stable components. A working hypothesis suggested by these findings is that FDF is associated with a small group of peptides, each contributing an essential function to the process of fibre differentiation. PMID- 3956586 TI - Absence of intermediate filaments in a human adrenal cortex carcinoma-derived cell line. AB - Subclones of a human adrenal cortex carcinoma-derived cell line (SW13) are described which by immunofluorescence lack detectable expression of any of the five known classes of intermediate filament (IF) proteins. Further investigation for vimentin and keratins in these subclones by two-dimensional gel analysis and by immunoblotting gave results consistent with the immunofluorescence results. Despite the apparent absence of IFs, SW13 subclones have organized actin and microtubule cytoskeletal networks, maintain an epithelial shape and colony pattern, and grow well in culture. Although a rat hepatoma cell line which similarly appears to have ceased IF expression has been reported, this is the first such report of a human cell line. Although rare, these cases provide evidence that IFs in general are not essential to growth in culture, nor are the keratin-containing IFs in particular necessarily responsible for the 'cobblestone' morphology or colony-type growth pattern characteristic of cultured epithelial cells. PMID- 3956587 TI - Polypeptides during early conjugation in Tetrahymena thermophila. AB - As Tetrahymena thermophila cells differentiate from their vegetative life cycle to sexual reproduction, their polypeptide pattern undergoes a series of changes. These changes have been traced in extracellular, cellular, and subcellular compartments. The first alteration is induced by the nutritional shift-down and results in stimulation of at least one ciliary polypeptide and affects a series of polypeptides from other compartments. The second alteration is induced by mixing starved cells of complementary mating types and this stimulates the synthesis of nine ciliary polypeptides before pairs have formed and eight afterwards. At least five of these early and one of the late conjugation-related ciliary polypeptides are removed by low concentrations of EDTA, indicating that they are located on the external side of the plasma membrane. No differences were observed between polypeptides excreted during starvation and after mixing of complementary mating types. At Tris concentrations restrictive for conjugation, cilia lack the conjugation-related polypeptides. Some of these are instead found among the excreted polypeptides. Using O'Farrell gels and silver staining on isogenic cells of all possible mating types, we have been unable to correlate changes in polypeptide patterns to specific mating types. PMID- 3956588 TI - Fibroblasts on micromachined substrata orient hierarchically to grooves of different dimensions. AB - Contact guidance was studied by light, scanning (SEM) and transmission electron microscopy (TEM) in cultures of human gingival fibroblasts cultured on grooved surfaces. The grooves were originally produced in silicon wafers by micromachining, a process which is based on the methods used to fabricate microelectronic components, and the grooved surfaces were then replicated in Epon. Micromachining enables precise control of groove depth, groove spacing, and groove shape to be obtained. In silicon wafers with appropriate crystal orientation, a second smaller set of grooves, called the minor grooves, is found on the floor of the major grooves. The minor grooves are oriented at a 54 degree angle to the major grooves, so that cells cultured on such surfaces are concurrently exposed to grooves of different dimensions which direct cell migration in different directions. Marked fibroblast alignment with the major grooves was observed both within the grooves and in the intervening flat ridges between the grooves. In addition, shallow and closely spaced grooves in epon or titanium-coated polymer or silicon were also capable of orienting fibroblasts. Although the minor grooves were able to orient fibroblasts in the absence of any other orienting influence, when fibroblasts were concurrently exposed to major and minor grooves the cells aligned themselves with the major grooves. TEM showed that the cellular filamentous cytoskeletal elements reflected the orientation of the cell as a whole. Fibroblasts on grooved substrata appeared to have more filopodia and to round up more frequently than fibroblasts cultured on flat substrata. It is suggested that both the mechanical properties of the cytoskeleton as well as the durability of the cellular attachment to groove edges may play a role in the contact guidance effected by grooved surfaces produced by micromachining. PMID- 3956589 TI - The effect of mannose 6-phosphate on the turnover of the proteoglycans in the extracellular matrix of human fibroblasts. AB - Human fibroblasts (SL66) were cultured in medium containing 35SO2-4 to label the glycosaminoglycans (GAGs). The cells were then detached from the culture dish to leave radioactively-labeled components of the extracellular matrix, hereafter termed 35S-labeled substrate-attached material. When unlabeled SL66 fibroblasts were plated onto this 35S-labeled substrate-attached material, the cells mediated two distinct events: (a) release of radioactivity from the substrate-attached material into the medium; (b) degradation of certain glycosaminoglycans into radioactive components of very low molecular weight including free radioactive sulfate. In the presence of mannose 6-phosphate, however, the degradation of the substrate-attached material by SL66 cells was partially inhibited. Analyses of this effect in terms of the dose-response curve, saccharide specificity, ammonium chloride sensitivity, and the requirement for cells suggest that both an intracellular compartment and the mannose 6-phosphate receptor that binds lysosomal enzymes at the cell surface may play important roles in the turnover and degradation of certain proteoglycans in substrate-attached material. PMID- 3956590 TI - Hepatocyte adhesion to collagen. Isolation of membrane glycoproteins involved in adhesion to collagen. AB - Adhesion of hepatocytes to collagenous substrates and their spreading have been shown to involve a specific recognition event, possibly mediated by membrane proteins with affinity for collagen. In the present communication, we describe the isolation of membrane components that are involved in the adhesion of rat hepatocytes to collagen. These components could be solubilized from liver microsomal membranes by treatment with detergents or papain--but not by treatment with EDTA, urea or high salt. The purification of detergent-solubilized components was monitored by an assay determining the ability of membrane components to neutralize antibody-mediated inhibition of hepatocyte adhesion to collagen. By affinity chromatography on lentil lectin-Sepharose it was found that the neutralizing activity resided within the glycoprotein fraction. These glycoproteins were purified further by affinity-chromatography on collagen type I linked to Sepharose. Antibodies raised against the glycoproteins with affinity for immobilized collagen, effectively inhibited hepatocyte adhesion to collagen. The bulk of the neutralizing activity migrated with an apparent molecular weight of 120 000-140 000 in preparative SDS-PAGE. PMID- 3956591 TI - Studies on vascular smooth muscle cells and dermal fibroblasts in collagen matrices. Effects of heparin. AB - The incorporation of such tissue-cultured mesenchymal cells as bovine vascular smooth muscle cells (SMS) and human dermal fibroblasts (DF) in a collagen matrix results in the reorganization and distortion of that matrix. A 2 ml collagen matrix populated by 55 000 bovine SMC and having a surface area of 800 mm2 will be reduced to 226 mm2 by 48 h. Under identical conditions, a lattice populated by 55 000 DF will achieve an area of 78 mm2 at 48 h. DF are thus more efficient at reducing the size of a collagen lattice by the process of lattice contraction. Bovine SMC proliferate in a collagen matrix; human DF do not. DF in a collagen matrix have a more elongate morphology than SMC. Actin cytoplasmic filaments were studied using the specific F-actin staining reagent, Rhodamine-phalloidin. DF in collagen matrix exhibit diffuse cytoplasmic staining while, in monolayer, they display prominent staining stress fibers. SMC in monolayer and in matrices show stained clumps at the periphery of the cell. The addition of 200 U/ml heparin to SMC eliminates those actin aggregates and causes the formation of stress fibers. It also causes stress fibers to form in dermal fibroblasts in a collagen lattice. However, the elongation and spreading--and the formation of stress fibers brought about by heparin--lead to an inhibition of lattice contraction. Heparin effectively inhibits cell-mediated lattice contraction in SMC and DF, and it also causes the formation of cytoplasmic stress fibers. PMID- 3956592 TI - Cell fractions from rat rib growth cartilage. Biochemical characterization of matrix molecules. AB - In an attempt to isolate and characterize the putative target cells for growth hormone, chondrocytes were isolated from rat rib growth cartilage and fractionated by centrifugation in a discontinuous Percoll gradient. This resulted in three cell fractions with differing properties. The fraction with the lowest density consisted mainly of large, lipid-containing cells which became flattened in subsequent culture. The cells in this fraction were fair collagen producers but synthesized only minor amounts of proteoglycans and apparently no proteoglycan aggregates. These cells probably originate in the hypertrophy zone of the growth plate. The fraction with highest density, on the other hand, consisted of small cells which upon cell culture became polygonal and surrounded with refractile matrix. They synthesized less collagen, but more proteoglycans than the low-density fraction. The proportion of proteoglycan aggregates was rather low (10-20%) but otherwise the proteoglycans were similar to those synthesized by other chondrocytes. This cell fraction was tentatively identified as cells from the upper part of the growth plate. Finally, the middle fraction was heterogeneous, consisting of cells of varying shape. This fraction synthesized large amounts of both collagen and proteoglycans. In all three cell fractions, type II collagen predominated. There were also minor amounts of (1a, 2a, 3a) collagen, and, in the two denser fractions, of type I collagen. PMID- 3956593 TI - Studies on the relation of DNA synthesis to retinoic acid-induced differentiation of F9 teratocarcinoma cells. AB - Inhibition of DNA synthesis in F9 embryonal carcinoma cells with high thymidine induces differentiation similar to that induced with retinoic acid (RA). The presence of differentiated cells is evident after 15 h of treatment with 2 mM thymidine, during which period DNA synthesis is inhibited 99%. The addition of RA during the period of high thymidine treatment does not increase the amount of differentiation seen at the end of the 15-h treatment, but does increase the amount seen after thymidine is removed. The inhibition of proliferation by low serum concentration does not induce differentiation in the absence of RA. In partially synchronized cultures of F9 cells, the addition of RA alters the pattern of DNA replication during the first third of S phase. If RA is present during this part of S phase, differentiation is evident both morphologically and biochemically during the following cell cycle. Addition of RA during the second half of S phase does not lead to obvious differentiation until after the next cell cycle. These results suggest that particular events during the early replication period of F9 cells are targets for RA action in induction of differentiation of F9 cells. PMID- 3956594 TI - Ultrastructural study of the relationships between the various nucleolar components in Ehrlich tumour and HEp-2 cell nucleoli after acetylation. AB - In the present study, we analysed the relationships between various nucleolar components in Ehrlich tumour and HEp-2 cells, using acetylation. Under these conditions, we found contacts between the condensed intranucleolar chromatin and the fibrillar centre, illustrating the continuity between the DNA present inside the fibrillar centre and that of condensed associated chromatin. We also found that although the dense fibrillar component is usually situated at the periphery of the fibrillar centre, it is sometimes found inside the centre. On the other hand, the layer of dense fibrils bordering the fibrillar centre is interrupted by nucleolar interstices. In addition, in HEp-2 cell nucleoli with a reticulated appearance, the numerous small fibrillar centres are bound together by strands of dense fibrillar component. These observations are discussed in terms of relationships between nucleolar ultrastructure and function(s). PMID- 3956595 TI - Sorting of micronuclei from PtK1 cells. AB - We report here a procedure allowing to select micronuclei corresponding to defined individualized chromosomes in conditions which preserve their synthetic activity. The mammalian PtK1 cells, which possess six chromosome pairs, were micronucleated by colchicine. DNA of the micronucleated cells was labeled by the Hoechst 33342 fluorochrome under vital conditions. The micronuclei were isolated by a gentle procedure and their fluorescence was analysed by flow cytometry. The flow-cytometry parameters were determined for the analysis of non-fixed subdiploid fractions. We obtained five distinct peaks of fluorescence which have been sorted. The sorted micronuclei are different in each peak exhibiting different fluorescence intensity. Peak 3 contains the micronuclei with nucleoli and chromocenters that correspond to the X chromosome in this cell line. PMID- 3956596 TI - Satellite DNA in the three C-bands of an unusual mouse marker chromosome. A model of chromosomal evolution. AB - A marker chromosome in the stemline of a new murine cell line is described on the basis of different stainings and in situ hybridization. The marker was characterized originally by three C-bands, one from each centromeric region of the three chromosomes constituting the marker. In the course of stemline evolution, two of the C-bands have been lost and the marker has developed into a monocentric chromosome, phenotypically and functionally normal. PMID- 3956597 TI - Histidyl-tRNA synthetase, the myositis Jo-1 antigen, is cytoplasmic and unassociated with the cytoskeletal framework. AB - The myositis-specific anti-Jo-1 autoantibody, which is directed against histidyl tRNA-synthetase, is found in 30% of polymyositis patients. The Jo-1 antigen has been reported to be a nuclear antigen by some authors. On the contrary we show that less than 2% of the total histidyl-tRNA and lysyl-tRNA synthetase activities are associated with purified rat liver nuclei or the hepatocyte intermediate filament-nuclear fraction. In the presence of polyethylene glycol, in which the high Mr multi-enzyme complex containing lysyl-tRNA synthetase is insoluble, 65% of the lysyl-tRNA synthetase and only 15% of histidyl-tRNA synthetase activities remained associated with the cytoskeletal framework. The Jo-1 antigen exhibited a diffuse granular cytoplasmic distribution in cultured rat hepatocytes as determined by indirect immunofluorescent microscopy. Hence, the Jo-1 antigen is cytoplasmic and unassociated with the cytoskeletal framework or high Mr synthetase complex in situ. PMID- 3956598 TI - Muscle cell cultures from chicken breast muscle have increased specific activities of creatine kinase when incubated at 41 degrees C compared with 37 degrees C. AB - Chicken muscle cell cultures were incubated at 41 degrees C, the physiological chicken body temperature, and compared with cultures incubated at 37 degrees C, the typical cell culture incubation temperature. The cultures incubated at 41 degrees C show not only an increase in creatine kinase (CK)-specific activity but also a marked increase in the percentage of adult muscle CK isozyme (MM-CK) in 7 day muscle cultures. Muscle cell cultures incubated in the presence of cytosine arabinoside (ara-C), a cell proliferation inhibitor, do not have the mononucleated cell overgrowth seen at 41 degrees C and thus exhibit a further increase in creatine kinase-specific activity compared with cultures incubated at 41 degrees C in the absence of ara-C. These results suggest that muscle cell cultures incubated at 41 degrees C are more highly differentiated than those incubated at 37 degrees C. PMID- 3956599 TI - Is the nuclear matrix the site of DNA replication in eukaryotic cells? AB - Four types of experiment were carried out to test the recently proposed model of matrix-bound replication in eukaryotic cells. In experiments with pulse-labelling we found preferential association of newly replicated DNA with the matrix only when the procedure for isolation includes first high-salt treatment of isolated nuclei and then digestion with nucleases, or when prior to digestion the nuclei have been stored for a prolonged time. In both cases, however, evidence was found that this preferential association is due to a secondary, artifactual binding of the newly replicated chromatin region to the matrix elements. Pulse-chase experiments and experiments with continuous labelling were carried out to answer the question whether during replication the DNA is reeled through the replication complexes, i.e., whether newly replicated DNA is temporarily or permanently associated with the matrix. The results showed that at that time the matrix DNA does not move from its site of attachment. Since, according to the model of matrix-bound replication, the forks are assumed to be firmly anchored to high salt resistant proteinaceous matrix structures, the chromatin fragments isolated with endonuclease not recognizing newly replicated DNA and purified by sucrose gradient centrifugation should be free of replication intermediates. The electronmicroscopic analysis of such fragments revealed the existence of intact replication micro-bubbles. Moreover, the fragments with replication configurations appeared as smooth chromatin fibres not attached to elements characteristic for the matrix. All these experiments suggest that the nuclear skeleton is not a native site of DNA replication in eukaryotic cells. PMID- 3956600 TI - Biochemical studies on the effects of continuous light on the albino rat retina. AB - The causal mechanism of light damage in the albino rat retina has been investigated. Male and female albino Wistar rats weighing 200-300 g and previously maintained in normal room lighting of approximately 15 hr light (0.85 +/- 0.05 X 10(-4) W cm-2) per 9 hr dark cycle were simultaneously exposed continuously to uniform fluorescent light flux of 3.01 +/- 0.5 X 10(-3) W cm-2 for a period of 6-18 hr. The animals were killed immediately after exposure and the retinas analysed for their contents of DNA, protein and lipids. There were significant losses of retinal DNA, protein, total lipid and polyunsaturated fatty acids, particularly docosahexaenoic acid. The losses were progressive with duration of exposure. There were also changes in phospholipid subclasses. These results could indicate altered photoreceptor-membrane viability secondary to continuous illumination. The ultimate effect would be the loss of photoreceptor cells with a concomitant loss of normal physiological function. Generally, gender was found to play no significant role, thus excluding possible endocrine interference. It is suggested that lipoperoxidative reactions could account for the observations made in this study. The danger of over-exposure to radiant flux in the tropics is inferred from these observations. PMID- 3956601 TI - Posterior cataract induction by UV-B radiation in albino mice. AB - UV-B radiation (290-320 nm) was very effective at inducing posterior cortical cataracts in mice similar to those seen in the human senile lens. UV-A radiation, in contrast, was at most weakly cataractogenic. The posterior opacities induced by UV-B began to appear 5-6 months after daily exposure to 8 X 10-6 W cm-2 for 12 hr per day or 10-4 W cm-2 for 1 hr per day. Progression was more rapid following the more intense exposure rate. The cataracts developed without any apparent damage to the cornea. A hypothesis of how damage sustained by the epithelium results in posterior opacities is presented. PMID- 3956603 TI - Selenium-induced cataract--a correlation of dry mass content and light scattering. AB - Selenium-induced cataracts in young rats were used to compare light scattering and dry mass concentration along the lens axis. Selenium-treated rats and control rats were examined 1, 2, 4 and 6 days after subcutaneous injection of selenium or 0.9% NaCl. The development of nuclear cataract was followed with a Scheimpflug slit-lamp camera. Light-scattering was determined by densitometry of the negatives taken by the Scheimpflug camera. Dry mass concentration was determined by quantitative microradiography of the extracted lenses. Increasing light scatter was seen from day 2 to day 6. The dry mass concentration, however, was not changed until day 6. Two distinct zones were found surrounding the center of the nucleus, one with increased and one with decreased dry mass. The rapid changes in dry mass concentration were probably caused by shifts in water distribution within the lens. Similar zones of hydration have also been found in human senile nuclear cataract. Selenium-induced cataract in the rat is discussed in relation to human nuclear cataract. PMID- 3956602 TI - Electron-microscopic study on the fibrillar network and fibrocyte--collagen interactions in the vitreous cortex at the ora serrata of human eyes with special regard to the role of disintegrating cells. AB - The diameter of the fibrils in the normal vitreous cortex at the ora serrata of human eyes was found to range from 10.8 to 12.4 nm. There is no significant increase in thickness with age. Periodic cross-striation typical for collagen could be demonstrated by microdensitometry. In senile eyes, secondary lateral aggregations of the fibrils are a common factor, usually in proximity to disintegrating cells. Disintegrating cells in the vitreous cortex were already observable in childhood. They were more often seen with increasing age. In a pathological case, acid phosphatase could be demonstrated both within the vitreous fibrocytes and in the extracellular space, released from disintegrating cells. Fibrils and segments of banded material were observed within pits and invaginations, and in intracytoplasmic channels and vacuoles of the aged vitreous fibrocytes. Linear aggregations of ruthenium red-positive material were seen at the surface and within invaginations of the same cells. The findings are interpreted as an indication for phagocytosis and--or secretion of collagen by the vitreous fibrocytes even in senile eyes. PMID- 3956604 TI - Morphological and cell volume changes in the rat lens during the formation of radiation cataracts. AB - Earlier studies in our laboratory showed that 24 hr after X-irradiation, epithelial cells of early postnatal rat lenses increased in volume. Three days after X-irradiation, the underlying lens fibers increased in volume. This finding suggested a correlation between damage to epithelial cell volume regulation and subsequent fiber cell swelling. To test this hypothesis 4-week-old rat lenses were three-dimensionally reconstructed to determine average cell volumes of specific lens regions and wet weights of whole lenses were measured during radiation cataract formation. In addition, the differentiation of epithelial cells into lens fibers was monitored by autoradiography. Four-week-old Sprague Dawley rats were injected with [3H]-thymidine and, 24 hr later, their eyes were irradiated with either 400 or 1200 rad. Lenses were examined with a slit lamp and cataracts were graded on a scale of 1+ to 4+. Animals were killed 24 hr and 3, 5, 15 and 30 weeks after exposure. Lenses were serially sectioned at 0.75 micron and epithelial, equatorial and cortical fiber cell volumes were determined. Rats exposed to 400 or 1200 rad developed 0.5-1.5+ or 2.5-3.0+ cataracts, respectively, 10-16 weeks after X-irradiation. Epithelial and equatorial cells of both groups did not significantly increase in volume during this period. Three weeks after irradiation with 1200 rad cortical fibers were disorganized and had increased volume. By 5 and 15 weeks, cortical fibers had more normal cell volumes, although their morphology remained grossly altered. Cortical fiber volume of lenses irradiated with 400 rad were not significantly different from control lenses throughout the experimental period. By 15 weeks lenses irradiated with 400 rad showed subtle changes in morphology. Wet weight determinations indicated that the localized increase in cortical fiber volume did not result in an increase in the wet weight of the entire lens. Autoradiography showed that affected fibers had been epithelial cells at the time of X-irradiation. These results provide additional evidence that disturbances in fiber differentiation are involved with cataract formation, but do not support the initial hypothesis that a disturbance in epithelial cell volume regulation leads to fiber cell swelling. Earlier results suggesting defects in lens epithelial volume regulation in radiation cataract formation may have been complicated by ocular inflammation. PMID- 3956605 TI - Induction of ocular neoplasms in Wistar rat by N-methyl-N-nitrosourea. PMID- 3956606 TI - Electroretinographic deficits in rats treated with guanidinoethyl sulfonate, a depletor of taurine. PMID- 3956607 TI - The silver nitrate prophylaxis of Crede causes silver deposition in the cornea of experimental animals. PMID- 3956608 TI - Correlated neuronal variability in monkey visual cortex revealed by a multi microelectrode. AB - Recordings from the visual cortex of anaesthetized monkeys taken with a 30-fold multi-microelectrode demonstrate that the neuronal variability, defined as the change in response strength over time spans of a few seconds to several minutes, is highly correlated within groups of neurones. Several such groups exhibiting independent variability between groups, coexist within the area recorded. This within-group covariance suggests that a major part of neuronal variability is due not to a noise process in the cells, but rather to additional inputs to the neurones, which are not under control of the experimenter. PMID- 3956609 TI - Neuronal responses to borders with and without luminance gradients in cat visual cortex and dorsal lateral geniculate nucleus. AB - We investigated responses of neurones in cortical areas 17 and 18 and in the dorsal lateral geniculate nucleus (dLGN) of the cat to a phase shift in a moving line pattern forming a border without a luminance gradient ("subjective contour"). In both areas 17 and 18, S cells and B cells respond only slightly or not at all along the phase shift while C cells respond strongly. The response of C cells is strongest for line patterns with medium line separation and decreases with smaller and larger separation. In the dLGN the relative magnitude of neuronal responses along a phase shift is similar to that of C cells. However, C cells respond uniformly along the entire phase shift, whereas geniculate cells merely respond to individual line ends along the phase shift. In addition we compared responses along a phase shift and those to a luminance gradient formed by a dotted line whose dots were separated by the same distance as the line ends along the phase shift. S cells and B cells respond preferentially to dotted lines whereas C cells and geniculate cells respond equally well along both phase shifts and dotted lines. Possible explanations for these results in terms of receptive field structure and differences in inhibitory input to the cells are discussed. Differential neurone responses may account for the perceptual distinctness of the contours with and without luminance gradients. PMID- 3956611 TI - Tonotopic organization in the inferior colliculus of the rat demonstrated with the 2-deoxyglucose method. AB - We studied the tonotopic organization in the inferior colliculus of the rat with the 2-deoxyglucose method. Isofrequency bands were observed in the central nucleus of the inferior colliculus. In coronal sections, higher sound frequencies elicited bands that were located more ventrally. At caudal levels of the inferior colliculus, isofrequency bands were relatively short and tilted slightly downward toward the midsagittal plane. As the plane of section moved more rostrally, isofrequency bands gradually lengthened, their orientation first turned horizontally and continued with a downward tilt toward the lateral aspect of the brainstem. At rostral levels, high-frequency (greater than 8000 Hz) bands showed more significant increases in length than low-frequency (less than 4000 Hz) bands. Thus, the amount of tissue in the inferior colliculus devoted to higher frequencies was significantly more than that for lower frequencies. In sagittal sections, the isofrequency band moved from a dorsoposterior position to a ventroanterior one as the plane of section moved more laterally. A three dimensional model of isofrequency planes was reconstructed from the above data. PMID- 3956610 TI - EMG responses to load perturbations of the upper limb: effect of dynamic coupling between shoulder and elbow motion. AB - Load perturbations were applied to the arm of human subjects under conditions where both limb segments (upper arm and forearm) were free to move. The perturbations consisted of pulses of torque 50 ms in duration and of pseudo random sequences of such pulses. They were applied to either the forearm or the upper arm. Under all conditions, the perturbations resulted in angular motion at the shoulder and elbow joints and evoked consistent responses in muscles acting about these joints (biceps, triceps, anterior and posterior deltoid). Activity in biceps and triceps was not related simply to angular motion at the elbow joint. For example, activation of biceps could be evoked during elbow flexion (by applying a torque perturbation at the shoulder) as well as during elbow extension (by applying a torque perturbation at the elbow). The effect of varying degrees of dynamic coupling between upper arm and forearm on EMG responses was investigated by applying torque perturbations to the upper arm over a wide range of elbow angles. When the forearm is extended, such a perturbation induces a greater amount of elbow flexion than when the forearm is in a flexed position. The results of these experiments showed that the larger was the amount of flexion of the forearm induced by the perturbation, the larger was the activation of biceps. The results are incompatible with the notion of a negative feedback of total muscle length as being responsible for the EMG activity following the load perturbations. It is suggested that the EMG responses can best be interpreted functionally in terms of parameters more global than muscle length. Among such global parameters, changes in net torque at a joint resulting from the perturbation gave the best correlation with the pattern of EMG activities observed. PMID- 3956612 TI - Cerebellar projections from the cervical enlargement: an experimental study with silver impregnation and autoradiographic techniques in the cat. AB - The cerebellar projection of neurons in the cervical enlargement was investigated in cats using two neuroanatomical methods, the successive degeneration method (Sherrington and Laslett 1903) and the autoradiographic tracing technique (3H leucine). With both methods projections were found to the anterior lobe, posterior vermis and paramedian lobule. In the anterior lobe the projection was bilateral mainly to the vermal part of lobules I-V and the adjoining part of lobule VI, although some projection was also observed bilaterally to lobules I-VI lateral to the vermis. In the posterior vermis projection was found bilaterally to lobule VIII and in neighboring parts of lobule VII B. In the paramedian lobule the projection was mainly ipsilateral to the lesions/injections to the pars copularis and the adjoining part of the pars posterior. Only minor differences between the two methods were noted. In conclusion, spinocerebellar neurons project mainly to the vermal area of the anterior lobe (including the most anterior part of lobule VI), to lobules VII B and VIII and to the ipsilateral paramedian lobule. PMID- 3956613 TI - The effects of intrahippocampal ibotenate on resistance to extinction after continuous or partial reinforcement. AB - Intracerebral injections of ibotenate were used to produce, in rats, extensive cell loss in the hippocampus and dentate gyrus (complete hippocampal, CH), in the CH plus subiculum (SUB + CH), or in the subiculum plus entorhinal cortex (SUB + EC). These rats and sham-operated controls were trained to run in a straight alley for food reward delivered on a continuous (CR) or partial (PR) reinforcement schedule. In controls PR training gave rise to the well-known partial reinforcement extinction effect (PREE), i.e., greater resistance to extinction than that observed in CR-trained animals. Previous work had shown that large aspiration lesions of the hippocampal formation eliminate the PREE by increasing resistance to extinction in CR-trained animals and decreasing resistance to extinction in PR-trained animals. In the present experiments the PREE survived CH lesions, which increased resistance to extinction in both CR and PR training conditions; these effects were observed in the start and run (but not goal) sections of the alley. In contrast, subicular cell loss (in both SUB + CH and SUB + EC groups) abolished the PREE (but in the goal section only) by increasing resistance to extinction in the CR condition and decreasing resistance to extinction in the PR condition. In addition, some of the effects of PR training on start and run speeds during acquisition were altered by the CH and SUB + CH lesions. These results confirm previous data showing that the hippocampal formation plays a role in mediating the behavioural effects of PR training, but require modification of the model previously proposed to account for these data. PMID- 3956614 TI - Spatial correlation between sensory regions and the drainage fields of pial veins in rat cerebral cortex. AB - Visual and somatosensory evoked potentials were mapped in the cerebral cortex of adult rats and, after filling the cerebral arteries and veins with dye, the mappings were then compared to the distribution of pial veins. A close relationship was found between the position, size and shape of the occipital venous drainage field and the distribution of visual evoked potentials with high amplitudes and short latencies. Accordingly, such potentials evoked by stimulation of the forepaw and tailroot were confined to the fronto-parietal drainage field. In the case of individual variations in the expansion and shape of sensory areas, the medial and lateral borders of the occipital drainage field and the medial border of the fronto-parietal drainage field covaried. Only at the common border between these two drainage fields, visual evoked potentials with small amplitudes and long latencies extended into the parietal drainage field and overlapped with somatosensory evoked potentials. This overlapping area corresponds in position to the anterior part of the peristriate cortex. A comparison between the vascular organization and cytoarchitectonic maps of the rat cortex indicates that other parts of the characteristic pattern of venous drainage fields may also correlate with the cytoarchitectonic and functional organization of the cerebral cortex. These observations suggest that during morphogenesis the formation of sensory projections to the cerebral cortex may interact with the angiogenesis, mainly with the development of veins. PMID- 3956616 TI - The effect of attentive fixation on eye movements evoked by electrical stimulation of the frontal eye fields. AB - Electrical stimulation of the frontal eye fields of the rhesus monkey evokes saccadic eye movements. Both the amplitude of electrically elicited saccades and the threshold current for eliciting them are primarily determined by the location of the stimulating electrode within the frontal eye fields; however, threshold and amplitude also are systematically affected by the monkey's behavioral state when the stimulation is applied. If the monkey is alert, but not performing a task, saccade amplitudes are largest and thresholds are lowest. Conversely, if the monkey actively fixates a visual target, elicited saccades are smaller and threshold currents are higher. Saccades evoked during fixation have slower velocities appropriate for their reduced amplitude. Phase plane plots of eye velocity versus eye position indicate that these saccades are originally programmed to be smaller and slower, and hence are not large saccades voluntarily braked in mid-flight. As opposed to their amplitude and threshold, the direction of electrically evoked saccades is unaffected by the state of fixation. The state of attentive fixation, but not the visual fixation target itself, is the responsible factor for these effects. These results suggest that there is a difference between the state of active fixation and the state of having the eye still in the orbit without active fixation. The oculomotor system in the latter case is relatively more susceptible to signals from the cerebral cortex. PMID- 3956615 TI - Pre-and postsynaptic actions of baclofen: blockade of the late synaptically evoked hyperpolarization of CA1 hippocampal neurones. AB - Using intracellular recording techniques, the effects of beta-p-chlorophenyl-GABA (baclofen) on passive membrane properties and postsynaptic potentials of CA1 pyramidal neurones were investigated. In experiments where only the hyperpolarizing action of baclofen was precluded by conventional current clamp techniques, 20 microM ( +/- ) baclofen blocked the early GABA-mediated IPSP and also a late hyperpolarization which, since it could be evoked by orthodromic stimulation subthreshold for spike firing, would not be expected to be produced by a Ca2+-activated increase in potassium conductance (AHP), but to be a transmitter-mediated event. In addition the conductance increase associated with this late IPSP evoked by subthreshold stimulation and also that associated with the AHP produced by spike activation were abolished. Baclofen also appeared to increase the duration of EPSPs, an event possibly related to loss of IPSPs. The hyperpolarization produced by baclofen was associated with an increased conductance of the resting membrane, an event possibly associated with an elevated potassium flux. To preclude this postsynaptic effect as a cause of reduced synaptic responses, tetraethylammonium chloride (TEA), a compound which decreases conductance and depolarizes the membrane of CA1 pyramidal neurones by a reduction of a 'leak' or resting potassium conductance (gK), was added to the bathing medium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956617 TI - Pattern of pyramidal tract collateralization to medial thalamus, lateral hypothalamus and red nucleus in the cat. AB - Stimulating electrodes were placed in the red nucleus, lateral hypothalamus and medial thalamus in order to determine whether pyramidal tract (PT) neurons send collaterals to those sites. The red nucleus projections are well-known, but it was discovered that PT neurons also project into the other two sites. All of the fibers that sent collaterals to all three sites originated from fast PT neurons. Those that responded to stimulation of the skin and that sent collaterals to two or three sites were predominantly fast PT neurons. Those neurons that responded only to cerebral peduncle stimulation were predominantly slowly-conducting, when compared with the set of PT neurons in response to cerebral peduncle stimulation. The patterns of collateral branching to red nucleus and to lateral hypothalamus were similar, suggesting a similar synaptic effect of the pyramidal system in the two sites. Measurement of the speed of conduction from three sites along the length of corticospinal fibers revealed large changes on some, but not all, fibers; there was no evident pattern to these changes that might be associated with collateral branching. A new hypothesis concerning the functional role of fast PT neurons in regulating movement is presented. PMID- 3956618 TI - Enhancement of cerebellar Purkinje cell complex discharge activity by microiontophoretic serotonin. AB - The major finding of the present study is that iontophoretically applied serotonin increased markedly (average 94.0%) the number of complex discharges within the majority (74%) of cerebellar Purkinje cells tested. Twenty-five percent of the cells showed an average 23% decrease in complex discharges, whereas 1% of the cells failed to respond. The effects of serotonin on complex activity were not related to any single effect of this amine on simple spike activity. It was apparent that the actions of serotonin on complex discharge activity were correlated with the initial simple-spike firing rate of the Purkinje cell and the predrug number of complex discharges. The other component of the complex discharge pattern analyzed in this study was the mean post-complex discharge interval (MPCI). Purkinje cells evincing lower MPCI values were those in which serotonin increased the MPCI value preferentially, whereas cells in which serotonin depressed MPCI values exhibited higher predrug MPCI values. The serotonin antagonists methysergide and metergoline antagonized serotonin-induced enhancements in the numbers of complex discharges, whereas ketanserin failed to alter the response, suggesting a degree of receptor specificity. Comparisons between the present study and our previous work identifying a rate-dependent component to the actions of serotonin on simple spike activity are described. PMID- 3956620 TI - Non monotonic morphometric changes produced at mouse neuromuscular junctions following in vivo stimulation at various frequencies. AB - Morphometric changes have been studied at the mouse neuromuscular junction (NMJ) as a function of the frequency of stimulation. In vivo stimulation was made at either 10, 25, 50 or 100 Hz. No significant change in the area of NMJ profiles is observed after stimulation. This indicates that stimulation does not change the volume of the nerve terminal. There is also no change of the volume density of mitochondria. However, there are significant reductions of the numerical density on area (NA, number/micron2) of the clear vesicles following stimulation at 25, 50 or 100 Hz. The NA of clear vesicles is not further reduced following stimulation at 50 or 100 Hz than after the stimulation at 25 Hz. The numerical density on area of the coated vesicles was significantly increased following the stimulation at 25 Hz and 100 Hz. It is not increased more following stimulation at 50 Hz or 100 Hz than following stimulation at 25 Hz. One possible interpretation of the clear vesicle and the coated vesicle results is that less vesicles are liberated per sec by the NMJ with stimulation at 50 and 100 Hz than at 25 Hz because the action potential may fail to invade some terminal arborizations. The total surface density (i.e. surface of membrane in micron2 per micron3 of nerve terminal) of the clear vesicles, the coated vesicles, the vacuoles and the presynaptic plasma membrane is not changed significantly following stimulation at any frequency. This indicates that there is no net loss of membrane at any of the frequencies investigated. PMID- 3956619 TI - An electrophysiological investigation of propriospinal inspiratory neurons in the upper cervical cord of the cat. AB - This study was performed in order to describe the location, axonal projection and possible synaptic action of the inspiratory neurons recently described in the upper cervical cord. In 26 cats anaesthetized with Nembutal, extracellular recordings were made from 224 cervical inspiratory units which were found near the lateral border of lamina VII and formed a column extending from the caudal end of the nucleus retroambigualis at the C1 segment to the rostral half of the C3 segment. Most of the units (approximately 85%) could be excited antidromically from the thoracic cord. Antidromic mapping showed collateral branches to the C5 segment in the vicinity of the phrenic nucleus, occasionally crossing the midline. No synaptic connections with phrenic motoneurones could be revealed either by cross-correlation of the activity of the cervical units with the discharge of C5 phrenic root, or by spike-triggered averaging (STA) of the post synaptic noise recorded intracellularly from phrenic motoneurons. Extensive branching was found in the examined T3-T5 segments with arborizations near the ipsilateral intercostal motor nuclei and often extending across the midline. Cross-correlation experiments did not show clear monosynaptic connections to the inspiratory intercostal motoneurons. Intracellular recording from intercostal motoneurons and STA resulted in a few (2 out of 37) small, probably disynaptic, e.p.s.p.s. It is concluded that the upper cervical neurons are involved in the control of phrenic and intercostal motoneurons, probably through a disynaptic pathway involving segmental interneurons. PMID- 3956622 TI - Cortifugal influences on dorsal column nuclei: an electrophysiological study in the rat using the cortical spreading depression technique. AB - The sign and duration of corticofugal effects on the extracellularly recorded spontaneous activity of cuneate and gracile neurons were examined by means of the cortical spreading depression technique (CSD). Among the 40 units studied 22 showed changes in their spontaneous firing rate during the passage of a CSD. Changes were of either short (5-20 s) or long (greater than 20-140 s) duration. Increases and decreases in activity, as well as sequences of both types of alteration were observed. Short duration changes were more frequent and much more pronounced than those of long duration. From their time course and intensity the short duration effects seem to be related to the brief high frequency cortical neuron discharge that precedes the cortical silence due to CSD, whereas the long lasting effects seem related to the cortical block. It is concluded that the most important corticofugal effects on gracile and cuneate neurons are phasic in nature and the sensorimotor cortical regions were found to be responsible for these influences. PMID- 3956621 TI - Pyramidal input to the basal ganglia in the cat. AB - In cats with mesencephalic decerebration sparing the cerebral peduncles and ablation of sensorimotor cortex, changes in firing of single neurons of caudate nucleus (CD), putamen (PU), globus pallidus (GP) and entopeduncular necleus (EN) were studied following stimulation of the ipsilateral medullary pyramidal tract (MPT). Cells in CD and PU were not extensively influenced by impulses backfired from MPT (14.7% and 18.7%, respectively). Conversely, a larger number of GP cells (28.1%) and especially EN cells (46.9%) exhibited pronounced changes in their firing following MPT stimulation. The MPT-induced effects on CD and PU were either inhibition or excitations, the latter appearing at latencies greater than 11 ms. The responses observed in GP and EN cells were most frequently excitations, some of which appeared with latencies below 5 ms. PMID- 3956623 TI - Abolition of CA1 population spike by sensory stimulation. AB - The effect of sensory stimulation, such as stroking of the animals' fur, on activation of the hippocampal CA1 field was studied in paralyzed and locally anaesthetized rats. CA1 population responses evoked either monosynaptically (ipsilateral CA3 stimulation) or trisynaptically (perforant pathway stimulation) decreased markedly when sensory stimulation was applied, and CA1 population spikes were absent during most periods of sensory stimulation. These results demonstrate the strong modulatory role of sensory inputs on hippocampal circuits. PMID- 3956625 TI - How is the normal locomotor program modified to produce backward walking? AB - The modifications occurring in the movement and muscle activity patterns of the leg when changing from forward to backward walking were studied in five healthy subjects during walking on a motor driven treadmill. Movements were recorded with a Selspot optoelectronic system and muscle activity with electromyography using surface electrodes. The movement trajectories of the leg in forward and backward walking essentially mirrored each other, even though the movements occurred in the reversed direction. The angular displacements at the hip, knee and ankle joints showed similar overall magnitude and pattern in the two situations. Most of the investigated muscles changed their pattern of activity in relation to the different movement phases. At the ankle, there was a switch between flexors and extensors with flexor activation during support in backward walking. The bursts of activity in knee extensors were prolonged and shifted to the main part of the support phase. In the hip extensors, the activity periods retained their positions relative to the leg movements, but changed function due to the reversed direction of movement. Thus, drastic changes occur in the normal locomotor program to produce a reversal of leg movements and propulsion backwards. PMID- 3956624 TI - Parietal cortical neurons responding to rotary movement of visual stimulus in space. AB - We found in the posterior parietal association cortex (area 7a) of alert monkeys a group of neurons that were specifically sensitive to the rotation of a visual stimulus (N = 21). They responded to rotation of a stimulus in a particular direction much better than to the linear movement in any direction, regardless of shape or orientation of the stimulus. Responses were relatively independent of stimulus position within relatively large receptive fields. The majority of these neurons (N = 13) responded to rotation in depth either in the saggital, horizontal or diagonal plane rather than in the frontoparallel plane. These neurons were localized in a small region on the anterior bank of the superior temporal sulcus and may be related directly to the perception of rotation of visual objects in space. PMID- 3956626 TI - Binocular summation in normal, monocularly deprived, and strabismic cats: visual evoked potentials. AB - We have studied visual evoked potentials (VEP) in the cat using dichoptically presented sinusoidal gratings. Our goals were to determine if binocular disparity causes differential responses in the VEP, and to examine the effects of monocular deprivation and convergent or divergent strabismus on the degree of binocular summation. Binocular disparity in stimuli causes no regular alterations of visual evoked responses, except at very low spatial frequencies. However, this apparent selectivity is probably due to luminance modulation in the central retina at low frequencies. The insensitivity to binocular disparity establishes that binocular summation in the VEP may be estimated without regard to the relative phase of gratings presented to the two eyes. Binocular summation of the VEP was examined in normal animals. We found that the ratio of the binocularly evoked response to the largest monocular response (averaged across spatial frequency) ranged from 1.27 to 2.12 (4 animals) and had a mean of 1.48. These values fall within the range which has been reported for human subjects. The degree of summation might be expected to be greatly reduced in strabismic and monocularly deprived animals, in which the majority of the cells are functionally monocular. While summation was found to be reduced in 5 esotropic (convergent) animals (range = 1.13-1.24; mean = 1.18) it was approximately normal in three exotropic (divergent) animals (range = 1.29-2.12; mean = 1.61). However, single unit recordings carried out on the same animals show similar reductions of cells that can be driven through either eye for both groups of animals. Recordings from three monocularly deprived animals, on the other hand, show evidence of binocular interaction in the form of suppression. In this case, response amplitudes obtained using binocular stimulation were consistently and substantially smaller than those obtained from the normal eye alone (range = 0.76-0.85; mean = 0.80). We conclude that convergent and divergent strabismus differ substantially in the degree to which binocular summation is exhibited in the VEP, which in the latter condition, is indistinguishable from the normal cat. Monocular deprivation causes an effect which is markedly different from either form of strabismus in that the deprived eye suppresses the response of the normal eye. PMID- 3956627 TI - Localized responses in the midsuprasylvian gyrus of the cat following stimulation of the central lateral nucleus in thalamus. AB - Evoked responses were mapped in the cerebral cortex following low intensity electrical stimulation in serial penetrations of the medial and intralaminar nuclei of the thalamus of the cat. A projection was found from one of the intralaminar nuclei, the central lateral nucleus (CL) to the midsuprasylvian gyrus, mainly areas 5 and 7. The projection is suggested to be direct, since the evoked responses had a short latency initial positivity. The most characteristic type of response consisted of this early positivity followed by two successive negativities. The earlier, so called first negativity followed high frequency stimulation and was recorded in a smaller area of the cortex than the later, so called second negativity. The first negativity is suggested to depend on monosynaptic depolarization and activation of cortical cells. The second negativity failed at frequencies higher than 10 Hz and was strongly depressed by the administration of barbiturates; it is suggested to depend on polysynaptic depolarization and cellular activity. In electrode penetrations of the cortex both negativities reversed at the border between cortical layers II and III, indicating a superficial termination of thalamic afferents in the cortex. The cortical evoked response to CL stimulation was facilitated by light mechanical and low intensity electrical stimulation of the periphery, as well as by electrical stimulation of the tooth pulp. The possible significance and function of this projection is discussed in relation to arousal, attention and pain. PMID- 3956628 TI - Subcortical afferent and efferent connections of the superior colliculus in the rat and comparisons between albino and pigmented strains. AB - Subcortical connections of the superior colliculus were investigated in albino and pigmented rats using retrograde and anterograde tracing with horseradish peroxidase (HRP), following unilateral injection of HRP into the superior colliculus. Afferents project bilaterally from the parabigeminal nuclei, the nucleus of the optic tract, the posterior pretectal region, the dorsal part of the lateral posterior-pulvinar complex and the ventral nucleus of the lateral lemniscus; and ipsilaterally from the substantia nigra pars reticulata, the pars lateralis of the ventral lateral geniculate nucleus, the intergeniculate leaflet, the zona incerta, the olivary pretectal nucleus, the nucleus of the posterior commissure, the lateral thalamus, Forel's field H2, and the ventromedial hypothalamus. Collicular efferents terminate ipsilaterally in the anterior, posterior and olivary pretectal nuclei, the nuclei of the optic tract and posterior commissure, the ventrolateral part of the dorsal lateral geniculate nucleus, the pars lateralis of the ventral lateral geniculate nucleus, the intergeniculate leaflet, and the zona incerta; and bilaterally in the parabigeminal nuclei and lateral posterior-pulvinar complex (chiefly its dorsal part). The general topographical patterns of some of the afferent and efferent projections were also determined: the caudal and rostral parts of the parabigeminal nucleus project to the caudal and rostral regions, respectively, of the superior colliculus; caudal superior colliculus projects to the most lateral, and lateral superior colliculus to the most caudal part of the terminal field in the dorsal lateral geniculate nucleus; caudolateral superior colliculus projects to the caudal ventrolateral part of the ventral lateral geniculate nucleus, while rostromedial parts of the colliculus project more rostrally and dorsomedially. Following comparable injections in pigmented and albino animals, fewer retrogradely labelled cells were found in subcortical structures in the albino than in the pigmented rats. The difference was most marked in nuclei contralateral to the injected colliculus. Thus, the effects of albinism on the nervous system may be more widespread than previously thought. PMID- 3956629 TI - Factors influencing the temporal phase of response to bar and grating stimuli for simple cells in the cat striate cortex. AB - We have characterized the speed of response of simple cells in cat striate cortex by the temporal phase of the response to bar and grating stimuli. Stimulation of the most responsive subregion (either ON or OFF) in the receptive field with a 1 Hz temporally modulated bar elicited responses whose phase led the excitatory phase of the stimulus by about 25 degrees. The response to stationary gratings whose contrast was sinusoidally modulated at 2 Hz also showed a phase lead. The differences in the phase of response of ON and OFF sub-regions exhibited a marked scatter about the expected value of 180 degrees. The phase of response to both temporally modulated bars and laterally moving gratings advanced by 20-35 degrees as the stimulus contrast was raised by a factor of 5. PMID- 3956630 TI - Postural responses in the cat to unexpected rotations of the supporting surface: evidence for a centrally generated synergic organization. AB - Postural reactions to disruptions of stance are rapid and automatic in both quadrupeds and bipeds. Current evidence suggests that these postural responses are generated by the central nervous system as patterns involving muscle synergies. This study attempted to test this hypothesis of a centrally generated postural mechanism by determining whether the same postural response could be evoked in the freely-standing cat under two different biomechanical conditions. The present work is an extension of previous experiments in which the stance of cats was perturbed by a horizontal translation of the supporting surface in the anterior and posterior directions (Rushmer et al. 1983). We now tested whether simple rotation of the metacarpo- and metatarsophalangeal (M-P) joints that mimics the digit rotation occurring during platform translation, was sufficient to evoke the translation postural response. The rotational perturbations were biomechanically different from translations in that the rotation did not cause displacement of the centre of mass of the animal, nor did it result in any significant movement about any but the M-P joints. Even so, rotational perturbations did evoke the appropriate translational muscle synergies in all four animals. Both plantar flexion rotation and headward translation activated the posterior hindlimb synergy (which included gluteus medius, semitendinosus and lateral gastrocnemius). Similarly, dorsiflexion rotation and tailward translation both activated the same anterior hindlimb synergy (iliopsoas, vastus lateralis and tibialis anterior) together with the forelimb synergy The postural responses elicited by rotational perturbations were biomechanically inappropriate, and caused the animal to displace its own centre of mass away from the stable, control position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956631 TI - Differential effects of stimulation of the cat's red nucleus on lumbar alpha motoneurones and their Renshaw cells. AB - The red nucleus region was stereotaxically stimulated with short trains of high frequency alternating current pulses in anaesthetized cats. The effects were studied, in contralateral lumbar segments, on the responses of microrecorded individual Renshaw cells (RCs) to antidromic or orthodromic test shocks of ventral root or muscle nerve fibres. Monosynaptic reflexes (MRs) of their motoneurone pools were recorded from one of the cut lumbar ventral roots. Averages of 10-20 replicate test responses of the RC (converted into instantaneous frequency curves, IFCs) and of the MR shapes were computed and graphically displayed. 2. Orthodromic (afferent) test shocks induced simultaneously MRs as well as responses of a RC belonging to the same motor pool. From their paired records at systematically varied shock strengths, whole "linkage characteristics" of the relation between the two events could be obtained, representing the functional linkage from the motoraxon collaterals to the RC under study. The overall result of rubral conditioning was a change in the course of the characteristic, which indicated a reduction of this linkage (= relative inhibition of the RC against its recurrent input). 3. Sequential trials with test shocks of constant, submaximal strength were performed with 45 individual RCs. The clearest results were obtained with RC responses to antidromic ventral root shocks: 65% of the RCs were partially inhibited by rubral conditioning. Interposed minor facilitory subcomponents could be seen in the course of inhibited IFCs. Mixed sequences of manifest inhibitory/facilitory effects were observed in 11%; reversed sequences (facilitory/inhibitory) did not occur. A pure but weak facilitation was found in only one case, paralleled by an increase of the MR. RCs belonging to either extensor or flexor motor pools were affected about equally. A little over 20% of the tested RCs remained uninfluenced by rubral stimulation. 4. The MRs, induced by constant, submaximal, orthodromic test shocks, were usually enhanced with only few exceptions, by rubral stimulation. The effects on the orthodromic RC responses were mainly inhibitory, but could be more or less masked by the concurrent increase of the MR, providing a stronger recurrent input to the RC. Such inhibition could be uncovered, however, by observing the above described linkage change. 5. Variation of several parameters of rubral conditioning (train duration, timing of train with respect to test shock, strength of train) modified the inhibitory effects on antidromic RC responses to a certain extent without changing their principal character.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3956632 TI - Cholinergic and non-cholinergic projections from the canine pontomesencephalic tegmentum (Ch5 area) to the caudal intralaminar thalamic nuclei. AB - The distribution and morphology of cholinergic and non-cholinergic neurons projecting to the caudal intralaminar thalamic nuclei from the Ch5 area in the dog were examined using a technique combining horseradish peroxidase (HRP) retrograde labeling with choline acetyltransferase (ChAT) immunocytochemistry. After processing for ChAT, cholinergic neurons were found primarily within the nucleus tegmenti pedunculopontinus (PPN) and the central tegmental tract (ctt). ChAT positive neurons were also located in the nucleus cuneiformis and among the fibers of the lateral lemniscus and medial longitudinal fasciculus. On the basis of immunocytochemical and cytoarchitectonic data, PPN was divided into two distinct cell groups - a compact cell group located dorsolateral to the brachium conjunctivum and a diffuse cell group intermingled among the fibers of the brachium conjunctivum. Tissue processed for WGA-HRP and ChAT following injections of lectin-conjugated horseradish peroxidase into either the centrum medianum (CM) or parafascicular (Pf) nucleus resulted in double labeled cholinergic projection neurons in both PPN and ctt. Injections which involved CM and the caudal part of the central lateral thalamic nucleus (CL) resulted in more retrogradely labeled neurons than did those injections involving Pf. Injections of CM and CL also resulted in more double labeled cells in the dorsolateral compact portion of PPN than did injections confined to Pf. In all cases a small number of cholinergic neurons located in the contralateral PPN were retrogradely labeled as well. A substantial number of retrogradely labeled neurons were not ChAT positive, and in some cases, comprised up to 27% of the total population of projection neurons. Measurements of cell soma areas indicated that cells comprising the general cholinergic population were mostly medium (300-600 micrograms2) or large (greater than 600 micrograms2) in size. The majority of cholinergic projection neurons fell within the medium size category while the noncholinergic projection neurons were significantly smaller than their cholinergic counterparts. The results of this study suggest that in the dog, Ch5 cholinergic neurons which project to the caudal intralaminar thalamic nuclei are medium in size and are located primarily within PPN and ctt. In addition, a parallel projection to the caudal intralaminar nuclei exists which originates from smaller, non-cholinergic neurons in these same regions. Based on the results of this study, it appears that cholinergic projections to intralaminar thalamic nuclei which in turn project to the neostriatum may be one of the pathways over which PPN can affect basal ganglia activity. PMID- 3956633 TI - Relative activation of two human elbow flexors under isometric conditions: a cautionary note concerning flexor equivalence. AB - We examined the electromyographic (EMG) activity of two human elbow-flexor muscles, biceps brachii and brachioradialis, during isometric contractions. The task required subjects to match the EMG level of one of the muscles (the control muscle) to one of four target levels (5, 10, 15, or 20% of maximum) at various elbow angles. A new technique was developed for the target-matching task. The activity of the other muscle (the test muscle) was simultaneously recorded during the task. For the notion of flexor equivalence to be supported, the EMG levels for the two muscles should have covaried. This was not the case. The results revealed three features: (1) while the control-muscle EMG remained constant across joint angles, the test-muscle EMG varied with joint angle, and the trend of this variation differed among subjects; (2) in nine out of ten subjects the trend of test-muscle EMG variation with joint angle was reversed when the other muscle served as the test muscle; and (3) the test-muscle EMG associated with the four target levels was subject-, muscle-, and angle-dependent. These results caution against the generalization of the flexor equivalent concept to isometric conditions. In particular, the activity of one muscle is not a reliable indicator of the activity of other muscles subserving the same joint action. PMID- 3956634 TI - A note on the projection from the rostral thalamus to the visual hyperstriatum of the chicken (Gallus gallus). AB - The rostral thalamo-hyperstriatal projection in young chicks was examined following large injections of wheat germ agglutin labelled with horseradish peroxidase (HRP-WGA) into the hyperstriatum. Retrograde labelling of thalamic neurons was present in the dorsolateral thalamus, rostrolateral part (DLAlr) and dorsolateral thalamus, lateral part (DLL). There was no evidence of a contralateral projection from the lateral anterior thalamic nucleus (LA) to the posterior aspect of the visual hyperstriatum as reported recently by Boxer and Stanford (1985). Furthermore, a comparison of labelled neurons in the contralateral rostral thalamus following injections into either the left or right hyperstriatum revealed no difference in the number of neurons. The study could therefore not confirm the presence of an asymmetrical LA-hyperstriatal projection, as reported by the above authors. PMID- 3956635 TI - Reciprocal inhibition during agonist and antagonist contraction. AB - Reciprocal inhibition of soleus motoneurones in man was studied during voluntary contraction of soleus or its antagonist. Inhibition was strongest during antagonist contraction or at rest and weak during contraction of soleus itself. Possible explanations for these changes are discussed. PMID- 3956637 TI - Cerebral cortical somatosensory evoked responses, multiple unit activity and current source-densities: their interrelationships and significance to somatic sensation as revealed by stimulation of the awake monkey's hand. AB - In awake monkeys, electrical pulse stimuli which mimic touch stimulation were delivered to the thenar eminence while electrophysiologic recordings were made from surface to depth in postcentral gyrus. Cortical depth profiles of somatosensory evoked responses (SEPs), multiple unit activity (MUA) and current source-densities (CSDs) were analyzed to gain insight into the neural process underlying the SEP and somatic sensation. The following was found: The thenar stimulus evoked four main SEP components which were seen over wide regions of postcentral gyrus: P1 at 12 ms, the primary evoked response; P1a, near 20 ms; N1, near 50 ms; and P2, around 120 ms after the stimulus. MUA was observed during the P1, P1a and N1 temporal intervals whose vigor changed as a function of the respective SEP component's amplitude. CSD analysis showed that during P1 a current sink and source appeared within the middle and superficial cortical layers, respectively. During P1a, a sink just above that of P1 and a superficial source became evident. During N1, a large superficial sink and one or two deep sources appeared. Evoked MUA during P1 and P1a was most prominent at the level of their current sinks while MUA during N1 appeared at the level of the current sources, in general. When stimulation was moved from the thenar portion of the hand to a region which most closely matched the receptive field of the cortical recording site, P1 and P1a increased amplitude while N1 both increased in amplitude and decreased in peak latency. Also, MUA activity during the early temporal intervals become more vigorous. These changes were similar to those observed with thenar stimuli as the recording site approached the thenar cortical representation. Over repeated trials at a single stimulus intensity, the spontaneous changes in SEP amplitude were found to be directly correlated with MUA and CSD measures within the same temporal interval. In contrast, SEP, MUA or CSD measures within the early temporal intervals (i.e., P1 or P1a) were uncorrelated or less frequently, inversely correlated with the same measures in the late temporal interval (i.e. N1). The multiple measures complemented one another which led to a descriptive model of the neural process underlying the evoked cortical response in postcentral gyrus of awake monkey. PMID- 3956636 TI - The nucleus reticularis tegmenti pontis and the adjacent rostral paramedian reticular formation: differential projections to the cerebellum and the caudal brain stem. AB - The projection of the nucleus reticularis tegmenti pontis and the adjacent tegmental area, to the caudal brain stem and the cerebellum were investigated by means of anterograde transport of tritiated leucine. The nucleus reticularis tegmenti pontis was found to be exclusively connected with the cerebellum. Mossy fiber terminals were absent only from lobule X and most abundant in lobule VII and the hemispheres with a slight contralateral predominance. The paramedian pontine reticular formation projects with bilateral symmetry to the cerebellar lobules VI, VII and the crura I and II, and heavily to the medial aspect of predominantly the ipsilateral reticular formation in the lower brain stem including specific targets as the nucleus reticularis paramedianus, the nucleus prepositus hypoglossi, the nucleus intercalatus, the nucleus of Roller, the nucleus supragenualis and the dorsal cap of the inferior olive. The nucleus vestibularis medialis receives a very weak projection. The connections are discussed in the light of their possible involvement in pathways for the execution of voluntary and reflex eye movements. PMID- 3956639 TI - The projection of different retinal ganglion cell classes to the dorsal lateral geniculate nucleus in the hooded rat. AB - The morphology of retinal ganglion cells which project to different parts of the dorsal lateral geniculate nucleus (DLG) in the hooded rat has been investigated. Small amounts of a retrograde tracer (horseradish peroxidase) were injected into the DLG, then labelled retinal ganglion cells were examined in retinal wholemounts. After injections into different parts of the DLG, differences were noted in the size, morphology and retinal distribution of labelled retinal ganglion cells. Specifically, after injections into the antero-ventral part of the DLG labelled retinal ganglion cells were spread sparsely across the retina, had large cell somas, and many were identified with Class I or Class III morphology. After injections into the postero-dorsal part of the DLG, labelled cells were more densely packed, had smaller somas, and more were identified with Class IIa and Class III morphology. The density of labelled cells was estimated to be no more than 37% of the total retinal ganglion cell density at any retinal position examined. These results show that in the rat, as in other species such as the cat or monkey, the terminals of different classes of retinal ganglion cells are segregated within different subdivisions of the DLG. However, unlike these other species, only a minority of the total retinal ganglion cell population projects to the DLG. PMID- 3956638 TI - Development of the spinal tract of the trigeminal nerve and its relation to early fetal behavior in rats under normal and hypothyroid conditions. AB - The effects of hypothyroidism on the development of the spinal tract of V and its relation to early fetal behavior were studied in rats from day 16 through day 20 of gestation. Hypothyroidism was induced by the administration of 0.5% Propylthiouracil mixed with rat diet beginning from day seven through term. The thyroid glands of treated and untreated control fetuses of the same age groups were examined in histologic sections. The position, size, and caudal extent of the ophthalmic and maxillomandibular divisions of the spinal tract of V were analyzed in detail with the aid of graphic reconstructions from serial sections of representative cases of both control and experimental fetuses. The ophthalmic and maxillomandibular divisions of the spinal tract of V at 15 days in the control group of fetuses extended into the second and fourth cervical spinal segments respectively, while by 19 days, both divisions of the spinal tract of V extended as far as the fourth cervical segment. In the treated group of fetuses, the ophthalmic and maxillomandibular divisions were greatly reduced in area as well as in their caudal extent into upper cervical levels compared to control groups at corresponding stages of development. At the behavioral level, the frequency of individual movements of the head, forelimbs and mouth in the treated group of fetuses was significantly reduced compared with control fetuses of the same age. Combination types of movements of head, mouth and forelimbs were severely affected both quantitatively and qualitatively in the treated group from day 18 of gestation age. It could be demonstrated that the caudal extent of the spinal tract of V corresponded very closely to the behavior repertoire seen in the fetuses of that age. We propose (1) that the spinal tract of V, in its relation with the upper cervical spinal cord levels which contain motor neurons of the spinal accessory nucleus and motor neurons which innervate the dorsal neck muscles, could play a decisive role in the integration of head and shoulder movements in early stages of development, and (2) that thyroid hormone may play a crucial role in the normal development of the spinal tract of V which is manifest in its caudal growth into upper cervical levels of the spinal cord. PMID- 3956641 TI - Effects of temperature and elevated intracranial pressure on peripheral and brain stem auditory responses in dogs. AB - Far-field recordings of central (P2 through P4) and peripheral (cochlear microphonic; and compound action potential of the eighth nerve) auditory responses were used to assess changes in auditory function resulting from elevated intracranial pressure. Normative data for eight dogs were obtained. The relationship between response latency and core temperature was examined. A mean slope of -0.17 ms/degrees C resulted for the temperature range of 35.0 to 40.0 degrees C. Systemic arterial pressure was measured in order to identify the cerebral ischemic response. Responses were not altered significantly unless the intracranial pressure approached within 15 to 30 mm Hg of mean systemic arterial pressure. Changes in the response consisted of both enhancement and deterioration during intracranial pressure elevation and were accompanied by increases in systemic arterial pressure during that elevation. Supernormal amplitudes of the action potential also occurred during recovery periods. Results suggest that: (i) during elevated intracranial pressure, changes in both central and peripheral auditory function result from ischemia rather than pressure-induced distortion of the cochlea or central neural assemblies. (ii) Far-field auditory responses may include an O2-dependent cochlear microphonic. (iii) An unknown process causing enhancement of central and peripheral neural responses exists and operates in connection with intracranial hypertension. Possible mechanisms underlying enhancement of response components are discussed. PMID- 3956640 TI - Judgment and control of velocity in rapid voluntary movements. AB - Control of velocity in rapid flexion movements of the interphalangeal joint of the thumb was investigated by examining movement trajectories and patterns of activity in the extensor pollicis longus (EPL) and flexor pollicis longus (FPL) muscles. Although velocity was controlled with considerable accuracy, it was not sensed with the same precision. Consistent errors were made when subjects attempted to match the peak velocities under conditions in which the relationship between muscle activity and joint acceleration had been altered, i.e. changing the angle from which movement was initiated or varying the load. Rather than relying on afferent feedback from peripheral sensory receptors for information about velocity during rapid movements, it is suggested that subjects were more likely to base their judgment of velocity on sensations evoked by the voluntary motor command. PMID- 3956642 TI - Evidence implicating dentate granule cells in wet dog shakes produced by kindling stimulations of entorhinal cortex. AB - We studied the occurrence of wet dog shakes during the evolution of kindling induced by electrical stimulation of the lateral entorhinal cortex. Wet dog shakes occur with high incidence, particularly early in development of kindling. We also demonstrated that microinjection of colchicine into the hippocampus, but not into neocortex, produced a 95% suppression of wet dog shakes. We propose that the suppressive effect of colchicine is mediated by destruction of dentate granule cells. Together with evidence from other investigations, these data support the idea that activation of hippocampal neurons is essential for production of wet dog shakes induced by stimulation of the limbic system. PMID- 3956643 TI - Hippocampal output to the subicular cortex: an electrophysiological study. AB - The hippocampal output to the subicular cortex was studied in the guinea pig in experiments of field potential analysis. Perforant path volleys, synaptically elicited by stimulation of the dorsal hippocampal commissure, were used to obtain the activation of pyramidal neurons in the lamellar circuits of the dorsal hippocampus and the consequent activation of pyramidal neurons in the ventral hippocampus. Discharge of the pyramidal neurons was followed by excitatory synaptic effects consisting of neuron depolarization and discharge throughout the ipsilateral subiculum. The laminar site of generation of these effects shifted from the deep to the superficial layers going from the dorsal to the ventral subiculum. All dorsoventral levels of the subiculum were activated by impulses coming from the corresponding hippocampal segments. Field CA3 appeared to be solely responsible for the subiculum activation. The data provide physiologic demonstration of powerful segmentally organized hippocampus-subiculum connections and suggest that the lamellar circuit should be extended to include the subiculum as a further element funneling the hippocampal output. PMID- 3956644 TI - The effect of limb immobilization and stretch on the fine structure of the neuromuscular junction in rat muscle. AB - Limb immobilization of rat plantaris muscle in the stretched position for 3 weeks led to increased postsynaptic areas of junctional folds and clefts per nerve terminals in both type I and type II muscle fibers. In addition, various ultrastructural alterations were evident in both types of end plates. PMID- 3956645 TI - Penicillin epileptogenic focus in the rat: requisites for transcortical reflex triggering. AB - Epileptiform discharges elicited by natural or electrical stimulations, proprioceptive or cutaneous, were studied in the rat with an experimental acute focus induced by penicillin application in the motor area. EEG paroxystic spikes were easily triggered with restricted foci (0.5 to 1 mm2) located in the representation area of the stimulated region. However, despite the large overlap of sensory and motor cortical limb areas in the rat, EEG spikes, either spontaneous or triggered, were followed by muscular jerks only with much larger foci: at least 2 and 4 mm2, respectively, for anterior and posterior limb areas. Cutaneous stimulations were the most efficient in discharge production; however, discharges were triggered indifferently by muscular or cutaneous afferent fibers in about three-fourths of the cases. The temporal relation between EEG spike and myoclonic jerk were very close. A latency analysis (delay between triggered EEG spike and EMG response, parallel latency fluctuation of both phenomena, delay between spontaneous EEG spike and jerk) supported the hypothesis that a transcortical reflex mechanism, rather than a spinal excitability rebound, was involved in the jerk genesis. Iontophoretic ejection of penicillin within layers III-IV resulted in the development of electroclinical paroxysms. However, similar penicillin ejection within layer V, did not allow efferent discharge production. It is concluded that the involvement of a large surface or volume of cortical tissue is required to produce efferent discharges following EEG paroxysms. This observation is likely related to the unexpectedly wide representation of individual muscles at the motor cortical level. PMID- 3956646 TI - Neuronal activity evoked by chronically implanted intracortical microelectrodes. AB - The averaged evoked compound action potentials (AECAPs) were recorded from the ipsilateral pyramidal tract of awake, unrestrained cats before, during, and after continuous electrical stimulation of the cerebral cortex via chronically implanted activated iridium or platinum-30% iridium (Pt30%Ir) microelectrodes. After stimulating 24 h at 20 pulses per second (pps), using charge-balanced, 200 microseconds pulse pairs of 40 to 80 microA (400 to 800 microC/cm2, 8 to 16 nC/phase (ph), 2 to 4 A/cm2), there was a transient elevation of the threshold of the early (direct) and of the alte (transynaptic) components of the AECAP. After cessation of continuous stimulation at 80 microA, the threshold of the early component of the AECAP remained elevated for as long as 24 h and the late component as long as 4 days, indicating significant but reversible depression of the electrical excitability of cortical neurons close to the microelectrodes. In three cats stimulated 23 h/day for 1 week, the AECAP also recovered to their prestimulus threshold. In contrast, pulsing for 24 h at 320 microA (3200 microC/cm2, 64 nC/ph, 16 A/cm2) produced marked elevation of the threshold of the AECAPs which was not reversed by 7 to 12 days after termination of intracortical stimulation. The electrical excitability of neurons adjacent to (unpulsed) microelectrodes 2 mm from the pulsed electrode was not affected. The observations reported here, in conjunction with the histologic results reported in the companion paper, indicate that both the Pt30%Ir and the iridium microelectrodes can be operated safely at currents to at least 80 microA, charge/ph of 16 A/cm2, and a charge density of 800 microC/cm2 X ph. However, on the basis of the electrophysiologic criteria, both types appear to be unsafe when pulsed at 320 microA (64 nC/ph, 3200 microC/cm2 X ph, 16 A/cm2). PMID- 3956647 TI - Histopathologic evaluation of prolonged intracortical electrical stimulation. AB - Chronic stimulating microelectrodes fabricated from platinum-30% iridium (Pt 30%Ir) or activated iridium were implanted in assemblies of three in the left sensorimotor cortex of the cat and pulsed continuously at currents of 10 to 320 microA (100 to 3200 microC/cm2 X ph, 2 to 64 nC/ph) for periods of 24 h or for 23 h/day for 7 days. The microelectrodes had beveled tips with uninsulated geometric surface areas of 20 X 10(-6) cm2. Neuronal activity evoked by the focal stimulation was monitored by recording compound action potentials from the ipsilateral pyramidal tract. By this criterion neuronal activation thresholds were 5 to 15 microA (50 to 150 microC/cm2 X ph, 1 to 3 nC/ph) for both types of electrodes. Histologic evaluations of tissue surrounding the electrode tips were carried out by either light or electron microscopy. No neural damage was induced by 24 or 161 h of pulsing using either type of electrode at currents of 10 to 80 microA. Neural damage attributable to electrical stimulation per se was observed in a few sites pulsed with 320 microA (3200 microC/cm2 X ph, 64 nC/ph, 16 A/cm2) with Pt-30%Ir but not activated iridium electrodes of the same size. Electrode dissolution appears to be best correlated with charge density and current density. Dissolution of the Pt-30%Ir microelectrode tip was observed by scanning electron microscopy at charge densities as low as 200 microC/cm2 X ph (1 A/cm2), whereas erosion of activated iridium microelectrodes occurred only at the highest charge and current densities (3200 microC/cm2 X ph, 16 A/cm2). Thus, the activated iridium electrode is superior to Pt-30%Ir for chronic stimulations, from the standpoint of electrode tip stability, because with the former, in contrast to the alloy, detectable erosion occurred only at an intensity well above that required for activation of nearby neurons. PMID- 3956648 TI - Rat cerebral cortical estrogen receptors: male-female, right-left. AB - We determined the concentration of cytosol estrogen receptors in the postnatal, developing right and left cerebral cortices of Long-Evans male or female rats 2 to 3, 7 to 8, 14 to 15, and 25 to 26 days of age. Under anesthesia, the rats were gonadectomized and 24 h later they were killed by decapitation, and the dorsal right and left cerebral cortices were separated from the underlying white matter and placed on ice. Sephadex LH-20 gel filtration chromatography was used to dissociate the majority of alpha-fetoprotein-bound [3H]estradiol while leaving the receptor [3H]estradiol complex intact. The correction for the residual nonreceptor binding, including alpha-fetoprotein, was made using parallel incubation containing unlabeled diethylstilbesterol. The amount of residual nonreceptor binding was subtracted from [3H]estradiol-bound protein to calculate high-affinity estradiol binding receptors. The results showed that in both sexes, estrogen receptor concentration was highest at postnatal days 2 to 3 in both the right and the left cerebral cortex and then decreased until 25 days of age. In the female, the right cerebral cortex, at postnatal day 2 to 3, had a higher estrogen receptor concentration than the left cortex (P less than 0.02). In the male, the left cortex had a higher cytoplasmic estrogen receptor concentration (P less than 0.02) than the right. Considering the reported growth-inhibiting effects of estrogen on the cerebral cortex, the results indicated that one determinant of cerebral dominance in both sexes may be the differential exposure to estrogen, in the case of the male testosterone converted to estrogen, during a critical period of development. PMID- 3956649 TI - Amygdala-kindled postictal inhibition: effect of intertrial intervals on repeated days. AB - Fully amygdala-kindled rats with stable afterdischarge durations and seizure ranks of five were evaluated with suprathreshold stimulations (400 microA) at variable interstimulus intervals. Subjects were stimulated either once a day or four times a day at one of five interstimulus intervals (5, 15, 30, 60, or 180 min) for 5 days. All subjects were tested under each of the six paradigms. Profound inhibition of seizure rank and afterdischarge duration occurred daily with intertrial stimulation times of 30 min or less. The initial stimulations each day at these intertrial intervals showed no significant residual inhibition from the stimulations of the previous day. The longer intertrial intervals of 60 and 180 min demonstrated little inhibition of elicited seizures on day 1 for trials 2 through 4; however, after the 1st day, increased inhibition was noted for trials 2 through 4 at the 60-min intertrial interval with relatively little inhibition noted for the first trial of each day at this interval. At the longest interval tested (180 min), a significant (P less than or equal to 0.05) reduction in both the seizure rank and afterdischarge duration was noted with the first elicited seizure of days 3 through 5. At the 180-min interval, seizures 2 through 4 on days 3 through 5 tended to increase in length and severity rather than decrease compared with the first seizure of the day. Significant interactions occurred between the length of intertrial interval used with multiple stimulation paradigms and repeated days of testing. The short-term inhibition seen with shorter intertrial interval testing interacted in a complex and poorly understood manner with the longer term inhibition associated with daily grouped stimulations in the amygdala-kindled model of epilepsy. PMID- 3956650 TI - Tooth pulp-evoked jaw-opening reflex in the cat: evidence for central facilitation induced by noxious discharge in the intradental nerve fibers. AB - The tooth pulp-evoked jaw-opening reflex was studied in the barbiturate anesthetized cat. At liminal intensity of the stimulus, a stable short-latency response was obtained in the digastricus and in the tongue. At a higher stimulus intensity, there occasionally appeared to be a prolonged discharge of variable duration in the digastricus, and a second period of activity in the tongue after a silent period. The threshold intensity for these late discharges was supraliminal for the intradental A-fibers and subliminal for intradental C fibers. Noxious conditioning stimulation of a tooth led to a temporary decrease of the threshold for the jaw-opening reflex elicited from a contralateral or adjacent tooth; only conditioning stimulation at an intensity producing a marked arousal reaction was effective in this respect. Infiltration of the tooth apex with epinephrine produced a local elevation of the threshold for the tooth pulp evoked jaw-opening reflex. Distant noxious conditioning stimulation (tail pinch) did not influence the jaw-opening threshold. The results indicated that based on some central mechanisms, conditioning noxious stimulation of a tooth can produce a facilitation of the jaw-opening reflex. PMID- 3956651 TI - Axon and neuron numbers after forelimb amputation in neonatal rats. AB - It seems a paradox that more primary sensory neurons are lost but recovery is better after peripheral nerve injury in neonates as compared to adult mammals. A possible explanation is that surviving neurons sprout in the neonate. To test this, forelimbs in neonatal rats were amputated, which caused the death of many primary sensory neurons. The number of neurons in the dorsal root ganglia, and the number of myelinated and unmyelinated fibers in the dorsal and ventral roots were determined on the amputated and contralateral normal sides. On the amputated side, soma loss in the ganglia was 30%, and the fiber numbers were decreased by 16% in the dorsal root and increased by 20% in the ventral root. These data are compatible with the hypothesis that there is axonal branching or sprouting from surviving sensory neurons. In addition, morphometric analyses showed a changed myelin-axon relationship for central processes of sensory cells whose distal processes have been cut. PMID- 3956652 TI - Sleep deprivation and kindled seizures. AB - Total sleep deprivation in a treadmill, and REM sleep and partial slow-wave sleep deprivation by the platform technique led to reduced seizure threshold in kindled rats. After treadmill deprivation there was also a reduction in seizure duration. Arousing aspects of the sleep deprivation procedures counteracted the sleep deprivation effect. In the treadmill experiment this led to an increase in seizure threshold in the control group. In the platform experiment the reduction in seizure threshold was delayed for 24 h after the deprivation because of these short-acting processes. Seizure thresholds remained low for at least 72 h. PMID- 3956653 TI - Power spectral analysis of electroencephalographic activity in kindled rats. AB - Power spectral analysis of the resting EEG activity of amygdala kindled rats revealed a decrease of power in the 1- to 3-Hz band and an increase in the 4- to 6-Hz band compared with 3-Hz-stimulated and operated control animals. This effect was observed only in the stimulated but not the contralateral amygdala. The alteration in power seen shortly after kindling was still evident after a 1-month stimulation-free period. PMID- 3956654 TI - Respiratory functions of the inferior pharyngeal constrictor and sternohyoid muscles during sleep. AB - We studied the respiratory activity of the inferior pharyngeal constrictor and sternohyoid muscles of the rat during non-rapid eye movement (non-REM) and REM sleep. Each animal carried chronically implanted electrodes for recording the integrated EMG activity of respiratory muscles as well as the electrocorticogram (ECoG) and postural tone (dorsal neck EMG). The latter permitted polygraphic identification of sleep states. Curled up postures enhanced inspiratory activity of both upper airway muscles during non-REM sleep, an effect which CO2 breathing failed to augment except in the well curled up position. Hypoxia reduced their activity. During REM sleep, the inferior pharyngeal constrictor and sternohyoid muscles retained their inspiratory activity. No tonic activity could be detected in either muscle. We conclude that the inferior pharyngeal constrictor and sternohyoid muscles safeguard upper airway patency in the two main sleep states. PMID- 3956655 TI - Composition of the pelvic nerve. AB - Surgical interruption of the pelvic nerve elevated immunoreactive vasoactive intestinal polypeptide in the major pelvic ganglion of the rat. Two changes were noted: (i) varicose and smooth fibers appeared in the neuropil and (ii) a small number of ganglion cells became highly reactive for the polypeptide. A more proximal transection of preganglionic parasympathetic fibers, at their origin from spinal nerves, had no effect on vasoactive intestinal polypeptide immunoreactivity. Ganglion cells were labeled when a dye was applied to the cut distal end of the pelvic nerve. We conclude that a population of vasoactive intestinal polypeptide-containing neurons in the major pelvic ganglion send their axons proximally in the pelvic nerve. PMID- 3956656 TI - Increased motor neuron projection during development does not increase the number of neuromuscular synapses. AB - We investigated in developing embryos whether the total number of neuromuscular synapses is determined by the muscle or by the number of innervating motor neurons. The superior oblique muscle of duck embryos was hyperinnervated by preventing the naturally occurring death of trochlear motor neurons using immunoglobulin G from patients with acquired myasthenia gravis. In spite of a significant increase in the number of motor neurons innervating the muscle, a corresponding increase in the number of neuromuscular synapses did not occur. These results suggest that the total number of synapses in a muscle is independent of the number of innervating motor neurons and that it is determined intrinsically by the muscle itself. PMID- 3956657 TI - Influence of standing on vestibular neuronal activity in awake cats. AB - Single-unit activity of vestibular nuclear neurons was recorded in chronically prepared, awake cats. To examine the influence of tonic activation of limb proprioception on vestibular function, the vestibular modulation by horizontal rotation (0.2 Hz, 17 deg) and head-tilt (0.1 Hz, 7 deg) was recorded in animals with freely hanging limbs and was compared with the modulation in standing cats. Of 29 examined cells responding to horizontal rotation, only about 30% were affected during standing, with most exhibiting a decrease of the mean discharge rate and gain. In contrast, about 70% of the 28 tilt-modulated cells showed pronounced effects during standing with a decrease of the gain and an increase of the mean discharge rate. The increase of the mean discharge rate in tilt cells may be caused by the excitatory spinovestibular afferent fibers or by the efferent vestibular system. For the observed inhibitory effects on the gain different mechanisms may be responsible: cerebellar inhibition and/or efferent vestibular receptor control. This control of labyrinthine information by somatosensory afferent fibers may serve for the stability of equilibrium in the moving animal. PMID- 3956658 TI - Axons regenerated through silicone tube splices. I. Conduction properties. AB - Changes in conduction properties of axons regenerating across a 10-mm gap bridged by a silicone cuff were investigated from compound action potential responses. Compound action potentials were detected as early as 6 weeks after surgery, and were small and slowly conducted at maximum velocities of about 3 m/s. With longer regeneration time, the potentials increased in size, velocity, and complexity. Conduction velocities increased rapidly at first than slowly and asymptotically approached rates that were approximately 40% below normal after 10 months. One component of the compound action potential, the refractory period, decreased from 5 ms to near normal value after only 3 months. The time constant of excitation changed more rapidly, and after 2 months approximated values near those for controls. The properties of axons regenerated across an epineural suture with no gaps. The database for the time course of events established here will be useful in guiding studies using the silicone cuff technique as an in situ experimental chamber for studies of regeneration and remyelination. PMID- 3956660 TI - Effective stimulation distance for current from macroelectrodes. AB - Effective spread of stimulating current from macroelectrodes was measured using antidromic responses of axons of the pyramidal tract as an indicator of excitation. Both monopolar and concentric bipolar electrode configurations were tested with stimulating distances as large as 7mm. The effective stimulation distance was greater from monopolar electrodes especially at greater current strengths, but differences between the two configurations were frequently small and reversals of this trend occurred. There was no statistically significant difference between the estimates of effective stimulation distance made using large and small axons. The shape of current-distance curves was approximately parabolic using both bipolar and monopolar stimulation. A current strength of 0.5 to 1.0 mA will confine effective current from a monopolar electrode to a sphere of 2-mm radius, but will not stimulate all elements within that area. Even in a brain area as homogeneous as the pyramidal tract, there is still a great deal of variability from mean values in effective stimulation distance. Presumably, the variability would be even greater in more heterogeneous regions. PMID- 3956659 TI - Axons regenerated through silicone tube splices. II. Functional morphology. AB - The recovery of axons regenerated through silicone tube splices was studied with electron microscopic and morphometric methods. Regenerated nerves contained both myelinated and unmyelinated axons of near normal morphology. The number and diameter of axons increased with postoperative time, and size-frequency histograms demonstrated that regeneration occurred in all major fiber groups. Remyelination occurred between about 4 and 6 weeks. Some of the smallest regenerated axons had unusually thick myelin sheaths, but overall regenerated axons had a slightly thinner sheath compared with similar-size normal fibers, although the ratio of sheath thickness to axon size was within the normal limits of g = 0.65 to 0.8 by 6 weeks. Axons did not, however, regain their normal size within 10 months of surgery. This deficit was apparently the primary factor limiting conduction velocity in these regenerated axons. PMID- 3956661 TI - Evidence implicating dentate granule cells in development of entorhinal kindling. AB - Kindling is an animal model of epilepsy induced by periodic focal electrical stimulation of the brain. The network of brain structures responsible for this permanent abnormal excitability is unknown. We hypothesized that the hippocampal formation serves a facilitatory role in lateral entorhinal cortex kindling. We therefore investigated the effect of dentate granule cell destruction induced by the neurotoxin, colchicine into entorhinal cortex kindling development. We found that injection of colchicine into the hippocampal formation, but not frontal cortex, resulted in a 31% increase in the number of stimulations required to establish kindling in comparison with vehicle-injected controls. The effect of intrahippocampal colchicine was due to a 95% increase in the number of stimulations required to attain a class 2 seizure. Based on these and other data, we propose that elimination of granule cells reduces activation of CA2/3 neurons, thereby impairing development of entorhinal kindling. PMID- 3956662 TI - Hormonal basis for sexual dimorphism of the sound-producing apparatus of the oyster toadfish. AB - We investigated the endocrine basis for sexual dimorphism of the sound-producing apparatus (swimbladder and attached sonic muscles) in the oyster toadfish Opsanus tau by implanting steroid pellets in gonadectomized females and males. In females, testosterone and dihydrotestosterone caused, respectively, 32.3 and 31.5% increase (P less than 0.0001), and estradiol 17 beta caused 11.3% increase (P less than 0.0104) in swimbladder weight compared with controls. In males, testosterone caused 17.7% (P less than 0.028), dihydrotestosterone 24.0% (P less than 0.0008), and estradiol 10.8% (N.S.) increase from controls. Swimbladder weight gains occurred despite the fact that these fish refused food and did not gain weight. In a final experiment on fed females, testosterone and 11-keto testosterone caused a similar increase (16.6 and 18.9%, respectively) compared with controls. These results indicate that swimbladders in adults of both sexes retain the ability to respond to steroid treatments and suggest that sexual differences in bladder size are controlled without a critical period by hormonal concentrations within the fish. PMID- 3956664 TI - Regional cerebral cortical deficits in the immune-deficient nude mouse: a preliminary study. AB - This report examines the morphology of the cerebral cortex in the nude mouse (nu/nu) compared with the BALB/c(+/+). Our experiments indicated that the thickness of the lateral frontal lobe was significantly reduced (8%; P less than 0.005) in the 4-month-old, female nude mouse compared with a BALB/c mouse of like sex and age. In addition, the left hemisphere was, in general, thinner in the nude than in the BALB/c, with area 18 being significantly thinner (2%; P less than 0.005). Oligodendrocytes were less in area 18 in the nude by 25% (P less than 0.02) in contrast to the BALB/c. In some respects these results extend the work of others. In previously published experiments, we showed that the thickness of the frontal cortex from enriched and impoverished female rats (from 60 to 116 days of age) differed by 2 to 3% (P less than 0.001) and in male rats by 3 to 4% (P less than 0.001). The oligodendrocytes in area 18 in the male differed by 20% (P less than 0.02) in rats exposed to their respective enriched or impoverished environments from 25 to 105 days of age. Thus, we have shown that the frontal cortical morphology as well as the occipital cortical oligodendrocytes were altered in both immune-deficient animals and environmentally stimulated or impoverished animals. Based on these separate sets of data, we will be interested to learn if our environmental conditions can alter the immune system and if so by what mechanism. PMID- 3956663 TI - Proximal and distal changes in collagen content of peripheral nerve that follow transection and crush lesions. AB - Collagen content of rat sciatic nerve was measured 10 weeks after either nerve transection or nerve crush. Nerve transection led to a significant increase in fascicular collagen in nerve segments 2.5 mm proximal and distal to the injury site. Remote from the transection, fascicular collagen was also significantly increased, this effect being most marked distally. Nerve crush by comparison resulted in only a small increase in fascicular collagen, significantly less than after transection. The greater amount of fascicular collagen far distal to the nerve injury could relate to a predominantly caudal endoneurial flow of inflammatory or growth factors. Differences in the amount of fascicular collagen formed after nerve transection compared with nerve crush are clearly due to factors other than axonal degeneration, and may relate to collagen synthesis by denervated Schwann cells or to the severity of the nerve injury. PMID- 3956665 TI - Baroreceptor sensitivity during desynchronized sleep. AB - Sleep is characterized by periods of cortical and subcortical desynchronization similar to that observed during arousal. Because baroreflex control of heart rate is suppressed in the aroused state, the present study compared the cardiac index of baroreflex sensitivity in awake cats with that during desynchronized sleep to determine the level of arousal and its affect on autonomic regulation. Cats were prepared for long-term arterial pressure, cortical, and subcortical EEG and EMG recording. After acclimatization to the laboratory, cats engaged in spontaneous periods of desynchronized sleep. During this period, a bolus of angiotensin II was injected i.v. and the subsequent change in the R-R interval of the cardiac cycle was recorded during the rising phase of the pressor response. These values were compared with values obtained from the same cats during quiet and active wakefulness and those obtained during drug-induced desynchronized sleep with gamma-hydroxybutyrate. The values obtained during naturally occurring desynchronized sleep were comparable to those observed during drug-induced desynchronized sleep. In contrast, the increase in the R-R interval in awake cats, particularly quiet ones, was greater than that seen during desynchronized sleep or during active periods in the awake animal. These data suggest that there is a correlation between the level of arousal, as measured by EEG activity, and the cardiomotor component of baroreflexes. PMID- 3956666 TI - Inhibition and excitation of the nociceptive flexion reflex by conditioning stimulation of a peripheral nerve in the cat. AB - A previous study in our laboratory showed a long-lasting, naloxone-reversible inhibition of the flexion reflex after prolonged repetitive stimulation of a peripheral nerve in the spinal cat. The present study employed a special pattern of conditioning stimulation for a shorter period (200 s) to determine the time course of the inhibition and the afferent fibers responsible for the inhibition. We stimulated the common peroneal nerve in 10 decerebrated and spinalized cats to elicit the flexion reflex, which we recorded as single-unit activity from filaments of the L7 ventral root. The C fiber-evoked late component of the flexion reflex was compared before, during, and after conditioning electrical stimulation applied to the tibial nerve. Stimulating the tibial nerve at an intensity that excited only A alpha beta fibers produced weak inhibition of the flexion reflex; increasing intensity above the threshold for A delta fibers produced much greater inhibition. Inhibition began during the first 10 s of conditioning stimulation and was maximum at about 100 s. Stimulation at a suprathreshold intensity for C fibers, however, produced an initial transient excitation, lasting 10 to 20 s, followed by inhibition. Intravenous injection of naloxone (0.05 mg/kg) produced no observable changes in this inhibition and excitation. These results suggest that conditioning stimulation of a peripheral nerve inhibits the flexion reflex. This inhibition has a short latency; the afferent fibers seem to be A delta fibers. In addition, input from afferent C fibers may trigger a mechanism that produces facilitation of the reflex. The differences in recovery time course and in sensitivity to naloxone suggest that two different mechanisms may be responsible for the fast-onset inhibition and the previously observed long-lasting inhibition produced after prolonged conditioning stimulation. PMID- 3956667 TI - Quinine tolerance during self-stimulation in cats. AB - Thirsty cats, offered a choice between distilled water and quinine solution, preferred the latter to distilled water and accepted quinine concentrations greater than those they accepted in control sessions when drinking quinine solution was rewarded by hypothalamic stimulation, whereas drinking distilled water was not. When the same stimulation rewarded drinking distilled water only, the cats switched to distilled water and refused quinine solutions at concentrations even less than those previously accepted in control sessions. It was concluded that drinking quinine solution was an instrumental response which secured the desirable hypothalamic stimulation. PMID- 3956668 TI - Transplants of purified astrocytes promote behavioral recovery after frontal cortex ablation. AB - Ablation of the medial frontal cortex produces a learning deficit on a reinforced alternation task. Recovery from this deficit was significantly accelerated in rats by transplantation of either cultured purified astrocytes or Gelfoam that had remained the previous 5 days in a brain wound in another animal (wound Gelfoam). Cell-free extracts of wound-Gelfoam did not enhance behavioral recovery. Embryonic frontal cortex was effective only if transplanted with a delay after ablation. It appears from these results that transplants can facilitate functional recovery by more than one mechanism, including promotion of survival and reactive synaptogenesis of host neurons, stabilization of the damaged environment and replacement of lost neurons. In this study, glial cells were capable of facilitating recovery from central nervous system damage to the same extent as neuronal transplants. PMID- 3956669 TI - Corticospinal neurons 25 weeks after right hind limb amputation. AB - Neuronal cell death in embryos and adult animals is seen after removal of target tissue. Transsynaptic cell death has been described in the mammalian visual system and suggested as a possible mechanism for loss of upper motor neurons in amyotrophic lateral sclerosis. We previously demonstrated that amputation of a hind limb decreased the number of motor neurons in the rat spinal cord. Careful counts of corticospinal neurons in these rats 25 weeks after amputation failed to demonstrate any loss of corticospinal neurons. Although amputation caused a loss of ventral horn neurons, no subsequent loss of upper motor neurons was detected at 25 weeks. PMID- 3956670 TI - Effect of cytosine arabinoside on the composition of the nonneuronal cell population in cerebral explants. AB - Rat cortical explants were cultured in the presence or absence of the mitotic inhibitor cytosine arabinoside to determine whether or not it affects the composition of the nonneuronal cell population within the outgrowth zone. Ultrastructural morphometric analysis of the incidence of fibroblasts, fibrous astrocytes, and protoplasmic astrocytes-epithelial cells at 18 days in vitro, revealed statistically significant decreases in the incidence of fibroblasts and fibrous astrocytes in the explants treated with the inhibitor compared with control explants. Coupled with earlier findings of enhanced neurite outgrowth and decreased nonneuronal cell proliferation that follows such treatment, it appears that cytosine arabinoside may potentiate neurite outgrowth by altering the composition, as well as the number, of nonneuronal cells in the outgrowth zone. These data indicate that fibroblasts and fibrous astrocytes may limit the regenerative response of severed axons in the mammalian central nervous system. PMID- 3956671 TI - Septohippocampal neurons after intraventricular AF64A administration in rats: an electrophysiological study. AB - The putative cholinergic neurotoxin, ethylcholine aziridinium ion (AF64A), was injected bilaterally into the cerebral ventricles of male rats. The properties of the medial septum-nucleus of the diagonal band of Broca's area (MS-nDBB) neurons were studied 4 to 6 or 19 to 23 days following injections. The spontaneous activity of those neurons was higher in the injected animals, but their responses to glutamate and cholinergic agonists were not modified. The proportion of orthodromic responses elicited by fimbria-fornix stimulation in MS-nDBB neurons was unchanged. In contrast, the proportion of septohippocampal neurons (SHNs) identified by the antidromic stimulation of the fimbria-fornix was smaller in pretreated animals and their mean antidromic latency was shorter. These results suggest that intracerebroventricular administration of the neurotoxin AF64A is followed by changes in the properties of MS-nDBB neurons and specifically by the disappearance of a subpopulation of SHNs. PMID- 3956673 TI - Spontaneous changes in the morphology of the human short-latency somatosensory evoked response: an interpretation in terms of two superimposed waveform components. AB - Spontaneous changes, with a time scale of hours or sometimes days, in the morphology of the short-latency somatosensory evoked response in comatose head injury patients were analyzed by a computer processing based on the proposition that the early cortical response consists of a superposition of two waveform complexes. These complexes were deduced to have similar triphasic forms, but one of them was delayed. The amplitude fluctuations of this delayed component caused the changes in the morphology of the response. PMID- 3956672 TI - Effects of training on the recovery of full-weight-bearing stepping in the adult spinal cat. AB - The effects of ambulatory training on the extent and time course of recovery of weight-bearing-stepping in cats spinalized (T12-T13) as adults were investigated. One month after spinal cord transection, 14 of 16 cats were capable of bearing the full weight of their hindquarters with their hind limbs during stepping on a motor-driven treadmill if the tail was pinched or crimped. Of those 14 cats 8 were assigned to a trained and 6 to an untrained group. Trained cats were subjected to 30 min/day of treadmill exercise, 5 days/week. Training was initiated 1 month posttransection and continued until 5 to 7 months posttransection. Daily records were kept on the treadmill speeds used, the time at each speed, and the number of steps that were not full weight bearing. The number of full-weight-bearing steps times treadmill speed was used as a measure of performance. The tail was crimped whenever necessary, but was required less and less as training progressed. Performance plateaus were reached between 25 and 85 days after initiating training (mean = 48 +/- 22 days). Maximum treadmill speeds increased in untrained cats from 0.075 +/- 0.042 m/s 1 month posttransection to 0.240 +/- 0.042 m/s 5 to 7 months posttransection and those of trained cats increased from 0.079 +/- 0.045 m/s to 0.619 +/- 0.133 m/s during this same period. We conclude that a much larger proportion of adult spinal cats are capable of full-weight-bearing stepping than reported, and that training which emphasizes early tail crimping and complete weight bearing at all times results in marked improvements in the locomotor capacity of the hind limbs. PMID- 3956674 TI - Anomolous path taken by branch of medial gastrocnemius nerve. AB - An anomolous branch of the cat medial gastrocnemius nerve was found to travel with the combined lateral gastrocnemius and soleus nerves in the popliteal fossa before innervating muscle fibers in the medial gastrocnemius. The innervation pattern was confirmed by EMG recording, elicitation of contraction in the medial gastrocnemius by stimulating the branch, isolation of a single motor unit innervating the medial gastrocnemius whose axon traveled in the branch, and glycogen depletion of medial gastrocnemius muscle fibers by stimulating the branch. Awareness of such anatomic variation is important, for example, in interpreting studies of synaptic connections and of mechanical properties during reinnervation of muscle. PMID- 3956675 TI - Alpha-melanocyte-stimulating hormone stimulates the outgrowth of myelinated nerve fibers after peripheral nerve crush. AB - The effect of alpha-melanocyte-stimulating hormone on peripheral nerve regeneration was studied by monitoring functional recovery and quantifying histologic changes that follow crush lesion of the rat sciatic nerve. The results showed that such treatment of rats with a crushed sciatic nerve resulted in a reduction of the recovery period and in an increase in the number of regenerating nerve fibers. PMID- 3956676 TI - Magnitude of the H reflex of the soleus substantially exceeds the myotatic response from rapid dorsiflexion of the ankle joint. AB - We compared the magnitude of short-latency EMG responses in the soleus after electrical stimulation and after muscle stretch. The peak to peak amplitudes and areas of such stretch-evoked responses, following initial rotation velocities to 200 degrees/s, did not extend beyond the lower part of the H reflex range (evoked electrically). The disparity suggests caution in the use of electrical stimulation of group 1 afferent fibers when a study is to be made of normal human movement. PMID- 3956677 TI - Taenia taeniaeformis: inhibition of metacestode development in the rat by gossypol. AB - The effect of gossypol, a polyphenolic compound, on developing Taenia taeniaeformis larvae in the rat liver was examined. Five groups of rats were used. In group 1, subcutaneous injection of gossypol at 10 mg/kg was started 5 days prior to administration of tapeworm eggs. In group 2, gossypol injections were started 5 days after administration of eggs. Groups 3 and 4 were infected and noninfected rats, respectively, which received the vehicle (10% ethyl alcohol in 0.85% NaCl) only. Group 5 rats were noninfected but received gossypol. From each group, 5 rats were killed on days 7, 12, and 22 of infection, respectively. The number and size of larvae and the size of the livers were much less in rats gossypol injected 5 days before infection than those in the vehicle-treated group. Administration of gossypol 5 days after infection resulted in less inhibition. The size and the thickness of the fibrous capsule around larvae of the gossypol-treated rats were much smaller than those of the control-infected group. The actively developing larvae excrete or secrete a sulfated glycosaminoglycan which is specifically stained with alcian blue. There was much more alcian blue-positive substance around the larvae and the capsule of the control-infected liver compared to the gossypol-treated infected animal. The percentage body weight of the spleen was significantly greater in the gossypol treated rats in both infected and noninfected groups. These results suggest that gossypol may directly inhibit tapeworm larval development or that elimination of the tapeworm may be resulted from gossypol-induced stimulation of host cell mediated immunity. PMID- 3956678 TI - Schistosoma mansoni: exposure in vitro of adult male surface antigens. AB - Incubation of adult male Schistosoma mansoni for 24 hr in medium containing newborn calf serum or normal human plasma resulted in an increase in the amount of parasite antigen exposed at the worm surface. No effect was observed on the amount of host antigen which was present. The increase in the exposure of parasite antigens takes place progressively over 24 hr and is partially dependent on the presence of lipoproteins in the culture medium. The possibility is discussed that the increase is due to environmentally induced changes in surface membrane lipid composition. PMID- 3956679 TI - Dirofilaria immitis: comparison of cytosolic and mitochondrial glutamate dehydrogenases. AB - Two membrane-bound glutamate dehydrogenases were found in adult Dirofilaria immitis, an NAD-linked enzyme (EC 1.4.1.2) in the cytosol (C-GDH) and an enzyme equally reactive with NAD or NADP (EC 1.4.1.3) in the mitochondria (M-GDH). The cytosolic enzyme had a pH optimum of 7.8-8.0 and exhibited 30% more activity at 25 C than at 37 C (pH 8.0). The mitochondrial enzyme had a pH optimum at 8.4 and exhibited 27% more activity at 37 C than at 25 C (pH 8.4); it was also more sensitive to heat denaturation. Gel filtration of worm subfractions separated four peaks of C-GDH activity with molecular weights of approximately 610, 285, 180, and less than 100 thousand, and a single major peak of M-GDH activity with a molecular weight of about 335,000. When assayed at pH 8, 37 C, and 200 microM NADH, the Km for the substrate, alpha-ketoglutarate, was equivalent for the two enzymes, but the Km for ADP (activator) was five times greater for M-GDH. When the two enzymes were assayed at pH 8.0, 37 C, and 100 microM NADH, 1 mM ADP approximately doubled and 1 mM ATP halved the velocity observed for each enzyme with no effector present. Under these assay conditions AMP, IDP, GDP, and GTP had opposite effects on the reaction velocities for the two enzymes. When the assay conditions were changed, the effects of added purine nucleotides varied, even directionally. Addition of up to 5 mM glutamate (product) had no significant effect on C-GDH kinetics, nor on the substrate Km of M-GDH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956680 TI - Eimeria maxima: characteristics of attenuated lines obtained by selection for precocious development in the chicken. AB - Both the Weybridge strain and a mixture of six laboratory and field strains of Eimeria maxima have been attenuated by selection for early maturation of oocysts during serial passage in chickens. The prepatent times of the resultant precocious lines produces after selection were reduced from approximately 120 hr to less than 107 hr, and their reproduction and pathogenicity were less than those of the parent strains. Chickens which had been inoculated with a small number of oocysts of the Weybridge precocious or mixed field isolate precocious lines were immune to subsequent challenge with the parent strains. In a comparison made between the endogenous development of the precocious lines and their parent strains, it was found that asexual multiplication of the precocious lines was reduced, due to the earlier onset of gametogony. The results of this study also indicate that the parent (i.e., normal) strains of E. maxima probably undergo a minimum of four generations of schizogony. PMID- 3956681 TI - Schistosoma mansoni: characterization of hemolytic activity from adult worms. AB - Homogenates of adult Schistosoma mansoni worms contain a hemolytically active component(s). Centrifugation at 10,000 g shows the major activity is present in the pellet fraction. Red blood cell lysis with the schistosome hemolytic agent is optimal at acid pH (5.0) and highly temperature dependent. The hemolytic component is resistant to boiling (5 min) and stable for extended periods of time at 38 C (22 hr). The length of the lag phase prior to hemolysis and the rate of hemolysis are both concentration and temperature dependent. Following hemolysis, red blood cell ghosts remain. PMID- 3956682 TI - Giardia muris: ultrastructural analysis of in vitro excystation. AB - Giardia muris cysts were examined by transmission electron microscopy before treatment, after induction, and at timed intervals during the incubation phase of in vitro excystation. Untreated G. muris cysts had a thick cyst wall composed of a fibrous outer wall and a thin, electron-dense inner membrane which extended from the trophozoite plasma membrane. The cytoplasm was devoid of endoplasmic reticulum, Golgi bodies,and mitochondria. Numerous large vacuoles were present within the ectoplasm just beneath the plasma membrane in untreated cysts. Following induction these cysts lacked ectoplasmic vacuoles. Concurrently, numerous membrane bound vesicles were seen in the peritrophic space closely adhering to the surface of the trophozoite. These vesicles appear to be of cytoplasmic origin. The cytoplasm of fully excysted trophozoites lacked ectoplasmic vacuoles but displayed well-developed ribbons of microtubular bodies, probably precursors of ventral disk, lateral flange, and median bodies and also contained extensive granular endoplasmic reticulum. No more than two nuclei were observed within each organism. The earliest excysted organisms were observed 0-5 min after incubation had begun and most organisms had excysted within 10 min. Cytokinesis occurred only after excystation was complete. PMID- 3956684 TI - The biology of olfaction. PMID- 3956683 TI - Trypanosoma rhodesiense: variable effects of cyclophosphamide on antibody production, survival, and parasitemia in infected mice. AB - Mice of the CBA/CaJ strain, infected with Trypanosoma rhodesiense, were injected with a single high dose (approximately 200 mg/kg) of the immunosuppressive drug cyclophosphamide to determine if an induced, transient inability to make antibody affected survival or parasitemia. When given on the day of infection, the drug had no significant effect on survival. It delayed, but did not prevent, the appearance of specific antibodies and the clearance of the infecting trypanosome variants. When cyclophosphamide was injected 1 week after infection, survival mass significantly decreased. Antibody production to specific variant antigens and to common trypanosome antigens were terminated, but the mice were able to eliminate the infecting trypanosomes. These findings suggest that a temporary inability to make antibody to trypanosomes does not result in more rapid death when only the infecting trypanosome variant is present. However, immunosuppression may accelerate death if it occurs when there are many different types of trypanosomes present. PMID- 3956685 TI - Telodendrial contacts between foveolar cone pedicles in the human retina. AB - The synaptic pedicles of foveolar cones in the human retina contact each other by means of telodendrial processes. Thus direct lateral coupling of photoreceptor terminals exists even in the area of highest acuity function. PMID- 3956686 TI - Effect of halogenmethylenebisphosphonates on bone cells in culture and on bone resorption in vivo. AB - Dihalogenmethylenebisphosphonates increase alkaline phosphatase activity and fatty acid oxidation in calvaria cells in culture (Cl2MBP greater than Br2MBP approximately equal to F2MBP). The monohalogen ClMBP and the non-halogenated analogues are less active on phosphatase and inactive on or inhibitory towards fatty acid oxidation. The three dihalogenbisphosphonates and ClMBP inhibit bone resorption in vivo, Cl2MBP most strongly. PMID- 3956687 TI - The biologically active conformation of ergot alkaloids. AB - Molecular mechanics and NMR studies of the D ring conformation of ergot alkaloids demonstrate that both D1 and D2 forms may exist in solution. The comparison of the geometric parameters defining the spatial relations between the aromatic moieties and the basic nitrogen of conformationally restricted dopamine analogs, and that of ergolene, shows the D1 conformation to be the bioactive one. PMID- 3956688 TI - Cadmium-induced changes in renal hemodynamics in the domestic fowl. AB - Low i.v. doses of cadmium chloride (15 micrograms Cd) given to pullets resulted in a significant reduction in urine flow (UF), glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). However, in hens treated with the heavy metal chelate FeNa EDTA prior to cadmium treatment no oliguria or reduction in GFR or ERPF was observed. It is suggested that the renal changes following the i.v. administration of cadmium to diuretic hens and alleviated in hens primed with the heavy metal chelate may result from changes in glomerular hemodynamics. PMID- 3956689 TI - Afferent fibers from the septum terminate on gamma-aminobutyric acid (GABA-) interneurons and granule cells in the area dentata of the rat. AB - Interneurons in the area dentata of the rat were immunostained with an antibody to gamma-aminobutyric acid. After septal lesions, degenerating terminals were found in asymmetric synaptic contact with granule cell somata and dendritic elements of immunoreactive and nonreactive cells in the supragranular part of the molecular layer. PMID- 3956690 TI - Effect of glucose and phloretin-2'-beta-D-glucose (phloridzin) on in vitro fertilization of mouse ova. AB - The fertilization ratio of mouse ova in vitro decreased when glucose concentration in the medium was lowered. However, the addition of phloretin-2' beta-D-glucose (phloridzin), known as a glucose uptake inhibitor, restored the fertilization ratio back to the control level. The glucose moiety of the phloridzin seemed to be responsible for this effect. PMID- 3956691 TI - Effect of taurine administration on liver lipids in guinea pig. AB - The oral administration of 0.4% taurine in drinking water for 14 consecutive days showed the following hepatic effects in male guinea pig. The percentage of tauro conjugated biliary bile acids was increased from 17.2-54.2%; the ratio liver weight/body weight was increased, and fatty change was induced. Liver triglyceride concentration was accordingly increased; diglyceride and phosphatidylcholine concentrations were reduced by the treatment, while phosphatidylethanolamine level was not affected. These changes suggest an adverse effect of taurine administration on phosphatidylcholine hepatic synthesis. PMID- 3956692 TI - Differential effects of calcium channel blockers on the responses of the rat vas deferens to intramural nerve stimulation and exogenous drugs. AB - The calcium channel blockers, nifedipine and verapamil, have separate effects on the phases of nerve-induced twitches which are not reflected by their actions on the responses to exogenous NA, ATP and the stable ATP analogue, alpha, beta-mATP. This implies that different calcium channels are used according to the manner of stimulation. PMID- 3956693 TI - Diltiazem prevents the damage to cultured aortic smooth muscle cells induced by hyperlipidemic serum. AB - Diltiazem, a calcium antagonist, significantly reduced the increased 45Ca uptake and the number of dead cells in cultured aortic smooth muscle cells induced by hyperlipidemic serum. PMID- 3956694 TI - Vasoactive intestinal polypeptide stimulates prolactin release in vivo in the ring dove (Streptopelia risoria). AB - I.v. administration of vasoactive intestinal polypeptide (VIP) to ring doves significantly elevated the plasma concentration of prolactin after 10 min in a dose-related manner. The plasma prolactin concentration of nonbreeding doves with low basal levels was increased by a similar amount as in brooding doves whose initially high concentration of plasma prolactin had been reduced by nest deprivation prior to treatment. PMID- 3956695 TI - Persistent 24-h variations of urinary 6-hydroxy melatonin sulphate and cortisol in Antarctica. AB - Bright light (2000-3000 lux) of sufficient intensity to suppress human melatonin secretion, acts as a strong zeitgeber in the entrainment of circadian rhythms in man. In polar conditions, light of this intensity is not experienced for several weeks during the winter. The entrainment of human circadian rhythms, in particular that of melatonin, is clearly of interest in these circumstances. Urinary 6-hydroxy melatonin sulphate (aMT6s) is a good index of melatonin secretion in man. In a limited study of seven male volunteers living on an Antarctic base the overall 24-h rhythm of aMT6s excretion was maintained at four different times of year (spring, summer, autumn and winter) and no significant seasonal effects were noted. Cortisol excretion, appeared to be markedly affected by the season although other factors such as social and environmental stress cannot be discounted. These observations suggest that in the absence of a strong light-dark cycle melatonin production may be entrained by other factors. PMID- 3956696 TI - The lymphatic route. 1) Albumin and hyaluronidase modify the normal distribution of interferon in lymph and plasma. AB - When human recombinant interferon-alpha 2 diluted in saline was injected s.c. into rabbits, the total amount recovered in thoracic lymph was less than 0.4%. Recoveries increased from 2- to 8-fold if interferon was injected in 4% albumin or with hyaluronidase, respectively. Albumin added to interferon acts as an interstitial fluid expander, thus favoring interferon absorption through lymphatics rather than blood capillaries. This strategy may increase the therapeutic index of interferon. PMID- 3956697 TI - Cellular and secreted tumor plasminogen activator: the effects of NaCl. AB - Plasminogen activator, secreted by metastatic tumor cells, was strongly inhibited in buffer or tissue culture medium containing physiological concentrations of NaCl. Intact cells, however, expressed strong activity under similar conditions. Thus, if plasminogen activator is involved in invasion and metastasis, the cellular activity, acting as an ectoenzyme, may be more important than secreted enzyme under physiological conditions. PMID- 3956698 TI - Influence of medium amino acids on the ouabain sensitive and insensitive 86Rb+ fluxes in HeLa cells. AB - Components of the 86Rb+-influx in HeLa cells were investigated in Joklik minimal essential medium, or in Earle's balanced salt solution with and without medium amino acids. The presence of amino acids led to the stimulation of the ouabain sensitive 86Rb+-uptake and inhibition of the diuretic-sensitive and residual 86Rb+-fluxes. These results show that the presence of amino acids is an important regulator of the K+/Rb+-fluxes under normal conditions in growth medium. PMID- 3956700 TI - Retinal S-antigen: immunocytochemical and immunochemical studies on distribution in animal photoreceptors and pineal organs. AB - Antiserum against bovine retinal S-antigen, a soluble protein (MW = 50 kDa) thought to be involved in phototransduction, was used in an immunohistochemical and immunochemical study of vertebrate eyes and pineal systems and invertebrate photoreceptor organs. Positive reactions, not seen with antiserum preabsorbed with highly purified S-antigen, were observed in planarian and starfish ocelli; scallop eyes; polychaete eye; crayfish compound eye; lamprey, salmon, frog, turtle, quail and hamster eyes. A specific reaction was also seen in the pineal organ of all the vertebrates examined, albeit weak in turtle and quail. In addition, several structures associated with photoreceptor organs, including the reduced frontal eyes of crayfish, the organ of Bellonci in crayfish eyestalk, and bipolar cells resembling those giving rise to Landolt's clubs in quail and golden hamster retinae, were immunopositive. Immunochemical studies revealed the presence of a single immunopositive band of protein which was similar but not identical in size in all vertebrate eyes and pineal organs (except that of chicken pineal) and invertebrate tissue examined. The wide distribution of positive reaction in photoreceptive tissue indicates that the retinal S-antigen determinant has been highly conserved during evolution. PMID- 3956699 TI - Hematocrit and hemoglobin concentration in four chromosomal species and some isolated populations of actively speciating subterranean mole rats in Israel. AB - Hematocrit (HCT) and hemoglobin (Hb) concentration were measured in four chromosomal species and some peripherally semi-isolated and isolated populations of the mole rat superspecies Spalax ehrenbergi in Israel. HCT was 52.0, 51.4, 50.9, and 47.8%, and Hb was 16.0, 16.6, 16.3, and 14.7 g/100 ml for 2n = 52, 58, 54, and 60, respectively. The species 2n = 60, which lives in arid habitats, had lower HCT and Hb than the other three species. HCT decreased as aridity increased between the species and within the species 2n = 60. Changes in HCT probably reflect clinal changes in both soil permeability to gases and ambient temperature. PMID- 3956701 TI - Photoreceptor latency: analysis and definition. AB - Latency as a time difference between the stimulating light-pulse and the recorded potential response was studied with intracellular recording techniques on blowfly (Calliphora) visual receptors. Latency was shown to be a meaningful parameter in analysing the information content of the recorded receptor potential responses by comparing latency vs. amplitude functions using different intensities of stimulating light, stimulating angles of the incident light, ambient temperatures, and flies of different developmental stages. The maximum amplitude of the response is not sufficient to describe stimulus-response functions. With the help of the linear correlation analysis the most useful latency criterion among three widely used latency parameters (viz. the amplitude threshold (1 mV), the visual estimation (detectable voltage) and the maximum slope intersection with the base-line) was investigated. These were studied by correlating them with other commonly used response parameters. An arbitrarily chosen latency parameter that shows the lowest correlation coefficient is considered to contain more additional information from the photoreceptor voltage response than a latency parameter with high correlation. According to our analysis the most useful latency determination is proposed to be the time from the stimulus onset to the intersection of the maximum tangent at the base line, a criterion which also allows one to use concepts derived from systems analysis. The concept of latency is discussed and a definition proposed in the light of this and other recent findings. PMID- 3956703 TI - Systemic research on chronicity factors in infantile asthma. AB - This work is the result of research into chronicity factors in infantile asthma. The research had two main goals. The first, using a sample of 100 asthmatic children, was to reconstruct the therapeutic history of the individual patients on the hypothesis that the therapeutic intervention they had undergone in fact conditioned the quality of the cure demand. The second was to evaluate the influence of family dynamics on the chronic development of infantile asthma. A comparison was made between two interactive models using a sample of 10 families with asthmatic children with chronic tendencies and a sample of 10 normal families. The results show that typical dysfunctional interactive patterns exist in the experimental sample and that they are correlated with the perpetuation of the asthmatic symptom. The paper concludes that every therapeutic intervention that is limited to dealing with the biological component of the asthmatic symptom and ignores the influence of family dynamics becomes itself a major chronicity factor. Thus a "systemic" intervention is considered necessary to prevent chronicity. PMID- 3956702 TI - The anaerobic heart: succinate formation and mechanical performance of cat papillary muscle. AB - Quiescent or paced, isometrically contracting right ventricular papillary muscles of cat heart were incubated under oxygenated or hypoxic (Po2 less than 10 Torr) conditions in order to investigate lactate and succinate formation. Both compounds were produced and released into the incubation medium during oxygen deficiency. Mechanical performance stimulated synthesis of both compounds under hypoxic as well as oxygenated conditions. Pacing led to the accumulation of large amounts of glutamine both under oxygenated and hypoxic conditions. Hypoxia resulted in a marked depletion of high-energy phosphates and concomitantly mechanical performance was impaired, i.e. developed tension fell rapidly and relaxation rate decreased. Supplying hypoxic, contracting muscles with aspartate (2 mM) resulted in maintenance of muscular function to some extent and led to augmented release of succinate and lactate. The data indicate that anaerobic succinate formation is correlated to the energy requiring processes of the myocardium. Maintenance of myocardial function by the supply of amino acids may be related to their conversion into succinate and to the stimulation of glycolysis. PMID- 3956704 TI - Communication deviances in parents of schizophrenics. AB - In an attempt to make a multimethod assessment of communication deviance in parents of schizophrenics, a communication conflict situation (CCS) and the TAT were used to obtain qualitative and quantitative measures of communication for a sample of 50 parental couples, 21 of which were parents of schizophrenics, 9 were parents of nonpsychotic psychiatric patients, and 20 were parents of normals. The results were a general confirmation of earlier reports that communication deviance is an outstanding characteristic in families with a schizophrenic offspring. The most important finding, however, was that parents of paranoid and nonparanoid schizophrenics score very differently on a majority of the communication variables. Parents of nonparanoid schizophrenics form one extreme on a continuum of communication deviance, and parents of paranoid schizophrenics and normals the other. Egocentrism, measured by CCS, turned out to be the single qualitative variable with best discriminating power across all groups. PMID- 3956706 TI - Enlisting family support in drug treatment. AB - Drug abuse programs often experience difficulties involving clients' families in treatment. This article describes general principles and specific techniques for recruiting family members in drug abuse programs and in other treatment settings. Stanton and Todd's principles of recruiting for family therapy in drug programs generally apply, adapted to a project that involves only one family member in multifamily groups and provides psychoeducational training rather than therapy. Additional principles include: focusing on family members who live with the client, tailoring recruitment to the needs of individual families, emphasizing how the family member will benefit, addressing resistance directly, helping families to build a support network, and informing family members of what is expected of them. The psychoeducational approach shows promise as a beneficial adjunct to client-focused treatment and as a gateway to more extensive family treatment. PMID- 3956705 TI - A tower of babble: the sociology of body and mind. PMID- 3956707 TI - A systemic approach to couple therapy. AB - This article presents a model of couple therapy based on the reciprocal double bind. Two cases are presented to illustrate the model, and different modes of intervention are described. This paper stresses that therapy has more to do with the intersection of the maps of the world of members of a system than it has with a search for some individual or systemic truth. PMID- 3956708 TI - Individual marital therapy: a critical reappraisal. AB - The belief that individual marital therapy (IMT) is an ineffective form of treatment for marriage problems and markedly inferior to the conjoint approaches has become almost an article of faith in family therapy circles. This position was originally advanced in the influential reviews of the research literature conducted by Gurman and Kniskern, and their conclusions have been cited in numerous other articles. This paper re-reviews the research studies purportedly supporting this conclusion and finds almost all of them to be invalidated by gross flaws in design and implementation. It is argued that from the highly inadequate evidence available, no conclusions can be reached concerning either the absolute or relative effectiveness of IMT. PMID- 3956709 TI - Life cycle and loss--the spiritual vacuum of heroin addiction. AB - This research studied the function of heroin addiction as a family-learned method of coping with death, separation, and loss across the life cycle. Heroin addicts, psychiatric outpatients, and normal students were given an extensive interview and test battery to determine the incidence of loss of family members and significant others. Because the impact of death is often overcome through religious rituals, this study also investigated the subjects' perception of their families' religious values and orientation to life's meaning and purpose. Results indicate that the incidence of death differs significantly across groups and that addicts have a distinct orientation to death, are more suicidal, and have more premature and bizarre death experiences. During childhood they have more family separations, and they tend to develop a distinct pattern of continuously separating from and returning to their families. They are also less likely to have a clearly defined purpose in life. A subset of parents from each group were also interviewed and tested, and these results support the theory of the intergenerational transmission of behavior. PMID- 3956710 TI - Sequences: toward a common denominator of family therapy. AB - This paper presents a conceptual framework that is designed to help clinicians and researchers organize their observations of the complex network of interconnected sequences of behavior and thinking that constitute family interactions. This framework distinguishes four classes of recursive sequences, each of which is defined by its period, i.e., the amount of time it takes for a sequence to complete one cycle. The shortest sequences (S1) are those face-to face interaction patterns that range in length from seconds to an hour. S2 sequences are played out over one day to one week, often depending on the routines of the family. S3 sequences range from several weeks to a year, and S4 sequences are those patterns of interaction and thought that repeat from generation to generation. In addition to outlining this framework, the paper contends that in many families with a problem, pertinent sequences from each class may be related to the problem and to each other in a cybernetic manner. Suggestions are offered for identifying pertinent sequences from each class and for selecting interventions that best address the targeted sequence. We have found that this conceptual framework has enabled us to use techniques from many different schools of family therapy while avoiding the conceptual contradictions inherent in previous attempts to integrate approaches. PMID- 3956712 TI - [The identification of collagen: bidimensional thin layer chromatography]. PMID- 3956711 TI - Quantifying family process: issues in the analysis of interaction sequences. AB - The analysis of behavior sequences can be a useful technique for understanding family process and has been increasingly employed as a result of developments in family theory. Some of the most popular sequential analytic methods are reviewed, and problems of applying these methodologies to investigations of family interaction are discussed. Independence-of-observations, nonstationarity, and autocontingency are differentiated as three distinct types of serial dependence. In addition, issues concerning the choice of data type, analysis of low base rate behaviors, and the decision as to whether to correct for base rates are considered. Guidelines are presented for dealing with each of these issues in the context of the research or clinical question being addressed. PMID- 3956713 TI - [Physico-chemical study of sulfamides: sulfadiazine, sulfadimethoxine and sulfamerazine]. PMID- 3956714 TI - [The contamination of large volume parenteral solutions by foreign particles. Proposal for updating the Italian regulations]. PMID- 3956715 TI - Synthesis and pharmacological properties of N,N'-bis-acylderivatives of phenobarbital. PMID- 3956716 TI - Bicyclic compounds with potential antiulcer and/or antisecretory activity. II. 1(or 3),4,6,7-Tetrahydro-1(3)H-pyrano[3,4-d]imidazoles and 1(or 3),4,6,7 tetrahydro-1(3)H-thiopyrano[3,4-d]imidazoles. AB - Owing to our current interest in synthesizing and evaluating the antiulcer and antisecretory activity of bicyclic compounds, a series of 1(or 3),4,6,7 tetrahydropyrano- and 1(or 3),4,6,7-tetrahydrothiopyrano-[3,4-d]imidazoles was synthesized and tested. The biological results were compared with those of some previously described 4,5,6,7-tetrahydroimidazo-[4,5-c]pyridine and 4,5,6,7 tetrahydrobenzimidazole derivatives. PMID- 3956718 TI - [Radioprotective agents derived from benzonitrile]. AB - Benzonitriles have been evaluated as potential antiradiation agents in mice. They have an interesting radioprotective activity, in particular 3,5 dinitrobenzonitrile, one of the non-sulfur-containing radioprotective compounds which presents a consistent DRF (DRF = 1.35). PMID- 3956717 TI - Studies on the development of physical dependence on barbitone in the rat and rat atrium. AB - The mechanisms underlying the development of barbitone dependence have been studied in the rat and in atrial preparations removed from dependent animals. Long-term oral administration to the rat of barbitone, alone or together with the analeptics bemegride or pentylenetetrazol, has shown that the intensity of the withdrawal syndrome generally parallels the degree of associated CNS depression. In addition, the overall relationship between the spontaneous or evoked (chemical or audiogenic) responses of representative drug-withdrawn rats and the inotropic responses of corresponding withdrawn atria to supramaximal nerve stimulation, noradrenaline or Ca2+ was reasonably good. It is proposed that the rat atrial preparation may provide a suitable model system for the study of barbitone dependence in the rat, especially in relation to Ca2+-dependent mechanisms, and that selective calcium antagonists may prove helpful in the management of barbiturate and similar types of drug dependence. The barbitone withdrawal syndrome has been described in terms of a membrane phase distribution hypothesis of drug action. PMID- 3956719 TI - Derivatives of 1,3,3-trimethyl-6-azabicyclo-[3.2.1]octane with hypotensive activity. III. AB - The synthesis of a series of alkyl and aryl thioureas (II) starting from 1,3,3 trimethyl-6-azabicyclo[3.2.1]octane is described. Some of alkyl thioureas showed a moderate hypotensive activity in rats. Effects on heart rate and hypoglycemic activity in rats, infiltration anesthesia and antiarrhythmic activity in mice are also reported. PMID- 3956721 TI - [Benzylidene-5 pyrrolones, furanones and thiophenones. 2. Quantitative structure activity relationship]. AB - Quantitative structure-activity relationships (QSAR) have been derived for twenty two 5-benzylidene furanones, pyrrolones and thiophenones having antifungal activity against Candida albicans. The correlation with the parabolic (Hansch) or bilinear (McFarland-Kubinyi) models are superior to those with the linear models (Free-Wilson or Fujita-Ban), while no significant differences exist between the parabolic and bilinear models. Lipophilicity was necessary for good in vitro activity of these compounds. PMID- 3956720 TI - [Pharmacologic activity of tert-aminoalkyl derivates of quinoxalinone, aza- and diaza-quinoxalinone]. AB - Eight tert-aminoalkyl derivatives of 3-methyl-6R-quinoxalin-2-one, 3-methyl-6/8 azaquinoxalin-2-ones and 3-methyl-6,8-diazaquinoxalin-2-one, previously selected for their deconditioning activity in rats were now tested in mice for analgesic, explorative and incoordinating (muscle relaxant) activities; acute toxicity was also determined. Several compounds show a good degree of activity in the tests used. PMID- 3956722 TI - DL-S-(2-[N-3-(2-oxo-tetrahydrothienyl)acetamido])-thioglycolic acid: a novel mucolytic agent of the class of homocysteine thiolactone derivatives. AB - The synthesis and the characterization of some DL-homocysteine thiolactone derivatives are described. Rabbits, affected by acute bronchitis, treated orally with the title compounds showed a considerable reduction of the viscosity of the bronchial mucus. DL-S-(2-[N-3-(2-oxo-tetrahydrothienyl)acetamido]]thioglycolic acid (RV 144, Dithiosteine) was the most active compound and was thus selected for further experimental studies. The structure elucidation, physical and chemical parameters of RV 144 (Dithiosteine) were determined. PMID- 3956723 TI - Norepinephrine with its precursors and their antagonists haloperidol and phentolamine interact with dye free radicals in opposite ways. AB - In the reactions with dye free radicals, catecholamines exhibited reversible electron donor and acceptor properties with the effectiveness increasing from tyrosine to norepinephrine. The physiological antagonists haloperidol and phentolamine showed opposite patterns of behaviour in the same reactions, changing their properties as acceptors to electron donors. The regularity observed is similar to that demonstrated earlier by a variety of Na+ and Ca2+ channel modulators. PMID- 3956724 TI - Structural relationships between the NADH dehydrogenases of Paracoccus denitrificans and bovine heart mitochondria as revealed by immunological cross reactivities. AB - An antibody raised against two subunits (Mr 48 000 and 25 000) of NADH dehydrogenase from Paracoccus denitrificans cross-reacts with one of more than 20 polypeptides that form the bovine heart mitochondrial NADH dehydrogenase. The cross-reacting subunit has Mr 51 000 and is believed to be the NADH-binding subunit of the enzyme. Antibodies raised against certain subunits of the bovine heart NADH dehydrogenase were tested for cross-reactivity with P. denitrificans cytoplasmic membranes. Of those tested, only one, an antibody specific for the 49 kDa subunit of mitochondrial NADH dehydrogenase, cross-reacted with the bacterial membranes. It recognised a polypeptide of approximate Mr 46 000. This is an indication for a previously undetected third subunit of NADH dehydrogenase from P. denitrificans. The immunological cross-reactions indicate that the NADH dehydrogenases from P. denitrificans and bovine heart mitochondria are related structurally. PMID- 3956725 TI - Secondary structure prediction of human salivary proline-rich proteins. AB - Conformations associated with secondary structure in human salivary proline-rich proteins A (PRPA), C (PRPC), P-D and P-E were predicted by analysis of their respective hydrophobicity profiles by computer programming. Structurally, PRPA and PRPC would present a globular head and a tail that consists of type 3(10) polyproline helices. P-D and P-E would be fibrilar molecules with helical zones of the polyproline 3(10) type. Alternatively for PRPA and PRPC, the head and tail would form one globular domain with the tail folding upon itself at places where random coils occur. PMID- 3956726 TI - Red blood cell targeting to smooth muscle cells. AB - Monoclonal antibody discriminating between endothelial and smooth muscle cells is suggested to be used as a vector for directed transport of drugs to injured (denuded) areas of blood vessel wall. An in vitro model system was used in the studies: vascular smooth muscle or endothelial cells grown on plastic surface were treated with specific mouse monoclonal antibody recognizing an antigen localized on the surface of smooth muscle rather than endothelial cells; then erythrocytes coated with secondary (rabbit antimouse) antibodies were added. The results were analyzed spectrophotometrically or with scanning electron microscopy. Under the experimental conditions, erythrocytes, possible 'containers' for carrying the drugs, were found to bind only to smooth muscle cells. The data show that antibody provides absolute discrimination between endothelial and smooth muscle cells and, thus, may be used as a vector for drug targeting. PMID- 3956727 TI - Chemical modification of the brown fat mitochondrial uncoupling protein with tetranitromethane. AB - Tetranitromethane reacts with the uncoupling protein of intact brown fat mitochondria. The chloride permeability in the absence of the inhibitory nucleotide GDP is not affected, but the affinity with which GDP binds is decreased, and the coupling between binding of nucleotide and inhibition of chloride permeation is broken. PMID- 3956728 TI - Structure of a Cephalosporium acremonium mtDNA replicator. AB - We have investigated the ARS (autonomously replicating sequence) activity of a 1.94 kb mitochondrial DNA fragment of Cephalosporium acremonium and found that several subfragments of this piece of mtDNA conferred the ARS phenotype. The nucleotide sequence of the fragment shows: (i) a high A + T content (72.5%); (ii) a perfect consensus ARS sequence (ATTTATATTTA) in the subfragment with the highest ARS activity; (iii) a large number of ARS consensus-related sequences in the other subfragments, even in one lacking ARS activity; (iv) several potential hairpin structures. One of them contains the perfect consensus ARS sequence. PMID- 3956729 TI - Structural study of a mutant type I collagen from a patient with lethal osteogenesis imperfecta containing an intramolecular disulfide bond in the triple helical domain. AB - We have built molecular models of collagen type I from a patient with lethal osteogenesis imperfecta incorporating one or two mutant alpha 1(I)-chains which contain a cysteine substituting a glycine near the C-terminal end. In either case, the cysteines can only be accommodated with considerable distortion of the native collagen structure, which disrupts inter-chain contacts. The disturbance of the triple helix is limited to a small local region. This suggests that the most important consequence of the mutation is delayed helix formation leading to overmodification and decreased collagen production, rather than the structural abnormality of the folded molecules, which are only marginally unstable. PMID- 3956730 TI - Proline isomerization during refolding of ribonuclease A is accelerated by the presence of folding intermediates. AB - The trans----cis isomerization of Pro 93 was measured during refolding of bovine ribonuclease A. This isomerization is slow (tau = 500 s) under marginally stable folding conditions of 2.0 M GdmCl, pH 6, at 10 degrees C. However, it is strongly accelerated (tau = 100 s) in samples which, prior to isomerization, had been converted to a folding intermediate by a 15 s refolding pulse under strongly native conditions (0.8 M ammonium sulfate, 0 degree C). The results demonstrate that extensive folding is possible before Pro 93 isomerizes to its native cis state and that the presence of structural folding intermediates leads to a marked increase in the rate of subsequent proline isomerization. PMID- 3956731 TI - Polymerization of beta-like actin from scallop adductor muscle. AB - Scallop adductor muscle beta-like isoactin differs from rabbit skeletal muscle alpha-actin in the rate, extent and critical concentration of polymerization. The difference is temperature- and [KC1]-dependent. In the presence of DNase I scallop actin was shown to be depolymerized more rapidly than rabbit actin. It was suggested that the polymers formed by beta-actin are less stable than those formed by alpha-actin. PMID- 3956732 TI - Reappraisal of the liver benzpyrene hydroxylase synthesized de novo after treatment of rats with 2,3,7,8-tetrachlorodibenzo-p-dioxin and 3 methylcholanthrene. AB - The dynamics of the inductive effects of MC and TCDD upon rat liver microsomal benzpyrene hydroxylase and the main properties of the de novo synthesized hemoproteins have been compared. The inadequacy of expression of the enzyme activity per total cytochrome P-448 content has been established. It was concluded that TCDD microsomes have a relatively low content of benzpyrene hydroxylase with a higher molecular activity than the enzyme from MC microsomes. PMID- 3956733 TI - Investigation of human plasma low density lipoprotein by three-dimensional fluorescence spectroscopy. AB - Human plasma LDL exhibits a diffuse fluorescence (excitation 360 nm) in the 400 600 nm range. Application of three-dimensional fluorescence spectroscopy shows the presence of 7 fluorophores in the lipid and 6 fluorophores in the protein domain. The 430 nm fluorescence in freshly prepared LDL and its apo-B is most likely indicative for remnants of in vivo lipid peroxidation. PMID- 3956735 TI - Qualitative difference in mitochondria of endothermic and ectothermic animals. AB - A significantly higher rate of respiration in the absence of added ADP has been revealed in mitochondria of endotherms as compared with that of the ectotherms with similar rates of respiration during phosphorylation. A high rate of ADP independent (non-coupled with ATP synthesis) respiration is observed during oxidation of succinate, NADH and ascorbate + cytochrome c, but not with NAD dependent substrates. It increases in the presence of cytochrome c during oxidation of succinate and NADH and is also revealed during oxidation of NAD dependent substrates in the presence of NAD+ and cytochrome c. ADP-independent respiration is not affected by oligomycin, however, it is essentially inhibited in the presence of GDP. It is suggested that the significant difference in the value of ADP-independent respiration of endo- and ectotherms is due to the existence in endotherms of a non-coupled population of mitochondria which generates heat without preliminary synthesis of ATP. PMID- 3956734 TI - NOE data at 500 MHz reveal the proximity of phenyl and tyrosine rings in enkephalin. AB - Met5-enkephalin-a pentapeptide (Tyr-Gly-Gly-Phe-Met)-can exist in two possible folded arrangements with a rigid two-hydrogen-bonded network. In one arrangement, a Gly 2-Gly 3 beta-bend is formed and in the other a Gly 3-Phe 4 beta-bend. The two conformations are distinguished by the spatial relation of Tyr 1 and Phe 4: in the Gly 2-Gly 3 beta-bend, Tyr 1 and Phe 4 can be brought close to each other while in the Gly 3-Phe 4 beta-bend they are far apart (greater than 5 A). We have utilized one-dimensional (1D) nuclear Overhauser effect (NOE) measurements between the ring protons of Tyr 1 and Phe 4 to determine their proximity. The NOE data clearly show that a pair protons, one each from Tyr 1 and Phe 4, are as close as 3.3 A while other inter-proton distances are beyond 4.5 A. Therefore, we propose the presence of a Gly 2-Gly 3 beta-bend (in which Tyr 1 and Phe 4 are spatially close) for Met5-enkephalin in solution. The structure of Met5 enkephalin in solution is very similar to the single crystal structure of Leu5 enkephalin and tends to explain the biological activity data of several modified enkephalins. PMID- 3956736 TI - Physical nature of the phase transition in globular proteins. Calorimetric study of human alpha-lactalbumin. AB - The guanidine hydrochloride-induced unfolding of human alpha-lactalbumin has been studied by isothermal calorimetry. It has been shown that a cooperative transition takes place only in the concentration interval of the denaturant between 0.3 and 2 mol X l-1. The cooperative transition coincides with the transition detected by circular dichroism in the near-ultraviolet region which reflects the destruction of the specific environment of aromatic side groups. According to scanning calorimetric investigations, the transition disappears in the acid form of the protein where circular dichroism of aromatic side groups is practically absent. At higher concentrations of guanidine hydrochloride, where destruction of the secondary structure and unfolding of the chain are observed, there is no cooperative heat absorption. PMID- 3956737 TI - Phosphorylation of 3-O-methyl-D-glucose by yeast and beef hexokinase. AB - Beef heart hexokinase and yeast hexokinase both catalyzed the phosphorylation of 3-O-[14C]methyl-D-glucose. The maximal velocity was 3 orders of magnitude lower and the Km for the glucose analogue 40-120-times higher than those observed with D-[U-14C]glucose. Hence, 3-O-methyl-D-glucose should not be considered as a truly nonmetabolized analogue of D-glucose. PMID- 3956738 TI - O2-dependent lipid peroxidation does not affect the molecular order in hepatoma microsomes. AB - Microsomal membranes from rat liver and from the fast-growing Morris hepatoma 3942A have been peroxidized to different extents and the order parameter of the membranes measured by fluorescence depolarization of the probe 1,6-diphenyl-1,3,5 hexatriene. The data have been analysed by applying a mathematical approach that takes into account simultaneously static and dynamic fluorescence parameters. It appears that tumour membranes are more ordered than the control and their order parameter does not increase with greater exposure to the action of O2 radicals in contrast to liver membranes. The fatty acid composition of the membrane lipids has been studied under different experimental conditions and correlated to the behaviour of the physical parameter. PMID- 3956739 TI - Interaction of actin with dansyl-tropomyosin. AB - 5-[Dimethylamino]naphthalene-1-sulfonyl chloride (dansyl chloride) reacts with rabbit skeletal muscle tropomyosin (TM) to yield a highly fluorescent product, DNS-TM. The extent of modification of TM can be regulated over a wide range, 0.3 15.5 dansyl groups per TM, depending upon the temperature and duration of the reaction. However, under all conditions employed, about 15 different fluorescent tryptic peptides of TM were produced. DNS-TM undergoes end-to-end polymerization at low ionic strengths, but to a somewhat lesser extent than unlabelled TM does. DNS-TM also binds muscle F-actin. This interaction may be followed fluorimetrically by observing a blue-shift in emission maximum, an increase in fluorescence intensity or an increase in fluorescence polarization of the DNS-TM complex with F-actin. PMID- 3956740 TI - Transbilayer reorientation of platelet-activating factor in the erythrocyte membrane. AB - Platelet-activating factor (PAF) is a phospholipid, intermediate in its structure between diacyl- and lysophospholipids. The reorientation of this highly bioactive compound to the inner membrane layer of human erythrocytes after its primary incorporation into the outer membrane layer has been studied. Reorientation was shown to be a slow process with an initial rate of only 0.012 h-1. It does not depend on energy supply. From the steady-state distribution of PAF between inner and outer membrane layers, after very long incubation times (40-50 h), a preference of PAF for the outer membrane layer analogous to that of endogenous lecithin is derived. Our data indicate that the process of simple transbilayer reorientation of PAF is probably too slow to account for very fast transmembrane signal transmission or for the fast uptake and metabolism observed in certain cell types. PMID- 3956741 TI - Muscarinic stimulation of inositol phosphate accumulation and acid secretion in gastric fundic mucosal cells. AB - The muscarinic agonist, carbachol (CCh), was shown to stimulate the production of inositol phosphates (IP) in isolated cells from rabbit fundic mucosa. This stimulatory effect was time- and dose-dependent: EC50 values for IP1, IP2 and IP3 accumulation were not statistically different. The mean value was 30 +/- 8 microM (n = 6). The corresponding maximal stimulation (% of basal value) observed after 20 min incubation in the presence of 100 microM CCh was 160 +/- 15%. CCh-induced IP accumulation was abolished by atropine (Ki = 0.32 +/- 0.18 nM (n = 3)). The CCh concentrations leading to half-maximal inhibition of N-[3H]methylscopolamine binding and half-maximal IP accumulation were similar. The half-maximal value for CCh-induced aminopyrine accumulation was 8-times lower. These results indicate that IP3-mediated mobilization of intracellular Ca2+ might be involved in CCh induced acid secretion by parietal cells. PMID- 3956742 TI - Molecular cloning of unintegrated closed circular DNA of porcine retrovirus. AB - Viral DNA of unintegrated closed circular form was isolated from a swine kidney cell line (SKL) which was infected with a porcine retrovirus Tsukuba-1 (PRetV) produced from a swine malignant lymphoma-derived cell line. Shimozuma-1 and cloned using a lambda phage vector, Charon 21A. One of ten independent clones contained the 8.3 kb DNA fragment as an insert, which was thought to be a full length of viral DNA molecule carrying a long terminal repeat (LTR) sequence. We have analyzed this insert by mapping the recognition sites of some restriction endonucleases by Southern blot hybridization with appropriate probes. PMID- 3956743 TI - Cytochrome P-450-dependent H2O2 production demonstrated in vivo. Influence of phenobarbital and allylisopropylacetamide. AB - By administration of allylisopropylacetamide, an inhibitor of cytochrome P-450, we demonstrated that cytochrome P-450 is involved in the production of H2O2 during aminopyrine metabolism and phenobarbital induction in both the unanaesthetized guinea pig and rat. In the guinea pig we also found evidence for the existence of a basal cytochrome P-450-dependent H2O2 production, i.e. in the absence of exogenous substrate. Catalase participates in the decomposition of H2O2 produced in the endoplasmic reticulum where cytochrome P-450 is localized. PMID- 3956744 TI - Mastoparan binding induces a structural change affecting both the N-terminal and C-terminal domains of calmodulin. A 113Cd-NMR study. AB - 113Cd-NMR studies of solutions of cadmium-loaded calmodulin (Cd4CaM) and the tetradecapeptide mastoparan in different ratios show that mastoparan binds to Cd4CaM with high affinity. The off-rate of protein- bound mastoparan is found to be 40 s-1 or less. The binding of one molecule of mastoparan to Cd4CaM is observed to affect all four metal-binding sites, indicating that both the N terminal and C-terminal globular domains of the protein undergo conformational changes. PMID- 3956745 TI - Deuterium NMR study of head-group deuterated phosphatidylserine in pure and binary phospholipid bilayers. Interactions with monovalent cations Na+ and Li+. AB - Head-group deuterated 1,2-dimyristoyl-sn-glycero-3-phosphorylserine (DMPS) was synthesized. 2H NMR spectra reflect the ionic strength-dependent polymorphism of DMPS aqueous dispersions. Results obtained with pure DMPS and mixed bilayers with phosphatidylcholine or phosphatidylethanolamine at various NaCl or LiCl concentrations indicate that interactions with Na+ and Li+ have very different effects upon the head-group quadrupole splittings. PMID- 3956746 TI - Existence of antizyme and ornithine decarboxylase-antizyme complex in RK13 kidney cells. AB - It has been reported that 'antizyme', a protein inhibitor of ornithine decarboxylase (ODC) induced by its product, is not found in rat or mouse kidney. We determined whether antizyme was present in rabbit kidney cells (RK13) in culture. Antizyme could be induced in these cells by putrescine treatment, a substantial portion being in the particulate fraction in contrast with hepatic antizyme. Furthermore, ODC-antizyme complex was present even in untreated cells. Pretreatment of cells with putrescine increased the relative amount of ODC antizyme complex and accelerated decay of ODC. These results support the ubiquitous existence of antizyme and its role in ODC degradation. PMID- 3956747 TI - Occurrence of two distinct succinate thiokinases in animal tissues. AB - Although succinate thiokinase from mammalian sources has hitherto been described as showing substrate specificity for guanine nucleotide, a range of mammalian tissues has here been found to display succinate thiokinase activity with both guanine and adenine nucleotides as substrates. Evidence is presented for the existence of two distinct succinate thiokinases and this is confirmed by their separation by affinity chromatography. Each enzyme is specific for one nucleotide and is inhibited by the non-substrate nucleotide. The physiological roles of the two enzymes is yet to be established. PMID- 3956748 TI - Segment alpha 182-198 of Torpedo californica acetylcholine receptor contains second toxin-binding region and binds anti-receptor antibodies. AB - The area around Cys-192 and Cys-193 is thought to be a functionally important part of the alpha-subunit of the acetylcholine receptor. We have synthesized peptide alpha 182-198 of the alpha-chain of the Torpedo californica acetylcholine receptor and investigated the binding to the peptide of alpha-bungarotoxin, cobratoxin and antibodies raised against acetylcholine receptor. The results showed that the synthetic peptide alpha 182-198 contains a second toxin-binding region and also binds a considerable fraction of anti-receptor antibodies. We also report here the toxin-binding activity of synthetic peptide alpha 125-148 of the human acetylcholine receptor which has been previously localized as a toxin binding region in the alpha-chain of the Torpedo receptor. PMID- 3956750 TI - The European Organization for Research on Treatment of Cancer. PMID- 3956749 TI - Temperature-dependent cleavage of chromatin by micrococcal nuclease near the nucleosome center. AB - Digestion of nuclei at 4 degrees C with micrococcal nuclease results in significant intranucleosomal cleavage compared to digestion conducted at 37 degrees C. Employing nucleoprotein gel electrophoresis in one dimension followed by DNA electrophoresis in a second dimension, we demonstrate that such temperature-sensitive, internal cleavage predominantly occurs about 20 bp from the nucleosome center. We suggest that lower temperatures reduce the stability of hydrophobic interactions within the histone octamer and lead to a conformational alteration in nucleosomes that is detected by micrococcal nuclease. PMID- 3956751 TI - Carcinoembryonic antigen in patients with gastric carcinoma. AB - Carcinoembryonic antigen (CEA) was quantified pre- and post-operatively in plasma from 171 patients with gastric carcinoma. The pre-operative plasma concentration was above the normal reference value (3.5 micrograms/l) in 18% of the patients in stage I-III (pTNM) and in 57% of the patients in stage IV. Pre-operative concentrations above 10 micrograms/l indicated metastatic or inoperable disease. The concentrations were not different between the stages I, II and III. However, the pre-operative CEA concentrations were related to survival after potentially curative resection. At recurrence most of the patients had markedly increased CEA, often with increasing CEA in the months before clinical recurrence. Most of the patients clinically disease-free at the end of the follow-up period had a transitory or prolonged post-operative elevation of CEA. This made the post operative evaluation of CEA difficult. Serial determination of CEA in the follow up of gastric cancer patients therefore had little or no clinical value, whereas the pre-treatment levels were of clinical significance. PMID- 3956752 TI - Vitamin A status and bladder cancer. AB - Serum retinol, retinol-binding protein (RBP), carotenoids, pre-albumin, zinc and copper were measured in a total of 111 patients. Of these 22 men and 9 women (mean age 68.4 years) had transitional cell carcinoma of the bladder, 29 men and 6 women (mean age 68.8 years) had no recurrence of bladder cancer detected at cystoscopy and 24 men and 5 women presented with non-malignant urological diseases. A further group of 16 patients, 14 of whom had a malignancy at some other site, with a mean age of 73.1 years constituted a miscellaneous group. There were no significant differences between any of the groups in serum concentrations of any of the constituents measured. However, serum concentrations of retinol, carotenoids and RBP were significantly lower in a small group of patients with invasive bladder cancer than in patients with non-invasive disease. Similarly, serum concentrations of the same constituents were lower in patients with poorly differentiated tumours. Estimates of retinol and carotenoid intake made by questionnaire showed that these low values were not due to lower intake. The results of this study do not support the suggestion that high dietary intakes of retinol or carotenoid--containing foods are associated with decreased risk of bladder cancer. Furthermore, low serum levels of retinol and associated components were not found in patients with early transitional cell carcinoma. The finding of low serum levels of retinol, RBP and carotenoids in 4 patients with poorly differentiated invasive bladder tumours warrants further study. PMID- 3956753 TI - Megestrol acetate in the treatment of advanced post-menopausal breast cancer. AB - The effect of megestrol acetate 160 mg daily was studied in 49 previously treated post-menopausal patients with advanced carcinoma of the breast. An overall response of 31% was obtained with 1 complete and 14 partial remissions, chiefly in soft tissue and bone. The median duration of response was in excess of 10 months. Toxicity was minimal and the only notable side effect was mild weight gain without fluid retention. Megestrol acetate is safe and well tolerated, with useful activity in the palliation of advanced breast cancer. PMID- 3956754 TI - The surgeon's attitude to malignant lymphomas of the breast. Analysis of eight cases. AB - Eight cases of malignant lymphomas of the breast were considered. The age of the patients ranged from 26 to 57 years. All the cases were staged according to the Ann Arbor classification system; the distribution was 2 Ie, 2 IIe, 1 IIIe and 3 IVe. Surgery was limited to excisional biopsy in all patients, one of whom had been operated on elsewhere. Six patients had radiotherapy following limited surgery. All of them received chemotherapy. The treatment resulted in complete local control of the disease in all cases and only 2 patients died from disseminated disease. Six patients were alive and free of disease from 34 to 84 months after the diagnosis. Our experience and analysis of the literature allow us to conclude that the role of surgery in the diagnosis and treatment of malignant lymphomas with breast involvement should be limited to removal of the nodule, when possible, or to incisional biopsy in the case of massive involvement of the breast. In effect, aggressive surgery with a radical aim is not presently justified; in contrast, systemic chemotherapy should always be administered. PMID- 3956756 TI - Antiestrogen therapy in pancreatic carcinoma: a preliminary report. AB - Ten patients with unresected pancreatic carcinoma, treated with Nolvadex 10 mg 3 times a day were compared to a historic untreated control group. The median survival was 7 months in the treated group compared to 3 months in the untreated. In the control group all patients died within the first 9 months, in the treated group 40% of the patients were still alive after 14 months. PMID- 3956755 TI - In vitro thymidine labelling index in primary operable breast cancer. AB - The in vitro Thymidine Labelling Index (TLI) of 164 primary breast carcinoma was measured. The relationship of TLI to other established prognostic variables was examined, and the rates of of recurrence and survival of groups of women with high and low TLI tumours were compared. Poorly differentiated tumours had significantly greater TLI values but there were no significant associations with tumour size, axillary lymph node status, age and menopausal status or steroid receptor status. Although there were more recurrences and deaths in the group of women with high TLI tumours, these differences were not statistically significant. In vitro TLI may be a further expression of tumour differentiation, rather than cellular proliferation, and from this study does not provide any additional prognostic information. PMID- 3956757 TI - Parotid swelling as the first manifestation of nasopharyngeal carcinoma: a report of two cases. AB - Nasopharyngeal carcinoma usually presents with enlargement of upper cervical lymph nodes, epistaxis, postnasal discharge, aural symptoms or cranial nerve palsy. Parotid swelling as the first and presenting symptom creates a diagnostic problem to both clinicians and pathologists. The authors report here two such cases to draw attention to this diagnostic problem and discuss the therapeutic implications. PMID- 3956758 TI - Can late recurrence of melanoma be predicted at the time of primary treatment. AB - A cohort of patients followed post-operatively in the Department of Surgery at the University of Wales College of Medicine has been studied to determine whether there were specific factors associated with late recurrence of malignant melanoma. The incidence of late recurrence (beyond 5 years after primary treatment) was 6.1%, seen predominantly in females with lesions of intermediate thickness. No more specific criteria could be defined to identify this small group of melanoma patients, and which might be useful in selecting patients requiring longer term careful follow-up. Since most late recurrence is loco regional, self-examination by the patient may be the best pragmatic approach to facilitate early diagnosis of recurrent disease without imposing a heavy burden on the follow-up services of the health system. PMID- 3956759 TI - The stomach, cholecystokinin, and satiety. AB - The stomach of the rhesus monkey empties liquids in a fashion that varies with the character of the solutions. Physiological saline empties exponentially. Glucose solutions empty biphasically--rapidly for the first minutes, then slowly and proportionately to glucose concentration to deliver glucose calories through the pylorus at a regulated rate (0.4 kcal/min). This prolonged and regulated second phase of gastric emptying depends on intestinal inhibition of the stomach. Cholecystokinin (CCK), a hormone released by food in the intestine, is an inhibitor of gastric emptying. In vitro receptor autoradiography demonstrates CCK receptors to be clustered on the circular muscle of the pylorus. Exogenous CCK, in doses that inhibit gastric emptying, will reduce food intake only if combined with an infusion of saline in the stomach. These observations indicate how gastric distension can be a means for provoking satiety. The variably sustained distension produced by the stomach's slow, calorically regulated emptying could prolong intermeal intervals and thus permit high-calorie meals to inhibit further caloric intake over time. CCK, by directly inhibiting gastric emptying during a meal, could promote gastric distension and so restrict the duration and size of individual meals. PMID- 3956760 TI - Satiety: the roles of peptides from the stomach and the intestine. AB - Rats were surgically prepared to allow perfusions of anatomically limited portions of the gastrointestinal (GI) surface during test meals. The results demonstrated that at least one potent satiety signal was generated when ingested food accumulated in the stomach and did not enter the small intestine. This gastric satiety signal did not require the vagus nerve for its operation. In addition, at least one other potent satiety signal was generated when food perfused the small intestine. This intestinal satiety signal did not require gastric distension for its operation. We tested a variety of GI peptides to determine whether any met the criteria imposed by this evidence for regionally specific satiety signals. Bombesin (BBS), a peptide present in high concentration in the stomach, was a potent and behaviorally specific inhibitor of food intake. Its satiating effect was not altered by subdiaphragmatic vagotomy. Cholecystokinin (CCK), a peptide hormone that is released from the small intestine by food, was also a potent and behaviorally specific inhibitor of food intake; its satiating effect did not require gastric distension for its expression, but its satiating effect was markedly reduced or abolished by subdiaphragmatic vagotomy. Thus, BBS and CCK may mediate at least part of the satiating effect of food acting in the stomach and in the small intestine, respectively. PMID- 3956761 TI - Contribution of angiotensin to the control of medullary hemodynamics. AB - The unique architecture and organization of medullary vasculature permit regional regulation of medullary hemodynamics by vasoactive hormones and are conducive to the operation of the countercurrent multiplication system. Recent studies suggest that an increase in inner medullary blood flow causes medullary solute washout, which in turn decreases passive sodium transport in the thin ascending limb of Henle's loop. In canine models of chronic sodium retention accompanied by activation of the renin-angiotensin system, glomerular filtration rate (GFR), renal blood flow (RBF), and intracortical blood flow distribution were similar to those in normal dogs; however, papillary plasma flow (PPF) was markedly reduced and papillary tissue solute content was increased significantly both during hydropenia and after saline loading. During euvolemic diuresis with loop diuretics, there was an increased renin release associated with a marked reduction in PPF, despite an increase in total RBF. Direct intrarenal infusion of angiotensin II (AngII) (at a dose not affecting GFR and RBF) induced ipsilateral sodium retention, conservation of urinary concentration, and papillary ischemia. These studies provide evidence for regional regulation of medullary hemodynamics by AngII, possibly contributing to sodium retention in chronic salt-retaining states. PMID- 3956763 TI - American Society of Biological Chemists. 76th annual meeting. Washington, DC, June 8-12, 1986. Abstracts of papers. Indexes. PMID- 3956762 TI - Adaptations of skeletal muscle grafts to chronic changes of physical activity. AB - After grafting, many structural and functional characteristics of skeletal muscle change with time until reaching a stable value. For several characteristics, these stable values are less than those observed in control skeletal muscle. Characteristics such as mass and fiber cross-sectional area are influenced by chronic changes in physical activity. The extent of our understanding of the dimensions and mechanisms of activity-induced adaptations of grafts is limited and based solely on experiments with rats. Improvements in mass, protein content, oxidative capacity, and glycogen concentration have been documented with conditioning by running of sufficient intensity and duration. The growth and development of soleus muscle grafts are severely impaired when normal weight bearing activity is removed. The mass and maximum tension development of grafts are increased with ablation of muscles that function synergistically to the grafts, but are diminished after chronic electrical stimulation. Chronic electrical stimulation does increase oxidative capacity, capillarity, and the resistance to fatigue. Much remains to be learned about the mechanisms by which activity-related adaptations occur in skeletal muscle grafts. PMID- 3956764 TI - On the nature and value of continuing medical education. PMID- 3956766 TI - Sexual behavior and steroid levels among gynecologically mature premenopausal women. AB - Twenty-seven gynecologically mature young women who participated in a 14-week study prospectively recorded daily sexual behavior and basal body temperature data. In addition, they supplied plasma three times during the last cycle of participation. Plasma was analyzed for estradiol (E2), testosterone (T), and progesterone (P) by radioimmunoassay. The levels of circulating sex steroid hormones during the luteal phase were examined in relation to measures of menstrual cycle length, sexual frequency, and coital total. The results indicated the following: (1) women who had weekly sex with men had higher levels of estrogen than women who did not; (2) total amount of coital behavior was not related to any of the hormones assayed; (3) neither T nor P were distinguished by the consistency of sexual behavior or by coital total; and (4) women with aberrant-length cycles tended to have lower levels of E2. Thus, E2 consistently showed relationships to sexual behavior and cycle length, whereas P and T did not. PMID- 3956765 TI - Advanced secretory changes in the proliferative human endometrial epithelium following clomiphene citrate treatment. AB - In an effort to characterize the effect of clomiphene citrate (CC) on the human endometrium, we took biopsy specimens of the endometrium 24 to 48 hours after CC treatment (100 to 250 mg/day for 5 consecutive days). Nineteen biopsy specimens were taken from 19 patients. Fifteen of the patients suffered from anovulatory infertility associated with oligomenorrhea or normal cycle length. The other four patients were amenorrheic, two in association with hypogonadotropic hypogonadism and two with hypergonadotropic hypogonadism. The histopathology of all samples was evaluated with the use of light microscopy, including periodic acid-Schiff (PAS) and PAS-diastase staining for glycogen demonstration. All samples were also examined with the use of scanning electron microscopy (SEM). Serum levels of estradiol (E2), progesterone (P), luteinizing hormone, and follicle-stimulating hormone were determined on the day of biopsy. In 10 of the 19 biopsy specimens, local or diffuse signs of early secretory events were demonstrated by the presence of subnuclear vacuolization and glycogen in the glandular epithelial cells. SEM corroborated these findings of advanced secretory changes by demonstrating apical protrusions at luminal epithelial cells and secretory products within the glands' openings. The E2 levels ranged between 110 and 1500 pg/ml (mean, 371 pg/ml) and P levels were either undetectable or less than 1.1 ng/ml. The two patients with hypogonadotropic hypogonadism both exhibited the same phenomena; those with primary ovarian failure had atrophic endometrium even after high-dose CC treatment. This observation, together with the low P levels detected, indicating the lack of luteinization, suggests a possible direct effect of CC on the endometrium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956767 TI - The biochemistry of human endometrium after two regimens of postcoital contraception: a dl-norgestrel/ethinylestradiol combination or danazol. AB - A combination of 0.5 mg levonorgestrel (in 1 mg dl-norgestrel) and 0.1 mg ethinylestradiol was administered to eight volunteers 48 hours after the start of the luteinizing hormone surge. A second dose was given 12 hours later. Endometrial samples were obtained 24 hours after the first dose was given. The steroid receptor concentration was compared with ovulatory spontaneous cycles. The dl-norgestrel/ethinylestradiol combination caused a significant reduction in receptor concentration. Isocitrate dehydrogenase (a progestin-sensitive enzyme) was also altered, suggesting an effect on endometrial metabolism. Danazol was used in a similar fashion, with two doses each of 400 mg. Nine volunteers were studied. A similar pattern of alteration of endometrial biochemistry was demonstrated but did not reach statistical significance. The relevance to the postcoital use of hormones is discussed. PMID- 3956768 TI - Comparison of two brands of clomiphene citrate for stimulation of follicular development in a program for in vitro fertilization. AB - Although clomiphene citrate (CC) is used frequently to stimulate multiple follicular development in in vitro fertilization programs, comparison of the two commercially available types has been limited. Therefore, a comparison was made of Serophene (Serono Laboratories, Inc., Randolph, MA) and Clomid (Merrell Dow Pharmaceuticals, Inc., Cincinnati, OH), using the same dosage regimen of CC (150 mg/day for days 3 to 7 of the cycle). Weights and ages of the two groups were not different. Serum estradiol (E2) levels were significantly elevated in Clomid cycles, but the number of developing follicles was not different between the two brands. The percentages of patients in each group who underwent laparoscopy, oocyte recovery, oocyte fertilization, and embryo transfer were also equivalent. Among patients undergoing laparoscopy, no differences in oocyte recovery, oocyte fertilization, and embryo development were noted. Thus, despite greater elevation of serum E2 levels with Clomid, no difference in stimulation regimen outcome was observed. PMID- 3956769 TI - Cytotoxic sperm antibodies inhibit sperm penetration of zona-free hamster eggs. AB - Zona-free hamster egg sperm penetration assay was used to study the effects of cytotoxic sperm antibodies on egg penetration by the sperm of fertile and infertile men. Twenty-nine fertile and 9 infertile men did not have significant cytotoxic sperm antibodies in their serum and seminal plasma; 7 infertile men were positive for these antibodies in serum and seminal plasma. Two others were positive in sera, and 14 were positive in seminal plasma. Sperm from 18 of 23 (78%) infertile men with sperm antibodies had poor egg penetration (less than or equal to 20%) compared with only 6 of 38 (16%) nonautoimmune men (P less than 0.0001). Sperm from nonautoimmune fertile men were coated with seminal plasma and serum of autoimmune men and serum of isoimmune women, resulting in a significant decrease in hamster egg penetration. Sixteen of 21 (76%) seminal plasma samples with cytotoxic sperm antibodies reduced the control sperm penetration of hamster eggs by greater than or equal to 50%. Coating of sperm from fertile men with serum and seminal plasma samples from non-sperm-immune fertile and infertile subjects did not alter their penetration of hamster eggs. Coating of sperm from autoimmune men with cytotoxic antibody-positive autologous seminal plasma samples resulted in a significant decrease of egg penetration. The inhibitory effect of antibody-positive seminal plasma samples on egg penetration by control sperm was abrogated when the samples were preabsorbed with sperm. It is concluded that cytotoxic sperm antibodies, especially those in seminal plasma, inhibit hamster egg penetration by autologous and control sperm. This may explain in part the incidence of infertility associated with sperm antibodies. PMID- 3956770 TI - Malposition of the ovary associated with uterine anomalies. PMID- 3956771 TI - Decreased sensitivity to insulin in women with microprolactinomas. AB - To determine whether there exists an altered sensitivity to insulin in hyperprolactinemia, we studied, in 15 women with microprolactinomas, the insulin effects on glucose, PRL, GH, and cortisol before and after successful adenoma removal. Our results show that in women with microprolactinomas, the sensitivity to insulin is lower in hyperprolactinemia than in normoprolactinemia achieved by selective adenomectomy. PMID- 3956773 TI - Endometrial biopsy. PMID- 3956772 TI - The risk of fetal anomalies as a result of progesterone therapy during pregnancy. AB - The incidence of congenital anomalies in infants born to 382 women treated with P was noted. Only five anomalies occurred in the infants born to women who had taken P. This study supports the data of Rock et al. by demonstrating a similar low incidence of birth defects in a much larger series of patients who also took a much higher dosage of P. Similarly, because only 1 of 189 patients treated with both P and 17-OHP developed anomalies, the data supports the study by Katz et al., suggesting no increase in anomalies related to 17-OHP therapy. PMID- 3956774 TI - Hysterosalpingography. PMID- 3956776 TI - [Non-invasive evaluation of end-systolic pressure in the left ventricle]. PMID- 3956775 TI - [Evaluation of the cholinergic regulation of cardiac activity in experimental hyperthyroidism]. PMID- 3956777 TI - [Comparative characteristics of the effect of various Ca2+ antagonists on coronary vessels and the myocardium]. PMID- 3956778 TI - [Antioxidants as antiarrhythmic drugs]. PMID- 3956779 TI - [Morphologic and biochemical criteria of the efficacy of clinical use of phosphocreatine (neoton) for intraoperative protection of the myocardium]. PMID- 3956780 TI - [Effect of hyponatremia and frenolone on the contractile function of isolated myocardium]. PMID- 3956781 TI - [Paradoxical effect of reductions in the concentration of extracellular sodium on parameters of the inward current in the membranes of isolated myocardiocytes]. PMID- 3956782 TI - [Contractile function of the myocardium and coronary circulation in acute coarctation of the aorta]. PMID- 3956783 TI - [Changes in the contractile and electrical activity of the myocardium of the rat in response to verapamil in the presence of inadequate oxygen supply]. PMID- 3956784 TI - [Contractile function of the papillary muscles of the heart of the rat at different ages]. PMID- 3956785 TI - [Effect of vagal bradycardia on reactive hyperemia of the myocardium]. PMID- 3956786 TI - [Use of beta-adrenoreceptor blockade to increase the information value of indices of contractility during evaluation of the functional state of the myocardium]. PMID- 3956787 TI - [Effect of sodium nitroprusside on central hemodynamics in healthy subjects and in a state of acute myocardial infarction]. PMID- 3956788 TI - [Evaluation of myocardial contractility during auxotonic contractions]. PMID- 3956790 TI - [Electrocardiographic and immunologic shifts and changes in blood coagulability in experimental myocardial infarct before and while using antibiotics]. PMID- 3956789 TI - [Oxygen supply to the bodies of patients with ischemic heart disease (IHD) during measured physical loading]. PMID- 3956791 TI - [Spike activity of neurons of the medulla oblongata associated with cardiac and respiratory rhythms]. PMID- 3956792 TI - Induction of oral tolerance, in mice, to gum arabic. AB - As part of a programme of research on the immunological properties of the exudate gums, the capacity of gum arabic to induce immunologic hyporesponsiveness when fed (oral tolerance) has been examined. Inbred mice were fed saline or gum arabic; 1 week later all were systemically immunized with the antigen emulsified in complete Freund's adjuvant. Mice which had been fed the antigen had significant suppression of the humoral (P less than 0.01) and cell mediated (P less than 0.01) immune responses to the antigen. These results demonstrate that although gum arabic is a complex, proteinaceous polysaccharide antigen, it is tolerogenic when an animal encounters it by the natural route, via the gut. PMID- 3956793 TI - Immunogenicity, immunological cross reactivity and non-specific irritant properties of the exudate gums, arabic, karaya and tragacanth. AB - An animal model has been used to investigate the immunogenicity and non-specific irritant properties of exudate gums. The materials studied were four preparations of gum arabic (Acacia spp.), two of gum karaya (Sterculia spp.), two of gum tragacanth (Astralagus spp.) and a residue obtained after ethanol extraction of gum arabic. Groups of animals were intradermally immunized with the gum in complete Freund's adjuvant. Serum antibody levels were measured by an ELISA technique and delayed hypersensitivity responses by a footpad swelling test. Antigenic cross-reactivity within each gum species was tested in a crossover fashion. All gum preparations elicited systemic immune responses after immunization. Further processing reduced immunogenicity, although there was no evidence that systemic immunity to these complex polysaccharide antigens responses could be completely abolished by processing or purification. The ethanolic extract, and some of the gum preparations, particularly tragacanth and karaya, caused considerable footpad swelling when injected intradermally. It is concluded that processing and awareness of subspecies differences can reduce the inherent immunogenicity and potential irritant effects of exudate gums. PMID- 3956794 TI - Effect on hepatic ornithine decarboxylase of some food additives and synthetic elastomers. AB - The food additives butylated hydroxytoluene, butylated hydroxyanisole and sodium cyclamate and the precursors for packaging materials acrylamide, acrylic acid, acrylonitrile and vinylpyrrolidone were investigated for their ability to induce hepatic ornithine decarboxylase (ODC) in vivo, in order to obtain indications about their possible tumour-promoting activities. It was shown that butylated hydroxyanisole, acrylonitrile, vinylpyrrolidone and acrylamide have the capacity to increase rat liver ODC activity, while butylated hydroxytoluene, acrylic acid and sodium cyclamate did not affect ODC activity. PMID- 3956795 TI - Migration of melamine and formaldehyde from tableware made of melamine resin. AB - Migration of melamine and formaldehyde into food-simulating solvents from cups made of melamine resin was studied under various conditions. Little migration of melamine was observed in any unused cups kept at 60 degrees C for 30 min, room temperature (26 degrees C) for 1 h or cooled at -20 degrees C for several days. Migration of both compounds was strongly affected by heating and acidity. The highest migration of melamine into 4% acetic acid used as a food-simulating solvent was 42.9 +/- 7.2 ppm when the migration test was repeated seven times at 95 degrees C for 30 min. In this time, the migration of formaldehyde was 14.2 +/- 0.6 ppm into the solvent. The molecular ratio of the migration amount of formaldehyde to melamine decreased according to the formula Y = 9.15X-0.813 over seven repetitions of the test, and was maintained at about 1.6 between the 10th and 20th repetitions. The inner surface of the cups became tarnished during the repetition of the test and their roughness increased from 1 micron before the test to 2.5-5 microns after 20 repetitions of the test. Migration of melamine from the cups being used at a cafeteria was 0.4 +/- 0.5 ppm, but that of formaldehyde was undetectable when the cups were kept at 60 degrees C for 30 min with 4% acetic acid. PMID- 3956797 TI - Liver trauma and bile leak: the value of liver and hepatobiliary imaging--a case report. PMID- 3956796 TI - Estimation of the dietary intake of chemicals in food. AB - Methods for estimating the exposure of individuals to chemical substances present in the diet require information to be obtained about the patterns of food consumption in a community as well as the concentration of these chemicals in the diet. Methods of estimating food intakes using food diaries/weighed intake studies, dietary recall studies, food frequency and food disappearance methods are described. Their use, together with calculations derived from the data they provide are described to estimate normal and atypical food consumption patterns. The methods which have been used to estimate the exposure to existing chemicals in food are briefly reviewed and include total diet studies, selective studies on individual foods and duplicate portion studies. These methods are inappropriate for estimating the prospective intake of a chemical in food and the ways in which this issue may be approached, both nationally and internationally, are described with particular reference to the intakes of pesticide residues and food additives. PMID- 3956798 TI - Solitary lung lesion with cavitation due to necrotizing sarcoid granulomatosis. PMID- 3956799 TI - Are all health disciplines working together. PMID- 3956800 TI - Selection of trauma victims for emergency room thoracotomy. PMID- 3956801 TI - No margaritas for babies, please. PMID- 3956802 TI - Accounting for migration in cohort-component projections of state and local populations. AB - Migration is the most difficult component of state and local population growth to forecast accurately because it is more volatile than either births or deaths, and subject to much larger fluctuations within a short period of time. In addition, migration rates can be based on several different measures of migration and the base population. The choice of the appropriate base population has received little attention from demographic researchers, but can have a tremendous impact on population projections. In this article, I develop three different models for projecting migration, each using a different denominator for migration rates. Population projections for ten states are made, using identical data and cohort component techniques, except for the different formulations of migration rates. Differences among the three sets of projections are noted, and conclusions are drawn regarding their usefulness as forecasts of population growth. PMID- 3956803 TI - Seasonal fertility cycles in rural Egypt: behavioral and biological linkages. AB - The annual birth cycle in rural Egypt peaks in December and has two distinguishable minima in June and September. This pattern bears a striking inverse resemblance to the seasonal movements of employment and wages. Infant and child mortality and marriage also display stable, though different seasonal patterns. The paper explores whether the correlation between labor demand, mortality events and fertility reflect some causal behavioral relationship. It is shown that the probability of a birth is lower in months with high opportunity cost of time. Direct replacement is a significant phenomenon in rural Egypt and it occurs fairly quickly. PMID- 3956804 TI - Comment on Barbara Devaney's "An analysis of variations in U.S. fertility and female labor force participation trends". PMID- 3956805 TI - The effects of breastfeeding and pace of childbearing on mortality at early ages. AB - The effects of the pace of childbearing and breastfeeding practices on infant mortality have rarely been considered together. In this paper, we design and use a set of methodological tools to test a variety of hypotheses postulating the effects of breastfeeding and pace of childbearing on mortality in infancy and early childhood, the mechanisms through which those effects operate, and the contingencies that strengthen or weaken them. The strong effects of both length of breastfeeding and the pace of childbearing on the risks of child death suggest that neither of them exerts an impact on mortality totally mediated by the other. Social and demographic factors (such as age of child, education of mother, and region of residence) also condition the impact of breastfeeding and pace of childbearing on mortality. PMID- 3956806 TI - The determinants of effective fecundability based on the first birth interval. AB - There are substantial differences in fecundability among nine developing countries in different parts of the world. In addition, within countries, later age at marriage has a clear, positive, nonlinear effect on fecundability. Women with higher education and those with more educated husbands have higher fecundability. Urban residents have higher fecundability than rural. The higher fecundability of more recent cohorts is the most consistent observation. Since those variables most frequently shown to have inverse relationships to fertility show direct relationships to fecundability within populations, the role of fecundability as a proximate variable in models of the determinants of fertility requires further specification. PMID- 3956807 TI - An economic model of teenage pregnancy decision-making. AB - In this paper, we model unmarried teenagers' decisions about their pregnancy outcome by considering that the teenager contrasts her expected utility (1) as a married mother, (2) as an unmarried mother, or (3) after abortion. We use cross sectional data on 297 California teenagers aged 13-19 who were pregnant for the first time between 1972 and 1974. Both Anglo and Mexican-American girls are included. We find that pregnant girls who are eligible for or are receiving public assistance are more likely to give birth and remain unmarried. Teenagers with greater time values are more likely to choose abortion, and Mexican-American girls are more likely to carry their pregnancies to term. PMID- 3956808 TI - The decline in occupational sex segregation during the 1970s: census and CPS comparisons. AB - An assessment of changes in occupational sex segregation during the 1970s, as measured by the Census and Current Population Survey, is complicated by the recent reclassification of occupations. Once this is taken into account, it is apparent from both the Census and the CPS that there was a decline in occupational sex segregation in the 1970s and that the decline was probably more substantial than in the 1960s. PMID- 3956809 TI - Mortality by nativity. AB - This note reports the reversal of the mortality-nativity relationship in the United States. In the first half of the twentieth century, mortality among foreign-born Americans was greater than among (white) native Americans. Data for 1980 show that now mortality among the foreign-born is markedly lower than among native Americans. PMID- 3956810 TI - Dynamic flow modeling with interregional dependency effects: an application to structural change in the U.S. migration system. AB - Causative matrix methods can be used to project levels of population change, to monitor changing migration trends, and to aid in forecasting movement during periods of consolidation and dissipation. They are appealing because they provide measures of the changing strengths of all interregional dependency effects. Separate competing destinations and competing origins perspectives on temporal change can be obtained. The column sums and the eigenvalues provide useful aggregate gauges of the relative strengths of regional shifts. Patterns of U.S. interregional migration from 1935 to 1982 are examined using the causative matrix approach. Trends in the gross migration streams underlying the dramatic increase in core-periphery net migration taking place in the 1970s are examined, as is a more recent shift in the major source area of core region net outflow. PMID- 3956811 TI - [Differential diagnosis of livedo reticularis]. PMID- 3956812 TI - [Treatment of naevi aranei and telangiectasis with an argon laser]. PMID- 3956813 TI - [Therapy of psoriatic arthritis]. PMID- 3956814 TI - The therapeutic activity of haemodialysis with polyacrylonitrile filters in certain skin disorders. PMID- 3956815 TI - [Experiences with the immunosuppressive treatment of circumscribed scleroderma in children and adolescents]. PMID- 3956816 TI - Pseudopelade of Brocq. AB - 41 cases with scarring alopecia seen from 1979 to 1983 were analyzed and differentiated. After exclusion of 7 cases with lichen planopilaris, of 5 cases with discoid lupus erythematosus, of 2 cases with scleroderma, and of 1 case with folliculitis decalvans, there remained 26 cases. The clinical histological and direct immunofluorescence (DIF) findings in these patients suggest that pseudopelade of Brocq might be a distinct disease unrelated to other known types of scarring alopecia. The histopathology is characteristic, and shows the following features: little or only moderate lymphocytic infiltrate, absence of significant follicular plugging, and absence or decrease of sebaceous glands. DIF is negative, occasionally only IgM can be found at the basement membrane. The course of the disease is slowly progressive (in spite of little or no visible erythema), becoming eventually stationary after several years and resulting in a more or less severe permanent hair loss. PMID- 3956817 TI - Langerhans cells in allergic contact dermatitis: state of the art. PMID- 3956818 TI - Quantitation of facial affection in scleroderma. AB - The interincisor distance, the vertical lip distance, and the horizontal oral distance were measured in 68 patients with generalized scleroderma and in 66 healthy individuals. Interincisor distance and vertical lip distance were decreased in scleroderma (p less than 0.001 and p less than 0.001). Vertical lip distance and horizontal oral distance provided clinically a clear differentiation between minor and major affection (p less than 0.001 and p less than 0.001), while the interincisor distance provided a weaker differentiation (p less than 0.05). The horizontal oral distance correlated with the duration of scleroderma (r = -0.289, p less than 0.05), and the vertical lip distances tended to do so (r = -0.208, n.s.). In healthy individuals interincisor and vertical lip distances decreased significantly with age (in males only), while the horizontal oral distance showed no significant decrease. In conclusion, interincisor and vertical lip distances are preferable for diagnosis and the horizontal oral distance for follow-up of facial scleroderma. If only one vertical parameter is wanted, the authors prefer the vertical lip distance to the interincisor distance. PMID- 3956819 TI - Colchicine treatment of urticarial vasculitis. AB - A patient with clinically and histologically typical urticarial vasculitis has been treated with 0.5 mg of colchicine three times per day. This treatment resulted in both disappearance of urticarial skin lesions and amelioration of severe systemic symptoms such as abdominal pain, fever and arthralgia. Colchicine is proposed as an effective therapeutic agent for urticarial vasculitis if other drugs are ineffective, poorly tolerated or contraindicated. PMID- 3956820 TI - Treatment of hyperhidrosis by a battery-operated iontophoretic device. AB - A new iontophoretic device was utilized in the treatment of hyperhidrosis axillaris (5 patients), hyperhidrosis manuum (12 patients) and hyperhidrosis pedum (10 patients). Unilateral treatment was carried out daily for 3 weeks. Degree of sweat inhibition was assessed quantitatively in relation to the untreated control side by means of hygrometry and also estimated by a colorimetric method. In 3 patients with palmar hyperhidrosis and in 2 patients with plantar hyperhidrosis sweating returned to normal levels, thus hyperhidrosis was completely curbed. A moderate reduction of sweat rates was induced in 4 patients on palms and in 3 patients on soles. In the remaining group sweat inhibition was only slight. In treatment of palmo-plantar hyperhidrosis side effects were minimal. Axillary hyperhidrosis was only moderately reduced in some patients. Skin irritation due to iontophoresis posed a problem. PMID- 3956821 TI - Immune complexes in patients with contact dermatitis. AB - By C1q binding assay, circulating immune complexes (cic) were detected in 19 out of 30 patients with contact dermatitis to nickel or chromium. Their presence was correlated with the duration of the disease, while any patients positive for cic showed any signs of type III immunopathological lesions. Atomic absorption analysis of the polyethlylene glycol precipitates (PEG ppt) from the sera of 16 patients--8 positive and 8 negative for cic--revealed an amount of nickel or chromium significantly higher in the PEG ppt from the sera of patients positive for cic. PMID- 3956822 TI - Atopic cataract induced by severe allergic contact dermatitis on the face. AB - Although atopic cataracts commonly occur in adolescent and young adult patients with severe atopic dermatitis, we observed a 34-year-old woman with mild atopic dermatitis who abruptly developed atopic cataracts in both eyes when she suffered from severe allergic contact dermatitis on the face. This case seems to suggest that prompt control of severe dermatitis on the face in patients with atopic dermatitis is important for prevention of atopic cataract, whether the dermatitis on the face is atopic or nonatopic in nature. PMID- 3956823 TI - Multiple agminate juvenile melanoma. PMID- 3956824 TI - Photosensitivity associated with Carprofen. PMID- 3956825 TI - Amniotic fluid 25-hydroxyvitamin D concentrations in normal and complicated pregnancy. AB - The concentration of 25-hydroxyvitamin D (25(OH)D) was measured in 85 samples of amniotic fluid (AF) obtained near term from mothers with normal pregnancy, diabetes, pre-eclampsia or intrahepatic cholestasis of pregnancy. Significantly lower AF 25(OH)D levels were found in diabetic mothers than in the three other groups. Our results suggest that the vitamin D status of the fetoplacental unit may be somewhat impaired in diabetic pregnancy. PMID- 3956826 TI - Chronic villitis of unknown aetiology and decidual maternal vasculopathies in sustained chronic hypertension. AB - Ninety-six full-term placentae were examined in the study. Of the 96 pregnancies, 72 were normotensive and 24 were complicated by hypertension. Of the 24 hypertensive pregnancies, 19 patients had chronic hypertension only, and 5 had chronic hypertension with superimposed preeclampsia. The birth weights of babies were over the 25th centile of our ponderal curve in all cases. Chronic villitis of unknown aetiology (CVUE) was found in 25% of control placentae and in 26% of placentae from chronic hypertension without preeclampsia. Eighty percent of placentae of chronic hypertension with superimposed preeclampsia presented the lesion. The incidence of CVUE was significantly higher in the latter than in the other groups. The same was observed about the proportion of inflamed villi. A higher frequency of maternal vascular lesions was observed in placentae of chronic hypertension with superimposed preeclampsia. Similar incidence and severity of the above-mentioned placental lesions have been recently described in preeclamptic pregnancies. These results suggest that these lesions (CVUE and maternal vasculopathies) are related to preeclampsia and not only to maternal hypertension. PMID- 3956827 TI - The effect of ten years of regionalized perinatal health care in Iowa, U.S.A. AB - In 1973, Iowa, a rural, midwestern state in the U.S.A., established a Statewide Perinatal Care Program. A major objective was to develop and maintain a regionalized system of care. Such a system has been developed but differed from traditional systems by using regional level II centers. Iowa's low population density necessitated this modification. The development and maintenance of Iowa's system is described. Evaluation is provided by analysis of commonly available birth and mortality data. Improved birth-weight-specific neonatal and fetal mortality rates suggest an overall improvement in care. A more favorable birth weight distribution and evidence of screening and selective referral of high-risk patients provide evidence of improvements in prenatal care. Data are presented to show that a stratified system of care is evidence in the state. Level I hospitals currently manage low-risk patients and report very low mortality rates. Level II facilities receive high-risk referrals, but selective referral occurs since the tertiary center accounts for a disproportionate number of fetal and neonatal deaths, and births weighting less than 1500 g. Other regions may benefit from similar approaches to development of regionalized systems of care and evaluation of the same. PMID- 3956828 TI - Essential prolonged and hypertonic contractions. AB - Spontaneous hypertonic and prolonged contractions (essential hypertonus) do exist, as illustrated in this case report. Conservative treatment can be used, if the fetal heart rate pattern remains normal. PMID- 3956830 TI - Predictive value of the abnormal PAP smear: a retrospective analysis of error rates. AB - The validity and performance of the Papanicolaou (PAP) smear, as a diagnostic test, was retrospectively analysed in 806 patients who presented with at least one abnormal smear. Histological tissue examination was available in 620 of these patients. It is shown that the definition of errors, selection criteria of smears, time intervals between examinations, definition of 'disease' and the values separating 'positive' and negative' test results must be clearly defined before comparison with other published error rates is possible. Consequently, a standardized method of reporting is recommended. Exact agreement between the results of cytology and histology was poor. The use of sensitivity, specificity and predictive values is preferred, but it is shown that precise definitions are still necessary. The optimal choice of the value separating positive and negative test results, i.e., the choice between an expectant and an active management of patients, must be tailored to the anticipated prevalence of the disease. PMID- 3956829 TI - Effect of selective occlusion of the umbilical arteries and/or veins on uterine blood flow in sheep. AB - Maternal uterine blood flow was depressed during total umbilical cord occlusion, probably based on an increased fetal cotyledonary tissue pressure (Hasaart and de Haan (1985) Eur. J. Obstet. Gynec. Reprod. Biol., 19, 125-131). This supposed mechanism was further analysed by performing selective occlusions of the umbilical arteries and/or veins (mean occlusion time 35 s). An occluding device which allowed separate occlusion of umbilical veins and arteries was applied to the umbilical cord in 7 chronically prepared fetal lambs between 106 and 135 days gestation. Median uterine artery blood flow (UBF) was measured with an electromagnetic flow meter. During occlusion of both umbilical veins (VV, n = 22) in 6 animals a maximal decrease in UBF to 87.5% of control value (P less than 0.001) was found at the end occlusion, followed by a gradual return to control value in the post occlusion period. Occlusion of both umbilical arteries (AA, n = 29) in 5 animals was accompanied by a slight increase in UBF to 103% of control value (P less than 0.01). Total occlusion of the umbilical arteries and veins simultaneously (n = 17) in 4 animals did not result in any change in UBF. The changes in volume and turgor in the fetal cotyledonary tissue associated with the arterial and venous occlusions should lead to respectively a decrease (AA) and increase (VV) in resistance to maternal flow, causing the changes in uterine blood flow. It is concluded that volume changes in the fetal compartment of the sheep placenta affect maternal uterine blood flow. PMID- 3956831 TI - The setting-up of an ambulatory urologic-gynecologic service. Management of patients and results. AB - An ambulatory set-up is presented which comprises a simple armamentarium for management of women complaining of urinary stress incontinence. Since history appeared to be not sufficiently reliable for management of patients, diagnosis was based mainly on cystomanometry and radiology. Of 58 women who have completed at least six months of follow-up, 11 had been diagnosed as suffering from detrusor instability (DI) and 47 from genuine stress incontinence (SI). Treatment was medical in the former group and surgical in the latter. Significant or complete relief of symptoms was reported in 91% of the former group and in 81% in the latter. PMID- 3956832 TI - First experiences with Swan-Ganz measurements in patients with severe hypertension during pregnancy from an unselected population. AB - In 10 patients with severe hypertension during pregnancy (6 patients with preexisting hypertension and 4 with severe preeclampsia) Swan-Ganz measurements were done in order to detect and correct a reduced circulating volume and lower the blood pressure. It appeared that 6 patients had a reduced circulating volume (group I) and 4 patients a normal circulating volume (group II). In both groups there were 2 patients with severe preeclampsia; most patients were referred and had antihypertensive medication before and most infants had a birthweight less than the 10th centile. A difference was found in prolongation of pregnancy if counted from the first hemodynamic measurement (and start of therapy): on average 25 days in group I (despite careful volume correction and vasodilatation) versus on average 25 days in group II (vasodilatation only). Moreover, all infants but one were delivered by cesarean section, but fetal distress as indication for delivery was only noted in group I. Although Swan-Ganz measurements are very useful to determine filling state and effect of therapy it is concluded that once a reduced circulating volume is present one is too late to be able to prolong pregnancy considerably despite proper therapy of volume correction and vasodilatation. This makes Swan-Ganz measurements on "fetal indication" questionable. PMID- 3956834 TI - Urinary steroid profiles in gestosis syndrome. AB - Urinary steroid profiles were studied using gas chromatography in eighteen pregnant women with EPH-gestosis. A drastic and probably aspecific decrease in urinary steroid concentrations was observed in all metabolic profiles when compared with physiological counterparts. The phenomenon seems to be strictly dependent upon the syndrome and disappears after effective therapy. PMID- 3956833 TI - Bladder wall mechanics and micturition before and after subtotal and total hysterectomy. AB - Twenty-two women were assigned at random to subtotal (n = 11) or total (n = 11) hysterectomy. The frequency of micturition was recorded and urodynamic investigation was performed before, and 6 weeks and 6 months after the operation. After hysterectomy the frequency of diurnal micturition decreased and the urethral conductance increased in all patients. After total hysterectomy an increased bladder volume was found. The two operative methods did not differ with respect to pre- and postoperative changes of urinary frequency or urodynamics. The bladder function was not altered by either operation. PMID- 3956835 TI - Evaluation of reliability of history in women complaining of urinary stress incontinence. AB - It was the aim of this study to evaluate critically the value of history in patients complaining of urinary stress incontinence. Diagnosis was established mainly by radiologic and cystomanometric assessment. History included 21 symptoms subdivided into various items. Only 3 symptoms were proven significant in distinguishing between various diagnostic groups. Assessment of stress incontinence should be regarded as incomplete without other means of evaluation in addition to history. PMID- 3956836 TI - Abdominal splenosis mimicking abdominal carcinomatosis. AB - Abdominal splenosis is an uncommon condition. Since ovarian abdominal carcinomatosis might be discovered unexpectedly and the finding might be similar to it, the scope of the present paper is to draw attention to such a possibility. PMID- 3956837 TI - In vitro fertilization and embryo transfer of pre-ovulatory rabbit oocytes. AB - The objective of this study was to develop an effective and successful technique of in vitro fertilization in rabbits that could lead us to start treatment of infertile couples by using extracorporal fertilization. Pre-ovulatory oocytes were harvested from follicles of virgin does 9 h after induction of ovulation by hCG injection, and incubated with in vivo capacitated sperm for 5 h. An 82% in vitro fertilization rate was achieved. The fertilized ova were cultivated for an additional 20, 44 and 68 h, and until they reached the hatched blastocyst stage. Most of these embryos (439) were transferred to 42 pseudopregnant recipients, asynchronous in the sense that they had been given hCG injections 0, 6, 12, 18, 24, 36 and 42 h later than the rabbits from which the ova had been obtained. With this type of synchronicity implantation rates of 31, 78, 52, 33, 52, 33, 51 and 10% were achieved, respectively. One hundred and twenty-eight embryos were not transferred to recipients but cultured in Ham's F-10 medium supplemented with 20% FCS. 77% of these embryos reached the stage of hatched blastocyst. A total of 143 young were born after 28-32 days of gestation and all are fertile till the third generation. Our results were obtained in a consecutive series of experiments, and demonstrated that in vitro fertilization can be made to work quite well in the rabbit, which in the early stages of embryogenesis has sufficient similarity to the human to make it a useful model for those wishing to acquire techniques applicable to human fertilization in vitro and embryo transfer. PMID- 3956838 TI - Human lactic dehydrogenase as a marker for monitoring the growth of prostatic carcinoma in nude mice. AB - Human lactate dehydrogenase (1,1,1,27-LDH) isoenzymes were determined in human prostatic carcinoma cell lines. The isoenzymes LDH-4/LDH-5 were identified and quantified in the serum of athymic mice bearing the human prostatic carcinoma cell lines PC-3, PC-3/M and DU 145 subcutaneously. The amounts of the slowly migrating isoenzymes released by the solid tumors correlated with increasing tumor volume and tumor weight. These correlations indicate that the human LDH 4/LDH-5 isoenzymes are useful parameters for monitoring the presence and growth of prostatic cancer in the athymic animal model. PMID- 3956839 TI - Low frequencies of apparently fragile X chromosomes in normal control cultures: a possible explanation. AB - Low frequencies of apparently fragile X [fra(X)] chromosomes have been reported in normal control, short-term, whole blood cultures, and they have been noted in both amniocyte and fetal blood cultures. However, there is currently no universal agreement on the lowest frequency for fra(X)(q27) that is diagnostic for the fragile X syndrome. Here, we present our observations on low levels of apparently fra(X) chromosomes in normal samples. We observed frequencies of 0.5% in short term whole blood cultures and 0.9% in amniotic fluid cell cultures. In 1982, Steinbach et al. described nonspecific telomeric structural changes (TSC) and suggested that such low frequencies of apparently fra(X) chromosomes in normal material may be occurring by the same mechanism that is responsible for TSC formation. To determine if TSC formation can explain the significant baseline frequencies of fra(X) in normal controls, 10,457 cells were screened from 178 individuals referred for fra(X) analysis. Our findings indicated that TSC are not randomly distributed across chromosomes but tend to occur at specific sites. Based on our observations, we offer the hypothesis that the low frequency of apparent fra(X) in normal individuals may be due to nonrandom TSC distribution. PMID- 3956840 TI - Characterization of acyl-CoA:cholesterol acyltransferase from neonatal chick liver. AB - Endogenous cholesterol esterification in chick liver microsomes was catalyzed by acyl-CoA:cholesterol acyltransferase using palmitoyl-CoA as substrate. An acyl CoA hydrolase activity was also found in our microsomal preparations. Acyltransferase activity was stable after microsomes storage at -40 degrees C for 6 weeks and increased linearly with the preincubation time between 0 and 45 min. In our assay conditions, cholesteryl ester formation was linear up to 0.3 mg of microsomal protein in the reaction vial and 10 min of incubation. Maximal activity was found in reactions carried out in the presence of 1-2 mM dithiothreitol and 1.2 mg of bovine serum albumin, while acyl-CoA hydrolase was clearly inhibited by increasing albumin amounts. PMID- 3956841 TI - Kinetics of the interactions of the chicken erythrocyte AMP deaminase with anthraquinone compounds. AB - Alizarine sulfonate, the anthraquinone containing both sulfonate and hydroxyl groups, showed an activating and inhibitory effect on the chicken erythrocyte AMP deaminase (EC 3.5.4.6). The cooperative effect of AMP, analyzed in terms of Hill coefficient, was decreased from 2.4 to 1.1 with the increase in the dye concentration, suggesting the dye as an allosteric activator of the enzyme. However, alizarine sulfonate acted as a mixed type inhibitor in the presence of higher level of AMP. The action of alizarine sulfonate can be accounted for by assuming that the dye binds to the enzyme at the allosteric-activating sites with a broad specificity toward nucleotide binding, and further at the specific inhibitory sites. PMID- 3956842 TI - Characterization of sialyltransferases from serum of normal and hepatoma Mc-29 bearing chickens. AB - Sialyltransferase was measured in serum of normal and hepatoma Mc-29 bearing chickens. By preparative isoelectric focusing the multiple forms of sialyltransferase from both kind of serums was studied as well. By using influenza virus neuraminidase an attempt was made for partial structural characterization of the sialylation sites in asialofetuin applied as exogenous acceptor for sialyltransferase determination. It was established an elevated serum sialyltransferase activity in tumor bearing chickens with tumor an enzyme form was detected with pI-4.99 identical with an enzyme form described previously in solubilized plasma membrane preparations from hepatoma Mc-29. Monitoring of multiple forms of serum glycosyltransferases may be of value in answering the problem concerning the tissue origin of serum enzymes. PMID- 3956843 TI - The reactivity of the disulfide bonds of human serum haemopexin. AB - The reactivity of the disulfide bonds of the specific haeme-binding plasma protein-human haemopexin has been studied with 2-mercaptoethanol. A molecule of haemopexin has six intrachain disulfide bridges (Takahashi et al., 1985) or which four are reactive while the remaining two can be reduced in the presence of greater than or equal to 4M urea. Disruption of the four reactive disulfide bonds in apohaemopexin abolishes the haeme binding ability. In equimolar haeme haemopexin complex only one disulfide is reactive which suggests a large change in the tertiary structure of this protein on haeme binding. PMID- 3956844 TI - Irreversible inhibition of trypsin by TLCK. A continuous method for kinetic study of irreversible enzymatic inhibitors in the presence of substrate. AB - This work presents a kinetic study on irreversible inhibition of trypsin by TLCK, using a new experimental approach. The method consists of the incubation of the enzyme with an irreversible inhibitor in the presence of a substrate which allows enzyme turnover as well as continuous measurement of the appearance of the product, a simultaneous change in the initial concentrations of the irreversible inhibitor and enzyme being undertaken, though a constant ratio between the latter, is maintained. This new approach enables the kinetic constants for TLCK, k2 and K1, to be determined. PMID- 3956845 TI - Organization and dynamics of protein complexes within the chloroplast thylakoid membrane. PMID- 3956846 TI - Biogenesis of plasma membranes in polarized epithelial cells. PMID- 3956847 TI - Use of monoclonal antibodies to investigate the intracellular transport and biogenesis of intestinal brush-border proteins. PMID- 3956848 TI - Formation of desmosomes in polarized and non-polarized epithelial cells: implications for epithelial morphogenesis. PMID- 3956849 TI - Photoregulation of expression of genes encoding ribulose-1,5-bisphosphate carboxylase/oxygenase. PMID- 3956850 TI - The carboxylase-large-subunit-binding protein: photoregulation and reversible dissociation. PMID- 3956851 TI - Comparative study of the therapeutic and adverse effects of two antidepressants- dothiepin and mianserin. PMID- 3956852 TI - Transcriptional and post-transcriptional inhibition of albumin gene expression by estrogen in Xenopus liver. AB - The purpose of this study was to investigate the suppression of albumin mRNA by estrogen in Xenopus liver. A single dose of estradiol rapidly suppressed albumin mRNA to 30% of the control level. Albumin mRNA remained at this new steady-state level for 9 days, after which it returned to the control level. Transcription 'run-on' experiments in isolated liver nuclei demonstrated a transient decrease of 60-90% in albumin transcription after 2-6 h and approached constitutive transcription by 12 h. Albumin gene transcription then remained constant for the following 12 days. Prolonged and enhanced suppression of albumin mRNA was observed in animals treated repeatedly with estrogen for 12 days. In these animals, albumin gene transcription was decreased 80-90% from the constitutive control level. These data indicate that albumin mRNA is suppressed by both transcriptional and post-transcriptional mechanisms. PMID- 3956853 TI - Characterization of the adenylate cyclase of the rat corpus luteum during luteolysis induced by a prostaglandin F2 alpha analogue. AB - Rats with superluteinized ovaries were injected with the prostaglandin F2 alpha (PGF2 alpha) analogue cloprostenol to induce luteolysis. The treatment led to decreased adenylyl cyclase response to hCG and isoproterenol in ovarian homogenates while the response to forskolin remained unchanged indicating that the catalytic unit of the enzyme was not affected by the treatment. The activation of adenylyl cyclase by Mg2+ or the non-hydrolysable guanosine triphosphate (GTP) analogue guanosine-5'-(beta,gamma-imido)-triphosphate (GMP P(NH)P) was not altered by the treatment with cloprostenol. Both basal and hormone-stimulated adenylyl cyclase activity increased with increasing concentration of GMP-P(NH)P. Unstimulated adenylyl cyclase continuously increased with increasing concentrations of Mg2+. The same applied to forskolin. The dependence of the adenylyl cyclase stimulation by hCG and isoproterenol on Mg2+ was complex. It is postulated that PGF2 alpha induces the attenuation of ovarian adenylyl cyclase by a modification in the coupling of the hormone-receptor to the N beta-component of the adenylyl cyclase complex while the catalytic unit remains unchanged. PMID- 3956854 TI - Structure of a guinea pig common precursor to a MSEL-type neurophysin and copeptin. AB - From guinea pig posterior pituitaries, a MSEL-type neurophysin (neurophysin containing methionine-2, serine-3, glutamic acid-6 and leucine-7), a glycopeptide referred to as copeptin and their common precursor have been purified to homogeneity and sequenced. The performed acid-oxidized precursor, subjected to trypsin hydrolysis, has given 9 peptides, 6 of which (T1-T6) identical to those given by oxidized MSEL-neurophysin except that T6 has an additional C-terminal arginine residue when compared to its homologue. The other 3 tryptic peptides (T7 T9) are identical to those given by copeptin. The 132-residue precursor therefore comprises a MSEL-type neurophysin (93 residues) and copeptin (38 residues) linked by an arginine residue. The molar proportion of this bound form compared with the free polypeptides is approximately 20%. It is believed that this precursor is a part of the vasopressin-MSEL-neurophysin-copeptin precursor incompletely processed during the transport from hypothalamus to neurohypophysis. PMID- 3956855 TI - Cyclic AMP-dependent phosphorylation of high molecular mass proteins in pig thyroid cells. AB - Four high molecular mass (H Mr) proteins were found to be phosphorylated in a cyclic AMP-dependent manner in both partially purified pig thyroid membrane fractions and in pig thyroid cells in culture. These phosphoproteins did not correspond to major cellular proteins; they were found in both soluble and particulate subfractions of homogenates from cultured thyroid cells. The molecular mass of the 4 proteins named HMr1 to HMr4 determined by polyacrylamide gel electrophoresis in the in the presence of sodium dodecylsulfate was about 310 000 for HMr1, 250 000 for HMr2, 240 000 for Hmr3 and 220 000 for HMr4. HMr1 comigrated with brain MAP1, whereas HMr3 and HMr4 had the same mobility as alpha and beta-spectrins, respectively. The 4 high molecular mass phosphoproteins are substrates of cyclic AMP-dependent protein kinase(s) since (a) their phosphorylation was increased by cyclic AMP and not by cyclic GMP or calcium alone or calcium in the presence of calmodulin or phospholipid; (b) the effect of cyclic AMP was prevented by the thermostable inhibitor of cyclic AMP-dependent protein kinases; (c) the purified catalytic subunit of cyclic AMP-dependent protein kinases markedly phosphorylated the 4 HMr proteins. The 32P-labeling of HMr proteins using either endogenous cyclic AMP-dependent protein kinase or the purified catalytic subunit was always lower in cells cultured in the presence of TSH (reassociated in follicle-like structures) than in freshly dispersed cells or cells cultured in basal conditions (cells in monolayer). These results suggest that the 4 high molecular mass thyroid phosphoproteins represent structural components, the phosphorylation of which could vary with the cellular organization. PMID- 3956856 TI - Characteristics of interaction of the antiandrogen flutamide with the androgen receptor in various target tissues. AB - In rat adenohypophysial cells in primary culture, the specific uptake of [3H] testosterone (T) is completely blocked by increasing concentrations of the pure antiandrogen flutamide-OH, the active metabolite of flutamide at an IC50 value of 50 nM while unlabeled T causes a similar inhibition at an IC50 value of 0.5 nM. After 210 min of incubation of 3 nM [3H]T with the anterior pituitary cells, 80% of radioactivity is still present as unchanged T. Direct binding studies show that flutamide-OH and flutamide interact with the rat anterior pituitary androgen receptor at Ki values of 55 and 1275 nM, respectively. In rat ventral prostate (cytosolic and nuclear fractions) and cytosol from human prostatic carcinoma, rat uterus and mouse Shionogi mammary carcinoma, the Ki values ranged from 0.1 to 0.47, 0.6 to 2.7, 62 to 205 and 1450 to 7550 nM for dihydrotestosterone, T, flutamide-OH and flutamide, respectively . Since the ability of flutamide-OH to inhibit the uptake of [3H]T in intact adenohypophysial cells and to compete for binding to the adenohypophysial androgen receptor shows almost identical values at approximately 1% of the potency of T itself, it is most likely that the antiandrogen activity of flutamide-OH can be completely explained by the ability of the pure antiandrogen to displace androgen from their specific receptor in target tissues. In addition, the finding of similar binding characteristics in a series of other tissues suggests that a similar potency of the antiandrogen can be expected in the other androgen-target tissues. PMID- 3956857 TI - Hormonal induction of riboflavin carrier protein in the chicken oviduct and liver: a comparison of kinetics and modulation. AB - Estrogen (E) induction of riboflavin carrier protein (RCP) in the chicken oviduct and liver was investigated to compare and contrast the kinetics, hormonal specificity and modulation of its elaboration in the 2 steroid-responsive tissues. During primary stimulation, continued daily E administration to immature female chicks elicited, after an initial lag, rapid growth and RCP content of the overduct; neither progesterone (P) nor testosterone (T) could substitute for E in this respect. Furthermore, P given along with E curtailed tissue growth and its RCP content, whereas E + T had a synergistic effect on tissue growth only. During secondary stimulation, E administration steeply enhanced both tissue weight and RCP content without any lag. Interestingly, P (but not T) could substitute for E in augmenting magnum RCP concentration to a comparable extent while a concomitant effect on tissue growth was less marked. In contrast, hepatic induction of RCP was absolutely E-specific during both primary and secondary stimulations. Secondary stimulation with either E or P of E-primed birds enhanced the rates of RCP synthesis in the oviduct relative to that of total protein, whereas in the liver only E was effective in this regard. The absolute rate of E-induced RCP synthesis in both the steroid-stimulated tissues was significantly higher than that of general protein elaboration. PMID- 3956858 TI - Different protein synthetic patterns in scale-forming, feather-forming, and apteric embryonic chick dermis. AB - We have examined the protein synthetic profile of embryonic chick dermis from different regions of both wild-type and scaleless mutant embryos by two dimensional polyacrylamide gel electrophoresis to determine if differences in inductive capability are associated with different patterns of gene expression. We have found proteins preferentially synthesized in dorsal dermis and anterior tarsometatarsal dermis at stages when these tissues are active in inducing feather or scale histogenesis, respectively, in the epidermis. Apteric dermis, which is unable to induce epidermal derivative formation, synthesizes a subset of the proteins specific to each region. Scaleless mutant dermis, which does not participate in feather or scale formation in vivo, synthesizes all of the dorsal dermis-specific or tarsometatarsal dermis-specific proteins appropriate to its regional origin. However, it lacks one protein common to all types of dermis tested, and synthesizes one protein inappropriate for its location. Examination of the protein synthetic profile of dorsal and anterior tarsometatarsal dermis at early stages of development reveals that young dorsal dermis, which can only form feathers, possesses the protein synthetic pattern specific to that region. Young tarsometatarsal dermis, which has the potential to form either feathers or scales, synthesizes the proteins we have identified as specific to dorsal and older tarsometatarsal dermis. These results suggest that different protein synthetic patterns are associated with different inductive potentials. However, combining young tarsometatarsal dermis with dorsal epidermis, which causes the formation of feathers, does not alter the pattern of proteins synthesized by the dermis. While this result may be due to an artifact of the culture system, an alternative explanation is that the protein synthesis pattern is not related to the type of epidermal derivative induced, but to the pattern in which the derivatives are induced. This is supported by the observation that the feathers formed in recombinants of tarsometatarsal dermis and dorsal epidermis are arranged in a scale pattern. PMID- 3956859 TI - Embryonic expression of a gut-specific esterase in Caenorhabditis elegans. AB - We describe an esterase activity that, by the criterion of histochemical staining, is completely localized to the intestine of the nematode Caenorhabditis elegans. Esterase activity appears in the embryonic gut when the embryo contains 4-8 intestinal precursor cells and 100-150 total cells. Esterase activity is abolished by treating early embryos with alpha-amanitin, indicating that expression depends upon transcription by RNA polymerase II within the developing embryo. In partial embryos produced by lysing one blastomere of a two-cell embryo, esterase expression appears only in descendants of the blastomere that normally produces the gut; esterase expression appears independent of the other non-gut blastomere. In early cleavage-stage embryos in which cytokinesis has been blocked by cytochalasin D, esterase expression appears at the normal time and only in cells in the gut lineage; thus neither normal cell division nor normal embryogenesis is required for lineage-specific expression. However, esterase does not appear in cytochalasin D blocked one-cell embryos. These observations confirm the traditional view that C. elegans development is "mosaic," with each cell following a defined independent program of gene expression. PMID- 3956860 TI - Spectrin in mouse gametogenesis and embryogenesis. AB - Antibodies to nonerythroid alpha spectrin (p 230) were used to study the distribution of this polypeptide in mouse germ cells, zygote, and early embryonic cells. In the primordial germ cells, fetal oocytes, and spermatogonia, spectrin was found predominantly in the form of a narrow condensed subplasmalemmal band, as in all other somatic cells. During spermatogenesis, spectrin is condensed into the supraacrosomal cytoplasm and is lost during the reduction of the cytoplasm of the maturing spermatozoa. The postnatal growth of the oocyte is accompanied by a loss of the dense cortical band of spectrin and its redistribution in the cytoplasm. Zygotes also contain granular dispersed spectrin. Cortical condensation of spectrin filaments gradually reappears in the blastomeres at the two-cell stage and in the secondary polar body. Cortically condensed filaments represent thereafter the predominant form of spectrin in all preimplantation stage embryonic cells. Trophoblastic cells spreading out from explanted blastocysts are devoid of the cortically condensed spectrin and contain, instead, spectrin arrays in the cytoplasm. Trophoblastic cells, which surround the implanted embryo in vivo, also show diffuse cytoplasmic spectrin which subsequently undergoes subplasmalemmal condensation. These data show that spectrin is present in all stages of gametogenesis and embryogenesis, except in mature spermatozoa; and that it undergoes cytoplasmic redistribution during morphogenesis. PMID- 3956861 TI - Retinoic acid modifies positional memory in the anteroposterior axis of regenerating axolotl limbs. AB - The effects of retinoic acid (RA) on anteroposterior (AP) positional memory of regenerating axolotl limbs were tested after removing the anterior or posterior half from the zeugopodium (lower arm or leg). RA (150 micrograms/g body wt) was injected into groups of animals bearing the following types of limbs: (1) anterior and posterior half zeugopodia grafted to the eyesocket and amputated distally 7 days later; (2) unamputated anterior and posterior half zeugopodia in situ; (3) double anterior and double posterior half zeugopodia amputated distally 7 days after their construction; (4) sham-operated zeugopodia amputated distally 7 days after operation. Controls consisted of these four groups injected with the retinoid solvent, dimethyl sulfoxide, or not injected. Control half zeugopodia grafted to the eyesocket regenerated no more than one or two digits. Control unamputated half zeugopodia in situ underwent partial or complete regeneration of the missing half from the proximal and midline wound surfaces exposed during construction of the half zeugopodia. Control double anterior and posterior zeugopodia both regenerated symmetrical, hypomorphic regenerates with 1-3 digits in the double anteriors and 1-6 digits in the double posteriors. Sham-operated controls regenerated normally. Regenerating anterior and posterior halves responded differently to RA. RA-treated anterior half zeugopodia in the eyesocket, and anterior half stumps adjacent to the unamputated posterior half zeugopodia in situ both produced regenerates that duplicated stump structures in the proximodistal axis and formed a complete and normal AP pattern. RA-treated double anterior zeugopodia regenerated proximodistal-duplicated pairs of mirror imaged limbs, each with a complete and normal AP pattern. In contrast, half posterior zeugopodia in the eyesocket, the posterior half stumps of unamputated half anterior zeugopodia in situ, and double posterior zeugopodia all failed to regenerate. These results suggest that RA modifies positional memory in only one direction in the AP axis, posterior. PMID- 3956862 TI - An altered series of ectodermal gene expressions accompanying the reversible suspension of differentiation in the zinc-animalized sea urchin embryo. AB - Early stage treatment of the sea urchin embryo with zinc ions is known to prevent its gastrulation. The treated embryo, termed "animalized" and classically regarded as a permanent blastula with possibly exaggerated ectodermal differentiation, can be viewed, instead, as being in a state of reversibly suspended differentiation. This proposition is supported by the following observations: (1) An embryo exposed to Zn2+ through its blastula stages and resuspended in fresh sea water retains the simple blastula morphology for at least 4 days; however, if the Zn2+ is also depleted by a chelator during this period, development resumes and reaches the pluteus stage. (2) A suppression of ectodermal differentiation in the zinc-animalized embryo can be inferred from the blockage of the developmental initiation of Spec 1 and CyIIIa actin mRNA accumulation, since the genes encoding them are specifically expressed in differentiated (aboral) ectoderm. (3) Chelation allows the zinc-blocked accumulation of these ectodermal mRNAs to proceed. The later the treatment with chelator, the more slowly these mRNA accumulations resume, and the longer the interval between them and the subsequent morphological differentiation. (4) The enhancement of some early ectodermal functions in the zinc-animalized embryo is indicated by the increased concentrations of mRNAs, encoded by a set of genes, Blast j1 and Spec 3, that normally display peak levels in the blastula. The association of these genes with ectoderm is based on their being specifically expressed, albeit at low levels, in the pluteus ectoderm, and their being suppressed when presumptive ectoderm is made to differentiate as endoderm in the case of the embryo treated with lithium. The program of cell division in the zinc animalized embryo remains essentially normal. Differentiation becomes reversibly suspended, with the enhancement of certain early mRNA expressions and the reversible suppression of certain late mRNA expressions, characteristic of differentiated tissues. PMID- 3956863 TI - Cell interactions and the control of gene activity during early development of Xenopus laevis. AB - During embryonic development, regulation of the zygotic genome may be mediated by inductive interactions and by cell-autonomous inheritance of informational material from the egg; we have studied certain aspects of such regulatory events in Xenopus laevis. Embryos cultured in Ca2+/Mg2+-free medium can be dissociated and dispersed, eliminating cell-cell contact and thus precluding inductive interactions. Such manipulations revealed that activation of the muscle-specific alpha-actin genes is absolutely dependent upon cell contacts. Conversely, the endoderm-specific DG42 gene and the ectoderm-specific DG81 cytokeratin gene are activated in embryo cells dispersed throughout blastula stages and therefore appear to be controlled by inherited factors. Nevertheless, abnormal cell arrangements may prevent expression of the cytokeratin gene, suggesting that animal pole cells can be diverted from their normal ectodermal fate by inductive contact with vegetally derived cells. The interactions required for alpha-actin induction and inhibition of cytokeratin expression are independent of strong adhesion between embryonic cells mediated by high concentrations of divalent cations. PMID- 3956864 TI - Defects in protein modification precede developmental defects in l(3)c21RRW630, a temperature-sensitive Drosophila developmental mutant. AB - The temperature-sensitive Drosophila developmental mutation, l(3)c21RRW630 (abbreviated RW630) disturbs oogenesis and has a maternal effect on embryogenesis. At restrictive temperature, RW630 alters post-translational modification of three abundant proteins. To examine the causal relationship between these biochemical defects and the developmental defects in RW630, a series of temperature-shift experiments was performed. It was found that defects in protein modification could be detected in RW630 ovaries after RW630 females had been exposed to restrictive temperature for 1 day. RW630 females treated in this fashion produce embryos which contain a low level of unmodified proteins. Nevertheless, these embryos hatch at a normal rate. Since these ovaries and these embryos are developmentally normal, but do show defects in protein modification, it is unlikely that the RW630 developmental defects cause the biochemical defects in RW630. It is more likely that accumulation of unmodified proteins after extended exposure to restrictive temperature produces the developmental defects in RW630. PMID- 3956865 TI - Intracellular pattern reversal in Tetrahymena thermophila. I. Evidence for reverse intercalation in unbalanced doublets. AB - Homopolar doublets of Tetrahymena thermophila possess two sets of similar cell surface structures, the most prominent of which are the complex and asymmetrical oral apparatuses. These initially are located on opposite surfaces of the duplex cell, but tend to shift so that they are no longer directly opposite each other. The two sets of oral structures are then separated by one wider and one narrower arc of cell surface. When one arc becomes sufficiently narrow, a new third oral apparatus with partially reversed internal asymmetry frequently becomes interposed between the two preexisting oral apparatuses, always within the narrower arc. After this happens, the reliability of development of new oral structures, particularly of the interposed ones, is reduced. Contractile vacuole pores, typically present within both arcs of homopolar doublets, tend to disappear from the narrower arcs. This anomalous partial triplet condition appears to be a transient intermediate stage in the reversion of homopolar doublets to normal singlets. We interpret the interposition of a transient third oral system in doublets that are regulating toward the singlet state as being a consequence of reverse intercalation of new positional values subsequent to excessive crowding of the preexisting positional values. This interpretation is an adaptation of the shortest-distance intercalation rule of the polar coordinate model applied in an intracellular and morphallactic context. PMID- 3956866 TI - Intracellular pattern reversal in Tetrahymena thermophila. II. Transient expression of a janus phenocopy in balanced doublets. AB - Homopolar doublets of Tetrahymena thermophila which have two normal oral systems directly opposite one another may undergo a global transformation of cell surface geometry to create transient imitations of mirror-image configurations brought about by mutations at janus gene loci. The process by which a typical doublet transforms into a janus-like organization involves loss of capacity to form oral structures at one of the two normal oral meridians, followed by interpolation of reversed oral structures at a new location to the cell's right of the disappearing normal oral meridian. At the same time, the contractile vacuole pore (CVP) set on the side of the cell that is undergoing the transformation shifts to the left. The combination of these events creates a symmetrical large-scale organization in which both of the CVP sets are situated on one side of the cell, between the normal and the partially reversed oral apparatus. This unilateral positioning of CVP sets is commonly manifested even when reversed oral structures are absent. These configurations probably represent intermediate stages in the transformation of balanced typical doublets into singlets. We propose that this pathway of regulation from the doublet to the singlet state, like the more common one that starts from unbalanced typical doublets (described in the preceding paper), involves reverse intercalation. The remarkable resemblance between the transient configuration described here and the stable configuration of janus mutant cells leads us to suggest that the phenotype of the mutant is also a consequence of reverse-intercalation, in that case provoked by a loss of capacity to maintain positional values rather than by a geometrical instability in the system of positional values. PMID- 3956867 TI - Precardiac cell migration: fibronectin localization at mesoderm-endoderm interface during directional movement. AB - The pathway of directional movement of chick precardiac mesoderm cells was studied by indirect immunofluorescence and by scanning electron microscopy. Directional movement of the precardiac cells begins at stage 6 from the lateral sides of the embryo at the level of Hensen's node. The cells move anteriorly in an arc to the embryo's midline. By stage 8 the cells arrive at the lateral sides of the anterior intestinal portal and movement ceases. The interval of this directional movement is approximately 10 hr. During migration the precardiac cells are in close association with the underlying endoderm. As migration proceeds, the cells encounter increasing amounts of fibrils in the substratum at the mesoderm-endoderm interface. Concomitant with increasing fibril formation there is an increase in fibronectin (FN) in the heart-forming region. During stage 5 FN first appears in the lateral heart-forming regions and increases in amount during the period of cell migration. By stage 7 a concentration difference of FN is apparent in the lateral regions with more FN cephalad and decreasing amounts caudad. At stages 7 and 8 large amounts of extracellular FN-associated fibrils are observed at the lateral sides of the anterior intestinal portal where the cells stop moving. The precardiac cells moving into this region are oriented perpendicular to the anterior intestinal portal and in close association with these fibrils. There is no evidence that the fibrillar meshwork forming the substratum of the precardiac mesoderm cells is physically oriented as a guide for directional movement. The correlations between FN distribution at the mesoderm endoderm interface and directional cell movement suggest that the precardiac cells may migrate by haptotaxis, i.e., by moving along the substratum toward areas of greater adhesiveness. PMID- 3956868 TI - Dynamic aspects of retinotectal map formation revealed by a vital-dye fiber tracing technique. AB - In the visual system of Xenopus laevis, the axons from the retinal ganglion cells of the eye form a topographic projection onto the optic tectum. Many studies have focused on revealing the mechanisms responsible for this precise and regular projection pattern. In contrast to the static view of the system that one might expect from examining the regularity of the projection, recent work on its regeneration and its changes during larval development indicate that part of the patterning process involves the dynamic behavior of optic fibers. Typically, anatomical and electrophysiological techniques have been used to obtain static views of the developing retinotectal projection which then must be complied to provide a glimpse of any dynamic behavior. Here we report on experiments using a newly developed fiber tracing technique to directly follow the emergence of topography in the developing retinotectal projection. Defined halves of the developing eyebud were labeled with a vital fluorescent dye which fills the growing axons, and the projection of the labeled cells was followed for up to 2 weeks in individual animals. The experiments confirm that dorsal and ventral optic nerve fibers sort out into an ordered projection early in development. In contrast, nasal and temporal fibers initially overlap, and the same sets of prelabeled fibers then sort out into the adult topography over a period of days. PMID- 3956869 TI - Pattern regulation in the eyebud of Xenopus studied with a vital-dye fiber tracing technique. AB - Evidence for pattern regulation in the developing Xenopus visual system has previously been obtained after surgical manipulations of the eyebud early in development. In one experimental paradigm, a "compound" eye is produced by combining a nasal (anterior) half-eyebud with normal dorsoventral polarity and a temporal (posterior) half-eyebud with inverted dorsoventral polarity. The adult retinotectal projection from such compound eyes, as assayed by electrophysiological mapping techniques, shows normal dorsoventral polarity in both halves, indicating an apparent reversal in the polarity of the surgically inverted half. We have utilized a fluorescent vital-dye fiber-tracing technique to investigate the early events in this regulatory process. The results show that the change in dorsoventral polarity is not due to cell movements in the eyebud after surgery. Interestingly, the experiments also demonstrate that the pattern of connections initially formed by the developing eye does not reflect the pattern regulation observed in the adult retinotectal map; instead, the temporal half of the eye projects to the tectum with inverted dorsoventral order. Thus, the regulation observed in the adult does not become evident in the pattern of the projection until after early larval development. PMID- 3956870 TI - Axonal pathfinding in organ-cultured embryonic avian retinae. AB - Eye cups from stage 14-28 (E2 to E5) chick and quail embryos consisting of neural retina, lens, and vitreous body were cultured for 1 or 2 days. These eyes expanded by proliferation of the retinal cells and the surface areas of the retinae increased several-fold. The area covered by ganglion cells and axons also expanded in vitro. [3H]Thymidine labeling showed extensive proliferation of the neuroepithelial cells including the formation of new ganglion cells. Culturing eyes from embryos before stage 17 results, as in vivo, in the generation of the first ganglion cells of the retina, but unlike in the in vivo situation, the outgrowing axons always formed a random fiber net in the central portion of the retina. A defined axonal pattern identical to the in vivo developed only in specimens from embryos of stage 17 and older. Some aberrant axons, however, were also observed at the retinal periphery in specimens from embryos of more advanced stages (20-24), but only during the second day of culturing. Axons in retinae from embryos of stages 23 to 26 heading toward the optic fissure often crossed the fissure and, in contrast to the situation in vivo, invaded the opposite retinal side. These axons of wrong polarity followed the pathways of axons growing centripetally but in reverse direction. This suggests that the polarity of growing nerve fibers and their course are determined by different factors. Culturing the eyes of embryos from stages 20 to 25 in the presence of antibodies showed that the antibodies penetrated the entire retina with 6 hr. Neither anti-N CAM nor the T-61 antibody--both recognizing membrane proteins of retinal cells- affected the growth of the eyes in vitro. The development of the axonal pattern in vitro was not affected by incubation with N-CAM-antibodies at concentrations up to 500 micron/ml, whereas the T-61 antibody which is known to block neurite extention in vitro (S. Henke-Fahle, W. Reckhaus, and R. Babiel (l984). "Developmental Neuroscience: Physiological, Pharmacological, and Clinical Aspects," pp. 393-398. Elsevier, Amsterdam/New York) showed inhibition of axonal growth in retina cultures at 50 micron/ml. These results indicate that the eye cultures can be used as a test system for antibodies against antigens which could be involved in axon extension and neurite pathfinding in situ. PMID- 3956871 TI - Transport and steady-state concentration of plasma proteins in the vitreous humor of the chicken embryo: implications for the mechanism of eye growth during early development. AB - The nature and origin of the proteins of the vitreous humor were examined in chickens during embryonic and early posthatching stages. The major proteins of the vitreous humor were similar in electrophoretic mobility to plasma proteins at all ages examined. Earlier studies from our laboratory and experiments described below showed that plasma proteins continuously entered and left the eye throughout its development. From these data it was concluded that the majority of vitreous-humor proteins were derived from the blood. The protein concentration of the vitreous humor was 13% of that of the plasma from embryonic Days 6 through 15 (E6 through E15). After E15, the relative protein concentration in the vitreous humor declined with respect to the plasma and reached 4% of the plasma protein concentration at hatching. Several possibilities were considered to account for how proteins can rapidly enter and leave the eye, yet maintain a steady-state concentration in the vitreous humor that is less than one-seventh of that in the blood. PMID- 3956872 TI - Regulation of intestinal brush border microvillus length during development by the G- to F-actin ratio. AB - We examined ultrastructural changes in developing chicken intestinal microvilli and correlated these with changes in the G- to F-actin ratio and the amount of actin per milligram cell protein. Three discrete morphological and temporal changes occur during late microvillus morphogenesis: an increase in microvillus number associated with microvilli becoming hexagonally packed on the cell surface; an increase in core actin filament number; and an increase in the length of microvilli. Dramatic rises in the amount of cell actin occur at the time of the first two morphological changes. Changes in the G- to F-actin ratio suggest that increases in the level of monomeric actin drive the elongation phase of microvillus growth since immediately prior to growth the G- to F-actin ratio shifts from its embryonic and adult 3:7 ratio to a 1:1. Our results also indicate, but do not prove, that an increase in the amount of G-actin precedes the rise in level of F-actin and growth of microvilli by 1 day, implying that an increase in the content of G-actin stimulates actin polymerization. Our findings also suggest that the G- to F-actin ratio and their absolute amounts, perhaps in combination with cytoskeletal protein turnover and/or the pool size of actin binding proteins, plays a role in restricting the mature constant length of microvilli. PMID- 3956873 TI - Transient synthesis of a specific set of proteins during the rapid cleavage phase of sea urchin development. AB - The rapid cleavage stage of early sea urchin development is characterized by the transient synthesis of a specific set of proteins. These proteins were identified by comparing the pattern of newly synthesized proteins from fully grown sea urchin oocytes, unfertilized and fertilized eggs, several embryonic stages, and adult tissues by one- and two-dimensional gel electrophoresis. We found that, in contrast to fertilization, meiotic maturation results in major changes in the relative amounts and types of proteins synthesized. The synthesis of many proteins in the oocyte, including actin, tubulin, and other proteins which have accumulated during oogenesis, appears to be greatly reduced or eliminated in the unfertilized and newly fertilized egg. An examination of the proteins synthesized in unfertilized and fertilized eggs reveals several proteins that are synthesized only during this phase of development and may be required for the rapid cell divisions which occur during this period. At the midblastula stage, when the cell doubling time shows down, the pattern of synthesis changes to resemble that of the oocyte. These results imply that many of the changes in the pattern of protein synthesis seen around the blastula stage may be associated with the return of the cell cycle to a normal length rather than synthetic changes associated with differentiation. PMID- 3956874 TI - The development of motoneurons in the embryonic spinal cord of the mouse mutant, muscular dysgenesis (mdg/mdg): survival, morphology, and biochemical differentiation. AB - Motoneuron development was studied in the spinal cord of the mouse mutant, muscular dysgenesis, between embryonic days (E) 13 and 18. Dysgenic embryos are characterized by the absence of neuromuscular activity (motility) and exhibit a number of other striking changes in neuromuscular development. Many of these changes have also been observed in chick embryos chronically treated with neuromuscular blocking agents that suppress motility. Motoneuron survival, as well as several other aspects of neuronal development, was examined in the thoracic and lumbar spinal cords of mutant and control embryos. There was a significant decrease in motoneuron numbers in control embryos indicating the presence of naturally occurring cell death in the mouse spinal cord. At all ages examined, the dysgenic embryos had significantly more healthy and significantly fewer degenerating motoneurons than controls. There were no differences in the number of dorsal root ganglion neurons or in any of the other morphometric parameters examined between mutant and control embryos. Creatine kinase activity, a marker for myofiber maturation, was significantly reduced in the limb musculature of mutant embryos. Choline acetyltransferase activity was significantly increased in the spinal cord of mutant embryos. No significant differences were observed in spinal cord levels of acetylcholinesterase activity between control and mutant embryos. The absence of muscle contractions in the dysgenic mouse is associated with a number of changes in neuromuscular development, including a substantial reduction of naturally occurring motoneuron death. PMID- 3956875 TI - Embryonic and regenerating Xenopus retinal fibers are intrinsically different. AB - Growth and guidance behavior of Xenopus embryonic (ER) (optic vesicle stage 25/26) and regenerating retinal fibers (stage 47/50 newly regenerating NR, and actively regenerating RR, respectively) have been studied in vitro on a variety of substrates in serum-free media. RR retinas receive a prior conditioning lesion 12-14 days before explantation while NR retinas are explanted immediately after axotomy. The substrates include plastic (UN), polylysine (PL), polyornithine (PO), laminin (LM), fibronectin (FN), and collagen type I (CO). Two kinds of experimental situations were tested, one in which substrates were derivatized to plastic as a planar surface, while the second involved the addition of a substrate as a soluble supplement to dishes derivatized with PL. A neurite growth index (NGI), based on density of neurite outgrowth and axon lengths, is determined for each fiber type on all substrates. Embryonic and regenerating fibers are phenotypically different fiber types; each displays a specific "substrate preference profile" (SPP), reflecting differential growth on each substrate. ER neurites grow equally well on all planar substrates, including plastic, but do not grow on CO (SPP, LM = FN = PL = PO = UN greater than CO). Both NR and RR neurites show distinct substrate preferences, but RR neurites grow more vigorously (SPP, LM greater than CO greater than PL = PO greater than FN). In media supplemented with LM, FN or CO, the SPPs showed little change but the neurite bundle patterns were qualitatively different. Only regenerating neurites display clockwise growth in laminin (LM) and fibronectin (FN)-supplemented media. Under no conditions do embryonic fibers exhibit this pattern which suggests that embryonic and regenerating retinal fibers also differ in cytoskeletal organization. Evidence of intrinsic growth differences in vitro suggest that embryonic and regenerating retinal fibers may not respond to identical guidance cues during in vivo development and regeneration of retinotectal connections. PMID- 3956876 TI - Substrate-bonded hyaluronic acid exhibits a size-dependent stimulation of chondrogenic differentiation of stage 24 limb mesenchymal cells in culture. AB - Extracellular matrix molecules including glycosaminoglycans have been implicated in several differentiative and morphogenetic processes including cell aggregation and migration. Previous reports have shown that plating of stage 24 limb mesenchyme cells onto hyaluronic acid (HA) bonded to the culture substrate causes an increase in the number of cells exhibiting chondrogenesis. This increased chondrogenesis is now shown to be dependent upon the source of the HA. When limb mesenchymal cells are plated onto HA from bovine vitreous humor, human umbilical cord, or large molecular weight HA (Healon), increased chondrogenesis is observed only on the bovine vitreous humor HA. Unsulfated chondroitin, which has a structure and charge density similar to those of HA, is capable of enhancing chondrogenesis, while cells plated onto sulfated glycosaminoglycan substrates are indistinguishable from controls. The evidence in this report suggests that the differentiation response is related to the molecular size of the HA bound to the culture substrate. Healon and human umbilical cord HA are ineffective because their molecular weight is too large, while smaller HA derived from these larger molecules or normally present in bovine vitreous humor preparations stimulates the chondrogenic differentiation of stage 24 limb mesenchymal cells in culture. The most active size class of HA elutes from a Sepharose CL-2B column with a Kav between 0.6 and 0.7 and, thus, has a molecular weight of approximately 200,000 400,000. These observations reinforce the hypothesis that local cues have an informational effect on the differentiation of chick limb mesenchymal cells. PMID- 3956877 TI - Decreased phospholipase A2 activity in plasma and liver in uncontrolled diabetes mellitus. A defect in the early steps of prostaglandin synthesis? AB - Arachidonic acid metabolites and prostaglandins participate in numerous physiologic functions. An enzyme important in the control of prostaglandin production is phospholipase A2. In this study, we have investigated the changes in plasma and hepatic phospholipase A2 activity in diabetes mellitus. In uncontrolled diabetic patients, the postheparin plasma phospholipase A2 level was 18.7 +/- 4.1 U/ml; this value was significantly different from the enzyme activities in control subjects (106 +/- 9.8 U/ml) and in controlled diabetic patients (87 +/- 7.3 U/ml). In the streptozocin-induced diabetic rat model, the postheparin plasma phospholipase A2 level (1.9 +/- 0.45 U/ml) was also decreased when compared with normal (9.4 +/- 1.6 U/ml) and controlled diabetic rats (7.0 +/ 1.3 U/ml). The total hepatic enzyme activity in the uncontrolled diabetic rats was only 21.6% of that seen in control rats. Subcellular fraction studies demonstrated that the enzyme activity is decreased in all fractions in the liver. Liver perfusion studies showed that the heparin-releasable phospholipase A2 activity in the perfusate was significantly decreased in the diabetic rats when compared with control and controlled diabetic animals. We conclude that postheparin plasma and hepatic phospholipase A2 activities are decreased in uncontrolled diabetes mellitus, that the low plasma activity is related to decreased release from the liver, and that the alterations in phospholipase A2 activity in plasma and liver are restored to normal by controlling the diabetic status. PMID- 3956878 TI - Relationship of fat distribution to glucose tolerance. Results of computed tomography in male participants of the Normative Aging Study. AB - Computed tomography (CT) scanning was used to assess the relationship of glucose tolerance to fat distribution in men. Three cross sections [chest (including upper arms), abdomen, and thigh] were scanned in 41 men randomly selected from the Normative Aging Study, a longitudinal study of aging. Greater amounts of fat in the upper body and greater ratios of upper-body fat to lower-body fat were significantly correlated with higher 2-h serum glucose levels after adjustment for age and body mass index. In particular, intra-abdominal fat, a feature uniquely measured by CT, was a significant correlate of 2-h glucose. Largely parallel results were obtained when we compared a sample of male diabetic subjects (N = 8) with the male normal subjects from our random sample. This investigation demonstrates that body fat distribution, adjusted for overall degree of obesity, is a significant correlate of glucose tolerance even in a sample unselected for extremes of physique. PMID- 3956879 TI - Relationship of muscle capillary basement membrane to renal structure and function in diabetes mellitus. AB - Muscle capillary basement membrane (MCBM) thickening has been considered to reflect microvascular changes in other tissues in diabetes mellitus. To explore the relationships between MCBM width and nephropathy, 27 patients aged 22-55 yr with type I diabetes for 14-33 yr were studied with creatinine clearances, urinary albumin excretion rates, multiple blood pressure measurements, glycosylated hemoglobin measurements, and renal and quadriceps muscle biopsies that were evaluated using standard stereologic techniques. MCBM width did not correlate with age, duration of diabetes, creatinine clearance, urinary albumin excretion, or fractional volume of the glomerular mesangium. MCBM width did correlate, although weakly, with glomerular basement membrane width (r = 0.47) and glycosylated hemoglobin (r = 0.44). There was no difference in MCBM width between patients with and without clinical nephropathy. Patients with normal fractional volume of mesangium exhibited a full range of MCBM width. Thus, while MCBM width may reflect glycemic control and glomerular basement membrane thickening, it does not relate to the functional or structural renal changes associated with progressive diabetic nephropathy. PMID- 3956880 TI - The effect of oxidation on sorbitol pathway kinetics. AB - The rapid conversion of glucose to sorbitol by aldose reductase and the consequent hyperosmolarity of the cytoplasm has been shown to be the primary cause of the so-called "sugar" or "osmotic" cataract in many animal lenses. It is not as clear, however, that hyperosmolarity is the principal factor in the etiology of cataracts in human diabetic subjects. In fact, the comparatively low activity of aldose reductase in the human lens as compared with several animal lenses, and the osmotically insignificant levels of sorbitol pathway products (sorbitol and fructose), suggest that hyperosmolarity, per se, may not be as important a factor in human cataract formation as it is in animals. We present evidence that the flux of glucose and sorbitol through the rat lens is markedly reduced by oxidative stress (0.1 mM H2O2). Sorbitol accumulation is reduced by 114%, sorbitol turnover is reduced by 78%, sorbitol production is reduced by 90%, fructose accumulation is reduced by 60%, and fructose turnover is reduced by 76% in the presence of 36 mM glucose. H2O2 does not affect glucose turnover, the glucose rate constant, or the ATP level significantly at 36 mM glucose, but at 5.5 mM glucose, 0.2 mM H2O2 leads to a rapid loss of ATP that can be prevented by 0.04 mM sorbinil, an aldose reductase inhibitor. These results suggest that inhibition of aldose reductase by sorbinil renders rat lenses better able to cope with oxidative stress. In the absence of an aldose reductase inhibitor, elevating ambient glucose may render a lens less able to scavenge oxidants by diverting NADPH into sorbitol production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956881 TI - Insulin-dependent diabetes mellitus is associated with genes that map to the right of the class I RT1.A locus of the major histocompatibility complex of the rat. AB - Previous studies have demonstrated that the presence of at least one u-haplotype of the rat major histocompatibility complex (MHC), RT1, is a necessary but not sufficient condition for the development of overt diabetes mellitus. The present studies were undertaken to determine which portion of the RT1 gene complex is necessary for the occurrence of diabetes. We crossed hooded diabetic rats (RT1.AuBuDu) with PVGr8 rats (RT1.AaBuDu). F1 animals were mated to give 82 F2 animals and backcrossed with the hooded diabetics to produce 41 backcross animals. Diabetes occurred in animals with all three possible RT1.A genotypes. The diabetes was similar to that seen in BB rats and in hybrid strains developed from them. An immunoregulatory defect was marked by decreased percentage of peripheral blood lymphocytes staining with w3/25 monoclonal antibody, by an increased percentage of peripheral blood lymphocytes binding a mouse ascites control protein, and by decreased responsiveness of peripheral blood lymphocytes to stimulation by concanavalin A. We conclude that the u-allele of the class I A locus gene product is not necessary for susceptibility to the development of diabetes in the rat. Therefore, either genes coding for the class II products of the u-haplotype or genes in linkage disequilibrium with these genes and mapping to the right of the A locus provide the permissive condition. Furthermore, the data suggest, but do not prove, that the u-haplotype derived from a strain remote from the BB rat can confer this susceptibility to the development of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956883 TI - Streptococcal preparation (OK-432) inhibits development of type I diabetes in NOD mice. AB - OK-432 (a streptococcal preparation) has been widely used for cancer immunotherapy in Japan. It is the most potent immunomodulator in activating both macrophages and killer T cells and in increasing interleukin 2 production. Two K.E. (Klinische Einheit, clinical unit) of OK-432 were given intraperitoneally to each of 17 female nonobese diabetic (NOD) mice every week from 4-24 wk of age. NOD mice as well as BB rats spontaneously develop type I diabetes. During administration of OK-432, the development of diabetes was inhibited in 17 of 17 mice over the 24-wk observation period, whereas 14 of 17 female NOD mice given physiological saline had developed diabetes by 24 wk of age. At the onset of diabetes, nonfasting blood glucose was 511 +/- 82 mg/dl. Histologic examination showed that in the OK-432-treated NOD mice, 98% of total islets were intact or mildly infiltrated with mononuclear cells, whereas in saline-treated NOD mice, 79% of total islets exhibited severe insulitis. In OK-432-treated NOD mice, both the number of the mononuclear spleen cells and their natural killer cell activity was significantly increased. PMID- 3956882 TI - Magnesium deficiency in IDDM related to level of glycosylated hemoglobin. AB - Magnesium and potassium were analyzed in plasma, erythrocytes, and urine collected during 24 h and in muscle biopsies from 25 subjects with insulin dependent, type I diabetes mellitus (IDDM). Magnesium was also measured in mononuclear cells. The results were compared with those of 28 healthy controls, and were also correlated with the degree of diabetic control as estimated by analysis of the level of glycosylated hemoglobin (HbA1c). Subjects with IDDM had significantly lower muscle (P less than 0.01) and plasma (P less than 0.001) concentrations of magnesium compared with those of healthy controls. The HbA1c levels correlated significantly with the concentrations of magnesium in muscle (r = -0.62, P less than 0.001), plasma (r = -0.62, P less than 0.001), and mononuclear cells (r = -0.47, P less than 0.05). The results indicate that some patients with IDDM have lowered contents of magnesium in striated muscular and/or plasma, and that those parameters are dependent on the degree of diabetic control. PMID- 3956884 TI - Guinea pig glucagon differs from other mammalian glucagons. AB - Mammalian glucagon is thought to be highly conserved. Glucagons from pig, cow, human, rat, and hamster have identical amino acid sequences, whereas the amino acid contents of rabbit and camel glucagons are consistent with this 29-amino acid sequence. It had earlier been reported that guinea pig (GP) glucagon contains 40 amino acids. In the current study, glucagon was purified from two GP pancreata by a series of three HPLC steps after acid-alcohol extraction and acetone precipitation. GP glucagon is a 29-amino acid peptide that differs from other mammalian glucagons by substitution of Gln for Asp in position 21, Leu for Val in position 23, Lys for Gln in position 24, Leu for Met in position 27, and Val for Thr in position 29. In view of the marked changes in the COOH-terminal of GP glucagon, receptor binding studies were performed using both rat and GP liver membranes. Labeled synthetic porcine glucagon has similar binding in the two systems and its binding is inhibited to a similar degree by synthetic porcine glucagon, whereas GP glucagon is 10-fold less potent at inhibiting binding in both systems. This suggests that glucagon receptor binding sites in the GP are evolutionarily more conserved than is GP glucagon. PMID- 3956885 TI - Thermal sensitivity tester. Device for quantitative assessment of thermal sense in diabetic neuropathy. AB - The Thermal Sensitivity Tester (TST) is a portable device designed to quantify the ability to discriminate small differences in temperature at the distal extremities of the hands and feet. The testing surfaces are two identical nickel coated copper plates, which can be set and maintained over a wide range of temperature levels. The threshold for detecting the colder surface is determined using a two-alternative, forced-choice algorithm. The mean threshold in the normal population is 0.67 degree C and 1.01 degree C for the index finger and great toe, respectively. The TST is especially useful in diabetic neuropathy and for rapid screening of large populations under field conditions. PMID- 3956886 TI - Impaired insulin receptor binding and postbinding defects of adipocytes from normal and diabetic pregnant women. AB - To evaluate the relative contribution of insulin binding and postbinding defects of glucose utilization in peripheral tissue during normal and diabetic pregnancy, we have studied the in vitro insulin action of isolated adipocytes from eight nondiabetic pregnant women and nine pregnant women with insulin-dependent diabetes mellitus who were undergoing cesarian section. The pregnant women were compared with a matched group of normal nonpregnant women undergoing gynecologic surgery. Insulin binding to adipocytes measured at tracer insulin concentration was reduced by 45% (P less than 0.01) in normal pregnant women and by 30% (P less than 0.02) in pregnant women with diabetes. In contrast, no changes were found between the three groups in insulin binding to pure monocytes and erythrocytes. The glucose transport system in fat cells from both groups of pregnant women was characterized by impaired maximal (P less than 0.05) and half-maximal (P less than 0.05) response to insulin. When fat cell glucose metabolism was studied, pregnant diabetic women exhibited decreased basal lipogenesis (P less than 0.05) and decreased maximal responses of lipogenesis and glucose oxidation to insulin stimulation (P less than 0.05). Similar but less pronounced abnormalities were seen in glucose metabolism of adipocytes from nondiabetic pregnant women. In conclusion, both in late normal and diabetic pregnancy, insulin binding to adipocytes is significantly reduced and accompanied by decreased insulin sensitivity and reduced maximal insulin responsiveness of glucose transport and by impaired basal and maximally insulin-stimulated glucose metabolism. PMID- 3956888 TI - American Diabetes Association, Inc. 46th annual meeting. June 21-24, 1986, Anaheim, California. Abstracts. PMID- 3956887 TI - Dietary sardine oil increases erythrocyte membrane fluidity in diabetic patients. AB - The effects of dietary sardine oil rich in eicosapentaenoic acid, C20:5 (EPA), on erythrocyte membrane fluidity and membrane and plasma lipids were investigated in diabetic and control subjects. Before consumption of this oil, the levels of erythrocyte membrane fluidity were lower in the diabetic subjects, as noted in our previous work (Diabetes 1983; 32:585-91). Decreased membrane polyunsaturated fatty acid contents were evident. Daily consumption of 2700 mg of sardine oil for 8 wk increased erythrocyte membrane fluidity, as determined by electron spin resonance using the 12- or 16-stearic acid label. This increase was seen after 4 wk, and the level remained elevated for 8 wk. Membrane EPA of phospholipid acyl chains significantly increased after 4 wk and was even more apparent after 8 wk. Membrane-free cholesterol to phospholipid molar ratios significantly decreased after 8 wk. Both the diabetic and normal subjects responded to the sardine oil in the same way. After feeding with sardine oil, there no longer were differences in erythrocyte membrane fluidity between the normal and diabetic subjects. We propose that improvement in membrane fluidity may contribute to the amelioration of altered cell membrane functions in diabetic patients. PMID- 3956889 TI - 24-hour intragastric pH: continuous monitoring or nasogastric aspiration? AB - Hourly gastric aspiration has commonly been used to assess the efficacy of antisecretory compounds. We have compared continuous ambulatory 24-hour pH monitoring using a radiotelemetry capsule with standard nasogastric aspiration. Eight studies were performed on four male duodenal ulcer patients in remission receiving either placebo or an antisecretory agent. A significant correlation was found between capsule and aspirate pH measurements (r = 0.88, p less than 0.01). Radiotelemetry capsule measurements clearly showed the onset of action of an antisecretory drug, and the buffering effect of food. Radiotelemetric pH monitoring is shown to be as good as gastric sampling in the measurement of 24 hour intragastric acidity, allows continuous measurement of pH during normal activity and can accurately assess the effect of drugs on gastric acidity. PMID- 3956890 TI - Recurrent Clostridium difficile-associated colitis responding to cholestyramine. AB - We describe a patient with relapses of Clostridium difficile cytotoxin-positive pseudomembranous colitis (PMC) after treatment with vancomycin, a course of metronidazole and a trial of bacitracin. She remains free of disease after a prolonged course of cholestyramine. We suggest there may be a role for anion exchange resins in patients with PMC relapsing after vancomycin therapy. PMID- 3956891 TI - Management of the pregnant diabetic patient--are the pundits right? AB - Many authorities are currently suggesting specific strategies for optimal obstetrical management of pregnant diabetic patients which involve early admission, frequent monitoring and a high Caesarean section rate. The author suggests that a more conservative approach may be indicated. In support of this contention, he cites from his personal experience of managing over 1,000 diabetic pregnancies during the past 34 years. As there were no therapeutic abortions, the series is consecutive and unmodified. There were no maternal deaths, and the perinatal loss during the 34-year period was 7.4%. In the years 1979-1984 the perinatal loss in 285 viables was 4.5%, and the Caesarean section rate was 25.9%. In 87 primigravidae, the Caesarean rate was 31%. PMID- 3956892 TI - Obstetrical management in diabetic pregnancy: the Copenhagen experience. AB - The outcome of 223 pregnancies in Type 1 (insulin-dependent) diabetic women managed from 1981 to 1985 in the Centre for Pregnant Diabetics in Copenhagen is presented. There were 17 spontaneous and 9 induced abortions. The latter were all done on medical indications. Among the 201 infants weighing 1000 g or more (including 4 pairs of twins), three died perinatally, 2 with lethal congenital malformations and one was stillborn in the 32nd gestational week. This represents a perinatal mortality rate of 2 percent. Timing and mode of delivery is individualized, but the general scheme is to induce labour around the 38th week of pregnancy. It is emphasized that an increased risk of sudden intrauterine death still exists in late diabetic pregnancy. PMID- 3956893 TI - Prevalence and development of retinopathy in children and adolescents with type 1 (insulin-dependent) diabetes mellitus. A longitudinal study. AB - In 231 subjects with Type 1 diabetes mellitus aged 17.6 +/- 4.0 years, with a diabetes duration of 8.5 +/- 4.9 years at the end of the study, the prevalence and the development of retinopathy during a period of 5 years were studied. All patients were examined between one and six times both by ophthalmoscopy and fluorescein angiography. A total of 626 fluorescein angiographies were evaluated. By the end of the study, 109 out of 231 patients (47%) had developed retinal changes, half of which were classified as minimal (less than 5 microaneurysms). Thirty-eight patients (35% of those affected) had background (n = 28) or proliferative (n = 10) retinopathy. In subjects less than 15 years of age and diabetic for less than 5 years, retinal lesions were rare. With increasing age and duration of diabetes, both the prevalence and severity of retinal changes increased markedly. Life-table analysis was used to calculate the median individual risk for the development of early retinal changes, which was 9.1 years of diabetes duration. This risk differed in sub-groups with different ages at onset of diabetes, i.e. 12.1, 8.9 and 6.6 years (p less than 0.0001), with diabetes starting below 4, between 5 and 9, and after 10 years of age respectively. After 18 years of diabetes, every patient demonstrated at least incipient structural changes. Fluorescein angiography allowed the detection of retinopathy, on average, four years earlier than with ophthalmoscopy. The median interval between the 'onset' of retinopathy, as indicated by a few microaneurysms, and background retinopathy was 5 years. PMID- 3956894 TI - Risk factors for the development of retinopathy in children and adolescents with type 1 (insulin-dependent) diabetes mellitus. AB - In our preceding paper, the prevalence and development of retinopathy in 231 Type 1 diabetic children and adolescents were reported to be associated with the duration of diabetes and its age at onset. This paper analyses the relationships between the development of retinopathy and the following factors: age, sex, puberty, blood pressure, insulin dosage, HLA antigens, long-term glycaemic control, and serum cholesterol and triglycerides. All these variables were longitudinally evaluated in a cohort of 322 insulin-dependent patients aged 16.2 +/- 4.9 years with diabetes for 7.4 +/- 5.2 years, including those 231 subjects whose eyes were examined once or repeatedly by ophthalmoscopy and fluorescein angiography. Long-term glycaemic control from the onset of diabetes to the retinal examination was assessed by both an arbitrary score comprising different parameters and by mean values of glycosylated haemoglobin, and was categorised as good, fair, and poor. With life-table analysis, the overall median individual risk for developing early retinal changes (9.1 years) was found to be significantly influenced by glycaemic control. Minimal lesions developed earlier (8.0 years) with poor control, but later with fair (10.5 years) and good glycaemic control (12.5 years) (p less than 0.01). Mean HbA1 values below 10% delayed the onset of both incipient (10.8 years) and background retinopathy (16.6 years), while values above 10% advanced it (8.0 and 11.8 years respectively) (p less than 0.05 and less than 0.008). By multivariate regression and stepwise discrimination analyses, only 4 out of 14 variables were found to exert significant independent influences on the development of retinopathy: diabetes duration, long-term glycaemic control, serum triglycerides and age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3956896 TI - Health centres and research. PMID- 3956895 TI - Long-term physical training in female type 1 (insulin-dependent) diabetic patients: absence of significant effect on glycaemic control and lipoprotein levels. AB - No objective evidence has been presented to support the beneficial effect of physical training on glycaemic control in Type 1 (insulin-dependent) diabetic patients trained two to three times a week for several months. In the present study we examined the possibility that a daily exercise programme would be more suitable for improving glycaemic control. Thirteen patients completed a 5-month study; 6 were randomized to exercise training (20 min daily bicycle exercise) and 7 served as non-exercising controls. The training resulted in an 8% increase in maximal oxygen uptake (p less than 0.05). No change in glycaemic control occurred during the study period in either group. In addition, serum lipid and lipoprotein levels were followed. Total cholesterol decreased during the study period irrespective of training. No effect was noted on the levels of LDL, VLDL, HDL and HDL2 cholesterol. A significant training effect was obtained in the HDL3 subfraction (-10%, p less than 0.05). Total triglycerides were unchanged, but a decrease in the level of LDL triglycerides was observed with training (-12%, p less than 0.01). It is concluded that, in female Type 1 diabetic patients, daily physical training for several months does not improve glycaemic control and results only in minor changes in serum lipoprotein profiles. PMID- 3956898 TI - A self-contained method of evaluating the provision of preventive care in general practice. AB - In an earlier paper a method was described by which general practitioners are able to obtain dissatisfaction data from their patients by means of questionnaires. A similar approach has been used to study preventive care activities of general practitioners. We have found it to be practicable and acceptable to patients and surgery personnel. It also yields results which are consistent and which have apparently stimulated some practitioners to alter their practice behaviour by increasing their preventive care activities. PMID- 3956899 TI - The patient-centred clinical method. 1. A model for the doctor-patient interaction in family medicine. AB - This article describes a patient-centred clinical method appropriate for family medicine. The method is designed to attain an understanding of the patient as well as his disease. This two-fold task is described in terms of two agendas: the physician's and the patient's. The key to an understanding of the patient's agenda is the physician's receptivity to cues offered by the patient, and behaviour which encourages him to express his expectations, feelings and fears. The physician's agenda is the explanation of the patient's illness in terms of a taxonomy of disease. In the patient-centred clinical method, both agendas are addressed by the physician and any conflict between them dealt with by negotiation. This is contrasted with the disease-centred method in which only the doctor's agenda is addressed. Further articles will describe the patient-centred method in operational terms. PMID- 3956897 TI - A self-contained method of evaluating patient dissatisfaction in general practice. AB - A method is described which enables patient dissatisfaction to be measured in a consecutive sample of adults attending for consultation in general practice. The method has been found to be practicable and acceptable, both to patients and doctors and to yield results which are both consistent and useful to the doctor in structuring his practice. PMID- 3956900 TI - U-shaped association between mortality and blood pressure in a thirteen-year prospective study. AB - The present study was performed to investigate the predictive value of casual blood pressure recordings for mortality in a geographically defined population (n = 1917), for which the primary health care services are responsible. Isotonic regression of blood pressure on age was used to define groups with low, medium and high blood pressure. In the age group 40 to 69 years mortality turned out to be a U-shaped function of blood pressure. In those aged 70 years and over blood pressure appeared to be of less importance as a risk indicator of death. The study has shown that a limited number of subjects in a defined population can be utilized in epidemiological studies of mortality as a function of blood pressure if an appropriate statistical method is used in the analyses, thereby justifying our model for studies in primary health care. PMID- 3956901 TI - Family attitudes to caring for the elderly mentally infirm at home. AB - Attitudes towards care-giving were examined in a sample of 129 supporters of elderly mentally infirm patients referred for psychogeriatric day care. As in previous studies, spouses felt more commitment to care-giving than other relatives. Commitment to care-giving was influenced by different factors in adult children and spouses, but consistently predicted subsequent decisions to institutionalize the dependant. Following institutionalization, most supporters felt relieved. They tended to perceive the decision to have been made by others, and to have resulted from a deterioration in their dependents' mental condition, rather than a failure of the care-giving relationship. PMID- 3956902 TI - Questionnaire assessment of patients' attitudes and beliefs about asthma. AB - The feasibility, face validity and repeatability of a self-complete questionnaire to assess patients' attitudes and beliefs about asthma was evaluated in 45 adult patients attending a hospital asthma clinic. The questionnaire consisted of 40 statements with which the patient agreed or disagreed by placing an 'X' along a visual analogue line. Patients completed questionnaires at their clinic consultation and then were interviewed to ascertain whether questionnaire responses agreed with a verbal description of their attitudes and beliefs. Repeatability was assessed by having patients complete an identical questionnaire four weeks after their interview. The questionnaire responses showed excellent agreement with interview findings, suggesting that face validity was good. Repeatability also appeared satisfactory in that agreement between responses on the first and second questionnaires was significant for 31 of the 40 items. Many patients (22%) incorrectly used the analogue line response scale making feasibility unacceptably low. However, subsequent studies showed this problem could be overcome by the use of a four-point Likert response scale. These findings suggest that this questionnaire is a satisfactory instrument for assessing patients' attitudes and beliefs about asthma. Its face validity appeared good and, with certain modifications, it was both feasible and repeatable. PMID- 3956903 TI - A scheme for the support of community health programmes in medical schools in the developing world. PMID- 3956905 TI - The evolution of anticipatory care for elderly patients in general practice. PMID- 3956904 TI - Patient education in asthma. PMID- 3956906 TI - Affect and learning--a critique. PMID- 3956907 TI - RCGP Classification 1984. PMID- 3956908 TI - Growth in Gurkha infants. PMID- 3956909 TI - Utilization of health services in a defined Swedish population. AB - With the aid of a data registration system and person-specific information, utilization behaviour has been studied in a defined Swedish population. Information from three registers was linked together in order to produce the current results: a medical information system in primary care, a population register, and a register of property. The higher health care consumption for females is shown to occur independently of diagnosis, even if diseases of the genitourinary system, psychoneurosis and rheumatoid arthritis were more common among females. The consultation rate was inversely related to the distance to the surgery from the patient's residence. There was less demand for primary health care during the summer months, July and August. For the rest of the year there were no differences. PMID- 3956911 TI - [Results of preoperative irradiation in the treatment of rectal adenocarcinoma]. AB - The goal of this retrospective study was to assess the tolerance and the efficacy of preoperative irradiation in the treatment of rectal carcinoma. From 1980 to 1983, 81 patients with potentially operable rectal carcinoma underwent abdominoperineal resection. Fourty-one were treated with surgery alone; 40 had a preoperative pelvic irradiation. They received 30 Gy in 15 fractions during three weeks. Surgery followed within four weeks after the last irradiation. In one third of the irradiated patients, the size of the tumor decreased by at least 50 p. 100. Postoperative morbidity and mortality were not increased following irradiation and there was no delay in perineal healing. Five year survival was improved by irradiation (78 p. 100 versus 28 p. 100) with statistical significance (p less than 0.05). In patients with stage C tumors according to Astler-Coller's modification of Dukes staging, 5 year survival was higher in patients who received preoperative irradiation (68 p. 100 versus 23 p. 100) with a statistically significant difference (p less than 0.05). Pelvic recurrence occurred in 8 p. 100 of the patients irradiated and in 45 p. 100 of the patients treated with surgery alone respectively. This difference was also statistically significant (p less than 0.05). Survival of patients who underwent abdominoperineal resection for rectal carcinoma appeared to be improved with preoperative irradiation. PMID- 3956910 TI - [Influence of Saccharomyces boulardii on jejunal secretion in rats induced by cholera toxin]. AB - The effects of a suspension of Saccharomyces boulardii cells on water and sodium secretion induced by cholera toxin was measured in male Wistar rats weighing 220 260 g, using the isolated jejunal loop technique. Concentrations per ml of 3.1 X 10(9), 2.1 X 10(9) and 0.7 X 10(9) viable cells and 3.1 X 10(9) cells killed by irradiation or heating respectively were tested. At this last concentration, the supernatant obtained after centrifugation of the suspension of living cells or of cells killed by irradiation was also tested. Four 10 cm-long loops, the first one beginning at the angle of Treitz, were isolated: the first two loops with and without S. boulardii, the other two (previously incubated with cholera toxin for 3 h) with and without the cells. Each loop contained 1.5 ml of test solution or suspension. S. boulardii living cells had no effect on water and sodium basal intestinal transport but significantly reduced water and sodium secretion induced by cholera toxin within 20 min. Irradiation and heating did not abolish this antisecretory effect while the supernatant obtained after centrifugation of living or irradiated cell suspensions had no inhibitory effect. PMID- 3956912 TI - [Medical writing]. PMID- 3956913 TI - [Epidemiological studies of intestinal functional disorders: aims and methods]. PMID- 3956914 TI - [Epidemiology of intestinal functional disorders in an apparently healthy population]. AB - The characteristics and the prevalence of functional bowel disorders in the general French population are unknown. Based on an epidemiological inquiry in a random population of 1,200 persons who were not seeking care, residents in our country we established: the prevalence of symptoms suggestive of functional bowel disorders; the epidemiological differences between symptomatic subgroups which included abdominal pain with or without bowel dysfunction, diarrhea and constipation. The amount of cases and the prevalence in each subgroup were: abdominal pain, 165, 13.8 p. 100, painless constipation, 75, 6.3 p. 100, diarrhea, 10, 0.8 p. 100. As a whole, functional bowel disorders occurred in 20 p. 100 of our population. The "irritable bowel syndrome" group defined as abdominal pain and/or diarrhea differ from normal subjects by the following higher frequency of age under 50, subjects in active duty, antecedents of diverticulosis, influence of stress on symptoms, nausea, vomiting, migraines, pyrosis and number of visits to a doctor. However neither the sex-ratio nor professional occupation were relevant. The constipation group differed from normal because of the higher frequency of female sex, antecedents of hiatus hernia, use of laxatives but not because of age nor by the number of associated symptoms. In conclusion, functional bowel disorders occurred in 20 p. 100 of our population; two subgroups were clearly different from an epidemiological point of view, the irritable bowel syndrome (13 p. 100) and constipation (7 p. 100); therefore these two groups deserve a specific physiopathological, psychological and therapeutic approach. PMID- 3956916 TI - [Atypical thoracic pain and the edrophonium (Tensilon) test]. PMID- 3956915 TI - [Human anisakiasis: 5 cases in northern France]. AB - We report 5 cases of human anisakiasis revealed respectively by an acute intestinal obstruction due to multiple small bowel stenosis, an acute inflammatory ileitis simulating appendicitis, ulcer type epigastralgia, purulent peritonitis and a latent small bowel tumor. Diagnosis was established in 4 cases on microscopic analysis of bowel specimens (eosinophilic granulomas and/or parasitic fragments) and in 1 case at gastroscopy. Serodiagnosis was positive in 2 of 4 cases and the consumption undercooked fishes was found in 4. In small samples we estimated the infestation (1 to 50 parasites) by anisakis larvae of 3 fish species: 80 p. 100 for herrings, 63 p. 100 for mackerels and 100 p. 100 for whitings. This work emphasizes the role of anisakiasis as a source of digestive symptoms and intestinal eosinophilic granuloma. PMID- 3956917 TI - [Effect of ranitidine on gastric emptying of nondegradable solids in duodenal ulcer patients]. PMID- 3956918 TI - [Good news: portal shunt is decidedly very efficacious in the irreducible ascites of cirrhosis]. PMID- 3956921 TI - Percutaneous removal of large gallstones. AB - Two patients are described in whom large gallstones, up to 4 cm in diameter, were removed percutaneously. The technique has some relevance to high risk patients with surgical cholecystotomies in whom elective cholecystectomy may be deferred if all the calculi can be removed. It may also be relevant if "percutaneous cholecystectomy" is ever developed clinically. PMID- 3956920 TI - Radiographic findings after incomplete pyloromyotomy. AB - The gastrointestinal series of 10 patients with persistent vomiting following pyloromyotomies for pyloric stenosis were reviewed. Four patients had incomplete pyloromyotomies and required reoperation. Their studies showed persistent obstruction with elongation and narrowing of the pyloric channel similar to preoperative studies, except that the proximal muscle mass was tapered in 3 of the 4 patients. Six patients with similar histories of postpyloromyotomy vomiting but who did not require repeat surgery had irregular but much wider pyloric channels, good gastric emptying, and gastroesophageal reflux. PMID- 3956919 TI - Radiologic diagnosis of Barrett's esophagus: critical analysis of 65 cases. AB - A recent increase in the number of Barrett's esophagus being diagnosed is probably directly related to a proportional increase in endoscopic biopsies of the esophagus and awareness of premalignant potential of Barrett's mucosa. While the endoscopist can detect Barrett's mucosa with fair degree of accuracy, the radiologic diagnosis of Barrett's esophagus still remains a diagnostic challenge despite several well established radiologic features. We reviewed 65 patients with pathologically proven Barrett's esophagus and found a wide spectrum of radiologic features. These include hiatus hernia in 49, gastroesophageal reflux in 38, strictures in 32, esophagitis in 20, and characteristic Barrett's ulcer in 12. In addition ascending or migrating strictures were found in 10, mucosal pattern simulating areae gastricae in 5, cricopharyngeal dysfunction in 4, and fixed spiral folds in 3 patients. This constellation of radiologic features, some of which have not been previously emphasized, should further assist radiologists in suggesting the diagnosis of Barrett's esophagus. PMID- 3956922 TI - Dissolution of cholesterol gallstones: comparison of solvents. AB - Various gallstone solvents are compared to evaluate their efficacy. Cholesterol gallstones from 5 patients were weight matched and incubated in 5 different solutions at 37 degrees C. These solutions consisted of methyl-tertiary butyl ether (MTBE), 90% mono-octanoin (MO), absolute alcohol, normal saline, and water. Absolute alcohol and MTBE were found to induce faster stone dissolution than the mono-octanoin derivative. Concentrations of alcohol below 80%, normal saline, and water were not effective in dissolving stones. Newer agents such as MTBE may prove valuable in dissolution of stones in the human gallbladder or bile ducts. PMID- 3956923 TI - Intraarterial digital subtraction angiography in the diagnosis and treatment of gastrointestinal disorders. AB - During a period of 18 months, intraarterial digital subtraction angiography (IADSA) was performed in 360 patients with various gastrointestinal disorders. This technique was useful both in diagnostic and interventional procedures. Due to increased contrast resolution, hepatic tumors and portal vein systems were better visualized than with the use of conventional angiography. Also, a significant reduction in the dosage of contrast medium resulted in markedly reduced patient discomfort. Small pancreatobiliary tumors were better evaluated on conventional angiograms due to the decreased spatial resolution of IADSA. PMID- 3956924 TI - Small-bowel varices due to mesenteric metastasis. AB - Small-bowel varices are rare, occurring almost exclusively in patients with portal hypertension. A patient with ileal varices due to mesenteric venous occlusion by metastatic tumor is reported. This association has not been described previously. PMID- 3956925 TI - Hypertrophic osteoarthropathy and primary intestinal lymphoma. AB - Hypertrophic osteoarthropathy (HOA) in association with primary bowel disease is rare, but is usually seen in patients with chronic diarrheal states, such as Crohn's disease and ulcerative colitis. We record the first case of HOA associated with primary intestinal lymphoma in a patient who presented with chronic diarrhea. PMID- 3956926 TI - Solitary rectal ulcer syndrome: a radiologic diagnosis? AB - The solitary rectal ulcer syndrome (SRUS) is an uncommon condition in which a solitary area of discrete ulceration is typically found on the anterior wall of the rectum. Between 1981 and 1983, we collected 8 pathologically proven cases of SRUS in which barium enema examinations had been performed (7 double-contrast, 1 single-contrast). Seven patients had rectal bleeding. On the original x-ray report, 4 cases were thought to be normal, but the pathologic tissue had been removed endoscopically in 2 of these cases prior to the radiologic study. The other 4 cases were thought to be abnormal, although the specific diagnosis of SRUS was not suggested in any case. In a blinded rereading of these 8 cases randomly interspersed with 29 other non-SRUS cases, however, the films were interpreted in light of recent radiologic experience with this condition. The same 4 cases were still thought to be normal. In the remaining 4 cases, barium enemas revealed thickened, edematous valves of Houston (3 cases) and a submucosal mass adjacent to the anal verge (1 case). The diagnosis of SRUS was suggested in all 4 cases with only 1 false-positive diagnosis due to a rectal stricture in a patient with endometriosis. Although barium enemas may be normal in patients with SRUS, the presence of thickened, edematous valves of Houston, particularly in a young patient with rectal bleeding, should suggest this condition. PMID- 3956927 TI - Computed tomographic air enema technique to demonstrate colonic neoplasms. AB - The use of intravenous glucagon and the judicious introduction of air into a clean colon offer additional help in the confirmation of the larger intracolonic tumors on computed tomographic examination. The procedure is simple and may aid in the differentiation of an intrinsic colonic tumor from other pathologic conditions, particularly those that are extracolonic in origin. PMID- 3956929 TI - Inversion of the right diaphragm: a thoracoabdominal CT pitfall. AB - A patient with a massive pleural effusion which resulted in inversion of the right diaphragm is presented. Computed tomography of the abdominothoracic region without sagittal reconstruction may yield an image that could be mistaken for a pseudohepatic mass. PMID- 3956928 TI - Utility of ceruletide in promoting intestinal opacification for abdominal and pelvic computed tomography. AB - An analysis of the utility of parenteral ceruletide, a cholecystokinin-like synthetic decapeptide, in promoting bowel opacification for computed tomography (CT) scanning was performed. Abdominal and pelvic CT scans of 85 patients who had received intramuscular ceruletide following oral contrast administration and of 85 control patients were reviewed and the degree of bowel opacification evaluated. No significant advantage was conferred by ceruletide in opacifying the stomach or major part of the small intestine. However, a statistically significant difference was found between the 2 groups in the presence or absence of contrast in the terminal ileum and right colon. Contrast was detected in the terminal ileum in 52 experimental compared with 35 control patients (p less than 0.009) and in the right colon in 56 experimental and 39 control subjects (p less than 0.01). Intramuscular administration of ceruletide will be helpful when terminal ileal opacification is essential or in patients in whom colonic opacification is desired but rectal contrast contraindicated. PMID- 3956930 TI - Barium gun for use in enteroclysis. AB - A simple modification of a caulking gun for the administration of high-viscosity barium during small-bowel enteroclysis is described. PMID- 3956931 TI - Hemorrhagic shock and acid gastric injury in the rat. Comparison of gross and histologic findings. AB - The purpose of this study was to compare the gross and histologic changes in the corpus and antrum in the rat hemorrhagic shock plus acid model of gastric injury, and to determine the effect of transfusion of shed blood or albumin on gastric lesion formation. The data indicate that (a) despite the gross appearance of more severe damage in the corpus, histologic damage was more severe in the antrum; (b) covering mucus and cell debris partly explain the difficulty in recognizing antral lesions grossly; (c) the severity of histologic injury was similar in transfused and nontransfused rats; and (d) transfusion of shed blood rendered corpus lesions more recognizable grossly but did not affect the severity of histologic injury. The latter findings raise questions about the pathogenetic importance of reperfusion in gastric ischemic injury and the validity of using gross lesions as an index of gastric injury. PMID- 3956932 TI - Indium 111-granulocyte scanning in the assessment of disease extent and disease activity in inflammatory bowel disease. A comparison with colonoscopy, histology, and fecal indium 111-granulocyte excretion. AB - Indium 111-leukocyte scanning has recently been introduced as a new method for imaging inflammatory bowel disease. The technique has recently been made more specific for acute inflammation by labeling a pure granulocyte fraction rather than the conventional mixed leukocyte preparation. We now report a prospective study comparing 111In-granulocyte scanning with endoscopy, histology, and fecal 111In-granulocyte excretion for the assessment of disease extent and severity in colonic inflammatory bowel disease. In 52 patients with Crohn's disease or ulcerative colitis, disease extent and severity were assessed macroscopically, histologically, or by scanning using a numerical grading system. Excellent correlations were found between both endoscopy and histology and 111In scans [r = 0.90 (endoscopy) and r = 0.90 (histology) for extent; r = 0.86 and r = 0.91 for disease activity]. Severity graded by scanning also showed a close correlation with fecal 111In-granulocyte excretion (r = 0.90). Indium 111-granulocyte scans are a rapid, accurate, noninvasive means of assessing both disease extent and severity of colonic involvement in inflammatory bowel disease. PMID- 3956933 TI - Correlation of esophageal motility abnormalities with neuropsychiatric status in diabetics. AB - Esophageal motility abnormalities, neuropathy, and psychiatric illness were independently determined in 30 patients with type 1 or type 2 diabetes mellitus to clarify the interrelationship of these findings in diabetics. Fifteen patients (50%) were found to have esophageal contraction abnormalities, a specific cluster of manometric derangements. Diagnoses of depression, dysthymia, or generalized anxiety disorder were made in 87% of those with contraction abnormalities but in only 21% of the patients with normal manometric patterns (p = 0.002). Log-linear analysis confirmed that this association was independent of neuropathy effects (p less than 0.001). Several changes in individual manometric parameters related to neuropathy alone were appreciated only when the patients with psychiatric illness were excluded from the analysis. These data indicate that some of the esophageal neuromuscular dysfunction observed in diabetics is independent of neuropathy yet is strongly associated with psychiatric disorder. Such findings help to clarify the discrepant relationship of motility disturbances to neuropathy noted in prior reports. We conclude that consideration should be given to psychiatric illness as well as to neuropathy when interpreting manometric features suggestive of autonomic dysfunction in diabetic patients. PMID- 3956934 TI - Prospective testing of a scoring system designed to improve case selection for upper gastrointestinal investigation. AB - A recently described scoring system designed to assess the individual risk of finding serious pathology in patients referred for upper gastrointestinal investigation has been prospectively tested in 1279 patients undergoing first time endoscopy and 321 patients undergoing radiologic examination. The scoring system has been confirmed to give a reasonable prediction of the likelihood of finding serious pathology in two hospitals with differing endoscopic practice, and also to be applicable to patients attending for radiology. The system works best at defining a low-risk group (score less than 412, 26% of total) in which the incidence of serious pathology was 3%. All cases of malignancy (n = 55) occurred in patients scoring greater than 464 (50% of total). A simple table is described that allows for the easy calculation of score at a glance without the use of a computer. We believe that this scoring system, which can be implemented in seconds, is the simplest yet described and that it could prove to be a useful educational aid. PMID- 3956935 TI - Lingual lipase: immunocytochemical localization in the rat von Ebner gland. AB - Rat lingual lipase was purified to homogeneity by solubilization in 1% octylglucoside, followed by centrifugation, affinity chromatography on hydroxylapatite, gel filtration, and chromatofocusing. Polyclonal antibodies to the enzyme were raised in rabbits, and monospecificity was established by immunoblotting. Tissues were embedded in either paraffin or Epon for light and transmission electron microscopy, respectively. Immunocytochemical localization of the enzyme was established using the peroxidase-antiperoxidase and streptavidin-gold techniques. Immunospecific staining was observed in all acinar cells of the serous von Ebner glands, but only in the demilunes of the lingual mucous glands. The secretory granules of the acinar cells of the von Ebner glands were stained with antilipase on electron microscopic examination. No staining was observed in the salivary glands, pancreas, esophagus, stomach, or duodenum. If a true gastric lipase exists in the rat, it is immunogenically distinct from lingual lipase. PMID- 3956936 TI - Gastric processing and emptying of fat. AB - This study was undertaken to determine whether fat leaves the stomach within or bound to the surface of particles of solid food. We studied gastric emptying of fat in 6 human subjects and in 6 dogs with Roux-en-Y duodenojejunostomies so that chyme leaving the stomach could be collected free of bile and pancreatic enzymes. Humans were studied with a duodenal multilumen tube so that phase-specific, nonabsorbed markers in the meal could be tracked with corresponding, phase specific markers perfused into the duodenum. In this way, we observed the separate time-courses of gastric emptying of the aqueous and solid phases, as well as the extracellular fat (ECF) and intracellular fat (ICF) phases of the meal. In the dogs, all chyme leaving the stomach was collected from a Roux-en-Y fistula and was analyzed directly for aqueous, solid, ECF, and ICF markers in the meal. In both the humans and the dogs, the aqueous phase emptied promptly, whereas the solid, ECF, and ICF phases emptied together, in parallel, after an initial lag. In humans, 22% of the ECF versus 51% of the ICF (p less than 0.02) emptied on or in the solid food particles. In dogs, 81% of the ECF emptied as an oil, 13% emptied on the solid particles, and only 6% emptied as a stable, aqueous emulsion. Sixty-six percent of the ICF emptied in the solid food particles, 20% as a stable, aqueous emulsion, and 14% as an oil. We conclude that most of the ICF empties within the solid food phase, whereas most of the ECF empties as an oil phase. PMID- 3956937 TI - Ontogeny of bile acid transport in brush border membrane vesicles from rat ileum. AB - We studied the postnatal development of bile acid transport in rat ileum, using brush border membrane vesicles prepared by a Ca2+ precipitation method. Membrane vesicles from developing (day 14-21) and adult Sprague-Dawley rats were enriched to a similar degree in brush border membrane marker enzyme activities (sucrase or lactase) compared with homogenate. Uptake of 25 microM [3H]taurocholate by adult membrane vesicles was markedly accelerated in the presence of an inwardly directed 100 mM Na+ gradient compared with a K+ gradient, and there was a transient intravesicular accumulation of isotope above equilibrium ("overshoot"). In contrast, at 14 and 16 days of age there was no difference in taurocholate uptake in the presence of a Na+ or a K+ gradient, and uptake was not saturable. The integrity of the vesicle preparation from 14- and 16-day-old rats was confirmed by the demonstration of Na+-dependent uphill transport of 100 microM L [3H]alanine. Stimulation of taurocholate uptake by a Na+ compared with a K+ gradient ("sodium effect") was first observed at age 17 days, but an overshoot was not present until 18 days of age. The initial rate of Na+-dependent taurocholate (25 microM) uptake increased sixfold between 17 and 21 days of age (24.36 +/- 6.11 to 148.59 +/- 8.56 pmol X mg-1 protein X 5 s-1). Absent or decreased Na+-dependent taurocholate uptake was not due to increased permeability or "leakiness" of vesicles from younger animals to Na+. Ileal brush border membrane vesicles demonstrated saturable kinetics at 21 days, but the Vmax was significantly lower (10.15 +/- 0.44 vs. 13.42 +/- 0.59 nmol X mg-1 protein X min 1, p less than 0.001) and the apparent Km higher (130.6 +/- 18.9 vs. 70.1 +/- 12.6 microM, p less than 0.007) than the adult. We conclude that (a) saturable, Na+-bile acid coupled transport is absent in rat ileum throughout most of the suckling period and (b) kinetic analysis suggests that maturation occurs near weaning, primarily through an increase in functional bile acid carriers within the ileal brush border membrane. PMID- 3956938 TI - Electrical basis of excitation and inhibition of human colonic smooth muscle. AB - Excitation and inhibition of electrical activities of the musculature of the human colon and the consequent changes in motor activities were studied in vitro. The mechanisms of excitation and inhibition were very different from those of the small intestine and colons from animal models. Carbachol increased spiking activity and the frequency of bursts of electrical oscillations in longitudinal muscle. Each longitudinal muscle contraction was related to a burst of electrical oscillations. Carbachol induced one of three patterns of activity in circular muscle: (a) continuous electrical oscillatory activity (14-24 cpm) with spikes, associated with tonic contraction; (b) bursts of such electrical activity, associated with broad phasic contractions; or (c) prolonged membrane potential depolarizations (frequency 1-3 cpm) with superimposed intense spiking activity, associated with phasic contractions. Isoproterenol inhibited all electrical and mechanical activities in both muscle layers. These results may provide a better understanding of (a) the origins of the variable patterns of electrical and motor activities and (b) the relationship between electrical and mechanical activities of the human colon musculature. PMID- 3956939 TI - Bile reflux is increased in cigarette smokers. AB - The effect of cigarette smoking on gastric emptying, gastric secretion, and bile salt reflux was measured in 19 healthy habitual cigarette smokers (greater than or equal to 20 cigarettes per day) and 18 nonsmokers. They were studied both in the fasting state and after being fed a mixed liquid meal. Ten of the smokers were studied twice, when smoking and when not, in randomized order. Smokers had lower basal gastric secretion rates than nonsmokers irrespective of actually smoking or not. In smokers, bile salt reflux and postprandial gastric bile salt concentration were higher than in nonsmokers even when not actually smoking (p less than 0.01). Smoking during the experiment slowed gastric emptying, and increased bile salt reflux rate and gastric bile salt concentration (p less than 0.01). It is concluded that cigarette smoking has both chronic and acute effects on gastric function, and that bile salt reflux may contribute to the increased incidence, and lower healing rate, of gastric ulcers in smokers. PMID- 3956940 TI - Effects of cisapride on jejunal motor activity in fasting healthy humans. AB - The effects of cisapride on jejunal interdigestive motor activity were studied in 12 healthy men participating in three experiments each. Five minutes after an activity front (phase III) they received, in random double-blind fashion, 10 mg of cisapride, 4 mg of cisapride, or saline placebo by intravenous injection. Motor activity was recorded for 4 h. A pneumohydraulic perfusion system and five catheters with orifices positioned 10-30 cm beyond the ligament of Treitz were used. Cisapride increased phase II-type activity (p less than 0.001) and reduced the number of activity fronts dose-dependently. Compared with phase II after placebo, the activity prevailing after cisapride was characterized by a significantly higher number and amplitude of contractions as well as by a significantly greater area under the pressure curve. Moreover, a significantly higher proportion of contractions was propagated aborally. Self-rated abdominal grumbling increased dose-dependently. Except for mild sedative effects, no side effects occurred. We conclude that cisapride induces a prolonged and highly propagative phase II-like jejunal motor activity in fasting humans. PMID- 3956942 TI - Splanchnic and systemic hemodynamics in portal hypertensive rats during hemorrhage and blood volume restitution. AB - In portal hypertension the hemodynamic events after episodes of bleeding and blood transfusions may have important pathophysiological and therapeutic implications. The present study was designed to evaluate the effect of hemorrhage and blood restitution on splanchnic and systemic hemodynamics in a rat model of portal hypertension induced by portal vein constriction. In 16 portal hypertensive rats, sequential measurements of arterial and portal pressure were obtained during withdrawal and reinfusion of 15 ml X kg-1 body wt of blood. At the completion of the hemorrhage, a decrease of 16.9% +/- 2.6% in arterial pressure and 27.3% +/- 2.2% in portal pressure was observed. After blood reinfusion, arterial pressure returned to baseline values while portal pressure increased by 20.4% +/- 3.2% (p less than 0.01). This increase in portal pressure was not observed in 5 normal rats that were subjected to the same blood volume changes. Hemodynamic studies using a radioactive microsphere technique revealed that the withdrawal of 15 ml X kg-1 body wt of blood is followed by a decrease in portal venous inflow (6.4 +/- 0.4 vs. 10.4 +/- 0.6 ml X min-1 X 100 g-1 body wt in the control group, p less than 0.01). After blood volume restitution, the portal venous inflow returned to control values while the portal-collateral resistance increased significantly (2.06 +/- 0.13 vs. 1.67 +/- 0.07 mmHg X min X ml-1. 100 g, p less than 0.05). These results indicate that during hypovolemia there is a marked reduction in portal pressure because of a reduction in portal venous inflow. Blood volume restitution returns the portal venous inflow to control values. However, the portal pressure increases beyond control values because of an increase in portal-collateral resistance. PMID- 3956941 TI - Amine trapping: physical explanation for the inhibitory effect of gastric acidity on the postprandial release of gastrin. Studies on rats and dogs. AB - We investigated the relationship between the pH dependence of meal-stimulated gastrin release and the permeability of the antral mucosa to dietary amines. This study was undertaken after previous work from our laboratory had demonstrated that dietary amines are potent in vivo and in vitro stimulants of gastrin release and that it is well established that amines are trapped in acidic environments. Three contrasting experimental model systems were employed to investigate the association of these two pH-dependent properties. In the first in vivo study, it was demonstrated that ingestion of standard rat Chow resulted in an increase in circulating gastrin and ammonia levels, whereas the postprandial increases in both properties were abolished if the rats ingested Chow that was preacidified to a pH of 2.4. Second, the antral uptake of the fluorescent cyclic amine, quinacrine, from the gastric lumen of pylorus-ligated rats was monitored by fluorescent microscopy and spectrophotometry and was demonstrated to be inhibited in a step-wise fashion as the luminal pH was decreased. Lastly, our in vitro studies suggested that the transport of [14C]methylamine into canine antral mucosa mounted in Ussing chambers was pH-dependent, as was gastrin release into the incubation medium. Thus, all the data are consistent with the possibility that meal-stimulated gastrin release is inhibited at low pH, due (in part) to the protonation of dietary amines, preventing their diffusion into the G cell to activate hormone secretion. PMID- 3956943 TI - Immediate diagnostic criteria for bacterial infection of ascitic fluid. Evaluation of ascitic fluid polymorphonuclear leukocyte count, pH, and lactate concentration, alone and in combination. AB - We prospectively evaluated the ascitic fluid (AF) polymorphonuclear cell (PMN) count, pH, and lactate concentration in single ascitic fluids from 60 patients to determine their relative predictive values for the immediate diagnosis of ascitic fluid infection. Nine of the 60 ascitic fluids were malignant. Of the remaining 51 samples, nine from cirrhotic patients were infected. The mean AF pH, lactate concentration, and PMN count in the infected group were 7.20 +/- 0.19, 80 +/- 51 mg/dl, and 18,199 +/- 19,650 cells/mm3, respectively, and all were significantly different from the corresponding values in noninfected ascites. Mean arterial blood-ascitic fluid (B-AF) pH and lactate gradients in the infected group were 0.23 +/- 0.17 and -46 +/- 31 mg/dl, respectively, and were significantly different from the corresponding values in noninfected ascites (p less than 0.05). Significant differences were not found between infected and malignant ascites, except for the AF PMN count (p less than 0.001). In cirrhosis with ascites, an AF pH less than or equal to 7.34 was the most specific single test (100%) and had the highest diagnostic accuracy (98%). In the larger group of patients with ascites of diverse etiology, a B-AF pH gradient greater than or equal to 0.10 or an AF PMN count greater than or equal to 500 cells/mm3 were the single tests with the highest diagnostic accuracy (92%). Combining an AF PMN count greater than 500 cells/mm3 with any of the other diagnostic criteria increased the specificity and diagnostic accuracy (up to 98%) compared to the best single criterion. Although our data support the use of a number of different combinations of AF measurements for the immediate diagnosis of infection, the simplest and most readily obtainable measurements are the pH and PMN count. Therefore, in the clinical setting we recommend the use of either an AF pH less than or equal to 7.34 or a B-AF pH gradient greater than or equal to 0.10 in combination with an AF PMN count greater than 500 cells/mm3 to obtain the highest degree of accuracy in the immediate diagnosis of ascitic fluid infection. PMID- 3956944 TI - pH of ascitic fluid: diagnostic and prognostic value in cirrhotic and noncirrhotic patients. AB - The pH measurements of 185 samples of ascitic fluid in 169 cirrhotic and 16 noncirrhotic patients were analyzed to assess their diagnostic and prognostic value. The 169 cirrhotic patients were divided into four groups: sterile ascites (group 1), spontaneous bacterial peritonitis (group 2), probable spontaneous bacterial peritonitis (group 3), and bacterascites (group 4). Mean ascitic fluid pH values were lower (p less than 0.001) in patients of groups 2 (7.24 +/- 0.17) and 3 (7.34 +/- 0.11) than in patients of groups 1 (7.44 +/- 0.06) and 4 (7.45 +/ 0.08), but there was an important overlap between these groups. Mean arterial ascitic fluid pH gradient values were higher (p less than 0.001) in patients of groups 2 (0.21 +/- 0.16) and 3 (0.10 +/- 0.13) than in patients of groups 1 (0.02 +/- 0.05) and 4 (0.02 +/- 0.05). This gradient had a better discriminant power than ascitic fluid pH alone. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy for the diagnosis of certain or probable spontaneous bacterial peritonitis were, respectively, 47%, 99%, 88%, 89%, and 89% for ascitic fluid pH values less than 7.32; 66%, 99%, 91%, 93%, and 92% for arterial-ascitic fluid pH gradient values greater than 0.10; and 97%, 96%, 86%, 99%, and 96% for polymorphonuclear cell count greater than 75/microliter. Ascitic fluid pH values appeared to have a high prognostic value, as 6 of 7 cirrhotic patients with ascitic fluid pH values less than 7.15 died rapidly. Low ascitic fluid pH values were found in patients with malignant and pancreatic ascites and tuberculous peritonitis but not in patients with cardiac ascites. We conclude that in cirrhotic patients with certain or probable spontaneous bacterial peritonitis (a) arterial-ascitic fluid pH gradient measurements had a slightly higher diagnostic value than ascitic fluid pH measurements but a slightly lower diagnostic value than polymorphonuclear cell count and (b) ascitic fluid pH measurements had a high prognostic value. In noncirrhotic patients, ascitic fluid pH and arterial-ascitic fluid pH gradient measurements had a poor diagnostic value. PMID- 3956946 TI - Lingual lipase. PMID- 3956945 TI - Chronic hepatitis in HBsAg carriers with serum HBV-DNA and anti-HBe. AB - We compared the clinical and serologic features of 118 hepatitis B surface antigen carriers with hepatitis B e antibody (anti-HBe) followed up for 3-10 yr (mean 6.1 yr), separated according to the presence or absence of hepatitis B virus-deoxyribonucleic acid (HBV-DNA) in serum. The test was performed by molecular hybridization. There were 28 carriers with and 90 without viral DNA. Carriers with serum anti-HBe/HBV-DNA had major liver disease; cirrhosis developed during the follow-up period in 9 of the patients. All had the hepatitis B "core" antigen in the liver, localized prevalently in the cytoplasm of the hepatocytes. Among carriers of anti-HBe alone, 73 had persistently normal tests of liver function and 17 had abnormal levels of alanine transaminase and usually minor forms of liver damage at histology. In a group of 24 carriers of hepatitis B e antigen who spontaneously seroconverted to anti-HBe, hepatitis and a prevalent nuclear distribution of intrahepatic hepatitis B core antigen were found in temporal correlation with the presence of hepatitis B e antigen in serum. The replication of the hepatitis B virion terminated and liver disease remitted after seroconversion to anti-HBe. A positive HBV-DNA test in anti-HBe carriers is associated with a severe and evolutive liver disease and may provide an indication for treatment with drugs inhibiting the synthesis of HBV-DNA. PMID- 3956947 TI - Hemorrhage, blood transfusion, and portal pressure. PMID- 3956948 TI - Rapid presumptive diagnosis of spontaneous bacterial peritonitis. PMID- 3956950 TI - Colorectal carcinomas in adenomas. PMID- 3956949 TI - Heterotopic gastric mucosa of the upper esophagus. PMID- 3956951 TI - Pathogenesis of colitis cystica profunda. PMID- 3956952 TI - Vagal effects on gallbladder emptying. PMID- 3956953 TI - NK cells, IBD, and cancer. PMID- 3956954 TI - Annual meeting of the American Gastroenterological Association and Digestive Disease Week. May 17-23, 1986, San Francisco, California. Abstracts. PMID- 3956955 TI - [Therapy and results of the treatment of breast cancer. A report on 1,003 cases 1970 to 1978]. AB - 1003 women with invasive breast carcinoma were treated in the Department of Obstetrics and Gynecology, Medical School Hannover, between 1970 and 1978. In 787 patients modified radical mastectomy was combined with postoperative radiation therapy. In 797 patients, who were observed for at least 5 years, the 5 year survival rate was 63.0%, depending on tumor stage. In spite of intensive loco regional treatment, local recurrence occurred in 18.0%. For us, that was one among other reasons to discontinue routine postoperative radiation therapy. PMID- 3956956 TI - [Simplified standardized afterloading therapy of cervical cancer using a new applicator system (modeled after the Munich method)]. AB - In order to be able to continue to benefit from the Munich method - fixed applicator geometry - even after changing from radium therapy to low dose rate afterloading therapy, our department has developed a standardized treatment program for the ring applicator. Its prerequisites are the dose specified on the Manchester point A and the distribution of sources specified for the ring applicator. The make-up of the source flow in the ring catheter is chosen in such a way as to reduce the maximum rectal dose to more favourable levels. PMID- 3956957 TI - [Value of plasma ribonuclease as a marker for gynecologic tumors and breast tumors]. AB - In 151 patients the plasma-ribonuclease-activity was measured. The results of a control group of 47 patients were compared to the pretherapeutic values of 21 cases with cervical intraepithelial neoplasia, 83 cases with gynecologic cancer and 47 cases with breast cancer. The upper limit of the normal range was 300 ng/ml. The method is not appropriate for the detection of precancer of the uterine cervix or for breast cancer. For gynecologic tumors we found a sensitivity rate of 87% and a specificity rate of 85%. PMID- 3956958 TI - [Obstructive endometriosis of the efferent urinary tract]. AB - Even though, in every 7th to 8th patient with endometriosis, it occurs in the efferent urinary tract, little attention has been paid this fact, generally speaking. This may be due in part to the atypical symptomatology of ureteral or respectively vesical endometriosis. However, its consequences can be serious in both younger patients as well as postmenopausal women. On the basis of two of the authors' own cases and the literature, the clinical symptoms and treatment of vesical endometriosis and ureteral obstruction associated with pelvic endometriosis are discussed. PMID- 3956959 TI - [Urodynamic parameters before and following a vaginal incontinence operation]. AB - We compared two groups of patients 14 months after vaginal hysterectomy and pelvic floor repair, group I (n = 20) postoperatively continent versus group II (n = 27) postoperatively incontinent. Preoperative urodynamic findings were of no prognostic value with regard to continence. There was no statistical difference in maximum resting urethral closure pressure (UCP), urethral functional length and dynamic and reflectoric vesico-urethral transmission factor, in spite of group I having a slightly higher resting UCP than group II. Group II showed a significant decrease of resting UCP postoperatively. PMID- 3956960 TI - [Rectoanal rest and stress pressure profile of the female for detecting fecal incontinence]. AB - In this article, the method used to record rectoanal rest and stress patterns is described. With reference to sample graphs and tabulated results, normal values in continent women are demonstrated. Results are discussed together with references in the literature. PMID- 3956961 TI - [Reliability of the vaginal diaphragm as a contraceptive method]. AB - With a failure rate of between 2 and 4 in recent statistics, the vaginal diaphragm can be considered a relatively reliable method of contraception. The physician can therefore recommend this method as an alternative if, e.g., ovulation inhibitors are contraindicated and the patient rejects an intrauterine pessary. In such cases diaphragms are as acceptable as condoms, the more so because the two methods are completely harmless. (Table 9 summarizes the advantages and disadvantages of diaphragms.) Whether, in the final analysis, the condom or the diaphragm is accepted, will largely depend on whether the man or the woman assumes the responsibility for family planning. The physician can use his influence when explaining the contraceptive principle of the diaphragm and showing the patient how to use it to keep the failure rate to a minimum. The present authors consider that even today, good, objective counseling on reliable family planning is one of the physician's most important tasks in the sphere of preventive medicine. PMID- 3956962 TI - [Neonatal septicemia and bacterial neonatal infection. Manifestation and course in early antibiotic therapy]. AB - The authors studied in the Paediatric Department of the Leverkusen Municipal Hospital retrospectively the influence of an early dose of antibiotics (broad spectrum penicillin combined with an aminoglycoside) in respect of the manifestation of bacterial newborn infections in infants with an increased risk of infection, during a period of 3 years (1981-1983). Among the infants born in the Gynaecological Department of the Leverkusen Municipal Hospital (exact data were available on the number of births and referrals) the incidence of bacterial newborn infections was 3.3% referred to the total number of deliveries (n = 3598); 0.7% of these newborn has sepsis. In the total group of children treated for newborn infection, the infection mortality was 5.5%; the mortality of the manifest newborn sepsis was 16.2%, i.e. lower than reported in literature. Early administration of antibiotics proved particularly effective in preventing purulent bacterial meningitis of newborn; this disease did not occur with any of the infants observed during the study period. Diagnosis of newborn infection included discolouration of the skin, respiratory disturbances, fever, shift to the left in the differential blood picture, and anaemia; these signs proved particularly suitable for arriving at a correct diagnosis. Identification of the pathogens was most frequently successful in gastric juice culture and anal smear. The latency period of more than 24 hours between rupture of the amnion and delivery does not represent an increased risk of infection for the newborn, as our results confirm, and this is, therefore, not an indication for initiating prophylaxis with antibiotics if there are no other abnormal findings. PMID- 3956963 TI - [Analysis of indirect maternal mortality cases]. AB - Among 145 cases of maternal deaths from the period 1975 to 1983, whose data had been collected in a nationwide survey, 30 cases (21%) were classified as associated causes of maternal deaths. 10 deaths (33%) occurred at the birth of the child, 11 (37%) within 6 weeks after delivery, 4 (13%) within the first trimester and 5 (17%) within the second trimester. The disease that was in causal relation to the complication leading to death was known in 16 cases (53%), unknown in 13 cases (43%); in one case information is missing. In 11 cases (37%) it was a cardiac disease, in 6 cases (20%) a cerebrovascular disease and in 4 cases (13%) a disease of the lung. All other diseases leading to the death of the mother were rare diseases. It can be concluded that more emphasis should be given to the diagnosis of cardiovascular diseases during pregnancy and further to the clarification of uncertain conditions in the postnatal period. In case of a disease with high maternal risk, sterilisation should be considered. PMID- 3956964 TI - [A test for the detection of fibrin in the plasma]. AB - The article reports on measurements of D dimer, a terminal plasmic lysis product of crosslinked fibrin, with an enzyme immunoassay (ELISA) employing recently developed specific monoclonal antibodies. Due to its sensitivity the test can be used on plasma samples. The D dimer concentrations in patients with deep vein thrombosis diagnosed by laboratory apparatus were significantly increased compared to a control group; in one patient with additional pulmonary embolism, the level was even higher. Moderately elevated concentrations of D dimer were observed in the hypercoagulable state of pregnancy, puerperium and during the postoperative course. This reduces the specificity of the test with regard to the recognition of thromboembolic episodes under these conditions. Obstetric patients with disseminated intravascular coagulation (DIC) showed excessively increased levels of D dimer. Hence, a marker function with regard to the recognition of thromboembolic disease can be attributed to the D dimer; the diagnosis of DIC can be confirmed if very high concentrations are detected. PMID- 3956965 TI - [Simplified hamster ovum-sperm penetration test (HSPT) in routine sterility testing]. AB - In 67 patients, in most of whom the spermiogram did not, a priori, furnish definitive proof of fertility, the hamster egg human sperm penetration test was performed as part of a screening programme for infertility therapy conducted from February 1984 to February 1985. Evaluation of the test was facilitated by identification of the decondensed spermatozoon head in the penetrated hamster egg with a simple fluorescein staining instead of the usual aceto-lacmoid staining. The penetration rate (= percentage proportion of the hamster ova liberated from the zona pellucida which are penetrated within 3 hours following incubation with 1 million motile spermatozoa) was evaluated statistically in comparison to the fertility criteria of the spermiogram (motility, density, pathoforms), in order to verify the existence of possible fertility disturbances due to inability to penetrate despite the motility of the spermatozoa. In 42 patients the diagnosis of infertility was confirmed by a penetration rate of less than 10%. In 17 patients fertility was conformed according to HSPT (penetration rate of over 20%), while in 7 patients fertility was in the lower normal range. In the light of the authors' findings fertility confirmed by the HSPT is a precondition of referral for extracorporeal insemination. In the light of the authors' findings intrauterine insemination appears advisable for women whose fertility is in the lower normal range according to HSPT. PMID- 3956966 TI - [Induction of secondary labor in triplet pregnancy]. AB - After premature birth of the first triplet we successfully delayed the delivery of the remaining triplets for 21 days until the 29th week of gestation. The 36 year-old patient from Africa (Uganda) was suffering secondary sterility due to bilateral salpingectomy. After transfer of four in-vitro fertilised eggs, triplets were diagnosed ultrasonographically in the 7th week of gestation. In the 26th week, despite tocolysis, premature labour led to the delivery of a 740 g female foetus who died 2 days later. Immediately after delivery cerclage was performed under halothane anaesthesia. Further treatment consisted of tocolytics, antiseptics locally, antibiotics systemically, and rest in bed. In the 29th week a caesarean section had to be performed because of uncontrollable contractions and threatening asphyxia of the second triplet. Both infants, 1100 and 1150 g, were female, both survived without handicaps. PMID- 3956967 TI - [Complicated pregnancy course following mitral valve replacement]. AB - A report is made on a woman patient with a Bjork-Shiley prosthesis in the mitral position, whose pregnancy was complicated by bacteraemia and a thrombotic obstruction of the artificial heart valve. With reference to research, the authors discuss the question of anticoagulation in pregnant women with artificial heart valves as well as the question of the choice of prosthesis in women wishing to have children. PMID- 3956968 TI - [Early diagnosis, treatment and prevention of iron deficiency anemia]. PMID- 3956969 TI - [Various characteristics of the intracellular metabolism and functional disorders of lymphocytes in reactive and neoplastic conditions of the lymphoid system]. PMID- 3956970 TI - [Effect of erythrocytapheresis on the oxygen-transport function of the blood in patients with polycythemia vera]. PMID- 3956971 TI - [Fatty acid composition of lipids absorbed by perfluorocompounds during their circulation in the blood vessels]. PMID- 3956972 TI - [Comparative study of electric and morphological properties of preserved blood]. PMID- 3956973 TI - [A method of evaluation of the number of adhesion-active polymorphonuclear leukocytes in the examined population]. PMID- 3956974 TI - [Changes in immunity after immunization of donors for obtaining antistaphylococcal plasma]. PMID- 3956975 TI - [Iron metabolism in acquired preleukemic dyserythropoiesis]. PMID- 3956976 TI - [Features of oxygen supply to the body after massive red cell transfusion]. PMID- 3956977 TI - [Immune mechanism of the regulation of hemostasis]. PMID- 3956978 TI - [Preventive correction of hemostasis in patients with polycythemia vera]. PMID- 3956979 TI - [Current principles of infusion-transfusion therapy of patients with thermal injuries]. PMID- 3956980 TI - [Various indices of humoral and cellular immunity in patients with polycythemia vera]. PMID- 3956981 TI - [Mechanisms of the cytopenic syndrome in hairy cell leukemia]. PMID- 3956982 TI - [Composition and morphocytochemical features of cell colonies in agar cultures of patients' bone marrow]. PMID- 3956983 TI - [Activity of the enzyme glucose-6-phosphate dehydrogenase in peripheral blood cells]. PMID- 3956984 TI - [Treatment of patients with mild and moderately severe burns with blood substitutes during the acute period]. PMID- 3956985 TI - Neurohormonal control of ecdysteroid biosynthesis by Carcinus maenas Y-organs in vitro, and preliminary characterization of the putative molt-inhibiting hormone (MIH). AB - Using simple culture techniques, the effects of neurosecretory tissue, sinus gland-conditioned media, and sinus gland extracts upon the biosynthesis of ecdysteroids by Carcinus maenas Y-organs in vitro were investigated. The sinus glands were found to be a major source of a factor which profoundly repressed ecdysteroid synthesis and which did not appear to be species-specific within other brachyurans examined (Liocarcinus, Cancer). It is suggested that the inhibitory factor is produced by the neurosecretory tissues of the medulla terminalis. It is argued that the inhibitory factor is the putative molt inhibiting hormone (MIH). Partial characterization revealed that MIH is a heat stable, trypsin-sensitive neuropeptide, eluting on a Sephadex G-50 gel in a range of approximately 6-14 kDa. By consideration of the dose-response characteristics, it is estimated that MIH may be active in the subpicomolar range. PMID- 3956986 TI - Influences of temperature and pH on free T4 and free T3 in charr and trout plasma. AB - The influences of temperature and pH on the percentages of T4 (L-thyroxine) or T3 (3,5,3'-triiodo-L-thyronine) in the free form (%FT4 or %FT3) were determined by equilibrium dialysis on Arctic charr and rainbow trout plasma. %FT4 and %FT3 of plasma from trout or charr acclimated at 12-13 degrees increased with dialysis temperature (5-19 degrees). When charr plasma was dialyzed at fish acclimation temperature (5, 13, 20 degrees), %FT4 and %FT3 also increased with temperature. However, when plasma from charr acclimated at 5, 13, or 20 degrees was dialyzed at 13 degrees, %FT4 and %FT3 showed no dependence on previous thermal acclimation. %FT4 of charr plasma increased with dialysis pH (7.0-7.8); %FT3 was less responsive to pH but was lower at pH 7.0-7.4 than at pH 7.6-8.0. It is concluded that acute in vitro physiologic changes in either temperature or pH alter the proportions of plasma T4 and T3 in the free form; comparable in vivo effects could explain aspects of environmentally modified T4 and T3 metabolism. PMID- 3956987 TI - Annual cycles of plasma and testicular androgens in the lizard Tiliqua (Trachydosaurus) rugosa. AB - Androgen production during the annual reproductive cycle was investigated in the male scincid lizard Tiliqua (Trachydosaurus) rugosa. Concentrations of testosterone and epitestosterone were measured in plasma and testis (incubated and nonincubated) using radioimmunoassay. Morphological and histological techniques were used to determine the anatomical changes in the testis. Mating behavior was observed during spring, and sperm were most numerous in the testis at this time. Histological evidence and changes in testicular weight indicated that spermatogenesis begins in autumn and culminates in spring. Testicular regression occurred soon after mating. Plasma concentrations of both androgens were maximal during spring and minimal during summer. The maximal concentrations were approximately 500 and 150 nmol/liter (epitestosterone and testosterone, respectively). The minimal plasma concentrations were 250 and 15 nmol/liter, respectively. Plasma and testicular androgen cycles followed a pattern similar to that of the spermatogenetic cycle, suggesting the possible involvement of one or both of these androgens in the control of spermatogenesis and mating behavior in these lizards. PMID- 3956988 TI - The mechanism of action of angiotensin II in the rat snake, Ptyas korros. AB - The hindquarter of the rat snake, Ptyas korros, was isolated for perfusion study in order to investigate the mechanism of action of angiotensin (ANG) II. Both ANG II and norepinephrine (NE) produced concentration-dependent increases in perfusion pressure. [Sar1, Ile8] ANG II significantly attenuated the response to ANG II but not that of NE. Phentolamine significantly reduced the responses to both ANG II and NE, with much greater inhibition on NE than ANG II. These findings suggest the presence of ANG II receptors and alpha-adrenergic receptors in the hindquarter. Since tyramine did not exert any increase in perfusion pressure, the release of ANG II-stimulated catecholamines was probably not involved in the increase in perfusion pressure to ANG II in the present preparation. The partial attenuation of the response to ANG II by phentolamine, therefore, suggests that ANG II may act directly on both specific ANG II receptors and alpha-adrenergic receptors. PMID- 3956989 TI - Median eminence equivalence of the neurohypophysis of the hagfish, Eptatretus burgeri. AB - Three substances of different molecular size were injected into the ventricular space (III) of the neurohypophysis of anesthetized hagfish, Eptatretus burgeri, to learn whether such substances could diffuse across the connective tissue barrier between the neuro- and adenohypophysis. The substances tested were trypan blue, a vital dye that is a fine particulate colloid; horseradish peroxidase (HRP), an enzyme protein whose distribution in tissue can be revealed through its chromogenic action on a substrate; and ferric ion, whose distribution can be revealed through the Prussian blue reaction. All three substances were transferred across the neurohypophyseal wall to the extracerebral area within a few minutes, the trypan blue and HRP apparently through action by tanycytes. The trypan blue, within a 15-min period, moved no further. The HRP protein diffused through connective tissue as far as the dorsal (2 min) and ventral (5 min) borders of the adenohypophysis, but did not enter the secretory cells themselves. The ferric ion reached the adenohypophysis quickly (2 min) and entered the secretory cells in higher concentration than it was in the surrounding connective tissue. These data indicate that the hagfish ventral neurohypophysis is functionally capable of supplying neurosecretory regulatory factors to the adenohypophysis. It is thus a "diffusional median eminence." We can propose that the cyclostome median eminence, lacking a portal relation to the adenohypophysis, represents the phylogenetically primitive brain--pituitary relationship. PMID- 3956990 TI - Antagonistic effects of prolactin and oxytocin on tail fin regression and acid phosphatase activity in metamorphosing Ambystoma tigrinum. AB - We have found that the inhibition of thyroxine-induced tail fin regression by prolactin in larval tiger salamanders is antagonized by oxytocin. Other workers have shown that prolactin blocks the rise in activity of several hydrolytic enzymes that occurs in regressing tissue during metamorphosis. Here, we examine the effects of prolactin and oxytocin--given alone and in combination--on tail fin regression and acid phosphatase specific activity in this tissue. Both long term (12-day) and short-term (48-hr) treatment paradigms using prolactin and oxytocin are investigated. The results show that long-term prolactin treatment of metamorphosing larvae blocks fin regression and the rise in acid phosphatase specific activity seen in metamorphosing controls; short-term prolactin treatment of metamorphosing larvae inhibits fin regression within 48 hr, but does not block the rise in acid phosphatase activity seen in controls; oxytocin antagonizes the effects of prolactin on tail fin regression; and oxytocin treatment (long-term or short-term) of metamorphosing larvae causes an elevation of acid phosphatase activity above that seen in metamorphosing controls. With long-term treatment, this effect of oxytocin is slightly antagonized by prolactin; with short-term treatment, no antagonism is observed even though an effect of prolactin on fin height is still evident. We have interpreted these results as suggesting that the effect of prolactin on hydrolase activity is not a prerequisite for its inhibitory effect on fin regression to occur. PMID- 3956991 TI - [Action of the extract from the optic tentacles of juvenile and adult snails on the in vivo development of the albumin gland of Helix aspersa]. AB - Injected optic tentacle homogenates in Helix aspersa were shown to cause a decrease in growth rate and albumen gland development. The effects of optic tentacles removed from young animals and from adult animals were compared. In young animals, injections of adult optic tentacle homogenate resulted in a reduction in both growth rate and albumen gland weight. In older adult animals injected with adult optic tentacle homogenate, growth and albumen gland development decreased, but not to the same extent as in young animals. In contrast, the inhibitory effect of the young tentacle homogenate was inverted. The possible source of a tentacular factor is discussed in relation to its possible origin in other investigated pulmonates, and also the mechanism of the homogenates heterochronic action. PMID- 3956992 TI - Direct control of the gonadotroph in a teleost, Poecilia latipinna: gonadal steroids. AB - Pituitaries from male and female fish were incubated with 1, 5, and 10 micrograms/ml of oestradiol-17 beta, testosterone, 17 alpha OH-progesterone, and 17 alpha,20 beta-dihydroxy-4-pregnan-3-one for 18 hr. Ultrastructural differences between control and experimentally treated glands were used to define the direct effects of these steroids on the gonadotropic cells of the adenohypophysis. The effects of the steroids differed according to sex and reproductive state of the donor animal. Oestradiol and testosterone stimulated gonadotropin secretion by active gonadotrophs, but inhibited it in inactive cells. Both the progesterones generally inhibited gonadotropin secretion although 17 alpha,20 beta-dihydroxy-4 pregnan-3-one had no effect on active gonadotrophs. The four steroids investigated all show potential for direct control of gonadotropin secretion in Poecilia latipinna although factors affecting the balance of these actions, and their relative importance in vivo, remain to be elucidated. PMID- 3956993 TI - Flight stimulates adrenocortical activity in pigeons (Columba livia). AB - The influence of long-distance flight on corticosterone secretion has been examined in trained racing pigeons. Flights of 315-561 min from release sites 115 557 km from the home loft greatly increased the circulating corticosterone concentration in comparison with the levels in nonexercised controls sampled before release or bled in the loft at the times of release or arrival. The increase in corticosterone concentration was unrelated to the distance flown or duration of flight. Flights of less than 1 min duration (from release sites 100 m from the loft) increased the corticosterone concentration, in comparison with that in the loft controls, but to levels much lower (P less than 0.001) than those following long-distance flights and to concentrations similar to those in birds that were returned to the loft by hand. PMID- 3956994 TI - Nuclear estrogen receptor bindings in granulosa cells and estradiol-17 beta contents in follicular membranes of the ovary of the hen during the ovulatory cycle. AB - Estrogen receptors were found in the nuclear fractions of granulosa cells of the largest (F1) and the second largest (F2) preovulatory follicle in the ovary of the hen. The maximum number of binding sites (NBSmax) of the nuclear estrogen receptors was greater in F2 than in F1, while the equilibrium dissociation constant (Kd) was not different. During the ovulatory cycle, the NBSmax of the estrogen receptors showed a change parallel to the change in the estradiol-17 beta content in the follicular membranes. The results suggest that estradiol-17 beta produced in the follicular membrane may exert a direct action on the granulosa cells in the hen ovary. PMID- 3956995 TI - Calcitonin effects on serum calcium level of the freshwater snake, Natrix piscator. PMID- 3956996 TI - The annual breeding cycle of the high-arctic Svalbard ptarmigan (Lagopus mutus hyperboreus). AB - Gonadal size, spermatogenesis, egg production, height of the supraorbital comb, moult, and plasma luteinizing hormone (LH) levels were measured during an annual cycle in wild Svalbard ptarmigans (Lagopus mutus hyperboreus). These birds live permanently at 77-81 degrees N where daylight is continuous from the beginning of April until mid September while the average ambient temperature is above freezing only between early June and mid September. The gonads and comb size began to enlarge in March coinciding with an increase in plasma LH, but sperm production and egg laying did not begin until the end of May and early June, respectively. This long lag between the onset of reproductive functions and the time of breeding reflects a slow rate of gonadal growth which may be caused by nonphotoperiodic, inhibitory input from the environment. Gonadal regression occurred in July and was associated with a steep decline in plasma LH levels indicating that the birds became long-day refractory. A moult from white to pigmented plumage occurred in females at the beginning and in males towards the end of the breeding season. This observation is consistent with the notion of an inhibitory effect of testosterone on moult in the males. Both sexes moulted simultaneously into white plumage in late September/early October. PMID- 3956997 TI - Circadian variations in plasma osmolality, electrolytes, glucose, and cortisol in carp (Cyprinus carpio). AB - Male carps (Cyprinus carpio) of about 1.5 kg were used in all experiments performed in December and February. Blood was taken by heart-puncture within 1 min or less every 4 hr from different fishes during a 24-hr period to establish circadian rhythmicities of all parameters. The water temperature was 11-12 degrees. In December circadian variations could be calculated for cortisol, Na+ and plasma osmolality in partly fed carps and for cortisol, Ca2+, glucose, and plasma osmolality in food deprived animals. No difference in cortisol level, amplitude, or acrophase was present between both experiments but plasma Na+ and osmolality was more elevated when feeding. Also the acrophase of the osmolality rhythm differed between both groups. In February carps, cortisol levels were still comparable to December ones, but a 4 hr shift in acrophase had occurred (from +/- 02 hr to 06 hr). Levels of all other parameters also were comparable to December, except for glucose with only 1/5th of the December values. There was also a shift in acrophase present from the morning to around midnight. The level of cortisol in February carps acclimated to 18 degrees for 1 week was twice the one found in the 11 degrees group. At the same time a significant increase in amplitude and shift in acrophase to 22 hr was seen. Other parameters, except for glucose of which the level was significantly lower than in the 11 degrees group, remained unchanged. Also no correlation between the individual 24-hr data of all parameters could be found. It is therefore concluded that cortisol is not responsible for the observed circadian rhythmicities of Na+, Ca2+, glucose, or plasma osmolality. PMID- 3956998 TI - Epinephrine effect on glycogen phosphorylase activity in catfish liver and muscles. AB - In catfish, the percentage of the active (a) form of glycogen phosphorylase with respect to the total (a + b) form varied in control slices from about 90% to 65% and 20%, respectively for liver, red, and white muscles. Epinephrine added to the incubation medium of liver and white muscle slices caused a significant increase in the specific activity of phosphorylase a in liver and white muscle, but not in red muscle. In liver slices epinephrine showed its effect from the concentration of 3.5 X 10(-8) M. The increase of enzyme activity explains the lowering of the glycogen level in liver and white muscle induced by epinephrine. PMID- 3956999 TI - Identification of a putative progesterone receptor in the oviduct of a viviparous watersnake (Nerodia). AB - The steroid hormone progesterone is of particular interest in reproductive tract adaptations associated with the processing of embryonic materials in the evolution of viviparity. To further understand the mechanisms of action of this steroid, a progesterone receptor-like moiety was partially characterized in the oviduct of the viviparous snake Nerodia. Using DNA-cellulose and LH-20 column chromatography, a binding component was identified which exhibits high affinity (KA = 1.5 X 10(9) M-1) and low capacity (approximately 10(-11) M) binding of the synthetic progestin, R5020. In addition, the binding exhibited physiological steroid specificity, and was only identified in reproductive structures considered targets of progesterone action. These characteristics are consistent with the primary characteristics associated with steroid-receptor binding and are similar in both cytosolic and nuclear extract preparations. PMID- 3957000 TI - The inheritance of pyloric stenosis explained by a multifactorial threshold model with sex dimorphism for liability. AB - The inheritance of pyloric stenosis is explained by a multifactorial threshold model with an underlying assumption that the liability for the disease is distributed in males and females showing a sex dimorphism. From the available data on familial occurrences of pyloric stenosis, it is shown, that an extra maternal effect is not required to explain the familial risk of pyloric stenosis, as opposed to the earlier literature. Explicit expressions for familial risks of a discontinuous trait exhibiting dimorphism of liability are presented, based on a model originally proposed by Rice et al [1981], which do not require the approximation of univariate normality of a conditional bivariate normal distribution. PMID- 3957001 TI - Cancer and autoimmune disease in families with common variable immune deficiency. AB - Twenty-five families including 34 individuals with common variable immune deficiency (CVID), with at least one affected female in each family, were studied. The distribution of cases within families was compatible with autosomal recessive inheritance, making it plausible to test hypotheses about the disease risk of heterozygote carriers of putative CVID genes by comparing the frequency of autoimmune disorders and cancer in 1033 adult blood relatives to that in 566 spouse controls. For cancer, observed numbers of cases or deaths were also compared to expected numbers derived from population rates. No single family had an unusual clustering of autoimmune conditions, and, overall, autoimmune disease was not found more frequently in blood relatives than in spouse controls. Blood relatives did have a modest, although not significant, excess of rheumatic heart disease. For cancer analyses, comparisons with general population rates indicated no heterozygote predisposition, while direct comparisons of blood relatives to spouse controls revealed a significantly elevated cancer rate in females (rate ratio = 2.3, P less than 0.003). The estimated relative risk of cancer for female CVID heterozygotes was most elevated in the 45-69-year-old age group. It is arguable whether comparisons with population or spouse controls are the most appropriate for evaluating the cancer risk of CVID heterozygotes. The hypothesis that the CVID gene predisposes heterozygous female carriers to cancer may be evaluated more easily in the future when the genetic basis for CVID is better understood. PMID- 3957002 TI - Segregation analysis of hereditary nonpolyposis colorectal cancer. AB - Segregation analysis of eleven families comprising 2762 individuals indicated compatibility of the data with segregation of a major autosomal dominant gene for hereditary nonpolyposis colorectal cancer. It was estimated that between 71% and 79% of the gene carriers were susceptible and had age of onset that was normally distributed with mean about 47 and standard deviation about 10 years. There was a low frequency of sporadic cases at the older ages, a little less than four percent of nongene carriers being affected by age 80. No significant differences were found between the families exhibiting endometrial cancer (cancer family syndrome) and those not exhibiting endometrial cancer (hereditary site-specific nonpolyposis colonic cancer). PMID- 3957003 TI - Construction of human linkage maps: likelihood calculations for multilocus linkage analysis. AB - Methods are given for efficient calculation of the likelihood for multilocus linkage in families comprised of grandparents, parents, and children. Such families are being used in large-scale cooperative efforts to build a detailed linkage map of the human genome. The methods are illustrated by an application to loci on chromosome 13. PMID- 3957004 TI - Three alleles for quantitative Lp(a). PMID- 3957006 TI - The allelic correlation structure of Gainj- and Kalam-speaking people. I. The estimation and interpretation of Wright's F-statistics. AB - The internal patterning of allelic correlations in the Gainj and Kalam swidden horticulturalists of highland Papua New Guinea is examined within the context of Sewall Wright's F-statistic model. A multiallelic extension of the model is given first, and multivariate variance-component estimators for the parameters are suggested. Then, it is shown that the expectation of the F-statistic set depends on the age structure of the population and that knowledge of the population and sample age structure is critical for meaningful analysis. The array of F statistics estimated jointly over five polymorphic enzyme loci reveals the following features of Gainj and Kalam population structure: (1) significant departures from panmictic expectations and (2) characteristics of a continuously distributed breeding population, rather than those expected for populations subdivided into demes with discrete boundaries. Finally, the F-statistics estimated for the Gainj and Kalam are briefly compared to estimates obtained from other tribal populations. It is seen that the level of differentiation observed in the Gainj and Kalam is only about one-third that observed in South American swidden horticulturalists. Consequently, some conventional wisdom regarding the interrelationship of socioecological settings and genetic structures may require reevaluation. PMID- 3957005 TI - Temporal and microgeographic variation in allozyme frequencies in a natural population of Drosophila buzzatii. AB - Temporal variation in allozyme frequencies at six loci was studied by making monthly collections over 4 yr in one population of the cactophilic species Drosophila buzzatii. Ten sites were defined within the study locality, and for all temporal samples, separate collections were made at each of these sites. Population structure over microgeographic space and changes in population structure over time were analyzed using F-statistic estimators, and multivariate analyses of allele and genotype frequencies with environmental variables were carried out. Allele frequencies showed significant variation over time, although there were no clear cyclical or seasonal patterns. A biplot analysis of allele frequencies over seasons within years and over years showed clear discrimination among years by alleles at four loci. During the 4 yr, three alleles showed directional changes which were associated with directional changes in environmental variables. Significant associations with one or more environmental variables were found for allele frequencies at every locus and for both expected and observed heterozygosities (except those for Est-1 and Est-2). Thus, variation in allele frequencies over time cannot be attributed solely to drift. Significant linkage disequilibria were detected among three loci (Est-2, Hex and Aldox), but there was no evidence for spatial or temporal patterns. The F-statistic analyses showed significant differentiation among months within years for all loci, but the statistic used (coancestry) was heterogeneous among loci. Estimates of F (inbreeding) for all loci were significantly different from zero, with the loci in four groups, Adh-1 (negative), Pgm(small positive), Est-2 and Hex (intermediate) and Est-1 and Aldox (high positive). The correlation of genes within individuals within populations (f) for each locus in each month by site sample differed among loci, as did the (f) for each locus in each month by site sample differed among loci, as did the patterns of change in f over time (seasons). Heterogeneity in the F-statistic estimates indicates that natural selection is directly or indirectly affecting allele and genotype frequencies at some loci. However, the F-statistic analyses showed essentially no microgeographic structure (i.e., among sites), although there was significant heterogeneity in allele frequencies among flies emerging from individual rots. Thus, microspatial heterogeneity probably is most important at the level of individual rots, and coupled with habitat selection, it could be a major factor promoting diversifying selection and the maintenance of polymorphism.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3957007 TI - Interchromosomal biased gene conversion, mutation and selection in a multigene family. AB - A mathematical model of the effects of interchromosomal biased gene conversion, mutation and natural selection on a multigene family is developed and analyzed. The model assumes two allelic states at each of n loci. The effects of genetic drift are ignored. The model is developed under the assumption of no recombination, but the analysis shows that, at equilibrium, there is no linkage disequilibrium, which implies that the conclusions are valid for arbitrary recombination among loci. At equilibrium, the balance between mutation, gene conversion and selection depends on the ratio of the mutation rates to the quantity [s + g(2 alpha - 1)/n], where s is the increment or decrement in relative fitness with each additional copy of one of the alleles, g is the conversion rate, and alpha is a measure of the bias in favor of one of the alleles. When this quantity is large relative to the mutation rates, the allele that has the net advantage, combining the effects of selection and conversion, will be nearly fixed in the multigene family. A comparison of these results with those from a comparable model of intrachromosomal biased conversion shows that biased interchromosomal conversion leads to approximately the same equilibrium copy number as does intrachromosomal conversion of the same strength. Interchromosomal conversion is much more effective in causing the substitution of one allele by another. The relative frequencies of interchromosomal and intrachromosomal conversion is indicated by the extent of the linkage disequilibrium among the loci in a multigene family. PMID- 3957008 TI - Selection and biased gene conversion in a multigene family: consequences of interallelic bias and threshold selection. AB - In a previous paper, I investigated the interactions in a gene family of additive selection and biased gene conversion in a finite population when conversion events are rare. Here I extend my "weak-conversion limit" model by allowing biased interallelic conversion (conversion between alleles at the same locus) of arbitrary frequency and various threshold selection schemes for rare interlocus conversion events. I suggest that it is not unreasonable for gene families to experience threshold fitness functions, and show that certain types of thresholds can greatly constrain the rate at which advantageous alleles are fixed as compared to other fitness schemes, such as additive selection. It is also shown that the double sampling process operating on a gene family in a finite population (sampling over the number of genes in the gene family and over the number of individuals in the population) can have interesting consequences. For selectively neutral alleles that experience interallelic bias, the probability of fixation at each single locus may be essentially neutral, but the cumulative effects on the entire gene family of small departures from neutrality can be significant, especially if the gene family is large. Thus, in some situations, gene families can respond to directional forces that are weak in comparison to drift at single loci. PMID- 3957009 TI - Additive variation maintained under stabilizing selection: a two-locus model of pleiotropy for two quantitative characters. AB - A model with two diallelic loci controlling two additive quantitative characters is suggested. One of the loci has a similar effect on both characters, whereas the second locus has an antagonistic effect on two characters. Both characters experience direct stabilizing selection. The model yields a stable polymorphic state, with both characters maintaining genetic variation. The genetic correlation between the characters at the equilibrium is zero, in spite of the pleiotropic effects of the loci controlling them. PMID- 3957010 TI - The homozygosity test after a change in population size. AB - The homozygosity of a population will be influenced by any recent change in the population size. The "homozygosity test" of the neutral mutation hypothesis might also be influenced by a population change. A computer simulation method is described that establishes the significance levels of observed homozygosities after a change in population size. Some numerical examples are given. PMID- 3957011 TI - Selection for increased mutation rates with fertility differences between matings. AB - Previous studies of mutation modification have considered models in which selection is a result of viability differences that are sex symmetric. The results of a numerical study of a model in which selection is a result of fertility differences between mated pairs demonstrate that the type of selection to which a population is subject can have a significant impact on the evolution of various parameters of the genetic system. When the fertility of matings between individuals with different genotypes exceeds the fertility of at least some of the matings between individuals with the same genotype, selection may favor increased rates of mutation, in contrast to the results from all existing constant viability models with random mating and infinite population size. Increased mutation rates are most frequently favored when forward and back mutation occur at approximately equal rates and when the modifying locus is loosely linked to the selected locus. We present one example in which selection favors increased rates of mutation even though the selection scheme is reducible to one of differential viability between the sexes. PMID- 3957012 TI - On the frequency of undetectable recombination events. AB - Simple analytical results show that many recombination events occur in such a way as to have no effect on the resultant DNA sequence. The proportion of these undetectable events depends on the population size, mutation rate and recombination rate and is quite large for reasonable values of these quantities. Efforts to estimate recombination rates and frequencies directly from DNA sequence data must, therefore, take this undetectable fraction into account. PMID- 3957013 TI - The evolution of restricted recombination and the accumulation of repeated DNA sequences. AB - We suggest hypotheses to account for two major features of chromosomal organization in higher eukaryotes. The first of these is the general restriction of crossing over in the neighborhood of centromeres and telomeres. We propose that this is a consequence of selection for reduced rates of unequal exchange between repeated DNA sequences for which the copy number is subject to stabilizing selection: microtubule binding sites, in the case of centromeres, and the short repeated sequences needed for terminal replication of a linear DNA molecule, in the case of telomeres. An association between proximal crossing over and nondisjunction would also favor the restriction of crossing over near the centromere. The second feature is the association between highly repeated DNA sequences of no obvious functional significance and regions of restricted crossing over. We show that highly repeated sequences are likely to persist longest (over evolutionary time) when crossing over is infrequent. This is because unequal exchange among repeated sequences generates single copy sequences, and a population that becomes fixed for a single copy sequence by drift remains in this state indefinitely (in the absence of gene amplification processes). Increased rates of exchange thus speed up the process of stochastic loss of repeated sequences. PMID- 3957014 TI - Metoclopramide-induced tardive dyskinesia: a case report. AB - A case of tardive dyskinesia developed in a patient who had been treated with metoclopramide for 8 months. Acute extrapyramidal side effects are also possible with this medication. Guidelines for the use of metoclopramide are presented with special emphasis on patients with renal insufficiency and the elderly. The importance of consultation-liaison psychiatrists' familiarity with the neurologic side effects of this commonly prescribed drug used in general medical practice is emphasized. PMID- 3957015 TI - Psychiatric consultation with general hospital chaplains. AB - This article describes a program in which psychiatrists serve as consultants to a group of chaplains working in a general hospital. The chaplains learn to use specific concepts and techniques from liaison psychiatry to evaluate and refine their own work. The consultants teach them about psychopathology in the medically ill, about the awareness and use of transference and countertransference reactions, and about how to define an appropriate role within the medical ward milieu. The article discusses the benefits of this consultation to chaplains and psychiatrists, especially in clarifying the role distinctions between the two groups. PMID- 3957016 TI - Training future dermatologists in psychodermatology. AB - The contents and design of a psychodermatology training programs (PTP) preparing future dermatologists to cope with the psychosomatic features of their practice are discussed. This program focuses on the psychosocial factors that may provoke, precipitate, and aggravate dermatoses. It singles out the secondary illness reaction which is the result of the particular somatopsychic consequences of the visibility of dermatoses, its repercussion on the patient's body image, and on his or her social and sexual life. The benefits and the risks of a grounding in psychodermatology as well as the dermatologist's specific resistance are pointed out. PMID- 3957017 TI - Liaison psychiatry in an Irish hospital: a survey of a year's experience. AB - A brief summary of the pattern of mental illness in Ireland is given and the work of a psychiatric consultation-liaison service in a general hospital in the southern part of the country is discussed in this context. The referral rates to the service mirror the referral rates in the United Kingdom more than those in the United States. The high rates of alcoholism and functional psychosis found in referred patients probably reflect the increased prevalence of these conditions in the general community. In Ireland, as elsewhere, the rate of referral of general hospital inpatients to a psychiatric consultation-liaison service is below the rate of psychiatric illness found in hospital inpatients. PMID- 3957018 TI - Cardiac antiarrhythmic effect of nortriptyline. AB - With a quinidine-like cardiac action, the tricyclic antidepressant drugs, imipramine in particular, have been proposed as potentially antiarrhythmic agents. The antiarrhythmic activity of nortriptyline is described in a depressed patient with premature ventricular complexes, and the basis for this activity is discussed. PMID- 3957019 TI - Development of agoraphobia after surviving cancer. AB - We present a case conference on a 32-year-old accountant who developed embryonal carcinoma of the testis, two months after the birth of a son with a missing leg. His cancer was successfully treated with surgery and chemotherapy. After 5 years, when he was told that he need not be closely followed by his physicians anymore because he had been cured of cancer, he developed agoraphobia with panic attacks. This interfered with his occupational and social adjustment. His phobia was treated successfully with pharmacotherapy, behavior therapy, and psychotherapy. We explore the psychologic impact of cancer, the activation of separation anxiety and aggressive impulses after its successful treatment, the crippling nature of his agoraphobia, and the ingredients of his successful response to treatment. PMID- 3957020 TI - A successful psychiatric training program for medical residents. AB - The psychosocial skills of 24 PGY I medical residents receiving psychiatric training every other week during the internship year were evaluated and compared to a control group of 13 PGY I residents. After the internship year, the psychiatrically trained residents showed an increase in their ability to recognize emotional problems, whereas the control group recognized less depression. Psychiatrically trained residents were more sophisticated in psychosocial problem descriptions and plan formulations, whereas the control group formulated more poor psychosocial plans. PMID- 3957022 TI - A case report of dissociative pseudodementia. AB - The authors report the case of a patient admitted to a medical hospital for seizures and considered for more than 1 month to be demented. Psychiatric examination revealed a fluctuating cognitive capacity, suggesting a psychogenic etiology. Following a sodium amytal interview, the patient's symptoms dramatically resolved. Diagnosis, treatment, and the importance of considering dissociative pseudodementia are discussed. PMID- 3957021 TI - The problem of alcohol in the medical/surgical patient. AB - The authors report the results of a computerized data-based study of 845 general hospital patients seen by a consultation-liaison psychiatry service in a major urban hospital. The findings indicate that only 5.2% of the referrals were for the problem of alcohol. Furthermore, the detection rate of an alcohol problem by both the referring physicians and the psychiatric consultants was low (8.3%) as compared with the literature's reported prevalence rate of alcoholism in the general hospital (8.7%-55%). The problem of recognition of an alcohol problem in the medical/surgical patient is explored with particular emphasis on the obstacles to diagnosis--masking of alcoholism by other major psychiatric disease, the categorization of patients by symptom rather than underlying causation, and the lack of sufficient employment of useful diagnostic screening devices. PMID- 3957024 TI - [The tryptophan operon of the facultative methylotrophic bacteria Pseudomonas sp. M. III. Characteristics of regulatory 5-MTR mutants]. AB - Regulatory 5-DL-methyltryptophan (5-MT)-resistant mutants of facultative methylotrophic Pseudomonas sp. M. were obtained. They are able to excrete tryptophan into the growth medium (60 to 300 g/ml). 5-MTR regulatory mutants are characterized by depression of trpE, trpD and trpC genes, which causes the production of intermediates of tryptophan biosynthesis and results in trpA and trpB genes induction as well as in two-fold activation of N-5-phosphoribosyl anthranilateisomerase (trpF gene product). Besides, all mutants demonstrate reduction of synthase feed-back inhibition about 4-11-fold. Together with tryptophan excretion, 5-MTR regulatory mutants are able to excrete tyrosine and unable to utilize this amino acid as the sole carbon source, which points to multiple nature of the selective effect of 5-MT. PMID- 3957023 TI - Depression, self-love, time, and the "right" to suicide. AB - Elizabeth Bouvia, whose legal struggle to compel a psychiatric hospital to assist her in committing suicide ended with a decision that she could be force fed by the hospital, presented the psychiatric community with a host of ethical questions concerning the rights of a patient to choose death, and the obligations of the medical profession to promote life. What the courts did not decide is when a patient is incompetent to decide her own fate, and what is the duty of the hospital to intervene with a suicidal patient. The authors suggest that there is an ambiguity present whenever a patient presents herself to a hospital or therapist as suicidal, and that a time limited period, or cooling-off period, should exist that would allow an alliance to form between patient and care-giver, if possible, and then permit them to explore underlying issues of depression. The authors believe that there is a need to acknowledge the patient's ultimate right to choose death, but that autonomy should not be confused with impulsivity when anyone is faced with the irrevocability of the decision to die. PMID- 3957025 TI - [Prognostic criterion in the mendelian analysis of quantitative traits]. AB - Prediction test for estimation of genetical parameters and the fitness of the hypothesis is proposed. The test is based on coincidence of values of quantitative character in individuals predicted on the basis of the genetic analysis and the empirical measured values. The method gives a higher correctness of prediction of phenotypical values than statistical methods. The problem of a choice of the boundary values for the test is considered. PMID- 3957026 TI - [Population genetics study of the differential fertility in urban populations]. AB - In an urban population with widespread birth control practice the distribution of the number of pregnancies, births and abortions was studied in a cohort of women of completed fertility. The mean number of pregnancies per woman was 4.03 +/- 0.08 (sigma = = 2.98); the mean number of births - 1.12 +/- 0.02 (sigma = 0.77). 7.4% of women which had completed their reproductive performance had no pregnancies and 19.5% - no births. The Crow's Index of the Opportunity for Selection and its components connected with differential fertility and differential mortality were estimated. In the population under study two components of selection - selection at the prenatal stages and selection associated with infertility - are shown to be still significant. Such type of selection is exemplified by investigation of couples suffering from repeated spontaneous abortions. PMID- 3957027 TI - [Genetic analysis of the structure of predisposition to diabetes mellitus. III. Genetic heterogeneity of diabetes mellitus with different ages of onset]. AB - The results of genetical-epidemiological analysis of the three conventional forms of diabetes mellitus (DM) differentiated for age-at-onset are presented (the form I - from 0 to 29 y. the form II - from 30 to 59 y. the form III - 60 y. and older). The estimates of heritability of liability to the forms I, II and III of DM were 0.57, 0.70 and 0.65, respectively. It was shown that genetic components of the forms I and II are virtually different: genetic correlation between these forms was rA = 0.216 +/- 0.203, which is statistically insignificant. These data support the hypothesis assuming genetic independence of juvenile and adult forms of DM. On the other hand, the forms II and III were found to have an essential number of genes in common: genetic correlation was rA = 0.495 +/- 0.134, being significant at the 5% level. Thus, the forms II and III of DM are not to be considered as two genetically distinct diseases. The low recurrence risks of the form I for siblings (not more than 3.6%) allow to reject the hypothesis of simple monogenic inheritance of juvenile DM and to propose multifactorial nature of the disease. PMID- 3957028 TI - [Characteristics of Candida tropicalis D-2 mutants resistant to nystatin, levorin, amphotericin B. I. Frequency of induction depending on the intracellular lipid level and phenotypic characteristics of mutants]. AB - Induction frequency of mutants of Candida tropicalis D-2 strain depends on the number of intracellular lipids and the nature of a chemical mutagen. Para aminobenzoic acid leads to a decrease in the lethality and mutagenicity of nitrosocompounds, which is stronger expressed in cells with enhanced quantity of lipids. Among nystatin and levorin-resistant mutants obtained independently, the mutants with supersensitivity to other antibiotics were discovered. The majority of mutants possess cross-resistance. PMID- 3957029 TI - [Verification of a monogenic hypothesis on pedigrees with an arbitrary structure selected for proband. I. Alternative trait]. AB - On the example of human familial hypercholesterinemia, a method for verification of hypothesis on monogenic diallele control of alternative characters is demonstrated. An algorithm of estimation of genotype frequencies and penetrances by pedigrees selected for collective probands, using the maximum likelihood method, is described. PMID- 3957030 TI - [Verification of a monogenic hypothesis on pedigrees with an arbitrary structure selected for proband. II. The problem of prognosis]. AB - Criteria of fitness of monogenic hypothesis based on the accuracy of prediction of individuals' phenotypes are proposed. These criteria made it possible to differentiate the pedigrees in heterogeneous samples. The accuracy of genetic counseling is discussed. The method is illustrated on the example of the familial hypercholesterinemia in man. PMID- 3957031 TI - [Behavior of mice with robertsonian translocations of chromosomes]. AB - The behaviour of mice with normal karyotype and those with robertsonian translocations was studied. The ability of the animals to solve an extrapolatory task was analysed. The experimental procedure was initiated with presentation of a food bait which the animal could reach only through a small opening in a screen. As the mouse started drinking, the food cup was moved leftward or rightward disappearing from the animal's view. The problem was to move in the direction of food, in which case the mouse could find it behind one of two feeding holes, to the right or to the left of the starting point. Laboratory mice were not able to solve this problem, whereas mice containing Rb(8, 17)1 IEM in karyotype demonstrated the extrapolatory ability - they solve the task correctly in a significant majority of cases. By means of a series of backcrosses of Rb(8, 17)1 IEM carriers on CBA strain (these mice have no extrapolatory ability) and subsequent inbreeding, a novel inbred strain was obtained, coisogenic to CBA and possessing the robertsonian translocation Rb(8, 17)1 IEM. These mice with the CBA genetic background solve the extrapolatory problem successfully, the level of correct choices being significantly above the 50% chance level. At the same time, their performance was lower than that of outbred mice with Rb(8, 17)1 IEM, the phenomenon possibly being the result of the influence of CBA genetic background. Mice with Rb(8, 17)6 Sic were also shown to possess the extrapolatory ability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957032 TI - [Mathematical model for estimating the ratio of cells having passed the different number of divisions in the culture]. AB - Different versions of the stochastic expansion of the continuous determined linear model proposed formerly for evaluation of the ratio of cells having passed the different number of divisions in the culture were worked out and theoretically based. The influence of approximation precision of the continuous model by its discrete analogues on the adequacy of the process under study was examined. The problem of simultaneous identification of unknown parameters and the model's primary conditions was solved. The proposed methods for construction of the stochastic models for evaluation of the ratio of cells having passed the different number of divisions in the culture make it possible not only to determine analytically the correlation of metaphases of the first, second, third and following divisions at definite times of fixation and under different conditions, but also to evaluate reliability of the results obtained. PMID- 3957033 TI - [Genetical aspects of hormonal modification of the stress reactivity. II. Modification in early ontogenesis of the stress reactivity of adult gray rats selected for behavior toward man]. AB - Inherited and modificational changes of the stress reactivity in two outbreed stocks of wild Norway rats trapped in nature and selected for behaviour were studied. During 18 generations the rats of one stock were selected for the lack of defensive behaviour in the glove test (tame), while in another stock the aggressiveness was maintained by the selection (aggressive). Interstock differences in the brain noradrenaline mechanisms were observed. The emotional stress reactivity of the tame animals was decreased, in comparison with the aggressive ones. Definitive stress reactivity of adult rats was modified by injections of hydrocortisone to their mothers on the 16 and 18 days of gestation. Hormonal treatment changed noradrenaline mechanisms and decreased the reaction to emotional stressor in aggressive rats. The modified level of the stress reactivity of aggressive rats was similar to the definitive level of the tame ones. Hormonal treatment did not modify stress reactivity in tame rats. Thus, the phenotype only emerging in aggressive rats, as a result of hormonal modification, is the inherited norm of the tame animals. However, due to rat selection for the lack of defensive behaviour towards the man, high corticosteroid level in the blood of pregnant females, an external developmental factor, in respect to the fetus, loses regulatory function during the development of the neuroendocrine mechanisms of the stress reaction. PMID- 3957034 TI - [Rare variants of Hb D Punjab, Hb O Arab and polymorphism of human hemoglobins]. AB - This report describes the occurrence, study and molecular diagnostics of 40 Hb O Arab beta 121 Glu Lys cases and 4 Hb D punjab beta 121 Glu Gln cases in Bulgaria. Hematological, morphological and clinical data for 12 patients with Hb O arab are listed. Among them we observed 7 simple heterozygotes for Hb O Arab/Hb A, two double heterozygotes-compounds for Hb O/beta+-thalassemia and three compounds for Hb O/beta 0-thalassemia (the latter assumed). Also, general hematological, morphological and clinical data are presented for 4 Hb D Punjab carriers, from which two are simple heterozygotes and two are assumed, as compounds for Hb D/beta 0-thalassemia. The consideration of heterozygosity, homozygosity for both abnormal hemoglobins and of the compound state of Hb O or Hb D/beta-thalassemia or HbS types let us suggest the relative neutrality of the variants and the limitation in their distribution, depending on genetic structure of populations, where they spread. It may be concluded that human hemoglobin is characterized by marked monomorphism. At the same time, the high frequency of HbS, HbE and HbC in some populations can be well explained by contemporary selectionism; the distribution of relatively neutral Hb D Punjab and Hb O Arab with some limitations can follow Kimura's neutralism concept. PMID- 3957035 TI - Genetic analysis of the Y-chromosome of the mouse: evidence for two loci affecting androgen metabolism. PMID- 3957036 TI - Effects of alleles at the agouti locus on minor skeletal variants in C57BL/6 house mice. PMID- 3957037 TI - Xce genotype has no impact on the effect of imprinting on X-chromosome expression in the mouse yolk sac endoderm. PMID- 3957039 TI - Screening of guinea pig strains for electrophoretic isoenzyme polymorphisms. PMID- 3957038 TI - Fertility of sperm from t/+ mice: evidence that +-bearing sperm are dysfunctional. PMID- 3957040 TI - Is offspring-midparent regression affected by assortative mating of parents? PMID- 3957041 TI - Biased conversion as the primary function of recombination. PMID- 3957043 TI - Preventing falls: home hazard checklists to help older patients protect themselves. PMID- 3957042 TI - Hot weather, exercise, old age, and the kidneys. AB - Thirst is not a very accurate measure of water need; optimal fluid replacement may lag 2 to 3 days behind actual needs, particularly for persons unaccustomed to a hot climate. If an older person begins an exercise program during warm weather or travels to a warmer climate, the intensity and duration of exercise should be restrained initially, then gradually increased over 10 to 14 days to allow for acclimatization. PMID- 3957044 TI - Preventing osteoporosis: current practices and problems. AB - A lateral x-ray of the thoracic and lumbar spine should be part of the routine examination of any woman aged 40 or older. Similarly, an anteroposterior x-ray of the hand as a first assessment may suggest a need for further investigation for osteoporosis. Estrogen treatment reduces the incidence of vertebral compression and has proven protective against central as well as peripheral bone loss. However, rapid bone loss after termination of estrogen therapy implies that the protective effect may last no longer than 2 to 3 years. PMID- 3957045 TI - [Toxicological characteristics of a new motor fuel--a benzomethanol mixture]. PMID- 3957046 TI - [Protective effect of antioxidants in experimental poisoning]. PMID- 3957047 TI - [Physiological and hygienic prerequisites to improving the design of the work places in the cabins of tractors and of self-propelled agricultural machinery]. PMID- 3957048 TI - [Physiological and hygienic characteristics of the team form of work and rest organization for sailors]. PMID- 3957049 TI - [Hygienic evaluation of an aeroionizer for bipolar ionization of the air of the work site in the electronics industry]. PMID- 3957051 TI - [Characteristics of performing a periodic medical examination in the transition to annual dispensary care for workers]. PMID- 3957050 TI - [Hygienic evaluation of the teaching of a foreign language by the rhythmopedic method]. PMID- 3957052 TI - [Problems of hygiene research in animal husbandry]. PMID- 3957053 TI - [Tasks of hygiene science and practice in realizing the decisions of the October (1985) Plenum of the Central Committee of the CPSU]. PMID- 3957054 TI - [Method of computing the human heat balance in cabin-type quarters]. PMID- 3957055 TI - [Protective properties of the Lepestok-G respirator against mercury-203 vapors]. PMID- 3957056 TI - [Determination of monochlorotoluenes in water]. PMID- 3957057 TI - [Sampling devices for conducting hygienic research on solid radioactive wastes]. PMID- 3957059 TI - [Continuous measurement of the concentration of hydrogen fluoride]. PMID- 3957058 TI - [Hygienic evaluation of the layout of the postnatal physiology departments of obstetrical hospitals]. PMID- 3957060 TI - [Determination of anionic surface-active substances in the blood serum by a colorimetric method]. PMID- 3957061 TI - [Comprehensive social hygiene examinations of the objects of a health inspection]. PMID- 3957063 TI - [Hygienic regulation of the repellent oxamate and its half-product in reservoir water]. PMID- 3957062 TI - [Hygienic establishment of the maximum permissible concentration of thioacylanilide in reservoir water]. PMID- 3957064 TI - [Establishment of the maximum permissible concentrations of toluin and its analogs in reservoir water]. PMID- 3957065 TI - [Establishment of the maximum permissible concentrations of norbornene, norbornadiene and dicyclopentadiene in reservoir water]. PMID- 3957067 TI - [Changes in the indices of reproductive function in white rats exposed to the herbicide edil]. PMID- 3957066 TI - [Autoallergenic action of dibutyl and dioctyl phthalates]. PMID- 3957068 TI - [Structural characteristics of the toxic action of styrene on the adrenal cortex]. PMID- 3957069 TI - [Changes in hepatocytes exposed to methyl-N-(2-benzimidazolyl)carbamate]. PMID- 3957070 TI - [Effect of surface-active substances on lipid metabolism in white rats]. PMID- 3957071 TI - [Toxicokinetics of tributyl phosphate in single and chronic intragastric administration to rats]. PMID- 3957072 TI - [Determination of trace amounts of sym-triazines in the air]. PMID- 3957073 TI - [Gas chromatographic determination of ketones present simultaneously in the air of the work area and in the washings from workers' skin]. PMID- 3957074 TI - [Academic activities and achievement of schoolchildren in the upper grades with different instructional methods]. PMID- 3957075 TI - [Main trends in improving working conditions in viscous fiber plants]. PMID- 3957076 TI - [Work hygiene and health status of workers in triacetate fiber plants]. PMID- 3957077 TI - [Various aspects of the biological effect of inhibitors of the atmospheric corrosion of metals]. PMID- 3957078 TI - [Comparative evaluation of the thermal state of men and women in a cool microclimate]. PMID- 3957079 TI - [Effect of a complex of climatic and navigational factors on the status of psychophysiological functions in sailors of the Arctic Navy]. PMID- 3957080 TI - [Role of periodic medical examinations in the outpatient care system for the entire population]. PMID- 3957081 TI - [Effect of massage and special exercises on the vascular system of the legs]. PMID- 3957082 TI - [Photometric method of determining the admixtures VNII NP-117 and 117/t in the air of mines]. PMID- 3957083 TI - [Problem of determining fluorides in the air]. PMID- 3957084 TI - [Toxicity and sanitary standardization of melamine cyanurate (experimental data)]. PMID- 3957085 TI - [Value of personnel selection for adaptation to work requiring a high degree of accuracy of movement]. PMID- 3957086 TI - [Predicting fatigue of the neuromuscular system of the hands using ergometric indicators]. PMID- 3957087 TI - [New disk-shaped "Emiks" valve for isolated mitral valve prosthesis]. PMID- 3957088 TI - [Causes and prevention of wedging by the "Emiks" heart valve prosthesis]. PMID- 3957090 TI - [Features of the structures of the microcirculatory bed of the pericardium of the dog after ligation of the internal mammary arteries]. PMID- 3957089 TI - [Functional signs detectable on catheterization and left kinoventriculography in the diagnosis of acquired heart defects]. PMID- 3957091 TI - [Causes of mortality and ways of improving the results of treatment of patient with abscesses of the lungs]. PMID- 3957092 TI - [Chylosorption--a new method of treating chylothorax]. PMID- 3957093 TI - [Diagnosis and treatment of acquired esophago-bronchial fistulas]. PMID- 3957094 TI - [Effect of experimental low frequency ultrasound on the protoscolices of of echinococcus and alveococcus]. PMID- 3957095 TI - [Intrathoracic complications of amebic abscess of the liver]. PMID- 3957096 TI - [Prevention of disorders of gas exchange and hemodynamics following pneumonectomy]. PMID- 3957097 TI - [Evaluation of ischemic lesions of the myocardium according to indices of intraoperative hemodynamics during radical correction of the tetrad of Fallot]. PMID- 3957098 TI - [Heparin prevention of blood coagulation disorders during pulmonary resections]. PMID- 3957099 TI - [Method of intravenous perfusate return after extracorporeal circulation]. PMID- 3957100 TI - [Case of rare location of patent ductus arteriosus]. PMID- 3957101 TI - [Posttraumatic recurrent pulmonary hemorrhage in a patient with an intravascularly closed arteriovenous fistula]. PMID- 3957102 TI - [Bronchoscopic removal of a large benign tumor of a lobar bronchus using electrosurgical instrumentation]. PMID- 3957103 TI - [Simultaneous bilateral surgery using a transsternal approach for postoperative clotted hemothorax and spontaneous pneumothorax]. PMID- 3957104 TI - [Bilateral cancer of the lung]. PMID- 3957105 TI - [Surgical treatment of post-traumatic intracardiac defects]. PMID- 3957106 TI - Effects of a pharmacological dose of cholecystokinin on bile acid kinetics and biliary cholesterol saturation in man. AB - In order to study the mechanisms influencing bile acid pool size and cholesterol saturation index of fasting gall bladder bile, eight obese volunteers were placed on a low calorie diet for six weeks, and given intramuscular injections of a pharmacological dose of cholecystokinin octapeptide (CCK-OP, 5 micrograms) at mealtimes for half that period (alternating order). During CCK-OP administration, postprandial emptying of the gall bladder (mean +/- SEM) increased from 58 +/- 11% to 82 +/- 5% (p less than 0.005), and small intestinal transit time decreased from 205 +/- 27 to 178 +/- 26 minutes (NS). Bile acid pool size decreased from 4.6 +/- 0.3 to 3.1 +/- 0.3 mmol (p less than 0.001), while fractional turnover rate for chenodeoxycholic acid increased from 0.23 +/- 0.02 to 0.36 +/- 0.03 per day (p less than 0.005), suggesting an increase in recycling frequency of the pool. Synthesis rate was unchanged (0.43 +/- 0.08 vs 0.44 +/- 0.07 mmol/day), suggesting a new steady state. The cholesterol saturation index of fasting gall bladder bile increased in all subjects from 1.3 +/- 0.1 to 1.6 +/- 0.1 (p less than 0.005). Fasting gall bladder volume was reduced from 29 +/- 4 to 20 +/- 7 ml (p less than 0.01). Fractional turnover rate on the two regimens correlated with gall bladder emptying (n = 16, r = 0.61, p less than 0.01), but not with small intestinal transit time (r = 0.07, NS). Bile acid pool size correlated with fractional turnover rate (r = -0.73, p less than 0.005) and with cholesterol saturation index (r = -0.56, p less than 0.025). These findings suggest that CCK influences bile acid kinetics and cholesterol saturation index of fasting gall bladder in man; and that these effects of CCK are mainly mediated via alterations in gall bladder emptying rather than through alterations in small intestinal transit rate. PMID- 3957107 TI - Frequencies and cyclical pattern of the human sphincter of Oddi phasic activity. AB - Basal frequency of sphincter of Oddi phasic contractility has been repeatedly measured during endoscopic manometry and reported to range, in control subjects, from (M +/- SE) 3.0 +/- 0.6 to 7.5 +/- 0.7 c/min. Recently, high frequency (greater than 8 c/min) phasic contractions or absence of phasic activity were recorded in patients with postcholecystectomy or pancreatic complaints, possibly suggesting a sphincter of Oddi dysfunction. In the present study, sphincter of Oddi (biliary tract) phasic contractility was measured by perendoscopic manometry in 13 subjects without specific clinical symptoms of biliopancreatic disease and with a normal common bile and pancreatic duct at ERCP. Four T-tube patients with no evidence of common bile duct stones or papillary stenosis were studied for comparison (transductal sphincter of Oddi manometry). Basal frequency was found to range from 0 to 7 c/min (M +/- SE: 2.99 +/- 0.46) in perendoscopic manometry (85 min of recording time) and from 0 to 12 c/min (2.0 +/- 0.3) in transductal manometry (2546 min of recording time). Long lasting transductal recordings also showed that frequency of activity derived from the sphincter area varied cyclically in close relation with the duodenal migrating motor complex. It is concluded that the sphincter of Oddi in man is likely to participate in the interdigestive gastrointestinal motor activity and that short perendoscopic recordings may not be representative of the overall sphincter of Oddi activity. PMID- 3957108 TI - Quantitative and qualitative comparison of gall bladder mucus glycoprotein from patients with and without gall stones. AB - Human gall bladder mucus glycoprotein was isolated by Sepharose 4B gel filtration followed by caesium chloride density gradient ultracentrifugation from four groups: patients with cholesterol gall stones, patients with pigmented stones, patients with complete obstruction of the cystic duct and patients with no biliary tract abnormalities (controls). Mucus glycoprotein concentrations in cholesterol gall stone bile (203 micrograms/ml +/- 199 SD, n = 17), pigment gall stone bile (110 micrograms/ml +/- 77 SD, n = 6) and control gall bladder bile (96 micrograms/ml +/- 98 SD, n = 11) were not significantly different. While bile from patients with complete obstruction of the cystic duct contained significantly higher concentrations of mucus glycoprotein (6220 micrograms/ml +/- 4130, n = 4). In vitro cholesterol nucleation time was not correlated to gall bladder mucus glycoprotein concentrations. Qualitative analysis of the carbohydrate and amino acid composition showed a basic structure typical of mucus glycoproteins in general. It is unlikely that either quantitative or qualitative differences in mucus glycoproteins are responsible for the rapid in vitro nucleation time characteristic of cholesterol gall stone patients. PMID- 3957109 TI - Enhanced synthesis of cholesterol and its precursors in jejunal mucosa in coeliac disease. AB - Patients with coeliac disease have a greatly enhanced whole body synthesis of cholesterol, but its origin is not known. In this paper the synthesis and concentrations of cholesterol and its precursors, squalene and methyl sterols, were studied in jejunal biopsies from healthy volunteers and adult patients with coeliac disease. The incorporation rates of 14C-acetate and 3H-mevalonate into non-saponifiable lipids (sum of squalene, methyl sterols and cholesterol) were increased 14 and six times in the damaged mucosa, respectively. The cyclisation rate of mucosal squalene and the conversion of squalene to cholesterol were also increased, indicating that cholesterol synthesis was activated before mevalonate, probably at the step of HMG-CoA reductase, and also after mevalonate and squalene. The steps from squalene to cholesterol were apparently not rate limiting because the mucosal concentrations and the percentage distribution of squalene and sterols were similar in the patients and in the controls. A positive correlation of the cholesterol synthesis with the number of crypt cells, suggests that the expanded crypt cell population contributed to the enhanced intestinal cholesterologenesis. Furthermore, the serum cholesterol level was negatively correlated with the 14C- and 3H-counts in the mucosal cholesterol and with the cyclisation rate of squalene probable signs of regulatory role of serum low density lipoprotein cholesterol in intestinal cholesterol synthesis. Consequently, provided that the synthesis of mucosal cholesterol is as high in vivo as in vitro it could contribute to the highly increased overall synthesis of cholesterol in the patients with coeliac disease. PMID- 3957110 TI - Effects of single daily doses of a pyridil-2-tetrahydrothiophene derivative (40749 RP) on 24 hour H+ activity, nocturnal acid output, gastrin and pepsinogen I profiles in duodenal ulcer patients. AB - 40749 RP is a pyridil-2-tetrahydrothiophene derivative, belonging to a new class of gastric antisecretory drugs. We compared its effects on gastric secretion with cimetidine. Intragastric acidity, nocturnal acid output, gastrin and pepsinogen-I profiles were measured in patients with duodenal ulcer in clinical remission. A single dose of 100 mg 40749 RP reduced median 24 h gastric acidity as effectively as cimetidine 1000 mg given as four divided doses, 0.63 vs 1.6 mmol/l. Continued treatment with 40749 RP for 10 days reduced the median 24 h gastric acidity even further, to 0.006 mmol/l (p less than 0.001) and significantly increased fasting concentrations of gastrin and pepsinogen-I (p = 0.02). The incremental gastrin secretion to a standard meal was significantly increased after 10 days treatment with 40749 RP when compared with the first day of 40749 RP, or with cimetidine. These results show that 40749 RP exerts a powerful inhibitory effect on gastric acid secretion after a single 100 mg dose, and that this inhibitory effect increases with continued administration. PMID- 3957111 TI - Effect of acetaminophen on human gastric mucosal injury caused by ibuprofen. AB - Acetaminophen has been proposed as an agent which protects the gastric mucosa against damage induced by aspirin and other non-steroidal anti-inflammatory agents. In order to evaluate this proposal further, 45 normal human volunteers were divided into three groups (n = 15); group one received ibuprofen 2400 mg daily (600 mg qid); group two received acetaminophen 3900 mg daily (975 mg qid) and group three received both drugs at the same dosages. There was no significant difference in the mucosal injury scores noted at endoscopy between the ibuprofen and the ibuprofen-acetaminophen group. The acetaminophen group had virtually no observed mucosal injury and this was statistically significant in comparison with the other groups (p less than 0.01). We conclude that contrary to previously reported studies using single doses of aspirin, acetaminophen failed to decrease the mucosal injury seen with ibuprofen when given for a period of seven days in combination with acetaminophen. PMID- 3957112 TI - Dextropropoxyphene induced hepatotoxicity mimicking biliary tract disease. AB - Three patients are described with recurrent jaundice, upper abdominal pain and rigors attributable to dextropropoxyphene hepatotoxicity. The diagnosis was established in each patient by rechallenge; post challenge hepatic histology is reported in two. Twelve previous patients with probable dextropropoxyphene hepatic toxicity have been described and are reviewed. In 10 of the 15 patients, a clinical diagnosis of gall stone disease was made. Liver function tests are usually hepatitic shortly after challenge, but more cholestatic after a few days. No fatalities have been described, but as dextropropoxyphene is widely available in many different analgesic preparations possible toxicity should be considered in patients with relapsing jaundice mimicking biliary disease, in whom gall stones have been excluded. PMID- 3957113 TI - Intestinal perforation in Wegener's granulomatosis. AB - Wegener's granulomatosis is a disease characterised by a necrotising vasculitis and granulomatous inflammation. The localised form involves the upper and/or lower respiratory tracts while in the commoner generalised form there is a widespread necrotising vasculitis and renal involvement. Intestinal involvement, which may be severe, has been detected at necropsy in 24% of cases. Gastrointestinal symptoms are uncommon, however, none being mentioned in a recent series of 87 cases. There has been only one reported case of intestinal perforation secondary to Wegener's granulomatosis. We report a case of small and large bowel perforations in a patient with Wegener's granulomatosis. PMID- 3957114 TI - Small bowel transit time. PMID- 3957115 TI - The significance of paraaortic node status in carcinoma of the cervix and endometrium. AB - Survival in 115 women with cervical carcinoma and 55 patients with carcinoma of the endometrium was correlated with the status of paraaortic lymph nodes and the clinical stage of disease. The survival probability at 48 months for patients with cervical cancer who had negative paraaortic lymph nodes was 86% for stage IB in comparison to 67% for those with advanced disease (clinical stages II, III, and IV). The difference of 19% between these two groups was not statistically significant nor was there a statistical difference in survival between early and advanced disease groups when paraaortic nodes contained tumor (37 vs 20%). For all stages of cervical cancer, survival was 80% with negative nodes and 20% with positive nodes at 48 months. In patients with endometrial carcinoma and negative paraaortic lymph nodes, projected survival at 48 months was 72% for stage I and 77% for stages II and III. When paraaortic lymph nodes demonstrated metastatic disease, survival uniformly decreased to 27% of patients with stage I cancer and 25% of those with stage II and III disease. For all stages of endometrial cancer, survival was 76% with negative nodes and 26% with positive nodes at 48 months. The presence or absence of metastatic disease in the paraaortic lymph nodes is an important prognostic factor that appears to be more useful in predicting survival than clinical stage of disease in patients with cervical and endometrial cancer. PMID- 3957116 TI - Correlations of dose and time-dose-fractionation factors (TDF) with treatment results and side effects in cancer of the uterine cervix. AB - Treatment results and side effects were analyzed for 57 patients with stage IB IIIA cancer of the uterine cervix who received external beam radiotherapy combined with intracavitary insertion of cesium-137 sources. The total dosage and time-dose-fractionation (TDF) factors were calculated at point A and at points of maximum exposure in the rectum and bladder. The overall 5-year survival was 62%, and 78% of the complete responders were free of disease at 5 years. A total of 12 patients (21%) developed rectal complications. Two patients (4%) had rectal fibrosis and proctitis; seven cases of rectal bleeding occurred (12%), and 3 patients (5%) developed rectovaginal fistulas. There was no correlation between dose and TDF at point A and treatment failure or appearance of rectal complications. However, the occurrence of radiation damage in the rectum was consistently associated with high values of TDF when they were calculated in the region of maximal exposure in the rectum. The results suggest that TDF may be a useful parameter for predicting radiation damage in combined external beam and intracavitary treatment of cervical cancer. PMID- 3957117 TI - Immunosuppressive effects of peritoneal fluids from ovarian cancer patients. AB - Peritoneal fluid samples from 42 patients with ovarian carcinomas were tested for their suppressive effects on in vitro responses of normal lymphocytes. Suppression was detected both in a natural killer cell assay against K562 cells and in an assay measuring phytohemagglutinin-induced lymphoproliferation. There was no correlation between the level of immunosuppression and the 1-year survival. The greatest suppression was seen in radically operated patients and in patients with normal amounts of peritoneal fluid. Complete suppression was also seen in two patients operated for benign diseases. The results indicate that immunosuppression is not restricted to malignant ascites, but may be a normal function of the peritoneal fluid. PMID- 3957118 TI - cis-Platinum as adjunctive to surgery in early stage ovarian carcinoma: effects on lymphoid cell subpopulations. AB - The effect of single-drug cis-diamminedichloroplatinum (CDDP) treatment on the distribution of T-lymphocyte subsets and monocytes was determined using monoclonal antibodies and a flow cytometry technique. Thirty-nine patients with radically operated ovarian carcinoma received postoperative treatment with six cycles of CDDP 50 mg/m2, and were examined either before, during, or after chemotherapy. During treatment, the number of OKT4+ (mainly T-helper) cells was reduced, whereas the number of OKT8+ (mainly T-suppressor/cytotoxic) cells was increased. Four to six months after the CDDP treatment was ended, these aberrations were no longer seen. The number of 1D5+ cells (monocytes) was not influenced by the treatment. It is concluded that no long-lasting change in the distribution of immunocompetent cells could be detected after this regimen of CDDP treatment. PMID- 3957119 TI - The influence of estrogen and progesterone receptors on survival in patients with carcinoma of the uterine cervix. AB - The prognostic value of estrogen receptors (ER) and progesterone receptors (PR) was studied in 246 women with primary carcinoma of the uterine cervix. In addition to the receptor status information on tumor stage, histological type, age at operation, and menopausal status was recorded and analyzed. If the patient died the cause of death was ascertained. The median survival time for the 97 patients who died was 15 months and the survivors were followed for an average of 34 months. The survival curve was compared with an age, sex, and year of death matched West-Australian population. The survival curves for patients with ER+ or ER- and PR+ or PR- tumors were virtually indistinguishable. Overall survival in patients with cervical carcinoma is not influenced by the receptor status or the receptor concentration of the carcinoma. PMID- 3957120 TI - Strategies in late stage cervix carcinoma. AB - Stage IIB-IV squamous cell carcinoma of the cervix when treated by irradiation has a significant failure rate. Causes of pelvic and distant failure are discussed. New techniques employed to improve local control and decrease distant metastasis are presented. Data on morbidity, mortality, and survival will be reviewed with respect to these new strategies employed. PMID- 3957121 TI - Treatment of persistent or recurrent ovarian carcinoma with sequential methotrexate and 5-fluorouracil. AB - Seventeen patients with persistent or recurrent epithelial cancer of the ovary were treated sequentially with methotrexate 125 mg/m2 or 250 mg/m2 iv followed in 1 hr with 5-fluorouracil 600 mg/m2 iv and in 24 hr with leucovorin rescue factor 10 mg/m2 q 6 hr for 6 doses every 14 days. Sixteen patients had Stage III or IV disease; one patient had Stage IIB disease. There were no complete or partial responders; nine patients had stabilization of disease for at least 1 month and three for greater than 4 months. There was minimal toxicity in the 89 courses given, with 8.9% neutropenia (less than 3000/mm3) and 2.2% thrombocytopenia (less than 100,000/mm3). Two patients developed severe diarrhea; there were no cases of mucositis. PMID- 3957122 TI - Use of the end-to-end anastomosis stapling device in low colorectal anastomosis associated with radical gynecologic surgery. AB - Between 1978 and 1984, 49 rectosigmoid anastomoses were performed using the end to end anastomosis (EEA) stapler. Seventeen (35%) of the patients had prior radiation treatment. Twenty-eight (57%) of the anastomoses were at the level of the peritoneal reflection and 21 (43%) were at the level of the levators. Fourteen patients (29%) had diverting colostomies and 11 (79%) of these were closed. There were 5 complications (10%) directly related to the anastomosis. These included two strictures, two anastomotic breakdowns, and one case of fecal incontinence after colostomy closure. All complications arose in patients with prior radiation treatment. PMID- 3957123 TI - cis-Diamminedichloroplatinum plus dimethyl-triazenoimidazole carboxamide as second- and third-line chemotherapy for sarcomas of the female pelvis. AB - From 1981 to 1984, 20 patients with sarcomas of the female pelvis were treated with dimethyl-triazeno-imidazole carboxamide (DTIC) combined with cis diamminedichloroplatinum II (DDP) in two sequential studies. Group 1 patients received low-dose (1 mg/kg) DDP plus DTIC; Group 2 patients received high-dose DDP (20 mg/m2 daily for 5 days) plus DTIC. Each regimen was repeated every 4 weeks depending on the patient and bone marrow tolerance. Of the 20 patients, 35% achieved an objective response. Of the 10 group 1 patients, 20% had an objective response (1 CR, 1 PR) both as second-line chemotherapy. For the group 2 patients, 50% (5) have responded (3 CR, 2 PR), one as third-line and 4 as second-line chemotherapy. These results suggest that DTIC plus DDP, especially at the higher dose (20 mg/m2 X 5), is effective chemotherapy for metastatic pelvic sarcomas. PMID- 3957125 TI - Malignant osteoclast-like giant cell tumor associated with a uterine leiomyosarcoma. AB - An unusual case of osteoclast-like giant cell tumor associated with a leiomyosarcoma of the uterus is described. The mononuclear cell component of the giant cell tumor was cytologically malignant and the giant cell tumor was present in a biopsy of vaginal recurrence. The patient expired 17 months after diagnosis with extensive tumor despite surgical and radiation treatment. This is the first report of malignant osteoclast-like giant cell tumor associated with a uterine leiomyosarcoma and only the third report of osteoclast-like giant cell tumor in the uterus. PMID- 3957124 TI - Cervical carcinosarcoma: a case report. AB - Cervical sarcomas and carcinosarcomas are exceedingly rare. The clinicopathologic characteristics, management and outcome of a patient with cervical carcinosarcoma is presented. PMID- 3957126 TI - Mixed intestinal adenocarcinoma-argentaffin carcinoma of the vagina. AB - A mixed intestinal adenocarcinoma-argentaffin carcinoma of the vagina in a 32 year-old woman is reported. Special stains showed the argentaffin and argyrophil reactions of the small cell population of this tumor. The small cells also contained serotonin as demonstrated by immunocytochemistry. Electron microscopy revealed characteristic cytoplasmic neurosecretory granules. The large cells were columnar and contained mucin droplets similar to those in Goblet cells in the intestines. The observations suggest that the tumor was mixed intestinal adenocarcinoma-argentaffin carcinoma (malignant carcinoid), which probably arose in aberrant intestinal epithelial cells in the vagina. The patient died with metastases of pure argentaffin carcinoma in 1 year. PMID- 3957127 TI - Primary malignant melanoma arising in a cystic teratoma of the ovary. AB - The 11th well-documented case of malignant melanoma, arising in a cystic teratoma of the ovary, is described. The melanoma which recurred 4 months after surgery responded completely to immunochemotherapy. PMID- 3957128 TI - A urethral valve for bladder drill in patients with motor urge incontinence. AB - A urethral valve has been constructed which can be mounted to an indwelling bladder catheter. Since the outflow resistance of the valve can be varied the intensity of the bladder training, i.e. the amount of work the detrusor has to produce to open it, can be varied simultaneously. Twenty-one valves were tested on 12 patients suffering from severe urgency or urge incontinence. All but two valves functioned properly from a technical point of view. From a clinical point of view bladder training with the valve was successful in 10 patients. It is concluded that the new technique might be considered a future alternative to presently existing methods for treatment of urgency or urge incontinence. PMID- 3957129 TI - Determination of lamellar body phospholipids in amniotic fluid: a method to predict when the fetal lung becomes mature. AB - Lamellar body material was isolated by highspeed centrifugation from the amniotic fluids of 10 mildly diseased patients followed longitudinally and of 60 other women. Three stages of development were defined: (1) immature stage: the phospholipid concentration is less than 20 mumol/l and phosphatidylcholine (PC) is approximately 50%; (2) transitional stage: the phospholipid concentration is between 18 and 40 mumol/l, of which PC is approximately 75% and phosphatidylinositol (PI) 10%. Phosphatidylglycerol (PG) is absent or present at very low concentrations; (3) mature stage: the phospholipid concentration is above 40 mumol/l; its PC percentage is 75% or more. PG is present and the percentage of PI decreases. An increase in phospholipid concentration of 3.27 +/- (SD) 0.75 mumol/l/day was found during the transitional stage. The rate of increase enables us therefore to approximate the number of days that it will take before the fetal lung is mature. PMID- 3957130 TI - Uteroplacental blood flow measurement using radioisotopes in small placentas. AB - In 25 pregnant females with a placental weight below the 20th percentile uteroplacental blood flow measurements using 113mIn-transferrin were performed in the 3rd trimester of pregnancy. Twelve patients with pregnancy-induced hypertension (PIH) were compared to 13 females with normal blood pressures. The results of uteroplacental blood flow measurements showed normal flow patterns in only 6 of the 25 subjects and were significantly worse in the group with PIH. Babies of patients with PIH had a mean birth weight of 1,100 g at a mean gestational age of 34.2 weeks versus 1,752 g and 37.4 weeks for newborns without PIH. Perinatal mortality was significantly higher in the PIH group. In combination with a small placenta PIH compounds the fetal risk. PMID- 3957131 TI - Vasopressin and prolactin as stress hormones. AB - The effect of electric stimulation of the uterine cervix on vasopressin and prolactin secretions was investigated in 16 patients with uterine myomas and/or hypermenorrhea. One month after hysterectomy a similar stimulation was induced near the fornix of the vagina. Particularly the first test also seemed to be a considerable psychic stress for the patients. The stimulation did not cause any significant changes in plasma vasopressin and prolactin concentrations. PMID- 3957132 TI - An autoradiographic study of changes in the uptake of tritiated estradiol in the anterior hypothalamus during the estrous cycle of the rat. AB - In cycling rats exposed to a controlled light schedule of 12 h of light daily from 22.00 to 10.00 h the concentration of estradiol in the anterior hypothalamus at 5.00-6.00 h on the day of proestrus was significantly higher than those at 0.00-1.00 h on day 1 of diestrus and estrus, and was about twofold higher than serum estradiol concentration, which reached a peak at 5.00-6.00 h on the same day. Autoradiographically, the uptake of tritiated estradiol by the nuclei of neurons in the nucleus (n.) preopticus, pars suprachiasmatica (POSC), n. preopticus periventricularis (POP), and anterior part of n. anterior hypothalami (AAH) was significantly higher at 1.00 h on the day of diestrus 1 than at 6.00 h on the day of proestrus and at 1.00 h on the day of estrus. These results suggest that the POSC, POP and AAH may be target sites in the anterior hypothalamus of estradiol for its feedback action. PMID- 3957134 TI - [Recent advances in olfaction]. PMID- 3957133 TI - Absorbable or nonabsorbable suture material for microsurgical tubal anastomosis. Randomized experimental study on rabbits. AB - In 20 female rabbits the influence of absorbable and nonabsorbable suture material on microsurgical anastomosis of the oviduct was investigated. No significant superiority of polyglactin 910 over polypropylene could be demonstrated. Concerning histological reaction to the different suture materials as well as pregnancies (calculated by nidation indices) the results were comparable. The modern suture materials obviously do not influence the functional sequelae of microsurgical reanastomosis of the rabbit fallopian tube. PMID- 3957135 TI - [Failure of prosthesis due to loosening at the bone-cement interface]. PMID- 3957136 TI - [Strongyloidiasis after immunosuppressive treatment of chronic lymphocytic leukemia]. PMID- 3957137 TI - [Pediatric neurology: six years experience of an outpatient service]. PMID- 3957138 TI - [Carotid endarterectomy under local anesthesia supplemented with neuroleptic analgesia]. PMID- 3957139 TI - [Traumatic rupture of the esophagus presenting as tension pneumothorax]. PMID- 3957141 TI - [Hypertrophic pyloric stenosis--innovations in the last decade]. PMID- 3957142 TI - [Diagnosis of chronic pancreatic disease]. PMID- 3957140 TI - [Renal medullary hypoxia--physiological and pathophysiological implications]. PMID- 3957143 TI - [Q fever endocarditis]. PMID- 3957144 TI - [Pheochromocytoma]. PMID- 3957145 TI - [The fate of pregnancy after first and middle trimester bleeding]. PMID- 3957146 TI - Social work screening in New Jersey hospitals: progress, problems, and implications. AB - The essential components of a viable high-risk screening system are identified in this report of a study of social work screening in New Jersey's acute-care hospitals. Although almost every hospital was found to use some form of screening, the most commonly used screening criteria tended to focus narrowly on identifying patients likely to have prolonged hospitalizations. The implications of these and other findings are discussed. PMID- 3957147 TI - Early identification of high social risk. AB - Many hospital social work departments depend on a referral system based on other professionals' decisions regarding when and with whom social work intervention is appropriate. Changing such systems should help facilitate the early evaluation of high-risk clients by social work staff. To achieve this goal, a model is provided for the identification of high social risk. PMID- 3957148 TI - Working with medicated clients: a primer for social workers. AB - The vastly increased use of prescribed and nonprescribed drugs in this society means that even such traditional social work activities as assessment and advocacy now frequently require a knowledge of the effects of drugs. Integrating a knowledge of basic concepts of pharmacology into practice will enable the social worker to help clients more effectively and to improve the health care they receive. PMID- 3957149 TI - Health services for underserved areas in the rural South. AB - Despite major advances in health care in this country, the rural South remains a region that is medically underserved. After reviewing the current state of health care delivery in underserved rural areas, the authors propose a model to unite traditional and nontraditional health services and prevention and treatment efforts to form a comprehensive network aimed at improving the availability of care. PMID- 3957150 TI - The chronically mentally ill in nursing homes: issues in policy and practice. AB - The release of large numbers of patients from mental hospitals has resulted in the frequent placement of former mental patients in nursing homes. This study examines the integration of a sample of former patients into the residential facility itself and the community at large and concludes that the environment of the facility has a key impact on levels of residents' social integration. PMID- 3957151 TI - Rural health promotion: bailiwick for social work. AB - A variety of factors have prompted increasing interest in prevention in health care practice in this country. In describing a rural health promotion project in which a social worker played a key role, this article illustrates how social work practitioners can bring their many skills to bear in efforts to promote health. PMID- 3957152 TI - Preventing tobacco use among young people. AB - Preventing tobacco use in youths may be an easier task than helping adults break the habit of smoking and overcome its ill effects. Using experimental procedures based on social work techniques, this study suggests that social work efforts are an effective tool in programs and services that focus on primary prevention. PMID- 3957153 TI - [Restorative effect of traxanox on the suppression of antibody production in BALB/c mice]. AB - The number of spleen-rosette forming cells (RFC) and thymus-RFC was assayed on day 4 after immunization with 5 X 10(8) sheep red blood cells (SRBC) in BALB/c mice. The number was decreased significantly by oral administration of cyclophosphamide (20 mg/kg) on days--1 and 0. The decrease in spleen-RFC and thymus-RFC by the pretreatment with cyclophosphamide was significantly restored or had a tendency to be restored by traxanox at doses of 3 and 30 mg/kg (p.o.). In addition, traxanox (30 mg/kg, p.o.) protected the reduced number of RFC in mice treated with cyclophosphamide (3 mg/kg, p.o.). Traxanox (30 mg/kg, p.o.) restored the decreased number of spleen-RFC and thymus-RFC in mice pretreated with dexamethasone (0.1 mg/kg, p.o.), and protected the decrease in the RFC in mice treated with prednisolone (10 mg/kg, p.o.). Also, phagocytosis of SRBC by the spleen adherent cells obtained from mice treated with dexamethasone (0.1 mg/kg, p.o.) was inhibited markedly in comparison with that by the spleen adherent cells of untreated mice. The transfer of the spleen adherent cells treated with dexamethasone into syngeneic recipient mice had no effect on the number of spleen hemolytic plaque forming cells (HPFC). On the other hand, the inhibition of phagocytosis of SRBC by spleen adherent cells of mice pretreated with dexamethasone was restored by the addition of traxanox (10 and 30 microM). The transfer of the spleen adherent cells treated with traxanox resulted in an increase in HPFC number. Traxanox (30 mg/kg, p.o.) protected the decrease in spleen-RFC and thymus-RFC in mice treated with indomethacin 1 mg/kg, p.o.) or acetylsalicylic acid (300 mg/kg, p.o.). Traxanox (3-30 mg/kg, p.o.) restored the decreased number of HPFC, spleen-RFC and thymus-RFC in mice pretreated with carrageenan (0.03 mg). The suppression of phagocytosis of SRBC by spleen adherent cells was restored by the treatment with traxanox (3 and 30 microM). The transfer of the spleen adherent cells treated with traxanox also resulted in an increase in HPFC count. These results strongly suggest that traxanox restores the artificially suppressed immune responses via macrophages. PMID- 3957154 TI - [Antitumor effects of a podophyllotoxin derivative, VP 16-213]. AB - Single and combination chemotherapies of VP 16-213, a new antitumor agent were evaluated for its antitumor effect against several murine tumors. Dose-dependent antitumor effects were observed when VP 16-213 was administered via any of the three routes, i.p., i.v. and orally, on days 1 and 5 after i.p. or s.c. inoculation of Ehrlich carcinoma and sarcoma 180. The drug also proved effective against i.v. inoculated EL-LP-12 (subline of Ehrlich carcinoma), i.p. or s.c. inoculated P388 and B16 melanoma, i.p. inoculated colon 26, and s.c. inoculated colon 38 and Lewis lung carcinoma. However, oral administration of the drug was not effective against B16 melanoma, colon 26 and Lewis lung carcinoma despite the fact that the doses employed for this route was higher than those employed for i.v. and i.p. routes. The optimum dosing schedule was also investigated with oral administration of the drug against s.c. inoculated Ehrlich carcinoma. A single dose (day 1) or two doses (days 1 and 5) were more effective than three doses (days 1, 3 and 5) or five consecutive daily doses. VP 16-213 showed additive and more than additive effects in combination with the antitumor agents, cyclophosphamide, BCNU, mitomycin C or cisplatin against s.c. inoculated Ehrlich carcinoma and i.v. inoculated EL-LP-12. PMID- 3957155 TI - [General pharmacological studies of VP 16-213. Effect on the peripheral system]. AB - The general pharmacological studies of VP 16-213, an antitumor agent, in the peripheral system were carried out by oral and i.v. administration with laboratory animals. VP 16-213 had no effect on the resting tone and spontaneous motility of all the isolated smooth muscle organs tested at concentrations of up to 10(-5) g/ml. VP 16-213 showed no significant influences on the neuromuscular transmission in the sciatic nerve-tibial muscle preparation of rabbits, on renal function in dogs and rats, on blood sugar level in rabbits, and on charcoal meal transport in mice. At a dose of 20 mg/kg, i.v., VP 16-213 reduced gastric secretion in rats. Antiinflammatory, local irritation and hemolytic effects were not observed after the administration of the drug. Single administration of VP 16 213 had orally no effect on the excretion of serum BSP in rats. However, successive administration of the drug (20 mg/kg/day) once daily for 10 days significantly depressed it. VP 16-213 decreased the number of hemolytic plaque forming cells in the spleens of immunized mice. PMID- 3957156 TI - [Anti-inflammatory effect of THS-201, a new intra-articular steroid]. AB - The effect of THS-201, a new intra-articular steroid, on inflammations was examined using acute, subacute and chronic experimental models, and the antiinflammatory action of THS-201 was compared with those of reference steroids such as triamcinolone acetonide (TA), methylprednisolone acetate (MPA), hydrocortisone acetate (HA) and halopredone (HP). Reference steroids, which were given s.c. or locally, dose-dependently inhibited carrageenin-induced foot-pad edema, sodium carboxymethyl cellulose-induced leukocyte migration, cotton pellet granuloma and carrageenin granuloma pouch in rats. Although the inhibitory effects of reference steroids on such inflammations were unrelated to their administration routes, the inhibitory potency decreased in the following order: TA greater than MPA greater than HA = HP. THS-201 even at a dose of 100 mg/kg had no inhibitory effects on such inflammations when given s.c. By contrast, THS-201 given locally had anti-inflammatory actions: the inhibitory potency of THS-201 in chronic models was higher than that of TA, but was lower in the acute models than that of HA. In antigen-induced arthritis in rabbits, the inhibition of swelling of inflamed joints by intra-articular injection of THS-201 (2 mg/joint) persisted more than 30 days, suggesting that the elimination of THS-201 from the injected site was very slow. In contrast to the finding of reference steroids, THS-201 showed no systemic adverse reactions in all experiments. The results, which are in agreement with the findings of labeled THS-201 into arthritic joints, indicate that THS-201 can strongly inhibit recurrence of inflammation as compared with reference steroids tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957157 TI - Biosynthesis of monensins A and B: the role of isoleucine. AB - Isoleucine added to the cultivation medium of Streptomyces cinnamonensis C-100-5 induced a relative increase of the production of monensin B at the expense of monensin A. U-14C-Isoleucine was found not to be a specific monensin B precursor. The incorporation of 1-13C-2-methylbutyrate into monensins A and B showed the label to be evenly incorporated in both products at carbon atoms originating from C(1) of propionate. In regulatory mutants insensitive to 2-amino-3-chlorobutyrate isoleucine influenced the production of monensins only slightly but strains resistant to 2-aminobutyrate and norleucine decreased their total production by 2 12% in the presence of isoleucine which was associated with a decrease of monensin A content by 14-52%. The inhibitory effect of isoleucine on the biosynthesis of valine, a specific precursor of the butyrate unit of monensin A, is discussed. PMID- 3957158 TI - Brain tumours in mice, with particular reference to astrocytoma. AB - In a survey of 75,000 brains from 23 inbred mouse strains studied during research work on scrapie, astrocytoma was by far the commonest neuroectodermal tumour. It occurred in VM and BRVR mice at a 1% incidence, but was virtually absent from other strains. In VM mice it occurred nearly twice as often in males as in females, sometimes causing neurological signs of circling, depression or spinal paralysis, but more often showing no clinical effects and being discovered only during routine neuropathology carried out for other purposes. Astrocytomas occurred in mice in the spinal cord or in the brain, with equal frequency in the fore-, mid- and hindbrain. A dual origin has never been confirmed, but astrocytomas occasionally co-existed with other central nervous system tumours. Macroscopically they cause no distortion of the brain; this contrasts with the rare oligodendroglioma, in cases of which the brain is sometimes swollen and misshapen. Astrocytomas characteristically spread through white-matter tracts, but in some grey-matter localities neoplastic astrocytes can co-exist with viable neurons, suggesting that they may subserve some functions of normal astrocytes. The astrocytomas found in this study often co-existed with scrapie lesions. Scrapie-induced vacuolation penetrated some astrocytomas in grey matter, and the specific scrapie-associated argyrophilic (amyloid) plaques occurred in the middle of an astrocytoma in several mice. However, there is no relationship between the occurrence of astrocytoma and scrapie infection, and the neoplasm also occurs independently both of the Sinc gene, which controls the pathogenesis of scrapie, and of the histocompatibility type of the strains concerned. The spontaneous VM astrocytoma is transplantable intracerebrally and, in the early series of in vivo subpassages, it only grew in the brains of mice of the strain of origin and its crosses. The age occurrence of astrocytoma and the incidence of other CNS tumours in mice are discussed in this paper. PMID- 3957159 TI - Spontaneous brain tumours in Sprague-Dawley rats. AB - Data were collected over a 5-yr period on brain tumours occurring spontaneously among Sprague-Dawley-derived rats in the HRC laboratories. Gliomas, like meningiomas, tended to occur more among males than in females, and in general appeared to be lesions of older rats. Astrocytic tumours of rats were less differentiated than those in man. The characteristic patterns of human glioblastoma multiforme were not observed in this series. Most of the astrocytomas were located in the cerebral areas. Secondary deposits observed in brain included those from tumours of Zymbal's gland, squamous-cell carcinoma, mammary adenocarcinoma, osteosarcoma and lymphoreticular neoplasms. PMID- 3957161 TI - The brain-tumour issue in long-term toxicity studies in rats. AB - Problems arise in the measurement of the neurocarcinogenic potential of chemical substances in chronic toxicity studies because of the spontaneous occurrence of neoplasms in the brain and other organs of rats from the age of about 2 yr. Statistical analysis may be equivocal and must be accompanied by a thorough biological analysis, to determine the presence or absence of the following characteristic effects of neurocarcinogenic agents: a reliable and consistent increase in brain-tumour incidence beyond the expected control level, a decrease in the age at which tumours appear and/or in survival, a dose-effect relationship, a greater effect on embryonal and foetal brain cells than on those of adults, a shift to more anaplastic types of tumour and the finding of preneoplastic lesions. These criteria have been met in chronic tests on the neurocarcinogens ethyl- and methylnitrosourea and some have been met in results obtained with the weak carcinogen methyl methanesulphonate. However, none of these criteria were met in the case of a test compound subjected to two 2-yr studies (one involving transplacental exposure), although brain tumours occurred in the controls and in all the experimental groups. The test substance is not considered to be a neurocarcinogenic agent. PMID- 3957162 TI - Frequency, size and location of brain tumours in F-344 rats chronically exposed to ethylene oxide. AB - Increased frequencies of primary brain tumours were seen in male and female F-344 rats exposed to 100 or 33 ppm ethylene oxide (EO) vapour (for 6 hr daily on 5 days/wk for up to 2 yr) but no such increase was seen in rats similarly exposed to 10 ppm EO. The tumours that were seen (glial-cell tumours, granular-cell tumours and malignant reticuloses) were similar in appearance to those that develop spontaneously in F-344 rats, but the tumours associated with EO exposure at levels of 100 or 33 ppm were larger, and in at least six cases were thought to be the primary cause of death. Only two of the 23 tumours seen microscopically were detected by gross examination at necropsy, and brain weights were of minimal value in predicting the presence of tumours. Only three animals demonstrated abnormal neurological signs. These findings point to the need for thorough microscopic examination of the brains of rodents in chronic studies. PMID- 3957160 TI - Primary brain tumours in Fischer 344 rats chronically exposed to acrylonitrile in their drinking-water. AB - Acrylonitrile (ACN) has been tested for carcinogenicity by various routes in a number of rat strains. At relatively high levels of administration (e.g. 500 ppm in the drinking-water) there were statistically significant increases in microscopically detectable primary brain tumours, which were difficult to classify. In a further study of ACN-induced brain tumours, ACN was administered to groups of 50 male and 50 female F-344 rats from 6 wk of age at levels of 0, 100 and 500 ppm in the drinking-water. A fourth group of 300 rats (147 males, 153 females), was also given 500 ppm ACN. Neurological signs were observed in 0, 4, 16 and 29, respectively, of the rats in these four groups within 12-18 months. Among the treated animals, females died slightly earlier than males. Few controls of either sex had died by month 18, but, apart from those killed for tumour donation, a high proportion of the rats in the 500-ppm groups had died by that time. Of the 49 brain tumours found in rats exposed to 500 ppm ACN, 11 were only detectable microscopically, 28 were 1-5 mm in diameter and 10 were greater than 5 mm. Despite this variation in size, all the tumours were similar in cellular and architectural features. They were densely cellular, with occasional areas of focal necrosis, and were infiltrative at the margins. They were negative for glial fibrillary acidic protein (GFAP). Ultrastructurally, the tumour cells showed intermingling cytoplasmic processes but no glial filaments and no neurosecretory granules or specialized cell contacts. Samples of tumour tissue were successfully grown in culture, but transplantation of samples from these cultures (observed for up to 12 wk) was unsuccessful. However, a direct intracerebral transplantation from a large tumour was successful. PMID- 3957163 TI - Brain tumours--problems and perspectives. AB - The interpretation of carcinogenesis bioassay data is a complex process that requires a 'weight of evidence' approach rather than a rigid decision based solely on statistics. This is particularly true for rat brain tumours, since recent bioassays have demonstrated rather marked variations in the incidence of these neoplasms. The objective of this paper is to point out some of the considerations that should be included in such a 'weight of evidence' approach and to provide a few examples relevant to brain tumours. Areas for future research on mechanisms of neuro-oncology should provide additional information relevant to determining the chemical causes of brain tumours. PMID- 3957164 TI - Multigeneration study of FD & C Blue No. 2 in rats. AB - In a three-generation reproduction study, groups of ten male and 20 female Charles River CD rats were fed FD & C Blue No. 2 at dietary levels providing intakes of 0.0, 2.5, 25, 75 and 250 mg/kg body weight/day. Slightly bluish coloured fur was noted in rats at the 250-mg/kg/day dose level and bluish-green coloured faeces were produced by rats in the 75- and 250-mg/kg/day groups. The gestation, viability and lactation indices of all litters were comparable for the control and treated groups. The fertility indices for female rats in the 2.5- and 25-mg/kg/day groups were significantly lower than those for control females in the case of the F2 litters. However, there was no reduction in the female fertility indices for the F2 litters at the two higher dosage levels, nor for the F1 and F3 litters at any dosage level. Although fertility indices were reduced for some groups of male rats in the F2b and F2c litters, these changes were not considered to be compound-related. Examination of the ovaries and uteri of all dams killed on day 19 of gestation of the F2c and F3c litters revealed no gross anatomical abnormalities. No unusual changes were observed in the stillborn pups or in pups dying during the study. There were no compound-related gross or microscopic pathological lesions in any of the F1 or F3a rats that were killed and necropsied, and no compound-related organ-weight variations were recorded in the F1 parental rats. PMID- 3957165 TI - Comparative metabolism and mutagenicity of azo and hydrazone dyes in the Ames test. AB - Enteric bacterial and hepatic azoreductase enzymes are capable of reducing azo dyes to yield the constituent aromatic amines. Azo dyes based on benzidine and benzidine congeners have received particular attention because of their widespread use and the known carcinogenicity of benzidine to humans. Azo dyes based on beta-diketone coupling components exist preferentially as the tautomeric hydrazones. A series of hydrazone dyes based on benzidine and benzidine congeners was prepared and characterized by NMR and UV-visible spectroscopy. These dyes were tested for mutagenicity using a modified Ames assay and, unlike the true azo dyes, showed no significant mutagenic activity. The hydrazone dyes were resistant to enzymatic reduction by FMN-supplemented hamster-liver post-mitochondrial supernatant (S-9); under identical conditions, azo dyes such as trypan blue were rapidly reduced. PMID- 3957166 TI - Subchronic oral toxicity testing in rats with a liquid hand-dishwashing detergent containing anionic surfactants. AB - A subchronic oral toxicity study on a model liquid dishwashing detergent containing anionic surfactants was performed to verify that the formulation, made up of a mixture of various ingredients, did not possess any toxicological properties that would not have been expected from available data for each separate ingredient. The product was administered to rats for 13 wk at dietary levels of 0, 0.025, 0.25 or 2.5% (w/w) in the diet. No adverse effects on gross or microscopic histopathology were apparent at any dose level, although increased relative liver weights at the 2.5% level suggested that this dose caused some adaptive changes. PMID- 3957167 TI - The induction of microscopic brain tumours in the rat. The significance for man. An international workshop. 19/20 July 1984, Robens Institute, University of Surrey. PMID- 3957168 TI - Neurogenesis and gliogenesis in the human brain. AB - The primary germinal neural epithelium lines the ventricular system of the brain and shows intense mitotic activity. Neuroblasts migrate from a juxtaluminal position to establish neural centres and, when this task is completed, the definitive ependymal epithelial lining of the ventricles develops, shifting the remnants of the germinal epithelium to a subendymal location. The subendymal layer continues to proliferate giving rise to glia in the postnatal brain. Premature arrest of migration of neuroblasts leads to the accumulation of heterotopic nests anywhere along the migratory path. Within such ectopia, neurons may make normal connections or they may remain undifferentiated and later become tumorigenic. The subependymal layer has long been considered the site of original of periventricular gliomas. Some migrating neuroblasts establish secondary germinal centres far removed from the ventricular system. An example of this is the external granular layer of the cerebellum which, in man, persists for the first 6 months of life. Cerebellar neuroblastomas could originate directly from this layer in the neonate, or from remnants of this layer in older individuals. PMID- 3957169 TI - Epidemiology of brain tumours in man and their relationship with chemical agents. AB - The 2000 or so deaths that result each year in England and Wales from brain tumours, as defined by ICD 191, represent approximately 0.3-0.4% of all deaths, with a slightly greater incidence in men than in women. Because of the low incidence of mortality from other causes in childhood, brain cancer accounts for 3.5% of all deaths in the 1-14-year age group. Mortality from brain cancer increased considerably between 1931 and 1961 but this is probably explained by changes in disease classification and improvements in diagnostic techniques. Because of the relatively low incidence of brain cancer in man, cohort studies need to be large in order to accrue sufficient cases for meaningful interpretation. Large cohort studies may run the risk of diluting a high-risk group of workers with lesser or non-exposed individuals. These considerations have encouraged the investigation of brain cancer by case-control studies and the interpretation of these must take into account possible sources of bias. At present the evidence for any chemical causation of brain cancer in man is inconclusive. PMID- 3957170 TI - Serum methanol concentrations in rats and in men after a single dose of aspartame. AB - Serum methanol concentrations were measured in rats and in humans given oral aspartame. The dose given to rats was the FDA's projected 99th percentile daily intake for humans, assuming aspartame were to replace all sucrose sweeteners in the diet (34 mg/kg). Four male adult volunteers each received 500 mg, equivalent to 6-8.7 mg/kg, which is approximately the FDA's estimate of mean daily human consumption. Both treatments caused a rise in serum methanol. In rats the mean peak value was 3.1 mg/litre 1 hr after administration; serum methanol returned to endogenous values 4 hr after treatment. In the men, the mean rise over endogenous values was 1.06 mg/litre after 45 min. Two hours after treatment, serum methanol had returned to basal levels. The temporary serum methanol increase showed peak values within the range of individual basal levels. PMID- 3957171 TI - Three-generation reproduction study of rats ingesting up to 10% sorbitol in the diet--and a brief review of the toxicological status of sorbitol. AB - Groups of 12 male and 24 female 5-wk-old Charles River CD (SD) BR rats (F0) were fed a sucrose-containing ground cereal-based diet in which 0, 2.5, 5.0 and 10.0% (w/w) sorbitol was included at the expense of sucrose. The rats were first mated after 14 wk on the diet. F1a litters were born 19 wk after the start of the study and F1b litters at wk 30. Groups of 12 male and 24 female F1b rats were first mated when 18 wk old. They gave rise to F2a litters after 3 wk and to F2b litters 10 wk later. Likewise, groups of 12 male and 24 female F2b rats were first mated when 18 wk old, producing F3a and F3b litters 3 wk and 10 wk later, respectively. F0 rats were killed 33 wk after the start of the study, F1a in wk 22, F1b in wk 68, F2a in wk 57, F2b in wk 92 and F3a in wk 96. Apart from slight reductions in food consumption in sorbitol-fed F1b males and in body-weight gain in sorbitol fed F0, F1b and F2b rats of both sexes, treatment was associated with no clinically observed effects. There were no deaths attributable to treatment and no adverse effects on mating performance or pregnancy rates in the parent animals of any generation. Treatment was associated with no consistent adverse effect on any measure of reproductive performance or behaviour during gestation or lactation. No abnormal pups were observed in any generation. Not unexpectedly, caecal enlargement was consistently observed at necropsy of sorbitol-treated rats of all generations and significant rises in serum calcium were observed in F0 males and females exposed to 10% sorbitol and in F1b males exposed to either 5 or 10% sorbitol. Differences between treated and control F3a rats in respect of T3 and TSH levels were probably spurious as they followed no consistent pattern. Similarly, between-group variations in gonadal weight were considered to have no toxicological significance because they lacked consistency and were not accompanied by any histologically-evident changes. Microscopic examination of lesions from F1a and F2a animals, of gonads from F1b and F2b and of selected tissues from the F3a generation revealed no changes of toxicological significance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3957172 TI - Influence of sulphite on the release of glycolytic metabolites in the perfused rat liver. AB - Sulphite interacts reversibly and irreversibly in vitro with many compounds of biological relevance. A possible inhibitory action of sulphite on hepatic lactate dehydrogenase activity was studied using the perfused rat liver to determine glycolytic metabolites released by the liver during sulphite infusion. A sulphite dependent reversible inhibition of lactate release but no increase in pyruvate production indicated that lactate dehydrogenase was inhibited by sulphite concentrations in the millimolar range. This effect was diminished by addition of pyruvate to the perfusion medium. It appears very unlikely that, under physiological conditions, sulphite levels in the portal blood or the liver of the rat would reach concentrations that inhibit lactate dehydrogenase activity. PMID- 3957173 TI - Enhancing effect of thiabendazole on urinary bladder carcinogenesis induced by sodium o-phenylphenate in F344 rats. AB - Sodium o-phenylphenate (OPP-Na), a urinary bladder carcinogen in rats, and another fungicide, thiabendazole (TBZ) were fed separately or simultaneously to F344/DuCrj rats of both sexes. The rats were fed one of six diets, either the basal (control) diet or basal diet containing 0.2% TBZ (group T), 1% OPP-Na (1% SO), 2% OPP-Na (2% SO), 1% OPP-Na plus 0.2% TBZ (1% SO-T) or 2% OPP-Na plus 0.2% TBZ (2% SO-T) for 13 or 65 wk. In the 13-wk study, in which groups of ten rats of each sex were used, urinary bladder tumours appeared in 8/10 males in each of three groups--the 2% SO, 1% SO-T and 2% SO-T groups--but not in the remaining animals. Of these tumours, carcinoma accounted for 3/8 tumours in the 2% SO group, 2/8 in the 1% SO-T group and 8/8 in the 2% SO-T group. In the 65-wk study, in which groups of 15 rats were used, the tumour incidence in males was 1/15 in the T group and 15/15, 12/15 and 14/15 in the 2% SO, 1% SO-T and 2% SO-T groups, respectively, while in the females, tumours were found in 2/15, 1/15 and 12/15 animals in the 2% SO, 1% SO-T and 2% SO-T groups, respectively. Of these tumours, carcinoma accounted for 10/15, 11/12 and 10/14 in the males of the 2% SO, 1% SO-T and 2% SO-T groups, respectively, and for 1/2 and 6/12 in the 2% SO and 2% SO-T females, respectively. The tumour incidences in the 1% SO-T males in the two studies and in the 2% SO-T females in the 65-wk study showed a statistically significant increase over those in the 1% SO males or the 2% SO females. Thus, TBZ apparently enhanced the carcinogenic effects of OPP-Na in the rat urinary bladder. PMID- 3957174 TI - Effects of skin storage conditions and concentration of applied dose on [3H]T-2 toxin penetration through excised human and monkey skin. AB - Penetration of [3H]T-2 toxin through excised human and monkey skin stored at -60 degrees C was faster than through human and monkey skin stored at 4 degrees C, respectively. The permeability of refrigerated human skin was 34% of the permeability of refrigerated monkey skin. Increasing the concentration of [3H]T-2 toxin applied to the refrigerated monkey skin increased the amount of [3H]T-2 toxin penetrating the skin and enhanced the efficiency of penetration. Metabolites of [3H]T-2 toxin were identified in the receptor fluid bathing the dermal side of the excised human and monkey skin. PMID- 3957175 TI - Effect of N-nitroso-n-butyl-(4-hydroxybutyl)amine exposure on the changes in mineral disposition caused by trisodium nitrilotriacetate. AB - Male Fischer 344 rats were used to determine effect of consumption of 0.5% N nitroso-n-butyl-(4-hydroxybutyl)amine (BNN) in the drinking-water for 2 wk on the response to 0.02, 0.2 and 2.0% trisodium nitrilotriacetate (Na3 NTA . H2O) in the diet in terms of urinary mineral excretion, bladder mass and bladder mineral concentrations. The primary objective of the study was to determine whether exposure of rats to an initiating dose of a bladder carcinogen (BBN) alters the threshold dose of Na3NTA . H2O required to alter urinary or bladder mineral concentrations or the dose-response to NTA. Such alterations are considered to be necessary precursors for changes in bladder morphology in rats fed NTA in chronic toxicity studies (Anderson, Bishop & Campbell, CRC Crit. Rev. Toxicol. 1985, 15, 1). The results demonstrated that BBN exposure caused an increase in bladder mass and bladder-tissue Zn concentration. However, BBN pretreatment did not have any effect on Na3NTA . H2O metabolism, the threshold dose of Na3NTA . H2O required to attain the necessary conditions for induction of bladder toxicity by NTA, or the dose-response relationships for NTA's effects on any parameter examined. From these data, it is concluded that it is unlikely that NTA would show a different threshold or dose-response for bladder tumour promotion than for its tumorigenicity at this site, which has been demonstrated previously (National Cancer Institute, DHEW Publication No. (NIH) 77-806, 1977). PMID- 3957176 TI - Toxicological evaluation of hydrochlorofluorocarbon 142b. AB - Groups of 110 rats of each sex were exposed by whole-body inhalation to 0, 1000, 10,000 or 20,000 ppm (v/v) of hydrochlorofluorocarbon 142b (CFC 142b or 1-chloro 1, 1-difluoroethane) for 6 hr/day, 5 days/wk for 104 wk (ten rats from each group were killed after 52 wk) in a combined chronic toxicity and oncogenicity study. Concurrently, ten male rats per group were exposed to the same concentrations for 13 wk in a bone-marrow cytogenicity study and another ten male rats per group were exposed for 15 wk in a dominant lethal study. No toxicologically significant compound-related effects were observed in behaviour, appearance, growth, clinical pathology, or gross and microscopic pathology. Respiratory infection and consequently higher than expected mortality during the first year did not compromise the studies or conclusions but may have contributed to the intergroup differences in the numbers of chromosome breaks and acentric fragments. No evidence for mutagenic potential was seen in either the dominant lethal or the cytogenetic assays. These data indicate the very low toxicity of CFC 142b with respect to chronic effects and genotoxic and oncogenic potential. The toxicological profile of CFC 142b is similar to that of other chlorofluorocarbons that have been assigned a threshold limit value (TLV) of 1000 ppm as a workplace 8-hr time-weighted average by the American Conference of Governmental Industrial Hygienists. PMID- 3957178 TI - HPLC determination of N-nitrosomethylurea in biological fluids by reaction with 4 nitrothiophenol. AB - A simple and sensitive method for the determination of N-nitrosomethylurea (NMU) in biological fluids was developed. The principle is based on the formation of 4 nitrothiophenol methyl thioether (NTP-Me) from 4-nitrothiophenol (NTP) and diazomethane formed from MNU by adding alkali. After sodium hydroxide solution was added to the mixture of NMU in aqueous solution and diethyl ether, the aqueous layer was removed and NTP was added to the ether layer in which diazomethane had been trapped. NTP-Me thus formed was determined by HPLC. This method was successfully applied to the analysis of NMU in biological samples with some clean-up. Stomach and intestine contents and blood samples from guinea-pigs were cleaned up by use of a kieselguhr column followed by heptane-water partition. The recoveries of NMU from the stomach and intestine contents were about 95% and that of NMU from blood samples was about 80%. The detection limit of NMU was 0.5 nmol/g for the stomach contents and 1 nmol/g for the intestine contents and blood samples. PMID- 3957177 TI - Dose-response relationships for initiation of rat liver tumours by diethylnitrosamine and promotion by phenobarbitone or alcohol. AB - Small doses of initiators, such as the nitrosamines, are present in the diet and man is also exposed to promoters, such as phenobarbitone or alcohol. A simple two stage model of rat hepatocarcinogenesis with a single ip dose of diethylnitrosamine (DEN) as the initiator and sodium phenobarbitone or ethanol given in the drinking-water for 12-18 months as the promoter was used to investigate dose-response relationships for initiation and promotion. Phenobarbitone given alone for 12 months had no carcinogenic effect on rat liver. Low doses of DEN, given prior to phenobarbitone promotion, resulted in the formation of hyperplastic nodules, but only the high dose of DEN (30 mg/kg) resulted in carcinoma formation. Basophilic foci showed a dose-response relationship with DEN and it is suggested that these may be more important than nodules in carcinoma formation and that they represent a heterogeneous group. Only the top concentration of phenobarbitone (1000 micrograms/ml) promoted carcinoma initiated by 30 mg DEN/kg although lower doses of phenobarbitone produce significant enzyme induction. A weak enzyme inducer, 5% ethanol, was as effective a promoter as 1000 micrograms phenobarbitone/ml. Enzyme induction and tumour formation are therefore not directly related. Commencing top-dose phenobarbitone promotion 10 months after the single dose of DEN led to tumour formation, demonstrating the persistence of DEN-initiated cells. The significance to man of the apparent thresholds for tumour initiation and promotion is discussed. PMID- 3957179 TI - Lack of oestrogen-like activity in commercially refined vegetable oils. AB - Commercially refined corn, safflower, sunflower and soya-bean oils, as well as well as lard and beef tallow, were fed to pre-pubertal female mice at a level of 5 or 20% of a semi-synthetic diet to assess whether they exhibited any oestrogen like activity, as measured by changes in uterine weight or in the ratio of uterine weight to body weight. No measurable oestrogen-like activity was observed, in contrast to the effects in positive-control animals treated with 5, 10 or 15 ppb diethylstilboestrol. This finding contradicts an earlier report in the literature. It also shows that oestrogen-like activity in a commercially refined oil is not likely to be a variable in the complex mechanism of the dietary modulation of induced breast-tumour growth. PMID- 3957180 TI - The roentgenographic appearance of the "corrected clubfoot". AB - Roentgenographic changes associated with a corrected clubfoot may not be readily apparent. In some individuals with minimal residual deformity, these roentgenographic changes are quite subtle. The roentgenographic abnormalities of the corrected clubfoot are described. PMID- 3957181 TI - Computerized tomographic analysis of acute calcaneal fractures. AB - Computerized tomography (CT) of the hindfoot is introduced as an effective technique in the evaluation of acute, intra-articular calcaneal fractures. Thirty two fractures in 30 patients have been reviewed, and common fracture characteristics identified. These included the presence of a sustentacular fragment, displacement and comminution of the lateral weightbearing surface, and lateral spread with loss of calcaneal height. Based on the improved understanding of fracture anatomy provided by the CT scan, treatment often can be determined more accurately. PMID- 3957182 TI - Neurilemoma of the lower extremity. AB - A series of 76 patients with 85 neurilemomas of the lower extremity was reviewed. The tumors were located throughout the lower extremity and had varied clinical presentations, which often posed problems in diagnosis. Pain, however, was a consistent symptom, and 63 (83%) of the patients presented with local or radiating (or both) pain. Electromyography was done in seven cases, but the results were abnormal in only two. When evaluating a painful mass or an atypical pain in the lower extremity, the clinician should have a high index of suspicion for neurilemoma. PMID- 3957183 TI - Limb salvage in a diabetic with necrotizing fasciitis: case report and literature review. AB - Necrotizing fasciitis must be considered in a diabetic with cutaneous ulceration. A case report of limb salvage in a 48-year-old diabetic female with progressive necrotizing fasciitis is presented. Methods of early diagnosis including clinical signs, radiographs, and soft tissue biopsy of the involved extremity are reviewed. The microbiology of the disease is also discussed. A modification of the Orr technique using infrequent dressing changes in the management of necrotizing fasciitis is presented. In our case this resulted in preservation of life and a functional limb. PMID- 3957184 TI - Technique tips: footings. Repair of dislocating peroneal tendons. PMID- 3957185 TI - Child Medical Evaluation Program: a statewide system for the medical and mental health evaluation of abused and neglected children. AB - The Child Medical Evaluation Program examines 1500 children per year suspected by county social service departments of having subtle physical evidence of abuse or neglect. The program utilizes private practitioners, primarily pediatricians, in a systematic manner and provides consultation, direction, and quality control. The system is a unique, cooperative effort between private practitioners and county departments of social service. It is administered from a state university department of pediatrics. The cost is low, government involvement minimal, and the service extensive. The system is recommended to other states. PMID- 3957186 TI - The status of the ethics of in vitro fertilization in 1985. AB - In many respects in vitro fertilization has been accepted as ethical by the majority of people in the Western world. Controversy now involves the ancillary issues of embryo freezing, embryo adoption, surrogate mothering of in vitro fertilization embryos, donor fathering of in vitro fertilization embryos, and research on embryos. The acceptance of in vitro fertilization as ethical was withheld until in vitro fertilization was demonstrated to be safe and effective under controlled circumstances. A similar approach to the ancillary issues is advocated. PMID- 3957187 TI - Phosphoenolpyruvate carboxykinase activity in human liver. AB - The activity of phosphoenolpyruvate carboxykinase (EC 4.1.1.32) (PEPCK), a rate limiting gluconeogenic enzyme, was found decreased by others in genetically determined disorders and in Sudden Infant Death Syndrome (SIDS). To understand these findings, we made a systematic study of normal human hepatic PEPCK activities in specimens obtained under various conditions from patients not suspected of having SIDS. PEPCK was assayed by the method of Ballard and Hanson [J. Biol. Chem., 244 (1969) 5625] and activity reported as units (1 mumol/min) per gram protein. Intra-assay precision was 4.1% (n = 1094); inter-assay precision using the same homogenate was 10.4% (n = 51); and inter-assay precision using different homogenates of the same tissue specimen was 16.3% (n = 17). The assay was linear with time and enzyme concentration for at least 60 min up to 1.3 mU/assay and for at least 5 min up to 20 mU/assay. Biopsy specimens had significantly (P = 0.015) higher PEPCK activity, 12.60 +/- 3.01 U/g (range 3.5 10.4, n = 9) compared to specimens obtained at autopsy, 3.20 +/- 0.45 U/g (range 0-8.6, n = 33). Specific activity was not significantly correlated with the patient's age, fresh vs. frozen tissue, postmortem intervals up to 68 h, or length of storage at -70 degrees C up to 21 years. One patient had activity at autopsy (tissue obtained less than 2 h postmortem) 26% less than was observed in his biopsy specimen. Autopsy samples separated by differential centrifugation into mitochondrial and cytosolic fractions and checked with marker enzymes ornithine transcarbamylase (mitochondrial) and arginase (cytosolic) had considerable cross-contamination between the two fractions in fresh and frozen specimens. PMID- 3957188 TI - Adverse effects of drugs and toxins in the pediatric age group. PMID- 3957189 TI - Ontogeny and dental genetics in forensic problems. AB - Teeth are an excellent and reliable source of information useful in establishing identities in the absence of dental records providing that matching dental casts or teeth of other possibly related family members are available and that information on dental trait frequencies can be obtained. Such demographic data is generally available from physical or odontological anthropology departments in universities or museums. The data collected is subjected to statistical scrutiny and treatment of probability methodology. PMID- 3957190 TI - Identification of children and adults through federal and state dental identification systems: recognition of human bite marks. AB - Forensic pathologists are often involved in the identification of unknown bodies. It is imperative, therefore, that they become aware of a national computerized identification system (NCIC) administered by the FBI. There is also a state system in California which has resulted in the identification of 59 individuals. This article describes the current methods available for dental identification and indicates the reasons pathologists must rely on odontologists. A brief description of human bite marks and their usual locations is also included, since forensic pathologists often encounter such important evidence during an autopsy. PMID- 3957191 TI - Battered child syndrome in a four year old with previous diagnosis of Reye's syndrome. AB - A 4-year-old Black child was admitted to hospital in coma and with retinal hemorrhages. He was diagnosed as having Reye's Syndrome and remained hospitalized for 1 month. At discharge, he was neurologically compromised with spasticity of the right arm and leg, and could not walk or sit unsupported. Three weeks later he was again seen in the emergency room with a swollen right arm and leg and was subsequently readmitted. Healing fracture of the right femur and probable healing fracture of the right humerus were diagnosed. These were thought to be due to a fall from a stroller. Almost 4 months later, the child died at his home in the care of his mother's boyfriend. Autopsy findings were consistent with a severely chronically battered child. PMID- 3957192 TI - Panhypopituitarism in a young drug abuser. AB - An intoxicated young man returned home from a drinking party and collapsed and died in his mother's presence. Three weeks earlier, he had been released from prison, having served a sentence for possession and sale of "street drugs". At the time of his release, he and his friends had gathered together for a celebration at which drugs were used. At the autopsy table, there was initial evidence of an intrasellar hemorrhage of recent onset with ablation of the adenohypophysis. At first the prosectors considered the case to be one of drug induced pituitary "apoplexy". However, there was subsequent autopsy evidence of chronic panhypopituitarism. The intrasellar lesion proved to be a Rathke-cleft cyst of dysontogenetic origin, probably unrelated to drug abuse. This case is presented as an example of the increasing complexities encountered by the forensic pathologist in a world of increasing numbers of available toxic substances. PMID- 3957194 TI - The epidemiology of sudden infant death syndrome in Finland in 1969-1980. AB - SIDS cases were defined by examining all death certificates, in which sudden deaths were expected to be found from the years 1969-80 from the Central Statistical Office of Finland. The age limits were 28-364 days. If the death certificate did not give enough information as to whether the cause of death was explained or unexplained, autopsy records and microscopic specimens were examined. If the death was sudden, but no autopsy was done, no microscopic specimens were taken, or there were some slight findings which could have partly explained the death were classified as borderline cases. The mean annual incidence of SIDS in Finland was 0.41/1000 livebirths in 1969-80. In 1969-74 and 1975-80 the incidences were 0.31 and 0.51, respectively. The increasing tendency of SIDS was partly due to more borderline cases in the first period and partly due to more twins, and infants with small birth weight, dying of SIDS in the second period. Deaths at weekends and sleeping with parents in the second period were more common than in the first study period. In the SIDs group the young maternal age, low social class, family type unmarried couple or single mother, maternal anemia during pregnancy were more common than in the control group. Mothers of SIDS infants had more previous children and fewer visits and later first visit to prenatal clinics than control mothers. The duration of gestation was shorter and the mean birth weight and length were smaller in the SIDS case than in the control group. Twins were more common among SIDS infants than in the common population. The most important risk factor of SIDS was maternal smoking during pregnancy. The epidemiological results conform with the hypoxia hypotheses. PMID- 3957193 TI - Hyponatremic seizures as a presenting symptom of child abuse. AB - Poisoning is an uncommon manifestation of child abuse. The intentional administration of water to a child as a form of punishment has rarely been reported as the responsible substance among children who have been poisoned. We describe a case of a 5-year-old girl presenting with severe hyponatremia due to acute water intoxication. The patient was brought to the emergency room in status epilepticus. A history was obtained from the child's mother stating that the patient had been playing outside when she collapsed. She had had no known prior illnesses. Laboratory evaluation included a hemoglobin of 10.1 mg%, glucose of 60 mg%, serum sodium of 107 mEq/l, potassium of 3.2 mEq/l and chloride of 71 mEq/l. A CAT scan obtained approximately 1 h after admission revealed generalized cerebral edema. Careful examination of the skin revealed multiple linear ecchymosis of varying ages on the back and thighs and a hand print on the right flank. In addition, the child demonstrated severe failure to thrive with height, weight and bone age compatible with a 2.5-year-old girl. Appropriate therapy for severe hyponatremia was successfully instituted. For the next 12 h she was deeply somnolent, but the following morning was alert and conversant. She stated that she "would be good if she didn't have to drink any more water". The child's mother subsequently admitted that she frequently used water ingestion as a form of punishment. The child stabilized metabolically and demonstrated rapid in hospital weight gain. She was placed in foster care at discharge and has had no further hyponatremia or seizures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957195 TI - The First International Conference on Forensic Pediatric Pathology. June 10-13, 1985, Providence, Rhode Island. PMID- 3957196 TI - Homicides of abused children prematurely returned home. AB - Five homicides of abused children are reviewed. These children had been removed from the parents because of physical abuse, then later returned to the home where they were subsequently killed. In each case, certain factors were present either during the interval of removal or after the return of the child, which could have alerted individuals, agencies or the court and, if heeded, could have prevented the deaths. Premature return occurred because of administrative inadequacies, including abbreviated investigations, violation of routine procedures because of heavy caseloads, and inadequate or absent psychotherapy of parents or caretakers. Court dates are not extended to compensate for these failings. The factors which operate in the home after the return of the child are essentially the same as those which prompted the removal: physical abuse. In these circumstances, more frequent follow-up visits by the agency or social worker are necessary and for a longer period of time. There should be a heightened awareness that in children who are returned home after removal for physical abuse, further physical abuse is a signal for immediate removal before a fatality occurs. PMID- 3957198 TI - [Nuclear magnetic resonance tomography in cervical cancer. Superior image quality -stage classification]. PMID- 3957197 TI - [Hysterocolpectomy. The method of choice in genital prolapse in geriatric patients]. PMID- 3957199 TI - [Bladder cancer--a consequence of industrialization?]. PMID- 3957200 TI - [The ready laboratory for the family physician. Single-button laboratories of various manufacturers]. PMID- 3957201 TI - [When the mother of a child is simultaneously its grandmother--and its sister.... On the problem of the use of in vitro fertilization]. PMID- 3957202 TI - [The call "back to nature" cannot replace medical care. The tension between sociocultural currents and medical responsibility: an obstetrical example]. PMID- 3957203 TI - [Emergencies in sports for the elderly]. PMID- 3957204 TI - [Anterior knee joint instability. A typical injury in Alpine skiing]. PMID- 3957205 TI - [Biomechanical analysis of falls in skiing]. PMID- 3957206 TI - [The role of dopamine in the dyspeptic symptom complex]. PMID- 3957207 TI - [Brain function in alcoholic patients. Correlation of flicker fusion frequency and psychopathologic findings]. PMID- 3957208 TI - [The Paraguay project. Short report on a tuberculosis/leprosy eradication program]. PMID- 3957209 TI - [Cryotherapy of urologic tumors]. PMID- 3957210 TI - [Cancer occurrence from the biometric viewpoint]. PMID- 3957211 TI - [Alternative methods in oncology. On the symposium "Cancer and alternative medicine," St. Gallen, 1985]. PMID- 3957212 TI - [Lymph node metastases of colorectal cancers. Incidence and topography]. PMID- 3957213 TI - [Carcinoid tumors--therapy and results]. PMID- 3957214 TI - [Role of dopamine in vomiting]. PMID- 3957215 TI - [A good mood. What everyone can contribute to its success (II)]. PMID- 3957216 TI - [Cerebrovascular diseases in childhood--etiology, clinical aspects and prognosis]. AB - Over a period of nine years we observed 52 children with acute neurological symptoms which were caused by a cerebrovascular disease. Fourteen patients had congenital vascular malformations, most frequently AV-angiomas (9 patients). A Sturge-Weber-Syndrome and a venous angioma were found in two cases and one patient had an aneurysm of the middle cerebral artery. Thirty-eight patients had acquired cerebrovascular diseases such as ischaemic infarctions (22), intracranial haemorrhages without vascular malformations (14) and thromboses of the dural sinus (2). The cerebral infraction was a complication of a congenital heart disease in 8 children, two others suffered from chronic renal insufficiency and were on haemodialysis. Two children had a trauma of the internal carotid artery and in one patient a large haemorrhagic infarct was caused by hypernatremic dehydration. In 9 patients (6 females, 3 males) no obvious aetiology of the infarct could be found. However, in most of these cases a nonspecific febrile illness preceded the neurological manifestations. The thrombosis of the dural sinus occurred in a 6-week old previously healthy infant and in a 3-year old boy as a complication of a nephrotic syndrome. Intracranial haemorrhages (without cerebrovascular malformations) occurred in 14 patients, mainly as a complication of haematological diseases (acute lymphatic leukaemia, severe aplastic anaemia, haemophilia A, lupus erythematodes). Four children had spontaneous intracerebral haemorrhages without obvious causes. The prognosis for survival was good in children with infarcts, but persisting neurological deficits were more severe than in children with haemorrhages. At the acute stage the lethality was higher in children with intracranial haemorrhages. PMID- 3957217 TI - [Comparison of clinical findings and nuclear magnetic resonance tomography in syringohydromyelia and intramedullary tumors]. AB - Magnetic resonance imaging allowed a distinct differentiation between syringohydromyelia (9 patients) and intramedullary tumour (2 patients). In syringohydromyelia the morphological evaluation showed a greater extension of the cavitation, especially in the caudal direction, than the estimation according to clinical findings. Tumours were visualised indirectly by changing the physiological shape of the spinal cord; therefore, small parts were not recognisable on magnetic resonance images but detected by the corresponding clinical symptoms. Clinical and morphological data were complementary and both necessary for a comprehensive appreciation of the pathological process. PMID- 3957218 TI - [Progressive lipodystrophy (Barraquer-Simon syndrome): differential diagnosis and clinical aspects]. AB - "Progressive lipodystrophy" or "partial lipodystrophy of the cephalothoracic type" is a rare, acquired condition of unknown aetiology with onset in childhood and a complete loss of subcutaneous fat of face, neck, trunk and upper extremities. The disease is more common in females than males and causes a disfigurement of the face; that it cannot be regarded only as a harmless variation, is above all due to a typical concomitant disease, membranoproliferative glomerulonephritis with hypocomplementaemia. Laboratory investigations nearly always reveal a complement-activation by the "alternative pathway" with consumption and lack of complement-component C3, a finding which allows a clear distinction between partial lipodystrophy and congenital or acquired forms of total lipodystrophy ("Berardinelli-Seip-Syndrom", lipoatrophic diabetes) and other circumscript lipodystrophies. PMID- 3957219 TI - [Chronic tuberculous meningoencephalitis as a cause of cerebrovascular insufficiency--a differential diagnostic problem]. AB - The often complicated diagnosis in the reason of uncertain primary clinical symptoms, in a chronical prolonged tuberculous meningoencephalitis, in correlation with the demonstration of an exemplary case, in the present study is reported. In addition, in this case the morphological and clinical signs are very uncommon also in cause of uncharacteristically and misleadingly clinical symptoms. The findings in computed tomography and finally also the rarely autopsy findings, like tuberculous ventriculitis and vasculitis are presented. The possibilities of different diagnosis will be discussed, in regard to the literature. The present study should be understood as a contribution to a quick and certain diagnose in tuberculous meningoencephalitis. PMID- 3957220 TI - [Current status of brain morphologic and related functional diagnosis in schizophrenic patients]. AB - Validity and interpretation of neuroradiological findings in schizophrenics are still discussed controversially. This applies also to some adjacent functional diagnostic techniques, which could possibly give support to neuroradiology, as post-mortem histopathological examination, electrophysiological recording, and positron-emission tomography. One of the causes for the inconclusive findings could be the patient- and control-group sampling, which is despite standardized diagnoses still heterogeneous in factors determining ventricular size. This heterogeneity applies also to the adjacent functional-diagnostic studies. A prevalence of enlarged ventricules of about 10% in schizophrenics is largely assumed, the measurements within the normal range tending to be somewhat higher than in the control-groups as well. Inconsistently a relation is reported between enlarged CSF-spaces on one side and unfavourable premorbid adjustment, chronic course of the illness, and predominance of negative symptoms on the other side. The CT findings in twin- and family studies stress also the etiological impact of brain morphology on schizophrenia. Size and width of ventricles in schizophrenics seem to be determined genetically as well as environmental. Most recently findings of unusual laterality or blurring of physiological lateral organization in the central nervous system gain growing interest. In this area brain morphological findings are supported and supplemented by electrophysiological and PET-findings. For interpretation most authors at present refer to the hypothesis of 2 subgroups of schizophrenia, with and without dementing factors. The author suggests the view, that there is a common feature in all the heterogeneous and contradictory biological findings: They generally indicate a loss of cerebral organization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957221 TI - [Long-term results following therapy with streptokinase in myocardial infarct]. AB - Long term results of thrombolytic therapy in myocardial infarction are determined primarily by the effects of treatment in the acute phase. Out of a total of 370 patients undergoing recanalization therapy, 170 consecutive patients were examined over a period of one to three years (mean 1.5 years) by means of ECG, exercise testing, thallium myocardial scintigraphy, radionuclide ventriculography, coronary angiography and contrast ventriculography. Frequency of chest pain, left ventricular function, reinfarction rate and mortality were analyzed. The patient cohort was divided into three subgroups: 1. patients with successful PTCR who underwent PTCA or bypass graft surgery; 2. patients with successful PTCR who were managed medically without subsequent reinfarction; 3. patients with definitive occlusion or reinfarction. Mortality in the hospital phase (within 30 days) was 4.9% in patients undergoing successful recanalization procedures as compared to 12.3% for patients with definitive occlusion. Late mortality at 1.5 years was 12.3% and 16.2%, respectively. These figures are similar to those found in the literature. In-hospital mortality is clearly reduced by early recanalization within 200 minutes of occlusion, and there is a reduction in the ultimate extent of infarction as well as improvement in left ventricular function. In order to prevent reocclusion (in 10 to 20% of cases) and reinfarction additional interventions such as PTCA or bypass grafting should be employed as soon as possible in suitable cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957222 TI - Effects of thrombolytic therapy on evolution of left ventricular function in acute myocardial infarction. AB - Use of thrombolytic therapy in the early hours of acute myocardial infarction (AMI) has gained widespread acceptance. One potential benefit of early reperfusion could be improved left ventricular (LV) function. Experimental animal studies have demonstrated that duration of coronary occlusion determines ultimate infarct size and have also raised the issue of reperfusion injury. The evolution of LV function after AMI in man where there is no attempt at early reperfusion is discussed. Studies of LV function following thrombolytic therapy in man have illustrated the following points. Time to successful reperfusion appears to be a critical determinant for potential for LV functional recovery. If reperfusion is achieved within 2.5 hours after onset of symptoms, consistent recovery of function within the infarct zone appears to be possible. With reperfusion from 2.5 to six hours after onset of symptoms, there is no predictable, substantial improvement in either global or regional LV function. Within the framework of this general conclusion, there are three potential exceptions: Successful reperfusion up to six hours after onset of symptoms may prevent infarct expansion. Patients with subtotal occlusion of the infarct vessel prior to therapy in this time period may have more potential for recovery of LV function than those with initial total occlusion. A tight residual stenosis following thrombolytic therapy may mask potential for functional recovery in the infarct zone. Earlier diagnosis and treatment of AMI is one obvious solution for the overall lack of beneficial results on evolution of LV function seen in most studies to date.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957223 TI - Porphyrins in Rotor's syndrome: a study on an Italian family. AB - Porphyrins in urine, plasma, erythrocytes and feces have been tested in two brothers affected by Rotor's syndrome and in three of their phenotypically normal relatives. In all five subjects normal values of delta-aminolevulinic acid and porphobilinogen in urine, and of prophyrins in plasma, erythrocytes and feces, were found. The two patients showed a marked increase in total urinary coproporphyrin excretion with a high percentage of isomer I. These observations confirm the hypothesis of a different route of the porphyrin excretion in Rotor's syndrome with a shift from the fecal route to the urinary one, and do not agree with the suggestion of an increased hepatic porphyrin production in this type of hyperbilirubinemia. PMID- 3957224 TI - Autoantibody to albumin of type G and M in acute and chronic viral hepatitis. AB - Autoantibodies to albumin (AAA) were tested by an ELISA method in patients with A, B and NANB acute and chronic hepatitis, and in a control group. AAA-IgM had a different behaviour in acute hepatitis type A, in which we observed a high average titre as compared with B, and NANB hepatitis, in which we observed a decrease in the average titre. In the chronic phase, we noted a decrement of the average titre in all the types of hepatitis. For AAA-IgG, in the acute phase the average titre in hepatitis A, B and NANB was lower than in the control group. In the chronic stage, only NANB hepatitis showed a decrement of the average titre of the antibody. On the base of these results, we can say that the involvement of AAA seems to be different in hepatitis A from the other two types, in which the decrement of average titre may be explained by the formation of immunocomplexes which are not detected by this test. PMID- 3957225 TI - Influence of long-term injection sclerotherapy on portal venous component of total liver perfusion measured by hepatosplenic radionuclide angiography. AB - In an attempt to establish whether repeated injection sclerotherapy (ST) has any influence on the portal venous fraction of hepatic blood flow, we investigated 8 patients with liver cirrhosis and esophageal varices immediately prior to and six months after ST, using computerized hepatosplenic radionuclide angiography. The mean values of the portal venous fraction of the hepatic blood flow before and after treatment did not differ (20 +/- SD 9% vs. 20 +/- 11%). Eight cirrhotics with esophageal varices who had received no ST served as controls. Also in these patients, the mean values did not change over a period of six months (17 +/- 10% vs. 17 +/- 14%). The mean portal venous fraction of hepatic blood flow was significantly higher (56 +/- 9%, p less than 0.001) in 10 subjects without hepatobiliary disease. The results show that while the portal venous fraction of hepatic blood flow is significantly reduced in patients with liver cirrhosis and esophageal varices, it is not influenced by ST. PMID- 3957226 TI - European Gastro Club. Abstracts of the 17th conference. Erlangen, October 18-19, 1985. PMID- 3957227 TI - Idiopathic fatty liver of pregnancy with a subsequent uncomplicated pregnancy and a progressive increase in serum cholinesterase activity during the third trimester. A case report. AB - We treated a patient with idiopathic fatty liver of pregnancy and a subsequent uncomplicated pregnancy. She experienced general fatigue, nausea, vomiting and jaundice, and renal failure occurred in the third trimester of her first pregnancy. Liver biopsy revealed swollen hepatocytes with microvesicular changes in the cytoplasm. A diagnosis of idiopathic fatty liver of pregnancy was made. Following delivery of a dead fetus, she recovered completely and was discharged on the 30th hospital day. Eighteen months later, she became pregnant again and was delivered of a healthy male baby in the 39th week of gestation. Total bilirubin and transaminase levels were normal, and renal function tests revealed no significant changes during the course of the pregnancy. However, cholinesterase activity increased progressively from the 7th month, thereby suggesting a predisposition to idiopathic fatty liver of pregnancy. PMID- 3957229 TI - Impaired antibody synthesis in patients with chronic hepatitis B infection. AB - In vitro synthesis of the anti-HBc, anti-HBs and polyclonal IgG and IgM classes of antibodies were determined from supernatants of peripheral blood mono-nuclear cells cultured in the presence of pokeweed mitogen. Thirty-seven patients with chronic hepatitis B and 10 healthy control subjects whose sera were positive for anti-HBs formed the study group. Twenty-four of 37 patients showed histologic evidence of chronic active hepatitis B while the remaining 13 patients had chronic persistent hepatitis B. Lymphocytes from chronic persistent hepatitis B, chronic active hepatitis B and healthy controls secreted similar levels of IgM. However, IgG synthesis was markedly impaired (p less than 0.002) in the chronic persistent hepatitis B group as compared with healthy controls or chronic active hepatitis B patients. In vitro anti-HBc production and serum anti-HBc titers correlated directly with hepatocellular inflammation and inversely with serum hepatitis B virus DNA. Anti-HBc synthesis was significantly higher in chronic active hepatitis B patients who exhibited a more pronounced hepatocellular damage when compared to chronic persistent hepatitis B patients who had little or no liver cell injury. PMID- 3957228 TI - Clinical, virologic and histologic outcome following seroconversion from HBeAg to anti-HBe in chronic hepatitis type B. AB - Seventy consecutive HBsAg- and HBeAg-positive patients with biopsy-proven chronic hepatitis were followed prospectively with serial determinations of SGPT levels and hepatitis B virus serum markers including HBsAg, HBeAg, anti-HBe and hepatitis B virus DNA. During a period of 1 to 11 years (mean +/- S.D.: 5.0 +/- 2.3 years), 28 patients remained persistently HBeAg positive, most with continuing biochemical and histologic activity, while 41 cases seroconverted to anti-HBe. One patient became HBeAg and anti-HBe negative. After seroconversion, 87.8% of the cases showed sustained normalization of SGPT, and clearance of hepatitis B virus DNA from serum and histologic improvement was documented in 79% of the cases who had a control liver biopsy, while 15.8% developed cirrhosis. In two patients (4.9%), the disease remained active despite seroconversion, and both cases had evidence of continuing hepatitis B virus replication. Finally, reactivation of liver damage and of hepatitis B virus replication was observed in three additional patients (7.3%) who had transiently normalized SGPT after seroconversion. All 70 patients were analyzed for hepatitis delta virus markers, and only two persistently HBeAg-positive cases were found positive for antibody to hepatitis delta virus in serum, one also having hepatitis delta antigen in the liver. These findings indicate that, in chronic hepatitis type B, termination of virus replication is associated in most patients with biochemical and histologic regression of inflammatory activity. After anti-HBe seroconversion has occurred, virus replication and liver disease may persist or reactivate in a small proportion of patients thus giving origin to the well-recognized group of anti HBe positive, hepatitis B virus DNA-positive chronic hepatitis type B. PMID- 3957230 TI - Detection of pre-S1 proteins in serum and liver of HBsAg-positive patients: a new marker for hepatitis B virus infection. AB - The presence of pre-S1 proteins in serum and liver of individuals with acute and chronic hepatitis B virus infection was investigated in Western blots using antibodies against a fusion protein, containing amino acids 20-120 of the pre-S region. Pre-S1 proteins were present in 20 of 38 HBsAg-positive sera. All sera positive for pre-S1 proteins were also positive for hepatitis B virus DNA indicating the presence of hepatitis B virions, and 16 of these sera were also positive for HBeAg. In five sera positive for hepatitis B virus DNA, pre-S1 proteins were not found. In an additional study, pre-S1 proteins could be detected in 4 of 6 patients with acute hepatitis B virus infection during the first 2 weeks after admission to the hospital. The presence of pre-S1 proteins showed a good correlation with the detection of hepatitis B virus DNA. After seroconversion from HBeAg to anti-HBe, both hepatitis B virus DNA and pre-S1 proteins were no longer detectable. Pre-S1 proteins were present in three liver tissue specimens from two patients with acute hepatitis B virus infection and from one patient with cirrhosis of the liver. The proteins were not found in the liver of two HBsAg-positive patients with hepatocellular carcinoma (primary liver carcinoma), negative for HBeAg. Pre-S1 proteins can be detected in serum, positive for hepatitis B virus DNA and in liver tissue of hepatitis B virus infected individuals. The presence of these proteins appears to correspond with the presence of hepatitis B virus DNA, both markers indicating hepatitis B virus replication. PMID- 3957231 TI - The risk of hepatitis B transmission from health care workers to patients in a hospital setting--a prospective study. AB - A prospective study was designed to determine the risk of hepatitis B transmission from health care deliverers to patients in the hospital setting. Six chronic carriers of hepatitis B were identified: 2 surgeons, 1 dialysis nurse, 1 pediatric ICU nurse, 1 pharmacist and 1 orderly. Three of the six were HBeAg positive. Two of the HBeAG-positive chronic carriers also had circulating hepatitis B virus DNA and accounted for approximately two-thirds of the total patient contacts. Two hundred thirteen patients were exposed 450 times to these six hepatitis B carrier staff without evidence of hepatitis B acquisition over a 6-month follow up. One-hundred nineteen control patients, exposed 789 times to noncarrier health care deliverers, were also negative. Another 33 patients were exposed to three additional individuals who were in the prodrome of acute hepatitis B: an intensive care nurse, a dental hygienist and a medical student. These patients showed no evidence of hepatitis B during 6 months of follow-up, nor did 25 separate control patients. Thus, 246 patients were exposed a total of 483 times to nine health care personnel who had either acute or chronic hepatitis B. No evidence of hepatitis B transmission was found. One-hundred forty-four controls revealed similar results after 814 exposures. Based on the number of exposures to chronic carriers alone, the risk of hepatitis B transmission is estimated to be less than 1%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957232 TI - Sodium excretion in advanced cirrhosis: effect of expansion of central blood volume and suppression of plasma aldosterone. AB - Sodium excretion in 13 patients with decompensated cirrhosis was measured under baseline conditions of water loading (n = 13) and during conditions designed to improve effective blood volume including: head-out water immersion alone (n = 13); norepinephrine infusion alone (n = 6), and combined norepinephrine and head out water immersion (n = 6). All 13 patients were in positive sodium balance under baseline conditions, with a mean plasma aldosterone concentration of 78.7 +/- 15.6 ng per dl. In only four patients was plasma aldosterone less than 50 ng per dl. During head-out water immersion alone, 5 patients achieved negative sodium balance and, in all 5, plasma aldosterone was less than 50 ng per dl (mean = 23.0 +/- 5.3 ng per dl). However, the mean plasma aldosterone during head-out water immersion in the eight patients who remained in positive sodium balance during this maneuver was 64.0 +/- 11.9 ng per dl (p less than 0.01). During norepinephrine alone, positive sodium balance was maintained in all patients, and plasma aldosterone was not significantly different from baseline. Combining norepinephrine and head-out water immersion resulted in the largest and most consistent negative sodium balance. The mean plasma aldosterone concentration was decreased significantly (78.7 +/- 15.6 to 32.6 +/- 9.9 ng per dl (p less than 0.05). Regardless of the maneuver performed, no patient in whom aldosterone exceeded 50 ng per dl achieved negative sodium balance. Furthermore, only in those studies utilizing head-out water immersion, with or without norepinephrine, was negative sodium balance seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957233 TI - Value of ascitic lipids in the differentiation between cirrhotic and malignant ascites. AB - Ascitic fluid concentrations of cholesterol, triglycerides and phospholipids, were compared with ascitic fluid total protein in 40 patients with chronic liver disease, 51 patients with various neoplasms and 1 patient with cardiac failure. Seven patients with both chronic liver disease and malignancy were considered separately. The first 54 patients (23 cirrhotic and 31 with malignancy) were used to determine median values and ranges and to define the most suitable cutoff concentrations between both groups. Median values for cholesterol (75 mg per dl), phospholipids 0.79 mmole per liter), triglycerides (75 mg per dl) and protein (3.8 gm per dl) were higher in malignant ascites compared to ascitic fluid concentrations of cholesterol (20 mg per dl), phospholipids (0.33 mmole per liter), triglycerides (51 mg per dl) and protein (1.9 gm per dl) in patients with cirrhosis. The best discrimination values were 48 mg per dl for cholesterol, 0.6 mmole per liter for phospholipids, 65 mg per dl for triglycerides and 2.5 gm per dl for protein. Application of these cutoff points to 38 subsequent patients (17 cirrhotic, 1 with cardiac failure and 20 with malignancy) revealed an efficiency of 86.8% for cholesterol, 86.8% for phospholipids, 68.4% for triglycerides and 79.0% for protein. From the data of all 92 patients, an efficiency of 92.3% for cholesterol, 79.4% for phospholipids, 72.8% for triglycerides and 79.4% for protein was calculated. We conclude that ascitic fluid cholesterol determination offers an excellent, cost-effective discrimination of ascites due to cirrhosis vs. ascites caused by malignancies. PMID- 3957234 TI - Hepatorenal syndrome without avid sodium retention. AB - A urinary sodium concentration [U(Na)] of less than 10 mmoles per liter is considered important in differentiating hepatorenal syndrome from other causes of progressive renal impairment in patients with liver disease. However, occasionally, patients with hepatorenal syndrome have been recognized in whom the U(Na) is consistently greater than 10 mmoles per liter. Eight such patients, in all of whom there was no clinical or laboratory evidence to implicate other causes of progressive renal impairment, were identified. The clinical features, hepatic and renal status and hospital course were compared with eight other patients who had hepatorenal syndrome and a U(Na) consistently less than 10 mmoles per liter. The mean U(Na) was 24 +/- 4 mmoles per liter in the high U(Na) group and 3.7 +/- 1.8 mmoles per liter in the low U(Na) group. All patients in both groups had acutely decompensated alcoholic hepatitis of similar severity and activity. The high U(Na) group had significantly less clinical ascites and peripheral edema and higher serum levels of sodium and chloride both at the onset of the hepatorenal syndrome and throughout the clinical course. Significant differences in the serum potassium and blood urea nitrogen levels became apparent between the two groups of patients as renal failure progressed, and the mean average blood urea nitrogen to serum creatinine ratio was significantly higher (p less than 0.025) in the low U(Na) group (13.8 +/- 0.9 vs. 10.1 +/- 1.1). Mean urinary potassium concentration was significantly higher in the high U(Na) patients but urinary creatinine concentrations, specific gravity and sediment were similar in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957235 TI - Elevated serum aminotransferase induced by isoniazid in relation to isoniazid acetylator phenotype. AB - Of 143 patients with pulmonary tuberculosis receiving isoniazid therapy, 52 (36%) had a transient elevation in serum aminotransferases. Among 74 patients taking isoniazid, rifampicin and streptomycin, 35 (47%) had such an increase, while of 69 patients taking isoniazid, amino-salicylic acid and streptomycin, 17 (24%) did; this difference was significant. Isoniazid therapy could be continued in all patients with the abnormal test results. In 36 of the patients receiving isoniazid, rifampicin and streptomycin, isoniazid and its metabolites were studied in the serum and urine using high-performance liquid chromatography after the oral administration of 10 mg per kg of isoniazid. We had chosen for this test 18 patients with normal aminotransferase levels and 18 with abnormal levels. There were 14 rapid acetylators in the patients with abnormal aminotransferase levels and 7 rapid acetylators in the patients with normal levels; this difference was significant. These results indicate that liver dysfunction is more often caused by an isoniazid/rifampicin regimen, and patients who are rapid acetylators are more susceptible. PMID- 3957236 TI - Ultrastructure of experimental cocaine hepatotoxicity. AB - Cocaine is a potent hepatotoxin in mice. It is converted in the liver by a minor oxidative pathway to the active metabolite, norcocaine nitroxide. Previous studies have shown evidence of a lipid peroxidative mechanism of toxicity, including increased conjugated diene absorption by hepatic microsomal lipids following a single 60 mg per kg i.p. dose of cocaine in DBA/2Ha mice. To explore this mechanism further, morphologic changes in the livers of DBA/2Ha mice were examined following the same dose of cocaine. The first ultrastructural change seen was dilatation of rough endoplasmic reticulum in centrilobular hepatocytes 1 hr following cocaine injection, coincident with the previously observed onset of increased conjugated diene absorption in microsomal lipids. During the previously observed period of peak conjugated diene absorption (2 to 4 hr), ultrastructural changes in centrilobular hepatocytes progressed. These included focal mitochondrial membrane disruption followed by more extensive mitochondrial swelling and disruption with increased swelling of rough endoplasmic reticulum. Changes in size, shape and concentration of histochemically labeled, morphometrically studied peroxisomes were also seen during this interval. Injury of centrilobular hepatocytes advanced to cell death in 6 to 8 hr. The time course and nature of these morphologic findings correlate with previously observed evidence of lipid peroxidation, supporting the hypothesis that this is the mechanism of cocaine hepatoxicity. PMID- 3957237 TI - Pericanalicular location of hepatocyte lysosomes and effects of fasting: a morphometric analysis. AB - Lysosomes constitute a small proportion of hepatocyte volume, but they play a key degradative role, particularly during catabolic states such as nutritional deprivation. Our preliminary observations in hepatocytes suggested that fasting may alter the distribution of lysosomes, which are thought to congregate about the biliary canaliculus. The current study aimed to provide, in both fed and fasted rats, a quantitative morphometric analysis of lysosomes in the immediate pericanalicular and successively more distant regions. We selected three regions of radius 0 to 2 (region 1), 2 to 4 (region 2) and 4 to 6 micron (region 3) about the bile canaliculus and compared lysosomal numerical and volume densities. In fed rats, numerical and volume densities of both primary and secondary lysosomes were 5 to 10 times greater in region 1 than in region 3. After a 72-hr fast, this gradient was lost due largely to a reduced number of primary and secondary lysosomes in region 1. Our calculations suggest that during fasting, lysosomes are redistributed away from the bile canaliculus towards the more distant cytoplasm rather than being lost from the cell, for example, into bile. The number of overt macroautophagic vacuoles was not altered by fasting. We estimate that, in fed rats, there are approximately 270 lysosomes per hepatocyte, and that 43% of lysosomes are contained in the immediate pericanalicular region 1, which comprises only 7 to 8% of the cytoplasmic volume. The reason for this pericanalicular concentration of lysosomes and the mechanism of the redistribution with fasting remain to be determined. PMID- 3957238 TI - The sodium retention of cirrhosis: a reappraisal. PMID- 3957240 TI - Type III procollagen: its use in the detection of hepatic fibrosis. PMID- 3957239 TI - Hepatic drug metabolism in the elderly. PMID- 3957241 TI - Detection of hepatitis B virus DNA levels in predicting the chronicity of acute viral hepatitis, type B. PMID- 3957242 TI - Hepatic uptake of propranolol. PMID- 3957243 TI - Changing views on chronic hepatitis. AB - The histological classification of chronic hepatitis is reviewed. The relative importance of piecemeal necrosis and of lobular necrosis in the progression to cirrhosis is assessed. Recent advances in virological and serological aspects of acute hepatitis are outlined and the importance of concomitant infection with more than one virus is discussed. The pathologist cannot assess prognosis on a histological basis alone without other clinical and serological information. PMID- 3957244 TI - Differentiation towards cartilage and bone in a primary tumour of pleura. Further evidence in support of the concept of mesodermoma. AB - A case of primary pleural malignant tumour is reported and its histological features described including histogenetic factors. The histological pattern was predominantly and typically biphasic (both epithelial and sarcomatous) with foci of sarcomatous cartilaginous differentiation and osteoid formation reproducing an embryonal pattern of enchondral ossification. This provides supportive evidence for the use of the term 'mesodermoma' to identify primary tumours of serous membranes and to the concept of identification of mesothelium with embryonal mesoderm. PMID- 3957245 TI - Dendritic cells in the dermal infiltrate of Sezary syndrome. AB - The dermal infiltrates of four patients with the Sezary syndrome were studied by electron microscopy and the data were evaluated quantitatively. The nuclear contour index of lymphocytes was calculated, and many tumour cells had an index greater than 6.5. Dendritic cells were found in all cases. The dendritic cells contained smooth and rough endoplasmic reticulum, moderately well-developed Golgi apparatus, scanty lysosomes and many thin and intermediate filaments; their surface was scalloped with numerous vesicles. Birbeck granules were not found in the cytoplasm of dendritic cells. Dendritic cells comprised 24% of infiltrating cells and were interspersed with lymphocytes; 75% of the lymphocytes were in contact with dendritic cells; 35% of the lymphocytes in contact with dendritic cells had a nuclear contour index higher than 6.5 and 76% had a nuclear contour index higher than 5. The data strongly suggest a functional relationship between lymphocytes and dendritic cells in the dermal infiltrate of Sezary syndrome. They are discussed in relation to the hypothesis that the disease is a consequence of chronic immune stimulation. PMID- 3957246 TI - Misplaced epithelium in ulcerative colitis and Crohn's disease of the colon and its relationship to malignant mucosal changes. AB - The presence of misplaced mucosal epithelium was studied in the colectomy specimens from 30 patients with Crohn's disease, 30 patients with ulcerative colitis, 15 patients with ulcerative colitis complicated by carcinoma and 30 patients with non-colitic colorectal carcinoma. Misplaced epithelium was present in 21 (70%) of the resection specimens with Crohn's disease, 20 (66.7%) with ulcerative colitis and 12 (80%) with ulcerative colitis complicated by carcinoma. None of the specimens with non-colitic colorectal adenocarcinoma showed misplaced foci of epithelium. Two pathogenetic mechanisms for epithelial misplacement are proposed: (1) the effects of mucosal inflammation and repair; and (2) muscular abnormalities in inflammatory bowel disease. The proposed mechanisms and patterns of epithelial misplacement are discussed and illustrated. The importance of its recognition is emphasized because, when associated with mucosal dysplasia, difficulties in interpretation arise in distinguishing it from 'early' invasive adenocarcinoma. Epithelial misplacement is common in patients with longstanding ulcerative colitis and may be a factor in increasing the significance of pre existing mucosal dysplasia and promoting the development of adenocarcinoma. This may explain the unusual growth pattern encountered in ulcerative colitis, of submucosal cancer underlying a flat, non-dysplastic mucosa. PMID- 3957247 TI - Fibrinogen inclusions in liver cells: a new type of ground-glass hepatocyte. Immune light and electron microscopic characterization. AB - A new type of ground-glass hepatocyte is described. The appearance is due to pale, homogeneous, weakly eosinophilic inclusions filling a portion of or the entire hepatocytic cytoplasm. On haematoyxlin and eosin stained sections, these cells closely resemble ground-glass hepatocytes described in other conditions. However, they are negative on special stains for HBsAg and on PAS staining. Immunohistochemically, they reveal a selective and exclusive positivity for fibrinogen. On electron microscopy, the immunoreactive fibrinogen appears as amorphous, fluffy or granular material within dilated cisternae of the rough endoplasmic reticulum. This finding suggests intracellular storage possibly reflecting a defective intracellular transport of fibrinogen. PMID- 3957249 TI - Adenolipoma of the thyroid gland. AB - A case of rare fat-cell-containing adenoma, an adenolipoma, in the thyroid gland is reported. Previously documented cases are reviewed. Diffuse lipomatosis of the thyroid, amyloid goitre with adipose tissue, and the relationship between lipomatosis and adenolipoma are discussed. PMID- 3957248 TI - Clear-cell carcinomas of thyroid gland: a clinicopathological study of 13 cases. AB - Thirteen primary thyroid clear-cell carcinomas and eight thyroid metastases of renal carcinomas are described. A broad variety of features is shown to be responsible for this follicle cell phenotype, some of which also occur in renal carcinomas. In biopsy specimens these two conditions can only be distinguished by immunohistochemistry. Clinical follow-up disclosed that in the papillary and follicular categories of thyroid cancer the biological behaviour of clear-cell tumours exhibits no significant difference to their non clear-cell counterparts. In the case of eight follicle cell carcinomas, various samples were available for study. These revealed some striking variations in histology at different stages, and even during the same stage, of disease. Both reversal of clear cell change and transitions towards other kinds of metaplasia occurred. Morever, maintenance of follicle cell function was documented in several of these lesions by estimations of serum thyroglobulin levels and radioiodine scans. On the basis of these findings the concept of regarding the clear-cell variant as a distinct subtype of thyroid cancer is refuted. Previous statements on the causal mechanism of clear-cell change are discussed and it is suggested that metaplastic transformation accounts for this phenomenon in at least some instances of this heterogeneous condition. PMID- 3957250 TI - Papillary carcinoma of the thyroid gland with lipomatous stroma: report of a peculiar histological type of thyroid tumour. AB - The author reports a case of a 53-year-old woman with a slowly growing thyroid papillary carcinoma. Microscopically the presence of adult adipose tissue was detected in numerous papillae. The recognition of this histological type as a new variety of papillary carcinoma is proposed. PMID- 3957251 TI - Prevalence and morphological features of adenomas of the large intestine in individuals with and without colorectal carcinoma. AB - The presence of adenomas in 164 surgical specimens of the large intestine from 81 males and 83 females with colorectal carcinomas was compared with the presence of adenomas in a general necropsy population in northern Norway. In the group of patients with colorectal carcinomas the observed prevalence of single or multiple adenomas was 5.9 times higher than expected from the prevalence in the general necropsy population. The observed-to-expected ratios of all adenomas (4.7), adenomas with villous elements (4.6), adenomas with moderate or severe grades of dysplasia (4.9) and adenomas 10 mm or larger (5.5) were also higher in the surgical series. The study indicates that factors which initiate the growth of adenomas and, to a minor degree, factors which promote the growth of adenomas to a large size are more prevalent in individuals with colorectal carcinoma than in the necropsy population. Factors determining the presence of villous elements and the grades of dysplasia of adenomas seem to operate similarly in adenoma-bearing patients with and without colorectal carcinoma. PMID- 3957252 TI - Soft tissue chondroma--a study of 15 tumours. AB - Fifteen cases of soft tissue chondroma have been reviewed. This lesion shows an equal sex incidence and occurs predominantly in middle-aged individuals. The majority arise in the hands and feet. Histologically these tumours are largely composed of adult-type hyaline cartilage, but in all cases foci show nuclear atypia and pleomorphism. In cartilaginous lesions of the axial skeleton or large limb bones this would probably have led to a diagnosis of well differentiated chondrosarcoma. Despite these worrying features none of the seven cases for which follow-up information is available recurred. The importance of recognizing the benign nature of these little-known tumours is stressed. The differential diagnosis of soft tissue cartilaginous tumours is briefly discussed. PMID- 3957253 TI - Melanocyte colonization of adenocarcinoma arising in an ovarian dermoid. AB - An adenocarcinoma which arose in a dermoid cyst of the ovary displayed areas of melanocyte colonization and pigmentation. Ultrastructural study revealed the presence of epithelial tumour cells and melanocytes; many tumour cells contained compound melanosomes, but not premelanosomes, suggesting transfer of melanin from melanocytes to tumour cells. Melanocyte colonization of malignant tumours is a curious phenomenon the significance of which remains to be elucidated. PMID- 3957254 TI - Operation-associated neutrophils in a percutaneous liver biopsy: effect of prior transjugular procedure. AB - A young man with chronic active hepatitis was heavily sedated during an attempted transjugular liver biopsy. The procedure was abandoned after 3 h and an immediate percutaneous liver biopsy was performed. This showed features of chronic active hepatitis but, in addition, groups of polymorphonuclear leukocytes in the parenchyma. These were similar to the operation associated neutrophils encountered in liver biopsies taken during the course of abdominal surgery. In a review of 78 liver biopsies from patients with chronic active hepatitis, this type of infiltrate was seen in four of eight surgically resected specimens but not in 70 percutaneous biopsies. The neutrophilic infiltrate in the present case appears to be an unique occurrence in a percutaneous liver biopsy. It was probably related to hypoperfusion during the preceding prolonged sedation and illustrates the ease with which an already diseased liver can be further damaged. PMID- 3957256 TI - Resting cortisol levels and the emergence of dominant status among male vervet monkeys. AB - Resting serum cortisol was measured in adult male vervet monkeys (Cercopithicus aethiops sabaeus) in four different conditions: (1) among groups with unaltered group membership and established dominance hierarchies; (2) among groups from which the original dominant male had been removed and in which the remaining males competed for dominant status; (3) among newly formed groups of three unfamiliar males each of which had been the dominant male in his previous group; and (4) among groups from which a dominant male was temporarily separated and returned. In Condition 1, cortisol concentrations did not differ between dominant and subordinate males. The second condition showed that cortisol levels were highest among males who eventually emerged as the dominant male. In the third condition, however, cortisol levels did not differentiate eventually dominant from eventually subordinate males. In the last condition, cortisol levels were highest in the animals that became or remained dominant following reintroduction. These data indicate that cortisol concentration does not differ between dominant and subordinate males in stable groups and that cortisol rises during competition for dominance among familiar males. PMID- 3957255 TI - The effect of hormonal condition on dose-dependent amphetamine-stimulated behaviors in the male rat. AB - The effects of varying doses (1.25, 2.5, and 5.0 mg/kg, ip) of D-amphetamine sulfate (AMPH) on eight individual behaviors (Rearing, Grooming, Sniffing, Stationary, Gnawing, Head Bobbing, "Sleeping," and Licking) of Castrate + Oil treated, Castrate + Testosterone Propionate (TP)-treated, and Intact male rats were examined. For Stationary, Sniffing, and "Sleeping" at 1.25 mg/kg AMPH and Rearing and Sniffing at the 2.5 mg/kg dose a significantly greater duration in the behavioral score was obtained for Castrate + Oil versus Castrate + TP and Intact males. These results indicate the complexity of the AMPH dose-response effects upon measurable behaviors, the alteration in the duration of these effects as a function of the hormonal condition of the male rat, and the importance of examining discrete components of behavior when hormone-amphetamine interactions are examined. PMID- 3957257 TI - Accessory olfactory bulb lesions and lordosis behavior in the male rat feminized with ovarian hormones. AB - Orchidectomized rats were given estrogen and progesterone and tested for feminine behavior in the presence of a mounting male after accessory olfactory bulb removal (AOBR). Complete AOBR caused a rise in the number of estrogen progesterone-treated male rats responding by lordosis behavior to male mounts as compared to controls and sham-operated animals. By contrast, LQ scores did not appear to differ in these three groups of animals. The results are discussed in terms of involvement of the main and the accessory olfactory systems in the regulation of feminine behavior in the male rat. PMID- 3957258 TI - Diurnal variations of sexual receptivity in the female Japanese quail (Coturnix coturnix japonica). AB - A series of experiments was performed to study the changes during the day of female receptivity in Japanese quail. In each experiment, the frequency of squatting and the percentage of male approaches which were followed by squatting increased at the end of the day, approximately 11 to 13 hr after lights on (in a photoperiod of 16L:8D). In some cases this increased receptivity was associated with a significant decrease of the long-avoid frequency. Analyses are presented which demonstrate that the increased receptivity at the end of the day is not directly caused by the oviposition and does not result directly from changes in the behavior of the male stimuli. This is strongly supported by the observation that the increase in receptivity was observed at the same time after lights on (but different clock times) in two groups of females which were raised in two different photoperiods shifted by 6 hr and tested with the same group of males raised in one of the two photoperiods. The increase in receptivity coincides with an increase in plasma estradiol and progesterone. Considering that this behavior is suppressed by ovariectomy, it is argued that the daily changes in receptivity could be controlled by the hormonal changes associated with the ovulatory cycle. PMID- 3957259 TI - Prolactin induces yawning and the stretch-yawning syndrome in young adult male rats. AB - Herein we report that subcutaneous injection of low doses of ovine prolactin (oPRL) induce yawning in young adult male rats. The most effective dose of oPRL in evoking yawning was 0.25 microgram/kg body weight (5.2 yawns/60 min at 1000 hr vs 0.3 in control animals). Doses of 0.025, 0.05, 2.5, 25, and 250 micrograms/kg were less effective. Interestingly, yawning in response to oPRL changes over the course of one circadian cycle with highest frequency at 1600 hr (11 yawns/80 min vs 2 yawns/80 min in animals injected with boiled oPRL). The onset of yawning in most oPRL-treated rats began approximately 40 min after oPRL injection, whereas with apomorphine the latency to the response was about 10 min. These results indicate that oPRL in addition to other hypophysial peptides such as ACTH and MSH can stimulate yawning. It is proposed that PRL after initial activation of the nigrostriatal dopamine system secondarily induces yawning by inhibition of this system via an autoreceptor-mediated negative feedback mechanism. This may explain the long latency to the response. PMID- 3957260 TI - Hormonal regulation of chemosignals of female mice that elicit ultrasonic vocalizations from males. AB - Two experiments examined the properties of vaginal, facial, salivary, and urinary odors from female house mice to elicit ultrasonic vocalizations from male mice. Experiment 1 demonstrated that facial and salivary secretions from hypophysectomized females were significantly less effective in eliciting ultrasonic vocalizations from male mice than were these same secretions from either intact or ovariectomized females. Thus the hormonal control of chemosignals from these two sources paralleled earlier findings of pituitary rather than ovarian regulation of the urinary chemosignal that elicits ultrasounds. In contrast, ovariectomy and hypophysectomy seemed to have similar depressive effects upon the vaginal cue that elicits ultrasounds. Experiment 2 demonstrated that long-term ovariectomy (8 or 9 months) diminished the effectiveness of female saliva, but not urine, to elicit vocalizations. The apparent dissociation of the hormonal regulation of salivary, vaginal, and urinary chemosignals suggests that multiple chemosignals may possess the property of eliciting male vocalizations. PMID- 3957261 TI - Intrauterine contiguity influences regulatory activity in adult female and male mice. AB - Female mice located in utero between two female fetuses exhibited higher levels of locomotor activity in adulthood than did females located between two male fetuses. Male mice, which were less active than females, also were influenced by intrauterine contiguity. Males located in utero between two female fetuses were more active than males which resided between two male fetuses. These results indicate that intrauterine position influences behaviors involved in the maintenance of metabolic homeostasis. PMID- 3957262 TI - Lordotic behavior in male rats: genetic and hormonal regulation of sexual differentiation. AB - The male offspring of Long-Evans rats treated with the aromatization inhibitor ATD (1,4,6-androstatriene-3,17-dione) during pregnancy show high levels of lordotic behavior when treated with estrogen and progesterone in adulthood. The male offspring of Sprague-Dawley dams treated in the same way show only a slight facilitation of lordotic potential. These strain differences could reflect strain differences in gestation length and therefore differences in the timing of the sensitive period of sexual differentiation; they could reflect differences in the sensitivity to the defeminizing actions of gonadal hormones; or they could reflect differences in the sensitivity to ATD treatment. We therefore directly compared the effects of prenatal and early postnatal treatment with ATD on the potential of male Long-Evans and Sprague-Dawley rats to show lordosis when given estrogen and progesterone in adulthood. In both strains ATD treatment facilitated adult lordotic behavior. Treatment appeared to have a greater effect in the Long Evans strain. However, control Long-Evans males were substantially more responsive to hormone treatment in adulthood than were Sprague-Dawley males. In the Long-Evans strain short-term ATD treatment (Days 20-23 of pregnancy) was as effective as long-term treatment (Days 10-23). In the Sprague-Dawley strain, ATD treatment was most effective when given prenatally and postnatally. Strain differences in hormonal sensitivity best account for the present findings. PMID- 3957263 TI - Lack of gonadal control of the dorsal gland and sandbathing in male and female bannertail kangaroo rats, (Dipodomys spectabilis). AB - Previous studies have demonstrated gonadal control of mammalian scent glands; castration leads to reduced scent-marking rates and smaller gland sizes. I investigated whether gonadal hormones control the size of the dorsal gland (a specialized sebaceous gland) and sandbathing as a scent-marking behavior in adult male and female bannertail kangaroo rats (Dipodomys spectabilis). Gland sizes of males and females were similar in all age classes, except adult males with larger body weights had proportionately larger glands than females. Male gland sizes declined 18% following castration but were not significantly smaller than those of intact males; females showed no change in dorsal gland size either as a result of ovariectomy or after estradiol benzoate implants. Sandbathing rates also did not decline as a result of gonadectomy. Rather, castrated males and overiectomized females sandbathed at higher frequencies than intact males and ovariectomized females with estradiol benzoate implants, respectively. Gonadal hormones apparently have little influence on the function of a specialized scent gland and may inhibit sandbathing as a scent-marking behavior in adult D. spectabilis. PMID- 3957264 TI - Self-help: the wave of the future. PMID- 3957265 TI - The psychiatric short procedure unit: a cost-saving innovation. AB - Dr. Sharfstein's Introduction: As the rules of reimbursement are being rewritten, it is important that psychiatrists create clinical innovations that make sense from both an economic and a quality-of-care perspective. The psychiatric short procedure unit is such an innovation. As described by the authors of this month's column, it also conceptualizes a new role for the psychiatric emergency service. The short procedure unit not only provides relief for the financial troubles of the psychiatric emergency service but also promises to be a cost-effective option to 24-hour inpatient hospital care. PMID- 3957266 TI - Adult children of alcoholics. PMID- 3957267 TI - Stress-response syndromes: a review of posttraumatic and adjustment disorders. AB - The signs and symptoms of response to a stressful life event are expressed in two predominant phases: the intrusive state, characterized by unbidden ideas and feelings and even compulsive actions, and the denial state, characterized by emotional numbing and constriction of ideation. In this review of stress-response syndromes, the author outlines those phases, discusses the DSM-III diagnoses for stress-response disorders, and considers the mutual etiologic effects of stressful life events, psychiatric disorders, and preexisting conflicts or functional deficits. Guidelines for brief dynamic psychotherapy for patients who need more than transient support are presented. PMID- 3957268 TI - Assessing the family environment of schizophrenic patients with multiple hospital admissions. AB - The authors compared the responses on the Family Environment Scale of 12 schizophrenic inpatients who had been hospitalized more than three times in the previous 12 months and a control group of 12 similarly diagnosed inpatients who had been admitted less frequently. Responses of the patients' families were also computed. Patients who were admitted more often reported greater family conflict and less freedom to express emotions. Family responses revealed significantly more incongruity among family members of the more frequently hospitalized patients than among those of the control group. The authors suggest that studies be conducted to determine if the data obtained by the scale are analogous to data on expressed emotion obtained by the more complex Camberwell Family Interview; if so, the Family Environment Scale could be an alternative to the Camberwell Family Interview in studies of schizophrenic patients and their families. PMID- 3957269 TI - A survey of the California Alliance for the Mentally Ill. AB - Family groups are becoming increasingly active in providing support to family members and in mental health advocacy. The authors report the results of a survey that assessed the concerns of members of the California Alliance for the Mentally Ill and the treatment history of disabled family members. The 199 respondents were typically the parents of a schizophrenic son between the ages of 24 and 34 whose illness was first noticed in the late teens and for whom assistance had been sought for at least a decade. The respondents indicated that medication, family support, socialization centers, community residential treatment, and locked facilities had most helped the family member to improve. The most important additional needs were housing, vocational, and social opportunities and research. PMID- 3957270 TI - A statistical method for determining suitability for community placement. AB - The authors developed a statistically based method for determining whether inpatient or outpatient placement is most appropriate for a given patient. This study assesses the method's accuracy by comparing statistical classifications of a random sample of inpatients at five New York State facilities with the classifications of multidisciplinary clinical teams. The statistical method proved to be very strong in screening patients who should not be considered for community placement and in four of the five facilities was also strong in identifying appropriate outpatients. The authors discuss the method's implications for outpatient screening and outpatient programs. PMID- 3957271 TI - Young adult chronic patients: visibility and style of interaction in treatment. AB - To explore the concept of the young adult chronic patient as a distinct clinical entity, the author analyzed a sample of 134 chronic patients on six variables relating to style of interaction with service providers and on diagnostic and demographic variables. The results showed that the 105 younger chronic patients in the sample were more likely than the older patients to be male, to be referred to treatment for suicidal and homicidal gestures and ideation, to have a diagnosis of personality disorder, and to be overrepresented in the treatment population. The author believes the combination of these factors helps create disproportionately high visibility for young adult chronic patients and requires special provisions for their engagement in treatment. PMID- 3957272 TI - Chronic mental patients in nursing homes: reexamining data from the National Nursing Home Survey. AB - A reanalysis of data from the 1977 National Nursing Home Survey, including data not available earlier, led to an estimate that 668,000 chronic mentally ill patients reside in nursing homes. Several subpopulations of nursing home residents were also identified and compared, which showed, for instance, that residents with only mental disorders were younger, were less likely to need the help of another person in daily activities, and were much less likely to be totally dependent than residents with only physical disorders. However, not surprisingly, mentally ill residents were more likely to have behavior problems and to have much longer stays. Residents diagnosed as senile, with or without a physical disorder, more closely resembled the purely physically ill than the purely mentally ill patients. The data illustrate the wide range of needs of mentally ill nursing home residents and reinforce the importance of assessing and improving the appropriateness of care offered. PMID- 3957273 TI - Small group work therapy for the chronic mentally ill. AB - In 1980 the authors reviewed the records of the first 130 patients to enter small group work therapy, a program begun in 1964 by Arkansas State Hospital and Arkansas Rehabilitation Services in which chronic schizophrenic patients live in group homes and work in Hot Springs. Forty-five of the original patients were still in the program in 1980. Although the patients had been hospitalized for an average of 11 years, they spent an average of seven years in the program, during which time their hospital utilization dropped significantly. Forty-two were discharged to settings offering greater independence. The authors focus on the role of a rehabilitative unit of Arkansas State Hospital known as the HIP unit, which, until it was closed in 1976, prepared patients to live and work with each other before entering small group work therapy. PMID- 3957274 TI - Treatment, care, and rehabilitation of the chronic mentally ill in the U.S.S.R. AB - The U.S.S.R. has established a graduated, differentiated system of psychiatric care based on psychoneurological dispensaries--a type of outpatient clinic--that are linked to mental hospitals or regular district (general) hospitals. Treatment is based on a system of active, ongoing study and follow-up care that permits timely intervention when the patient's condition or circumstances warrant it. Under the dispensary system no more than 8 percent of patients receiving psychiatric care are hospitalized at any one time. Programs of partial hospitalization, including sheltered workshops, day hospitals, and night hospitals, also are heavily used. Significant numbers of schizophrenic and other psychotic patients are being effectively treated in the day hospitals. PMID- 3957276 TI - Treating a severely disturbed self-destructive adolescent with cold wet sheet packs. PMID- 3957275 TI - A survey of homeless adults in urban emergency shelters. AB - Following a review of several studies of homeless populations, the authors describe a survey of 68 homeless adults in eight urban emergency shelters in Hennepin County, Minnesota. The results indicated impressive rates of mental illness, alcoholism, minor criminality, and chronic medical and dental problems. More significant, the authors believe, both for the homeless and for public policy planners, is that a majority of the interviewees were disconnected from supportive social networks and were underutilizing medical and welfare programs for which they were eligible. Almost 40 percent of those with chronic health problems were receiving no medical care, and only 6 percent were receiving mental health services, although more than 50 percent needed such care. The authors compare the findings with those of studies discussed in the literature review. PMID- 3957277 TI - Chronic medical problems in the chronic mentally ill. PMID- 3957278 TI - Patients' rights. PMID- 3957279 TI - Drugs in nursing homes. PMID- 3957281 TI - The underinsured: how much do we care? PMID- 3957280 TI - Destigmatizing hospitalization. PMID- 3957282 TI - ProPAC weakened by concern over federal deficit. PMID- 3957283 TI - Proposal to end vendors' recurring nightmare. PMID- 3957284 TI - HHS list useless, hospitals charge. PMID- 3957285 TI - Are distress sales causing price declines? PMID- 3957286 TI - Employers applaud AHA's indigent care plans. PMID- 3957287 TI - Group practice: what's the attraction? PMID- 3957288 TI - Durenberger tax proposal draws mixed reactions. PMID- 3957289 TI - Hospital could sell taxable bonds--under right terms. PMID- 3957290 TI - Assessments, risk pools favored for indigent care. PMID- 3957291 TI - Not-for-profits top trustee study. PMID- 3957292 TI - Consumer gripes about hospital services drop. PMID- 3957293 TI - Rural hospitals study the market. PMID- 3957295 TI - Physicians' input on purchasing is increasing. PMID- 3957294 TI - Coalition proposal threatens HMO Act. PMID- 3957296 TI - Day hospitals help to bridge inpatient, outpatient care. PMID- 3957298 TI - CEOs hone in on major purchasing decisions. PMID- 3957297 TI - Uncompensated care: solutions lag, problem grows. Interview by Pamela Taulbee. PMID- 3957299 TI - Early retirement: a pleasant way to downsize. PMID- 3957300 TI - Closings continue to hit smaller hospitals. PMID- 3957301 TI - Military hospitals see new chance in quality reviews. PMID- 3957302 TI - Patients pay for residency programs. PMID- 3957303 TI - The increasing health care cost of freedom. PMID- 3957304 TI - Brooklyn hospital reaches out to local immigrants. PMID- 3957306 TI - Murders get the press, but theft is the problem. PMID- 3957305 TI - Cocaine infants: a new arrival at hospitals' step? PMID- 3957307 TI - Survey plots CEOs' plans re laundries of large hospitals. PMID- 3957308 TI - Teamwork: the key to information systems success. PMID- 3957309 TI - Hospitals gear up for onslaught of data requests. PMID- 3957310 TI - Board issue rages in West Virginia. PMID- 3957311 TI - Clustering services? Consider antitrust laws. PMID- 3957312 TI - Portfolio reoptimization improves cash flow. PMID- 3957314 TI - Bond insurance, letters of credit used more in '85. PMID- 3957313 TI - Taxable bonds spell big trouble. PMID- 3957315 TI - Direct marketing prompts response, results. PMID- 3957316 TI - Hotels: a new hospital product. PMID- 3957317 TI - Prepaids' use of home health services booming. PMID- 3957318 TI - HMOs' grasp on drug benefits is getting stronger. PMID- 3957319 TI - Dean advocates alternate-site medical training. PMID- 3957320 TI - Hospitals wake up to sleep-disorders clinics. PMID- 3957323 TI - Organ request laws: high marks, high hopes. PMID- 3957322 TI - Hospitals learn key marketing lessons from banks. Interview by Emily Friedman. PMID- 3957321 TI - Hernia surgery makes its move to outpatient settings. PMID- 3957324 TI - PCs top hospitals' choice for cost accounting. PMID- 3957325 TI - State malpractice laws prove valuable. PMID- 3957326 TI - Hybrid policies generate interest. PMID- 3957327 TI - Hepatitis B virus and sex ratio of offspring in East Greenland. PMID- 3957328 TI - Time course of skin-plus-fat compression in males and females. PMID- 3957329 TI - Dental occlusal variation among rural and urban Bengali youths. PMID- 3957330 TI - Selective forces and the maintenance of immunoglobulin polymorphisms. PMID- 3957331 TI - An analysis of the geographical distribution of selected British surnames. PMID- 3957332 TI - Opportunity for natural selection in the Utah Mormons. PMID- 3957333 TI - Mitochondrial traffic problems. PMID- 3957334 TI - Margins of "lumpectomy" for breast cancer. PMID- 3957335 TI - Prognostic factors in squamous cell carcinoma of the lower lip. AB - One hundred eighty-seven squamous cell carcinomas of the lower lip were examined microscopically to identify parameters that might predict metastasis and patient outcome. Excision specimens of 157 nonmetastasizing carcinomas (group I) were compared with specimens from 30 tumors that had metastasized (group II). The following features were recorded: architectural pattern; microscopic thickness (mm); cytologic grade; presence of muscle, nerve, or vessel invasion; inflammatory response; and mitotic rate. The mean thickness was 2.5 mm for group I tumors and 7.5 mm for group II tumors. Seventy-six per cent of the group I tumors were 3 mm thick or less, whereas only one group II lesion (3 per cent) was less than 3 mm thick. Five per cent of the group I neoplasms, compared with 77 per cent of the group II tumors, were at least 6 mm thick. Perineural invasion was seen in 5 per cent of the group I and 41 per cent of the group II lesions. Three per cent of the group I carcinomas had a dispersed pattern, compared with 57 per cent of those in group II. One group I lesion (0.6 per cent) and 37 per cent of the group II tumors were grade 4. Each of these differences was statistically significant (P less than 0.0001). For all lesions studied, metastases had occurred in 60 per cent with perineural invasion, 74 per cent measuring 6 mm or more, 77 per cent with a dispersed pattern, and 92 per cent that were grade 4. These important prognostic variables were best evaluated in the deeper portions of the lesions. PMID- 3957336 TI - Neonatal hemochromatosis. AB - Neonatal hemochromatosis is a specific entity in the spectrum of pediatric liver disease. The clinical course is characterized by progressive deterioration, leading to death within a few days to weeks. The pathologic changes are hepatic fibrosis with massive iron accumulation in hepatocytes. Lesser amounts of iron are found in parenchymal cells of the endocrine organs (adrenal, thyroid, pancreas, pituitary), the heart, and renal tubules. Little iron is present in cells of the reticuloendothelial system. The morphologic pattern thus resembles that of adult idiopathic hemochromatosis. Iron accumulation is a relatively specific finding, as shown by a review of a series of pediatric autopsy cases. Premortem diagnosis of this disease has been made only rarely, and little information is available on laboratory parameters. Recognition of this entity in living neonates is necessary for better understanding of its pathogenesis and treatment. PMID- 3957337 TI - Schneiderian papillomas: a clinicopathologic study of 67 cases. AB - The clinical and pathologic features of schneiderian papillomas were studied in 67 patients. There were 40 male and 27 female patients, and the mean age at diagnosis was 49 +/- 17.9 (SD) years. Nasal obstruction or perception of a nasal mass was the most common presenting symptom; mean duration of symptoms was 10.8 +/- 15.8 (SD) months. Almost equal numbers of papillomas had predominantly endophytic (inverted) (n = 32) and predominantly exophytic (fungiform) (n = 30) patterns, and five had mixed patterns. Multiple morphologic variables were evaluated in the initial specimens, including cytologic atypia and number of mitotic figures; there were no statistically significant correlations between these variables and biologic behavior. Of the 39 patients for whom follow-up information was available (mean follow-up period, 38.6 months), six patients (all with predominantly endophytic patterns) had copresented with schneiderian papillomas and carcinomas. The remaining 33 patients initially had only benign schneiderian papillomas. In these 33 patients, recurrences developed in 11 (33 per cent), local invasion in two (6 per cent) (both with inverted papillomas), and epidermoid carcinoma in one (3 per cent) (with an inverted papilloma). Three patients had evidence of disease when last examined, and two patients had died of disease (both after copresentation with schneiderian papillomas and carcinomas). The continued use of the term inverted papilloma (endophytic pattern) as a specific subset of schneiderian papillomas is recommended, as all serious complications, including progression to local invasion, copresentation with carcinoma, and development of carcinoma, were associated with these lesions. PMID- 3957338 TI - Pulmonary lesions in Wegener's granulomatosis: a clinicopathologic study of 22 autopsy cases. AB - Pulmonary lesions in 22 autopsy cases of Wegener's granulomatosis (WG) were studied clinicopathologically, with special emphasis on the relation of the lesions to systemic vasculitis, glomerular changes, and clinical manifestations. The pulmonary lesions were divided, on the basis of morphologic characteristics, into four types: 1) the fulminant type, which was characterized by diffusely distributed acute exudative and proliferative alveolitis with prominent small vessel vasculitis (three cases); 2) the granulomatous type, the classic granulomatous lesion (seven cases); 3) the fibrous scar type (five cases); and 4) the mixed type, which had features of both acute exudative and scar-type lesions (seven cases). Clinically, lesions of the fulminant type had rapidly deteriorating courses, terminating in respiratory failure immediately following the onset of the pulmonary manifestations, whereas those of the fibrous scar type had protracted courses. The systemic vasculitis and glomerular lesions in the cases of the fulminant type were almost exclusively fresh lesions. In contrast, the systemic lesions in the cases of the fibrous scar type were nearly always cicatricial. Thus, the morphologic features of the systemic lesions and the clinical profile in each case were well correlated with the pathologic classification of the pulmonary lesions. This correlation may support the assumption that the respiratory tract lesion plays an important role in the progression of systemic involvement in the disease. A comparative study of vascular lesions in various organs revealed some histologic differences between vasculitis in the lungs and that observed outside the respiratory tract; pathogenetic heterogeneity was thus suggested between lesions in the two locations. PMID- 3957339 TI - The importance of mesenteric vascular insufficiency in meconium peritonitis. AB - The etiology of bowel perforations leading to meconium peritonitis was investigated in an attempt to explain the occurrence of such perforations in the absence of primary intestinal obstruction. Bowel specimens from 22 patients who had presented with meconium peritonitis during a 15-year period, as well as specimens from five patients with intestinal atresia without associated meconium peritonitis, were re-evaluated microscopically. An extensive review of the literature concerning meconium peritonitis, involving 1,084 patients, was compared with the results of a retrospective study of 69 patients from The Netherlands. In approximately 50 per cent of these cases there was no detectable primary cause of the bowel perforation. The pathologic findings, in combination with earlier experimental studies, indicate that vascular insufficiency may result in bowel wall perforation without prior intestinal obstruction. It is suggested that temporary decrease of mesenteric blood flow could lead to intestinal atresia and/or meconium peritonitis. PMID- 3957340 TI - Brainstem subarachnoid respiratory epithelial cysts: report of two cases and review of the literature. AB - Two cystic lesions that were lined by pseudostratified ciliated columnar epithelium containing goblet cells are described. Both lesions were found in the subarachnoid space between the vertebrobasilar arterial system and the brainstem. One cyst was an incidental finding in a patient who died of orbital phycomycosis. The cyst was filled with clear mucinous material. The second cyst presented as a mass adjacent to the brainstem in a woman who had progressive brainstem dysfunction. This lesion showed transition from pseudostratified ciliated columnar epithelium with goblet cells to papillary stratified squamous epithelium, histologic features essentially identical to those of squamous papillomas of the nasal cavity. This lesion was filled with squamous debris. The proposed origin of these lesions is discussed. PMID- 3957342 TI - Parathyroid hyperplasia. PMID- 3957341 TI - Clear cell sarcoma of the penis. AB - The case of a 10-year-old boy in whom clear cell sarcoma occurred at the root of the penis is reported. The tumor cells were positive for S-100 protein, and ultrastructural examination showed the presence of melanosomes. PMID- 3957343 TI - Neuronal aging. PMID- 3957344 TI - Umbilical cord lesions. PMID- 3957345 TI - First trimester fetal karyotyping: one thousand diagnoses. AB - Cytogenetic investigations for diagnostic purposes were performed on 1000 first trimester samples of chorionic villi (CVS) in two laboratories using similar techniques. Fetal karyotyping was the primary indication for CVS in 912 and maternal age was the major indication in 758 of them. The risk category "previous child/fetus with chromosome abnormality" included 74 diagnoses, while the category "chromosome abnormality in one of the parents" included 38 diagnoses. Sex determination was the primary indication for CVS in 53 pregnancies. The overall incidence of chromosomal abnormalities was 70, of which 47 were balanced and 23 unbalanced. The results are detailed for each of the risk categories and the incidence of abnormal karyotypes is given for each year of maternal age. In the maternal age of 35-37 years the incidence of unbalanced karyotypes was 2.9% and in the years 38 onwards it was 6.6%. The incidence of unbalanced karyotypes was about 4% when the sampling was made in the weeks 9 to 12 but six abnormal karyotypes were found among 39 CVS performed at the eight week of gestation. The 11 trisomies of the type not found at birth were clustered between the 8th and the 10th week of pregnancy. The technical problems encountered in this experience and the preliminary estimates of fetal loss are discussed. PMID- 3957347 TI - Oncogenes and the mammalian X chromosome. AB - None of the up to now localized and expressed oncogenes maps to the mammalian X chromosome. This fact is discussed in the light of a trans-acting regulation mechanism for oncogenes. Such a specific regulation mechanism is demonstrated here for a qualitative change--i.e., varying timing of DNA-replication--at the putative c-myc gene locus in band 15E of murine T-cell leukemia. In intraspecific hybrids between tumor and non-tumor cells this qualitative change spreads over to all chromosomes 15 of the same cell, irrespective of their origin. This effect is thought to reflect a binary trans-acting regulation mechanism between homologous chromosomal loci. In the past specific chromosomal aberrations have been described in various tumors but none of these aberrations involve the X chromosome. For the mammalian X chromosome where there is usually only one gene copy per cell active the described kind of binary trans-acting regulation between homologous gene loci is rendered impossible. PMID- 3957346 TI - Analysis of spreading of inactivation in eight X autosome translocations utilizing the high resolution RBG technique. AB - Eight X autosome translocations were studied with replication banding to localize spreading of late replication into the autosomal segments. Partial spreading into the autosomal segment was seen in four translocations and no spreading of late replication was seen in four translocations. In those translocations with partial spreading of late replication into the autosomal segment, late replication did not always spread continuously from the X chromosome breakpoint throughout the autosome. Instead, it appeared to skip some bands and affect others. The data on the pattern of replication, taken to indicate also a spread of inactivation into these autosomal segments, correlated well with the clinical data in most cases and suggest that spreading of late replication is often incomplete and may be discontinuous. PMID- 3957348 TI - Mental impairment in Martin-Bell syndrome is probably determined by interaction of several genes: simple explanation of phenotypic differences between unaffected and affected males with the same X chromosome. AB - A family with Martin-Bell syndrome (MBS) is described with transmission of this X linked trait by a normal male who manifested the fragile site at Xq27. This family shows features apparently typical for all families with a normal male transmitter. The daughters of this male are mentally normal and their fragile site is difficult or impossible to detect but detection of the heterozygous genotype is much easier among the granddaughters. This can be explained by a model assuming that mental deficiency in patients with MBS is determined by several genes, i.e. the X-linked MBS-gene as "major gene" undergoing X inactivation and interacting with at least one modifying gene. The model assuming one autosomal modifier segregating independently from the MBS-gene is tested using the results of segregation analysis performed by Sherman et al. (1984, 1985). No significant differences have been found between the predictions of this model and the findings of the segregation analysis. Nearly all of the segregation data are exactly predicted by the model. Possible differences are discussed either to be due to biased data or to require slight modification of the model to get a better fit of the data. The apparent phenotypic differences between a normal carrier grandfather and his affected grandsons as well as between his daughters and his heterozygous granddaughters are also simply explained on the basis of this model. Several modifier loci may exist each of them related to one of the various phenotypic effects of the X-linked major gene (MBS-gene) leading to a syndrome that does not include any obligate feature. PMID- 3957349 TI - Morphology alone does not make an isochromosome. AB - Isochromosomes are chromosomes with genetically identical arms. Chromosomes morphologically similar to isochromosomes can arise from alternative mechanisms: whole-arm translocations and crossing over within inversion loops. Cases are presented which could have arisen by each of these latter two mechanisms. The first case is 46,XX,t(15;15) (qter-cen-qter;pter-cen-pter) and the second 46,XY,rec(18),dup q,inv(18) (p11.32q11.2). PMID- 3957350 TI - Prophase pairing in a mosaic 18p-;iso 18q human female foetus studied by surface spreading. AB - The pachytene configurations formed in the ovary of a mosaic 18p-;iso 18q human foetus (22 weeks gestation) are analysed using a surface spreading technique. Three features of interest are the apparent meiotic delay of oocyte development, oocyte degeneration, and the triple pairing which occurs in one cell line when the iso 18q both pairs with itself and with the normal chromosome 18. PMID- 3957351 TI - A new synaptic anomaly: irregular synaptonemal complexes. AB - In this paper we describe a new synaptic anomaly characterized by the presence of irregular synaptonemal complexes (SCs) in two sterile patients. PMID- 3957352 TI - Prenatal diagnosis and the Prader-Willi syndrome. PMID- 3957353 TI - Cutaneous manifestation of lethal genes. PMID- 3957354 TI - Effect of meptazinol on chronic anticoagulant therapy. AB - Six elderly hospitalized patients (four female, two male; mean age 85.3 years) stabilized on warfarin therapy were treated with meptazinol (200 mg four times daily) for 7 days. There was no significant difference from pretreatment levels either in mean warfarin dosage prothrombin index after introduction or withdrawal of meptazinol. These findings provide no evidence for any major interaction between warfarin and meptazinol. PMID- 3957355 TI - Choice reaction time in workers exposed to styrene vapour. AB - Behavioural effects of occupational exposure to vapour from styrene-based resin were investigated in 10 female workers with a portable test of choice reaction time. Testing was carried out both at the beginning and end of the day's shift. Uptake and metabolism of styrene were assessed by monitoring post-shift urinary mandelic acid excretion rates. By using these data workers were allocated to three groups reflecting zero, low or high exposure. After exposure slowing of reaction times was found in those with the highest mandelic acid excretion rates, whereas a slight improvement or no change was found in those with low or zero exposure. Subsequent improvements in extraction and ventilation in the workroom were shown to be associated with both decreased mandelic acid excretion and absence of long reaction times in those previously most heavily exposed. PMID- 3957356 TI - Urinary excretion of benzidine in relation to the acetylator status of occupationally exposed subjects. AB - Twenty-four male workers engaged in the manufacture of benzidine dihydrochloride for 1-4 years were included in this study. Urinary levels of free benzidine were estimated by high-pressure liquid chromatography in all the workers. Acetylator status of the workers was determined with sulphamethazine. There was substantial absorption of benzidine over an 8-h work shift. A significant correlation was observed between the rate of sulphamethazine acetylation and urinary excretion of free benzidine. PMID- 3957357 TI - Intoxication of 76 children by chlorine gas. AB - A collective intoxication with chlorine gas in 76 children (21 males, 55 females; the median age was 9.9 years) is reported. They were treated with a combination of oxygen gas (O2) and corticosteroids until the symptoms disappeared. PMID- 3957358 TI - Change in binding reactivity of an anti-tumor monoclonal antibody after the introduction of 2-pyridyl disulphide groups. AB - The use of monoclonal antibodies for in vivo therapeutic approaches depends largely on their specificity. During the characterization of ricin A-chain-murine monoclonal antibody conjugates we found that the binding specificity of a monoclonal antibody raised against human ovarian carcinoma (MOv2) seemed altered. Therefore, the binding reactivity of the unmodified antibody (MOv2), the conjugation intermediate (MOv2-PDP) and the conjugate (MOv2-A chain) was titrated by solid-phase radioimmunoassay on 11 human tumor cell lines belonging to seven different histotypes. The three reagents bound with the two reference cell lines (SW626:ovary carcinoma and HT-29:colon carcinoma). The MOv2-PDP and the Mov2-A chain also reacted with seven other cell lines which were unreactive with the unmodified MOv2. In addition MOv2-PDP exhibited reactivity on all normal cells tested (peripheral blood lymphocytes and skin fibroblasts). To elucidate the significance of these findings the following experiments were performed: cross inhibitions between the unmodified and modified monoclonal antibodies; comparative absorption tests with different cell lines; and immunoblotting analysis of the target antigens. The results suggest that after chemical modification with SPDP the monoclonal antibody MOv2 increases its binding activity, so that even a low number of antigenic sites can be detected. This study underlines the need to redefine the specificity of a conjugate before considering therapeutic applications. PMID- 3957359 TI - Production of stable mouse x human hybridomas secreting HBs antigen-specific human monoclonal antibody by using in vitro sensitization. AB - The stable mouse x human hybridomas were established by cell fusion of a mouse myeloma cell line, a P3-X63-Ag8-653 (P3-653) subclone, with human peripheral blood mononuclear cells (PBMs) from normal volunteers for production of human monoclonal antibody against a predefined, clinically important antigen of viral origin, hepatitis-B surface (HBs) antigen. For successful mouse x human fusions, it was extremely important to preselect volunteers and to sensitize their PBMs by using in vitro sensitization. The resulting mouse x human hybridomas have continuously secreted a relatively high amount of human monoclonal antibodies to HBs antigen over nine months without cloning. PMID- 3957360 TI - Monoclonal antibodies against ricin: effects on toxin function. AB - Monoclonal antibodies against ricin toxin were produced and some of their properties investigated. Antibodies 196 C12 and 197 C7 raised against A-chain reacted with a CnBr fragment probably comprised between amino acid 254 and 262. Antibodies 193 A9, 196 A3, and 191 B7 recognized a 6-7 kD CnBr peptide. A second set of antibodies was raised against whole inactivated ricin. Most of them bound in a solid phase radioimmunobinding assay only to ricin and few had a low activity against purified A-chain. Different effects were noted on toxin action in cultured leukemic cells. If cells were preincubated with ricin followed by antibodies, MAb 207 E5 and 216 B3 had a strong enhancing effect on toxin action. If antibodies and toxin were mixed and then added to sensitive cells, antibody 207 E5 gave a strong protection while 216 B3 maintained its enhancing activity. The effect of antibody 216 B3 was further investigated by quantitative cloning experiments which showed that toxin had a fivefold enhancement in its activity by a preincubation with this antibody. Binding of fluoresceinated ricin to leukemic target cells was inhibited by a preincubation with antibody 207 E5 while antibody 216 B3 had no effect. PMID- 3957361 TI - A thick-film multiple component cathode three-electrode oxygen sensor. PMID- 3957362 TI - A Pd-PdO film potentiometric pH sensor. PMID- 3957363 TI - Optical fluorescence and its application to an intravascular blood gas monitoring system. PMID- 3957364 TI - Equilibrium binding in immunosensors. PMID- 3957366 TI - Electrocatalytic determination of glucose in a Ringer's solution by pulse voltammetry. PMID- 3957365 TI - The low-potential approach of glucose sensing. PMID- 3957367 TI - Solid-state physical transducers for biomedical research. PMID- 3957369 TI - Measurement of ventricular volume by intracardiac impedance: theoretical and empirical approaches. PMID- 3957368 TI - Analysis, design, and performance of a capacitive pressure sensor IC. PMID- 3957370 TI - Design and implementation of an implantable goniometer. PMID- 3957371 TI - Thin-film multiple electrode probes: possibilities and limitations. PMID- 3957372 TI - Solid-state electrodes for multichannel multiplexed intracortical neuronal recording. PMID- 3957373 TI - Use of electric fields to monitor the dynamical aspect of cell behavior in tissue culture. PMID- 3957374 TI - The packaging of implantable integrated sensors. PMID- 3957375 TI - Biosensors. PMID- 3957376 TI - The Achilles' heel of potentiometric measurements, the liquid junction potential. PMID- 3957377 TI - An integrated sensor for electrochemical measurements. PMID- 3957378 TI - Development of low-drift pH electrodes based on neutral carrier in PVC overlayered metallizations. PMID- 3957379 TI - An integrated circuit-based optical sensor for in vivo measurement of blood oxygenation. PMID- 3957380 TI - The effects of thoracic inhomogeneities on the relationship between epicardial and torso potentials. PMID- 3957381 TI - A two-part model for determining the electromagnetic and physiologic behavior of cuff electrode nerve stimulators. PMID- 3957382 TI - Role of light scattering in whole blood oximetry. PMID- 3957383 TI - A tubular self-synchronous motor for artificial heart pump drive. PMID- 3957384 TI - Telemetry system for stimulation and monitoring of freely moving patients. PMID- 3957385 TI - The forward problem in electroneurography. I: A generalized volume conductor model. PMID- 3957386 TI - The forward problem in electroneurography. II: Comparison of models. PMID- 3957387 TI - Intramuscular electrical activation of the phrenic nerve. PMID- 3957388 TI - Evaluation of simple algorithms for spectral parameter analysis of the electroencephalogram. PMID- 3957389 TI - Gaussian and Poisson blink statistics: a preliminary study. PMID- 3957390 TI - Roundoff errors in signal averaging systems. PMID- 3957391 TI - Character pattern recognition for a telecommunication aid for the deaf. PMID- 3957392 TI - Identification of time-varying ventricular parameters during the ejection phase. PMID- 3957393 TI - A contact method of ocular pulse detection for studies of carotid occlusions. PMID- 3957394 TI - Intracranial pressure telemetry system using semicustom integrated circuits. PMID- 3957395 TI - Formative mechanisms of current concentration and breakdown phenomena dependent on direct current flow through the skin by a dry electrode. PMID- 3957396 TI - Aberrant heating: a problem in regional hyperthermia. PMID- 3957397 TI - Superposition of constant and oscillatory flows in a rigid cylindrical tube: influence of entrance effects. PMID- 3957398 TI - ECG data compression using Fourier descriptors. PMID- 3957399 TI - The zero-delay wavenumber spectrum estimation for the analysis of array ECG signals--an alternative to isopotential mapping. PMID- 3957400 TI - Correlation of constant flow rate with frequency spectrum of respiratory sounds when measured at the trachea. PMID- 3957401 TI - A bidomain model for the extracellular potential and magnetic field of cardiac tissue. PMID- 3957402 TI - [Haemophilus aphrophilus as the causative agent in a case of bacterial sepsis]. AB - Haemophilus aphrophilus was isolated from 5 blood cultures of a 31-year-old male patient who developed septicaemia two years after heart surgery. The bacteriological and clinical properties of H. aphrophilus are discussed in view of the available literature. PMID- 3957403 TI - [Blood culture: efficacy of the specimens for the analysis of bacteremia and sepsis]. AB - The indication for examination of blood cultures is discussed. The evaluation of clinical information with respect to the underlying diseases demonstrated that in most cases a microbiological etiology was suspected. Mostly we obtained diagnosis like chill, septic shock or suspicion of nosocomial infection. In most cases the infection origin was related to the gastrointestinal tract or the genitourinary tract. The examination of different specimens yielded the blood culture bottle as the best medium for diagnosis of septicemia. The laboratory diagnostic procedure is briefly presented. The rate of positive results, the contamination rate and the interpretation are discussed. PMID- 3957404 TI - [Effect of the cephalosporin derivative cefodizime on the immune system in in vivo experiments]. AB - In various infection models with the pathogenic yeast Candida albicans, Cefodizime influences the development of the infection. Although it does not exhibit any fungicidal or fungistatic action it decreases the number of yeast cells or prolonges survival. PMID- 3957405 TI - [Therapy and diagnosis of bacteremia and sepsis: where and how are improvements possible?]. PMID- 3957406 TI - [Determination of tumor markers NSE and CEA in patients with various lung diseases, especially carcinomas]. AB - Serum neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA) are two very good tumor markers for diagnosis and for monitoring response to therapy in patients with lung carcinoma. Especially, NSE has a high sensitivity and specificity for early detection of small-cell lung cancer and for management of these patients. PMID- 3957407 TI - Depletion by monolayer binding of specific precursors of antibody-forming cells directed against cellular antigens. AB - Conditions have been established to permit poly-L-lysine (PLL)-attached cell monolayers to adsorb specific antibody-forming cell precursors (AFCP) from immune spleen cell populations as a negative selection technique. In a model system, sheep red blood cell (SRBC) immune spleen cells were adsorbed onto SRBC monolayers and the cells remaining non-adherent transferred to irradiated recipients. Subsequent to SRBC immunization, these recipients showed up to 95% reduction in splenic anti-SRBC plaque-forming cells (PFC) compared with recipients of control cell populations which had not been exposed to a SRBC monolayer. The depletion observed was shown to be antigen-specific and the extent of depletion comparable with that attained by removal of anti-SRBC AFCP as rosettes. The depletion of AFCP directed against mouse (EL4) and human (QIMR-WIL) leucocyte antigens was then examined. Mixtures of spleen cells immune to EL4 and WIL cells were adsorbed onto PLL-attached monolayers of EL4 or WIL cells, and spleen cells remaining non-adherent transferred to irradiated recipients which were then immunized with either of these cell types. Analysis of recipient serum samples by determination of antibody titre and by immunoblotting indicated that the response to the cell type used in the adsorbing monolayer had been specifically depleted while the response to the other cell type remained unchanged or only slightly impaired. The maximum level of depletion occurred on Day 7 after transfer and declined thereafter. The application of this procedure to improve the frequency of production of spleen cell hybridomas directed against leucocyte differentiation antigens is discussed. PMID- 3957408 TI - Anti-I-J alloantisera elicited by immunization of B10.A(3R) (I-Jb) mice with bone marrow-derived macrophages from B10.A(5R) (I-Jk) mice. AB - In this paper we describe production of alloantisera specific for determinants encoded by I-J gene loci expressed on macrophages. B10.A(3R) (I-Jb) mice were hyperimmunized with pure macrophages grown in vitro from bone marrow stem cells of congenic B10.A(5R) mice. The antisera contained predominantly IgM antibody that was non-adherent to protein-A-Sepharose with a minor component of IgG1, and IgG2a antibodies that were adherent to protein-A-Sepharose. The protein-A non adherent antibody completely blocked the in vitro generation of humoral immune responses to sheep erythrocytes by spleen cell from B10.A(5R) mice and from inbred strains that share the I-Jk haplotypes, but did not alter the responses of spleen cells of the I-Jb haplotype. In the presence of complement, both protein-A adherent and protein-A non-adherent antibodies eliminated the capacity of B10.A(5R) spleen cells to generate humoral and proliferative responses, but the functional activity of B10.A(3R) cells was unaffected. These data indicate the I Jk specificity of the antisera. The capacity of the anti-macrophage antibody to block humoral immune induction was removed by absorption with bone marrow-derived macrophages from B10.A(5R) mice, but not from B10.A(3R) mice. Further, the B10.A(5R) macrophages completely restored the humoral responses of antibody- and complement-treated B10.A(5R) spleen cells, but B10.A(3R) macrophages showed only partial restoration that was consistent with a factor-mediated allogeneic effect. These data demonstrate the specificity of our anti-I-J sera for macrophages and indicate that bone marrow-derived macrophages express surface I-J encoded molecules. PMID- 3957409 TI - Unusual complement activation properties of serum immunoglobulins of the pigeon Columba livia. AB - Complement-mediated lysis of mouse erythrocytes (MRBC) by whole pigeon antisera was found to occur in the presence of magnesium ions alone. The underlying basis for this observation was demonstrated to be the ability of IgM antibodies to activate the alternative pathway of pigeon complement, whereas IgG activates a calcium-dependent pathway possessing an unusually low lytic capacity. In addition to differing from the alternative pathway by requiring both calcium and magnesium ions, the calcium-dependent pathway exhibited higher activity at low temperature and more rapid kinetics of haemolysis. The presence of early acting C1 in pigeon serum was inferred by the selective depletion of calcium-dependent activity which occurred as a result of incubating serum containing only calcium ions with MRBC sensitized with IgG. Under the same conditions, MRBC sensitized with IgM failed to deplete complement activity, indicating that C1 does not participate in complement activation by this isotype. Interestingly, the calcium-dependent pathway detected in pigeon serum appears to more closely resemble the C1-bypass pathway rather than the classical pathway of mammalian complement. PMID- 3957410 TI - Eosinophil-mediated cellular cytotoxicity induced by zymosan-activated serum. AB - The aim of the present work was to develop an in vitro model of eosinophil cytotoxicity which mimics numerous in vivo situations characterized by complement activation through the alternative pathway. Our results demonstrate that eosinophilic granulocytes from patients with parasitic diseases and blood eosinophilia were able to damage chicken red blood cells when incubated with zymosan-activated serum (ZAS) as assessed by a 51Cr release assay. The phenomenon was independent of the presence of antibodies directed against the target cells and related to the quantity of ZAS added to the wells. As target cell lysis is totally or partially inhibited by catalase, sodium azide and potassium cyanide, an involvement of toxic oxygen derivatives as cytolytic mediators was suggested. PMID- 3957411 TI - Modification of the neutrophil Fc receptor by neutrophil granule products: its significance for phagocytosis and bactericidal activity. AB - Preincubation of neutrophils with various amounts of autologous neutrophil granule products induced a dose-dependent decrease in neutrophil Fc receptor expression. However, neutrophil granule products did not affect the neutrophil phagocytic and bactericidal activities. PMID- 3957412 TI - Immunogenetic analysis of rat strains with recombinations in different regions of the MHC. PMID- 3957413 TI - Correspondence of the monocyte antigen HMA-1 to the non-HLA antigen 9a. AB - Monocyte-specific antibodies are detrimental to bone marrow and renal transplantation. By using human antimonocyte sera we were able to identify two monocyte-specific antigens, human monocyte antigen 1 and 2 (HMA-1 and HMA-2). The presence of HMA-1 and HMA-2 was compared with the presence of several non-HLA antigens. In panel and inhibition studies, HMA-1 corresponded to the previously described non-HLA granulocyte antigen 9a. Absorption studies showed that HMA-1 and 9a were both present on granulocytes and monocytes. The clinical relevance of these antigens is discussed. PMID- 3957414 TI - An analysis of class I antigens of man and other species by one-dimensional IEF and immunoblotting. AB - A procedure for the molecular identification of MHC class I products based on 1-D IEF and subsequent immunoblotting is described. Optimal conditions for 1-D IEF, the electrophoretic transfer of proteins out of denaturing, nonionic detergent containing gels to nitrocellulose, and the requisite antibodies, both polyclonal and monoclonal, for the visualization of class I heavy chains have been established. Cross-reactivity of antibodies has enabled the biochemical analysis of class I heavy chains in the dog. The procedure reported here requires modest amounts of cells and allows a rapid molecular characterization of class I heavy chain polymorphisms in man and other species without the need for radiochemical methods. PMID- 3957416 TI - Effect of urapidil, clonidine, and prazosin on sympathetic tone in conscious rats. AB - To test the hypothesis that the hypotensive action of urapidil is in part related to a direct action on the brain, the central (intracerebroventricular) and peripheral (intravenous) effects of urapidil were studied and compared with those obtained with clonidine and prazosin. All studies were conducted in conscious, chronically instrumented stroke-prone spontaneously hypertensive rats (SHRSP). Efferent sympathetic nervous system activity was estimated by means of a bipolar electrode implanted on the splanchnic nerve. Only clonidine, administered intracerebroventricularly and intravenously, decreased sympathetic nerve activity. Urapidil and prazosin either did not affect sympathetic nerve activity after central administration or increased it after peripheral administration at low and high doses, respectively. Centrally administered urapidil and prazosin lowered blood pressure but also blocked the response to intravenously administered phenylephrine; this result suggests a peripheral effect. Centrally administered urapidil decreased heart rate. Urapidil given either intracerebroventricularly or into the cisterna magna had no influence on baroreceptor responses. Intravenous infusions of urapidil and prazosin in sufficient doses to lower blood pressure in spontaneously hypertensive rats by 50 mm Hg completely blocked the actions of phenylephrine. These data suggest that in conscious SHRSP urapidil lowers blood pressure through peripheral blockade of alpha 1-adrenergic receptors rather than by means of central sympathetic suppression. In this regard urapidil resembles prazosin rather than clonidine; however, the effect of urapidil on heart rate is consistent with a central mode of action. PMID- 3957415 TI - Ly-6A.2 and Ly-6E.1 molecules are antithetical and identical to MALA-1. AB - Rat monoclonal antibodies YE3/19.1, defining the murine-activated lymphocyte antigen MALA-1, and D7, detecting an Ly-6 locus-controlled antigen, bound highly purified Ly-6E.1. On western blots of lymphocyte surface proteins which had been solubilized and electrophoretically separated in octylglucoside, they detected bands which comigrated with Ly-6A.2 or Ly-6E.1 antigens. On cells or in an immunoassay they blocked alloantibodies against Ly-6A.2 or Ly-6E.1. The tissue distribution of MALA-1 also correlated with Ly-6A.2 or Ly-6E.1. Upon octylglucoside or sodium dodecyl sulfate-polyacrylamide gel electrophoresis, these antigens displayed similar sizes. Thus, Ly-6A.2 and Ly-6E.1 are most likely products of alternate alleles. Electrophoretic analysis showed a similar size and charge for Ly-6A.2, Ly-6B.2, Ly-6D.2, and Ly-27.2. Ly-6C.2 and Ly-28.2 appeared to be identical, and were similar in size to Ly-6A.2, but they differed in charge and in intrachain disulfide constraints. Since Ly-6D.2 and Ly-27.2 may represent the same or different epitopes on the Ly-6A.2 molecule, the previously postulated five Ly-6-like antigens that were thought to be separable on the basis of tissue distribution, may represent no more than three separate proteins which can be assigned to one of two distinct categories by electrophoretic mobility in gels containing octylglucoside. PMID- 3957419 TI - Weight-reducing diets and sodium intake. PMID- 3957417 TI - Hypertensive potency of 18-oxocortisol in the rat. AB - The hypertensogenic effect of 18-oxocortisol, an aldosterone analogue possessing both mineralocorticoid and glucocorticoid properties, was studied at the same dosage but under different experimental conditions in two experiments. Under experimental conditions conducive to the development of mineralocorticoid hypertension (i.e., rats with a single kidney on a high NaCl intake), there was an extremely rapid onset of saline polydipsia and hypertension accompanied by cardiac and renal enlargement, marked thymic involution without adrenal atrophy, cardiovascular lesions, and hypokalemia. With the exception of the thymic changes, the same changes occurred in rats given the biologically equivalent dose of deoxycorticosterone acetate. Under circumstances favoring the development of glucocorticoid hypertension (i.e., intact rats on a normal sodium intake), the same dose had only a transient blood pressure-elevating effect, attaining prehypertensive levels at most, and caused neither chronic hypertension nor hypokalemia. The biologically equivalent glucocorticoid dosage of cortisol was similarly ineffective. Under these circumstances, both steroids caused thymus involution but only 18-oxocortisol caused kidney enlargement. PMID- 3957418 TI - Lacunar stroke. PMID- 3957420 TI - Sodium chloride-dependent hypertension. PMID- 3957421 TI - Phlogistic activity of leukotriene D4 in the mouse. AB - An investigation of the phlogistic activity of LTD4 in the mouse was accomplished by examination of its ability to cause increased capillary permeability and edema formation following subcutaneous administration. It was observed that nanogram quantities of LTD4 caused edema and increased capillary permeability in a dose related manner. The increase in capillary permeability was not inhibited by pretreatment with indomethacin and thus was unrelated to the production of cyclo oxygenase products. These data suggest that LTD4 can mediate the edematous phase of the inflammatory response in the mouse and illustrate the sensitivity of this species to LTD4. PMID- 3957422 TI - Effect of lithium therapy on inflammatory response. AB - Chemiluminescence produced by normal cells was reduced in response to zymosan which was opsonized with serum from patients on prophylactic lithium therapy, compared to control serum from normal subjects (68 +/- 3.1 vs. 93 +/- 3.4 mV/5 X 10(5) cells). Preincubation of normal cells with serum from patients also resulted in reduced chemiluminescence activity when the cells were stimulated with autologous serum-coated zymosan (47 +/- 4.5 vs. 64 +/- 6.3 mV/5 X 10(5) cells). Spontaneous complement conversion was increased in the serum of patients on lithium therapy (46.3 +/- 3.8 vs. 25.3 +/- 2.5% conversion). These studies demonstrated that lithium, at safe therapeutic levels (0.4-0.9 mmol/liter), significantly altered complement conversion and had a marked affect on chemiluminescence activity by normal cells. PMID- 3957424 TI - Clearance of endotoxin from blood of rabbits injected with staphylococcal toxic shock syndrome toxin-1. AB - This study was undertaken to examine some of the properties of staphylococcal toxic shock syndrome toxin 1 (TSST-1) with regard to the clearance of endotoxin from blood. The concentration of endotoxin in blood was measured by using a chromogenic limulus test and modified perchloric acid method. When TSST-1, which produces fever in rabbits, was injected (100 ng/ml or 100 micrograms/ml per kg) intravenously (i.v.) into the animals, no measurable level of endotoxin was detected in the blood. In control animals, which were given 5 micrograms of endotoxin per ml per kg i.v., endotoxin could be detected in the blood at rapidly declining levels. These results suggested that TSST-1 might not lead bacterial endotoxin from other body sites into the blood. When the animals were given TSST 1 (1 to 100 ng/ml per kg) i.v. and then endotoxin (5 micrograms/ml per kg) i.v. 4 h later, endotoxin was detected in the blood at a high level, depending on the dose of TSST-1 injected. These results showed that TSST-1 inhibited the clearance of endotoxin in the blood; this clearance is thought to be mainly done by the reticuloendothelial system. In the animals given TSST-1 (100 ng/ml per kg) and endotoxin (5 micrograms/ml per kg) simultaneously, the endotoxin level in the blood was found to be higher than that in control animals given endotoxin only but lower than that in the animals given TSST-1 and then endotoxin at the same doses. PMID- 3957423 TI - Turnover of low-density lipoprotein isolated from interstitial inflammatory fluid of the rabbit. AB - Utilizing the polyvinyl sponge-implant model in the rabbit, we have described in vivo modification of low-density lipoproteins (LDL) in interstitial inflammatory fluid (IF). In the present studies, plasma clearance rates of IF-LDL were determined and compared with normal whole plasma LDL (WP-LDL) as well as plasma LDL modified by chemical reaction with acetic anhydride (Ac-LDL). Lipoproteins were labeled with 125I and injected into the lateral ear vein of recipient rabbits. At 10 min after injection, only 51.5% of IF-LDL could be accounted for in recipient plasma, as compared to 91.9% for WP-LDL, and 2.4% of Ac-LDL. Subsequent log-linear decay rates were similar for IF-LDL and WP-LDL (t 1/2 = 9.5 vs. 11.0 h). Autoradiography of plasma obtained from recipient animals at 15 min and 1 h after injection revealed a return to normal electrophoretic mobility of [125I]IF-LDL. These results indicate that IF-LDL is a mixture of both modified and essentially unmodified particles. We propose that the modified particles may be removed from the circulation by mechanisms described for Ac-LDL. PMID- 3957425 TI - Isolation and characterization of a fructosyltransferase gene from Streptococcus mutans GS-5. AB - A fructosyltransferase (FTF) gene from Streptococcus mutans GS-5 has been isolated from a lambda L47.1 clone bank. The gene was contained on an 11.7 kilobase GS-5 DNA fragment and was initially subcloned into plasmid pACYC184 as a 5.4-kilobase HindIII fragment. However, further analysis revealed that transcription of the FTF gene was initiated at the P1 promoter contained on the vector. It was possible to subclone the FTF gene with its presumed promoter as a 3.4-kilobase EcoRI fragment to produce the chimeric plasmid pSS22 expressing FTF activity. The cloned enzyme was purified to apparent homogeneity after ammonium sulfate precipitation, gel filtration, and DEAE-Bio-Gel-A chromatography followed by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The purified enzyme displayed a lower molecular weight (63,000) compared with the multiple activities detected in the culture fluids of strain GS-5. In addition, storage of the purified enzyme resulted in the formation of even lower-molecular weight enzymatically active species. These results suggested that proteolytic degradation of the FTF occurs both in S. mutans and in Escherichia coli. In addition, a comparison of the properties of the cloned enzyme with those previously characterized from another serotype c S. mutans strain suggests that multiple FTF genes may be present in these organisms. PMID- 3957426 TI - Biochemical and immunological characterization of cell surface proteins of Pasteurella multocida strains causing atrophic rhinitis in swine. AB - In a previous paper (B. Lugtenberg, R. van Boxtel, and M. de Jong, Infect. Immun., 46:48-54, 1984) we showed that among 34 isolates from swine the membrane protein and lipopolysaccharide (LPS) patterns, as analyzed by sodium dodecyl sulfate-gel electrophoresis, could be classified into three and six patterns, respectively. In all cases a certain LPS pattern was correlated with a certain protein pattern. Certain combinations of types of cell surface proteins and LPSs were correlated with pathogenicity, the latter property being judged by the guinea pig skin test. In the present paper the immunological and biochemical properties of cell surface constituents were analyzed. The reaction between electrophoretically separated cell surface constituents with guinea pig and sow antisera showed that LPS as well as several proteins were immunogenic. Among these is protein H, whose electrophoretic mobility is the main criterium for typing of cell envelope protein patterns. Protein H was the most heavily labeled component when whole cells were iodinated by the Iodo-Gen procedure showing its accessibility at the cell surface. These properties of protein H make it an attractive vaccine candidate. Further biochemical analyses revealed that protein H shares many properties with pore proteins of members of the family Enterobacteriaceae. One of these properties, association between pore proteins and peptidoglycan, was used as the basis for a simple procedure developed to partially purify protein H. PMID- 3957427 TI - Effect of methylprednisolone on bacterial clearance and endotoxin liberation during experimental sepsis induced by gram-negative bacteria. AB - To determine the effect of methylprednisolone administration on the clearance of bacteremia and the release and clearance of endotoxin during antibiotic therapy of gram-negative bacterial sepsis, Escherichia coli K1 sepsis was induced in paired rabbits. Moxalactam and either methylprednisolone or placebo were administered to infected rabbits 1.5 h after intraperitoneal administration of live bacteria. Serial blood samples were obtained for quantitation of bacteremia and endotoxemia, arterial blood gases, and complete blood count. Arterial blood pressure, heart rate, and core body temperature were also monitored. There were no significant differences between the methylprednisolone-treated and placebo treated groups in either the levels of bacteremia or endotoxemia or in the physiologic, metabolic, or hematologic parameters that were measured. We conclude that methylprednisolone administration has no acute effect on bacterial clearance or on the kinetics of endotoxin release and clearance during antibiotic therapy of gram-negative bacterial sepsis in this experimental model. PMID- 3957428 TI - Quantitative and temporal analyses of murine antibody response in serum and gut secretions to infection with Giardia muris. AB - We analyzed the appearance and level of Giardia muris-specific antibody of immunoglobulin A (IgA), IgG, and IgM isotypes, at weekly intervals, over the course of a 7-week infection in BALB/c and C57BL/6 mice. Using sensitive immunoradiometric assays, we observed that IgA antibody was the only detectable anti-G. muris antibody in intestinal secretions throughout the course of infection. No secreted IgG or IgM anti-G. muris antibody was detected even in concentrated intestinal secretions. The expulsion of G. muris by the mice was associated closely with the appearance and increasing levels of secreted anti-G. muris IgA antibody. Both IgG and IgA serum antibody to G. muris were detected, but no serum IgM antibody was detected. Serum IgA and IgG anti-G. muris antibody remained at high levels up to 10 weeks following clearance of the parasite. An interesting observation indicated that serum IgA antibody to G. muris developed more slowly in response to infection than secreted IgA antibody. An analysis of the molecular weight distribution of total serum IgA in infected mice determined that infection produced a transient but significant shift in serum IgA to high molecular-weight (greater than or equal to dimeric IgA) forms. The results indicate that a substantial IgA antibody response occurs in sera and in gut secretions of G. muris-resistant mice and that IgA antibody is the dominant and possibly the only effector antibody active in intestinal secretions during G. muris infection in mice. PMID- 3957429 TI - Purification and partial characterization of a non-O1 Vibrio cholerae hemolysin that cross-reacts with thermostable direct hemolysin of Vibrio parahaemolyticus. AB - A newly identified hemolysin (NAG-rTDH), which is related to the thermostable direct hemolysin (Vp-TDH) of Vibrio parahaemolyticus produced by non-O1 Vibrio cholerae, was studied. NAG-rTDH was purified by successive column chromatographies on DEAE-cellulose and an immunoaffinity column coupled with anti Vp-TDH immunoglobulin. The molecular weight of NAG-rTDH was estimated as 18,500, similar to that of Vp-TDH, as judged by sodium dodecyl sulfate slab gel electrophoresis, but its charge or molecular shape was different, judging from its electrophoretic mobility. The lytic activities of NAG-rTDH on erythrocytes of most animals were essentially similar to those of Vp-TDH, but that on sheep erythrocytes was different. The hemolytic activity of NAG-rTDH was stable on heating at 100 degrees C for 10 min, as was that of Vp-TDH. Immunological cross reactivity between NAG-rTDH and Vp-TDH was demonstrated by both the Ouchterlony test and the neutralization test. Thus, we conclude that non-O1 V. cholerae produce a new type of hemolysin that is similar but not identical to the thermostable direct hemolysin of V. parahaemolyticus. PMID- 3957430 TI - Hormonal influence on experimental infections by a toxic shock strain of Staphylococcus aureus. AB - Subcutaneous infection chambers in rabbits were infected with a strain of Staphylococcus aureus isolated from a patient with toxic shock syndrome. Estrogens (mestranol and 17-beta-estradiol) protected male rabbits and prolonged survival. Neither androgens (testosterone and dihydrotestosterone) nor progesterone affected the susceptibility of intact or ovarihysterectomized female rabbits. PMID- 3957431 TI - Antigenic variation in the phase I lipopolysaccharide of Coxiella burnetii isolates. AB - Coxiella burnetii isolates from a variety of clinical and geographical sources were screened for antigenic variation of lipopolysaccharides (LPSs) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis coupled with silver staining or immunoblotting. All isolates from chronic Q fever or other sources possessed a phase I-type LPS. These LPSs appeared to fall into three groups based on the sodium dodecyl sulfate-polyacrylamide gel electrophoresis profile or on reactivity with rabbit anti-C. burnetti antisera. The LPS of one group was identified on isolates from milk, ticks, or primary Q fever. The two remaining groups were found almost exclusively on isolates from human cases of chronic Q fever. PMID- 3957432 TI - Purification and characterization of Vibrio cholerae non-O1 heat-stable enterotoxin. AB - A toxin which causes rapid fluid accumulation in a suckling mouse assay and which was produced by Vibrio cholerae non-O1 was investigated. The toxin was purified from the culture supernatant of V. cholerae non-O1 (strain A-5) by ammonium sulfate fractionation, hydroxyapatite treatment, ethanol extraction, column chromatographies on SP-Sephadex C-50 and DEAE-Sephadex A-25, and high-pressure liquid chromatography on a Lichrosorb RP-8 column. About 1.4 X 10(5)-fold purification was achieved, with a recovery of about 12%. Although the crude preparation was heat labile, the purified toxin was heat stable. The minimum effective dose of purified toxin was about 5 ng in the suckling mouse assay. The amino acid composition of the purified toxin was determined to be Asp(3), Glu(1), Ala(1), half-Cys(6), Ile(2), Leu(1), Phe(1), and Pro(1). These data show the production of a new type of heat-stable enterotoxin (NAG-ST) by V. cholerae non O1. PMID- 3957433 TI - Pulmonary involvement in Mycoplasma pneumoniae infection in families. AB - The transmission rate and the clinical and pulmonary manifestations of serologically proven mycoplasma infections were reviewed in 34 patients from 11 families consisting of 30 children and adolescents aged 1 to 18 years, and four parents aged 30 to 41 years (total number of family members = 59:37 children, 22 adults). Twenty-seven of the 37 children had pulmonary involvement (73%). The total infection rate was 58%, and the infection rate in children 81%. The roentgenologic findings in children with pneumonia showed no pathognomonic features. The most common X-ray finding was bronchopneumonia (48%). Pulmonary infiltrates occurred in six children (20%) under four years of age. Three of the children (10%) had severe clinical and/or radiological manifestations. These findings depict a pattern of mycoplasma infection that is different from previous reports, i.e. high pulmonary infection rates in families, the occurrence of pneumonic infiltrations in young children and a quite severe clinical and radiological course in some of the patients. PMID- 3957434 TI - Reinfection in erythema migrans disease. AB - Two patients received oral penicillin for erythema migrans disease (EMD) in 1973 and 1977. Five and seven years later, respectively, they developed EMD for a second time after being bitten by ticks. The first and second erythema migrans lesions appeared in different places. Tests of sera evaluated for antibodies to Borrelia burgdorferi before (in one case), during and after the second episode of EMD remained negative (patient 1) or yielded an at least four-fold rise of IgG antibody titers, but did not become positive (patient 2). These cases provide evidence that reinfection in EMD may occur without a significant elevation of specific antibody titers. PMID- 3957436 TI - Inactivation of aldehyde dehydrogenase by a putative metabolite of cefamandole. Re: K.J. Freundt et al. Infection 13 (1985) 91. PMID- 3957435 TI - Efficacy of penicillin G, flucloxacillin, cefazolin, fusidic acid, vancomycin, rifampicin and fosfomycin in muscular infections in mice due to Staphylococcus aureus. AB - Two strains each of sensitive, penicillinase-producing, methicillin-resistant and "tolerant" Staphylococcus aureus were used to infect mice intramuscularly. The mice were then treated with three doses each of fosfomycin, vancomycin, rifampicin, fusidic acid, penicillin G, flucloxacillin or cefazolin intravenously. Infections due to sensitive strains were effectively treated with all antibiotics investigated except fusidic acid. Fosfomycin, vancomycin, rifampicin and flucloxacillin showed the best activity against penicillinase producing strains. Fosfomycin and vancomycin were equally effective against infections due to methicillin-resistant S. aureus. Infections caused by "tolerant" strains again responded best to fosfomycin, vancomycin and rifampicin. PMID- 3957437 TI - Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust. AB - In 1972, a procedure was introduced by the Industrial Injuries Insurance Institutes (Berufsgenossenschaften) of the Federal Republic of Germany, which is to be used by the special occupational health service for employees exposed to asbestos dust. Since 1 January 1972, occupational health examinations are performed when exposure to asbestos dust has been of at least 3 years' duration. On 1 January 1977, a prospective cohort study was started with employees formerly exposed to asbestos dust whilst working for companies manufacturing or using asbestos. Data on these persons are collected in the Central Register of Employees Exposed to Asbestos Dust of the Industrial Injuries Insurance Institutes. A total of 3,070 male and female employees in whom asbestos exposure terminated after 1 January 1972 formed subcohort I of the study. For comparison, 665 persons whose exposure terminated before 1 January 1972 served as subcohort II. In addition to several other inclusion criteria, each individual's permission was required before personal data could be evaluated. Of the subjects in the two subcohorts, 185 and 71, respectively, had died by 31 December 1982. Tumours were more frequently than this cause of death is expected in the general population. In addition to a high incidence of mesothelioma, the standard mortality rate was especially increased for lung cancer. The proportional mortality rates of about 40% for tumours of all sites (with about 17% lung cancer and 8% mesothelioma) especially in subcohort II, seemed to be comparable to the international figures for epidemiological mortality. PMID- 3957438 TI - A tentative proposal for classification of audiograms in noise-induced deafness: relationship between audiogram and subjective complaints in noise-exposed workers. AB - Audiograms obtained from workers exposed to occupational noise were classified into six stages, namely, "normal" and stages I-V of noise-induced deafness, using the audiometric chart and the classification table designed by the authors. Close correlations were observed between the severity of the stage and the degree of hearing in daily life, which support our classification method. On the other hand, the prevalence rate of tinnitus also showed a linear increase in proportion to the severity of the stage, although the mechanism of tinnitus in noise-induced deafness has not yet been elucidated. From the viewpoint of protecting workers from hearing damage due to noise exposure, further investigation is required to make the best use of our classification method in noisy workplaces. PMID- 3957439 TI - Urine mutagenicity, chromosomal abnormalities and sister chromatid exchanges in lymphocytes of nurses handling cytostatic drugs. AB - The effects of handling antineoplastic drugs were examined in 17 nurses working in a pneumology department in a hospital in the Paris area. Twenty-five others in the same department who were not handling such drugs acted as controls. Exposure to antineoplastic drugs was evaluated by questionnaire and by assessment of urine mutagenicity. The cytogenetic repercussions of exposure were assessed by examining sister chromatid exchanges and chromosomal abnormalities in circulating lymphocytes. The urine of the exposed nurses was significantly more mutagenic than that of the controls. No cytogenetic abnormalities were revealed in the exposed subjects since both these and the control nurses exhibited similar frequencies of chromosomal abnormalities and similar average numbers of sister chromatid exchanges in circulating lymphocytes. However, in smokers, the urine was significantly more mutagenic compared to that of nonsmokers, chromosomal abnormalities were twice as frequent, and the number of sister chromatid exchanges was significantly larger. Comparison of these results with the findings of other authors suggests that the moderate exposure to antineoplastic drugs prevailing in this pneumology department (i.e., an average of about 11 infusions per week) does not cause detectable cytogenetic abnormalities even though it significantly increases urine mutagenicity. PMID- 3957441 TI - The relationship between blood-lead concentrations, intelligence, attainment and behaviour in a school population: the second London study. AB - This study replicates an earlier one carried out in London in which an association was found between lead and intelligence, reading and spelling. In the present study 194 children living near an urban motorway were given the same battery of tests as well as an extensive family interview to determine background variables. Before social factors were taken into account there were no significant associations between lead and outcome variable. Possible reasons for the negative results from this study are discussed. PMID- 3957442 TI - Antibody in tears, saliva and nasal secretions following oral immunization of humans with inactivated influenza virus vaccine. AB - Oral immunization of 5 volunteers with an enteric-coated inactivated influenza vaccine resulted in a significant rise of IgA-specific antibodies in tears, saliva and nasal secretion, reaching a maximum response 5-7 weeks after completion of immunization. PMID- 3957443 TI - Sensitization induced in guinea pigs with beta-propiolactone-treated serum albumin: experimental evidence for the cause of allergic reactions in humans receiving human diploid cell rabies vaccines. AB - beta-Propiolactone-treated (BPL-T) homologous serum albumin caused anaphylaxis in guinea pigs with a frequency and severity equal to that of guinea pigs inoculated with human albumin. Untreated guinea pig serum albumin did not cause any reactions in these animals. Some recipients of current rabies vaccine produced in human diploid cells available in the USA develop systemic allergic reactions, usually following booster immunization. The BPL-T human albumin component of the vaccines was believed to be the cause of the complications. Our studies support this conclusion. PMID- 3957440 TI - Effects of sinusoidal whole-body vibration on the lumbar spine: the stress-strain relationship. AB - The aim of this experimental study was to estimate the strain in the lumbar spine due to whole-body vibration (WBV). Four male subjects were exposed to vertical sinusoidal WBV with frequencies ranging from 1 to 15 Hz at two intensities (I1 = 1.5 ms-2 rms; I2 = 3.0 ms-2 rms). The compressive forces acting on the disc L3-4 during the extreme values of acceleration were predicted on the basis of anthropometric data, EMG of back muscles and the acceleration of the upper trunk, using a simple biomechanical model. The estimated mechanical activity of back muscles was not able to protect the spine under many exposure conditions. The highest compressive forces were predicted for WBV with 7.5, 8 and 4.5 Hz. The results suggest the possibility of fatigue failures at the endplates of lumbar vertebrae after intense long-term exposure to WBV. PMID- 3957444 TI - Comparative studies on tree pollen allergens. X. Further purification and N terminal amino acid sequence analyses of the major allergen of birch pollen (Betula verrucosa). AB - The previously isolated major allergen of birch pollen (fraction BV45), Int. Archs Allergy appl. Immun. 68: 70-78 (1982), was further purified by recycling chromatography. The purified preparation was run on a high-performance liquid chromatography (HPLC) TSK-G-2000 gel filtration chromatography column and, finally, on paper high-volt electrophoresis. The protein recovered met the homogeneity criteria required for performing the N-terminal sequence analysis. The allergenic and antigenic reactivities of the HPLC-purified protein, designated BV45B, was examined. A single homogeneous precipitation line in crossed immunoelectrophoresis (CIE) was shown. Specific IgE-inhibition tests and immuno-autoradiographic prints indicated that this allergen could bind reaginic IgE specificially and with good affinity. The homogeneity of BV45B was examined by isoelectric focusing (IEF). Several minor bands of pI differences of less than 0.1 units were visible, demonstrating the existence of some molecular variants of this protein. The N-terminal sequence analysis of the molecule was performed, and the following four amino acids were tentatively shown by sequential cleavage: NH2 Ala-Gly-Ile-Val-. The demonstration of one dominant N-terminal 1-dimethyl-amino-5 naphthalene sulphonyl (DNS)-amino acid by polyamide thin-layer chromatography at each sequence step confirmed that the N-terminal residue of the protein was not blocked; the heterogeneity shown by the IEF system was merely due to the presence of several homologous polymorphic proteins with identical N-terminal amino acid, the adequacy of the purification repertoire used. PMID- 3957445 TI - Serum factors which suppress natural cytotoxicity in cancer patients. AB - Spontaneous cytotoxicity mediated by natural killer (NK) cells is potentially an important mechanism of immunosurveillance against tumor or virus-infected cells. NK activity is impaired in many cancer patients. This study investigated the possibility that humoral factors are responsible for depressed NK activity in cancer patients and examined whether these factors were anti-lymphocyte antibodies (ALA) or immune complexes. The degree of NK suppression induced by 20 cancer patients' sera was determined by preincubating normal peripheral blood mononuclear cells with cancer sera. Eight of the 20 serum samples from cancer patients had NK-suppressive humoral factors. Elimination of immune aggregates by ultracentrifugation did not remove the inhibitory factors. The degree of NK suppression induced by cancer sera correlated with the extent of NK impairment in the serum donors (p less than 0.05). The cancer sera was examined for the presence of ALAs using flow cytometry. All cancer sera tested contained only low ALA reactivity to NK cell-enriched suspensions (less than 15%). This is in marked contrast to previous reports regarding NK-inhibitory systemic lupus erythematosus sera which contained large amounts of large granular lymphocyte (LGL) reactive ALAs. This study demonstrates that certain cancer sera suppress NK cell function. These inhibitory serum factors do not appear to be LGL-reactive ALAs or immune aggregates. PMID- 3957446 TI - Intraepithelial migration of nasal mucosal mast cells in hay fever. AB - Mast cells were studied by light microscopy in mucosal imprints and in biopsies of nasal mucosa of 12 birch pollen allergic individuals before and during the pollen season, using techniques optimized for the demonstration of mucosal mast cells. We also measured the histamine content of nasal mucosa, whole blood and plasma, and counted the numbers of circulating blood basophils. Before the pollen season the nasal mucosa was found to contain many mast cells located in the mucosal connective tissue stroma, and very few cells with basophilic and metachromatic granules were found in mucosal imprints. During the pollen season there was a redistribution of mast cells into the epithelium, many such cells now being recovered in mucosal imprints. The total number of mucosal mast cells counted in tissue sections did not change significantly with the onset of the pollen season, suggesting a redistribution of mucosal mast cells by migration. Judged by morphologic appearance and naphthol-AS-D chloroacetate esterase activity, the intraepithelial mast cells found in tissue sections had rather the properties of tissue mast cells than of blood basophils, and only a few of the basophilic cells of the imprints had a morphology compatible with blood basophils. The histamine content of the mucosa, as well as histamine levels of whole blood and plasma, and circulating blood basophil numbers did not change significantly in relation to the pollen season. These findings suggest that an intraepithelial migration of mucosal mast cells is part of the allergic mucosal response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957447 TI - IgG2 antibodies block IgE antibody-induced asthma in guinea pigs. AB - In order to examine the blocking activity of IgG2 antibodies to guinea pig for IgE antibodies-induced guinea pig asthma, experiments were carried out as follows. Guinea pigs were passively sensitized intravenously with guinea pig serum containing IgE antibodies to ovalbumin (OA). 8 days after sensitization, IgG2 purified from guinea pigs hyperimmunized with OA was intravenously injected. One hour later, the guinea pigs were challenged by inhalation of OA solution. Asthma attacks were not observed in the guinea pigs, whereas the attacks were observed in guinea pigs passively sensitized with the IgE antibodies but injected IgG2 fraction from normal guinea pigs 1 h before inhalation. These observations suggested that IgG antibodies that increased after immunotherapy might block asthma caused by inhalation of allergens in humans. PMID- 3957448 TI - Liver dysfunction in dialysis patients. PMID- 3957449 TI - Experiments with continuous hemofiltration and hemofiltrate regeneration in the rat. AB - Experimental studies were made with continuous hemofiltration treatment for bilaterally nephrectomized rats and initial observations regarding the effects of such treatment on leukocyte and thrombocyte counts are reported. Hemofiltration of unanesthetized rats able to move freely within their cage could be continued for up to 30 h using a pump-driven ECC system. Blood parameters recorded during this treatment indicate that the detoxification was effective. In another series of experiments the water and electrolyte reabsorption capacity of the colon ascendens of healthy rats was tested by continuously supplying NaCl solution into the colon via a fistula. A large proportion, if not all, of the hemofiltrate can be discharged into the colon without diarrhoea. A final series of experiments showed that the three-stage operation (implantation of permanent catheters, connection of a permanent intestinal fistula and bilateral nephrectomy) is possible with the rat. PMID- 3957451 TI - Design and fabrication of a capillary cell culture chamber for the study of convective flow. AB - The use of capillary culture chambers as artificial pancreas and artificial liver devices would be aided by an improved ability to control the movement of molecules through the capillary walls. The modeling and analysis of the flow and mass transfer in capillary cell culture chambers in which cultured mammalian cells are grown to form masses with tissue density in the extra-capillary spaces is desirable as a basis for scaleup and optimization of the particular microenvironment. The relative roles of diffusion and ultrafiltration with convection in enhancing mass transfer across the capillary membranes are poorly understood in real cell cultures and the effects on culture viability of flow conditions chosen to promote convective flow across the capillary membranes and through the cultured cell masses are also of interest. In this report, experience with materials and techniques for fabricating capillary culture chambers with a more readily analyzed fully defined regular geometric relationship between 90 to 100 capillaries in a parallel bundle is described. High and low pressure capillaries were interspersed in a regular array. Evidence is presented for retention of cell viability during flow conditions which were chosen to induce convective flow through the cultured cells in such a chamber. PMID- 3957452 TI - Prevention and amelioration of acute renal failure. PMID- 3957450 TI - Deranged concentrations of water-soluble vitamins in the blood of undialyzed and dialyzed patients with chronic renal failure. AB - Blood concentration of water-soluble vitamins were measured in patients with mild chronic renal insufficiency, uremic undialyzed and dialyzed patients and control subjects. The whole blood concentration of B1 was significantly lower in dialyzed patients. Plasma levels of B2 were elevated in uremic and dialyzed patients and plasma B6 was significantly increased in dialyzed patients. Serum levels of B12 and folic acid were elevated in uremic and dialyzed patients. The results of this study differ from those reported from Europe and the U.S.A. These geographical differences may arise primarily from differences in staple food, vegetable intake, and traditional methods of food preparation. PMID- 3957453 TI - Polymer resins with amino acid containing pendants for sorption of bilirubin. II. Polyamide resins with various basic amino acids. AB - Short peptides, three to eight amino acids in length, containing various combinations of alanine, arginine, lysine, histidine and tyrosine have been synthesized onto water-swellable polyamide resin by the solid phase peptide synthesis method. The amount of bilirubin adsorbed from aqueous buffer solution (pH = 7.8) by the resins increases with increasing basicity of the amino acids in the pendant. As the number of basic amino acids on the pendant is increased from one to five a 4.7 fold enhancement in the adsorption capacity is seen for arginine while a 9.3 fold enhancement is obtained for lysine. A corresponding increase in length for the non-basic histidine results in a 6 fold enhancement. With alanine the adsorption capacity is uneffected by an increase in pendant length. PMID- 3957455 TI - Experimental considerations for the centrifugal separation of blood cell components. AB - Processing techniques using recycle and staging for blood cell collection lead to numerous conceptual design configurations. From a practical viewpoint, many of these schemes can become incongruous. Experimental fractional recoveries with up to six stages are presented, and material balance considerations and process comparisons are made. Isolation of specific leukocyte types, and cell viability effects are studied. PMID- 3957456 TI - Depletion lymphocytapheresis in chronic lymphocytic leukemias: criteria for predicting which patients will respond to treatment. AB - Depletion lymphocytapheresis therapy using the continuous-flow separator was used in twenty-two cases of chronic lymphocytic leukemia. Applying the Montserrat scoring system, a prediction can be made, to a good approximation, whether the patient will be a "responder" or a "non-responder" to leukapheresis. Criteria have been formulated for decisions on when depletion lymphocytapheresis is absolutely or only relatively indicated, on the basis of total scores from 2 through 6 using the Montserrat criterion. PMID- 3957454 TI - Hematological and biochemical studies in calves living over 100 days with the polymethylmethacrylate total artificial heart TNS Brno II. AB - A polymethylmethacrylate total artificial heart (kinetic components made of polyetherurethane) of TNS Brno II type was implanted into seven calves (2-5 months of age) surviving for the average of 152.4 +/- 19.1 days after the implantation. During the entire post-operative period the animals received oral warfarin-sodium, acetylsalicylic acid, dipyridamole and alpha-tocopherol. Blood was taken for biochemical and hematological examinations twice a week from the jugular vein. During the experiments there were decreases in the number of red blood cells, hematocrit and hemoglobin levels. Plasma free hemoglobin and serum enzymes (alkaline phosphatase, AST, ALT, LDH) increased. Coagulation tests were abnormal because anticoagulation therapy was used. There were minimal changes in the number of white blood cells and platelets, fibrinogen, blood pH, blood glucose, serum electrolytes, bilirubin (total and direct), creatinine, blood urea, and lactate. Possible reasons for observed changes include the gradual rise in the central venous pressure and damaged function of the liver parenchyma. Other factors playing a possible role in inducing changes in laboratory findings are also discussed. PMID- 3957457 TI - End stage renal disease in leprosy. PMID- 3957458 TI - Adenosine deaminase complexing protein (ADCP) immunoreactivity in colorectal adenocarcinoma. AB - Immunoreactive adenosine deaminase complexing protein (ADCP) was studied in 91 human colorectal adenocarcinomas. The expression of ADCP was correlated with that of secretory component (SC) and carcinoembryonic antigen (CEA), with the histological grade and the Dukes' stage of the carcinomas. The histological grade was scored semi-quantitatively according to 5 structural and 4 cytological variables. ADCP expression was observed in 3 different staining patterns, namely: (1) diffuse cytoplasmic (77% of the carcinomas); (2) granular cytoplasmic (13%); and (3) membrane-associated (66%). These patterns were observed alone or in combination. Eleven percent of the carcinomas exhibited no ADCP immunoreactivity. Linear regression analysis showed that the expression of ADCP correlates with that of SC and CEA. However, no significant correlation emerged between the histological parameters or the Dukes' stage and any of the immunohistological parameters. Comparison of the histological characteristics of carcinomas exhibiting little or no ADCP immunoreactivity with those showing extensive immunoreactivity, showed that membranous ADCP immunoreactivity occurs more frequently in well-differentiated carcinomas. Structural parameters showed a better correlation with membranous ADCP expression than the cytological variables. It is concluded that membranous expression of ADCP and CEA are indicators of a high level of differentiation as reflected primarily in the structural characteristics of the tumor. PMID- 3957459 TI - Cancer of the nasal cavity and paranasal sinuses, and formaldehyde exposure. AB - This case-control study of nasal and paranasal sinus tumors, in males diagnosed between 1978 and 1981 in the Netherlands, was designed to identify environmental risk factors. Special attention was given to assessing any association between nasal cancer and an occupational history of possible formaldehyde exposure while taking into account histologic type of tumor, history of tobacco use, and occupational exposure to wood dust. Of the 116 cases and 259 controls identified, interviews were completed for 91 (78%) of the cases and 195 (75%) of the controls. Adenocarcinoma was strongly associated with a history of high wood dust exposure (RR = 27.0). Two independent assessments of the association between possible formaldehyde exposure and the risk for nasal cancer were carried out (Assessments A and B). By Assessment A the relative risk for nasal cancer associated with possible formaldehyde exposure was 2.5 and by Assessment B it was 1.9. The risk appeared to be most strongly associated with squamous-cell carcinoma and could not be attributed to differences between cases and controls in age, smoking habits, or wood dust exposure. By its retrospective nature, the classification of formaldehyde exposure in this study is not based on known exposures to formaldehyde but on assessment of employment in jobs where formaldehyde exposure is thought possible. Given the limitations of the study, the authors do not consider that it provides conclusive evidence of a carcinogenic effect for formaldehyde, but that it indicates a need for further research--particularly into formaldehyde and squamous carcinoma of the nose. PMID- 3957460 TI - Use of monoclonal antibodies to human breast-tumor-associated antigens in fine needle aspirate cytology. AB - Fine-needle aspiration cytology (FNAC) is currently used in evaluating the nature of breast nodules. In the present study we have examined whether monoclonal antibodies (MAbs) to breast-tumor-associated antigens (BTAA) can be employed in FNAC for the diagnosis of breast cancer. For this purpose we have used 2 murine MAbs recognizing 2 distinct BTAA expressed by breast tumors, irrespective of their histotype, in an indirect avidin-biotin immunohistochemical technique on aspirate smears. The results of this study show that, while benign lesions are consistently negative, tumor cells containing aspirates are reactive with at least one MAb in 95% of the cases. Thus, selected MAbs to BTAA may be a powerful diagnostic tool in conjunction with conventional cytology, and because of the objective interpretation of the immunohistochemical findings, FNAC of the breast can eventually be extended outside specialized institutions. PMID- 3957461 TI - Procoagulant activity of human alveolar macrophages: different expression in patients with lung cancer. AB - Mononuclear phagocytes, an integral part of the lymphoreticular infiltrate of many malignant tissues, might contribute to tumor-associated fibrin deposition through the production of procoagulant activity (PCA). We have studied the PCA of human alveolar macrophages in 28 patients with primary lung cancer and in 9 control subjects. Alveolar macrophages (greater than 97% esterase positive) were isolated form bronchoalveolar lavage fluids by adherence onto plastic. PCA was evaluated by a one-stage clotting assay immediately after isolation (basal PCA) and after incubation (4 hr at 37 degrees C) in the absence and in the presence of endotoxin. Cells from control subjects had low basal PCA (3.9 +/- 1.0 units/5 X 10(4) cells) but, upon exposure to endotoxin, they displayed a 5- to 16-fold increase in PCA. In patients, different patterns of PCA were observed. In the 8 patients in whom lavage had been carried out on the contralateral side to the neoplasm, alveolar macrophages behaved essentially like those from controls. In contrast, in the 20 patients in whom macrophage populations close to the site of the tumor were examined, PCA was abnormal in many respects. In 12 of these, alveolar macrophages had basal PCA comparable to or somewhat lower than control cells, but exhibited a poor procoagulant response when incubated in vitro in the presence of endotoxin. Alveolar macrophages from the remaining 8 patients expressed far higher levels of basal PCA than control cells (25.1 +/- 5.9 units as compared to 3.9 +/- 1.0 units/5 X 10(4) cells). These cells retained their ability to respond to endotoxin in vitro with a 3-fold increase in PCA. In all instances, alveolar macrophage PCA had the characteristics of tissue factor. These data suggest that the presence of primary lung cancer may modulate the expression of PCA in alveolar macrophages close to the tumor site. PCA might be useful to better characterize the functional state of macrophages near the tumor. PMID- 3957462 TI - Prevention of metastatic spread by postoperative immunotherapy with virally modified autologous tumor cells. I. Parameters for optimal therapeutic effects. AB - Effective anti-metastatic therapy was achieved in a mouse tumor model by combining surgery with post-operative immunotherapy using virus-modified autologous tumor cells. No therapeutic effect was observed when using for immunotherapy the nonmodified autologous tumor ESb, which is only weakly immunogenic and highly metastatic. The viral modification was achieved by infecting the tumor with an avirulent strain of Newcastle disease virus (NDV), which led to expression of viral antigens and to an increase in the tumor cells' immunogenicity. Parameters which were of decisive influence for success or failure of therapy were the time of operation of the primary tumor and the dose of virus which was admixed to a standard dose of irradiated tumor cells. There was a low dose optimum of NDV at about 100 hemagglutinating units per 25 X 10(6) tumor cells. The therapeutic effect observed was less pronounced if the virus was given separately from the tumor cells. Post-operative immunotherapy with NDV modified tumor cells had the following therapeutic effects: (1) disappearance of micrometastases from visceral organs as ascertained by a sensitive bioassay; (2) life prolongation in virtually all animals when compared to controls (operated only); (3) cures in about 50% of the treated animals. The possible mechanism of this therapeutic effect and its potential for clinical application are discussed. PMID- 3957463 TI - Chemosensitivity profiles of human cancers assessed by the 6-day SRC assay on serially xenografted tumors. AB - To assess the potential value of the 6-day subrenal capsule (SRC) assay in preclinical evaluation of new drugs using serially xenografted human tumors as source of tumor tissue, we studied the response of 31 human tumor lines (8 malignant melanomas, 12 sarcomas, 9 lung carcinomas and 2 colon carcinomas) to relevant standard drugs and to a new imidazotetrazine, Mitozolomide. Mitozolomide was found to be the most active drug tested in 50% of the lung carcinomas and as active as CCNU in melanomas. The activity of the standard anticancer drugs against subrenal grafts closely resembled the patterns seen with the same tumors in the clinic. In further attempts to validate the procedure, sensitivity profiles of some tumors were concurrently determined in the subcutaneous (s.c.) nude mouse model. In 11 out of the 12 tumors, the two assays selected the same drug as being the most active and in most of these tumors the two procedures gave the same ranking for the different drugs. Also, when the relative sensitivities of a series of melanoma xenografts to each of two drugs (DTIC and CCNU) were tested, the two assays gave the same ranking of the xenografts for each drug. The concordance between the two assays and the fact that the s.c. nude mouse assay reflects the chemosensitivity of the parent tumor in patients, suggest that the application of the 6-day SRC assay to xenografted tumors is a valid and useful procedure permitting rapid preclinical evaluation of new drugs to be carried out at relatively low cost. PMID- 3957464 TI - Modulation of protein kinase C and Ca2+ lipid-independent protein kinase in lymphoma induced by Moloney murine leukemia virus in BALB/c mice. AB - We investigated the possible role of protein kinase C (PKC) in the progression of Moloney murine leukemia virus (Mo-MuLV)-induced lymphoma in BALB/c mice. Mice injected with Mo-MuLV on the first day after birth developed lymphoma within 1 1/2-3 months. The development of lymphoma was characterized by a gradual increase in the number of spleen cells. However, no analogous changes could be detected in the thymuses of these mice, although cells of both organs were found to be virus producers as early as 3-4 weeks after inoculation. PKC activity, which was assayed in extracts of spleen and thymus cells, declined gradually during the development of lymphoma. Concomitantly with this decline, a progressive appearance of Ca2+/lipid-independent protein kinase activity was observed. TPA treatment of intact cells from normal mice reduced the level of soluble PKC activity, while inducing Ca2+/lipid-independent phosphorylation. By contrast, TPA had no effect on these enzymatic activities in cells derived from leukemic mice. Spleen enlargement caused by injection of a non-leukemogenic inflammatory agent such as mineral oil was ineffective in this respect, suggesting that the PKC Ca2+/lipid-independent protein kinase modulation is associated with the virally induced leukemogenesis. PMID- 3957465 TI - Phenotypes of placental-type alkaline phosphatase in seminoma sera as defined by monoclonal antibodies. AB - PLAP-like enzymes could be detected in serum of patients with primary testicular tumors, in particular seminomas. The use of a panel of monoclonal antibodies (MAbs) permitted typing into 6 different testicular serum phenotypes, of which one appeared similar to a placental type (II) and 2 have not been previously described. Most tumor sera belonged to type I, as described for seminoma tissues. With a more advanced tumor the mean serum PLAP-like levels increased. After operation, after radiotherapy or with no evidence of disease lower or non detectable enzyme levels were found. In typing the tissue PLAP-like antigen in serum of the same patient or sera from recurrences of a seminoma in the same patient, the same phenotypes of PLAP-like antigen were usually but not always found. None of the 6 phenotypes appeared to confer a poorer prognosis. We conclude that the expression of PLAP-like antigen is eutopic and is enhanced by testicular malignancy, especially in seminoma cells. PMID- 3957466 TI - Altered glycosylation of membrane glycoproteins in human uroepithelial cell lines. AB - Total cellular glycopeptides of 7 human uroepithelial cell lines that differ in the grade of transformation (TGr) were analysed by gel filtration and affinity chromatography on immobilized lectins. The 4 cell lines that are tumorigenic in nude mice and invasive in vitro (TGr III) possess more highly branched, tri- and tetraantennary N-acetyllactosaminic glycans, with less biantennary glycans than the 2 non-tumorigenic, noninvasive (TGr II) cell lines examined. The only exception to this general pattern is the third cell line, which is classified as TGr II. The cellular glycopeptide distribution pattern in this cell line is similar to that of the TGr III cells. The possible relationship between altered glycosylation of membrane glycoproteins and the expression of a malignant phenotype is discussed. PMID- 3957467 TI - Estimation of the peak-to-peak pressure gradient in aortic stenosis by Doppler echocardiography. AB - The present study was designed to develop a new Doppler method to estimate noninvasively the peak-to-peak pressure gradient in patients with aortic stenosis. It was carried out in two steps. In the first study, left heart catheterization data were analysed in 58 patients with aortic stenosis. The peak pressure gradient correlated highly with (r = 0.98) but overestimated significantly the peak-to-peak pressure gradient. The averaged pressure gradient (average of the peak gradient and the gradient at the peak aortic pressure) was found to approximate closely the peak-to-peak pressure gradient (r = 0.99) with a good separation between significant and insignificant aortic stenosis. The ratio of the left ventricular ejection time over the aortic pressure descending time was studied and the beginning of the late one-third systole was chosen as the point for determining the late systolic gradient by the Doppler technique. In the second study, Doppler echocardiography and cardiac catheterization were performed in 35 patients with aortic stenosis. The Doppler-determined peak pressure gradient correlated highly with catheterization-measured peak pressure gradient (r = 0.95) but overestimated significantly the peak-to-peak pressure gradient. The Doppler-determined averaged pressure gradient (average of the peak and the late systolic gradients) estimated accurately the peak-to-peak gradient (r = 0.97) with a good separation between significant and insignificant aortic stenosis. These results demonstrate the limitations of the peak pressure gradient measurement and the reliability of the Doppler-determined averaged pressure gradient for estimation of the peak-to-peak pressure gradient. PMID- 3957468 TI - Cardiac function and plasma catecholamines during upright exercise in healthy young subjects. AB - Radionuclide left ventricular ejection fraction, left ventricular volume changes and plasma catecholamines were recorded in six healthy untrained male subjects at rest and during upright exercise at increasing work loads. During mild submaximal exercise mean left ventricular ejection fraction increased 10% because of end diastolic dilation, while a further 4% increase of left ventricular ejection fraction was recorded at heavy submaximal exercise mainly due to increased end systolic contraction. Great individual changes were recorded during maximal exercise. Alterations in plasma catecholamines were most pronounced at the high exercise levels indicating that changes in cardiac contractility are not linearly correlated with changes in sympathetic nervous activity. Repeat studies showed only minor variations of mean left ventricular ejection fraction and plasma catecholamines indicating an acceptable reproducibility of the measurements. Variations of both left ventricular ejection fraction and catecholamines were smaller during exercise than at rest. PMID- 3957469 TI - Effects of nicardipine on left ventricular function and energetics in man. AB - The effects of nicardipine, a new dihydropyridine calcium antagonist, on left ventricular function and energetics were studied in 13 patients. Nicardipine was administered as a 2 mg bolus (i.v.) followed by an infusion titrated to maintain a 10-20 mm Hg decrease in systolic pressure. Nicardipine increased heart rate 19% (P less than 0.001) while left ventricular end-diastolic pressure was not significantly changed and stroke volume (ml) increased 13% (P less than 0.01). Peak values for the first and second time derivatives of left ventricular pressure were increased by 26% (P less than 0.01) and 50% (P less than 0.02) respectively. Peak aortic blood flow, peak aortic blood acceleration, and the peak rate of change of ejection power were increased 86% (P less than 0.001), 123% (P less than 0.01), and 113% (P less than 0.001), respectively. Stroke work was not changed during nicardipine infusion. External power increased by 40% (P less than 0.01); however, the ratio of oscillatory to total power was not significantly different. Although the product of heart rate and systolic aortic pressure was not significantly altered with nicardipine, myocardial oxygen consumption increased 18% (P less than 0.02) with a disproportionate increase in coronary blood flow of 41% (P less than 0.001) and decrease in coronary resistance of 39% (P less than 0.001). The time constant for left ventricular isovolumic relaxation decreased 22% (P less than 0.001) during nicardipine infusion while the minimum value of dP/dt was unchanged. Thus, when administered intravenously in man, nicardipine is a potent coronary and systemic vasodilator producing reflex tachycardia, increased indices of myocardial contractile state, and improved isovolumic relaxation with an associated increase in myocardial oxygen consumption. PMID- 3957470 TI - Effect of intravenous and oral flecainide on ventricular tachycardia. AB - The effect of flecainide acetate, a class 1c antiarrhythmic agent, was examined in 15 patients with recurrent ventricular tachycardia. Intravenous flecainide was administered in a dose of 2 mg/kg at the time of intracardiac stimulation and recording studies. Oral flecainide was given to 10/15 patients and retesting was undertaken using an indwelling electrode. Intravenous flecainide terminated sustained stable tachycardia in 8/11 patients and prevented reinitiation of tachycardia in 5/10 patients. Oral therapy prevented induction of tachycardias in only 2/10 patients. Five patients had non-sustained tachycardia and three had slower sustained tachycardia. "New" non-clinical tachycardias could be induced in six patients after flecainide but five of these had had more than one type of induced tachycardia. Four of 10 patients remained free of tachycardias during follow-up. Withdrawal of oral treatment was necessary in three patients, one of whom had severe proarrhythmic effects. Two patients required additional antiarrhythmic therapy. Long-term suppression could not be predicted from the results of oral therapy, but testing after intravenous drug seemed to be a more useful prognostic indicator. In summary, intravenous flecainide is effective for slowing and termination of stable ventricular tachycardia. Oral therapy is also effective but caution should be exerted in patients with multimorphic tachycardias. PMID- 3957471 TI - Coarctation of the aorta associated with pulmonary valve stenosis. AB - A 7-year-old patient had coarctation of the aorta associated with moderate and dysplastic pulmonary valve stenosis. The child underwent corrective surgery of the coarctation. This unusual association cannot be satisfactorily explained by the theory of fetal flow patterns. PMID- 3957472 TI - Anatomical-echocardiographic correlations in pulmonary atresia with intact ventricular septum. Use of subcostal cross-sectional views. AB - Cross-sectional echocardiographic images from 26 patients presenting pulmonary atresia with intact ventricular septum were compared with anatomical findings in specimens having the same anomaly. The echocardiographic study was based on a subcostal approach using oblique projections, and specimens were cut in the same planes. Patients were classified into three groups. In the first group the morphologically right ventricle was represented by all of its three component parts: inlet, trabecular and outlet (12 cases). The second group was made up of patients with overgrowth of the apical component. Consequently the right ventricle had only two effective components: inlet and outlet (6 cases). In the third group, muscular overgrowth of both outlet and apical portions meant that the right ventricle was represented only by an inlet portion (8 cases). The good morphologic assessment and correlation with anatomic cuts, obtained in particular by using the "right oblique equivalent" view can avoid invasive study in this malformation prior to palliative surgery. PMID- 3957473 TI - Conduction abnormalities detected by electrophysiologic testing following repair of ostium primum atrioventricular septal defect. AB - Since 1983 we have performed electrophysiologic studies in 6 patients who had previously undergone repair of an ostium primum atrioventricular septal defect. Information obtained during electrophysiologic studies was crucial in guiding appropriate pacemaker therapy in these patients. As judged from the resting electrocardiogram, sinus or junctional bradycardia was present in 3/6, atrial flutter / fibrillation in 2/6, and paced rhythm in 2 patients who had had ventricular pacemakers implanted for complete atrioventricular block. During maximal exercise testing 4 patients had reduced heart rates; 2 had sudden drops in heart rate at 1 min postexercise; 1 patient had exercise induced ventricular bigeminy; and 1 patient with atrial flutter and 2: 1-4: 1 block at rest developed 1: 1 conduction during Stage II with an effective ventricular rate of 220/min. During electrophysiologic studies, the maximum corrected sinus node recovery time was abnormal in five of the six, ranging from 410 to 5630 msec. There was no spontaneous atrial rhythm in the other patient. Complete atrioventricular block was present in 2 patients while the atrioventricular Wenckebach phenomenon occurred abnormally at atrial pacing cycle lengths greater than 450 msec in 2 others. Supraventricular tachycardia or atrial flutter/fibrillation, was either spontaneous or induced in 2/6 patients, while ventricular tachycardia was induced in 1/3 patients who underwent programmed ventricular stimulation. Electrophysiologic studies were important in unmasking severe sinus node disease in 3 patients and atrioventricular node disease in 2. We therefore recommend that electrophysiologic studies be strongly considered as part of the evaluation of conduction abnormalities following repair of ostium primum atrioventricular septal defect. PMID- 3957474 TI - Early echocardiographic detection of right-sided intracardiac thrombus. AB - A right atrioventricular thrombus occurring as a consequence of a central venous catheter was echocardiographically detected in an asymptomatic 62-year-old man after an acute myocardial infarction. Prompt surgical removal of the thrombus removed the potential for pulmonary embolism. PMID- 3957475 TI - The value of gallium-67 scintigraphy in localising infection following cardiac surgery. AB - Radioactive gallium-67 has been used in a 64-year-old woman who developed persistent fever and a small sinus in the upper chest 6 weeks following open heart surgery for the replacement of a rheumatic aortic valve. The scintigraphy revealed unexpected extensive inflammation tracking down from the region of the sinus to the lower chest in front and under the heart. Chest X-ray and echocardiographic findings were inconclusive. The value of gallium scintigraphy in this case was not only in the localisation of the lesion but also in defining the extent of inflammation, the latter feature determining the need for reintervention. PMID- 3957476 TI - Lack of association between prodromes nausea and vomiting, and specific electrocardiographic patterns of acute myocardial infarction. AB - We conducted an observational study on 164 patients consecutively admitted to our coronary care unit in order to evaluate the predictive role of cardiac prodromes nausea and vomiting, in distinguishing a particular electrocardiographic pattern (Q wave versus non-Q wave and localisation) of an acute myocardial infarction. Patients with the prodromes made up 47.0% of all Q wave myocardial infarction and 59.4% in those without Q wave myocardial infarction. Furthermore, patients had nausea and vomiting in 25.0% of all Q wave myocardial infarction and in 31.2% of all non-Q wave infarction. No significant differences were found in the patients who experienced nausea and vomiting in the localisation (anterior versus inferior) of myocardial infarction. Our findings indicate that the cardiac prodromes of nausea and vomiting do not play any particular role in predicting a specific electrocardiographic pattern of acute myocardial infarction. PMID- 3957477 TI - The response of the coronary collateral circulation to acute administration of nifedipine: an angiographic and ergometric study. AB - To evaluate the role of collaterals in patients with effort angina we retrospectively compared the coronary cineangiograms of 14 subjects ("responders") who improved their exercise tolerance after acute nifedipine therapy with 14 subjects ("non-responders") with the same symptomatology who did not respond to the same treatment. The status of collaterals was graded with a score from a minimum of 0 to a maximum of 5. The responders showed a greater score than the non-responders (3 +/- 1 vs. 1 +/- 1, P less than 0.001), whereas there was no difference in the number of stenosed vessels between the two groups (1.8 +/- 0.9 vs. 2 +/- 0.8). Thus, in patients with effort angina and critical coronary stenosis, the presence of an efficient coronary collateral circulation can favour the increase in coronary flow reserve after vasodilator therapy. Our results suggest that the grading of collaterals may add useful information to the simple classification of one-, two- or three-vessel coronary artery disease. PMID- 3957478 TI - Causes of death in neonates born with a heart malformation. AB - All deceased infants were autopsied in a territory with a population of 1 220 000 inhabitants and a mean of 17 410 live births a year. During a period of 25 years (which preceded the introduction of advanced neonatal cardiac surgery), 393 neonates (6% of all deceased neonates) had died in whom a congenital heart malformation was found at autopsy. 118 (30%) of deaths were due to noncardiac causes. Lethal congenital noncardiac malformations caused death in 38 (10%) neonates. A perinatal disease (including birth trauma) was the cause in 65 (16%) neonates. An association of a noncardiac congenital malformation with a perinatal disease was involved in 6 (2%) neonates and a birth weight lower than 1000 g (together with a lethal perinatal disease or alone) was considered responsible in 9 (2%) neonates. Noncardiac but not unambiguously lethal malformations (mostly multiple) could at least have contributed to the fatal outcome in a further 86 (22%) neonates. A low birth weight could have contributed to death in 102 (26%) neonates, particularly in 42 (11%) neonates with a low birth weight associated with multiple noncardiac nonlethal malformations. A most probable or possible noncardiac cause of death was found in all cases of atrial septal defect, in 93% of tetralogies of Fallot, in 84% of ventricular septal defects, in 72% of hearts with double outlet right ventricle and in 57% of those with aortic coarctation. A congenital heart malformation was considered responsible for a fatal outcome in 82% of cases with discordant ventriculoarterial connexions ("transposition of the great arteries"), 79% of hypoplastic left hearts, 68% of pulmonary atresias and 53% of tricuspid atresias. The high proportion of noncardiac death noted to occur in the first postnatal day was found rapidly to decrease in the following days. PMID- 3957479 TI - Embryology of the mitral valve. AB - Development of the aortic (anterior) leaflet of the mitral valve was studied in human embryos from 3.6 to 25 mm crown-rump length. The notion that endocardial cushion tissue does not materially contribute to the atrioventricular valves has yet to be investigated for this particular leaflet. The study showed that the fused endocardial cushions act as an intermediary between the antero-superior and postero-inferior components of the valve leaflet. These latter components derive from the primary fold and the inlet septum, respectively. The cushion tissue itself is incorporated in a small portion of the leaflet which is continuous with the aortic-mitral intervalvar fibrous tissue. PMID- 3957480 TI - Developmental considerations of mitral valve anomalies. AB - Atrioventricular valve development is described as following the general principle of junctional invagination and myocardial undermining. We have added considerations of the topographic relations of the developing mitral valve to these principles. Two groups of malformations are then distinguished: the first comprises disturbances of the general principle, the second is related to topographic abnormalities. It is shown that the atrioventricular septal defect, the straddling mitral valve and the isolated mitral cleft all have their own specific developmental backgrounds. PMID- 3957481 TI - Ventricular tachycardia during exercise treated by verapamil. AB - The case history of two patients with symptomatic ventricular tachycardia is described. The first patient with systolic narrowing of a segment of the left anterior descending artery did not show any improvement on class I and III antiarrhythmic drugs. Oral verapamil suppressed the arrhythmia which showed some features of triggered activity. Cessation of the drug resulted in symptomatic recurrence. The second patient presented with a sustained ventricular tachycardia showing the morphology of right bundle branch block and left axis deviation. During electrophysiologic study the tachycardia was not inducible after oral verapamil. No definite conclusion on the mechanism of the arrhythmia could be drawn, nor on the mechanism of the antiarrhythmic action of verapamil in the first patient. Appropriate techniques to prove the efficacy of verapamil are needed in patients when it is given for chronic treatment of ventricular tachycardia. PMID- 3957482 TI - Downgrading of biochemical and cardiovascular responses to an intravenous infusion of terbutaline following chronic treatment with oral terbutaline. AB - Beta 2-agonists are known to cause a range of unwanted biochemical and cardiovascular responses. The present study was designed to investigate the effect of chronic exposure to beta 2-stimulation on the magnitude of these responses produced by an acute challenge with a beta 2-agonist. In this single blind placebo controlled study in six healthy male volunteers, we have compared the effects of chronic dosing with either oral terbutaline (5 mg three times daily for two weeks) or placebo on a number of these responses produced by an intravenous infusion of terbutaline (6 micrograms per kilogram over 1 hour). The infusion was given twenty-four hours after the last dose of oral terbutaline or placebo. The rise in pulse rate, systolic blood pressure and plasma glucose and the fall in serum potassium during terbutaline infusion, although still demonstrable, were significantly reduced following treatment with oral terbutaline compared to placebo. This suggests downgrading of beta-receptor function after chronic beta 2-stimulation. PMID- 3957483 TI - Rapid estimation of total body clearance of theophylline in patients receiving intravenous aminophylline infusion. AB - The method of Chiou to rapidly estimate theophylline total body clearance using two serum concentration data during the early stage of intravenous aminophylline infusion was evaluated in 16 patients with acute exacerbation of asthma or chronic obstructive pulmonary disease. The observed serum concentrations at later times were compared with those predicted. The mean prediction error for serum concentrations was 4.93% with a standard deviation of 20.06%. These results indicate that this simple method of Chiou may offer a reliable rapid estimation of total body clearance for dosage individualization in patients receiving intravenous aminophylline infusion. PMID- 3957484 TI - D-penicillamine in the therapy of fibrotic lung diseases. AB - We studied 12 patients with pulmonary fibrosis treated with D-Penicillamine in an attempt to regulate the collagen metabolism that is seriously affected in this group of patients. After six years follow-up we found a 33% survival rate compared to a 5% survival rate in patients treated with corticosteroids (p less than 0.01). Functional respiratory tests as well as quality of life were improved in all patients. No side effects attributable to D-Penicillamine were detected probably due to the fact that we used smaller doses than those reported in the treatment of other diseases of the connective tissue. We conclude that D Penicillamine can be a useful alternative drug in the therapy of patients with pulmonary fibrosis. PMID- 3957485 TI - Determination of isoniazid half-life from salivary samples. AB - Measurements of isoniazid (INH) half-lives from salivary samples were conducted in 8 healthy volunteers. The study showed a significant positive correlation between salivary and serum INH concentrations (rs = 0.92, n = 50) with the mean saliva/serum concentration ratio of 0.81 (+/- s. e. m. 0.05). The correlation in INH concentration between salivary and serum samples obtained during the elimination phase (rs = 0.92, n = 50) was greater than that obtained during the absorption phase (rs = 0.71, n = 18). The measurements of INH half-lives from salivary samples were very close to those from serum (rs = 0.95, n = 8), and no misclassification into either phenotype was made by using salivary INH half-life for acetylator phenotyping, compared to that by using serum samples. It was concluded, therefore, that INH half-life measurement from saliva could be used as a reliable and convenient method for acetylator phenotyping. However, the calculation of absorption kinetic parameter, of clearance and of the volume of distribution of INH by using salivary samples could not be justified. PMID- 3957486 TI - Electrophysiological characteristics of lorcainide, a new antiarrhythmic drug. AB - The electrophysiological characteristics and the antiarrhythmic indication areas of lorcainide were studied by using electrophysiological investigations and clinical studies in patients suffering from sustained arrhythmias. According to the data of the arrhythmia analyses (30 patients) the most important electrophysiological effects of lorcainide are: increase of the effective refractory period of the atria and ventricles; prolongation of the conduction time in the His bundle; prolongation of the refractory period and conduction of the accessory pathways. In the course of clinical studies (55 patients) lorcainide proved to be very effective in treating ventricular arrhythmias and preventing or disrupting ventricular tachyarrhythmic attacks. Lorcainide has a very promising antiarrhythmic effect in the suppression of tachyarrhythmias with accessory pathway conduction, too. PMID- 3957487 TI - Assessment of bio(in)equivalence of deriphyllin-digoxin in human volunteers. AB - Bioavailability of digoxin from the formulations of a fixed dose combination of the glycoside with xanthines was compared with that of "Lanoxin". The in vitro analysis of the fixed dose "Deriphyllin-Digoxin" tablets showed that these tablets had low dissolution even at the end of four hours. The in vivo study had a randomized cross-over design with a 14 days wash-out period. The formulations were administered to 14 healthy adult volunteers and periodic blood samples were collected up to 24 hours. The samples were analyzed for digoxin concentration using radioimmunoassay. Results indicate poor and delayed absorption of digoxin from the fixed dose combination. It is concluded that a multiple dose study with pharmacodynamic assessment, in patients or in volunteers, would be adequate to critically reassess the need for the marketed fixed dose combination. PMID- 3957489 TI - Disposition kinetics and urinary excretion of verapamil and some of its primary metabolites after oral administration in patients with angina pectoris. AB - Pharmacokinetics of verapamil and of its three primary metabolites [norverapamil, 2-(3,4-dimethoxyphenyl)-2-isopropyl-6-azaheptanitrile (D-617) and 2-(3,4 dimethoxyphenyl)-2-propylamino-3-methylbutyronitrile (D-260)] was studied after oral administration in 7 patients with stable angina pectoris. Serum levels of metabolites were found to be in the same range as that of the intact drug. Areas under the serum concentration time curves of each metabolite were higher and serum half-lives were significantly longer than those of verapamil. Half-life values obtained from urinary excretion data and from serum levels did not differ for the metabolites, but for the unchanged drug, the half-life from urinary excretion data was longer. Cumulative urinary excretion of verapamil, norverapamil, D-617 and D-620 up to 48 h postdose was averaged to 1%, 2.2%, 11.4%, and 6.7% of the dose administered, respectively. The extent of verapamil bioavailability was directly measured in one patient receiving an intravenous dose as well as an oral one and was found to be 42.3%. In other patients, bioavailability was assessed by means of a regression equation relating the reciprocal of bioavailability and oral clearance of the drug, and was averaged at 35.1%. The possibilities of contribution of the metabolites to verapamil effects in patients were discussed. PMID- 3957488 TI - Pharmacokinetic studies of nifedipine and digoxin co-administration. AB - We have studied the possible interactions between nifedipine and digoxin in 8 healthy subjects in two ways: A. The effect of digoxin (0.25 mg, tablet q.d. for 8 days) on the pharmacokinetics of nifedipine following single-dose (10 mg capsule) administration. Mean values for peak concentration, area under the serum concentration time curve (AUC), total serum clearance and the half-life of elimination of nifedipine did not differ before and concomitantly with digoxin administration. B. The effect of nifedipine (30 mg t.i.d.p.o. for 6 days) on the pharmacokinetics of digoxin following single dose (0.5 mg i.v.) administration. No significant differences were found between the mean values of the half-life of the alpha and beta phases, the AUC and the apparent volume of distribution of digoxin before and concomitantly with nifedipine administration. However, during the later period, the mean cumulative 96 h urinary excretion of digoxin increased by 18% (p less than 0.05) and the renal clearance of digoxin by 26% (p less than 0.05). No change was found, however, in the total plasma clearance of digoxin. PMID- 3957490 TI - The effect of activated charcoal on the bioavailability of piroxicam in man. AB - The effect of single and multiple oral doses of activated charcoal (a.c.) on the plasma concentrations of piroxicam was investigated in a cross-over study in 6 healthy volunteers after oral and rectal doses of 20 mg piroxicam. 50 g a.c. swallowed 5 min after the oral administration of one capsule of piroxicam almost completely prevented the absorption of the drug. 70 g a.c. per day were given in multiple doses over the interval of 10-58 h after the oral and 2-58 h after the rectal administration of piroxicam. This treatment reduced the mean bioavailability of piroxicam by 41.7% (oral) or 48.8% (rectal), relative to the control. The apparent total clearance increased significantly (p less than 0.05) to 163.6% (oral) or 187.9% (rectal) of the control. Half-lives of elimination were reduced on the average from 40.2 h to 19.6 h after the oral dose and from 40.7 h to 21.6 hours after the rectal dose under the a.c. treatment. It is inferred from these results that piroxicam is subject to enteral circulation. A.c. appears useful as an antidote in acute intoxications from piroxicam. PMID- 3957491 TI - The importance of the lymphatic system. PMID- 3957492 TI - Prevention of bronchial hyperreactivity in atopic asthmatics during the period of maximal allergenic risk: a six-month study. AB - Several different parameters of respiratory functions were measured to determine the hyperreactive bronchial responses to the fog-test of 21 atopic asthmatic subjects (prick test and RAST positive for grasses). Measurements were made before and after three and six months of prophylaxis with 1 mg b.i.d. ketotifen, with the period of the trial (April to September) chosen to correspond to the period of maximal allergen exposure. A further 8-patient control group, without prophylactic treatment, underwent the same fog-test and respiratory function measurements were repeated at the same times. In the ketotifen-treated patients almost total protection against the bronchoreactive response to the fog-test was seen after only three months of treatment (in June). The effectiveness of the treatment was maintained to the same extent throughout the rest of the 6-month trial. PMID- 3957493 TI - Bioavailability of rifampicin caplets (600 mg and 450 mg) in healthy Indonesian subjects. AB - A bioavailability study of rifampicin 450 mg caplets and rifampicin 600 mg caplets was carried out in 20 healthy male subjects. The higher dose was administered to subjects with a body weight greater than 50 kg. Subjects were divided into two groups where group 1 was treated with a single oral dose of 450 mg rifampicin in fasting condition. Group 2 was treated in the same way as group 1, but with a dose of 600 mg rifampicin. Our results in group 1 show peak heights of serum levels of rifampicin ranging from 13.6 to 21.0 micrograms X ml-1 (mean value was 17.6 micrograms X ml-1). AUC values ranged from 81.1 to 177.9 micrograms X ml-1h (mean value was 145.2 micrograms X ml-1 h.) Respective figures with 600 mg rifampicin were 11.0 to 27 micrograms X ml-1 (mean = 20.0 micrograms X ml-1) for peak heights and 132.0 to 260.6 micrograms X ml-1h (mean value = 181.1 micrograms X ml-1h) for AUC. In vitro dissolution tests were conducted on the same batch of respective products. Results show that maximum dissolution occurred in 15 minutes. It is concluded that our results were rather high compared to what has been reported so far. It has been suggested to reduce the dose to body weight ratio for rifampicin. PMID- 3957494 TI - A new aspect of serum protein binding of tolbutamide. AB - Tolbutamide is known to bind highly to serum proteins. Quite different values have, however, been reported for binding, ranging from 80 to 99 percent. In this study, in vivo and in vitro binding of increasing concentrations of tolbutamide to human serum proteins were evaluated. In vitro studies were done serum from three healthy males and for in vivo studies serum samples from eight healthy males who had received 1,000 mg tolbutamide were used. Protein binding was determined by equilibrium dialysis, using DIANORM system. Tolbutamide concentrations were determined by HPLC method of Uihlein and Hack. The results suggest that there is an increase in percent tolbutamide bound with increasing concentrations of tolbutamide. Generally, an inverse relationship between the total concentration of a drug in serum and its bound fraction is observed. Our findings seem to be contrary to this, at least within the concentration range studied. There exist at least two binding sites on albumin with different affinities for tolbutamide and most probably, at low concentrations, the drug binds mainly to the high affinity sites, whereas at higher concentrations additional drug will bind to the lower affinity sites leading to the observed increase in fraction bound with concentration. In conclusion it may be said that serum protein binding is a much more complicated phenomenon than generally stated and that the normal observations are only true for some ideal compounds where only one site of adsorption has to be taken into account. PMID- 3957495 TI - Comparative effects of combined dopamine and nitroprusside versus dobutamine and nitroprusside infusions for computer-controlled management of low-output cardiac failure after open heart surgery. AB - In order to evaluate the possible differences in response to two currently preferable inotropic-vasodilator drug combinations, the hemodynamic effects of automated infusions of nitroprusside-dobutamine and nitroprusside-dopamine were studied in two clinically similar groups of patients with low-output syndrome after aorto-coronary bypass surgery. Nitroprusside, when infused in combination with dopamine, was effective in lowering filling pressures of both ventricles and systemic and pulmonary arterial pressures reflecting the reversal of deleterious rise of these parameters including determinants of myocardial oxygen consumption (mean arterial pressure rate by +6%, heart rate by +20%) caused by dopamine (6 micrograms/kg/min) infused alone. The combination of the more cardioselective catecholamine dobutamine with nitroprusside brought about similar increase in cardiac output by 50%, but derived its hemodynamic efficiency from the sum of separate effects of components and produced less in the way of elevation of determinants of oxygen consumption. Dobutamine when infused alone (6 micrograms/kg/min) has not affected systemic and pulmonary arterial pressures and stroke index rose more markedly (+9%) as a result of more moderate heart rate increase (+13%). Nitroprusside contributed in an additive manner to the achieved overall reduction of SVR and PVR by 43% and 50%, resp., the automated infusion being helpful in maintaining these values within close tolerances. PMID- 3957496 TI - Tolbutamide kinetics in cigarette smokers in the Indian population. AB - A single oral dose of 500 mg tolbutamide was administered to 9 chronic cigarette smokers and 8 healthy matched control volunteers. Plasma tolbutamide half-life (t1/2 B) was shortened in cigarette smokers as compared to the nonsmokers, but the difference was not statistically significant (p greater than 0.05). However, the area under the plasma concentration (AUC O----x) and peak concentration (Cmax) were reduced significantly in smokers. Concern over enhanced metabolism of several drugs is probably warranted in cigarette smokers. PMID- 3957497 TI - Hemoperfusion/hemodialysis in the treatment of acute theophylline poisoning- description of a fatal case. AB - Treatment of theophylline overdosage with hemodialysis and/or hemoperfusion is accepted as necessary in the most severe cases. We treated a 63 year-old woman who had an initial theophylline concentration of 1000 micromol/l with resin hemoperfusion (Extracorporeal XAD-4). The theophylline concentration before and after the filter was found to approach each other in a linear pattern, and it was possible to predict the time of saturation of the filter. This happened after 2 hours and the treatment was then changed to hemodialysis and charcoal hemoperfusion in series. This combination was highly efficient in removing theophylline and no saturation occurred during the rest of the treatment. Theophylline clearance fell from 200 ml/min to 28 ml/min in 2 hours using resin hemoperfusion and from 196 ml/min to 177 ml/min using the combination of dialysis and charcoal hemoperfusion. Despite this theoretical successful treatment, the patient died 24 hours later. PMID- 3957498 TI - Clinical pharmacokinetics of theophylline during co-treatment with cefaclor. AB - The effect of cefaclor on the steady state pharmacokinetics of theophylline was investigated in healthy young adults by comparing the pharmacokinetic parameters as found during a nine days course of theophylline alone and as obtained during co-medication with the antibiotic cefaclor. The pharmacokinetic parameters obtained on Day 9 during the two periods of drug treatment accounted for the following figures respectively: minimum plasma concentration 5.0 +/- 1.7 mg X 1( 1) (mean +/- SD) and 6.0 +/- 2.0 mg X 1(-1); maximum plasma concentration 9.7 +/- 2.6 mg X 1(-1) and 9.0 +/- 2.6 mg X 1(-1); time to peak 3.2 +/- 0.4 h and 3.9 +/- 0.8 h; AUC 132.54 +/- 41.73 mg X 1(-1) X h and 126.90 +/- 40.45 mg X 1(-1) X h; half-life of elimination 6.6 +/- 1.6 h and 7.1 +/- 1.2 h; clearance 0.059 +/- 0.011 1 X h-1 X kg-1 and 0.063 +/- 0.014 1 X h-1 X kg-1; volume of distribution 0.54 +/- 0.09 1 X kg-1 and 0.64 +/- 0.17 1 X kg-1. Only the values for cmax and tmax after cefaclor co-treatment were slightly, but significantly (p less than 0.05) different from the values found after administration of theophylline alone. As the volume of distribution and the clearance were not affected by cefaclor, it is concluded that both drugs can be given concomitantly without any dosage adjustment of theophylline. PMID- 3957499 TI - Treatment of duodenal ulcers with ethoxzolamide, an inhibitor of gastric mucosa carbonic anhydrase. AB - Duodenal ulcer healing was followed by endoscopy in 186 ethoxzolamide-treated patients. Ethoxzolamide was given in doses of 5-10 mg/kg body weight/day in association with Na and K salts to avoid electrolytic losses. A control group of 161 duodenal ulcer patients received the usual doses of antacids and anticholinergics. The clinical course of pain, inhibition of gastric acid secretion and endoscopic healing of ulcers after 15 and 21 days of treatment were followed, together with the incidence of relapses over a 2-year period. Pain disappeared after 4-6 days of treatment in 91% of the ethoxzolamide-treated group and in 13% of the controls. After 10 days of treatment, ethoxzolamide reduced basal HCl output by 98%, in the control no significant secretory changes were recorded. Endoscopy showed healing in 92% of the cases after 15 days of treatment with ethoxzolamide and in 98% after 21 days; in controls, the corresponding figures were 36% and 46% respectively. Relapse rate after 6 months was 5% in the ethoxzolamide-treated patients and 38% in controls; after one year, relapses were endoscopically confirmed in 7% of the cases in the first group and in 51% respectively in controls; the same rate was 11% and 79% respectively after 2 years. Ethoxzolamide is superior to antacids and anticholinergics in healing duodenal ulcers. PMID- 3957500 TI - Binding of minaprine to human serum proteins and erythrocytes. AB - The binding of minaprine to human serum, isolated proteins and erythrocytes was studied in vitro. This drug shows both a saturable and a nonsaturable binding process in serum. The drug is bound to alpha 1-acid glycoprotein in a saturable fashion with a moderate affinity whereas albumin is involved in the nonsaturable and major binding. The combination of these two processes results in a slight decrease (7%) in the drug binding to serum within the range of therapeutic concentrations. Competitive binding with metabolites of minaprine or with other basic drugs seems unlikely when these compounds are present in serum at therapeutic levels. The binding of minaprine to erythrocytes remains constant within the range of therapeutic concentrations. PMID- 3957501 TI - Clinical usefulness of a dopaminergic agonist in headache diagnosis. AB - The dopaminergic system seems to be involved in pain modulation. In a 1983 publication, the administration of a dopaminergic agonist has been proposed as a test able to distinguish migraine from other cephalalgia. In the present study, 123 people were tested, 102 of them being migraine patients and the others being normal subjects. The test showed highly specificity for headache patients when compared to normal subjects, and was highly specific for migraine patients when compared to headache patients. Data are discussed considering the clinical diagnostic value, pathophysiological and therapeutic aspects. PMID- 3957502 TI - Effectiveness of flunarizine in altering electronystagmographic patterns in migraine patients: a preliminary report. AB - In this double-blind study versus placebo, the anti-migraine efficacy of flunarizine 20 mg/per os/day for 14 days, followed by 10 mg/per os/day up to 120 days has been evaluated in 30 patients suffering from common and classical migraine. During the trial the vestibular function (slow phase velocity (SPV) and number of spikes) was also studied. To date 18 patients have completed the study. The results show a significant difference before and after the treatment with flunarizine, while no difference was observed in the placebo group, with regard to headache unit indices. Flunarizine seems to increase SPV max, which is reduced between attacks in migraine patients; the number of spikes does not change significantly. PMID- 3957503 TI - Study on the absorption of ketoprofen topically administered in man: comparison between tissue and plasma levels. AB - In this study the transcutaneous passage of ketoprofen (gel) topically administered and its distribution in the inner part of the knee-joint were evaluated in six patients. The ketoprofen concentrations detected were: 4.70 mcg/g +/- 3.87 in the intra-articular adipose tissue; 2.35 mcg/g +/- 2.41 in the capsular sample and 1.31 mcg/g +/- 0.89 in the synovial fluid. Plasma concentrations of the drug were also examined. In the samples studied, the ketoprofen levels amounted to about one hundred times higher than the plasma concentrations. PMID- 3957504 TI - Serum azathioprine and 6-mercaptopurine levels and immunosuppressive activity after azathioprine in uremic patients. AB - The pharmacokinetics of azathioprine (AZA) and 6-mercaptopurine (6-MP) was studied in uremic patients after 100 mg AZA intravenously (fifteen patients) and orally (eight patients). 6-MP was analysed with gas chromatography mass spectrometry following extractive alkylation. AZA was determined indirectly assuming quantitative conversion to 6-MP in whole blood. The plasma concentration of AZA fell rapidly after i.v. administration. The mean half-time of elimination for the first rapid phase (t1/2 alpha) was 6.1 min (S.D. +/- 4.1) and for the terminal phase (t1/2 beta) 50 min (+/- 31). The total plasma clearance (Cl) was 6.9 1./min (+/- 3.0). AZA was rapidly converted to 6-MP in vivo, and maximal plasma concentrations of 6-MP were found as early as 5 min after i.v. injection of AZA. The mean t1/2 alpha was 4.6 min (+/- 2.2), t1/2 beta 74 min (+/- 58) and Cl 8.0 1./min (+/- 5.8). The plasma levels of both AZA and 6-MP were either low or undetectable 4-6 h after dose. In erythrocytes AZA levels were low or undetectable indicating rapid conversion to 6-MP in these cells. 6-MP concentration - time curve in erythrocytes was similar to that in plasma, except for a somewhat slower terminal phase of elimination. Oral administration of AZA generated flat plasma curves for AZA and 6-MP. The area under the concentration - time curve (AUC) was considerably smaller than after i.v. administration, 18 and 41% for AZA and 6-MP, respectively. There seems to be little danger of accumulation of AZA/6-MP in uremia. We also studied inhibition of Leucoagglutin (LA) stimulated lymphocyte proliferation by patient plasma at different times in six of the patients following AZA i.v. Sera drawn at 5, 10 and 30 min significantly inhibited the LA-induced proliferation, with an estimated minimum effective concentration of 6-MP in the cultures of about 0.02-0.04 microM. This suggests the possibility of a therapeutic effect even of the low plasma levels of 6-MP obtained after AZA orally. The combined use of sensitive pharmacokinetic and immunological assays as described should be useful in studying the relationship between plasma levels of AZA/6-MP and their immunosuppressive effect and toxicity. PMID- 3957505 TI - Effects of immunological adjuvants on the mouse complement system--II. Anti complementary effects of surface-active compounds. AB - The anti-complementary effects of the surface-active immunological adjuvants dimethyldioctadecylammonium bromide (DDA) and pluronic polyols L101 and L121 were investigated in the mouse system. All three adjuvants showed complement (C) inactivating effects. DDA caused a time- and dose-dependent reduction of alternative pathway (AP) and overall C activity, which varied with the serum concentration. Polyols induced a preferential inactivation of the AP by a more direct mechanism. A rather general, causative relationship between anti complementary and immunological adjuvant activities is suggested. This might involve interference with nonspecific elimination of antigen, counteraction of immunosuppression by terminal C components, and/or moderation of C3b-mediated reduction of Ia-expression, leading to a better antigen presentation. PMID- 3957506 TI - Purification and characterization of complement activating-acidic polysaccharide from the root of Lithospermum euchromum Royle. AB - An extraordinary potent anti-complementary substance was isolated from the root of Lithospermum euchromum Royle (Japanese name: Nan-shikon) which activates the complement system in vitro, and the active principle was shown to be acidic polysaccharide (LR-polysaccharide IIa). LR-polysaccharide IIa was purified by chromatographies on DEAE-Sepharose, Sephadex G-100, concanavalin A-Sepharose, Ricinus communis agglutinin conjugated Sepharose, Sepharose CL-6B and Sepharose CL-2B. LR-polysaccharide IIa was found to be composed of rhamnose, fucose, arabinose, xylose, mannose, galactose and glucose in the molar ratios of 2.0:2.5:3.4:2.8:5.6:9.6:14.4. The polysaccharide also contained 15% of galacturonic acid and 3.8% of protein. The methylation analysis of the polysaccharide showed that rhamnose, arabinofuranose, xylose, glucose and galactose are present as a part of the nonreducing terminal residues. The main chain and side chains are composed of ----3Glc1----,----3Gal1----,----6Man1----,- --4Gal1, [corrected] and the branching points consist of (formula; see erratum) These results indicated that LR-polysaccharide IIa has a highly complicated structure. A marked consumption of C4 was observed after the incubation of the serum with LR-polysaccharide IIa in the presence of the Ca++ ion. The anti complementary activity of LR-polysaccharide IIa was reduced partially in the absence of the Ca++ ion. After the incubation of the serum with LR-polysaccharide IIa in the absence of Ca++ ion, a cleavage of C3 in the serum was found to have occurred through immunoelectrophoresis as well as from the consumption of the complement when rabbit erythrocytes were used in the assay system. These results indicate that the mode of complement activation by LR-polysaccharide IIa is via both the alternative and classical pathways. Complement titer also decreased in guinea pigs upon i.p. injection of LR-polysaccharide IIa. PMID- 3957507 TI - Why are the many poor? AB - In this article the author restates the same arguments put forward in the first Fabian Tract of 1884 entitled Why Are the Many Poor? Today, mass poverty is still the central problem facing the British nation and all nations. The only long-term remedy is to restrict the power and wealth of the rich, to dismantle the present structures of social privilege, and to build social institutions based on fair allocation of wealth and on social equality. The public debate of one hundred years ago on the connections between poverty and wealth is revived in this article. PMID- 3957508 TI - Health hazards in the microelectronics industry. AB - The microelectronics industry is explored as a source of occupational health hazards resulting from the extensive use of toxic chemicals in the production of semiconductor chips and the assembly of electronic components. Information is provided on the range of chemicals used in the industry and their particular health implications. Case materials are drawn from Massachusetts' "Route 128" region and California's "Silicon Valley." Problems with worker exposure in the plants are compared with the risks experienced by residents of local neighborhoods from the leakage of industrial chemicals from underground storage tanks into the local groundwater used for drinking water. The recent development of the industry, its highly innovative character, the absence of unions and organizations for worker protection, and the persistence of a public perception that the industry is relatively safe and clean, are all identified as determinants of the extent of health hazards posed by chemical exposure. The paper concludes with recommendations for further studies, worker organization, and increased attention to the reduction of the volume and toxicity of chemicals in industrial production. PMID- 3957509 TI - New patterns in health sector aid to India. AB - Criticisms of health aid have largely been derived from African and Latin American experiences. It is suggested that such analyses, while valuable, cannot be applied wholesale to India without detailed examination of the patterns of health sector aid which have actually characterized the period since 1947. This article brings together material on the scale and form that this assistance has taken, and demonstrates that its focus has been preventive in emphasis and oriented towards the primary care sector. In some periods it has contributed a substantial share of total public sector expenditures, and in some spheres, it has played a major role, particularly the control of communicable diseases. However, the impact of less substantial sums going to prestige medical colleges or to population control programs should not be ignored; and several of the aid categories have been of dubious origin (PL-480 counterpart funds and U.S. food surpluses as the prime examples). However, the "new" health aid programs do not deserve the ready dismissal they have received in some quarters. PMID- 3957511 TI - Corporate interests, philanthropies, and the peace movement. AB - Corporate and philanthropic involvement in the peace movement is growing. In considering medical peace groups as examples, we have studied the ways that corporate and philanthropic funding have shaped the course of activism. Our methods have included: review of the Foundations Grant Index from 1974-1983; analysis of corporations' and foundations' criteria for grants in the categories of peace, arms control, and disarmament; interviews with leaders of activist organizations and with foundation officials; and our own experiences in the peace movement. Corporate interests in preventing nuclear war stem from a concern for global stability in which world markets may expand, and from a hope to frame issues posed by the peace movement in a way that will not challenge basic structures of power and finance. Several general features make peace groups respectable and attractive to philanthropies; an uncritical stance toward corporate participation in the arms race; a viewpoint that the main danger of nuclear war stems from a profound, bilateral conflict between the United States and the Soviet Union; and a single-issue focus that does not deal with the many related problems reflecting the injustices of capitalism. The two major medical groups working for peace, Physicians for Social Responsibility (PSR) and International Physicians for the Prevention of Nuclear War (IPPNW), have accomplished many goals; however, their adherence to subtle criteria of respectability and their dependence on philanthropic funding have limited the scope of their activism. The struggle for peace can not succeed without fundamental changes in the corporate system that initiates, maintains, and promotes the arms race. PMID- 3957510 TI - Socio-medical indicators of health in South Africa. AB - Socio-medical indicators developed by WHO for monitoring progress towards Health for-All have been adapted to reveal, clearly and objectively, the devastating impact of state planning based on an outmoded immoral and unscientific philosophy of race superiority in South Africa on the health of the disenfranchised majority within the context of social and economic discrimination; Health policy indicators confirm that the government is committed to three options (Bantustans, A New Constitution, and A Health Services Facilities Plan) all of which are inconsistent with the attainment of Health-for-All; Social and economic indicators reveal gross disparities between African, Coloured, Indian, and White living and working conditions; Provision of health care indicators show the overwhelming dominance of high technology curative medical care consuming about 97 percent of the health budget with only minor shifts towards community-based comprehensive care; and Health status indicators illustrate the close nexus between privilege, dispossession and disease with Whites falling prey to health problems related to affluence and lifestyle, while Africans, Coloureds, and Indians suffer from disease due to poverty. All four categories of the indicator system reveal discrepancies which exist between Black and White, rich and poor, urban and rural. To achieve the social goal of Health-for-All requires a greater measure of political commitment from the state. We conclude that it is debatable whether a system which maintains race discrimination and exploitation can in fact be adapted to provide Health-for-All. PMID- 3957512 TI - Socio-medical determinants of hospital utilization in Quebec, Canada, 1970-1975. AB - The relationship between ambulatory physician use and hospitalization was studied using aggregate data in the Province of Quebec, Canada. The analysis showed that the introduction of health insurance covering physician services had a negligible influence on hospitalization. The average length of short-term hospital stays was determined by the proportion of aged population, the proportion of English speaking persons, and the prior level of hospitalization in the medical market areas. Overall, hospital discharge rates remained very constant during the period of six years (1970-1975). There were, however, reductions in hospitalization for infectious diseases, diseases of the blood and blood-forming organs, respiratory diseases, and diseases of the skin and subcutaneous tissue, and increases in the hospitalization rates for neoplasms, circulatory system disorders, musculoskeletal conditions, congenital anomalies, and perinatal morbidity and mortality. PMID- 3957513 TI - Health education in Cuba: a preface. AB - Critics of health education policy in the United States fault it for ignoring the unequal ability of Americans to adopt more healthy behavior and for underestimating the social, economic, and political causes of disease. Many critics hypothesize that health education in a less bourgeois society would be more equitable and less individualistic. This article tests that hypothesis by analyzing the current Cuban health education program aimed at the reduction of chronic diseases. It argues that while the Cuban program appears to be every bit as individualistic as the North American program, theirs may not be comparable to ours because Cubans are less likely than Americans to reify the state. At least among supporters of the revolution, Cubans do not automatically make a conceptual distinction between the individual and the society. Discussions about responsibility for disease prevention take on new meaning in this light. PMID- 3957514 TI - Effects of eight weeks of bicycle ergometer sprint training on human muscle buffer capacity. AB - This investigation was undertaken to determine whether human skeletal muscle buffer capacity (BCm) is affected by training. Eight untrained males participated in 8 weeks of sprint training on bicycle ergometers. Muscle biopsy samples were taken from the vastus lateralis before and at several times following an incremental bicycle ergometer test (0 min, 5 min, 15 min). These subjects were tested before (PRE) and following (POST) the training period. Seven endurance trained cyclists (ET) were also tested for the purpose of comparing the BCm of ET to that of PRE and POST. Biopsy samples were quick-frozen in liquid nitrogen and later analyzed for lactate concentration (HLam), homogenate pH (pHm), and creatine phosphate concentration. BCm was calculated from the change in HLam and pHm observed from rest to exhaustion and was expressed as mmol X kg-1 X pH-1 (Slykes). There was no significant difference in resting HLam or resting pHm among the groups. There was a significant difference in HLam at exhaustion between PRE (21.41 +/- 1.65 mmol X kg-1), POST (25.61 +/- 2.38 mmol X kg-1), and ET (11.16 +/- 0.31 mmol X kg-1) but no significant difference in pHm at exhaustion between PRE (6.65 +/- 0.03 pH units) and POST (6.69 +/- 0.06 pH units). pHm at exhaustion for the ET group was significantly higher than the others at 6.91 +/- 0.02 pH units. A significant difference between PRE and POST BCm was found (PRE: 44.68 +/- 3.03 S1; POST: 61.04 +/- 4.11 S1) while ET BCm (47.21 +/- 7.26 S1) was not significantly different from PRE. These data indicate that muscle buffer capacity is increased with highly intense sprint training but provide no evidence to suggest that muscle buffer capacity is affected by endurance training. PMID- 3957515 TI - Free plasma catecholamines, heart rates, lactate levels, and oxygen uptake in competition weight lifters, cyclists, and untrained control subjects. AB - Responses of free plasma noradrenaline and adrenaline were evaluated in 10 competition cyclists, 8 competition weight lifters, and 9 untrained control subjects during exhaustive, incremental cycling. Ergometric performance and oxygen uptake ability were 403 +/- 20 W and 65.8 +/- 4.7 ml X kg-1 for the cyclists, 294 +/- 42 W and 47.2 +/- 4.6 ml for the weight lifters, and 296 +/- 40 W and 46.7 +/- 9.4 ml for the control subjects. At 100- and 150-W levels, noradrenaline was significantly lower in cyclists and weight lifters, and in cyclists also at 200- and 250-W levels, related to the other groups. No significant noradrenaline differences were seen between the three groups at their respective exhaustion levels. Compared with the control subjects, adrenaline responses were lower in cyclists and weight lifters at all identical work loads. The weight lifters showed the lowest levels of all three groups, even at their exhaustion level, which indicates an alteration of the adrenaline-noradrenaline ratio. Dynamically and statically trained subjects exhibit a similar training related control of sympathetic activity. An increased vagal tone, however, only occurs in conjunction with dynamic endurance training. PMID- 3957517 TI - Role of sports in etiology and prognosis of surgically treated acute knee ligament injuries. AB - During the period 1975-1981, 48 persons were operated on at Tampere University Central Hospital for an acute knee ligament sports injury. Their mean age was 31.6 years. A total of 40 patients had a postoperative follow-up ranging from 2 to 7 years (average 41 months). The number of operations increased greatly during the observation period: in 1980-1981, 29 operations (60%) were performed. Of all the injuries, 29 (60%) occurred in the winter season (January-March). Cross country skiing was the cause in nearly half of the cases (23), and 21 of these were spare time sports injuries involving mainly middle-aged women (15). According to the questionnaire and clinical and radiological reexamination, the patients injured in spare time sports did not differ significantly from the patients with no sports injury in respect to the amount, quality, or position of the pathological changes in the knee. However, the whole group of top-level or competitive sportsmen had significantly better healing results than the other patients. Slippery cross-country skis made from glass fibers seem to be dangerous, especially for older female spare time skiers. Competitive sportsmen's better healing results are obviously based on their younger age, better muscular performance, and higher motivation, and better possibilities for rehabilitation. PMID- 3957516 TI - Physiologic and biochemical changes during a triathlon competition. AB - The triathlon has come to be recognized as a distinct endurance event and although a substantial body of research information exists with regard to the individual components (canoeing, cycling, running, etc.), the physiologic demands imposed by combining the respective activities into one continuous event have not yet been assessed. Twenty-three male athletes (age = 33 +/- 5.2 yr; mass = 71.79 +/- 7.42 kg; height = 176.0 +/- 7.21 cm; means +/- SD) participated in the study on the basis of informed consent. Venous blood samples, taken immediately prior to and on completion of the Iron Man Triathlon held in Johannesburg during 1983, were assayed for parameters of energy metabolism, fluid and electrolyte balance, and stress (tissue enzymes in serum). On the basis of post-race blood glucose (6.17 mmol. l-1), free fatty acids (1943 mumol. l-1), and blood lactate (3.45 mmol. l-1) changes, it was concluded that the triathlon is primarily, in an overall sense, an aerobic event. With the exception of magnesium and iron, serum electrolyte changes agreed with literature findings. However, body mass reductions (average 3.23 kg, i.e., 4.5%) indicated that the extent of dehydration is more severe in the triathlon than in comparable endurance events. Post-race enzyme levels (LD, CK, and AST) were significantly elevated, and LD negatively correlated with total performance time (P less than 0.01). The general conclusion is that the physiologic demand of the triathlon exceeds that of other comparable endurance events. PMID- 3957518 TI - Mechanical efficiency of pure positive and pure negative work with special reference to the work intensity. AB - The mechanical efficiencies of pure positive (eta) and pure negative (eta-) work were investigated on a special "sledge ergometer" with 25 and 36 subjects, respectively. The work intensities varied in positive work between 40% and 90% and in negative work from 30% to 120% of the maximum concentric exercise. In 54 exercises of positive work, eta was 17.1% +/- 2.2%, and its value correlated negatively with the work intensity (r = 0.367, P less than 0.01) and with the average knee angular velocity, omega+ (r = 0.359, P less than 0.01). In 103 eccentric exercises, eta- was on the average 80.2% +/- 31.8%, correlating positively with the work intensity (r = 0.396, P less than 0.01). Both inter- and intrasubject variations were large (32%-163%). The integrated electrical activity (IEMG) of the leg extensor muscles increased with an increase of work intensity both in the positive and in the negative work situations. Less efficient MU recruitment in higher positive work rates is suggested to be the reason for the decrease in eta, whereas better stiffness regulation via increased preactivation is speculated to cause high values of eta- in higher work intensities in eccentric exercise. PMID- 3957519 TI - Isokinetic torque levels for knee extensors and knee flexors in soccer players. AB - The knee extensor and knee flexor strengths were measured isokinetically (30 degrees, 180 degrees/s) and isometrically with a Cybex II device in three groups of male soccer players (national team players, n = 13; division I, n = 15; division IV, n = 180) and a group of nonsoccer players (n = 32). There were difference in strength between soccer players and nonsoccer players and between players from different divisions. Correction for body surface area did not affect the results. The knee flexor/knee extensor ratio (H/Q ratio) was significantly higher for soccer players than for nonsoccer players. The fast-speed/slow-speed ratio for knee extensors was higher for nonsoccer players and for national team players than for players from divisions I and IV. PMID- 3957520 TI - Morphology of immobilized skeletal muscle and the effects of a pre- and postimmobilization training program. AB - The hind limbs of mice were immobilized with plaster cast for different periods of time, and the atrophy of the anterior tibial muscle was examined by measuring fiber cross sections. In a second series of experiments, mice were trained on a treadmill before and after immobilization. The most pronounced decrease in fiber diameters was observed during the 1st week; during prolonged immobilization, only a moderate atrophy occurred. Red fibers were found to be more susceptible to immobilization atrophy than white fibers. The ultrastructural observations extended to loss and fragmentation of myofibrils, mitochondria, and the sarcotubular system. Some fibers split and appeared to undergo segmental necrosis, which was followed by invasion of leucocytes into the muscle. Still while immobilized, the muscles exhibited a regenerative capacity; satellite cells differentiated to myoblasts, which fused to myotubes, being the precursors of new muscle fibers. This was already observed during the 1st week of immobilization. The effect of training after immobilization was documented by an increase of fiber diameters. The ultrastructural alterations, however, in these muscles were severe; it was concluded that a postimmobilization training has to be undertaken very carefully. When the muscles were trained before immobilization, the atrophy was almost negligible. A preimmobilization training can probably prevent the muscle from developing severe atrophy. PMID- 3957521 TI - Compulsory treatment of narcotic addiction. PMID- 3957522 TI - Court experts, assessors and the public interest. PMID- 3957523 TI - Lifetime police contacts of discharged Psychiatric Security Review Board clients. PMID- 3957524 TI - Women declared insane: a follow-up study. PMID- 3957525 TI - Comparative review of reporting and registration legislation for treatment of drug and alcohol dependent persons. PMID- 3957526 TI - The compulsory treatment of alcoholic drunken drivers referred by the courts: a 7 to 9 years outcome study. PMID- 3957527 TI - Not guilty by reason of insanity: a research note. AB - The question of the insanity defense centers around the moralist-determinist debate. Insanity defense laws are premised on the assumption that individuals choose between right and wrong, and are responsible for that choice. Mental disease, however, can overpower, and thus, not of their own volition, insane persons become out-of-control. Hence, they cannot be held responsible for their behavior or subject to criminal punishment. It is the purpose of the insanity defense, of course, to distinguish between offenders in need of punitive disposition and ones where a medical-custodial disposition is best. The research presented here indicates that defendants who successfully raise the plea of NGRI do not beat the rap. In other words, they do not spend fewer days in confinement via an NGRI plea than had they been convicted and sentenced. Thus, for the reasons of justice, equity, and fairness the insanity defense should be kept intact. The wave of public fear and reaction to the decision in a few highly publicized cases is insufficient grounds for eliminating the plea. Not only is the use of the insanity defense infrequent, but defendants who select it give up important safeguards. Namely, they are unable to plea bargain, are stigmatized as "mad and bad," have no access to probation or parole, and are confined for an indeterminate amount of time. That some would call this leniency we find surprising. And, of course, we should not forget the findings reported here. NGRI acquittees spend more time being locked up. Defendants who successfully raise the NGRI plea are confined until professionals say they are no longer dangerous.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957528 TI - Competency on death row. PMID- 3957529 TI - Severe measles in Sunderland, 1885: a European-African comparison of causes of severe infection. AB - On the basis of research in Guinea-Bissau, this paper re-analyses a severe measles epidemic which occurred in 1885 in Sunderland (England). In both England and Guinea-Bissau, acute measles mortality was higher in households with multiple cases than in families with only a single case of measles. Secondary cases (infected in the house) had higher mortality and higher frequency of severe complications than index and single cases. In Sunderland, severe complications were associated with a history of previous respiratory infection and with greater number of siblings. Since cases with severe complications had significantly prolonged prodromal symptoms and shorter periods of incubation, it is suggested that high dose of infection may be an essential mechanism in the pathogenesis of severe disease. Overcrowding may be a major determinant of severe measles because it increases the risks of intensive exposure, intercurrent infections, and previous respiratory infection. PMID- 3957530 TI - A person to person hepatitis A outbreak. AB - A person to person outbreak of hepatitis A is described: 90 cases of hepatitis A occurred in a small town in Calabria, southern Italy; all cases were under 18 years of age with the highest age-specific incidence rate in the 6-10 year age group. Transmission was identified by tracing close contacts with other incubating or active cases; only eight out of 90 cases were not identified as having a very probable or possible contact with an infecting case. Transmission was high between family members leading to a secondary family attack rate of 51% in children under 16. An enteric disease educational campaign was carried out together with IgG and no cases of hepatitis A were reported in the two years following the investigation. PMID- 3957531 TI - Hepatitis B infection in prostitutes. AB - The prevalence of HBV markers in prostitutes is known to be higher than that of the normal population of similar age range in previous studies. This study showed a significant correlation between the duration of prostitution and the prevalence of HBV antibodies amongst the prostitutes. The prevalence of HBV antibodies doubled after the first year of prostitution. A two-year follow-up study of these prostitutes showed that 37% of HBsAg positive prostitutes lost the HBsAg. The seroconversion rate of HBsAg negative prostitutes was 10% during this two-year period. Early immunization against HBV infection should be considered in this high risk group in view of these findings. PMID- 3957533 TI - Terminal digit preference in blood pressure measurements: effects on epidemiological associations. AB - A study was conducted to determine the extent of terminal digit preference in recording blood pressures in an industrial screening programme and its effect on the estimates of the associations between blood pressure and both age and body mass index (BMI). The results showed that 78.5% of systolic and 74.2% of diastolic blood pressure readings were digit preferenced (p less than 0.0001) and that the examining doctors were least likely to preference their readings near the diagnostically important cut-off points of 150 mmHg systolic and 90 mmHg diastolic. Digit preferencing did not generally affect estimates of the slopes and intercepts of the relationships between blood pressure and age or BMI, however, the associations between blood pressure and both age and BMI showed greater error variance when digit preferenced readings were used compared to non digit preferenced readings. Digit preferencing would have the effect of reducing the power of statistical tests thereby making it more difficult to assess associations between blood pressure and other potential risk factors. PMID- 3957532 TI - Risk factors for diarrhoeal deaths: a case-control study at a diarrhoeal disease hospital in Bangladesh. AB - The study of diarrhoeal mortality risk has been limited to descriptive epidemiological investigations. This is the first case-control study in this area, and our results show that certain risk factors are predictive of diarrhoeal deaths. We have compared the disease history, associated complications, signs, symptoms and laboratory values of 346 patients who died on the medical wards of Dhaka Hospital and that for 346 matched controls to identify the risk factors for mortality. Patients presenting with oedema, severe dehydration or convulsion were found to have a risk of mortality two times higher than controls. Several laboratory results were compared by a matched pair analysis, demonstrating that hyponatraemia (less than 130 mmol/L), hypobicarbonaemia (less than 20 mmol/L) and raised anion gap (greater than 14.9 mmol/L) were moderately associated with mortality. However, hypoproteinaemia (less than 50 gm/L) was strongly associated. For children less than 10 years of age, both hyper- and hyponatraemia were found to be associated with mortality, and the nutritional status of the children modified the effect of hypernatraemia on diarrhoeal mortality. The strong association between diarrhoeal death and hypoproteinaemia may be due to the effect of the pre-existing malnutrition of these patients and/or their loss of protein during shigella infection. The various risk factors that we have identified could be used as a prognostic guide by physicians treating such patients. PMID- 3957534 TI - Statistical analysis of case-control studies of communicable diseases. AB - At the Communicable Disease Surveillance Centre most outbreak investigations are carried out by questioning cases and unaffected 'controls' to look for associations with possible sources of infection. Illness rates are compared in those exposed with those not exposed to a possible risk factor, using statistical techniques appropriate to the survey design. Significance testing to obtain evidence of the source of transmission is made as quickly as possible so that action may be taken. Microbiological corroboration is sought wherever possible. Unlike chronic disease epidemiology the estimation of odds ratios and relative risk is seldom of primary importance. Examples are given of the analysis of three types of study. Firstly where the whole population is interviewed and then where cases are matched 1:1 and 1:M with controls, including an example with missing data, ie variable numbers of controls. PMID- 3957535 TI - Respiratory and gastrointestinal infections and prop feeding. PMID- 3957536 TI - Japanese lung cancer mortality rates, 1947-80 and per capita cigarette consumption in Japan 5. PMID- 3957537 TI - Conceptual subtleties of the percentile. PMID- 3957538 TI - HDL cholesterol and 24-year mortality. PMID- 3957539 TI - An insight on the use of multiple logistic regression analysis to estimate association between risk factor and disease occurrence. AB - Multiple logistic regression is an accepted statistical method for assessing association between an anticedant characteristic (risk factor) and a quantal outcome (probability of disease occurrence), statistically adjusting for potential confounding effects of other covariates. Yet the method has potential drawbacks which are not generally recognized. This article considers one important drawback of logistic regression. Specifically the so-called main effect logistic model assumes that the probability of developing disease is linearly and additively related to the risk factors on the logistic scale. This assumption stipulates that for each risk factor, the odds ratio is constant over all reference exposure levels, and that the odds ratio exposed to two or more factors is equal to the product of individual risk factor odds ratios. If the observed odds ratios in the data follow this pattern, the model-predicted odds ratios will be accurate, and the meaning of the odds ratio for each risk factor will be straightforward. But if the observed odds ratios deviate from the model assumption, the model will not fit the data accurately, and the model-predicted odds ratios will not reflect those in the data. Although satisfactory fit can always be achieved by adding to the model polynomial and product terms derived from the original risk factors, the odds ratios estimated by such an interaction logistic model are difficult to interpret, viz., the odds ratio for each risk factor depends not only on the reference exposure levels of that factor, but also on the exposure level in other factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957540 TI - Trends in cancer mortality among Puerto Rican-born migrants to New York City. AB - Age-standardized cancer death rates in Puerto Rican-born males and females residing in New York City have been calculated for 1979-81, and compared with those for white non-Puerto Rican-born people. For all population groups the rates in 1979-81 have been compared with rates in 1969-71. For some cancer sites, in particular cancers of the lung, breast and ovary, the Puerto Rican migrant population exhibited rates well below those of other residents of New York at both time periods. For other sites, most notably colon cancer (and to a lesser extent, prostate and bladder cancer), the rates for Puerto Ricans were somewhat lower than those of other New Yorkers in 1979-81, but had very markedly increased from levels shown in the earlier period. The Puerto Rican-born population at each time period had considerably higher rates of stomach cancer and cervical cancer than did 'other' white New Yorkers. Although substantial reductions in risk for these sites occurred among Puerto Ricans during the intercensal period examined, these corresponded to the reductions among 'other' white New York residents. The trends are discussed with reference to differences in lifestyle patterns, especially diet. PMID- 3957541 TI - An analysis of the mortality effect in a breast cancer screening study. AB - In order to better understand the effect of breast cancer screening on mortality, we use the theory of competing risks to analyse deaths from the long-term follow up of the HIP breast cancer screening trial. We conclude that some, but not all, of the breast cancer cases detected early as a result of screening realized a benefit in terms of elimination of the risk of breast cancer mortality. Breast cancer screening appears not to affect the rate of mortality from causes of death other than breast cancer. Methodologically, we demonstrate the importance of analysing mortality separately for the breast cancer cases as well as for the entire population in a trial. PMID- 3957542 TI - Trends in mortality from ischaemic heart disease in Singapore, 1959 to 1983. AB - Mortality from ischaemic heart disease in Singapore has been studied from vital statistics for the 25 years from 1959 to 1983. The age-standardized rates for ages 30 to 69 years increased in men from 106.8 per 100 000 in 1959-1963 to 204.5 in 1979-1983, while for women they increased from 30.7 to 72.0 per 100 000. The male to female ratios in the age-standardized rates for ischaemic heart disease fell from 3.5 to 2.8 in the period, while remaining steady for all causes. However, while mortality rates for ischaemic heart disease have increased steadily over the period in the older age groups, they have recently declined in the younger ages with a birth cohort effect. For males the decline started with the 1932-1936 birth cohort (men now aged around 50 years), while for females it was the 1937-1941 birth cohort (women now aged around 45 years). The reasons for this decline are discussed but no clear explanation is at present apparent and it would be useful to have future monitoring of lifestyles and coronary risk factors. PMID- 3957544 TI - The relation of thirteen-year mortality to ventilatory impairment and other respiratory symptoms: the Cracow Study. AB - The relation of mortality to ventilatory function and some respiratory symptoms detected during interview has been studied in 3047 men and women followed-up for 13 years. The analysis was performed for all natural causes of death, and separately for deaths due to circulatory diseases and neoplasms. The results confirm the strong predictive power of ventilatory impairment for overall and circulatory mortality, even after adjustment for age, cigarette smoking and other factors in logistic regression models. The risk of cancer death in men increased with decrease of FEV1. However, chronic cough, mucus hypersecretion or asthmatic syndrome were not related to subsequent mortality. A strong predictor of overall and circulatory 'mortality' in men was also self-assessed health status. This was independent of other factors. PMID- 3957543 TI - High density lipoprotein cholesterol: prognosis after myocardial infarction. The Israeli Ischemic Heart Disease Study. AB - In people without overt clinical coronary heart disease (CHD), reduced levels of high density lipoprotein cholesterol (HDLC) are a known predictor of a first myocardial infarction (MI), and of death from CHD. Less is known about the role of HDLC in the prognosis of patients with coronary heart disease. In 130 men with electrocardiographic evidence of myocardial infarction examined in the Israeli Ischemic Heart Disease Study in 1963, the relationship of HDLC to prognosis was examined. Approximately 60% (77 men) died between 1963 and 1978. Analysis of mortality by HDLC quartiles revealed the highest rate, 74%, in the bottom HDLC quartile (less than 30 mg/dl). Quartile analysis was also performed for HDLC as a per cent of total cholesterol (PHDL), known as a better predictor of CHD incidence. Mortality was as high as 81% in the bottom quartile (PHDL less than 13%), with a relative mortality risk of 1.71 for subjects in the bottom quartile compared to those in the top quartile (PHDL greater than or equal to 19%). Initial mean PHDL in patients surviving 15 years was significantly higher than in those dying during that time (17.8% versus 16.2%, p less than 0.05). Multivariate analysis, using the Cox proportional hazards model, indicated an association close to conventional statistical significance between HDLC and long-term mortality (p = 0.069). The results are comparable with those reported by the Coronary Drug Project Study. Further investigations of larger cohorts of CHD survivors are needed before firm conclusions about the role of HDLC and the potential for the use of HDLC affecting drugs or lifestyle changes can be drawn. PMID- 3957545 TI - Short-term effects of air pollution on mortality in Athens. AB - Short-term effects of air pollution on mortality in Athens during the years 1975 1982 were studied. Daily values of sulphur dioxide (SO2) and smoke, measured by a five-station network of the National Observatory of Athens, were used as air pollution indicators. Mortality data were abstracted from the Town Registries of Athens and 18 other contiguous towns within the Greater Athens area. It was found that the adjusted daily mortality (estimated by subtracting from the observed value of mortality an 'expected' value, calculated after fitting a sinusoid curve to the empirical mortality data) depends positively and significantly on the level of SO2 (b = +0.0058, p = 0.05). This relation is independent of temperature, relative humidity, secular, seasonal, monthly and weekly variations of mortality as well as of synergistic effects of the above variables with season. No relation was found between smoke and adjusted daily mortality. An analysis for the determination of a possible threshold in the levels of SO2 causing health effects was also undertaken, by studying changes in the SO2 regression coefficients after successive deletion from the regression model of the days with the highest SO2 values. Our study shows that if there is an SO2 threshold it must lie slightly below the level of 150 micrograms/m3 (mean daily value). PMID- 3957546 TI - Sources of variability in quantitative levels of alcohol use in a total community: sociodemographic and psychosocial correlates. AB - This article describes the transformation of reported alcohol consumption into a quantitative variable, Standardized Alcohol Intake (SAI), which is used to investigate various sociodemographic and psychosocial factors as correlates of alcohol use in a total community sample (N = 1672), in Tecumseh, Michigan. Statistically significant relations were obtained between alcohol usage and marital status, education, smoking status, and church attendance with the latter accounting for the 15% of the variability in drinking. On measures of personality, SAI was positively and significantly associated with level of activity, sociability, impulsivity, and extraversion. For drinkers, their attitudes toward drinking and changes in mood varied significantly in relation to the amount consumed. These findings are important and necessary for the appropriate control of these correlates in the future study of familial aggregation of SAI in the Tecumseh community. PMID- 3957547 TI - Seasonal variation of births in rural southwestern Nigeria. AB - A total of 12 708 live births registered between 1965 and 1975 in Igbo Ora, a rural area in southwestern Nigeria, were examined for seasonal variation using trigonometric regression analysis. The monthly number of registered births showed a significant seasonal pattern with a peak in May and corresponding minima in November. The extent of the seasonal variation above and below the annual mean was about 7%. There has been no significant shift in both the month of peak occurrence and the magnitude of the variation within the 11-year period of study. It is thought that the observed seasonal pattern may be related to climatic factors as well as sociocultural patterns of life associated with cyclical farming activities characteristic of a predominantly agricultural community. PMID- 3957548 TI - Natural immunity to measles, rubella and mumps among Spanish children in the pre vaccination era. AB - Prior to the start of mass vaccination campaigns against measles, rubella and mumps, a prevalence study of natural immunity to these diseases was undertaken in a sample of 1700 unvaccinated Spanish children. They were representative of the 3 7 year-old population in terms of age, regional distribution and urban or rural environment. Measles infection prevalence was significantly higher than that for rubella and mumps from 3 (48.3%, 14.2%, 25.5%, respectively) through 7 years of age, (64%, 40.9%, 39%). As a function of age, naturally-acquired immunity increased according to parabolic progressions. In the 3-5 year-old group, rural environment, low socioeconomic status, no school attendance and lack of brothers were associated with statistically lower levels of measles, rubella, or mumps infection. In the 6-7 year-old group, only 12% of the children showed antibodies against the three diseases and 18.7% exhibited triple susceptibility. PMID- 3957549 TI - Papillary squamous cell carcinoma of the uterine cervix: a clinicopathologic study of nine cases. AB - Papillary squamous cell carcinoma (PSCC) of the uterine cervix is an infrequently described subtype of cervical malignancy. Nine cases of PSCC encountered at the University of Virginia Medical Center are reviewed. The clinical course of these patients, including a propensity for late metastases and recurrences, appears distinctive. The papillae of PSCC are lined by dysplastic cells, unlike verrucous carcinoma. PSCC may exist in an in situ state, and demonstration of invasion, when present, requires deep biopsies or cervical conization. Therapy for PSCC appears to be the same as for ordinary squamous cell carcinoma of equivalent clinical stage. PMID- 3957550 TI - Lymphoid tissue of the normal fallopian tube--a form of mucosal-associated lymphoid tissue (MALT)? AB - Mucosal-associated lymphoid tissue (MALT) is a specialized form of peripheral lymphoid tissue which is found in mucosal surfaces directly or indirectly exposed to the environment. Using immunohistological labeling techniques and electron microscopy, we have explored the possibility that MALT exists in the normal fallopian tube. Immunohistological analysis has demonstrated a striking degree of uniformity in the phenotype of intraepithelial lymphocytes with a predominance of T-lymphocytes of T-cytotoxic/suppressor subtype. Occasional intraepithelial macrophages are also present, but B-cells, T-helper cells, and natural killer cells are absent or are rarely found in the epithelium. Electron microscopy has provided morphological evidence of an interaction between epithelial cells and intraepithelial lymphocytes. The opposing plasma membranes of these two cell types are arranged in the form of complex interdigitations and laminations. These striking arrangements substantially increase the total area of contact between the two cell types. We conclude that MALT does exist in the fallopian tube and that epithelial cells form an integral part of the system. A hypothetical view of the relationship between these cell types is presented. PMID- 3957551 TI - Vaginal cysts: a clinicopathological study of 41 cases. AB - The clinicopathological features of 43 vaginal cysts in 41 patients treated at Magee-Womens Hospital between 1972 and 1982 were evaluated. Thirty-five of the patients were white and six black; their ages ranged from 19 to 68 years with an average of 37.6 years. Most patients complained of a swelling or mass in the vagina, accompanied in some by stress incontinence, dyspareunia, dysfunctional uterine bleeding, or a history of episiotomies or vaginal lacerations. The majority of the cysts were located in the lateral and posterior walls of the vagina. The most frequent cyst type was mucus-secreting mullerian (19; or 44%), followed by ten (23%) epidermal inclusion cysts; three of the latter were located in a previous episiotomy site. The remainder were five (11%) of Gartner's duct type, three (7%) of Bartholin's duct type, and three (7%) of endometriotic type. The remaining three were unclassified for lack of an epithelial lining in two, and one cystourethrocele was confused with a vaginal cyst. None disclosed atypical epithelial hyperplasia or malignant change. PMID- 3957552 TI - The oocytic origin of dysgerminoma. AB - An early dysgerminoma, found by chance in a grossly normal ovary, was completely blocked and multiply sectioned. It was found to have a mainly cortical location, being densest in the subtunical and adjacent zones where primordial follicles are normally most numerous, and to be associated with a reduction of the oocyte count in tumor-involved areas. An oocytic origin of the tumor is inferred from these findings and from other data, including the age incidence, available in the literature. PMID- 3957553 TI - Adenomatoid tumor of uterus: presentation in endometrial curettings. AB - A case of adenomatoid tumor of the uterus with an unusual initial presentation is reported. The patient, a 25-year-old female, underwent a dilatation and curettage during investigation for infertility. Endometrial curettings revealed infiltration of the stroma by epithelioid and signet-ring-type tumor cells. Subsequent hysterectomy revealed a large, somewhat ill-defined posterior myometrial tumor that on the basis of histologic, histochemical, and ultrastructural investigation proved to be an adenomatoid tumor with infiltration into the endometrium. PMID- 3957554 TI - Endocrine cells in the female genital tract. PMID- 3957555 TI - Renal anomalies and agenesis associated with total intestinal aganglionosis. AB - Four patients with total aganglionosis of the intestine had renal abnormalities. Two patients had cortical subcapsular cysts, one had unilateral renal agenesis and one other had unilateral renal dysplasia. The consistency of renal anomalies with total aganglionosis suggests the presence of a common genetic origin. PMID- 3957556 TI - The effect of dialysate volume on ultrafiltration in young patients treated with CAPD. AB - The effect of dialysate volume on ultrafiltration in young patients on continuous ambulatory peritoneal dialysis (CAPD) was studied. Twelve patients were evaluated. Each patient was studied with five different dialysate volumes (30, 40, 50 cc/kg and 2, 3 liters/1.73 m2) and two different dialysate glucose concentrations (1.5% and 4.25%). Dialysate osmolalities were measured at 30 minutes, one hour, two hours, and four hours. Dialysate volume was measured after four hours. Increased dialysate volume was associated with an increase in ultrafiltration rate and a slower fall in dialysate osmolality. It is concluded that since infants have a greater peritoneal surface area per kg than adults, they absorb dialysate glucose at a greater rate when related to body weight. This will lower dialysate osmolality at a faster rate and reduce ultrafiltration. Dialysate volume prescribed for children should not be extrapolated from the adult experience on the basis of 2 liters/70 kg, but rather by surface area (2 liters/1.73 m2). PMID- 3957557 TI - Hemolytic uremic syndrome associated with Corynebacterium diphtheria infection. AB - Although hemolytic uremic syndrome (HUS) is usually idiopathic, it follows a number of infections. The pathogenesis of post-infectious HUS is endothelial cell damage by either circulating endotoxin or exotoxin. Diphtheria exotoxin has never been implicated in HUS. We report HUS following diphtheria infection in a 9 yr old un-immunized white female admitted with a short history of sorethroat and thrombocytopenia. There were hemorrhages in sclera, gums and left tonsillar area and a grayish exudate on right tonsil. Laboratory values revealed Hgb 14.4 g/dl, decreasing to 7.6 g/dl, WBC/26,900 mm3, platelet count 7,000/mm3. Bone marrow examination revealed normal megakaryocytes. She was oliguric with BUN 214 mg/dl, serum creatinine 12.4 mg/dl and serum uric acid 19.2 mg/dl. Despite peritoneal dialysis, red cell and platelet transfusions and exchange transfusion she expired. A postmortem examination was refused. A throat culture done on admission grew corynebacterium species which was later confirmed to be toxigenic C. diphtheriae. Diphtheria exotoxin inactivates an enzyme in cytoplasm which is necessary for peptide chain elongation. This may have interfered with prostacyclin synthesis thereby allowing the development of HUS. PMID- 3957558 TI - Sequential fine needle aspiration biopsy in glomerulonephritis. AB - Cellular immune mechanisms have been shown to play a prominent role in glomerulonephritis. Cellular mediators of inflammation cause both acute and progressive glomerular and tubular injury. Understanding the mediation pathways offers the opportunity for therapeutic manipulation. In addition to polymorphonuclear leucocytes, monocytes/macrophages, B-cells and T-cells subsets are being enumerated in normal and diseased renal tissues. The correlation between immunological findings in peripheral blood and infiltrate composition in renal tissue, by using weekly Fine Needle Aspiration Biopsy (FNAB), for assessing the clinical status and monitoring the immunosuppressive therapy was the aim of this study. When determining the intensity of inflammation the numerical values of the Total Corrected Increment (T.C.I.) were defined as follows: less than 1.5 no inflammation; from 1.5 to 2.0 inflammation possible; greater than 2.0 inflammation. The ratio between OKT4 and OKT8 was used as the index: greater than 2.0 immunologic activation; greater than 2.0 no immunologic activation. When the T.C.I. was greater than 1.5 and the OKT4/OKT8 less than 2.0, or the T.C.I. less than 1.5 and the OKT4/OKT8 greater than 2.0 we used only a standard treatment. When both activation indexes were in the normal range we have not treated the patients. When the T.C.I. was greater than 1.5 and the OKT4/OKT8 was greater than 2.0 we treated the patients with standard treatment plus methylprednisolone pulses every time the activation indexes monitored by FNAB, showed an increase. A spontaneous improvement was obtained in untreated patients. The patients treated by standard therapy alone showed a different outcome. All patients treated with standard therapy plus methyl-prednisolone pulses showed a progressive clinical improvement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957559 TI - Effects of improved glycemic control on microalbuminuria in adolescents with insulin-dependent diabetes mellitus. AB - The effect of improved glycemic control on microalbuminuria was evaluated longitudinally in 13 adolescents with insulin-dependent diabetes mellitus (IDDM) of 8.4 +/- 0.8 years duration. Glycemic control and microalbuminuria were assessed under three treatment regimens: conventional therapy (Period A); after 6 weeks of intensified conventional therapy (Period B); and at three periods during continuous subcutaneous insulin infusion (CSII) (Period C = 10-14 days, Period D = 2-4 months, and Period E = 6-8 months, of CSII). Although euglycemia was not achieved, there was a decrease in mean 24-hour blood glucose concentrations measured hourly in the hospital, with values averaging 239 mg/dl in Period A, 202 mg/dl in Period B, and 156-184 mg/dl in Periods C to E. This was accompanied by significant reductions in the values for whole blood, and to a lesser extent, in stable glycosylated hemoglobin A1 (GHbA1) (p less than 0.05), but not in creatinine clearance, albumin clearance, or in albumin excretion rate. Significant correlations were found between whole blood GHbA1 levels and albumin clearance in each of Periods B to E and between albumin clearance and albumin excretion in Periods B to D (p less than 0.05) but not in Period A. Our data suggests that the degree of improvement in glycemic control obtained in our adolescent population with IDDM using either intensive conventional therapy or CSII does not reduce the microalbuminuria. If modulation of microalbuminuria is achievable it may require euglycemia or may involve other factors which have a more direct effect on the transit of albumin across the glomerular basement membrane. PMID- 3957561 TI - Cognitive functioning in children with end stage renal disease pre- and post dialysis session. AB - Eighteen ESRD and 18 Control subjects equated for age and intellectual level were assessed pre- and post-dialysis on measures of learning, problem solving and immediate memory. No significant differences were found between ESRD and Control subjects on any of the measures. Both groups showed significant learning over trials on the Paired Associate Learning Task. No correlational associations of statistical or clinical significance were found between the cognitive measures and blood pressure, blood urea nitrogen or serum creatinine. There was no difference between pre- and post-dialysis session performance by the ESRD subjects. These findings were inconsistent with prior research showing immediate improvement in cognition post-dialysis. PMID- 3957560 TI - A study of the renin-angiotensin-aldosterone system in severe infantile malnutrition. AB - Renin activity, renin substrate and aldosterone were measured in plasma of 17 children aged 12 to 28 months and suffering from severe malnutrition (marasmic kwashiorkor). Plasma renin activity was very high (median 29.0 ng/ml/hr) at admission, decreased after equilibration with a normal sodium diet (9.9 ng/ml/hr) and was negatively correlated with urinary sodium excretion. Plasma renin substrate and aldosterone concentrations were in the normal range; plasma aldosterone correlated positively with serum potassium. The hyperactivity of the renin-angiotensin system may be of relevance to the renal function in severe malnutrition. PMID- 3957562 TI - Resin hemoperfusion for chloramphenicol intoxication. AB - A case report of a three kilogram, four month infant who received excessive doses of chloramphenicol for the treatment of bacterial meningitis is presented. The child was treated with resin hemoperfusion (XAD-4) to reduce her serum chloramphenicol concentration. Her treatment was complicated by hypocalcemia and thrombocytopenia. During hemoperfusion a mean clearance of chloramphenicol of 27.4 ml/min was achieved. This represents a significant improvement over normal body clearance (4.7 ml/min/kg) in pediatric patients. We conclude that using hemoperfusion is an effective modality which may be used as an adjunct to supportive therapy when there is a need to increase the body clearance of chloramphenicol. PMID- 3957563 TI - Progressive renal damage due to lead intoxication in early life. AB - We have evaluated the effect of an increased body lead burden in young (3 weeks old) and adult (9 weeks old) Sprague-Dawley rats. Following intraperitoneal administration of lead on two occasions, both renal blood flow and glomerular filtration rates were diminished in the young rats, but not in the adult rats. Our study lends credence to the hypothesis that age at the time of exposure is critical to the development of progressive renal damage. PMID- 3957564 TI - Decreased endothelial pump function with aging. AB - Endothelial function may be affected by the endothelial cell loss and increased variability in cell shape and size (polymegathism) that accompany normal aging. Endothelial function can be evaluated by monitoring corneal hydration recovery following hypoxic stress. The authors compared corneal recovery and endothelial morphology between a group of younger (mean = 26.7 yr) and older (means = 65.7 yr) subjects with normal corneas. Edema (60 microns) was induced with hydrogel lenses worn with the eyes closed. Following lens removal, the decrease in corneal thickness was monitored for 4 hr with one eye open while the contralateral eye remained closed. For both age groups, corneal recovery followed a non-linear time course. The open eye required 2.5 hr and 3.0 hr to return to baseline for the younger and older age groups, respectively. Recovery during eye closure took 3.5 hr to reach the normal closed eye level for the younger subjects and was not complete at 4 hr for the older subjects. Recovery rates were significantly slower for the older vs younger subjects during the first 2 hr of closed eye recovery, 10.5 vs 15.0 microns/hr, and for the initial 1 hr of open eye recovery, 26.5 vs 35.6 microns/hr. For both age groups combined, the rate of recovery was negatively correlated with the coefficient of variation in cell area, r = -0.62 and -0.69 (P less than 0.01), for both closed and open eye recovery, respectively. When each morphological characteristic was isolated, the only significant correlation found was between the coefficient of variation in cell area and the rate of recovery during eye closure, r = -0.66 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957565 TI - Epithelial wound closure in the rabbit cornea. A biphasic process. AB - The rapid and complete repair of the corneal epithelium following ocular surgery or trauma is essential for the maintenance of normal visual acuity. In this study the authors examined epithelial wound healing in the rabbit after cells were mechanically removed leaving the basal lamina intact. The decrease in wound area (mm2/hr) was neither linear nor amenable to simple kinetic analysis. However, analysis of the data in terms of the decrease in wound radius (mm/hr) revealed a biphasic process consisting of an initial latent phase with no epithelial movement (5.5 +/- .3 hr), followed by a linear healing phase. The rate of epithelial movement in the linear healing phase was 64 +/- 2 microns/hr. Neither the latent phase nor the rate of epithelial migration during the healing phase was affected by variations in initial wound size. Ultrastructural studies demonstrated that during the latent phase there was an increased desquamation of surface cells as well as cellular and subcellular reorganization of the basal cells. At the end of the latent phase, the leading edge of the wound was composed of a single cell layer. The onset of epithelial migration coincided with the first ultrastructural observation of typical ruffled membranes and filopodia. This work demonstrates that the analysis of the decrease in wound radius provides a straightforward and accurate means to assess the kinetics and therapeutic modulation of epithelial wound healing. PMID- 3957567 TI - Experimental ocular onchocerciasis in cynomolgus monkeys. AB - Infection of cynomolgus monkeys with microfilariae (Mf) of Onchocerca lienalis was studied as a model for human ocular onchocerciasis. Normal monkeys and immunized monkeys were given intracorneal/subconjunctival, intracameral, or intravitreal injections of Mf or bovine serum albumin (control). Selected animals were given diethylcarbamazine citrate (DEC) orally (15 mg/kg) daily after the ocular infection. Following intravitreal challenge, living Mf and fibrinous exudates were visible by slit-lamp in both the anterior chamber and vitreous. Eosinophils and macrophages surrounded the Mf in the vitreous, with degranulated eosinophils adherent to the Mf. Eosinophils infiltrated the uvea and surrounded the retinal vessels. After intracorneal injection of Mf, living Mf were visible by slit-lamp biomicroscopy in the cornea for 3 days, with minimal inflammation of the corneas occurring over the 7 days after injection. Intracamerally injected Mf induced anterior uveitis. The extent of the inflammatory reactions was not substantially altered by DEC treatment following intraocular injection of Mf. In vitro proliferative responses of peripheral blood leukocytes to a crude Mf antigen were not observed in infected monkeys and proliferative responses to mitogen declined in these animals. Responses to mitogen were inhibited by addition of Mf antigen in vitro in normal monkeys. Circulating IgG antibodies were present in the sensitized, intracorneally, and intravitreally challenged animals. No obvious correlations were present between IgG antibody level and ocular inflammation. PMID- 3957566 TI - Bacterial lipases and chronic blepharitis. AB - Eyelids and conjunctivae of 36 normal individuals and 60 patients from six clinical groups of chronic blepharitis were cultured for aerobic and anaerobic bacteria. The most common species isolated were coagulase-negative staphylococci (C-NS) and Propionibacterium acnes. All strains of these species, and all Staphylococcus aureus strains isolated were tested for the ability to break down triglycerides, cholesterol esters, and fatty waxes. Each strain was incubated independently with appropriate substrates in nutrient media. Each medium was then extracted and assayed for the presence of substrate hydrolysis products by thin layer chromatography. The percentage of strains capable of hydrolyzing a particular substrate was determined for each individual. S. aureus was a consistent and strong lipase producer, able to hydrolyze all three substrates. P. acnes was able to hydrolyze triolein and behenyl oleate but not cholesteryl oleate. No differences were observed among groups for P. acnes or S. aureus. C-NS showed a high degree of strain variability. Eighty-three percent of C-NS strains could hydrolyze triolein, 82% behenyl oleate, and 40% cholesteryl oleate. Significant group differences were seen in the percentage of lipase positive C-NS strains isolated per individual. Patients in the mixed staphylococcal/seborrheic, meibomian seborrheic, secondary meibomitis, and the meibomian keratoconjunctivitis (MKC) groups harbored significantly more C-NS strains capable of hydrolyzing cholesteryl oleate than did normal individuals. Patients in the meibomian seborrheic, secondary meibomitis, and MKC groups harbored significantly more C-NS strains capable of hydrolyzing behenyl oleate than did normals. No group differences were seen among groups with triolein hydrolyzing C NS strains. PMID- 3957568 TI - Role of natural killer cells in intraocular melanoma metastasis. AB - The authors studied the role of natural killer (NK) cells in spontaneous metastasis of murine intraocular melanoma by transplanting murine B16 melanoma cells into the anterior chamber of the eye in syngeneic C57BL/6 mice and determining the number of metastatic lung tumor colonies after 40 days. Depletion of NK activity by anti-asialo GM1 serum dramatically enhanced metastasis and augmentation of NK activity by interferon inhibited it. The strong correlation between host NK activity and intraocular melanoma metastasis indicated that NK cells have an important role in spontaneous metastasis of intraocular melanoma. PMID- 3957569 TI - Pharmacokinetic of topical cyclosporin A in the rabbit eye. AB - 3H labelled cyclosporin A (CS-A) eye drops (2% in castor oil) were applied in rabbits. When a single drop of 10 microliters was given CS-A reached a maximal concentration of 900-1400 ng/ml in the cornea 6 hr after application and then slowly decreased. A substantial level of 600-900 ng/ml was still present after 48 hr. When corneas were analysed for their cellular compartments, 67% of CS-A was found in the epithelium, 25% in the stroma (probably in keratocytes), and 8% in the endothelium. In corneas denervated by circular keratotomy, slightly reduced concentrations were found after surgery, the reduction was not therapeutically significant. Using the HPLC method a significant corneal metabolism of CS-A could be excluded. Scleral concentrations of CS-A as high as 180 ng/ml were found. Concentrations of CS-A in aqueous humor, lens, vitreous body and uvea/retina were below the therapeutic range. PMID- 3957570 TI - Subconjunctival injections. Preservative-related changes in the corneal endothelium. AB - The morphologic effects on rabbit corneal endothelium of several common ophthalmic vehicle constituents were examined following subconjunctival administration. Profound dose-dependent changes consisting of intercellular vacuolization and thickening of the endothelial layer were noted within 1 day following administration of solutions that contained sodium bisulfite or methylparaben and propylparaben. These changes persisted for at least 5 days except in those eyes treated with the lowest concentration of sodium bisulfite. In contrast, administration of sodium citrate and creatinine or unpreserved normal saline resulted in only minimal effects. These changes are of concern because these agents are present in many preparations used to treat a wide variety of eye diseases. PMID- 3957571 TI - Orientation discrimination in amblyopia. AB - Using extended sinusoidal gratings to avoid potential problems of eccentric fixation, the authors have studied orientation discrimination in amblyopia. For all subjects, elevated orientation discrimination thresholds at high spatial frequencies were found. However, raised thresholds decrease with decreasing spatial frequency, and can be normal at low frequencies. Orientation discrimination thresholds for both amblyopic and non-amblyopic eyes are independent of contrast over most of the visible range. Therefore, amblyopic orientation discrimination thresholds cannot be mimicked in non-amblyopic eyes by reducing contrast. Control experiments show that the orientation discrimination deficits are not restricted to vertical stimuli and that they are not a result of exaggerated cyclotorsional eye movements. PMID- 3957572 TI - Fatigue and structural change: two consequences of visual pattern adaptation. AB - In a tilt aftereffect (TAE) paradigm, 2 min of adaptation produced an aftereffect that decayed almost completely within 4 min. Four minutes of adaptation produced a TAE that lasted more than 2 wk. Two modes of adaptation contribute to the TAE and account for other aftereffects: short-term fatigue, produced very quickly and long-term structural change, requiring more extended adaptation. PMID- 3957573 TI - The dissociability of accommodation from vergence in the dark. AB - A special case was set up in which accommodation and vergence were totally deprived of their stimuli, in order to determine whether their responses remained coordinated or whether they became dissociated. A dynamic, infrared optometer and infrared, eye-movement sensors were used simultaneously to monitor accommodation and vergence respectively in the dark. Responses were recorded continuously over an extended time course, and the two systems were found to behave essentially independently of each other in darkness. However, a statistical cross-correlation analysis revealed that, despite the readily apparent dissociation of the two responses in the time domain, there was a correlation between them in the frequency domain. The time-domain dissociation suggests that the tonic controllers of both motor systems are positioned downstream from the crosslinks that join them (accommodative vergence and vergence accommodation). The frequency domain correlation suggests that the crosslinks are not completely dormant in the dark, but that they carry low-amplitude noise, at a more or less fixed temporal frequency, from one motor system to the other. PMID- 3957574 TI - Short-term changes in tonic accommodation. AB - Experiments were performed to determine the diurnal variation of, as well as the influence of total darkness on, tonic accommodation. In general, under both conditions trend analysis showed that variations in tonic accommodation over time were either nonsystematic in nature or could be best described by a simple linear function. Given the relatively small range of mean tonic accommodation values over time (0.5 to 1.1 D), the results demonstrate the robustness and stability of tonic accommodation under naturally occurring viewing conditions during the course of a day. In contrast, during the 2-hr period in total darkness, tonic accommodation exhibited a three-fold increase in mean range (0.6 to 2.5 D) as well as a significant increasing linear trend in some subjects, suggesting less stability of tonic accommodation in the absence of visual stimuli. PMID- 3957575 TI - Quantitative assessment of disparity vergence components. AB - Earlier evidence suggests qualitatively that at least two control modes may mediate a single vergence response. Thus, in a vergence response to step disparity, the transient component drives the initial fast dynamic portion of the response, while the sustained component maintains the latter slower portion of the response. The authors extended this hypothesis by quantitatively defining the stimulus pattern and dynamics that elicit this dichotomous behavior. The disparity target consisted of vertical lines 2 deg in height presented to each eye. Ramp disparity velocities ranged from 0.7 deg/sec to 36 deg/sec with amplitude of up to 4 deg. Photoelectric recordings of eye movements from both eyes were subtracted to give the vergence response. Fast and slow ramp stimulus velocities were found to elicit transient and sustained component responses respectively. In addition, the finding of staircase-like responses to fast ramp stimuli has strong implications on control mechanisms, indicating a sampling process in the transient component of the disparity vergence system. PMID- 3957576 TI - The relation of monocular optokinetic nystagmus to peripheral binocular interactions. AB - Human observers with deficient foveal stereopsis often show characteristic abnormalities of monocular optokinetic nystagmus (OKN). The present study examined the effect of binocular interactions in the peripheral visual field on these OKN deficits. A variety of binocular functions (binocular acuity summation, interocular suppression, motion-in-depth) were assessed at various positions throughout the visual field in subjects with deficient or no foveal stereopsis and related to monocular OKN deficits seen with different stimulus field sizes. Extent and location of peripheral binocular interactions accurately predicted the changes in monocular OKN observed with different field sizes. This indicates that the effects of early developmental conditions on cortical and subcortical binocularity, responsible for the deficits of stereopsis and OKN, show very close functional parallels. The results further suggested that monocular OKN deficits and peripheral acuity profiles are determined before the age of 5 yr. PMID- 3957577 TI - Monocular and binocular optokinetic nystagmus in humans with defective stereopsis. AB - In order to investigate the previously suggested relation between cortical binocular function and deficits in monocular optokinetic nystagmus (OKN), monocular and binocular OKN was examined in normal, stereodeficient, and stereoblind observers, using a variety of stimulation velocities and stimulus field sizes. Most stereodeficient and stereoblind observers showed monocular OKN deficits in one or both eyes, which took the form of either a directional asymmetry or a reduction of the response in both directions. The deficits were often more pronounced at higher stimulation velocities and with smaller stimulus field sizes. The severity of the OKN deficit was related to the degree of residual foveal stereopsis, while the type of the deficit seemed to be influenced by the presence and depth of amblyopia. Binocular OKN resembled the best monocular response in subjects with a directional or ocular asymmetry. The results fit well with current animal models of the neural control of OKN. PMID- 3957578 TI - Necessary conditions for the perception of motion in depth. AB - This study investigated the relation between the perception of motion in depth and ocular vergence movements for a single foveally viewed dot, and for a 30 deg X 30 deg pattern of many dots. When the target's disparity was changed, it appeared to move in depth relative to stationary reference marks, but removing the reference marks completely abolished the sensation of motion in depth for the multi-dot target and left only a weak sensation of motion in depth for the single dot target. However, it is not the case that motion-in-depth sensation per se depends on the presence of reference marks; motion in depth generated by changing size stimulation was unaffected by removing reference marks. Possible explanations for the loss of motion-in-depth sensation include ocular vergence exactly tracked stimulus motion; vergence changes and disparity changes, though unequal, produced equal and opposite motion-in-depth signals; vergence changes, though producing no motion-in-depth signals, suppressed the signals produced by disparity changes; motion-in-depth sensation requires relative motion. Explanation is rejected because vergence tracking errors were large. Explanation is rejected because vergence changes do not in themselves induce a sensation of motion in depth. Explanation is rejected because motion-in-depth threshold is not affected by vergence changes. Conclusions are as follows. For a single-dot target, visual sensitivity to motion in depth is much higher for changes in relative retinal disparity than for changes in absolute retinal disparity, while for a multi-dot target any residual sensitivity is abolished by an interaction between neighboring coherently moving dots. The authors suggest that the relative velocity elements proposed to explain sensitivity to changing size feed the stereomotion mechanism also. PMID- 3957579 TI - Stereoacuity in young children. AB - Previous investigations of stereopsis in children have found that stereoacuity improves gradually over time and does not reach adult levels until well into childhood. The unusually protracted period of development implied by these data is at odds with the development of other visual capacities, such as acuity, contrast sensitivity, increment thresholds, and flicker fusion. When tested on those dimensions, children, by the age of five, achieve thresholds that are only moderately higher than those achieved by adults. To determine if the elevated thresholds for stereopsis found in children could be attributable to the methods used to obtain them, the authors assessed stereoacuity of children, 3 to 5 yr of age, using a laboratory test combined with procedures designed to optimize the limited attentional, motivational, and response capabilities of young children. The thresholds obtained (median = 12.6 sec) are much lower than previously reported and are close, but not equal, to the thresholds of adults. These data suggest that the development of stereopsis is not unusually protracted relative to the development of other visual capacities. The elevation of threshold relative to adult values is similar to the shortfall found in studies of other visual capacities and has led investigators to suggest, and the authors concur, that children do not possess the sophisticated cognitive strategies that adults can employ when thresholds are approached and uncertainty is high. Given that interpretation, it is suggested that the maturation of stereoscopic capacity is nearly complete in children 3 to 5 yr of age. PMID- 3957580 TI - Effect of aniseikonia on binocular function. AB - The pattern reversal visual evoked response (VER) was recorded under conditions of artificially unbalanced visual input between two eyes, an aniseikonia induced by size lenses that alter the perceived retinal image size without changing refraction. At 3.0% aniseikonia binocular summation started to decrease, and at 5.0% aniseikonia there was no significant binocular summation. In higher aniseikonia (8.0-10.0%), binocular inhibition replaced binocular summation. The phase difference between binocular and monocular VER was largest at zero aniseikonia. When aniseikonia exceeded 5.0%, there was no significant phase difference between the two recording conditions. These results suggested that the binocular system can compensate for up to a 3.0% difference in perceived retinal image size (aniseikonia), but in higher aniseikonia the binocular system can no longer compensate for the difference and binocular inhibition takes place. These findings agree with previously reported subjective and psychophysical results. The authors suggest that this objective method of evaluation using the pattern reversal VER may be helpful in pediatric ophthalmology when subjective methods are of limited use. PMID- 3957581 TI - Tear immunoglobulins measured by ELISA. AB - The authors applied an ELISA to measure IgG, IgA, and IgM concentration in tears from 20 normal subjects. This assay was more sensitive than any other previously reported technique to quantitate tear immunoglobulin. Only 2 microliter of tears were required and concentrations as small as 1 ng/ml could be detected. IgM was present in all samples at a geometric mean level of 5.6 micrograms/ml. Mean IgA level was 186 micrograms/ml and mean IgG was 6.7 micrograms/ml. No correlation was found between tear and serum levels, suggesting that local synthesis was responsible for most of the tear immunoglobulin. This ELISA offers a sensitive and reliable method to analyze very small volumes of tears. It can be modified to test for many different antigens and antibodies. PMID- 3957582 TI - Susceptibility of Acanthamoeba to soft contact lens disinfection systems. AB - Members of the genus Acanthamoeba are increasingly recognized as agents of indolent, chronic, infectious keratitis. Recently, Acanthamoeba corneal infection has been reported in some persons who wear soft contact lenses. In this study, three "heat" and three "cold" soft contact lens disinfection systems were tested according to the manufacturers' instructions against Acanthamoeba castellanii and Acanthamoeba polyphaga in separate trials, and with appropriate controls. Suspensions of Acanthamoeba cysts or trophozoites of each species were tested individually. Each of the three heat disinfection units killed all acanthamoebae in one cycle in all trials. A chlorhexidine 0.005%/thimerosal 0.001% solution killed A. castellanii trophozoites and cysts, but those of A. polyphaga survived. Trophozoites and cysts of both species survived an alkyl triethanol ammonium chloride 0.013%/thimerosal 0.002% solution and a hydrogen peroxide 3% preparation. Heat disinfection overall appears to be more effective in killing Acanthamoeba trophozoites and cysts as compared to cold disinfection methods. PMID- 3957583 TI - Bioavailability and corneal anti-inflammatory effect of topical suprofen. AB - The bioavailability in rabbit cornea and aqueous humor of an ophthalmic formulation of suprofen, a nonsteroidal anti-inflammatory drug, was evaluated following topical administration of a single dose to the eye. The drug penetrated rapidly into the uninflamed cornea with intact epithelium; highest levels occurred during the first 30 to 45 min after instillation and decreased thereafter. The bioavailability of suprofen in cornea and aqueous humor following administration of a 1.0% concentration was twice that produced by a 0.5% concentration of the drug. Topical application of multiple doses of suprofen failed to suppress polymorphonuclear leukocyte invasion of the cornea if treatment was started after the induction of inflammation. Suprofen therapy initiated prior to the induction of corneal inflammation and maintained into the post-inflammation period did produce a significant (P less than 0.01) decrease in the numbers of PMNs that invaded the inflamed cornea. There was no significant difference (P greater than 0.05) in the corneal anti-inflammatory effect achieved by the 0.5% and 1.0% concentrations of suprofen when administered according to this regimen. PMID- 3957584 TI - Migraine and low-tension glaucoma. A case control study. PMID- 3957585 TI - Regional pulmonary distribution of iodine-125-labeled oleic acid. Its relationship to the pattern of oleic acid edema and pulmonary blood flow. AB - Oleic acid infusion in dogs produces a patchy, predominantly peripheral lesion on CT scans. This study correlates the pattern of oleic acid injury with the distribution of infused oleic acid and pulmonary blood flow. Radiolabeled oleic acid (I-125, 0.05 ml/kg) and radiolabeled 15-micron microspheres (Co-57) were infused into the right atria of 11 dogs. Oleic acid was given after the microspheres in six dogs and before microspheres in five dogs. Ten minutes after infusion, the lungs were removed. Four transverse slices (0.5 cm thick) of the lower lobes were taken from each dog and cubed. Samples were grouped into three regions of the transverse slice: outer, middle, and inner concentric rings. In both groups, I-125 (oleic acid) activity was greater in the outer than the middle and inner concentric layers (P less than 0.001). When Cobalt-57 microspheres were given before oleic acid, Cobalt-57 activity was marginally lower in the outer layer compared with the middle and inner layers. However, when oleic acid was given first, microsphere activity in the outer layer was significantly lower (P less than 0.001) than the middle layer. Thus, oleic acid was preferentially distributed to the peripheral regions of the lung, similar to the regions of injury on CT. This distribution did not correspond to the pattern of pulmonary blood flow as indicated by the microspheres. Immediately after oleic acid infusion, pulmonary blood flow to the periphery was reduced, reflecting a response to the predominantly peripheral injury by oleic acid. PMID- 3957586 TI - Measurement of lung gas volume and regional density by computed tomography in dogs. AB - To determine if computed tomography (CT) can accurately measure lung volume, we compared lung gas volume measured by helium dilution with the equivalent volume calculated from CT total lung volume and density in 13 supine dogs. CT lung gas volume underestimated helium volume by 34% (range: -63 to 0%). Studies of wooden lung phantoms varying in density from 0.082g/cc to 0.776g/cc showed that only 15% of this error could be mimicked by the phantoms. The rest of the discrepancy is attributed to the lung's irregular borders, and the sharp density gradients surrounding and within the lung that result in x-ray beam hardening, sampling limitations, and partial volume measurement errors. Serial biweekly measurements in three dogs for 14 weeks showed CT gas volume to be highly reproducible with less scatter than seen in the helium measurements. Density in the lungs of all dogs showed a uniform gradual decrease from approximately 0.60g/cc at the dependent surface to 0.20g/cc at the superior surface with relatively constant density at any horizontal level. These studies show that whereas CT underestimates gas volume in the lungs, serial measurements are highly reproducible in experimental studies and are a promising technique to monitor diseases or response to therapy. Density gradients in the lungs were sufficiently uniform so that disruption of the normal gradient may be an indicator of early lung disease. PMID- 3957587 TI - Early changes in experimental hydrocephalus. AB - In acute obstruction of the cerebral spinal fluid (CSF) absorption pathways, fluid is produced more rapidly than it is absorbed, and the ventricles enlarge proximal to the obstructions. Communicating hydrocephalus results from a difference between the rates of production and absorption of cerebrospinal fluid. In animals with chronic communicating hydrocephalus, the initial pathologic changes appear to involve the periventricular tissue near the angles of the lateral ventricles. The present investigation was designed to identify the various changes associated with the production of communicating hydrocephalus in acutely hydrocephalic preparations and to relate these findings to those found in experimental animals with chronic communicating hydrocephalus. The results of this study seem to confirm that the changes noted in the chronically hydrocephalic animals occur as early as 12 hours after the restriction of the normal flow of CSF. PMID- 3957588 TI - Urography with a low osmolality contrast agent. Comparison of Hexabrix with Conray 325. AB - A double-blind, parallel group comparison study of Hexabrix and Conray 325 for adult intravenous urography was performed. Sixty patients with a mean age of 54 years were included. Doses of contrast ranged from 0.5-1.1 ml/kg for both groups with a mean of 0.7 ml/kg. Hematology, urinary and biochemical laboratory tests were performed prior to the study in all patients and at 24 hours afterward in nearly half the group. Biochemical laboratory tests were done at 72 to 96 hours in approximately one third of the patients. Hexabrix proved satisfactory for standard urography at a chosen dose of 16 g of iodine (50 ml). There were no statistically significant differences in the diagnostic quality of the urogram in the two groups except for bladder filling. The decreased osmotic diuresis associated with Hexabrix necessitated delayed bladder filming for optimal evaluation. Excellent patient tolerance was achieved with less pain on injection with Hexabrix. There was one death in the Hexabrix group in a patient with multiple medical problems. Although the patient's medical problems appeared well controlled and did not meet specific rejection criteria, they almost certainly played a role in his death. Hexabrix may be useful for adult urography at a lower dose range, eg, 16 g iodine, than is typically used, which also may be cost effective (competitive) given the higher projected cost of the new low osmolar agents. PMID- 3957590 TI - Estimating digital information throughput rates for radiology networks. A model. AB - The design and implementation of a digital radiology image management system requires the definition, evaluation, and comparison of appropriate measures of system performance. The mean throughput rate is an important measure of the actual performance of a finished system. The mean throughput rate identifies the transmission of digital information either in bits/second or tasks/second. It is dependent on software, database management, equipment interface designs, number of users and display stations, and communications media. The mean throughput rate can document resource allocation bottlenecks within a given system. A model for estimating the mean throughput rate and its application in helping us design our radiology digital image networks is described. PMID- 3957589 TI - In vivo 31P-MR spectroscopy of the liver in the infant rabbit to study the effect of hypoxia on the phosphorus metabolites and intracellular pH. AB - In vivo 31P-magnetic resonance spectroscopy (MRS) with a chronically implanted detection coil was used to study the effect of hypoxia on the phosphorus metabolites and intracellular pH in the liver of infant rabbits. A two-turn 10-mm radiofrequency coil was placed between the hepatic lobes in each of four infant New Zealand white rabbits (10-16 days old). Two days later, the rabbits were anesthetized and mechanically ventilated with 1.5% isoflurane in 98.5% O2. Blood gases, heart rate, and mean arterial pressure were monitored. 31P-MR spectra were continuously obtained every 5 minutes during 15 minutes of hyperoxia (PaO2 greater than 250 torr), 15 minutes normoxia (PaO2 approximately equal to 100 torr), 60 minutes hypoxia (PaO2 = 24 torr +/- 4 S.D.), and 15 minutes recovery (hyperoxia). In addition, 31P-MR spectra of perchloric-acid extracts of the liver of an adult and of an infant rabbit, removed under normoxic conditions, were examined. The 31P-MR spectra of liver of the normoxic adult (in vitro) and infant rabbits (in vitro and in vivo) revealed a high level of phosphodiesters, namely glycerol-3-phosphorylethanolamine, glycerol-3-phosphorylcholine, and phosphoenolpyruvate, compared with that reported for adult rat and adult mouse liver. The inorganic phosphate (Pi)-to-adenosine triphosphate (ATP) ratio was about 0.90 during hyperoxia and during normoxia. Within 15 minutes after induction of hypoxia, the level of phosphorus metabolites changed markedly: The ATP decreased 41% +/- 18 S.D. (P less than .01) and the Pi increased 206% +/- 29 S.D. (P less than .01); the Pi/ATP ratio was 5.0.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957591 TI - A uniform acceptance date for resident recruitment. AB - Residency recruitment in diagnostic radiology remains a challenge. We recommend a unified policy of recruitment, to be agreed upon and adhered to by all residency training program directors. We endorse the action discussed at the 1985 Residency Training Program Symposium in Nashville to institute a Resident Match and strongly urge all program directors to participate. With more qualified candidates and a shrinking number of positions, it is the only rational solution to this dilemma. PMID- 3957592 TI - Marked disparity between trabecular and cortical bone loss with age in healthy men. PMID- 3957594 TI - Chemical ablation of the canine kidney using sodium tetradecyl sulfate (Sotradecol). A histopathologic study. AB - We studied the histopathologic effect of intraarterial Sotradecol (Elkins-Sinn, Inc., Cherry Hill, NJ) on the kidney and examined the mechanism for destruction of renal parenchyma by Sotradecol. Sotradecol was injected into one renal artery distal to an occlusion balloon catheter in six dogs, and the kidneys were removed for histologic examination; four dogs within 20 minutes, and one each at 12 and 24 hours after embolization. The contralateral kidney of each dog underwent the same procedure but was injected with normal saline, and served as control. Histologic examination of the control kidneys was unremarkable. The embolized kidneys revealed extensive endothelial denudation and mural necrosis of the arteries and coagulation necrosis of the renal parenchyma. The changes were evident as early as 20 minutes after embolization, and necrosis became complete by 24 hours. The arteries were filled with red blood cell sludge. Sotradecol produces extensive tissue necrosis and complete renal parenchymal destruction through its direct cytotoxic action on the arterial wall, blood cell elements, and renal parenchyma. PMID- 3957593 TI - Serotonin-induced visualization of the popliteal lymph node by angiography. A unique microvascular response to serotonin. AB - Regulation of the blood supply to lymph nodes is an important determinant of lymphocyte traffic but remains poorly understood. Infusion into the femoral artery of serotonin (5 HT), an agent that may produce either vasoconstriction or vasodilatation, induced striking arteriographic visualization of the popliteal lymph node in 19 of 20 dogs. Neither other vasodilator agents (acetylcholine, tolazoline, histamine, isoproterenol, sodium arachidonate, the prostaglandin analog CL115, 347) nor vasoconstrictor substances (norepinephrine, epinephrine, phenylephrine, and ergonovine maleate) produced the same effect. The timing of appearance and disappearance of the contrast medium during 5HT infusion suggests that an increase in capillary blood flow secondary to arteriolar dilatation in the lymph node is responsible for the augmented visualization. 5HT-induced visualization of the popliteal lymph node was not modified by pretreatment with either the specific 5HT-2 antagonist ketanserin or the nonspecific antagonist methysergide. The specificity of action of 5HT and its availability for release from circulating and noncirculating cellular elements suggest that it may be important in the regulation of lymph node circulation, and thereby, lymphocyte traffic. This approach may provide another means to enhance the visualization of lymph nodes. PMID- 3957595 TI - Changes in proton relaxation times of the rat spleen during adjuvant-induced immunologic reaction. AB - Possible changes in magnetic resonance (MR) relaxation times resulting from an immune reaction were evaluated in the rat spleen by means of in vitro proton spectroscopy and an established model of immune disease. Heat-killed Mycobacterium butyricum in Freund's adjuvant was injected intradermally into the tail of 28 rats. Ten normal rats served as controls. At different times following the injection of adjuvant (day 7, day 10, day 12, day 14, or day 22), the spleens were removed and weighed, and proton T1 and T2 relaxation times were measured with a 0.25-T spectrometer (10.7 MHz). Water content was also determined. Specimens of each spleen were histologically examined; this included Prussian blue staining for detection of hemosiderin. In 22 of the 28 adjuvant-injected rats, spleen T1 values increased significantly, from a mean value of 451 msec +/- 23 S.D. (control rats) to a maximum mean value of 571 +/- 15 S.D., which occurred on day 12; this T1 increase paralleled an increase in weight and water content and a histologic appearance of granulomatous inflammation. In these rats, T2 changes were not significant. In the other six adjuvant-injected rats, spleen T2 relaxation time significantly decreased from a mean value of 42 msec +/- 5 S.D. to a mean value of 32 msec +/- 1 S.D. Histologic evaluation indicated that the origin of this T2 decrease was probably the presence of hemosiderin in the spleens of only these six rats. Mean T1 of these spleens decreased slightly, but not significantly. PMID- 3957596 TI - Osteoarthritis of the sternoclavicular joint. Radiographic features and pathologic correlation. AB - Osteoarthritis (OA) of the sternoclavicular (SC) joint has been extensively characterized in the pathology literature, but the radiographic appearance of this entity has received comparatively little attention. To define the radiographic patterns of OA at this joint, we used high resolution PA radiographs (industrial grade film) to examine 55 SC joints obtained by block resection at autopsy. Ten of these also were selected for coronal complex motion tomography. Fifty cases were histologically correlated. Radiographic and pathologic material was evaluated by four criteria characteristic of OA: joint-space narrowing, osteophytes, sclerosis, and cysts. Each criterion was independently assessed for severity and distribution. Moderate or severe radiographic changes of OA were uncommon in specimens younger than age 40, but present in 53% older than age 60. Changes were typically bilateral, although a mild degree of asymmetry was common. OA was most severe along the inferior portion of the clavicular head, which comprises its articulating margin with the sternum. Complex motion tomography was generally more accurate than plain radiography for assessing OA in the ten specimens in which comparison was performed. PMID- 3957599 TI - Histogram-directed processing of digital chest images. AB - One of the potential advantages of digital chest imaging is the ability to process these images. However, such processing, when uniformly applied to the entire image, is often unsatisfactory due to the different processing requirements of lung field and mediastinum. Therefore, a method to selectively process these regions based upon the histogram of the original image has been developed. Thirteen conventional chest films were digitized with a laser film scanner. Analysis of individual lung field and mediastinum histograms showed that the chest image histogram is essentially bimodal with significant lung field mediastinum histogram peak separation; overlap between these peaks is small (9% of the total histogram) and insensitive to minor pathologic change or radiographic technique. Using these histograms, a gray level threshold distinguishing mediastinum from lung field was selected and used to direct the regionally-selective processing of several chest images. This technique may prove especially useful for digital enhancement of the underexposed mediastinum often encountered on conventional chest radiographs. PMID- 3957597 TI - Effects of radiographic contrast media on monolayer cell cultures. AB - The relationship between iodine concentration, osmolality, and toxicity for nine different contrast media was studied. High osmolal conventional ionic contrast media (Na-metrizoate, Na-iothalamate, meglumine/Na-diatrizoate, meglumine-calcium metrizoate) and the new low osmolal nonionic (Metrizamide, iopamidol, iohexol) and ionic dimer (Meglumine/Na-ioxaglate) contrast media were tested. Monolayer cell cultures of human cervical carcinoma in situ cells were used as a test system. The toxicity of contrast media on cell cultures was strongly dependent on the osmolality, and different contrast media with the same osmolality had about similar effects on the cell cultures. However, contrast media seem to have some additional and more specific effects since equiosmolal saline and mannitol were better tolerated. When the toxicity was related solely to iodine concentration it emerged that the new low osmolal contrast media were much better tolerated than the high osmolal conventional contrast media. PMID- 3957598 TI - Contrast, coagulation, and fibrinolysis. AB - Some adverse clinical effects of intravascular radiologic contrast agents have been attributed to their interference with the normal hemostatic processes. This study compares the effects of the low osmolality agents with those of the conventional agents by in vitro studies of platelet function, fibrin formation, and fibrinolytic activation. In various degrees, all the contrast agents studied inhibit platelet aggregation and fibrin formation but show virtually no direct activation of fibrinolysis. The new low osmolality agents generally show lesser inhibitory effects on the hemostatic mechanisms. Some clinical implications are discussed. PMID- 3957600 TI - Spatial resolution analysis of computed tomographic images. AB - Methods are presented for the quantification of spatial resolution in x-ray computed tomographic (CT) images. Model-dependent methods are derived and compared with model independent methods for computation of the Modulation Transfer Function (MTF). These techniques are applied to phantom images of point, line, edge, and ring discontinuities. The model-dependent methods utilize multiparameter fits of a two-dimensional model function to the image data. Model predictions are compared with results obtained in a model-independent way by numerical transformation of the data. Results of resolution measurements of an Imatron C-100 CT scanner at UCSF and a second experimental scanner at the UCSF Physics Research Laboratory are presented. PMID- 3957601 TI - Computed tomographic volumetric calculation reproducibility. AB - Previous studies have described computed tomographic (CT) measurement of the total volume of large organs and tumors. This study examines sources of error in the CT volumetric measurement of small anatomic structures, and has potential application to the volumetric measurement of small extravisceral tumors. Volume is determined by multiplying observer measurement of area by the CT slice thickness. We focused on the measurement of small cross-sectional areas as a major source of error in volumetric calculations. One observer made ten area measurements on each of 12 structures of various sizes. For areas larger than 8 to 10 cm2, any single measurement was within 2 to 4% of the mean of ten values. For areas smaller than 8 to 10 cm2, measurements varied more with respect to the mean, and rose approximately exponentially as the measured cross-sectional area approached zero. PMID- 3957602 TI - Anal submucosal injection: a new route for drug administration in pelvic malignancies. Part I. Experimental study of misonidazole distribution in serum and tissues, with special reference to urinary bladder. Preliminary report. AB - The anal and oral administration routes were compared in 30 rats to study the distribution of misonidazole, a radiation sensitizer, in the serum and tissues with special reference to the urinary bladder. 14C-labelled misonidazole was administered in a dose of 0.2 ml water/100 gm body weight containing 1 mu Ci misonidazole. The dose was given orally by stomach tube in 15 rats, and was injected in the submucosa of the anal canal in another 15. Animals were then killed after 15, 30, 60, or 120 minutes or after 24 hours. Organs were dissected, and radioactivity was determined in each by the internal standard method. The study has shown that the highest drug concentration in the bladder tissue relative to the serum was achieved with the anal submucosal route. Its level was eight and five times that of the serum 15 and 30 minutes after administration, respectively, in contrast to the oral route in which the drug concentration was one-quarter and equal to the serum level at the same time intervals. The anal route would thus provide the adequate channel required for misonidazole to promote radiation responsiveness in bladder carcinoma. PMID- 3957604 TI - The case for a clinical year prior to radiology residency. PMID- 3957603 TI - Comparison of lecture and case presentation formats for teaching radiology to residents. PMID- 3957605 TI - Comparison of CT and MR in 400 patients with suspected disease of the brain and cervical spinal cord. PMID- 3957606 TI - Policy and attitudes toward the pregnant radiology resident. PMID- 3957607 TI - Routine admission chest x-ray in the management of hospitalized patients. PMID- 3957608 TI - Advocate 17 changes in Iowa malpractice law. PMID- 3957609 TI - Iowans in favor of liability reform. PMID- 3957610 TI - New delivery approaches still target on economy. PMID- 3957611 TI - Using the minimal weight prediction equations for scholastic wrestlers. PMID- 3957612 TI - The effect of dietary protein on drug clearance. PMID- 3957613 TI - Lice & scabies control. PMID- 3957614 TI - Substance abuse problems in Iowa: coordinating our efforts. PMID- 3957615 TI - Substance abuse detection--current medical perspectives. PMID- 3957616 TI - Intervention strategies. PMID- 3957617 TI - Treatment of chemical dependency: a new field for physicians. PMID- 3957618 TI - Alcoholism and depression. PMID- 3957619 TI - Ethanol trauma syndrome (ETS). PMID- 3957620 TI - Bromocriptine--an update. PMID- 3957621 TI - Update on newborn screening. PMID- 3957622 TI - Adolescent chemical dependency programs: meeting the need? PMID- 3957623 TI - Cerebrospinal fluid lymphocyte subpopulations in multiple sclerosis. AB - T3+ (all-T) and T8+ (suppressor/cytotoxic) cells were studied in cerebrospinal fluid (CSF) from 24 patients with multiple sclerosis (MS) and from 24 subjects with various "non-immunological" disease (NID). MS patients were classed as (a) during the acute phase of the 1st episode of the disease, (b) in acute relapse, (c) with chronic progressive disease, (d) with increased or (e) normal CSF IgG content or (f) with neurological impairment (Kurtzke scale) less than or equal to 3 or (g) greater than 3. In MS cases considered as a whole a significant decrease in CSF T3+ cells was found compared to NID patients. When single groups were considered, T3+ cells decrease was significant in classes (b), (d) and (f). Significantly lower percentages of T8+ cells, compared to NID, were found in MS classes (a), (d) and (f). PMID- 3957625 TI - Autosomal-dominant dystrophy with humeroperoneal weakness and cardiopathy: a genetic variant of Emery-Dreifuss disease? AB - Two females mother and daughter, were affected by a neuromuscular disorder, characterized by slow progression, humeroperoneal weakness and wasting, limited neck flexion, elbow and ankle joint contractures, cardiopathy and myopathic pattern on EMG. Muscle histology and histochemistry showed type I fiber atrophy and predominance in both. Cardiac abnormalities, in the first case, were suggestive of a hypertrophic cardiomyopathy while in the second hypotension and chronic bradycardia were present. Neurological signs, EMG and morphology seemed to point to a genetic variant of the form of dystrophy named Emery-Dreifuss disease. The mode of transmission and cardiac abnormalities, however, raise the problem of variability even in this well-defined, usually X-linked, disorder. PMID- 3957624 TI - Myoadenylate deaminase deficiency in twins with recessive olivopontocerebellar atrophy. AB - Two adult non-identical twins with autosomal recessive olivopontocerebellar degeneration (OPCA) had markedly deficient adenylate deaminase in skeletal muscle homogenates. Ischemic exercise failed to increase the blood ammonia, while lactate increased normally. Glutamate dehydrogenase and NADP-dependent malic enzyme activities in muscle mitochondria of both patients were normal. The significance of adenylate deaminase deficiency in these twins with OPCA is discussed. PMID- 3957626 TI - Asbestos exposure and Alzheimer disease. AB - 10 cases in which an asbestos-related disease (malignant pleural mesothelioma or asbestosis) was associated with severe Alzheimer type lesions in the brain are reported. The patients, all males aged between 67 and 78 years, had been occupationally exposed to asbestos in the shipbuilding industry. The hypothesis that asbestos is a favoring factor in the genesis of Alzheimer disease is discussed. PMID- 3957628 TI - Italian multicenter study of dementia: a pathologically verified case of Alzheimer disease. AB - The pathological findings in a case included in the Italian multicenter study of dementia on clinical grounds are reported. The histological and ultrastructural examination confirms the diagnosis of Alzheimer disease, evidence for the validity of the clinical protocol. PMID- 3957627 TI - Thalamic dementia: report of a case with unusual lesion location. AB - Thalamic dementia usually results from a bilateral paramedian thalamic infarction. We report a case with typical clinical and neuropsychological features of thalamic dementia, but with CT evidence of an unusual and asymmetrical location of ischemic lesions. Somatosensory evoked potential recordings were consistent with a left medial thalamic infarction, associated with a contralateral lesion, possibly at lemniscal level. This case suggests that thalamic dementia may develop following a unilateral paramedian thalamic infarction. PMID- 3957629 TI - Carbamazepine poisoning: a case report. AB - In a case of acute intoxication produced by carbamazepine overdose ataxia and cyclic coma were the salient features. The mechanisms underlying these symptoms are discussed. Some peculiarities such as breathing irregularities and microhematuria are also described. PMID- 3957630 TI - On a further case of radiation meningioma. PMID- 3957631 TI - An Italian series of patients with organic dementia. AB - A series of 224 patients with organic mental deterioration, including 129 patients with presumptive Alzheimer dementia, is described chiefly from the neuropsychological standpoint. Several methodological problems arising from research on dementia are discussed. PMID- 3957632 TI - Neuropsychological findings during a transient global amnesia attack and its follow-up. AB - An extensive neuropsychological study was made during an attack of transient global amnesia and during four follow-up. The neuropsychological findings are compared to those of previous reports. Transient global amnesia appears to be a relatively benign syndrome but it leaves some "fragility" of memory, detected by complex neuropsychological tasks. PMID- 3957633 TI - Ataxic hemiparesis syndrome: clinical and CT study of 20 new cases and review of the literature. AB - 20 new cases of ataxic hemiparesis syndrome (AHS) are reported and the findings compared with those of published cases. AHS may be due to lesions either of the brainstem or of supratentorial structures, where motor fibers run together with the cerebro-cerebellar pathways. Specific syndromes related to the lesion site cannot be identified from the clinical signs. Ischemic infarct is the most frequent cause of the syndrome, but hemorrhagic, neoplastic and demyelinating lesions have also been reported. PMID- 3957634 TI - Motor and psychomotor functions in amyotrophic lateral sclerosis evaluated by tests of motor ability. AB - 18 patients with typical sporadic Amyotrophic Lateral Sclerosis (ALS) were investigated by the Motor Accuracy and Speed Test (MAST) and 18 healthy age- and sex-matched volunteers, acted as controls. All performed each of the five tests 10 times with both the right and the left hands and repeated the experiment after one week by the same procedure. Motor performances were better in the controls than in the ALS patients only in the first three tasks. At retest, one week later, the controls generally improved while ALS patients did not. The mean percentages of changes showed a statistically significant difference in the fifth task. Analysis of the results suggests the possibility that, among the other mechanisms, a disturbance of motor learning ability could be operating in ALS patients. PMID- 3957635 TI - Single fiber EMG and cardiovascular reflexes in botulism: a follow-up study. AB - A patient with botulism was studied at different times after intoxication using various autonomic tests of the cardiovascular reflexes, and by single fiber EMG (SFEMG). The control of heart rate and blood pressure appeared markedly impaired in the early stage of the disease as well as SFEMG. Autonomic function recovered more slowly as neuromuscular transmission. Monitoring autonomic derangement in botulism may give the opportunity to select patients at risk for cardiac or respiratory arrest. PMID- 3957636 TI - Altered CSF protein pattern in a case of mycosis fungoides with nervous system involvement. AB - We report the clinical, neurophysiological and CSF study in a case of mycosis fungoides with nervous system involvement. The CSF contained an abnormal protein of molecular weight 22000 that was not in the patient's serum or in the CSF of control subjects and that disappeared after intrathecal immunosuppressive therapy. The nature of this protein is discussed in the light of hypothesis regarding the pathogenesis of the disease. PMID- 3957638 TI - Papilledema in idiopathic inflammatory polyradiculoneuropathy. AB - Papilledema is a rare finding in idiopathic inflammatory polyradiculoneuropathy. A case in which the papilledema arose at the beginning of the disease and had a favorable course is reported and the principal hypotheses regarding its pathogenesis are discussed. PMID- 3957637 TI - Clinical-electrophysiological correlations in the carpal tunnel syndrome. AB - 56 patients with carpal tunnel syndrome (CTS) with 84 hands affected were investigated. All patients were assessed clinically and electromyographically in order to find out whether there is a correlation between clinical signs and/or symptoms and the EMG data. A highly significant correlation was found between sensory deficit (hypoesthesia to touch and/or pain) and the amplitude of SAP and a significant correlation between motor deficits (weakness and/or atrophy) and distal motor latency. PMID- 3957639 TI - Somatosensory evoked potentials to muscle percussion in humans: upper extremity. AB - Cortical as well as presumably subcortical potentials were recorded from 20 normal subjects in response to mechanical percussion of the thenar eminence. Nuchal-to-frontal recordings detected an initial negative component at 21 msec, followed by positivities at 29 and 36 msec. C-prime to frontal recordings produced prominent positivities at 29 and 44 msec. Recordings over the peripheral nerve did not reveal consistent potentials. Control experiments indicate that potentials are initiated by fast-adapting muscle receptors. If additional control experiments continue to support these findings, yet another constituent of electrically evoked somatosensory potentials--which may prove useful in the definition of muscle innervation disorders--will have been identified. PMID- 3957640 TI - Is human methane production affected by long-term occupational exposure to a methanogenic flora? AB - The factors determining human methane production or nonproduction are unknown. Exposure at a young age to a methanogenic flora is thought to be of significance. We examined whether long-term occupational exposure to methanogenic flora in adult life affects methane production. Among 38 subjects who worked in a cowshed for a mean period of 14 +/- 15 years, the proportion of methane producers was identical to that found in well-matched controls. The length of work in the cowshed had no effect on methane production. PMID- 3957641 TI - Ixodid tick attacks on man in Israel: medical implications. AB - Various species of ixodid ticks that have been recorded to attack man were surveyed, and boutonneuse fever caused by Rickettsia conorii, which is transmitted in Israel by Rhipicephalus sanguineus s.l., is reviewed. Only in one case were a complement fixation test and exact determination of the species of the tick performed. Tick toxicosis and tick paralysis are discussed, and the possibility of human babesiosis and Lyme disease or erythema chronicum migrans appearing in Israel is considered. PMID- 3957642 TI - Herpes encephalitis during pregnancy: failure of acyclovir and adenine arabinoside to prevent neonatal herpes. AB - A gravid woman with herpes Type II encephalitis delivered an infant with herpes neonatorum despite therapy with acyclovir. Acyclovir was not measurable in the baby's serum 10 h after birth. The viral isolate was sensitive to acyclovir in vitro, and the neonatal infection responded to treatment with the drug. Prenatal antiviral therapy may be ineffective in preventing intrauterine herpesvirus infection. PMID- 3957643 TI - Methemoglobinemia, muscle damage and renal failure complicating phenazopyridine overdose. AB - A 19-year-old woman with no history of renal or hematologic dysfunction developed methemoglobinemia, muscle damage, rhabdomyolysis and severe acute renal failure after an overdose of phenazopyridine hydrochloride (pyridium). The methemoglobinemia reversed after 24 h, but the patient remained oliguric, with myalgia and increased muscle enzymes. The patient received supportive treatment and recovered completely after 3 weeks. Since phenazopyridine is a commonly used drug, the physician should be alert to these possible severe complications. PMID- 3957644 TI - Computed tomographic diagnosis of acute hemopericardium following myocardial infarction. AB - A patient with acute hemopericardium following myocardial infarction is described. At surgery there was no evidence of myocardial rupture. The value of computed tomographic scanning in the diagnosis of fresh blood within the pericardial sac is discussed. PMID- 3957645 TI - Velopharyngeal insufficiency in children: the variable clinical presentation. PMID- 3957646 TI - Bilateral uterine adnexal torsion: case report and review of the literature. PMID- 3957647 TI - Human methane production: a study of population groups and environmental factors in Israel. PMID- 3957648 TI - Activation of the alternative pathway of complement by an antitumor (1----3)-beta D-glucan from Alcaligenes faecalis var. myxogenes IFO 13140, and its lower molecular weight and carboxymethylated derivatives. AB - An antitumor (1----3)-beta-D-glucan with a number-average degree of polymerization (DP) of 540 from Alcaligenes faecalis var. myxogenes IFO 13140, and its lower molecular weight derivatives were found to activate the alternative pathway of complement (APC), as judged by hemolytic and immunoelectrophoretic analyses. Of the native and derivative (1----3)-beta-D-glucans measured, the smallest one that showed APC-activating ability was that with a DP of about 20. The effect of carboxymethylation of the (1----3)-beta-D-glucans with DPs of 49, 131 and 540 on their APC-activating ability was investigated. In any (1----3) beta-D-glucan the ability was decreased with the increase of carboxymethyl substitution and was completely lost when about one carboxymethyl group per glucose residue was incorporated. In contrast, strong inhibitory ability against C1 hemolytic activity appeared on carboxymethylation. PMID- 3957649 TI - Indomethacin abrogates the suppression by cyclosporin A of lectin-dependent cell mediated cytotoxicity to HEp-2 cells. AB - The effects of cyclosporin A, prostaglandin E1 and indomethacin were studied on lectin-dependent cell-mediated cytotoxicity (LDCC) against adherent HEp-2 human epipharynx carcinoma target cells. LDCC activity by human peripheral blood lymphocytes was evaluated by detachment from the monolayer of [3H]thymidine prelabelled HEp-2 cells in a 24-h assay at 50:1 effector:target cell ratio in the presence of 25 micrograms/ml concanavalin A. Under these conditions, but without concanavalin A, considerable natural cell-mediated cytotoxicity was not elicited although LDCC was significantly augmented in the presence of concanavalin A. Addition of both cyclosporin A (0.1, 1.0 or 10 micrograms/ml) and prostaglandin E1 (10(-8), 10(-7) or 10(-6) M) dose-dependently suppressed LDCC activity. Indomethacin (0.1, 1.0 or 10 micrograms/ml) did not in itself influence LDCC although suppression of LDCC by cyclosporin A, but not prostaglandin E1, was abrogated in the presence of indomethacin. Similar to indomethacin, acetyl salicylic acid also reversed the inhibition of LDCC by cyclosporin A. In parallel experiments, cyclosporin A elicited a more than two-fold increase of prostaglandin E production under LDCC assay conditions as measured by radioimmunoassay. Contrary to LDCC, depression of concanavalin A induced blastogenesis by cyclosporin A was not influenced by indomethacin, suggesting that the inhibition by cyclosporin A of LDCC and concanavalin A-induced blastogenesis proceed via different mechanisms. PMID- 3957650 TI - On dying more than one death. AB - Death (with a capital D) can best be understood as a series of distinct but related deaths. For example, a pregnant woman was found to be brain-dead but her vital functions were artificially sustained for nine weeks until her fetus could be delivered, after which the machines were removed and she died a second, conceptually distinct death. This procedure is probably justifiable, but any legislation or policy regarding such cases should be flexible and should require consent. PMID- 3957651 TI - When a pregnant woman endangers her fetus. PMID- 3957652 TI - Lawyers and doctors face the perils of practice. PMID- 3957653 TI - The patterns of herpesvirus infection in a multiracial population Kauai County, Hawaii, 1981-1985. PMID- 3957654 TI - Migraine warnings. PMID- 3957655 TI - Brainstem auditory evoked potential (BAEPs) in cluster headache (CH): new aspects for a central theory. PMID- 3957656 TI - Visual evoked potentials in cluster headache: central structures involvement. PMID- 3957657 TI - Emergency treatment of intractable migraine. PMID- 3957659 TI - Amelioration of ophthalmoplegic migraine by prednisone: a case report. PMID- 3957658 TI - The Headache Scale: an examination of its reliability and validity. PMID- 3957660 TI - Multiple headaches in a case of multiple personality disorder. PMID- 3957661 TI - [Proliferating epidermal cysts]. AB - While proliferating trichilemmal cysts are a well-known entity, so far there have been no reports on the proliferating processes of epidermal cysts. Two patients with multiple proliferating cysts are presented. Histologically, there was a well developed stratum granulosum in the wall of the most cysts, and the cavity contained orthokeratotic horny material. The possible pathogenetic mechanisms of cyst formation are discussed. PMID- 3957662 TI - [Pigment demarcation lines in pregnancy]. AB - A 37-year-old female patient from Indonesia is reported, who developed pigmentary demarcation lines during the last trimenon of her first pregnancy. The lines resolved spontaneously after delivery. PMID- 3957663 TI - [Stereoscopic demonstration of fungi]. PMID- 3957664 TI - [Local and transcutaneous pharmacotherapy. Pharmacokinetic principles and clinical evaluation]. AB - The pharmacological and pharmacokinetic postulates and preconditions for the various kinds of pharmaco-therapy (topical, systemic and transcutaneous) are presented. Taking into consideration mathematical and physical principles as well as anatomical and physiological factors, the possibilities for influencing the flow of drugs into and through the skin are described (choice of vehicle and concentrations, permeation enhancers). In the clinical part of the study, it is shown that following these guidelines can lead to new forms of therapy and to safer application of drugs and cosmetics. PMID- 3957666 TI - [Comparative cutaneous measurement of oxygen pressure (pcuO2) in healthy individuals and in patients with progressive scleroderma]. AB - A modified method combining the two methods of measuring either tissue oxygen tension (pO2) or transcutaneous pO2, which have already been proven in other clinical fields, is presented for application in particular skin diseases. This so-called "cutaneous pO2 measurement" (pcuO2) is based on measurements from commercially available transcutaneous pO2 devices, but produces moderate hyperemia through the lower electrode temperature (e.g., 40.5 degrees C) instead of maximal hyperemia (by 44 degrees-45 degrees C temperature). Values obtained this way depend more upon local skin properties, including peripheral capillary flow, than on the arterial pO2. Thus the data are termed cutaneous pO2 (pcuO2). With this method, over 140 measurements were carried out on 14 healthy subjects and 14 patients with progressive systemic scleroderma (PSS); the measurements were made at various skin sites (interdigital fold II/III, back of mid-hand) and under different conditions (3-min upper arm arterial occlusion, 5-min arm muscle activity, cold stimulus to fingers). The pcuO2 values obtained from the PSS patients were significantly below (0-15 mm Hg) those from the healthy subjects (15-42 mm Hg). Fall and recovery times for pcuO2 (during and after arterial occlusion) were prolonged about twice as long in the patients. The pcuO2 reactions to muscle activity and cold stimulus were also significantly delayed in the patients as compared to the subjects. The modified method of cutaneous oxygen tension measurement presented can be employed for more precise assessment of the degree and severity of vascular disorder in PSS, and it is complementary to other clinical methods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957665 TI - [Total IgE levels in the serum in dermatologic diseases]. AB - A total of 2,951 determinations of total IgE serum levels in dermatologic patients revealed significantly elevated geometric mean values in 18 of 25 diagnostic groups. The highest IgE concentrations (geometric mean greater than 100 kU/l) were found in atopic diseases (atopic eczema, extrinsic asthma, allergic rhinitis), scabies, ichthyosis vulgaris and diseases of the prurigo group. Furthermore, total IgE was elevated in acute, chronic, and physical urticaria, in patients with immediate-type allergies, in various kinds of eczema, in patients with characteristic features of atopy (typus atopicus), in psoriasis, in pyogenic skin infections, and alopecia areata. The range of individual IgE values was wide: in all diagnostic groups individual IgE levels beneath the normal adult geometric mean of 14 kU/l were found; the maximum concentrations were 340-47,000 kU/l, thus exceeding the upper limit of 100 kU/l for individual values. Knowledge of the patient's clinical condition is a prerequisite for the diagnostic interpretation of an individual total IgE serum level. PMID- 3957667 TI - [Differentiation of the antipsoriatic and phototoxic effectiveness of topical PUVA therapy]. AB - Using a 0.075% 8-methoxypsoralen solution, minimal phototoxic doses and improvement of psoriasis lesions were investigated in 15 patients suffering from chronic stationary psoriasis. The time interval between topical 8-methoxypsoralen application and long-wave ultraviolet light irradiation was increased stepwise. The mean minimal phototoxic dose declined with increasing time interval and reached its minimum 2 h after 8-methoxypsoralen application. In spite of that, antipsoriatic efficiency was maximal 15 min after application. In order to obtain a favorable relationship between antipsoriatic efficiency and unwanted side effects when using topical PUVA treatment, irradiation should be started 15 min after 8-methoxypsoralen application. PMID- 3957669 TI - A diffusion barrier charcoal adsorption collector for measuring Rn concentrations in indoor air. AB - Development of a practical detector for collecting Rn by adsorption in charcoal with a time integration of 2 d or more, achieved by use of a diffusion barrier through which Rn enters, is described. The sensitivity is adequate for monitoring Rn levels in houses. It is easily sent and returned by mail, and instructions for use are simple enough for any householder to follow. The cost per measurement is apparently well below that for competitive techniques. PMID- 3957668 TI - [Secondary cutaneous mycoses caused by Alternaria species]. AB - Analysis of 2 of our own cases of cutaneous alternariosis (CA) and 31 reported cases showed this mycosis to be nosologically heterogeneous. CA may present as an endogenous, multilocular form or as an exogenous, usually localized form. In the endogenous form of CA (11 cases), infection most probably occurs via the lung by inhalation. The highly dermatotropic organisms spread hematogenically to the skin where they cause the typical verruciform or granulomatous lesions. In the exogenous form (8 cases), the organisms are inoculated at the site of a trauma ("traumatogenic CA"). In both forms, the underlying pathogenic disorders are of a non-mycotic nature, and hypercorticism plays the most important role. In the third form ("dermatopathic CA", 14 cases), Alternaria alternata secondarily colonizes, in a non-parasitic fashion, in preexisting lesions, which are predominantly steroid-treated eczema of the face. This form represents nosoparasitism of A. alternata rather than genuine mycosis. With regard to the pathogenesis of alternariosis, the predisposing factors mentioned are more important than the relatively weak pathogenicity of the organisms. Elimination of the predisposing factors usually cures the disease. If this fails, surgical excision of the lesions is required since an effective systemic anti-mycotic drug for CA is not yet available. PMID- 3957670 TI - A contribution to optimizing radiological protection in a U mine. AB - This article presents an optimization study for radiological protection in a U mine. The mathematical model of the alpha contamination associated with short lived Rn daughters allows the comparison of various protection strategies through a cost-effectiveness analysis. Determining the optimal protection strategy is carried out by choosing a value for the mansievert. This procedure may be of use as a decision-aiding tool within the framework of radiological protection. PMID- 3957671 TI - Effect of variable doses of ultraviolet radiation (253.7 nm) on thermoluminescence NaCl:Ca(T) material. AB - This paper studies the thermoluminescence (TL) glow curves of NaCl:Ca(T) phosphors to various doses of 253.7-nm ultraviolet (UV) radiation at room temperature. TLD grade NaCl:Ca(T) material was obtained by crystallization from solution and was subsequently annealed at 750 degrees C for 2 h, followed by sudden quenching. We undertook measurement of the effect of variable UV radiation doses (10(2) to 10(6) J m-2) on the TL behaviour of NaCl:Ca(T) phosphors. It was observed that the phosphor exhibits a dominant peak around 167 degrees C along with a weak peak at lower temperature. The high-temperature peak (Peak II) is found to grow linearly with the increase in UV dose in the range of 10(2) to 10(6) J m-2. Since the nature of the glow curves under the influence of different doses remains more or less identical, it is believed that the phosphor does not undergo radiation damage and displays high intrinsic TL around Peak II. Examination of the system for fundamental dosimetry requirements shows that it can be used in dosimetry work at 253.7 nm. PMID- 3957672 TI - The radioactivity of spas on the Greek island Ikaria and influencing factors. AB - The aim of this research is the qualitative and quantitative determination by gamma-spectroscopy analysis of all the natural radioisotopes which exist in the waters of the municipal thermometallic radioactive springs (spas) of the Greek island Ikaria. An explanation is suggested for the different concentrations of natural radioisotopes in these spa waters in connection with physical factors (geological composition, temperature of the spas, etc.). In addition to the aforementioned, we also seek to compare radioactivity values of different spas during the same season as well as of an individual spa at different seasons of the year. PMID- 3957673 TI - Radiation protection during treatment of children with 131I-meta iodobenzylguanidine. AB - This paper describes the radiation protection procedures that were used in caring for three children treated with therapeutic amounts of 131I-meta iodobenzylguanidine. Since it was not possible to leave a child alone in a shielded room for several days, the presence of one parent was requested during the treatment. The dose equivalent to the parent was kept to an acceptable level of approximately 1 mSv. This dose equivalent was almost completely due to external radiation since blocking of the parent's thyroid led to a negligible dose equivalent from internal contamination. PMID- 3957674 TI - A quick method for the assessment of internal contamination by 45Ca. PMID- 3957675 TI - Translocation of 239Pu in mice following inhalation of sized 239PuO2. AB - This study showed that when SAS/4 mice were exposed to sized 239PuO2 only about 0.5% of the 239Pu was translocated from lung to other organs. The fraction of 239Pu translocated appeared to be independent of the particle size of the administered 239PuO2 within the range of AMADs investigated (0.8-2.2 microns). The distribution of translocated 239Pu was similar to that observed with other species in that most of the activity was associated with the lung-associated lymph nodes followed by bone and liver. The fraction of 239Pu translocated was comparable to that found in studies with rats (ICRP72) but less than that found in more extended studies with beagle dogs. PMID- 3957677 TI - The effect of the choice of response matrix on neutron spectra unfolded from Bonner sphere data. PMID- 3957676 TI - Accumulation of fallout 137Cs in some plants and berries of the family Ericaceae. PMID- 3957679 TI - Pulsed CO2-laser corneal injury thresholds. PMID- 3957678 TI - Calculations of effective dose equivalent, ambient dose equivalent and individual dose equivalent for a set of reference neutron spectra and field geometries. PMID- 3957680 TI - Comments on 'Pulsed CO2-laser corneal injury thresholds'. PMID- 3957681 TI - The Bayesian approach to estimation. PMID- 3957682 TI - The politics of health education: do we constrain ourselves? PMID- 3957684 TI - Correlates of accurate knowledge of cancer. AB - Knowledge acquisition, although a prerequisite of preventive behavior, has been a neglected area of research. Mass communication research shows that audience characteristics explain most of the variation in knowledge acquistion. Since cancer information is mainly disseminated via the media, we hypothesized that the same audience characteristics would be related to accuracy of cancer knowledge. Bivariate and multivariate associations between the hypothesized variables and a cancer knowledge score were tested using a three-stage random sample of Los Angeles County (N = 931). Smoking status, education, degree of cancer worry, health improvement behavior, ethnicity, age, household size, and frequency of health worry were related to knowledge accuracy. An examination of the underlying dimensions of cancer knowledge revealed three beliefs about cancer: smoking causes cancer; cancer can be cured; and the environment does not cause cancer. Smoking status, ethnicity, health improvement behavior, and worry about cancer and health were associated with the belief that smoking causes cancer. The independent variables in this study were not significantly related to the other two beliefs. These results conform with the general predictions of mass communication research. We conclude that targeting of cancer information and particular uses of media could raise the general level of cancer knowledge. PMID- 3957683 TI - Skills methods to prevent smoking. AB - School health educators have devoted much attention to cigarette smoking. Recent years have seen the testing of interventions to prevent smoking. To date, controlled studies have not evaluated the added value of skills methods for preventing smoking. This article describes such an evaluation with sixth-grade students from two schools. Subjects were pretested and randomly assigned to receive conventional health education methods or to receive skills intervention. Both conditions included films, peer testimonials, discussions, and homework. Health education condition subjects additionally participated in oral quizzes, games, and debates. Skills condition subjects additionally learned problem solving, self-instruction, and interpersonal communication methods. At postintervention, skills condition subjects, more than health education condition subjects, had better scores on measures of smoking-related knowledge, attitudes, and intentions. In addition, reported cigarette use, validated by biochemical data collection, was lower in the skills condition than in the health education condition at all postintervention measurements, including a 24-month follow-up. The article discusses the strengths, limits, and implications of the study for other smoking prevention efforts in schools. PMID- 3957685 TI - Patient medication instruction and provider interactions: effects on knowledge and attitudes. AB - This prospective study examines whether a patient medication instruction sheet (PMI) given to clinic patients by their health care provider affects knowledge and/or attitudes with thiazide diuretic use as part of an antihypertensive regimen. Adult male patients (N = 285) in a general medicine clinic were assigned to groups receiving the American Medical Association PMI describing their diuretic. Patients getting the PMI obtained it either directly from their provider or at the pharmacy dispensing window. All patients were surveyed by phone 1 week following the clinic visit with regard to the PMI, knowledge of medication use, and attitudes toward drug use. Results indicate that a provider dispensed PMI results in higher levels of drug knowledge and greater patient satisfaction with their knowledge than a pharmacy-dispensed PMI. In addition, the PMIs educational value may be lessened by an incomplete verbal consult. This study demonstrates that the AMA PMI is an effective educational tool when distributed by a provider and can promote better understanding and use of prescribed medications. PMID- 3957686 TI - Computerized health education: a comparison with traditional formats. AB - The present study compared a computerized health education format to face-to-face and written methods. The effects of delivery method on the retention of health information and on participant evaluation of the condition were assessed. College student participants (N = 200) were randomly assigned to one of four conditions (computerized, face-to-face, written, or control) such that each condition contained 25 males and 25 females. The experimental groups reviewed a lengthy text on sexually transmitted diseases (STD) whereas the control group received no information. Participants were then assessed for self-report anxiety, appraisement of the experience, and recall of the text. Results showed participants in the computer and written conditions freely recalled at an equivalent rate which was superior to the face-to-face format. No differences emerged between high and low computer experience subgroups of the computer condition. The face-to-face and computer conditions were assessed in positive terms with the written format being assessed more negatively. Although, detailed analysis revealed there was the potential for more negative perception of the computer method in association with increased anxiety. Results are discussed in terms of their demonstrating support for a computerized approach to health education. PMID- 3957687 TI - The role of self-efficacy in achieving health behavior change. AB - The concept of self-efficacy is receiving increasing recognition as a predictor of health behavior change and maintenance. The purpose of this article is to facilitate a clearer understanding of both the concept and its relevance for health education research and practice. Self-efficacy is first defined and distinguished from other related concepts. Next, studies of the self-efficacy concept as it relates to health practices are examined. This review focuses on cigarette smoking, weight control, contraception, alcohol abuse and exercise behaviors. The studies reviewed suggest strong relationships between self efficacy and health behavior change and maintenance. Experimental manipulations of self-efficacy suggest that efficacy can be enhanced and that this enhancement is related to subsequent health behavior change. The findings from these studies also suggest methods for modifying health practices. These methods diverge from many of the current, traditional methods for changing health practices. Recommendations for incorporating the enhancement of self-efficacy into health behavior change programs are made in light of the reviewed findings. PMID- 3957688 TI - The role of health belief attitudes, sex education, and demographics in predicting adolescents' sexuality knowledge. AB - As part of a pretest-posttest design to evaluate a 15-hour Health Belief Model (HBM)-based sex education program, we interviewed 203 teenagers (aged 13-17) of both genders regarding their preintervention sexual and contraceptive knowledge, attitudes toward pregnancy and contraception, and prior sex education and sexual activity experiences. A multiitem sexual and contraceptive knowledge measure yielded several specific topic area scales and a total knowledge score, and a multiitem attitudes measure also yielded five reliable HBM-based scales. A series of regression analyses that used teenagers' previous sexuality-related experiences, demographic information, and attitudes predicted knowledge scores well (R2 = 0.22-0.54). Across specific knowledge areas, HBM-based attitudes (e.g., perceived serious consequences of teen pregnancy) were consistently significant predictors. Interestingly, neither previous sex education nor personal sexual experiences were significantly associated with specific knowledge areas (e.g., venereal disease), although they were related to total knowledge scores. Similarly, age and gender were poor predictors of specific areas of knowledge, but minority ethnic status was consistently associated with less sexual and contraceptive knowledge. Our model was highly successful in accounting for a substantial portion of the variance in total knowledge scores (R2 = 0.54). Results are discussed in terms of their implications for designing sex education programs that focus on motivation for pregnancy avoidance and contraception as well as factual information for teenagers. PMID- 3957689 TI - Reactions of oxy- and methemoglobin with tryptophan metabolites, 3 hydroxyanthranilic acid and 3-hydroxykynurenine. AB - It was found that 3-hydroxyanthranilic acid and 3-hydroxykynurenine have the capacity of oxidizing and reducing oxy- and met-hemoglobin. However, tryptophan metabolites such as kynurenine and anthranilic acid in which hydrxyl group is not involved did not oxidize and reduce these hemoglobins. The oxidation of oxyhemoglobin with 3-hydroxyanthranilic acid and 3-hydroxykynurenine was much accelerated in the presence of myo-inositol hexakisphosphate or superoxide dismutase, but was much suppressed in the presence of catalase. Deoxyhemoglobin was not oxidized by these compounds. On the other hand, the reduction of methemoglobin with 3-hydroxyanthranilic acid and 3-hydroxykynurenine proceeded both under aerobic and anaerobic conditions, though the rate of reduction was much faster under aerobic conditions than under anaerobic conditions. The reduction of methemoglobin with these compounds was accelerated by myo-inositol hexakisphosphate, but was partially suppressed by superoxide dismutase under aerobic conditions. On the basis of these results, the paradoxical effects of 3 hydroxyanthranilic acid and 3-hydroxykynurenine are discussed in relation to the mechanism of oxidation and reduction of hemoglobin. PMID- 3957690 TI - The identification of five rare beta-chain abnormal hemoglobins by high performance liquid chromatographic procedures. AB - The detection, quantitation, and characterization of five relatively rare beta chain abnormal hemoglobins mainly by high performance liquid chromatographic procedures are described. The variants involved are Hb City of Hope (beta 69 Gly- --Ser), Hb Austin (beta 40 Arg----Ser), Hb Leiden (beta 6 or 7 Glu----0), Hb Louisville (beta 42 Phe----Leu), and Hb Presbyterian (beta 108 Asn----Lys). Some clinical and hematological data are also included. PMID- 3957691 TI - The survey of abnormal hemoglobins in the Kobe district: Hb G-Coushatta [beta 22(B4)Glu----Ala], Hb Ankara (beta 10(A7)Ala----Asp], Hb Handa [alpha 90(FG2)Lys- --Met], and Hb J-Habana [alpha 71(E20)Ala----Glu]. PMID- 3957692 TI - Hemoglobin Hamadan [beta 56(D 7) glycine----arginine] found in a Japanese male. PMID- 3957694 TI - Hemoglobin San Diego/beta zero thalassemia in a Greek adult. AB - Interaction of beta zero thalassemia with Hb San Diego [a high affinity hemoglobin variant, alpha 2 beta (2)109(G11)Val----Met] in a 29-year-old Greek male is described. A marked polycythemia with low MCH and MCV, but minor clinical problems were observed. Functional properties of the isolated variant are described. PMID- 3957696 TI - Non-enzymatic glycosylation influences Hb S polymerization. AB - In vivo glycosylated components of Hb S were isolated from red cell hemolysates of sickle cell anemia patients by application of affinity chromatographic and cation exchange chromatographic techniques. The total glycosylated fraction (GHb) of the whole hemolysate, Hb SIc, Hb So-glycosylated (formed mostly by glycosylation epsilon-NH2 groups of lysyl residues), and Hb So-nonglycosylated fractions were isolated in this manner. GHb contained about 33% Hb SIc and 42% Hb So (Hb So-glycosylated) and the rest was glycosylated Hb F and Hb A2. As expected, the binding of 2,3-DPG was affected only in Hb SIc and not in Hb So glycosylated. Hb SIc and Hb So-glycosylated had higher solubility in concentrated phosphate solutions and had higher minimum gelling concentrations than the non glycosylated form of Hb So. These effects are interpreted to be due to modification by glycosylation of specific sites that are directly or indirectly involved in the intermolecular contacts. PMID- 3957693 TI - Incidence of hemoglobin S carriers in Sicily. PMID- 3957697 TI - Hb M Iwate [alpha (2)87His----Tyr beta 2]: de novo mutation in an Irish family. PMID- 3957695 TI - Ultrathin-layer polyacrylamide gel isoelectric focusing for the identification of hemoglobin variants. AB - An ultrathin-layer polyacrylamide gel isoelectric focusing method for typing hemoglobin is described. This method, which uses Pharmalyte pH 6.7-7.7 and an electrode wick distance of 5.0 cm, clearly resolves the A, F, S, C and a number of rare variant allelic products. The technique is ideal for rapid screening of a large number of fresh blood and/or bloodstained samples. PMID- 3957698 TI - First observation of hemoglobin J-Iran [beta 77 (EF1)His----Asp] in Turkey. PMID- 3957699 TI - Description of a food recording electronic device for use in dietary surveys. AB - A Food Recording Electronic Device has been developed for quantitative collection of dietary data in the home for a period of up to 3 weeks. The accumulated information on the weights and types of food, and time of consumption, is transferred to a host computer for calculation of the nutrient composition of the diet. Using this method the subject does not have to read the balance or keep a written diary, and the need for coding of records by a dietitian is eliminated. PMID- 3957700 TI - Energy, protein and fat intake estimated using a food recording electronic device compared with a weighed diary. AB - Twenty nine subjects kept a weighed diet diary for 7 days. This was coded using both detailed food composition tables and food groups. During the 7 days a Food Recording Electronic Device (FRED) with food group keyboard labelling was also used. This group of motivated subjects had no difficulty in using the device, and the use of food groups was not a source of error. Some technical problems were identified which led to a significant systematic underestimation of energy, protein and fat determinations using the FRED, although the correlation coefficients between the two methods were high. The technical problems were of a type which can be eliminated in future models of the FRED. PMID- 3957701 TI - Dietary intakes of mercury, lead, cadmium and arsenic by Finnish children. AB - In connection with the Multicenter Study on Atherosclerosis Precursors in Finnish Children, the dietary intakes of some toxic heavy metals were determined. The population of this study, conducted in five urban and 12 rural areas in Finland, consisted of 1768 children ages 3, 6, 9, 12, 15, and 18 years. Food consumption was measured by the 48-h recall method. The intakes of mercury, lead, cadmium, and arsenic were estimated using analytical data for the heavy metal content of Finnish foods. The total daily intakes of these four heavy metals increased with age. The energy-adjusted intakes of mercury, lead and arsenic were highest in the youngest age groups, whereas no change was observed in the mean cadmium intake expressed per 1000 kcal. Mean daily intakes of these metals per kg of body weight were three times higher in the 3-year-old children compared with the 18-year olds. Cereals, potatoes and vegetables, and milk products were the main sources of these metals in the diet. Fruits and berries were also a significant source, especially in the youngest age groups. Consumption of fish was positively associated with intakes of mercury and arsenic, despite a contribution of only 1 per cent to the daily energy from this food group. The large standard deviations in the mean daily intakes of these metals indicate that exposure to these metals via diet is unevenly distributed among the Finnish children and adolescents. Further detailed evaluation of food patterns with a risk of high intakes of toxic heavy metals by children is needed. PMID- 3957702 TI - Dietary intake in pregnancy. A comparison between 49 Cambridgeshire women and current recommended intake. AB - The mean daily nutrient intakes from dietary sources of 49 pregnant women in the third trimester of normal pregnancy were assessed using a 7-day weighed inventory method and standard food tables. Mean daily intakes of all major nutrients reached DHSS recommended levels, with the exceptions of energy (2065 kcal/8.65 MJ), proportion of energy derived from carbohydrate (48 per cent), calcium (1047 mg), and vitamin D (2.58 micrograms). These results are in agreement with those of comparable published studies and lend support to suggestions that some of the increased requirements in pregnancy may be being met by physiological adaptation, without the need for greatly increased dietary intakes, or for indiscriminate vitamin and mineral supplementation. For seven women with low weight gain (less than 8 kg at 36 weeks; mean 6.97 kg), mean daily intakes of most nutrients were lower, and were below recommended levels for energy (1770 kcal/7.4 MJ), ascorbic acid (47.4 mg), vitamin D (2.18 micrograms), calcium (980 mg), and iron (10.5 mg). Proportional intakes of carbohydrate (50 per cent) and dietary fibre (20.1 g/day) however, tended to be higher in this group. PMID- 3957703 TI - The phytic acid mineral, trace element, protein and moisture content of UK Asian immigrant foods. AB - A study has been made of the protein, phytate, calcium, magnesium phosphorus, zinc, copper, iron and manganese content of raw and cooked, whole and ground pulses, of chapatis and of three types of chapatis flour as purchased and consumed by Asian immigrants in the UK. The protein, mineral and trace element contents of raw products were similar to those published in a previous study. In general, partial (ground) or total removal of the seed coat of pulses (ground and washed) was without effect on composition. Soaking the pulses followed by cooking under pressure was without effect on the protein, mineral and trace element composition, although it resulted in variable losses of phytic acid. In all instances greater nutrient and phytate losses were observed when the seed coat was completely removed. With nutrient and phytate losses were observed when the seed coat was completely removed. With the exception of lentils, the phytate: Zn molar ratios of cooked pulses and chapatis was greater than 15 and the [Phytate] X [Ca]/[Zn] (mol/kg) ratios of the chapatis and four of the 13 cooked dishes were greater than 0.5. Both of these ratios may provide useful indices of the bioavailability of dietary Zn. The results are discussed in relation to the possible inadequacy of available dietary Zn in some sections of the UK, Asian community. PMID- 3957705 TI - Nutritional labelling formats. PMID- 3957704 TI - A study of different dietary survey methods among 30 civil servants. AB - A sample of 30 volunteers from a population of 100 Ministry of Agriculture, Fisheries and Food (MAFF) civil servants took part in a series of dietary assessments. Food frequency interview, 24-hour dietary recalls, 7-day weighed food record, duplicate diet analysis and 28-day household food purchase records were all used to estimate intakes of energy and a range of nutrients. When results for energy, fat and iron, using the five different methods, were compared there appeared to be systematic differences between methods. The highest results came from food purchase records for the women and from food frequency interviews for the men. Lowest results came from the duplicate diet analysis for fat and energy but from the 24-hour recall for iron, for men and women alike. The implications of these findings, together with possible explanations for them, are discussed. PMID- 3957706 TI - Obesity in children. PMID- 3957707 TI - A longitudinal study of adipose tissue glucose utilization during pregnancy and the puerperium in normal subjects. AB - A longitudinal study of carbohydrate and lipid metabolism in normal pregnant volunteers demonstrated distinct alterations in maternal fuel utilization as pregnancy progresses. Glucose uptake into maternal adipose tissue and plasma glucose levels were significantly reduced in late pregnancy compared to early pregnancy and post-partum values. Plasma fatty acids, glycerol and ketone levels were elevated in late pregnancy. This confirms the concept of the third trimester as a catabolic phase within the maternal system, and provides support for the view that the insulin resistance of pregnancy may be a compensatory response to overcome the inhibitive effects of metabolites such as fatty acids on peripheral uptake of glucose. PMID- 3957708 TI - Folate status during pregnancy and lactation in a West African rural community. AB - Red cell folate concentration was used to measure folate status in 89 rural Gambian women, 81 of whom were pregnant or lactating for the duration of the study. During pregnancy, the women received a haematinic supplement of 500 micrograms pteroyl glutamic acid and 47 mg iron a day, and a food supplement was also given to some of the women during either pregnancy, or lactation, or both. During pregnancy, the red cell folate levels reached a peak around the fifth month, attributable to the haematinic supplement. By the third month of lactation they had fallen back to a low plateau, which was below the accepted lower limit of normality in 56 per cent of those who did not receive a food supplement during lactation. In addition to these changes, there was a significant cyclical variation with season, peak values occurring in the rainy season. Plasma iron values followed the red cell folate patterns quite closely. Changes in blood haemoglobin levels during pregnancy were similar to those reported from other communities; there was also an increase in mean red cell volume during the first half of pregnancy, reaching a peak at the same stage as the peaks of red cell folate and plasma iron. There was no indication of the presence of raised cell volumes in association with low folate indices which might suggest megaloblastosis. It is concluded that the 500 micrograms daily folate supplement is both necessary and adequate to maintain red cell folate levels during pregnancy in this community, but that in the absence of further supplements during lactation, red cell folate levels will fall to undesirably low levels in many subjects by the third-to-sixth month of lactation. PMID- 3957709 TI - Platelets, leucocytes and buffy layer vitamin C after surgery. AB - The changes in buffy layer (BL) vitamin C concentration following surgical operations were studied in relation to changes in the leucocyte and platelet counts. It was found that the postoperative fall and subsequent changes in BL vitamin C concentration corresponded to changes in the platelet/leucocyte ratio (PLR) in whole blood and consequently in the buffy layer preparations from which vitamin C concentrations were measured. The results of the study showed that the fall in BL vitamin C measured following operations is an artifact of the method used rather than a demand for vitamin C. It highlights the importance of measuring the PLR, and suggests the need for a differential leucocyte count, when undertaking BL vitamin C analysis. PMID- 3957710 TI - Investigation of vitamin A nutrition in pregnant British Asians and their infants. AB - Plasma retinol and retinol-binding protein (RBP) concentrations were lower in 23 South London Asian women of Indo-Pakistani origin than in 21 non-Asian controls during pregnancy (P less than 0.01 and P less than 0.05 respectively). Cord blood concentrations of retinol and RBP were the same in Asians and non-Asians. Plasma retinol concentration decreased with increasing gestation (P less than 0.01), but RBP concentration did not alter. Retinyl palmitate, 8000 i.u. daily from 30 weeks gestation to term, was given to a group of 14 Asian mothers with low plasma retinol concentrations. This caused a significant increase in maternal plasma retinol concentration at delivery compared with 15 controls, indicating possible deficiency, but did not affect cord blood concentrations. There was no difference in anthropometric measurements of the infants of control or supplemented mothers, nor was there a correlation between the anthropometric measurements and the plasma retinol or RBP concentrations. PMID- 3957711 TI - Effect of increasing the caloric/osmotic content of the liquid component of a mixed solid and liquid meal on gastric emptying in obese subjects. AB - A dual isotope scintigraphic technique was used to assess the effect of increasing the caloric content of the liquid component of a mixed solid and liquid meal on gastric emptying in control and obese subjects. For the two test meals used gastric emptying of solid was significantly slower in the obese subjects compared to the control subjects. In both obese and control subjects the substitution of 25 per cent dextrose for water as the liquid component of the meal resulted in a significant delay of both solid and liquid emptying. The magnitude of this change was similar in obese and control subjects. The results suggest that the duodenal receptor mechanisms which slow gastric emptying are not defective in obesity. PMID- 3957712 TI - Nutritional status in girls with juvenile chronic arthritis. AB - Nutritional status, with emphasis on nutrients involved in inflammatory processes, was investigated in 26 girls with juvenile chronic arthritis (JCA) and in healthy controls. Children with JCA had decreased plasma selenium compared to controls. Glutathione peroxidase activity in plasma was similar in both groups but the activity in blood was slightly depressed in JCA. The decrease in blood glutathione peroxidase was more pronounced in patients with high to medium disease activity. Ascorbic acid was measured in plasma, platelets, mononuclear cells and granulocytes. A slight decrease in granulocyte ascorbic acid was observed in patients but in plasma, platelets and mononuclear cells no difference was observed. Serum alpha-tocopherol, blood folate and serum cobalamine was the same in both groups. Several patients, especially in the youngest group, exhibited impaired growth. Serum creatinine and arm muscle circumference were lower in the arthritic patients indicating a lower muscle mass. These changes were more pronounced in patients with systemic or polyarticular onset of the disease. The possibility that the changes in nutritional status in patients with JCA can be corrected by dietary supplementation needs further investigation. PMID- 3957713 TI - Dietary calcium intake in rural black South African children. The relationship between calcium intake and calcium nutritional status. AB - Dietary calcium intake in relation to calcium status in rural black South African children was investigated. Fifteen subjects in each age group, 3-5 years, 8-10 years, 13-16 years with lowered serum calcium (less than 2.25 mmol/l) and raised serum alkaline phosphatase (greater than 300 i.u./l) were matched with controls having normal serum biochemistry. A dietary interview and 24-h recall was conducted with each subject; nutrient value of the diet was calculated from standard food tables. At 3-5 years, although the study group had significantly lower calcium intakes, there was no significant relationship between dietary calcium intake and calcium status. Study children in the age groups 8-10 years and 13-16 years had significantly lower dietary calcium intakes than controls and dietary calcium intake showed significant correlation with serum calcium levels, serum alkaline phosphatase levels, bone mineral density, metacarpal cortical thickness and calcium excretion. Thus it appears that low dietary calcium intakes may be reflected by hypocalcaemia, elevated alkaline phosphatase and decreased bone mineral content in pre-adolescent children. PMID- 3957714 TI - Plasma pyridoxal 5'-phosphate in women with the premenstrual syndrome. AB - Measurements of plasma pyridoxal 5'-phosphate (PLP) were made in 210 healthy premenopausal women, and related to their experience of the premenstrual syndrome (PMS). The 41 women (20 per cent) who had moderate or severe PMS were compared with 95 women (45 per cent) with no, or only slight, premenstrual symptoms: the former group were older and were more likely to have children, but there were no significant differences in smoking habits or mode of contraception. Plasma PLP values were similar in the two groups (mean values with s.d. 39.59 +/- 22.95 and 40.56 +/- 23.33 nmol/l respectively). We conclude that pyridoxine status, as measured by plasma PLP levels, is not altered in women with PMS and that pyridoxine deficiency is unlikely to contribute to the occurrence of this syndrome. PMID- 3957715 TI - Does the pattern of tissue mobilization dictate protein requirements? PMID- 3957716 TI - Relationship between maternal vitamins B2 and B6 status and the levels of these vitamins in milk at different stages of lactation. A study in a low-income group of Indian women. AB - Riboflavin and vitamin B6 status of mothers from a low-income group were assessed by erythrocyte glutathione reductase activation and erythrocyte aspartate aminotransferase activation tests respectively, at different stages of lactation. Levels of these vitamins in milk were also measured. The majority of the women had biochemical evidence of vitamins B2 and B6 deficiency. There was a bizarre reduction in erythrocyte glutathione reductase activation from 6 to 30 d post partum. Levels of riboflavin in milk were in general satisfactory, but vitamin B6 levels were lower than the values reported from developed countries. Clear-cut correlations between the enzymatic indices of vitamin status evaluation and milk levels of the corresponding vitamins were not apparent. PMID- 3957717 TI - Observations on the variability of creatinine excretion. AB - This paper reports the intra-individual variability of creatinine excretion under conditions of variable food intake and stress. Urine collections over 24 h were made by six subjects for 24 d in the course of an expedition to the Colombian Andes. The average coefficient of variation (CV) of day-to-day creatinine excretion was 11.4 per cent and of N excretion 28 per cent. When the outputs were averaged by 3-d period the mean CV of creatinine excretion was reduced to 5.7 per cent. It is concluded that in metabolic studies the 3-d creatinine excretion is a useful index even when food intakes and other conditions are not controlled. PMID- 3957718 TI - Effect of early childhood undernutrition and child labour on growth and adult nutritional status of rural Indian boys around Hyderabad. AB - A longitudinal study of rural Hyderabad children has been in progress from 1965. About 700 boys who are under follow-up are now in late adolescence and young adult stage. Of them, 410 had completed linear growth by the 1983-84 annual round. Severe growth retardation was observed among one-sixth at their 5th year of life. The severely undernourished group grew up as the shortest and lightest young adults. One-fifth of the boys under study worked for wages in their childhood. Their work experience ranged from 4 to 8 years at 14 years of age (child labourers or working children). Growth and development of working children was compared with students, who were matched for nutritional status at age 5. Working children lost considerable ground and suffered significant growth deficits. PMID- 3957719 TI - Energy expenditure over 24 hours on low physical activity programmes in human subjects. AB - The Fifth World Food Survey (FAO, 1986) has defined energy malnutrition as an intake below maintenance requirement and has suggested that maintenance requirement is equal to 1.4 times the resting metabolic rate (RMR), or, alternatively, 1.4 X RMR minus twice the standard deviation of the variation between normal subjects. In order to give substance to these numbers, we have measured the 24-h energy expenditure on two different physical activity programmes. The measurements were made on 38 men and 18 women, all apparently healthy and weighing about 65 kg. The measurements were performed at 24 degrees C and ambient humidity and the subjects wore clothes such as to be within the thermal comfort range. Measurements of the RMR were also performed. In one of the programmes, the average value of the 24-h energy expenditure divided by the RMR was found to be identical in men and women and equal to 1.38 X RMR. In another programme, with more intense physical activity, the corresponding number was 1.53 X RMR. In all three series of measurements, the coefficient of variation between subjects was found to be the same, ie between 6 and 8 per cent. PMID- 3957721 TI - Effect of spiced food on metabolic rate. AB - Since the time of Lavoisier it has been known that the ingestion of food in animals and man produces an increase in oxygen consumption. This increase in metabolic rate was originally called 'specific dynamic action' (SDA) and is now widely referred to as the thermic effect (TE) of food or diet-induced thermogenesis (DIT) (Rothwell & Stock, 1981). Much of the early work on the thermic effect was confined to the type and amount of food, notably the macronutrients--proteins, fats and carbohydrates. Later, it was shown that certain minor constituents of the diet such as caffeine and associated methylxanthines (Zahorska-Markrewicz, 1980; Jung et al., 1981) in tea and coffee could also have a profound effect on metabolic rate. The consumption of alcohol was also shown to increase metabolic rate (Rosenberg & Durnin, 1978). The work described in this paper reports the effect of another minor constituent of food, spices, on metabolic rate. Although the use of spices in our food has steadily increased with time little information exists on their effect on the metabolic rate. It has been estimated that approximately 40 different spices are used in our diet today. This communication reports the effect of chilli (red pepper, capsicum annuum) and mustard (Brassica juncea). PMID- 3957720 TI - Dietary antioxidants and chronic pancreatitis. AB - Fifteen patients with idiopathic chronic pancreatitis (aged 17-78 years), who had not altered their diet since their first symptoms, completed 7-d weighed dietary records at home. The computed information was compared with that from 15 age- and sex-matched volunteers. Attention was focussed on the intakes of antioxidants and unsaturated fatty acids. The patients ingested less selenium, vitamin E, vitamin C and riboflavin than did controls (P less than 0.001, P less than 0.02, P less than 0.001 and P less than 0.05 respectively, using paired t-tests): selenium was by far the best discriminator on step-wise analysis. When the selenium intakes were examined alongside the results of theophylline tests--which reflect cytochromes P450 activities and, thereby, provide an index of antioxidant demand- a line of discrimination separated the majority of patients (with faster drug clearances and lower selenium intakes) and controls. There were no differences in the intakes of individual unsaturated fatty acids, C14:1 through to C24:6, between the two groups. However, amongst six subjects in the overlap zone, three with chronic pancreatitis habitually ate greater amounts of highly unsaturated fatty acids C20:4 to C24:6 inclusive (1970, 1049, 750 mg/d) than did three controls (329, 320, 82 mg/d). Animal experiments show that suboptimal intakes of dietary antioxidants and/or excessive intakes of highly unsaturated fatty acids and/or induction of cytochromes P450 facilitate peroxidation of cellular lipid membranes by free radicals. Our dietary data, taken in conjunction with pharmacokinetic data, thus suggest that a similar situation--favouring lipid peroxidation--may underlie human chronic pancreatitis. PMID- 3957722 TI - Obesity in boys: the distinction between fatness and heaviness. PMID- 3957723 TI - Food and people. PMID- 3957724 TI - [Pathogenic immune factors in recurrent mucous tympanic effusion in children]. AB - In children with recurrent secretory otitis media (SOM) a mechanical malfunction of the Tuba Eustachii (by adenoids, myogenous palatotubal insufficiency, persistent cartilaginous collapse of the tube) should be taken into consideration as well as immunological factors of the lymphatic structures of the pharynx which may influence the tubotympanal mucosa. The pharyngeal tonsil and the tubotympanal mucosa are part of the immune system of the mucosa which itself has a regulating immunological function and importance as do the central and peripheral lymphatic organs. The lymphatic ring of Waldeyer regulates the reactivity of the tubotympanal mucosa in a similar way as the plaques of Peyer do control and influence immunologically the mucosa of the guts. The importance of persisting infections in the pharyngeal tonsil (by adenovirus, pneumococcus, H. influenzae) as well as the influence of IgG-mediated immune complex reaction for the perpetuation of inflammatory processes of the middle ear mucosa are discussed. The question to which extent the hyperergic immune reaction is pathogenetically involved in the secretory otitis media is thoroughly discussed. Compared to the other immune mechanisms the hyperergic immune reaction is of minor importance and may be considered as a predisposing factor. PMID- 3957725 TI - [Tuberculosis of the head, neck and ear--a rare disease?]. AB - Between 1980 and 1984 we treated 9 patients with tuberculosis of the lymph nodes, middle ear, parotid gland, larynx and sphenoid sinus. Diagnosis is difficult because of the unusual courses of the disease, the special pathways of infection and because tuberculosis is rarely suspected as the diagnosis. The importance of a combined conservative-surgical therapy is stressed. PMID- 3957726 TI - [Suitability of speech audiometry study procedures for current demands in clinical and general practice]. AB - The quality of the recorded audiometric test material (the "Freiburg" and "Marburg" language test) meets the High Fidelity standards of the 1960's. In the light of current technology (digital technique, compact disc, etc.), the question arises whether speech-audiometry can still contribute to diagnosis, medico-legal assessment and fitting of hearing aids. Results of the "Freiburg" language test are presented, which analyse the comparability of the individual groups in quiet and in noisy surroundings, the technical and technological aspects of the sound systems, orthophonic reproduction and the practical performance of audiometric speech tests. Finally, recommendations of the commission for speech-audiometry and hearing aids of the ADANO are presented and discussed. These may explain present and future demands and possibilities of a broad-band audiometric investigation spectrum in hospital and practice. PMID- 3957728 TI - [Fibrolipomas of the hypopharynx and esophagus. Contribution to their clinical aspects and therapy]. AB - Five patients with benign fibrolipomas of the hypopharynx or the oesophagus are presented. The diagnosis, clinical features, differential diagnosis and therapy of these rare tumours are discussed with special reference to an uncommon case. PMID- 3957727 TI - [Measurement of the acoustically evoked stapedius reflex in intubation anesthesia]. AB - The threshold of the acoustically elicited stapedial reflex was measured in 45 persons with normal hearing aged 13-34 years. The intravenous barbiturate given for induction of general anaesthesia was found to raise the reflex threshold by an average of 15 dB. Ketanest and Halothane raise the reflex threshold by an average of 24 dB and 28 dB respectively. The ipsilateral reflex response was altered less by general anaesthesia than the contralaterally evoked response. The stapedial reflex can thus be measured under general anaesthesia if sedation fails to control disturbed and severely handicapped children. PMID- 3957729 TI - [Papillary adenocarcinoma of the vocal cord--first case in the literature]. AB - The first case of a papillary adenocarcinoma of the vocal cord is presented. The patient was a 63-year-old man: he was treated by a frontolateral hemilaryngectomy. The patient is alive and well with no evidence of disease 5 1/2 years later. PMID- 3957731 TI - Improved survival of patients with nasopharyngeal squamous cell carcinoma. AB - One hundred and one patients with nasopharyngeal squamous cell carcinoma (NPC) were treated with irradiation. The UICC TNM staging system (1978) was used: 6 patients were T1N0, 10 T2N0, 5 T3N0, 13 T4N0, 11 T1N+, 18 T2N+, 19 T3N+ and 19 T4N+. Since 1978, 34 patients were examined with computed tomography (CT) at first presentation. Fourteen (41%) of the 34 tumors were upstaged based on the CT findings alone. The technique of radiation therapy was markedly changed around 1978. The fields to the primary site and neck were enlarged. Two-year relapse free survival was significantly better for the post-CT era than pre-CT era. This was mainly because of improved local-recurrence-free survival, and cervical relapse-free survival. Improved local-recurrence-free survival, however, was appreciated in only T3 + T4 patients; there was no difference in T1 + T2 patients. It is suggested that merely enlarging radiation fields or increasing radiation doses could not be curative for some subpopulations. In order to increase local control rates further, we have started to use intracavitary irradiation with an after-loading technique as a boost. Preliminary results are encouraging. PMID- 3957730 TI - [Magnesium content of laryngeal precancerous conditions and laryngeal cancers]. AB - The content of magnesium in tissues, erythrocytes and serum was analysed by atomic absorption spectrometry. A higher concentration of magnesium was found in malignant laryngeal tissue and in lymph nodes of the neck compared to homologous pre-cancerous tissue. In pre-cancerous lesions of the larynx the magnesium concentration of the erythrocytes and serum lay at the lower limit of normal. In patients with cancer of the larynx, the magnesium concentration was considerably below the normal levels and continued to decline as the disease progressed. PMID- 3957732 TI - Hysterectomy and adjuvant irradiation for pathologic stage III adenocarcinoma of the endometrium. AB - Three hundred and four evaluable patients with FIGO clinical Stage I adenocarcinoma of the endometrium were treated with hysterectomy and adjuvant irradiation. At surgery, 15 patients (5%) were found to have disease outside the uterus, but within the pelvis Pathologic Stage III (PSIII). A higher grade of tumor was not associated with an increase in the frequency of PSIII, being 7/158 (4%), 5/89 (6%), and 3/57 (5%) for Grades 1, 2, and 3 respectively. Depth of myometrial invasion correlated with PSIII disease in 5/69 (7%) for less than 1/3 myometrial invasion versus 7/33 (21%) for greater than 1/3 invasion (p = .05). One patient died of intercurrent disease at 4 months with 6/14 (43%) of the remaining patients developing recurrent disease. The site of initial failure was pelvis 1/15 (7%), pelvis and distant metastasis 3/15 (20%), and distant metastasis alone 2/15 (13%). Of seven patients who received external pelvic irradiation, there was one local failure (14%), which is not statistically significant from the 3/8 (38%) local failure rate among patients not receiving external pelvic irradiation (p = .569). None of the seven patients experienced a treatment related complication as a result of adjuvant irradiation. PMID- 3957733 TI - Treatment of stage I adenocarcinoma of the endometrium by hysterectomy and adjuvant irradiation: a retrospective analysis of 304 patients. AB - Three hundred and four evaluable patients with FIGO Stage I adenocarcinoma of the endometrium were treated with hysterectomy and irradiation. Irradiation was preoperative in 250 and postoperative in 44 patients. Ten patients had a preoperative implant and postoperative external irradiation. The 5 year actuarial survival was 94%, 80% and 76% for grades 1, 2 and 3, respectively. Within each grade and for all patients there was no difference in survival for Stage IA versus IB. The initial failure rate was 26/304 (9%) with 2% of patients having only a pelvic failure, 2% pelvic and distal failure and 4% a distal failure only. There were four distal vaginal failures and no isolated cuff recurrences. The upper abdomen was the most frequent site of extra-pelvic failure for grade 3, while the periaortic nodes and lung constituted the most common sites of distal failure for grades 1 and 2 tumors. Timing of the hysterectomy following the irradiation was of importance when evaluating the prognostic significance of residual disease or depth of myometrial invasion. The presence of residual disease or greater than 1/3 myometrial invasion had a significantly worse prognosis only among patients who received no preoperative irradiation or who underwent their hysterectomy immediately following a preoperative implant. There was no difference in survival among patients with an initial local failure only as compared to those with an initial distal metastases, as the majority of patients with an initial local failure subsequently developed distant metastases. PMID- 3957734 TI - Dosimetry of CT-guided volumetric IR-192 brain implant. AB - Over the past 2 years, an afterloading technique has been developed and refined to implant radioactive Ir-192 sources into brain tumors. The implantation procedure integrates a stereotaxic system with computerized tomography (CT), which provides tumor position, volume, and guides the placement of catheters. A radiolucent ring-frame immobilizes the head as holes are made at 1 cm intervals with the aid of a template. Catheters containing dummy sources 1 cm apart are then inserted to the desired depth, and their position verified in three dimensions to insure complete coverage of visible tumor volume as defined by contrast enhancement. Once catheters are secured, the anesthetized patient is moved to the intensive care unit where the dummy sources are replaced by ribbons of Ir-192 seeds (specific activity 0.6-1.0 mg Ra eq). CT scans with the dummy sources in place are used to designate spatial coordinates of the active sources. A computer program converts position data and source strength into isodose contours in any plane. The implant duration (70-100 hours) for the desired dose to the tumor periphery (60-120 Gy) is then calculated. Dose rate contours are superimposed on preimplant CT scans. Maximum and minimum doses are determined in each of the various planes. Verification dosimetry has been carried out with thermoluminescent dosimeters placed in a catheter located in a plane along the tumor periphery. In vivo isodose values compared to idealized plans agree within +/-5%-10%. PMID- 3957735 TI - Capacitive heating of phantom and human tumors with an 8 MHz radiofrequency applicator (Thermotron RF-8). AB - The thermal profile was investigated in agar phantoms and in human tumors heated capacitively with 8 MHz RF. Deep and homogeneous heating could be achieved in a large homogeneous phantom of 25 cm diameter and 24 cm thick when heated with a pair of 25 cm diameter electrodes, coupled to both bases of the phantom. When the size of the two electrodes was not the same, the region near the smaller electrode was preferentially heated. It was, therefore, possible to control the depth of heating by choosing properly sized electrodes. Therapeutic temperature (greater than 42 degrees C) could be obtained in 7 out of 9 small, as well as, bulky superficial human tumors as large as 8 X 8 X 10 cm. Indications are that heating of some deep-seated human tumors might be achieved by the capacitive method, provided that subcutaneous fat layer is cooled by temperature controlled bolus and large electrodes are used. The effect of the anatomical structure on the power deposition in the human body during capacitive heating should be further investigated. PMID- 3957737 TI - Axillary-subclavian vein thrombosis following combination chemotherapy and radiation therapy in lymphoma. AB - Four patients with deep venous thrombosis of the upper extremity (DVTUE) following combined modality therapy (mantle radiotherapy and chemotherapy) for either Hodgkin's disease or non-Hodgkin's lymphoma were seen at Stanford University Medical Center between March 1980 and April 1984. A total of 235 patients had received similar combined modality therapy during this time period. Three patients presented with acute onset of DVTUE and were anticoagulated. One patient who was referred with a several month history of DVTUE was observed closely after diagnostic evaluation revealed no evidence of recurrent Hodgkin's disease. All patients remained without evidence of their original lymphoma and had developed adequate venous collateralization. These cases of DVTUE were felt to be treatment related, a previously unreported late complication of combined irradiation and chemotherapy. Methods of diagnosis and therapeutic options are discussed. PMID- 3957736 TI - Measurement of blood flow using temperature decay: effect of thermal conduction. AB - Within the framework of the bioheat equation, we studied the effect of conduction on the thermal washout curve for a model tissue configuration subjected to a thermal perturbation such as hyperthermia treatment. In particular, we studied the implications of the assumption made by many investigators to neglect the effect of thermal conduction while analyzing the temperature decay curve for measuring blood perfusion. The present analysis suggests that during the localized hyperthermia treatments, this assumption can lead to inaccurate values for the blood perfusion parameter. This is particularly so under non-steady state conditions when the temperature distribution is changing. In addition to the value of blood flow, the shape of the temperature decay curve depends on the temperature distribution at the start of temperature decay. PMID- 3957738 TI - Oral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data. AB - Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena. PMID- 3957740 TI - The accuracy of the line and point source approximations in Ir-192 dosimetry. AB - The dosimetric approximations used in computer-aided treatment planning of Ir-192 seed implants generally ignore individual seed dimensions and internal structure. Most commonly, each seed is approximated by an isotropic point source. Alternately, each ribbon assembly consisting of uniformly spaced seeds is replaced by an unfiltered line source. Using filtration corrections applicable to platinum- and steel-encapsulated seeds calculated by the Monte Carlo method, the dosimetric errors introduced by these models into two-and-three-dimensional dose distributions arising from multiple plane implants are analyzed. Our results demonstrate that when anisotropy correction factors of 0.96 and 0.99 are used for platinum- and steel-filtered seeds, respectively, the point source model is accurate within 2%. The accuracy of the line source approximation depends significantly upon the details of its implementation. If the linear density of the line is set equal to individual seed strength for an inter-seed spacing of 1 cm, and filtration correction factors of 0.94 and 0.97 are used for platinum- and steel-clad seeds, respectively, the accuracy of the line source model is 1.5% near the implant center. The method of dose-volume histograms is used to compare the predictions of the different models. PMID- 3957739 TI - Radiotherapeutic prophylaxis of estrogen-induced gynecomastia: a study of late sequela. AB - Radiation therapy is an effective means of preventing the development of hormone induced gynecomastia in men with cancer of the prostate. The efficacy and morbidity of this type of radiation was studied in a retrospective analysis of 87 patients referred for treatment from 1972 to 1982. Patients receiving DES as treatment for prostate carcinoma were treated with irradiation to the breast tissue. Patients were treated with 4 MV, 60Co superficial X rays. Doses range from 1200 to 1500 cGy in 3 fractions. The majority of patients had satisfactory results in terms of prevention of gynecomastia and mammalgia. There were few acute reactions noted and no evidence of long term sequela. PMID- 3957741 TI - Isoeffect curves for radiation-induced myocardial damage. PMID- 3957742 TI - Pelvic and perineal recurrence in patients with rectal cancer. PMID- 3957743 TI - Precaution concerning eye-shields for AIDS patients. PMID- 3957744 TI - Pediatric brain stem tumors. PMID- 3957745 TI - Prophylactic treatment of uninvolved lymph nodes. PMID- 3957746 TI - Parental reactions to the onset of adolescence. AB - This paper documents the common changes associated with the onset of puberty and examines parents' reactions to these changes. Nine hundred questionnaires were sent to the parents of sixth and seventh graders (11-13 years old) in four communities. The questionnaire requested information on the perception of recent behavioral changes and the parents' emotional responses to them. Four hundred parents responded. Parents reported significant changes, both positive and negative, in their children in the year prior to the study. Reported changes were not significantly related to community locations, demographic or education variables, and, with one exception, to the sex of the child. First-born children were perceived more negatively and generated more negative feelings in parents. Younger parents (less than or equal to 38 years of age) perceived more negative changes and experienced more negative and anxious feelings toward their children than did older parents (greater than or equal to 39 years). These findings suggest that a primary cause of stress for parents with children in this age group may be a lack of knowledge about the developmental process. Physicians may be able to reduce the stress by providing anticipatory guidance to parents about the physical growth and psychologic aspects of early adolescence. PMID- 3957747 TI - Depressive symptoms and life events in physically ill hospitalized adolescents. AB - To study life events and depressive symptoms in adolescents hospitalized for physical illness, we administered the Coddington Life Events Survey and the Beck Depression Inventory (BDI) to 43 acutely ill adolescents, 42 chronically ill adolescents, and 140 adolescents from a general population. There were no differences between the three groups in total BDI, Psychological BDI, and Coddington Life Change Categories adjusted for hospitalization. The Somatic BDI was significantly greater in the acutely ill and chronically ill than in the general population sample (p less than 0.01). In the chronically ill, the Family Life Change score correlated with the psychological BDI (r = 0.44, p less than 0.01) but the Undesirable Life Change score did not. In the acutely ill and the general population, the Undesirable Life Change Score correlated with the Psychological BDI (r = 0.44, p less than 0.01), (r = 0.43, p less than 0.01) but the Family Life Change Score did not. PMID- 3957748 TI - Pregnancy outcomes among adolescent and older women receiving comprehensive prenatal care. AB - This study compares three birth outcomes, gestational age, birthweight, and type of delivery, among adolescent and older mothers. Data were collected from 911 women who attended a comprehensive prenatal-care program in a large urban teaching hospital. Women aged 13-19 years were at increased risk for low-birth weight babies (less than 2500 g) and for preterm infants of fewer than 38 weeks gestation, even with antenatal care, ethnicity, and other factors controlled. Results of bivariate analyses suggested that women aged 20-36 years are more likely than adolescent mothers to have a cesarean section; however, multivariate analyses suggested that maternal age was not an important factor in relation to type of delivery. Thus, even with similar comprehensive care, pregnant adolescents were at an increased risk of some adverse outcomes. However, the amount of antenatal care is a more important predictor of pregnancy outcome than is maternal age. PMID- 3957749 TI - Obtaining a personal and confidential history from adolescents. An opportunity for prevention. AB - Fifty adolescent girls ages 12-18 years (mean 14.9 years) were asked to complete a confidential questionnaire exploring many important issues of adolescence. The responses included the following: 38 (76%) girls did not wear seatbelts while riding in a car, 23 (46%) had used alcoholic beverages (10 at age less than or equal to 13 years), 17 (34%) had experience with marijuana, four (8%) had used other psychoactive drugs, and 14 (28%) were having sexual intercourse, while only eight were using contraception. Of the 16 (32%) girls who smoked cigarettes ten did not want to quit. Twenty-two (44%) girls had dysmenorrhea but only four had sought medical attention for the problem. This study suggests the usefulness of a questionnaire to identify individual health care needs for which preventive counseling may be offered. PMID- 3957750 TI - A patient's view of cystic fibrosis. PMID- 3957751 TI - Inadequate care of rape cases in emergency rooms of hospitals with a religious affiliation. PMID- 3957752 TI - Adolescent pregnancy-prevention program. A model for research and evaluation. AB - Despite the increased interest in the effects of adolescent pregnancy-prevention programs, most interventions lack the research design and data essential for evaluation. This article describes a model in which evaluative research was incorporated in program design. The derivation of the model, the selection of measurable parameters, characteristics of the population reflected in baseline and subsequent data, and problems in quantifying and interpreting appropriate variables are discussed. Clinic data and aggregate data from three self administered surveys is used. The surveys were completed by students in the inner city junior and senior high schools that cooperated in the education and clinical program. We demonstrate how these two types of data augment one another in assessing program effects. The study explores the evaluation and the timing of change in sexual knowledge, attitudes, and behavior (coital, contraceptive, and clinic) and thus may contribute to the design of measurable, replicable interventions. PMID- 3957753 TI - Adolescent suicidal and self-destructive behavior. Results of an intervention study. AB - This study evaluates an intervention program designed to reduce suicidal, self destructive behavior among high-risk adolescents aged 13- to 17 years. The intervention combined a program of community education and direct service to youth who had required emergency care for self-inflicted injuries. The intervention program was effective in increasing subjects' compliance with medical regimen. To a lesser degree, the intervention also facilitated early help seeking among adolescents with suicidal thoughts and appeared to diminish slightly the overall occurrence of emergency room admissions for suicidal behaviors. However, the intervention program had no demonstrable effect on the occurrence of repeat suicidal episodes. PMID- 3957755 TI - Support for closing of experimental head injury laboratory. PMID- 3957754 TI - Adolescent coitus and infant birthweight. AB - Seventy-nine percent of a group of adolescent mothers reported coitus during pregnancy. There was a significant difference between the mean birthweight and gestational age of infants born to mothers who reported coitus within 90 days of delivery compared to the mean birthweight and gestational age of infants of mothers who reported no gestational age of infants of mothers who reported no coitus within 90 days of delivery. Thirty-nine percent of the variance in birthweight was explained by maternal factors alone, but only 1.0% of the variance in birthweight was accounted for by the interval between last coitus and delivery. Prepregnancy weight (r = 0.380) and weight gain during pregnancy (r = 0.327) contributed 19.1% and 7.4% of the variance in birthweight, respectively. PMID- 3957756 TI - Splenectomy: an old issue of current controversy. PMID- 3957757 TI - Practice standards and the standard of skill and care. PMID- 3957758 TI - Inconsistencies in the absorptive capacities of Schirmer tear test strips. AB - The absorptive capacities of 4 commercially available tear test strips were determined and compared with 5-mm X 40-mm strips of #41 filter paper. Significant differences in the absorption of water over a given time interval were found in 3 of the groups tested. Major inconsistencies were found only within 1 lot of tear test strips from a single manufacturer. Tear test strips from this lot consisted of 2 distinct populations that were distinguishable by transillumination. Strips with widely spaced horizontal lines had the same absorptive capacity as the filter paper, whereas those with fine lines consistently absorbed less water. The clinical importance of this discrepancy was verified by comparing measurements of tear production in 6 normal dogs. PMID- 3957759 TI - Congenital feline portosystemic shunts. AB - Five young cats with portosystemic communications, 2 with single intrahepatic and 3 with single extrahepatic portosystemic communications, were managed surgically. One cat with a ductus venosus was treated successfully by surgery. Ptyalism and behavioral changes were similar in all 5 cats. Biochemical abnormalities included low BUN values, increased blood ammonia values, and increased sulfobromophthalein retention. None of the cats had portal hypertension at the time of surgery. Seemingly, single portosystemic shunts should be considered a surgical disease in the cat. PMID- 3957760 TI - Detection of ovine intramammary infection with the California mastitis test. AB - The overall sensitivity of the California mastitis test (CMT) for detecting intramammary infection (the likelihood of a positive CMT score in the presence of intramammary infection) was 69.3%. The specificity of the CMT (likelihood of a negative test in the absence of intramammary infection) was 76.5%. When only infections by major ovine mastitis pathogens were considered, the sensitivity increased to 100% and the specificity decreased to 71.1%. Bacterial cultural examination and CMT scores were recorded for 526 samples of milk obtained from 106 brood ewes. Positive CMT scores were recorded for all samples from udder halves infected with major ovine mastitis pathogens (coagulase-positive staphylococci, Escherichia coli, and Pasteurella haemolytica). The CMT scores for samples from udder halves infected with coagulase-negative staphylococci were variable. PMID- 3957761 TI - Myotonia congenita in a Chow Chow pup. AB - Myotonia congenita was diagnosed in a 12-week-old female Chow Chow that had hindlimb ataxia, a stiff gait, and occasional collapsing. The diagnosis was based on the history, clinical signs, electrodiagnostics, and microscopic examination of biopsied muscle specimens. PMID- 3957762 TI - Infraspinatus muscle contracture associated with trauma in a dog. AB - Infraspinatus muscle contracture was diagnosed in a 4 1/2-year-old female Doberman Pinscher with lameness characterized by abduction and outward rotation of the right antebrachium and carpus. After infraspinatus tenotomy, the dog recovered. This case differs from previously reported cases of infraspinatus muscle contracture because of an associated history of blunt trauma. PMID- 3957764 TI - Treatment of cryptococcosis in three cats, using ketoconazole. AB - Ketoconazole was effective in the treatment of cryptococcosis in 3 cats. A dosage of 10 to 15 mg/kg of body weight was given once or twice daily with a meal for 11 to 33 weeks. Fungal cultures and serotesting were used to assess the efficacy of treatment and resolution of active infection. In some of the cats, the treatment was associated with gastrointestinal signs and increased serum liver enzyme activity. Ketoconazole has been used in human beings, dogs, and cats for the treatment of systemic mycoses. PMID- 3957763 TI - Bubonic plague in a cat. AB - Bubonic plague was diagnosed in a cat. The diagnosis was made by isolation of bacteria from a ruptured bubo and by demonstration of an antibody titer to Yersinia pestis. The cat was treated successfully with amoxicillin and streptomycin. The entire veterinary staff was treated prophylactically with tetracycline. PMID- 3957765 TI - Potential of chrysotherapy in veterinary medicine. PMID- 3957766 TI - Emergence of antibiotic-resistant Salmonella agona in horses in Kentucky. AB - Eighty-seven of 283 isolates of salmonellae recovered from horses in Kentucky by the Livestock Disease Diagnostic Center from July 1, 1980 through June 30, 1984 were Salmonella agona. No isolations of S agona were made from Jan 1, 1972 through June 30, 1980. Salmonella agona was isolated from horses on 56 farms and most of the isolations were made in the spring. All age classes of horses were involved. Clinical forms of salmonellosis observed were diarrhea, septicemia, infertility, and abortion. Antibiotic susceptibilities were determined for 83 of the 87 isolates, and 79 were resistant to multiple antimicrobial agents, including chloramphenicol and gentamicin. PMID- 3957767 TI - Slab fractures of the fourth and intermediate carpal bones in five horses. AB - Fractures of the fourth carpal bone were diagnosed in 5 horses; 3 fractures were associated with fracture of the intermediate carpal bone. The diagnosis was delayed in all 5 horses, apparently because of the moderate nature of the clinical signs. Open surgical reduction with lag screw type fixation was used in all horses. Because of delayed treatment, transfixation of carpal bones (necessary for stability), and surgical trauma, degenerative joint disease with osteophyte formation occurred in all 5 horses. None of the 5 horses was able to begin or return successfully to work, although 4 of the 5 were pasture/breeding sound. One horse was euthanatized after being allowed free exercise too early. A mechanical hypothesis is presented for the pathogenesis of these fractures. PMID- 3957768 TI - Vertebral body abscesses in cattle: a review of five cases. AB - Over a 4-year period, vertebral body abscess (VBA) was diagnosed in 5 young cattle at the University of Minnesota, College of Veterinary Medicine. Review of these cases indicated that laboratory findings may not support a diagnosis of VBA and that the most important basis for diagnosis of this condition is a thorough neurologic examination. In 4 cases, necropsy revealed abscesses in the lungs or thoracic cavity as well, suggesting that a history of pneumonia preceding paresis may favor the diagnosis of VBA. PMID- 3957769 TI - Large colon resection and anastomosis in horses. AB - Large colon resection and anastomosis was performed in 11 horses at various levels of the colon, using several surgical methods. The level of resection ranged from the pelvic flexure to the cecocolic ligament. Nine of 11 horses survived and at follow-up (4 months to 7 years) were free of clinical signs referable to disease of the gastrointestinal tract. Seven horses could be evaluated as to athletic or reproductive function and all returned to original potential. PMID- 3957770 TI - Herd problem of abortions and malformed calves attributed to bovine viral diarrhea. AB - A herd problem of abortions and the birth of malformed calves developed subsequent to a transient febrile illness in adult cows. The herd was not vaccinated against bovine viral diarrhea (BVD). Bovine viral diarrhea virus was isolated from blood of one calf. The problem continued for 8 months. The entire herd was vaccinated with a killed BVD virus product. No further problems developed. This herd problem illustrates one of the many recognized clinical manifestations of BVD. PMID- 3957771 TI - Parelaphostrongylus tenuis in captive reindeer and sable antelope. AB - Parelaphostrongylus tenuis caused neurologic disease in 6 reindeer (Rangifer tarandus tarandus) and 2 sable antelope (Hippotragus niger) that were housed at the National Zoological Park Conservation and Research Center in Front Royal, Va. Progressive hindlimb ataxia and weakness were seen in all affected animals. The parasite was recovered from the subdural space of one reindeer and was seen histologically within the neuropil of another reindeer and a sable antelope. In the other reindeer and sable antelope, diagnoses of parelaphostrongylosis were based on clinicoepidemiologic findings and microscopic lesions. Because parelaphostrongylosis is a density-dependent disease and because the number of white-tailed deer probably will increase, the incidence of P tenuis infections in domestic and nondomestic animals probably will increase as well. Zoos and wildlife parks especially should be cautious when introducing exotic hoofstock to areas with Parelaphostrongylus tenuis-infected white-tailed deer. PMID- 3957772 TI - Multiple myeloma in a horse. AB - Multiple myeloma was diagnosed in a 22-year-old Arabian mare with a history of chronic weight loss. Quantitative immunoglobulin analysis revealed monoclonal gammopathy (IgG(T), 9,800 mg/dl). Due to progressive weight loss, the horse was euthanatized. Microscopy of tissues revealed plasma cell infiltrates in bone marrow, spleen, pituitary gland, adrenal cortex, muscle of the tongue, and bronchial, renal, and mesenteric lymph nodes. PMID- 3957773 TI - Megaesophagus in a cow. AB - Megaesophagus developed subsequent to presumed pharyngeal trauma in a cow. Signs resolved after prolonged antibiotic treatment and supportive care. PMID- 3957774 TI - Bone scintigraphy as an aid in the diagnosis of occult distal tarsal bone trauma in three horses. AB - History, physical examination, and bone scintigraphy were used to diagnose central and/or third tarsal bone trauma in 3 acutely lame horses. In all 3 cases, the results of initial radiographic examination were negative. Bone scintigraphy revealed focal, intense radioisotope uptake at the level of the distal tarsal bones in the 3 horses. Radiographs obtained 4 weeks after injury in one horse demonstrated a slab fracture of the central tarsal bone. Conservative management of the tarsal bone disease resulted in acceptable return to function in all 3 horses. PMID- 3957776 TI - Hindlimb hyperesthesia associated with rabies in two horses. AB - Rabies was diagnosed in 2 adult Quarter Horses with hindlimb hyperesthesia and progressive weakness. Microscopic examination of the cord and brain of the first horse revealed nonsuppurative meningomyelitis and ganglioneuritis in the cord extending cranially to the 6th cervical segment. Fluorescent antibody test results of both horses were positive for rabies in hindlimb peripheral nerve specimens, but negative in sections of the upper lip. Salivary gland, cerebrum, cerebellum, hippocampus, musculocutaneous nerve, cornea, and optic nerve specimens were tested for rabies by fluorescent antibody technique to determine viral distribution in the body of the second horse. PMID- 3957775 TI - Intramuscular hemangiosarcoma with pulmonary metastasis in a horse. AB - Intramuscular hemangiosarcoma resulting in severe anemia and thrombocytopenia was diagnosed in a 3-year-old Thoroughbred filly. Necropsy revealed multiple tumors within skeletal muscles and multiple pulmonary metastases. PMID- 3957777 TI - Vertebral body osteomyelitis in the horse. AB - Over a 4-year period, vertebral body abscess was diagnosed in 5 young cattle. The laboratory findings in most of these cases did not suggest a diagnosis of vertebral body abscess. The most important basis for diagnosis of this condition was a thorough neurologic examination. In 4 cases, necropsy revealed abscesses in the lungs or thoracic cavity as well, suggesting that a history of pneumonia preceding paresis may favor the diagnosis of vertebral body abscess. PMID- 3957778 TI - The training of multicompetent allied health professionals using a combined fields method. AB - With the advent of DRGs, quality and cost have become the chief considerations of care providers and institutional managers; as a result, persons who can perform competently in crossover fields may be more employable and valuable than their single-credentialed counterparts. In academic health centers with more than one health-related school, opportunities exist to combine degree programs that result in educating multicompetent health care providers (MCHCP). In lieu of thinking about interdisciplinary education in the traditional sense, the training of MCHCPs can be achieved by simply combining one or more aspects of their respective curricula. Three methods--intra-, across-, and extra-field combinations--of melding two historically separate fields are described. An example of an across-field combination--the Baylor College of Medicine Physician Assistant/Perfusion Technology Program--is given. PMID- 3957779 TI - A paying health promotion clinic: combining client services and student learning. AB - Major societal changes over the past two decades have created the need for competent health care professionals able to provide high quality health care in a rapidly changing, highly technical society. To meet this goal, the University of Northern Colorado College of Health and Human Services prepares graduates in a unique multidisciplinary health promotion clinic. Department chairs along with clinic and faculty coordinators manage student-learning and client-service activities in this 9,000-square-foot, on-campus clinic. Income is generated through third-party payments and client fees from programs in nursing, nutrition, communication disorders, human rehabilitative services, and community health. Problems encountered in developing this clinic included staffing, physician consultation, fee assessment, faculty hesitancy, and health care competition. Positive outcomes were a more autonomous professional identity for students, clinic practice and research opportunities for faculty, and health promotion care for selected client groups. PMID- 3957780 TI - Use of interdisciplinary education to foster familiarization among health professionals. AB - This paper describes a pilot interdisciplinary experience between the dental hygiene and medical technology programs at Marquette University. It was designed, in part, to familiarize dental hygiene students with the medical technology profession. Comments solicited from students on the final evaluation form indicated that this pilot project was highly successful and met the objectives. Affective, multiple-choice questions on pretests and posttests showed a positive change in attitude, but this change was not statistically significant. Possible reasons for this are discussed. Benefits of this pilot project were an improved understanding of medical technology on the part of the dental hygiene students, enhanced interdepartmental communication, and plans to develop a reciprocal interdisciplinary experience for the medical technology students. It is hoped that this pilot project will serve as a stimulus for similar experiences among other health science programs. PMID- 3957781 TI - Techniques for managing the self-study. AB - Accreditation is a status frequently sought by institutions and programs. It is also a process that includes a self-study, an on-site visit, and a survey report. The need for self-evaluation as part of the accreditation process is well documented. Many institutions have difficulty initiating the activity of developing the self-study. This article attempts to provide assistance in preparing the self-study. It outlines the basic steps of accreditation and provides a checklist for accreditation activities. Finally, it offers suggestions for carrying out this essential component of the accreditation process. PMID- 3957783 TI - American Society of Andrology 11th annual meeting. Grand Rapids, April 20-23, 1986. Abstracts. PMID- 3957782 TI - Development and validation of the Attitude Toward Arthritis Patients Scale (ATAPS). AB - The development and validation of a four-item scale, the ATAPS, measuring attitude toward working with arthritis patients is described. Three separate samples of occupational and physical therapists were surveyed. Data from the first random sample were used to select a reliable subset of items from a larger pool and to provide a baseline for comparison with the second sample. The second sample comprised arthritis workshop attendees and confirmed the scale's reliability and its ability to differentiate between therapists with an active interest in arthritis and a group with no special interest in the disorder. The third stratified random sample further confirmed the scale's reliability and demonstrated that the ATAPS scores were associated with the number of arthritis patients in therapists' practices but not with measures of professional experience unrelated to arthritis. PMID- 3957784 TI - Effects of neonatal estrogen administration on rat testis development with particular reference to Sertoli cells. AB - An ultrastructural and morphometric study of the testes in 15-, 22-, 45-, and 90 day-old neonatally estrogenized rats was performed. At 45 days of age, the Sertoli cells appeared immature in estrogenized rats, whereas they were fully mature in the controls. This finding might be related to a deficiency in gonadotropins and androgens during the postnatal period. In 90-day-old estrogenized rats, however, Sertoli cell maturation had occurred, which might be attributed to a recovery of hormone levels. Cytoplasmic alterations, however, such as vacuolation, were present at this age. The morphometric study revealed decreased testicular and tubular volumes as well as decreased mean tubular diameters in the estrogenized animals. In contrast, the absolute tubular length increased more in these animals than in the controls during the period from 15 to 90 days of age. This lengthening process might be related to the large number of hypercurved tubules in the estrogenized rats. PMID- 3957785 TI - Spectrum of the pulsatile characteristics of LH release in normal men. AB - To assess the spectrum of LH pulse characteristics in normal men, blood samples from 36 individuals were drawn at 20-minute intervals for 8 hours. The subsequent immunoactive LH concentrations were analyzed by computer algorithms to delineate the frequency and amplitude characteristics of pulsatile LH secretion. The absolute range for LH pulse frequency estimated by a modified threshold method was 1-6 pulses/8 hr, with a mean (+/- SEM) of 3.36 +/- 0.17 (median -3)pulses/8 hr. The distribution differed significantly from a Gaussian pattern. The mean LH pulse amplitude expressed as a percent increase above nadir was 92.1 +/- 6.1 (median-91.5%). When LH pulse amplitude was defined as an increment (mIU/ml) above nadir, the mean value was 5.13 +/- 0.4 (median -4.8) mIU/ml. These two expressions of amplitude were positively correlated (P less than 0.01), while the incremental (mIU/ml) pulse amplitude correlated inversely with pulse frequency (P less than 0.01). To examine the influence of more intensified rates of venous sampling on the spectrum of LH pulse properties, blood was sampled at 4-minute intervals for 8 hours in a subgroup of 13 men. Under these conditions, estimated LH pulse frequency was significantly higher, with a mean of 10.31 +/- 1.87 (median -9) pulses/8 hr compared with 20-minute sampling in the same individuals (P less than 0.001). Although the estimates of LH pulse frequency at 4-minute and 20-minute sampling intervals were significantly correlated (P less than 0.01), the dispersion of the LH pulse frequency estimates was considerably larger at more rapid rates of sampling. There was an absolute range of 2-20 pulses/8 hr for the 4-minute sampling, and 1-6 pulses/8 hr for the 20-minute sampling in the same individuals. This increase in LH pulse frequency and the broader dispersion of the range of frequencies estimated at 4-minute compared with 20-minute sampling intervals were confirmed using either another pulse detection algorithm, or separate criteria designed to adjust false-positive error rates in relation to sampling intensity. It was concluded that eugonadal men exhibit a broad spectrum of pulsatile LH characteristics, and the range of LH pulse attributes is even greater at more intensive rates of venous sampling. The results of this study in normal men demonstrate that a wider dispersion of physiologic LH pulse characteristics must be recognized in man.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3957787 TI - New metabolites of Fusarium martii related to dihydrofusarubin. AB - Six strains of Fusarium martii produced fusarubin and dihydrofusarubins A and B. Further examination of strains, T-77 and T-127, showed that four additional metabolites were produced. By 1H and 13C NMR spectral analyses, these additional metabolites have been identified as 3-O-methyl and 3-O-ethyl ethers of fusarubin and dihydrofusarubin A. The methyl ethers are new compounds and showed moderate cytostatic activity against mouse leukemia L1210 culture cells as well as moderate antibiotic activity against leukemia L1210 culture cells as well as moderate antibiotic activity against Gram-positive bacteria and fungi. 3-O-Methyl and 3-O-ethyl ethers of dihydrofusarubin A were converted non-enzymically to the respective ethers of fusarubin under alkaline conditions. Since in addition, only dihydrofusarubin derivatives were formed when an acidic pH was maintained in the culture, it can be concluded that only these are true metabolites of Fusarium martii. PMID- 3957786 TI - Accessory sex gland function in normal young (20-25 years) and middle-aged (50-55 years) men. AB - A comparison of various parameters of prostatic and vesicular secretory function was made between the seminal plasma of young (20-25 years; n = 23) and middle aged (50-55 years; n = 19) male volunteers. These parameters included prostatic acid phosphatase, zinc, citric acid, spermine, spermidine, putrescine (prostatic origin), fructose, and prostaglandin E (vesicular origin), in addition to protein and testosterone. Spermatozoa were counted and monitored for abnormalities. The concentration in the ejaculate of the majority of the parameters investigated did not change with age, although the total contribution to the ejaculate from the prostate and seminal vesicles was reduced significantly in the older men. The concentration of three constituents was significantly altered in the older age group: putrescine (P less than 0.001) and prostaglandin E (P less than 0.01) were reduced, while zinc levels were elevated (P less than 0.05). These changes are discussed in relation to possible disturbances of prostate function and pathology in the middle-aged man. PMID- 3957788 TI - Studies on monocyclic beta-lactam antibiotics. V. Synthesis and antibacterial activity of 3-[2-(2-aminothiazol-4-yl)-(Z)-2-(O-substituted oxyimino)-acetamido] 1-(1H-tetrazol-5-yl)-2-azetidinones having various functional groups at C-4 position of beta-lactam. AB - The synthesis and antibacterial activity of the 3-[2-(2-aminothiazol-4-yl)-(Z)-2 (O-substituted oxyimino)acetamido]-1-(1H-tetrazol-5-yl)-2-azetidinones++ + having various functional groups at C-4 position of beta-lactam are described. These compounds exhibited a strong activity against a variety of Gram-negative bacteria including beta-lactamase-producing strains. Among various C-4 substituents explored, the fluoromethyl and carbamoyloxymethyl moiety were found to increase the activity. PMID- 3957789 TI - Semisynthetic beta-lactam antibiotics. II. Effect on antibacterial activity of ureido N-substituents in the 6-[(R)-2-[3-(3,4-dihydroxybenzoyl)-1- ureido]-2 phenylacetamido]penicillanic acids. AB - The synthesis and the relationship between in vitro and in vivo activities of 6 [(R)-2-[3-(3,4-dihydroxybenzoyl)-3-R1-1-ureido]-2- phenylacetamido]penicillanic acids having C2 approximately 8 alkyl or substituted alkyl groups as the substituents (R1) are described. In this series, 6-[(R)-2-[3-(3,4 dihydroxybenzoyl)-3-(3-hydroxypropyl)-1-ureido] -2-phenylacetamido]penicillanic acid (1b, AO-1100) showed the most potent protective effect on mice in experimental Pseudomonas aeruginosa infections, although it did not have the strongest in vitro activity among the penicillins we synthesized. PMID- 3957790 TI - Regulation of enzymes involved in the biosynthesis of the sesquiterpene antibiotic pentalenolactone in Streptomyces arenae. AB - The production of the sesquiterpenoid antibiotic pentalenolactone in the producer strain Streptomyces arenae TU 469 is controlled by the activity of the enzyme farnesylpyrophosphate cyclase. In contrast to the activity of this enzyme, the specific activities of all other enzymes of the mevalonoid pathway tested so far, proved to be not rate-limiting. Several metabolites of the pentalenolactone pathway were tested for inhibitory effects on the activity of the HMG-CoA reductase and farnesylpyrophosphate cyclase. The activity of the cyclase was inhibited by low concentrations of pentalenolactone and its derivatives, thus suggesting an end product inhibition of the starting enzyme of the pentalenolactone pathway. The activity of HMG-CoA reductase was not inhibited by pentalenene or any pentalenolactone-derivatives. According to these results, an end-product inhibition of the first enzyme which is specific for pentalenolactone synthesis seems to be a mechanism involved in the regulation of pentalenolactone biosynthesis. PMID- 3957791 TI - Adecypenol, a unique adenosine deaminase inhibitor containing homopurine and cyclopentene rings. PMID- 3957793 TI - Quantitative validation of cochlear models using the Liouville-Green approximation. AB - This article is devoted to the question of whether linear and passive models of the cochlea can mimic the recently observed sharply tuned data of basilar membrane vibration. The model equations are solved by means of an asymptotic approach, the Liouville-Green approximation, which is adequate for quantitative comparisons with experimental data. The conclusions are: (i) the older, mildly tuned basilar membrane responses can be matched very well by means of linear, passive models; (ii) the newer, sharply tuned data cannot be matched satisfactorily by linear, passive modelling. Hence, this study supports the view that the cochlea must contain an active mechanical filter which manifests itself at the level of BM vibration. PMID- 3957792 TI - Interaction of naphthomycin A with sulfhydryl compounds. PMID- 3957794 TI - The pathogenesis of stereocilia abnormalities in acoustic trauma. AB - Stereocilia abnormalities develop in anesthetized guinea pigs within two minutes of exposure to loud sound (3 kHz, 125 dB SPL). Displacement, fracture, fusion and membrane rupture were observed well before the development (after 10 or more minutes) of fine structural changes to other cytoplasmic organelles within the hair cells. Thus stereocilia abnormalities can arise very rapidly due to the direct effects of noise on their microfilaments, cross linkages and limiting membranes. Such abnormalities are thus not necessarily secondary to changes in the body of the affected hair cells. PMID- 3957795 TI - Field analysis of auditory evoked brainstem potentials. AB - Surface distribution maps of auditory evoked brainstem potentials (AEBPs) are presented for time instants corresponding to the waves of major interest (I, III and V) in humans. Maps are shown to be fully consistent with the results of two approaches that have been recently proposed for the analysis of AEBPs, namely dipole localization methods and three-channel Lissajous trajectories, thus confirming the technical feasibility of methods for extracting information on the sources of AEBPs from surface data. PMID- 3957796 TI - Contrast enhancement in frequency spectra of cochlear microphonic responses to complex stimuli. AB - Cochlear microphonic responses were measured in pigeons and guinea pigs during stimulation with complex sounds. The acoustical stimuli had many component frequency spectra with a more or less undulating envelope. Enhancement of the peak-and-valley structure of the envelope occurred at high stimuli levels, especially if all frequency components in the stimulus had equal (cosine) phase. The observed effects could very well be modelled with a simple passive electronic network, as well as with an analytical expression that describes saturation of the cochlear microphonic at high stimulus levels. PMID- 3957797 TI - The bandwidth effect on monaural and binaural localization. AB - Listeners located, monaurally and binaurally, an 8.0 kHz centered noise burst whose bandwidth was set at 2.0, 4.0, 6.0 and 8.0 kHz. Loudspeakers, placed 7.5 degrees apart, covered an arc extending from 15 degrees to 165 degrees to the left of midline. Listeners reported the number of that loudspeaker from which the noise bursts appeared. A significant reduction in localization errors was associated with increments in bandwidth and for binaural localization, this was attained largely through fewer instances of confusing sounds from the front with those from the rear. While overall, binaural accuracy exceeded monaural accuracy when sounds came from the front or rear, no appreciable differences between the two listening conditions were noted when the sounds came from the middle section of the arc. Only when broadband noise was employed, as it was in a supplementary set of observations, did binaural localization uniformly surpass monaural localization in accuracy - a finding attributed to the introduction of low frequencies which resulted in the addition of interaural ongoing phase differences to the constellation of localization cues. PMID- 3957798 TI - Cochlear emissions simulated using one-dimensional model of cochlear hydrodynamics. AB - Stapes velocity was computed using a nonlinear, one-dimensional model of cochlear hydromechanics. The model's compliances and damping coefficients were mechanically nonlinear and instantaneously varying in proportion to simulated current injected into the cochlea. Experimental data showing the spectral content of the pressure waveform near the eardrum during the delivery of sound and current to the cochlea were compared with model results. PMID- 3957800 TI - Effect of feed and(or) water deprivation prior to weaning on reproductive performance of sows: a cooperative study. AB - A total of 292 sows, at three experimental stations (Auburn, Texas A&M, Texas Tech), was used to determine the effects of depriving sows of feed and(or) water before weaning on reproductive performance. The four treatments were arranged as a 2 X 2 factorial to evaluate two periods of feed deprivation (0 and 48 h) and two periods of water deprivation (0 and 24 h) before weaning. Sows were allowed to consume feed ad libitum during lactation, and were fed 1.8 kg/d during the weaning to breeding interval. Only sows nursing six or more pigs at weaning were used. Pigs were weaned at approximately 42 d at Auburn and 28 d at Texas A&M and Texas Tech. Treatment responses were similar at each station with no evidence of a station X treatment interaction for any of the traits (P greater than .10). During the 48-h treatment period, sows receiving feed and water ad libitum lost 1 kg compared with weight losses of 16 kg for sows deprived of feed for 48 h, 13 kg for sows deprived of water for 24 h, and 17 kg for sows deprived of feed for 48 h and water for 24 h. Weight losses for sows deprived of water only, may have partially resulted from reduced feed intake during the 24-h treatment period; however, feed intake during this period was not measured. At breeding, sows deprived of feed and(or) water maintained their greater weight losses, suggesting that some tissue loss occurred during the 48- or 24-h treatment periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957799 TI - Representation of a low-frequency tone in the discharge rate of populations of auditory nerve fibers. AB - Discharge rates for populations of single auditory nerve fibers in response to 1.5 kHz tone bursts were measured in anesthetized cats. Separate plots of average rate vs. best frequency (rate-place profiles) were made for high, medium and low spontaneous rate (SR) auditory nerve fibers. At the lowest sound levels studied (34 dB SPL), all three SR groups show a peak in the rate-place profile centered around 1.5 kHz. At the highest sound levels studied (87 dB SPL), the average rates of the high and medium SR fibers are saturated across a wide range of best frequencies, but a peak around 1.5 kHz is maintained in the rate-place representation of the low SR fibers. These results show that in addition to the temporal information present in the discharge patterns of auditory nerve fibers, a rate-place representation of a single low-frequency tone exists in the auditory nerve over a wide range of sound levels. PMID- 3957801 TI - Prevalence and effects of intramammary infection in beef cows. AB - Prevalence and effects of intramammary infection in 322 beef cows was determined during three calving intervals. Intramammary infection was confirmed in 37% of cows and 18.1% of quarters. Coagulase-positive staphylococci accounted for 17.9% of infections with Staphylococcus aureus isolated from 7.1% of cows. Coagulase negative staphylococci and micrococci accounted for the remainder of infectious organisms. Butterfat and total protein levels were reduced 27.3 (P less than .05) and 25.5% (P less than .01), respectively, in milk from quarters infected with S. aureus. Somatic cell counts were elevated (P less than .001) with 3,827 X 10(3) cells/ml for S. aureus-infected quarters as compared with 555 X 10(3) cells/ml for uninfected quarters. Somatic cell counts were negatively correlated with 210 d calf weaning weights. Staphylococcus aureus-infected cows weaned calves weighing 19.1 kg less (P less than .01) than uninfected cows. At a present market value of $1.65/kg, economic losses were placed at $31.43/calf from cows infected with S. aureus in one or more quarters. PMID- 3957802 TI - Biological characteristics for assessing low phosphorus intake in finishing swine. AB - Three replicates of a randomized complete-block design in a 3 x 3 factorial arrangement of treatments involving 141 pigs were conducted to evaluate the effect of low P intake on various response criteria in swine from 65 to 95 kg body weight. Total dietary P levels of .09, .21 and .31% were each fed in a Ca:P ratio of 1.1, 1.5:1 or 2:1 for a 35-d experimental period. The basal diet was formulated using corn starch, dextrin and a soy protein concentrate with monosodium phosphate and limestone supplying desired treatment levels of Ca and P. Blood and bones were collected for mineral analysis. Gain and feed performance responses were not affected by Ca:P ration or dietary P level for the 35-d period. Serum inorganic P concentrations declined as Ca:P ratio increased, but increased as dietary P increased. Serum alkaline phosphatase activity increased with higher Ca:P ratios, and decreased as dietary P level increased. Percent bone ash was not influenced by Ca:P ratio, but increased as dietary P level increased. Bone-bending moment was influenced by Ca:P ratio, and increased linearly as dietary P increased. Dietary P level resulted in a linear increase in total bone and its ash component weight, and in the accretion of the ash and organic matrix component. These data suggest that between 65 to 95 kg body weight, percent bone ash was affected by dietary P level, while bone-bending moment, bone component weights, their accretion, both dietary p level and Ca:P ratio. PMID- 3957803 TI - [14C]monensin balance in bile-fistulated ponies. AB - To measure absorption of monensin or its metabolites and its elimination from the body, [14C]monensin sodium was given orally (1 mg/kg body wt) to two bile fistulated ponies and iv (8.7 mg) to one bile-fistulated pony. For one orally dosed pony, 4.7% of the 14C was eliminated in bile, 52% in feces, .7% in urine and 33% remained in the gastrointestinal (GI) tract after 3 d. Total 14C recovery was 90%. For the other orally-dosed pony, 18.3% of the 14C was eliminated in bile, 69% in feces, 1.7% in urine and 7% remained in the GI tract after 4 d. Total 14C recovery was 98%. For the iv-dosed pony, 72% of the 14C was eliminated in bile, .5% in feces, 4.9% in urine and 15% remained in the GI tract after 23 h. Total 14C recovery was 96%. Maximum rate of 14C elimination in feces from the orally-dosed ponies occurred on the third and fourth days, and the maximum rate of biliary elimination occurred between 16 and 24 h for one pony and 48 and 56 h for the other. For the iv-dosed pony, 14C became immeasurable in plasma within 12 h after dosing and appeared in bile within 30 min, with maximum biliary concentration occurring at about 1 h. Monensin accounted for a minimum of 19% of the 14C in a 56- to 72-h sample of feces for one orally-dosed pony and a minimum of 25% of the 14C in feces from the same time period for the other.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957804 TI - Temporal relationship of the pulsatile fluctuation of luteinizing hormone and progesterone in cattle: a time series cross-correlation analysis. AB - The temporal relationship between the pulsatile patterns of plasma luteinizing hormone (LH) and progesterone (P4) was studied in mid-luteal (ML) and early pregnant (EP) dairy cows. Blood samples were collected (via external jugular vein cannulae) at 10-min intervals for 16 h in 5 ML cows (d 10 to 12 of the cycle) and for 10 h in 5 EP cows (d 52 to 56 of gestation). Concentrations of LH and P4 were determined by radioimmunoassays and a time series cross-correlation analysis was utilized to evaluate the temporal relationship between them. A pulsatile pattern was found for both hormones in both groups, and in all animals LH peaks were uniformly followed by P4 peaks. In 80% of the cows in both groups the highest cross-correlation occurred between samples LH(n) and P4 (n + 1) (n = sample number), suggesting that a lag time of about 10 min is necessary for luteal stimulation. Results from both groups demonstrate that P4 is released from the corpus luteum in a pulsatile manner and that its release is at least partially dependent upon the pulsatile pattern of plasma LH. Correlation coefficients between LH and P4 mean level, basal levels, peak frequencies and peak amplitudes obtained in both groups indicate that the conceptus alters the hypothalamic pituitary-ovarian relationship found in the ML cows, suggesting the existence of another factor(s) acting along with LH to release P4 in EP cows. PMID- 3957805 TI - Dynamics of digestion in cattle, sheep, goats and deer. AB - Four experiments were conducted to study factors affecting digestibility of forages in cattle, sheep, goats and white-tailed deer. In a series of digestion trials (Exp. 1), the dry matter digestibility of a moderately high fiber diet was greater in cattle than in deer. Digestibilities of the diet in sheep and goats were intermediate and not different from either extreme. In a second series of trials (Exp. 2), relative organic matter digestibilities were for goats more than sheep more than deer. However, in Exp. 2, intake in goats was very low and digestibility appeared to be positively related to retention time and inversely related to turnover rate. Results of three trials (Exp. 3) suggested that rate of digestion was related more to diet than to the animal species consuming the diet. In grazing animals (Exp. 4), goats digested a smaller percentage of consumed material than either cows or sheep during three of four seasons even though diets were of similar in vitro digestibility. This difference was related to a faster turnover and shorter retention time in goats. These data support the concept that there are species differences in gastrointestinal dynamics which may be which may be important determinants of adaptability to grazing conditions. PMID- 3957806 TI - Effect of intake and forage level on ruminal turnover rates, bacterial protein synthesis and duodenal amino acid flows in sheep. PMID- 3957807 TI - Influence of copper supplementation on blood and liver copper in cattle fed tall fescue or quackgrass. AB - Copper concentrations were measured in naturally Cu-deficient and Cu-supplemented yearling Hereford heifers fed tall fescue (Festuca arundinacea Schreb.) or quackgrass (Agropyron repens [L] Beauv.) forage. The data were used to establish a relationship between dietary Cu supplementation and accumulation of liver Cu, and to test the influence of diet and Cu supplementation on blood plasma Cu and ceruloplasmin oxidase activity. Dietary Cu supplementation was positively correlated with accumulation of liver Cu; the rate of increase in liver Cu levels diminished at high supplementation rates (liver Cu = 410.43 - 353.47 x e-.00295 x mg Cu supplement; R2 = .740), suggesting an efficient mechanism preventing fast, toxic Cu-overloading in cattle. The linear relationship (R2 = .7878) between blood plasma Cu and ceruloplasmin oxidase activity indicated that similar percentages of blood plasma Cu were present as ceruloplasmin in deficient, normal and Cu-supplemented cattle. However, the portion of plasma Cu occurring as ceruloplasmin changes significantly with type of feed. When compared with quackgrass, tall fescue not only produced rapid Cu depletion in unsupplemented cattle, but affected intermediary Cy metabolism and activity of Cu-enzyme ceruloplasmin differently at all levels of experimental Cu supplementation. PMID- 3957809 TI - Response of fall-born calves to progesterone-estradiol benzoate implants and reimplants. AB - Two trials, involving 469 steer and heifer calves, were conducted to evaluate the practices of implanting or reimplanting suckling fall-born calves with progesterone-estradiol benzoate (PE) implants (100 mg of progesterone, 10 mg of estradiol benzoate). Calves having an average initial weight of 67 kg were randomly allocated within sex and location to remain either nonimplanted or to receive a PE implant in the late fall, in the spring just before green grass, or in both fall and spring. All animals grazed good- to excellent-quality native Bluestem range. Nonimplanted calves in Trial 1 gained .57 kg/d during the winter months and PE implants improved growth rate by 7% to .61 kg/d (P less than .05). Growth rate of calves on dry winter range in Trial 2 was only .20 kg/d, and was not affected by PE implants. Average daily gain of nonimplanted calves during the spring and summer months was .96 and .87 kg/d for trials 1 and 2, respectively. Performance of implanted calves during that period was improved an average of 4.3 to 10% (P less than .05) by PE implants in both trials regardless of when the calves were implanted. Growth rate of calves over the entire 8-mo trials was .66 kg/d for nonimplanted calves and was improved (P less than .01) to .70, .70 and .71 kg/d for calves on the two single-implant and reimplant schedules, respectively. Implanted calves gained an average of 10.4 kg more than nonimplanted calves during the study. PMID- 3957808 TI - The effect of a preassembly zeranol implant and post-transit diet on the health performance and metabolic profile of feeder calves. AB - A total 262 Angus steer calves averaging 207 kg from none (trial 1) and five farms (trial 2) were identified on the farm of origin and one-half of the calves on each farm was implanted with 36 mg of zeranol before entering the feeder calf assembly and marketing system. Calves were assembled, fasted for 24 h and fed hay for 72 h, then shipped 1,368 km. Upon arrival, the following receiving diets were fed for 4 wk to one-third of the calves from each farm and implant group: 1) control diet, 2) high-potassium diet, 3) escape-protein diet using corn gluten meal, which can escape ruminal degradation as a protein source. Implanted calves gained more weight (P less than .10) than nonimplanted calves while on the farm, but changes in weight during assembly, transit and the 28-d receiving period were not different (P more than .10). Plasma glucose and total protein concentrations were higher (P less than .05), while urea nitrogen concentration was lower (P less than .05) for implanted calves following transit. Increasing the potassium concentration of the receiving diet increased (P less than .05) post-transit weight gains, but had no affect on dry matter consumption. Corn gluten meal replaced soybean meal in the escape-protein diet and resulted in similar weight gains. Plasma urea nitrogen concentrations were higher (P less than .05) at 2 wk post-transit in the escape-protein diet group as compared with the control group. Receiving diet had no effect on the incidence or severity of bovine respiratory disease, but affected (P less than .05) performance during the subsequent 69-d stocker phase of ad libitum access to medium quality hay and 2.27 kg of supplement per day. PMID- 3957811 TI - Efficiency of growth in mice with a major gene for rapid postweaning gain. AB - Previous research in this laboratory demonstrated the existence of a major gene (hg), inherited as a homozygous recessive, which increases postweaning growth by 40 to 50% in C57Bl/6 mice (Ch) compared to the same genetic stock without the major gene (CH). Although its effect has not been previously evaluated, this single recessive allele is also in a line of mice selected for rapid postweaning gain for over 70 generations. Gh represents that line of mice with the major gene for growth (hg) in the growth-selected background and GH the growth-selected background without the major gene. Total body weight, daily weight gain, feed consumption and gain/feed, measured daily from 21 to 42 d of age, were all significantly greater (p less than .01) in the two lines with the hg/hg genotype (Ch and Gh) compared with their respective control lines (CH and GH). Differences in body composition at 42 d of age between CH compared with Ch and GH compared with Gh were accounted for by difference in body weight. Gross and net energetic efficiency, calculated assuming a similar maintenance energy requirement, were improved (P less than .01) in Ch and Gh compared to CH and GH, respectively. The results demonstrated that hg influences growth in growth-neutral and growth selected backgrounds. The gene also alters energy metabolism by increasing energetic efficiency of growth and(or) decreasing maintenance energy requirement. PMID- 3957812 TI - Effect of boar presence before and after weaning on estrus and ovulation in sows. AB - Two hundred sixty-two sows were used to investigate the effects of boar exposure during the last week of nursing (BPRE) and after weaning (BPOST) on the return to estrus. Because approximately one-half of the sows were weaning their first litter, a third factor, primiparous vs multiparous (LITT), was considered in the statistical analysis. To evaluate the effect of treatment on ovarian activity, the sows were also blood-sampled twice weekly for 3 wk after weaning for the measurement of plasma progesterone concentrations as an index of ovulation. Boar exposure after weaning was the most important stimulus of early ovulation and estrus after weaning (P less than .001). A greater proportion of first-litter sows exhibited estrus later (P less than .02) and ovulated later (P less than .09) than did multiparous sows. First-litter sows were unaffected (P greater than .10) by boar exposure before weaning. Multiparous sows were sensitive to boar exposure during nursing. Maximal boar exposure for these sows (BPRE + BPOST) resulted in 95% of sows in estrus and ovulating within 20 d of weaning. No boar exposure resulted in 45% and 38% anestrus and anovulatory sows. Boar exposure, either before or after weaning, was effective in reducing the number of anestrus and anovulatory sows to between 15 to 30%. The effects of BPRE and BPOST on return to ovulation were additive and approximately equal. PMID- 3957810 TI - Maternal behavior of beef cows at parturition. AB - Over an 11-yr period maternal behavior, calf birth weight and calf condition were recorded within 24 h for 2,684 parturitions. Maternal behavior was rated on a scale from 1 to 11, where 1 indicated extreme aggressiveness and 11 indicated no maternal attentiveness. Birth condition was rated on a scale from 1 to 9, with 9 being fattest and 1 thinnest. Respective breed means of Hereford, Angus, Charolais and Red POll were 6.2, 5.3, 6.0, and 5.7 for maternal behavior rating; 30.6, 27.3, 39.2 and 32.6 kg for birth weight, and 5.5, 4.7, 5.6 and 5.5 for birth condition. Heritability estimates for maternal rating, birth weight and birth condition were .06 +/- .01, .48 +/- .02 and .19 +/- .01, respectively. Genetic correlations between maternal rating and birth weight and condition were .04 +/- .05 and -.02 +/- .06, respectively. These results suggest that, in the population of cows studied, nongenetic influences were the primary cause of differences in aggressiveness of cows at parturition. PMID- 3957814 TI - Influence of level of feeding and nutrient content of the concentrate on growth and development of yearling horses. AB - Three experiments using 63 Thoroughbred and Quarter Horse yearlings were conducted to evaluate the influence of level of feeding, and protein and calculated energy content of pelleted concentrates on growth and bone development. Animals were housed in drylot paddocks and individually fed concentrates twice daily. Coastal bermudagrass (Cynodon dyctylon) hay was group fed. Yearlings offered a corn-based concentrate (3.56 Mcal digestible energy [DE]/kg) consumed levels of dry matter similar to yearlings fed a mixed-grain concentrate (3.32 Mcal DE/kg but consumed slightly more digestible energy. No differences in growth or bone development were detected. Yearlings fed restricted levels of concentrate that provided approximate National Research Council (NRC) recommendations for protein and DE had lower weight and girth gains (P less than .05) than those provided ad libitum concentrate intake during two 1.5-h daily feeding periods. Restricting concentrate intake had no effect on skeletal growth (P less than .05) but resulted in numerically lower values for bone radiographic density. Protein addition to a diet restricted to approximate NRC energy intake recommendations had no effect on weight gain, body measurements or bone mineral deposition (P greater than .05) and growth and development was less than that resulting from higher intakes of a lower protein concentrate. PMID- 3957813 TI - Implanting young bulls with zeranol from birth to four slaughter ages: I. Live measurements, behavior, masculinity and carcass characteristics. AB - Seventy-two Simmental bull calves were allotted randomly at birth to either a zeranol (Ralgro) implanted (I) treatment or a nonimplanted control (C) group. At birth, bulls assigned to the I treatment were implanted with 36 mg of zeranol and reimplanted at average intervals of 84 d until slaughter. Calves were weaned at 7.2 mo, preconditioned for 2 wk, and randomly assigned by treatment to slaughter ages of 12.0, 13.8, 15.7 and 17.4 mo and fed an 83% concentrate diet until slaughter. At 7.7 mo and all slaughter ages, live weights and hip heights were similar (P greater than .10), but I bulls had lower (P less than .05) masculinity scores than C bulls. Scrotal circumferences for I bulls were smaller (P less than .05) at 7.7, 12.0, 13.8 and 15.7 mo, but similar (P greater than .10) at 17.4 mo to C bulls. Behavioral observations of passive bunting, mounting attempts, facility rubbing and overall activity were less (P less than .05) for I bulls than C bulls from 12.0 to 13.8 mo but similar (P greater than .10) from 13.8 to 17.4 mo. Aggressive bunting was less (P less than .05) for I bulls during five of the seven observation times for the 12.0-to-13.8-mo period only. Slaughter and carcass weights and dressing percentages were similar (P greater than .10) for I and C bulls. Skeletal maturity and marbling scores, fat thicknesses, yield grades and 9-10-11th rib fat percentages were higher (P less than .05) and lean maturities, forehead hide weights, high dermis thicknesses, femur measurements and 9-10-11th rib bone weights and percentages were lower (P less than .05) for I than C bulls. Rib eye areas and carcass masculinity traits of jump muscle and crest of I bulls were less (P less than .05) at 13.8 mo but reached similar (P greater than .10) development to C bulls at 15.7 mo. Testicle weights of I bulls were lighter (P less than .05) at 12.0, 13.8 and 15.7 mo, but similar (P greater than .10) to C bulls at 17.4 mo. Growth traits (all weights plus hide and femur measurements) and maturation traits (skeletal and lean maturities, marbling scores, fat thicknesses and pizzle eye sizes) increased the most from 12.0 to 13.8 mo and 13.8 to 15.7 mo, respectively. We concluded that implanting young bulls with zeranol from birth to slaughter had minimal effects on live measurements, improved carcass desirability and delayed masculinity and behavioral development. PMID- 3957815 TI - Birth weight, dystocia and calf mortality in some New Zealand beef breeding herds. AB - Calf mortality data were summarized from four experiments, including a total of 15,694 birth records over 39 herd-years. Two experiments at Waikite and Waikeria were long-term, straightbred Angus and Hereford selection trials and the other two, at Goudies and Tokanui stations, were comparisons of 11 sire breeds mated to Angus and Herefore cows. The objective of the analyses was to study the relationship between birth weight (BW) and calf mortality for both calf sexes and for different dam age or parity groups. Overall calf death rates from birth to weaning were greater (P less than .01) from 2-yr-old than from older dams at Waikite (13.4 vs 5.3%) and Waikeria (14.7 vs 5.2%). Sex differences in death rate within 2 d of birth were small for calves from older dams. Death rate of males vs females from 2-yr-old dams were 9.1 vs 3.2% (Waikite) and 17.7 vs 10.5% (Waikeria). Mature Angus dams at Goudies had 3.7% calf deaths at birth (4.9 vs 2.4% for males vs females), a further 1.8% calf deaths to weaning and 4.6% assisted births. The BW of calves at Waikite from Angus 2-yr-old vs older dams averaged, respectively, 6.8 and 6.5% of their dam's precalving live weights. Corresponding figures for Waikeria Angus were 7.8 and 6.6% and for Waikite Herefords, 7.3 and 6.9%. Quadratic regressions revealed that, on a whole-herd basis, a small increase in BW would have no effect on total mortality at Waikeria and would decrease total mortality at Waikite; regression lines were different in shape and minimum value for calves from the two dam age groups. Quadratic models also provided an adequate fit to data from Goudies and Tokanui. There was no particular threshold BW. PMID- 3957816 TI - Vitamin B12 and monensin effects on performance, liver and serum vitamin B12 concentrations and activity of propionate metabolizing hepatic enzymes in feedlot lambs. AB - Monensin in ruminant diets increases production of propionic acid. We have tested the hypothesis that propionic acid may be elevated to such an extent by monensin that it cannot be optimally metabolized by the methyl malonyl-CoA pathway requiring vitamin B12 (B12) in the liver. Thus, the effects of weekly B12 injections (10 mg X head-1 X wk-1, intramuscularly) with and without dietary monensin (25 mg/kg diet) on average daily gain (ADG), dry matter intake (DMI), feed to gain ration (F/G), liver and serum B12 concentrations and liver activity of propionate metabolizing enzymes were examined in an 84-d trial. Sixteen lambs (27.5 kg average initial wt) were assigned randomly to one of four treatments in a factorial arrangement: monensin plus B12, monensin without B12, no monensin plus B12 and no monensin without B12. Lambs were fed an 80% concentrate diet and slaughtered at the end of the trial. Liver samples were obtained by biopsy on d 0 and at slaughter on d 84 to determine activity of propionate metabolizing enzymes and B12 concentrations. Serum samples were taken on d 0, 28, 56 and 84 to determine serum B12 concentration. Neither monensin nor B12 affected (P greater than .10) ADG, DMI or F/G. Lambs receiving B12 had higher (P less than .01) serum B12 concentrations, but this was not reflected (P greater than .10) in higher liver B12 concentrations. No difference (P greater than .10) in liver propionate metabolizing activity among treatments was detected; however, monensin decreased (P less than .05) fumarate and malate formation by liver homogenates. Liver B12 concentrations were highly correlated with endogenous propionate metabolizing activity at d 0 (r = .73, P less than .01) and d 84 (r = .51, P less than .05). Results suggest no advantage to providing supplemental B12 to lambs fed monensin supplemented, high-concentrate diets. PMID- 3957817 TI - Use of injectable vitamin E and selenium-vitamin E emulsion in ewes and suckling lambs to prevent nutritional muscular dystrophy. AB - Forty-eight Blackbelly X Dorset, 27 Finnish, 26 Finnish X Dorset, 28 Rambouillet and 8 Dorset Suffolk-sired lambs were used in this experiment. Three weeks before lambing, one-half of the ewes received a selenium emulsion (Se-E) containing .05 mg selenium and 3.7 IU of vitamin E/kg body weight (BW). A 2 X 3 X 2 factorial arrangement was used; lambs from either treated or nontreated ewes were randomly assigned irrespective of breed to one of six treatment combinations consisting of 0 or .025 mg/kg BW selenium (Se) injected at birth or two .025 mg/kg BW Se injections, one at birth and one 2 to 3 wk later, and two levels of injectable Vitamin E (E; 0 and 100 IU) given at birth. Both lambs and ewes were provided access to 75% concentrate diets supplemented with Se and E at recommended NRC levels. Plasma activity of creatine phosphokinase (CPK) was highest at 1 d of age and exhibited decreases (P less than .001) over time. In lambs, the E injection tended to decrease plasma activity of CPK. Plasma glutathione peroxidase activity was lowest at 1 d of age and increased over the course of the experiment but was unaffected by treatments (P less than .05). Plasma tocopherol concentration decreased (P less than .01) with time, with E therapy tending to increase tocopherol concentration. Differences in mean plasma tocopherol concentrations among breeds were also observed (P less than .01). Selenium concentration increased over time and with the E injection (P less than .01). An interaction between ewe and lamb Se-E treatments also was observed (P less than .10), with nontreated lambs from nontreated ewes exhibiting lower Se concentrations than treated lambs from injected ewes. An increase in lamb plasma Se concentration was noted in response to Se-E treatments (P less than .001). In the ewes, plasma tocopherol concentration was lower while Se concentration was higher at 18 d than at 1 d postpartum (P less than .01 and P less than .001, respectively). Milk Se concentration was lower at 18 d than at 1 d (P less than .001) and was higher (P less than .10) in Se-E-treated ewes. PMID- 3957818 TI - Niacin assay by monitoring changes in electrical conductance caused by microbial growth. AB - A computerized Malthus 128 H Growth Analyser was used to determine the changes in conductance produced by growth of a niacin-dependent strain of Lactobacillus plantarum ATCC 8014 in different concentrations of niacin in the growth medium. Changes in conductance varied linearly with the niacin concentration in the range 5-50 ng/ml. The time required to complete a test is inversely related to the inoculum size, and results can be obtained after 6 h. PMID- 3957819 TI - Adaptation of rat knee meniscus to prolonged exercise. AB - The morphological and biochemical adaptations of knee meniscus to prolonged exercise were studied. Female Sprague-Dawley rats maintained under controlled environmental conditions were randomly assigned to either an endurance-trained or a sedentary group. Training consisted of a progressive exercise protocol on a motor-driven treadmill, 5 days/wk for 12 wk. Knee lateral menisci were obtained from anesthetized rats and used for morphological and biochemical analyses. Gastrocnemius succinate dehydrogenase increased 65% in the endurance-trained group, as evidence for a training effect. In the trained group, collagen, proteoglycan, and calcium concentrations increased significantly in the posterior region of the lateral meniscus. In contrast, no significant changes were found in the anterior region of the lateral meniscus. The region-specific changes in meniscal concentrations of calcium and matrix macromolecules in response to prolonged exercise are consistent with the distinctly different mechanical properties and functional roles of the anterior and posterior regions of the rat knee meniscus. PMID- 3957820 TI - Energy balance in exercise-trained rats acclimated at two environmental temperatures. AB - The present study was carried out to investigate the effects of exercise training on energy balance in male rats acclimated at two different environmental temperatures. Sedimentary and exercised rats were housed and trained at either 24 or 4 degrees C, with the training program consisting of running on a motor-driven treadmill within their respective environments. After 45 days, energy, protein, and fat contents of rats were determined together with the energy content of food and feces. The results show that metabolizable energy intake was reduced by 10% in exercise-trained groups. Substantial differences in energy gains were observed between sedentary and trained rats; sedentary rats showed almost three times more energy gain than trained rats. Carcass analysis revealed the energy gain differences to be mainly due to varied amounts of fat deposition. Energy expenditure (kJ) excluding the cost of exercise training was corrected for metabolic body size (BW 0.75), which in turn showed no significant differences between trained rats and their respective sedentary controls. The present results suggested that exercise training in rats leads to neither increase nor decrease in energy expenditure through components additional to physical activity. The present results also indicated that brown adipose tissue thermogenesis, as assessed through mitochondrial guanosine 5'-diphosphate binding, was not significantly modified by exercise training, regardless of the temperature at which the rats were housed and trained. PMID- 3957821 TI - Density dependence of maximal expiratory flow before and during tracheal constriction in dogs. AB - The effect of carbachol-induced central bronchoconstriction on density dependence of maximal expiratory flow (MEF) was assessed in five dogs. MEFs were measured on air and an 80% He-20% O2 mixture before and after local application of carbachol to the trachea. Airway pressures were measured using a pitot-static probe, from which central airway areas were estimated. At lower concentrations of carbachol the flow-limiting site remained in the trachea over most of the vital capacity (VC), and tracheal area and compliance decreased in all five dogs. In four dogs, decreases in choke point area predominated and produced decreases in flows. In one dog the increase in airway "stiffness" apparently offset the fall in area to account for an increase in MEF. Density dependence measured as the ratio of MEF on HeO2 to MEF on air at 50% of VC increased in all five dogs. Increases in density dependence appeared to be related to increases in airway stiffness at the choke point rather than decreases in gas-related airway pressure differences. Lower concentrations produced a localized decrease in tracheal area and extended the plateau of the flow-volume curve to lower lung volumes. Higher concentrations caused further reductions in tracheal area and greater longitudinal extension of bronchoconstriction, resulting in upstream movement of the site of flow limitation at higher lung volumes. Density dependence increased if the flow limiting sites remained in the trachea at mid-VC but fell if the flow-limiting site had moved upstream by that volume. PMID- 3957822 TI - Critique on application of diaphragmatic time-tension index to spontaneously breathing humans. AB - Bellemare and Grassino (J. Appl. Physiol. 53: 1196-1206, 1982) have reported that the diphragmatic time-tension index (TTdi) (i.e., the product of mean transdiaphragmatic pressure/maximum transdiaphragmatic pressure and the inspiratory duty cycle) can be used as a predictor of diaphragmatic fatigue in humans. However, the publications of these authors do not directly address the question of whether inspiratory flow or transdiaphragmatic pressure should be used to calculate the inspiratory duty cycle. To gather data on this point, we computed TTdi by both methods in spontaneously breathing normal adult males (AMN) and age-matched males with chronic obstructive pulmonary disease (COPD) at rest and during treadmill exercise. During rest and exercise in both AMN and COPD, the fraction of the breathing cycle over which diaphragmatic tension was maintained (Tdi/TT) exceeded the fraction of the breathing cycle over which inspiratory airflow was maintained (TI/TT). Therefore, TTdi calculations using Tdi/TT were greater (P less than 0.05) than TTdi computations using TI/TT. However, this difference in TTdi values was relatively small (approximately 15%). PMID- 3957823 TI - Description and validation of an ECG removal procedure for EMGdi power spectrum analysis. AB - We describe a cross-correlation procedure for removing contaminating electrocardiogram (ECG) complexes from the diaphragmatic electromyogram (EMGdi). First, the operator selects ECG templates from the EMGdi signal during expiratory intervals. Second, these templates are used to locate ECG complexes occurring during inspiratory EMGdi activity. Third, at the point of maximum correlation between the template and these ECG complexes, the template is adjusted in size and offset to "match" the ECG complex, and adjustments are determined by the linear regression coefficients. Finally, the modified template is subtracted from the EMGdi signal. To evaluate our method, we compared the power spectral density (PSD) obtained from processing EMGdi signals by our method with those obtained from the EMGdi signal in which ECG complexes had been removed by gating. Our results indicate that PSD obtained by these two different methods shows no statistically significant differences with respect to the following features: centroid frequency, median frequency, total power, standard deviation, skewness, and kurtosis. PMID- 3957825 TI - Beyond the principle of similitude: renormalization in the bronchial tree. AB - The average dimensions (diameter, length, and volume) of the airways in the mammalian bronchial tree, long thought to be exponential functions of the generation number, are shown to be power laws in generation number modulated by a harmonic variation. These data are satisfactorily described by means of a functional scaling relation--renormalization group property--between successive generations for the average variable of interest. This type of scaling may provide a mechanism for the morphogenesis of complex but highly stable structures. PMID- 3957824 TI - Method of high-precision microsample blood and plasma mass densitometry. AB - The reliability of the mechanical oscillator technique (MOT) for blood and plasma mass density measurements on small samples is quantified in this paper. Sources of measurement errors that can reduce both the accuracy and precision of density determinations include storage of plasma samples, inhomogeneity of blood samples, and density reading before adequate temperature equilibration. Measurements on fractions from identical samples and repeated samplings from test subjects under steady-state conditions revealed a 10(-2) g/l reproducibility of density readings. The mean plasma density (PD) readings did not change significantly after up to 1-wk storage at +4 degrees C or up to 2 mo storage at -20 degrees C. The variability of the PD findings increased with storage time and were generally higher with storage at -20 degrees C, compared with +4 degrees C. Densitometers of different sizes were used to evaluate rheological influences on blood density (BD) readings. Linear correlations between PD and plasma protein concentration, between BD and blood hemoglobin concentration, and between erythrocyte density and mean corpuscular hemoglobin concentration were significant (P less than 0.001). Rapid density measurements with up to 10(-2) g/l reliability on small (less than 0.1 ml) volumes of biological fluids and continuous blood densitometry can be performed with use of the MOT. PMID- 3957826 TI - Dynamic lung compliance in newborn and adult cats. AB - Static (Cstat) and dynamic (Cdyn) lung compliance and lung stress relaxation were examined in isolated lungs of newborn kittens and adult cats. Cstat was determined by increasing volume in increments and recording the corresponding change in pressure; Cdyn was calculated as the ratio of the changes in volume to transpulmonary pressure between points of zero flow at ventilation frequencies between 10 and 110 cycles/min. Lung volume history, end-inflation volume, and end deflation pressure were maintained constant. At the lowest frequency of ventilation, Cdyn was less than Cstat, the difference being greater in newborns. Between 20 and 100 cycles/min, Cdyn of the newborn lung remained constant, whereas Cdyn of the adult lung decreased after 60 cycles/min. At all frequencies, the rate of stress relaxation, measured as the decay in transpulmonary pressure during maintained inflation, was greater in newborns than in adults. The frequency response of Cdyn in kittens, together with the relatively greater rate of stress relaxation, suggests that viscoelasticity contributes more to the dynamic stiffening of the lung in newborns than in adults. A theoretical treatment of the data based on a linear model of viscoelasticity supports this conclusion. PMID- 3957827 TI - Oxygen delivery and utilization in hypothermic dogs. AB - Hypothermia produces a decrease in metabolic rate that may be beneficial under conditions of reduced O2 delivery (Do2). Another effect of hypothermia is to increase the affinity of hemoglobin for O2, which can adversely affect the release of O2 to the tissues. To determine the overall effect of hypothermia on the ability of the peripheral tissues to extract O2 from blood, we compared the response to hypoxemia of hypothermic dogs (n = 8) and of normothermic controls (n = 8). The animals were anesthetized, mechanically ventilated, and paralyzed to prevent shivering. The inspired concentration of O2 was progressively reduced until the dogs died. The core temperatures of the control and hypothermic dogs were 37.7 +/- 0.3 and 30.5 +/- 0.1 degree C, respectively (P less than 0.01). The O2 consumption (VO2) of the control dogs was significantly greater than that of the hypothermic dogs (P less than 0.05), being 4.7 +/- 0.4 and 3.2 +/- 0.3 ml X min-1 X kg-1, respectively. Hypothermia produced a left shift of the oxyhemoglobin dissociation curve (ODC) to a PO2 at which hemoglobin is half saturated with O2 of 19.8 +/- 0.7 Torr (control = 32.4 +/- 0.7 Torr, P less than 0.01). The O2 delivery at which the VO2 becomes supply dependent (DO2crit) was 8.5 ml X min-1 X kg-1 for control and 6.2 ml X min-1 X kg-1 for hypothermia. The hypothermic dogs maintained their base-line VO2's at lower arterial PO2's than control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957828 TI - Pulmonary vascular response to leukotriene D4 in unanesthetized sheep: role of thromboxane. AB - We examined the pulmonary vascular response to an intravenous leukotriene D4 (LTD4) injection of (1 microgram X kg-1 X min-1 for 2 min) immediately followed by infusion of 0.133 microgram X kg-1 X min-1 for 15 min in awake sheep prepared with lung lymph fistulas. LTD4 resulted in rapid generation of thromboxane A2 as measured by an increase in plasma thromboxane B2 concentration. The thromboxane B2 generation was associated with increases in pulmonary arterial and pulmonary arterial wedge pressures while left atrial pressure did not change significantly. Pulmonary lymph flow (Qlym) increased (P less than 0.05) transiently from base line 6.87 +/- 1.88 (SE) ml/h to maximum value of 9.77 +/- 1.27 at 15 min following the LTD4 infusion. The maximum increase in Qlym was associated with an increase in the estimated pulmonary capillary pressure. The increase in Qlym was not associated with a change in the lymph-to-plasma protein concentration (L/P) ratio. Thromboxane synthetase inhibition with dazoxiben (an imidazole derivative) prevented thromboxane B2 generation after LTD4 and also prevented the increases in pulmonary vascular pressures and Qlym. We conclude that LTD4 in awake sheep increases resistance of large pulmonary veins. The small transient increase in Qlym can be explained by the increase in pulmonary capillary pressure. Thromboxane appears to mediate both the pulmonary hemodynamic and lymph responses to LTD4 in sheep. PMID- 3957829 TI - Effect of flow direction on collateral ventilation in excised dog lung lobes. AB - We determined the effect of flow direction on the relationship between driving pressure and gas flow through a collaterally ventilating lung segment in excised cranial and caudal dog lung lobes. He, N2, and SF6 were passed through the lung segment distal to a catheter wedged in a peripheral airway. Gases were pushed through the segment by raising segment pressure (Ps) relative to airway opening pressure (Pao) and pulled from the segment by ventilating the lobe with the test gas, then lowering Ps relative to Pao. Driving pressures (Ps - Pao) between 0.25 and 2 cmH2O were evaluated at Pao values of 5, 10, and 15 cmH2O. Results were similar in cranial and caudal lobes. Flow increased as Ps - Pao increased and was greatest at Pao = 15 cmH2O for the least-dense gas (He). Although flow direction was not a significant first-order effect, there was significant interaction between volume, driving pressure, and flow direction. Dimensional analysis suggested that, although flow direction had no effect at Pao = 10 and 15 cmH2O, at Pao = 5 cmH2O, raising Ps relative to Pao increased the characteristic dimension of the flow pathways, and reducing Ps relative to Pao reduced the dimension. These data suggest that at large lobe volumes, airways (including collateral pathways) within the segment are maximally dilated and the stiffness of the parenchyma prevents any significant distortion when Ps is altered. At low lobe volumes, these pathways are affected by changes in transmural pressure due to the increased airway and parenchymal compliance. PMID- 3957831 TI - Unique spectral peak in phrenic nerve activity characterizes gasps in decerebrate cats. AB - The respiratory pattern of gasping has been characterized on the phrenic nerve as rapidonset, rapid-rise, large-amplitude bursts of neural activity. Furthermore, medullary sites critical for the neurogenesis of gasping have been identified and are not the sites of identified respiratory neurons, such as the dorsal and ventral respiratory groups. I classified envelopes of phrenic nerve activity as eupneic breaths, or gasps based on the time-domain features of duration, shape, and amplitude. Gasps were elicited by hypoxia and low blood pressure in 9 of 12 decerebrate cats. Inspiratory times were 1.15 +/- 0.43 (SD) for eupneic breaths and 0.55 +/- 0.18s for gasps. The high-frequency peaks in the power spectra of phrenic nerve activity were at 80 +/- 13 Hz for eupneic breaths and at 120 +/- 21 Hz for gasps. Three of the 12 cats developed a breathing pattern that began as a normal breath and terminated in a gasp. Power spectra of the normal portion had eupneic spectral peaks (75 +/- 24 Hz); power spectra of the gasp portion had the high peaks at 110 +/- 23 Hz, a value 1.5 times higher than that for the normal peaks. Although this analysis of peripheral nerve activity cannot distinguish between two central pattern generators at two distinct anatomical sites or one pattern generator operating in two distinct modes, the fact that gasps were much shorter in duration and had markedly higher spectral peaks than control breaths supports the idea that the central pattern generator for gasping is not the central pattern generator for eupnea. PMID- 3957830 TI - Plasma lactate and ventilation thresholds in trained and untrained cyclists. AB - Six trained male cyclists and six untrained sedentary men were studied to determine whether the plasma lactate threshold (PLT) and ventilation threshold (VT) occur at the same work rate in both fit and unfit populations. The PLT was determined from a marked increase in plasma lactate concentration ([La]) and VT from a nonlinear increase in expired minute ventilation (VE) during incremental leg-cycling tests; work rate was increased 30 W every 2 min until volitional exhaustion. The trained subjects' mean VO2 max (63.8 ml O2 X kg-1 X min-1) and VT (65.8% VO2 max) were significantly higher (P less than 0.05) than the untrained subjects' mean VO2max (35.5 ml O2 X kg-1 X min-1) and VT (51.4% VO2 max). The trained subjects' mean PLT (68.8% VO2 max) and VT did not differ significantly, but the untrained subjects' mean PLT (61.6% VO2 max) was significantly higher than their VT. The trained subjects' mean peak [La] (10.5 mmol X l-1) did not differ significantly from the untrained subjects' mean peak [La] (11.5 mmol X l 1). However, the time of appearance of the peak [La] during passive recovery was inversely related to VO2 max. These results suggest that variance in lactate diffusion and/or removal processes between the trained and untrained subjects may account in part for the different relationships between the VT and PLT in each population. PMID- 3957832 TI - Hypoxemia lowers cerebrovascular resistance without changing brain and blood [H+]. AB - We designed the present study to see whether, during acute moderate isocapnic hypoxemia, changes in cerebral vascular resistance (CVR) and brain extracellular fluid (ECF) [H+] can or cannot be dissociated from each other. In seven anesthetized and paralyzed dogs we measured brain ECF pH with surface electrodes (n = 4) or double-barreled microelectrodes (n = 3) with tip diameters of less than 30 micron inserted 5 mm below the surface. Cerebral blood flow (CBF) was measured by radioactive microspheres during normoxemia and moderate hypoxemia, whereas brain ECF pH was measured continuously. In six of the seven dogs brain pH did not change during moderate hypoxemia of 4-20 min duration. In these six animals the mean arterial O2 partial pressure decreased from 84.8 +/- 12.9 (SD) to 46.7 +/- 10.2 Torr during hypoxic gas breathing, resulting in a significant drop in CVR from 3.88 +/- 1.88 to 3.27 +/- 1.97 Torr X ml-1 X min X 100 g and a rise in CBF from 31.7 +/- 12.7 to 47.8 +/- 31.5 ml X min-1 X 100 g-1. The mean brain ECF [H+] was 57.4 +/- 8.2 nmol/l (pH = 7.24) during normoxemia and did not change significantly during hypoxic gas breathing [56.6 +/- 7.7 nmol/l (pH = 7.25)]. Furthermore, arterial and sagittal venous blood and cisternal cerebrospinal fluid (CSF) pH did not change significantly during hypoxic gas breathing. We conclude that during acute moderate hypoxemia reduction in CVR can occur independently from increases in brain ECF, cisternal CSF, and arterial and sagittal venous blood [H+] and PCO2. PMID- 3957833 TI - Contamination of lung lymph following standard and modified procedures in sheep. AB - The sheep lung lymph fistula preparation of Staub et al. is reported to be contaminated by systemic lymph. The published estimates of contamination range from 5% (awake sheep) to 60% (anesthetized sheep). In view of these conflicting estimates, we investigated the pre- and postoperative contaminating sources, morphological and functional consequences of the proposed contamination reducing modifications, and base-line lung lymph flow in awake sheep following standard and modified cannulation procedures. Our morphological observations are not compatible with the higher estimates of contamination (25-60%). Evidence of lymph leakage from cauterized lymphatics was found. The lymphatics that appear after diaphragmatic cautery and partial resection of caudal mediastinal lymph node were found to constitute "new" contaminating sources. The lymph flow data from base line and increased vascular pressure conditions were consistent with the reported low estimates of contamination (5%). We propose simple modifications of the standard procedure of Staub et al. which may be nearly as effective in reducing contamination by extrapulmonary lymph as the more invasive and/or traumatic modifications. PMID- 3957834 TI - Use of NMR for measurement of total body water and estimation of body fat. AB - A nuclear magnetic resonance (NMR) method is described for quantitatively measuring total body water (TBW) and for estimating the fat content of baboons. The hydrogen associated with water was measured as the amplitude of the free induction decay voltage following a series of 90 degree radio frequency pulses at the Lamour frequency for hydrogen with a pulse length of 14 microseconds and a peak measuring time of 50 microseconds. TBW was calculated by multiplying the peak amplitude (volts) by the experimentally determined constant for a water standard (g water/V). This NMR method yielded TBW contents similar to those obtained in the same baboons by direct gravimetric procedures. In contrast, the widely used 3H2O-dilution method usually and variably overestimated body water. By providing an accurate measure of body water, this NMR procedure provides a rapid, noninvasive, reasonably accurate way of estimating body fat content. PMID- 3957835 TI - Hemodynamic effects of resistive breathing. AB - To examine the acute hemodynamic effects induced by large swings in intrathoracic pressure such as may be generated by obstructive lung disease, airway obstruction was simulated by means of two different fixed external alinear resistances and the results were compared with those for unobstructed breathing (C). Eight normal subjects breathed through external resistances during inspiration (I), expiration (E), or both (IE) at rest (Re) and exercise (Ex). The resistances were chosen to induce similar mouth pressure (Pm) swings at Re and Ex. Pleural pressures (Ppl) were found to correlate closely with Pm. During IE resistive breathing mean swings in Pm were -31 and +19 cmH2O at Re and -38 and +22 cmH2O at Ex, with a corresponding decrease in minute ventilation (-30 and -18%) and an increase in end-tidal PCO2 (+5.6 and +4.2 Torr); these were associated with an increase in heart rate (delta HR = 4 and 6 beats/min) and systolic systemic arterial pressure (delta Psas = 10 and 14 Torr at Re and Ex, respectively). O2 consumption and cardiac output did not change. The myocardial O2 consumption, estimated from the product HR X (Psas--Ppl), increased by 17 and 20% at Re and Ex, respectively. Changes in mechanics, gas exchange, and hemodynamics were less pronounced during I or E resistive loading. It is concluded that breathing through a tight external resistance during IE at Re and Ex increases the metabolic load on the myocardium. PMID- 3957836 TI - Phrenic afferents and their role in inspiratory control. AB - In anesthetized cats, with vagi cut and the spinal cord severed at the C8 level, phrenic motor and/or sensory discharge was recorded. Small afferent phrenic fibers were identified through their activation by lactic acid, hyperosmotic NaCl solution, or phenyl diguanide. They exhibited a spontaneous but irregular low frequency discharge. Block of their conduction by procaine had no effect on eupneic motor phrenic activity. Large afferent phrenic fibers showed a spontaneous rhythmic discharge, and cold block (6 degrees C) of these fibers significantly prolonged the phrenic discharge time (Tphr) and total breath duration (TT) during eupnea. The stimulation of all afferent phrenic fibers lowered the impulse frequency of phrenic motoneurons (f impulses) and shortened both Tphr and TT. When the stimulation was performed during cold block all of the effects on phrenic output persisted, but changes in timing were less pronounced. Under procaine block, only the effects of phrenic nerve stimulation on Tphr persisted. These results suggest that both large and small afferent phrenic fibers control the inspiratory activity with a prominent role of small fibers on phrenic motoneuron impulse frequency. PMID- 3957837 TI - Intravenous acid infusion without lowering arterial pH stimulates breathing. AB - The aim of this study was to determine whether increases in ventilation would occur during intravenous acid infusion even if systemic arterial pH was held constant. In six awake ponies, HCl (500 ml, approximately 0.312 M) was infused into the right atrium at a total dose of 1.0 meq/kg over 18 min while an equivalent dose of NaOH was infused into the left heart to restore systemic arterial pH to normal. Total ventilation increased at the onset of the infusion and remained elevated although systemic arterial pH was normal to slightly alkaline. The increase in ventilation during the initial 2 min of the infusion coincided with an increase in pulmonary arterial PCO2 and decrease in pulmonary arterial pH. As the infusion progressed, however, pulmonary arterial pH and PCO2 returned to near control values due to the recirculation of systemic arterial blood with an acid-base status that had been altered consequent to the hyperventilation. Pulmonary arterial blood pressure was increased significantly during the entire infusion. Infusion of equivalent doses of hypertonic saline led to only minor alterations in the variables that were measured. These experiments demonstrate that this dose of intravenous HCl can increase ventilation independent of reductions in systemic arterial pH. Because increases in ventilation and pulmonary arterial H+ were not well correlated throughout the entire infusion, and pulmonary arterial blood pressure was increased, it is not clear if the mechanism for this ventilatory response is due to stimulation of pulmonary chemoreceptors, pulmonary vascular mechanoreceptors, or some other mechanism unrelated to increases in systemic arterial H+ concentration. PMID- 3957839 TI - Velocity profiles in central airways with endotracheal intubation: a model study. AB - Steady inspiratory velocity profiles were measured at two flow rates in a 3:1 scale model of the human central airways in the presence of five modes of endotracheal intubation. The presence of an orifice or a short endotracheal tube had no significant effect on the velocity profiles distal to the carina. Long endotracheal tubes change the profiles in both main bronchi. A significant peak occurred in the frontal plane near the walls, and the maximum velocity in the airway was almost identical to the endotracheal tube center-line velocity. The flow impinging on the medial wall of the main bronchus was redirected up around the anterior and posterior walls yielding bipeak velocity profiles in the sagittal plane. A tube placed eccentrically in the trachea over the right main bronchus did not alter the velocity profiles in the left main bronchus, suggesting a redirection of flow over the carina into the left lung. An endobronchial tube at the mouth of the right main bronchus did change the shape of the velocity profiles in the left main bronchus. In the left upper lobar bronchus the presence of trachea intubation had no effect on the velocity profiles. However, in the right upper lobar bronchus, the long endotracheal tube flattened the velocity profiles from the strongly skewed ones seen in the absence of the endotracheal inserts. These results not only are relevant to distribution of ventilation and aerosol particle deposition, but also have strong implications in intrapulmonary gas mixing, especially when high-frequency low tidal-volume ventilation is involved. PMID- 3957838 TI - Determinants of behavioral response with ozone exposure. AB - Three separate experiments were performed to evaluate how the topography of a behavioral response and its consequences influence the behavioral effects produced by ozone (O3) exposure. The first experiment measured the responding of food-deprived rats working to obtain intermittent delivery of small pellets of food by completing an active response, wheel running. Low O3 concentrations (0.12 ppm) reduced the frequency of running responses maintained by this fixed-interval 10-min schedule of food delivery. The second experiment examined the effects of O2 on food-deprived rats performing a response (nose poking) that required minimal physical effort to produce deliveries of food pellets. Rats in this situation began to show reductions in responding at 0.5 ppm O3. A third experiment showed that responses requiring minimal physical effort, such as lever pressing, can be a sensitive index of O3 exposure if the response provides access to wheel running. We concluded that increased physical activity during exposure appeared to be an important variable in determining sensitivity to O3 exposure. PMID- 3957840 TI - Criteria for mucus transport in the airways by two-phase gas-liquid flow mechanism. AB - The critical conditions for mucous layer transport in the respiratory airways by two-phase gas-liquid flow mechanism were investigated by using 0.5- and 1.0-cm-ID tube models. Several test liquids with rheological properties comparable to human sputum were supplied continuously into the vertically positioned tube models in such a way that the liquid could form a uniform layer while traveling upward through the tube with a continuous upward airflow. The critical airflow rate and critical liquid layer thickness required for the upward transport of the liquids were determined. The critical airflow rate was in the Reynolds number (Re) range of 142-1,132 in the 0.5-cm-ID tube model and 708-2,830 in the 1.0-cm-ID tube model depending on the types of liquids tested. In both models, the critical airflow rate was lower with viscoelastic liquids than with viscous oils. The critical liquid layer thickness ranged from 0.2 to 0.5 mm in the 0.5-cm-ID tube model and 0.8 to 1.4 mm in the 1.0-cm-ID tube model at Re of 2,800. These values decreased rapidly with increasing airflow rate. The critical thickness relative to the tube diameter ranged from 3 to 15% of the respective tube diameter and was lower by approximately 30-50% in the 0.5-cm-ID tube model than in the 1.0-cm-ID tube model over the entire Re range tested. The results indicate that the critical conditions for the mucus transport by two-phase gas-liquid flow mechanism are within the range that can be achieved in patients with bronchial hypersecretions during normal breathing. PMID- 3957841 TI - Mucus transport in the airways by two-phase gas-liquid flow mechanism: continuous flow model. AB - Mucus transport speed induced by two-phase gas-liquid interaction was measured in the continuous two-phase annular flow tube models, and factors influencing the transport speed were assessed in conjunction with rheological properties of mucus. The flow model was made with 1.0-cm-ID glass tubes and positioned either vertically or horizontally. During a continuous passage of airflow through the model tube, mucus stimulants were supplied into the tube at a rate of 0.5-2.0 ml/min. The advancing speed of the leading edge of the mucous layer and mean mucous layer thickness were then measured. The transport speed in the vertical tube model ranged from 1.1 to 3.1 cm/min with a mucus feed rate of 0.5 ml/min at airflow rates of 0.33-1.17 l/s and increased with increasing airflow rates but decreased rapidly with increasing viscosity of mucus. The transport speed increased almost proportionally with increasing mucus feed rate. Elasticity of mucus did not affect the transport speed itself. However, more elastic mucus caused lower flow resistance and thereby could be transported with a much reduced work load. The transport speed in the horizontal tube model was 5-60% faster than that in the vertical tube model. The mean mucous layer thickness in the vertical tube model was found to be in the range of 0.5-1.5 mm in the experimental conditions used, and decreased rapidly with increasing airflow rate and decreasing viscosity of mucus. From these data the transport speed could be functionally related to airway diameter, mucous layer thickness, and mucus production rate. PMID- 3957842 TI - Effects of 0.5 ppm ozone on glycoprotein secretion, ion and water fluxes in sheep trachea. AB - We studied the effects of ozone (O3) exposure on airway mucus secretion. Sheep were exposed in vivo to 0.5 ppm O3, 4 h/day for 2 days (acute, n = 6), 6 wks (chronic, n = 6) or 6 wks + 1 wk recovery (chronic + recovery, n = 6). Secretion of glycoproteins (radiolabeled with 35SO4 and [3H]threonine), and transepithelial fluxes of Cl-, Na+ and water were subsequently measured in tracheal tissues in vitro, and were compared with values from control, unexposed sheep (n = 8). Acute O3 exposure increased basal secretion of sulfated glycoproteins (P less than 0.05), but had no effect on ion fluxes. Chronic exposure reduced basal glycoprotein secretion, but increased net Cl- secretion. Under open-circuit conditions, chronic exposure also induced net water secretion (P less than 0.05). With 7 days recovery, basal glycoprotein secretion (predominantly sulfated) was greatly increased above control, while the increased net secretion of Cl- and of water persisted (P less than 0.05). Histology of the airways indicated that acute exposure induced moderate hypertrophy of submucosal glands in the lower trachea (P less than 0.05), while chronic exposure (with and without recovery) induced a large hypertrophy of submucosal glands in both upper and lower trachea (P less than 0.05). Without recovery, however, the gland cells were devoid of secretory material, whereas with recovery they were full of secretory material. This suggests that the decreased glycoprotein secretion with chronic exposure alone resulted from incomplete replenishment of intracellular stores after 6 wks of stimulation. We conclude that both short- and long-term O3 exposure causes airway mucus hypersecretion. PMID- 3957843 TI - Three degree of freedom description of movement of the human chest wall. AB - A three degree of freedom description of movement of the human chest wall is presented. In addition to the standard variables representing surface displacements of the rib cage and abdominal wall in transverse planes, the description includes a variable representing axial displacements of the chest wall associated with postural movements of the spine and pelvis. A simple technique was developed for quantifying the axial displacements using a single measurement by magnetometry of changes in the distance between a point on the anterior surface of the rib cage near the xiphisternum and a point on the abdominal surface near the pubic symphysis. It was found that axial displacements produced by either flexion-extension of the spine or rotation of the pelvis in the standing postures can be treated as a single degree of freedom. The chest wall displacements induced over the range of axial displacement examined were as large as those normally accompanying a change in lung volume on the order of 30 50% of the vital capacity. It is concluded, however, that although this additional degree of freedom can cause large chest wall displacements, it probably cannot independently change lung volume. This implies that the system is constrained so that there are only a limited number of independent modes of chest wall movement that are capable of producing significant changes in lung volume. It also suggests that the system is constructed so that lung volume can be relatively independent of certain postural distortions of the chest wall. PMID- 3957844 TI - Verapamil and zero Ca2+ alter responses of cat muscle to halothane and caffeine. AB - Strips of soleus (slow twitch, oxidative) and gracilis (fast-twitch, glycolytic) muscle were obtained from 27 anesthetized cats and mounted in organ baths filled with oxygenated Krebs-Ringer solution (37 degrees C). The responses to caffeine, halothane (1%), caffeine in the presence of halothane, and electrical stimulation in the presence of halothane were examined in the two fiber types. These responses were compared with those observed in paired strips of muscle that had been treated with verapamil (10 or 28 microM), a slow calcium (Ca2+) channel blocker, with zero Ca2+, or with zero Ca2+ where magnesium (3.7 mM Ca2+) was added to replace the Ca2+. Halothane-induced contractures in the soleus were blocked by verapamil and zero Ca2+. Caffeine-induced contractures and tetanic contractions were attenuated in zero Ca2+ and by verapamil in both fiber types. Halothane overcame verapamil-induced reductions of caffeine contractures and tetanic contractions in both fiber types. In contrast, halothane did not overcome zero Ca2+-induced reductions in caffeine contractures or tetanic contractions in either fiber type. Furthermore, the addition of Mg2+ to the zero Ca2+ did not restore the responses. The findings with verapamil indicate that in cat muscle, both halothane- and caffeine-induced contractures and tetanic contractions are dependent on the influx of extracellular Ca2+. This extracellular Ca2+ may enter through the slow Ca2+ channels. However, because halothane in combination with caffeine or electrical stimulation overcame the effects of verapamil, there may be other sites involved. PMID- 3957845 TI - Reflex cardiovascular responses caused by stimulation of pulmonary C-fibers with capsaicin in dogs. AB - The purpose of these studies was to determine quantitatively the reflex cardiovascular responses to stimulation of the pulmonary C-fibers in dogs. We used a preparation in which the airway, pulmonary artery, and the pulmonary veins to the left lung were cannulated in situ. Ventilation and perfusion of the right lung maintained the animal in relatively normal homeostasis. Capsaicin, a decylenic acid amide of vanillylamine that selectively stimulates nerve endings of unmyelinated fibers (C-fibers), was injected into the left pulmonary artery in 5-ml boluses. Maximal reflex responses were obtained with concentrations as low as 0.8-1.6 X micrograms-1 X kg-1. Heart rate, hindlimb resistance, and left ventricular contractility were lowered transiently (the maximal responses showing declines of 40, 13, and 15.2%, respectively). As a result of these changes, combined with vasodilation in other resistance vessels, cardiac output fell 28% and blood pressure fell 35%. Interrupting the afferent neural pathway by severing the ipsilateral cervical vagus nerve eliminated these responses, confirming the distribution of their reflex origin. Although the role of these reflexes in homeostasis has not been decided, the results of this study suggest that the lungs of dogs, if appropriately stimulated, potentially can exert a major inhibitory influence on the neural regulation of cardiovascular function. PMID- 3957846 TI - Mechanisms by which dopamine alters blood flow distribution during lobar collapse in dogs. AB - Dopamine increases blood flow to a hypoxic left lower lobe in dogs. To elucidate possible mechanisms, left lower lobe collapse was induced in anesthetized dogs, and lobar (QLLL) and total (QT) pulmonary blood flow was measured by electromagnetic flow probes. Dopamine infusion increased mean pulmonary arterial pressure (Ppa), QT, and QLLL. However, the increase in QLLL was double that produced by a similar increase in Ppa without increase in QT (inflation of a Swan Ganz balloon in right pulmonary artery) or by a similar increase in QT with smaller increase in Ppa (opening of arteriovenous fistulas). QLLL/QT was not changed by opening arteriovenous fistulas, but was increased by Swan-Ganz balloon inflation, and by infusion of dopamine. It is concluded that the increase in QLLL/QT produced by dopamine was due to a decrease in hypoxic vasoconstriction in the lobe secondary to an increase in mixed venous PO2 and to vasoconstriction in the oxygenated lung. PMID- 3957847 TI - Effect of cardiogenic oscillations on gas mixing during tracheal insufflation of oxygen. AB - In a previous study using tracheal insufflation of O2 (TRIO) at a rate of 2 l/min, we showed that anesthetized paralyzed dogs could be adequately oxygenated for up to 5 h, albeit with hypercapnia (mean arterial PCO2 approximately 160 Torr). To examine the contribution of cardiogenic oscillations in producing this gas exchange, we studied seven anesthetized paralyzed dogs weighing between 19.6 and 25.5 kg and quantified gas transport by analyzing continuous N2-washout curves in vivo and postmortem. We found that cardiogenic oscillations increase gas mixing roughly fourfold and that this value was independent of insufflation flow rate (0.2-10.0 l/min). Our results lend indirect evidence that, with regard to gas exchange, there are two mechanistically different zones in the lung during TRIO. One zone, located in the more peripheral areas of the lung, is dominated by the effects of cardiac oscillations and molecular diffusion and accounts for the increase in gas mixing found in the alive vs. dead dog. A second zone, close to the insufflated jet of O2, uses convective streaming to produce greater gas mixing at higher flows. PMID- 3957848 TI - Electrolyte composition of pulmonary alveolar subphase in anesthetized rabbits. AB - We measured the concentration of Na+, K+, Ca2+, and Cl- in the aqueous subphase of the alveolar lining by puncturing the most superficial alveoli of the exposed lungs of anesthetized rabbits with ion-selective microelectrodes and a nonselective KCl microelectrode. A buffered electrolyte solution bathed the lung surface to keep it moist and warm (38 +/- 1 degrees C) and to serve as a reference for each measurement of ionic concentration. The serum and alveolar concentrations (meq/l) were Na+ 134 +/- 6 and 135 +/- 5, K+ 3.4 +/- 0.2 and 7.3 +/- 0.7, Ca2+ 3.1 +/- 0.2 and 3.2 +/- 0.4, and Cl- 106 +/- 7 and 103 +/- 5 (mean +/- SD). Only K+ was significantly different (P less than 0.001). There was a small electrical potential difference between the alveolar lumen and the pleural surface (-3.5 +/- 0.8 mV, lumen negative) that was significantly different from zero (P less than 0.001). Although it is not possible to measure ion fluxes with these techniques, the results are consistent with active transport of one or more of the ions studied. PMID- 3957849 TI - Role of social support in the experience of stress at work. PMID- 3957850 TI - Role ambiguity, type A behavior, and job satisfaction: moderating effects on cardiovascular and biochemical responses associated with coronary risk. PMID- 3957851 TI - Thirty-seventh annual meeting of the Tissue Culture Association. June 4-8, 1986, Chicago, IL. Abstracts. PMID- 3957852 TI - Photomicrography of living specimens with electronic flash. PMID- 3957853 TI - A new breakthrough in ringflash design and engineering: the Minolta Macro 80PX Auto Electroflash. PMID- 3957854 TI - Stereo photography of the temporal bone. PMID- 3957855 TI - Photographing insects. PMID- 3957856 TI - Dopamine-beta-hydroxylase (DBH) and homovanillic acid (HVA) in autistic children. AB - In the present study, plasma DBH activity and urinary HVA levels were measured in 19 autistic and 15 normal children. DBH activity was significantly elevated in the 8 less retarded autistic patients. In this subgroup, a negative correlation was found between plasma DBH and urinary HVA levels. These results support the hypothesis of a possible involvement of brain catecholamine dysfunction in the production of autistic symptoms. PMID- 3957857 TI - The occurrence of autistic children's self-stimulation as a function of familiar versus unfamiliar stimulus conditions. AB - The present study was conducted to determine whether certain stimulus conditions were associated with high and low rates of autistic children's self-stimulation. Six autistic boys were assessed in situations varying along three dimensions: familiarity or unfamiliarity of setting, learning task, and therapist. Each child was observed in 10 10-min stimulus conditions, and trained observers recorded the occurrence of self-stimulation within each condition. The results of a 2 x 2 x 2 ANOVA indicated that self-stimulation occurred significantly more often with an unfamiliar than with a familiar therapist. Unfamiliar versus familiar setting and task were not significant effects, and there were no significant interactions. Also, significant differences were found within each condition, with self stimulation increasing in frequency as the sessions progressed. Finally, there was a significant and negative correlation between the occurrence of self stimulation and correct responding. These findings suggest several treatment strategies for facilitating a generalized suppression of autistic children's self stimulation. PMID- 3957858 TI - Increasing simple toy play in profoundly mentally handicapped children: II. Designing special toys. AB - The purpose of this study was to increase simple toy play in profoundly mentally handicapped children by presenting them with specially designed toys. Twenty children (mean chronological age 14 years, mean mental age less than 1 year) were observed while playing with the special toys, which emitted stimuli (vibration, light, or sound) when appropriately operated. They were also observed with the toys when the stimuli were unavailable. There were large individual differences, but, in general, children interacted significantly more with the experimental toys than with the control toys and engaged in significantly less stereotyped behavior when the experimental toys were available. The implications for clinical and research work are discussed. PMID- 3957860 TI - Brief report: characteristics of methods of subject selection and description in research on autism. AB - Characteristics of autism research were examined in this survey of a subset of studies published between 1971 and 1982. Results indicated that replicability of research, and appropriate generalization of findings, are likely to be impaired because of inadequacies of subject selection procedures and omission of important descriptive information. Although there were improvements in these areas over this 12-year span, increased use of objective, quantitative measures of diagnosis of autism and assessment of intellectual abilities of autistic subjects are needed. PMID- 3957859 TI - Kinetics of 3H-serotonin uptake by platelets in infantile autism and developmental language disorder (including five pairs of twins). AB - The kinetics of 5-HT uptake by platelets was studied in cases of infantile autism and developmental language disorder (DLD) and normal subjects. Two patients of the autism group were twins, and the seven patients of the DLD group were members of four pairs of twins. The Vmax values (means +/- SD) for autism and DLD were 6.46 +/- .90 pmol 5-HT/10(7) cells/min and 4.85 +/- 1.50 pmol 5-HT/10(7) cells/min, respectively. These values were both significantly higher than that of 2.25 +/- .97 pmole 5-HT/10(7) cells/min for normal children. The Km values of the three groups were not significantly different. Data on the five pairs of twins examined suggested that the elevated Vmax of 5-HT uptake by platelets was determined genetically. PMID- 3957861 TI - Comparison of two short overcorrection procedures on the stereotypic behavior of autistic children. PMID- 3957862 TI - Further speculations on possible dopamine-opioid link in autism. PMID- 3957863 TI - A pilot study on allergic responses. PMID- 3957865 TI - Two patterns in the Aeromonas salmonicida A-layer may reflect a structural transformation that alters permeability. AB - Electron micrographs of negatively stained regular surface layers (A-layers) of Aeromonas salmonicida showed two square patterns having p4 symmetry. Computer image processing demonstrated that, at a resolution of 2.3 nm, both square arrays were composed of two different morphological units arranged alternatively to give a face-centered lattice in which the four nearest neighbors of each unit were the other type of unit. The lattice constant was slightly but significantly different in the two patterns, and the orientation of one of the two morphological units changed by about 20 degrees between patterns. These patterns were probably not derived from different strains present in the preparation, since both were seen in material that appeared to come from a single layer. This and the difference in lattice constant made it unlikely that they represented different sides of the A layer. However, it is possible that the two patterns may reflect a structural transformation of the layer. In this respect, it is interesting that the rotation of one morphological subunit changed the size of the gaps between units in the layer. This raised the possibility that the transformation could be related to a change in permeability of the A-layer, possibly analogous to that proposed for gap junctions in eucaryotic cells. PMID- 3957864 TI - Treponema phagedenis has at least two proteins residing together on its periplasmic flagella. AB - Treponema phagedenis is an anaerobic, motile spirochete with several periplasmic flagella (PFs) at each cell end. This study provides the first genetic evidence that multiple protein species are associated with the PFs. In addition, these proteins were found to reside together on a given PF. Nonmotile mutants which lacked the PFs were isolated, and spontaneous revertants to motility regained the PFs. These results suggest that the PFs are involved in the motility of T. phagedenis. Isolated PFs had two major protein bands with molecular weights of 33,000 and 39,800, as revealed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Western blots with monoclonal and polyclonal antibodies indicated that both proteins were absent in the PF mutants but present in the revertants. Immunoelectron microscopy revealed that the 39,800-molecular-weight protein was distributed along the entire PF. Immunoprecipitation analysis suggested that the 39,800- and 33,000-molecular-weight proteins were closely associated in situ. PMID- 3957866 TI - Naphthalene association and uptake in Pseudomonas putida. AB - Two methods for bacterial membrane transport, filtration and flow dialysis, were used to study cellular association of Pseudomonas putida with naphthalene. It is not technically possible to determine the exact cellular or vesicular location of the naphthalene, and because it is hydrophobic, it could be at the membrane(s) rather than inside the cells. As an index of naphthalene having crossed the inner membrane we used the intracellular formation of its first catabolite. An energized membrane or ATP was not essential for association or movement into the cell. Evidence for a nonspecific association and a movement into cells by simple diffusion are the lack of saturation of association, an absence of inhibition of association by protein inhibitors and structural analogs, and the passage of naphthalene through cell membranes in the presence of iodoacetamide. Specific naphthalene metabolism gene expression was not required for association. PMID- 3957867 TI - Genetic diversity and relationships in populations of Bordetella spp. AB - Genetic diversity in 60 strains of three nominal Bordetella species recovered from humans and other mammalian hosts was assessed by analyzing electrophoretically demonstrable allelic variation at structural genes encoding 15 enzymes. Eleven of the loci were polymorphic, and 14 distinctive electrophoretic types, representing multilocus genotypes, were identified. The population structure of Bordetella spp. is clonal, and genetic diversity is relatively limited compared with most other pathogenic bacteria and is insufficient to justify recognition of three species. All isolates of Bordetella parapertussis were of one electrophoretic type, which was closely similar to 9 of the 10 electrophoretic types represented by isolates of Bordetella bronchiseptica. Bordetella pertussis 18-323, which is used in mouse potency tests of vaccines, is more similar genetically to isolates of B. bronchiseptica and B. parapertussis than to other isolates currently assigned to the species B. pertussis. Apart from strain 18-323, the isolates of B. pertussis represented only two closely related clones, and all isolates of B. pertussis from North America (except strain 18-323) were genotypically identical. Strain Dejong, which has been classified as B. bronchiseptica, was strongly differentiated from all of the other Bordetella isolates examined. PMID- 3957868 TI - Purification and characterization of glucose oxidase from ligninolytic cultures of Phanerochaete chrysosporium. AB - Glucose oxidase, an important source of hydrogen peroxide in lignin-degrading cultures of Phanerochaete chrysosporium, was purified to electrophoretic homogeneity by a combination of ion-exchange and molecular sieve chromatography. The enzyme is a flavoprotein with an apparent native molecular weight of 180,000 and a denatured molecular weight of 80,000. This enzyme does not appear to be a glycoprotein. It gives optimal activity with D-glucose, which is stoichiometrically oxidized to D-gluconate. The enzyme has a relatively broad pH optimum of 4 to 5. It is inhibited by Ag+ (10 mM) and o-phthalate (100 mM), but not by Cu2+, NaF, or KCN (each 10 mM). PMID- 3957869 TI - Nucleotide sequence of the enterotoxin B gene from Staphylococcus aureus. AB - The complete nucleotide sequence of the enterotoxin B gene from Staphylococcus aureus, as well as the 5' and 3' flanking regions, was determined. Starting from an ATG initiator codon, an open reading frame encoded the enterotoxin B precursor that consisted of 266 amino acids (Mr, 31,400). The 5' terminal portion of the gene encodes a signal peptide 27 amino acids long. The deduced amino acid sequence matched, with a few exceptions, the published amino acid sequence of enterotoxin B. The structural gene was flanked on the 5' side by a promoter-like sequence and on the 3' side by a palindromic structure followed by a thymine-rich region that resembled a transcription termination signal. Downstream from the entB gene were two overlapping open reading frames corresponding to 134 and 185 amino acids in the opposite orientation. The signal sequence of the enterotoxin B precursor resembled that of other secreted proteins found in other bacteria. PMID- 3957870 TI - Genetic transformation of the extreme thermophile Thermus thermophilus and of other Thermus spp. AB - Genetic transformation of auxotrophs of the extreme thermophile Thermus thermophilus HB27 to prototrophy was obtained at high frequencies of 10(-2) to 10(-1) when proliferating cell populations were exposed to chromosomal DNA from a nutritionally independent wild-type strain. The transformation frequency was proportional to the DNA concentration from 10 pg/ml to 100 ng/ml. T. thermophilus HB27 cells did not require chemical treatment to induce competence, although optimal transformation was obtained by the addition of a divalent cation (Ca2+ or Mg2+). Competence was maintained throughout the growth phase, with the highest transformation frequencies at pH 6 to 9 and at 70 degrees C. T. thermophilus HB27 and four other typical Thermus strains, T. thermophilus HB8, T. flavus AT62, T. caldophilus GK24, and T. aquaticus YT1, were also transformed to streptomycin resistance by DNA from their own spontaneous streptomycin-resistant mutants. A cryptic plasmid, pTT8, from T. thermophilus HB8 was introduced into T. thermophilus HB27 Pro- at a frequency of 10(-2). PMID- 3957871 TI - Analysis of forward mutations induced by N-methyl-N'-nitro-N-nitrosoguanidine in the bacteriophage P22 mnt repressor gene. AB - We describe the isolation and genetic characterization of N-methyl-N'-nitro-N nitrosoguanidine (MNNG)-induced mutations in the phage P22 mnt repressor gene cloned in plasmid pBR322. Mutations in the mnt repressor gene or its operator on this plasmid, pPY98, confer a tetracycline resistance phenotype, whereas the wild type plasmid confers tetracycline sensitivity. Cells carrying pPY98 were briefly exposed to MNNG to give 20 to 40% survival and a 50- to 100-fold increase in tetracycline-resistant cells. DNA sequence analysis showed that 29 of 30 MNNG induced mutations were GC-to-AT transitions and one was an AT-to-GC transition. About 80% of the mutations are in three hotspots. This mutation spectrum is consistent with the proposed mechanism of mutagenic action of MNNG, which involves mispairing of an alkylated base, O6-methylguanine. The mnt gene may be a useful target for determining mutagenic specificity at the nucleotide level because forward mutations are easily isolated, the target size is small, and the DNA sequence changes of mutations can be determined rapidly. PMID- 3957872 TI - Arginine catabolism in Agrobacterium strains: role of the Ti plasmid. AB - We present a study of the enzymatic activities involved in the pathway for arginine catabolism by Agrobacterium tumefaciens. Nitrogen from arginine is recovered through the arginase-urease pathway; the genes for these two activities are probably chromosomally born. Arginase was found to be inducible during growth in the presence of arginine or ornithine. Urease was constitutively expressed. Ornithine, resulting from the action of arginase on arginine, could be used as a nitrogen source via transamination to delta 1-pyrroline-5-carboxylate and reduction of the latter compound to proline by a reductase (both enzymatic activities are probably chromosomally encoded). Ornithine could also be used as a carbon source. Thus, we identified an ornithine cyclase activity that was responsible for direct conversion of ornithine to proline. This activity was found to be Ti plasmid encoded and inducible by growth in medium containing octopine or nopaline. The same activity was also chromosomally encoded in some Agrobacterium strains. In such strains, this activity was inducible during growth in arginine-containing medium. PMID- 3957873 TI - Exopolysaccharides of the phytopathogen Pseudomonas syringae pv. glycinea. AB - Exopolysaccharides (EPS) of the soybean pathogen Pseudomonas syringae pv. glycinea were isolated from culture filtrates and infected soybean leaves. Levan (a polyfructan with a C-2----C-6 backbone and C-2----C-1 branching) or acetylated alginate (a linear polyuronide of C-1----C-4-linked mannuronic and guluronic acids) was isolated from culture filtrates when bacterial strains were grown in a semisynthetic medium containing sucrose or glucose, respectively, as the primary carbon source. Acetylated alginate was the only EPS isolated from soybean [Glycine max (L.) Merr.] leaves inoculated with compatible (disease-inducing) strains of P. syringae pv. glycinea. The acetyl content of the P. syringae pv. glycinea alginates varied from 3 to 14%, and the amount of guluronic acid varied from less than 1 to 20%. The P. syringae pv. glycinea alginates from in vitro batch cultures were of lower molecular weight and polydispersity than those from in planta cultures, and both were of lower molecular weights than alginates produced by Pseudomonas aeruginosa. PMID- 3957874 TI - Critical micelle concentrations of lipoteichoic acids. AB - Purified lipoteichoic acids (LTAs) from several gram-positive organisms have been shown, by methods involving spectral changes of an added merocyanine dye probe, to have critical micelle concentrations in the range of 1 to 10 micrograms/ml, suggesting that acylated LTAs in their monomer forms may represent the major configuration of extracellular LTAs in bacterial culture fluids. The critical micelle concentrations obtained did not differ markedly with degree of carbohydrate substitution of the polymers. The significance of these findings in relation to the biological properties of LTA is discussed. PMID- 3957875 TI - Physical and functional map of supervirulent Agrobacterium tumefaciens tumor inducing plasmid pTiBo542. AB - Agrobacterium tumefaciens strains carrying pTiBo542 induce large, fast-appearing tumors and have an unusually wide host range. A clone bank was made from this 250 kilobase plasmid in a wide-host-range vector, and restriction maps were determined for BamHI and SalI. The virulence genes, transferred DNA genes, plasmid incompatibility region, and a region that inhibits growth of certain A. tumefaciens strains were localized. The six virulence genes and two tms genes were highly homologous to the genes of pTiA6, but the tmr gene was not. Mutations in each of the six vir loci of pTiA6 were complemented by clones from the vir region of pTiBo542. PMID- 3957876 TI - Physical complaints correlate better with depression than do dexamethasone suppression test results. AB - DST responses of 67 Israeli inpatients, a group heterogeneous in ethnic background, were examined. Overall, 56% of depressed patients and 34% of patients with diagnoses other than depression were DST nonsuppressors. Ethnic background did not significantly influence the DST response. Scores on the Carroll Rating Scale for Depression (CRS) and the Physical Complaints List (PCL) did not correlate significantly with DST response. PCL scores correlated significantly with the diagnosis of depression. The data support the view that the DST has limited utility as a biologic marker of depression, but that an analysis of physical complaints using the PCL may be useful in the differential diagnosis of depression in some cultures. PMID- 3957877 TI - Response of depressed patients to sequential unilateral nondominant brief-pulse and bilateral sinusoidal ECT. AB - Of 37 endogenously depressed patients given a course of unilateral nondominant brief-pulse ECT, 20 responded well and received no further treatment; 17 showed minimal clinical improvement but improved significantly after a subsequent course of bilateral sinusoidal ECT. These findings suggest that there may be subgroups of depressed patients who respond differentially to unilateral and bilateral ECT, to high- and low-energy stimuli, or to combinations thereof. Seizure duration did not appear to be a crucial variable in the efficacy of ECT; among the unilateral nonresponders, seizures of equal duration induced by unilateral stimulation were not as therapeutically effective as those induced by bilateral ECT. Response to the first three ECTs appeared to be the only predictor of unilateral responsiveness. PMID- 3957878 TI - Monosymptomatic hypochondriacal psychosis manifesting as delusions of infestation: case studies of treatment with haloperidol. AB - Pimozide has been successfully used in the treatment of delusions of infestation; however, it is not widely available in the United States. Similarities in both chemical structure and degree of potency suggest that haloperidol may be an alternative treatment for this syndrome. Three cases of delusions of infestation successfully treated with haloperidol are described. In all three the symptoms were relieved acutely; in two the improvement was maintained. PMID- 3957879 TI - The demographic profile of borderline personality disorder. AB - In a survey of borderline personality disorder, 23 studies that included data on age, sex, or race of the patient samples were identified. Comparison of patients who had borderline personality disorder with control groups in these studies revealed that a significant preponderance of patients with the disorder were young, white, and female. This finding cannot be considered conclusive because data were pooled from studies with questionable sampling techniques. Yet, this demographic profile warrants confirmation because it may imply diagnostic biases or actual differences in the prevalence of borderline personality disorder among various groups. PMID- 3957880 TI - Atropine and glycopyrrolate as ECT preanesthesia. AB - Twenty-four patients receiving ECT were systematically studied to compare the effects of two dosages of atropine and two dosages of glycopyrrolate as preanesthetic agents. Glycopyrrolate resulted in more cardiac arrhythmias, nausea and vomiting, and episodes of bradycardia than atropine (p = .4). More patients receiving atropine showed post-ECT confusion, but the clinical impact of this was minimal. Atropine appears to be preferable to glycopyrrolate for use in ECT preanesthesia. PMID- 3957881 TI - Pathological gambling and major affective disorder: preliminary findings. AB - Twenty-five pathological gamblers were examined for additional DSM-III diagnoses and family history of psychiatric illness. Eighteen subjects (72%) had experienced at least one episode of major depression, and 13 (52%) had recurrent major affective episodes. A high prevalence (20%) of panic disorder and/or agoraphobia was also found. PMID- 3957882 TI - Late-life paraphrenia: an organic delusional syndrome. AB - Five patients with late-life onset of schizophrenic symptomatology (late-life paraphrenia) were found to have occult organic disorders. Although it was not possible to prove that the organic disorders were causal in these patients, none had any psychiatric illness until late in life and none had any significant risk factors for developing schizophrenia. This study demonstrates the need to investigate the medical and neurologic condition of any elderly patient presenting with a new onset of delusions. Modern investigative techniques may permit more accurate classification (and therapy) of some patients with late-life paraphrenia. PMID- 3957883 TI - Organic affective syndrome associated with metoclopramide: case report. AB - Metoclopramide, a substituted benzamide derivative, was orally administered to a patient with intractable hiccups. Dysphoria, akathisia, depressed mood with suicidal ideation, insomnia, racing thoughts, and labile affect were seen following the administration of metoclopramide. The episode met criteria for an organic affective syndrome. It is suggested that the mental status of patients undergoing metoclopramide therapy be monitored, since these symptoms have not been previously reported. PMID- 3957884 TI - Bethanechol chloride can reverse erectile and ejaculatory dysfunction induced by tricyclic antidepressants and mazindol: case report. AB - A 43-year-old man who experienced profound dose-related erectile and ejaculatory dysfunction without loss of libido on three separate antidepressants and on the anorectic agent mazindol is described. Bethanechol chloride 20 mg p.o., taken 1 to 2 hours prior to sexual activity, permitted satisfactory erection and ejaculation during sexual intercourse, while the patient continued to take protriptyline or mazindol. Bethanechol chloride may prove to be of use in treating sexual dysfunction associated with drugs or conditions which increase sympathetic tone. PMID- 3957885 TI - Verapamil in the treatment of premenstrual syndrome: case report. AB - A woman with a long history of premenstrual tension syndrome (PMS) received verapamil for treatment of mitral valve prolapse. Associated with verapamil therapy was a decreased severity in many symptoms of PMS, including agitation, depression, emotional outbursts, and irritability. A possible mechanism is discussed. PMID- 3957886 TI - Axis II character disorders in PTSD. PMID- 3957887 TI - EEG and CT scan in Alzheimer's disease. PMID- 3957888 TI - The multiple dangers of smoking. PMID- 3957889 TI - Improvement in tardive dyskinesia and MMPI scores with propranolol. PMID- 3957890 TI - ECT in delusionally depressed patients. PMID- 3957891 TI - Panic attacks and psychomotor seizures following right temple lobectomy. PMID- 3957893 TI - The folding type of a protein is relevant to the amino acid composition. AB - The folding types of 135 proteins, the three-dimensional structures of which are known, were analyzed in terms of the amino acid composition. The amino acid composition of a protein was expressed as a point in a multidimensional space spanned with 20 axes, on which the corresponding contents of 20 amino acids in the protein were represented. The distribution pattern of proteins in this composition space was examined in relation to five folding types, alpha, beta, alpha/beta, alpha + beta, and irregular type. The results show that amino acid compositions of the alpha, beta, and alpha/beta types are located in different regions in the composition space, thus allowing distinct separation of proteins depending on the folding types. The points representing proteins of the alpha + beta and irregular types, however, are widely scattered in the space, and the existing regions overlap with those of the other folding types. A simple method of utilizing the "distance" in the space was found to be convenient for classification of proteins into the five folding types. The assignment of the folding type with this method gave an accuracy of 70% in the coincidence with the experimental data. PMID- 3957892 TI - ATP synthesis in cell envelope vesicles of Halobacterium halobium driven by membrane potential and/or base-acid transition. AB - Cell envelope vesicles active in ATP synthesis were prepared from Halobacterium halobium cells, which genetically lack bacteriorhodopsin, by sonication in the presence of substrates. ATP was synthesized when vesicles were illuminated to build up membrane potential through the action of halorhodopsin. The threshold value of membrane potential for ATP synthesis was about -100 mV relative to the external medium, i.e., inside-negative. ATP synthesis also occurred in the dark upon acidification of the external medium of a suspension of cell envelope vesicles. This base-acid transition ATP synthesis took place when the pH difference was greater than 1.6 units. The threshold pH difference was lowered when the base-acid transition was carried out under dim light which induced a membrane potential of about -100 mV. Regardless of the sort of driving force, ATP synthesis was optimum at the intravesicular pH of around 6.5 and almost nil at 8, where ATP syntheses by F0F1 type ATPases in other organisms are most active. The synthesis could be inhibited by N,N'-dicyclohexylcarbodiimide (DCCD) with a half maximum inhibition at around 25 microM/2 mg protein/ml. These results strongly suggest that in halobacteria a DCCD-sensitive H+-translocating ATP synthase is in operation which is driven by membrane potential and/or pH gradient, and obeys chemiosmotic energetics. The results also suggest that the ATP synthase may not be identical to F0F1 type H+-translocating ATPases found in mitochondria, chloroplasts and eubacteria. PMID- 3957894 TI - Binding between thermolysin and its specific inhibitor, N-phosphoryl-L-leucyl-L tryptophan (PLT). AB - The interaction between thermolysin and its specific inhibitor, PLT (N-phosphoryl L-leucyl-L-tryptophan), has been investigated by steady-state inhibitory kinetics analysis, fluorometric titration, and the stopped-flow method. The inhibitor constant of PLT, Ki, and the dissociation constant of thermolysin(E)-PLT(I) complex, Kd, are found to be smaller by a factor of 4 to 300, depending on pH, resulting in stronger binding, than those of talopeptin and phosphoramidon, but all of them show similar pH dependence. The dependence of the apparent first order rate constant, Kapp, on the inhibitor concentration is consistent with a minimum two-step mechanism, including a fast bimolecular step followed by a slow unimolecular step, (Formula: see text). The values of K-1 (the dissociation constant of the intermediate EItr) and K-2 (the backward rate constant in the unimolecular step) are not so significantly different between PLT and talopeptin, while the K+2 (forward rate constant in the unimolecular step) value for PLT is about 14 times larger than that of talopeptin (pH 5.5). These facts suggest that the forward rate of the isomerization step, EItr----EI, is much larger in the absence of the sugar moiety of talopeptin, and hence it induces the stronger binding of PLT to thermolysin than that of talopeptin. PMID- 3957895 TI - Production of nitrite ions from trinitrophenyl myosin and from trinitrophenyl subfragment-1. AB - When trinitrophenyl (TNP) myosin of either chicken breast muscle or porcine cardiac muscle was left to stand in an alkaline medium at 20 degrees C for several hours, nitrite ions were found to be gradually produced. The nitrite production from myosin trinitrophenylated in the presence of PPi occurred at the same rate and to the same extent as that from myosin trinitrophenylated in the absence of PPi. The nitrite production was significantly reduced when thiols of myosin were modified with 2-nitro-5-thiocyanobenzoate. Four different preparations of TNP subfragment-1, S1(Aa), S1(Ab), S1(Ba), and S1(Bb), were obtained from chymotryptic digest of chicken breast myosin trinitrophenylated in the absence of PPi. When these preparations of TNP-S1 were left to stand at alkaline pH, a significant amount of nitrite was produced from S1(Ab) and S1(Bb), but very little from S1(Aa) and S1(Ba). In our previous report (J. Biochem. 97, 965-968, 1985), S1(Aa) and S1(Ba) were suggested to correspond to "non-burst" heads of myosin, and S1(Ab) and S1(Bb) to "burst" heads of the myosin molecule (Inoue et al. (1980) Adv. Biophys. 13, 1-194). Therefore, the present findings described above strongly suggest that the nitrite production involves some interaction of TNP groups with thiols, and that it occurs at the "burst" heads. PMID- 3957896 TI - A method for direct incorporation of radiolabeled cholesteryl ester into human plasma low-density-lipoproteins: preparation of tracer substrate for cholesteryl ester transfer reaction between lipoproteins. AB - [14C]Cholesteryl ester was directly incorporated into human plasma low-density lipoproteins (LDL) for the purpose of preparing a tracer substrate for investigation of the cholesteryl ester transfer reaction between plasma lipoproteins. The radiolabeled cholesteryl oleate was sonicated with egg phosphatidylcholine to form cholesteryl ester-containing liposomes. The liposomes were incubated with plasma fraction of density greater than 1.006 at 37 degrees C in the presence of dithionitrobenzoic acid. When the distribution of the radiolabeled cholesteryl ester was equilibrated among liposomes and lipoprotein fractions, the mixture was applied to an affinity chromatography column of dextran sulfate-cellulose (LA01) (Arteriosclerosis 4, 276-282). LDL was eluted by increasing the NaCl concentration and was finally isolated as a floating fraction by ultracentrifugation at a solvent density of 1.063 (adjusted with NaCl). The chemical composition, electrophoretic mobility and density of the labeled LDL were consistent with those of the native LDL. Radioactivity in this preparation was present exclusively in cholesteryl ester. Apolipoprotein B100 was preserved intact throughout the procedure. When the rate of cholesteryl ester transfer was measured between LDL and high-density lipoproteins by using this labeled LDL, the kinetics was consistent with the equilibrium transfer model, but the apparent rate measured was slightly higher than that measured with the labeled LDL prepared by the method using the intrinsic cholesterol esterification reaction of plasma. PMID- 3957897 TI - Subunit structure and multiple phosphorylation sites of phospholamban. AB - The phosphorylation-induced mobility shift of the high molecular weight form of phospholamban (24,500 daltons) in the cardiac sarcoplasmic reticulum produced on 3',5'-cyclic AMP (cAMP)-dependent phosphorylation with 5 mM ATP was resolved into five clear steps on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and on Ca2+-calmodulin-dependent phosphorylation into ten steps. The mobility shift of the low molecular weight form of phospholamban (less than 14,400 daltons) in these reactions occurred in one step and two steps, respectively. With the two protein kinase activities, the electrophoretic pattern of the mobility shifts of the high and low molecular weight forms of phospholamban was similar to that obtained with Ca2+-calmodulin-dependent protein kinase alone. The results of pulse-chase experiments involving the centrifuge column method suggested that the site(s) of phosphorylation by cAMP- and Ca2+ calmodulin-dependent protein kinase activities are on the same phospholamban molecule. Two-dimensional tryptic peptide maps of phosphorylated phospholamban indicated that cAMP-dependent protein kinase phosphorylates at a single site, A, and Ca2+-calmodulin-dependent protein kinase phosphorylates at sites C1 and C2 in the low molecular weight form, where A is different from C1 but may be the same as C2. The high molecular weight form of phospholamban is suggested to be a pentamer of identical monomers (low molecular weight form) having one phosphorylation site for cAMP-dependent protein kinase and two for Ca2+ calmodulin-dependent protein kinase. PMID- 3957898 TI - Retinoic acid 5,6-epoxidation by hemoproteins. AB - Retinoic acid 5,6-epoxidase activity was found in several hemoproteins such as human oxy- and methemoglobin (HbO2 and MetHb), equine skeletal muscle oxy- and metmyoglobin (MbO2 and MetMb), bovine liver catalase, and horseradish peroxidase. Hematin also catalyzed retinoic acid 5,6-epoxidation. The results suggest that the heme moiety participates in the epoxidation. However, neither horse heart cytochrome c, nor free ferrous ion nor free ferric ion exhibited the epoxidase activity. Some hemoproteins (HbO2, MetHb, MbO2, MetMb, catalase, peroxidase, and hematin) exhibited characteristic individual pH dependences of the activity, suggesting that the epoxidase activities of the hemoproteins are influenced by the apoenzymes to some degree. This view is also supported by the finding that preincubation of an HbO2 preparation at various temperatures (37-70 degrees C) reduced its epoxidase activity with increasing temperature, whereas the activity of hematin was unaffected. Active oxygen scavengers such as mannitol, catalase, and superoxide dismutase exhibited no effect on the epoxidase activities of HbO2, MetHb, MbO2, and MetMb. A ligand of heme, CN- (100 mM), inhibited the epoxidase activities but N3- (100 mM) did not. The epoxidase activities were completely inhibited by NADPH, NADH, and/or 2-mercaptoethanol but not by NADP+ and/or NAD+. An intermediate in the epoxidation may be reduced by NADPH, NADH and/or 2 mercaptoethanol. Radical species can be considered as plausible candidates for the intermediate. PMID- 3957899 TI - Purification of a cytotoxic protein produced by the murine macrophage-like cell line J774.1 in response to Sarcophaga lectin. AB - A tumor specific cytotoxic protein produced by the murine macrophage-like cell line J774.1 in response to stimulation with Sarcophaga lectin was purified to homogeneity in three steps from the culture medium. This cytotoxin, named tumor killing factor (TKF), was a protein with a molecular weight of 15,000, and aggregated forming an oligomer with a molecular weight of 48,000. Its amino acid composition was similar to that of human TNF. Purified TKF had a significant effect on transplanted murine ascites tumor sarcoma 180. The biological significance of TKF in terms of ontogeny is discussed from the view point of developmental biology. PMID- 3957900 TI - Interaction of monodispersed and micellar phospholipids with an Agkistrodon halys blomhoffii phospholipase A2, in which the alpha-amino group had been modified to an alpha-keto group. AB - The pH dependence of the binding constant of Ca2+ to a phospholipase A2 of Agkistrodon halys blomhoffii, in which the alpha-amino group had been selectively modified to an alpha-keto group, was studied at 25 degrees C and ionic strength 0.1 by the tryptophyl fluorescence method. The dependence was compared with the results for the intact enzyme (Ikeda et al. (1981) J. Biochem. 90, 1125-1130). The pH-dependence curve could be well interpreted in terms of the participation of the two ionizable groups Asp 49 and His 48, with pK values of 4.70 and 6.69, respectively. These values were slightly different from the respective pK values for the intact enzyme, 5.15 and 6.45. Ca2+ binding to the intact enzyme involves the participation of an additional ionizable group with a pK value of 7.30, which was thus assigned as alpha-amino group. The pH dependence of the binding constant of monodispersed n-dodecylphosphorylcholine (n-C12PC) to the alpha-NH2-modified enzyme was studied at 25 degrees C and ionic strength 0.1 by the aromatic circular dichroism (CD) method. The pH-dependence curve for the modified apoenzyme was interpreted as reflecting the participation of a single ionizable group with a pK value of 4.7, which was assigned to Asp 49 (to which a Ca2+ ion can coordinate) since the curve for the Ca2+ complex lacked this transition: the binding constant was independent of pH. The pH-dependence curves for the intact apoenzyme and its Ca2+ complex involve the participation of an additional ionizable group with pK values of 7.30 and 6.30, respectively (Ikeda & Samejima (1981) J. Biochem. 90, 799-804), which was assigned as the alpha-amino group. The hydrolysis of monodispersed 1,2-dihexanoyl-sn-glycero-3-phosphorylcholine (diC6PC), catalyzed by the intact and the alpha-NH2-modified enzymes was studied by the pH stat method at 25 degrees C, pH 8.2, and ionic strength 0.1 in the presence of 3 mM Ca2+. The Km value for the modified enzyme was found to be very similar to that for the intact enzyme: this was compatible with the results of the direct binding study on the monodispersed n-C12PC under the same conditions. However, the kcat value was about 43% of the value for the intact enzyme, suggesting that the alpha-keto group introduced by the chemical modification perturbed the network of hydrogen bonds in the active site.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3957901 TI - Binding of iron by factor IX. Possible role for beta-hydroxyaspartic acid. AB - In concentrations exceeding 1 mg/ml, bovine factor IX exhibits a pink color that arises from a broad absorption band with a lambda max = 500 nm. Analysis by x-ray fluorescence reveals the presence of iron but no other transition metals in the factor IX preparation. Quantitative analysis by atomic absorption spectroscopy indicates that 1 g atom of iron is bound tightly to 1 mol of factor IX. The iron is removed slowly (t1/2 = 3 h) by EDTA. In contrast, prothrombin binds no detectable iron, and factor X binds less than 0.2 g atom/mol. alpha Hydroxybutyrate chelates Fe3+ with sufficient stability to preclude formation of [Fe(OH)3]n. It is proposed that factor IX binds iron with physiologically significant affinity and that the beta-hydroxyaspartate residue in factor IX is a chelator for the bound metal. PMID- 3957902 TI - Metabolism and structure of triacylglycerols in rat epididymal fat pad adipocytes determined by 13C nuclear magnetic resonance. AB - Carbon-13 nuclear magnetic resonance (NMR) methods have been applied to a study of the structure and metabolism of the triacylglycerols from rat epididymal fat pad adipocytes. Complete NMR signal assignments are provided for adipocytes, the extracted triacylglycerols, and methyl esters of the derived fatty acids. 13C NMR yielded rapid, nondestructive, quantitative analysis of the amounts of unsaturation of the fatty acyl chains; in cells from rats given ad libitum access to a standard laboratory diet the predominant fatty acids were found to be palmitate (29.9%), oleate (27.9%), and linoleate (34.1%). These results agreed with gas chromatographic separation of the derived methyl esters of the extracted lipids. Lipid dynamics were examined in situ and showed a substantial restriction of motion of glyceride-glycerol as compared with free glycerol; the nuclear magnetic spin-lattice relaxation times for free glycerol of 2.52 +/- 0.12 (C1,3) and 4.37 +/- 0.21 (C2) s decreased to 0.15 +/- 0.009 and 0.21 +/- 0.013 s, respectively, upon esterification. Segmental motion of the chains, monitored by relaxation time measurements, increased progressively from the alpha-carbon (nT1 = 0.70 s) to the methyl ends of the chains (nT1 = 9.63). The incorporation of C 13-labeled substrates ([1-13C]glucose and [3-13C]lactate) into the glycerol moiety of triacylglycerols was monitored in real time, in the presence of insulin. Lactate (10 mM) inhibited the incorporation of glucose (5.5 mM) into glyceride-glycerol. Lipolysis at the natural abundance level of 13C was measured in the presence of 10 microM isoproterenol. Simultaneous lipogenesis and lipolysis were found to occur in situ and were measured with the aid of [1 13C]glucose and isoproterenol; the labeling pattern of medium glycerol versus extracted triacylglycerols was significantly different from that found using natural abundance glucose. Our results indicate that 13C NMR is a useful new method for the real-time monitoring of lipid structure and metabolism in vivo. PMID- 3957903 TI - Branched chain alpha-keto acid oxidative decarboxylation in skeletal muscle mitochondria. Effect of isolation procedure and mitochondrial delta pH. AB - In order to study branched chain alpha-keto acid oxidative decarboxylation in skeletal muscle mitochondria, an improved procedure was developed for isolating muscle mitochondria. The procedure uses the protease Nagase in mannitol sucrose media (Procedure A). These mitochondria exhibited high rates of oxygen consumption, good respiratory control ratios, and improved rates of branched chain alpha-keto acid oxidation. At 20 microM [1-14C]alpha-ketoisovalerate (KIV), rates were 1.99 +/- 0.09 nmol/mg of mitochondrial protein/min versus 0.85 +/- 0.02 in mitochondria prepared in electrolyte media without Nagase treatment (Procedure B). The apparent kinetic constants for KIV and alpha-ketoisocaproate (KIC) oxidation were determined. In the presence of ATP, the Vmax and K0.5 for KIV were 17.7 +/- 2.5 nmol/mg of mitochondrial protein/min and 82 microM, respectively. The K0.5 for KIV was at least 2-fold higher than for KIC as were apparent Vmax values. Branched chain alpha-keto acid oxidative decarboxylation in skeletal muscle mitochondria was compared to the activity in mitochondria isolated from liver, heart, and kidney. Rates of KIV and KIC oxidative decarboxylation were highest in heart mitochondria and quite similar in skeletal muscle, liver, and kidney mitochondria. It is the low mitochondrial content of mixed skeletal muscle, not the specific activity of the branched chain alpha-keto acid dehydrogenase, that limits muscle oxidative capacity. The data also indicate that the total activity in muscle has been routinely underestimated. Addition of ATP which increased the matrix pH (increases delta pH) stimulated the rate of oxidative decarboxylation of branched chain alpha-keto acids. On the other hand, addition of uncoupler which decreased the delta pH inhibited the rate of oxidation. Nigericin in low K+ medium inhibited oxidation to about the same degree as uncoupler, while addition of valinomycin in high K+ medium, which will decrease the electrical potential, had little effect on oxidation rates. Transport of branched chain alpha-keto acids should be sensitive to the mitochondrial pH gradient. Hence, the effects of ATP and the mitochondrial inhibitors on rates of branched chain alpha-keto acid oxidation suggest that mitochondrial transport may be partially rate-controlling for oxidation at physiological concentrations of the branched chain alpha-keto acids. PMID- 3957904 TI - Specific pools of phospholipids are used for lipoprotein secretion by cultured rat hepatocytes. AB - Since phospholipids are major components of all serum lipoproteins, the role of phospholipid biosynthesis in lipoprotein secretion from cultured rat hepatocytes has been investigated. In liver, phosphatidylcholine is made both by the CDP choline pathway and by the methylation of phosphatidylethanolamine, which in turn is derived from both serine (via phosphatidylserine) and ethanolamine (via CDP ethanolamine). Monolayer cultures of rat hepatocytes were incubated in the presence of [methyl-3H]choline, [1-3H] ethanolamine, or [3-3H]serine. The specific radioactivity of the phospholipids derived from each of these precursors was measured in the cells and in the secreted lipoproteins of the cultured medium. The specific radioactivities of phosphatidylcholine and phosphatidylethanolamine derived from [1-3H]ethanolamine were markedly lower (approximately one-half and less than one-tenth, respectively) in the secreted phospholipids than in the cellular phospholipids. Thus, ethanolamine was not an effective precursor of the phospholipids in lipoproteins. On the contrary, the specific radioactivity of phosphatidylcholine made from [methyl-3H]choline was approximately equal in cells and lipoproteins. In addition, over the first 4 h of incubation with [3-3H]serine, the specific radioactivities of phosphatidylcholine and phosphatidylethanolamine were significantly higher in the lipoproteins than in the cells. These data indicate that there is not a random and homogeneous labeling of the phospholipid pools from the radioactive precursors. Instead, specific pools of phospholipids are selected, on the basis of their routes of biosynthesis, for secretion into lipoproteins. PMID- 3957905 TI - Neplanocin A. Actions on S-adenosylhomocysteine hydrolase and on hormone synthesis by GH4C1 cells. AB - We have investigated the biochemical actions of Neplanocin A (Nepl A), a carbocyclic adenosine analog, on purified calf liver S-adenosylhomocysteine hydrolase and in the GH4C1 strain of functional rat pituitary cells. Addition of 1 mol of Nepl A/2 mol of S-adenosylhomocysteine hydrolase subunit led to rapid and complete inactivation. Concomitant with inactivation, half of the enzyme bound NAD was reduced and adenine was released stoichiometrically from Nepl A. In GH4C1 cells Nepl A caused a dose-dependent rapid (within 5 min) and irreversible inactivation of S-adenosylhomocysteine hydrolase and concomitant increase in intracellular S-adenosylhomocysteine. In cells treated with Nepl A for 4-5 days, methylation of DNA cytosine was depressed approximately 50%, and the level of cytoplasmic prolactin mRNA was elevated 2-fold. While acute (30 min) release of prolactin from intracellular stores was unaffected, Nepl A acted in a dose- and time-dependent manner to increase the production of both prolactin and growth hormone, the two hormones synthesized and secreted by GH4C1 cells. The lowest effective dose was 0.12 microM, the concentration required to decrease S adenosylhomocysteine hydrolase activity by 50%. By 4-7 days the production of both hormones in Nepl A-treated cells was increased 2-3 times above control. The action on hormone production persisted for at least 7 days after removal of Nepl A from the culture medium. We conclude that Nepl A inhibits S adenosylhomocysteine hydrolase, raises cellular S-adenosylhomocysteine, decreases bulk DNA methylation, and increases hormone synthesis in GH4C1 cells. PMID- 3957906 TI - UDP-glucose 4-epimerase from Saccharomyces fragilis. Presence of an essential arginine residue at the substrate-binding site of the enzyme. AB - UDP-glucose 4-epimerase from Saccharomyces fragilis was inactivated by the arginine-specific reagents phenylglyoxal, 1,2-cyclohexanedione, and 2,3 butanedione following pseudo first order reaction kinetics. The reaction order with respect to phenylglyoxal was 1.8 and that with respect to the other two diones was close to unity. Protection afforded by substrate and competitive inhibitors against inactivation by phenylglyoxal and the reduced interaction of 1 anilinonaphthalene 8-sulfonic acid, a fluorescent probe for the substrate-binding region after phenylglyoxal modification, suggested the presence of an essential arginine residue at the substrate-binding region. Experiments with [7 14C]phenylglyoxal in the presence of UMP, a ligand known to interact at the substrate-binding region, showed that only the arginine residue at the active site could be modified by phenylglyoxal. The characteristic coenzyme fluorescence of the yeast enzyme was found to be enhanced three times in phenylglyoxal inactivated enzyme suggesting the incorporation of the phenyl ring near the pyridine moiety of NAD. PMID- 3957907 TI - Stereochemistry and function of oxaloacetate keto-enol tautomerase. AB - Oxaloacetate keto-enol tautomerase, partially purified from porcine kidney, catalyzes the conversion of enol- to keto-oxaloacetate by a mechanism in which solvent protons end up equally distributed between the two prochiral positions at C3 of keto-oxaloacetate. This conclusion is based upon the observation that when enzyme catalyzed ketonization is conducted in 3H2O in the presence of excess malate dehydrogenase and NADH, only 50% of the 3H in the isolated (2S)-[3 3H]malate is labilized to solvent upon treatment with fumarase. From a stereochemical perspective, this enzyme is unlike phenylpyruvate keto-enol tautomerase that is known to catalyze stereospecific proton transfer between solvent and the pro-R position of keto-substrate. As a result of an attempt to clarify the physiological importance of oxaloacetate tautomerase activity, keto oxaloacetate was demonstrated to be directly transported across the inner membrane of rat liver mitochondria on the basis of the results of kinetic and isotope-trapping experiments. PMID- 3957908 TI - D-2 dopamine receptor-mediated inhibition of pro-opiomelanocortin synthesis in rat intermediate lobe. Abolition by pertussis toxin or activators of adenylate cyclase. AB - Stimulation of the D-2 dopamine receptor inhibits pro-opiomelanocortin (POMC) synthesis in isolated rat intermediate lobe tissue. Intermediate lobe tissue was incubated in the absence or presence of various dopaminergic compounds, and then its capacity to incorporate [3H]tyrosine into POMC was tested. D-2 dopaminergic agonists caused a dose-dependent inhibition of POMC synthesis; the maximal inhibitory effect was approximately a 50% reduction in the amount of POMC synthesized. D-2 dopaminergic antagonists blocked the inhibitory effect of each agonist. Pretreatment of the tissue with pertussis toxin abolished the D-2 dopaminergic inhibition of POMC synthesis. The potency of pertussis toxin in abolishing the dopaminergic inhibition of POMC synthesis corresponded to its potency in abolishing the D-2 dopaminergic inhibition of adenylate cyclase activity. Cholera toxin, forskolin, and 8-bromo-cAMP, compounds that activate the cAMP pathway, enhanced the capacity of intermediate lobe tissue to synthesize POMC and counteracted the dopaminergic inhibition of POMC synthesis. Incubation of intermediate lobe tissue for 24 h with bromocriptine, a D-2 dopaminergic agonist, decreased the POMC mRNA content by 46% as determined by hybridization of RNA to a 32P-labeled probe. Incubation of intermediate lobe tissue with forskolin increased the level of POMC mRNA; incubation of the tissue with a combination of bromocriptine and forskolin also resulted in an increase in the level of POMC mRNA. It is proposed that Ni, the inhibitory guanyl nucleotide binding protein, and possibly adenylate cyclase mediate the dopaminergic inhibition of POMC synthesis. PMID- 3957909 TI - Nonmuscle tropomyosin from ascites tumor cell microvilli. AB - Tropomyosin has been isolated from microvilli preparations from 13762 rat mammary adenocarcinoma ascites tumor cells by Triton extraction and pelleting of the microvillar microfilament core, extraction of the microfilament core with 1 M KCl, heat treatment, and hydroxyapatite chromatography. Three major isoforms, designated 31K-a (acidic), 31K-b (basic), and 29K, were identified as tropomyosins by two-dimensional isoelectric focusing-dodecyl sulfate electrophoresis, a urea shift on dodecyl sulfate electrophoresis, chemical cross linking, amino acid analysis, and molecular weight determinations. The native (60,000) and subunit (31,000 and 29,000) molecular weights, the amino acid composition, and the stoichiometry for binding to F-actin (actin/tropomyosin, 6:1) were typical of nonmuscle tropomyosins. The amount of tropomyosin present in the microvilli preparations is sufficient to saturate about half of the microvillar F-actin. By two-dimensional isoelectric focusing-dodecyl sulfate electrophoresis, the 31K isoforms appeared similar to isoforms of normal rat kidney cells but the 29K isoform was apparently smaller than any normal rat kidney isoforms. All three isoforms bound to F-actin, but the 29K form bound most strongly. Its behavior was similar to that of muscle tropomyosin, exhibiting saturable binding as a function of both ionic strength and Mg2+ concentration. In contrast, the 31K isoforms bound more weakly and required higher concentrations of Mg2+ for binding than that required for saturation with 29K (4 mM). These results clearly indicate that nonmuscle tropomyosin isoforms from a single source and location (subplasmalemmal) in the cell can exhibit different properties. PMID- 3957910 TI - The effect of mild diamide oxidation on the structure and function of human erythrocyte spectrin. AB - Oxidants can alter erythrocyte membrane properties and cause ultimate hemolysis, but the mechanisms responsible for these changes are not understood. A protein skeleton preserves the normal integrity of the erythrocyte membrane. In this study, we investigated the effects of limited chemical oxidation on the structure and function of the major skeletal protein, spectrin. After mild treatment of spectrin with 2.5 microM diamide, with formation of an average of only one disulfide bond, we observed a 50% reduction in the ability of protein 4.1 to amplify spectrin-actin binding. The oxidized spectrin specifically lacked the ability to bind protein 4.1, whereas all other spectrin functions remained intact. However, oxidation also produced a structural change in spectrin. A rapidly migrating species appeared on non-denaturing gels in a dose-dependent manner with increasing diamide concentrations. By electron microscopy, the oxidized spectrin appeared as single-stranded signet rings with irregular knob like protrusions. Fifty per cent of spectrin was converted to the ring form after the formation of an average of two disulfide bonds. Both the structural and functional defects were reversed by chemical reduction. The loss of spectrin function or the structural transformation in spectrin may contribute to erythrocyte membrane failure in the oxidative environment. PMID- 3957911 TI - The charge polymorphism of rat apoprotein E. AB - Rat apolipoprotein E (apo-E) exists in plasma as four unique isoelectric forms (designated E-1, E-2, E-3, or E-4 from acidic to basic, respectively). We have examined the processes accounting for this polymorphism using intact rats or cultured rat hepatocytes. Intrahepatic precursors of rat apo-E were isolated and analyzed on isoelectric focusing gels. The primary translation product of rat liver apo-E mRNA focused as two isoproteins with more basic pI values than the isoproteins of plasma apo-E. The microsome-processed translation product also focused as two isoproteins having pI values corresponding to apo-E-4 and apo-E-3 isoproteins of plasma apo-E. Following a bolus injection of [3H]leucine into the portal vein, intrahepatic isoproteins corresponding to plasma apo-E-2 and apo-E-1 isoproteins were first detected in the rough endoplasmic reticulum (RER) and Golgi fractions, respectively. The apparent molecular weight of intrahepatic apo E increased as it passed from the RER to the Golgi. Only the most acidic isoform, apo-E-1, of plasma apo-E was sensitive to neuraminidase treatment indicating that sialic acid residues are responsible, in part, for the polymorphism of rat apo-E. Using cultured hepatocytes, tunicamycin (1 microgram/ml) inhibited the incorporation of [3H]glucosamine into both molecular weight forms of apolipoprotein B but did not influence the synthesis, glycosylation (as measured by [3H]glucosamine incorporation), or secretion of apo-E. Tunicamycin-inhibited hepatocytes secreted the normal complement of apo-E isoforms including apo-E-1, thus confirming that apo-E-1 is not an N-linked glycoprotein. These results suggest that post-translational modifications involving both RER and Golgi specific reactions contribute to the polymorphism of rat apo-E. PMID- 3957913 TI - Intestinal basement membrane of Ascaris suum. Molecular organization and properties of the collagen molecules. AB - The collagenous components of Ascaris suum intestinal basement membrane were isolated by extraction with 0.1 M Tris-HC1, 0.5 M NaC1, 0.5% 2-mercaptoethanol, pH 8.3, and Sephacryl S-300 gel filtration. Rotary-shadowing electron microscopy showed that the collagenous components occur as monomers and dimers with mean contour lengths of 469 +/- 21 and 918 +/- 24 nm, respectively. The molecules each contain a globular domain, with that of the dimer being slightly larger than that of the monomer. Electrophoresis in sodium dodecyl sulfate-polyacrylamide gels under reducing conditions revealed two polypeptides of Mr = 185,000 and 179,000. A similarity to type IV collagen was indicated by a glycine content of less than 33 mol % and the presence of fucose, mannose, and glucosamine residues. Treatment of the collagen with pepsin resulted in loss of the globular domains but retention of 90% of the length of fibrous collagen segments. Collagenase, however, removed the fibrous regions but left the globular moieties intact. These results extend the previously proposed model (Hung, C.-H., Noelken, M. E., and Hudson, B. G. (1981) J. Biol. Chem. 256, 3822-3826) in which the collagenous domain consists of two monomer-sized triple-helical subunits joined end-to-end by disulfide bonds, with the constituent chains of each subunit being cross-linked by disulfide bonds. PMID- 3957912 TI - Pretranslational regulation of type I collagen, fibronectin, and a 50-kilodalton noncollagenous extracellular protein by dexamethasone in rat fibroblasts. AB - The effect of dexamethasone on the synthesis of total cellular and extracellular proteins and specifically on the synthesis of type I procollagen chains, fibronectin, and a 50-kDa extracellular noncollagenous polypeptide was examined in cultured rat dermal fibroblasts. A slight but consistent inhibition of total protein synthesis by dexamethasone was dose and time dependent. Treatment of cells with 1 microM dexamethasone for 24 h while abolishing procollagen synthesis nearly completely (less than 95%) had the opposite effect (5-7-fold increase) on the synthesis of an extracellular noncollagenous 50-kDa polypeptide. Dexamethasone did not significantly affect the rates of synthesis of fibronectin. Cell-free translation of mRNA from dexamethasone-treated cells revealed corresponding changes in the steady-state levels of functional mRNAs coding for procollagens, the 50-kDa polypeptide, and fibronectin. Northern blot hybridization using nick-translated cDNA plasmids coding for pro-alpha 1(I), fibronectin, and cytoplasmic beta-actin mRNA corroborated the data obtained from cell-free translation experiments. Run-off transcription assays using nuclei from cells treated with 1 microM dexamethasone for 24 h revealed that glucocorticoid treatment did not significantly affect the rate of transcription of type I collagen genes; similarly, the rate of transcription of fibronectin and cytoplasmic beta-actin genes also remained unchanged under these conditions. An analysis of the kinetics of decay of radiolabeled mRNA coding for pro-alpha 1(I), pro-alpha 2(I), and fibronectin in dexamethasone-treated cells revealed that procollagen mRNAs were turned over at an accelerated rate in glucocorticoid treated cells. These data suggest that dexamethasone regulates type I collagen gene expression by preferentially decreasing the stability of pro-alpha 1(I) and pro-alpha2(I) mRNAs. Although dexamethasone increased the levels of translatable mRNAs coding for a 50-kDa polypeptide, the molecular mechanism(s) of how hormone exerts this effect remains unknown. PMID- 3957914 TI - Tyrosine phosphorylation of insulin receptor beta subunit activates the receptor tyrosine kinase in intact H-35 hepatoma cells. AB - The phosphorylation characteristics of insulin receptor from control and insulin treated rat H-35 hepatoma cells 32P-labeled to equilibrium have been documented. The 32P-labeled insulin receptor is isolated by immunoprecipitation with patient derived insulin receptor antibodies in the presence of phosphatase and protease inhibitors to preserve the native phosphorylation and structural characteristics of the receptor. The unstimulated insulin receptor contains predominantly [32P] phosphoserine and trace amounts of [32P]phosphothreonine in its beta subunit. In response to insulin, the insulin receptor beta subunit exhibits marked tyrosine phosphorylation and a 2-fold increase in total [32P]phosphoserine contents. High pressure liquid chromatography of the tryptic hydrolysates of the 32P-labeled receptor beta subunit from quiescent cells results in the resolution of up to 9 fractions containing [32P]phosphoserine. The insulin-stimulated tyrosine phosphorylation is concentrated in two of these receptor phosphopeptide fractions, whereas the increase in [32P]phosphoserine content is scattered in low abundance over all receptor tryptic fractions. Insulin receptors affinity purified by lectin- and insulin-agarose chromatographies from insulin-treated, 32P-labeled cells exhibit a 22-fold increase in the Vmax of receptor tyrosine kinase activity toward histone when compared to controls. The elevated kinase activity of the insulin receptor derived from insulin-treated cells is not due to the presence of hormone bound to the receptor because the receptor kinase activity is assayed while immobilized on insulin-agarose. Furthermore, the insulin-activated receptor kinase activity is reversed following dephosphorylation of the receptor beta subunit with alkaline phosphatase in vitro. The correlation between the insulin-stimulated site specific tyrosine phosphorylation on receptor beta subunit and the elevation of receptor tyrosine kinase activity strongly suggests that the insulin receptor kinase is activated by hormone-stimulated autophosphorylation on tyrosine residues in intact cells, as previously demonstrated for the purified receptor. PMID- 3957915 TI - Mechanism of the calcium-dependent self-association of bovine prothrombin. Use of a covalent cross-linking reagent to study the reaction. AB - The present study has made use of a covalent cross-linking agent, dithiobis(succinimidylpropionate), to study the self-association of prothrombin and has demonstrated that the covalent dimerization reaction involves the gamma carboxyglutamic acid region of prothrombin (1-42 of 582). An essential role for the gamma-carboxyglutamic acid residues of prothrombin in the association reaction was demonstrated by experiments that converted gamma-carboxyglutamic acid residues to gamma-methylene glutamic acid or glutamic acid and resulted in a prothrombin species that was inactive in our cross-linking assay. Other experiments showed that very high concentrations of calcium ion inhibit the cross linkage of prothrombin. This result is most consistent with an essential gamma carboxyglutamic acid-calcium ion-gamma-carboxyglutamic acid bridge(s) in the calcium-dependent self-associated form of prothrombin. PMID- 3957916 TI - Extensive hydrolysis of N-formyl-L-methionyl-L-leucyl-L-[3H] phenylalanine by human polymorphonuclear leukocytes. A potential mechanism for modulation of the chemoattractant signal. AB - Chemoattractant receptors on human polymorphonuclear leukocytes (PMNs) stimulate a series of important biological responses. In an attempt to better understand the mechanism of stimulus response coupling of chemoattractant receptors, the kinetics of N-formyl-L-methionyl-L-leucyl-L-[3H]phenylalanine (fMet-Leu-[3H]Phe) binding to PMNs was evaluated. Unexpectedly, extensive degradation of the ligand was found to occur rapidly at 37 degrees C. Exposure of 10(7) cells/ml to 10 nM fMet-Leu-[3H]Phe led to the specific uptake of approximately 1% of the ligand within 10 min, while approximately 50% of the extracellular chemoattractant was hydrolyzed to free amino acids. Under the same conditions, isolated plasma membranes equivalent to 2.5 X 10(7) PMNs/ml bound specifically approximately 1% of the ligand and degraded about one-half of it primarily to Leu-[3H]Phe. The fMet-Leu-[3H]Phe hydrolysis commenced with no apparent latency, yet disobeyed first order kinetics as a 100-fold excess unlabeled ligand enhanced the initial consumption rate of 10 nM fMet-Leu-[3H]Phe by 500-fold, yielding an enhancement of the relative hydrolysis to approximately 70%. 1-butanol at 0.25%, which accelerates chemotaxis but inhibits superoxide anion and lysosomal enzyme secretion, reduced the hydrolysis to about 15% independent of the fMet-Leu [3H]Phe specific activity. Lysosomal secretion could not mediate the hydrolysis process, since the supernatants of PMNs exposed either to 10 nM of 1 microM fMet Leu-Phe reveal no degradation capacity toward fMet-Leu-[3H]Phe. These data indicate that the hydrolysis of the chemoattractant occurs at the cell surface and is dependent on the plasma membrane physical state. This phenomenon may well modulate the chemotactic signal due to its ability to profoundly alter the level of the chemoattractant proximate to the cell surface. PMID- 3957917 TI - Generation of an auto-anti-idiotypic antibody that binds to glucocorticoid receptor. AB - A monoclonal antibody (8G11-C6) that is directed to a region near the ligand binding site of the glucocorticoid receptor was obtained by an auto-anti idiotypic route, using a derivative of triamcinolone coupled to thyroglobulin to immunize a mouse. The resulting hybridomas were screened for anti-idiotypic antibody (anti-antisteroid) with Fab fragments of affinity-purified polyclonal rabbit anti-triamcinolone antibody. The anti-idiotypes were then screened for binding to rat cytosol glucocorticoid receptor by a depletion procedure, yielding a clone, 8G11-C6, whose specificity for receptor was verified by sucrose density and Western blot analyses. Depletion was not significantly reduced by prelabeling the cytosol with [3H]triamcinolone acetonide. The anti-idiotype (8G11-C6) bound to Fab fragments of antisteroid and to partially purified receptor in a concentration-dependent manner. Both binding reactions were inhibited only by rabbit serum albumin conjugates of steroids known to bind to the glucocorticoid receptors. Triamcinolone derivatives of lysine and of oligopeptides containing up to six amino acids inhibited the binding of the anti-idiotype to the Fab fragments but not to the receptor, implying that the target epitope of the antisteroid antibody may be closer to its glucocorticoid-binding site than the cross-reacting epitope of the receptor. Our findings demonstrate further the versatility of the auto-anti-idiotypic route for the preparation of anti-receptor antibodies. PMID- 3957918 TI - Characterization of a diphosphonopentaosylceramide containing 3-O-methylgalactose from the skin of Aplysia kurodai (sea hare) AB - The complete structure is proposed for a ceramide (Cer), bis(2 aminoethylphosphono)-pentaoside, isolated from the skin of Aplysia kurodai. This new phosphonoglycosphingolipid was purified using two systems of column chromatography on silicic acid. The purity of the glycolipid was confirmed by thin-layer chromatography, analysis of its composition, and proton magnetic resonance spectrometry. The component carbohydrates were glucose, galactose, N acetylgalactosamine, and 3-O-methylgalactose. Most (90%) of the fatty acid was palmitic acid and the major sphingosine bases were octadeca-4-sphingenine (51%) and anteisononadeca-4-sphingenine (38%). 2-Aminoethylphosphonyl-6-galactose was identified after its partial hydrolysis. From studies by methanolysis, permethylation, mild acid hydrolysis, hydrogen fluoride treatment, chromium trioxide oxidation combined with thin-layer chromatography, gas liquid chromatography, gas chromatography-mass spectrometry, and proton magnetic resonance spectrometry, the structure of the glycolipid was concluded to be 3 OMeGal beta 1----3GalNAc alpha 1----3[6'-O-(2-aminoethylphosphonyl)-Gal alpha 1-- -2](2-aminoethylphosphonyl----6)Gal beta 1----4Glc beta 1----1Cer. PMID- 3957919 TI - Characterization of nonheme type bromoperoxidase in Corallina pilulifera. AB - Bromoperoxidase was purified from the crude extract of Corallina pilulifera to be homogeneous upon polyacrylamide disc gel and sodium dodecyl sulfate polyacrylamide gel electrophoreses according to the procedures previously reported (Itoh, N., Izumi, Y., and Yamada, H. (1985) Biochem. Biophys. Res. Commun. 131, 428-435). The enzyme had a molecular weight of approximately 790,000 and was composed of 12 subunits of identical molecular weights (Mr 64,000). Hexagonal molecular shapes of the enzyme were observed by electron microscopy. The isoelectric point of the enzyme was 3.0, and the predominance of acidic amino acids was revealed by amino acid analysis of the enzyme. The enzyme was specific for I- and Br- and inactive toward Cl- and F-. The optimum pH of the enzyme was 6.0, and the enzyme was stable in a range from pH 5.0 to 11.0. The enzyme had no hemeor flavin-like compounds as a prosthetic group. Plasma emission spectroscopy revealed that the enzyme contains 2.3 +/- 0.2 atoms of iron and 1.6 +/- 0.1 atoms of magnesium/molecule of protein. Hence, bromoperoxidase of C. pilulifera was distinct from other haloperoxidases and many peroxidases, which are hemoproteins. PMID- 3957920 TI - Conversion of human plasma high density lipoprotein-2 to high density lipoprotein 3. Roles of neutral lipid exchange and triglyceride lipases. AB - Cholesterol esters accumulating in human plasma high density lipoproteins (HDL) are important in conversion of HDL3 to larger HDL2. We studied whether mechanisms of removal of cholesterol esters from HDL might be important in a reverse direction, i.e. conversion of HDL2 to HDL3. Native HDL2 or HDL3 is incubated with very low density lipoproteins (VLDL) and lipoprotein-poor plasma (d greater than 1.21 g/ml) at 37 degrees C. After incubation, "modified" (M) VLDL, and HDL2 or HDL3 are reisolated by ultracentrifugation. In modified M-HDL2 or M-HDL3, triglyceride becomes the major core lipid as the triglyceride/cholesterol ester weight ratio increases 8-10-fold relative to native HDL. With only small changes in protein/phospholipid ratios in M-HDLs, the large decrease in cholesterol ester/protein ratios suggest net cholesterol ester loss from HDL. Quantitative recovery analyses prove that the cholesterol esters lost from HDL are transferred to M-VLDL, which is now richer in cholesterol ester and poorer in triglyceride. These substantial exchanges of HDL lipids are not associated by significant transfer of HDL apoproteins but are dependent on neutral lipid transfer factors present in human lipoprotein-poor plasma (d greater than 1.21 g/ml). Similar results are obtained when purified core lipid transfer protein replaces d greater than 1.21 g/ml plasma in these incubations. After depletion of cholesterol ester from HDL, most but not all, exchanged triglyceride can be removed by lipolysis with either hepatic or lipoprotein lipase, resulting in a post-lipolysis HDL2 with an increased triglyceride content relative to normal HDL. With successive incubations with VLDL, and core lipid transfer factors, HDL2 loses more than two thirds of its cholesterol esters. After lipolysis of acquired triglyceride, HDL2 is remodeled, in both composition and flotation parameters, toward HDL3. PMID- 3957921 TI - Localization of the ganglioside-binding site of fibronectin. AB - It has been demonstrated via biological assays that fibronectin possesses a receptor for gangliosides that is involved in cell adhesion and restoration of the normal morphology of transformed cells. In this study, fluorescence polarization has been employed to monitor the binding of ganglioside oligosaccharide to fibronectin. Parameters involved in ganglioside oligosaccharide binding to fibronectin are described and compared to the interaction of heparin with fibronectin. A Kd of 1.4 X 10(-8) mol/liter has been calculated, and it is demonstrated that labeled ganglioside oligosaccharides can be eluted from fibronectin with either unlabeled ganglioside oligosaccharides or 4 M urea. Using the fluorescence polarization assay developed in this study for measurement of ganglioside binding to fibronectin, it is demonstrated that gangliosides bind to the 31,000-dalton amino terminal heparin-binding domain of fibronectin. A ganglioside-Sepharose affinity column has been constructed which specifically binds the 31,000-dalton amino terminal fragment of fibronectin. The localization of the ganglioside receptor to the amino terminal domain of fibronectin indicates that the ganglioside receptor is distinct from the putative fibronectin cell surface receptor which is located near the center of the fibronectin molecule. PMID- 3957922 TI - Electrostatic attraction governs the dimer assembly of human hemoglobin. AB - We have investigated the effect of surface charge on the rate of assembly of alpha beta dimers of human hemoglobin A: alpha + beta k a----alpha beta. Heme intact beta A subunits were compared with four mutant subunits which differ by integral units of charge: beta N(Lys-95----Glu) (2-); beta J(Gly-16----Asp) (1-); beta S(Glu-6----Val) (1+); beta C(Glu-6----Lys) (2+). Subunit competition experiments were performed as follows. Varying amounts of 3H-labeled alpha A subunits were added to a mixture containing equal amounts of beta A and beta X subunits so that alpha/(beta A + beta X) ranged from 0.05-1.0. The reconstituted 3H-labeled Hbs A and X were analyzed by ion-exchange high pressure liquid chromatography as well as by gel electrofocusing and fluorography. Under the solvent conditions employed (10 mM PO4(Na), pH 7.0, 0 degrees C) a predominant proportion of the beta subunits was monomeric. Therefore, the ratio of Hb X to Hb A formed from subunit reconstitution when alpha/(beta X + beta A) approached zero provides a direct measure of the relative rates of monomer combination: kXa/kAa. The experimental values of this ratio decreased monotonically with the overall charge of the variant beta subunit: beta N = 2.6; beta J = 1.5; beta S = 0.41; beta C = 0.13. In contrast surface charge had no significant effect on the rate of dissociation of the alpha beta dimer: alpha beta kd----alpha + beta. At pH 8.0, where the alpha chains lack a net surface charge, they combined equally well to beta A and beta C chains. These experiments are consistent with a two-step mechanism, alpha + beta in equilibrium (alpha...beta) in equilibrium alpha beta, where the oppositely charged monomers diffuse together under the influence of their mutual electrostatic interaction to form a nonspecifically bound encounter complex [alpha...beta] that undergoes a surface charge-independent rearrangement to form the stable dimer. PMID- 3957923 TI - An apo-E-free very low density lipoprotein enriched in phosphatidylethanolamine in human plasma. AB - Normal human plasma contains a fraction of very low density lipoprotein (VLDL) which, unlike most VLDL, contains no apolipoprotein E and, unlike apo-E containing VLDL, is enriched in phosphatidylethanolamine. This fraction made up 0.28 +/- 0.09 of total VLDL triglyceride. Interconversion of the two isolated VLDL fractions was not detected during incubation (2 h, 37 degrees C) and they may represent the physical forms of apo-B corresponding to distinct metabolic pathways in plasma. PMID- 3957924 TI - Fertilization (activation)-induced 200- to 9-kDa depolymerization of polysialoglycoprotein, a distinct component of cortical alveoli of rainbow trout eggs. AB - Polysialoglycoprotein, a novel type of glycoprotein found in the eggs of rainbow trout has been shown to undergo dramatic depolymerization (200- to 9-kDa) upon fertilization of the eggs. Molecular mechanism of this depolymerization has been elucidated to be the result of proteolysis catalyzed by a highly specific protease induced at fertilization. The low molecular weight polysialoglycoprotein obtained from the fertilized eggs accounted for about 85% of total polysialoglycoprotein and comprised glycotridecapeptides with a uniform peptide sequence which was determined to be Asp-Asp-Ala-Thr*-Ser*-Glu-Ala-Ala-Thr*-Gly Pro-Ser-Gly, where * indicates the site of glycosylation. This glycotridecapeptide constitutes a repeating unit of the 200-kDa polysialoglycoprotein in the unfertilized eggs: (Asp) 0-2-Ala-Thr*-Ser*-Glu-Ala Ala-Thr*-Gly-Pro-Ser-Gly-(Asp-Asp-Ala-Thr*-Ser *-Glu- Ala-Ala-Thr*-Gly-Pro-Ser Gly)n (n = 25) (Kitajima, K., Inoue, Y., and Inoue, S. (1986) J. Biol. Chem. 261, 5262-5269). The fertilization-induced depolymerization of polysialoglycoprotein appeared to be completed within 5 min postfertilization. The same reaction was also induced by parthenogenetic activation of the eggs by immersing in fresh water or nonelectrolyte solutions. Thus the phenomenon is closely associated with the exocytosis of cortical vesicles (alveoli) of the eggs. PMID- 3957925 TI - Chemotactic peptide binding by rabbit polymorphonuclear leukocytes. Presence of two compartments having similar affinities but different kinetics. AB - N-Formylnorleucylleucylphenylalanine (f-Nle-LeuPhe) bound to rabbit peritoneal polymorphonuclear leukocytes at 4 degrees C exists in at least two compartments that can be differentiated by their off rates. The off rate of one compartment is similar to that of the receptor characterized previously, about 0.4 min-1 (Aswanikumar, S., Corcoran, B., Schiffmann, E., Day, A. R., Freer, R. J., Showell, H. J., Becker, E. L., and Pert, C. B. (1977) Biochem. Biophys. Res. Commun. 74, 810-817; Sullivan, S. J., and Zigmond, S. H. (1980) J. Cell Biol. 85, 703-711); the off rate of the second compartment is about 0.005 min-1. Lysis of the cells at 4 degrees C with 1% Triton does not affect the peptide release from either compartment. Accumulation of peptide at 4 degrees C into the fast off-rate compartment is rapid, reaching a plateau in about 5 min, while peptide in the slow off-rate compartment continues to increase for up to 4 h. The rate of accumulation in the slow off-rate compartment is approximately proportional to the amount of peptide bound to the fast off-rate compartment. Cells lysed at 4 degrees C before binding are still able to accumulate peptide into both compartments. Three possible models to explain the data are presented. PMID- 3957926 TI - Regulation of the streptokinase-mediated activation of human plasminogen by fibrinogen and chloride ions. AB - The effects of human fibrinogen and Cl- on the activation of native human plasminogen by streptokinase, at 37 degrees C, in isotonic buffers, consisting of 10 mM Hepes-NaOH, 150 mM NaOAc-NaCl, pH 7.4, have been examined. We find that Cl- acts as a mixed-type inhibitor of plasminogen activation, with a Ki in the range of 6.4-9.2 mM, in the absence and presence (1.0 microM) of fibrinogen. Fibrinogen displays an effect on plasminogen activation kinetics consistent with its function as a mixed-type nonessential activator, with Ka values between 110 and 240 nM, in the absence and presence (50 mM) of Cl-. These observations suggest opposing roles for fibrinogen and Cl- in regulating plasminogen activation. PMID- 3957927 TI - Purification of ricin A1, A2, and B chains and characterization of their toxicity. AB - This paper describes a protocol for the preparation of highly purified A (A1 and A2) and B chains of the plant toxin, ricin, and biochemical and biological characterization of these proteins. Intact ricin was bound to acid-treated Sepharose 4B and was split on the column into A and B chains with 2 mercaptoethanol. The A chains were eluted with borate buffer containing 2 mercaptoethanol. A1 and A2 were then partially separated by cation exchange chromatography and the contaminating B chain was removed by affinity chromatography on Sepharose-asialofetuin and Sepharose-monoclonal anti-B chain. The B chain was eluted from the Sepharose 4B column by treatment with galactose and was further purified by cation and anion exchange chromatography; contaminating A chains were removed by affinity chromatography on Sepharose monoclonal anti-A chain. The purified A and B chains were active as determined by their ability to inhibit protein synthesis in a cell-free assay and their binding to asialofetuin, respectively. Furthermore, by polyacrylamide gel electrophoresis, toxicity in mice, and toxicity on several different cell types, both A and B chains were shown to be minimally cross-contaminated. Finally, it was shown that ammonium chloride significantly enhanced the nonspecific toxicity of B chains for cells in vitro. In contrast, ammonium chloride did not enhance either the nonspecific toxicity of A chains in vitro or the specific toxicity of A chain-containing immunotoxins prepared with the highly purified A1, A2 chains. PMID- 3957928 TI - Novel peptide fragments originating from PGLa and the caerulein and xenopsin precursors from Xenopus laevis. AB - Skin secretions from the South African frog Xenopus laevis have been chromatographed by high performance liquid chromatography (HPLC), fractionated, and analyzed by fast atom bombardment-mass spectrometry (FAB-MS). The HPLC chromatograms showed the secretion to be a complex mixture with over 30 components at similar levels to the four peptides previously isolated from X. laevis skin, i.e. xenopsin, caerulein, thyrotropin-releasing hormone, and PGLa. FAB-MS analysis of the HPLC fractions gave numerous protonated molecular ions ranging from m/z 491 to 2662. Preliminary assignments of these components were made by comparing these experimental molecular weights to those predicted for regions within the xenopsin, caerulein, thyrotropin-releasing hormone, and PGLa precursors. These results suggested that many of these skin secretions were peptides originating from additional processing of the xenopsin, caerulein, and PGLa precursors, primarily involving cleavage at single arginine residues, and a novel cleavage at the NH2-terminal side of single lysines. These assignments were subsequently confirmed by Edman degradation, FAB-MS peptide sequencing, and amino acid analysis. All of these peptides contain one or more lysines and would be expected to have amphiphilic structures. As yet, nothing is known about their activity, although they resemble in composition the mast cell degranulating peptides melittin and the bombolitins. These precursor fragments were also found to have limited sequence homology to bombinin, a hemolytic amphibian peptide isolated from the European Bombina toad. PMID- 3957929 TI - Covalent labeling of the nonsubstrate ligand-binding site of glutathione S transferases with bilirubin-Woodward's reagent K. AB - The dimeric enzyme glutathione S-transferase B is composed of two dissimilar subunits, referred to as Ya and Yc. Transferase YaYc and the YaYa homodimer were purified from rat liver cytosol. An enol ester derivative of bilirubin (bilirubin Woodward's reagent K) was prepared and used to label covalently the nonsubstrate ligand-binding site on these two proteins. There was a linear relationship between the amount of bilirubin-Woodward's reagent K added to the reaction mixture and the amount of labeling achieved up to a ratio of 2:1 (bilirubin Woodward's reagent K: protein-YaYc). A maximum of 0.87 mol of label bound per mol of transferase YaYc. At higher molar ratios, the label appeared to also be binding at a second site on the enzyme. The label blocked the nonsubstrate ligand binding site of the two transferases but not the catalytic site. The divalent reagent was shown to label equally the Ya and Yc subunits of transferase YaYc, suggesting that the single high affinity bilirubin-binding site present on this protein is formed by an interaction between the subunits rather than residing on a specific subunit. At low ratios of label to protein, bilirubin-Woodward's reagent K appears to label specifically the nonsubstrate ligand-binding site of two forms of glutathione S-transferase, and use of this label should allow for the localization of the nonsubstrate ligand-binding site in the primary amino acid sequence of the Ya and Yc subunits. PMID- 3957930 TI - Stereoselective metabolism of the (+)-(S,S)- and (-)-(R,R)-enantiomers of trans 3,4-dihydroxy-3,4-dihydrobenzo[c]-phenanthrene by rat and mouse liver microsomes and by a purified and reconstituted cytochrome P-450 system. AB - Metabolism of (+)-, (-)-, and (+/-)-trans-3,4-dihydroxy-3, 4 dihydrobenzo[c]phenanthrenes by liver microsomes from rats and mice and by a purified monooxygenase system reconstituted with cytochrome P-450c has been examined. Bay-region 3,4-diol 1,2-epoxides are minor metabolites of both enantiomers of the 3,4-dihydrodiol with liver microsomes from 3 methylcholanthrene-treated rats or with the reconstituted system (less than 10% of total metabolites). Microsomes from control and phenobarbital-treated rats and from control mice form higher percentages of these diol epoxides (13-36% of total metabolites). Microsomes from 3-methylcholanthrene-treated rats and cytochrome P 450c in the reconstituted system form exclusively the diol expoxide-1 diastereomer, in which the benzylic hydroxyl group and oxirane oxygen are cis to each other, from the (+)-(3S,4S)-dihydrodiol. The same enzymes selectively form the diol expoxide-2 diastereomer, with its oxirane oxygen and benzylic hydroxyl groups trans to each other, from the (-)-(3R,4R)-dihydrodiol (77% of the total diol epoxides). Liver microsomes from control rats show similar stereoselectivity whereas liver microsomes from phenobarbital-treated rats and from control mice are less stereoselective. Three bis-dihydrodiols and three phenolic dihydrodiols are also formed from the enantiomeric 3,4-dihydrodiols of benzo[c]phenanthrene. A single diastereomer of one of these bis-dihydrodiols with the newly introduced dihydrodiol group at the 7,8-position accounts for 79-88% of the total metabolites of the (-)-(3R,4R)-dihydrodiol formed by liver microsomes from 3 methylcholanthrene-treated rats or by the reconstituted system containing epoxide hydrolase. In contrast, the (+)-(3S,4S)-dihydrodiol is metabolized to two diastereomers of this bis-dihydrodiol, a third bis-dihydrodiol, and two phenolic dihydrodiols. PMID- 3957931 TI - Purification and characterization of a human lectin specific for penultimate galactose residues. AB - A novel lectin has been found in human plasma. The lectin was purified by affinity chromatography using an adsorbent in which 2-O-alpha-D-glucopyranosyl-O beta-D-galactopyranosylhydroxylysine (Glc-Gal-Hyl) was coupled to Sepharose. The molecular weight of the lectin was determined by gradient gel electrophoresis to be approximately 240,000. On polyacrylamide gel electrophoresis in sodium dodecyl sulphate, the subunit had the molecular weight of 29,500. Composition analysis has shown the lectin is a glycoprotein in which 12% of the molecule consists of carbohydrate. Native human, horse, calf, sheep, rabbit, and rat erythrocytes were agglutinated by the lectin in the presence of calcium. Glc-Gal-Hyl, N-acetylated Glc-Gal-Hyl, and stachyose inhibited the hemagglutination, whereas monosaccharides, maltose, cellobiose, lactose, raffinose, galactosylhydroxylysine, and N-acetylated galactosylhydroxylysine were not inhibitory. The lectin is strongly inhibited by the desialylated bovine erythrocyte glycoprotein, which contains galactose beta 1-3galactose beta sequence at the nonreducing termini of the sugar chains, whereas disialylated orosomucoid did not inhibit the lectin. These results indicate that the lectin recognizes the penultimate galactose residue in a hapten molecule in contrast to usual galactose-binding proteins or galactose-specific lectins, which recognize exposed, terminal galactose residues of sugar chains. PMID- 3957933 TI - Purification and properties of human erythrocyte band 4.2. Association with the cytoplasmic domain of band 3. AB - We have purified the human erythrocyte membrane protein band 4.2 to greater than 85% homogeneity. The protein was extracted from spectrin-actin-depleted inside out vesicles in a pH 11 medium and purified by gel filtration in the presence of 1 M KI. The purified protein was heterogeneous and had an average S20,w of 5.5 and an average Stokes radius of 82 A. By electron microscopy, the protein appeared heterogeneous in size and shape, having a diameter ranging from 80 to 150 A. The protein bound saturably to band 4.2-depleted red cell inside-out vesicles, and the binding exhibited a concave Scatchard plot. Binding was reduced greater than 90% by proteolytic digestion of membranes. Digestion studies suggested that there are two classes of binding sites for band 4.2 on the cytoplasmic aspect of red cell membranes, one of which is likely to be band 3. The purified 43-kDa cytoplasmic domain of band 3 competed for band 4.2 binding to red cell membranes and could completely abolish binding when added at a concentration of greater than 200 micrograms/ml. The purification of band 4.2 and the characterization of its association with red cell membranes should facilitate the discovery of the function of this major red cell membrane protein. PMID- 3957932 TI - Novel fucolipids of human adenocarcinoma: disialosyl Lea antigen (III4FucIII6NeuAcIV3NeuAcLc4) of human colonic adenocarcinoma and the monoclonal antibody (FH7) defining this structure. AB - A new fucoganglioside, disialosyl Lea, has been found in the disialoganglioside fraction of human colonic adenocarcinoma. The ganglioside has been isolated from four other disialogangliosides by high-performance liquid chromatography followed by preparative high-performance thin-layer chromatography. The structure of the antigen was characterized by its conversion to lactofucopentaosyl(II)ceramide (Lea-active ceramide pentasaccharide), methylation analysis, and high-mass range electron-impact as well as field-desorption mass spectrometry of the permethylated derivative, as shown below: (Formula; see text) Specific removal of alpha 2----3-linked sialosyl residue by influenza virus A2 sialidase, or preferential hydrolysis of the same residue by Clostridium perfringens sialidase in the absence of detergent, resulted in the formation of an intermediate product, monosialosyl LeaII (III4FucIII6NeuAcLc4), which reacted with anti-Lea antibody and with monoclonal antibody FH7 and may have a sialic acid linked at the 6 position of GlcNAc. The IgG3 monoclonal antibody FH7 was established, which reacts specifically with disialosyl Lea and monosialosyl LeaII as above, but does not react with disialosyllactotetraosylceramide (IV3NeuAcIII6Neu-AcLc4), monosialosyl LeaI (IV3NeuAcIII4FucLc4), and other mono- and disialogangliosides isolated from the same cancer tissue. The antibody FH7 may be useful in the detection of human cancer. PMID- 3957934 TI - Characterization of a fatty acid-binding protein from rat heart. AB - A fatty acid-binding protein has been isolated from rat heart and purified by gel filtration chromatography on Sephadex G-75 and anion-exchange chromatography on DE52. The circular dichroic spectrum of this protein was not affected by protein concentration, suggesting that it does not aggregate into multimers. Computer analyses of the circular dichroic spectrum predicted that rat heart fatty acid binding protein contains approximately 22% alpha-helix, 45% beta-form and 33% unordered structure. Immunological studies showed that the fatty acid-binding proteins from rat heart and rat liver are immunochemically unrelated. The amino acid composition and partial amino acid sequence of the heart protein indicated that it is structurally related to, but distinct from, other fatty acid-binding proteins from liver, intestine, and 3T3 adipocytes. Using a binding assay which measures the transfer of fatty acids between donor liposomes and protein (Brecher, P., Saouaf, R., Sugarman, J. M., Eisenberg, D., and LaRosa, K. (1984) J. Biol. Chem. 259, 13395-13401), it was shown that both rat heart and liver fatty acid-binding proteins bind 2 mol of oleic acid or palmitic acid/mol of protein. The structural and functional relationship of rat heart fatty acid binding protein to fatty acid-binding proteins from other tissues is discussed. PMID- 3957935 TI - Gangliosides of bovine buttermilk. Isolation and characterization of a novel monosialoganglioside with a new branching structure. AB - Bovine buttermilk was found to contain 0.92 mumol of lipid-bound sialic acid/g dry weight. On ganglioside mapping, at least seven gangliosides were detected, and the structures of the five major molecules were determined by degradation with exoglycosidases and methylation analysis. GM3, GD3, and GT3 were found to comprise 80% of the total gangliosides. The other two gangliosides had a new core structure with a branched oligosaccharide chain. One was a novel monosialoganglioside with a 2----6 linked sialic acid residue with the following structure: (Formula, see text) There were 41 nmol of this ganglioside/g of buttermilk (4.5% of total gangliosides). The other was a trisialogangliosides with the above new core structure. PMID- 3957937 TI - [Importance of serological controls after anti-rabies vaccination with a vaccine prepared on human diploid cells]. PMID- 3957936 TI - In vitro phosphorylation of type I collagen by cyclic AMP-dependent protein kinase. AB - Both the triple-helical and denatured forms of nonfibrillar bovine dermal type I collagen were tested as substrates for the catalytic subunit of cAMP-dependent protein kinase in an in vitro reaction. Native, triple-helical collagen was not phosphorylated, but collagen that had been thermally denatured into individual alpha chains was a substrate for the protein kinase. Catalytic subunit of cAMP dependent protein kinase phosphorylated denatured collagen to between 3 to 4 mol of phosphate/mol of (alpha 1(I)2 alpha 2(I). Pepsin-solubilized and intact collagens were phosphorylated similarly, as long as each was in a nonhelical conformation. The first 2 mol of phosphate incorporated into type I collagen by the protein kinase were present in the alpha 2(I) chain. The alpha 1(I) chain was only phosphorylated during long incubations in which the stoichiometry exceeded 2 mol of phosphate/mol of (alpha 1(I)2 alpha 2(I). Phosphoserine was the only phosphoamino acid identified in collagen that had been phosphorylated to any degree by the protein kinase. The 2 mol of phosphate incorporated into the alpha 2(I) chain were localized to the alpha 2(I)CB4 cyanogen bromide fragment. The catalytic subunit of cAMP-dependent protein kinase phosphorylated denatured pepsin-solubilized collagen with a Km of 8 microM and a Vmax of approximately 0.1 mumol/min/mg of enzyme. Denatured, but not triple-helical, type I collagen was also phosphorylated by cGMP-dependent protein kinase, although it was a poorer substrate for this enzyme than for the cAMP-dependent protein kinase. Collagen was not a substrate for phospholipid-sensitive Ca2+-dependent protein kinase. These results suggest the potential for nascent alpha chains of type I collagen to be susceptible to phosphorylation by cAMP-dependent protein kinase in vivo prior to triple-helix formation. Such a phosphorylation of collagen could be relevant to the action of cAMP to increase the intracellular degradation of newly synthesized collagen. PMID- 3957938 TI - The enumeration of Leptospira interrogans serovar pomona by a bioluminescence ATP assay. AB - A rapid method for enumerating viable Leptospira interrogans serovar pomona cells was investigated using a bacterial adenosine triphosphate (ATP) assay. The ATP was assayed by the luciferin-luciferase bioluminescence reaction. Samples of serovar pomona grown in liquid polysorbate 80-bovine albumin (P80-BA) medium for 1-3 days were analysed for ATP content, culture density (nephelometry), direct cell count and most probable number of viable cells (MPNVC) as determined by the dilution tube technique. A linear relationship was found between ATP content and the number of viable cells over the range of 4 X 10(8) to 8 X 10(9) leptospires/ml. Over this range the correlation coefficient for ATP content versus viable cells (0.96) was similar to the coefficient for culture density versus the number of viable cells. The coefficient for direct counts versus the number of viable cells was smaller. The bioluminescence assay of bacterial ATP is a promising method for enumerating viable leptospires in pure culture. PMID- 3957939 TI - The International Standard for Kanamycin. AB - The International Reference Preparation of Kanamycin has been replaced by the International Standard for Kanamycin. The potency of the standard is based upon a collaborative study in ten laboratories in ten countries. Each ampoule of the International Standard of Kanamycin is defined as containing the activity of 10345 International Units of Kanamycin. PMID- 3957940 TI - [Screening for enzootic bovine leucosis by the ELISA test applied to mixed milk: study of a theoretical model]. PMID- 3957941 TI - A biomechanical analog of curve progression and orthotic stabilization in idiopathic scoliosis. AB - A biomechanical analog of curve progression and orthotic stabilization in idiopathic scoliosis has been developed using the classical theory of curved beam columns. The interaction of the spinal musculature and other supporting structures is incorporated in the model using an equivalent flexural rigidity. The stability of a given scoliotic curve relative to a normal spine is described in terms of the so-called critical load ratio (Pc/Pe). This dimensionless quantity appears in the exact solution of the governing differential equation and boundary conditions. It is defined as the ratio of the load bearing capacity of a scoliotic spine (Pc) to that of a normal spine where the load bearing capacity of a normal spine is defined as Euler's buckling load (Pe). The computation of Pc/Pe is based upon a maximum allowable moment criterion. This model is used to study the effect of the degree of initial curvature and curve pattern in the frontal plane on the stability of untreated idiopathic scoliosis. Although restricted to two-dimensions, the model appears to demonstrate the synergistic effects of end support, transverse loading, and curve correction on improvement in relative stability of an orthotically supported scoliotic curve. The results of this study are in qualitative agreement with clinical findings that are based on long-term studies of natural history of idiopathic scoliosis and of patients undergoing orthotic management for scoliosis. PMID- 3957942 TI - Analysis of the effect of using two different strain rates on the acoustic emission in bone. AB - To study the effect of strain rate on the acoustic emission amplitude signature of bone, bovine cortical bone was milled into standard tensile specimens which were tested at two different strain rates while being monitored with acoustic emission equipment. It was demonstrated that the amplitude distribution of the acoustic events in bone is dependent on strain rate. Greater numbers of events occurred with the slower strain rate (0.0001 s-1), but these events were of lower amplitude than those emitted during the more rapid strain rate (0.01 s-1). The plot of the cumulative event amplitude distribution followed the power-law model, and the slope of this output, the b-value, represented a signature of the amplitude distribution. The mechanical test results were consistent with the behavior of a viscoelastic multi-phase composite material. PMID- 3957943 TI - Steady flow velocity measurements in a pulmonary artery model with varying degrees of pulmonic stenosis. AB - Velocity and flow visualization studies were conducted in an adult size pulmonary artery model with varying degrees of valvular stenosis, using a two dimensional laser Doppler anemometer system. Velocity measurements in the main, left and right branches of the pulmonary artery revealed that as the degree of pulmonic stenosis increased, the jet type flow created by the valve hit the distal wall of the LPA farther downstream from the junction of the bifurcation. This in turn led to higher levels of turbulent and disturbed flow, and larger secondary flow motion in the LPA compared to the RPA. The high levels of turbulence measured in the main and left pulmonary arteries with the stenotic valves, could lead to the clinically observed phenomenon of post stenotic dilatation in the MPA extending into the LPA. PMID- 3957944 TI - A kinematic study of center of mass motions in the hammer throw. AB - Eight highly-skilled hammer throwers were studied using film analysis procedures. The location and velocity of the center of mass (c.m.) of each thrower, hammer and thrower-hammer system were calculated. The vertical component of motion of all three c.m.s followed cyclic patterns with one fluctuation per turn. The fluctuation of the c.m. of the thrower was ahead of that of the hammer by approximately a third of a cycle, and this made the periods of upward vertical acceleration of the system c.m. coincide approximately with the double-support phases. In the horizontal direction, the c.m.s of the thrower and of the hammer followed roughly trochoid patterns as a result of the combination of rotation with forward displacement across the throwing circle. Their rotations were out of synchrony by approximate synchrony with the hammer, or an essentially straight trajectory. The results of this study suggest that the investigation of the hammer throw might be facilitated by the use of a quasi-inertial non-rotating reference frame that follows the general motion of the system c.m. while ignoring its fluctuations within each turn. PMID- 3957945 TI - Dynamic performance characteristics of the liquid metal strain gage. AB - Performance characteristics of the liquid metal strain gage (LMSG) were evaluated by both static and dynamic bench testing. Statically, the devices were found to have outputs closely proportional to engineering strains, up to strain levels of 40%. While individual gage factors varied appreciably (up to 50%), each of the gages studied showed excellent reproducibility of behavior. Dynamically, the response to sinusoidal strain inputs was frequency-independent up to 50 Hz, and there was no detectable phase shift. Similarly, the LMSG response to constant speed displacement inputs was velocity-independent over the range of nominal strain rates from 20 s-1 to 0.02 s-1. The devices proved capable of maintaining stable outputs when held stretched to fixed lengths, even if such tests were performed immediately following stepwise displacement inputs. Thermal artifacts were found to be modest (0.185% apparent strain per degree C), and there was no appreciable sensitivity to non-axial strains. When mounted on an in vitro ligament preparation, the LMSG measured apparent ligament strain similar to that detected by a video dimension analyzer. A protocol by which an implanted LMSG could be used to infer in vivo muscle forces was demonstrated, based on recordings of tendo-Achilles strains developed by a rabbit during slow hopping. PMID- 3957946 TI - Comments on the paper 'Incompressibility in bone' by Mahanian and Piziali. PMID- 3957947 TI - The effects of tibial-femoral angle on the failure mechanics of the canine anterior cruciate ligament. AB - A series of canine femur-ACL-tibia complexes were subjected to tensile tests with axial tibial orientation and 0 degree, 45 degrees or 90 degrees femoral orientation with respect to load direction. A deflection rate of 51.0 cm min-1 was used in all tests. Marked differences occurred in ultimate loads, deflection and energy absorbed as a consequence of differences in femoral-tibial orientation. The mode of structural failure, as determined by post-test examination, also varied markedly as a function of femoral-tibial orientation. It is concluded that differences both in measured mechanical properties and observed failure details are a consequence of varying the loading pattern of the fiber bundles across the finite breadth of the ligament. PMID- 3957948 TI - Estimation of the abrasive wear coefficient in Lillehei-Kaster cardiac valve prostheses. AB - An approximate hemodynamic theory, which predicts the opening dynamics of the Lillehei-Kaster heart valve, is used in conjunction with an abrasive wear model to predict the wear process on the shields. The hemodynamic theory predicts markedly different opening dynamics between the mitral and aortic positions and is shown to give excellent correlation with the experimental results of other investigations. The abrasive wear model is also shown to give excellent correlation with the experiments of others when the abrasive wear coefficient is taken as k = 6.4 X 10(-6). The theoretical results of this effort and the experimental data from clinical explants of other investigators is used to predict that occluder dislodgement is unlikely in less than 90 yr for either the mitral or aortic positions (for a mean cardiac output of 3.8 l.min-1 and a mean heart rate of 70 beats min-1). PMID- 3957949 TI - Comparative cardiovascular responses to intravenous capsaicin, phenyldiguanide, veratrum alkaloids and enkephalins in the conscious dog. AB - Cardiovascular responses to intravenous bolus doses of certain exogenous substances (capsaicin, phenyldiguanide, cryptenamine, veratrine sulphate) which act on chemoreceptors in the pulmonary or proximal arterial circulation were compared to the naturally occurring chemoreceptor agonist, leucineenkephalin (Leu5-ENK) in the conscious dog. Capsaicin (40 micrograms/kg) and phenyldiguanide (40 micrograms/kg) produced hypotension and bradycardia 5 to 12 sec after injection (P less than 0.05) followed by hypertension (P less than 0.05). Cryptenamine (5 micrograms/kg) produced only hypotension and bradycardia (P less than 0.05) whereas Leu5-ENK (35 micrograms/kg) produced only hypertension and tachycardia (P less than 0.05). The hypotension and bradycardia produced by capsaicin and phenyldiguanide occurred earlier than the pressor response to Leu5 ENK, capsaicin, and phenyldiguanide and the depressor response to veratrine (P less than 0.05). Cryptenamine (5 micrograms/kg) and Leu5-ENK (35 micrograms/kg) when given together had additive effects on heart rate but interacted significantly in influencing blood pressure (P less than 0.05). It is concluded that the early response to capsaicin and phenyldiguanide are compatible with stimulation of known pulmonary chemoreceptors (including J receptors) whereas the pressor effect of phenyldiguanide and Leu5-ENK and the depressor response to veratrum alkaloids are due to activation of receptors in the proximal arterial circulation. The influence of Leu5-ENK on the haemodynamic response to veratrine suggest that ENK may modulate the Bezold-Jarisch reflex. PMID- 3957951 TI - A study of the relationship between dopamine and noradrenaline content and transmural pressure in the mesenteric arteries of the dog. AB - Transmural pressure was measured in the main trunk and in a proximal branch of the mesenteric artery from normotensive dogs. Dopamine and noradrenaline content were determined in both mesenteric arterial segments. For each vessel transmural pressure values and dopamine and noradrenaline content were plotted for calculation of linearity of regression. A positive correlation was found between transmural pressure values and catecholamine content in both segments of the mesenteric artery; i.e. in the main trunk and in the proximal branch. These findings suggest a reciprocal regulation between structure/function of these blood vessels and their sympathetic innervation. PMID- 3957950 TI - Biochemical characteristics of muscarinic cholinoreceptors in swine tracheal smooth muscle. AB - The tritiated muscarinic cholinoreceptor antagonist quinuclidinyl benzilate, [3H]QNB, was used to characterize the muscarinic receptors associated with homogenized membrane of the smooth muscle from swine trachea. Based on receptor binding assays, the homogenate had specific, saturable, high-affinity receptors for [3H]QNB. Specific binding was time- and temperature-dependent. The association of [3H]QNB with the muscarinic receptor reached equilibrium much sooner at 37 degrees C than 25 degrees C at a [3H]QNB concentration of 180 pM (30 min and 2 h, respectively). Equilibrium at both temperatures was attained within 5 min at a [3H]QNB concentration of 1800 pM. All remaining experiments were performed at 37 degrees C. Binding was saturable with respect to [3H]QNB and tissue concentrations. Analysis of binding isotherms yielded an apparent equilibrium dissociation constant (KD) of 51 +/- 20 pM and a maximum receptor density (Bmax) of 2.17 +/- 0.27 pmole/mg protein. The Hill coefficient for [3H]QNB binding was 1.07 +/- 0.16. The association (K1) and dissociation (K-1) rate constants were determined to be (5.51 +/- 0.16) X 10(8) M-1 min-1 and (1.41 +/- 0.18) X 10(-2) min-1, respectively. KD calculated from the ratio of K1 and K 1 was 26.3 +/- 3.8 pM; this value is close to the value of KD calculated from Scatchard plots of binding isotherms. The density of muscarinic receptor binding sites was 10-fold greater in tracheal smooth muscle than in tracheal epithelium (0.20 +/- 0.03 pmole/mg protein). There is no difference between weanling and young adult swine in the density of muscarinic receptors in tracheal smooth muscle. The nonselective muscarinic antagonists atropine, scopolamine and quinuclidinyl benzilate (QNB) competitively inhibited [3H]QNB binding to the homogenate with Hill coefficients of 0.9-1.0 and inhibition constants (Ki) of nanomolar range. Competition with selective muscarinic antagonists pirenzepine and 3-quinuclidinyl xanthene-9-carboxylate (QNX) gave Ki values, 0.26 M and 0.78 nM, respectively, and Hill coefficients of approximately 1. There was a single population of [3H]QNB binding sites of the M2 subtype for all tested muscarinic antagonists. Competition with selective muscarinic agonists pilocarpine and carbachol yielded Ki values of micromolar range, Hill coefficients of less than 1, and revealed the existence of two binding sites (P less than 0.01). PMID- 3957952 TI - The cardiovascular effects of centrally administered 5-hydroxytryptamine in the conscious normotensive and hypertensive rat. AB - The cardiovascular effects of centrally administered 5-hydroxytryptamine (5-HT) have been analysed in conscious normotensive and hypertensive rats. In conscious normotensive rats, 5-HT, (1-30 micrograms) administered intracerebroventricularly (i.c.v.) produced profound and immediate dose-related decreases in heart rate and small increases in blood pressure. The initial pressor responses were followed by secondary secondary depressor responses at high doses of 5-HT. Similar effects were produced by 5-HT i.c.v. in conscious DOCA-salt and spontaneously hypertensive rats, although the magnitude of the pressor responses was substantially greater in hypertensive than normotensive rats. Pretreatment with either N-methylatropine or atenolol intra-arterially reduced the 5-HT-induced bradycardia in normotensive rats; the reduction was enhanced when both antagonists were given in combination. The 5-HT2 antagonist, cyproheptadine (10 micrograms i.c.v.) increased basal blood pressure and heart rate in normotensive rats. Subsequent administration of 5-HT i.c.v. produced biphasic effects on heart rate consisting of an initial tachycardia followed by a marked bradycardia. Methysergide (10 micrograms i.c.v.) pretreatment did not alter resting heart rate, but attenuated the 5-HT induced bradycardia. A higher dose of methysergide, (30 micrograms i.c.v.), decreased resting blood pressure and heart rate. This study has demonstrated, therefore, that the 5-HT induced bradycardia is produced by not only a centrally mediated decrease in sympathetic tone, but also an increase in vagal drive to the heart. The bradycardia is antagonised by centrally administered methysergide, but not by cyproheptadine, which suggests that it is probably mediated through a '5-HT1-like' receptor mechanism. PMID- 3957953 TI - Comparison of the cardiac effects of beta-adrenoreceptor agonists in anaesthetised and conscious dogs. AB - The cardiovascular effects of some beta-adrenoreceptor agonists on heart rate, blood pressure and myocardial contractility (maximum rate of change of left ventricular pressure/integrated isometric tension) were measured in pentobarbitone-anaesthetised and conscious, instrumented greyhounds. In anaesthetised dogs isoprenaline increased heart rate and myocardial contractility and reduced blood pressure. Prenalterol and RO 363, in equiactive inotropic doses, induced greater increases in heart rate than isoprenaline if blood pressure fell by less than 25 mmHg. Salbutamol had hypotensive activity at all doses and appeared to be a relatively selective inotrope. None of the agonists caused blood pressure to fall in the conscious dogs. Prenalterol and RO 363 were more effective inotropic stimulants, producing smaller increases in heart rate and more pronounced increases in myocardial contractility. Salbutamol, however, elicited greater increases in heart rate in the conscious animals and the inotropic selectivity demonstrated in the anaesthetised animals was lost. The direct effects of the beta-adrenoreceptor agonists, without modification by reflexes could be observed in the anaesthetised animals. The differences in the actions of the agonists in the conscious animals appear to be attributable to the state of the baroreceptor reflex control system and the relatively enhanced responsiveness of the heart. PMID- 3957954 TI - Fracture toughness determination of dental amalgams through microindentation. AB - A microindentation technique was used to study and estimate the fracture toughness of six amalgams. A significant difference is observed between fracture toughness at the bulk and the margin of amalgams. All amalgams show significant differences in fracture toughness as a function of distance from the margin. Microindentation measurement of fracture toughness appears to be an effective method of evaluating the localized brittleness of amalgams. PMID- 3957955 TI - Percutaneous healing of clinical tympanic membrane implants. AB - Percutaneous healing is plagued by materials compatibility problems, epidermal reactions, and mechanical factors. To our knowledge, no studies have evaluated the effects of one of these factors while controlling the others. The tympanic membrane is an implant site where mechanical factors are minimized. Titanium has been shown to be a very histocompatible material, although no reports of the histology of percutaneous titanium implants exist. This study reports on aspects of the epidermal and connective tissue healing around titanium tympanic membrane implants that were explanted from human subjects. The lack of inflammation and the direct adherence of the tissues substantiate the materials compatibility and the absence of mechanical factors. Tissue healing patterns appear to reach an equilibrium which is suitable for the long-term existence of the percutaneous device. This implant location provides a suitable model for studying the tissue reactions to various percutaneous materials. PMID- 3957956 TI - The effects of an enhanced inflammatory reaction on the surface properties of cast Biomer. AB - The ability of a biomaterial to withstand the rigors of the harsh biologic environment is an important consideration when considering a material for long term biomedical applications. Using a cage implant system, the effects of an intense inflammatory reaction on cast Biomer have been investigated. The inflammatory response to cast Biomer was greatly increased by coimplanting Biomer films with a cytotoxic poly(vinyl chloride) (PVC) in rats for a period of 21 days. Cast Biomer films were characterized by weight, advancing contact angle with water in air, attenuated total reflectance infrared spectroscopy and scanning electron microscopy (SEM). The analyses were performed before any treatment, after autoclaving and sonication, and after 21 days implantation with the cytotoxic (PVC) in rats. The results of the study indicated that cast Biomer does not undergo significant chemical degradation when subjected to the effects of an intense inflammatory reaction for 21 days. Implantation does, however, lead to rearrangement that results in a more polar and hydrophilic surface, suggesting that the polymer adapts to the hydrophilic environment of the inflammatory exudate. PMID- 3957957 TI - Acoustoelectric technique for assessing the mechanical state of the dental implant-bone interface. AB - A simple technique is described for in vivo assessing the interfacial rigidity between a dental root implant and the bone surrounding it. The method is based on estimating the frequency (10 to 150 KHz) and amplitude of the vibration of the implant induced by a small pulsed force. Application of the force to the implant and detection of the vibrational signal from the implant are performed by lightly touching it with two fine needles connected with piezoelectric elements. A distinct signal difference observed in animal tests of bioactive implant and nonbioactive one is shown to well agree with that obtained from corresponding ex vivo models. PMID- 3957958 TI - Synthesis and bioevaluation of alkyl 2-cyanoacryloyl glycolates as potential soft tissue adhesives. AB - A series of alkyl 2-cyanoacryloyl glycolate tissue adhesives were synthesized and characterized by NMR. Physical properties and bond strengths are presented. Within the series, bond strength decreased with increasing molecular weight. Corresponding polymers were evaluated by in vitro and in vivo techniques for biocompatibility. In general, in vitro biocompatibility increased with molecular weight. Based on in vitro and in vivo results, the isobutyl and isoamyl derivatives gave polymers that were most biocompatible, however, the entire series was found to be less reactive than poly(methyl 2-cyanoacrylate) and only the isopropyl derivative polymers more reactive than poly(isobutyl 2 cyanoacrylate). Approximately one-third of the isobutyl polymer biodegraded in vivo after 6 weeks. PMID- 3957959 TI - Synthesis and bioevaluation of a rapidly biodegradable tissue adhesive: 1,2 isopropylidene glyceryl 2-cyanoacrylate. AB - A rapidly biodegradable tissue adhesive, 1,2-isopropylidene glyceryl 2 cyanoacrylate, was synthesized and characterized by NMR. Bond strength was determined. Three types of corresponding polymers were prepared and evaluated for in vitro and in vivo toxicity. The polymers were generally found to be in the moderately toxic and toxic groups similar to the lower alkyl 2-cyanoacrylates. PMID- 3957960 TI - Release of corrosion products by F-75 cobalt base alloy in the rat. II: Morbidity apparently associated with chromium release in vivo: a 120-day rat study. AB - There is concern whether in vivo corrosion of chromium-cobalt alloys releases ions containing trivalent [Cr(III)] or hexavalent [Cr(VI)] chromium. The question arises from indications that Cr(VI) is far more biologically active than Cr(III). Using a previously developed microsphere implant model, specimens of F-75 chromium-cobalt-molybdenum alloy were implanted in rats for periods up to 120 days. Blood and urine were collected at intervals during the study. Significant postoperative serum and urine chromium concentration elevations were observed. In addition, weight gain inhibition, lung morbidity, and animal mortality, related to the implant surface area to animal body weight ratio (SA/BW), were observed. Comparison of measured chromium serum concentrations with those concentrations found by others to be biologically active in tissue culture studies strongly suggests the release of Cr(VI) in this study. PMID- 3957961 TI - Thrombin uptake and inhibition on endothelium and surfaces with a stable heparin coating: a comparative in vitro study. AB - The endothelial lining and two differently heparin-coated surfaces were compared in vitro regarding thrombin uptake and inhibition. One heparin surface was based on stabilized ionic binding of heparin, the other on covalent binding of partially degraded heparin. Both heparin surfaces have previously been shown to have pronounced thromboresistant properties. The two heparinized polyethylene surfaces and the endothelial surface of segments of the porcine aorta were studied. After exposure to the surfaces, thrombin disappeared from the solution and appeared bound to the surfaces. The disappearance rate of thrombin from the solution was the same on exposure to the endothelium and the covalently bonded heparin surface, but less following exposure to the ionically bonded heparin surface. The thrombin activity appearing on the endothelium was lower than on the heparin surfaces, indicating that the endothelium exerted a slow thrombin inhibiting capacity. On exposure of the thrombin-loaded endothelium to plasma, thrombin was rapidly inhibited. Thrombin bound to the covalently bonded heparin surface was inhibited at a slower rate than on the ionically bonded surface, but still faster than the rate at which free thrombin was inhibited in nonheparinized plasma. It is concluded that the endothelium and stabilized heparin coatings bind thrombin and accelerate its inhibition by plasma. PMID- 3957962 TI - SEM analysis of surface-treated dialdehydestarch. AB - Surface characteristics of protein-treated dialdehydestarch (DAS), which is utilizable as a gastrointestinal sorbent for the treatment of uremia, are examined by scanning electron microscopy (SEM). Unique wrinkles or continuous depressions were observed on the surface of some albumin-treated DAS particles. An increase in concentration and composition of albumin to DAS produces more particles with this kind of rugged surface. On the other hand, gelatin treatment provided a DAS with somewhat rough surface. As the stoichiometric ratio of gelatin to DAS increases, some fibrous or thin-leaves-like projections became outstanding on the surface. Urea-binding properties of protein-treated DAS are just about the same regardless of the protein concentration or composition. In addition, wrinkles or depressions partly observed on the surface of albumin treated DAS are of little benefit in terms of effective urea binding. These results mean that inherent physical properties of DAS such as dialdehyde content would be a critical factor in urea-sorption ability, rather than surface characteristic or the presence of protein. PMID- 3957963 TI - Composites for use in posterior teeth: mechanical properties tested under dry and wet conditions. AB - The purpose of this investigation was to determine some mechanical properties of eight different posterior composites, and how they are affected by water sorption. Creep characteristics in compression were expressed as compliance/log time functions. Stress-strain relationship at a constant loading rate was determined both in compression and flexure, and presented as elastic modulus, ultimate strength, and ultimate strain. Water sorption increased creep values for all materials. Generally, the materials with the highest water sorption had the highest increase in creep. Water sorption decreased the elastic modulus and ultimate strength values. The creep values decreased and the elastic modulus increased with increasing quantity of inorganic fillers. PMID- 3957964 TI - Polyurethane radiopaque marker for indwelling devices. PMID- 3957965 TI - Zinc release from dental restorative materials in vitro. AB - Zinc release from a range of dental restorative materials was measured in the absence and presence of dentin over a 2-week period. The presence of dentin was designed to simulate the residual dentin in vivo. There were considerable differences in both the levels and pattern of zinc release for the different materials. In several cases the concentrations exceeded the level which has been reported cytotoxic to cells in culture. With dentin, little zinc passed into solution, and high concentrations were measured in the dentin. This may explain the discrepancy between in vivo toxicity tests using zinc-containing materials and previous in vitro tests which have not included dentin in the test system. PMID- 3957966 TI - Glass transition temperatures of dental porcelains at high heating rates. AB - The glass transition temperature (Tg) of a dental porcelain is a factor in determining the magnitude of residual stresses introduced in a dental porcelain during cooling of a porcelain-fused-to-metal prosthesis. Tg is known to vary with changes in heating or cooling rate. However, available commercial instrumentation does not permit Tg to be obtained at the very high cooling rates commensurate with actual dental laboratory practice. Tg values are reported here for a number of commercial dental porcelains and other materials. These data were obtained by the bending beam technique, employing a special low thermal-mass furnace to permit rapid heating and cooling rates. Measurements were made at rates as high as 600 degrees C/min. Coefficients of determination (r2) for 1/Tg vs. ln (heating rate) were excellent. This relation is consistent with previously reported low rate Tg data obtained by a different technique. PMID- 3957967 TI - In vitro calcification and in vivo biocompatibility of the cross-linked polypentapeptide of elastin. AB - The in vitro calcifiability and molecular weight dependence of calcification of the polypentapeptide, (L X Val1-L X Pro2-Gly3-L X Val4-Gly5)n, which had been gamma-irradiation cross-linked have been determined when exposed to dialyzates of normal, nonaugmented fetal bovine serum. The material was found to calcify: calcifiability was found to be highly molecular weight dependent and to be most favored when the highest molecular weight polymers (n approximately equal to 240) had been used for cross-linking. The in vivo biocompatibility, biodegradability, and calcifiability of the gamma-irradiation cross-linked polypentapeptide were examined in rabbits in both soft and hard tissue sites. The material was found to be biocompatible irrespective of its physical form and to be biodegradable but with n of 200 or less it was not shown to calcify or ossify in the rabbit tibial nonunion model. PMID- 3957968 TI - A simple method to heparinize biological materials. AB - A new method was developed inducing antithrombogenicity to biologic materials. A basic protein, protamine, was used to increase heparin binding to collagenous materials. Protamine sulfate solution was poured into a collagen-rich material (porcine ureter). The protamine adsorbed to the collagen was then cross-linked to the material by glutaraldehyde. The collagen-protamine complex was then interacted with a heparin solution to ionically bind heparin to the material. The amount and the distribution of the bound heparin can be controlled by changing the protamine fixation to the material. A heparinized porcine ureter as a vascular substitute showed excellent antithrombogenicity in experimental animal studies. This method is expected to be used as method for developing antithrombogenic artificial organs, and as a method for the development of antiadhesive membranes. PMID- 3957969 TI - Polyacrylic acid-metal adhesive bond joint characterization by x-ray photoelectron spectroscopy. AB - The adhesive force to human tooth and metallic restoration of dental cements which contain polyacrylic acid (PAA) is found to be stronger than that of previous cements. Chemical interaction at the interface between metals and carboxylate groups of PAA were studied by x-ray photoelectron spectroscopic method combined with Ar+-ion beam etching technique to examine the mechanism of adhesion. A 2.5 wt% aqueous solution of PAA was painted on the surface of metal plates which are usual elements of dental alloy. Ar+-ion etching was used to scrape off in situ the PAA film coated on the metal plate gradually in the sample chamber of the ESCA equipment. After a few minutes of etching, ESCA spectra were observed. The profile of the spectra and binding energy of 4f5/2 and 4f7/2 levels of Au coated with PAA show little change by the Ar+-ion etching, and remain in the same state as those of uncoated Au. Similar behaviors were obtained in case of Pt. There are three chemical states on Sn plate coated with PAA. The lowest binding energy peak is assigned to pure Sn. The middle one is assigned to SnO2. The highest one corresponds to Sn combined with carboxylate groups of PAA. The chemical reaction corresponding to the highest binding energy peak seems to contribute to the strong adhesive force of these cements to Sn. These aspects of spectra corresponded to McLean's results which showed that these cements had weak adhesion to Au and Pt, but strong adhesive force to tinned Au and Pt. PMID- 3957971 TI - On the correlation between the failure of vascular grafts and their structural and material properties: a critical analysis. AB - A statistical investigation of reported vascular graft failures over a period of 30 years is undertaken. The most important causes of graft failure are underlined, as well as the time to failure and relative frequency of each failure mechanism. This brings out the need for a critical review of the properties of basic textile structures used in today's vascular prosthetic grafts. The physiologic and structural factors which contribute to mechanical failure of arteries and artery/implant composite systems are analyzed. The importance of obtaining the complete set of time-dependent elastic constants of the artery- which is viewed as an anisotropic material--is pointed out. Future research areas important for characterizing the mechanical behavior of artery/implant systems are suggested, with the aim of establishing rational standards for prosthesis evaluation. PMID- 3957972 TI - Resource allocation and the needs of orthopedic surgeons--the Academy's role. PMID- 3957970 TI - Mechanical effects on rates of hemolysis. AB - Empirical studies were conducted on how rates of hemolysis were influenced by mechanical factors, such as shear, turbulence, agitation, pressure fluctuation, and bubbling, in five types of experimental apparatus: rotating cylinder, rotating disks, agitated vessel, pressure pulsator, and bubble columns. Our data indicate, at least qualitatively, that an important mechanical factor controlling rates of hemolysis in practical devices, in which blood does not flow in thin channels or capillaries, is the turbulent stress in the bulk blood, rather than the shear at the blood-solid interface. PMID- 3957973 TI - Primary neoplasms of the cervical spine. Diagnosis and treatment of twenty-three patients. AB - The records of twenty-three patients with a primary benign or malignant osseous neoplasm of the cervical spine were reviewed in an attempt to clarify the most appropriate diagnostic and treatment methods for such tumors. Thirteen patients had a benign tumor and ten patients had a malignant tumor. Nineteen patients had been followed for two to eighteen years (average, six years), and four had died from the malignant disease between one and five months after its discovery. In addition to surgery, medical treatment in the ten patients with a malignant tumor included radiation therapy in seven and chemotherapy in two. Surgical treatment consisted of an anterior and posterior partial resection combined with an arthrodesis in four patients; an anterior partial resection in three, two with an arthrodesis; a posterior partial resection and an arthrodesis in two; and a biopsy but no further treatment in one patient. The duration of survival ranged from one to five months for four patients and from two to three years for four, and was eight and sixteen years in two patients. Two of the thirteen patients with a benign tumor received radiation therapy. Surgical treatment included both an anterior and a posterior resection with arthrodesis in four, an anterior resection in three (with arthrodesis in two), a posterior resection in four (with arthrodesis in three), and a biopsy without surgical resection in two. At follow up, twelve patients were pain-free and had a solid arthrodesis, although one had required a repeat excision posteriorly. One patient with Gorham's disease (diffuse hemangiomatosis) died. During the period of thirty years (1953 to 1983) when these patients were seen, both the diagnostic methods available and the surgical approaches used have changed. Our present opinion is that all primary osseous lesions of the cervical spine should be carefully defined by arteriography, tomography, bone-scanning, computed tomographic scanning, and myelography in order to properly plan the surgical approach. Total excision of suspect malignant lesions is not attempted, but a major intralesional excision should be carried out to decompress neural and vascular structures and to obtain a biopsy specimen, followed by an arthrodesis to stabilize the spine. For both malignant and benign tumors, an anterior resection should be performed if the tumor is located anteriorly, and a posterior approach should be used if the tumor is predominantly in the posterior vertebral elements. Both of these procedures should be combined with an arthrodesis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3957974 TI - Orthopaedic manifestations of leukemia in children. AB - Acute leukemia of childhood may present with various clinical manifestations that mimic orthopaedic conditions. The osseous radiographic abnormalities of this disease, although well described in the literature, are not pathognomonic, and certain changes may not be as frequent as was previously thought. In a retrospective study, we reviewed the cases of 107 patients, less than eighteen years old, who had been seen at the Winnipeg Children's Hospital. The mean follow up was 4.6 years for the fifty-eight patients who were still alive and 2.0 years for the forty-nine non-survivors. In twenty-two (20.6 per cent) of the patients, the presenting complaints were pain in the extremities, back pain, osteomyelitis, septic arthritis, or fracture. The radiographic abnormalities, which were present in forty-seven (43.9 per cent) of the children at the time of diagnosis, were osteopenia, lytic lesions, metaphyseal bands, periosteal new bone, and sclerotic lesions. Since the initial symptoms of leukemia commonly involve the musculoskeletal system, a high index of suspicion must be maintained by orthopaedic surgeons. PMID- 3957975 TI - Total hip arthroplasty in juvenile rheumatoid arthritis. Two to eleven-year results. AB - From 1971 to 1980, forty-five patients with juvenile rheumatoid arthritis had eighty-three cemented total hip replacements at The Hospital for Special Surgery and North Carolina Memorial Hospital. Thirty-four of these patients, with sixty two involved hips, returned for examination and radiographs. The average age of these thirty-four patients at the time of surgery was twenty-six years, and twenty-seven of them, with forty-nine involved hips, were thirty years old or less. The average length of follow-up was six years (range, two to eleven years), with forty-one hips having been followed for five to eleven years. According to The Hospital for Special Surgery hip-rating system, thirty hips were rated excellent; nineteen, good; nine, fair; and four, poor. Of the four hips with a poor result, two (in the same patient) had severe heterotopic ossification with ankylosis postoperatively, and two had required revision: one for acetabular loosening six years after replacement and the other for a broken stem of the femoral component ten years postoperatively. Radiographic review of the sixty-two hips demonstrated progressive radiolucencies or migration of 26 per cent of the acetabular components and 8 per cent of the femoral components. The frequency of acetabular migration or progressive radiolucencies was related to the postoperative position of the component relative to the position of the true acetabulum. These results were somewhat better than those in other reports on cemented total hip replacement in young patients. The difference is probably related to the lower average weight and decreased activity level of patients with juvenile rheumatoid arthritis. PMID- 3957976 TI - Bone allografts of femoral heads: procurement and storage. AB - Orthopaedists are increasingly using femoral heads as bone grafts, which can be easily stored by freezing without elaborate equipment and with minimum personnel involved. Our experience has shown that if standard sterile techniques are followed in procurement and storage, an abundant supply of useful allografts can be ensured. PMID- 3957977 TI - Loosening of the porous coating of bicompartmental prostheses in patients with rheumatoid arthritis. AB - Thirty-four porous-coated anatomical (PCA) total knee arthroplasties in twenty eight patients with rheumatoid arthritis were followed for an average of seventeen months. In these thirty-four knees, twenty-three tibial and fifteen femoral components were cemented. The rest were uncemented. At follow-up, more than half of the knees (nineteen of thirty-four) showed radiographic evidence of displacement of some of the beads from the porous coating. In fourteen knees the beads loosened more than three months postoperatively, and all of these knees had a radiolucent zone. Six knees had beads within the joint. Eight of nine non cemented tibial components (excluding one tibial component) and five of the nineteen femoral components that were not cemented showed late loosening of beads (after three months). This study indicates that the metallurgical technique for porous coating with heat-sintered cobalt-chromium beads does not produce a coating that is sufficiently strong to prevent loosening in the case of the porous-coated anatomical prosthesis. The long-term clinical relevance of our findings is unclear. The mechanical strength of the porous coating on the prosthetic surface should be improved and the prosthesis should be tested in limited clinical studies before cementless fixation can be recommended. PMID- 3957978 TI - Fractures of the tibial plafond. AB - The cases of one hundred and forty-two patients with 145 fractures of the ankle joint that involved the tibial plafond were reviewed. The fractures were classified into five types according to the severity of the injury. The methods of treatment were divided into two groups: open reduction and rigid internal fixation by the AO technique, and other methods. The most important variables that affected the final clinical result were the type of fracture, the method of treatment, and the quality of the reduction (p less than or equal to 0.05). The best results were obtained by rigid open reduction and internal fixation, with which 65 per cent of the more severe type-III, IV, and V fractures obtained a good or excellent result. PMID- 3957980 TI - Natural history of scoliosis in Friedreich's ataxia. AB - Does scoliosis associated with Friedreich's ataxia behave like an idiopathic or a typical neuromuscular scoliosis? Should it be treated like an idiopathic or a neuromuscular curve? Since no precise information to answer these questions could be found in the orthopaedic literature, a retrospective study was undertaken of seventy-eight patients with Friedreich's ataxia who had been followed at our neuromuscular clinic. Fifty-six of these patients were found to have typical Friedreich's ataxia in accordance with the criteria of Geoffroy et al., and their cases were retained for analysis. Their mean age was twenty years (range, eight to thirty-three years). The average length of clinical follow-up was nine years and the average duration of radiographic follow-up of the scoliosis was 3.5 years. A scoliosis of more than 10 degrees was found in all patients and was associated with a hyperkyphosis in 66 per cent. Both sexes were equally affected. Fifty-seven per cent of the curves were double thoracic and lumbar; 14 per cent were thoracolumbar; 7 per cent, double thoracic and thoracolumbar; 7 per cent, thoracic; 4 per cent, lumbar; and 11 per cent, multiple small curves. Of the fifty-six patients whose cases were studied, thirty-six had been followed for at least ten years. Among these thirty-six, there were twenty whose curves were more than 60 degrees and progressed (Group I) and sixteen whose curves were 40 degrees or less and did not progress (Group II).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957979 TI - Delayed paraplegia complicating sublaminar segmental spinal instrumentation. AB - The cases of two patients with delayed paraplegia after segmental spinal instrumentation with sublaminar wiring are reported. Both patients had complex spinal deformities and had transient neural deficits after the first-stage procedure of anterior release and spine fusion. They had uneventful spinal-cord monitoring during the second-stage procedure of posterior instrumentation and fusion, and function of the lower extremities was present immediately after that operation. Paraplegia then ensued, and was recognized thirty hours later in one patient and six days later in the other. Considering our reproducible and reliable experience (no false-negative results) with spinal cord monitoring in 307 operations, we propose that the delayed onset of paraplegia resulted from a progression of ischemic and edema-producing events that had not developed sufficiently intraoperatively to be reflected by the monitoring. The paraplegia became evident only when the subarachnoid space was obstructed because of progressive postoperative neural edema. The presence of sublaminar implants in narrow, kyphotic segments of the spinal canal probably exacerbated the neural irritation by dural impingement, which was seen myelographically. PMID- 3957981 TI - Syme amputation. An evaluation of the physical and psychological function in young patients. AB - Twenty-one patients who had had twenty-three Syme amputations at an average age of four years and eleven months were studied to assess their physical and psychological functional status. Physical evaluation was based on a timed fifty yard (45.7-meter) dash, Cybex testing of quadriceps and hamstring function, and history of sports participation. Psychological function was based on four psychological tests. Quadriceps power correlated closely with athletic function. Excessive genu valgum caused a noticeable abnormality of gait. Migration of the heel pad did not cause problems with gait. Better psychological function correlated with better orthopaedic function. The level of family stress was the predominant factor that influenced test results relative to behavior, self concept, and intelligence quotient. As a result of this study, we believe that a Syme amputation in a young patient may be compatible with athletic and psychological function closely approaching that of a non-handicapped child of the same age. PMID- 3957982 TI - Evaluation of the Noiles hinged knee prosthesis. A five-year study of seventeen knees. AB - The Noiles hinged knee prosthesis has been reported to diminish sheer and tensile loading on the cement-bone interface. Theoretically, this should eliminate the complication of loosening, commonly reported in hinged total knee prostheses. We reviewed the cases of all of the patients who have been treated with the Noiles knee prosthesis at our institution. Eighteen knees in fourteen patients were available, seventeen of which were followed for more than five years. Although all of the prostheses did well initially, ten knees in eight patients (56 per cent) had failed by an average of thirty-two months postoperatively. These eight patients included four of the five who weighed more than ninety kilograms and all of those who had had a prior arthroplasty. The failures were clearly defined along the lines of sex distribution. Measurements on the radiographs showed a significant difference between sexes in the metaphyseal diameter and thus in the percentage of the femoral canal that was filled by the prosthesis and cement. We concluded that prosthetic design must incorporate cortical cement support to reduce stress at the cement-bone interface, especially in a medullary canal with a larger diameter. PMID- 3957983 TI - Primary myectomy for sarcoma. AB - Sixteen patients with an intramuscular or intermuscular high-grade Stage-IIA soft tissue sarcoma in the upper or lower extremity were treated by en bloc myectomy of one or several muscles without preoperative or intraoperative open biopsy. The total anatomical compartment containing the tumor, bounded by deep fascia and major intermuscular septa, as defined by the Musculoskeletal Tumor Society, was not removed. Adjunctive therapy was not given. The clinical and radiographic diagnosis of sarcoma was supported by the study of cells obtained by fine-needle aspiration in eleven patients. During a median length of follow-up of seven years (range, one to fourteen years), there was only one local recurrence. Thus, it is our experience that, in addition to deep fascia and major intermuscular septa, an uninvolved muscle fascia that has not been transgressed by an open biopsy is an adequate barrier against tumor growth or so-called skip metastases, and that with the proper indications total compartmental resection is not necessary even for a high-grade sarcoma. PMID- 3957985 TI - Arthrography in the diagnosis of fractures of the distal end of the humerus in infants. AB - Single-contrast arthrography was performed in six infants who had an injury to the elbow because the exact nature of the injury was uncertain from interpretation of the plain radiographs and clinical findings. A correct diagnosis was made in all six patients, and it significantly altered the treatment in five. Four lesions were a Salter-Harris Type-I fracture and two were a Salter-Harris Type-II fracture. Three patients had a closed reduction, two required no reduction, and one had an open reduction. Child abuse of two infants was confirmed, and it was suspected in another two. PMID- 3957984 TI - The treatment of the painful hip in cerebral palsy by total hip replacement or hip arthrodesis. AB - The painful dislocated or subluxated hip in the patient with cerebral palsy presents a difficult problem in management. Twenty-three patients with cerebral palsy who had a painful subluxated or dislocated hip with degenerative changes were operated on at The Hospital for Special Surgery. Eight patients had a unilateral hip arthrodesis. Six had a successful arthrodesis initially, resulting in relief of pain and return to the preoperative functional level. A pseudarthrosis developed in two patients, but both had successful revision surgery, one by a second arthrodesis and the other by a total hip replacement. Thirteen of the fifteen patients with a total hip replacement were pain-free and functioning at a level consistent with their over-all involvement. One patient had migration of the greater trochanter and slight bending of the femoral component, with persistent pain. A second patient had progressive loosening of the femoral component over a period of seven years, but continued to walk with minimum pain. Two patients had a recurrent dislocation, one requiring revision of the femoral component and the other, of the acetabular component. We think that the presence of cerebral palsy, even in the patient with severe involvement, is not a contraindication for either a hip arthrodesis or a total hip replacement for a painful deformed or degenerated hip. These patients should be treated for the pain in the hip, and the presence of the underlying neuromuscular disorder should not deter the appropriate treatment. For unilateral hip disease in patients who are unable to walk and in young, active patients, we recommend hip fusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3957986 TI - Treatment of idiopathic scoliosis with the Wilmington brace. Results in patients with a twenty to thirty-nine-degree curve. AB - The results in seventy-nine adolescent patients (ninety-five curves) who had idiopathic scoliosis treated with the Wilmington brace are reported. The average follow-up was two years and six months (range, one to nine years). Before treatment, all of the patients had a curve that measured 20 to 39 degrees and a Risser sign of zero or 1. Although the magnitude of the curve was generally reduced by about 50 per cent with the initial application of the brace, a gradual loss of this initial improvement was observed both during active treatment and after the patient was weaned from the brace. Although twenty-seven (28 per cent) of the curves had progressed more than 5 degrees at follow-up, Lonstein and Carlson reported that the projected probability of progression of untreated 20 to 29-degree curves is 68 per cent. Thirty-six per cent of the thoracic curves, 16 per cent of the thoracolumbar and lumbar curves, and 28 per cent of the double major curves had progression of more than 5 degrees. However, only 11 per cent of the patients had a curve that progressed sufficiently to warrant fusion. Our findings indicate that the Wilmington brace favorably alters the natural history of 20 to 39-degree idiopathic curves. PMID- 3957987 TI - Excessive metal release due to loosening and fretting of sintered particles on porous-coated hip prostheses. Report of two cases. PMID- 3957988 TI - Rupture of the extensor tendons of the fingers. Report of three unusual cases. PMID- 3957989 TI - Monteggia fracture-dislocation in children. Late treatment in two cases. PMID- 3957990 TI - Congenital fibrosarcoma of the forearm. A case report. PMID- 3957991 TI - Fractures of the femoral neck associated with technical errors in closed intramedullary nailing of the femur. Report of two cases. PMID- 3957992 TI - Suprascapular nerve denervation secondary to attenuation by a ganglionic cyst. PMID- 3957993 TI - The randomized clinical trial in orthopaedics: obligation or option? PMID- 3957994 TI - Surgery for full-thickness rotator-cuff tears. PMID- 3957995 TI - The operative treatment of mid-shaft clavicular non-unions. PMID- 3957996 TI - The need for a standardized system for evaluating results of total hip surgery. PMID- 3957997 TI - Fractures of the sternum associated with spinal injury. AB - Twelve cases of sternal injury associated with spinal fractures have been reviewed. The sternum is regularly buckled or fractured in patients with high thoracic spinal fractures. Our review suggests that sternal injuries may also be associated with spinal fractures outside this region, and with types of fracture other than crushing of vertebral bodies. Injury to the sternum, when due to indirect violence, is almost always associated with a severe spinal column injury. A displaced fracture of the thoracic spine, with or without an associated sternal fracture, can produce significant widening of the mediastinal shadow on a chest radiograph. This is caused by a paravertebral haematoma, and can be difficult to differentiate from widening due to an aortic rupture. PMID- 3957998 TI - Fractured odontoid with fractured superior articular process of the axis. Report of three cases. AB - We report three patients in whom a fractured odontoid process was associated with a fracture of the superior articular process of the second cervical vertebra. Although there were no signs of neurological disorder, damage to the C1-C2 joint in all three patients made fusion necessary. Forced lateral flexion is suggested as the possible mechanism of injury. PMID- 3957999 TI - Stabilisation of spondylolisthesis using Dwyer instrumentation. AB - A method of stabilising spondylolisthesis using Dwyer instrumentation is described and the results in seven patients are presented. The operation is straightforward, has few complications and also succeeds in reducing the angle of slip. PMID- 3958000 TI - The surgical treatment of Scheuermann's kyphosis. AB - The results of surgery in 59 patients with Scheuermann's kyphosis are reported at an average follow-up of 56 months. These show that in skeletally immature patients, in whom the iliac apophysis has not yet fused to the body of the ilium, posterior fusion alone is adequate and is followed by little loss of correction. For skeletally mature patients combined anterior and posterior surgery is recommended. In all cases a period of pre-operative treatment is important. It is stressed that the indications for surgery are limited. PMID- 3958001 TI - Congenital scoliosis in monozygotic twins. Genetically determined or acquired in utero? AB - The term "congenital scoliosis" contributes little to our understanding of aetiology, for "congenital" simply means "to be born with" and is applicable to deformities present at birth whether these are genetically determined or acquired in utero. The presentation of monozygotic twins, one of whom has congenital scoliosis (vertebral anomalies) while the other is normal, provides a rare opportunity to study the cause of this deformity. Three pairs of monozygotic twins, previously unreported, are presented with a review of the previous literature. These cases add weight to the argument that congenital scoliosis may be acquired in utero rather than being genetically determined. PMID- 3958002 TI - The iliolumbar ligament. A study of its anatomy, development and clinical significance. AB - The development of the iliolumbar ligament and its anatomy and histology were studied in cadavers from the newborn to the ninth decade. The structure was entirely muscular in the newborn and became ligamentous only from the second decade, being formed by metaplasia from fibres of the quadratus lumborum muscle. By the third decade, the definitive ligament was well formed; degenerative changes were noted in older specimens. The iliolumbar ligament may have an important role in maintaining lumbosacral stability in patients with lumbar disc degeneration, degenerative spondylolisthesis and pelvic obliquity secondary to neuromuscular scoliosis. PMID- 3958003 TI - Arthroscopic surgery of the shoulder. A general appraisal. AB - Arthroscopic surgery of the shoulder was performed on 439 patients over a 10-year period: these patients are reviewed after a minimum follow-up of one year. Diagnostic arthroscopy is known to be valuable and we have found that arthroscopic surgery also is safe and effective. It was useful in treating frozen shoulder, early osteoarthritis, isolated tears of the glenoid labrum and lesions of the biceps tendon. It was less useful in treating partial tears of the rotator cuff, tendonitis and severe osteoarthritis, and of little value in treating complete tears of the rotator cuff or in treating patients in whom previous operations on the rotator cuff had failed. It may prove to be a useful method of performing synovectomy in rheumatoid arthritis and of treating instability. PMID- 3958004 TI - Designing an implant by CT scanning and solid modelling. Arthrodesis of the shoulder after excision of the upper humerus. AB - Techniques are described by which metal implants can be designed and produced to fit precisely a bony site at a subsequent operation. CT scans and solid modelling were used to produce an accurate three-dimensional representation of the surface of the bone. These techniques were applied to the production of an internal fixation device for shoulder arthrodesis after the resection of a neoplasm of the proximal humerus. The reconstruction utilised a free vascularised fibular graft between the scapula and the distal humeral remnant, fixation being secured with the custom-made implant. PMID- 3958005 TI - The significance of spasticity in the upper and lower limbs in myelomeningocele. AB - One hundred and nine children with myelodysplasia were evaluated and classified according to the level and type of paralysis and its effect on functional ability. Thirty-one per cent of the patients were paralysed at the thoracic level, 26% at the upper lumbar level, 30% at the lower lumbar level and 13% at the sacral level. Fifty-four per cent of these patients demonstrated the classic flaccid paralysis in the lower limbs with normal upper limbs; 9% were flaccid in the lower limbs, but were spastic in the upper; 24% were spastic in the lower limbs; 13% were spastic in the upper and lower limbs. Patients with spastic lower limbs required more orthopaedic procedures, more days in hospital and in casts, and were less likely to walk than those with flaccid paralysis. Patients with spastic upper limbs were less likely to be independent in activities of daily living and were more likely to require special schools than patients with normal upper limbs. In addition to the spinal cord level of the lesion, the degree of spasticity is important in the evaluation, treatment and prognosis of myelodysplastic patients. PMID- 3958006 TI - Total hip replacement in children with juvenile chronic arthritis. AB - The results of 75 total hip replacements in 42 children with juvenile chronic arthritis are reported after a mean follow-up of 5.4 years. Their ages ranged from 11 to nearly 17 years at operation and many had active disease. Severe pain and marked stiffness of the hips were limiting their independence. At least half of the children were still growing and continued to grow after operation. The patients were carefully selected and gratifying results were obtained, but pre operative assessment and overall supervision by a rheumatologist are important. Technical difficulties related to the size and maldevelopment of the hip are discussed. There was no infection and the single case of loosening of a femoral component after nine years has been successfully revised. PMID- 3958007 TI - Synovectomy of the knee in juvenile chronic arthritis. A retrospective, consecutive follow-up study. AB - We report 60 synovectomies of the knee in 51 children with juvenile chronic arthritis. Synovitis had been present for an average of 5 years and the average age at operation was 13 years. Results were evaluated in terms of pain, knee movement, relapse of synovitis and radiological change during a follow-up averaging 7.5 years. The relief of pain was rewarding and there was a slight postoperative gain in range of knee movement in most cases. The older the patient at onset of disease, the greater the risk of pain during follow-up. Progressive joint destruction was more common in younger patients, those with systemic or polyarticular disease, and those with highly active disease at the time of operation. Recurrence of synovitis was more frequent in patients who had their operation in a phase of high disease activity; this occurred most often in patients with polyarticular disease. PMID- 3958008 TI - Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis. AB - Closed rupture of the middle slip of the extensor hood of a finger is easily missed until the late appearance of a buttonhole deformity. Early diagnosis gives the best chance of satisfactory treatment, but Boyes' test becomes positive only at a late stage. A new test is described in which, from a 90 degree flexed position over the edge of a table, the patient tries to extend the proximal interphalangeal joint of the involved finger against resistance. The absence of extension force at the proximal joint and fixed extension at the distal joint are immediate signs of complete rupture of the central slip. The theoretical basis and the method of performing the test are discussed. PMID- 3958009 TI - The value of remanipulating Colles' fractures. AB - The value of remanipulating a Colles' fracture which has redisplaced after primary reduction was assessed in 50 patients. In those over 60 years old, remanipulation failed to achieve a lasting improvement in position, while the majority of those under 60 years maintained a significant improvement in dorsal angulation. It is concluded that the elderly patient does not benefit from this procedure. PMID- 3958010 TI - Internal fixation of ununited femoral neck fractures combined with muscle-pedicle bone grafting. AB - Fifty-six patients with ununited intracapsular fractures of the femoral neck were treated by internal fixation and muscle-pedicle bone grafting. All had some absorption of the femoral neck, and many had avascular necrosis of the femoral head. At operation the sclerosed surfaces of the fractures were freshened, the avascular femoral head was decompressed and the muscle-pedicle graft was fixed with silk thread wrapped around pins. Satisfactory union occurred in 42 patients (75%), and delayed union in seven, of whom four (7%) eventually united without further treatment and three united after osteotomy. Non-union occurred in five patients and technical failure in two. PMID- 3958011 TI - Subtrochanteric fractures: Zickel nail or nail-plate? AB - Of 135 consecutive patients admitted with subtrochanteric fractures of the femur, 104 were studied; half had internal fixation with a Zickel nail and half had a nail-plate device. Fractures treated with a Zickel nail had significantly less blood loss during operation and took less time to walk with full weight-bearing, but the incidence of technical error at operation was higher. Errors included malalignment of the cross-pin, penetration of the femoral cortex and comminution of the greater trochanter. There was mechanical failure within one year of surgery in 17% of the nail-plate series but no implant failures in the Zickel nail group within the same period. The total time spent in hospital was similar in both groups. The Zickel nail provides better fixation for subtrochanteric fractures than a simple nail-plate but, because of technical difficulty, its use should be reserved for surgeons of reasonable experience. PMID- 3958012 TI - Triple arthrodesis. A critical long-term review. AB - The results of triple arthrodesis performed in 80 feet and followed for an average of 13 years are reviewed. Although the majority of patients were very pleased, the results of objective assessment were less favourable. There was a high incidence of degenerative joint changes in the ankle and midfoot and also of pseudarthrosis, avascular necrosis of the talus and residual deformity. Pre operative rigid equinovarus deformity produced the majority of the poor results. It is suggested that bony resection alone might not be the best means of correcting severe equinus. PMID- 3958013 TI - A simple technique for arthrodesis of the ankle. AB - We report the results of a simple technique of ankle arthrodesis which is, however, indicated only when the foot can be reduced manually to a functional position. A special milling-cutter with an expulsion piston is used to obtain a cylindrical bone graft which is reintroduced having been reversed from left to right and rotated through 90 degrees. The operation is simple and very rapid. It has been performed on 72 patients, 62 of whom have been followed up for an average of six years. Fifty-seven were painless with bony fusion in a functional position; one was solid and painless but in valgus. In only four patients were the results unsatisfactory. PMID- 3958014 TI - Acute haematogenous osteomyelitis and septic arthritis--a single disease. An hypothesis based upon the presence of transphyseal blood vessels. AB - The acute childhood diseases haematogenous staphylococcal osteomyelitis and septic arthritis were studied concurrently using avian models which closely resemble the human diseases. Ultrastructural studies during the initial stages of bone and joint infection showed that adherence of bacteria to cartilage, bacterial proliferation, cartilage destruction and subsequent bacterial spread along the vascular channels within cartilage were common to both disease processes. Histological studies revealed that transphyseal blood vessels were present in the growing chickens and were a likely explanation for the frequency of the concurrence of acute osteomyelitis and adjacent joint infection following intravenous injection of bacteria. Transphyseal vessels provide a direct connection between the growth plate (physis) and epiphyseal cartilage supplying a route for bacteria to spread from an osteomyelitic focus in the metaphysis to the epiphysis and subsequently to the joint lumen. PMID- 3958015 TI - The safety of the Denis Browne abduction harness in congenital dislocation of the hip. AB - The Denis Browne abduction harness was used in the management of 127 abnormal hips in 104 children at Queen Mary's Hospital for Children from 1966 to 1980, both as the initial treatment for unstable hips recognised soon after birth, and for children presenting later and whose hips first required reduction by gradual abduction in traction. The incidence of significant avascular necrosis was 3.1%, and occurred only in the primary treatment group, emphasising again the need for gentle care of infant hips. There have been no other significant complications and the appliance has functioned well. PMID- 3958016 TI - Mechanical and biochemical properties of human articular cartilage in osteoarthritic femoral heads and in autopsy specimens. AB - We studied the mechanical and biochemical properties of articular cartilage from 22 osteoarthritic femoral heads obtained at operation and 97 femoral heads obtained at autopsy. Cartilage from the zenith and from the antero-inferior aspect of each head was tested both in tension and in compression. Water content, swelling ability and proteoglycan content were measured, the cartilage was examined histologically and the density of the underlying bone was assessed. Fifty-five of the autopsy specimens were defined as macroscopically normal because they exhibited no progressive fibrillation patterns on staining with Indian ink; but significant changes in water content, bone density and tensile strength related to age were seen in this group. In 20 pairs of femoral heads which were both macroscopically normal, we found, surprisingly, that cartilage from the left and right sides of the same patient was sometimes very different. Compared with the normal autopsy specimens the osteoarthritic specimens had a significantly increased swelling ability, a lower proteoglycan content and impaired mechanical properties, being both weaker in tension and softer in compression. Abnormal autopsy specimens had values intermediate between those of osteoarthritic and normal groups. Results from this abnormal group suggest that there is no primary loss of proteoglycan in early osteoarthritis. PMID- 3958017 TI - The outcome of infected arthroplasty of the knee. AB - In order to define the predisposing factors and outcome of infected arthroplasty of the knee, a retrospective analysis of a consecutive series of 471 knee arthroplasties was performed. There were 23 cases of superficial wound infection and 25 of deep infection. Superficial wound infection alone resulted in a painfree gait, with little limitation of movement. Rheumatoid arthritis, the use of constrained prostheses and the presence of a superficial wound infection, all predisposed to deep infection. Deep infection was eradicated by long-term antibiotics in only two patients in whom skin cover was successfully provided by a gastrocnemius musculocutaneous flap. Excision of a sinus track, wound debridement and exchange arthroplasty were universally unsuccessful. Arthrodesis, however, in 11 out of 12 cases, provided the painfree gait these patients desire. PMID- 3958018 TI - Radiological assessment of anterior cruciate ligament deficiency. A new technique. AB - A new method of demonstrating sagittal laxity in the anterior cruciate-deficient knee is described. Seventy such knees were compared to 70 normal knees. Sagittal laxity was recorded as the average displacement of the medial and lateral femoral condyles. This displacement index was significantly different between the two groups of knees (P less than 0.0001). A range for normal and abnormal knees is discussed. Quantitative assessment of the degree of sagittal laxity by clinical evaluation is shown to be unreliable. Only the pivot-shift test demonstrated any significant correlation with the amount of sagittal displacement (P less than 0.05). PMID- 3958019 TI - Radiographic assessment in patellar instability and chondromalacia patellae. AB - Minor degrees of malalignment of the patella and anatomical abnormalities including a flattened sulcus angle and an increased ratio between patellar tendon length and patellar length (PT:P) have been suggested as predisposing factors in the causation of chondromalacia patellae, as well as patellar instability. In order to confirm or refute this hypothesis a prospective study has been performed comparing the congruence and sulcus angles and the PT:P ratio in a group of 35 patients with chondromalacia confirmed by arthroscopy and a group of 33 patients with instability, with those of a group of 50 knees in normal volunteers. While there was a statistically significant correlation between an increased sulcus and congruence angle and a high-riding patella in patients with instability, no correlation could be identified in patients with idiopathic chondromalacia. PMID- 3958021 TI - Subperiosteal juxta-articular osteoid osteoma. AB - Subperiosteal osteoid osteoma in a juxta-articular site presents a diagnostic challenge. The clinical features of joint stiffness, synovitis, muscle atrophy and local warmth may suggest arthritis rather than osteoid osteoma, while radiographs, bone scans and angiograms may not be diagnostic. We describe four cases of this rare condition. PMID- 3958020 TI - The tricho-rhino-phalangeal syndrome. A report of 14 cases in 7 kindreds. AB - Tricho-rhino-phalangeal syndrome is probably not so much uncommon as unrecognised. Its significance to orthopaedic surgeons, apart from the functionally unimportant minor finger deformities, lies in its mimicking both Perthes' disease and diaphyseal aclasis. The 14 cases analysed in this paper illustrate the wide range of clinical variation. PMID- 3958023 TI - Presidential address: Australian Orthopaedic Association. PMID- 3958022 TI - Radical excision of an osteoblastoma of the cervical spine. A combined anterior and posterior approach. AB - We report and discuss a combined anterior, anterolateral and posterior approach to the lower cervical spine. This was used for the radical resection of a recurrent osteoblastoma which involved the lateral mass, pedicle, and lamina of the sixth cervical vertebra. PMID- 3958024 TI - Proceedings 18th National Cancer Congress of the German Cancer Society. March 4 8, 1986, Munich, Federal Republic of Germany. Abstracts. PMID- 3958025 TI - Initial histopathology of the autovein graft in late occlusion after arterial reconstruction. AB - Five patients developed local stenosis of autologous vein grafts implanted for femoro-popliteal arterial occlusive lesions. This stenosis occurred in the vein grafts 2 months to 5 years after the initial operation. Histopathologic study revealed that the stenotic segments had a thickened intima with a prominent proliferation of smooth muscle cells associated with fibrous extracellular matrix. There were no findings showing deposition of mural thrombi, as has heretofore been reported. The intimal thickening due to excessive fibromuscular proliferative response of the vein graft may possibly play an important role in the development of late graft occlusion. PMID- 3958026 TI - Freeze-preserved vein grafts and atherosclerosis. An experimental study. AB - Histopathological changes of three types of vein grafts were studied. Freeze preserved, fresh human grafts and autografts were inserted as patches in the aorta of rabbits on regular and variable cholesterol diets. In all grafts the endothelium and adventitia were reconstituted after a few months. In the wall, smooth muscle and elastic tissue were markedly diminished and poorly oriented with accompanied collagenisation. Cholesterol diet led to progressive fat and/or calcium deposition with subintimal proliferation in the autografts and fresh xenografts. In contrast this was seen to a much lesser degree and later in freeze preserved xenografts, even on higher cholesterol diets. Deep freezing considerably reduces the cellularity of the graft and its metabolic ability to accumulate lipids. Freeze-preserved veins seem to be a suitable graft for vascular reconstructions in severely atherosclerotic patients and compare favorably with vein autografts. PMID- 3958027 TI - Ruptured abdominal aortic aneurysms. AB - A series of 180 consecutive patients with ruptured aortic aneurysms has been studied to determine the causes of death. 18% died before operation could be carried out, 8% proved inoperable and a further 10.5% died before operation could be completed. Overall mortality was 75%. By multivariate analysis, the most significant preoperative features influencing survival were a systolic BP less than 80 mmHg on admission and a history of hypertension, angina or myocardial infarct. The mortality increased with increasing age. Administration of fresh frozen plasma preoperatively significantly increased survival. However, we could not identify a single group of patients for whom the outcome was inevitably fatal. PMID- 3958029 TI - Should all spontaneous popliteal aneurysms be operated on? AB - Operative treatment of spontaneous popliteal aneurysms (S.P.As) is occasionally disappointing. In order to determine the criteria for operation we analyzed retrospectively the fate of 77 S.P.As in 52 patients (mean age, 66 +/- 10 years). S.P.As were divided into 3 groups according to initial symptoms: group I, asymptomatic or mild symptoms, group II, rest pain or toe gangrene, group III, severe ischemia or foot gangrene. Patency rate of arterial reconstruction in groups I, II, III were respectively 83%, 43%, 36%. The course of S.P.As of group I that were not initially operated was not significantly different compared to those operated on, as long as they were frequently reviewed and operated on expeditionaly in cases of complications. The nature of the arterial substitute was the second contributing factor. Quality of run-off had no influence in groups I and II, but was determinant in group III. A good general condition was essential for survival. Operative indications of S.P.As is considered according to classification into 3 groups. Group I: bypass is mandatory, except when the general condition of the patient is poor or when a bad run-off is associated with an unavailable vein. Group II: bypass should be attempted whenever a distal arterial segment seems suitable. Otherwise lumbar sympathectomy may sometimes save a limb. Group III: bypass should be attempted only when the run-off is sufficient and when the tissue damage seems reversible. In the other cases, primary amputation is safer. PMID- 3958028 TI - Chronic traumatic aneurysms of the descending thoracic aorta (19 cases). AB - From 1973 through 1983, 19 cases of chronic traumatic aneurysms (CTA) were observed. Initial trauma was well documented in every case. Patients mean age at time of trauma was 22; mean age at time of surgery was 34. Sixty per cent of patients had no apparent thoracic injury at time of trauma. Ninety-five per cent had associated injuries. Ten/nineteen were asymptomatic. Eighteen were operated on. Rupture was complete in 11, partial in 7. One of the partial ruptures was a simple scar on the aorta. Eighteen were located at the site of the aortic isthmus, one was at level T8-T9. Seventeen had a prosthetic dacron graft sutured from inside the aneurysm. The case where a simple scar was found had a dacron wrapping. Spinal cord protection was used in all cases except in one who was already paraplegic preoperatively. Various shunts were used in 12 cases; 1 patient in the by-pass group had paraplegia. CTA is not a benign disease and all cases, even asymptomatic, should be operated on with a very low risk of mortality (0/18). Occurrence of paraplegia still remains a possible complication although the risk of spinal cord ischemia seems lower than in arteriosclerotic dissecting aneurysms. We favour the "old" technique of temporary dacron shunt graft in CTA for simplicity and easy assessment of function ot the shunt. PMID- 3958030 TI - Causes of limb loss in civilian arterial injuries. AB - Progress in the management of complex vascular injuries of the extremities has not eliminated the necessity for amputation. An analysis of 100 consecutive patients treated at the Lincoln Medical and Mental Health Center during 1974-1980 disclosed that five amputations followed 24 instances of blunt trauma, but only one minor amputation of toes was required in 76 patients after repair of arterial injuries associated with penetrating wounds. Extensive skeletal, muscular and skin loss at the sites of blunt trauma precluded salvage of two limbs. Physicians' failure to suspect arterial injury on admission in three patients with blunt trauma caused delay in the diagnosis and management of occlusive arterial injury that ultimately led to three amputations. In contrast, limited soft tissue damage accompanying penetrating wounds and high index of suspicion resulted in expeditious repair, accounting for the minimal risk of limb loss. Amputation may be obligatory in the presence of extensive skeletal and soft tissue destruction. However, limb loss due to delay in diagnosis is preventable. In every instance of blunt trauma to extremities, we advocate the same suspicion of vascular injuries as in penetrating trauma, with early liberal use of angiography whenever pulses are not absolutely normal, and prompt revascularization of ischemic limbs. PMID- 3958031 TI - Ischaemic syndrome of the lower limb produced by a hydatic cyst. AB - The development of two hydatid cysts following two primary inseminations near each other, one in the wall of the femoral artery and the other in the adductor muscles, resulted in an ischaemic syndrome in the affected limb. This raised interesting problems of diagnosis and pathology especially since the second cyst presented three and a half years later. PMID- 3958032 TI - Failure to culture bacteria in groin lymph nodes during arterial reconstruction. AB - A prospective trial was undertaken to establish if infection of groin lymph nodes was a significant risk factor in postoperative wound infection in patients undergoing groin dissection for arterial reconstruction surgery. In a series of 32 patients there was no growth on culture of any lymph nodes biopsied. None of the cases developed a post-operative infection discharging pus. In five cases minor superficial infections occurred from which bacteria were cultured. All resolved rapidly. All patients received prophylactic systemic antibiotics. We conclude that our present direct approach via a short vertical incision carries no increased risk of infection and has the advantage of speed and simplicity. It is unnecessary to make any special more complicated incision designed to avoid lymphatics. PMID- 3958033 TI - The "Lympha-Press" intermittent sequential pneumatic device for the treatment of lymphoedema: five years of clinical experience. AB - Five years of clinical experience with the "Lympha-Press" is presented. This intermittent sequential pneumatic device has proved to be very efficient as a conservative method of treatment in lymphoedema of the upper and lower limbs, and as an aid for surgery of lymphoedema. PMID- 3958035 TI - Ruptured abdominal aortic aneurysm with fistula into the inferior vena cava. AB - Aortocaval fistula is an unusual complication of ruptured abdominal aortic aneurysm. A case of coincident rupture of an abdominal aortic aneurysm into both the retroperitoneum and the inferior vena cava is presented. The symptoms and the treatment are discussed. PMID- 3958034 TI - Axillary vein thrombosis: a rare complication following creation of arteriovenous fistula for hemodialysis. AB - Thrombosis of the axillary vein occurred in two patients following creation of an arteriovenous fistula for hemodialysis. The thrombosis developed before the fistula was used for dialysis, and was demonstrated by venography. Treatment in both cases involved anticoagulant therapy and ligation of the fistula; both patients experienced relief of pain and swelling, although the collateral venous congestion remained unchanged. This complication of arteriovenous fistula creation has not been previously described, probably because thrombosis does not usually occur in a high venous flow state. PMID- 3958036 TI - Late pathological changes of Carpentier-Edwards porcine bioprostheses in the mitral position. AB - Eighty-nine patients received mitral valve replacement with Carpentier-Edwards porcine bioprostheses between 1975 and 1983. Eighty-three patients (93.3%) were followed up after the operation; early death (within one month of operation) occurred in 6 patients and late death in 2 patients. After the operation, 64 survivors (85.3%), who did not require reoperation, exhibited improved symptoms according to the NYHA functional class. Of the 6 patients (6.7%) who required reoperation, 5 patients underwent reoperation 50 to 85 months after the implantation. Pathologically, all the removed valves showed degeneration of collagen and elastic fibers, no host endothelialization and mild to moderate infiltration of inflammatory cells. Thrombus in the left atrium was detected in one case. Destruction of the cusps was seen in three cases and calcification of the cusps developed in three cases. In general, the Carpentier-Edwards porcine bioprosthesis provided good clinical improvement over the periods studied. However, morphological changes of the bioprosthetic valve, such as destruction collagen and elastic fiber, and inflammatory cell infiltration of the cusps, seems to occur more frequently with the passage of time. We therefore suggest that patients with this prosthesis should be followed carefully, particularly at late intervals after implantation. PMID- 3958037 TI - Surgical therapy of pulmonary thrombosis due to candidiasis in a premature infant. AB - We report a case of surgical removal of a pulmonary thrombosis in a premature infant with candidemia. The pulmonary thrombotic material contained candida albicans. Following surgical therapy the child recovered soon and candidemia did not recur. We conclude that surgical treatment of pulmonary thrombosis can be successfully done even in premature infants. PMID- 3958038 TI - Angiocardiographic demonstration of a partial defect of the pericardium with herniation of the left atrium and ventricle. AB - A case of a patient of 44 years of age with nonspecific thoracic symptomatology and anomalous protrusion of the second arch of the left border of the cardiac silhouette is reported. Cineangiocardiography showed a herniation of the left atrium and ventricle through a partial defect in the left pericardium demonstrating a mechanism that can give rise to sudden death by cardiac incarceration. Prophylactic longitudinal pericardiectomy was performed and the patient made an uneventful recovery. PMID- 3958039 TI - Anomalous origin of the left coronary artery from the pulmonary artery: new electrocardiographic, echocardiographic and surgical observations. AB - The case of a two year old girl with anomalous origin of the left coronary artery from the pulmonary artery is described. She was never in heart failure but had cardiomegaly and anginal pain. The ECG showed a typical infarct pattern with left ventricular hypertrophy. An unusual finding was a prolonged QTc of 0.52. During cardiac catheterization and twice 24 hours later she developed ventricular fibrillation treated with electroshock and prevented later with propranolol. The QTc returned to normal after surgery. Echocardiography showed diastolic flutter and early systolic closure of the pulmonary valve. This disappeared after surgical correction. Transverse 2D echo of the aortic root showed a large right coronary artery which decreased in size after surgery. The left coronary artery was not seen on echocardiography. At cardiac catheterization the diagnosis of an anomalous origin of the left coronary artery from the pulmonary artery was established, with a large shunt to the pulmonary artery through the anomalous artery. Mild pulmonary hypertension and mild mitral regurgitation were present. At surgery, since direct implantation was technically impossible, the left coronary artery was successfully connected to the aorta via a 6 mm expanded Poly Tetra-Fluoro-Ethylene (P.T.F.E.) graft. PMID- 3958040 TI - Aorto-left atrial fistula. AB - The authors present a case of fistula between the ascending aorta and the left atrium, with four large aneurysmal sacs and marked enlargement of the left atrium. The 10-year-old patient was treated by closing the fistula with a Dacron patch. The results were satisfactory in this extremely rare case of a congenital cardiac lesion. PMID- 3958041 TI - Assembly of protein 4.1 during chicken erythroid differentiation. AB - Protein 4.1 is a peripheral membrane protein that strengthens the actin-spectrin based membrane skeleton of the red blood cell and also serves to attach this structure to the plasma membrane. In avian erythrocytes it exists as a family of closely related polypeptides that are differentially expressed during erythropoiesis. We have analyzed the synthesis and assembly onto the membrane skeleton of protein 4.1 and in this paper we show that its assembly is extremely rapid and highly efficient since greater than 95% of the molecules synthesized are assembled in less than 1 min. The remaining minor fraction of unassembled protein 4.1 differs kinetically and is either degraded or assembled with slower kinetics. All protein 4.1 variants exhibit a similar kinetic behavior irrespective of the stage of erythroid differentiation. Thus, the amount and the variants ratio of protein 4.1 assembled are determined largely at the transcriptional or at the translational level and not posttranslationally. During erythroid terminal differentiation the molar amounts of protein 4.1 and spectrin assembled change. In postmitotic cells, as compared with proliferative cells, far more protein 4.1 than spectrin is assembled onto the membrane-skeleton. This modulation may permit the assembly of an initially flexible membrane skeleton in mitotic erythroid cells. As cells become postmitotic and undergo the final steps of maturation the membrane skeleton may be gradually stabilized by the assembly of protein 4.1. PMID- 3958042 TI - Identification of Rhizobium plasmid sequences involved in recognition of Psophocarpus, Vigna, and other legumes. AB - Symbiotic DNA sequences involved in nodulation by Rhizobium must include genes responsible for recognizing homologous hosts. We sought these genes by mobilizing the symbiotic plasmid of a broad host-range Rhizobium MPIK3030 (= NGR234) that can nodulate Glycine max, Psophocarpus tetragonolobus, Vigna unguiculata, etc., into two Nod- Rhizobium mutants as well as into Agrobacterium tumefaciens. Subsequently, cosmid clones of pMPIK3030a were mobilized into Nod+ Rhizobium that cannot nodulate the chosen hosts. Nodule development was monitored by examining the ultrastructure of nodules formed by the transconjugants. pMPIK3030a could complement Nod- and Nif- deletions in R. leguminosarum and R. meliloti as well as enable A. tumefaciens to nodulate. Three non-overlapping sets of cosmids were found that conferred upon a slow-growing Rhizobium species, as well as on R. loti and R. meliloti, the ability to nodulate Psophocarpus and Vigna, thus pointing to the existence of three sets of host-specificity genes. Recipients harboring these hsn regions had truly broadened host-range since they could nodulate both their original hosts as well as MPIK3030 hosts. PMID- 3958043 TI - Ultrastructural localization of the progesterone receptor by an immunogold method: effect of hormone administration. AB - The progesterone receptor has been localized in the rabbit uterus by immunocytochemistry at the electron microscopic level, using monoclonal antibodies and the protein A-gold technique. The progesterone receptor in uterine stromal cells was mainly localized in the nucleus; however, a small fraction of antigen was present in the cytoplasm, where it was associated with the rough endoplasmic reticulum and with free ribosomes. The plasma membrane was not labeled. In the nucleus, the receptor was always associated with condensed chromatin or areas surrounding condensed chromatin, whereas the nuceolus was not labeled. In the chromatin, receptor distribution varied according to the hormonal state: in the absence of progesterone, the receptor was randomly scattered over the clumps of condensed chromatin; after administration of the progestin R5020, it was mainly detected in the border regions between condensed chromatin and nucleoplasm and, to a lesser extent, over dispersed chromatin in the nucleoplasm. These areas have been shown to be the most active sites of gene transcription. PMID- 3958044 TI - Electrophysiological properties of Achlya hyphae: ionic currents studied by intracellular potential recording. AB - The electrical properties of the water mold Achlya bisexualis were investigated using intracellular microelectrodes. Hyphae growing in a defined medium maintained a membrane potential (Vm) of -150 to -170 mV, interior negative. Under the conditions used here, this potential was insensitive to changes in the inorganic ion composition of the medium. Changes in external pH did affect Vm, but only outside the physiological pH range. By contrast, the addition of respiratory inhibitors caused a rapid depolarization without affecting the conductance of the plasma membrane. Taken together these findings strongly suggest that the membrane potential is governed by an electrogenic ion pump rather than by an ionic diffusion potential. Previous work from this laboratory showed that Achlya hyphae generate a transcellular proton current that enters the growing tip, flows along the hyphal length, and exits distally from the trunk. These initial experiments used an extracellular vibrating electrode, and I now report intracellular electrical recordings which support the hypothesis that protons enter the tip by symport with amino acids and are expelled distally by a proton-translocating ATPase. Most significantly, current flowing intracellularly along the hyphal length is associated with a cytoplasmic electric field of 0.2 V/cm or greater. Conditions that inhibit the current also abolish the internal field, suggesting that these two phenomena are closely linked. PMID- 3958045 TI - Increase in urokinase plasminogen activator mRNA synthesis in human carcinoma cells is a primary effect of the potent tumor promoter, phorbol myristate acetate. AB - The effect of tumor promoters and growth factors on the synthesis of urokinase and urokinase mRNA in human carcinoma cells has been investigated. In urokinase producing human carcinoma cells (A1251), a 20-40-fold increase in urokinase mRNA level is obtained after treatment with 10 nM phorbol myristate acetate (PMA), a smaller effect (two- to fourfold) with 2 ng/ml platelet-derived growth factor (PDGF) and no effect with epidermal growth factor (EGF) (up to 50 nM). After treatment with PMA, urokinase mRNA level increases already at 30 min peaking 2-4 h thereafter. Cell line A431, which has an abnormally high number of EGF receptors, shows the same response to PMA, but also responds to EGF (two- to fourfold increase in mRNA). The kinetics are similar to those of A1251. Nuclear transcription experiments show that the PMA-induced increase in urokinase mRNA is due to increased synthesis. The protein synthesis inhibitor, cycloheximide (10 micrograms/ml), also increases the level of urokinase mRNA. When both cycloheximide and PMA are used, super-induction is observed. This result may indicate that a short-lived protein negatively regulates the level of urokinase. The different efficiency of the effectors (PMA and PDGF better than EGF) and their kinetics, as well as the effect of cycloheximide on urokinase mRNA synthesis, (a) are reminiscent of the effect of PDGF and PMA on competence phase genes (Kelly, K., B.H. Cochran, C.D. Stiles, and P. Leder, 1983, Cell, 35: 603 610), (b) demonstrate that the synthesis of urokinase is part of the early cellular response to these factors, and (c) provide a preliminary insight in the overproduction of urokinase by primary malignant tumors and transformed cells in culture. PMID- 3958046 TI - Posttranslational processing of concanavalin A precursors in jackbean cotyledons. AB - Metabolic labeling of immature jackbean cotyledons with 14C-amino acids was used to determine the processing steps involved in the assembly of concanavalin A. Pulse-chase experiments and analyses of immunoprecipitated lectin forms indicated a complex series of events involving seven distinct species. The structural relatedness of all of the intermediate species was confirmed by two-dimensional mapping of 125I-tryptic peptides. An initial glycosylated precursor was deglycosylated and cleaved into smaller polypeptides, which subsequently reannealed over a period of 10-27 h. NH2-terminal sequencing of the abundant precursors confirmed that the intact subunit of concanavalin A was formed by the reannealing of two fragments, since the alignment of residues 1-118 and 119-237 was reversed in the final form of the lectin identified in the chase and the precursor first labeled. When the tissue was pulse-chased in the presence of monensin, processing of the glycosylated precursor was inhibited. The weak bases NH4Cl and chloroquine were without effect. Immunocytochemical studies showed that monensin treatment caused the accumulation of immunoreactive material at the cell surface and indicated that the ionophore had induced the secretion of a component normally destined for deposition within the protein bodies. Consideration of the tertiary structure of the glycosylated precursor and mature lectin showed that the entire series of processing events could occur without significant refolding of the initial translational product. Proteolytic events included removal of a peptide from the surface of the precursor molecule that connected the NH2- and COOH-termini of the mature protein. This processing activated the carbohydrate binding activity of the lectin. The chase data suggest the occurrence of a simultaneous cleavage and formation of a peptide bond, raising the possibility that annealment of the fragments to give rise to the mature subunit involves a transpeptidation event rather than cleavage and subsequent religation. PMID- 3958047 TI - Liver endothelium mediates the hepatocyte's uptake of ceruloplasmin. AB - The mode of transport of ceruloplasmin (CP) into the liver was investigated in fractionated liver cell suspensions. Incubation of 125I-CP at 4 degrees C with these different fractions led to its binding only to endothelial cells but not Kupffer cells and hepatocytes. Incubation at 37 degrees C led to rapid uptake of 125I-CP by endothelium, but cell-associated radioactivity declined after 15 min, which suggests the release of the labeled substance. Internalization was confirmed by fractionation of surface-bound and internalized ligand. The released label now acquired binding potential for fresh target hepatocytes, and the binding was inhibitable with asialoceruloplasmin but not native CP. This suggested that the released molecule was modified in the endothelium by desialation. Desialation was confirmed by incubation of endothelium with double labeled CP (3H label on sialic acid and 125I on the protein part). We conclude that in the liver, CP is first recognized and taken up by endothelial cells that are endowed with appropriate surface receptors for the protein. Endothelium then modifies the molecule by desialation to expose the penultimate galactosyl residues. The modified molecule is then released, recognized, and taken up by hepatocytes through their membrane galactosyl-recognition system. These findings are consistent with the role of endothelium as an active mediator of molecular transport between blood and tissue, and further assign a biological role for the galactosyl-recognition system in hepatocytes. PMID- 3958049 TI - Identification and further characterization of the specific cell binding fragment from sponge aggregation factor. AB - Monoclonal antibodies (McAbs) were raised against the aggregation factor (AF) from the marine sponge Geodia cydonium. Two clones were identified that secrete McAbs against the cell binding protein of the AF complex. Fab fragments of McAbs: 5D2-D11 completely abolished the activity of the AF to form secondary aggregates from single cells. The McAbs were determined to react with the AF in vitro; this interaction was prevented by addition of the aggregation receptor, isolated and purified from the same species. After dissociation of the AF by sodium dodecyl sulfate and 2-mercaptoethanol, followed by electrophoretical fractionation, a 47 kD protein was identified by immunoblotting which interacted with the McAbs: 5D2 D11. During this dissociation procedure, the sunburst structure of the AF was destroyed. In a second approach, the 47-kD protein was isolated by immunoprecipitation; 12 molecules of this protein species were calculated to be associated with the intact AF particle. The 47-kD AF fragment bound to dissociated Geodia cells with a high affinity (Ka of 7 X 10(8) M-1) even in the absence of Ca++ ions; the number of binding sites was approximately 4 X 10(6)/cell. This interaction was prevented by addition of the aggregation receptor to the 47-kD protein in the homologous cell system. Moreover, it was established that this binding occurs species-specifically. The 47-kD fragment of the AF was localized only extracellularly by indirect immunofluorescence staining in cryostat slices. These data suggest that the 47-kD protein is the cell binding molecule of the AF from Geodia. PMID- 3958050 TI - A long-lived fusogenic state is induced in erythrocyte ghosts by electric pulses. AB - Treatment of erythrocyte ghosts in random positions in a suspension with membrane fusion-inducing direct current electric field pulses causes the membranes to become fusogenic. Significant fusion yields are observed if the membranes are dielectrophoretically aligned into membrane-membrane contact with a weak alternating electric field as much as 5 min after the application of the pulses. This demonstrates that a long-lived membrane structural alteration is involved in this fusion mechanism. Other experiments indicate that the areas on the membrane which become fusogenic after treatment with the pulses may be very highly localized. The locations of these fusogenic areas coincide with where the trans membrane electric field strength was greatest during the pulse. The fusogenic membrane alteration, or components thereof, in these areas laterally diffuses very slowly or not at all, or, to be fusogenic, must be present at concentrations in the membrane above a certain threshold. The loss of soluble 0.9-3-nm-diameter fluorescent probes from resealed cytoplasmic compartments of randomly positioned erythrocyte ghosts occurs through electric field pulse-induced pores only during a pulse but not between pulses or after a train of pulses if the probe diameter is 1.2 nm or greater. For a given pulse treatment of membranes in random positions in suspensions, an increase in ionic strength of the medium results in (a) a decrease in loss during the pulse, (b) no difference in loss between pulses, and (c) an increase in fusion yield when membrane-membrane contact is established. The latter two results (b and c) are incompatible with a fusion mechanism that proposes a simple relationship between electric field-induced pores and fusion. PMID- 3958048 TI - A lens intercellular junction protein, MP26, is a phosphoprotein. AB - The major protein present in the plasma membrane of the bovine lens fiber cell (MP26), thought to be a component of intercellular junctions, was phosphorylated in an in vivo labeling procedure. After fragments of decapsulated fetal bovine lenses were incubated with [32P]orthophosphate, membranes were isolated and analyzed by SDS PAGE and autoradiography. A number of lens membrane proteins were routinely phosphorylated under these conditions. These proteins included species at Mr 17,000 and 26,000 as well as a series at both 34,000 and 55,000. The label at Mr 26,000 appeared to be associated with MP26, since (a) boiling the membrane sample in SDS led to both an aggregation of MP26 and a loss of label at Mr 26,000, (b) the label at 26,000 was resistant to both urea and nonionic detergents, and (c) two-dimensional gels showed that a phosphorylated Mr 24,000 fragment was derived from MP26 with V8 protease. Studies with proteases also provided for a localization of most label within approximately 20 to 40 residues from the COOH-terminus of MP26. Published work indicates that the phosphorylated portion of MP26 resides on the cytoplasmic side of the membrane, and that this region of MP26 contains a number of serine residues. The same region of MP26 was labeled when isolated lens membranes were reacted with a cAMP-dependent protein kinase prepared from the bovine lens. After the in vivo labeling of lens fragments, phosphoamino acid analysis of MP26 demonstrated primarily labeled serines, with 5-10% threonines and no tyrosines. Treatments that lowered the intracellular calcium levels in the in vivo system led to a selective reduction of MP26 phosphorylation. In addition, forskolin and cAMP stimulated the phosphorylation of MP26 and other proteins in concentrated lens homogenates. These findings are of interest because MP26 appears to serve as a protein of cell to-cell channels in the lens, perhaps as a lens gap junction protein. PMID- 3958051 TI - Autoradiographic visualization of the mouse egg's sperm receptor bound to sperm. AB - The extracellular coat, or zona pellucida, of mammalian eggs contains species specific receptors to which sperm bind as a prelude to fertilization. In mice, ZP3, one of only three zona pellucida glycoproteins, serves as sperm receptor. Acrosome-intact, but not acrosome-reacted, mouse sperm recognize and interact with specific O-linked oligosaccharides of ZP3 resulting in sperm-egg binding. Binding, in turn, causes sperm to undergo the acrosome reaction; a membrane fusion event that results in loss of plasma membrane at the anterior region of the head and exposure of inner acrosomal membrane with its associated acrosomal contents. Bound, acrosome-reacted sperm are able to penetrate the zona pellucida and fuse with the egg's plasma membrane (fertilization). In the present report, we examined binding of radioiodinated, purified, egg ZP3 to both acrosome intact and acrosome reacted sperm by whole-mount autoradiography. Silver grains due to bound 125I-ZP3 were found localized to the acrosomal cap region of heads of acrosome-reacted sperm. Under the same conditions, 125I-fetuin bound at only bacKground levels to heads of both acrosome-intact and -reacted sperm, and 125I ZP2, another zona pellucida glycoprotein, bound preferentially to acrosome reacted sperm. These results provide visual evidence that ZP3 binds preferentially and specifically to heads of acrosome intact sperm; properties expected of the mouse egg's sperm receptor. PMID- 3958053 TI - Effects of protease inhibitors and substrates on motility of mammalian spermatozoa. AB - A series of protease inhibitors were tested on the motility of human, rat, bull, and rabbit demembranated reactivated spermatozoa. Some inhibitors, including aprotinin, boc-gln-leu-lys-H, and D-phe-pro-arg-H, could inhibit motility as well as prevent initiation of motility. In general, with the exception of aprotinin, protease inhibitors were more potent in preventing the initiation of movement than in blocking motility of demembranated spermatozoa. Protease substrates could also block sperm motility. Of the substrates tested only those with arg or lys ester bonds were active. The inhibition of motility by protease substrates was reversible, as once spermatozoa hydrolyzed the added exogenous protease substrates, motility reappeared. The importance of ester bond in the inhibitory action of protease substrates was confirmed by experiments that showed the lack of effect of pre-hydrolyzed protease substrates. The results suggest that a serine protease with lys and arg ester bond specificity is involved in the control of sperm motility. The fact that protease substrates also block motility of intact spermatozoa further emphasizes the physiological relevance of this new regulatory system. PMID- 3958052 TI - Changes in sperm plasma membrane lipid diffusibility after hyperactivation during in vitro capacitation in the mouse. AB - We have used the technique of fluorescence recovery after photobleaching to measure the diffusibility of the fluorescent lipid analogue, 1,1'-dihexadecyl 3,3,3',3'-tetramethylindocarbocyanine perchlorate on the morphologically distinct regions of the plasma membranes of mouse spermatozoa, and the changes in lipid diffusibility that result from in vitro hyperactivation and capacitation with bovine serum albumin. We found that, as previously observed on ram spermatozoa, lipid analogue diffusibility is regionalized on mouse spermatozoa, being fastest on the flagellum. The bovine serum albumin induced changes in diffusibility that occur with hyperactivation are also regionalized. Specifically, if we compare serum incubated in control medium, which maintains normal motility, with those hyperactivated in capacitating medium, we observe with hyperactivation an increase in lipid analogue diffusion rate in the anterior region of the head, the midpiece, and tail, and a decrease in diffusing fraction in the anterior region of the head. PMID- 3958054 TI - Effects of mechanical tension on protrusive activity and microfilament and intermediate filament organization in an epidermal epithelium moving in culture. AB - Mechanical tension influences tissue morphogenesis and the synthetic, mitotic, and motile behavior of cells. To determine the effects of tension on epithelial motility and cytoskeletal organization, small, motile clusters of epidermal cells were artificially extended with a micromanipulated needle. Protrusive activity perpendicular to the axis of tension was dramatically suppressed. To determine the ultrastructural basis for this phenomenon, cells whose exact locomotive behavior was recorded cinemicrographically were examined by transmission electron microscopy. In untensed, forward-moving lamellar protrusions, microfilaments appear disorganized and anisotropically oriented. But in cytoplasm held under tension by micromanipulation or by the locomotive activity of other cells within the epithelium, microfilaments are aligned parallel to the tension. In non spreading regions of the epithelial margin, microfilaments lie in tight bundles parallel to apparent lines of tension. Thus, it appears that tension causes alignment of microfilaments. In contrast, intermediate filaments are excluded from motile protrusions, being confined to the thicker, more central part of the cell. They roughly follow the contours of the cell, but are not aligned relative to tension even when microfilaments in the same cell are. This suggests that the organization of intermediate filaments is relatively resistant to physical distortion and the intermediate filaments may act as passive structural support within the cell. The alignment of microfilaments under tension suggests a mechanism by which tension suppresses protrusive activity: microfilaments aligned by forces exerted through filament-surface or filament-filament interconnections cannot reorient against such force and so cannot easily extend protrusions in directions not parallel to tension. PMID- 3958055 TI - Trichohyalin, an intermediate filament-associated protein of the hair follicle. AB - A precursor protein associated with the formation of the citrulline-containing intermediate filaments of the hair follicle has been isolated and characterized. The protein, with a molecular weight of 190,000, was isolated from sheep wool follicles and purified until it yielded a single band on a SDS polyacrylamide gel. The Mr 190,000 protein has a high content of lysine and glutamic acid/glutamine residues and is rich in arginine residues, some of which, it is postulated, undergo a side chain conversion in situ into citrulline residues. Polyclonal antibodies were raised to the purified protein, and these cross-react with similar proteins from extracts of guinea pig and human follicles and rat vibrissae inner root sheaths. Tissue immunochemical methods have localized the Mr 190,000 protein to the trichohyalin granules of the developing inner root sheath of the wool follicle. We propose that the old term trichohyalin be retained to describe this Mr 190,000 protein. Immunoelectron microscopy has located the Mr 190,000 protein to the trichohyalin granules but not to the newly synthesized filaments. This technique has revealed that trichohyalin becomes associated with the filaments at later stages of development. These results indicate a possible matrix role for trichohyalin. PMID- 3958058 TI - Altered polyamine metabolism in Chinese hamster cells growing in a defined medium. AB - Chinese hamster cells (line CHO) maintained in McCoy's 5A medium (modified) supplemented with insulin (10 micrograms/ml), transferrin (5 micrograms/ml), and ferrous sulfate (1.1 microgram/ml) proliferate at rates similar to cultures growing in the McCoy's medium supplemented with 10% fetal bovine serum. Colony forming ability is similar in cultures supplemented with either serum or the combination of growth factors. By 6 hours after replacement of serum with growth factors, ornithine decarboxylase (ODCase) activity increases, reaching a maximum value by 24 hours after serum replacement. This maximum is cell density dependent and can exceed a 30-fold increase over enzyme activity in cultures supplemented with serum. The increased enzyme activity is due to a decrease in the turnover rate of the enzyme, based on protein synthesis inhibition studies, and an accumulation of active enzyme molecules rather than an activation of existing molecules, since the catalytic activity of ODCase, determined using the radiolabeled form of alpha-difluoromethylornithine (an enzyme-activated, irreversible inhibitor of ODCase) in concert with supplements. Intracellular putrescine and spermidine levels are substantially decreased when cultures are maintained in medium supplemented with insulin, transferrin, and ferrous sulfate, rather than serum, which is the sole source of exogenous ornithine. Titration of cultures growing in the defined medium with ornithine leads to a decrease in ODCase activity and an increase in intracellular putrescine and spermidine levels. Putrescine- and spermidine-dependent S-adenosyl-L-methionine decarboxylase activities are similar in cultures maintained in either medium. These data demonstrate that some, but not all, aspects of polyamine biosynthesis are affected by the availability of ornithine, the first substrate in the pathway. PMID- 3958056 TI - Actin at receptor-rich domains of isolated acetylcholine receptor clusters. AB - Acetylcholine receptor (AChR) clusters of cultured rat myotubes, isolated by extraction with saponin (Bloch, R. J., 1984, J. Cell Biol. 99:984-993), contain a polypeptide that co-electrophoreses with purified muscle actins. A monoclonal antibody against actin reacts in immunoblots with this polypeptide and with purified actins. In indirect immunofluorescence, the antibody stains isolated AChR clusters only at AChR domains, strips of membrane within clusters that are rich in receptor. It also stains the postsynaptic region of the neuromuscular junction of adult rat skeletal muscle. Semiquantitative immunofluorescence analyses show that labeling by antiactin of isolated analyses show that labeling by antiactin of isolated AChR clusters is specific and saturable and that it varies linearly with the amount of AChR in the cluster. Filaments of purified gizzard myosin also bind preferentially at AChR-rich regions, and this binding is inhibited by MgATP. These experiments suggest that actin is associated with AChR rich regions of receptor clusters. Depletion of actin by extraction of isolated clusters at low ionic strength selectively releases the actin-like polypeptide from the preparation. Simultaneously, AChRs redistribute within the plane of the membrane of the isolated clusters. Similarly, brief digestion with chymotrypsin reduces immunofluorescence staining and causes AChR redistribution. Treatments that deplete AChR from clusters in intact cells also reduce immunofluorescent staining for actin in isolated muscle membrane fragments. Upon reversal of these treatments, cluster reformation occurs in regions of the membrane that also stain for actin. I conclude that actin is associated with AChR domains and that changes in this association are accompanied by changes in the organization of isolated AChR clusters. PMID- 3958059 TI - Effect of fibroblast growth factor and lipoproteins on the proliferation of endothelial cells derived from bovine adrenal cortex, brain cortex, and corpus luteum capillaries. AB - Bovine adrenal and brain cortex and corpus luteum-derived capillary endothelial cells have been established in culture, taking advantage of their ability to proliferate at clonal density when maintained on extracellular matrix (ECM) coated dishes in the presence of serum supplemented medium. All three cell types formed at confluency a monolayer of small, tightly packed, contact inhibited cells that express factor VIII related antigen. Their proliferative response to basic and acidic FGF when cells were maintained on plastic and exposed to serum supplemented medium was similar to that previously reported for endothelial cells derived from large vessels, with acidic FGF being 30-fold less potent than basic FGF. Their requirement for high density lipoproteins and transferrin in order to proliferate actively when maintained on ECM-coated dishes and exposed to serum free conditions was also similar to that previously reported for endothelial cells derived from large vessels. Heparin strongly reduced the proliferative response of capillary endothelial cells to either basic or acidic FGF, as well as their response to serum alone, regardless of whether cells were maintained on plastic or on ECM-coated dishes. The present data indicate that bovine endothelial cells derived from large or small vessels are indistinguishable in so far as their response to growth factors, plasma factors, and substrata are concerned. PMID- 3958057 TI - Role of stress fiber-like structures in assembling nascent myofibrils in myosheets recovering from exposure to ethyl methanesulfonate. AB - When day 1 cultures of chick myogenic cells were exposed to the mutagenic alkylating agent ethyl methanesulfonate (EMS) for 3 d, 80% of the replicating cells were killed, but postmitotic myoblasts survived. The myoblasts fused to form unusual multinucleated "myosheets": extraordinarily wide, flattened structures that were devoid of myofibrils but displayed extensive, submembranous stress fiber-like structures (SFLS). Immunoblots of the myosheets indicated that the carcinogen blocked the synthesis and accumulation of the myofibrillar myosin isoforms but not that of the cytoplasmic myosin isoform. When removed from EMS, widely spaced nascent myofibrils gradually emerged in the myosheets after 3 d. Striking co-localization of fluorescent reagents that stained SFLS and those that specifically stained myofibrils was observed for the next 2 d. By both immunofluorescence and electron microscopy, individual nascent myofibrils appeared to be part of, or juxtaposed to, preexisting individual SFLS. By day 6, all SFLS had disappeared, and the definitive myofibrils were displaced from their submembranous site into the interior of the myosheet. Immunoblots from recovering myosheets demonstrated a temporal correlation between the appearance of the myofibrillar myosin isoforms and the assembly of thick filaments. The assembly of definitive myofibrils did not appear to involve desmin intermediate filaments, but a striking aggregation of sarcoplasmic reticulum elements was seen at the level of each I-Z-band. Our findings suggest that SFLS in the EMS myosheets function as early, transitory assembly sites for nascent myofibrils. PMID- 3958060 TI - Hexose transport in L6 rat myoblasts. I. Rate-limiting step, kinetic properties, and evidence for two systems. AB - The hexose transport system of undifferentiated L6 rat myoblasts was investigated. 2-Deoxy-D-glucose (2-DOG) and 2-deoxy-2-fluoro-D-glucose (2FG) were used as analogues to investigate the rate-limiting step of hexose uptake into the cell. Virtually all of the 2-DOG or 2FG taken up into the cell was found to be in the phosphorylated form. No significant pool of intracellular free sugar could be detected. This demonstrates that hexose transport, not phosphorylation, is the rate-limiting step. The inhibitory effect of various glucose analogues on 2-DOG and 3-O-methyl-D-glucose (3-OMG) uptake revealed that these two sugars may be taken up into the cell by different carriers. In addition, kinetics analysis of the transport of both sugars also indicates that two hexose transport systems may be present in L6 cells. 2-DOG is transported by high and low affinity transport systems (Km 0.6 mM and 2.9 mM, respectively), whereas 3-OMG is transported by a low affinity system (Km 3.5 mM). Treatment of cells with ionophores or energy uncouplers results in inactivation of the high affinity system, but not the low affinity system. PMID- 3958061 TI - Tubulin-colchicine complex (TC) inhibits microtubule depolymerization by a capping reaction exerted preferentially at the minus end. AB - The effects of colchicine and tubulin-colchicine complex (TC) on microtubule depolymerization were studied using the axoneme-subunit system described previously [Bergen LG, Borisy GG; J Cell Biol 84:141-150, 1980]. This system allows the independent analysis of the polymerization kinetics at both the plus and minus ends of a microtubule. Depolymerization was induced by isothermal dilution with 10 volumes of an experimental solution containing colchicine, TC, or buffer alone. Colchicine alone (5-100 microM) blocked depolymerization at the minus end, whereas depolymerization at the plus end occurred at almost control rates. A similar effect was produced by TC (0.4:1-1:1 molar ratio to free tubulin). High molar ratios of TC to tubulin (10:1) blocked depolymerization at both plus and minus ends, and intermediate molar ratios of TC:T allowed depolymerization of the plus ends but at attenuated rates. The blockage was not readily reversible; TC-affected ends neither shortened upon dilution nor grew longer upon incubation with additional tubulin. We conclude that TC at suprastoichiometric ratios to tubulin inhibits microtubule depolymerization by a capping reaction and that this effect is exerted preferentially at the minus end. PMID- 3958062 TI - Immunoreactive fibroblast growth factor (FGF) in a transplantable chondrosarcoma: inhibition of tumor growth by antibodies to FGF. AB - Using a radioimmunoassay for bovine pituitary fibroblast growth factor (FGF), we have established the presence of the immunoreactive mitogen in extracts of a transplantable mouse chondrosarcoma. Both neutral and acidic extracts of the tumor contain an immunoreactive FGF (ir-FGF) that cross-reacts in a parallel and dose-dependent fashion in the radioimmunoassay. The ir-FGF is retained on heparin Sepharose affinity columns and can be detected in the same molecular weight forms as rat pituitary FGF. Mice (C57/Bl) inoculated with the tumor (10 mg, im) show a decreased rate of tumor growth when passively immunized with the antiserum to FGF. The results establish the presence of FGF in this tumor and implicate its role in the etiology of its development. PMID- 3958063 TI - Photochemically induced cortical infarction in the rat. 1. Time course of hemodynamic consequences. AB - Alterations in local CBF (LCBF) were assessed autoradiographically in the rat at several time points following photochemically induced cortical infarction. Cortical infarction of consistent size and location was produced by irradiating the brain with green light through the intact skull for 20 min following the systemic injection of rose bengal. A consistent pattern of altered LCBF was recorded in both ipsilateral and contralateral brain regions over the course of the study. At 30 min, a severely ischemic zone surrounded by regions of cortical hyperemia was apparent. LCBF was also depressed relative to control values in ipsilateral cortical regions remote from the irradiated area, while contralateral cortical structures were mildly hyperemic. By 4 h, the zone of severe ischemia had enlarged and its margins were no longer hyperemic. Ipsilateral cortical and some subcortical structures demonstrated significantly depressed levels of LCBF. At 5 days, LCBF throughout both ipsilateral and contralateral cortices was depressed compared with control values. By 15 days, LCBF had returned to control levels in most brain structures shown histopathologically not to be irreversibly damaged. The temporal sequence and magnitude of these hemodynamic alterations are consistent with findings in clinical studies in which repeated measurements of CBF have been carried out in patients with acute stroke. The ability to produce a cortical infarct that results in a consistent pattern of altered CBF should facilitate the investigation of stroke mechanisms responsible for these hemodynamic abnormalities. PMID- 3958064 TI - Photochemically induced cortical infarction in the rat. 2. Acute and subacute alterations in local glucose utilization. AB - Local CMRglu (LCMRglu) values were measured by [14C]2-deoxyglucose autoradiography in the rat at 4 h and 5 days following photochemically induced cortical infarction, and these data were compared with neuropathological findings in adjacent serial sections. At both time periods, LCMRglu was markedly reduced within the lesion center, and irregular regions of moderate-to-marked glucose hypermetabolism were noted within the marginal zone of the developing infarct. At 4 h, the hypermetabolic zones were shown by pathological examination to be characterized by normal-sized, moderately hyperchromatic neurons scattered among occasional dark, shrunken neurons within preserved neuropil. In contrast, the hypermetabolic zones at 5 days coincided with foci of intense macrophage infiltration, with dissolution of the neuropil. Significant decreases in glucose utilization were also demonstrated at 4 h within brain structures remote from the site of focal injury. These structures included the lateral and auditory cortices ipsilaterally, the striatum and thalamus ipsilaterally, and the hippocampus bilaterally. In addition to these remote metabolic effects, depressed metabolism occurred within the homologous cortical region contralateral to the site of infarction. By 5 days, glucose utilization was severely depressed in all ipsilateral cortical regions but not within any contralateral cortical region. Analysis of these data suggests that more than one mechanism is responsible for the metabolic alterations occurring within brain regions remote from the site of irreversible damage. Results are discussed in light of the hemodynamic alterations occurring in this stroke model, which are presented in the accompanying report. PMID- 3958065 TI - Characterization of experimental ischemic brain edema utilizing proton nuclear magnetic resonance imaging. AB - Correlations between T1 and T2 relaxation times and water and electrolyte content in the normal and ischemic rat and gerbil brains were studied by means of both nuclear magnetic resonance (NMR) spectroscopic and imaging methods. In the spectroscopic experiment on excised rat brains, T1 was linearly dependent on tissue water content and T2 was prolonged in edematous tissue to a greater extent than expected by an increase in water content, showing that T2 possesses a greater sensitivity for edema identification and localization. Changes in Na+ and K+ content of the tissue mattered little in the prolongation of relaxation times. Serial NMR imaging of gerbil brains insulted with permanent hemispheric ischemia offered early lesion detection in T1- and especially T2-weighted images (detection as soon as 30 min after insult). The progressive nature of lesions was also imaged. Calculated T1 and T2 relaxation times in regions of interest correlated excellently with tissue water content (r = 0.892 and 0.744 for T1 and T2, respectively). As a result, detection of cerebral ischemia utilizing NMR imaging was strongly dependent on a change in tissue water content. The different nature of T1 and T2 relaxation times was also observed. PMID- 3958066 TI - [Fractures of the lower end of the humerus in adults: influence of per- and postoperative tactics on results. Apropos of 70 osteosyntheses]. AB - Results in 70 cases of osteosynthesis of lower end of humerus in adults were analyzed as a function of the fracture line, and the operative (approach route, type of support, attitude towards ulnar nerve transposition) and postoperative (with or without plaster immobilization) tactics. Best results were obtained in simple joint fractures (condyles, capitellum, Hahn Steinthal) with a good outcome in 89% of cases, while prognosis was poorer (68.5% of delayed good results) in more or less comminuted supra- or inter-condylar fractures (41 cases). Results are better in these latter types of fracture when an extra-articular trans olecranon posterior approach is used. Ulnar nerve transposition was performed 43 times without adverse effects and osteosynthesis by 2 posterior screw plates (one on external and one on internal column) in 50% of cases. Valid comparison of results with or without postoperative plaster immobilization was not possible since only 8 patients were not plastered. PMID- 3958067 TI - [Postoperative thyroidal arteriovenous fistula of late manifestation or disclosed 14 years after thyroidectomy]. AB - A postoperative arteriovenous fistula of the upper thyroidal pedicle was detected 14 years after thyroidectomy. Treatment in this rare case was by elective surgical excision of the fistula. PMID- 3958068 TI - [The megaureter-megabladder syndrome. Apropos of a case]. AB - The authors report the observation of a five year old boy who presents recurrent urinary tract infections with infrequent voiding and without residual urine. Uroradiologic investigations show a megaureter-megabladder syndrome. Pathogenesis and management of this syndrome are then discussed. PMID- 3958069 TI - [Choledochoduodenal anastomoses in biliary lithiasis]. AB - In choledocholithiasis, after opening the common bile duct, we used to perform choledochoduodenostomy in old patients. The aim of this study was to evaluate our results in 77 patients. The mean age of the patients was 75 years. Twenty-two patients were operated for angiocholitis, 19 had jaundice, and 36 had gallstones without angiocholitis or jaundice. There was two hospital deaths (2.6 p. cent). All the patients but two could be traced. The mean follow-up was 6.7 years. Two patients had had transients episodes of angiocholitis. Twenty-five patients have dead. Expected mortality in french population corresponding in age and sex was 29 deaths. Our results suggest that choledochoduodenostomy is a safe and effective procedure in the management of calculous biliary tract disease for old patients. PMID- 3958070 TI - [Leiomyoma and leiomyomatosis of the esophagus. Apropos of 2 cases]. AB - The authors present two cases of leiomyoma of the oesophagus treated by enucleation. They review the literature on this subject and distinguish single leiomyomas (97%) from multiple leiomyomas (2.4%). The early diagnosis is based on endoscopy and oesophagogastric barium studies. Biopsies are controversial. Surgical treatment remains the general rule, but the anatomical extension may be slow so that surgical abstention with regular follow-up is justified in asymptomatic patients. PMID- 3958071 TI - [Cure of an external biliary fistula complicating pancreatic pseudocyst by an endocholedochal prosthesis]. AB - A persistent and abundant external biliary fistula appeared following the three stage surgical treatment of a pseudocyst of the head of the pancreas. This fistula was probably due to a leak from the stump of the cystic duct maintained by peri-choledochal sclerosis. It was successfully treated by an intra-hepatico choledochal prosthesis inserted endoscopically. PMID- 3958072 TI - [Experimental realization of a continent ileocolic valve in rats]. AB - The ileocecal valve plays a primordial role in pediatric digestive disorders. Various technical procedures have been proposed based on formation of an anastomosis with invagination of the distal extremity of the ileal segment into the colic portion. A resection of 20% of the small intestine and an ileocolic anastomosis were performed in the rat using three different methods: simple end to-end ileocolic anastomosis, ileocolic anastomosis with invagination of ileal segment, and ileocolic anastomosis with ileal hemi-valve intubated into colon. Three animals died in the first group, the surviving three animals presenting massive reflux on barium meal examination. Of the 7 animals in the second group, 6 developed signs of occlusion from anastomotic stenosis. Two of the 10 animals the third group died, one before the 15th and one before the 40th day, as a result of anastomotic stenosis. Autopsy of the 8 survivors sacrificed after 3 months showed permeable anastomoses. PMID- 3958073 TI - [Enteropathy caused by clofazimine]. AB - A case of Clofazimine enteropathy is reported, diagnosed on the demonstration of red brown birefringent crystals in the small bowel mucosa and submucosa as well as in the mesenteric lymph nodes whereas the clinical and radiological signs appear to be non specific. After the withdrawal of the drug, a clear improvement of the symptoms was achieved only under a gluten free diet. The possibility of such accidents, sometimes lethal, suggests the restriction of clofazimine to leprosy. PMID- 3958074 TI - Psychosocial aspects of childhood cancer: a review of the literature. AB - The literature concerning the psychosocial aspects of childhood cancer is reviewed. The emphasis of the literature is on the impact of the disease on the child and family and depicts the life-situation when faced with childhood cancer and responses to the disease. The literature strongly indicates that families experience serious difficulties and are a population at risk of developing psychosocial problems. The approach of studying the child with cancer and family is discussed and suggestions are made for future research. PMID- 3958075 TI - Parent-child agreement on child psychiatric symptoms assessed via structured interview. AB - Correlations between scores derived from structured interviews with 299 disturbed children aged 6-18 and their parents indicated low-to-moderate levels of agreement regarding the presence and severity of child psychiatric symptoms. Agreement was higher on behavior and conduct problems than on anxiety, fears, obsessions-compulsions, psychotic symptoms and affective disturbances. Parents reported more child behavior and conduct problems than children, whereas children reported more affective and neurotic symptoms than parents. Parent-child agreement also increased sharply with age. PMID- 3958076 TI - Childhood family placement history and behaviour problems in 6-year-old children. AB - The relationship between childhood family placement history and maternal/teacher reports of child behaviour at 6 years was studied in a birth cohort of New Zealand children. Children who had experienced a marital breakdown showed a tendency to increased aggressive/antisocial behaviour. Within the group of children experiencing a family breakdown, behavioural outcomes varied with the child's subsequent family history and children whose parents reconciled or whose mother remarried appeared to suffer more behavioural difficulties than children who remained in a single-parent family. Multivariate analysis suggested that these differences arose from social and contextual factors associated with differing family situations. PMID- 3958077 TI - Developmental changes in trait and situational denial under stress during childhood. AB - Decline in denial usage during childhood was examined by obtaining four measures of denial from 34, 6-, 8- and 10-year-old boys. Significant age declines were observed for two trait denial measures and one situational denial measure. Positive relationships among denial measures were observed only for the trait measures. It appears that knowledge of trait denial may not be very useful in predicting situational denial; and that future research should be directed toward more detailed examination of cognitive processes associated with defensive outcomes and toward changes in external factors, such as peer evaluation of defensive behaviors, which could impact on the production of defensive responses. PMID- 3958078 TI - Pre-pubertal anorexia nervosa: a retrospective controlled study. AB - Pre-pubertal anorexia nervosa is a challenge to the explanatory powers of the many aetiological theories. This retrospective controlled study specifically compares 20 subjects with pre-pubertal anorexia nervosa to matched post-pubertal anorectic and pre-pubertal neurotic groups. The results show greater pre-morbid feeding problems in the index group and their families; both pre-pubertal groups show more behavioural problems before becoming ill. The illness is very similar in the two anorectic groups; they show comparable levels of sexual anxiety, and self-injury rates (35%) are equal. The implications of these findings for the various theories are discussed. PMID- 3958079 TI - Abdominal pain in six-year-olds: an epidemiological study in a new town. AB - This study investigated recurrent abdominal pain in all 494 second-year infant children in a new town using a postal questionnaire followed by sampling and detailed interview. A prevalence of between 24.5 and 26.9% was found and there were associations with psychiatric deviance both at home and at school. There were also associations with social support of the mother, difficulties in settling into school and status of house ownership. Details of parental management of their children's symptoms are described. PMID- 3958080 TI - Identification of soy protein in meat by pyrolysis-high-resolution gas chromatography. AB - Pyrolysis-gas chromatography was applied to the characterization of ground beef and soy protein isolate and its mixtures at the 50, 30 and 10% levels. A cryogenic trap pyrolysis mode was employed and the volatile pyrolysates were analysed by a high-resolution capillary gas chromatograph. Two phenolic derivatives, o-methoxy- and dimethoxyphenol, as well as 2,3-dithiabutane are uniquely observed at a large concentration in the soy pyrolysate. Quantification of these characteristic compounds allow the estimation of the level of soy inclusion in the mixture. This approach effectively denotes soy addition up to the 10% level in comminuted beef. PMID- 3958081 TI - Improved method of determination of biologically important C10:0-C22:6 fatty acids as their 2-nitrophenylhydrazides by reversed-phase high-performance liquid chromatography. AB - Fatty acids were separated by reversed-phase high-performance liquid chromatography after derivatization with 2-nitrophenylhydrazine hydrochloride in the presence of 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride. The separation of a mixture of fourteen kinds of biologically important fatty acid hydrazides (C10:0-C22:6) was achieved within 15 min. Using margaric acid (C17:0) as internal standard, each fatty acid could be quantitated over the range of 2.5 5000 pmol per injection. Analytical recoveries ranged from 98.1 to 102.6%. The intra- and inter-assay coefficients of variation were less than 2.5 and 3.2%, respectively. For the determination of esterified fatty acids in fats and oils, the saponified mixture was directly derivatized without extraction. This method was compared gave similar fatty acid profiles to those obtained with the conventional liquid-liquid extraction method. It is simple, rapid and accurate for routine analyses of esterified fatty acids in biological materials. PMID- 3958082 TI - Effects of mobile phase and stationary phase on the quantitative determination of oxytocin. PMID- 3958083 TI - Simultaneous analysis of twelve biogenic amine metabolites in plasma, cerebrospinal fluid and urine by capillary column gas chromatography-high resolution mass spectrometry with selected-ion monitoring. AB - A procedure is described for the simultaneous determination of twelve acidic and alcoholic metabolites of trace and catecholic biogenic amines in plasma, cerebrospinal fluid and urine by capillary column gas chromatography--high resolution mass spectrometry. Protein precipitation with sulphosalicylic acid, derivatization with two different reagent systems, final sample clean-up with a buffer wash and a program for automatically changing the reference mass of the mass spectrometer to suit each group of compounds as they are eluted from the column, are the main novel features of the procedure. A brief description of the synthesis of the deuterium-labelled internal standards is provided. The procedure is applied to biological samples and a comparison to reported values is given. PMID- 3958084 TI - Automated method to estimate catecholamine and indoleamine content and turnover rates. AB - A double-label isotopic method for estimation of the rate of formation of serotonin (5-HT) and dopamine (DA) in mouse striatum, hippocampus and cortex was standardized. Mice received an intravenous pulse injection of [3H]tryptophan (TRP) and [3H]tyrosine (TYR) at 2.5, 5, 10 or 20 min before sacrifice by microwave irradiation. Compounds of interest were separated by automated high performance liquid chromatography and their contents were determined by electrochemical detection. Programmed collection of the TYR, DA, 5-HT and TRP peaks allowed determination of their radioactivity by liquid scintillation. Conversion of [3H]TYR to [3H]DA was nearly ten times greater in striatum than cortex, whereas the formation of [3H]5-HT from [3H]TRP was similar in striatum, cortex and hippocampus. PMID- 3958085 TI - Measurement of penicillamine and N-acetylcysteine in human blood by high performance liquid chromatography and electrochemical detection. AB - A rapid and precise high-performance liquid chromatographic assay for both N acetylcysteine and penicillamine in blood samples is described using selective reductive electrochemical detection and a high-efficiency C18 reversed-phase column. The use of an internal standard compensated for changes in detector responses during a run and for variable sample recovery. The detection limits for N-acetylcysteine and penicillamine were 25 and 10 ng/ml, respectively, using 500 microliters blood samples. Reproducibility of measurement for both thiols was excellent. This method allows routine monitoring of blood levels and pharmacokinetic studies with N-acetylcysteine and penicillamine. PMID- 3958086 TI - High-performance liquid chromatographic separation and quantitation of glycosylated hemoglobin A2 as an alternate index of glycemic control. AB - By a combination of DEAE-cellulose chromatography and cation-exchange high performance liquid chromatography glycosylated components of hemoglobin (Hb) A2 were separated and quantitated from persons with diabetes and some common hemoglobinopathies. Hb A2Ic values correlated well with total glycosylated Hb levels assayed by affinity chromatography, and Hb AIc, Hb SIc and Hb CIc levels, determined by high-performance liquid chromatography. The results indicate that Hb A2Ic may serve as an alternate index of glycemic control. PMID- 3958087 TI - Determination of methyl- and ethylmercury in rat blood and tissue samples by capillary gas chromatography with electron-capture detection. AB - A precise and accurate method has been developed for the determination of either methyl- or ethylmercury in the blood and tissue of rats using capillary gas chromatography with electron-capture detection. The biological sample was spiked with an internal standard (methyl- or ethylmercury chloride) and after treatment with sodium thiosulphate and cupric bromide the alkylmercurials were extracted into benzene as their bromide derivatives and analysed on an OV-275 glass capillary column. The sensitivity and selectivity of the method enabled determinations to be made on small volumes of blood and tissue homogenates. The method has been applied to a pharmacokinetic study in rats dosed orally with 8 mercury as methylmercury chloride or ethylmercury chloride. PMID- 3958088 TI - Fluorometric determination of 2,3-dimercaptopropane-1-sulfonic acid and other dithiols by precolumn derivatization with bromobimane and column liquid chromatography. AB - The increasing therapeutic use of dithiol metal binding agents, such as 2,3 dimercaptopropane-1-sulfonic acid (DMPS), has stimulated the need for a sensitive and selective method for their determination in biological fluids. A method has now been developed in which DMPS was converted to a highly fluorescent and stable derivative by reaction with bromobimane in aqueous solution at pH 8.3. The reaction was complete within 5 min. The derivative was separated by ion-pair reversed-phase column liquid chromatography. The mass spectrum of the derivative showed that two bromobimane molecules reacted with one DMPS molecule. This method is also applicable to the determination of other dithiols. The detection limit for DMPS in urine is 10 pmol per 20-microliters injection and the precision is 7.4% at the 100-pmol level. The fluorescence response was linear from 1 to 400 micron. This method was used to determine DMPS in the urine of rabbits treated with this metal binding agent. In addition, total DMPS was determined by adding sodium tetrahydridoborate to the same urine to reduce biotransformed and oxidized DMPS. PMID- 3958089 TI - Quantitative determination of propranolol in plasma and plasma water from normal subjects and patients with angina pectoris by high-performance liquid chromatography. AB - A precise and sensitive high-performance liquid chromatographic method using a column packed with porous polystyrene gel is described for the determination of propranolol in plasma and plasma water from normal subjects and patients with angina pectoris. Propranolol in the samples was extracted with an n-heptane isoamylalcohol (98.5:1.5) mixture after addition of penbutolol used as an internal standard. The extracts were chromatographed and detected with a spectrofluorophotometer. The quantitative limit of propranolol was 1 ng using 1 ml of plasma or 0.5 ml of plasma water. The present method should be useful for monitoring propranolol concentrations in plasma and plasma water during drug therapy and for pharmacokinetic study of propranolol. PMID- 3958090 TI - Determination of betaxolol enantiomers by high-performance liquid chromatography. Application to pharmacokinetic studies. AB - A high-performance liquid chromatographic (HPLC) method is described for the determination of (R)- and (S)-enantiomers of betaxolol in blood and other biological fluids. Separation of the enantiomers is performed after preparation of diastereomeric derivatives with the chiral reagent R(-) naphthylethylisocyanate by reversed-phase HPLC. Fluorimetric detection allows the quantification of betaxolol enantiomers down to 0.5 ng/ml. This method was used to evaluate the pharmacokinetic profile of the betaxolol enantiomers in three subjects following one single oral dose (20 mg) of racemic betaxolol. No significant difference was observed in blood levels of the isomers. PMID- 3958091 TI - Enantiospecific high-performance liquid chromatographic analysis of 2 phenylpropionic acid, ketoprofen and fenoprofen. AB - A high-performance liquid chromatographic method has been developed for the quantitation of the R- and S-enantiomers of 2-phenylpropionic acid, ketoprofen and fenoprofen. The assay consists of extracting the arylpropionic acid with an internal standard and measuring the total (R + S) concentration of enantiomers by reversed-phase chromatography, derivatising the chromatographic fraction corresponding to the enantiomers to form R- and S, R-2-phenylethylamide distereoisomers which are resolved by normal-phase chromatography in order to calculate the fraction of each enantiomer. The limits of sensitivity of the assay for 2-phenylpropionic acid, ketoprofen and fenoprofen are 6, 0.2 and 2.5 mg/l, respectively. PMID- 3958092 TI - Improved qualitative method for establishing flunitrazepam abuse using urine samples and column liquid chromatography with fluorimetric detection. AB - The abuse of flunitrazepam (Rohypnol), a potent benzodiazepine-type hypnotic, cannot be established with the widely used immunoassays for urine analysis owing to lack of specificity. A simple method is described which is based on the formation of acridine derivatives and measures the sum of metabolites of flunitrazepam in urine samples using column liquid chromatography with fluorimetric detection. PMID- 3958093 TI - Determination of histidine, 1-methylhistidine and 3-methylhistidine in biological samples by high-performance liquid chromatography. Clinical application of urinary 3-methylhistidine in evaluating the muscle protein breakdown in uraemic patients. PMID- 3958094 TI - Determination of human serum ceruloplasmin by ion chromatography based on its ferroxidase activity. PMID- 3958095 TI - Determination of nimodipine by gas chromatography using electron-capture detection; external factors influencing nimodipine concentrations during intravenous administration. PMID- 3958096 TI - Analysis of trazodone and m-chlorophenylpiperazine in plasma and brain tissue by high-performance liquid chromatography. PMID- 3958097 TI - Analysis of amiodarone and desethylamiodarone in serum and tears by reversed phase high-performance liquid chromatography. PMID- 3958098 TI - Sensitive screening method for buprenorphine in urine. PMID- 3958099 TI - Measurement of haloperidol and reduced haloperidol in human plasma using reversed phase high-performance liquid chromatography. PMID- 3958100 TI - Assay of triclabendazole and its main metabolites in plasma by high-performance liquid chromatography. PMID- 3958101 TI - Reversed-phase high-performance liquid chromatography of 5-(3,3-dimethyl-1 triazeno)imidazole-4-carboxamide and metabolites. PMID- 3958102 TI - Quantitative determination of alizapride in human plasma by high-performance liquid chromatography. PMID- 3958103 TI - High-performance liquid chromatographic determination of cimetidine in rat plasma, urine and bile. PMID- 3958104 TI - Simultaneous determination of thymine and 5-bromouracil in DNA hydrolysates using gas chromatography-mass spectrometry with selected-ion monitoring. AB - The gas chromatographic-mass spectrometric method using selected-ion monitoring (GC-MS-SIM) described here quantitatively determines the amount of DNA thymine replacement by 5-bromouracil (BU) after exposure to 5-bromo-2'-deoxyuridine (BUDR) in as few as 10(5) cells. DNA is extracted, enzymatically hydrolyzed, the nucleic acid bases (with added internal standards, 5-iodouracil and 5 chlorouracil) are extracted into ethyl acetate, concentrated and derivatized with bis(trimethylsilyl)trifluoroacetamide. Thymine and BU are then quantitated by GC MS-SIM. Response is linear to thymine over the range of 100-2000 ng per sample and BU of 1.3-52 ng per sample with a coefficient of variation of less than 10% and an accuracy for seeded samples within 8% of theoretical value. With V79 cells in culture, exposure to increasing BUDR concentrations (0.03-1.0 microM) results in increasing thymine substitution by BU over a range of 1-28%. Other important applications of this technique are mentioned. PMID- 3958105 TI - Headspace gas chromatographic-mass spectrometric analysis of light hydrocarbons and volatile organosulphur compounds in reduced-pressure cultures of Clostridium. AB - A static headspace gas chromatographic method for the simultaneous separation of trace light hydrocarbons and volatile organosulphur compounds in gases of nineteen Clostridium cultures at reduced pressure is described. The separation was achieved on n-octane-Porasil C after sampling of the gaseous compounds in a PTFE loop without any pretreatment. Most peaks were identified by gas chromatography-mass spectrometry. The presence of methane and ethylene sulphide among Clostridium volatiles is confirmed and 3-methyl-1-butene, 2-methyl-2 butene, dimethyl trisulphide and S-methyl thioacetate are reported for the first time in the Clostridium group. PMID- 3958106 TI - High-performance liquid chromatographic method for quantitation of acrolein in biological samples. PMID- 3958107 TI - Highly sensitive determination of free fatty acids in human serum by high performance liquid chromatography with fluorescence detection. AB - A highly sensitive and rapid high-performance liquid chromatographic method for the determination of free fatty acids in human serum is described. The fatty acids are converted into the corresponding fluorescent derivatives by the reaction with 3-bromomethyl-6,7-dimethoxy-1-methyl-2(1H)-quinoxalinone in the presence of potassium carbonate and 18-crown-6 in acetonitrile. The derivatives are separated simultaneously within 44 min on a reversed-phase column (YMC-Pack C8) with a gradient elution of aqueous methanol and detected fluorimetrically. The detection limits are 0.5-2 fmol in a 10-microliters injection volume. This sensitivity permits precise determination of free fatty acids including lauric, myristoleic and linolenic acids, which occur in serum at very low concentrations, in 5 microliters of sera from healthy subjects and patients with diabetes. PMID- 3958108 TI - Quantification of tryptamine in brain using high-performance liquid chromatography. AB - The concentration of endogenously formed tryptamine in central nervous system tissue was determined after extraction into ethyl acetate, purification on a weak cation-exchange resin and analysis using high-performance liquid chromatography with fluorometric detection. Final chromatographic separation of this indoleamine was achieved using a muBondapak C18 reversed-phase column under isocratic conditions. Using this method, the concentration of tryptamine in the whole brain of normal rats was found to be 0.60 +/- 0.06 ng/g of tissue, while pretreatment with dl-p-chlorophenylalanine, tranylcypromine and l-tryptophan increased the concentration to 96.7 +/- 21.9 ng/g. PMID- 3958110 TI - Detection of delta-aminolevulinic acid, porphobilinogen and porphyrins related to heme biosynthesis by high-performance liquid chromatography. AB - Two new high-performance liquid chromatographic methods are described for the quantitative determination of porphyrins and their precursors. In our method, sub nanomole quantities of porphyrins, delta-aminolevulinic acid and porphobilinogen derivatized with ophthalaldehyde were injected onto a C18 reversed-phase column and eluted with 0.1 M monobasic sodium phosphate-methanol-tetrahydrofuran (4:6:3) and detected with a spectrofluorometer. A second reversed-phase system using methanol-tetrahydrofuran-22 mM acetate buffer (15:6:11) was also developed. PMID- 3958111 TI - Separation and detection of closely related endorphins by liquid chromatography electrochemistry. AB - The specific aim of this study was to investigate the selectivity of liquid chromatography--electrochemistry for minor variations in the structure of small endorphins. Using isocratic mobile phases, chromatographic conditions were established for the separation of a series of closely related endorphins. Hydrodynamic voltammetry showed that each peptide exhibited a characteristic oxidative behavior that was also reflected in peak current ratios. Changes in a small moiety altered both the chromatographic behavior and electroactivity of these neuropeptides. PMID- 3958112 TI - Trace analysis of methanol in rat serum by headspace high resolution gas chromatography/selected ion monitoring. AB - A high resolution headspace gas chromatography/selected ion monitoring analytical method has been developed for the quantitation of methanol in body fluids. The addition of tetradeuterated methanol as internal standard gives this method high accuracy and reproducibility. The high sensitivity of the mass spectrometer permits analysis of methanol in aqueous solutions at concentrations down to 0.012 mg/l. The analytical procedure described was used to measure serum methanol in rats given 5 mg/kg of this alcohol orally. The method proved suitable for analysis of endogenous levels of methanol and of variations close to endogenous levels. PMID- 3958109 TI - Separation of N1- and N8-acetylspermidine isomers by reversed-phase column liquid chromatography after derivatization with dansyl chloride. AB - The separation of dansyl derivatives of N1- and N8-acetylspermidine by reversed phase column liquid chromatography is reported. The influence of organic solvents on the retention of acetylspermidines was studied. Best resolutions were achieved using a C18 column and a ternary mobile phase composed of water, methanol and acetonitrile. The precolumn derivatization method permitted the detection of picomole quantities. A method for the determination of acetylspermidines in rat tissues is described. PMID- 3958113 TI - Selective screening. PMID- 3958114 TI - Rates of senile dementia, Alzheimer's type, in the Baltimore Longitudinal Study. AB - Research participants (519) in the ongoing Baltimore Longitudinal Study, Gerontology Research Center, National Institute on Aging, from 1958-1978 were screened for new onset of Senile Dementia-Alzheimer's Type (SDAT), a global and progressive cognitive disorder. Their medical record abstracts were reviewed by two psychiatrists, who applied algorithmic criteria to identify 27 incident cases and date onsets. Intrarater bias, interrater reliability, and concurrent validity of the case ascertainment methods were assessed. A radix was created to estimate age-specific incidence rates, prevalence rates, remaining lifetime morbid risk for the disease-free and expected years of impairment with disease. Incidence was modeled as an exponential function of chronological age beyond 60. Survival analysis failed to detect premature death among SDAT cases; death rates depended only on chronological age--not on disease acquisition, duration, or age at onset. Prevalence at every age depended on incidence, exceeding 50% among those 95 and over. PMID- 3958115 TI - The use of regression analyses in a cohort mortality study of welders. AB - Using an internal nonexposed comparison group, and two types of regression analysis, we have reanalyzed the data from a cohort mortality study of 3247 welders and 5432 nonwelders who worked in Western Washington during the period 1950-1976. Previous analyses relied primarily on the standardized mortality ratio (SMR) for lung cancer as a summary statistic to estimate relative risk; welders were compared to the U.S. population, stratified by age, sex, race, and calendar time. In the present study, nonwelders from the same union were used as the reference group; an internal referent group is often preferable to the U.S. population, because it is likely to have shared similar lifestyles (e.g. smoking habits) as the exposed. Cox regression was used to estimate relative risk. In addition, the data was analyzed via logistic regression in order to compare Cox to logistic regression. A regression analysis of these data enabled us to analyze exposure as a continuous variable and simultaneously adjust for potentially confounding variables without stratification. Interactions terms could also be easily tested. The previous analysis found as SMR for lung cancer of 1.32 (p = 0.06). Cox regression with an internal comparison group yielded similar results. Issues discussed include the differences between logistic and Cox regression, the appropriate variable for time in Cox regression, and the definition of risk set in Cox regression. Finally, a newly available program is discussed which selects random samples of the risk sets used in Cox regression, in order to do a case control analysis. PMID- 3958116 TI - The role of before-after studies of therapeutic impact in the evaluation of diagnostic technologies. AB - Studies in which clinicians' therapeutic plans are determined before and after application of a new test offer an attractive alternative to randomized trials as a strategy for establishing the usefulness of diagnostic technologies. To maximize scientific credibility such studies should include a number of design features: specific clinical questions should be addressed; consecutive patients presenting with a clinical problem should be entered; the test's accuracy should be assessed; and changes in therapy should be described in sufficient detail to allow an estimate of the impact on patient outcome. Even with attention to these issues, the validity of before-after studies of therapeutic impact is limited by possible discrepancies between clinicians' stated plans and actual behavior, and by the often tenuous link between change in therapy and patient benefit. Before after designs will be most useful in primary investigations which, if positive, should be followed by more rigorous studies to establish patient benefit. PMID- 3958117 TI - The association of obesity with joint pain and osteoarthritis in the HANES data. AB - Data from 4225 persons from the National Health and Nutrition Examination Survey (HANES) was used to determine whether obesity was associated with osteoarthritis (OA) or joint pain. Subjects were divided into four groups on the basis of sex and race. We found that obesity was associated with OA of the knee for each sex/race group (p less than 0.01). The association was strongest for women, and it was present even for subjects without evidence of knee pain on physical examination. Frame size was not significantly associated with OA of the knee. Relative weight was weakly associated with OA of the hips in white women and nonwhite men but not significantly associated with OA of the sacroiliac joint. Diabetes did not seem to be an important risk factor for OA. These results suggest that the additional mechanical stress resulting from obesity is the principal reason for the association between obesity and OA. PMID- 3958118 TI - The tyrant of the garden. PMID- 3958119 TI - Selection bias in epidemiological studies of screening participants. PMID- 3958120 TI - Admission criteria for nonexperimental studies of treatments. PMID- 3958121 TI - Linear regression analysis with repeated measurements: comment. PMID- 3958122 TI - Early normalization of luteinizing hormone pulsatility after successful transsphenoidal surgery in women with microprolactinomas. AB - In eight hyperprolactinemic amenorrheic women who had a microprolactinoma, LH secretion was examined by measuring its concentration in blood samples collected every 15 min for 6 h before and 8 days after successful selective adenomectomy. Computer analysis was used for LH peak evaluation. In both circumstances, serum PRL and basal estradiol (E2) levels were also determined. Before operation, the number of LH peaks ranged from zero to one per 6 h in seven patients and was two per 6 h in the eighth patient. In all patients, serum PRL was normal on the eighth postoperative day, while E2 levels remained low, similar to the values usually found in the early follicular phase of the cycle in normal women. Postoperatively, mean LH levels were similar to preoperative levels, but there was a dramatic increase in the number of LH peaks (three to five per 6 h) in five of the eight patients. These observations confirm the impairment of LH pulsatility in hyperprolactinemia and demonstrate that normalization of PRL levels by surgery can restore LH pulsatile secretion in certain women as early as the eighth day after operation in the absence of a significant change in serum E2 levels. Thus, the preoperative impaired pulsatility of LH secretion was probably a central effect of hyperprolactinemia. PMID- 3958123 TI - Ectopic prolactinoma in a patient with hyperparathyroidism and abnormal sellar radiography. AB - In a patient with hyperparathyroidism and chronic renal failure due to polycystic kidney disease, a finding of destroyed sellar and parasellar structures and hyperprolactinemia suggested the diagnosis of invasive pituitary prolactinoma. At surgery no tumor was found, and pathological examination of the sphenoid bone revealed a parathyroid bone lesion (brown tumor) as well as ectopic prolactinoma in the clivus. This patient demonstrates that a tumor may develop in ectopic pituitary tissue. The combination of radiographically abnormal sellar structures with pituitary hormone hypersecretion should not be regarded as absolute proof of a pituitary adenoma. PMID- 3958124 TI - Basal oxygen uptake: a new technique for an old test. AB - To assess the metabolic effects of T4 and T3, we measured serum total T4 (TT4), free T4 (FT4), total T3 (TT3), TSH, and basal oxygen uptake (VO2) in eight normal subjects in the basal state and after treatment with L-T3 (T3) and sodium ipodate for 2 weeks. T3 treatment resulted in a rise of serum TT3 from a baseline of 137 +/- 16 (+/- SE) to a peak of 239 +/- 15 ng/dl. Serum TT4 declined from 8.14 +/- 0.56 to 6.08 +/- 0.43 micrograms/dl, FT4 from 1.59 +/- 0.13 to 1.03 +/- 0.05 ng/dl, and TSH from 1.74 +/- 0.24 to 0.56 +/- 0.16 microU/ml. Basal VO2 increased from 2.66 +/- 0.11 to 3.15 +/- 0.09 ml/kg X min. Ipodate, on the other hand, led to a lower serum TT3 concentration (102 +/- 21 ng/dl), higher serum TT4 and FT4 (9.59 +/- 0.5 micrograms/dl and 1.91 +/- 0.13 ng/dl, respectively), and elevated TSH (3.64 +/- 0.14 microU/ml). Basal VO2 was reduced to 2.44 +/- 0.06 ml/kg X min. Linear regression analysis revealed an excellent positive correlation between serum TT3 and basal VO2 (n = 25; r = 0.747; P less than 0.001) and a significant negative correlation between serum TT3 and TSH (n = 26; r = -0.526; P less than 0.01). Serum TT4 and FT4 correlated negatively with VO2 and positively with serum TSH. The higher T4 level during ipodate treatment was associated with lower VO2 and higher TSH, and vice versa when T4 was suppressed while receiving T3. When ipodate was given concomitantly with T3 to five subjects, only the effects of T3, characterized by increased VO2 and decreased TSH, were evident. These data indicate that both basal VO2 and serum TSH are sensitive indices of thyroid hormone activities. The latter gives only the directional change (hyper- or hypothyroidism), while the former more accurately quantitates the magnitude of the derangement. Moreover, it appears that in man, T3, and not T4, is the primary hormone that regulates thermogenesis and TSH secretion. PMID- 3958125 TI - Physiological properties of the luteinizing hormone pulse signal: impact of intensive and extended venous sampling paradigms on its characterization in healthy men and women. AB - The pulsatile nature of the gonadotropin signal is a critical determinant of physiological activation of the gonadal axis. Nonetheless, major uncertainties exist regarding the exact patterns of LH secretion that constitute normal physiological profiles in man. To assess possible bases for the discrepancies in the literature, we sampled blood at 5-min intervals for 24 h in eight normal men and eight normal women in the early follicular phase of the menstrual cycle. The constituent 5-, 10-, 15-, and 20-min immunoactive LH series and the consituent 6 , 12-, or 24-h sampling durations provided ranges of sampling intensities and durations for analysis of significant LH pulses. A technique for minimizing the influence of false positive immunoassay errors on peak detection was used to aid in estimating apparent true positive LH pulse frequency. Nonlinear curve fitting of the relationship between sampling intensity and apparent true positive LH pulse frequency revealed a stable pulse frequency estimate at intensive rates of venous sampling, with values of 19.5 +/- 1.9 (+/- SEM) pulses/24 h (periodicity, 73.8 +/- 6.5 min/pulse) in men and 20.6 +/- 3.6 pulses/24 h (periodicity, 70.0 +/ 10 min/pulse) in women. Further analyses indicated that sampling every 3.1 and 2.0 min for 24 h would be required to capture 90% of the LH pulses in men and women, respectively. Moreover, even with a 5-min sampling rate, the statistical counting errors of the LH pulse frequency estimates varied markedly with sampling duration; for example, in men sampled in 6-, 12-, and 24-hr sessions, the values were, respectively, 49%, 35%, and 24% of the observed pulse frequencies. Similar variations were found in women. Counting errors were 30-50% higher for conventional 20-min sampling rates than for 5-min sampling intervals. Measured interpulse intervals varied widely from 10-330 min (median, 60 min; n = 131 LH pulses) in men and from 10-340 min (median, 65 min; n = 125 LH pulses) in women. In addition, absolute LH pulse amplitudes varied from 1-28 mIU/ml (median, 4.1 mIU/ml) in men and from 1-24 mIU/ml (median, 3.6 mIU/ml) in women. These estimates were associated with a median number of points identified within each pulse of 6.0 in men and 4.0 in women. In summary, the present exhaustive sampling studies demonstrate for the first time stable estimates of physiological LH pulsations in normal men and women, and document broad ranges of normal LH pulse amplitudes and interpulse intervals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958126 TI - Ovulation induction with bromocriptine in normoprolactinemic anovulatory women. AB - Afternoon-evening and nocturnal serum PRL levels and PRL responsiveness to metoclopramide (MCP) were determined in 34 women with normoprolactinemic anovulation (nPRL-Anov) and in the early follicular phase (EFP) in 6 normal women. Subsequently, the nPRL-Anov women were treated with 5 mg bromocriptine (Br) twice daily for 2 months, and its action on ovulation was determined. Those women who did not respond to Br received 50-150 mg clomiphene for 5 days. The nPRL-Anov patients were classified into 3 groups in terms of the efficacy of Br treatment: group I, those who ovulated with Br (n = 13); group II, those who ovulated after receiving Br and clomiphene (n = 7); and group III, those who failed to ovulate after the above treatments (n = 10). Four patients dropped out of the study. Diurnal serum PRL levels were approximately 10 ng/ml in all patients, and no statistical difference was found among the groups. Peak nocturnal serum PRL levels (the highest PRL value during the 0000-0400 h period) were 38.0 +/- 23.9 (+/- SD) ng/ml in group I patients, higher (P less than 0.05) than in groups II and III and normal (EFP) women (20.1 +/- 9.1, 20.7 +/- 7.7, and 16.3 +/- 2.7 ng/ml for the group II and III patients and the EFP women, respectively). MCP induced rapid and marked elevation in serum PRL levels in all subjects. The maximum post-MCP PRL value in the group I patients was 224.2 +/- 89.7 ng/ml, which was significantly higher (P less than 0.002) than the maximum value in the remaining groups (120.5 +/- 25.8, 121.3 +/- 54.2, and 101.9 +/- 28.1 ng/ml, respectively). Ten (76.9%) and 12 (92.3%) group I patients had nocturnal PRL levels above 25 ng/ml and maximum PRL values after MCP above 150 ng/ml, respectively. We conclude that some nPRL-Anov patients have elevated nocturnal serum PRL levels or enhanced PRL responsiveness to MCP, indicative of nocturnal or latent hyperprolactinemia. Br effectively induced ovulation in these patients. A MCP provocation test can predict the outcome of Br treatment in such nPRL-Anov patients. PMID- 3958127 TI - Distribution of catecholamines between fetal and maternal compartments during human pregnancy with emphasis on L-dopa and dopamine. AB - This study was undertaken to determine the differential distribution of catecholamines, in particular L-dihydroxyphenylalanine (L-dopa) and dopamine, between the fetal and maternal compartments during human pregnancy. Amniotic fluid and fetal and maternal blood were obtained from two groups of pregnant women with uncomplicated pregnancies. One group was at 15-20 weeks of gestation and the second group was in labor after 36-41 weeks of gestation. Samples were analyzed for L-dopa, dopamine, norepinephrine, and epinephrine by radioenzymatic assays. L-Dopa constituted about 80% of the total circulating fetal catecholamines, and levels were 2- to 3-fold higher in fetal than maternal plasma. Marked increases in norepinephrine, small rises in epinephrine, but no changes in L-dopa or dopamine concentrations occurred in fetal plasma from mid- to late gestation. Maternal plasma catecholamines did not change. Towards the end of gestation, dopamine in the amniotic fluid increased 15-fold, and norepinephrine increased 5- to 6-fold; L-dopa remained high and unchanged. We conclude that L-dopa is the predominant catecholamine in fetal plasma and amniotic fluid during human pregnancy. No significant changes in its concentrations occur in either compartment between mid- and late gestation. In contrast, dopamine levels, which are 30- to 50-fold lower than those of L-dopa in amniotic fluid during midgestation, show a striking elevation toward the time of labor. Neither the sources nor the possible physiological functions of either L dopa or dopamine during fetal life are known. PMID- 3958128 TI - Inhibition of luteinizing hormone/human chorionic gonadotropin-stimulable adenylyl cyclase activity in rat luteal membranes by nonsteroidal component(s) in human follicular fluid. AB - We examined the ability of nonsteroidal components of human follicular fluid (hFF) to alter gonadotropin responsiveness using the LH/hCG-sensitive adenylyl cyclase system of rat luteal membranes. Follicular aspirates were obtained from regularly ovulatory women (n = 10) whose follicles were stimulated by human menopausal gonadotropin and hCG as part of an in vitro fertilization program. hFF from large follicles was pooled and extracted with 10% (wt/vol) activated charcoal. Maximal hCG stimulation of adenylyl cyclase activity obtained with 10 micrograms/ml hCG and 100 microM of the hydrolysis-resistant GTP analog guanyl 5' yl-imidodiphosphate was significantly inhibited by hFF in a dose-dependent manner. Addition of about 500 micrograms hFF protein caused inhibition of 70% compared to the control value. Fractionations of hFF by ultrafiltration using membranes of precalibrated pore size demonstrated that the inhibitory activity was associated with a less than 10,000 mol wt fraction; 3 micrograms protein/assay of this fraction resulted in 50% inhibition (IC50) of maximal hCG stimulation. The inhibitory activity also passed through an Amicon YM-2 membrane (mol wt retention, 1,000), but not through an Amicon YC-05 membrane (mol wt retention, 500). An IC50 of about 0.01 microgram protein/assay was found for both the 500-1,000 and the 1,000-5,000 mol wt fractions. NaF or forskolin-stimulated adenylyl cyclase activity was not altered by unfractionated hFF or by the 500 10,000 mol wt subfractions, suggesting that inhibition was limited to LH/hCG stimulation. Further analysis of the effects of low mol wt fraction on hCG stimulation of adenylyl cyclase indicated that enzyme inhibition was not accompanied by a shift in the hCG concentration required for half-maximal stimulation (the apparent activation constant) compared to dose-response curves obtained in the absence of added fraction. Equilibrium binding studies showed that [125I]hCG interaction with luteal membranes was significantly inhibited by hFF; 7 micrograms protein/assay of the less than 10,000 mol wt fraction reduced specific binding by 60%. Moreover, kinetic analysis carried out in the absence or presence of a fixed amount of low mol wt fractions revealed a competitive type of binding inhibition. Our data demonstrate that a nonsteroidal component(s) of hFF has a direct inhibitory effect on LH/hCG-responsive luteal adenylyl cyclase and that the inhibitor(s) exerts its actions through a mechanism involving competition with LH/hCG for the same binding sites. PMID- 3958129 TI - Detection of autoantibodies to thyroid peroxidase in autoimmune thyroid diseases by micro-ELISA and immunoblotting. AB - Serum autoantibodies to thyroid peroxidase (TPO) in patients with thyroid autoimmune diseases were studied by micro-ELISA and immunoblotting. Twenty-four patients, 15 with Graves' disease and 9 with Hashimoto's thyroiditis, whose serum titers were greater than 3200 on the microsomal hemagglutination test (except for 1 patient with a titer of 800) had autoantibodies to TPO. Both immunoglobulin G and M classes of autoantibodies were detected, with the former being more prominent. When TPO and thyroid microsomes were used as a target in a competitive binding inhibition test, the results suggested that TPO was a major thyroid microsomal antigen. On the other hand, immunoblotting analysis showed 3-4 bands in the 45-60K region stained by patients' sera in addition to human TPO with mol wt of 100K and 107K; only the latter 2 bands stained with antiporcine TPO antibody. In the majority of sera, TPO bands were clearer than others, although some sera showed the clearest band with a mol wt of 55K. These results indicate that patients with autoimmune thyroid disease often have autoantibodies to TPO that can be detected by micro-ELISA and immunoblotting, and that TPO is a major component of the thyroid microsomal antigen. PMID- 3958130 TI - Acute parathyroid hormone secretory dynamics: hormone secretion from normal primate and adenomatous human tissue in response to changes in extracellular calcium concentration. AB - PTH secretion has been evaluated extensively using short term incubation techniques, but these methods cannot be used to adequately evaluate the early phases of PTH secretion. We developed a dispersed cell perifusion system to study these acute secretory events. Responses to low calcium conditions were studied using dispersed cells from normal primate and adenomatous human parathyroid tissue. When these cell were perifused with 1.0 mM calcium medium, PTH secretion was stable, but increased within minutes in a dose-dependent manner in response to a lowering of extracellular calcium concentrations. Similarly, PTH secretion quickly declined when cells were exposed to higher extracellular calcium concentrations. In studies of cells from 11 human adenomas, the mean maximum secretion in response to 0.25 mM calcium conditions was 587 +/- 330% (+/- SD) of that in response to 1.0 mM calcium. The magnitude of the response to low calcium stimulation was variable, and cells from two additional adenomas failed to respond to low calcium stimulation despite responses to other secretogogues. Variation in the rate of increase in stimulated PTH secretion was also found among the adenomas examined (128 +/- 95% of baseline/min), and the rate of increase in PTH release and the eventual maximum rate of release were positively correlated. In studies of cells from 4 normal primates (rhesus macaque), the maximum response to 0.25 mM Ca2+ (544 +/- 118% of baseline) and the rate of increase in PTH secretion (95 +/- 35% of baseline/min) were similar to those in adenomatous human tissue. These results indicate that 1) acute PTH secretion can be studied in vitro, and that it appears to be similar to the in vivo process; 2) there is a wide variation among adenomatous tissues in the magnitude of secretion stimulated by low calcium concentrations; 3) in addition to varied magnitude of secretion, the rate at which hormone secretion increases in response to a low calcium stimulus varied among adenomas; and 4) PTH secretion from human adenomatous tissue is similar to that from normal primate tissue in both the rate and magnitude of response. PMID- 3958131 TI - Deficient nocturnal surge of thyrotropin in central hypothyroidism. AB - In normal individuals, serum TSH concentrations have a circadian pattern characterized by a nocturnal surge which begins in the late afternoon and reaches its peak after midnight. We assessed the nocturnal surge of TSH in 16 patients with pituitary and/or hypothalamic diseases, 6 of whom were judged to be hypothyroid. To assess the magnitude of the nocturnal surge in individual patients, TSH was measured in 5 serum samples obtained during the normal time of the TSH nadir in the late afternoon and in 5 samples obtained during the normal time of the peak of serum TSH after midnight. A significant nocturnal surge of TSH was defined as a significantly greater mean nighttime TSH level than the mean daytime TSH concentration. The nocturnal TSH surge was absent in the 6 patients with central hypothyroidism, while it was present in the 10 euthyroid patients with central lesions. In 6 hypothyroid patients who did not have pituitary or hypothalamic lesions, the nocturnal TSH surge was intact, indicating that hypothyroidism per se does not account for the deficient nocturnal TSH surge in central hypothyroidism. We conclude that central hypothyroidism is characterized by a deficient nocturnal surge of TSH, and accordingly, we suggest that evaluation of the circadian pattern of TSH may be a useful adjunct in making the diagnosis of hypothyroidism in patients with diseases involving the pituitary or hypothalamus. PMID- 3958132 TI - Urinary cortisol in the assessment of pituitary-adrenal function: utility of 24 hour and spot determinations. AB - To more conveniently assess dynamic changes in the biologically active fraction of cortisol, we measured cortisol in 1-h urine samples obtained from 0700-0800 and from 2200-2300 h. In 20 normal subjects, morning 1-h urinary cortisol levels were 78 +/- 36 ng/mg creatinine (mean +/- SD), whereas levels from 2200-2300 h were 22 +/- 12 ng/mg creatinine, demonstrating diurnal variability. In 14 patients with Cushing's syndrome, mean morning urinary cortisol was elevated (207 +/- 176 ng/mg creatinine), but there was overlap with values in normal subjects. In contrast, evening values in Cushing's syndrome (248 +/- 208 ng/mg creatinine) were elevated in each patient; there was no diurnal variation and no overlap with normal subjects. Similarly, the morning urinary cortisol response to dexamethasone (1 mg, orally, at 2300 h) clearly separated normal subjects from those with Cushing's syndrome (5 +/- 6 vs. 169 +/- 149 ng/mg creatinine, respectively). In 10 patients with secondary hypoadrenalism, urinary cortisol levels were less than 2 ng/mg creatinine in both morning and evening 1-h samples. Thus, the determination of cortisol in 1-h samples is a practical and simple method of assessing cortisol secretion and allows multiple sampling without hospitalization. It is effective in assessing dynamic cortisol responses, such as diurnal variation and responsiveness to suppression, and it is an effective screening test for Cushing's syndrome and hypoadrenalism. PMID- 3958133 TI - Relationships between glucose and mannose during late gestation in normal pregnancy and pregnancy complicated by diabetes mellitus: concurrent concentrations in maternal plasma and amniotic fluid. AB - Enzymatic assays were modified to permit sensitive and highly reproducible simultaneous measurements of D-mannose and D-glucose in biological fluids during weeks 34-40 of human pregnancy. Plasma mannose and glucose averaged 9.8 +/- 0.4 (+/- SEM) and 790 +/- 16 micrograms/ml, respectively, after an overnight fast in pregnant women (n = 22) with normal carbohydrate metabolism. Significantly higher plasma mannose levels were found, despite only minor increases in plasma glucose, in pregnant women with relatively well controlled diabetes mellitus after an overnight fast (16.9 +/- 0.6 micrograms/ml mannose; 883 +/- 29 micrograms/ml glucose; n = 31) or 3-4 h after breakfast (15.7 +/- 1.2 micrograms/ml mannose; 1159 +/- 101 micrograms/ml glucose; n = 19). Plasma mannose correlated significantly with plasma glucose in the women with diabetes mellitus, particularly after an overnight fast. Samples of amniotic fluid were also obtained from the gravida with diabetes mellitus to provide some index of simultaneous relationships in utero. Amniotic fluid mannose and glucose averaged 5.9 +/- 0.4 and 302 +/- 24 micrograms/ml, respectively, after an overnight fast and 6.7 +/- 1.3 and 459 +/- 84 micrograms/ml 3-4 h after breakfast. In amniotic fluid, as in plasma, the concurrent levels of mannose and glucose conformed to relatively fixed relationships. Thus, both fetus and mother appear to be exposed to readily demonstrable amounts of mannose during late gestation and the absolute as well as relative abundance of mannose may be increased coincident with faulty maternal glucoregulation. However, since mannose did not exceed 3% of the concurrent concentration of glucose in any instance, it does not seem likely that endogenous levels of circulating mannose can modify glucose utilization appreciably by competing with glucose for phosphorylation via hexokinase and subsequent intracellular processing. PMID- 3958134 TI - Synthesis and release of glycosylated prolactin by human decidua in vitro. AB - To determine whether human decidual tissue synthesizes and secretes a glycosylated form of PRL (G-hPRL), explants of decidua obtained after normal term delivery were cultured for up to 5 days. During each day of incubation, the decidual explants incorporated [3H]mannose and [3H]glucosamine into immunoprecipitable G-hPRL. The explants released 33-50% less G-hPRL than hPRL. The release of decidual G-hPRL was unaffected by treatment with TRH (10(-4)-10( 8) M) or dopamine (10(-5)-10(-9) M) during a 4-h incubation period. G-hPRL also was sought in samples of amniotic fluid. Glycosylated hPRL was detected in all amniotic fluid samples from normal pregnant women at 32-40 weeks of gestation. These results indicate that human decidual explants in vitro may be used as a model system to study the secretion of G-hPRL and its regulation during pregnancy. PMID- 3958135 TI - Role of natural killer cytotoxic factors in the mechanism of target-cell killing by natural killer cells. AB - Studies on the mechanism of cell-mediated cytotoxicity (CMC) have suggested a stimulus-secretion model and implicated a role of soluble cytotoxic mediators. Our studies in the natural killer (NK) system provide several lines of evidence for the involvement of natural killer cytotoxic factors (NKCF) in NK CMC and led to the development of a model for the NK lytic mechanism. This model delineates several interactions between NK cells and targets that are deemed necessary to achieve target-cell lysis. The first stage is the interaction of the effector with the target cell, resulting in contact and adhesion. This is presumably mediated by NK recognition structures and target-cell structures. Following binding, the target cell stimulates the NK cell to release NKCF. This step is functionally distinct from the initial effector-target binding. The trigger mechanism for release of NKCF appears to be dependent on protein kinase C. The released NKCF binds to NKCF binding sites on the target cell followed by "processing" or "internalization" and, ultimately, resulting in cell death. This model has been shown to be useful in investigating the mechanism of defective NK activity in certain disease states. Biochemical analysis and comparative studies suggest that NKCF is a distinct molecule from other cytotoxins studied to date. The studies in the NK CMC system supporting a role of cytotoxic mediators also suggest a possible role for cytotoxic factors in other cytotoxic systems. Furthermore, the selective susceptibility to lysis of tumor or infected cells by NKCF suggests a possible role of their effectiveness in in vivo therapy. PMID- 3958136 TI - Salivary antibody responses to oral and parenteral vaccines in children. AB - Salivary IgA antibody to poliovirus and tetanus toxoid was measured in whole salivas of 151 children between 2 and 48 months of age from North America and from Scandinavia. Children from urban and suburban populations in the greater Boston, MA, area receive both oral poliovaccine and a parenteral injection with tetanus toxoid (TT), initially at approximately 2 months of age. Children from Goteborg, Sweden, initially receive parenteral injections of TT at 2 months of age and parenteral injections of killed polio vaccine initially at 9 to 10 months of age. Twenty-six percent of the Boston subjects who were less than 12 months old had detectable salivary IgA antibody to poliovirus after oral immunization. In contrast, within the first year after parenteral immunization with killed poliovirus, the Swedish group had detectable salivary antibody in 9% (1 of 13) of the subjects. Forty to 65% of the children in the older Boston-area age groups had positive salivary IgA antibody levels to this antigen. No differences were seen in salivary IgA antibody to TT among the three populations. By 36 months of age at least 50% of all populations had detectable salivary antibody to TT. The ratio of enzyme-linked immunosorbent assay (ELISA) activity using rabbit anti human secretory component versus rabbit anti-human alpha chain was significantly higher in subjects less than 12 months of age compared with older groups. This suggested either that free secretory component was binding to tetanus toxoid or that secretory antibody of isotypes other than IgA was present in these youngest subjects. PMID- 3958137 TI - Decreased synthesis of serum carboxypeptidase N (SCPN) in familial SCPN deficiency. AB - Serum carboxypeptidase N (SCPN) is the primary inactivator of the C3a, C4a, and C5a anaphylatoxins as well as an inactivator of bradykinin. Thus SCPN deficiency potentially could result in significant pathophysiologic consequences. Previous studies identified a deficient subject afflicted with frequent episodes of angioedema, and other family members also had SCPN deficiency. To delineate this abnormality further, the fractional catabolic rate (FRC) and enzyme synthesis were determined in three members of the afflicted kindred as well as in five normal persons following the infusion of homogeneous 125I-SCPN. The mean FCR and synthesis rates for SCPN in the normal subjects were 1.3%/hr and 20,793 U/kg/hr, respectively. Reduced synthesis was concluded to be primarily responsible for the low SCPN levels in the afflicted kindred. The high FRC of SCPN discourages attempted maintenance therapy with infusions of enriched SCPN preparations. PMID- 3958138 TI - Emergence of bactericidal and opsonizing antibody to Vibrio vulnificus following bacterial infection. AB - Virulent isolates of Vibrio vulnificus resist the bactericidal and opsonizing effects of normal human serum, in contrast to environmental isolates, which are highly serum susceptible. Immune responses to bacteremic V. vulnificus infections in human subjects have not been characterized. Serum from a patient who survived sepsis caused by V. vulnificus had substantial bactericidal and opsonizing immunoglobulin G (IgG) for his own bloodstream isolate. Killing was mediated by the classical complement pathway, whereas opsonization was effected by either the classical or the alternative pathway. IgG that reacted strongly with 55-, 58-, and 68-kilodalton outer membrane proteins was present in the patient's convalescent-phase serum but was absent from normal human serum. These findings suggest that humoral immunity to V. vulnificus, mediated by bactericidal and opsonizing antibody, emerges during infection and may be due, in part, to IgG directed against identifiable outer membrane proteins. PMID- 3958140 TI - Detection by gas chromatography of 3-deoxy-D-manno-2-octulosonic acid and L glycero-D-manno-heptose in whole cells of Neisseria elongata. AB - Lipopolysaccharide components 3-deoxy-D-manno-2-octulosonic acid and L-glycero-D manno-heptose were detected in hydrolysates from whole cells of Neisseria elongata by gas-liquid chromatography. Cells from a single plate were hydrolyzed, and carbohydrate components were converted to aldononitrile and O-methyloxime acetate derivatives for subsequent analyses by gas-liquid chromatography. 3-Deoxy D-manno-2-octulosonic acid was well separated from other cell components as the O methyloxime acetate derivative. With both derivatives, L-glycero-D-manno-heptose was readily identified by their different retention times. The procedure requires only a relatively small number of cells, and detection is accomplished without prior isolation of the lipopolysaccharide. PMID- 3958139 TI - Use of 51Cr release to measure the cytotoxic effects of staphylococcal leukocidin and toxin neutralization on bovine leukocytes. AB - Leukocidin toxin from Staphylococcus aureus produces specific cytolytic effects on neutrophils and macrophages. The most commonly used method for determination of leukocidin activity is microscopic examination for characteristic morphological changes in toxin-treated cells. The 51Cr release assay was modified to allow quantitation of the cytolytic effects of leukocidin on bovine peripheral blood neutrophils and lymphocytes. Toxin neutralization by serum and milk samples was quantitated by this method. The neutralizing abilities of the various samples were found to correlate with the levels of immunoglobulin G (IgG1) specific for leukocidin. Undiluted normal serum samples, however, were capable of partially preventing the cytotoxic effects of leukocidin. The assay was shown to be an effective means of quantitating the cytotoxic activity of leukocidin on neutrophils as well as demonstrating neutralization of cytotoxicity by milk and serum samples. PMID- 3958142 TI - Simplified lysed-blood culture technique. AB - A blood culture system was developed in which a lysing agent (either Tween 20, one of several other polyoxyethylene adducts, digitonin, or Triton X-100) is added to the blood culture medium. Of 33 Triton compounds, 9 lysed human blood, as did 7 of 21 polyoxyethylene compounds and digitonin, all at a concentration of 0.05%. Under the specific test conditions, three of the hemolytic polyoxyethylene compounds and digitonin had no inhibitory effect. All of the Triton compounds had at least some inhibitory effect on the most sensitive of the pathogenic bacteria that were tested, Streptococcus pneumoniae and Neisseria meningitidis. Because of results from previous studies, Triton X-100 was tested further, despite evidence in this study of its inhibition of bacteria. Of the 55 lysing agents tested, digitonin, Triton X-100, Brij 96, and Tween 20 were selected for further testing as additions to conventional culture broth. Comparative culture studies with bacteremic blood from infected rabbits were performed with the conventional blood culture, the Isolator system (Du Pont Co., Wilmington, Del.), and the new lysing medium. The new system has the advantages of lysis filtration and lysis centrifugation without the associated added cost and processing complexity. PMID- 3958141 TI - Selective medium for the isolation of Bacteroides gingivalis. AB - Bacteroides gingivalis has been implicated in various forms of periodontal disease and may be responsible for other diseases in humans. The role of B. gingivalis in disease has been difficult to assess, because it is inhibited by most selective media commonly used by clinical laboratories to aid in isolating gram-negative, nonsporeforming anaerobes. We have developed a new medium, Bacteroides gingivalis agar, which contains bacitracin, colistin, and nalidixic acid as selective agents. This medium allowed B. gingivalis to be isolated from oral specimens with little difficulty and also allowed B. gingivalis to be isolated from phenotypically similar Bacteroides species, such as B. asaccharolyticus and B. endodontalis, with which it can easily be confused. PMID- 3958143 TI - Evaluation of a blood-free, charcoal-based, selective medium for the isolation of Campylobacter organisms from feces. AB - A blood-free, charcoal-based selective medium (CSM) consisting of a Columbia agar base, activated charcoal (4 g/liter), hematin (0.032 g/liter), sodium pyruvate (0.1 g/liter), cefoperazone (32 mg/liter), vancomycin (20 mg/liter), and cycloheximide (100 mg/liter) supported the growth of Campylobacter jejuni and C. coli with colony counts equivalent to those obtained on antibiotic-free horse blood agar. CSM was compared to Skirrow medium (SKM) for the recovery of C. jejuni and C. coli from stools of patients with diarrhea, the media being incubated for 2 days under reduced oxygen tension at 43 degrees C. These campylobacters were isolated from 35 (2.9%) of 1,227 stools tested (29 on both media, 5 on CSM alone, and one on SKM alone). Whenever C. jejuni and C. coli were recovered, growth was pure on 29 CSM cultures (85%), but on only 11 SKM cultures (37%). Complete suppression of "contaminating" flora occurred in 704 CSM cultures (57%) compared with 426 SKM cultures (35%). CSM more effectively suppressed contaminating pseudomonads, gram-positive organisms, and yeasts than did SKM; both media failed to suppress members of the family Enterobacteriaceae in about a quarter of the samples. Studies on 20 representative Enterobacteriaceae contaminants showed that susceptibility to cefoperazone and growth on CSM were markedly dependent on inoculum size; 12 strains were inhibited by cefoperazone (32 mg/liter) at inoculum sizes of 5 X 10(2) and 5 X 10(4) but not 5 X 10(6) organisms, indicating that the frequency of contaminants on CSM could probably be reduced further by ensuring that stools were not inoculated too heavily on CSM. Our findings confirm that charcoal is an effective substitute for blood in media for growing campylobacters, and that CSM is a highly effective blood-free selective medium for isolating C. jejuni and C. coli from stools. PMID- 3958144 TI - Quantitative gas chromatographic analysis of volatile fatty acids in spent culture media and body fluids. AB - Gas chromatographic analysis of volatile fatty acids for identification of obligately anaerobic bacteria and for presumptive diagnosis of anaerobic infections is now widely practiced. However, it is difficult to compare data because only a qualitative analysis is done or only chromatograms are presented instead of quantitative data on volatile fatty acid production. We compared three stationary phases for volatile fatty acid analysis of aqueous solutions and four methods of pretreating samples for gas chromatography. Quantitative analysis could be done accurately by using Carbowax as the stationary phase after pretreatment of spent culture media with Dowex columns. If only qualitative analysis is required (e.g., for presumptive diagnosis of anaerobic infections), ether extraction and headspace analysis are equally suitable. The overall variation coefficient for volatile fatty acid production by four reference strains of obligately anaerobic bacteria after 24 h of incubation was approximately 10%. PMID- 3958145 TI - Design and analysis considerations in evaluating the chemiluminescence response of mouse spleen cells. AB - Chemiluminescence is the result of the respiratory burst generated by phagocytic cells after stimulation by antigen. The measurement of chemiluminescence represents a sensitive means for detecting antigenic stimulation and immune cell function. Although the kinetics of chemiluminescence reactions have been described, appropriate statistical methods for the evaluation of data from chemiluminescence assays have not been reported. Based on examination of data from several studies in which the chemiluminescence response of spleen cells was investigated after stimulation with the particulate antigen zymosan, recommendations are made for the design and statistical evaluation of such studies. Three parameters were used in assessing the chemiluminescence response; peak intensity of the emitted light, time to peak, and the area under the intensity-time curve. The data indicated that peak intensity alone provides an adequate characterization of the chemiluminescence response. Since percent change in response upon treatment is of interest, analysis on the log scale is appropriate, and the statistical procedure of choice in evaluating data of this type is a trend analysis. The need for a balanced allocation of treatments to avoid potential bias is demonstrated. The methods proposed are illustrated with data from two studies in which the effect of preincubation with low concentrations of ketoconazole, an antifungal agent, on the chemiluminescence response of BALB/cBY spleen cells was examined. PMID- 3958146 TI - Distribution and serotypes of Campylobacter jejuni and Campylobacter coli in enteric Campylobacter strains isolated from children in the Central African Republic. AB - One hundred eighty-five enteric Campylobacter strains isolated from diarrheic or healthy children in Bangui (Central African Republic) were studied to determine their species and serotypes. C. coli was identified in 38.9% of all strains and in 43.9% of strains from diarrheic children. By the hemagglutination technique for heat-stable antigens, 73.5% of the strains could be serotyped. Of the typeable strains, 75% were distributed among 13 more frequent serotypes. C. coli serotype Pen 37,56 was the most common serotype from diarrheic children. PMID- 3958147 TI - Prevalence, species differentiation, and toxigenicity of Aeromonas strains in cases of childhood gastroenteritis and in controls. AB - In a 1-year period (January to December 1984), Aeromonas strains were isolated from feces of 21 of 561 (3.7%) children with gastroenteritis and from 12 of 576 (2.1%) children without intestinal disturbances (controls). The difference between the two isolation rates was not significant (X2 = 2.2; P greater than 0.05). In five cases of illness other intestinal pathogens were isolated together with Aeromonas in the same stool sample. A total of 39 Aeromonas strains were detected since in some cases aeromonads with different biochemical characteristics were obtained from the same stool sample. Of the 39 Aeromonas isolates, 6 strains (5 from patients) were Aeromonas hydrophila, 5 strains (3 from patients) were Aeromonas sobria, and 26 strains (18 from patients) were Aeromonas caviae; 2 strains isolated from controls did not ferment sucrose and were considered a distinct group of Aeromonas. We found no significant difference between the prevalence of each of these species from patients and the prevalence from controls. We found no significant difference in the prevalence of enterotoxin-producing strains (suckling mouse model), cytotoxin-producing strains (HEp-2 cell model), or hemolysin-producing strains (rabbit erythrocyte model) between patients and controls. In our geographical region there is no evidence that Aeromonas species are primary intestinal pathogens in children. PMID- 3958148 TI - Selective and differential medium for the primary isolation of members of the Proteeae. AB - A new differential and selective medium for the isolation of members of the Proteeae, PIM (Proteeae isolation medium) agar, was developed and evaluated. The medium relies on the ability of all members of the Proteeae (with the exception of a very few Morganella morganii strains) to produce a dark brown pigment in medium containing DL-tryptophan. An additional differential property, tyrosine degradation, was also demonstrated by the medium. Members of the Proteeae appeared as dark brown colonies with a halo of clearing of fine tyrosine crystals when cultured on PIM agar. Occasional strains of Citrobacter sp. and Pseudomonas aeruginosa may degrade tyrosine, but none has the ability to produce dark brown pigmentation on PIM agar. Quantitative recovery studies showed that the addition of 5 mg of clindamycin per liter suppressed gram-positive bacteria without inhibiting any strains of the Proteeae. The addition of 100 mg of colistin per liter made the medium highly selective for strains of the Proteeae, but approximately 10% of the strains were not isolated, thus making this formulation unsuitable for general surveys of the occurrence of members of the Proteeae. PIM agar should aid the investigation of episodes of cross infection caused by members of the Proteeae and the isolation of the new species of the Proteeae recently described. PMID- 3958151 TI - Persistence of cholera in the United States: isolation of Vibrio cholerae O1 from a patient with diarrhea in Maryland. AB - A case of cholera was identified in Baltimore County, Md., in October 1984. The Vibrio cholerae O1 isolate from the patient was hemolytic, biotype El Tor, serotype Inaba, and was toxigenic by the Y-1 adrenal cell assay; on Southern blot analysis, the strain had a unique HindIII restriction site in the cholera toxin gene identical to that of other U.S. V. cholerae O1 isolates. Two days before he became ill, the patient had eaten meat from crabs harvested along the Texas coast. PMID- 3958149 TI - Composition and antimicrobic resistance of skin flora in hospitalized and healthy adults. AB - The aerobic bacterial flora of the skin of the anterior nares, axilla, perineum, and toe web in a group of 37 patients hospitalized for at least 2 weeks was compared with the flora of 30 healthy adults. Colony counts were significantly higher for flora of the perineum and toe web in both groups (P less than 0.05). Patients had significantly higher carriage rates of Proteus, Pseudomonas, and Candida spp. (P less than 0.01). Staphylococcus haemolyticus was isolated more frequently from patients, and S. hominis was isolated more frequently from controls (P less than 0.01). Patient microflora, including gram-positive cocci, gram-negative bacilli, large-colony diphtheroids, and lipophilic diphtheroids, showed a high degree of resistance to multiple antimicrobial agents. The gram positive coccal flora of patients was significantly more resistant than that of controls for 8 of 10 antimicrobial agents tested. Methicillin resistance occurred in only 2.9% of isolates from controls, but in 44.3% from patients (P less than 0.01). This extensive survey identifies qualitative and quantitative differences in skin flora and confirms that significantly higher levels of antimicrobial resistance are present in all types of organisms from a number of skin sites in hospitalized patients. PMID- 3958150 TI - Evaluation of the 10-micrograms clindamycin disk for susceptibility testing of anaerobes by the aerobically incubated thioglycolate broth disk method. AB - The reliability of the 10-micrograms clindamycin disk was evaluated for susceptibility testing of anaerobes by the aerobic thioglycolate broth disk method. A good correlation between the aerobic thioglycolate broth disk method and the reference agar dilution procedure of the National Committee for Clinical Laboratory Standards was obtained by using a 4-microgram/ml breakpoint. Improved correlation was obtained when the medium of the National Committee for Clinical Laboratory Standards was buffered. PMID- 3958152 TI - Comparison of a yellow latex reagent with other agglutination methods for the identification of Staphylococcus aureus. AB - A new commercial yellow latex agglutination reagent (Bacto-Staph) was compared with the slide and tube coagulase tests and three other commercial reagents for the identification of 283 Staphylococcus aureus and 54 non-S. aureus staphylococcal strains. Test sensitivities for the identification of S. aureus were as follows: tube coagulase, 99.6%; slide coagulase, 98.6%; Bacto-Staph, 99.6%; Staphylatex, 98.6%; Sero STAT Staph, 98.2%; and Staphyloslide, 97.5%. No false-positive reactions were observed with any of the commercial reagents. PMID- 3958154 TI - Wound colonization by Ewingella americana. AB - Ewingella americana was recovered from a wound on the left leg of a 46-year-old male after a compound fracture of the tibia and fibula. Compared with the reported characteristics of 44 American strains, this strain was shown to belong to biogroup 1. The isolation of this bacterium in South Africa confirms its wide geographical distribution in clinical specimens. Colonization was not associated with clinical deterioration. PMID- 3958153 TI - Comparison of cross-staining reactions by Pseudomonas spp. and fluorescein labeled polyclonal and monoclonal antibodies directed against Legionella pneumophila. AB - Commercially prepared polyclonal antisera to Legionella pneumophila are known to cross-react with organisms of the genus Pseudomonas. To determine whether a commercially available monoclonal antibody reagent specific for L. pneumophila would also cross-react with pseudomonads, a two-laboratory study was undertaken to test both monoclonal and polyclonal reagents against 33 isolates of Pseudomonas spp., including 25 Pseudomonas aeruginosa, 4 P. putida, 2 P. maltophilia, 1 P. fluorescens, and 1 P. alcaligenes. Four antisera were tested; polyclonal anti-legionella antisera pools A and B (Centers for Disease Control [CDC], Atlanta, (Ga.), polyclonal 1-6 antisera (BioDx, Inc., Denville, N.J.), and a monoclonal antibody reagent produced by Genetic Systems Corp., Seattle, Wash. All reagents were labeled with fluorescein. Cross-staining reactions were found with the BioDx L. pneumophila antisera and 10 isolates of Pseudomonas. Four of these isolates demonstrated cross-staining with CDC pool A. When tested with individual serotype-specific reagents (CDC), three of four cross-reacted with L. pneumophila serotype 1 antisera; the fourth cross-reacted with serotype 3. No cross-staining reactions were noted with the monoclonal reagent and any of the pseudomonads tested, demonstrating that the Genetic Systems Corp. monoclonal reagent is the most specific of the four reagents tested. PMID- 3958155 TI - Nonlinear summation of contractions in striated muscle. I. Twitch potentiation in human muscle. AB - The adductor pollicis of intact man was electrically stimulated via its motor nerve, with series of two supramaximal pulses delivered at various intervals. Muscle surface action potential, myogram and corresponding first derivative (dPt/dt) were recorded under isometric conditions. When two stimuli are delivered at intervals shorter than 150 ms a more-than-linear summation, or potentiation, is observed. This potentiation of force production by a second stimulus involves both increased duration and acceleration of contraction. The potentiation is larger in muscles with small twitch-to-tetanus ratio (Pt/Po), and is found to decrease or increase when Pt/Po is respectively augmented (for example in positive staircase and in contractile disuse) or reduced (for example in negative staircase and in dynamic training). No significant modification of muscle surface action potential is observed when these contractile changes are present. Combined prolongation and intensification of intracellular processes, associated with muscle excitation-contraction coupling in a twitch, could account for the potentiation observed in nonlinear summation of contractions. PMID- 3958156 TI - Nonlinear summation of contractions in striated muscle. II. Potentiation of intracellular Ca2+ movements in single barnacle muscle fibres. AB - Nonlinear summation of contractions is studied in single barnacle (Balanus nubilus) muscle fibres, loaded with the photoprotein aequorin. The results indicate that nonlinear summation of aequorin transients is indeed present and for short interpulse intervals (25-250 ms), a more-than-linear summation of transients, which suggest an increase of the cytosolic Ca2+ concentration in the second response, is observed. This augmented Ca2+ concentration is not merely due to summation with the preceding conditioning transient, but to an enlargement of the second transient in its own right. Furthermore, the enlargement of the second Ca2+ response is not the result of prolonged release, or slowing of re-uptake by intracellular organelles. On the contrary, Ca2+ release is found to be enhanced and for short depolarizations (20 ms), its time to half re-uptake is reduced. The intensified Ca2+ release, triggered by the second standard depolarization, is related to the level of cytosolic Ca2+ concentration reached in the conditioning response and, for example, appears to be larger in the presence of Dantrolene sodium, which is known to reduce Ca2+ movements in a single twitch. It is concluded that contractile potentiation observed during nonlinear summation of contractions, is associated with a potentiation of intracellular Ca2+ movements, which interact to regulate the cytosolic Ca2+ concentration during contraction. PMID- 3958158 TI - Contractile properties and ultrastructure of three types of muscle fibre in the dogfish myotome. AB - Three main types of fibre can be differentiated in the adult dogfish myotome at the immediate post-anal level. An outer band of muscle consists of 80-90 pale multiply innervated fibres (superficial fibres). These fibres are 80-90 micron in diameter, lack M-lines and have a low Ca2+-activated myosin ATPase activity. Volume densities of myofibrils (Vv(my,f] and mitochondria (Vv(mt,f] are respectively 76 and 9.5%. Beneath this layer are around 8000 red multiply innervated fibres. These have an average diameter of 25-40 micron. Vv(my,f) and Vv(mt,f) are 62 and 21% respectively, and M-lines are present. Around 11 000 white focally innervated twitch fibres lie beneath the red fibre zone. White fibres with an average diameter of 80-120 micron have a high Ca2+-activated myosin ATPase activity and Vv(my,f) and Vv(mt,f) are 78 and 5% respectively. Contractile properties of single skinned fibres were determined at 12 degrees C. Maximum Ca2+ activated tensions (kN m-2) and unloaded contraction speeds (muscle lengths s-1) were 49 and 0.5 for superficial, 70 and 1.4 for red and 180 and 4.4 for white muscle fibres. Superficial fibres have not been reported in other elasmobranchs with the exception of the closely related nursehound (Scyliorhinus stellaris L.) It is suggested that they are specialized for sustained force generation, having a tonic (postural) rather than a locomotor role. PMID- 3958157 TI - A three-state model for oscillation in muscle: sinusoidal analysis. AB - The crossbridge mechanism leading to oscillation in insect flight muscle is studied theoretically based on a three-state model proposed by Nishiyama et al. [Biochim. biophys. Acta 460, 523-36 (1977)]. Skeletal muscle as well as insect flight muscle shows. oscillatory contraction. We demonstrate this oscillatory contraction in muscle by choosing proper rate constants among the three states of the model. It is established that our model gives out not only Hill's force velocity relation but also other mechanical properties of skeletal muscle. The model is then compared with two types of experiment by Kawai & Brandt [J. Musc. Res. Cell Motility 1, 279-303 (1980)] and by Steiger & Ruegg [Pflugers Arch. 307, 1-21 (1969)]. Kawai & Brandt obtained the Nyquist plot showing the relation between the phase shift and the amplitude of tension change in response to sinusoidal length changes at various frequencies. Steiger & Ruegg studied the power output and ATPase activity at various frequencies of the length change. Our theoretical results are in good agreement with the results of these two experiments. To determine the crossbridge mechanism which produces the positive power output, spatio-temporal crossbridge distributions in the three states are calculated. It is shown that, after the stretching phase of sinusoidal change in muscle length, the delayed rise of tension is caused by attachment of crossbridges to the active state via the preactive state while the delayed fall is caused by detachment from the active state after release. To obtain the oscillatory property it is not necessary to assume that stretch in muscle length increases the attaching rate as originally proposed by Thorson & White [Biophys. J. 9, 360-90 (1969)]. PMID- 3958159 TI - The enthalpies of ionization of the imidazole group of carnosine and the methylimidazole group of anserine. PMID- 3958160 TI - Abstracts of the Fourteenth European Conference on Muscle and Motility. Ulm, 11 15 September 1985. PMID- 3958161 TI - Humoral immune responses within the human central nervous system following systemic immunization. AB - We investigated sequential humoral immune responses in the CSF and blood of 6 stable multiple sclerosis (MS) patients without decreases in the blood-brain barrier. Anti-tetanus toxoid antibodies (anti-TT Ab) increased to a similar relative degree within the CSF and blood starting within 2 weeks after subcutaneous booster injection of TT. In 3 of 4 subjects, CSF lymphocytes obtained at 2 weeks secreted anti-TT Ab to the same degree as autologous blood lymphocytes when cultured with pokeweed mitogen. These findings suggest a prompt antibody response within the CSF to systemically administered antigen, not due to diffusion from the serum, with active trafficking of TT-sensitized lymphocytes into the central nervous system. PMID- 3958162 TI - Open reduction for congenital hip dislocation: the risk of avascular necrosis with three different approaches. AB - A review of 49 hips with congenital dislocation that were treated with anterior open reduction after traction and arthrogram showed that partial avascular necrosis can occur even when adequate decompression of the femoral head is obtained. When femoral osteotomy is done in conjunction with open reduction, the rate of avascular necrosis is not greater than for open reduction alone. Open reduction combined with innominate osteotomy had the highest rate of partial avascular necrosis and also the highest rate of additional surgery required. PMID- 3958164 TI - Fever following orthopedic operations in children. AB - One hundred fifty-three orthopedic operations in 129 children were analyzed for the significance of postoperative fever (POF) as a predictive factor for possible complications. In 72% of the operations, a temperature of greater than 37 degrees C was recorded. In 63 operations (41%), the temperature was greater than 38 degrees C. Sixteen children had positive clinical signs that might explain the fever, and all of them had a temperature of greater than 38 degrees C. Duration of operation of greater than 1 h, clubfoot releases, open reduction of fractures, and spine fusion operations gave higher incidences of POF. POF indicates a complication only when associated with positive physical findings. A postoperative temperature of greater than 38 degrees C, therefore, mandates repeated physical examination, which is the most reliable method of discovering the presence of complications. PMID- 3958163 TI - The trichorhinophalangeal dysplasia syndrome: report of eight kindreds, with emphasis on hip complications, late presentations, and premature osteoarthrosis. AB - The trichorhinophalangeal dysplasia syndrome is characterized by peripheral cone shaped epiphyses and unusual facies and hair. It is generally considered to be an uncommon dysplasia that presents in childhood. Thirteen cases in eight kindreds are reported. In four patients, the diagnosis was not established until after the 40th year, and it is suggested that the dysplasia may present in adult life and be more common than is generally appreciated. The skeletal stigmata of the syndrome are described, with special reference to hip involvement, and a severe and progressive degenerative arthritis is reported. PMID- 3958165 TI - Strength training for children. AB - The indications for progressive resistive strength training for prepubescent children in sports training and rehabilitation have been a source of controversy. Eighteen prepubescent children, two at Tanner Stage II and the remainder at Tanner Stage I, were studied. Examination included anthropometric upper and lower extremity strength and flexibility measurements. The study group participated in progressive resistive strength training sessions on machines three times per week. The study group had a mean increase in strength of 42.9%, whereas strength in the control group increased 9.5% (p less than 0.05). The study group had a mean increase in flexibility of 4.5% compared with 3.6% in the control group. The study group showed a mean decrease in body weight during the training period of 0.51% and then gained 3.48% over the subsequent 9 weeks. The control group's body weight increased an average of 6.66% during the 18 weeks. There were no injuries during the training period. It is concluded that prepubescent children can make significant gains in muscle strength in response to progressive resistive training. PMID- 3958166 TI - Epiphysiodesis: evaluation of a new technique. AB - Proximal tibial epiphyseal fusion was performed in immature black Labrador retriever dogs using an 8-mm drill followed by a high-speed burr. Epiphysiodesis was complete at 2 weeks in all experimental animals (average growth of 1.5 mm, whereas the unoperated side averaged 5.9 mm of growth). Minimal surgical exposure resulted in less pain in the experimental animals than in those undergoing epiphysiodesis by traditional means. This new technique may be of use in pediatric orthopedic patients. PMID- 3958167 TI - Percutaneous epiphysiodesis: experimental study and preliminary clinical results. AB - An experimental study was conducted to determine the feasibility of using percutaneous drilling and pneumatic burring under image intensification to effect premature closure of the distal femoral epiphyseal plate in immature New Zealand white rabbits. Serial roentgenograms were made before the animals were killed at 6 or 10 weeks to document leg length inequality as compared with the contralateral leg following the procedure. Microscopic examination of nonoperated and operated epiphyseal plate revealed complete arrest of the operated epiphysis with bone fusion at the epiphyseal plate in eight of the nine rabbits. Since this animal study, 13 children have undergone percutaneous epiphysiodesis. Roentgenographically, all the growth plates appeared fused following the procedure. However, complete growth arrest cannot be substantiated until skeletal maturity. This is a preliminary report of a procedure that needs further documentation. PMID- 3958168 TI - Clinical experience with the reciprocal gait orthosis in myelodysplasia. AB - Ambulation has always been difficult for patients with myelodysplasia; however, introduction of the reciprocal gait orthosis seemingly offered increased potential as an ambulatory aid. Review of 41 patients with myelodysplasia treated with the reciprocal gait orthosis revealed that 78% reached community or household ambulator status, a marked improvement over previous results with traditional hip-knee-ankle-foot orthoses. PMID- 3958169 TI - Gait analysis in surgically treated clubfoot. AB - Clubfoot, a congenital foot abnormality, has been successfully managed with surgical treatment. To assess gait in individuals with surgically treated clubfeet, the patterns of electromyographic activity for the medical gastrocnemius and tibialis anterior muscles and the stride characteristics during gait were measured and compared with normal values. The duration of medial gastrocnemius activity was significantly greater than normal, whereas tibialis anterior activity, stride length, and single limb support times were not different. No correlation was found between the results of the gait analysis and the quality of the surgical result. PMID- 3958170 TI - Orthopedic manifestations of the Lowe (oculocerebrorenal) syndrome. AB - Lowe oculocerebrorenal syndrome (OCRS), as previously described in the literature, consists of a well-defined constellation of clinical findings involving the eyes, cerebrum, and kidneys. However, the only musculoskeletal abnormalities reported in patients with OCRS have been joint hypermobility, recurrent fractures, rickets, tenosynovitis, and joint effusions. No other specific orthopedic problems have been described. This study presents new clinical findings of scoliosis, kyphosis, platyspondyly, dislocated and/or subluxed hips, and cervical spine abnormalities in six patients with OCRS treated at Carrie Tingley Hospital (Albuquerque, NM, U.S.A.). This study further supports an X-linked recessive mode of inheritance and adds clinical support to the published work that suggests that Lowe syndrome may be due to biochemical abnormalities in glycosaminoglycan metabolism. PMID- 3958171 TI - Infiltrating angiolipoma or intramuscular hemangioma? A report of five cases. AB - We report five cases of tumors composed primarily of angiomatous and adipose tissue occurring within skeletal muscle in relatively young individuals. Pain is frequently the presenting symptom. The tumors have been described in the literature as angiolipomas, infiltrating angiolipomas, and intramuscular hemangiomas. A discussion of the use of these terms is included. It is our conclusion the term "intramuscular hemangioma" is most appropriate for these lesions. PMID- 3958172 TI - Pathological fracture complicating long bone osteomyelitis in patients with sickle cell disease. AB - Pathological fracture of long bones occurred in 26 of 129 (20.2%) consecutive patients with sickle cell disease and osteomyelitis. The 26 patients were in either the first (17 subjects) or second (nine subjects) decade of life. The male:female ratio was 9:4. The fracture was significantly more common in acute than in chronic osteomyelitis (p less than 0.05) and in gram-negative than in staphylococcal infection (p less than 0.0001). Therefore, acute long bone osteomyelitis in young patients with sickle cell disease should be immobilized rigidly early and until sufficient new bone has formed, particularly in young West African boys with whole diaphyseal, gram-negative infection. PMID- 3958173 TI - Effect of a thoracolumbosacral orthosis on lateral trunk shift in idiopathic scoliosis. AB - The effect of the Wilmington brace on lateral trunk shift in adolescent idiopathic scoliosis was studied in 80 patients. With an average follow-up of 1 year 10 months after completion of brace treatment, improvement was seen in 58% of those patients with thoracic curves, 65% with thoracolumbar-lumbar curves, and 88% with double major curves. Lateral trunk shift decreased an average of 0.8 cm in patients with thoracic curves and 1.0 cm in patients with thoracolumbar-lumbar or double major curves. Improvement of existing lateral trunk shift was an additional consideration for instituting brace treatment in idiopathic scoliosis. PMID- 3958174 TI - Tibial tubercle avulsions. AB - Avulsion of the tibial tubercle is not common. Sixteen cases are recorded, with a mean age of 15 years 2 months. All subjects were boys, 15 cases were left-sided, and three individuals had other associated knee injuries. All were treated operatively. Immobilization time averaged 4.9 weeks, with a mean follow-up of 15 months. Fourteen subjects regained full motion and activity. Three complications were noted, none of which was associated with this injury. This injury occurs in a vulnerable period when the physis is undergoing physiologic changes that weaken its ability to resist tensile loading. PMID- 3958175 TI - Degloving injuries in children. AB - Degloving injuries are uncommon but serious and are being encountered with increasing frequency in children. A 5-year review of experience with degloving injuries on the Orthopaedic Service at the Winnipeg (Manitoba, Canada) Children's Hospital revealed 16 patients who had sustained this trauma in association with fractures. Twelve of these children had typical anatomical degloving. However, six patients had an associated concealed degloving or so-called "physiological degloving," with disruption of the underlying skin vasculature but no actual disruption of the skin surface. The most common causes of degloving injuries were being run over by a motor vehicle and farm machinery accidents. The diagnosis and proper management of the degloved extremity, especially when accompanied by underlying fracture, are essential in children if morbidity and limb loss are to be minimized. PMID- 3958177 TI - Unilateral posterior dislocation of the radial head in identical twins. AB - Congenital dislocation of the radial head, particularly bilateral, is seen in association with many syndromes affecting the musculoskeletal system. The consensus in the literature suggests that all isolated unilateral dislocations are posttraumatic in origin. Recent reports, therefore, recommend that unilateral dislocation be treated by open reduction, despite the benign natural history of the anomaly. We report on identical twins with isolated unilateral posterior dislocation in whom there is little doubt about the presence of the dislocation at birth. PMID- 3958176 TI - Acetabular epiphysis-labrum entrapment following traumatic anterior dislocation of the hip in children. AB - Traumatic anterior dislocations of the hip during childhood are rare injuries. Although a concentric reduction can usually be achieved with closed techniques, open reduction is occasionally required. We recently treated two children, 10 and 13 years of age, with nonconcentric closed reductions following traumatic anterior dislocation sustained 6 weeks and 6 months previously, respectively. Preoperative evaluation revealed intraarticular entrapment of the acetabular epiphysis and its contiguous labrum as the cause of the nonconcentric reduction. This was confirmed at surgery. Although displacement of the acetabular epiphysis has not been previously described, it is probably a common source for cartilaginous and osteocartilaginous fragments that have been recognized at open reduction following both traumatic anterior and posterior hip dislocations in children. Damage to this secondary center of ossification does not appear to affect adversely further growth and development of the acetabulum. PMID- 3958178 TI - Voluntary habitual dislocation of the hip joint in a child. AB - A review of the literature revealed that voluntary habitual dislocation of the hip in children is a rare entity. We encountered the case of a 6-year-old girl with habitual posterior subluxation of the hip. Parental counseling is all that was needed while spontaneous resolution of the condition was awaited. PMID- 3958179 TI - Pseudomalignant tumor after biopsy of periostitis. AB - Periosteal reaction is a commonly encountered radiographic finding. Differential diagnoses include trauma, infection, and neoplasia. Biopsy may be necessary for the definitive diagnosis. Surgical trauma to an inflamed periosteum can stimulate a rapid and tremendous bone-forming response. PMID- 3958180 TI - Muscle weakness and congenital contractures in a case of congenital myasthenia. AB - A case of nonautoimmune, prenatal-onset, congenital myasthenia with congenital contractures including camptodactyly is presented. The clinical features re identical to those in three previously reported cases. In this form of congenital myasthenia, the muscle weakness and congenital contractures may resolve completely after conservative treatment, including anticholinesterase medication. Diagnosis can be made by the characteristic clinical history, neurological assessment, and electromyography with repetitive nerve stimulation. PMID- 3958181 TI - Lesion of the clavicle. PMID- 3958183 TI - Prognostic role of antibody reactivity to melanoma. AB - Antibody reactivity against cultured allogeneic melanoma Y-Mel 81:180 was studied in 43 patients who participated in an adjuvant trial for stage I and II melanoma. Serum samples were obtained at trial entry within 2 mo of definitive surgery. At the time of serum acquisition, all patients were free of disease by physical examination and routine radiologic and laboratory parameters. Serum antibody reactivity was tested for by protein A hemadsorption before and after acid dissociation and ultrafiltration of serum. We have previously shown that this technique for immune complex dissociation augments autologous antibody reactivity. Results of serum antibody reactivity were scored by an investigator blinded to the patient's clinical status. Of the 43 patients studied, 15 relapsed and 28 remained disease-free. At study entry, there were 25 stage I patients and 18 stage II patients. Breslow depth was 3.25 +/- 2.5 mm in relapse patients and 1.67 +/- 1.1 mm in disease-free patients. The presence and titer of antibody directed against melanoma in either native serum or serum dissociated from immune complexes was found to be associated with eventual relapse (P = 0.0001). When results were subgrouped by stage of disease, Breslow depth, and hypopigmentation, antibody reactivity was still correlated with eventual relapse. The incidence and titer of antibody reactivity against melanoma appears to be a new prognostic factor in predicting eventual disease recurrence. PMID- 3958182 TI - Metabolism of very low density lipoproteins after cessation of cholesterol feeding in rabbits. A factor potentially contributing to the slow regression of atheromatous plaques. AB - Aortic atheromatous plaques regress slowly in cholesterol-fed rabbits that have been returned to normal laboratory diet. To delineate metabolic factors potentially responsible for persistence of atherosclerosis under these conditions, the physical, chemical, and metabolic characteristics were determined for lipoproteins of d less than 1.006 g/ml; such lipoproteins are thought to be the major determinant of progression of atherosclerotic lesions in cholesterol fed rabbits. At the time of return to a normal laboratory diet regimen after 3 mo of feeding with cholesterol-enriched laboratory diet, plasma cholesterol concentrations were 2,275 +/- 252 mg/dl, mostly attributable to cholesteryl ester rich very low density lipoproteins (VLDL). On the hypercholesterolemic diet, fractional catabolic rates of plasma clearance of 125I-labeled VLDL were reduced (0.011 +/- 0.002 vs. 0.151 +/- 0.015 h-1), but the total VLDL catabolic rate was increased considerably (17.1 +/- 2.2 vs. less than 1.2 +/- 0.4 mg of protein/kg X d), because of the expansion of the endogenous pool of cholesteryl ester-rich VLDL. The total catabolic rate of VLDL was maintained above estimated control values (5.8 +/- 0.7 mg protein/kg X d) even 10 wk after return of the rabbits to a normal chow regimen, an effect attributable to continued high rates of cholesteryl ester-rich VLDL synthesis in liver. Accumulation of cholesteryl ester rich VLDL into aortic tissue persisted at a high rate. Thus the persistence of aortic atheromatous lesions after cessation of cholesterol feeding was attributable in part to continued high rates of hepatic production of cholesteryl ester-rich VLDL and its persistent delivery into the aortic wall. PMID- 3958184 TI - Metabolic clearance of biologically active luteinizing hormone in man. AB - The plasma metabolic clearance of biologically active luteinizing hormone (bioactive LH) was studied using the rat interstitial cell testosterone (RICT) bioassay in six hypogonadotropic men after single bolus injection of highly purified human LH and during continuous steady-state infusions of three graded doses of LH. The LH bolus disappearance curves provided estimates of metabolic clearance rates (MCR) of 24.1 +/- 4.7 (+/- SD) ml/min for bioactive LH vs. 56.2 +/- 12 ml/min for immunoactive LH in the same men (P = 0.03). A lower MCR of bioactive LH compared with immunoactive LH was also observed during continuous infusions of physiological doses of LH; for example, the mean steady-state MCRs for bioactive and immunoactive LH were, respectively, 26.1 +/- 3.1 and 34.2 +/- 3.2 ml/min (P = 0.02). Moreover, the stepped-dose infusion regimens permitted us to demonstrate that increasing doses of pure human LH resulted in progressive and parallel decreases in the apparent MCRs of both bioactive and immunoactive LH. Based on the respective steady-state MCRs calculated at physiological plasma concentrations of immunoactive and bioactive LH, we estimate a mean endogenous production rate for bioactive hormone of 1,937 IU/24 h, and for immunoactive LH of 589 IU/24 h in normal men. These results indicate that previous estimates of LH production rates from immunoassay data alone markedly underestimate the quantity of biologically active hormone secreted in man. PMID- 3958185 TI - Mechanisms of enhanced cholesteryl ester transfer from high density lipoproteins to apolipoprotein B-containing lipoproteins during alimentary lipemia. AB - In vitro lipoprotein lipase enhances the cholesteryl ester transfer protein (CETP)-mediated transfer of cholesteryl esters from high density lipoproteins (HDL) to very low density lipoproteins as a result of lipolysis-induced alterations in lipoprotein lipids that lead to increased binding of CETP. To determine if there are similar changes during alimentary lipemia, we measured the transfer of cholesteryl esters from HDL to apo B-containing lipoproteins in incubated fasting and postprandial plasma. In seven normolipidemic subjects there was 2-3-fold stimulation of cholesteryl ester transfer in alimentary lipemic plasma. Cholesteryl ester transfer was stimulated when either the d less than 1.063-or d greater than 1.063-g/ml fraction of lipemic plasma was recombined with its complementary fraction of fasting plasma. To determine the distribution of CETP, plasma was fractionated by agarose chromatography and CETP activity was measured in column fractions in a standardized assay. In fasting plasma, most of the CETP was in smaller HDL, and a variable fraction was nonlipoprotein bound. During lipemia there was increased binding of CETP to larger phospholipid enriched HDL and in two subjects an increase in CETP in apo B-containing lipoproteins. The total CETP activity of fractions of lipemic plasma was increased 1.1-1.7-fold compared with fasting plasma. Lipemic CETP activity was also increased when measured in lipoprotein-free fractions after dissociation of CETP from the lipoproteins. When purified CETP was incubated with phospholipid enriched HDL isolated from alimentary lipemic or phospholipid vesicle-treated plasma, there was increased binding of CETP to the phospholipid-enriched HDL compared with fasting HDL, with a parallel stimulation in CETP activity. Thus, the pronounced stimulation of cholesteryl ester transfer during alimentary lipemia is due to (a) an increased mass of triglyceride-rich acceptor lipoproteins, (b) a redistribution of CETP, especially increased binding to larger phospholipid-enriched HDL, and (c) an increase in total activity of CETP, perhaps due to an increased CETP mass. PMID- 3958186 TI - Experimental induction of isolated lower esophageal sphincter relaxation in anesthetized opossums. AB - Isolated lower esophageal sphincter (LES) relaxation, defined as a transient sphincteric relaxation unaccompanied by esophageal peristalsis, has been shown to precede most episodes of gastroesophageal reflux in humans. We studied the genesis of isolated LES relaxation in anesthetized opossums by observing the response of four components of the deglutition reflex (mylohyoid electrical activity, pharyngeal contraction, esophageal peristalsis, and LES relaxation) to pharyngeal tactile stimulation, electrical stimulation of superior laryngeal nerve (SLN) afferents or cervical vagal efferents, and to balloon distention of the esophageal body. A single pharyngeal stroking evoked isolated LES relaxation in 56% of 160 instances. The proportion of isolated relaxations in response to SLN electrical stimulation varied inversely with the stimulus frequency, occurring in 64% of the responses at 5 Hz and 4% of the responses at 30 Hz. A full four-component deglutition sequence was most likely to occur at the higher frequencies of SLN electrical stimulation. Esophageal balloon distention elicited isolated LES relaxations or no response at low distending volumes, whereas at higher volumes LES relaxation and esophageal contraction predominated. Isolated LES relaxation had significantly less magnitude than relaxations accompanied by esophageal contractions. Bilateral cervical vagotomy abolished all LES and esophageal body responses induced by pharyngeal stroking and SLN stimulation, and rendered the esophageal body and LES less responsive to small volumes of distention. Vagal efferent stimulation produced isolated LES relaxation at lower frequency stimulation and LES relaxation with esophageal contractions at higher frequency stimulation. These studies show that isolated LES relaxation represents incomplete expression of either the deglutitive reflex or the peripheral reflex mediating secondary peristalsis. PMID- 3958188 TI - Interaction of histidine-rich glycoprotein with fibrinogen and fibrin. AB - Histidine-rich glycoprotein (HRGP) is a human plasma and platelet protein of apparently diverse biological functions. In this study a new interaction for HRGP is described. HRGP specifically interacts with fibrinogen as demonstrated by two independent systems. Using an enzyme-linked immunosorbent assay it was demonstrated that HRGP bound to adsorbed fibrinogen in a concentration-dependent and saturable manner, with an apparent dissociation constant (Kd) of 6.7 nM. The binding was specific, reversible, and not mediated by a conformationally altered adsorbed fibrinogen molecule. The interaction was divalent cation-dependent and ionic in nature. The HRGP-fibrinogen interaction was also demonstrated using rocket immunoelectrophoresis. The HRGP-fibrinogen interaction had an effect on the kinetics of conversion of fibrinogen to fibrin as demonstrated by a prolongation of the thrombin time. HRGP also became incorporated into fibrin clots in a concentration-dependent and saturable manner, with an apparent Kd of 0.25 microM. The incorporation of HRGP into fibrin clots occurred in a plasma milieu as demonstrated by the direct incorporation of radiolabeled HRGP into plasma clots and by a significant decrease in serum HRGP levels as compared with plasma levels. HRGP prolonged the lag time phase of fibrin gel formation, and decreased the rate of turbidity rise, as well as the final absorbance of fibrin gels. Since the extent of fibrin polymerization was not influenced by the presence of HRGP, these data suggest that fibrin is distributed over more, but thinner, fibrils in the presence of HRGP. In addition to its potential effect on fibrin polymerization, the HRGP-fibrin interaction may play a role in the cell cell interactions of platelets and macrophages. PMID- 3958189 TI - Adaptation during surgical stress. A reevaluation of the role of glucocorticoids. AB - Pharmacologic doses of glucocorticoids are administered to patients with adrenal insufficiency during operative procedures to prevent hemodynamic instability, cardiovascular collapse, and death. Since these supraphysiologic doses might not be necessary and might have adverse effects, we examined the effects of different doses of glucocorticoids on hemodynamic adaptation during surgical stress in adrenalectomized primates. Sham-adrenalectomized placebo-treated animals served as controls. Adrenalectomized monkeys were maintained for 4 mo on physiologic glucocorticoid and mineralocorticoid replacement. The adrenalectomized monkeys were then stratified into three groups receiving, respectively, subphysiological (one-tenth the normal cortisol production rate), physiological, or supraphysiological (10 times the normal cortisol production rate) cortisol (hydrocortisone) treatment. 4 d later a cholecystectomy was performed. The intraoperative hemodynamic and metabolic parameters, perioperative survival rates, and postoperative wound healing were compared. The subphysiologically treated group was hemodynamically unstable before, during, and after surgery and had a significantly higher mortality rate than control. In this group, arterial blood pressure was low, and the cardiac index, systemic vascular resistance index, and left ventricular stroke work index were all reduced, suggesting decreased cardiac contractility and blood vessel tone. In contrast, the physiologically replaced group was indistinguishable from either supraphysiologically treated animals or sham-operated controls. All groups had similar metabolic profiles and normal wound healing. These findings suggest that the permissive actions of physiologic glucocorticoid replacement are both necessary and sufficient for primates to tolerate surgical stress. Supraphysiological glucocorticoid treatment has no apparent advantage during this form of stress in the primate. PMID- 3958187 TI - Interrelationships among thyroxine, growth hormone, and the sympathetic nervous system in the regulation of 5'-iodothyronine deiodinase in rat brown adipose tissue. AB - Thyroxine (T4) and reverse triiodothyronine are potent inhibitors of brown adipose T4 5'-deiodinase (BAT 5'D). This effect does not require protein synthesis and is due to an acceleration of the rate of disappearance of the enzyme. Growth hormone (GH) also inhibits BAT 5'D but by a mechanism mediated through a long-lived messenger that correlates with growth rate. This explains the failure of BAT 5'D to increase abruptly after thyroidectomy as does the type II 5'-deiodinase in pituitary and central nervous system or the BAT 5'D itself after hypophysectomy. Although virtually inactive when given acutely, triiodothyronine replacement partially reduces BAT 5'D in hypophysectomized and thyroidectomized (Tx) animals probably as a result of improvement of systemic hypothyroidism and an increase in GH levels in the Tx rats. The fine balance between these inhibitory factors and the stimulatory effects of the sympathetic nervous system suggests an important physiologic role for the enzyme in this tissue. PMID- 3958190 TI - Identification of 3-methylglutarylcarnitine. A new diagnostic metabolite of 3 hydroxy-3-methylglutaryl-coenzyme A lyase deficiency. AB - Deficiency of 3-hydroxy-3-methylglutaryl-coenzyme A (CoA) lyase affects the metabolism of leucine as well as ketogenesis. This disorder is one of an increasing list of inborn errors of metabolism that presents clinically like Reye's Syndrome or nonketotic hypoglycemia. Four patients with proven 3-hydroxy-3 methylglutaryl-CoA lyase deficiency were shown to excrete a new diagnostically specific metabolite. The technique of fast atom bombardment and tandem mass spectrometry revealed that only 3-methylglutaryl-CoA is a substrate for acylcarnitine formation. Neither 3-methylglutaconyl-CoA nor 3-hydroxy-3 methylglutaryl-CoA are excreted as acylcarnitines. The excretion of 3 methylglutarylcarnitine may explain, in part, the apparent secondary carnitine deficiency in this disorder. Carnitine supplementation with moderate dietary restrictions may be a useful treatment strategy for this disorder. PMID- 3958191 TI - Spleen cell transfusion in the Bio-Breeding/Worcester rat. Prevention of diabetes, major histocompatibility complex restriction, and long-term persistence of transfused cells. AB - We report that transfusions of RT1u Wistar-Furth (WF) spleen cells prevented spontaneous diabetes in the RT1u BB/W rat while RT1b Buffalo rat spleen cells did not. In addition, donor origin WF T lymphocytes were detected in nondiabetic susceptible BB/W recipients 5 mo after transfusion. Survival of donor-origin lymphocytes may provide the cellular mechanism by which major histocompatibility complex-compatible WF spleen cell transfusions prevent BB rat diabetes. PMID- 3958192 TI - Older age treatment expectations. AB - The relationship between age and treatment expectation (TE) has been virtually ignored. This study assessed the TE and posthospital adjustment of 5,347 psychiatric patients, 4,361 younger (less than 55) and 986 older (greater than 55). Patients were evaluated on admission with self- and other rating adjustment scales and again at 3-months postdischarge. One factor in the self-rating scale included TE. Outcome measures involved posthospital adjustment (self- and other rated), both corrected and noncorrected for initial adjustment levels. Results show that TE rises with age. There is also some indication that higher TE leads to better adjustment. Older age and higher TE in combination, however, do not translate into better community adjustment. Also, differences between younger and older patients in TE are most pronounced in psychotics and in older patients not fully or currently employed. PMID- 3958193 TI - Performance of agoraphobic families vs. non-agoraphobic families on the Sixteen Personality Factor Questionnaire (16PF). AB - This study investigated whether the personality variables, as measured by the Sixteen Personality Factor Questionnaire (16PF), differed significantly between families with an agoraphobic parent and families with nonagoraphobic parents. Participants were 15 agoraphobic female parents and 5 male agoraphobic parents, their spouses, and children. Two matched control groups of subjects (comparable to the female agoraphobic and male agoraphobic families) were used. Significant differences in personality variables were found between the families with agoraphobic parents and their matched controls. Significant personality differences among family members in the agoraphobic family were evident, and they also differed according to whether the agoraphobic parent was female or male. PMID- 3958194 TI - MMPI measures of psychological disturbance in adolescent and adult victims of father-daughter incest. AB - The MMPI was used to study psychological disturbance in two different age groups of victims of father-daughter incest. The profiles of a group of 27 adolescent victims and 31 adult victims were compared and analyzed. All subjects had a history of being molested when they were children by their fathers or stepfathers, and all were in psychotherapy at the time of testing. In order to establish clear age differentiation between the two groups, no adolescent was over the age of 19 and no subject in the adult group was under age 30 when they were tested. The results indicated that the overall profiles were more elevated for the adult victims than for the adolescent victims. Both groups were elevated (T greater than 70) on Scale 8 (Sc), and the adults also were elevated on Scale 4 (PD), while the adolescents were high (T = 69) on Scale 9 (MA). The results are discussed in terms of core personality disturbance shared by the two groups and the probable influence of time or age on how the psychopathology is expressed. PMID- 3958195 TI - The role of activity level and cognition in depressed mood in a university sample. AB - This study examined the role of activity level and cognition on mood by contrasting a monitor only (N = 22), increase pleasant events (N = 20), and increase pleasant events plus focusing on event pleasantness (N = 23) groups over a 2-week period. The results show that subjects who were instructed to increase their number of pleasant events did so and obtained more pleasure as a result. The group which increased pleasant events and focused on event pleasantness also showed a significant decrease in level of depression. The results are interpreted to support the role of monitoring and pleasant events on mood, but the potential necessity for cognitive change to create "antidepressant" effects. PMID- 3958196 TI - Prediction of leisure time exercise behavior among a group of lower-limb disabled adults. AB - The aim of this study was to predict leisure time exercise behavior among a group of 62 lower-limb disabled adults. The theory of reasoned action proposed by Fishbein (Fishbein & Ajzen, 1975) provided a framework for the study. Variables measured included the Fishbein model variables, habit, education, disability type, fitness level, and a 7-day follow-up of exercise behavior. Some 35% of the variance in exercise behavior could be explained; intention was the strongest predictor (.31, p less than .05). In comparison, the ability to predict intentions to exercise by using the other variables was quite poor, with only 7% of the variance explained by habit. None of the Fishbein model variables contributed to this prediction. These results indicated the importance of specific factors, such as the strength of the exercise habit and the cause of disability, on exercise behavior. PMID- 3958197 TI - Examination of the unintentional effect of stimulus medium and context on preference for psychotherapy. AB - Past research that has examined preferences for different psychotherapy orientations has yielded inconsistent results. This study investigated whether the discrepant results are artifacts of the methods chosen. Stimulus context (therapy session vs. therapy description) and stimulus medium (audiovisual vs. written) were investigated in comparing preferences for the behavioral and person centered orientations. Over 300 undergraduates rated their preference for both psychotherapy orientations on a 4-item questionnaire. The behavioral orientation received a significantly higher preference score when both orientations were presented audiovisually as a therapy session. Conversely, the person-centered orientation received a higher preference score when both orientations were presented as a written description. Given the current methodology, rated preference for type of therapy may be determined more by how specifically the therapies are presented than by the actual saliency that a particular orientation holds for an individual. PMID- 3958198 TI - Differences between terminally ill patients who know, and those who do not know, that they are dying. AB - Four GPs each selected 6 patients, 2 terminally ill with knowledge of diagnosis and prognosis, 2 terminally ill without knowledge, and 2 chronically ill. Semi structured interviews were conducted with the patients, and the transcripts' content was analyzed. There were large group differences in the predicted direction in frequency of utterances that indicated knowledge, which both validated the content analysis and verified the GPs' capacity to categorize patients according to knowledge. Terminally ill patients with knowledge produced significantly longer transcripts than the other two groups. Groups did not differ significantly on state or trait anxiety scales. Differences due to demographic variables could not account for the main effects. There were significant associations that involved age, anxiety, and the dependent variables of the content analysis, especially among the terminally ill patients without knowledge. PMID- 3958199 TI - Considerations in the treatment of the adult blind patient. AB - This paper contends that blindness is not a single clinical determinant, but, rather, that there are two groups of blind people for whom the treatment considerations are quite different. For those congenitally blind, lack of vision can cause developmental difficulties, e.g., impairments in human attachment, object permanence, and self-representation. For those who later acquire blindness, the premorbid psychodynamics and object relationships are most important in understanding the person's reactions to his/her disability. Two adult cases are presented to illustrate these phenomena in the context of psychotherapy. PMID- 3958200 TI - Masculinity-femininity scale of the MMPI and intellectual functioning of female addicts. AB - In a group of 85 female chronic alcoholics and other addicts, scores on the Raven's Matrices and on a multiple-choice version of WAIS Vocabulary were found unrelated to the 13 standard and 4 MMPI research scales and 3 MMPI indices (average profile elevation, average elevations of the neurotic and the psychotic triad) except for the relationship of the raw scores (r = -.32) and the IQ equivalents (r = -.30) on the Vocabulary test to Masculinity-Femininity scores and of IQ equivalents on the Matrices to Barron's Ego Strength scale (r = .32): Women with more extensive vocabulary scored lower on the Masculinity-Femininity scale, and women with better visuo-spatial reasoning skills obtained higher Ego Strength scores. PMID- 3958201 TI - Factor structure of the Diagnostic Inventory of Personality and Symptoms in a private psychiatric hospital population. AB - The factor structure of the Diagnostic Inventory of Personality and Symptoms (DIPS) in a private psychiatric patient population was examined (N = 60). Principal components factor analysis with Varimax rotation yielded three well defined factors, which accounted for 70% of the total variance. These factors can be conceptualized as neurotic, psychotic, and characterological. Results support the construct validity of the Diagnostic Inventory of Personality and Symptoms and are discussed in relation to previous psychometric studies of psychopathology that employed the MMPI. PMID- 3958202 TI - Applying posttraumatic stress disorder MMPI subscale to World War II POW veterans. AB - In order to determine whether the MMPI-PTSD subscale has application for assessing DSM-III diagnosed PTSD among populations other than Vietnam veterans, a group of WWII POWs (N = 69) were given the subscale. Results indicated that the use of the PTSD subscale can be generalized to older veterans; in a small sample of Pacific POWs, PTSD is more common among those from the Pacific theater than those from Europe. However, the subscale fails to distinguish between Pacific and European POW veterans. Difficulties in sampling and confounding stressors are discussed, as well as implications for treatment of WWII veterans. PMID- 3958203 TI - Relationships among Wechsler intelligence and memory scale quotients in adult closed head injured patients. AB - Correlations and discrepancy scores (Full Scale IQ minus Memory Quotient) among Wechsler intelligence and memory quotients were assessed in a sample of 126 closed head injured (CHI) adults. Results indicated a slight, generalized decrease in CHI patients' mean level of performance. A significant correlation of .76 was obtained between patients' IQ and MQ scores. Discrepancy scores were relatively smaller than those found in prior research and were influenced partially by the patient's age and by time of testing postinjury. The relative magnitude of discrepancy scores found in CHI is discussed in relationship to other groups of brain-injured patients. PMID- 3958205 TI - Separation of brain-damaged from psychiatric patients with the combined use of an ability and a personality test: a validation study with a Puerto Rican population. AB - The purpose of this study was to validate the results obtained by Watson, Gasser, Schaefer, Buranen, and Wold (1981) by utilizing the Smith Symbol-Digit Modalities Test (Form W) and the MMPI (Psychiatric-Organic) scale in combination. Forty recently admitted/readmitted male patients were given both the SDMT and the MMPI (P-O) at a point in their hospitalization in a private inpatient psychiatric hospital in Puerto Rico. The combined use of the Smith and the P-O scale, with the criteria originally developed by Watson et al. (1981), provided a modest level of discrimination by correctly identifying 80% of the brain-damaged sample (organic group) and 55% of the functional sample (psychiatric group) subjects. This combination of tests yielded an overall mean hit rate of 67.5%. These results moderately support the findings obtained by Watson et al. (1981). PMID- 3958204 TI - Wechsler Memory Scale performance in geropsychiatric patients. AB - Patients (N = 36) on a geropsychiatric acute care unit were administered the Wechsler Memory Scale (WMS) at admission and discharge. The results indicated that there were significant increases in WMS scores from admission to discharge. Mean scores on the WMS were generally below those previously reported for normal geriatric groups, but above those reported for chronically ill or demented groups. As in previous studies, a significant positive relationship was found between education and WMS score, although no such relationship was found between age and WMS score. Overall, the results highlight the need for comprehensive norms for the elderly, which would increase greatly the practical utility of the WMS in clinical settings. PMID- 3958206 TI - Implications of large WISC/WISC-R Verbal-Performance IQ discrepancies. AB - Forty children with Verbal-Performance IQ discrepancies on the WISC/WISC-R were studied in regard to clinical findings on psychological, educational, speech language, and medical evaluations. Significant delays in the development of verbal when compared to performance skills were observed frequently in this referred sample. The verbal deficits were mostly developmental in nature, rather than secondary to emotional or family background factors. These children's developmental difficulties were frequently complex ones that benefitted from multidisciplinary assessment and treatment planning. It was emphasized that future research in regard to these intellectual patterns should be conducted within the confines of more neuropsychologically oriented approaches. PMID- 3958207 TI - A possible relationship between figure drawing data collected in medical school and later health status among physicians. AB - Figure drawings obtained while subjects were in medical school were scored using two different scales: (a) Sophistication-of-Body-Concept, a scoring system that measures the overall quality of the drawings; and (b) Conventionality/deviancy of the drawings, as determined by the relative frequency with which 42 different characteristics occurred in the total sample of drawings. Figure drawings were obtained from 1951 to 1964. As of 1984, subjects were classified into 1 of 11 health outcome (disease) categories plus a "healthy" category. Statistical analysis included one-way analyses of variance and multiple logistic regression in which age and cigarette consumption were controlled. Several statistically significant differences among groups were noted with respect to Conventionality/deviancy, but not with respect to Sophistication-of-Body-Concept. PMID- 3958208 TI - Impediments to psychiatric hospital discharge: what different professional groups think. AB - Perceived impediments to psychiatric hospital discharge were investigated across six professional groups. Seventy-nine psychologists, psychiatrists, social workers, rehabilitation personnel, registered nurses, and psychiatric aides were asked to select five behaviors and five other factors that they believed impeded hospital discharge. Violent behaviors, such as suicide, homicide, and damaging property, and financial factors, such as inadequate funds and inadequate living arrangements, emerged as the two areas that hospital staff consistently selected as principal impediments to discharge. Treatment plans of 20 patients were surveyed to ascertain whether the behaviors and other factors identified by staff were reflected in treatment goals. PMID- 3958210 TI - Training in geropsychology at the doctoral level: 1984. AB - To study type and amount of training in geropsychology available to students in APA-approved doctoral programs in clinical and counseling psychology, a questionnaire was mailed to all such programs in 1984. Response rate was 71 of 132 (59%) for clinical programs and 27 of 37 (73%) for counseling programs. Very little difference was found between responses of clinical and counseling programs and between this 1984 survey and one conducted in 1975-76. There seems to be a very small increase in training opportunities for psychology students in geropsychology in 1984 at the doctoral level. PMID- 3958209 TI - Health psychology for children: a step-child/stepping stone. AB - This paper presents the position that health psychology for children is not given proper attention in mainstream health psychology, which is primarily adult in orientation. It is proposed that the neglect of child-related problems in the recent Proceedings of the National Conference on Training in Health Psychology exemplifies the general orientation of mainstream health psychology, which views children's health problems primarily in terms of their effect on adult health rather than as problems that need current and immediate attention. We propose that applying a developmental perspective to the health psychology field would be one way of highlighting the fact that children's problems are unique and that children need to be viewed as something other than potential consumers of adult health psychology services or as agents for the prevention of adult health problems. PMID- 3958211 TI - Community psychology as a model for the new private practice of psychology. AB - The continuing increase in graduates from training programs in psychology when coupled with the decline of publicly supported mental health facilities or funds will lead more psychologists to offer services privately. At the same time, the private practice of psychology is changing, and a community psychology model may be useful in the development and offering of services. The community concepts of prevention, crisis intervention, and consultation can be related to family, work, and health in the development of some of the services that will become more prevalent in private practice. PMID- 3958212 TI - Doctoral student selection in one professional psychology program. AB - The determinants of the selection decision for applicants (N = 239) to one clinical Doctor of Psychology program during a 3-year period were examined, and relationships among selection variables measured at the time of application and program performance variables measured 2 years later for those matriculated were determined. Results and discussion also illuminate the determinants of ratings made of applicants based on reading written application materials and determinants of ratings made of applicants based on personal interviews. Recommendations for selection procedures in similar practitioner-oriented clinical psychology doctoral programs and for future research are offered. PMID- 3958213 TI - Stability of cefuroxime sodium in some aqueous buffered solutions and intravenous admixtures. AB - Cefuroxime sodium (Zinacef) is a new semisynthetic, broad spectrum cephalosporin antibiotic for parenteral administration which is stable to most of the beta lactamases. The stability of cefuroxime sodium in aqueous solutions, with or without phosphate buffer, and in 5% dextrose and 0.9% sodium chloride injections was studied using a stability-indicating high-pressure liquid chromatographic method developed in our laboratory. The optimum pH range of stability was determined to be approximately 4.5-7.3. Both buffered and unbuffered solutions followed first-order decomposition. In 5% dextrose and 0.9% sodium chloride injections, cefuroxime was stable for 1 day (more than 90% potent) at 25 degrees C and for at least 30 days at 5 degrees C. At -10 degrees C, there was negligible decomposition after 30 days. The pH values of the solutions stored at 5 degrees C and -10 degrees C remained in the maximum stability range and the solutions were clear even after 30 days of storage. Thawing the frozen solutions in a microwave oven adversely affected the stability. PMID- 3958214 TI - The propriety of narcotic usage in hospitalized patients. AB - The propriety of narcotic usage at the Hadassah Hospital has been studied in 35 cancer patients and 70 post-operative patients. Eighty-three per cent of the cancer patients and 66% of the surgical patients remained in moderate to severe distress in spite of the analgesic therapy. Insomnia and anxiety, plus depression in the cancer patients, were the major results of uncontrolled pain. The inadequacy of the treatment was attributed to the incorrect selection of medication, usage "as needed' policy and smaller daily doses than advocated. This resulted mainly because of exaggeration of the risk of tolerance and addiction by both patients and personnel. PMID- 3958215 TI - Serum ferritin concentration in sickle cell crisis. AB - Serum ferritin, aspartate aminotransferase (AST), alkaline phosphatase and hydroxybutyrate dehydrogenase (HBD) were studied during 21 vaso-occlusive crises in 12 adults with sickle cell disease (11 SS, 1 S beta degrees). The patients comprised three groups: those who had been untransfused (4), those who had received occasional exchange transfusion in crisis (3), and those who had been multiply transfused (5). Serum ferritin concentrations in crisis were compared with those of the steady state value. Rises in serum ferritin concentrations occurred in all crises in all groups. Although AST, alkaline phosphatase, and HBD rose, there was no correlation between these and log ferritin concentrations. The clinical impression was that the degree of rise in ferritin related to the severity of the particular crisis, and the above results showed that haemolysis and liver damage were not causally related to this rise. An estimate of serum ferritin cannot be used to assess the state of iron balance in sickle cell disease unless the patient is in the steady state. The considerable rise in serum ferritin concentration found in crisis, however, may be a useful marker of the extent of vaso-occlusion and tissue damage. PMID- 3958217 TI - Transitional carcinoma of the upper urinary tract: a histological and cytopathological study. AB - A histological and cytopathological study of 54 patients with transitional carcinoma of the upper urinary tract was undertaken. There were 17 patients with grade 1 tumours, 35 with grades 2 or 3, and two with carcinoma in situ. Only 16 had non-invasive tumours. A preoperative cytological diagnosis of tumour was made in 67% of the group as a whole and in 75% of patients with grade 2 or 3 tumours. Seventy per cent of voided urines and 80% of ileal conduit urines were positive for tumour. Cytological grading correlated with histology in 12 of 14 grade 1 tumours and 26 of 35 grade 2 or 3 tumours, with seven assigned grade 1. Two cases of pelvicalycine carcinoma in situ were graded 3 by cytology. Cytological investigation by those experienced in urinary cytology has an important diagnostic contribution to make in transitional carcinoma of the upper urinary tract. PMID- 3958216 TI - Iron state in alpha and beta thalassaemia trait. AB - The iron state was examined in two groups of pregnant women who were carriers of alpha and beta thalassaemia genes. In both groups the haematological expression of the disease--namely, haemoglobin and mean cell haemoglobin concentrations--was nearly identical. In patients with alpha thalassaemia the ferritin concentrations and percentage of ferritin deficiency was the same as in normal pregnant patients, whereas in those with beta thalassaemia the ferritin concentrations were usually much higher and iron deficiency four times less common. This variance appears to be explained by different degrees of extravascular or intravascular haemolysis between the two thalassaemias as assessed by the activities of serum alpha hydroxybutyrate dehydrogenase. PMID- 3958218 TI - Serotyping of Streptococcus pneumoniae strains by coagglutination. AB - The coagglutination test, which uses staphylococcal protein A, for serotyping strains of Streptococcus pneumoniae, was extended to include serotyping within serogroups. Serotyping was performed with "factor sera" prepared in the laboratory. Fifty one strains of S pneumoniae, which belonged to one of the seven serogroups included in the 14 valent vaccine formulation, were tested, and no inconsistency was found when compared with the capsule swelling reaction. PMID- 3958219 TI - Micromodification of Serodia HBe haemagglutination kit and modification of kit to test for anti-HBe. AB - Modification of the Serodia HBe haemagglutination kit produced by Fujirebio Incorporated, Tokyo, Japan, gave a rapid, economical, and easily performed test for hepatitis Be antigen (HBeAg). The use of this method to test serum samples for HBeAg is described. A modification of the kit to screen for anti-HBe is also described. The results obtained showed that this kit, when used by the method described, gave results comparable with those of a sensitive, commercial enzyme immunoassay method. PMID- 3958220 TI - Mobiluncus spp: pathogenic role in non-puerperal breast abscess. PMID- 3958221 TI - Fibrinogen mediated activation of platelet aggregation. PMID- 3958222 TI - Pseudolipoma of Glisson's capsule simulating metastatic tumour. PMID- 3958223 TI - The influence of hemodialysis on the pharmacokinetics of ibuprofen and its major metabolites. AB - The pharmacokinetics of ibuprofen and its two major metabolites, the hydroxy and carboxy derivatives, were studied in seven functionally anephric subjects undergoing hemodialysis therapy. Subjects received ibuprofen 800 mg tid for 14 days. Hemodialysis was performed three times weekly during this period. Arterial and venous blood samples were collected before dialysis and along with dialysate, and during the final dosing interval and dialysis session. No accumulation of ibuprofen plasma concentrations and an absence of intact ibuprofen in dialysate indicated clearance through metabolic pathways. The metabolites did accumulate significantly (mean plasma levels, carboxy 249 micrograms/mL and hydroxy 57 mu/mL); however, both were detected in dialysate. Mean extraction efficiencies were 0.16 (hydroxy) and 0.15 (carboxy). Dialysis clearance calculated by arterial venous difference was found to agree with actual recovery in dialysate for both metabolites. Side effects were not observed in any subject. PMID- 3958224 TI - Correlation between thiopental induction dose and the volume of distribution of caffeine in human subjects. AB - The correlation between the apparent volume of distribution (aVd) of caffeine and the induction dose of thiopental was studied in 23 patients. Caffeine, which has an effective partition coefficient that approaches that of thiopental, was used as an indicator substance to estimate the immediate volume of distribution of thiopental. The immediate volume of distribution is critical in determining thiopental induction dose. The aVd of caffeine was determined noninvasively from serial saliva samples after consumption of caffeine, which was given to the patients as coffee. A strong correlation (r = .69; P less than .01) was found between the aVd of caffeine and the anesthetic induction dose of thiopental when the loss of eyelid reflex was used as the end point. The correlation between thiopental induction dose and body weight for the same individuals (r = .188) was not statistically significant. PMID- 3958225 TI - Enhanced bioavailability of triazolam following sublingual versus oral administration. AB - The rate and extent of the absorption of triazolam following sublingual and oral administration were evaluated in this study. Eight healthy volunteers received triazolam 0.5 mg in a commercially available tablet, by sublingual and oral routes on two occasions in random sequence. Plasma triazolam concentrations during 24 hours after each dose were measured by electron-capture gas-liquid chromatography. The mean total area under the curve for sublingual administration was significantly larger than that following oral dosage (28.9 vs 22.6 ng-hr/mL, P less than .025). The peak plasma concentration after sublingual dosage was also higher than after oral administration (4.7 vs 3.9 ng/mL, P less than .1). No significant differences between sublingual and oral administration were found for the elimination half-life of triazolam (4.1 vs 3.7 hr) and the time of peak concentration (1.22 vs 1.25 hr) after dose. Thus, the bioavailability of triazolam after sublingual administration is increased by an average of 28% compared with oral administration of the same dose, possibly because first-pass extraction is bypassed. Clinical effects of triazolam may likewise be enhanced by sublingual dosage. PMID- 3958226 TI - Intrarenal concentration-time profile of ampicillin after administration of bacampicillin to patients before nephrectomy. AB - Nineteen patients with renal cancer who were to undergo nephrectomy received a single oral dose of bacampicillin 800 mg at approximately three (N = 5), six (N = 7), or nine (N = 7) hours before nephrectomy. Serum samples were taken at 30, 60, and 90 minutes after administration and at nephrectomy. Urine was collected immediately before operation. Samples of medulla and cortex tissues were immediately and carefully dissected from a healthy part of the removed kidney and homogenized with a buffer solution. All concentrations were determined by bioassay. Bacampicillin was well absorbed, with a mean +/- SD serum concentration of 16.0 +/- 11.4 mg/L at one hour. The concentrations in renal tissues were higher than the serum levels taken at the same time, and the highest concentrations were found in the urine. the mean ampicillin elimination half-life was approximately the same in the cortex, medulla, and urine, (2.7, 2.3, and 2.4 hr, respectively) but it was shorter in the serum (1.4 hr). Bacampicillin 800 mg produced concentrations in the renal tissues that were higher and more sustained than in the serum and were well above the minimum inhibitory concentrations for common urinary pathogens even ten hours after the dose. PMID- 3958227 TI - Comparison between the dimensions of dendritic spines in the cerebral cortex of newborn and adult guinea pigs. AB - Dendritic spines in the cerebral cortex of newborn and adult guinea pigs were compared quantitatively. An increase in the average diameter of the head by 21% and in the diameter of the stalk by 29% was found. No difference could be measured in the average length of the spines of both age groups. When plotting the individual measurements against each other, a slight correlation could be found only between the size of the spine head and the thickness of the stalk. PMID- 3958228 TI - Location of motoneurones projecting to the cat distal forelimb. I. Deep radial motornuclei. AB - The position of the motornuclei projecting through the dorsal interosseus (DR) nerve to the distal forelimb muscles has been investigated in the cat. Horseradish peroxidase (HRP) and fluorescent (Fl) compounds have been used as retrograde tracers. They were either injected into forelimb muscles or applied to the proximal end of transected forelimb nerves. Limb muscles that were not investigated have been carefully denervated. HRP was used to trace the position and the architecture of the individual motornuclei. The topographical relations between the nuclei were established with application of up to three F compounds in the same animal. The position of the labeled motornuclei was reconstructed with a computer-assisted approach which is described in the appendix. The DR representation area extends from the caudal C5 to the caudal Th1 segments. In C6 it forms a dorsoventrally oriented narrow region at the lateral border of the ventral horn; in C7 and rostral C8 it forms a broad column in the dorsolateral corner of the ventral horn. In caudal C8 and Th1 this column is shifted into a ventral direction. The motoneurones projecting to the individual DR muscles are not randomly distributed in this area, but arranged in long, slender columns. These motornuclei occupy specific positions with only minimal interindividual variations. Three nuclei (brachioradialis, extensor carpi radialis, and supinator) are located in the C6 and C7 segments. They compose about one-third of the DR cell population. The nuclei to the other radial muscles are all located in C8 and Th1. Thus most of the DR motoneurones are located in these two segments. These results, together with those from the companion paper on the location of the median and ulnar motornuclei, provide important anatomical knowledge for the investigation of the cat brachial enlargement. PMID- 3958229 TI - Location of motoneurones projecting to the cat distal forelimb. II. Median and ulnar motornuclei. AB - The position of the motornuclei projecting through the median (Mn) and ulnar (Ul) nerves to the cat distal forelimb has been investigated. Horseradish peroxidase (HRP) and fluorescent (Fl) compounds have been used as retrograde tracers. They were either injected into forelimb muscles or applied to the proximal end of transected forelimb nerves. Limb muscles that were not investigated were carefully denervated. The position and the architecture of the individual motornuclei were traced with HRP. The topographical relations between the nuclei were established with application of up to three different Fl compounds in the same animal. The Mn motoneurones had a bimodal distribution in the brachial spinal cord. The motoneurones to the pronator teres and flexor carpi radialis muscles were located in C7 and the other Mn motoneurones were located in C8 and Th1. In C7 the Mn motoneurones occupied a single representation area, which is located some distance medially of the lateral funiculus. In C8 and Th1 two Mn representation areas were found: A dorsal one that contacts the lateral funiculus and is located at the level of the central canal; a ventral one that is located ventrally in the ventral horn. The dorsal area is occupied by the motornuclei projecting to the intrinsic hand muscles and the ventral one by the nuclei projecting to the limb. The Ul motoneurones extend with an unimodal distribution from the caudal C7 to the caudal Th1 segments. They occupy a single, broad representation area. The dorsal part, which contacts the lateral funiculus, is located at the level of the central canal and harbours the nuclei to the intrinsic hand muscles. The other Ul nuclei are located ventromedially deep in the ventral horn. These results, together with those from the companion paper on the location of the deep radial motornuclei, provide important anatomical information for the investigation of the cat brachial enlargement. PMID- 3958230 TI - Species differences in electric organs of mormyrids: substrates for species typical electric organ discharge waveforms. AB - The organization of electric organs is described for the mormyrid fishes from Africa. The electric organ's spike-generating cells or electrocytes are wafer shaped cells with a special geometry that relates to the number of phases and polarity of their pulsatile electric organ discharge (EOD) waveform. Six "families" of electrocytes are recognized on the basis of cell geometry. Each family includes species with EODs of similar polarity and phase number. Despite such similarities, there are still dramatic species differences in EOD waveforms for a given family that may further depend on specialized features of the electrocyte's excitable membranes. It is each species' particular electrocyte "profile" that must underlie the development of species-specific and hormone dependent sex differences in the EOD waveforms. PMID- 3958231 TI - Ontogenetic change in the distribution of callosal projection neurons in the postcentral gyrus of the fetal rhesus monkey. AB - In the postcentral gyrus of the mature rhesus monkey the distribution of callosal projection neurons is discontinuous. The density of callosal projection neurons, which are mainly located in the supragranular layers, varies both within and across cytoarchitectonic areas (Killackey et al., '83). In the present study, we investigated the ontogeny of corpus callosum projections of the postcentral gyrus in five fetal rhesus monkeys, ranging in age from embryonic day (E) 108 to E 133. Multiple large injections of horseradish peroxidase that involved the underlying white matter were made into the postcentral gyrus of one hemisphere and the distribution of labeled neurons in the ipsilateral thalamus and the other hemisphere was determined. The pattern of thalamic label indicated that the tracer was effectively transported from all portions of the postcentral gyrus. We found that the areal distribution pattern of labeled callosal projection neurons varied at the different fetal ages. At early fetal ages (E 108, E 111, and E 119) callosal projection neurons were continuously distributed throughout the postcentral gyrus. As in the adult animal, the vast majority of labeled callosal projection neurons were found in the supragranular layers, although a few labeled cells were located in the infragranular layers. From the earliest age, there was regional variation in the width of the band of labeled supragranular callosal projection neurons. The difference between the precentral and postcentral gyrus was most obvious, but there was also a difference between anterior and posterior portions of the postcentral gyrus. The first indication of some discontinuity in the distribution of callosal projection neurons was noted at E 126. By E 133, approximately 1 month before birth, the distribution of callosal projection neurons appeared remarkably mature. On E 119 aggregations of anterograde label could be detected in restricted portions of the posterior postcentral gyrus beneath the cortical layers. By E 133 anterograde label was found within the cortical layers (most densely in layer IV) in these regions of the postcentral gyrus. Thus, the emergence of the discrete pattern of callosal projection neurons appears to be temporally correlated with the ingrowth of callosal afferents. On the basis of these observations, as well as those of others (discussed in the text), we propose that the ontogenetic changes in the distribution of callosal projection neurons reflect the unique strategy employed by cortical projection neurons in establishing their patterns of connectivity. It is hypothesized that this strategy may involve multiple processes. PMID- 3958232 TI - Development of connections between the mediodorsal nucleus of the thalamus and the prefrontal cortex in the rat. AB - The postnatal ingrowth of thalamocortical fibers from the mediodorsal nucleus to the prefrontal cortex was investigated in relation to the development of cortical lamination. Like the dopaminergic fibers in the prefrontal cortex and the thalamic fibers in the visual cortex, the mediodorsal fibers have entered the prefrontal cortex at birth. Most of the fibers are found in the developing layer VI, but, in contrast to the above-mentioned systems, a considerable number of mediodorsal fibers have already penetrated into the upper, most immature part of the cortical plate on postnatal day 1. From day 1 to day 7 an increasing number of mediodorsal fibers reach the upper cortical plate, which by then is developing layer III, the terminal layer of these fibers. The reciprocal connection from the layer VI cells of the prefrontal cortex to the mediodorsal nucleus develops between day 4 and day 9. Finally, the projection from the contralateral prefrontal cortex to the mediodorsal nucleus is established around day 10. The early presence of the mediodorsal fibers in the upper, differentiating cortical plate might indicate an important role for the mediodorsal fibers in the laminar development of the prefrontal cortex. PMID- 3958233 TI - The ultrastructure of enkephalin-immunoreactive neurons in the interpeduncular nucleus of the rat. AB - The interpeduncular nucleus of the rat is a complex structure, displaying diverse immunocytochemical and ultrastructural features. This nucleus contains opiate receptors, enkephalin-positive cell bodies and enkephalin-positive fibers. The ultrastructure of rat interpeduncular enkephalinergic neurons has not been described, nor has the role that these neurons play in the internal organization of the interpeduncular nucleus been established. The purpose of the present study was to describe the ultrastructure of enkephalinlike-immunoreactive (ELI) cells with particular emphasis on the subnuclear organization of their dendritic and terminal fields. Enkephalinlike-immunoreactive (ELI) cell bodies are present in the rostral and apical subnuclei of the interpeduncular nucleus (IPN), but are absent from the other subnuclei of the IPN. The rostral subnucleus also contains immunoreactive dendrites that are postsynaptic to nonreactive terminal boutons. Numerous ELI axon terminals were observed in the central and intermediate subnuclei. The results of our study suggest that enkephalinergic interneurons link the rostral IPN with more caudal regions of this nucleus. PMID- 3958234 TI - The lamination and connectivity of embryonic cerebral cortex transplanted into newborn rat cortex. AB - Sheets of frontal or occipital cerebral cortex were taken from embryonic day (E) 15 rat embryos and placed in shallow depressions made in the occipitoparietal region of newborn rats. These transplants developed normal patterns of lamination, which could be in an inverted orientation if the transplant itself was placed upside down. Irrespective of the cortical area of origin of the grafted tissue, the transplants consistently received projections from those host thalamic nuclei that were normally found to innervate the adjacent host cortex. This indicates that immature cortical tissue, up to at least E15, may not contain the information necessary to define the specific thalamocortical connections characteristic of individual areas. On the contrary, the observed input pattern may be the result of sprouting of fibers that normally innervated host cortical regions adjacent to the transplant. Similarly, callosal afferents to transplants seemed to be a direct extension of the callosal input to the host cortex immediately beneath the transplant. Results from HRP studies of callosal connections indicated that transplant efferents to the contralateral cortex are smaller in magnitude than their afferents. This may be related to the superficial location of the transplants, which may limit the access transplant efferents have to the white matter. This study suggests that, while the cortical lamination is largely determined intrinsically, the innervation of the cortex is influenced by the context in which it develops. PMID- 3958235 TI - Electrophysiological and morphological correlates of axotomy-induced deafferentation of the goldfish Mauthner cell. AB - Axotomy-induced changes in afferent synapses to the goldfish Mauthner cell have been analyzed with intracellular recordings and with electron microscopy. The studies encompassed 7-208 days after cervical spinal cord transection. The physiological findings suggest a persistent and specific reduction in excitatory chemical inputs to the soma and proximal lateral dendrite, with no changes in somatic inhibition or in the electrotonic and chemical inputs to the more distal regions of the lateral dendrite. Corroborative morphological evidence includes swelling of the M-cell soma, as indicated by a 35% increase in the length of its minor diameter, an increased spacing and a quantitatively lower density of terminals on the soma, and the appearance of astrocytic processes partially or completely engulfing the terminals in that region. Similar changes were observed on the inferior dendrites projecting from the ventral surface of the soma, although these dendrites do not exhibit the chromatolytic changes observed at the soma. In contrast, there are no noticeable changes in either the synaptic investment of the lateral dendrite or its ultrastructure. Quantitative and qualitative data support the conclusion that there is a restricted and specific reduction in the proximal excitatory inputs to the M-cell. The evidence also suggests that electrotonic junctions between afferents and the M-cell remain intact, functionally and structurally. PMID- 3958236 TI - Origin and identification of fibers in the cranial nerve IX-X complex of Xenopus laevis: Lucifer Yellow backfills in vitro. AB - The central projections of individual components of the IX-X nerve complex in the South African clawed frog, Xenopus laevis, were mapped by dye diffusion with Lucifer Yellow in an isolated brain preparation. The method reliably revealed fiber tracts, termination zones, and detailed cell morphology. In addition, motor neurons could be doubly labelled by retrograde transport of horseradish peroxidase from muscle targets followed by backfilling the appropriate nerves with Lucifer Yellow. The most anterior root associated with the nerve IX-X complex, root 1, is composed of lateral line afferents that terminate in the medial medulla. Root 2 contains sensory fibers that terminate in the nucleus tractus solitarii and axons of lateral line efferent neurons. Root 3 is composed of sensory and motor fibers, including a major somatosensory component that terminates in posterior medulla and anterior spinal cord, and axons from cranial nerve nucleus IX-X. The most posterior root of the IX-X nerve complex, root 4, contains axons of laryngeal motor neurons and of general visceral efferent neurons. PMID- 3958237 TI - Postnatal loss of axons in normal rat sciatic nerve. AB - Myelinated and unmyelinated axons were counted in sciatic nerves of newborn, 5 day-old, 14-day-old, and adult rats. Myelinated axons increase from essentially none at birth to approximately 8,000 in adulthood, but total axon numbers decrease steadily from 33,954 at birth to 22,872 in adulthood. Thus there is a significant postnatal loss of axons from rat sciatic nerve. This loss is, in our opinion, not associated with the death of the cells that give rise to these axons. This is thus an example of a regressive event that probably is of importance in normal neural development, namely the postnatal elimination of axons unaccompanied by death of the neurons that give rise to axons. These findings presumably imply a considerable amount of proximal peripheral axon branching, and the postnatal elimination of axons in the sciatic nerve presumably results from a reduction of this branching. Thus postnatal elimination of processes on, for example, somatic muscle cells may be at least partially the result of long axon elimination rather than local withdrawal of presynaptic processes, as is usually thought to be the case. In addition, an increased number of axons resulting from early postnatal manipulations may indicate cessation of axon loss rather than formation of new axons. PMID- 3958238 TI - The projections from striate cortex (V1) to areas V2 and V3 in the macaque monkey: asymmetries, areal boundaries, and patchy connections. AB - The organization of projections from V1 to areas V2 and V3 in the macaque monkey was studied with a combination of anatomical techniques, including lesions and tracer injections made in different portions of V1 and V2 in 20 experimental hemispheres. Our results indicate that dorsal V1 (representing the inferior contralateral visual quadrant) consistently projects in topographically organized fashion to V3 in the lunate and parietooccipital sulci as well as to the middle temporal area (MT) and dorsal V2. In contrast, ventral V1 (representing the superior contralateral quadrant) projects only to MT and ventral V2. A corresponding dorsoventral asymmetry in myeloarchitecture supports the idea that V3 is an area that is restricted to dorsal extrastriate cortex and lacks a complete representation of the visual field. The average surface area of myeloarchitectonically identified V3 was 89 mm2. Additional information was obtained concerning the laminar distribution of connections from V1 to V2 and V3, the patchiness of these projections, and the consistency of projections to other extrastriate areas, including V4 and V3A. PMID- 3958239 TI - The early embryogenesis of papillary (sweat duct) ridges in primate glabrous skin: the dermatotopic map of cutaneous mechanoreceptors and dermatoglyphics. AB - The present study documents the early innervation of the epidermis prior to the onset of differentiation of the papillary (sweat duct) ridge in glabrous digital skin of rhesus monkey embryos measuring 45, 50 and 55 mm (crown-rump) length. We observed small papillary ridges, spaced at a distance of approximately 40 microns, projecting into the dermis in the center of the distal glabrous digital pad of digits 2-5 in the 55-mm embryo. The other digital pads lacked any sign of ridge formation. A two-dimensional, approximately hexagonal grid of afferent nerves was present in the superficial dermis of all digital and palmar pads. At regular intervals of approximately 40 microns, afferent nerves ascended from the superficial dermal nerve plexus and innervated the overlying epidermis. By electron microscopy, axonal growth cones were identified contacting Merkel cells that projected several microns down into the superficial dermis in the digital pad of digit 3. Thus, the earliest wave of differentiated dorsal root ganglion neuroblasts innervates Merkel cells. Schwann cells partially encircled these growing axon tips and could be identified by the presence of rough endoplasmic reticulum and free ribosomes. The youngest embryo studied had no sign of ridge formation; however, axons ascended from the superficial dermal nerve net at 30-40 microns intervals to innervate the epidermis. We conclude that afferent nerve fibers provide a two-dimensional grid that could modulate the spacing and arrangement of the papillary or sweat duct ridges of successive digits. Such an interaction is possible between digits based on the overlapping dermatotopic maps of each rete ridge. An abnormal fingerprint could thus reflect abnormal dorsal root ganglion neuroblasts expressed through mesenchyme and epidermis. PMID- 3958240 TI - Optic tectum of the eastern garter snake, Thamnophis sirtalis. I. Efferent pathways. AB - Extracellular, iontophoretic injections of horseradish peroxidase were used to anterogradely fill axons efferent from the optic tectum in garter snakes. The tectal efferent pathways consist of six axon types with distinct projections and terminal morphologies. Tectogeniculate axons pass into the diencephalon via the optic tract, bearing collaterals that form spatially restricted, rodlike arbors in the pretectum, the ventral lateral geniculate nucleus, and the ventrolateral nucleus. Tectoisthmi axons exit the tectum as a thin-caliber component of the ventral tectobulbar tract. They form spatially restricted, spherical arbors within nucleus isthmi. Tectoisthmobulbar axons also give rise to small, spherical arbors within nucleus isthmi, but the parent axons continue caudally into the pontine and medullary reticular formation issuing many short collateral branches. Tectorotundal axons reach the diencephalon via the tectothalamic tract and give rise to fine terminal collaterals in the nucleus of the tectothalamic tract ipsilaterally and in nucleus rotundus bilaterally. Single axons form sheetlike terminal fields that span the rostrocaudal extent of nucleus rotundus. Ipsilateral tectobulbar axons descend into the midbrain tegmentum where they issue several thick collaterals that terminate widely throughout the nucleus lateralis profundus mesencephali. The parent axon continues caudally giving off several widely spreading collaterals within the pontine and medullary reticular formation. Crossed tectobulbar axons enter the dorsal tectobulbar tract and cross the midline to form the predorsal bundle. Single axons give rise to terminal collaterals in the nucleus lateralis profundus mesencephali bilaterally, the contralateral pontine and medullary reticular formation, and the intermediate gray of the cervical spinal cord. PMID- 3958241 TI - Synaptic organization of the cone horizontal cells in the catfish retina. AB - Horizontal cells of the vertebrate retina are known to contribute to the formation of the receptive field surrounds of photoreceptor and bipolar cells. However, few synapses have been described anatomically that might mediate these interactions. We have observed in the catfish retina that cone horizontal cell perikarya and dendrites make conventional chemical synapses onto photoreceptor terminal telodendria and onto bipolar cell dendrites, while horizontal cell axon terminals make chemical synapses onto the perikarya and processes of amacrine cells. The synapses are characterized by clusters of round vesicles aggregated close to the site of contact, as well as by electron-dense material associated with both pre- and postsynaptic membranes. The three kinds of synapses observed anatomically correspond to the synaptic pathways involving cone horizontal cells that have been suggested by the physiology of these cells. PMID- 3958242 TI - Spiking local interneurones in the mesothoracic ganglion of the locust: homologies with metathoracic interneurones. AB - Two bilaterally symmetrical groups of spiking local interneurones have been characterized in the mesothoracic ganglion of the locust. The cell bodies of one group, the "midline group," lie at the ventral midline. Their primary neurites run in the ventral loop of ventral commissure II to form extensive branches in the neuropile of one-half of the ganglion. A dorso-ventral process in the perpendicular tract links two distinct fields of branches, one ventral and consisting of numerous fine branches of a uniform texture that arise from stout secondary neurites, and the other more dorsal consisting of fewer branches of a varicose appearance. Cell bodies of the second, the "anterior-lateral" group, lie close to the lateral edge of an anterior connective. Their primary neurites run in a more anterior ventral commissure and their neuropilar branches are divided into two fields by a process in a more anterior dorso-ventral tract. Within the two groups, each interneurone has its own distinctive shape that is an elaboration on these basic plans. Each interneurone also has its own characteristic physiology, being excited by a particular array of mechanoreceptors on the middle leg on the same side of the body as its neuropilar branches. The receptive fields of the interneurones, defined in this way, can be extensive and cover a particular surface of all parts of the leg, or restricted to one surface of, for example, the tarsus. These interneurones therefore bear a striking resemblance to two groups of spiking local interneurones in the adjacent segmental ganglion of the metathorax. PMID- 3958243 TI - The sympathetic and sensory components of the caudal lumbar sympathetic trunk in the cat. AB - The cell bodies of the lumbar sensory and sympathetic pre- and postganglionic neurons that project in the caudal lumbar sympathetic trunk of the cat have been labeled retrogradely with horseradish peroxidase applied to the central end of their cut axons. The application was made just proximal to the segmental ganglion that sends its gray rami to the L7 spinal nerve, and so identified the sympathetic outflow concerned primarily with the vasculature of the hindlimb and tail. The numbers, segmental distribution, location, and size of the labeled somata have been determined quantitatively. Labeled cell bodies were found ipsilaterally, but the segmental distributions of the different cell types were not matched. Afferent cell bodies lay in dorsal root ganglia L1-L5 (maximum L4), preganglionic cell bodies in spinal segments T10-L5 (maximum L2/3), and postganglionic cell bodies in ganglia L2-L5 (maximum L5). Both numbers and dimensions of labeled dorsal root ganglion cells were variable between experiments (maximum about 1,000); the majority were small relative to the entire population of sensory neurons. Labeled preganglionic cell bodies were located right across the intermediate region of the spinal cord, extending from the lateral part of the dorsolateral funiculus to the central canal. The highest density of labeled neurons lay at the border between the white and gray matter (corresponding to the intermediolateral cell column) with smaller proportions medially in L1-L2, and laterally in caudal L4-L5. Medial preganglionic neurons were generally larger than those lying in lateral positions. From the data, it is estimated that about 650 afferent, about 4,500 preganglionic, and some 2,500 postganglionic neurons project in each lumbar sympathetic trunk distal to the ganglion L5 in the cat. PMID- 3958244 TI - A quantitative morphological study of interstrain variation in the developing rat optic nerve. AB - Groups of pigmented (Black and White Hooded Lister) and albino (Sprague Dawley) rats were killed at 7, 15, and 25 postnatal days of age. Their optic nerves were embedded in resin suitable for both light and electron microscopy. Quantitative stereological procedures were used to estimate total fibre number and the degree of myelination in the optic nerves at the various ages. At 7 days of age, both albino and pigmented rats had about 220,000 optic nerve fibres. By 15 days, both strains showed a reduction of some 30,000 fibres. This fibre loss continued in both strains after 15 days of age, but more rapidly in the pigmented strain. At 25 days of age, pigmented rats had 72,371 +/- 7,244 fibres, whilst albino rats had 102,681 +/- 4,138 fibres (P less than .01). More than 99.5% of optic nerve axons in both strains were unmyelinated at 7 days of age. By 25 days of age about 90% of all remaining fibres were myelinated in both strains. The mean diameter of the myelinated axons was estimated to be between 0.59 and 0.65 micron in all animals, there being no significant age or strain differences. In contrast, the mean diameter of nonmyelinated axons increased significantly with age. This increase was greater for albino than pigmented rats, such that by 25 days of age the respective values were 0.49 micron and 0.42 micron (P less than .05). PMID- 3958245 TI - Delayed development of song control nuclei in the zebra finch is related to behavioral development. AB - The postnatal development of two visual areas (nucleus rotundus and ectostriatum) and two song control areas (hyperstriatum ventrale pars caudale, HVc, and nucleus robustus archistriatalis, RA) of the zebra finch brain was followed from birth to adulthood. The following parameters were investigated: (1) neuron size, (2) volume of the brain nuclei, and (3) myelination of axons. The nucleus rotundus, the diencephalic station of the tectofugal pathway, exhibits the fastest development: rotundal neurons reach their maximum size at 20 days of age; the volume of this structure reaches adult size at the same time. The process of myelination begins between day 5 and day 10 and is completed at 40 days of age. A similar temporal sequence of development is seen in the ectostriatum, except myelination starts some days later. Thus the development of these visual areas is completed at 40 days. In contrast, the development of the song control nuclei is delayed. Neurons in RA and HVc grow steadily up to 40 days of age, attaining a size larger than that observed in adults. Whereas the volume of HVc increases until day 40 and remains stable thereafter, RA volume increases until day 70 and evidences a decrease thereafter. It is not until postnatal day 20 (RA) and day 40 (HVc) that the myelination process starts in the song control areas. Adult myelin density is achieved by 70 days in RA and by 100 days in HVc. It can be demonstrated that the development of the visual system parallels the development of visual performance of the birds. Delayed growth of song control nuclei coincides with development of song. PMID- 3958246 TI - Regeneration of the cerebellofugal projection after transection of the superior cerebellar peduncle in kittens: morphological and electrophysiological studies. AB - In contrast to the current concept of abortive regeneration of mammalian central axons, occurrence of marked, functionally active regeneration of the cerebellofugal projection was proved in kittens after complete transection of the decussation of the brachium conjunctivum (BCX). By means of the anterograde axonal transport of horseradish peroxidase that was injected into the cerebellar lateral and interpositus nuclei, the origin, course, and destination of the regenerated fibers were identified unambiguously and the time-course of axonal regeneration was clarified. Functional connectivity of the regenerated cerebellothalamic projection was tested electrophysiologically. In eight out 82 animals, marked regeneration of the cerebellofugal projection occurred; in the majority of the rest of the animals, trace amounts of regenerated fibers were observed. In the former but not in the latter animals, marked cerebellocerebral responses, as in intact animals, were evoked in the frontal motor and parietal association cortices. Most of the regenerated axons took a course similar to that of the normal projection and terminated in the normal projection areas, whereas a small proportion of fibers showed an aberrant course and termination. The cut ends of axons began to swell as early as 15 minutes after transection, and the regenerated axons produced dense terminals in the thalamus by 19 days. PMID- 3958248 TI - Optic tectum of the eastern garter snake, Thamnophis sirtalis. IV. Morphology of afferents from the retina. AB - The morphology of single retinal terminals in the optic tectum of the eastern garter snake was demonstrated by orthograde filling from extracellular injections of horseradish peroxidase (HRP) into the optic tract. HRP-filled terminals share a characteristic shape and structure. Their parent axons course caudally in the stratum opticum within fascicles of 200-300 fibers of varying diameters. Single axons exit a fascicle and course into either the stratum fibrosum et griseum superficiale, ventrally, or the stratum zonale, dorsally, where they bifurcate successively two or three times into preterminal branches. Each preterminal branch gives rise to many thin, terminal branchlets laden with boutons. The arbors are ellipsoidal with their long axes oriented mediolaterally and their short axes oriented rostrocaudally. Arbors vary in their overall size (from 45 to 150 micron), in the diameters of their parent axons (from less than 0.5 to 3.0 micron), and in the size of their terminal boutons (from 0.5 to 3.5 micron). Bouton size increased with increasing diameter of the parent axon. The great majority of arbors are confined to one of three retinorecipient sublayers in the superficial tectum. However, the full range of arbor sizes and axon diameters is present in each sublayer. PMID- 3958247 TI - Optic tectum of the eastern garter snake, Thamnophis sirtalis. III. Morphology of intrinsic neurons. AB - Extracellular iontophoretic injections of horseradish peroxidase and Golgi preparations were used to study the distribution and morphology of intrinsic neurons of the garter snake optic tectum. Four morphologically distinct classes of neurons were identified. The type A neuron is found throughout the retinorecipient tectal layers. It has a large, fusiform soma and infrequently branching dendrites that radiate in the horizontal plane and are studded with varicose appendages. An axon arises from the soma or proximal dendrite and gives rise to widely spreading branches that overlap the cell's dendritic field. The type B neuron has a small, spherical soma in sublayer b of the stratum fibrosum et griseum superficiale. Thick, varicose dendrites ascend from the soma and form a bushy arbor in the overlying sublayer a. A thin axon descends vertically from the soma and arborizes in vertical alignment with the cell's dendritic field in sublayer c of the stratum fibrosum et griseum superficiale and the upper third of the stratum griseum centrale. The type C neuron is a bipolar cell with a small, vertically fusiform soma situated at the upper border of the stratum griseum centrale. Thin, sparsely branching dendrites extend vertically into the superficial and central gray layers. An axon arises from the soma and courses ventrally into the stratum griseum centrale where it gives rise to a plexus of widely spreading branches that extend medially from the cell's dendritic field. The type D neuron is a small, stellate cell with a spherical soma and fine, appendage-laden dendrites that are restricted to the stratum griseum centrale. The axon of the type D cell courses in the central gray where it gives rise to widely spreading branches that extend laterally from the cell's dendritic field. PMID- 3958250 TI - Intrinsic connections of the retrohippocampal region in the rat brain. II. The medial entorhinal area. AB - The present study describes the efferent projections and terminal distributions within the retrohippocampal region of individual layers of the rat medial entorhinal area (MEA) as studied by the methods of anterograde transport of the lectin Phaseolus vulgaris leucoagglutinin (PHA-L) and retrograde transport of the fluorescent dye Fast Blue (FB). Analysis of the PHA-L injections that were relatively well restricted to single layers of the MEA reveals very sparse projections to the parasubiculum, presubiculum, and subiculum, while numerous projections within the MEA are found. The course and the termination of the intra entorhinal projections differ depending upon the particular layer under study, and marked differences are found between the deep and the superficial layers in terms of the divergence of their respective projections. However, the general intra-entorhinal orientation of these projections is essentially the same for all layers: longitudinal with a slightly oblique course, such that at ventral levels the center of a particular terminal field is always located lateral to the center of the respective PHA-L injection. PHA-L injections into layer II label axons running horizontally within this layer as well as within the deep part of layer I, and PHA-L injections into the medial sector of layer II reveal horizontal projections that innervate most of the second layer. The horizontal projections of layer III are more restricted than those of layer II but both layer II and III have prominent longitudinal projections directed ventrally. From layers II and III, numerous axons project to the deep layers (IV-VI) probably en route to extra entorhinal structures, since no major terminal fields were detected in the deep layers. The PHA-L and the FB experiments show that the deep layers (in particular IV and VI) have far more divergent intra-entorhinal projections than have layers II and III. PHA-L injections into layers IV, V, and VI reveal widespread efferent projections to all of the more superficially located layers of the MEA in addition to projections to the lateral EA. The retrograde transport studies show that layers IV and VI are the major sources of these divergent projections and that cells situated throughout the entire medial to lateral width of these layers project to every sector of the retrohippocampal region. Taken together, the findings of the present experiments suggest that (1) all layers of the MEA have longitudinal projections directed primarily toward the ventral (or temporal) part of this cortex, (2) the projections of layers II and III are relatively restricted compared of the deeper layers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958249 TI - Afferent and efferent connections of cerebellar lobe C1 of the mormyrid fish Gnathonemus petersi: an HRP study. AB - The corpus of the highly developed cerebellum of the weakly electric fish Gnathonemus petersi is differentiated into four lobes, numbered C1 to C4. The present paper deals with the extrinsic connections of the rostralmost lobe C1. Relevant nuclei were studied in normal histological material and HRP injections were placed in lobe C1, the neighbouring pedunculus valvulae, and the brainstem. The largest number of afferents to lobe C1 originates from the nucleus lateralis valvulae, a large nucleus of tightly packed small cells in the dorsal midbrain tegmentum. In Gnathonemus this nucleus encompasses nine subdivisions, of which the rostral, caudal, and exterolateral parts project in particular to lobe C1. Larger neurons in the dorsal midbrain tegmentum and presumed mesencephalic trigeminal neurons project to C1 as well. In the rhombencephalon, afferents to lobe C1 arise from the first funicular nucleus, the lateral reticular nucleus, and the inferior olive. Efferents of lobe C1 have been found to arise from a peculiar cell type in the Purkinje cell layer (so-called eurydendroid neurons) and to project predominantly to the nucleus of the fasciculus longitudinalis medialis, the nucleus reticularis superius and medius, and the trigeminal motor nucleus. Additional small projections terminate in the tectum mesencephali and in the nucleus reticularis inferior. Compared with other parts of the mormyrid cerebellum as well as with the cerebellum of other teleosts, the connections of lobe C1 appear to be quite restricted and specialized. In this respect the connections with the trigeminal nerve via the first funicular nucleus, the mesencephalic trigeminal nucleus, and the trigeminal motor nucleus are of particular interest. The absence of central cerebellar nuclei intercalated in the efferent cerebellar connections, in combination with the presence of a precerebellar nucleus (lateralis valvulae) involved in the afferent cerebellar connections, represents a remarkable difference between teleosts and other vertebrate classes. PMID- 3958251 TI - Intracerebral transplants of the rat fascia dentata: a Golgi/electron microscope study of dentate granule cells. AB - In the present study we describe the morphological characteristics of dentate granule cells in intracerebral allografts of the rat fascia dentata. Blocks of hippocampal tissue containing the fascia dentata were taken from late embryonic and newborn rats and transplanted to the hippocampal region of other newborn and young adult rats. After survival periods of several months the recipient brains were fixed by perfusion and serially sectioned on a Vibratome. Some sections were stained with thionin to determine the localization and general histological organization of the transplants, while others were Golgi stained with a modification of the section Golgi technique. Well-impregnated transplant granule cells were gold-toned and deimpregnated thus allowing a correlated, light and electron microscopic analysis of identified neurons to be done. At the light microscopic level the morphology of the dentate granule cells in the transplants was very similar to Golgi-impregnated, gold-toned granule cells in the fascia dentata of normal rats (controls). A few irregular, more obliquely curved dendrites occurred, but basal dendrites passing into the hilar region were never observed. Following an initial spine-free segment granule cell dendrites were densely covered with spines. The axon, the mossy fiber, originated as usual from the basal pole of the cell body. In the electron microscope, both small and larger complex spines (v and w types) were seen to emerge from the gold-toned dendrites of the identified granule cells. The thin unmyelinated granule cell axons gave rise to giant mossy fiber boutons in the dentate hilus, but in addition numerous aberrant mossy fiber terminals were found innermost in the dentate molecular layer just above the granule cell layer. The results demonstrate that dentate granule cells that have gone through the major part of their differentiation after transplantation develop characteristic dendritic and axonal elements very similar to those of granule cells in the fascia dentata in situ. The minor changes observed correspond to the redistribution of intrinsic connections that results from the absence of major extrinsic afferents. PMID- 3958252 TI - Single thalamic neurons project to both lateral suprasylvian visual cortex and area 17: a retrograde fluorescent double-labeling study. AB - Area 17 and the posteromedial lateral suprasylvian (PMLS) visual cortex receive inputs from three thalamic nuclei in common: the lateral division of the lateral posterior nucleus (LPl), the C-laminae of the lateral geniculate nucleus (LGNd), and the medial interlaminar nucleus (MIN). The present study determined whether these projections originate from the same cells via bifurcating axons or from separate populations of cells. Double-label retrograde transport techniques were used to label cells projecting to area 17 with one fluorescent dye and to label cells projecting to PMLS cortex with a different dye. The two dyes used were fast blue and Evans blue. Following injections into the two cortical areas, some cells were double labeled and some were single labeled in all three thalamic nuclei studied. However, the relative number of double- and single-labeled cells, as well as the relative number of cells single-labeled following injections into each cortical area, differed among the three thalamic nuclei. In both MIN and the C-laminae of the LGNd, the number of double-labeled cells was small. Similarly, the number of cells single labeled with the dye placed in PMLS cortex was small in these two nuclei. In contrast, a relatively large number of cells were single labeled with the dye placed in area 17, especially in the C-laminae of the LGNd. These results suggest that in both MIN and the C-laminae of the LGNd, few cells project to both area 17 and the PMLS cortex, few cells project only to PMLS cortex, and a relatively greater number of cells project only to area 17. In LPl, many cells were labeled after the cortical injections. In fact, when the areas of densest labeling for both dyes overlapped, almost every labeled cell in LPl was double labeled. This indicates that almost all LPl cells that project to one cortical area also project to the other via a bifurcating axon. PMID- 3958253 TI - Retinotopic organization within the cat's posterior suprasylvian sulcus and gyrus. AB - The organization of extrastriate visual areas of the cat's posterior suprasylvian sulcus and gyrus was studied with electrophysiological mapping methods. Analysis of retinotopic organization confirmed the presence of dorsal lateral and ventral lateral suprasylvian (DLS, VLS) visual areas (Palmer et al., '78, J. Comp. Neurol. 177:237-256) and demonstrated new features of organization. Areas DLS and VLS occupy the upper two-thirds of the posterior suprasylvian sulcus, with DLS wholly confined to the upper bank and VLS straddling the sulcal fundus. Both areas contain a partial representation of the lower quadrant of the visual field. A narrow strip of visually responsive cortex (periauditory belt) was identified adjoining DLS on the posterior ectosylvian gyrus; its organization and extent were not explored in detail. The organization of the posterior suprasylvian areas (PS) (Updyke, '82, Soc. Neurosci. Abst. 8:810) was explored in detail. Area PS lies inferior to areas VLS and 21b in the lower third of the posterior suprasylvian sulcus and gyrus, extending onto the fusiform gyrus. PS contains a partial representation of the lower quadrant of the visual field. It shares a representation of horizontal meridian with area 21b and a representation of central gaze with area VLS. Analysis of the PS/20 border region indicates that the representation of the lower quadrant periphery is common to the borders of PS, 20a, and 20b rather than lying internal to areas 20a and 20b as suggested by Tusa and Palmer ('80, J. Comp. Neurol. 193:147-164). PMID- 3958254 TI - The absence of significant postnatal motoneuron death in the brachial and lumbar spinal cord of the rat. AB - Motoneuron numbers in the brachial and lumbar lateral motor column (LMC) of the rat were examined quantitatively on embryonic day (E) 15 and postnatal days (P) 1 5. There was a significant (40-45%) loss of motoneurons in both regions between E15 and P1. No further loss was observed between P1 and P5. The decline of motoneurons between E15 and P1 is very likely due to cell death since there were considerable numbers of dying motoneurons present on E15. By contrast, few dying motoneurons were observed on P1-P5. Possible reasons for discrepancies between the present results and previous investigations are discussed. It is concluded that there is not a significant loss of either brachial or lumbar motoneurons in the postnatal rat and thus that postnatal rearragements of muscle innervation are most likely the result of axon elimination, not cell death. PMID- 3958255 TI - Grafting of skin ulcers with cultured autologous epidermal cells. AB - We treated five adult individuals with six full-thickness chronic ulcerations in the skin caused by venous insufficiency, sickle cell anemia, or surgical wounds. Each patient received applications to the ulcerations of sheets of autologous epidermal cells grown in culture. All patients experienced relief of pain after grafting. Four of the six ulcers healed completely in 21 to 35 days, and three of the four remained healed for up to 2 years. One ulceration recurred within 2 months. Our experience suggests that cultured autologous epidermal grafts can provide continuous covering, relief from pain, and rapid healing of chronic debilitating ulcerations of the skin. PMID- 3958256 TI - Diagnosis of the dysplastic nevus in different populations. AB - Because of the relationship of the dysplastic nevus to melanoma, physicians are being encouraged to identify the clinical features of this newly defined entity. However, the dysplastic nevus was originally characterized in the familial setting, and application of equivalent criteria to the general population will be disappointing. The ability of the clinician to diagnose the presence of dysplastic nevi will be markedly influenced by the true underlying prevalence of dysplastic nevi in the population subjected to the examination. Even with superlative (and perhaps unattainable) examining skills (e.g., sensitivity and specificity both 90%), the positive predictive value in the general population will be relatively low (less than one third). Grading the severity of clinical dysplasia, obtaining serial observations, and improving specificity of clinical examination are important but irrelevant to this problem because these items focus only on examining skills. Consideration given to the epidemiologic and referral characteristics of the person undergoing examination will substantially improve the ability to predict dysplastic nevi on clinical evaluation. Although comprehensive recommendations must await further research, some priorities in the diagnosis and management of patients with presumptive dysplastic nevi are suggested. PMID- 3958257 TI - An immunologic and cultural study of Pityrosporum folliculitis. AB - In patients with Pityrosporum folliculitis the mean serum antibody titer against Pityrosporum orbiculare was significantly higher than in healthy control subjects (p less than 0.01). The mean number of P. orbiculare organisms per square centimeter cultured from normal-looking skin in patients was not significantly higher than the number cultured from normal-looking skin in control subjects. Results of prick tests against P. orbiculare extract were negative or weak, indicating that patients with Pityrosporum folliculitis had no type I hypersensitivity against P. orbiculare. Immunohistochemical staining of skin lesions showed perivascular dermal cell infiltrates near the hair follicles dominated by anti-Leu 3a-reactive T lymphocytes. Human lymphocyte antigens with the DR locus, but not those with the DQ locus, on keratinocytes were observed in one case. PMID- 3958258 TI - Eosinophilic pustular folliculitis. AB - Eosinophilic pustular folliculitis was first described by Ofuji et al in 1970. It is characterized by pruritic circinate plaques that are studded with follicular papules and pustules. Lesions are located chiefly on the face, trunk, and arms. Biopsies of lesions demonstrate an infiltrate of eosinophils and neutrophils within hair follicles, dermis, and epidermis. Peripheral leukocytosis and eosinophilia are common. PMID- 3958259 TI - Eosinophilic pustular folliculitis. AB - Sterile, pruritic papules and papulopustules that formed annular rings developed on the back of a 58-year-old woman. The individual lesions evidenced peripheral extension with central clearing and were characterized by exacerbations and partial remissions. The general health of the patient was good. Laboratory determinations showed moderate peripheral blood eosinophilia. Spongiosis with eosinophilic exocytosis, often localized to the hair follicles, was found on examination of histologic specimens. These findings led to a diagnosis of eosinophilic pustular folliculitis, a disease of unknown cause that has rarely been reported in the North American literature. PMID- 3958260 TI - Eosinophilic pustular folliculitis. AB - We present the case of an American adult patient with eosinophilic pustular folliculitis. The majority of previously reported patients have been Japanese. Eosinophilic pustular folliculitis is a rare condition characterized by recurrent, peripherally expanding, sterile papulopustules and plaques. Hair bearing areas such as the face, chest, back, and extensor surfaces of the upper arms are usually involved, although palms and soles can be affected as well. Histologic examination shows subcorneal and intrafollicular abscesses and spongiosis of the outer root sheath. The eosinophil is a prominent infiltrating cell, although mononuclear cells and neutrophils may also be seen. There is often a dense perivascular infiltrate of eosinophils in the dermis. Our patient was unusual in that he did not respond to multiple therapeutic regimens. PMID- 3958261 TI - Treatment of primary and secondary syphilis: serologic response. AB - Eighty-eight patients with their first attack of primary syphilis and 101 patients with secondary syphilis were treated with penicillin G benzathine, 2.4 million units intramuscularly each week for 2 consecutive weeks, for a total of 4.8 million units. The serum of all patients with primary syphilis became negative within 1 year and of those in the secondary stage, within 2 years. This report confirms three previously published articles on the serologic response to treatment in a grand total of 588 patients with primary syphilis and 623 patients in the secondary stage. PMID- 3958262 TI - Cutaneous granulomatous vasculitis: its relationship to systemic disease. AB - Microscopic and medical review of twenty-six patients with skin biopsy specimens that showed granulomatous vasculitis demonstrated vascular histiocytic granulomas with fibrinoid destruction of blood vessels in the dermis and panniculus. Cultures of the biopsy specimens were nonspecific. The skin lesions varied from erythema to papulonodular and vesicular eruptions; they were usually on the extremities but also involved the trunk. Eight patients had systemic lymphoproliferative diseases: three, lymphoma; two, angioimmunoblastic lymphadenopathy; two, preleukemia; and one, chronic granulocytic leukemia. Five of these eight patients died within 2 years after the onset of skin lesions. The four patients with systemic vasculitis died within 1 year after the onset of skin lesions. Five patients with arthritis, four with gastrointestinal disease, three with systemic sarcoidosis or sarcoidlike disease, and one with tuberculosis had a more favorable prognosis. The histologic pattern of cutaneous nonlymphomatoid granulomatous vasculitis is associated with significant systemic disease, especially lymphoproliferative disorders. Patients with lymphoproliferative disorders or systemic vasculitis have a much poorer prognosis than those with inflammatory or infectious granulomatous disease. PMID- 3958263 TI - The fasciae of the face: an anatomic and histologic analysis. AB - The face has two distinct fascial components--a superficial layer and a deep layer. The anatomy of the fasciae in relation to surgically significant vessels, nerves, and muscles is examined with anatomic and histologic specimens. PMID- 3958264 TI - Benign junctional epidermolysis bullosa in three related Moroccan families. PMID- 3958265 TI - Carbuncles caused by Candida albicans. PMID- 3958266 TI - Hydrazine derivatives and induction of systemic lupus erythematosus. PMID- 3958267 TI - Avascular necrosis of the hips following longterm use of clobetasol propionate. PMID- 3958268 TI - Magnifiers in dermatology. PMID- 3958269 TI - Scrotal squamous cell carcinoma in a psoriatic patient treated with coal tar. PMID- 3958270 TI - Long-term use of psoralens and ultraviolet A for psoriasis: evidence for efficacy and cost savings. AB - A 7.3-year prospective study of 1,380 patients with psoriasis who were treated with oral methoxsalen (8-methoxypsoralen) and ultraviolet A photochemotherapy (PUVA) revealed that patients who continued on PUVA therapy used inpatient hospital treatment less than one fourth as often as those who had discontinued treatment. Patients who continued to use PUVA therapy also had less extensive psoriasis than did other patients in this cohort who discontinued PUVA therapy. These findings demonstrate that PUVA is an effective outpatient therapy for severe psoriasis. The potential toxicity of PUVA treatment, which was the primary reason that one third of the study patients were concerned about their prolonged or continued treatment, must be balanced against the therapy's apparent effectiveness and relatively low cost. PMID- 3958271 TI - How well do physicians recognize melanoma and other problem lesions? AB - The alarming increase in the incidence of cutaneous malignant melanoma in the United States emphasizes the importance of its early detection and treatment. Early detection requires accurate clinical recognition of both malignant and precancerous skin lesions (dysplastic nevi). This study presents data on dermatologists' and nondermatologists' ability to diagnose skin lesions. A total of 105 nondermatologist physicians, from first-year residents to practicing physicians, and forty-eight dermatologists were asked to identify color slides or photographs of eleven cutaneous lesions, including malignant melanomas, dysplastic nevi, and innocuous lesions such as seborrheic keratoses and common moles. Diagnosis of cutaneous lesions was generally inaccurate among nondermatologists. Only 38% correctly identified four or more of the six melanomas as melanoma of any type, and 58% were unable to diagnose dysplastic nevi. Only 17% categorized their relevant training as excellent or good. Improved training in the diagnosis of skin lesions for practicing physicians and house staff is required if mortality from malignant melanoma is to be decreased in the United States. PMID- 3958272 TI - Cutaneous keratocysts of nevoid basal cell carcinoma syndrome. AB - Four cysts were removed from two unrelated patients with nevoid basal cell carcinoma syndrome. Multiple sections from each cyst were studied. Two cysts showed histologic features similar to keratocysts that occur in the jaws of patients with this syndrome. The cysts were lined by a festooned epithelium consisting of two to five layers of squamous cells that formed keratin without the presence of a granular cell layer. One cyst contained some lanugo hair and a small bud of follicular epithelium. This cyst was therefore similar to cutaneous steatocysts but did not have an identifiable sebaceous component. The second cyst was devoid of hair and adnexal structures and was indistinguishable from a jaw keratocyst. Two other cysts were typical epidermoid (infundibular) cysts. Although speculative, it is likely that some cutaneous cysts in patients with nevoid basal cell carcinoma syndrome are identical to jaw keratocysts and may be another cutaneous marker for this disease complex. PMID- 3958273 TI - Delayed hypersensitivity to topical corticosteroids. AB - Topical hypersensitivity to corticosteroids was studied by epicutaneous testing using the Finn Chamber technic. The steroids were tested in both ethanol and white petrolatum and, in certain cases, in dimethyl sulfoxide. Additionally, commercial preparations were tested. Three groups of patients were studied: (1) patients with a history of hypersensitivity to at least two topical preparations (five of ten patients studied showed a positive patch test reaction for corticosteroids), (2) patients in whom topical corticosteroid hypersensitivity was suspected because of treatment-resistant eczema (seven of twenty-five patients showed a positive patch test reaction), and (3) dermatologic inpatients and outpatients undergoing epicutaneous testing for suspected topical hypersensitivity. Hydrocortisone-17-butyrate (H-17-B) was included in the standard patch test series; of 450 patients tested, two showed a positive patch test reaction. All the patients with corticosteroid hypersensitivity had a positive reaction to H-17-B. In six patients, additional hypersensitivities to one or several other steroid preparations were seen. Use testing was performed as an open test, with 0.1% or 1% H-17-B in ethanol on normal skin of the flexor side of the upper extremities. A positive test reaction was seen in only one of nine patients. Results of use testing with the commercial 0.1% H-17-B (Locoid) ointment were always negative. Our study suggests that the sensitivity of patch tests for corticosteroid hypersensitivity can be increased by using ethanol as vehicle. PMID- 3958274 TI - Kaposi's sarcoma of the conjunctiva. AB - Three cases of Kaposi's sarcoma involving the conjunctiva are reported. The first patient had been affected by a single lesion on the glans penis. In the second patient the conjunctival lesion adopted a peculiar globular shape. The third patient had been treated with corticosteroids for pemphigus when the Kaposi's sarcoma lesion appeared. Although these conjunctival lesions are extremely rare, dermatologists should not rule out the possibility of Kaposi's sarcoma with ocular involvement, bearing in mind its higher incidence because of the epidemic of acquired immunodeficiency syndrome and the increasing number of patients with immunosuppression. PMID- 3958275 TI - Finger pebbles: a common finding in diabetes mellitus. AB - Several authors have now described the relatively common occurrence of thickening of the skin on the dorsum of the fingers and hands in persons with diabetes mellitus, and skin thickening in these patients has been documented histologically for other body locations. To date, the presence of finger and hand skin thickening has been determined by an examination difficult to objectify- palpation and attempted tenting of the affected area. In a survey of sixty subjects with diabetes, it was found that forty-five patients (75%) have a visual marker for skin thickening, that is, a pebbly appearance of the knuckle and distal finger skin. Similar changes were present in eleven of control subjects (21%). A limited histologic study indicates that the epidermis and papillary dermis are primarily responsible for this thickening. A pebbly appearance of volar finger skin may be a more easily recognized marker of diabetic skin thickening. PMID- 3958276 TI - Dermabrasion of the scalp as a treatment for actinic damage. AB - Dermabrasion of the scalp was safely and effectively performed on five patients as a treatment for actinic damage. This surgical modality can be an important part of the management of solar keratoses of the scalp in patients with alopecia. PMID- 3958277 TI - Sebaceous carcinoma of the eyelid treated with Mohs' surgery. AB - Sebaceous carcinoma of the eyelid is a rare neoplasm usually arising from the meibomian gland. This tumor has distinctive histologic features characterized by unique foamy cytoplasm. The cases of three patients with this tumor who were treated by Mohs' surgery, followed by ophthalmologic cosmetic repair, are presented and discussed. PMID- 3958278 TI - Public education: an approach, Skin cancer awareness project using the solar meter. PMID- 3958279 TI - Acquired epidermolysis bullosa without basement membrane zone immunoreactants. PMID- 3958280 TI - Epidermodysplasia verruciformis. PMID- 3958281 TI - Porokeratosis and immunosuppression. PMID- 3958282 TI - Lymphangiosarcoma following radiation therapy. PMID- 3958283 TI - HLA subtypes and D-penicillamine-associated pemphigus. PMID- 3958284 TI - Urticaria pigmentosa and natural sunlight. PMID- 3958285 TI - Acquired cutaneous lymphangiectasias secondary to scarring from scrofuloderma. PMID- 3958286 TI - Congenital smooth muscle hamartoma. PMID- 3958288 TI - Social and psychological implications of alopecia areata. PMID- 3958287 TI - Treatment of brown recluse spider bites. PMID- 3958289 TI - Seasonal variation and characterization of Micrococcaceae present in ewes' raw milk. AB - Samples (120) of ewes' raw milk collected over a 12-month period on arrival at the dairy and freshly drawn ewes' milk samples (30) collected at the farm were analysed for total viable counts and staphylococci. Total viable counts reached on the average 5.4 X 10(6)/ml in dairy samples and 6.0 X 10(5)/ml in farm samples, whereas mean levels of staphylococci were 5.9 X 10(4)/ml and 3.3 X 10(3)/ml, respectively. A high proportion (62%) of coagulase-positive isolates from Baird-Parker agar plates was detected in spring months. Staphylococcus aureus (42%), Staph. haemolyticus (23%) and Staph. epidermidis (10%) were the predominant species in 210 characterized isolates of staphylococci from ewes' raw milk. Seven coagulase-positive, maltose-negative staphylococci could not be identified with any of the recognized Staphylococcus species. Eighteen Micrococcus strains were identified as M. varians, whereas 111 Micrococcus strains of uncertain taxonomic status were separated into three groups, according to their physiological characters. PMID- 3958290 TI - No evidence for the presence of beta-casomorphins in human plasma after ingestion of cows' milk or milk products. PMID- 3958291 TI - Fractionation of bovine caseins by reverse phase high performance liquid chromatography: identification of a genetic variant. AB - Samples of reduced whole casein from genetically typed individual cows were quantitatively separated into their main components, alpha s1-, alpha s2-, beta- and kappa-caseins by reverse phase high performance liquid chromatography (RP HPLC) using a mobile phase of phosphate-buffered aqueous propan-2-ol containing sodium dodecyl sulphate and an octadecylsilyl stationary phase. One casein sample was found to give two peaks of beta-casein of approximately equal areas. RP-HPLC of tryptic digests of the two separated peak fractions gave identical patterns with the exception of one peptide peak with different retention times. Amino acid analyses performed on both fractions showed that they corresponded to peptide 114 169 of beta-casein A1. The atypical beta-casein differed from the typical one by a Pro----Leu substitution in region 114-169. PMID- 3958292 TI - Short-term associations between disease and milk yield of dairy cows. AB - Short-term associations between disease and milk yield were studied in 1594 lactations occurring between 1977 and 1982 in 732 Friesian, Ayrshire and Holstein crossbred cows. Statistically significant differences in milk yield between one week before and one week after clinical diagnosis were observed for ketosis (5.1 kg/d), hypomagnesaemia (4.1 kg/d), mastitis occurring after peak yield (2.1 kg/d) and lameness (1.1 kg/d). Milk yield declined for as much as 2-4 weeks before diagnosis of disease, and total losses in milk yield associated with ketosis or hypomagnesaemia were estimated to be 60-70 kg. No significant differences were found for endometritis or for mastitis when it occurred before peak yield. Milk yield was suppressed for about 4 weeks after calvings with retained placenta, but there were no corresponding effects of dystocia or hypocalcaemia on milk yield. It is suggested that if automatic daily milk recording is available it may be possible to detect deviations from normal, and hence detect subclinical disease 2 or more weeks before its clinical appearance. PMID- 3958293 TI - Good moments in psychotherapy: a preliminary review, a list, and some promising research avenues. PMID- 3958294 TI - The attrition dilemma: toward a new strategy for psychotherapy research. PMID- 3958295 TI - Dissemination and adoption of innovative psychosocial interventions. PMID- 3958297 TI - Influence tactics in psychotherapy. PMID- 3958296 TI - Sequential analyses of language variables in psychotherapy process research. PMID- 3958299 TI - Therapeutic alliance: its place as a process and outcome variable in dynamic psychotherapy research. PMID- 3958298 TI - Structural analysis of social behavior: application to a study of interpersonal process in differential psychotherapeutic outcome. PMID- 3958300 TI - Change process research. PMID- 3958301 TI - Individualized outcome measures of internal change: methodological considerations. PMID- 3958302 TI - Zung, Beck, and Hamilton Rating Scales as measures of treatment outcome: a meta analytic comparison. PMID- 3958304 TI - Placebo controls in psychotherapy research: a sine qua non or a placebo for research problems? PMID- 3958303 TI - Generalizability of treatment studies utilizing solicited patients. PMID- 3958305 TI - Scientific and practical advantages of comparative design in psychotherapy outcome research. PMID- 3958307 TI - Learning the basics #2: Debulking the lesion before cryosurgery. PMID- 3958306 TI - Comparative outcome studies of psychotherapy: methodological issues and strategies. PMID- 3958308 TI - Bowenoid actinic keratoses. PMID- 3958309 TI - Sponge rubber surgery. PMID- 3958310 TI - Merkel cell carcinoma--a problem with microscopically controlled surgery. AB - Trabecular cell carcinoma, originally described by Toker, is a malignant skin tumor, probably of Merkel cell origin. These tumors are locally aggressive and may metastasize. Prompt surgical removal is mandatory. The clinical features are often not diagnostic, and diagnosis is primarily by histologic examination. Special studies, especially electron microscopy, may be required to differentiate this tumor from others. During surgery, particularly with Mohs microscopically controlled excision, provision must be made for proper handling of the specimen so that these special studies can be carried out. PMID- 3958311 TI - Superficial vessels after sclerotherapy. PMID- 3958312 TI - Effects of propoxur treatment on populations containing susceptible and resistant German cockroaches (Orthoptera: Blattellidae). PMID- 3958313 TI - Behavioral responses of the German cockroach, Blatella germanica (L.) (Orthoptera: Blatellidae), to a propoxur formulation. PMID- 3958314 TI - Distribution, seasonal abundance, and pest status of the oriental cockroach (Orthoptera: Blattidae) and an evaniid wasp (Hymenoptera: Evaniidae) in urban apartments. PMID- 3958315 TI - Masking effects on ABR waves I and V in infants and adults. AB - The effects of high- and low-pass masking on waves I and V of the auditory brain stem response (ABR) were measured in normal infants who were 2-4 weeks old, and in adults. The signal was a 4-kHz tone pip presented at 86 dB peak equivalent sound-pressure level (p.e.SPL). The masking patterns were different for latency and amplitude criteria, and were also different for infants and adults. The largest difference between infants and adults was seen in the wave I data. Low pass maskers were very disruptive of the infant wave I, while little or no effect was noted on the adult wave I. High-pass maskers were very disruptive of the adult wave I, while less of an effect was measured on the infant wave I. The wave V data were similar between groups. Cochlear regions which contribute most importantly to wave I extend up to one octave above the frequency of the signal in adults, and to one-half octave above the signal frequency in infants. The reasons for the differences found between infants and adults are uncertain. Two possible mechanisms which can explain these data are differences in peripheral auditory sensitivity, and differences in tuning characteristics of the auditory system. PMID- 3958316 TI - Absolute intensity discrimination using two responses. AB - The observer was asked to judge whether a comparison sound was more or less intense than a standard sound of 60 dB SPL. The sounds were broadband noises of 100-ms duration. The independent variables were the range of intensities used in the set of comparison sounds and the presence or absence of feedback. The main dependent variable was the variability of such judgments, which was measured from the psychometric function. The variability, measured in terms of the Weber function, increased from about 1.5 to 4 dB when the stimulus range changed from 10 to 60 dB. Increases in stimulus range increased the variability of the binary judgments in this task, as they had in previous experiments where multiple responses were required. Feedback improved performance primarily at the largest ranges. Only a small fraction of these changes in variability stems from sequential effects. PMID- 3958317 TI - Age categorization of high-frequency auditory threshold data. AB - This article presents high-frequency (8- to 20-kHz) auditory threshold measurements for 157 subjects with normal conventional hearing, ranging in age from 6-30 years. Normative descriptive data are provided in five semidecade age categories. Intra-age category mean and variance values for threshold sensitivity and interaural threshold differences are included. Generally, the data are consistent with the expectation of a gradual diminution of high-frequency sensitivity through the adolescent and early adult years. Several unresolved issues related to high-frequency normative data and clinical applicability of high-frequency threshold measurements are discussed. PMID- 3958319 TI - The effect of across-frequency differences in masking level on spectro-temporal pattern analysis. AB - Masking noise well separated in frequency from the signal may improve the detectability of the signal if the masking noise is modulated. This effect is referred to as co-modulation masking release (CMR). The present experiments examine the effect of across-frequency differences in masking noise level on CMR. Three experiments were performed, each using a different method to create modulated noise stimuli having across-frequency differences in the spectrum level. All stimulation was monaural. Experiment I used a notched noise method (selectively reducing the level for the critical band centered on the signal). Experiment II used a method in which the level of a 100-Hz-wide masker centered on the signal was varied, and flanking noise bands were of constant level. Experiment III used a method in which flanking noise bands were varied in level, and the 100-Hz-wide masker centered on the signal was of constant level. The signal was a 1000-Hz, 300-ms pure tone. The CMR effect was negated by small spectral notches centered on the signal (experiment I). However, CMR proved to be relatively robust to across-frequency level differences in experiments II and III (a CMR effect occurred for across-frequency differences in spectrum level as great as 20 dB). Low CMR's obtained in experiment I were probably due to relatively poor correlation of across-frequency modulation pattern which occurred with notched noise. The results of experiments II and III suggest that the fluctuation pattern is of primary importance in providing release from masking, and that information on absolute levels, coded across frequency, is of less importance. PMID- 3958318 TI - On the relations of intensity jnd's to loudness and neural noise. AB - It is shown experimentally that, in contradiction of the fundamental concept of Fechner's law, the intensity jnd for auditory sinusoidal signals follows loudness, rather than its derivative with respect to sound intensity. The evidence is obtained by comparing the jnd's of a population with normal hearing to those of a population with hearing loss accompanied by loudness recruitment. Although the recruitment increases the slope of the loudness function, the jnd's of both populations were found to be practically equal when the loudness were equal. The phenomenon is accounted for mathematically by assuming that psychophysically relevant neural noise depends not only on the magnitude of loudness, but also on its derivative with respect to sound intensity. A related derivation accounts for the near miss to Weber's law. PMID- 3958320 TI - The role of frequency versus informational cues in uncertain frequency detection. AB - The role of frequency and informational cues in the detection of tones of uncertain frequency was investigated using the probe-signal method [G.Z. Greenberg and W.D. Larkin, J. Acoust. Soc. Am. 44, 1513-1523 (1968)] with auditory and visual test patterns. Patterns consisted of a sequence of events, either tones or visual stimuli, preceding the tone to be detected. Both frequency and informational cues were available in the auditory patterns, whereas only informational cues were available in the visual patterns. Results indicated that observers in the auditory condition displayed trial-by-trial selective attention to one or another frequency band as a function of the cues provided by earlier pattern components. In contrast, listeners in the visual condition displayed simultaneous attention to the two separate frequency bands that could possibly contain the tone, regardless of the information provided by the cues. Results are discussed in terms of single- and multiple-band models of attention. PMID- 3958321 TI - Level discrimination of tones as a function of duration. AB - Difference limens for level [delta Ls (dB) = 20 log[p + delta p)/p), where p is the pressure] were measured as a function of duration for tones at 250, 500, and 8000 Hz. Stimulus durations ranged from 2 ms to 2 s, and the stimulus power was held constant. Rise and fall times were 1 ms. The interstimulus interval was 250 ms. At each frequency, three levels were tested: 85, 65, and approximately 40 dB SPL. An adaptive two-alternative forced-choice procedure with feedback was used. For three normal listeners, delta Ls decreased as duration increased, up to at least 2 s, except at 250 Hz. At 250 Hz, delta L stopped decreasing at durations between 0.5 and 1 s. In a double logarithmic plot of delta L versus duration, the rate of decrease is generally well fitted by a sloping line. The average slope is -0.28; it is steeper at high levels than at low levels. Because the average slope is shallower than the -0.5 slope predicted for an optimum detector, it may be that fast adaptation of auditory-nerve activity and/or memory effects interfere with level discrimination of long-duration tones. Finally, the delta Ls at 8 kHz decreased nonmonotonically with increasing level. PMID- 3958323 TI - Spatial mapping of intracranial auditory events for various degrees of interaural coherence. AB - The broadening and splitting of auditory events in dichotic listening conditions with various degrees of interaural coherence are discussed. By using a psychoacoustical mapping method, it has been possible to observe broadening and splitting for a wide range of stimuli, including broadband pink noise as well as bandpass noises with different relative bandwidths and center frequencies. The spatial extents of the auditory events decrease with increasing center frequencies for bandpass stimuli of constant relative bandwidth. The number of partial events for bandpass stimuli decreases with increasing degrees of interaural coherence. These results are, for example, of interest with respect to auditory spaciousness in architectural acoustics. PMID- 3958322 TI - Psychometric functions for frequency discrimination from listeners with sensorineural hearing loss. AB - Psychometric functions for pulsed pure-tone frequency discrimination were obtained from hearing-impaired listeners at frequencies with normal hearing and at frequencies with mild or moderate hearing losses. The general form of psychometric functions at hearing-impaired frequencies was found to be the same as at normal-hearing frequencies, i.e.,d' was linear with the frequency difference between tones, in Hz. For all but one psychometric function, the addition of an intercept term to the fitting equation did not account for significantly more variance than did the slope term alone. Therefore, it was concluded that psychometric functions for frequency discrimination can be adequately described with only one parameter: the slope of the psychometric function. Deficits in discrimination at hearing-loss frequencies were manifested by more gradual slopes of psychometric functions. Procedures for normalizing psychometric functions are presented, which facilitate comparisons of normal and impaired frequency discrimination data across studies and frequencies. Comparisons of dlf's (difference limen for frequency) obtained with adaptive and fixed procedures show a bias toward larger dlf's with adaptive procedures, but only at higher frequencies. A discussion of equal-interval and equal-ratio adaptive stepping rules indicates that an equal-ratio rule may be preferable. PMID- 3958324 TI - Perception of syllable timing by prebabbling infants. AB - Adults hear alternating syllables with isochronous syllable onset-onset times as having a long-short, alternating rhythm when the syllables differ in initial consonant. This occurs because adults attend to syllable-internal events, called the "P centers" or "stress beats", rather than to syllable onsets. Thus they report that stress-beat aligned speech is isochronous and stress-beat aligned clicks are synchronized with the speech. The question asked here is whether, like adults, infants attend to the timing of syllable stress beats. In experiment 1, infants showed differences in time to habituate to sequences of alternating monosyllables, [bad] and [strad], having two different onset-onset times (onset- and stress-beat-timed) and two different placements of clicks on the syllables (on syllable onsets and on stress beats). Infants habituated more slowly to sequences with clicks on the stress beats than to sequences with clicks on syllable onsets and most slowly of all to stress-beat-timed speech with clicks on the stress beats. To interpret these findings, a second experiment was run using sequences only of the syllable [strad] so that speech timing measured according to onsets and stress beats was the same. Syllables had isochronous timing or a long-short alternating rhythm, corresponding to two possible ways of hearing the stress-beat-timed speech of experiment 1. In addition, two patterns of click placement were compared, uniform and syncopated, corresponding to two ways of hearing the stress-beat aligned clicks of experiment 1. The patterns of sucking times in the two experiments match exactly if stress-beat aligned speech in experiment 1 is identified with the isochronous speech of experiment 2 and the stress-beat aligned clicks of experiment 1 match with the uniformly timed clicks of experiment 2. It is inferred from this correspondence that infants perceive stress beats and stress-beat timing of syllables as adults do. PMID- 3958325 TI - Discrete representation of perceptual structure underlying consonant confusions. AB - The perceptual representation of speech is generally assumed to be discrete rather than continuous, pointing to the need for general discrete analytic models to represent observed perceptual similarities among speech sounds. The INDCLUS (INdividual Differences CLUStering) model and algorithm [J.D. Carroll and P. Arabie, Psychometrika 48, 157-169 (1983)] can provide this generality, representing symmetric three-way similarity data (stimuli X stimuli X conditions) as an additive combination of overlapping, and generally not hierarchial, clusters whose weights (which are numerical values gauging the importance of the clusters) vary both as a function of the cluster and condition being considered. INDCLUS was used to obtain a discrete representation of underlying perceptual structure in the Miller and Nicely consonant confusion data [G.A. Miller and P.E. Nicely, J. Acoust. Soc. Am. 27, 338-352 (1955)]. A 14-cluster solution accounted for 82.9% of total variance across the 17 listening conditions. The cluster composition and the variations in cluster weights as a function of stimulus degradation were interpreted in terms of the common and unique perceptual attributes of the consonants within each cluster. Low-pass filtering and noise masking selectively degraded unique attributes, especially the cues for place of articulation, while high-pass filtering degraded both unique and common attributes. The clustering results revealed that perceptual similarities among consonants are accurately modeled by additive combinations of their specific and discrete acoustic attributes whose weights are determined by the nature of the stimulus degradation. PMID- 3958326 TI - Mistuning a harmonic of a vowel: grouping and phase effects on vowel quality. AB - The harmonic sieve has been proposed as a mechanism for excluding extraneous frequency components from the estimate of the pitch of a complex sound. The experiments reported here examine whether a harmonic sieve could also determine whether a particular harmonic contributes to the phonetic quality of a vowel. Mistuning a harmonic in the first formant region of vowels from an /I/-/e/ continuum gave shifts in the phoneme boundary that could be explained by (i) phase effects for small amounts of mistuning and (ii) a harmonic sievelike grouping mechanism for larger amounts of mistuning. Similar grouping criteria to those suggested for pitch may operate for the determination of first formant frequency in voiced speech. PMID- 3958327 TI - Spectral analysis of sung vowels. III. Characteristics of singers and modes of singing. AB - The 1/3-oct spectra of nine different vowels, sung by 14 professional male and female singers in nine different modes of singing, were analyzed to reveal spectral characteristics of individual singers and modes of singing. The main spectral differences between singers could be described in two dimensions characterizing, respectively, differences among male and among female singers. Spectral characteristics of these dimensions suggested that interindividual differences among males, like the average difference between males and females, arise mainly from differences in vocal tract dimensions, whereas interindividual differences among females may have a glottal basis. The spectral characteristics of the modes of singing could be represented for each vowel in two dimensions. Differences among the soft (pianissimo), light, neutral, free, straight, extra vibrato, and loud (fortissimo) modes were mainly due to the spectral effect of vocal effort, which constituted a very dominant first spectral dimension. This dimension essentially reflected the slope of the spectrum. The second dimension mainly described the spectral differences between the dark and pressed modes of singing. A possible explanation of the results in terms of glottal and supraglottal morphological variation is discussed. PMID- 3958328 TI - Assessment of site-specific environmental problems. PMID- 3958329 TI - Indoor air quality in cold climates: hazards and abatement measures. Summary of an APCA international specialty conference. PMID- 3958330 TI - Effects of peroxyacetyl nitrate alone and in combination with ozone in healthy young women. PMID- 3958331 TI - Acute thrombotic obstruction with disc valve prostheses: diagnostic considerations and fibrinolytic treatment. AB - Twenty-six patients presenting with 28 instances of massive acute thrombotic obstruction of a prosthetic valve (16 mitral, 12 aortic) were treated with fibrinolytic agents. In 15 cases the patient presented with acute pulmonary edema and low cardiac output, in 10 with congestive heart failure and embolism and in 3 with peripheral embolism only. The diagnosis of thrombotic obstruction was made by echocardiography or cineradiography, in patients in whom the disc was immobile or barely moving; cineangiography was necessary in only four patients. The fibrinolytic agents administered were streptokinase, 2,000,000 U for 10 hours (14 cases), urokinase, 4,500 U/kg per h for 12 hours (7 cases), or the two agents successively (7 cases). Fibrinolysis was entirely successful in 19 patients: 18 are alive and well without surgical intervention after follow-up of 6 to 64 months and 1 patient had surgical revision after fibrinolysis. In two patients, fibrinolytic treatment was apparently successful but obstruction recurred 4 and 19 months later, respectively, and the patients were again treated by fibrinolysis. In two patients complete failure of fibrinolytic treatment led to emergency surgery, and in three patients improvement was incomplete and death occurred shortly after treatment. No hemorrhagic complications were observed, but there were five cases of embolism during the fibrinolytic treatment. Fibrinolytic treatment would seem to be an attractive, nonsurgical alternative for the thrombosis of a valve prosthesis but, because of the risk of embolism with possible permanent damage, its use should be reserved for critically ill patients who are too sick to undergo immediate surgery. PMID- 3958332 TI - Factors influencing survival after out-of-hospital cardiac arrest. AB - Survival to hospital discharge was related to the clinical history and emergency care system factors in 285 patients with witnessed cardiac arrest due to ventricular fibrillation. Only the emergency care factors were associated with differences in outcome. Both the period from collapse until initiation of basic life support and the duration of basic life support before delivery of the first defibrillatory shock were shorter in patients who survived compared with those who died (3.6 +/- 2.5 versus 6.1 +/- 3.3 minutes and 4.3 +/- 3.3 versus 7.3 +/- 4.2 minutes; p less than 0.05). A linear regression model based on emergency response times for 942 patients discovered in ventricular fibrillation was used to estimate expected survival rates if the first-responding rescuers, in addition to paramedics, had been equipped and trained to defibrillate. Expected survival rates were higher with early defibrillation (38 +/- 3%; 95% confidence limits) than the observed rate (28 +/- 3%). Because outcome from cardiac arrest is primarily influenced by delays in providing cardiopulmonary resuscitation and defibrillation, factors affecting response time should be carefully examined by all emergency care systems. PMID- 3958333 TI - Pathophysiologic relevance of neurohumoral measurements in chronic heart failure. PMID- 3958334 TI - Diastolic mitral regurgitation in patients with atrioventricular conduction abnormalities: a common finding by Doppler echocardiography. AB - M-mode and Doppler echocardiography were performed in 16 patients with first degree atrioventricular (AV) block, 1 patient with second degree (Wenckebach type) and 3 patients with third degree AV block; 20 individuals with a normal PR interval served as control subjects. The time from the onset of the P wave to the mitral valve closure by M-mode and to the end of mitral flow by Doppler echocardiography were obtained. In 20 normal subjects, the P wave to mitral valve closure interval measured 220 +/- 30 ms by M-mode and to the end of mitral flow 225 +/- 29 ms by Doppler technique (p = NS). In patients with first degree AV block, these intervals measured 242 +/- 41 and 249 +/- 36 ms, respectively (p = NS). Late diastolic (before the onset of the QRS complex) mitral regurgitation was detected by pulsed mode Doppler imaging in 9 (56%) of the 16 patients with first degree AV block but in none with a normal PR interval. In the four patients with advanced AV block, intermittent mid or late diastolic mitral regurgitation was found to depend on the position of the P wave in diastole. With early diastolic P waves, the end of mitral valve flow by Doppler technique occurred 230 to 250 ms after the onset of the P wave and was followed by mild diastolic mitral regurgitation of variable duration. With P waves falling in systole, the mitral valve remained open throughout diastole; during most of diastole, however, there was neither forward mitral flow (diastasis) nor diastolic mitral regurgitation detected by Doppler technique.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958335 TI - Detection of skeletal muscle hypoperfusion during exercise using phosphorus-31 nuclear magnetic resonance spectroscopy. AB - Blood flow to working skeletal muscle is frequently reduced in patients with heart failure or peripheral vascular disease. To determine if phosphorus nuclear magnetic resonance (NMR) can noninvasively detect such muscle underperfusion, gated phosphorus-31 NMR spectroscopy was used to compare muscle inorganic phosphate, phosphocreatine and pH during mild wrist flexion exercise at 0.2, 0.4 and 0.6 W in eight normal men, before and after reduction of forearm blood flow. Forearm flow was reduced by cuff inflation to a pressure determined by Doppler ultrasound to bring flow to 40 to 60% of control. Attention was focused on the inorganic phosphate to phosphocreatine (Pi/PCr) ratio and pH, two variables potentially sensitive to muscle oxygen delivery. At rest with normal flow, Pi/PCr averaged 0.12 +/- 0.03 and pH averaged 7.02 +/- 0.04. Exercise produced a progressive increase in Pi/PCr (0.2 W = 0.43 +/- 0.12; 0.4 W = 0.75 +/- 0.31; 0.6 W = 1.04 +/- 0.47) and a modest decrease in pH (0.2 W = 6.94 +/- 0.04; 0.4 W = 6.86 +/- 0.18; 0.6 W = 6.85 +/- 0.06). Flow reduction had no effect on Pi/PCr or pH at rest. In contrast, flow reduction during exercise was associated with higher Pi/PCr at all three work loads (0.2 W = 0.60 +/- 0.27; 0.4 W = 0.99 +/- 0.50; 0.6 W = 2.00 +/- 1.26 [all p less than 0.05 versus normal flow]) and lower pH (0.2 W = 6.78 +/- 0.12; 0.4 W = 6.69 +/- 0.23; 0.6 W = 6.65 +/- 0.30 [p less than 0.01 versus normal flow at 0.2 and 0.4 W; p = 0.05 at 0.6 W]).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958336 TI - Instantaneous pressure gradient: a simultaneous Doppler and dual catheter correlative study. AB - To more precisely measure the beat to beat and instantaneous pressure gradients across outflow stenotic lesions, simultaneous Doppler and dual catheter pressure gradient measurements were performed in 95 patients (mean age 42 years, range 1.5 to 85). There were 38 right ventricular and 62 left ventricular outflow obstructive lesions. Forty-nine patients also had a nonsimultaneous Doppler study performed within 7 days before catheterization. The simultaneous pressure waveforms and Doppler spectral velocity profiles were digitized at 10 ms intervals deriving maximal, mean and instantaneous gradients (mm Hg). For simultaneous maximal Doppler and catheter gradient measurements, the correlation coefficient (r) was 0.95 (SEE = 10 mm Hg), for Doppler and catheter mean gradients it was 0.94 (SEE = 8 mm Hg) and for maximal Doppler and peak to peak catheter gradients it was 0.92 (SEE = 13 mm Hg). The correlation of maximal and mean Doppler gradients with the respective catheter gradients was similarly high when the right and left ventricular outflow lesions were analyzed separately. However, the maximal Doppler gradient was significantly higher than the peak to peak catheter gradient. This was more evident with left ventricular outflow stenotic lesions. The correlation of the outpatient maximal Doppler and catheter gradients (r = 0.80, SEE = 17 mm Hg) was significantly lower than the simultaneous correlation (r = 0.96, SEE = 10 mm Hg) in the 49 patients with two Doppler studies. Continuous wave Doppler echocardiography accurately measures the instantaneous pressure gradient across both left and right ventricular outflow obstructive lesions. The maximal Doppler gradient should not be equated with the peak to peak catheter gradient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958337 TI - Prospective evaluation of the left main coronary artery using digital two dimensional echocardiography. AB - Recent clinical studies emphasize the importance of identification of patients with left main coronary artery obstruction. Although two-dimensional echocardiography can detect left main coronary artery disease, the technique requires frame by frame analysis, as no single frame provides all the necessary information. To determine if newly available computer-based digital processing techniques could overcome some of these technical difficulties, 119 consecutive patients were prospectively evaluated with two-dimensional echocardiography before coronary angiography. A continuous loop recording of the left main coronary artery was recorded as it passed through the ultrasonic beam in the short-axis view. Starting at a point when the vessel was first visualized, the ensuing eight consecutive fields, each 17 ms apart, were captured in digital format, thus providing a series of parallel, sequential, longitudinal slices of the left main coronary artery as it traversed the imaging plane. This was successfully accomplished in 100 (84%) of the 119 consecutive patients. By angiography, 16 patients (16%) had greater than 50% narrowing of the left main coronary artery. Digital echocardiography correctly identified 15 of these 16 patients (94% sensitivity) and accurately localized the lesion in 12 (80%) of 15. Of 84 patients without significant left main coronary artery obstruction, digital echocardiography correctly identified 78 (93% specificity). It was concluded that computer-based digital processing techniques can be applied to two-dimensional echocardiography to allow reliable visualization of the left main coronary artery. The technique provides more information than a single still frame and allows accurate noninvasive detection and possible localization of left main coronary artery lesions. PMID- 3958338 TI - In vivo validation of the origin of the esophageal electrocardiogram. AB - Esophageal electrocardiography is a clinical and investigational technique that is useful for determining atrial conduction intervals, analyzing atrial rhythms and mapping conduction pathways. Although the left atrial origin of the esophageal electrocardiogram has long been implied, recently that origin has been questioned. In the present study, the origin of the esophageal deflection is defined by direct right and left atrial mapping studies performed with simultaneous esophageal electrograms obtained from three positions (high, mid and low). Seven patients with normal left atrial dimensions (group I) and five patients with left atrial enlargement (group II) underwent transseptal catheterization during the course of electrophysiologic study. In group I (normal left atrial dimensions), conduction time from the high right atrium to each of the three esophageal positions corresponded to conduction times to left atrial sites ranging from 1 to 3 cm lateral to the left interatrial septum. The mid- and low esophageal conduction times were all significantly longer than conduction time to the left side of the septum (p less than 0.05). In group II (enlarged left atrium), conduction times to each of the esophageal sites corresponded to conduction times to left atrial sites lying between the mid-left atrium and a point 1 cm lateral to the left side of the septum. A significant trend toward longer conduction time to the mid-esophageal position than to the left septum was noted (p less than 0.1). In both groups, conduction times measured with the esophageal catheter were significantly longer than conduction time to the right interatrial septum (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958340 TI - Inducibility and reproducibility of ventricular arrhythmias: therapeutic implications. PMID- 3958339 TI - Reproducibility of arrhythmia induction with intracardiac electrophysiologic testing: patients with clinical sustained ventricular tachyarrhythmias. AB - In order to characterize the day to day reproducibility of arrhythmias provoked during electrophysiologic stimulation, 114 patients with documented sustained clinical ventricular tachyarrhythmias were studied. Two baseline electrophysiologic tests were performed in the drug-free state and within 6 to 24 hours of one another. There was a significant increment (p less than or equal to 0.02) in the induction of sustained ventricular tachyarrhythmias as the number of programmed extrastimuli increased from one (10% induction) to four (64% induction). Provoked arrhythmias were observed to be more frequently nonreproducible (as reflected in a major change in rate or duration, or both, of an induced ventricular arrhythmia between baseline tests) as the number of extrastimuli increased from one (7%) to four (27%). Nonreproducibility with three and four extrastimuli was not significantly greater than when two extrastimuli were utilized. Electrophysiology-directed drug trials should be interpreted in light of this observed variability in induced arrhythmias. PMID- 3958341 TI - Cellular electrophysiologic changes and "arrhythmias" during experimental ischemia and reperfusion in isolated cat ventricular myocardium. AB - The cellular electrophysiologic consequences of both regional and global experimental ischemia and reperfusion were studied in the isolated cat myocardium, using conventional microelectrode techniques. Oxygenated Tyrode's solution was perfused through the left anterior descending and circumflex coronary arteries, while the preparation was superfused with Tyrode's solution gassed with 95% nitrogen and 5% carbon dioxide. Electrophysiologic characteristics of endocardial muscle cells were normal during coronary perfusion. When perfusion was discontinued for 30 minutes, resting membrane potential was decreased by 21.6 +/- 4.1%, action potential amplitude was decreased by 29.1 +/- 8.6% and action potential duration was decreased by 54.1 +/ 12.5% (p less than 0.001). Ectopic activity occurred after 5 to 10 minutes of ischemia and was more frequent in regional than in global ischemia (p less than 0.05). Rapid ventricular activity was observed in only 5 (17%) of 29 preparations during ischemia, whereas it occurred in 24 (83%) of 29 preparations during reperfusion. Rapid ventricular activity began 5 to 40 seconds (mean 19) after the start of reperfusion, stopped spontaneously after a mean of 113 +/- 211 seconds and occurred after both regional and global ischemia. The cellular electrophysiologic changes induced by ischemia returned to baseline values within the next 5 minutes. Repeated ischemia and reperfusion runs reproduced the same electrophysiologic changes and rapid ventricular activity. Coronary perfusion with procainamide (20 mg/liter) aggravated the ischemic depressions of action potential amplitude and action potential duration and increased conduction delay during ischemia, but it did not prevent rapid ventricular activity induced by reperfusion. In contrast, verapamil (1 mg/liter) perfusion did not affect the changes in action potential variables during ischemia but prevented reperfusion induced rapid ventricular activity. Perfusion with calcium ion (Ca2+)-free Tyrode's solution just before ischemia and during reperfusion slowed or prevented reperfusion-induced rapid ventricular activity, without affecting the action potential changes during ischemia. It is concluded that, in these isolated perfused ventricular muscle preparations, different mechanisms may be operative in ischemic and reperfusion arrhythmias and Ca2+ may play an important role in the development of arrhythmias during the reperfusion phase of ischemia/reperfusion sequences. PMID- 3958342 TI - Serial imaging of canine myocardial infarction by in vivo nuclear magnetic resonance. AB - Anterior infarction was produced in eight dogs to characterize serial changes in nuclear magnetic resonance signal intensity within the infarct zone. Magnetic resonance imaging was done on the day of infarction, on day 4, 5 or 6, on day 13 and day 20 using a 0.15 tesla (6.25 MHz) resistive imager. Electrocardiographically triggered spin echo (30, 45 and 60 ms echo times) and inversion recovery (400 to 500 ms inversion time) pulse sequences were employed to obtain single slice images. On day 20, the excised hearts were sectioned and examined to determine infarct location and extent. In the spin echo images, signal intensity within the ischemic zone was visibly increased in seven of the eight dogs on the day of infarction, and in all dogs by days 4 to 6. Signal intensity remained elevated in all but two dogs at day 20. With inversion recovery imaging, changes in the infarct zone were highly variable; both ill defined increases and decreases in signal intensity were noted. With a 30 ms echo time, signal intensity in the infarct zone was increased on average 29.8 +/- 24.1% above that in normal myocardium on the day of infarction. The relative signal intensity increased to 62.4 +/- 23.5% during the first 2 weeks after infarction (p less than 0.05), then decreased to 12.0 +/- 18.5% by day 20 (p less than 0.05). Similar changes were detected in the images using the 45 and 60 ms echo times. Nuclear magnetic resonance imaging therefore is able to detect regions of myocardial infarction and follow evolutionary changes in signal intensity within the infarct zone with healing. PMID- 3958344 TI - Twenty-four hour survival in a canine model of cardiac arrest comparing three methods of manual cardiopulmonary resuscitation. AB - Two new modifications of manual cardiopulmonary resuscitation, high impulse compression at a rate of 120/min and interposed abdominal compression at a rate of 60/min, have been reported to produce better hemodynamic responses than standard cardiopulmonary resuscitation at 60/min. However, the effect of these two new methods on initial resuscitation success and 24 hour survival is unknown. In this study, 30 mongrel dogs were divided into three equal groups, each treated with one of three types of manual cardiopulmonary resuscitation. Ventricular fibrillation was induced electrically in morphinized, endotracheally intubated dogs emerging from halothane anesthesia. After 3 minutes of circulatory arrest without intervention, one of the three techniques of manual cardiopulmonary resuscitation was begun, and continued for 17 minutes. Defibrillation was performed at 20 minutes. Successful resuscitation was defined as a mean arterial blood pressure of at least 60 mm Hg, without chest compressions, 10 minutes after the initial defibrillation attempt. Intensive care was provided for 2 hours, including hemodynamic and respiratory monitoring, and drug intervention when required. Twenty-four hour survival and neurologic deficit were used as critical measures of outcome. Ten of 30 animals survived 24 hours with a mean neurologic deficit score of 5% (normal = 0, brain dead = 100). There was no difference in initial resuscitation success, 24 hour survival or neurologic deficit of the survivors among the three manual cardiopulmonary resuscitation methods. Aortic diastolic and calculated coronary perfusion pressures were similar for all three methods. Well performed standard manual cardiopulmonary resuscitation is as effective as these modified versions (high impulse compression and interposed abdominal compression) when compared in the same animal model. PMID- 3958343 TI - Inducible sustained ventricular tachycardia and ventricular fibrillation in conscious dogs with isolated right ventricular infarction: relation to infarct structure. AB - The susceptibility of infarcted right ventricular myocardium to inducible ventricular tachyarrhythmias was serially evaluated in 18 conscious dogs during the first 2 weeks after permanent right coronary artery occlusion. Properly timed double premature stimuli applied to the right ventricular outflow tract induced sustained (longer than 1 minute) ventricular tachycardia at rates of 190 to 400 beats/min in nine dogs, and ventricular fibrillation in six dogs. No ventricular arrhythmias could be induced in the remaining three dogs. The zone of premature coupling intervals within which ventricular tachyarrhythmias could be induced decreased in each dog as the infarct aged, and by day 12 after occlusion, no ventricular arrhythmias could be induced in any of the dogs studied. Both the size and the degree of patchiness (graded from 0 for no patchiness to +4 for patchiness throughout the infarct) of the infarct appear to be related to the nature of the induced rhythm. Infarcts with greater heterogeneity and those that were larger than 8% of the right ventricular volume were associated with a higher incidence of ventricular fibrillation, and infarcts with a lesser degree of patchiness were more suitable for sustained ventricular tachycardia (3.4 +/- 1.2 versus 1.4 +/- 0.4, p less than 0.05). These findings indicate that the infarcted right ventricular myocardium, independent of left ventricular involvement, can be associated with malignant ventricular tachyarrhythmias, ventricular tachyarrhythmias can be induced only during a well defined postinfarction period; and both the size and geometry of the right ventricular infarct determine the nature of the induced ventricular rhythm. PMID- 3958346 TI - Doppler echocardiographic estimation of systolic pulmonary artery pressure in patients with aortic-pulmonary shunts. AB - The objective of this study was to determine if the pressure drop across various types of aortic-pulmonary shunts could be accurately estimated by Doppler echocardiography, and if systolic pulmonary pressure could be estimated by referencing the pressure drop across the aortic-pulmonary shunt to systolic systemic arterial pressure measured by cuff sphygmomanometry. This was done in 22 patients and Doppler results were compared with pulmonary artery pressure measured directly by strain gauge manometry. Adequate Doppler waveforms were obtained in 21 of 22 patients; 3 had a Waterston shunt, 10 had a Blalock-Taussig shunt, 1 had a left pulmonary artery-aortic anastomosis, 6 had a patent ductus arteriosus and 1 had an aortic-pulmonary window. Systolic pulmonary artery pressure estimated by Doppler echocardiography ranged from 12 to 90 mm Hg (mean 41.3 +/- 21.4 [SD] ), and measured by strain gauge manometry ranged from 20 to 90 mm Hg (mean 44.7 +/- 20.7) (p = NS, r = 0.94, SEE = 7.4 mm Hg; slope = 0.90, y intercept = 7.4 mm Hg). Systolic pulmonary artery to aortic pressure ratios predicted by Doppler recording ranged from 0.1 to 1.0 (mean 0.4 +/- 0.2 [SD] ); when calculated from direct measurement it ranged from 0.2 to 1.0 (mean 0.4 +/- 0.2) (p = NS, r = 0.92; SEE = 0.08, slope = 0.80, y intercept = 0.09). This study demonstrates that Doppler echocardiography provides an estimation of pressure drop across aortic-pulmonary shunts, and that the data can be used to estimate systolic pulmonary artery pressure by subtracting the estimated pressure drop from the systolic systemic arterial pressure. PMID- 3958345 TI - Comparison of high pulse repetition frequency and continuous wave Doppler echocardiography for velocity measurement and gradient prediction in children with valvular and congenital heart disease. AB - To compare the ability of high pulse repetition frequency and continuous wave Doppler echocardiography to detect the peak velocity of a jet flow disturbance and to predict pressure gradients accurately, two groups of children with valvular or congenital heart disease were examined using both Doppler techniques. The use study group included 84 children or adolescents (aged 1 day to 19 years) who underwent examination in the echocardiography laboratory with both Doppler techniques in a randomized sequence. The peak velocity recorded with high pulse repetition frequency Doppler echocardiography was compared with the peak velocity recorded with the continuous wave technique. The accuracy study group included 41 children or adolescents (aged 1 day to 16 years) who underwent examination with both Doppler techniques at the time of cardiac catheterization. Doppler pressure gradients were calculated from the peak velocity using the simplified Bernoulli equation and were compared with peak instantaneous gradients and peak to peak gradients measured at catheterization. In the use study, a high correlation was found between peak velocities detected by high pulse repetition frequency and continuous wave Doppler echocardiography (r = 0.94, SEE = 0.28 m/s). In the accuracy study, close correlations were found between measured peak to peak pressure gradients and pressure gradients calculated from continuous wave (r = 0.95, SEE = 7.9 mm Hg) and high pulse repetition frequency Doppler echocardiography (r = 0.94, SEE = 8.7 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958347 TI - The optimal Doppler examination: pulsed, continuous wave or both? PMID- 3958348 TI - Doppler and two-dimensional echocardiographic observations of systolic anterior motion of the mitral valve in d-transposition of the great arteries: an explanation of the left ventricular outflow tract gradient. AB - Echocardiographic demonstration of systolic anterior motion of the mitral valve was seen in a 17 year old patient after the Mustard operation for d-transposition of the great arteries with intact ventricular septum. An increased flow velocity was measured by continuous wave Doppler echocardiography in the left ventricular outflow tract corresponding to an estimated peak gradient of 46 mm Hg. The presence of such a gradient had been shown earlier by the postoperative cardiac catheterization. PMID- 3958349 TI - Mucocutaneous lymph node syndrome (Kawasaki disease): delayed aortic and mitral insufficiency secondary to active valvulitis. AB - A 2 8/12 year old girl with acute mucocutaneous lymph node syndrome (Kawasaki disease), presented 17 months later with a new onset of mitral and aortic insufficiency. Congestive heart failure rapidly developed and double valve replacement was performed. Pathologic study of the excised valve tissue disclosed active valvulitis. This is the first report of late onset aortic and mitral valvulitis associated with Kawasaki disease. PMID- 3958350 TI - A new model to study quantitative effects of laser angioplasty on human atherosclerotic plaque. AB - A new model for analyzing the major effects of the use of any laser angioplasty system is described. Changes in any of the six major determinants of effect (energy, duration, wavelength, medium, absorption, geometry) can be evaluated. In this report a neodymium: yttrium aluminum garnet (Nd:YAG) laser was used to make 408 laser exposures in vitro on segments of human cadaveric atherosclerotic aorta. Energy, medium (air, human blood, perfluorochemical and saline), geometry and duration were varied. The depth and width of the resultant plaque craters were measured. A large amount of exposure to exposure variability was found in all groups of experiments, even when conditions were held as constant as possible in this rigidly controlled laboratory setting. This variability is attributable to differences in energy absorption by the plaque. Changes in media and fiber optic tip to plaque distance also markedly altered exposure outcome. For example, the average depth of the hole created by a 15 W, 2 second blast with the fiber tip adjacent to the plaque in blood was 1.7 +/- 0.1 mm (n = 27), but the range was between 0.5 and 2.7 mm. Under the same conditions, except with the fiber tip 1 mm away from the plaque, the average hole depth was 0.4 +/- 0.1 mm (n = 12) and the range was 0.0 to 1.7 mm. The use of this model to analyze the major determinants of lasing effects in different laser angioplasty systems should help to select the best conditions for lasing and allow assessment of the variability of outcome. PMID- 3958351 TI - Comparative survival after permanent ventricular and dual chamber pacing for patients with chronic high degree atrioventricular block with and without preexistent congestive heart failure. AB - To determine whether survival after permanent ventricular demand (VVI) pacing differs from survival after permanent dual chamber (DVI or DDD) pacing in patients with chronic high degree atrioventricular (AV) block (Mobitz type II or trifascicular block), 132 patients who received a VVI pacemaker (Group 1) and 48 patients who received a DVI or DDD pacemaker (Group 2) were followed up for 1 to 5 years. There was no significant difference in sex distribution, mean age or incidence of coronary heart disease, hypertension, valvular heart disease, diabetes mellitus, stroke or renal failure between Groups 1 and 2. Overall, the predicted cumulative survival rate at 1, 3 and 5 years was 89, 76 and 73%, respectively, for Group 1 and 95, 82 and 70%, respectively, for Group 2. In patients with preexistent congestive heart failure, the predicted cumulative survival rate at 1, 3 and 5 years was 85, 66 and 47%, respectively, for Group 1 (n = 53) and 94, 81 and 69%, respectively, for Group 2 (n = 20). The 5 year predicted cumulative survival rate was significantly lower in Group 1 patients with preexistent congestive heart failure than in Group 2 patients with the same condition (p less than 0.02). There was no significant difference in 5 year cumulative survival rate between Groups 1 and 2 for patients without preexistent congestive heart failure. The results suggest that permanent dual chamber pacing enhances survival to a greater extent than does permanent ventricular demand pacing in patients with high degree AV block and preexistent congestive heart failure. PMID- 3958352 TI - Combined bipolar dual chamber pacing and automatic implantable cardioverter/defibrillator. AB - A 67 year old man with recurrent hypotensive ventricular tachycardia, amiodarone induced bradyarrhythmias and severe cardiac dysfunction underwent simultaneous implantation of an automatic cardioverter/defibrillator and bipolar atrioventricular (AV) pacemaker. The pacing electrodes were placed epicardially near the right atrial appendage and on the lateral right ventricular wall. The rate detector of the automatic defibrillator was placed epicardially on the posterobasal left ventricular wall. Effective bipolar AV pacing produced no false counting of the heart rate by the automatic cardioverter/defibrillator, and ventricular tachycardia properly inhibited the pacemaker. Long-term follow-up study confirmed the safety of this treatment. With proper precautions, bipolar AV pacing can be safely combined with an automatic cardioverter/defibrillator. PMID- 3958353 TI - Utility of ambulatory electrocardiographic monitoring for predicting recurrence of sustained ventricular tachyarrhythmias in patients receiving amiodarone. AB - The prognostic implications of changes in ventricular ectopic activity on serial 24 hour ambulatory electrocardiographic (Holter) recordings were prospectively evaluated in 107 patients with a history of sustained ventricular tachyarrhythmias treated with amiodarone for at least 30 days. Twenty-seven patients (25%) had insufficient ventricular ectopic activity (less than 10 ventricular premature complexes/h and no repetitive forms) on baseline Holter recordings for serial statistical analysis. In 53 (66%) of the remaining 80 patients, serial 24 hour Holter monitor recordings showed efficacy of treatment, defined as a 75% decrease in ventricular premature complexes, a 95% decrease in ventricular couplets and absence of ventricular tachycardia. During a mean follow up period of 14.2 +/- 9.9 months, 34 (32%) of the 107 patients had recurrence of a sustained ventricular tachyarrhythmia. Holter recording correctly predicted nine recurrences and correctly identified 37 patients who did not experience a recurrence. Holter efficacy failed to predict recurrence of a sustained ventricular tachyarrhythmia in 16 patients, and 18 patients remained free of recurrence despite failure to achieve Holter efficacy. The positive predictive value of Holter monitoring efficacy was 33% and the negative predictive value was 70%; however, these differences were not statistically significant by chi-square analysis. Similar results were obtained using Holter recordings performed relatively early in therapy (6 weeks and 4 months). Of the 27 patients without significant ventricular ectopic activity on the baseline Holter recording, 9 had an arrhythmia recurrence despite continued infrequent ventricular premature complexes and no repetitive forms on subsequent recordings. The recurrence rate in this group (33%) was similar to the overall recurrence rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958354 TI - Venous systolic thrill and murmur in the neck: a consequence of severe tricuspid insufficiency. AB - A palpable venous systolic thrill and murmur at the base of the neck are described as new physical findings in five patients with severe tricuspid regurgitation. In two of these patients, the tricuspid valve had been resected as treatment for infective endocarditis related to intravenous drug abuse. The third patient had severe chronic pulmonary disease with right heart failure. The fourth patient had a complex congenital defect in which the mitral valve served as the venous atrioventricular valve and was severely incompetent. The fifth patient suffered from long-standing rheumatic mitral and tricuspid disease with pulmonary hypertension 10 years after placement of a mitral prosthesis. From these observations, it is apparent that pulsatile retrograde flow in the cervical veins resulting from severe right-sided atrioventricular valve incompetence can produce a palpable systolic thrill and murmur at the base of the neck. PMID- 3958355 TI - Quantitation of shunting at the atrial level using rapid acquisition computed tomography with comparison with cardiac catheterization. AB - Contrast-enhanced rapid acquisition computed tomography was employed to quantitate intracardiac shunts in two adult patients. Contrast medium was injected through a median antecubital vein and data were accumulated using the R wave-triggered flow mode. Time-density curves from a region of interest were generated by a gamma variate fit method and areas under the curves were calculated. Comparisons of calculated left to right shunts (Cases 1 and 2) with results of computed tomography and right to left shunt (Case 2) with cardiac catheterization data resulted in close agreement. This is the first report of quantitation of intracardiac shunts at the atrial level in humans by rapid acquisition computed tomography. PMID- 3958356 TI - Echocardiographic demonstration of outlet strut fracture of a Bjork-Shiley mitral prosthesis. AB - Fracture of the outlet strut of the Bjork-Shiley mitral valve prosthesis has been recognized with increasing frequency, prompting recall of unimplanted valves manufactured before March 1982. Presenting dramatically with acute severe pulmonary edema and low cardiac output, strut fracture is frequently a fatal complication. This case report documents the first reported echocardiographic demonstration of occluder disc dislodgment secondary to outlet strut fracture with survival after emergency valve replacement. PMID- 3958357 TI - Successful medical therapy of mitral anular abscess complicating infective endocarditis. AB - A case of staphylococcal endocarditis with the echocardiographic findings of mitral anular abscess is described. The anular mass resolved after 9 weeks of antibiotic therapy. This case illustrates that perivalvular abscess complicating infective endocarditis may respond to medical therapy. PMID- 3958358 TI - Intracavitary electrode catheter cardioversion of atrial tachyarrhythmias in the dog. AB - This study examined factors determining efficacy of intracavitary cardioversion of atrial tachyarrhythmias in closed chest, anesthetized dogs with talc pericarditis. Electrode catheters were positioned transvenously with the cathode in the right atrial appendage. In Group 1 dogs (n = 6), three anode sites (superior and inferior venae cavae ostia and mid-right atrium) were tested with graded energy shocks to determine the lowest effective cardioversion energy at each anode position. In Group 2 dogs (n = 9), multiple cardioversion attempts with energy levels of 0.01 to 5.0 J were used to evaluate reproducibility of energy thresholds. In Group 3 dogs (n = 6) without talc-induced pericarditis, atrial pathologic study was done after five intracavitary shocks (0.5 or 5.0 J). In Group 1, cardioversion was achieved with 0.75 J or less with no significant difference in minimal effective cardioversion energies among the three anode positions tested. In Group 2, 98 (26%) of 372 cardioversion attempts were successful. Intra-animal minimal effective cardioversion energies varied widely, and timing of shocks relative to atrial electrograms did not influence efficacy. Complications were infrequent and included delayed sinus rhythm recovery, transient atrioventricular block and ventricular fibrillation. Ventricular fibrillation occurred in 9 (2.4%) of 372 shocks, and was associated with higher delivered energies (6 of 9 with greater than or equal to 1.0 J) and with shocks delivered 116 to 180 ms after onset of the QRS complex. In Group 3, two dogs had no histologic damage, three dogs had multiple small foci of subendocardial necrosis and in one dog these foci coalesced to involve half the atrial wall thickness. Thus, low energy cardioversion of atrial tachyarrhythmias is feasible using intracavitary electrodes. Synchronization of energy delivery to the QRS complex is important to minimize risk of ventricular fibrillation. PMID- 3958359 TI - Comparison of an implanted abdominal aortic counterpulsation device with the intraaortic balloon pump in a heart failure model. AB - The abdominal aortic counterpulsation device is a round pumping chamber with a valveless opening which is implanted retroperitoneally on the abdominal aorta. The Utah driver is connected to the device through an air conduit and is synchronized on the electrocardiographic signal to provide diastolic aortic augmentation. For comparison an intraaortic balloon was also driven by the Utah driver system. The abdominal aortic counterpulsation device (stroke volume = 30, 40 and 60 ml) and the intraaortic balloon pump (balloon volume = 20 ml) were tested in dogs with acute left ventricular failure. The abdominal aortic counterpulsation device was also tested in normal animals. In acute left ventricular failure the abdominal aortic counterpulsation device at a stroke volume of 30, 40 or 60 ml decreased left ventricular end-diastolic pressure by an average of 28.56 (p less than 0.001), 39.56 (p less than 0.001) and 44.14% (p less than 0.005), respectively; aortic end-diastolic pressure by 24.11 (p less than 0.001), 26.67 (p less than 0.001) and 19.57% (p less than 0.01); and aortic systolic pressure by 18.56 (p less than 0.002), 26.0 (p less than 0.001) and 22.43% (p less than 0.005). It increased cardiac index by 27.58 (p less than 0.02), 35.59 (p less than 0.005) and 43.42% (p less than 0.001) and it provided peak aortic diastolic augmentation of 64.5 (p less than 0.001), 69.78 (p less than 0.001) and 74.43% (p less than 0.001), respectively, above the control aortic end-diastolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958360 TI - Disparity of reperfusion arrhythmias after reversible myocardial ischemia in open chest and conscious dogs. AB - Myocardial reperfusion after brief, reversible ischemia is frequently associated with malignant arrhythmias in experimental animals. These observations have been extrapolated to humans despite being restricted to anesthetized, open chest preparations. No data are available regarding the incidence of reperfusion arrhythmias after reversible (less than 20 minutes) ischemia in the conscious state. Thus, reperfusion arrhythmias after a 15 minute occlusion of the left anterior descending coronary artery were compared in 24 open chest dogs (17 anesthetized with pentobarbital and 7 with chloralose plus urethane) and 25 conscious, unsedated, trained dogs. The incidence of all rhythm disorders (single premature ventricular complexes, pairs, ventricular tachycardia and fibrillation) was markedly and significantly lower in conscious than in either pentobarbital- or chloralose-anesthetized dogs. The disparity was not accounted for by differences in coronary collateral flow, coronary reactive hyperemia or occluded bed size. The conscious animals, however, exhibited lower heart rates and arterial pressures during reperfusion than did the open chest dogs, suggesting a lower level of adrenergic stimulation, which might have contributed to the reduced incidence of reperfusion arrhythmias. Coronary reperfusion after 15 minutes of occlusion is unlikely to precipitate ventricular tachyarrhythmias in the conscious, trained dog, even after severe ischemia. The occurrence of these rhythm disorders in anesthetized models may reflect the influence of surgical trauma or excessive adrenergic activity, or both. Reperfusion arrhythmias after reversible ischemia may be considerably less common in the clinical setting than previously postulated on the basis of open chest animal experiments. PMID- 3958361 TI - Regional myocardial blood flow in experimental myocardial infarction after pretreatment with aspirin. AB - The effects of aspirin on myocardial blood flow in an area of ischemia were studied in 12 baboons. In each, a diagonal branch of the left anterior descending coronary artery was ligated. Six of the baboons received aspirin (2 X 600 mg orally, 12 hours and 1 hour before ligation); the other six did not receive aspirin and served as a control group. The extent of myocardial ischemia was delineated with an electrode wire grid on the surface of the anterior left ventricular wall. The maximal area circumscribed by electrodes with 2 mV or more ST segment elevation was compared with the area of reduced myocardial blood flow. Myocardial blood flow was measured with the radioactive microspheres method using strontium-85-labeled carbonized spheres. Two areas of reduced myocardial blood flow were noted, one with severely reduced flow in the center of the myocardial infarct (0 to 49% of noninfarcted myocardium) and another with mild to moderately reduced myocardial blood flow at the border of the myocardial infarct (50 to 90% of noninfarcted myocardium). Myocardial blood flow in the border area (margins of ST elevation area) for the total wall was 85 +/- 8% of normal in the aspirin treated animals and 40 +/- 4% in the control group (p less than 0.01); for the epicardium it was 67 +/- 10% of normal in noninfarcted myocardium after aspirin and 37 +/- 5% for the control group (p less than 0.05); and for the endocardium it was 78 +/- 8% of normal in noninfarcted myocardium after aspirin and 39 +/- 6% in the control group (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958362 TI - Etiology of pure tricuspid regurgitation based on anular circumference and leaflet area: analysis of 45 necropsy patients with clinical and morphologic evidence of pure tricuspid regurgitation. AB - Despite recent renewed interest in the detection of tricuspid valve regurgitation by echocardiographic and Doppler techniques, little morphologic information is available on dysfunctioning tricuspid valves. This report describes 45 necropsy patients with clinical and morphologic evidence of pure (no element of stenosis) tricuspid regurgitation and provides morphometric observations (anular circumference, leaflet area) of the tricuspid valve useful in determining the etiology of pure tricuspid regurgitation. Of 45 patients, 24 (53%) had pure tricuspid regurgitation resulting from an anatomically abnormal valve (prolapse in 7, papillary muscle dysfunction in 6, rheumatic disease in 5, Ebstein's anomaly in 3, infective endocarditis in 2, carcinoid tumor in 1), and 21 (47%) had an anatomically normal valve with systolic pulmonary artery hypertension (cor pulmonale in 12, mitral stenosis in 9). Anular circumference was dilated (greater than 12 cm) in patients with various causes of pulmonary hypertension, floppy valve and Ebstein's tricuspid anomaly. Leaflet area was increased in floppy valve and Ebstein's anomaly. Of the 45 patients, 24 had pulmonary systolic artery pressure measurements available for correlation with tricuspid valve morphology. Pulmonary artery pressures accurately predicted morphologically normal from abnormal valves in 16 patients (89%). Morphologic overlap occurred in six patients with pulmonary pressures of 41 to 54 mm Hg. Of these six, the additional knowledge of normal or dilated anular circumference correctly separated valves with normal and abnormal leaflets. PMID- 3958363 TI - The automatic implantable cardioverter-defibrillator: evaluating suspected inappropriate shocks. AB - Two patients who received inappropriate shocks from an implanted defibrillator are presented. In one case, fracture of a sensing lead was responsible and in the other case, sensing of both pacemaker stimuli and the evoked ventricular electrogram resulted in inappropriate shocks. In both cases, phonograms recorded over the generator area with a magnet in place revealed audible tones synchronous with each sensed event which allowed noninvasive documentation of a sensing problem. This procedure appears to be a valuable step both in the confirmation of sensing problems, including pacemaker-defibrillator interactions, and in evaluating suspected inappropriate shocks. PMID- 3958364 TI - Hemodynamic influences on sinus node recovery time: effects of autonomic blockade. AB - Ten patients with normal sinus node function were evaluated prospectively, to determine whether the decrease in blood pressure during rapid atrial pacing shortens the corrected sinus node recovery time. All patients had 30 seconds of atrial pacing at cycle lengths from 600 to 300 ms, with continuous arterial pressure monitoring, before and after intravenous administration of propranolol (0.2 mg/kg body weight) and atropine (0.04 mg/kg). In the control state, a decrease in corrected sinus node recovery time was recorded with faster atrial pacing rates, which was significantly related to the initial drop in systolic blood pressure at the onset of atrial pacing. Specifically, as the initial pressure drop increased from 15 mm Hg or less to 16 to 45 and 45 to 100 mm Hg, corrected sinus node recovery time decreased from 272 +/- 79 to 205 +/- 70 ms (p less than 0.04) and to 134 +/- 120 ms (p less than 0.04), respectively. In contrast, after autonomic blockade, the corrected sinus node recovery time was prolonged, in a near linear fashion, as atrial pacing rates increased. The magnitude of blood pressure drop with atrial pacing did not differ significantly from that in the control state at similar pacing rates. These findings suggest that hypotension during rapid atrial pacing activates autonomic reflexes that significantly shorten the corrected sinus node recovery time. Autonomic blockade negates this effect and the corrected sinus node recovery time prolongs with faster atrial pacing. PMID- 3958365 TI - Exercise tolerance and cardiorespiratory response to exercise after the Fontan operation for tricuspid atresia or functional single ventricle. AB - To determine the impact of the Fontan operation on exercise tolerance and on the cardiorespiratory response to exercise, we compared the results of graded exercise to maximal effort of 81 patients with tricuspid atresia or single functional ventricle studied preoperatively with those of 29 patients studied postoperatively. Postoperatively, the values for total work performed, duration of exercise and maximal oxygen uptake increased significantly. Regardless of operative status, the maximal heart rate during exercise was reduced. The cardiac output and stroke volume response to exercise were subnormal after operation. Systemic arterial blood oxygen saturation was reduced markedly preoperatively both at rest and during exercise; postoperatively, it was significantly greater than the preoperative value but it remained slightly abnormal. The ventilatory response to exercise (respiratory rate, minute ventilation and ventilatory equivalent for oxygen) decreased toward normal after operation. Exercise tolerance and the cardiorespiratory responses to exercise improve after the Fontan operation. Formal exercise testing is essential to quantitate the degree of improvement. PMID- 3958366 TI - Nuclear magnetic resonance imaging in evaluation and follow-up of children treated for coarctation of the aorta. AB - Electrocardiographic-gated nuclear magnetic resonance imaging was used to evaluate 10 patients, aged 2.5 to 18 years, with coarctation of the aorta. Six patients had balloon dilation angioplasty, one had surgical repair and three are awaiting treatment. Imaging studies were performed before and after therapy in three patients. In all pretreatment studies, the sagittal and 60 degrees left anterior oblique imaging planes adequately revealed the anatomy of the coarctation. Post-treatment imaging studies demonstrated effective relief of the coarctation in all cases. In three of the six patients who had balloon angioplasty, there was a variable degree of dilation of the aorta at the site of the previous coarctation. Nuclear magnetic resonance imaging is an effective noninvasive imaging method for visualizing coarctation of the aorta and for follow-up after treatment. PMID- 3958367 TI - Progressive obstruction of the foramen ovale in patients with left atrioventricular valve atresia. AB - Thirteen patients with left atrioventricular (AV) valve atresia and a normal aortic root were studied to evaluate the status of the interatrial communication with advancing age. Six patients had cardiac catheterization within the first 2 weeks of age; of these, five had repeat studies before 7 months of age. The seven other patients initially underwent catheterization after 2 weeks of age. In the group with catheterization before 2 weeks of age, the mean left atrial pressure was 7.8 +/- 5.5 mm Hg and the left atrial-right atrial mean pressure gradient was 1.7 +/- 2.4 mm Hg. In the combined group of patients with catheterization after 2 weeks of age, the mean left atrial pressure was 25.9 +/- 5.6 mm Hg and the mean left atrial-right atrial pressure gradient was 21.1 +/- 5.1 mm Hg. Seven of the 13 patients have survived and have now reached a median age of 6.5 years. Balloon atrial septostomy was adequate for long-term survival in one patient; all of the others have required surgical atrial septectomy. Progressive obstruction of the foramen ovale is part of the natural history of left AV valve atresia, and obstruction develops despite the absence of a left atrial-right atrial gradient during newborn study. Balloon atrial septostomy is recommended during the neonatal period in all patients with left AV valve atresia, even in the absence of an interatrial gradient. Because early surgical atrial septectomy is usually necessary for long-term survival, these patients should have serial noninvasive evaluation of the patency of the interatrial communication. PMID- 3958368 TI - Evaluation of pulmonary vascular resistance in the presence of a large pulmonary arteriovenous malformation. AB - A 1 day old infant presented with severe cyanosis and congestive heart failure. Cardiac catheterization confirmed the clinical suspicion of a pulmonary arteriovenous malformation of the right lower lobe. Catheter occlusion of the right lower pulmonary artery allowed evaluation of the integrity of the remaining pulmonary vascular bed as well as improvement of the patient's hemodynamic condition pending more definitive therapy. PMID- 3958369 TI - Systemic and coronary effects of intravenous milrinone and dobutamine in congestive heart failure. AB - The effects of dobutamine and intravenous milrinone on systemic hemodynamics, coronary blood flow and myocardial metabolism were studied in 11 patients with severe congestive heart failure. Although milrinone and dobutamine similarly increased cardiac index from 1.9 +/- 0.4 to 2.5 +/- 0.4 liters/min per m2 (p less than 0.001) and from 1.9 +/- 0.4 to 2.8 +/- 0.8 liters/min per m2 (p less than 0.001), respectively, milrinone decreased left ventricular end-diastolic pressure to a greater extent than dobutamine, that is, from 26 +/- 6 to 12 +/- 8 mm Hg (p less than 0.001) versus 26 +/- 8 to 20 +/- 8 mm Hg (p less than 0.001). In contrast to dobutamine, milrinone significantly reduced mean systemic arterial and right atrial pressures. Dobutamine increased the first derivative of left ventricular pressure (dP/dt) from 1,013 +/- 309 to 1,360 +/- 538 mm Hg/s (p less than 0.01) but milrinone did not. Similarly, blood flow and myocardial oxygen consumption were increased by dobutamine from 152 +/- 87 to 187 +/- 118 ml/min (p less than 0.05) and from 17.7 +/- 10.9 to 21.5 +/- 14.9 ml O2/min (p less than 0.05), respectively, but were unchanged by milrinone. Both drugs significantly decreased coronary vascular resistance and myocardial oxygen extraction but did not change myocardial lactate extraction. Thus, dobutamine and milrinone produce similar improvement in cardiac index. However, dobutamine increases myocardial oxygen consumption, whereas milrinone does not. This difference can probably be explained by the substantial vasodilating properties of milrinone. PMID- 3958370 TI - Comparative antiarrhythmic efficacy of verapamil, 17-monochloracetylajmaline, mexiletine and amiodarone in patients with severe chagasic myocarditis: relation with the underlying arrhythmogenic mechanisms. AB - The antiarrhythmic effects of verapamil, 17-monochloracetylajmaline, mexiletine and amiodarone were compared in 14 patients with chagasic myocarditis. Drugs and placebo were administered orally in the following order: placebo and verapamil, placebo and 17-monochloracetylajmaline, placebo and mexiletine (1 week each) and placebo and amiodarone (4 weeks each). A 24 hour ambulatory electrocardiographic recording was obtained after administration of each placebo and drug. Verapamil had no effect on the number of ventricular premature complexes, ventricular couplets and runs of ventricular tachycardia. 17-Monochloracetylajmaline did not reduce the number of ventricular premature complexes and ventricular couplets but caused a moderate reduction in runs of ventricular tachycardia. Mexiletine failed to significantly reduce ventricular premature complexes but caused a moderate decrease in both ventricular couplets and runs of ventricular tachycardia. Amiodarone was the only one of the four drugs that caused a substantial reduction of ventricular premature complexes (logarithmic mean 97.8%; p less than 0.001), total suppression of runs of ventricular tachycardia in 11 of 11 patients and suppression of ventricular couplets in 8 of 14 patients and a significant reduction in the remaining 6 patients. The much greater efficacy of amiodarone as compared with the two sodium channel modifiers (17-monochloracetylajmaline and mexiletine) and one calcium channel blocker (verapamil) suggests that its potent antiarrhythmic activity is probably related to other peculiar and still undefined electrophysiologic and pharmacologic properties. PMID- 3958371 TI - Flecainide and amiodarone interaction. AB - Oral amiodarone therapy was given to seven patients already taking oral flecainide regularly. In one additional patient, administration of flecainide was temporarily discontinued when amiodarone therapy was begun, and then resumed. Amiodarone produced a rise in mean dose-adjusted flecainide plasma level (trough plasma level at steady state/daily dose) from 2.3 +/- 0.8 to 3.4 +/- 0.9 (ng/ml)(mg/day) (p less than 0.01). Accordingly, the mean dose of flecainide required to maintain similar plasma levels of the drug was one-third lower during combined treatment than during therapy with flecainide alone. This drug interaction must be accounted for when amiodarone and flecainide are used concomitantly. PMID- 3958372 TI - Procainamide pharmacokinetics in patients with acute myocardial infarction or congestive heart failure. AB - Abnormal procainamide pharmacokinetics (prolonged half-life and decreased volume of distribution) and pharmacodynamics (decreased threshold for the suppression of premature ventricular complexes) have been suggested in patients with acute myocardial infarction or congestive heart failure, or both. To better define procainamide kinetics, 37 patients in the acute care setting received intravenous procainamide (25 mg/min, median dose 750 mg) with peak and hourly blood samples taken over 6 hours. Compared with the 10 control patients, the 12 patients with acute myocardial infarction and the 15 patients with congestive heart failure had normal procainamide pharmacokinetics with respect to half-life (2.3 +/- 1.0, 2.5 +/- 0.9 and 2.6 +/- 0.8 hours, respectively), volume of distribution (1.9 +/- 0.7, 1.8 +/- 0.4 and 1.8 +/- 0.5 liters/kg, respectively), clearance (11.3 +/- 7.5, 9.3 +/- 3.6 and 9.1 +/- 3.5 ml/min per kg, respectively) and unbound drug fraction (66 +/- 9, 66 +/- 9 and 69 +/- 4%, respectively). Low thresholds for greater than 85% premature ventricular complex suppression were confirmed in these patients (median 4.7 micrograms/ml in patients with acute myocardial infarction and 3.3 micrograms/ml in patients with congestive heart failure). Thus, differences in the response of premature ventricular complexes to procainamide reflect electropharmacologic differences dependent on clinical setting rather than pharmacokinetic abnormalities. Furthermore, the reduction of procainamide dosing in patients with acute myocardial infarction or congestive heart failure, based solely on prior kinetic data, may result in inappropriate antiarrhythmic therapy. PMID- 3958374 TI - Reversibility of long-standing left ventricular aneurysm predicted by thallium 201 imaging. AB - Stress thallium-201 perfusion scintigraphy was used to assess the reversibility of a long-standing left ventricular aneurysm. By identifying reversible ischemia, it was predicted that this patient's ventricular function would benefit significantly from surgical revascularization or percutaneous transluminal coronary angioplasty. PMID- 3958373 TI - Utility of echocardiography in the management of patients with penetrating missile wounds of the heart. AB - Nine consecutive patients with penetrating missile wounds of the heart were evaluated by M-mode and two-dimensional echocardiography for localization of retained missile fragments noted to be moving in synchrony with the heart by fluoroscopy. Echocardiography precisely located all 12 moving fragments: 2 in the pericardium, 5 in the anterior right ventricular wall, 3 in the free left ventricular wall, 1 in the interventricular septum and 1 in the right posterior atrioventricular groove. Five patients had echocardiographic evidence of pericardial effusion and only one manifested a wall motion abnormality, indicating that direct myocardial perforation does not always result in detectable intrapericardial bleeding or asynergy. Localization of the missile fragments to be in danger of endocardial perforation, in danger of eroding the right coronary artery and creating a clinically unsuspected membranous ventricular septal defect led directly to surgical intervention in three different patients. In all three, intraoperative echocardiography quickly localized the missile fragments and significantly reduced patient cardiopulmonary bypass time. In the remaining six patients, localization of missile fragments well within the myocardium with no danger of erosion led to decisions against surgical removal. PMID- 3958375 TI - Echocardiographic identification of an aortic valve ring abscess. AB - A valve ring abscess was diagnosed in four patients with a prosthetic aortic valve by identifying an echo-free space on two-dimensional echocardiography. Three of the patients presented with severe aortic regurgitation and congestive heart failure after an episode of endocarditis, but two of them did not have evidence of active endocarditis. The fourth patient had endocarditis, but no evidence of aortic regurgitation or heart failure. All four patients required valve replacement. Similar findings in all 11 previously reported cases suggest that a valve ring abscess can be diagnosed by two-dimensional echocardiography. It may be found without clinical evidence of endocarditis, in the absence of aortic regurgitation, without echocardiographically identifiable vegetations or during resolution of endocarditis. PMID- 3958376 TI - Intracardiac thrombus causing peritoneovenous shunt failure: detection by two dimensional echocardiography. AB - Peritoneovenous shunts have become an accepted mode of therapy for ascites refractory to medical treatment. However, their use is known to be associated with significant morbidity and mortality. Reported is the case of a patient with a Denver shunt who developed massive intracardiac thrombosis and subsequent shunt malfunction, despite preserved shunt patency. PMID- 3958378 TI - Transseptal catheterization and estimation of prosthetic mitral valve area. PMID- 3958379 TI - Myocardial mechanics in hyperthyroidism: importance of left ventricular loading conditions, heart rate and contractile state. AB - Hyperthyroidism has been reported to affect all of the major determinants of left ventricular performance in a manner that would augment ventricular shortening characteristics. The hypothesis tested in this study is that reduced afterload in conjunction with increased preload and heart rate, rather than augmented contractility, accounts for much of the increase in left ventricular performance noted previously in these patients. To investigate this hypothesis, 11 hyperthyroid patients were evaluated serially over 4 +/- 2 months. With therapy, serum total thyroxin (T4) decreased significantly (p less than 0.001). Ventricular hemodynamics were assessed by two-dimensional targeted M-mode echocardiograms and calibrated carotid pulse tracings. Ventricular preload was estimated by end-diastolic dimension, whereas afterload was measured as end systolic wall stress. Overall left ventricular performance was quantitated by the extent and velocity of shortening, whereas myocardial work was assessed by ventricular systolic stress-length relations. With therapy, overall left ventricular performance declined (p less than 0.01). This change was associated with no change in end-diastolic dimension or end-systolic wall stress, and a 24% fall in heart rate (p less than 0.01). This latter finding has been shown previously to have no significant effect on left ventricular contractile state over the range of heart rates encountered in this study. In all cases, the end systolic stress/rate-corrected shortening velocity relation fell with attainment of normal thyroid status, characteristic of a decline in contractility. There was a strong positive correlation between left ventricular contractility and serum thyroid hormone level (r = 0.83). In addition, ventricular minute work declined with therapy (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958380 TI - Prevalence and severity of mitral regurgitation in the mitral valve prolapse syndrome: a Doppler echocardiographic study of 80 patients. AB - Doppler echocardiography was performed in 80 consecutive patients (22 men, 58 women), aged 38 +/- 16 years, who had mitral valve prolapse diagnosed by two dimensional echocardiography. Of the 80 patients, 16 (20%) were asymptomatic and 11 (14%) had a normal physical examination (no click or murmur). The M-mode echocardiogram was negative for mitral valve prolapse in 11 patients (14%) and equivocal or nondiagnostic in 19 patients (24%). Mitral regurgitation was evaluated using pulsed mode Doppler echocardiography and was quantified by the mapping technique as minimal or mild when a holosystolic regurgitant jet was recorded just below the mitral valve into the left atrium, and as moderate or severe when the jet was detected at the mid- or distal left atrium. Mitral regurgitation was found in 55 (69%) of the 80 patients and it was minimal or mild in 47 patients (59%) and moderate or severe in 8 (10%). In 20 (36%) of the 55 patients with mitral regurgitation by Doppler technique, a systolic murmur was not detected and each of the 20 had only mild mitral regurgitation. Left atrial and left ventricular size were significantly smaller in patients with mild or no regurgitation as compared with the eight patients with moderate or severe regurgitation. These eight patients were all men (six over 50 years of age) who usually presented with dyspnea and a holosystolic murmur; the mitral valve prolapse was holosystolic by M-mode and involved both leaflets by two-dimensional echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958377 TI - Hemodynamic compromise (tricuspid stenosis and insufficiency) caused by an unruptured aneurysm of the sinus of Valsalva. AB - A patient is described with an unruptured aneurysm of the noncoronary sinus of Valsalva that occupied the right ventricular inflow tract and caused dynamic tricuspid stenosis and insufficiency. Results of two-dimensional echocardiography delineated the anatomy of the aneurysm and pulsed Doppler examination provided evidence that the aneurysm was unruptured. The unruptured aneurysm was resected successfully. PMID- 3958381 TI - Prevalence and severity of circumflex coronary artery disease in electrocardiographic posterior myocardial infarction. AB - To determine the coronary anatomy responsible for electrocardiographic posterior myocardial infarction, the prevalence and severity of disease in the right coronary and left circumflex coronary arteries were compared in 21 patients with electrocardiographic posterior infarction (17 of whom had associated inferior infarction) and 23 patients with isolated electrocardiographic inferior infarction. Significant circumflex coronary artery disease (greater than or equal to 75% stenosis) was more prevalent in patients with posterior or inferoposterior infarction (17 of 21) than in those with isolated inferior infarction (11 of 23) (p less than 0.02). Significant right coronary artery disease was less prevalent in patients with posterior or inferoposterior infarction (16 of 21) than in those with isolated inferior infarction (23 of 23) (p less than 0.05). Among the 21 patients with posterior or inferoposterior infarction, disease was more severe in the circumflex coronary artery in 10 and the right coronary artery in 5 and was of equal severity in 6. Among the 23 patients with isolated inferior infarction, the more diseased artery was the right coronary artery in 21 and the circumflex artery in 2 (p less than 0.001 by chi-square analysis). Variant patterns of coronary artery dominance accounted for only 4 of the 17 patients with inferoposterior infarction. These data suggest that the likely substratum for electrocardiographic posterior or inferoposterior infarction is severe circumflex coronary artery disease, usually in association with significant right coronary artery disease. The pattern of tall, wide R waves in leads V1 or V2 (RV1,2) in patients with inferior infarction is highly predictive of at least two vessel coronary artery disease. PMID- 3958382 TI - Isolated coronary ostial stenosis in women. AB - Isolated coronary ostial stenosis is a rare condition of unknown etiology previously reported in only 22 patients. Of 2,105 consecutive patients with angiographically defined coronary disease, 27 (1.3%) had 50% or greater stenosis of one or both coronary ostia. Serious complications occurred during angiography in three patients (11%) with one death. Coronary bypass surgery was performed in 25 patients with 1 early death (4.0%) and 1 late death (mean follow-up 28 months). Twenty-two patients (Group 1) had associated multivessel coronary disease, of whom 18 (82%) presented with stable angina of variable duration (43 +/- 53 months) and 10 (46%) were in the New York Heart Association functional class II. The prevalence of risk factors was high, especially among the eight women (3.0 +/- 0.8 per patient), seven of whom had hyperlipidemia. Five patients (Group 2) representing 0.2% of the total had isolated coronary ostial stenosis. All were women (age 41 +/- 6 years). In contrast to patients in Group 1, this group presented with a short history (2.0 +/- 1.7 months) of severe angina and had a low incidence of risk factors (0.8 +/- 0.6 per patient). Histopathologic study in one case showed typical atheroma. Isolated coronary ostial stenosis is a rare lesion occurring predominantly in young or middle-aged women. The clinical and angiographic profile appears unique and, despite the histopathologic findings, suggests a natural history distinct from that usually seen in atherosclerotic coronary disease. PMID- 3958383 TI - Possible role of diet in delayed pressure urticaria--preliminary report. AB - Late cutaneous reactions preceded by an immediate wheal-and-flare reaction have been described after allergen skin testing, intradermal 48/80 injection, and skin testing with heterologous antihuman IgE. We report the finding of delayed cutaneous reactions after prick food skin testing in a subgroup of five patients with delayed pressure urticaria. This subgroup is also defined by symptomatic clearing after fasting. We demonstrate a correlation of food challenge with skin test response in this same subgroup. Some patients who had previously required prednisone for control of urticaria were able to be managed without it while they were receiving the exclusion diet. In addition, their pressure symptoms and challenge disappeared while they were receiving the restricted diet. These findings suggest that an underlying food sensitivity may be an important precipitating factor in some patients with delayed pressure urticaria. PMID- 3958384 TI - Theophylline partially inhibits bronchoconstriction caused by inhaled histamine in subjects with asthma. AB - Sixteen adult subjects in a clinical steady state had four consecutive histamine inhalation tests on the same day when they were not receiving oral theophylline medication. The provocative concentration of histamine causing a 20% fall in FEV1 (PC20) was used to assess the response. They were then administered active or placebo sustained-release theophylline preparations according to a double-blind, randomized 4.4.1. two-treatment crossover design. Medication was administered for a minimum of 3 consecutive days, and PC20 was reassessed on 4 different days, 3 to 4 hours after receiving active or placebo medication (two visits for each medication). A significant but small bronchodilator and blocking effect on histamine excitability was demonstrated for the active medication. This latter effect was present even by adjusting for changes in baseline airway caliber and for the intraindividual variability of the four PC20 values obtained on day 1. We conclude that theophylline partially blocks bronchial responsiveness to inhaled histamine. PMID- 3958385 TI - The effect of cigarette smoke from the mother on bronchial responsiveness and severity of symptoms in children with asthma. AB - The effect of parental smoking was assessed in 94 consecutively observed children, aged 7 to 17 years, who had a history of asthmatic wheezing. The 24 children whose mothers smoked, when they were compared with children whose mothers did not smoke, had 47% more symptoms, a 13% lower mean FEV1 percent, a 23% lower mean FEF25-75%, and fourfold greater responsiveness to aerosolized histamine. A dose response was evident. There was a highly significant correlation between the results of the tests and the number of cigarettes the mother smoked while she was in the house. The differences between the children of smoking and nonsmoking mothers were greater in older than in younger subjects. The smoking habits of the father were not correlated with the severity of the child's asthma. PMID- 3958386 TI - High levels of IgE in patients suffering from frequent recurrent herpes simplex lesions. AB - We have examined a large number of patients suffering from frequent or infrequent recurrences of lesions induced by herpes simplex virus (HSV). We report in this article that patients suffering from very frequent HSV recurrences (five or more recurrences per year) had IgE serum levels that were significantly higher than those found in patients who suffered relatively few recurrences of HSV-induced disease. These elevated serum IgE levels were only detected during periods of active disease. PMID- 3958388 TI - Anaphylactic shock caused by formaldehyde in a patient undergoing long-term hemodialysis. AB - Formaldehyde (F) elicits contact dermatitis and asthma in subjects who are exposed to this chemical when it is applied on the skin or inhaled. An immediate type hypersensitivity reaction was never confirmed in these reactions. F is widely used in hemodialysis to sterilize adhesives, surgical devices, or reconditioned dialyzers. A 20-year-old woman who was subjected to hemodialysis for the past 4 years had a contact dermatitis to F. When hemodialysis was performed with a new dialyzer not sterilized with F, there were no symptoms. She had minor symptoms of anaphylaxis characterized by rhinitis, wheezing, and headache on the first use of a reconditioned dialyzer. Two days later, she was dialyzed with the same reconditioned dialyzer and developed within minutes a severe anaphylactic shock requiring resuscitation. The patient had no personal or family history of atopy. Prick tests and RAST to common food and inhlant allergens were negative. Prick tests performed with 0.1% and 1% F were positive in the patient, whereas they were negative in control subjects. RAST to F was performed with discs specially prepared and coated with human serum albumin. RAST was strongly positive. RAST to ethylene oxide was negative. A patch test with F was performed and induced an anaphylactic shock 26 hours after the skin application of F. The patient did not present any anaphylactic symptoms with the use of nonreconditioned dialyzers. An immediate-type allergy to F mediated by IgE may be envisaged in this patient. PMID- 3958387 TI - Circulating IgG autoantibodies to IgE in atopic syndromes. AB - Sera from nonatopic healthy donors and patients with hyper-IgE syndrome, allergic respiratory disease, i.e., allergic rhinitis and asthma, and atopic dermatitis were assayed for the presence of IgG and IgM antibodies to IgE. The assay used was based on an ELISA method that measured the binding of IgG or IgM in test sera to myeloma IgE (PS)-coated microtiter wells. The levels of IgG anti-IgE but not of IgM anti-IgE were elevated in patient sera of all three categories tested. The same sera failed to demonstrate increased levels of IgG anti-IgM or IgG anti-IgA. Significant IgG anti-IgE activity remained after absorption of patient sera over pooled human IgG F(ab')2 Sepharose. The IgG anti-IgE activity appeared to be directed toward the Fc portion of IgE because absorption of positive sera over IgE (ADZ) Sepharose but not over myeloma IgG Sepharose completely removed their reactivity with IgE (PS) and because sera from atopic individuals but not from normal subjects contained IgG anti-IgE activity against the protein backbone of the Fc portion of IgE synthesized from a fragment of the cloned gene of human myeloma IgE (ND) heavy chain. Regression analysis demonstrated a weak but significant correlation (r = 0.31; p less than 0.05) between serum IgE levels and IgG anti-IgE activity. Fractionation of sera from the three patient categories by gel filtration over Sepharose 6B revealed that IgG anti-IgE activity was present both as monomeric IgG and in IgE containing immune complexes (IC). Intermediate molecular size IC (between 7S and 19S) were present in all three patient groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958389 TI - Use of haptenizing ELISA to evaluate respiratory disease in a worker exposed to capacitor-coating powder. AB - We were asked to evaluate respiratory disease in a worker exposed to a powder containing unidentified components that was heated and used to coat capacitors. Because the powder was used as a coating material, we hypothesized that the capacitor-coating powder (CCP) contained either an anhydride or an isocyanate. We modified the initial step of a standard ELISA so that we could use CCP as a hapten in this assay. With this modified ELISA technique and inhibition analysis with antisera of known specificity, we determined that CCP contained a substance that cross-reacted with trimellitic anhydride. Later, we confirmed from the manufacturer that it contained benzophenone tetracarboxylic dianhydride. With the modified ELISA assay we also determined that the worker we were to evaluate did not have antibody to CCP or trimellitic anhydride. From clinical and immunologic evaluation we diagnosed chronic obstructive lung disease. Thus, this modified assay has proved useful in the evaluation of a worker exposed to a powder whose contents were not initially known and may prove useful in immunologic evaluation of workers in other industrial settings. PMID- 3958390 TI - Predicting skin test sensitivity and total serum IgE levels in family members. AB - A total of 278 individuals in 42 randomly ascertained nuclear families were studied to determine correlations among family members for skin test response and total serum IgE levels. The major aim was to determine whether these measures of allergic response in family members could be used to predict whether the last child in the family would be skin test positive. There were significant correlations in total log[IgE] levels between parents and their children and an even higher correlation between siblings. For the measurement of skin test response (allergy index), the only significant correlation was between siblings. Discriminant analysis was performed with the fourth child in the family as the index case. This was done to determine how many of the index cases could be correctly predicted to be skin test positive or negative based on family information. With just the skin test results on the parents, only three of the 13 positive index cases were correctly predicted. However, when the mean value for the skin test results in the siblings (mean allergy index) was used, eight of the 13 skin test positive index cases were correctly predicted. These results suggest that, although there is a high degree of concordance for allergic disease within families, information from other siblings may be the most useful predictor of allergic status in another child. PMID- 3958391 TI - Emergency administration of radiocontrast media in high-risk patients. AB - Patients with previous anaphylactoid reactions to radiographic contrast media (RCM) are at increased risk for subsequent reactions on repeat exposure. The most efficacious pretreatment regimens require administration of medications up to 13 hours before the anticipated procedure. Emergency administration of RCM in patients requiring essential procedures precludes prolonged pretreatment. We report results of pretreatment in nine patients requiring emergency administration of RCM. We recommend hydrocortisone, 200 mg intravenously, immediately, and every 4 hours until the procedure is completed, and diphenhydramine, 50 mg intravenously, 1 hour before the procedure. No reactions occurred in these patients, suggesting that this pretreatment regimen may be valuable in prophylaxis for patients requiring emergency administration of RCM who have experienced previous anaphylactoid reactions. Although used in only one additional patient, ephedrine, 25 mg orally, 1 hour before the procedure may also be valuable. PMID- 3958392 TI - Occupational asthma caused by cellulase. AB - Inhalation of enzyme dusts can cause occupational asthma, and the list of enzymes able to induce asthma is increasing. We report two patients with asthma induced by occupational exposure to cellulase powder derived from Aspergillus niger. A type I hypersensitivity to this enzyme was demonstrated by means of skin test reactivity, positive passive transfer test, positive reverse enzyme immunoassay for specific IgE, and immediate bronchial provocation test response to cellulase dust. Skin tests with an A. niger extract were positive. Cross-reactivity between cellulase dust and an entire A. niger extract was also demonstrated. PMID- 3958394 TI - Theophylline--how much is enough? PMID- 3958393 TI - Occupational asthma caused by eastern white cedar (Thuja occidentalis) with demonstration that plicatic acid is present in this wood dust and is the causal agent. AB - A worker developed symptoms of work-related asthma a few weeks after starting to work in a sawmill where eastern white cedar (Thuja occidentalis) was transformed into shingles. The diagnosis of occupational asthma was confirmed by monitoring of peak expiratory flow rates and bronchial responsiveness to histamine off work and at work, and specific inhalation challenges in the laboratory that demonstrated an isolated late asthmatic reaction after exposure for 4 hours to the wood dust. Specific inhalation challenges with western red cedar (thuja plicata) for 2 hours and plicatic acid (PA) for 7 minutes also caused an isolated late asthmatic reaction. Elevated specific IgE levels to PA were present. Antiserum was produced in rabbits that were immunized with PA conjugated to human serum albumin. With this antiserum in inhibition experiments, cross-reactivity between western red cedar and eastern white cedar, both belonging to the family of arborvitae, was found. It is estimated that eastern white cedar contains approximately half the amount of PA present in western red cedar. PMID- 3958395 TI - Stinging insect allergy. PMID- 3958396 TI - Creativity: a key to attaining excellence in a rapidly changing world. PMID- 3958398 TI - Weight loss: a comparison of group and individual interventions. AB - A series of 12 behavior modification group programs (with 125 participants) was compared with 28 individual programs to determine differences in short- and long term weight loss success. Data were collected directly and via questionnaire during the program and 10 to 36 months after the program. Different factors predicted weight loss during and after program participation, but in neither case was type of program (group vs. individual) significant. When data for the two collection periods were pooled, several factors were identified as significantly related to overall weight loss: (a) Individuals who were more overweight lost more weight. (b) The more prior programs tried the less weight loss occurred. (c) Men participating in group sessions and women seen in individual sessions lost the most weight. (d) The more sessions attended, the greater the weight loss. (e) Attending subsequent programs resulted in greater weight loss. (f) The use of behavioral technique--slow rate of eating--resulted in greater weight loss. (g) Increasing age was associated with less weight loss. The seven variables accounted for almost two-thirds (64%) of the variance. PMID- 3958397 TI - Family-based behavioral weight control in obese young children. AB - The effects of a family-based, behavioral weight control program on weight, linear growth, and nutrient intake among 17 obese children aged 1 to 6 were studied. The 1-year behavioral treatment involved three components: diet, exercise, and child management. Treatment meetings were held weekly for 10 weeks and then monthly for the remainder of the year. Relative body weight decreased significantly from 42.1% at baseline to 24.0% overweight at 1 year and 27.8% overweight at 2 years, while height increased normally over the 2 years of observation, suggesting that the children were obtaining adequate calories to maintain growth. The caloric and nutrient intakes of the children were analyzed from 3-day food records kept by the mothers during baseline and the tenth week of treatment. The mean caloric intake was 1,457 kcal prior to treatment and 1,025 kcal during treatment. Nutrient intake exceeded the Recommended Dietary Allowances at pretreatment for the nutrients investigated and continued to exceed the RDAs for all nutrients except calcium (96% of RDA) and iron (84% of RDA) during treatment. Improvements in nutrient density were shown for all nutrients. The results suggest that obesity can be treated successfully in young children without detrimental effects on growth or nutrient intake. PMID- 3958399 TI - Comparison of calculated estimates and laboratory analysis of food offered to hospitalized eating disorder patients. AB - Estimation of caloric intake is an integral part of a comprehensive research/treatment program for patients with eating disorders at the National Institute of Mental Health. Caloric intakes are estimated by recording daily food intake and calculating calories using food exchange lists and food composition tables. To evaluate the validity of that method, caloric intake estimates were compared with laboratory analysis data over a 15-day period. The estimations for daily caloric intake in comparison with the laboratory analysis data were underestimated by a mean percent difference of 2.4%. The estimated carbohydrate and fat intakes were overestimated by 4.5% and 5.4%, respectively. The estimated protein intake was underestimated by 1.1%. The data suggest that estimates of caloric intake based on food exchange lists and food composition tables are within an acceptable range of error and, therefore, represent a practical approach to estimating caloric intake for patients hospitalized with an eating disorder. PMID- 3958400 TI - Beverages in the diets of American teenagers. AB - The purpose of this study was to investigate the role of beverages, particularly soft drinks, in the diets of American teenagers by analyzing data collected in the Nationwide Food Consumption Survey, 1977-78. Interviewers obtained 24-hour recalls of dietary intake, and respondents completed diet records for the following 2 days. Variation in beverage intake was examined by eating occasion, season, day of the week, region, urbanization, race, age, sex, and household income. Soft drink and milk intakes were negatively correlated (r = -.22). Soft drinks were just as likely to be drunk at lunch or supper as for snacks. Those results suggest that teenagers may have substituted soft drinks for milk at meals. The nutritional impact of soft drink consumption was assessed by determining the part correlations of soft drink intake with intakes of energy and 14 nutrients, while controlling for 19 variables related to time, location, and personal and household characteristics. The negative part correlations of soft drink intake with intakes of calcium (-0.11), magnesium (-0.06), riboflavin ( 0.09), vitamin A (-0.08), and ascorbic acid (-0.06) indicate that soft drinks may contribute to low intakes of those nutrients by some teenagers. PMID- 3958402 TI - Preparing public health nutritionists to meet the future. AB - Public health nutrition personnel have been defined as those specialized nutrition professionals and paraprofessionals who provide nutrition services through agencies whose mandate is health protection and promotion, disease prevention, and/or primary care to people in the community. Educators preparing graduate level nutritionists for future demands of federal, state, and local public health programs must read the scientific, technological, and societal trends, including changes in demographics, health delivery systems, communications technologies, and consumer demands. As research more clearly defines the role of nutrition and diet in human health, nutritionists should be educated to monitor trends and be proactive in seeking emerging opportunities. It is nutritionists' responsibility to assure that scientific findings in nutrition, dietetics, and food science are considered in policy formulation as well as in the technical input into agency and community programs. The nutritionist who understands the changing values and life-styles of diverse populations uses acceptable techniques to motivate any necessary behavior changes. To be effective in the community, he/she uses community assessment, epidemiological, and program planning skills basic to public health practice. In the current climate of cost containment, the public health nutritionist will successfully compete for dwindling funds by managing programs with skill and documenting cost benefits and cost-effectiveness. PMID- 3958403 TI - The descriptive sales slip: a dietary assessment tool on the horizon. PMID- 3958401 TI - Dietary characteristics of hyperactive and control boys. AB - The purpose of this study was to examine the relationship between dietary habits and behavioral problems in hyperactive boys and to determine how successful parents are in maintaining their children on sugar-free diets. The mothers of 32 hyperactive boys aged 7 to 12 years and 26 matched controls completed 3-day diet records and food frequency interviews. The hyperactive boys were also evaluated in a playroom for impulsivity, compliance, attention, motor activity, memory, and learning. No differences were found in any of the measures of dietary content between the hyperactive and control groups. The only significant differences between those two groups were a lower socioeconomic status and a greater number of parents attempting sugar-restricted diets in the hyperactive group. Boys on sugar-restricted diets had only one significant dietary difference from those not restricted. Correlations between the information obtained in food frequency interviews and in 3-day diet histories were not significant (r = .06 to .33) for the hyperactive group, but the food frequency interviews were significant for the control group (r = .41 to .47). Four behavioral variables showed significant partial correlations with reported sugar intake. Overall, the results demonstrated that the diets of a group of hyperactive boys were similar to those of a control group. There appeared to be little difference between the diets of the families that attempted to restrict sugar and those that did not. PMID- 3958405 TI - Health claims for foods: an impelling public policy issue for members. PMID- 3958404 TI - Soup consumption as a behavioral weight loss strategy. PMID- 3958406 TI - ADA comments on proposed rule for meat alternates used in child nutrition programs. PMID- 3958407 TI - Symptom prevalence in the elderly. An evaluation of age, sex, disease, and medication use. AB - Prevalence of reported symptoms was studied in 1927 women and 1140 men over 65 years of age in an ambulatory health screening program. Reports of 28 common symptoms were obtained from a standardized questionnaire completed by participants at the time of their fourth annual visit to the program. A comparison was made of the prevalence of specific symptoms by sex, age, disease states, and drug use patterns. The most common symptoms reported by women were nocturia (80.4%), swollen feet or ankles (30.5%), cold feet and/or legs (28.6%), and irregular heartbeat (23.2%), whereas men complained most often of nocturia (79.8%), irregular heartbeat (24.8%), cold feet and/or legs (23.6%), and tinnitus (23.1%). Women reported a mean of 3.99 symptoms compared with 3.22 reported by men (P less than .0001). In women their was a statistically significant association for most symptoms in subjects reporting the use of medication compared with a group who did not use medication. In men the use of medication was less highly correlated with reports of symptoms. Nearly 100% of participants reported having at least one disease state. The number of symptoms reported was strongly related to the number of disease states, and after adjusting for diseases, women reported more symptoms than men. The best predictor of symptom prevalence was the number of disease states followed by the number of drugs used and then age. PMID- 3958408 TI - Symptomatic depression in elderly medical outpatients. I. Prevalence, demography, and health service utilization. AB - The authors assessed the prevalence and demography of depressive symptoms, their association with specific chronic diseases, and their influence on health service use in a large sample of elderly men seen in a primary care setting. Twenty-four percent of respondents reported clinically significant depressive symptoms; the prevalence of major depressive disorders was estimated at 10%, but only 1% reported receiving mental health treatment by a specialist. Self-reported marital separation or divorce and physical disability affecting employment were strongly associated with high depression scores, whereas the normative stresses of aging (widowhood, retirement, social isolation) were not. Only chronic lung disease was differentially associated with high depression scores, and this effect was weak. The authors discuss the implications of these findings for the design of comprehensive health services for the elderly with chronic disease. PMID- 3958409 TI - Families of Alzheimer's victims. Family support to the caregivers. AB - This study examined the instrumental and social-emotional support provided by families to the primary caregivers of Alzheimer's patients. It was anticipated that the more adequate the support provided by the family, the less sense of burden and the better the coping effectiveness of the caregiver. Ratings of instrumental assistance, social-emotional support, adequacy of support, and coping effectiveness were made by trained raters from transcribed interviews with 23 primary caregivers. Also, a second family member who was usually next closest of kin to the caregiver was interviewed in order to provide another perspective of the support the family provided. While the major caregiving tasks were performed by the primary caregiver, the types of assistance from family that seemed most appreciated were visits and having persons stay with the patient so that the caregiver could take a trip, rest, run errands, or get out of the house for social activities. The majority of caregivers felt a high degree of support from their families and reported low levels of emotional upset resulting from family support efforts. The most common family problems reported were lack of visits, disagreement over level of patient's mental and physical functioning, and disagreement over the type of care required. The data confirmed the hypothesis that family support was positively associated with the caregiver's coping effectiveness. In addition, caregivers who did not receive enough support were most burdened; however, the group receiving the greatest amount of support was the next most burdened, a finding which was unanticipated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958410 TI - Cognitive performance correlates with cerebrovascular impairments in multi infarct dementia. AB - Cerebral blood flow (CBF) was measured by the 133Xe inhalation method in patients with multi-infarct dementia (MID, N = 26), Alzheimer's dementia (AD, N = 19), and among age-matched, neurologically normal, healthy volunteers (N = 26). Cognitive performance was assessed in all subjects using the Cognitive Capacity Screening Examination (CCSE). Cerebral vasomotor responses were calculated from differences in values of mean hemispheric gray matter blood flow (Delta CBF) measured during inhalation of 100% oxygen (hyperoxia) compared with CBF measured while breathing room air. Significant correlations were found between CCSE performance and vasomotor responsiveness in patients with MID (P less than .01), but not in patients with AD or in neurologically normal volunteers. Loss of vasomotor responsiveness is an indicator of cerebrovascular disease with rigidity and/or loss of reactivity of cerebral vessels, which impairs cerebrovascular responses to situational demands and predisposes to cerebral ischemia. Loss of cerebral vasomotor responsiveness among MID patients, which is a biologic marker of cerebrovascular disease, provides confirmatory evidence of the vascular etiology of MID and assists in separating MID from AD patients. PMID- 3958411 TI - Surgical repair of remediable postinfarction cardiogenic shock in the elderly. Early and long-term results. AB - The in-hospital mortality associated with acute myocardial infarction rises markedly with advancing age. It is not established whether the elderly may benefit from early surgical repair of postinfarction cardiogenic shock due to ventricular septal defect (VSD), acute severe mitral regurgitation (MR), or left ventricular power failure. Eighteen consecutive patients between the ages of 66 and 79 (mean, 72 years) and in cardiogenic shock underwent surgical repair, most with counterpulsation support, within one week of developing VSD, MR, or left ventricular power failure. Of ten patients with VSD, five (50%) survived. Three of seven patients with MR (43%) and the only patient with power failure survived for an overall survival of 50%. The nine long-term survivors were followed up for six months to five years (mean 31 months) by personal interviews with the patient or referring physician. There was one late death, due to congestive heart failure, ten months after the operation. Of the remaining eight patients, seven are categorized as New York Heart Association class I, and one as class II. These patients have all been able to live and function independently after cardiac operation. The authors conclude that older patients with postinfarction cardiogenic shock may benefit from early operation and that advanced age does not preclude successful surgical outcome. Furthermore, operation may result in excellent long-term quality of life. PMID- 3958412 TI - New questions about steroids. PMID- 3958413 TI - Perspectives on a geriatric fellowship: a personal account. PMID- 3958414 TI - The hype for rigid gas permeable contact lenses. PMID- 3958415 TI - Contact lens advancements: let's look elsewhere. PMID- 3958416 TI - Sorbic acid revisited. AB - 135 patients wearing hydrogel lenses were prescribed a care system of sorbic acid preserved surfactant, Lensept and Bausch and Lomb Sensitive Eyes Saline (sorbic acid 0.10%). Fifteen percent of patients presented with an adverse ocular response to their care system. The etiology was attributed to sorbic acid as the use of nonpreserved saline eliminated the signs and symptoms. This incidence of reaction is similar to those published earlier on thimerosal preserved saline and sorbic acid preserved saline. PMID- 3958417 TI - Bifocal hydrogel lenses: an overview. AB - Until the advent of bifocal hydrogel lenses, monovision or reading glasses were the modes of correction for hydrogel contact lens wearing presbyopes. Recent design innovations and improvements in the manufacturing technology of soft contact lenses have made possible new developments in bifocal hydrogel lenses. Patient selection and patient education play key roles in optimizing patient success. There are several hydrogel bifocal designs that are possible for the presbyope. The variations of these designs and their pertinent considerations are discussed. PMID- 3958418 TI - Clinical management and control of giant papillary conjunctivitis secondary to contact lens wear. AB - An overview of giant papillary conjunctivitis (GPC) secondary to the wearing of contact lenses, as well as a systematic clinical approach for the control and treatment of this disorder are discussed. This clinical approach has proven to be extremely successful. PMID- 3958419 TI - Keratoconus: the clinical spectrum. AB - This paper reports observations made on 57 keratoconus patients, 32 women and 25 men. Particular attention is paid to the retinoscopic reflex, intraocular pressure, and the patient's bodyweight. Diagnostic criteria are proposed. PMID- 3958420 TI - Correction of residual astigmatism on an against-the-rule cornea of moderate toricity. AB - The use of prism ballasting and toric base curves are both commonly cited means of stabilizing lens orientation, although it is rare that both are necessary in the same lens. Base curve cylinder has an optical effect as well as a stabilizing effect, and this can be utilized to advantage under specific circumstances. This report presents a case which emphasizes the benefit of combining these two techniques of stabilization in a rigid lens design and also illustrates the utilization of the toric base curve in compensating residual astigmatism. PMID- 3958421 TI - Liability issues in contact lens practice. AB - Professional liability issues are an important consideration for clinicians who fit and dispense contact lenses. Among the most important are legal requirements related to patient consent, guarantees concerning materials or services, emergency care, instructions given to patients, termination of care by the doctor, information or services given by employees, and documentation of examination findings, instructions, and recall appointments. Optometrists should observe legal guidelines in order to minimize the risk of injury to patients and to reduce the opportunity for litigation. PMID- 3958422 TI - Neuropathy target esterase in human lymphocytes and platelets. AB - The target enzyme in organophosphorous-induced delayed neuropathy (OPIDN) has been designated neuropathy target esterase or neurotoxic esterase (NTE). NTE activity can be measured in blood lymphocytes and platelets, which could be of use as biomonitors in man at risk for the development of OPIDN. Separation of lymphocytes and platelets from whole blood, recovery, purity, storage and expression of data were examined. A substantial amount of the NTE activity of a human lymphocyte preparation made using Ficoll/Pacque was due to contamination by platelets; further purification was achieved by sucrose-gradient centrifugation. In an easily prepared sample of human platelets less than 10% of NTE was associated with contaminating white cells. We were unable to preserve NTE activity of platelets or lymphocytes at -80 degrees C either 'dry' or with added buffer and glycerol. In 68 male subjects, NTE activity in platelets averaged 8.36 +/- 1.54 nmol min-1 mg protein-1 and NTE activity in lymphocytes, obtained from blood after removal of platelets, 13.34 +/- 2.42 nmol min-1 mg protein-1. A good correlation was found between platelet and lymphocyte NTE activity. NTE activity in platelets may be a preferable method for measuring exposure to axonopathic organophosphorous compounds because of the ease and purity of separation. No correlation with other neuropathic risk factors such as age, smoking and alcohol intake was noted. PMID- 3958423 TI - Comparative cytotoxicity of naphthalene and its monomethyl- and mononitro derivatives in the mouse lung. AB - Male Swiss-Webster mice were exposed to naphthalene, 1-methyl-, 2-methyl-, 1 nitro- and 2-nitronaphthalene by intraperitoneal injection of peanut oil solutions over a dose range of 0.5-3.0 mmol kg-1 body weight. Treated mice were killed at times from 6 hours to 14 days post-treatment. Tissues were analyzed for cytotoxic effects by optical and electron microscopy, and for cell proliferation by autoradiography following in vitro labeling of lung slices with 3H-thymidine. The naphthalene derivatives varied widely in their cytotoxic effects. The most toxic was 1-nitronaphthalene with no mice surviving doses greater than 1 mmol kg 1. Naphthalene and 2-methylnaphthalene were about equally toxic, followed by 2 nitro- and 1-methylnaphthalene, in decreasing order of toxicity. In all cases the first evidence of cytotoxic effects was seen in the Clara cells of the bronchiolar epithelium, and, at the highest doses, toxic effects were found in the adjacent ciliated cells. Changes could be detected at the ultrastructural level at all doses, and within 6 hours after treatment. Only slight effects were seen in other cell types. Increased cell proliferation following chemical treatment was seen only in the bronchiolar epithelium, among cells tentatively identified as Clara cells or their precursors. Cytotoxic effects of naphthalene and its 1- and 2-methyl derivatives were confined to the lung, with minimal evidence of toxicity in the liver and kidney. The mononitronaphthalenes both produce small areas of centrizonal necrosis in the liver, but no discernible effects in the kidney. The experiments demonstrate the effect of small structural differences on the cytotoxicity of this group of environmental pollutants and also illustrate the sensitivity of the Clara cell as a target for xenobiotics. PMID- 3958424 TI - Deposition of ultrafine aggregate particles in exercising rats. AB - The effect of exercise on particle deposition in rats was investigated. Twenty male rats were trained to run on a treadmill and were exposed to gallium-67 oxide (67Ga2O3) particles (0.1 micron activity median diffusion diameter) for 30 min while running at 30 m min-1. Twenty resting controls were exposed in the same system while confined in wire mesh cages. Ten exercising and 10 resting rats were killed 2 h and 12 days after exposure. Tissue radioactivity levels of 67Ga2O3 were measured and normalized for differences in exposure concentration and body weight. Significantly (P less than 0.05) more 67Ga was deposited in the nasal passages (20 vs 5 nCi) and in the trachea and mainstem bronchi (0.05 vs 0.03 nCi) of exercising rats than in resting rats. There were no significant differences between the exercising and resting rats in amounts of 67Ga in the lung lobes at 2 h after exposure. Using assumed minute volumes, exercising rats had a significantly (P less than 0.05) lower lung deposition efficiency, expressed as percentage of estimated inhaled material, than did resting rats (3 vs 10%). The results suggest that exercising rats inhale more ultrafine particles, but deposit a smaller fraction of them in their lungs. The result is a similar lung burden of 0.1 micron particles in resting and exercising animals. PMID- 3958425 TI - Respiration of F344 rats in nose-only inhalation exposure tubes. AB - The respiration of naive F344 rats confined in nose-only inhalation exposure tubes was measured to obtain data for normal adult rats of different ages and to evaluate the tubes for exposures lasting several hours. Exposure tubes were modified for use as volume-displacement plethysmographs. Respiration of 10 male and 10 female rats at 3, 6, 12 and 24 months of age was measured in the tubes during simulated exposures of up to 6 h duration. Measurements included respiratory frequency, tidal volume, minute volume and body surface temperature. The mean respiratory frequencies of 3, 6, 12 and 24 month old rats during the first hour of exposure were 172, 152, 123 and 136 breaths min-1, respectively. Minute volumes were 1.40, 0.89, 0.67 and 0.82 ml g-1 body weight, respectively. Both frequency and minute volumes g-1 body weight were significantly greater for the youngest group, declined with age to 12 months and then increased at 24 months. Minute volumes g-1 body weight were similar for males and females. Minute volume and respiratory frequency of 3 and 12 month old rats declined progressively between 1 and 6 h of confinement in the tubes. Surface temperature did not increase after the first hour. The age and sex-specific data provide a basis for predicting respiration of naive tube-confined rats during inhalation exposures to non-irritating materials. PMID- 3958426 TI - Preclinical toxicity of the new antineoplastic agent, ametantrone acetate, in mice and dogs. AB - Ametantrone acetate (anthracenedione diacetate, NSC 287513) is an experimental antineoplastic agent with activity against a comprehensive panel of solid transplantable tumors in mice and dogs were carried out to establish tolerable levels. In mice, LD10, LD50 and LD90 values were respectively, 26, 35 and 47 mg kg-1 28 days following single intravenous injection and 22, 67 and 206 mg kg-1 14 days after single intraperitoneal injection. Hemorrhage and necrosis of the small intestine occurred in intercurrent deaths. A 5-day, consecutive intraperitoneal dosing study yielded 28 day, LD10, LD50 and LD90 values of 18, 21 and 26 mg kg-1, respectively, in mice. Bone marrow hypoplasia, lymphoid depletion and focal cardiac changes were observed in animals which died during the 28-day postdose observation period. In dogs, single intravenous injections repeated twice at intervals of 3-8 weeks resulted in leukopenia and thrombocytopenia at a dose of 2.71 mg kg-1 and decreased myeloid: erythroid ratios at a dose of 0.68 mg kg-1. Five consecutive daily intravenous injections in dogs of 0.7 mg kg-1 induced significant clinical and laboratory signs of toxicity but 0.35 mg kg-1 day-1 was tolerated. In dogs, bone marrow, lymphoid tissue and gastro-intestinal tract in both sexes and gonads in the males were target organs for toxicity. Clinical signs and clinical laboratory abnormalities abated in surviving mice and dogs. The spectrum of tissue changes induced by ametantrone was qualitatively similar to that elicited with other intercalating agents. PMID- 3958427 TI - Intestinal absorption of aluminum in rats: effect of intraluminal pH and aluminum concentration. AB - The intestinal absorption of aluminum (Al) was studied in an in situ perfusion system of rat small intestine in combination with systemic and portal blood sampling. The jejunum-ileum was perfused with media containing 4.63, 9.25 and 18.50 mmol l-1 Al chloride at pH 4.0 and 7.0. Both mucosal retention was not affected by pH but at lower pH more Al was released into the blood. The amount of Al which appeared in the blood was linearly related to the mucosal retention. The Al release into the blood was much less (mumol l-1) than the mucosal retention (mmol l-1). It is concluded that the intestinal absorption of Al is pH- and concentration-dependent. PMID- 3958428 TI - In vivo percutaneous absorption studies of volatile solvents in hairless mice. I. Description of a skin-depot. AB - A stainless-steel skin-depot is discussed that may be used during short-term studies to measure directly percutaneous absorption of radiolabeled, volatile chemicals through the skin of unanesthetized, unrestrained hairless mice. The skin-depot is glued to the backs of the mice using cyanoacrylate glue. The top portion of the depot contains activated charcoal (or other sorbent) to capture for analysis the portion of the test chemical which normally evaporates from the treatment site. This allows the use of metabolism cages for the capture of expired breath, as well as urine and feces. Thus, dermal absorption of the test chemical can be summed directly from the radioactivity found in excreta (urine and feces), the animal carcass (including the skin treatment site) and expired breath. PMID- 3958429 TI - The effect of prednisolone on the foetotoxicity of cadmium in pregnant mice. AB - The effects of prednisolone was investigated on the foetotoxicity of cadmium. CFLP female mice were given a single i.p. dose of 2.5 mg cadmium (Cd) per kg body weight on day 5 or 9 of gestation. This treatment significantly decreased both the number of live foetuses and foetal weights on day 18 of gestation. Prednisolone (0.1 mg kg-1) given daily from the day of cadmium treatment death, prevented the effects of cadmium on foetal weights in both groups, and on the number of live foetuses when cadmium was given on day 9 of gestation. When Cd was given on day 13 of gestation similar treatment with prednisolone did not influence either litter size or the weights of 1-day-old pups. PMID- 3958430 TI - Renal effects of aluminium in uraemic rats and in rats with intact kidney function. AB - The effect on renal function following administration of aluminium (i.p., five times weekly (0.05 or 0.5 mg kg-1 body weight) for 12 weeks) to partially nephrectomized (5/6 NX) or intact female rats was examined. The observed loss of concentrating ability, characterized by increased urine volume and an increased sodium excretion, as well as increased renal excretion of p-aminohippurate (demonstrable after low-dose treatment with nephrotoxins) can be interpreted as an initiation of kidney function injury. No distinct differences in response were observed between partially nephrectomized and intact animals. PMID- 3958431 TI - The mechanism of biooxidation of mercury. AB - The mechanism of oxidation of mercury by peroxidase is reported. The reaction is first order both in mercury and in peroxidase Compound I, and involves a one-step two-electron oxidation. The enzyme acts as a recycling chemical oxidant. PMID- 3958432 TI - Functional characterization of preganglionic neurons projecting in the lumbar splanchnic nerves: neurons regulating motility. AB - Lumbar preganglionic neurons, which projected in the lumbar splanchnic nerves and were probably involved in regulating motility of colon and pelvic organs (motility-regulating, MR neurons), were analyzed for their discharge patterns. The responses of the neurons to the following stimuli were tested: stimulation of arterial baro- and chemoreceptors and of afferents from the urinary bladder, colon, mucosal skin of the anus and perianal hairy skin. The following findings were made: a total of 131 preganglionic neurons were classified as MR neurons; these reacted to natural stimulation of at least one of the afferent inputs from the urinary bladder, colon and anal and perianal skin. The ongoing activity of these neurons did not correlate with the cardiac cycle or the cycle of the artificial ventilation. Most of them did not respond to an increase of blood pressure produced by i.v. injection of adrenaline or noradrenaline; some showed a weak depression or weak excitation which, in the time course, was untypical for visceral vasoconstrictor neurons. Stimulation of arterial chemoreceptors either did not influence MR neurons or produced only a secondary response owing to contraction of the urinary bladder. Ninety-seven preganglionic MR neurons could be subclassified: MR1 neurons were excited by distension and contraction of the urinary bladder and/or inhibited by distension and contraction of the colon (n = 61), a few were excited from both organs (n = 4); MR2 neurons were inhibited by distension and contraction of the urinary bladder and/or excited by distension and contraction of the colon (n = 32). Ninety-five out of 121 MR neurons (78.5%) were excited, 10 (8%) were inhibited and 16 (13%) not influenced by mechanical shearing stimuli applied to the mucosal skin of the anus. Most neurons which were excited by anal stimulation were not influenced by mechanical stimulation of the perianal (perigenital) skin. Twenty-eight per cent of the MR neurons (18 out of 64) were excited or inhibited upon stimulation of perianal skin. A few of these (7 out of 64 neurons, 11%) were involved in reflex responses which were different from those elicited from anal skin. At present no further consistent subclassification of MR1 and MR2 neurons appears possible on the basis of the excitatory and inhibitory anal and perianal reflexes. The results show that the population of visceral preganglionic neurons, which are probably involved in regulation of motility of colon and pelvic organs, is not homogeneous and probably consists of several subpopulations. PMID- 3958433 TI - Functional characterization of preganglionic neurons projecting in the lumbar splanchnic nerves: vasoconstrictor neurons. AB - Lumbar preganglionic neurons, which project in the lumbar splanchnic nerves and which probably have a vasoconstrictor function (visceral vasoconstrictor, VVC neurons), were analyzed for their discharge patterns. The responses of these neurons to the following natural stimuli were tested: stimulation of arterial baroreceptors, arterial chemoreceptors and visceral afferents from the urinary bladder, the colon and the mucosal skin of the anus. Forty-nine preganglionic neurons were classified as VVC neurons. They showed the following characteristics: the ongoing activity of the VVC neurons exhibited pronounced cardiac rhythmicity and correlated with the cycle of the artificial ventilation. Stimulation of arterial baroreceptors, produced by increase of blood pressure or by increase of pressure in an isolated carotid blind sac, led to inhibition of activity in VVC neurons. Unloading of arterial baroreceptors, produced by decrease of blood pressure, led to an increase in VVC neuron activity. Stimulation of arterial chemoreceptors by bolus injections of CO2-enriched saline solution, close to a carotid glomus, led to a weak excitation of VVC neurons. Stimulation of arterial chemoreceptors by systemic hypoxia led to weak excitation and/or to depression of activity in VVC neurons. Stimulation of visceral afferents from urinary bladder and colon by isovolumetric contractions and distensions of the organs had no effect on most VVC neurons. Anal stimulation also did not induce reflexes in the majority of the VVC neurons. Some 14% of the VVC neurons (7 from 49) were excited by at least one of the visceral stimuli in the same manner as the motility-regulating (MR) neurons. This investigation shows that preganglionic neurons, probably involved in regulation of vascular resistance in colon and pelvic organs, are functionally a distinct population of neurons with some interesting functional overlap with the motility-regulating neurons. PMID- 3958434 TI - Secondary functional properties of lumbar visceral preganglionic neurons. AB - Preganglionic visceral vasoconstrictor (VVC) neurons and motility-regulating (MR) neurons and other visceral preganglionic neurons, which project in the lumbar splanchnic nerves, were analyzed for their segmental distribution, the conduction velocity of their axons, ongoing activity and reflexes elicited by electrical stimulation of visceral afferents in white rami and of somatic afferents in spinal nerves. Identified preganglionic neurons and neurons without ongoing and reflex activity were distributed over segments L1-L5. VVC neurons were distributed over segments L1-L4 and MR neurons over segments L3-L5. VVC axons conducted at 2.8 +/- 2.5 m/s (mean +/- 1 S.D., n = 49), MR axons at 8.1 +/- 4.7 m/s (n = 131). The ongoing activity of VVC neurons was 1.6 +/- 0.7 imp/s (n = 46), that of MR neurons 0.8 +/- 0.7 imp/s (n = 91). There was no correlation between the conduction velocity of preganglionic axons and the rate of ongoing activity for VVC and MR neurons. (4) Electrical stimulation of visceral afferents in white rami and of somatic afferents in spinal nerves elicited short-latency (less than 50 ms) and long-latency (greater than 50 ms) reflexes in practically all VVC neurons, but preferentially short-latency reflexes in only 50 to 60% of the MR neurons. These results show that VVC and MR neurons are not only different in their reflex patterns, elicited by stimulation of visceral receptors and of arterial baro- and chemoreceptors, but also in the 4 properties analyzed in this paper. PMID- 3958435 TI - Discharge patterns of motility-regulating neurons projecting in the lumbar splanchnic nerves to visceral stimuli in spinal cats. AB - Reflexes in visceral preganglionic motility-regulating (MR) neurons which project in the lumbar splanchnic nerves were investigated in acutely spinalized cats. Some neurons were analyzed before and after spinalization. The stimuli used were mechanical stimulation of mucosal skin of the anus and of perianal (perigenital) hairy skin, and distension and contraction of urinary bladder and colon. Most MR neurons exhibited a reflex pattern which consists of the following components: excitation upon bladder distension, inhibition or no effect upon colon distension and excitation (or, rarely, no effect) upon anal stimulation. This is the reflex pattern of MR1 neurons. Some neurons were excited by anal stimulation but not affected from the colon and urinary bladder. Some were inhibited by anal and perianal stimulation but otherwise exhibited the reflex patterns of the MR1 neurons. Analysis of the reflexes before and after spinalization showed that, in particular, inhibition elicited by anal, perianal and bladder stimulation was abolished; inhibition elicited from the colon was enhanced after spinalization. It is concluded that the reflexes elicited in preganglionic lumbar visceral neurons by the natural stimuli probably use spinal pathways, with the afferent input occurring at the sacral spinal cord. These spinal reflex pathways are probably controlled by descending inhibitory and excitatory spinal systems from the supraspinal neuraxis. PMID- 3958436 TI - Increased basal and reactive plasma norepinephrine and epinephrine levels in awake DOCA-salt hypertensive rats. AB - The sympatho-adrenal basal tone and reactivity were studied using plasma norepinephrine (NE) and epinephrine (E) levels in awake DOCA-salt hypertensive rats. In those animals, basal NE and E levels were about twice greater than those found in normotensive rats. Moreover, plasma NE levels could be significantly correlated with mean arterial pressures in both groups of animals. Following a hemorrhagic hypotension, elevation in NE and E levels tended to be greater in hypertensive rats. These studies suggest that the basal activity of the sympatho adrenal system is increased and that its reactivity might be potentiated in DOCA salt hypertension. PMID- 3958437 TI - Metabolic and morphological alterations of brown adipose tissue after sympathetic denervation in rats. AB - Effects of sympathetic denervation on biochemical and morphological changes of brown adipose tissue (BAT) were studied in rats after severing 5 intercostal nerve bundles that enter the unilateral interscapular BAT, the contralateral BAT being used as the control. Four weeks after denervation, there was no appreciable change in BAT weight or its DNA and protein contents, whereas the triglyceride content was increased significantly. However, the rate of fatty acid synthesis was decreased to about half the rate in controls. The denervated BAT was much paler than controls and contained lots of adipocytes filled with large lipid droplets, some of which were unilocular. The results are discussed with reference to changes in BAT seen after bilateral lesions of the ventromedial hypothalamus. PMID- 3958438 TI - Distribution and location of slowly adapting pulmonary stretch receptors in the airways of cats. AB - The distribution and location of slowly adapting pulmonary stretch receptors (PSRs) that affect respiratory and cardiovascular functions were investigated in anaesthetized, artificially ventilated and thoracotomized cats. The location of the receptors was done by punctate stimulation and local mechanical stimulation after occlusion of the trachea at end-expiration (Exp). 84% of the slowly adapting PSRs were found to be located in the lung parenchyma. The occlusion technique alone was found to be of help only for a limited population of stretch receptors. The intrapulmonary distribution of PSRs revealed a greater percentage of receptors in the diaphragmatic lobe. No correlation was found between conduction velocity and receptor location. Both the slowly and rapidly conducting receptors were found to be scattered throughout the entire lung parenchyma. However, it was observed that while the majority of low threshold (LT) PSRs were located closer to the hilum of the lung, many of the higher threshold (HT) receptors were located farther away. In addition, when veratrine was administered into the pulmonary circulation, 83% of HT PSRs studied were stimulated by the drug, while only 25% of LT PSRs under study could be stimulated this way. The significance of the above findings is discussed. PMID- 3958439 TI - The hypothalamic and brainstem areas from which the cardiovascular and behavioural components of the defence reaction are elicited in the rat. AB - Electrical stimulation has been employed to map areas of the rat's brain from which the cardiovascular and behavioural components of the defence reaction are elicited and hence to identify the defence areas in this species. In the anaesthetized rat, the cardiovascular pattern of response includes increases in arterial blood pressure and heart-rate, an atropine-resistant vasodilatation in the hind-limb skeletal muscle, with renal and splanchnic vasoconstriction. This was elicited from comparatively well localized areas, not confined to any particular nuclei. Responses were evoked from the rostro-caudal extent of the hypothalamus but most consistently from a region ventral to the fornix. In the midbrain, responsive sites were localized to the dorsal half of the central grey matter, the tegmentum ventro-lateral to it and a ventro-medial region which continued into the pons. Stimulation using implanted electrodes in conscious rats, within the hypothalamic and midbrain areas described above, elicited typical 'flight' and 'escape' behaviour: thus, the localized regions from which the visceral alerting response is elicited contain neurones or nerve fibres integrating the whole defence-alerting response in the rat, as in other species. PMID- 3958440 TI - Properties of femoral venous afferent inputs and lumbosacral distribution of spinal evoked activity. AB - The present studies were done to determine details of the anatomical and physiological characteristics of femoral-saphenous venous afferent input to the lumbar spinal cord. Gross anatomical examination revealed that afferent bundles could be seen coursing from the saphenous nerve to the femoral-saphenous vein. Compound action potentials elicited by femoral-saphenous venous afferent stimulation were recorded from the femoral nerve and in dorsal rootlets of the 6th lumbar cord segment. The compound action potentials included activity correlated with that of fibers conducting impulses at the rate of 31 to 61 m/s. Lumbar cord dorsum potentials elicited by femoral-saphenous venous afferent stimulation were abolished by rhizotomy of the most caudal rootlets of the 6th lumbar cord segment. L6 was also the cord segment from which the largest amplitude cord dorsum negative potentials were recorded, while action potentials with large late positive waves were recorded from more caudal cord segments. These observations suggested that the L6 segment contained the largest number of spinal neurons responding to primary femoral-saphenous venous afferent input, and that input reached the more caudal segments via intersegmental connections. A proposed physiological role of these afferents is briefly described. PMID- 3958441 TI - Acidaemia reduces cardiac output and left ventricular contractility in conscious lambs. AB - We studied the effects of HCI-induced metabolic acidaemia on cardiac output, contractile function, myocardial blood flow, and myocardial oxygen consumption in nine unanaesthetized newborn lambs. Through a left thoracotomy, catheters were placed in the aorta, left atrium and coronary sinus. A pressure transducer was placed in the left ventricle. Three to four days after surgery, we measured cardiac output, dP/dt, left ventricular end diastolic and aortic mean blood pressures, heart rate, aortic and coronary sinus blood oxygen contents, and left ventricular myocardial blood flow during a control period, during metabolic acidaemia, and after the aortic pH was restored to normal. We calculated systemic vascular resistance, myocardial oxygen consumption and left ventricular work. Acidaemia was associated with reduction in cardiac output, maximal dP/dt, and aortic mean blood pressure. Left ventricular end diastolic pressure and systemic vascular resistance increased, and heart rate did not change significantly. The reduction in myocardial blood flow and oxygen consumption was accompanied by fall in cardiac work. Cardiac output returned to control levels after the pH had been normalized but maximal dP/dt was incompletely restored. Myocardial blood flow and oxygen consumption increased beyond control levels. This study demonstrates that HCI-induced metabolic acidaemia in conscious newborn lambs is associated with a reduction in cardiac output which could have been mediated by the reduction in contractile function and/or the increase in systemic vascular resistance. The decreases in myocardial blood flow and oxygen consumption appear to reflect diminished cardiac work. The restoration of a normal cardiac output after normalization of the pH appears to have resulted from the increases in heart rate and left ventricular filling pressures in conjunction with an incomplete restoration of contractile function. PMID- 3958443 TI - Severely comminuted distal radial fracture as an unsolved problem: complications associated with external fixation and pins and plaster techniques. AB - Seventy-six patients with severely comminuted distal radial fractures were treated at two institutions, of which the overwhelming majority were Frykman class VIII. Fifteen fractures were open. Thirty patients were seen at the University Hospital; 17 had pins and plaster and 13 had external fixation. Forty six patients were seen at Kaiser Hospital; all had pins and plaster treatment. The complication rate for those with pins and plaster at the University Hospital was 53%; the complication for external fixation rate was 62%. The affiliated hospital complication rate was 52%. All patients with ipsilateral forearm shaft and carpal fractures developed a nonunion of the carpal fracture. Few patients maintained anatomic reduction, and many had significant intra-articular malalignment. External fixation with threaded half pins did not obviate pin problems in our series. These methods may help manage severely comminuted distal radial fractures, but complications should be anticipated and alternative treatment considered, especially when ipsilateral carpal or forearm shaft fractures are present. PMID- 3958442 TI - The mechanism of low serum T3 in the fetus: hepatic T4-5'-monodeiodinase versus tissue sulfhydryl content--a clarification. AB - Using optimal tissue concentration, supplemented with a thiol-protecting agent, the fetal liver has lower T4 5'-monodeiodinating activity than maternal or neonatal tissue. This is a true deficiency and is not due to deficiency of sulfhydryl groups in fetal tissue as previously suggested. Evidence indicates a dissociation of the neonatal surge of serum T3 and the increase in hepatic T4 to T3 conversion activity, suggesting that the neonatal T3 surge is related more to thyroid gland stimulation than to T4 to T3 conversion in non-thyroid tissues. PMID- 3958444 TI - The long-term results of Swanson silicone rubber interpositional wrist arthroplasty. AB - Fifty-three Swanson silicone rubber interpositional wrist arthroplasties were done in 42 patients. A painful rheumatoid wrist was the most common operative indication. Very acceptable clinical results were obtained early in follow-up, with more than 90% of the wrists obtaining significant pain relief. However, in the group of wrists followed for more than 2.5 years, only 61% had good or excellent results. The reoperation rate in this group was 25%. Postoperative complications included prosthetic breakage (9.4%), ulnar cap breakage (71%), and a very high incidence of progressive radiographic deterioration (70%). PMID- 3958445 TI - Failure of silicone rubber wrist arthroplasty in rheumatoid arthritis. AB - Of 71 silicone rubber wrist arthroplasties performed between 1976 and 1983, 20% were found to have fractured, and an additional 5% required revision for deformity and pain. In most cases, no specific cause for the failure could be identified. However, excessive wrist motion, overuse, and inadequate surgical technique appear to be contributory. Prosthetic fracture is associated with increasing wrist pain, instability, and deformity with decreasing strength and function. Twelve of 14 fractured prostheses required revision. Eleven of these were revised with another silicone rubber implant, and two of these have refractured. Based on this review, we have narrowed our indications for silicone rubber wrist arthroplasty and now give greater consideration to alternative methods of treatment. PMID- 3958446 TI - Carpometacarpal dislocations: report of five cases and review of the literature. AB - Carpometacarpal dislocations occur in less than 1% of hand injuries. Since 1973, five cases were treated at Henry Ford Hospital. Three of the dislocations were unstable and required internal fixation. Of these dislocations only one needed open reduction. The other two dislocations were successfully treated by closed reduction and cast immobilization. Follow-up ranged from 2 to 13 months. Three patients were asymptomatic, and the other two, both of whose injuries had been treated by internal fixation, reported pain with activity. PMID- 3958447 TI - Radial sensory nerve entrapment in the forearm. AB - A group of 51 patients with complaints related to entrapment of the superficial sensory branch of the radial nerve is described. Symptoms included altered sensibility over the dorsoradial aspect of the hand and dorsoradial cutaneous pain with ulnar flexion of the wrist or with gripping and pinching. Pertinent history included compressive or crushing forearm injuries, work activities requiring frequent pronation and wrist hyperextension, and associated illnesses, such as diabetes. Physical examination included abnormal touch perception, abnormal moving two-point discrimination over the dorsoradial area of the hand, a positive Tinel sign in the forearm, and aggravation of the patient's symptoms with forced forearm pronation and wrist ulnar flexion. Seven (37%) of 19 patients treated with nonoperative modalities after a mean of 28 months from the onset of symptoms or their injury were improved. Of the 32 patients treated with surgery with a mean follow-up of 10 months (range of 6 to 29 months), there has been excellent subjective improvement in 37%, good subjective improvement in 49%, and fair subjective improvement in 6%, and 8% were not improved. Of this group of surgically treated patients, 43% have returned to their regular jobs, and 22% are in either vocational rehabilitation or working at a different job. PMID- 3958448 TI - Histopathology of compression of the superficial radial nerve in the forearm. AB - A histologic assessment of the radial sensory nerve from a patient with nerve compression is reported. Histologic changes were confined to the region of the nerve compression. Connective tissue changes consisted of an increased thickness of the epineurium and perineurium. Nerve fiber changes consisted of Schwann cell pathology with marked thinning of the myelin noted in the myelinated fibers and evidence of degeneration and regeneration noted in the unmyelinated fiber population. Nerve fiber pathology was not uniform but varied from fascicle to fascicle in the compressed area. PMID- 3958449 TI - Saddle deformity. Posttraumatic interosseous-lumbrical adhesions: review of eighty-seven cases. AB - Trauma to the hand can result in adhesions between the interosseous and lumbrical muscles with subsequent painful impingement on the deep transverse metacarpal ligament during intrinsic contraction. If these adhesions also develop between the intrinsic muscles and the deep transverse metacarpal ligaments or metacarpophalangeal capsule, discomfort may be produced by stretching of the intrinsic tendons. Release of these adhesions, partial resection of the ligament, and early mobilization can produce relief of the symptoms. Eighty-seven cases are reviewed with respect to causes, diagnosis, and treatment. PMID- 3958450 TI - Carpal tunnel syndrome caused by aberrant lumbrical muscles associated with cystic degeneration of the tenosynovium: a case report. AB - A 7-year-old boy who suffered from carpal tunnel syndrome caused by aberrant lumbrical muscles associated with cystic degeneration of the tenosynovium of the left hand is described. Judging from the literature studied, this seems to have a very rare origin. Symptoms subsided, and no recurrence has been noticed after operative removal of these structures. PMID- 3958451 TI - An industrial cause of carpal tunnel syndrome. AB - A retrospective study was done to determine why a meat packing plant in Illinois had such an unusually high incidence of carpal tunnel syndrome. In the past 12 years, 14.8% of employees at this plant have had a carpal tunnel release. Only two of 117 patients remained unimproved at an average follow-up of 37.4 months. The most consistent result after release was relief of the paroxysmal attacks of burning pain and paresthesia. Weakness of grip was the most significant postoperative complaint in 78%. Highly repetitive motions involving extreme wrist positions, especially flexion and ulnar deviation while grasping, are predominant in meat cutting and probably contribute to the development of carpal tunnel syndrome in this industry. Previous reports of industrial carpal tunnel syndrome have not approached the incidence identified in this study. Patient awareness and Workers' Compensation benefits may account for the high numbers seeking treatment. PMID- 3958452 TI - Unusual rupture of a flexor profundus tendon. AB - An unusual rupture of a flexor profundus tendon, previously unreported in the literature, is presented. There was avulsion and proximal displacement of a large bone fragment from the palmar base of the distal phalanx and further retraction of the tendon unattached to the bone fragment. PMID- 3958453 TI - Conservative treatment of two cases of mallet thumb. PMID- 3958454 TI - Trigger thumb of de Quervain's disease. AB - Triggering of the thumb due to de Quervain's Disease has not been reported in an adult, and only one case in a child has been documented in the literature. Two cases of trigger thumb that were due to stenosing tenosynovitis in which the extensor pollicis brevis tendon triggered in a separate fibro-osseous tunnel within the first dorsal compartment are cited. PMID- 3958455 TI - Chronic sesamoiditis of the thumb: pathomechanics and treatment. AB - Entrapment of the sesamoids within the metacarpophalangeal joint can result in irreducible dislocations; however, dysfunction from trauma-induced, chronic sesamoiditis is unfamiliar. Twenty-five patients with intractable posttraumatic pain of the metacarpophalangeal joint of the thumb are reported. The mechanisms of the palmar plate injury included hyperextension, direct compression, shear forces, and lateral stress. Sesamoidectomy achieved good results in 80% of patients as evidenced by return to preinjury activities. Residual joint stiffness was present in 20% of patients, and 8% had significant residual pain. Traumatic microtears appear to produce pathologic findings in the perisesamoid tendon and/or sesamoid-metacarpal articulation. PMID- 3958457 TI - Interscalene brachial plexus block anesthesia for upper extremity surgery. AB - Use of the interscalene brachial plexus block for upper extremity anesthesia in a primarily rheumatoid population is reviewed in 88 cases. The interscalene approach described by Winnie was used. Anesthesia was effective in 93% of the cases. Failure to achieve anesthesia was more likely to occur in surgical procedures on the distal upper extremities. The technique allowed effective and reliable anesthesia throughout the upper extremity, including the shoulder. Problems associated with other forms of upper extremity regional anesthesia, such as tourniquet pain, pneumothorax, systemic anesthetic toxicity, and inadequate duration of anesthesia, were not encountered. Difficulties with more distally based block administration due to decreased shoulder motion were obviated. PMID- 3958456 TI - Fascia patch graft for a digital flexor sheath defect over primary tendon repair in the chicken. AB - The histologic appearance of 14 chicken flexor tendon repair sites with a defect in the tendon sheath was compared with 14 covered by fascia patch grafts. Half the animals (seven with and seven without the patch) were studied 3 weeks after surgery and the other half 8 weeks after surgery. The qualitative microscopic examination showed that the area of healing was better organized with less restrictive-appearing adhesions when the sheath defect was grafted. PMID- 3958458 TI - The locked metacarpophalangeal joint: diagnosis and treatment. AB - The locked metacarpophalangeal joint of a finger is an unusual condition frequently confused with a "trigger finger." The causes can be classified into degenerative and spontaneous groups. Ten cases are presented. The cause of locking of one patient in the degenerative group was gouty arthritis, a cause not previously reported in the literature. Although surgery is usually necessary, joint mobility was restored in 30% of the cases by distending the joint capsule with an intraarticular injection of a local anesthetic followed by gentle manipulation. In addition to routine x-ray films, arthrotomography was found to be a useful diagnostic technique in determining the cause of locking. PMID- 3958459 TI - Chronic palmar dislocation of proximal interphalangeal joints. AB - Seven patients with chronic palmar dislocations of proximal interphalangeal joints are described. The duration of the dislocation ranged from 4 weeks to 19 months. Satisfactory mobility was restored in each patient after operative reduction and reconstruction of the extensor mechanism. Motion of the proximal interphalangeal joint averaged 57.1 degrees and 29.3 degrees at the distal interphalangeal joint. This method of treatment is preferable to an arthrodesis in selected patients. PMID- 3958460 TI - Arterial anatomy of the triangular fibrocartilage of the wrist and its surgical significance. AB - This vascular injection study of the triangular fibrocartilage (TFC) was carried out in 12 fresh cadaver arms--eight adults and four infants--with Ward's blue latex. The TFC receives its blood supply from (1) the ulnar artery through its palmar and dorsal radiocarpal branches, (2) the dorsal branch of the anterior interosseous artery, and (3) the palmar branch of the anterior interosseous artery. These vessels are arranged in a radial fashion in relation to the fibrocartilage. Histologic sections of the TFC reveal vascularity in the outer 15% to 20% of the disc, and the rest is avascular. On the basis of these findings, we feel that tears of the TFC in its vascular zone have the potential to heal if repaired and those in the central avascular zone do not have this potential. PMID- 3958461 TI - Multiple anomalous tendons of the fourth dorsal compartment. AB - Variations of the extensor tendons of the fourth dorsal compartment are usually single anomalous tendons to multiple digits or multiple anomalous tendons to a single digit. They are not uncommon. However, while exploring a dorsal wrist mass, we discovered that it was a tenosynovitis presumably secondary to the 12 tendons found in this compartment rather than the expected five extensor tendons. PMID- 3958462 TI - Functional limb salvage with multimodality treatment in epithelioid sarcoma of the hand: a report of two cases. AB - Two cases of epithelioid sarcoma in the hand are reported. The first presented as a space-occupying lesion causing carpal tunnel syndrome, which has not been previously reported. The second case presented with a tumor in the palm that was initially misdiagnosed as a benign tumor and was treated inadequately and recurred. With treatment consisting of surgical excision, adjuvant local radiotherapy, and pulsed systemic chemotherapy combined with early detection and aggressive treatment of distant metastases, both patients have functional hands without local recurrence. They are presently free of obvious disease and remain under close observation at short follow-up of 6 and 4 years, respectively. PMID- 3958463 TI - Invasive squamous cell carcinoma of the carpus: malignant transformation of epidermis dysplasia verruciformis. AB - Epidermodysplasia verruciformis is a rare disease that is characterized by the eruption of wartlike skin lesions. There is a high incidence of malignant transformation of these lesions, especially in areas exposed to the sun, such as the face or the dorsum of the hands. We present a case that demonstrates many aspects of this disease entity, which ultimately required amputation of the hand because of invasive squamous cell carcinoma of the carpal bones. PMID- 3958464 TI - Intravascular papillary endothelial hyperplasia in the hand. AB - Intravascular papillary endothelial hyperplasia is a rare benign tumor of vascular origin. The hand is one of its common locations. The case reported showed bony erosion that has not been described in the hand. PMID- 3958465 TI - The management of multiple fractures in one upper extremity: a case report. AB - Multiple fractures involving the dominant proximal forearm and wrist in a 24-year old woman were treated with a combination of internal and external fixation. The rigid skeletal fixation permitted rapid postoperative mobilization and a successful functional outcome. PMID- 3958466 TI - Fixation of metacarpal and phalangeal fractures with miniature plates and screws. AB - Fifty-two unstable metacarpal and phalangeal fractures were treated with miniature plates and screws as internal fixation devices with excellent results based on the criteria of the American Society for Surgery of the Hand (total active range of motion greater than 220 degrees). This technique stabilizes the skeleton, preserves the gliding tissues, and thus allows immediate active range of motion exercises. Transverse, spiral, oblique, and condylar fractures of the metacarpals and phalanges are best suited for this method. PMID- 3958467 TI - Epiphyseal destruction of children's hands after frostbite: a report of two cases. AB - Two cases of epiphyseal destruction resulting from frostbite in the hands of children are reported. The most significant change observed on the x-ray film was the absence of the epiphyses. Stunted growth and mild flexion deformity of the fingers are characteristic sequelae. PMID- 3958468 TI - Infections of the upper extremity. PMID- 3958469 TI - "Improved exposure for arterial repair and thumb reimplantation". PMID- 3958470 TI - "Dynamic compression for small bone arthrodesis". PMID- 3958471 TI - Hepatobiliary fibropolycystic diseases. A clinical and histological review of 51 patients. AB - The clinical, radiological and hepatic histological features of 51 patients with hepatobiliary fibropolycystic disease were reviewed. Many of the patients had more than one of the diseases; the combination of both congenital hepatic fibrosis (CHF) and Caroli's disease was most striking. Twelve patients with CHF (50% male) presented at 6 +/- 2 years of age (mean +/- SEM) with hepatosplenomegaly or variceal bleeding. Their main problems were recurrent variceal bleeds and renal disease. Polycystic kidneys and renal stones were present in 79% and chronic renal failure in 30%. Six of the 8 patients with Caroli's disease were male (75%) and presented later (aged 37 +/- 8 years) with hepatomegaly or cholangitis. Recurrent cholangitis developed in most (7/8) and 2 had polycystic kidneys. Twelve patients had a combination of CHF and Caroli's disease presenting with hepatosplenomegaly, bleeding or cholangitis. As in Caroli's disease, most (83%) were male, but the age of presentation (15 +/- 4 years), and the incidence of polycystic kidneys (42%) and renal failure (8%) was intermediate between CHF and Caroli's disease. In these patients, bleeds always predated cholangitis. Histologically, acute cholangitis was superimposed on the changes of CHF. Adult polycystic liver disease (10 patients) presented later (43 +/- 3 years) in females (90%) with pain, a mass or incidentally; polycystic kidneys were present in 33%. Microhamartomas (10 patients), which were usually incidental findings, were diagnosed latest (50 +/- 6 years). Three choledochal cysts were seen. The hazard of cancer in these diseases was reflected by 2 bile duct cancers and 1 pancreatic cancer (incidence 6%). This study has confirmed that hepatobiliary fibropolycystic diseases form part of a family and are often associated together. However, the diseases are of greatly differing severity and the prognosis in an individual patient is determined by the fibropolycystic diseases present. PMID- 3958472 TI - Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. AB - This paper reviews the complications that arose after 68 276 percutaneous liver biopsies performed from 1973 to 1983. The complications are analyzed in relation to the underlying liver disease and to the type of needle used. Death was infrequent (9/100 000); it was always due to haemoperitoneum and occurred only in patients with malignant diseases or cirrhosis. Complications were less frequent in AVH (44/100 000) than in other liver diseases (from 125 to 278/100 000). Death, serious haemorrhagic complications, pneumothorax and biliary peritonitis were more frequent after biopsy with the Trucut needle than after biopsy with Menghini's needle (3/1000 against 1/1000). Sixty-one percent of complications were discovered within two hours of biopsy and 96% within one day. The data indicate a post biopsy observation period of at least 24 hours. The day-case procedure should be reserved for patients not presenting liver tumour or cirrhosis. PMID- 3958473 TI - Integration of HBV-DNA may not be a prerequisite for the maintenance of the state of malignant transformation. An analysis of 110 liver biopsies. AB - Hundred and ten liver biopsy specimens from various parts of the world were examined for episomal and integrated HBV-DNA sequences. In 54 patients with HBsAg chronic liver disease episomal HBV-DNA was found in 83% of HBeAg-positive patients, compared to only 22% of patients with anti-HBe. Furthermore episomal HBV-DNA in the latter predominated among the Asians. Integrated HBV-DNA was found only in 5.5% of HBeAg-positive patients but in 16.5% of patients with anti-HBe. In 28 HBsAg-positive patients with hepatoma, episomal HBV-DNA was found in 50% of HBeAg-positive patients but in only 11% of anti-HBe patients. Conversely integrated sequences were less common (25%) in HBe-Ag-positive patients than in anti-HBe patients (50%), giving an overall incidence of integration in this group of 45%. No episomal, and only one case of integrated sequences of HBV-DNA, could be detected among 10 patients with HBsAg-negative hepatoma. In addition neither episomal nor integrated HBV-DNA could be detected in 18 patients with non-HBV related liver disease. Our data suggests that stable integration of HBV-DNA into the host's genome is not necessarily a prerequisite for the maintenance of the state of malignant transformation but may be necessary for its initiation. Alternatively, the detection of integrated HBV-DNA may represent a 'snap shot' of a random integration event amplified by clonal expansion promoted by other factors. PMID- 3958475 TI - Alterations in relative proportions of microheterogenous forms of human alpha 1 acid glycoprotein in liver disease. AB - To determine whether liver damage correlates with typical changes in alpha 1-acid glycoprotein (alpha 1-AGP) carbohydrate branching, we selected patients with liver disease determined by histological liver findings. The severity of their illness was assessed by a clinical classification depending on the presence singly or together of four clinical complications (jaundice, ascites, hepatic encephalopathy and weight loss). An alpha 1-AGP crossed immunoelectrophoresis with Concanavalin A, an easy-to-perform method, revealed 3 or 4 subpopulations, the areas of which were calculated. A ratio R was determined as the most anodic peak area relative to the other ones. In our experimental conditions a ratio R value exceeding 1 correlated with the presence of one or more clinical complications. These results, evidencing fluctuations in the proportion of the carbohydrate variants of alpha 1-AGP, lead us to propose such a ratio as an index for grading liver damage. The sensitivity of this test was 86% and its specificity was 83%. PMID- 3958474 TI - Epidemiological studies on the prevalence of hepatitis Delta virus infections in the Federal Republic of Germany. AB - This study evaluated the prevalence of hepatitis Delta virus (HDV) infections in various groups of HBsAg carriers including drug addicts and patients with hemophilia in the Federal Republic of Germany. HDV was found only occasionally (less than 1%) in individuals found HBsAg positive during an examination as potential blood donors or in hemodialysis patients, but in 3% in patients with chronic hepatitis and up to 50% in drug addicts and hemophilia patients. These findings are in agreement with data reported from other European countries. Presence of antibodies to HDV in two hemodialysis patients indicates the presence of HDV in this group and screening for HDV infections in hemodialysis units is indicated to prevent outbreaks of this disease in HBsAg-positive patients with possibly serious consequences. PMID- 3958476 TI - Alteration in response of the portal tributary vascular bed to the beta-agonist dobutamine in rats with extrahepatic portal hypertension. AB - The acute effects of 2 doses of the beta-agonist dobutamine on systemic and splanchnic haemodynamics were studied in normal rats and in rats with portal hypertension due to portal vein stenosis. Cardiac output and splanchnic organ blood flow were estimated with the radioactive microsphere method and portal pressure was measured. Low dose (5 micrograms/kg) of dobutamine did not change significantly arterial pressure and portal pressure but, cardiac output was significantly higher after dobutamine than after placebo in both groups of rats. Similar results were observed with 15 micrograms/kg of dobutamine except for a significant decrease in arterial pressure in portal-hypertensive rats. In sham operated rats, dobutamine significantly increased portal tributary blood flow; this rise was parallel to cardiac output. In contrast, in portal-hypertensive rats, portal tributary blood flow did not change significantly after dobutamine. Accordingly in the former group, portal tributary vascular resistance significantly decreased, whereas in the latter group, no change in this resistance was observed with a low dose and a significant decrease was noted with a high dose. In both groups of rats, hepatic arterial blood flow was not significantly different after dobutamine than after placebo. This study demonstrates that the vasodilatory response of the portal tributary vascular bed to an increase in cardiac output is altered in anaesthetized rats with portal hypertension due to portal vein stenosis. PMID- 3958477 TI - Serum bile acids. Physiological determinants and results in liver disease. PMID- 3958478 TI - Acid-base disturbances in liver disease. AB - There are several important associations between the liver and acid-base balance. First, primarily because of its metabolism of certain cationic amino acids and organic acid anions, particularly lactate, the liver has a surprisingly important influence on normal acid-base homeostasis. Second, in the presence of the necessary pathogenic milieu, the liver may produce a life-threatening number of hydrogen ions. Examples include accelerated ketogenesis during insulinopenic states, or lactate production during severe hepatic parenchymal hypoxia. Third, patients with various types of liver disease, both acute and chronic, often develop complicating acid-base disturbances. In addition, liver disease may predispose the patient to a particular acid-base disorder such as phenformin induced lactic acidosis. Finally, the acid-base disturbance may be a complication of therapy, as when diuretic therapy directed at ascites results in metabolic alkalosis. PMID- 3958479 TI - Genes that affect morphogenesis of the murine mandible. Recombinant-inbred strain analysis. AB - The CXB set of recombinant inbred mouse strains provided an opportunity to observe the effects of reassorted subsets of genes on the shape of the mandible. The distances between 12 landmarks in all paired combinations were calculated to evaluate genetic control in small regions. The genetic relationships between interlandmark distances revealed genes to have most of their effects in localized regions, and the greater heritabilities usually to apply to those distances between adjacent landmarks. Interrelationships between measurements are usually explicable on a developmental basis. It is proposed that genes of this sort bring about the changes seen in organ shape during evolution. A model plan for the organization of gene activation during morphogenesis is described. PMID- 3958480 TI - Embryonic characteristics in superovulated mouse strains. Comparative analyses of the incidence of chromosomal aberrations, morphological malformations, and mortality of embryos from two strains of superovulated mice. AB - Superovulation was induced in an inbred (C3HeB/FeJ) and a random-bred (CD-1) strain of mice and pregnant females were serially sacrificed from 6-15 days of gestation. All embryos were examined chromosomally and by external morphology. A G-banding technique was used to detect specific chromosomal constitutions. The common types of chromosomal aberrations were monosomies and trisomies. Our results showed that the proportion of chromosomally abnormal embryos was significantly greater in the superovulated group of inbred mice, than in the spontaneously ovulating inbred group, an observation not made in the random-bred mice. In each strain, superovulation yielded a significantly higher proportion of morphologically malformed embryos, but no significant difference between strains with respect to this criterion was noted after superovulation. There was a significant increase in the post-implantation embryonic mortality in the random bred strain but not in the inbred strain following superovulation. This study indicates that each strain has its intrinsic pattern with regard to the fate of embryos following superovulation. PMID- 3958481 TI - Linkage of genes for ectopic testes and male pseudohermaphroditism in the rat. PMID- 3958482 TI - Precise location of breakpoints in a frequent reciprocal translocation between chromosomes 11 and 22. AB - One of the most frequent chromosomal translocations in human beings is 11q/22q, which results in the "partial trisomy of 22q syndrome." However, the breakpoint on the long arms of chromosomes 11 and 22 is still a matter of controversy. In the present study, we have used chromosomes from lymphocytes of a neonate who happened to have this classical abnormality, and by R-banding prometaphase chromosomes with acridine orange it has been possible to establish that the translocation between chromosomes 11 and 22 resulted from 3:1 meiotic maternal nondisjunction. A detailed analysis of the chromosome regions involved in this translocation revealed that the breakpoints on chromosomes 11 and 22 were at 11q23.3 and 22q11.1, respectively. PMID- 3958483 TI - Design and interpretation of studies comparing individuals with and without a family history of high blood pressure. PMID- 3958484 TI - Subcellular membrane properties in vascular and non-vascular smooth muscles of Dahl hypertensive rats. AB - Subcellular membrane fractions were isolated from mesenteric arteries and vas deferens of salt-resistant and salt-sensitive Dahl rats on low-salt (0.4% NaCl) high-salt (8.0% NaCl) diets. Only the salt-sensitive Dahl rats on the high-salt diet developed sustained high blood pressure (BP) after 5 weeks of the high-salt diet. Protein contents, membrane associated enzyme activities, calcium ion (Ca2+) binding and ATP-dependent CA2+ transport were compared in fractions isolated from all four groups. No obvious changes were observed, except for minor enhancement in magnesium ion (Mg2+)- and CA2+ ATPase activities of mesenteric arterial membranes isolated from salt-sensitive Dahl rats on high-salt diet compared to those from other groups of rats. The membrane fractions from vas deferens of salt sensitive Dahl rats on the high-salt diet, on the other hand, showed decreased ATP-dependent Ca2+ transport compared to those from salt-sensitive Dahl rats on the low-salt diet. No difference was observed in membrane fractions isolated from salt-resistant Dahl rats on high-salt diet compared to those on low-salt diet. The significance of these observations are discussed in relation to the findings previously obtained from corresponding smooth muscle tissues of spontaneous hypertensive rats (SHR). PMID- 3958485 TI - Cardiac dimensions in spontaneously hypertensive rats following different modes of blood pressure reduction by antihypertensive treatment. AB - The present study examined changes in left ventricular design in spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rats in response to different types of antihypertensive therapy. Blood pressure was reduced for 12 weeks by either peripheral vasodilators [hydralazine or felodipine (calcium antagonist)] or by sympatholytic drugs (alpha-methyldopa or metoprolol). End diastolic volumes (EDV) were obtained in vitro by determining the diastolic pressure-volume relationships of isolated perfused hearts, arrested in diastole by excluding calcium from the perfusate. Wall thickness (w) and internal radius (ri) were calculated from a ventricle considered as a spherical model. Compared with WKY, untreated SHR had elevated EDV and w. Vasodilator therapy, particularly felodipine, increased EDV but reduced w, while sympatholytic therapy with alpha methyldopa reduced EDV in SHR. It is suggested that cardiac design is affected not only by the prevailing arterial pressure level which will affect w, but also by the haemodynamic situation. Vasodilators turn such a situation into one characterized by increased cardiac output and hence increased cardiac filling, whereas sympatholytic drugs by venodilatation will turn the haemodynamic situation towards a state characterized by reduced cardiac filling. Left ventricular EDV (ri) therefore seems to adapt to long-term filling conditions, while w adapts to bring w:ri ratio in balance with the pressure load. PMID- 3958486 TI - The survival of treated hypertensive patients and their causes of death: a report from the DHSS hypertensive care computing project (DHCCP). AB - A prospective study has been carried out to determine the causes of death and risk factors for survival in 4994 patients referred with a diagnosis of hypertension to hospital specialist clinics and 457 patients treated by their general practitioners for this condition. At the time of entering the prospective study, 69% of the patients were already being treated for hypertension. Four hundred and eleven patients have died, and their causes of death and death rates have been compared with the rates for the population of England and Wales. Ischaemic heart disease accounted for over one-third of the deaths and stroke for one-fifth. The death rates for these conditions were two to five times those expected for men and women aged 50-59 years and up to twice the rate expected for the age group 60-69 years. Survival in these selected patients was impaired by the following independent risk indicators: cigarette smoking, previous history of myocardial infarction or stroke, diagnosis of angina, impaired renal function and raised blood sugar. The following factors were not independent positive risk factors: smoking a pipe or cigars, obesity, a low plasma potassium and an elevated serum uric acid. PMID- 3958487 TI - Inhibition of lymphoid cell growth by a lipid-like component of macrophage hybridoma cells. AB - Previous studies have shown that plasma membranes of murine lymphocytes and lymphoid tumor cells can reversibly inhibit the growth of both normal and transformed lymphocytes. The inhibitor can be extracted with organic solvents and has properties consistent with it being a lipid or lipid-like component of the membrane. This report identifies a series of cloned macrophage hybridoma cell lines, obtained by fusion of splenic adherent cells and the P388D1 line, which have very high levels of lipid-like growth-inhibitory molecules. Furthermore, a survey of seven cloned lines indicated that the macrophages fell into two distinct groups with regard to their level of growth-inhibitory activity. Group 1 lines had little or no inhibitory activity when cells were examined for their effect on a B lymphocyte proliferative response. Organic extracts from these macrophages had inhibitory activity (on a per cell basis) comparable to that seen with extracts of the P388D1 parental cell line and lymphoid tumor cells. In contrast, relatively low numbers of Group 2 macrophages could profoundly inhibit B macrophage proliferation. The growth-inhibitory activity was quantitatively recovered in organic extracts of the macrophages. Although the precise nature of the lipid moiety remains undefined, the data argue against the involvement of oxidized cholesterol. These findings indicate that lipid-like inhibitors of cell growth are present and functional in these macrophage cell lines. In addition, the results demonstrate that the inhibitory activity found in plasma membranes and liposomes is present and active in the membranes of intact cells, which is in contrast to the possibility that the inhibitor is an artifact generated during subcellular fractionation. Thus, the inhibitor is likely to have a physiologic role in growth control and in macrophage-mediated immunoregulation, probably acting via a mechanism involving cell-cell contact. PMID- 3958488 TI - C5b-9 assembly: average binding of one C9 molecule to C5b-8 without poly-C9 formation generates a stable transmembrane pore. AB - Membrane attack by serum complement normally results in the formation of C5b-9 complexes that are heterogeneous with respect to their C9 content. We here report that an apparently homogeneous population of C5b-9 complexes can be generated through treatment of C5b-7-laden sheep erythrocytes with C8 and C9 for 60 min at 0 degree C. Experiments performed by using radioiodinated C8 and C9 components have indicated that binding of C8 to these target cells is essentially temperature independent. In contrast, when a surplus of C9 molecules is offered to C5b-8 cells, an approximately fourfold to 4.5-fold higher number of C9 molecules become cell bound at 37 degrees C as opposed to 0 degree C. C5b-9 complexes isolated from target membranes treated with C9 at 0 degree C contain no polymerized C9 and do not exhibit the ring structure characteristic of the classical complement lesion. Nevertheless, these complexes generate stable transmembrane channels and cause hemolysis at 37 degrees C. The pores have been sized to 1 to 3 nm effective diameter by osmotic protection experiments. SDS-PAGE of the isolated complexes indicates an average stoichiometry of only one molecule C9 bound per C5b-8 complex. The results show that oligomerization of C9 with formation of ring lesions is not a basic requirement for the generation of stable transmembrane complement pores in sheep erythrocytes. They indirectly support the contention that terminal complement components other than C9 contribute to the intramembrane domains of C5b-9 pores. PMID- 3958490 TI - The effect of antibody valency and lysosomotropic amines on the synergy between ricin A chain- and ricin B chain-containing immunotoxins. AB - The cytotoxicity of A chain immunotoxins containing IgG or Fab fragments specific for the surface immunoglobulin of the Daudi cell line was assessed in the presence of B chain immunotoxins (IgG or Fab) or lysosomotropic amines, or both. The concentration required for 50% inhibition of protein synthesis (IC50) in Daudi cells was 1.3 X 10(-8) M for IgG-A and 5 X 10(-8) M for Fab-A. The toxicity of both A chain immunotoxins was enhanced twofold by ammonium chloride. In the presence of A chain immunotoxins and ammonium chloride, a maximum of 99 and 90% reduction of clonal precursors was obtained with IgG and Fab-A chain immunotoxins respectively. Immunotoxins containing ricin B chain and IgG or Fab fragments specific for the antibody portion of A chain immunotoxins were used as secondary "piggyback" immunotoxins to treat cells that were pretreated with A chain immunotoxins. Both B chain immunotoxins were nontoxic at 1 X 10(-6) M. When added to target cells pretreated with specific A chain immunotoxins, the IC50 of the A chain immunotoxins was decreased up to 16-fold in the absence of ammonium chloride. In contrast to the results obtained with A chain immunotoxins alone, ammonium chloride significantly increased the toxicity of the complete piggyback system, resulting in the killing of 99.999% or five logs of target cells in the clonal assay. This decreased the IC50 of A chain immunotoxins up to 116-fold when compared with A chain immunotoxin alone. This enhanced toxicity was independent of the valency of either immunotoxin. PMID- 3958489 TI - Prophylactic treatment of BALB/c mice with cyclosporine A and its analog B-5-49 enhances resistance to Leishmania major. AB - The effect of cyclosporine A (Cs A) and its analog B-5-49 on Leishmania major in vitro and in vivo in the highly susceptible BALB/c mouse strain has been investigated. In vitro, both of these drugs showed significant toxicity toward L. major, but only at relatively high levels (greater than 25 micrograms/ml). However, at 5 and 10 micrograms/ml, levels which correspond more closely to physiologically achievable concentrations, no growth-inhibitory effect in vitro was observed. On administration of the drugs to animals with established lesions, no beneficial effect was observed and, in fact, some exacerbation of lesion development and disease progression was noted. Surprisingly, a majority of the mice treated prophylactically with Cs A for a period of 7 consecutive days beginning 1 day before infection with L. major did not develop ulcerated cutaneous lesions, although some footpad swelling was observed 10 days to 2 wk after infection. These resistant animals displayed a sustained DTH after infection, and were resistant to further challenge with virulent L. major. Prophylactic treatment with the B-5-49 analog of Cs A was also effective in enhancing resistance to L. major infection in BALB/c mice, although to a somewhat lesser degree. Because the cyclosporines tested do not appear to be directly toxic nor inhibitory in vivo for established L. major infections, it appears that these drugs may be effective in modulating the induction stage of the immune response toward the parasites in the BALB/c mouse in such a way as to allow a protective immunity to develop. PMID- 3958491 TI - Phenotypic alterations in tumors that developed from threshold subcutaneous inocula. I. Reduced binding of natural antibodies and sensitivity to hypotonic lysis. AB - Tumors obtained from the injection site of threshold subcutaneous inocula of L5178Y-F9 or SL2-5 lymphomas in syngeneic mice exhibited increased tumor frequencies and reduced sensitivities to other parameters of natural immune resistance in vivo and in vitro. An examination of the resistant phenotype of cells derived through this model of tumor progression revealed that the more aggressive in vivo grown cells were less able to inhibit natural killer (NK) cell cytolysis and to bind natural antibodies (NAb) measured through fluorescence analysis, although they could not be distinguished from the starting clones by absorption of NAb for complement-mediated lysis. The in vivo grown cells also exhibited a reduced sensitivity to hypotonic lysis, which was not detectable after preincubation at 4 degrees C or upon exposure to sodium azide, procedures that reduced the lysis of the starting clones. The differential susceptibility of the in vivo grown cells was increased to control levels by treatment with cycloheximide or colchicine. These studies suggest that a decreased sensitivity to lysis associated with a reduced autolytic process and an increased counterlytic mechanism, in addition to a reduced antigen expression for binding of NK cells and certain NAb contribute to this resistant phenotype, which may characterize tumors that arise under the selective pressure of natural resistance mechanisms in the natural course of neoplastic development. PMID- 3958492 TI - Origin and differentiation of natural killer cells. II. Functional and morphologic studies of purified NK-1.1+ cells. AB - Cells bearing the NK-specific marker NK-1.1 were purified from mouse spleens by utilizing a monoclonal anti-NK-1.1 antibody and cell sorting. In normal adult mice, all of the splenic NK activity against YAC-1 cells was found in the NK-1.1+ fraction, whereas NK-1.1- cells were depleted of NK activity. The NK activity of sorted NK-1.1+ cells was enriched 15- to 30-fold over unfractionated spleen cells. Light and electron microscopic studies of purified NK-1.1+ cells showed a homogeneous population of cells, each containing one to four cytoplasmic granules. Mice whose bone marrow has been destroyed by chronic exposure to 17 beta-estradiol have very low NK activity. However, spleen cells of estradiol treated mice contained a normal frequency of NK-1.1+ cells which bound to YAC-1 cells, but failed to lyse them even after purification and subsequent exposure to interferon-alpha/beta in vitro. It appears, therefore, that in the absence of intact bone marrow, NK-1.1+ cells may be arrested in a nonlytic and interferon unresponsive state. Spleens of neonatal mice which have low NK activity were analyzed to ascertain whether immature NK-1.1+ cells, similar to those found in estradiol-treated mice, could be demonstrated. Spleens of 8- to 9-day-old mice also contained NK-1.1+ cells which had very low NK activity even after purification. Sorted NK-1.1+ cells were examined for cytotoxicity in mice whose NK activity was suppressed by pretreatment with Corynebacterium parvum (-15 days). In contrast to cells from estradiol-treated and neonatal mice, NK-1.1+ from mice treated with C. parvum had normal functional activity. Similarly, although NK activity of unfractionated bone marrow cells is low, sorted NK-1.1+ cells were greatly enriched for lytic activity. Thus, we conclude that cell sorting with monoclonal anti-NK-1.1 antibody provides a powerful tool for examining the mechanisms underlying various states of low NK activity, and there exist NK-1.1+, nonlytic, interferon-unresponsive cells which apparently require an intact marrow microenvironment for differentiation into mature, lytic NK cells. PMID- 3958493 TI - Isolation and analysis of primitive hemopoietic progenitor cells on the basis of differential expression of Qa-m7 antigen. AB - In the presence of the hemopoietic growth factor CSF-1, the later committed cells of the macrophage lineage can be detected by their ability to form small colonies in clonal agar culture (CFCCSF-1). Synergistic factors have been described that in combination with CSF-1 stimulate developmentally early hemopoietic progenitor cells of high proliferative potential (HPP-CFC). By using a monoclonal antibody to the Qa-m7 antigenic determinant, we investigated and compared the expression of Qa-m7 on CFCCSF-1 and on HPP-CFC of two types that grow in response to either 1) CSF-1 plus synergistic factor from human placenta-conditioned medium (HPP CFCHplac+CSF-1) or 2) CSF-1 plus synergistic factor from conditioned medium of the WEHI-3 myelomonocytic cell line (HPP-CFCW+CSF-1). We have shown that HPP-CFC of both types express relatively more Qa-m7 antigen than CFCCSF-1 and can be separated and enriched on this basis by discontinuous buoyant density centrifugation and fluorescence-activated cell sorting of normal bone marrow. Significant enrichments of HPP-CFCHPlac+CSF-1 (43.5-fold) and HPP-CFCW+CSF-1 (28.8-fold) have been achieved with cloning efficiencies of HPP-CFC in the most enriched fractions reaching 4 to 5%. These results clearly illustrate the fact that there are populations of progenitor cells from normal, unperturbed bone marrow that strictly require a combination of two hemopoietic growth factors (CSF 1 plus synergistic factor) in order to be detected. PMID- 3958494 TI - Antigenic modulation of human myotube acetylcholine receptor by myasthenic sera. Serum titer determines receptor internalization rate. AB - Antibodies to the acetylcholine receptor (AChR) added to AChR-bearing muscle cells cross-link the receptors, thus increasing their internalization and degradation rate (antigenic modulation). This mechanism contributes to AChR loss in myasthenia gravis. Until recently, antigenic modulation has been studied in animal tissues, where only a small fraction of human anti-AChR antibodies bind. In the present study, we examined the antigenic modulation of AChR by using patients' sera and cultures of human muscle cells. We aimed to see whether antigenic modulation correlates better with disease severity or with antibody titer. Antibody-containing sera from 29 myasthenic patients in various states of the disease and with different antibody titers against AChR were tested. Control sera from six healthy individuals were also tested. Our experiments showed that all myasthenic sera affected the overall AChR content on the human myotube surface, causing a 49 to 82% loss, whereas control sera had no effect. Although at fixed serum volumes there was some correlation between disease severity and AChR loss, this effect was clearly due to differences in antibody titers. In fact, the antigenic modulation depended mainly on the final concentration of the antibody present. Thus, intrinsic factors other than antibodies to AChR may determine or influence the patients' susceptibility to the disease. PMID- 3958495 TI - Only the initial binding of cationic immune complexes to glomerular anionic sites is mediated by charge-charge interactions. AB - The role of charge-charge interactions between cationic immune complexes and the anionic sites on the glomerular basement membrane was examined. For this purpose, soluble immune complexes at fivefold antigen excess were prepared with human serum albumin and cationized rabbit antibodies to this protein. When unrelated cationic proteins, protamine sulfate or cationized rabbit serum albumin, were given 1 min before the cationized immune complexes, glomerular immune deposits did not form. Cationic immune complexes allowed to deposit in glomeruli could readily be displaced by protamine sulfate or cationized rabbit serum albumin injected 1 min after the immune complexes. If the same cationic molecules were injected 1 hr after the immune complexes, the complexes could not be displaced from glomeruli. In contrast, cationic complexes that were deposited in glomeruli in the presence of a very high degree of antigen excess in circulation to prevent their condensation into larger complexes in glomeruli were readily displaced at 1 min and 1 hr with protamine sulfate or with cationized rabbit serum albumin. On the basis of these results, we concluded that the initial binding of cationic immune complexes to glomeruli occurs by charge-charge interactions. Once the immune complexes in glomeruli condense to larger deposits, forces other than charge-charge interactions are responsible for their retention in glomeruli. PMID- 3958496 TI - Specificity and neutralizing capacity of antibodies elicited by a synthetic peptide of scorpion toxin. AB - Polyclonal antibodies raised against a synthetic peptide (sequence 50-59) of Androctonus australis Hector toxin II can neutralize the effects of toxin II in vivo. The antigenic specificities of anti-peptide and anti-toxin antibodies were compared by competitive aqueous phase radioimmunoassay by using 125I-toxin II, chemically modified or homologous toxins, and the synthetic peptide 50-59, either free or bound to bovine serum albumin (BSA). The antipeptide and anti-toxin antibodies had a comparable high affinity for the native toxin, but anti-peptide antibodies exhibited a lower binding capacity. Anti-peptide antibodies had a higher affinity for native toxin than for the peptide 50-59 bound to BSA, used as immunogen, and were unable to recognize the free peptide. These results suggest that it is necessary to restrict the conformational freedom of the immunizing peptide in order to obtain anti-peptide antibodies with a high affinity for the toxin. The lysine residue at position 58 of toxin II, essential for toxicity, appears to be immunogenic when immunization is with peptide 50-59 bound to BSA and not with the native toxin. This residue is antigenic in the native toxin, however, as shown by the anti-peptide antibodies. PMID- 3958497 TI - Lack of cellular cytotoxicity by human mononuclear cells to Giardia. AB - Cytotoxicity of mononuclear leukocytes (MNL) to Giardia lamblia was compared by using two techniques. The first method assessed the viability of surviving Giardia directly by culturing and the second method measured release of incorporated [3H] thymidine. Cytotoxicity, as measured directly by culturing and visual assessment, showed that the numbers of surviving Giardia decreased over time whether cultured with or without MNL but that Giardia survived significantly better in the presence of MNL at 18 hr (21.8 +/- 8.3% with MNL compared with 3.4 +/- 1.5% without MNL). Release of [3H]thymidine increased whether Giardia were cultured with or without MNL and although there was a tendency for increased release with MNL, there was no significant difference. Dead labeled Giardia released significantly more label in the presence of MNL than without MNL, suggesting that MNL cause release of [3H]thymidine after phagocytosis. The thymidine release assay therefore does not measure spontaneous cytotoxicity of MNL to Giardia. PMID- 3958498 TI - Washing of ELISA plates with running tap water. PMID- 3958499 TI - Potentiation of hybridoma production by the use of mouse fibroblast conditioned media. AB - L-CM is a conditioned medium prepared from cultures of L-929 cells, a murine fibroblast line. It will promote the growth and antibody secretion of B cell hybridomas after fusion as well as facilitating cloning at limit dilution and the growth of cloned B cell lines in bulk culture. The medium is easy to prepare and stores well at 4 degrees C. It thus provides a convenient alternative to the use of feeder cells in the production of monoclonal antibodies. PMID- 3958500 TI - Monoclonal antibody for DNA measurement in biological fluids. AB - Two highly sensitive immunoassays for measuring soluble DNA are described. These methods employ a purified mouse monoclonal anti-DNA antibody in enzyme-linked immunoassays. One assay is an antigen capture method utilizing immobilized antibody. Bound DNA is subsequently detected with biotinylated monoclonal anti DNA antibody, avidin-coupled horseradish peroxidase and a chromogenic substrate. The limit of detection of the assay was 2 ng/ml of DNA. A competition assay relying on immobilized heat-denatured DNA was also designed. In this assay the solution to be analyzed is mixed in equal proportions with monoclonal anti-DNA antibody and the mixture is incubated in the DNA-containing microtiter plates. The inhibition of antibody binding as detected with peroxidase-conjugated anti mouse IgG was proportional to the concentration of DNA in the sample. The competition assay was tested for its ability to detect DNA in human plasma. The detection limit of DNA in plasma was approximately 150 ng/ml. The assays were compared in their ability to detect various size fragments of DNA. The competition assay was capable of detecting DNA fragments as small as 30 base pairs. In contrast, the capture assay failed to detect low molecular weight fragments up to 150 base pairs although its sensitivity for undigested DNA was comparable to the competition assay. The assay may be of use in the rapid quantitation of low levels of DNA, especially low molecular weight DNA and may also be useful in measuring DNA in human plasma. PMID- 3958501 TI - Use of microcalorimetry in analysing the kinetics of ADCC. AB - Microcalorimetry was found to be a useful technique for the demonstration of antibody-dependent cellular cytotoxicity (ADCC) against human melanoma cells mediated by a heterologous rabbit antiserum and two monoclonal antibodies in combination with human peripheral blood lymphocytes as effector cells. The rabbit antiserum and the monoclonal IgG3 antibody 2B2 directed against the GD3 ganglioside expressed cell-inhibitory effects resulting in a decreased heat production rate over 2-18 h of incubation. The 4.2 monoclonal IgM antibody to GD3 had no similar cell-inhibitory effect. In contrast, the 4.2 antibody expressed a much stronger effect than 2B2 in tests for complement-dependent cytotoxicity. The kinetics of these effects were quite reproducible. It is concluded that microcalorimetry is a sensitive and particularly suitable method for the analysis of cytotoxicity kinetics. PMID- 3958502 TI - Re.: Anti-pneumococcal polysaccharide ELISA. PMID- 3958504 TI - Sequential bacteriological findings in the cerebrospinal fluid of Nigerian patients with pneumococcal meningitis. AB - Sequential bacteriological observations were made on the cerebrospinal fluid (CSF) of 28 patients with pneumococcal meningitis treated with high doses of penicillin for 2 weeks. The organism was isolated from the CSF of four patients 48 h or more after the start of treatment and from a further patient 48 h after treatment was stopped. Positive cultures were obtained in spite of the demonstration in the CSF of penicillin at a concentration well above the minimum inhibitory concentration for the organism isolated. Persistence of bacteria and their products in the CSF of patients with pneumococcal meningitis contrasts with the rapid clearance of bacteria from the CSF of patients with meningococcal meningitis and may contribute to the difference in the prognosis of these forms of meningitis. PMID- 3958503 TI - Efficacy of post-exposure prophylaxis with hepatitis B immunoglobulin in Norway. AB - The efficacy of hepatitis B immunoglobulin (HBIG) in preventing infection by hepatitis B virus (HBV) after exposure to blood or blood-containing secretions that carried hepatitis B surface antigen (HBsAg), was studied in an uncontrolled trial in Norway from 1976-1983. Of the 177 HBIG recipients, followed up for 5-24 months, 166 were exposed by needle-stick, splash on mucous membranes or open wounds, sexual contact or medical investigation. With few exceptions, this group was given a single injection of 1250 IU of antibody to HBsAg (anti-HBs) within 7 days after exposure. One person developed clinical hepatitis B (HB) of short duration and two others developed anti-HBs. Six infants with perinatal exposure were injected with three or four doses of about 1250 IU anti-HBs at intervals of 2-3 months. The first dose was given immediately after birth. One child developed clinical HB at the age of 14 months and recovered. Of five patients exposed by blood transfusion, four developed clinical HB; the fifth apparently developed passive-active immunity. One of the four probably became an HBsAg carrier. These patients, except the one without clearance of HBsAg, received one to seven doses of HBIG within 2 days after exposure. Administration of HBIG after needle-stick and similar types of exposure, as well as administration to infants at risk of contracting HB, seems to be of great value. PMID- 3958505 TI - Resolution of fever in Staphylococcus aureus septicaemia--retrospective analysis by means of Cusum plot. AB - The treatment of Staphylococcus aureus septicaemia continues to be an important clinical challenge. Spikes of fever during antibiotic therapy complicate assessment of the response. In an attempt to analyse response to treatment in terms of resolution of fever we have retrospectively studied 17 patients with microbiologically proven S. aureus septicaemia. The data from temperature charts of such patients were converted to Cusum plots and analysed in order to estimate time to defervescence of fever and time to abolition of fever following the start of antibiotic therapy. Compared with conventional temperature charts, the Cusum data allowed defervescence of fever to be clearly seen. When the Cusum data were used, the time to defervescence of fever from the onset of antibiotic treatment was 21.7 h (range 8-96 h) and to abolition of fever 58.3 h (range 12-180 h). Antibiotic treatment was changed in 61% of patients on the basis of continued fever shown on the conventional temperature chart. In all of these patients, however, the Cusum plot showed clear evidence of response. PMID- 3958506 TI - Erwinia herbicola as a cause of bacterial endocarditis. AB - A case of endocarditis due to Erwinia herbicola is reported. Three years previously the patient had been fitted with a porcine xenograft. PMID- 3958507 TI - Mycobacterium tuberculosis as a cause of peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis. AB - Tuberculous peritonitis is reported in an Asian immigrant undergoing continuous ambulatory peritoneal dialysis (CAPD). Unusual laboratory findings which resulted in delayed diagnosis are described. PMID- 3958508 TI - Prosthetic valve endocarditis due to Neisseria mucosa. PMID- 3958509 TI - Biological control studies: bacteria associated with moribund Biomphalaria glabrata (Mollusca) in the laboratory. PMID- 3958510 TI - Serum-free culture of primitive murine hemopoietic colony-forming cells. AB - We report the effect of four sources of hemopoietic growth factors, alone or in combination, on colony growth in serum-free cultures of bone marrow from normal mice or marrow from mice pre-treated with 5-fluorouracil (5-FU-bm). The four supplements were: mouse spleen conditioned medium (SCM, a source of multi-lineage colony-stimulating activity, multi-CSA), human placental conditioned medium (HPCM, a source of synergistic activity), pregnant mouse uterus extract (PMUE, a source of M-CSA) and erythropoietin (Epo). First, in cultures of normal marrow, only PMUE and SCM induced significant colony growth when added alone. The majority of those colonies contained granulocytes and macrophages (myeloid colonies). In Epo-supplemented cultures, only SCM supported the growth of erythroid bursts and mixed erythroid-myeloid colonies. HPCM thus appears to be a poor source of multi-CSA. Second, in cultures of 5-FU-bm, few colonies developed if any of the above supplements were added alone. Only SCM + Epo together stimulated the formation of a low number of very large, mixed erythroid/myeloid/megakaryocyte colonies. HPCM, but not SCM, synergized with PMUE to augment myeloid colony numbers. Hence, SCM appears to be a poor source of synergistic activity (SA). In cultures of 5-FU-bm already supplemented with HPCM + PMUE, the addition of Epo did not change total colony numbers but did induce erythroid differentiation in one third of the colonies present. These data suggest that multi-CSA and SA may be expressed by different factors and that 5-FU pre-treated marrow contains: a population of primitive multipotential progenitors which form large, mixed colonies in the presence of SCM + Epo, and a larger Epo sensitive population which also requires HPCM + PMUE to form mixed colonies. PMID- 3958511 TI - Pre-CFU-f: young-type stromal stem cells in murine bone marrow following administration of DNA inhibitors. AB - Occurrence of young-type stromal stem cells (defined here as "pre-CFU-f") in murine bone marrow is reported in this study. Two consecutive intraperitoneal (i.p.) cytosine arabinoside (ara-C) injections were administered to C57B1 mice (2 X 200 mg/kg at 6-h intervals). Two days later the bone marrow was collected and assayed for colony-forming units-fibroblastoid (defined here as "CFU-f"). In additional experiments, ara-C-treated marrow was exposed in vitro to hydroxyurea (HU; "hydroxyurea killing test"), prior to plating, to establish the cycling state of stromal stem cells. In separate cultures of ara-C-treated marrow, replating of adherent cells was carried out up to quaternary sub-cultures. The results indicate ara-C-treated marrow produces approximately 20% "huge" fibroblastoid colonies (approximately 5 mm diameter versus 0.5-2 mm normal size); most stromal stem cells producing huge colonies are cycling cells; and adherent cells from primary ara-C-treated marrow cultures replated to secondary cultures produce adherent layers with double the number of cells than in the control secondary cultures. We conclude that the ara-C-treated murine bone marrow contains certain young-type cycling stromal stem cells which we refer to as pre CFU-f. These stem cells produce huge fibroblastoid colonies in culture, indicating that they probably go through more cell cycles than CFU-f during the culture period. Alternatively, pre-CFU-f may have a higher self-replicative capacity than CFU-f. PMID- 3958513 TI - Lack of correlation between in vitro corticosteroid effect on hemopoietic colony formation and response to corticosteroid therapy in aplastic anemia. AB - We performed hemopoietic colony culture assays in 15 patients with aplastic anemia (AA) in order to test the effect of hydrocortisone (HC) on late erythroid colony (CFU-e) formation of the patients' marrow and to correlate the in vitro culture results with the clinical response to corticosteroid therapy. HC enhanced CFU-e growth in four patients. All four patients failed to respond to corticosteroid, but three improved with with androgens. The addition of HC did not increase CFU-e colony formation in 11 patients. However, two of them responded to corticosteroid therapy. Among the nine patients showing no HC effect in vitro, two subsequently improved with androgens and one each with anti thymocyte globulin and anti-lymphocyte globulin. The results suggest that the in vitro corticosteroid effect may not necessarily correlate with responsiveness to corticosteroid therapy. PMID- 3958512 TI - Burst-promoting activity in anemia and polycythemia. AB - Burst-promoting activity (BPA) in the sera of patients with various types of anemia and polycythemia was compared with that of normal subjects by an in vitro method using mouse bone marrow cells. The control culture contained normal human AB serum instead of sample materials. Results were expressed as a percentage of burst numbers in control cultures. Serum erythropoietin (Epo) levels were determined by a radioimmunoassay. Serum BPA in patients with aplastic anemia (155.4 +/- 56.7%, mean +/- SD) was significantly higher than that in normal subjects (112.1 +/- 29.1%, Wilcoxon's rank sum test, P less than 0.05). However, serum BPA in patients with uremic anemia (122.2 +/- 26.5%), polycythemia vera (101.9 +/- 19.5%) and stress polycythemia (115.5 +/- 25.6%) was not significantly different from normal subjects. There was a correlation between serum BPA and Epo titers in patients with aplastic anemia and paroxysmal nocturnal hemoglobinuria (r = 0.81, t test, P less than 0.001). PMID- 3958514 TI - [Concentrations of growth hormone, prolactin and thyroid-stimulating hormone in the maternal, fetal and amniotic compartments]. AB - GH, PRL and TSH in the maternal, fetal and amniotic compartments were measured by radioimmunoassay in normal pregnant women (group I, n = 16) and patients with anencephalic fetuses (group II, n = 10). The concentrations of GH (20.6 +/- 8.5 ng/ml, mean +/- SD) in cord blood of normal fetuses were significantly higher (p less than 0.001) than those (5.1 +/- 3.5 ng/ml) in anencephalic fetuses. Both maternal PRL levels in group I and group II were lower than their respective cord bloods. The concentrations of PRL (283.1 +/- 127.5 ng/ml) in normal fetuses were higher, but not significantly, than those (199.4 +/- 111.8 ng/ml) in anencephalic fetuses. Also, compared with PRL levels in the maternal and cord blood, those in amniotic fluid were significantly higher (p less than 0.001) in both groups. On the contrary, GH and TSH levels in amniotic fluid were much lower than those in the maternal and fetal blood. The concentration of TSH (10.2 +/- 4.6 microU/ml) in normal fetuses was significantly higher (p less than 0.05) than those (7.1 +/- 3.1 microU/ml) in maternal blood, but not significantly different from those (11.3 +/- 3.6 microU/ml) in anencephalic fetuses. These results suggest that GH, PRL and TSH do not cross human placenta and biosyntheses of these hormones in the maternal and fetal pituitaries are independent. PMID- 3958515 TI - [Colposcopy in dysplasia, carcinoma in situ and microinvasive cancer of the cervix--systematic diagnosis]. AB - Recently colposcopy has come to be increasing used in the diagnosis of the early cervical cancer. We studied colposcopic findings (epithelial, vascular and glandular findings) of dysplasia, carcinoma in situ and microinvasive cancer of the uterine cervix. The results were as follows. We could classify the cases without white epithelium into microinvasive cancer and carcinoma in situ according to elevation or hollowness and roughness and the cases with I grade white epithelium (thin white epithelium) into severe dysplasia and mild or moderate dysplasia according to the existence of elevation, roughness, II type vessels and elevation of gland opening. Among the cases with II grade white epithelium (thick white epithelium) those without roughness, II type vessels and increased gland opening were mild or moderate dysplasia and most case with III or IV type vessels were microinvasive cancer. We concluded that more than half of the cases without III or IV type vessels spread to transverse pollution of white epithelium and lack or indefiniteness of gland opening, severe dysplasia with 0 finding, carcinoma in situ with 1 or 2 finding and microinvasive cancer with 3 findings. With these criteria, we were able to obtain high (93.4% with mean) correct diagnostic ratios. PMID- 3958517 TI - [The effect of cis-platinum (CDDP) on methotrexate-resistant choriocarcinoma cell line]. AB - Cis-platinum (CDDP) was investigated in vitro and in vivo for its ability to inhibit the growth of Methotrexate (MTX)-resistant choriocarcinoma cell line (BeWo) and was compared with the effect of MTX and Actinomycin D (ACD). Each drug was added into medium (RPMI 1640 containing 10% FBS) for 1 hr. at the concentration of peak plasma level in clinical use (CDDP 7 X 10(-6)M, MTX 10( 6)M, and ACD 8 X 10(-8)M), or for 48 hrs. at one-tenth of the level. CDDP inhibited the cell growth to 40% of control at 7 X 10(-6)M for 1 hr., and 25% at 7 X 10(-7) M for 48 hrs. And ACD suppressed the cell growth to 10% at both 8 X 10(-8)M for 1 hr. and 8 X 10(-9)M for 48 hrs. But MTX did not inhibit the cell growth at 10(-6)M for 1 hr., and inhibited to 60% of control at 10(-7)M for 48 hrs. On the other hand, BeWo transplanted to athymic nude mice (CD-1(ICR) nu/nu) was treated with intraperitoneal injections of CDDP (1.4 mg/kg/day for 4 consecutive days in a week and repeated for 2 and 4 weeks), MTX (2mg/kg/day for 4 consecutive days in a week and repeated for 2 weeks), and ACD (90 micrograms/kg/day for 4 consecutive days in a week and repeated for 2 and 4 weeks). The suppression of the tumor growth was seen in CDDP-treated group (TRW/CRW = 6.5%) and ACD-treated group (TRW/CRW = 29%) after 2 courses of treatment, but no apparent suppression was shown in the MTX-treated group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958516 TI - [Correlation between nuclear DNA content and cellular morphology in endometrial cancer--analysis by cell sorting with flow cytometry]. AB - A comparative study of nuclear DNA content and morphological features of various endometrial lesions was carried out. The results were as follows: Similar nuclear DNA patterns were obtained by both FCM and fluorescence cytophotometry. On nuclear DNA histograms, a monopeak at 2C was shown in normal endometrium. In hyperplasia, a peak at 2C and a tapering pattern to 4C was shown. In endometrial cancer, 3C cells were characteristic of a well differentiated type, and polyploidy cells over 4C was specific for an anaplastic type. In a comparison of the nuclear area and nuclear DNA content, nuclear area correlates well with nuclear DNA content in 2C and 3C, and does not correlate well in polyploidy over 4C because of a chromatin conformation. In a comparison of nuclear DNA content with cellular morphology on endometrial cancer, 2C cells were 33.2 micron2, 3C were 55.8 micron2, and polyploidy were 78.1 micron2 in the nuclear area. It is easy to diagnose polyploidy as malignant, but very hard to recognize 2C and 3C cells as malignant. In a well differentiated type, the richness of 3C cells which are relatively hard to detect makes the diagnosis difficult. To make a correct diagnosis, not only polyploidy cells but 3C cells have to be detected precisely. PMID- 3958518 TI - [Hemorheology in pregnancy and fetal growth]. AB - The relationship between fetal birth weight and maternal hemorheological factors in 37-41 weeks of gestation were investigated in pregnant women who delivered normal and small for gestational age singleton infants without malformation. Blood viscosities were measured at low shear (0.5 sec-1) and high shear (230 sec 1) rates. Erythrocyte deformability was measured by a filtration method, which involved the measuring of a filtered volume of erythrocyte, suspended in phosphate buffer and passed through a nuclepore polycarbonate filter. The filters pores were 5 microns in diameter and the driving pressure on erythrocyte suspension was -10cmH2O. Mothers who delivered small for gestational age infants had significantly higher levels of blood viscosity at the low shear rate and lower levels of erythrocyte deformability than those who delivered normal infants. But there was no significant difference in blood viscosity at the high shear rate between the two groups. There was a significant negative correlation between the maternal blood viscosity at the low shear rate and the birth weight of their infants, and a positive correlation between the maternal erythrocyte deformability and the birth weight. From these results, it was suggested that fetal growth was affected by maternal hemorheological factors. PMID- 3958519 TI - [Studies on somatomedin C in diabetic pregnancies]. AB - Somatomedins have been shown to have potent mitogenic activities in cultured cells and also promote individual growth. We studied the concentrations of somatomedin C in diabetic pregnant women and rats. Serum and liver somatomedin C were measured by RIA double antibody method, after extraction with an ODS silica column. Serum somatomedin C concentrations were 20.45 +/- 5.14 nM/l (mean +/- S.D.) in nonpregnant normal women. In nonpregnant diabetic women, these were 16.96 +/- 4.37 nM/l, which were significantly lower than those of normal nonpregnant women. The concentrations of pregnant normal and diabetic women were similar to those of nonpregnant normal women. Maternal concentrations of somatomedin C significantly correlated with infant weight (r = 0.41, p less than 0.05, n = 41). Serum somatomedin C concentrations in the normal infants were 6.45 +/- 1.97 nM/l, which were considerably lower than those of their mothers. In the infants from diabetic mothers, these were 9.17 +/- 3.28 nM/l, which were significantly higher than those of normal infants. Rat serum somatomedin C concentrations which were 15.86 +/- 2.37 nM/l in nonpregnant normal rats, tended to increase during pregnancy. The mother's concentration significantly correlated with fetus weight (r = 0.491). Liver somatomedin C levels decreased in diabetic and pregnant states. Fetal rats had lower hepatic somatomedin C, which was about 10% of the mother's levels. These were higher in the fetuses from diabetic mothers. These finding suggested that the mother's somatomedins might contribute to fetal growth. PMID- 3958520 TI - [Effect of low density lipoprotein on intracellular cholesterol and progesterone production by monolayer cultured human luteal cells]. AB - The purpose of the present study was to define the effect of low density lipoprotein (LDL) on progesterone (P) synthesis and on intracellular cholesterol content using monolayer cultured human luteal cells. When cultured in TC199 containing 10% lipoprotein poor serum (LPPS), P production decreased as culture time passed. In the presence of hCG, it also decreased, but slowly. In the presence of LDL, P production was kept at a higher level. Intracellular cholesterol content in luteal cells was measured by gas chromatography. The cholesterol content of luteal cells in a 4 day LPPS culture was higher than that in a 10 day LPPS culture. The cholesterol content in a 10 day LPPS culture with LDL was higher than that in a 10 day LPPS culture. The cholesterol content in a 10 day LPPS culture with hCG had a tendency to be lower than that in a 10 day LPPS culture, but there was no statistical difference (p less than 0.1). It was concluded that LDL was utilized in supplying intracellular cholesterol to luteal cells as a substrate for P synthesis. And in a state of LDL depletion in the medium, the luteal cells produced a small amount of P utilizing intracellular cholesterol. It was estimated from the results of the present study that hCG enhanced utilization of intracellular cholesterol. PMID- 3958521 TI - Prognostic significance of nuclear analysis in invasive carcinoma of cervix patients treated by primary radiation. AB - The value of microspectrophotometric analysis was studied for the assessment of prognosis in patients with squamous cell carcinoma of the cervix treated with primary radiation therapy. Cellular nuclear desoxyribonucleic acid (DNA) content and nuclear size were measured in smears taken before, during and immediately after radiation therapy. Additional determination of DNA content/nuclear size ratio was made. Changing patterns of DNA distribution, nuclear size and their ratio were classified into Type I, II, III, and IV, according to the mode of their shifts in the course of radiation therapy. The results showed diploid (47%), polyploid (23%) and aneuploid (30%) DNA distribution in pre-treated carcinomas. Particularly, the results showed a distinct correlation between the type of histograms and patient outcome. Patients with Type II histograms (initial shift to the right and posterior shift to the left) showed a better survival rate and no recurrences compared with other types. On the other hand, patients with Type III histograms (initial shift to the left and posterior shift to the right) had poor prognosis and were predominant among dead cases with radioresistant tumors. These results suggested the potential usefulness of cytophotometric analysis for assessing prognosis in advanced cases. PMID- 3958522 TI - [Quantitative nuclear DNA analysis of human trophoblasts in early gestation]. PMID- 3958523 TI - [The clinical management for abortion in early gestational weeks]. PMID- 3958524 TI - [Myasthenia gravis and malignant thymoma in pregnancy: a case report]. PMID- 3958525 TI - [Topical idoxuridine for vulvar condyloma acuminatum]. PMID- 3958526 TI - Blood flow of peripheral nerve effects of dissection, stretching and compression. AB - Blood flow rate of the peripheral nerve was measured using the hydrogen washout technique and the effects of dissection, stretching and compression were studied on blood flow of the rabbit sciatic nerve. Regional surgical dissections revealed that a proximal portion of the sciatic nerve receives its blood supply from gluteal vessels whereas a distal portion receives from popliteal vessels. Blood flow direction in the proximal half of the sciatic nerve in the thigh was found to be distal whereas in the distal half to be proximal. The longitudinal pathway appeared to be capable of compensating for local diminution of blood flow. The average stretching of more than 15.7% caused complete arrest of blood flow in the stretched nerve. The average stretching force at this point was 74 grams. Complete standstill of intraneural circulation was observed under compression of 50 to 70 mm Hg, or 60 to 80% of mean arterial pressure. These values of critical stretching and compression on the intraneural blood flow corresponds well with those previously reported by Lundborg, 1973; Rydevik, 1981). PMID- 3958527 TI - The role of internal fixation in closed fractures of the proximal phalanges and metacarpals in adults. AB - The results of Kirschner wire and A.O. mini-screw fixation of fractures of the proximal phalanges and metacarpals in adults are compared with conservative treatment of displaced fractures and better results emerge from the use of A.O. screws than of Kirschner wires. PMID- 3958528 TI - Lateral approach to the hook of hamate for its fracture. AB - We have recently experienced one case of the fracture of the hook of the hamate that was diagnosed only by the CT scan. As a surgical approach, lateral approach to the hook of the hamate for its fracture was utilized. We found that this approach was safe, easy and quick. PMID- 3958529 TI - Simultaneous fracture of carpal scaphoid and trapezium. AB - A previously undescribed simultaneous fracture of carpal scaphoid and trapezium (greater multangular) is reported. A short discussion on fractures of the trapezium together with the reported associated scaphoid fracture is given and the probable mechanism of injury is considered. PMID- 3958530 TI - Shingles following axillary nerve block. A case report. AB - Axillary nerve blocks are now frequently used for emergency and elective upper limb surgery. The method gives reliable anaesthesia with few complications. A case is described in which a patient developed Herpes Zoster following an Axillary Nerve Block, a hitherto unreported complication. PMID- 3958531 TI - Effect of submuscular versus intramuscular placement of ulnar nerve: experimental model in the primate. AB - A primate model was developed to study the effect of submuscular versus intramuscular placement upon the development of ulnar nerve fibrosis. No significant adherence was found in either location between the ulnar nerve and the flexor-pronator muscle mass. There was no significant difference in the mean nerve fibre diameter or in the percent neural tissue between the ulnar nerves in the two different locations. It is suggested that it is the interaction of the transposed ulnar nerve with other fibrous anatomical structures proximal to, across, and distal to the elbow that causes failure in ulnar nerve transposition procedures, rather than an adverse reaction between the incised flexor-pronator muscle mass and the ulnar nerve. PMID- 3958532 TI - Elbow arthrography in the evaluation of posterior interosseous nerve compression in rheumatoid arthritis. AB - This is a case report of a fifty-nine-year-old rheumatoid arthritic woman who developed lack in finger extension bilaterally. These deficits had two completely different aetiologies, Posterior Interosseous Nerve (PIN) Syndrome and extensor tendon rupture. No previous report in the literature has used elbow arthrography as a diagnostic tool in a patient with PIN Syndrome. Elbow arthrography confirmed the abnormality at this joint and aided in appropriate management. PMID- 3958533 TI - Acute cubital tunnel syndrome from post traumatic calcific neuritis. AB - The normal ulnar nerve is not visible on radiographs of the elbow. An unusual case is described in which symptoms of ulnar nerve compression with a swollen, tender ulnar nerve at the elbow developed after relatively minor trauma. Radiology suggested "Calcific Neuritis", but this was short lived with complete regression of the symptoms. PMID- 3958534 TI - Use of bromphenol blue printing method for detecting sweat on the palm. AB - Sympathetic nerve fibres innervating the sweat glands in the skin are known to accompany sensory nerve fibres closely. Examination of sudorific function, therefore, is a useful aid in making a diagnosis of severed peripheral nerve and also provides valuable information on nerve function in the recovery stage following injury and surgery such as neurorrhaphy. Among the many methods which have been used clinically, the one employing bromphenol blue is thought to be the most simple and accurate. PMID- 3958535 TI - The micropathology of the typical carpal tunnel syndrome. AB - The synovial membrane in the carpal tunnel of twenty-nine patients suffering from the typical clinical picture of carpal tunnel syndrome was examined microscopically over an eighteen month period with a follow-up of six months to two years. Unusual causes such as tendon sheath tumours and post-Colles fractures were excluded. Three micropathological pictures emerged. Oedema was found in twenty-four patients, chronic perivascular inflammation in three and fibrinous synovitis in two. No difference was detected in the clinical presentation in the three pathological appearances. The authors believe that oedema is the typical picture and the other two appearances could indicate irritation of the synovial membrane as a result of finger activity. PMID- 3958536 TI - Isolated palsy of the nerve to flexor pollicis longus. AB - Two cases of isolated paralysis of the nerve to flexor pollicis longus are described, both of which recovered after division of constricting fibrous bands. Anatomical considerations and treatment are described. PMID- 3958537 TI - An unusual foreign body in hand. A case report. AB - Small sharp foreign bodies are common in dominant hand. A case of an unusual, large, blunt, metallic foreign body in the non-dominant hand, with treatment and result, is reported. PMID- 3958538 TI - Sarcoidosis presenting with pathological fracture of a metacarpal. AB - We describe a patient who presented with pathological fracture of the fifth metacarpal which on further investigation, was found to be due to Sarcoidosis. There is no previous record of the condition presenting in this way, with a pathological fracture. PMID- 3958539 TI - Chondromyxoid fibroma of the proximal phalanx. A tumour that may be confused with chondrosarcoma. AB - Chondromyxoid fibroma is a rare benign tumour of chondral origin. The diagnosis is difficult, but as Jaffe emphasized, "its recognition is of some importance in that pathologically it may be mistaken for sarcoma and, as such, treated more radically than is necessary" (Jaffe, 1948). Salzer (1965) found only 136 cases in the world literature since 1948 when Jaffe defined the criteria for their histological diagnosis. Only six cases of chondromyxoid fibroma have been reported involving the hand (Frank, Rockwood, 1969; Zatyepin, Klimova, Lipkin, Perety, 1979). PMID- 3958540 TI - An external fixator in finger reconstruction. AB - A fast, simple and always available low cost external fixation device, made of two parallel plastic tubes and transverse Kirschner wires was devised and clinically tested. PMID- 3958541 TI - Finger reconstruction using toe transplantation. AB - In the mutilated hand where all the fingers are destroyed, the undamaged mobile thumb will not be capable of performing the important function of making a grip or pinch alone. Under such circumstances, it is worthwhile reconstructing the missing fingers so as to restore this simple but basic function. PMID- 3958542 TI - Reconstructive surgery of the post-burn boutonniere deformity. AB - A retrospective study of fifty-four longstanding post-burn boutonniere deformities was carried out to evaluate the problems associated with the surgical procedures. The aim is to describe the pathophysiological changes of the burned fingers, the primary treatment, the reconstructive principles, the patients and materials and the final post-operative results. PMID- 3958543 TI - Problems in managing reconstructive surgery for brachial plexus lesions contrasted with peripheral nerve lesions. PMID- 3958544 TI - Total thumb reconstruction by an index finger transposition. AB - A case of total thumb reconstruction after traumatic amputation is described. The reconstruction was carried out as a staged procedure with preliminary application of a pedicle flap, and a normal index finger transposition, followed by opposition transfer using the abductor digiti quinti muscle. Twenty-seven months after the index finger pollicization, the reconstructed thumb had satisfactory function. PMID- 3958545 TI - Partial thumb reconstruction using the proximal skin paddle radial artery island flap. AB - Four cases of partial thumb reconstruction using the radial artery island flap are presented. The flap will provide in variable amounts all the elements required for reconstruction of a severely damaged thumb. PMID- 3958546 TI - Single stage lengthening by intercalary bone graft in patients with congenital hand deformities. AB - The experience with single-stage lengthening by intercalary bone graft in four patients with congenital hand deformities is presented. In all seven lengthenings the gap was bridged by a toe phalanx bone graft. The elongation of the ray ranged from 5-14 mm. Examination of patients followed from one to five years after the treatment showed a good appearance of the lengthened ray. One bone graft assimilation resulted in a pseudoarthrosis and another had osteopenia that resolved spontaneously. All others healed uneventfully. The quality of the skin sensitivity, vascular status and tendon balance is preserved after the lengthening. PMID- 3958547 TI - Multiple dislocations of the carpometacarpal joints. AB - A case of multiple dislocations of the carpometacarpal joints associated with low energy trauma is reported. Open reduction and internal fixation has produced a good result. PMID- 3958548 TI - Irreducible compound dorsal dislocations of the proximal interphalangeal joint of the finger. AB - Three cases of compound irreducible dorsal dislocation of the proximal interphalangeal joint of the finger are reported. The probable mechanism is discussed. The findings warrant the description "volar capsular boutonniere" as the condyles of the proximal phalanx buttonhole, through the volar structures. Open reduction combined with debridement, is the treatment for such compound irreducible dorsal dislocations. Dislocation of the proximal interphalangeal joints of the fingers are common and can usually be reduced by simple traction. Occasionally reduction by closed methods is unsuccessful because of interposition of volar or dorsal soft tissue structures (Lamb 1981). This study reports three cases of compound dorsal dislocation of the proximal interphalangeal joint with volar soft tissue interposition. Such lesions are sparsely mentioned in text books on fractures and hand injuries and hitherto only a few cases have been published (Lamb 1981, Bunnell 1956). PMID- 3958549 TI - Volar dislocation of the metacarpophalangeal joint of the thumb--a case report. AB - A patient with a volar dislocation of the metacarpophalangeal joint of the thumb is reported in which closed reduction proved impossible because of the interposition of the dorsal capsule, extensor pollicis longus tendon and extensor pollicis brevis tendon in the metacarpophalangeal joint. The collateral ligament was also ruptured. Therefore open reduction is recommended for similar cases. PMID- 3958551 TI - Dupuytren's contracture in the Negro. AB - In 1979 the first Negro patient with Dupuytren's Contracture who had no evidence of Caucasoid Admixture in his genetic make-up was reported on. Another five such cases are presented. PMID- 3958550 TI - Fibrin/fibrinogen and fibrinolytic activity of the palmar fascia in Dupuytren's contracture. AB - Considering the proved interaction of fibrin with fibroblasts and the seemingly decisive role of structural and functional changes ("modulation") of these cells in the evolution of Dupuytren's contracture, research has been carried out in order to investigate the fibrinolytic capacity and the possible presence of fibrin/fibrinogen in the palmar fascia of subjects operated upon for Dupuytren's Disease. Fibrin/fibrinogen were detected by a direct immunofluorescence technique and fibrinolytic activity was assessed by a fibrin plate method. A remarkable decrease of fibrinolytic activity and the presence of fibrin/fibrinogen were observed in small nodules in the early stage of disease, whereas large nodules showed a high amount of plasminogen activator enzymes. Small nodules seem to form and increase by progressive adhesion of fibroblasts to the polymerizing fibrin, while high fibrinolytic activity of large nodules probably results from "modulation" of many fibroblasts into contractile myofibroblasts and could therefore be considered as a biochemical sign of the evolutionary phase of Dupuytren's contracture. PMID- 3958553 TI - Dupuytren's disease in the thumb: two cases of a central cord. AB - Two cases of a pattern of Dupuytren's disease in the thumb not described before are presented. The more usual pattern of radial disease is discussed and compared with that in the fingers. PMID- 3958552 TI - Ischaemic contracture of the intrinsic muscles of the hands. A hazard of physical restraint. AB - A case is described of bilateral ischaemic contracture of the intrinsic muscles of the hands, presenting in a mentally-disturbed patient one year after a reported period of immobilisation in a physical restraint device. Involvement of the deep thenar muscles and the interossei on the radial side of the hand can be explained by consideration of the anatomy of the deep palmar arch. Division of the tendons of the contracted interosseous muscles proximal to the metacarpophalangeal joints and release of the left first web improved hand function. Those who supervise the use of physical restraint devices should be aware of the risk of intrinsic muscle ischaemia and of the need for prompt diagnosis and treatment. PMID- 3958554 TI - The excursions of the long extensor tendons of the hand. AB - In a cadaveric study in seven hands, the mathematical relationship between extensor tendon excursion and joint motion (wrist, m.p., p.i.p. and d.i.p.) has been investigated. This has been found to be linear at all joints, allowing the mean tendon excursions corresponding to ten degrees of joint motion to be calculated for each of the above joints for all five rays of the hand. A table of these excursion values is presented as a reference for calculation of clinical problems. PMID- 3958555 TI - Trapezius transfer for paralysis of the deltoid. AB - A case of selective paralysis of shoulder muscles with its reconstructive procedure, is presented. The deltoid, infra- and supraspinatus paralysed, leaving one of the steering group of muscles around the shoulder--the subscapularis- intact, made the transfer of the trapezius to deltoid feasible, utilizing a modification of Saha's technique. An excellent result with full range of motion of the paralysed shoulder has been achieved. PMID- 3958556 TI - Palmaris longus transfer for replacement of the first dorsal interosseous. AB - Using palmaris longus, the first dorsal interosseous was reconstructed without free tendon graft. Palmaris longus prolonged with a strip of palmar fascia was transferred rectilinearly to the site of insertion of the first dorsal interosseous via a subcutaneous tunnel and fixed. This method was applied to seven hands of six patients and the follow-up observation continued for more than six months postoperatively. In six hands, favourable stability and abduction function of the index finger was achieved. In one hand, adhesion occurred at the site of the first dorsal interosseous muscle resulting in tenodesis. This operative method appears to be useful in the reconstruction of the first dorsal interosseous muscle from non-recovering paralysis following injury of the first dorsal interosseous muscle, or ulnar nerve. This method may also be utilized after decompression of chronic compression of the ulnar nerve giving no expectation of complete recovery by the reconstruction and augmentation of the first dorsal interosseous muscle. No unpleasant side effect was encountered. PMID- 3958557 TI - Spontaneous rupture of the extensor pollicis longus tendon after anabolic steroids. PMID- 3958559 TI - Assessment of thumb to index pulp to pulp pinch grip strengths. AB - In this study of fifty men and women with normal hand function, the strength of thumb to index finger pulp to pulp pinch grip was assessed with the remaining fingers either flexed or extended. When the pinch grip was performed with the remaining fingers flexed the value was up to 92% higher than when the remaining fingers were extended. In future studies where thumb to index finger pinch grip is used as an objective test of function then the position of the remaining fingers must be defined to aid interpretation of the results. PMID- 3958558 TI - Continuous passive motion as an adjunct therapy for tenolysis. AB - A model was developed to evaluate continuous passive motion as an adjunct to tenolysis. The use of continuous passive motion after tenolysis was associated with a significant increase in tendon rupture and the terminal force necessary to flex the phalanx actively. Also, there was a decrease in the passive range of motion in the continuous passive motion group which appeared to be the result of increased granulation tissue which formed around tenolysed tendon. PMID- 3958560 TI - The early experience of silastic trapezium implants. AB - This paper reports the early results of thirteen total trapezium replacements and seven partial trapezium replacements in the treatment of pantrapezial disease and first carpometacarpal arthritis. The results showed satisfactory relief of pain with good function of the thumb. This review highlights the difficulty in achieving implant stability and suggests the cause of this problem. PMID- 3958562 TI - Nonfreezing technique for short-term storage of mouse embryos. AB - Mouse morulae were stored at 0 degrees C in the medium containing various sugars, and their effect on the embryonic viability was examined. The longevity of the embryos was considerably extended, if a hexose or a disaccharide was supplemented in the medium. The most effective concentration appeared to be 0.5-0.75 M, irrespective of the molecular weight. Glucose, galactose, fructose, sucrose and lactose were more effective than mannose and maltose. Considering that the embryos stored with sugars were recovered shrunken, the beneficial effect of sugars seemed to be from proper dehydration of the cells caused by osmotic pressure afforded by a non-toxic and non-permeable non-electrolyte. The non freezing technique using a sugar could also be used combined with a freezing technique, if 1-6 h of incubation is incorporated between the two treatments. If the non-freezing technique prove to be available to the embryos of domestic animals, it will practically be more useful. PMID- 3958561 TI - A comparison of conservative treatment and silicone replacement arthroplasty in Kienbock's disease. AB - Two forms of treatment of Kienbock's disease were compared in a total of thirty seven wrists. Sixteen had been treated conservatively and were followed-up for an average of twenty years. Twenty-one had undergone silicone replacement arthroplasty an average of five years prior to review. Clinical results of conservative treatment showed four (25%) good, six (37.5%) fair and six (37.5%) with a poor result. Radiological deterioration was seen in only a quarter of cases. After silicone replacement there were nine (43%) good and seven (33%) fair. Five (24%) cases had a very poor result associated with dislocation of the prosthesis but design improvements have made this less frequent. Radiological abnormalities were noted in more than half of cases treated by silicone replacement arthroplasty. These included carpal collapse, scapho-lunate diastasis and generalised degenerative changes in the carpus. There were two cases with cyst formation in the capitate which closely resembled previous reports of silicone synovitis. PMID- 3958563 TI - Long-term storage of eight-cell mouse embryos at - 196 degrees C. AB - Stocks of mutant mice have been reestablished from eight-cell embryos stored in liquid nitrogen for varying periods up to 11 years, and no evidence has been found of deterioration of survival with time of storage. Also, studies on the simulated cumulative effect of background radiation during storage failed to find any detrimental effect when embryos were exposed to the equivalent of about 2000 years of background radiation. However, in some cases embryos that carry mutant genes or chromosome anomalies tend to survive the freezing and thawing procedure less well than F1 hybrid embryos. Although this effect is probably independent of storage time, recent improvements in technique upon embryonic survival are to be welcomed. PMID- 3958564 TI - Mouse embryo cryobanking. AB - The frozen storage of mouse embryos is a practical means of assuring the preservation of scientifically valuable strains of mice for research. Banks are maintained at over 15 institutions throughout the world. At the Jackson Laboratory eight-cell embryos from approximately 500 strains are preserved in liquid nitrogen storage. PMID- 3958565 TI - Cryobiological principles of embryo freezing. AB - During a cryopreservation process a preimplantation embryo has to undergo multiple changes in volume caused by osmotic forces. When parameters such as cryoprotectant and water permeability coefficients and their temperature coefficients are known, equations can be solved to predict the volume response of an embryo during cryopreservation. This approach will allow the development or modification of cryopreservation procedures using relatively few embryos. PMID- 3958566 TI - Cryopreservation and transfer of baboon embryos. AB - The feasibility of modifying bovine cryopreservation methods for use with baboon embryos was evaluated. Twenty-six baboon embryos at the eight-cell to blastocyst stage of development were transferred after being frozen using glycerol as cryoprotectant. Either a two-step fast of a controlled linear temperature depression was achieved to -40 degrees C, followed by plunging into liquid nitrogen. After thawing, embryos were rehydrated in medium containing sucrose (0.5 to 1.0 M) using various methods of glycerol dilution. Embryos were transferred nonsurgically to anesthetized recipient baboons. Two term pregnancies resulted from six embryos frozen using the controlled linear cooling method and rehydrated by dropwise dilution of the sucrose (0.8 M) medium. Later cell stages had a greater morphological integrity postthaw than did earlier developmental stages, and embryos frozen by the linear cooling-rate method had less cell damage than those frozen by the fast method. PMID- 3958567 TI - Experience with the cryopreservation of human embryos using the mouse as a model to establish successful techniques. AB - Mouse embryos at the one-, two-, and eight-cell stages have been used to optimize the conditions for cryopreservation of human oocytes and embryos. For storage in glass vials using 1.5 M dimethyl sulfoxide (DMSO) as a cryoprotectant and slow cooling (approximately 0.3 degrees C/min), phosphate-buffered medium was superior to Hepes-buffered medium. Termination of slow cooling at -80 degrees C before transfer to liquid nitrogen with subsequent slow thawing (approximately 8 degrees C/min) resulted in more embryos surviving than when cooling terminated at -40 degrees C and rapid thawing (approximately 500 degrees C/min) was employed. Dilution of DMSO upon thawing with medium containing 0.5 M sucrose gave higher embryo survival rates than a stepwise (0.25 M decrements) dilution. Using these techniques, three pregnancies were established upon the transfer of 11 frozen thawed embryos to seven patients. Rates of embryo survival using the simpler cryopreservation technique of ice-free vitrification in 0.25-ml straws have been disappointing. PMID- 3958568 TI - Factors affecting survival and implantation of cryopreserved human embryos. AB - Five- to ten-cell embryos and expanded blastocysts from 68 patients were thawed in an attempt to establish pregnancy. Three fresh embryos had been replaced unsuccessfully in these patients. Forty-five patients had intact freeze-thawed embryos replaced and 12 became clinically pregnant. Ten of these pregnancies have now advanced beyond week 24. The preliminary results presented here demonstrate that significantly more expanded blastocysts survive cryopreservation than cleaving embryos. Faster-growing embryos did not survive better than slowly growing embryos, but the incidence of implantation was higher with faster developing embryos. Significantly more blastocysts with a "normal" morphology survived cryostorage than those scored as "irregular" (77 versus 7%). A similar trend was observed when normal and irregular cleaving embryos were frozen, but the difference was not significant. The severity of contraction of blastocysts upon the addition of cryoprotectant increased the incidence of survival. The proportion of patients whose embryos had holes in the zona pellucida following cryopreservation was significantly higher when embryos were frozen at the cleaving stage (39%) rather than the expanded blastocyst stage (16%). Almost all embryos with damaged zonae degenerated. The proportion of cleaving embryos that survived cryostorage was inversely correlated with the number of follicles aspirated. PMID- 3958569 TI - Cryopreservation of human embryos: progress on the clinical use of the technique in human in vitro fertilization. AB - Embryo cryopreservation has been studied at Monash University since 1981 and has been available to patients since mid-1983. Of approximately 1200 patients' cycles of in vitro fertilization (IVF), 445 have had excess embryos which they requested to be frozen. To date 205 patients have requested thawing of their embryos and 144 have had frozen-thawed embryos replaced in utero, resulting in 16 pregnancies. Four of these pregnancies aborted, four are ongoing, and eight deliveries have resulted, including one stillbirth at 26 weeks and one set of twins. Analysis of the data collected to date shows that patients with three or more embryos frozen have a significantly higher pregnancy rate than patients with one or two embryos frozen (23 versus 4%, respectively). Embryo viability, but not embryo survival, following freeze-thawing is related to the degree of embryonic fragmentation and the cell stage at freezing. Eight-cell embryos had a significantly higher viability than other cleavage stages. Those resulting in pregnancy tended to be the faster-dividing eight-cell embryos and were undamaged after freezing and thawing. However, when considering all cleavage stages, there was little effect of freezing damage on embryo viability, providing that at least 50% of the cell complement of embryos were intact and the zona pellucida was undamaged. Nor was there any marked effect of the age of embryos postinsemination. It is also possible that patients who were pregnant following the initial embryo replacement on the cycle of IVF treatment are more likely to conceive following replacement of their frozen-thawed embryos. PMID- 3958570 TI - Glomerular and tubular dynamics in mercuric chloride-induced acute renal failure. AB - Mercuric chloride (HgCl2)-induced acute renal failure has received considerable investigative attention but little agreement as to its pathogenesis. A source of some disagreement has been the lack of direct glomerular dynamics measurements in this disorder. We examined glomerular dynamics, tubular integrity, and whole kidney function at 24 hours in Munich-Wistar rats given either HgCl2, 3.5 mg/kg, or a similar volume of 0.9% saline solution intramuscularly. Arterial blood pressure was elevated in HgCl2-injected rats, but renal blood flow and its distribution were similar to those of controls. Inulin clearance, however, was reduced by 89% in HgCl2-injected animals. Glomerular dynamics experiments demonstrated similar glomerular plasma flow (QA) and glomerular capillary and tubular pressures in control and HgCl2-injected animals but a higher net afferent ultrafiltration pressure and lower ultrafiltration coefficient (Kf) in the HgCl2 injected group. Single-nephron glomerular filtration rate (SNGFR), when measured from Bowman's space and HgCl2-injected rats, was similar to that measured from late proximal tubules in controls. However, SNGFR determined from the later proximal tubule in HgCl2-injected rats was only one third of that measured from Bowman's space. QA estimated from glomerular counting was similar to that calculated from Bowman's space SNGFR in HgCl2-injected rats. 3H-inulin microinjection experiments confirmed the presence of tubular fluid backleak suggested by the discrepancy in Bowman's space and late proximal tubular SNGFR measurements. It is concluded that at 24 hours in low-dose HgCl2-induced acute renal failure, tubular fluid backleak is the major pathogenetic factor, with a decline in Kf having a potential secondary role. PMID- 3958571 TI - Polyethylene glycol polymers of low molecular weight as probes of intestinal permeability. I. Innovations in analysis and quantitation. AB - The differential passive permeation of polymers of different lengths across the intestinal mucosa has been proposed as a probe to test mucosal integrity under a variety of physiologic and pathologic conditions. Polyethylene glycol (PEG) 400 contains a series of polymers whose pattern of urinary recovery after oral administration has been used to characterize intestinal mucosal function. To extend this method to the low levels of PEG polymers found in the urine of children with diarrhea, we have introduced three methodologic innovations. These alterations involve (1) formulation of a balanced PEG polymer mixture, (2) improved isolation, derivatization, and gas chromatography techniques, and (3) a new quantification of the pattern of PEG urinary recoveries. Urinary recovery of orally administered PEG was assessed in four normal adults, six hospitalized infants without gastrointestinal complains, two infants with prolonged diarrhea and carbohydrate malabsorption, and two children with cystic fibrosis. A parameter characterizing the urinary recovery of PEG, N1/2, which is the theoretical number of subunits in the polymer whose recovery is reduced to 50% of the value of the polymer whose recovery is maximal, gave stable, reproducible, and consistent results in normal adults and infants. PMID- 3958572 TI - Relationship of platelet-associated immunoglobulin G and platelet protein to platelet size and density in normal individuals and patients with thrombocytopenia. AB - Total platelet-associated immunoglobulin G (PA-IgG) and platelet volume and protein content in normal individuals and in patients with idiopathic thrombocytopenic purpura (ITP) and other thrombocytopenias of presumed nonimmune origin have been measured on platelets separated into subpopulations on the basis of density on continuous polyvinylpyrrolidone (Percoll) gradients. In all subjects PA-IgG per platelet was primarily found in the lightest platelets at levels up to sevenfold greater than in the heavier platelets. PA-IgG level per platelet was raised in light platelets in 29% of patients with thrombocytopenia and in heavy platelets in 60%. In almost half of these instances the PA-IgG level fell to within the normal range when considered in relation to either platelet volume or protein content. PA-IgG levels of patients with untreated ITP did not differ significantly from those with treated ITP or thrombocytopenia of other causes. Mean platelet volume and protein content of the total platelet population of all subjects showed significant linear correlation (P less than 0.01). Thus PA IgG of both controls and patients with thrombocytopenia of all causes is preferentially located in the lightest platelets, but increases in PA-IgG in immune thrombocytopenias occur more frequently in the heavier platelets. These findings suggest that part of the process of IgG accumulation by platelets is the same in normal individuals as in patients with thrombocytopenia. PMID- 3958573 TI - Characteristics of renal p-aminohippurate and urate excretion in rabbits. AB - Urate and p-aminohippurate (PAH) excretion was studied in New Zealand white rabbits to determine the extent to which the renal tubular handling of these organic anions by intact kidneys paralleled observations made in single isolated perfused tubules in vitro. At low plasma concentrations (less than 60 mumol/L) net reabsorption of urate was observed in the majority of animals; as plasma urate concentration was increased by infusing lithium urate, net urate secretion was demonstrated, the fractional excretion of urate (FE urate) reaching 270%, and net urate secretion (filtered urate minus urinary concentration of urate times volume flow rate) 1.8 mumol/min at mean plasma urate levels 200 and 310 mumol/L. A maximal urate secretion rate was not demonstrated. Probenecid (250 mumol/kg) reduced FE urate to 27%, thereby revealing concealed reabsorption despite high plasma urate levels. By contrast, net secretion of PAH at all plasma levels was achieved by infusing NaPAH. The highest secretory rate was 38.6 mumol/min at plasma PAH levels between 1000 and 1750 mumol/L. Probenecid reduced fractional excretion of PAH (FEPAH) from 796% to 265%, no evidence of PAH reabsorption being found after inhibition of secretion with probenecid. At comparable plasma levels (220 mumol/L), net PAH secretion exceeded net urate secretion (reflected by the decrement in urate and PAH excretion caused by probenecid) by a factor of 5.3:1. These experiments indicate that urate and PAH are filtered and secreted by the rabbit kidney; however, only urate is significantly reabsorbed over the range of plasma organic anion levels examined. The configuration of the relation between plasma levels and net secretion rates and the greater secretory rate for PAH for urate in the living rabbit are consonant with the characteristics of PAH and urate transport determined previously in studies of isolated perfused proximal tubules. PMID- 3958574 TI - Effect of premercurial resetting of intrarenal vascular resistance on HgCl2 induced acute renal failure. AB - The role of renal hemodynamics in the first hours of HgCl2-induced acute renal failure was examined by studying the influence of resetting the total renal vascular resistance (RT) within the limits of autoregulation before and after the mercury administration. Intravenous HgCl2 alone (3 mg/kg) caused an early fall of glomerular filtration rate (GFR) from 69 +/- 3 to 38 +/- 4 ml/min/100 gm kidney weight (KW) and of renal blood flow (RBF) from 535 +/- 42 to 276 +/- 27 ml/min/100 gm KW, 3 hours after HgCl2 (P less than 0.01). In a second series, the RT was decreased by clamping the aorta before and after HgCl2 so that the mean renal perfusion pressure (MRPP) was lowered to a mean of 87 +/- 5 mm Hg). This maneuver did not prevent the fall in GFR (from 81 +/- 5 to 36 +/- 6 ml/min/100 gm KW) or in RBF (from 510 +/- 79 to 197 +/- 20 ml/min/100 gm KW) after HgCl2 (P less than 0.01). In a third group, the RT was increased by a rise of MRPP to 158 +/- 8 mm Hg by bilateral carotid clamping. Subsequently, 3 hours after HgCl2, the GFR decreased not significantly from 72 +/- 6 to 61 +/- 7 ml/min/100 gm KW, and RBF increased from 405 +/- 66 to 431 +/- 71 ml/min/100 gm KW. Three hours of continued carotid clamping alone caused a rise of GFR from 64 +/- 7 to 83 +/- 7 ml/min/100 gm KW (P less than 0.05) and of RBF from 425 +/- 16 to 581 +/- 28 ml/min/100 gm KW (P less than 0.01). Autoregulation of RBF was studied in a control period and after 3 hours of carotid clamping and found to be lost during prolonged carotid clamping. The autoregulatory capacity remained intact after HgCl2 alone. The renal vasoconstrictive response to norepinephrine was not affected 3 hours after carotid clamping. It is concluded that the fall of GFR and RBF after HgCl2 can be prevented by prolonged carotid clamping. This is related to a loss of the capacity to maintain renal vasoconstriction after carotid clamping because of a concomitant loss of autoregulation of RBF and points at least in part to a pathogenetic role of changes in renal hemodynamics in the first hours after HgCl2. The tubular effects of HgCl2 were, however, maintained, despite the protection of GFR. PMID- 3958575 TI - Early nutrition and intestinal transport function: effect of low-cholesterol diet. AB - Intestinal structure and function change with aging and with manipulation of the diet. The present study was undertaken to assess the absorption of selected nutrients and the morphologic characteristics of the intestine of weaning rabbits fed chow for 2, 4, or 6 weeks, and to determine the effect of feeding a low cholesterol diet (LCD) for 2 weeks on these changes. Over the 6-week period in the chow-fed rabbits, an increase was seen in the jejunal villus height, villus surface area, and mucosal surface area, whereas in the ileum no change occurred in the villus height, and a decrease in the mucosal surface area was seen. Feeding LCD for 2 weeks had no effect on the jejunal or ileal mucosal surface area, and returning to chow for 2 weeks after 2 weeks of the low-cholesterol diet (LCD-C) also had no effect on mucosal surface area. Food consumption was lower in animals fed LCD than in animals fed chow, but body weight gain was unchanged. With an in vitro technique, the jejunal, ileal, and colonic uptake of lipids was shown to change over 6 weeks in animals fed chow, with a decline in the value of the incremental change in free energy (integral of delta Fw----I) associated with the uptake of medium-chain fatty acids, and an increase in the uptake of dodecanol, suggesting lower effective resistance of the intestinal unstirred water layer. The jejunal and ileal uptake of glucose and leucine fell from 2 to 6 weeks of age. Feeding LCD for 2 weeks was associated with marked changes in transport: in the jejunum there was increased uptake of fatty acids (FA) 6:0, 8:0, 12:0, 14:0, and 16:0, dodecanol, glucose, and galactose, and reduced uptake of FA 10:0 and 18:0, cholic acid, and leucine. Feeding LCD abolished the site related differences in integral of delta FW----I, and reduced the early age related fall in integral of delta FW----I in the ileum and colon. With LCD-C some of the changes in uptake were returned to normal, whereas for others new abnormalities became apparent. Thus, (1) the intestinal structure and transport function of young growing rabbits undergoes complex alterations, with the direction and magnitude of the absorption changes depending on the probe and the intestinal site; (2) feeding LCD for 2 weeks alters the age-related process of intestinal development.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958576 TI - Resuscitation and transfer of trauma patients: a prospective re-evaluation. PMID- 3958577 TI - Acupressure: a hands-on technique for treating headaches. PMID- 3958578 TI - Diabetic neuropathy can affect the physician's ability to treat the diabetic patient. PMID- 3958579 TI - New methods for monitoring insulin-dependent diabetes clinical application and results. PMID- 3958580 TI - Maternal mortality. PMID- 3958581 TI - Absence of privilege. PMID- 3958582 TI - Peristaltic closure of a safety pin--an unusual fate of a safety pin seen as a foreign body in the gastrointestinal tract. AB - This report presents a case where an open safety pin passed through the Esophagus and where Nature herself finally solved the problem by closing the pin, which was afterwards carried in the faecal stream and discharged from the body without any harm to the patient. PMID- 3958583 TI - Secretory otitis media--evidence for an inherited aetiology. AB - In a study to determine whether or not there is a familial or hereditary predisposition to develop secretory otitis media (SOM), the parents of 73 children with persistent SOM and 35 controls were examined clinically, and abnormalities of the tympanic membrane (TM) noted. Analysis of the findings suggests that heredity plays a large part in determining a child's likelihood of developing SOM. PMID- 3958584 TI - The migration theory of cholesteatoma formation. Some experimental observations. AB - The migration theory of cholesteatoma formation considers that stratified squamous epithelium from the external auditory meatus migrates into the middle ear, giving rise to cholesteatoma. To test the ability of squamous epithelium to migrate in this manner, 73 stains were placed in relation to 23 chronic perforations. In no instance did epithelium migrate into the middle ear cleft. The limitations of the migration theory are discussed. PMID- 3958585 TI - Inversion of the stapedial reflex in ossicular chain lesions. AB - In ears with minor conductive hearing loss of traumatic origin, it is sometimes possible to invert the deflection of the stapedial reflex by application of a small underpressure in the external auditory meatus of the injured ear (probe ear). This inversion can be explained by an ossicular discontinuity bridged by soft tissue. PMID- 3958586 TI - Hearing in patients with blast lung. PMID- 3958587 TI - Intraturbinate Ethanolamine oleate as a method of treatment in chronic non specific rhinitis. PMID- 3958588 TI - A critical evaluation of the role of CT scanning in ethmoidal cancer. PMID- 3958589 TI - Monostotic fibrous dysplasia of the ethmoid. Surgical treatment using a combined endocranial and transfacial approach. AB - Two cases of monostotic fibrous dysplasia of the ethmoid are presented. This condition is of interest to the rhinologist because of the difficulty of differential diagnosis, its location, and the frequent tendency to local recurrence. The two patients presented in this paper were aged fifteen and seven respectively, with almost identical lesions and with very similar x-rays. A clinical picture of each patient is given, following a brief description of fibrous dysplasia. Special emphasis has been placed on the treatment which is necessarily surgical. In both cases extensive radical surgery of the lesion was performed using a combined craniofacial approach. Finally, a brief evaluation is made of these two cases. PMID- 3958590 TI - Juvenile laryngeal papillomatosis. AB - From the records of 23 patients with juvenile laryngeal papillomatosis, various aspects of the aetiology, natural history and treatment of the condition have been presented. The lesions are thought to be viral in origin, they are notoriously unpredictable in their behaviour, and treatment can often be prolonged and frustrating. Tracheostomy should be avoided, if possible, owing to the risk of further dissemination down the trachea and bronchi. The CO2 laser now seems to be the surgical treatment of choice, and early reports of adjuvant interferon therapy are encouraging. However, the laser is only available in certain centres, and interferon supplies are limited at present. PMID- 3958591 TI - Subglottic haemangioma in children. AB - Our experience with the treatment of 23 cases of subglottic haemangioma in children at the Hospital for Sick Children is presented. Different modalities of treatment are mentioned, with particular emphasis on excision with laryngo tracheoplasty and the use of CO2 surgical laser. In a self-limiting lesion, our present policy is to use the CO2 laser to accelerate the rate of regression while minimizing morbidity and mortality. PMID- 3958593 TI - Instrumental perforation of the oesophagus. A ten year study from two ENT clinics. AB - During the 10-year period 1972-1981, 3,688 and 867 oesophagoscopies were performed at two ENT clinics of a university hospital and of a county hospital with an incidence of oesophageal perforation of 0.8 per cent and 1.1 per cent respectively. Rigid instruments were used in all cases, most often in combination with dilatation of a benign stricture. PMID- 3958592 TI - Use of tongue flap in submucous palatal fibrosis. AB - Submucous palatal fibrosis invariably leads to trismus due to fibrosis in the retromolar region. Medical lines of treatment are of no use in relieving the trismus once it is established. Various surgical methods, such as excision of fibrous tissue or excision of fibrous tissue with skin grafting, have been suggested, but none of them has been proved to give a lasting cure. We have made use of tongue flaps on either side in cases of trismus due to submucous palatal fibrosis in the retromolar region. Twenty-five cases have been operated upon with this technique and the results are quite encouraging. Regular follow-up for up to three years has shown good results without any complications. PMID- 3958594 TI - Middle ear adenoma: a case report with ultrastructural findings. AB - A 56-year-old woman presented with unilateral tinnitus and hearing loss for 18 months. A middle ear mass was detected clinically. At operation, the tumour was found to have eroded the stapes. The light and electron microscopic features of the tumour were those of a middle ear adenoma. This rare benign tumour has an excellent prognosis. Erosion of an ossicle has not been previously associated with this tumour. Benign adenomatous tumours arising from middle ear mucosa are rare (Mills and Fechner, 1984). The term adenoma of middle ear was proposed by Hyams and Michaels (1976), and their review of 20 cases emphasized the benign behaviour of these tumours. We report a case of middle ear adenoma in which ossicular erosion occurred. PMID- 3958595 TI - Encephalocele of the middle ear. AB - A case of congenital encephalocele of the middle ear presenting as a conductive hearing loss is reported. In retrospect it is possible that CT scanning with metrizimide contrast studies may have been helpful in establishing the diagnosis (Cooper and Kassel, 1982). However, it is stressed that even in the absence of radiological abnormality of the temporal bone, surgical exploration of the middle cranial fossa should be undertaken. PMID- 3958596 TI - Wegener's granulomatosis arising in pregnancy. PMID- 3958597 TI - An unusual case of laryngeal carcinoma. AB - A 62-year-old male patient presented with carcinoma of the larynx which behaved in an atypical fashion clinically. It increased in size rapidly within a period of 5 weeks and clinically presented as a dumbell-shaped neck swelling over the thyroid alae. It had features on plain x-ray, tomography and CT scan which led to the diagnosis of chondrosarcoma of the larynx. After total laryngectomy, it turned out to be a squamous cell carcinoma of the larynx with some unusual histopathological features including bone formation in the tumour. PMID- 3958598 TI - A suspicious lump in the neck. PMID- 3958599 TI - Warthin's tumour with bilateral synchronous presentation. Survey of the literature and a new case. PMID- 3958600 TI - Repair of pharyngo-cutaneous fistula using a bipedicled tubed flap. AB - The successful closure of a large pharyngo-cutaneous fistula by a bipedicled tubed flap is described. This procedure is technically simple and reliable. An advantage of this method is that both lining and covering are obtained in the same flap. PMID- 3958601 TI - School learning, time and learning disabilities: the dissociated learner. PMID- 3958602 TI - Grounding LD definitions and practices in systems of educational thought. PMID- 3958603 TI - K-ABC/WISC-R factor analysis for a learning disabled population. PMID- 3958604 TI - How learning disabled adolescent boys make moral judgments. PMID- 3958605 TI - Some audiological, psychological, educational and behavioral characteristics of children with bilateral otitis media with effusion: a longitudinal study. PMID- 3958606 TI - Empirically derived learning disability subtypes: a replication attempt and longitudinal patterns over 15 years. PMID- 3958607 TI - Preparation and characterization of 3-monohydroxylated bile acids of different side chain length and configuration at C-3. Novel approach to the synthesis of 24 norlithocholic acid. AB - A series of 3-monohydroxylated bile acids, in unlabeled and radioactive form, of varying side chain length and configuration at C-3 has been synthesized and rigorously characterized. They include: 3 alpha- and 3 beta-hydroxy-5 beta androstane-17 beta-carboxylic acids (C20); 3 alpha- and 3 beta-hydroxy-5 beta pregnan-21-oic acids (C21); 3 alpha- and 3 beta-hydroxy-23,24-bisnor-5 beta cholan-22-oic acids (C22); 3 alpha- and 3 beta-hydroxy-24-nor-5 beta-cholan-23 oic acids (C23, norlithocholic and isonorlithocholic acids); and 3 beta-hydroxy-5 beta-cholan-24-oic acid (C24, isolithocholic acid). A novel approach to the degradation of lithocholic acid acetate to 24-norlithocholic acid is described. This degradation involves the photochemical modification of a Hunsdiecker reaction and Kornblum oxidation of the intermediate 23-bromide. The availability of these compounds makes it possible to study the metabolism and biological effects of short chain bile acids. PMID- 3958608 TI - Compensatory mechanisms governing the concentration of plasma low density lipoprotein. AB - To evaluate factors regulating the concentrations of plasma low density lipoproteins (LDL), apolipoprotein B metabolism was studied in nine Pima Indians (25 +/- 2 yr, 191 +/- 20% ideal wt) with low LDL cholesterol (77 +/- 7 mg/dl) and apoB (60 +/- 4 mg/dl) and in eight age- and weight-matched Caucasians with similar very low density lipoprotein (VLDL) concentrations, but higher LDL (cholesterol = 104 +/- 18; apoB = 82 +/- 10; P less than 0.05). Subjects received autologous 131I-labeled VLDL and 125I-labeled LDL, and specific activities of VLDL-apoB, intermediate density lipoprotein (IDL)-apoB, and LDL-apoB were analyzed using a multicompartmental model. Synthesis of LDL-apoB was similar (1224 +/- 87 mg/d in Pimas vs 1218 +/- 118 mg/d in Caucasians) but in Pimas the fractional catabolic rate (FCR) for LDL-apoB was higher (0.48 +/- 0.02 vs 0.39 +/ 0.04 d-1, P less than 0.05). In the Pimas, a much higher proportion of VLDL-apoB was catabolized without conversion to LDL (47 +/- 3 vs 30 +/- 5%, P less than 0.01). When all subjects were considered together, LDL-apoB concentrations were negatively correlated with both FCR for LDL-apoB (r = -0.79, P less than 0.0001) and the non-LDL pathway (r = -0.43, P less than 0.05). Also, the direct removal (non-LDL) path was correlated with VLDL-apoB production (r = 0.49, P = 0.03), and the direct removal pathway and FCR for LDL-apoB were correlated (r = 0.49, P = 0.03). In conclusion, plasma LDL appear to be regulated by both the catabolism of LDL and the extent of metabolism of VLDL without conversion to LDL; both of these processes may be mediated by the apoB/E receptor, and appear to increase in response to increasing VLDL production. PMID- 3958609 TI - Direct transesterification of all classes of lipids in a one-step reaction. AB - Conventional techniques for the determination of fatty acid composition of lipids require solvent extraction, purification, hydrolysis, and derivatization procedures that are both lengthy and cumbersome. A 1-hr direct transesterification procedure carried out in methanol-benzene 4:1 with acetyl chloride circumvented all these steps and was applicable for analysis of both simple (triglycerides) and complex lipids (cholesteryl esters, phospholipids, and sphingomyelin). Recoveries (greater than 95%) of standards unaffected by the presence of 5% water and 200 mg of silica suggested that the technique could be used for the quantitative analysis of total fatty acids as well as of fatty acids in classes of lipids separated on silica from biological samples. When compared to the Folch procedure, the technique led to a 20.1% increase in total fatty acids for plasma, 3.9% for feces, 7.4% for bile, and 9.7% for rat liver. We therefore conclude that this one-step direct transesterification procedure is superior to currently used methods, not only because of its simplicity and speed, but also because of its added precision. PMID- 3958610 TI - Short bed-continuous development thin-layer chromatography of glycosphingolipids. AB - The technique of short bed--continuous development chromatography has been utilized to increase the separation of glycosphingolipids on high performance thin-layer chromatography plates. The theoretical goal of increasing separation of bands by decreasing solvent strength was achieved within a practical time span as a result of the high solvent velocities in the short bed tank. Examples are given for increased separation of short and long chain neutral glycolipids, acetylated neutral glycolipids, and gangliosides. PMID- 3958611 TI - Effect of adipokinetic hormone on the structure and properties of lipophorin in locusts. AB - The reversible association of a low molecular weight hemolymph protein (mol wt 20,000 estimated by SDS-polyacrylamide gel electrophoresis) with lipophorin, following treatment with adipokinetic hormone (AKH), was demonstrated by density gradient ultracentrifugation and by specific precipitation of lipophorin from the hemolymph of resting and AKH-injected locusts. The injection of AKH also stimulated the loading of diacylglycerol from fat body by lipophorin and resulted in a lower density lipophorin ("activated lipophorin"). The activated lipophorin particles (diameter 21.7 +/- 3.0 nm, 15.8 to 33.6 nm) were larger and more heterogeneous in size than those of resting lipophorin (14.5 +/- 1.6 nm, 11.9 to 19.2 nm). A theoretical analysis based on the experimental data (e.g., density gradient profile, electron microscopic observation, and diacylglycerol content) suggests that very large lipophorin particles result from intermolecular fusion of the lipophorin molecules that are activated by AKH. Attempts to demonstrate the effect of AKH on the structure of lipophorin, in vitro, were unsuccessful. PMID- 3958612 TI - Apolipoprotein B synthesis in rat small intestine: regulation by dietary triglyceride and biliary lipid. AB - Apolipoprotein B (apoB) synthesis rates have been determined, in vivo, in rat enterocytes. Following intralumenal administration of a pulse of [3H]leucine, newly synthesized apoB was quantitated by specific immunoprecipitation and compared to [3H]leucine incorporation into total, trichloroacetic acid-insoluble protein. ApoB synthesis rates were determined after acute administration of either 0.1 or 1 g of triglyceride to fasting animals. No differences were found at any time from 90 min to 6 hr after challenge and values were not different from the basal values established in fasted controls. Animals rechallenged with triglyceride after 8 days' intake of fat-free chow also failed to demonstrate a change in intestinal apoB synthesis rate. By contrast, enterocyte content of apoB appeared to fall, temporarily, with the onset of active triglyceride flux. Groups of animals were then subjected to external bile diversion for 48 hr, a maneuver designed to remove all lumenal sources of lipid. Jejunal apoB synthesis rates fell by 43% (from 0.76% +/- 0.14 to 0.43% +/- 0.12, P less than 0.001), a change that was completely prevented by continuous replacement with 10 mM Na taurocholate. The suppression of jejunal apoB synthesis, induced by prolonged bile diversion, was reversed after 14 hr, but not 8 hr, of intralumenal perfusion with 10 mM Na taurocholate. The addition of micellar fatty acid-monoolein to the perfusate for 4 hr produced no further change in apoB synthesis. Ileal apoB synthesis rates fell by 70% (from 0.61% +/- 0.15 to 0.18% +/- 0.10, P less than 0.001) following 48 hr external bile diversion, a change that was only partially prevented by continuous bile salt replacement. These results suggest that jejunal apoB synthesis demonstrates bile salt dependence but not regulation by acute triglyceride flux. The data further suggest that key aspects of the regulation of apoB synthesis by cellular lipid flux may be mediated independently in jejunal and ileal enterocytes. PMID- 3958614 TI - Sterol substrate specificity of acyl coenzyme A:cholesterol acyltransferase from the corn earworm, Heliothis zea. AB - The enzymatic activity and sterol substrate specificity of acyl coenzyme A:cholesterol acyltransferase (ACAT) were measured in microsomes of cells from Heliothis zea. Under standard assay conditions, the specific enzymatic activity of ACAT was highest in the intestine followed by the fat body and ovary (380.7, 30.7, 8.3 pmol/min per mg, respectively). The structure of the exogenous sterol used in the ACAT assay affected its rate of esterification. The relative rates of esterification of analogs of cholesterol with various modifications of the side chain were: 24-H greater than 24 alpha-CH3 greater than delta 22 greater than delta 24 greater than 24 alpha-C2H5 greater than 24 beta-CH3, delta 22-24 beta CH3 and delta 22-24 alpha-C2H5. The number and position of double bonds in the B ring of the sterol nucleus greatly affected the rate of esterification of sterols by ACAT. The average relative rates of esterification of sterols with differences in their B-rings were: delta 7 much greater than delta 8 greater than delta 0 greater than delta 5 greater than delta 5.7. The presence of a 9,14-cyclopropane group and/or methyl groups at the C-4 and 14 positions prevented significant esterification of such sterols. The formation of cholesteryl and lathosteryl esters was partially inhibited in microsomes from the intestine, fat body, and ovary by the addition of the ACAT inhibitor, 3-(decyldimethylsilyl)-N-[2-(4 methylphenyl)-1-phenylethyl]prop anamide (Sandoz Compound 58-035).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958613 TI - ApoE is necessary and sufficient for the binding of large triglyceride-rich lipoproteins to the LDL receptor; apoB is unnecessary. AB - Large triglyceride-rich very low density lipoproteins (VLDL) Sf 60-400 from hypertriglyceridemic (HTG) patients, but not VLDL from normal subjects, bind to the LDL receptor of human skin fibroblasts because they contain apolipoprotein E (apoE) of the correct conformation, accessible both to the LDL receptor and to specific proteolysis by alpha-thrombin. Trypsin treatment of HTG-VLDL Sf 60-400 causes extensive apoB hydrolysis (fragments less than 100,000 mol wt), total degradation of apoE, and thus complete loss of LDL receptor binding. The reincorporation of apoE (1 mol/mol VLDL) into trypsin-treated HTG-VLDL completely restored the ability of HTG-VLDL to interact with the LDL receptor, suggesting that apoE probably does not induce a conformational change in apoB which results in receptor recognition, nor is intact apoB necessary to maintain the appropriate conformation of apoE for LDL receptor binding. As a model of large triglyceride rich VLDL Sf greater than 60, we fractionated Intralipid by the Lindgren method of cumulative flotation and prepared apoE-Intralipid complexes. Competitive binding studies demonstrated that apoE-Intralipid is at least as effective as LDL for uptake and degradation of 125I-labeled LDL. Control Intralipid complexes containing apoA-I instead of apoE do not compete with iodinated LDL. Since these TG-rich complexes contain no apoB, apoB is, therefore, not only not sufficient for receptor-mediated uptake of large particles, it is not necessary. ApoE of the correct conformation is not only necessary but is sufficient to mediate receptor binding of large triglyceride-rich particles to the LDL receptor. PMID- 3958615 TI - Bile acid synthesis in man: assay of hepatic microsomal cholesterol 7 alpha hydroxylase activity by isotope dilution-mass spectrometry. AB - The present work describes an accurate assay of the rate-limiting enzyme in bile acid synthesis, the cholesterol 7 alpha-hydroxylase, in human liver. The assay is based on isotope dilution-mass spectrometry, and endogenous microsomal cholesterol is used as the only substrate for the enzyme. Operative liver biopsies were obtained from patients undergoing elective cholecystectomy under highly standardized conditions. In ten gallstone patients, the enzyme activity of the microsomal fraction averaged 9.6 +/- 1.4 (mean +/- SEM) pmol X min-1 X mg protein-1 corresponding to a daily synthesis of about 0.5 mmol of bile acids. Three cholestyramine-treated patients displayed a four-fold higher enzyme activity. No evidence was obtained supporting the concept that the cholesterol 7 alpha-hydroxylase is modulated by phosphorylation-dephosphorylation. PMID- 3958616 TI - Separation of phospholipid molecular species by high performance liquid chromatography: potentials for use in metabolic studies. AB - Different molecular species of phospholipids exhibit distinctly different patterns of biologic behavior. In this minireview, the utility of HPLC for analysis of molecular species of phospholipids is illustrated in studies in which it has been demonstrated that molecular species are selectively synthesized, selectively transported, and selectively participate in enzymatic reactions. HPLC appears to be more adaptable for routine use than older procedures used to separate phospholipid molecular species. Since the metabolism of intact molecules can be characterized with HPLC, this procedure promises to provide particularly novel information with respect to changes in composition brought about by remodelling reactions during the biologic life of specific phospholipids. PMID- 3958617 TI - Adaptations in lipid metabolism of bovine adipose tissue in lactogenesis and lactation. AB - The timing and magnitude of metabolic adaptations in adipose tissue during lactogenesis and lactation were determined in first lactation bovines. In vitro rates of lipogenesis and palmitate esterification were measured to estimate in vivo synthesis. Lipolysis was measured in the basal state and as maximally stimulated by norepinephrine or epinephrine to estimate physiological adaptations as well as the changes in catecholamine responsiveness. Subcutaneous adipose tissue was biopsied at -1, -0.5, +0.5, 1, 2, and 6 months from parturition. From 1 to 0.5 months prepartum there was a 54% reduction in lipogenesis, a 16% reduction in esterification, a 54 and 77% increase in norepinephrine- and epinephrine-stimulated free fatty acid (FFA) release, respectively, and a 28% increase in epinephrine-stimulated glycerol release. The immediate postpartum period (0.5 and 1 month) was marked by a decrease in lipogenesis to 5% and esterification to 50% of -1 month rates. During this period, norepinephrine stimulated FFA release increased 50% above -1 month rates, epinephrine-stimulated FFA release increased 128%, and norepinephrine- and epinephrine-stimulated glycerol release increased 30 and 87%, respectively. Midlactation (2 and 6 months) was marked by a dramatic rebound in lipogenesis and esterification to 14 fold and 2.5-fold prepartum rates, respectively. Basal glycerol release doubled during this period, while basal FFA release declined to near prepartum levels. Catecholamine-stimulated FFA and glycerol release decreased from the peak during midlactation, but remained elevated compared to prepartum levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958618 TI - Stereospecificity of monoacylglycerol acyltransferase activity from rat intestine and suckling rat liver. AB - The stereospecificity of monoacylglycerol acyltransferase from rat intestinal mucosa and suckling rat liver microsomes was examined using sn-1,2-diacylglycerol kinase from Escherichia coli. With 2-monooleoyl glycerol and palmitoyl-CoA, 88 and 87.9% of the diacylglycerol synthesized by the intestinal mucosa and suckling liver, respectively, was demonstrated to be the sn-1,2-isomer. Analysis of similar preparations of these diacylglycerol products by gas-liquid chromatography-mass spectrometry indicated that most of the remaining diacylglycerol was the 1,3-isomer that probably arose via acyl-migration. These results indicate that monoacylglycerol acyltransferase is stereospecific. Measurement of acyltransferase activities in microsomes using 1- and 2-monoacyl- and monoalkylglycerols as substrates indicated that the monoacylglycerol acyltransferases from suckling liver and intestinal mucosa have different substrate specificities. PMID- 3958619 TI - Desorption chemical ionization mass spectrometry of 1-O-alkyl-2-O-acetyl-sn glycero-3-phosphocholines and analogues. AB - Ammonia desorption chemical ionization of ether-linked phospholipids of the type 1-O-alkyl-2-O-acetyl-sn-glycero-3-phosphocholine (platelet-activating factors) and a series of analogues revealed a systematic fragmentation pattern that is characteristic for these compounds. The predominant ions included the protonated molecular ion and a series of fragments derived from the molecular ion having the following nominal mass losses: MH-14, MH-42, MH-59, and MH-183. Deuterated ammonia was used to elucidate the nature of several fragments. In addition, desorption chemical ionization was used to quantitate 1-O-hexadecyl-2-O-acetyl-sn glycero-3-phosphocholine at the nanogram/sample level. PMID- 3958620 TI - Oxidoreduction of different hydroxyl groups in bile acids during their enterohepatic circulation in man. AB - The extent of oxidoreduction of the 3 alpha-, 7 alpha- and 12 alpha-hydroxyl groups in bile acids during the enterohepatic circulation in man was studied with the use of [3 beta-3H]-labeled deoxycholic acid and cholic acid, [7 beta-3H] labeled cholic acid, and [12 beta-3H]-labeled deoxycholic acid and cholic acid. Each [3H]-labeled bile acid was given per os to healthy volunteers, together with the corresponding [24-14C]-labeled bile acid. The rate of oxidoreduction was calculated from the decrease in the ratio between 3H and 14C in the respective bile acid isolated from duodenal contents collected at different time intervals after administration of the labeled bile acids. The mean fractional conversion rate was found to be 0.29 day-1 for the 3 alpha-hydroxyl group in deoxycholic acid (n = 2), 0.18 day-1 for the 12 alpha-hydroxyl group in deoxycholic acid (n = 6), 0.09 day-1 for the 3 alpha-hydroxyl group in cholic acid (n = 3), 0.05 day-1 for the 7 alpha-hydroxyl group in cholic acid (n = 2), and 0.03 day-1 for the 12 alpha-hydroxyl group in cholic acid (n = 2). The extent of oxidoreduction of the 12 alpha-hydroxyl group in [12 beta-3H]-labeled deoxycholic acid given to two patients operated with subtotal colectomy and ileostomy was markedly reduced (less than 20% of normal).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958621 TI - Bile acid production in human subjects: rate of oxidation of [24,25 3H]cholesterol compared to fecal bile acid excretion. AB - Bile acid production has been quantitated in seven subjects by methods that compare the results of two independent approaches, namely, quantitation of cholesterol side-chain oxidation and fecal bile acid excretion. Six hypertriglyceridemic (HT) subjects and one normolipidemic control were studied by both techniques. A further control subject was studied by the cholesterol side chain oxidation method alone. Cholesterol side-chain oxidation was quantitated by measuring the appearance of 3H2O after intravenous administration of [24,25 3H]cholesterol, using multicompartmental analysis of plasma cholesterol and [3H]water specific activity. Body water kinetics were independently defined by use of oral D2O. Two HT subjects were restudied while they were taking cholestyramine, 16 g/day. In all ten studies, multicompartmental analysis closely simulated the observed appearance of 3H2O. Values obtained for bile acid production suggest that cholesterol oxidation, or bile acid input, was significantly greater than fecal bile acid output in the HT subjects (P less than 0.05). Cholesterol side-chain oxidation rates in the two normal subjects were lower than those encountered in HT subjects, being similar to published values for normal subjects both for bile acid synthesis as determined by isotope dilution kinetics and fecal bile acid excretion. Studies conducted with two, synthetically different, preparations of [24,25-3H]cholesterol indicated that, in one of the two preparations, approximately 20% of the tritium label was at positions proximal to C24. In the other preparation examined, all of the tritium was located at, or distal to, C24. Further studies revealed that 0.055-0.24% of the dose was present as labile tritium by virtue of its appearance as 3H2O following in vitro incubation with human plasma. Provided these isotope effects are taken into account, multicompartmental analysis of plasma [24,25 3H]cholesterol and body water appears to be a useful technique for quantitating cholesterol oxidation in human subjects. PMID- 3958622 TI - Dietary supplementation with Pluronic L-81 modifies hepatic secretion of very low density lipoproteins in the rat. AB - Supplementation of high fat/cholesterol-enriched diets with polyoxypropylene polyoxyethylene copolymers containing 90% hydrophobic constituents has been found to impair enteric secretion of chylomicrons, lower plasma levels of very low density (VLDL) and low density (LDL) lipoprotein cholesterol and prevent diet induced hypercholesterolemia and atherosclerosis. These agents are known to be absorbed from the gastrointestinal tract and excreted in bile. In order to determine whether dietary supplementation with this group of hydrophobic poloxalenes influences hepatic secretion of triglyceride-rich lipoproteins, groups of rats were maintained for 21-34 days on either standard chow, semisynthetic diet containing 10.0% safflower oil/1.0% cholesterol, or each of the above diets supplemented with the hydrophobic poloxalene Pluronic L-81. At the end of the feeding period, newly secreted hepatic VLDL were isolated from 2 hr recirculating liver perfusates, quantitated, and characterized. Compared to perfusions in chow-fed rats, perfusion experiments in rats fed the high fat/cholesterol-enriched semisynthetic diet revealed a 3.1-fold increased net hepatic VLDL secretion rate; enrichment of secretory VLDL in cholesteryl esters and in C18:2 core lipid fatty acids; and a shift in the size distribution of secretory VLDL towards larger particles. When the 0.5% Pluronic L-81 was included in the high fat/cholesterol-enriched semisynthetic diet, the net hepatic VLDL secretion rate fell significantly and the physicochemical properties of secretory VLDL in these rats were found to resemble those of chow-fed animals. Supplementation of the chow diet with L-81 resulted in a significant fall in the net hepatic VLDL secretion rate from that observed in rats fed chow alone. Compared to rats fed chow alone, perfusate VLDL from rats fed each of the other experimental diets contained markedly lower amounts of both apoB molecular weight variants, as analyzed by gradient gel electrophoresis and densitometric gel scanning. Since previous studies have demonstrated that VLDL are the major cholesterol transport lipoproteins following fat/cholesterol feeding; a precursor product relationship exists between fat/cholesterol-induced hepatic VLDL and plasma VLDL; such particles are capable of delivering cholesterol to the arterial wall; and dietary supplementation with hydrophobic poloxalenes prevents both the increase in plasma VLDL-cholesterol and diet-induced atherosclerosis, it is possible that dietary supplementation with hydrophobic poloxalenes may influence the atherogenic process through direct and/or indirect effects on hepatic VLDL transport. PMID- 3958623 TI - Capillary gas-liquid chromatography of glycine-conjugated bile acids without prior hydrolysis. AB - A method is described for the gas-liquid chromatographic (GLC) analysis of intact glycine conjugates of the major bile acids present in human plasma. It is, therefore, now possible to analyze glycine-conjugated and unconjugated bile acids together on a single GLC column without the necessity for a hydrolytic step. A large number of derivatives of bile acid glycine conjugates were examined, but only acetate- and silyl ether-derivatives of carboxylic acid methyl esters were found initially to be suitable. It was not possible to make acetates consistently, and trimethylsilyl ethers did not allow resolution of the glycine conjugates of cholic and chenodeoxycholic acids. Dimethylethylsilyl ether methyl ester derivatives were subsequently found to give the best results. Chromatographic conditions for successful analysis of these derivatives were examined and it was found to be necessary to use wall-coated capillary columns of thin film thickness (0.12 micron) and very high carrier gas flow rates (ca. 20 ml/min hydrogen). Using acetonitrile and Bond Elut extraction, fractionation on Sep-Pak SIL cartridges, and derivatization as dimethylethylsilyl ether methyl esters, the capillary gas-liquid chromatography of intact glycine-conjugated bile acids from human plasma was demonstrated for the first time. PMID- 3958624 TI - Determination of ketone body kinetics using a D-(-)-3-hydroxy[4,4,4-2H3]butyrate tracer. AB - In studies where D-(-)-3-hydroxy[4,4,4-2H3]butyrate is employed as isotopic tracer in vivo, we have described a selected ion monitoring, gas-liquid chromatography-mass spectrometry micromethod which measures [2H3] tracer enrichment in 3-hydroxybutyrate and acetoacetate from 300-microliters blood samples. For plasma samples in the physiologic range, intra- and interassay precisions for each ketone averaged better than +/- 1% and +/- 2%, respectively. The use of the method was validated by comparing kinetic data obtained with the above tracer with simultaneous flux data obtained with conventional D-(-)-3 hydroxy[3-14C]butyrate tracer in five fasted rats. PMID- 3958625 TI - Synthesis of heteroatom-substituted analogues of stearic acid. AB - We report herein the syntheses of several analogues of stearic acid in which oxygen or sulfur atoms or sulfoxide groups have replaced the methylene groups at either position 9 or position 10 of the polymethylene chains. These compounds have been fully characterized by the results of proton and carbon 13 nuclear magnetic resonance, and low and high resolution mass spectral studies. PMID- 3958626 TI - [Acute pain following sclerosing injections]. PMID- 3958627 TI - [Arteriopathy caused by radiation]. PMID- 3958628 TI - [Acceptable use of non-steroidal anti-inflammatory agents]. PMID- 3958630 TI - [Treatment of vascular edema of the limbs using mercury pressure]. PMID- 3958631 TI - [Acute ischemia of the upper limb]. PMID- 3958629 TI - [Chilblains]. AB - Chilblain is a frostbite, it belongs to the vascular acrosyndromes by the mere fact of symmetrical lesions and to the dystrophic group by its organic obstructive and thrombotic microangiopathy, especially of venules. Chilblain is conditional on a dysesthesia for cold, diagnosis is easy if in the know, prognosis as usual good and treatment must be more preventive than curative. PMID- 3958632 TI - An analysis of a dendritic neuron model with an active membrane site. AB - We formulate and analyze a mathematical model that couples an idealized dendrite to an active boundary site to investigate the nonlinear interaction between these passive and active membrane patches. The active site is represented mathematically as a nonlinear boundary condition to a passive cable equation in the form of a space-clamped FitzHugh-Nagumo (FHN) equation. We perform a bifurcation analysis for both steady and periodic perturbation at the active site. We first investigate the uncoupled space-clamped FHN equation alone and find that for periodic perturbation a transition from phase locked (periodic) to phase pulling (quasiperiodic) solutions exist. For the model coupling a passive cable with a FHN active site at the boundary, we show for steady perturbation that the interval for repetitive firing is a subset of the interval for the space clamped case and shrinks to zero for strong coupling. The firing rate at the active site decreases as the coupling strength increases. For periodic perturbation we show that the transition from phase locked to phase pulling solutions is also dependent on the coupling strength. PMID- 3958633 TI - What the hen can tell about her eggs: egg development on the basis of energy budgets. AB - By a simple model involving the state variables size and storage, it is possible to describe a wide variety of observations on the feeding, growth, energy storage and reproduction of animals. The model is based on the assumption that reproduction, growth as well as maintenance depend on the stored energy only and not directly on feeding. If an egg is thought of as a non-feeding animal, the model predicts the respiration ontogeny and growth of the embryo inside the egg. These predictions seem to hold well for published data on the development of eggs of fish and ratite, precocial and altricial birds. The latter two are known to follow different respiration ontogenies, but both are described well, differing only in one (compound) parameter value. The model explains why the incubation times of eggs of different species tend to increase linearly with egg size to the power 1/4, and why kiwis and petrels, which lay relatively large eggs, have to brood them much longer than larger birds with eggs of the same size. Conversely, it explains why the small eggs of the (parasitic) European cuckoo, hatch earlier than the still smaller eggs of their tiny hosts. Furthermore, it has been shown how the maintenance rate constant, which frequently appears in the microbial literature, can be obtained from measurements on the respiration and weight ontogeny in embryos, so linking independent lines of research. Application of the model shows an increase of the maintenance rate constant from bacteria, crustaceans, up to fish and birds, and a decrease from bacteria to green algae, suggesting lines of evolutionary development. PMID- 3958634 TI - Influence of nonlinear incidence rates upon the behavior of SIRS epidemiological models. AB - When the traditional assumption that the incidence rate is proportional to the product of the numbers of infectives and susceptibles is dropped, the SIRS model can exhibit qualitatively different dynamical behaviors, including Hopf bifurcations, saddle-node bifurcations, and homoclinic loop bifurcations. These may be important epidemiologically in that they demonstrate the possibility of infection outbreak and collapse, or autonomous periodic coexistence of disease and host. The possible mechanisms leading to nonlinear incidence rates are discussed. Finally, a modified general criterion for supercritical or subcritical Hopf bifurcation of 2-dimensional systems is presented. PMID- 3958635 TI - Spontaneous oscillations in two 2-component cells coupled by diffusion. AB - Mathematical examples are presented of oscillators with two variables which do not oscillate in isolation, but which do oscillate stably when coupled with a twin via diffusion. Two examples are presented, the Lefever-Prigogine Brusselator and a system used to model glycolytic oscillations. The mathematical method is not the usual bifurcation theory, but rather a type of singular perturbation theory combined with bifurcation theory. For both examples, it is shown that all stationary solutions are unstable for appropriate parameter settings. In the case of the Brusselator, it is further shown that there exist limit cycles; i.e. stable oscillations, in this parameter range. A numerical example is presented. PMID- 3958636 TI - Evolutionary games and two species population dynamics. AB - Competition between species has long been modeled by population dynamics based on total numbers of each species. Recently, the evolution of strategy frequencies has been used successfully for competition models between individuals. In this paper, we illustrate that these two views of competition are compatible. It is shown that the rate of intra and interspecific competitions between individuals largely determines the population dynamics. Competition models over a single common resource and predator-prey models are developed from this individual competition approach. In particular, the equilibrium strategies in a co-evolving predator-prey system are shown to be more stable than the predicted strategy cycling of standard evolutionary game theory. PMID- 3958638 TI - Models for age structured populations with distributed maturation rates. AB - In the use of age structured population models for agricultural applications such as the modeling of crop-pest interactions it is often essential that the model take into account the distribution in maturation rates present in some or all of the populations. The traditional method for incorporating distributed maturation rates into crop and pest models has been the so-called "distributed delay" method. In this paper we review the application of the distributed delay formalism to the McKendrick equation of an age structured population. We discuss the mathematical properties of the system of ordinary differential equations arising out of the distributed delay formalism. We then discuss an alternative method involving modification of the Leslie matrix. PMID- 3958637 TI - Cell growth and division: a deterministic/probabilistic model of the cell cycle. AB - A model of the cell cycle, incorporating a deterministic cell-size monitor and a probabilistic component, is investigated. Steady-state distributions for cell size and generation time are calculated and shown to be globally asymptotically stable. These distributions are used to calculate various statistical quantities, which are then compared to known experimental data. Finally, the results are compared to distributions calculated from a Monte-Carlo simulation of the model. PMID- 3958639 TI - Complete chaos in a simple epidemiological model. AB - A first-order difference equation which constitutes a simple model for a lethal parasite-host interaction is studied. Completing a study initiated by May and Anderson, the dynamics are shown to be completely chaotic. PMID- 3958640 TI - A model of proliferating cell populations with inherited cycle length. AB - A mathematical model of cell population growth introduced by J.L. Lebowitz and S.I. Rubinow is analyzed. Individual cells are distinguished by age and cell cycle length. The cell cycle length is viewed as an inherited property determined at birth. The density of the population satisfies a first order linear partial differential equation with initial and boundary conditions. The boundary condition models the process of cell division of mother cells and the inheritance of cycle length by daughter cells. The mathematical analysis of the model employs the theory of operator semigroups and the spectral theory of linear operators. It is proved that the solutions exhibit the property of asynchronous exponential growth. PMID- 3958641 TI - The stroke patient: nursing care and home health services. PMID- 3958642 TI - Acquired cerebrovascular disease. PMID- 3958643 TI - Stroke rehabilitation. PMID- 3958645 TI - Cognitive and conative issues in contemporary philosophy of medicine. PMID- 3958644 TI - Counseling the stroke patient and family. PMID- 3958646 TI - Methodological concerns in bioethics. AB - Methodological concerns are moving to the top of the bioethics agenda for the next decade. This paper examines some of those concerns: medical ethics as a subset of bioethics versus medical ethics as a subset of professional ethics; a more in-depth examination of some methodological problems in treating medical ethics as professional ethics; the senses in which bioethics constitutes an inquiry into secular undertakings in a pluralistic society; 'federal ethics', the emergence to prominence of public commissions and study groups; and the institutional impact of bioethics on the relationship between medical schools and the liberal arts core of their sponsoring universities. PMID- 3958647 TI - From philosophy and medicine to philosophy of medicine. PMID- 3958648 TI - The sense of suffering. AB - Medical practice is animated by the intention to cure; it aims to relieve the immense variety of sufferings to which human beings are subject in virtue of the conditions of their embodied existence. My purpose here is to demonstrate how a philosophical analysis of the formal structures and kinds of human suffering provides an essential foundation for determining certain ethical dimensions of the physician's relation to his suffering patient. Can paternalism in medical practice be justified by the aim of relieving suffering? What are the scope and limits of the patient's responsibility for his suffering, and what difference does this make in the physician's response to it? How is the suffering that medical treatment itself exacts in the name of cure to be justified? Such questions can be answered only by an analysis of the sense or value of suffering in human life. PMID- 3958649 TI - Exemplar reasoning about biological models and diseases: a relation between the philosophy of medicine and philosophy of science. AB - This paper discusses the structure of medical science with a special focus on the role of generalizations and universals in medicine, and philosophy of medicine's relation with the philosophy of science. I argue that a usually overlooked aspect of Kuhnian paradigms, namely, their characteristic of being "exemplars", is of considerable significance in the biomedical sciences. This significance rests on certain important differences from the physical sciences in the nature of theories in the basic and the clinical medical sciences. I describe those differences and maintain that they are these differentiating features that require the use of more comparative and analogical reasoning in medicine. I suggest that Kitcher's recent introduction of the notion of a 'practice' may have similar implications if it is construed to contain more analogical elements than he appears to recognize in his initial formulation. Finally I argue that though Gorovitz and MacIntyre's characterization of medicine as a "science of particulars" bears some similarities with my thesis, I maintain that such a position without careful qualification can lead to ignoring both the nature of generalizations in these sciences and their role as positive analogies tying together a family of overlapping models. PMID- 3958650 TI - Clinical judgment, expert programs, and cognitive style: a counter-essay in the logic of diagnosis. AB - The question of the extent to which one can rationally reconstruct the process of medical diagnosis and reduce it to an algorithm is explored. The act of diagnostic insight is such that a computational program cannot 'catch on' in the way that a competent diagnostician can. Clinical diagnostic reasoning in a particular case requires as a necessary condition an extraordinarily complex and rich structure of background knowledge as well as an intuitive element, such as is manifest when one 'catches on' to a joke. Computers cannot 'catch on' due to their limitations in the computational mode. As a consequence, there can be no computer simulation of an essential element in diagnostic procedures. PMID- 3958651 TI - Philosophy of medicine: towards a definition. PMID- 3958652 TI - Exemplary reasoning? A comment on theory structure in biomedicine. AB - The contributions that the philosophy of medicine can make to both the philosophy of science and the practice of science have been obscured in recent years by an overemphasis on personalities rather than critical themes. Two themes have dominated general discussion within contemporary philosophy of science: methodological essentialism and dynamic gradualism. These themes are defined and considered in light of Kenneth Schaffner's argument that theories in biomedicine have a structure and logic unlike that found in theories of the natural sciences. Schaffner's arguments are suggestive but not definitive as a refutation of methodological essentialism. I argue that a primary reason for differences in the logic and structure of theories in biomedicine is not, as some philosophers have suggested, a product of ontological differences, but rather a product of the practical and pragmatic concerns of scientific theorizing in many areas of science, such as medicine. PMID- 3958653 TI - Atrial myxomas: clinical and echocardiographic features of 14 cases at Siriraj Hospital. PMID- 3958654 TI - Rheumatoid factors in sera of Thai patients with various infectious diseases. PMID- 3958656 TI - Erythropoietic protoporphyria: report of a case. PMID- 3958655 TI - Abortion: an attitude study of professional staff at Ramathibodi Hospital. PMID- 3958657 TI - Cerebellar medulloblastoma with extraneural metastases diagnosed during life. PMID- 3958658 TI - Preparation of urine microscopic slides by double cover slips technique. PMID- 3958659 TI - 5th joint meeting of British endocrine societies. 7-10 April 1986, Sheffield. Abstracts. PMID- 3958660 TI - Human coffee drinking: manipulation of concentration and caffeine dose. AB - In a residential research ward coffee drinking was studied in 9 volunteer human subjects with histories of heavy coffee drinking. A series of five experiments was undertaken to characterize adlibitum coffee consumption and to investigate the effects of manipulating coffee concentration, caffeine dose per cup, and caffeine preloads prior to coffee drinking. Manipulations were double-blind and scheduled in randomized sequences across days. When cups of coffee were freely available, coffee drinking tended to be rather regularly spaced during the day with intercup intervals becoming progressively longer throughout the day; experimental manipulations showed that this lengthening of intercup intervals was not due to accumulating caffeine levels. Number of cups of coffee consumed was an inverted U-shaped function of both coffee concentration and caffeine dose per cup; however, coffee-concentration and dose-per-cup manipulations did not produce similar effects on other measures of coffee drinking (intercup interval, time to drink a cup, within-day distribution of cups). Caffeine preload produced dose related decreases in number of cups consumed. As a whole, these experiments provide some limited evidence for both the suppressive and the reinforcing effects of caffeine on coffee consumption. Examination of total daily coffee and caffeine intake across experiments, however, provides no evidence for precise regulation (i.e., titration) of coffee or caffeine intake. PMID- 3958661 TI - Binocular depth perception in the pigeon. AB - By means of a discrete-trial simultaneous discrimination procedure, pigeons were trained to respond differentially to visual arrays that were identical except that one of them contained a circle displaced in depth when viewed stereoscopically. Performance was severely disrupted when one eye was occluded. The monocular deficit was peculiar to the depth task, inasmuch as no such decrement was seen on a pattern discrimination. The results imply that presence of the displaced circle was discriminated on the basis of a binocular cue. It was also found that pigeons could discriminate the direction of the displacement. Discrimination of depth was independent of the global form and still occurred when elements of the array were randomly displaced in depth. Performance was not disrupted when the absolute convergence angle of the depth stimulus was changed. The cue that consistently accounted for the behavior seen was the detection of the relative angles of convergence--that is, the retinal disparity of the two planes in depth. Thus, despite the lateral position of the eyes of the pigeon, a small binocular field mediates the binocular discrimination of near objects in depth. PMID- 3958662 TI - Conjoint control of performance in conditional discriminations by successive and simultaneous stimuli. AB - In a conditional discrimination, reinforcement of pigeons' responses to pairs of simultaneously presented wavelength stimuli depended on the orientation of white lines superimposed on the wavelengths. Over different conditions in Experiment 1, three wavelength differences were combined with two differences between successively presented line orientations. Measures of stimulus discriminability increased with increases in the difference between both orientation and wavelength stimuli. Conditional-discrimination performance was thus conjointly determined by stimulus disparity in the successive and simultaneous discriminations. In Experiment 2, ratios of rates of reinforcement contingent upon the two categories of correct responses were varied over several conditions for difficult and easy discriminations. Ratios of responses to wavelength pairs were sensitive to variations in the reinforcement ratio to a greater extent for the more difficult orientation discrimination than for the easier orientation discrimination. Performance in the conditional discrimination was therefore determined by the interacting effects of stimulus disparity and the relative rates of reinforcement contingent upon the two correct choices. It was concluded that the effect of temporally distant reinforcement on behavior in a prevailing schedule component is attenuated to an extent that depends on similarity of stimuli that delineate the successive components. PMID- 3958663 TI - Behavioral contrast in fixed-interval components: effects of extinction-component duration. AB - Seven albino rats were exposed to a multiple schedule of reinforcement in which the two components (fixed interval and extinction) alternated such that a presentation of the extinction component followed each fixed-interval reinforcement. In baseline sessions, the duration of the extinction component was constant and always one-third of the fixed-interval value. Probe sessions contained a probe segment in which the duration of the extinction component was increased; the response rate in fixed-interval components during the probe segment was compared with the response rate in the segments preceding and following the probe. The effect of increasing the duration of the extinction component was studied under three values of fixed interval: 30 s, 120 s, and 18 s, in three successive conditions. Response rate within fixed intervals was a direct function of duration of the extinction component. Pausing at the beginning of the fixed interval decreased as extinction duration increased. These effects were larger and more consistent for the shorter fixed-interval values (18 s and 30 s). These results indicate a functional relation between relative component duration and responding. For the component providing more frequent reinforcement, this could be stated as an inverse relationship between relative component duration and response rate. This relation is similar to findings regarding the ratio of trial and intertrial duration in Pavlovian conditioning procedures, and suggests that behavioral contrast may be related to Pavlovian contingencies underlying the multiple schedule. PMID- 3958664 TI - Brief exposure to contingent reinforcement produces a sustained increment in the strength of an elicited response. AB - Squirrel monkeys' lever pressing produced by response-independent shock was measured before, and for an extended period following, exposure to a shock avoidance procedure. Following avoidance training, the frequency of responding increased by multiples of 10 to 50 across subjects and evidence little or no decrement for up to 6 months of postreinforcement testing. Manual responding produced by intense environmental stimulation may be substantially strengthened by a brief history of reinforcement, such that it is sustained over long periods without reinforcement. PMID- 3958665 TI - Effects of chlorpromazine on fixed-ratio responding: modification by fixed interval discriminative stimuli. AB - Effects of chlorpromazine (1 to 100 mg/kg) were assessed on two pigeons' responding under various modifications of a multiple schedule of food delivery. During a fixed-interval component, the first response after 5 min produced food; during the subsequent, fixed-ratio component, the 30th response produced food. Modifications of the schedule entailed changes in stimulus conditions imposed during the fixed-ratio component that did not systematically alter characteristics of performance under non-drug conditions. In the first phase of the experiment, distinctive visual stimuli were correlated with each schedule component (conventional multiple schedule); chlorpromazine produced small decreases in fixed-ratio responding (20% at 30 mg/kg). When each response during the fixed-ratio component produced the stimulus correlated with the fixed interval schedule (fixed-interval discriminative stimulus) for 1.2 s, effects of chlorpromazine were not different from those under the conventional multiple schedule. Chlorpromazine produced greater decreases in fixed-ratio responding (55% at 30 mg/kg) when either the first response of each fixed ratio changed the stimulus correlated with the fixed-ratio schedule to the fixed-interval discriminative stimulus for the remainder of the fixed-ratio component, or when the fixed-interval discriminative stimulus was presented independently of responding according to a matched temporal sequence. When the fixed-interval discriminative stimulus was present continuously during the fixed-ratio component (mixed schedule), chlorpromazine produced even more substantial decreases in fixed-ratio responding (greater than 80% at 30 mg/kg). Effects of chlorpromazine on fixed-interval responding were also modified by the schedules of fixed interval discriminative stimulus presentation. The effects of chlorpromazine were a joint function of the stimuli prevailing during the multiple schedule and the degree to which responding influenced these stimuli. PMID- 3958666 TI - Molecular analyses of the effects of d-amphetamine on fixed-interval schedule performances of rats. AB - A series of doses (0.5 to 2.0 mg/kg) of d-amphetamine was administered to rats whose lever pressing was maintained by fixed-interval 30-s, 60-s, or 120-s schedules of reinforcement by sucrose delivery. Under both saline and d amphetamine conditions, molecular features of responding were reliably described in terms of the distribution of postreinforcement pauses and local response rate following the onset of responding. Postreinforcement pause always varied from interval to interval but, on average, shortened under the drug. Local response rate (response rate exclusive of pause time) tended to decrease under the drug, and where acceleration occurred within runs of responses, it was reduced by the drug. All of these effects were dose-related. These findings suggest that fixed interval behavior can be analyzed effectively at a molecular level, and that the effects of d-amphetamine are best described as disruption of temporal discrimination. PMID- 3958668 TI - Some thoughts about the future. PMID- 3958667 TI - Drug-behavior interaction history: modification of the effects of morphine on punished behavior. AB - Squirrel monkeys were trained to respond under a multiple fixed-interval, fixed interval schedule in which the first response after 5 min terminated a visual stimulus in the presence of which electric shocks could occur. During one component of the schedule, correlated with one color of stimulus lights, every 30th response also produced electric shock; responding was suppressed during this component to approximately 10 to 12% of that occurring in the alternate component in which responding was not punished. In contrast to previous research, morphine (0.03 to 1.0 mg/kg) increased punished responding. Unpunished responding, however, was either not affected or decreased at doses of morphine that increased punished responding. Increases in rate of punished responding also occurred when the single-schedule punishment condition was studied alone in these animals. Subsequent experimentation, which systematically analyzed the development of the rate-enhancing effects of morphine on punished responding, involved the study of drug effects in additional monkeys trained initially under a single-schedule punishment condition. The effects of morphine on punished responding were studied before, after, and then during exposure to the multiple schedule that included a component in which responding was not punished. Increases in response rate with morphine did not occur until it was administered during exposure to the multiple schedule that included a component in which responding was not punished. As with the other monkeys, once the rate increases in punished responding occurred under the multiple schedule, these effects of morphine persisted, even when the multiple schedule was removed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958669 TI - Activity of crayfish abdominal-positioning interneurones during spontaneous and sensory-evoked movements. AB - The premotor interneurones that produce coordinated abdominal movements in crayfish (Procambarus) when stimulated directly, are also 'sensorimotor'. Sets of these interneurones respond in predictable ways to touching the body surface. One set of interneurones (type I) is activated to spiking by touch, while another (type II) receives only subthreshold influences. Several of these interneurones have overlapping receptive fields on the body surface. Touching areas of overlap activates groups of interneurones which discharge at low to moderate frequencies, rather than producing a high-frequency discharge of a single cell. No single positioning interneurone has been identified which is solely responsible for a "voluntary' (spontaneous) motor programme. When active, the positioning interneurones contribute to the production of the behaviour as a member of a constellation of such cells. The results show that this motor system comprises interneurones with sensory as well as motor properties. Although single cells can produce coordinated movements when stimulated at high frequencies, these positioning interneurones appear to function as 'command elements' within a large 'command system' and not as individual units. PMID- 3958670 TI - Capillarity and mitochondrial distribution in rat myocardium following exercise training. AB - Rats were subjected to a laddermill running programme either once per week for 6 weeks, or daily for 6 weeks. Heart mass and maximal oxygen consumption rate increased relative to controls and with the frequency of the running programme. Mitochondrial distribution, measured in seven regions within fibres, was similar in all hearts, with a peak volume density of 0.42 +/- 0.01 occurring 4-5 microns from the centre of a capillary. Capillary density decreased with increasing heart mass, but total capillary length and capillary-to-fibre ratio were constant. Thus the higher metabolic demands of the running programmes did not alter the volume density or distribution of mitochondria, despite significant increases in heart mass and decreases in capillarity. PMID- 3958671 TI - Human homing: still no evidence despite geomagnetic controls. AB - Baker's highly influential and widely cited studies suggest that people are capable of non-visual navigational performance comparable to that of homing pigeons. Past failures to replicate this work have been attributed by Baker to geomagnetic influences. We report a series of experiments in which both temporal and spatial geomagnetic controls were introduced. We could still find no evidence for blindfold homeward orientation in humans. PMID- 3958672 TI - The release of the prothoracicotropic hormone in the tobacco hornworm, Manduca sexta, is controlled intrinsically by juvenile hormone. AB - Pupal development is elicited early in the last larval instar of the tobacco hornworm, Manduca sexta (Johannson), by a precise temporal and quantitative increase in the haemolymph titre of 20-hydroxyecdysone. This increase in the titre is referred to as the pupal commitment peak, and it occurs once the titre of juvenile hormone (JH) has dropped. If the haemolymph titre of JH remains elevated at this time due to topical application of the hormone or of its analogue ZR512, commitment is delayed or inhibited in a dose-dependent manner. This delay or inhibition is due to the curtailment of the commitment peak in the ecdysteroid titre, which results from a failure of the prothoracic glands (PG) to increase the synthesis/secretion of the premoulting hormone, ecdysone. Since the PG from ZR512- and JH 1-treated larvae are capable of being activated in vitro by the prothoracicotropic hormone (PTTH), the effect of JH on the PG does not involve suppression of gland sensitivity to PTTH. The locus of the JH effect was determined to be the brain-retrocerebral complexes (Br-CC-CA), on the basis of experiments which tested the effect of implanted Br-CC-CA from pre-commitment larvae treated with JH on the occurrence of pupal commitment in head-ligated larval hosts. The implanted, JH-treated Br-CC-CA exhibited a delayed release of PTTH, and the effect was at concentrations of JH that were physiological. These results argue that JH functions to control the time during the last larval instar when pupal commitment occurs by dictating when PTTH will undergo gated release. PMID- 3958674 TI - The physiology of wandering behaviour in Manduca sexta. III. Organization of wandering behaviour in the larval nervous system. AB - The locomotor patterns typical of wandering behaviour were studied electromyographically in abdominal segments of freely moving larvae of Manduca sexta. Crawling locomotion consisted of stereotyped, anteriorly-directed, peristaltic waves of intersegmental muscle contraction. During burrowing the intersegmental muscles of all abdominal segments contracted simultaneously for several consecutive cycles and then performed a single bout of the crawling pattern. Sensory inputs determined which motor patterns were used and how they were modified. Local sensory inputs could modify patterns in the specific segments affected. The neural circuitry that was required to generate the peristaltic and bracing patterns was repeated among the thoracic and abdominal ganglia, and normally wa activated by the suboesophageal ganglion (SEG) and brain. In the absence of connections with the SEG and brain the segmental motor pattern generators could be activated by strong sensory stimuli. When the thoracic and abdominal segments lacked connections with the SEG, spontaneous movements were infrequent prior to wandering, but increased markedly at wandering or following 20-hydroxyecdysone (20-HE) infusion. Prior to wandering the SEG drives spontaneous locomotion in debrained larvae, but this function disappears in wandering larvae, or following 20-HE infusion. Prior to wandering the brain exerted a net inhibitory influence on locomotion. Removal of the medial region of the brain abolished this inhibition, resulting in strong, continuous locomotion which was driven by the lateral region of the brain. This lateral excitatory function of the brain was not altered by 20-HE infusion prior to wandering, nor did it change with the appearance of wandering behaviour. We conclude that the locomotor patterns used during wandering are produced by pattern generators in the segmental ganglia and are modified by sensory information. The circuitry responsible for activating these motor pattern generators is associated with the SEG, and is under the control of the brain. The brain exerts a net inhibitory influence prior to wandering, which becomes excitatory during wandering. Ecdysteroids appear to alter locomotor function by acting at various levels including the segmental ganglia, the SEG and the brain. A model is advanced describing this effect. PMID- 3958673 TI - Localization and stimulation of chromatophore motoneurones in the brain of the squid, Lolliguncula brevis. AB - The relatively simple chromatophore system of the squid, Lolliguncula brevis, was studied with combined behavioural, morphological and electrophysiological methods in order to understand how the chromatophore patterns in the skin are organized at the level of the posterior chromatophore lobes (PCL). There are nine simple chromatic components of patterning in L. brevis. Retrograde transport of horseradish-peroxidase from chromatophores in the mantle skin established that the chromatophore motoneurones are located in the PCL. Focal threshold stimulation of the PCL in perfused, semi-intact preparations showed that the motor fields of individual chromatophore motoneurones are compact, including 2-60 chromatophores, generally of the same colour. Adjacent motoneurones in the lobe do not necessarily have adjacent motor fields in the skin. PMID- 3958675 TI - The physiology of wandering behaviour in Manduca sexta. IV. Hormonal induction of wandering behaviour from the isolated nervous system. AB - Prior to exposure to ecdysteroids, the isolated central nervous system (CNS) of the fifth instar Manduca sexta larvae exhibited infrequent motor bursts over a 24 h period of extracellular recording from segmental motor nerves. In contrast, the CNS isolated from wandering larvae was characterized by persistent, frequent spontaneous motor bursts throughout the 24-h incubation. The motor bursts generated by the isolated CNS of wandering larvae were similar to those observed in deafferented segments of partially dissected wandering larvae during locomotion. In both cases bursts in the deafferented ganglia were synchronous and had a lower frequency than in intact animals. Removal of the brain from a CNS isolated prior to ecdysteroid exposure resulted in the appearance of spontaneous bursts, which were abolished by removing the suboesophageal ganglion (SEG). By contrast, when the brain was removed from the isolated CNS of wandering larvae, spontaneous bursts ceased. These results parallel the behavioural effects of the same lesions in intact larvae of the respective stages. The CNS isolated from larvae prior to ecdysteroid exposure initiated sustained frequent bursting after an average latency of 15 h following incubation in haemolymph taken from larvae during the interval of ecdysteroid secretion. Incubations of the CNS with 1 microgram ml-1 20-hydroxyecdysone (20-HE) resulted in the onset of the same pattern of sustained motor activity. In a CNS isolated prior to ecdysone release, it was necessary and sufficient to expose the brain to 20-HE in order to induce the state of persistent motor bursts characteristic of wandering. We conclude that the spontaneous persistent motor bursts observed in the isolated CNS of wandering larvae are directly related to the sustained locomotion seen during the wandering behaviour. 20-HE acts directly on the CNS, specifically the brain, to induce this state of neural activity. PMID- 3958676 TI - Accessory lymph sacs and body fluid partitioning in the lizard, Sauromalus hispidus. AB - Chuckwalla lizards (genus Sauromalus) may accumulate substantial quantities of body fluid in extracoelomic, lateral abdominal spaces called accessory lymph sacs. The lymph sac fluid (LSF) of S. hispidus is similar to that of serum in Na+, K+ and Cl- concentrations, but the total protein content (3.58 +/- 0.20 g dl 1) is only half that measured in serum (7.05 +/- 0.26 g dl-1). These analyses confirm that LSF is an extravascular form of extracellular fluid, similar in composition to true lymph. Measurements of body fluid partitioning by dilution analysis indicate that Sauromalus hispidus Stejnejer possesses a comparatively large (38.9% body mass) and labile extracellular fluid volume (ECFV), and that the volume of LSF is dependent on the ECFV. Expansion of the ECFV (and subsequent accumulation of LSF) is observed following large, intercompartmental fluid shifts from intracellular to extracellular locations when lizards are kept inactive in simulated hibernation, are injected with KCl in amounts similar to those found in their field diet, and are hydrated with NaCl that is isotonic to their body fluids. These data collectively suggest that the lymph sacs of chuckwallas facilitate expansion of the ECFV, and may be adaptive not only as a means to store body water, but to accommodate transient shifts in body fluid from intracellular to extracellular locations. PMID- 3958677 TI - The contribution of nasal receptors to the cardiac response to diving in restrained and unrestrained redhead ducks (Aythya americana). AB - In restrained redhead ducks, forced submergence caused heart rate to fall from 100 +/- 3 beats min-1 (mean +/- S.E.M., N = 12) to a stable underwater rate of 35 +/- 4 beats min-1 (N = 12) within 5 s after submergence. Bradycardia was unaffected by breathing oxygen before a dive, but was virtually eliminated by local anaesthesia of the narial region. In contrast, in a dabbling duck (Anas platyrhynchos) bradycardia in short dives was eliminated by breathing oxygen before a dive. In unrestrained diving, on a man-made pond, heart rate in redheads diving voluntarily (y) was related to pre-dive heart rate (x) by the equation y = 76 + 0.29 +/- 0.05x +/- 17 (r2 = 0.71). Chasing, to induce submergence, had variable effects on this relationship. Local anaesthesia of the narial region inhibited voluntary diving but heart rates in chase-induced dives after nasal blockade were significantly higher, by 10-30%, than those obtained from untreated ducks in chase-induced dives. Breathing oxygen before voluntary dives had no apparent effect on heart rate after 2-5 s submergence. Voluntary head submersion by dabbling ducks caused no change in heart rate. We conclude that nasal receptors make only a minor contribution to cardiac responses in unrestrained dives, compared with forced dives, in diving ducks. Furthermore, these results show that little can be learned about cardiac responses in free diving ducks from studies of forced dives in dabblers or divers. PMID- 3958678 TI - Effect of thermal acclimation on locomotor energetics and locomotor performance in a lungless salamander, Desmognathus ochrophaeus. AB - To determine the effects of thermal acclimation upon locomotor performance and the rate of oxygen consumption (MO2) during activity, small (less than 3 g), lungless salamanders, Desmognathus ochrophaeus Cope, were acclimated to three temperatures (5, 13 and 21 degrees C) and exercised at various controlled speeds within an exercise wheel while their MO2 was measured. MO2 increased with speed at low speeds (less than 14 cm min-1). Although animals could sustain greater speeds, MO2 did not increase further. These small, exclusively skin-breathing salamanders could increase their MO2 9-11 times during exercise and could sustain nearly half of the oxygen flux expected across a similar surface area of the mammalian lung. However, their maximum aerobic speed was remarkably slow (14 cm min-1) and their net cost of transport remarkably large (15-17 ml O2 g-1 km-1). Thermal acclimation affected MO2 during activity, the maximum sustainable speed and locomotor stamina in different ways. During exercise at 13 degrees C, cold acclimated animals had a significantly greater MO2 than warm-acclimated animals, but did not differ in stamina or the maximum sustainable speed. During exercise at 21 degrees C, cold acclimation did not affect the MO2 significantly, but it decreased the stamina and increased the rate of lactate accumulation. Thus, these results suggest that thermal acclimation of the MO2 is not tightly coupled to thermal acclimation of locomotor performance in salamanders. PMID- 3958679 TI - Meconium aspiration. PMID- 3958680 TI - A diagnostic problem and family assessment. PMID- 3958681 TI - Use of the likelihood ratio in the management of the young child with fever. AB - The febrile infant is a common clinical problem for the primary health care provider. This paper employs the example of a young infant with fever to describe an important epidemiologic concept that is useful in the interpretation of diagnostic data--the likelihood ratio. The likelihood ratio expresses the odds of a given diagnostic test result occurring in a patient with (as opposed to without) the target disorder. Likelihood ratios have three properties that are helpful for clinicians: (1) The likelihoods that make up the likelihood ratio are calculated in a manner similar to sensitivity and specificity and therefore show little variation with change in disease prevalence (unlike predictive values, which change dramatically with disease prevalence). (2) Likelihood ratios can be calculated at several levels of a sign, symptom, or laboratory test. (3) Likelihood ratios can be used to shorten the list of diagnostic possibilities because the pretest "odds" X likelihood ratio = post-test "odds" of a disease. Using likelihood ratios in the practice of primary care medicine should reduce the number of patients with false-positive or false-negative results, sparing some patients needless therapy as well as minimizing the number of patients denied efficacious interventions. Support for likelihood ratios within the primary care medical community will hasten their availability in laboratories of clinical medicine. PMID- 3958682 TI - Effects of hygiene among the uncircumcised. AB - Recommendations against routine neonatal circumcision are based on the assumption that good penile hygiene can offer the same advantages as this procedure. The purpose of this study was to investigate hygienic practices of uncircumcised subjects and the relationship of these practices to the condition of the prepuce and glans. Outcome was related to hygiene: subjects who retracted the foreskin when bathing were less likely to have smegma accumulation, inflammation, phimosis, or adhesions than those who did not. Significant correlations were also found between early instructions concerning hygiene and the type of hygiene practiced. These results support the recommendation that good hygiene can offer many of the advantages of circumcision and highlight the need for clear, early instructions on hygiene to uncircumcised patients. PMID- 3958683 TI - A randomized trial of special packaging of antihypertensive medications. AB - This article reports a randomized controlled trial designed to test the effects of special packaging of antihypertensive medication on compliance and blood pressure control. One hundred eighty subjects who had exhibited elevated blood pressure greater than 90 mmHg in the two years prior to the study were recruited from patients receiving care at a community hospital-based family medicine practice. After completing preenrollment interviews and blood pressure measurements, subjects were randomly assigned to receive their antihypertensive medications either in the usual vials or in special unit dose-reminder packaging. Follow-up interviews, pill counts, and blood pressure measurements were performed at three-month intervals. There were no statistically significant differences between the control and experimental groups with regard to age, sex, race, employment, education, marital status, insurance coverage, or blood pressure regimens. Prior to the intervention, the experimental group had slightly lower diastolic blood pressure and reported better compliance than the control group. Analyses performed on 165 subjects completing the first follow-up visit revealed no significant improvements in blood pressure control or compliance for patients receiving special medication packaging. While some patients found it easy to remember to take pills packaged using this format, they also found the packages somewhat more difficult and inconvenient to use. In contrast to previously reported work, this study did not demonstrate any significant improvement in compliance with special packaging of antihypertensive medications. PMID- 3958685 TI - Treatment and outcome of warts. PMID- 3958684 TI - Abdominal pain in pregnancy. AB - In many respects abdominal pain in pregnancy is managed just as in a nonpregnant patient, but the diagnostic criteria, methods of diagnosis, therapy, and consequences of mismanagement differ. This article discusses appendicitis, cholecystitis, urolithiasis, pancreatitis, and intestinal obstruction--conditions that often manifest a similar clinical picture. The article presents epidemiologic data, distinguishing characteristics, modifications of the workup, and treatment appropriate to pregnancy and perinatal complications of each condition. PMID- 3958687 TI - Acquired immunodeficiency syndrome (AIDS) associated with blood transfusion: review of literature and report of two cases from Dominican Republic and Haiti. PMID- 3958686 TI - Systemic reaction to pyrimethamine-sulfadoxine. PMID- 3958689 TI - Should Florida physicians embrace medical trade unionism? PMID- 3958688 TI - Thymoma associated with lupus syndrome and associated findings of pulmonary sequestration. PMID- 3958690 TI - The individual and the estimation of his blood alcohol concentration from intake, with particular reference to the "hip-flask" drink. PMID- 3958691 TI - The occurrence of chlordiazepoxide degradation products in sudden deaths associated with chlordiazepoxide overdosage. PMID- 3958692 TI - Spatial properties of the prolonged depolarizing afterpotential in barnacle photoreceptors. I. The induction process. AB - In invertebrate photoreceptors, when the light stimulus results in substantial net transfer of the visual pigment from the rhodopsin (R) to the metarhodopsin (M) state, the ordinary late receptor potential (LRP) is followed by a prolonged depolarizing afterpotential (PDA). The dependence of the amplitude of the PDA on the amount of pigment conversion is strongly supralinear, and the PDA duration also depends on this amount. These observations indicate an interaction among the elements of the PDA induction process and also make possible a test of the range of this interaction. The test consists of a comparison of the PDA after localized pigment conversion, obtained by strong spot illumination, to that after weaker diffuse illumination converting a comparable total amount of pigment. The experiment was performed on the barnacle lateral eye. The effective spot size was measured by the early receptor potential (ERP), in seawater saturated with CO2, which considerably reduced the electrical coupling between the photoreceptors. The ERP was also used to determine whether there is diffusion of R molecules into the illuminated spot. The spot illumination induced a PDA with small amplitude and long duration, while no detectable PDA was induced by the diffuse light. This indicates that the range of the PDA interaction is much smaller than the entire cell. In addition, the ERP results showed that there was no detectable diffusion of R molecules into the illuminated spot area over 30 min. This measurement, with a calculated correction for the microvillar geometry of the photoreceptor, enabled us to put an upper limit on the diffusion coefficient of the pigment molecules in the inact, unfixed barnacle photoreceptor of D less than 6 X 10(-9) cm2 s-1. PMID- 3958694 TI - Comparison of neurovirulence of different strains of yellow fever virus in mice. AB - The virulence of different vaccine and wild-type yellow fever (YF) viruses for young adult mice was compared using both intracerebral and intranasal routes of administration. Thirty-five different YF viruses killed mice within 12 days following intracerebral inoculation. In contrast, only seven of those examined killed mice following intranasal administration; these were Asibi virus (YF-AS), the French neurotropic vaccine, two out of three 17DD vaccine substrain viruses (Brazil, Colombia but not Dakar) and three out of six wild-type isolates (YF-B7, YF-B12 and YF-B15). None of eight distinct preparations from the 17D-204 vaccine substrain was virulent by the intranasal route. Thus, strains of YF virus can be distinguished on the basis of their virulence for mice if the intranasal route is used. Evidence of heterogeneity in mouse virulence within the populations was obtained using large and small plaques selected from wild-type stocks of virus. Following intranasal inoculation, a YF-AS small plaque variant was more virulent than either its parent virus or a large plaque variant. On the other hand, a large and a small plaque variant from a nonvirulent wild-type strain could not be distinguished in these tests. PMID- 3958693 TI - Spatial properties of the prolonged depolarizing afterpotential in barnacle photoreceptors. II. Antagonistic interactions. AB - In the preceding article, we investigated the spatial properties of the induction of the prolonged depolarizing afterpotential (PDA) by shifting visual pigment from the rhodopsin (R) to the metarhodopsin (M) state in the barnacle photoreceptor. In this work, we have studied the ranges within the cell of the antagonistic effects on the PDA of M-to-R transfer. When this transfer occurs during a PDA, it depresses the PDA; when it precedes PDA induction, it impedes that induction ("anti-PDA"). These ranges were previously shown (by a statistical technique) to be at least a few tens of nanometers within a half-second (D greater than 10(-13) cm2 s-1). We now demonstrate, with local illumination techniques in which a PDA was induced in one side of the cell and PDA depression or anti-PDA was induced in the other side, that both ranges are much smaller than the cell diameter (approximately 100 microns) within 30 s (D less than 10(-6)). We further show, using a less direct but shorter-range technique involving colored polarized light, that the interaction of the PDA with the anti-PDA is restricted to less than approximately 6 microns (D less than 6 X 10(-9)). This figure is quite low and suggests that the interaction may be confined to the pigment molecules, possibly in a complex of the type suggested in the preceding article. PMID- 3958695 TI - Genetic relatedness of Palyam serogroup viruses by RNA-RNA blot hybridization. AB - Cognate genes of members of the Palyam serogroup of orbiviruses have been identified previously, and their relatedness to the prototype virus was determined by blot hybridization of the genome segments of members of the serogroup using Palyam genomic RNA and isolated Palyam RNA segments as probes. In this study, the genetic relatedness of nine Palyam serogroup isolates was determined by reciprocal blot hybridizations of genomic RNA from each virus to the segments of all members of the group. The number and identity of highly related genes varied between isolates. For example. CSIRO Village and Palyam were related in genes 2 and 6, while Bunyip Creek and Vellore were related in genes 2 and 6. However, CSIRO Village and Bunyip Creek were highly related to D'Aguilar in all genes except 2 and 6, suggesting that there may have been genetic reassortment of Palyam serogroup dsRNA segments. Genes 2 and 6 were correlated consistently with serotype specificity. Genes 5, 7 and 9 were highly related among all members of the group. The Indian strains, Palyam and Vellore, were highly related in genes 1, 3 and 8, and they exhibited weak homology to genes 1, 3 and 8 of the Australian and African strains. However, one Indian isolate, Kasba, was more closely related to strains from Africa and Australia than it was to other Indian strains. There was little evidence which indicated that geography was predictive of the genetic relationships of the strains. Thus, immunological pressure may be the most important factor affecting the Palyam serogroup gene pool. PMID- 3958697 TI - [Congenital glaucoma]. PMID- 3958698 TI - ["Genetic crystalline lenses" and their treatment]. PMID- 3958696 TI - Mode of sensitivity and resistance of vaccinia virus replication to interferon. AB - In this study we show that vaccinia virus replication can be sensitive or resistant to interferon (IFN) in the same strain of mouse L cells. When IFN treated L cells were maintained in suspension culture, infection led to a rapid inhibition of both viral and cellular protein synthesis together with breakdown of viral RNA and of rRNA. When IFN-treated L cells were maintained in monolayer culture, infection did not lead to significant inhibition of viral protein or RNA synthesis and breakdown of viral or of rRNA was not observed. The resistance of vaccinia virus replication to IFN was not dependent on the input multiplicity or state of growth of the cells (actively dividing or resting). Qualitative and quantitative differences in viral transcription and translation were observed between the two virus-cell systems. Our findings are consistent with the hypothesis that the sensitivity or resistance of vaccinia virus to IFN is mediated by specific viral products that act as activators or selective inhibitors of, at least, the dsRNA-dependent ppp(A2'p)nA synthetase/RNase system. PMID- 3958700 TI - Interhemispheric transfer in major psychoses. AB - The authors studied 25 schizophrenics and 21 affectively ill, pure right-handed, male patients by using the Tactual Performance Test (TPT), a stereognosis block identification task, and an anomia task to evaluate their interhemispheric information transfer. Although both groups generally had difficulty performing the TPT, the pattern of performance deficit was not different between diagnostic groups and was not consistent with a clear-cut interhemispheric transfer problem. Schizophrenics made more naming errors and TPT preferred-hand errors than did affectively ill patients, whereas affectively ill patients were able to identify more blocks with their preferred hand than could the schizophrenics. Patient index age, illness onset age, handedness, medications received at time of testing, personal and family history of alcoholism, and family history of major mental illness did not relate to cognitive performance. It is concluded that these data are not consistent with an interhemisphere transfer deficit that is specific for schizophrenia, but they are consistent with either a nonspecific interhemisphere transfer deficit in psychoses or with a left or bilateral hemisphere impairment in schizophrenia. PMID- 3958699 TI - [Genetic pathology of the retina]. PMID- 3958701 TI - Attentional performance in positive- and negative-symptom schizophrenia. AB - Two tasks designed to measure selective attention were administered to schizophrenics, patients with bipolar disorder, and normal subjects. Schizophrenics were divided into three subgroups: positive-, negative-, and mixed symptom patients. Positive-symptom schizophrenics showed significant deficits on a digit-span task when compared to normal subjects. Furthermore, the positive group was the only one to show a significant performance decrement in the distraction condition of the digit-span task. There were no significant group differences in performance on a dichotic listening test. The results of the present study are contrary to the hypothesis that selective attention deficits are characteristic of negative-symptom schizophrenia. Instead, the findings suggest that positive symptoms are associated with greater susceptibility to distraction. PMID- 3958702 TI - Lifetime and recent alcohol consumption among male alcoholics. Neuropsychological implications. AB - Alcoholics experience a relatively well-documented pattern of decline in cognitive and motor functions. This decline is likely the result of multiple causal factors that include head injury, malnutrition, and alcohol consumption. Although alcohol consumption per se has been considered a primary causal agent, research has not demonstrated a consistent relationship between levels of alcohol consumption and these neuropsychological deficits. This study explored such relationships within a sample of 40 detoxified male inpatient alcoholics who did not have a history of polydrug abuse, malnutrition, head injury, neurological disease, or non-alcohol-related psychiatric treatment. Increasing lifetime alcohol consumption was associated with increasing age-adjusted impairment on Halstead-Reitan tests that measure such aspects of functioning as concept formation, cognitive flexibility, and perceptual-motor abilities. Alcohol consumption had a linear relationship with test scores and hypothesized interactions with age did not emerge, nor did the effects of recent drinking appear dependent upon total lifetime consumption. The pattern of consumption (e.g., amount consumed per occasion, spree drinking) was also unrelated to impairment, and the critical neuropathological factor appeared to be the total amount of lifetime alcohol consumption. PMID- 3958703 TI - The correspondence of health complaints and depressive symptoms among Anglos and Mexican-Americans. AB - This study examines the relationship between depressive symptoms and somatic complaints and/or disorders in two ethnic groups. Data reported herein are from an epidemiological field survey of a disproportionate stratified sample of Anglos (N = 637) and two Mexican-American subsamples, United States-born (N = 342) and Mexican-born (N = 201), all living in Santa Clara County, California. The covariation between depressive symptoms and a severity of somatic complaints/disorders scale derived from collapsing International Classification of Diseases categories was compared among the three ethnic subsamples with control on age, sex, education, and marital status. A significant, direct linear correlation was found between depressive symptomatology and severity of somatic complaints/disorders for each ethnic group and was found in multivariate analyses not to change significantly with the introduction of controls. Partial correlations pointed to a stronger association for Mexican-Americans than for Anglos. PMID- 3958705 TI - Associative intrusions in the verbal behavior of the first-degree relatives of adult schizophrenics. A preliminary study. AB - The first-degree blood relatives of schizophrenics were compared to a matched control group on a psychometrically matched test of responsiveness to associative intrusions. The groups differed on the subtest containing an associative alternative but not on the equally difficult subtest free of associative distractors. Results were consistent with the hypothesis that an overresponsiveness to associative distractors, well documented in schizophrenics, may also be a characteristic of their nondisturbed first degree blood relatives. The possible existence of cognitive markers in the relatives of schizophrenic patients that might indicate familial psychopathology was supported. Limitations of the present preliminary findings, as well as the case for additional investigation of the cognitive behavior of the first-degree relatives of schizophrenics, are discussed. PMID- 3958704 TI - The relationship between social support and psychiatric symptomatology in medical students. AB - This study investigated the relationship between social support and psychiatric symptom-atology among 82 first-year medical students at the University of Texas Medical School at Houston. A questionnaire was administered at several points during the medical school year. This questionnaire included the Hopkins Symptom Checklist and a measure of social support adapted for this study. It was hypothesized that social support and psychiatric symptomatology would be negatively correlated, i.e., that students who described themselves as experiencing more social support would be less symptomatic. The data supported this hypothesis at the beginning of the school year. However, by midyear, social support and symptomatology were positively correlated with each other. These findings, in conjunction with a few isolated studies in the social support literature, led the authors to conclude that in certain settings such as medical school, social ties may present competing demands on an individual's time and energy which have potentially detrimental as well as beneficial effects on mental health. In addition, the findings suggested that the relationship of social support to psychiatric symptomatology may change over time, that there are gender differences in the relationship, and that there may be an interaction between demographic factors, such as gender and marital status, and social support. PMID- 3958706 TI - A homologous series of N-alkylated cis-(+)-(1 S, 2 R)-5-methoxy-1-methyl-2 aminotetralins: central dopamine receptor antagonists showing profiles ranging from classical antagonism to selectivity for autoreceptors. AB - N-alkylated and N,N-dialkylated cis-(+)-(1 S, 2 R)-5-methoxy-1-methyl-2 aminotetralins were tested for central dopamine receptor antagonism using in vivo biochemical and behavioral models in rats. The di-methyl analogue showed a profile similar to classical dopamine receptor antagonists. It produced a marked hypomotility including catalepsy and a pronounced increase in dopamine synthesis rate. This compound also displaced DiPr-5, 6-ADTN from striatal binding sites and antagonized the hyperactivity induced by the ligand. In contrast, the mono-propyl analogue increased locomotor activity and dopamine synthesis rate over a wide dose range. This compound failed to antagonize the hyperactivity induced by DiPr 5, 6-ADTN and to displace this in-vivo binding ligand. Thus, the mono-propyl analogue appears to lack postsynaptic dopamine receptor antagonistic properties; it seems to produce its effects via a selective dopamine autoreceptor antagonism. The di-ethyl and di-propyl, but not the dibutyl, analogues were also active in the models used. Whereas the di-ethyl compound shows a profile similar to classical dopamine receptor blockers, the di-propyl compound appears to act preferentially on autoreceptors. PMID- 3958707 TI - Urinary norepinephrine excretion in panic and phobic disorders. AB - Morning urinary norepinephrine (NE) was assessed in 36 patients suffering from panic and phobic disorders according to DSM III. Urinary NE excretion was significantly higher in this group than in a normal control one. Phobic patients excreted lower levels of NE than panic ones. No significant association was found between urinary NE levels and anxiety scores according to Zung's Anxiety Status Inventory or Wittenborn Psychiatric Rating Scale. The NE increase is interpreted as reflecting a sympathetic nervous system hyperactivity in anxiety. A concomitant effect upon NE metabolism of benzodiazepine withdrawal cannot be discarded since the group of patients previously medicated showed the highest NE excretion. PMID- 3958708 TI - The inhibition of bovine ceruloplasmin oxidase activity by thiomolybdates in vivo and in vitro: a reversible interaction. AB - The administration of pharmacological doses (greater than 100 mg Mo) of trithiomolybdate or tretrathiomolydbate to ruminants causes a transient apparent decrease in the ceruloplasmin oxidase activity of plasma and a more persistent increase in copper bound to plasma albumin. Sephadex gel-filtration and/or dilution of "inhibited" samples taken from an infused animal or of plasma treated with thiomolybdate in vitro restores activity back to pretreatment levels. The increase in albumin bound copper does not appear to be related to ceruloplasmin breakdown. It is concluded that, contrary to a recent report, the inhibition of ceruloplasmin oxidase activity is reversible and thus unlikely to be of pathological relevance, since circulatory thiomolybdate concentrations in molybdenotic animals are likely to be very low. It is recommended that thiomolybdate preparations used for in vitro and in vivo studies should be carefully purified by Sephadex chromatography. PMID- 3958709 TI - Undecagold clusters for site-specific labeling of biological macromolecules: simplified preparation and model applications. AB - We report simple and rapid procedures for the synthesis of a variety of stable, water-soluble undecagold cluster, and model applications of a thiol-reactive gold cluster for the specific labeling of cysteine residues in proteins. PMID- 3958710 TI - Characteristics of synthesis of very-long-chain saturated and tetraenoic fatty acids in swine cerebral microsomes. AB - The elongation of arachidoyl-CoA (20:0-CoA) yielded 22:0 and 24:0 concomitantly, whereas the elongation of behenoyl-CoA (22:0-CoA) yielded only a negligible amount of 24:0 in adult swine cerebral microsomes. The dependence on time, pH, and the substrate concentrations were examined for the synthesis of 22:0 and 24:0 from 20:0-CoA. A microcomputer-aided simulation study suggested that there were two parallel pathways in the elongation of 20:0-CoA to 22:0 and 24:0. The elongation of 22:0-CoA could not be observed in adult swine cerebral microsomes; however, it was observed clearly in newborn swine and rat brain microsomes. A dilution experiment with the addition of cold 22:0-CoA in the reaction of elongation of 20:0-CoA confirmed the above suggestion that no intermediate 22:0 appeared during the synthesis of 24:0 from 20:0-CoA. The elongation of endogenous 20:4-CoA to 22:4 and 24:4 was examined in newborn swine cerebral microsomes, and the presence of two parallel pathways in the elongation of 20:4-CoA to 22:4 and 24:4 similar to those involved in the elongation of 20:0-CoA to 22:0 and 24:0 was suggested. PMID- 3958711 TI - Identification of multiple binding sites for [3H]5-hydroxytryptamine in the rat CNS. AB - Recent studies indicate that there may be multiple subtypes of [3H]5 hydroxytryptamine ([3H]5-HT) binding sites. Mianserin and spiperone inhibited the specific binding of [3H]5-HT (2-3 nM) to rat brain cortical membranes with shallow displacement curves. The displacement data for spiperone were best described by the presence of three independent binding sites, for which spiperone had high, medium, and low affinities. The displacement data for mianserin were best fitted by two independent, high- and low-affinity sites. The inclusion of mianserin (250 nM) to inhibit [3H]5-HT binding to the mianserin-sensitive site selectively blocked one of the sites discriminated by spiperone. These results suggest the presence of three binding sites for [3H]5-HT, one blocked by low concentrations of spiperone (5-HT1A), one blocked by low concentrations of mianserin (5-HT1C), and one blocked only by high concentrations of both mianserin and spiperone (5-HT1B). Regional differences in the relative densities of the three sites were observed. The hippocampus was rich in 5-HT1A sites, whereas the striatum contained mainly 5-HT1B and 5-HT1C sites. Selective degeneration of 5-HT containing nerve terminals induced by the neurotoxin 5,7-dihydroxytryptamine increased binding to all three sites in the cerebral cortex. Binding of [3H]5-HT to the three sites was differentially modulated by CaCl2 and guanylimidodiphosphate. The present data suggest the presence of three independent 5-HT1 binding sites having different affinities for mianserin and spiperone and having different regional distributions. PMID- 3958712 TI - Distribution of the glucose transporter in the mammalian brain. AB - We used [3H]cytochalasin B as a specific ligand to study the glucose transporter of the following tissue preparations: (a) microvessels derived from the cerebral cortex and cerebellum of the rat and pig, (b) particulate fractions of the cerebral cortex and cerebellum of the rat and pig, (c) lateral, third, and fourth ventricular choroid plexus of the pig, and (d) synaptosomes from the pig cerebral cortex. Specific, D-glucose-displaceable binding of [3H]cytochalasin B was present in all the preparations studied. This binding was saturable and displayed the kinetics of a single class of binding sites, similar to the glucose transporter found in other mammalian tissues. The density of the glucose transporter was much higher in cerebral and cerebellar microvessels and choroid plexus than either in crude particulate fractions of the cerebrum and cerebellum or in cerebral synaptosomes. These findings agree with the physiologic function of brain microvessels that transport glucose, not only for their own use, but also for the much greater mass of the entire brain. In the pig, the density of the glucose transporter in cerebral microvessels was significantly higher than in cerebellar microvessels. Irreversible photoaffinity labeling of the glucose transporter of synaptosomal membranes with [3H]cytochalasin B followed by solubilization and polyacrylamide gel electrophoresis demonstrated a single region of radioactivity that corresponded to a molecular mass of 60,000-64,000 daltons. PMID- 3958713 TI - Regional kinetic constants for blood-brain barrier pyruvic acid transport in conscious rats by the monocarboxylic acid carrier. AB - The present investigation using labeled pyruvate describes the regional distribution and kinetics of the monocarboxylic acid carrier at the blood-brain barrier of conscious rats. The experimental procedure involved the arterial injection of a single bolus of 200 microliter containing [1-14C]pyruvate, [3H]water, and varying concentrations of unlabeled pyruvate into the common carotid via an indwelling externalized catheter. The hemisphere ipsi-lateral to the injection and rostral to the midbrain was removed and dissected into five regions. A kinetic analysis revealed no significant regional differences in Km values with an overall average of 1.37 mM. However, there was regional variation in the density of the monocarboxylic acid carrier as indicated by varied levels of the kinetic constant Vmax. The cortex showed the highest Vmax value of 0.42 +/ 0.08 mumol/min/g whereas values for the caudate/putamen, thalamus/hypothalamus, and remaining portion of hemisphere ranged significantly lower at 0.22-0.27 mumol/min/g. The Vmax for the hippocampus was intermediate at 0.37 +/- 0.12 mumol/min/g. The nonsaturable carrier described kinetically by KD had an overall average of 0.034 ml/min/g. The present study confirms quantitatively previous results suggesting a variable regional distribution of the monocarboxylic acid carrier. PMID- 3958714 TI - Blood-brain transfer of glucose and glucose analogs in newborn rats. AB - Little is known of the selectivity of the blood-brain barrier at birth. Hexoses are transported through the barrier by a facilitating mechanism. To study the capacity of this mechanism to distinguish between analogs of D-glucose, we compared the transport of fluorodeoxyglucose, deoxyglucose, glucose, methylglucose, mannose, galactose, mannitol, and iodoantipyrine across the cerebral capillary endothelium in newborn Wistar rats. Cerebral blood flow, glucose consumption, and the blood-brain permeabilities of the hexoses were 25 50% of the adult values but the ratios between the permeabilities of the individual hexoses were similar to the ratios observed in adult rats. The mannitol clearance into brain was considerably higher than in adult rats (about 10-fold), indicating a higher endothelial permeability to small polar nonelectrolytes. The brain water content was higher in newborn than in adult rats and was associated with a higher steady-state distribution of labeled methylglucose between brain and blood. Hexose concentrations were determined relative to whole blood because the apparent erythrocyte membrane permeability to glucose was as high as in humans and thus considerably higher than in adult rats. The half-saturation concentration of glucose transport across the blood-brain barrier was considerably higher than in adult rats, about three-fold, suggesting that net blood-brain glucose transfer is less sensitive to blood glucose fluctuation in newborn than in adult rats. PMID- 3958716 TI - Release of catecholamines from superfused bovine adrenal chromaffin cells cultured on microcarrier beads. AB - A procedure is described for the establishment of stable primary cultures of bovine chromaffin cells on microcarrier beads. The cells flatten and send out processes with varicosities over a few days and maintain their catecholamine content for 2 weeks. The beads may be incorporated into a superfusion apparatus with a chamber volume of about 150 microliters, enabling the efficient perfusion of a high density of cells. The response to the introduction of nicotine and high potassium into the perfusing medium is shown to be more rapid and more transient than hitherto described, with each secretagogue producing a different degree of preferential stimulation of noradrenaline-secreting cells. PMID- 3958715 TI - Amino acid neurotransmitters in the CNS: properties of diaminobutyric acid transport. AB - Uptake of L-2,4-diaminobutyric acid (DABA), a positively charged analogue of gamma-aminobutyric acid (GABA), by a synaptosomal fraction isolated from rat brain occurred with a Km of 54 +/- 12 microM and a Vmax of 1.3 +/- 0.2 nmol/min/mg protein. The transport of DABA was inhibited competitively by GABA whereas that of GABA was affected in the same manner by addition of DABA. The maximal accumulation of DABA ([DABA]i/[DABA]c) was observed to increase as the second power of the transmembrane electrical potential ([K+]i/[K+]e) and the first power of the sodium ion concentration gradient. These findings indicate that DABA is transported on the GABA carrier with a net charge of +2, where one charge is provided by the cotransported Na+ and the second is contributed by the amino acid itself. Since uptake of GABA, an electroneutral molecule, is accompanied by transfer of two sodium ions, the results obtained with DABA suggest that one of the sodium binding sites on the GABA transporter is in proximity to the amino acid binding site. PMID- 3958718 TI - Effect of adenosine, adenosine derivatives, and caffeine on acetylcholine release from brain synaptosomes: interaction with muscarinic autoregulatory mechanisms. AB - Synaptosomes, prepared from rat cerebral cortex and hippocampus, were preincubated with [methyl-3H]choline. The effect of adenosine, cyclohexyladenosine, N-ethylcarboxamide adenosine, 2'-deoxyadenosine, and oxotremorine on K+-evoked 3H efflux was investigated. High-voltage electrophoretic separation showed that in the presence of physostigmine, the K+ evoked 3H efflux from hippocampal synaptosomes was 90% [3H]acetylcholine and 10% [3H]choline. Adenosine (30 microM) and oxotremorine (100 microM) both decreased [3H]acetylcholine release from hippocampal synaptosomes. The effect was inversely proportional to the KCl concentration and disappeared at a KCl concentration of 50 mM. Cyclohexyladenosine was approximately 3,000 times more active than adenosine, whereas N-ethylcarboxamide adenosine and 2'-deoxyadenosine were inactive. This indicates that A1 adenosine receptors were involved in the inhibitory effect. Caffeine antagonized the adenosine effect, and at a concentration of 100 microM, it stimulated [3H]acetylcholine efflux. The inhibitory effect of oxotremorine was as great in cortical as in hippocampal synaptosomes. In contrast, adenosine was much less active in cortical than in hippocampal synaptosomes. When inhibitory concentrations of adenosine and oxotremorine were added together into the incubation medium, the effect of adenosine on [3H]acetylcholine release was consistently reduced. An interaction between muscarinic and A1 adenosine presynaptic receptors at a common site modulating acetylcholine release can be assumed. PMID- 3958717 TI - Fatty acid composition of endoneurium and perineurium from adult rat sciatic nerve. AB - Reports on lipid composition of peripheral nervous system have generally been restricted to the saturated fatty acids of the endoneurium. In this work we attempt to determine the fatty acid composition of the different lipid classes in both endo- and perineurium from sciatic nerve microdissection on adult rats. Unsaturated fatty acids were found to make up around 60% of total fatty acids in samples of endoneurium and perineurium, with monounsaturated fatty acids forming 40-50% of total unsaturated fatty acid content. Although the same fatty acids were present in both tissues there was a striking difference in C 18:1 (n-9) and C 18:2 (n-6) ratio between endoneurium and perineurium, which is particularly rich in linoleic acid. The nonpolar perineurial lipids were found to be richest in linoleic acid. Phospholipids were present in the perineurium, and they contained high proportions of saturated and medium-chain monounsaturated fatty acids. PMID- 3958719 TI - Dose response for amphetamine-induced changes in dopamine levels in push-pull perfusates of rat striatum. AB - Levels of dopamine were determined in push-pull perfusates of striatum in chloral hydrate-anesthetized rats as a function of increasing systemic doses of amphetamine over the range 0.5-5.0 mg/kg. In the absence of amphetamine administration, basal dopamine levels remained stable for at least 6 h. Perfusate levels of dopamine responded in a quantitatively predictable fashion to increasing doses of amphetamine: (1) the maximal increase in perfusate levels of dopamine after amphetamine, relative to predrug levels, was directly proportional to the dose of the drug up to 3 mg/kg (fivefold after 0.5 mg/kg to 30-fold after 3 mg/kg); (2) the duration over which perfusate levels of dopamine were significantly elevated, with respect to preamphetamine levels, was proportional to the dose of amphetamine up to 5 mg/kg; and (3) each successively higher dose of amphetamine significantly increased the perfusate level of dopamine over that observed at the next lower dose up to 3 mg/kg amphetamine. However, maximal levels of dopamine in striatal perfusates were achieved following 3 mg/kg amphetamine and were not increased further at higher doses of the drug. The data suggest that, at higher doses of amphetamine, extraneuronal metabolism of dopamine may be of sufficient capacity to limit increases in synaptic levels of dopamine. The absence of further increases in perfusate levels of dopamine as the dose of amphetamine is increased beyond 3 mg/kg is discussed in terms of potential relevance to mechanisms of amphetamine-induced stereotyped behaviors. PMID- 3958720 TI - Metorphamide levels in chromaffin cells increase after treatment with reserpine. AB - Exposure of bovine chromaffin cells in primary culture to 0.01-1 microM reserpine caused a dose- and time-dependent increase in intracellular levels of the amidated enkephalin peptide metorphamide. Maximal levels (approximately 800% of control) were obtained at 0.1 microM reserpine and increased levels were apparent by 16 h of treatment. Metorphamide increases were at least fivefold more than that of either Met- or Leu-enkephalin, suggesting that reserpine stimulates both enkephalin processing and amidation in the secretory vesicle. Treatment with elevated potassium, which increases enkephalin levels by stimulating production of preproenkephalin messenger RNA, elicited an increase in metorphamide levels equivalent to, but not greater than, the increase in Met-enkephalin pentapeptide. The ratio of Met-enkephalin to metorphamide in untreated chromaffin cells is approximately 140:1, whereas the final Met-enkephalin: metorphamide ratio in reserpinized chromaffin cells is approximately 30:1, similar to the Met enkephalin:metorphamide ratio in enkephalinergic neurons of the CNS. PMID- 3958721 TI - Arteriovenous malformations of the brain: natural history in unoperated patients. AB - Two-hundred and seventeen patients from a total population of 343 patients with arteriovenous malformations, were managed without surgery. Follow up was for a mean of 10.4 years. Using life survival analyses, there was a 42% risk of haemorrhage, 29% risk of death, 18% risk of epilepsy and a 27% risk of having a neurological handicap by 20 years after diagnosis in unoperated patients. PMID- 3958722 TI - Position sense in a damaged knee. PMID- 3958723 TI - Transient paraparesis--a manifestation of ischaemic episodes in the anterior cerebral artery territory. PMID- 3958724 TI - Absence of immunoreactive interferon-alpha in CSF from patients with multiple sclerosis. PMID- 3958727 TI - Generalized dystonia, whispering dysphonia and Wilson's disease in members of the same family. PMID- 3958726 TI - Familial hypoplasia of the thenar eminence: a report of three cases. PMID- 3958725 TI - Treatment of acute myelopathy in systemic lupus erythematosus with plasma exchange and immunosuppression. PMID- 3958728 TI - Patients with Parkinson's disease can employ a predictive motor strategy. PMID- 3958729 TI - The significance of traumatic haematoma in the region of the basal ganglia. AB - Computed tomography demonstrated a haematoma in the region of the basal ganglia in 61 of 2000 head injured patients. In 41 the haematoma occurred as an isolated lesion while in 20 there was another associated intracranial haematoma. Clinical and radiological differences within these groups are discussed. The patients with basal ganglia haematoma were more severely injured than those in a group who had an intracranial haematoma evacuated by craniotomy and the findings closely resembled those of a group of patients who had sustained diffuse brain damage. They share many features with those of patients with diffuse white matter injury and have a worse prognosis than other traumatic intracranial haematomas. PMID- 3958730 TI - The dopamine withdrawal test following surgery for intracranial aneurysms. AB - Cerebral blood flow was measured in eight patients who were being treated with dopamine in order to maintain cerebral perfusion after the onset of delayed postoperative ischaemia following intracranial aneurysm surgery. Measurements were made whilst on treatment and repeated either during a reduction in the dosage or withdrawal of dopamine. There was a significant fall in cerebral blood flow in both hemispheres in all eight patients. Clinical deterioration was observed in seven of nine instances in which cerebral blood flow fell by 25% or more of the value while on dopamine treatment. There were no episodes of deterioration in six tests where the fall in cerebral blood flow was less than 25% of the starting value. It is suggested that cerebral blood flow measurement can be useful in predicting when it is safe to withdraw dopamine treatment in these patients. Hypertensive treatment should be maintained if a withdrawal test is associated with a fall in cerebral blood flow of 25% or more. PMID- 3958731 TI - Adult medulloblastoma. AB - Twelve cases of adult onset medulloblastoma are presented. Clinical features, treatment and outcome are discussed. It was found that the survival rates for adults are no better than for children. There were no clinical or histological features that distinguished these tumours from those occurring in childhood, except for a higher incidence of hemisphere lesions. PMID- 3958732 TI - Ovarian hormones, anticonvulsant drugs, and seizures during the menstrual cycle in women with epilepsy. AB - The excretion of three oestrogen fractions and progesterone metabolites in 64 female epileptic patients was determined during the menstrual cycle, and in 50 women of this sample serum phenytoin and phenobarbitone levels were measured. A significant decrease of both hormones in epileptic patients was found as compared to a control group. The variations in serum phenytoin levels were greater in females with so-called catamenial epilepsy with a marked fall of drug levels between days 27 and 28 corresponding with an increase of seizure frequency. The effect of progesterone deficit on seizure susceptibility before menstrual bleeding is discussed, and the need of serum anticonvulsant level determination during the premenstrual phase in epileptic women is suggested. PMID- 3958733 TI - Primary hemifacial spasm: a neurophysiological study. AB - A series of 53 cases of primary hemifacial spasm have been evaluated by means of blink reflexes and their results compared with a normal control group. Reflex responses were obtained by percutaneous electrical stimulus of both the supraorbital nerve (trigemino-facial reflex), and the facial nerve at the stylo mastoid region (facio-facial reflex). The R2 response was considered abnormal when its latency was shortened (hyperactivity) or delayed (hypoactivity). Thirty six out of 53 cases with primary hemifacial spasm showed abnormal responses, with a combination of facial nerve impairment (delayed R2 in the facio-facial reflex) and trigeminal-facial hyperactivity (shortened R2 in the trigemino-facial reflex). Five cases showed hyperactivity in both the trigemino-facial reflex and the facio-facial reflex reflexes. These results suggest a state of hyperexcitability, probably at the level of the facial nucleus, combined with a peripheral facial nerve involvement in a high proportion of patients with primary hemifacial spasm. PMID- 3958735 TI - The response to isoniazid of action tremor in multiple sclerosis and its assessment using polarised light goniometry. AB - Isonicotinic acid hydrazide (isoniazid) was evaluated in five patients as a treatment for the control of severe cerebellar action tremor occurring in multiple sclerosis. Oral doses of isoniazid BPC were increased every 2 weeks from 300 mg to 1200 mg daily over an 8 week period. Four patients reported considerable symptomatic benefit at doses ranging from 600 mg to 900 mg daily. Polarised light goniometry demonstrated a two to three-fold reduction of tremor in these patients when standard methods of clinical assessment showed only marginal improvement. PMID- 3958734 TI - Control and postural thixotropy of the forearm muscles: changes caused by cold. AB - The forearm was cooled in water at 5-10 degrees C while wrist biodynamics were investigated. Pronounced loosening following a perturbation (thixotropy) was no longer seen. The wrist became stiffer for large or moderate but not small movements; EMG activity did not increase. Cooling the wrist alone, or opposite forearm, was without effect. The ability to make rapid reciprocating movements was reduced and muscle relaxation time was increased. Single movements were not affected. PMID- 3958736 TI - Entrapment of the temporal horn: a form of focal obstructive hydrocephalus. AB - Three cases of a form of focal hydrocephalus are described which the authors term "entrapment of the temporal horn". Obstruction of one lateral ventricle in the region of the trigone isolates the temporal horn. Continued secretion of cerebrospinal fluid within the temporal horn causes it to behave as a mass lesion. In the cases described the causes of the condition were recurrent glioma, previous tuberculous meningitis and surgical excision of an arteriovenous malformation which extended into the trigone. Shunting of the trapped temporal horn provides satisfactory treatment. PMID- 3958738 TI - A method of monitoring function in corticospinal pathways during scoliosis surgery with a note on motor conduction velocities. AB - Spinal cord potentials produced by high voltage electrical stimulation of the scalp over the motor cortex were recorded intraoperatively from bipolar electrodes inserted into the epidural space of eleven patients undergoing corrective surgery for scoliosis. Responses to single stimuli could be recorded from the cord at all levels from cervical to low thoracic regions. The potentials were larger in the cervical than in the thoracic region and sometimes were followed by later waves at high stimulation intensities. Conduction velocity in large corticomotoneuron fibres was estimated to be between 50-74 ms-1 in different patients. This technique for monitoring motor tract function may be a useful adjunct to conventional monitoring of the sensory pathways during surgery. PMID- 3958737 TI - Benign intracranial hypertension: visual loss and optic nerve sheath fenestration. AB - Five patients with serious ocular complications of benign intracranial hypertension are described. Optic nerve sheath fenestration resulted in resolution of papilloedema with, in three instances, improvement in vision. Benign intracranial hypertension may not always be benign for vision and fenestration operations may prevent or reverse visual deterioration by an effect on the optic nerve rather than by reducing intra-cranial pressure. PMID- 3958739 TI - Relation of clinical, serological, morphological, and electrophysiological findings in galactocerebroside-induced experimental allergic neuritis. AB - Rabbits were immunised repeatedly with bovine brain galactocerebroside. Almost all animals developed overt polyradiculoneuropathy. Circulating IgG antibodies to galactocerebroside in the serum and deposits of IgG in the spinal roots were detectable weeks before definite clinical, morphological, and electrophysiological alterations occurred. The levels of IgG antibody titres to galactocerebroside did not correlate with the severity of the clinical disease and of nerve conduction slowing. Remyelination and a virtually complete recovery of nerve dysfunction occurred although circulating antibodies to galactocerebroside were still present. PMID- 3958740 TI - Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity. AB - The time relation between flexor spasms, detrusor contractions and anal sphincter activity was recorded in a consecutive series of 111 patients with hyperreflexic bladder and flexor spasms. In 76 of the patients flexor spasms were preceded by detrusor contractions. The opposite pattern, namely detrusor contractions preceded by flexor spasms, was seen in only nine patients. The anal sphincter activity was generally increased in relation to detrusor contractions in patients with spinal lesions but decreased in patients with cerebral lesions. The treatment of flexor spasms and uninhibited detrusor contractions is discussed on the basis of this mutual relationship. PMID- 3958741 TI - Brain stem auditory evoked potentials in patients with multiple system atrophy with progressive autonomic failure (Shy-Drager syndrome). AB - Brain stem potentials from three groups of patients, namely those with pure progressive autonomic failure, Parkinson's disease and multisystem atrophy with progressive autonomic failure (Shy-Drager syndrome) were compared with each other and a group of normal subjects. In virtually all the patients with multisystem atrophy with progressive autonomic failure the brain stem potentials were abnormal in contrast to normal findings with Parkinson's disease. The closely associated group of patients with progressive autonomic failure alone also revealed no abnormalities of the BAEP. This separation of the two groups, Parkinson's disease and progressive autonomic failure from multisystem atrophy with progressive autonomic failure is important clinically as multiple system atrophy of the Shy-Drager type has extra-pyramidal features closely resembling Parkinsonism or a late onset cerebellar degeneration. From the abnormalities of the brain stem response in multisystem atrophy with progressive autonomic failure, it is clear that some disruption of the auditory pathway occurs in the ponto-medullary region as in nearly all patients there is a significant delay or reduction in the amplitude of components of the response generated beyond this region. The most likely area involved is the superior olivary complex. PMID- 3958742 TI - Abnormal deposits of chromium in the pathological human brain. AB - Three patients presented with encephalopathies: an undiagnosed degenerative disease of the brain, a degenerative cerebral disease in a patient with a myeloma but without a myelomatous deposit in the CNS and a malignant astrocytoma. Perivascular pallidal deposits (vascular siderosis) containing chromium, phosphorus and calcium plus sometimes traces of other elements were present in the three cases. Such deposits were present in the pallidal parenchyma and around vessels in the cerebellum in one case. Calcium and phosphorus are always present in any CNS calcification but the presence of chromium has not been reported. Chromium and its compounds (ingested, injected or inhaled) are toxic to humans and animals in trace doses. Approximately 900 cases of chromium intoxication have been reported and usually have had dermatological or pulmonary lesions (including cancer) but there is no report of involvement of the CNS. Sublethal doses of chromium nitrate injected intraperitoneally in rats and rabbits results in the presence of chromium in the brain. A thorough investigation was made to find the source of the chromium in these patients. Chromium was found to be present in trace amounts in the radiological contrast agents administered to these patients and in the KCl replacement solution and in mylanta, an antacid, given to one case. The evidence that chromium induced pathological changes in these three brains is circumstantial but shows that chromium can penetrate the human brain. This study indicates that vascular siderosis found in the brains of the majority of middle-aged and elderly humans is not simply an anecdotal pathological curiosity, but that it can serve as a route of entry for toxic products into the brain. PMID- 3958743 TI - A comparison of nerve cell loss in cortical and subcortical structures in Alzheimer's disease. AB - Loss of nerve cells from temporal cortex, hippocampus, nucleus basalis of Meynert and locus caeruleus was measured in 32 patients with Alzheimer's disease ranging from 48 to 92 years of age. Similar changes were present within the cerebral cortex and within the two subcortical structures. PMID- 3958744 TI - HLA antigens and acetylcholine receptor antibody in the subclassification of myasthenia gravis in Hong Kong Chinese. AB - Thirty seven Chinese adults and 23 children in Hong Kong with myasthenia gravis were tested for HLA-A and -B antigens and acetylcholine receptor (AChR) antibody. HLA BW46 had a significantly increased prevalence in patients with juvenile onset ocular myasthenia gravis. Only one third of the juvenile ocular patients had AChR antibodies and the titres were generally low. In the adult patients taken as a whole there was a non-significant increase in the prevalence of HLA B5 and HLA B15. HLA BW46 was more prevalent in adult patients without AChR antibody and less prevalent in patients with AChR antibody but the findings were not statistically significant. It is suggested that ocular myasthenia gravis is determined by a pathological mechanism for which susceptibility is determined by HLA BW46. There was a strong correlation between ocular myasthenia gravis and Graves' disease in the adult patients. The possibility that ocular myasthenia gravis is accentuated by a BW46-associated predisposition to ocular Graves' disease is considered. PMID- 3958745 TI - Eosinophilic fasciitis and the carpal tunnel syndrome. AB - Eosinophilic fasciitis is characterised by induration and inflammation of the fascia of the extremities. It is a nosologically distinct clinical entity typified by swelling, tenderness, and stiffness of the extremities associated with peripheral eosinophilia. Six of our eight patients with eosinophilic fasciitis seen in a 3 1/2 year period have had an associated carpal tunnel syndrome. The presenting complaints in three patients were those of carpal tunnel syndrome and in the other three patients were muscle aching, swelling, and tightness. Diagnosis was made by EMG and deep fascial biopsy. Although small doses of corticosteroid medications were helpful initially in five of the six patients, two patients later required surgical decompression. PMID- 3958747 TI - Triphasic waves in Mollaret's meningitis. PMID- 3958746 TI - Cryptococcal meningitis and cerebral toxoplasmosis in a patient with acquired immune deficiency syndrome. AB - A 34-year-old homosexual male developed cryptococcal meningitis as the initial manifestation of Acquired Immune Deficiency Syndrome (AIDS). With antifungal therapy he improved. Six weeks later he developed focal motor seizures and progressive hemiplegia. Computer assisted tomography revealed multiple, ring enhancing, low density lesions. The patient expired and at necropsy he was found to have multiple toxoplasma brain abscesses as well as chronic cryptococcal meningitis. This case demonstrates that in a patient with AIDS with pre-existing central nervous system infection who develops new neurological symptoms the possibility of a second and potentially treatable infection must be considered and its diagnosis pursued vigorously. PMID- 3958748 TI - Herpes simplex encephalitis presenting as the sick sinus syndrome. PMID- 3958749 TI - Aseptic meningitis due to trimethoprim-sulfamethoxazole. PMID- 3958750 TI - Thermal discrimination thresholds in normal subjects and in patients with diabetic neuropathy. PMID- 3958751 TI - Simulated paraplegia: an occasional problem for the neurosurgeon. PMID- 3958752 TI - Lipophilic muramyl dipeptide-induced changes in electron microscopic morphology and phagocytic function of murine macrophages. AB - The capacity of a lipophilic derivative of synthetic muramyl dipeptide (MDP), B30 MDP, to induce morphological changes and functional alterations in the activity of resident peritoneal macrophages was studied. Macrophages incubated in vitro for 24 h with B30-MDP, but not with MDP or medium, showed rounding and extensive ruffling of the cell surface when examined by scanning electron microscopy. Transmission electron microscopy of B30-MDP-treated macrophages revealed the development of large cytoplasmic vacuoles. These structural changes did not affect the viability of macrophages. The Fc receptor-mediated phagocytosis of 51Cr-labeled sheep red blood cells by adherent macrophages incubated with a high dose of MDP showed a modest response whereas even low doses of B30-MDP greatly enhanced the phagocytic activity. Adherent macrophages incubated with B30-MDP generated elevated levels of luminol-dependent chemiluminescence in response to stimulation by zymosan. PMID- 3958753 TI - Recombinant interferon alpha-2 (INTRON A) in a phase II study of renal cell carcinoma. AB - Because two of five patients with renal cell carcinoma in a Phase I study had partial response to recombinant alpha-2 interferon (IFN), we treated 26 patients with advanced renal cell carcinoma with a 3-month regimen of IFN. Patients were randomized to receive IFN either subcutaneously (2 X 10(6) IU/m2 3 times a week) or intravenously (3 X 10(7) IU/m2 for 5 consecutive days every 2-3 weeks). Patients whose disease was responding or stable were treated further, while those with progressive disease on subcutaneous treatment were offered intravenous therapy. Sites of metastasis included lung (14 patients), bone (7 patients), soft tissue (7 patients) and liver (2 patients). Twenty patients were evaluable for response. One patient had a partial response at the end of the third course of intravenous IFN and subsequently had complete disappearance of a 12 X 7 cm subcutaneous mass after the seventh course of treatment. The disease was stable in 13 patients including two minor responses, and six patients had progressive disease (5 with subcutaneous treatment; 1 with intravenous treatment) including one mixed response. All patients experienced early flu-like symptoms of fever, chills, and rigors during the first few days of treatment and most had mild to moderate fatigue. Three patients left the study because of fatigue, and one had an urticarial rash. From these results and our previous experience, it appears that IFN has activity against renal cell carcinoma with acceptable toxicity. PMID- 3958754 TI - Comparative effects of soluble and particulate glucans on survival in irradiated mice. AB - The survival-enhancing capabilities of particulate (P) and soluble (F) glucan, a B-1,3 polyglycan biological response modifier, were assayed in 60Co irradiated mice. Although glucan-P was slightly more effective than glucan-F, both glucans significantly enhanced survival in otherwise lethally irradiated (9.0-11.0 Gy) C3H/HeN mice. Following 9.0 Gy, 60% of the glucan-P treated and 53% of the glucan F treated mice exhibited long-term survival as opposed to 0% of the radiation control mice. The survival-enhancing effects of glucan-P and glucan-F decreased as the radiation dose increased to 11.0 Gy. At higher radiation doses (e.g., 12.0 Gy) neither glucan preparation was capable of enhancing survival. Both glucan-P and glucan-F enhanced the recovery of peripheral blood white cell numbers, platelet numbers, and hematocrit values. In addition, both agents increased endogenous pluripotent hemopoietic stem cell numbers in sublethally irradiated mice. Taken together, these results demonstrate that both glucan-P and glucan-F can significantly enhance survival in lethally irradiated mice. However, these agents appear to function specifically by enhancing hemopoietic recovery and are not effective at radiation does also known to induce gastrointestinal damage. PMID- 3958755 TI - The melanoneurons of the human cerebellum (nucleus pigmentosus cerebellaris) and homologues in the monkey. AB - Little has been written about the cells here termed cerebellar melanoneurons. This paper describes and illustrates their cytologic features and topographic relationships. In the human brain these large pigmented neurons are scattered in a narrow layer near the lateral wall, dorsal angle and roof of the fourth ventricle. They form an inconspicuous part (group A4) of the system of catecholamine, neuromelanin-containing cells well known in the brain stem. Rostrally, a few of them provide a tenuous continuity with the locus ceruleus but topographically the two nuclei are independent. With ordinary stains the cerebellar cells can be seen as early as the 26th week of gestation (the earliest period examined). Brown neuromelanin granules do not appear until two and a half years of age but argentaffin granules, foreshadowing the production of pigment, are found in increasing numbers in the fetal and postnatal period. Homologues of the human cerebellar cells are reported in two species of monkey, Macaca nemestrina and Lagothrix sp. Neuromelanin, not previously observed in non-human cerebellar cells, occurs in M. mulatta and M. nemestrina. The proximity of the cerebellar melanoneurons to the ventricle raises the possibility that they are related to functions of the ependyma, or that they influence, or are affected by, constituents of the cerebrospinal fluid. The pathologic changes they undergo in Parkinson's disease and other disorders are to be described elsewhere. PMID- 3958756 TI - The growth and development of microvasculature in human cerebral cortex. AB - Sections of the occipital cortex from 31 fetuses, infants and children, ranging in age from 15 weeks gestation to ten years postnatal, were stained to demonstrate alkaline phosphatase activity in intracortical vessels. At 15 weeks gestation intracortical positively staining vessels, assumed to be arterial precursors, were radially oriented, originating from leptomeningeal arteries. Most radial vessels coursed through the cerebral cortex without branching to vascularize the subcortical tissue. By 20 weeks gestation horizontal branches arose from radial vessels, most frequently in the lower half of the cortex. Occasionally, recurrent collaterals ascended from these horizontal branches to more superficial cortex. From 20-27 weeks gestation, the number of horizontal branches and recurrent collaterals increased in the lower half of the cortex, horizontal branches appeared in the upper half. From 27 weeks to term, shorter radial vessels, terminating in the more superficial cortical laminae increased in number. After birth a network of fine vessels, presumable precursors of capillaries, increased, particularly vascular layer 3 (neuronal lamina IV and Va). The number of radially oriented vessels per mm2 of pial surface (NA) decreased throughout development, with the most dramatic decrease occurring prenatally. In five cases of trisomy values of NA decreased less rapidly than in the normal. PMID- 3958757 TI - Hyperoxia produces neuronal necrosis in the rat. AB - Widespread cerebral neuronal necrosis occurred in newborn Sprague-Dawley rats submitted to three hours of pure oxygen (100% O2) at normal atmospheric pressure. Neuronal necrosis (NN) was most severe in the immediate newborn period and less marked with advanced maturation. It was minimal and different in its morphological characteristics in rats 10, 15 and 20 days old, and in adults breathing pure oxygen at normal atmospheric pressure for three hours. In the newborn rat, hyperoxemic NN was different in topography and cytopathology from that induced by hypoxia in the same animals. Hyperoxemic NN was similar to the NN described in human premature infants submitted to episodic hyperoxemia. Neuronal damage with karyorrhexis was most prominent in the subiculum of the hippocampus, thalamus, reticular nuclei of the brain stem and the granular cells of the cerebellum. Ultrastructural studies demonstrated nuclear and cytoplasmic membrane damage in neurons and the cellular accumulation of electron-dense lipid droplets. The pathogenesis of NN produced by hyperoxia in the human premature newborn infant may be related to lipid peroxidation of cell membranes such as that induced by oxygen-free radicals in other experimental and in vitro studies, when the anti-oxidant cellular defenses (mainly enzymes such as superoxide dismutase) are overwhelmed. PMID- 3958758 TI - Measles encephalitis in rodents: defective expression of viral proteins. AB - Synthesis of measles virus proteins in rodent brains and Vero cell cultures infected with the hamster neurotropic (HNT), and for comparison the LEC strain, was studied by use of monoclonal antibodies against five structural components. In the brains of HNT-infected adult BALB/C mice two proteins, the nucleocapsid (NP) and phosphoprotein (P) were detected. Suckling hamster brains in addition expressed demonstrable hemagglutinin (HA) protein. In cell cultures all structural components except the matrix (M) protein were detected. In contrast, all five proteins were found in LEC strain-infected suckling hamster brains and cell cultures. The restriction in HNT viral replication observed may be caused by a primary defectiveness in M-protein expression, but the possibility that this restriction is secondary to cellular suppression remains to be explored. Minimal inflammation was seen in the brains of HNT-infected adult mice and viral antigen was primarily located in the cerebral cortex. A selective necrosis of the pyramidal cell layer of the hippocampus was observed. This change did not seem to correlate with virus replication. PMID- 3958760 TI - Hodgkin's disease. IIB or not to be--using irradiation alone or in combination with chemotherapy? That is the question! PMID- 3958759 TI - Cortical degeneration with swollen chromatolytic neurons: its relationship to Pick's disease. AB - We report two cases of dementia in which cortical degeneration with widespread swollen chromatolytic neurons (SCN) was the dominant pathologic feature. Each patient had received the diagnosis of Alzheimer's disease on the basis of clinical findings. There was no deficit of cortical choline acetyltransferase activity, assayed in one case, or lesions of the nucleus basalis of Meynert. The brains had moderate to marked frontal atrophy. Comparison of SCN with several other cerebral degenerative disorders indicates a similarity with certain features of the transmissible spongiform encephalopathies and with corticodentatonigral degeneration. The pathologic features of our cases are those of a number of other cases reported as "Pick's disease," and may represent an earlier stage in the pathogenetic process than the severe, sharply circumscribed atrophy with "nonspecific" cell loss and gliosis as the only microscopic residuals. Our findings re-emphasize the need to search for pathogenetically distinct subgroups which have been wholly or partially subsumed into the concept of Pick's disease. PMID- 3958761 TI - Stage IIB Hodgkin's disease: the Stanford experience. AB - Between 1968 and 1982, 126 patients with pathologic stage (PS) IIB Hodgkin's disease were treated at Stanford University with either irradiation alone or irradiation combined with chemotherapy. Actuarial survival and freedom from relapse rates at 10 years for the overall group were 81% and 74% respectively, with no statistically significant difference between the treatment approaches. The impact of the severity and number of constitutional (B) symptoms, as defined by the Ann Arbor Conference, was analyzed. Patients who presented with all three B symptoms had significantly poorer survival and freedom from relapse compared with those patients with only one or two B symptoms (for survival differences, P = .005 and .007; for freedom from relapse differences, P = .002 and .04). Male sex was the only other prognostic factor that correlated with a poor outcome. At 10 years, the survival rate was 66% for males v 84% for females (P = .01), and the freedom from relapse rate was 75% for males v 89% for females (P = .02). The presence of extralymphatic sites of involvement, age greater than 40, or involvement of greater than three lymphoid sites had no significant adverse effect on either freedom from relapse or survival. Patients with large mediastinal masses treated with irradiation alone had a 10-year freedom from relapse rate of 54% v 81% for those treated with combined-modality therapy (P = .15), but there was no significant difference in survival rates (85% for irradiation alone v 71% for combined modality therapy). Treatment recommendations for stage IIB Hodgkin's disease are discussed. PMID- 3958762 TI - Prognostic significance of terminal deoxynucleotidyl transferase activity in acute nonlymphoblastic leukemia. AB - Bone marrow and/or peripheral blood samples from 133 (75%) of a total of 177 consecutive previously untreated protocol patients with acute nonlymphoblastic leukemia (ANLL) were analyzed for terminal deoxynucleotidyl transferase (TdT) activity at the time of presentation. Twenty-nine (22%) were found to exhibit TdT activity (greater than or equal to 0.10 U/10(8) cells, TdT+) as measured in a biochemical microassay. There were no differences between TdT+ as compared with TdT-negative (TdT-) patients with respect to age, sex, French-American-British (FAB) classification, or the presence of Auer's rods. Remission induction rates were higher for the TdT- patients, with 68% v 48% for the TdT+ patients (P = .05). TdT- patients also experienced longer remissions (P = .003) than TdT+ patients, especially in the Auer's rod-positive subgroup (P = .002). None of five patients with TdT+ ANLL treated with vincristine and prednisone as initial therapy achieved complete remission; all required induction regimens containing daunorubicin or amsacrine in combination with cytosine arabinoside and 6 thioguanine. It is concluded that TdT activity in ANLL indicates biphenotypia or lineage infidelity and is associated with a poor prognosis on chemotherapy protocols currently used for the treatment of ANLL. PMID- 3958763 TI - Primary lymphoma of bone in children: analysis of treatment results with adriamycin, prednisone, Oncovin (APO), and local radiation therapy. AB - Primary lymphoma of bone is an unusual extranodal presentation of pediatric non Hodgkin's lymphoma (NHL). Treatment with radiotherapy alone has resulted in a disease-free survival rate of approximately 50% in most adult series. Between January 1973 and April 1985, 11 children with biopsy-proven NHL of bone were seen and treated at our institutions. The minimal clinical staging included chest and bone radiographs, a radionuclide bone scan, complete blood cell counts and serum chemistries, and a bone marrow aspirate and biopsy. The age range was 9 to 17 years with a median age of 14 years. Histology included diffuse lymphoblastic lymphoma in four patients and diffuse histiocytic lymphoma in seven. Each patient was treated with the Adriamycin/prednisone/Oncovin (APO) protocol and ten patients received concomitant radiation to the whole bone when possible and a boost to the primary lesion(s). The median tumor dose was 5,000 rad (range, 3,600 to 5,600). The median follow-up was 8 years. There have been no relapses, but two patients have developed second bone tumors 5 and 7 1/2 years after beginning therapy. Each second tumor arose directly in the radiation field. The overall 8 year actuarial survival is 83%. We conclude that APO and local radiation results in excellent overall survival for children with primary NHL of bone. The occurrence of two second bone tumors, however, raises questions regarding dose and/or the role of radiation for this disease. PMID- 3958764 TI - Pancreatic carcinoma and Trousseau's syndrome: experience at a large cancer center. AB - It is common belief that carcinoma of the pancreas has an inherent and unique ability to induce a hypercoagulable diathesis that leads to clinically significant thrombosis. We evaluated 130 consecutive patients with adenocarcinoma of the pancreas to document the incidence and the predisposing factors related to the postulated increased association of thromboembolic disorder (TED) and pancreatic carcinoma. Only nine such patients (6.9%) demonstrated TED complications of the classical Trousseau syndrome. In these instances, the location of the tumor and its mucin-producing potential were significant predisposing factors. In our series, TED was usually associated with tumors of the body and tail, which had a greater likelihood to be mucinogenic as compared with those localized to the head of the pancreas. Routine tests for hemostasis were not helpful in predicting the development of TED except, perhaps, for decreased platelet counts. Therefore, we believe that the relationship between cancer of the pancreas and TED should be de-emphasized since it is neither unique nor especially common to pancreatic carcinoma and since it may be frequently encountered in other varieties of visceral malignancies of the cancer patient population. PMID- 3958765 TI - Prognostic factors in advanced ovarian carcinoma. AB - Nineteen factors were analyzed for prognostic significance in a series of 89 women with advanced (stage III or IV) ovarian carcinoma treated with chemotherapy after initial debulking surgery. Seventy-eight of these women received cyclophosphamide, Adriamycin (Adria Laboratories, Columbus, Ohio), and cisplatin (CAP) treatment, and 11 received cyclophosphamide initially with Adriamycin and cisplatin administered at the time of recurrence. Median survival and remission duration were 25 and 19 months, respectively. Using survival as an end point, significant prognostic factors in univariate analyses included the total residual mass after debulking (P = .0007), largest residual mass after debulking (P = .0008), and stage (P = .0098). Using remission duration as an end point, significant prognostic factors in univariate analyses included total residual mass after debulking (P = .007) and the largest residual mass after debulking (P = .0020). The prognostic variables were then considered as possible predictors of survival in a multivariate analysis using the Cox proportional hazards model resulting in the following expression: lambda i(t)/lambda o(t) = exp(0.5928 (log TRM - 1.8117) + 0.6450 (stage - 0.3827) + 0.6673 (C4 - 0.4198) - 0.8596 (CAP - 0.8642)), where lambda i(t)/lambda o(t) is the risk of dying for a particular patient compared with the average risk of the entire group; log TRM is the log of the volume of the total residual mass in cm3 plus 1.0; stage = 0 if stage III, 1 if stage IV; C4 = 0 if cytologic grade is 1, 2, or 3 and 1 if grade 4; CAP = 0 if treatment is cyclophosphamide and 1 if CAP. Median survival times of patients with relative risk greater than 1 and less than 1 are 43 and 19 months respectively. If this model is confirmed in a prospective study, then it could be used to assign risk and assess treatment options for similar patients at diagnosis. PMID- 3958766 TI - Results of semen cryopreservation in young men with testicular carcinoma and lymphoma. AB - Sixty-two young men with testicular carcinoma (31 patients) or lymphoma (31 patients) were referred for semen analysis and possible cryopreservation before systemic therapy. Seventy-seven percent of the patients, 24 patients with testicular carcinoma and 24 patients with lymphoma, had semen with a decreased chance for fertility (ie, sperm density less than 20 X 10(6)/mL and/or less than 40% motile sperm and/or decreased sperm motility). A decreased number of motile sperm as well as a poor grade of motility appeared in the majority of semen specimens from both patient groups. However, 14 patients had semen that met our criteria for fertility with sperm density greater than or equal 20 X 10(6)/mL, greater than or equal 40% motile sperm, and motility grade greater than 2. Semen quality appeared to be better in patients referred immediately after diagnosis than in patients in whom there was a delay between diagnosis and referral for semen cryopreservation. Twelve patients with semen meeting our criteria for possible fertility and 42 patients failing our criteria elected to cryopreserve semen. A median of three collections per patient were stored. To date, seven patients have withdrawn semen for artificial insemination by husband attempts, and two of these attempts have resulted in pregnancies. Both attempts involved patients with semen that meet our criteria for potential fertility. In the minority of young men with lymphoma or testicular carcinoma who have good-quality semen, semen cryopreservation can preserve reproductive potential after therapy that might otherwise cause sterility. PMID- 3958767 TI - Kaposi's sarcoma and the acquired immunodeficiency syndrome: treatment with high and low doses of recombinant leukocyte A interferon. AB - The efficacy of recombinant leukocyte A interferon (rIFN-alpha A [Roferon-A, Hoffman-La Roche, Nutley, NJ]) treatment of Kaposi's sarcoma in patients with acquired immunodeficiency syndrome was evaluated in sequential trials using high doses (36 X 10(6) units) and low doses (3 X 10(6) units) of interferon. A major response was seen in 38% of patients treated at the high dose, with a median response duration of 18 months. At the low dose, the major response rate was 3%; dose escalation to 36 X 10(6) units resulted in an additional major response rate of 17% in low-dose nonresponders, with a median response duration of 10 months. Four of 11 patients who achieved a complete response remain free of disease, whereas all partial responders have shown disease progression. Unacceptable toxicity occurred in 27% of patients initially treated at the high dose and only in 10% of those who had progressive dose escalation up to 36 X 10(6) units. Prior opportunistic infections correlated negatively with therapeutic response, whereas large tumor burden and gastrointestinal involvement did not. Responding patients showed a significantly longer survival and a lower incidence of subsequent opportunistic infections than nonresponders. However, from our study we cannot determine whether rIFN-alpha A has an effect on the natural history of Kaposi's sarcoma in patients with the acquired immunodeficiency syndrome. PMID- 3958769 TI - Improved methods for venous access: the Port-A-Cath, a totally implanted catheter system. AB - We prospectively evaluated the performance and rate of long-term complications with the Port-A-Cath (PAC), a totally implanted vascular access system. Two catheter styles were evaluated, a small-bore (SB) catheter (0.51-mm diameter) and a large-bore (LB) catheter (1.02-mm diameter), in conjunction with the use of a strict catheter care protocol. The PAC performed well, and with both SB and LB systems, no significant extravasation, skin necrosis, hematoma, septum damage or leakage, or subcutaneous portal infections occurred after 7,240 days of implantation and 1,435 days of use. Complications with the PAC system consisted of catheter occlusion (seven patients, 21.5%) and one instance of possible catheter infection (3.1%). Occlusions were limited to patients implanted with the SB catheter (seven of 16, 43.8%), and five of the seven (71.4%) occurred in patients receiving continuous infusion chemotherapy and/or total parenteral nutrition. Patency of the PAC system was maintained using a regular flushing schedule once every 30 days, a significant advantage compared with the daily maintenance schedule required with externally placed venous catheters. The results of this study suggest that the PAC system can provide a safe and reliable method for venous access in patients requiring intermittent or prolonged intravenous therapy. PMID- 3958770 TI - A mastectomy--how so? An etymologic plea. AB - The word mastectomy and its modifiers are used so loosely and have so many meanings in the literature that it is often difficult to determine precisely what procedure the authors are discussing. Simple descriptive terms should be used that would standardize the terminology with respect to operative techniques. The classical term radical mastectomy should be reserved to refer to a complete en bloc resection of the breast with the pectoralis major and minor muscles and the entire axillary contents, with or without a skin graft for wound closure. A total mastectomy should indicate a complete resection of the breast, including the fascia of the pectoralis major muscle. A local excision should be defined as a resection of the primary tumor with margins that are free of disease, with specific margins stated if desired. The axillary lymph node dissection should be defined according to the extent of the axillary contents excised. PMID- 3958768 TI - Spinal computed tomography and computed tomographic metrizamide myelography in the early diagnosis of metastatic disease. AB - New lesions were shown by Tc99m bone scans to have developed in sixty patients with known metastatic cancer or high-risk primary cancer and normal neurologic examinations; they were further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M) according to an algorithm. Three groups were identified based on plain radiographs: group 1 (normal radiograph), group 2 (compression fracture as indicated by radiograph), group 3 (evidence of metastasis as indicated by radiograph). In group 1 (n = 18), spinal CT revealed that 33% of the patients had benign disease and 67%, metastases; epidural compression was seen in 25% of the patients with metastasis as indicated by CT-M. In group 2 (n = 26), CT-M disclosed that 38% had a benign compression fracture and 62% had metastases and that 63% of the patients with metastases had an epidural compression. In group 3 (n = 16), spinal CT revealed that 15 patients had metastases (one patient had benign disease). Epidural cord compression was seen in 47% of the patients with metastatic disease. In all groups, the presence of cortical bone discontinuity around the neural canal (seen in 31 patients) was highly associated with epidural compression (seen in 20 patients). Our approach allowed the early and accurate diagnosis of spinal metastasis and epidural tumor as well as the diagnosis of benign disease and was useful in planning optimal local therapy. PMID- 3958771 TI - Circadian CEA variability: when to sample. PMID- 3958772 TI - The 131I antiferritin breakthrough. PMID- 3958773 TI - Acute leukemia following cisplatin for bladder cancer. PMID- 3958774 TI - Development of better treatment in neuro-oncology. PMID- 3958775 TI - Supraophthalmic carotid infusion with low dose cisplatin and BCNU for malignant glioma. AB - Arterial infusion of select chemotherapeutic agents has been shown to deliver increased drug concentration to brain tumors with reduced systemic toxicity. In this study, nine patients with histologically confirmed malignant glioma received cisplatin 110 mg and BCNU 300 mg fixed dose. All patients had received standard doses of cranial radiation after their initial surgical procedures. In three patients, intraoperative modification of the cerebral circulation was accomplished prior to the actual infusion because the vascular supply of the tumor arose from major arteries other than a single internal carotid artery. Supraophthalmic catheterization technique was employed. No neurological deficits occurred post infusion. The radiographic response rate was 25%. No responses were seen in patients who received less than 69 mg/M2 cisplatin this combination. The longest survival is 11+ months in a patient with anaplastic astrocytoma. Our first thirteen patients received cisplatin 150-200 mg and BCNU 300 mg for each infusion with a response rate of 83% in evaluable patients. Since modest reduction in cisplatin dose dramatically reduced the response rate, future studies should be directed at fine tuning the dose of this drug, or at neutralizing recirculating drug after its high dose first pass through the arterial circulation. PMID- 3958776 TI - Central neurotoxicity following intracarotid BCNU chemotherapy for malignant gliomas. AB - Central neurotoxicity is reported in 5 of 16 patients with recently diagnosed anaplastic gliomas, who received intra-arterial BCNU (200 mg/M2/course) and also 2 in a series of 26 patients with recurrent gliomas similarly treated. Neurotoxicity was usually delayed, commencing several weeks following the second or third course. CT scans during central neurotoxicity represented 1 or more of 3 patterns: no change; increased low density area(s); and/or ipsilateral gyral enhancement and punctate calcification in the middle cerebral artery territory. In one clinicopathological correlation, coagulative necrosis of the white matter was observed, identical histologically to those changes recognized as delayed vascular events following radiotherapy. Cautious exploration of the various clinical factors that may contribute to this toxicity seems appropriate, as exploration of the potential benefits of regional chemotherapeutic infusions is undertaken. PMID- 3958777 TI - Nalbuphine and droperidol in combination for sedation and prevention of nausea and vomiting during intra-carotid BCNU infusion. AB - A therapeutic regimen is described for sedative, analgesic, and anti-emetic effect in patients receiving intra-arterial carmustine (BCNU) for malignant gliomas. This regimen consists of nalbuphine, 30 mg, i.v., and droperidol, 2.5 mg, i.v., given immediately prior to intra-carotid BCNU infusion. Droperidol, 2.5 mg, i.v., is then administered on four hour intervals for sixteen hours post procedure. This combination provided excellent effect in nine patients treated for twelve intra-carotid infusions. None of the nine patients experienced vomiting, one experienced mild nausea several hours post-infusion, and non complained of severe pain or discomfort. Thirteen additional patients received diazepam, 10 mg, P.O., prior to the intra-carotid BCNU infusion, with fentanyl, 100 mcg, i.v., and prochlorperazine, 10 mg, i.m. at the onset of infusion. All thirteen patients suffered from severe nausea, vomiting, and orbital pain. The nalbuphine/droperidol combination is thought to provide a superior alternative to the traditional narcotic/pheonothiazine/benzodiazepine combination for carotid BCNU infusion. This combination has theoretical advantages for the patient with intracranial mass lesions by providing analgesia and sedation with minimal potential for respiratory depression and carbon dioxide retention. PMID- 3958778 TI - Evaluation of polyamine levels in cerebrospinal fluid of children with brain tumors. AB - Cerebrospinal fluid (CSF) polyamine levels were analyzed retrospectively in 21 pediatric patients with different types of intracranial malignant tumors to determine the benefit of following these markers during the clinical management of brain tumors. The tumors included 16 medulloblastomas and 1 each of germinoma, ependymoma, primitive neuroectodermal tumor, astrocytoma, and malignant teratoma. The clinical course of each patient was followed by neurologic examination, cranial computed tomography, CSF cell count, and cytology after cytocentrifugation. The correlation of CSF putrescine and spermidine levels with the clinical course of the brain tumors was analyzed. The following results were obtained: (1) A significant increase in CSF putrescine levels was observed in children with medulloblastoma when there was recurrent or metastatic disease in the sites close to the CSF pathway compared with the children whose disease status was stable after successful treatment (P less than 0.005). (2) The increase of CSF putrescine levels was the earliest predictor of recurrence or metastasis near the CSF pathway. (3) In tumors other than medulloblastoma, the levels of polyamines were not predictive of disease activity with the possible exception of germinoma. (4) Spermidine levels in the CSF were of limited clinical importance for patients with brain tumors. CSF putrescine levels may be the earliest and most sensitive quantitative marker of the progression of medulloblastoma, and their evaluation should be included in the diagnostic work up and follow-up examination of children with medulloblastoma. PMID- 3958779 TI - PCNU in the treatment of recurrent medulloblastoma and ependymoma--a POG Study. AB - Seventeen children with recurrent medulloblastoma and ependymoma received PCNU (100 mg/m2) in a Phase II trial. Response was evaluated by CAT scan. There were no responses. Administration of PCNU was associated with significant thrombocytopenia. PMID- 3958780 TI - Anguidine potentiates cis-platinum in human brain tumor cells. AB - Anguidine pretreatment was previously shown to potentiate cis-platinum in Chinese hamster ovary cells by 100-fold, probably by enhancing cellular cis-platinum uptake. Since both cis-platinum and anguidine have been reported to have clinical efficacy in human brain tumors, the present study was initiated to investigate whether anguidine's potentiation of cis-platinum was applicable to human brain tumor cells in culture. Using the colony formation assay, it was found that anguidine enhanced cis-platinum's cytotoxicity by ten-fold, producing a dose modification factor of 1.74. Alkaline elution analysis of cis-platinum-induced DNA cross-links found that anguidine enhanced cross-linking by a factor of 1.55, 1.76, 1.63, and 1.48 at 0, 6, 24, and 48 hr, respectively, after cis-platinum treatment. This enhancement of cross-linking is evidence for anguidine increasing cis-platinum uptake. Thus, anguidine enhances cis-platinum-induced DNA cross linking and subsequent cytotoxicity in human brain tumor cells, and may be clinically useful in combination with cis-platinum in those tumors. PMID- 3958781 TI - Effect of combined AZQ and radiation on the tolerance of the rat spinal cord. AB - The effect of combined AZQ (aziridinylbenzoquinone) and ionizing radiation on the rat spinal cord has been investigated. The highest dose of AZQ (3 mg/kg) tolerated by rats weighing 250 g was injected intravenously 15 min before a single dose of radiation or the first of 2 fractional doses. The development of paralysis due to white-matter necrosis in rats of each dose group was scored and dose-response curves were constructed. It has been found that a combination of AZQ with radiation did not lead to a significant shift of the dose-response curve as compared to that of radiation alone. Thus, AZQ administered according to the schedule used in the present study did not seem to reduce the radiation tolerance of the central nervous system. PMID- 3958782 TI - Laser microsurgery: a review of 105 intracranial tumors. AB - The relative importance or utility of the carbon dioxide laser within the total context of multimodality therapy and in comparison to conventional surgical techniques is unknown. Over a 36 month period, 421 operations for tumors of the brain and spinal cord were performed in our clinic. Of these, 111 (26%) were carried out with the aid of the laser. After excluding stereotactic and transsphenoidal operations, a comparison was made between 105 laser and 216 non laser craniotomies. With the exception of pituitary tumors, the most frequent diagnoses in both the laser and non-laser cases were the same: malignant astrocytoma (48.6 vs 33.9%), meningioma (11.4 vs 14.2%) and low grade astrocytoma (8.6 vs 8.7%). The number of reoperations in the laser group (60.1%) was higher than in the non-laser group (32.7%; p less than 0.000001) and the mean operating time (299 minutes vs 237 minutes; p less than 0.00001) was longer, but there was no significant mean difference in mortality, CNS morbidity, mean blood loss (638 ml vs 671 ml) or mean length of stay (23 vs 25 days). For the subgroup of 134 cases of malignant astrocytoma, 82% of laser procedures were reoperations versus 50% for non-laser cases (p less than 0.0002) and the mean operating time was slightly longer (p less than 0.02). The length of stay for laser cases tended to be less (21 vs 27 days; p less than 0.04), but there was again no difference in blood loss (457 ml vs 522 ml), CNS morbidity (7.8 vs 4.8%) or mortality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958784 TI - Central and peripheral contributions to coding of acoustic space by neurons in inferior colliculus of cat. AB - Recordings of response to free-field stimuli at best frequency were made from single units in the central nucleus of the inferior colliculus of anesthetized cats. Stimulus position was varied in azimuth, and the responses of units were compared with variation in the intensity and arrival time of the sound at each ear, derived from cochlear microphonic (CM) recordings. CM recordings were made at each frequency and at every point in space for which single-unit data were collected. Interaural time difference (delay) increased monotonically, but not linearly, as the stimulus was moved away from the midline. However, a given delay did not represent a single azimuth across frequency. Low-frequency interaural intensity differences (IIDs) were monotonic across azimuth and peaked at, or near, the poles. Higher-frequency IIDs were nonmonotonic and peaked relatively close to the midline, decreasing toward the poles. Units that showed little variation in discharge across azimuth formed 28% of the sample and were classified as omnidirectional. For other units, the spike-count intensity function and the variation of the CM with azimuth were combined to form a derived monaural azimuth function. For 29% of those units showing azimuthal sensitivity, the derived monaural azimuth function matched the actual azimuth function. This suggested that these units received input from only one ear. The largest group of azimuthally sensitive units (47%) was formed from those units inferred to be IID sensitive. At higher frequencies these units displayed a peaked azimuth function paralleling the nonmonotonic relation of IID to azimuth. The proportion of inferred IID-sensitive units was close to that found in dichotic studies. PMID- 3958783 TI - Conductance mechanism responsible for long-term potentiation in monosynaptic and isolated excitatory synaptic inputs to hippocampus. AB - The biophysical mechanisms underlying long-term potentiation (LTP) were investigated in identifiable and monosynaptic excitatory inputs to hippocampal neurons. The results provide the first insights into the conductance changes that are responsible for the expression of LTP. Both current- and voltage-clamp measurements of the mossy fiber synaptic response in pyramidal neurons of region CA3 were made with a single-electrode-clamp system. The excitatory postsynaptic response was pharmacologically isolated by bathing hippocampal slices in saline containing 10 microM picrotoxin, which blocks the synaptic inhibition that normally accompanies the experimentally evoked mossy fiber response. LTP was induced by tetanically stimulating the mossy fiber input for 1 s at 100 Hz. Before and 20 min to 1 h after inducing LTP, we attempted to measure the mean excitatory postsynaptic potential (EPSP) amplitude, intrasomatic current-voltage relationship to a step (RN) or alpha function (AN) current waveform, membrane time constant (tau m), spike threshold (T50), peak excitatory postsynaptic current amplitude (IP), synaptic conductance increase (delta G), and synaptic reversal potential (VR); but adequate assessments of all eight of these were not always obtained for every cell that was studied. The induction of LTP increased the mean (+/- SE) EPSP amplitude form 10.5 +/- 1.4 mV during the control period to 16.8 +/- 2.4 mV after the induction of LTP (n = 14; P less than 0.05). This change was not accompanied by increases in the mean value of RN (63 +/- 11 M omega before and 61 +/- 11 M omega after induction; n = 8; P greater than 0.05); AN, which approximates the effective synaptic input resistance at the soma (10.0 +/- 1.50 M omega before and 10.5 +/- 1.60 M omega after; n = 10; P greater than 0.05); or tau m (22 +/- 2 ms before and 20 +/- 2 ms after; n = 8; P greater than 0.05). There was no significant change in T50, which was also assessed with an alpha function current waveform (1.48 +/- 0.11 nA before and 1.49 +/- 0.10 nA after; n = 6; P greater than 0.05). The mean value of IP increased from 1.1 +/- 0.2 nA during the control period to 1.8 +/- 0.3 nA after inducing LTP (n = 15; P less than 0.05). Similarly, delta G increased from 30 +/- 4 nS before to 47 +/- 4 nS after induction (n = 10; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958785 TI - The detailed somatotopic organization of the dorsal horn in the lumbosacral enlargement of the cat spinal cord. AB - The somatotopic organization of spinocervical tract cells and unidentified dorsal horn neurons that lie in the same depth range as the spinocervical tract cells has been examined in detail in the lumbosacral enlargement of cats anesthetized with alpha-chloralose. Only gentle hair movement or light touch of glabrous skin were used as stimuli. Within the region of the dorsal horn containing these neurons there is a precise somatotopic organization. However, there is considerable variation between animals in the relationship between the somatotopic map and the lumbosacral segmental boundaries. The somatotopic map described here is considered to be restricted to a 300- to 500-micron thick lamina. In the medial half to two-thirds of this lamina in the L6 and L7 segments the toes are represented in a rostrocaudal sequence from toe 2 to toe 5. Over the most medial 200-500 micron of this part of the dorsal horn are found cells that respond to stimulation of the glabrous skin of the toe pads and the central pad. The toe representation is surrounded by a strip of foot representation, which is in turn surrounded by a strip of leg representation. The most lateral part of the lamina curves ventrally in the L6 and L7 segments and contains a continuous rostrocaudal representation of the skin of the thigh. In this region are found both spinocervical tract cells and unidentified dorsal horn neurons with receptive fields on the thigh. The skin of the hindlimb is represented such that a line of discontinuity runs down the posteromedial thigh, leg, and foot. Skin lateral to this line is represented caudally, while skin medial to it is represented rostrally. PMID- 3958786 TI - Stimulation of the lateral habenula inhibits dopamine-containing neurons in the substantia nigra and ventral tegmental area of the rat. AB - Neurons in the lateral habenula (LHb) of rats have efferent projections that terminate in the substantia nigra pars compacta (SNC) and ventral tegmental area (VTA), where cell bodies of dopamine-containing neurons are located. In order to study the influence of the habenula on dopaminergic activity, single-cell electrophysiological techniques were used to record unit discharge of dopamine containing neurons in the SNC and VTA during electrical stimulation of the LHb or adjacent structures. Dopamine-containing neurons in the SNC and VTA were identified by their characteristic spike duration (greater than 2 msec), discharge rate (2-8 spikes/sec), and irregular firing pattern. Analysis of peristimulus time histograms showed that 85% of SNC cells and 91% of VTA neurons were inhibited after single pulse stimulation (0.25 mA, 0.1 msec) of the LHb. The mean time between stimulation and onset of inhibition was 11 msec (range, 2-22 msec) and mean duration of maximal suppression was 76 msec (range, 20-250 msec). Stimulation of structures adjacent to the LHb (hippocampus, lateral thalamus, medial dorsal thalamus, medial habenula) had little or no effect. Destruction of the fasciculus retroflexus, the fiber pathway that contains most habenular efferents, blocked the stimulation effects on dopamine-containing neurons. Destruction of the stria medullaris, which contains most habenular afferents, did not alter the inhibitory effect of habenular stimulation. Injection of a cytotoxin, kainic acid, in the LHb 1 week before recording sessions blocked the inhibitory consequences of habenular stimulation. These experiments show that activation of neuronal perikarya in the LHb causes orthodromic inhibition of dopamine-containing neurons in SNC and VTA via the fasciculus retroflexus. PMID- 3958787 TI - Modification of the discharge of lateral geniculate neurons during visual learning. AB - Visually conditioned heart rate change in the pigeon has been developed as a vertebrate model system for cellular analysis of associative learning. Previous studies have characterized the behavior, largely delineated the neural circuitry mediating the conditioning, and estimated the central processing time for the conditioned response. Most recently, this system has been used to investigate neuronal activity during conditioning along the visual pathways that transmit the conditioned stimulus (CS) information. It was first shown that neither maintained nor CS-evoked discharge of retinal ganglion cells changes during conditioning. Subsequently, we found that the thalamic and telencephalic components of the ascending tectofugal pathway show associative modification. We report here studies of the thalamofugal pathway, the avian homolog of the mammalian geniculocortical system. Single-cell activity was recorded in the thalamic relay of this pathway, the dorsal lateral geniculate equivalent (LGNe). This provided an opportunity to evaluate the generality of the training-induced modification found along the tectofugal pathway, and to determine if such modification occurs as peripherally as retinorecipient neurons. The results show that almost all LGNe neurons (97%) respond phasically to the onset of whole-field illumination. Most (94%) also respond to the unconditioned stimulus (US), footshock, some with increased and others with decreased discharge. Of cells receiving convergent input, those responding with decreased discharge to the US showed associative change (52%). Neurons that did not respond to both the CS and US, or that responded to the US with increased discharge, did not show associative modification. These findings suggest that the visual pathways transmitting CS information are not merely input lines, but undergo training-induced modification; such modification can occur as peripherally as the retinorecipient neurons of these pathways; and CS-US convergence is necessary but not sufficient for associative modification, since modifiability is apparently contingent on specific US response properties. PMID- 3958788 TI - Morphology of HRP-injected spinocervical tract neurons: effect of dorsal rhizotomy. AB - Twenty-five physiologically identified spinocervical tract (SCT) neurons in the sixth lumbar segment of the cat were filled with HRP by intracellular injection. All were reconstructed from sagittal sections using the camera lucida, and a subset (n = 18) was also reconstructed using a computer reconstruction system. Thirteen cells were in intact preparations, nine were in spared root preparations (L5, L6, S1, S2 cut; L7 spared), and three were in preparations with L5 through S2 cut. Analysis of the dendritic tree of these neurons revealed little change in gross morphology after partial deafferentation despite increased proportions sensitive to nociceptive input (Sedivec et al., 1983). The dendrites still largely respected the lamina II-III border, and relatively few dendrites were directed ventrally from the cell body, although the ratio of ventral to dorsal dendrites was greater than normal. The major change was an increase in surface area and volume caused by changes in diameter (but not length) of the dendrites. Larger-than-usual maximum branch order of individual dendritic trees of some cells was also observed after chronic deafferentation. Thus, SCT cells in deafferented segments do not undergo atrophy, but show, rather, limited signs of growth and the possibility of dendritic reorganization. We have also computed correlations between different parameters of these cells (cell body size, number and size of primary dendrites, total area and length of individual dendrites) and have found that, as in motoneurons, diameter of the primary dendrite measured 30 micron from the soma is significantly correlated with total dendritic surface area and length. SCT neurons tend to have more dendrites than spinal alpha motoneurons, but total surface area is smaller for a given diameter of a proximal dendrite. PMID- 3958789 TI - Localization of acetylcholine receptors and cholinesterase on nerve-contacted and noncontacted muscle cells grown in the presence of agents that block action potentials. AB - The possible role of nerve activity in triggering changes in the localization of acetylcholine receptors (AChRs) and cholinesterase (ChE) on nerve-contacted Xenopus muscle cells has been assessed. The localization of these molecules was examined on nerve-contacted and noncontacted muscle cells in cultures of spinal cord and myotomal muscle derived from Xenopus embryos. Sites of high AChR density were revealed by staining with fluorescent alpha-bungarotoxin and sites of ChE localization were revealed histochemically. Localization of AChRs and ChE at sites of nerve-muscle contact occurred when the culture medium contained 1.2 micron tetrodotoxin (TTX), 1.2 micron TTX, 10 mM magnesium, and no calcium salts, 1.2 micron TTX and 2 mM manganese, or 106 mM potassium methyl sulfate instead of sodium chloride. The nerve-contacted muscle cells in each of these modified culture media also exhibited a reduced incidence of AChR and ChE patches away from the site of contact. It is concluded that the neural factor(s) that triggers the local and remote changes in AChR and ChE distribution can be supplied to the neurites and externalized in the absence of nerve impulses, and that the nerve and muscle cells can interact even when they are largely depolarized. PMID- 3958790 TI - Loss of acetylcholine receptor clusters induced by treatment of cultured rat myotubes with carbachol. AB - Prolonged exposure to carbachol disrupts the acetylcholine receptor (AChR) clusters of cultured rat myotubes without causing myotube loss. The effect is reversible, and is dependent on temperature. Half-maximal cluster loss is achieved at 3 microM carbachol. Cluster loss is also caused by other agonists of the AChR and is blocked by receptor antagonists. QX314 (a lidocaine derivative), meproadifen, and fluphenazine also completely block cluster loss caused by carbachol. These results are consistent with the idea that cluster loss caused by carbachol and other receptor agonists results from their interaction with the AChR, and the consequent influx of cations into the myotubes. Several experiments suggest that extracellular Na+ and Ca2+ are required, and that at least Na+ must permeate the AChR ion channel for full cluster loss to occur in the presence of carbachol. Depolarization alone is not sufficient to cause cluster loss, however. Ca2+-activated proteases do not play a significant role in carbachol-induced cluster loss. PMID- 3958791 TI - Movements resembling orientation or avoidance elicited by electrical stimulation of the superior colliculus in rats. AB - Some studies have reported that stimulation of the superior colliculus in rats produces orienting responses, as it does in a number of species. However, other studies have reported movements resembling avoidance and escape, which are not characteristic of collicular stimulation in other mammals. This apparent discrepancy was investigated by systematically recording the effects on head and body movements of electrical stimulation at a large number of sites throughout the superior colliculus (SC) and surrounding structures. It was found that the nature of the movements observed depended on the location of the stimulating electrode. Contralateral head and body movements resembling orienting and approach were obtained from sites in the intermediate and deep layers in rostral colliculus, the intermediate white layer and immediately surrounding tissue in central colliculus, and in all layers except deep white in caudal colliculus. At the remaining responsive sites, movements resembling avoidance and escape were obtained. The most common response was an ipsilateral cringelike movement of the body that developed into ipsilateral locomotion, followed by running and jumping as the current was increased. These movements were obtained from sites in the superficial and intermediate layers rostrally; from the intermediate gray and the medial superficial and deep layers in central colliculus; and from the deep layers and underlying tegmentum caudally. The distributions of sites, together with evidence from other studies, suggested the following conclusions: Within the superficial layers, avoidance responses were obtained from a region of the superior colliculus that appeared to represent the upper visual field, whereas orienting responses were obtained from a region apparently representing the lower visual field. Stimulation of the area containing the cells of origin of the predorsal bundle produced orientation and approach movements, whereas the avoidance and escape movements were probably mediated by parts of the ipsilateral descending pathway. The stimulation-induced avoidance and escape may reflect the importance of such responses to visual "events," particularly in the upper part of the visual field, in animals, like rats, with many predators. PMID- 3958793 TI - Synaptic plasticity in vitro: cell culture of identified Aplysia neurons mediating short-term habituation and sensitization. AB - The gill withdrawal reflex of the marine mollusk, Aplysia californica, shows habituation and sensitization, two simple forms of learning. In order to extend the cellular studies on synaptic plasticity underlying the changes in the reflex behavior, and to explore further the development of synaptic plasticity during synapse formation, we have sought to establish the neural circuit of the gill withdrawal reflex in vitro. We report here the reconstruction of the elementary gill withdrawal circuit in cell culture and find that the cells show short-term homosynaptic depression and heterosynaptic facilitation, the cellular mechanisms of habituation and sensitization, respectively. PMID- 3958792 TI - Estrogen establishes sex differences in androgen accumulation in zebra finch brain. AB - In zebra finches, androgens stimulate the production of a learned courtship song in males but not in females. Corresponding to this behavioral dimorphism, neural regions controlling the learning and production of song are much larger in males than in females. In two of these song-related brain regions, magnocellular nucleus of the anterior neostriatum (MAN) and hyperstriatum ventrale pars caudale (HVc), males have a larger percentage of androgen-accumulating cells than females. Since sex differences in the capacity for song and in the size of songrelated nuclei are established by gonadal hormones shortly after hatching, we determined whether the early hormonal environment also establishes sex differences in androgen accumulation within MAN and HVc. Newly hatched female zebra finches received either estradiol (E2) or cholesterol (Ch). Three to six months later, E2-females, Ch-females, and normal adult males were gonadectomized and injected 24 hr later with 3H-dihydrotestosterone. Autoradiograms were prepared, and the incidence of androgen-labeled cells was determined for MAN, HVc, and a control region, the lateral septal nucleus (SL). In females, early E2 exposure dramatically increases the percentage of androgen-accumulating cells in MAN and HVc, without influencing androgen accumulation in SL. In MAN and HVc, the percentage of androgen-concentrating cells in E2-females approximates that observed in normal adult males. Cells also tended to be more densely labeled in E2-females than in Ch-females. Since early E2 exposure renders the female song system neuroanatomically and functionally responsive to androgens, we suggest that E2 establishes this responsiveness by regulating the number of androgen target neurons within MAN and HVc. PMID- 3958794 TI - Reinnervation of the extraocular muscles in goldfish is nonselective. AB - The selectivity of axonal regeneration to the extraocular muscles in teleosts has been reinvestigated by mapping, with retrogradely transported HRP, the motor pools of the muscles innervated by the oculomotor nerve. In normal goldfish, the motoneurons of the superior rectus, inferior rectus, and inferior oblique muscles formed discrete, nonoverlapping motor pools; the motor pool of the medial rectus muscle overlapped with those of the inferior oblique and inferior rectus muscles. In fish whose oculomotor nerve had regenerated (after intracranial transection), in contrast, many motoneurons in other, inappropriate motor pools reinnervated the superior rectus and inferior oblique muscles (the only muscles examined in lesioned animals). Furthermore, these inappropriate motoneurons continued to project to these muscles for at least 1 year. The oculomotor nerve and its molecular branches were examined by light and electron microscopy to determine the pathway by which axons regenerated to their muscles. Axons regenerated within the basal laminae of Schwann cells, which persisted in the distal nerve-stump after a lesion. After labeling the inferior oblique nerve with HRP in regenerated nerves, there were labeled axons in all of the muscular branches; this indicates that regenerating axons branched, which was confirmed by finding an increased number of myelinated axons in other, regenerated inferior oblique nerves. Thus, different branches of the same axons sometimes reinnervated different muscles. These results demonstrate that regenerating axons in the oculomotor nerve are misdirected to inappropriate muscles, and do not selectively reinnervate individual muscles, as had been previously suggested (Sperry and Arora, 1965). PMID- 3958795 TI - Serotonin enhances the excitatory acetylcholine response in the RB cell cluster of Aplysia californica. AB - The RB cells, an identified cluster of serotonergic neurons in the abdominal ganglion of Aplysia californica, are excited by ACh. We have found that serotonin (5-HT) enhances the ACh responses recorded from the RB cells. The locus and specificity of the serotonergic interaction with the ACh response were analyzed using the conventional two-electrode voltage-clamp technique. We compared the current responses evoked in RB cells by constant-current iontophoretic pulses of ACh in control solutions and in solutions containing various concentrations of 5 HT. Serotonin consistently enhances the ACh evoked response in a dose-dependent manner while simultaneously directly activating the RB cells by turning on a small steady-state inward current. The dose-response characteristics for the 5-HT mediated steady-state current differ, however, from those of the 5-HT-induced ACh response facilitation. The ACh response enhancement appears to be an effect of 5 HT upon RB cell ACh receptors since the enhancement is present under conditions that eliminate presynaptic input, and 5-HT is still capable of enhancing the iontophoretically evoked response when the AChE-resistant agonist carbachol is substituted for ACh. We tested other neurons in the Aplysia CNS exhibiting ACh evoked responses qualitatively similar to the RB cell ACh responses; 5-HT does not enhance the iontophoretically evoked ACh responses of these cells. Also, although the RB cells are responsive to dopamine and histamine, these putative neurotransmitters do not enhance the ACh response. PMID- 3958796 TI - Retinal constraints on orientation specificity in cat visual cortex. AB - Most retinal ganglion cells (Levick and Thibos, 1982) and cortical cells (Leventhal, 1983; Leventhal et al., 1984) subserving peripheral vision respond best to stimuli that are oriented radially, i.e., like the spokes of a wheel with the area centralis at the hub. We have extended this work by comparing directly the distributions of orientations represented in topographically corresponding regions of retina and visual cortex. Both central and peripheral regions were studied. The relations between the orientations of neighboring ganglion cells and the manner in which the overrepresentation of radial orientations is accommodated in the functional architecture of visual cortex were also studied. Our results are based on an analysis of the orientations of the dendritic fields of 1296 ganglion cells throughout the retina and the preferred orientations of 1389 cells located in retinotopically corresponding regions of cortical areas 17, 18, and 19 in the cat. We find that horizontal and vertical orientations are overrepresented in regions of both retina and visual cortex subserving the central 5 degrees of vision. The distributions of the orientations of retinal ganglion cells and cortical cells subserving the horizontal, vertical, and diagonal meridians outside the area centralis differ significantly. The distribution of the preferred orientations of the S (simple) cells in areas 17, 18 and 19 subserving a given part of the retina corresponds to the distribution of the dendritic field orientations of the ganglion cells in that part of retina. The distribution of the preferred orientations of C (complex) cells with narrow receptive fields in area 17 but not C cells with wide receptive fields in areas 17, 18, or 19 subserving a given part of the retina matches the distribution of the orientations of the ganglion cells in that part of retina. The orientations of all of the alpha-cells in 5-9 mm2 patches of retina along the horizontal, vertical, and oblique meridians were determined. A comparison of the orientations of neighboring cells indicates that other than a mutual tendency to be oriented radially, ganglion cells with similar orientations are not clustered in the retina. Reconstructions of electrode penetrations into regions of visual cortex representing peripheral retina indicate that columns subserving radial orientations are wider than those subserving nonradial orientations. Our results provide evidence that the distribution of the preferred orientations of simple cells in visual cortex subserving any region of the visual field matches the distribution of the orientations of the ganglion cells subserving the same region of the visual field.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958797 TI - Effect of monensin on deoxyglucose uptake in cultured astrocytes: energy metabolism is coupled to sodium entry. AB - This study was undertaken to measure the effect of maximal stimulation of sodium pump activity on the rate of energy metabolism in mouse cerebral astrocytes. The rate of uptake of 3H-2-deoxyglucose (3H-2-DG) was measured in astrocyte cultures sodium-loaded either by incubation in a K+-deficient solution or by use of the carboxylic sodium ionophore monensin. Sodium-loading by the first method caused 3H-2-DG uptake to increase by 80%, but the effect was brief (about 5 min) compared with the period of uptake measurement (20 min). In contrast, the presence of monensin (20 microM) caused a sustained 3.4-fold increase in the rate of 3H-2-DG uptake. The concentration-response relationship for monensin indicated a Kd of 1.5 microM and a maximum uptake enhancement of approximately fourfold. The monensin-stimulated uptake of 3H-2-DG was totally inhibited by incubation of the cultures in either K+-free or Na+-free solutions, or in the presence of ouabain (0.4 mM), indicating that the enhancement of uptake was the result of Na+ influx and sodium pump activation. These results raise the possibility that astroglia contribute significantly to regional variations in glucose consumption associated with functional activity in the brain. Ultrastructural analysis showed that sodium-loading in K+-free solution caused swelling confined to the trans face of Golgi stacks. However, monensin (5 microM) caused swelling of the entire Golgi stack, with progressively more severe swelling from cis to trans cisternae and formation of cytoplasmic vacuoles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958798 TI - Uniformity of metabolic enzymes within individual motor units. AB - Individual muscle fibers of 10 motor units from the tibialis posterior muscle of cat were identified by glycogen depletion techniques, characterized for histochemical type, diameter, and intramuscular locations, and analyzed by quantitative biochemical methods. Four enzymes, representing different energy yielding pathways, were quantitatively assayed in muscle fibers belonging to motor units selected from each of the three major physiological types. All four enzymes demonstrated identical activities among fibers within a motor unit, while showing up to 11-fold differences among fibers belonging to different motor units. Moreover, fibers within a single motor unit, but of substantially different diameters, were nevertheless homogeneous in specific enzyme activities. PMID- 3958799 TI - Dietary n-3 polyunsaturated fatty acids: modification of rat cardiac lipids and fatty acid composition. AB - The effects of 5, 10 and 20% dietary menhaden oil (MO) on the composition of heart lipid classes and fatty acids were studied. Male Sprague-Dawley rats were fed ad libitum 0, 5, 10 and 20% MO for 3 wk. The heart phosphoglyceride content and composition and cholesterol were unchanged by dietary MO. A nonlinear dose response relationship was observed between dietary MO levels and fatty acid compositional changes. Cardiolipin, choline (PC), ethanolamine (PE) and serine/inositol (PS/PI) phosphoglycerides showed an incorporation of n-3 fatty acids, eicosapentaenoic (20:5n-3) and docosahexaenoic (22:6n-3), between the control and 5% MO group, a plateau between the 5 and 10% MO groups and a further increase at the 20% MO level. The initial reduction in 20:4n-6 content remained unchanged as dietary MO increased except in PE where a further reduction was found at the 20% MO level. Dietary MO did not significantly change the 20:4n-6 content in neutral lipids. Linoleic acid content was most resistant to dietary MO removal. The level of 18:2n-6 was significantly lowered in heart PC when rats were fed 10% MO. No significant differences were found in PS/PI. In PE and NL significant differences occurred only when rats were fed 20% MO. The significant fatty acid modifications of heart lipid and PL found between the control and lowest level of dietary MO (5%) suggest that dietary fish oil supplementation in human diets may not be required for this effect. PMID- 3958800 TI - Role of adipocyte precursors in the onset of obesity induced by overfeeding in suckling rats. AB - Rats were overfed during the suckling period by litter size manipulation in order to investigate the possible contribution of preadipocytes from the stroma vascular compartment of adipose tissue to the development of obesity. Rats raised in litters of four pups were overfed; for normal feeding we assigned eight pups per litter. As early as 10 d of age, overfed rats became fatter than controls, and showed an increase in both plasma insulin and triacylglycerol levels. At this age, adipose tissue overdevelopment arose only from adipocyte hypertrophy, since hyperplasia occurred only at 15 d of age. Concurrently, compared to normal feeding, overfeeding led to significantly higher activities of lipoprotein lipase (LPL), glycerophosphate dehydrogenase (GPDH) and glycerophosphate acyltransferase (GPAT) in mature fat cells; 10-d-old overfed pups exhibited a higher stromal cell number. Further separation of this heterogeneous fraction by density gradient centrifugation showed a higher preadipocyte number as compared to that of controls. In stromal cells, LPL, GPDH, GPAT and acyl CoA ligase activities were detected during the suckling period. As compared to controls, overfeeding induced an increase in both LPL and GPDH activities in 10-d-old pups. Results indicate that overfeeding in early life induced an excess of fat storage capacity through a simultaneous increase in proliferation and differentiation rates of adipocyte precursors. PMID- 3958801 TI - Studies of nitrogen balance in male highlanders in Papua New Guinea. AB - Nitrogen metabolism in Papua New Guinea highlanders was studied by examining their nitrogen balance when they ate their usual diet (experiment 1) or an experimental diet (experiment 2). Studies were made on 39 male highlanders between October and December in 1980 and 1982. In experiment 1, the average protein and energy intakes (mean +/- SD) for three consecutive days of usual diets were 116.2 +/- 31.2 mg N/kg body weight and 46.9 +/- 8.9 kcal/kg body weight in 1980 and 143.5 +/- 54.8 mg N/kg body weight and 47.3 +/- 10.5 kcal/kg body weight in 1982, and thus the nitrogen balances were 27.7 +/- 28.3 and 18.4 +/- 24.2 mg N/kg body weight, respectively. Most dietary protein and energy was derived from sweet potatoes and other vegetable foods, but between 1980 and 1982 the diet changed slightly with increased consumption of imported foods such as rice and canned fish. In the second experiment, when 10 highlanders were given adequate protein diet (about 200 mg N/kg body weight and about 44 kcal total energy/kg body weight for 13 d, much of the dietary nitrogen was retained in their bodies (45.1 +/- 19.3 mg N/kg body weight). When another group of men were fed a sweet-potato diet (81.1 mg N/kg body weight for 8 d followed by a low protein sweet-potato diet containing only 42 mg N/kg body weight with 50 kcal/kg body weight for 14 d, nitrogen true digestibility and net protein utilization increased and their nitrogen balance showed no significant change (-11.0 +/- 5.6 mg N/kg body weight).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958802 TI - Effect of arginine-free diet on ammonia metabolism in young and adult ferrets. AB - Two-month-old, male ferrets were fasted for 16 h and fed a synthetic, arginine free diet. Within 2-3 h after ingesting the diet, they developed hyperammonemia and encephalopathy. Ammonia levels in the serum, brain and cerebrospinal fluid were greatly elevated compared to those of ferrets fed the synthetic diet supplemented with arginine. Orotic acid and glucose levels in serum were also significantly elevated. Urinary orotic acid was significantly increased but citrate and creatinine level were unaltered. Adult (18-mo-old) ferrets did not develop hyperammonemia and encephalopathy after eating the arginine-free diet. Serum and urinary orotic acid levels were significantly elevated in the adult ferrets fed arginine-free diet. Hyperammonemia and encephalopathy were prevented in young ferrets by supplying dietary arginine and abbreviated by ornithine injections given during encephalopathy. These results suggest that young ferrets are unable to meet their ornithine needs from precursors other than arginine, whereas adult ferrets appear to be able to synthesize ornithine from sources other than dietary arginine. Intraperitoneal injection of sodium benzoate to young ferrets fed arginine-free diet failed to decrease serum ammonia levels. PMID- 3958803 TI - Food and water interrelations and the protein requirement for growth of an altricial bird, the cockatiel (Nymphicus hollandicus). AB - Cockatiel (Nymphicus hollandicus) chicks were hand-fed diets diluted to various levels of solids to determine the optimum ratio of solids to water for survival and growth. In later experiments protein levels in the solid portion of the diet were varied to determine the protein requirement for growth. Cockatiels survived and grew well when hand-fed a diet of 7% solids during the first 4 d after hatching, followed by 30% solids until 28 d of age. The solid portion of this diet contained 20% isolated soybean protein, methionine, cornstarch, vitamins and minerals. When chicks were fed 10% solids from hatch, growth rates were one-third to one-half those of chicks fed 20 or 30% solids; by 23 d most chicks fed 10% solids had died, with survivors being permanently stunted. By 3-5 d before death, crop emptying ceased, yet chicks appeared hungry. Chicks fed 20 or 30% solids from hatching grew well after an initial 3-d period of some mortality. The water needed by cockatiel chicks decreased during the first 4 d posthatching; thereafter, diets containing 90% water or more were harmful. Groups of chicks fed diets ranging from 5 to 35% protein of the solids exhibited wide differences in growth, with 20% protein being the lowest level that permitted maximal growth. PMID- 3958804 TI - Gamma irradiation treatment of cereal grains for chick diets. AB - Wheat (W), triticale (T), hulled barley (HB), hull-less barley (HLB), hulled oats (HO), and hull-less oats (HLO) were gamma irradiated (60Co) at 0, 3, 6 and 9 Mrad to study the effect of irradiation on the nutritional value of cereal grains for chicks. A significant curvilinear relationship between radiation dose and 3-wk body weight of chicks fed irradiated cereals was noted for T, HB, HLB, HO and HLO. Chicks fed W or T showed no effect or lower body weight, respectively, while body weights of chicks fed barley or oat samples were higher with irradiation. The improvement tended to be maximal at the 6 Mrad level. Irradiation significantly improved the gain-to-feed ratio for chicks fed either HO or HLO. Apparent fat retention and tibia ash were higher in chicks fed irradiated HLO than in those fed untreated HLO. In a second experiment chick body weight, apparent amino acid and fat retention, tibia ash, and gain-to-feed ratios were lower in chicks fed autoclaved (121 degrees C for 20 min) barley than in those fed untreated barley. Irradiation (6 Mrad) subsequent to autoclaving barley samples eliminated these effects. Irradiation appears to benefit cereals containing soluble or mucilagenous fiber types as typified by beta-glucan of barley and oats. These fibers appear prone to irradiation-induced depolymerization, as suggested by increased beta-glucan solubility and reduced extract viscosity for irradiated barley and oat samples. PMID- 3958805 TI - Effects of estrogen and progestogen on the ascorbic acid status of female guinea pigs. AB - Female, adult guinea pigs were fed a low ascorbic acid diet ad libitum. Oral administrations of either estinyl (5 micrograms) or progestogen (250 micrograms) in combination with 5 mg of ascorbic acid (minimum requirement) daily for 21 d, resulted in significantly lower (P less than 0.05) concentrations of ascorbic acid in plasma, liver, adrenals and urine than in animals receiving only 5 mg of the vitamin. None of these animals showed any clinical signs of ascorbic acid deficiency. Clinical manifestations of scurvy were exhibited, however, when animals receiving no ascorbic acid supplement were treated with the steroid hormones for 7 d. All of these animals died by d 10. On the other hand, the animals receiving neither ascorbic acid nor the steroids remained free from any signs of scurvy, except one (out of six), which died by d 12. In vitro studies revealed a markedly higher rate of oxidation of ascorbic acid in the presence of either estinyl or progestogen than in untreated controls. These results were further supported by a higher level of plasma ceruloplasmin in animals receiving a combination of estrogen and progestogen than in animals receiving no hormones. An in vivo dose-related effect of ascorbic acid indicated that the steroid mediated lowering effect of the vitamin status could be counteracted by increasing the dose of ascorbic acid from 5 to 10 mg/d for 2 wk. These results suggest that the interactions between oral contraceptive hormones and ascorbic acid may be of clinical importance only in the case of borderline intake of the vitamin. PMID- 3958806 TI - Hypervitaminosis A and calcium-regulating hormones in the rat. AB - The effect of vitamin A on calcium-regulating hormones was studied in rats. A single oral dose of 30 mg retinol equivalents (RE) given to adult rats caused no change to serum biologically active parathyroid hormone (bioactive-PTH) concentrations. Bioactive-PTH secretion from rat thyroparathyroid gland complexes was not significantly altered after in vitro incubation with 1.18 X 10(-6) M retinol. Chronically intoxicated rats given 15 mg RE 3 times a week for 6 wk, showed higher osteoclast numbers and lower osteoid than controls. Serum bioactive PTH was not detectable and serum 25-hydroxyvitamin D (25-OHD) (25.2 +/- 12.5 nmol/L) was significantly (P less than 0.03) lower than controls (43.3 +/- 3.1). In acutely intoxicated rats (60 mg RE/d for 2 d), serum bioactive-PTH levels were significantly lower (0.02 +/- 0.05 ng/ml, P less than 0.03) than in control animals (0.14 +/- 0.08). Lower doses of vitamin A, 7.5 mg RE 3 times a week for 3 wk, suppressed serum bioactive-PTH to undetectable levels but had no significant effect on serum 25-OHD. Serum calcium and 25-OHD levels were significantly lower in vitamin D-intoxicated rats given 7.5 mg RE 3 times a week (ca. 3.16 +/- 0.19 mmol/L; 25-OHD 599.7 +/- 110.6 nmol/L) than vitamin D-intoxicated controls (3.42 +/- 0.17; 789.3 +/- 17.7). These results suggest that hypervitaminosis A can alter the metabolism of calcium-regulating hormones. PMID- 3958807 TI - Effects of isolated zinc deficiency on the composition of skeletal muscle, liver and bone during growth in rats. AB - We investigated the effects of zinc deficiency on body composition by using intragastric force-feeding to obviate decreased food intake and altered eating patterns. Weanling male Sprague-Dawley rats were fed a purified zinc-deficient diet: the ad libitum-fed control group (AL; eight rats) was given powdered diet and water containing 25 ppm zinc; the zinc-replete group (ZN; nine rats) was force-fed a diet blended with water containing zinc in an amount of equal caloric intake to the AL group and allowed access to water containing zinc. The zinc intake of ZN rats was approximately twice that of AL rats based on water intake. The zinc-deficient group (ZD; 13 rats) was fed similarly to the ZN group except deionized water was used for diet preparation and drinking water. After 8 d, body and muscle weight were lower in the ZD group than in the ZN group. Femur weights were similar in the two groups. Serum, liver and femur zinc concentrations were 85, 22 and 42% lower, respectively, in the ZD group than in the ZN group. Serum glucose, relative liver weight, liver glycogen and liver lipids were higher, but muscle and liver DNA were lower in the ZD group than in control groups. PMID- 3958808 TI - Influence of dietary chloride on fluoride bioavailability in the rat. AB - A factorial experiment was conducted with weanling rats fed a purified diet to determine the influence of dietary chloride (0.02, 0.10 and 0.50%) as sodium chloride on fluoride bioavailability (2 or 10 ppm as sodium fluoride). After 6 wk, rats fed the lowest chloride-containing diets had significant reductions of plasma chloride, urinary chloride excretion and growth rate compared to other chloride groups. Depressed growth occurred in rats fed chloride-deficient diets despite the fact that food intake was similar for all treatments. Fluoride retention was greatest in chloride-deficient rats, which was reflected in enhanced skeletal uptake of fluoride. Fluoride absorption was not inhibited by high chloride intake. We therefore conclude that emphasis on the effect of chloride on fluoride bioavailability should be directed towards an enhancement of fluoride retention by low salt (sodium chloride) diets rather than in terms of a possible negative effect of a high salt diet on fluoride absorption. PMID- 3958809 TI - Effect of fructose or starch on copper-67 absorption and excretion by the rat. AB - Studies with 67Cu were conducted with copper-deficient or supplemented rats fed fructose or starch in an effort to investigate the effects of different dietary carbohydrates and inadequate copper intake on the absorption, tissue distribution and excretion of copper. After being fed their diets for 5 wk, they were killed at 8, 24, 48 and 96 h following the intubation of their respective copper supplemented diets extrinsically labeled with 67Cu. Only at 48 and 96 h following the intubation of 67Cu, the gastrointestinal (GI) contents of rats fed the copper deficient fructose diet exhibited higher radioactivity than rats fed the copper deficient starch diet. Although not always significant, this apparent retention of copper in GI contents was accompanied by decreased whole-body radioactivity and depressed urinary excretion. The cumulative excretion of 67Cu via feces over the 96-h period of collection was similar for both groups of copper-deficient rats, regardless of whether the dietary carbohydrate was fructose or starch. The data suggest that the more severe copper deficiency is related to the sustained higher level of radioactivity in the GI contents. This increased retention of 67Cu in GI contents suggests impaired absorption of copper. PMID- 3958810 TI - The retardation of aging in mice by dietary restriction: longevity, cancer, immunity and lifetime energy intake. AB - We sought to clarify the impact of dietary restriction (undernutrition without malnutrition) on aging. Female mice from a long-lived strain were fed after weaning in one of six ways: group 1) a nonpurified diet ad libitum; 2) 85 kcal/wk of a purified diet (approximately 25% restriction); 3) 50 kcal/wk of a restricted purified diet enriched in protein, vitamin and mineral content to provide nearly equal intakes of these essentials as in group 2 (approximately 55% restriction); 4) as per group 3, but also restricted before weaning; 5) 50 kcal/wk of a vitamin and mineral-enriched diet but with protein intake gradually reduced over the life span; 6) 40 kcal/wk of the diet fed to groups 3 and 4 (approximately 65% restriction). Mice from groups 3-6 exhibited mean and maximal life spans 35-65% greater than for group 1 and 20-40% greater than for group 2. Mice from group 6 lived longest of all. The longest lived 10% of mice from group 6 averaged 53.0 mo which, to our knowledge, exceeds reported values for any mice of any strain. Beneficial influences on tumor patterns and on declines with age in T-lymphocyte proliferation were most striking in group 6. Significant positive correlations between adult body weight and longevity occurred in groups 3-5 suggesting that increased metabolic efficiency may be related to longevity in restricted mice. Mice from groups 3-6 ate approximately 30% more calories per gram of mouse over the life span than did mice from group 2. These findings show the profound anti aging effects of dietary restriction and provide new information for optimizing restriction regimes. PMID- 3958811 TI - Carnitine metabolism in lean and obese Zucker rats during starvation. AB - Carnitine metabolism during starvation was studied in adult lean and obese female Zucker rats. Comparisons were made between rats starved for 0, 3, 6 or 9 d. Total plasma carnitine was not affected by obesity or starvation, but free plasma carnitine decreased with starvation. Plasma acid-soluble acylcarnitine was lower in obese than in lean rats, and increased with starvation in both lean and obese rats. Plasma acid-insoluble acylcarnitine was not affected by obesity but increased with starvation. Liver free and acid-soluble acylcarnitine were lower in obese rats than lean rats, and starvation increased liver free carnitine and acid-insoluble acylcarnitine. Free carnitine was lower in muscle from obese rats than from lean rats. In kidney, free carnitine decreased during starvation. Heart carnitine was not affected by obesity or starvation. Urinary free carnitine and acid-soluble acylcarnitine clearance decreased during starvation. These studies indicate that: 1) lean and obese Zucker rats conserve carnitine during starvation; and 2) the decreases in liver carnitine concentration reflect the loss of cellular constituents rather than increases in total hepatic carnitine. PMID- 3958812 TI - Alterations in hepatic microsomal mixed-function oxidase system during different levels of food restriction in adult male and female rats. AB - Wistar strain adult male and female rats were given 25, 50 and 75% less food than an ad libitum-fed group of rats for 45 d and the effects of food restriction on hepatic drug metabolizing enzymes, microsomal electron transport components, NADPH-dependent lipid peroxidation and glutathione-S-transferase activities were studied. Compared to ad libitum-fed controls, the cytochrome P-450 levels were higher in food restricted male rats, while they were lower in food restricted females. The activities of NADPH cytochrome c reductase were lower in food restricted females than in ad libitum-fed controls. The activities of drug metabolizing enzymes, aminopyrine N-demethylase and acetanilide hydroxylase were higher in food restricted males, whereas in food restricted females these activities were lower than in respective groups fed ad libitum. Microsomal, NADPH dependent lipid peroxidation was higher in 25 and 50% food restricted females while in 50 and 75% food restricted males it was lower than in ad libitum controls of the same sex. The cytosolic glutathione-S-transferase activities were lower in food restricted rats of both the sexes than in the same sexed controls. Another group of male and female rats were given 75% less food than the ad libitum-fed rats and refed for 3 d prior to killing. Here also, the effects of restriction were different between sexes. It is concluded that hepatic microsomal mixed-function oxidase system (MFOS) is altered due to feed restriction and food restriction followed by refeeding, in a sex-related manner. PMID- 3958813 TI - Effects of dietary protein and ethanol intake on pregnant beagles fed purified diets. AB - Maternal weight gain of beagles was approximately 50% lower when ethanol was given twice daily at a dose of 1.8 g/kg body weight with either control protein (17% energy from protein) or low protein (8.5%) diet as compared to isocalorically sucrose-treated animals. Similarly, pup birth weights were about 27% lower from beagles given ethanol with either diet when compared to those from sucrose-treated bitches. Two weeks after beginning ethanol treatment, pregnant bitches fed either diet had higher hematocrit values and lower plasma concentrations of albumin and calcium as compared to sucrose-treated animals. Low dietary protein treatment, rather than ethanol, lowered maternal concentrations of red blood cell folate during pregnancy. As compared to sucrose-treated bitches, ethanol prevented folate levels in red blood cells from returning to the normal range by the 9th wk of pregnancy in animals fed low dietary protein. These data show that ethanol consumption and low dietary protein intake, independently of each other, significantly depress maternal weight gain, pup birth weight and some nutritionally related parameters of the mother. PMID- 3958814 TI - Nutritional balance studies: indicators of human requirements or of adaptive mechanisms? PMID- 3958815 TI - Is carnitine an essential nutrient for humans? PMID- 3958816 TI - Characteristic patterns of an inhomogeneous imaging system with an application to vision. AB - We examine consequences of image-forming inhomogeneity in the form of a point spread function that changes with position on the image plane. The familiar self replicating sinusoids, which a homogeneous system simply multiplies by its spatial modulation-transfer function, generalize to eigenfunctions, which the system multiplies by eigenvalues. We give a way to calculate the eigenfunctions and eigenvalues from the variable point-spread function. We illustrate this with data from the visual system and show that these lead to a discrete set of most sensitive eigenfunctions, which we construct. PMID- 3958817 TI - Bridge to understanding: the China connection. PMID- 3958818 TI - Third World medicine--adventure in a work of mercy. PMID- 3958819 TI - Human bite wounds of the hand. PMID- 3958820 TI - Hydrocarbon ingestion in children: its sequelae and management. PMID- 3958821 TI - Joseph disease in India--report of two families. AB - Joseph disease (JD) has only rarely been described in families of non-Portuguese ancestry. Two Indian families with an autosomal dominant inherited ataxia are described in this report. The clinical picture resembled the spectrum seen in JD. An interesting feature was the very early manifestation of the disease process in the third generations. Considerable phenotypic variation within one family was another important aspect. These families had always lived in northern India for the past many generations. PMID- 3958822 TI - Spinocerebellar ataxia associated with localized amyotrophy of the hands, sensorineural deafness and spastic paraparesis in two brothers. AB - Two brothers aged 75 and 61 years, born from non-consanguineous non-affected parents, had spinocerebellar ataxia and impaired proprioception in the lower limbs, associated with sensorineural deafness, amyotrophy of the hands and spastic paraparesis. The older patient also had vitiligo of the right hand, and both displayed likely dysendocrine features. The disease was present since the second-third decade and showed a slow course. An EMG confirmed a neurogenic disorder strictly localized to the distal upper limbs. This new phenotype of heredoataxia is compared with previously reported similar syndromes and, in particular, with diseases featuring localized amyotrophy of the hands. PMID- 3958823 TI - Increased nasal potential difference and amiloride sensitivity in neonates with cystic fibrosis. AB - Patients with cystic fibrosis (CF) have an increased nasal transepithelial potential difference (PD) which reflects increased sodium absorption across epithelium relatively impermeable to chloride. To evaluate nasal epithelial function in neonates with CF, the PD was recorded and the voltage response to superfusion of 10(-5M) amiloride, an inhibitor of sodium transport, measured between a Ringer perfused bridge on the nasal mucosa and a reference electrode in the subcutaneous space. We studied three neonates with CF with meconium ileus and compared the results with those in 24 term healthy neonates, including one obligate heterozygote for CF, and 27 control neonates with disease. All three CF neonates had raised sweat chloride values (mean 100 mEq/L) at 2 months. The CF neonates had higher PDs (-64.0 +/- 8.4 mV) than those in normal (-24.4 +/- 2.0 mV) or control (-25.8 +/- 2.0 mV) neonates. Superfusion with amiloride induced a 72% reduction in PD in the CF neonates as compared with healthy (37.5 +/- 1.0%) and diseased (36.0 +/- 1.3%) neonates. The PD and amiloride response in CF neonates are similar to those in CF infants (2.24 months), older CF children (greater than 6 years), and CF adults (-64.9 +/- 9.3 mV; 77.7 +/- 1.8%, n = 51). These results suggest that (1) nasal epithelial dysfunction is present in patients with CF shortly after birth, and (2) the nasal PD may be a diagnostic adjunct to the sweat test in the early diagnosis of CF. PMID- 3958824 TI - Clinical utility of magnetic resonance imaging in pediatric neurosurgical patients. AB - The clinical utility of magnetic resonance imaging in pediatric neurosurgical patients was reviewed in a series of 126 scans. MRI was determined to be superior or equivalent to other imaging techniques in the evaluation of intracranial hypertension, developmental abnormalities, or acute conditions involving the spinal cord. In 74% of the scans performed because of these clinical problems, adequate data were obtained for both specific anatomic diagnosis and surgical planning. The scan proved equivalent to CT in the imaging of structural abnormalities associated with seizure disorders or degenerative conditions. In acute head injuries and generalized infections of the central nervous system, MRI offered no advantage in diagnostic specificity, and had significant logistic limitations. PMID- 3958825 TI - Chronic afterload reduction in infants and children with primary myocardial disease. AB - The purpose of this study was to determine the long-term effects of chronic afterload reduction with oral hydralazine therapy in patients with primary myocardial disease (PMD). Twenty-six children aged 3 to 48 months with the diagnosis confirmed by M-mode and two-dimensional echocardiograms and angiograms were given digitalis and diuretics. Fourteen of these patients also received hydralazine orally in doses up to 4.0 mg/kg/day in four divided doses. Echocardiograms were initially repeated at 1- to 3-month intervals and subsequently at 6-month intervals. Long-term follow-up data were available in 10 patients given hydralazine and eight control patients; the follow-up interval ranged from 3 to 48 months. In the hydralazine group the shortening fraction rose from 14.5 +/- 4.9 to 23.2 +/- 7.5 (P less than 0.01), and the ratio of pre ejection period to ejection time (0.52 +/- 0.05 to 0.35 +/- 0.06, P less than 0.001) and left ventricular size, normalized to body surface area (116 +/- 7 to 87 +/- 21, P less than 0.01), decreased. Significant improvement was demonstrated by echocardiography after 12 months of hydralazine therapy. There was no significant change in any of these values in the control group. We conclude that hydralazine therapy is a useful adjunct in the management of primary myocardial disease in infancy and childhood. PMID- 3958826 TI - Chronic Q fever endocarditis with massive splenomegaly in childhood. AB - Two children with congenital heart disease developed persistent fever, anemia, and hepatosplenomegaly. Both were shown to have intracardiac vegetations and evidence of infection with Coxiella burnetti. Thus, the same clinical manifestations of Q fever may develop in both children and adults. PMID- 3958827 TI - Hypothalamic-pituitary dysfunction in primary empty sella syndrome in childhood. AB - In a series of 37 consecutive CT scans performed in children referred to our pediatric endocrine unit, an empty (eight) or partially empty (one) sella turcica was found in nine (24%) patients with short stature or delay in sexual maturation, precocious puberty, or hypoparathyroidism. The size and contour of the sella were abnormal in only three patients. Five of the nine children had evidence of decreased growth hormone secretion as determined by subnormal GH secretory responses to provocative tests (peak GH concentration less than 7 ng/ml) or assessment of endogenous 24-hour GH secretion (mean 24-hour GH concentration less than 3 ng/ml). Two children had multiple pituitary hormone deficiencies. Although primary empty sella syndrome was often associated with hypothalamic-pituitary dysfunction in this series, the prevalence of an empty sella in normal children is unknown. Further identification and evaluation of children with empty sella may provide new information regarding the cause of pituitary dysfunction in childhood. PMID- 3958828 TI - Improved erythrocyte survival with combined vitamin E and selenium therapy in children with glucose-6-phosphate dehydrogenase deficiency and mild chronic hemolysis. AB - To study the antioxidant effect of high-dose vitamin E alone and in combination with selenium in patients with glucose-6-phosphate dehydrogenase deficiency with mild chronic hemolysis, 36 male children with such manifestations were enrolled consecutively into two equal groups. Group 1 received 800 IU vitamin E daily, and group 2 received 800 IU vitamin E in combination with 25 micrograms selenium. Hematologic status before and 2 months after treatment was evaluated. After treatment there was a significant change toward normal in both groups. The mean red cell half-life increased in group 1 from 16.9 to 22.8 days (P less than 0.01), and in group 2 from 15.6 to 24.3 days (P less than 0.01). A comparison of the mean difference of paired values in the two groups revealed a more significant increase in hemoglobin (0.9 +/- 0.1 gm/dl vs 1.2 +/- 0.2 gm/dl, P less than 0.05), hematocrit (2.4% +/- 0.4% vs 3.8% +/- 0.3%, P less than 0.05), and red cell half-life (5.9 +/- 3.0 days vs 9.1 +/- 4.4 days, P less than 0.01), and more significant reduction in reticulocytes (-0.7% +/- 0.2% vs -1.5% +/- 0.4%, P less than 0.01) in group 2. Clinical assessment and follow-up indicated no side effects related to the drugs. PMID- 3958829 TI - Abnormal defecation dynamics in chronically constipated children with encopresis. AB - We studied the ability to defecate water-filled balloons in 16 healthy and 37 chronically constipated children with encopresis. The act of bearing down for defecation was evaluated by measuring intra-abdominal pressure, rectal pressure, anal pressure, external anal sphincter EMG activity, and rectal sensation and rectal volume necessary to inhibit the anal sphincters. Fifteen control children and 20 constipated children were able to defecate rectal balloons. External sphincter activity decreased during the act of bearing down for defecation in 100% of controls, in 58% of constipated children able to defecate balloons, and in only 7% of patients unable to defecate balloons. Constipated children unable to defecate balloons were significantly less likely to recover after conventional laxative treatment than constipated children able to defecate balloons (P less than 0.02). Increased external sphincter activity during defecation appears to be the factor that prevents balloon expulsion in constipated children and could be the cause of their chronic fecal retention. PMID- 3958830 TI - Primary hypothyroidism, empty sella, and hypopituitarism. PMID- 3958831 TI - Transient neonatal hypothyroidism probably related to immaturity of thyroidal iodine organification. PMID- 3958832 TI - Pulmonary hemorrhage in pediatric patients with systemic lupus erythematosus. PMID- 3958833 TI - Upper cervical cord compression as cause of death in osteogenesis imperfecta type II. PMID- 3958834 TI - Ocular involvement in Niemann-Pick disease type B. PMID- 3958835 TI - Tracheal lavage and plasma fibronectin: relationship to respiratory distress syndrome and development of bronchopulmonary dysplasia. AB - Plasma for fibronectin determinations was obtained from 39 neonates with uncomplicated respiratory distress syndrome (RDS) and from 15 infants with RDS who developed bronchopulmonary dysplasia (BPD). Tracheal lavage fibronectin and albumin concentrations were measured in 15 infants with RDS and 15 with BPD. Control plasma fibronectin values were obtained from 20 healthy preterm infants on days 1, 2, 3, 14, and 30 of life. Control tracheal lavage fibronectin and albumin concentrations were measured in 17 neonates of various gestational ages who required tracheal intubation for nonpulmonary indications. Mean plasma fibronectin concentrations from patients with RDS was 121 +/- 11 micrograms/ml on days 1, 2, and 3, versus control level of 163 +/- 12 micrograms/ml (P less than 0.01). Mean tracheal lavage fibronectin/albumin ratio was 3.8 +/- 0.6 ng per microgram of albumin on days 1 to 5 for infants with RDS, versus control level of 5.6 +/- 3.6 (P = NS). Tracheal lavage fibronectin/albumin ratio from patients with BPD was elevated at 16.3 +/- 5.0 ng fibronectin per microgram of albumin on days 14 to 21, and 23.6 +/- 7.4 on day 30 (P less than 0.05 versus control and and versus RDS days 1 to 10). Low plasma fibronectin concentrations early in RDS may contribute to the development of pulmonary capillary leak. High tracheal lavage fibronectin levels may foster the development of pulmonary fibrosis in patients with BPD. PMID- 3958836 TI - Decline in serum calcium, magnesium, and phosphorus values with oral glucose in normal neonates: studies of serum parathyroid hormone and calcitonin. AB - In 10 normal term infants aged 52 +/- 2.5 hours, serum calcium, magnesium, phosphorus, ionized calcium, parathyroid hormone, and calcitonin were studied at 0, 1/2, 1, and 2 hours after administration of 1.77 +/- 0.08 gm/kg glucose orally over 20 minutes. In response to glucose administration, serum glucose concentration rose and serum P, Ca, and Mg concentrations fell. Serum PTH concentration rose significantly, and blood ionized Ca and pH were unaltered. Serum calcitonin was elevated, as compared with adult values, and did not change. We suggest that in neonates, as in adults, oral ingestion of glucose lowers serum Ca, Mg, and P, and a compensatory rise in serum PTH concentration maintains blood ionized Ca concentration. PMID- 3958837 TI - Inaccuracy in neonatal measurement of urine concentration with a refractometer. PMID- 3958838 TI - Cognitive maturity and self-management among adolescents with insulin-dependent diabetes mellitus. AB - The ability of adolescents with insulin-dependent diabetes mellitus (IDDM) to assume responsibility for self-management is complicated by normal psychosocial developmental tasks, including establishing independence from authority. We evaluated self-managerial behavior and its relation to cognitive maturity. Forty one adolescents with IDDM (age range 12 to 21 years) and their parents, who were trained to self-adjust insulin on compensatory and anticipatory bases, participated. The data indicated that parents withdrew from the insulin adjustment process as their adolescents grew older. Parental participation had virtually ceased by the time the child reached age 15 years. Parental withdrawal, however, was not always balanced by the adolescent's assumption of responsibility for insulin adjustments. Older adolescents were statistically no more likely than younger adolescents to self-adjust insulin doses. Both self-adjustment and metabolic control (HbA1 values) among adolescents were, however, related to cognitive maturity. More cognitively mature adolescents were also more likely to perceive themselves as being in control of their illness. Thus, older adolescents who are less cognitively mature than their peers are sometimes given responsibility for self-managerial behaviors that they are unable to assume. PMID- 3958839 TI - Home Screening Questionnaire: its validity in assessing home environment. AB - To develop a quick, practical tool to identify home environments likely to be suboptimal for the development of children, we adapted segments of the Home Observation for Measurement of the Environment (HOME) Inventory, which assesses the environments of children from birth to 6 years, and devised the Home Screening Questionnaire (HSQ). Whereas the HOME Inventory requires a home visit, the HSQ consists of two forms, one for children from birth to 3 years, another for 3 to 6 years, that are completed by parents without a home visit. The questions are formulated at the third to sixth grade reading level and can be completed in 15 to 20 minutes. Scoring and interpretation by a professional takes 5 minutes. HSQ questions were answered by more than 1500 parents of low-income families. Between 81% and 86% of the environments determined to be of concern by the HOME Inventory were identified by the briefer and less expensive HSQ. Thus the HSQ readily lends itself to use by health care providers who serve low-income families. PMID- 3958840 TI - Extrapyramidal reactions to domperidone. PMID- 3958841 TI - Efficacy of acellular pertussis vaccine. PMID- 3958842 TI - Female pseudohermaphroditism with associated anomalies. PMID- 3958843 TI - Local and systemic antibody response to rotavirus infection. PMID- 3958844 TI - Stretching strictures. PMID- 3958845 TI - Esophagitis and findings of long-term esophageal pH recording in children with repeated lower respiratory tract symptoms. AB - Esophagoscopy was performed on 116 children with recurrent lower respiratory tract symptoms; esophagitis of various degrees was detected in 45% of the cases. The presence of verified esophagitis correlated with endoscopic findings of bile stained gastric contents, suggesting a role of bile reflux in the pathogenesis. Esophageal pH recordings covering an 18-24-h period were performed on 22 patients with esophagitis and 19 patients without esophagitis. Gastroesophageal reflux (GER) during the sleeping period was detected in 95% of children with esophagitis, as compared to 42% in children with no esophagitis (p less than 0.001). The percentage of time with esophageal pH below 4 of the total registration time was significantly greater (p less than 0.05) in children with esophagitis (9.5%) than in those with no esophagitis (4.0%)--the difference being due to a greater share of nocturnal GER of the recording time. These criteria could be applied to a search for clinically significant GER in children with recurrent lower respiratory tract symptoms and to select patients for esophagoscopy. PMID- 3958847 TI - Cow's milk protein-sensitive enteropathy: number and timing of biopsies for diagnosis. AB - Intestinal biopsy is an essential procedure in the diagnosis of cow's milk protein-sensitive enteropathy. The number and timing of biopsies, however, is still controversial. Twenty-two infants who were clinically suspected of having cow's milk protein intolerance were put on a milk-free diet, during which they all improved. In the first 14 infants (Group I), milk withdrawal lasted 6-8 weeks; in the following 8 infants (Group II), milk withdrawal lasted 3.5-4 months. At the end of the withdrawal period, each patient was submitted to an oral lactose tolerance test and then to a first jejunal biopsy, followed by a cow's milk challenge, and a second biopsy (1-2 days later). None of the infants showed evidence of lactose intolerance, but they all reacted adversely to milk reintroduction. In Group I, the distribution of mucosae from grade 0 (normal) to III was almost the same before and after challenge (p greater than 0.5); this is considered to be due to the severe mucosal damage still present in prechallenge biopsies. In Group II, however, a significant difference was found in the distribution of mucosae before and after challenge (p less than 0.05), and a deterioration could be observed in each case after challenge. Intraepithelial lymphocyte counts and mitotic index determinations before and after milk reintroduction were of no diagnostic value in either group. It is suggested that the diagnosis of cow's milk protein-sensitive enteropathy may rely on two biopsies, the first after a period of 3.5-4 months on milk-free diet and the second following milk challenge. PMID- 3958846 TI - Evaluation of the nutritional condition and absorptive capacity of nine infants with short bowel syndrome. AB - Nutritional conditions and absorptive capacity of nine infants with short bowel syndrome were investigated during a long follow-up period from 1.5 years to 14 years and 7 months. The length of the residual small intestine ranged between 13 90 cm. The nine infants had normal meals at home and most of them did not suffer from persistent diarrhea. Most of the infants were thin. Nutritional parameters were kept relatively normal. The results of D-xylose absorption test had gradually improved, but the absorptive capacity of sugars and amino acids, observed by potential differences, were within the normal limits or slightly subnormal except for one infant. This indicated that the absorptive capacity of sugars and amino acids per a given area of the residual small intestine did not increase. Severe steatorrhea continued for several years in infants with less than 50 cm of small intestine. In these infants the concentration of serum vitamin D and total cholesterol were below the normal limits and the absorption of bile acids was disrupted. From our examination, infants with less than 50 cm of small intestine must be followed up for a long period and nutritional supplements are necessary. PMID- 3958849 TI - Sugar absorption in healthy preterm and full-term infants. AB - We have studied carbohydrate absorption in 40 healthy term infants and 10 preterm neonates (31-35 weeks gestation) by respiratory H2, fecal pH, and chromatographic analysis of stools. Sequential studies of H2 excretion (24-h collection) in response to breast feeding were carried out in premature infants during the first 8 weeks of life. Five expired H2 during the first 2 weeks, and two continued to do so in the 3rd to 4th weeks. Breath H2 excretion fell below 10 ppm by 8 weeks and was not related to feeding or sleep. In term neonates, the frequency of incomplete carbohydrate absorption (4-h test) at the end of the first week was 36% for 14 breast-fed, 42% for 12 formula-fed, and 64% for 14 mixed-fed neonates (not significant differences). There were no significant differences between the absorbing and malabsorbing subjects in fecal pH. Chromatographic analysis showed only small quantities of sugars. In summary, incomplete carbohydrate absorption occurred in a high percentage of the newborns studied; the 24-h test evaluated better than the 4-h test; and negative breath H2 excretion indicated development of the capacity of the small intestine to hydrolyze carbohydrates. In the majority of the preterm malabsorbing babies, completely functional lactase occurs within the first month of life. The growth modulators in human milk may increase the rate of maturing of the small intestine. PMID- 3958848 TI - Comparative reliability of D-xylose absorption and serum beta-carotene measurements in small intestinal disease. AB - Comparative reliability of D-xylose absorption and serum beta-carotene measurements was studied in 63 healthy and sick children suspected of having proximal small intestinal disease. Group 1 included children with newly diagnosed celiac disease (CD) who were on a normal diet (xylose, n = 46; carotene, n = 43); group 2 included children with CD in remission (xylose, n = 17; carotene, n = 15); group 3 included children with CD in remission, but who were exposed to a gluten-containing diet for an average of 1.4 years (xylose, n = 19; carotene, n = 17); and group 4 included 17 healthy children, insofar as this study is concerned, in whom serum carotene was examined. The means of serum xylose of groups 1 and 3 were significantly lower than the mean of group 2 (p less than 0.001 in both cases). D-Xylose had a sensitivity of 76.9% and a specificity of 100%. The mean serum carotene concentration for group 2 patients with CD in remission was equal to the mean of group 4, which included healthy children. The means of groups 1 and 3 were significantly lower than the means of groups 2 and 4 (p less than 0.001 in all cases). Serum beta-carotene had a sensitivity of 95% and a specificity of 87.5%. The use of these two serum tests in combination would give a specificity of 100% and a sensitivity of 94.1%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958850 TI - Safe oral rehydration of hypertonic dehydration. AB - Eighteen infants with severe hypernatremic dehydration secondary to acute gastroenteritis were rehydrated during the 1st day with an oral glucose electrolyte solution containing 60 mmol sodium/L at a mean rate of 120 ml/kg/24 h. These 18 children were safely treated with oral therapy alone. No convulsions were observed during treatment. The mean decrease in natremia was 0.32 mmol/L/h, which compared favorably with the mean fall in natremia of 26 other infants in similar initial conditions who were treated intravenously. The present study lends additional support to the opinion that a slow decrease in plasma sodium (less than 0.5 mmol/L/h) helps to avoid seizures during treatment. As no other untoward effects were observed, this study also confirms that oral solutions given at a slow rate can effectively replace intravenous fluids in the majority of such children. PMID- 3958851 TI - Use of powdered formula and incidence of underweight among infants of educated and uneducated mothers in Ile-Ife, Nigeria. AB - The duration of usage of a tin of powdered formula and the incidence of underweight among 250 infants 14 days to 12 months old, whose parents were educated and uneducated, are reported. Twenty-two percent of the educated mothers and 42% of the uneducated mothers started their infants on formula from the 14th day of life. Only 6% of all the mothers exclusively breastfed for 1 month, and a meager 2% of the uneducated mothers exclusively breastfed for 3 months. There was a significant (p less than 0.001) increase in the duration of usage of a tin of powdered formula among the uneducated mothers as compared to the educated ones. Of the 250 infants, 93 (37.2%) greater than or equal to 1 month old were assessed as underweight for age. Most of the underweight infants had uneducated mothers. Practical ways of improving feeding practices and curbing early introduction of supplementary feeds are suggested. PMID- 3958852 TI - Milk versus no milk in rapid refeeding after acute gastroenteritis. AB - Sixty-five infants (mean age 14.7 months, range 6-34 months), hospitalized for acute gastroenteritis, were treated with oral rehydration and rapid reintroduction of full feedings appropriate for age. Cow's milk and milk products were eliminated from the diet of 27 infants, whereas the remaining 38 children continued to receive their usual milk and milk products as parts of the mixed diet. There was no difference between the groups in the clinical recovery from diarrhea. No child had prolonged diarrhea. No new cases of clinical atopy were observed at 1-month follow-up, and there were no significant increases in the total or milk-specific IgE levels. Serum IgG and IgA antibodies to beta lactoglobulin and alpha-casein were initially present in the majority of the children, but there were no appreciable changes in these cow's milk antibodies after gastroenteritis, regardless of the type of diet. It is concluded that cow's milk and milk products can be safely given in acute gastroenteritis as parts of the mixed diet for children over 6 months of age. Rapid reintroduction of feedings is beneficial for recovery from diarrhea, and there appears to be little need for dietary restrictions in this age group. PMID- 3958853 TI - Reliability of a new technique for the determination of vitamin B12 absorption in children: single stool sample test--a double isotope technique. AB - The fractional vitamin B12 absorption (FAB12) was determined in 39 patients with various gastrointestinal diseases by a double-isotope technique, employing a single stool sample test (SSST), as well as a complete stool collection. The age of the patients ranged from 2.5 months to 16.2 years (mean 5.0 years). The test dose was administered orally and consisted of 0.5-4.5 micrograms of 57CoB12 (approximately 0.05 microCi), carmine powder, and 2 mg 51CrCl3 (approximately 1.25 microCi) as the inabsorbable tracer. The wholebody radiation to a 1-year-old child averaged only 20 mrad. The stool and napkin was collected and homogenized by addition of 300 ml "chromium sulfuric acid." A 300-ml sample of the homogenized stool and napkin, as well as 300 ml chromium sulfuric acid (75% v/v) containing the standards, were counted in a broad-based well counter. The FAB12 determined by SSST employing the stool with the highest content of 51Cr (which corresponded to the most carmine-colored stool) correlated closely to the FAB12 based on complete stool collection (r = 0.98, n = 39, p less than 0.001). The reproducibility of FAB12 determined by SSST was assessed from double assays in 19 patients. For a mean value of 12%, the SD was 3%, which corresponded to a coefficient of variation (CV) of 25%. The excretion of 57Co and 51Cr in the urine was examined in six patients with moderate to severe mucosal damage and was found to be low.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958854 TI - Vitamin B12 absorption capacity in healthy children. AB - B12 absorption was investigated in 47 healthy children aged 7 months to 15.8 years (median 4.9 years). The patients had either recovered from giardiasis, the post-gastroenteritis syndrome, or had celiac disease in remission (treated with a gluten-free diet). The B12 absorption was measured by a double-isotope technique using 57CoB12 and 51CrCl3, the latter being the inabsorbable marker. The radiation dose was minimal. The results were presented as fractional absorption of B12 (FAB12). Within the different age groups, the absorption test was performed by means of the following oral amounts of B12: 0- less than 1 year, 0.5 microgram; 1-3 years: 1.7 micrograms, 4-6 years, 2.5 micrograms; 7-10 years; 3.3 micrograms; and 11-15 years, 4.5 micrograms. When using these oral amounts of B12, the medians (and ranges) of FAB12 were found to be: 1-3 years (n = 18), 37% (16-80%); 4-6 years (n = 10), 27% (19-40%); 7-10 years (n = 9), 32% (21-44%); and 11-15 years (n = 8), 27% (19-59%). The FAB12 in two children aged 7 and 11 months was 31% and 32%, respectively. These results may be interpretated as reference values for B12 absorption in children. Further absorption tests were performed in seven children representing the four age groups from 1 to 15 years. When a high oral amount of B12 was given (i.e., three times the saturation dose), the FAB12 ranged from 0 to 20% (median 9%), whereas a low amount (i.e., one-ninth of the saturation dose) produced fractional absorptions from 65 to 82% (median 74%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958855 TI - Folate nutrition is optimal in exclusively breast-fed infants but inadequate in some of their mothers and in formula-fed infants. AB - Plasma concentrations of folate were studied in a group of exclusively breast-fed infants and their mothers (their numbers gradually decreased from 200 at birth to 7 at 12 months) and in infants completely weaned to a cow's milk formula (containing 35 micrograms of folate/L) and solid foods. The exclusively breast fed infants were in no danger of folate deficiency; their plasma levels were elevated after the age of 2 months and, on average, were 2.0-3.3-fold higher than maternal levels throughout the study. None of these infants had an inadequate plasma concentration, whereas up to 5% of the mothers had values less than or equal to 3 micrograms/L, despite supplementation during lactation with 0.1 mg folate/day. In the formula-fed infants, 69-94% of the plasma folate concentrations lay below the lowest concentration for the breast-fed infants. Although no infant had signs of anemia or macrocytosis in red cell indices, the infants weaned earliest had the lowest hemoglobin concentrations (p = 0.09) and the highest mean corpuscular volume (MCV) values (p = 0.06) at 9 months of age. Thus, an infant fed a formula containing the recommended amount of folate runs a risk of folate deficiency. PMID- 3958856 TI - Seasonal differences in serum vitamin D binding protein in exclusively breast-fed infants: negative relationship to sunshine exposure and 25-hydroxyvitamin D. AB - Vitamin D binding protein (DBP) is the major carrier for vitamin D and its metabolites in serum. DBP increases in pregnancy and decreases in cirrhosis; no seasonal variation has been reported in adults. We observed significant seasonal differences in 41 exclusively breast-fed infants who were less than 6 months of age. Winter DBP concentrations exceeded summer DBP concentrations: 398 +/- 22 versus 297 +/- 20 micrograms/ml (mean +/- SEM). The mean concentration for spring and fall was 329 +/- 25 micrograms/ml. Maternal DBP concentrations did not differ by season. A sunshine exposure score, previously verified, was used to document time and body surface exposed to the sun. DBP was inversely related to sun exposure (r = -0.46, p = 0.005). Infant DBP was significantly and negatively correlated with 25-hydroxyvitamin D concentrations (r = - 0.38, p = 0.02). We speculate that serum DBP fluctuations are a response to varying vitamin D needs: increased serum DBP occurs in low vitamin D status to maximize uptake of vitamin D from skin. PMID- 3958858 TI - Transfer of orally or intravenously administered proteins to the milk of the lactating rat. AB - Lactating rats were given a test solution containing various marker proteins via oral or intravenous routes. Using immunoprecipitation methods for the detection of ovalbumin (OvA), bovine serum albumin (BSA), and bovine gammaglobulins (BIgG) and radioimmunoassay for the analysis of beta-lactoglobulin (beta-LG), these proteins could be found in the blood serum and the milk of the rat 6 h after administration. A specific distribution pattern between the serum and the milk was observed for each protein. The results show that orally fed dietary proteins are able to cross the gut of the lactating rat and can be found in the serum and the milk. It was also observed that oral feeding of the proteins resulted in relatively greater concentrations in the milk than did intravenous administration. This very early presentation to the young of antigenic macromolecules derived from the mother's diet might be of importance for the development of a proper immunological response to common food antigens. PMID- 3958857 TI - Blood lipids as related to food intake, body composition, and cardiorespiratory efficiency in preschool children. AB - A group of 3-5-year-old children (n = 22) with a level of somatic development and physical fitness (modified Step test) that corresponded to a previously measured representative sample was studied. The depot fat proportion was 16.3 +/- 4%, and obesity was absent. Lean body mass (LBM) was 16.1 +/- 1.8 kg. As in previous studies, the fat intake was higher as compared to recommended allowances. The blood cholesterol level was 4.9 +/- 0.8, high density lipoproteins (HDL) 1.2 +/- 0.2, low density lipoproteins (LDL) 3.6 +/- 0.8, triglycerides 0.6 +/- 0.2 mmol/L, and creatine kinase (CK) 42.2 +/- 14.4 U/L. The step test index (STI) was 92 +/- 9, and the cardiac efficiency index (CEI) was 0.575 +/- 0.096. The sex differences were not significant, except for body weight. Marked variability was found in all characteristics measured. There were no significant relationships among somatic development, body composition, food intake, STI, CEI, blood lipids, and CK. The LBM/10 cm height index correlated significantly with CEI, CK, and fat intake. PMID- 3958860 TI - Relapsing pseudomembranous colitis. AB - Pseudomembranous colitis secondary to C. difficile and its toxin(s) is a well recognized disease in children and usually responds to treatment with oral vancomycin. There are well-documented reports of relapse in adults after initial successful treatment with vancomycin. This report documents relapse in a child who developed diarrhea following treatment of pseudomembranous colitis. Stool cultures were negative for C. difficile at the end of the initial course of treatment, but the organism was isolated from the stool when the diarrhea recurred. The symptoms improved following a second course of treatment with vancomycin and have not recurred during 8 months of follow-up monitoring. PMID- 3958859 TI - Abnormal expression of secretory component in term newborns with bowel perforation--a report of two cases. AB - Expression of secretory component (SC) in intestinal resection specimens from two term newborns with bowel perforation due to necrotizing enterocolitis (NEC) or and NEC-like syndrome was determined and compared with the SC immunoreactivity in a panel of intestinal tissues from fetuses at different ages of gestation. Expression of SC was absent in one patient, whereas in the other patient, SC immunoreactivity was observed in the basal cell part of colonic epithelium only. SC was normally expressed in a follow-up biopsy on one of these patients. In contrast, SC was present in the apical plasma membrane and brush border of colonic epithelium from 32 weeks of gestation onwards in fetuses without demonstrable intestinal disease. From these findings we conclude that the expression of SC was impaired in our patients, thus possibly playing a role in the development of the bowel perforation in these full-term newborns with an NEC like syndrome or resulting from its pathogenesis. PMID- 3958861 TI - Pseudomembranous colitis in a preterm neonate. AB - This preterm female infant abruptly developed diarrhea and bowel distention at 25 days of age and died within 60 h with fulminating pseudomembranous colitis and proctitis. Toxin-producing C. difficile was recovered from the stool. The pseudomembranous colitis developed 12 days after the last dose of ampicillin was given to the baby. Necrotizing enterocolitis, a condition pathologically distinct from pseudomembranous colitis, was also present. PMID- 3958862 TI - Functional gastrointestinal obstruction in a child with chronic granulomatous disease. AB - A child with chronic granulomatous disease developed an antral-pyloric obstruction, followed a month later by a postbulbar duodenal obstruction. At both areas, there was no evidence of an anatomical lesion, and some improvement in the passage of barium was observed following glucagon and metoclopramide administration. Presumably, symptoms have resulted from a functional disturbance of gastrointestinal motility. PMID- 3958863 TI - Lactose malabsorption is not a cause of diarrhea during phototherapy. PMID- 3958864 TI - Critical self-management competencies for children with asthma. PMID- 3958865 TI - A comparison of the positive and negative consequences approaches upon car restraint usage. PMID- 3958866 TI - Rewarding parents for their children's use of safety seats. PMID- 3958867 TI - Behavior problems in sexually abused young children. PMID- 3958868 TI - Social interaction and cardiovascular response of boys exhibiting the coronary prone behavior pattern. PMID- 3958869 TI - Munchausen syndrome by proxy: a review and case study. PMID- 3958870 TI - Use of a Stated Waiting List Contingency and Reward Opportunity to increase appointment keeping in an outpatient pediatric psychology clinic. PMID- 3958871 TI - Retinal vascular and optic nerve abnormalities in albinism. AB - Albinism is a condition in which the pigment melanin may not be synthesized from tyrosine. The fundus photographs of 24 eyes of 12 patients with the clinical diagnosis of either ocular or oculocutaneous albinism were reviewed. We observed two findings that to our knowledge have not been reported previously. Eighteen eyes of ten patients had prominent retinal vessels coursing through the putative macular area instead of arching around it. Large noncilioretinal vessels extended from the disc to the dysplastic "foveal zone" in eight eyes of five patients. Typical optic nerve hypoplasia (ONH) was seen in six eyes of four patients; features suggestive of ONH were present in an additional ten eyes of six patients. The cross-over (sharing) of clinical features between albinism and aniridia is striking and raises questions about pathophysiologic mechanisms. PMID- 3958872 TI - Clinical features of Duane's syndrome. AB - This report describes the clinical findings in 70 cases of Duane's retraction syndrome. There were 25 (36%) affected males and 45 (64%) females. Left eye preponderance (67%) was observed and seven (10%) were bilateral. Type 1 cases were the most common (73%), and bilateral cases often were of different types. The features studied were primary position deviation, face turn, anomalous vertical movements, divergence in midline vertical gaze, anisometropia, and amblyopia. Horizontal saccadic velocities in ten patients were confirmatory. The significance of head positions and distance/near alignment comparisons, and the role of case classification and saccadic velocity determination are discussed. PMID- 3958873 TI - A comparison of the succinylcholine induced ocular position and the postoperative alignment in strabismus. AB - Succinylcholine was injected intraoperatively in 41 strabismus patients with congenital esotropia or intermittent or constant exotropia. Regression analyses were performed to investigate the predictive relationships between the one-, six , and 26-week postoperative alignment and the intraoperative, succinylcholine induced ocular position. Ocular position, determined by the interlimbal distance in millimeters, was calculated using a semi-automated, video replay analysis system. Large, statistically significant correlation coefficients were obtained for patients undergoing bimedial recessions of 4.0 to 5.5 mm and bilateral lateral rectus recessions of 5.0 to 7.0 mm. Small correlations were obtained for esotropes undergoing the recession/resection procedure and those with bimedial recessions of 6.0 mm or greater. These data support the theory that the succinylcholine-sensitive subgroup of the extraocular muscle fibers are those whose tonic contracture provide the motor component to ocular alignment. Sample sizes at present are insufficient to suggest clinical use of these data. In future research, these relationships will be tested for their ability to predict postoperative alignment and thereby, improve success rates in strabismus surgery. PMID- 3958874 TI - Reliability and variability in the measurement of interlimbal distance with a semiautomated video replay analysis system (SAVRAS). AB - This paper reports on the reliability and variability of a semi-automated, video replay and analysis system (SAVRAS) in determining interlimbal distance in patients with strabismus. Factors under investigation were: choice of observer, choice of video frame, patient age and patient state (awake or anesthetized). It was demonstrated that SAVRAS was a highly reliable and reproducible system. This system is currently in use to evaluate the relationship between the succinylcholine induced ocular position, under anesthesia, and the postoperative awake alignment. PMID- 3958875 TI - Traumatic total hyphema in a patient with severe hemophilia. AB - A 12-year-old hemophilic boy suffered from secondary glaucoma in his right eye due to total hyphema following trauma. An emergency operation was performed to evacuate the hyphema under a tight anti-hemophilic treatment. A careful postoperative treatment with factor VIII concentrate, antiglaucomatous drugs and aminocaproic acid was administered. Intraocular pressure returned to normal and remained so during the four months follow-up period. Visual acuity returned to 6/9 and there was no rebleeding into the anterior chamber. To the best of our knowledge, this is the first reported case of traumatic hyphema and of an operation to wash this hyphema in a hemophiliac. The dilemma of management of such a case is discussed. PMID- 3958876 TI - Efficacy of different techniques of superior oblique weakening in the correction of the "A" anisotropia. AB - The authors present the results of 118 operations in which five different techniques for superior oblique weakening were employed for the correction of "A" pattern: recession of the tendon, split-lengthening, posterior fiber tenectomy near the scleral insertion, full tenectomy near the scleral insertion and marginal tenotomy (Z lengthening). In all the techniques but one, the marginal tenotomy, a high percentage of correction and a good coefficient of correlation between initial incomitance and obtained correction were found. We propose a new technique of superior oblique weakening, the full tenectomy of the tendon near the scleral insertion, and an easy, safe and effective technique. PMID- 3958877 TI - Anterior segment ischemia syndrome following muscle surgery: the AAPO&S experience. PMID- 3958878 TI - Traumatic hyphema. AB - Multiple modalities of treatment for traumatic hyphema have been advocated in the past. Therapy should be directed at reducing the risk of secondary hemorrhage and the potentially devastating complications of corneal blood staining and optic atrophy. Therapeutic regimens proven successful include: a patch and shield to the traumatized eye; daily visual acuity and slit-lamp biomicroscopy, including intraocular pressure, evaluation of corneal clarity, and size of hyphema; topical atropine; the systemic administration of aminocaproic acid; and topical and systemic antiglaucomatous medications with elevated intraocular pressure. Surgical intervention should generally be avoided in hyphemas of less than 50%. In larger hyphemas, there are definite indications for surgical intervention. Preferred surgical methods include: irrigation and aspiration, and hyphema evacuation by vitrectomy instrumentation. PMID- 3958880 TI - Papers presented before the 32nd annual congress of the British Association of Paediatric Surgeons. Vienna, Austria, July 17-19, 1985. PMID- 3958879 TI - Intraocular pressure variation during strabismus surgery. AB - The changes in IOP during strabismus surgery were studied in 40 patients. In most, 37 eyes, there was a marked decrease of IOP during surgery and rapid return to initial levels of IOP. In 13 out of 14 eyes that underwent bilateral surgery, the IOP in the first operated eye returned to about baseline levels by the end of surgery on the second eye. No correlation was found between the changes in IOP and: the type of surgery, the operated muscles, the duration of surgery and anesthesia, or the patients' age. We surmise that the decrease of IOP is probably associated with the intensity of the massage of the globe during the surgery. PMID- 3958881 TI - Bladder mucosa graft for construction of male urethra. AB - A graft of bladder mucosa was used to construct the urethra in 35 males. Most were complicated hypospadias cases. In all patients there was insufficient prepucial or penile shaft skin available to use for making a substitute urethra. The bladder mucosa worked well in every case. There were no fistulas. There was no case with stenosis of the anastomosis between the graft and the patient's own urethral tissue. The one possible disadvantage encountered in using bladder mucosa was its tendency to become edematous and irritated if the graft was redundant at the meatus, a situation that is not encountered with grafts made from prepucial skin or skin taken from a remote area. Revision of the meatus was required in six patients. It is the experience of the authors that a free graft that is covered by two well vascularized layers, subcutaneous tissue, and skin, fares as well or better than a graft with a vascular pedicle. PMID- 3958882 TI - Diagnosis and management of congenital cystic disease of the lung in children. AB - Pulmonary sequestration, congenital adenomatoid malformation (CAM), congenital lobar overinflation (CLO), and bronchogenic cysts are four congenital lesions that may present as abnormal cystic areas within the pleural cavity in early life. They share similar clinical and embryologic characteristics, are frequently difficult to diagnose, and all require surgical treatment. From December 1974 to January 1985, 22 patients were operated upon on the Pediatric Surgical Service for congenital cystic disease of the lung. There were eight females and 14 males, ranging in age from 1 day to 18 years; 12 were under 6 months of age, and 14 were under one year. There were 7 CAMs, 5 extralobar pulmonary sequestrations, 5 intralobar pulmonary sequestrations, 3 bronchogenic cysts, and 3 cystic lobes caused by CLO. One patient had bilateral pulmonary sequestrations, intralobar on one side and extralobar on the other, with both sharing a common systemic artery arising from the infradiaphragmatic aorta. All except two asymptomatic patients presented with either progressive respiratory distress or recurrent pulmonary infections, and had cystic changes noted on chest roentgenograms. The differentiation of these congenital lesions from resolvable inflammatory cysts is important. Diagnosis was aided by selective utilization of barium contrast studies, ultrasonography, computed tomography, and arteriography. Operation consisted of resection alone of the extralobar pulmonary sequestrations and bronchogenic cysts, and total lobectomy in CAM, intralobar sequestration, and CLO. One infant with CAM died 1 day postoperatively from bilateral hypoplastic lungs. The other 21 patients are alive and well with follow-up ranging from 1 month to 9 years, with a mean of 3.5 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958883 TI - "High" anorectal anomalies treated by early (neonatal) operation. AB - Between 1973 and 1983, 18 patients with "high" anorectal anomalies were treated by one of the authors (N.V.F.) by immediate sigmoid loop-colostomy, followed by a sacroperineal or abdominosacroperineal pull-through operation as soon as possible thereafter. This was performed in seven patients between 1 and 14 days, in seven patients between 15 and 40 days, and in four patients between 60 and 120 days. Daily anal dilatations were started 7 to 10 days postoperatively and continued until the anus was soft and supple. The colostomy was then closed, the aim being to complete all treatment by the age of 3 to 4 months. Continence was assessed using Kiesewetter's criteria. Results in 70% were "good", 18% "fair", and 12% "poor". The clinical results are discussed together with the possible advantages of definitive surgery in the neonatal period for "high" anorectal anomalies. PMID- 3958884 TI - Ambulatory esophageal pH monitoring in children as an indicator for surgery. AB - Twenty-four-hour esophageal pH monitoring was performed in 59 children with symptoms of gastroesophageal reflux using a miniature pH electrode and a portable recording system to establish the diagnosis. Significant reflux was seen in 26 (44%) of the patients and these were treated for six weeks with cimetidine, Gaviscon, and Nestargel. Five children who did not improve either symptomatically or on repeat pH monitoring while on treatment underwent antireflux surgery. The pretreatment reflux index in this group was 26.5 compared with a pretreatment reflux index of 11.2 in the 21 patients who improved on therapy (P less than 0.01). Esophageal pH monitoring has enabled selection of children for surgery and may be used as an early indicator of those who will not benefit from long-term medical therapy. Ambulatory and home monitoring techniques are more convenient and cost-effective and allow studies to be performed in the normal home environment. PMID- 3958885 TI - Neuroblastoma and nutritional support: influence on the host-tumor relationship. AB - The nutritional sequelae of neuroblastoma are secondary to tumor burden, tumor host influenced metabolism, and antitumor operative, pharmacologic, and radiation therapy. Nutritional support and its influence on the outcome of clinical cancer is confusing; but in a defined murine system, we hypothesized that whether or not nutritional repletion favors the host-tumor relationship is dependent on a nutritional augmentation of host antitumor immunity. C1300 murine neuroblastoma (NB) elicits a host antitumor immune response as determined by in vivo and in vitro testing; but the TBJ clone of the same tumor is nonimmunogenic. After receiving two weeks of either regular 24% protein or protein restricted 2.5% protein chow, normal and malnourished mice received either C1300-NB or TBJ-NB and were serially followed to animal death. The median survival time (MST) of TBJ recipients was shorter in this more aggressive tumor, but the MST of 27.5 days was equal for normal and malnourished mice. Contrasting with these data were an MST of 38 days for malnourished C1300 NB recipients and an MST of 64.5 days for normally nourished C1300 NB recipients, values that are significantly different (P less than 0.02). These data suggest that nutritional support influencing host antitumor immunity may be of benefit only in that circumstance where the tumor elicits an antitumor immune response. PMID- 3958886 TI - Experimental studies of photo radiation therapy on neuroblastoma. AB - A combination of Photo Radiation Therapy (PRT) using Argon-Dye Laser with hematoporphyrin derivatives (HpD) was used experimentally on a cytogenetically highly malignant neuroblastoma xenograft, which exhibited a homogeneously staining region and caused DNA amplifications in chromosomes. The tumor tissue was treated with 500 joules/cm2 of laser. The dosage of HpD was 50 mg per kg body weight. Necrosis of over 50% of the tumor was observed in half the specimens. Swollen cytoplasmic organelles and ruptured cell and nuclear membranes were observed by electron microscopy after PRT. PRT may be used with other treatment modalities for the removal of residual and metastatic tumors. PMID- 3958887 TI - Total colonic aganglionosis (with or without ileal involvement): a review of 27 cases. AB - From 1960 to 1984, 27 cases of total colonic aganglionosis were treated at the Sick Children's Hospital in Paris; in 19 cases there was ileal involvement, 16 of them extending more than 15 cm above the ileocecal valve. Five had a family history of Hirschsprung's disease. Nine infants died without having had definitive surgery, because of delayed diagnosis, or intractable malabsorption in extensive ileal aganglionosis. Two cases were diagnosed only at the ages of 6 and 13 years. Eleven children had Martin's modification of the Duhamel operation, the oldest of these being now 13 years old; and one girl aged 13 underwent a Swenson operation with ileoanal anastomosis, and one child has had a Kimura procedure. Four infants still have a diverting ileostomy. One out of the 14 operated children died 3 years after operation with fulminating enterocolitis. Late surgical nutritional results are analyzed with regard to the length of the side to-side ileocolorectal anastomosis, and to the size of the ileorectal anastomosis, on which adequate pouch emptying depends. The essential problem in total colonic aganglionosis is not the surgical management of the condition, but rather its prompt diagnosis and the handling of the neonatal intestinal obstruction. PMID- 3958888 TI - Juxtapancreatic intestinal duplications with pancreatic ductal communication: a cause of pancreatitis and recurrent abdominal pain in childhood. AB - Pancreatic duplications with ductal communications should be included in the differential diagnosis of any child presenting with recurrent abdominal pain of unknown etiology and should be considered as a possible cause of pancreatitis in childhood. Such duplications most likely arise from nonregressing diverticula of the pancreatic bud during embryologic development. Their clinical presentation is unique from other duplications because of their anatomic association with the pancreatic duct. Pain and weight loss are the major presenting complaints, although many patients have nausea and vomiting. Serum chemistries, in particular the serum amylase, are usually normal and are of little help in the differential diagnosis. Radiographic evaluation has not been particularly helpful in the past. ERCP, ultrasonic examination, and CT scan show great promise, however. Operative intervention should be tailored for the individual patient. The operation performed will depend upon operative findings. Intraoperative pancreatograms or cystograms are very helpful in differentiating these cysts from others at the time of operation. Pathologically, most of the duplications have a thickened muscular coat that usually has some evidence of inflammation. They are usually lined with gastric mucosa. Except in the most severe cases, the pancreas is histologically normal, suggesting that most of the pain experienced by these patients is secondary to inflammation within the duplication. The inflammatory response may completely destroy the mucosal lining and cause fibrosis within the muscular coat of the duplication. In those instances, these lesions cannot be differentiated from pancreatic pseudocyst. This may account for some of the "idiopathic" pseudocysts reported in the literature. PMID- 3958889 TI - Portal hypertension after successful hepatic portoenterostomy in biliary atresia. AB - From 1953 through 1984, we have operated on 225 cases of biliary atresia, and 95 patients are presently surviving. Portal hypertension with esophageal varices was endoscopically confirmed in 26 of 66 patients (39%) examined, 14 with and 52 without jaundice. All these patients except two had had frequent episodes of postoperative cholangitis. Eight patients have undergone treatment for portal hypertension. The treatment for variceal bleeding in jaundice-free infants with biliary atresia should be initiated conservatively, including endoscopic sclerotherapy. The results of our experience, however, justifies the employment of shunt procedures for patients older than 6 or 7 years of age. PMID- 3958890 TI - Evidence for pineal involvement in timing implantation in the western spotted skunk. AB - Experiments were designed to test the hypothesis that the pineal gland mediates the effects of changing day length and thereby synchronizes implantation within the population of spotted skunks. Intact, sham-superior cervical ganglionectomized (SCGx), SCGx, and SCGx/bilateral orbitally enucleated (B1) pregnant skunks were subjected to a natural photoperiod, and the duration of the preimplantation period was monitored. In a second set of experiments, melatonin was administered to pregnant skunks via two methods to determine whether or not this pineal hormone would mimic the effects of short day photoperiods or B1 on duration of the preimplantation period. Bilateral SCGx, which presumably denervated the pineal, had no effect on the average duration of the preimplantation period (232 +/- 57 vs. 199 +/- 6 days). However, SCGx reversed the inhibitory effect of B1 on implantation as SCGx/B1 animals had an average duration of the preimplantation period that was not significantly different from intact controls (262 +/- 46 vs. 214 +/- 11 days) but was significantly shortened in comparison to enucleated animals (262 +/- 46 vs. 316 +/- 45 days). Melatonin significantly lengthened the duration of the preimplantation period in animals receiving either daily afternoon injections of melatonin or those receiving melatonin Silastic capsule implants. These results are consistent with the hypothesis that the pineal gland synchronizes photoperiod-induced blastocyst implantation in the western spotted skunk. PMID- 3958891 TI - Morphometric analysis of the synaptic ribbons and nerve vesicles of the cat pineal gland after electrical stimulation of the superior cervical ganglia. AB - The nerve vesicles and synaptic ribbons were quantified in the cat pineal gland after electrical stimulation of the pineal sympathetic nerve fibers. It has been shown that the bilateral electrical stimulation of the preganglionic fibers innervating the superior cervical ganglia (SCG) markedly reduces the number of dense cores of small dark vesicles (SDV) and, on the other hand, modifies the number and shape of the large dark vesicles (LDV). An increase in the number of the synaptic ribbons after stimulation of the SCG supports the hypothesis that the numerical reduction of dense cores of nerve vesicles in the cat pineal gland influences the level of synaptic ribbon formation. PMID- 3958892 TI - Effects of pinealectomy on photoperiodic control of hair follicle activity in the Limousine ram: possible relationships with plasma prolactin levels. AB - Twelve adult Limousine rams (five pinealectomized, four sham operated, and three control) were housed under an artificial lighting regime of alternating periods of long (16L:8D) and short (8L:16D) days for 18 months, and long-term variations in kemp follicle growth were recorded along with measurements of the plasma prolactin concentrations. In control and sham-operated rams, both parameters varied in relation to imposed lighting regime. Moult and growth of the kemp follicles occurred during each short-day period at a time when the concentrations of prolactin were low and vice versa. Variations in the pinealectomized rams were different from those in the control or sham-operated ones. There was no synchronous periodic kemp activity: some follicles remained active at all times, and the seasonal pattern of plasma prolactin levels disappeared. The relationship between the kemp follicle cycle and the pattern of plasma prolactin concentrations and its control by the pineal gland are discussed. PMID- 3958893 TI - The effect of serotonin, N-acetylserotonin, and melatonin on spontaneous contractions of isolated rat intestine. AB - A dose-dependent increase in tone and reduction in amplitude of contractions was observed after serotonin (5-HT) was administered to isolated segments of rat ileum, incubated in Locke's solution at 38 degrees C. Melatonin (M) reduced the tone but not the amplitude or frequency of contractions. Addition of M (administered in doses 20 to 100 X higher than 5-HT) relieved the spasm induced by 5-HT. Furthermore, pretreatment with M significantly reduced the 5-HT effect. N-acetylserotonin (NAS) exhibited delayed but similar effect to M. Neither M nor NAS could prevent or relieve acetylcholine-induced contractions or influence relief of intestinal contractions by adrenaline. This indicates that 5-HT and M act via a different mechanism than that of adrenaline and acetycholine system. Serotonin muscle receptor blocker methysergide reduced 5-HT effect but was not able to abolish it completely. As methysergide could not reduce the muscle tone and did not relieve spasm caused by 5-HT, it is speculated that M is not acting as antagonist of 5-HT-stimulatory receptors but rather as agonist of 5-HT inhibiting neuronal receptors. PMID- 3958894 TI - Effects of pineal indoles and arginine vasotocin on lipolysis and lipogenesis in isolated adipocytes. AB - The effects of arginine vasotocin and the pineal indoles melatonin, serotonin, N acetylserotonin, hydroxytryptophol, methoxytryptophol, hydroxyindoleacetic acid, methoxyindoleacetic acid, and methoxytryptamine on lipolysis and lipogenesis in isolated adipocytes were studied. Basal lipolysis was inhibited by all the indoles tested at a dose of 1 mumole except hydroxytryptophol. Methoxytryptamine and serotonin inhibited hormone-induced lipolysis in a dose-dependent manner and exhibited the highest antilipolytic activity in isolated rat, rabbit, and hamster adipocytes. However, their antilipolytic activity could not be overcome by increasing the dose of the lipolytic hormone. Dibutyryl cyclic AMP-induced lipolysis was also inhibited. All the pineal indoles tested were capable of suppressing basal and insulin-stimulated lipogenesis in the dose range 0.33-3 nmole. At lower doses there was no effect. Arginine vasotocin at a dose of 25 nmole significantly augmented basal lipogenesis. PMID- 3958895 TI - Neuropharmacological modification of central catecholamines: effects on pinealectomy-induced convulsions. AB - Removal of the pineal gland produces stereotyped tonic convulsions in parathyroidectomized rats. Inasmuch as central levels of norepinephrine (NE) are decreased in these animals, the purpose of this study was to investigate the effects of alterations in central catecholamine function on convulsions produced by pinealectomy in parathyroidectomized rats. The treatment of rats with alpha methyl-p-tyrosine or FLA-63 produced large reductions in forebrain levels of both NE and dopamine or NE alone, respectively, which were not associated with facilitation of convulsions. However, the incidence of convulsions was increased by FLA-63 in rats pretreated with the catecholamine precursor L dihydroxyphenylalanine. Reserpine, a monoamine depleter, had no effect on either the incidence or severity of convulsions. An acute injection of desipramine, an inhibitor of the reuptake of NE, however, significantly lowered the incidence of convulsions. Timolol, a beta-adrenergic receptor antagonist, reduced, in a dose dependent manner, the average latency to onset of convulsions and increased the average number of convulsions each rat experienced. Clonidine, an alpha 2 adrenergic agonist, did not significantly alter convulsions. Thus presynaptic mechanisms such as synthesis and storage of both NE and DA appear to have little, if any, effect on pinealectomy-induced convulsions, whereas enhancing synaptic levels of NE by blocking its reuptake into adrenergic axons had an anticonvulsant effect. Further evidence suggesting a role for NE in modulating these convulsions is provided by the proconvulsant effect of blocking central beta-adrenergic receptors. PMID- 3958896 TI - Effects of timed melatonin infusion on prolactin secretion in pineal denervated goat. AB - The effects of timed melatonin infusion on prolactin secretion were examined in the pineal denervated goat. Ovariectomized Shiba goats (n = 5) were subjected to bilateral superior cervical ganglionectomy (SCGX); this procedure resulted in complete abolition of endogenous melatonin release during the dark phase. SCGX goats failed to coordinate their prolactin secretion with the prevailing photoperiod. Melatonin was infused (20 micrograms/h, s.c.) daily into these goats either for 8 h (the long-day-type infusion) or for 16 h (the short-day-type infusion) to mimic the nocturnal profile of plasma melatonin under long days or short days, respectively. The long-day-type melatonin infusion for 9 days, in comparison with control saline infusion, accelerated prolactin secretion, inducing a nocturnal rise in plasma prolactin; this was comparable to that seen in the pineal intact goats under long photoperiods. On the other hand, the short day-type melatonin infusion suppressed prolactin secretion throughout the day as the short-day treatment did in intact goats. The prevailing photoperiod appeared to have no distinct effect on these prolactin responses to exogenous melatonin, which were indistinguishable under 16L8D and 8L16D conditions. The results indicate that the information about external light-dark cycles is converted by the pineal gland into the endocrine signal as a daily pattern of melatonin secretion, which eventually regulates prolactin secretion from the pituitary gland of the goat. PMID- 3958897 TI - Pineal dependence of the Syrian hamster's nocturnal serum melatonin surge. AB - The usual nocturnal surge of pineal melatonin content was blocked by bilateral superior cervical ganglionectomy in male Syrian hamsters. Ganglionectomy and pinealectomy each prevented the nocturnal rise of serum melatonin concentration seen in control animals. The normal nocturnal surge of circulating melatonin in this species appears to depend on the pineal gland and its sympathetic innervation. PMID- 3958898 TI - DNA replication is not restricted to specific regions in young vegetative Streptomyces mycelia. AB - In order to determine the localization of DNA-synthesis in Streptomyces granaticolor and Streptomyces hygroscopicus, mycelia (growing either on agar or in liquid medium) were pulse-labelled with 3H-thymidine and prepared for autoradiography. The distribution of silver grains showed no regions of preferential incorporation of 3H-thymidine in mycelia up 300 micron in length. Since mycelia grow by apical elongation of hyphae, the frequency of silver grains was quantitatively analysed along individual main hyphase. No significant difference of labelling was found within zones of different age up to a distance of 80 micron from the hyphal tip. Also, the very youngest part of the hyphae enclosing only the most apically situated nucleoid did not show any deviation from the average frequency of silver grains. PMID- 3958899 TI - Parasexual process in the yeast Yarrowia lipolytica. AB - Genetic studies of several events of the life cycle of Y. lipolytica demonstrated that diploid strains were unstable and produced mitotic segregants by haploidization. A screening system was developed which enabled us to show that parasexual processes can take place in addition to the sexual life cycle. This haploidization occurred through aneuploid intermediates as was proven statistically by the deviations from the segregation pattern as well as by the segregation data of the clones. The direction of the cross, was--with respect to the resistance to 2-deoxyglucose of A- or B-strain--not important for selection of mitotic segregants. PMID- 3958900 TI - Dissolution and partition thermodynamic functions of some nonsteroidal anti inflammatory drugs. AB - Solubility values of a selected group of nonsteroidal anti-inflammatory drugs have been determined in water and 1-octanol as a function of temperature. Thermodynamic functions of dissolution and partition have been calculated and discussed with respect to various physical parameters of each solute and the two solvents. The calculated solubility values show good agreement with the experimental values. The analysis of the experimental solubility values of these compounds in terms of solid-state contribution and solute-solvent interaction suggests the different importance of these parameters in promoting solubility of solid nonelectrolytes. PMID- 3958901 TI - Effect of polyethylene glycol 400 on the penetration of drugs through human cadaver skin in vitro. AB - The effect of polyethylene glycol 400 on the penetration of drugs through human cadaver skin is reported. Polyethylene glycol 400 was used in various concentrations in the donor and the receptor compartments. It was observed that polyethylene glycol 400 had significant effects on the penetration rates of compounds, both when used in the donor as well as in the receptor solutions. These effects were barrier specific and are related to the alteration of the skin structure and the mass flow of water. PMID- 3958902 TI - A simulation study on the effect of a uniform diffusional barrier across hepatocytes on drug metabolism by evenly or unevenly distributed uni-enzyme in the liver. AB - The effect of a uniform diffusional barrier on hepatic extraction of the parent drug by evenly or unevenly distributed uni-enzyme was quantitatively determined by the present simulation study. Five models of enzymic distribution were defined with regard to the hepatic blood flow path, and the extraction ratios were calculated or simulated under the various conditions of average intrinsic clearances and diffusion clearances across hepatocytes. Differences in the extraction ratios among the five models were evaluated by the "relative extraction ratios," which are the extraction ratios in each model divided by that in the model where the enzymatic activity is evenly distributed. It was found that when a diffusion clearance was high compared to the intrinsic clearance, enzymic distribution was not an important determinant of the extent of hepatic extraction. By contrast, when a diffusional barrier across hepatocytes exists, i.e., the diffusion clearance is low or intermediate compared to the intrinsic clearance, extraction ratios differed widely among the models of enzymic distribution, especially at intermediate average intrinsic clearances. In the presence of a diffusional barrier, the more skewed the distribution of the enzymatic activity is, the lesser the amount of drug eliminated at steady state. The most efficient metabolism occurred when the enzymatic activity was evenly distributed. PMID- 3958903 TI - Pilocarpine prodrugs I. Synthesis, physicochemical properties and kinetics of lactonization of pilocarpic acid esters. AB - Various alkyl and aralkyl esters of pilocarpic acid were synthesized and evaluated as prodrug forms for pilocarpine with the purpose of improving the ocular bioavailability of pilocarpine through increased corneal membrane permeability. The esters were found to undergo a quantitative cyclization to pilocarpine in aqueous solution of pH 3.5-10, the rate of cyclization being a function of the polar and steric effects within the alcohol portion of the esters. The rates of lactonization increased proportionally with the hydroxide ion activity over the pH range studied which is in accord with a reaction mechanism involving intramolecular nucleophilic attack of alkoxide ion on the ester carbonyl moiety. At pH 7.4 and 37 degrees C, half-times of lactonization ranging from 30 min (p-chlorobenzyl ester) to 1105 min (n-hexyl ester) were observed for the various esters. The esters are markedly more lipophilic than pilocarpine. The results suggested that the pilocarpic acid esters may be potentially useful prodrugs, especially when further derivatized to give in vitro stable pilocarpic acid diesters. PMID- 3958904 TI - Intranasal delivery of nicardipine in the rat. AB - The intranasal absorption of nicardipine hydrochloride was characterized in an in vivo rat model system in which the normal mechanisms of mucociliary clearance and drainage of an instilled dose were not physically altered. The results obtained in this manner, therefore, are expected to be predicative of the delivery and absorption dynamics exhibited in the nasal mucosa of primates and humans. Intranasal delivery of nicardipine was studied in male rats using this model on single-dose administration of 1.0 mg/kg, and compared with both oral and intravenous administration. The effect of the addition of a viscosity agent, hydroxyethyl cellulose, on plasma levels following nasal delivery was also examined. Nicardipine plasma levels were determined by a rapid and specific reversed-phase HPLC method with electrochemical detection that employed nifedipine as an electroactive internal standard in the analysis. The limit of quantitation for nicardipine at 1.0 V versus Ag/AgCl was 8 ng/mL and the linear dynamic range was 15-150 ng/mL. Following intravenous administration the area under the plasma concentration curve was 5110 ng . min/mL as compared to 3730 ng . min/mL following intranasal dosing. This corresponds to a bioavailability of 73%. The addition of a viscosity agent to the nasal formulation was found to give a slight but statistically insignificant increase in the systemic availability (77%). Plasma levels of nicardipine following oral administration (1.0 mg/kg) were determined to be below the limit of quantitation of the analytical technique. These results therefore suggest that nasal delivery of nicardipine is a viable and efficient route of administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958905 TI - Pharmacokinetics of orally administered pentoxifylline in humans. AB - The pharmacokinetics of pentoxifylline was studied in healthy male volunteers following single oral doses of 100, 200 and 400 mg of the drug in solution. Concentrations of the drug and three of its metabolites were determined in plasma. The major urinary metabolite was also determined for 24 hours after dosing. Pentoxifylline was rapidly and extensively absorbed at all doses. Peak plasma concentrations of pentoxifylline occurred between 0.29 and 0.41 hours after dosing. Its metabolites, a secondary alcohol and two homologous carboxylic acids showed tmax values from 0.72 to 1.15 hours. Cmax and AUC values increased in a dose-dependent manner for pentoxifylline and its metabolites over the three dose levels though strict dose proportionality could only be demonstrated for the principal carboxylic acid metabolite. The apparent plasma half-life of pentoxifylline varied between 0.39 and 0.84 hours for the various doses while the apparent half-lives of the metabolites were in the range of 0.96 to 1.61 hours. The major circulating metabolites, the secondary alcohol and carboxypropyl derivative, were at consistently higher plasma concentrations than the parent drug. Two major pathways account for the circulating metabolites of pentoxifylline though oxidation of the parent drug to a carboxylic acid accounts for the formation of the principal urinary elimination product. Because of the pharmacological activities of pentoxifylline, studies are proposed of the pharmacokinetic-pharmacodynamic correlations of pentoxifylline and its metabolites. The present pharmacokinetic results further support the use of a controlled-release dosage form of pentoxifylline for therapy. PMID- 3958906 TI - Sustained-release delivery systems, I: Phase diagram studies of dapsone and selected derivatives. AB - In order to develop slowly dissolving particles containing the antileprotic drug dapsone (4,4'-sulfonylbisbenzamine, that would be suitable for a sustained release intramuscular injection, the dilauryl and monolauryl derivatives of dapsone, N,N'-didodecanoyl-4,4'-sulfonylbisbenzamine and N-dodecanoyl-4,4' sulfonylbisbenzamine, respectively, were studied for their ability to form solid dispersions with the parent compound. The 1:2 binary phase diagram showed these two compounds were partially miscible in the liquid state, leading to the coexistence of a monotectic and a eutectic system in the phase diagram. The 1:3 phase diagram showed that these compounds were completely miscible in the liquid state and formed discontinuous solid solutions in the solid state. At a cooling rate of 2.5 degrees C min-1, eutectic mixtures lying on the dapsone side of the eutectic point formed glass solutions. Taken as a whole, the results demonstrate that the molecular interactions between 1 and 3 are stronger than those between 1 and 2. Accordingly, 3 would appear to be the better carrier for reducing the rate of dissolution of dapsone from a solid dispersion. PMID- 3958907 TI - Sustained release of nifedipine from granules. AB - Two kinds of granules were prepared: one with pH-dependent release and the other with pH-independent release. The former was composed of nifedipine, hydroxypropyl methylcellulose phthalate, ethylcellulose, and microcrystalline cellulose, while the latter was composed of nifedipine, hydroxypropyl methylcellulose, ethylcellulose, and corn starch. The effects of the mixing ratios of the polymers and the drug contents in the granules were examined in vitro. In both granules, the release was decreased with the increment of ethylcellulose. These sustained release granules and the commercial fine granules were orally administered to rabbits. In the plasma levels of nifedipine detected from rabbits orally administered sustained-release granules, a reduced but sustained level was observed. This indicates the sustained release of the drug from the granules in vivo. Furthermore, the plasma profiles of nifedipine indicated that the granules with pH-independent release were superior to that with pH-dependent release with respect to prolonging the effective plasma levels and to minimizing the intersubject variations. PMID- 3958908 TI - Water migration from soft gelatin capsule shell to fill material and its effect on drug solubility. AB - The bioavailability of some poorly water-soluble drugs was reported to increase due to a change in dosage form from a tablet to a solution encapsulated in soft gelatin capsules. However, the objective of increasing the bioavailability may be defeated if the drug crystallizes from a solution inside the capsule. In this study, a water-insoluble drug [alpha-pentyl-3-(2 quinolinylmethoxy)benzenemethanol; REV 5901] was solubilized in both polyethylene glycol 400 (PEG 400) and a 6:1 mixture of Gelucire 44/14:PEG 400. The solutions were then encapsulated in soft elastic gelatin capsules with a fill weight of 700 mg (drug, 125 mg), and water migration from the capsule shell into the fill material and its effect on the solubility of the drug were investigated. Gelucire 44/14 is a mixture of hydrogenated fatty acid esters with a mp of 44 degrees C; PEG 400 was added to reduce the mp of solution to approximately 36 degrees C for easier encapsulation. After equilibration of capsules at ambient condition, the amount of water in the PEG 400 solution was 6.3%. This reduced the solubility of the drug by 45%, resulting in drug crystallization. The solubility decreased exponentially with the increase in water content. The water in the encapsulated Gelucire:PEG solution was only 1.1%, which did not affect the solubility significantly. PMID- 3958909 TI - Determination of partial solubility parameters of lactose by gas-solid chromatography. AB - On the basis of the Snyder/Karger-Hansen interaction model, where delta EA = Vi(delta di delta dj + delta pi delta pi + delta hi delta nj), the partial solubility parameters of a solid used as the stationary phase may be determined through gas-solid chromatography by null-injection of solutes with known solubility parameters. Using n-decane, acetonitrile, and 1-propanol as molecular probes, the values found for unhydrated lactose were 9.6, 12.8, 11.3, and 19.5 (cal1/2/cm3/2) for delta d, delta p, delta h, and delta t, respectively; relative standard errors were better than 3%. The choice and the minimum number of the best molecular probes were determined by optimization of the experimental matrix according to the D-criterion, which permits considerable reduction of experimental time yet enhances total precision. PMID- 3958910 TI - A potentiometric study of lithium complexation with catecholamines. AB - A potentiometric study of lithium complexation with tyramine, dopamine, norepinephrine, and 5-hydroxytryptamine was undertaken using monovalent cationic selective and pH glass electrodes. The conditional stability constants for the lithium catecholamine complexes were calculated for a range of pH values from direct potentiometric measurement of the free lithium ion concentration. The ionic strength was maintained at 0.5 with tetramethylammonium chloride and glycine buffers. Temperature was maintained at 25 degrees C. Titration data for the catecholamines and lithium-catecholamine complexes at the same temperature and ionic strength were also obtained using tetramethylammonium hydroxide as titrant. All solutions were maintained essentially oxygen free during the analytical procedure. Alkali metals are generally recognized as being weakly complexed in aqueous solution. The magnitude of the stability constants determined in this study indicates there is a weak interaction of lithium with catecholamines. PMID- 3958911 TI - In vivo hyperglycemic effect of (-)- and (+)-epinephrine in dogs. AB - (-)-Epinephrine is a major component in the regulation of the physiological homeostasis of glucose levels in the blood. (+)-Epinephrine, a synthetic stereoisomer, has been reported to have 10% of the in vitro adrenergic-lipolytic activity of (-)-epinephrine and only 7% in vitro competitive binding activity to fat cells. The in vivo hyperglycemic effects of the two stereoisomers were studied in 6 dogs using a continuous glucose monitor. The method allowed a direct comparison between the hyperglycemic effects of the two stereoisomers in each dog in the course of each test; therefore, the effect of individual variability of response was eliminated. Previous reports on the relative activity of the two stereoisomers were carried out only in vitro. The previous methods required interassay comparison. The present method is in vivo and uses intra-assay comparison. The hyperglycemic activity of (+)-epinephrine bitartrate was found to have 12.8% of the hyperglycemic activity of its natural (-)-stereoisomer. PMID- 3958912 TI - Analysis of chlorhexidine sorption in soft contact lenses by catalytic oxidation of [14C]chlorhexidine and by liquid chromatography. AB - Two methods are described for the analysis of chlorhexidine sorption in soft contact lenses. The first is an isocratic ion-pairing high-performance liquid chromatographic (HPLC) method with UV detection at 220 nm that allows the determination of chlorhexidine, p-chloroaniline, and other chlorhexidine degradation products in ophthalmic solutions. This procedure had a detection limit of 0.1 ng. The second involves the catalytic oxidation of the lens matrix containing [14C]chlorhexidine to [14C]carbon dioxide and water. The label is then trapped as carbon dioxide in a cocktail and is analyzed by liquid scintillation counting. These methods are sensitive, accurate, and reproducible, and can be used independently or in conjunction for the determination of chlorhexidine sorption in soft contact lenses. PMID- 3958913 TI - A modified, sensitive liquid chromatographic method for measurement of propranolol with fluorescence detection. AB - A simple, sensitive, and rapid fluorometric-high-performance liquid chromatographic method for quantitating human and animal plasma and blood levels of propranolol has been developed. The procedure, which requires microliter volumes of triethylamine in the mobile phase mixture and microliter volumes of plasma or blood (50-100 microL), may be applied in routine clinical analysis as well as in pharmacokinetic studies using small laboratory animals. A single, selective extraction step precedes the analysis. The limiting concentration that can be detected is 1 ng/mL. PMID- 3958914 TI - Liquid chromatographic determination of 4-(2-di-N,N-propylaminoethyl)-2-(3H) indolone in rat, dog, and human plasma with ultraviolet detection. AB - A sensitive, specific, and accurate assay for 4-(2-di-N,N-propylaminoethyl)-2 (3H)-indolone, 1 (SK&F 101468), in plasma was developed using high-performance liquid chromatography with UV detection. The method involves sample preparation by solid-phase extraction, elution of 1 and the internal standard with a volatile solvent, concentration, and reversed-phase chromatography in the presence of an ion-pairing agent. Using 1 mL of plasma, 5 ng/mL of 1 is detectable and 10 ng/mL of 1 can be quantitated. The recovery of 1 and internal standard from plasma is greater than 95%. The within-day precision of this method at 17.5, 219, and 395 ng/mL is 3.4, 1.3, and 1.5%, respectively. The between-day precision at these concentrations is 6.0, 1.9, and 2.6%, with a mean accuracy of 100.6, 98.3, and 100.2%, respectively. Stability studies indicate that 1 is stable in plasma at 80 degrees C for less than or equal to 180 d. PMID- 3958915 TI - Kinetics and mechanism of the solid-state decomposition of propantheline bromide. AB - The kinetics of the solid-state hydrolysis of propantheline bromide (1) was studied with respect to the effect of temperature and water vapor pressure on the decomposition rate. For the hydrolysis at a relative humidity (RH) above the critical relative humidity (CRH), the percent decomposed (x) could be described by the empirical equation: x = ktn, where n is a constant independent of temperature and water vapor pressure, and k is related to temperature (T) and water vapor pressure (P) by the equation: k = k'e-Ea/RTPs (k' and s are constants). A mechanism in which the decomposition products serve to provide reaction nuclei is proposed. On the other hand, the hydrolysis at RH below the CRH could be described by a zero-order kinetic model with a lag time, and the dependence of the zero-order rate constant and the lag time on T and P was determined. The kinetic data suggested that decomposition occurs in an adsorbed moisture layer. PMID- 3958916 TI - Stability of aspirin in solid mixtures. AB - It has been shown that the degradation of aspirin in mixtures may be monitored by thermal analytical techniques. The methodology employed differential scanning calorimetry and thermal gravimetric analysis by standard techniques providing simple and rapid analysis for screening the stability of aspirin in mixtures. The degradation was found to depend on the nature of the additive but, in particular, the presence of acidic or basic groups within its structure. PMID- 3958917 TI - Mixing-tank model for predicting dissolution rate control or oral absorption. AB - A mixing-tank model is used to simulate GI absorption of nonionized drugs. The model is useful for predicting circumstances under which dissolution rate dominates membrane transport and transit rate, thus limiting the extent of absorption. The model is developed from mass balance considerations in which the nonsink dissolution term is a function of the remaining surface area and the concentration gradient across the boundary layer. Other dissolution parameters include initial particle radius, dose, diffusivity, density, and boundary-layer thickness. Readily calculable estimators for the general solution of the model are derived and their ranges of usefulness are discussed. Drug examples chosen for simulation are griseofulvin and digoxin. The model correctly predicts bioavailability as a function of particle size for both of these poorly soluble drugs. PMID- 3958918 TI - Comparison of four experimental techniques for studying drug absorption kinetics in the anesthetized rat in situ. AB - Theophylline absorption kinetics were determined using in situ perfusion techniques. The objectives of this study were to obtain information on the effective permeability constant (ke) of theophylline and its variance during the course of an experiment, and to study the dependence of ke on the experimental technique used. Four in situ intestinal perfusion techniques were compared in the rat: single-pass perfusion, recirculating perfusion, oscillating perfusion, and the closed loop method. The absorption of theophylline appeared to be strongly dependent on the hydrodynamics in the lumen. Constant values and similar coefficients of variation for ke values were obtained for the single-pass perfusion, the recirculating perfusion, and the oscillating perfusion methods. The closed-loop method suffered both from a dropping value of ke with time and a relatively large coefficient of variation. PMID- 3958919 TI - Transport of cisplatin in rat brain following microinfusion: an analysis. AB - The post-microinfusion transport of cis-diamminedichloroplatinum(II) (cisplatin) in rat brain has been modeled as a linear diffusion-reaction-permeation process. The model has been used to analyze the experimental data of Kroin and Penn to obtain the macromolecular binding constant of cisplatin in the brain, k = 0.0050 +/- 0.0023 min-1, and the capillary permeability, p = (9.0 +/- 4.4) X 10(-7) cm/s. Inclusion of saturation effects led to the same p value and a higher k value of 0.007 min-1. The corresponding diffusion length is 0.8 mm. The reaction constant is similar to those reported for plasma (0.008 min-1) and muscle (0.004 min-1), and the permeability value is within the range predicted by correlation with the permeability-octanol/water partition coefficient. Fits to data were accomplished with mathematical expressions giving the average total platinum concentration in saggital cerebellar sections which were not subdivided. Both time-dependent and steady-state solutions were obtained for the transport model, the former predicting a half-time to steady state of 3 h. Boundary effects were also investigated. Concentration profiles, calculated for a point source and for a 23-gauge cannula, were shown to differ by 7%. Similar comparisons between two profiles, one computed for an infinite diffusion range and another computed for drug diffusion into a flowing cerebrospinal fluid (CSF) at a finite range of 3 mm, showed differences of less than 3%. Free and bound drug forms, protein turnover, and CSF uptake have been accounted for as well as the percent infusate recoveries at 100 and 160 h reported by Kroin and Penn.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958921 TI - 13C NMR studies of the molecular flexibility of antidepressants. AB - The solution dynamics of a series of clinically potent antidepressants have been investigated by measuring 13C NMR relaxation parameters. Correlation times and internal motional rates were calculated from spin-lattice relaxation times and nuclear Overhauser effects for the protonated carbons in mianserin, imipramine like antidepressants, and amitriptyline-like antidepressants. These data were interpreted in terms of overall molecular tumbling, internal rotations, and inherent flexibility of these structures. Of particular interest was the conformational variability of the tricyclic nucleus of the tricyclic antidepressants, where the data indicated a fivefold difference in mobility of the dimethylene bridge of imipramine-like antidepressants relative to amitriptyline-like compounds. The implications of such a difference in internal motions is discussed in relation to previous NMR studies and to the reported differences in pharmacological activity of these antidepressants. PMID- 3958920 TI - Metabolic fate and solubility of triamterene--not an explanation for triamterene nephrolithiasis. AB - In an attempt to explain the triamterene stone diathesis, we studied the excretion and solubility of triamterene, 1, and its metabolite, the sulfate ester of the hydroxy derivative of triamterene, 3. The urinary excretion pattern and metabolism in stone formers was the same as in other chronic users of triamterene or healthy volunteers. The solubility of triamterene in urine was approximately one-half of its solubility in buffer solution, whereas the sulfate ester, 3, was nearly twice as soluble in urine as in the buffer solution. In the majority of the subjects studied, we found concentrations of 3 which approached or exceeded apparent solubility limits in urine. This was not true for triamterene where most measured urine concentrations were less than the apparent solubility as determined by equilibration. Alteration in the metabolism of triamterene is probably not a causative factor for triamterene nephrolithiasis. The saturation of urine with triamterene and especially with the sulfate ester, 3, may be related to stone formation, but other physical factors play a role in determining the relative amounts of drug found in calculus material. PMID- 3958922 TI - Inhibition of vaccinia RNA guanine 7-methyltransferase by compounds designed as multisubstrate adducts. AB - Several potential inhibitors of mRNA guanine 7-methyltransferase, which were designed from mechanism-based considerations, were evaluated against the vaccinia virus capping enzyme complex. Of the compounds tested, 5'-deoxy-5'[6-(2 aminopyrrolo[2,3-d]-pyrimidine-4-one) methylthio]adenosine (9) had good selective inhibitory activity against vaccinia mRNA guanine 7-methyltransferase, exhibiting an IC50 of 9.2 X 10(-5) M. Structure-activity considerations suggest that specific inhibition of RNA methyltransferases by low molecular weight multisubstrate adduct inhibitors may be achievable. PMID- 3958923 TI - Effect of renal failure or biliary stasis on the pharmacokinetics of amiodarone in the rat. AB - The single dose intravenous pharmacokinetics of amiodarone (50 mg/kg) were examined in rats with 72 h of biliary stasis secondary to bile duct ligation compared with paired control animals; and in rats with uranyl nitrate induced acute renal failure compared with paired control animals. Plasma and tissue levels (liver, kidney, heart, and lung) of amiodarone (1) and its N-deethyl metabolite 2 were obtained at 4 and 24 h following drug administration. Pharmacokinetic parameters were derived from plasma samples obtained over a 24-h period. Compared with controls, biliary stasis caused a decrease in the total clearance of 1 (1.74 versus 0.35 L/h/kg) and in the volume of distribution at steady state (21.1 versus 5.0 L/kg); renal failure caused a decrease in total clearance (1.67 versus 0.9 L/h/kg) and an increase in apparent elimination half life (13.7 versus 10.1 h). Both disease processes produced significantly higher plasma levels of 1 when compared with control animals at 4 and 24 h. However, only the cholestatic animals had consistently higher tissue levels of 1 in the face of elevated plasma levels. In normal rats, no 1 or 2 was detected in the urine after a 50 mg/kg intravenous dose of 1, and less than 0.5% of the total dose of amiodarone (1) was excreted into bile by 12 h. PMID- 3958924 TI - Inhibition of pentoxifylline clearance by cimetidine. AB - The effect of cimetidine on the single-dose pharmacokinetics of pentoxifylline and one of its major metabolites, 3,7-dimethyl-1-(5-hydroxyhexyl)xanthine (1), was examined in two groups of male Sprague-Dawley rats (6 rats/group) after the administration of pentoxifylline (1 mg/kg) alone and following a 50 mg/kg iv dose of cimetidine. The addition of cimetidine resulted in a 37% decrease in pentoxifylline clearance (23.8 +/- 7.5 versus 15.0 +/- 3.2 mL/min; p less than 0.03). No changes in the volume of distribution of pentoxifylline or in the total area under the plasma concentration-time curve for 1 were observed with the addition of cimetidine. The mechanism of this metabolic interaction is probably cimetidine-induced inhibition of hepatic microsomal enzymes, which blocks the major excretory pathways for pentoxifylline. Further studies are warranted in humans to determine the existence and clinical significance of this interaction. PMID- 3958925 TI - Stable-isotope methodology in the bioavailability study of 17 alpha methyltestosterone using gas chromatography-mass spectrometry. AB - The application of a stable-isotope coadministration technique for estimating the relative bioavailability of 17 alpha-methyltestosterone is described. Eight healthy male subjects were administered orally a single 10-mg 17 alpha methyltestosterone tablet together with a 10-mg 17 alpha-methyltestosterone-d3 solution. The serum concentrations of 17 alpha-methyltestosterone and 17 alpha methyltestosterone-d3 were determined by gas chromatography-mass spectrometry with selected ion monitoring using 17 alpha-methyltestosterone-d6 as an internal standard. The extent of absorption from the tablet formulation was comparable to that from the oral solution. The stable-isotope methodology was compared with the conventional cross-over method for evaluating the bioavailability of 17 alpha methyltestosterone. PMID- 3958926 TI - Hydrophilic cyclodextrin derivatives enable effective oral administration of steroidal hormones. AB - Condensation products of beta-cyclodextrin with propylene oxide or epichlorohydrin, which are amorphous and thus very soluble in water, were used to form complexes with testosterone, progesterone, and estradiol. Sublingual/buccal administration of tablets of these complexes led to effective absorption and entry of the hormones into the systemic circulation, followed by gradual elimination; rapid first-pass loss was avoided. beta-Cyclodextrin itself, its 2,6 dimethyl derivative, and a nonionic detergent did not enable effective buccal absorption. Absorption from the GI tract of hormones complexed with hydrophilic cyclodextrins was also less effective. Effective absorption of drugs from the oral cavity requires (a) that the drug and solubilizer form a complex of the inclusion type which dissolves completely and rapidly and (b) that the solubilizer neither enters nor damages oral tissue. PMID- 3958927 TI - An isolated perfused rat lung preparation for the study of aerosolized drug deposition and absorption. AB - The isolated, perfused rat lung preparation was modified to allow characterized solid aerosol delivery. Deposition and airway-to-perfusate transfer of disodium fluorescein from 3-4 micron dae solid aerosols were studied under different ventilatory regimes. The lungs inhaled from an aerosol stream of constant concentration via a tracheal cannula. Air displacement from a sealed artificial thorax housing the lungs provided the driving force for inhalation. The lungs were suspended in a physiologically normal position and both left and right sides of the heart were cannulated for constant rate perfusate flow. Fractional deposition was inversely proportional to respiratory frequency implying that sedimentation was the primary deposition mechanism. Increasing tidal volumes similarly enhanced the ratio of amount deposited/amount administered. Fluorescein transfer to the perfusate occurred from the lung regions containing intact vasculature, was apparent first-order, and independent of perfusate flow. The average rate constant for transfer was 0.057 +/- 0.02 min-1 (t1/2 = 12.2 +/- 4.2 min-1). The ratio of transferable amount/amount deposited appeared to indicate the depth of aerosol penetration. This increased at high respiratory frequency and tidal volume, while decreasing with increasing aerosol particle size. Potential applications of the model are discussed in the light of these results. PMID- 3958928 TI - In vitro bioactivity of a synthesized prostaglandin E1-heparin conjugate. AB - A covalently bound conjugate of commercial grade heparin and prostaglandin E1 (PGE1) was synthesized to provide the dual pharmacological role of decreasing the extent of platelet aggregation and inhibiting fibrin formation during thrombogenesis. The compound was synthesized using a modified mixed carbonic anhydride method of amide bond formation between the carboxylic acid moiety of PGE1 and a primary amine group on heparin. Quantitation of coupling was measured spectrophotometrically by monitoring a degradation product of the prostaglandin E1-heparin conjugate (prostaglandin B1-heparin conjugate). Bioactivity tests on the conjugates (activated partial thromboplastin time and platelet aggregation) confirmed that both the anticoagulant activity of heparin and the inhibitory effect of PGE1 on platelet aggregation were maintained. PMID- 3958929 TI - Evaluation of penetration enhancement of lidocaine by nonionic surfactants through hairless mouse skin in vitro. AB - The effect of two nonionic surfactants (polyoxyethylene sorbitan monoesters) on percutaneous absorption of lidocaine in the presence of various concentrations of propylene glycol is reported. Comparisons were made in vitro using excised hairless mouse skin as the barrier membrane. Under infinite dose conditions, steady-state flux was enhanced by surfactants at high propylene glycol concentrations. The same trend was observed following application of a thin layer of formulation to the skin (finite-dose conditions). However, penetration behavior was complex due to: (a) changes in vehicle composition following application, (b) temperature changes resulting from evaporation or moisture uptake, and (c) depletion of lidocaine as a result of penetration with compositions that lost water by evaporation. Two peaks in the flux versus time curve were observed. Surfactant monomer concentration in the vehicles was increased in the presence of propylene glycol. PMID- 3958930 TI - Effects of solvent polarity on the acid dissociation constants of benzoic acids. AB - The pKa values of benzoic acid, p-methylbenzoic, and p-aminobenzoic acid (PABA) were determined by potentiometric titration in mixtures of 0-0.5 volume fractions of various cosolvents and water. The differences between the aqueous and semiaqueous pKa values were similar for the three solutes at a particular cosolvent-water mixture for most of the cosolvents studied. The largest differences occurred in the dimethyl sulfoxide (Me2SO)-water system, where the pKa changes were larger for PABA than the other two solutes. The data are analyzed by a consideration of both electrostatic and nonelectrostatic medium effects. The electrostatic medium effect was calculated from the Born Equation while any residual pKa change was attributed to nonelectrostatic medium effects. The residual effects were found to correlate well with indexes of solvent hydrogen bond acceptor ability such as HBA and beta-values. These results provide a rationale for the use of two solvent polarity indexes for more accurate estimates of pKa values of weak electrolytes in semiaqueous solvent systems. Analysis of solubility data of the salt and acid forms of PABA and benzoic acid in ethanol-water and Me2SO-water mixtures suggests that the higher activity of the anionic form of PABA in Me2SO-water mixtures is primarily responsible for the large pKa changes observed for that solute. PMID- 3958931 TI - Surface electric charge of the active and inactive polymorphs of chloramphenicol palmitate. AB - Higher zeta-potential values were found for the crystalline particles of polymorph A when compared with polymorph B of chloramphenicol palmitate when measured at identical conditions. In the case of the thermomicroscopically prepared crystal sample being a mixture of the polymorphs, the resulting zeta potential was higher than that measured for pure form B and lower than that found for form A. It has been assumed that the zeta potential reflects differences in the surface properties of the polymorphs. These differences are briefly discussed from the point of view of the adsorption of the charge-generating ions as well as of the marked differences in bioactivity reported for the polymorphs. PMID- 3958932 TI - Albumin-induced changes of fluorescence spectra of 1-pyrenebutyric acid. AB - Changes in the fluorescence spectra and quantum yield of 1-pyrenebutyric acid (1) induced by human, bovine, rabbit, and dog serum albumins and healthy adult serum, liver-disease patient serum, and renal-disease patient serum were compared at pH 7.4. Human serum albumin, healthy adult serum, and liver-disease patient serum caused marked quenching of the fluorescence of 1-pyrenebutyric acid. On the contrary, bovine, rabbit, and dog serum albumins increased the fluorescence intensity. Renal-disease patient serum also enhanced the intensity but caused quenching of the fluorescence after treatment with charcoal. Thus, 1 pyrenebutyric acid clearly shows interspecies differences in the environment or the structure of the binding site on serum albumin between humans and other animals. Furthermore, it is suggested that some substance which influences the character of the binding site for 1-pyrenebutyric acid exists in the serum of renal-disease patients. PMID- 3958934 TI - Hydrolysis of nicotinyl 6-aminonicotinate. AB - The degradation kinetics of nicotinyl 6-aminonicotinate in aqueous buffer solutions were studied over the pH range from 4.0 to 10.0. In all cases, pseudo first-order kinetics were observed at constant hydronium ion concentration. The pH-rate profile indicated that the hydrolysis of nicotinyl 6-aminonicotinate may be described by at least two catalytic terms. In alkaline solution the hydrolysis is catalyzed primarily by hydroxyl ions. In acidic solution the hydrolysis may be attributed to either the water-catalyzed reaction of the protonated species or the hydronium ion catalyzed reaction of the free base. The resulting catalytic profile afforded a sharp pH minimum of approximately 5.90 at 65 degrees C. An activation energy of 16 Kcal/mol was obtained in a phosphate buffer solution at a pH of approximately 5.90 +/- 0.2. The first- and second-order reaction constants for water and hydroxyl ion catalysis were determined, and the temperature dependency of the reaction was studied. The buffer effect and solvent effect on the hydronium and hydroxyl ion catalysis was also investigated. PMID- 3958933 TI - The effect of enzymatic reaction on dissolution rate: theoretical analysis and experimental test. AB - The dissolution behavior of N-acetylphenylalanine ethyl ester (1) and N benzoyltyrosine ethyl ester (2) from a rotating disk into aqueous solutions containing the enzyme alpha-chymotrypsin was investigated. The effect of the bulk enzymatic reaction on the dissolution rates is modeled using the continuity equation where the reaction term is considered a constant throughout the reaction zone. Dimensional analysis on the continuity equation defines the important parameter R* = KcatE0h2/(CsD) which is the ratio of the diffusion time to the reaction time. This parameter correctly predicted the fact that the enzymatic reaction had only a slight impact on the dissolution of the highly soluble 1 while the effect on the less soluble 2 was large. Also predicted by R* is the dissolution dependence on the catalytic rate constant. The variation of this rate constant with pH is consistent with the dependence on pH found for the dissolution rate of 2. It is further demonstrated that the decrease in dissolution rate with solubility can be significantly reduced when the dissolving compound is an enzyme substrate. For the two compounds used in this study the dissolution rate decreased with the square root of solubility, as predicted by the theoretical analysis in the presence of enzyme. Other experiments included the variation of the enzyme concentration and the rotational speed of the spinning disk. All experiments were designed to show how R* could correctly predict the relative importance of the convective, diffusive, and reactive processes. PMID- 3958935 TI - Degradation kinetics and mechanism of N6-[(dimethylamino)methylene]mitomycin C in aqueous solutions. AB - The degradation of N6-[(dimethylamino)methylene]mitomycin C, a semisynthetic analogue of mitomycin C, was studied in aqueous solution. The compound degraded rapidly and followed pseudo-first-order kinetics in both acidic (pH less than 5) and basic pH greater than or equal to 9) media. In the near-neutral pH region, however, biphasic kinetics were observed. At the pH of maximum stability (6.5), 10% activity was lost after approximately 6 h at 22 degrees C. Citrate and phosphate species were catalytic at pH 6.5. Spectrophotometric and HPLC methods were used to elucidate the degradation mechanism at pH 7-9. Under these conditions, equilibrium addition of one water molecule into the amidine side chain occurred, followed by parallel formation of mitomycin C and N6 (formyl)mitomycin C. The latter compound subsequently hydrolyzed to mitomycin C. PMID- 3958936 TI - A novel column/buffer combination for chromatographic analysis of basic drugs in simulated gastrointestinal fluids. AB - In vitro dissolution testing of solid pharmaceutical dosage forms has become a routine aspect of data collection for new product submissions and quality control purposes. With increasing frequency, dissolution testing is performed in buffered media, including low pH simulated gastric fluid and/or alkaline pH simulated intestinal fluid. High-performance liquid chromatographic separation of multicomponent formulations is the most convenient method of quantitation for dissolution samples in such aqueous media; however, particularly in the analytical methodology of drugs containing basic moieties, the direct injection of dissolution media may cause spurious peaks, base line disturbances, and other manifestations of column disequilibration. Using a column packing consisting of 16% w/w alumina in unbonded silica and aqueous mobile phases buffered with monofluorophosphate ion, it is possible to achieve stability in a system exposed to injections differing from the mobile phase in pH and composition. PMID- 3958937 TI - Buccal and oral bioavailability of nalbuphine in rats. PMID- 3958938 TI - Kaposi's sarcoma. A report of two cases and literature review. PMID- 3958939 TI - Histopathology of squamous cell carcinoma. PMID- 3958940 TI - Bowen's disease. PMID- 3958941 TI - Radiodermatitis. A result of therapeutic irradiation of verrucae. PMID- 3958942 TI - Hansen's disease with pedal involvement. A case report. PMID- 3958943 TI - Cavernous hemangioma of the plantar forefoot. A literature review and case report. PMID- 3958944 TI - Morphologic and immunologic implications of pedal cutaneous aspergillosis. PMID- 3958945 TI - Comparison of intraocular acetylcholine and carbachol. AB - Commercially available 1% acetylcholine chloride and 0.01% carbachol chloride, which are commonly used as miotics in intraocular surgery, have recently been reformulated. Comparative studies of these agents show similar miotic activity. However, in vitro perfusion of human corneas demonstrated that 1% acetylcholine chloride causes marked changes in endothelial function and ultrastructure as compared to carbachol or BSS Plus. This study showed that 0.01% carbachol chloride was less toxic to the corneal endothelium than 1% acetylcholine chloride and suggests that 1% acetylcholine should not be used in corneas with compromised endothelium as in primary corneal endotheliopathies. PMID- 3958946 TI - Lens epithelial inhibition by PMMA optic: implications for lens design. AB - It has been a clinical impression that posterior chamber lens implants in some way inhibit opacification of the posterior lens capsule after extracapsular cataract extraction. The mechanism of this inhibition is unclear; it may be related to mechanical contact or blockage of migration of lens epithelial cells, or possibly to the leeching of toxic factors from the lens itself. A better understanding of the exact mechanism of opacification inhibition may have important clinical implications for intraocular lens design. For example, some lens designs that facilitate Nd:YAG capsulotomy by physically separating the posterior chamber lens and the posterior capsule may result in less inhibition and in fact more opacification of posterior capsules. We performed in vitro tissue culture studies of the effect of the polymethylmethacrylate (PMMA) optic of a planoconvex intraocular lens on cultured rabbit lens epithelium. These studies demonstrated both inhibition of lens epithelial migration beneath the PMMA optic (plano side down) as well as metaplasia and necrosis of lens cells growing directly beneath the optic. The clinical implications of these studies for intraocular lens design are discussed. PMID- 3958947 TI - Excimer laser surgery of the cornea: qualitative and quantitative aspects of photoablation according to the energy density. AB - Using an excimer laser working in the far ultraviolet and cutting fresh corneas of human cadaver eyes, we were able to demonstrate that there is an ideal fluence (joule/cm2/pulse) that allows a maximum tissue ablation depth per shot. Above the threshold of 1 J/cm2/pulse the depth of tissue ablated does not increase and both thermal and mechanical damage appears at the cut edges. PMID- 3958949 TI - Early experience with STAAR silicone elastic lens implants. AB - Silicone elastic intraocular lens implants (STAAR Model B) were implanted in 18 human eyes following extracapsular cataract extraction by phacoemulsification. Visual acuity of 20/40 or better was obtained in 17 eyes which had no preexisting pathology. Implants decentered and tilted in five of six eyes in which implants were placed in the bag. This was the only significant complication observed and is prevented by avoiding in-the-bag placement of the implant. PMID- 3958948 TI - Potential acuity meter to predict postoperative visual acuity. AB - Thirty-three eyes were examined with the potential acuity meter (PAM) to determine preoperatively the expected visual acuity for patients undergoing cataract surgery. The preoperative visual acuity was compared to the best postoperative visual acuity. Although several patients had moderate macular degeneration as well as cataracts, there was an overall accuracy to within two lines of the best visual acuity in 96% of patients. There was a tendency to underestimate rather than overestimate postoperative visual acuity when these readings were in error. The instrument was only used if the cataract examined had some clarity. Older patients who were unsteady had difficulty performing the test. PMID- 3958950 TI - Posterior chamber intraocular lens implantation in ethnic minorities by resident housestaff. AB - The first 45 cases of extracapsular cataract extraction, with posterior chamber intraocular lens implantation performed by ophthalmology residents at an urban county hospital were evaluated. These cases, which were performed from March 1983 to June 1984, involved a patient population that was primarily black and Hispanic (88.8%). Over half the cases represent the first five cataract implant surgeries performed by five resident surgeons in their second and third year of residency. Twenty-eight of the 45 cases (62%) were available for examination six months postoperatively. Excluding two cases with decreased vision secondary to preexisting ocular disease, 100% of these patients achieved a best corrected visual acuity of 20/40 or better. PMID- 3958951 TI - Extracapsular cataract extraction and primary posterior chamber lens implantation. AB - We reviewed the charts of 420 consecutive extracapsular cataract extraction cases in which the surgeon's primary intention was to implant a posterior chamber lens. Posterior chamber lens implantation was precluded in eight cases (1.9%) because of vitreous loss or capsule dehiscence. A visual acuity of 20/40 or better was achieved by 83.8% of patients. When nonoperative causes of poor vision were eliminated, this result was achieved by 96.7% of patients. The percentage of patients achieving 20/40 or better acuity decreased with increasing age but remained constant despite varying follow-up periods. The most common complication was opacification of the posterior capsule, occurring in 25.7%; 83.8% of the complications occurred during the first two postoperative years. We conclude that extracapsular cataract extraction with primary posterior chamber lens implantation is an efficient way to restore good vision after cataract formation and that the results appear to remain stable over time. PMID- 3958952 TI - A prospective comparison of Amvisc and Healon in cataract surgery. AB - A prospective, randomly assigned, double-masked study was designed to compare two solutions of sodium hyaluronate--Amvisc and Healon. All cases were planned extracapsular cataract extractions with posterior chamber intraocular lenses performed by a single surgeon in glaucomatous and nonglaucomatous eyes. Subjective performance of the products were rated in regard to ability to maintain the chamber, coat the intraocular lens, dilate the pupil, separate the leaves of the capsule, and be easily removed. Objective comparisons of intraocular pressure, anterior chamber reaction, and endothelial cell loss were also made. There was no subjective or objective difference between the two products. PMID- 3958953 TI - Correction of posterior chamber lens malposition. PMID- 3958955 TI - Using a Sinskey hook for nucleus removal. PMID- 3958954 TI - Side effect of microscope drape. PMID- 3958956 TI - Combined intraocular lens and strabismus surgery. AB - Ten cases of combined strabismus surgery and intraocular lens implantation were reviewed to determine if there were increased risks and complications. A review of these cases revealed the contrary was true; i.e., there were no complications arising from the combined surgery and there were benefits in the decreased hospitalization and operative time, less mental trauma, and improved muscle surgical outcome. From these results, we conclude that combined intraocular lens and strabismus surgery is efficacious and indicated in patients with strabismus and cataracts or aphakia. PMID- 3958957 TI - Sodium hyaluronate vitrectomy. AB - In a series of 34 vitrectomies performed over more than three years, sodium hyaluronate was used in a new vitrectomy technique that facilitated the removal of vitreous. Sodium hyaluronate simplified the procedure, eliminated the use of any special surgical instrument, and prevented trauma to the vitreous cavity. No severe postoperative complications developed, and 65% of the patients attained a visual acuity of 20/20 to 20/30. PMID- 3958958 TI - Management of acute postoperative intraocular pressure elevation by laser-induced filtration. AB - We describe a simple, rapid technique for creating a filtering bleb in the early postoperative period using the argon or Nd:YAG laser. After cutting a suture, an immediate reduction of the intraocular pressure will result as filtration occurs, thereby safely eliminating the need for and the risk of traditional surgery. PMID- 3958959 TI - The double implant: alternative management for intraocular lens dislocation. AB - We describe a new management of posterior dislocation of an intraocular lens implant into the vitreous by means of focal retinal photocoagulation and implantation of a secondary anterior chamber lens to correct subsequent aphakia. PMID- 3958960 TI - Effects of SQ 26,533 on reperfusion arrhythmias, ST-segment elevation and on infarct size in anesthetized dogs. AB - The antiarrhythmic, antifibrillatory activities and the ability of SQ 26,533 to reduce infarct size were investigated in the canine models of reperfusion arrhythmias. In model 1, halothane-anesthetized dogs were subjected to acute occlusion of left circumflex coronary artery (LCX) for 30 min followed by reperfusion. SQ 26,533 infused at 50 micrograms/kg/min for 45 min significantly reduced (78%) the incidence of ventricular ectopic beats during the 30-min ligation of LCX. In addition, four of seven dogs (57%) survived after reperfusion, in contrast to 100% mortality observed in untreated animals. In model 2, left anterior descending artery under pentobarbital anesthesia was occluded for 20 min and released. SQ 26,533 (2.5 mg/kg i.v.) given 1 hr before occlusion significantly reduced (81%) ventricular ectopic beats during acute occlusion and four of five animals (80%) survived left anterior descending artery reperfusion, unlike saline controls (100% mortality). Similar efficacy was seen in a feline model of reperfusion arrhythmias. The model 3 animals under pentobarbital anesthesia were occluded for 60 min followed by reperfusion of the LCX in the presence of critical stenosis. SQ 26,533 (2.5 mg/kg every 90 min) given 50 min after LCX occlusion not only resulted in a significant reduction (91%) of postreperfusion ventricular ectopic beats for the entire 5-hr observation period but also significantly reduced (42%) the infarct size at 24 hr. Antiarrhythmic doses of SQ 26,533 caused minimal hemodynamic changes, except for a marked decrease in heart rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958961 TI - Characteristics of tolerance, recovery from tolerance and cross-tolerance for cocaine used as a discriminative stimulus. AB - Rats were trained to discriminate an injection of cocaine (10 mg/kg) from saline using a two-lever choice procedure with food as a reinforcer. Subsequently, training was stopped, and cocaine was injected chronically. In one experiment, 10.0 or 20.0 mg/kg/8 hr 8 hr of cocaine for 7 days produced a 2-fold shift to the right of the discriminative stimulus dose-effect curve. A dose of 5.0 mg/kg/8 hr for up to 14 days did not shift the dose-effect curve. In a second experiment, 20 mg/kg/8 hr for 7 or 14 days produced comparable degrees of tolerance. In a third experiment, after termination of 12 days of chronic cocaine injection (20 mg/kg/8 hr), base-line sensitivity to the training stimulus recovered progressively across 18 days. Additional experiments tested the effects of chronic administration of drugs that were substituted (d-amphetamine) or were not substituted (morphine) for the training stimulus. d-Amphetamine (2.5 mg/kg/8 hr for 7 days) produced a 4-fold shift to the right of the dose-effect curve for the detection of both d-amphetamine and cocaine; in contrast, 7 days of escalating morphine doses produced signs of physical dependence but did not alter the sensitivity of rats to the cocaine training stimulus. These results provide evidence that tolerance for cocaine used as a discriminative stimulus occurs as a function of chronic dose, dosing regimen and class of drug administered. PMID- 3958962 TI - Pharmacokinetics and pharmacodynamics of subcutaneous naltrexone pellets in the rat. AB - Subcutaneous implantation of naltrexone pellets is a standard method of producing chronic blockade of opioid receptors. In the present experiments, rats were treated with two, 30-mg naltrexone pellets and the pharmacokinetics and pharmacodynamics examined. This dosing method produced high plasma naltrexone levels (350 ng/ml) by 1 hr which declined over an implant period of 192 hr (24 ng/ml). Approximately 40% of the systemically available naltrexone (15.6 mg) was released in the first 24 hr. A total of 39.8 mg was released over the 192-hr implantation period. At 192 hr after implantation, naltrexone produced a greater than 50-fold shift to the right in the dose-response curve for morphine analgesia relative to placebo-implanted controls. When naltrexone pellets were removed at 192 hr after implantation, morphine analgesia (10 mg/kg) returned with a time course that was inversely related to the elimination of naltrexone. Pharmacokinetic analysis indicated that naltrexone has a terminal elimination half-life of 4.6 hr. Probit analysis revealed a linear plasma level-response relationship for naltrexone antagonism of morphine analgesia with a plasma ED50 of 2.1 ng/ml when plasma morphine levels average 1126 ng/ml. In the rat, s.c. naltrexone pellets are a dosage form that provides a rapid release of systemic drug. The systemic availability of naltrexone continues for at least 192 hr after implantation. The high potency of naltrexone permits continued antagonism of morphine even when the systemic availability of naltrexone from the pellets has greatly diminished. PMID- 3958963 TI - Cholecystokinin octapeptides alter the release of endogenous dopamine from the rat nucleus accumbens in vitro. AB - Sulfated cholecystokinin octapeptide (CCK-8S) has been reported to be extensively colocalized with dopamine in the posterior, but not the anterior, portion of the nucleus accumbens (NAc). The hypothesis tested in the present study was that CCK 8S alters the release of dopamine in this structure and the actions it produces are dependent on the extent of colocalization with dopamine. We observed in vitro that CCK-8S enhanced the resting release of dopamine from the posterior, but not anterior, NAc. It was also found that CCK-8S attenuated the release of dopamine induced by potassium-evoked depolarization in both regions of the NAc, although the concentration-release curves for the two areas differed. In the posterior NAc, a biphasic response was seen whereas, in the anterior NAc, there was a monophasic attenuation. Proglumide, a putative CCK-8S antagonist, was found to antagonize the action of a low concentration of CCK-8S on 40 mM K+-induced dopamine release from slices of the posterior, but not anterior, NAc. Unsulfated CCK-8 had mixed action on K+-evoked dopamine release, as it enhanced this form of release in the posterior NAc but attenuated it in the anterior NAc. Additionally, we found no effect of sulpiride on the actions of CCK-8S with respect to evoked release, suggesting that CCK-8S is not acting to alter dopamine autoreceptor function, as has recently been hypothesized. In summary, our results demonstrate that the observed effects of CCK-8S on dopamine release are dependent upon the region of the NAc studied, and there appear to be different subtypes of CCK-8S receptors present in the two regions. PMID- 3958964 TI - Parasympathetic stimulation as a mechanism for platelet-activating factor-induced contractile responses in the lung. AB - Platelet-activating factor (PAF) contracts isolated parenchymal tissues from guinea-pig lung at nanomolar concentrations. Previous studies indicate that, although significant quantities of thromboxane A2 are released from lung tissues stimulated with PAF, inhibition of thromboxane synthesis does not significantly diminish the in vitro spasmogenic response. In contrast, treatment of the tissues with the specific neurotoxin tetrodotoxin or with atropine results in significant inhibition of PAF-induced contractions. Contractile responses to the other lipid spasmogens leukotrienes C4 and D4 and prostaglandin F2 alpha and the stable thromboxane A2 analog U-46619 or histamine are not altered by these drugs. In the presence of physostigmine, an acetylcholinesterase inhibitor, the PAF-induced contractions of lung strips were modestly enhanced, consistent with release of endogenous acetylcholine. The rate of degradation of PAF in lung tissue was not altered by physostigmine. Lack of inhibition by the preganglionic blocking agent hexamethonium localizes the site of PAF action to a point at or distal to the parasympathetic ganglion but proximal to the neuromuscular junction. Thus PAF, or a metabolite thereof, acts presynaptically on cholinergic neurons in lung tissues to effect smooth muscle contraction, and this phospholipid may constitute a link between the immunologic humoral and autonomic pathways that lead to bronchoconstriction. PMID- 3958965 TI - A low molecular weight lead-binding protein in brain attenuates lead inhibition of delta-aminolevulinic acid dehydratase: comparison with a renal lead-binding protein. AB - A low molecular weight high-affinity lead-binding protein (PbBP) in kidney appears to account, at least in part, for the relative insensitivity of renal delta-aminolevulinic acid dehydratase (ALAD) to Pb inhibition. A PbBP is also known to exist in brain cytosol but is not a major Pb-binding constituent in liver. This study was undertaken to examine the relative sensitivity of brain and liver ALAD to Pb inhibition in vitro and to determine if inhibition of hepatic ALAD by Pb could be reversed by addition of partially purified brain PbBP to liver cytosol. This effect was also compared with that of a previously described renal PbBP. Finally, the mechanism(s) of reversal of Pb inhibition of ALAD by these tissue-specific PbBPs were studied. A concentration-dependent reversal of Pb-induced inhibition of hepatic ALAD activity was observed for both brain and kidney PbBPs. Inhibition of hepatic ALAD activity by 0.1 to 1.6 microM Pb was partially reversed by a single concentration of brain PbBP. No differences in sensitivity of ALAD to Pb inhibition in various brain regions were observed. Kinetic analysis of both brain and liver ALAD activity at an IC50 Pb showed a "mixed" or noncompetitive inhibition pattern. Addition of brain PbBP reduced markedly the inhibitory effects of Pb on the Vmax of the liver enzyme. Incubation of 65Zn-labeled PbBP fractions from brain and kidney with purified bovine liver ALAD demonstrated that the PbBPs donate Zn to ALAD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958967 TI - Effect of nialamide on the metabolism of dopamine injected into the nucleus accumbens of old rats. AB - We have reported previously that after nialamide pretreatment there is an age related difference in the stimulation of locomotor activity produced by the injection of dopamine bilaterally into the nucleus accumbens. Thus, the stimulation of locomotor activity produced by dopamine in old rats was significantly less than that of young and mature rats. The purpose of the present study was to determine whether nialamide was an effective inhibitor of the metabolism of dopamine after dopamine was injected into the nucleus accumbens of old rats. When we measured the concentration of injected dopamine in the limbic forebrain (nucleus accumbens and olfactory tubercle) of young (6 months), mature (15 months) and old (26 months) rats pretreated with nialamide, the amount of dopamine that was present was significantly less in old rats than in young or mature rats. Consistent with this observation, the concentrations of the dopamine metabolites, homovanillic acid and dihydroxyphenylacetic acid were higher in nialamide-pretreated old rats than in young and mature rats, suggesting that there was a smaller inhibition of the metabolism of dopamine in the limbic forebrain of old rats after nialamide pretreatment. In support of this hypothesis, nialamide (25-100 mg/kg i.p.), which inhibited monoamine oxidase activity in limbic forebrain homogenates of old, mature and young rats, was a less effective inhibitor of this enzyme in the old rats. These results suggest that the reduced locomotor activity response of old rats to the intra-accumbens injections of dopamine after nialamide pretreatment may be due to the reduced ability of nialamide to inhibit monoamine oxidase (and dopamine metabolism) in these animals. PMID- 3958966 TI - Comparative electropharmacology of mexiletine, lidocaine and quinidine in a canine Purkinje fiber model. AB - Although said to be lidocaine-like, there is evidence that mexiletine has some properties similar to those of quinidine. To evaluate the relationship between the effects of these three drugs we analyzed their effects on action potentials of Purkinje fibers from canine false tendons. Experiments with each drug were done on single preparations from each of six dogs over the concentration range 0.31 to 10.0 X 10(-5) M. Lidocaine shortened action potential duration and effective refractory period with a log concentration-response relationship. The maximum velocity of phase "0" (Vmax) was unaffected at low concentrations and only slightly depressed at high concentrations. Quinidine also shortened action potential duration and effective refractory period but the effect levelled off at midrange and was reversed at higher concentrations. Quinidine depressed Vmax throughout the concentration range studied. Mexiletine shortened action potential duration with a log concentration response relationship. Effective refractory period was shortened at low concentrations but the effect levelled off and then reversed at higher concentrations of the drug. Mexiletine had no effect on Vmax at the lower end of the concentration curve but did suppress this parameter at higher concentrations. Mexiletine resembled lidocaine in its effect on Vmax and action potential duration whereas the effects of quinidine on these two parameters were distinct. On the other hand, the effects of mexiletine on effective refractory period were more akin to quinidine than lidocaine. PMID- 3958968 TI - Ethanol inhibition of codeine and morphine metabolism in isolated rat hepatocytes. AB - Suspensions of isolated hepatocytes from male Wistar rats were prepared according to a two step Ca++-free collagenase perfusion method. Codeine, morphine or norcodeine were incubated with hepatocytes at 37 degrees C for up to 90 min in the absence and presence of ethanol. The elimination rate constant (Kel) of codeine and morphine was reduced with approximately one-third and one-fourth, respectively, in the presence of 60 mM ethanol, whereas the presence of ethanol did not alter the Kel of norcodeine significantly. The inhibition of codeine metabolism was dose-dependent, extending from approximately 15% at 10 mM ethanol to 40 to 50% at 100 mM. A 3-fold increase in the ratio of morphine concentration (formed from codeine) to the amount of codeine metabolized was observed in the presence of ethanol as compared to control cells. The mean morphine concentration was 170% higher in the ethanol-treated suspensions than in the controls. The ratio of norcodeine concentration to codeine metabolized was unchanged. The inhibition of morphine metabolism was accompanied by a similar reduction of morphine-3-glucuronide formation. The accumulation of morphine observed in the cell medium in the presence of ethanol might be due to inhibition of other metabolic pathways from codeine, thus shunting to morphine formation, combined with the inhibitory effect of ethanol on morphine metabolism per se. PMID- 3958969 TI - Effects of hydralazine on streptozotocin-induced diabetic rats: prevention of hyperlipidemia and improvement in cardiac function. AB - The effects of hydralazine on blood lipids, systolic pressure and cardiac performance were assessed in male Wistar rats, 6 weeks after they were made diabetic with streptozotocin (STZ). STZ-induced diabetes results in a loss of body weight, hyperglycemia and hypoinsulinemia. These effects are not altered after hydralazine treatment. STZ-diabetes also produced a significant bradycardia, elevation of blood pressure, hyperlipidemia and decreases in the levels of triiodothyronine and thyroxine. Hydralazine treatment successfully prevented all these alterations. In addition, cardiac performance was depressed in the untreated diabetic animals, but the cardiac performance of the hydralazine treated diabetic animals showed a definite improvement. Thus, hydralazine controlled the high serum lipids and blood pressure and improved cardiac performance in STZ diabetic rats. PMID- 3958970 TI - A comparative study of the induction of epidermal hyperplasia by natural and synthetic retinoids. AB - Retinoids are potent inducers of epidermal hyperplasia. In the present study the ability to induce epidermal hyperplasia by a variety of retinoids has been compared. Thirteen retinoids and beta-carotene were applied topically in an acetone vehicle to the dorsal skin of hairless mice and the dose-response and time course for the induction of hyperplasia were measured. Peak hyperplasia occurred 4 to 5 days after a single topical dose, and was induced by doses well below those producing gross or histological signs of cutaneous toxicity. The induction of hyperplasia was dose-dependent, the number of epidermal cell layers increasing initially in proportion to the log of the dose and then tending to plateau or, in some cases decrease, after which further increases in dose were associated with the appearance of gross and histological toxicity. The slopes of the initial increasing phase were determined and potencies expressed as the dose producing a 50% increase in the number of epidermal cell layers. All-trans retinoic acid and its analogs, etretinate and its free acid, (E)-4[2-(5,6,7,8 tetrahydro-5,5,8,8-tetramethyl- 2-naphthalenyl)-1-propenyl]-benzoic acid (arotinoid) derivatives, retinol and retinal produced an increase in the number of cell layers proportionate to the log of the dose. Decarboxylated (E)-4[2 (5,6,7,8-tetrahydro-5,5,8,8- -tetramethyl-2-naphthalenyl-1-propenyl]-benzoic acid, a cis-locked aryl triene derivative of retinoic acid and beta-carotene were inactive. Similar time courses were observed when retinoids were dosed p.o. The relative potencies of the retinoids in this system show similar trends to those reported for biological activities measured in other in vivo and in vitro assays. PMID- 3958971 TI - Effects of cysteine pro-drugs on acetaminophen-induced hepatotoxicity. AB - The effects of three cysteine pro-drugs on the hepatotoxicity and biotransformation of acetaminophen were examined to evaluate the factors responsible for antidotal effectiveness. N-Acetyl-L-cysteine, L-2-oxothiazolidine 4-carboxylate or the L- or D-isomers of 2-methylthiazolidine-4-carboxylate were administered to male mice immediately after a hepatotoxic dosage of acetaminophen (5.0 mmol/kg). In general the antidotal efficacies and potencies of the L cysteine pro-drugs were similar; 5.0 mmol/kg prevented hepatotoxicity whereas moderate and no protection were observed after 1.65 and 0.55 mmol/kg, respectively. In contrast, the D-isomer of 2-methylthiazolidine-4-carboxylate was ineffective at all dosages. Both L-2-oxothiazolidine-4-carboxylate and L-2 methylthiazolidine-4-carboxylate enhanced blood acetaminophen elimination (28-31% decrease in half-life) whereas N-acetyl-L-cysteine and D-2-methylthiazolidine-4 carboxylate did not. The L-cysteine pro-drugs increased the urinary excretion of the cysteine and mercapturic acid conjugates of acetaminophen (34-119%) but did not alter excretion of acetaminophen-glucuronide or acetaminophen-sulfate. The D cysteine pro-drug did not affect the urinary excretion of the acetaminophen metabolites examined. Biochemical analyses of the phase II pathway co-substrates, i.e., UDP-glucuronic acid, adenosine 3'-phospho-5'-phosphosulfate and glutathione, were performed on liver samples from mice treated with pro-drugs and/or acetaminophen. The pro-drugs exhibited their greatest effect on hepatic glutathione concentrations. Treatment with L-cysteine pro-drugs decreased the extent of depletion and/or increased the rate of repletion of hepatic glutathione levels after acetaminophen administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3958972 TI - In vivo actions of a calcium channel blocker (nimodipine) on the cerebrovascular response to infused 5-hydroxytryptamine. AB - Previous in vitro studies show that the calcium channel blocker, nimodipine, inhibits the cerebrovascular contraction elicited by 5-hydroxytryptamine (5-HT). The present study determined if this effect was present in vivo in the baboon cerebral circulation rendered sensitive to infused 5-HT by prior intracisternal injection of autologous blood. Five to seven days after injection of this blood the five baboon displayed a vasoconstrictor response to intracarotid 5-HT at 10 micrograms/kg/min (cerebrovascular resistance increased from 2.19 +/- 0.16 to 2.75 +/- 0.30 mm Hg/ml X min-1). Subsequent i.v. infusion of nimodipine produced cerebral vasodilation with an efficacy similar to that in normal baboons. Reinfusion of 5-HT during nimodipine infusion caused a cerebrovascular resistance increase of similar magnitude to that in the prenimodipine test. These results suggest that nimodipine produces cerebral vasodilation after a mild cerebrovascular insult but did not significantly reduce the vasoconstrictor response to 5-HT. PMID- 3958973 TI - Antinociceptive activity of salmon calcitonin injected intraventricularly in mice: modulation of morphine antinociception. AB - Salmon calcitonin (sCT) was tested i.v.t. for its ability to produce antinociception in mice as quantitated by the tail-flick, hot-plate and p phenylquinone (PPQ) writhing tests. sCT from two sources, Bachem (Torrance, CA) and Armour Pharmaceutical Co. (Chicago, IL), was shown to have naloxone reversible antinociceptive activity in the tail-flick and hot-plate tests. However, the sCT analgesic activity in the PPQ test was only partially naloxone reversible. sCT produced a naloxone reversible potentiation of doses of morphine that had low analgesic activity, but sCT failed to potentiate higher doses of morphine in the tail-flick test. sCT has a similar biphasic effect on morphine in the PPQ test in that low doses of morphine were selectively potentiated. However, the potentiation in the PPQ test was not naloxone reversible. sCT was shown not to be cross-tolerant to morphine in the PPQ test. Thus, sCT appears to produce its antinociceptive effects via interaction with both opiate and nonopiate mechanisms. PMID- 3958974 TI - Modification of morphine tolerance by behavioral variables. AB - These experiments assessed whether the opportunity to perform a target operant in the presence of morphine would alter the development of behavioral tolerance. Morphine tolerance was assessed in rats responding under a fixed-ratio 30 schedule of food delivery. Separate groups of rats were administered 10 mg/kg of morphine either pre- or postsession for 9 weeks. The degree of drug tolerance was assessed by determining cumulative dose-response functions for morphine before, during and after chronic administration. Three to 4-fold tolerance to the rate decreasing effects of morphine developed in rats receiving morphine presession, whereas no tolerance developed in rats receiving an equal dose of morphine postsession. Morphine sensitivity returned to initial values 4 weeks after termination of chronic administration. Eight weeks after termination of chronic administration, the drug-daily session relationship was reversed and the rats were re-exposed to 10 mg/kg of morphine for 9 additional weeks. There were fewer differences between groups receiving morphine pre- or postsession during this second chronic administration phase. During chronic administration of morphine, the dose of naloxone required to suppress response rates decreased 100-fold in rats receiving morphine presession, but only 10-fold in rats receiving morphine postsession. In contrast, chronic administration of morphine did not alter the rate-decreasing effects of the nonopioids d-amphetamine, ketamine or pentobarbital. These experiments suggest that reinforcement of an operant response in the presence of morphine promoted the development of pharmacologically specific behavioral tolerance to morphine. PMID- 3958975 TI - Endothelium-dependent gender differences in the response of the rat pulmonary artery to the thromboxane mimic (U46619). AB - The pulmonary arteries of rats were studied in order to determine the existence of sexual dimorphism. Gender differences, in the sensitivity (EC50) and maximum contractility (Tmax) of ring preparations of the main pulmonary arteries of adult male and female rats, were evaluated with the synthetic endoperoxide analog [(15S)]-hydroxy-11 alpha,9 alpha-(epoxymethano)-prosta-5Z, 13E-dienoic acid,] (U46619) and norepinephrine. There were no significant gender differences in the Tmax values obtained with either U46619 or norepinephrine. However, when the intimal surface of vessel segments from female rats was rubbed, U46619 but not norepinephrine elicited a significantly lower Tmax. In contrast, no change in Tmax was observed with denuded vessel segments from males. Removal of the endothelium did not significantly affect the EC50 of U46619 or norepinephrine in segments from either sex. The inhibitory effect of verapamil on the U46619 induced contractile response was studied on both intact and denuded vessels from rats of both gender. The Tmax of intact vessels from males but not females was significantly attenuated by verapamil (P less than .05). The EC50 values with verapamil were not significantly different in any of the vessel preparations. We suggest that the endothelium of the pulmonary artery of female rats significantly potentiates the contractile response to U46619 and attenuates the inhibitory effect of verapamil. PMID- 3958976 TI - The electrotonic location of low-resistance intercellular junctions between a pair of giant neurones in the snail Lymnaea. AB - The passive electrotonic properties of neurones VD1 and RPD2 in the brain of the snail Lymnaea can be represented by a soma-finite cable model with closed-circuit axon termination. There is a considerable individual variation in input resistance, membrane time constant, electrotonic length and axon-soma conductance ratio, but the average values for these parameters are similar in the two neurones. The cells are tightly coupled by an electrotonic synapse giving an average steady-state coupling coefficient of 0.68 and an average resistance measured between recording sites in the cell bodies of 20 M omega. Calculations using a model consisting of a symmetrical pair of cells with standard values for the electrotonic parameters show that in this system, for a soma-soma resistance of 20 M omega, the junction cannot be more than 0.16 length constants from the cell bodies. Reduction in coupling due to membrane current losses in such short proximal axon segments is insignificant. Intra-axonal recordings indicate that most of the coupling resistance is located at the junction between VD1 and RPD2, which must therefore be closer to the cell bodies than the limiting value of 0.16 length constants assuming an electrical equivalent model which includes the standard electrotonic parameters. If all the soma-soma resistance is located at the junction, then it could be physically a single array of gap-junction particles. Despite its low conductance (1/20 M omega = 50 nS) and possibly small physical dimensions, the electrotonic synapse is more than sufficient to ensure spike synchrony in the two cells. PMID- 3958977 TI - Effects of changes in excitability and intercellular coupling on synchronization in the rabbit sino-atrial node. AB - The mechanisms of synchronization between sino-atrial pace-maker cells were studied in biological preparations from rabbit hearts, and in computer simulations of the Hodgkin & Huxley type. For biological experiments, thin strips of sino-atrial node were placed in a three-compartment bath. The electrical properties of the tissue in the middle segment (the 'gap') were manipulated pharmacologically to alter electrical coupling and/or excitability of cells in that segment, and to study the patterns of interaction between two pace-maker centres in the external segments. Superfusion of the gap segment with either verapamil (2 microM) or acetylcholine (10 microM) produced a loss of 1:1 synchrony (entrainment) of spontaneous discharges generated by the external pace makers but subharmonic (i.e. 3:2; 5:4; 9:8; etc.) entrainment was always maintained. When the gap segment was superfused with heptanol (3.5 mM), which is known to increase intercellular resistance, the pace-maker centres in the external chambers beat independently of one another. Progressive loss of synchrony paralleled reductions in amplitude of electrotonic responses to current pulses applied across the gap. Gap superfusion with hypertonic Tyrode solution (600 mosM) produced a major reduction in the degree of synchronization between the external pace-makers, even though the cells in the central compartment maintained their excitability. Under these conditions, as many as three independent pace-maker centres, one in each chamber, coexisted in a given preparation. Using computerized simulations based on equations of time- and voltage-dependent membrane currents, three 'cells', each capable of maintaining spontaneous activity, were connected in a linear array through ohmic resistances. When selective parameters (e.g. membrane conductances, coupling resistance) were modified appropriately, the mathematical simulations reproduced very closely the interaction patterns observed in the experimental preparations. Our results show that synchronization in the sinus node results from mutual interactions and entrainment between all the cells in this region. These interactions are of the kind expected for a population of coupled, self-sustained oscillators, and are mediated through electrotonic propagation of current across low-resistance junctions. PMID- 3958978 TI - Cell membranes and paracellular resistances in isolated renal proximal tubules from rabbit and Ambystoma. AB - Transepithelial specific resistance (Re) was measured in isolated and perfused rabbit proximal convoluted tubules by cable analysis and intracellular micro electrode techniques were used to calculate the electrical resistances of the cell membranes and of the paracellular pathway. Re was 16 +/- 2 omega cm2 and the space constant was 130 +/- 14 micron, n = 29. Re was significantly increased by a decrease in temperature from 37 to 10 degrees C, and was practically abolished by nominal removal of Ca2+ from the bathing solution (to 2.0 +/- 0.3 omega cm2, P less than 0.001, n = 6). The apparent ratio of cell membrane resistances (luminal to basolateral) was 3.1 +/- 0.3. The control values of apical and basolateral membrane resistances (Ra and Rb) were calculated from the values of (1) Re, (2) the apparent ratio of cell membrane resistances, and (3) the effects of addition of either Ba2+ (1 mM) to the bath solution or glucose (8 mM) to the perfusate on basolateral and apical membrane voltages (assuming that the initial effects of Ba2+ and glucose are restricted to the ipsilateral membrane). Control values of Ra (omega cm2 of epithelium) were 249 +/- 68 (Ba2+ method) and 227 +/- 42 (glucose method). Values of Rb were 70 +/- 11; and 66 +/- 12 respectively. The low paracellular resistance values obtained with the Ba2+ and glucose methods, respectively, 17 +/- 5 and 15 +/- 1 omega cm2, explain the low transepithelial resistance. The use of the Ba2+ and glucose methods provides alternatives to cell cable determinations for the calculation of cell membrane resistances. Cell membrane and shunt resistances measured by the same methods in isolated perfused Ambystoma tigrinum proximal tubules (in omega cm2 of epithelium) were: Ra, 2650 +/- 180 (glucose method) and 2368 +/- 350 (Ba2+ method). Values of Rb were 665 +/ 99 (glucose method) and 701 +/- 124 (Ba2+ method). The paracellular resistance values were 58 +/- 11 (glucose method) and 84 +/- 12 (Ba2+ method). These results are in good agreement with previously reported values obtained by intracellular cable analysis (Maunsbach & Boulpaep, 1984). PMID- 3958979 TI - Blood pressure response evoked by ventral root afferent fibres in the cat. AB - Systemic arterial blood pressure changes in response to stimulation of the distal stump of the cut spinal ventral root were investigated in anaesthetized, vagotomized, and carotid sinus-denervated cats. Low intensity electrical stimulation (less than 20 T, where T is threshold intensity) of the ventral root caused a rise in blood pressure. This elevation was abolished by paralysing the muscles with gallamine. This pressor response has been reported previously, and it is likely to be evoked by afferents excited by the contracting muscle. High intensity electrical stimulation (500 T) of the ventral root caused a second and marked pressor response. This was not affected by muscular paralysis or by cutting the sciatic nerve, but it was abolished by cutting the dorsal root. Threshold intensity for the second component of the pressor response was within the same range as the intensity needed for activation of C fibres in the ventral root, ranging between 200 T and 300 T. This response was graded with increasing stimulus intensity, and it showed both spatial and temporal summation. From the above results, we conclude that non-myelinated fibres in feline spinal ventral root course distally to the dorsal root ganglion and then enter the spinal cord via the dorsal root. Activation of these fibres results in a marked elevation of the systemic arterial blood pressure as in other somato-sympathetic reflexes induced by peripheral C fibre activation. PMID- 3958980 TI - The hypothalamo-hypophyseal rat explant in vitro: endocrinological studies of the pars intermedia dopaminergic neural input. AB - Short-term in vitro incubation of hypothalamo-hypophyseal tissue from young rats was undertaken to discern more clearly the functional relationship between putative dopaminergic neural projections in the pars intermedia and the secretory activity of melanophore stimulating hormone (MSH). This explant consisted of a portion of the mediobasal hypothalamus containing the dopamine neurone cell bodies of interest, with the attached pituitary neuro-intermediate lobe (n.i.l.). The n.i.l. was inserted into the end of a 1 mm diameter tube attached to a perfusion pump which allowed uninterrupted sampling of medium neighbouring the n.i.l. A 'real-time' analysis of hormone secretion was obtained by immediately and continuously bioassaying for MSH. A bipolar stimulating electrode was placed on the ventral floor of the mediobasal hypothalamus either directly on the arcuate nucleus, median eminence or infundibular stalk. Electrical stimulation for 5 min (0.1-20.0 Hz) caused a transient inhibition of basal MSH secretion, while continuous stimulation (0.1-5.0 Hz) led to a much greater, long-term, reversible inhibition. In the latter, the degree of inhibition was generally dependent on stimulation rate up to a maximum at 5 Hz. Application of the dopamine D2 receptor antagonist, 1-sulpiride (0.001-0.1 microM) to the perfusion medium not only completely and reversibly blocked the stimulus-induced inhibition of MSH release but by itself, significantly increased the basal secretion rate. Applied to the isolated n.i.l., 1-sulpiride did not alter release but did prevent the inhibitory response caused by exogenously applied dopamine (0.1 microM). The gamma-aminobutyric acid receptor antagonist, bicuculline (0.01-1.0 microM), had no effect on any of the parameters studied. In explants, cutting the infundibular stalk linking the mediobasal hypothalamus with the n.i.l., mimicked the effects of 1-sulpiride by interrupting impulse flow to the gland. Thus, electrical stimulation of hypothalamic neurones in these explants apparently causes a release of dopamine from nerve terminals in the pars intermedia to inhibit MSH secretion and perhaps other pro-opiomelanocortin-derived peptides as well. PMID- 3958981 TI - The roles of paracellular and transcellular pathways and submucosal space in isotonic water absorption by rabbit ileum. AB - Water movements have been studied in sheets of isolated rabbit ileum using a method which measures net volume flows across the mucosal and serosal surfaces of the tissue continuously with high resolution. At 35 degrees C, with the tissues incubated in isotonic Ringer solution containing D-glucose (25 mM) on both sides, there is a steady net inflow of fluid at the rate of 24 +/- 2 microliter cm-2 h-1 across the mucosal surface (Jm) and an outflow of 8 +/- 1 microliter cm-2 h-1 across the serosal surface (Js) (n = 16). The stable transepithelial p.d. across these tissues is 2.7 +/- 0.2 mV, serosa positive. Jm can be reversibly inhibited by anoxia. Ouabain (0.1 mM) added to the serosal solution inhibits inflow across the mucosal and serosal surfaces by 75% (n = 7) within 30 min. If phlorizin (0.1 mM) is added to the mucosal Ringer solution containing glucose (20 mM) within 30 min of the commencement of in vitro absorption, Jm is reduced from 37 +/- 3 to 28 +/- 2 microliter cm-2 h-1 (n = 3). Dilution of the mucosal Ringer solution by 50 mosmol kg-1 (with the serosal solution kept isosmolar) results in a rapid transient increase in mucosal inflow. An increase of 50 mosmol kg-1 in the mucosal Ringer solution with NaCl, sucrose or mannitol causes a transient reversal of mucosal flow, followed by a return of inflow at a reduced level. Rabbit ileum can transport water against gradients of approximately 75 mosmol kg 1 of sucrose, NaCl, or mannitol. Addition of polyethylene glycol (mol. wt. 20000; 3 mosmol kg-1) causes a sustained reversal of mucosal inflow; inflow can be restored only by removing polyethylene glycol from the mucosal Ringer solution. The tissue can absorb water against an osmotic gradient of 200 mM-glycerol. The above data have been incorporated into a new model to explain isotonic flow of fluid by this epithelium. The main features are that the hydraulic conductivity (Lp) of the mucosal boundary of the lateral intercellular space is approximately 1 X 10(-8) cm s-1 cmH2O-1. This Lp is too low to sustain isotonicity of the flow emerging from the lateral intercellular space at the observed rates. Hypertonic fluid emerging from the lateral intercellular space is diluted by transcellular water flow generated by the hypertonicity of the submucosa and back-diffusion of solute via mucosal shunt channels.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958982 TI - The non-uniform character of expiratory synaptic activity in expiratory bulbospinal neurones of the cat. AB - Intracellular recordings were made from caudal medullary expiratory neurones in pentobarbitone-anaesthetized, vagotomized and artificially ventilated cats. The sample consisted of thirty-three bulbospinal neurones and seven neurones which were not antidromically excited from either the spinal cord (C2-C3) or vagus nerve. Their rhythmic activity consisted of an alternating inspiratory hyperpolarization due to Cl(-)-dependent inhibitory post-synaptic potentials (i.p.s.p.s) (Mitchell & Herbert, 1974) and an expiratory depolarization. The precise shape of the expiratory depolarizing wave varied within a given neurone depending on the over-all pattern of respiration. This variation extended from a smoothly developing depolarization, continuous throughout its course, through an intermediate state in which depolarization proceeded in two stages with a definite transition between them, to a final state in which the early part of expiration was occupied by a distinct hyperpolarizing component to the membrane potential trajectory. Under conditions of a brisk phrenic nerve discharge, these variations in the shape of the membrane potential profile were related to the time course and intensity of post-inspiratory discharge in the nerve. However, other factors (depth of anaesthesia and stimulation of laryngeal receptors) could influence the time course of the membrane potential profile of expiratory neurones independently of post-inspiratory phrenic discharge. In five of fifteen neurones which were tested, early expiration was occupied by a rapidly developing, decrementing wave of Cl(-)-dependent i.p.s.p.s (post-inspiratory i.p.s.p.s). These i.p.s.p.s were present only under conditions of a strong phrenic rhythm (large amplitude, fairly rapid phrenic discharge). They became weaker and ultimately disappeared when the level of anaesthesia was deepened and the phrenic rhythm became slower. Under these conditions, the post-inspiratory wave of i.p.s.p.s could be restored by stimulation of the superior laryngeal nerve. Adequate stimulation of presumed 'irritant' laryngeal receptors elicited post-inspiratory i.p.s.p.s in seven of ten neurones tested which initially showed either no post-inspiratory i.p.s.p.s or possibly just a weak pattern. In ten of fifteen neurones tested, the responses to current injection revealed clear differences in membrane potential behaviour in early and late expiration, which became intensified following stimulation of the superior laryngeal nerve.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958983 TI - Length-related changes in activation threshold and wave form of motor units in human masseter muscle. AB - Action potentials of single motor units in the human masseter muscle were recorded during isometric contractions at different muscle lengths over most of the working range of the temporomandibular articulation. The shape of the unit potential wave form changed progressively as the muscle length changed. This was considered to be due principally to a change in the geometric relationship of the electrode to the muscle fibres at various muscle lengths. The recruitment thresholds for all units increased sharply when the jaw opening approached the maximal gape. The pattern of change of unit thresholds with muscle length closely paralleled the curve of length versus passive tension for the combined jaw closing muscles, temporomandibular articulation and associated soft tissues. It was concluded that the change in unit recruitment thresholds with length is likely to be a consequence of the length-passive tension relationship of the muscles, joint and soft tissues. The results of this study indicate that attempts to assign masseter motor units to one or other of the accepted functional categories on the basis of recruitment force or wave form only are unlikely to give reliable results. PMID- 3958984 TI - Ventilation in intact and glossopharyngeal nerve sectioned anaesthetized rats exposed to oxygen at high pressure. AB - The cause of the initial hyperventilation, which occurs on exposure to O2 at high pressure (o.h.p.), has been investigated by measuring tidal volume (VT), frequency of breathing (f) and hence ventilation (VE) in thirty-six barbiturate anaesthetized rats, with or without their glossopharyngeal (IX) nerves sectioned, during 30-60 min of exposure to o.h.p. at 4, 6 or 8 atm absolute. In intact rats the rates of rise of VT, f and VE with time during exposure to o.h.p. were smallest at 4 and greatest at 8 atm absolute. In IX-sectioned rats the rates of rise of VT at 4, 6 and 8 atm absolute and of f at 4 atm absolute were similar to those of intact rats. At 6 atm absolute and even more so at 8 atm absolute, however, f decreased. Hence the slope of VE in IX-sectioned compared with intact rats was similar at 4 atm absolute but smaller at 6 and 8 atm absolute. In fact at 8 atm absolute VE remained constant in IX-sectioned rats. Since the slope of VE versus time in intact rats was steeper the greater the pressure and since the removal of carotid bodies in IX-sectioned rats reduced the VE slope at 6 and 8 atm absolute, the stimulus to the hyperventilation induced by o.h.p. cannot be an accumulation of CO2 in the brain resulting from the lack of O2 desaturation of haemoglobin. This theory would predict that VE should be identical at all pressures above 3.5 atm absolute. The findings in the IX-sectioned rats indicate a major contribution of the carotid bodies to the f increase in o.h.p. They may be stimulated by a histotoxic hypoxia induced by early O2 poisoning. Since the VT increase on exposure to o.h.p. was both large and fairly similar in intact and IX sectioned rats, it is suggested that a large part of the VT increase was caused by stimulation of the central chemoreceptors by lactic acidosis induced by an o.h.p.-induced histotoxic hypoxia of the brain. PMID- 3958985 TI - Plasma oxytocin and oxytocin neurone activity during delivery in rabbits. AB - The extracellular electrical activity of magnocellular neurones was recorded from unanaesthetized, unrestrained rabbits in birth and the post partum suckling period. The activity of oxytocin neurones was differentiated from that of vasopressin cells on the basis of their stereotyped activity in suckling. Oxytocin neurones showed five to fourteen discrete bursts of accelerated discharge in parturition. Each burst lasted 2-22 s and represented a 3-100-fold increase in the rate of firing, compared with pre-partum values, and was followed 10-34 s later by delivery. After parturition, the spontaneous activity of these neurones returned to pre-partum rates of firing. Vasopressin neurones did not show any bursts of discharge in delivery. There was a significant fall in the discharge frequency compared with pre-partum levels (P less than 0.05: Student's t test) and a significant (P less than 0.01) lengthening of the modal interspike interval. Serial blood samples were obtained during parturition in ten rabbits. Simultaneous recordings of magnocellular neurones activity and plasma oxytocin measurements were made in four of these experiments. Plasma oxytocin profiles were related to the observed events of parturition. Frequent blood samples (0.2 0.3 ml every 10-15 s) were taken throughout delivery and plasma oxytocin measured by sensitive radioimmunoassay in unextracted plasma (lower limit sensitivity of assay 5 pg ml-1). Before birth, plasma oxytocin was 53 +/- 12 pg ml-1 (mean +/- S.E. of mean) and rose to 2846 +/- 326 pg ml-1 within 40-120 s of the onset of the expulsive phase of delivery. Peak concentrations of oxytocin were coincident with delivery of the first or second fetus. No sign of pulsatile release of oxytocin was demonstrated in the profiles but significantly (P less than 0.001) greater variance in oxytocin titres was found during birth compared with pre partum values which is suggestive of pulsatile release. There was a straight line relationship between peak oxytocin concentrations in the plasma and the speed of delivery, implying that oxytocin facilitates as well as maintains labour in the rabbit. PMID- 3958986 TI - The effects of inorganic phosphate and creatine phosphate on force production in skinned muscles from rat ventricle. AB - Thin ventricular trabeculae from rat hearts were skinned with the non-ionic detergent Triton X-100. The isometric force development of these muscles was investigated over a range of Ca2+ concentrations (0.2-200 microM) in the presence of various concentrations of creatine phosphate (CP), creatine and inorganic phosphate (Pi). The addition of Pi (1-30 microM) at constant ionic strength reduced the maximum Ca2+-regulated force (obtained at 200 microM-Ca2+). At 20 mM Pi force was 31 +/- 5% (mean +/- S.E. of mean, n = 7) of that in Pi-free solution. This inhibitory action of Pi was not due to an inhibition of creatine kinase activity or to a reduction in the amount of free energy available for work from ATP hydrolysis. Increases in Pi concentration over the range 0-20 mM shifted the sigmoid relationship between force and [Ca2+] to higher Ca2+ concentrations. The [Ca2+] required for 50% activation rose from 8.3 +/- 1.5 microM (mean +/- S.E. of mean, n = 7) in Pi-free solutions to 19.8 +/- 4.2 microM in 20 mM-Pi. An increase in CP concentration in the range 10-30 mM had a small inhibitory effect on maximum Ca2+-regulated force but did not alter the force--[Ca2+] relationship. Creatine (0-30 mM) was without effect on the skinned muscles. The inhibitory effects of Pi suggest that a net hydrolysis of CP to Pi and creatine in the myoplasm of intact cardiac cells could reduce force development at a given myoplasmic [Ca2+], especially if the latter was below the level needed to fully activate the myofibrils. This suggestion is discussed in relation to the CP hydrolysis and decrease in force development that are observed in cardiac muscle during hypoxia or ischaemia. PMID- 3958987 TI - Spatial interaction in the domain of disparity signals in human stereoscopic vision. AB - When a few isolated features are viewed foveally, changes in the binocular disparity of one introduces apparent depth changes in others. For features a very few minutes of arc apart, the effect is equivalent to a pooling of their disparity signals, even though the features are seen distinctly as separate. When the distance between them is 4-6 minutes of arc or more, the effect is in the opposite direction: the features act as if they repelled each other in depth. Using a null method, it was possible to characterize this interaction effect numerically. There are some quantitative, but no qualitative, differences between observers, and in any one observer the disparity interaction between vertically separated targets is not necessarily the same as between horizontally separated ones. The disparity interaction effect is seen with presentations both of 50 ms and of 1 s duration. There is a very small temporal after-effect, seen when the extinction of inducing flanks is synchronous with test target onset. PMID- 3958989 TI - Sensory aids for hearing impairment. PMID- 3958990 TI - Hearing impairment and sensory aids: a tutorial review. PMID- 3958988 TI - Electrophysiological properties of neonatal rat motoneurones studied in vitro. AB - The electroresponsive properties of neonatal lumbar spinal motoneurones were studied using isolated, hemisected spinal cords from neonatal rats aged 3-12 days. The extracellular and intracellular responses to electrical stimulation of the ventral and dorsal root were studied as well as the intracellular response to current injection. Field potentials recorded in the lateral motor area following electrical stimulation of lumbar ventral roots had a triphasic positive-negative positive wave form. The negative component did not return to the base line smoothly but exhibited a 'shoulder' where the negativity increased in duration. Following electrical stimulation of the dorsal root, presynaptic field potentials were recorded upon activation of the afferent axons as well as following synaptic activation of interneurones and motoneurones. The input resistances of neonatal motoneurones determined from the slope of current-voltage plots were high compared with the adult. The resistance decreased with age with a mean of 18.1 M omega for animals 3-5 days old, 8.8 M omega for animals 6-8 days old and 5.4 M omega for animals 9-11 days old. Values for the membrane time constant were similar to those in the adult with a mean of 4.5 ms. Action potentials elicited by ventral or dorsal root stimulation or by intracellular current injection were marked by a pronounced after-depolarization (a.d.p.) and an after hyperpolarization (a.h.p.). The amplitude of the a.h.p. varied with that of the a.d.p. The amplitude of excitatory post-synaptic potentials (e.p.s.p.s) elicited by electrical stimulation of the dorsal root was affected by intracellular current injection. Two types of e.p.s.p.s were distinguished: those with a biphasic reversal (early phase first) and those in which the early phase was unaffected by inward current injection while the later phase was reversed. Unlike in the adult, the reversals could be achieved with low current levels and the amplitude of both types of e.p.s.p. was increased by inward current injection. Inhibitory post-synaptic potentials (i.p.s.p.s) were elicited by dorsal or ventral root stimulation. The amplitude of these i.p.s.p.s was diminished and reversed in sign with inward current injection and their amplitude was enhanced with outward current injection. Activation of neonatal motoneurones with long current pulses revealed that there is one steady-state firing range.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3958991 TI - Performance requirements for hearing aids. AB - The requirements for hearing aid frequency responses, SSPL characteristics, compression limiting, directional response, and internal noise are examined. On the basis of the assumptions made, aids would best serve the hearing impaired if they had flat very-low-frequency gains (and various mid- and high-frequency gains), SSPL responses adjustable in shape and level, directional responses, and internal noise levels below a recommended criterion level. PMID- 3958992 TI - Vibrotactile stimulation: case study with a profoundly deaf child. AB - This case study reports results obtained from a young, profoundly deaf child, M, who was fitted with a single-channel vibrotactile device, the Tactaid I, at 29 months of age. Her progress in speech and language development was evaluated over a 14-month period. During this period, M learned to understand 101 words through lipreading and the Tactaid I, and to produce consistent approximations of 90 words. Her scores on language tests with hearing-impaired norms progressed from below average to above average for her age. M's scores on language tests with hearing norms also reflected significant progress, although she did not achieve normal language development. These results indicate that a single-channel vibrotactile aid may facilitate the acquisition of spoken language in a profoundly deaf child who is unable to benefit from a conventional hearing aid. PMID- 3958993 TI - Continuing evaluation of the Queen's University tactile vocoder. I: Identification of open set words. AB - Identification of open set words, by an experienced normal hearing subject using the tactile vocoder developed at Queen's University, was examined. The tactile vocoder filters and processes the acoustic waveform into 16 filter channels, each of which controls a vibrator on the skin surface. After acquiring a 250-word vocabulary through the tactile vocoder, the subject was presented with three sets of 1000 different open set words in three reception conditions. The percentages of words correctly identified in the tactile vocoder (TV), lipreading (L), and lipreading plus tactile vocoder (L + TV) conditions were 8.8, 39.4, and 68.7 percent respectively. Phonemic analysis of stimulus/response pairs revealed that 36.7, 64.9 and 85.5 percent of the phonemes were correctly identified in TV, L, and L + TV conditions, respectively, indicating that incorrect-response words often contained many correct phonemes. Also, syllabic stress of stimulus and response words was identical 88 percent of the time in the TV condition. Important information about speech was transmitted through the tactile vocoder. PMID- 3958994 TI - Continuing evaluation of the Queen's University tactile vocoder II: Identification of open set sentences and tracking narrative. AB - Identification of open set words by an experienced normal hearing subject using the tactile vocoder developed at Queen's University was examined. The tactile vocoder filters and processes the acoustic waveform into 16 filter channels each of which activates a vibrator on the skin surface. After acquiring a 250-word vocabulary through the tactile vocoder, the subject was presented with 1000 different open set sentences in two reception conditions. The percentages of words correctly identified within the sentences in the lipreading (L) and lipreading plus tactile vocoder (L + TV) conditions were 57.8 percent and 79.6 percent, respectively. After two presentations of the stimulus sentences, the number of sentences repeated verbatim in the L + TV condition was 58.4 percent, which was 27.8 percent higher than scores obtained in the L condition. Performance on the tactile vocoder was also evaluated using the "tracking procedure," in which phrases of text are read to the subject who attempts to repeat the material verbatim. The final tracking rate obtained using lipreading was 15.3 words per minute, which was considerably lower than the L + TV tracking rate of 49.3 words per minute. The tactile vocoder provided valuable information which improved the subject's lipreading ability. PMID- 3958995 TI - Lipreading with tactile supplements. AB - Lipreading performance, after brief training, was measured in two normal subjects, as the percentage of words recognized in sets of unrelated sentences. Three receptive conditions were used: lipreading alone, lipreading plus a single channel tactile display of fundamental frequency (temporal only), and lipreading plus a multichannel, tactile, spatial display of fundamental frequency (temporal spatial). After training, performance with tactile supplements was better than without, but it was not possible to conclude that either of the tactile displays was better than the other. During training, a significant correlation between performance and session number was found for the temporal-spatial display only. PMID- 3958997 TI - Comparison of amplification systems in a classroom. AB - "Listening systems" are used for hearing impaired listeners as an alternative to public address systems (PA) used for the general public. These listening systems allow individual control of sound pressure level and minimize the effects of background noise and room reverberation. Three listening systems, based on an audio induction loop (AL), frequency modulation of radio frequencies (FM), and modulation of infrared light (IR) were compared among themselves and with a PA system in a medium-size classroom. Listening groups were normal hearing, hearing impaired, hearing aid users, and elderly. Word identification scores were obtained with the Modified Rhyme Test at two conditions: with a babble of 12 voices at a speech-to-noise ratio (S/N) of + 8 dB, and without the babble at S/N of +20 dB. Analysis of variance indicated that the main effects of systems, groups and room S/N were significant. Also significant were interactions of systems by groups, and systems by S/N. For all groups, the three listening systems provided better scores than the PA system. It can be concluded that all three of the tested listening systems are suitable for listeners with various degrees of hearing losses. PMID- 3958996 TI - Multichannel syllabic compression for severely impaired listeners. AB - Two listeners with congenital hearing losses characterized by flat audiograms and dynamic ranges of 18-33 dB were tested with three compression systems and one (reference) linear amplification system. The compression systems placed progressively larger amounts of speech energy within the listener's residual dynamic range, by raising to audibility and compressing 25, 50, and 90 percent of the short-term input amplitude distribution in each of 16 frequency bands. The comparison linear system was defined by adjusting six octave-wide bands of speech to comfortable levels. System performance was evaluated with nonsence CVC syllables presented at a constant input level and spoken by two talkers. Extensive training was provided to ensure stable performance. The results were notably speaker-dependent, with compression consistently providing better performance for one speaker, linear amplification for the other. Averaged over speakers, however, there was no net advantage for any of the compression systems for any listener. The use of high compression ratios and large input ranges tended to degrade perception of initial consonants and vowels. Under some conditions, however, final consonant scores were higher with compression than with linear amplification. Compression generally enhanced the distinction between stops and fricatives, but degraded spectral-concentration and relative-intensity cues required to identify place of articulation. PMID- 3958998 TI - Speech perception through FM auditory trainers in noise and reverberation. AB - Speech perception through FM auditory trainers was explored in conditions of noise and reverberation. Special attention was paid to the mode of transmission and individual capabilities of various commercially-available units to handle speech in noise and reverberation. Results indicate an overwhelming advantage of FM transmission for maintaining speech intelligibility in noise and reverberation, irrespective of the instrument. PMID- 3958999 TI - Induction loop listening system designed for a classroom. AB - The principles of designing an induction loop listening system are discussed. Step-by-step procedures for building an induction loop are presented. The loop described was installed in a medium-size classroom and listening tests were performed comparing the loop and loudspeakers. Two groups of hearing impaired listeners were used. One group of listeners wore hearing aids while the other group did not. Result indicated that for both groups, speech perception was enhanced with the loop system. PMID- 3959000 TI - Inductive coupling of hearing aids and telephone receivers. AB - The present investigation sought to determine the effects of hearing loss, signal level, telephone receiver type, and telecoil location on the aided word discrimination abilities of hearing impaired subjects using electromagnetic coupling of their hearing aids to the telephone. As expected, significant deterioration in discrimination scores was observed with increasing hearing loss. In addition, significant improvement in discrimination scores was observed, for all subject groups, as the signal level increased from 80 dB SPL to 105 dB SPL. Of the four receiver conditions, the U1 and BARC receivers resulted in the best discrimination scores. Also, the results suggest that the U1 and BARC receivers are indeed equivalent in terms of word discrimination scores. Finally, the telecoil location in individual hearing aids appeared to have little influence on the speech discrimination capabilities of the subjects in this study. However caution must be used in interpreting that result, since subjects were allowed to adjust the telephone handset position to maximize the signal level in any given condition. This occasionally resulted in inappropriate handset locations for conventional telephone use. PMID- 3959001 TI - A digital master hearing aid. AB - The use of computer simulation in evaluating conventional and experimental hearing aids is described. Two illustrative examples are provided. The first involves the simulation of a conventional master hearing aid and its application in evaluating different adaptive strategies in the prescriptive fitting of hearing aids. The second example involves the simulation of an experimental hearing aid embodying modern digital signal-processing techniques for the reduction of background noise. A high-speed array processor is used in order to accomplish these simulations in real time. PMID- 3959002 TI - Entamoeba histolytica Schaudinn, 1903: from xenic to axenic cultivation. PMID- 3959003 TI - Movement of Naegleria fowleri stimulated by mammalian cells in vitro. AB - Naegleria fowleri amebae, but not those of N. australiensis, N. gruberi, or N. lovaniensis, demonstrated enhanced motility when placed in proximity to mammalian cells. Amebae of nonpathogenic species of Naegleria, however, were more motile in cell culture medium than the amebae of N. fowleri. The locomotory response of highly pathogenic mouse-passaged N. fowleri amebae to nerve cells was greater than axenically cultured amebae. The enhanced mobility elicited by whole nerve cells or disrupted nerve cells was not directed migration but chemokinetic. Naegleria fowleri responded to disrupted neuroblastoma cells more vigorously than to disrupted African green monkey kidney (Vero) cells. PMID- 3959004 TI - Eimeria tenella: parasite-specific incorporation of 3H-uracil as a quantitative measure of intracellular development. AB - An assay has been developed using parasite-specific incorporation of 3H-uracil to assess the intracellular growth of Eimeria tenella in vitro. As shown by both scintillation counts and autoradiography, 3H-uracil was incorporated specifically into intracellular parasites from the onset of infection and continued throughout development of the first generation schizonts. Mature schizonts and first generation merozoites did not continue to incorporate additional 3H-uracil, indicating that RNA synthesis had halted in these stages. Based on these findings, a semi-automated microscale uracil incorporation assay was developed to determine parasite viability. This method should be useful for biochemical studies with intracellular parasites and for screening compounds for anticoccidial activity. The ease, rapidity, and quantitative nature of this assay contrasts favorably with standard morphometric approaches of determining parasite development. In addition, parallel studies using host cell incorporation of 3H uridine have been introduced as a method of determining whether antiparasitic activity is direct or indirect in relation to effects on the host cell. PMID- 3959005 TI - Experimental transmission of Caryospora simplex (Apicomplexa: Eimeriidae) to Palestine vipers, Vipera xanthina palestinae (Serpentes: Viperidae). AB - Four littermate, laboratory-reared Palestine vipers, Vipera xanthina palestinae (#149, #150, #151, #152) (Serpentes: Viperidae) were used to determine modes by which Caryospora simplex (Apicomplexa: Eimeriidae) could be transmitted to snakes. Viper #149 was inoculated orally by stomach tube with 5.0 X 10(4) sporulated oocysts of C. simplex obtained from the feces of an Ottoman viper, V. x. xanthina and began passing unsporulated oocysts of C. simplex 121 days post inoculation (DPI). Viper #150 was fed five mice that had been inoculated orally greater than or equal to 25 days previously with 5.0 X 10(4) sporulated oocysts of C. simplex and it began passing unsporulated oocysts of C. simplex 33 days after being fed the first two of five mice. Viper #151 was inoculated orally with sporulated oocysts of C. simplex obtained from viper #150 and began passing oocysts 52 DPI. Viper #152 served as an uninoculated control and did not pass oocysts of any species of coccidian. This study demonstrates that snake/snake and mouse/snake transmission of C. simplex readily occurs. PMID- 3959006 TI - Cytoplasmic inheritance of temperature sensitivity in a wild stock of Paramecium primaurelia. AB - One stock, GBC, has a maximum temperature of growth about 5 degrees C lower than other recently collected stocks of Paramecium primaurelia. The resistant stocks (R) are able to grow continuously at 35 degrees C while the sensitive stock (S) cells die within 48 h. The F1s of R X S crosses exhibited a cytoplasmic pattern of inheritance and all F2-by-autogamy lines derived from the S cytoplasmic parent are sensitive. The F2-by-autogamy lines cytoplasmically descended from the R parent were predominantly (93%) R in the initial assay. Upon reinvestigation one year later, only 64% of these lines were R, 9% were S, and 27% had a new phenotype, weak (W), intermediate between R and S. Backcrosses of W lines to both R and S strongly suggest that the W lines have normal cytoplasm (i.e. R) but also have nuclear gene(s) for temperature sensitivity that are derived from the original S stock. The delayed manifestation of the W phenotype is not understood. PMID- 3959008 TI - Fine structure and development of Pilosporella chapmani (Microspora: Thelohaniidae) in the mosquito, Aedes triseriatus (Say). AB - New information on the life cycle and fine structure of Pilosporella chapmani, a microsporidium of the mosquito Aedes triseriatus, is presented. Pilosporella chapmani is shown to have two sporulation sequences, one of them being involved in transovarial transmission. One sequence, involving meiosis and production of a moniliform sporogonial plasmodium, occurs in the larval fat body, resulting in eight uninucleate, spherical, and fully developed spores. The other occurs in oenocytes of adult mosquitoes and results in isolated, binucleate, elongate, and thin-walled spores. Also, for the first time, metabolic products are shown to be expelled into the surrounding host tissues through the wall of the sporocyst. PMID- 3959007 TI - Effect of colchicine, vinblastine, and cytochalasin B on cell surface anionic sites of Tritrichomonas foetus. AB - Drugs that interact with microtubules (colchicine and vinblastine) and microfilaments (cytochalasin B) partially inhibited cell growth and motility of Tritrichomonas foetus. Parasites incubated with these substances became rounded and cell division was blocked. Neither colchicine nor vinblastine disrupted the microtubules that form the peltar-axostylar system. Any one of these drugs interfered with the net negative surface charge of T. foetus as evaluated by determination of the cellular electrophoretic mobility (EPM). The decrease in the EPM of cytochalasin B-treated cells was caused by dimethylsulfoxide, which was used as solvent. Untreated cells as well as cytochalasin B-treated cells showed a uniform distribution of anionic sites on the plasma membrane as seen with cationized ferritin particles. In cells treated with colchicine or vinblastine the anionic sites were distributed in patches. These results are discussed in terms of participation of labile cytoplasmic microtubules and microfilaments in the control of the distribution of anionic site-containing macromolecules located on the cell surface of T. foetus. PMID- 3959009 TI - Cytochrome-free mitochondria of an anaerobic protozoan--Blastocystis hominis. AB - Isolated mitochondria of the anaerobic protozoan Blastocystis hominis were subjected to spectral analysis, color, catalase, and peroxidase tests and found to be completely negative for cytochrome enzymes, catalase, and peroxide. Based on the absence of cytochrome enzymes, the possible evolution of B. hominis mitochondria from anaerobic bacteria is postulated. PMID- 3959010 TI - Identification of the basal bodies and kinetodesmal fibers in living cells of Paramecium tetraurelia Sonneborn, 1975 and Paramecium sonneborni Aufderheide, Daggett & Nerad, 1983. AB - Critical use of Nomarski DIC optics and a rotocompressor permits basal bodies and kinetodesmal fibers to be visualized in the cortices of living Paramecium tetraurelia and Paramecium sonneborni. The identification of these structures is confirmed by the correspondence of the images obtained by DIC optics of living cells and by brightfield optics of fixed cells stained by the Fernandez-Galiano silver technique. Examination of cells carrying cortical inversions (portions of the cortex rotated 180 degrees) shows that inverted regions may be identified and distinguished from normal regions by the orientation of the kinetodesmal fibers of the kinetids (cortical units) within the kineties (ciliary rows). This demonstrates that both the asymmetry and the polarity of each cortical unit may be assessed in the living cell. This technique has useful applications in the study of morphogenesis and patterning in living cells and for the screening of mutations and variants conferring altered cortical phenotypes. PMID- 3959011 TI - In vitro production of metacyclic forms of Trypanosoma musculi and their infectivity in CBA mice. AB - Bloodstream forms of Trypanosoma musculi, cultured in Schneider's drosophila medium at room temperature, multiply and differentiate through a series of developmental stages into infective metacyclic trypomastigotes in 10 days. Oral inoculation with these culture forms into CBA mice produced a parasitemia similar to that produced by intraperitoneal infection with bloodstream forms except for a three-day longer prepatent period. Attempts to induce parasitemia with bloodstream forms given orally were unsuccessful. PMID- 3959012 TI - Study of an amoeboflagellate isolated from the nasal mucosa of man. AB - This paper examines the biology, morphology, and pathogenicity for mice of an amoeboflagellate isolated from human nasal mucosa. The biological and morphological relationships of this isolate with the amoebae (Lobosea) and the true slime molds (Eumycetoza) are discussed though the taxonomic affinities of the organism have not been determined. PMID- 3959013 TI - Eimeria tenella (Eucoccidiorida): a quantitative assay for sporozoite infectivity in vivo. AB - A quantitative technique for the assessment of sporozoite infectivity in vivo, using intra-cecal inoculation of Eimeria tenella sporozoites, has been developed. Evaluation of the infection using cecal lesion scores and oocyst counts showed that this technique should be useful for the quantitation of sporozoite viability and thus for the anti-sporozoite activity of different treatments prior to inoculation. Pre-treatment of sporozoites with heat-inactivated hyperimmune antisera neutralized sporozoite infectivity in vivo and indicated that antibodies in the absence of complement inhibited sporozoite infectivity in vivo. PMID- 3959015 TI - Extratubal ectopic pregnancies. Diagnosis and treatment. AB - Extratubal gestations account for a disproportionate percentage of the serious morbidity and mortality attributable to ectopic gestations. While the relative rarity of these conditions makes them difficult to study, the available information may be useful in maximizing diagnostic and therapeutic efforts. PMID- 3959016 TI - Induction of labor with an electric breast pump. AB - Nipple stimulation with an electric breast pump was compared with oxytocin infusion as a means of labor induction. The time from stimulation to the onset of regular uterine activity and to 200 Montevideo units of uterine activity and the time until entrance into the active phase of labor were significantly shorter in the nipple stimulation group. Once the women were in active labor, there was no difference between the groups in the length of labor or mode of delivery. PMID- 3959014 TI - A comparison of endogenous development of three isolates of Cryptosporidium in suckling mice. AB - Suckling mice were used as a model host to compare the endogenous development of three different isolates of Cryptosporidium: one from a naturally infected calf, one from an immunocompetent human with a short-term diarrheal illness, and one from a patient with acquired immune deficiency syndrome (AIDS) and persistent, life-threatening, gastrointestinal cryptosporidiosis. After oral inoculation of mice with oocysts, no differences were noted among developmental stages of the three isolates in their sites of infection, times of appearance, and duration, morphology, and fine structure. Sporozoites excysted within the lumen of the duodenum and ileum, penetrated into the microvillous region of villous enterocytes, and developed into type I meronts with six or eight merozoites. Type I merozoites penetrated enterocytes and underwent cyclic development as type I meronts or they became type II meronts with four merozoites. Type II merozoites did not exhibit cyclic development but developed directly into sexual forms. Microgamonts produced approximately 16 small, bullet-shaped microgametes, which were observed attaching to and penetrating macrogametes. Approximately 80% of the oocysts observed in enterocytes had a thick, two-layered wall. After sporulating within the parasitophorous vacuole, these thick-walled oocysts passed through the gut unaltered and were the resistant forms that transmitted the infection to a new host. Approximately 20% of the oocysts in enterocytes consisted of four sporozoites and a residuum surrounded only by a single oocyst membrane that ruptured soon after the parasite was released from the host cell. The presence of thin-walled, autoinfective oocysts and recycling of type I meronts may explain why a small oral inoculum can produce an overwhelming infection in a suitable host and why immune deficient persons can have persistent, life-threatening cryptosporidiosis in the absence of repeated oral exposure to thick-walled oocysts. PMID- 3959017 TI - Effect of labor on neutrophil phagocytic function in patients with uncomplicated term pregnancies. AB - This investigation analyzed the effect of labor on the phagocytic activity of neutrophils in women with uncomplicated term pregnancies. Nineteen healthy women who were not pregnant and did not use oral contraceptives or glucocorticoids served as controls. Peripheral venous blood samples were collected from 15 study patients who were in the active phase of labor (5-10 cm of dilation). Neutrophil phagocytic function was evaluated with the radioiodine fixation test. Assays were conducted utilizing both pooled homologous serum and autologous serum. There was no statistically significant difference in the neutrophil phagocytic function of laboring patients and controls. In addition, there was no evidence that serum from pregnant women exerted a depressant effect on phagocytosis. PMID- 3959018 TI - Successful intrauterine pregnancy after unilateral hysterectomy in a patient with uterus didelphys. A case report. PMID- 3959020 TI - Management of serious vaginal injury. A case report. AB - Hemorrhage was the major complication of a serious vaginal injury. Failure to control such a hemorrhage with local suturing should prompt an exploratory celiotomy and ligation of the visible bleeding points. Hypogastric artery ligation is indicated in cases of intractable bleeding. PMID- 3959019 TI - Ruptured intracranial aneurysms during pregnancy. A report of four cases. AB - Four patients presented with ruptured intracranial aneurysms during pregnancy. Problems encountered during the management of these cases included delayed diagnosis, obstructive hydrocephalus, cerebral ischemia due to vasospasm and recurrent subarachnoid hemorrhage. Recent advances in the management of ruptured intracranial aneurysms, including early computerized tomographic scanning, intravascular volume expansion and induced hypertension for the management of cerebral vasospasm, and the timely obliteration of the aneurysm are applicable to the subarachnoid hemorrhage patient even if her condition is complicated by pregnancy. PMID- 3959021 TI - Umbilical cord stricture associated with intrauterine fetal demise. A report of two cases. AB - Two cases occurred of umbilical cord stricture with intrauterine fetal demise. The cause of this defect is unknown. Our cases represented the common findings of stricture at the squamoamnionic junction and an increased incidence with twin gestations. One fetus had a reactive nonstress test at 30 1/2 weeks and died two days later. PMID- 3959022 TI - The increasing problem of ectopic pregnancies and its impact on patients and physicians. AB - The incidence of ectopic pregnancies tripled between 1970 and 1980. Nonwhite patients are at considerably greater risk in all categories surveyed than are white ones. Numerous reasons for the increase have been postulated, including a possible increase in pelvic inflammatory disease, microsurgical procedures on diseased tubes, the increased number of sterilizations and an increase in the number of recognized cases. Ultrasound and beta-human chorionic gonadotropin pregnancy tests coupled with laparoscopy allow earlier and more accurate diagnosis of this problem. Deaths related to ectopic pregnancies have decreased because of the better diagnostic methods available and increased clinician awareness. PMID- 3959023 TI - Surgical settings and incisions for the management of ectopic pregnancies. AB - Ectopic pregnancies do not have to be managed through a laparotomy incision in a hospital. Alternative settings and surgical incisions are available. Most patients can be managed in either free-standing or hospital outpatient facilities using either a minilaparotomy, laparoscopic or possibly a colpotomy incision. Conservative surgical management, which is so important in women desiring future children, can also be done through a minilaparotomy or laparoscopic incision in an outpatient setting. PMID- 3959024 TI - Tranexamic acid derivatives with enhanced absorption. AB - Derivatives of the antifibrinolytic drug tranexamic acid [trans-4 (aminomethyl)cyclohexanecarboxylic acid] containing one or two tranexamic acid moieties were synthesized. Most of the derivatives have good stability in acidic and neutral solutions but are easily hydrolyzed in plasma. By measuring the amount of tranexamic acid excreted in the urine after an oral dose, relative absorptions of a number of derivatives in the rat were estimated. Most of the derivatives showed greater absorption than tranexamic acid itself. 1 [(Ethoxycarbonyl)oxy]ethyl trans-4-(amino-methyl)cyclohexanecarboxylate hydrochloride was chosen for studies in man. PMID- 3959025 TI - A common structural model for central nervous system drugs and their receptors. AB - On the basis of the hypothesis that there is a common structural basis for central nervous system (CNS) drug action consisting primarily of an aromatic group and a nitrogen atom, a four-point model for a common pharmacophore is defined with use of five semirigid CNS-active drug molecules: morphine, strychnine, LSD, apomorphine, and mianserin. Two of the points of the model represent possible hydrophobic interactions between the aromatic group and the receptor, while the other two represent hydrogen bonding between the nitrogen atom and the receptor. The model is then extended by the inclusion of nine additional CNS-active drug molecules: phenobarbitone, clonidine, diazepam, bicuculline, diphenylhydantoin, amphetamine, imipramine, chlorpromazine, and procyclidine, each being chosen as a key representative of a different CNS-active drug class or neurotransmitter system. Consideration of all phenyl group and nitrogen atom combinations, as well as all feasible conformations, shows that all nine molecules closely fit the common model in low-energy conformations. It is proposed that the model may eventually be used to design CNS-active drugs by mapping the relative locations of secondary binding sites. It can also be used to predict whether a given structure is likely to show CNS activity: a search over 1000 entries in the Merck Index shows a high probability of CNS activity in compounds fitting the common structural model. PMID- 3959026 TI - Potential antitumor agents. 46. Structure-activity relationships for acridine monosubstituted derivatives of the antitumor agent N-[2-(dimethylamino)ethyl]-9 aminoacridine-4-carboxamide. AB - A series of monosubstituted derivatives of the new antitumor agent N-[2 (dimethylamino)ethyl]-9-aminoacridine-4-carboxamide has been prepared, bearing methyl, methoxy, and chloro groups at available acridine positions. The physicochemical properties and antitumor activity of these compounds varied more with the position than with the nature of the substituent groups. The highest levels of both in vitro and in vivo antileukemic activity were shown by 5 substituted derivatives, while 7- and 8-substituted derivatives possessed the highest selectivity toward the HCT-8 human colon carcinoma line compared to the L1210 mouse leukemia line in vitro. PMID- 3959027 TI - Synthesis and antitumor and antiviral properties of 5-alkyl-2'-deoxyuridines, 3',5'-cyclic monophosphates, and neutral cyclic triesters. AB - A series of 5-alkyl-2'-deoxyuridine 3',5'-cyclic monophosphates (5-R-cdUMP's, R = Et, i-Pr, n-Pr, n-Bu, n-Pent, n-Hex, n-Oct) was prepared and tested in culture systems as antitumor and antiviral agents in comparison to the 5-alkyl-2' deoxyuridines (5-R-dUrd's) themselves. Only the 5-Et- and 5-n-Bu-cdUMP showed appreciable cytostatic activities against murine L1210 and human lymphoblast Raji cells (ID50 range: 28-82 micrograms/mL). 5-Et-dUrd itself was much more active (ID50 = 1.6 and 2.9 micrograms/mL). The 5-i-Pr-, and 5-n-Bu-dUrd's were inactive, but activity increased again for groups with chain lengths of five carbons or greater. 5-Et-cdUMP and 5-Et-dUrd had greatly reduced activities against deoxythymidine kinase deficient (TK-) L1210 and Raji cells. 5-Et-cdUMP evidently is not an efficient prodrug source of the corresponding 5'-monophosphate where the TK- cells are concerned. Of the 5-R-cdUMP's, 5-Et-cdUMP displayed reasonably good antiviral potency against herpes simplex types 1 and 2 (MIC50, mostly 7-70 micrograms/mL) and vaccinia virus (MIC, 70 micrograms/mL). The activity was nonetheless 10- to 100-fold less than that for 5-Et-dUrd. The other 5-R-dUrd's generally showed decreasing antiviral activity with increasing 5-R chain length. Methyl and/or benzyl neutral triesters of certain 5-R-cdUMP's were inactive as antivirals and largely inactive against tumor cells in culture. In contrast to the 5'-monophosphates, the 5-R-cdUMP's failed to inhibit thymidylate synthetase from L1210 cells. PMID- 3959028 TI - Oxidation of 5-hydroxytryptamine and 5,7-dihydroxytryptamine. A new oxidation pathway and formation of a novel neurotoxin. AB - The electrochemical oxidation of 5-hydroxytryptamine (5-HT) in acidic solution proceeds through a minor route leading first to 5,7-dihydroxytryptamine (5,7-DHT) then to 4,5,7-trihydroxytryptamine and finally to 5-hydroxytryptamine-4,7-dione. The latter compound is a major electrochemical oxidation product of 5,7-DHT at pH 2 and 7 and a major autoxidation product at pH greater than or equal to 6. Preliminary biological results indicate that 5-hydroxytryptamine-4,7-dione is a more potent central nervous system toxin than 5,7-DHT. These results show for the first time a chemical pathway from 5-HT to 5,7-DHT and suggest possible minor metabolic oxidative pathways for the neurotransmitter 5-HT to at least two powerful neurotoxins. PMID- 3959029 TI - On the significance of clusters in the graphical display of structure-activity data. AB - A method is presented to evaluate the statistical significance of an apparently clustered group in the graphical display of structure-activity data. Two variations are described; each is implemented by means of a computer program. The first is applicable in situations with relatively small sets of compounds where a complete enumeration of all possible clusters can be accomplished reasonably on a high-speed electronic computer. The second is applicable in cases where such a calculation would be too time consuming. This latter variation uses random sampling of the set of all possible clusters. An application for each variation is given: for the smaller case a reevaluation of a study on aminotetralin and aminoindan monoamine oxidase inhibitors; for the larger case the discovery of some physical parameters that influence mutagenicity among some aminoacridine derivatives. It is proposed that this new technique be called cluster significance analysis (CSA). PMID- 3959030 TI - Thromboxane synthetase inhibitors and antihypertensive agents. 1. N-[(1H-imidazol 1-yl)alkyl]aryl amides and N-[(1H-1,2,4-triazol-1-yl)alkyl]aryl amides. AB - The title compounds were prepared to investigate their potential as thromboxane synthetase inhibitors as well as antihypertensive agents. Imidazoles VIII and triazoles X were prepared to examine the effects of aromatic substitution, chain length, and heterocycle substitution upon biological activity. Imidazoles VIII and triazoles X were thromboxane synthetase inhibitors that did not inhibit prostacyclin formation. The most interesting thromboxane synthetase inhibitors prepared were 4-chloro-, 4-(trifluoromethyl)-, and 4-bromobenzamide derivatives of (1H-imidazol-1-yl)alkylamines with C5-C8 alkyl chains separating the heterocycle from the amide moiety, while the most active antihypertensive agents were 3- or 4-chloro-, -bromo, or -(trifluoromethyl)benzamides with C3 alkyl chains. The best thromboxane synthetase inhibitors in this study were up to 10 times more potent than the standard, dazoxiben (UK 37,248). PMID- 3959031 TI - Relationship between lipophilic character and urinary excretion of nitroimidazoles and nitrothiazoles in rats. AB - Many processes are involved in the renal excretion of drugs, but very little is known about their quantitative structure-activity relationship. The relationship between urinary excretion and lipophilic character of a series of nitroimidazoles and nitrothiazoles was studied. The unmetabolized forms of the drugs were detected in the urine by means of UV and HPLC procedures. The urinary excretion of unmetabolized forms is parabolically related with the log P, as an expression of lipophilic character of molecules. PMID- 3959032 TI - Conformational analysis of clinically active anticonvulsant drugs. AB - A series of ureides active against grand mal epilepsy have been studied by using classical potential energy calculations. The series includes phenyl ethyl and diphenyl derivatives of hydantoins, succinimides, glutarimides, oxazolidine-2,4 diones, pyrimidine-2,6-diones, barbituric acids, and phenacemide. A thorough examination of the conformational possibilities did not reveal an exclusive conformation that could account for their activity. However, comparisons with diazepam and other benzodiazepines known to have the ability to competitively bind with drugs such as diphenylhydantoin at some sites show that there is a distinct conformational preference that may well account for their activity against grand mal epilepsy. The conformational studies led to the proposal of a general model for anticonvulsant activity comprising two aromatic rings or their equivalent in a favored orientation and a third region, usually a cyclic ureide, comprising a number of hydrogen-bond-forming functional groups. The specific placement of hydrogen-bonding groups in this region appears to be of less importance than the correct conformational arrangement of the hydrophobic elements. PMID- 3959033 TI - Synthesis and evaluation of 4-(substituted thio)-4-androstene-3,17-dione derivatives as potential aromatase inhibitors. AB - The synthesis and evaluation of 4-(substituted thio)-4-androstene-3,17-dione derivatives as inhibitors of estrogen synthetase (aromatase) are described. All compounds were prepared by the addition of various thiol reagents to 4 beta,5 beta-epoxyandrostanedione. Inhibitory activity of synthesized compounds was determined with use of a human placental microsomal preparation as the enzyme source and [1 beta-3H]-4-androstene-3,17-dione as substrate. Synthesized compounds exhibiting high inhibitory activity were further evaluated under initial velocity conditions to determine apparent Ki values. Several compounds were effective competitive inhibitors and have apparent Ki values ranging from 36 to 73 nM, with the apparent Km for androstenedione being 53 nM. The results of these studies demonstrate a tightly fitted enzyme pocket that can accommodate bulk up to about 5.5 A. PMID- 3959034 TI - Absolute configuration of (-)-5-benzoyl-1,2-dihydro-3H-pyrrolo[1,2-alpha]pyrrole 1-carboxylic acid, the active enantiomer of ketorolac. AB - The (-)-S isomer of 5-benzoyl-1,2-dihydro-3H-pyrrolo[1,2-alpha]pyrrole-1 carboxylic acid is about 60 times more potent than the (+)-R isomer in the carrageenan edema test and ca. 230 times more active than the (+)-R isomer in the mouse phenylquinone writhing assay. PMID- 3959036 TI - Anomalies of Section 2 of the Homicide Act 1957. AB - Section 2 of the 1957 Homicide Act is indefensible: the concept of 'mental responsibility' is a hybrid which turns the psychiatrist witness either into a thirteenth juryman or a spare barrister. But reform does not lie along the lines suggested by the Butler Committee or the Criminal Law Revision Committee. The latter leaves the jury with insufficient guidance; the former returns to the bad eighteenth century policy of treating mental illness not as a factor in determining responsibility but as a status exempting from responsibility. The much criticised McNaughton rules provide a sounder basis for deciding where responsibility should be assigned in criminal cases. PMID- 3959035 TI - Reducing murder to manslaughter: whose job? AB - This paper compares two versions of the diminished responsibility defence, which reduces murder to manslaughter: the present statutory formulation and a proposed reformulation. The comparison confirms that evidence such as psychiatrists are commonly invited to give in murder cases takes them beyond their proper role. Paradoxically, although the two formulations mean essentially the same thing, the proposed change of wording must have the practical effect of subduing the psychiatrist's evidence. This conclusion leads to speculation about why psychiatrists are at present allowed so large a function in diminished responsibility cases and to some general observations about the role of the expert in relation to those of judge and jury. PMID- 3959037 TI - The mandatory sentence and Section 2. AB - Sentencing in homicide depends on how psychiatrists view the issues of Section 2. In most killings that do not involve clear-cut mental disorder, strong emotions and stress play a part. Both can be cited in aid of diminished responsibility. If doctors cite them, however tentatively, it becomes feasible for the court to review any mitigating factors and to choose an appropriate penalty. Otherwise, the mandatory penalty is imposed. Thus doctors, by opining not on the medical but on the legal and moral aspects of Section 2, decide who shall automatically get a life sentence and who shall not. Anomaly and injustice are the results. They would be remedied by the abolition of the mandatory sentence for murder. PMID- 3959038 TI - Murder, manslaughter and responsibility. PMID- 3959039 TI - Some comments on Dr Iglesias's paper, 'In vitro fertilisation: the major issues'. AB - In an article in an earlier edition of the Journal of Medical Ethics (1) Dr Iglesias bases her analysis upon the mediaeval interpretation of Platonic metaphysics and Aristotelian logic as given by Aquinas. Propositional forms are applied to the analysis of experience. This results in a very abstract analysis. The essential connection of events and their changing temporal relationships are ignored. The dichotomy between body and soul is a central concept. The unchanging elements in experience are assumed to be more real than the actual world of experienced process. Such a view makes the analysis of the temporal factors in experience impossible. Its abstractness is quite unsuitable for the analysis of the ontological structure and development of the neonate from fertilisation to birth. A N Whitehead made the notion of organism central to his philosophy. He refused to place human experience outside nature, or admit dualism. His philosophy of organism is an attempt to uncover the essential elements connecting human experience with the physical and biological sciences. Time, change and process are, in his view, more real than the static abstractions obtainable by the use of the fallacy of misplaced concreteness. Use of the latter negates the essential connectedness of events and the importance of temporarily and change (2). In this paper I argue that the embryo, being an organism, is not analysable in terms of thinghood. It is a process. To apply Aristotelian logical concepts to it is to distort the real nature of the datum. PMID- 3959040 TI - Case method. AB - Teaching medical ethics by the case method may be enriched by adding to the principles-and-rules approach to practical reasoning modes of inquiry and interpretation that engage the moral imagination. PMID- 3959041 TI - Health workers' strikes: a rejoinder rejected. PMID- 3959042 TI - Health workers' strikes: a further rejoinder. PMID- 3959043 TI - English law and the mentally abnormal offender. PMID- 3959044 TI - Ethical issues of a doctors' strike. PMID- 3959045 TI - The effect of commercial coaching courses on performance on the MCAT. AB - Two studies on the relationship between taking a commercial coaching course and performance on the Medical College Admission Test (MCAT) are reported. In both studies, one based on repeating examinees and another based on first-time examinees, differences in scores favoring coached examinees were found on the Science Knowledge and Science Problems subtests. The results on the Skills Analysis: Quantitative subtest were mixed, while neither study found differences between the two groups in scores on the Skills Analysis: Reading subtest. The analyses further revealed that the differences in scores on the Science Knowledge and Science Problems subtests were less pronounced for examinees with low scores on the Skills Analysis: Reading and Skills Analysis: Quantitative subtests, examinees with very low or very high undergraduate grade-point averages, and examinees from very selective undergraduate colleges. The substantive importance of the differences was also explored. The coaching effect was estimated to increase an average student's probability of acceptance by 5 percentage points. The results suggest that coaching for the MCAT has a limited effect that supports rather than undermines the validity of the test. PMID- 3959046 TI - Race and socioeconomic status in medical school choice and indebtedness. AB - Current and proposed cutbacks in student financial assistance may significantly reduce the likelihood that low-income and minority individuals will be able to pursue a medical career. In order to estimate the magnitude of the potential effects of these cutbacks, the authors of the study reported here examined the effectiveness of the federal health manpower programs of the 1960s and 1970s in increasing access to medical education. The results suggest that regardless of race or ethnic background individuals from families with small resources were able to enter even the most expensive medical schools without incurring substantially greater debt than individuals with more family resources. In addition, the debt burden of the minority physicians examined was not very different from that of nonminority physicians. Thus, the health manpower programs appear to have been very effective, and their elimination should have a larger adverse effect on low-income individuals than on high-income persons. PMID- 3959047 TI - Evaluation of ambulatory care training by graduates of internal medicine residencies. AB - In 1984, 154 physicians who had completed residencies in internal medicine at 15 major teaching hospitals in 1982 evaluated their residency training in ambulatory care. A majority of the physicians would have liked more experience in practical areas related to career planning and office management, more input from subspecialties such as orthopedics and dermatology, greater knowledge about the management of psychosocial problems, and more information about exercise and nutrition. Although many physicians also wanted more time devoted to several other topics, less than 20 percent recommended spending less time on 26 of the 27 topics being evaluated. Since these recommendations are similar to those reported in evaluation studies published over the past 25 years, it appears that training programs in internal medicine have not been successful in restructuring their curricula to meet many of the needs of practicing physicians. PMID- 3959049 TI - A case study of a medical school special admissions program. PMID- 3959048 TI - Students' perceptions of values emphasized in three medical schools. AB - The purpose of the study presented here was to assess medical students' perceptions of the weight given to scientific and humanistic values in their learning environment and to determine whether students' perceptions in a given school vary according to their level of medical training and personal characteristics. The study was conducted in 1979 via a mail questionnaire sent to a sample of 713 freshmen, juniors, and graduates from three U.S. medical schools; 82.2 percent responded. The results indicated that the students' perceptions of school values varied little according to the students' personal characteristics, such as sociodemographic and educational background, interests before medical training, and expected specialty choice. However, important differences were observed in students' perceptions of values emphasized to them at different schools. Preclinical and clinical students' perceptions of the importance given to scientific values were similar. As for humanistic values, significantly lower ratings were given by clinical students than preclinical students in two of the schools. PMID- 3959050 TI - Comparison of the abbreviated and original versions of the Myers-Briggs Type Indicator personality inventory. PMID- 3959051 TI - Preventive health measures carried out by residents during new and follow-up patient visits. PMID- 3959053 TI - Using filing cards to document and computerize procedures performed by internal medicine residents. PMID- 3959052 TI - Performances of female medical students in an obstetrics and gynecology clerkship. PMID- 3959054 TI - Teaching critical appraisal and application of medical literature to clinical problem-solving. PMID- 3959055 TI - Should higher diagnostic and therapeutic costs be justified for educational reasons alone? PMID- 3959056 TI - A comparison of the predictive validity of the MCAT for coached and uncoached students. PMID- 3959057 TI - Commentary on the report of the Panel on the General Professional Education of the Physician and College Preparation for Medicine. Adopted by the Executive Council of the Association of American Medical Colleges. September 12, 1985. PMID- 3959058 TI - Surgical and microscopic anatomy of parotid and submandibular salivary glands of rhesus monkeys (Macaca mulatta). AB - Wedge biopsy of the caudal borders of the parotid or submandibular salivary glands of rhesus monkeys avoids major nerves, ducts, and blood vessels. This is a minor surgical procedure that provides adequate material for in vitro studies and causes no significant postoperative complications. Gross and light microscopic anatomy of the rhesus and human salivary glands are similar. We have concluded that rhesus monkeys are good models for human salivary diseases, including radiation sialoadenitis. PMID- 3959059 TI - A coprological study of parasitism in orangutans (Pongo pygmaeus) in Indonesia. AB - Fecal specimens from 89 orangutans (36 captive, 34 rehabilitant, and 19 wild) at different locations in Indonesia were examined. Strongyloides spp, Balantidium coli, and strongylid nematodes were the most common infestations detected. A syngamid nematode, Mammomonogamus sp, is reported for the first time in orangutans. PMID- 3959060 TI - Spontaneous hypercholesterolemia and atherosclerosis in a titi monkey. AB - An adult male Callicebus moloch was presented for acute congestive heart failure. Therapy was unsuccessful and necropsy showed severe systemic atherosclerosis. Analysis of serum revealed hypercholesterolemia with specific elevation of the betalipoprotein fraction. PMID- 3959061 TI - Massive sequestration of human sickle cells after transfusion to a baboon. AB - A baboon was exchange-transfused with sickle cell anemia patients' blood. The animal died suddenly, and postmortem examination showed widespread red cell sequestration, particularly in the spleen and liver. The clinical and pathological findings were similar to those in children with sickle cell anemia who die of acute splenic sequestration syndrome. A control animal, exchange transfused with normal human blood, tolerated the procedure without difficulties for a period of 4 days, when a delayed transfusion reaction occurred. Thus the baboon can be used as a model for the abnormal circulatory behavior of sickle cells and for the sickle cell sequestration syndrome. PMID- 3959062 TI - The effect of chamber restraint (with or without lower body positive pressure) on hematopoiesis (particularly erythropoiesis) in squirrel monkeys (Saimiri sciureus) AB - Squirrel monkeys, restrained in lower body positive pressure (LBPP) chambers in attempts to model the space flight-induced hematological consequences of a cephalad fluid shift, showed a decrease in red blood cell mass which was largely independent of actual LBPP. The only LBPP-specific hematological effect was an alteration in red blood cell (RBC) survival. This monkey model represents the second, ground-based animal system in which this phenomenon has been recorded and shown to be unique to a cephalad fluid shift. These data suggest a re-evaluation is necessary of the role of altered RBC clearance as a contributing factor to the anemia of space flight in humans. PMID- 3959063 TI - Blood characteristics of the crab-eating monkeys (Macaca fascicularis) in Bali Island, Indonesia: implication of water deficiency in West Bali. AB - Environmental effects on blood characteristics of macaques were examined by comparing several blood indices of the free-ranging crab-eating monkeys (Macaca fascicularis) in two distinct regions of Bali Island, Indonesia. The total plasma protein level and concentrations of creatinine and sodium ion were higher with macaques of Teluk Terima in the west part of Bali Island (dry area) than those in the central Bali (wet area). Results indicated that water deficiency in the dry area significantly affects the blood characteristics of macaques. PMID- 3959066 TI - Microscopic observation and video recording of cellular response to sudden changes in environment. AB - A method to record responses of single cells to rapid changes in their environment is described. A rectangular glass microcapillary is filled with the cell suspension under investigation and placed under a light microscope. With the aid of a micromanipulator a smaller microcapillary with a narrowed tip, which was still over 10 times wider than the cell diameter, is driven into the larger, cell containing, microcapillary. The environment of the cells is changed by injecting a new medium via the smaller capillary and the cell responses are recorded using a video recording system. The usefulness of the system has been examined by studying the time course of the osmotic swelling of erythrocytes after water injection and the shape transformations caused by lysophosphatidylcholine. PMID- 3959065 TI - Properties of an anion/H+ cotransport system in L1210 cells that utilizes phthalate as a nonphysiological substrate. AB - [14C]Phthalate is transported into L1210 cells via two separate routes, an anion exchange system whose primary substrates are folate compounds, and a second less active system which is sensitive to bromosulfophthalein. When the principal uptake component was blocked by a specific irreversible inhibitor of this system, the remaining route (at pH 7.4) appeared to be saturable and was inhibited by several anions in addition to bromosulfophthalein (Ki = 2 microM), including 8 anilino-1-naphthalein sulfonate (Ki = 25 microM), unlabeled phthalate (Ki = 500 microM), and chloride (Ki = 3500 microM). A pronounced effect by pH was also observed. Influx and total uptake of phthalate both increased progressively with decreasing pH and reached values that were 20-fold higher at pH 6.0, compared with pH 7.4. This pH-dependent increase could be blocked, however, by the addition of compounds (nigericin and carbonylcyanide m-chlorophenylhydrazone) which, in combination, collapse proton gradients. Phthalate efflux was relatively insensitive to changes in extracellular pH but could be inhibited (up to 90%) by bromosulfophthalein. Several other anions also inhibited efflux, but to a lesser extent, while chloride, phthalate, lactate, glycolate and acetate enhanced efflux up to 1.8-fold. Efflux also increased at pH 6.0, but not at pH 7.5, upon addition of nigericin and carbonylcyanide m-chlorophenylhydrazone. These results suggest that phthalate is a nonphysiological substrate for a carrier system which mediates transport via an anion/H+ symport mechanism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959064 TI - Demarcation of Ca2+ transport processes in guinea pig stomach smooth muscle. AB - Microsomal fractions were isolated from gastric antrum and fundus smooth muscle of guinea pigs. Ca2+ uptake into and Ca2+ release from the membrane vesicles were studied by a rapid filtration method, and Ca2+ transport properties of the different regions of the stomach were compared. ATP-dependent Ca2+ uptake was similar in microsomes isolated from both regions. This uptake was increased by oxalate and was not affected by NaN3. Oxalate affected Ca2+ permeability of both antrum and fundus microsome vesicles similarly. Fundus microsome vesicles preincubated in 100 mM NaCl and then diluted to 1/20 concentration with Na+-free medium had significantly higher ATP-independent Ca2+ uptake than vesicles preincubated in 100 mM KCl and treated the same way. This was not true for antrum vesicles. Monensin abolished Na+-dependent Ca2+ uptake, and NaCl enhanced Ca2+ efflux from fundus microsome vesicles. The halflife values of Ca2+ loss from fundus vesicles in the presence of NaCl were significantly smaller than those in the presence of KCl. The release of Ca2+ from the vesicles within the first 3 min was accelerated by NaCl to three times that by KCl. However, NaCl had no effect on Ca2+ release from antrum microsome vesicles. Results suggest two distinct mechanisms of stomach membrane Ca2+ transport: (1) ATP-dependent Ca2+ uptake and (2) Na+-Ca2+ exchange; the latter in the fundus only. PMID- 3959067 TI - Microscopic spectral imaging using a video camera. AB - A technique is described which permits the simultaneous acquisition of multiple fluorescent emission and/or absorption spectra from discrete regions of a specimen under microscopic observation. The instrument consists of a modified inverted microscope, an optical diffraction grating, a silicon intensified target (SIT) camera, and a digital video image processor. Observation of the zero diffraction order of the grating with the SIT camera permits an optical slice of the specimen to be selected by positioning the region of interest over the entrance slit of the grating housing. To obtain the spectral characteristics of this optical slice, the grating is rotated to impinge the first order diffraction on the camera. The video image of this first order diffraction maintains spatial integrity along the slit's long axis and provides spectral dispersion on the perpendicular axis. Thus, each of the horizontal video lines along the long axis of the slit represents a spectral analysis of the corresponding spatial location within the specimen. The spectral resolution (0.2 nm/channel) of each video line is determined by the resolution of the camera system in conjunction with the resolution of the grating. The image processing system acquires and processes all 500 spectra in 33 ms and permits the accurate localization of the source of each spectrum in the slice. This type of topological spectral analysis permits the determination of both spatial and spectral characteristics of intrinsic or extrinsic chromophores within the specimen. In addition, this technique permits the detection of and the possible correction for photobleaching, light scattering and image plane effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959068 TI - Quantitative DNA measurements in an instrument combining scanning electron microscopy and light microscopy. AB - An instrument for combined scanning electron microscopy (SEM) and light microscopy (LM) to which a photometer unit is attached is described. A special stage in the vacuum chamber of a scanning electron microscope incorporates light microscope optics (objective and condenser) designed for transmission and epi illumination fluorescence LM. An optical bridge connects these optics to a light microscope, without objective and condenser. The possibility of performing quantitative DNA measurements in this combined microscope (the LM/SEM) was tested using preparations of either chicken erythrocytes, human lymphocytes, or mouse liver cells. The cells were fixed, brought on a cover-glass, quantitatively stained for DNA, dehydrated, and critical point dried (CPD). After mounting the cells were coated with gold. The specimens were brought into the vacuum chamber of the combined microscope and individual cells were studied with SEM and LM. Simultaneously DNA measurements were performed by means of the photometer unit attached to the microscope. It is shown in this study that DNA measurements of cells in the combined microscope give similar results when compared to DNA measurements of embedded cells performed with a conventional fluorescence microscope. Furthermore, it is shown that although the gold layer covering the LM/SEM specimens weakens the fluorescence signal, it does not interfere with the DNA measurements. PMID- 3959070 TI - Fast cryofixation technique for X-ray microanalysis. AB - The proposed cryofixation technique uses a tubule-shaped needle chilled in liquid propane for simultaneous excision and freezing of a tissue specimen. Due to this simultaneity, ionic shifts created by traumatic influences are avoided even in the outermost cells of the specimen. Moreover, it is shown here that stopping the blood flow for more than about 10 s results in notable ionic shifts between cells and extracellular space in rat heart and liver. Such preparative ischaemic injury is minimized by the Fast Cryofixation Technique because it can be easily performed on organs within the circulatory system, whilst the heart of the animal is still beating. Intracellular concentrations of the monovalent ions in rat heart and liver, obtained by this method, tally well with recent results from different independent techniques reported in the literature. As demonstrated by cross-sectioning and freeze-fracturing, the structural preservation of the freezing technique is sufficient for X-ray microanalytical work. PMID- 3959069 TI - A sample preparation for quantitative determination of magnesium in individual lymphocytes by electron probe X-ray microanalysis. AB - We present a sample preparation method for measuring magnesium in individual whole lymphocytes by electron probe X-ray microanalysis. We use Burkitt's lymphoma cells in culture as the test sample and compare X-ray microanalysis of individual cells with atomic absorption analysis of pooled cell populations. We determine the magnesium peak-to-local continuum X-ray intensity ratio by electron probe X-ray microanalysis and calculate a mean cell magnesium concentration of 39 +/- 19 mmol/kg dry weight from analysis of 100 cells. We determine a mean cell magnesium concentration of 34 +/- 4 mmol/kg dry weight by atomic absorption analysis of pooled cells in three cell cultures. The mean cell magnesium concentrations determined by the two methods are not significantly different. We find a 10% coefficient of variation for both methods of analysis and a 30% coefficient of variation in magnesium concentration among individual cells by electron probe X-ray microanalysis. We wash cells in ammonium nitrate for microanalysis or in buffered saline glucose for atomic absorption analysis. We find cells washed in either solution have the same cell viability (85%), recovery (75%), cell volume (555 microns 3) and cytology. We air dry cells on thin film supports and show by magnesium X-ray mapping that magnesium is within the cells. We conclude that: our microanalysis cell preparation method preserves whole intact lymphocytes; there is no systematic difference in results from the two methods of analysis; electron probe X-ray microanalysis can determine the variation in magnesium concentration among individual cells. PMID- 3959071 TI - Surface exchange area of the porcine placenta: morphometry of anisotropic interdigitating microvilli. AB - The pig has a diffuse epitheliochorial placenta. The foeto-maternal surface area (Sv(F), Sv(M)) is enlarged at three levels: level I: macroscopic folds of uterine mucosa covered by foetal membranes; level II: light microscopic folds of uterine epithelium covered by trophoblastic epithelium; level III: ultrastructural formation of both maternal and foetal microvilli in an interdigitating pattern. This study presents a morphometric method, using intersection counting, to estimate the surface area of these interdigitating, highly oriented microvilli at level III, i.e. the 'true' surface exchange area. The method is applied to different stages in pregnancy. The epithelial surfaces are enlarged by a factor 8 11 due to the formation of microvilli. This factor varies during pregnancy, being lower early in gestation and before delivery, and for the first time it is shown to be significantly different for mother and foetus. At level III the foetal surface of placenta is larger than the maternal indicating that the two opposing surfaces are not congruent at the ultrastructural level and that membrane-linked placental transport may be different in mother and foetus. A three-compartment model is suggested for placental exchange with maternal, intermicrovillous and foetal compartments. PMID- 3959072 TI - A method for observing intracellular structures of free cells by scanning electron microscopy. AB - A new method is described for scanning electron microscopic observation of cultured free cells using chitosan embedding. Intracellular structures of free cells can be clearly observed using a combination of the chitosan embedding and the Osmium-DMSO-Osmium (O-D-O) method. Chitosan, a polysaccharide, is not affected by the osmium maceration procedure central to the O-D-O method, which destroys other possible embedding media such as gelatin, agar, egg albumin and fibrin. Chitosan cracks to yield a fracture face which is featureless at low magnifications, and causes no recognizable artefacts. PMID- 3959073 TI - Electronic image formation in high-voltage TEM by sequential pixel acquisition. AB - We describe a complete hybrid imaging system for the electronic detection and manipulation of high-voltage TEM images. The system includes a recently incorporated two-dimensional beam deflector for dissecting the image into pixels by displacing it in a raster in front of an aperture leading to an electron detector. The characteristics of images thus formed by sequential pixel acquisition and displayed on a CRT are discussed and illustrated. Absorption or thickness profiles are also obtained by displaying the scanned pixel intensity in Y-modulation. Similarly, the displacement of an entire diffraction pattern allows the intensities of individual diffraction spots to be quantitated directly over a wide dynamic range. The direct splitting of the image into electronically controlled pixels can be applied to local mass measurements and to energy-loss analysis by means of a simple magnetic prism that can also provide energy filtering in lieu of a more elaborate electron-optical, image-preserving system. PMID- 3959074 TI - Cat scratch encephalopathy. PMID- 3959075 TI - Outstate Neurology Clinics for the medically indigent--a continuing need. PMID- 3959076 TI - Mississippi adopts national medical standards for measurement of medical malpractice. PMID- 3959077 TI - Prediction of the occurrence of the ADP-binding beta alpha beta-fold in proteins, using an amino acid sequence fingerprint. AB - An amino acid sequence "fingerprint" has been derived that can be used to test if a particular sequence will fold into a beta alpha beta-unit with ADP-binding properties. It was deduced from a careful analysis of the known three-dimensional structures of ADP-binding beta alpha beta-folds. This fingerprint is in fact a set of 11 rules describing the type of amino acid that should occur at a specific position in a peptide fragment. The total length of this fingerprint varies between 29 and 31 residues. By checking against all possible sequences in a database, it appeared that every peptide, which exactly follows this fingerprint, does indeed fold into an ADP-binding beta alpha beta-unit. PMID- 3959079 TI - Nuclear magnetic resonance identification of "half-turn" and 3(10)-helix secondary structure in rabbit liver metallothionein-2. AB - Analysis of 1H-1H nuclear Overhauser effects and amide proton-C alpha proton coupling constants in rabbit liver metallothionein-2 resulted in the identification of two segments of 3(10)-helix and numerous secondary structure elements of a novel type, which we call "half-turn". A half-turn can be generated starting from a type II tight turn by rotation of phi 3 from +90 degrees to -90 degrees. Its appearance in metallothionein appears to be a consequence of the constraints on the polypeptide conformation by the large number of metal binding sites. PMID- 3959078 TI - Polypeptide fold in the two metal clusters of metallothionein-2 by nuclear magnetic resonance in solution. AB - The solution conformation of rabbit liver Cd27+-metallothionein-2 was determined by nuclear magnetic resonance (n.m.r.) and distance geometry. The n.m.r. data are based on complete sequence-specific resonance assignments for the polypeptide chain. This letter describes the global arrangement of the polypeptide chain, which forms two distinct domains containing metal clusters of three and four Cd ions, respectively. PMID- 3959080 TI - Conformational study of 13C-enriched fibroin in the solid state, using the cross polarization nuclear magnetic resonance method. AB - Silk fibroin with the alanyl carboxyl carbon enriched with 13C was obtained by giving a diet containing 13C-enriched alanine to the larvae of Bombyx mori and Antheraea pernyi at the fifth instar. Sericin-free fibroin fibers were prepared from cocoons, and gut was made from the liquid silk in the gland. The final 13C content was about 13%. Cross polarization/magic angle sample spinning spectra at 25 MHz and 75 MHz were measured for each sample at different orientations. Spectra were simulated using the principal values and orientations of the shielding tensor in the alanine crystal. The results indicate that the beta structure of the fibroin may be a little more flattened than the typical pleated sheet beta-structure. PMID- 3959081 TI - New crystal forms of ribulose-1,5-bisphosphate carboxylase/oxygenase from Rhodospirillum rubrum. AB - Three crystal forms of the dimeric form of the enzyme ribulose-1,5-bisphosphate carboxylase from the photosynthetic bacterium Rhodospirillum rubrum have been obtained from the gene product expressed in Escherichia coli. Form A crystals formed from the quaternary complex comprising enzyme-activator carbamate-Mg2+-2' carboxyarabinitol-1,5-bisphosphate are shown here to be devoid of ligands. In contrast, crystals of the quaternary complex formed with the hexadecameric L8S8 enzyme from spinach contain both the activator carbamate and 2'-carboxyarabinitol 1,5-bisphosphate. Form B crystals of the R. rubrum enzyme are monoclinic, space group P2(1) with cell dimensions a = 65.5 A, b = 70.6 A, c = 104.1 A and beta = 92.1 degrees, with two subunits per asymmetric unit. Rotation function calculations show a non-crystallographic 2-fold axis perpendicular to the monoclinic b-axis. Form C crystals are orthorhombic (space group P2(1)2(1)2(1)) with cell dimensions a = 79.4 A, b = 100.1 A and c = 131.0 A. The monoclinic crystal form diffracts to at least 2.0 A resolution on a conventional X-ray source. PMID- 3959082 TI - Transcribed human ribosomal RNA genes are attached to the nuclear matrix. AB - Nuclear matrices were prepared from HeLa nuclei in high or low-salt buffers. After digestion with restriction enzymes, the DNA associated with the nuclear matrix was analysed for its content of ribosomal DNA sequences (rDNA). In both salt conditions, the entire rDNA repeat unit was found to be enriched in the matrix DNA. No enrichment, however, was detected in the absence of rRNA transcription either due to treatment with actinomycin D or when cells arrested in the G0 stage were used to prepare matrices. rDNA was found to be linked to chromosomal scaffolding structures when similar experiments were performed on chromosomes. Moreover, a gradient of enrichment along the rDNA repeat unit was observed, in which the promoter-containing portion was the most highly enriched. I conclude from these experiments that the tandem repeats of rDNA are not randomly associated with matrix or scaffold structure but are probably attached at transcription complexes. PMID- 3959083 TI - Identification of a distinct class of vinblastine binding sites on microtubules. AB - Vinblastine, at concentrations above approximately 1 to 2 microM, causes depolymerization of steady-state bovine brain microtubules in vitro by a fraying of microtubule ends into protofilament-like spirals. Microtubule depolymerization is associated with the binding of vinblastine in approximately molar stoichiometry to tubulin in microtubules with apparent low affinity, as determined by binding experiments with radiolabeled vinblastine and by the ability of vinblastine to inhibit DEAE-dextran decoration of microtubule surfaces. Our data suggest that depolymerization occurs by a propagated mechanism, initially involving binding of vinblastine to a limited number of available sites on microtubule surfaces. This appears to cause loosening of protofilament associations which results in the exposure of new vinblastine binding sites. Additional vinblastine binding in turn results in further loosening of protofilament associations. Such loosening, when it occurs at microtubule ends, results in protofilament-like splaying and end-wise depolymerization. Microtubule depolymerization appears mechanistically distinct from inhibition of microtubule polymerization by the drug, which is associated with the binding of vinblastine to small numbers of high-affinity binding sites on tubulin at one or both microtubule ends. PMID- 3959084 TI - The effects of sex steroid treatments on sexual differentiation in a unisexual lizard, Cnemidophorus uniparens (Teiidae). AB - Cnemidophorus uniparens is a parthenogenetic unisexual species of lizard in which each individual develops as a female, making it a unique animal model for the study of sexual differentiation. In one study, administration of exogenous testosterone before and/or after hatching influenced the development of the gonads, the accessory reproductive ducts, the renal sex segment of the mesonephric kidney, and the femoral glands, a secondary sex character. Testosterone treatment also affected the cross-sectional area of the gonad and the proportions of cortical and medullary tissues present in the developing gonad. The oviducts and femoral glands of testosterone-treated individuals were hypertrophied; the collecting tubules of the kidney of these animals contained granules, an androgen-dependent, sexually dimorphic character in squamate reptiles. In another study, testosterone, dihydrotestosterone, or estradiol were administered to C. uniparens embryos. No treatment effects on gonadal development were detected on the day of hatching. However, estradiol, but not testosterone and dihydrotestosterone, stimulated development of the oviducts. Taken together these studies suggest that androgen aromatization may play a role in sexual differentiation in lizards. PMID- 3959086 TI - Comparative features of the surface morphology of the basilar papilla in five families of salamanders (Amphibia; Caudata). AB - The surface morphology of the basilar recess and papilla was examined in 14 species of newts and salamanders selected from the five families of urodeles (Ambystomatidae, Salamandridae, Hynobiidae, Cryptobranchidae, and Amphiumidae) known to have this end-organ. In this sampling, the general organization of basilar structures is essentially similar across species investigated. The recess forms a tubular diverticulum of the proximal part of the lagena. One wall of the recess is associated with a diverticulum of the intracapsular periotic sac, and an adjacent wall is occupied by the basilar papilla. The papilla contained from as few as five hair cells in specimens of Taricha torosa to over 200 hair cells in Cryptobranchus allegheniensis. In most species, the papilla showed a morphological continuum between tall centrally or distally placed ciliary bundles and short ciliary bundles near the papillar margins. In certain species examined, tall bundles had kinocilia with swellings near their tips. Most forms showed a tendency to have groups of ciliary bundles morphologically polarized either toward or away from the saccule. In Cryptobranchus and Dicamptodon, many bundles had a random orientation. The gross and fine structural features of the basilar complex are compared in urodeles and anurans, and "generalized" features for the amphibian basilar complex are suggested. The basilar complex of Cryptobranchus is interpreted as being most generalized, representing a structural form from which most features of the basilar complex in other urodeles and anurans can be derived. PMID- 3959085 TI - Morphological and fine structural features of the basilar papilla in ambystomatid salamanders (Amphibia; Caudata). AB - The morphology and fine structure of the basilar recess and basilar papilla were investigated in four species of salamanders from the family Ambystomatidae. The otic relationships of the recess and papilla to the proximal part of the lagena and saccule are described, and new terminology is suggested for the periotic relationships of the basilar recess to a diverticulum of an intracapsular periotic sac. The basilar papilla consists of supporting cells united laterally by gap junctions, capped by microvilli uniformly arranged around a short, central cilium, and hair cells that typically show several synapses with a single afferent nerve fiber, each marked by a rounded synaptic body surrounded by vesicles. In contrast to anuran basilar papillae, efferent nerve terminals were observed in synapse with hair cells and, rarely, upon afferent fibers. The distal half of the ambystomatid papilla contained hair cells capped by tall ciliary bundles, with kinocilia that show swellings near their tips with delicate attachments to adjacent tall stereocilia. A tectorial body covers only this region of the papilla. Hair cells with shorter stereocilia, situated in the proximal half and at the papillar margins, are related only to filamentous extensions of the tectorial body. The ambystomatid basilar recess and papilla are compared to auditory end-organs in other vertebrates, and it is suggested that a basic distinction can be made between aural neuroepithelia in amniotes versus that in nonamniotic vertebrate ears. PMID- 3959087 TI - Functional morphology of the M. gastrocnemius medialis of the rat during growth. AB - Length-force relations, both active and passive, and twitch contraction characteristics were quantified for left medial gastrocnemius muscles of four young, four adult, and four old male Wistar rats. Muscle and bundle optimum length and muscle weight were also determined and subsequently used for calculation of a number of morphological characteristics of the muscles. Fiber optimum length was derived from muscle bundle optimum length. Generally, physiological characteristics remained constant during growth. There was no change either in active tension at muscle optimum length or in active working range relative to fiber optimum length, relative passive fiber stiffness, active force relative to passive force at optimum length, twitch contraction time and twitch half relaxation time at optimum length. A number of morphological changes, however, did take place in the medial gastrocnemius muscle during growth. Fiber optimum length increased but only by about 2 mm from youth to old age, whereas muscle optimum length increased by approximately 14 mm, presumably owing to extensive hypertrophy of the muscle fibers during growth. The priority for force of the medial gastrocnemius muscle (defined as the quotient of physiological cross-sectional area of a muscle and the cubed root of its volume, a measure independent of architecture and dimensions of muscles) increased during growth. This increase indicates that during growth the muscle shifts relatively more towards force generation than towards excursion generation. These findings are discussed in view of existing scaling theories. PMID- 3959088 TI - Diastolic coronary resistance after ischaemia in the isolated rabbit heart: effect of nifedipine. AB - The effect of nifedipine on tension, coronary flow and perfusion pressure was studied in the Langendorff rabbit heart after 15 and 60 min global ischaemia. Nifedipine (1.44 X 10(-8) M) added to the perfusate before 15 min ischaemia prevented the increase of diastolic coronary resistance which occurred on reperfusion in the absence of the drug. The recovery of force of contraction was unaltered. There was no change in the increase in resistance on reperfusion if nifedipine (1.44 X 10(-8) M) was given at the time of reperfusion after 15 min ischaemia. Ventricular fibrillation on reperfusion was prevented if nifedipine was added before 15 min of ischaemia. After a more prolonged period of ischaemia (60 min) the rise of resting tension on reperfusion was not prevented by giving nifedipine (1.44 X 10(-8) M or 1.44 X 10(-7) M) before ischaemia, although the rise during ischaemia was delayed. Both concentrations of nifedipine reduced the increase in diastolic coronary resistance which occurred on reperfusion. These results suggest that nifedipine, in a concentration close to the therapeutic range, increases coronary reperfusion after global ischaemia. This represents one mechanism by which nifedipine can have a beneficial effect on the ischaemic myocardium. PMID- 3959089 TI - Relation between the phosphocreatine to ATP ratio determined by 31P nuclear magnetic resonance spectroscopy and left ventricular function in underperfused guinea-pig heart. AB - The relation between the PC/ATP ratio and left ventricular function was examined in the Langendorff-perfused guinea-pig heart over a range of perfusion flow rates. PC/ATP ratios were determined from the 31P-nuclear magnetic resonance spectra of hearts obtained at 80.98 MHz and ventricular function estimated by measuring pressure in the left ventricle. When flow rates were increased over the range 0.6 to 6.0 ml/min, the PC/ATP ratio increased from 0.64 +/- 0.05 at 0.6 ml/min to 1.82 +/- 0.12 at 3.8 ml/min with no further increase up to a flow rate of 6.0 ml/min. Developed pressure (DP) increased with the flow rate up to 6.0 ml/min but the end diastolic pressure (EDP) also increased. The DP/EDP ratio was found to correlate closely with the PC/ATP ratio over the range of flow rates examined. The PC/ATP ratio may be a practical index of myocardial function available to the clinician when the topical magnetic resonance technique is fully developed. PMID- 3959090 TI - Systemic hypertension induces disparate localized left ventricular action potential lengthening and altered sensitivity to verapamil in left ventricular myocardium. AB - Previously, we demonstrated that acute exposure to superfusate containing verapamil suppresses action potential plateau to a greater degree in cells at the tip of the anterior papillary muscle compared to those at its base in normal cat left ventricle (LV) studied in tissue bath. To determine the effects of chronic pressure overload brought about by renal hypertension on papillary muscle electrophysiology and regional sensitivity to verapamil, LV were isolated from cats subjected to unilateral nephrectomy and contralateral kidney wrapping. After 3 months, systemic hypertension (mean increase = 60.2 +/- 1.4 mmHg) was associated with moderate LV hypertrophy of approximately equal to 18% (LV weight/body weight). Transmembrane action potentials recorded from the endocardial surface (including anterior papillary muscle) in pressure overloaded LV in vitro (800 ms stimulus cycle length) showed increased action potential duration at 25, 75 and 90% of repolarization (APD25, APD75 and APD90, respectively) relative to controls (LV from normal and sham operated cats). With respect to the anterior papillary muscle in pressure overloaded LV, APD25, APD75 and APD90 were increased to a greater extent in cells at the base of the muscle compared to those increases observed at the tip (P less than 0.05). In contrast to its effects in controls, verapamil (2 micrograms/ml) significantly reduced APD25 at both the base and the tip of the papillary muscle in pressure overloaded preparations, but particularly at the base; also, the disparities between the APD75 or APD90 at tip and base were decreased. Thus, regional electrophysiologic disparities were induced in systemic hypertension, and these differences were subsequently reduced by verapamil.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959092 TI - Effect of acute alcoholic intoxication on myocardial electrolyte and water distributions. AB - Myocardial electrolyte distributions and sarcolemmal permeability in vivo were compared among control, acutely alcoholic, and recovery groups of rats. Rats in the alcoholic group received an intraperitoneal dose of 56 ml 12.5% ethanol per kg rat over a 5-h period. One hour after receiving the last injection of ethanol, blood was withdrawn from the right atrium and the heart excised. Rats in the recovery group had one day to recover from the alcohol treatment. Control rats were injected with n-saline instead of ethanol. Myocardial extracellular space was assessed by morphometric and tracer techniques. Results indicate that myocardial water content increases during acute alcoholic intoxication and this increase is restricted to the extracellular space. The nominal cellular concentration of potassium increased nearly 10% while that of sodium fell by nearly one-third. Plasma concentration of magnesium increased markedly (36%) and that of calcium fell slightly (5%). The results suggest that the myocardial sarcolemma is not rendered leaky by acute ethanol intoxication even several days after binge drinking, when the skeletal muscle cell sarcolemma appears to become slightly more permeable. PMID- 3959091 TI - Developmental change in the function of sarcoplasmic reticulum. AB - This study investigates the developmental changes of sarcoplasmic reticulum function in rabbit heart. We used ryanodine to evaluate sarcoplasmic reticulum function in the isolated arterially perfused fetus, newborn and adult rabbit heart muscles. The magnitude of the negative inotropic effect of ryanodine was similar in the fetus and the 3-day-old newborn, and it was less than in the 7-day old while the effect in the 7-day-old newborn was significantly less than in the adult. In the adult, and not in the newborn, ryanodine (10(-6) M) caused prolongation of half relaxation time and time to peak tension, and an increase in resting tension. In addition, ryanodine (10(-1) M was more effective in the adult, compared to the 3-day-old newborn, in the attenuation of the positive inotropism of staircase, hyperosmolarity and paired electrical stimulation. These data suggest that sarcoplasmic reticulum function dramatically changes during the perinatal period, and furthermore, suggests that the adult hearts are most likely dependent on Ca2+ release and uptake from sarcoplasmic reticulum, while the perinatal hearts are more dependent on transsarcolemmal Ca2+ influx than on sarcoplasmic reticulum Ca2+ release in excitation-contraction coupling. PMID- 3959093 TI - Different effects of calcium-antagonists on automaticity in single pacemaker cells and in synchronized networks of cultured embryonic heart muscle cells. AB - The inhibitory effects of the calcium antagonists D-600 and diltiazem on impulse formation of pacemaker cells were studied in embryonic chick heart cells, cultured either as single cells or as synchronized multicellular networks. Our findings show that D-600 and diltiazem inhibit the spontaneous action potentials of the cultured cells in a potential- and use-dependent way. However, a marked reduction of the beat frequency could not be found during inactivation of the spontaneous action potentials in the single cells. Only in synchronized multicellular networks cultured under the same conditions was the beat frequency clearly reduced, probably due to the ability of Ca-antagonists to inactivate the most quickly discharging cells first. Thus, the dominant pacemaker cell in a synchronized multicellular network will fade out first and the subsequent negative chronotropic effect is the outcome of a shift in the pacemaker center to cells with a lower intrinsic frequency. These findings indicate that Ca antagonists predominantly inhibit excitability and impulse conduction. The velocity of slow diastolic depolarization of the single pacemaker cell is not markedly decreased and, therefore, cannot be used to explain the process behind the negative chronotropic effects seen in multicellular systems. PMID- 3959094 TI - Ornithine decarboxylase in perfused rat heart. AB - In the isolated perfused rat hearts, the activity of tissue ornithine decarboxylase gradually decreases over 90 min. In contrast, the activity of S adenosylmethionine decarboxylase, lactate dehydrogenase, and glutamate oxalacetate transaminase stays unchanged after a small decrease during the first 10 min. Ornithine decarboxylase is released from the perfused heart under conditions in which neither the lower molecular weight S-adenosylmethionine decarboxylase nor polyamines leak out. Ten minutes of ischaemia did not change the rate of release of ornithine decarboxylase. Ischaemia followed by reperfusion (20 min) increased release of ornithine decarboxylase. PMID- 3959095 TI - Comparison of the protective effects of verapamil, diltiazem, nifedipine, and buffer containing low calcium upon global myocardial ischemic injury. AB - This study was designed to compare the effects of the Ca2+ slow channel blocking agents verapamil (2 X 10(-6) M), diltiazem (7.5 X 10(-7) M), and buffer containing reduced Ca2+ content (0.95 mM) on myocardial ischemic injury. These treatments were equiactive, reducing cardiac function to 20% of the control value, and fully reversible in nonischemic, isolated, working rat hearts. Hearts which were reperfused (30 min) following 27 min of global ischemia recovered 17% of control cardiac function and had a markedly reduced ATP and creatine phosphate content and ATP/ADP ratio compared to nonischemic hearts. When verapamil, diltiazem, nifedipine, or low Ca2+ treatments were given before and during ischemia, equal improvement in cardiac function was observed upon reperfusion, and tissue ATP levels, creatine phosphate levels, and ATP/ADP ratio were significantly higher than in hearts which did not receive the treatments or which received the drug vehicle. Large increases in recovery of contractile function were observed with a partial preservation of ATP reserves. These treatments, which were equiactive in nonischemic hearts, provided equivalent preservation of cardiac function, ATP, and creatine phosphate in the reperfused ischemic hearts. When the ischemic period was increased to 33 min and the effective concentrations reduced to depress cardiac function to 40% of the control value (4.5 X 10(-7) M verapamil, 2.5 X 10(-6) M diltiazem, 3 X 10(-7) M Nifedipine, 1.25 mM Ca2+), equal improvement in cardiac function was again observed. Thus, major differences among these Ca2+ slow channel blockers or low Ca2+ treatment were not detected in this experimental system. PMID- 3959096 TI - Daunomycin-induced cardiomyopathy in rabbits: isolated heart and papillary muscle energetics. AB - Daunomycin was administered to one of each pair of litter mate rabbits at a weekly dosage rate of 40 mg/m2. Treated animals were killed when their pre ejection period: left ventricular ejection time ratio (PEP:LVET) reached 0.4 and there was other evidence of cardiac abnormalities or when they had received 12 doses of daunomycin. Langendorff-perfused hearts from the treated animals had lower intrinsic heart rates (16%) and decreased coronary resistance (31%) in the arrested state. There was no significant difference between the basal metabolism of the arrested control and treated hearts but the magnitude of the activation component, measured under beating non-working conditions, was depressed by daunomycin. After the whole heart perfusion studies were complete, approximately 2 h after cardiectomy, papillary muscles were dissected out from the right ventricles and mechanical, myothermic and polarographic studies were undertaken. The resting heat production, in support of the whole heart metabolic data, was practically unchanged by the treatment regime. Peak stress development and work output were similar in both the control and treated groups. In energetic terms the slope of the relationship between total stress development and active heat production per beat was unchanged but there was a 21% depression of the activation heat component in the treated animals. Daunomycin treatment had not altered the work output per contraction or significantly changed energy output and hence mechanical efficiency was unaltered. It is clear that 2 h of Langendorff perfusion does not produce any depression of contractile or energetic properties in papillary muscles. PMID- 3959097 TI - Factors affecting the development of contraction band necrosis during reperfusion of the isolated isovolumic rat heart. AB - The effects of time, oxygen availability and transmural fibre location on the post-ischaemic development of contraction-band necrosis was investigated in isolated isovolumic rat hearts. Anoxic reperfusion after 60 min of total ischaemia was associated with the slow development of contraction bands (8% of myocytes affected after 20 min), particularly in the circumferentially oriented mid-myocardial muscle fibres. This could be completely prevented by the presence of 3 mM amytal. Oxygenated reperfusion caused a rapid development of contraction bands (6% of myocytes affected after 5 mins) which was significantly (P less than 0.05) increased to 18% of cells affected by 20 mins reoxygenation. The mid myocardium always contained the greatest number of contraction bands with up to 46% of cells involved after 20 mins of oxygenated reperfusion. In all groups many cells were observed to have disrupted sarcolemmae irrespective of the presence or absence of contraction bands. The predominance of contraction bands in the constrictor muscles encircling the heart suggests that their formation may be influenced by the tension or strain imposed upon myocardial fibres during the ischaemic episodes. PMID- 3959098 TI - Sex differences in the distribution and regulation of glucocorticoid receptors in cardiac tissues of rats. AB - We compared the binding of [3H]-dexamethasone in cytosols prepared from atria and ventricles. The effects of steroid treatment and adrenalectomy on receptor concentration were measured in both male and female rats. In male rats the distribution of receptors was similar in atria and ventricles. In contrast, the atria of female rats in all treatment groups had twice the number of receptors as did the ventricles. Adrenalectomy in females resulted in receptor up-regulation, but dexamethasone treatment, which was effective in reducing binding in males and in the ventricles of females, failed to alter atrial binding in females. These results suggest that the atria of female rats may be more responsive than ventricles to the effects of circulating glucocorticoids. PMID- 3959099 TI - Measurement of therapy outcome and maintenance of gains in the behavioral treatment of secondary orgasmic dysfunction. AB - Choice of therapeutic goals and criteria used for evaluation of therapeutic outcome represent fundamental conceptual and methodological issues. The present investigation examined the relationship between how data were obtained (by retrospective questionnaire or ongoing daily self-monitoring), what outcome criteria were used (behavioral or cognitive-affective), whose data were being analyzed (the female or male partner), and when measurements were taken (at posttherapy or follow-up) in a sample of 23 couples with the problem of secondary orgasmic dysfunction in the wife. The results indicate that retrospective measurement was more optimistic than ongoing; cognitive-affective changes were twice as likely to occur as changes in behaviors; females benefited more than males; and there were considerable losses of therapeutic gains at follow-up. These results underscore the need for multiple measurement techniques and highlight the multidimensional quality of the sexual experience. PMID- 3959100 TI - Relational sexuality: an understanding of low sexual desire. AB - Low sexual desire is discussed within the context of the relationship in which it occurs, with emphasis on each partner's intrapsychic issues as they intersect with the interpersonal issues between them. The conceptualization of the problem is based in object relations theory, whereas treatment involves systems theory and gestalt and experiential psychotherapy. Relational sexuality and intimacy in marriage are presented as foundations for treatment procedures. The therapy techniques are illustrated by case examples. PMID- 3959101 TI - Sexual dysfunction as an aftermath of sexual assault of men by women. AB - Three men have been treated for sexual dysfunction and disorder that developed subsequent to sexual assault by women. Although the men were able to respond effectively sexually during the actual assault experience, they were unable to interact with a female partner of choice in all subsequent sexual opportunities over more than a 2-year period. In treatment, more difficulties were encountered in returning to each man his sense of personal dignity and confidence in his masculinity than in reversal of openly expressed anxieties about sexual performance and neutralization of spectator roles. When possible, parallels were drawn to reactive similarities between male victims of sexual assault and female rape victims. PMID- 3959102 TI - Couples undergoing treatment for infertility: dimensions of life satisfaction. AB - The purpose of this study was to investigate the perceived life, marital, and sexual satisfaction of married couples undergoing treatment for infertility. A survey research design was utilized involving the responses of 43 husband-wife pairs. The findings indicated that wives had a significantly lower level of satisfaction with life than their husbands and that there were significant relationships between husband-wife pairs for both marital and sexual satisfaction. In comparison to paired wives, the responses of 17 wives whose husbands chose not to respond to the survey indicated higher levels of dissatisfaction in all three dimensions of life satisfaction. Furthermore, a majority of the scores for this group indicated clinical levels of depression. It was evident that individuals, especially females, undergoing treatment for infertility experienced stress in various areas of their lives. Hence, suggestions are given to assist caregivers in their endeavor to enhance the quality of life for infertile couples. PMID- 3959103 TI - Female orgasm via penile stimulation: a criterion of adequate sexual functioning? AB - This study assessed the extent to which a woman's ability to orgasm in coital situations with and without penile stimulation affects perceptions of sexual/psychological functioning. Subjects were asked to make diagnostic judgments about women described in written scenarios depicting heterosexual coital activity. Subject responses to all dependent measures reflected more positive/less pathological assessments for those situations in which the female in the scenario was described as being orgasmic via penile as well as manual stimulation, as opposed to those in which the female was described as being coitally orgasmic only with direct manual stimulation. PMID- 3959104 TI - Severe regressive reactions in sex therapy. AB - In this paper we describe five cases of severe regressive reaction during the initial evaluation of treatment for sex therapy. We focus on three dimensions useful for assessment in guarding against such regressions: the nature of the patient's defensive posture; the nature of the couple's interaction and dynamics regarding the sexual symptom; the context of the referral for brief sex therapy treatment. The particular constellation of these factors appear to make regressive reactions quite likely. Guidelines for evaluation and handling decompensation are briefly noted. PMID- 3959105 TI - Number of siblings and birth order of sexually dysfunctional males and sexual delinquents. AB - We compared the number of siblings and the birth order of a group of 600 sexually dysfunctional males with those of groups of sexual delinquents. The sexual delinquents included: 238 sexual aggressors, 249 exhibitionists, 437 pedophilic and 57 homosexual delinquents. We found that patients treated for sexual dysfunctions had a significantly higher incidence of only-children than each of the sexually delinquent groups. Pedophilic and homosexual delinquents were more frequently the last of three or more children, a difference that was significant when compared with the sexually dysfunctional men. PMID- 3959106 TI - Special issue on inhalation and pulmonary toxicology. PMID- 3959107 TI - Comparative anatomy of mammalian respiratory tracts: the nasopharyngeal region and the tracheobronchial region. AB - Silicone rubber casts of the respiratory tract were used in morphological studies of the human, baboon, rhesus monkey, dog, rabbit, guinea pig, rat, hamster, and mouse. In these studies, the trachea of the specimen was opened by tracheotomy, and silicone rubber (734 RTV) was introduced through the trachea to form nasopharyngeal and tracheobronchial casts. Measurements were made on the nasal structures, and the lungs were observed for species variation in branching pattern and number of lobes per lung. While species differences in respiratory tract anatomy are known to exist, the present study provides a focus for toxicologists when extrapolating toxicological results from one species to another. PMID- 3959109 TI - Pulmonary clearance of soluble and insoluble forms of manganese. AB - Manganese is an essential metal of toxicologic concern primarily because of exposure via inhalation. Environmental forms of Mn exist mainly as insoluble oxides, yet much of the research information available relates to the soluble salts. In the present study, adult male Sprague-Dawley rats were intratracheally instilled with either soluble MnCl2 or insoluble Mn3O4 labeled with 54Mn. Lungs and other major organs were sampled over a span of 3 mo after dosing with the respective chemicals, which were equivalent to 8 mu Ci and 1 mumol of manganese in 0.2 ml of buffer. There was rapid clearance of Mn from the lungs in the case of both chemicals; the chloride cleared at an initial rate of nearly four times that of the oxide. Despite this early difference, the amount of 54Mn remaining in the lungs after 2 wk was similar for both compounds. The level of 54Mn in the liver, kidney, spleen, and testes peaked at the 3-d sampling point in the case of the oxide, whereas the chloride peaked in these organs within 4 h. At 1 wk after administration, however, the 54Mn activity was comparable for both compounds in most organs sampled. Mn uptake in the brain was also more rapid with the chloride form, but both compounds remained at high levels for several weeks. PMID- 3959108 TI - Pulmonary changes resulting from subchronic exposure to cadmium chloride aerosol. AB - Fischer-344 rats were exposed to 0.0, 0.3, 1.0, or 2.0 mg Cd/m3 as CdCl2 aerosol for 6 h/d, 5 d/wk, for 62 exposure days. Exposure to 2.0 mg Cd/m3 resulted in rapid weight loss, and all of the animals died within the first 45 exposure days. As a group, female rats survived significantly longer than the males. Exposure to Cd resulted in dose-dependent increases in lung weight. The increased weight was the result of additional tissue mass rather than edema. Both connective-tissue components, elastin and collagen, were significantly increased in the 1.0-mg/m3 group when these components were expressed on the basis of dry weight. Dose dependent changes at the terminal bronchioles consisted of hyperplasia and flattening of type II cells, inflammation, and the proliferation of fibroblasts. Exposure to Cd also resulted in the development of intralymphatic microgranulomas in the perivascular and peribronchiolar lymphoid tissues. PMID- 3959110 TI - Early alveolar clearance in rabbits intermittently exposed to sulfuric acid mist. AB - During the course of 1-h/d, 5-d/wk exposure to submicrometer sulfuric acid mist at 250 micrograms/m3, rabbits were exposed to a radioactively tagged polystyrene latex tracer aerosol to assess clearance from the alveolar region during the period 2-14 d after tracer exposure. The latex was administered on d 1, 57, and 240 following the start of the H2SO4 exposures. Early alveolar clearance was found to be accelerated during the first test, and this acceleration was maintained throughout the 8-mo monitoring period. PMID- 3959111 TI - Effects of low-yield-cigarette smoke inhalation on rat lung macrophages. AB - It has been suggested that low-yield cigarettes (LYC) may be less hazardous and that smokers of these cigarettes are exposed to less tar, nicotine, and carbon monoxide. Recent studies have challenged this and question the analysis techniques for measuring yields of these cigarettes. Because published LYC contents may not reflect tissue toxicity and because compensatory puffing behaviors may alter smoke delivery to end-organ tissues, we studied the effect of smoke from a typical LYC on phagolysosome fusion and phagocytosis in alveolar macrophages of rats that chronically inhaled the smoke generated by an intermittently puffing apparatus. Alveolar macrophages were obtained by lung lavage and established in monolayers. Phagolysosome fusion and phagocytosis were assessed using the acridine orange fluorochrome assay. After 8 wk of exposure, there was no difference in phagolysosome fusion between controls and smokers. Carboxyhemoglobin levels in controls versus smokers were 1.36 +/- 0.09% versus 2.13 +/- 0.32% (mean +/- SE) (p = 0.06). A group of animals was similarly exposed, but the side pores of the cigarette filters were sealed with tape to simulate the compensatory behaviors often used by LYC smokers of occluding filter pores with their lips or fingertips. This significantly increased smoke exposure, and the carboxyhemoglobin level of the smokers increased to 7.0 +/- 1.4% (versus controls, p less than or equal to 0.01). Cells from these rats showed alterations in phagocytosis and in phagolysosome fusion compared with alveolar macrophages of control rats. These data suggest that the tobacco in LYC may have toxic effects similar to those of high-yield cigarettes and that LYC are likely to be less hazardous only if smoked in a fashion similar to that of a smoke-generating apparatus. PMID- 3959112 TI - Activation and increment of alveolar macrophages induced by nitrogen dioxide. AB - Male Wistar rats were exposed to 4 ppm nitrogen dioxide (NO2) for 10 d, and at intervals alveolar macrophages were collected by pulmonary lavage. A metabolic enhancement of alveolar macrophages was observed on d 4 of exposure. The specific activities of glucose-6-phosphate dehydrogenase and glutathione peroxidase of the peroxidative metabolic pathway increased to 1.29-fold (p less than 0.001) and 1.17-fold (p less than 0.05) those of the control values, respectively. The specific activities of succinate-cytochrome c reductase of the mitochondrial respiratory system and pyruvate kinase of the glycolytic pathway also increased to 1.17-fold (p less than 0.01) and 1.20-fold (p less than 0.01) those of the control values, respectively. In addition, the incorporation of [3H]leucine and [14C]thymidine into alveolar macrophages were elevated to 1.77-fold (p less than 0.001) and 1.84-fold (p less than 0.01) those of the control values, respectively. The activities of all enzymes tested decreased to control levels by d 10. The number of alveolar macrophages collected from exposed animals increased to 1.24-fold (p less than 0.01) that of the control value on d 7 and was maintained at a significantly higher level until d 10. Alveolar macrophages were heterogeneous in size (7-21 micron in diameter), and most of them were distributed between 11 and 17 micron in diameter. Exposures to 4 ppm NO2 increased significantly the cells of 9-13 micron in diameter on the seventh day. These results show that exposures to 4 ppm NO2 cause a metabolic enhancement and subsequent increase in alveolar macrophages. PMID- 3959113 TI - Effects of NO2 on immune responses. AB - The effects of NO2 on immune responses of mice were investigated. Mice were exposed to various concentrations of NO2 in inhalation chambers. After exposure the following parameters were measured: phagocytosis of polystyrene beads by both peritoneal and alveolar macrophages, production of antibody-forming cells from mice immunized with sheep erythrocytes, lymphocyte blastogenesis of splenic cells, and susceptibility to influenza virus. The production of antibody-forming cells was reduced in mice that were exposed to 5 ppm NO2. The serum antibody titers, phagocytosis, and other immune parameters measured were not affected. Exposure to NO2 did not affect mortality to influenza virus. These data indicate that certain immune parameters were altered by exposure to NO2; however, NO2 does not appear to be a major immunosuppressive factor at the concentrations tested. PMID- 3959114 TI - Effect of ozone on mean linear intercept in the lung of young beagles. AB - Although photochemical air pollutants are believed to be associated with respiratory illness, there is also a need to consider their possible effects on postnatal lung maturation. The purpose of this study was to determine whether the maturation of lungs of young beagle dogs might be altered by an inhalation exposure to ozone that represents a severe 5-d episode of photochemical oxidant air pollution. Exposures were at 6 wk of age to purified air, 1 or 2 ppm ozone for 4 h/d on 5 consecutive days. After holding for 6 wk in clean air, lungs were removed and weighed, and the left lung was fixed both by inflation at 30 cm pressure and immersion using buffered formalin. Histologic sections were used for morphometric measurements. Statistical analysis showed that the mean linear intercept (inversely related to lung surface area) was greater than controls (up to about 5%) in the 1 ppm ozone-exposed group. This effect was not seen at 2 ppm ozone, apparently due to large variations in mean linear intercept. No significant differences were seen in body weight, chest girth, lung weight, or volumes of the fixed, inflated lungs. It is concluded that if anatomic maturation of the lung was retarded by this brief regimen of ozone exposure, the effect was small and not likely to have major health consequences. PMID- 3959115 TI - Cytogenetic variability of lymphocytes from phenotypically normal men: influence of age, smoking, season, and sample storage. AB - A cytogenetic study was conducted on cultured lymphocytes from a group of 60 male volunteers to determine the baseline of chromosomal aberrations in nonchemical workers. Only males were included in the study to avoid any sex effects on the results. Blood samples were collected from each man every 13 w (quarterly) over a period of 12 m. A single batch of culture medium was used for the entire study. The influence of storing the blood samples prior to culture, donor's age, cigarette smoking, and seasonal variation on lymphocyte mitotic index and chromosomal aberration yield was analyzed. A significant decrease in mitotic activity was observed in cultures from samples stored for 3 d at room temperature (22 +/- 1 degree C). Storing of samples at refrigerator temperature (4 +/- 1 degree C) for up to 3 d prior to culture did not affect lymphocyte growth. Although the mitotic index was found to be inversely proportional to the age of the donors, a significant influence of age on total cytogenetic aberrations was not detectable. A group of 15 smokers appeared to have higher number of chromosomal aberrations; however, the difference in mean mitotic activity between lymphocytes of the two groups was not statistically significant. No detectable seasonal influence was found on any chromosomal aberration category except in the number of chromatid gaps. The mitotic indices of the first quarter cultures, on the other hand, showed significant differences from the other three quarters. The chromosomal aberration baseline of the group was not strikingly different from the ones reported by other investigators.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959116 TI - Suppressive effects of 3-methylcholanthrene on the in vitro antitumor activity of naturally cytotoxic cells. AB - Transient suppression of splenic natural killer (NK), natural cytotoxic (NC), and peritoneal macrophage cytotoxicity was observed following a single injection of 3 methylcholanthrene (3-MC) into C3H/HeN mice. Natural killer cell activity was depressed by 30-60% 4-6 d after injection of 1.0 mg 3-MC. Levels of NK reactivity returned to normal 8 d post 3-MC injection, and no suppression of natural killing was seen when tested 6 wk after 3-MC treatment. 3-MC did not affect Propionibacterium acnes augmentation of NK cell activity when tested both 6 d and 6 wk after carcinogen injection. The results indicate that the observed suppression of naturally cytotoxic cells may not be important in allowing 3-MC induced tumors to grow, since suppression is not long-lasting. Therefore, any effect on tumor growth mediated by a suppression of naturally cytotoxic cells would have to be exerted at the earliest stages of tumor development. PMID- 3959117 TI - Inhibition of coal fly ash polycyclic aromatic hydrocarbons and metals induced mixed-function oxidase activity in rat lung and liver by vitamin A and citrate. AB - Administration of benzene-soluble fraction (FAE) and benzene-insoluble fraction (FAR) of fly ash for 3 consecutive days to rats significantly raised cytochrome P 450 levels, aryl hydrocarbon hydroxylase (AHH) activity, and glutathione S transferase activity in liver. This treatment also significantly increased pulmonary AHH and glutathione S-transferase activity. Intratracheal administration of FAR (5 mg/100 g body weight) alone for 6 consecutive days also significantly increased hepatic cytochrome P-450 levels and the activity of glutathione S-transferase. Intragastric administration of retinyl palmitate (5000 IU/100 g body weight), along with intratracheal FAE and FAR administration, significantly reduced P-450 levels, activity of glutathione S-transferase in liver, and activity of AHH and glutathione S-transferase in lung of rats. Intraperitoneal administration of citrate (40 mg/100 g body weight) along with FAR significantly reduced FAR-induced increase in hepatic cytochrome P-450 levels and glutathione S-transferase activity. The activity of AHH was not affected by these treatments. PMID- 3959119 TI - In vitro binding of mirex by mouse hepatocytes. AB - Mirex (dodecachlorooctahydro-1,3,4-metheno-2H-cyclobuta[cd]+ ++pentalene) is a hepatic tumorigen that is shown to cause marked disturbances in hepatic cell ploidy in rodents. Kinetic measurements of [14C]mirex binding were performed in freshly prepared diploid (DP) and polyploid (PP) hepatocytes, as well as in erythrocytes, under controlled conditions. The binding of mirex to hepatocytes, irrespective of their ploidy, was partially Na+-dependent and totally Ca2+ independent. Variations in temperature and pH appeared to significantly inhibit mirex binding; the optimum binding was seen at 37 degrees C under physiological pH. The saturation kinetic data revealed that PP cells were saturated at a very low concentration of mirex (two- to threefold) compared to DP, exhibiting a high affinity binding of mirex to PP with a low Km (347 nM) and Vmax (102 nmol/mg X min). The Km (550 nM) and Vmax (340 nmol/mg X min) values determined for DP cells were of higher magnitude, like those of erythrocytes (Km, 819 nM; Vmax, 330 nmol/mg X min), indicating that distinct differences exist in the binding affinities of three cell types. However, erythrocytes and DP cells showed close similarity in their Vmax values. Interestingly, mirex levels in the lipid compartments of DP and PP cells revealed no apparent differences. The results are discussed in terms of the possible susceptibility of PP cells and their role in the initiation of toxic response leading to hepatotumorigenesis in rodents. PMID- 3959118 TI - Effect of neurotoxic organophosphorus compounds in turkeys. AB - To determine the neurotoxic effects of organophosphorus compounds in turkeys, adult birds were given a single oral dose of 125, 250, 500 mg/kg triorthotolyl phosphate (TOTP) or a single subcutaneous dose of 0.4 mg/kg O,O'-diisopropyl phosphorofluoridate (DFP). At 24 h after dosing with TOTP, neurotoxic esterase activity was found to be inhibited in a dose-related manner, as were the activities of blood cholinesterase and liver cholinesterase. Clinical signs of neuropathy appeared within 2 wk in TOTP-treated groups of birds with neurotoxic esterase activities at 59 +/- 3% (125 mg/kg), 47 +/- 7% (250 mg/kg) and 33 +/- 3% (500 mg/kg) of control values (mean +/- SEM, n = 5) at 24 h after dosing. Signs appeared earlier in turkeys given DFP. Histological examination revealed only mild lesions of delayed neurotoxicity in birds given either TOTP or DFP. PMID- 3959120 TI - Effects on the fetus of maternal benomyl exposure in the protein-deprived rat. AB - The separate and combined effects of protein deprivation and benomyl [(methyl 1 butylcarbomoyl)-2-benzimidazole carbamate] exposure were studied in the pregnant rat fed a diet containing 24% (control) or 8% (deficient) casein throughout gestation. Within each diet group, subgroups were gavaged at 31.2 mg/kg body weight with benomyl or corn-oil carrier only on d 7-16 or 7-21 of gestation. No effects on the skeleton were seen. Benomyl exposure in the last 2 wk in dams fed the 24% casein diet resulted in a high incidence of fetal brain anomalies. This effect did not occur in those with benomyl exposure during the period of organogenesis only and was reduced in groups fed the protein-deficient diet. Exposure to benomyl in the last 2 wk in the protein-deprived rat resulted in a decrease in the weight of the fetal heart in excess of that attributable to diet alone. Lungs were a smaller portion of body weight in fetuses of benomyl-treated dams in both diet groups. The teratogenic effect on the brain in animals exposed to benomyl in wk 2 and 3 of gestation suggests that screening for teratogenic effects during organogenesis only may be insufficient. PMID- 3959122 TI - Structural effects in the dithiocarbamate-enhanced biliary excretion of cadmium. AB - The dithiocarbamate enhancement of the biliary excretion of cadmium in rats loaded with cadmium (by either the oral or sc route) was found to be strongly dependent on the structure of the groups attached to the nitrogen atom of the dithiocarbamate moiety. Those dithiocarbamates containing hydroxyl-bearing attached groups were found to be capable of causing the greatest enhancement of the cadmium content of the bile. For the compounds of this type that were examined, this enhancement of biliary cadmium content varied from 30-fold to over 2000-fold. No enhancement of the biliary excretion of cadmium was found subsequent to the administration of sodium diethyldithiocarbamate, though this compound is known to cause a significant increase in the fecal excretion of cadmium. PMID- 3959121 TI - Effects of dithiocarbamates on cadmium distribution and excretion in chronically exposed rats. AB - One month after termination of a 3-mo exposure of rats to cadmium (Cd in drinking water at a concentration of 50 mg/l), the effects of dithiocarbamate analogs on the excretion and distribution of the cadmium were determined. Sodium salts of three dithiocarbamates [sodium bis(hydroxyethyl) dithiocarbamate, DEDTC; sodium N methyl-D-glucamine dithiocarbamate, MGDTC; and sodium 4-carboxamidopiperidine dithiocarbamate, INADTC] were given to rats ip 2 times at 2.46 mmol/kg. In the following administration of the first injection of DEDTC, cadmium excretion via the urine amounted to 15.8 micrograms and via bile amounted to 124.4 micrograms Cd. Following administration of MGDTC, the urinary and biliary excretions of cadmium were 14.5 and 47 micrograms, respectively, while in the case of INADTC the corresponding values were 23.6 and 7.9 micrograms cadmium. In control animals the urinary and biliary excretion per 12 h reached 0.09 and 0.12 micrograms Cd. Gel permeation chromatography (GPC) analysis of bile revealed differences in the distribution of Cd in the elution fractions after the first injections of the individual dithiocarbamates. For all three dithiocarbamates, significant decreases of the concentrations of cadmium in the liver and kidney were found. DEDTC (but neither of the other compounds) increased the concentration of cadmium in the brain from control levels of 49 +/- 5 ppb to 105 +/- 16 ppb. PMID- 3959123 TI - Transfer of thiocyanate into chicken eggs. AB - Laying hens were fed thiocyanate (SCN) as a solution of potassium thiocyanate (KSCN) in their drinking water to determine whether dietary SCN was transferred into eggs. The thiocyanate content of their eggs was measured before and during thiocyanate administration. Egg thiocyanate content increased from 6 micrograms SCN/g albumen to 31 micrograms SCN/g (a 400% increase) in the period immediately following thiocyanate administration and then fell progressively, seeming to stabilize much closer to but still well above control levels. PMID- 3959124 TI - Distribution, excretion, and metabolism of butylbenzyl phthalate in the rat. AB - The disposition of butylbenzyl phthalate (BBP), a widely used plasticizer, was evaluated after oral and iv administration to rats. Male Fischer-344 rats were dosed with [14C]BBP at 2, 20, 200, or 2000 mg/kg po or 20 mg/kg iv to determine the effects of dose on rates and routes of excretion. In 24 h, 61-74% of the dose was excreted in the urine and 13-19% in the feces at 2-200 mg/kg. At the 2000 mg/kg dose, 16% of the 14C was excreted in the urine and 57% in the feces. Urinary 14C was composed of monophthalate derivatives (MP: 10-42% of the dose) and glucuronides of these monophthalate derivatives (2-21% of the dose). At 4 h after iv administration of BBP (20 mg/kg), 53-58% of the dose was excreted in the bile of anesthetized rats. No parent compound was found in the bile, but monobutyl phthalate-glucuronide and monobenzyl phthalate-glucuronide (26% and 13% of the dose, respectively) and trace amounts of free monoesters (2% of the dose) and unidentified metabolites (14% of the dose) were present. Although BBP is an asymmetric diester with the potential of forming equal amounts of monobutyl phthalate (MBuP) and monobenzyl phthalate (MBeP), larger quantities of MBuP were formed (MBuP = 44% versus MBeP = 16% of the dose). The half-lives of BBP, MP, and total 14C in blood (20 mg/kg, iv) were 10 min, 5.9 h, and 6.3 h, respectively. This study indicates that BBP is rapidly metabolized and that the major route of excretion of metabolites is biliary. These metabolites are reabsorbed and ultimately eliminated in the urine. PMID- 3959125 TI - Reproductive toxicity associated with acrylamide treatment in male and female rats. AB - The present study was designed to evaluate the influence of acrylamide (ACR) on male and female reproductive function. Male rats received ACR in drinking water (50, 100, or 200 ppm) for up to 10 wk. Copulatory behavior, semen, and (for controls and 100 ppm only) fertility and fetal outcomes were evaluated. Females received ACR (25, 50, 100 ppm) for 2 wk prior to initiation of breeding and then throughout gestation and lactation. Hindlimb splaying was apparent in the 200-ppm males by wk 4; less severe splaying appeared in the 100-ppm group at wk 8. Disruptions in copulatory behavior preceded the appearance of this ataxia. These disruptions in mating performance interfered with ejaculatory processes and subsequent transport of sperm, since semen was found in the uterus of only 1 of the 15 females mated with the 100-ppm males at wk 9. Moreover, only 33% of the females mated (wk 10) to the 100-ppm males were pregnant. Postimplantation loss was also significantly increased in this group. Hindlimb splaying appeared in the females receiving 100 ppm ACR during wk 1-2 of pregnancy. Body weight and fluid intake were also depressed. Dams in the 50-ppm group showed depression in these parameters during the last 2 wk of lactation. ACR did not significantly affect mating performance of the females, pregnancy rates, litter size, or survival. However, ACR did significantly depress pup body weight at birth (100-ppm group) and weight gain during lactation through post-weaning, d 42 (50- and 100-ppm groups). Vaginal patency was delayed in the 100-ppm group only. PMID- 3959126 TI - Hypotaurine uptake by the retina. AB - A study of the transport of 3H-hypotaurine by rat retina has been carried out. The process is markedly sodium and temperature dependent. Kinetic analysis of the data revealed two values for the affinity constant (K) of 4.91 microM and 1,071.3 microM. Some related and unrelated amino acids were examined as competitive inhibitors of 3H-hypotaurine transport. Only GABA and beta-alanine exhibited appreciable inhibitory activity. Taurine, glycine, and guanidine ethane sulfonate were not inhibitors. 3H-hypotaurine uptake was similarly distributed in the retinal subcellular fractions P1 and P2. The active uptake of 3H-hypotaurine by retinas of the rat and other species including chick and frog was studied and compared to cerebral cortex slices. The chick retina was similar to the rat in its capacity to transport hypotaurine whereas frog exhibited fourfold less activity. Slices of cerebral cortex from rat and chick exhibited hypotaurine uptake but again the magnitude of the transport was three to fourfold less than in the comparative retinas. PMID- 3959127 TI - Stimulation of oligodendrocytes by extracts from astrocyte-enriched cultures. AB - A soluble, heat-labile, trypsin-sensitive factor present in extracts of astrocyte enriched cultures enhances the expression of myelination-associated events in rat brain cultures enriched in oligodendrocytes. Both the number of oligodendrocytes detected by immunofluorescence microscopy and the levels of biochemical activities associated with oligodendrocyte differentiation increased in the cultures in response to the extract in a time- and concentration-dependent fashion. The possible significance of these studies for normal oligodendrocytes function, and thus myelination, is discussed. PMID- 3959128 TI - Development and elimination of presynaptic elements on polylysine-coated beads implanted in neonatal rat cerebellum. AB - Polylysine-coated sepharose beads were implanted in the cerebellum of neonatal rats and examined at 3 hr, 3 days, 7 days, 14 days, and 21 days after surgery. Previous studies at 5 or 8 days after implantation showed that axons formed neuronal swellings that appeared to be presynaptic elements, with the bead surface in the position of a postsynaptic element. Results reported here show that no beads at 3 hr had presynaptic elements, whereas the number of beads with presynaptic elements increased to high levels at 3 and 7 days but dropped to low values at 14 and 21 days after implantation. Presynaptic elements were seen on beads regardless of their distance from cerebellar tissue except at 3 hr, when no axons were seen in the implant, indicating that axons first grew into the implant and then formed presynaptic elements. The morphological measurements of presynaptic elements on beads at 3 to 7 days after implantation showed increases in area and number of synaptic vesicles, which then decreased at 14 and 21 days after implantation. These results show that axons can grow into implants of polylysine-coated beads and form presynaptic elements that do not survive with increased time after implantation. The survival of presynaptic elements on beads can be used as a model for investigations into regeneration of axons and presynaptic elements in the injured brain. PMID- 3959129 TI - Association of endogenous substrate with solubilized bovine brain sialidase. AB - Nonidet P40 solubilized up to 90% of the sialidase, active towards added ganglioside substrate, that was associated with the total membrane fraction prepared from gray matter of bovine brains. Solubilized sialidase acted upon endogenous substrate (sialic acid containing compounds solubilized with the enzyme), hydrolyzing approximately 50% of the readily available sialosyl residues within 20 min. During a 2-hr reaction time 80% of the polysialylated gangliosides solubilized with the enzyme were acted upon. A 20-min lag was observed before sialidase acted upon added ganglioside substrate. The lag could be reduced to less than 2 min when the enzyme was allowed to act on endogenous substrate prior to exposure to exogenous substrate, suggesting that the solubilized enzyme acted preferentially on endogenous substrate. A protease inhibitor prevented much of the 86% loss of activity towards added substrate that was seen when the enzyme was stored at 4 degrees C for 6 days; activity towards endogenous substrate decreased only 34%. PMID- 3959130 TI - Metabolism of choline in brain of the aged CBF-1 mouse. AB - In order to quantify the changes that occur in the cholinergic central nervous system with aging, we have compared acetylcholine (Ach) formation in brain cortex slice preparations from 2-year-old aged CBF-1 mouse brains and compared the findings with those in 2-4-month-old young adult mouse brain slices. Incorporation of exogenous radioactively labelled choline (31 nM [3H] choline) into acetyl choline in incubated brain slices was linear with time for 90 min. Percentage of total choline label distributed into Ach remained constant from 5 min after starting the incubation to 90 min. In contrast, distribution of label into intracellular free choline (Ch) and phosphorylcholine (Pch) changed continuously over this period suggesting that the Ch pool for Ach synthesis in brain cortex is different from that for Pch synthesis. Incorporation of radioactivity into Ach was not influenced by administration of 10 microM eserine, showing that the increment of radioactivity in Ach reflects rate of Ach formation, independently from degradation by acetylcholine esterases. Under our experimental conditions, slices from cortices of aged 24-month-old mouse brain showed a significantly greater (27%) incorporation of radioactivity into intracellular Ach than those from young, 2-4-month-old, brain cortices. Inhibitors of Ach release, 1 mM ATP or GABA, had no effect. Since concentration of radioactive precursor in the incubation medium was very low (31 nM), the Ch pool for Ach synthesis in slices was labelled without measurably changing the size of the endogenous pool. These data suggest a compensatory acceleration of Ach synthesis or else a smaller precursor pool specific for Ach synthesis into which labelled Ch migrated in aged brain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959131 TI - Effect of morphine-induced cortical excitation on spinal sensory transmission. AB - Bioelectrical responses evoked in the ventrolateral funiculus (VLF) of the spinal cord by electrical stimulation of the contralateral hind limb were studied following topical application of 1% morphine solution to the somatosensory SI area of the rat cerebral cortex. After morphine, a typical pattern was observed in the electrocorticogram, characterized by the appearance of rhythmic spiking activity. Time-related with each cortical spike, a significant reduction in the amplitude of VLF responses was observed. It is concluded that cortical excitation induced by morphine generates descending influences having the ability to inhibit spinal sensory transmission. PMID- 3959133 TI - Reversal by estrogen of the effect of dorsal raphe stimulation on release of LH but not prolactin. AB - Electrical stimulation of the dorsal raphe nucleus (DRN) was administered to rats 2-4 weeks after ovariectomy and at least 7 days following implantation of a bipolar electrode. During stimulation the concentration of luteinizing hormone (LH) decreased whereas that of prolactin (Prl) increased in serial plasma samples obtained from the unanesthetized animals via a cannula chronically implanted in the right external jugular vein. Administration of estradiol benzoate (5 micrograms/100 g BW) for 2 days prior to the experiment reversed the effect of stimulation on LH but augmented the Prl response, suggesting modulation by estrogen of the relative effectiveness of opposing pathways ascending from DRN to influence LH release. It is also apparent that LH and Prl release are controlled by distinct mechanisms since estrogen exerted opposite influences on the responses of these two hormones to stimulation of DRN. PMID- 3959132 TI - Differential effects of kainic-acid-induced hippocampal lesions on the acquisition of the jump-box avoidance task in mice. AB - This research examined the effects of kainic-acid (KA)-induced hippocampal lesions on the acquisition of a jump-box avoidance task in mice. When the hippocampal lesion was unilateral, mice with lesions in the lateral portion of the CA1 region showed deficits in acquisition while those with lesions in the CA3 region and/or the medial portion of the CA1 region did not. When the hippocampal lesion was bilateral, on the other hand, mice with lesions in the CA3 region and/or the lateral portion of the CA1 region were deficient in acquisition while those with lesions in the medial portion of the CA1 region were not. Among the mice with various KA-induced hippocampal lesions avoidance responses were not correlated with the level of open field activity, indicating that acquisition differences observed are not dependent upon, nor secondary to, levels of spontaneous activity. These results strongly suggest that there exist regional differences in the involvement of hippocampal pyramidal cell layers in acquisition of the jump-box avoidance task: both the CA3 region and the lateral portion of the CA1 region are involved in acquisition, while the medial portion of the CA1 region is not. PMID- 3959134 TI - Primary retinal and cortical glial cell cultures: effects of medium and serum on attachment and growth. AB - Glial cells of the retina are anatomically distinctive and are thought to contribute importantly to retinal electrophysiology. However, no adequate preparation exists for studying them in isolation, in vitro. This report provides guidelines for primary retinal glial cultures (RET) and compares basal tissue culture features with those for neocortical glia (CX) and the well-studied rat glial line, C6. Cell attachment and growth of RET, CX, and C6 are unique. These differences are explored by the use of specific media and sera. RET attachment, unlike that for CX or C6, was far more sensitive to medium than serum. RET cells attached least quickly, CX most quickly; 4 hr after plating 20% of RET remained unattached. RET growth was poor and relatively insensitive to medium. In contrast, growth of CX or C6 was medium dependent. Serum had substantial effects on the growth of all three glial lines. Pig, goat, horse, and dog sera were particularly effective, often comparing favorably to fetal calf serum. Medium or serum optimal for cell attachment, typically, was not optimal for growth and serum effects were more dramatic than those of medium. By all measures, CX and C6, both derived from brain, were more alike than were the two rabbit primaries, CX and RET. The data reveal substantial differences between presumably similar cells and indicate a need for an empirically based choice of both basal-salt media and serum to optimize specific aspects of cell development in culture. PMID- 3959135 TI - Treatment of partial flexor tendon lacerations: the effect of tenorrhaphy and early protected mobilization. AB - Controversy exists in the literature regarding the proper treatment of partial flexor tendon lacerations. In this study, a novel nonweightbearing canine model was developed in order to closely approximate human flexor tendon conditions. The relative effects of immobilization, early protected mobilization, tenorrhaphy, and no repair of flexor tendon healing were evaluated by paired comparisons of four experimental groups (24 animals). Parameters evaluated after a 35-day healing period included tendon excursion, breaking strength, energy absorption, and stiffness. The contralateral digit-matched profundus tendon served as a normal control. Eight additional animals were studied histologically and by scanning electron microscopy. Data analysis revealed statistically significant adverse effects on breaking strength, stiffness, and energy absorption when repaired by modified Kessler technique. Early motion improved excursion and stiffness significantly, and resulted in more nearly normal tendon morphology than immobilized tendons. Thus, we conclude that partial flexor tendon lacerations of 60% cross-sectional area are optimally treated without tenorrhaphy and with early mobilization. PMID- 3959136 TI - Management of injuries to the superior mesenteric artery. AB - From 1978 through 1984, 22 patients with 20 penetrating and two blunt injuries to the proximal superior mesenteric artery were treated. Patients presented with exsanguinating hemorrhage (19), midline hematomas (two), or 'black bowel' (one). Two other patients developed 'black bowel' during operation. Direct cutdown through the mesentery was the approach in 11 patients, and three survived; a Mattox maneuver was used in ten patients, and five survived. Complex bypass or grafting procedures were performed in nine patients, and two survived. Ten of 15 deaths were secondary to hemorrhagic shock; two of five late deaths were related to problems with the vascular repair in patients with multiple injuries. Interposition grafting near a major pancreatic injury may lead to catastrophic postoperative problems. Bypass grafts from the distal aorta should have retroperitoneal tissue coverage of the suture line. PMID- 3959137 TI - Early open reduction and internal fixation of the disrupted pelvic ring. AB - Early open reduction and internal fixation (ORIF) of extremity fractures in patients with multiple injuries has been demonstrated to be safe, improve survival, and decrease the incidence of respiratory failure. Complications leading to abandonment of planned operative fixation and death in several patients with pelvic fractures led us to initiate a policy of early ORIF of the disrupted pelvic ring. Early ORIF of the pelvis was performed in 15 multiply injured patients between May 1984 and August 1985. Patients ranged in age from 13 to 79 years, their Hospital Trauma Index-ISS scores ranged from 14 to 68, and number of preoperative transfusions ranged from 0 to 42. Types of fractures were A-P compression, two, lateral compression, one, vertical shear, seven, complex, two, and acetabulum with ring disruption, three. All patients were resuscitated, transported in pneumatic antishock garments, and evaluated by abdominal and pelvic CT scan (in two patients following celiotomy). Preoperative angiograms to assess retroperitoneal hemorrhage in eight patients resulted in identification and control of significant bleeding in five. The mean time from injury to pelvic stabilization was 38 hours. Seven patients underwent ORIF within the first 24 hours. In most cases simultaneous anterior and posterior internal fixation was performed with the patient in the lateral decubitus position. Excluding associated procedures, operative time averaged 5.1 hours. Intra-operative transfusions averaged 4 units (range, 0-11). Rigid fixation was achieved in all patients. Most patients were out of bed by the third postoperative day. No patient developed respiratory failure. Two patients developed wound infections. Modification of our technique has avoided this complication in the latter part of this series.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959138 TI - Indications for intubation in blunt chest trauma. AB - The value of endotracheal intubation and internal stabilization in severe chest injuries is well known. Recent reports have proposed that many such patients can be managed without intubation. To determine which patients need intubation we reviewed 140 patients with three or more rib fractures who presented to our hospitals from 1 January 1979 through 31 December 1983: 119 nonintubated patients (Group A); 13 patients intubated on admission (Group B); five patients intubated after hospital day 1 (Group C); and three patients intubated questionably on admission (Group D). The purpose of this report was to identify the factors which indicated severe pulmonary injury necessitating intubation. The need for intubation was correlated with five risk factors: 1) initial respiratory rate of over 25 min; 2) pulse greater than 100 min; 3) systolic blood pressure less than 100 mm Hg; 4) poor initial arterial blood gas; 5) the presence of other injuries. There was no correlation between severity of pulmonary injury and number of fractures, bilateral and/or segmental fractures, flail chest, contusion of lung, or age of patient. There was a greater percentage of complications and deaths in intubated patients (Groups B, C, and D). Group C patients all had poor initial blood gases and were erroneously not intubated early, even though 60% of them had three or more risk factors, as did Group B patients. Only 4% of patients who did not need intubation (Group A) had three or more risk factors. Group D patients were intubated without apparent indication. They had good initial blood gas levels and only one risk factor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959139 TI - Fibronectin depletion and microaggregate clearance following trauma. AB - Ninety-seven traumatized patients had blood samples taken immediately upon admission before any resuscitation. Microaggregate (MA) formation was measured by the screen filtration pressure (SFP) technique. Plasma fibronectin levels (Fn) were measured by immunoturbimetric assay. An Injury Severity Score (ISS) was calculated for each patient. The results show a highly significant correlation between severity of trauma, amount of MA formation, and amount of Fn depletion. We conclude that the highly significant correlation between MA formation and Fn depletion following trauma suggests a role for the reticuloendothelial system (RES) in the clearance of MA that form following trauma. Further, enhancement of RES clearance of MA may be possible by purified Fn or cryoprecipitate administration early in the treatment of trauma patients, thereby preventing the adverse sequelae of end organ MA deposition. PMID- 3959140 TI - Financial charges of hospitalized motorcyclists at the Massachusetts General Hospital. AB - We studied 47 hospitalized motorcyclists admitted through the Massachusetts General Hospital emergency room during a 1-year period. Four factors were studied: 1) hospitalization charges, 2) hospitalization lengths, 3) medical insurance profiles, and 4) patterns of injuries. The mean hospitalization charges were +15,114. The total hospital charges for this group of patients were nearly +700,000. These figures excluded the costs of subsequent admissions, surgeons' fees, rehabilitation, vocational training, legal suits, and loss of wages. Sixteen per cent of the charges were uncollectable. Forty-six per cent of the patients were uninsured. The average hospitalization was 22 days. The mean age was 22 years and 90% of patients were less than 30 years old. Eighty-five per cent of the patients sustained at least one fracture. Lower extremity fractures occurred in 60%, open fractures in 55%, and tibia fractures occurred in 33% of the patients. Associated head, chest, or abdominal injuries occurred in 40% of the patients. Patients with multiple fractures, open fractures, and grade 3 open tibia fractures had substantially higher hospital bills. PMID- 3959141 TI - Isoleucine and valine oxidation following skeletal trauma in rats. AB - Nitrogen losses in the urine are derived from amino acid oxidation, and the increased loss of urinary nitrogen during stress indicates accelerated amino acid oxidation. This study compared isoleucine and valine oxidation by traumatized rats with that by pair-fed control rats. Seventy rats received bilateral hind limb fractures and were fed an oral liquid diet ad libitum, and 70 healthy rats were pair-fed with the trauma group. Daily food intake, body weight, and 24-hr urinary nitrogen were monitored for each animal, and isoleucine and valine oxidation were measured on days 1 through 7 postinjury using five rats from each group for each amino acid. Amino acid oxidation was determined from the percentage of dose appearing in the breath during 4 hours following a single injection of C-14 labeled amino acid. Anesthesia had a pronounced effect on all parameters on day 1, and its effects were dissipated by day 2. Skeletal trauma produced elevated urinary nitrogen losses that lasted for 5 days and peaked on day 3. Valine and isoleucine oxidation were increased for 5 days, and the peak increase occurred on day 3 post-trauma. These data show that isoleucine and valine oxidation parallel excessive urinary nitrogen excretion after skeletal trauma and that isoleucine and valine, like leucine, contribute to the increased urinary losses after trauma. PMID- 3959142 TI - A study of injuries during life in three male populations. AB - In a population study of samples of 60-, 50-, and 30-year-old men, information about injuries suffered during life was obtained by personal interview. Included were head injuries with unconsciousness, and injuries which had caused restricted activity for more than one day or had caused medical attendance. The interview technique was the only way to cover all these injuries. Possible biases are discussed. The results indicated that the young men tended to report a higher incidence of injuries, to suffer their first injury at an earlier age and to attend medical services to a larger extent than the older men. An incidence peak in adolescence was reported in all three cohorts. Accidents with multiple injuries were more common in higher ages in all cohorts. Falls, blows, and impacts, cutting and piercing agents, and traffic accidents were the most common causes of injuries in all cohorts. PMID- 3959143 TI - Ballistics: a pathophysiologic examination of the wounding mechanisms of firearms: Part II. PMID- 3959144 TI - Displaced hip fractures in children and adolescents. AB - The results of ten acute, displaced proximal femoral fractures in patients 14 years and under are reported. These high-risk fractures were managed with urgent open reduction and pin or screw fixation with supplemental spica casting. The exception to this protocol was in two Delbet's type IV (intertrochanteric) fractures which were managed by closed reduction and spica casting. There was a case of partial avascular necrosis of the femoral head in a type I transepiphyseal fracture. At a minimum followup of 2 years the patients were asymptomatic with no significant limitation of hip motion. PMID- 3959145 TI - The acridine orange fluorochrome microassay: a new technique for quantitation of neutrophil function in burned patients. AB - A new assay for determination of neutrophil bacterial killing and phagocytosis is presented. The acridine orange (AO) fluorochrome microassay is a simple, reliable technique for assessing polymorphonuclear (PMN) function. It requires small amounts of blood and provides a rapid and reproducible quantitation of neutrophil activity. Using this technique, bacterial killing and phagocytosis were assessed in a group of five severely burned patients admitted to the Medical College of Virginia Burn Unit. All patients studied demonstrated a significant decrease in bacterial killing at some point during their clinical course. The AO assay was found to be a reliable and effective means of quantitating PMN bacterial phagocytosis and killing in this group of burned patients. PMID- 3959146 TI - The diagnostic value of computed tomography in a selected case of penetrating thoraco-abdominal injury. AB - A patient with a penetrating thoraco-abdominal injury produced by a pencil left in situ is described. CT scan accurately demonstrated the innocuous path of the pencil which was removed without sequelae. CT scan may be valuable in the management of penetrating injuries of the trunk with weapon still in place. PMID- 3959147 TI - In extremis use of a Foley catheter in a cardiac stab wound. AB - A case is discussed of a patient who presented in extremis after a stab wound to the right ventricle. He underwent successful resuscitation using a Foley catheter both for hemostasis and for administration of resuscitation fluids. While not commonly employed in cardiac trauma management, this technique may permit increased salvage due to its simplicity and speed. PMID- 3959149 TI - The effects of gossypol on the ultrastructure and function of tracheal ciliated cells. AB - Gossypol acetic acid inhibits rabbit tracheal ciliary function in a concentration dependent manner. At concentrations of both 10(-4)M and 5 X 10(-5), ciliary beat is reduced to less than 2 beats/sec in approximately 60 min. At 10(-5)M, reduction of frequency is more gradual, requiring 120 min or longer to approach inhibition. The primary site in the cell showing morphological alteration is the mitochondrion, although extended exposure at lower concentrations does seem to cause increase in the amount of endoplasmic reticulum and Golgi. At the time of inhibition of ciliary beat, mitochondria have a washed out matrix, disrupted cristae and extensive infolding of the outer membrane. Some indication of mitochondrial swelling is also evident. Demembranated axonemes exposed to gossypol show the same dose-dependent response as intact ciliated cells. At 10( 4)M gossypol, axonemes are completely inhibited from reactivation. Axonemes can be reactivated in the presence of 10(-5)M gossypol but are quickly inhibited. 10( 6)M gossypol has no inhibitory effect on demembranated axonemes or intact ciliated cells. Gossypol may be acting initially as a direct but reversible inhibitor of axonemal function while damage to mitochondria may be responsible for the long term, non-reversible inhibition of ciliary function. PMID- 3959148 TI - Three-dimensional architecture of the Golgi complex observed by high resolution scanning electron microscopy. AB - In spite of many light and transmission electron microscopic studies of the Golgi complex, many important points remain unsettled. Recently, we have devised a method of observing the three-dimensional configurations of intracellular structures by scanning electron microscopy. We have used this method to study the three-dimensional structure of the Golgi complex in several tissues of the rat, paying special attention to three problems: the overall configuration; the spatial construction of each stack, and the relationship to neighbouring organelles. The interconnected stacks which form the Golgi complex are arranged in a manner characteristic of the particular cell type. In rat extraorbital lacrimal gland the stacks form an irregular network spread throughout the cell, while in anterior pituitary cells they form a hollow sphere. Continuities were seen between cisternae within a stack, and in one case a stack actually consisted of one helically wound cisterna. We also observed slender tubules connecting Golgi stacks to neighbouring rough endoplasmic reticulum. Vesicles, presumably transport vesicles, were frequently observed on the surface of the cisternae, most commonly at the cisternal rims. However the continuities among stacks and connections with cisternae and with the rough endoplasmic reticulum demonstrated here offer alternative routes for movement of substances through the cellular endomembrane system. PMID- 3959150 TI - Cytochemical localization of acid phosphatase in Leishmania mexicana amazonensis. AB - Acid phosphatase was cytochemically detected at the ultrastructural level in infective and non-infective promastigotes and in amastigotes of the parasitic protozoan Leishmania mexicana amazonensis. Cerium chloride was used as the capture agent of the phosphate liberated during the hydrolysis of the substrate (Na-beta-glycerophosphate). Reaction product, indicative of enzyme activity, was seen in the outer face of the plasma membrane of many, but not all, infective and noninfective promastigote forms. No reaction product was seen in the plasma membrane of amastigote forms. Reaction product was seen in the endoplasmic reticulum, in the Golgi complex, in vesicles located close to the flagellar pocket and in cytoplasmic structures which may represent lysosomes. No reaction product was seen when the substrate was omitted from or sodium fluoride was added to the incubation medium. The possible role played by the acid phosphatase present in the plasma membrane of Leishmania parasites is discussed. PMID- 3959151 TI - Morphometry of mitochondrial changes in mouse trophoblast cells at early implantation. AB - The blastocysts of a mouse in an experimentally delayed implantation are known to have a low consumption of oxygen, but when implantation is initiated their oxygen consumption increases within 4 h. Our stereological analyses of the mitochondria have demonstrated that these changes are associated with an increase in volume density of the mitochondrial matrix and a decrease of surface density of the inner membranes. Thus, at this early stage of blastocyst implantation, the mitochondria of the activated blastocysts change to an orthodox state. PMID- 3959152 TI - An ultrastructural study of megachiropteran (Mammalia: Chiroptera) spermatozoa: implications for chiropteran phylogeny. AB - The fine structure of epididymal or electro-ejaculated spermatozoa of Pteropus poliocephalus, P. scapulatus, P. conspiculatus, P. alecto and Syconycteris australis is described. The sperm of all species were found to be very similar. The head is extremely flattened and spatulate; the nucleus is capped by a long acrosome that comprises the proximal half of the head and covers two-thirds of the nucleus area, and a prominent sub-acrosomal space possesses a unique 'anvil' like shape. Redundant nuclear envelope forms a 'scroll' in a restricted region of the neck, next to the base of the proximal centriole and the most proximal of the mitochondria. The axoneme is atypical for mammals, the central singlets arising distal to the outer doublets. Coarse fibres 1, 5, 6 and 9 are larger than the remainder, a feature shared with the Microchiroptera, most insectivores and the Primates. The large sub-acrosomal space of the megachiropteran sperm is significantly is different from that of the Microchiroptera. We consider that the difference in sperm ultrastructure between the chiropteran sub-orders is not inconsistent with theories of a di-phyletic origin for this group. The use of sperm ultrastructure as a phylogenetic tool is discussed and comparisons with the spermatozoa of other closely related Eutheria are made. PMID- 3959153 TI - Light and electron microscopic study of the postnatal prostate in male Praomys (Mastomys) Natalensis. AB - The postnatal development of the prostate was studied in male Praomys (Mastomys) Natalensis using both light and electron microscopy. At birth, the ventral and dorsal lobes consist of cords of cells that previously budded from the urogenital epithelium into condensed pads of stroma. The ventral cords have developed small lumina, whereas lumina do not develop in the dorsal lobe until two days after birth. The cords and tubules lengthen, branch, and coil so that by six days, the tubules of the ventral lobe almost completely make up the substance of the enlarged prostate, and those containing the larger lumina have only one to two cell layers surrounding them and contain a small amount of secretory product. The dorsal lobe, however, remains composed of small tubules. The ventral prostatic acini of the 12 day animal develop epithelial infoldings, the lining cells increase in height, and many acquire supranuclear light areas. The dorsal lobe acini remain smaller than those of the ventral lobe and are lined by cuboidal cells. Their secretion is evident at 18 days. By one month, the ventral and dorsal prostates of the male Praomys appear similar to those of the adult. Thereafter, changes include increase in size, acinus number and size, and epithelial involutions as well as the development of more prominent supranuclear light areas in the ventral prostatic epithelial cells. PMID- 3959154 TI - Glycocalyceal bodies on goblet cells in the human upper airways. AB - The ultrastructure and distribution of glycocalyceal bodies are described in the nasal and tracheal respiratory epithelium of children suffering from chronic airway infections. From the presented data it is assumed that glycocalyceal bodies do occur in chronic infected airways and are related only with the goblet cells; they seem not to be formed by budding from the microvillus membrane or by secretion of rod-containing bodies (R-bodies), a formation of glycocalyceal bodies by budding from the apical cell membrane cannot be fully excluded; plasmamembrane and membrane surrounding intracytoplasmic secretory granules may in some way contribute to the formation of glycocalyceal bodies, glycocalyceal bodies may represent a means by which excess of membrane is eliminated from the cell; further investigations, beyond the scope of the present study, are required to fully solve the problems on the origin(s) and function(s) of glycocalyceal bodies. PMID- 3959155 TI - Ultrastructure of an intraocular lacrimal gland choristoma. AB - An intraocular lacrimal gland choristoma which was at first mistaken for a medulloepithelioma (diktyoma) was studied with the electron microscope. The tumour did not contain cells with neuronal and glial differentiation as expected in a medulloepithelioma but it did contain acini, ducts and dilated ducts or cysts. The tumour, in fact, bore much resemblance to the lacrimal gland, in that it contained electron-dense serous granules, and at times, a myoepithelial cell was detected at the base of an acinus. The ductal and cystic elements were lined by a single layer of cells or by stratified or pseudostratified epithelium. An interesting, unexpected feature was the occurrence of a myoid band (composed of thin filaments with focal densities along their course) under the cell membrane of the epithelial cells adjacent to the lumen of the ducts and cysts. PMID- 3959156 TI - The human parathyroid chief cell--a model for a polypeptide hormone producing endocrine unit as revealed by various functional and pathological conditions. A thin section and freeze-fracture study. AB - The ultrastructure of the human parathyroid chief cell has been studied by comparing thin section with freeze-fracture findings in close consideration of functional activity. Assessment of function was based on the careful analysis of normal and pathological conditions of the parathyroids in patients with various entities of hyperparathyroidism including clinical data. In contrast to the atrophic glands contralateral to an actively secreting adenoma, stimulated chief cells especially in cases with acute hyperparathyroidism (hypercalcemic crisis), display several remarkable findings: an enlargement of the nucleus with an increase in pores, an abundant amount of rough endoplasmic reticulum, many mitochondria and conspicuous interdigitations of the plasma membrane and an extensively developed Golgi apparatus with budding of numerous vesicular structures and dense lysosomal bodies as well as secretory granules. The fine structure of these alterations was assumed to reflect different states of function in consideration of clinical and laboratory parameters. The process of extrusion of secretory granules and the retrieval of membrane material by endocytosis was particularly investigated by comparison of images obtained by thin sections and freeze-fracture replicas. Our results demonstrate that the human parathyroid chief cell may serve as an ideal model for the study of a polypeptide hormone synthesizing cell with a well known feedback mechanism expressed by the various pathological conditions in patients with the clinical picture of primary and secondary hyperparathyroidism. PMID- 3959157 TI - Localization of transcription in nucleoli of rat sympathetic neurons. A quantitative ultrastructural autoradiography study. AB - A quantitative electron microscopy autoradiography method was used to locate the sites of initial rRNA transcription and to determine whether there was a variability of fibrillar centres size related to nucleolar transcription in nucleoli of sympathetic neurons of a rat killed during the dark span of its light dark cycle. Indeed, in this model two types of fibrillar centres (nucleolar organizing regions) were observed: a single large type characteristic of this phase of the photoperiod and a small type composed by several small fibrillar centres of normal size. The present results clearly demonstrated that: there was no incorporation into the fibrillar centres themselves; the rRNA transcription sites were restricted to the ribonucleoprotein (RNP) fibrillar component and the products thereafter migrated into the RNP granular component. There was no variability of fibrillar centres size related to nucleolar transcription. The level of transcription was found to be identical around the two types of fibrillar centres. They might be considered as equivalent. The results provide evidence that at least in this model, the size of fibrillar centres and the transcriptional activity are not correlated. Other factors must therefore be responsible for the difference in size. PMID- 3959158 TI - The effect of angiotensin II on glomerular function and morphology in the rat. AB - We have observed alterations of glomerular and afferent arteriolar structure in nephrotoxic and ischemic models of acute renal failure. These alterations may have been caused by angiotensin II. To test this notion, we infused the peptide directly into the left renal artery of anesthetized rats. At sub-pressor doses of 1.9 and 6.5 ng/100g body weight/min, the peptide caused dose-related decreases in glomerular filtration rate similar to those that occur in models of acute renal failure. In some animals, methacrylate casts of the infused and contralateral kidneys were made for later examination by scanning electron microscopy. In other animals, the kidneys were fixed with glutaraldehyde for examination of the glomerular epithelium and endothelium by scanning electron microscopy. Cast analysis showed no detectable alteration of afferent arteriolar diameter, and only moderate bilateral changes in the tapering of the arterioles. In contrast, the diameter of the casted glomerular tuft was significantly reduced by the highest dose of angiotensin II. No alterations of the glomerular epithelium or endothelial fenestrae were observed. We conclude that angiotensin II probably did not mediate the changes in glomerular structure in our earlier studies of acute renal failure, even though similar reductions of glomerular filtration rate occurred. Reduced diameter of the glomerular tuft is consistent with a possible role for angiotensin II as a modulator of intrinsic contractile elements in glomeruli. PMID- 3959159 TI - Ultrastructural changes of afferent nerve terminals in the cat medial geniculate body after destruction of the inferior colliculus. AB - Three to seven days after destruction of the inferior colliculus, changes of the afferent nerve terminals of the cat medial geniculate body were examined morphometrically by thin sectioning and freeze fracture. The results were compared with those of the control. Three and five days after the operation, postsynaptic densities (PSD) of synapses of the afferent nerve terminals increased their width significantly (p less than 0.01) compared with the control. The packing density of intramembrane particles (IMPs) in aggregates at the synaptic site on the postsynaptic E-face decreased significantly (p less than 0.01) during this period. IMPs of 13 nm in diameter within these aggregates decreased. Ring-shaped IMP aggregates having an IMP free area at the center increased. Width of dense materials of the filamentous contact, which is a non synaptic contact, decreased significantly (p less than 0.01) 3 and 5 days after the operation as compared with the control, but 7 days after the operation they recovered to the level of the control. No significant change was observed in the intervals of dense materials of the filamentous contact after the operation. PMID- 3959161 TI - Comparative electron microscopic study of bovine, porcine and human parietal pericardium, as materials for cardiac valve bioprostheses. AB - Light, scanning and transmission electron microscopy were used in the comparison of bovine, porcine and human parietal pericardium. Bovine pericardium is widely used for heart valve bioprosthesis, is thicker than the other two, and has more coarse connective tissue fiber components, whereas porcine pericardium possesses relatively larger quantities of fat cells in regular layers. Human tissue is thinner than either the bovine or porcine parietal pericardium and its mesothelium seems less delicate. The human tissue, being thinner, may provide a source of materials for valves with significant hemodynamic characteristics. Such material might be used to produce small diameter valves directed towards younger patients. Though the literature does not mention its usage, porcine pericardium is of intermediate thickness and it too may serve in the future as a construction material for valve bioprostheses. PMID- 3959160 TI - Cytoprotective effects of Bencianol on porcine vascular endothelial cells in vitro. AB - Endothelial cells of porcine thoracic aorta were chosen as in vitro model to study the reaction of endothelial cells to injury induced by carbon tetrachloride (CCl4 0.2 microliter/ml). Lactate dehydrogenase (LDH) was used as the biochemical marker of cell injury. The changes in the morphology of the surface endothelial cells were observed by scanning electron microscopy. In addition, cell survival rate after replating cultures was evaluated. The pretreatment with Bencianol (10( 10) M-10(-7) M) produced cytoprotective effects against CCl4 induced cell injury on the above three parameters. PMID- 3959162 TI - Ultrastructure of dog parotid gland. AB - The ultrastructure of the parotid gland was examined in two purebred strains of dogs, as well as in mongrels. The seromucous acinar cells contain numerous secretory granules of unusual substructure that varies somewhat from one granule to another. The most common configuration consists of a large, dense spherule surrounded by a thin electron-lucent halo. The matrix is composed of a series of dense beads, each delimited by a light ring. Between these beads is a material of intermediate density that sometimes forms a corona around the spherule. The organization of the granule is somewhat altered when osmication is omitted from the fixation procedure. Striated ducts have basal regions that are of conventional appearance, but the cell apex is characterized by a collection of ellipsoidal structures oriented perpendicular to the luminal plasma membrane. At least in some cases these are joined to the plasma membrane by fine threads. Despite the obvious phenotypic differences in the canine breeds used in this study, their parotid glands were identical, indicating that the genetic mechanisms that control gland structure, especially secretory granule substructure, have not been affected by selective breeding. PMID- 3959163 TI - Gap junctions between gonocytes and epithelial cells in the sex cords of the one day old rat. A freeze fracture study. AB - In this report we document the presence of gap junctions between gonocytes and epithelial cells in the sex cords of the one day old rat. Morphologically these junctions are comparable to those seen between germ and Sertoli cells in the adult rat seminiferous epithelium. The possibility that gap junctions the adult rat seminiferous epithelium. The possibility that gap junctions between germinal and supporting elements in the one day old rat and in the adult have similar functional roles is also discussed. day old rat and in the adult have similar functional roles is also discussed. PMID- 3959164 TI - Effect of socioeconomic status on body length of Pakistani infants during first year of life. PMID- 3959165 TI - Does health intervention ameliorate the effects of poverty-related diseases?- III. Propagating the use of oral rehydration in diarrhoea. PMID- 3959166 TI - Socioeconomic differentials in child nutrition and morbidity in a rural area of Bangladesh. PMID- 3959167 TI - Breastfeeding: a verbal bonding. PMID- 3959168 TI - Evaluation of a programme of teaching mothers the management of acute diarrhoea. PMID- 3959169 TI - Health status of primary school children in central Tanzania. PMID- 3959170 TI - Vernier tape for circumferential measurements. PMID- 3959171 TI - Foreign body in the ear and its importance: the Nigerian experience. PMID- 3959172 TI - Foreign body in the larynx in Nigerian children. PMID- 3959173 TI - Clinico-bacteriological study of diarrhoea complicating measles. PMID- 3959174 TI - On proximate determinants of infant mortality in developing countries. PMID- 3959175 TI - Leucocyte counts in cord blood of Nigerian neonates. PMID- 3959176 TI - Cochlear echoes, spontaneous emissions, and some other recent advances in auditory science. AB - This is the second of two tutorials designed as an update on recent advances in auditory science for audiologists, otolaryngologists, and others studying or working in the area of hearing and deafness. This article spans diverse areas from psychophysical measures of audiogram fine structure to physical measurements of the motion of the basilar membrane and to so-called cochlear echoes and acoustic emissions. The review is not comprehensive but it gives an overview of salient points of interest as well as an indication of the current state of knowledge in these areas. PMID- 3959177 TI - Mini-myringoplasty in the treatment of tympanic atelectasis. AB - Mini-myringoplasty is an outpatient procedure developed to simultaneously lateralize the tympanic membrane and provide middle ear ventilation in patients who have developed atelectasis. This paper describes the operative procedure and reports on 50 consecutive cases in which these objectives were achieved. Patients experience a minimum of discomfort. Restoration of the normal tympanic membrane configuration and improvement in hearing are noted within a few days. PMID- 3959178 TI - Attempt at systematization in the treatment of isolated fractures of the zygomatic bone: techniques and results. AB - Two series of cases with isolated zygomatic bone fractures have been compared with regard to the treatment applied and its results, i.e. 258 cases treated by conventional methods, and 437 cases treated by osteosynthesis with miniaturized screwed plates (MSP). In the second series, reduction failure is eight times less frequent than in the first series, and fixation by plates is solid in the three spatial planes. The incidence of postoperative infra-orbital nerve sequelae was diminished by 50% in the second series. This easy, comfortable and efficient method is now used by the authors for the treatment of all unstable zygomatic fractures and in all cases presenting the following functional signs: limited buccal opening, diplopia by trapping, or involvement of the infra-orbital nerve. PMID- 3959179 TI - Extensive facial malignancies--concepts and management. AB - A small number of malignant facial neoplasms recur or persist despite initial adequate local conventional therapy. Ten such cases treated by the author over a three year period demonstrate the aggressiveness of skin tumors when recurrence develops in the region of fusion lines. A major surgical resection was required to control the ensuing malignant process. An approach, with concepts and management of extensive recurrent facial lesions is presented with reconstructive techniques outlined. PMID- 3959180 TI - Ectopic thyroid tissue in the head and neck. AB - A review has been performed of thyroid ectopia seen during a 10 year period. There were five cases of total ectopia; three of these were lingual thyroids, one situated in the perihyoid region had been clinically diagnosed as a thyroglossal cyst, while the fifth presented as a tumor in the lateral neck. In the same period 41 thyroglossal cysts were removed. None of these showed uptake on technetium scintigraphy. Thyroid tissue was present in the cyst walls in 41% of cases. Scintigraphy should be performed routinely if the clinical picture is at all compatible with thyroid ectopia. PMID- 3959181 TI - Third branchial cleft sinus route of infection in deep neck abscesses. AB - Several recent articles have described a third branchial cleft sinus as a route of infection in deep neck abscess. This article describes two children whose presentation and clinical course were secondary to a third branchial cleft sinus. PMID- 3959182 TI - Capnocytophaga ochracea and group F beta-hemolytic streptococcus suppurative thyroiditis. AB - The route of infection in acute suppurative thyroiditis is unknown in most cases; when demonstrated, pyriform sinus fistula appears to be the most frequent one. We report the clinical and laboratory findings of a child in whom culture of the thyroid pus yielded two bacteria which are part of the normal oropharyngeal flora: capnocytophaga ochracea and group F Beta-hemolytic streptococcus. The preliminary results of the culture, which showed a mixed flora, prompted us to search and to find a pyriform sinus fistula. Apart from the onset in infancy, the left lobe involvement and the frequent recurrence, the recovery from the thyroid pus of bacteria from normal oropharyngeal flora should be included in the characteristic features of thyroiditis resulting from an infection through the pyriform sinus fistula. PMID- 3959183 TI - Acute parotid swelling with rapid subsidence in childhood. PMID- 3959184 TI - A modification of the Otis urethrotome as an aid to fascial dilation of percutaneous nephrostomy tracts. AB - An Otis urethrotome has been modified by drilling a 3/64-inch hole through the tip to permit passage into the kidney over a 0.038-inch guide wire. This instrument has been used to aid in the performance of 12 nephrostomy tract dilations without significant complications. When compared to 10 Amplatz tract dilations, the modified Otis method required an average of 3.6 minutes versus 8.7 minutes to dilate the nephrostomy tract to 24F. Ease of tract dilation as well as decreased time to dilate make this technique a useful adjunct to standard nephrostomy tract dilation techniques. PMID- 3959186 TI - Studies on renal damage from percutaneous nephrolitholapaxy. AB - To study in detail the effects of percutaneous nephrolitholapaxy on renal function, a consecutive series of 11 patients were investigated preoperatively by excretory urography, gamma camera renography for determination of individual renal function and computerized tomography of the kidneys. Postoperatively, gamma camera examination, computerized tomography, antegrade nephrostography, renal angiography and excretory urography were performed. With 2 exceptions, percutaneous nephrostomy, dilation of the tract and stone removal were done in 1 stage with the patient under continuous epidural anesthesia. Nephrostomy tract dilation was done with an Olbert type balloon catheter or Alken metallic dilators. Thickening of Gerota's fascia was demonstrated by computerized tomography in most cases, and small to moderate perirenal hematomas were found in several. At gamma camera examination decrease of renal function was noted regularly on postoperative day 1 and returned to near initial levels 2 weeks postoperatively in most cases. Angiography in 10 patients showed discrete parenchymal scarring in some and a peripheral arteriovenous fistula in 1. We conclude that percutaneous renal stone surgery usually is tolerated well by the kidney. PMID- 3959185 TI - Combined percutaneous and extracorporeal shock wave lithotripsy for staghorn calculi: an alternative to anatrophic nephrolithotomy. AB - Combinations of percutaneous and extracorporeal shock wave lithotripsy were performed on 46 patients with 52 staghorn calculi. Of the renal units 15 per cent had minute residual fragments but only 9.7 per cent with struvite had residual stones. The morbidity of this combined approach is less than that of anatrophic nephrolithotomy. We believe that the majority of staghorn calculi can be removed in this manner. Nephrostolithotomy should be the initial procedure in most instances. This less invasive approach is especially advantageous in patients at high risk for recurrence. PMID- 3959187 TI - Ureteroscopy: the initial experience. AB - A prospective study of our first 81 cases of ureteroscopy using extended length rigid endoscopes was performed. Of 55 stone manipulations attempted in 51 patients by 6 endoscopists 38 (69 per cent) were successful. Analyzed sequentially, removal was successful in 12 of 23 attempts (52 per cent) among the initial 40 patients and in 26 of 32 (81 per cent) among the subsequent 41 patients. Of 11 calculi larger than 1 cm. and of 23 positioned above the iliac vessels 7 (64 per cent) and 11 (48 per cent), respectively, were removed successfully. Disimpaction by ureteroscopic manipulation combined with extracorporeal shock wave lithotripsy was successful in 4 cases of upper ureteral calculi not treatable by extracorporeal shock wave lithotripsy alone. Diagnostic and therapeutic uses of the ureteroscope in addition to treatment of ureteral calculi have included the delineation of ureteral filling defects (9 patients), fulguration of known low grade tumors (4) and dilation of ureteral strictures (5). In 10 patients information was obtained endoscopically that was not possible by standard diagnostic techniques. The direct visual approach to the ureter has distinct advantages over blind ureteral instrumentation. PMID- 3959188 TI - Flow cytometry of deparaffinized nuclei compared to histological grading for the pathological evaluation of transitional cell carcinomas. AB - Recent developments in flow cytometric analyses have resulted in a practical method to examine the deoxyribonucleic acid ploidy of various tissues, including bladder cancers. Although the technique provides information not readily available from usual pathological examinations, its value as a diagnostic test in clinical urology remains to be investigated. We confirm previous reports that flow cytometry can be performed on tissues stored in paraffin and demonstrate a positive correlation among deoxyribonucleic acid ploidy, histological grade and clinical outcome in patients with transitional cell carcinoma. Nevertheless, deoxyribonucleic acid ploidy offered no more prognostic information than histological grading alone when these tests were performed on the initial bladder tumors in 63 patients. PMID- 3959189 TI - Bladder reconstruction following cystectomy by uretero-ileo-colourethrostomy. AB - Five patients who had had the bladder removed underwent uretero-ileo colourethrostomy construction to allow for urination in a physiological manner. All 5 patients void spontaneously and have daytime continence, while 1 requires intermittent catheterization twice daily and 1 has significant enuresis. This method is promising for reconstruction of the urinary tract following cystectomy for benign and malignant diseases. PMID- 3959190 TI - Failure of the Jonas prosthesis. AB - A total of 27 patients received the standard Jonas silicone-silver penile prosthesis. The procedure was done at 3 separate hospitals by 2 surgical teams. Four patients who were reported on previously presented consecutively to our clinic with failed penile rigidity and complete multiple wire fractures were found at reoperation. Therefore, the remaining 23 patients were reviewed and 7 had positive findings suggesting fracture, including decreased penile rigidity, crackling that was audible or palpable and/or evidence of fracture on an x-ray. Seven patients had completely negative evaluations and 9 were lost to followup. Two patients with suspicious x-ray findings and 1 with negative x-ray findings but who reported less rigidity have since had the prostheses removed, and all had multiple wire fractures. Radiographs of fractured prostheses, both in the penis and explanted, attest to the limited reliability of x-ray in the diagnosis of wire fracture. PMID- 3959191 TI - Transurethral resection of the prostate with local anesthesia in 100 patients. AB - We performed transurethral resections of the prostate in 100 patients under local anesthesia supplemented when appropriate by intravenous medication. In the first part of the study (40 patients) local anesthesia was infiltrated into the prostate transurethrally only, while in the second part (60 patients) infiltration was performed transurethrally and perineally. Prostate sizes ranged from 5 to 50 gm., and pain control was excellent in the majority of the patients, especially when perineal infiltration was added to the procedure. Of the patients 98 per cent said they would do it again, no patient required conversion to general anesthesia and there were no significant complications relating to the anesthesia. Local anesthesia with intravenous supplementation can be performed successfully in the majority of the patients with small to moderately sized prostate glands. PMID- 3959192 TI - Ultrasonic lithotripsy: the risk of hearing loss. AB - Ultrasonic lithotripsy has been applied widely to the percutaneous removal of upper tract calculi. The high noise levels generated by ultrasonic lithotriptors during clinical use have raised some concern among endourologists. In this study sound level measurements of all 3 commercially available ultrasonic lithotriptors were obtained in the audiology laboratory and operating room. In all circumstances the maximum noise levels recorded (103 dBA. or less) for the time of exposure that would be encountered in the clinical setting of ultrasonic lithotripsy never exceeded safe levels. We concluded that the routine use of ultrasonic lithotriptors does not present a hazard to the hearing of normal individuals. PMID- 3959193 TI - Comparative urological outcome in women with spinal cord injury. AB - We evaluated 35 women for urological complications followed for 2 to 12 years after spinal cord injury. Of the patients 13 were treated with a Foley catheter, while 22 were managed by intermittent catheterization. Urological complications in the chronic catheterization group were frequent and serious compared to those in patients treated by intermittent catheterization. PMID- 3959194 TI - Refractoriness of urethral striated sphincter during voiding: studies with afferent pudendal reflex arc stimulation in male subjects. AB - To assess the excitability of the striated sphincter under normal and abnormal conditions, electrostimulation of the periurethral striated sphincter via the dorsal nerve of the penis was done with the patient at rest and during voiding. Monitoring of simultaneous intravesical and intramembranous urethral pressures, and electromyographic responses of the striated sphincter was performed under fluoroscopic guidance in 14 male subjects. The urethral striated sphincter attained a state of relative refractoriness during detrusor contraction (voiding phase) and greater amounts of afferent stimulation were required to elicit sphincter contractile activity compared to the amounts required during resting states. Under conditions of a hyperactive detrusor with synergic voiding, the amounts of stimulation required to elicit striated sphincter responses were higher than those required in normal subjects. On the other hand, under conditions of striated sphincter dyssynergia, minute amounts of afferent stimulation were enough to produce sphincter contraction during voiding. PMID- 3959195 TI - Urological evaluation in the Shy Drager syndrome. AB - Nine patients with the Shy-Drager syndrome underwent complete urological and neurological investigation of bladder symptoms. Urodynamic studies revealed detrusor areflexia in 6 patients (67 per cent), detrusor hyperreflexia in 3 (33 per cent), a lower motor neuron lesion involving the periurethral striated muscle in 9 (100 per cent) and an open vesical neck at rest in all 5 patients in whom cystography was performed. These findings support the current view that parasympathetic, pudendal and sympathetic involvement is part of the pathophysiology of the Shy-Drager syndrome. PMID- 3959196 TI - Megalourethra. AB - Megalourethra is a rare congenital malformation characterized by dilatation of the penile urethra. We review 6 previously unreported cases and 35 cases reported in the literature. The distinction between scaphoid and fusiform megalourethra seems arbitrary, and the disorder is better viewed as a spectrum rather than as 2 distinct entities. Significant concomitant upper urinary tract abnormalities may be present in any patient with megalourethra, a fact that should lead to the routine investigation of the upper urinary tract in all patients with this developmental anomaly. PMID- 3959197 TI - An 18-year-old woman born with cloacal exstrophy. PMID- 3959198 TI - Nephrobronchial colonic fistula complicating perinephric abscess. AB - Perinephric abscess is an uncommon complication of acute pyelonephritis. A nephrobronchial colonic fistula is a rare sequela of perinephric abscesses. We report such a case, review the literature, and discuss the associated morbidity and diagnostic dilemmas. PMID- 3959199 TI - Pseudoxanthoma elasticum and its urological implications. AB - We describe a ureteral disruption in a patient with pseudoxanthoma elasticum. Pseudoxanthoma elasticum is characterized by major changes in the physical properties of tissues that indicate a need for modifications in classical tissue handling techniques. In particular, low elasticity and tensile strengths make dilation a more hazardous procedure in patients with pseudoxanthoma elasticum. PMID- 3959200 TI - Two cases of ureteroscopy and attempted stone disintegration complicated by disruption of the burr tip of the ultrasonic probe. AB - Ureteroscopy with endoscopic stone removal or stone disintegration has become an established technique for removal of ureteral stones. This rapidly advancing technology has not been without problems. We report 2 cases in which defects in the instruments led to failure of the endoscopic technique, and the stones and broken parts of the ultrasound probe were removed by an open operation. Convalescence was uneventful. PMID- 3959201 TI - Retained straight catheter: complication of clean intermittent catheterization. AB - Clean intermittent catheterization is a simple and widely used technique with relatively few complications. A child on intermittent catheterization recently was treated for a retained straight catheter. Removal of the catheter was accomplished by urethral dilation. Proper technique of catheter insertion can prevent this complication. PMID- 3959202 TI - Infected suture granuloma simulating mass of urachal origin: case report. AB - We report a case of an infected suture granuloma. The patient presented with a solid mass located superior to the dome of the bladder. Evaluation showed a normal intestinal tract and absence of a primary bladder abnormality. Based on these findings the mass was considered to be of urachal origin but surgical excision revealed that the mass was an infected suture granuloma. Suture granuloma should be considered in patients who have had previous inguinal surgery, particularly when associated with the use of nonabsorbable suture. PMID- 3959203 TI - Alum irrigation for severe bladder hemorrhage. AB - We report 5 cases of severe bladder hemorrhage treated with alum irrigation. The severe hemorrhage stopped in all patients after 12 to 48 hours of irrigation. No toxic side effects were noted in all 5 patients, including 1 in whom intra abdominal spillage of the solution occurred after spontaneous rupture of the bladder. PMID- 3959204 TI - Skene's gland calculi produced by a Ureaplasma urealyticum infection. AB - We report a case of calculi in a Skene's gland abscess produced by Ureaplasma urealyticum. The enzyme urease, produced by the Ureaplasma urealyticum, is thought to be the etiological factor in stone production, vaginitis and urethritis. PMID- 3959205 TI - Mesothelioma of the testicle in a child. AB - A case of paratesticular mesothelioma in a child is presented. This is a rare benign tumor in childhood. PMID- 3959206 TI - Spontaneous regression of testicular seminoma: case report. AB - A 33-year-old man had a 1-year history of a painless testicular mass and a 2 month history of an enlarging left supraclavicular mass. Biopsy of the supraclavicular mass showed classical seminoma. Massive abdominal lymphadenopathy was demonstrated by computerized tomography. Radical orchiectomy was performed and examination of the specimen showed only fibrous scar tissue consistent with regression of a primary tumor in the testis. While complete regression of a primary testicular tumor with progressive growth of metastases is well recognized in cases of nonseminomatous germ cell tumors, this phenomenon is reported rarely with seminoma. PMID- 3959207 TI - Chylous ascites following retroperitoneal lymphadenectomy for granulosa cell tumor of the testis. AB - We report on an infant with chylous ascites following retroperitoneal lymphadenectomy for granulosa cell tumor of the testis. Granulosa cell tumor of the testis is an extremely rare lesion, with only 8 cases reported previously, including 1 in an infant. Chylous ascites is a rare problem in children and it has been reported in only 92 cases. The options for management of this difficult problem are discussed. PMID- 3959208 TI - Verrucous elephantiasis of the scrotum: an unusual variant of genital lymphedema. AB - Verrucous elephantiasis of the scrotum is a severe debilitating variant of scrotal lymphedema. A case is reported, and its pathophysiology and treatment are discussed. PMID- 3959209 TI - Testicular seminoma metastatic to the prostate. AB - A 43-year-old man had clinically manifest prostatic involvement by a metastatic testicular seminoma. The signs, symptoms, diagnosis and treatment of this entity, as well as a hypothesis regarding its development, are discussed. PMID- 3959210 TI - Metastatic adenocarcinoma of the prostate as a cause of subdural hematoma. AB - Nontraumatic subdural hematoma secondary to dural metastasis from adenocarcinoma of the prostate was encountered in 2 patients. The mechanism of production and a review of the literature are presented. PMID- 3959211 TI - The crush syndrome: a complication of urological surgery. AB - A few cases of the crush syndrome occurring postoperatively have been reported. We present a case of the crush syndrome involving the gluteal compartment secondary to prolonged duration of the patient in the right lateral decubitus position during a urological operation. A review of the literature demonstrates that prompt diagnosis is essential to avoid catastrophic results. The essentials of diagnosis, treatment and prevention are reviewed. PMID- 3959212 TI - Re: Kidney stone removal: percutaneous versus surgical lithotomy. PMID- 3959213 TI - Extracorporeal stone disintegration using chemical explosive pellets as an energy source of underwater shock waves. AB - Extracorporeal renal stone disintegration using a chemical explosive pellet (lead azide 10 mg.) as an energy source of underwater shock waves has been successfully performed in animals. The shock wave was observed by holographic interferometry. Shock wave generation was performed by a reflector whose configuration was part of a pseudoellipsoid. The explosions were conducted 10 to 100 times for each animal and the stone (extracted human renal calculus or model calculus of activated alumina) placed in the renal pelvis was disintegrated satisfactorily. Negative findings in explorative laparotomy and histological examination, except for minor bleeding in several tubular lumina of the kidney, indicated that the method was clinically applicable. PMID- 3959215 TI - Extracorporeal shock wave lithotripsy of ureteral stones: clinical experience and experimental findings. AB - ESWL of impacted ureteral or caliceal stones is not as successful as expected. To study this problem a model for extracorporeal shock wave lithotripsy of ureteral stones has been designed. After initial fragmentation of the outer shell of impacted stones during the first series of shock wave application those fragments are kept in place by external mucosal contact, creating a lot of new interfaces. Absorption or reflection of shock wave energy within this fragmented shell seems to be responsible for the poor success rate in these cases. In regard to our experimental and clinical results we advise pushing ureteral stones back into the renal collecting system by means of a ureteral catheter. PMID- 3959214 TI - Identification of urinary stone and sediment crystals by scanning electron microscopy and x-ray microanalysis. AB - A procedure based on scanning electron microscopic techniques is described for the identification of crystals in urinary sediments and stones. The crystals are identified by their morphology and elemental composition using scanning electron microscopy and x-ray microanalysis. The procedure has a number of advantages over conventional methods. It is easy to use. It is non-destructive so that both the exterior and interior of the same stone can be separately analyzed. It is the only technique in which information about spatial relationships between various crystals in a stone can be obtained easily. Scanning electron microscopic techniques can detect minor components, and analysis of a wide variety of materials ranging from amorphous substances to microcrystals to macroscopic stones is possible. PMID- 3959216 TI - Membrane interactions with calcium oxalate crystals: variation in hemolytic potentials with crystal morphology. AB - Crystal-induced membranolysis of human red blood cells has been quantitated for calcium oxalate monohydrate and calcium oxalate dihydrate crystals. Calcium oxalate monohydrate crystals are significantly more membranolytic than calcium oxalate dihydrate crystals at constant surface area. If the crystal morphology of calcium oxalate monohydrate is altered by grinding, the lytic potential at constant surface area is markedly reduced. However, altered calcium oxalate dihydrate crystals are as lytic as natural calcium oxalate dihydrate crystals at constant surface area. Differences in the calcium oxalate monohydrate and dihydrate crystal structures, specifically the structural characteristics of the disordered water channel in calcium oxalate dihydrate, can explain these different membranolytic characteristics. PMID- 3959217 TI - Functional effects of in vitro obstruction on the rabbit urinary bladder. AB - Bladder outlet obstruction has been the subject of numerous clinical and experimental investigations. Although these studies have demonstrated that the bladder can respond to outlet obstruction with muscular hypertrophy and hyperplasia, resulting in markedly altered morphological and functional characteristics, the nature of the direct effect of obstruction on the ability of the bladder to empty is relatively unknown. If one regards the bladder as a simple pump mechanism, decreasing the diameter of the outlet port (obstruction) would be expected to increase the work the bladder muscle would have to do in order to empty. The purpose of this present investigation is to better define the physical nature of the increased stress placed on the normal bladder via partial outlet obstruction. For these studies, the in vitro whole bladder is an appropriate model for several reasons: 1) one has complete control of initial intravesical volume, pressure, outlet diameter, and outlet resistance, and 2) this model quantitatively measures the effect of pharmacological agents and electrical stimulation on intravesical pressure and the ability of the bladder to empty. The results of these studies indicate that the obstructed bladder requires an increased pressure to empty. Although the obstructed bladder can empty completely, the rate of emptying is reduced significantly and the time required to completely empty is significantly increased. The obstructed bladder fatigues rapidly with repetitive stimulations, whereas the normal bladder is far less subject to fatigue. The physical alterations observed in these studies would play a direct role in the development of the functional alterations observed in in vivo obstruction. PMID- 3959218 TI - Mechanism of the LAI test in bladder cancer patients. AB - To clarify the mechanism of the leukocyte adherence inhibition (LAI) test, 30 bladder cancer patients were studied by the fractionated LAI test in which peripheral lymphocytes were separated into monocyte rich and monocyte deplete fractions. The mean LAI reactivity of 30 bladder cancer patients on the monocyte rich fraction (43.2 +/- 20.3 per cent) was significantly higher than that of the corresponding patients on the standard LAI test (30.4 +/- 12.7 per cent), whereas the mean LAI reactivity of these patients on the monocyte deplete fraction (15.6 +/- 10.7%) was significantly lower than that on the standard LAI test of the same patients (respectively p less than 0.001 and p less than 0.01). It suggests that monocytes play an important role in the capillary LAI test. To further comprehend the mechanism of the LAI phenomenon, indicator cells involved in the LAI test were observed by transmission and scanning electron microscopy. The microvilli on the cell surface of nonadherent monocytes of bladder cancer patients were decreased in number and shortened in length but other populations of nonadherent cells were not remarkably changed. These observations showed that the bladder tumor antigens in extracts from tumors appear to have an influence on the microvilli of monocytes, specifically on monocytes from bladder cancer patients. These morphological changes correlate with the results from fractionated LAI assay and may result in the tumor antigen specific LAI reactivity observed in leukocytes of bladder cancer patients. PMID- 3959221 TI - American Urological Association, Inc. Eighty-first annual meeting. May 18-22, 1986, New York, New York. Abstracts [abstract no. 633 retracted in: J Urol 1993 Jul;150(1):202]. PMID- 3959219 TI - Binding of oxalate to mitochondrial inner membranes of rat and human kidney. AB - Oxalate bound specifically to homogenates of rat kidney and liver but not to homogenates prepared from heart, lung, skeletal muscle, spleen, stomach, small or large intestine. In the renal cortex, binding was localized to the inner mitochondrial membrane where it was enriched fourfold when compared to homogenate. Binding of the oxalate reached equilibrium in two minutes at 23C. Analysis of the binding sites by Scatchard plot indicated that the maximum binding capacity was 49 pmol./mg. protein and the apparent dissociation constant (Kd) was 43 nM. The IC50 of oxalate was 0.25 microM. Among the inhibitors studied the IC50 was in the following order: oxalate less than oxamate less than parabanate less than glyoxalate less than oxaloacetate less than malate less than citrate = glycollate. Heat and treatment with lubrol abolished the binding completely. Binding was not enhanced by the presence of calcium in the incubation medium; neither was it inhibited by the presence of calcium together with its transport inhibitors. A binding substance with some characteristics similar to the rat mitochondrial binding factor was also found in the human renal cortex. PMID- 3959220 TI - Human penile hemodynamics studied by a polarographic method. AB - Observations of the tissue oxygen tension alteration were made using an open tip type oxygen electrode polarographic method as an index of blood flow change in the penile skin, corpus cavernosum and thigh skin of 16 males aged 20-26 years (average age: 20.5 years). In another five males aged 18-21 (average age: 19.8 years) the relationship between corpus cavernosum tissue oxygen tension alteration and penile circumference change in the erection process was observed. This relation was obtained in the penile circulation model, and penile hemodynamics were ascertained. In the flaccid penis the corpus cavernosum contains low-oxygen blood and there is a blockade at the vascular tree in the corpus cavernosum. In the tumescence phase the blood flow of the corpus cavernosum increased suddenly by the relief of cavernosum vascular blockade. During the penile tumescence phase the increased inflow and outflow persisted in corpus cavernosum, and in penile skin the blood also increased initially, but gradually decreased as penile circumference increased. After erection was attained it is thought that resistance to inflow occurred by outflow pathway contraction. In the detumescence phase, a decrease of inflow and a concomitant increase of outflow occurred and the reopening of outflow is thought to be necessary for prompt penile detumescence. PMID- 3959222 TI - The association of hypertension, the Ask-Upmark kidney and other congenital abnormalities. AB - We report 2 cases of hypertension with segmental renal hypoplasia (Ask-Upmark kidney) and other anomalies in the absence of vesicoureteral reflux. These cases support the view that the Ask-Upmark kidney is a defect of renal development rather than acquired as a consequence of vesicoureteral reflux. In 1 patient the abnormal renal vein renin ratio suggested that the renin-angiotensin system may have had a part in the pathogenesis of the hypertension. PMID- 3959223 TI - Oncocytoma in a horseshoe kidney. AB - Renal oncocytoma is an unusual tumor that has been identified with increasing frequency during the last decade, and more than 150 cases have been reported in the literature, including multifocal and bilateral tumors. We report a case of oncocytoma in a horseshoe kidney. Oncocytoma and tumors in horseshoe kidneys are discussed. PMID- 3959224 TI - Regression of metastatic renal cell carcinoma: a case report and literature review. AB - The literature provides few examples of regression of documented metastatic renal cell carcinoma. We report a case of cytologically documented pulmonary metastases from a renal cell carcinoma, which resolved following nephrectomy and hormonal therapy. The patient has been followed for 6 years without evidence of recurrence. PMID- 3959225 TI - Candida of the bladder wall: computerized tomography demonstration. AB - We describe a patient with a history of vulvar cancer, aplastic anemia and diabetes who was found to have a bladder wall lesion on a computerized tomography scan, which was compatible with malignancy. Pathological examination of the biopsy specimen revealed the lesion to be Candida. The differential diagnosis of filling defects in the bladder as seen on computerized tomography is discussed. PMID- 3959226 TI - Hernias after transpubic urethroplasty. AB - We report 2 cases of herniation following repair of posterior urethral strictures. Both patients underwent transpubic bulboprostatic urethral anastomosis and omentoplasty, which resulted in a perineal hernia in one and a pubic hernia in the other. PMID- 3959227 TI - Primary malignant melanoma of the urethra in a black man: a case report. AB - We report a unique occurrence of primary urethral melanoma in a black man. The biological relationships to melanocyte/melanin site densities or to precursor mucosal lesions are discussed as possible etiological factors in the occurrence of this rare neoplasm. PMID- 3959228 TI - Sarcoidosis of the penis: report of a case. AB - We report a case of sarcoidosis identified histologically as the cause of chronic painful erythematous induration of the penis with several subcutaneous nodules and cutaneous ulceration. The lesions improved in response to topically applied corticosteroids but they reappeared later and persisted despite treatment. We suggest that sarcoidosis, although rare, should be considered in the differential diagnosis of any chronic lesion involving the penis in adults. PMID- 3959229 TI - Mature teratoma of the testis metastasizing as mature teratoma. AB - We report an unusual case of mature teratoma of the testis with retroperitoneal metastasis of mature teratoma. Mature teratoma of the testis should be considered a low grade malignant neoplasm. PMID- 3959230 TI - Vasal urinary fistula with retrograde reflux of urine after vasectomy. AB - We report a case of urinary fistula after scrotal vasectomy for recurrent epididymo-orchitis. The etiology of this rare complication is discussed and the literature is reviewed. PMID- 3959231 TI - Embryological and diagnostic aspects of seminal vesicle cysts associated with upper urinary tract malformation. AB - Congenital seminal vesicle cysts represent a rare but illustrative type of embryological malformation. They often are combined with ipsilateral upper urinary tract abnormalities. In most of the cases described in the literature the diagnosis has been made with rather invasive procedures. On the basis of our experience with 3 cases we recommend pelvic ultrasonography as the initial study in patients in whom such a malformation is suspected. Although other radiological procedures may be required to confirm the diagnosis, this approach appears to be cost-effective and accurate in most instances. The treatment of such malformations should be restricted to symptomatic cases and usually consists of vesiculectomy with or without removal of the ipsilateral dysplastic or hypoplastic kidney. PMID- 3959232 TI - Primary genitourinary tuberculosis: rapid progression and tissue destruction during treatment. AB - We report a case of primary genitourinary tuberculosis associated with severe progressive scarring, and obstruction of the left collecting system and proximal ureter, a contracted bladder with persistent vesicoureteral reflux and a bulbar urethral stricture. Scarring commenced soon after initiation of medical therapy, and resulted in left nephrectomy and reconstruction with colocystoplasty, right ureteral reimplantation and urethroplasty. The rapidity of disease progression and severity of tissue destruction in this case suggest that patients with genitourinary tuberculosis require close supervision starting at initiation of drug treatment. When complications do arise appropriate surgical intervention may become mandatory to decrease morbidity and to conserve renal function. The pathophysiology, clinical manifestations, radiological findings and treatment of genitourinary tuberculosis are reviewed. PMID- 3959233 TI - Human bladder tumors in organ culture. AB - We have established a reliable method for culturing transitional cell tumors of the human urinary bladder. Out of seventy-four set up in culture, forty-eight were successfully maintained and their behavior studied using metaphase arrest and 125IUdR uptake. PMID- 3959234 TI - Glycosaminoglycans content of stone matrix. AB - The role of urinary glycosaminoglycans (GAGs) in lithogenesis is a topic of current interest in urologic research. One GAG, chondroitin sulfate, has previously been shown to inhibit calcium oxalate crystal formation. It has long been known that the chemical components of GAGs are present in the matrix of urinary concretions, but it has not been determined whether these components exist in free form or as constituents of GAG. This study was undertaken to determine whether GAGs are present in urinary stone matrices and, if so, to characterize them. Matrices of nine single urinary stones of various compositions and of three stone pools (calcium oxalate, magnesium ammonium phosphate) were isolated by exhaustive dialysis. The techniques of cellulose acetate electrophoresis, Alcian blue staining and enzymatic degradation were used to identify various GAGs. Material that stained Alcain blue was present in eleven of twelve samples. GAG was detected as this material in ten samples. The GAGs identified are heparan sulfate, hyaluronic acid and possibly keratan sulfate. The most prominent urinary GAG, chondroitin sulfate, was notably absent from urinary stone matrix. GAG seems to be incorporated into matrix on a selective basis. This finding may be due to differences in the affinities of different GAG species for the crystals which comprise the calculi. It has been proposed that the inhibitory activity of GAGs lies in their ability to bind to (and therefore block) the growth sites of crystals. It is apparent from this study that certain GAG species are incorporated into the structure of the stone and they may be intimately related to stone development and growth. PMID- 3959235 TI - Effect of estrogens on the weight and muscarinic cholinergic receptor density of the rabbit bladder and urethra. AB - We have determined the muscarinic cholinergic receptor (MChR) density in the adult female rabbit bladder body and bladder base/urethra following three weeks of estrogen treatment. Fifteen female rabbits were separated into three treatment groups. Group I remained intact, Group II underwent bilateral ovariectomy, and Group III underwent simultaneous bilateral ovariectomy followed by subcutaneous placement of a 250 mg. estradiol pellet. The weight, total DNA content, and MChR density were determined for each of the tissues in the three treatment groups. The mean weight of the bladder body following ovariectomy and estrogen treatment (Group III) was three-fold greater than in the intact rabbits (Group I) (p less than 0.001) and two-fold greater than in the ovariectomized rabbits (Group II) (p less than 0.05). Similar increases were observed in the mean weights of the bladder base/urethral segments in the three treatment groups. The mean total DNA content in Group III was also significantly greater than Group I (p less than 0.01) and Group II (p less than 0.05) for both the bladder body and bladder base/urethral segment. The MChR density in the three treatment groups was determined using radioligand receptor binding using [3H]N-methylscopolamine ([3H]NMS). The MChR density in the bladder body (1.72 fmol./gm. DNA) for Group III was significantly decreased compared to the receptor density in both Group I (3.17 fmol./gm. DNA) and Group II (3.14 fmol./gm. DNA) (p less than 0.05). The binding of [3H] NMS to the MChR in bladder body was of high affinity (Kd = 0.07 0.15 nM) and was unaltered by hormonal treatment. No difference was found in the MChR density in the bladder base/urethral segment in any of the three treatment groups. In this study, we have shown that estrogens increase the weight and modulate the MChR density of the female rabbit bladder body. The ability to modulate neurotransmitter receptor density by sex steroid hormones may have important clinical implications. PMID- 3959236 TI - Comparative effects of four prostaglandin synthesis inhibitors on the obstructed kidney in the dog. AB - Comparative effects of four prostaglandin synthesis inhibitors (PGSI) on the acutely obstructed kidney were studied using an intact canine model. Trigonal vesicostomies were constructed and totally implanted nephrostomy tubes were placed to monitor renal pelvic pressures. After recovery, experiments were run at weekly intervals with one drug administered each week in a random fashion. Complete ureteral obstruction was obtained using a Fogarty balloon catheter passed retrogradely into the distal ureter and inflated. When renal pelvic pressure reached 80 cm./H2O the designated PGSI was given and a repeat dose was given 30 minutes later. Mean blood pressure was also monitored during several experiments. With the first dose significant decreases in renal pelvic pressure were obtained with all drugs tested. Only ibuprofen showed a significant further decrease with the second dose. Ibuprofen showed the greatest decrease in pressure with the first dose, which was significantly greater than the other drugs tested. There was no association between mean blood pressure changes and the nadir of renal pelvic pressure. PMID- 3959237 TI - Proliferation, esterase activity, and propidium iodide exclusion in urologic tumor cells after in vitro exposure to chemotherapeutic agents. AB - After exposing urological tumor cells to anticancer agents in vitro, cellular esterase activity and the ability to exclude propidium iodide (PI) were examined as dual indicators of functionality or "viability." High esterase activity/PI exclusion was observed in assays in which anticancer agents failed to inhibit cellular proliferation, while low esterase activity/PI exclusion was often observed when proliferation had been significantly inhibited. In a number of instances, exposure to anticancer agents did produce significant inhibition of proliferation without lowering viability. In this setting, the recovery of proliferative capacity could be demonstrated with several transitional cell carcinoma cell lines, and this recovery was always associated with high esterase activity/PI exclusion. When the proliferation of primary urological tumor preparations was inhibited by drug exposure, estimates of elevated viability were obtained in 27 per cent of the determinations. Thus, viability estimates may be an indicator of the potential for tumor-cell recovery from exposure to anticancer agents. Moreover, the potential for recovery may explain differences between the results of chemosensitivity testing and actual clinical events by reconciling clinical failures with elevated viabilities indicative of this potential. PMID- 3959238 TI - Methodology for endoscopic treatment of ureteral calculi. AB - The records of 27 patients undergoing endoscopic treatment of ureteral calculi were reviewed. The percutaneous nephrostomy approach was used for calculi located above the iliac vessels, while the transurethral approach was used for those below the iliac vessels. The success rates achieved for these calculi were 82.3 and 90.0 per cent, respectively. Endoscopic treatment has proved to be safe and effective in patients with ureteral stones. PMID- 3959239 TI - Iatrogenic ureteral injury. AB - We treated 27 patients with iatrogenic ureteral injuries during a 6-year period. Gynecological operations were the most common antecedent surgical procedures (52 per cent). The diagnosis of ureteral injury was made immediately in 4 patients and was delayed 1 to 34 days in 23. Three of the 4 injuries recognized during an operation were repaired successfully at the time of injury; the primary repair in the remaining patient leaked and ultimately resulted in a nephrectomy. In the delayed diagnosis group retrograde ureteral catheterization was successful in only 1 of 20 attempts. Of the 23 patients with injuries recognized in the postoperative period 11 were managed successfully with percutaneous nephrostomy (with or without stenting) alone, 3 required surgical repair after temporary percutaneous nephrostomy drainage, 4 were treated surgically without prior nephrostomy drainage and 1 had spontaneous resolution of hydronephrosis. The remaining 3 patients required nephrectomy: 1 because of a urinary fistula in a previously irradiated field, 1 because of a concomitant (ipsilateral) renal cell carcinoma and 1 because of renal hypertension. Percutaneous nephrostomy or ureteral stenting was successful as primary therapy in 73 per cent of the patients in whom it was used. PMID- 3959240 TI - Histological parameters and pitfalls in the interpretation of bladder biopsies in bacillus Calmette-Guerin treatment of superficial bladder cancer. AB - We report the morphological effects of intravesical bacillus Calmette-Guerin therapy on early post-treatment biopsies of the bladder in 39 patients with superficial transitional cell carcinoma (stage Ta, T1 or Tis) of the bladder. Although submucosal granulomatous inflammation in bladder biopsies of patients receiving intravesical bacillus Calmette-Guerin treatment has been described previously, a complete morphological description of the early effects of bacillus Calmette-Guerin on all bladder layers and the prostatic urethra has not been reported. In the majority of cases the superficial epithelium was eroded and the edematous submucosa contained noncaseating granulomas with a surrounding lymphoplasmocytic and eosinophilic infiltrate. Langhans' giant cells occasionally were found, and acid-fast bacilli were demonstrated only rarely by special stains in the 6-week post-treatment biopsy. In some cases the prostatic urethra and muscle bundles contained noncaseating granulomas. Features distinguishing epithelial atypia resulting from bacillus Calmette-Guerin treatment and superficial cancer include the presence of epithelial maturation, preserved nuclear/cytoplasmic ratio, smooth nuclear contours and lack of nuclear pleomorphism, nucleoli or cytomegaly. PMID- 3959241 TI - Superficial bladder tumors (stage pTa, grades 1 and 2): the importance of recurrence pattern following initial resection. AB - We treated 414 new patients with stage pTa, grades 1 and 2 bladder tumors by transurethral resection between 1970 and 1982. All of the patients with grade 3 or previous upper tract tumors, or who had been treated at some stage with intravesical chemotherapy were excluded. Followup for 5 or more years was available in 188 of the patients. There was a low increase in T stage (6 per cent). Of the patients followed for 5 or more years 46 per cent remained free of tumor. Only 16 per cent of the patients had multiple tumors at presentation and 20 per cent had tumors of 10 gm. or more. These factors were associated with a worse prognosis. Patients free of tumor at 3 months had an 80 per cent chance of having no further recurrences and this rate remained the same up to 2 years from the start of the disease. Patients with a recurrence at 3 months were much less likely to remain free of tumor, and had a higher chance of recurrence at every future visit. PMID- 3959243 TI - Venous incompetence: critical study of the organic basis of high maintenance flow rates during artificial erection test. AB - We tested whether the necessity for high flow rates of saline to maintain an artificial erection actually corresponds to an organic abnormality able to induce impotence as claimed recently. A total of 56 patients with presumed vascular impotence and 13 with typical psychogenic impotence underwent dynamic cavernosography followed by the artificial erection test. The former 56 patients also underwent bilateral selective internal iliac arteriography. A severely elevated maintenance flow rate (more than 120 ml. per minute) was found in 19 of the 56 patients with vascular and none of the 13 with psychogenic impotence, while a moderately elevated maintenance flow rate (80 to 120 ml. per minute) was found in 11 and 3, respectively. In most cases a severely elevated maintenance flow rate was associated with arterial (16 patients) or neurological abnormalities able to disturb erection. However, a severely elevated maintenance flow rate seemed to correspond to an organic abnormality able to induce impotence or to worsen erectile failure induced by other organic factors. Indeed, we found no severely elevated maintenance flow rates among our 13 patients with psychogenic impotence and the nocturnal penile tumescence test was normal in only 1 of 12 tested patients, although 7 had no other organic impairment sufficient to induce impotence (only moderate arterial stenoses in 4). In addition, sexual treatment succeeded in only 1 of the 13 patients, while our success rate is 43 per cent among patients with arterial impotence exclusively and this treatment succeeded in 6 of 10 patients with a moderately elevated maintenance flow rate. On the contrary, a moderately elevated maintenance flow rate does not seem to correspond to a genuine organic abnormality able to induce impotence. Indeed, we found it in 3 of 13 patients with psychogenic impotence, and every patient with a moderately elevated maintenance flow rate and normal arteries had a normal nocturnal penile tumescence test or was cured by sexual therapy. In conclusion, a maintenance flow rate exceeding 120 ml. per minute seems to reveal a genuine venous incompetence but in most cases this abnormality is only the cofactor of an arterial obstruction. PMID- 3959242 TI - Diagnostic tests for impotence: a comparison of papaverine injection with the penile-brachial index and nocturnal penile tumescence monitoring. AB - The diagnostic usefulness of nocturnal penile tumescence monitoring, penile brachial index and intracorporeal injection of papaverine (60 mg. in 20 ml. normal saline) was compared in 43 impotent men. Intracorporeal pressure was measured with a pressure transducer. Based on turgidity, and the time of onset and duration of erection, we classified the impotence as psychogenic/neurogenic (normal vascular competence), mild or severe arteriogenic, or venogenic. The intracorporeal injection of papaverine was useful as a functional diagnostic test for impotence. The penile-brachial index, an indirect measurement of the flaccid penis, did not correlate well with the results of the papaverine test. A poor response to papaverine injection documents organic impotence and, under these circumstances, nocturnal penile tumescence monitoring is not necessary. We conclude that the intracorporeal injection of papaverine currently is the best screening technique for the differential diagnosis of vasculogenic impotence. PMID- 3959244 TI - Experience with the AMS 600 malleable penile prosthesis. AB - A malleable penile prosthesis incorporating a stainless steel core has been designed to provide a more rigid prosthesis while still ensuring concealability. A total of 56 patients in our initial series underwent implantation of this malleable penile prosthesis. Our experience indicates that this prosthesis provides ease of implantation, outstanding cosmetic results, and a much simplified and reduced inventory. PMID- 3959246 TI - Chronic scrotal hypothermia: results in 90 infertile couples. AB - We studied the use of a testicular hypothermia device worn daily for at least 16 weeks in 64 men with subfertile semen and elevated testicular temperature, who had had an infertile marriage for 2 or more years in which the wife was judged fertile. Improvement in 1 or more semen parameters was seen in 42 patients (65.6 per cent). Semen analysis was converted into the motile oval index, a numerical value representing the count, motility and normal morphology. The motile oval index helps to predict pregnancy outcome. Of 21 patients with pre-treatment motile oval indexes greater than 4.8 million per ml. 11 (52.4 per cent) produced pregnancy. Patients with lower starting indexes did not fare as well. Of 20 patients who met the criteria, and who wore the device for less than 2 weeks or not at all and had no other treatment 1 (5.0 per cent) produced pregnancy. Mean hypothermia time to date of missed menses was 4.2 months. Six patients with nonobstructive azoospermia showed no semen change with the testicular hypothermia device. PMID- 3959245 TI - The management of erectile deformity in adults with exstrophy and epispadias. AB - The management of 20 patients with erectile deformities owing to exstrophy and epispadias is described. The type of deformity was defined by cavernosography and intraoperative artificial erections. Of the 20 patients 15 had dorsal chordee, 2 had lateral deviation (1 also had dorsal chordee) and 3 had bilateral rudimentary corpora producing small and inadequate erections. The latter 3 patients were considered inoperable. Of the 15 patients with dorsal chordee 12 were treated by insertion of lyophilized human dura in the concave side of the corpora. The results were good after 1 attempt in 8 and after 2 attempts in 1, while 1 had recurrent chordee distal to the first site and further dural phalloplasty was successful, 1 was improved and 1 was a failure. Of the remaining 3 patients in this group 2 underwent excision of scar tissue (1 also had a ventral Nesbit procedure) and the condition was not bad enough to require an operation in 1. Of the 2 patients with lateral deviation 1 was treated by division of a rudimentary corpus and dural phalloplasty of the normal corpus, which produced a straight but rather unstable erection, and 1 underwent bilateral dural phalloplasty with a good result. PMID- 3959247 TI - Operative recovery of vasal sperm from anejaculatory men: preliminary report. AB - Sperm showing good motility and function, as demonstrated by the in vitro sperm penetration assay using hamster ova, were collected from the vas deferens of 3 men with ejaculatory failure. The collection procedure may be repeated over multiple ovulatory cycles. The sperm may be used to attempt artificial insemination or in vitro fertilization. PMID- 3959248 TI - Fine needle aspiration biopsy of the prostate gland: a study of 103 cases with histological followup. AB - Fine needle aspiration specimens of the prostate gland were compared to histological material in 103 patients. The sensitivity was 95 per cent, specificity 97 per cent and efficiency 87 per cent. Initial core needle biopsy compared to the final histological diagnosis in this study had a sensitivity of 76 per cent, specificity 100 per cent and efficiency 71 per cent. Fine needle aspiration by a well trained cytopathologist is less traumatic, and has fewer side effects and a higher sensitivity rate than conventional core needle biopsy. PMID- 3959249 TI - Oxybutynin versus propantheline in patients with multiple sclerosis and detrusor hyperreflexia. AB - Hyperreflexia is the most common urological finding in patients with multiple sclerosis. A prospective randomized study was done to compare the effectiveness of 2 commonly used drugs, oxybutynin and propantheline. Of the 34 patients entered into the trial 19 were treated with oxybutynin and 15 with propantheline. The urological symptoms (frequency, nocturia, hesitancy, urgency and urge incontinence) were graded according to severity from 0 to 3. Patients with urinary infection were excluded. Urodynamic examination, consisting of cystometrography and electromyography, was performed in all patients before treatment. Both groups of patients had comparable neurological, urological and urodynamic status before treatment. In 4 patients (21 per cent) treated with oxybutynin and in 4 (27 per cent) treated with propantheline side effects were so severe that the treatment had to be discontinued. Symptomatic response to oxybutynin was good in 10 patients (67 per cent), fair in 2 (13 per cent) and poor in 3 (20 per cent). Propantheline produced good symptomatic results in 4 patients (36 per cent), fair in 1 (9 per cent) and poor in 6 (55 per cent). The mean increase in maximum cystometric capacity on cystometrography was significantly larger in the oxybutynin group than in the propantheline group (144 +/- 115 versus 35 +/- 101). Our results indicate that oxybutynin is more effective than propantheline in the treatment of detrusor hyperreflexia in patients with multiple sclerosis. PMID- 3959250 TI - Augmentation cystoplasty in the management of neurogenic bladder disease and urinary incontinence. AB - Vesical augmentation procedures were performed on 15 patients for neurogenic bladder disease and urinary incontinence. Enterocystoplasty with ileum, cecum and sigmoid was used associated with different operations to prevent upper tract deterioration or urinary incontinence. The small bowel stored larger amounts of urine at a lower maximal detrusor pressure at capacity than the large bowel. All ureterointestinal and ureterovesical reimplantations were successful, including 5 ureteroileal with the Camey procedure. The 2 failures, characterized by persistent urinary incontinence, included a male patient who refused intermittent catheterization and a girl with persistent hypersecretion of mucus and recurrent urinary tract infections. PMID- 3959251 TI - Unsuspected proximal urethral obstruction in young and middle-aged men. AB - Proximal urethral obstruction, a common cause of prostatism in young and middle aged men, often is misdiagnosed as prostatitis, neurogenic bladder or a psychogenic voiding disorder. Simple urodynamic studies (uroflowmetry and cystometry) do not distinguish a poor flow owing to bladder neck obstruction from that caused by poor detrusor contractility in these patients. Only the simultaneous measurement of detrusor pressure and uroflowmetry can make this distinction. A total of 23 patients with unsuspected proximal urethral obstruction underwent synchronous video-pressure-flow electromyography studies, and were treated and followed for a minimum of 1 year. Treatment by transurethral prostatic resection or bladder neck incision almost always was curative but alpha adrenoceptor blocking agents have not been effective. All patients who underwent transurethral prostatic resection or bladder neck incision at the 5 and 7 o'clock positions have had retrograde ejaculation but both patients who underwent unilateral bladder neck incision reported antegrade ejaculation. PMID- 3959252 TI - Dissolution of staghorn calculus associated with amiloride-hydrochlorothiazide, sulfamethoxazole and trimethoprim, and ascorbic acid. AB - We report a case of a large staghorn calculus of the right kidney that was treated with sulfamethoxazole and trimethoprim, and amiloride hydrochlorothiazide. The patient, who had refused any surgical intervention, also elected to take ascorbic acid. Without any other treatment x-rays revealed dissolution of the staghorn calculus 8 weeks later. PMID- 3959253 TI - Rapidly recurrent renal calculi caused by Ureaplasma urealyticum: a case report. AB - We report on a patient operated upon 8 times for recurrent bilateral struvite stones. Multiple conventional bacterial cultures had been negative. No etiological agent for the rapidly recurring concrements could be detected until Ureaplasma urealyticum cultures were performed at the time of the seventh operation. Ureaplasma urealyticum was found in the bladder and renal pelvic urine, and in the stones. That operation was followed by appropriate antibiotic treatment (doxycycline), which eradicated the microorganism and no stones recurred for 6 months. The urinary pH, which constantly had been highly alkaline before treatment, was normal as was the ammonium loading test. However, 1 year after the seventh operation the Ureaplasma infection recurred, probably due to sexual transmittance, and a new renal stone was discovered. These findings strongly suggest that Ureaplasma urealyticum can induce the formation of infection concrements. PMID- 3959255 TI - Massive pulmonary embolism--catastrophe or blessing? PMID- 3959254 TI - Isolated dissecting aneurysm of the renal artery. AB - A 40-year-old man with a history of renal stone formation was evaluated for left flank pain. An excretory urogram failed to show any renal calculi. However, renal arteriography and computerized tomography studies demonstrated a primary dissection of the left renal artery with resulting decreased perfusion to the lower pole of the left kidney. PMID- 3959256 TI - Thoracoabdominal aortic aneurysm: observations regarding the natural course of the disease. AB - Thoracoabdominal operation was not performed in 94 patients with thoracoabdominal aortic aneurysms during a 25-year period because of refusal by patients (eight patients), associated disease or age (64 patients), small size of aneurysm (five patients), and staging of operations in which another operation was performed instead of aneurysm resection (17 patients). The cause of aneurysm was chronic dissection in 23 patients and nondissection in 71. Most of the patients entered the study during the past 5 years and follow-up information is complete for all of them. Twenty-four percent of the patients were alive at 2 years, calculated by the Kaplan-Meier method, and half of the deaths were due to aneurysm rupture. In contrast, among our 604 patients treated surgically, 70% were alive at 2 years and 59% at 5 years. This study suggests that the natural course of the disease is favorably altered by surgical treatment. PMID- 3959258 TI - Contralateral neurologic symptoms after carotid surgery: a nine-year follow-up. AB - A study was undertaken to observe the long-term clinical behavior of the contralateral, asymptomatic carotid artery of patients after unilateral carotid endarterectomy (UCE). A consecutive series of 182 patients undergoing UCE were followed up for 1 to 9 years (mean 4.2 years). The operated artery was symptomatic in 169 cases (92.8%) whereas in 13 (7.2%) it was asymptomatic but stenotic. Follow-up included an accounting of all hemispheric or focal neurologic events in the territory of the nonoperated artery, as well as associated cardiovascular risk factors. A total of 11 patients (6%) suffered stroke (CVA) and six (3.3%) had transient ischemic attacks (TIAs) in the distribution of the nonoperated carotid artery. By life-table analysis, major neurologic symptoms developed in 11.6% of patients within 5 years. Hypertension was an important prognostic factor: significantly more hypertensive patients had late contralateral neurologic symptoms (p less than 0.05, chi square). The cumulative incidence of CVA and TIA in these patients was 17.3% by life-table analysis at 5 years vs. 9.1% for normotensive patients. Since only a small proportion of the patients studied had a high-grade stenosis of the nonoperated artery, no conclusions could be made regarding its prognostic importance. The relevant published studies are discussed and compared with this report. Guidelines for the management and follow-up of the patient after UCE are discussed. PMID- 3959257 TI - Composition and metabolism of symptomatic distal aortic plaque. AB - This study examines the composition of advanced human atherosclerotic lesions removed by endarterectomy and compares the collagen synthesis in the lesion with that of the intima-media layer of uninvolved vessel wall. The most striking feature of the lesions is an enormous accumulation of calcium that was raised more than tenfold, from a level of about 3% of dry tissue weight in the normal tissue to values approaching 50% in the pathologic specimens. The composition of the organic matrix was also altered. Elastin and glycosaminoglycan content decreased, whereas collagen content more than doubled, thus becoming the major component of the organic matrix. The cholesterol content increased severalfold above normal but even then accounted for less than 10% of the organic matrix. The lesion specimens synthesized collagen in vitro at a greater rate than normal tissue. The endarterectomy specimens with the highest calcium content exhibited the highest rate of collagen synthesis. PMID- 3959259 TI - Is percutaneous insertion of the intra-aortic balloon pump through the femoral artery the safest technique? AB - Between Jan. 1, 1979, and Sept. 30, 1983, 423 intra-aortic balloon pumps (IABPs) were successfully inserted into 400 patients; IABPs could not be inserted in 36 patients (success rate 91.7%). Before 1980 all balloons were inserted surgically through a graft and by 1983 virtually all IABPs were inserted by percutaneous techniques. Infectious complications occurred in 12.3% of IABPs inserted by the open technique and 1.5% of IABPs inserted percutaneously (p less than 0.001). Major ischemic complications were not significantly different between the two groups when all of the patients were analyzed together (p greater than 0.5) and when only the surviving patients were analyzed (p greater than 0.75). However, ischemic complications occurred in 32.9% of women in the study and only 19.7% of the men (p less than 0.005). The percutaneous insertion of the IABP is recommended as the technique of choice because of the ease of insertion, lack of infectious complications, and similar rate of major ischemic complications when compared with IABPs inserted by open surgical means through a graft anastomosed to the common femoral artery. PMID- 3959260 TI - Noninvasive blood flow measurement in expanded polytetrafluoroethylene grafts for hemodialysis access. AB - Volume flow rates were measured in 31 expanded polytetrafluoroethylene grafts (6 mm) of 26 patients undergoing hemodialysis. Flow was calculated from the known access graft diameter and by measurement of the mean Doppler shift frequency waveform. Overall flow rates were 750 +/- 383 ml/min (range, 0 to 1921 ml/min). There was no difference in flow between grafts anastomosed to either antecubital or upper arm veins but there was a significant difference in flow rate between straight and loop grafts (652 and 914 ml/min) and between grafts anastomosed to the radial, distal brachial, and proximal brachial arteries (648, 876, and 1169 ml/min, respectively). Flow rates measured during a preocclusive 14-day period in five grafts were significantly lower than flow rates in grafts that remained patent for at least 2 weeks following examination (307 +/- 172 vs. 849 +/- 346 ml/min). This is a safe, repeatable noninvasive measure of access graft hemodynamics, which may be useful as a functional monitor and a warning of impending failure. PMID- 3959261 TI - Surgical correction of abdominal aortic coarctation and hypertension. AB - Coarctations of the abdominal aorta are often associated with renal artery stenosis resulting in hypertension, which is commonly the presenting symptom. Controversy exists concerning the origin of these lesions, but there is general agreement that surgical intervention is the treatment of choice. We report four patients with abdominal aortic coarctation and concomitant renal artery stenosis who required aortoaortic bypass and appropriate bypass to the renal vessels. We advise total correction in one stage and proximal renal artery bypass from native aorta or iliac artery when it is technically feasible. PMID- 3959262 TI - Successful management of Histoplasma capsulatum infection of an abdominal aortic aneurysm. AB - A 65-year-old woman with disseminated histoplasmosis underwent resection of an atherosclerotic abdominal aortic aneurysm. Yeast forms of Histoplasma capsulatum were present in the aneurysm. Surgical resection and revascularization with a Dacron graft followed by systemic amphotericin B therapy and chronic ketoconazole suppressive therapy have resulted in a patient without symptoms 15 months postoperatively. It is important to be aware of the potential for artherosclerotic aortic aneurysm involvement by H. capsulatum. PMID- 3959263 TI - Leiomyosarcoma of the inferior vena cava. Case report and review of the literature. AB - Leiomyosarcoma of the inferior vena cava is reported with increasing frequency but remains a rare lesion. In this article we report one case and review 69 cases. The disease affects mainly women approximately 50 years of age. The symptoms vary according to the location of the tumor; Budd-Chiari syndrome and leg edema occur in the more centrally located tumors and abdominal pain and swelling are seen in the more peripherally located ones. In 40% of the cases distant metastases are evident at the time of the patients' first presentation and are found most commonly in the liver and/or lungs. After resection the majority of the patients eventually die of metastatic disease with a mean survival of approximately 40 months. PMID- 3959264 TI - Clinicopathologic correlation in postendarterectomy recurrent stenosis. A case report and bibliographic review. AB - The case history of a 60-year-old man with symptomatic recurrent stenosis of the left carotid artery 20 years after carotid endarterectomy is presented. At reoperation (repeat endarterectomy and venous patch angioplasty) the lumen was found to be reduced by 60% and histopathologic study revealed atheromatosis with organizing mural thrombus. The case is discussed in the context of the recent literature concerning restenosis, the reported frequency of which varies depending on the size of the population studied and the method of follow-up, with noninvasive studies revealing that restenosis is more commonly asymptomatic than symptomatic. Early simple fibrous restenosis differs histologically from the more complex, frankly atherosclerotic late restenosis and appears to reproduce the original pathologic condition of the carotid bifurcation; as in the original lesions hemodynamic conditions probably play a major etiologic role in the formation of the restenoses. The most important clinical factor in restenosis is continued cigarette smoking. In the majority of the studies reviewed, more than half of the patients with recurrent disease presented with symptoms referable to the site of the original operation. An argument in favor of routine vein patching during the primary procedure to attempt to prevent restenosis is presented. PMID- 3959265 TI - Ulnar artery aneurysm complicated by distal embolization: management with regional thrombolysis and resection. AB - We report the first use of preoperative regional thrombolysis followed by resection and primary anastomosis performed for distal embolization that complicated ulnar artery aneurysm. This treatment scheme may be applicable to other situations in which distal emboli complicate the management of arterial lesions. PMID- 3959266 TI - Aortobifemoral bypass with autogenous saphenous vein in treatment of paninfected aortic bifurcation graft. AB - An alternative method is presented in which aortobifemoral bypass with autogenous great saphenous vein is implanted after excision of previously inserted synthetic aortobifemoral grafts because of prosthetic "paninfection." The procedure was followed in five patients; one death occurred and the remaining four patients recovered completely from graft infection. Only in one case did saphenous vein thrombosis occur. These results are encouraging considering the high mortality rates following the previously available methods of management. PMID- 3959267 TI - Optimal proximal anastomosis/tunnel for axillofemoral grafts. AB - The proximal anastomosis of the axillofemoral graft may be optimally placed with standard "cobra-head" technique at an oblique angle to the axillary artery if a subpectoralis minor course of the graft into the anterior-inferior axilla is used. Theoretical advantages of such an anastomosis include improved flow characteristics, decreased tendency to pseudoaneurysm formation, and a decreased tendency to axillary artery thrombosis or brachial artery embolus. PMID- 3959268 TI - Medial approach to the anterior tibial artery. PMID- 3959270 TI - "Coral reef" atherosclerosis of the suprarenal aorta. PMID- 3959269 TI - The fate of human umbilical vein grafts as an infrarenal aortic substitute in monkeys. PMID- 3959271 TI - Routine coronary angiography in patients undergoing surgery for abdominal aortic aneurysm and lower extremity occlusive disease. AB - Between 1978 and 1982, 1000 patients under consideration for peripheral vascular reconstruction underwent coronary angiography. Normal coronary arteries were found in 8%; mild to moderate coronary artery disease (CAD), in 32%; advanced but compensated CAD, in 29%; severe correctable CAD, in 25%; and inoperable CAD, in 6%. Severe correctable CAD was demonstrated in 14% of patients who had no indications of CAD on clinical criteria. Patients with severe correctable CAD were advised to undergo myocardial revascularization before the vascular operation. Under this protocol, a total of 1292 cardiac and peripheral vascular reconstructions were performed with an overall mortality rate of 2.6% (5.2% for myocardial revascularization and 2% for vascular operation). Only one death (0.8%) occurred after peripheral vascular reconstruction in 130 patients who had preliminary myocardial revascularization. These results indicate that approximately 30% of all patients who require vascular reconstruction have severe, but surgically correctable, CAD and that preliminary myocardial revascularization appears to add a margin of safety to the subsequent vascular operation. PMID- 3959272 TI - Combined carotid and coronary disease--a conservative strategy. AB - The optimal approach to patients undergoing coronary bypass surgery for coronary artery disease with coexisting carotid disease is controversial. To determine the best approach to these patients, we screened carotid arteries in patients undergoing coronary artery bypass preoperatively with noninvasive ultrasonic duplex scanning. No correlation was noted between stroke and asymptomatic carotid disease in patients undergoing coronary revascularization. Prospective application of this finding in 2251 patients has yielded a very low incidence of perioperative stroke. We concluded that asymptomatic carotid arterial disease is not a significant risk to patients undergoing cardiopulmonary bypass and should be managed conservatively. PMID- 3959273 TI - Surgical management of synchronous carotid and coronary artery disease. AB - To determine the safest method of treating simultaneously occurring coronary artery disease and asymptomatic carotid stenosis, patients were randomly assigned to either combined operation or a staged procedure with coronary artery surgery done first, followed by carotid endarterectomy. In the initial 70 patients, there were two strokes (5.9%) and two deaths (5.9%) in the combined group and four strokes (11%) and one death (2.8%) in the group with coronary artery surgery performed first. PMID- 3959274 TI - Conditioned skeletal muscle: new assist for failing heart? PMID- 3959275 TI - Leads from the MMWR. Premature mortality due to sudden infant death syndrome. PMID- 3959276 TI - Follow-up of patients with esophageal angina. PMID- 3959277 TI - The removal of central venous silicone rubber catheters. PMID- 3959279 TI - Young academic physicians and publication. PMID- 3959278 TI - Consensus on electroconvulsive therapy. PMID- 3959281 TI - Bone disease in end-stage renal failure. PMID- 3959280 TI - Sarcoidosis. PMID- 3959282 TI - Glucagon for propranolol overdose. PMID- 3959283 TI - American Indian medicine: paternalism and pluralism. PMID- 3959284 TI - Ewing vs Michigan. PMID- 3959285 TI - Spontaneous movements in brain-dead patients. PMID- 3959286 TI - Health effects of long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. AB - In 1971, sludge wastes contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin were mixed with waste oil and sprayed on a dirt road at the Quail Run Mobile Home Park in Gray Summit, Mo. We performed a comprehensive examination of 154 exposed and 155 unexposed persons in the area. There were no consistent differences between the two groups on medical history, physical examination, serum and urinary chemistry studies, and neurologic tests. Results of liver function tests suggested possible subclinical effects. The exposed group had an increased frequency of anergy (11.8% vs 1.1%) and relative anergy (35.3% vs 11.8%). The exposed group also had non-statistically significant increased frequencies of abnormal T-cell subset test results (10.4% vs 6.8%), a T4/T8 ratio of less than 1.0 (8.1% vs 6.4%), and an abnormality in the functional T-cell test results (12.6% vs 8.5%). These findings suggest that long-term exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin is associated with depressed cell-mediated immunity, although the effects have not resulted in an excess of clinical illness in the exposed group. Further studies are indicated to elucidate the pathophysiology and clinical significance of these immunologic findings. PMID- 3959287 TI - Pulmonary embolism as a cause of death. The changing mortality in hospitalized patients. AB - We studied the frequency and characteristics of death due to pulmonary embolism among all hospital and surgical patients in a university hospital from 1966 through 1980. Of 6,858 deaths, 3,412 autopsies were performed using a standardized and sensitive technique for pulmonary dissection. Our study showed that 6% of deceased patients (4.7% of surgical patients) had massive fatal embolism. Significant declines in embolism mortality were noted during this time period for hospital and surgical patients. The percentage of embolism cases among autopsies fell from 9.3% in the first five years to 3.8% in the last five years. Excluding patients receiving anticoagulants at the time of death, these percentages fell from 8.8% to 2.7%. The estimated hospital mortality rate for embolism fell during the same years from 0.37% of hospital discharges to 0.13%. During the years studied, the use of anticoagulants among all adult patients at the hospital increased from 4% of patients to nearly 12.3%. This and other evidence suggest the possibility that both the incidence rate and the case fatality rate for pulmonary embolism have decreased in the hospital population we studied. PMID- 3959288 TI - Alcohol abuse, other drug abuse, and mental disorders in medical practice. Prevalence, costs, recognition, and treatment. AB - Millions of Americans suffer and die of alcohol abuse, other drug abuse, and mental disorders that go undiagnosed and untreated. Studies showing that up to 19% of the US adult population have these disorders also have found that only one fifth of those affected have sought help for them in the previous six months. Many of these persons have disorders that are treatable with modern medications and therapy. Because more than half of all persons with these disorders obtain all of their care from the general medical sector, a great potential exists in primary care for prevention, detection, treatment, and referral of these patients. Primary care physicians, however, have not been very successful at diagnosing and treating substance abuse and mental disorders because of inadequate training, patients' attitudes, and the constraints of the health care system. Recommendations to improve this situation include continued research, improved physician education, and increased emphasis on care of these disorders by organized medicine. Although tobacco use is also a major health problem, data relating to nicotine addiction were not included in this report. PMID- 3959289 TI - The occurrence of chlamydial and gonococcal salpingitis during the menstrual cycle. AB - We evaluated 104 women hospitalized with a diagnosis of acute salpingitis to compare the relationship between the menstrual cycle and onset of acute chlamydial and/or gonococcal salpingitis and acute salpingitis associated with other facultative aerobic and anaerobic bacteria. Neisseria gonorrhoeae was recovered from 42 women (40%), Chlamydia trachomatis from 28 (27%), and nongonococcal, nonchlamydial organisms only from the upper genital tract in 48 (46%). Among 37 cases with symptoms of acute salpingitis within seven days of onset of menses, 30 (81%) had chlamydial and/or gonococcal infection. Of 35 cases with onset after 14 days postmenses, 23 (66%) had nongonococcal, nonchlamydial organisms only. Of the 28 women with chlamydial infection, 17 (57%) had the onset of disease within one week from the first day of their last menstrual period. Similarly, 23 (55%) of gonococcal infections had onset of symptoms within one week from onset of menses. However, only seven (14%) of the women with nongonococcal, nonchlamydial salpingitis reported onset of symptoms within one week. The temporal pattern of onset of chlamydial or gonococcal acute salpingitis showed significant differences when compared with the time of onset for nongonococcal, nonchlamydial acute salpingitis. PMID- 3959291 TI - Case reports in the medical literature. PMID- 3959290 TI - Electrocardiographic changes suggestive of cardiac ischemia in a patient with esophageal food impaction. 'A case that's hard to swallow'. PMID- 3959292 TI - The electrocardiogram in esophageal impaction. PMID- 3959293 TI - Leads from the MMWR. Years of potential life lost attributable to low birthweight -United States, 1980 birth cohort. PMID- 3959294 TI - Leads from the MMWR. Leading work-related diseases and injuries--United States. PMID- 3959295 TI - Electric- and lightning-induced cardiac arrest reversed by cardiopulmonary resuscitation. PMID- 3959296 TI - Accidents and all-terrain vehicles. PMID- 3959297 TI - Public funds and the injured motorcyclist. PMID- 3959298 TI - Densitometry of the peripheral skeleton to detect osteopenia. PMID- 3959299 TI - Compulsiveness in physicians. PMID- 3959300 TI - Pen pusher's paresthesia. PMID- 3959301 TI - Impact of a rural high blood pressure control program on hypertension control and cardiovascular disease mortality. AB - Kentucky is a predominantly rural state with relatively high death rates from hypertension and cardiovascular disease. We report the results of a community based high blood pressure control educational program undertaken in two rural counties of southeastern Kentucky. In the intervention counties, systolic and diastolic blood pressures of both men and women decreased despite the five-year increase in age; moreover, hypertension was better controlled after the program, and substantial decreases in deaths due to cardiovascular disease were seen. These differences were greater among men in the two regions than among women. The results of this program suggest that, in sparsely populated rural areas, existing resources and programs can be successfully utilized in a communitywide cardiovascular disease risk reduction educational program. PMID- 3959302 TI - Mass intervention vs screening and selective intervention for the prevention of coronary heart disease. PMID- 3959304 TI - The Archives of Surgery, New England Surgical Society, and JAMA. PMID- 3959305 TI - Keep murine typhus in mind. PMID- 3959303 TI - Diagnosis of the partial androgen insensitivity syndrome during infancy. PMID- 3959306 TI - Exfoliated cytopathology of Acanthamoeba keratitis. PMID- 3959307 TI - Using tools of epidemiology, physicians monitor medical care. PMID- 3959308 TI - Radiologist devises figures to monitor twin fetuses. PMID- 3959309 TI - Leads from the MMWR. Mumps--United States, 1984-1985. PMID- 3959310 TI - Leads from the MMWR. Rubella and congenital rubella syndrome--United States, 1984 1985. PMID- 3959311 TI - Don't recap needles, even on television. PMID- 3959312 TI - Failure of spiramycin to prevent neurotoxoplasmosis in immunosuppressed patients. PMID- 3959313 TI - Neuroleptic malignant syndrome. PMID- 3959314 TI - The late appearance of postpartum eclampsia. PMID- 3959315 TI - But not alone: the grief of infertility. PMID- 3959316 TI - Swine flu vaccine and amyotrophic lateral sclerosis. PMID- 3959317 TI - The prevalence and causes of colonic cancer. PMID- 3959318 TI - Adjuvant chemotherapy for breast cancer. PMID- 3959319 TI - The impact of the acquired immunodeficiency syndrome on patterns of premature death in New York City. AB - This report examines the impact of acquired immunodeficiency syndrome (AIDS) on patterns of mortality among persons aged 15 to 64 years in New York City. The New York City AIDS surveillance registry was matched to the New York City vital statistics registry to identify deaths caused by AIDS. In 1984, the AIDS mortality rate per 100,000 persons aged 15 to 64 years was 42.2 for males and 5.3 for females. Analyzed by five-year age groups, AIDS was among the five leading causes of death for males aged 25 to 54 years, and the leading cause of death for males aged 30 to 39 years. For females, AIDS was the fourth leading cause of death for women aged 25 to 29 years, and the second leading cause for women aged 30 to 34 years. Almost 10% of the years of potential life lost to males aged 15 to 64 years was due to AIDS, and for females, 3.6%. For both men and women in the highest-risk age group, 20 to 44 years, blacks and Hispanics had higher mortality rates than Asians or whites. The higher mortality in blacks and Hispanics is believed to be related to a higher prevalence of drug abuse in these populations and not to ethnicity per se. These findings document the enormous increases in premature mortality attributable to AIDS. PMID- 3959320 TI - Alcohol and hemorrhagic stroke. The Honolulu Heart Program. AB - Since 1965, the Honolulu Heart Program has followed up 8,006 men in a prospective study of cardiovascular disease. Of those subjects free of stroke at the time of study entry, 2,916 were classified as nondrinkers of alcohol and 4,962 as drinkers. In 12 years of follow-up, 197 drinkers and 93 nondrinkers experienced a stroke. No significant relationships were noted between alcohol and thromboembolic stroke. When compared with nondrinkers, however, the risk of hemorrhagic stroke more than doubled for light drinkers and nearly tripled for those considered to be heavy drinkers. These findings are statistically significant and independent of hypertensive status and other risk factors. Results further indicate that alcohol has a greater effect on hemorrhagic strokes that are subarachnoid in origin, conferring a threefold to fourfold increased risk for moderate and heavy drinkers compared with nondrinkers. PMID- 3959321 TI - Treatment of intractable rheumatoid arthritis with combined cyclophosphamide, azathioprine, and hydroxychloroquine. A follow-up study. AB - Cyclophosphamide, azathioprine, and hydroxychloroquine sulfate were prescribed for 31 patients (26 women and five men) with rheumatoid arthritis refractory to conventional therapy. Maintenance drug dosages (mean +/- SD) were as follows: cyclophosphamide, 30 +/- 24 mg/day; azathioprine, 74 +/- 44 mg/day; and hydroxychloroquine sulfate, 210 +/- 92 mg/day. Disease suppression began in 30 patients within three to 24 months (mean, nine months). Results after 43 months (range, 12 to 102 months) were as follows: 16, complete remission; seven, near remission; seven, partial disease suppression; one, no response. None remained in prolonged remission without some form of therapy. Treatment was discontinued in three patients because of pulmonary infection (two) or thrombocytopenia (one). Four patients had five malignant neoplasms (surgical cures) before therapy (two breast, one colon, one melanoma, one endometrial); four patients developed a malignant neoplasm during combined drug therapy (one colon, one endometrial, one lung, one erythroleukemia); and three died. The absolute risk of malignancy from combined drug therapy is still unclear. We concluded that combined use of remittive agents may have promise in treatment of severe rheumatoid arthritis; cyclophosphamide should be replaced with a nonalkylating agent; and the place of combined drug therapy remains uncertain in the absence of controlled trials. PMID- 3959322 TI - Now read this: the SI units are here. PMID- 3959323 TI - Lack of modulation of postoperative immunosuppression by isotonic amino acid infusion. AB - Effects of an isotonic amino acid solution on the immune defence systems of surgical patients were studied. Twenty-two patients admitted for major abdominal operations were randomly allocated into two groups. Eleven of them received 1 liter of 3% amino acid solution daily for 5 days postoperatively, while 11 control patients received balanced 5% glucose-containing electrolyte solutions. Immune variables were studied preoperatively and at 1, 3 to 4, and 6 to 7 days postoperatively. These studies included leukocyte and differential counts, T (OKT3+), B (sIg+), T helper/inducer (OKT4+) and suppressor/cytotoxic (OKT8+) cell determinations, measurement of in vitro lymphocytic responses to phytohemagglutinin (PHA), pokeweed mitogen (PWM) and Staphylococcus aureus Cowan I (StaCw) in cultures of separated lymphocytes, and to PHA, concanavalin A (Con A), and PWM in whole blood cultures. B lymphocyte functions were studied by measuring synthesis of immunoglobulins IgG, IgM, and IgA in the cell culture medium when lymphocytes were stimulated with PWM alone and in the presence of Con A or hydrocortisone. Postoperative amino acid infusion slightly improved the capacity of lymphocytes to synthetize and secrete IgG and IgM. By contrast, no improvement was seen in cell counts or lymphocyte transformation patterns. PMID- 3959324 TI - Nutritional assessment of pediatric patients admitted to an acute-care pediatric service utilizing anthropometric measurements. AB - Two hundred consecutive pediatric patients were given a nutritional assessment at the time of their admission to the hospital. A weight-for-height below the 5th percentile was an indication of acute depletion and a height-for-age below the 5th percentile a sign of chronic depletion. Measurement of weight-for-height and/or height-for-age was below the 5th percentile in 32% of those assessed. Seventy-five percent of the acutely depleted children and 60% of the acute and chronically depleted children had midarm circumferences below the 5th percentile. Midarm muscle circumference below the 5th percentile was significantly more prevalent in all the depleted children. This paper reports the results of our study of the objective (quantitative) elements of our nutritional assessment. These measurements indicate that a significant number of patients are at nutritional risk at the time they are admitted to the hospital. An adequate nutritional assessment cannot be limited to objective considerations, however. A complete medical evaluation of the patient is required, including objective and subjective considerations. PMID- 3959325 TI - Protective effect of vitamin E in rats with acute liver injury. AB - We have previously shown that supplemental vitamin E has a cytoprotective effect in the liver of rats with chronic CCL4-induced liver cirrhosis. In this study, we hypothesized that vitamin E would have a protective effect in acute liver injury induced by D-galactosamine. D-Galactosamine-induced injury has been thought to be due to a synergistic direct toxic effect and presence of intestinal bacteria and/or endotoxins. D-Galactosamine was used to induce acute "hepatitis" (1.5-2.0 g/Kg body weight, ip). Rats were placed on either standard chow or the same chow supplemented with vitamin E (300 mg DL-alpha-tocopherol/Kg diet) and 6 days later were given D-galactosamine. There was significantly improved early (5-day) survival and late (14-day) survival in the vitamin E-supplemented group. The vitamin E beneficial effect was manifested also by decreased liver fat and collagen content and decreased SGPT level. Because bacterial endotoxins have been implicated as playing a role in the pathogenesis of D-galactosamine hepatitis, the same experiment was carried out using germ-free and conventional rats. There was significantly improved survival in both the germ-free and conventional vitamin E-supplemented groups both at 5 and 14 days. There was no significant difference between conventional and germ-free rats with or without vitamin E supplementation. In summary (a) vitamin E improves the early fat and collagen accumulation in the liver, decreases SGPT level, and improves survival in the D galactosamine experimental model of acute liver injury in both conventional and germ-free rats; and (b) D-galactosamine toxicity is probably not mediated through intestinal bacteria and/or endotoxins. PMID- 3959326 TI - [Practical plate-thermography in the diagnosis of breast cancer]. AB - Described of diagnostic practices of Plate-thermography in breast diseases Described of Takahashi's classification of Plate-thermography referring to both benign and malignant clinical cases. Of 63 cases of breast cancer and 117 cases of benign diseases, the rate of correct diagnosis for cancer was 81% and those of benign disease was 80.1%. PMID- 3959327 TI - [Scintigraphy in breast cancer]. AB - At present, scintigraphic studies of bone, liver and lymph node have widely been in assessment of metastasis due to breast cancer. Bone scintigraphy is sensitive in the detection of bone metastasis. However, it has also a demerit of high false positive rate. In order to exclude this possibility, bone marrow scintigraphy using 99mTc-Re-colloid is used. Bone marrow scintigraphy is able to differentiate bone metastasis from benign bone lesion and to clarify the intra-medullary metastasis. Liver scintigraphy associated with emission CT gives better detectability of SOL due to liver metastasis. Radionuclide lymphography is used for the visualization of parasternal lymph nodes, and for the evaluation of lymph nodes metastasis. Labelled estrogen as receptor imaging has been tried to delineate breast cancer itself or metastatic focus, but is remained to be further investigated. PMID- 3959328 TI - [Histological classification of breast cancer. 2]. PMID- 3959330 TI - [The association of obesity with case distribution and prognosis of breast cancer]. AB - We analyzed the association of obesity with case distribution and prognosis of breast cancer. We obtained the following results by using 1,587 breast cancer cases mastectomized between 1965 and 1974 at the Cancer Institute Hospital, Tokyo. 1) Non-invasive ductal carcinoma was prominent in non-obese patients. 2) The ratio of obese group was increasing as the patients became older. 3) Obese patients had bigger size of tumor and more advanced lymph node metastasis than non-obese patients. 4) In premenopausal patients but not in postmenopausal ones, obese group showed poorer 5-year survival rate than non-obese group (p less than 0.01), and it was true even after equalizing the tumor size and lymph node metastasis. PMID- 3959329 TI - [Statistical studies on metastasis of breast cancer and cancer metastasis to the breast]. AB - Metastasis of breast cancer is examined by the database of the Annuals of the Pathological Autopsy Cases in Japan from 1981 to 1983. Breast cancer metastases to the lungs (70.3%), liver (58.4%), bone marrow (53.1%), pleura (29.0%), adrenals (27.9%), skin-subcutaneous tissue (19.7%), brain (14.3%) are frequent in decreasing order. Bone marrow, adrenals, ovaries (11.5%) and thyroid gland (11.1%) are more likely invaded by breast cancer than others. After menopause, the metastases become less frequent than before, especially after 65 years. Breast cancer is one of the highly widespread metastatic cancers, such as malignant melanoma, neuroblastoma, leukemia and malignant lymphoma. On the contrary, cancers metastatic to the breasts are rare (less than 1%). There is no special cancer metastatic to the breast. PMID- 3959331 TI - [The accuracy of frozen sections in the diagnoses of breast lesions]. AB - To evaluate the accuracy in diagnosing breast lesions by frozen sections, 657 consecutive diagnostic biopsies seen during 1982 were reviewed. Of 559 lesions considered benign at frozen sections, 558 were also benign in paraffin sections, the remaining one being a papillary carcinoma (i.e. 1/559 or 0.2% false negative). All 78 cases diagnosed as malignant in frozen sections were also malignant in paraffin sections (i.e. 0% false positive). Of the 20 doubtful cases, in frozen sections, 15 showed a papillary lesions; 7 of them were malignant in paraffin sections and the rest 13 benign. It is concluded that the frozen sections are usefull in the diagnoses of mammary disorders except for those cases with papillary tumors. PMID- 3959332 TI - [Long term results in 69 breast cancer cases treated by radiation therapy at the Radiation Department of Cancer Institute Hospital from 1947 to 1958]. AB - Histologically proved 69 cases of breast cancer were treated by irradiation without mastectomy after either removal of primary tumor or biopsy only at the Radiation Department of Cancer Institute Hospital, Tokyo from 1947 to 1958. Five or 10 years survival rates obtained by Kaplan-Maier's method were 84.6%, 76.2% for Stage I (13 cases), 81.4%, 76.2% for Stage II (34 cases), 25%, 25% for Stage IIIa (4 cases) and 9.1%, 0% for Stage IIIb (11 cases), respectively. Our results of Stage I and II were neary the same as that of curative operation. Our stage III patients showed poorer survival rates than that of curative operation probably due to technical insufficiency. PMID- 3959333 TI - [Treatment result of radiation therapy alone in carcinoma of the breast--analysis of 116 cases from 19 hospitals]. AB - In order to analyze the radiation effect for the breast cancer 116 patients without distant metastasis were collected from 19 large hospitals in Japan. The cumulative five and ten year survival rates were 85%, 80% in stage I (20 cases), 75%, 61% in stage II (41 cases) and 21%, 9% in stage III (55 cases), respectively. In stage I-II, the five year actuarial survival rate of the papillotubular type is better than that of the scirrhous type. In stage III, more than 70 Gy for the primary breast tumor and more than 50 Gy for the regional lymph node regions must be given, to obtain the good result. On the other hand, no correlation was observed between the given dose and the survival rate in stage I-II, due to the influence of the distant metastasis. PMID- 3959334 TI - [Results of radiation therapy of carcinoma of the salivary glands]. AB - The results of radiation therapy in 152 patients with carcinoma of the major and minor salivary glands during the past 30 years were analyzed. Long-term survivors with recurrent disease and/or distant metastasis were common in the minor salivary glands as compared to the major salivary glands. The effects of radiation therapy depend on the degree of residual tumor after surgery. The treatment of choice for the tumor must be the surgery. However, local control was obtained by radiation therapy in many patients treated with brachytherapy or intracavitary electron beam in the minor salivary glands with a slight degree of residual tumor. PMID- 3959335 TI - [The incidence of breast cancer in Niigata Prefecture]. AB - The number of operations, regarded as the incidence, of breast cancer in Niigata Prefecture between 1972 and 1983 was surveyed. The age-adjusted incidence rate of female breast cancer in Niigata Prefecture has increased from 12.2 (per 100,000) to 21.1 (per 100,000) during the past 10 years, although the age-adjusted mortality rate has increased only slightly, from 3.7 to 4.2 (per 100,000) during that time. The age-adjusted incidence rate also increased in the middle-aged (61%) and elderly (41%) group, incidence increased only in the elderly group (74%). It has recently been reported that the aging phenomenon of breast cancer in Japan shows a Western-type tendency. In this paper, however, this phenomenon was considered to be due merely to the increase (24%) in the population of the elderly. PMID- 3959337 TI - [A clinicopathological study of five cases of adenosquamous carcinoma of the stomach]. AB - Five cases of adenosquamous carcinoma with resected stomach were subjected to this study, and the clinicopathological characteristics of this condition were described. The five patients represented 0.8% of 589 cases of resected stomach. There were two men and three women ranging in age from 40 to 70 (average, 62.8). Macroscopically, the adenosquamous carcinomas were all advanced gastric cancer situated in the lower body along the lesser curvature of the stomach, averaging 7.6 cm in size. The characteristic finding was the histologically differentiated type, invading to the serosa. Lymph node metastasis was most prominent. PMID- 3959336 TI - [A study of cases of early gastric cancer with hematemesis and/or melena]. AB - In this hospital, gastric cancers showed a slightly lower incidence (9.3%) of hematemesis and/or melena than gastric ulcers (13.9%), and no distinct difference in such incidence between early gastric cancers and advanced gastric cancers was observed. A study of the literature on early gastric cancers presenting such symptoms revealed that male patients showed an extremely high incidence of these symptoms, as did those with depressed lesions, including types II c + III, and lesions occurring in the MC-C regions dominated by the left gastric artery. PMID- 3959339 TI - [The effects of PS-K on long-term survival of uterine cervical cancer patients treated with radiation]. AB - The effects of PS-K on long-term survival of uterine cervical cancer patients treated with radiation was studied. The patients receiving PS-K were anxious about curability more or less at the time of completion of radiation therapy. Between 1977 and 1983, out of 96 patients with stage III, IV uterine cervical cancer treated with radiation, 27 were given PS-K as adjuvant therapy. The number of cases with PS-K administration were 15 (23%) out of 64 in stage IIIb, seven (37%) out of 19 in stage IVa and five (38%) out of 13 in stage IVb. Out of 27 patients administered PS-K, 19 were given the agent within three months after irradiation and the remaining eight after recognition of recurrence or metastasis. As a rule, PS-K was given orally, 3.0 g per day, intermittently in the pattern of two weeks per month. Judgement of the effects of PS-K was made in comparison with the survival rate of the patients with and without PS-K, and then by observation of the changes of the PPD skin test, ESR, appetite and body weight as early effectiveness of PS-K. The results were as follows. Obvious prolongation of survival was recognized in the patients with PS-K after irradiation. Namely, the cumulative five-year survival rates of stage IIIb were 65% and 49% with and without PS-K, respectively. Improvement by PS-K as early effectiveness was obtained in seven cases (37%) out of 19. The conditions necessary for long-term survival with PS-K were thought to be as follows: that the tumor almost disappears as a result of irradiation and that the condition of the host is superior to that of the tumor in the tumor-host relationship. The effectiveness of intermittent administration of PS-K was suggested. PMID- 3959338 TI - [Observer variability in the histopathologic grading of prostatic carcinoma]. AB - To evaluate the feasibility of histopathological grading systems for prostatic carcinoma, interobserver variability was studied. Fifty patients with prostatic carcinoma were independently observed by five experienced pathologists according to each grading system (Gleason, Mayo Clinic, Mostofi, Gaeta, M.D. Anderson Hospital and Japanese Uro-Pathological Committee). Consensus reading was made in each case, and subsequently a mean discrepancy score was calculated in each grading system. Among the six systems, the lowest discrepancy score was obtained by the Japanese Uro-Pathological Committee's. It seems that this system is the most suitable for the histopathological grading of prostatic carcinoma. PMID- 3959340 TI - [Chronic subdural hematoma secondary to metastasis of adenocarcinoma of the dura mater and skull--a case report]. AB - A 72 year-old woman was hospitalized with the complaint of headache and nausea. Under the diagnosis of right chronic subdural hematoma, a small craniotomy was performed for the total removal of the hematoma. The patient died 14 days after the operation because of the complication of acute DIC. Histologically, metastasis of adenocarcinoma was detected in the dura mater and skull. Previously reported cases of subdural hematoma secondary to cancer were reviewed in the literature. It is considered that a coagulation defect such as DIC may play a significant role in the development of subdural hematoma. It is suggested that the chronic subdural hematoma in the present case was caused by chronic DIC due to metastasis of bone marrow, and that the patient deteriorated as a result of acute DIC triggered by the surgical therapy. PMID- 3959342 TI - [Growth substances]. PMID- 3959341 TI - [Leiomyosarcoma of the remnant stomach--a case report]. AB - A case of leiomyosarcoma of the remnant stomach is reported. The patient was a 57 year-old woman whose chief complaint was easy fatigability. Twenty six years earlier, she had undergone gastrectomy with the diagnosis of duodenal ulcer. By X ray examination of the stomach, a Borrmann type I gastric cancer was suspected on admission. Endoscopic study of the stomach was performed, and a diagnosis of leiomyosarcoma was made from the biopsy specimens. Total gastrectomy was performed. On the resected specimen, a Borrmann type I like tumor measuring 4.5 X 5.5 X 3.2 cm was identified in the anterior part of the body of the remnant stomach. Histologically, the lesion was confirmed as leiomyosarcoma of the stomach. PMID- 3959343 TI - [Growth factors]. PMID- 3959344 TI - [Protein and polypeptide growth factors--renal growth factor]. PMID- 3959345 TI - Isolation of smooth muscle excitatory substances from chicken rectum and their characterization. AB - Acid-acetone extracts of the chicken rectum were subjected to chromatographic and electrophoretic separation, and two new smooth muscle-contracting substances close to purity were obtained. One of them showed chemical and biological characteristics similar to those of substance P, but it was clearly different from substance P on the basis of chromatographic and electrophoretic criteria. Thus, one could be a peptide belonging to the substance P-family. The other substance was also shown to be of peptide nature since its biological activity was destroyed by chymotrypsin and carboxypeptidase A. Parallel bioassay on the two tissues of the longitudinal muscle of the guinea-pig ileum and the isolated whole chick rectum revealed that none of the peptides such as substance P, physalaemin, kassinin, eledoisin, bradykinin and angiotensin II could be a candidate for the active substance. The biological activity was not antagonized by naloxone, suggesting that the substance was a peptide other than the opioid compounds. The molecular sizes estimated by gel filtration are 1300 for the substance P-like peptide and 1600 for the other substance. The possible physiological roles of the two substances as an excitatory non-adrenergic, non cholinergic transmitter were discussed. PMID- 3959346 TI - Effects of vitamin K-deficient diets and fasting on blood coagulation factors in conventional and germ-free rats. AB - Feeding of vitamin K-deficient diets or fasting produced vitamin K deficient syndromes in both conventional and germ-free male rats in 3 days, increasing prothrombin time (PT), activated partial thromboplastin time (APTT), plasma and liver descarboxyprothrombin (PIVKA) levels and liver gamma-glutamylcarboxylase activities, but decreasing plasma clotting factor VII and prothrombin levels. These changes were not found when daily 30 micrograms/rat of vitamin K1 was injected during this period. The changes caused by fasting were comparable with those caused by a diet containing 20-30 ng/g of vitamin K1, while a diet containing less than 5 ng/g caused greater changes in both conventional and germ free rats. Germ-free rats on a diet containing sufficient amounts of vitamin K1 showed PT and APTT values similar to those in conventional rats, but lower plasma clotting factor levels and higher PIVKA and microsomal gamma-glutamylcarboxylase activities. The values for PT, APTT, factor VII, prothrombin and PIVKA in the fasted germ-free rats were almost the same as those in the fasted conventional rats. These findings suggest that menaquinones synthesized in the large intestine are not utilized sufficiently to prevent vitamin K deficiency in rats. PMID- 3959347 TI - Mode of action of probucol in reducing serum cholesterol in mice. AB - The mode of action of probucol in reducing serum cholesterol was studied in normal and cholesterol-fed mice. Probucol did not affect intestinal absorption of radioactive cholesterol in normal and cholesterol-fed mice. In normal mice, probucol treatment resulted in inhibition of incorporation of [14C]-acetate into cholesterol in the liver, while it stimulated the incorporation in the small intestines. Incorporation of [14C]-mevalonate into cholesterol was not affected by the treatment. These results were consistent with the finding that the HMG-CoA reductase activity was decreased in the liver, but increased in the intestinal tissues of the treated mice. In cholesterol-fed mice, probucol treatment had no effect on cholesterol synthesis in the liver, while it increased the intestinal cholesterol synthesis. The over-all effect of this drug on cholesterol synthesis was not significant, although it tended to be inhibitory in normal mice and stimulatory in cholesterol-fed mice. On the other hand, probucol treatment resulted in acceleration of the clearance of [14C]-cholesterol-derived radioactivity from the circulation and resulted also in a significant increase in fecal excretion of the radioactivity, cholesterol and bile acids without changes in lipid composition of the bile. Cholesterol content in and radioactivity distribution among the tissues were not affected by probucol. Hepatic cholesterol 7 alpha-hydroxylase activity was increased by probucol. These findings indicate that probucol lowers serum cholesterol mainly by increasing catabolic excretion of cholesterol into bile. PMID- 3959348 TI - Effects of trimebutine maleate (TM-906) on the spontaneous contraction of isolated duodenum and ileum in both guinea pigs and rabbits. AB - Effects of trimebutine maleate (TM-906) on the spontaneous contraction of isolated duodenum and ileum were studied in both guinea pigs and rabbits. In the duodenum and ileum of both guinea pigs and rabbits, TM-906 (10(-6) g/ml, 10(-5) g/ml) produced a potentiation of the spontaneous contraction in preparations with low contractile activity (low tone or small contraction), while it caused an inhibition of the spontaneous contraction in preparations with high contractile activity (high tone or large contraction). The potentiation of spontaneous contraction by TM-906 was more pronounced in the ileum than in the duodenum of both guinea pigs and rabbits. When the spontaneous contraction of duodenum and ileum was decreased by atropine, the potentiation of spontaneous contraction by TM-906 was further augmented and was more pronounced in the ileum than in the duodenum. When the spontaneous contraction was remarkably potentiated by physostigmine or acetylcholine, TM-906 markedly inhibited the potentiated spontaneous contraction, and the potentiation by TM-906 seen in preparations with low contractile activity disappeared. From these results, it is concluded that TM 906 produces, depending on the contractile activity of the preparations, a potentiation or an inhibition of the spontaneous contraction of duodenum and ileum in both guinea pigs and rabbits and that the potentiation by TM-906 is more pronounced in the ileum than in the duodenum. It is suggested that the endogenous acetylcholine partly modifies the effects of TM-906, but that it does not relate to the more pronounced potentiation by TM-906 in the ileum than in the duodenum. PMID- 3959349 TI - Experimental neurogenic bladder in rats and effect of Robaveron, a biological prepared from swine prostate, on it. AB - An experimental neurogenic bladder was induced in rats by an intraspinal injection of 10% phenol-glycerin solution. The functional and biochemical changes in the bladder were studied in vivo and ex vivo, and the effect of Robaveron, a biological prepared from swine prostate, on these changes were examined. The forced voiding pressure in the control rats which had been caused by the neurogenic bladder was reduced to 1/4-1/5 that of the intact animals. Robaveron recovered a decrease in the pressure, and the effect of 150-250 mg/kg, p.o., corresponded nearly to that of 40 mg/kg, i.m. In the ex vivo study with the strips of isolated neurogenic bladder muscle, the time required to cause 50% of the maximum contraction by transmural electric stimulation prolonged to about four times that of the intact one. Such a prolongation was recovered by Robaveron in a dose-dependent fashion, and the effect of Robaveron given p.o. corresponded to about 1/6 that of the drug given i.m. No change in Ca2+-influx, was found, although Ca2+-efflux was inhibited in the strip of neurogenic bladder muscle. Such an inhibition was significantly relieved in that of animals treated with Robaveron. In the neurogenic bladder rat, the ratio of bladder weight to body weight increased, and the activities of total ChE and AChE in the bladder muscle decreased, on which Robaveron did not show any influence. Phasic and tonic contractions in the strips of intact rat bladder and guinea pig ileum were inhibited by La3+, particularly phasic response in both the strips. Robaveron recovered the inhibition in a dose-dependent fashion. The present study suggests that the urinary dysfunction in neurogenic bladder may be caused not only by nervous disorders but also by changes in the bladder muscle itself. Robaveron was found to be effective for most of such changes. These findings may support the clinical efficacy of Robaveron for improving the attenuated bladder function. PMID- 3959350 TI - Divalent cation dependent conformations of brain calmodulin detected by 1H NMR. AB - The effects of the Ca2+, Mg2+, Zn2+, Cd2+, Hg2+ and Mn2+ on the conformation of calmodulin (CaM) have been tested by using 400 MHz 1H NMR. In the aromatic region of the spectrum of CaM with a one molar ratio of cation per CaM, Zn2+, Cd2+, Hg2+ and Mn2+ induced spectral changes which were very similar to those seen for Ca2+. However, the Mg2+-induced change was different. These results are consistent with our pharmacological findings on divalent cations. PMID- 3959351 TI - Changes of total acetylcholine content and the activity of related enzymes in SART (repeated cold)-stressed rat brain and duodenum. AB - In SART-stressed rats regarded as pathologically diseased model animals with vagotonic-type autonomic imbalance, a decrease of total acetylcholine (T-ACh) content and enhancements of choline acetyltransferase (CAT) and acetylcholinesterase (AChE) activities were recognized in the basal ganglia and hypothalamus. In contrast, in the duodenum, an increase in T-ACh content and a decrease in AChE activity were found, while CAT activity showed no change. These findings suggest that in both brain areas of basal ganglia and hypothalamus in SART-stressed rats, ACh neurons may be activated. PMID- 3959352 TI - Cephalothin and penicillin G polymers as elicitors of rat PCA mediated by mouse IgE antibodies. AB - PCA-eliciting activities of cephalothin- and penicillin G-polymers were examined in rats sensitized with homologous IgE antibodies of mouse origin. Cephalothin polymers elicited PCA regardless of the source of antibodies and the methods to raise them, the minimal effective dose being 2 to 20 micrograms/animal. Penicillin G-polymers provoked PCA only when anti-benzylpenicilloyl IgE antibody of C57BL/6J mouse raised early after immunization was used. The minimal effective dose in this case was 5 micrograms/animal, being comparable to that of cephalothin polymers. PMID- 3959353 TI - Heterogeneity of cross-reactivity of mouse anti-benzylpenicilloyl antibodies against cephalothin haptens or polymers. AB - The cross-reactivity of mouse anti-benzylpenicilloyl antibodies against cephalothin-haptens and cephalothin-polymers was divergent depending on the source and isotype of antibodies and the methods to raise them. High cross reactivity nearly equal to the reactivity to homologous haptens and polymers was obtained only with the IgE antibody of C57BL/6J mouse raised shortly after an immunizing injection of the emulsion containing Freund's complete adjuvant and benzylpenicilloyl-bovine gamma-globulin conjugate. With the other antibody preparations, cross-reactivity was moderate to negligible. PMID- 3959354 TI - Effect of external Ca2+ on the spontaneous and the various stimuli-induced acetylcholine release from guinea-pig ileum myenteric plexus. AB - Effect of external Ca2+ concentration ([Ca2+]o) on spontaneous and various types of stimuli-induced acetylcholine (ACh) release from guinea-pig ileum myenteric plexus was studied. Electrical field stimulation- or high-K+-induced ACh release increased with the increment of [Ca2+]o. On the other hand, the spontaneous and the nicotine-induced ACh release increased up to 0.45 mM [Ca2+]o and then declined progressively as [Ca2+]o was raised. Qualitatively similar results were obtained with dimethylphenylpirerazinium-, 5-hydroxytryptamine- and substance P induced ACh release. These results were discussed in terms of the stabilizing effect of Ca2+. PMID- 3959355 TI - Inhibition of IgE antibody formation by n-pentyl alpha-L-sorbopyranoside. AB - Effect of n-pentyl glycosides and alkyl alpha-L-sorbopyranosides on IgE antibody formation in rats and mice were investigated. When n-pentyl alpha-L sorbopyranoside was given subcutaneously or orally, the IgE antibody formation in rats and mice was suppressed, while no suppression of hemagglutinin formation was observed. The study on timing of administration indicated that n-pentyl alpha-L sorbopyranoside significantly suppressed the secondary IgE antibody response when administered before the secondary immunization. PMID- 3959356 TI - Paradoxical elevations of plasma glucagon levels in patients after pancreatectomy or gastrectomy. AB - In twenty-five patients undergoing total pancreatectomy (TP), twenty distal gastrectomy (DG) and twenty healthy subjects, effects of oral glucose loading on the plasma glucagon (IRG) levels were determined. Plasma IRG levels were elevated after glucose loading in the TP and DG patients, but not in the healthy subjects. To clarify events related to the elevations in IRG, the plasma IRG components were analyzed by gel filtration in 6 of the TP patients, 5 of the DG patients and 4 of the controls. In the TP group, IRG3500 was not detectable either in the basal state or after glucose loading, while IRG9000 was markedly increased after glucose (p less than 0.002). In the DG group, IRG3500 was significantly suppressed after glucose (p less than 0.05), but IRG9000 was clearly increased (p less than 0.005). In the controls, IRG3500 was suppressed after glucose (p less than 0.05), however, IRG9000 was not detected throughout the examination. Thus, in patients with TP or DG, the essential cause of the high responses of plasma glucagon after oral glucose loading was the increase in IRG9000. Because the food passage route is much the same in TP and DG patients, the IRG9000 elevations are probably related to secretion in the digestive tract. PMID- 3959357 TI - Long term follow-up of surgical treatment for ulcerative colitis--with special reference to recurrence and the quality of life. AB - From 1961 to 1984, fifty-one patients with ulcerative colitis were surgically treated at Tohoku University Hospital. The results of various types of surgical treatments for ulcerative colitis were analysed and discussed with special reference to recurrence and the quality of life at the time of follow-up. Total colitis and left-sided colitis were observed in 42 and 9 patients, respectively. There were five operative deaths. Thirteen patients received total proctocolectomy and 38 patients received various types of conservative operations at the first operation. In seven patients there was a recurrence of the disease in the retained colon or rectum and proctocolectomy with ileostomy was carried out. Forty-six patients were followed. Four died of other diseases and two were lost to follow-up. The periods of follow-up after the final operation ranged from 3-29 years. The types of operative procedures were ileostomy in 19, ascendicostomy in 14, ileoproctostomy in 6 and ascendicoproctostomy in 1 patient. Following treatment of recurrence of the disease, in most patients who had undergone various surgical treatments, favorable results of quality of life were attained, even in those with ileostomy. These results indicate that it is important to select the most proper types of operative procedures for surgical treatment of ulcerative colitis by individualizing each case. PMID- 3959358 TI - Morphology of the human and dog spleen with special reference to intrasplenic microcirculation. AB - The terminal structure of splenic arterial capillaries, studied by scanning transmission electron microscopy, provided a three-dimensional view of the microarchitecture of human and dog spleens. There are reports that the terminal arterial capillaries end "openly" in the cord, however, our microphotographs indicate the possibility of a closed circulation in humans and dogs. In the human spleen, we found two types of arterial capillaries, one with a flat and continuous endothelium, and the other with discontinuous rod-shaped endothelial cells and a sheath-like structure. The microarchitecture and the termination of these arterial capillaries differ markedly among species. PMID- 3959359 TI - Natural history of intermittent claudication in the Japanese. AB - The natural history of intermittent claudication (IC) was surveyed in 59 limbs of 44 patients. The mean follow-up period was 3 years (1 to 8.3 years). During the follow-up period, 72.0 per cent of the limbs with a solitary arterial lesion improved or remained unchanged. However, detailed analysis showed that 53.3 per cent of limbs with iliac artery stenosis and 50.0 per cent of those with femoropopliteal artery stenosis worsened, whereas only 18.7 per cent of limbs with iliac artery occlusion and no limbs with femoropopliteal artery occlusion had worsening of symptoms. Of limbs with multiple arterial lesions, 62.5 per cent worsened. Although the natural history of IC is relatively favorable, IC due to a solitary arterial stenosis tends to worsen, whereas IC due to a solitary arterial occlusion will, in more than 80 per cent of cases, improve or remain unchanged. In cases of arterial stenosis, therefore, more careful follow-up, including control of risk factors, is mandatory. PMID- 3959360 TI - Hemorrhagic necrosis of pheochromocytoma associated with reversible renal artery stenosis. AB - An unusual case of pheochromocytoma associated with renal artery stenosis is described. Despite the removal of bilateral adrenal pheochromocytoma, laboratory findings suggested the presence of residual pheochromocytoma and abdominal aortography revealed more pronounced stenosis of the right renal artery. Two months later, the undetected residual pheochromocytoma underwent hemorrhagic necrosis with acute cessation of catecholamine release. Thereafter, the patient's blood pressure decreased to a normal level with marked improvement in hypertensive symptoms. No remaining stenosis was demonstrated on follow up renal angiography. Our case suggests that constant local secretion of catecholamines may be responsible for the development of renal artery stenosis. PMID- 3959361 TI - Secretory carcinoma of the breast in a Japanese woman. AB - We report a case of secretory carcinoma of the breast in a 33 year old woman. Secretory carcinoma is a rare tumor and has distinctive pathological characteristics. This tumor usually occurs in children or adolescents. Modified radical mastectomy was carried out and the patient is doing well with no evidence of recurrence at 25 months later. Negative findings were obtained in the assay of estrogen and progesterone receptor. PMID- 3959362 TI - Bilateral sleeve lobectomy for metachronous multiple primary lung cancer. AB - In a patient with metachronous multiple primary lung cancer, bilateral lobectomy was performed, using bronchoplastic procedures. This case may be one of very few such cases reported in the literature. A 56-year-old man with squamous cell carcinoma was surgically treated for lung cancer. At the first operation, right upper lobectomy with wedge resection of the right main bronchus was performed, as the tumor occupied the orifice of the right main bronchus. Six months later, re operation for stricture at the anastomotic line was done because of granulation. By means of sleeve resection of the strictured right main bronchus, the airway was reconstructed. The patient remained well for five years, then a similar cancer at the orifice of the left lower lobe and bulging into the left main bronchus became evident. Left lower sleeve lobectomy was done for the second primary cancer. The postoperative course was uneventful and he is well with no signs of recurrence 6 years and 10 months after the first operation and 19 months after the second sleeve lobectomy. PMID- 3959363 TI - In vitro susceptibility of Mycoplasma hyopneumoniae to antibiotics. PMID- 3959364 TI - Mechanisms of nonlinear pharmacokinetics of sulfadimethoxine in cocks. PMID- 3959365 TI - Application of glucose consumption test for evaluating blastogenesis in bovine lymphocytes. PMID- 3959366 TI - Further carcinogenicity study on methylmercury chloride in ICR mice. PMID- 3959367 TI - Genesis of bifid T wave in rats. PMID- 3959368 TI - A lactate dehydrogenase anomaly in a cat. PMID- 3959369 TI - Pancreatic and renal glomerular lesions in dogs with hyperglycemia and/or glucosuria. PMID- 3959370 TI - Glomerulopathy in swine: microscopic lesions and IgG or C3 deposition in 100 pigs. PMID- 3959371 TI - Case report: coccidioidomycosis in a Holstein-Friesian cow. PMID- 3959372 TI - Focal hepatic necrosis in young ferrets infected with Aeromonas species. PMID- 3959373 TI - A case of Hyostrongylus rubidus infection in a pig. PMID- 3959374 TI - Morphological changes of neurons in experimental avian encephalomyelitis. PMID- 3959375 TI - Chondrifying fibrosarcoma in the abdominal cavity of a bovine aborted fetus. PMID- 3959376 TI - Astrocytoma in the spinal cord of an aged rat. PMID- 3959377 TI - Yersinia enterocolitica serotype 03 in naturally infected raw pork. PMID- 3959378 TI - Liver lesions and serum antibodies in mice surviving Tyzzer's disease. PMID- 3959379 TI - Growth of rat sialodacryoadenitis viruses in LBC cell culture. PMID- 3959380 TI - Evaluation of bovine lymphocyte blastogenic response by fluorometric DNA synthesis assay. PMID- 3959381 TI - Restricted feeding regimen affects the diurnal prolactin surge but not nocturnal surge in pseudopregnant rats. PMID- 3959382 TI - An outbreak of fowl cholera in wild ducks (Rosyibilled pochard) in Japan. PMID- 3959383 TI - Measurement of blastogenesis of canine peripheral blood lymphocytes against PHA by glucose consumption test. PMID- 3959384 TI - Alteration of fetal heart rate caused by extrauterine environmental changes. PMID- 3959385 TI - Experimental development of resistance to decoquinate and robenidine in a multiple drug-resistant strain of Eimeria necatrix. PMID- 3959386 TI - Erythrophagocytosis by the trophoblast in a bovine placentome. PMID- 3959387 TI - Clinical studies on canine dirofilarial hemoglobinuria: relationship between the presence of heartworm mass at the tricuspid valve orifice and plasma hemoglobin concentration. PMID- 3959388 TI - Hospice philosophy and care in Kansas. PMID- 3959389 TI - Myocardial contusion in a child. PMID- 3959390 TI - Bacterial endocarditis in MVP. PMID- 3959391 TI - Psychosocial aspects of AIDS. PMID- 3959393 TI - AIDS & the blood supply. PMID- 3959392 TI - AIDS in America. PMID- 3959394 TI - Insurance costs related to AIDS. PMID- 3959395 TI - AIDS: an overview. PMID- 3959397 TI - Symposium on biochemical insights into the regulation of renal function. PMID- 3959396 TI - The legal aspects of AIDS. PMID- 3959398 TI - Abstracts. American Society of Nephrology. New Orleans, LA, USA, December 15-18, 1985. PMID- 3959399 TI - [Relevance of hospital hygiene for incubators]. PMID- 3959401 TI - [Strategies for neonatal (perinatal) care]. PMID- 3959400 TI - [Consequences of various protein contents in breast milk for the nutrition of the underweight newborn infant]. PMID- 3959402 TI - [Behavior of body mass, body length and cephalic growth of highly premature infants fed with breast milk]. PMID- 3959403 TI - [Ligation of a persistent ductus arteriosus in an extremely premature infant]. PMID- 3959405 TI - [Method for assessing multifactor laboratory criteria in suppurative surgical infection]. PMID- 3959404 TI - [Scientific and technical progress and new materials in surgery]. PMID- 3959406 TI - [Microflora of suppurative wounds of the fingers and hands in workers in the manganese ore industry]. PMID- 3959407 TI - [Complications of postoperative intraperitoneal abscesses]. PMID- 3959408 TI - [The psychological barrier in assessing the indications for a relaparotomy and the procedural problems in the postoperative period]. PMID- 3959409 TI - [Effect of intraperitoneal electrolysis on liver function and the indices of poisoning in peritonitis]. PMID- 3959411 TI - [Sources and the mechanisms of the spread of the causative agents of hospital infection in a surgical hospital]. PMID- 3959410 TI - [Basis for using hemosorption in the combined treatment of patients with acute diffuse peritonitis]. PMID- 3959412 TI - [Direct interventions on the pancreas in chronic pancreatitis]. PMID- 3959413 TI - [Experimental evaluation of new fibrous hemosorbents based on polymeric materials]. PMID- 3959414 TI - [Enzyme characteristics of the liver in acute diffuse peritonitis in an experiment]. PMID- 3959415 TI - [Possibility for drug stimulation of the digestive function of the small intestine in the early postoperative period]. PMID- 3959416 TI - [Use of the cryogenic method in treating complicated carbuncles of the skin]. PMID- 3959417 TI - [Low-intensity laser radiation in the treatment of suppurative wounds]. PMID- 3959418 TI - [Use of the helium-neon laser in treating trophic ulcers]. PMID- 3959419 TI - [Tissue electrophoresis of antibiotics and lactic acid in treating suppurative wounds]. PMID- 3959420 TI - [Use of papain and ultrasound in the combined treatment of gangrenous lactation mastitis]. PMID- 3959421 TI - [Treatment of suppurative wounds with trypsin immobilized on a cellulose fabric carrier]. PMID- 3959423 TI - [Cationic protein content in the peripheral blood neutrophilic leukocytes of patients with suppurative-inflammatory processes]. PMID- 3959422 TI - [Methods for the contact use of a levamisole solution on surgical patients]. PMID- 3959424 TI - [Most frequent physician errors in treating patients with postinjection suppurative-necrotic lesions of the soft tissues]. PMID- 3959425 TI - [Drug disease as a cause of diagnostic errors in the surgeon's practice]. PMID- 3959426 TI - [Necrosis of the round ligament of the liver and of the lesser omentum as a cause of diffuse peritonitis]. PMID- 3959427 TI - [Chronic peritonitis encapsulans]. PMID- 3959428 TI - [Splenic abscess with rupture into the abdominal cavity]. PMID- 3959429 TI - [Drainage of the abdominal cavity]. PMID- 3959430 TI - [Spontaneous autograft of the spleen after its closed injury]. PMID- 3959431 TI - [Long-term presence of a foreign body in the abdominal cavity]. PMID- 3959432 TI - [Casuistics of an epithelial coccygeal cyst]. PMID- 3959433 TI - [Regional administration of antibiotics in suppurative-inflammatory diseases]. PMID- 3959434 TI - [Immunological reactivity of patients with abscesses and phlegmons of the face and neck]. PMID- 3959435 TI - [Cases of echinococcosis of the muscles]. PMID- 3959436 TI - [Fixation of nasogastric tubes in surgical patients]. PMID- 3959437 TI - [Rupture of a varicose dilated vein of the uterus]. PMID- 3959438 TI - [Method of treating a suppurative wound]. PMID- 3959439 TI - [Modification of the Hippocratic cap-shaped bandage]. PMID- 3959440 TI - [The irrigator-aspirator]. PMID- 3959441 TI - [Method of treating occlusive lesions of the arteries of the aortofemoral segment in emergency and planned surgery]. PMID- 3959442 TI - [Treatment of the appendiceal stump]. PMID- 3959443 TI - [Basic trends in the use of a new organosilicon adsorbent polymethylsiloxane in surgery]. PMID- 3959444 TI - [A method of draining the subdiaphragmatic space after extensive resection of the liver]. PMID- 3959445 TI - [Covering the experimental wound surface of the pancreas with a serous and muscular flap from the gastric wall]. PMID- 3959446 TI - [Disputable problems of pathogenesis in extrahepatic portal hypertension]. PMID- 3959447 TI - [Results of endocholedochal papillosphincterotomy]. PMID- 3959448 TI - [Surgical treatment of congenital cysts of the common bile duct]. PMID- 3959450 TI - [Antipyrine test in evaluation of the functional state of the liver in the postoperative period]. PMID- 3959449 TI - [Surgical treatment of hepatic alveococcosis with metastases to the lungs and brain]. PMID- 3959451 TI - [Treatment of acute cholecystitis in middle-aged and elderly patients]. PMID- 3959452 TI - [Selection of the method of liver resection]. PMID- 3959453 TI - [Surgical treatment of acute pancreatitis]. PMID- 3959454 TI - [Choledochotomy and the methods of its completion]. PMID- 3959455 TI - [Diagnosis and endoscopic removal of residual calculi from the bile ducts]. PMID- 3959456 TI - [Intraoperative electroroentgenocholangiography]. PMID- 3959457 TI - [Percutaneous transhepatic cholangiostomy in the preparation of patients with mechanical jaundice for radical operation]. PMID- 3959458 TI - [Role of endoscopic examination with retrograde contrast study of the biliary and pancreatic ducts in patients after operations on the biliary tract]. PMID- 3959459 TI - [Characteristics of the clinical picture and surgical treatment of intestinal obstruction caused by cholelithiasis]. PMID- 3959461 TI - [Surgical treatment of biliary tract diseases caused by anomalies of the organs in the hepatopancreatoduodenal area]. PMID- 3959460 TI - [Controlled decompression of the gallbladder in acute cholecystitis]. PMID- 3959462 TI - [Rehabilitation of patients after operations on the extrahepatic bile ducts]. PMID- 3959463 TI - [Exercise therapy in the pre- and post-cholecystectomy period for middle-aged and elderly persons]. PMID- 3959464 TI - [Metastasis of malignant tumors to the liver]. PMID- 3959465 TI - [Combined operations in diseases of the biliary tract and pancreas]. PMID- 3959466 TI - [Intra-aortic infusions in destructive pancreatitis]. PMID- 3959467 TI - [Longitudinal pancreatojejunostomy in complicated chronic pancreatitis]. PMID- 3959468 TI - [Heterotopic autotransplantation of splenic tissue after splenectomy]. PMID- 3959469 TI - [The timing of surgical interventions in acute cholecystitis]. PMID- 3959470 TI - [Postoperative complications in hepatic alveococcosis]. PMID- 3959471 TI - [Significance of the flicker test for follow-up and prognosis in optic nerve neuritis]. AB - In 105 eyes with florid optic neuritis (ON) the sensation of brightness lessened when the frequency of flickering light was reduced to between 5 and 10 Hz, but remained stable or increased in 239 healthy eyes, 106 eyes after an ON had subsided, and 117 eyes with other diagnoses. This Aulhorn Flicker Test is highly accurate (98%) and specific. It gives pathologic results only for florid ON, and yields normal results again after the inflammation has subsided, even though other visual functions may remain reduced. The Flicker Test therefore makes it possible to distinguish between acute, recidivous, chronic and subsided ON, a distinction which is clinically often ambiguous and cannot be made on the basis of visually evoked potentials. The fact that the Flicker Test reveals pathologic conditions even in abortive cases or when an Uhthoff phenomenon is present is of great diagnostic value. Five representative cases from the group of patients with ON are described in some detail to show how the test can be used to judge the course of the disease, course, to predict its prognosis and to distinguish various patterns of development. PMID- 3959472 TI - [Carotinoid retinopathy. III. Reversibility]. AB - Twenty-five patients (erythropoietic protoporphyria 23, polymorphous light eruption 1, "cosmetics" 1) were re-examined 2-10 months after therapy with beta carotene and canthaxanthine was discontinued. Dark adaptation and ERG parameters had normalized, whereas crystalline retinopathy and pigment epithelial defects showed no signs of reversibility. PMID- 3959473 TI - [Impression cytology as a noninvasive method of conjunctival biopsy and its results]. AB - Impression cytology is a non-invasive, repeatable, and uncomplicated method of examining the conjunctiva. Cellulose-acetate filters are used to remove the superficial layers of the conjunctiva. This technique causes no subjective discomfort to the patient. The method combines the advantages of a biopsy with those of a "Hautchenpraparat." The authors used 3 different stains for the conjunctival imprints: PAS-hematoxylin, Alcian blue and a combination of Alcian blue and PAS. From the different staining characteristics of the goblet cells it was possible to draw conclusions about different functional cell conditions. The metachromatic properties of a few cells among the large number of epithelial cells led to speculation on the existence of different cell types and their possible correlation with the various cell types described by Rohen for the conjunctiva of monkeys. In patients with keratoconjunctivitis sicca or Sjogren's syndrome pathologic nuclear changes occur that lead to chromatin taking on a snake-like appearance, the so-called "snakes." To the authors' surprise, similar chromatin changes were found in a great number of cells of contact lens wearers, with frequency depending on the type of contact lens. Impression cytology is a special method of non-invasive biopsy providing new possibilities for diagnosis, differential diagnosis, and therapeutic control of conjunctival disorders. PMID- 3959474 TI - [Scanning electron microscopy image of the cells of the conjunctival epithelium in specimens from impression cytology]. AB - Impression cytology specimens of the conjunctiva can be examined by scanning electron microscopy. If a cellulose-acetate filter is pressed onto the conjunctiva, the microvilli-bearing epithelium becomes so firmly attached to the fine meshwork of the filter that the most superficial conjunctival cell layers adhere to the filter. When the filter is removed intercellular connections are destroyed without any damage to the cell membranes being detectable in the SEM image. Since the surface of the corneal epithelium is spread out on the filter and is firmly attached to it the lateral bond between the cells is preserved. Shrinkage is minimal. The posterior surface of the epithelial cells, facing the observer, consists of smooth, porous cell membranes. The nuclei of many cells are clearly distinguishable. Since it can be directly compared with light-microscopic specimens, the SEM image can help provide answers to morphological and pathological questions, and may represent a useful diagnostic aid. PMID- 3959475 TI - [A test of pressure tolerance of the optic nerve head in ocular hypertension]. AB - VER was recorded in 7 patients with ocular hypertension while intraocular pressure was artificially elevated. Four of the patients manifested signs of vascular autoregulation, while in 3 no such signs were observed. This absence of autoregulation was also observed in primary open-angle glaucoma patients. On the basis of these first results it may be expected that the pressure compliance test will identify patients with ocular hypertension in whom damage to the optic disk is likely to occur at a later date. PMID- 3959476 TI - [Current status of PMMA intraocular lens sterilization]. AB - One possible reason for the "toxic lens syndrome" may be the method of IOL sterilization used. Advantages and disadvantages of wet and dry sterilization techniques are discussed. Ethylene oxide remnants in IOL optics were measured using headspace chromatography. The influence of gamma radiation on PMMA lens optics was studied by spectrometry. PMID- 3959477 TI - [Sjogren syndrome in childhood]. AB - The authors report on the case of a 7-year-old girl with keratoconjunctivitis sicca. The diagnostic difficulties are discussed and the literary data on Sjogren's syndrome in childhood are summarized. PMID- 3959478 TI - [Functional aniseikonia following implantation of a posterior chamber lens in the early postoperative phase]. AB - Three to five days after unilateral posterior chamber lens implantation in 25 patients iso-iconia was measured with the Aulhorn phase difference projection haploscope. The results were compared with measurements obtained with a computerized calculation program. The average aniseikonia values (4.1%) were in good agreement with the pre-calculated computer data (3.2%). Causes of the wideranging individual differences are discussed: postoperative astigmatism; anterior chamber depth; measuring errors; reliability of the information provided by the patients. This investigation confirms that aniseikonia after implantation of a posterior chamber lens is less pronounced than when cataract spectacles or contact lenses are used. PMID- 3959479 TI - [Experiences with the effectiveness and tolerance of guanethidine/dipivefrin-AT in the treatment of increased intraocular pressure]. AB - Investigation of the fixed combination of 0.5% guanethidine and 0.1% Dipivefrin demonstrated a good pressure-lowering effect (26.6% on average) as well as good subjective and objective tolerance. These findings justify its use as a preparation for lowering intraocular pressure. PMID- 3959481 TI - [Scattered light in implanted artificial lenses in a model trial]. AB - The scattered light produced by 4-loop Binkhorst anterior chamber lenses, Kratz Elliptical posterior chamber lenses and Choyce Mark IX anterior chamber lenses were investigated in relation to different pupil diameters (1.5; 4.0; 6.0 and 8.0 mm) using a model. The light ray first met the anterior surface of the lens vertically and thereafter from 30 degrees to the left. The scattered light was photographically documented. The most scattered light was produced by the Binkhorst 4-loop anterior chamber lens and was caused by the fixation points of the loops near the centre of the lens. This was deduced from the fact that no scattered light could be seen if the pupil diameter was 1.5 mm, a situation one cannot find in a patient where the pupil is incapable of contracting to such an extent because of the loops. The Kratz Elliptical posterior chamber lens generally produced a minimum of scattered light. Increased glare sensitivity diminishing the ability to drive under mesopic conditions can be due to scattered light produced by artificial lenses. PMID- 3959480 TI - [A corneal polishing instrument for the Microkeratron]. PMID- 3959482 TI - [Instruments combined to demonstrate the focal length of the optic system of the eye]. AB - By combining a zoom lens with a telescope, short focal lengths similar to those found in the optic system of the eye can be achieved with a 35 mm camera. PMID- 3959483 TI - [Subjective free-vision determination of refraction with the opto-refractor]. AB - The optorefraktor is an instrument for determining refraction subjectively with free vision, and is used for monocular prerefraction. Aphakic and pseudoaphakic patients, who represent a difficult group for a subjective examination because of their often very low visual acuity and dilated pupils, were examined with this instrument. The prerefraction values determined with the optorefractor were compared with the values obtained using a phorometer. It was found that the optorefractor is just as suitable for prerefraction as other well-known and sometimes very costly devices and techniques for objective prerefraction. PMID- 3959484 TI - [Cardiomyopathies in childhood]. AB - Primary cardiomyopathies are heart muscle diseases of unknown cause. In hypertrophic cardiomyopathy (HCM) a hypertrophy of unknown aetiology results either in asymmetric septal hypertrophy (mostly with obstruction) or in concentric hypertrophy of the left ventricle (mostly without obstruction). This condition is rare in childhood, partly inherited and sometimes observed already in newborns. Sudden cardiac death is a main complication in the second decade. In non-obstructive HCM endomyocardial biopsy is the tool to differentiate secondary forms. Dilated cardiomyopathy is recognized by aetiologically unclear dilatation of left or right or both ventricles. In childhood this condition has to be differentiated from coronary anomalies, endocardial fibroelastosis, and myocarditis. Also rare secondary forms have to be considered because of possible therapeutic consequences. From the very few histologically proven reports a reliable prognosis for this disease in childhood cannot be deduced. PMID- 3959485 TI - [Decreased prothrombin coagulation activities in breast-fed children?]. AB - Intracranial bleeding due to vitamin K deficiency in infants without prior symptoms of disease has been reported. All of these children were fully breastfed. To evaluate a potential deficit of vitamin K dependent coagulation factors in fully breastfed infants we determined the prothrombin clotting times in healthy babies on the 5th day (n = 204) and in the 5th week of life and correlated the results to the feeding. On the fifth day of life prothrombin coagulation times in fully breastfed infants were significantly longer than in babies receiving formula exclusively or additionally. Vitamin K supply in fully breastfed neonates should therefore be reinvestigated. In the 5th week of life, however, there was no difference in prothrombin coagulation times between fully breastfed infants and infants with exclusive or supplementary formula feeding. PMID- 3959486 TI - [Free amino acids in the saliva of children with phenylketonuria]. AB - Free amino acids were determined quantitatively in saliva of 23 children with phenylketonuria (male = 11, female = 12) (ages 6-17 years). Saliva was deproteinised by adding an equal volume of 5% sulphosalicylic acid and the amino acids were separated by ion exchange column chromatography. RESULTS: The comparison of the amino acid concentrations in saliva of phenylketonuric children with healthy children (male = 34, female = 31) (ages 6-13 years) showed, that vast majority of amino acids - taurine, serine, glutamine, glycine, alanine, citrulline, a-aminobutyric acid, valine, isoleucine, leucine, tyrosine, phenylalanine, ornithine, lysine, delta-aminovaleric acid - were excreted significantly lower in saliva of phenylketonuric children. PMID- 3959487 TI - [The intermediate form of maple syrup disease]. AB - A severely retarded and tetraspastic child died at the age of four years upon a respiratory infection with acidosis, disturbances of serum electrolytes and lactic aciduria. Brain autopsy showed a spongy degeneration and led to suspect an inborn error of amino-acid metabolism. These findings corresponded with the results of computer-tomography and were supported by post mortem amino-acid analysis. An intermediate variant of leucinosis was detected in an younger sister at the age of five months after cerebral convulsions and opisthotonic posture. The activity of the branched chain ketoacid decarboxylase in fibroblasts was reduced to 3-4% of normal. A protein restricted diet allowed a nearly normal cerebral development and improvement of computer-tomographic results. The similarity of clinical and biochemical data in both children indicate that a maple syrup urine disease was most likely the underlying disease in the older sister. Later performed electron-microscopical examinations of the older sister indicate that spongy degeneration of the central nervous system in leucinoisis is caused by a spongy myelinopathy, which is different from the alterations found in Canavan's disease, what could be pointed out for the first time. PMID- 3959488 TI - [Sonographic follow-up of pronounced brain concussion in a 3-week-old infant following trauma caused by shaking]. AB - Cerebral sonography was performed in a 3 week old whiplash shaken baby who had no external marks of injury and no skull fracture. On the day of admission, increased echogenicity in the white matter could be correlated with hypodense contusional lesions in the cranial computerized tomography. Sonographic follow-up showed multiple cystic defects in the white matter and later on marked dilatation of the adjacent lateral ventricle. In all infants with open anterior fontanel presenting with unexplained clouding of consciousness and/or external marks of child abuse, cerebral sonography should be a basic diagnostic method. PMID- 3959489 TI - [Neonatal tricuspid insufficiency--a contribution to the differential diagnosis of the cyanotic newborn infant]. AB - A cyanotic newborn is described to illustrate and discuss the rare transient tricuspid insufficiency together with functional pulmonary atresia. Etiologically the manifold causes of perinatal asphyxia are to be taken into consideration. The clinical appearance corresponds to type A of transient myocardial dysfunction according to the classification of Rowe together with respiratory distress syndrome and heart failure. Pathogenetically the disease is based on the different histological consequences of myocardial ischaemia of the right ventricle in connection with a delayed fall of the pulmonary arterial resistance. Fetal connections lead to a pronounced right-to-left-shunt. The diagnosis is primarily established by the way of clinical and echocardiographic investigation and pulsed doppler examination. The most important differential diagnosis are in Ebstein-anomaly, obstruction and atresia of the right ventricular outflow tract. Therapy is conservative. Its aim is to improve myocardial performance and to lower right ventricular afterload. Outcome of patients with neonatal tricuspid insufficiency is uncertain and depends on the severity of myocardial ischaemia. In our patient the course has been uneventful after initial difficulties. PMID- 3959490 TI - [Ductus aneurysm as a rare cause of inspiratory stridor in the newborn infant]. AB - A paralysis of the left vocal cord was seen by laryngoscopy in a 3-days-old boy with inspiratory stridor. A ductus aneurysm was established by angiocardiography, which was believed to be the cause of the vocal cord paralysis. Within 8 days after the angiocardiography the aneurysm became smaller and the stridor disappeared. Twelfth months later the control-angiocardiography showed the total obliteration of the ductal aneurysm. PMID- 3959491 TI - [Lupus erythematodesus profundus]. AB - A 4 year old boy with lupus panniculitis since the third month is presented. Typical discoid lupus erythematosus lesions were also present. There were no signs of systemic involvement. Lupus panniculitis is an uncommon subtype of cutaneous lupus erythematosus. Our case is very unusual as the lesions developed already 3 month after birth. Clinical manifestation, therapy and histopathology of lupus panniculitis are discussed. PMID- 3959492 TI - [Niikawa-Kuroki syndrome (the so-called Kabuki make up syndrome)]. AB - The first case of Niikawa-Kuroki-syndrome (so called Kabuki-make up-syndrome) in Europe and the second one out of Japan has been reported. It concerns a male child with retardation of growth, mental and motoric development. The syndrome can be diagnosed through the typical dysmorphia of the face, epicanthus, arched eyebrows, broad and depressed nasal tip, large malformed ears and stubby fingers. Anomalies of the dermatoglyphic patterns of the fingers observed in the Japanese patients could not be confirmed in our case. There was a normal chromosomal pattern. No further cases in the family could be found. The etiology of this new syndrome is not yet elucidated. PMID- 3959493 TI - [5 years of continuous ambulatory peritoneal dialysis in the child]. AB - Ten patients aged 5-14 years and 1 adolescent were treated by CAPD during 12 patient years. Overall survival and rehabilitation were good despite relatively high serum concentrations of urea (19 mmol/l) and creatinine (735 mumol/l). Dietary restrictions were only occasionally necessary, 6 patients required phosphate binders. No radiological bone changes developed in 4 patients with initially normal x-rays, but lesions progressed in 3 with pre-existing osteodystrophy despite administration of 1.25 (OH) 2D3 and Al-hydroxide. Statural growth was unsatisfactory: Height decreased in the 7 patients observed over 1 year from -2.4 to -2.7 SDS. Peritoneal diffusion curves varied considerably between patients, yet remained unchanged at repeat examination. Parents fatigue developed in 6 families and was partly responsible for peritonitis. The incidence of peritonitis fell from 1 episode in 3.3 months to 1 in 8 months. Intensive family support by regular telephone contact and home visits appeared as the most important measure in prevention of parents fatigue and hence of peritonitis. We consider CAPD as a valuable alternative method to haemodialysis. PMID- 3959494 TI - [Factitious disease. Observations on 44 cases at a medical clinic and recommendation for a subclassification]. AB - From 1971 to 1985, 44 cases of self-induced factitious disorders were observed in the Medical Department of a University Hospital. The diseases were often severe, one patient even died. The various symptoms and diseases presented by the patients, the methods of producing them, and the diagnostic and therapeutic aspects of these cases are described. Patients were analysed with regard to age, sex, profession, psychosocial adaptation, number and duration of hospitalisations, presentation of complaints, behaviour on the ward, relation to the doctor, self-destructive tendencies, readiness to suffer and possible motivations. According to the criteria of the DSM-III, seven patients were malingerers (DSM-III: V 65.20) and 37 had a "chronic factitious disorder with physical symptoms" (DSM-III: 301.51). However, the findings in the patients of the latter group strongly suggest that they form an extremely heterogeneous population. Therefore we propose a subclassification of the DSM-III category 301.51 as follows: Type A. Muenchausen syndrome in the proper sense; dramatic deception of mainly acute illness; pseudologia fantastica; social maladaptation, chaotic life situations; many, mostly short hospitalisations; many interventions; at first well adapted, later hostile; mostly men. Type B. Self-induced, mainly chronic illness; behaviour adequate, highly compliant; often little emotion, contrasting with the sometimes severe illness; socially adapted; history remarkably blank with regard to psychosocial stress; several often longlasting hospitalisations and many interventions; almost exclusively younger women from (para-)-medical professions. Type C. Willfull interference with the healing of wounds, cutaneous ulcers, abscesses or dermatological artefacts; history with marked personal losses or severe chronic medical problems; at first well adapted, later hostile, passive/aggressive; women prevail. A conversion syndrome (DSM-III: 300.11) was not observed. In contrast to malingering, the basis of the disorder in types A, B and C is unconscious in origin, thus similar to the conversion syndrome. Contrary to the latter, however, the production of physical symptoms is under voluntary control. The proposed subclassification represents a hypothesis for testing which might facilitate the analysis of the basic personality disorder, so far lacking. The investigation of the psychopathology of these patients and their treatment is difficult if not impossible because most refuse psychiatric exploration and therapy. Consequently follow-up studies and data on the prognosis are rare. PMID- 3959495 TI - [Cryptococcus neoformans meningoencephalitis in AIDS]. AB - The risk for AIDS patients from Cryptococcus neoformans is outlined on the basis of a case report on a 28-year old male patient whose disease was complicated by cryptococcosis. Beside the description of the diagnosis of cryptococcosis (demonstration of the agent and its antigen), epidemiological associations (habitat of Cr. neoformans in fecal matter of birds) and the clinically, mostly not recognized, route of infection via the lungs is stressed. The effective therapy with the combination of amphotericin B and 5-flucytosine, which also in this case has been successful is described from the clinical and microbiological angles. Finally, proposals for the prevention of Cr. neoformans infections in AIDS patients and for a special mycological surveillance directed at this fungus are made. PMID- 3959496 TI - Reduced cold-induced thermogenesis in familial human obesity. AB - It is well known that cold and diet-induced thermogenesis, which is mediated in small rodents by the hypothalamic-noradrenergic fibers-brown adipose tissue axis, is impaired in genetically obese mice. To test whether these adaptive mechanisms are also impaired in obese humans, 12 young males who were otherwise healthy (6 lean and 6 obese) were examined. The obese subjects had an early-onset type of obesity with a strong family history of it as well. Deep body temperature was measured by using a deep body thermometer furnished with three thermocouples. They were respectively placed on the sternum, on the interscapular area immediately under the neck (HIS), and on the 4th intercostal space (LIS) in order to study core temperature as well as heat production where brown adipose tissue could also be present in adults. Both lean and obese subjects were kept in a thermoneutral environment (28 degrees C) until they reached a steady-state body temperature and then rapidly transferred into a cold room (6-8 degrees C) where they remained up to 60 min. Body temperature decreased in both groups, but the decrease was more marked in the obese individuals on the sternum (P less than 0.01), on HIS (P less than 0.05) and on LIS (P less than 0.05) when compared to lean individuals. In conclusion, cold-induced thermogenesis is impaired in familial early-onset human obesity and in genetically obese mice. PMID- 3959497 TI - Lipid abnormalities in plasma and red cell membranes of chronic alcoholics. AB - The fatty acid composition of plasma and red cell membranes was determined in alcoholics without liver dysfunction upon admission for withdrawal therapy and after a 4-week period of abstinence, and in normal subjects. Fatty acid analysis of plasma by capillary gas chromatography showed a higher proportion of saturated fatty acids in alcoholics on admission than in normal subjects. Other major differences in plasma fatty acids in alcoholics were the reduction of linoleic acid and the increase in palmitic acid. Similar abnormalities were measured in red cell membranes of alcoholics. Although there were less polyunsaturated fatty acids in red cells of alcoholics, the degree of hydrogen peroxide or phenylhydrazine-induced lipid peroxidation was the same as in controls. Membrane tolerance to ethanol was attributed to adaptive membrane alterations (increase of saturated fatty acids in membranes). However, the here reported changes in plasma and red cell lipids suggest that alterations in red cell membrane lipids reflect abnormalities in plasma lipids due to equilibrium exchanges rather than signify adaptive changes of the red cells to ethanol. PMID- 3959499 TI - [Value of various lipid metabolism indices in the diagnosis of chronic active viral hepatitis]. PMID- 3959498 TI - [Isolated spontaneous coronary artery dissection. A report on the differential diagnosis of coronary heart disease]. AB - A complete review of the literature on the disease entity isolated spontaneous coronary artery dissection (72 ascertained cases with our own three) is given. The emphasis is placed on differential diagnosis of coronary heart disease, particularly in young patients without typical atherosclerotic risk factors. Isolated spontaneous coronary artery dissection is defined as a spontaneously dissecting hematoma limited to one or more coronary arteries. Women are involved considerably more frequently than men (84% of cases). Mean age at onset of the disease is 41 years (range: 21-70 years). The main site of involvement is the left coronary artery (79% of cases). In one-third of the female patients there is a temporal relationship to pregnancy (peripartum coronary artery dissection). Three types can be differentiated by coronary arteriography. Less than one-third of the patients survive the first 24 h after acute onset of symptoms; attempts at emergency reperfusion of the ischemic myocardium by aortocoronary bypass surgery or thrombolytic therapy have not been successful. PMID- 3959500 TI - [Digestive system in congenital adrenal cortex dysfunction]. PMID- 3959501 TI - [Manual therapy in reflex syndromes of lumbar osteochondrosis]. PMID- 3959502 TI - [Clinical differentiation of the edematous-infiltrative and nodular forms of cancer of the breast]. PMID- 3959503 TI - [Recurrences of lymphogranulomatosis]. PMID- 3959504 TI - [Immediate results of treating psoriatic arthritis using the hemosorption technic]. PMID- 3959505 TI - [Value of determining serum immunoglobulin E in burn patients]. PMID- 3959506 TI - [Spinal fluid evacuation in the complex treatment of encephalopathy and coma in viral hepatitis patients]. PMID- 3959507 TI - [Case of myxoma of the left atrium]. PMID- 3959508 TI - [Antemortem diagnosis of pericardial mesothelioma]. PMID- 3959509 TI - [Case of alkaptonuric ochronosis]. PMID- 3959510 TI - [Treatment of arterial hypertension]. PMID- 3959511 TI - [Composition of bile and biliary calculi in cholelithiasis patients as determined by spectrophotometry and derivatography]. PMID- 3959512 TI - [Concept of the anaerobic threshold and its clinical significance]. PMID- 3959513 TI - [Systemic lupus erythematosus among adolescents]. PMID- 3959514 TI - [Various aspects of reconstructive surgery of the aorta and major arteries]. PMID- 3959515 TI - [Clofeline chronotherapy of patients with essential hypertension]. PMID- 3959516 TI - [Status of central hemodynamics and phase structure of the cardiac cycle in relation to the level of leukocytes in the blood of myocardial infarct patients]. PMID- 3959517 TI - [Comparative evaluation of hemodynamics before and after a myocardial infarct]. PMID- 3959518 TI - [Cardioportal blood flow and its relation to the absorptive-excretory function of the liver in acute myocardial infarct patients]. PMID- 3959519 TI - [Effect of obzidan on the function of endocrine glands regulating calcium metabolism in patients with ischemic heart disease]. PMID- 3959520 TI - [Use of L-DOPA and a traveling pulse magnetic field to treat patients with neurocirculatory dystonia]. PMID- 3959521 TI - [Relation between platelet aggregation in ischemic heart disease patients and the type of hyperlipoproteinemia]. PMID- 3959522 TI - [Treatment of patients with disorders of the cardiovascular system with onset during exposure to toxic substances]. PMID- 3959523 TI - [Myocardial function, systemic and pulmonary hemodynamics in chronic obstructive bronchitis associated with arterial hypertension]. PMID- 3959524 TI - [Various problems in the diagnosis of chronic pyelonephritis]. PMID- 3959525 TI - [Status of the upper digestive tract in chronic renal failure]. PMID- 3959526 TI - [Acetylcholine-cholinesterase system of the blood in chronic gastritis]. PMID- 3959527 TI - [Status of the stomach and duodenum in the early period after ulcer perforation in young men]. PMID- 3959528 TI - [Experience in treating patients with peptic ulcer exacerbation with solcoseryl and etimizol]. PMID- 3959529 TI - Hematologic abnormalities in simian acquired immune deficiency syndrome. AB - Hematologic abnormalities were defined in 31 rhesus monkeys (Macaca mulatta) with simian acquired immune deficiency syndrome (SAIDS). Animals manifested anemia (hypochromic/microcytic), severe neutropenia and progressive lymphopenia, monocytosis and occasional thrombocytopenia. Bone marrow studies showed erythroid hyperplasia with a marked left shift and adequate megakaryocytes. Two animals showed profound hypoplasia of all hematopoietic elements. Most animals were iron deficient, but the course of the anemia suggested additional factors. There was no evidence of immune hemolysis. The pathogenesis of these abnormalities is not clear and will require further study. This reproducible disease will allow studies to elucidate the mechanisms of viral-induced hematologic abnormalities. PMID- 3959530 TI - Effect of acclimation to caging on nephrotoxic response of rats to uranium. AB - Animal studies of the toxicity and metabolism of radionuclides and chemicals often require housing of rats in metabolism cages for excreta collection. Response of rats to toxic substances may be affected by environmental factors such as the type of cage used. Dose-response studies were conducted to assess the effects of two types of cages on the nephrotoxic response of rats to uranium from implanted refined uranium ore (yellowcake). The LD50/21 days was 6 mg of uranium ore per kilogram body weight (6 mg U/kg). The 95% confidence limit (C.L.) was 3-8 mg U/kg for rats housed in metabolism cages beginning on the day of implantation (naive rats). However, for rats housed in metabolism cages for 21 days before implantation (acclimated rats) the LD50/21 days was 360 mg U/kg (95% C.L. = 220 650 mg U/kg), which was the same value obtained for rats housed continuously in polycarbonate cages. This significant difference (P less than 0.01) in response of naive rats compared to response of acclimated rats appeared related to a significantly lower water consumption by the naive rats. PMID- 3959531 TI - Colonization of Syrian hamsters with streptomycin resistant Campylobacter jejuni. AB - A streptomycin resistant Campylobacter jejuni inoculated per os into two populations of Syrian hamsters (one endemically harboring C. jejuni, the other free of C. jejuni) established chronic colonization of the organism in both groups. Diet, steroid administration, age of hamsters or prior exposure to C. jejuni did not appreciably alter incidence of diarrhea or colonization of C. jejuni. The majority of hamsters sampled during the course of the experiment (1 to 22 weeks) shed streptomycin resistant C. jejuni in the feces. In four hamsters sampled at 14, 17, 19, and 22 weeks, post inoculation, streptomycin resistant C. jejuni were recovered in ileal, cecal, jejunal, duodenal and colonic contents (10(4) to 10(7) colony forming units/gram of intestinal content). The hamster appears to be a potentially useful model for the study of intestinal colonization of enteropathogenic C. jejuni. Hamsters shedding C. jejuni in their feces for extended periods of time should be considered a zoonotic threat to both pet owners and laboratory personnel. PMID- 3959532 TI - Resistance of cats to the diabetogenic effect of alloxan. AB - Experimental diabetes mellitus can be induced chemically in many species of animals with streptozotocin or alloxan. However, the cat is known to be resistant to the diabetogenic effect of streptozotocin. The purpose of this study was to find the optimal dose and rate of injection of alloxan to consistently produce hyperglycemia (blood sugar levels greater than 300 mg/dl) in cats. Alloxan was administered to 22 cats at various concentrations (50, 100 and 150 mg/kg) and different rates of injection (0.5, 1.0 and 1.5 ml/min). No hyperglycemic effect was observed at any of the concentrations or different rates of injection. Cats receiving high concentrations and/or high rates of injection of alloxan died due to kidney damage. The results of this study suggest that the cat is resistant to the diabetogenic effect of alloxan, but is susceptible to its toxic side effects. PMID- 3959533 TI - Sperm counts and reproductive tract lesions in male Syrian hamsters exposed in utero to diethylstilbestrol. AB - Pregnant hamsters were administered diethylstilbestrol (DES) orally on day 14 of gestation. Sperm counts from F1 adult males were lower than controls. Significant and consistent lesions were confined to the epididymides of DES exposed males, in which epididymal granulomas were the most common lesion. Epididymal granulomas of the tail have been associated with a bacterial etiology while granulomas of the head may be related to blind ductules or a lack of ductule connection. PMID- 3959534 TI - Spontaneous lesions in the sternums of growing rats. AB - Pathologic examination of sternums from young growing rats revealed a number of skeletal lesions involving both cartilage and bone elements. Degeneration or aseptic necrosis of the intersternebral cartilage was a frequent finding in most rats that were examined either at 130 or 180 days of age. Thickening of the sternal cortices and trabeculae containing prominent cement lines were less frequently occurring lesions in these sternums. These changes were absent in rats of 70 days of age. The etiology of the lesions is not understood, although several factors may be incriminated. PMID- 3959536 TI - Canine rhinosporidiosis in Arkansas. AB - Rhinosporidiosis is a fungal infection caused by Rhinosporidium seeberi, a microorganism of complicated, undetermined life cycle. Many species of animals are susceptible to rhinosporidiosis, including human beings. The frequency of occurrence of the disease in domestic animals is unknown. A one-year-old male Collie dog from Northeast Arkansas was found to have rhinosporidiosis presenting as an intranasal polypoid mass. We believe this is the first documented report of rhinosporidiosis from the State of Arkansas. PMID- 3959535 TI - Surgical correction of eyelid disfigurement in a stumptailed monkey (Macaca arctoides). AB - Self-aggression in an adult male stumptailed monkey (Macaca arctoides) resulted in severe lower eyelid distortion, conjunctivitis and epiphora. The behavior ceased with a change in environment, but the eyelid defect, conjunctivitis and epiphora persisted, requiring corrective surgery. Surgical correction was partially successful, although the animal died due to unrelated medical problems before final correction could be accomplished. PMID- 3959537 TI - Supplemental chloralose anesthesia in morphine premedicated dogs. AB - This study evaluated the cardiorespiratory stability of six dose-regulated, 12 hour, chloralose anesthetic maintenance protocols. Thirty mongrel dogs were premedicated with morphine sulfate (5mg/kg) and anesthetized with an induction dose of chloralose (80mg/kg). Fifteen animals were permitted to breathe spontaneously and 15 animals were ventilated mechanically to maintain a constant arterial pCO2 (40 +/- 5 mmHg). The spontaneously breathing dogs were separated into three groups in which animals (n = 5) were given different bolus doses of supplemental anesthetic. Initially the spontaneously breathing animals were hypoxemic, acidemic and hypercapnic. No consistent hemodynamic difference was noted among these groups. The mechanically ventilated animals were also divided into three groups that received varying doses of supplemental chloralose by constant infusion. Significant (p less than 0.01) myocardial depression was noted in the heavy-dosed animals by the third hour. Systolic pressure decreased 44%, pulse pressure decreased 37% and peak left ventricular dP/dt decreased 52%. All heavy-dosed animals expired before the eighth hour. Although these data suggest that morphine-premedicated, chloralose-anesthetized animals generally provide a stable cardiopulmonary model, high-dose chloralose supplementation depressed ventilation and produced a dose-dependent cardiotoxicity. PMID- 3959538 TI - Acute restraint device for rhesus monkeys. AB - A practical and inexpensive alternative to the standard primate chair is described. The apparatus is designed to allow easy removal of rhesus monkeys from their home cages and to allow restraint without anesthesia. A portable Plexiglas cage, which can be adjusted to accommodate rhesus monkeys of varying sizes, is placed against an animal's home cage. The animal is then trained to avoid the squeeze mechanism of the home cage by going into the Plexiglas cage. The animal's head can then be secured by means of poles hooked to a light weight collar worn permanently. This device and procedure allows an investigator to work with a restrained animal without resorting to drugs, unnecessary force or chronic restraint. Animals can be transferred daily with this technique with minimal conditioning and cooperation. PMID- 3959539 TI - An indwelling catheter for the collection of cat uterine fluids. AB - A catheter system is described which allows for repeated samplings of uterine fluids in an awake animal. At laparotomy, catheters were inserted surgically into the ovarian pole of each uterine horn. The catheter ports then were passed through the abdominal wall through a stab incision and tunneled subcutaneously to a midlumbar position on each flank. The common uterine body was ligated to form a closed compartment. Uterine fluids were collected by saline lavage. Approximately 80% of the saline injected into one port was collected from the contralateral port and the catheters functioned successfully in each animal for approximately 45 repeated samplings. PMID- 3959540 TI - A boric acid-rodenticide mixture used in the control of coexisting rodent cockroach infestations. AB - Rodent bait combined with a commercially available boric acid compound was found in laboratory experiments to be completely effective in eliminating American cockroaches given the mixture as a food source. The presence of boric acid compound did not interfere with the rodenticidal capacity of the rodent bait. PMID- 3959541 TI - A glass drinking tube for small birds and mammals. AB - A drinking tube was fabricated with a piece of 8 or 10 mm O.D. glass tubing. It gives accurate measurement of the volume of liquid consumed by small birds and mammals. The tube can be readily cleaned and autoclaved. PMID- 3959542 TI - Tissue repair in rat kidney cortex after short treatment with aminoglycosides at low doses. A comparative biochemical and morphometric study. AB - The tissue repair subsequent to aminoglycoside-induced tubular necrosis has been evaluated for five different derivatives given at low doses. Gentamicin, dibekacin, netilmicin, and tobramycin were administered intraperitoneally three times a day at 10 mg/kg per day; amikacin was given intraperitoneally twice a day at 37.5 mg/kg per day. The drugs were administered for 4 or 10 days. Tissue regeneration in kidney cortex was assessed by: the rate of DNA synthesis (i.e., the specific radioactivity of DNA measured 1 hour after intraperitoneal injection of 200 microCi of [3H] thymidine per animal); the occurrence of less differentiated cells estimated by the morphometry of peroxisomes. In mature cells, identified by the presence of drug-induced myelin-like figures, peroxisomes occupied 3.0% of the cytoplasmic area, whereas in less differentiate cells devoid of myelin-like figures, the same organelles made 1.4% of the cytoplasmic area (mean values obtained from 20 treated animals). Gentamicin and amikacin were both shown to induce a dose-related enhancement of DNA synthesis in kidney cortex, except that the latter antibiotic was about 10 times less potent as compared to the former. When the five drugs were compared on the basis of their effect on DNA synthesis after 10 days of treatment, they gave the following ranking: gentamicin (5.6 times the mean control value) greater than or equal to dibekacin greater than netilmicin greater than tobramycin greater than amikacin (1.6 times the mean control value). The differences were less striking after 4 days of treatment. For each antibiotic, sections of proximal tubular cells obtained from four animals treated for 10 days (total surface, 2.10(4) microns2) were scanned for the presence of regenerative tissue (areas poor in peroxisomes). In gentamicin-treated rats, the areas poor in peroxisomes represented more than 18% of the scanned cytoplasmic surface in proximal tubular cells, as compared to about 4.5% in controls. The ranking of the five antibiotics according to the estimated area of undifferentiated tissue in proximal tubules was parallel to that found for DNA synthesis i.e., in gentamicin-treated rats undifferentiated tissue was much more prominent, as compared to amikacin-treated animals (about 6% of the scanned area). Since the relative extent of kidney cortex regeneration induced by each antibiotic at low dose is likely to reflect the degree of tubular necrosis, we conclude that the ranking outlined above indicates a difference in potential nephrotoxicity. PMID- 3959543 TI - Injury to cultured endothelial cells by thrombin-stimulated platelets. AB - In vivo, stimulated platelets may injure the endothelium. We have used cultured endothelial cells to assess endothelial cell damage caused by platelet stimulation with thrombin. Endothelial cells were cultured from umbilical veins and semiconfluent cultures were labeled with Na2 51CrO4. Twenty four hours later washed human platelets (final concentration 200,000 platelets/microliters) and thrombin (final concentration 4 units/ml) were added to the medium and the culture dish was shaken for 15 minutes. The percentage of cells detached from the culture dish and the percentage of 51Cr lost from the endothelial cells into the ambient fluid during the shaking were determined and used as indicators of cell injury. Increased percentages of loosened cells and 51Cr in the ambient fluid were observed with platelet suspension and thrombin compared to controls with neither platelet suspension nor thrombin and controls with either platelet suspension or thrombin. The platelet-free supernatant obtained after reaction of the platelets with thrombin also increased the percentage of loosened cells, but it did not increase the percentage of 51Cr in the ambient fluid to a significant degree. Thrombin alone caused a moderate loss of 51Cr, but no increased loosening of cells. Treatment of the platelets with acetylsalicylic acid prior to the experiment depressed the detachment effect of thrombin-stimulated platelets, but did not alter the effect on the release of 51Cr into the ambient fluid. Scanning and transmission electron microscopy of cultured endothelial cells exposed to thrombin-stimulated platelets confirmed the presence of loosening and injury to the endothelial cells. Thus, platelet stimulation with thrombin had at least two effects on the cultured endothelial cells: a loosening effect caused by material released from the platelets; an injury effect which, in order to reach its maximum, required the presence of stimulated platelets. PMID- 3959545 TI - Endogenous peroxidase activity in human mast cells. PMID- 3959544 TI - Anthracycline effects on actin and actin-containing thin filaments in cultured neonatal rat myocardial cells. AB - Adriamycin (ADR, Doxorubicin) effects on actin and other proteins in cultured neonatal rat cardiac myocytes were investigated. Heart cells were exposed to ADR in doses of 10(-8) M to 10(-5) M for 24 hours. Cells were harvested in 2 mM of Tris buffer containing Triton X-100, homogenized and centrifuged in a microfuge. Parallel dishes of cultured cardiac myocytes were washed in buffered saline and were fixed at 4 degrees C in Karnovsky's fixative. The supernatant solutions were dialyzed and then incubated with pancreatic DNAase I to quantify actin by enzyme inhibition. In parallel studies, both cell supernatant solutions and pellets were subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis and the stained polypeptide bands were quantified by densitometry. Results showed that heart cells exposed to 10(-6) M of ADR for 24 hours had unpolymerized actin levels reduced to 7.7 micrograms/10(6) cells (as measured by DNAase I inhibition or by sodium dodecyl sulfate polyacrylamide gel electrophoresis along with densitometry) compared to 11.0 micrograms/10(6) cells in untreated culture heart cells. When ADR concentration was 10(-7) or 10(-8) M, unpolymerized actin levels were similar to the levels of untreated heart cells. Protein content of extract solutions of untreated and ADR-treated myocytes were 1.2 mg/ml and 0.8 mg/ml, respectively. Gel densitometry of electrophoretograms showed actin to account for 12 to 16% of total density of bands on sodium dodecyl sulfate polyacrylamide gel electrophoresis. Comparative densitometry of ADR-treated cells treated with 10( 6) M of ADR show depolymerized actin to account for 77% of total actin. Ultrastructural results show a large clear cytoplasmic zone of disorganized 12 to 14-nm filaments in cultured myocytes exposed to 10(-6) M ADR. Little change in myocyte ultrastructure was seen at 10(-7) M or 10(-8) M ADR exposure. Data support ADR as a cellular disruptor with toxic effects on cardiac cytoplasmic and contractile proteins and filaments. This ADR effect on heart cells in culture is dose-related. PMID- 3959546 TI - Material constants for a finite element model of the intervertebral disk with a fiber composite annulus. AB - A simple axisymmetric finite element model of a human spine segment containing two adjacent vertebrae and the intervening intervertebral disk was constructed. The model incorporated four substructures: one to represent each of the vertebral bodies, the annulus fibrosus, and the nucleus pulposus. A semi-analytic technique was used to maintain the computational economies of a two-dimensional analysis when nonaxisymmetric loads were imposed on the model. The annulus material was represented as a layered fiber-reinforced composite. This paper describes the selection of material constants to represent the anisotropic layers of the annulus. It shows that a single set of material constants can be chosen so that model predictions of gross disk behavior under compression, torsion, shear, and moment loading are in reasonable agreement with the mean and range of experimentally measured disk behaviors. It also examines the effects of varying annular material properties. PMID- 3959548 TI - A theoretical model of localized heat and water vapor transport in the human respiratory tract. AB - A steady-state, one-dimensional theoretical model of human respiratory heat and water vapor transport is developed. Local mass transfer coefficients measured in a cast replica of the upper respiratory tract are incorporated into the model along with heat transfer coefficients determined from the Chilton-Colburn analogy and from data in the literature. The model agrees well with reported experimental measurements and predicts that the two most important parameters of the human air conditioning process are: the blood temperature distribution along the airway walls, and the total cross-sectional area and perimeter of the nasal cavity. The model also shows that the larynx and pharynx can actually gain water over a respiratory cycle and are the regions of the respiratory tract most subject to drying. With slight modification, the model can be used to investigate respiratory heat and water vapor transport in high stress environments, pollutant gas uptake in the respiratory tract, and the connection between respiratory air conditioning and the function of the mucociliary escalator. PMID- 3959547 TI - Measurement of local mass transfer coefficients in a cast model of the human upper respiratory tract. AB - Local mass transfer coefficients measured using the naphthalene sublimation technique in an acrylic cast model of the human upper respiratory tract are reported as the Sherwood numbers for the corresponding regions. A steady air flow rate of 12 L per min was used for all measurements. Values of the Sherwood number are seen to be highest in the nasal cavity and proximal nasopharynx while a minimum value occurs just downstream from the larynx. Local values of the Nusselt number obtained in the trachea and proximal nasal cavity assuming a complete heat and mass transfer analogy agree well with in-vivo physiological measurements. The mass transfer coefficients found can be incorporated into an analytical model of respiratory heat and water vapor transfer or into a model of pollutant gas uptake in the respiratory tract. PMID- 3959549 TI - O2 transport in cerebral microregions (mathematical simulation). AB - The effects of the circulation rate in capillaries, the intensity of O2 consumption by nerve cells and the capillary network density on the O2 tension distribution in the cerebral cortex have been studied, utilizing a mathematical model simulating actual neuron-capillary relationships. The model has been written as a system of equations in partial derivatives, its solution obtained by the net-point method. Regulatory variations of the capillary circulation rate in certain cerebral microregions have been shown to ensure similar changes in oxygen supply throughout the region. A drop of the pO2 level in a cerebral microregion with a rising O2 consumption by nerve cells is shown to be due, by 75 percent, to the increase of O2 consumption and by 25 percent, to the lower pO2 in the capillaries. Conversely, an increase in pO2 in microregions resulting from a lower O2 consumption by neurons is due by 75 percent, to a pO2 rise in capillaries and by 25 percent, at the expense of an O2 consumption decrease. In cerebral regions differing in capillary network density by 20 percent, changes in the conditions for oxygen supply to tissue are due by 1/3 to pO2 variations in the capillaries and by 2/3 to alterations in the diffusion distances. PMID- 3959550 TI - Stress analysis and failure prediction in the proximal femur before and after total hip replacement. AB - An investigation was performed to determine the effects of the presence of two lengths of proximal Muller prosthesis on predicted failure loads, as compared to those for an intact femur. Three-dimensional stresses in a bone/cement/prosthesis system were determined using finite element methods, with both isotropic and transversely isotropic material properties used for the diaphyseal cortex. Significant increases in prosthesis stem stresses were found when the transversely isotropic material properties were employed in the diaphyseal cortex. This leads to the conclusion that accurate anisotropic material properties for bone are essential for precise stress determination and optimum design in prosthetic implants. Failure loads were also predicted for vertical compression and axial torque, similar to available experimental conditions, and were within the range of the experimental failure data found in the literature. The technique developed herein can be used to systematically assess existing as well as future implant designs, taking into account the complex three-dimensional interaction effects of the overall bone/cement/prosthesis system. PMID- 3959551 TI - Investigation of temperature fields around embedded cryoprobes. AB - The temperature fields around cryoprobes were investigated analytically and experimentally. Two cryoprobes were employed: a spherically shaped general purpose probe utilizing liquid nitrogen and a cylindrical "glaucoma" probe utilizing the Joule-Thomson effect in gaseous CO2. Both probes were operated by commercial cryostats. The analytical solutions included a one-dimensional integral solution for the general purpose cryoprobe, and finite element solutions for both cryoprobes. Both solutions were based on the enthalpy method. Analytical and experimental results compared reasonably well. Deviations of these results are believed to be due, mainly, to the incomplete specification of the boundary conditions on the surface of the cryoprobe. PMID- 3959552 TI - Blood platelet surface interactions on fibrinogen under flow as viewed with fluorescent video-microscopy. AB - The interaction of fluorescently labeled blood platelets with fibrinogen-coated glass was studied in Poiseuille flow at 3 wall shear rates, 40, 80 and 944 s-1. Observations were made via video-microscopy at a distance of 0.5 cm from a tube's entrance over a 1370 microns 2 portion of luminal area. The rates of arrival and detachment, and the net rate of adhesion of cells increased nonlinearly with flow rate. The fraction of arriving cells, first contacts, which adhered without subsequent movement and the fraction of arriving cells which adhered, moved to new positions and then remained adherent, were maximal at 80 s-1. For platelets which adhere and then move to a number of new positions, the likelihood of permanent adhesion is greater than 85 percent. The adhesion process is one in which 40-60 percent of cells permanently adhere on first contact with an additional 30 percent adhering after several moves along the surface. Cells contacting where a platelet was previously adherent had a greater chance of adhering than they would on an unaltered fibrinogen surface. The efficiency of platelet adhesion is greater for second contacts than for first contacts on unaltered fibrinogen coated surface. PMID- 3959553 TI - A sensitivity analysis of the Thermal Pulse Decay method for measurement of local tissue conductivity and blood perfusion. AB - The Thermal Pulse Decay (TPD) method for the determination of local tissue thermal conductivity and blood perfusion rate is based on a comparison of measured with theoretically calculated temperatures. A sensitivity analysis of the theoretical model is performed. This analysis supports the establishment of an experimental protocol which reduces the measurement errors: An "optimal" measurement time interval for typical perfusion rates (up to 6 mL/mL/min) was found to be between 3 and 11 s after the heat pulse is turned off. Within this interval, the maximum error in determination of tissue conductivity and blood perfusion caused by experimental measurement errors is expected not to exceed 5 percent. The presently chosen pulse duration of 3 s is in agreement with the analysis as a good compromise between accuracy and excessive tissue heating. PMID- 3959554 TI - Swing phase simulation and design of above knee prostheses. AB - A detailed dynamic model of the stump-prosthesis system for an above knee amputee was developed. The model was used to examine the influence of controls and design parameters on the limb system performance during the swing phase of gait. The model duplicated the clinically known fact that hydraulic knee controllers allow the amputee to change walking speed while mechanical knee controllers limit the amputee to a single walking speed. Contrary to current practice, the simulations suggest that light weight prosthesis designs do not perform as well as heavier designs. A simple design based on a constant friction knee is shown to yield good overall performance. PMID- 3959555 TI - Sensitivity of insertion locations on length patterns of anterior cruciate ligament fibers. AB - A technique is demonstrated, employing an instrumented spatial linkage, for the determination of the length patterns of discrete fiber bundles within a ligament under controlled loading conditions. The instrumented spatial linkage was used to measure the three-dimensional joint motion. The linkage was also used as a three dimensional coordinate digitizer to determine the spatial location of bony landmarks and the ligament's insertion areas. The length of pseudo fiber bundles was determined as the straight line distance between bone attachments. A comparison is presented, showing good agreement, between elongation patterns obtained from this method and those measured using an instrumented fine wire cable fiber. A sensitivity analysis was performed to evaluate the influence of tibial and femoral attachment location on the length pattern of fiber bundles of the anterior cruciate ligament. It was found that the relationship between fiber elongation and knee flexion depended strongly on the fibers femoral attachment location but not on its tibial attachment location. PMID- 3959556 TI - Wolff's law of trabecular architecture at remodeling equilibrium. AB - An elastic constitutive relation for cancellous bone tissue is developed. This relationship involves the stress tensor T, the strain tensor E and the fabric tensor H for cancellous bone. The fabric tensor is a symmetric second rank tensor that is a quantitative stereological measure of the microstructural arrangement of trabeculae and pores in the cancellous bone tissue. The constitutive relation obtained is part of an algebraic formulation of Wolff's law of trabecular architecture in remodeling equilibrium. In particular, with the general constitutive relationship between T, H and E, the statement of Wolff's law at remodeling equilibrium is simply the requirement of the commutativity of the matrix multiplication of the stress tensor and the fabric tensor at remodeling equilibrium, T*H* = H*T*. The asterisk on the stress and fabric tensor indicates their values in remodeling equilibrium. It is shown that the constitutive relation also requires that E*H* = H*E*. Thus, the principal axes of the stress, strain and fabric tensors all coincide at remodeling equilibrium. PMID- 3959557 TI - Parametric studies on the three-layer microcirculatory model for surface tissue energy exchange. AB - The new three-layer microvascular mathematical model for surface tissue heat transfer developed in, which is based on detailed vascular casts and tissue temperature measurements in the rabbit thigh, is used to investigate the thermal characteristics of surface tissue under a wide variety of physiological conditions. Studies are carried out to examine the effects of vascular configuration, arterial blood supply rate, distribution of capillary perfusion, cutaneous blood circulation and metabolic heat production on the average tissue temperature profile, the local arterial-venous blood temperature difference in the thermally significant countercurrent vessels, and surface heat flux. PMID- 3959558 TI - The effect of alcohol on self-evaluation and perception of negative interpersonal feedback. AB - Recent theories of alcohol use and misuse assume that alcohol alters cognitive perceptual mediating processes that indirectly reduce emotional distress. One view is that alcohol enhances perceptions of control and power. Alternatively, it has been suggested that alcohol is used to reduce self-awareness, perceptions of negative feedback and negative self-evaluations. The purpose of this study was to test these two hypotheses. Forty men, all college students, participated in the study and were randomly assigned to the four conditions in a 2 X 2 balanced placebo design. Subjects interacted with a woman confederate at two points in the procedure: first under positive feedback conditions and then, after beverage consumption, under negative feedback conditions. Both sequences were videotaped and eventually viewed by the subjects. Before and after each interaction period and after the videotape procedure, subjects completed rating forms which assessed their self-perceptions. Whereas perceptions of control and power were diminished when subjects were sober, the ratings of intoxicated subjects remained stable after they received negative interpersonal feedback. Alcohol impaired the perception of negative feedback and reduced negative evaluations of the videotaped sequences. PMID- 3959559 TI - Resilient offspring of alcoholics: a longitudinal study from birth to age 18. AB - This study focuses on child characteristics and on the qualities of the caregiving environment that differentiated between offspring of alcoholics who did and those who did not develop serious coping problems by age 18. The 49 subjects (22 male) are members of a multiracial cohort of 698 children born in 1955 on the island of Kauai, Hawaii, who were followed at ages 1, 2, 10 and 18. In this group, males and the offspring of alcoholic mothers had higher rates of psychosocial problems in childhood and adolescence than females and the offspring of alcoholic fathers. Children of alcoholics who developed no serious coping problems by age 18 differed from those who did in characteristics of temperament, communication skills, self-concept and locus of control. They had also experienced fewer stressful life events disrupting their family unit in the first two years of life. Results of the study support a transactional model of human development and demonstrate bidirectionality of child-caregiver effects. PMID- 3959560 TI - Predictors of outcome type in treated problem drinkers. AB - Fifty successful controlled drinkers, 45 abstainers and 44 relapsers who had been followed up intensively for a minimum of 1 year were compared on 32 pretreatment variables in an attempt to isolate those which would be predictors of outcome type. Treatment was behaviorally oriented, and all subjects except for those with liver damage were left to make their own choice of treatment goal. The results showed that the best predictors of abstinence were: previous contact with Alcoholics Anonymous (A.A.); medium period of previous abstinence; having been initiated to seek help by a specialist; having been a periodic drinker, and drinking exclusively alone or socially. Controlled drinkers were more likely to be continuous drinkers, were not likely to have attended A.A. or to have abstained for a significant period of time, were likely to have relatives with a drinking problem, to have been motivated to seek help by a friend or a relative and to be less discriminating about the social drinking environment. Relapsers were more likely to be unemployed, to have a history of A.A. attendance and to have had a short period of previous abstinence. They were most likely to have liver damage and therefore advised to abstain. The results were interpreted as suggesting that outcome is likely to be influenced by the subjects' cognitions, by past behavioral expectations and experience of abstinence, as well as having the freedom of a choice of goals for recovery. PMID- 3959561 TI - The implications and limitations of genetic models of alcoholism and other addictions. AB - The kind of clear-cut model of the genetic sources of alcoholism perceived by the public and presented in popular tracts does not accurately reflect the state of knowledge in this area. No persuasive genetic mechanism has been proposed to account for accumulated data about alcoholic behavior, social differences in alcoholism rates or the unfolding of the disease. Biological findings about the offspring of alcoholics have been inconsistent and grounds exist to challenge the notion of an enhanced genetic liability for alcoholism that has been accepted wisdom for the last decade. Genuine attempts to forge data and theory into genetic models have been limited to men alcoholics and to a minority of severely afflicted alcoholics with other special characteristics. However, several investigators dispute the idea of a special type of inherited alcoholism affecting only such groups. Even for these populations, balanced genetic models leave room for the substantial impact of environmental, social and individual factors (including personal values and intentions) so that drinking to excess can only be predicted within a complex, multivariate framework. The denial of this complexity in some quarters obscures what has been discovered through genetically oriented research and has dangerous consequences for prevention and treatment policies. PMID- 3959562 TI - Hepatic dysfunction and neuropsychological test performance in alcoholics with cirrhosis. AB - Fifteen alcoholic inpatients who had had a liver biopsy for medical reasons were given a series of laboratory tests and a neuropsychological test battery. Results indicated significant correlations between the biochemical measures of hepatic dysfunction and different aspects of cognitive test performance. PMID- 3959563 TI - Primary men alcoholics with histories of suicide attempts. AB - A structured questionnaire administered to 913 primary alcoholics entering an alcoholism treatment program revealed that 155 (17%) had attempted suicide. Compared to other primary alcoholics, those with histories of suicide attempts were more likely to have had early life difficulties with police, school and parents; reported more misuse of drugs; and were significantly more likely to have an alcoholic or depressed close relative. PMID- 3959564 TI - The perception of empathy in alcoholism counselors. AB - Alcoholic inpatients evaluated the level of empathy demonstrated by a purported alcoholism counselor. Forty-two detoxified subjects viewed a 15-min videotape of a simulated alcoholism counseling session. Subjects had been randomly assigned to one of two groups: Group 1 was told that the counselor they were about to see was a recovering alcoholic whose empathy they were to evaluate. The subjects in Group 2 were given the same instructions; however, the information concerning the counselor's drinking history was omitted. A form of the Barrett-Lennard Relationship Inventory (BLRI) was administered immediately after the viewing. No statistical differences between group means on the empathy subscale of the BLRI were found. This finding does not support the contention that a history of drinking and rehabilitation enhances the perception of counselor empathy among alcoholics. PMID- 3959565 TI - Improvement in men inpatients in an alcoholism rehabilitation unit: a week-by week comparison. AB - The Brief Symptom Inventory (BSI), a 53-item psychiatric symptom checklist, was administered to 57 alcoholic inpatients on days 2, 10, 18 and 26 of their 28-day stay in an alcoholism rehabilitation unit at a Veterans Administration hospital. The results of the test show a steady decline in the patients' psychiatric symptomatology from week 1 to week 4 with the most dramatic improvement evidenced between weeks 1 and 2. PMID- 3959566 TI - Diaphragmatic paralysis and eventration in infants. AB - Twenty-six children with eventration (congenital in 10, resulting from birth trauma in four, and resulting from operative phrenic nerve injury in 12) under 15 months of age were evaluated at a single institution in a 5 year period. There was a high incidence of significant associated anomalies and prematurity. All operative phrenic nerve injuries occurred in patients under 3 months of age, and they were most common in patients undergoing Blalock-Taussig shunt. Plication (12 thoracic, nine abdominal) was performed in 21 patients, 19 of whom had respiratory distress or were ventilator dependent. Repeat plication was required in four patients. All long-term survivors were extubated within 1 week of plication. Of 21 patients undergoing plication, 14 (67%) died. Death was attributed directly to complications of eventration in three patients and was a contributing factor in nine patients. We reached the following conclusions: The incidence of operative phrenic nerve injury in infants undergoing lateral thoracotomy, particularly for Blalock-Taussig shunt, is higher than generally appreciated; plication is a safe procedure as performed by either an abdominal or thoracic approach; failure to achieve extubation within a week of plication is an ominous prognostic sign; mortality in patients with eventration in the presence of major associated conditions may be high despite plication. PMID- 3959567 TI - Regional accuracy of computed tomography of the mediastinum in staging of lung cancer. AB - To determine the regional accuracy of computed tomography of the mediastinum in staging lung cancer, we compared the results of preoperative computed tomographic staging to pathologic findings in lymph nodes taken at mediastinoscopy and/or thoracotomy in 61 patients. Twenty-two patients had adenocarcinoma, 24 had squamous cell carcinoma, eight had large cell tumors, and seven had small cell cancer or mixed cellular types. Sixteen patients had Stage I, eight had Stage II, and 37 had Stage III disease. Thirteen patients had mediastinoscopy only, and the remaining 48 patients had thoracotomy. Computed tomographic staging of the mediastinum as a whole had an accuracy of 88% with a negative predictive index of 96.1%. In examining the differential regional accuracy within the mediastinum we found results in the aortopulmonary window to be inferior to those of other regions, with an accuracy of 80% and a negative predictive index of 83.3%. The reliability of computed tomographic scan staging varied relative to cell type. The accuracy rate in adenocarcinoma was 94.7% compared to 70.6% in squamous cell carcinoma. Computed tomography is accurate for staging the mediastinum in lung cancer, and this accuracy holds over the regions of the mediastinum except the aortopulmonary window. Computed tomography is more accurate for staging adenocarcinoma than squamous cell cancer. PMID- 3959568 TI - Repair of atrioventricular septal defects in infancy. AB - Fifteen infants less than 12 months of age with complete atrioventricular septal defects underwent repair of the defect between January, 1981, and December, 1984. The average age at operation was 8 1/2 months and the average weight was 5.7 kg. Eight of 15 (53%) infants had preoperative mild to moderate mitral insufficiency. Pulmonary artery hypertension was present in all infants and 13 of 15 infants had a pulmonary arterial resistance greater than 4 units (mean 8.8 units). Operative indication was based on pulmonary artery hypertension, congestive heart failure, and failure to thrive. Ventricular distention was utilized during operative repair to assess location of valve incision, level of attachment of valves to the patch, and cleft approximation. It was also used to check the competency of the mitral repair once complete. The average circulatory arrest time was 55.7 minutes. There were no operative deaths. There were two late deaths. We conclude that ventricular distention is the key to the operation, and operative repair is safe in infants with atrioventricular septal defects. PMID- 3959569 TI - Reoperation for failed antireflux operations. AB - Experience with gastroesophageal reflux in patients without prior operations has yielded understanding of pathophysiology, surgical techniques, and results. Less is known about patients with failed antireflux operations. This report of 61 patients undergoing repeat antireflux procedures addresses this issues. Not included are patients with gastroesophageal reflux after ulcer operations or with inappropriate antireflux operations for motility disorders. Group A patients (n = 34) had only one previous operation, Group B (n = 19) had two, and Group C (n = 8) had three or more. Group C had significantly (p less than 0.05) more dysphagia and less heartburn than Group A. This observation correlated with findings from manometry, pH testing, and endoscopy, which showed progressively worse esophageal body function and a greater incidence of severe esophagitis and esophageal leak, but less gastroesophageal reflux, in Group C than B and in Group B compared to A. Operative mortality was 4.9%. Repeat antireflux operations in the 58 survivors were as follows: Group A included 25 standard antireflux procedures and seven bowel interpositions, and 75% were transthoracic. Group B included 16 antireflux procedures and one bowel interposition, and 82% were transthoracic. Group C included four antireflux procedures and three interpositions, and all were transthoracic. Clinical results were excellent or good in 85% in Group A, 66% in Group B, and only 42% in Group C (A versus C, p less than 0.05). Surgical complications increased from 27% in Group A to 75% in Group C (p less than 0.05). CONCLUSIONS: Patients with one prior operation and recurrent gastroesophageal reflux are similar to patients with no prior operations. Results of repeat antireflux operations deteriorate with increasing operations because of impaired esophageal function and progressive tissue destruction. Therefore, second reoperations must be definitive and resection and reconstruction with healthy tissue considered. A transthoracic approach is preferable for first reoperations and mandatory after multiple antireflux procedures. PMID- 3959570 TI - Temporary extracorporeal support of the right ventricle. AB - Six patients having severe right ventricular failure after cardiac surgical procedures were treated temporarily with an extracorporeal pump to bypass the right ventricle. The initial operative procedures included coronary artery bypass procedures with and without concomitant valvular and aortic replacement. A Biomedicus centrifugal pump was used as the right ventricular assist device in most cases. The assist period ranged from 3 to 96 hours, and an intra-aortic balloon pump was used in five of the six patients. All patients initially responded to the right ventricular assist device, four were successfully weaned, and one patient is a long-term survivor. The use of a right ventricular assist device is not difficult or complicated and can be lifesaving for those patients having potentially reversible profound right ventricular failure. PMID- 3959571 TI - Arterial line filtration during cardiopulmonary bypass. Neurologic, neuropsychologic, and hematologic studies. AB - One hundred patients who underwent elective cardiac operations were randomized into two groups. Group 1 had a 20 micron nylon screen filter in the arterial line. In Group 2 no filter was used in the arterial line. Neurologic and neuropsychologic examination of the patients was performed with seven psychometric tests of the Wechsler Memory Scale and the Wechsler Adult Intelligence Scale. These tests were conducted before and a mean of 10 days after the operation. Platelet counts and hemoglobin and total protein levels were measured at the onset and at the end of cardiopulmonary bypass. Two patients died during their hospital stay. Neurologic damage with focal signs was found in the postoperative examination in six patients (three in each group). Twenty-eight patients (28.5%) exhibited signs of mild cerebral dysfunction as assessed by the presence of archaic (primitive) reflexes. Fifteen were in Group 1 and 13 in Group 2 (no significant difference). Sixty patients (61%) had decrements greater than one standard deviation in at least one of the three tests that showed most decreased postoperative scores. There were 32 in Group 1 and 28 in Group 2 (no significant difference). When each test was analyzed individually, there were no significant differences between the two groups. Platelet counts decreased, during cardiopulmonary bypass, a mean of 33% in Group 1 and 34.5% in Group 2 (no significant difference). Both hemoglobin and total protein levels remained virtually unchanged. These results indicate that the addition of a small-pore filter in the arterial line does not prevent the neurologic and neuropsychologic disturbances frequently encountered after cardiopulmonary bypass. The filter itself does not appear to have a direct effect on the blood components. Routine use of an arterial line filter remains questionable. PMID- 3959572 TI - Hydraulic pouches of canine latissimus dorsi. Potential for left ventricular assistance. AB - We have studied the fatigue rates of hydraulic pouches constructed in the form of a multilayered conical spiral using the latissimus dorsi muscle of 17 beagles. The roles that electrical muscle conditioning and early interruption of collateral blood supply have in the prevention of pouch fatigue were evaluated. The length of time that a pouch could generate flow in a hydraulic test system was measured; afterload was set at 80 mm Hg and preload 24 mm Hg. Pouches (N = 3) fashioned from muscles subject to neither electrical conditioning nor a vascular delay generated an initial flow of 990 +/- 346 ml/min, but could sustain flow for only 2.3, 3.8 and 3.6 minutes. Pouches (N = 5) constructed with electrically unconditioned muscles after a vascular delay (median 3 weeks) demonstrated a variable improvement in fatigue rates (initial flow 826 +/- 265 ml/min; time to no forward flow, 2.5, 7.5, 7.5, 10, and 200 minutes). Four of six pouches that received the benefit of long-term electrical muscle conditioning and a vascular delay (N = 6) were able to generate flow for a 4 hour period, at which time the experiment was terminated (initial flow 478 +/- 204 ml/min; final flow 195 +/- 157 ml/min). After the 4 hour fatigue test was completed, one electrically conditioned pouch was placed in series with the heart and served as a counterpulsator. The initial volume of blood pumped by the muscle pouch was 262 ml/min or 13.8% of cardiac output. After the pouch had contracted at a rate of approximately 45 beats/min for 1 hour, the volume of blood pumped was 178 ml/min, or 11% of cardiac output. In three other animals a pouch was fashioned and then left in situ for a 1 to 3 week period before hydraulic testing. These pouches generated significant initial flows (390 +/- 60 ml/min), which demonstrates the feasibility of further study of permanent pouches. These results suggest that permanent electrical muscle conditioning and perhaps a vascular collateral delay might permit an auxiliary skeletal muscle-powered ventricle to assume a portion of left ventricular function. PMID- 3959573 TI - Effect of initial reperfusion temperature on myocardial preservation. AB - The effect of initial postischemic reperfusion temperature on myocardial preservation was studied in the isolated working rat heart model. After baseline measurement of aortic flow rate, coronary flow rate, and heart rate, 40 hearts were subjected to 60 minutes of ischemic arrest at 15 degrees C induced with a single dose of cold potassium cardioplegic solution. Hearts were then revived with a 10 minute period of nonworking reperfusion at 28 degrees, 31 degrees, 34 degrees, or 37 degrees C (10 hearts each), followed by 5 minutes of nonworking reperfusion at normothermia, followed by 30 minutes of working perfusion. Repeat measurements of function were obtained and postischemic release of creatine kinase into coronary effluent was determined. Recovery of aortic flow was significantly reduced at lower initial reperfusion temperatures (75% at 28 degrees C versus 88% at 37 degrees C) and the effect was approximately linear throughout the range studied (p less than 0.05). Release of creatine kinase into coronary effluent was greater at lower initial reperfusion temperatures (421 ImU/min/gm wet weight at 28 degrees C versus 115 ImU/min/gm wet weight at 37 degrees C), also in a linear manner (p less than 0.05). In this model, initial postischemic hypothermic reperfusion is deleterious to cellular integrity and functional recovery of the preserved myocardium. Studies in higher animals and humans are warranted to further evaluate the effect of initial reperfusion temperature on myocardial preservation. PMID- 3959574 TI - Random versus predictable risks of mortality after thoracotomy for lung cancer. AB - Over a period of 12 1/2 years, 476 patients underwent thoracotomy for lung cancer at two affiliated hospitals. Hospital mortality for all patients was 5.25% and for those undergoing pulmonary resection, 5.67%. Hospital mortality is more indicative of true risk than is the 30 day mortality figure, which we regard as arbitrary and misleadingly low. Thirty-seven preoperative risk factors were analyzed for their effects on both morbidity and mortality, and 12 classes of postoperative complications were analyzed for their effect on mortality. All preoperative risk factors together accounted only for 12% of the risk of mortality (R2 by multiple regression analysis). Only three of these factors bore a significant association with mortality: patient age 60 years or over (p less than 0.05), need for pneumonectomy (p less than 0.005), and premature ventricular contractions on the admission electrocardiogram (p less than 0.05). All the listed postoperative complications together accounted for only 28% of the risk of mortality. Of these complications, four showed a significant association with postoperative death: infectious complications (pneumonia and empyema) and cardiovascular accidents (pulmonary embolism and myocardial infarction). In both analyses, the remainder of the risk of death must be attributed either to factors not considered or to purely random factors. It follows that much the greater part of the risk of death from surgical treatment of lung cancer could not be predicted from the preoperative status of the patients. PMID- 3959575 TI - Carpentier-Edwards supra-annular porcine bioprosthesis. Clinical experience and implantation characteristics. AB - The investigational Carpentier-Edwards supra-annular valve was implanted in 592 patients from November, 1981, to February, 1984 (aortic valve replacement in 286, mitral valve replacement in 259, and multiple valve replacement in 47, for a total of 638 prostheses). A previous cardiac operation had been performed in 77 patients (13%). Concomitant procedures were performed in 202 patients (34.1%), including coronary artery bypass in 163 patients. The patient evaluation was 98.6% complete. The early mortality was 7.4% (44 patients) and the late mortality was 6.2% per patient-year (41 patients). The valve-related causes of late mortality were thromboembolism (five), anticoagulant-related hemorrhage (one), and prosthetic valve endocarditis (one). The overall patient survival, including operative death, was 85% at 2 years. The linearized occurrence rate for valve related complications was 5.6% per patient-year (37 events)--thromboembolism 2.7% per patient-year (18) anticoagulant-related hemorrhage 1.2% (eight), prosthetic valve endocarditis 0.8% (five), and periprosthetic leak 0.9% per patient-year (six). There were no cases of primary tissue failure or structural failure. At 2 years, the freedom from valve-related complications was 86.9%, from valve-related mortality, 98.7%, and from valve-related mortality and reoperation, 97.7%. This valve is fixed in glutaraldehyde at low pressure and is designed to improve durability. It has provided a low incidence of valve-related complications without structural failure. The structural design of the prosthesis does not always conform to the anatomy of bicuspid aortic valves. PMID- 3959576 TI - Aortic intramural coronary artery in three hearts with transposition of the great arteries. AB - Three hearts with transposition of the great arteries had an aberrant coronary artery coursing between the aortic and pulmonary roots. This coronary artery remained embedded in the aortic wall for some distance. In each case, on external inspection, the abnormal artery presented as a separate vessel at the site from which it usually originates in the left sinus of Valsalva. Internal inspection showed that in two cases the aberrant coronary orifice was in the posterior sinus, intimately related to the commissure between the left and posterior sinuses. In the third case the orifice was in an ectopic high position above this commissure. Diagnostic and surgical implications of this rare coronary arterial configuration are discussed. PMID- 3959577 TI - Infundibular septum and coronary anatomy in Jatene operation. AB - Displacement of the infundibular septum and coronary anatomy was studied in 40 patients with variable transposition of the great arteries who underwent the Jatene operation between August, 1982, and May, The perioperative mortality was 12.5%. Fourteen of the 16 patients (87.5%) with intact ventricular septum (Group I), eight of the 12 patients (67%) with aligned infundibular septum and perimembranous trabecular defect (Group II-A), and four of the 12 patients (33%) with anteriorly displaced infundibular septum, malaligned defect, overriding of the pulmonary valve, and severe pulmonary hypertension (Group hypertension (Group II-B) has Shaher type 1 coronary anatomy. In this type of coronary anatomy, the left coronary artery courses in front of the pulmonary artery. However, two patients (12.5%) from Group I, four (33%) from Group II-A, and eight (67%) from Group II-B had various unusual coronary patterns, such as Shaher types 2,3,4,7, and 9. All patients had a left or circumflex coronary artery coursing behind the pulmonary artery. These data suggest that the displacement of the infundibular septum not only determines the type of the defect and hemodynamics, but also often relates to the coronary anatomy Removal of a whole, scallop-shaped sinus of Valsalva and minimal dissection of the coronary artery are preferable, particularly for translocation of such unusual coronary anatomy. PMID- 3959578 TI - Surgical approach to severely symptomatic newborn infants with tetralogy of Fallot and absent pulmonary valve. AB - The surgical management of severely symptomatic newborn infants with tetralogy of Fallot and absent pulmonary valve has been controversial, and the results of a variety of operative approaches have not been satisfactory. We report on a technique for the treatment of these patients, which consists of (1) ligation of the main pulmonary artery to eliminate pulmonary regurgitation, excessive right ventricular stroke output, and secondary pulmonary artery dilation and airway obstruction and (2) insertion of a subclavian-pulmonary artery polytetrafluoroethylene shunt to provide pulmonary blood flow. The procedure was used in four neonates. Two patients operated on at 2 and 3 days of age are doing well 15 and 19 months postoperatively. The other two, operated on at 3 and 4 weeks of age after unsuccessful prolonged medical treatment and positive-pressure ventilation, failed to show long-term improvement and died of sepsis and respiratory failure 3 and 5 months after operation. This experience, though limited, suggests that early surgical intervention to control pulmonary regurgitation prevents progressive pulmonary artery dilatation and secondary bronchial compression, decreases the need for prolonged preoperative and postoperative ventilation, and improves the outcome of these critically ill neonates. PMID- 3959579 TI - Surgical treatment of absent pulmonary valve syndrome. AB - The absent pulmonary valve syndrome includes agenesis of the pulmonary valve, annular stenosis, and pulmonary insufficiency. The pulmonary arteries are aneurysmal and usually compress the tracheobronchial tree. These features are associated with a ventricular septal defect and right ventricular hypertrophy. Nineteen children aged 5 days to 11 years were treated between 1976 and 1983. Nine were younger than 1 year. Intractable respiratory symptoms and heart failure were the main features in the infant group; five required preoperative assisted ventilation. Older children had decreased exercise tolerance and repeated respiratory infections. Several surgical techniques were used in this series. The best results were achieved when the size of the main, right, and left pulmonary arteries was reduced by extensive anterior resection; the ventricular septal defect was closed; and an aortic homograft was interposed between the right ventricle and the pulmonary artery. Four infants and four children treated in this way survived the operation. Five of the nine operated infants died (56%); all older children survived the operation. At follow-up, six children were asymptomatic and one was in New York Heart Association Class II. All four infants were progressing satisfactorily although all had some residual pulmonary symptoms. Closure of the ventricular septal defect, reduction of the size of the pulmonary arteries, and insertion of an aortic homograft was the optimal treatment in our series. PMID- 3959580 TI - Delayed sternal closure. An improved method of dealing with complications after cardiopulmonary bypass. AB - Intraoperative closure of the median sternotomy after cardiac operations in patients with complications, including severe postoperative bleeding, impaired cardiac function caused by myocardial edema, and cardiac dilatation, may lead to a critical and possibly fatal deterioration of hemodynamic function. In an effort to prevent this complication, we delayed mediastinal closure in 15 patients, covering the wound temporarily with a sheet of rubber latex (Esmarch bandage). An oval patch of this material was sized and sutured to the skin edges with a continuous suture. This technique provided easy and fast access to the mediastinal structures in four of the 15 patients who required multiple surgical interventions in the early postoperative period. Delayed closure was indicated for severe bleeding in 10 patients, heart compression in four patients, and severe postbypass arrhythmias in one patient. Definitive closure of the chest was delayed until satisfactory hemostasis was achieved or the heart size returned to normal. Thirteen of the 15 patients were long-term survivors, none of them had wound infections, and their wounds healed well. Delayed closure of the median sternotomy was an effective and safe approach in these groups of critically ill patients. PMID- 3959581 TI - Cancer of the kidney invading the vena cava and heart. Results after 11 years of treatment. AB - Between October, 1973, and October, 1983, 18 patients with cancer of the kidney or adrenal gland that had invaded the vena cava, and in 11 cases had reached the heart, were operated on by seven surgical teams. The surgical excision in all patients was performed with extracorporeal circulation, circulatory arrest and deep hypothermia. No deaths occurred. If there are no detectable metastases before operation, the 5 year survival rate is 75% as compared to 6 months with medical treatment. This clinical situation is not uncommon, as 3% to 10% of cancers of the kidney invade the inferior vena cava and 40% of them reach the heart. The possibility of curing the cancers with minimal operative risk should prompt a systematic search for venous invasion with any cancer of the kidney. PMID- 3959582 TI - Timing of abnormal interventricular septal motion after cardiopulmonary bypass operations. Lack of injury proved by preoperative, intraoperative, and postoperative echocardiography. AB - Abnormal interventricular septal motion after cardiopulmonary bypass is a widely known occurrence. The cause and exact timing of this phenomenon remain unclear. We have studied 21 patients prospectively with preoperative, intraoperative, and postoperative two-dimensional and M-mode echocardiograms. Intraoperative studies were obtained with the pericardium closed and open and after completion of procedures performed with cardiopulmonary bypass. Fourteen patients had coronary artery bypass graft operations alone. Six patients had valve replacement with or without coronary bypass, and one patient had removal of a left atrial myxoma. All patients had normal interventricular septal motion before the operation, and none had abnormal septal motion intraoperatively. Four to eight days postoperatively, the septum still thickened normally in all patients, with five patients having normal, nine patients abnormal, and seven patients paradoxical interventricular septal motion. Studies in 11 patients 1 to 4 months postoperatively showed no change from the early postoperative study. The pericardium was left open postoperatively in all patients. Six patients were studied a few hours after sternal closure and all had abnormal interventricular septal motion. We conclude that abnormal interventricular septal motion after cardiac operations is not due to injury of the septum, adhesion formation, or loss of pericardial constraint. Closure of the chest wall itself, with the pericardium left open, is associated with this abnormality. PMID- 3959583 TI - Time course of effective interventional left heart assist for limitation of evolving myocardial infarction. AB - Previous work has shown that if pulsatile left atrial-femoral artery bypass is instituted after occlusion of the left anterior descending coronary artery for from 15 minutes to 2 hours, it can significantly limit the size of the infarct resulting 4 hours later. This study investigated whether pulsatile left atrial femoral artery bypass begun after more clinically pertinent periods of initial ischemia can still significantly limit infarct expansion. After baseline measurements of hemodynamics, tension-time index, and regional myocardial blood flow in 73 open-chest, adult dogs, the left anterior descending coronary artery was ligated for 15 minutes or 1, 2, 4, or 6 hours of unprotected ischemia. In the five control groups, the initial ischemic period was merely extended for another 4 hours. In the five experimental groups, the animals were placed on pulsatile left atrial-femoral artery bypass for another 4 hours after the initial ischemic period. At the end of each procedure, gentian violet was used to identify the area at risk of infarction, and triphenyltetrazolium chloride was used to delineate the area of infarct. The results showed a significant reduction in the area of infarct as a percentage of the area at risk in each bypass group compared with its control group for all ischemic periods of less than 6 hours. These findings suggest that the maximum permissible ischemic time delay for myocardial salvage by pulsatile left atrial-femoral artery bypass is one which is pertinent in a clinical setting. The results justify continued attempts to develop appropriate techniques for percutaneous application of this modality to patients with an evolving myocardial infarction. PMID- 3959584 TI - Mitral valve replacement complicated by unsuspected pheochromocytoma. AB - This report describes the case of a 65-year-old woman who underwent elective mitral valve replacement complicated by a malignantly vasoactive pheochromocytoma. The early recognition of this condition and the importance of immediate and aggressive pharmacologic intervention are discussed. PMID- 3959586 TI - Transapical aortic cannulation. PMID- 3959585 TI - Superoinferior ventricular heart with situs inversus, levo-loop and dextro malposition (I,L,D), and double-outlet right ventricle: a case report. AB - A case of a 20-year-old man with superoinferior ventricular heart complicating situs inversus, levo-loop and dextro-malposition (I,L,D), and double-outlet right ventricle is described. The associated anomalies were hypoplastic right ventricle, ventricular septal defect, atrial septal defect secundum, infundibular and valvular pulmonary stenosis, and mitral regurgitation. Intraventricular conduit repair was successfully performed. PMID- 3959587 TI - Favorable results with the subxiphoid pericardial window technique. PMID- 3959588 TI - Computer implemented digital filtering, scaling and addition for analysing the structure of early somatosensory evoked responses. AB - Computer-implemented digital filters are used to separate the fast wave complexes which are superimposed on slower background waves in human short latency somatosensory evoked responses (SSERs). The choice of filter for picking out the fine structure of the fast wave is shown to be not critical. After scaling and adding digitally filtered SSERs from two electrode montages, the peaks believed to be of cortical origin are cancelled, leaving visible a repetitive wave which must be presumed to be generated subcortically. From this, a new interpretation of the origins of peaks in short latency SSERs is made. PMID- 3959589 TI - A review of, and improvements to, the techniques of trace element analysis of raw water for home dialysis. AB - The optimum operating conditions for the measurement of aluminium and iron concentrations in water by atomic absorption spectrometry have been determined experimentally. The characteristics of an ion-selective electrode for the measurement of fluoride have also been investigated. Contrary to other work, the addition of acid to samples did not improve their storage stability, although the acid-washing of polyethylene containers is recommended for the storage of water. PMID- 3959590 TI - A new hydraulic heart assist device. AB - For the right drive of a hydraulic biventricular assist device (HBVAD), a new lightweight magnet with a permanent magnetic armature was constructed. A miniature optically incremental position sensor was developed, which is an integral part of the control loop of the driving unit, and was incorporated in the armature. Mock circulation tests proved the stability of the drive and showed the expected sensitivity to the preload pressure. In vivo experiments in calves were carried out in order to test its haemodynamic efficiency on a beating and on a fibrillating heart, and to test the mutual interaction of the left and right hydraulic assist devices (LVAD, RVAD) via the vascular system. Both drives were controlled independently, operating in the volume-controlled mode. For the modelling of a heart disease, the heart was blocked by the administration of verapamil (Isoptin). It could be shown that the HBVAD is able to maintain the circulation. Various tests with the left and/or right drive active showed distinct unloading effects for the natural heart and proved the mutual interaction of both drives via the vascular system. An inherent feature of the hydraulic drive system is its ability to be triggered by a (weakly) beating heart. The preload sensitivity of the HBVAD was tested by the administration of adrenaline. Similar reactions of the drives resulted for a beating and for a fibrillating heart, showing the regulation characteristic according to Starling's law. PMID- 3959591 TI - Microvascular replacement: experimental data. PMID- 3959592 TI - Design of a laminar flow chamber to study platelet aggregation. AB - The growing importance of the utilization of artificial materials in cardiovascular surgery makes it necessary to know their thrombogenic capacity. Our flow chamber, which is constructed of methacrylate, is capable of providing a laminar flow. The chamber itself consists of the trunks of two cones, one for the inflow and the other for the outflow, which are joined at their widest point to the ends of a cylinder of the same diameter. In the interior of the cylinder, which constitutes the central part of the system, are placed three rectangular fragments of the material to be studied. The vertices of the trunks of the cones allow the coupling of two flexible siliconized tubes in such a way that the system can be utilized in an "ex vivo' experimental model, constituting a bridge between the femoral artery and the right atrium of a large experimental animal, as well as in vitro, coupled to a continuous perfusion pump. The advantages provided by this system are that: (a) three materials can be studied simultaneously in an identical situation, (b) it is possible to submit these materials to conditions similar to those that give rise to platelet thrombi, and (c) it is possible to quantify the aggregation on each material by labelling the platelets with 111In-oxine. PMID- 3959593 TI - Relationship of endogenous magnesium and calcium levels to oxytocin augmentation. AB - The relationship between plasma levels of magnesium (Mg) and calcium (Ca) and the plasma Ca to Mg ratios has been investigated in two groups of women. One group of 19 women required augmentation of labor with oxytocin and the control group of 50 patients had normal successful labor. The Mg levels in the plasma were significantly higher in those patients requiring oxytocin augmentation of labor and the Ca/Mg ratio was significantly lower. In the control group, 13 out of the 50 patients had Ca/Mg ratios below 3, whereas 13 out of 19 patients requiring augmentation of labor with oxytocin had Ca/Mg ratios below 3. PMID- 3959594 TI - Vitamin B6 and magnesium. AB - Administration of vitamin B6 at doses of 1 and 1.5 g/day, for 2-7 weeks, showed that only the high doses increased erythrocyte magnesium. Similarly, magnesium balance studies in subjects receiving 500, 1,000 and 1,500 mg/day of vitamin B6 for 8 days showed that doses of 1 g or less had no effect upon the intestinal absorption of magnesium. In view of the existence of reversible neurological complications in subjects taking 2 g of pyridoxine per day, the use of very high doses of vitamin B6 must be considered as inadvisable, even if effective. A study of the long-term effects, and upon leukocyte magnesium, of doses of 1 g or less would be desirable. PMID- 3959595 TI - Tissue magnesium in spontaneously hypertensive rats. AB - Magnesium (Mg) is a vasodilator which may play a role in the regulation of blood pressure. The present study measured tissue Mg and calcium (Ca) levels in a hypertension model, the spontaneously hypertensive (SHR) rat, using the Wistar Kyoto rat as a control. Mean serum Mg levels were normal in both types of rats. In SHR rats given H2O ad libitum, four of nine tissues (kidney, heart, lung, bone) had significant 6-16% decreases in Mg content (less than 0.025-0.0005). In SHR rats undergoing chronic saline diuresis, seven of nine tissues (liver, kidney, testis, heart, lung, spleen, bone) had significant 7-18% decreases in Mg content. Tissue Ca in these same rats was significantly decreased by 6-39% in four of nine tissues, but was increased in other tissues. These observations indicate that both Mg and Ca depletion can occur in selected tissues in SHR rats and the number of tissues with Mg depletion doubles during chronic saline diuresis. If Mg depletion is also found in the vascular smooth muscle of this hypertension model, it may be a contributory factor in the hypertension. PMID- 3959596 TI - Magnesium-responsive incomplete distal renal tubular acidosis in patients with liver cirrhosis. AB - In 4 patients with nonalcoholic liver cirrhosis, the incomplete form of distal renal tubular acidosis was demonstrated by the CaCl2 load test. Mg replenishment corrected the acidification defect. PMID- 3959597 TI - Decreased bone magnesium in beta thalassemia with spinal osteoporosis. AB - Low bone Mg concentration was found in a case of beta thalassemia associated with osteoporosis. In the absence of endocrine abnormalities and congestive heart failure, this low bone Mg suggests Mg depletion in uncomplicated beta thalassemia. PMID- 3959598 TI - Clinical hypomagnesemia, coronary spasm and cardiac arrhythmia. AB - The case report demonstrates another case of hypomagnesemia with electrocardiographic evidence of acute myocardial ischemia due to coronary spasm. The patient was successfully treated with intravenous, followed by oral, magnesium sulfate. Magnesium therapy may be justified especially in patients with prolonged QT intervals, cardiac arrhythmias and hypokalemia with hypomagnesemia. PMID- 3959600 TI - A return to time, cells, systems, and aging: IV. Further thoughts on Gompertzian survival dynamics--the neonatal years. AB - In this paper, I attempt to address the problem of how to model the survival curve in the early lifespan years; the neonatal years. I present a general model for a two group population in which the first group represents early stage failure and the second group represents the classical Gompertzian failure. After calculating the instantaneous failure rate for this population, I compare it to the single group Gompertzian with log-linear instantaneous failure rate. The theoretical results are then compared to the known biological data. It is demonstrated that this new model embeds, within itself, a variety of the known biological survival dynamics. PMID- 3959599 TI - Proteoglycans in the substratum adhesion sites of human papillary or reticular dermal fibroblasts. Aging in vivo or in vitro. AB - Sulfate-radiolabeled proteoglycans (PG) have been characterized from the tissue culture substratum adhesion sites of two human dermal fibroblast subpopulations, papillary (PAP) or reticular (RET), to determine the consequences of aging of these cells either in vivo or in vitro upon properties of these cells: matrix interfacing molecules. Cells were isolated from a 1-day-old male infant (patient 5) and a 78-year-old male (patient 8) and, after longterm radiolabeling in culture, detached from the substratum by EGTA treatment. The substratum adhesion sites were then extracted with a mixture of 1% octylglucoside, 1 M NaCl, and 0.5 M guanidine hydrochloride (GdnHCl) in acetate buffer with various protease inhibitors; these reagents quantitatively solubilize PG from adhesion sites and can be readily removed to test biological activities. PAP adhesion sites contained significantly more free chains of glycosaminoglycan than the sites of RET cells. Fractionation on DEAE-Sepharose columns under two different sets of gradient elution conditions [DEAE-I in which only acetate buffer was used; or DEAE-II in which acetate buffers were supplemented with 8 M urea] identified two major classes of PG in both PAP and RET cells - heparan sulfate proteoglycan (HS PG) and chondroitin, dermatan sulfate proteoglycans (CS, DS-PG) - with an increased proportion of HS-PG in cells which had aged in vivo or in vitro (late passage cells also generate a low molecular weight component that resolves on these columns). On DEAE-I columns, 70-80% of the PG forms high molecular weight aggregates that require high concentrations of urea or GdnHCl for further fractionation (DEAE-II conditions). Subsequent fractionation of the two PG classes was performed using three affinity chromatography systems. On platelet factor-4 (PF4) Sepharose columns, the HS-PGs from all cells studied bound completely and eluted with considerable heterodispersity. The CS, DS-PGs from middle-passage cells bound completely to PF4 as well but gave a more homodisperse pattern of elution; in contrast, late-passage (in vitro-aged) adhesion sites contained CS, DS-PGs that were more heterodisperse and that contained a high avidity class. On plasma fibronectin (pFN)-Sepharose columns, the HS-PGs of middle or late-passage cells bound completely and eluted with a homodisperse pattern; in contrast, the HS-PGs from in vivo-aged cells contained 15-20% of their molecules which failed to bind to the column and a small subset which bound with greater avidity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3959601 TI - Fibronectin localization and endocytosis in early and late mouse embryonic fibroblasts in primary culture: a study by light and electron microscopic immunocytochemistry. AB - In spreading fibroblasts, strong endocytosis of exogenous fluorescent fibronectin (FN) was observed from the beginning of their attachment to the substratum. In early fibroblasts, the internalized FN was localized both in the peripheral ruffles and in the perinuclear cytoplasm; in late fibroblasts, whose spreading was slower, FN uptake was not detected in the ruffles. In growing cultures, supracellular FN fibres, detected by direct fluorescence microscopy or by the indirect peroxidase-anti-peroxidase (PAP) complex technique, were scarce on early cells, but very numerous on the upper face and on the filopodia of late cells. At the ultrastructural level, FN, localized with the immuno-gold staining method, was found associated with fibres of the extracellular matrix and the upper face of the cells. FN was endocytosed via smooth vesicles and we suggest that the internalization process is slower in the late cells. In confluent early cultures, an extended network of pericellular FN was observed as usual. The pericellular FN of late grouped cells was present as a few coarse fibres connected with some of the cell surface threads. PMID- 3959602 TI - Age-related changes in the rate of esterification of plasma cholesterol in Fischer-344 rats. AB - Plasma cholesterol and triglyceride levels and selected molecular species of plasma cholesteryl esters and triglycerides were determined in 6-, 12-, 15-, 18-, 21-, and 24-month-old Fischer-344 rats. Lecithin:cholesterol acyltransferase (LCAT) activity was also determined using two independent methods utilizing endogenous and exogenous substrates. Plasma cholesterol levels increased up to 18 months of age and then plateaued. Of the plasma triglyceride molecular species investigated (C50, C52, C54 and C56), only the levels of C52 increased linearly with age. The concentration of other triglyceride molecular species did not change with age. The fractional rate of plasma cholesterol esterification showed a decreasing trend with age, whereas, the net cholesterol esterification rate showed a gradual age related increase. However, this latter parameter remained unchanged with age when the data were normalized for body weight. The cholesterol esterification rates measured using an exogenous substrate (estimating LCAT enzyme levels) showed essentially no change with age. These data indicate that changes in the levels and/or composition of lipoprotein substrate(s) for LCAT are likely causes of the observed age-related changes in the fractional rate of plasma cholesterol esterification. The net esterification rate of plasma cholesterol was significantly correlated with the plasma triglyceride levels when the animals for all age groups were treated as one experimental group. PMID- 3959604 TI - Shear stresses in fluid flow through curved tubes and their applications in extracorporeal circuit design. PMID- 3959603 TI - Monitoring surface EMG spectral changes by the zero crossing rate. PMID- 3959605 TI - Penetration of electric fields into a concentric-sphere model of biological tissue. PMID- 3959606 TI - Automatic apparatus to test electrical safety of electromedical instrumentation. PMID- 3959607 TI - Some properties of spastic ankle joint muscles in hemiplegia. PMID- 3959608 TI - Model of electrical conductivity of skeletal muscle based on tissue structure. PMID- 3959609 TI - When are actively balanced biphasic ('Lilly') stimulating pulses necessary in a neurological prosthesis? I. Historical background; Pt resting potential; Q studies. PMID- 3959610 TI - When are actively balanced biphasic ('Lilly') stimulating pulses necessary in a neurological prosthesis? II. pH changes; noxious products; electrode corrosion; discussion. PMID- 3959611 TI - Effects of alternating magnetic fields and low-frequency electric currents on human skin blood flow. PMID- 3959612 TI - Development of multielectrode impedance plethysmography. PMID- 3959613 TI - Characteristics of skin admittance for dry electrodes and the measurement of skin moisturisation. PMID- 3959614 TI - Optical method for determining the frequency response of pressure-measurement systems in respiratory mechanics. PMID- 3959615 TI - Method for analysing multiple-breath nitrogen washouts. PMID- 3959616 TI - Instrument to indicate acute airway obstruction in remote anaesthesia. PMID- 3959617 TI - Peripheral device for online unit detection and parametering in multiunit recordings. PMID- 3959618 TI - Uncertainties in compartmental analysis studied by linear programming techniques. PMID- 3959619 TI - Calculating the costs of training in primary care. AB - The costs of postgraduate medical education remain a relevant topic for educators and managers as well as for the payors of medical care. Historically, the pervasive problem has been that of identifying education costs in a program that jointly produces patient services and research as well as training. This problem is often approached by an accounting "allocation" of program costs to education. The previous literature on calculating the costs of medical education is reviewed in this paper and the theory related to joint product costing presented as an alternative to the accounting approach. A discussion of the issue centered around an example selected from a teaching hospital outpatient practice is presented. PMID- 3959620 TI - Pediatric nurse practitioner functions in the outpatient clinics of a tertiary care center. AB - Previous research has neglected to delineate pediatric nurse practitioner (PNP) roles in tertiary care settings (TCS). New PNP roles have developed as TCS seek cost-effective solutions to providing quality patient care and to meeting new demands for outpatient care. The authors evaluated the roles of 11 PNPs in eight specialty clinics in a large university TCS. Data were collected from various sources, including interviews, typical day information, and on-site information. Content analysis was used to analyze aspects of the PNP role that are different from other PNP clinic settings that potentially contribute to greater continuity of patient care. TCS PNPs spent less time in direct patient care and more time providing care by telephone, teaching health professionals, consulting, comforting, and counseling. PNPs performed more in-depth counseling (situational crises) and administrative tasks (follow-up, record review) and fewer primary care tasks (physical examinations) than expected. The type of clinic, average patient age, case load, and physician availability modified the PNP role. It was concluded that PNPs have a viable TCS role and contribute to patient care by performing a wide range of functions vital to a multispecialty setting. PMID- 3959621 TI - Estimating medical industry impacts on a regional economy. AB - The authors demonstrate a large-scale, computerized simulation model to estimate the economic impacts of the regional health services industry on a seven-county region in Northeast Minnesota, known as the Arrowhead Region. The model, known as SIMLAB, was developed at the University of Minnesota. SIMLAB is designed to simulate the economic performance of a subnational region. Three scenarios were developed: one to illustrate a regional economy functioning normally, one to show how the area's economy would operate in the absence of its entire health services industry, and one to show the regional economic impacts of the closing of a single major hospital within the region. The first two scenarios were compared, with the differences between them representing the impact estimates for the region. The findings give a graphic demonstration of how vitally important health services are to the region. Without the health sector, the region's total gross output for all industries is estimated to fall by more than $1 billion by 1990. A comparison of the first and third scenarios demonstrates the sensitivity of SIMLAB to smaller but still significant economic dislocations, such as the closing of a single major health care facility. PMID- 3959622 TI - [Determination of the DNA of hepatitis B virus. A new marker?]. PMID- 3959623 TI - [Double disease in rheumatology]. PMID- 3959624 TI - [Contribution of M-mode echocardiography to the diagnosis of auricular myxomas]. PMID- 3959625 TI - [Detection and quantification of adverse reactions on the embryo and the fetus: studies and registries of congenital malformations]. PMID- 3959627 TI - [Non-functional paraganglioma of Zuckerkandl's organ]. PMID- 3959626 TI - [Candidiasis in a university hospital]. PMID- 3959628 TI - [Calcitonin and osteoporosis]. PMID- 3959629 TI - [Infectious sacroiliitis]. PMID- 3959630 TI - [Cushing's syndrome caused by topical administration of betamethasone]. PMID- 3959631 TI - [Myoclonus and electroencephalographic periodic activity in Alzheimer's disease]. PMID- 3959632 TI - [Risk factors in hospital urinary infections. Prospective study]. PMID- 3959633 TI - [Brucellosis: a prospective study of 100 cases]. PMID- 3959635 TI - [Further information on the Vancouver style]. PMID- 3959634 TI - [Renal function in hypoxemia]. PMID- 3959636 TI - [Brucellosis 1985]. PMID- 3959637 TI - [Immunoprophylaxis of the vertical transmission of the hepatitis B virus. An urgent need]. PMID- 3959638 TI - [Intracranial infiltration by multiple myeloma. Description of a case]. PMID- 3959639 TI - [Acute dilatation of IV ventricle: early cause of death in intracerebral hemorrhages]. PMID- 3959640 TI - [Hypercalcemia and pancreatitis]. PMID- 3959641 TI - [Kala-azar and agranulocytosis]. PMID- 3959642 TI - [Streptococcus group A bacteremia and pneumonia in a patient with carcinoma of the oropharynx]. PMID- 3959643 TI - [Ultrastructure of the cryoglobulins]. PMID- 3959644 TI - [Morphologic changes and pathologic anatomy associated with acquired immune deficiency syndrome]. PMID- 3959645 TI - [Acquired immune deficiency syndrome: an infection complicated by more infections]. PMID- 3959646 TI - [First case of acquired immune deficiency syndrome in a drug addict from Seville]. PMID- 3959647 TI - [Acquired immune deficiency syndrome in poor countries: disseminated tuberculosis as opportunistic infection in drug addicts?]. PMID- 3959648 TI - [Salivary testosterone and its applications]. PMID- 3959649 TI - [Use of salivary testosterone in hirsutism]. PMID- 3959650 TI - [Etiology of chylothorax of non-traumatic origin]. PMID- 3959651 TI - [Effects of bezafibrate in patients with combined hyperlipidemia]. PMID- 3959652 TI - [Primary localized nodular pulmonary amyloidosis. Presentation of a case with spontaneous pneumothorax and treatment with colchicine]. PMID- 3959653 TI - [Toxic shock syndrome: presentation of a case]. PMID- 3959654 TI - [A 58-year-old woman with right hydropneumothorax]. PMID- 3959655 TI - [Pulmonary biopsy in the diagnosis of tuberculosis]. PMID- 3959656 TI - [Cyclosporin A and dermatopolymyositis]. PMID- 3959657 TI - [Poisoning by Amanita phalloides: therapeutic aspects]. PMID- 3959658 TI - [Epidermoid carcinoma or keratoacanthoma?]. PMID- 3959660 TI - [Poorly differentiated lymphocytic lymphoma with primary testicular manifestation]. PMID- 3959659 TI - [Acute pancreatitis in adolescents]. PMID- 3959661 TI - [Health care aspects of parkinsonian syndromes]. PMID- 3959662 TI - AIDS and other medical problems in the male homosexual. PMID- 3959663 TI - Social and behavioral aspects of male homosexuality. AB - This article describes some of the social and behavioral aspects of homosexual life styles, with particular reference to their implications for diagnosis, treatment, and continuing medical management. The cultural, psychologic, and sexual variables that may necessitate varying the management of homosexual or bisexual men compared with heterosexual men are emphasized. Areas of psychosomatic involvement, and the influence of social support and stigmatization on presentation and response, are also discussed. PMID- 3959664 TI - Routine care and psychosocial support of the patient with the acquired immunodeficiency syndrome. AB - Due to the magnitude of the AIDS epidemic in San Francisco, centralization of services has been essential for providing maximal patient care and support, and allowing for efficient performance of clinical investigation. While other locales with fewer numbers of documented cases may not have the need for such extensive organization, lessons can be adopted from the San Francisco experience. It is never an easy task to provide routine medical care and psychosocial support for a young patient with an ultimately fatal illness. Close cooperation of the medical establishment and the community at large, with governmental assistance and support, facilitates this difficult undertaking. PMID- 3959666 TI - [Breathing exercises and physical training in cystic fibrosis]. PMID- 3959665 TI - Update on ONCOCIN: a chemotherapy advisor for clinical oncology. PMID- 3959667 TI - [Pain during swallowing and suspected infection in the throat was actually a double lid in the larynx]. PMID- 3959668 TI - [Boutonneuse fever--an unusual disease with difficult diagnosis]. PMID- 3959669 TI - [Epidemiologic study in Ostergotland. Every sixth child has a psychological disorder]. PMID- 3959670 TI - [Skiing injuries are expensive for society. Tibial fracture costs 8200 crowns]. PMID- 3959671 TI - [Severe arterial spasm in a patient after treatment with dihydroergotamine heparin]. PMID- 3959673 TI - [Cardiopulmonary resuscitation--current views]. PMID- 3959672 TI - [A child with severe combined immunologic deficiency dies because of BCG vaccination]. PMID- 3959674 TI - [Differences in the neonatal mortality among the various levels of care in Sweden 1976-1980]. PMID- 3959675 TI - [Physical therapy for better control of defecation is an effective complement to surgery of anal atresia]. PMID- 3959676 TI - [Hernia through the foramen of Winslow--a rare abdominal disorder]. PMID- 3959677 TI - [Sheer madness at Huddinge Hospital: many injuries caused by the revolving door]. PMID- 3959678 TI - [How are the bacteria classified?]. PMID- 3959679 TI - [Aneurysm of the popliteal vein as the source of a lung embolism]. AB - A case of pulmonary embolism secondary to a clinically unsuspected aneurysm of the popliteal vein is presented. The importance of venography in establishing the source of pulmonary emboli is stressed in comparison to other diagnostic investigations such as ultrasonography, computed tomography or pletysmography. The aneurysm was suitable for local venous reconstruction. Previously reported cases are reviewed, etiology, diagnosis and treatment of this uncommon condition are discussed. PMID- 3959680 TI - [Roux-Y reconstruction following distal stomach resection using only staplers]. AB - The spreading of stapled suture techniques has also entailed the utilization of staplers in gastric surgery. A functional, up-to-date, and exclusively stapled reconstruction procedure, Roux-Y-reconstruction, after subtotal gastrectomy was established and analyzed in a pilot study (n = 25). In doing so, one proceeded as follows after subtotal gastrectomy and systematic lymphadenectomy in cases of carcinoma: duodenal closure (GIA or TA30), gastric resection (TA90), jejunojejunostomy (EEA25), gastrojejunostomy (EEA25/28), closure of the projecting efferent loop (GIA). This study intended to achieve the following advantages: increased suture safety, saving of time, reduction of complications, and especially the extension of indications regarding age and localization of the tumor. A special program to eliminate mistakes in handling is required for the sole and systematic application of staplers in the upper gastrointestinal tract. Every complication occurring during and after surgery was carefully recorded in this study and the attainable quality of life after subtotal gastrectomy was assessed. PMID- 3959681 TI - [Functional anatomy of stomach circulation: localizing factors in the pathogenesis of stomach ulcer]. AB - Comparative vertebrate anatomy shows that acid secretion and wall stress processes typically occur in different compartments. In the human single-chamber stomach both processes are physiologically separated in time. If both processes take place in one hollow organ at the same time, focal ischemia will occur. Using the microsphere technique a submucous steal-phenomenon, which the effect is due to, has been reproduced experimentally. A network model of the human gastric vascular bed produces borderline infarcts at the preferred sites of human gastric ulcer. PMID- 3959683 TI - [What surgical significance does pancreas divisum have?]. PMID- 3959682 TI - [Experimental conditions for the reproduction of a submucous steal phenomenon in the dog stomach]. AB - The influence of pentagastrin on gastric blood flow has been investigated using 9 mu-microspheres in dogs. As soon as 6 min after the onset of a pentagastrin infusion blood flow rises in all gastric probes in fasted animals. In dogs, fed two hours previously, such a response can only be seen in the corpus-mucosa areas. Blood flow in the antrum mucosa specimen falls beneath its initial value. This gastric steal-phenomenon takes place at the level of the submucous plexus, as has been shown earlier. PMID- 3959684 TI - [Knee joint exarticulation in arterial occlusive disorders of the lower extremity]. PMID- 3959686 TI - [Treatment of keloids of the head and neck]. PMID- 3959685 TI - [Knee joint exarticulation in arterial occlusive disorders of the lower extremity]. AB - In 35 patients suffering from peripheral ischemic disease of the legs, disarticulation of the knee joint was performed instead of above-knee amputation. Operations were executed primarily or after failed bypass procedures for the salvation of the limb. 24 cases (67%) showed primary or delayed secondary stump healing. In 11 cases (31%), however, no stump healing was achieved due to either a wound infection (4 cases) or a necrosis of the anterior flap covering the weight bearing area of the stump (7 cases). Factors influencing the outcome of stump healing are discussed and different techniques of knee disarticulation are evaluated as to their benefits and disadvantages in ischemic limbs. As the method offers several advantages over above-knee amputation, a more frequent use of knee disarticulation in the surgical treatment of ischemic legs which cannot be preserved by other surgical measures and usually would be amputated at above-knee level is recommended. PMID- 3959687 TI - [Value of cryosurgery in the treatment of malignant nasopharyngeal tumors]. AB - Sixty-one patients with malignant nasopharyngeal carcinoma received combined surgical and radiological treatment between 1965 and 1981. Additional cryotherapy was performed in 14 of these patients. The favourable survival rates of the latter, compared with those who had been subjected to radiological treatment alone, indicate the usefulness of this supplemental therapeutic procedure. Its effect could have purely local causes (destruction of the primary tumour prior to radiotherapy) or possibly involve certain immunological processes already demonstrated in other tumour types. PMID- 3959688 TI - [Anaerobic infections in ulcerating tumors of the head and neck. A contribution to the problem of odors]. AB - Incurable exulcerated head and neck tumours frequently produce a foul odour which is a great problem for patients, nurses and family of patients. This odour is a sign of anaerobic infection in necrotic tumours. Bacteriological examinations in fifteen patients with tumours of the oral cavity, the oropharynx and with recurrent tumours of the hypopharynx and larynx showed anaerobic bacteria. Bacteroides melaninogenicus, B. oralis, B. bivius, Peptococcus and Fusobacterium were most frequently represented. Five cases showed mixed aerobic-anaerobic infections. Foul odour disappeared regularly after a short time by antianaerobic chemotherapy (clindamycin or metronidazole). Foetor is evidently caused by microbial activity of anaerobic bacteria in secondary infected tumours. Antibiotic treatment directed strictly against anaerobes helps to improve quality of life of patients with advanced head and neck cancer with regard to foetor. PMID- 3959689 TI - [High-resolution computer tomography of osseous changes following radical operation of the maxillary sinuses]. AB - The opacification of the maxillary sinuses following Caldwell-Luc procedure seen with plain films depends to a great deal on bony changes. Based on 60 cases the advantages of the computed tomography especially in high-resolution mode are described in comparison with plain films. CT-scans clearly demonstrate the bony changes following Caldwell-Luc procedure, they show the size of the air-filled antrum and reveal inflammation of fibrous soft tissue within the sinus maxillares. Computed tomography facilitates differential diagnosis with regard to other pathological changes of the antrum. If radiological examination following Caldwell-Luc procedure is indicated, CT represents the method of choice. PMID- 3959690 TI - [Functional results following stapedectomy. A 5-year study]. AB - Results of partial stapedectomy with the formation of small fenestra and the use of teflon piston prostheses in the period of 1980-1984 are shown. Particular attention was paid to the group of patients under 18 years of age representing 3.3% of all operated cases, as well as to patients with combined hearing loss. In both groups, functional results of surgery were very good. Of the total of 284 operated ears, there were 20 reoperations. PMID- 3959691 TI - [Arachnoid cysts in the internal ear canal and facial canal (Fallopius)]. AB - We report about 3 patients with a Arachnoidal Cyst in the internal acoustic meatus. The first patient had a cyst deriving from the Falloppian Canal fundus into the cochlea reaching the internal carotic artery. The second cyst we found followed the widened Falloppian canal from the internal acoustic meatus to the region of the oval window with disturbance of the ossicular chain function. The third patient had a Arachnoidal Cyst in the borders of a enlarged internal acoustic meatus. We describe the history and the anatomic situation of the three patients. PMID- 3959693 TI - [Removal of the iliac crest bone]. AB - The paper covers diagnoses indicating removal of bone from the iliac crest, positioning, an approach to the iliac crest, and techniques for removing bone. The hazards incident to the removal of spongiosa, cortical substance, or spongeous-cortical bone chips are described. Haemorrhages from the spongiosa must be staunched carefully with wax plugs or fibrin glue (Tissucol1). Complications such as perforation, hernia, hyperaesthesia, muscular atrophy, and changes in contour are discussed, as well as suitable measures to avoid complications. PMID- 3959692 TI - [Cisplatin ototoxicity. A clinical study]. AB - The ototoxicity of cis-DDP (cisplatin) has been known for some time. It affects the outer and inner hair cells of the cochlea which are damaged. So far, the data laid down in the literature concerning extent and frequency of hearing defects differ widely. In the present study we analysed the ototoxic effect of cis-DDP in 124 patients with different types of carcinoma. We investigated a possible dependence of ototoxicity of the patient's age, the platinum dose, the manner of administration, and of the previously existing audiometric anomaly. In 48% of the patients studied we found a therapy-induced, dose-dependent hearing defect mainly at a high frequency range (4-8 kilohertz). Its degree is influenced by the mode of cisplatin application. The most serious hearing defects were caused by a dose of 100 mg per square metre body surface. The results of our investigations are discussed and compared with those of other clinical studies. PMID- 3959694 TI - Spontaneous enophthalmos from chronic maxillary sinusitis. AB - Spontaneous enophthalmos has been reported to occur after demineralization of the orbital floor from chronic maxillary sinusitis. We report a 24-year-old female who developed spontaneous enophthalmos without demineralization of the orbital floor. A contracture from the maxillary sinus apparently pulled the orbital floor downward. Release of the fibrous tissue through a combined orbital and sinus approach produced satisfactory correction of the enophthalmos without the use of alloplastic implants. This case suggests that fibrotic contraction in the maxillary sinus pulling the floor of the orbit downward can produce spontaneous enophthalmos without boney destruction. PMID- 3959695 TI - Nasal polypectomy and sinus surgery in patients with asthma and aspirin idiosyncrasy. AB - This study attempted to determine whether or not nasal and sinus surgery had a beneficial or deleterious effect upon the asthma of patients with nasal polyps and aspirin idiosyncrasy. There were 205 patients in this study. A classification system was devised to provide a means of determining the severity of asthma before and after surgery. The data indicate that surgery does improve the patient's asthma for relatively long periods of time. PMID- 3959696 TI - Management of facial palsy caused by birth trauma. AB - We present a newborn with a unilateral complete facial palsy caused by birth trauma, and discuss the differential diagnosis, pathophysiology, and management of this common, usually benign, condition. This child made a rapid, complete, spontaneous recovery despite a severe initial injury. Surgical exploration of the facial nerve should be considered only for infants with complete paralysis, clinically and electrophysiologically, who demonstrate no improvement by 5 weeks of age. PMID- 3959697 TI - Hearing aids poststapedectomy: incidence and timing. AB - Ninety-four percent of 508 patients operated on between 1960 and 1975 have been followed-up at yearly intervals. Their status as of 1977 was assessed in order to determine their mean duration of socially adequate hearing levels and to relate the type of surgical procedure to the interval between operation and hearing aid requirement. Postoperative hearing losses due to conduction and sensorineural deficits resulted in preoperative bone/postoperative air gaps greater than 10 dB in up to 40% of large fenestra operations and in 15% of small fenestra operations at 5 years. On average, a large fenestra ear would require amplification at 13 years and a small fenestra ear at 21 years postoperatively. PMID- 3959698 TI - Melanoma of the larynx. AB - Primary laryngeal melanomas (LM) are rare. In a review of all mucosal melanomas of the head and neck (MMHN) at Memorial Hospital from 1949 to 1983 we identified only three such cases. Review of the literature shows that LM usually involve the supraglottic larynx of elderly males. Although survival is as poor as for other MMHN, local recurrence is less frequent, even when primary therapy consists of more conservative surgical procedures than total laryngectomy. PMID- 3959699 TI - Inverting papilloma of the nose and paranasal sinuses. AB - A series of 30 patients with inverted papillomas of the nose and/or the paranasal sinuses is presented. The inverted papilloma is a rare tumor with an overall incidence varying from 0.5% to 4% of all primary nasal tumors. The incidence of inverted papilloma is much more common in the fifth to seventh decades. An association between inverted papilloma and carcinoma is well established. In the large series of patients, the incidence of malignancy associated with inverted papilloma ranges from 1% to 13%, and in our series 10%. Treatment of inverted papilloma is always surgical. The incidence of recurrence is directly related to the method of surgical treatment. Among our 20 patients who were treated by limited surgery, there was recurrence in 14 cases (70%). By contrast, medial maxillectomy and ethmoidectomy via lateral rhinotomy reduced the recurrence rate dramatically. In our opinion this approach is the surgery of choice in the treatment of inverted papilloma. PMID- 3959700 TI - A finite element model of skin deformation. I. Biomechanics of skin and soft tissue: a review. AB - Skin flap design has traditionally been based on geometric models which ignore the elastic properties of skin and its subcutaneous attachments. This study reviews the theoretical and experimental mechanics of skin and soft tissues (I) and proposes a mathematical model of skin deformation based on the finite element method (III). Finite element technique facilitates the modeling of complex structures by analyzing them as an aggregate of smaller elements. This paper gives the results of an animal model developed to study the deformation and mechanical properties of skin, including its viscoelastic properties (hysteresis, creep, and stress relaxation). A new skin extensometer, constructed with digital stepper motors and controlled with a microcomputer, is described to measure these properties for both skin and its subcutaneous attachments. Deformation grids quantitated from photographs with a digitalizing tablet are presented, and computer software is introduced to standardize and analyze them (II). The mathematical model is used to simulate wound closures such as the ellipse and rectangular advancement flap. In addition, a series of mathematical experiments performed to simulate deformation of a strip of skin are described; the relationships between the various elastic constants are investigated; and a comparison of these simulations with actual deformation is presented. Limitations of the model and areas for future investigation are discussed (III). PMID- 3959701 TI - A finite element model of skin deformation. II. An experimental model of skin deformation. AB - Skin flap design has traditionally been based on geometric models which ignore the elastic properties of skin and its subcutaneous attachments. This study reviews the theoretical and experimental mechanics of skin and soft tissues (I) and proposes a mathematical model of skin deformation based on the finite element method (III). Finite element technique facilitates the modeling of complex structures by analyzing them as an aggregate of smaller elements. This paper gives the results of an animal model developed to study the deformation and mechanical properties of skin, including its viscoelastic properties (hysteresis, creep, and stress relaxation). A new skin extensometer, constructed with digital stepper motors and controlled with a microcomputer, is described to measure these properties for both skin and its subcutaneous attachments. Deformation grids quantitated from photographs with a digitalizing tablet are presented, and computer software is introduced to standardize and analyze them (II). The mathematical model is used to simulate wound closures such as the ellipse and rectangular advancement flap. In addition, a series of mathematical experiments performed to simulate deformation of a strip of skin are described; the relationships between the various elastic constants are investigated; and a comparison of these simulations with actual deformation is presented. Limitations of the model and areas for future investigation are discussed (III). PMID- 3959703 TI - Effect of middle ear infection upon the pneumatization of the mastoid: an experimental study in pigs. AB - The suppression of the temporal bone's pneumatized cavities is commonly observed in chronic middle ear inflammatory disease, but this fact has not been explained in respect to its etiology, i.e., whether the poorly pneumatized cavity induces chronic middle ear infection or middle ear inflammatory condition suppresses the pneumatization of cellulae. We studied the effect of middle ear infection and eustachian tubal dysfunction in the early stage of life upon the development of pneumatization of the mastoid using 13 pigs, whose mastoid is comparable to that of man. We used two methods, the eustachian tube stenosis test and the tympanic membrane paraffin infusion test. The present study indicated that in six pigs infection of the middle ear in the early stage of life suppressed the normal development of pneumatization of the mastoid bone in pigs. PMID- 3959702 TI - A finite element model of skin deformation. III. The finite element model. AB - Skin flap design has traditionally been based on geometric models which ignore the elastic properties of skin and its subcutaneous attachments. This study reviews the theoretical and experimental mechanics of skin and soft tissues (I) and proposes a mathematical model of skin deformation based on the finite element method (III). Finite element technique facilitates the modeling of complex structures by analyzing them as an aggregate of smaller elements. This paper gives the results of an animal model developed to study the deformation and mechanical properties of skin, including its viscoelastic properties (hysteresis, creep, and stress relaxation). A new skin extensometer, constructed with digital stepper motors and controlled with a microcomputer, is described to measure these properties for both skin and its subcutaneous attachments. Deformation grids quantitated from photographs with a digitalizing tablet are presented, and computer software is introduced to standardize and analyze them (II). The mathematical model used to simulate wound closures such as the ellipse and rectangular advancement flap. In addition, a series of mathematical experiments performed to simulate deformation of a strip of skin are described; the relationships between the various elastic constants are investigated; and a comparison of these simulations with actual deformation is presented. Limitations of the model and areas for future investigation are discussed (III). PMID- 3959704 TI - Role of aerobic and anaerobic microorganisms in chronic suppurative otitis media. AB - This study reports results of cultures of drainage from 119 cases with chronic otitis media. Mixed infections were found to occur 30 times more frequently among cholesteatomatous cases compared to noncholesteatomatous. A significant association was found between prior use of gentamicin ear drops and bacterial resistance to the drug. The role of aerobes and anaerobes in mixed infections of cholesteatomatous ears is discussed. The relevant literature is critically reviewed and the mechanisms of synergistic anaerobic infections of the ear are summarized. The need for animal studies of bacterial pathogenicity and parallel human studies of response to rational medicinal treatment is stressed. PMID- 3959705 TI - Hard palate reconstruction in maxillectomy. PMID- 3959706 TI - Use of bladder section of blood pressure cuff for neck extension. PMID- 3959708 TI - Cutaneous laser surgery--clinical and laboratory investigation. PMID- 3959707 TI - Comparative skin and RAST test results. PMID- 3959709 TI - Laser treatment of discoid lupus (case report). AB - This is a case report of vaporization of the characteristic disfiguring plaques of discoid lupus erythematosus (DLE) with the carbon dioxide laser. This patient had a dramatic clinical and cosmetic improvement. It is suggested that the altered but not vaporized cells that remained were responsible for the retardation of the disease process. PMID- 3959710 TI - Argon laser treatment of superficial vascular lesions in children. AB - The author's experience in the use of the argon laser in the treatment of superficial vascular lesions in children is reviewed. Deteriorating portwine stains, strawberry hemangiomas, other hemangiomas, telangiectasias, and other lesions are discussed. Their natural histories are discussed. Details are given regarding indications for therapy, techniques, and postoperative results. PMID- 3959711 TI - Toward the ideal treatment for the port wine stain with the argon laser: better prediction and an "optimal" technique. AB - Treatment of the port wine stain with the argon laser still remains more of an art form than a scientific technique. Already, some very satisfactory results are being obtained, and these will be improved by greater accuracy in predicting those patients who will respond well to argon laser therapy and by the development of an optimal treatment technique. PMID- 3959712 TI - Treatment of cutaneous and deep vascular lesions with the Nd:YAG laser. AB - This study intends to document and evaluate the first compiled experience in the treatment of both cutaneous and deep vascular lesions using the Nd:YAG laser. Thirty-eight patients were treated over a 5-year period from 1979 to 1984 using the Nd:YAG laser with FDA approval. Lesions included capillary, cavernous, combined capillary-cavernous hemangiomas, portwine stains, arteriovenous malformations, lymphangiomas, multiple telangiectasias, and one case of Klippel Trenaunay-Webber syndrome. The number of treatments per patient ranged from one to four. Partial or complete resolution of these various lesions, as evidenced by a decrease in size, and/or normalization of pathologic cutaneous changes was noted in a majority of patients. While both the argon and CO2 lasers have been well studied in the treatment of cutaneous vascular lesions, this is the first compiled series reporting results using the Nd:YAG for such problems. The Nd:YAG laser represents an alternative modality in the treatment of cutaneous hemangiomas and introduces an efficacious method in the treatment of cavernous vascular lesions. PMID- 3959713 TI - Argon laser photocoagulation of port wine stain hemangiomas. AB - A total of 66 patients with port wine stains is reported. All of these were tested and 46 patients treated (80 treatments). Good to excellent results (significant lightening of color and/or smoother texture of skin) was achieved in 74% of tests (0 scar) and in 82% of treatments (4.3% scar). Treatment results correlate well with test spots but vary somewhat as the lesions are not homogeneous and skin textures vary. The lowest energy density commensurate with successful treatment should be used to reduce the incidence of scarring. Future methods of manipulating the PWS may make it possible to achieve better results with less scarring. Teenagers fared well in this series, while the problem of successful treatment in the young child remains unsolved. PMID- 3959714 TI - Preliminary investigation of KTP/532 laser light in the treatment of hemangiomas and tattoos. AB - Preliminary investigation of a frequency-doubled YAG laser (KTP 532 nm) manufactured by Laserscope of Santa Clara was undertaken. Twenty-five patients with either port wine hemangiomas or decorative tattoos were treated with a 532 nm light and the results compared to argon laser at identical power settings. Clinical and histological results were identical between the two lasers. PMID- 3959715 TI - Argon and neodymium YAG laser therapy of dark nodular port wine stains in older patients. AB - Thirty-seven patients of mean age 52 with large dark nodular port wine stains were treated with argon and neodymium YAG lasers. The level of patient satisfaction was high (mean 7.1 on scale of 10) despite residual color in 36 of 37 patients. It was possible to accomplish flattening of the lesion and removal of nodules in all patients. In four patients, it was necessary to use neodymium YAG laser for removal of residual large vascular nodules following previous argon therapy. Twenty-nine patients required a mean number of 1.6 retreatments for residual tufts of vessels. An unusual finding was that of recurrent color deepening of lesion in three patients after initial improvement. This recurrence responded to treatment. Spontaneous bleeding or bleeding initiated by trauma such as shaving was a problem noted in 13 out of 37 patients. PMID- 3959716 TI - The "chemo-laser" technique for the treatment of decorative tattoos: a more complete dye-removal procedure. AB - A technique embodying the use of chemical agents and the argon laser was developed in the 1981-1982 that provides for a more complete removal of tattoo dye with one treatment. The number of visits for the laser treatment to the patient is reduced to two or three treatment sessions, compared to five to eight visits previously required. The area of "chemo-laser" approximated the normal skin without hypertrophic scar tissue more than the areas of multiple or heavy laser treatment. PMID- 3959717 TI - Application of photodynamic therapy in plastic surgery. AB - Photodynamic therapy is a technique for administering a sensitizer, hematoporphyrin derivative, which is selectively retained in malignant tissue. This is then activated by light, usually of 630 nm resulting in selective deterioration of the malignant tissue. This technique has been used for detecting and treating a variety of cancers in experimental animals and human beings. In plastic surgery, it has been applied to both basal and squamous cell carcinomas as well as to other skin lesions. Metastatic deposits will also respond to this treatment. Advantages include ease of treatment, sometimes requiring little or no anesthesia, low incidence of reactions, ability to repeat the treatment any number of times, and sparing of normal tissue. Photodynamic therapy has been used as a salvage operation, to clear tissue of suspected or probable remaining malignant disease, and to alleviate the need for a radical operation, allowing a more conservative one. Photodynamic therapy continues to be an investigational tool, and it should be used only as an adjunct to commonly accepted techniques, and then only when needed. Common disadvantages include a severe photosensitivity of the patient for several weeks following administration of the drug as well as inability to treat adequately bulky tumors. New techniques of administration and methods of activation will make this an increasingly common and useful tool in the practice of plastic surgery. PMID- 3959718 TI - Treatment of keloids and hypertrophic scars with an argon laser. AB - A report is given on the treatment of keloids and hypertrofic scars using an argon laser. Of the 45 patients who participated, only three patients had a diminishing of over 50%, and 40 patients were classified as obtaining slight improvement, which means a diminishing of between 20 and 50% of the original keloid. Twenty-seven patients showed no change after treatment with the argon laser and one patient had a poorer result, due to a complication after the last treatment. Directly after treatment, most keloids showed an obvious shrinkage. After several days, however, the keloids became the same size as before treatment. Decrease of tension of the skin after treatment seems to influence the result favorably. We find the best response to treatment with an argon laser in long narrow keloids (hypertrofic scars). In general, the results are disappointing, especially because until now the literature claims good results on this subject. PMID- 3959719 TI - Is there an optimal laser treatment for port wine stains? AB - Optimization of laser treatment of port wine stains (PWS) is discussed from the standpoint of heat production. Laser wavelength, irradiation time, heat conduction, and external epidermal cooling are the variables considered in conjunction with absorbing and scattering behavior of a PWS-model consisting of epidermis, dermis, and ectatic blood vessel. Ideal treatment is defined as minimal heating of the epidermis and upper dermis, but with irreversible damage to the capillary wall. The analysis shows that irradiation times of 1-10 ms in conjunction with external epidermal cooling may give optimal results. The wavelength of choice is 577 nm, followed by 540, 415, 560, and 500 nm (argon laser). The ruby and Nd-YAG lasers are predicted to damage the epidermis and dermis at all times when the capillary is coagulated. Concurrent cooling to prevent epidermal-dermal damage is also recommended here. The CO2 laser is predicted to be the worst laser and, according to our analysis, should not be used to treat PWS. Both upper dermal and capillary destruction can only result from heat conduction from the damaged epidermis and external cooling cannot be applied here. PMID- 3959720 TI - Possible hazards from irradiation with the carbon dioxide laser. AB - Previous investigators, using relatively high irradiance levels, have been unable to demonstrate viable tissue in the plume during carbon dioxide laser vaporization. Our study was undertaken to reinvestigate this possibility, particularly at the lower irradiance levels that are currently in clinical use. Fresh post-mortem skin was injected with a known quantity of bacterial spores and vaporized at different levels of irradiance and energy fluence. The plume and splatter were collected and cultured. Spores were found following the vaporization of five of 13 specimens treated at an irradiance of less than 500 W/cm2, while there were none in the 20 specimens treated at an irradiance of greater than 997 W/cm2. These results show that the widely accepted assumption that the carbon dioxide laser produces a sterile field may be false and that viable particles may be disseminated during vaporization at low irradiance. This may be important when considering the treatment of potentially infectious lesions. PMID- 3959721 TI - Effects of argon, dye, and Nd:YAG lasers on epidermis, dermis, and venous vessels. AB - The aim of the present study, which was performed at the dorsal aspects of the ears of guinea pigs, was to compare effects of different lasers on epidermis, dermis, and small venous vessels. Irradiations were performed with argon, dye, and Nd:YAG lasers. In the first series tissue repair processes were studied after argon laser application. Laser defects were excised after 1, 4, 8, and 14 days and were prepared for routine histological examination. The breadth of epidermal defect and extent of dermal coagulation and occlusion of vessels by thrombus formation were examined histologically. In a second series parameters of irradiation (ie, exposure time, laser power) of the three different lasers were changed systematically. Laser-induced morphological tissue changes could be best observed 24 hours after irradiation. Each of the lasers led to occlusion of vessels by thrombus formation and also coagulated epidermis and dermis. The extent of dermal and epidermal coagulation was less pronounced after dye laser application. Using short exposure times it was possible to reduce the extent of epidermal damage caused by argon and Nd:YAG lasers. Only 50-msec dye laser pulses led to intravascular thrombus formation without epidermal and dermal damage. PMID- 3959722 TI - Tunable dye laser (577 nm) treatment of port wine stains. AB - Despite steady improvement in the laser treatment of port wine stains (PWS), hypertrophic scarring remains a serious side-effect in approximately 10% of patients. The tunable dye laser (577 nm) has been shown to cause selective vascular destruction in normal and PWS skin. We have treated ten patients using a tunable dye laser (577 nm, 300 mu sec) resulting in clearing of the PWS without any evidence of hypertrophic scarring. Treatment requires no anesthesia or wound care, and there were no postoperative infections. PMID- 3959723 TI - [Normal stomach emptying and its disorders]. PMID- 3959724 TI - [Protection of the gastric mucosa by prostaglandins--is this physiologic concept suitable for ulcer therapy?]. PMID- 3959725 TI - [Follow-up diagnosis in peptic ulcer]. PMID- 3959726 TI - [The values of parameters in acute kidney failure in a clinical evaluation]. PMID- 3959727 TI - [Pollinosis in the area of Dubrovnik]. PMID- 3959728 TI - [Ulcer disease in patients with cirrhosis of the liver]. PMID- 3959729 TI - [Echocardiographic detection of a penduncular tumor formation (probably a thrombus) in the right atrium in a patient with congestive cardiomyopathy]. PMID- 3959731 TI - [Biologic availability of oral preparations of diclofenac]. PMID- 3959730 TI - ["Atypical" auscultation findings in mitral stenosis]. PMID- 3959732 TI - [Surgical treatment of nephrolithiasis--intrasinus pyelotomy]. PMID- 3959733 TI - [The intensity of pain and pleasure in childbirth as factors in the quality of childbirth]. PMID- 3959734 TI - [Obesity]. PMID- 3959735 TI - [Analysis of the quantitative characteristics of dermatoglyphics in gonadal dysgenesis]. PMID- 3959736 TI - [Kidney growth in children with vesicoureteral reflux]. PMID- 3959737 TI - [Etiologic factors in the onset of degenerative changes in the knee joint]. PMID- 3959738 TI - [Relation between the degree of respiratory tract obstruction and electrocardiographic changes in patients with chronic obstructive lung disease]. PMID- 3959739 TI - [Diagnosis and therapy of atypical ventricular tachycardia. 7 case reports]. PMID- 3959740 TI - [Lingual thyroid]. PMID- 3959741 TI - [Systematic and selective use of streptokinase in acute myocardial infarct]. PMID- 3959742 TI - [Characteristics and the use of blood transfusions and blood components in patients with hemostasis disorders. I. Transfusion of blood and plasma]. PMID- 3959743 TI - [Treatment and prevention of viral hepatitis]. PMID- 3959744 TI - Chronic administration of clomipramine inhibits morphine hot plate analgesia. AB - Clomipramine, chronically administered in mice, for 3 days, inhibits partially but significantly morphine analgesia in the hot plate test, when used at dose of 10 mg/kg/day, i.p.; 2.5 and 5 mg/kg/day were ineffective. Neither higher doses (20 and 40 mg/kg/day) nor longer duration of pretreatment (8 and 16 days) modified the intensity of this inhibition. Reduction in morphine analgesia was obtained after a 24h delay between the last injection of clomipramine and that of morphine (30 min before testing), while clomipramine did not induce any antinociceptive effect and clomipramine and desmethylclomipramine plasma and brain levels were low or undetectable. These results provide new evidence for the interaction between clomipramine and the endogenous opiate system. A pharmacokinetic interaction between clomipramine and morphine was excluded; involvement of change in opiate and 5 HT2 receptors by chronic administration of clomipramine is discussed. PMID- 3959745 TI - Neuropathology and amphetamine-induced turning resulting from AF64A injections into the striatum of the rat. AB - The putative specific cholinergic neurotoxin AF64A was prepared by a micro-scale procedure which afforded the neurotoxin in greater than 95% purity and was microinjected unilaterally into the striatum of male albino rats. The AF64A injected animals displayed amphetamine- and apomorphine-induced ipsilateral turning indicating disruption of normal striatal pathways. These turning effects were absent in the control injected animals. Histological examinations of the brains revealed that AF64A in amounts as low as 1 nmole produced regions of necrosis in the striatum in some cases extending along the cannula tract up to and including the cortex. These results indicate that the striatum is highly sensitive to relatively low doses of AF64A, and that consideration should be given to the possibility of gross tissue damage when interpreting behavioral data. PMID- 3959746 TI - Effects of methylphenidate and pentobarbital on the spontaneous activity levels of rats with selective hippocampal system damage. AB - The effects of various types of experimentally-induced neural damage involving selective areas of the hippocampal system on spontaneous non-operant activity were studied in adult male rats using stabilimeter apparatus. A hierarchy of lesion-induced activity increases relative to sham-lesioned controls was revealed in which colchicine-induced dentate granule cell lesions produced the greatest increase in activity and kainic acid-induced pyramidal cell lesions produced the least. Methylphenidate (0.2, 0.4, 2.0, 4.0, 8.0 mg/kg) tended to increase this activity in a dose-dependent manner while pentobarbital (0.5, 1.0, 5.0, 10.0 mg/kg) tended to decrease it. These results indicate that such neural damage does not sufficiently alter the responsivity of rats to these drugs to produce a "paradoxical" effect although some lesion group differences in drug responsivity were seen. All this is discussed in light of the neuro-architecture of this system. PMID- 3959747 TI - Hypotensive and renal effects of an extract of the edible mushroom Pleurotus sajor-caju. AB - An aqueous extract of Pleurotus sajor-caju was found to have a hypotensive effect in rats. Intravenous infusion of the extract into rats caused a decrease of the mean systemic blood pressure in a dose dependent manner. A typical dose of 25 mg of the extract decreased the mean systemic blood pressure from 110 mm Hg to 70 mm Hg. The systolic and diastolic pressure changed proportionally with minimal alteration in heart rate. The hypotensive effect of the extract was not due to its major electrolyte content because a solution reconstituted with the same electrolyte composition had a transient pressor effect rather than lowering the blood pressure. The same extract was also found to affect renal hemodynamics such that it caused a decrease in the glomerular filtration rate by more than 50% after 120 minutes. The effect did not seem to be mediated through changes in systemic blood pressure. PMID- 3959748 TI - Aerosolized leukotriene D4 converts monkeys that are negative aerosolized ascaris responders to positive airway responders. AB - We designed studies to determine if Leukotriene D4 (LTD4) could alter airway reactivity such that rhesus monkeys with positive skin reactivity and consistently negative airway responses would respond to ascaris airway challenge. The experiments were complicated by the observation that aerosolized LTD4 would occasionally increase airway hyperreactivity in some monkeys used as controls such that an airway response occurred to saline, the diluent for ascaris antigen. In spite of this, we were able to demonstrate induction of airway responsiveness to ascaris antigen. These results demonstrate that LTD4 will induce airway hyperreactivity to a nonspecific stimulus such as aerosolized saline or to an allergen. PMID- 3959749 TI - In vivo modulation of brain cholesterol level and learning performance by a novel plant lipid: indications for interactions between hippocampal-cortical cholesterol and learning. AB - In this account we report in vivo effects of a plant lipid preparation (MMPL) on brain cholesterol and the activity and learning performance of aging male rats. Three-month-old rats were fed for 3 months with a diet that was enriched with 3% MMPL. Another group of 18 month-old rats was fed for 6 months with a 3% MMPL enriched diet. This food regime lowered markedly the cholesterol level in the hippocampal and cortical regions and increased their lipid membrane fluidity. The animals of both age groups also responded to MMPL with a higher activity and their learning performances, compared to normal diet-fed animals, improved notably. This improvement continued at least 4 months after terminating the supply of MMPL. Significant inverse correlationships were obtained between the length of the training period required to attain proper criteria and cholesterol levels of the hippocampal and cortical brain fractions. PMID- 3959751 TI - Alternating lateralization of plasma catecholamines and nasal patency in humans. AB - The nose receives both sympathetic and parasympathetic innervation that is manifested by the alternating dominance of sympathetic activity on one side with concurrent parasympathetic dominance on the other. This ultradian rhythm of autonomic function, known as the nasal cycle, averages 2-3 hours in length. Previous experiments have shown that the nasal cycle is correlated in an inversely coupled fashion to the alternating dominance of activity in the two cerebral hemispheres, suggesting a common mechanism of regulation. Here we show that there is an alternation in catecholamine levels of blood drawn from anticubital veins that may also correlate with the nasal cycle. Radioenzymatic measurement of norepinephrine, epinephrine, and dopamine in blood sampled simultaneously from both arms every 7.5 minutes for periods of 3-6 hours demonstrated alternating high levels of catecholamine in one of the two arms. This alternating lateralization of neurotransmitters was observed in 7 out of 7 experiments using resting human male subjects. The ratio of norepinephrine in the two arms also parallels the pattern of airflow in the nasal cycle. This study suggests that the autonomic nervous system may alternate in activity through paired structures. PMID- 3959752 TI - High affinity [3H]imipramine binding and serotonin uptake to platelets of adolescent females suffering from anorexia nervosa. AB - High affinity [3H]imipramine binding and [3H]serotonin uptake to platelets were investigated in 17 anorexic females aged 15-18 years as compared to 15 healthy females of similar ages. A significant decrease in the density of [3H]imipramine binding sites was observed in anorexics as compared to controls (368 +/- 40 vs 517 +/- 38 fmoles/mg protein, p less than 0.01). No alteration in Kd values or in the kinetic parameters of serotonin uptake (Vmax, Km) were noted. The fact that the decrease in imipramine binding is not accompanied by a parallel reduction in serotonin uptake might indicate that anorexia nervosa is not ultimately related to major depression and that the imipramine binding site is not identical to the serotonin uptake site. PMID- 3959750 TI - 3H-5-hydroxytryptamine accumulation by rat brain synaptic vesicles in a membrane impermeant medium, and selective reduction by 5,7-dihydroxytryptamine. AB - In order to examine possible selectivity of amine uptake by synaptic vesicles, the ATP-stimulated accumulation of 3H-5-hydroxytryptamine (5HT) by synaptic vesicles from rat whole brain was examined in a medium comprised largely of membrane-impermeant anions (d-tartrate). Such media have previously been shown to stabilize vesicular accumulation of several neurotransmitters. Accumulation of 3H 5HT did not occur in tartrate medium alone, but was increased biphasically with increasing concentrations of both potassium phosphate and potassium bicarbonate. At optimal concentrations of each anion (10 mM), stable accumulation of 3H-5HT was observed at 37 degrees (26.1 +/- 1.2 pmol/mg protein; Km 6 X 10(-7) M), which was reduced by greater than 95% in the absence of K2ATP, at 4 degrees C, in the presence of 10(-6) M reserpine, or in the presence of the proton ionophore carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP). Uptake was significantly antagonized by millimolar concentrations of Na+, Mg++ or Cl-, but was unaffected by ouabain (10(-5) M). Pretreatment of animals with 5,7 dihydroxytryptamine (5,7-DHT) (200 micrograms, intraventricular) 10 days prior to sacrifice reduced endogenous 5HT levels by 70%, while levels of endogenous norepinephrine (NE) and dopamine (DA) were unaffected. Accumulation of 3H-5HT, examined in the presence of 10(-6) M NE to block 3H-5HT accumulation by vesicles from noradrenergic nerve endings, was reduced by 40% in vesicles from treated animals. Vesicular accumulation of 3H-(-)-NE and 3H-DA was unaffected by 5,7-DHT treatment. The data suggest the possibility of preferential accumulation of 3H 5HT by vesicles arising from serotonergic nerve endings. PMID- 3959753 TI - Structure-activity relationships of enkephalins containing serially replaced thiomethylene amide bond surrogates. AB - An isomeric series of four leucine-enkephalin analogs containing the thiomethylene ether unit as an amide bond replacement in all positions have been prepared by solid phase methods. The resulting pseudopeptides divulged widely differing retentive behaviors on reversed phase high performance liquid chromatography (HPLC). An analog containing the Phe psi[CH2S]Leu dipeptide replacement at the 4-5 position exhibited binding close to the parent, leucine enkephalin; its guinea pig ileum (GPI) activity was the highest of the analogs tested. Another compound, Tyr psi[CH2S]Gly1-2]-Leu-enkephalin, also displaced 3H etorphine well in the binding assay, but caused increased contractions in the GPI assay at low concentrations. The Phe psi[CH2S]Leu results are not compatible with the necessity of a beta-turn structure for agonist activity in the GPI assay. PMID- 3959754 TI - Analgesic effect of metoclopramide and its mechanism. AB - Metoclopramide produced a significant analgesic effect when tested by both acetic acid induced writhing and hot plate test. This effect was reduced by naloxone suggesting opioid involvement. Further, bromocriptine which inhibits the release of PRL attenuated the effect of metoclopramide indicating that this drug could act by releasing PRL. The unaltered analgesic effect of metoclopramide by yohimbine reveals that alpha-2 adrenoceptors may not be involved in this action. PMID- 3959755 TI - Non-opiate and peripheral-opiate cardiovascular effects of morphine in conscious dogs. AB - Morphine is generally regarded as having a centrally mediated depressant effect upon the cardiovascular system. We report here that in chronically instrumented conscious dogs, morphine produces a biphasic response; heart rate and mean arterial pressure initially increase followed by a reduction to below baseline levels. Differential inhibition by naloxone (NAL) and methylnaloxone (MRZ), a quaternary opiate antagonist which does not readily enter the CNS, suggests that the initial pressor response is mediated peripherally, while the latter occurring vasodepressor and bradycardic responses are mediated centrally. The initial tachycardia was not inhibited by NAL or MRZ, suggesting that this response is mediated by a non-opiate mechanism. PMID- 3959756 TI - Evidence for an underlying opponent process during morphine elicited hyperactivity in the hamster. AB - Two experiments investigated the effects of naloxone on morphine elicited hyperactivity in the hamster. In Experiment 1, naloxone (0.4 mg/kg) administered two hours after morphine (15 mg/kg) produced sedation in animals running at high rates under the influence of morphine. Saline control animals running at comparable rates were unaffected by naloxone. In Experiment 2, naloxone administered two hours after morphine converted morphine elicited hyperactivity into sedation. These results are discussed in terms of a modified dual-action hypothesis which holds that morphine elicited hyperactivity masks an underlying opponent process. PMID- 3959757 TI - A muscarinic receptor type in human lymphocytes: a comparison of 3H-QNB binding to intact lymphocytes and lysed lymphocyte membranes. AB - Human blood lymphocytes from normal blood donors exhibited specific binding of the muscarinic antagonist 3H-quinuclidinyl benzilate (3H-QNB). The 3H-QNB binding to intact viable lymphocytes as well as to lysed lymphocyte membranes "P2" was saturable and displaceable by both muscarinic agonists and antagonists. For the lysed lymphocyte membranes "P2" a single binding site with a Bmax of 109 pmol/g protein and a Kd of 15 nM was obtained. Intact viable lymphocytes also showed one binding site with a Kd of 24 nM and a Bmax of 1556 pmol/g protein. The higher Bmax value might be explained in terms of uptake of the ligand when using intact cells or through loss of binding sites when using lysed lymphocyte membranes "P2". IC50 values were lower by a factor of 10(2) for atropine and scopolamine and by 10(4) for pirenzepine when lysed lymphocyte membranes "P2" were used instead of intact viable lymphocytes. PMID- 3959759 TI - The apo E/apo CIII molar ratio affects removal of cholesterol ester from modified human lipoproteins injected into cebus monkeys. AB - The removal of postprandial (PP) and postabsorptive (PA) human LDL and HDL cholesterol was examined in cebus monkeys (Cebus albifrons) following in vitro labelling of these lipoproteins by 3H-cholesterol in the presence or absence of DTNB. The removal of LDL cholesteryl ester was 3.5 and 2 times greater than that of HDL in male and female monkeys, respectively. Incubation with DTNB reduced cholesteryl ester removal by 45 and 52% for LDL and HDL, respectively. Cholesteryl ester from PA lipoproteins was removed 80% faster than that PP particles only when plasma was incubated without DTNB. Cholesterol removal from these lipoproteins was positively (r = 0.941) and significantly (P less than 0.001) correlated with the molar apo E/apo CIII ratio. The data suggest that density of lipoproteins was less important than their apoprotein composition in dictating their removal from circulation. PMID- 3959758 TI - Cations decrease specific [3H]-spiroperidol binding in human prefrontal cortex. AB - Ligand binding at many physiologically relevant receptors is regulated by divalent cations. To determine whether [3H]-spiroperidol binding sites in prefrontal cortex might be physiologically relevant receptors, we examined the effect of ions on the binding of this ligand in postmortem human prefrontal cortex. Our results indicate that several cations decreased [3H]-spiroperidol binding in a dose-dependent fashion. Of these, Cd++ and Zn++ were the most able to decrease [3H]-spiroperidol binding with IC50 of 5.5 +/- 2.4 X 10(-6)M and 5.6 +/- 1.1 X 10(-5)M respectively. These findings indicate that [3H]-spiroperidol may bind at physiologically relevant receptors in human prefrontal cortex. PMID- 3959760 TI - Stimulation of 3H-norepinephrine release by trifluoperazine from rat pineal glands. AB - Trifluoperazine (5-200 microM) stimulated the release of 3H-NE from isolated whole pineal glands in a dose dependent manner. Trifluoperazine-induced release was not dependent on extracellular Ca++, whereas 60 mM K+-evoked release was attenuated in the presence of EGTA and zero Ca++ Krebs. 60 mM K+ and 50 microM trifluoperazine produced an additive effect on 3H-NE release. Clonidine (5 microM) significantly reduced trifluoperazine-induced release by approximately 50% in the presence of Ca++, and in its absence, clonidine significantly attenuated the trifluoperazine response by 42%. Thus trifluoperazine may be acting upon the alpha 2 receptor or intracellular stores of Ca++. These intracellular interactions remain for further study. PMID- 3959761 TI - Ultrasonic vocalization in rat pups: effects of early postnatal exposure to haloperidol. AB - The effects of prolonged postnatal administration of haloperidol (H) on ultrasonic vocalization elicited by the removal of rat pups from their nest were investigated. The results show that the number of ultrasonic calls was significantly reduced by H exposure from the 8th until the 14th day after birth. Conversely, this neuroleptic significantly increased the duration of ultrasound from the 4th up to the 16th day of age. Moreover, changes in the frequency of calls were produced by early postnatal treatment with H. These alterations could be due to an impaired functional maturation of the dopaminergic system produced by neonatal exposure to H. Furthermore, the present data suggest that ultrasonic vocalization may be considered as an early sensitive indicator of subtle changes elicited by the postnatal treatment with a dopamine receptor blocking agent at dose levels below those associated with overt signs of neurotoxicity. PMID- 3959762 TI - Pimozide blocks establishment but not expression of cocaine-produced environment specific conditioning. AB - Two experiments were conducted to examine the effects of pimozide on cocaine produced conditioning to a specific environmental context. On 8 treatment days, 12 rats were injected with cocaine (10 mg/kg i.p.) and 12 with saline prior to placement for 60 min into a test chamber outfitted with infrared emitters and detectors. Following each treatment session the saline group received cocaine in their home-cages and the cocaine group received saline. Cocaine produced a significant increase in vertical activity on treatment days. On test days all rats received saline. Significantly greater vertical activity was observed in the group previously receiving cocaine in the test environment. All rats then received 8 more treatment sessions. On saline test days, pimozide (0.4 mg/kg i.p.) pretreatment failed to antagonize expression of the conditioned effect. In experiment 2, pimozide was given prior to treatment and no evidence of conditioning was seen on saline test days. Thus, pimozide blocked the establishment but not the expression of cocaine-produced environment-specific conditioning. These results suggest that during conditioning, the effects of cocaine on dopaminergic neurons may have produced a change that subsequently influenced behaviour even when dopaminergic systems were blocked. PMID- 3959763 TI - Age-dependent enhancement of diazepam sensitivity is accelerated in New Zealand Black mice. AB - Separate age groups of C57BL/6 and autoimmune New Zealand Black (NZB) mice were compared for diazepam-induced ataxia and barbiturate-induced loss of righting reflex. Between 1 and 3 months of age, both strains showed a similar age-related decrease in ED50 for diazepam-induced ataxia. However, between 3 and 12 months the decrease in ED50 was markedly greater in NZB mice. In contrast, age-related increases in the durations of loss of righting reflex following hexobarbital or barbital were similar in both strains. The results suggest that NZB mice show relatively accelerated age-related increases in sensitivity to benzodiazepine, but not to barbiturates. PMID- 3959765 TI - HPLC measurement of testicular long chain acyl-CoA synthetases with different substrate specificities. AB - Acyl-CoA synthetase activity with various long chain fatty acid substrates was measured in microsomes from rat testes, isolated spermatids and testes of hypophysectomized adult rats, using reversed-phase high performance liquid chromatography (HPLC). The spectrophotometric HPLC method produced results comparable to those of parallel radiometric assays and was highly specific for acyl-CoA products. At optimal pH and cofactor concentrations, specific activity from whole testis was similar for 18:1, 20:4 and 22:5 but somewhat lower for 16:0 over the substrate range 0.01-3.2 mM. Activity from spermatids or from testes of hypophysectomized rats was much lower with 22:5 than with 18:1 or 20:4, whereas activities with 18:1 and 20:4 were similar at all substrate concentrations. All substrates exhibited Michaelis-Menten type saturation kinetics and linear Lineweaver-Burke plots at lower substrate concentrations but inhibited activity at higher concentrations. Apparent values of KM for 16:0, 18:1 and 20:4 were more than twice that of 22:5, whereas both observed and calculated maximum velocities were similar for the four fatty acids. Differences in pseudokinetic parameters and differential expression of the testicular acyl-CoA synthetase activities with different fatty acids suggest the presence of multiple enzymes, at least one of which may be hormonally regulated. PMID- 3959764 TI - Stimulation of a neutral triacylglycerol hydrolase from rat heart by phosphatidylethanolamine and lysophosphatidylethanolamine. AB - Triacylglycerol hydrolase activity measured at pH 7.5 in a pH 5.2 precipitate fraction from rat heart was increased two- to three-fold by the presence of phosphatidylethanolamine (PE) or lysophosphatidylethanolamine (LPE). This stimulatory effect also could be obtained in assays with particulate and soluble subcellular fractions and was observed with two different methods of preparing triolein substrate emulsions. Ethanolamine and glycerophosphorylethanolamine had no effect on hydrolase activity, whereas phosphatidylcholine (PC) and acidic phospholipids such as cardiolipin were inhibitory. Palmitic acid, palmityl CoA and palmityl carnitine inhibited PE-stimulated hydrolase activity, but ethyl esters of palmitate had no effect. The preparation of acetone-ether powders resulted in a marked reduction of triacylglycerol hydrolase activity, but PE and LPE now stimulated hydrolase activity by ten-fold or greater, suggesting that these phospholipids may have an obligatory role in modulating triacylglycerol hydrolase activity. Triton X-100 also stimulated hydrolase activity in acetone ether powders. PMID- 3959766 TI - Papers from the H.W. Kircher Memorial Symposium on chemistry biosynthesis and function of sterols. 76th AOCS (American Oil Chemists' Society) annual meeting. Philadelphia, Pennsylvania, May 1985. PMID- 3959768 TI - The chemistry of lipid peroxidation metabolites: crosslinking reactions of malondialdehyde. AB - Malondialdehyde reacts readily with amino acids to form adducts containing vinylogous amidine linkages. Crosslinking reactions between nucleic acid bases and amino acids induced by malondialdehyde also have been investigated. The physical data obtained for the adducts provide structural information on the possible mode of crosslinking of proteins and nucleic acids induced by this lipid metabolite. PMID- 3959767 TI - Oxysterols: chemical synthesis, biosynthesis and biological activities. AB - As a class of compounds, oxysterols have demonstrated a wide variety of biological properties. Due to the general interest in these compounds, new methods of chemical synthesis have been developed to provide them for biological investigation. The specific inhibition by oxysterols of cholesterol biosynthesis in mammalian cells has been shown to result primarily from a decrease in cellular levels of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity. Recent evidence suggests these cellular responses may be mediated by an oxysterol binding protein found in the cytosol of many lines of cultured cells. In certain instances, oxysterols have been shown to be produced in biological systems. These results support the supposition that oxysterols may regulate sterol biosynthesis at the cellular level. Included herein are the inhibitory effects of 9 alpha, 11 alpha-epoxycholest-7-en-3 beta-ol cholest-8-en-3 beta-ol-7-one and cholest-8-en-3 beta-ol-11-one on HMG-CoA reductase activity and their relative affinities for a cytosolic binding protein. PMID- 3959769 TI - Hydroxymethylglutaryl-CoA reductase, a key enzyme in phytosterol synthesis? AB - Hydroxymethylglutaryl-CoA reductase (HMGR) regulates the synthesis of mevalonic acid (MVA), the precursor of the myriad of isoprenoid compounds functional in plant cells, with phytosterols representing one class of major importance. Recently, it has shown possible to solubilize and purify the membrane-bound enzyme from a heavy membrane fraction (P 16,000 x g) isolated from a cell-free homogenate of etiolated radish seedlings. What is presently known about the molecular and kinetic properties of radish HMGR is reported. Mevinolin, a highly specific competitive inhibitor of HMGR, has been valuable as a research tool in studying the regulatory role of HMGR activity for the growth and development of intact seedlings and cell cultures. The results obtained indicate a primary effect of mevinolin on phytosterol accumulation, whereas other endproducts of the multibranched isoprenoid pathway, such as ubiquinone in the mitochondria or chlorophylls and carotenoids in the plastids, are less or not at all affected. This and other data can be interpreted to mean that the organelles are autonomous in their capacity to synthesize MVA. Since the mevinolin-induced drop in free sterol accumulation is paralleled by significant plant growth retardation, a rate limiting role of HMGR activity for phytosterol synthesis and normal development of plants is suggested. PMID- 3959770 TI - Distribution of glycosphingolipids of monkey small and large intestinal mucosa. AB - The ganglioside and neutral glycosphingolipid composition of adult monkey small and large intestinal mucosa were characterized and compared. GM3, GM2 and GD1A were found to be the principal gangliosides in each of these tissues. Dihexosylceramide was the major neutral glycosphingolipid of both organs. The total content of gangliosides and neutral glycolipids/ceramide, however, was ca. four-fold and two-fold higher, respectively, in small intestinal than colonic mucosa. While all glycosphingolipids examined contained hydroxy and nonhydroxy fatty acids, the former fatty acids accounted for 60-90% of the total fatty acids in both organs. Sphingosine was the predominant long chain base of ceramide, mono , di-, tri- and tetrahexosylceramide, whereas phytosphingosine was the major base of GM3 in both tissues. The results of these studies demonstrate that while many similarities of monkey small and large intestinal glycosphingolipids exist, qualitative and quantitative differences are present along the length of the monkey gut. These differences may be at least partially responsible for certain of the well-recognized variations in normal physiological and pathological processes that occur in these organs. PMID- 3959771 TI - Distribution of glycosphingolipids and ceramide of rat small intestinal mucosa. AB - Previous studies have suggested that glycosphingolipids may be involved in a number of physiological functions of the small intestinal mucosa. Regional variations in many of these processes exist along the length of this organ. In the present studies, the glycosphingolipid and ceramide composition of the proximal, middle and distal thirds of the rat small intestine were characterized and compared. Mono- and trihexosylceramide were the major neutral glycolipids and hematoside (GM3), the principal ganglioside of this organ. Monohexosylceramide was the major glycolipid of the proximal segment, whereas trihexosylceramide predominated in the distal segments. The total content of neutral glycolipids, ceramide and gangliosides as well as the content of the individual glycosphingolipids and ceramide were highest in the distal segment, intermediate in the middle and lowest in the proximal segment. Additionally, regional variations were noted in the fatty acid composition of the major glycosphingolipids. These differences in the composition of glycolipids and ceramide along the length of the intestine may be responsible, at least partially, for the regional functional specialization seen in this organ. PMID- 3959772 TI - Comparison of fatty acids and lipids of smolting hatchery-fed and wild Atlantic salmon Salmo salar. AB - In Atlantic Canada the Atlantic salmon Salmo salar change from the parr stage to the smolt stage while still in fresh water, preparatory to migration to salt water. In some stocks this takes place during the second overwintering. In several hatcheries where the water temperature drops to 0-0.5 C and the ponds ice over, there is a high incidence of erosion of the dorsal and pectoral fins and sometimes of the caudal fin. No disease organism has been identified, and the lesions heal over in most cases. Dietary fatty acids were thought to be a factor. A detailed study of lipid recoveries and classes has shown that in the skins of abnormal fish the total lipid is 7.8% compared to 4.7% in control fish. Unexpectedly, an analysis of one lot of healthy smoltstage wild fish showed that whole bodies have only a quarter of the lipid of comparable hatchery fish. Comparison of fatty acids showed that wild fish lipids include a higher proportion of arachidonic acid than those of the hatchery fish. In the latter, linoleic acid is provided readily by diet but the elongation to arachidonic acid evidently does not proceed. These results suggest that the smolt lipid is involved intimately with either the cause of the dermal lesion or is a defense mechanism, possibly mediated through oxygenase activity. PMID- 3959773 TI - Retention of linoleic acid in carcass lipids of rats fed different levels of essential fatty acids. AB - Rats of an inbred Sprague-Dawley strain were fed purified diets with low (0.3% of total energy), normal (3%) or high (10%) content of essential fatty acids (EFA) for at least three generations. Two 30-day-old rats with similar weights were chosen from one litter. One was killed; weight increase and food consumption of the other rat was measured for 15 days. Total lipid content and fatty acid composition in total lipid and lipid classes were determined in both rats. Seven pairs of rats from each group were treated in the same way. Calculations based on amount of linoleic acid ingested and retained in the carcass lipids showed that 50% of the ingested linoleic acid was retained in the low EFA rats compared to 10 15% in the normal and high EFA rats. PMID- 3959774 TI - Formation of complexes between lecithin and apovitellenin I, an avian egg-yolk apoprotein. AB - In a study of lipid-protein interactions in egg yolk, it was found that L-alpha dipalmitoyl lecithin gave two distinct noncovalent complexes (A and B) with apovitellenin I, an apoprotein in the major yolk lipoprotein. Interaction took place under widely varied conditions, and yolk lecithin gave similar complexes. Complex A, which was formed within minutes, consisted of round particles of about 9 nm diameter. Complex B, which was formed more slowly, consisted of larger particles, possibly resembling curved discs, with diameter of 30-40 nm. The preparation and some properties of these complexes are described. It is suggested that they may be suitable for an extensive study of phospholipid-protein interactions in yolk. PMID- 3959775 TI - Effects of essential fatty acid administration on cardiovascular responses to stress in the rat. AB - This study examined the effects of 18:2(n-6), 18:3(n-6), 20:4(n-6) and 18:3(n-3) on cardiovascular responses to isolation stress in male rats. Group-acclimated rats were fasted for 2 days, then placed on a fat-free diet. Two wk later animals were divided into six groups (six animals per group) and given eight-wk intraperitoneal osmotic pumps releasing 1.47 X 10(-7) mol/hr of either olive oil (OL), or of 18:2(n-6), 18:3(n-6), 20:4(n-6) or 18:3(n-3) in OL. Another group received dummy pumps. Two wk after pump implantation, animals were isolated for four wk. Blood pressure (BP), heart rate and body weight were followed before and during stress. Following the stress period, animals were assessed for cardiovascular reactivity to norepinephrine (NOR) and angiotensin (ANG). Prior to isolation, 18:3(n-6) lowered BP vs OL (p less than 0.01). Stress increased BP within 24 hr in all groups except 18:3(n-6) and 20:4(n-6). Treatment with 20:4(n 6) vs OL prevented the BP rise (p less than 0.001) only for the first two wk of stress. Administration of 18:3(n-6) vs OL prevented any BP increase over the four wk stress period (p less than 0.001). Stress increased heart rate in all groups except 20:4(n-6). Heart rate was lowered by 18:3(n-6) vs OL (p less than 0.01) before and during stress. Vascular reactivity to NOR was unaffected by treatment, but OL and 18:3(n-6) decreased responses to ANG infusion. These data suggest that 18:3(n-6) supplementation attenuates cardiovascular responses to chronic stress, and that delta 6- and delta 5-desaturase activity are inhibited during chronic psychological stress. PMID- 3959776 TI - A method for isolation of milk fat globules. AB - The traditional procedure for isolating milk fat globules involves repeated cycles of centrifuging to obtain globules and redispersion of them in fresh buffer to eliminate other milk components. We have evaluated a simpler, less manipulative method whereby globules are centrifuged out of the milk and through an overlying buffer layer. Human milk samples ranging from 0.1 to 35 ml were centrifuged at 1500 X g for 20 min after deposition under a suitable quantity of buffer. This yielded purified globules, in less time, which could be dispersed more satisfactorily than those by the traditional procedure. Protein, phospholipid and cholesterol contents of globules by the two methods were quite similar. A lower protein content (10.4 vs 13.2 mg/g of lipid) was characteristic of globules prepared by the multiple wash method. However, large differences could not be seen in gel electrophoresis patterns of the proteins. By using plastic centrifuge tubes, tube freezing and cleavage just below the globule layer enables clean separation of globule and nonglobule phases for analysis of milk component distributions. Macro (5 to 35 ml of sample) and micro (200 microliter or less) versions of the method are described. Limited trials showed that the method can be applied satisfactorily to cow's and goat's milks, but for highly pure globules a deeper buffer column than that used with human milk is required because of their much higher casein content. PMID- 3959777 TI - Two geometrical isomers of linoleic acid: improved total syntheses. AB - The total syntheses of 9(Z),12(E)- and 9(E), 12(Z)-octadecadienoic acids have been carried out. A useful intermediate in both syntheses, 8-bromo-octanoic acid, recently has become available from commercial sources. This compound has been used to expedite the preparation of these isomers. The remaining carbon atoms were derived from propargyl alcohol along with either 1-heptyne or acetylene and 1-bromopentane. Because the overall yield for each sequence was roughly 15% and there were no extraordinary reaction conditions in any of the synthetic steps, the compounds could be prepared readily in multiple gram quantities. The syntheses of the two compounds were supported by data from a variety of spectroscopic techniques. PMID- 3959778 TI - Informed of consent in medical research. PMID- 3959779 TI - Professional medical negligence in Southern African legal practice. PMID- 3959780 TI - How much risk is duty for the health care practitioner? PMID- 3959781 TI - Mental health services in U.S. correctional facilities. PMID- 3959782 TI - Medicolegal aspects of transsexualism in Western Europe. A comparative review. PMID- 3959783 TI - Man and microbe in the 1980s--a challenge? PMID- 3959784 TI - Chemical screening and prediction of bacteriuria--a new approach. PMID- 3959785 TI - The effect of carbon tetrachloride-induced cirrhosis of the liver on fibrinogen bound sialic acid and sialyltransferase activity in the rat. PMID- 3959786 TI - Intrinsic factor antibody detection and quantitation. PMID- 3959787 TI - Simple immunoassays for salivary and plasma steroids. PMID- 3959788 TI - Spot blood glucose determination: a new method and its application to home monitoring. PMID- 3959789 TI - Control of stirring rate on commercial magnetic stirrers. PMID- 3959790 TI - Diphtheroid-like properties of Mycoplasma arthritidis. PMID- 3959791 TI - Heat treatment before biochemical analysis of AIDS risk samples. PMID- 3959792 TI - [Experimental evaluation of the the possible use of 99mTc- and 133mIn-labelled aminomethylene phosphonates for skeletal scintigraphy]. AB - The pharmacokinetics of 99mTc and 113mIn labeled aminopolymethyl phosphonic acids was studied in experiments on animals. Noticeable osteotropism of these compounds was shown. Scans of the rabbit and rat skeleton in health and experimental pathology 1 h after i.v. administration of these compounds were obtained making it possible to reveal the affected foci. PMID- 3959793 TI - [Radiation therapy of malignant eyelid tumors]. AB - The authors presented the short- and long-term results of brachytherapy and combined radiotherapy in 348 patients with malignant eyelid neoplasms localized in the lower eyelid in 187 patients, in the upper eyelid in 99, in both eyelids in 4, in the inner angle of the eye in 39 and in the outer angle of the eye in 10 patients. A single focal dose was 1.5-2.5 Gy, a total dose 45-80 Gy with relation to tumor prevalence and histological structure. The eyeball was protected with the help of a lead lens ("eye prosthesis") and a universal tungsten membrane. The devices ensured nearly 100% protection of the eyelid against ionizing radiation. Direct clinical cure was noted in 342 patients, partial tumor resorption in 6 patients. Three-year recurrence-free survival was noted in 330 patients (94.8%), five-year survival in 319 (92.8%). PMID- 3959794 TI - [Direct and immediate results of the radiation and combined treatment of laryngeal cancer with local use of metronidazole]. AB - The paper is concerned with the results of radiation and combined therapy of 122 patients with Stage III-IV laryngeal cancer, divided into 2 groups: 74 controls and 48 patients of the study group. The patients of the study group received radiotherapy in combination with local administration of 5% solution of metronidazole in dimethyl sulfoxide. According to biopsy findings, the average concentration of metronidazole in tumor was 569.5 +/- 196 micrograms/g. Therapeutic results were evaluated by the degree of expression of tumor radiation injury and by direct and short-term results. A statistically significant increase in the frequency of Stage IV tumor radiation injury from 31.1 +/- 5.4% in the control group to 58.3 +/- 7.2% in the study group (P less than 0.05) was revealed. The direct and short-term therapeutic results indicate an increase in tumor radiation injury in the patients of the study group. PMID- 3959795 TI - [Combined treatment of the diffuse form of pigmented villonodular synovitis]. AB - Pigmented villonodular synovitis is a specific lesion of the synovial membrane of the joint and bursal mucosa. In recent years it is frequently regarded as tumor like disease. The problem of therapy of the diffuse form of the disease is yet to be solved. Recurrence rates after partial synovial capsulectomy remain high (33 46%) as well as after operation combined with radiation therapy. The authors summed up their experience in combined therapy of pigmented villonodular synovitis. The method was used in 24 patients with the diffuse form of the disease, ranging in age from 15 to 62. In 18 of 24 patients the process affected the knee joint, in 6 patients the articular bones were involved in the process. Partial synovial capsulectomy with subsequent development of recurrences was recorded in 14 patients' history. Total synovial capsulectomy was performed at the first stage; in knee joint involvement the operation was supplemented by meniscectomy. gamma-beam therapy followed operation in 3-4 weeks. Radiotherapy was necessitated by the fact that elements of the affected synovial sheath could not be completely removed even in total synovial capsulectomy. Irradiation was given from 2 fields, a single focal dose being 1.2-1.5 Gy, 5 fractions a week; a summary focal dose reached 16-20 Gy. A follow up period lasted from 6 mos to 6 yrs. Complete convalescence was noted in 23 patients. Occupational rehabilitation was achieved in 21 patients. In 2 patients the functional outcome was considered to be satisfactory. The data obtained indicated to a high efficacy of combined therapy of the diffuse form of pigmented villonodular synovitis and the appropriateness of the use of radiotherapy in the postoperative period. PMID- 3959796 TI - [Restoration of the skin of mice following damages cause by ionizing radiation and hyperthermia]. AB - The half-period of mouse skin regeneration after sublethal injuries caused by hyperthermia (44 degrees C) was 2.9 h and completed within 16-24 h. The half period of regeneration after sublethal injuries caused by ionizing radiation was 2.1 h at a dose of 5 Gy and 4.3 at a dose of 20 Gy. The rate of mouse skin regeneration after sublethal injuries caused by exposure to ionizing radiation only and in combination with hyperthermia at similar levels of injury did not differ. PMID- 3959797 TI - [Dose-time correlation in the irradiation of the lung of piglets for evaluating a model of human radiogenic pneumopathy]. AB - Dose-time relationships with respect to a pulmonary radiogenic reaction were studied in 62 improved-breed pigs aged 3 mos. with the mass of 20-30 kg. The animals received fractionated irradiation with 60Co. Irradiation and its doses were computed in a way similar to that used in clinical practice. Clinical evidence, respiration rate, chest x-ray, histological and biochemical investigations of pulmonary tissue served as quantitative criteria of pulmonary lesion. ED50 was determined, i.e. a dose at which 50% of the experimental animals fell ill. The number of fractions produced a greater effect on an isoeffect curve than the entire period of irradiation. The pulmonary radiogenic reaction in pigs could be expressed by the calculation D approximately N0,32 T0,05. A possibility to introduce the results of the experiments on pigs into clinical practice allows practical use of the dose-time relationships obtained in the experimental studies. PMID- 3959798 TI - [Morphometric cellular characteristics of the inflammatory infiltrate in nonirradiated and irradiated rectal cancer]. AB - A morphometric analysis of the inflammatory infiltrate cells of the stroma and adjacent tissue of adenocarcinomas of the rectum was performed in 40 patients. As to therapeutic modality, the patients were divided into 4 groups of 10 patients in each. The 1st group was given surgery only, the 2nd group preoperative gamma therapy at a dose of 19.5 Gy, the 3rd 30 Gy and the 4th 40 Gy. Integral fractions of lymphocytes, plasmocytes and eosinophils were determined on randomly selected sections using the point counting technique. It was shown that in adenocarcinomas of the rectum integral fractions of the above cells had similar values irrespective of tumor macroscopic shape, degree of differentiation and growth depth. Cellular reactions in the adjacent tissues were more noticeable than in tumor itself, and numerical values of the integral fractions of inflammatory infiltrate cells depended on growth depth. After irradiation a decrease in the lymphocyte integral fraction and an increase in the plasmocyte integral fraction were noted both in the stroma and adjacent tissues. PMID- 3959799 TI - [Microroentgenographic study of the pancreatic vessels in terminal states]. AB - The authors summed up the results of a study of the peripheral vascular channel of the pancreas on the autopsy material using microroentgenography. It was shown that the vascularization of the pancreas in patients who died from cardiovascular insufficiency developing in the presence of myocardial infarction or acute disorder of the cerebral circulation, reflected with a sufficient degree of accuracy the energetic level which was typical of the body during disease. PMID- 3959800 TI - [Basic radiation values and their eponyms]. PMID- 3959801 TI - [Treatment of polycythemia with 32P]. PMID- 3959802 TI - [Radiation therapy of tumors in children]. PMID- 3959803 TI - [Radionuclide study of absorption in the intestines in acute poisonings]. AB - A study was made of the intestinal absorption of 131I-oleic acid and human serum 131I-albumin in patients with acute exogenous intoxications and endogenous intoxications caused by acute intestinal ileus using the method of external radiometry of the abdominal parts. The utmost disorders of absorption were noted in patients with an average and grave degree of exogenous intoxication as well as in patients with complete occlusion ileus. Absorptive intestinal capacity in most of the patients improved as a result of therapeutic measures. A rapid method for the evaluation of absorption power was developed and compared with the method of external radiometry of the abdominal parts. An equation of regression was derived making it possible to determine values of the parameter of a period of drug semiabsorption using the rapid method values. PMID- 3959804 TI - [Scintigraphic signs of liver cirrhosis]. AB - A complex of statistical and dynamic methods for evaluation of the state of parenchyma and organ microcirculation of the liver was used before and after endovascular operations. Liver size, specific count over the right and left lobes of the liver, a ratio of the count over the right lobe to that over the left lobe, spleen size, specific count over the spleen, the liver/spleen ratio, a bone marrow uptake, a contribution of the arterial and venous components to the liver blood supply in a study of the liver blood flow, cardioportal time, a period of semiaccumulation of the drug in the liver and the share of the drug accumulated in the liver in the unit of time were determined. A degree of the importance of each of the quantitative criteria for diagnosis of hepatocirrhosis as well as the nature of regenerative processes after liver retrograde infusion and liver arterial blood flow reduction were shown. PMID- 3959805 TI - [Relation of blood serum ferritin and ferritin-bearing lymphocytes in breast cancer]. AB - The ratio of the blood serum ferritin level and the amount of ferritin-bearing lymphocytes was determined in breast cancer patients and mastopathy patients. Direct relation between a rise of blood serum ferritin concentration, a drop in the amount of ferritin-bearing cells and tumor spreading was established in breast cancer. The maximum amount of ferritin-bearing cells was present in the blood of the patients with Stage I-IIA disease. Radical mastectomy in such patients returned the blood serum ferritin level and the amount of ferritin bearing cells to normal. PMID- 3959806 TI - [Use of radioactive fatty acids for evaluating the processes of beta-oxidation of fatty acids in the body]. AB - The pharmacokinetics and metabolic features of I-radionuclide labelled derivatives of aliphatic carboxylic acid were studied in experiment. The authors show the possibilities of nuclear medicine in deriving information on the activity of fatty acid beta-oxidation in the animal liver and body using compounds with C4 = C11 aliphatic chain locus. PMID- 3959807 TI - [Distribution of iodinated antibodies to the human organ-specific intestinal antigen in athymic mice with heterotransplanted tumors]. AB - 131I labeled rabbit antibodies to the human epithelial intestinal antigen beta 1 MA was administered intravenously to nude mice together with human tumor grafts: colon cancer (CC), breast cancer, Ewing's sarcoma and hepatoma. Antibodies to beta 1-MA were selectively accumulated in CC only, excluding the other tumors. Iodinated nonspecific rabbit IgG in mice with CC were distributed like antibodies to beta 1-MA in the body of mice with control heterografts. A conclusion was made of the promising use of labeled antibodies to beta 1-MA in radioimmuno scintigraphy of CC and its metastases. PMID- 3959808 TI - [Transmission-emission lung scintigraphy in the diagnosis of lung diseases]. AB - The potentialities of transmission-emission scintigraphy in the diagnosis of pulmonary diseases were studied. Thirty-eight patients were examined using transmission positive scintigraphy and 85 patients using transmission-perfusion pulmoscintigraphy. An analysis of the results obtained showed that a combined use of positive and transmission pulmoscintigraphy was a simple and available method providing a full-value idea of the anatomotopographic interrelationships of a tumor lesion and the surrounding tissues. A combined use of transmission and perfusion pulmoscintigraphy considerably expanded the diagnostic potentialities of the latter permitting accurate estimation of the volume of perfusion disorders in the lungs. The above method allows one to objectivize the estimation of positive and perfusion pulmoscintigrams. PMID- 3959809 TI - [Use of a kinetic model of radio-hippuran transport in the human body for the quantitative evaluation of total and divided kidney functions]. AB - The paper is concerned with the results of a method for the interpretation of commonly used methods of the determination of blood clearance and radio nephrography with 131I-hippuran based on a mathematical model of its transport in the human body. Empirical values of model parameters were obtained in 120 patients with chronic glomerulo- and pyelo-nephritis verified morphologically and roentgenologically. The use of computational-interpretation algorithms made it possible to determine the volume of circulating plasma (blood), values of true summary and isolated effective renal plasma flow (blood flow) by means of a single i. v. hippuran administration. New indicators for assessment of isolated excretory-transport function and renal hemodynamics as well as indicators of the symmetry of renal function were proposed. The results of a statistical analysis made it possible to recommend some of them as criteria of early diagnosis of pre uremic disorder of renal function. Radionuclide indicators of renal function showed good correlation with biochemical, morphological and roentgenological characteristics of renal damage in renal diseases. PMID- 3959810 TI - [Combination gamma-therapy of cancer of the oral mucosa]. AB - The authors analysed the results of therapy of 72 oral mucosa cancer patients who had received combined modality radiotherapy using at the stage of intracavitary irradiation sources of 60Co of a raised dose rate on the afterloading AGAT unit. Forty four patients received irradiation as part of combined modality therapy, 28 were treated by irradiation only. Two variants of combined modality radiotherapy were employed: gamma-beam and intracavitary irradiation was given simultaneously on the same day; consecutively alternating gamma-beam (on the 1st day) and intracavitary (on the 2nd day) irradiation. The most effective summary focal dose values in preoperative combined irradiation were 40-45 Gy (with the ratio of the contribution of gamma-beam therapeutic doses of 30-35 Gy and intracavitary doses of 10-15 Gy) and in radiotherapy used alone 75-80 Gy (with the ratio of irradiation components being 50-55 Gy and 25-30 Gy respectively). Complete tumor resorption in combined modality radiotherapy used independently was achieved in 19 out of 28 patients (67.8%). In combined treatment tumor regression by more than 50% after preoperative irradiation was achieved in 65.9% of the patients. Tumor recurrences were noted in 5 of 44 (11.3%) patients in combined treatment and in 3 out of 19 (15.7%) in radiotherapy used alone. Five-year survival rates calculated with the help of life tables were 55.7 +/- 10% after combined treatment and 48.7 +/- 11% after radiotherapy used alone. Clinical evidence indicated the advantages of combined modality radiotherapy with simultaneous intracavitary and gamma-beam irradiation. PMID- 3959811 TI - [Effectiveness of radiotherapy of patients with inoperable lung cancer]. AB - Data on 203 patients with locally advanced lung cancer subjected to exploratory thoracotomy were studied: the 1st group--68 patients received symptomatic therapy only, the 2nd group--71 patients received a palliative course of radiotherapy, and the 3rd group--64 patients were on radiotherapy after a radical program. Radiotherapy in the 3rd group was performed after a split course using staged change of dose fractionation regimens. The use of the palliative radiotherapy course brought about a subjective effect in 39.0 5% of the patients but had no effect upon their survival. Radiotherapy after a radical program resulted in a subjective effect in 82.8 +/- 5.2% of patients and objective improvement in 56.3 6%. The mean survival time of the patients in the 3rd group was twice as much as compared to the patients in the 1st group, being 13.8 mos. versus 6 mos. In the 3rd group 15.4 +/- 7.2% of the patients lived over 3 yrs. Whereas none of the patients in the 1st and 2nd groups had survived by that time. Better results were obtained in the group of patients with epidermoid lung cancer. PMID- 3959812 TI - [Radiotherapy, using metronidazole, of regional lymph node metastases of cancer of the oral mucosa]. AB - Altogether 67 patients with oral mucosa cancer metastases to the regional lymph nodes were given a split course of gamma-beam therapy with traditional dose fractionation and dynamic fractionation. Radiotherapy in the presence of metronidazole radiosensitization was given to 40 patients. Metronidazole was administered per os 3 = 4 h before irradiation with fractions I, III and V of each phase of a split course. A single dose of metronidazole was 5 g/m2, a summary dose 30 g/m2. Radiotherapy with metronidazole resulted in a 2-year cure of 17.5 +/- 6% of the patients. The therapy was the most effective in patients with metastases of diameter up to 2 cm. The results of therapy of oral mucosa cancer metastases to the regional lymph nodes were better in the use of the dynamic fractionation regimen. PMID- 3959813 TI - [Results of the clinical use of 75Se-methionine in gastroenterology with different modes of administration]. AB - Gamma-topography of the abdominal region and radiometry of duodenal aspirates were used for examination of 707 patients with different gastroenterological pathology using various modes of the administration of 75Se-methionine (intravenously, per os, into the duodenal and cecal lumens, intra-arterially in the celiac trunk and superior mesenteric artery). The RP administered intravenously was accumulated in health in the liver and pancreas. The drug fixation by the proximal part of the jejunum was also typical of chronic pancreatitis, the degree of fixation being well correlated with a period of disease. A jejunum image on gamma-topograms proved to be determined not by radioactivity of the jejunum in passage of labeled pancreatic juice but by extraction of the radionuclide from the blood by its wall. In transduodenal administration of the radionuclide its major part was rapidly absorbed and accumulated in the liver. At the same time a considerable part of the drug remained at the site of administration and retained there for several days. There was almost no absorption of the drug in the cecum and ascending colon. Like in the duodenum, the drug retained at the site of administration for a long time. Intestinal extravasal trophicity was assumed. PMID- 3959814 TI - [Dose-effect relationship based on frequency of occurrence of radiation cataracts]. AB - The paper is concerned with the results of experiments on random bred mice concerning dose-effect relationship estimated by radiation cataract developing 1 year after x-ray irradiation at doses of 0.05, 0.5, 4, 7 and 10 Gy. It was shown that the effect of ionizing radiation on the lens registered by its opacity, could be threshold-free and described with the equation of the straight line. The authors found it appropriate to introduce a concept of a permissible risk dose causing a certain degree of cataract. In their opinion, the existing maximum tolerance radiation dose based on the absence of cataract at doses less than 7.5 Gy, should be lowered not less than by one order. PMID- 3959815 TI - [Post-irradiation modification of radiation damage to cells. Increase in reproductive death during post-irradiation reduction of cellular pH]. AB - The effect of enhancement of reproductive death in postradiation reduction of intracellular pH(pHk) was studied on Chinese hamster hypoxic cells. It was shown that pHk reduction up to 6.0 for 1 h enhanced the radiation damaging effect. The maximum effect was observed in pHk reduction shortly after irradiation. The dependence of the effect on the interval between irradiation and subsequent pHk reduction was different under various conditions of postradiation incubation: in good oxygenation due to fast reparation of potential injuries the effect of pHk reduction sharply decreased with time; the effect of additional influence of pHk reduction was insignificant against a background of low survival of cells incubated after radiation under hypoxic conditions. It was assumed that low survival under postradiation hypoxic conditions was determined by pHk reduction shown in this study during cell incubation under hypoxic conditions. PMID- 3959816 TI - [Possibilities of the use of an apparatus with a movable source for intracavitary multi-position irradiation]. PMID- 3959818 TI - [Methodological bases of regulating the irradiation of patients during x-ray examinations]. PMID- 3959817 TI - [Radioimmunologic test system for determining the concentration of thyroglobulin in human blood serum]. PMID- 3959819 TI - [Enhancement of the reproductive death of cells as affected by post-irradiation hypoxia]. PMID- 3959820 TI - [Determination of calcitonin and parathyrin in blood serum in the diagnosis of tumor metastases to bone]. AB - Calcitonin and parathyroid hormone concentrations were determined using a radioimmunoassay in the blood serum of lung, breast and kidney cancer patients who had undergone combined treatment for major disease, healthy males, patients with spinal tuberculosis and patients with eosinophilic granuloma of the cranial bones. A significant rise of the calcitonin level and change in the ratio of calcitonin and the parathyroid hormone were established in the blood serum of patients with tumor metastases to the skeleton, spinal tuberculosis and eosinophilic cranial granuloma. During cancer patients' monitoring the determination of calcitonin is recommended as a screening test for skeletal metastases to select patients for gamma-topographic investigation. PMID- 3959821 TI - Men of science v. men of law: some comments on recent cases. PMID- 3959822 TI - Psychiatric interim regional secure unit: seven years' experience. PMID- 3959823 TI - Hanging in Northern Ireland--a survey. PMID- 3959824 TI - A statistical analysis of road traffic accidents in Athens, 1978-82. PMID- 3959825 TI - Solvent abuse using bromochlorodifluoromethane from a fire extinguisher. PMID- 3959826 TI - Sudden natural deaths associated with commercial air travel. PMID- 3959827 TI - Contraception, pregnancy, childbirth--when things go wrong. PMID- 3959828 TI - The psychopathology of the hostage experience--a review. PMID- 3959829 TI - The estimation of stature from anthropometric and photogrammetric measurements of the limbs. PMID- 3959830 TI - Diminished responsibility--some observations arising from three case studies. PMID- 3959831 TI - Investigation of the responses of 'fakers' and 'non-fakers' on the Gudjonsson Suggestibility Scale (GSS). PMID- 3959832 TI - Denial and memory performance in two cases of homicide. PMID- 3959833 TI - Expert evidence in the adversarial system of criminal justice. PMID- 3959834 TI - [Quantitative evaluation of pulsatile flow in the extremities using a rheographic method]. AB - A model of a limb part represented as a multilayer cylindrical conduction section is considered. The impedance is measured by means of four electrodes, and the exact and approximate expressions for the impedance are derived. With the expressions, one can calculate the value of the pulse blood flow. Various factors affecting the measurement accuracy such as skin conditions, local depths of major vessels, and relative electrode positions are analyzed. Recommendations for the choice of the electrode spacing are given to calculate the pulse and specific blood flow depending upon dimensions of the body part under study, the accuracy being not less than the preset value. PMID- 3959835 TI - [Contact-free determination of the degree of blood filling of human organs and parts of the body at different depths in local regions]. AB - By using the Eddy current rheograph one can measure the level of the blood supply to human organs or body parts at three different depths in local zones as well as study the blood flow in organs in the course of surgery and in the early postsurgical period directly from the area of surgical intervention. Measurements may be performed when applying the unit on dressing and bandages. PMID- 3959836 TI - [Automated system for recording galvanic skin reaction parameters]. AB - Since variations in the electric skin impedance delta R depend on an instantaneous value R, parameters of the cutaneogalvanic reaction should be assessed in the scale of the natural logarithm lnR. Such methodology allows an adequate comparison of results obtained in many patients or in a single patient during a long-term period. PMID- 3959837 TI - [Effect of tissue heterogeneity on choice of x-ray tube operating conditions in x ray diagnostic studies]. PMID- 3959838 TI - [Technological characteristics of soldering the framework of heart valve prostheses and method of nondestructive quality control of the joints]. AB - Among factors affecting the reliability of heart valve prostheses (HVP) the following ones are of a great importance: the temperature and the duration of soldering a big clamp of the HVP, the occurrence of nonmetal inclusions in the original material (the alloy 45KXBH), etc. Analysis is given to the factors causing the destruction of the HVP during its operation by contact effects, and the possibility of such failures is eliminated. The technique to test the soldering nondestructively is discussed. The tests of the HVP have been performed on the special test board under acceleration, and as they have shown after 528 mln cycles (that is approximately equal 13,2 years of continuous operation) the HVP remained normal, there were no failures. PMID- 3959839 TI - [Scientific and technical progress and science-industry consortia]. PMID- 3959840 TI - [Artificial heart valve made from a Co-Cr-W-Ni-based alloy]. PMID- 3959841 TI - [Unification of medical instruments and evaluation of its level]. AB - Consideration is given to the general methodologic approach to unify medical instruments. It is based on an analysis of specific parameters of medical instruments to be unified and on characteristics of medical instrumentation production. The technique of calculating the unification level for an individual product and for a group of uniform products is demonstrated as exemplified by medical forceps. PMID- 3959842 TI - [Diagnostic effectiveness of fibrocolonoscopes in relation to features of their construction]. PMID- 3959843 TI - [Equipment for extracorporeal blood oxygenation during hemosorption]. AB - A portable blood oxygenator is developed on the basis of the conventional sorption column. The prime volume of the oxygenator is up to 100 ml thus providing 100% saturation of the blood with oxygen at the perfusion rate of up to 300 ml/min. The device has been used in 54 hemosorption procedures for acute peritonitis, the improvement of the detoxication effect being observed. PMID- 3959844 TI - [Improvement in radionuclide imaging of the adrenals]. AB - The most adequate method of extracting the background in radionuclide images is proposed. The level of the 131I labelled cholesterol in the adrenal glands is detected with the system consisting of the gamma camera and computer. The method represents a solution of an incorrect problem. Variations of the background caused by the effect of the radiopharmaceutical preparation (RPP) in the liver are assumed to be exponential, and that serves as an additional information to reduce the job to the correct, steady problem. The method offers higher accuracy and consistency as compared to the conventional averaging in detecting the level of the RPP absorbed in the adrenal glands. PMID- 3959845 TI - [Device for replenishing the fixative unit in electroroentgenographic equipment]. PMID- 3959846 TI - [Stands and equipment for testing the mechanical systems of flexible endoscopes]. PMID- 3959848 TI - [AG-80 voice-producing device]. PMID- 3959847 TI - [VOD 11 visible spectrum source for treatment of neonatal jaundice]. PMID- 3959849 TI - [Method of studying cardiac activity based on recording magnetocardiographic maps]. AB - A method of diagnosing cardiac activity is proposed that is more informative as compared to conventional electrocardiography yet more complicated because of the necessity to use liquid helium. By using an objective physical model magnetocardiography is capable of providing an estimation of disorders in cardiac conduction. PMID- 3959850 TI - Introduction to the symposium: exercise in the treatment of obesity. PMID- 3959852 TI - Caffeine alters ventilatory and gas exchange kinetics during exercise. AB - The purpose of these experiments was to determine the effects of oral caffeine ingestion on the kinetics of oxygen uptake (VO2), expired carbon dioxide output (VCO2), and expired ventilation (VE) in the transition from rest to exercise. Nine male subjects underwent three repetitions of constant load cycle ergometer exercise (approximately 80% ventilatory threshold) on two occasions. A single blind experimental procedure was followed, with one trial being performed 60 min after the subject ingested caffeine (7 mg X kg-1), while the second trial required the subject to ingest a placebo with the treatment order being counterbalanced. Ventilation and gas exchange were monitored by open circuit techniques. The data from three repetitions of the same protocol were pooled and modeled with a single-component exponential function incorporating a time delay: (formula; see text) Kinetic analysis of VO2 revealed no significant difference (P greater than 0.05) in the mean response time between treatments. In contrast, the mean response time for VCO2 and VE were longer (P less than 0.05) for the caffeine trial when compared to the control experiment. These data suggest that caffeine will influence both VCO2 and VE kinetics in the transition from rest to work and should be considered by investigators when planning experiments to study ventilatory and gas exchange kinetics during exercise. PMID- 3959851 TI - Metabolic aspects of exercise and weight reduction. AB - Current knowledge about the thermic effects of exercise in lean and obese subjects and the relationships between exercise and food intake, resting metabolic rate, and dietary-induced thermogenesis were reviewed. Studies of the effects of carbohydrate restriction during low calorie diets on the capacity to perform physical exercise and of the effects of weight reduction with or without the addition of physical training on the metabolic abnormalities of non-insulin dependent diabetes mellitus are also described. The metabolic efficiency of physical work is normal in obesity, total energy expenditure is increased because of increased body mass, and increased energy expenditure is not necessarily matched by a compensatory increase in caloric intake. Thus, increased physical activity can be expected to result in negative energy balance in obese subjects. It is not clear whether exercise increases resting metabolic rate, but there is considerable evidence that exercise may potentiate the thermic effect of food in lean subjects and that this response may be blunted in the obese. The capacity to perform moderate-intensity exercise during carbohydrate-restricted, low calorie diets is maintained after a period of adaptation, but the capacity for high intensity exercise (greater than 70% VO2max) is decreased unless adequate carbohydrate is provided to maintain muscle glycogen stores. The major effect of the addition of a program of physical training to dietary restriction and weight reduction in the treatment of non-insulin-dependent diabetes mellitus is an increase in peripheral sensitivity to insulin, primarily due to increased non oxidative glucose disposal in muscle tissue. PMID- 3959853 TI - Anaerobic contribution to distance running performance of trained cross-country athletes. AB - Recent reports have suggested that running economy (RE) defined as oxygen consumption at standardized treadmill speeds may be an important determinant for successful distance running performance. The purpose of this study was to examine the additional role, if any, played by anaerobic factors in distance running performance. Highly trained male cross-country runners (N = 12) were administered a battery of standardized aerobic and anaerobic laboratory evaluations. Maximal oxygen uptake (VO2max) and RE (ml X kg-1) were measured using open circuit spirometry during treadmill exercise. RE was measured at 241 and 295 m X min-1, and ventilatory threshold (Tvent) was determined and verified using a number of non-invasive ventilatory measures (VE, VE/VO2, VE/VCO2, VCO2, FECO2). Anaerobic measures included the Margaria power test and the Monod critical power test to determine anaerobic work capacity (AWC). The data were subjected to a SAS STEPWISE analysis which combines stepwise addition and backward elimination and were used to predict performance time in a 8.05-km (5-mile) cross-country race in which all the runners participated. The subjects averaged 26.21 min for the 8.05 km run, with 72.1 ml X kg-1 X min-1 for the VO2max with a Tvent at 60.4 ml X kg-1 X min-1 (84% VO2max). AWC (Monod) was 17400 Joules with a range of 8,000-28,400 Joules. The STEPWISE procedure reveals that AWC contributes significantly (P less than 0.003) to a 3 variable model predicting race performance (R2 = 0.76, P less than 0.01). AWC accounts for 58% of total shared variance with VO2max and an indirect measure of Tvent accounting for the remaining 17%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959854 TI - Effect of blood pH on peripheral and central signals of perceived exertion. AB - Ten male subjects underwent exercise testing in three modes, arms (A), legs (L), and arms + legs (A + L), after ingesting 0.3 g X kg-1 body weight of either NaHCO3 to induce alkalosis or CaCO3 as a placebo (i.e., six exercise trials). Ratings of perceived exertion (RPE: Borg, 15-pt scale) for the arms (RPE-A), legs (RPE-L), chest (REP-C), and overall body (RPE-O) did not differ between acid-base conditions at 20, 40, or 60% VO2max for all three exercise modes. At 80% VO2max, 1) RPE-A was lower (P less than 0.01) during A; 2) RPE-L was lower (P less than 0.01) during L; and 3) RPE-A and RPE-L were lower (P less than 0.01) during A + L under the NaHCO3 as compared to the CaCO3 condition. Differences were not found for RPE-L during A or for RPE-A during L. RPE-C and RPE-O were lower (P less than 0.01) under NaHCO3 during A, L, and A + L. Blood acid-base, VO2, and cardiorespiratory responses were not differentially influenced by exercise mode. Blood pH was significantly higher under NaHCO3 than CaCO3 at pre-exercise and 80% VO2max. VO2, heart rate, and tidal volume did not differ between acid-base conditions at any exercise intensity. VE and respiratory rate did not differ between acid-base conditions at 20, 40, or 60% VO2max but were significantly lower under NaHCO3 at 80% VO2max. RPE-A and L were positively related to blood [H+], and RPE-C was positively related to VE for all exercise modes. PMID- 3959855 TI - Triathlete characterization and response to prolonged strenuous competition. AB - The purpose of this study was to characterize triathletes and to assess their responses to prolonged, strenuous competition. Nine triathletes (6 males, 3 females) participated. Mean V0(2)max and percentage of body fat were 72.0 ml X kg 1 X min-1 and 7.1%, respectively, in the four males who finished in the top 15. This compared to values of 58.4 ml X kg-1 X min-1/10.2% and 58.7 ml X kg-1 X min 1/12.6% in the other males and females, respectively. In the 5 wk preceding competition (Hawaii "Ironman Triathlon World Championship") the average daily training of the four top 15 male competitors consisted of swimming 2720 m, running 13.6 km, and biking 84.0 km. This was approximately 1.5 times greater than that of the other athletes. The average training diet was 59% carbohydrate, 21% fat, and 20% protein. Immediately following competition, SGOT, SGPT, and serum LDH were increased 700, 262, and 222% (P less than 0.004), respectively, and still remained marginally elevated 5-6 d later (P less than 0.02). Immediately following competition, serum triglycerides remained unchanged, while serum glucose, glycerol, and nonesterified fatty acids increased 52, 248, and 191% (P less than 0.005), respectively. By 5-6 d post-competition glucose had returned to normal, while triglycerides were elevated 94% (P less than 0.005) and nonsterified fatty acids were decreased 58% (P less than 0.01). PMID- 3959856 TI - The effect of training on exercise-induced R-wave amplitude changes in young females. AB - The effects of an exercise training program on R-wave amplitude (Ramp) changes during graded exercise were investigated in 14 adolescent females. The experimental group (EG) (N = 6) underwent a 20-wk aerobic exercise program. Eight subjects served as controls (CG). Oxygen uptake (VO2), heart rate (HR), and Ramp were determined during incremental exercise to exhaustion, pre- and post-program. The Ramp was calculated by using the average of 10 electrocardiographic complexes to provide a stable criterion. Pre-training, EG and CG were not significantly different for VO2max and HRmax; Ramp decreased significantly between rest and 5 min prior to exhaustion for both groups (P less than 0.05). Ramp changes were significant between the first min of exercise and 2 min prior to exhaustion for EG (P less than 0.05) and between the first min of exercise and 1 min prior to exhaustion for CG (P less than 0.05). These changes occurred at 87% of VO2max and 95% of HRmax for EG and at 93% of VO2max and 97% of HRmax for CG. CG showed no change in these variables post-program except for Ramp exhibiting a significant change between rest and the first min of exercise (P less than 0.05). EG showed a significant increase in VO2max (P less than 0.05), and Ramp changes during exercise were delayed. The first significant change occurred between rest and 3 min prior to exhaustion (P less than 0.05), and the second change occurred between the first min of exercise and exhaustion (P less than 0.05). Thus the latter Ramp change was delayed to 100% of VO2max and HRmax post training.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959857 TI - High rate of osteoarthritis of the knee in former soccer players. PMID- 3959858 TI - Exercise as a partial therapy for the extremely obese. AB - The management of the extremely obese patient is best accomplished by a multidisciplinary approach which includes exercise training as an integral component. While diet alone is a potent factor in improving the metabolic complications associated with obesity, the combination of diet and exercise training can further improve these complications and greatly enhance cardiorespiratory function. Although the fitness of extremely obese people is low, individualized exercise programs can be used to safely and progressively train these patients, reduce fatigue, and greatly increase maximum work tolerance. Additional benefits derived from exercise training include improved insulin-mediated glucose utilization, lower serum lipid concentrations, and improved psychological distress scores and anxiety levels. Thus, exercise training can contribute to the success of a weight reducing program by improving metabolic, cardiorespiratory, and psychological factors. Additional important interventions in a multidisciplinary treatment of severe obesity include psychiatric, psychosocial, and vocational counseling. PMID- 3959859 TI - Special ergometric techniques and weight reduction. AB - Several physiological and psychological benefits can be achieved with exercise training provided an adequate exercise threshold is reached. In recommending exercise regimens to obese individuals, it is important to consider the exercise intensity, frequency, and duration that is most likely to lead to the desired benefits of exercise training. The special problems that some obese individuals may encounter with exercise training should also be considered. Walk/jog and stationary cycling are the two most commonly recommended modes of exercise. Aquatic exercise, due to the buoyancy and thermal properties of water, may be especially suitable as a method of exercise for obese individuals. In addition to swimming, cycling exercise and aerobic dance can be performed in a water environment. PMID- 3959860 TI - Direct calorimetry and the energetics of exercise and weight loss. AB - Laboratory studies using direct calorimetry, a technique which is no longer either rare or difficult, have shown no essential differences between men and women who gain weight easily and the always lean. Both groups gained weight similarly when overeating by 1,000 kcal X d-1. Thermogenic responses to eating and the energy losses in food and urine were similar in the overweight and lean. Daily sedentary energy expenditure is a function of fat-free mass, and fat-free mass increases with obesity. During exercise, calorimetry has shown that heat losses are not always exactly matched to heat production as calculated from respiratory gas exchange, but a 24-h exercise period with a cycle ergometer showed reasonable energy balance when subjects ate as much as they spent. During weight loss from restricting food intake by 1,000 kcal X d-1, calorimetry showed a 12% reduction in sedentary energy expenditure. Based on calorimetry studies and other evidence in the literature, exercise increases energy expenditure, it may eliminate the reduced energy expenditure of caloric restriction, and it can increase muscle mass and thus increase both fat-free mass and daily expenditure. PMID- 3959861 TI - Electro-mechanical response times and rate of force development in males and females. AB - Muscle force development is influenced by both central (pre-motor end plate) and peripheral (post-motor end plate) components. Conflicting results are available concerning gender-related differences in the central component. This study compared males and females with regard to the following electro-mechanical response variables: total reaction time, pre-motor time, electro-mechanical delay, and the rate of force development during a maximal voluntary isometric contraction (MVC) of the elbow flexors. Forty-six males and 40 females performed MVCs against a bar attached to a force transducer. Subjects were instructed to attempt to flex the elbow with maximal force as rapidly as possible after perceiving a visual stimulus. Surface electromyographic activity was recorded from the biceps brachii and was sampled simultaneously with the force transducer data at 2 kHz and stored digitally. For data analyses the subjects were separated into four groups based on the force generated during the MVC: weak females, weak males, strong females, and strong males. Neither total reaction time nor pre motor time was significantly different across groups. The electro-mechanical delay for both male groups was significantly shorter than for both female groups. Electro-mechanical delay was weakly, but significantly, correlated with rate of force development and maximum force. During a single MVC the times required to attain 25, 50, 75, and 100% MVC were similar in all groups. The results suggest that at least part of the gender difference in maximum strength may be due to differences in electro-mechanical response times. PMID- 3959862 TI - Bioelectric characteristics of the electromechanical delay preceding concentric contraction. AB - Fifteen male subjects performed a series of unrestricted, unidirectional 45 degrees elbow extensions at three different initial muscle lengths and at four movement velocities. Online electromyography, accelerometry, and electrogoniometry were used in the data collection to investigate the relationship between the myoelectric activity during the electromechanical delay and various kinematic variables representing the concentric phase of the muscular contraction. Results indicate that the integral of the myoelectric signal during the electromechanical delay is a more reliable variable than the duration of the latency which was shown to be inconsistent in its ability to discriminate between manipulated conditions. It appears that the use of electromyographical quantification of the electromechanical delay can be useful in the derivation of preacceleration muscular force and perhaps provide an noninvasive technique to quantify the elastic characteristics of muscle and the contributions of the elastic response to movement. PMID- 3959863 TI - Analysis of the reliability and validity of the kinetic communicator exercise device. AB - The Kinetic Communicator (KINCOM), a microcomputer controlled, hydraulically driven device for the test, measurement, and rehabilitation of human joint function, was tested for the reliability and validity of its operating systems. Testing focused on the three primary functions of the KINCOM: lever arm position, lever arm velocity, and force measuring systems. Measurements of the functions were made via external devices and were compared to measurements simultaneously made by the KINCOM system. Tests were performed for both static and dynamic operation of the unit. Force measurements averaged a difference of 3.2% or less, lever arm speed was within 1.5% of the target speed in all cases, and no difference was found in position measurement. These discrepancies were felt to be due to calibration error and were not considered an indication of inaccuracy in the KINCOM system. PMID- 3959864 TI - Effects of selected softball bat loading strategies on impact reaction impulse. AB - Interior loading strategies to modify the location and size of the effective hitting area of aluminum softball bats were identified. The effects of these strategies on theoretically derived and empirically determined relevant mechanical parameters were compared. Loading strategies consisted of adding 315 g to the interior of three similar (790 g) aluminum softball bats: at the center of mass of the original bat (bat C); at the ends of the bat and distributed so that the center of mass was unchanged, (bat A); and at the ends of the bat and distributed so that the moment of inertia about the swing axis (I1) was the same as that of bat C (bat B). The following parameters were derived theoretically by considering the bat as a physical pendulum and empirically by observing the impact reaction impulse on the axis of suspension: moment of inertia about the suspension axis (I0); moment of inertia about the swing axis; distance from the suspension axis to the center of percussion; and the slope of the impact reaction impulse (P1) relative to the impact impulse (P) as a function of impact location. These values for each bat were compared. Both empirical and theoretically derived data indicated that: the center of percussion of bat B was farther away from the axis than bats A and C; the moment of inertia about the swing axis of bat A was much greater than that of bats B and C; and the slope of the impact reaction regression line as a function of impact location for bat B was significantly less than that of the other bats. Thus, the effective hitting area of bat B was moved toward the barrel end of the bat and enlarged without a substantial increase in the moment of inertia about the swing axis. PMID- 3959865 TI - Dietary-induced severe obesity: exercise implications. AB - A rat model for severe obesity has been developed by feeding the animals a fat rich, sugar-rich diet. The concentration of fat in the diet was similar to what most Americans consume (about 40% kcal from fat). Calories from sugar was calculated to be 40.6%. As adults, body fat content in these animals averaged 61 or 51%, depending on whether the fat-rich, sugar-rich diet caused hyperphagia. The rate of body fat accretion in these severely obese rats raised in litters of four was estimated to be 1.78 +/- 0.12 (SE) g X d-1 (61% body fat) or 0.9 +/- 0.03 g X d-1 (51% body fat). In contrast, lean rats eating a diet of Purina chow deposited fat at a rate of 0.20 +/- 0.02 g X d-1, resulting in a carcass fat content of 18%. Preliminary evidence based on adult body weights of sugar-fed rats suggests that sucrose alone can cause severe obesity similar to that seen with dietary fat alone. Currently, an attempt is being made to determine how dietary fat and/or dietary sugar work to produce severe obesity. One possibility is that dietary fat in the form of a chylomicron and dietary sugar in the form of a very low density lipoprotein may modify adipose tissue lipoprotein lipase activity. This enzyme acts as a gatekeeper for circulating triglycerides entering the adipocyte. It is our belief that the results obtained will help to lay the groundwork for determination of the role of exercise in weight control. PMID- 3959866 TI - Relationships among anthropometric and stroking characteristics of college swimmers. AB - A theoretical model was developed to identify anthropometric variables relevant to success in swimming. Frontal areas, cross-sectional areas (XSA), and lengths of body segments were measured on twelve members of a men's college team using a photographic procedure. Motion-picture films were taken of the subjects competing in freestyle events and were analyzed to determine the average stroke length (SL), average stroke frequency (SF), and average stroking speed (S). Correlation and multiple regression procedures were used to determine the relationships among the anthropometric variables and SL, SF, and S, respectively. Of the 21 anthropometric variables selected with the aid of the theoretical model, 6 were found to be significantly related to one or more of the measures of swimming performance when the influence of event distance was partialled out (P less than or equal to 0.05). The anthropometric variables characterizing the subjects accounted for 89% (SL), 41% (SF), and 17% (S) of the variances in the measured characteristics of their strokes. The axilla XSA was shown to have the largest influence on both SL and SF, accounting for 57% of the variance in the SL and 24% in the SF. These results suggest that although S is little influenced by the physique of a swimmer, the combination of SL and SF used to attain a given S is very much a function of his physique. PMID- 3959867 TI - Stretch sensitivity of Golgi tendon organs in fatigued gastrocnemius muscle. AB - Alterations in Golgi tendon organs' (Ib afferent receptors) stretch sensitivity were assessed in fatigued gastrocnemius muscle of cats. Muscle fatigue to 60-50% peak tension was induced in 13 cats by electrical stimulation of L7 and S1 ventral roots. Forty-three group Ib afferent fibers were recorded in L7 or S1 dorsal root filaments before and during fatigue. Fiber activity was assessed by applying to the Achilles tendon a 5-mm ramp stretch at 5 or 25-30 mm X s-1. Group Ib afferent responses to both velocities of stretch were either completely abolished or depressed over several seconds compared to pre-fatigue firing frequencies. When responding, longer latencies (measured at 5 mm X s-1 only) to firing onset occurred during fatigue. Increasing the rate of stretch (250 mm X s 1) to produce a 5-mm stretch approximately equivalent to twitch tension time revealed a depression more selective to static stretch sensitivity. Post excitation depression of the Ib receptor potential appears to be one possible mechanism. These acute adaptations in Ib afferent discharge to muscle stretch were opposite in direction to those recently reported in fatigued muscle for group Ia and group II muscle spindle afferents. Functional implications of these results are discussed. PMID- 3959868 TI - Factors in delayed onset muscular soreness of man. AB - In this study 11 subjects performed exercise resulting in delayed onset muscular soreness in m. gastrocnemius with one leg, the experimental leg. The other leg served as control. Pre-exercise and 24, 48 and 72 h postexercise, soreness perception, resting EMG level of m. gastrocnemius, and volume and skin temperature of both legs were measured, and a leukocyte count was performed. Perception of soreness in m. gastrocnemius reported 24, 48, and 72 h postexercise was not accompanied by an increase in resting EMG level. This result indicates that soreness perception is not related to a tonic localized spasm in sore muscles. A rise in volume of the experimental leg relative to volume of the control leg was found 24, 48, and 72 h postexercise (P less than 0.05). It is suggested that the volume rise is due to edema formation in the experimental leg and that this edema formation is responsible for soreness perception. Since granulocytosis was not found, the hypothesis that edema formation reflects muscle inflammation is not substantiated. PMID- 3959870 TI - 1986 American College of Sports Medicine. Annual meeting abstracts. May 28-31, Indianapolis, Indiana. PMID- 3959869 TI - Exercise intensity and erythrocyte 2,3-diphosphoglycerate concentration. AB - The present study examines the acute effects of two different exercise intensities on erythrocyte 2,3-diphosphoglycerate (2,3-DPG) concentration. Thirty one females (X +/- SD age = 23.7 +/- 3.37 yr; VO2max = 44.3 +/- 5.40 ml X kg-1 X min-1) completed 2 separate 15-min constant load cycling tests at exercise intensities representing 35 and 75% of VO2max. Venous blood was obtained pre exercise (PRE), immediately post-exercise (POST), 15 min post-exercise (POST15), and 30 min post-exercise (POST30) to determine lactic acid, 2,3-DPG, and hemoglobin concentrations and hematocrit. Significant increases (P less than 0.01) in lactic acid concentration (1.1 +/- 0.14 at PRE to 6.2 +/- 0.48 m X mol-1 X l-1 at POST), 2,3-DPG concentration (1.9 +/- 0.06 at PRE to 2.1 +/- 0.06 mumol X ml-1 at POST), and 2,3-DPG corrected for plasma volume shift (PVC 2,3-DPG) (1.9 +/- 0.06 at PRE to 2.4 +/- 0.07 mumol X ml-1 at POST15) were observed only following the 75% submaximal exercise. At POST30 (75% VO2max) PVC 2,3-DPG and lactic acid remained 5.3 and 97% (P less than 0.05) above baseline, respectively. An exercise intensity effect was observed only in lactic acid response (P less than 0.05) but not in 2,3-DPG (mumol X ml-1 and mumol X g-1 hemoglobin or PVC 2,3 DPG. A significant time-intensity interaction (P less than 0.05) for PVC 2,3-DPG suggests that PVC 2,3-DPG response over time was different between the two exercise intensity levels, with the 75% intensity eliciting a greater increase in PVC 2,3-DPG.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959871 TI - Nuclear magnetic resonance imaging characterization of a rat mammary tumor. AB - Intradermal injection (1 X 10(6) cells) of rat mammary adenocarcinoma (13762A) was made in the back skin in 12 rats. Tumor growth and characterization was followed with nuclear magnetic resonance imaging (NMRI) in 9 rats (3 rats died before completion of the study) at 3, 4, and 5 weeks after injection, using spin echo, inversion-recovery, and calculated T1 techniques. Three rats were sacrificed after each of the three imaging periods for histological studies designed to distinguish solid tumor mass from necrosis. Qualitative NMR imaging T1 values increased as the tumors increased in size as evidenced by a progressive decrease in image intensity compared to the surrounding tissues on the T1 weighted images. Calculated T1 values also increased as the tumors aged (Week 3 = 0.3 +/- 0.11; Week 4 = 0.45 +/- 0.07; Week 5 = 0.42 +/- 0.03). Planimetry of tumor areas on histological sections showed that as tumors increased in size, the ratio of necrotic area to solid tumor area increased (Week 3 = 0.3 +/- 0.11; Week 4 = 0.45 +/- 0.07; Week 5 = 0.51 +/- 0.05). These findings indicate that the progressive increase in T1 observed on NMR images may be secondary to the increasing degree of necrosis, with a resultant change in water content and state. Thus, the range of T1 values observed in tumors of similar type may be due to change in tumor physiology and anatomy as tumor growth progresses. In conclusion, careful correlation of histological data with NMR image data is necessary before NMR imaging can be used to provide reliable noninvasive histological information concerning tumor pathology. PMID- 3959872 TI - Phosphorus-31 nuclear magnetic resonance measurements of 2,3-DPG degradation in human adult and cord blood erythrocytes. AB - We have measured the percent change in 2,3-diphosphoglycerate (DPG) concentration in cord blood erythrocytes and adult erythrocytes during incubation at 37 degrees C using 31P nuclear magnetic resonance spectroscopy. DPG concentrations remained unchanged during the first 4.0 +/- 0.9 h (mean + SD) for cord blood erythrocytes and 6.0 +/- 1.0 h for adult blood erythrocytes. After this plateau phase, cord blood and adult erythrocyte DPG concentrations decreased at a rate of 11.6 +/- 0.4 and 11.4 +/- 0.5% of the baseline DPG concentration per hour, respectively. There was no statistically significant difference in the percent rate of DPG degradation when comparing cord blood erythrocytes to adult erythrocytes during either the plateau phase or the decay phase. Starting at the onset of the decay phase, the neonate 3-P DPG resonance shifted downfield at a rate of 0.03 +/- 0.006 ppm per hour; the adult 3-P DPG resonance shifted downfield at a rate of 0.02 +/- 0.003 ppm per hour. PMID- 3959873 TI - Quadrature-multiplexed rf excitation for information doubling in NMR imaging. AB - A quadrature multiplexed pulse sequence to double the data information in a given acquisition time is proposed for NMR tomography. This technique takes advantage of the Hermitian property of the Fourier transform operation in NMR imaging. The proposed technique uses two rf pulses with 90 degrees phase difference simultaneously applied for the excitation of the spins in two different slices. The method results in truly simultaneous data acquisition coming from two different anatomical slices which can be separated into the real and imaginary parts of the image domain. This technique, therefore, also allows us either to reduce the experiment time by half or double the number of slices in the same examination time, depending on the applied imaging scheme. As a preliminary study, simultaneous dual-slice imaging of a human head using a conventional single-slice imaging scheme was performed. PMID- 3959874 TI - Are quenches dangerous? AB - There exists some uncertainty about the hazards which the quenching of a superconducting magnet would present to a subject undergoing an NMR examination. To investigate this problem, a 1.6-T whole-body magnet was quenched with an anesthetized pig lying in the bore. This paper reports our findings which, in the circumstances of this experiment, suggest that the risks are small. PMID- 3959875 TI - Quadrature rf coil pairs. PMID- 3959876 TI - Boundary artifact in inversion-recovery images. AB - Modulus reconstruction of inversion-recovery images causes a pixel value to be assigned the absolute magnitude of the signal amplitude. Consequently, contrast between tissues is reduced if they have amplitudes of opposite sign. When contrast is reduced between adjacent tissues, dark line artifacts are created at the tissue boundaries. The artifacts may enable tissues to be spatially distinguished even if there is no contrast between them. However, the artifacts may lead to misinterpretation of the image since they may be difficult to distinguish from real anatomical structures. PMID- 3959877 TI - A modified saturation-recovery approximation for multiple spin-echo pulse sequences. AB - In equations describing multiple spin-echo pulse sequences, the T1 dependence is often approximated by a saturation-recovery expression, which is valid only when the repetition time TR is much greater than the time required for the echoes. A slight modification of this approximation greatly increases its accuracy for small TR values. PMID- 3959879 TI - The application of steady-state free precession to the study of very slow fluid flow. AB - An NMR imaging technique sensitive to slow flow (approximately 1 mm/s) using a conventional imaging gradient strength (0.025 mT/cm) is described. Two projections with different spatial magnetic periodicity (determined by the SSFP pulse interval), and thus with different flow sensitivities, are subtracted to give signal from flows in a velocity window. PMID- 3959878 TI - 1.5 T in vivo 31P NMR spectroscopy of the human liver using a sectorial resonator. AB - A novel resonator for receiving 31P NMR signals at 1.5 T, which because of its topology has been named a "sectorial resonator," exhibits good radio frequency coupling to the adult human liver. Minimal contamination from nonliver tissue (i.e., muscle) was achieved by the use of depth selective pulses and also because the geometry results in cancellation of signals arising from tissues that are close to the two openings of the structure. PMID- 3959880 TI - In vitro 1H NMR "mapping" of human intervertebral discs. AB - Human intervertebral discs were investigated by 1H NMR in vitro. The measured parameters of samples differently located in discs give the "maps" of discs. The spin-lattice relaxation-time maps show similar structure to dry matter and bound water maps, which might mean the future possibility to detect certain disc processes via accurate T1 images. PMID- 3959881 TI - Real-value representation in inversion-recovery NMR imaging by use of a phase correction method. AB - A new technique of real-value representation in inversion-recovery (IR) imaging by use of a phase-correction method is proposed. In this scheme, negative magnetizations at the beginning of the inversion point (T1 approximately equal to 0) are correctly represented as negative values rather than positive. By use of this new scheme, a consistent IR image set as a function of several inversion times (T1) can be obtained. The latter, i.e., consistent image set which represents the real value of T1 weighted images at several inversion times is important in the search for tumors and abnormalities since the inversion time (T1) in the pulse sequence strongly affects T1 contrast. PMID- 3959882 TI - Neurometabolic effects of an inborn error of amino acid metabolism demonstrated in vivo by 1H NMR. AB - The elevated levels of brain histidine in histidinaemic mice are detected in vivo by 1H NMR at 8.5 and 1.9 T. The concentrations determined from the in vivo spectra correlate well with subsequent analytical determinations. This technique is discussed in relation to monitoring phenylalanine in humans with phenylketonuria. PMID- 3959883 TI - Elimination of coupling between cylindrical transmit coils and surface-receive coils for in vivo NMR. AB - Coupling between large transmit and surface-receive coils is eliminated using a lambda/4 cable, terminated with crossed diodes to ground, inserted between the receive coil and ground, and by using a cable of length a little less than lambda/2 inserted between the transmit match capacitance and the normal crossed diodes in the transmit input line. PMID- 3959884 TI - 31P and 23Na NMR studies of the structure and lability of the sodium shift reagent, bis(tripolyphosphate)dysprosium(III) ([Dy(P3O10)]7-) ion, and its decomposition in the presence of rat muscle. AB - The 31P NMR of aqueous [Dy(P3O10)2]7- demonstrates that it is in slow exchange with P3O5-10 on the NMR time scale. In the presence of tissue, [Dy(P3O10)2]7- decomposes to PO4 with an accompanying slow change of the tissue 23Na NMR of extracellular Na+ ion in several NMR distinguishable extracellular sites. PMID- 3959885 TI - Hypoxia-sensitive NMR contrast agents. AB - The rate of reduction of nitroxides is shown to be more rapid in hypoxic cells. The rate of reduction and the effect of hypoxia on the reduction rate vary for different nitroxides. These findings indicate that it may be feasible to develop in vivo NMR contrast agents that selectively will indicate areas of hypoxia and thereby aid in the detection of disease processes such as neoplasia, ischemia, and inflammation. PMID- 3959886 TI - Flow measurement by the development of phase differences during slice formation in MR imaging. AB - A method for measuring flow based on the shifting of the rephasing pulse following slice selection in partial saturation is described. The technique is based on a partial saturation sequence and retains much of the high signal which is a feature of the use of this sequence. Images obtained while encoding for the flow signal compated with those when not encoding appear very similar. PMID- 3959887 TI - Hepatic gluconeogenesis from alanine: 13C nuclear magnetic resonance methodology for in vivo studies. AB - This paper describes an experimental protocol designed to optimize 13C NMR spectra from the liver of the living anesthetized rat at 1.9 T. The protocol involves the use of a Helmholtz NMR coil which is positioned around the liver after surgical exposure. 1H decoupling is facilitated by double tuning this coil to both the 1H and the 13C frequencies. The protocol was shown to be suitable for studying the hepatic metabolism of 13C-labeled substrates in vivo by investigating the metabolism of [3-13C]alanine. Labeled glucose, glutamate, glutamine, and aspartate were formed and detected by 13C NMR in vivo in this experiment. The labeling patterns in these metabolites provided evidence that the major flow of alanine carbon into the Krebs cycle is via the pyruvate carboxylase reaction rather than through pyruvate dehydrogenase. PMID- 3959888 TI - Instrumentation for rapid MR image synthesis. AB - MR image synthesis has previously been developed as a means of retrospectively optimizing contrast of arbitrary materials in MR images. The first step of this process is to form computed N(H), T1, and T2 images from source images acquired at a variety of echo delay and repetition times. The second step is to take these computed images, along with operator-selected timing parameters, and mathematically generate a synthesized image. Computation is carried out pixel by pixel according to the equation describing the chosen pulse sequence. This paper presents a study of design considerations for a digital image processor capable of rapidly performing the second step, the actual synthesis. In this work the computations inherent to image synthesis are identified, and the feasibility of performing them in high-speed hardware examined. An analysis of the imprecision due to bit-limited calculations shows that an error bound of 0.4% is possible with a 16-bit processor design. A method is described which uses a commercially available image processor by which images can be synthesized according to any of the standard pulse sequences in less than 600 ms. PMID- 3959890 TI - High-order coils as transmitters for NMR imaging. AB - High-order radiofrequency transmitter coils are described that permit, in the context of NMR imaging, a knowledgeable trade-off between coil complexity and the degree of inhomogeneity over a specified volume of space. A mathematical formulation of high-order coils is developed for an axially symmetric polarizing dc field and transverse rf field. The field is created by a number of longitudinal current filaments with equal angular separations on the wall of a cylinder. In its most general form, each current can be independently specified. Circularly or linearly polarized fields can be created. Quadrature and saddleshaped coils emerge as special cases of the general formulation. The development has been tested experimentally and good agreement found. High-order coils can also be used as receivers, permitting more equal weighting of the sensitivities of each pixel. PMID- 3959889 TI - Energetics of human muscle: exercise-induced ATP depletion. AB - The energetics of human muscle have been investigated in vivo during and after fatiguing aerobic, dynamic exercise. Changes in cytoplasmic pH and concentrations of phosphocreatine, ATP and Pi were followed using 31P nuclear magnetic resonance spectroscopy. ATP was significantly depleted in 6 out of 12 experiments and in these 6 experiments decreased to 55 +/- 5% of the pre-exercise concentration. Depleted muscle had a lower phosphocreatine concentration (17 +/- 5% of resting value) and lower pH (6.12 +/- 0.04) than fatigued muscle in which ATP loss was not observed (26 +/- 5% for phosphocreatine and 6.37 +/- 0.09 for pH). The free energy of hydrolysis of ATP was not significantly different in the two groups and was also similar in exhausted and nonexhausted muscle. Loss of ATP was associated with altered recovery of the muscle: [phosphocreatine], [Pi], and pH returned more slowly to their pre-exercise values and the initial rate of oxidative phosphorylation was diminished. The restitution of [ATP] to its pre-exercise value was much slower than that of the other metabolites. PMID- 3959891 TI - Optimization of signal-to-noise ratio in calculated T1 images derived from two spin-echo images. AB - A simplified model relating signal intensity in an MR image to spin-lattice relaxation time (T1), repetition time (TR), number of signal averages and the average tip angle (-alpha) of the protons within the slice has been developed. This model has been used to select the optimal repetition times of two spin-echo images for a fixed total imaging time to maximize signal to noise in calculated T1 images. Theoretical predictions of T1 are virtually identical to spectroscopically measured values, and the relative noise (delta T1) in T1 images calculated from two measured spin-echo images is in good agreement with the theoretically predicted values of delta T1/T1. This model predicts that: (a) for a T1 of approximately 500 ms, the least T1 image noise is obtained with one of the spin-echo images collected with a TR of 400-500 ms. The longer the TR of the other spin-echo image, the lower the T1 image noise, but past a TR of approximately 1400 ms, T1 image signal/noise is optimized for the same total imaging time by increasing the number of averages in the shorter TR spin-echo image rather than increasing the TR of the second spin-echo image. (b) The error is reduced and the optimum TR1 is reduced as -alpha is increased from 63 to 90 degrees. (c) For a range of T1, optimal selection of TR1 and TR2 based on an intermediate value of T1, results in relatively little increase over optimal values in delta T1/T1 for the entire T1 range. PMID- 3959892 TI - The sectorial loop-gap resonator for 31P NMR of the adult human liver at 1.5 T with surface tissue suppression. AB - A new type of loop-gap resonator, which because of its topology is called a "sectorial resonator," is described in considerable analytical detail. It was used for 31P NMR of the livers of two human adult normal volunteers. An effective strategy for suppression of signals from surface tissue was developed. Depth selection was achieved using a separate excitation coil, permitting a reasonable degree of control of the shape of the sensitive region by adjustment of the dimensions of the excitation coil and of the type of pulse delivered. In addition a new principle for cancellation is described: the topology of the sectorial resonator leads to cancellation signals from tissue masses at the two openings of the structure. Using a phase-alternated repeated 90 degrees FID pulse sequence, good spectra were achieved in 2.5 min that are free from contamination by the phosphocreatine peak. PMID- 3959893 TI - Suppression of water and other noncoupled spins by homonuclear polarization transfer in magnetic resonance imaging. AB - The water component of an NMR image is suppressed by selectively detecting only those protons which are coupled to other protons. Selectivity is obtained by polarization transfer between the coupled spins. Since spin-spin coupling is independent of magnetic field strength, the suppression obtainable by polarization transfer is independent of chemical shift. Consequently, this technique does not require extremely homogeneous magnetic fields for the separation of water and lipid signals. In addition, water suppression by this technique is independent of T1 and T2. Suppression of the water signal intensity has been observed experimentally to be as high as a factor of 100. Suppression is limited only by instrumental imperfections. PMID- 3959894 TI - In vivo spectroscopic magnetic resonance imaging using estimation theory. AB - The ability to map spectroscopic components for in vivo application is a highly desirable goal. Thusfar it has been unavailable because of the low SNR inherent in the measurement of each voxel. In this paper we deal with this low SNR in two ways. First, estimation theory, using a priori data, is used to estimate the amplitudes in each voxel. Second, the resultant estimates are presented in an image format so that they are readily correlated with anatomical and physiological patterns. A computer simulation is presented of a case where the SNR is -10 dB. At this level, conventional Fourier transform spectroscopy provides meaningless results. Using estimation theory and an imaging format, a simulated lesion is readily seen. PMID- 3959895 TI - Genetics of the spontaneous diabetic syndrome. Interaction of MHC and non-MHC associated factors. AB - The occurrence of the spontaneous insulin-dependent diabetic syndrome in the rat is the result of several genetic susceptibilities. There is a requirement for the u haplotype of the rat major histocompatibility complex (MHC), RT1. More specifically this requirement is for genes mapping to the right of the RT1 A locus, which codes for class I products. Furthermore, u haplotypes from inbred strains other than the BB rat can provide this permissive u haplotype. Diabetes occurs in animals with either one or two u haplotype and the diabetic syndrome is similar in its characteristics. In addition to the requirement for the MHC genes, there are abnormalities of the immune system of the various diabetes-prone strains, which are present in animals that develop overt disease. These abnormalities segregate independently of the RT1 and interaction between the susceptibilities is necessary for the manifestation of the complete clinical syndrome. PMID- 3959896 TI - Multiprofessional perspectives on prevention. PMID- 3959897 TI - Resource allocation approach for determining clients' need status. PMID- 3959898 TI - How to establish official student chapters of AAMD at colleges and universities. PMID- 3959899 TI - Changing second graders' attitudes toward people with mental retardation: using kid power. PMID- 3959900 TI - Decrease in resting metabolic rate during rapid weight loss is reversed by low dose thyroid hormone treatment. AB - In order to determine if reduced serum T3 concentrations contribute to the decrease in resting metabolic rate (RMR) during rapid weight loss, we administered T3 (30 micrograms/d) and T4 (100 micrograms/d) to obese subjects receiving a very low energy diet to reverse a decrease in serum thyroid hormone concentrations. During the first two weeks of weight loss, before thyroid hormone replacement, the mean RMR of five obese subjects declined to 86% of the baseline level as the mean serum T3 concentration decreased to 72% of the baseline level. Thyroid hormone replacement for one week, while the low energy diet continued, increased the mean RMR to 94% of the baseline level while increasing mean serum T3 and T4 concentrations to approximately 130% of the baseline level. A second week of thyroid treatment caused no further change in RMR. These data suggest that reduced serum T3 concentrations contribute to the decrease in RMR during rapid weight loss. However, the regimen of thyroid hormone replacement employed did not completely restore a normal RMR in obese subjects on a very low energy diet, in spite of elevating serum thyroid hormone concentrations slightly above weight-maintenance levels. PMID- 3959901 TI - Role of the availability of substrates on hepatic and renal gluconeogenesis in the fasted late pregnant rat. AB - Studies were conducted to examine the role of gluconeogenetic substrate availability on glucose production in the fasted late pregnant rat. Virgin and 21 day pregnant rats were studied after 24 hours' food deprivation. Pregnant animals showed decreased circulating glucose and gluconeogenic amino acid and increased plasma glycerol concentration. Glucose formation was studied in vivo two, five, and ten minutes after the intravenous administration of two concentrations of 14C alanine, 14C-pyruvate, or 14C-glycerol. Concentrations of 0.2 mmols of 14C glycerol or 14C-pyruvate, but not of 14C-alanine, enhanced 14C-glucose production in pregnant rats, whereas 1 mmol of any of the three 14C-substrates always enhanced 14C-glucose production in these rats. Both 1 mmol/L and 5 mmol/L 14C alanine increased 14C-glucose formation in 90-minute-incubated liver slices of fasted pregnant rats, in spite of decreased cytosolic activity of alanine aminotransferase. The three substrates enhanced "in vitro" renal gluconeogenesis in pregnant rats. Under all experimental conditions studied, labeled glycerol was converted more efficiently into glucose than equivalent amounts of any other substrate used, and this difference was greater in pregnant, than in virgin animals. Results indicate that, in spite of enhanced gluconeogenetic activity, maternal glucose production in the fasted state at late gestation is limited by the deficiency of certain substrates, such as amino acids. It is proposed that glycerol derived from enhanced maternal adipose tissue lipolysis constitutes a preferential gluconeogenetic substrate in comparison with others, such as alanine, that are more efficiently transferred through the placenta to the fetus. PMID- 3959902 TI - Cancer cachexia and the rate of whole body lipolysis in man. AB - While malnutrition attending cancer cachexia may be associated with variable losses of body fat, lipid metabolism has been only minimally studied. To clarify potential aberrations of lipid metabolism in weight losing cancer patients, the whole body rate of lipolysis was determined in 9 cancer patients in the postabsorptive state and compared to that in 5 normal subjects. A primed-three stage infusion of glycerol was used to measure plasma glycerol clearance and turnover. A positive correlation between glycerol turnover and plasma concentration was demonstrated in both cancer patients (r = 0.72) and in normal subjects (r = 0.81). Glycerol turnover rate in cancer patients (2.05 +/- 0.14 mumol X kg-1 X min-1) was not different from that in normals (2.31 +/- 0.50); while glycerol clearance in cancer patients (1.72 +/- 0.13 L/min) was significantly lower (P less than 0.025) by 32% than that in normals. This study demonstrates that the whole body lipolytic rate in cancer patients is not different from healthy normals. As a consequence, the loss of body fat in patients with cancer cachexia may be due to a reduced rate of lipogenesis rather than augmented lipolysis as is observed in nonmalignant malnutrition, starvation, or injury. PMID- 3959903 TI - Plasma triglycerides related decrease in high-density lipoprotein cholesterol and its association with myocardial infarction in heterozygous familial hypercholesterolemia. AB - Recent studies suggest that decreased levels of high-density lipoprotein (HDL) may contribute to the risk of premature occlusive atherosclerosis in familial hypercholesterolemia (FH). To investigate further, we have analyzed the concentration as well as distribution of HDL cholesterol in relation to plasma triglycerides and their influence on ischaemic heart disease in FH subjects. The study was carried out in 71 men with heterozygous FH and 46 matched controls. FH subjects were relatively young with a mean age of 38 +/- 11 years. Tendon xanthomatas were observed in 57% of the subjects, whereas ischemic heart disease was identified in 33%. Compared to normals, the mean value of HDL cholesterol is significantly reduced by 21% in FH heterozygotes (42 +/- 12 v 33 +/- 9 mg/dL, P less than 0.001). The decrease in HDL cholesterol is highly correlated to the levels of plasma triglycerides (r = -0.50, P less than 0.001) and VLDL cholesterol (r = -0.53, P less than 0.001). Moreover, HDL cholesterol decrease is not associated with elevated levels of LDL cholesterol (r = -0.20, NS), which is the primary characteristic feature of FH subjects. However, HDL cholesterol decrease is weakly related to total plasma cholesterol concentration (r = -0.24, P less than 0.05). The body weight is also contributory to the reduction of HDL cholesterol (r = -0.42, P less than 0.01), probably due to its strong positive correlation to plasma triglycerides (r = +0.54, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3959904 TI - Sex differences in uric acid metabolism in adults: evidence for a lack of influence of estradiol-17 beta (E2) on the renal handling of urate. AB - The serum urate concentration of adult women, which is lower than in men of a similar age, is thought to be related to a higher renal clearance of urate in women, possibly due to their higher plasma estrogen levels. Intersexual differences in the renal handling of uric acid was assessed in 9 normal adult women and 9 normal age-matched men. Women showed a significantly lower serum urate concentration as compared to men (3.5 +/- 0.3 v 4.9 +/- 0.7 mg/dL, P less than 0.001), higher fractional excretion of urate (9.8 +/- 1.0 v 7.3 +/- 0.8%, P less than 0.001), and significantly lower tubular urate postsecretory reabsorption (67.2 +/- 1.6 v 76.6 +/- 1.4% of secreted urate, P less than 0.01). To test whether plasma E2 has a uricosuric effect we administered estradiol valerate and estradiol benzoate to either oophorectomized or adult women. Plasma E2 levels and urinary total estrogen excretion increased significantly in both groups but the treatment failed to significantly modify serum urate or the fractional excretion of uric acid. Furthermore, in 4 normal adult women, the tubular phases that modulate the renal excretion of urate were not significantly influenced by increased plasma E2 levels. We conclude that in comparison to men of a similar age, the lower tubular urate postsecretory reabsorption of adult women is in accordance with the intersexual differences in uric acid metabolism. Plasma E2 does not influence renal handling of uric acid or serum urate levels. PMID- 3959905 TI - Correlation of cardiovascular and neuroendocrine tests of autonomic function in diabetes. AB - Six normal subjects and 16 insulin-dependent diabetics with varying degrees of autonomic damage each had blood sampled for norepinephrine and pancreatic polypeptide for fifteen minutes after a mixed meal and intravenous (IV) edrophonium (Tensilon). The normal subjects showed a brisk but short-lived rise in norepinephrine after edrophonium (average maximum increase 70% between 2 and 6 minutes), as did most diabetics. However, diabetics with cardiovascular reflex evidence of sympathetic damage showed no rise in norepinephrine. Pancreatic polypeptide concentrations increased up to 400% above baseline after a mixed meal in both the normal and the diabetic group with normal cardiovascular reflexes. There was no significant rise in pancreatic polypeptide either in the diabetics with parasympathetic damage alone or in those with additional sympathetic damage. These results provide further evidence for the diffuse nature of the damage in diabetic autonomic neuropathy. PMID- 3959906 TI - Adrenal imaging with technetium-99m-labelled low density lipoproteins. AB - Evaluation of adrenal cortical function by external imaging is currently accomplished by injection of radiolabelled analogs of cholesterol. Although the adrenals do utilized exogenous cholesterol for steroid hormone synthesis, the cholesterol is delivered to the glands not as free cholesterol but through the uptake of low density lipoproteins (LDL), which are subsequently degraded within the adrenal cortical cells to provide cholesterol. Thus, we sought to assess the use of 99mTc-labelled LDL injected into rabbits to obtain external images of the adrenal glands. Adrenal images of all nine rabbits tested were obtained within 18 to 21 hours after injection of 99mTc-LDL. Seven of the rabbits were subjected to adrenal cortical suppression with dexamethasone and then all nine rabbits were imaged a second time. In the untreated animals, visualization of the adrenal glands was accompanied by normal serum cortisol concentrations and accumulation of radiolabel in the adrenals, whereas in the dexamethasone-treated animals, lack of visualization of the adrenal glands was correlated with low serum cortisols, and greatly decreased accumulation of the radionuclide in the adrenals. These findings demonstrate for the first time that LDL, when labelled with 99mTc, can be used to evaluate adrenal cortical function by external imaging. PMID- 3959909 TI - Transcapillary fluid balance in spontaneously hypertensive rats: autoregulation of capillary pressure. PMID- 3959907 TI - Diabetes-induced increases in vascular permeability and changes in granulation tissue levels of sorbitol, myo-inositol, chiro-inositol, and scyllo-inositol are prevented by sorbinil. AB - In a recently developed animal model, we investigated the pathogenesis of diabetic vascular disease and demonstrated that 125I-albumin permeation is markedly increased in new "granulation tissue" vessels formed in subcutaneous tissue after the onset of diabetes. The studies described in this report were undertaken to examine the effects of an aldose reductase inhibitor on diabetes induced increases in vascular permeability in this animal model. 125I-albumin permeation was assessed 3 weeks after the subcutaneous implantation of sterile preweighed polyester fabric (to stimulate angiogenesis) in diabetic male Sprague Dawley rats, in controls, and in diabetic rats given sorbinil approximately 12 or approximately 25 mg/kg/d mixed in ground rat chow. Sorbinil administration prevented the diabetes-induced increase in vascular permeability by approximately 60% at the lower dose and by approximately 80% at the higher dose without affecting body weight or plasma glucose levels. Diabetes-induced changes in tissue levels of sorbitol, myo-inositol, scyllo-inositol, and chiro-inositol were also prevented by the high dose of sorbinil (data were not obtained for the lower dose). These observations are consistent with evidence linking diabetic cataracts and neuropathy to imbalances in sorbitol/inositol metabolism and support the hypothesis that diabetic vascular disease as well as neuropathy and cataracts are mediated by excess metabolism of glucose through the polyol pathway. Furthermore, these observations suggest that increased vascular permeability associated with diabetic microangiopathy in humans may be prevented by inhibitors of aldose reductase without the need to normalize blood glucose levels. PMID- 3959908 TI - Fluid filtration and protein clearances through large and small pore populations in dog lung capillaries. AB - Solvent drag reflection coefficients (sigma f) for six protein fractions with hydrodynamic radii ranging from 37 to 120 A were determined using dog lung lymph CL/CP data over a range of lung lymph flows (QL). Two equivalent pore populations with effective radii of 75-85 A and 200-325 A were determined for the pulmonary capillaries over a range of mean lymph flows for 1.8 to 6.3 times control. Fractional fluid clearance through the large pore population was observed to decrease from 0.28 to 0.16 as QL increased. These data indicate that lymph flow (filtration) increased primarily by an increased filtration through small pores with relatively little increase in filtration through the large pore population. The shift to small pore filtration at high filtration rates accounts for the dependence of the homoporous estimate of total protein sigma f on lymph flow previously observed using lung lymph (Parker et al., 1981). If capillary membrane heteroporosity is present then there should be a net convective clearance of protein across the capillary caused by a volume circulation between large and small pore populations. Minimal estimates of 6-10% of protein clearance are attributed to this mechanism even in the absence of net fluid movement across the capillary. The optimal solute radius for clearance due to volume circulation is about 60 A, based on the membrane pore sizes determined for lung capillaries. Although convective transport of macromolecules is generally acknowledged to account for most transcapillary protein clearance at high filtration rates, the inclusion of a volume circulation component suggests that convection may also be the dominant mode of macromolecular transport at low filtration rates. PMID- 3959910 TI - In vivo size of leukocytes in the spontaneously hypertensive rat. PMID- 3959912 TI - Pressure in capillaries. PMID- 3959911 TI - Transcapillary fluid exchange during arteriolar vasomotion. PMID- 3959913 TI - Distribution of cell surface charges on mesothelium and lymphatic endothelium. AB - The distribution of anionic sites on the luminal surfaces of the peritoneal mesothelium and lymphatic endothelium was investigated by injecting cationized ferritin (CF) intraperitoneally. After washing with phosphate-buffered saline, the diaphragm was fixed and processed for electron microscopy. CF label occurred in discontinuous patches along the mesothelial surface. Microvilli were heavily marked and often closely applied to the mesothelial surface. The intercellular cleft was also heavily labeled. The luminal aspect of the lymphatic endothelium was more extensively labeled, with the marker occurring in long discontinuous dense bands. The clefts of lymphatic endothelial intercellular junctions were extensively labeled especially along regions where cells were loosely apposed. The existence of a high density of anionic sites on membranes at the intercellular junctions of both mesothelial and lymphatic endothelial cells represent a salient feature which is very different from binding in blood capillary endothelium. The presence of a high density of anionic sites along the intercellular clefts of adjacent cells may play a role in the rapid movement of small solutes and molecules from interstitial spaces into the lymphatic lumen. PMID- 3959914 TI - Cell specific effects of glycosaminoglycans on the attachment and proliferation of vascular wall components. AB - Capillary formation has been correlated with changes in basement membrane associated glycosaminoglycans (GAGs). During capillary growth when endothelial cells (EC) undergo extensive proliferation and migration and pericytes are scarce, hyaluronic acid (HA) levels are elevated. Upon capillary maturation when EC migration and proliferation cease and pericytes appear, the dominant GAG is heparan sulfate (HS). To investigate the potential role of GAGs in the angiogenic process, we studied the effect of HA, heparin, chondroitin sulfate, and dermatan sulfate on the attachment and proliferation of vascular wall cells in vitro. Cell attachment was studied by determining the number of cells attached to GAG-treated substrates. Whereas HA inhibited the attachment of both pericytes and smooth muscle cells (SMC) by nearly 80% after 8 hr, it enhanced capillary EC attachment by more than 30%. Retinal pigment epithelial cells and dermal fibroblasts were employed as controls and none of the GAGs examined significantly altered the attachment of these cells. The effect of GAGs on cell proliferation was determined by the addition of soluble GAGs to cells cultured for the time required for three population doublings. Heparin addition resulted in a dose dependent inhibition of both pericyte and SMC proliferation with maximal inhibition of 50% at 100 micrograms/ml, whereas this concentration of heparin moderately enhanced capillary EC proliferation. These effects were not observed for any other cell type or with any other GAG and indicate that GAGs have cell specific effects on the attachment and proliferation of cells of the vascular wall. PMID- 3959915 TI - Capillary anastomoses between the left anterior descending and circumflex circulations in the canine heart: possible importance during coronary artery occlusion. AB - The mammalian coronary microcirculation is a complex network of anastomosing vessels. Previous studies have documented the presence of anatomoses between capillaries originating from a common artery; however, the existence of anastomotic vessels connecting different arteries remains a subject of controversy. The objective of the current study was to determine the extent of anastomotic connections between the left anterior descending (LAD) and circumflex (Cx) beds at the capillary level in the canine heart. Red phthalo pigment (Dupont: Wilmington, Del.) was perfused in vitro, at 120 mm Hg, into the LAD bed, while blue pigment was perfused simultaneously, under the same pressure, into the Cx. Capillary anastomoses between the LAD and Cx were confirmed histologically by the consistent presence of vessels at the junction of the two perfusion fields filled with both colors of pigment. In normal dog hearts, 21.9 +/- 2.8% (mean +/- SEM) of vessels at the junction of the LAD and Cx were perfused by both arterial trees; the percentage capillary anastomoses did not vary significantly with location, apex to base, in the hearts. In addition, the proportion of capillary anastomoses was not altered by either 1 or 6 hr of coronary artery occlusion followed by reperfusion (21.3 +/- 2.8% and 22.5 +/- 2.6%, respectively), or by postmortem cautery of the epicardial collateral vessels (21.8 +/- 5.1%). To assess the potential functional role of these capillary interconnections, regional blood flow at the outer margin of the LAD bed, measured during LAD occlusion by injection of radioactive microspheres, was considered as a function of percentage capillary anastomoses. There was a positive correlation (r = 0.87) between the proportion of anastomoses between the two circulations and blood flow at the outermost edge of the LAD bed, while the LAD was occluded. These results suggest that the anastomoses between the LAD and Cx beds in canine hearts could be important in maintaining blood flow at the extreme outer edge of the perfusion field, if flow through one of the arteries is impaired. PMID- 3959916 TI - Hemodynamics at stenoses formed by growing platelet thrombi in mesenteric microvasculature of rat. AB - Quantitative analyses of the dynamics of stenosis development were expressed in terms of the time course for changes in blood flow velocity in a stenosed region and thrombus configuration in the microvasculature of rat mesentery. The platelet thrombus was induced in microvessels by irradiation of filtered light in combination with intravascular administration of fluorescent dye. The blood flow velocity began to increase soon after the initiation of thrombus formation and continued to increase progressively with the growth of the thrombus in the radial direction. After the velocity reached an almost constant level, the velocity fluctuation became significant due to the frequent detachment of platelet aggregates. Meanwhile, the blood flow velocity precipitously dropped. Two different definitions of a critical stenosis were proposed. The first definition was the condition that the blood flow velocity reached a maximum. The critical area stenosis based on this definition had almost a constant value, i.e., 75-95% of the lumen area. The second definition of critical stenosis was given as the condition that the blood flow rate decreased by more than 15%. In the higher velocity range the values of critical stenosis based on the second definition were almost constant, i.e., 70-90% of the lumen area. However, in the lower velocity range, the critical condition seemed to occur in smaller stenosis. PMID- 3959917 TI - Here are guidelines for AIDS management. PMID- 3959918 TI - Some aspects of PA 350 will affect physician practice. PMID- 3959919 TI - Consider a simplified employee pension program. PMID- 3959920 TI - Proposed legislation could hamper biomedical research. PMID- 3959921 TI - How to combat the AIDS--and FRAIDS--epidemics. PMID- 3959922 TI - Consider the psychosocial consequences of AIDS. PMID- 3959923 TI - Teaching medical history-taking: a comparison between the use of audio- and videotapes. AB - The efficacy of audiotape was compared with that of videotape as a way of teaching students the essentials of the medical interview. Two consultants--a general physician and a neurologist--were videotaped as they took histories from two patients. The neurologist described his methods and summarized his findings, but his interview was conducted conventionally without interruptions (continuous interview). In a contrasting style, the general physician frequently explained his methods and findings in steps, interrupting his interview to do this (discontinuous interview). Fifty students starting their main medical term were divided into two groups (A and B). Group A was shown the videotape of the discontinuous interview while group B was played an audiotape of that interview. Groups A and B were then crossed over, but this time group A was allowed only to hear the audiotape of the continuous interview, while the videotape of it was played to group B. After each tape the students were tested on its content. There was no significant difference between the mean scores of Group A and Group B when tested on the discontinuous interview and both groups scored well. For the continuous interview the group who saw the videotape scored significantly better than the group who only heard this tape. Both groups scored significantly better in the test based on the discontinuous interview than they did in the test based on the continuous interview. The results indicate that videotapes are a good medium for teaching history-taking, but also suggest that audiotape recordings of medical history-taking can be effective teaching aids if the interview is explained in stages. PMID- 3959924 TI - Problem-solving styles of medical students related to knowledge and personality in simulated clinical situations. AB - A study of problem-solving styles, employing a method previously used with general practitioners, was carried out with 40 final-year medical students. By giving their ratings on a five-point rating scale of 21-24 statements relating to each of three case histories, an answer index could be computed, expressing each student's tendency to make assertive versus non-assertive decisions. The relationship of this answer index to knowledge (grades and educational level), personality (Eysenck personality inventory [EPI]), and time used in the exercises was examined. High answer index (high degree of decisiveness in the clinical simulations) was significantly correlated with extroverted personality on the EPI (P less than 0.05) and negatively correlated with time spent on the exercises (P less than 0.01), whereas no relationship was found with grades in medical school, educational level, neuroticism on the EPI, or the students' sex and age. The findings are discussed in relation to previous studies on clinical problem solving. PMID- 3959925 TI - Assessment in undergraduate psychiatric education. AB - An assessment of medical students' psychiatric performance demonstrated no association between the ability to rate psychopathology or to observe interview behaviour and traditional written methods of academic achievement. This is in accordance with those few studies which have addressed this issue and indicates that there may well be at least three independent skills involved in clinical decision-making: the ability to engage in interpersonal interaction and elicit information; and the ability to acquire and use academic knowledge. This is consistent with work suggesting that maturational and learning processes influence clinical reasoning, and demonstrates that each component should be addressed in assessing students in psychiatry. PMID- 3959926 TI - Do medical students learn from multiple choice examinations? AB - Fifty-two students sat two 60-question multiple choice examinations 8 months apart. The second examination consisted of 30 of the questions used at the first sitting, together with 30 questions with repeated stems but different responses. Immediately after the first sitting, 27 of the students went through the paper with the examiner. They were given the correct answers, and any problems were discussed. For the 30 questions with new options, the increase in marks was similar in the two groups. The group given feedback had a significantly greater improvement in those questions repeated in the second examination than those given no feedback. It is concluded that feedback on examination answers does lead to learning of the specific times, but does not lead to a general increase of information in the same area. PMID- 3959927 TI - Modified essay questions: are they worth the effort? AB - The method chosen for important examinations strongly influences the nature of student learning. The Newcastle Medical School in Australia developed a 5-year problem-based curriculum and adopted the Modified Essay Question (MEQ) as the main written instrument for assessing students' problem-solving skills. Even with the best of intentions the MEQ has been abused by its over-use, as shown in this review of annual assessment for years 1, 3 and 5 of the course. Analysis of staff and students' dissatisfaction with this instrument showed some difficulties attributable to the nature of MEQ items. However, a number of problems also emerged as a result of subtle changes in the teaching staff's approach to learning and assessment. This paper concludes by acknowledging the strengths and limitations of the MEQ. It recommends ways in which the MEQ can be effective, as part of a balanced programme involving other suitable instruments. PMID- 3959928 TI - Medical education and experience affecting intra-observer variability. AB - Intra-observer variability for history and simple test evaluation was assessed in a group of 10 final-year medical students and in five senior hospital staff members. Substantial agreement between the results of two evaluations made 7-10 days apart was found in 20 out of 30 instances for staff and in 17 out of 60 instances for students. However, there were instances when variability seemed to be unrelated to the academic standard of students or to the training and experience of staff. It is concluded that the nature of diagnostic procedure and present training in medical school or long-term experience may not be the only factors that affect intra-observer variability in everyday simple diagnostic applications. PMID- 3959929 TI - Pre-registration posts in general practice. AB - Though the UK Medical Act of 1978 made the creation of pre-registration house officer posts in general practice in the UK a serious proposition there have been few attempts to explore the possibility. The absence of agreed educational objectives for the year makes it impossible to conduct the properly evaluated experiments that might assuage existing doubts about the appropriateness of introducing general practice as a setting in an objective way. Experience so far shows that carefully designed schemes are both feasible and worthwhile in the opinion of those involved. The implications for general practice are explored, the need for new educational thinking is discussed and suggestions about criteria for the approval of practices are put forward. PMID- 3959930 TI - Training clinical teachers in psychiatry to teach interviewing skills to medical students. AB - To study the feasibility of training all clinical teachers in psychiatry to teach interviewing skills to medical students, 24 (unselected clinicians were assigned to one of four different training methods. They received either experiential or didactic instruction, and their initial teaching sessions were either supervised or unsupervised. A total of 287 medical students subsequently received feedback training from these teachers. While all students showed significant increases in skill after training, those taught by experientially trained teachers showed the greatest gains. Neither supervision nor the teachers' own interviewing skills exerted significant effects on students' performance. It is concluded that with only brief training unselected clinicians can become effective teachers of essential interviewing skills. Feedback training in such skills can, therefore, be incorporated into existing curricula without major disruption of other requirements. PMID- 3959931 TI - Teaching behaviour therapy to psychiatrists with a structured learning format. AB - A 5-day, in-service training in behaviour therapy, which was attended by six psychiatrists, is described. The course covered principles of behavioural assessment and therapy within a structured learning format. The results of this systematic approach are presented in terms of six measures, administered before and after training. Two of these assessed attitudes to treatment, one gauged knowledge of behavioural principles and the remaining three evaluated the psychiatrists' skills in some key areas of behaviour therapy. Statistically significant improvements were found on the knowledge questionnaire and on one skill measure. These results were compared to those obtained by a control group (n = 18) and a course-trained group (n = 65) of qualified psychiatric nurses. The main conclusion drawn was that the course succeeded as an efficient learning programme, developing understanding and skills of value both clinically and in terms of collaborative teamwork. PMID- 3959932 TI - Racial and sexual discrimination in the selection of students for London medical schools. AB - Analysis of the names of students from London medical schools taking their final examinations in June 1982, 1983 and 1984 has revealed that racial and sexual discrimination operate when students are selected for medical education. On the basis of name the ratios of European to African, Asian or Arabic students vary significantly between the two extreme schools (P less than 0.01), and for any school the proportion tends to be consistent from year to year. Differences also occur between the proportion of females at each school. Furthermore, the pattern of racial and sexual discrimination at each school shows a highly significant rank correlation (r = 0.77). The admission policies at the different London medical schools need to be reviewed. PMID- 3959933 TI - Combined premedical-medical programmes: programme structure and student outcomes at four universities. AB - Many American universities now support combined premedical-medical programmes which shorten and integrate the education of doctors. This paper reviews combined baccalaureate-MD programmes at four institutions: Boston University, the City College of New York, The University of Michigan-Ann Arbor, and the University of Missouri-Kansas City. In comparison to most US medical schools, the combined programmes have admitted and educated larger portions of women students. In addition, some have had large proportions of graduates choosing primary-care careers. PMID- 3959934 TI - Conceptual frameworks in preclinical and clinical textbooks. AB - This is an exploratory attempt to investigate the organization of knowledge in preclinical and clinical textbooks. A theoretical framework to understand the role of textbooks in medical education is developed. An analysis of preclinical and clinical textbooks indicates that preclinical textbooks organize the same field of knowledge differently to clinical ones. In clinical textbooks two different types of organization are indicated. The implication of these findings is discussed. PMID- 3959935 TI - The clinical engineer's role in design of medical devices. PMID- 3959936 TI - User problems and medical device recalls. PMID- 3959937 TI - From problem reporting to technological solutions. PMID- 3959938 TI - Symposium on incorporating user requirements in medical equipment design. PMID- 3959939 TI - The automatic external defibrillator-pacemaker: clinical rationale and engineering design. AB - Prompt defibrillation is the cornerstone of therapy for out-of-hospital sudden cardiac arrest. Overwhelming evidence indicates that victims whose cardiac arrest is witnessed and whose ECG rhythm is ventricular fibrillation can be successfully resuscitated, with significant prolongation of life. The automatic external defibrillator-pacemaker (AEDP) is designed to be used by family members of patients with known heart disease, by basic level technicians in emergency rescue systems, and by lay rescuers in corporate-industrial-public environments. The AEDP is designed for safety and ease of use. It incorporates a highly sensitive and specific electronic diagnostic logic. It defibrillates and paces with a unique tongue-chest electrode system or through two adhesive chest electrodes. The AEDP should be a cost-effective device for the treatment of sudden cardiac arrest and can play a major role in public health strategies for optimizing care for this enormous problem. PMID- 3959940 TI - Attention to the medical equipment user in biomedical engineering. PMID- 3959941 TI - Optimization of epicardial electrode size and implant site for reduced sequential pulse defibrillation thresholds. AB - The influence of epicardial electrode surface area and implant site on sequential pulse defibrillation threshold was investigated in four isolated heart preparations. Electrodes with surface areas of 2.5, 5.0, and 10.0 cm2 were each sutured, in random order, to the epicardial surface of the isolated heart at each of four sites: mid-ventral left ventricle (LV); mid-dorsal LV; lateral-apical LV; and lateral-basal LV. The epicardial electrode is one of the electrodes in a three-electrode, two-current pathway, sequential pulse system. The first two electrodes, which are catheter-mounted, are located in the right ventricular apex (RVA) and superior vena cava (SVC). In sequential pulse defibrillation, one shock is delivered from the SVC to the RVA, followed 1 msec later by a second shock delivered from the third electrode to the RVA. Sequential pulse defibrillation threshold was obtained with each epicardial electrode used at each site. A single pulse (SVC to RVA) catheter threshold was also obtained in each heart. The overall mean sequential pulse threshold was 47 per cent less than the mean single pulse threshold (P less than 0.001). Increasing patch size reduced sequential pulse threshold (P less than 0.03), but no significant effect of patch location could be demonstrated. It is concluded that sequential pulse defibrillation is superior to single-pulse catheter defibrillation and that increasing epicardial patch size is advantageous, although patch location does not influence thresholds in the isolated heart. PMID- 3959942 TI - Transesophageal atrial pacing: importance of the atrial-esophageal relationship. AB - To determine the thresholds for transesophageal atrial capture, as well as factors that might influence the thresholds, the authors measured the minimal current and pulse duration required to pace the atrium through transesophageal bipolar lead systems in 32 patients during 42 trials. Mathematical modeling suggested that the current density at the posterior atrial wall was dependent upon the current delivered, the electrode distance, and, most importantly, the esophageal-atrial geometry, expressed as the distance from the esophagus to the excitable tissue. To examine this esophageal-atrial distance, 17 different patients, aged 11 months to 44 years, were studied concurrently with either computerized tomography or magnetic resonance imaging of the chest. The thresholds needed to capture the atrium from the esophagus were 13.2 +/- 3.7 mA at a pulse duration of 5.8 +/- 3.1 msec. Further, the data demonstrated that the threshold for transesophageal atrial pacing was poorly related to the patient's age or size. The fit between these data and the mathematical model suggested that the distance between the left atrial posterior wall and the esophagus was approximately 5-6 mm. Likewise, the minimal esophageal-atrial distance as measured by the two imaging techniques was equal to or less than 3.3 mm. These observations suggest that the distance (anterior-posterior dimension) between left atrial posterior wall and the esophagus is small and remains constant despite obvious changes in somatic and linear growth. PMID- 3959944 TI - Automatic cardiac resuscitator. PMID- 3959943 TI - Development phases for medical devices. AB - An orderly procedure for analyzing potential new medical devices to determine whether or not they should be commercially developed is presented. A product checklist screens devices to determine their need and whether they will be economically viable. A design specification ensures that design engineers, marketing personnel, and financial personnel agree on function and costs. Reviews during the design, development, pre-production, and production provide continual management of the project to keep it on course. PMID- 3959945 TI - Applying technology to operator requirements in medical equipment design. AB - The methodology used by the author consists of the following elements: Expose the design team to the user environment, followed by question and answer periods with users while still in the use environment. Place biomedical engineers in the leading teaching institutions where they will have day-to-day exposure to the use of products similar to the one being designed. Bring biomedical engineers back into the company as part of the design team. Expose concepts to focus groups while the product is in the definition stage. Bring a select group of users into the design review process. Evaluate the ease of use of the device as part of clinical trials. Establish a means of monitoring product performance after the product has been released. How well such a methodology will work in any particular environment is a function of management's recognition of the concept that ease of operator use is a vital element to the overall success of the product. PMID- 3959947 TI - Calling it quits. PMID- 3959946 TI - Trends in health care and use of technology by nurses. PMID- 3959948 TI - National campaign against drug abuse. PMID- 3959950 TI - Management of non-traumatic paraplegia. AB - Spinal cord damage with resultant paraplegia or quadriplegia is associated with special problems that require expert attention, irrespective of the cause of the damage. Where the damage results from disease, as opposed to acute trauma, it is easy for these problems to be overlooked while attention is directed to the disease. A review is presented of 109 patients with spinal cord damage of non traumatic origin who were treated in a rehabilitation hospital. A plea is made for the recognition of the special needs of such persons, for the early involvement of spinal rehabilitation expertise in the management team, and for the availability of adequate and appropriate rehabilitation facilities. PMID- 3959949 TI - Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals. AB - The "Quit. For Life" campaign was a media-based programme that was aimed at reducing the prevalence of smoking in Sydney. The programme committee set four intermediate goals which it felt had to be met for such a change in prevalence to occur. From households selected at random in Sydney and Melbourne, 5713 people were interviewed to assess whether the campaign attained these goals. The television commercials that were designed for the campaign, their frequency and the timing of their screening produced a higher recall of the commercial's message and the use of campaign back-up services than were specified originally in the goals. During the campaign there was a progressive increase in the number of smokers in Sydney who reported that they were likely to quit; this was significantly different from Melbourne data by the end of the campaign and thus fulfilled another campaign goal. However, shortly after the campaign ended, the proportion of smokers who intended to quit smoking was the same in the two cities. A cohort study of 949 people from the baseline study showed that, during the 12-month period of follow-up, 66% of Sydney smokers tried to stop or to reduce their smoking. In the control city, Melbourne, 60% of smokers reported making such attempts. Of the original smokers, 23% in Sydney and 9% in Melbourne quit during the follow-up period--a statistically significant difference. As well, 10% of the original ex-smokers in Sydney and 11% in Melbourne relapsed, while 4% of nonsmokers in both cities began smoking by the end of the second survey. PMID- 3959951 TI - Rectal gangrene: a complication of phosphate enema. AB - Three cases of rectal gangrene are reported. All cases were compromised with intercurrent illnesses and all patients had complicated haemorrhoids before the gangrene developed. Rectal gangrene as a complication of haemorrhoids is rare and, whereas reports have suggested that this complication is due to nozzle injury, we believe that it may be due to a direct necrotizing effect of the phosphate on the rectum. We no longer recommend its use in compromised patients. PMID- 3959953 TI - Delayed toxicity with slow-release theophylline. PMID- 3959954 TI - Campylobacter-like organisms and gastric ulcer. PMID- 3959952 TI - Should we treat herpes zoster with corticosteroid agents? AB - Herpes zoster is a common disease which is frequently followed by severe long term pain--post-herpetic neuralgia. The arrival of new antiviral agents, not yet widely available, may lead to the neglect of the older, effective and inexpensive method of treatment with systemic corticosteroid agents. Evidence for the value of corticosteroid therapy is strong, while published data discouraging its use is weak. Consequently, the administration of these agents should be the standard treatment for painful acute zoster. PMID- 3959955 TI - AIDS information. PMID- 3959956 TI - Stability of povidone-iodine antiseptic solution stored at 37 degrees C. PMID- 3959957 TI - Underwater drains. PMID- 3959958 TI - Fluoridation and bone. PMID- 3959960 TI - Routine medical examinations. PMID- 3959959 TI - General practice location and use of hypnotics by the elderly. PMID- 3959962 TI - Blood banking--public or private, isologous or autologous? PMID- 3959961 TI - Tennis elbow. PMID- 3959963 TI - The hazards of underwater diving. PMID- 3959964 TI - Simplifying cardiac rehabilitation. PMID- 3959965 TI - Autologous blood transfusion for elective surgery. AB - Between September 1983 and June 1985, 336 patients were assessed by the Autologous Blood Transfusion Service; 267 men, mean age, 65 (range, 16-75) years, and 40 women, mean age, 63 (range, 40-70) years, participated in the programme (29 patients were excluded as unsuitable). Orthopaedic and vascular surgery accounted for 80% of the cases. Complications were minor even in this elderly group. Surgical and transfusion details for a one-month period were studied retrospectively. Of the surgical cases that required crossmatched blood, 50% were for "emergency" and "burn" surgery, and 50% for elective surgery. Forty-five per cent of this latter group were unsuitable as autologous donors, 21% had participated in the autologous blood transfusion programme, and an additional 34% were deemed to be suitable donors. The realistic upper limits of our autologous blood transfusion programme were determined as being 55% of elective cases that require crossmatched blood. To be efficient an autologous blood transfusion service must be incorporated into an existing homologous blood transfusion service and must complement, rather than replace, homologous blood transfusion. PMID- 3959966 TI - Does non-clinical decompression stress lead to brain damage in abalone divers? AB - Abalone divers are subject to considerable decompression stresses and could be at risk of progressive cognitive impairment. A sample of abalone divers was compared with a sample of fishermen, by means of a battery of neuropsychological tests. No evidence of cognitive impairment was found in the divers, in spite of evidence of their exposure to decompression stress. The implications for other professional divers and for recreational underwater divers who follow standard decompression protocols are reassuring. PMID- 3959967 TI - Psychogenic pelvic pain or occult prolapse syndrome? AB - Occult prolapse, a syndrome of pelvic pain, sacral ache, dyspareunia, irritable bladder, but not severe dysmenorrhoea, has been studied in 180 young parous women. Organic disease was not present, but the uterus was very mobile and descended easily down the vagina. The pain was worse in the upright posture and was relieved by lying down, supporting, elevating or removing the uterus in 87% of cases. PMID- 3959969 TI - Intraperitoneal haemorrhage from a ruptured corpus luteum. A cause of "acute abdomen" in women. AB - During the 10-year period 1974-1983, 68 patients with intraperitoneal haemorrhage as a result of the rupture of a corpus luteum were managed at the University Hospital, Kuala Lumpur, Malaysia. Most of the patients were aged between 18 and 35 years. In 63% of the patients the rupture occurred between the 14th and the 35th day of the menstrual cycle, and 10 patients had intraperitoneal bleeding severe enough (450-1500 mL) to require blood transfusion. The condition is often confused with other surgical emergencies such as appendicitis and ectopic pregnancy. An increased awareness of the problem in women of reproductive age and the use of laparoscopy, when indicated, will allow a more conservative approach to be adopted for those patients with minimal bleeding. The performance of an appendicectomy in the presence of blood in the peritoneal cavity did not appear to increase morbidity in those patients with a preoperative diagnosis of "appendicitis". PMID- 3959968 TI - Buprenorphine: a new maintenance opiate? AB - Heroin-dependent out-patients who had been prescribed buprenorphine by general practitioners took part in a controlled study in which 2 mg or 4 mg of buprenorphine were administered by the sublingual route to assess its acceptability as a maintenance opiate and to determine the effects of its abrupt withdrawal and reintroduction a week later. Subjects who received 4 mg of buprenorphine reported being more intoxicated and having fewer symptoms of opiate withdrawal than did the subjects who received the 2-mg dose. Subjects who received the higher dose also abused opiate and benzodiazepine drugs less frequently. When buprenorphine was ceased abruptly, the subjects reported mild withdrawal discomfort for which many requested symptomatic treatment. The reintroduction of buprenorphine caused their condition to restabilize. The subjects' use of opiate drugs, as shown by urine assay, rose from a prevalence of around 15% of specimens at the beginning to about 50% of specimens at the end of the five-week study period. Sublingual buprenorphine was acceptable to opiate addicted outpatients as a maintenance treatment. However, daily doses of greater than 4 mg will probably be required to suppress concurrent opiate abuse, and detoxification will need to be undertaken gradually. PMID- 3959970 TI - The Tasmanian Insulin-treated Diabetes Register. Inception and progress in the first 12 months. AB - A Statewide register of insulin-treated diabetic patients has been established in Tasmania. The register is the first of its kind in Australasia. Insulin treatment was chosen as the criterion for admission to the register because it was a suitably "hard" end-point, and because the completeness of the register could be validated easily by insulin prescription statistics. Both subjects with insulin dependent diabetes mellitus and those with non-insulin-dependent diabetes mellitus (who happened to be treated with insulin as of the prevalence date, May l, 1984) are eligible for registration in the prevalent population. Furthermore, no age restrictions have been placed upon entry. It is to be hoped that this all inclusive policy will assist in the development of an epidemiological definition of insulin-dependent diabetes mellitus. Access to cases has been by hospital records, general practitioners, lay bodies and general publicity. Of over 600 diabetic subjects who were contacted during the first 12 months of the study (approximately one-half of the estimated prevalent population), only three declined to join the register. Once fully established and validated, the register will be used to test aetiological hypotheses in addition to providing descriptive cross-sectional information about diabetes in Tasmania. It is intended that a longitudinal study of insulin-treated diabetes will follow once the cross sectional information is complete. PMID- 3959971 TI - Children, medical treatment and contraceptive agents. Is parental consent necessary? AB - In summary, what should you do when approached by a minor who seeks medical advice or treatment? Emergency. Emergency medical treatment can be provided without parental consent. Non-emergency. Non-emergency medical treatment can be provided without parental consent if the patient is capable of understanding the nature and consequences of the treatment. Contraceptive agents/medical termination of pregnancy. Contraceptive advice or treatment, or medical termination of pregnancy, can be provided without parental consent if the five conditions laid down by the House of Lords are satisfied. PMID- 3959972 TI - Who has the right to advise children on birth control? PMID- 3959974 TI - The magical mystery tour of health insurance. PMID- 3959975 TI - Cancer: viscosity viewpoint. PMID- 3959973 TI - Turcot's syndrome. AB - The first reported case of Turcot's syndrome (brain tumour with polyposis coli) in Australia is described. An awareness of the possible extracolonic concomitant conditions of polyposis coli should lead to the prompt investigation of any patient with either known polyposis or a family history of polyposis who develops a disorder of the central nervous system. PMID- 3959976 TI - Treatment of migraine. PMID- 3959977 TI - Limitation of gamete intrafallopian transfer in the treatment of male infertility. PMID- 3959978 TI - Implantable infusion pumps. PMID- 3959979 TI - Pertussis vaccination. PMID- 3959980 TI - Public health--what is this thing called...? PMID- 3959981 TI - Smoking, disease and the admissibility of evidence. PMID- 3959982 TI - Medicare. PMID- 3959984 TI - Sea-snake envenomation. PMID- 3959983 TI - Practitioners and vaccinations. PMID- 3959985 TI - The unsuspected killer. PMID- 3959986 TI - [Anatomy of the eye]. PMID- 3959987 TI - [Drug injuries in the lower gastrointestinal tract]. PMID- 3959988 TI - Drugs for treatment of systemic fungal infections. PMID- 3959989 TI - Potassium citrate tablets for nephrolithiasis. PMID- 3959990 TI - Release of Fc-receptors after streptococcal lysis induced by a lytic enzyme from Streptomyces globisporus. AB - Streptomyces globisporus produced an enzyme which had lytic effects on streptococci and was able to solubilize their Fc-receptors. A new method for rapid purification of this enzyme was described. It consisted of adsorption to Amberlite CG 50 and subsequent chromatography on CM-cellulose Whatman CM 52. The purified enzyme was free of proteases and had lysed streptococci of serological groups A, B, C, G and L. It released Fc-receptors from the streptococcal surface in a biologically active form. PMID- 3959991 TI - Insect iridescent virus type 6 induced toxic degenerative hepatitis in mice. AB - The toxic effect of insect iridescent virus type 6 - chilo iridescent virus - (CIV) was investigated using Balb/c mice (strain ByJ Ico and Kisslegg). The animals were inoculated with CIV intraperitoneally (1 X 10(9) to 9.2 X 10(11) TCID50/animal). The animals which were administered with 1 X 10(11) to 9 X 10(11) TCID50 of CIV per animal, developed acute clinical illness and died during 18 to 80 h post infection. Histopathological and electronmicroscopic examinations of the liver tissues of those animals which died and/or were sacrificed when moribund showed acute degenerative hepatitis leading to death. No evidence for viral replication was found in the liver cells affected. A mortality rate between 21.1% and 100% was recorded for CIV, depending on the strain and number of mice used and the dose of virus administered. The toxic effect of CIV was eliminated or reduced extensively using heat denaturation or treatment of CIV with sodium dodecylsulphate or proteinase K. This indicates that the nature of the factor causing toxic degenerative cell damage is a protein. PMID- 3959992 TI - [Discovery of Anopheles messeae Fall. breeding sites at the Sayan reservoir and in the tailrace of the Yenisei in the construction area of Sayan-Shushenskoe hydroelectric station]. PMID- 3959993 TI - [Effect of the concentration and number of mosquito larvae (Diptera, Culicidae) on the results of toxicological trials of bacterial insecticides]. PMID- 3959994 TI - [Discovery of the breeding sites of flies in different categories of buildings]. PMID- 3959995 TI - [Dynamic regression models of human tick-borne encephalitis morbidity in the Latvian SSR]. PMID- 3959996 TI - [The modern clinical course of tick-borne relapsing fever]. PMID- 3959997 TI - [Echinococcosis in the Chukot National Okrug]. PMID- 3959999 TI - [Evaluation of the role of a number of biological factors in the emergence of diphyllobothriasis foci in reservoirs]. PMID- 3959998 TI - [Achievements in controlling trichinelliasis in the Ukrainian SSR and the practical public health tasks for its prevention among the population]. PMID- 3960000 TI - [Emergence and current status of a focus of diphyllobothriasis in the Krasnoyarsk reservoir]. PMID- 3960002 TI - [Infestation of the humpback salmon Oncorhynchus gorbuscha (Walbaum) by the metacercariae of the trematode Nanophyetus salmincola schikhobalowi Skrjabin et Podjapolskaya, 1931) n. comb. Filimonova, 1967 (Trematoda, Nanophyetidae) in the Amur basin]. PMID- 3960001 TI - [Comparative effectiveness of different methods of sensitizing an erythrocyte diagnostic agent with the whole Opisthorchis antigen]. PMID- 3960003 TI - [Appearance of a population of Anopheles messeae mosquitoes downstream of the Sayan-Shushenskoe reservoir]. PMID- 3960004 TI - Management of an unsuspected case of malignant hyperpyrexia. PMID- 3960006 TI - An anaphylactic reaction during anesthesia. PMID- 3960005 TI - Anesthetic management of pheochromocytoma. PMID- 3960007 TI - Snake bites and the anesthesiologist. PMID- 3960009 TI - Patient with spinal cord injury. PMID- 3960008 TI - Anesthesia for intracranial cerebrovascular disease. PMID- 3960010 TI - Congenital diaphragmatic hernia. PMID- 3960011 TI - Emergency cesarean section for fetal distress. PMID- 3960012 TI - Intraoperative therapy for massive blood loss. PMID- 3960013 TI - Renal cells in culture. PMID- 3960014 TI - Endogenous calcitonin does not protect against hyperparathyroid bone disease in renal failure. AB - The paper challenges the widely held notion that calcitonin antagonizes effects of the parathyroid hormone (PTH) on bone and inhibits the development of hyperparathyroid bone disease in uremic patients. This was done by studying 16 patients on chronic maintenance dialysis with various levels of PTH and endogenous calcitonin. In addition, 2 patients with normal kidney function and high calcitonin levels due to medullary carcinoma of the thyroid were evaluated, one of them with an excessive, the other with a low-normal PTH level. Undecalcified bone histology was done in all patients and quantitative static and dynamic parameters of bone structure, bone formation, mineralization and resorption were correlated with serum calcitonin and PTH levels using Dunn's multiple comparison procedure. Covariables such as bone aluminum accumulation, immobilization or other diseases were taken into consideration or avoided. In contrast to the literature, no correlations were found between calcitonin and PTH or between calcitonin and bone histology, whereas PTH correlated with parameters of bone resorption and formation. One uremic patient with no circulating calcitonin and high PTH did not show excessive signs of PTH activity on bone. In addition, bone histology in the nonuremic patient with high PTH and high calcitonin did reveal signs of a PTH overactivity on bone which were not seen in the other nonuremic patient with high calcitonin only. These findings indicate that endogenous calcitonin is not protective against hyperparathyroid bone disease. PMID- 3960015 TI - Hyperphosphatemia after surgical correction of hypercortisolism in patients with Cushing's syndrome. AB - The change in phosphate metabolism after surgical correction of Cushing's syndrome was examined in 3 consecutive patients. During replacement therapy with hydrocortisone after successful operation, when serum cortisol levels were undetectable in the early morning, serum inorganic phosphate (PI) levels increased gradually with reduction of the replacement dose of hydrocortisone. Hyperphosphatemia developed 3-7 weeks after surgery when the patients was given 20-25 mg/day of hydrocortisone, and 2 patients demonstrated clinical manifestation of glucocorticoid deficiency. During these periods, there was a significant inverse relationship between serum Pi and the replacement dose of hydrocortisone in each patient. Thereafter, serum Pi started to decrease despite administration of the same amount of hydrocortisone and became normal by 26 weeks after surgery. Daily urinary Pi excretion was decreased compared to that before surgery, and the maximal tubular reabsorptive capacity for Pi (TmP/GFR) changed in parallel with serum Pi in all patients. Serum immunoreactive parathyroid hormone and urinary 3',5'-cyclic adenosine monophosphate excretion remained unchanged during the postoperative course. The serum concentrations of 1,25 dihydroxyvitamin D decreased from preoperatively normal values to subnormal levels after surgery with development of hyperphosphatemia and returned to normal with the fall of serum Pi. In summary, the present study demonstrates that surgical correction of hypercortisolism is accompanied by a transient hyperphosphatemia during the postoperative periods, probably due to increased renal Pi reabsorption, and that parameters of parathyroid function do not change during these periods. These results suggest that glucocorticoid has a direct action on Pi metabolism and that during the replacement therapy after surgical treatment of hypercortisolism hyperphosphatemia may develop due to relative glucocorticoid deficiency. PMID- 3960016 TI - Impaired extrarenal disposal of an acute oral potassium load in patients with endstage renal disease on chronic hemodialysis. AB - The relative importance of renal versus extrarenal mechanisms in the impaired potassium homeostasis in the various stages of chronic renal failure remains undefined. We evaluated potassium homeostasis after an acute oral load of potassium chloride (0.25 mEq/kg body weight) in 10 patients with end-stage renal disease on chronic hemodialysis and 8 control subjects. The maximal increment in plasma potassium concentration in the patients (1.06 +/- 0.13 mEq/1) was significantly higher than that of controls (0.39 +/- 0.1 mEq/1). When expressed as a percentage of the retained load, the patients translocated less potassium into cells (21 vs. 51%). Four of the patients exhibited no apparent transfer of potassium into cells, all the administered load remaining in the extracellular fluid compartment. The extrarenal abnormality does not appear to be related to acidemia, hyperglycemia, or abnormalities in insulin secretion. We conclude that patients with end-stage renal disease undergoing hemodialysis exhibit impaired extrarenal mechanisms of potassium disposal. PMID- 3960018 TI - Reduced renal phosphate threshold concentration in chronic alcoholics: one component of a more complex tubule dysfunction? PMID- 3960017 TI - Pathogenesis of hypercalciuria in spontaneously hypertensive rats. AB - The etiology of hypercalciuria remains unknown in spontaneously hypertensive rats (SHR). In order to differentiate absorptive versus renal hypercalciuria, serial measurements of urinary calcium (UCaV) excretion were made weekly under fasting (3-hour urine collection) and after oral administration of CaCl2 (50 mg/100 g; 4 hour urine collection) from age 8 to 14 weeks in SHR (n = 14) and normotensive Wistar Kyoto rats (WKY; n = 14). Fasting UCaV was significantly greater in WKY than in SHR throughout the periods of observation. In contrast, after oral Ca loading UCaV was greater in SHR after 13 weeks of age (13 weeks: SHR UCaV = 954 micrograms/mg creatinine, WKY UCaV = 541 p less than 0.01; 14 weeks: SHR UCaV = 988 micrograms/mg creatinine, WKY UCaV = 534, p less than 0.01). Fasting urinary cyclic adenosine monophosphate (AMP) excretion was not different between WKY and SHR. However, cyclic AMP excretion of SHR, but not WKY, was decreased after calcium loading when compared to the fasting values. The cyclic AMP was also significantly lower in SHR than in WKY rats after calcium loading. Calcium handling by the kidney was not different between SHR and WKY with or without parathyroidectomy. Calcium disposition kinetic studies were performed on these animals at age 15 and 16 weeks. No significant difference of intravenous 45Ca was observed between WKY (n = 6) and SHR (n = 6) in total plasma clearance, nonrenal clearance, biologic half-life, and elimination rate constant from the central compartment. However, the WKY had a significantly greater renal clearance of 45Ca than the SHR (0.48 +/- 0.04 vs. 0.24 +/- 0.02 ml/n, p less than 0.001). Since tissue disposition of intravenous 45Ca was not different between WKY and SHR, the increased renal excretion of calcium after oral administration in SHR, therefore, reflects increased intestinal absorption of calcium. Correction of established hypertension did not abolish the hypercalciuria. We believe that increased gastrointestinal absorption of calcium is responsible for the hypercalciuria in SHR. PMID- 3960019 TI - Hypotensive effect of a high calcium diet in the Wistar rat. AB - In order to study the effects of Ca supplementation upon systolic blood pressure, male weanling Wistar rats were fed rat chow or chow mixed with either CaCO3 (to 2.5% total Ca) or CaHPO4 (to 3.4% total Ca). In the first study rats receiving CaCO3 supplementation had lower systolic pressures after 6 weeks on the diet. Urinary P was reduced, fecal P was increased and urinary Ca was increased with this diet. Ionized Ca in blood was unaltered by Ca supplementation, but total Ca was decreased and plasma P was increased. In the second study with CaCO3, only a transient effect on blood pressure was found. The effects of the diet upon Ca and P metabolism, however, were similar to those found in the first study. In the third study, with CaHPO4 as the vehicle for Ca supplementation, blood pressure was consistently reduced in rats after 8 weeks on the high Ca diet. Plasma P, total Ca and whole blood ionized Ca were unaltered by this diet, but ionized Ca was reduced in plasma. The dietary intake of nutrients other than the Ca salt did not differ between control and and experimental groups in any of the experiments. Urinary Na and K were similar in control and experimental animals in all three experiments. These data suggest that neither increased ionized Ca, P depletion nor increased Na excretion are necessary conditions for expression of the hypotensive effect of supplementary Ca. PMID- 3960020 TI - Resorption of soft tissue calcification: a possible mechanism of hypercalcemia. AB - In rats with intact parathyroid glands and normal renal function, extraskeletal Ca3(PO4)2 deposits cause an increase in serum Ca2+ concentration from 4.39 +/- 0.07 to 5.24 +/- 0.13 mEq/l (p less than 0.001) and an increase in urinary excretion of calcium. In rats with acute renal failure and secondary hyperparathyroidism, Ca3(PO4)2 deposits potentiate the pre-existing elevation of serum calcium from 4.9 +/- 0.08 to 5.4 +/- 0.13 mEq/1 (p less than 0.01). In parathyroidectomized rats, Ca3(PO4)2 produce a significant increase in serum calcium from 3.39 +/- 0.07 to 4.19 +/- 0.2 mEq/1 (p less than 0.005). Induction of acute renal failure elevated the serum calcium concentration both in intact rats from 4.39 +/- 0.07 to 4.9 +/- 0.08 mEq/1 (p less than 0.01) and in parathyroidectomized rats from 3.39 +/- 0.07 to 3.85 +/- 0.15 mEq/1 (p less than 0.02). In parathyroidectomized rats with acute renal failure, Ca3(PO4)2 deposits cause an increase in serum Ca2+ concentration from 3.85 +/- 0.15 to 4.26 +/- 0.15 mEq/1 (p less than 0.05). PMID- 3960021 TI - [A resected case of pleomorphic carcinoma of pancreatic head]. AB - A 41-year-old man was admitted to the hospital complaining of back pain and progressive jaundice. Ultrasonography, CT and hypotonic duodenography revealed a large and well-defined tumor in the head of pancreas. The tumor was hypervascular on angiography. Total pancreatectomy was performed, and the examination of the resected specimen disclosed that the tumor was 50 X 45 mm in size and extrapancreatic tumor-forming type. Histopathologically, the tumor comprized mostly bizzare mono- and multinucleated giant cells with sarcomatous growth pattern. The patient died 6 months after operation due to liver metastasis and peritoneal dissemination. The pathological feature of the pleomophic carcinoma of the pancreas is well-known, but the clinical feature is vague because the resected cases are rare. The pathological finding of the specimen of this case is typical and it is considered that the clinical findings of this case, such as well-defined and hypervascular tumor, are characteristic of the pleomorphic carcinoma of the pancreas. PMID- 3960022 TI - [Cavoatrial bypass in obstruction of the inferior vena cava in the hepatic portion through the posterior route of the hepatic caudate lobe]. AB - In a 32-year-old Japanese female who had a history of Sjogren's syndrome, the obstruction of the inferior vena cava in the hepatic portion was found associated with Budd-Chiari syndrome. The obstruction of the inferior vena cava was about 6 cm in length by cavography. Cavoatrial bypass grafting was successfully performed with a 16 mm ring reinforced expanded polytetrafluoroethylene graft, which ran behind the caudate lobe of the liver and connected to the right atrium via right pleural cavity. This may be the first report of the posterior route of the hepatic caudate lobe in cavoatrial bypass grafting in Japanese and English literature. PMID- 3960023 TI - [Effect of postoperative administration of fat emulsion on plasma amino acids balance]. PMID- 3960024 TI - [New method for motion analysis of chest wall and diaphragm studied by fluoroscopic image]. PMID- 3960025 TI - [Experimental study on carbohydrate metabolism and pancreatic endocrine function after pancreatectomy--influence of islet activating protein (IAP)]. AB - The influences of IAP on the residual pancreatic endocrine function and carbohydrate metabolism after extensive pancreatectomy in the rat were studied with oral glucose tolerance test (OGTT), arginine tolerance test (ATT), and measurement of hepatic glycogen, and hepatic glycolytic enzyme activity, and histological examination, etc. Wistar male rats weighing around 300 g were divided into the groups with IAP treatment and without it, and in the group with IAP treatment IAP 10 micrograms/kg was administered without anesthesia via the tail vein. In each group 60 and 90% pancreatectomies were performed in accordance with Scow's method, and the simple laparotomy group was used as control. Slight abnormality of glucose tolerance was shown in 60% pancreatectomy. The abnormality became worse with time in 90% pancreatectomy. Glucagon secretion was not damaged markedly even after extensive pancreatectomy. IAP stimulated IRI secretory response and improved glucose tolerance in 60% pancreatectomy group. IAP showed no effect in 90% pancreatectomy group. IAP did not stimulate IRG secretory response after pancreatectomy. Hepatic glycolytic enzyme activity was high in the group with IAP treatment. From the above observation, it has been suggested that IAP may be indicated for the abnormal carbohydrate metabolism after pancreatectomy, if pancreatectomy is not too extensive. PMID- 3960026 TI - [Clinical studies on pulmonary metastases from differentiated thyroid carcinoma- characteristics of patients with pulmonary metastases which appear before thyroid operation or afterward]. AB - At Ito Hospital we have experienced 70 primary cases of differentiated thyroid carcinoma with pulmonary metastasis during the last 32 years. These patients were divided into two groups; patients who presented with the metastasis before thyroid operation (M-1 cases) and afterward (M-O cases). Contrary to our expectation, the over-all survival rate was more favorable in M-1 cases. We therefore studied on the clinical characteristics of these patients to see if there may be any differences between the two groups. The over-all survival rate of M-1 and M-0 cases was 85.7% and 42.9%, respectively. This difference was statistically significant (p less than 0.001). In M-1 cases percentage of male patients was higher, mean age was lower, papillo-follicular carcinoma was more predominant, and the outcome of RI therapy was more favorable. There were no significant differences on the roentgenographical type of metastatic foci and on the intraoperative findings between the two groups. From these results it is suggested that differentiated thyroid carcinoma with pulmonary metastasis in younger patients may be pathogenetically different from those in the older, and that biological characteristics of the disease that shows pulmonary metastasis in early stage differ from that which shows later. PMID- 3960027 TI - [Results and prevention of complications in bronchoplastic surgery in lung cancer]. AB - Fifty-eight patients have undergone bronchoplastic surgery for lung cancer and were reviewed in an attempt to evaluate its postoperative survival rate and to establish a certain method to prevent postoperative complications. Five-year survival rates of the patients with the reconstructive surgery were 36.9, 66.6, 7.9 per cent in over-all patients, stage I and II patients, and stage III patients, respectively. These results can compare favorable with the results obtained in patients who underwent standard operation for lung cancer. Seven of 9 patients with sleeve lobectomy and pulmonary artery reconstruction died within 2 years and 7 months postoperatively, and 4 of them showed distant metastasis. This type of operation may be alternative to pneumonectomy only when pneumonectomy would not be tolerated because of low cardiopulmonary reserve. Six of 8 patients died within 3 years after carina reconstruction. In this type of operation 4 cases showed tumor relapse around anastomotic site. Including 4 patients with carina reconstruction, 8 cases revealed postoperative local tumor recurrence despite the tumor free bronchial stump by frozen sections. These results indicate that prophylactic radiation therapy may be necessary to prevent local tumor relapse after the reconstructive surgery for the advanced lung cancer patients. PMID- 3960028 TI - [A case of tuberculous abdominal aortic aneurysm which ruptured and perforated the sigmoid]. AB - Tuberculous aneurysm is a very rare disease and the prognosis is not good. The authors carried out an emergency abdominal section on a 48 year old patient who had a serious hematochezia and vasography was performed on the patient in order to diagnose the bleeding site. However, the patient had a second serious hematochezia during vasography and fell into the state of shock. Laparotomy revealed innumerable tubercular knobs were and a seemingly tuberculous abdominal aortic knob, which ruptured and perforated to the sigmoid. The aorta was clamped above and below the knob and the knob was sutured and partially removed. A by pass operation using an artificial blood vessel was carried out and the sigmoid was removed. After operation, acute renal insufficiency developed and the patient died suddenly 13 days after operation. The cause of the death is unknown because we could not perform autopy on this patient. Pathology of the resected specimen of the aorta showed the rest from which bleeding had occurred and caseous necrosis, expansion of cell infiltration and Langhans giant cells. Pathological diagnosis of the specimen was tubercuous aortic aneurysm. PMID- 3960029 TI - Altered cardiac tissue gene expression during acute hypoxic exposure. AB - Anoxia has been shown to induce the expression of one or more "stress proteins' in mammalian cells and tissues. A less severe form of oxygen depletion, hypoxic hypoxia, occurs in response to hypobaric decompression which simulates high altitude conditions. Under these conditions mouse hearts accumulate mRNAs for at least two polypeptides at substantially elevated levels. The molecular weights of these proteins, 85 kDa and 95 kDa, are similar to those reported for other mammalian stress proteins or glucose-regulated proteins. Time course experiments suggest that mRNAs for these species increase continuously for up to 16 hours of treatment, while mRNA for 71 kDa and 79 kDa polypeptides are elevated early in the treatment, but later decrease to control values. Total heart mRNA template activity is also increased by the hypobaric treatment. These results demonstrate that mouse cardiac tissue is capable of mounting a cellular stress-like response when exposed to moderately stressful conditions. It also provides a model for studying the direct effects of acute hypoxic stress on cellular gene expression, and its relationship to physiological adaptation. PMID- 3960030 TI - Rat red blood cell hexokinase purification, properties and age-dependence. AB - Rat erythrocytes, in contrast to red blood cells from other mammals, have been shown to contain only one hexokinase isozymic form identified as type I by chromatographic and kinetic properties. Rat reticulocytes contain 3.6-times the hexokinase activity found in mature erythrocytes but exactly the same isozyme. By a combination of ion-exchange chromatography, dye-ligand chromatography and high pressure liquid chromatography the rat erythrocyte hexokinase was purified more than 84 000-fold to a specific activity of 143 units/mg protein and shown to be homogeneous by sodium dodecyl sulfate-gel electrophoresis. The native protein showed a molecular weight of 100 000 by gel-filtration and an apparent molecular weight of 98 000 under denaturating conditions in sodium dodecyl sulfate-gel electrophoresis. The isoelectric point was shown to be 6.3 pH units. This data provides evidence of only one form of hexokinase in the erythrocytes of a mammal. PMID- 3960031 TI - Isotype distribution and fine specificity of the antibody response of inbred mouse strains to four compounds belonging to a new group of synthetic branched polypeptides. AB - A new group of synthetic branched polypeptides was developed to initiate a systematic study of the relationships between the chemical structure (charge, size, primary structure, configuration and conformation), the carrier potential and the antigenic properties of these biodegradable and biocompatible macromolecules. This model system has two main advantages over the previously used ones: (i) the side chains grafted to the poly(L-lysine) backbone are composed of about three DL-Ala and a single chain-terminating amino acid with different absolute configuration and/or identity, and (ii) the conformation of these polypeptides is characterized in solution. The size, charge and inside area of the four molecules selected for this study were identical; however, the identity, the absolute configuration of the chain-terminating amino acids (D-Leu, Leu, Phe or D-Phe) and, in consequence, the conformation of the macromolecules were different. The qualitative and quantitative features of the antibody response induced by the four polypeptides were characterized in inbred mouse strains by IgM and IgG type antibody levels, as well as by isotype distribution and fine specificity of antibodies produced during the primary and memory response. The intensity of the memory response and the characteristics of subclass distribution were dependent on the conformation of the branched polypeptides. These molecules carry at least two types of antigenic determinants. One is ordered to the tetrapeptide side chain, the expression of which proved to be inversely correlated with the backbone-originated helix content of the molecules. The other antigenic determinant corresponds to the common inside area of the polypeptides which is less conformation-dependent and therefore common to all four polypeptides. PMID- 3960032 TI - Secretory component as the mucosal transport receptor: separation of physicochemically analogous human IgA fractions with different receptor-binding capacities. AB - This paper describes the separation and characterization of several IgA fractions from the same human monoclonal source, based on their ability to bind secretory component (SC). The study was undertaken to elucidate features of the immunoglobulin-binding site for SC, and to examine the dependence of mucosal transport on IgA-SC interaction. Enrichment or depletion of SC-binding activity was accomplished on an affinity adsorbant made with SC from human colostral whey. The affinity-purified human IgA fractions contained IgA polymers and were 77% active in rebinding to the adsorbant; this activity was diminished significantly by direct radioiodination. The non-adherent IgA fractions contained both polymer and monomer, and were only 8% active in rebinding to the adsorbant. When the polymer and monomer components were separated from each other, the non-adherent polymer was found to resemble the affinity-purified fraction by all criteria examined including J-chain content, except that the SC-binding capacity was greater than five-fold lower. These findings have two implications for the SC binding site on human IgA: first, the presence of J-chain is insufficient to bestow IgA with SC-binding activity; second, a critical tyrosine participates in maintaining the SC-binding region, possibly on the IgA heavy chain. The relationship between SC binding and mucosal transport was tested in the rat hepatobiliary model. All radiolabeled human IgA fractions were captured rapidly from blood by the rat liver, but only the SC-binding fractions underwent substantial intact transport to bile (greater than 70% of the injected dose). Even though a nominal proportion of the SC-non-adherent IgA appeared in bile (4 15% of the dose), most IgA in these fractions was rapidly degraded within the liver. Thus, only a small amount of monomeric and polymeric IgA can use alternative receptors to get to bile by diversion from the degradative pathway. Polymeric IgA can undergo efficient transport across the cell, strictly conditional on a high binding capacity for SC. This demonstrates that membrane SC is the receptor conferring specificity on the mucosal-transport pathway. PMID- 3960033 TI - Increased hemolytic activity of the trypsin-cleaved ninth component of complement. AB - Human C9 treated with trypsin is initially cleaved into two fragments with relative mol. wts of 53,000 and 20,000. This limited cleavage of C9 induces a 2.4 times increase in the hemolytic activity of C9 when compared to untreated C9. This difference diminishes when C9 activity is tested in an assay using a prolonged incubation time of C9 with C5b-8-bearing red blood cells. Trypsinization of C9 also promotes spontaneous C9 polymerization. SDS-resistant tubular C9 complexes are formed at a C9 concn of 1 mg/ml within 8 hr at 37 degrees C. Our data indicate that specific limited proteolysis of C9 not only induces spontaneous C9 polymerization but also increases the hemolytic activity of C9, suggesting that a similar molecular mechanism is involved in both processes. PMID- 3960034 TI - Activation of carcinogenic N-nitrosopropylamines to mutagens by lung and pancreas S9 fractions from various animal species and man. AB - The mutagenic potential of 7 carcinogenic N-nitrosopropylamines was examined by the Ames liquid incubation assay, using lung and pancreas 9000 X g supernatant (S9) fractions from rats, hamsters, mice, rabbits, monkeys and humans for metabolic activation. N-Nitroso(2-hydroxypropyl)(2-oxopropyl)amine (HPOP), N nitrosobis(2-oxopropyl)amine (BOP) and N-nitrosomethyl(2-oxopropyl)amine (MOP) showed positive mutagenicity in strain TA100 in the presence of lung S9 from each of the uninduced animals and humans. Besides the 3 N-nitrosopropylamines, N nitrosomethyl(2-hydroxypropyl)amine (MHP) was also positive in the presence of lung S9 from polychlorinated biphenyl (PCB)-induced rats, hamsters and mice. On the other hand, in the presence of pancreas S9 from uninduced or PCB-induced animals, only HPOP and BOP showed positive mutagenicity. In contrast, N nitrosobis(2-hydroxypropyl)amine (BHP), N-nitrosobis(2-acetoxypropyl)amine (BAP) and N-nitroso-2,6-dimethylmorpholine (NDMM) showed negative mutagenicity in the presence of lung and pancreas S9 from either uninduced or PCB-induced animals and humans. HPOP was a direct-acting mutagen, and lung and pancreas S9 from 5 animal species and man did not affect the activity. BOP was mutagenic even in the presence of bovine serum albumin. The mutagenic activation of MHP by lung S9 from PCB-induced rats, hamsters and mice was completely inhibited by preincubation in an atmosphere of carbon monoxide or by addition of cytochrome c or metyrapone to the S9 mixture, whereas 7,8-benzoflavone totally lacked this effect. However, that of MOP was insensitive to these inhibitors. These results of mutagenicity assay indicate that only the methyl derivatives of N-nitrosopropylamines, MHP and MOP are activated by the lung from 5 animal species and man, whereas the pancreas from all the tested animals did not activate the 7 N-nitrosopropylamines to mutagens, and that the phenobarbital-inducible major cytochrome P-450 in the lung of rodents is involved in the mutagenic activation of MHP. PMID- 3960035 TI - The role of short-lived DNA lesions in the production of chromosome-exchange aberrations. AB - Human lymphocytes were treated with combined UVC radiation and X-rays or they were X-irradiated and incubated for 60-90 min in the presence of the DNA-repair inhibitor ara-C. The X-ray-induced chromosome exchange aberration yield was enhanced both by UVC and ara-C. approximately a factor of two in the linear (low dose) portion of the dose-response curve. The enhancement was small in the dose squared (high dose) portion where previous dose-fractionation experiments have shown that X-ray-induced lesions leading to aberrations exist for several hours. The yield of aberrations in lymphocytes incubated after irradiation in the presence of ara-C reaches a saturation level almost immediately after irradiation (5-15 min). These cytogenetic observations together with a previous finding (Holmberg and Strausmanis, 1983) give direct and indirect evidence that the enhanced aberration yield is due to short-lived DNA breaks formed immediately after X-irradiation. Measurements on the repair kinetics of the DNA breaks induced by X-irradiation show that ara-C strongly impairs the repair of short lived X-ray-induced DNA breaks. It was also observed that the DNA breaks generated after UVC irradiation occur almost immediately after irradiation and the level of these transient DNA breaks reaches saturation even for short incubation times. Thus, the repair of these breaks can complete with the repair of short-lived X-ray-induced DNA-breaks in combined irradiation with UVC and X rays. The experimental results can be explained on the assumption that X-ray induced aberrations originate from exchange complexes formed in interactions between both short-lived and long-lived DNA breaks. The short-lived DNA breaks give rise to exchange complexes mainly within single ionization tracks where the DNA breaks are close together. The time between irradiation and exchange complex formation is of the order of 5-15 min within such a track, and short-lived breaks might be repaired before complexes have been formed. If the DNA repair of these breaks is delayed by UVC or ara-C treatment this results in a higher probability of exchange-complex formation. In contrast, interactions between breaks in different tracks originate from long-lived DNA breaks and the probability for complex formation from these breaks is not markedly affected by UVC or ara-C. PMID- 3960036 TI - The nature and repair of DNA lesions that lead to chromosomal aberrations induced by ionizing radiations. AB - Short treatment (up to 1 h) of cytosine arabinoside (araC) increases the frequencies of aberrations induced by X-rays in human lymphocytes, evaluated at the first mitosis following stimulation, or as prematurely condense chromosomes of G0 nuclei. Parallel biochemical experiments using nucleoid sedimentation technique, demonstrate that araC inhibits rejoining of DNA-strand breaks effectively. These results point out that X-ray-induced short-lived DNA strand breaks lead to chromosomal aberrations in human lymphocytes. PMID- 3960037 TI - A critical comparison of the micronucleus yield from high and low LET irradiation of plateau-phase cell populations. AB - Experimental data are presented which cast doubt on the usefulness of micronucleus assays as a quantitative measure of radiation damage. Synchronised (G1) Syrian hamster fibroblasts (BHK21 C13) were exposed to doses of gamma- or neutron radiation which yielded equivalent survival response. The cultures were examined at intervals during a 120-h post-irradiation incubation, for the appearance of micronuclei. Dose-response curves for the micronucleus yield constructed at a single sample time of 30 h were compared with those for the peak yield, irrespective of sampling time at each dose. When the total production of acentric fragments was compared with the peak yield of micronuclei no clear correlation could be seen. Qualitative hypotheses have been suggested to account for the various features of the data. The production and expression of micronuclei has been found to be a very complicated relationship and is a warning against too simplistic an interpretation of micronuclei data. PMID- 3960038 TI - Enzyme-activity mutations detected in mice after paternal fractionated irradiation. AB - (101/E1 X C3H/E1)F1-hybrid male mice were exposed in a 24-h fractionation interval to either 3.0 + 3.0-Gy or 5.1 + 5.1-Gy X-irradiation, and mated to untreated Test-stock females. The offspring were examined for mutations at 7 recessive specific loci and for activity alterations of erythrocyte enzymes controlled presumably by 12 loci. No enzyme-activity mutant was found in 3610 F1 offspring of the control group. In the experimental groups, no mutant was detected in 533 (3.0 + 3.0 Gy) and 173 (5.1 + 5.1 Gy) offspring from postspermatogonial germ cells treated. After treatment of spermatogonia. I mutant in 3388 F1-offspring of the 3.0 + 3.0-Gy group, and 5 mutants in 3187 F1 offspring of the 5.1 + 5.1-Gy group were found. The mutants were all genetically confirmed. The frequency (expressed as mutants/locus/gamete) of enzyme-activity mutations is 2 (5.1 + 5.1-Gy group) to 10 (3.0 + 3.0-Gy group) times lower than the frequency of recessive specific-locus mutations. PMID- 3960039 TI - Reactivity and fate of benzene and formaldehyde in culture medium with and without fetal calf serum; relevance to in vitro mutagenicity testing. AB - Gas chromatographic-mass spectrometric analyses were performed to determine the reactivity and fate of benzene (BEN) and formaldehyde (FA) in culture medium. BEN (solubility in water: approximately 500 ppm) does not react with culture medium, either with or without fetal calf serum, but its volatility, even in closed vials, is so great that 90% of a 250-ppm solution is lost to the head space after 1 h at 24 degrees C. FA, as a 37% aqueous solution, is a complex mixture that changes composition after 15-min incubation at 38 degrees C. FA is extremely reactive in culture medium containing fetal calf serum, and is much less reactive with medium components in the absence of serum. There is a dramatic increase in the number of daughter products in FA-treated medium over time, such that those seen immediately after FA is added to medium have been replaced after 60-min incubation (38 degrees C in closed vials) by many other interaction products. Methods ensuring maximum solubilization and minimal volatilization of BEN during exposure are essential for obtaining reproducible data on the mutagenic potential of BEN. The volatilization of FA from stock formalin solutions, and, more importantly, the interaction product(s) formed by this highly reactive compound with medium components, especially those in serum, are probably the critical aspects of an effective testing protocol for FA. PMID- 3960040 TI - An assessment of the metaphase finding capability of the Cytoscan 110. AB - The Cytoscan 110 metaphase finder has been tested with cultures of human peripheral blood lymphocytes prior to its introduction into routine use for the analysis of radiation-induced chromosomal damage. Cells of varying quality and density of distribution on slides, stained with orcein or Giemsa, were examined by the same technician using the Cytoscan and a conventional microscope. The Cytoscan was able to locate rapidly (less than 2 min) virtually all metaphases known to be present and with an acceptably low rate of false positives. The presence of mixtures of FPG-stained first- and second-division spreads did not reduce its efficiency in metaphase finding. The instrument automatically divides the objects that it locates into 4 quality ranks and this was very effective in separating good metaphases, suitable for high-magnification scoring, from unscorable spreads and debris. With cultures of X-irradiated blood it was shown that the criteria by which the Cytoscan locates metaphases and ranks their appearance do not introduce bias in the yields of dicentric and other unstable chromosome-type aberrations. PMID- 3960041 TI - Testing for the chemical induction of aneuploidy in the male mouse. AB - Dyad scores of metaphase II spermatocytes in the mouse have been used as an end point to assess the aneuploidy-inducing potential of three different chemicals; p fluorophyalanine, phenylalanine and 6-mercaptopurine. The sensitivities of three different spermatogenic stages have been tested; pre-leptotene, zygotene and metaphase I. No effect was found at any treated stage for 6-mercaptopurine and phenylalanine. p-Fluorophenylalanine, when compared to control treatments, did, however, induce non-disjunction when applied at metaphase I. It also caused a delay to spermatogenesis when applied at this stage. The potential of mammalian test systems for the routine screening of chemicals as non-disjunction inducers, is discussed. PMID- 3960042 TI - International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 3. The concept of negativity in experimental carcinogenesis. AB - The problems that arise in the interpretation of experimental data on chemical carcinogenesis are addressed. In particular, the difficulties in demonstrating negative results are shown to present problems in delineating carcinogens from noncarcinogens. The use of the virtually safe dose estimated under the assumption of low dose linearity is shown to lead to potentially anomalous results if used indiscriminately in bioassays in which no statistically significant increase in tumor occurrence is induced. It is suggested that there is a need to establish an operational definition of negativity in carcinogenesis, with the realization that this definition may be revised in light of new information. The establishment of negativity in aligning data from positive and negative experiments and in considering possible thresholds is also discussed. PMID- 3960043 TI - Mutagenic evaluation of tromaril (N-beta-phenylethylanthranilic acid), a novel anti-inflammatory drug, using mammalian test systems. AB - The mutagenic effect of tromaril, a new anti-inflammatory drug, was assessed in Swiss male mice employing bone-marrow micronucleus induction, abnormal sperm formation, and the induction of meiotic chromosome anomalies in spermatocytes as the test parameters. Administration of tromaril induced significantly higher percentages of MN and abnormal sperm at 600 and 900 mg/kg body wt., whereas chromosomal anomalies in spermatocytes were significantly higher at all the 3 doses of 300, 600 and 900 mg/kg body wt. at time intervals of 7, 15 and 30 days as compared to parallel controls. PMID- 3960044 TI - Chromosome aberrations in individuals occupationally exposed to ethylene oxide, and in a large control population. AB - Chromosome aberration frequencies in 61 employees potentially exposed to ethylene oxide (ETO) were compared with those in unexposed control groups. We studied 3 worksites with differing historical ambient levels of ETO. Within worksites, groups were classified as high potential exposed, low potential exposed, or controls. Further control groups including an off-site community control group were added to give a total of 304 control individuals. Blood samples were drawn several times over a 24-month period. Aberrations were analyzed in 100 cells per sample after culture for 48-51 h. Worksites I, II and III respectively represented increasing levels of potential ETO exposure. At worksites I and II, no consistent differences in aberration frequencies were found among groups. At worksite III aberration frequencies in potentially exposed individuals were significantly increased compared with controls. The frequencies of cells with aberrations were 5.6% for the 2 individuals in the high potential exposure category and 2.6% for 23 persons in the low potential exposure group. The overall frequency of cells with aberrations in the matched control individuals was 1.4%. In the total control group of 304 individuals we found significant increases in aberrations associated with smoking and with increasing age. We have also reported previously an association between sister-chromatid exchange (SCE) frequency and ETO exposure (Stolley et al., 1984). When aberration frequencies were compared with levels of SCEs there was only a weak overall association. The correlation was found in potentially exposed but not in control groups, and for any individual, one observation could not be used to predict the other. PMID- 3960045 TI - Genetic toxicological testing of some dyes by the micronucleus test. AB - Three widely used dyes, acridine orange, blue VRS and fast green FCF were administered to male mice in order to study the induction of gross chromosomal anomalies using the micronucleus test. All 3 compounds were shown to be clastogenic. PMID- 3960046 TI - Lack of DNA-strand breaks in rat testicular cells after in vivo treatment with sodium fluoride. AB - Oral administration of up to 84 mg/kg of NaF to adult male rats did not induce DNA-strand breaks in testicular cells when measured by alkaline elution. Although plasma fluoride levels were as high as 12 ppm is rats given 84 mg/kg of NaF, testicular fluoride levels in most cases were only 10-20% of plasma levels. Fluoride did not accumulate in the testes after 5 daily treatments. Therefore, it is unlikely that NaF, even at high doses, poses a hazard with respect to heritable genetic effects. PMID- 3960047 TI - Fungitoxic properties of the essential oil of Trachyspermum ammi sprague. PMID- 3960048 TI - A case of sporotrichosis with numerous fungal elements phagocytized by polymorphonuclear leukocytes. PMID- 3960049 TI - [Clinical evaluation of diethanolamine in the treatment of trichophytosis in a young fattening animal]. PMID- 3960051 TI - Size-fractionation of the small chromosomes of Trypanozoon and Nannomonas trypanosomes by pulsed field gradient gel electrophoresis. AB - We have compared the molecular karyotypes of trypanosomes from different subgroups within subgenus Trypanozoon by pulsed field gradient (PFG) gel electrophoresis. Although the overall karyotype was similar, there was much variation in the size of chromosomes between different stocks. Two of three stocks of Trypanosoma (Trypanozoon) brucei gambiense had remarkably small mini chromosomes: 25-50 kilobase pairs compared to 50-150 kilobase pairs for the mini chromosomes of other Trypanozoon stocks. The relative amount of DNA in the mini chromosomal fraction of different stocks correlated well with the amount of 177 base pair satellite DNA monomer per microgram nuclear DNA. Hybridisation of Southern blots of pulsed field gradient gels with a number of gene probes showed that the loci for tubulin and phosphoglycerate kinase in Trypanozoon probably lie on the same chromosome, together with some variant surface glycoprotein genes; the genes for triose phosphate isomerase and glyceraldehyde phosphate dehydrogenase are separately located both with respect to each other and the above housekeeping genes. Therefore, there are at minimum three pairs of chromosomes carrying housekeeping genes in Trypanozoon. In some stocks the chromosomes carrying the tubulin and phosphoglycerate kinase genes are split into two bands, suggesting that homologous chromosomes may differ substantially in size in trypanosomes. One Trypanosoma (Nannomonas) congolense stock examined had a similar pattern of chromosome distribution to that of Trypanozoon, but with very small mini-chromosomes (25-50 kilobase pairs.) PMID- 3960050 TI - A surface-labeled 18 kilodalton antigen in Schistosoma mansoni. AB - A mild surface-labeling procedure was applied to various developmental stages of Schistosoma mansoni. An 18 kDa protein was preferentially labeled in freshly transformed schistosomula. The labeled protein was equally present on skin penetrated and mechanically prepared schistosomula and it disappeared upon digestion of intact parasites with proteolytic enzymes. The 18 kDa protein could be specifically precipitated with an antiserum raised against 3-h schistosomula. Six-day lung forms also presented a single major labeled protein component, but the apparent molecular weight of this protein in acrylamide gels was higher than 18 000. Fourteen-day-old and adult schistosomes showed only weak labeling distributed in several bands. The radioactivity pattern of adult worms (but not of schistosomula) could also be obtained by incubating fresh parasites in a medium which had previously been used to label schistosomes and to which a 100 000-fold excess of 127I over 125I had been added. Post-labeling incubation of parasites was found to be essential for the detection of stable surface proteins. PMID- 3960052 TI - Solution properties of the variant surface glycoprotein of Trypanosoma brucei. AB - The solution properties of the membrane form and soluble form of variant surface glycoproteins from Trypanosoma brucei have been compared. Solution cross-linking studies established that both forms are dimers, although dissociation of membrane form variant surface glycoprotein can be promoted by certain ionic and zwitterionic detergents. Sedimentation coefficients were measured under a range of conditions, and the results were comparable with the results of solution cross linking. Stokes radii were measured by gel filtration, allowing a value for the frictional coefficient to be calculated. The two forms show no differences other than those consistent with binding of detergent micelles to the hydrophobic moiety present on membrane form surface glycoprotein. This validates the use of soluble variant surface glycoprotein in X-ray crystallography experiments. PMID- 3960053 TI - An investigation of the glucose metabolism of Brugia pahangi and Dipetalonema viteae by nuclear magnetic resonance spectroscopy. AB - This study followed the metabolism of [13C]glucose under anaerobic and aerobic conditions in the adult filarial nematodes Brugia pahangi and Dipetalonema viteae using non-invasive 13C nuclear magnetic resonance techniques. Adult B. pahangi and D. viteae showed a rapid uptake of labelled glucose which remained linear over at least 4 h. Both species of worm removed significantly more glucose from the medium under aerobic conditions than under anaerobic conditions. The principal product of metabolism, under both anaerobic and aerobic conditions, was lactate, which accounted for 62-71% of the original [13C]glucose. Examination of the maintenance medium following worm incubation revealed a further excretory product which was identified as succinate. This product accounted for 1-2% of labelled glucose in adult B. pahangi and 2-5% in adult D. viteae. The presence of succinate as an excretory product suggests that a partial reversed tricarboxylic acid cycle is active in these filarial nematodes. A further peak was identified in the worm homogenate and identified as trehalose. The disaccharide was not an excretory product and occurred only within the worm. The peak accounted for 13 14% of the 13C-labelled glucose in B. pahangi and 15-16% in D. viteae. Trehalose has not been previously recorded in either of these nematodes and is likely to have a storage function. PMID- 3960054 TI - Conservation of kinetoplastid minicircle characteristics without nucleotide sequence conservation. AB - The nucleotide sequence and restriction fragment electrophoretic mobility of four minicircles from the kinetoplast DNA of Trypanosoma brucei were determined. Each minicircle possesses an approximately 130 base pair conserved sequence which occurs in other African trypanosome minicircles and contains a 13 base pair sequence that is conserved among kinetoplastid genera [Kidane et al. (1984) Gene 27, 265-277]. A sequence located adjacent to the conserved sequence conserves purine versus pyrimidine strand bias, but not nucleotide sequence, and contains periodic oligo(dA) tracts. Minicircle fragments containing the conserved sequence and adjacent segment exhibited anomalous electrophoretic mobility in polyacrylamide gels. The position of the oligo(dA) tracts in the fragments appears to influence this anomalous mobility. The presence of conserved features independent of conserved nucleotide sequence and the lack of conserved open reading frames among these minicircles suggests that minicircles may have a function other than encoding protein. PMID- 3960055 TI - Surface components of Onchocerca volvulus. AB - A technique employing Sephadex G25 gel filtration has been developed for the rapid isolation and purification of live microfilariae of Onchocerca volvulus from subcutaneous nodules and skin samples. Microfilariae, adult worms and L3 larvae have been surface radiolabelled using the Iodogen technique. Two proteins have been characterised on the surface of uterine microfilariae: these have apparent molecular weights of 14,800 and 15,000. A MW 15,000 protein was the only molecule labelled on the surface of skin microfilariae. Ten proteins were labelled on adult male worms: these have molecular weights of 15,000, 17,500, 20,000, 22,000, 24,000, 29,000, 32,000, 37,000, 42,000, and 50,000. Some, if not all, of these proteins were also identified on female worms. Seven proteins were labelled on the surface of L3 larvae: these have molecular weights of 17,500, 48,000, 50,000, 52,000, 54,000, 57,000, and 105,000. Three of the adult surface proteins were precipitated by selected human infection serum: these are the MW 17,500, 32,000 and 42,000 molecules. The microfilarial surface proteins were not precipitated by human infection serum. The antiserum used in these experiments was shown by Western blot analysis to contain high levels of antibody with specificity for microfilarial and adult antigens. Indirect immunofluorescent assays showed these sera to contain antibody which bound to the surface of adult worms and eggs but not microfilariae. The possibility that skin microfilariae absorb host serum albumin was investigated: Western blot analysis and surface immunofluorescence assays using a specific anti-human albumin serum gave negative results. Fluorescent lectin binding studies revealed the presence of stage specific carbohydrate moieties exposed on the surface of adult worms and eggs. Microfilariae do not have surface carbohydrate determinants. PMID- 3960056 TI - A superoxide dismutase of metacestodes of Taenia taeniaeformis. AB - Superoxide dismutase was purified from Taenia taeniaeformis metacestodes by sequential ion exchange chromatography on quaternary-amino-ethyl-cellulose, gel filtration chromatography on ACA 44 and ion exchange chromatography on DEAE cellulose, followed by chromatofocusing on polybuffer exchanger 94. This isolation procedure resulted in the detection of a single protein-staining band on alkaline gels, coincident with enzyme activity. We have, however, detected what appear to be two peaks of enzyme activity within this single protein staining band. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis using gradient slab gels and analysis under reducing conditions, resulted in the detection of only one protein at an apparent Mr of 16,600, while analysis under non-reducing conditions, gave a single protein of an apparent Mr of 64,000. The isoelectric point of the purified protein is 6.6. Boiling for 3 min completely destroyed the enzyme, whereas incubation for 2 h at 37 degrees C resulted in the loss of 56% of the enzymic activity. Incubation with 10 mM KCN resulted in 83% inhibition of the enzyme. We have detected up to 168 U ml-1 of enzyme activity in the cyst fluid surrounding the parasite in situ. This is the first instance in which any parasite superoxide dismutase has been purified to apparent homogeneity. Parasite-mediated enzymic destruction of superoxide anion can not only protect against oxygen toxicity as a result of normal parasite respiratory processes but also may serve as yet another mechanism used by tissue-dwelling parasites to evade host immunologic attack. PMID- 3960057 TI - Sequence organization in African trypanosome minicircles is defined by 18 base pair inverted repeats. AB - We have found that minicircles of African trypanosomes contain 18 base pair sequences that occur as 3 or 4 pairs of imperfect inverted repeats. The 18 base pair sequence is polar; one half is almost perfectly conserved, while the other half has a more variable sequence. The distribution of the 18 base pair sequences in minicircles defines two classes of sequences ('A' and 'B' segments) that have distinct characteristics. 'A' segments vary considerably in length and contain about 10% more G+C than 'B' segments which are all about 100 base pairs long. The 18 base pair sequences are absent from minicircles of other kinetoplastids. Thus, 'B' segments along with their terminal 18 base pair sequences superficially resemble insertion sequences. Minicircles of African trypanosomes therefore conserve their organization but have only limited nucleotide sequence homology. PMID- 3960058 TI - Types of collagen in Opisthorchis viverrini infected hamster liver. AB - Levels and types of collagen from normal and Opisthorchis viverrini infected hamster livers were compared. Normal liver contained approximately twice as much type I collagen than type III collagen. Upon infection by O. viverrini, both type I and type III collagen were elevated, but the increase in type III was proportionately larger than type I collagen. Of the 3-fold increase in total collagen content of infected livers, type I and type III collagen increased 2- and 4-fold, respectively. As a result, the ratio of type I to type III collagen changed from 2 in normal liver to 1.1 in the livers of animals infected with O. viverrini. The extent of the increase in both type I and type III collagen was found to depend on the infection times and on the number of worms present. In livers infected with 50 metacercariae of O. viverrini, both collagen types increased gradually with duration of infection and reached plateau after 4 months of infection. In livers from 3 month infections, with 15 worms or less, both types of collagen increased directly with the number of worms recovered. Levels of type I and type III collagen did not increase in infections with more than 20 worms. PMID- 3960059 TI - Lateral displacement of the brain and level of consciousness in patients with an acute hemispheral mass. AB - Brain-tissue shifts associated with drowsiness, stupor, and coma were studied by clinical examination and CT scanning in 24 patients with acute unilateral cerebral masses. Studies were performed soon after the appearance of the mass to detect the earliest CT changes associated with depression of consciousness. Contrary to traditional concepts, early depression of the level of alertness corresponded to distortion of the brain by horizontal displacement rather than transtentorial herniation with brain-stem compression. Horizontal displacement of the pineal body of 0 to 3 mm from the midline was associated with alertness, 3 to 4 mm with drowsiness, 6 to 8.5 mm with stupor, and 8 to 13 mm with coma. Moreover, drowsy or stuporous patients and some comatose patients had widened cisterns between the tentorial edge and the midbrain on the side of the mass, suggesting that the space was not filled by herniated medial temporal lobe. Downward displacement of the pineal body, indicating central transtentorial herniation, did not occur. Compression of one hemisphere by the other anteriorly (transfalcial herniation) was inconsistently related to alertness, though very large anterior displacements may have caused stupor in some patients. Current concepts of the pathoanatomical nature of depressed consciousness, based on pathological material obtained well after clinical examinations, may require revision, because they do not reflect early brain-tissue distortions. PMID- 3960060 TI - Interactive medical telecomputing. An alternative approach to community health education. PMID- 3960061 TI - Nobel Peace Prize lecture. A prescription for hope. PMID- 3960062 TI - Transmission of HTLV-III infection from man to woman to man. PMID- 3960063 TI - QRS duration in acute overdose of tricyclic antidepressants. PMID- 3960064 TI - The creatine kinase system in normal and diseased myocardium. PMID- 3960065 TI - Microangiopathy in a young adult with cystic fibrosis and diabetes mellitus. PMID- 3960066 TI - Increased serum pyridoxal-5'-phosphate in pseudohypophosphatasia. PMID- 3960067 TI - Dextromethorphan danger. PMID- 3960068 TI - The use of animals in research. PMID- 3960069 TI - Left (sided examination) may be right, too! PMID- 3960070 TI - Complete suppression of the symptoms of congenital erythropoietic porphyria by long-term treatment with high-level transfusions. PMID- 3960072 TI - Pet-associated illness. PMID- 3960071 TI - The campaign against smokeless tobacco. PMID- 3960073 TI - Antineoplastic drugs and spontaneous abortion in nurses. PMID- 3960074 TI - Smokeless tobacco use among native American adolescents. PMID- 3960075 TI - Basic medical equipment on commercial airlines. PMID- 3960076 TI - Breakfast of Champions or of hypertensives? PMID- 3960077 TI - More on medical treatment in South Africa. PMID- 3960078 TI - The campaign against smoking gains momentum. PMID- 3960079 TI - Chronology of cholelithiasis. Dating gallstones from atmospheric radiocarbon produced by nuclear bomb explosions. AB - We investigated the natural history of cholelithiasis in 59 samples of stones from the gallbladder or common bile duct in 15 patients, using as a tracer for the timing of stone formation the 14C released into the environment during nuclear weapons testing. The ages of the stones were correlated with the dates of onset of symptoms and with other clinical data. None of 11 symptomatic patients had symptoms or complications until at least two years (mean +/- SD, 8.0 +/- 5.1 years) after stone formation began. There was a lag time of 11.7 +/- 4.6 years between initial stone formation and cholecystectomy. The growth rates of stones from 11 symptomatic patients and 4 asymptomatic patients were similar (2.6 +/- 1.4 and 2.6 +/- 1.1 mm per year). Studies of two stones retrieved from the common bile duct showed that one had the same age as a cholecystic stone; the other, removed two years after cholecystectomy, apparently grew in the common bile duct. The long latency period between the formation of gallstones and the onset of symptoms indicates that interruption of the natural progression of gallstone disease is potentially possible with medical therapy. PMID- 3960080 TI - Do seizures in children cause intellectual deterioration? AB - We studied whether the occurrence of seizures in childhood affected intellectual performance. We compared the full-scale IQs at seven years of age of children who had experienced one or more nonfebrile seizures with the IQs of their seizure free siblings who were tested at the same age in a large longitudinal study. Among 98 children with seizures, the mean score on IQ tests at seven years was not significantly different from the mean score of their siblings. Mental retardation was more common among the children with seizures, but the excess was accounted for by children who had neurologic abnormalities before the first seizure. We also examined the IQ before and after the onset of seizures in 62 children whose first seizure occurred in the interval between psychometric examinations given at four and seven years of age. The IQ at seven years in the children with seizures did not differ significantly from that in controls matched for IQ (as determined at the four-year assessment), sex, race, and socioeconomic status. Thus, in both the sibling-control comparison and the comparisons made between controls and subjects before and after the onset of seizures, the occurrence of nonfebrile seizures was not associated with a significant change in full-scale IQ. PMID- 3960081 TI - The use of ambulatory testing in prepaid and fee-for-service group practices. Relation to perceived profitability. AB - To examine the influence of method of payment on ambulatory testing by internists, we compared the rate at which patients with uncomplicated hypertension were tested by 10 doctors practicing in large fee-for-service groups with that by 17 doctors in large prepaid groups. We examined the use of individual tests and asked the doctors in the fee-for-service groups what they believed about the profitability and costs of tests. After correcting for the patient's age, sex, duration of disease, and severity of disease as measured by pretreatment blood pressure, and for the doctor's year of medical school graduation, we found that 50 percent more electrocardiograms were obtained among patients in fee-for-service practices (0.69 per patient per year vs. 0.45, P = 0.006), and 40 percent more chest radiographs (0.49 vs. 0.35, P = 0.11). Fee-for service doctors believed that both tests were associated with high profit and costs. These results suggest that the use of certain high-profit, high-cost tests is higher in large fee-for-service groups than in large prepaid groups. Although the generalizability of conclusions based on this limited study must be considered tentative, the findings suggest that it may be appropriate to consider changing the payments for tests as part of a more general reform of the fee schedules. PMID- 3960083 TI - It is still a privilege to be a doctor. PMID- 3960082 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 16-1986. A 79-year-old woman with a progressive neurologic disorder of 12 years' duration. PMID- 3960084 TI - Doxorubicin cardiotoxicity. PMID- 3960085 TI - Long-term follow-up of patients with mitral-valve prolapse. PMID- 3960086 TI - Drug use in pregnancy and congenital heart disease in offspring. PMID- 3960087 TI - Person-to-person transfer of transdermal drug-delivery systems: a case report. PMID- 3960088 TI - Peer review organizations. PMID- 3960089 TI - Bacteriuria and mortality in an elderly population. AB - Bacteriuria detected in the screening of adult and elderly populations has been associated with an increased mortality rate, but it is not clear whether the increase is a result of the bacteriuria itself or of differences in age, concomitant disease, or both. We screened a representative sample of the elderly population of Goteborg, Sweden (n = 1966), for bacteriuria. The mean (+/- SD) age at the time of screening was 70 years +/- 2 months. The five-year mortality among women with bacteriuria was 13.4 percent, whereas that among women without bacteriuria was 9.4 percent. The nine-year mortality in the two groups of women was 23.9 and 23.3 percent, respectively (P not significant). When the women with indwelling catheters were excluded from the analysis, the five-year mortality was 9.0 and 9.2 percent, respectively. Men with bacteriuria had an increased frequency of cancer (27.3 vs. 5.8 percent at age 70; P less than 0.002) and a higher five-year mortality than the other men; however, among the men with bacteriuria but not cancer the mortality was not increased. We conclude that fatal diseases associated with bacteriuria may account for the increase in mortality among elderly patients with bacteriuria. PMID- 3960090 TI - Heparin use as a risk factor for intraventricular hemorrhage in low-birth-weight infants. AB - In a systematic review of data on drug use and adverse clinical events in infants with birth weights under 2000 g, we observed an association between germinal matrix-intraventricular hemorrhage and the use of heparin to maintain the patency of vascular catheters. Sixty-six infants with germinal-matrix (periventricular) or intraventricular hemorrhage or both (cases) were matched with 254 infants with other conditions (controls), and analysis, taking the matching factors into account, yielded an odds ratio of 14.0 (95 percent confidence interval, 5.4 to 34). When potential confounding factors were taken into account, the odds ratio was 3.9 (1.4 to 11). The association did not appear to vary according to the severity of hemorrhage or to the method of administration or dose of heparin. The data suggest that the routine use of heparin in neonatal intensive care units is associated with a four-fold increase in the risk of germinal matrix intraventricular hemorrhage. Because of the possibility that confounding may have been incompletely controlled for, the true risk cannot be determined from these data, and a controlled clinical trial of heparin use in low-birth-weight infants is recommended. PMID- 3960091 TI - Adult supraglottitis (epiglottitis) PMID- 3960092 TI - Circadian variation in myocardial infarction. PMID- 3960093 TI - Failure of open-heart massage to improve survival after prehospital nontraumatic cardiac arrest. PMID- 3960094 TI - More on AIDS in a surgeon. PMID- 3960095 TI - HTLV-III/LAV infection of the central nervous system in a 57-year-old man with progressive dementia of unknown cause. PMID- 3960096 TI - Extracranial-intracranial arterial bypass. PMID- 3960098 TI - Rational remuneration. PMID- 3960097 TI - Decreased glucocorticoid receptors in cultured skin fibroblasts from a patient with primary cortisol resistance. PMID- 3960099 TI - A fatal poisoning from an amatoxin containing Lepiota. AB - The mushroom Lepiota josserandii Bon and Boif. has been identified as the cause of an unintentional, fatal intoxication in New York. The course of the symptoms, beginning with a 9 h latent period, was similar to what would be expected in a case of Amanita phalloides-type intoxication. Despite supportive medical care the victim expired 110 h after ingestion. Thin layer chromatography detected the presence of alpha- and gamma-amanitin and radioimmunoassay confirmed a level of 3.5 mg/gm dry weight of amatoxins in mushrooms from the same location. PMID- 3960100 TI - Enzyme-linked immunosorbent assay for secalonic acid D. AB - A competitive enzyme-linked immunosorbent assay was developed for the xanthone dimer secalonic acid D. The immunogen and enzyme marker were prepared by direct reaction of secalonic acid D with bovine serum albumin and horseradish peroxidase, respectively. The resultant conjugates were characterized by UV/VIS spectra and thin layer chromatography. The hapten:protein ratios in the conjugates were estimated by difference UV/VIS spectra and by fluorescent techniques. Immunization procedures were conducted utilizing New Zealand rabbits over a period of 12 weeks. The competitive enzyme-linked immunosorbent assay on microtiter plates showed that secalonic acid D was detectable within a range of 250-25 000 ng/assay. PMID- 3960102 TI - Antifungal activity of some mediterranean algae. AB - The antifungal activity of 15 mediterranean algae species on some dermatophyte strains (Epidermophyton floccosum, Microsporum canis, M. gypseum and Trichophyton mentagrophytes) and pathogenic yeasts (Candida albicans, C. guillermondii, C. krusei, C. tropicalis and Torulopsis glabrata) has been tested following a modification of Aubert's technique. Among the algae species studied, Falkenbergia rufolanosa is the most active in front of all the fungi tested. PMID- 3960101 TI - Paracoccidioidomycosis in a four-year-old boy. AB - A case of fatal, generalized paracoccidioidomycosis is described in a four-year old urban dwelling child. Marked lymphadenopathy, hepatosplenomegaly and an abdominal mass were the main clinical manifestations. The diagnosis was established by histopathological studies and culture. The authors comment on the rarity of this infection in children less than 7 years of age and on the importance of considering this pathology in the differential diagnosis of malignant non-Hodgkin lymphoma and tuberculosis, in children. PMID- 3960103 TI - Embryo research. PMID- 3960104 TI - Developmental neurobiology. Axon outgrowth in vertebrates. PMID- 3960105 TI - Molecular biology. Brevity is the soul of wit. PMID- 3960106 TI - Serial and parallel processing of visual feature conjunctions. AB - Treisman and others have reported that the visual search for a target distinguished along a single stimulus dimension (for example, colour or shape) is conducted in parallel, whereas the search for an item defined by the conjunction of two stimulus dimensions is conducted serially. For a single dimension the target 'pops out' and the search time is independent of the number of irrelevant items in the set. For conjunctions, the search time increases as the set becomes larger. Thus, it seems that the visual system is incapable of conducting a parallel search over two stimulus dimensions simultaneously. Here we extend this conclusion for the conjunction of motion and colour, showing that it requires a serial search. We also report two exceptions: if one of the dimensions in a conjunctive search is stereoscopic disparity, a second dimension of either colour or motion can be searched in parallel. PMID- 3960107 TI - Homing behaviour of axons in the embryonic vertebrate brain. AB - In embryonic nervous systems, growing axons must often travel long distances through diverse extracellular terrains to reach their postsynaptic partners. In most embryos, axons grow to their appropriate targets along particular tracts or nerves, as though they were following guidance cues confined to specific pathways. For example, in all vertebrates, axons from the retina invariably grow to the tectum along the well-defined optic tract. Yet, transplant experiments demonstrate that retinal axons make tectal projections even though they enter the brain at locations which are distinctly off the optic tract. Only recently has it become possible to label discreet growing projections in the embryonic vertebrate brain. Thus, it is not yet known whether displaced retinal axons grow directly towards the tectum or find it accidently, through random extension. To resolve this question, pioneering axons from normal and transplanted eyes in embryonic Xenopus were labelled using a short-survival horseradish peroxidase (HRP) method, and their orientation during growth was quantitatively assessed. The finding that the ectopic fibres head towards their distant targets implies that guidance cues are not restricted to specific pathways but are distributed throughout the embryonic brain. The significance of this result is discussed with respect to the ontogeny and evolution of the visual pathway. PMID- 3960110 TI - Medical Research Council. Government blamed for decay. PMID- 3960108 TI - Pathway selection by growth cones of identified motoneurones in live zebra fish embryos. AB - How is the adult pattern of connections between motoneurones and the muscles that they innervate established during vertebrate development? Populations of motoneurones are thought to follow one of two patterns of development: (1) motor axons initially follow stereotyped pathways and project to appropriate regions of the developing muscle or (2) motor axons initially project to some regions that are incorrect, the inappropriate projections being eliminated subsequently. Here we observed individually identified motoneurones in live zebra fish embryos as they formed growth cones and as their growth cones navigated towards their targets. We report that from axogenesis, each motor axon followed a stereotyped pathway and projected only to the specific region of the muscle appropriate for its adult function. In addition, the peripheral arbor established by each motoneurone was restricted to a stereotyped region of its own segment and did not overlap with the peripheral arbor of the other motoneurones in that segment. We conclude that the highly stereotyped pattern of innervation seen in the adult is due to initial selection of the appropriate pathway, rather than elimination of incorrect projections. PMID- 3960109 TI - Retrovirus-mediated transfer and expression of drug resistance genes in human haematopoietic progenitor cells. AB - Patients with certain genetic disorders can be cured by bone marrow transplantation. However, as prospective donors do not exist for most patients with potentially curable genetic abnormalities, an alternative treatment for such patients involves the transfer of cloned genes into the patient's haematopoietic stem cells followed by re-infusion of the treated cells. Retroviral vectors provide an efficient means for transferring genes into mammalian cells and have been used to transfer genes into mouse haematopoietic cells. We have now produced amphotropic retroviral vectors containing either the bacterial gene for neomycin resistance or a mutant dihydrofolate reductase gene that confers resistance to methotrexate and have used these vectors to infect and confer drug resistance to human haematopoietic progenitor cells in vitro. Transfer could be demonstrated in the absence of helper virus by using an amphotropic retrovirus packaging cell line, PA12 (ref. 9). These studies are an important step towards the eventual application of retrovirus-mediated gene transfer to human gene therapy and for molecular approaches to the study of human haematopoiesis. PMID- 3960112 TI - Creationism. On the tracks of men and money. PMID- 3960111 TI - Environmental pollution. US suit charges cancer causation. PMID- 3960113 TI - Visual cortex. What layer 6 tells layer 4. PMID- 3960114 TI - Major groove or minor groove? PMID- 3960115 TI - X chromosomes and dosage compensation. PMID- 3960116 TI - Scotophobin resurrected as a neuropeptide. PMID- 3960117 TI - Perception of apparent motion by commissurotomy patients. AB - When two spatially separated light spots are flashed in rapid succession, the spot will appear to move between the two locations--an illusion called apparent motion. We have presented this display to callosum-sectioned human patients and found that they could correctly report the temporal order of a simple apparent motion sequence presented across the vertical meridian. Hence, the forebrain commissures are not required for this function. PMID- 3960118 TI - Sampling in spatial vision. AB - The human visual system is capable of making spatial discriminations with extraordinary accuracy. In normal foveal vision, relative position, width or size can be judged with an accuracy much finer than the size or spacing of even the smallest foveal cones. This remarkable accuracy of spatial vision has been termed 'hyperacuity'. Almost a century ago Ewald Hering proposed that the accuracy of Vernier acuity could be accounted for by averaging of discrete samples along the length of the lines comprising the targets; however, the discovery that Vernier acuity of a few arc seconds could be achieved with dots has rendered the nature and role of sampling in spatial discrimination unclear. We have been investigating the sampling of spatial information in central and peripheral vision (the perifovea) of normal human observers and in observers with strabismic amblyopia. Our results, presented here, show that peripheral vision and central vision of strabismic amblyopes differ qualitatively in their sampling characteristics from those of the normal fovea. Both the periphery and the central visual field of strabismic amblyopes demonstrate marked positional uncertainty which can be reduced by averaging of spatial information from discrete samples. PMID- 3960119 TI - Generation of end-inhibition in the visual cortex via interlaminar connections. AB - To understand the mechanisms by which the receptive field properties of visual cortical cells are generated, one must consider both the thalamic input to the cortex and the intrinsic cortical connections. In the cat striate cortex, layer 4 is the main recipient of input from the lateral geniculate nucleus, yet the cells in that layer possess several receptive field properties that are distinct from the geniculate input, including orientation specificity, binocularity, directionality and end-inhibition, the last of which allows cells to respond to edges of a restricted length. These properties could be generated by connections within the layer, by its input from the claustrum or by the massive projection that layer 4 receives from layer 6. In the present study, we attempted to determine the functional role of the layer 6 to layer 4 projection by reversible inactivation of layer 6 using the inhibitory transmitter gamma-aminobutyric acid (GABA). After inactivating layer 6, cells in layer 4 lost end-inhibition. Cells in layer 2 + 3, which receive their principal input from layer 4, were similarly affected. The elimination of end-inhibition was specific, other receptive field properties, such as direction selectivity or orientation specificity, remaining intact. PMID- 3960120 TI - Retrovirus insertion inactivates mouse alpha 1(I) collagen gene by blocking initiation of transcription. AB - Mov13 mice carry a single Moloney murine leukaemia virus (M-MuLV) proviral copy in the first intron of the alpha 1(I) collagen gene. Virus insertion interferes with the synthesis of stable alpha 1(I) collagen messenger RNA and causes a recessive lethal mutation. The virus insertion has induced changes of the methylation pattern as well as the chromatin conformation in the mutated gene. Specifically, a DNase-hypersensitive site which is associated with active transcription of the wild-type collagen gene is not present in the mutant allele. The block of collagen expression could be caused by virus-induced instability of collagen mRNA or by impaired initiation of transcription. To distinguish between these possibilities, we have compared the activity of the alpha 1(I) collagen gene promoter in cell lines derived from wild-type and Mov13 embryos by nuclear run-on transcription experiments and S1 mapping of nuclear RNA. We show here that initiation of transcription of the mutant gene is reduced 20-100-fold. This indicates that the virus-induced change of chromatin structure in the promoter region of the mutant gene prevents RNA polymerase from binding to its DNA template. Our results are consistent with the notion that the promoter-associated DNase-hypersensitive site is a prerequisite for rather than a consequence of gene activity. PMID- 3960121 TI - A model of synthetase/transfer RNA interaction as deduced by protein engineering. AB - The recognition of transfer-RNA by their cognate aminoacyl-tRNA synthetases is the crucial step in the translation of the genetic code. In order to construct a structural model of the complex between the tyrosyl-tRNA synthetase (TyrTS) from Bacillus stearothermophilus and tRNATyr, 40 basic residues at the surface of the TyrTS dimer have been mutated by site-directed mutagenesis and heterodimers created in vitro by recombining subunits derived from different mutants. As reported here a cluster of basic residues (Arg 207-Lys 208) in the N-terminal domain of one TyrTS subunit interacts with the acceptor stem of tRNATyr and two separated clusters of basic residues (Arg 368-Arg 371; Arg 407-Arg 408-Lys 410 Lys 411) in the C-terminal domain of the other subunit interact with the anticodon arm. The TyrTS would thus clamp the tRNA in a fixed orientation. The precise alignment of the flexible... ACCA 3' end of the tRNA for attack on the tyrosyl adenylate is made by contacts closer to the catalytic groups of the enzyme, such as with Lys 151. PMID- 3960122 TI - AIDS research. New human retroviruses: one causes AIDS ... PMID- 3960123 TI - Infectious AIDS. PMID- 3960124 TI - Japanese psychiatry. PMID- 3960125 TI - Intracellular signalling. GTP and calcium release. PMID- 3960126 TI - Link between lamins and intermediate filaments. PMID- 3960127 TI - Screwworm eradication a grand delusion? PMID- 3960128 TI - An ombudsman for laboratory animals? PMID- 3960129 TI - UK research. MRC units close. PMID- 3960130 TI - Cell biology. Finding the missing links. PMID- 3960131 TI - Evolution of antibodies. The road not taken. PMID- 3960132 TI - DNA structure. Bent molecules--how and why? PMID- 3960133 TI - DNA bending at adenine . thymine tracts. AB - Intrinsic bending of DNA molecules results from local structural polymorphism in regions of homopolymeric dA . dT which are at least 4 base pairs long; the A . T tracts must be repeated in phase with the helix screw. Bending, in the direction of base-pair tilt rather than roll, occurs at the junctions between the A . T tract and adjacent B-DNA, with a larger angle at the 3' than at the 5' end of the A tract. PMID- 3960134 TI - Long-range colour-generating interactions across the retina. AB - The existence of colour-generating interactions across the corpus callosum has recently been suggested from observations with a 'split-brain' patient, thus indicating long-range colour computations at the cortical level. Observations on induced colours described here suggest long-range colour computations at the retinal level. If a white surface surrounded by a particular colour is fixated for some time, the resulting after-image has two colours: the surround appears in complementary colour, whereas the white centre takes on the colour of the surround. The question of whether such colour induction is located in the retina or more centrally was tested in a brain-injured patient with hemianopia. It could be demonstrated that areas of the visual field that are no longer represented in the geniculo-striatal pathway still contribute to colour induction, suggesting that colour induction is a retinal phenomenon. PMID- 3960135 TI - Colour-contingent after-effects are really wavelength-contingent. AB - McCollough reported that following adaptation to (say) a red and black pattern of vertical stripes, alternating every few seconds with a green and black pattern of horizontal stripes, an orientation-contingent colour after-effect is observed when black and white gratings are viewed. Vertical gratings are tinged with green and horizontal gratings with pink. We have exploited colour constancy, the tendency for objects to appear constant in hue despite large changes in the spectral composition of the illuminant, to examine whether the colours observed on the McCollough effect test gratings are determined by the wavelength composition of the adaptation patterns or by their perceived colour. The key to this approach can be illustrated by Edwin Land's elegant demonstrations of colour constancy using 'Mondrian' displays. By embedding the adapting grating that is used to induce the McCollough effect within a Mondrian we show that the effect depends upon the wavelength of light coming from the grating, rather than the perceived colour. PMID- 3960136 TI - Envelope structure of Semliki Forest virus reconstructed from cryo-electron micrographs. AB - The basic principles of the architecture of many viral protein shells have been successfully established from electron microscopy and X-ray data, but enveloped viruses have been more difficult to study because they resist crystallization and are easily deformed when prepared for electron microscopy. To avoid the limitations of conventional techniques when applied to enveloped viruses, we have used a cryo-electron microscopy method in which unfixed and unstained viruses are observed in an unsupported thin layer of vitrified suspension. Because of electron beam damage, the many different views required for high-resolution three dimensional reconstruction cannot be obtained from a tilt series of the same particle. The images of many differently oriented viruses are combined using a novel reconstruction method, 'reconstruction by optimized series expansion' (ROSE). The structure of the envelope of Semliki Forest virus has been reconstructed to 3.5-nm resolution. The T = 4 geometry of the surface lattice, the shape of the trimeric spikes and their arrangement on the lipid bilayer are visualized. PMID- 3960137 TI - Structure of an adenine-cytosine base pair in DNA and its implications for mismatch repair. AB - Mutational pathways rely on introducing changes in the DNA double helix. This may be achieved by the incorporation of a noncomplementary base on replication or during genetic recombination, leading to substitution mutation. In vivo studies have shown that most combinations of base-pair mismatches can be accommodated in the DNA double helix, albeit with varying efficiencies. Fidelity of replication requires the recognition and excision of mismatched bases by proofreading enzymes and post-replicative mismatch repair systems. Rates of excision vary with the type of mismatch and there is some evidence that these are influenced by the nature of the neighbouring sequences. However, there is little experimental information about the molecular structure of mismatches and their effect on the DNA double helix. We have recently determined the crystal structures of several DNA fragments with guanine X thymine and adenine X guanine mismatches in a full turn of a B-DNA helix and now report the nature of the base pairing between adenine and cytosine in an isomorphous fragment. The base pair found in the present study is novel and we believe has not previously been demonstrated. Our results suggest that the enzymatic recognition of mismatches is likely to occur at the level of the base pairs and that the efficiency of repair can be correlated with structural features. PMID- 3960138 TI - Pairing of unwound DNA duplexes as hypothetical intermediates in genetic recombination. PMID- 3960139 TI - Multinuclear approach to nuclear magnetic resonance investigations in tissue with heteronuclei: 14N, 35Cl, 39K. PMID- 3960140 TI - Deutsche Pharmakologische Gesellschaft. Abstracts. 27th spring meeting, March 11 14, 1986, Mainz. PMID- 3960143 TI - [Stress and immunity: the importance of multidisciplinary research]. PMID- 3960142 TI - [Drugs against foot fungi]. PMID- 3960141 TI - [Bellyache or acute abdomen?]. PMID- 3960144 TI - [The Campylobacter pyloridis story]. PMID- 3960146 TI - [Information on cancer treatment in the media]. PMID- 3960145 TI - [Bacteremia in 2 general hospitals: the tip of the iceberg of hospital infections]. PMID- 3960147 TI - [Noninvasive diagnosis of peripheral artery disorders; the blood vessel laboratory]. PMID- 3960148 TI - [Observations on the perispinal administration of pharmaceuticals]. PMID- 3960150 TI - [The yet unexpected vitamin K deficiency]. PMID- 3960149 TI - [Vitamin K deficiency in infants]. PMID- 3960151 TI - [Barbiturates as sedatives--too dangerous to have in the house]. PMID- 3960152 TI - [Ruptures of the lateral ankle ligament(s); to operate or not?]. PMID- 3960153 TI - [Hemorrhage in the first weeks of life and vitamin K prevention]. PMID- 3960155 TI - [Patients admitted following attempted suicide or self-inflicted injury]. PMID- 3960154 TI - [Adenolymphoma (Warthin's tumor) of the parotid gland]. PMID- 3960156 TI - [A simple surgical method for the treatment of chronic ankle instability]. PMID- 3960157 TI - [Results of preoperative radiotherapy in patients with a local fixed rectal carcinoma]. PMID- 3960158 TI - [Medicine and euthanasia]. PMID- 3960159 TI - [Increasing number of suicide cases using different methods]. PMID- 3960160 TI - [Is the crest of the lung cancer epidemic in the Netherlands in sight?]. PMID- 3960161 TI - [Remember the small intestines]. PMID- 3960162 TI - [Inhalation corticosteroids in asthma]. PMID- 3960163 TI - [Kidney stone surgery: still necessary or superfluous?]. PMID- 3960164 TI - [Malignant tumors originating in the small intestine]. PMID- 3960165 TI - [Calcium antagonists in the treatment of angina pectoris]. PMID- 3960166 TI - [Diltiazem: a new calcium antagonist in the Netherlands]. PMID- 3960167 TI - [Serum fructosamine levels: an alternative measurement to the percentage glycosylated hemoglobin as a control measure for diabetes]. PMID- 3960168 TI - [Rifampicin induces withdrawal symptoms in methadone users]. PMID- 3960169 TI - [Analysis of pain scoring methods; the measurement of and discrimination between subjective feelings (pain and anxiety)]. PMID- 3960170 TI - [A consensus on cholesterol?]. PMID- 3960171 TI - [A sailor with an abdominal tumor]. PMID- 3960172 TI - [The significance of endocervical cells in the vaginal smear and a new technic for the collection of endocervical smears]. PMID- 3960173 TI - [A case of listeriosis in the 33d week of pregnancy]. PMID- 3960174 TI - [Tuberculosis of the skeleton]. PMID- 3960175 TI - [Euthanasia does not need legislation]. PMID- 3960176 TI - [Clinical pharmacokinetics--practical applications]. PMID- 3960177 TI - [Course and treatment of diabetic nephropathy]. PMID- 3960178 TI - [Follow-up study of the effects of lung rehabilitation in men with CARA]. PMID- 3960179 TI - [Kidney stone analysis]. PMID- 3960181 TI - ["Physicians without Frontiers" in Chad]. PMID- 3960182 TI - [Tumors of the cauda equina: the importance of early diagnosis]. PMID- 3960180 TI - [Epidemiology of primary glomerulonephritis and glomerulopathy in the South Limburg region]. PMID- 3960183 TI - [What is the value of carotid endarterectomy?]. PMID- 3960184 TI - [Differential diagnostic considerations in Raynaud's phenomenon]. PMID- 3960185 TI - [Bronchoalveolar lavage; clinical and diagnostic aspects]. PMID- 3960186 TI - [Reuse of pacemakers]. PMID- 3960187 TI - [Unexplained fatigue and hemoglobin level; a study of family practice patients]. PMID- 3960188 TI - [Regret after sterilization in women]. PMID- 3960189 TI - [Another route of transmission in a Legionella pneumophila hospital infection]. PMID- 3960190 TI - [The presence of parents at medical procedures and at induction of anesthesia]. PMID- 3960191 TI - [Euthanasia does not need legislation]. PMID- 3960192 TI - [The treatment of juvenile laryngeal papillomatosis in adults with alpha interferon]. PMID- 3960194 TI - Breast cancer: a challenge to Nebraska physicians. PMID- 3960193 TI - Neonatal intracranial ultrasound. PMID- 3960195 TI - Comparison of operative and percutaneous catheter drainage of intraabdominal abscesses. PMID- 3960196 TI - [Efferent projections of neurons of the mesencephalic locomotor region of the cat brain]. AB - Efferent projections of mesencephalic locomotor region neurons were studied by means of horseradish peroxidase technique in cat. Ascending and descending projections of these neurons to different structures of the brain with predominant course to the brainstem reticular formation were traced. Some fibres passed through the bulbar and spinal locomotor strip. Mutual bilateral interconnections of the mesencephalic locomotor regions were observed. PMID- 3960197 TI - [Isolation, identification and properties of the calcium component of the action potential in isolated neurons of the spinal ganglia of the rat]. AB - Electrophysiological properties of isolated dorsal root ganglion neurons from adult rats were studied by intracellular microelectrodes. All investigated cells were separated into two groups according to the duration of their action potential and the shape of its falling phase. The calcium component of the action potential could be separated by placing the cells into sodium-free, calcium- and TEA-containing medium. The presence of this component was revealed in all studied neurons. PMID- 3960198 TI - [Locomotion in the cat induced by electric stimulation of midbrain structures]. AB - Treadmill locomotion elicited by means of electrical stimulation of the central grey is shown in decerebrate cats. Thresholds were 20-200 microA. Stepping was also seen during 100 microA stimulation of the midline raphe nucleus. PMID- 3960199 TI - [Special forms of synaptic junctions in cultures of dissociated mammalian spinal cord and spinal ganglia]. AB - The ultrastructural study of cells in the monolayer culture of dissociated spinal cord and spinal ganglia of mouse embryos has been performed. The results obtained show that in the course of differentiation of completely isolated cells of the spinal cord special forms of synaptic contacts may appear. They are typical of the spinal cord of phylogenetically inferior animal species. These "mixed" synaptic contacts having properties both of electrical and of chemical synapses seem to represent phylogenetically determined processes of synaptogenesis. PMID- 3960200 TI - [Dynamic thermomapping of the brain of the rat during sensory stimulation and spreading depression]. AB - Dynamics of spatial distribution of temperature over the dorsal surface of white rat cerebral cortex was studied through the skull with the thermovision technics. Visual, somatosensory and acoustic stimulation revealed both diffuse and regionally specific thermoreactions of the brain as well as multiple local termoresponses. After injection of KCl into the cortex temperature waves spreading over the cortex were obtained. Mechanisms of brain patterned thermoreactions dealing with blood flow and neuronal metabolic thermoproduction are discussed. PMID- 3960201 TI - [Afferent connections of the nucleus of the facial nerve in the cat detected using the technic of retrograde axonal transport of horseradish peroxidase]. AB - Neuronal populations in the brainstem and spinal cord as sources of fibre pathways to the facial nucleus were studied in adult cats by means of microionophoretic injections of horseradish peroxidase into restricted zones of the facial nucleus. Projection from nucleus nervi hypoglossi, nucleus praepositus hypoglossi, nucleus raphe pallidus, nucleus intercalatus, medial nucleus of the solitary tract, dorsal motor nucleus of the vagus, neurons of genu of the facial nerve, ipsilateral red nucleus and reticular formation of the midbrain to the facial nucleus are found. Projections from a number of other brain structures to the facial nucleus are confirmed. A topographical map of distribution of the brainstem and spinal cord afferents in the facial nucleus is proposed. PMID- 3960202 TI - [Spreading depression in the cortex and subcortical structures of the brain of the rat induced by exposure to focused ultrasound]. AB - Steady potential shifts produced by focused ultrasound were recorded in the cerebral cortex, hippocampus, thalamus and caudate nucleus of the rat. Impulses of 50-100 ms duration were presented with frequency 5 and 10 Hz. Negative slow potential shifts gradually increased up to 3-7 mV during 10-30 s and were often followed by the spreading depression (SD) waves. In every analyzed structure the SD amplitude reached 20-30 mV; the SD duration in the cortex, caudate nucleus and thalamus was 30-40 s while in the hippocampus it was 80-120 s. Seizures initiated by the ultrasound influence proceded in some cases the SD. Threshold ultrasound doses were not effective for 5-7 min after every the SD wave but at the end of the refractory period they became effective again. So, local influence of the focused ultrasound may result in functional blockade of the brain structures due to the cortical and subcortical spreading depression. PMID- 3960203 TI - [Olfactory rhythm in the electrical activity of the amygdaloid nucleus of the human brain]. AB - Electrical activity of human amygdala was studied by implanted electrodes at epileptic clinic. Respiration-linked spindles of 20-30 cps, 30-50 microV, 1-3 s duration were registered in response to various odoriferous stimuli. Room air was less but effective to induce this activity. The spindles seemed to emerge at the end of inspiration or the beginning of expiration and in case of monorhinal breathing or sniffing occurred in the ipsilateral structure only. Frequency analysis (within 20-40 Hz range) showed that quasisinusoidal olfactory rhythm may be expanded into sinusoidal components but no specific odour-dependent peculiarities of the rhythm were observed. PMID- 3960204 TI - [Spectral sensitivity of photoreceptors of the compound eye of the locust]. AB - Intracellular recordings have shown that there are three types of receptors in the retina of the locust with lambda max = 360, 430 and 530 nm. Their spectral sensitivity curves are considerably wider than the absorption curves of the corresponding pigments. On the basis of spectral sensitivity curves obtained and assuming that each receptor contains only one pigment, possible coefficients of electrical coupling between receptors with different spectral characteristics are calculated. They correspond to coefficients of electrical coupling obtained by Shaw and Lillywhite in the locust. Thus the observed broadening of spectral sensitivity curves as compared with the absorption curves of pigments may be caused by electrical coupling between receptors. PMID- 3960205 TI - [Morphologic features of the chemosensory, visual and vestibular pathways of Helix lucorum]. AB - The structure of chemosensory, visual and statocyst pathways of the snail Helix lucorum has been studied by means of five histological methods. The chemoreceptors of the optic tentacle bulb, small and large neurons of tentacle ganglion and bipolar cells of olfactory nerve send their processes to the CNS of the mollusc. In the CNS these processes divide into many clusters of branches. All protocerebral cells and the cluster of neurons of the commissural part of metacerebrum send their processes within the olfactory nerve towards the periphery. The axons of eye cells terminate in the enlargement of optic nerve near the eye; so do the CNS cells and neurons of the optic nerve. In the neuropile of pleural part of metacerebrum a region of ramification of cell axons of the visual pathway is found. Hair cells of statocyst send their axons within the static nerve to the cerebral ganglion (CG). Small cells of metacerebrum send their axons towards the statocyst. In the neuropile of ipsilateral CG some processes of statocyst pathway cells divide into many thin branches; others- cross to the contralateral cerebral neuropile via the commissure joining two CG. In the neuropile of contralateral ganglion these processes give off a spray of many branches just as in the ipsilateral ganglion. The axons of the visual pathway cells and statocyst pathway cells ramify in the same region. PMID- 3960206 TI - [Differences in the properties of 2 groups of orientation detectors of the visual cortex in the cat]. AB - Functional properties of 149 neurons in field 17 of the visual cortex were studied in immobilized cats. They were divided into two groups. In 37% of neurons the initial and peak latencies of responses changed not more than by 10 ms in the orientation range. They were named "timer"-neurons. 63% of neurons were called "scanners". "Timers" reliably differed from "scanners" in shorter latencies, time of the discharge frequency increase, duration of the response and higher discharge frequency in all stimuli orientations. Scanners had a higher orientation selectivity, they considerably more often scanned the range of orientations in time. Neurons of the two groups had contraphase dynamics of the width of tuning orientation during response while distribution of their preferential orientations supplemented each other. In orientation columns of the visual cortex, both timers and scanners were most often found with a predominance of the latter. The columns consisting of only timers or only scanners were more seldom. The role of differences in properties of two neuronal groups in the cat visual cortex for orientation detection is discussed. PMID- 3960207 TI - [Responses of caudate nucleus neurons to acoustic stimulation during functional blockade of the centrum medianum of the thalamus in the cat]. AB - Responses of caudate nucleus to sound clicks (0.5/s) were recorded extracellularly in chronic experiments on cats under conditions of functional blockade of centrum medianum. Analysis of average poststimulus histograms has shown that functional blockade of centrum medianum in 30% of the caudate nucleus neurons induced a decrease in phasic activating responses to sound signals and in 52% of neurons their disappearance. A decrease in the level of spontaneous caudate nucleus neurons activity was also found. Direct pathways from centrum medianum to caudate nucleus are discussed for their significance in transmission of sound signals to caudate nucleus neurons. PMID- 3960208 TI - Lymphonodal response to sensitization with 2,4-dinitrochlorobenzene (DNCB) in laboratory rats. AB - The authors investigated the lymphonodal response to peripherally administered 2,4-dinitrochlorobenzene (DNCB). DNCB is known as a strong irritant binding to membrane proteins of the Langerhans cells of the skin. The conjugate is a potent neoantigen able to induce local tumor-destruction and raise cellular immune defence. White laboratory rats were used for the experiments. Their popliteal lymph nodes were investigated after sensitization with DNCB and i.c. injection of H3-thymidine and Patent Blue Violet at several intervals following the challenge with the hapten DNCB. Changes of weight of lymph nodes further uptake of H3 thymidine by the cells were investigated by autoradiography, while the content of H3-DNA indicating an increased DNA-metabolism due to blastic transformation of the small lymphocytes, was determined quantitatively by a liquid scintillation method. The data obtained speak for the usefulness of DNCB as an immunostimulant, comparable to BCG but of less toxicity. PMID- 3960209 TI - Effect of hydroxyurea treatment on lysosomal membrane stability and enzyme latency in L5178Y cells in culture. AB - The stability of lysosomes prepared from hydroxyurea (HU) treated or untreated L5178Y cells and exposed to an HU-free iso- or hypoosmotic solution was compared. The data revealed that exposure of the cells to 1-10 mM HU for few hours tends to stabilize lysosomes. Partial protection against this effect could be afforded by catalase and superoxide dismutase. Under the same conditions of HU treatment lysosomal enzyme latency remained similar in HU treated and untreated cells. PMID- 3960210 TI - Ovarian and endometrial endometrioid carcinoma: diagnostic implications of flow cytometry. AB - Surgical specimens from two patients with simultaneously occurring ovarian and endometrial endometrioid carcinoma were studied by flow cytometry (FCM) and routine histological examination. Tissue derived from the uterine and the ovarian lesion showed similar FCM curves in each case. The information obtained from FCM was more relevant than the study of frozen histological sections as far as confirming or ruling out a common histogenesis was concerned. Study of paraffin sections provided additional data, suggestive of metastatic spread from ovary to uterus in Case 1, and from uterus to ovary in Case 2. PMID- 3960211 TI - In vitro monocyte maturation in patients with malignant melanoma and colorectal cancer--clinical significance. AB - In vitro monocyte maturation was studied in 52 malignant melanoma patients, 15 patients with colorectal cancer and 44 healthy donors. Index of maturation (IM) was in malignant melanoma patients 6.3 +/- 5.1%, in colorectal cancer 12.7 +/- 9.6%, and in healthy donors 40.4 +/- 18.0%. The difference between mean values in malignant melanoma patients and patients with colorectal cancer was significant when compared with healthy donors (p less than 0.001). The values in malignant melanoma patients decreased in accordance with stage of the disease and the difference between Stage I and Stage IV was significant (8.2 +/- 4.0% vs. 2.8 +/- 2.0%, p less than 0.01). In patients with colorectal cancer significant difference was established between operated patients and inoperable cases (21.4 +/- 10.0 vs. 5.1 +/- 1.9%, p less than 0.01). Monocyte maturation was influenced by the success of treatment. In patients with complete response the values were significantly higher than in patients with progression (11.7 +/- 6.7% vs. 2.2 +/- 1.5%, p less than 0.001). Autologous serum seems to inhibit the maturation process in vitro in cancer patients, while it apparently has no influence in healthy donors. When a response to treatment was achieved the previously low values of IM increased, while at progression a decrease was noted. The correlation between in vitro monocyte maturation and clinical factors leads to conclusion that the in vitro maturation reflects the in vivo process and may prove useful as a marker of tumor load or spread and may be a sensitive monitor of the treatment effect. PMID- 3960212 TI - Zinc in human malignancies. AB - Serum zinc level (SZL) was determined in normal patients and in patients with primary tumors of different sites, with measurements made before and after therapy. Serum zinc concentration was depressed in some of the tumor types examined. In some cases serum zinc concentration increased again after successful treatment. Diagnostic and prognostic value of the serum zinc concentration in malignancy is discussed. PMID- 3960213 TI - Procarbazin in advanced malignant melanoma. AB - Experience in applying procarbazin in the treatment of advanced malignant melanoma are very limited. Actually it has never been adequately tested as monotherapy. We administered procarbazin to 28 patients in a dosis of 100 mg/m2 on days 1 to 10 at 4-week intervals. As a result we obtained 25% remissions which suggest that procarbazin deserves greater attention in the above indication. PMID- 3960214 TI - Gastric cancer in Poland--a decreased malignancy due to changing nutritional habits of the population. AB - The paper deals with the mortality pattern from stomach cancer over the period of last 20 years in Poland. The decrescent nature of gastric cancer was discussed in the light of data regarding the food consumption over several past decades and the results of the case-control study on stomach cancer and diet. In men the mortality rates dropped over 20 years by about 50% in younger and by about 40% in older age groups. Among women the drop in the rates was slightly faster than in men with the exception of age group 40-44 years. When examining the consumption of specific food products per capita over the period of last few decades, one has to note a marked increase in meat and drop in the consumption of cereals, as well as potatoes. The case-control study showed that the high risk of stomach cancer run the people with low level of vegetable and fruit consumption. Analysis performed confirmed the downward trend in stomach cancer rates in Poland over the last 20 years and explains the pattern observed by the marked changes in the nutritional habits of the population at large. PMID- 3960216 TI - [Unilateral and bilateral infarcts in the area supplied by the posterior thalamoperforating artery: neuropathologic findings]. PMID- 3960215 TI - [Specific antibody activity as a marker of pathogen-stimulated immune response in the central nervous system. Exemplified by syphilis and zoster diseases]. AB - Under normal conditions the portion of any antigen specific IgG of total IgG is identical in serum and CSF. This thesis was investigated in 51 patients who were found to have seropositive syphilis without CNS involvement. For this purpose a special index (ITpA-index) was used, based on the ratio of specific IgG per total IgG of CSF to specific IgG per total IgG of serum. This index has a value of 1 (0.5-2), if there is no antibody synthesis in the CNS, as confirmed on the 51 seropositive control patients. In patients with syphilitic CNS involvement the index rose above 2 (3-430), due to local antibody synthesis in the CNS. When there is an ITpA-index below 2.0 in patients with seropositive syphilis who show any CNS symptoms whatsoever, it can be presumed that the actual CNS disease is not a consequence of the former syphilitic infection, but is caused by a condition other than syphilis. In 6 patients with reactive syphilis tests, moderate CSF pleocytosis and increased CSF total IgG, the ITpA-index was below 0.5. Among these 6 patients the inflammatory CNS process was non-syphilitic. The principle of the ITpA-index is applicable to other bacterial or viral CNS diseases insofar as a local humoral immune response takes place. This could be demonstrated in cases of herpes zoster. PMID- 3960217 TI - [Congenital weakness of the vascular wall and dissecting aneurysm of the middle cerebral artery as a cause of anemic brain infarct in a young female]. PMID- 3960218 TI - [Holoprosencephaly and arhinencephaly]. PMID- 3960219 TI - [CT findings in patients with thalamic pain]. PMID- 3960220 TI - [Cryptococcal meningitis]. AB - Cryptococcal meningitis is a life-threatening disease. Headache, vomiting, cranial nerve symptoms and mental changes are the most common symptoms, but as many as 15% may have no symptoms referable to the CNS. For chemotherapy four drugs are available: namely amphotericin B, 5-fluorocytosine, miconazole and ketoconazole. Most cases have been treated by combination of amphotericin B and 5 fluorocytosine. The intrathecal administration of amphotericin B should be considered for patients who fail to respond to the usual intravenous therapy. The case is reported of a patient who died due to hydrocephalus, and the CSF-levels of the administered drugs are presented. Some pitfalls of therapy are discussed. PMID- 3960221 TI - [Toxoplasma encephalitis--multiple sclerosis: differential diagnosis by nuclear magnetic resonance tomography?]. PMID- 3960222 TI - [Partial seizure status with complex symptomatology. Case report on the problem of diagnostic difficulties]. PMID- 3960223 TI - [Suicidal tendency in the judgment of clinically-active physicians]. PMID- 3960224 TI - [Phenomenological spectrum of endogenous and depressive agitation]. PMID- 3960225 TI - [Vital disorders of the mouth (glossodynia) in depressive involutional psychoses]. AB - Eight cases of glossodynia arising in the context of an endogenous depression are reported and the case histories of four of them are presented. Somatic features, in particular the sensation of having a burned tongue, were by far the most prominent and tended to relegate the depressive symptoms to the background. The clinical picture can usefully be classified as the coenesthetic form of a depressive psychosis of late life. A good treatment response can be achieved with antidepressants, possibly in combination with neuroleptics. PMID- 3960226 TI - [Compulsory admission and ambulatory services]. PMID- 3960227 TI - [Psychogenic psychoses]. PMID- 3960228 TI - [The concept of reaction in psychiatry and its significance for the image of the psychiatrist]. PMID- 3960230 TI - [Cranial muscle activity in dissociated brain death]. AB - The origin of spontaneous myogenic activity during the registration of isoelectric EEGs for documentation of total brain death has not yet been explained. In nine patients with total brain death, completely abolished acoustic evoked brainstem potentials (AEP), somatosensory evoked potentials (SEP) as well as electrically evoked blink-reflexes (BR) were demonstrated. The peripheral conduction capacity of the facial nerve, however, was never impaired. These findings suggest that peripheral nerve function may be well preserved although brain stem activity is completely abolished and therefore support the thesis that the myogenic activity in cranial muscles in total brain death is not mediated by the brain stem but is of extracerebral origin. PMID- 3960229 TI - [Plasma exchange treatment in chronic polyneuritis of the Guillain-Barre type. Experiences with 9 personal cases]. AB - Following a review of pertinent literature, nine cases of chronic polyneuritis are reported, who underwent a total of 21 series of plasma exchange treatment during immunosuppressive medication. The effect of treatment was variable. Four out of 7 patients with relapsing and/or stepwise progressive disease demonstrated reproducible improvement of neurological signs. The three others responded to a lesser degree. Two patients with a chronic progressive course experienced only mild improvement. In general, the reaction to plasma exchange did not correlate with duration and severity of the previous clinical course, reaction to immunosuppressive drugs, or electrophysiological and morphological findings in muscle and nerve biopsies. Moreover, a clear correlation with pathogenic effects of patient-IgG in animal experiments ("passive transfer") was not discernible. PMID- 3960231 TI - [Cerebrospinal fluid changes in Garin-Bujadoux-Bannwarth meningoradiculitis]. AB - 56 cerebrospinal fluid (CSF) and 46 matched serum samples were investigated in 23 patients, who suffered from meningopolyneuritis Garin-Bujadoux-Bannwarth. CSF cells and proteins were elevated for several months. The most prominent findings were the predominantly lymphocytic cell reactions with high numbers of plasma cells and the persistence of humoral immune reactions, i.e. intrathecally produced IgG, IgM and IgA. Both give evidence that the responsible infectious agent has rather low pathogenic but high immunogenic properties and that it has a tendency for a long persistence in the nervous system. PMID- 3960232 TI - [Optic neuritis and myasthenia]. PMID- 3960233 TI - [Brain infarct and polyradiculitis as a sequela of attempted suicide with disulfiram]. PMID- 3960234 TI - [Benign pseudovestibular cerebellar infarct]. PMID- 3960235 TI - [Brain abscess with Actinomyces naeslundi. Case report]. PMID- 3960236 TI - [Normalization of hyperreactive thrombocytes in patients with TIA by piracetam?]. PMID- 3960237 TI - [A rare cerebrospinal fluid finding in carcinomatous meningiosis]. PMID- 3960238 TI - Growth of tall boys without and during androgen treatment. PMID- 3960239 TI - Plasma exchange in a patient with severe rheumatoid arthritis complicated by mononeuritis multiplex and cutaneous ulcers. PMID- 3960240 TI - Diminished parathyroid gland responsiveness to hypocalcemia in diabetic patients with uremia. AB - The parathyroid gland responsiveness to hypocalcemia induced by short-term calcium-free hemodialysis in patients with insulin-dependent diabetes mellitus was investigated in comparison with 10 nondiabetic uremic patients and compared with test results from the autonomic nervous system. Diabetic patients had lower C-terminal parathyroid hormone (cPTH) levels before hemodialysis than uremic control patients and showed a significantly smaller increase in cPTH during hypocalcemia. The neurological tests revealed severe disturbances of the autonomic functions in the diabetic group. In conclusion, the disturbances observed in the parathyroid secretory pattern are probably caused by gland dysfunction; it is hypothesized that the defective autonomic nervous system has an additional effect on the development of this hormonal dysfunction. PMID- 3960241 TI - Effects of hemodialysis on guanidinopropionic acid metabolism. AB - Blood levels of guanidinopropionic acid (GPA), a putative uremic toxin, have been evaluated in 5 uremic patients before a dialytic session, at the end of it and during the following 68 h. GPA levels are markedly higher in uremic patients than in controls and are significantly reduced at the end of dialysis even if still higher than in controls. The clearance of GPA is similar to those of urea and creatinine, even if at the end of the dialysis session the percent decrease of GPA is significantly lower than that of urea. During the first 8 h after the end of dialysis GPA levels increase steeply; subsequently, the rate of accumulation of GPA in blood declines markedly remaining constant until the 68th hour. In conclusion GPA is markedly increased in blood of uremic patients and is significantly removed by dialysis. The evaluation of GPA increase per hour after the end of dialysis may provide an estimation of GPA production in uremic patients. PMID- 3960242 TI - Exercise training reduces coronary risk and effectively rehabilitates hemodialysis patients. AB - This study examines the effects of 12 months of endurance exercise training (cycling, walking and jogging) on lipid profiles, glucose metabolism, blood pressure, anemia and psychological function in 14 hemodialysis patients. Maximal aerobic capacity (VO2max) increased 18% in the exercisers (p less than 0.01), but did not change in 11 controls. This was associated with a reduction in depression, a decrease in dosages of antihypertensive medications, a significant increase in hematocrit and hemoglobin levels (red cell mass rose, plasma volume did not change), a decrease in plasma triglyceride by 23% (p less than 0.05) and an increase in high-density lipoprotein cholesterol (HDL-C) levels by 21% (p less than 0.01) (both HDL-C and triglyceride levels worsened in the sedentary controls), and an 18% increase in glucose disappearance rates (p less than 0.05) in spite of a 52% decrease in fasting insulin levels (p less than 0.01), suggesting that insulin sensitivity improved. These results demonstrate that some of the complications present in hemodialysis patients may be caused by their sedentary life-style, rather than endstage renal disease itself. This suggests that rehabilitation through exercise is possible for these patients. By reducing coronary risk factors in hemodialysis patients, exercise training may also decrease their heightened morbidity and mortality from atherosclerotic complications. These possibilities need to be examined in a longitudinal study. PMID- 3960244 TI - Limitations of the rat remnant kidney model of chronic renal failure: absence of calcium oxalate tissue injury. AB - We have studied the rat remnant kidney model as a tool to assess the impact of secondary oxalosis on renal failure. Although the plasma of uremic rats demonstrated increased levels of oxalic acid, deposits of oxalate crystals in tissue were not observed. The absence of such deposits in the remnant kidney, as well as other tissues, may be due to a lesser degree of hyperoxalemia observed in the rat compared to man or may reflect that uremic deaths among the experimental animals occurred prior to formation of detectable calcium oxalate deposition. We conclude that the rat remnant kidney is not a suitable model to study the impact of uremic oxalosis in man. PMID- 3960243 TI - Lowered tissue-fluid oncotic pressure protects the blood volume in the nephrotic syndrome. AB - We have studied the role of adjustments of tissue-fluid colloid osmotic pressure (COP) in the maintenance of the blood volume in 10 patients with the nephrotic syndrome before and after diuretic treatment until dry weight. A mean weight reduction of 13.5 +/- 6.4 kg was attended by a fall in blood volume in 3 patients and no change in 6, but the final blood volume was within the normal range: 84.3 +/- 3.7 ml/kg (normal value: 87.6 +/- 8.8 ml/kg). Albumin content and COP of tissue-fluid, obtained with subcutaneous wicks, were low before edema removal and rose slightly after it, parallel to changes in the plasma. Thus, the transcapillary gradient in COP did not change: 6.5 +/- 1.5 mm Hg before and 6.2 +/- 1.7 mm Hg after diuretic treatment. Considering the low COP, 8.6 +/- 1.6 mm Hg in edematous and 11.7 +/- 3.7 mm Hg in dry conditions, this gradient was only slightly below the value of about 10 mm Hg normally found with this technique. We conclude that a lowered tissue-fluid COP is important for the preservation of blood volume in dry patients with the nephrotic syndrome. In addition, this adaptation can explain why the blood volume is often normal and not expanded despite the sometimes huge overhydration in these patients. PMID- 3960245 TI - Evidence for a role of plasticizers in 'eosinophilic' peritonitis in continuous ambulatory peritoneal dialysis. PMID- 3960247 TI - Serum alpha-1-acid glycoprotein (AAG) in chronic renal failure. PMID- 3960246 TI - Increased plasma levels of alpha-1-acid glycoprotein in chronic renal failure are unlikely to be due to decreased renal elimination. PMID- 3960248 TI - Proteinuria and gut tumours. PMID- 3960249 TI - Normal-pressure hydrocephalus: twelve years experience. AB - The authors report on twelve years experience with so-called normal pressure hydrocephalus. If care is taken to make a correct diagnosis and give adequate treatment with a shunt, hydrocephalic dementia has a good prognosis. Such cases should be distinguished from other syndromes, particularly senile dementia and Alzheimer's disease. The occurrence of a syndrome of dementia should compel every neurologist and neurosurgeon to carry out careful investigations in order to determine the favourable time for possible treatment. PMID- 3960250 TI - Surgical treatment of multiple supratentorial aneurysms. AB - Multiple aneurysms are a common radiological finding in patients who have had a SAH. The doubtful question in the treatment of multiple aneurysms is whether to delay operation or treat the unruptured aneurysms conservatively. Patients with multiple intracranial aneurysms treated conservatively, have a late-rebleeding rate of 3% every year. We report our experience in seven cases treated surgically with complete exclusion of all the aneurysms. Surgical morbidity and mortality rates vary between 5 and 10%, although surgical procedures must be performed as soon as possible and should be preferred to delayed treatment. PMID- 3960251 TI - Our experiences in early aneurysm operations: a preliminary report. AB - Twenty-seven patients affected by ruptured aneurysms and operated on within three days of the first haemorrhage, are presented. At operation 22 patients were graded I-II; a six months follow-up showed a 22% mortality rate. Five patients were graded III-IV at operation and none survived. The results of early operation in our series are examined and discussed. In our opinion it is necessary to know the results of other larger series in order to obtain a final evaluation of early operations on aneurysms. PMID- 3960252 TI - Intrameatal aneurysm. AB - A case of aneurysm of the anterior inferior cerebellar artery at the internal auditory meatus is presented in which severe subarachnoid haemorrhage was followed by facial palsy. Eighteen cases in the literature are reviewed and their diagnostic and surgical implications discussed. PMID- 3960253 TI - Rupture of cerebral aneurysm during angiography. AB - The rupture of a cerebral aneurysm during angiography is an unusual event. There are approximately 35 reported cases in the literature. Our case was documented by both angiography and computed tomography. PMID- 3960254 TI - Intracavernous giant fusiform aneurysm of the carotid artery treated with Gianturco coils. AB - A 30-year-old man with a giant fusiform aneurysm of the intracavernous segment of the right carotid artery, clinically revealed by right painful ophthalmoplegia with exophthalmos, was treated by closure of the carotid artery in the neck with two paediatric Gianturco coils. The aneurysm, which had already shown partial spontaneous intraluminal thrombosis on CT and angiography, was no longer filled and its volume progressively decreased, with almost complete recovery of the oculomotor deficits. Serial CT and angiography performed seven months after treatment demonstrated the reduction in size of the aneurysm, its exclusion from the circulation and a good supply of the intracranial vascular bed, without the necessity of an extracranial-intracranial by-pass. PMID- 3960255 TI - Neurosarcoid reaction in association with a ruptured ACA-aneurysm. AB - A case of neurosarcoid reaction presenting itself as a mass lesion associated with a ruptured ACA aneurysm is reported. Diagnosis was established by histological investigation of the resected "brain tumour". The pre-operative diagnostic problems, similar cases in the literature as well as the possible pathogenesis are discussed. PMID- 3960256 TI - [Presence of newberyite in the right kidney and carbonated apatite in the left kidney in a patient with recurrent urinary infections]. AB - In about 20% of the cases, urolithiasis is directly linked to chronic urinary tract infection by urea splitting bacteria, essentially Proteus mirabilis. The stones are generally composed of struvite and carbonate apatite which usually occur as staghorn calculi feared because of their obstructive and infectious consequences that cause important renal damage. The case of a 48 year-old woman with chronic urinary infection is described whose right kidney showed a staghorn calculus essentially composed of newberyite, a very rare constituent of urolithiasis, and whose left kidney contained three carbonate apatite calculi. Clinical and technical examinations, relations between the two mineral constituents are discussed in this paper with a review of the literature on the subject. PMID- 3960257 TI - [Value of aspiration biopsy of subcutaneous fat in amyloidosis]. AB - Fine-needle aspiration of subcutaneous fat (FNAF) was performed in 24 patients, 12 with previously diagnosed amyloidosis presenting with proteinuria or nephrotic syndrome, and 12 presenting a nephrotic syndrome without amyloidosis on renal biopsy. FNAF was positive in 10 of 12 patients with amyloidosis (sensitivity: 83%) and negative in 12 of 12 patients with non-amyloid nephrotic syndrome (specificity: 100%). Considering a 2.5 to 10% prevalence of amyloidosis in adult patients with proteinuria or nephrotic syndrome, a positive FNAF is diagnostic of amyloidosis, and a negative FNAF rules out the diagnosis with a probability of 98 to 99%. FNAF is a simple and safe method which can be useful in patients who cannot undergo a renal biopsy. PMID- 3960258 TI - [Anemia in primary hyperparathyroidism]. AB - Among the complications associated with primary hyperparathyroidism, anemia has not been extensively studied. In order to assess the frequency of this anemia we make a retrospective study of the medical records of 62 patients with a primary hyperparathyroidism. In 40 of the 62 hyperparathyroidic patients the diagnosis was surgically proven (group 1) and in 22, typical laboratory changes were found (group 2). In all these cases no other causes of anemia, except hyperparathyroidism, could be found. The 2 groups were similar concerning age and sex. A normochromicnormocytic anemia was present in 11 patients in group 1 (24,5%) and in 7 in group 2 (31, 8%). This anemia was corrected after a successfull parathyroidectomy (parathyroid adenoma in all the operated cases). Anemia was correlated with neither Ca and P blood levels nor C1/P ratio. A significant inverse correlation was found between age and hemoglobin in anemic hyperparathyroidic patients. The etiopathogeny of this findings is discussed. PMID- 3960259 TI - [Evaluation of the modification of renal function induced by transit in the lateral decubitus position: a methodological problem]. PMID- 3960260 TI - [Diagnostic and therapeutic problems in a severe case of hyperparathyroidism with renal insufficiency]. AB - It may sometimes be difficult to distinguish primary from secondary hyperparathyroidism when advanced renal failure coexists. We report here the case of a patient with end-stage renal failure who had severe hyperparathyroidism. Cervical exploration revealed only the presence of four parathyroid glands normal in size and histological appearance which were removed. Because the existence of severe hyperparathyroidism had been firmly established based on biochemical and radiological evidence, the diagnosis of primary hyperparathyroidism due to an ectopic adenoma became obvious. Digital angiography and computerized tomography were then carried out. The results of angiography were inconclusive but computerized tomography revealed and precisely localized a mediastinal adenoma which was subsequently removed via sternotomy. The existence of a hypoparathyroid state was confirmed over the following two months. Reimplantation of parathyroid fragments which had been cryopreserved during the first operation, was then performed with success. PMID- 3960261 TI - [Preventive medical treatment of recurrent urinary calcium calculi]. AB - In 59 out of 80 patients with recurrent renal calcium stones studied between 1977 and 1982 and followed up for 4,5 to 7 years, an index has been used to determine the activity of the disease, before and after treatment with diet, high water intake, thiazide and/or allopurinol. As estimated by variations of the "activity index", the treatment was effective in all groups studied: patients with idiopathic hypercalciuria were prescribed a low purine and oxalate diet and a large water intake associated or not with thiazide; hyperuricosuric patients were treated by the same diet and allopurinol; patients with no metabolic abnormality were submitted to diet and/or thiazide and/or allopurinol. The association of thiazide and allopurinol seems to be a more effective therapy in recurrent stone formers with primary hyperoxaluria than high diuresis and succinimide. PMID- 3960262 TI - Stability of dendrites in cortical barrels of C57BL/6N mice between 4 and 45 months. AB - Qualitative and quantitative studies of dendritic parameters were conducted on Golgi-impregnated layer IV spiny stellate neurons in the posteromedial barrel subfield (PMBSF) of somatosensory cortex of the C57B1/6N mouse. Three mice each, at 4, 12, 22, 26, 30, 36 and 45 months of age were studied. No qualitative changes were observed among animals of different ages. The quantitative data indicated that dendritic length and numbers of segments remained unchanged over all ages studied. PMID- 3960263 TI - Age-dependent spontaneous EEG bursts in rats: effects of brain phosphatidylserine. AB - During aging, male Sprague-Dawley rats display increasing frequency of bursts of seizure-like EEG patterns. They also have a decreased retention of passive avoidance response and a loss of spontaneous alternation in a Y maze. A study was made on the effects of chronic administration of phosphatidylserine in aged rats. It was found that BC-PS reduced by 65% the number of seizures, and by 70% their duration. It also facilitated retention of passive avoidance and of spontaneous alteration behavior. These results suggest that phosphatidylserine can affect electrophysiological and behavioral parameters in aged rats probably by counteracting age-related biochemical changes. PMID- 3960264 TI - Hypothalamic aromatase activity in young and old male rats. AB - We studied the capability of hypothalamic tissue from young (3-4 months) and old (22-24 months) male rats to aromatize androgens to estrogens. Aromatase activity was measured in homogenates of brain tissue by using a radiometric assay that quantifies the stereospecific production of 3H2O from [1 beta-3H]androstenedione as an index of estrogen formation. Despite the 40% drop in circulating testosterone (T) levels associated with aging in males, we found that hypothalamic aromatase activity was unaffected by age. This finding suggested that chronic exposure to low levels of circulating T can maintain brain aromatase activity in aged male rats. In an experiment designed to examine the acute response of hypothalamic aromatase activity to induction by T, we found a significant positive correlation between circulating T levels and hypothalamic aromatase activity in both age groups. These results demonstrate that T remains an effective regulator of hypothalamic aromatase in old male rats. PMID- 3960265 TI - Testosterone is more effective than dihydrotestosterone plus estradiol in activating sexual behavior in old male rats. AB - Sexual behavior declines in old male rats, and testosterone therapy does not restore the behavior to levels found in young males. If as a result of aging, old males have less capacity to aromatize or reduce testosterone, dihydrotestosterone plus estradiol treatment should be more effective than testosterone treatment in restoring sexual behavior in old castrated males. In a test of this hypothesis, the sexual behavior of old (24 months) castrated Fischer 344 males given injections of testosterone propionate (TP) or dihydrotestosterone propionate (DHTP) plus estradiol benzoate (EB) and that of old sham-operated males given injections of vehicle were observed. The DHTP/EB proved to be less effective overall than the TP in increasing sexual behavior in old castrated males. In a second experiment, young (3 months) and old (30 months) males were tested to verify that the reduced effectiveness of DHTP/EB treatment was age-related. Testosterone propionate and DHTP/EB were equally effective in restoring most measures of sexual behavior in young castrated males. In old castrated males, DHTP/EB treatment was no more or less effective than TP treatment in increasing these same measures. Neither hormone increased the behavior of old males to the level found in young males. Since DHTP/EB treatment is less effective than TP treatment in stimulating sexual behavior in old males, a reduced capacity to aromatize or reduce testosterone is not a likely explanation for decreased responsiveness to testosterone in old male rats. PMID- 3960267 TI - 3H-imipramine binding in aged mouse brain: regulation by ions and serotonin. AB - The density of binding sites (Bmax) for 3H-imipramine was elevated in cerebral cortical, hypothalamic and hippocampal membranes from 24 month old male C57BL/6J mice. Cerebellar binding was constant with increasing age. There were no changes in the equilibrium dissociation constant (Kd) for 3H-imipramine in any brain region. The increase in the binding of 3H-imipramine induced by sodium and chloride ions in vitro was diminished in cerebral cortical homogenates from aged mice; both the sodium-sensitive and chloride-sensitive components of binding were about 50% less in aged mice. Dose-response curves indicated that the effectiveness with which chloride enhanced binding was similar with age, even though the absolute increase in binding was less. The rate of dissociation of 3H imipramine from cerebral cortical homogenates was similar with age and serotonin slowed the rate of dissociation equally at all ages. Possible mechanisms for the age-related increase in brain 3H-imipramine binding are discussed. Ion-sensitive binding is discussed in relationship to the current controversy surrounding desipramine-sensitive versus ion-sensitive binding. PMID- 3960266 TI - Age-related alterations in monoamine release from rat striatum: an in vivo electrochemical study. AB - In vivo electrochemistry was used to examine presynaptic alterations in dopamine release in the striatum of aged rats. Chronoamperometric determinations of monoamine release, induced by local micro pressure-ejection of K+, were made using Nafion-coated graphite epoxy electrodes. Recordings were made from the striatum of urethane-anesthetized Fischer 344 rats at 6, 24, and greater than or equal to 29 months of age. Following the in vivo electrochemical experiments, the animals were sacrificed and the caudate nucleus removed for analysis of whole tissue levels of monoamines and their metabolites using standard HPLC techniques. Overall, mean amplitudes of K+-evoked releases from the striatum of 6 month and 24 month F344 rats did not differ significantly (p greater than 0.1). However, this result was complicated by the observation that the mean values obtained from two separate groups of 24 month animals, recorded 6 months apart, were significantly different from each other (p less than 0.001). Mean releases for the later 24 month group were significantly less than for the 6 month group (p less than 0.01). No difference was found in the release magnitudes of 6 month animals recorded contemporaneously with the two groups of 24 month rats. Release amplitudes for the greater than or equal to 29 month group were clearly less than from the 6 month animals (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960268 TI - Effect of 64 hours of sleep deprivation upon sleep in geriatric normals and insomniacs. AB - Fifty-eight geriatric normal and chronic insomniac sleepers were screened with sleep recordings to define groups of 12 Normal (Sleep Efficiency greater than 85%) and Insomniac (Sleep Efficiency less than 80%) sleepers. All subjects then had 4 baseline sleep nights, 64 hours of total sleep loss, and 4 recovery nights. Insomniacs, had lower sleep efficiencies and less REM than Normals during baseline. Sleep efficiency was high (97%) in both groups on the first recovery night but decreased toward baseline values in both groups between the second (Normal) and fourth (Insomniac) recovery night. The groups had relatively little slow wave sleep, but had a significant increase on the first recovery night. Five Normals and one Insomniac had REM latency of less than 15 min on their first recovery night. This REM latency was found to be significantly correlated with the amount of slow wave sleep on baseline. Decreased REM latency in initial recovery sleep was interpreted as evidence of decreased pressure for slow wave sleep in aging. PMID- 3960269 TI - Circadian temperature rhythms in young adult and aged men. AB - The core body temperatures of ten healthy young adult and eight healthy aged men were recorded continuously for 14-24 hours using rectal thermometers and analog tape recorders. Aged subjects had significantly higher temperatures at the nadir of the temperature curve compared to the young subjects. Cosinor analysis of the data revealed that, while all subjects' data significantly fit an idealized cosine function of 24 hours periodicity, the peak to trough amplitude of the rhythm was significantly lower in the aged group. No group differences in the 24 hour mean temperature, the mean temperature during the sleep period time, the mesor, or the acrophase were found. These data are in essential agreement with previously reported data but expand upon those findings and demonstrate that the age-related changes in amplitude of the temperature rhythm are not confined to subjects studied under isolated laboratory environments. PMID- 3960271 TI - Rats that consume caffeine show decreased brain protein synthesis. AB - The effect of caffeine on protein synthesis in brain and liver was studied. When caffeine was added to a post-mitochondrial supernatant from rat brain protein synthesis was inhibited, i.e. 1 mM caffeine about 20%. The effect on protein synthesis of two weeks administration of large doses of caffeine in the drinking fluid of rats was also measured. Caffeine decreased protein synthesis in rat brain by about 32% and 20% compared with "ad libitum" and pair-fed controls. Protein synthesis was calculated taking into account the levels of free leucine determined by HPLC:0.10 mumol/g brain of "ad libitum"; 0.11 for pair-fed and 0.07 for caffeine. The pattern of proteins synthesized was not significantly altered by caffeine as shown by gel-electrophoresis and fluorography. There was no effect on protein synthesis of liver. The possible significance of these results is briefly discussed. PMID- 3960270 TI - Uptake of ethanolamine in neuronal and glial cell cultures. AB - The uptake of radioactive ethanolamine has been studied in exclusively neuronal and glial cell cultures from dissociated cerebral hemispheres of chick embryos. Both cell types show saturable kinetics; neurons have an apparent Km of 6.7 microM, Vmax 41.4 pmol mg prot.-1 min-1 and glial cells a Km of 119.6 microM, Vmax 3,917 pmol mg prot-1 min-1. The lower affinity of the transport and the 100 fold increase in Vmax observed in glial cells correlated with a more important accumulation of free ethanolamine found in glial cells and with a higher degree of phosphorylation of ethanolamine. The uptake appeared to be temperature and Na+ ions dependent but was not affected by CN- or ouabain. Monomethyl-, dimethylethanolamine and choline were effective in inhibiting the uptake. Little or no effect was observed with serine, methionine, carnitine, alanine or glutamate. PMID- 3960272 TI - Uptake and autoreceptor-controlled release of [3H]-GABA by the hypothalamic median eminence and pituitary neurointermediate lobe. AB - The uptake and release of gamma-[3H]-aminobutyric acid ([3H]-GABA) by the median eminence and the neurointermediate lobe of the pituitary was investigated using sucrose homogenates as crude synaptosomal preparations. Uptake in both areas showed predominantly neuronal specificity and similar Km values, but the median eminence had a considerably greater Vmax value. Release of [3H]-GABA could be stimulated by elevated K+ concentrations, in a Ca2+-dependent manner. Stimulated release was reduced by muscimol, implying the existence of presynaptic autoreceptors in both areas. A number of other transmitters and peptide hormones were demonstrated to have no effect on stimulated release of [3H]-GABA in either area. PMID- 3960274 TI - Central release of oxytocin, vasopressin and neurophysin by magnocellular neurone depolarization: evidence in slices of guinea pig and rat hypothalamus. AB - Using slices of rat hypothalamus maintained in vitro, we have examined release of oxytocin and vasopressin under conditions of increased neuronal activity. We report here that when the supraoptic or paraventricular nucleus is depolarized with high K+ solutions, hormone is released into areas close to the nucleus. Similar experiments with guinea pig hypothalamus suggest that neurophysin may also be co-released with oxytocin and vasopressin. Use of acetylcholine to selectively stimulate vasopressin neurones appears to evoke a rise in local release of vasopressin but not oxytocin. These results suggest that under conditions of increased neuronal activity, hormones normally secreted from the neurohypophysis are secreted locally into the hypothalamus. PMID- 3960273 TI - Effects of cortisol treatment on protein synthesis in septum and hippocampus of rat brain. AB - The effects of cortisol on protein synthesis in distinct brain regions were studied. Hormone administration produced increases in tubulin and actin content in the soluble fraction isolated from septum and hippocampus. Therefore, the poly(A)RNAs were isolated from the same brain regions and their translational capacity was tested in a heterologous cell-free system. Poly(A)RNAs from cortisol treated animals, as compared to control animals, had a stimulatory effect on 35S methionine incorporation into tubulin and actin. Thus, our results suggest that cortisol treatment increases the amount of mRNAs coding for tubulin and actin. More importantly, this study indicates that the molecular mechanism of glucocorticoid action in the brain involves modulation of protein synthesis. PMID- 3960275 TI - Two possible mechanisms for precocious puberty induced in female rats by pituitary grafts. AB - Many reports indicate that prolactin has a role in puberty occurrence. The present study was developed to evaluate the action of pituitary grafts on puberty. Female rats grafted on day 21 with "adult' (90 days old) or "young' (21 days old) pituitaries showed precocious vaginal opening and first estrus. The puberty advancement induced by "adult' transplants was due to an increase in plasma prolactin values and can be blocked by bromocriptine treatment. The puberty advancement induced by "young' transplants was not associated with increased prolactin levels and cannot be blocked by bromocriptine. These results suggest the existence of two possible mechanisms in precocious puberty induced by pituitary grafts: a prolactin-dependent one and another one not directly related with prolactin. PMID- 3960276 TI - Effect of ovarian steroids to stimulate region-specific hypothalamic 5 hydroxytryptamine synthesis in ovariectomized rats. AB - Accumulations of 5-hydroxytryptophan (5HTP) and L-dihydroxyphenylalanine (L-DOPA) following decarboxylase inhibition as indices for 5-hydroxytryptamine (5HT) and catecholamine (dopamine and/or norepinephrine) synthesis, respectively, were both increased in the preoptic area-anterior hypothalamus (POA-AH) of ovariectomized rats treated with a combination of 17 beta-estradiol benzoate (E2) and progesterone (P). Similarly, an increased accumulation of L-DOPA was seen in the mediobasal hypothalamus (MBH) and median eminence (ME) of these animals although no change was observed in 5HTP accumulation in the MBH or ME of these rats. Hypophysectomy negated these steroid-induced effects on L-DOPA accumulation. However, hypophysectomy had no apparent effect on steroid-stimulated 5HTP accumulation in the POA-AH of these rats. Under the experimental conditions of our study, the results suggest that the stimulatory effect of ovarian steroids on hypothalamic catecholamine synthesis is dependent on an intact pituitary gland, that the stimulatory effect of ovarian steroids on 5HT synthesis in the POA-AH is not dependent on an intact pituitary gland, and (3) that ovarian steroids do not seem to influence 5HT synthesis in the ME or MBH. The significance of these results may lie in the function of these hypothalamic monoaminergic neurotransmitter systems to regulate gonadotrophin release and subsequent steroid feedback modulation of such central regulatory mechanisms. PMID- 3960277 TI - Monoamine biosynthesis in hypothalamic regions of dwarf mice: effect of replacement of deficient anterior pituitary hormones. AB - Female Ames dwarf and phenotypically normal female mice were killed 30 min after treatment with NSD-1015, an aromatic L-amino acid decarboxylase inhibitor. The accumulation of dihydroxyphenylalanine (DOPA) and 5-hydroxytryptophan were measured by high-performance liquid chromatography with electrochemical detection and provided estimates of the endogenous biosynthesis of dopamine (DA) in the median eminence (ME) and serotonin biosynthesis (5-HT) in all brain regions which were examined. Dopamine synthesis was markedly suppressed in the ME while 5-HT synthesis was enhanced in both the ME and mediobasal hypothalamus (MBH) of dwarfs as compared to phenotypically normal mice. Overall, catecholamine biosynthesis (DOPA accumulation) was suppressed in the MBH of the dwarf mice but was not different from that observed in normal mice in the preoptic area anterior hypothalamus (POA-AH). The biosynthesis of 5-HT was not different in the POA-AH of dwarf mice as compared to normal mice. In the second experiment dwarf mice received saline vehicle, ovine prolactin (PRL), growth hormone (GH) or thyroxin (T4) daily for 14 days. Normal mice received saline only. Replacement with PRL significantly enhanced DA synthesis in the ME and was the only hormone to suppress significantly the elevation of 5-HT synthesis normally observed in the ME and the MBH of the dwarfs. Both GH and T4 only partially reduced 5-HT synthesis in the ME and MBH so that this parameter was no longer statistically different from either saline-treated dwarfs or normal mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960278 TI - Neonatal electroencephalography during the first twenty-four hours of life in full-term newborn infants. AB - Analysis of 84 EEGs recorded during the first 24 hours of life in 80 full-term newborns admitted in intensive care unit for different reasons. - 35 died, 45 survived (normal outcome: 30, minor sequelae: 6, major sequelae: 9). Extremely abnormal EEGs (27 cases) demonstrated singly or in combination: electrical discharges - isoelectric activity (after 10 hours of life) - Permanent discontinuous activity with longest interval greater than 40 seconds, shortest interburst interval greater than 3 seconds, longest burst shorter than 6 seconds. These abnormalities were observed in babies with unfavourable outcome. Normal or minimally abnormal EEGs (31 cases) were observed in babies with normal outcome (21 cases), minor sequelae (3) or in babies died without cerebral injury at autopsy. Twenty-two EEGs could not be classified easily after a single recording, most of then obtained before the 10th hour of life. Sleep state organization was assessed in 56 neonates; sleep state organization was present in 11 infants (normal outcome or minor sequelae). The EEG of the first day of life can be a useful tool in assessing the degree of early cerebral injury in infants requiring intensive care. PMID- 3960279 TI - Spontaneous remission of cerebral palsy. AB - Among 2100 children with a diagnosis of cerebral palsy (CP) twenty carried the diagnosis: Previous CP, now normalized. Seventeen patients could be traced and were reevaluated. Cerebral palsy was diagnosed in these seventeen children (ten boys, seven girls) between the ages of three months and three years (average eleven months). They were found to be normal when reexamined between the ages of one year and five years (average two years two months). Two patients had tetraplegia, three diplegia, nine paraplegia ("paraplegia" were cases of diplegia with minimal affection of the upper limbs - now called "diplegia type I"), and one hemiplegia. One patient had atactic diplegia, and one was athetotic. The records of these seventeen patients were evaluated with respect to aetiology and symptomatology. Upon reexamination seven patients were found to be completely normal. Five patients had no motor symptoms but showed signs of specific neuropsychological difficulties. Two patients were intellectually retarded without motor symptoms. One showed signs of neuropathy, and one had fetal alcohol syndrome. Signs consistent with CP could be demonstrated in one patient only. This study shows that signs of CP may in rare cases disappear altogether. PMID- 3960281 TI - Genetic EEG patterns in febrile convulsions--a multivariate analysis. AB - Genetically determined EEG patterns being found during a longterm follow-up of children with febrile convulsions are subjected to a multivariate statistical analysis. The study is mainly concerned with the examination of interrelationships between spikes and waves, theta-rhythms, and photosensitivity. The three patterns form two-categorial variables (occurrence yes, no) and enter a three-way contingency table. Associations between the variables are examined by fitting a log-linear model to the data. Three effects in the structure of the contingency table are statistically significant: the main effect of theta-rhythms which are relatively frequent in the group, and the two-variable-interactions of spikes and waves with theta-rhythms and photosensitivity respectively. The results of the study emphasize that combinations of different genetic factors are important in the pathogenesis of febrile convulsions. PMID- 3960280 TI - Autoantibodies to neuroblastoma cell surface antigens in neuropsychiatric lupus. AB - A human neuroblastoma cell line, LA-N-1 was used as a target cell in a I131 radiolabeled staphylococcal protein-A (I131-SpA) binding assay, to characterize the pattern of antineuronal activity of human sera in fifty-four cases of systemic lupus erythematosus (SLE) including twenty-six patients with neuropsychiatric manifestations of SLE (LE-CNS), out of which ten were pediatric patients aged eleven to eighteen years, thirty-six normal donors and sixteen rheumatoid arthritis patients. The IgG binding activity of normal control sera with LA-N-1 neuroblastoma cells was determined to be 998 +/- 490 cpm I131-SpA, per 5 micrograms LA-N-1 protein (mean +/- SD), 2936 +/- 2607 cpm I131-SpA per 5 micrograms LA-N-1 protein for rheumatoid arthritis patients, 5109 +/- 3304 cpm I131-SpA per 5 micrograms LA-N-1 protein for SLE patients. The binding activity of for LE-CNS patients sera was: 10 565 +/- 2993 and 15 346 +/- 2993 cpm I131-SpA per 5 micrograms LA-N-1 protein, for the pediatric and adult group of patients respectively. Absorption assays disclosed that the antineuronal IgG autoantibody detected in the LE-CNS group of patients is cross reacting with human adult brain, while the anti-neuronal activity of rheumatoid arthritis and SLE patients could be removed by sequential absorption with homogenates of human lung, liver, and kidney, fetal calf serum, human muscle and human lymphocytes. We conclude that detection of autoantibodies binding to LA-N-1 human neuroblastoma cells may be helpful in the diagnostic workup of pediatric and adult LE-CNS patients. PMID- 3960282 TI - Benign myoclonus of early infancy or benign non-epileptic infantile spasms. AB - Lombroso and Fejerman (1983) described a syndrome which shares with West syndrome the clinical features of flexion spasm with onset in early infancy. However the syndrome differs from West syndrome in the absence of mental and psycho-motor involvement and having a normal EEG during wakefulness and sleep. We report four cases of these benign spasms of early infancy with polygraphic recording of the spasms providing the following information: the spasms are clinically similar to those often observed in West syndrome; namely they are characterized by a short (2-4 sec.) tonic contraction, there are no significant changes of the EEG concomitant to the spasm, series of spasms can occur not only during the daytime but also during sleep and immediately after awakening. Differential diagnosis is discussed with West syndrome and benign myoclonic epilepsy in infancy and with non-epileptic syndromes. The authors propose to name this syndrome: Benign Non Epileptic Infantile Spasms. PMID- 3960283 TI - Salla disease variants. Sialoylaciduric encephalopathy with increased sialidase activity in two non-Finnish children. AB - The case reports of two Swedish girls with initially pseudostationary clinical pictures, one simulating ataxic and the other dyskinetic cerebral palsy, are presented. It was eventually revealed that they had a slowly progressive encephalopathy with pronounced gross motor disability and signs of severe dyskinesia, but only mild intellectual delay. Electron microscopy of skin biopsies showed a picture identical to that in Salla disease. They had a moderately increased 5-10 fold urinary free sialic acid excretion, increased sialidase activity in lymphocytes but normal activity in cultured fibroblasts. These two Swedish cases represent variants of Salla disease, a group of conditions with probable genetic heterogeneity. PMID- 3960284 TI - Studies on a case of HHH-syndrome (hyperammonemia, hyperornithinemia, homocitrullinuria). AB - A patient with the hyperornithinemia, hyperammonemia, homocitrullinuria syndrome is described. This patient represents the 12th documented case of this rare, presumably autosomal recessive condition. Increased levels of ammonia, ornithine and homocitrulline were demonstrated in blood and cerebrospinal fluid. The blood ammonia concentration could be lowered by supplementation of the diet with low doses of arginine. High doses of arginine precipitated seizures, although plasma levels of arginine and ornithine were not altered. The uptake of ornithine by the particulate fraction of the patient's fibroblasts was lower than that of controls, but still measurable. It is suggested that HHH patients have a partial impairment of the uptake of ornithine by mitochondria. PMID- 3960286 TI - Basilar aneurysm surgery: the subtemporal approach with section of the zygomatic arch. AB - The authors propose a modification of the classic subtemporal approach for basilar aneurysm. This modification allows excellent access to the floor of the temporal fossa, the tentorial edge, and the interpeduncular fossa with less brain retraction than is required with the original technique. The procedure is described, our experience with it is presented, and suggestions are made for its use. PMID- 3960285 TI - High dose B6 treatment in infantile spasms. AB - A total dose of 0.2-0.4 g.kg-1 pyridoxine stopped infantile spasms with hypsarrhythmia in three infants within five to six days. The case histories are presented and the results briefly discussed. PMID- 3960287 TI - Chronic cerebral vasospasm: effect of calcium antagonists. AB - The efficacy of the calcium antagonists nifedipine and nimodipine was evaluated in a multiinjection canine model of severe chronic cerebral vasospasm. Each of 21 adult mongrel dogs (15 to 20 kg) was assigned to one of four experimental groups. All animals received a total of 15 ml of fresh, unheparinized arterial blood via three cisterna magna injections. Selective left vertebral arteriography was performed 1 week before and exactly 7 days after the simulated subarachnoid hemorrhage. Treatment with calcium antagonists was initiated at 24 hours and continued for 7 consecutive days. Comparisons were based on the percentage of reduction in basilar artery diameter. On a milligram/kilogram basis, we used the manufacturer's maximal recommended daily dosages of nifedipine, whereas the dosages of nimodipine used were 3 to 7 times greater than that reported to be therapeutically effective in reducing the incidence of severe deficits from vasospasm in patients with aneurysmal subarachnoid hemorrhage. In this laboratory trial, systemic treatment with calcium antagonists did not prevent or significantly reduce chronic arterial narrowing. In the control group, spasm reduced basilar artery diameter an average of 71% +/- 11 (SD). In the group treated with nifedipine, 10 mg orally every 6 hours, vessel diameter was reduced an average of 58% +/- 13%. In those animals treated with nimodipine, 20 or 40 mg orally every 4 hours, the basilar artery diameter was decreased an average of 59% +/- 8 and 56% +/- 7, respectively. A preliminary trial using direct intracisternal administration of these agents demonstrated increased vessel diameter within 20 minutes in four of six animals, supporting other reports that this route of administration may prove more efficacious in the treatment of chronic cerebral vasospasm. PMID- 3960288 TI - Improved neurological outcome in experimental focal cerebral ischemia treated with propranolol. AB - Propranolol has been shown to exert a protective effect in experimental myocardial, renal, and early acute focal cerebral ischemia. However, propranolol was not found to reduce infarct size in nitrous oxide-anesthetized, paralyzed, mechanically ventilated cats subjected to 6 hours of acute focal ischemia. The objective of the current investigation was to study further the effects of racemic (d,l)-propranolol on the evolution of acute focal cerebral ischemia in awake, conscious cats. Adult cats were anesthetized with halothane and underwent the implantation of an occluding device around the right middle cerebral artery. After a 48-hour recovery period, the right middle cerebral artery was occluded for 6 hours and then reopened, allowing reperfusion for an additional 6 hours. Neurological examinations were conducted every 2 hours throughout each experiment. Ten cats received d,l-propranolol (2 mg/kg) 1 hour before occlusion, immediately before occlusion, and every 2 hours throughout each experiment. Eleven cats serving as controls were not treated. The neurological examination significantly improved over time in the treated group when compared to the untreated group (P = 0.01). Carbon filling defects, gross brain swelling, and infarct size were reduced in treated cats. The results of this study suggest that propranolol does have beneficial effects in acute focal cerebral ischemia. PMID- 3960289 TI - Ventriculoperitoneal shunts in low birth weight infants with intracranial hemorrhage: neurodevelopmental outcome. AB - Fifty preterm infants (mean birth weight, 1266 +/- 303 g; mean gestational age, 30 +/- 2 weeks) who required a ventriculoperitoneal (VP) shunt for posthemorrhagic hydrocephalus (92% with Grade III or IV hemorrhage) were followed for neurodevelopmental problems. VP shunts were placed at a median age of 29 days (range, 18 to 87 days) after serial lumbar punctures failed to control progressive and symptomatic ventriculomegaly. A total of 34 infants (68%) required one shunt revision or more, and the overall infection rate per patient was 50%. Seven infants died, 2 from shunt infections. The infants were evaluated with audiological, ophthalmological, and neurodevelopmental examinations. Of the survivors, 11 (28%) have severe visual loss and 10 (24%) have hearing impairment. Of the infants, 21 (49%) have severe motor handicaps and 19 (38%) have seizure disorders. Developmental and motor scores were obtained using the Bayley or Knobloch-Gesell scales. Seven infants (18%) have normal developmental outcomes; 26 (60%) have multiple handicaps. Grade IV hemorrhage or the occurrence of seizures was a predictor of poor neurodevelopmental outcome. We conclude that progressive posthemorrhagic hydrocephalus in low birth weight infants is associated with multiple handicaps despite early VP shunt placement. PMID- 3960291 TI - Use of the Philadelphia collar as an alternative to the halo vest in patients with C-2, C-3 fractures. AB - We analyzed retrospectively 27 individuals with C-2, C-3 fractures, 8 of whom were treated with a Philadelphia collar rather than the more commonly used halo vest. Successful fusion without neurological deficit occurred in all cases whether treatment was by Philadelphia collar (n = 8), halo apparatus (n = 16), or prolonged bed rest (n = 3). There was an increase in subluxation in 3 patients in both the Philadelphia collar group and the halo apparatus group. However, 1 of the 3 in the collar group was uncooperative and discarded his collar during treatment. If he is excluded, the subluxation rate in the Philadelphia collar group is 27%; the rate in the halo group is 19%. The Philadelphia collar seems to be an acceptable means of stabilizing the neck in C-2, C-3 fractures, but one must consider the degree of cervical movement in the collar (as detected by dynamic x-ray films), patient reliability, and patient age. The presence of subluxation did not preclude successful fusion in either the Philadelphia collar or the halo vest groups. PMID- 3960290 TI - Delayed ischemic deterioration in patients with early aneurysm operation and intravenous nimodipine. AB - A consecutive series of 100 individuals with aneurysmal subarachnoid hemorrhage were subjected to early aneurysm operation followed by subsequent intravenous administration of the calcium antagonist nimodipine during the critical period for symptomatic vasospasm. A total of 85 patients were in Hunt and Hess neurological Grades I through III, and 15 were in Grade IV or V before operation. In 39 individuals the aneurysm was located in the anterior cerebral artery complex (ACA), in 29 it originated from the internal carotid artery complex (ICA), and in 32 individuals the ruptured aneurysm arose from the middle cerebral artery (MCA). Of the patients, 71% made a good neurological recovery; the morbidity was 22%, and the mortality was 7%. Of the Grade I-III patients, 79% made a good neurological recovery, and the mortality was 6%. Delayed ischemic cerebral deterioration with permanent dysfunction occurred in five patients, all with ruptured ACA aneurysms. No single patient in the ICA or MCA populations developed delayed ischemic deterioration with fixed neurological deficit despite the presence of several potential risk factors, especially among the MCA aneurysm patients. PMID- 3960292 TI - Comparison of surgical and anesthetic complications in neurosurgical patients experiencing venous air embolism in the sitting position. AB - Because venous air embolism (VAE) has been considered to be a major deterrent to use of the sitting position, records of 255 patients undergoing neurosurgery in the sitting position from 1975 to 1982 were reviewed to determine the nature of morbidity and mortality in relation to the surgical procedure as well as to the occurrence of VAE. Complications were classified as surgical or anesthetic during joint review by a neurosurgeon and two neuroanesthesiologists. Outcome was classified on the basis of postoperative hospital course and discharge examination. The incidence of VAE was 30%. Although there was a variety of perioperative complications in patients with and without VAE, most of the complications were related to the operative procedure, not the sitting position or VAE. The episodes of VAE did not seem to be significant factors in the perioperative morbidity and mortality in our series of patients operated upon in the sitting position. Two case reports are discussed in detail. PMID- 3960293 TI - Cavernous angioma: a review of 126 collected and 12 new clinical cases. AB - The histopathological, clinical, and radiological features of the intracranial cavernous angioma are reviewed, based on an analysis of 138 symptomatic, histologically verified cases. Twelve of the cases are from our own series and 126 were collected from appropriately documented reports in the modern literature. The analysis indicated that, at the time of diagnosis, one-third of the patients (49 cases) were being evaluated for seizures, one-third (40 cases) for clinical evidence of hemorrhage, and one-third (49 cases) for mass lesions. Unlike the other two groups, the group presenting with clinical evidence of hemorrhage was distinguished by a dominant age at the time of diagnosis (41% were diagnosed during the 4th decade of life), by a high incidence of prior neurological evaluation (43%), by a higher rate of diagnosis at autopsy (28%) than at operation, and by the absence of microscopic calcification within the lesion. PMID- 3960294 TI - Auditory brain stem evoked responses in comatose head-injured patients. AB - Brain stem evoked responses (BSERs) were obtained within the first 72 hours after hospital admission from 38 patients with closed head injuries whose Glasgow coma scale scores were 8 or less. Peak V latency differentiated patients with unfavorable outcomes (vegetative or dead) from patients with more favorable outcomes, but no features of the response could further discriminate good, moderate, and severe outcomes as assessed by the Glasgow outcome scale. These data provide further support that BSERs are generally resistant to central nervous system trauma but, when impaired, are prognostic of unfavorable outcome. PMID- 3960295 TI - Arachnoid cysts of the posterior fossa. AB - Arachnoid cysts of the posterior fossa are an uncommon clinical entity. The two cases presented in this review were evaluated without vertebral angiography. We think that the development of magnetic resonance imaging may obviate the need for angiography in selected cases. PMID- 3960296 TI - Pure word deafness: a possible explanation of transient deteriorations after extracranial-intracranial bypass grafting. AB - Pure word deafness is a rare behavioral disorder in which the comprehension of spoken language is grossly disturbed, but the abilities to speak, read, write, and process nonverbal auditory stimuli remain intact. This disorder is caused by superior temporal gyrus lesions in the dominant hemisphere that isolate Wernicke's area from incoming auditory information. This involved area is supplied by cortical middle and posterior temporal end-artery branches of the middle cerebral artery. Among approximately 100 extracranial-intracranial bypass procedures performed at our institution in the past 5 years, three patients developed the syndrome of pure word deafness. A cortical or posterior temporal branch of the middle cerebral artery was utilized as the recipient artery in each instance. In all cases, the deficit was transient, delayed (i.e. the patient did not awaken from anesthesia with the deficit), and unrelated to the preoperative deficit. The syndrome of pure word deafness may be more common after bypass than is currently recognized. Localized arterial spasm, dysautoregulation secondary to operative manipulation, or focal brain swelling may be operative mechanisms in the development of this and other delayed, reversible deficits related to bypass surgery. PMID- 3960298 TI - Clivus epidural hematoma: a case report. AB - An acute traumatic epidural hematoma extending from the odontoid process to the dorsum sella is described. The mechanism for the formation of an extradural hematoma in this unusual location seems to be related to age and a severe hyperflexion injury. PMID- 3960297 TI - Neuroleptic malignant syndrome complicating closed head injury. AB - Lethargy, hyperpyrexia, tremor, and rigidity associated with leukocytosis and elevation of the creatine kinase level occurred in a patient with a closed head injury who was being treated with haloperidol for control of agitation. This constellation of symptoms, known as the neuroleptic malignant syndrome (NMS), partially improved when the neuroleptic medication was stopped, but complete resolution of the syndrome did not occur until the patient was treated with bromocriptine. Because haloperidol is the most widely used medication for the agitation that develops in patients with significant closed head injuries, neurosurgeons should be aware of the NMS. The NMS is caused by neuroleptic medications and may initially present with unexplained hyperpyrexia, leukocytosis, and elevated creatine kinase levels. Halting the neuroleptic, supportive care, and the use of dantrolene sodium and bromocriptine are the treatment modalities of choice for this syndrome, which has a mortality rate of 20 to 30% and may be linked to malignant hyperthermia. PMID- 3960300 TI - Traumatic false aneurysms of the middle meningeal artery. AB - The authors report a rare case of traumatic false aneurysm of the middle meningeal artery associated with a delayed contralateral extradural hematoma. The extradural hematoma was evacuated, and the pseudoaneurysm was removed to avoid delayed rupture. The literature on traumatic aneurysms is reviewed. PMID- 3960299 TI - Intrasellar mucocele simulating pituitary adenoma: case report. AB - Mucoceles occupying the sella turcica with suprasellar extension are quite rare. A case of intrasellar mucocele is reported. The preoperative clinical and computed tomographic appearance could not be differentiated from that of pituitary adenoma. PMID- 3960301 TI - Variant aneurysms of the fenestrated basilar artery. AB - Two cases of aneurysm occurring on a fenestrated basilar artery are reported. One patient had a saccular aneurysm in the typical location at the vertebrobasilar junction at the proximal end of the fenestrated basilar segment. The aneurysm sac projected dorsally into the brain stem. The other patient had a blister-like aneurysm distal to a fenestration of the terminal basilar artery. The development of a distal aneurysm on a fenestrated basilar artery is predictable based on the reported morphology of the vessel wall in this vascular anomaly. PMID- 3960302 TI - Neuroradiological and electroencephalographic features in a case of temporal lobe status epilepticus. AB - A patient with medically intractable status epilepticus of temporal lobe origin is presented. A computed tomogram showed a low density area adjacent to the midbrain, possibly related to atrophy of the medial temporal lobe. Cerebral angiography revealed early filling veins and an anterior temporal blush. Magnetic resonance (MR) scanning (T2 weighted images) showed increased signal intensity in the region of the amygdala and anterolateral left temporal lobe. Ictal activity was recorded from scalp electrodes over the left temporal area, and many paroxysms were recorded from cortical surface electrodes. An anterior temporal lobectomy revealed only gliosis. The cerebral blood flow changes accompanying status epilepticus of focal origin are reviewed, and a possible relation of electroencephalographic, angiographic, and MR findings is discussed. PMID- 3960303 TI - Subarachnoid hemorrhage due to anterior spinal artery aneurysm. AB - This case report describes a 29-year-old man with subarachnoid hemorrhage due to an anterior spinal artery aneurysm. Surgical obliteration of the aneurysm was successful. This is the sixth reported case of an isolated symptomatic aneurysm of a spinal artery. PMID- 3960305 TI - Carotid artery surgery. PMID- 3960304 TI - Intraventricular morphine. PMID- 3960306 TI - Motor evoked potential. PMID- 3960307 TI - Effects of dexamethasone on brain edema induced by kainic acid seizures. AB - The histopathological alterations developing in the hippocampus, piriform cortex and thalamus of the rat brain, the blood-brain barrier damage, and the effects of dexamethasone pretreatment on the brain edema were investigated 4 h following intraperitoneal kainic acid administration. The most pronounced Evans Blue extravasation accompanied by increases in the water and sodium contents and a decrease in the potassium content, were observed in the thalamus. Dexamethasone, injected in a dose of 5 mg/kg 2 h before kainic acid administration, reduced considerably the vasogenic edema and neuronal damage in the thalamus, but the cytotoxic edema of the hippocampus and piriform cortex remained unaltered. Kainic acid-induced seizures lead to the development of vasogenic brain edema mainly in the thalamus, as well as to cytotoxic edema in the hippocampus and piriform cortex. The vasogenic edema seems to contribute to the cell damage in the thalamus. Dexamethasone reduces the vasogenic edema and cell damage in the thalamus, possibly by inducing the synthesis of certain protein(s) with antiphospholipase A2 activity. PMID- 3960308 TI - Effects of polyunsaturated fatty acids and hormones on synaptogenesis in serum free medium cultures of mouse fetal hypothalamic cells. AB - The effects of soluble factors on synaptogenesis by mouse fetal hypothalamic cells cultured in chemically defined conditions have been examined using transmission electron microscopy. Hypothalami taken on the 16th day of gestation were mechanically dissociated and cells were seeded in a minimum serum-free medium supplemented or not with the following components: triiodothyronine, corticosterone and a mixture of polyunsaturated fatty acids (arachidonic acid plus docosahexaenoic acid bound to defatted bovine serum albumin). In the minimum serum free medium synapses were found after 10 days in culture. However, the development of synaptic vesicles was very limited, whereas that of the presynaptic and postsynaptic densities was apparently normal. Supplementation of the minimum serum-free medium with triiodothyronine, corticosterone and polyunsaturated fatty acids added simultaneously, permitted a full development of synapses as attested to by the increase in number and the regular shape and diameter of synaptic vesicles as well as by the complexity and diversity of synapse configurations. Among those three factors, polyunsaturated fatty acids clearly played a key role. The ability of synapses formed in culture to respond to potassium evoked depolarization was examined on cultures grown for 12 days in the simultaneous presence of the three above mentioned supplements. Exposure for 3 min to 60 mM potassium chloride induced in synaptic boutons vesicular depletion, apposition of vesicle clusters onto the presynaptic grid, appearance of a rich filamentous network and of some coated vesicles. Return to 3mM potassium chloride induced in 3 min a massive restoration of the population of vesicles which slightly differed from synaptic vesicles in control cultures. These results show that: (1) the formation of synaptic vesicles in this system is regulated by soluble factors among which polyunsaturated fatty acids play a major role, and (2) synapses formed de novo in chemically defined conditions of culture display the same ability to respond to and to recover from potassium evoked depolarization as adult axon terminals. Thus, they offer a suitable model for analysis of the mechanisms involved in membrane traffic in central neurons. PMID- 3960309 TI - Neuropeptides and NADPH-diaphorase activity in the ascending cholinergic reticular system of the rat. AB - A major group of cholinergic neurons is present in the midbrain and pontine tegmentum. These cells could be selectively stained using either monoclonal antibodies to choline acetyltransferase, the pharmacohistochemical acetylcholinesterase procedure, or reduced nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase histochemistry. Using these three techniques, the precise distribution of this cell group was determined. By combining these techniques with immunohistochemical staining for various neuropeptides, examples of peptide-cholinergic coexistence could be demonstrated in this cell group. Approximately 30% of these cholinergic neurons displayed substance P immunoreactivity. Most of these cells also showed corticotropin-releasing factor immunoreactivity and bombesin/gastrin-releasing peptide immunoreactivity. These results therefore provide evidence for the coexistence of various neuropeptides together with NADPH-diaphorase activity in the ascending cholinergic reticular system. PMID- 3960310 TI - Electrophysiological study of sympathoexcitatory structures of the bulbar ventrolateral surface as related to vasomotor regulation. AB - The responses in T3-4, T10-11 and L2-3 white rami to stimulation of different zones of the bulbar ventrolateral surface were maximal when the region of about 4 mm laterally to the midline was stimulated. A weak surface stimulation of all these zones elicited only a long latency response consisting of three waves. A short latency response appeared when supramaximal stimuli were applied only to the intermediate zone--the region up to 6 mm rostrally to the hypoglossal nerve root level (zone S and caudal part of zone M). The data presented show that long and short latency responses are conducted from the intermediate zone to the spinal cord via dorsolateral funiculus fibres with a conduction velocity of about 5.6 +/- 0.6 m/s. In addition, a special descending sympathoexcitatory pathway oriented to T2 preganglionic neurons with a conduction velocity of about 12.3 +/- 3.2 m/s was demonstrated. Antidromic discharges of the output sympathoexcitatory neurons elicited by dorsolateral funiculus stimulation were found in the intermediate zone only at a depth of about 400-2000 microM. Stimuli applied to different regions of the ipsilateral bulbar ventrolateral surface activate at least two groups of surface fibres (conduction velocities 6.7-8.0 and 2-3.2 m/s) which, in turn, activate the output neurons with a rather constant delay of about 20 ms equal to a difference between the latencies of long and short latency white rami responses. The mechanism of delay formation seems to be concentrated in the intermediate zone and formed probably by a chain of interneurons. A possible scheme of neuronal organization of the bulbar ventrolateral sympathoexcitatory structures is presented and discussed. The descending tonic activation of spinal vasomotor neurons is formed by spontaneous discharges of antidromically identified output neurons with a mean firing rate of about 14.4 imp./s. Some neurons are reflexly activated within the time limits of the late somatosympathetic reflex response. Coagulation of the intermediate zone resulted in a profound fall of blood pressure, disappearance of pressor and late somatosympathetic reflexes, whereas the spinobulbospinal somatosomatic reflex remains unchanged. The baroreceptor inhibition is partly realized through the elements of sympathoexcitatory intermediate zone because the preferable inhibition of the long latency white rami response was demonstrated in the middle of R-R interval and during a sharp increase in the arterial pressure induced by vasoconstrictor drugs. Thus, the structures of the intermediate zone seem to play a key role in supporting of blood pressure level and organization of pressure reflexes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3960311 TI - Central organization of the efferent supply to the labyrinthine and lateral line receptors of the dogfish. AB - Neurons that provide the efferent innervation of the inner ear and lateral line were located in the brain by applying horseradish peroxidase to appropriate cranial nerves. The efferent neurons are found in a rhombencephalic nucleus, called here the octavolateralis efferent nucleus, which lies at the rostral pole of the visceromotor column. Up to 40% of these neurons are contralateral. The location of efferent cells is not topographically related to the sense organs they innervate. Their axons leave the brain together with other motor axons in the facial and glossopharyngeal nerves and there is evidence that some neurons innervate both the ear and the lateral line. The efferent nucleus receives direct sensory input from the labyrinth, but not from the lateral line. The organization of the efferent neurons and the distribution of their axons indicates that their effect on the sense organs is probably widespread and nonspecific. PMID- 3960312 TI - Autoradiographic localization and pharmacology of unique [3H]tryptamine binding sites in rat brain. AB - The distribution and pharmacological specificity of [3H]tryptamine binding to coronal and horizontal sections of the rat brain were investigated with computer assisted autoradiography. [3H]Tryptamine bound to brain regions with up to 58% specificity, as determined with 10 microM tryptamine as a displacer. The capacity (Bmax) of saturable [3H]tryptamine binding sites was greatest in the nucleus accumbens and claustrum (660-760 fmol mg protein-1), with intermediate binding site concentrations in hippocampus, septum, olfactory tubercle, frontal cortex, cingulate cortex and caudate-putamen. The phenylalkylamine, p methoxyphenylpropylamine and the beta-carboline, harmaline, as well as 5-methyl tryptamine, displaced [3H]tryptamine from each of these brain regions with a potency that approximated the 5-9 nM affinity (Kd) of [3H]tryptamine binding to each site. Only micromolar concentrations of serotonin displaced [3H]tryptamine, which did not bind to S1, S2, D1, D2 or alpha- or beta-adrenergic sites. The unique pharmacology and the regional overlap of [3H]tryptamine binding sites with dopaminergic nerve terminals in the nucleus accumbens and caudate-putamen suggest that tryptamine-containing neurons in the mammalian brain may modulate behavioral functions such as locomotion. PMID- 3960313 TI - Alzheimer plaques and cortical cholinergic innervation. PMID- 3960314 TI - Alzheimer plaques and cortical cholinergic innervation. PMID- 3960315 TI - The role of GABAergic inhibition in the response properties of neurones in cat visual area 18. AB - Bicuculline methiodide was iontophoretically applied to single neurones in cat area 18 to investigate how removal of gamma-aminobutyrate mediated inhibition affects the visual response properties. Moving sinusoidal gratings were used to study spatial and temporal response characteristics. Orientation sensitivity and spatial and temporal frequency tuning curves were determined with and without iontophoretically applied bicuculline. In most neurones, orientation sensitivity and spatial frequency tuning remained largely unaffected, whereas temporal frequency tuning was very much broadened. It is suggested that the dominant excitatory input to area 18 cells is a spatially organized input from area 17 and local inhibition in area 18 sharpens primarily temporal selectivity. An alternative explanation of our results would be that the distribution of synapses mediating temporal tuning in area 18 is fundamentally different from that mediating spatial frequency and orientation tuning, which may be located at sites distant from the cell body and relatively inaccessible to the drug application. PMID- 3960316 TI - The structural and functional characteristics of striate cortical neurons that innervate the superior colliculus and lateral posterior nucleus in hamster. AB - Intracellular recording and horseradish peroxidase injection techniques were used to structurally and functionally characterize the striate cortical neurons in hamster that projected to the superior colliculus and/or lateral posterior nucleus of the thalamus. With two exceptions, the receptive field properties and morphological characteristics of the neurons antidromically activated from the colliculus and lateral posterior nucleus were quite similar. Striate corticotectal and striate cortico-lateral posterior neurons generally had non oriented receptive fields which gave either "on-off' or no responses to flashed stimuli. Only a small number (less than 5%) were orientation selective, but about one-third were directionally selective. Most of the cells preferred movement with an upward component. Most striate corticotectal and cortico-lateral posterior cells responded to a wide range of stimulus velocities and exhibited little spatial summation. With the possible exception of two cells, all the projection neurons we recovered were large lamina V pyramidal cells whose apical dendrites extended to and branched extensively in layer I. All had extensive (in some cases over 1 mm) tangential axon collaterals, primarily in layers V and/or VI. The electrophysiological experiments also demonstrated that some (50% of a sample of 20 cells) corticotectal neurons also sent an axon collateral to the lateral posterior nucleus. Finally, our recordings showed that many (56% of a sample of 27 neurons) cells which could be antidromically activated from the lateral posterior nucleus, but not the superior colliculus had response latencies which exceeded those of almost all the cells which could be antidromically activated from the tectum. Retrograde transport of diamidino yellow and true blue confirmed the electrophysiological result that individual cortical neurons projected to both the superior colliculus and lateral posterior nucleus. These experiments showed that 20% of the striate cortical cells that projected into colliculus also sent an axon collateral to the lateral posterior nucleus. PMID- 3960317 TI - Enhanced graft survival in the hippocampus following selective denervation. AB - The trophic effects of denervation on the survival of fetal cholinergic neuronal cell suspensions grafted to the hippocampal formation of the rat were assessed in the present study. Young adult female rats were injected with cell suspensions of neurons obtained from the fetal basal forebrain region into the hippocampal formation simultaneously with (or without) a fimbria-fornix transection, which removes the hippocampal cholinergic afferents. Four to six months later, one group of grafted animals was evaluated histochemically for: transplant volume; number of acetylcholinesterase-positive cells, and size of acetylcholinesterase positive cells in the graft. A parallel study was conducted to determine the total number and size of the acetylcholinesterase-positive cells in the septal diagonal band-substantia innominata complex of the adult rat, to match with the cell survival and growth in the grafts. A second group of grafted rats was taken in parallel for biochemical analysis of choline acetyltransferase activity in the grafted hippocampus. The transplant volume in the rats with fimbria-fornix transection was greater than twice the volume seen in animals without fimbria fornix lesion. In addition, the number of acetylcholinesterase-positive cells in the transplant was twice as great in the denervated animals as in the non denervated ones. However, the number of acetylcholinesterase-positive cells per mm3 of graft volume did not differ between the two groups, suggesting that the trophic effect of the denervation was not specific for the cholinergic neurons, but affected the entire grafted tissue. The hippocampal choline acetyltransferase activity of the animals that received the fimbria-fornix lesion simultaneously with transplantation was about three times higher than that of the rats that received grafts but no simultaneous fimbria-fornix transection. A control experiment with animals that received an aspirative lesion of the retrosplenial cortex, transecting the perforant path input, revealed no enhancing effect of hippocampal choline acetyltransferase activity over non-lesioned grafted animals. Thus, the denervation-enhancing effects of the fimbria-fornix lesion appear to be selective and not the result of a general wound-induced mechanism. These results strongly support the contention that neurotrophic factors are released as a result of denervation in the adult hippocampal formation, and that these neurotrophic factors can support survival and growth of central cholinergic neurons. However, the factors involved do not appear to be specific for the cholinergic neurons, but rather have their trophic effects on many types of cells. PMID- 3960318 TI - High resolution autoradiographic determination of the topographic distribution of radioactivity in the hippocampal formation after injection of [1-14C]glucose or 2 deoxy[14C]glucose. AB - Using high resolution autoradiography, the accumulation of radioactivity after intravenous injection of [1-14C]glucose was measured in the corpus callosum, hippocampus, dorsal hippocampal commissure, somatosensory cortex, inferior colliculus and pontine periaqueductal grey. Autoradiograms were prepared by thaw mounting 4 micron frozen sections on nuclear emulsion-coated slides, and were evaluated quantitatively with a computer-assisted video system for automated counting of silver grains. In all brain regions examined, silver grain densities were greater in rats killed 30 min after injection of [1-14C]glucose compared to rats killed 10 min after injection. After intravenous injection of [1-14C]glucose or 2-deoxy[14C]glucose, the relative uptake and retention of radioactivity in different hippocampal subregions was compared. Striking differences were found in the hippocampus between 2-deoxy[14C]glucose and [1-14C]glucose autoradiograms. After injection of 2-deoxy[14C]glucose, there were large variations in the uptake and retention of radioactivity among different pyramidal cell fields. The CA 3 pyramidal cell field retained considerably more radioactivity than other pyramidal cell fields after injection of 2-deoxy[14C]glucose, while after injection of [1-14C]glucose, the retention of radioactivity was similar in all pyramidal cell fields. After [1-14C]glucose injection, the dentate gyrus contained relatively high levels of radioactivity and more 14C accumulated in the granular layer, compared to the molecular layer. In contrast, after 2 deoxy[14C]glucose injection, there was uniformly less radioactivity throughout the dentate gyrus when compared to rats injected with [1-14C]glucose and there was no preferential accumulation of 2-deoxy[14C]glucose in the granular layer compared to the molecular layer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960319 TI - Gangliosides GM1 and GD1b are antigens for IgM M-protein in a patient with motor neuron disease. AB - We studied a patient with an IgM M-protein and lower motor neuron disease to identify the antigens to which the M-protein bound. Gangliosides from peripheral nerve and spinal cord were separated by high-performance thin-layer chromatography and immunostained with the patient's serum. The serum IgM immunostained two gangliosides identified as GM1 and GD1b, and immunostaining was specific for the M-protein light chain type. IgM-binding to the two gangliosides was detectable by ELISA at serum dilutions of greater than 1:10,000, and the M protein was selectively immunoabsorbed by liposomes containing GM1 or GD1b. The IgM M-protein also bound to asialo-GM1, indicating reactivity to the galactosyl(beta 1-3)N-acetylgalactosaminyl moiety shared by GM1, GD1b, and asialo GM1. PMID- 3960320 TI - Penetrating war injuries of the basal forebrain: neurology and cognition. AB - We compared the neurologic and cognitive performance of 15 young veterans who suffered unilateral penetrating missile wounds to the basal forebrain 15 years ago in the Vietnam War with uninjured controls and patients with lesions elsewhere in the brain. The subjects performed worse on tests of episodic memory, reasoning, and arithmetic and had more prolonged unconsciousness after injury; but their performance usually compared favorably with that of uninjured controls on tests of intelligence, attention, and language and was not consistent with that of a demented patient. The data suggest that the basal forebrain is functionally related to the reticular formation and to the basal forebrain is functionally related to the reticular formation and to the limbic-hippocampal memory system. PMID- 3960321 TI - Aphasia in left-handers: lesion site, lesion side, and hemispheric asymmetries on CT. AB - Language in left-handed aphasics with left (n = 27) or right (n = 4) hemisphere lesion was examined. Left occipital CT asymmetry was the most common asymmetry and could not be used to predict handedness or which hemisphere, if damaged, would produce aphasia. When left hemisphere lesion sites were matched between eight left-handed and eight right-handed aphasics, there were no significant group differences on language measures. Two nonfluent cases with good comprehension and large right frontal, parietal, and temporal lesions appeared to have "Broca's area" in the right hemisphere, but "Wernicke's area" in the left. Results suggest separate hemispheric loci for handedness, speech output, and/or comprehension dominance in some left-handers. PMID- 3960322 TI - Miller-Dieker syndrome: a disorder affecting specific pathways of neuronal migration. AB - A patient with the typical craniofacial features and clinical course of Miller Dieker syndrome (MDS) was found on autopsy to have focal pachygyria rather than lissencephaly. The brainstem and cerebellum were hypoplastic, but thalami and basal ganglia were normal. We believe that MDS is a syndrome in which multiple specific pathways of neuronal migration are affected selectively, such as migration to the neocortex, migration via corpus pontobulbare, and cerebellar migration. However, another migration pathway (via corpus gangliothalamicum) is spared. PMID- 3960323 TI - Preliminary trial of poly ICLC in chronic progressive multiple sclerosis. AB - Eighteen patients with chronic progressive multiple sclerosis (MS) were treated in an open preliminary trial of the interferon inducer and immune modulator, poly ICLC. All patients produced substantial interferon levels and experienced acute side effects, including fever and transient worsening of neurologic symptoms. Of nine patients with rapid neurologic deterioration at the time of entry into the study, only three had disease progression during treatment. We conclude that poly ICLC can be administered safely to MS patients, and that a controlled trial will be necessary to determine efficacy. PMID- 3960324 TI - Basal temporal language area demonstrated by electrical stimulation. AB - We report on a 38-year-old patient with intractable complex partial seizures originating in the dominant left medial temporal region. In the work-up for seizure surgery, arrays of subdural electrodes were placed, and electrical stimulation revealed marked language interference in a 2 X 2-cm area in the left basal temporal fusiform gyrus (3.5 to 5.5 cm posterior to the temporal tip). Complete receptive and expressive aphasia, inability to repeat, agraphia, and alexia were elicited, but visual memory was preserved, and no constructional apraxia was noted. Stimulation of the basal temporal gyrus at lower stimulus intensities produced a relatively selective and severe anomia. PMID- 3960325 TI - Familial adult motor neuron disease: amyotrophic lateral sclerosis. AB - We analyzed the medical records of 103 patients with familial adult motor neuron disease (MND). In the 72 families, 329 members were known to be affected. Observations were compared with the sporadic and Mariana forms of MND. Clinical and laboratory examinations of all three forms were similar in clinical course and findings, but there were minor variations in age at onset, sex ratio, survival, and the frequency with which onset occurred in the lower extremities. Recognition of the familial form still depends on diagnosis of the disease in more than one member of a family. PMID- 3960326 TI - Clinical and angiographic features of carotid circulation thrombus. AB - We studied five patients with intraluminal carotid thrombus visualized by angiography. The distinctive clinical features included the following: thrombus formation without significant atherostenosis; peripheral and cerebral arterial thrombosis; step-wise evolution of cerebral and/or peripheral signs over a period of days to several weeks; clotting tendency despite heparin anticoagulation; and carotid or iliac artery thrombosis after thrombo-endarterectomy. These unusual features serve to identify an uncommon subgroup of stroke patients with large artery thrombosis. Pathogenesis was not established. Coagulopathy with elevated factor VIII levels was the suspected mechanism. PMID- 3960327 TI - Multiple sclerosis: rat and human oligodendrocytes are not the target for CSF immunoglobulins. AB - CSF Ig from 28 patients with MS and 25 patients with other neurologic diseases (OND) were examined for their capacity to bind to rat or human oligodendrocytes in culture. We have used a double-label approach combining CSF Ig with antibodies against galactocerebroside (GalC). As normal human IgG at a concentration higher than 250 micrograms/ml were found to bind nonspecifically to oligodendrocytes in culture, patients' CSFs were used unconcentrated, at a final IgG concentration never exceeding 115 micrograms/ml. In these experimental conditions, we have not been able to detect any fixation of CSF Ig from MS (or OND) patients to rat or human GalC+ oligodendrocytes. PMID- 3960328 TI - Partial dorsal mesencephalic hemorrhages: report of three cases. AB - We studied three patients with spontaneous dorsal mesencephalic hemorrhages. One patient had Parinaud's syndrome with a unilateral hemorrhage confined to the rostral tectal plate. The second patient had vertical gaze palsy, skew deviation, and bilateral Horner's syndrome due to a unilateral hemorrhage that involved the superior colliculus and extended anteriorly into the midbrain tegmentum and inferiorly to the rostral dorsal pons. The third patient had a hemorrhage in the caudal tectal plate, with bilateral fourth cranial nerve palsies, unilateral Horner's syndrome, and ataxia. There was hydrocephalus due to obstruction of the aqueduct in two patients. The patients recovered, but with some degree of disability. PMID- 3960329 TI - Testing for apnea in suspected brain death: methods used by 129 clinicians. AB - Neurologists in Colorado and California were asked the methods they use to test for apnea when determining brain death. Most (65.1%) of 129 respondents simply observed the patient for respiratory efforts for 3 minutes or less while off the ventilator. Only 22.5% measured arterial carbon dioxide, 12.4% used a published recommended rigorous method for testing for apnea, and 11.6% did not test for apnea. Clinicians in full-time academic practice more frequently used the rigorous method. The data indicate that methods used most often in the communities surveyed are less rigorous than published guidelines. PMID- 3960330 TI - Botulinum toxin for blepharospasm: single-fiber EMG studies. AB - In four patients who received periocular injections of botulinum toxin for blepharospasm, abnormal neuromuscular transmission was demonstrated by single fiber EMG in arm muscles. The time course with which the abnormalities developed and cleared, as well as the inverse relationship between the neuromuscular jitter and the firing rate in the abnormal muscles, indicated that the toxin caused the abnormalities in arm muscles. No weakness was detected clinically in muscles distant from the face, but the abnormal neuromuscular transmission indicates that the toxin spread remotely from the site of injection. PMID- 3960331 TI - Tear analysis in multiple sclerosis. AB - We examined tears from 12 MS patients and 20 normal controls. In MS tears, the total IgG concentration was increased. Electrophoresis revealed low molecular weight bands (25 to 34k) in tears from patients with demyelinating optic neuritis; similar, less intense bands were seen in some patients with a history of optic neuritis. Production of tears was impaired in almost one-half of MS patients, especially in clinical exacerbations. Analysis of tears may offer new insight into immune function in MS, particularly of the mucosal immune system. PMID- 3960332 TI - Glutamate dehydrogenase in olivopontocerebellar atrophies: leukocytes, fibroblasts, and muscle mitochondria. AB - Glutamate dehydrogenase (GDH) activity was 68% of control values in leukocyte homogenates of 11 patients with dominant olivopontocerebellar atrophies (OPCA) and 46% in muscle mitochondria of 4 patients with dominant OPCA. In three patients with recessive OPCA and in one sporadic patient, muscle GDH was lower than in controls. However, muscle GDH activity was normal in one of two dominant patients in the same family and decreased in the other, and patients' activities overlapped with lower control values. Plasma glutamate levels were significantly higher in dominant patients than in controls after glutamate challenge. GDH activity may be partially altered at the mitochondrial level in a subgroup of OPCA patients. PMID- 3960333 TI - Vitamin E-deficient spinocerebellar syndrome due to intestinal lymphangiectasia. AB - A 23-year-old woman with congenital intestinal lymphangiectasia developed a progressive spinocerebellar syndrome and neuropathy. The clinical findings were typical of vitamin E deficiency, which was documented in the patient. Intestinal lymphangiectasia is an additional vitamin E-deficient disease that may cause this neurologic syndrome. PMID- 3960334 TI - Subacute sclerosing panencephalitis: remission after treatment with intraventricular interferon. AB - Three children with stage II-III subacute sclerosing panencephalitis (SSPE) were treated with intraventricular human leukocyte interferon for 6 months. All three improved to varying degrees and for different lengths of time. Clinical remissions were associated with decreased titers of antibody to measles virus in CSF and with reduced rates of intrathecal IgG synthesis. There were no serious complications or side effects. Intraventricular interferon deserves further study as a potential therapeutic agent in SSPE. PMID- 3960335 TI - ALS serum has no effect on three enzymatic activities in cultured human spinal cord neurons. AB - Dissociated human spinal cord cells were grown in monolayer cultures in the presence of serum from normal controls or from patients with ALS or other neurologic diseases. After 20 to 24 days, the levels of choline acetyltransferase, glutamic acid decarboxylase, and lactate dehydrogenase activities were determined in the cultures. On the basis of these biochemical measurements, there was no detectable difference between the effects of the three types of serum on the cultures. PMID- 3960336 TI - Olivopontocerebellar degeneration, abnormal sleep, and REM sleep without atonia. AB - Polygraphic studies during sleep performed in two patients with olivopontocerebellar degeneration (OPCD) revealed an abnormal control of muscle tone. It was demonstrated by bursts of EMG activity during sleep and progressive disappearance of muscle atonia during sleep. Muscle atonia disappeared during rapid eye movement (REM) sleep, permitting movements and expression of feelings probably associated with REM sleep-related oneiric activity. Patients, unaware of their nocturnal sleep disturbance, complained only of the resulting daytime tiredness and sleepiness. PMID- 3960337 TI - Visual evoked response in head trauma: pattern-shift stimulus. AB - Studies of visual evoked potentials in head injuries have all utilized the flash stimulus. We studied the efficacy of monocular pattern-shift visual evoked potentials (PSVEPs) in eliciting residual dysfunction of the visual pathways in 33 patients 6 to 24 months after head injury. Those with ocular trauma or ocular pathology were not included. Abnormal PSVEPs were seen in one-third of 33 head injured patients. Only 1 (11%) of 9 patients with mild cognitive impairment had abnormal PSVEPs compared with 7 (39%) of 18 with moderate and 3 (50%) of 6 with severe cognitive impairment. PMID- 3960338 TI - Genetic linkage studies in Alzheimer's disease. AB - We studied 18 families with Alzheimer's disease in family members, under the assumption that the disease is due to a single gene with an autosomal dominant form of inheritance. There was no evidence of linkage of Alzheimer's disease with any of 27 phenotypic gene markers analyzed, but close linkage for the Rh and MNS blood group loci was excluded. PMID- 3960339 TI - Unruptured intracranial aneurysm and transient focal cerebral ischemia: a follow up study. AB - Transient focal cerebral ischemia may occasionally be due to distal embolization of a clot from an unruptured intracranial aneurysm. Follow-up data in 12 such patients revealed no ischemic strokes, subarachnoid or parenchymal hemorrhages in a mean follow-up period of 6.5 years. The aneurysms ranged in size from 2 to 12 mm in diameter, and only two were larger than 10 mm. Two patients had clip ligation of the aneurysm, five patients were given platelet antiaggregation therapy, one was given oral anticoagulants after aortic valve surgery, and four had no specific therapy. The prognosis for unruptured aneurysms presenting with transient focal ischemia was good, regardless of therapy. PMID- 3960340 TI - Evoked potentials in Guillain-Barre syndrome. AB - We studied evoked potentials (EPs) in 27 patients with typical acute Guillain Barre syndrome and 3 with Fisher's syndrome. Three of 21 had BAEP abnormalities: 1 with bilateral I-III, 1 with unilateral I-III, and another with unilateral III V interwave latency prolongations. Three with Fisher's syndrome had normal BAEPs (one had a poorly formed wave V unilaterally with one click polarity only). Ten of 21 median nerve EPs and 9 of 12 peroneal or tibial nerve somatosensory EPs were abnormal. Seven patients with normal somatosensory EPs had abnormal F waves from the same nerve; none had normal late responses and abnormal somatosensory EPs. These observations differ from previous reports on the frequency and interpretation of EP abnormalities in Guillain-Barre syndrome. PMID- 3960342 TI - Meningioma and transient global amnesia: another report. PMID- 3960341 TI - Phenylpropanolamine and vasospasm. PMID- 3960343 TI - Erythromycin-carbamazepine interaction. PMID- 3960345 TI - American Academy of Neurology. 38th annual meeting program. New Orleans, Louisiana, April 27-May 3, 1986. Abstracts. PMID- 3960344 TI - Blink reflexes evoked by different stimuli in a comatose patient. PMID- 3960346 TI - [Progress in lymphatic microsurgery: interposition of veins between lymph ducts]. PMID- 3960347 TI - [Our experience in aneurysms of the abdominal aorta in emergencies]. PMID- 3960348 TI - [Changes in sexual activity in surgery of aneurysms of the abdominal aorta]. PMID- 3960349 TI - [Non-invasive diagnosis of the mesenteric, aorto-iliac and hypogastric-femoral steal syndrome]. PMID- 3960350 TI - [Incidence of mesenteric ischemia in patients with obliterative arteriopathy of the legs. Angiographic study]. PMID- 3960352 TI - [Significance of the morphology of the communicating veins and of the small saphenous veins in the surgery of varices of the legs]. PMID- 3960351 TI - [Reflected-light rheography. A new methods for the non-invasive evaluation of varices of the legs]. PMID- 3960353 TI - [Current direction in the treatment of varices of the legs]. PMID- 3960354 TI - [Recurrent varices: diagnosis and therapy]. PMID- 3960356 TI - [Our experience in the microsurgical treatment of lymphedema in childhood]. PMID- 3960355 TI - [An instrumental solution to the esthetic problems in radical surgery of varices of the legs]. PMID- 3960357 TI - [Regeneration of the cirrhotic liver after partial hepatectomy]. PMID- 3960358 TI - [Large laparoceles: experience in 250 cases]. PMID- 3960359 TI - [Emergency venous thrombectomy with in situ perfusion of urokinase. Preliminary note]. PMID- 3960360 TI - [Parathyroid adenoma revealed by subcapsular hemorrhage]. PMID- 3960361 TI - [Surgical treatment of cicatricial alopecia]. PMID- 3960362 TI - [Small-cell primary tumor of the skin. Observations on a personal case]. PMID- 3960363 TI - [Case of Fournier's syndrome]. PMID- 3960364 TI - A retrospective study of surgical common bile-duct exploration: ten years experience. AB - The results of surgical common bile duct exploration in 1007 patients were evaluated in a retrospective study. Overall mortality was 2%. Under the age of 70 years mortality was 0.9%. Mortality increased significantly in patients older than 80 years (9.5%), including the patients with acute cholangitis. The most frequently encountered complications were wound infection in 7%, severe pulmonary insufficiency in 4%, and cardiovascular problems in 3%. The results of the present series show that in the current state of pre-, intra- and postoperative care surgical common bile-duct exploration has a low morbidity and mortality rate in patients under 80 years of age. PMID- 3960365 TI - Progressive pneumoperitoneum as preoperative preparation for large hernial repair in patients with severe chronic obstructive lung disease. AB - The results of operation in four patients with a large hernia associated with severe chronic obstructive lung disease show the advantages and limitations of a preparatory progressive pneumoperitoneum. If carefully employed, it seems possible to repair very large hernias in patients suffering from severe chronic obstructive lung disease. PMID- 3960366 TI - Rectal prolapse; a review of Dutch surgical practice. AB - Many different technics have been described for the treatment of rectal prolapse. Transabdominal fixation of the rectum is the procedure currently most favoured, as in The Netherlands, where the majority of patients with rectal prolapse are treated in this way. A questionaire sent to all teaching hospitals showed that in only seven out of 27 hospitals postanal repair is carried out in cases of postoperative fecal incontinence. PMID- 3960367 TI - Leiomyoblastoma of the gastric wall. AB - A patient with leiomyoblastoma of the gastric wall is reported. The manifestations of the tumor are described and guidelines for therapy and prognosis are provided, based on a review of literature. PMID- 3960368 TI - Implantation technic for CAPD catheters. PMID- 3960369 TI - Giant lymph nodes in the mesenteric root. An unusual cause of abdominal discomfort. PMID- 3960370 TI - A rare complication of a benign ovarian teratoma. PMID- 3960371 TI - Surgical tools: the use of a cordless bone drill in traumatology. PMID- 3960372 TI - Venous outflow measurement in the diagnosis of deep vein thrombosis--principles and practice. AB - Venous outflow measurement (kenoseography) is increasingly applied in the diagnosis of deep vein thrombosis. Performance and interpretation of this examination have a considerable influence on the final result. The influence of congestion pressure, outflow determination, positioning of the patient and the site of measurement are discussed. One should be aware that figures obtained by one institution can not always be applied by others. PMID- 3960373 TI - [Pathogenesis of EPH gestosis]. PMID- 3960374 TI - [Complex balanced translation]. PMID- 3960375 TI - [Maternal and cord prolactin during labor and delivery]. PMID- 3960376 TI - [Malignant melanoma of the vulva. Considerations on 4 cases]. PMID- 3960377 TI - [New hypotheses on ovulation]. PMID- 3960378 TI - [Case of abdominal pregnancy]. PMID- 3960379 TI - [Case of carcinomatous degeneration of a dermoid cyst]. PMID- 3960381 TI - [Physical work in pregnancy in relation to premature birth]. PMID- 3960380 TI - [Comparative changes of exocervical exfoliative cytology in intrauterine device users]. PMID- 3960382 TI - [ Ferritin, adenosylcobalamin coenzyme and folic coenzyme combination: its use in pregnancy]. PMID- 3960383 TI - Lesions of substantia nigra retard pavlovian somatomotor learning but do not affect autonomic conditioning. AB - New Zealand albino rabbits with bilateral radio frequency lesions of the substantia nigra (SN) were compared with sham-operated animals on a pavlovian conditioning task in which eyeblink (EB) and heart rate (HR) responses were concomitantly assessed. Lesions of SN increased the number of trials required to reach an EB learning criterion but left the HR conditioned response intact. These results together with other reports in the literature suggest that extrapyramidal motor structures are involved in mediating somatomotor conditioning but are not involved in autonomic learning. PMID- 3960384 TI - Role of the monkey substantia nigra pars reticulata in orienting behaviour and visually triggered arm movements. AB - The role of the substantia nigra pars reticulata (SNpr) has been studied in the head-free monkey during orienting behaviour in response to visual instruction signals triggering head positioning and conditioned arm movement. During the behavioural responses we recorded the electromyographic activities of neck muscles and triceps brachii, head movement, horizontal electrooculogram and single unit activity of SNpr neurons. Activity of 38 neurons located in the medial part of SNpr were analysed during the visuo-motor task. Forty percent of these units showed a moderate decrease in tonic firing rate during postural preparation preceding the orientation toward eccentric visual signal. This decrease, unrelated with saccadic eye movements per se, was followed by a marked pause observed when the rewarded stimulus was switched on and the conditioned arm movement was executed to get the reward. These data suggest that the pause in discharge of these SNpr neurons are time locked with behaviourally relevant visual stimuli and/or appropriate motor responses. PMID- 3960386 TI - Lateralized and compulsive exteroceptive orientation in rats treated with apomorphine. AB - A new behavioral test afforded the original demonstration of a compulsive and extremely lateralized taxis for edges in a minority (16%) of rats treated with the dopamine (DA) receptor agonist apomorphine (APO) (1.25 mg/kg, s.c.). APO also induced a reliable lateralization of locomotor direction in a rotometer in 29% of rats. The lateralizing effects of the drug on taxis for edges and rotational direction were not reliably associated, however, suggesting that these effects of APO are independent of each other. Interhemispheric asymmetries of DA receptors in functionally distinctive brain regions may underlie the diverse lateralizing effects of APO in subpopulations of rats. PMID- 3960385 TI - Detection of anti-acetylcholine antibodies in myasthenic patients. AB - Antibodies, directed against an acetylcholine (ACh) conjugate, were found in the sera of myasthenic patients by using a modified enzyme-linked immunosorbent assay method. Binding of sera from control patients to the conjugate was extremely low. From competition experiments, done with compounds close to ACh, a good antibody specificity for the ACh conjugate was demonstrated in the sera of myasthenic patients. Laboratory tests will be done to help a more precise diagnostic of the disease to be given. These results may also be of value in further understanding of the process of the disease itself. PMID- 3960387 TI - Prolongation of gamma-aminobutyric acid-mediated inhibitory postsynaptic potentials by 4,5,6,7-tetrahydroisoxazolo[4,5-c]pyridin-3-ol (THPO). AB - The effects of 4,5,6,7-tetrahydroisoxazolo[4,5-c]pyridin-3-ol (THPO), an inhibitor of gamma-aminobutyric acid (GABA) uptake, were examined in the rat hippocampal slice and compared to the actions of the potent GABA uptake inhibitor, cis-4-OH-nipecotic acid. THPO reversibly prolonged GABA-mediated inhibitory postsynaptic potentials (IPSPs) but did not prolong conductance changes evoked by iontophoresed GABA. In contrast, cis-4-OH-nipecotic acid prolonged responses to iontophoresed GABA but had little effect on IPSPs. THPO reduced the intensity of spontaneous epileptiform bursts observed in elevated (8.5 mM) potassium; this effect was absent after addition of 100 microM bicuculline. These results suggest that drugs similar to THPO may be useful for enhancing GABA-mediated inhibition, but that THPO acts by a mechanism distinct from that of the GABA uptake inhibitor, cis-4-OH-nipecotic acid. PMID- 3960388 TI - Distant blood-brain barrier opening in subfields of the rat hippocampus after intrastriatal injections of kainic acid but not ibotenic acid. AB - Blood-brain barrier (BBB) permeability towards proteins was determined in rats 4 h after intrastriatal kainic or ibotenic acid application, using Evans blue as indicator. Whereas, with the exception of the unspecific damage in cortex, after ibotenic acid BBB remained intact in deep brain areas. Evans blue leakage was found ipsilateral to the kainic acid injection, occasionally in striatum, thalamus and amygdala and regularly in hippocampus. There it was confined to the fimbria and the CA3 field. Only rarely a mirror focus-like staining was present in the contralateral hippocampus. The ultrastructural investigation revealed that BBB opening in CA3 is due to increased transendothelial pinocytosis; the tight junctions were intact. Thus, changes in the microenvironment around vessels, elicited by kainic acid and/or seizures, might be responsible for BBB opening. PMID- 3960389 TI - Intracortical stimulation in pyramidotomized monkeys. AB - In order to examine, separately, the organizations of pyramidal and extrapyramidal projections from the primary motor cortex, efforts were made to map the forelimb area of two rhesus monkeys with microstimulation before and after unilateral pyramidotomy. However, microstimulation was not effective in evoking motor responses following complete pyramidal tract section. Movements were evoked using a modified intracortical electrode with a large exposed tip and using stimulation parameters similar to those used for surface stimulation. The results from this modified intracortical stimulation generally agree with those from surface stimulation studies in that: (1) the extrapyramidal topography is similar to the normal motor cortex topography and (2) while peripheral responses can be evoked from the cortex following pyramidotomy, greater spatial and temporal summation are necessary to evoke these responses. In addition, the modified intracortical technique revealed a more widespread post-pyramidotomy digit representation than observed previously with surface stimulation. Results from an incomplete pyramidal tract lesion suggest that recovery of motor function may include plastic changes in surviving corticospinal axons. PMID- 3960390 TI - The norepinephrine and dopamine content of the cat carotid body in vivo under normoxic and hypoxic conditions. AB - The norepinephrine (NE) and dopamine (DA) content of the cat carotid body (CB) in vivo was investigated under normoxic and hypoxic conditions (5% O2 for 1 h) by radiolabelling method. To avoid a large scattering of the measured values due to inhomogeneity of the biological material, young sib animals were used. The mean NE content under normoxia was 617 +/- 184 pmol/CB, and the mean DA content 451 +/ 200 pmol/CB. Under hypoxia, NE and DA were lowered significantly by 37% and 30%, respectively. From these results we conclude that both transmitters with their known excitatory and inhibitory actions probably influence the chemoreceptive elements in the carotid body. PMID- 3960391 TI - A new pathway from primary afferents to the red nucleus. AB - Evidence is provided that rubrospinal neurons receive feedback information from the periphery via pathways which bypass both the cerebellum and the cerebral cortex. It appears that the primary afferent fibers which ascend in the dorsal columns of the spinal cord give off collaterals via which they activate ascending tracts with axons in the ventral quandrants of the spinal cord. The existence of such pathways indicates that the red nucleus is part of a long feedback loop assisting the ongoing movement. PMID- 3960392 TI - The distribution of GABA-transaminase-dehydrogenase activity in the myenteric plexus of rat small intestine: a histochemical analysis. AB - The presence and distribution of gamma-aminobutyric acid (GABA) degradative enzyme (GABA transaminase-succinic semialdehyde dehydrogenase) activity in the rat myenteric plexus was determined histochemically using laminar preparations of the small intestine. Blue-diformazan staining resulting from reduction of the tetrazolium salt, Nitro-BT, during GABA catabolism was present in a scattered population of ileal and jejunal myenteric ganglion cells, including those resembling multipolar type II and unipolar nerve cells. Such staining was almost completely prevented under conditions of GABA-T inhibition. These results indicate that GABA is enzymically degraded at specific sites in the rat enteric nervous system where it is proposed to have a neurotransmitter function. PMID- 3960393 TI - A histochemical examination of the metabolic profiles of rat ventral tegmental area and substantia nigra arterioles. AB - To determine the metabolic profiles of arterioles of the rat ventral tegmental area and zona compacta and zona reticulata of the substantia nigra (SN), the distribution of selected enzymes, or by-products, of key metabolic pathways were examined histologically. Arterioles of all three regions expressed the enzymes required for aerobic and anaerobic metabolism. However, the relative abundance of the enzymes and byproducts suggests a lower metabolic capacity for the SN than the ventral tegmentum, while lipid catabolism in both regions appears non operative. Moreover, the larger ventral tegmental arterioles possess a greater potential for nucleic acid and protein synthesis. Together, these results suggest the larger ventral tegmental arterioles possess a greater capacity for proliferation and repair. PMID- 3960394 TI - Magnetic field effects on the rat pineal gland: role of retinal activation by light. AB - In view of the reported involvement of the retinae in mediating magnetic field effects on pineal function in rats, the present study sought to test the hypothesis - based on theoretical calculations - that dim light activation of photoreceptors is necessary for magnetoreception by the retinae. Adult male rats were exposed to a single nocturnal inversion of the earth's magnetic field in the presence or absence of dim red light. Pineal gland N-acetyltransferase and hydroxyindole-O-methyltransferase activities were measured as indices of magnetosensitivity. In animals exposed to dim red light, pineal enzyme activities were inhibited significantly by the magnetic stimulus in comparison to controls (dim red light only). In contrast, the pineal response to a magnetic stimulus was absent in total darkness. These results support the notion that photoreceptor stimulation by dim light is necessary for the perception of weak magnetic fields. PMID- 3960395 TI - Direct projection of cat midbrain tegmentum neurons to the medial rectus subdivision of the oculomotor complex. AB - This study explores neurons in the medial midbrain tegmentum of cats projecting directly to the medial rectus subdivision of the oculomotor complex, using antidromic microstimulation techniques. Many of these neurons were located in areas just lateral and dorsal to the oculomotor complex, e.g. in the medial part of the midbrain reticular formation and ventralmost part of the periaqueductal gray. These results suggest that at least some neurons in the midbrain tegmentum presumed to be the site of origin of vergence eye movements directly project to the medial rectus subdivision to control medial rectus motoneurons. PMID- 3960396 TI - A sexually dimorphic nucleus in the quail preoptic area. AB - The cytoarchitectural analysis of the preoptic-anterior hypothalamic region of the Japanese quail reveals a sexual dimorphism in the total volume of the medial preoptic nucleus (significantly larger in males than in females). Different nuclei of the region (dorsal preopticus, suprachiasmaticus) do not show any statistically significant difference. The sex-related difference is more consistent comparing the distribution of dark volume. This last is due to a larger number of cells containing high amount of Nissl's substance in male than in female. Present findings represent the first example of sexual dimorphism in the avian hypothalamus. PMID- 3960397 TI - Evidence for the inhibitory subunit of adenylate cyclase (Ni) in nervous and heart tissue of Aplysia. AB - Cyclic adenosine 3',5'-monophosphate (cAMP) plays a critical role in modulating a variety of neuronal responses in Aplysia californica. Previous studies have focused on the neurotransmitter activation of adenylate cyclase, which presumably occurs via the guanosine 5'-triphosphate (GTP)-regulated excitatory subunit (Ns). While adenylate cyclase has also been shown to be regulated by inhibitory neurotransmitters, coupled through the inhibitory GTP-regulated coupling protein Ni in some systems, the effects of Ni-mediated adenylate cyclase inhibition on neuronal processing in Aplysia have not previously been reported. In the present study Ni is detected in Aplysia by both protein chemistry and enzymatic activity. A 40 kdalton substrate for the enzymatic activity of Bordetella pertussis toxin is observed. Incubation of Aplysia nervous tissue homogenates with pertussis toxin (IAP) and 32P-nicotinamide-adenine dinucleotide labels a single protein, assessed by polyacrylamide gel electrophoresis and autoradiography. Furthermore, crude membrane suspensions of this tissue demonstrate biphasic adenylate cyclase activity in response to increasing concentrations of GTP, showing Ni and Ns functional activities. These findings provide evidence that Ni is present in Aplysia tissue. Ni may serve as an important site for the regulation of cAMP synthesis and neuronal plasticity. PMID- 3960399 TI - Long time treatment of N1E-115 neuroblastoma cells with atropine induces changes in markers of muscarinic cholinergic function. AB - N1E-115 neuroblastoma cells were grown in the absence or presence of atropine (1 microM) for 9 days. After 9 days membranes were prepared from control and atropine-treated cells. They were stored frozen until some markers of muscarinic cholinergic function were measured. Atropine treatment increased the number of muscarinic receptors from 100 +/- 10 fmol/mg protein to 145 +/- 20 fmol/mg protein, decreased the cholinesterase activity from 3.5 +/- 2.0 U/mg protein to 1.0 +/- 0.5 U/mg protein and increased the choline acetyltransferase activity from 0.25 +/- 0.13 pmol [3H]acetylcholine synthesized/min X mg protein to 1.80 +/ 0.59 pmol [3H]acetylcholine synthesized/min X mg protein. It is suggested that all these changes are correlates of muscarinic receptor supersensitivity. PMID- 3960398 TI - Analysis of [3H]spiperone binding sites in the rat striatum and frontoparietal cortex by means of quantitative receptor autoradiography after inactivation of dopamine receptors by N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline in vivo: selective protection by sulpiride in the striatum. AB - By means of quantitative receptor autoradiography in combination with inactivation of dopamine (DA) receptors by N-ethoxycarbonyl-2-ethoxy-1,2 dihydroquinoline (EEDQ), it was demonstrated in the male rat that [3H]spiperone predominantly labels D2 receptors in the striatum, nucleus accumbens and tuberculum olfactorium, and predominantly non-DA receptors in the frontoparietal cortex, probably mainly serotonin type 2 (5-HT2) receptors in layer IV. Furthermore, the [3H]spiperone-labelled D2 receptors found all over the dorsal and ventral striatum appear to be similarly inactivated by EEDQ and protected by the D2 antagonist (+/-) sulpiride but not the D1 antagonist SCH 23390, indicating a homogeneity of the striatal D2 receptors. PMID- 3960400 TI - Estradiol can suppress haloperidol-induced supersensitivity in dyskinetic monkeys. AB - We have studied a monkey model of lingual dyskinesia, due to a midbrain lesion, which is markedly increased by apomorphine. In such animals a single large intramuscular dose of haloperidol (HAL), 1 mg/kg, almost completely abolishes the apomorphine potentiation after 24 h, but 15 days later there is a 5-fold increase in the response to apomorphine which we attribute to supersensitivity. Estradiol benzoate (0.15 mg/kg, subcutaneously) on days 3, 6, 9 and 12 after HAL completely suppresses the expected rebound supersensitivity to apomorphine. However, the suppression is not seen if the animals have received HAL and estradiol together in the initial treatment. PMID- 3960401 TI - Morphine-sensitive and morphine-insensitive actions of C-fibre input on the rat spinal cord. AB - A dose-dependent differential action of morphine on the hamstring flexor withdrawal reflex recorded in flexor alpha-motoneurones has been found in the decerebrate-spinal rat. At low doses (0.5 mg/kg) morphine pretreatment reduces the prolonged heterosynaptic facilitation of the reflex that follows brief (20 s) C-primary afferent fibre conditioning stimuli, without modifying the activation of the motoneurones by C-fibre input or noxious peripheral stimuli. Moderate doses (5 mg/kg) of morphine are required to suppress the C-fibre-induced excitability increase once it is established by the conditioning stimulus buy only very high doses (20 mg/kg) reduce the direct reflex activation of the flexor motoneurones by either C-fibre input or noxious stimuli. The relevance of these findings to the antinociceptive and analgesic actions of morphine are discussed. PMID- 3960402 TI - Relationship between intracellular calcium concentration and relaxation of rat fast and slow muscles. AB - Following injection of aequorin into small bundles of rat soleus and extensor digitorum longus muscles, simultaneous measurements of light (proportional to the intracellular free calcium ion concentration ([Ca2+]i)) and force were recorded during muscle twitches over a range of temperatures from 10 to 37 degrees C. The Arrhenius plots for rate of decline of [Ca2+]i following a twitch were linear and yielded the same activation enthalpy (Ea) for both muscle types, indicating that the same process controls Ca2+ uptake in both fast and slow muscles. Arrhenius plots of force decay rate constants showed a break around 20 to 25 degrees C with the Ea's above the break being similar to the Ea's for decline of [Ca2+]i and indicating a close relationship between rate of relaxation and decline of [CA2+]i above this temperature. PMID- 3960403 TI - Vasoactive intestinal polypeptide promotes sleep without effects on brain temperature in rats at night. AB - The possible sleep-promoting activity of vasoactive intestinal polypeptide (VIP) was contrasted with the physiological sleep suppression in the diurnal active period through the i.c.v. injection of 100 ng VIP into rats at dark onset. The sleep-wake activity and brain temperature (Tbr) were recorded for 24 h (dark period and light period, 12 h each), and the effects were evaluated with respect to records obtained after artificial cerbrospinal fluid injection. Without altering the normal course of Tbr, VIP induced a prompt and persistent increase of sleep. Wakefulness was significantly suppressed and non-REM sleep increased for 6 h, while REM sleep increased for 3 h. The obvious sleep-promoting action of VIP, unrelated to thermoregulatory effects, supports the notion that the peptide might be involved in sleep regulation. PMID- 3960404 TI - Loss of nerve cells from locus coeruleus in Alzheimer's disease is topographically arranged. AB - Serial sectioning of the locus coeruleus (LC) was employed to determine a topographic loss of nerve cells in patients with Alzheimer's disease (AD). Heaviest loss of nerve cells occurred in the central part of the LC which is thought to project to the temporal cortex and hippocampus, whereas least loss of cells occurred in the most rostral and caudal parts, thought to project to frontal and occipital regions of cortex, respectively. Such changes suggest that the primary damage to these nerve cells in AD occurs within their terminal fields and that perikaryal loss follows as a secondary retrograde change. PMID- 3960405 TI - Event-related brain potentials (P300) and neuropsychological deficit in patients with focal brain lesions. AB - Sixteen patients with chronic focal brain lesions were investigated with an acoustic P300 test and psychological tests of spatial abilities (Maze Tracing Speed Test, Form Board Test), cognitive speed (Sequential Number Connection Test), categorization (Figure Sorting Test), verbal fluency and vigilance. Neither the psychological battery nor P300 analysis discriminated frontal from retrorolandic brain lesions. Abnormalities of P300 significantly correlated with impairments in those psychological tests which had a spinal component in common. We suggest that abnormality of the P300 with focal brain damage rather indicates higher mental function impairment than direct effects of the lesion. PMID- 3960406 TI - Presynaptic effect of clonidine on unmyelinated afferent fibers in the spinal cord of the cat. AB - The effects of clonidine (Clo) were investigated on the excitability of intraspinal primary afferent terminals of both A- and C-fibers of cutaneous origin. Primary afferent terminal excitability was tested by delivering constant current pulses to the dorsal horn of acutely spinalized cats anesthetized with pentobarbital. Clo given i.v. selectively increased the excitability of the C fiber primary afferent terminals (mean 85%). Primary afferent terminal excitability of A-fibers was not affected. This effect of Clo was reversed by yohimbine or phentolamine, thus suggesting mediation by alpha2-adrenoceptors. These findings suggest a presynaptic inhibitory effect of Clo in spinal nociceptive pathways that might explain the mechanism of action of this drug. PMID- 3960407 TI - Feeding during diarrhea. PMID- 3960408 TI - Feeding practices of American infants and children. PMID- 3960409 TI - Breast-feeding and weaning in Mexico and the US. PMID- 3960410 TI - Dietary phosphorus and secondary hyperparathyroidism in infants receiving humanized cow's milk formula. PMID- 3960411 TI - Vitamin A deficiency. PMID- 3960412 TI - Alaska implements new prescriptive regulations for advanced NPs. AB - This article outlines the history of advanced nurse practitioner legislation in Alaska, and describes the new regulations, effective Dec. 1, 1984, which give the board of nursing sole regulatory authority over nurse practitioner practice. The new regulations also provide nurse practitioners with prescriptive authority through the board of nursing. PMID- 3960413 TI - Malignant melanoma: a primary care perspective. AB - The incidence of malignant melanoma within our society is increasing at rates exceeding nearly all other cancers. This increase is associated with a high degree of morbidity and mortality, despite the fact that malignant melanoma is curable through surgery if recognized and treated early. Primary care nurses are in a position to be front-line defenders in fighting melanoma through early case finding and client education. Nurse practitioners must be attuned to identifying changes and irregularities in moles which may signal the development of malignant melanoma. Through health promotion they must also educate the public about associated risk factors and preventive measures. PMID- 3960414 TI - Management of neonatal jaundice. AB - Jaundice is the most commonly encountered neonatal clinical problem; 80 percent of neonates become clinically jaundiced, while 5 percent develop serum bilirubin levels above currently recommended treatment standards. This article outlines theories about the pathophysiology of neonatal jaundice and presents a logical approach to its management. First, the health care provider must distinguish between physiologic, exaggerated and pathologic jaundice. The treatment modalities of exchange transfusion, phototherapy and cessation of nursing are discussed. PMID- 3960415 TI - Primary choriocarcinoma of the fallopian tube. Report of a case with survival and postoperative delivery. Review of the literature. AB - A patient is presented with primary choriocarcinoma of the fallopian tube arising from a tubal pregnancy. Treatment consisted of an initial operation including adnexectomy and resection of bilateral ovarian thecalutein cysts, followed by chemotherapy. The patient delivered a healthy infant 2 years later, and is alive and well 5 years after the event. PMID- 3960416 TI - Differential effects of thiazide and estrogen upon bone mineral content and fracture prevalence. AB - Individual and combined effects of thiazides and estrogens upon bone mineral content at four sites (proximal radius, distal radius, os calcis, lumbar spine) and fracture prevalence were assessed retrospectively in 993 postmenopausal women. Compared with untreated women, use of thiazide alone was associated with significantly higher bone mineral content (P less than or equal to .01); nonspine fracture prevalence in this group was reduced by one-half (P = .07). Estrogen alone also was associated with significantly higher bone mineral content (P less than or equal to .0001); nonspine fracture prevalence was reduced by almost one half (P = .07). The users of both estrogen and thiazide had the highest bone mineral content levels, which were significantly different than the thiazide-only group at four bone sites (P less than or equal to .001), and the estrogen-only group for three bone sites (P less than or equal to .05). Nonspine fracture prevalence for the users of both drugs was 17% that of the untreated group (P = .02). The relationships with spine fracture prevalence were less consistent; however, estrogen users appeared to have a lower spine fracture prevalence rate and higher spinal bone mineral content than thiazide users. These findings suggest a potential role for thiazides in the prevention of osteoporosis. PMID- 3960417 TI - Cytoplasmic estrogen and progesterone receptors as prognostic parameters in primary endometrial carcinoma. AB - Eighty-six cases of primary endometrial carcinoma were assayed for the presence or absence of cytoplasmic estrogen and progesterone receptors by the saturation point dextran-coated charcoal assay. The levels of cytoplasmic progesterone receptors and estrogen receptors were analyzed according to clinical stage, histologic type and grade of the tumor, presence or absence of lymph node metastases, myometrial invasion, and survival. The cases were divided into positive and negative receptor groups with levels chosen of greater than 10 fmol/mg of cytosol protein for progesterone receptor and 5 fmol/mg of cytosol protein for estrogen receptor as discrimination points. Statistically significant survival differences were found between estrogen receptor positive versus estrogen receptor negative patients, progesterone receptor positive versus progesterone receptor negative patients, and estrogen positive-progesterone receptor positive versus estrogen negative-progesterone receptor negative patients. Mean cytoplasmic estrogen and progesterone receptor levels were inversely proportional to grade. This report suggests that treatment protocols should be devised to reflect the prognostic significance of receptor status. PMID- 3960419 TI - Maternal-fetal pH difference and fetal scalp pH as predictors of neonatal outcome. AB - The purpose of this study was to determine if interpretation of fetal scalp pH values would be enhanced by concurrent measurement of maternal venous pH. The last fetal capillary pH obtained before delivery was compared with simultaneous maternal-fetal pH difference as predictors of neonatal outcome assessed by five minute Apgar scores. Fetal scalp pH and maternal-fetal pH difference were significantly correlated with r = -0.72 (P less than .0001). The acidotic fetuses born to acidotic mothers had low maternal-fetal pH differences, and all were nondepressed at birth. A 33% reduction in false negatives was found using maternal-fetal pH difference instead of scalp pH alone. Errors in interpretation of fetal scalp pH can be reduced by the use of maternal-fetal pH difference. PMID- 3960418 TI - Nuclear deoxyribonucleic acid heterogeneity of ovarian borderline malignant serous tumors. AB - Sixteen borderline malignant serous ovarian tumors and seven well-differentiated invasive serous ovarian carcinomas were examined with the technique of Feulgen microspectrophotometry for the determination of nuclear deoxyribonucleic acid (DNA) ploidy patterns (diploid versus aneuploid) and ploidy levels of the stem cell lines. Of the nine stage I-II borderline malignant tumors, only one (11%) was aneuploid. In contrast, four of seven (57%) stage III borderline malignant neoplasms and all stage III carcinomas were aneuploid. The stem cell modal values in all borderline serous tumors were less than triploid (3N) while in five of seven carcinomas stem cell modal values were greater than triploidy. This contrast in ploidy patterns and ploidy levels may explain the differences in biologic behavior between borderline malignant serous tumors and invasive serous carcinomas of the ovary. PMID- 3960420 TI - Amniocentesis and the management of premature labor. AB - Two applications of amniocentesis for the evaluation of the patient in idiopathic premature labor, fetal lung maturity testing, and detection of occult intraamniotic infection were evaluated in a review of 59 cases. Seven patients (12%) had positive amniotic fluid cultures despite the absence of clinical signs of infection. This group presented at earlier gestational ages (29 + 2.3 versus 32 + 2.0 weeks, P less than .005) and were more likely to rupture membranes while on tocolytic therapy (four of seven versus two of 52, P less than .001) than patients whose cultures were negative. All seven patients with a positive culture delivered within 48 hours of admission, whereas 44 of 52 patients with negative cultures delivered after 48 hours (P less than .001). Increase in maternal and neonatal morbidity seemed to be related primarily to a higher cesarean section rate and earlier gestational ages at delivery in this group. Lecithin/sphingomyelin ratio was predictive of fetal lung maturity as expected. More than one-half of patients greater than 33 weeks and one-third of patients at 31 to 32 weeks demonstrated fetal lung maturity. The authors conclude that amniocentesis is an important tool in evaluating patients in preterm labor, especially with respect to making appropriate management decisions regarding tocolytic and/or corticosteroid therapy. PMID- 3960421 TI - Effect of mode of delivery on morbidity and mortality of infants at early gestational age. AB - The effect of mode of delivery on the mortality and morbidity of 26- to 32-week neonates was studied. Five hundred six consecutive deliveries at 26 to 32 weeks' gestation were reviewed. The populations were divided into high-risk and low-risk neonates by evaluation of antepartum variables known to increase neonatal risk, ie, abruptio placenta. One hundred ninety-six infants were classified as low risk. In this group, 124 vaginal and 72 cesarean section deliveries were compared using demographic, peripartum, and neonatal variables. Cesarean delivery was associated with highly significant maternal morbidity, including a 30% incidence of vertical uterine incision. No difference in neonatal mortality was shown. Cesarean delivery was associated with lower one-minute Apgar scores and a greater incidence and severity of hyaline membrane disease. No neonatal differences were shown in the incidence of trauma, intraventricular hemorrhage, or seizures. This study does not support cesarean delivery of all tiny neonates. PMID- 3960422 TI - Intrauterine asphyxia and long-term outcome in preterm fetuses. AB - The long-term outcome of 108 infants born before the 33rd week of gestation was evaluated and correlated to a fetal heart tracing from the last 24 hours before delivery. Infants with signs of asphyxia (N = 30) were born at the same gestational age as those without (N = 78), but had a significantly lower birth weight (P less than .001). Severe intraventricular hemorrhage occurred more often in infants with asphyxia (30%) than in those without (5%) (P less than .05). Fourteen of 30 asphyxia infants (47%) and 11 of 78 nonasphyxia infants (14%) died within the first two years (P less than .005). At two years of age, four (25%) asphyxia and eight (12%) nonasphyxia infants have developmental or neurologic abnormalities (not significant). Of the eight infants with asphyxia born before the 29th week of gestation in the present study, none was normal at two years of age. The authors conclude that signs of asphyxia, as determined from fetal heart rate pattern, were associated with poor fetal outcome, and especially in infants born before the 29th week of gestation. The clinical implications of these findings are discussed. PMID- 3960423 TI - Pregnancy outcome of intensive therapy in severe hypertension in first trimester. AB - The purpose of the present clinical investigation was to determine the maternal and perinatal outcome associated with continuing pregnancy in 44 consecutive patients with severe chronic hypertension in the first trimester. Each patient was observed closely throughout pregnancy with frequent prenatal visits and intensive monitoring of the clinical status of both mother and fetus. There were no maternal deaths, but morbidity was very significant. Most patients required repeated hospitalizations and on many occasions parenteral medications were used to reduce blood pressure. Nineteen had transient and one permanent renal deterioration. These results confirm that pregnancy in women with severe hypertension is beset with considerable morbidity, but with expert intensive care, gestations can be concluded successfully in those women who refuse termination. Twenty-three patients (52%) developed superimposed preeclampsia, one patient developed pleural effusion, and one patient had postpartum hypertensive encephalopathy. In addition, there was no evidence of late puerperal maternal cardiovascular or renal damage on long-term follow-up. There were ten stillbirths and one neonatal death for an overall perinatal mortality of 25%. Seventy percent of the infants were delivered before 37 weeks' gestation, and 19 infants (43%) were small for gestational age. However, all the perinatal deaths and most of the neonatal morbidity occurred among the 23 patients with superimposed preeclampsia. PMID- 3960424 TI - Incidence and recurrence rate of abruptio placentae in Sweden. AB - It is desirable to identify those pregnancies that run an increased risk of abruptio placentae, as this disorder still is associated with a high perinatal mortality. Data were collected from the Swedish nationwide birth registry system on all 894,619 births in Sweden in the period 1973 to 1981. The overall incidence of abruptio placentae was 0.44%, with a perinatal mortality of 20.2% and a cesarean section frequency of 74.6%. The incidence of abruptio placentae was significantly increased in the case of twin birth, male offspring, mothers below 20 years of age, and with every delivery after the second one. A history of abruptio placentae increased the risk of a similar incident in a subsequent pregnancy by 10.2-fold. The frequency of cesarean section in subsequent parturitions remained high (32.1%) even in the absence of reabruptio placentae, thus demonstrating the need to identify further risk groups. PMID- 3960425 TI - Frequency of asymptomatic bacteriuria in preeclampsia. AB - Asymptomatic bacteriuria has a reported prevalence of 4 to 7% during pregnancy. Preeclampsia has been reported to increase susceptibility to infection; therefore, the authors examined asymptomatic bacteriuria (greater than 100,000 colonies/mL of urine) as a possible marker for host resistance in preeclamptic pregnancies. One hundred preeclamptic primigravidas at term were compared with 100 nonpreeclamptic primigravidas undergoing primary cesarean section and 100 multigravidas undergoing elective repeat cesarean section. Urine cultures were obtained by bladder catheterization. A significant difference (P less than .005) in the rate of asymptomatic bacteriuria was found in patients with preeclampsia (19%), when compared with that of primigravid (3%), or multigravid (6%) control subjects. Preeclamptic patients with bacteriuria had significantly lower total serum protein and albumin than preeclamptic patients without bacteriuria (P less than .001). PMID- 3960426 TI - Influence of the beta-1 selective blocker, metoprolol, on the development of pulmonary edema in tocolytic therapy. AB - Research on one group of nine anesthetized dogs pretreated with alpha-naphthyl thiourea showed that doses of the beta-sympathicomimetic fenoterol such as those normally administered in clinical tocolysis (2 micrograms/kg per minute) lead to significant fluid displacement to the extravascular space of the lung in the sense of a preclinical interstitial edema. In a second group (N = 9) with the same pretreatment the addition of the beta-1 selective blocker, metoprolol (1.5 micrograms/kg per minute) served to antagonize the hemodynamic changes and possibly the increase of pulmonary capillary permeability induced by the beta mimetic. Fluid displacement into the interstitium of the lung was prevented by metoprolol. These observations corroborate the hypothesis that pulmonary edema occurring during tocolytic therapy is largely a result of the use of beta mimetics. In addition to its cardioprotective effect, the administration of the beta-1 selective blocker, metoprolol, may reduce the risk of the development of pulmonary edema in beta-sympathicomimetic therapy for premature labor. PMID- 3960427 TI - Effect of irrigation or intravenous antibiotic prophylaxis on infectious morbidity at cesarean section. AB - The efficacy of intraoperative irrigation with cefamandole nafate at cesarean section was evaluated in a prospective, randomized double-blind study. Two hundred and eight patients were treated with antibiotic irrigation and intravenous placebo or with perioperative intravenous cefamandole and irrigated with normal saline. The rate of endometritis was 10.9% in the irrigation group and 14% in the intravenous group, but the difference was not statistically significant. The rate of any infection, the number of days with fever, additional hospitalization days, and number of antibiotics used for treatment were similar in the two groups. It thus was concluded that irrigation with antibiotic is equal but not superior to perioperative intravenous antibiotics. PMID- 3960428 TI - Fetal cardiac asystole during labor. AB - A review of 14 cases of fetal cardiac asystole greater than two seconds during labor revealed two distinct patterns. Type 1 episodes developed without warning in eight apparently healthy fetuses at the nadir of a variable deceleration. These episodes were both preceded and followed by normal to increased variability, stable baseline heart rate, and less dramatic variable decelerations. Analysis of the fetal electrocardiogram (ECG) complexes during the asystole revealed a normal QRS complex, either biphasic or absent P-waves, and occasional ventricular extrasystoles. One of eight fetuses in this group died; the remainder were delivered in good condition and required minimal resuscitation. The mechanism of type 1 episodes appears to be an exuberant vagal response to umbilical cord compression. Rapid intervention probably is not warranted. Type 2 episodes developed in seriously asphyxiated infants and frequently were preceded by absent variability and, usually, severe decelerations. The fetal ECG pattern during the episode revealed bradycardia with sinus rhythm. Five of the six infants with type 2 episodes died either in utero or in the neonatal period. Despite the ominous portent of type 2 patterns, rapid delivery appears to be indicated. PMID- 3960429 TI - Fetal respiratory movements: only part of the biophysical profile. AB - In a period of 1.5 years, approximately 1000 women with high-risk pregnancy received sonographic examinations in the authors' laboratory. Of these patients, five women with postterm pregnancy were found to have oligohydramnios and no other reassuring body or limb movements, despite the finding in each case of regular, sustained fetal respiratory movements. Four of the five neonates had evidence of fetal compromise at birth and the fifth had intrauterine growth retardation but good Apgar scores. The recurrence of the problem emphasizes the need to consider fetal respiration as only one part of the total biophysical profile. PMID- 3960430 TI - Improved outcome of twice weekly nonstress testing. AB - The nonstress test is a commonly used tool for fetal well-being assessment. The antenatal death rate using the nonstress test as a primary modality is significantly higher than that with the use of the contraction stress test. The nonstress test is commonly performed on a once-a-week basis. The rate of stillbirths with reactive nonstress tests, performed once a week, was 6.1 per 1000 in the author's previously published report. Nonstress tests were performed on a twice-a-week basis beginning January 1981, and results are reported on 913 such patients. The rate of stillbirths with reactive nonstress tests was reduced to 1.9 per 1000 in this second group. It is suggested that the patients who are at risk for fetal stress should be evaluated on a twice-a-week basis when the nonstress test is used as the primary test. PMID- 3960431 TI - Comparison of maternal and neonatal morbidity in midforceps delivery and midpelvis vacuum extraction. AB - The present study examines the incidence of maternal and neonatal morbidity associated with delivery from the midpelvis using the vacuum extractor when compared with obstetric forceps. Previous studies have failed to minimize the influence of confounding variables such as maternal and neonatal disease and indication for delivery on outcome when comparing determinants of maternal and neonatal morbidity in the two groups. Results indicate that there was significantly more maternal morbidity in forceps deliveries across most variables. There were no statistically significant differences in neonatal morbidity between the two groups except for a higher incidence of inconsequential cephalhematoma in the vacuum group. It is concluded that the vacuum extractor may be a valuable instrument in delivery from the midpelvis and that it should be more widely used in appropriate clinical situations. PMID- 3960432 TI - A birth center affiliated with the tertiary care center: comparison of outcome. AB - A matched pair study compares 250 low risk women delivered in a tertiary care center with a similar group cared for and delivered in an affiliated birth center. The patients could be matched in every respect with the exception of educational background. Twenty-one percent of the birth center patients required transfer to the hospital during the intrapartum period. Differences were found in cervical dilatation upon admission and length of labor. Intermittent fetal heart auscultation was used exclusively in birth center mothers, oral fluids and light diet were allowed. The hospital group received intravenous fluids. Oxytocin augmentation was used twice as often, and the incidence of shoulder dystocia appeared significantly higher in the control group. The reasons for transfer are described. The one neonatal death was due to persistent fetal circulation. PMID- 3960433 TI - Incidence of premature ovarian failure. AB - To assess the occurrence of premature ovarian failure, the age-specific incidence rates of natural menopause were determined for a cohort of 1858 women born between 1928 and 1932. These women were identified as Rochester, Minnesota residents in 1950 and were followed for date and type of menopause. A total of nine experienced natural menopause before age 40 years, which represents a 1% risk of natural menopause to age 40. The annual incidence rates of natural menopause per 100,000 person-years were ten for ages 15 to 29 and 76 for ages 30 to 39. In the age group 40 to 44, the incidence of natural menopause increased greatly to 881 per 100,000 person-years at risk. PMID- 3960434 TI - Risk factors for shoulder dystocia in the average-weight infant. AB - Almost half (47.6%) of all deliveries with shoulder dystocia occurred in association with the delivery of an average-weight infant (under 4000 g). Of 4294 nondiabetic gravidas delivering infants of birth weight 3500 to 3999 g, 94 (2.2%) experienced a shoulder dystocia. Protraction and arrest disorders were associated with a statistically significant increase in the incidence of shoulder dystocia, and this effect was further augmented by low forceps delivery. Among 6252 infants weighing 3000 to 3499 g, there were 40 instances of shoulder dystocia (0.6%). Only arrest disorders were associated with an increased rate. PMID- 3960435 TI - Changes in smoking and alcohol consumption during pregnancy: a population-based study in a rural area. AB - Changes in smoking and drinking behavior during pregnancy and factors influencing these changes were studied in a typical rural county. Using birth certificates and mailed questionnaires, information was obtained from 255 married women residents of Callaway County, Missouri, who gave birth in a one-year period. The women were much more likely to drink alcohol than to smoke before pregnancy (48.6 versus 28.2%, P less than .01). There was a significant decrease in both smoking and drinking during pregnancy, though the women were much more likely to modify drinking behavior than smoking behavior. Of the women who drank alcohol before pregnancy, 53.2% stopped alcohol consumption completely during pregnancy, while only 16.7% of smokers stopped smoking during pregnancy (P less than .001). Women cited fear for the infant's health as an important factor underlying the decision to decrease these behaviors more often than they did advice from doctor, family, friends, or media, or adverse physical effects of tobacco or alcohol. It was very difficult to predict changes in smoking and drinking behavior during pregnancy on the basis of demographic and behavioral characteristics such as age, income, education, attendance of childbirth classes, desirability of pregnancy, and method of infant feeding. PMID- 3960436 TI - Surgical management of diffuse peritonitis complicating obstetric/gynecologic infections. AB - A retrospective review of 176 women undergoing surgery for diffuse peritonitis secondary to pelvic infections from 1972 to 1976 was conducted. Mortality with septic abortion was 27.3% (12 of 44), with pelvic inflammatory disease 7.1% (eight of 113), and with puerperal sepsis 6.7% (one of 15). Overall mortality was 13.1% (23 of 176). Mortality was lower (P less than .05) with surgery within 24 hours (7.5%, six of 80) than after 24 hours (17.7%, 17 of 96). Mortality was lower (P less than .01) with specific antianaerobic antibiotics (zero of 36) than without (16.4%, 23 of 140). Mortality was 21.3% with hysterectomy (ten of 47) and 10.1% (13 of 129) with conservative surgery, however hysterectomy was usually performed in the more severe cases (septic abortion 75%, puerperal sepsis 66%, pelvic inflammatory disease 3%). Mortality declined from 17.6% in 1972 to 1974 (21 of 119) to 3.5% in 1975 to 1976 (two of 57). Significant differences between the two periods included an increased use of specific antianaerobic antibiotics (8.4%/45.5%) and an increased incidence of early surgery (35.3%/66.6%) in the latter years. This series emphasizes the overriding importance of early surgery and the need for the inclusion of specific antianaerobic antibiotic agents in the chemotherapeutic regimen. PMID- 3960437 TI - Endometrial curettage at the time of cervical conization. AB - Endometrial curettage often is done as a routine procedure at the time of cervical conization, although the indications for this are unclear. Of 207 consecutive cone biopsies done recently at the Medical College of Pennsylvania, 199 (96%) included endometrial curettage. Two patients exhibited mild endometrial hyperplasia; the rest had no significant abnormality. Three uterine perforations (1.5%) occurred. Routine endometrial curettage is not necessary at the time of conization, and should be limited to patients with specific indications for sampling the endometrium, based on history, physical examination, and the finding of abnormal glandular cells on cytology. It is estimated that the elimination of routine curettage would result in a savings of over $100 per patient. PMID- 3960438 TI - Behavior of mild cervical dysplasia during long-term follow-up. AB - Five hundred and fifty-five women with cervical cytologically diagnosed mild cervical dysplasia were followed by cytology without major treatment. Biopsies were performed in 14% resulting in no significant influence on the outcome of the studied material. Regression to normal occurred in 62% (follow-up 39 months), progression to severe dysplasia/carcinoma in situ/invasive carcinoma in 16% (invasive carcinoma: two patients), and persistence of dysplasia in 22%. Life table analysis calculated the risk of progression of mild dysplasia to be 250 to 800/100,000 women/year. A comparison with the incidence of carcinoma in situ, four of 100,000 women/year, illustrates the yearly risk for a woman with mild dysplasia as 560 times greater than for a woman without cervical dysplasia to develop severe dysplasia/carcinoma in situ/invasive carcinoma. PMID- 3960439 TI - Papillary serous adenocarcinoma of the endometrium. AB - The clinical outcome of 15 women with papillary serous adenocarcinoma of the endometrium is presented. In 14 instances the diagnosis was made by uterine curettage. Eight cases (53.3%) were clinically understaged based on laparotomy findings. Intraoperative assessment for extrauterine spread of disease was infrequently performed. Recurrent disease developed in 12 patients (80.0%) with ten arising within the abdomen either alone or in conjunction with another site. Eleven patients (73.3%) have died of disease and two of the four alive have been treated for a recurrence. The need to determine appropriate adjuvant therapy for patients with this disease exists. A protocol for patient management is proposed. PMID- 3960441 TI - Endocervical neoplasia in long-term users of oral contraceptives: clinical and pathologic observations. AB - Adenocarcinoma of the cervix has been associated with oral contraceptive use, often prolonged. The clinicopathologic features of seven cases of endocervical neoplasia in long-term combination pill users, all 33 years of age or younger, were reviewed and compared with seven cases in nonusers. Duration of drug use ranged from 4.5 to nine years. Adenocarcinoma in situ was found in all cases either in pure form or associated in invasive adeno- or adenosquamous carcinoma; squamous carcinoma in situ (CIS) was seen in two cases, one of which showed focal microinvasion. Hypersecretory changes were seen in adjacent endocervix in two cases but the morphology of neoplastic lesions was similar to that unassociated with pill use. The possible role of chronic hormonal stimulation in cervical carcinogenesis is discussed in light of these findings and current epidemiologic data. PMID- 3960440 TI - Flow cytometry of peritoneal washings in gynecologic neoplasia. AB - A prospective, double blind study was initiated to compare flow cytometry to cytopathology in detecting malignant cells within peritoneal washings. Deoxyribonucleic acid (DNA) histograms were generated using 4',6-diamidino-2 phenylindole (DAPI) as a DNA fluorochrome. Evaluation of these data revealed a correlation of 84.5% with the cytologic findings. Two specimens demonstrated euploidy in the presence of cytologically malignant cells (false negative), 28 of 128 specimens (21.8%) manifested aneuploidy with negative cytologic findings (false positive). Further evaluation of this latter subgroup revealed 22 of the 28 to possess unequivocal histologic evidence of malignancy, thus yielding an actual false positive rate of 4.7%. This preliminary study demonstrates that flow cytometry is a highly sensitive, accurate, and analytic method for the detection of malignant cells within peritoneal washings and that it may augment the cytologic examination. However, additional comparative studies are necessary to conclusively demonstrate its apparent diagnostic potential. PMID- 3960442 TI - Suppression of testosterone-estradiol binding globulin by medroxyprogesterone acetate in polycystic ovary syndrome. AB - Serum androgen binding capacity is decreased in hirsute women and normal women receiving medroxyprogesterone acetate. A sensitive radioimmunoassay was used to measure the main androgen binding protein, testosterone-estradiol-binding globulin, in 13 patients with hirsutism and the polycystic ovary syndrome. Testosterone-estradiol-binding globulin concentrations were determined before, during, and after treatment with medroxyprogesterone acetate. Testosterone estradiol-binding globulin was lower in untreated polycystic ovary syndrome patients than in normal controls (21.9 +/- 3.7 versus 64 +/- 4 nmol/L, P less than .01). Administration of medroxyprogesterone acetate (400 mg intramuscularly every 15 days for nine months) to polycystic ovary syndrome patients caused a decrease of serum testosterone and further lowering of testosterone-estradiol binding globulin (7.6 +/- 1.9 nmol/L, P less than .01). In two patients the concentration of testosterone-estradiol-binding globulin reached values as low as 0.9 and 0.8 nmol/L, approximately 1/60 and 1/70 of the normal level. Testosterone estradiol-binding globulin returned to basal levels (15.1 +/- 1.3 nmol/L) between one and two years after discontinuation of medroxyprogesterone acetate. Corticosteroid binding globulin levels were normal in polycystic ovary syndrome and did not change with medroxyprogesterone acetate. It was concluded that: medroxyprogesterone acetate causes marked lowering of plasma testosterone estradiol-binding globulin; the effect is not mediated by sex hormone levels; and the decrease in testosterone-estradiol-binding globulin offsets, at least partially, the beneficial action of medroxyprogesterone acetate. PMID- 3960444 TI - Excision of Bartholin duct cysts using the CO2 laser. AB - Many methods have been used to treat cystic enlargement of the duct of the Bartholins gland. Widely used methods have the disadvantage of recurrence, hemorrhage, persistent drainage, or considerable scarring. The carbon dioxide laser offers a simple and effective means of treating cystic Bartholin ducts. Ten patients were treated with the CO2 laser. The cyst was incised with the laser and the cyst wall was vaporized from the inside. In a follow-up period of one to four years, there were only two recurrences, and these responded to a second treatment. Surgery was rapid and uncomplicated in all cases, and healing occurred without scar formation. The CO2 laser offers several advantages over conventional methods for treating cysts of the Bartholin duct. PMID- 3960443 TI - Chlamydia trachomatis infection in women with ectopic pregnancy. AB - Fifty women with ectopic pregnancy and 49 control women with intrauterine pregnancy were interviewed and evaluated for evidence of Chlamydia trachomatis infection. Among women with ectopic pregnancy, 14 women were wearing an intrauterine contraceptive device or had a tubal ligation (group A), and 36 women had no readily identifiable risk factors (group B). Group B women had greater total numbers of sexual partners than did control women with intrauterine pregnancy (P less than .005). Group B women more often had C trachomatis antibody than group A (P = .03) and control women (P = .002). Of 27 C trachomatis cultures from fallopian tube tissue from women with ectopic pregnancy, none were positive. Fallopian tube tissue distant from the site of ectopic implantation was available for histopathology of 41 cases. Nine (22%) had extensive subepithelial plasma cell infiltration. All nine were among group B women (P = .06) and all seven with plasma cell salpingitis who were tested for C trachomatis antibody were seropositive (P = .004). It is concluded that a subset of women with ectopic pregnancy were at increased risk for acquiring a sexually transmitted disease by virtue of their sexual behavior and that women in this subset frequently have serologic evidence of C trachomatis infection and histologic evidence of plasma cell salpingitis. Because few of these women recall having had pelvic infection, the authors speculate that subclinical C trachomatis tubal infection producing plasma cell salpingitis may commonly underly ectopic pregnancy. PMID- 3960445 TI - Intravenous gammaglobulin therapy in the management of a patient with idiopathic thrombocytopenic purpura and a warm autoimmune erythrocyte panagglutinin during pregnancy. AB - Intravenous gammaglobulin (IVIgG) was recently introduced for the treatment of idiopathic thrombocytopenic purpura (ITP). Reported is a previously splenectomized patient who had a severe exacerbation of her ITP during pregnancy and was managed with large doses of IVIgG throughout the second half of her pregnancy. She also had an autoimmune IgG erythrocyte panagglutinin on her red blood cells and in her serum, but only minimal evidence of hemolysis. There was little or no transplacental passage of her autoimmune antibodies since she delivered a normal fetus after 34 weeks of gestation who had a normal platelet count and no evidence of an antierythrocyte antibody. Interestingly, at the time of delivery the mother's serum IgG was dramatically elevated, but the cord serum IgG was normal for the length of gestation, indicating the presence of a dramatic and abnormal difference in IgG between maternal and fetal blood. This raises the possibility that the IVIgG therapy may have actually prevented transplacental passage of the pathological antibodies. PMID- 3960446 TI - A technique for surgical correction of fallopian tube prolapse. AB - Prolapse of the fallopian tube is a rare complication of gynecologic surgery. Five cases were operated upon in the authors' hospital within the past year. A summary of these cases is given. One of the cases, which required a second operative procedure, is discussed. The surgical technique for complete excision of the prolapsed fallopian tube via the vagina is described. PMID- 3960447 TI - Revision of dilatation and curettage. PMID- 3960448 TI - Documenting hearing conservation tests equipment's effectiveness. PMID- 3960449 TI - Packaging materials may cause 55-gallon plastic drum controversy. PMID- 3960450 TI - Universities need adequate employee safety, health programs. PMID- 3960451 TI - Proper ladders, scaffolding can prevent dangerous slips, falls. PMID- 3960452 TI - Business should be cautious before jumping on health program bandwagon. PMID- 3960453 TI - Proper sole selection key to safety footwear comfort, protection. PMID- 3960454 TI - Employee input makes health promotion plan effective. PMID- 3960455 TI - Integrated health care plans cut costs without sacrificing care. PMID- 3960456 TI - The physician and antitrust. PMID- 3960457 TI - Retrospective review of the sensitivity of barium enema examination in a community hospital setting. PMID- 3960459 TI - Where's the patient? or business as usual in health care--an internist's view. PMID- 3960458 TI - Infections in total joint replacement. PMID- 3960460 TI - Hazards in the workplace. PMID- 3960461 TI - Business body shops. How corporate fitness centers are shaping America.... PMID- 3960462 TI - [Mutant gene expression in murine aggregation chimeras. 5. The ocular retardation and fidget genes]. AB - Analysis of ocular retardation (or) and fidget (fi) genes expression in 18 day old embryos, 10 and 20 day old or/or C/C----+/+ c/c and fi/fi or/or C/C----+/+ +/+ c/c mice has shown that genes or and fi are active in developing retina and suppress cell proliferation. Structural defects of retina and decrease in the eye size in the chimaeras, compared to the normal embryos, were observed already in the presence of 13-16% of mutant cells. As the fraction of mutant cells increased, the degree of eye disturbances increased as well. In the fi/fi or/or-- -+/+ +/+ chimaeras structural defects of retina and decrease in the eye size are more pronounced than in the or/or----+/+ chimaeras, due to the synergetical effect of both mutant genes in the fi/fi or/or cell clones. In the ontogenesis of the or/or----+/+ chimaeras the development of the retinal photoreceptor layer is normalized due to the substitution of mutant cells for actively proliferating normal cells. No metabolic cooperation between the mutant and normal cells was observed in the developing retina of chimaeras. PMID- 3960463 TI - [Thymic hormonal effects on the antigen-dependent differentiation of accessory T lymphocytes in the humoral immune response]. AB - In the conditions of experimental deficiency of serum thymic factor (FTS) theophylline (TP) recovers in the post--thymic precursors of helper T lymphocytes an ability for differentiation to the effector regulatory stage and inhibits this process in the normal conditions. In the same conditions fraction 2 of thymosin (F2T) recovers this process and in combination with TP can relieve its opposite effects. The diversity of action of F2T on the differentiation of the post- thymic precursors of helper T lymphocytes is accounted for by the possibilities of realisation of the F2T and STF hormonal signals to these cells which depend on the condition of their specific receptors controlled by intracellular cAMP levels. PMID- 3960465 TI - Eyelid penetration of a hard contact lens, simulating a neoplasm. AB - A hard contact lens penetrated the right upper lid at the level of the aponeurosis of the levator palpebral superior's muscle. Later tumor-like symptoms developed of a hard movable mass with blepharoptosis. PMID- 3960464 TI - [Effect of the in vitro conditions of mouse oocyte maturation on their capacity for parthenogenetic activation as affected by cycloheximide and ethanol]. AB - The efficiency of 7% ethanol and cycloheximide (CH) as activators of parthenogenesis was compared on the in vitro matured oocytes of the CBA/C57BL (F1) mice. CH is a more potent activator but the oocytes are activated by ethanol more synchronously. The oocytes matured in the F12, F10 and RPMI 1640 media were activated by ethanol reliably better than those matured in the Minimum Essential Medium Eagle or in the M3 medium. Addition of five amino acids (arginine, alanine, serine, aspartic and glutamic acids), only ornithine or arginine, as well as prolongation of oocyte cultivation in M3 from 19.5 to 26.5 h reliably increased the percentage of activated oocytes. PMID- 3960466 TI - Toxicity of intravitreal interferon. AB - We evaluated the toxicity of injecting human fibroblast interferon intravitreally in rabbit eyes. A single intravitreal injection of 166,660 units/0.1 ml was nontoxic to ocular structures, as demonstrated by electroretinographic and histologic examination. PMID- 3960467 TI - Lamellar keratoplasty in the management of recurrent pterygium. AB - Our experience with excision and LK in ten cases of recurrent pterygia was reviewed. Although a recurrence occurred in three of ten cases, the new pterygia only partially involved the lamellar graft. Visual acuity improved in six cases. Lamellar keratoplasty following excision of recurrent pterygia seems to be a useful alternative in their treatment. PMID- 3960468 TI - Concern regarding delayed socket granuloma formation following evisceration. PMID- 3960469 TI - Differences between men and women as related to intraocular lens implantation. AB - We examined 291 cases of IOL implantation in order to evaluate differences between males and females for several factors. We found that women have shorter axial lengths, older age at time of surgery, greater preoperative corneal curvature, higher power of IOL implanted, more surgically induced astigmatism, and a higher rate of complications. Insignificant differences between the two groups included pre- and postoperative refraction, preoperative astigmatism, visual acuity, type of IOL implanted, corneal thickness, endothelial cell count, and percent of patients requiring discissions. PMID- 3960470 TI - Trapezoidal relaxing incision for post keratoplasty astigmatism. AB - Eleven patients with high astigmatism after penetrating keratoplasty underwent a new form of relaxing keratotomy, the trapezoidal relaxing keratotomy, originally described by Ruiz. The average preoperative astigmatism was 7.89 diopters (range 4.25 to 12.50 diopters) with an average reduction in cylinder of 5.00 diopters (range 0-9.5 diopters). No complications were experienced. PMID- 3960471 TI - Fire hazard in ophthalmic surgery. PMID- 3960472 TI - Transscleral cyclophotocoagulation using a neodymium YAG laser. AB - The effects of a neodymium: YAG laser, working in the free-running mode (1 and 20 millisecond pulses), upon the ciliary body via the transscleral route have been studied using 16 autopsy eyes. The experiments described were designed to find an efficient strategy of transscleral cyclodestruction of the ciliary body. It was found that pulse energies of between 6 and 7 Joules, an exposure duration of 20 milliseconds, and maximal defocusing are optimal. A beam, tangentially oriented and positioned 1/2 to 1 mm posterior to the limbus has a high probability of hitting the ciliary body and damaging the ciliary processes. In these experiments a first generation of contact lenses could not be demonstrated to have an advantageous effect. PMID- 3960473 TI - Posterior chamber pseudophakes in glaucoma patients. AB - In the past, glaucoma has been considered a relative contraindication to the use of an intraocular lens (IOL) in a patient undergoing cataract extraction. In this study, we examined postoperative intraocular pressure (IOP) control for three months postoperatively in 46 eyes with glaucoma undergoing cataract extraction with implantation of a posterior chamber IOL. Twenty-six eyes or 56.5% could be classified as having improved IOP control three months postoperatively. At the same time, 19 eyes or 41.3% demonstrated the same IOP control after lens implantation. Thus, 45 of the total of 46 eyes had as good or better postoperative IOP control. Of the 46 eyes, 100% required preoperative glaucoma medication, while postoperatively only 41% required medication. PMID- 3960474 TI - Mucoepidermoid carcinoma of the conjunctiva: report of a case in a 36-year-old with paranasal sinus invasion. AB - Mucoepidermoid carcinoma is a rare, highly invasive tumor of the conjunctiva that occurs in elderly persons. Although clinically indistinguishable from squamous cell carcinoma, mucoepidermoid carcinoma is more likely to recur following excision and to invade the eye. The following case report describes a 36-year-old man with mucoepidermoid carcinoma of the right caruncle that invaded orbit, paranasal sinuses, and nasal cavity. The patient is the youngest person known to have had this tumor, and represents the first reported case in which mucoepidermoid carcinoma of the conjunctiva has extended beyond the orbit. This case emphasizes the importance of prompt and adequate primary treatment. PMID- 3960475 TI - Retinal toxicity study of intravitreal cyclosporin. AB - We investigated the toxicity of intravitreal cyclosporin in the rabbit. Histologic retinal changes were found with intravitreal injections of 200 micrograms. No histologic or electroretinographic changes were observed with doses of 100 micrograms or less. This nontoxic dose is projected to be at least 77 times the amount needed to be effective. PMID- 3960478 TI - How to avoid drape fires. PMID- 3960477 TI - Combined iris and cornea retractor for intracapsular cataract surgery. PMID- 3960476 TI - Experiences with the Neodymium: YAG laser: interruption of anterior hyaloid membrane of the vitreous and cystoid macular edema. AB - Patients who needed posterior capsulectomy at different times following cataract surgery were treated with: The Meditec OPL3 mode-locked Nd:YAG laser; The LASAG Microruptor 2 Q-switched Nd:YAG laser. Random selection determined which instrument should be used for which patient. Further random selection determined the use of placebo with topical steroids vs. topical Indomethacin and topical steroid treatment. The results showed that there is a connection between the time the posterior capsulectomy is performed after cataract surgery, the number of applications used to interrupt the membrane, and the integrity of the anterior hyaloid membrane. PMID- 3960480 TI - Consternation regarding the article "Multiple complications following radial keratotomy in an elderly patient: a case report". PMID- 3960479 TI - Anesthesia for cataract extraction. PMID- 3960481 TI - Weck-Cel sponges and Steri-Drapes burn. PMID- 3960482 TI - Blindness prevention and progressive transfer of leadership in developing nations. PMID- 3960483 TI - Conservative management of cyanoacrylate ankyloblepharon: a case report. PMID- 3960484 TI - Finger in his eye. AB - A 21-year-old soldier sustained a schrapnel blast injury during an accident with a mortar fuse. Surgical repair included the use of one of his reconstructed metacarpal bones to repair the orbital floor. The remainder of the orbital floor was repaired using maxillary bone. It proved an excellent method of repairing this patient's orbital floor. PMID- 3960485 TI - Response of sheep and cattle to combined polyvalent Pasteurella haemolytica vaccines. AB - The antibody response to various combined polyvalent Pasteurella haemolytica vaccines was studied in sheep and cattle. In sheep, certain oil adjuvant vaccines gave rise to a better antibody response to P. haemolytica than an A1(OH)3 adsorbed vaccine. This finding, however, was not consistent for all serotypes, and with respect to P. multocida, oil adjuvants had no advantage. Furthermore, it was found that the removal of all the culture supernatant fluid during the production process had no deleterious effect on the antigenicity of the product. In cattle, good responses were obtained with both alum-precipitated and A1(OH)3 adsorbed vaccine where all culture supernatant fluid was not removed during the production process. No advantage was gained with oil emulsion vaccines. The degree of immunity afforded to mice and the antibody response to different serotypes of P. haemolytica varied considerably. Further detailed studies with respect to specific serotypes of P. haemolytica are therefore required. PMID- 3960486 TI - Dispersal, density and habitat preference of the blow-flies Chrysomyia albiceps (Wd.) and Chrysomyia marginalis (Wd.) (Diptera: Calliphoridae). AB - 16 000 Chrysomyia albiceps and 52 000 C. marginalis adults were radioactively labelled with 32P-orthophosphate and released in the northern Kruger National Park, South Africa. After a 1-week dispersal period 69 baited blow-fly traps were placed in different habitat types and at varying distances around the release point. C. albiceps were subsequently found to have covered up to 37.5 km and C. marginalis 63.5 km, suggesting dispersal rates per day of 2.20 km and 2.35 km for the 2 species, respectively. Calculation of density using the Lincoln Index yielded estimates per hectare of 7.56 C. albiceps and 29.03 C. marginalis. Both species were trapped more numerously in forested environments than in open scrub, and both avoided arid scrubland. PMID- 3960487 TI - Studies on the ability of different strains or populations of female Rhipicephalus evertsi evertsi (Acarina:Ixodidae) to produce paralysis in sheep. AB - Simultaneous infestation of 3-6 month-old Black-head sheep with 15 South African wild strains of Rhipicephalus evertsi evertsi males and females as well as a strain from Rwanda clearly showed that all strains are capable of inducing paralysis. Assessment of the infestation-rate of engorging female ticks during the period that their mass ranged between 15 and 21 mg/kg sheep body mass indicated that toxicity is quantitatively identical and exhibits no intraspecific gradations. The period between the beginning of infestation to the manifestation of the first clinical symptoms is, however, strain dependent: 4 days for ticks from Warmbaths, and at least 5 days for all other strains. PMID- 3960488 TI - Investigations into the paralysis-inducing ability of Rhipicephalus evertsi mimeticus and that of hybrids between this subspecies and Rhipicephalus evertsi evertsi. AB - Studies performed on sheep showed that Rhipicephalus evertsi mimeticus is a paralysis-competent tick species whose toxicity is either the same as, or only slightly less than that of R.e. evertsi. It was also proved that the paresis or paralysis induced by the mimeticus females is characterized by a constant incubation period which is independent of the tick infestation rate and body mass of the host, and consequently of its age. This period is entirely determined by the state of repletion of the ticks and is regulated by the date of mating. It was further proved that a precise relationship exists between an increase of engorgement or salivation activity and the intensity as well as the persistence of clinical symptoms. Thus only female ticks in the mass range of 15-21 mg are toxic. Strain-dependent differences could not be demonstrated. The infestation rates of subspecific hybrid female ticks, and of their descendants, that are necessary to produce the respective symptoms showed no differences in toxicity. When infestations were limited to a small skin area minimum paresis could frequently not be induced, even though the actual number of ticks applied was sufficient to cause lethal paralysis. PMID- 3960489 TI - Proof of transovarial transmission of Cowdria ruminantium by Amblyomma herbraeum. AB - Transovarial transmission of Cowdria ruminantium by Amblyomma hebraeum does occur in certain instances. Both the transovarial and the filial infection rates appear to be very low. The infection may reappear only in the adults or nymphae, or in all 3 stages of the tick's life cycle. PMID- 3960491 TI - A field evaluation of Bacillus thuringiensis var. israelensis as a biological control agent for Simulium chutteri (Diptera:Nematocera) in the middle Orange River. AB - Bacillus thuringiensis Berliner var. israelensis de Barjac (Serotype H-14) (B.t.i.) at a concentration of 1.6 ppm/10 min and a toxicity of 1500 AAU/mg was tested against Simulium chutteri Lewis larvae in the Orange River near Prieska, South Africa. Samples of benthic fauna from the stones-in-current biotope were collected before application of the product and at various intervals up to 80 h afterwards at 4 stations from 200 m to 11 km downstream of the application site. Fauna drift increased slightly after the arrival of the Bacillus at 2 stations 1.4 and 6 km respectively downstream of the application site. Large numerical decreases in benthic simuliid larval numbers after the application of B.t.i. in the Orange River were not statistically different (P greater than 0.05). This indicated that the size of replicated samples that showed significant decreases (P less than 0.05) of simuliid numbers in the Vaal River was not adequate to show statistical differences in the Orange River. The quantity of dead larvae on stones collected from rapids after application of the B.t.i., and the numerical decreases found by comparing median values of larval counts on stones indicated that B.t.i. effectively killed simuliid larvae. Three days after application of the Bacillus, recruitment of small simuliid larvae on stones 1.4 km downstream of the application site was discernible again. Tanytarsini were also numerically reduced after B.t.i. application. At a flow rate of 38 m3/s B.t.i. was visibly effective in killing S. chutteri up to 6 km downstream of the application site and statistically significant decreases (P less than 0.05) in numbers of larvae were seen at a site 11 km downstream of the application site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960490 TI - The detection of antibodies to Cowdria ruminantium in serum and C. ruminantium antigen in Amblyomma hebraeum by an enzyme-linked immunosorbent assay. AB - A sensitive and reliable enzyme-linked immunosorbent assay for the detection of antibodies to Cowdria ruminantium in serum and C. ruminantium antigen in Amblyomma hebraeum nymphae is described. For the screening of antibodies, C. ruminantium from A. hebraeum nymphae, partially purified by wheat-germ lectin affinity chromatography, was used as antigen. To screen nymph populations, sera from either Ball 3 strain-infected sheep or Kumm-strain infected mice were used. By using appropriate controls the assays were rendered specific with respect to C. ruminantium. PMID- 3960492 TI - Immunization of guinea-pigs and cattle with a reduced dose Clostridium chauvoei vaccine produced in a semi-synthetic medium. AB - A semi-synthetic culture medium and method are described for the production of a reduced dose Clostridium chauvoei vaccine. The vaccine gave excellent results in guinea-pigs, and 2 injections of 2.0 ml protected cattle against challenge with 2 M.L.D. of a virulent culture for at least 12 months. The suitability of C. chauvoei Strain OP64 as a vaccine strain was confirmed. PMID- 3960493 TI - An ovine hepatotoxicosis caused by the plant Pteronia pallens (Asteraceae) L.f. AB - The hepatotoxicity of Pteronia pallens was demonstrated in 5 sheep which developed lesions that ranged from centrilobular necrosis to diffuse hepatocellular degeneration. Botanical, clinical and pathological data are given and the lesions are briefly compared with those caused by other hepatotoxic plants in South Africa. PMID- 3960494 TI - [A method of transosseous osteosynthesis--a new stage in the development of Russian traumatology and orthopedics]. PMID- 3960495 TI - [Work capacity and evaluation of the employment of invalids with sequelae of leg and spine injuries and with spinal diseases]. PMID- 3960496 TI - [Outpatient care of patients and invalids with sequelae of long bone fractures]. PMID- 3960497 TI - [Organization and experience with the treatment of World War II invalids with sequelae of war injuries]. PMID- 3960498 TI - [Mistakes in the diagnosis and treatment at the pre-hospital and hospital stages of patients with injuries of the abdominal organs and locomotor system]. PMID- 3960499 TI - [Clinical aspects of instability of the cervical segment of the spine]. PMID- 3960500 TI - [Unilateral subluxations and dislocations of the cervical vertebrae]. PMID- 3960501 TI - [Place of one-stage closed manual repositioning in the treatment of dislocations of the cervical vertebrae]. PMID- 3960502 TI - [Early activation in the treatment of uncomplicated fractures of vertebral bodies in the lower thoracic and lumbar segments]. PMID- 3960503 TI - [Stable osteosynthesis with bone plates in the treatment of sequelae of distal femur injuries]. PMID- 3960504 TI - [Differential approach to the surgical treatment of stable post-traumatic extension contractures of the knee joint]. PMID- 3960506 TI - [Prospects of improving the rehabilitation treatment of traumatological and orthopedic patients]. PMID- 3960505 TI - [Complications of the treatment of long-bone fractures and their sequelae by transosseous osteosynthesis]. PMID- 3960507 TI - [Transosseous osteosynthesis in the treatment of children with sequelae of hematogenous osteomyelitis]. PMID- 3960508 TI - [Comparative evaluation of reparative regeneration after closed and open intramedullary osteosynthesis]. PMID- 3960509 TI - [Tissue traumatization and methods for its reduction during pin insertion]. PMID- 3960511 TI - [Trends in the further development of the problem of osteosynthesis (concerning the article by L.N. Ankin "Various problems of osteosynthesis"]. PMID- 3960510 TI - [Surgical treatment of fractures of the distal end of the humerus]. PMID- 3960512 TI - [Classification of children's injuries. What is its status?]. PMID- 3960513 TI - [Bronchodilators and the preventive effect of aspirin in bronchial asthma]. PMID- 3960514 TI - [Surgical treatment of pulmonary valve atresia associated with an intact ventricular septum, or critical pulmonary valve stenosis in neonatal age and infancy]. PMID- 3960515 TI - [Vertigo in childhood]. PMID- 3960516 TI - [Incidence and outcome of facial clefts in Hungary]. PMID- 3960517 TI - [Biological behavior of bladder tumors]. PMID- 3960518 TI - [Classification and treatment of bladder cancer]. PMID- 3960519 TI - [Moral and legal limitations of medical advice]. PMID- 3960521 TI - [Reoperation on the biliary tract]. PMID- 3960520 TI - [Infectious endocarditis]. PMID- 3960522 TI - [From the intrauterine biological dialogue to the development of neurologic disorders]. PMID- 3960524 TI - [Notes on the history of the management of pediatric brain tumors (with special reference to Hungary)]. PMID- 3960523 TI - [Idiopathic thrombocytopenic purpura and pregnancy]. PMID- 3960525 TI - [The role of calcium antagonist withdrawal in perioperative coronary spasm]. PMID- 3960526 TI - [HBsAg-positive patients under hemodialysis for chronic uremia]. PMID- 3960527 TI - [Bronchial hyper-reactivity in occupational asthma--a longitudinal study]. PMID- 3960528 TI - [Traumatic injury to the chest in a child]. PMID- 3960529 TI - [Isolated spinal cord aplasia (amyelia) simulating symptoms of respiratory distress syndrome]. PMID- 3960530 TI - [Is melanosis coli a harmless secondary finding?]. PMID- 3960531 TI - [Calculus-forming capacity of hepatic bile, characterized by lithogenic indices, after transduodenal sphincter operations]. PMID- 3960533 TI - [Incidence of secondary hypertension]. PMID- 3960532 TI - [Degranulation of mast cells of the small intestine after a single gliadin loading in celiac disease]. PMID- 3960534 TI - [Physiopathology and therapy of hypovolemia caused by burns]. PMID- 3960535 TI - [Surgical and conservative treatment of puerperal uterine inversion]. PMID- 3960536 TI - [Interaction between the endocrine organs regulating calcium metabolism]. PMID- 3960537 TI - [Significance of synthetic calcium phosphate ceramics as a bone replacement material]. AB - With reference to the chemical and crystallographic differences, the line is drawn against bone substitute material produced from biological material. Extensive animal experiments demonstrated the good healing properties when using calcium phosphate ceramics in bony defects. In the long term, there was more new bone formed after filling up the defect with calcium phosphate ceramics than when using autologous bone grafts. Clinically, there is an indication for using this material to fill up bone cysts and defects if there is enough time for biodegradation; in other cases, a mixture using an autologous spongoid graft is necessary. PMID- 3960538 TI - Review of obstetrical delivery and IQ. PMID- 3960539 TI - Nosocomial pneumonia due to A. hydrophila. PMID- 3960540 TI - An island in a storm. PMID- 3960542 TI - Merger: means to meet your practice goals? PMID- 3960541 TI - Statewide health survey reveals risky behavior. PMID- 3960543 TI - Alternatives? PMID- 3960544 TI - Child abuse law in Pennsylvania. PMID- 3960545 TI - Medical crisis revisited. PMID- 3960546 TI - Abuse of children. PMID- 3960547 TI - Physician has enjoyed music throughout career. PMID- 3960548 TI - Rare migraine and migraine equivalents: is migraine a pineal syndrome? PMID- 3960549 TI - Medical practice as a business. PMID- 3960550 TI - Phlebitis complicating central venous infusion. PMID- 3960551 TI - [Antibacterial chemotherapy--strict indications and developmental trends]. PMID- 3960552 TI - [Current problems of nonspecific neonatal infections. II. Clinical hygiene and antibiotic therapy]. PMID- 3960553 TI - [Thoughts on drug therapy in childhood]. PMID- 3960554 TI - [Side effects of pharmacotherapy in childhood]. PMID- 3960555 TI - [Evaluation of pharmacogenetic aspects in pediatric therapy]. PMID- 3960556 TI - [Drug concentrations in the cerebrospinal fluid of children with hydrocephalus internus]. PMID- 3960557 TI - [Problems of compliance and reliability in ambulatory drug therapy in childhood]. PMID- 3960558 TI - [Prospective studies of morbidity in children receiving day care and possibilities for its modification]. PMID- 3960559 TI - [Knowledge of the child and our responsibility]. PMID- 3960560 TI - [Ischemic damage of the testis as a complication of incarcerated hernia in the infant]. AB - The possibility of atrophy of testicular tissue after torsion of testis is well known. To a lesser extent it is known that an incarcerated inguinal hernia carries the risk of ischemia of the testis by pressure on the testicular vessels. Incarceration of an inguinal hernia is most common in premature and young babies. When it occurs a reposition should be tried, but, if unsuccessful an urgent operation is indicated. Between 1979 and 1983 we operated on 36 boys under the age of one with an unreducible inguinal hernia. As sign of partial or total tissue destruction the follow-ups showed a smaller testis on the operated side in five cases and a total atrophy in four cases. Early operation of inguinal hernias in babies seems to be the best prophylaxis of this above mentioned complication of an otherwise rather harmless anomaly. PMID- 3960561 TI - [Pharmacokinetic-therapeutic studies of ceftriaxone in premature and mature newborn infants]. AB - Ceftriaxone a third generation Cephalosporine exhibits a high degree of antimicrobial activity against the most common pathogens causing life threatening infections in premature and newborn infants. Ceftriaxone was used therapeutically in 16 premature and newborn infants with proven or suspected bacterial infections. Pharmakokinetic investigations were performed during this therapeutic trial. 0.1 ml of blood was taken at 2, 6 and 10 hours after intravenous administration of 50 mg/kg BW Ceftriaxone administered as a single daily bolus injection. Again on day two and four 2 hours after readministration of the same dose, serum concentrations were determined by a biologic test method. With these five samples only, we were able to calculate all clinically relevant pharmakokinetic parameters. There was a high degree of agreement between the experimentally determined and the calculated parameters. Premature infants showed a lower Cmax (115 micrograms/ml) which corresponded to the higher volume of distribution of 44% in this age group. Newborn infants in contrast showed a Cmax of 129 micrograms/ml corresponding to a volume of distribution of 39%. The halflife of elimination was 10.4 and 9.6 hours resp. for premature and mature newborn infants. Cumulation of the drug was seen during the first two days of treatment. A steady state however ensued on day three in both age groups after which no further increase in maximum serum concentrations was seen. Our data suggest, that 50 mg/kg BW once daily given intravenously by bolus-injection or short infusion over 30 minutes constitutes sufficient therapy for serious bacterial infections in premature and newborn infants with susceptible organisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960563 TI - Diagnostic approach in children with severely retarded psychomotor development of unknown origin. AB - In infants and children with severe motor and/or mental retardation combined with a loss of acquired skills or with characteristic signs, such as e.g. a cherry red spot in the fundus, it is easy to suspect the presence of a hereditary metabolic disorder and to undertake the appropriate investigations. The diagnostic approach is, however, more difficult in retarded children with an uncertain developmental stillstand. Our goal was to devise strategies of how to deal with these patients from a diagnostic point of view. We retrospectively studied 77 children affected by severe developmental lag of unknown origin and without any clear signs of improvement or regression. A diagnosis of a hereditary metabolic disorder could be established in 12 of these children. In 5 other children a chromosomal abnormality or a structural abnormality of cerebral development was detected. Sixty children remained without any aetiological or pathogenetic diagnosis; 55 of them could be reexamined clinically after one year, and 32 of these showed then a clear improvement of their mental and/or motor performance. From the individual analysis of the 77 patients and from literature we conclude that if a child presents multiple minor malformations, investigations should concentrate on chromosomal aberrations and on possible structural brain abnormalities. Metabolic studies should be performed if the same disease already occurs in the family and where characteristic signs are present. In children without such signs the psychomotor development should be reevaluated after one year. If after this year there is an improvement, there is no reason for starting extensive investigation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960562 TI - [The audio-visually determined reaction evaluation test (A-V-R test) (a hearing test for infants and small children)]. AB - The A-V-R-test is accomplished in a free sound field, either with a play audio metric table (clinical use) or with a textile paravent (practice). The main effort of this reactiontest is the auditive-visual determination. The examiner provokes the auditive readiness with a supraliminal impulse, which prepares the starting position for offering an acoustic test impulse in a low signal strength on the left or right side. If the test is realized with the textile paravent, frequency and intensity proved music instruments or other sound producing objects (bunch of keys, Ewing-rattle, etc.) are offered to the child. If the A-V-R-test is accomplished with the play-audio-metric table, the tester presents a frequency specific narrow band noise to the examinee. Only the turn of the infant's head towards the source of the sound is evaluated. Infants older than 2 years may show specific reactions, depending on the stage of their development. PMID- 3960564 TI - Cri du chat-syndrome in combination with partial trisomy 9 p. AB - A partial monosomy 5p leading to the Cri du chat-Syndrome combined with a partial trisomy 9p was observed in a mentally defective boy with typical clinical features for both syndromes. This chromosomal aberration is inherited from a t [5; 9] (p. 13.3; 13.1) translocation carrier father. Further family investigations showed many balanced translocation carriers through several generations. PMID- 3960565 TI - [Thrombosis of the inferior vena cava with successive lung embolization in a 15 year-old boy with nephrotic syndrome]. AB - The authors report on a boy with typical course of recent nephrotic syndrome, who developed massive thrombosis involving the iliac inferior holden veins during the standard therapy with corticosteroid. The first sign of this complication was pulmonary embolism. Thrombosis was treated by surgery, during which 3 large thrombi from veins were removed. The patient developed recurrent thrombosis occurring at the previous sites in the later stage and he died 23 days after the first sign of thromboembolic complication. Autopsy showed only minimal glomerular changes. The cause of the death was massive pulmonary embolisation. The aethiopathogenesis of the complication and preventive approach in children with nephrotic syndrome are discussed. PMID- 3960566 TI - [Clinical experiences with an antimycotic foam preparation with added prednisolone (Nystacorton foam)]. AB - Twenty-five infants and children with Candida infections in the perianal, genital and inguinal areas and on the skin normally covered by the napkin or diaper, confirmed by culture tests and microscopy, were treated with a new combined foam preparation containing the active substances nystatin, chlorhexidine and prednisolone. Even partially very severe lesions with multiple, satellitelike colonies on the trunk, extremities and neck were, without exception, cured within a maximum of 13 days. After disappearing of the exudative stage, intermittent treatment with a rather more greasy excipient (Excipial Cream) containing no active substance, has proved beneficial. PMID- 3960567 TI - [Thoughts on the diagnosis, treatment and long-term course of patients with gluten-induced celiac disease]. AB - The criteria for the diagnosis of coeliac disease are the evidence of a well characterized and typical, albeit not pathognomonic lesion of the proximal small bowel mucosa in untreated patients as well as the unequivocal rapid response to a gluten free diet (GFD). The instruction and the motivation of the patients in GFD aims at an early and positive establishment of dietary habits, based on an adequate choice of gluten free foods. As coeliac disease is genetically determined, GFD should be maintained life long. The results of long term evaluations of relapses in coeliac patients confirm this postulate by demonstrating that only 6.5% of the patients show no mucosal alteration upon gluten ingestion, even after years on GFD, and that another group (12-18%) will deteriorate very slowly over years. Routine gluten challenges in patients, whose initial diagnosis was established according to the discussed criteria, seem therefore unjustified, as they represent a serious challenge of established dietary and life habits for the vast majority of patients without any positive issue for them. PMID- 3960568 TI - [The screaming baby. A family dynamic study on causes, sequelae and therapeutic possibilities in the crying baby]. AB - The main goal of this paper is to point at the still unknown aetiology of the "screaming babies". To neglect the corresponding symptoms or to inadequately treat them mostly results in a derangement of the behaviour of the children even years afterwards, resulting in abnormal behaviour, psychosomatic symptoms or even retardation of development, as can be observed during psychotherapeutic treatment later on. Analyzing aetiologic factors will give hints for therapy, which enable us to help and support these children or their suffering parents. Since we believe that multifactorial reasons lead to the symptoms of the "screaming baby", the aetiologic aspect will be demonstrated on three levels: Neurophysiological aspects, dysfunction of the mother-child relationship and also family-dynamic aspects in the context of the family as a whole. PMID- 3960569 TI - Development of an observation method for assessing pain behavior in rheumatoid arthritis patients. AB - Four studies examined the reliability and validity of a behavioral observation method for the assessment of pain associated with rheumatoid arthritis (RA). The major purpose of experiment 1 was to evaluate the interobserver reliability of the observation method. Two observers recorded the frequencies of pain behaviors displayed by 20 RA patients. Each of 3 types of reliability estimates indicated that the pain behavior could be reliably observed. The purpose of experiment 2 was to examine the concurrent validity of the observation system by correlating 53 patients' self-reports of pain with the frequencies of their pain behaviors. Significant and positive correlations were found between patients' total pain behavior and 3 self-report measures of pain and functional disability. Furthermore, unlike the self-reports of pain, total pain behavior was only minimally related to self-report of depression. Experiment 3 was performed in order to assess the observation method's construct validity. Naive observers viewed video recordings of 25 RA patients and made global estimates of patients' pain severity and unpleasantness. Highly significant and positive correlations were found between these global estimates and total pain behavior. In experiment 4, the pain behaviors of 11 RA patients were recorded prior to and immediately following cognitive-behavioral treatment for the reduction of RA pain. There was a significant decrease in total pain behavior from pretreatment to posttreatment. The data indicate that the observation method provides a reliable, valid, and relatively objective measure of RA patient pain behavior. Future validation studies of the observation method are discussed. PMID- 3960570 TI - Effects of vibratory stimulation on muscular pain threshold and blink response in human subjects. AB - The effects of vibratory stimulation on muscular pain threshold were investigated in 28 healthy subjects. Pain sensation was evaluated by the subjects' verbal reports in response to electrical stimulation of the vastus medialis muscle. Concomitant variations of blink response evoked as a component of the startle reaction were also studied. In all the subjects tested, high frequency vibration (110 Hz) induced a marked and long lasting elevation of the muscular pain threshold but only when vibration was applied to the skin overlying the ipsilateral quadriceps tendon or neighbouring areas and not when applied to remote ipsi- or contralateral regions. This effect was prevented either when tonic vibration reflex (TVR) of the quadriceps muscle was elicited or the skin underlying the vibrator was anaesthetized. Vibratory stimulation at low frequency (30 Hz) failed to produce any consistent effect on muscular pain threshold. Variations in threshold for blink response, as a rule, closely followed those of muscular pain threshold. However, a facilitation of the blink response, not accompanied by changes in pain sensation, was observed during the first period of both high and low frequency vibratory stimulation. The effectiveness of high frequency vibration in raising the muscular pain threshold is coherent with previous results showing that vibration is able to affect pain sensation. Present results suggest a role for rapidly adapting receptors (RA) and/or pacinian corpuscles (PC) in this effect and support the hypothesis of an inhibition of nociceptive messages, possibly at spinal segmental levels, by volleys in large myelinated afferent fibres. PMID- 3960571 TI - Hyperalgesia following ischaemia of the rat's tail. AB - We have investigated the effects of ischaemia on responses to a subsequent noxious stimulus in rats. Tail flick latencies to a noxious thermal stimulus were determined by immersing the tail in water at temperatures ranging from 39 to 49 degrees C. We then produced ischaemia by occluding the blood supply to the tail; ischaemia was terminated at the first signs of an escape response. Tail flick latencies were recorded immediately after termination of ischaemia and at 30 min intervals for another 2 h. Each rat acted as its own control. Tail flick latency decreased after ischaemia; we found a decrease of about 39% immediately after ischaemia, at immersion temperatures above 39 degrees C. The duration of the hyperalgesia increased with increasing water temperatures. Thus noxious ischaemia of the rat tail induced hyperalgesia to subsequent noxious thermal stimuli. The hyperalgesia could have arisen through either central or peripheral mechanisms. PMID- 3960572 TI - The effects of thermal stimulation on clinical and experimental itch. AB - In order to substantiate accidental observations on the influence of skin temperature on itch, and to elucidate a possible involvement of thermoreceptors in itch generation, the effects of thermostimulation on clinical and experimental itch were studied. Eighteen patients with atopic dermatitis rated the intensity of spontaneous itch on one of their forearms before, during, and after its immersion in a waterbath of either 10 degrees C or 45 degrees C. In 40 normal subjects itch was elicited by histamine topically applied to a 7 cm2 skin area of the volar forearm. Before and after histamine application thermal thresholds were recorded. Then the skin area was heated or cooled at a rate of 0.5 degrees C/sec and itch intensity was continuously rated. Cooling abolished itch in all patients and in most of the normal subjects. Heating produced less clear effects: in two thirds of both patients and normal subjects itch disappeared or was reduced whereas in the others itch was aggravated. Usually after the end of thermostimulation the opposite changes in itch intensity occurred. In the normal subjects thermal thresholds were not significantly influenced by histamine. Over a certain temperature range itch and thermal sensations could coexist as separate modalities. The results indicate that changes in skin temperature have a marked influence on itch intensity. Whereas cooling seems to act directly on the sensory receptors mediating itch, warm stimuli could have a central inhibitory effect. A direct role of thermoreceptors in the generation of itch is improbable. PMID- 3960573 TI - Reliability of the pressure algometer as a measure of myofascial trigger point sensitivity. AB - Three studies are presented demonstrating the reliability of the pressure algometer as an index of myofascial trigger point sensitivity. The first study showed high reliability between and within experimenters when measuring marked trigger point locations. In study 2, significant between experimenter reliability in locating and measuring the same unmarked trigger point locations was shown, while study 3 supported the idea that trigger points are discrete points of focal tenderness within the muscle. The ability to quantify and reliably measure trigger point sensitivity opens the door to a range of clinical and research possibilities for myofascial and related musculoskeletal pain problems. PMID- 3960574 TI - Influence of psychological factors on postoperative pain, mood and analgesic requirements. AB - Previous research has indicated that postoperative pain, mood and analgesic requirements are influenced by diverse demographic and psychological variables. The data, however, are inconsistent and the extent of these influences has not been explored using multivariate statistical methods. In the present investigation patients scheduled for elective gallbladder surgery were examined for levels of pain, mood and analgesic needs, and the data were analyzed by using stratified stepwise multiple regression analysis. The results indicate that approximately half of the variability in the postoperative outcome measures could be predicted by a set of variables which include the patient's anxiety, extroversion, depression, educational level, previous chronic pain syndromes, and bias toward using medication. The implications of these results are discussed in relation to pain management strategies for surgical populations. PMID- 3960575 TI - Predicting treatment response in depressed and non-depressed chronic pain patients. AB - Although it has often been observed that chronic pain and depression are associated, there have been few systematic comparisons of chronic pain patients with and without depression. In the study reported in this article, depressed and non-depressed chronic pain patients were found to be quite similar with respect to demographic, pain-related, and treatment response variables. The primary aim of the study, however, was to examine the hypothesis that treatment response in these two groups of patients would be predicted by different patterns of variables. In non-depressed patients, beneficial response to treatment was related to a greater number of treatment visits, not receiving workmen's compensation, fewer previous types of treatment, and low back pain. As predicted, a different pattern of predictors of treatment response was found for the depressed patients, who were more likely to benefit when they were employed at the beginning of treatment and when their pain was of shorter duration. These results suggest that activity and active involvement in treatment are particularly important with chronic pain patients who are depressed. In addition, they suggest that the best prediction of treatment response in future research on chronic pain patients may be achieved by dividing patients into groups based on psychological characteristics. PMID- 3960576 TI - Exercise quotas, anticipatory concern and self-efficacy expectancies in chronic pain: a preliminary report. AB - Reduced activity levels are a frequently encountered problem among chronic pain patients which has been shown to be responsive to exercise quota systems. This study extends the knowledge of exercise quota systems by examining their effects on beliefs relevant to exercise avoidance. Results indicate that exercise quota systems produce systematic increases in both exercise levels and expectancies of capability while reducing worry and concern about exercising. These data highlight the importance of avoidance learning in chronic pain and suggest that the effectiveness of exercise quota systems is related to a deconditioning process based on exposure rather than the process of applying reinforcement to quota achievement. PMID- 3960577 TI - Acute pain response in infants: a multidimensional description. AB - Fourteen infants who were undergoing routine immunization were studied from a multidimensional perspective. The measures used were heart rate, crying, body movement/posturing, and voice spectrographs. There was wide variability between infants on the measures, especially on the cry spectrographs, although facial expression was consistent across infants. The pattern that did emerge was characterized by an initial response: a drop in heart rate, a long, high pitched cry followed by a period of apnea, rigidity of the torso and limbs, and a facial expression of pain. This was followed by a sharp increase in heart rate, lower pitched, but dysphonated cries, less body rigidity, but still facial expression was of pain. Finally, in the second half of the minute's response, heart rate remained elevated, cries were lower pitched, more rhythmic, with a rising-falling pattern, and were mostly phonated, and body posturing returned to normal. Those faces that could be viewed also were returning to the at rest configuration. It was suggested that facial expression may be the most consistent across-infant indicator of pain at this point in time. PMID- 3960578 TI - Hitchcock pain classification. PMID- 3960579 TI - Pathological calcium metabolism in the elderly. PMID- 3960581 TI - Primary hyperparathyroidism. A series of 76 cases observed between 1965 and 1984. PMID- 3960580 TI - Value of glycosylated hemoglobin measurements after acute myocardial infarction. PMID- 3960582 TI - Oncologic hyperthermia in progress. PMID- 3960583 TI - Association between chronic hepatic diseases and kidney neoplasms mortality rates and its possible causal meaning. PMID- 3960584 TI - Self-perceived psychological effects on males of chronic unemployment by occupational classification. PMID- 3960585 TI - Human calcitonin and malignant osteolysis. PMID- 3960586 TI - Urinary problems in decompression sickness. AB - The records of 25 patients with type II decompression sickness and urinary problems have been reviewed. Seventeen patients were professionals and 8 were above the age of 40. The disease appeared within the 1st hour of emergence from the water in 70% of the cases and within the first 4 hours in the remaining 30%. Nine patients were diagnosed as paraplegic and two as tetraplegic. All patients had urinary disturbances and 14 were on Foley-catheter drainage during the decompression while 11 were on intermittent catheterisation. Fifteen patients had improved urinary function after recompression, 8 had some difficulty, 2 underwent a sphincterotomy and one a transurethral prostatectomy. The low percentage of complete recovery was due to the delayed arrival at the decompression chamber. PMID- 3960587 TI - Nocturnal penile tumescence studies in spinal cord injured males. AB - Traditional methods of evaluating sexual function in disabled individuals using neurological examinations, interviews, and psychological screening has been well established. A patient's ability to have erections and ejaculations are recorded through interviews with the patient and his partner. Therefore, to obtain a more objective view of the patient's sexual function, we used a nocturnal penile tumescence monitor in 12 tetraplegics and 12 paraplegics. Patients were interviewed for sexual histories before and after the injury. Their penile size was monitored during sleeping time using two strain gauges attached to each end of the penile shaft. The bridge output from these strain gauges was amplified to a single channel recorder. The spontaneous increase of penile circumference and its duration was recorded. The result showed that: tetraplegics had a greater increase of penile size and longer duration of erection than paraplegics, there is no correlation between incompleteness of spinal lesion and erection, there is no correlation between the presence of bulbocavernosus reflex and erection, and there is no correlation between sex dreams and erections. PMID- 3960588 TI - The Quadriplegia Index of Function (QIF): sensitivity and reliability demonstrated in a study of thirty quadriplegic patients. AB - The Quadriplegia Index of Function (QIF) was originally developed by the authors in 1980 because the popular Barthel Index was deemed too insensitive to document the small but significant functional gains made by quadriplegics (tetraplegics) during medical rehabilitation. The QIF has now been tested on a group of 30 complete quadriplegic patients at admission to and discharge from inpatient medical rehabilitation. Resultant scores were compared to those simultaneously obtained by the Barthel Index and the Kenny Self-Care Evaluation. The QIF was found to be more sensitive (46 per cent improvement as opposed to 30 per cent by the Kenny Self Care Evaluation and 20 per cent by the Barthel Index). The QIF was also tested for reliability. Ratings by three different nurses, working independently, were found to be significantly positively correlated for all sub scores (p less than .001). We conclude that the QIF provides a useful option in choosing a functional assessment instrument for use with quadriplegic patients. PMID- 3960589 TI - Liaison psychiatry in a spinal injuries unit. AB - Spinal cord injury may produce both immediate and long term stress and disability. The liaison psychiatrist may have an important role in dealing with the problems of the spinal cord injured patient, his family and the medical team. Problems occurring may cause or be exacerbated by psychological difficulties. Problems occurring during rehabilitation and long term adjustment have not been systematically studied. Many assumptions concerning the psychological responses to injury have been made. Such assumptions have important implications for both the short and long term treatment of patients. This paper examines some of these areas. PMID- 3960590 TI - Sex-influenced response in the pathogenesis of cutaneous leishmaniasis in mice. AB - Male B10 X 129 (10M) ScSn mice were relatively resistant to cutaneous leishmaniasis, while females frequently developed non-healing expanding ulcers, leading to loss of infected extremities, metastasis to distal skin sites, and in some animals, death. Anti-leishmanial antibody titers were higher, and delayed type hypersensitivity responses to parasite antigens, lower, in infected females than in males. Sex differences in response to cutaneous infection were not marked in BALB/cJ mice, a highly susceptible strain, and both males and females ultimately lost infected extremities, developed metastases, and died. PMID- 3960591 TI - Gametogenesis and fertilization in Dirofilaria immitis (Nematoda: Filarioidea). AB - Gametogenesis in Dirofilaria immitis has been studied principally by means of the aceto-orcein chromosomal squash technique, but with additional ultrastructural observations. A terminal germinative zone, in which a continuous and rapid division of germ cells occurs, has been identified in the gonoduct of both male and female worms. Approximately 20% of cells within these germinative zones were in arrested mitotic division following the incubation in vitro of excised gonads in 0.01% colchicine for 4 h. All primary spermatocytes within a 1-2 cm length of the testis proximal to the germinative zone were at the prophase of the 1st meiotic division. In the corresponding region of the ovary, the primary oocytes were similarly at the prophase of the 1st meiotic division in 75% of female worms examined but in the remaining 25% all primary oocytes possessed markedly less condensed, probably interphase nuclei. A possible hormonal control of the cyclical development of primary oocytes, but not primary spermatocytes in D. immitis is suggested. In most of the remaining length of the gonoducts beyond this region of cells at meiotic prophase, the chromatin material of both primary spermatocytes and oocytes is decondensed. Recondensation of chromosomes in the spermatocytes is observed just prior to entry into the seminal vesicle, where meiosis I is completed and meiosis II takes place. In the primary oocyte, completion of meiosis only occurs after fertilization within the seminal receptacle by an entire male gamete. Following the 2 meiotic divisions in the oocyte and subsequent extrusion of the 2 polar bodies, the haploid chromosome complement of the female unites with that of the male, re-establishing the diploid number of the zygote (2n = 10). Male chromosomes within the oocyte remain visible throughout late oogenesis and fusion occurs without the formation of pronuclei. PMID- 3960592 TI - An investigation of the prevalence of intestinal parasites in pre-school children in Ghana. AB - Evidence for the presence of 11 intestinal parasites in pre-school children from 4 rural villages in Ghana was obtained from an examination of stool samples. Striking differences were detected between the prevalence of some of the 6 common infections in the 4 villages. The prevalence of Ascaris lumbricoides varied from about 76% in one village (Oshiyie, coastal savanna) to apparently 0% in another (Akuma, forest zone). No differences in prevalence for any infection were observed to be sex dependent. Investigation of the relationship between age of the children and prevalence showed that the degree of prevalence of both A. lumbricoides and Trichuris trichiura had essentially levelled off by the time the children were 4 years old. There was no evidence to suggest that the prevalence of either Entamoeba sp. or spp. or hookworm was approaching a maximum value, even in the oldest children. These trends applied across the villages regardless of the differences in prevalence values for the infections. On average, the children of Oshiyie were found to harbour twice as many infections as the children of the other villages. The investigation of the prevalence data revealed evidence of associations between pairs of infections, particularly those involving hookworm and T. trichiura. PMID- 3960594 TI - Independent expression of the metacyclic and bloodstream variable antigen repertoires of Trypanosoma brucei rhodesiense. AB - The variable antigen repertoire expressed by metacyclic Trypanosoma brucei rhodesiense is not influenced by the anamnestic expression whereby the variable antigen type (VAT) ingested by a tsetse fly is present at high levels in early bloodstream populations of fly-infected mice. This has been demonstrated by feeding to Glossina morsitans a trypanosome line expressing a VAT which is normally a component of the metacyclic repertoire. The VAT did not constitute a significantly increased proportion of the resultant metacyclic population which would have occurred had anamnestic expression and metacyclic expression been linked. Five other metacyclic VATs were also present at control levels. We conclude that the mechanisms of expression of VATs in the fly and in the mammal are independently controlled. PMID- 3960593 TI - The use of DNA hybridization and numerical taxonomy in determining relationships between Trypanosoma brucei stocks and subspecies. AB - The nuclear DNAs of 71 trypanosome stocks from different African countries, representative of the three Trypanosoma brucei subspecies, and one T. evansi stock, have been analysed by the combined use of restriction endonuclease digestion, gel electrophoresis and molecular hybridization with both trypanosome surface-antigen-specific and undefined genomic DNA probes. In contrast with T. brucei brucei and T. brucei rhodesiense stocks, all the T. b. gambiense stocks are characterized by a conserved, specific DNA band pattern, regardless of the probe. This allows T. b. gambiense to be non-ambiguously identified. On the contrary, T.b. brucei and T. b. rhodesiense, which could not be discriminated by the same criteria, both yield highly variable DNA band patterns. Our data confirm that domestic animals like pig, dog and sheep constitute a potential reservoir for T.b. gambiense. Using a numerical analysis of the DNA hybridization patterns we have measured the degree of similarity between the 72 trypanosome stocks. This investigation shows that all T.b. gambiense stocks are included in the same homogeneous population, while the stocks from the two other subspecies seem to be distributed in several heterogeneous groups, some of these showing correlation with the geographical origin of the trypanosomes. It is concluded that (i) T.b. gambiense stands out as a real subspecies that has undergone a distinct evolution relative to the 'non-gambiense' group, (ii) the alleged T.b. rhodesiense subspecies does not fit with any of the groups evidenced by our cladistic analysis and hence does not appear as a distinct subspecies and (iii) 'non gambiense' trypanosomes are probably evolving much more rapidly than T.b. gambiense. Different aspects of trypanosome relationships and evolution are discussed. PMID- 3960595 TI - Metacyclic Trypanosoma vivax possess a surface coat. AB - Coated metacyclics of Trypanosoma vivax exist in the hypopharynges of infected tsetse flies and are extruded in low numbers when the flies are induced to probe onto warm slides or into medium. After extensive searching of T. vivax-infected proboscides, and resort to a process for the examination of single, extruded, metacyclic trypanosomes, electron microscopic evidence is presented that, contrary to an earlier report, metacyclic T. vivax acquire a surface coat before contact with the mammalian host. Since T. vivax exhibits antigenic variation, the role of the surface coat in this species is likely to be functionally equivalent to the surface coat of the other tsetse-transmitted trypanosome species, T. brucei and T. congolense. PMID- 3960596 TI - The conditional emotional response as a model of Pavlovian conditioning. AB - Many investigators have assumed that the conditional emotional response (CER) with its attendant response measure, response suppression, can be used as a model for Pavlovian conditioning; that is, that the experimental results obtained with the CER will yield findings similar to those obtained with the direct conditional stimulus (CS)-conditional response (CR) paradigm, e.g., conditioning of the eyeblink, electrodermal (EDR), finger withdrawal, etc. Several problems, however, have emerged with this assumption. The first is a methodologic-statistical one. Measurement of response suppression using the familiar ratio measure assumes that different base rates of responding should play no role in determining the size of the suppression ratio, and operant responding from one pre-CS period to another will remain stable. These assumptions have been found to be in error. In addition, the statistical assumptions of normally distributed data and homogeneous variances of the experimental and control groups also have been called to question. Some experimenters, however, have taken the position that if CER and direct CS-CR experimental findings are in general agreement when a particular conditioning variable has been manipulated, the methodologic statistical problems that we have identified can be ignored. The experimental evidence suggests that although such comparisons frequently indicate an identity of findings, there are sufficient exceptions in which caution is urged in assuming that the two paradigms are measuring the same learning correlate. PMID- 3960597 TI - Dentist phobia. AB - This study analyzes so-called hopeless gaggers, i.e., patients in whom dental treatment and wearing of a prosthesis produced a retching or vomiting reaction, in order to investigate the sources and properties of this pathologic reaction. In 35 patients, an anamnestic inquiry, a determination of the reflexogenic zone, a recording of the peripheral pattern of the pathologic reflex, and extinction training were performed. A group of six normal persons served as a comparison group. It was shown that patients, in comparison with normals, had an enlarged receptive field, were sensitive to a broader population of stimuli, and showed precursors and aftereffects of the retching-vomiting not found in normals. This pathologic reaction was the symptom of different psychopathologic processes, such as specific fear, repugnance-fear-based disturbances, diffuse anxiety, goal directed behavior, depressive states and, at least in one case, visceral pathology. The various patients differed with respect to properties of the reaction as well as in the sensitivity to the extinction procedure. It is discussed that different integrative nervous processes play a role in the origin and development of the syndrome: activation of unconditional reflexes, activation of classic and instrumental conditional reflexes, activation of such reflexes by an increase of the reactivity level of specific and unspecific structures of the brain, generalization of stimuli, etc. PMID- 3960598 TI - High calcium intake does not prevent stress-salt hypertension in dogs. AB - Avoidance conditioning sessions and isotonic saline (1.3 L/day) were administered to dogs for 12 days under conditions of a low (0.1%) or high (1.5%) calcium diet. Twenty-four-hour mean arterial pressure increased comparably during the stress salt conditioning periods on both the low (systolic: +16 +/- 5 mm Hg; diastolic: +6 +/- 2 mm Hg) and high (systolic: +17 +/- 4 mm Hg; diastolic: +11 +/- 4 mm Hg) calcium diets. Urine volume, sodium excretion, and serum calcium levels on the high calcium diet were not significantly different from those on the low calcium diet. In a second experiment, calcium was infused continuously for six days into the arterial circulation of normotensive or stress-salt hypertensive dogs at a rate of 0.12-0.23 mEq/min. Although serum calcium levels increased by up to 50% under these conditions, there were no significant effects on 24-hour levels of arterial pressure. In contrast to the protective effect of augmented potassium intake, these findings indicate that calcium intake does not influence the development of stress-salt hypertension in dogs. PMID- 3960599 TI - Status asthmaticus. PMID- 3960600 TI - Office evaluation and management of pediatric asthma. PMID- 3960601 TI - Asthma self-management programs and education. PMID- 3960602 TI - Asthma--a pediatrician's experience. PMID- 3960603 TI - An overview of pediatric asthma. PMID- 3960605 TI - Cerebral palsy--a permanent disability. PMID- 3960604 TI - Approach to the wheezing infant. PMID- 3960606 TI - Etiologic factors in cerebral palsy. AB - A variety of insults can cause cerebral palsy, but the dominant mechanism of damage is ischemic and/or asphyxial. Table 2 provides a rough estimate of the relative contribution of each of the several risk factor groups to the total burden of cerebral palsy. This table is only approximate both because of our lack of knowledge, and because risk factors often interact with one another. Cerebral palsy is frequently multifactorial in nature. For example the small-for gestational age infant is both more likely to experience labor asphyxia, and is also more susceptible to its effects. The numerically largest etiologic grouping in cerebral palsy consists of pre-term/low birthweight infants, many of whom have experienced ischemic damage perinatally. The second largest grouping is infants born at term experiencing severe perinatal asphyxia. Congenital infections, and metabolic conditions such as hyperbilirubinemia certainly play some role in the genesis of cerebral palsy but genetic conditions as such rarely cause cerebral palsy. Some infants, if carefully studied, will prove to have a congenital brain malformation. The role of intrauterine ischemic events is at present not well understood, but is probably significant. PMID- 3960607 TI - The early signs and differential diagnosis of cerebral palsy. PMID- 3960608 TI - Early neuromotor reflexes in infancy. AB - While motor milestones--the neurodevelopmental functional end point of the transitioning of the immature and mature primitive reflexes into volitional activity--have been highlighted in predicting future motor function, the primitive reflexes represent the earliest neurodevelopmental markers available for study. By pediatricians becoming familiar with their quantitative and qualitative aspects coupled with the time of their appearance and suppression, they will have this neuromotor tool available for the early detection of a significant motor handicap. Primitive reflexes II have been highlighted since they are available at birth to be clinically evaluated and followed during sequential office visits during the first 6 months of life, the time during which infants are more closely followed at office visits. Delay or deviancy (nonsequential appearance) of motor milestones are preceded by an exaggeration or delayed suppression of the primitive reflexes. It is anticipated that the study and standardization of an intrauterine primitive reflex profile will eventually lead to the identification of a high-risk fetus. This endeavor will be fostered by the further development and refinement of non-invasive roentgenographic techniques. PMID- 3960609 TI - Rehabilitation strategies for the child with cerebral palsy. PMID- 3960610 TI - Counseling families of children with cerebral palsy. PMID- 3960611 TI - Pediatric toxicology. PMID- 3960612 TI - Salicylate toxicity. AB - Understanding of the pharmacologic principles and the pathogenesis of salicylate toxicity provides a basis for the optimization of clinical management. The role of salicylate as a scientifically proven cause of Reye's syndrome remains controversial despite epidemiologic data. The management guidelines discussed illustrate treatment details based on the pathophysiology of salicylate toxicity. PMID- 3960613 TI - Sudden infant death syndrome in infants evaluated by apnea programs in California. AB - Home apnea/bradycardia monitoring is frequently used in the management of infants at increased risk for sudden infant death syndrome (SIDS). However, some infants have died despite evaluation by infant apnea programs, and the benefits of home monitoring remain unproven. To determine the SIDS rate and risk factors of infants evaluated by infant apnea programs, 31 apnea programs and ten home monitor vendors in California were surveyed. Eleven (35%) of the apnea programs and four (40%) of the vendors responded. Information was obtained on 26 infants who died. Thirteen (50%) deaths were due to SIDS. Abnormal sleep studies did not predict death. Fifteen infants died despite a recommendation for home monitoring. Seven deaths occurred in association with technical errors or noncompliance with monitoring. Four deaths were due to nonaccidental trauma. The apnea programs evaluated 3,406 infants during a 5-year period; 1,841 had monitoring recommended. Term infants with apnea, subsequent siblings of SIDS victims, and infants evaluated at referral centers were more likely to have monitoring recommended than premature infants with apnea or infants evaluated at nonreferral centers (P less than .0001). Infants who had monitoring recommended were at equal risk of dying of SIDS as those who did not. PMID- 3960614 TI - Impact of maternal work outside the home during pregnancy on neonatal outcome. AB - The impact of mothers' work during pregnancy upon neonatal outcome has not been fully elucidated. A study of maternal health habits and neonatal outcome conducted from 1977 to 1979 at Boston City Hospital assessed the effects of paid work outside the home during pregnancy, particularly third trimester work in a standing position, upon duration of gestation and intrauterine growth, while controlling for potentially confounding variables. Postpartum, 1,690 low-income women were interviewed to provide detailed information on their sociodemographic and health characteristics. Of the 1,507 women whose work status during pregnancy could be classified, 55% did not perform paid work outside the home or attend school, 7% worked into the third trimester in a standing position, and 38% had other work histories or attended school. Infants were examined according to a standard protocol by pediatricians blind to mothers' work history. There was no significant relationship between the mothers' work history during pregnancy and the infants' length of gestation, weight, or head circumference at birth, when confounding variables were controlled statistically by multiple regression analyses. However, women who worked in a standing position into the third trimester delivered infants who were longer than infants born either to mothers with other work histories or to mothers who did not work or attend school. Healthy women with uncomplicated low-risk pregnancies who feel well enough to attend school or work during pregnancy, even in a job requiring some standing, may do so without fear that their infant will suffer shortened gestation or impaired intrauterine growth. PMID- 3960615 TI - Impact of revaccinating children who initially received measles vaccine before 10 months of age. AB - Two hundred fifty-four infants who had received measles vaccine at less than 10 months of age were revaccinated at greater than or equal to 15 months of age, and their immune responses were compared with 129 control infants who received their first doses of measles vaccine at greater than or equal to 15 months of age. Sera were collected at the time of revaccination (study infants) or primary vaccination (control infants), 3 weeks, and 8 months later and tested for antibody by hemagglutination inhibition (HI), enzyme-linked immunosorbent assay (ELISA), and cytopathic effect neutralization (CPEN). Of the 121 study infants who were initially HI negative, 116 (95.9%) made HI antibody 3 weeks postrevaccination compared with 126 (99.2%) of 127 control infants (P = 0.19). Of the 63 study infants with no initial detectable antibody by any of the three tests, 14 (22.2%) had a measles-specific IgM response 3 weeks postrevaccination compared with 37 of 50 (74.0%) randomly chosen control infants. By 8 months after revaccination, the 121 initially HI-negative study infants were significantly less likely to have detectable HI antibodies than control infants (52.1% v 97.6%) (P less than .001). However, 96.7% of these 121 study infants had detectable neutralizing antibody 8 months postrevaccination, an antibody thought to correlate best with protection. This study confirms the altered immune response to revaccination in infants first vaccinated prior to 10 months of age; however, the data suggest that most of these infants were successfully primed and are probably protected after revaccination. PMID- 3960616 TI - Use of oral gentamicin, metronidazole, and cholestyramine in the treatment of severe persistent diarrhea in infants. AB - Oral gentamicin, metronidazole, and cholestyramine were given either as single agents or in various combinations to infants who still required treatment after seven days in the hospital for persistent diarrhea. The effect of these drugs and the interactions between them were assessed by comparing daily stool output during treatment with that in the pretreatment period. The effect of the drugs on apparent nitrogen and fat absorption was also studied. On the first day of treatment the presence of cholestyramine was associated with a significantly greater decrease in stool output. This effect appeared to be largely due to an interaction with gentamicin. Thereafter, only gentamicin produced a significantly greater decrease in stool weight. At no stage was metronidazole of benefit. Gentamicin and cholestyramine also indirectly improved apparent nitrogen and fat absorption by reducing stool output. The combination of oral gentamicin and cholestyramine is recommended as a safe and effective way of treating infants with severe persistent diarrhea following acute gastroenteritis. PMID- 3960617 TI - Childhood enuresis: prevalence, perceived impact, and prescribed treatments. AB - Childhood enuresis can indicate an underlying problem as benign as developmental immaturity or as serious as urinary tract obstruction. As part of a large population-based study, parents of 1,753 children aged 5 to 13 years were asked about the presence and frequency of enuresis, perceived impact, and physician prescribed treatments. Enuresis at least once during a 3-month period was reported for 14% of this general population of children. Boys were significantly more likely to experience enuresis than girls (16% v 12%; P less than .01). The prevalence of enuresis at least once a week was similar among boys and girls (7% v 6%). Parents reported that more than half of the children are distressed by their enuresis, and two thirds of parents expressed concern. Thirty-eight percent of bed wetters have seen a physician about their condition. More than one third of these children have been treated with a drug. The most commonly recommended regimen in the literature, the bed alarm, was prescribed to only 3% of bed wetting children who saw a physician. PMID- 3960618 TI - Identification of a high-risk group for sudden infant death syndrome among infants who were resuscitated for sleep apnea. AB - Of the 1,153 infants who completed monitoring by Aug 1, 1984, through our program at Massachusetts General Hospital, 76 infants had an initial apnea spell during sleep which was characterized by a change in tone and color, was unresponsive to repeated vigorous stimulation, and was terminated only after mouth to mouth resuscitation. The infants were hospitalized for observation and evaluation, and no cause could be identified. All were discharged on a home apnea or cardiorespiratory monitor, and subsequent episodes of apnea and/or bradycardia were reviewed. We grouped infants based on the intervention used to terminate subsequent episodes: Group 1, resuscitation; group 2, vigorous stimulation; and group 3, neither resuscitation or vigorous stimulation. There was no significant difference in clinical features or in the results of the initial evaluation in groups 1 and 2, compared with group 3. However, the mortality rate was significantly higher in group 1 (4/13) and group 2 (3/12) than in group 3 (3/51) (P less than .007). Siblings of victims of sudden infant death syndrome (n = 8) were at a significantly higher risk of an adverse outcome (two deaths and four resuscitations) than nonsiblings (P less than .02). A seizure disorder that developed during monitoring was associated with a high mortality (4/11 v 6/65, P less than .02). We conclude that these relatively rare infants who have sleep onset apnea that responded only to resuscitation and have a subsequent similar episode or are siblings of victims of sudden infant death syndrome or develop a seizure disorder during monitoring have a very high risk of dying (31%, 25%, and 36% respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960619 TI - Zinc and copper balances in preterm infants. AB - Preterm infants are at risk for copper and zinc depletion if sufficient quantities of these nutrients are not provided in a bioavailable form in postnatal life. The purpose of this study was to determine whether the use of a whey-predominant, 50% medium chain triglyceride formula with relatively high concentrations of zinc and copper would promote the achievement of the in utero accretion rate for zinc and copper in the preterm infant. Two groups of five preterm infants were fed a diet containing 12.5 mg/L of zinc and either 0.9 mg/L or 2.1 mg/L of copper. Seventy-two-hour metabolic balance studies were performed at an average postconceptual age of 34 weeks and an average weight of 1,549 g. All infants were in positive zinc balance and nine of ten achieved the in utero accretion rate for zinc for a 34-week gestation fetus (greater than or equal to 0.432 mg/d). Three infants receiving the high copper formula and two receiving the lower copper formula were in positive copper balance. Two infants from each group achieved the in utero accretion rate for copper for a 34-week gestation fetus (0.088 mg/d). A formula that provides 12.5 mg/L of zinc permits positive zinc balance and zinc retention similar to in utero rates. A formula that provides as much as 2.1 mg/L of copper, however, may not always permit positive copper balance. PMID- 3960621 TI - Longitudinal evaluation of a statewide network of hospital programs to improve child passenger safety. AB - As a project begun in 1979 to improve child passenger safety, a statewide network of hospital-based car safety seat rental and education programs was implemented by a coalition of volunteers, nurses, physicians, and state agencies. A car safety seat program was established at every hospital delivering newborns. To evaluate the effectiveness of this network of programs, 1,846 newborns (87% of hospital discharges) were observed at discharge at ten hospitals during 33 observation studies from 1979 to 1984. Mean correct car safety seat usage increased from less than 21% in 1979 to 82% in 1984. Concurrently, use of the dangerous lap or arms position decreased from 70% preprogram to 6% postprogram, and incorrect car safety seat usage decreased from 28% to 3%. In addition 1,597 children from 0 to 3 years of age were observed at an annual county fair from 1982 to 1984. Use of either a vehicle seat belt alone or car safety seat with harness and seat belt increased from 34% in 1982 to 67% in 1984. Car safety seat and seat belt misuse occurred in 42% of infants less than 1 year of age and 20% of children 1 to 3 years of age. These findings suggest that a network of hospital-based car safety seat rental and education programs is an effective means of improving the passenger safety of newborns, infants, and young children. PMID- 3960620 TI - Risk factors for traumatic infant death in Oregon, 1973 to 1982. AB - A retrospective study of risk factors for traumatic infant deaths in Oregon occurring from 1973 through 1982 was performed using vital records and medical examiner records. A total of 146 such deaths occurred during this period. Relative risks were calculated for various risk factors in the study group compared with all Oregon births. Factors found to be significantly associated with all traumatic deaths were low maternal age, out-of-hospital birth, unwed mother, late or no prenatal care, low birth weight, and low maternal education. Race, sex, and birth order were not associated with traumatic infant death. The traumatic deaths were grouped into homicides and accidents. The same risk factor associations, with the exception of out-of-hospital birth, were found for each group. PMID- 3960622 TI - Children in self-care: a new priority for pediatricians. PMID- 3960623 TI - An impossible assignment for the pediatrician. PMID- 3960624 TI - Early indicators of self-destruction in childhood and adolescence: a survey of pediatricians and psychiatrists. AB - This paper reports a comparison of pediatricians' and psychiatrists' opinions about screening for children and adolescents at risk for self-destruction. Fifty nine percent of the members of the Nebraska Chapter of the American Academy of Pediatrics and 69% of the members of the Nebraska District Branch of the American Psychiatric Association completed questionnaires containing selected early indicators for self-destruction and programs for suicide prevention. Principal findings were that pediatricians placed less emphasis than child psychiatrists on major depressive disorder, younger pediatricians placed more emphasis than psychiatrists on psychosocial indicators, physicians from both groups said they usually hospitalize attention-seeking self-destructive children, and pediatricians from smaller communities expressed less confidence in referral to psychiatrists but more confidence in community-based programs. Findings suggest that a small group of children and adolescents at risk for eventual suicide may not be identified as early as the more obvious larger groups of individuals who are accident prone, who ingest toxic substances, and who come from violent families. General indicators of risk for self-destruction include substance abuse, psychosocial problems, and minor depression. Factors indicating more specific risk for suicide include escalating stress, family enmeshment, and major mental illness, particularly major depressive disorder. Postgraduate education, instruments for discriminate screening, and balanced programs for suicide prevention are suggested to improve care. PMID- 3960625 TI - Changing patterns of hospitalization for children requiring surgery. AB - Increasing health care costs have directed public attention to changing rates of hospital care. We examined changes in hospitalization and surgical rates for children during the decade from 1972 to 1981. Total hospitalizations for children younger than 15 years of age increased by only 4% during the decade. For teenagers and young adults (ages 15 to 24 years), hospitalizations declined by 19%. Admissions for surgery declined more for the younger group than for the older one. For children younger than 15 years of age, inpatient tonsillectomies and adenoidectomies (T and A) decreased 43%, representing 58% of the total decline in surgical procedures for this age group. Teaching hospitals continued to provide a sizable proportion of all childhood surgeries and increased their share of both high- and low-technology procedures during the decade. Payment sources varied among procedures. Self-pay varied from a low of 1.6% for T and A to 13.5% for spina bifida. Private insurance or Blue Cross payment varied from 59% for congenital heart disease surgery to 84% for T and A. These data on payments suggest that some children may lack access to some surgical care. Furthermore, insofar as the bulk of payment is from nonfederal sources, changes in hospitalization for surgical procedures will likely come mainly from changing incentives in the private sector. PMID- 3960626 TI - Polysorbate 80 and E-Ferol toxicity. AB - The relatively recent introduction and use of an intravenous form of a vitamin E preparation (E-Ferol) has been associated with the development of an unusual syndrome and fatalities among low birth weight (less than 1,500 g), premature infants in neonatal intensive care units. We have observed an inhibitory effect by this vitamin E preparation on the in vitro response of human lymphocytes to phytohemagglutinin (PHA). E-Ferol suppressed the expected response to low doses of PHA. However, this suppression was not due to the alpha-tocopherol acetate (vitamin E) component, because alpha-tocopherol acetate by itself was not inhibitory; in fact, it often enhanced the PHA response. Because a mixture of polysorbate 80 and polysorbate 20 is used as a carrier in E-Ferol, these components were also tested and were found to be responsible for the suppression, especially the polysorbate 80. Concurrent with this suppression of PHA-induced mitogenesis was a decrease in the percentage of T11 lymphocytes. PMID- 3960627 TI - Changing epidemiology of Reye syndrome in the United States. AB - The average annual incidence of Reye syndrome reported through national surveillance was lower during 1981 to 1984 than during the previous five surveillance years. This is accounted for by a decrease in cases among children younger than 10 years of age; the number of cases in 10- to 19-year-old persons remained relatively stable during this period. The overall decline in incidence and the differing age-specific incidence trends are apparent for both varicella associated cases and for nonvaricella-associated cases. During 1985, the incidence has been much lower than during any previous year since surveillance was initiated; this most recent decrease includes children 10 to 19 years of age. Independently conducted surveys suggest that the prevalence of salicylate use for viral illnesses has decreased among children in recent years, particularly among children younger than 10 years of age. The changing epidemiology of Reye syndrome may reflect, in part, the declining use of salicylates among children and teenagers in the United States. PMID- 3960628 TI - Driving safety and adolescent behavior. AB - Accidents, and mainly automotive accidents, are currently the leading cause of mortality and morbidity among young people. Understanding and addressing the issue of automotive accident prevention requires an awareness of the multiple psychodynamic, familial, and societal influences that affect the development and behavior of adolescents. Risk-taking behavior is the product of complex personal and environmental factors. As pediatricians, we have the obligation and the opportunity to improve the safety of our youth who drive and ride. This opportunity is available to us not only in our roles as counselors to youth and families, but also as we serve as role models, educators, and agents for change within our communities. PMID- 3960629 TI - Forgotten full-term infant mortality rate. PMID- 3960630 TI - Predicting outcome in low birth weight infants. PMID- 3960631 TI - Kawasaki syndrome, Reye syndrome, and aspirin. PMID- 3960632 TI - Chest pain. PMID- 3960633 TI - Rehydration. PMID- 3960635 TI - School buses and seat belts. PMID- 3960634 TI - On partial splenectomy in Gaucher's disease. PMID- 3960636 TI - [Renal scintigraphy in children with glomerulonephritis]. PMID- 3960637 TI - [Sudden death syndrome in hospitalized children with kidney diseases]. PMID- 3960638 TI - [Incidence and severity of disorders of motor function of the gallbladder in children with various gallbladder deformities]. PMID- 3960639 TI - [Science serves medical practice]. PMID- 3960640 TI - [Bile secretion and the absorptive and excretory functions of the liver in children after cholecystectomy]. PMID- 3960641 TI - [Morphological substantiation of rheohepatographic data in fibrocholangiocystosis in children]. PMID- 3960642 TI - [Methods of evaluating anal sphincter function in healthy children]. PMID- 3960643 TI - [Variants of the clinical course of chronic duodenal obstruction in children]. PMID- 3960644 TI - [Chronic course of epidural hematoma in infants]. PMID- 3960645 TI - [Adaptation of children to hospitalization]. PMID- 3960646 TI - [Role of district pediatricians in organizing the activities of district nurses]. PMID- 3960647 TI - [Tactics in the teaching of the basic subjects of pediatrics in advanced training courses]. PMID- 3960648 TI - [Characteristics of enzyme levels in the urine of patients with hereditary and acquired nephritis]. PMID- 3960649 TI - State-trait anxiety and motocross performance. AB - The prediction from state-trait theory that subjects low in anxiety will perform better than highly anxious subjects on a more difficult task was tested on a motocross competition. We analyzed the relationships among the entire rank order of finish and state and trait anxiety measured by State-Trait Anxiety Inventory for 32 motocross riders (males whose age ranged from 16 to 27 yr.) participating in a national competition in Italy. A negative correlation between performance (measured by rank at the finish of the competition) and state anxiety was noted. The r for state and trait anxiety scores was also negative, but that between performance and trait anxiety was nonsignificant. Additional studies of high level sport competition will provide data relevant to planning interventions to control athletes' anxiety. PMID- 3960651 TI - Perceived hazard of video display terminals: an informal look. PMID- 3960650 TI - Relationship between emotions and some aspects of respiratory activity: morphology of the chest, cyclic activity, and acid-base balance. AB - The relationship between the style of affective-emotional management measured on the Gottschalk test and respiratory activity of 19 undergraduate students in psychology was examined. The biological measurements were tonic-static attitudes of the chest (morphology), amplitude and duration of the phases of the respiratory activity, and acid-base balance. Statistically significant correlations were observed between affectivity (hostility and anxiety) and some biological scores. A psychophysiological model integrating biological and psychological levels was discussed. PMID- 3960652 TI - Speech-mediated retention in dyslexics. AB - Dyslexics (6 to 9 yr. old) and a control group of 12 normal readers (second graders) were tested on a memory task with rhyming and non-rhyming items. The most important finding is that both groups were penalized by rhyme, indicating speech coding. It was observed that the dyslexics were not less penalized by rhyme than were controls. The present results are compared with those of other recent studies. PMID- 3960653 TI - Utility of the group coefficient of variation in predicting speech-motor equivalence in normal and articulatory disordered speakers. AB - Coefficients of variation of EMG signals from the orbicularis oris superior, orbicularis oris inferior, and masseter muscles of normal 4- and 8-yr.-olds and adults and of articulatory disordered 8-yr.-olds suggests that development of speech motor equivalence is individualized, muscle-dependent, and affects all children. Age-related differences were noted. Group data did not predict individual values. PMID- 3960654 TI - Other race recognition: a comparison of black American and African subjects. AB - The ability of black American and black African men to recognize previously seen white male faces was assessed. Relationships between recognition, performance scores and quality of interracial experience were also examined. Black American participants (n = 10) performed significantly better and made fewer false responses than the Nigerian participants (n = 10). Significant positive relationships were found between performance scores and interracial experience. Differential use of cues for discriminating white male faces by both groups was also found. PMID- 3960655 TI - EEG alpha asymmetry: task difficulty and hypnotizability. AB - Parieto-occipital EEG alpha was recorded bilaterally, while 20 high- and 20 low hypnotizable women performed one left-hemisphere and one right-hemisphere task of low difficulty and two other comparable tasks of high difficulty. Every task was performed twice, once with eyes open and once with eyes closed. All subjects were right-handed. The tasks were originally selected to be of high and low difficulty. The subjective rating of task-difficulty was also evaluated. The integrated amplitude alpha and the alpha ratio (R-L/R + L) were the dependent variables. The highly hypnotizable women showed significantly higher alpha amplitude in eyes-closed condition than the low scorers; this difference disappeared during task performance and in the eyes-open condition. The left tasks showed lower alpha amplitude in both hemispheres than right-tasks and baseline. The right-hemisphere alpha amplitude was lower than left in all experimental conditions. On tasks of high and low difficulty there was different hemispheric behavior on right and left tasks. Performance reflecting the right and left hemispheres in the low-difficulty condition showed no changes between baseline, right- and left-tasks, while under high difficulty there was a decrease in alpha amplitude in the right and even more marked decrease in the left hemisphere during left-tasks. The pattern of task effects for ratio scores was the same as for alpha amplitude, however, despite the analysis of alpha scores, an interaction of hypnotizability X task-difficulty was detected. The highly hypnotizable women showed less negative alpha ratio during a task of low difficulty than during tasks of high difficulty; the reverse was true for the low hypnotizable women. Finally, the highly hypnotizable subjects showed less subjective difficulty during performance than the low scorers. PMID- 3960657 TI - Effects of an observer on conformity to handwashing norm. AB - Women were observed after elimination in a public restroom to determine the effects of the presence or absence of an observer upon the likelihood of handwashing. 18 of 20 subjects in the presence of another and 3 of 19 who were not observed washed. The difference in frequency of handwashing between the two groups was clearly significant. PMID- 3960656 TI - Effect of playing a video game on a measure of spatial visualization. AB - 70 undergraduate students, without any prior experience of video games playing, were given a pretest and a posttest on the Space Relations Test of the DAT, Forms A and B being, respectively, administered on the two occasions. The experimental group of 38 had eight sessions of playing the Zaxxon video game, each session including five plays. The control group of 32 received no such treatment. A 2 (sex) by 2 (group) analysis of covariance, using pretest scores as the covariate, yielded a significant effect for group which supports the hypothesis that spatial visualization test scores can be improved by video game playing. Moreover, the sex-related difference in visual-spatial skills frequently reported does not appear on the pretest. Finally, no effect for sex and no interaction of group X sex were found, indicating that both male and female subjects gained equally from playing Zaxxon. PMID- 3960658 TI - Informed consent: III. Informing subjects that performance will not affect credit may affect performance. PMID- 3960660 TI - Responses to salivary olfactants in relation to dominance of the degu (Octodon degus). AB - Large amounts of head sniffing and grooming have been associated with social dominance in the degu. This study examined whether salivary olfactants act as cues which could potentially mediate social dominance in 4 male and 8 female adults. Using salivary samples taken from the buccal cavities of partners of predetermined status, no preferences for dominant or submissive stimuli were evident. Comparison of work with the degu and that with other species was made. PMID- 3960659 TI - Distance perception in photographic displays of natural settings. AB - Distance perception of depicted objects was examined as a function of photographic perspective. 24 subjects viewed slides of outdoor scenes and directly estimated the distances to specified objects. Perspective was manipulated by photographing each scene with lenses of four different focal lengths: 48 mm, 28 mm, 24 mm, and 17 mm. Distance perception along the pictorial depth plane (z-axis) was systematically transformed by changing the photographic perspective: the shorter the focal length of the camera lens, the greater the perceived distance. Perceived distance between objects along the lateral plane (x axis) was unaffected by changes in lens focal length. PMID- 3960661 TI - Effect of directional response variables on eye-hand reaction times and decision time. AB - To determine if direction of response affects reaction time, we measured the time for hand response to a visual stimulus, using a sensitive, microprocessor-based testing device to determine simple reaction time (RT), choice RT, and decision time. Mean simple RT was 207 +/- 3.7 msec. (mean +/- SEM); mean choice RT was 268 +/- 4.2 msec; and mean decision time was 61 msec. No differences were noted for leftward versus rightward movements, or midline versus lateral movements. Choice RT increased by 1.49 msec./yr. of age. Simple RT increased significantly with age for the nondominant hand, but not for the dominant hand. Right-handed subjects were more rapid with the dominant hand for choice RT. We conclude that dominance of hand tested and test initiation mechanism have major effects, but direction of movement in the lateral plane has little effect on reaction time. PMID- 3960662 TI - Perceptual and physiological responses during exercise in cool and cold water. AB - This investigation examined the interaction of exposure to cold water stress with both perceived exertion and thermal sensation during exercise. Eight male volunteers performed arm, leg, and combined arm and leg exercise for 45 min. in water at 20 and 26 degrees C. Exercise was performed at a low (n = 7) and a high (n = 8) intensity relative to the ergometer specific peak oxygen uptake (VO2 peak). In general, percent VO2 peak did not differ between types of exercise in either 20 or 26 degrees C water. During low intensity exercise when power output was matched across water temperatures (Tw), percent VO2 peak was greater in 20 degrees C water (52%) compared to 26 degrees C water (42%). Ratings of perceived exertion (RPE) did not differ between Tw. During high intensity exercise when percent VO2 peak was matched across Tw, RPE was lower during exercise in 20 degrees C compared to 26 degrees C. Multiple correlation analyses comparing both final RPE and thermal sensation (TS) with physiological and thermal measures were performed across type of exercise and Tw. RPE was moderately correlated with heart rate (r = 0.68) and ventilation (r = 0.61), whereas very slight relationships were established with TS (r = 0.16), skin and rectal temperatures (r = 0.10 and r = 0.20). TS was moderately correlated with skin and rectal temperatures (r = 0.64 and r = 0.73), whereas low correlations existed between TS and both heart rate (r = 0.32) and ventilation (r = -0.12). These data suggest that the change in oxygen uptake associated with exercise in cold water does not add to the over-all perception of exertion. This perception appears to be related to cardiopulmonary variables rather than thermal measures, whereas thermal sensation is related to thermal measures and not cardiopulmonary variables. PMID- 3960663 TI - Note on test-retest characteristics of the General Health Questionnaire. AB - The state-type 60-item General Health Questionnaire was administered on two occasions, with intervening periods of 11-12 mo. and 6-7 mo., to 186 male school leavers and 101 men facing redundancy, respectively. Significant test-retest correlations suggested that the questionnaire is to some considerable extent measuring an underlying tendency for normal subjects to report a general, minor, nonpsychotic psychiatric morbidity, as opposed to purely transitory fluctuations in mental well being. PMID- 3960664 TI - Cognitive-academic correlates of finger localization in right-handed kindergarten girls. AB - The scores of 49 right-handed girls in early kindergarten on a battery of finger localization tests were compared with their end-of-year achievement scores on the Metropolitan Readiness Tests. Examination of the correlations between performance with each hand and test measures of achievement favored a substantive role for each cerebral hemisphere in early acquisition. Strength of prediction was comparable for tasks with and without a naming requirement (numerical coding of fingers) and was independent of children's verbal-receptive ability on the Peabody Picture Vocabulary Test. Apparently, differential hemispheric efficiency presumed to underlie left-right differences in finger localization is not closely related to level of academic skills in girls of kindergarten age. PMID- 3960665 TI - Flight-skill decay and recurrent training. AB - This article addresses the problem of flight-skill decay. The complexity of the problem is outlined with regard to identifying the nature and extent of decayed skills. It is suggested that cognitive/procedural skills are more prone than control-oriented skills to decay over periods of disuse. Effective recurrent training methods offer the most promise in forestalling loss of proficiency. Several such methods are described, and the importance of cognitive training is emphasized. Finally, criteria are noted for evaluating the utility of recurrent training media. The theories and practical measures discussed apply to many skills other than those of flying. PMID- 3960666 TI - Visual dominance in the cross-modal kinesthetic to kinesthetic plus visual feedback condition. AB - In previous studies subjects who have learned a positioning response with kinesthetic feedback tended to make greater errors when visual feedback was provided during later trials. These subjects have always performed with both kinesthetic and visual feedback available. This study determined whether subjects with only visual feedback would produce errors similar to those who received kinesthetic plus visual feedback. Blindfolded subjects learned to move a handle to a criterion location with knowledge of results following each trial. Subjects then were assigned to one of three experimental groups, with only kinesthetic feedback, with kinesthetic plus visual feedback, or with only visual feedback. Subjects had 9 trials without knowledge of results in these feedback conditions. When visual feedback was available, subjects tended to make longer response errors. This finding replicates previous studies. Also, the similarity of performances from the conditions with visual feedback indicated the dominance of visual information in the condition with kinesthetic plus visual feedback. PMID- 3960667 TI - Sleep duration and eating behaviors of college students. AB - 31 short-sleeping college students tended to eat more small meals or snacks than 37 long sleepers, all of whom were satisfied with their sleep. This disrupted pattern of larger meals was predicted from work of Elomaa and Johansson with rats who were partially REM-sleep deprived. PMID- 3960668 TI - Changing the perception of behavioral properties by subliminal presentation. AB - Profiles designed by Pittenger and Shaw were used in a tachistoscopic experiment. Subjects were asked to make estimates of age of a profile of a 10-yr.-old boy preceded subliminally by an older (old group) or younger (young group) profile or by a blank card (control group). Results show the mean estimate of the young group to be significantly smaller than that of the control group. The mean estimate of the old group was not significantly greater than that of the control group. The results are discussed in the framework of the debate on direct versus indirect perception. Marcel's 1983 data and the present results indicate that higher level perceptual processing (the perception of behavioral properties) can precede lower level perceptual processing (the perception of physical properties). By assuming that people do perceive directly the behavioral properties of an event, the direct approach avoids the danger of putting too much emphasis on intelligence in perception and at the same time avoids the homunculus trap. PMID- 3960669 TI - Syntactic decoding times of learning disabled children. AB - Syntactic decoding reaction times of 20 learning disabled children comprising two groups of subjects (mean age of 8 and 13 yr., respectively) were compared to the responses of normal controls matched for age and sex. An analysis of variance procedure showed that the learning disabled children and their normal peers did not differ significantly in responses to the experimental stimuli. This held true regardless of linguistic complexity, suggesting that delays in processing elementary syntactic constructions are not a concomitant of learning disabilities. PMID- 3960670 TI - Handwriting analysis in diagnosis and treatment of alcoholism. AB - This preliminary study of the alcoholic personality, based on handwriting material before and after the over-indulgence period shows a characteristic dynamic development which could be manifest in different forms. The prealcoholic individual apparently was subjected to a strong discipline by a strict Super-ego, and at the same time being quite vulnerable, due to a basic emotional sensitivity. The drastic change in the handwriting of the recovery period indicates that the postalcoholic individual has broken the chains of the early discipline. He starts to struggle with his self-image, tries to cope with his now liberated psychic dynamics, experiencing some emotional discomfort. He still has preserved his emotional sensitivity. One could conclude that the handwriting from the recovery period conveys the beginning of individual development. PMID- 3960671 TI - Relationship of left-right reversals to academic achievement. AB - The study was designed to investigate the relationship of reversal of letters and numbers to academic achievement to decide if the tendency to reversal might be used to predict achievement. Two groups of 45 predominantly white third-grade students whose chronological ages were 9.0 yr. or above were administered the California Achievement Tests and the Jordan Left-Right Reversal Test. A statistical comparison was made using scaled scores on the California Achievement Tests and raw errors on the Jordan Left-Right Reversal Test. Reversal was significantly correlated with academic achievement. Children who exhibit reversals at 9 yr. of age or older may be expected to perform less well academically than children who do not reverse letters. PMID- 3960672 TI - Pupillometric assessment of the readability of two video screen fonts. PMID- 3960673 TI - Differences in hemispheric functional asymmetry between athletes and nonathletes: evidence from a Unilateral Tactile Matching Task. AB - To study the hemispheric specialization for spatial information processing in athletes and nonathletes a Unilateral Tactile Matching Task was administered. Athletes showed more marked hemispheric specialization than nonathletes. The right hemisphere of the former, in fact, indicated a more pronounced accuracy than those of the latter in perceiving rod orientations. PMID- 3960675 TI - Naming reaction times to tachistoscopically presented pictures: some evidence of right hemisphere encoding. AB - The present study measured naming reaction times by normal subjects to unilaterally presented picture stimuli. Significant differences in picture-naming reaction time did not exist between left and right visual-field stimulations. The right hemisphere in the intact brain is capable of generating a verbal label for pictured stimuli. A psychological model suggests that a possible processing synergy between the two hemispheres may be tied to spatial processing and elementary linguistics. PMID- 3960674 TI - Sex differences in dual-task interference between speaking and a manual force production task. AB - 12 male and 12 female right-handed adults performed a unimanual force-production task alone and while sound-shadowing high frequency words. The secondary speech task disrupted right-hand performance by men and left-hand performance by women. The implications of these findings for intrahemisphere-interference models of dual-task performance are discussed. PMID- 3960677 TI - Classical conditioning of pupillary constriction. AB - Previous attempts to condition classically the pupillary response have resulted in mixed outcome. Studies using light as the UCS have generally been unsuccessful while those studies using shock as the UCS have been more successful. In the present study six subjects were visually presented 15 CVC trigrams while their pupil sizes were monitored. Five of the CVCs had been previously presented, five had been previously presented while paired with shock, and five had not been previously presented. Analysis indicated that more pupillary constriction occurred to the five CVCs paired with shock than those presented without shock or those not previously presented. The resulting classically conditioned pupillary constriction is discussed in terms of the development of meaning through classical conditioning. PMID- 3960678 TI - Vision and academic performance of learning disabled children. AB - The purpose of this study was to assess difference in academic performance among myopic, hyperopic, and emmetropic children who were learning disabled. More specifically, myopic children were expected to perform better on mathematical and spatial tasks than would hyperopic ones and that hyperopic and emmetropic children would perform better on verbal measures than would myopic ones. For 439 learning disabled students visual anomalies were determined via a Generated Retinal Reflex Image Screening System. Test data were obtained from school files. Partial support for the hypothesis was obtained. Myopic learning disabled children outperformed hyperopic and emmetropic children on the Key Math test. Myopic children scored better than hyperopic children on the WRAT Reading subtest and on the Durrell Analysis of Reading Difficulty Oral Reading Comprehension, Oral Rate, Flashword, and Spelling subtests, and on the Key Math Measurement and Total Scores. Severity of refractive error significantly affected the Wechsler Intelligence Scale for Children--Revised Full Scale, Performance Scale, Verbal Scale, and Digit Span scores but did not affect any academic test scores. Several other findings were also reported. Those with nonametropic problems scored higher than those without problems on the Key Math Time subtest. Implications supportive of the theories of Benbow and Benbow and Geschwind and Behan were stated. PMID- 3960676 TI - Snacking, aversive imagery, and weight reduction. AB - This study was designed to explore the relationship between reduced snacking and weight loss and to evaluate the effectiveness of an aversive imagery procedure. Twenty-two participants completed an 11-wk. program designed to reduce the frequency of snacking. Reading an aversive "fat sheet" immediately prior to or after snacking, combined with a point system, was no more effective in reducing snacking than was the point system alone. Although incidence of snacking was significantly reduced, weight loss was greatest during the baseline period, when snacking was most frequent. The correlation between weekly weight loss and weekly number of snacks was nonsignificant. These results suggest that a single-minded focus on the reduction of snacking is unlikely to produce significant weight loss for most dieters. PMID- 3960679 TI - Relationship between specific disfluency variables and dichotic listening in stutterers. AB - 86 stutterers' disfluency patterns were examined in relation to their laterality preferences. Results suggest that young stutterers are a heterogeneous group and that specific disfluency variables were not related to ear preferences on a dichotic consonant-vowel listening task. PMID- 3960680 TI - Validity of the Barksdale Personal Stress Evaluation. PMID- 3960681 TI - Stevens' power law and time perception: effect of filled intervals, duration of the standard, and number of presentations of the standard. AB - Subjects estimated the duration of five different time intervals, either filled or unfilled, in relation to one or two standard intervals. Half of the subjects were presented with the standard at the beginning of the experiment only, and half were presented with the standard before every interval. The five estimations were then used to calculate, for each subject, the exponent in Stevens' Power Law which describes the form of the power relationship. The resulting over-all exponent of .91, although nearly linear, was significantly different from 1.0. The data were then analyzed by a 2 X 2 X 2 analysis of variance which showed a significant interaction between presenting the standard either once or before each interval with the duration of the standard. PMID- 3960682 TI - Symmetric distribution in latencies of cortical somatosensory potentials evoked by right and left posterior tibial nerve stimulation in right-, left-, and mixed handed men and women. AB - The latencies of the P1, N1, P2, and N2 components of the somatosensory potentials evoked by stimulation of the right and left posterior tibial nerves in the right-, left-, and mixed-handed men and women were subjected to a statistical analysis. The mean latencies of the primary and secondary cortical responses are symmetrically distributed between the right and left sides for all the subjects. The mean latencies obtained of women were significantly shorter than those of men. This difference was accounted for by the fact that the mean body height of women was significantly less than that of men, since there was a significant positive correlation between body height and latency. It was concluded that the conduction times for the cortical input as well as the early cortical information processing, despite synaptic interventions, cannot play a role in the cerebral lateralization concerning the perceptual and manipulospatial tasks. PMID- 3960683 TI - Visual correction of a rapid goal-directed response. AB - The purpose of this study was to investigate the role of dynamic and static visual cues in improvement of accuracy during a pointing movement. In the experiment, subjects were required to point finger rapidly at visual targets as accurately as possible. Movement amplitude was 15 cm, and movement times ranged from 100 to 190 msec. Three visual feedback conditions were applied: no feedback, dynamic ongoing feedback on the complete hand trajectory, and static error feedback on the movement end-point. Two spatial movement outcomes were considered, mean constant error and intraindividual dispersion of pointings. Data were analyzed with regard to effects of feedback and speed. Under the no-feedback condition, accuracy was lowest; constant error was not speed-dependent, whereas dispersion increased with speed of movement. Accuracy was highest under the complete feedback condition and was speed-dependent, as shown by both constant error and dispersion. Under error feedback, accuracy was intermediate and was also speed-dependent. The results are discussed in terms of the interchange between correcting mechanisms vs delayed control within the motor regulatory processes. PMID- 3960684 TI - Spatial complexity and hand usage on the Block Design Test. AB - The Block Design test is a task utilizing spatial ability, on which subjects are required to arrange red and white blocks in a pattern similar to one presented on a stimulus card. 69 right-handed subjects were presented a series of trials which varied in difficulty or spatial complexity. The amount of time that each subject's hand was in contact with the blocks during each of the reproduction attempts was recorded. Analysis of these times shows that subjects use their right hands with greater frequency only on tasks of low and moderate spatial complexity. This preference is not present on tasks of high spatial complexity. Interpretations of this finding are offered. PMID- 3960685 TI - Gross motor profiles of deaf children. AB - The purpose of this study was to evaluate and summarize the gross motor development of 132 hearing impaired children between the ages of 3 and 14 yr. The subjects were individually evaluated on the 11 gross motor items of the Ohio State University Scale of Intra Gross Motor Assessment. Delays were noted in catching, kicking, jumping, and hopping. It was determined that gross motor skill performance was not related to etiology of deafness or to the sex of the subjects. PMID- 3960686 TI - Impact of physical fitness on strategy development in decision-making tasks. AB - Data from 30 female subjects indicated that a 17.3% increase in a physical fitness index improved by 12% to 68% the information processing and decision making capabilities of the subjects. The changes in physical fitness did not affect the performance on a variety of other tasks. PMID- 3960687 TI - Effect of context on perception of emotion among psychiatric patients. AB - The purpose of this research was to examine the extent to which verbal statements of context influence psychiatric patients' perception of photographs of emotion (fear, anger, sadness, and happiness). The major findings showed that, when photographs were paired congruently with context statements, there were significant changes in agreement among subjects on two of the four emotion stimuli. There was significantly less agreement on the meaning of facial expressions when the stimuli for fear, anger, and happiness were accompanied by incongruent verbal statements than when they were viewed alone. These data appear to have implications for practitioners working with this population. PMID- 3960689 TI - Time compression and spectral characteristics of phonemes. AB - The present study compared spectral characteristics of the test phonemes of Subtest 13 of Auditory-Visual Abilities Test produced at a normal rate and a 50% time-compression. Results showed marked damping of high frequency energy above 3000 Hz, a by-product of the instrumentation. PMID- 3960688 TI - Bilateral transfer across ages 7 to 17 years. AB - The purpose of this experiment was to determine the effect of age on bilateral transfer. 96 girls, ages 7 to 17 yr., performed 14 trials on a rotary pursuit tracking task (45 rpm, 30-sec. trials, 10 sec. between trials). Half of the subjects performed the first seven trials with the preferred hand, using the nonpreferred hand on the subsequent seven trials. The order was reversed for the other subjects. There were no significant differences between groups in initial scores or in increases in time on target over the first seven trials, supporting the hypothesis that this was a novel task. There was an increase in time on target across ages and age influenced bilateral transfer, with older girls profiting more from the other-hand practice. Transfer was greater from preferred to nonpreferred than the reverse. PMID- 3960690 TI - Quinolones in vitro. AB - The first quinolone compound, nalidixic acid, showed activity against a limited number of Gram-negative micro-organisms. 'One step' resistance developed in vitro and during treatment. Resistance was not mediated by transfer of R-plasmids, which is a characteristic of all quinolones. Newer quinolones like oxolinic acid, piromidic acid, cinoxacin and pipemidic acid exhibit an extended spectrum of activity against Gram-negative bacteria at lower MIC values. In recent years fluorinated quinolones were introduced like ciprofloxacin, norfloxacin, pefloxacin, ofloxacin, enoxacin and amifloxacin. These compounds exhibit in vitro a broad spectrum of activity against Gram-negative and Gram-positive bacteria at MIC values seventy to four hundred times less than those for nalidixic acid. The in vitro activity of these compounds has been investigated in a large study of uncomplicated urinary tract infections in general practice (PINISU). No resistance was found. The fluorinated quinolones are very promising antimicrobial agents for a limited number of indications. PMID- 3960691 TI - Pharmacokinetics: metabolism and renal excretion of quinolones in man. AB - The quinolones are relatively poorly absorbed from the gastrointestinal tract. The elimination proceeds mainly by renal excretion. The half-life of elimination depends on the molecular structure and varies between 2 and 10 h. Impaired kidney function is expected to increase the half-life of elimination, though this effect is not always observed. Since the 4-oxo-metabolites show a higher renal clearance than the parent drug, renal impairment will result in a cumulation of the metabolites in the body. PMID- 3960692 TI - Place of quinolones in the therapeutic armoury. AB - On the basis of antimicrobial activity, resistance development, pharmacokinetics, side effects and pre-clinical results, the applicability of the quinolones ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin is assessed. These quinolones seem especially useful in infections in hospitalized patients, in gonococcal infections and in urinary tract infections. Also salmonellosis and shigellosis might be indications for quinolones. PMID- 3960693 TI - The quinolones in chronic bronchitis. AB - Results are presented from 186 hospitalized patients treated for acute purulent exacerbations of chronic bronchitis with orally administered ciprofloxacin (80 patients), enoxacin (26 patients), ofloxacin (30 patients) or pefloxacin (50 patients). In general, good clinical results were observed in 50-70% of the patients treated, most failures being due to relapses or reinfections with Streptococcus pneumoniae or Pseudomonas aeruginosa. Studies on blood and sputum concentration suggested that gastro-intestinal absorption was not always satisfactory. Unwanted drug effects were noted with all agents studied, generally presenting as stomach pain, nausea, hallucinations, or dizziness. Most adverse drug reactions were seen with enoxacin, often but not always during concomitant treatment with theophylline. PMID- 3960694 TI - The place of quinolones in antibacterial therapy in hospitals. AB - A comparative evaluation is made on activity, resistance problems and side effects of nine quinolones. These data and the information on clinical experiences are used to outline the author's view on the present position of these compounds in treatment policies. The following indications seem appropriate: norfloxacin or pipemidic acid in lower urinary tract infection, secondary to nitrofurantoin and sulfonamides; one of the more active quinolones, like ciprofloxacin, in case of therapy failure or multiple resistance; application for gonorrhoea appears attractive, but data on long-term effects and resistance are needed; in antibacterial combinations for selective bowel decontamination. Comparative clinical trials are essential before other indications for quinolones in clinical policies can be defined. PMID- 3960695 TI - Bioavailability of orally administered zinc, using Taurizine. AB - Zinc aspartate equivalent to 50 mg of elementary zinc, orally administered to seven normal healthy male volunteers in an enteric-coated tablet (Taurizine), gave no significantly increased plasma zinc levels, neither when this drug was taken in a fasting state nor during a lunch. The formulation of this tablet seems to obstruct the absorption of zinc. PMID- 3960696 TI - Three types of sympathetic preganglionic neurones with different electrophysiological properties are identified by intracellular recordings in the cat. AB - Intracellular recordings were obtained from sympathetic preganglionic neurones (SPN) of the third thoracic segment in cats. Based on differences in their active and passive electrophysiological properties, three different types of SPNs were discerned: Type A neurones had a high resting membrane potential (RMP) (-60 to 86 mV) and a low input resistance (RN) 12-23 M omega). Action potentials of these neurones had a pronounced IS-SD inflexion and a prominent shoulder in their falling phase. Spikes were rarely generated from the on-going synaptic activity. Type B neurones had a lower RMP (-48 to -65 mV) and a higher RN (21-37 M omega). Their action potentials were characterized by an after-depolarization; they showed a slight IS-SD inflexion and a less pronounced shoulder in their falling phase. The after-depolarization was abolished by membrane hyperpolarization in a time dependent way. A hyperpolarization of at least 50 ms duration was required for its abolition. The after-depolarization was also abolished during repetitive discharges. In most of these neurones spikes were generated at irregular intervals and low rates (0.06-4.6 spikes/s) from the synaptic activity. Type C neurones were similar to type B neurones, but their action potentials did not show the after-depolarization. Additionally, spikes were generated at fairly regular intervals and rather high rates (0.8-6.5 spikes/s). The rate of spike repolarization of all neurones was markedly increased by hyperpolarization and decreased by membrane depolarization. Current-voltage curves of some type B and C neurones showed a marked rectification upon membrane hyperpolarization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960698 TI - Acousticolateral processing in the torus semicircularis of the trout Salmo gairdneri. AB - Characteristics of single units in the trout torus semicircularis to acousticolateral stimulation were investigated with tone bursts. Auditory (A) units (33%, N = 67), exclusively sensitive to frequencies higher than 125 Hz, and low frequency (L, 12%) units responding to tones up to 125 Hz were found next to the third type, the broadband (B,55%) unit, sensitive to both low and high frequencies. For many B units sensitivity to intermediate frequencies is absent. The sensitivity range of 85% of the units does not exceed 450 Hz. Most units (70%) show an increase in spike firing during the tone burst irrespective of frequency (ON units), but for a minority (9%) firing is maximal in the silent intervals (OFF units). OFF units are mostly found among A units. All L units are ON units. The remaining ON/OFF (ON behaviour for some and OFF behaviour for other frequencies) or ON + OFF (ON and OFF behaviour for all frequencies) units are all B units. Tonic ON units are most common. Some units show habituation and only sensitive ones may exhibit phase-locking. The different behaviour of some B units for low versus high frequencies, as expressed in their ON and OFF behaviour and latencies, presumably reflects convergence of inputs from acousticolateral subsystems with distinct properties. PMID- 3960697 TI - An effect of noradrenaline on resting potential and Na activity in sheep cardiac Purkinje fibres. AB - Noradrenaline (NA; 10(-9) to 10(-6) M) depolarizes the cell membrane of quiescent sheep Purkinje fibres at resting potential level. A corresponding inward shift of the holding current occurs in voltage clamped preparations in a potential range between ca. -40 and -100 mV. The depolarizing effect is present in phentolamine (1.5 X 10(-6) M) containing solution, mimicked by isoprenaline, blocked by propranolol (5 X 10(-6) M) and is therefore supposed to be beta-adrenoceptor mediated. The inward shift of the holding current is half maximum at 60 nM noradrenaline. The shift is accompanied with an increase of the intracellular Na activity (aiNa) of the fibres as measured by Na sensitive microelectrodes. Both, the inward shift of the holding current and the accompanying aiNa increased are strongly inhibited by 2 mM CsCl. It is concluded that the depolarizing action of noradrenaline is mainly caused by the known catecholamine induced shift of the steady state activation curve of the pacemaker current (if). The shift increases if in a potential range between -40 and -100 mV and augments thereby aiNa. PMID- 3960699 TI - ATP-evoked membrane responses in Xenopus oocytes. AB - Voltage-clamp technique and intracellular injections of drugs were used to study the adenosine triphosphate (ATP)-evoked depolarizing current response in the Xenopus laevis oocytes. The depolarizing current was comprised of a fast transient component (D1) followed by a late long-lasting component (D2). It was carried mainly by Cl- ions. The depolarizing current was better elicited by ATP and ADP than by AMP or adenosine and was not blocked either by theophylline (0.2 mM) or by quinidine sulphate (1 mM). The D2 current was sometimes masked by an ATP-evoked K+ hyperpolarizing current which was blocked by theophylline and mediated via P1 purinoceptors. This study suggests that the oocyte's membrane embodies at least two different purinoceptor's types, each of these types subserves a different set of ionic channels. PMID- 3960700 TI - Effects of brain and trunk temperatures on exercise performance in goats. AB - In 40 experiments on seven goats head and trunk temperatures were altered independently of each other and the effects on exercise performance on a treadmill (speed: 3 km/h, slope: 16%-20%) were observed. Brain temperature between 38.5 degrees C and 42.0 degrees C and trunk temperature between 39 degrees C and 43.5 degrees C did not reduce exercise performance or running time. Blood lactate concentration increased with rising brain and trunk temperatures, but did not exceed 13.1 mmol/l-1. Blood pressure and heart rate did not show any dependence on brain or trunk temperatures. Brain temperature between 42.0 degrees C and 42.9 degrees C shortened running time in 3 out of 12 experiments and reduced performance during shortlasting upward deviations of temperature. This suggests that in this species, the thermal safety limit to exercise is very close to that range of temperature which is likely to induce heat stroke. PMID- 3960701 TI - The role of the glycine sensitive area of the ventral medulla in cardiovascular responses to carotid chemoreceptor and peripheral nerve stimulation. AB - The present study on cats anaesthetised with Althesin, which unlike more commonly used anaesthetics does not prevent reflex activation of the brain-stem defence areas, reaffirmed that carotid chemoreceptor stimulation and radial nerve stimulation can evoke the visceral components of the alerting stage of the defence response (visceral alerting response). This includes tachycardia, mesenteric vasoconstriction but vasodilatation in skeletal muscle which is not secondary to the hyperventilation. However, mild chemoreceptor stimulation which evoked but a weak hyperventilation elicited bradycardia and vasoconstriction is mesentery and in muscle i.e. a response comparable with that evoked by chemoreceptor stimulation under chloralose or barbiturate anaesthesia. This suggests that chemoreceptor stimulation can evoke two separate patterns of response, the visceral alerting response predominating when the defence areas are strongly activated. The efferent pathway from the defence areas is known to synapse in the 'glycine sensitive area' of the ventral medulla which contains neurones whose activity seems to provide the main sympatho-excitatory drive for normal arterial pressure. Bilateral application of glycine to that area produces a pronounced fall in arterial pressure, apnoea and greatly attenuates the response to defence area stimulation, the vasoconstrictor components being abolished. In the present study bilaterally applied glycine abolished the muscle vasodilatation of the visceral alerting response evoked by chemoreceptor and radial nerve stimulation but both stimuli evoked vasoconstriction in mesenteric and muscle vasculature at least until arterial pressure was very low. It is proposed that both chemoreceptor and peripheral nerve stimulation can activate the defence areas to produce a visceral alerting response which is relayed via neurones of the glycine sensitive area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960702 TI - A method of measurement of longitudinal resistances in an isolated cardiac and smooth muscle preparation. AB - The longitudinal internal as well as external resistance was measured by means of simultaneous intracellular and sucrose gap voltage recordings. The longitudinal internal resistance could be calculated from a formula comprising the shunt resistance, membrane action potential and transgap action potential before and after shunting. The longitudinal external resistance was calculated from another formula comprising the same quantities. PMID- 3960703 TI - Electrophysiological properties of sympathetic preganglionic neurons in the cat spinal cord in vitro. AB - Intracellular recordings were obtained from sympathetic preganglionic neurons of the intermedio-lateral nucleus of the adult cat in slices of upper thoracic spinal cord maintained in vitro. The neurons were identified by their antidromic responses to stimulation of various ipsilateral sites. Sites from which antidromic responses could be evoked were the white ramus, the ventral root, the ventral root exit zone, the white matter between the latter and the outer edge of the tip of the ventral horn, the lateral edge of the ventral horn. Resting membrane potential was --61.3 +/- 1.6 mV (mean +/- SEM), input resistance 67.5 +/ 3.7 M omega, time constant 11.5 +/- 1.2 ms. The amplitude of the action potential generated by antidromic or direct stimulation was 77.4 +/- 2.3 mV. Threshold for direct spikes was 18.2 +/- 1.8 mV. The action potential had an average duration of 3.03 +/- 0.16 ms. It showed a prominent "hump" on the falling phase. The action potential had a tetrodotoxin (TTX)-sensitive and a TTX resistant component. The latter was abolished by cobalt. Tetraethylammonium, cesium and barium prolonged the action potential duration which acquired a plateau-shape. A prolonged after-hyperpolarization (AHP) followed the sympathetic preganglionic neuron spike. Following a single spike, AHP duration and peak amplitude were 2.8 +/- 0.3 s and 16.6 +/- 0.7 mV, respectively. The AHP was abolished by cesium or barium, but enhanced by tetraethylammonium. An AHP followed the TTX-resistant spike. EPSPs and IPSPs could be generated by focal stimulation. The EPSP triggered spikes when threshold (15.0 +/- 2.0 mV) was reached.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960704 TI - Effects of temperature, ouabain and diuretics on the cell sodium and potassium contents of isolated rat kidney tubules. AB - Cell Na+ and K+ contents were measured by flame photometry in single pieces of rat medullary thick ascending limb (MAL) and medullary collecting tubules (MCT) after an overnight incubation at various temperatures. Below 8 degrees C, MCT samples were no more able to sustain high-K+, low-Na+ cell concentrations, and sodium progressively replaced cell potassium as the temperature decreased. The loss of potassium and the accompanying accumulation of sodium by MCT cells occurred at lower or higher temperature when amiloride (20 mumol/l) or ouabain (1 mmol/l) was present respectively in the incubation medium compared to that observed on control non-treated MCT. In contrast, MAL samples maintained normal cation gradients across their membrane at all temperatures, including 0 degree C, even in the presence of ouabain. However, MAL cells lost nearly all their potassium which was replaced by sodium when they were incubated in K+-free solution. These Na+-loaded, K+-depleted MAL cells restored high-K+ and low-Na+ contents similar to those of control samples when they were further incubated for 1 h at 0 degree C in presence of 5 mmol/l external potassium. Even in the presence of 1 mmol/l ouabain and at 0 degree C, a restoration of almost normal cation gradients occurred provided that Na+-loaded MAL were incubated for 24 h after potassium addition to the external medium. The results are discussed in relation to the respective effects of low temperatures on the passive and active components of the cation balance in the cells of the two nephron segments. PMID- 3960705 TI - Effects of external potassium concentrations on the cell sodium and potassium contents of isolated rat kidney tubules. AB - The effects of 20 mumol/l amiloride, 10 mumol/l furosemide and 1 mmol/l ouabain on cell Na and K concentrations were investigated by flame microphotometry in isolated rat medullary collecting tubules and medullary thick ascending limbs (MCT and MAL) as a function of the external potassium concentration [Ke]. The results are expressed as Na and K concentrations per liter cell volume ([Nac] and [Kc], mmol/l) and relative sodium content, [Nac]/([Nac] + [Kc]). From the experimental curves, [Ke]1/2 is defined as the [Ke] value corresponding to half maximal exchange of K against Na in cells. When [Ke] was 5 mmol/l, the relative Na content was less than 15% in control and amiloride-treated MCT as well as in control and furosemide-treated MAL, and about 24% in ouabain-treated MCT and MAL. In MCT, relative cell Na content increased up to 90% or more when [Ke] was reduced from 2.5 to 0.25 mmol/l. [Ke]1/2 was 0.55, 0.45 and 1.25 mmol/l for control, amiloride-treated and ouabain-treated MCT respectively. In MAL, similar increases in relative Na content were observed when [Ke] was reduced from 0.5 to 0.05 mmol/l. [Ke]1/2 was 0.25, 0.10 and 1.75 mmol/l for control, furosemide treated and ouabain-treated MAL respectively. When [Ke] was reduced from 5 to 1 mmol/l, [Nac] dropped from 16.4 to 8.4 mmol/l (P less than 0.01) in control MAL. When [Ke] was 5 mmol/l, [Nac] was lower in furosemide-treated MAL (7.8 mmol/l) than control MAL (P less than 0.01). At 1 mmol/l [Ke], [Nac] was similar in both groups. These results are discussed in terms of the balance between the active and passive components of Na and K fluxes across apical and basolateral cell membranes. They indicate that a K-dependent passive Na entry process exists in the membranes of MAL cells but not of MCT cells. This process was proportionally more inhibited than the active Na pump when [Ke] was reduced from 5 to 1 mmol/l. In addition, it was found sensitive to furosemide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960706 TI - Location-dependent characteristics of pulmonary stretch receptor activity in the rabbit. AB - In anaesthetized, thoracotomized and artificially ventilated rabbits, the location of pulmonary stretch receptors (SR) was established by means of local mechanical stimulation as well as by micro-injections of the local anaesthetic cinchocaine. Differences in SR activity were analyzed in relation to the receptor site during specific stimulation by lung inflation, as well as during nonspecific activation by ammonia inhalation. Out of 107 SR, 55% were located in larger airways, i.e., in the trachea, main bronchus and lobar bronchi ("central SR"), whereas 45% were found to lie more peripherally ("peripheral SR"). There were several differences with respect to the discharge pattern evoked by lung inflation and by ammonia inhalation between SR of different locations. The increase of discharge rate evoked by lung inflation and by ammonia inhalation was significantly greater in peripheral than in central SR. Significantly more central than peripheral SR discharged throughout the whole respiratory cycle, i.e., even at end-expiratory lung volume. Furthermore, a delayed inspiratory recruitment as well as a transient cessation of firing after the initial increase of activity, which followed ammonia inhalation, occurred more frequently in central than in peripheral SR. PMID- 3960707 TI - Barium can replace calcium in calmodulin-dependent contractions of skinned renal arteries of the rabbit. AB - Renal arteries of the rabbit were chemically skinned using Triton X-100. In EGTA buffered solutions containing calmodulin and ATP, small strips of the skinned preparations were found to develop contractile force which was dependent on the concentrations of either free calcium or of free barium. However, a 220 times greater concentration of barium than of calcium was necessary for comparable effects. Quantitatively, the response to barium was dependent on the concentration of calmodulin added to the test solutions. The contractile effect of barium was partly antagonized by the calmodulin antagonist, trifluoperazine. PMID- 3960708 TI - Hyperthermic effect of neurotensin in the rabbit. AB - Neurotensin injected into the anterior hypothalamus of the rabbit induces a consistent upward shift of the threshold core temperatures for inducing cold thermogenesis, peripheral vasomotor tone and respiratory evaporative heat loss, while leaving the efficiency and the intensity of these thermoregulatory outputs unchanged. Neurotensin injections into the PH are without effect on body temperature control. The effect of neurotensin is interpreted as a selective inhibition of activity of warm sensors in the anterior hypothalamus. The possible mediating role of dopaminergic pathways in the neurotensin action is discussed. PMID- 3960710 TI - [Hemophiliacs can almost live a normal life today]. PMID- 3960711 TI - [Natural killer cells--a possible defence against metastasis]. PMID- 3960709 TI - The dependence on chloride ions of the loop diuretic sensitive component of passive sodium efflux from human red cells. AB - A study has been made of the passive (ouabain-insensitive) Na efflux from human red cells. The inhibition by loop diuretics (furosemide, piretanide and bumetanide) was additive with respect to ouabain and non-additive with respect to each other. They inhibited with high affinity in the sequence bumetanide greater than piretanide greater than furosemide. Passive Na efflux was not inhibited by amiloride, DIDS or SITS. In Cl-free media, Na efflux was reduced and there was no diuretic-sensitive component with any of the six Cl substitutes tested, except Br. The chloride concentration dependence of the diuretic-sensitive efflux was generally linear but saturable with sulphate and concave with acetate. In Na-free media, efflux was reduced, the apparent affinity for loop diuretics was lower and there was no chloride dependence. The diuretic-insensitive efflux was unaffected by anions in all conditions. PMID- 3960712 TI - [The kappa coefficient--a goal for evaluating the reproducibility of nominal and ordinary data]. PMID- 3960713 TI - [Chronic hepatitis and delta infection]. PMID- 3960714 TI - Care research--what is it? PMID- 3960715 TI - Isolation of a further anonymous informative DNA sequence from chromosome seven closely linked to cystic fibrosis. AB - A library prepared from flow-sorted chromosomes was used to isolate single-copy sequences from chromosome seven. One such sequence 7C22 has been shown to be polymorphic for an EcoRI restriction site and to be informative for the study of CF in approximately 35% of matings. The segregation of the 7C22 alleles was followed through nineteen informative families with more than one child affected by cystic fibrosis. We report that the locus for 7C22 is linked to the locus for cystic fibrosis at a recombination fraction of 0.045. This marker will prove useful in improving the accuracy and informativeness of prenatal diagnosis and in constructing a fine genetic map around the cystic fibrosis gene. PMID- 3960716 TI - Interaction between E. coli RNA polymerase and the tetR promoter from pSC101: homologies and differences with other E. coli promoter systems from close contact point studies. AB - The interaction between E. coli RNA polymerase and the tetR promoter from pSC101, was studied by protection and premodification experiments, using dimethyl sulfate, methylation of single stranded cytosines, and DNAase I footprinting. Whereas qualitative and quantitative results from the chemical approach conform to patterns already displayed by other promoter systems, hypersensitive sites to DNAase I attack differ from those of other promoters. Distribution and nature of the contacts suggest that regions of the promoter sequence participates differently in complex formation. The involvement of major and minor grooves of the double helix in the complex with the enzyme, differs along the promoter. After a comparison of the results from seven different promoters, a pattern of conserved contacts seem to appear. Comparison of temperature dependence of local unwinding around the transcription start site (detected by the appearance of single stranded cytosines), and DNAase I footprinting, reveals that the process leading to stable complex formation can be achieved without disruption of base pairing. PMID- 3960717 TI - Sequence heterogeneity within the human alphoid repetitive DNA family. AB - We have cloned and determined the base-sequence and genome organization of two human chromosome-specific alphoid DNA fragments, designated L1.26, mapping principally to chromosomes 13 and 21, and L1.84, mapping to chromosome 18. Their copy number is estimated to be approximately 2,000 per haploid genome. L1.84 has a double-dimer organization, whereas L1.26 has a much less defined higher order tandem organization. Further, we present evidence that the restriction-site spacing within the alphoid DNA family is chromosome specific. From sequence analysis, clones L1.26 and L1.84 are found to consist of 5 and 4 tandemly duplicated 170 bp monomers. Cross-homology between the various monomers is 65 85%. The analysis suggests that the evolution of tandem-arrays does not take place via a defined 340 bp unit, as was inferred by others, but via circularly permutated monomers or multimers of the 170 bp unit. PMID- 3960718 TI - Analysis of the genome structure of tobacco rattle virus strain PSG. AB - The sequence of the 3'-terminal 2077 nucleotides of genomic RNA 1 and the complete sequence of genomic RNA 2 of tobacco rattle virus (TRV, strain PSG) has been deduced. RNA 2 (1905 nucleotides) contains a single open reading frame for the viral coat protein (209 amino acids), flanked by 5'- and 3'-noncoding regions of 570 and 708 nucleotides, respectively. A subgenomic RNA (RNA 4) was found to lack the 5'-terminal 474 nucleotides of RNA 2 and is the putative messenger for coat protein. The deduced RNA 1 sequence contains the 3'-terminal part of a reading frame that probably corresponds to the TRV 170K protein and reading frames for a 29K protein and a 16K protein. Proteins encoded by the first two reading frames show significant amino acid sequence homology with corresponding proteins encoded by tobacco mosaic virus. Subgenomic RNAs 3 (1.6 kb) and 5 (0.7 kb) were identified as the putative messengers for the 29K and 16K proteins, respectively. At their 3'-termini all PSG-RNAs have an identical sequence of 497 nucleotides; at the 5'-termini homology is limited to 5 to 10 bases. PMID- 3960719 TI - mRNA transcripts of several plant genes are polyadenylated at multiple sites in vivo. AB - We have analyzed the polyadenylation sites for the small subunit of ribulose bisphosphate carboxylase and chlorophyll a/b binding protein genes of Petunia (Mitchell) and the bronze gene of Zea mays. Sequence analysis of multiple cDNA clones revealed that polyadenylation of the transcripts occurred at either 2 or 3 sites for all three groups of genes. In the examples where 3 polyadenylation sites were detected, the middle site was the one predominantly used. Putative polyadenylation signals preceding the poly A tails diverged significantly from the animal consensus sequence AATAAA. In all the genes examined the first A residue in the poly A tail of the cDNA clones corresponded to an A residue in the homologous genomic sequence. PMID- 3960720 TI - On the structure of poly d(A-S4T). AB - The helical twist of poly d(A-s4T) was determined from the periodicity of the cleavage patterns of the double stranded polydeoxynucleotide adsorbed on calcium phosphate and found to be 14 bp per turn. Both cleavage patterns and 31P NMR spectra indicate a mononucleotide structure rather than an alternating B DNA like poly d(A-T). The failure of nucleosome formation excludes a B type structure. The discrepancy of the mononucleotide structure found in 31P NMR spectra and the dinucleotide structure given by X ray fiber diffraction is explained by an alternating tilt of the planes of the base pairs (base roll) as a consequence of a strong propeller twist. The importance of interstrand stacking interactions of adjacent 4-thiothymidines for the helical stability is discussed. PMID- 3960721 TI - A theoretical investigation on the sequence selective binding of adriamycin to double-stranded polynucleotides. AB - Theoretical computations are performed on the structural and energetical factors involved in the sequence selective binding of adriamycin (ADM) to five self complementary double-stranded hexanucleotides. Among the two regularly alternating hexanucleotides d (TATATA)2 and d (CGCGCG)2, a stronger binding is predicted for the former. The strongest complex is computed, however, for the mixed hexanucleotide d (CGTACG)2, containing the intercalation site between two CG base pairs and an adjacent TA base pair. The overall sequence preference is the result of an intricate interplay of sequence preferences of the constituents in particular of daunosamine and the 9-OH substituent. Altogether, the selective base pair recognition by adriamycin cannot be defined in terms of the two base pairs implicated in the intercalation site alone but must be expressed in terms of a triplet of base pairs. PMID- 3960723 TI - Mutations induced by DNA polymerase alpha upon in vitro replication of M13mp8(+) DNA. AB - The forward mutation of the lacZ part of the bacteriophage M13mp8 has been used to study the fidelity of the 9S DNA polymerase alpha from calf thymus during in vitro replication of single-stranded DNA. Errors leading to a loss of alpha complementation were identified by DNA sequencing. The overall mutation rate of the lacZ target sequence was in the range of 1:300-1:1000 which is more than one order of magnitude higher than the spontaneous mutation rate. In a mutL host the mutation rate was nearly threefold higher as compared to the wildtype host. Base substitutions comprise 86% of the errors whereas base deletions amount to 12%. The addition of a base was detected only in one mutant out of 71 sequenced ones. The frameshift mutations occurred predominantly in runs of the same base. The frequencies of individual base substitution are in the order of 2 X 10(-4)-4 X 10(-4) for most of the mismatches. Mutations involving dCTP:T and dGTP:T mismatches are observed with a lower frequency, those involving dTTP:C mismatches with a higher frequency. PMID- 3960724 TI - Antithrombin III tours gene: identification of a point mutation leading to an arginine----cysteine replacement in a silent deficiency. PMID- 3960722 TI - The rDNA of C. elegans: sequence and structure. AB - We have sequenced one complete rDNA tandem repeat from the nematode C. elegans. By comparative analysis we derive secondary structures for the 18s, 5.8s, and 26s rRNA molecules, and comment on other important features of the sequence. We also present the sequence of a junction between the rDNA and non-ribosomal DNA. Finally, we use our data to quantify the evolutionary relationships among several organisms currently studied in developmental biology. PMID- 3960725 TI - Structure of the amino-terminal end of mammalian elongation factor Tu. PMID- 3960726 TI - The effect of changing the distance between the TATA-box and cap site by up to three base pairs on the selection of the transcriptional start site of a cloned eukaryotic gene in vitro and in vivo. AB - We have studied how small changes in the distance between the TATA-box and cap site affect transcription of a eukaryotic gene in vitro and in vivo. The trout protamine gene TPG-3 [Gregory et al. (1982) Nucl. Acids Res. 10, 7581-7592] is a good model for such a study as it has (i) a consensus TATA-box 32 base pairs (bp) upstream from an A-residue which is the natural cap site (designated +1) (ii) two further A-residues at -5 and +5, providing alternative transcriptional start sites which are in significantly different sequence environments and (iii) a unique AvaII restriction site immediately downstream from the TATA-box which is ideal for the insertion or deletion of up to 3bp. Transcripts of the wild type and mutant genes were generated in vitro using a HeLa whole cell extract or 'in vivo' by transient expression following their transfection into HeLa cells. These 'spacer' mutations did not affect the efficiency of transcription of the gene in vitro but they did affect the selection of transcriptional start site both in vitro and 'in vivo'. Analysis of 5'-ends by S1-mapping and primer extension showed that the A-residue(s) selected are those which, by insertion or deletion, come to lie on the same face of the DNA double helix as the TATA-box, although the DNA sequence in the immediate vicinity of the potential start sites influences their utilisation. Comparison of the TPG-3 wild type transcripts in these experimental systems with natural mRNA suggests that cap site selection is more stringent in the developing trout testis. PMID- 3960727 TI - Protein complexes formed during the incision reaction catalyzed by the Escherichia coli UvrABC endonuclease. AB - An examination has been made into the nature of the nucleoprotein complexes formed during the incision reaction catalyzed by the Escherichia coli UvrABC endonuclease when acting on a pyrimidine dimer-containing fd RF-I DNA species. The complexes of proteins and DNA form in unique stages. The first stage of binding involves an ATP-stimulated interaction of the UvrA protein with duplex DNA containing pyrimidine dimer sites. The UvrB protein significantly stabilizes the UvrA-pyrimidine dimer containing DNA complex which, in turn, provides a foundation for the binding of UvrC to activate the UvrABC endonuclease. The binding of one molecule of UvrC to each UvrAB-damaged DNA complex is needed to catalyze incision in the vicinity of pyrimidine dimer sites. The UvrABC-DNA complex persists after the incision event suggesting that the lack of UvrABC turnover may be linked to other activities in the excision-repair pathway beyond the initial incision reaction. PMID- 3960728 TI - The structure of nucleosome core particles as revealed by difference Raman spectroscopy. AB - Raman spectra have been observed of nucleosome core particles (I) prepared from chicken erythrocyte chromatin, its isolated 146 bp DNA (II), and its isolated histone octamer (H2A+H2B+H3+H4)2 (III). By examining the difference Raman spectra, (I)-(II), (I)-(III), and (I)-(II)-(III), several pieces of information have been obtained on the conformation of the DNA moiety, the conformation of the histone moiety, and the DNA-histone interaction in the nucleosome core particles. In the nucleosome core particles, about 15 bp (A.T rich) portions of the whole 146 bp DNA are considered to take an A-form conformation. These are considered to correspond to its bent portions which appear at intervals of 10 bp. PMID- 3960729 TI - Homologies of nucleotide sequences in the 5'-end regions of two developmentally regulated genes of Sarcophaga peregrina. AB - In the previous paper we demonstrated that the storage protein gene and 25-kDa protein gene are expressed sequentially in the fat body of middle third-instar Sarcophaga peregrina larvae. In this paper, we showed that the expressions of these two genes are regulated at the transcriptional level, and searched for homologous nucleotide sequences in the two genes in the vicinity of their 5' ends, assuming that these two genes are regulated by a common mechanism. We selected 9 homologous sequences and found that most of them were distributed in two clusters located between positions -400 and +1. We identified an SV40 enhancer core segment-like sequence in the nontranslated region of the first exons of both genes, which might explain the efficient transcriptions of these two genes. PMID- 3960730 TI - The legumin gene family: structure of a B type gene of Vicia faba and a possible legumin gene specific regulatory element. AB - The field bean, Vicia faba L. var. minor, possesses two sub-families of 11 S legumin genes named A and B. We isolated from a genomic library a B-type gene (LeB4) and determined its primary DNA sequence. Gene LeB4 codes for a 484 amino acid residue prepropolypeptide, encompassing a signal peptide of 22 amino acid residues, an acidic, very hydrophilic alpha-chain of 281 residues and a basic, somewhat hydrophobic beta-chain of 181 residues. The latter two coding regions are immediately contiguous, but each is interrupted by a short intron. Type A legumin genes from soybean and pea are known to have introns in the same two positions, in addition to an extra intron (within the alpha-coding sequence). Sequence comparisons of legumin genes from these three plants revealed a highly conserved sequence element of at least 28 bp, centered at approximately 100 bp upstream of each cap site. The element is absent from the equivalent position of all non-legumin and other plant and fungal genes examined. We tentatively name this element "legumin box" and suggest that it may have a function in the regulation of legumin gene expression. PMID- 3960731 TI - Comparison of the interactions of the adenovirus type 2 major core protein and its precursor with DNA. AB - The interactions of the major core protein of adenovirus type 2 (Ad2) protein VII, and its precursor, protein pre-VII, with viral DNA, were studied using UV light induced crosslinking of 32P-labelled oligonucleotides to the proteins. Proteolytic fragments of these two proteins that contain DNA-binding domains were identified by virtue of their covalently attached, alkali-resistant 32P radioactivity. The overall efficiency of crosslinking of protein pre-VII to DNA, in H2ts1 virions assembled at 39 degrees C, was comparable to that of the crosslinking of protein VII to DNA in Ad2 virions. However, a protease V8 fragment comprising the N-terminal half of protein pre-VII crosslinked to DNA at least ten times more efficiently than the corresponding N-terminal fragment of protein VII, which is truncated by the removal of 23 amino acids from the N terminus of protein pre-VII during virion maturation. PMID- 3960732 TI - Salt induced B----A transition of poly(dG).poly(dC) and the stabilization of A form by its methylation. AB - Raman spectra of poly(dG).poly(dC) have been observed in aqueous solutions at various ionic strengths, [NaCl] = 0.03 to 4 M, and at different temperatures, 10 to 60 degrees C. At 30 degrees C, and at [NaCl] = 0.03 M, it was found to have a B-form (with O4'endo-anti guanosine and C2'endo-anti cytidine), whereas, at [NaCl] = 4 M, an A form (with C3'endo-anti guanosine and C3'endo-anti cytidine). At 30 degrees C and [NaCl] = 1 M, namely at an intermediate state, a fraction of this molecules was considered to have a "heteronomous A" form (with O4'endo-anti guanosine and C3' endo-anti cytidine). At 60 degrees C and [NaCl] = 1 M, it assumes the B form, and at 10 degrees C and [NaCl] = 1 M, the A form. Cytosine-5 methylation was found to cause a marked stabilization of the A form. Even at [NaCl] = 0.1 M (at 30 degrees C), a substantial portion of poly(dG).poly(dm5C) was found to have a heteronomous form, in which the dG atrand is in the B form and the dC an A form; it never assumes a complete B form. PMID- 3960733 TI - In vitro deletion analysis of ARS elements spanning the replication origin in the 5' non-transcribed spacer of Tetrahymena thermophila ribosomal DNA. AB - Two adjacent but non-overlapping restriction fragments that encompass the replication origin of the macronuclear copy of rDNA from Tetrahymena thermophila allow autonomous replication of plasmids in the yeast Saccharomyces cerevisiae; i.e. they function as autonomously replicating segments (ARS). Deletions generated in vitro into these fragments yield an 82 bp segment from each as the smallest sequence specifying ARS function. These 82 bp segments are at the 5' end of a 220 bp region of homology between the two original ARS restriction fragments. A 39 bp region of almost complete sequence identity between the two 82 bp fragments is suggested to be a core sequence element necessary for ARS function. This 39 bp sequence contains a region identical or nearly identical to the 11 bp yeast ARS consensus sequence (T/ATTTATPuTTTA/T) which is suggested to be essential for ARS function. Detailed comparisons of the 82 bp segments and of the 39 bp core with other ARS sequences reveal no extensive homologies aside from the consensus. PMID- 3960734 TI - Nucleotide sequence analysis of the spacer regions flanking the rat rRNA transcription unit and identification of repetitive elements. AB - We investigated the organization of the rat rDNA non-transcribed spacer (NTS) by determining the sequence of large NTS segments located upstream (2501 bp) and downstream (4025 bp) from the rRNA transcription unit. We identified four B2-like and two ID mobile elements. They may be grouped in three pairs with the members of each pair located in the upstream and downstream NTS. The ID sequences are identical to the consensus sequence, while the pairs of B2-like elements show 85% and 50/65% homology to the consensus B2 sequence. The proximal part of the downstream NTS contains a region of widely diverged SalI tandem repeats. A considerable part of the analyzed upstream and downstream NTS sequences is constituted by different types of simple sequences and long poly(purine) X poly(pyrimidine) tracts. These data show that the rat rDNA NTS regions flanking the rRNA transcription unit are characterized by a combination of short interspersed (B2-superfamily) and various simple sequences. PMID- 3960735 TI - Promoter and nonspecific DNA binding by the T7 RNA polymerase. AB - T7 RNA polymerase plays an important role in both the transcription and replication of bacteriophage T7. In this study we have used a nitrocellulose filter binding assay to examine the binding properties of the T7 RNA polymerase with T7 promoters cloned into plasmid DNAs. Promoter-specific binding was shown to be relatively insensitive to variations in the ionic strength of the incubation solution but dependent on the helical structure of the DNA. On the other hand, nonpromoter interior-site binding was independent of the superhelicity of the DNA but extremely sensitive to changes in the ionic strength. These results suggest that nonspecific binding results from ionic interactions between positively charged residues of the polymerase and the polyanionic backbone of the DNA, whereas promoter-specific binding is dependent upon base-specific contacts within the promoter sequence. A comparison between the transcriptional activity and binding strengths of the RNA polymerase to specific promoters indicates little correlation between these two properties. This suggests that differential promoter binding does not represent a major mechanism for regulating transcription in bacteriophage T7. Instead, factors which influence the efficiency or rate of formation of the polymerase-promoter open complex are found to have the major role in determining transcriptional levels in this system. PMID- 3960736 TI - M13 vectors with T7 polymerase promoters: transcription limited by oligonucleotides. PMID- 3960737 TI - Conserved nodulation genes from the non-legume symbiont Bradyrhizobium sp. (Parasponia). AB - A nodulation locus from the broad-host-range, non-legume symbiont Bradyrhizobium sp. (Parasponia) strain ANU289, has been identified by hybridisation to cloned Rhizobium trifolii nodulation (nod) genes. Transfer of cloned ANU289 nod genes to R.trifolii nodulation-deficient mutants showed that the locus contains a functional homologue of the R. trifolii nodD gene. DNA sequence analysis revealed the presence of three additional genes nodA, nodB and nodC clustered adjacent to nodD. The four genes from ANU289 share substantial sequence homology with those characterised from narrow-host-range Rhizobium strains. A novel 700-bp sequence inserted between the nodD and nodABC genes encodes an open reading frame designated nodK and is oriented in the same direction as nodABC. nodKABC appear to be organized in a single transcriptional unit and nodD is oriented divergently to nodKABC. A 35-bp sequence containing the ribosome binding site for the nodD gene and an AT-rich core sequence has been identified by comparison with sequences from other Rhizobium strains and is likely to be implicated in the plant-mediated induction of nodulation gene expression. PMID- 3960739 TI - The 5' part of the gene for ribosomal protein S12 is located 30 kbp downstream from its 3' part in tobacco chloroplast genome. PMID- 3960738 TI - DNA sequence selectivity of guanine-N7 alkylation by nitrogen mustards. AB - Nitrogen mustards alkylate DNA primarily at the N7 position of guanine. Using an approach analogous to that of the Maxam-Gilbert procedure for DNA sequence analysis, we have examined the relative frequencies of alkylation for a number of nitrogen mustards at different guanine-N7 sites on a DNA fragment of known sequence. Most nitrogen mustards were found to have similar patterns of alkylation, with the sites of greatest alkylation being runs of contiguous guanines, and relatively weak alkylation at isolated guanines. Uracil mustard and quinacrine mustard, however, were found to have uniquely enhanced reaction with at least some 5'-PyGCC-3' and 5'-GT-3' sequences, respectively. In addition, quinacrine mustard showed a greater reaction at runs of contiguous guanines than did other nitrogen mustards, whereas uracil mustard showed little preference for these sequences. A comparison of the sequence-dependent variations of molecular electrostatic potential at the N7-position of guanine with the sequence dependent variations of alkylation intensity for mechlorethamine and L-phenylalanine mustard showed a good correlation in some regions of the DNA, but not others. It is concluded that electrostatic interactions may contribute strongly to the reaction rates of cationic compounds such as the reactive aziridinium species of nitrogen mustards, but that other sequence selectivities can be introduced in different nitrogen mustard derivatives. PMID- 3960740 TI - Infectious bronchitis virus RNA D encodes three potential translation products. PMID- 3960741 TI - The nucleotide sequence of a tRNA gene cluster from Spiroplasma meliferum. PMID- 3960742 TI - Two RFLPs associated with the human prealbumin gene (PALB). PMID- 3960743 TI - An anonymous single copy genomic clone at 13q12-13q13 identifies three RFLPs [HGM8 assignment no. D13S11]. PMID- 3960744 TI - RFLP identified by the anonymous DNA segment pBAM34 at 19q13.3-qter [HGM8 assignment D19S6]. PMID- 3960745 TI - Schizophrenia. PMID- 3960746 TI - Dermoid cyst of the spine in childhood. AB - A 1 year, 10-month-old boy presented with a history of meningitis, a recent neurologic deficit, and myelographic evidence of a thoracic, extradural compressive lesion. The lesion was subtotally totally excised at surgery and found to be a dermoid cyst. Treatment of this uncommon tumor is facilitated by its early recognition and excision before onset of infection. Incomplete removal can result in regrowth. PMID- 3960748 TI - Weightlifting, weight training and injuries. PMID- 3960747 TI - Unusual resolution of a complication of compression hip screw. PMID- 3960749 TI - Tarsal tunnel syndrome: a case report and review of the literature. PMID- 3960750 TI - Acute fractures of the femoral neck managed by total hip replacement. AB - The criteria for the management of patients with femoral neck fractures by internal fixation, hemiarthroplasty, or total hip replacement are becoming better defined. Our experience in 111 cases indicates that total hip arthroplasty has a definite role if the cases are carefully selected. The main indication is a high risk fracture in an elderly patient with associated pre-existing joint disease. PMID- 3960751 TI - External callus formation of closed femoral shaft fractures treated by medullary fixation. AB - Various radiographic patterns were observed for external callus formation of closed femoral shaft fractures treated by closed and open medullary Rush pin fixation. Closed pinning tends to form more adequate lateral callus, to have less looping of bridging callus over the cortex, and to form smooth, dense callus. Open pinning tends to form less lateral callus, to have more looping (radiolucent space under callus) of the callus over the cortex and fracture site, and to have areas of exuberant callus with the appearance of myositis ossificans. The circulatory status of the cortex and soft tissues seem to be a factor in these callus patterns. Avascular cortex of shaft fractures is inferred by the radiographic findings of bridging callus loops over the cortex, relative increased density of cortical bone, and resorption of cortical bone. PMID- 3960752 TI - Advantages of ambulatory metrizamide myelography with contrast CT tomography. AB - Outpatient metrizamide cervical and lumbar myelography complimented by CT scanning is a safe and effective method of assessing the contents of the neural canal. By minimizing the dose of metrizamide and using a small needle, the incidence of side effects is reduced. The techniques of needle insertion metrizamide injection and radiography as well as pre- and post procedure care are described in detail. PMID- 3960754 TI - Localized acquired hypertrichosis associated with fractures of the arm in young females. A report of two cases. AB - Two cases of transient hypertrichosis of the upper extremity in young females associated with closed fractures are presented in support of the concept of the "regional acceleratory phenomenon" as proposed by Frost wherein trauma evokes increased regional blood flow and increased metabolism on the part of all local soft tissues. This abnormality which was of much concern in terms of cosmesis resolved over approximately six months. PMID- 3960753 TI - Olecranon fractures treated with AO screw and tension bands. AB - Twenty-eight patients averaging 36.4 years of age underwent open reduction and internal fixation of olecranon fractures. The AO cancellous screw was used alone in 16 and with tension banding in 12. Banding was used when the bone was soft or severely comminuted. The fractures were clinically healed at an average of nine weeks and roentgenographic healing with obliteration of the fracture line occurred at 13 weeks. Sixty-seven percent acquired full motion by the ninth postoperative week. All but two patients regained full supination and pronation. No patient lost greater than 30 degrees of extension and only two lost greater than 30 degrees of flexion. There were few operative difficulties or postoperative complications. We found the AO cancellous screw alone and in severely comminuted cases in combination with tension band wiring to be an excellent fixation device for olecranon fractures. It allows for early range of motion in young patients with excellent healing prospects by 16 weeks. PMID- 3960755 TI - A computer model of slipped capital femoral epiphysis. Causes of fixation error and chondrolysis. AB - Penetration of the joint by metal pins can occur when treating slipped capital femoral epiphysis. Predisposing factors are present in the usual surgical methods. These include x-ray detail loss secondary to the pelvic projection and failure to obtain specific x-ray orientation to the axis of the capital epiphysis. One operative strategy to reduce these predispositions is presented. A probable mechanism of how chondrolysis can occur without joint penetration following extra capsular osteotomy is described with a theoretical remedy. Computer disease modeling and treatment simulation are the basis of this study. The computer model, which closely simulates all degrees of the disease, suggests that SCFE deformation is caused by hip extension against anterior hip capsule contracture. The latter is also the proposed cause of chondrolysis following realignment procedures. PMID- 3960756 TI - Wrist injuries and instability. PMID- 3960757 TI - The section of trauma, Karolinska Hospital, Stockholm, Sweden. PMID- 3960758 TI - Calf muscle atrophy and muscle function after non-operative vs operative treatment of achilles tendon ruptures. AB - Fifteen operatively and eight non-operatively treated subcutaneous achilles tendon ruptures were randomly selected from 120 surgically and 35 non-surgically treated patients. Their calf muscle function was studied three to five years after treatment. Non-operatively treated patients were found to have a significantly impaired dynamic muscle function of the calf muscles when tested in a specially constructed heel-raise test device. Operatively treated patients did not show any significant impairment of their muscle function. Measurement of muscle area with CT-scanning showed a significant reduction of the calf muscle in the non-operatively treated patient while no such difference could be found in the operatively treated patients. Isokinetic muscle torque did not differ in the two groups of patients, thus Cybex-measurements do not seem to be a discriminating method in studying muscle function after achilles ruptures. On the basis of our findings we recommend that all athletes with achilles tendon ruptures be treated surgically. In non-athletes and older patients non-operative treatment might be considered. PMID- 3960759 TI - Diagnostic and operative arthroscopy of the hip. AB - Diagnostic and operative arthroscopies of the hip joint have been performed from an anterior approach after extension of the joint. The force needed to achieve a sufficient visualization of the hip joint was studied. In an anesthetized patient 300 Newtons (N) to 500 N was required, whereas up to 900 N was needed in an unanesthetized subject to achieve sufficient joint extension. Hip arthroscopy has been performed with a standard 5 mm Storz arthroscope. Alternatively, fluid and gas was used. It was possible to achieve good visualization of the anterior parts of the hip. Gas gave better information about the degree of degenerative arthritis while fluid was preferable for operative arthroscopy, eg, arthroscopic synovectomy. Synovial biopsies, removal of loose bodies, and partial arthroscopic synovectomy have been performed. The advantage was a very short time of rehabilitation. No serious complications occurred. PMID- 3960761 TI - Immediate or delayed Kuntscher-rodding of femoral shaft fractures. AB - Early rodding of femoral fractures is preferable from an intensive care point of view. It has, however, been claimed that early rodding leads to impaired healing of the fractures. Healing time and complications in 20 fractures of the femur operated with Kuntscher rods within 12 hours after injury were therefore compared with 47 fractures treated with traction for ten days and then Kuntscher-rodding. No significant differences in results were found between the two groups concerning complications, but the acutely operated individuals returned to work on an average of two months earlier than the delayed group. If proper shock treatment is given and concomitant injuries with higher priority are treated first, early Kuntscher-rodding does not seem to impair the healing of femoral fractures. PMID- 3960760 TI - Knee arthroscopy with local anesthesia in ambulatory patients. Methods, results and patient compliance. AB - Knee arthroscopy in locally anesthetized ambulatory patients has been performed by filling the knee joint with 50 ml to 60 ml of 0.5% prilocaine, with adrenaline and with additional local infiltration at the sites of puncture. During the arthroscopic procedure the joint cavity is further distended with a mixture of the same local anesthetic diluted 1:10 with physiological saline or Ringer's acetate. During a normal arthroscopy of the knee joint about 500 mg of the local anesthetic is used. In 17 patients the blood concentrations of the local anesthetic used was measured 2.5 min to 135 min after instillation. The highest plasma levels found (after 60 min to 120 min) were still 10 to 15 times lower than an acceptable upper plasma level. These low blood levels probably depend on a slow absorption and that a considerable amount of the local anesthetic is washed out after the arthroscopy. A questionnaire was sent to 278 patients who during a two year period had undergone arthroscopy as an outpatient procedure. The degree of satisfaction for the anesthetic procedure was highest for general anesthesia where 97% were completely satisfied. Sixty-four percent were satisfied when given spinal anesthesia. However, 11% had to be put to sleep due to insufficient spinal block and 12% had headaches more than one day after outpatient spinal anesthesia. Seventy-seven percent were satisfied with local anesthesia. There was no statistical difference between the degree of satisfaction after local or spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960762 TI - Stalked patellar tendon graft in reconstruction of the anterior cruciate ligament. AB - A careful description of the surgical technique in reconstruction of the anterior cruciate using the medial third of the patellar tendon is given. It is pointed out that it is a technical advantage if the drill hole for the patellar tendon enters the knee joint into or just behind the remnants of the normal anterior cruciate ligament. It is also emphasized how important it is that the ligament is anchored to its normal anatomic insertion far back posterolaterally. With the technique suggested about 90% stable knees can be expected at an early follow up. The most common complication was an extension lag and recommendations for how this should be treated are given. PMID- 3960763 TI - Reconstruction of the posterior cruciate ligament. AB - Presented is a three to eight year follow up of reefing of the posterior cruciate in 20 cases, and reconstruction of the posterior cruciate with a patellar tendon, quadriceps tendon flap as a "reversed Jones' procedure" in 10 cases. Using the reefing procedure, there were six excellent results, ten acceptable, and four poor results. The reconstruction resulted in no excellent results, six acceptable, and four unchanged. Further improvements in present techniques are necessary before satisfactory results following reconstruction of the posterior cruciate ligament can be routinely expected. PMID- 3960764 TI - The influence of nylon cerclage on diaphyseal bone strength: an experimental evaluation of Partridge bands on rabbits. AB - Partridge-designed nylon bands which are used for the cerclage of fractured osteoporotic bones. These bands were given elevations on their inner surfaces to raise the band from the bone surface and thus minimize the negative effects on the periosteal blood circulation. It has previously been shown that the Partridge bands, when applied to a diaphyseal bone, cause a mechanical irritation to the periosteum resulting in an increased callus formation by comparison with the case when corresponding bands with no elevations are applied. It has been suggested that the increased amount of callus would result in increased strength. We have studied the effect of bands designed in accordance with Partridge, compared with corresponding bands having no elevations, in terms of torsion strength (maximum torque capacity), on intact rabbit femora. The results show an increased torsion strength in the femora to which Partridge bands had been applied for eight weeks, while the femora to which corresponding plain nylon bands had been applied had decreased in strength. The experimental study performed supports Partridge's recommendation to use the bands as cerclage in the internal fixation of fractured osteoporotic bones, preferably in combination with further internal fixation materials. PMID- 3960765 TI - Spinal cord tumor presenting as a herniated lumbar disc. AB - The lesion encountered in this case was that of an intradural-extramedullary tumor. Histologic section showed an organized hematoma, which is a very rare tumor. In a recent review of the literature, only 85 cases have been reported, most in relation to a bleeding intraspinal neoplasm. Our case is especially unusual because there was no clotting abnormality or repeated lumbar punctures or arteriovenous malformation. This case also points out the necessity of a complete physical examination. A CT scan was initially negative because the scan started just below the tumor, hence it was never visualized. Metrizamide myelogram followed by the enhanced CT scan provides a more complete diagnostic study. In this patient's case, the CT scan would have led to inappropriate therapy, whether lumbar laminectomy or chemonucleolysis. PMID- 3960766 TI - Evitable vs inevitable complications. PMID- 3960768 TI - Child abuse. PMID- 3960767 TI - New techniques for arthroscopic surgery of the ankle: preliminary report. AB - The history of the development of techniques for arthroscopy of the ankle up to the 1980s was reviewed. The author's early experience with ankle arthroscopy and surgery is analyzed and illustrated to show how the need for better access to this joint, particularly posteriorly, led to the development of these methods. Laboratory work was done to prove their safety. Materials and methods are shown. Steps for performing both techniques are described in detail. A protocol has been developed for study and analysis of a series of patients to be reported at a later date. This should further verify the safety of the above. The end results with the employment of these techniques and of the final operative long-term results will be submitted. Methods for the prevention of complications were developed. This study, therefore, should establish better indications, as well as safer and far better means of performing diagnostic and operative arthroscopy of the ankle joint. PMID- 3960769 TI - Concomitant discitis and spondylolisthesis at adjacent lumbar vertebrae. PMID- 3960770 TI - A hole in (B) one. AB - Radiolucencies are frequently observed in the carpus, often in asymptomatic patients. Evaluation of the clinical significance of these radiolucent areas is aided by use of bone scanning. In this case, correlation of the physical exam, bone scan and tomograms allowed effective direct surgical treatment of a symptomatic intraosseous ganglion. PMID- 3960771 TI - Vascular injuries of the extremities: hazards of unnecessary delays in diagnosis. AB - Delay in the diagnosis of vascular injuries of the extremities is still considered acceptable practice by many, despite its inherent high risk of morbidity and permanent disability. Such practice must be discouraged, because vascular wounding can be diagnosed early and with great precision by angiography. The arteriogram should become part of the initial emergency room assessment of all patients who sustain penetrating injuries of the extremities, as well as those who suffer violent blunt extremity trauma. PMID- 3960772 TI - Bipolar implant shoulder arthroplasty. AB - A bipolar implant was designed by the author in 1975 for reconstruction of the severely arthritic shoulder. It has the advantage of not requiring glenoidal component fixation, but still provides an artificial joint interface. The ball of the humeral intramedullary stemmed component articulates with a polyethylene bearing within the glenoid cup component. This bipolar prosthesis was implanted in 15 shoulders of patients who presented severe arthritic shoulder disabilities. The follow up period averaged 41 months. Nine patients had rheumatoid arthritis, and five had osteoarthritis; all presented with severe pain and joint crepitation with loss of motion. A "shoulder score" system, based on the rating of pain, activities of daily living and range of motion, was devised to categorize the results obtained. Patients obtained greatly improved range of motion with good to excellent pain relief and very good functional restoration. Radiographically, the implant was well tolerated and there was no stem loosening. This procedure appears to be safe and efficacious for use in the severely arthritic shoulder. PMID- 3960773 TI - Bateman bipolar hip arthroplasty. A review of 44 cases. AB - A consecutive series of 71 Bateman hemiarthroplasties were performed in a single hospital over a 20-month period. Forty-four hips or 62% were available for review with an average follow up of 22 months. Of the 44 cases, the Bateman Universal Proximal Femur, original design was used in 40 acute, displaced femoral neck fractures, two failed Austin Moore prostheses, and two cases of femoral head osteonecrosis unassociated with fracture. The mean Harris hip score was 84.7%. Of the patients 93.2% had minimal or no pain. The range of motion was excellent and the dislocation rate was 1.8%. Morbidity was not increased compared to more conventional unipolar implant procedures. The Bateman Universal Proximal Femur (UPF) is felt to offer improved surgical results compared to Austin Moore and Thompson prostheses, and this may be due to the low friction inner bearing motion that occurs with this bipolar implant. PMID- 3960774 TI - Periosteal chondroma with atypical behavior in a 9-year-old black female: case report. AB - Periosteal chondroma is an uncommon benign cartilaginous tumor of bone reported most often in children and young adults but is as of yet unreported in a black child. This is a case of periosteal chondroma in a 9-year-old black female with unusual findings of short duration of symptoms; large size; suspicious x-ray appearance and; aggressive behavior. The lesion was histologically benign and has not recurred six years post curettage. PMID- 3960775 TI - Clinical basis for a mechanical etiology in adolescent Blount's disease. AB - The exact etiology and treatment of adolescent Blount's disease remains uncertain. In this study, the clinical and radiographic characteristics of eight consecutive patients (ten knees) with late onset tibia vara are reviewed to identify common features suggestive of aberrant mechanical forces causing their deformity. Consistent clinical features include progressive varus during the adolescent growth spurt and gross obesity. All patients were black, most were males with unilateral disease, and the only female patient had bilateral involvement. All were symptomatic cases, but in no case was trauma the cause of their disease. In addition, measurements of the physeal widths of the proximal tibia and distal femur on preoperative x-rays demonstrate consistent characteristics compatible with aberrant forces predicted by Heuter-Volkman and Delpech's laws. The clinical findings along with our surgical results confirm that these patients are best treated by corrective osteotomy to neutral mechanical axis and that over-correction is unwarranted. PMID- 3960776 TI - Precision thermal imaging of the extremities. AB - Precision thermal imaging can give valuable physiological information which is not obtainable by any other means. It is particularly useful for follow up because it is painless and noninvasive. Meticulous attention to technique is necessary. A strict pre-examination protocol must be adhered to. Proper equilibration with ambient temperature is essential. The parts to be imaged must be insulated from other parts of the body. Standard views must be obtained. Adherence to good technique will yield repeatable accurate images. PMID- 3960777 TI - Sporotrichosis of the knee. A case report. AB - Articular infections due to the fungus Sporothrix schenkii are rare. Only 46 cases of Sporotrichosis arthritis have been well-documented in the English literature to date. The presentation may be limited to a monoarticular synovitis, hence the diagnosis may be confused with other more common causes resulting in costly delays in proper treatment. Reported is a case of Sporotrichosis of the knee misdiagnosed multiple times over a three-year period yet illustrating important clinical features that could lead to earlier diagnosis and management. PMID- 3960778 TI - Objective anterior cruciate ligament testing. AB - We examined subjects with the Stryker knee laxity tester as part of the clinical examination to determine its usefulness in evaluating the anterior cruciate ligament. We measured 123 athletes with no history of knee injury, as well as 30 patients with ACL injury proven by arthroscopy, and 11 injured patients with intact ACL at arthroscopy. We recorded anterior and posterior tibial displacement at 20 degrees of knee flexion and 20 lbs force in each direction. Anterior laxity and side to side difference correlated with ACL injury; posterior and total AP laxity did not. In normal subjects, mean anterior laxity was 2.5 mm. Only 8% of normal knees had anterior laxity of 5 mm or more. Ten percent of normal subjects had a side to side difference of 2 mm or more. In ACL tears, mean laxity was 8.1 mm, with 94% measuring 5 mm or more. Of the subjects, 89% with unilateral ACL injury had an increase of 2 mm or more on the injured side. Ten of ten acute ACL tears were detected by these criteria, with no false positives. In injured knees with intact ACL, measurements did not differ significantly from normal. We found the objective knee laxity measurement to be a useful complement to clinical knee examination. PMID- 3960779 TI - Allogenic transplantation of ultra-deep frozen osteochondral grafts. An experimental study in dogs. AB - Twenty dogs were subjected to allotransplantation of the lower end of the femur, frozen at -196 degrees C for 24 hours in liquid nitrogen, and stored at -30 degrees C. Two dogs were sacrificed at monthly intervals, providing the grafted bone for histological study. Eight dogs were excluded from the study following infection or death, resulting in a follow up of only 6 months. Monthly roentgenographic assessment showed bridging of the host-graft unit by the second month, with posterior subluxation of the graft with subsequent malunion. Histologically, exuberant callus was seen around the interface with progressive incorporation of the graft. However, the articular cartilage degenerated after 2 months. Attempts to repair the articular surface with new fibrocartilage were poor in the malunited grafts. The technical problems in surgery including control of infection, sound mechanical fixation and repair of tendons and ligaments must be solved to ensure a successful allograft. PMID- 3960780 TI - Lumbar discography: redefining its role with intradiscal therapy. PMID- 3960781 TI - Coexistent Mycobacterium intracellulare gonarthritis and patellar osteomyelitis in a patient with pulmonary sarcoidosis. A case report and literature review. AB - We present a 48-year-old man with known pulmonary sarcoidosis who developed septic arthritis of the left knee with concomitant patellar osteomyelitis due to Mycobacterium intracellulare. The patient underwent synovectomy and was started on appropriate combination chemotherapy, but clinical improvement did not occur until patellectomy was performed. Both bone and radiogallium scans were important in the medical and surgical management of this patient. PMID- 3960782 TI - Radiologic case study. Osteochondritis dissecans. PMID- 3960783 TI - Calcaneus fracture. PMID- 3960784 TI - Modified latissimus dorsi and teres major transfer for external rotation deficit of the shoulder. AB - Variable impairment occurs following birth associated brachial plexus injury. Muscle transpositions have evolved in response to patient need for functional reconstruction. Loss of external rotation limits the ability to perform activities with the arm in an overhead position. A modification of the combined latissimus dorsi and teres major transfer is described by means of which increased excursion of the transfer may be achieved. PMID- 3960785 TI - Cow horn used as a stimulating bone graft: a 20 year follow up. PMID- 3960786 TI - Case report of a rare mallet finger injury. AB - Mallet finger injuries are commonly seen in the emergency room and the treatment is usually simple, consisting of extension splinting of the DIP joint. The hyperextension mallet finger is a rare variant. The diagnosis can be made if the fracture fragment involves more than 50% of the joint surface. For this injury splinting is inadequate and open reduction is the treatment of choice. PMID- 3960787 TI - Breakage of the patellar component of a kinematic total knee arthroplasty. A case report. AB - Most complications of total knee arthroplasty have been of a general nature (ie, infection, pulmonary embolus, nerve palsy), or have involved either the tibial or femoral components. Occasionally, problems involving the patellar implant have been described including subluxation/dislocation, soft tissue impingement and patellar fractures. This article provides the first description of a new complication, fracture of the patellar implant at the stem-button interface. PMID- 3960789 TI - Severe cervical injury due to break dancing. A case report. PMID- 3960788 TI - Open elbow dislocation with brachial artery disruption: case report and review of the literature. AB - Open dislocations of the elbow are rare, while associated vascular injuries are common. The recommended method of treatment in a pulseless dislocated extremity is reduction, stabilization and vascular repair by interpositional vein grafting. PMID- 3960790 TI - Atraumatic osteolysis of the distal clavicle: histologic evidence of synovial pathogenesis. A case report. AB - Osteolysis of the distal clavicle was diagnosed in a young male athlete following many years as a baseball pitcher with a supplementary weightlifting program. There was no history of ligamentous injuries, contusions, fractures or separation of the acromioclavicular joint. As such, this case was categorized as "atraumatic" osteolysis. Non-decalcified histologic sections from the resected clavicle suggest that the pathogenesis of this atraumatic osteolysis arose from the synovium. PMID- 3960791 TI - Volar dislocation of the carpal scaphoid. Case report and review of the literature. PMID- 3960792 TI - Post laminectomy kyphoscoliosis following surgical treatment for spinal cord astrocytoma. PMID- 3960793 TI - Spontaneous osteonecrosis. PMID- 3960794 TI - Cardiovascular evaluation of adolescents and young adults. Salient aspects of the examination. AB - Cardiac findings in adolescents and young adults are usually normal, and most murmurs and other abnormalities that are found are benign. However, the primary care physician needs to obtain a complete personal and family history and perform a thorough physical examination to rule out cardiovascular disease and its precursors. Of primary concern are a personal or family history of syncope, family history of sudden death, and several pathologic murmurs such as those caused by mitral valve prolapse and hypertrophic cardiomyopathy. The physician may need to reassure the patient until a definitive diagnosis is made and can also provide accurate information on cardiac disease prevention. PMID- 3960795 TI - Idiopathic segmental infarction of the greater omentum. Report of a case mimicking appendicitis. AB - Idiopathic segmental infarction of the greater omentum seldom enters into the differential diagnosis of acute abdominal pain, and diagnosis is usually not made until laparotomy. A preoperative clue to the diagnosis may be the lack of systemic gastrointestinal symptoms in the presence of impressive abdominal findings. Intraoperative clues are serosanguineous peritoneal fluid but normal appendix, distal small bowel, and mesentery. In this setting, careful examination of the omentum through the initial incision is recommended. Once identified, the infarcted omentum should be completely excised to prevent formation of adhesions and possible sepsis. In the case reported here, the serendipitous discovery of edematous omentum prompted a thorough--but technically difficult--exploration of the greater omentum, which eventually led to the correct diagnosis. PMID- 3960796 TI - Infarction of the greater omentum. Elusive cause of acute abdominal pain. AB - Omental infarction may be much more common than the number of cases reported in the literature would imply. The condition should be considered in the differential diagnosis of acute abdominal pain. A thorough search for it should be made in patients whose findings at laparotomy are not consistent with the preoperative diagnosis (usually acute appendicitis), especially when serosanguineous fluid is found in the peritoneal cavity. Treatment is excision of infarcted omentum to prevent formation of adhesions with obstructive and septic complications. PMID- 3960797 TI - The need to address sexual dysfunction in diabetes. PMID- 3960798 TI - Psoriasis. How to keep mild disease from becoming severe. AB - Progress in care of mild psoriasis has been slight. Good, practical therapy of mild disease emphasizes organization of and strict compliance to well-known therapies rather than use of new therapies. Of greatest importance is prevention of disabling severe disease. For severe psoriasis, which occurs infrequently, care is best assigned to dermatologists with special experience. Advances in oncology, bacteriology, and photobiology have led to new and effective treatments for severe disease. Because psoriasis is so poorly understood, physicians should be restrained from making claims about its causes and aggravating influences. Every affected patient deserves to be thoroughly informed about the disease and helped to obtain independence through an inexpensive therapeutic regimen that can be adapted to his or her job, income level, and lifestyle. There is no simple cure for psoriasis today. PMID- 3960799 TI - Cutaneous lupus erythematosus. Recognition of its many forms. AB - The three major forms of cutaneous lupus erythematosus (LE) are chronic (discoid), subacute, and acute (found in systemic LE). Neonatal LE has recently been recognized as a separate disease with unique therapeutic problems. Subsets of DLE, such as rosaceous DLE, LE panniculitis, verrucous DLE, and chilblain LE, have still different characteristics and prognoses. This diversity of presentation creates a wide spectrum of cutaneous disease, which may be seen by a practitioner of any medical specialty. The physician must recognize cutaneous LE in its many forms to properly diagnose, treat, and advise the patient, because for many LE patients, skin problems are the only manifestation of their disease. PMID- 3960801 TI - Mushroom madness. Psychoactive fungi and the risk of fatal poisoning. AB - Despite its illegality, mushroom use as a hallucinogen is widespread. The reported toxicity of hallucinogenic mushrooms ranges from significant to relatively harmless. The greatest danger lies in the potential for mistaking a highly poisonous variety that contains cyclopeptides for the relatively innocuous hallucinogenic varieties. PMID- 3960800 TI - Hair loss. Common congenital and acquired causes. AB - Hair loss is a common problem likely to be encountered by a clinical practitioner. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. In the adult population, causes to be considered are alopecia areata and hair loss associated with systemic disease and hormonal influence. The clinician must be able to separate the types and causes of hair loss into those that reflect primary dermatologic conditions and those that represent reaction to systemic disease. PMID- 3960802 TI - Sexual dysfunction in diabetes. A survey of physicians' responses to patients' problems. AB - Results of this study suggest that physicians generally attend more to the sexual functioning of male diabetic patients than to that of female diabetic patients. Additionally, they view the men as more troubled than the women by sexual dysfunction. These physicians also were more likely to refer a male diabetic patient for further evaluation or treatment of the sexual dysfunction. Given the incidence of sexual dysfunction within the diabetic population, primary care physicians should actively involve themselves in the identification of such problems in both their male and female diabetic patients. PMID- 3960803 TI - From 'patient' to 'customer'. A dangerous trend in healthcare. PMID- 3960804 TI - The role of dental disease in fever of unknown origin. AB - The case presented emphasizes the need for evaluation of the oral cavity in the diagnostic workup of fever of unknown origin. Hurley stated, "Protracted fever of obscure cause remains one of the more daunting clinical challenges facing the physician. It calls for mobilization of all the physician's own skills and the expertise of colleagues as well as maintenance of an open mind to the patient's complaints and observations. Dogged determination and a systematic approach are the keys to solving the problem." When the possibility of dental disease is overlooked, the resulting search is sometimes long, tedious, and expensive. Early examination of the oral cavity by qualified personnel should be done even though pain is not present. PMID- 3960805 TI - Splenomegaly. When and how to treat. AB - Splenomegaly results from a variety of illnesses that can interfere with normal splenic function. The great number of potential predisposing factors and clinical settings necessitates a thorough history and careful physical examination that includes well-defined laboratory studies. Appropriate therapy covers a broad range, from doing nothing more than periodic follow-up to laparotomy with splenectomy, depending upon the factors involved in the individual case. PMID- 3960806 TI - Clinical management of children with hyperactivity. A shift in diagnostic and therapeutic emphasis. AB - Children who have attention deficit disorder with (or without) hyperactivity are handicapped by their inability to concentrate and control their impulsivity, especially while in school. Specific performance disabilities prevent them from demonstrating, especially through written schoolwork, what they have learned. Parents and teachers are likely to mistake these children's symptoms for willful misbehavior or lack of motivation, which leads to misunderstandings and even mistreatment. The critical issue in the management of a child with hyperactivity is to effectively treat the key problems of inattention and impulsivity rather than the hyperactivity per se. A nonintensive long-term approach combining stimulant therapy and a cooperative liaison among the physician, child, family, and teachers is recommended. PMID- 3960807 TI - Clarification of magnesium dosage. PMID- 3960808 TI - The history and future of the cryopreservation of avian germ plasm. PMID- 3960809 TI - Vitamin B12 nutriture of chickens fed raw soybean meal. AB - Experiments were conducted to investigate a possible interference by raw soybean meal (RSM) with B12 nutriture of chickens. In Experiment 1, day-old chicks were fed B12-free isonitrogenous and equienergetic diets containing 0 or 40% RSM to determine if RSM accelerated storage losses of B12. After 42 days, RSM decreased growth (P less than .01), decreased hepatic (P less than .01) and blood (P less than .05) concentrations of glutathione (GSH), and increased (P less than .01) pancreas and liver weights. However, statistically significant differences due to treatment were not detected in hepatic B12 concentration, indicating that RSM does not enhance B12 turnover in chicks. To ascertain the effect of RSM on B12 absorption, 9 micrograms B12/kg diet was added to diets containing 0 or 40% RSM and fed to chicks to 42 days of age. Raw soybean meal depressed growth (P less than .001) and hepatic GSH (P less than .01) and increased (P less than .001) pancreas weights. The RSM had no effect on hepatic B12 concentration, suggesting that RSM trypsin inhibition does not impair B12 absorption in chicks. A third experiment was designed to test the hypothesis that vitamin B12 stimulates egg production or feed intake of hens fed a diet with 27% RSM. Vitamin B12-depleted hens were fed RSM or heat-treated soybean meal (HSM) diets containing equivalent amounts of soybean protein, oil, and hulls. Hens received either 26 micrograms B12/kg BW per os or 13 micrograms B12/kg BW intramuscularly twice within a 30-day period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960811 TI - Reduced food intake following intracerebroventricular administration of a low molecular weight fraction of plasma from free-feeding fowl. AB - Plasma was collected from free-feeding Leghorn cockerels and partitioned by gel filtration into fractions of different molecular weight ranges. The individual fractions were then lyophilized and reconstituted to four times the original concentration. The plasma was administered to 10-week-old Leghorn cockerels via a stainless steel guide cannula, stereotaxically implanted into the lateral cerebral ventricle. Sated cockerels received 10 microliters intracerebroventricular (ICV) injections of one of the concentrated plasma fractions or of a control injection of artificial cerebrospinal fluid. Food and water intake were monitored following injection. Food intake was significantly decreased by the ICV injection of plasma fractions less than 1500 mol wt, whereas water consumption was not significantly different from that of the controls. The 1500 to 5000 mol wt fraction and the fraction above 5000 did not alter either food or water intake. These results suggest that the plasma of free-feeding domestic fowl contains a low molecular weight factor that is involved in the regulation of food intake. PMID- 3960810 TI - Excess dietary vitamin A in the growing chick: effect of fat source and vitamin D. AB - Studies were conducted to determine the nutritional interrelationship between different fat sources, vitamin D3 (vit D) and excess dietary vitamin A (vit A) in the growing chick. Birds tolerated as much as 30 times the recommended level of vit A without compromising performance or skeletal development as measured by bone ash. The response to excess dietary vit A was not influenced by the type of dietary lipid (corn oil, tallow, or poultry oil). No nutritional interaction between vit A (1,500, 15,000, or 45,000 IU/kg) and vit D (100 or 1000 ICU/kg) was detected as measured by growth, bone ash, growth hormone, incidence of tibial dyschondroplasia (TD), or rickets. Serum alkaline phosphatase activity, however, was significantly affected by vit A, vit D, and age of the chicks. The higher vit D level significantly enhanced growth, bone ash, and reduced incidence of rickets, although it had no effect on incidence of TD. PMID- 3960812 TI - Ultrastructure of epithelial thymic cysts of the chicks. AB - The medulla of the chick thymus contains variable numbers of intercellular and intracellular cysts. The epithelium varies from squamous to columnar or stratified and contains cystic, endocrine-like, and lymphoid cells. The lumen lining cystic cells contains microvilli, moderately developed rough- and smooth surfaced endoplasmic reticulum, and Golgi complex. Mitochondria, free ribosomes, and varying number of microfilaments are observed. Endocrine-like cells are separated from the lumen by the cystic cells, which in places are extremely attenuated. The cytoplasm is characterized by the presence of membrane-limited secretory granules. Cleft-like spaces, partially lined by microvilli, are also encountered. Numerous vesicles, some in tight association with the core rootlets, are evident. Cystic cells with single or multiple cysts, lined with microvilli, are also observed. The lumina of these cystic elements contain flocculent or dense granular material, amorphous masses, cellular elements, or debris. Morphological evidence suggests synthetic and secretory activities of the cystic cells in the young chicks. PMID- 3960813 TI - Effects of temperature on reproduction in guinea fowl. AB - The effects of four temperature regimens on the onset and maintenance of semen and egg production, fertility, hatchability, and feed consumption by guinea fowl were examined. Temperatures of 26.7 and 21.1 C hastened the onset of egg and semen production in guinea fowl. However, egg and semen production rates of guineas exposed to ambient or 15.6 C minimum temperatures eventually increased to the level of those exposed to the higher temperatures. This suggests that it may be possible to initiate production by exposure to a warm environment and then reduce the environmental temperature after egg and semen production has been well established. There were no statistically significant differences in fertility or hatchability. Differences seen in feed conversion were mainly due to delayed onset of egg production in the lower temperature regimens. Thus, it appears that proper winter management of guinea breeders would involve exposure to a warm temperature for some period of time. PMID- 3960814 TI - Daily variation of corticosterone and thyroid hormones in broiler cockerels. AB - An experiment was conducted to monitor fluctuations in the major adrenal steroid, corticosterone (B), and two iodinated thyroid hormones, triiodothyronine (T3) and thyroxine (T4), over the course of a 24-hr day in broiler cockerels. A circadian variation was observed in B concentrations with the highest found at 0130 hr (23 hr light: 1 hr darkness; photophase beginning at 0100 hr). No circadian variation was observed for either T3 or T4. PMID- 3960815 TI - Changes in the physical and chemical properties of skin collagen from broiler chickens exhibiting oily bird syndrome. AB - The mechanical and thermal properties of the skin and some chemical characteristics of the skin collagen have been examined for broiler chickens exhibiting Oily Bird Syndrome (OBS) and compared with material from normal birds. Comparisons of skin thickness showed that there was no significant difference between the two groups. There was also no difference in the melting temperature of the skin collagen between the two groups when examined by the isometric melting method. The strength of the skin was examined at 36 C and at 93 C. At both temperatures, the skin from OBS birds was significantly weaker than skin from normal birds. Skin collagen was examined for birds from OBS flocks (greater than 20% OBS occurrence) without distinction of the characteristics of the individual birds and compared with the skin collagen birds from flocks where OBS was absent. Comparisons of cyanogen bromide-digested collagen from both groups by polyacrylamide gel electrophoresis showed a clear distinction between the groups. The observed differences suggested that a change that lowered the extent of collagen crosslinking was present in the birds from OBS flocks, and this observation is consistent with the weaker mechanical properties of the skin of these birds. All birds in these flocks show the difference even if the individual birds do not all show OBS. This suggests that a change leading to lowering of the structural integrity of the connective tissue is present in all birds in an OBS affected flock, but that individual variation between birds determines those birds that actually exhibit OBS. PMID- 3960816 TI - Reproductive toxicity of monocrotophos to bobwhite quail. AB - Pairs of 1st-year breeding bobwhites were fed constant or decreasing concentrations of monocrotophos for 15 days. In addition, a control diet was used in a pair-fed group matched with the pairs in the constant group. Dietary concentrations for the constant group were logarithmically spaced at .100, .178, .316, .562, 1.000 ppm of actual insecticide and also at 0 ppm (control) for five pairs at each concentration. The beginning concentrations for (control) for five pairs at each concentration. The beginning concentrations for the decreasing pairs were identical to the constant group but regularly decreased to reach 25% of the starting concentrations by Day 13. Food consumption, egg production, hatchability of eggs under artificial incubation, and survival of hatched chicks for 2 weeks were recorded pairwise during 15-day treatment and 14-day posttreatment periods. Mortality was high at the greatest constant concentration and in the associated pair-fed group. Food consumption and egg production rates were negatively dose-related during the treatment period in the constant and decreasing groups. The laying rate of pair-fed hens was reduced to the same extent as in the constant group. Reproductive inhibition was not permanent, and pairs resumed laying after a dose-related recovery interval. No dose-related effects on hatchability or chick survival were detected. There was no evidence of a pesticide effect on reproduction other than that exerted through pesticide induced anorexia. PMID- 3960817 TI - Estimation of chicken microbial load using the growth curve parameters of chicken microflora. AB - Chicken microbial loads, estimated through absorbance increase of culture medium inoculated with the contaminant microflora of the carcasses, were compared with total plate counts and psychrotrophic counts obtained on the same carcasses using the pour plate method after 0, 48, 96, and 144 hr stored chicken at 4 to 5 C. For estimating microbial loads on the carcasses, the mathematical relation 1n AO = 1nA1 - R - Kt was used, which was developed by combining the growth and R equations (described in Materials and Methods) and using growth data at 28 C. The values obtained by this method, when compared with those of plating, give correlation coefficients of .94, .91, .88, and .64 for total plate counts after 0, 48, 96, and 144 hr of storage and .94, .83, .82, and .86 for psychrotrophics counts after 0, 48, 96, and 144 hr of cold storage. The method proposed in the present work permits the estimation of psychrotrophics and total counts in no more than 11 hr, which is very promising for industrial applications. PMID- 3960819 TI - Comparison of three methods of excreta collection used in estimation of energy and nitrogen excretion. AB - Three methods of excreta collection: plastic trays (T), human colostomy bags affixed to the bird (B), and B containing 25 ml .5 N HCl (A) were compared in three experiments with adult, Single Comb White Leghorn cockerels. There were 128, 130, and 120 birds in Experiments 1, 2, and 3, respectively, from which 97, 84, and 105 excreta samples were obtained; most of the losses occurred among the B- and A-groups. Birds were fasted for 24 hr prior to the experiments and then precision-fed, by intubation, with 0, 5, 10, 15, 20, 25, 30, or 35 g of fish meal (Exp. 1) or soybean meal (Exp. 2). In the third experiment, the inputs were 30 g of corn, fish meal, soybean meal, and a 50:50 (wt/wt) blend of fish meal and soybean meal; control birds were fasted. Excreta were collected for 48 hr after feeding, and the outputs of excreta energy (FE + UE), excreta nitrogen (FN + UN), and (FE + UE) corrected to zero nitrogen balance (FEn + UEn) were measured. True metabolizable energy (TME) values and TME corrected to zero nitrogen balance (TMEn) were calculated. In Experiments 1 and 2, the regressions of (FE + UE), (FN + UN), and (FEn + UEn) on feed input had slopes which were independent of excreta collection methods (P greater than .05), indicating that estimates of TME and TMEn based upon the linear regression assay were not different (P greater than .05). In both experiments, the levels of excreta and energy output using T were greater (P less than .01) than when using B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960818 TI - Detoxification of high tannin sorghum grains. AB - One in vitro and two in vivo experiments were conducted to determine appropriate methodology for and effects of detoxifying Darset, Redlan, and one commercial hybrid brown sorghum grain variety in threonine-deficient and nutritionally complete poultry rations. The detoxification procedure, which involves adding water to sorghum grain to bring dry matter to 70% and subsequent anaerobic incubation at 32 C, removes up to 100% of the chemically detectable tannin. Rate of tannin elimination was dependent upon sorghum grain variety with commercial brown sorghum requiring approximately 3 days longer than the Darset for tannin elimination. Detoxification of high tannin sorghum grains improved (P less than .05) growth rate and feed efficiency dramatically in threonine-deficient, crystalline amino acid-fortified rations; the same process applied to low tannin sorghum grains was without benefit. The desirable effects of this type of grain processing appear to be due to the reduced grain tannin content. Including detoxified sorghum grains in a practical-type broiler ration failed to elicit a weight gain response although feed efficiency was improved by 13% over untreated sorghum and 3% over corn grain. Lack of a gain response was likely due to the excess protein included in the basal diet. This type of grain processing offers an alternative method of reducing sorghum grain tannin content and is likely of greatest value in rations containing marginal indispensable amino acid and protein levels. PMID- 3960820 TI - The effect of feeding programs on reproductive traits and selected blood chemistries of caged broiler breeder males. AB - The effects of five different feeding levels [136, 125, 113, 102, and 91 g/male/day of a 13.1% crude protein (CP), 3167 kcal metabolizable energy (ME)/kg feed] were evaluated on the reproductive traits of caged adult broiler breeder males from 30 to 60 weeks of age. Individual body weights, semen volume, sperm cells per ejaculate, and fertilizing ability were measured at 30, 40, 50, and 60 weeks of age. To assist in measuring the effect of feed restriction on metabolism during these periods, average hematocrits, plasma cholesterol, total protein, and uric acid levels were analyzed. Significant (P less than .05) reductions were observed in average body weights, semen volume, sperm cell numbers per ejaculate, testicular weights, and hematocrits with feed restriction at the 91-g compared to the 136-g feeding level. At 40 weeks of age, the percent of males producing semen was significantly reduced for the 102-and 91-g compared to the 136-g feeding level. Average plasma cholesterol levels were significantly increased at the 91-g compared to the 136-g feeding level, but little effect was observed in plasma total protein and uric acid levels. Correlation coefficients were negative for plasma cholesterol to body weights, sperm numbers per ejaculate, and testicular weights but positive for body weights to hematocrits and testicular weights. PMID- 3960821 TI - [Mucociliary transport pattern in the dog trachea]. PMID- 3960822 TI - [Therapeutic lavage in alveolar proteinosis]. PMID- 3960823 TI - [Incidence of Legionella pneumonia in autopsy findings at a large hospital- retrospective studies of the year 1978]. PMID- 3960824 TI - [Congenital abnormalities of the lung in adults]. PMID- 3960825 TI - [Bronchoalveolar lavage in exogenous allergic alveolitis]. PMID- 3960826 TI - [Ultrastructure of alveolar macrophages in smokers and nonsmokers]. PMID- 3960827 TI - [Significance of bronchoscopy for the evaluation of the local operability of esophageal cancer]. PMID- 3960828 TI - [Bronchoscopy in elderly patients with local anesthesia]. PMID- 3960829 TI - [Formation of a pancreaticobronchial fistula in chronic pancreatitis]. PMID- 3960830 TI - [Relation of the child to the outside and personal world. On the formation of object constancy in normal and disordered early childhood development]. PMID- 3960831 TI - [Remarks on the development of creativeness]. PMID- 3960832 TI - [Psychotherapy of ulcerative colitis in adolescence]. PMID- 3960833 TI - [Long-term observation of patients with a history of bronchopulmonary tuberculosis in adolescence]. PMID- 3960835 TI - [Compensatory characteristics of the central hemodynamics and body oxygen of patients with tuberculosis and other lung diseases undergoing surgical treatment]. PMID- 3960834 TI - [Clinical x-ray and immunological parallels in pulmonary tuberculomas]. PMID- 3960836 TI - [Basic trends in the journal Problemy tuberkuleza in 1986]. PMID- 3960837 TI - [Use of rheopulmonography in assessing the effectiveness of pathogenetic agents in the combined treatment of pulmonary tuberculosis patients]. PMID- 3960838 TI - [Hemodynamic function of acute pneumonia patients based on echocardiographic data]. PMID- 3960839 TI - [Use of the carbon dioxide laser in the surgical treatment of patients with chronic postoperative pleural empyema]. PMID- 3960840 TI - [Surgery of pulmonary tuberculosis in diabetes mellitus patients]. PMID- 3960841 TI - [Surgical treatment of Mycobacterium infections of the lungs]. PMID- 3960842 TI - [Biogenic amines in the diagnosis of ocular tuberculosis]. PMID- 3960843 TI - [Action of laser radiation on the ciliated cells of the tracheal and bronchial mucosa (an experimental study)]. PMID- 3960844 TI - [The function of phagocytosing cells in pulmonary tuberculosis patients]. PMID- 3960845 TI - [The function of the bronchi draining healed caverns]. PMID- 3960846 TI - [Diagnosis of pulmonary mucoviscidosis in a female patient with a bronchopulmonary syndrome]. PMID- 3960847 TI - [Instructions on using a dried tuberculosis vaccine (BCG) for intracutaneous administration]. PMID- 3960848 TI - The effect of dentures on the indices describing the function of the masticatory system among 58 year old men. PMID- 3960849 TI - Trends in edentulousness among 40 to 64 year old Finns. PMID- 3960850 TI - [Headache in relation to masticatory system disorders]. PMID- 3960851 TI - [Incipient carious lesion changes as effected by the use of xylitol]. PMID- 3960852 TI - [Changes in dental pain mechanisms]. PMID- 3960853 TI - Arthroplasty of the temporomandibular joint with condylar steel prostheses. A report of two patients. PMID- 3960854 TI - Comparative effects of aminoglycosides on renal cortical and urinary phospholipids in the rat. AB - We examined the relationship between the nephrotoxicity potential of four aminoglycosides and the capacity of the drugs to induce a renal cortical phospholipidosis. Sprague-Dawley rats were injected subcutaneously with neomycin, gentamicin, tobramycin, or netilmicin, 100 mg/kg per day, for 1 to 4 days, and phospholipid accumulation in the renal cortex and phospholipid excretion in the urine were measured. The rank order of the drug-induced renal cortical phospholipidosis was netilmicin greater than tobramycin greater than gentamicin greater than neomycin. This order is the reverse of the previously established nephrotoxicity potentials of these drugs. Conversely, the rank order according to peak urinary excretion of phospholipids was gentamicin greater than neomycin greater than tobramycin greater than netilmicin. The rank order of the total urinary phospholipid excretion during the 4 days of the study was neomycin greater than or equal to gentamicin greater than tobramycin greater than or equal to netilmicin. Urinary phospholipid excretion may prove to be a sensitive indicator of aminoglycoside nephrotoxicity. PMID- 3960855 TI - Cardiopulmonary response to an induced pulse in intracranial pressure. AB - Increased intracranial pressure may result in the Cushing response. We applied a short pulse of pressure to the cranial cavity of anesthetized cats which were intubated, curarized, ventilated, and the cranium exposed to an 80- to 100-msec pulse of pressure at 5.3 atm. The following significant increases developed: Intracranial pressure rose from 7.4 +/- 1.5 to 150.6 +/- 19.4 mm Hg, systolic arterial peak pressure from 130.7 +/- 8.1 to 299.0 +/- 11.4, pulmonary peak pressure from 18.9 +/- 1.9 to 42.9 +/- 4.9. Alveolar lavage protein in controls was 6.7 +/- 0.4 mg/g lung compared to 11.9 +/- 2.0 in the experimental group. Extravascular lung water/dry weight ratios increased from 3.36 +/- 0.04 in controls to 3.51 +/- 0.09 but varied inversely with pulmonary systolic peak pressure (r = 0.59). These results showed that a pulse of pressure applied to the cranium of cats produced lung edema which was inversely related to pulmonary artery pressures. PMID- 3960856 TI - Distribution of label after intragastric administration of 7Be-labeled carbon to weanling and aged mice. AB - Single doses of 7Be-labeled carbon particles prepared by proton bombardment of carbon black were administered by gavage to weanling (4 weeks) and aged (18 months) mice. Body distribution of 7Be radioactivity was determined 4 hr and 1, 2, 5, and 14 days later. The results were compared with those obtained after administration of a solution of 7BeCl2. 7Be radioactivity in nonintestinal tissues was 17-58 times greater in mice gavaged with the soluble salt than in those gavaged with the particles, indicating that particle-bound 7Be was well confined to the gastrointestinal tract. Upper limits of the amount of labeled carbon remaining in intestinal Peyer's patches were as follows: 1 day: weanling, 1.8 X 10(-3)%, old, 5.5 X 10(-3)%; 15 days: weanling, 3.3 X 10(-5)%, old, 8.4 X 10(-5)%. The particles are potentially useful as models for diesel emissions or other particulate pollutants. PMID- 3960857 TI - Purification of monkey prolactin from culture medium: biochemical and immunological characterization. AB - Serum-free culture medium, previously incubated with dispersed monkey pituitary cells, provided a relatively uncontaminated source for extraction and purification of 15 mg of monkey prolactin. N-terminal group analysis of this preparation, M21GB, produced predominantly leucine. The amino acid composition closely resembles that of both human and sheep prolactin. M21GB monkey prolactin migrates in 10% polyacrylamide with sodium dodecyl sulfate (SDS) as a single band with a molecular weight of about 23,000. Multiple bands typical of prolactins are seen with nondenaturing polyacrylamide disc electrophoresis. M21GB contains less than 1% growth hormone, incorporates radioactive iodine with a specific activity of 15 microCi/micrograms and specifically binds to the anti-human prolactin serum 3 provided by the National Hormone and Pituitary Program (B spec/total = 23%). M21GB does not compete in a linear fashion with iodinated human prolactin-16 for the human prolactin antiserum, but M21GB does compete in a linear fashion with iodinated M21GB with the same antiserum. Monkey serum, pituitary homogenate, and culture medium containing unknown levels of monkey prolactin are not parallel with NIAMDD-HPrl-RP1 in the human prolactin assay, but are parallel when M21GB is used as the reference preparation and for iodination. Finally, antisera to M21GB were generated in rabbits which are specific for monkey and human prolactin and which can be used for radioimmunoassay or immunocytochemistry. In summary, serum free medium from primary cultures of dispersed monkey pituitaries provided a quantitity of monkey prolactin which promoted biochemical analysis and production of a specific antiserum. This culture system may be a unique and ongoing source for extraction of significant quantities of monkey prolactin suitable for investigative use. PMID- 3960858 TI - Exaggerated natriuresis in experimental hypertension. AB - The exaggerated natriuretic response to intravenous isotonic saline volume expansion in conscious spontaneous hypertensive rats (SHR), compared to normotensive Wistar-Kyoto rats (WKY), is associated with an exaggerated inhibition of renal nerve activity. Following bilateral renal denervation, the natriuresis was significantly attenuated in SHR but unaffected in WKY. Thus, the exaggerated natriuretic response to intravenous isotonic saline in SHR is dependent on their enhanced inhibition of renal nerve activity. Conscious Dahl salt-sensitive rats, on either low or high salt diet, did not exhibit an exaggerated natriuretic response to intravenous isotonic saline volume expansion which may be explained by their known impairment of cardiopulmonary baroreceptor reflex mediated suppression of efferent sympathetic nerve activity during intravenous volume expansion. Conscious hypertensive DOCA-NaCl rats exhibited an exaggerated natriuretic response to oral but not to intravenous isotonic saline volume expansion, suggesting differences in gastrointestinal absorption of isotonic saline. It is concluded that enhanced inhibition of efferent renal sympathetic nerve activity via cardiopulmonary baroreceptor reflex activation contributes to the exaggerated natriuretic response to intravenous isotonic saline volume expansion in certain models of experimental hypertension. PMID- 3960859 TI - Hemoglobin deficit: an inherited hypochromic anemia in the mouse. AB - The character and pathogenesis of hemoglobin deficit (gene symbol, hbd), an autosomal recessive trait in the mouse, were studied. The main hematological features of hemoglobin deficit are anemia, red cell hypochromia and microcytosis, and reticulocytosis. The absence of raised fecal urobilinogen excretion and frank hyperbilirubinemia and bilirubinuria suggests that excess hemolysis is not the primary cause of the anemia. The raised plasma iron concentration and the failure of the anemia to respond to parenteral iron treatment indicate that the anemia is not due to iron deficiency. The absence of siderocytes and sideroblasts suggests that anemia is probably not due to ferrochelatase deficiency. Thalassemia is excluded by the finding of balanced reticulocyte globin chain synthesis. The markedly elevated levels of free red cell protoporphyrin taken together with the other findings already noted suggest that the anemia of hemoglobin deficit is due to a defect in the erythroid cell iron procurement mechanisms leading in turn to diminished heme and hemoglobin synthesis. PMID- 3960860 TI - Decreased triiodothyronine binding to isolated nuclei from livers of preobese and obese (ob/ob) mice. AB - L-Triiodothyronine (T3) binding to hepatic nuclei from (ob/ob) mice at different ages was examined and compared with that of lean controls. Results showed a significant reduction in T3 binding in liver nuclei of obese mice at all ages studied. The preobese mice at 2 weeks of age had 27.9% fewer receptor sites/mg DNA compared to lean controls, receptor concentration further decreased to 67.7% at 18 weeks of age. Data presented here demonstrates that the impaired triiodothyronine (T3) binding to hepatic nuclei present in older (ob/ob) obese mice is an antecedent to the obesity. This report also helps to explain the poor thermoregulation and low oxygen consumption present during the preobese phase of the postnatal development of these animals. PMID- 3960862 TI - Acquired immunodeficiency syndrome. PMID- 3960861 TI - Changes in liver glutathione S-transferase activities in Coturnix quail fed municipal sludge-grown cabbage with reduced levels of glucosinolates. AB - Cabbage, green beans, or seeds from sunflowers grown either on municipal sewage sludge-amended soil or soil alone were fed to male and female Coturnix quail, as 50% of a complete diet, for 5 weeks. Specific activities of liver glutathione S transferase (GST) were similar in all quail fed the latter two plant diets and also similar to quail fed a nonplant, control diet. Sludge-grown cabbage-treated quail exhibited liver GST activities significantly higher (P less than 0.05) than levels of liver GST in birds fed the other plants, with a further twofold activity increase in quail fed the soil-grown cabbage. This response seems to be correlated with the levels of glucosinolates present in the cabbage, i.e., 3040 and 9253 ppm (dry basis) in the sludge-grown and soil-grown cabbage, respectively. PMID- 3960863 TI - Simian acquired immunodeficiency syndrome. PMID- 3960864 TI - Estrogen regulation of H59 antigen in vivo and in vitro. AB - H59 antibody, a murine monoclonal antibody, recognizes a cell surface peptide of approximately 30,000 MW which is estrogen regulated. The data supporting this conclusion have been generated from in vitro systems and indirectly from human tissue specimens. The antigen is detected only in estrogen regulated breast cancer cells in culture and is not detected in two estrogen independent cell lines, R3 and R27, which were derived from estrogen sensitive MCF-7 that contain the antigen. The antigen is increased in estrogen stimulated cells and decreased in tamoxifen inhibited cells. H59 antigen appears estrogen regulated in human breast colostrum and milk and in endometrium. The antigen is found in 40% of breast cancer and most, if not all, normal breast tissue. In the more than 300 breast cancer specimens studied, H59 antigen was detected in predominately estrogen and/or progesterone receptor containing tumors. This antigen was found only in about 50% of ER positive tumors. When the presence of H59 was compared to other prognostic factors in breast cancer, it appeared to be an independent variable and correlated only with the presence of estrogen and progesterone receptor. The antigen can be detected in normal serum, and studies are underway to determine if it will serve as a circulating marker protein in hormone dependent breast cancer. PMID- 3960865 TI - Serum and tumor sialyltransferase activities in women with breast cancer. PMID- 3960867 TI - Monitoring of occupational genotoxicants. Proceedings of a satellite symposium to the Fourth International Conference on Environmental Mutagens. Helsinki, Finland, June 30-July 2, 1985. PMID- 3960866 TI - Biochemical epidemiology of breast cancer. PMID- 3960868 TI - Application of human sperm parameters for monitoring. PMID- 3960869 TI - Covalent binding of styrene oxide to amino acids, human serum proteins and hemoglobin. PMID- 3960870 TI - Environmental and biological monitoring of mutagenic/carcinogenic hazards in working environments exposed to petroleum derivatives. PMID- 3960871 TI - Integration of laboratory and epidemiologic studies to evaluate genotoxic exposure in tool and die workers. AB - In summary, the data presented here provides perspective on the analysis of cancer in a relatively small population of tool and die workers. Each part of the effort establishes evidence for or against the presence of a workplace carcinogenic effect. Overall, the weight of evidence leads to the hypothesis that cutting fluids are a likely candidate for observed increases in urinary system cancer and perhaps other sites. Because cutting fluids and a wide variety of metals are used together, the interaction of these entities need be considered in the overall process of carcinogenesis in the workplace. PMID- 3960872 TI - Case-control surveillance system of congenital anomalies in relation to occupational exposures. PMID- 3960873 TI - A preliminary investigation of the parallelogram concept in genetic monitoring and risk estimation. PMID- 3960874 TI - Ranking the carcinogenic hazards of occupational exposures: Exposure-Potency Index (EPI) values for nine volatile industrial chemicals. AB - Employers, employees, and occupational health professionals need a a simple index to rank carcinogens according to their potential danger at exposure levels which are commonly encountered in workplaces. We describe such an index, the Exposure Potency Index (EPI). This simple proportion, dose level (mg/kg body weight/day) to which workers are permitted to be exposed/cancer-causing dose (mg/kg body weight/day) in test animals, permits comparisons among carcinogens. We have calculated this index for inhalation exposures to 1,3-butadiene, 1,2-dibromo-3 chloropropane (DBCP), 1,2-dibromoethane (EDB), ethylene oxide, formaldehyde, methylene chloride, propylene oxide, tetrachloroethylene (perchloroethylene), and trichloroethylene (TCE). The permitted worker exposure levels have frequently been close to the levels which induce tumors in laboratory animals. More recently, Permissible Exposure Limits (PEL's) for for some chemicals have been markedly reduced, and this is reflected in lowered EPI values. Combining EPI values with information on the numbers of exposed workers provides a simple means of identifying and ranking dangers to populations of workers. PMID- 3960875 TI - Future perspectives, needs and expectations of biological monitoring of exposure to genotoxicants in prevention of occupational disease. PMID- 3960876 TI - Spontaneous level of somatic chromosome aberrations in man. PMID- 3960877 TI - What has been achieved with cytogenetic monitoring? PMID- 3960879 TI - Cytogenetic findings on employees with potential exposure to epichlorohydrin. PMID- 3960878 TI - Sister chromatid exchange (SCE) analysis in 106 control individuals. PMID- 3960880 TI - Risk and reason. Risk assessment in relation to environmental mutagens and carcinogens. Proceedings of a satellite symposium to the Fourth International Conference on Environmental Mutagens. Oslo, Norway, June 21-22, 1985. PMID- 3960881 TI - Is it possible for man to develop "resistance" to the risk from environmental mutagens? PMID- 3960882 TI - The management of risk for industrial metallic aerosols: in vitro assessment of delivered dose per unit exposure. PMID- 3960883 TI - Risk assessment policy in the United States. PMID- 3960884 TI - Regulation principles and actions on mutagens and carcinogens in the countries of the Council of Mutual Economic Aid /CMEA/. PMID- 3960885 TI - The Italian regulatory policy in relation to chemical mutagens. PMID- 3960886 TI - Regulation principles and actions on carcinogens and mutagens in Norway. PMID- 3960887 TI - ICPEMC perspectives on the scientific basis of risk assessment in genetic toxicology. PMID- 3960888 TI - The dynamics of scientific uncertainty and its implications for the use of conservative procedures in risk analysis. PMID- 3960890 TI - Psychological aspects of risk management. PMID- 3960889 TI - Identification of risk. PMID- 3960891 TI - Consent and responsibility in risk management. PMID- 3960892 TI - Pricing life: a historical and sociological perspective. PMID- 3960893 TI - Probability of causation. PMID- 3960894 TI - Genetic toxicology in industry: perspectives and initiatives. PMID- 3960895 TI - The quantification of the frequency of induced dominant and recessive mutations. PMID- 3960896 TI - Electric fields and the vibrating probe, for the uninitiated. PMID- 3960897 TI - Ionic currents in development. Proceedings of a satellite meeting to the Tenth International Congress of the International Society of Developmental Biologists. Los Angeles, California, August 2-4, 1985. PMID- 3960898 TI - Ionic currents during wall morphogenesis in Micrasterias and Closterium. PMID- 3960899 TI - Transcellular current and morphogenesis in Acetabularia mediterranea grown in white, blue and red light. PMID- 3960900 TI - A two-dimensional vibrating probe with a computerized graphics display. PMID- 3960901 TI - Ionic basis of tip growth in the fern gametophyte. PMID- 3960902 TI - Steady ionic currents around haploid embryos formed from tobacco pollen in culture. PMID- 3960903 TI - Electrical properties of insect ovarian follicles: some challenges of a multi cellular system. PMID- 3960904 TI - Extracellular currents during insect oogenesis: special emphasis on telotrophic ovarioles. PMID- 3960906 TI - Electrical fields around the polytrophic ovarian follicles of Sarcophaga bullata and the panoistic follicles of Locusta migratoria. PMID- 3960905 TI - Dorsoventral currents are associated with vitellogenesis in cockroach ovarioles. PMID- 3960907 TI - Ionic currents through the cleaving egg of Lymnaea stagnalis (Mollusca, Gastropoda, Pulmonata). PMID- 3960909 TI - Detection of transcellular currents and effect of an imposed electric field on mouse blastomeres. PMID- 3960908 TI - A direct comparison of the extracellular currents observed in the activating frog egg with the vibrating probe and patch clamp techniques. PMID- 3960910 TI - Microprocessor controlled two- and three-dimensional vibrating probes with video graphics: biological and electro-chemical applications. PMID- 3960912 TI - Voltage gradients in newt limb stumps. PMID- 3960911 TI - Current flow measurements from the apical side of toad skin. A vibrating probe analysis. PMID- 3960913 TI - The role of natural and applied electric fields in neuronal regeneration and development. PMID- 3960914 TI - Effects of applied DC fields on sensory nerve sprouting and motor-nerve regeneration in adult rats. PMID- 3960915 TI - Spatially-resolved optical imaging of membrane potentials induced by applied electric fields. PMID- 3960916 TI - Reversible inhibition of neurite growth by focal electric currents. PMID- 3960917 TI - Neurite growth and response to electrical fields in calcium-free medium. PMID- 3960918 TI - Quantitative analyses of filopodial activity of mammalian neuronal growth cones, in exogenous, electrical fields. PMID- 3960919 TI - Electrical stimulation of growth and differentiation in plant tissue cultures. PMID- 3960920 TI - Pitfalls of the vibrating probe technique, and what to do about them. PMID- 3960922 TI - The effects of calcium on electric field-induced cell shape changes and preferential orientation. PMID- 3960921 TI - Role of electric fields in fibroblast motility. PMID- 3960923 TI - New insights into galvanotaxis and other directed cell movements: an analysis of the translocation distribution function. PMID- 3960924 TI - Applications of current measurement over corroding metallic surfaces. PMID- 3960925 TI - Theory of ion transport and the vibrating probe. PMID- 3960926 TI - Measuring intracellular free Ca2+ with single- and double- barreled ion-specific microelectrodes. PMID- 3960928 TI - Ion currents, electrical fields and the polarized growth of fungal hyphae. PMID- 3960927 TI - Cytoplasmic free calcium in growing rhizoids of Fucus serratus. PMID- 3960930 TI - Transfusion medicine: recent technological advances. Proceedings of the XVIIth annual scientific symposium of the American Red Cross. Arlington, VA, May 8-10, 1985. PMID- 3960929 TI - Transcellular ion currents in the water mold Achlya. PMID- 3960931 TI - Fluosol-DA in radiation therapy. PMID- 3960932 TI - DNA-probing assay in the detection of hepatitis B virus genome in human peripheral blood cells. PMID- 3960933 TI - Automation in blood component preparation. PMID- 3960934 TI - Transfusion medicine, recent technological advances. PMID- 3960935 TI - Properties of hemoglobin interdimerically cross-linked with NFPLP. PMID- 3960937 TI - [Determination of pilocarpine and isopilocarpine by high performance liquid chromatography in normal phase. The stability of eye drops with a pilocarpine base and comparison of this method with a colorimetric method using hydroxylamine]. PMID- 3960936 TI - [Stabilization of adrenaline solutions. 2. The stability of adrenaline solutions]. PMID- 3960938 TI - Thermodynamic aspects of dissolution of some 1,4-benzodiazepines. PMID- 3960939 TI - The effect of changes in the polarity of the reaction solvent (the medium) upon the reaction of a cationic micelle with benzocaine. PMID- 3960940 TI - [Pickering emulsions with antion-cation-tenside emulsifiers]. PMID- 3960941 TI - [Pathogenic microorganisms in non-sterile drugs]. PMID- 3960942 TI - [Poisonous fish]. PMID- 3960944 TI - A comparative study of theophylline in a slow-release 'sprinkle' format with a standard syrup preparation in young children with asthma. AB - Sixty-one chronic asthmatic children received either a new slow-release sprinkle format of theophylline, twice daily, or theophylline liquid, 4-times per day. Over a study period of three months, there was no measurable difference in compliance or symptom control between the two groups. The sprinkle-treated patients, however, had a greater incidence of side-effects and had higher rates of nebulization with beta-agonists. Possible explanations are discussed. PMID- 3960943 TI - The management of genital candidosis with an oral antimycotic agent, ketoconazole. AB - Fifty-three women with clinical evidence of vaginal candidosis confirmed by culture were entered into an open study. Patients received 400 mg ketoconazole once daily for 5 days. At 2 weeks post-treatment, 49 (92.5%) showed clinical and microbiological remission. The remaining 4 patients received 400 mg ketoconazole once daily for a further 21 days, along with a 400 mg 5-day course for their sexual partners. On completion of this second course of treatment, 3 of these patients were cured. Apart from some mild nausea, no side-effects were reported or observed. PMID- 3960945 TI - [Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in the irritable colon: I. Administration by single i.v]. AB - Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive a single intravenous dose of 50 mg tiropramide, 50 mg trimebutine maleate or 10 mg octilonium bromide. Before and after injection, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Significant variations in tonus were not observed with any drug, but, while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and octilonium. The overall power of spontaneous colonic contractions did not vary significantly with tiropramide, whereas some decrease was observed with trimebutine, and a substantial one with octilonium. Moreover, while with tiropramide and, to a lesser extent, with trimebutine there was a significant redistribution of muscular power so as to increase phasic propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium only a decreased wave amplitude was recorded without alteration of the frequency of transient spasms. Based on these observations, tiropramide was evaluated as being at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, while setting itself aside from both reference drugs as it was the only one to act contemporarily as both an antispasmodic and a synchronizer. PMID- 3960946 TI - [Intraoralia containing gelatin--a dissolution model and means of influencing dissolution behavior]. AB - A dissolution model was developed especially for the study of Intraoralia containing Gelatin and used to determine the dissolution behaviour of disc-shaped pieces of Gelatin of different composition (addition of a plasticizer and Formaldehyde) by means of the electrical conductance. PMID- 3960947 TI - [Preparations of matrix tablets from a polyacrylate base]. AB - The authors report with the example of the model drug, caffeine, on the preparation and investigation of matrix tablets on the basis of acrylates. The release values obtained were analysed by the equations of Higuchi and also Noyes Whitney. It was demonstrated, that the polymer composition and the drug content in the tablets have an influence on the release of the drug. PMID- 3960948 TI - [The in vitro liberation behavior of quinidine from drug forms with prolonged release by various liberation methods]. AB - The liberation behaviour of the following preparations were tested using two models: Chinidin-Duriles (Astra, Sweden), Chinidin-longo (VEB Isis-Chemie Zwickau, GDR), Chinidin-retard-Isis (VEB Isis-Chemie Zwickau, GDR). The received data were estimated by multivariate statistical methods. It was found, that the three tested preparations are different in their liberation behaviour. Moreover it was shown, that there are differences between the two apparatus. Nevertheless both methods are able to characterize the liberation behaviour of the three preparations. PMID- 3960949 TI - [Studies on the stability of drug substances of moderate stability]. PMID- 3960950 TI - [Synthesis of 7-benzyl-5,6,7,8-tetrahydro-pyrido[4',3':4,5]thieno [2,3 d]pyrimidine-4(3H)-ones with alkylthioester groups in position 2 and examination of their platelet aggregation-inhibiting activity]. PMID- 3960951 TI - New pyrazolinylanilinoquinolines and other related products of possible antibacterial activity. PMID- 3960952 TI - [Simultaneous determination of propyphenazone, caffeine and codeine in drug mixtures by reverse phase HPLC]. PMID- 3960953 TI - The effect of the chemical character of certain penicillins on the resistance of the beta-lactam group in their molecules. Part 4: Effect of ionic strength. PMID- 3960954 TI - [Crystallographic behavior of carbamazepine preparations under compression pressure]. PMID- 3960955 TI - Biopharmaceutical investigation of rectal suppositories. Part 3: Influence of particle size on the bioavailability of drugs. PMID- 3960956 TI - 14C-ethimizol: binding to plasma proteins and distribution between components of rat blood. PMID- 3960957 TI - [Metabolic interactions of propiverin and triperiden]. PMID- 3960958 TI - [The influence of 4-amidinophenylpyruvic acid on aorta muscle cells in primary culture]. PMID- 3960959 TI - Nootropics are without effect on postictal locomotor depression. PMID- 3960960 TI - [Myorelaxant action of tilorone derivatives]. PMID- 3960961 TI - [Action of new quaternary iminium compounds against selected strains of bacteria and fungi. 14. Synthesis of 1-methyl-3-(n-alkylthiomethyl)-5-chlorimidazolium chloride]. PMID- 3960962 TI - [The influence of high doses of ethanol on the vascular reactivity of the hind limb of the rat]. PMID- 3960963 TI - Lorazepam: effects on sleep and withdrawal phenomena. AB - Lorazepam, an anxiolytic drug, was evaluated in a 2-mg dose using a 16-night protocol including 7 nights of drug trial. Initially and with continued use the drug was moderately effective in inducing and maintaining sleep. Side effects included episodes of memory impairment and confusion in 2 subjects and group mean increases in daytime anxiety and tension with continued drug use. Following drug withdrawal, there was a marked and significant worsening of sleep above baseline levels (rebound insomnia) on the third night as well as significant increases in tension and anxiety the next day. The peak degree of withdrawal sleep disturbance was several times the peak degree of sleep improvement with drug administration. PMID- 3960964 TI - Acetaldehyde adducts with serum proteins: effect on diazepam and phenytoin binding. AB - The in vitro effects of acetaldehyde treatment on the binding of phenytoin and diazepam to human serum albumin (HSA) and human serum proteins (HSP) have been investigated. The incorporation of acetaldehyde into proteins following incubation with different concentrations of [1,2-14 C]-acetaldehyde (0.5, 25, 100 mmol/l) was carried out. The proteins were then dialyzed so that only the stable adduct was retained. Binding of phenytoin and diazepam was then studied. Scatchard plot analysis showed a slight decrease (p less than 0.01 for HSP and 25 mmol/l acetaldehyde) in the number of binding sites for phenytoin when the acetaldehyde/protein ratio was increased. The affinity constant was also increased (p less than 0.01) with 100 mmol/l acetaldehyde. No change could be demonstrated in the number of diazepam binding sites on HSA; an increase in the binding capacity of HSP was shown following incubation with 25 mmol/l acetaldehyde. The fraction of drug bound at therapeutic levels has been also calculated for both drugs. An increase for diazepam but no change for phenytoin can be observed before or after treatment of proteins with acetaldehyde. PMID- 3960965 TI - Enhanced sympathetic activity as a mechanism for cardiac glycoside toxicity in hypomagnesemia. AB - Hypomagnesemia was induced in dogs by administration of furosemide (20 mg/kg/day) for 7 days. Following replacement of a concomitant loss of potassium, ouabain was infused at 1 microgram/kg/min until death. The inotropic response, sustained ventricular arrhythmias, and death all occurred at significantly lower ouabain doses in hypomagnesemic animals than in normomagnesemic dogs. Additionally, hypomagnesemic dogs exhibited an abrupt sympathetic discharge which could be interrupted by bilateral ablation of the stellate ganglia. These results suggest that the neuroexcitatory effects of cardiac glycosides are enhanced during hypomagnesemia. PMID- 3960967 TI - Current scope of psychopharmacological research in Europe. Copenhagen, May 2-3, 1985. PMID- 3960966 TI - Pulmonary absorption of drugs in the dog: comparison with other species. AB - To investigate the pulmonary absorption rate of drugs in the anesthetized beagle dog, 5 ml of drug solution was administered into the lungs by rapid injection through a tracheal cannula. After various times, lungs were removed and assayed for unabsorbed drug. The dog absorbed lipid-insoluble drugs such as p aminohippuric acid, mannitol, and procainamide ethobromide at the same rate as the rat, two times more rapidly than the rabbit, and approximately 2-3 times more slowly than the mouse and guinea pig. In contrast, the dog absorbed a lipid soluble drug like procainamide at the same rate as the other four species. The results suggest that pulmonary absorption rates measured in small laboratory animals can be used to predict absorption rates in large animals. PMID- 3960968 TI - Nosological developments in European psychiatry and psychopharmacology. PMID- 3960969 TI - American and European classifications of affective disorders. AB - This paper reports applications of American classifications of affective disorders, particularly the Research Diagnostic Criteria, and relationships with some European classifications. The value of defined criteria for classifications is emphasised. The Research Diagnostic Criteria have been found useful to define inclusion thresholds, to examine diagnostic characteristics of patients with depression and other disorders in general practice and to compare general practice and outpatient depressives. Relationships are reported with PSE/CATEGO subtypes of depression and with empirical indices of endogenous depression. PMID- 3960970 TI - Approaches to the assessment of schizophrenia in Europe. AB - All definitions of schizophrenia rely more or less on Kraepelin's hypothesis, Bleuler's theory or Schneider's pragmatic criteria. After a discussion on how these assumptions are referred to in classical and operational diagnostic systems in Europe, the results of a survey of 1983 literature are presented to show what kinds of assessments European workers currently employ. Lastly, guidelines are presented to enable psychopharmacological research to make the best use of the diagnostic systems to suit its purposes: essentially, which system or systems (the polydiagnostic approach for example) one should choose depends upon the symptoms the medication to be tested is supposed to treat, keeping in mind that patient sampling varies according to the system in question. PMID- 3960971 TI - The relevance of categorical and dimensional classification systems for the comparability of patient samples in psychopharmacological research of depression. AB - Operational diagnoses of endogenous depression have gained special importance for psychopharmacological research. The high reliability of operationally defined diagnoses is a prerequisite for sampling comparable patient group. The simultaneous application of competing categorical diagnostic system ("polydiagnosis") allows us to determine whether differences in research findings are due to differences in patient samplings. Furthermore, a dimensional classification of patients by means of a newly developed polydiagnostic scale (so called OPD scale) allows us to compare the diagnostic homogeneity of patient groups diagnosed as endogenous depression cases and to select extreme groups with high diagnostic homogeneity for comparing the distribution of variables under research in patients with endogenous and nonendogenous depression. PMID- 3960972 TI - The "Melancholia Rating Scale": a useful instrument for the assessment of affective disorders. Validity and reliability of the Spanish adaptation. AB - This instrument has been constructed with the purpose of quantifying the severity of depressive states, i.e. to identify the depressive patient and to measure the response to treatment with an antidepressant. Type of instrument: Ordinal rating scale, 11 items, 5 grades. Eleven variables are assessed: Activity (motor); Activity (verbal); Retardation (intellectual); Anxiety (psychic); Suicidal impulses; Lowered mood; Self-depreciation and guilt feelings; Emotional retardation; Sleep disturbances; Tiredness and pain; Work and interests. Tests were done to verify concurrent validity with the Hamilton Depression Scale (HDS); some data on inter-observer reliability are given. PMID- 3960973 TI - Simple display routines for NMR proton density and T1 images. PMID- 3960974 TI - Displaying radionuclide images using random interpolation. PMID- 3960975 TI - Effects of brief cold exposure on finger dexterity and sensibility in subjects with Raynaud's phenomenon. AB - Treatment of the person with Raynaud's phenomenon is directed toward improving hand function during cold exposure. To assess treatment objectively, hand function after cold stress needs to be assessed. The purpose of this study was to determine whether two-point discrimination and finger dexterity were affected differentially between a healthy sample and subjects with Raynaud's symptoms as a result of exposure to an ice bath. The results showed a decreased performance on the Purdue Pegboard test and in two-point discrimination for both groups. A statistically significant decrease for performance on the Purdue Pegboard test was noted when the Raynaud's group was compared with the control group. Perception of cold pain also was statistically greater in the Raynaud's group but did not correlate with the reduction in finger dexterity. We discuss the use of ice water immersion as a potential evaluation procedure for assessing improved hand function in patients undergoing temperature biofeedback and other treatment methods. PMID- 3960976 TI - Predicting to 9-month performance of premature infants. AB - This article identifies variables found to be predictive of sensorimotor and psychosocial performance in infants at 9 months adjusted age. The subjects were 102 infants with a birth weight of less than 1,500 g, who were participants in an early intervention project. Multiple regression analyses disclosed that poor 9 month performance was related to a lack of special Neonatal Intensive Care Unit (NICU) intervention, to minority group membership, to birth weight, and to performance on selected tests administered in the NICU. We present implications for the early prediction of handicapping conditions and for further research. PMID- 3960977 TI - Length and circumference measurements in one-joint and multijoint muscles in rabbits after immobilization. AB - In this article, we compared changes in the length and circumference of the soleus and the plantaris muscles in rabbits. The rabbits were assigned to a nonimmobilized external control group (n = 4), an experimental shortened-position group (n = 10), or an experimental lengthened-position group (n = 9). One hind limb of each animal in the experimental groups was immobilized in a cast for four weeks to put the muscles in either a shortened or lengthened position. The contralateral limb served as an internal control for the animals in the experimental groups. After the immobilization period, the limbs were fixed in situ, the muscles were dissected, and length and circumference measurements were taken. In both experimental conditions, the immobilized soleus muscles were shorter than their contralateral counterparts (p less than .05); the length of the plantaris muscles did not change. The immobilized muscles had decreased circumference values regardless of the immobilization angle. When compared with the control condition, the shortened soleus muscles had a greater decrease in circumference than did the plantaris muscles. More connective tissue was observed in the muscle bellies of the soleus after immobilization than in the plantaris. Similar significant changes (p less than .05) were found in the nonimmobilized limbs of the animals in the experimental groups. Specifically, the soleus muscles demonstrated length and circumference changes, whereas the plantaris muscles showed changes only in circumference. These findings suggest that when a weight bearing limb is immobilized, adaptations in gross muscle length and circumference are to be expected in the involved and uninvolved limbs. An assessment of similar adaptations in humans should be a part of the evaluation during recovery. PMID- 3960978 TI - Decreased isometric knee flexion torque with hip extension in hemiparetic patients. AB - I measured the 90-degree isometric knee flexion torque of 12 hemiparetic patients while they performed unilateral knee flexion in sitting and supine positions. The measurements were taken to clarify why hemiparetic patients have difficulty flexing their involved knees when their involved hip is extended. The patients generated more torque in the sitting position than in the supine position and more torque on their nonparetic side than on their paretic side. The ratio of supine-to-sitting knee flexion torque did not differ significantly between sides. This finding suggests that hemiparetic patients do not have relatively greater difficulty generating knee flexion torque on their involved side with the hip extended than with the hip flexed. Recommendations for assessment and treatment are made with this finding in mind. PMID- 3960979 TI - Influence of aerobic fitness on cardiovascular responses during slow head-down tilting. AB - This study examined the influence of cardiorespiratory fitness (CRF) on mean heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) responses to slow head-down tilting. Twenty-four young, healthy volunteers were tilted randomly from the horizontal plane to -30, -60, and -90 degrees with lower limbs extended or flexed. A multivariate analysis of variance between three independent variables (level of CRF, tilt angle, and lower limb position) and three dependent variables (mean HR, SBP, and DBP) was performed on the cardiovascular changes from an initial horizontal baseline value (absolute change) and from a horizontal value that immediately preceded tilting angles (relative change). The results for significant absolute cardiovascular changes indicated a CRF influence on HR increase (F = 6.42, p less than .05), a tilt angle influence on SBP increase (F = 9.56, p less than .001), and DBP increase (F = 6.49, p less than .01) and an interaction influence between CRF level and limb position for DBP (F = 5.83, p less than .05). Significant relative cardiovascular change was noted for tilt-angle influence on HR (F = 9.04, p less than or equal to .001). We conclude, therefore, that physical therapists should consider the CRF of individuals and the tilt angle to be used before they conduct slow head down tilting for therapy. PMID- 3960980 TI - Sequential analyses of postural reactions in nonhandicapped infants. AB - The purpose of this study was to identify an empirically validated sequence of automatic postural reactions in a sample of 40 nonhandicapped infants. Using a cross-sectional design, we tested infants between the ages of 2 and 10 months for the presence of full and partial righting, equilibrium, and protective reactions. Two types of sequential analyses were performed. The Thurstone absolute scaling technique identified an age-related sequence, and the scalogram technique yielded a measure of the variability of the sequence. The sequence of postural reactions defined in this study is in general agreement with the sequence reported in previous clinical reports, although some differences in ordering are noted. A consistency index of .727 indicated that the sequence of postural reactions had fairly good predictive ability. This study contributes a data-based sequential model of postural reactions and an indication of the degree of sequential variability in the order of emergence of postural reactions in nonhandicapped infants. Definition of the sequence and the observed variability in nonhandicapped infants is an initial step in the understanding of the processes underlying the development of postural reactions. PMID- 3960981 TI - Abuse and neglect of elderly persons by family members. A special communication. AB - Abuse and neglect of elderly persons, particularly by adult family members, is a serious social and health phenomenon that cannot be ignored. Physical therapists who deal with elderly persons must prepare themselves to recognize signs of abuse and neglect and to become familiar with existing intervention agencies and outlets for prevention. Awareness that the problem exists and improved detection and intervention procedures are needed to prevent abuse and neglect of elderly persons from becoming more widespread. PMID- 3960982 TI - Citation analysis of Physical Therapy. A special communication. PMID- 3960983 TI - Providing resistive breathing exercise to the inspiratory muscles using the PFLEX device. Suggestion from the field. AB - This report describes a 6-step process for prescribing resistive inspiratory exercise using the PFLEX device, which is an inexpensive and effective method of enhancing the performance of the vital muscles of respiration. Until further clinical validation of minimal threshold guidelines for prescribing PEPs is achieved, the clinical judgment of the physical therapist remains the most important element in the prescription process. PMID- 3960985 TI - Mention the name of McKenzie. PMID- 3960984 TI - Survey of student clinical practice. Implications for educational programs. AB - The purpose of this survey was to analyze the content of physical therapy students' clinical education programs. We developed and used patient and student record forms that elicited information on the age and sex of the patient groups, the types of pathological conditions, the number and types of treatments administered, the levels of assessments, the levels of supervision of students by clinical instructors, the time spent with patients, and the specialized educational activities at each facility. One hundred seventy-six students participated in the three-year survey; each student completed 600 hours of study for a total of 105,600 hours. The results of this study revealed that musculoskeletal disorders (47.26%) were reported most frequently; fractures of the lower extremities constituted 10.5% of those disorders. Therapeutic exercise was the most frequently used treatment procedure (57.3%). The data obtained through this survey may be useful for evaluating curricula and developing improved practice-specific education programs. PMID- 3960986 TI - Notes on neonates. PMID- 3960987 TI - Touche? PMID- 3960989 TI - The challenge of adaptational physiology. PMID- 3960988 TI - A brushup on Rood's technique. PMID- 3960990 TI - Blindness and play fighting in juvenile rats. AB - Play behavior of blinded and sighted juvenile rats was measured using the brief paired-encounter procedure. Dyads of sighted-sighted, blind-blind, or sighted blind rats were observed in a large or small chamber on alternate days for ages 28 through 43 days. Blinded rats played as frequently as sighted rats regardless of pair composition or chamber size. Vision is not essential for initiating or maintaining play fighting. PMID- 3960991 TI - Inhibition of infanticide after mating by wild male house mice. AB - The effect of mating on the behavior of male house mice (Mus musculus) toward young has been examined in numerous domestic stocks of mice, and the somewhat contradictory results led us to examine the effects of mating on the behavior of wild male mice toward young. The wild mice were the F1-F4 offspring of mice trapped in Missouri. Virtually all wild males exhibit infanticide prior to mating, but virrually all wild males were inhibited from exhibiting infanticide 3 weeks after mating whether they were placed into the cage of their former mate and her litter or into the cage of an unfamiliar female and her litter, similar to the effect of mating on the behavior of CF-1 male mice toward young. In contrast, wild males that had exhibited infanticide prior to mating were inhibited from exhibiting infanticide 3 weeks after mating when placed with their former mates and their 2-day-old young but not when placed with unfamiliar females and their 2-day-old young. When wild males were tested for their behavior toward young using the procedure of placing a single pup into each male's home cage, mating did not result in an inhibition of infanticide (about 90% of the males exhibited infanticide). Cohabitation with a female without mating also did not influence the behavior of wild males toward young. Wild males that exhibited infanticide when placed with a lactating female produced their own young more rapidly than did noninfanticidal males, thus providing further support for the hypothesis that under some conditions, infanticide can be an adaptive trait.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3960992 TI - Hypothalamic nuclear progestin receptors and the duration of sexual receptivity in ovariectomized and ovariectomized-hysterectomized rats. AB - In order to determine if the enhancement of sexual behavior in hysterectomized rats is associated with an increased level of hypothalamic nuclear progestin receptors, ovariectomized (OVX) and ovariectomized-hysterectomized (OVHX) rats were injected with 2 micrograms estradiol benzoate. Twenty-four hr later, animals were injected with 0.5 mg progesterone and were tested for sexual receptivity every 4 hr. Hysterectomy had an overall facilitatory effect on lordosis and increased the duration of the period of sexual receptivity by about 4 hr. In a second experiment, similarly-treated animals were killed 4, 8, or 12 hr after progesterone injection, and hypothalamic nuclear progestin receptor levels were measured. In contrast to what has been reported for guinea pigs, nuclear progestin receptor levels decreased to baseline 8-12 hr before the termination of sexual receptivity. Nuclear progestin receptor concentrations were higher in OVHX rats than in OVX rats at 4 hr after progesterone injection, and there was a trend toward higher receptor concentrations in OVHX rats at 8 hr. These results demonstrate that hysterectomy-induced facilitation of sexual receptivity is associated with an increased level of hypothalamic nuclear progestin receptors. Furthermore, they suggest a fundamental difference in the regulation of nuclear progestin receptor retention between rats and guinea pigs. PMID- 3960993 TI - Stress adaptation and adrenal activity in isolated and crowded rats. AB - Socially reared male control rats (Co) were compared with crowded reared rats (Cr) and isolated reared rats (I). We assayed the adaptation to moderate stress (activity and defecation rate in open-field test) and to intensive stress sensitivity to restraint ulcer), so as the basal adrenal activity measuring basal values of corticosterone (R.I.A.) and fresh weight of adrenal and thymus glands. Results show a great lack of adaptation to moderate and intensive stress in Cr and I reared rats which leads to a decrease of activity variables, an increase of defecation rates and a high sensitivity to restraint ulcers. The effect of crowding conditions show higher values than isolation. We also found, in isolated and crowded reared rats, an increase in the adrenal function with great values for the basal secretion of corticosterone and atrophy of the thymus gland, besides which, crowded reared animals showed adrenal hypertrophy. PMID- 3960994 TI - Behavioural, physiological and immunological consequences of social status and aggression in chronically coexisting resident-intruder dyads of male rats. AB - The behavioural and physiological consequences of social status and reciprocal fighting in resident-intruder dyads of Long Evans male rats were evaluated. Before a chronic cohabitation of 10 days, residents and intruders were individually housed for one month to increase their aggressiveness. Control animals included isolates, i.e., animals kept individually housed throughout the experiment and pair-housed rats, i.e., pairs of rats housed together from their rats in the laboratory. In 19 out of 20 dyads, a clear dominance relationship developed with an advantage to the resident in 68% of the cases. Dominants showed more exploratory activity than subordinates in a open-field test at the end of the cohabitation period; subordinates groomed longer than animals from other experimental groups. Dominants had lower pain thresholds than individually and pair-housed animals. Both dominants and subordinates had higher tyrosine hydroxylase enzymatic activities in the left adrenal than isolated and pair housed rats. Subordinates lost body weight and had higher plasma corticosteroid concentrations than animals from the other experimental groups. In addition, they had smaller thymus glands and reduced spleen lymphocyte responses to mitogenic stimulation in vitro, in comparison to dominant animals. These results show that subordination in the dyadic resident-intruder paradigm leads to a complex syndrome of behavioural and physiological changes, some of which may be modulated by the intensity of aggressive interactions. PMID- 3960995 TI - The influence of central infusions on drinking due to peripheral osmotic stimuli in the pigeon (Columba livia). AB - The drinking responses of pigeons infused simultaneously IV (0.334 ml/min) and ICV (2 microliters/min) for 15 min with various osmotic solutions were observed during, and for 60 min after, the combined infusions. Drinking in response to IV infusion of 0.5 M NaCl or 1.0 M sucrose was unaffected by simultaneous ICV infusion of 0.15 M NaCl, enhanced by ICV 0.3 M NaCl, inhibited during the infusion of water ICV and attenuated by ICV infusion of 0.9 M sucrose. Drinking in response to IV infusion of 1.0 M NaCl or 1.5 M sucrose, two solutions that would have greatly increased CSF sodium concentration, was only slightly affected by simultaneous ICV infusions of NaCl, sucrose or water. These results show that drinking following IV administration of osmotic stimuli can be affected by ICV infusions that may have further increased or decreased CSF sodium concentration thereby suggesting that CSF sodium concentration may play a "permissive role" in osmotically induced drinking. PMID- 3960996 TI - Metabolic changes of twenty weeks food-restriction schedule in rats. AB - In previous studies several metabolic and hormonal adaptations were detected as a consequence of food restriction schedule (single daily meal offered during two hours from 7:30 to 9:30 a.m.) imposed for four weeks. During this period, the most prominent metabolic adaptations were: high alimentary efficiency, delayed gastric emptying, high hepatic glycogen concentration during the intermeal periods, glycemic maintenance during 22 hours of intermedal period as were low mobilization of free fatty acids. In the present work these metabolic adaptations were studied for twenty weeks. The results obtained show that the metabolic and hormonal pattern, defined during four weeks of training to such alimentary scheme, was maintained even after the 20th week. Moreover, it was clear that neither did the body weight increase rapidly nor did it reach that of free-fed rats, after adaptation phase, as reported by other authors. PMID- 3960997 TI - Multiple, brief maternal separations in the squirrel monkey: changes in hormonal and behavioral responsiveness. AB - Infant squirrel monkeys had their mother removed from the home cage for 2 hr on 80 occasions between 12 and 31 weeks of age. The initial separation elicited high levels of infant vocalizations. By the second observation session (Separation 14), no vocal response to separation was observed. Plasma cortisol levels were markedly elevated at the beginning of the separation series, and there was a significant decline in this response by Separation 28, which was the next separation during which cortisol was monitored. However, there was no further decline, so that significant cortisol elevations were observed throughout the remainder of the separation series. At 35 weeks, the infants were separated one additional time and their responses were compared to those of a previously nonseparated control group. The control group vocalized more, but the two groups exhibited equivalent cortisol elevations. Observations of time spent riding on the mother during undisturbed conditions indicated that both groups developed independence from the mother at about the normal rate. Overall, the data show that brief separation from the mother can activate the infants' pituitary-adrenal system even when the infant has been separated 80 times previously, no longer appears behaviorally responsive to separation, is almost 9 months of age, and exhibits normal signs of independence from the mother. PMID- 3960998 TI - Olfactory acuity in the common raven (Corvus corax). AB - The efficacy with which ravens can locate concealed carrion and similar foods has been noted from antiquity. This ability has been claimed in folklore to indicate an acute sense of smell. Contemporary opinion among ornithologists is that the sense of smell is weak at best in passerines, and particularly so in corvids which lack developed olfactory apparatus. Four studies were performed to test whether ravens could find hidden food (fresh ground fish) under conditions where scent was presumed to be the sole cue. The subjects, captive juvenile ravens (five males and three females) capably chose which one in a pair of containers held food buried under 2.0 cm of No. 4 gravel, discovered food concealed under as much as 2.5 cm of gravel, and located as little as 1.0 g of food covered by 1.5 cm of gravel. The several findings are consistent with the possibility that ravens can use olfactory cues to find food. PMID- 3960999 TI - Murine aggression induced by a boar chemosignal: a stimulus presentation dependency. AB - Male mice were used to assess for the presence of aggression-promoting cues in the boar chemosignal, 5 alpha-androst-16-ene-3-one. The findings of Experiment 1 indicated that this steroid has no aggression-promoting properties when mixed in water. When mixed in urine from castrated males, however, the steroid was shown to induce agonistic behavior in aggressors. Thus, the steroid was shown to possess aggression-promoting cues when associated with urine. Experiment 2 was designed to assess the chemosignal properties of the steroid when mixed in urine or juxtaposed either proximally or distally to urine. It was determined that the steroid needed to be either adjacent to or mixed in urine for chemosignal activity to be evidenced. It was concluded that (1) urine may function as an orienting stimulus for the appropriate detection of the steroid or (2) the conjoint presentation of the steroid and urine provided a qualitatively different stimulus complex than either stimulus presented alone. The findings of both experiments question the species specificity of the boar chemosignal and have methodological implications for studies attempting to isolate a chemocommunicative substance. Appropriate stimulus presentation procedures need to be considered for future research projects. PMID- 3961000 TI - The effects of early dietary experience on subsequent protein selection in the rat. AB - Two series of experiments were designed to investigate the effects of protein composition of the first solid food consumed by young rat pups on their subsequent protein intake after weaning. In the first series of experiments, pups were allowed access to the maternal diet between 17 and 21 days of age, then weaned to a choice of 10% and 60% casein diets at 21 days. Pups with access to a maternal diet containing 39% casein selected high levels of protein (calculated as % of total calories selected as protein: 50 +/- 1% (access) vs. 29 +/- 3.5% (no access), p less than 0.05), whereas lower levels of protein were selected following access to a maternal diet containing 26% casein (16 +/- 1.1% (access) vs. 23 +/- 1% (no access), p less than 0.05) or 10% casein (27 +/- 3.9% (access) vs. 39 +/- 3.7% (no access), p less than 0.05). In a second series of experiments, the influence of early diet composition on subsequent protein selection was confirmed by prematurely weaning rats at 17 days of age to either 39% or a 10% casein diet. When given a choice of 10% and 60% casein diets at 21 days, pups selected higher levels of protein if weaned to a 39% casein diet as compared to a 10% casein diet (37 +/- 5.0% vs. 19 +/- 3.5% (p less than 0.05) for the first experiment and 43 +/- 3.0% vs. 26 +/- 4.0% (p less than 0.05) in a second experiment). It was concluded that the level of protein selected by young rats is positively correlated with the protein concentration of their first solid food. PMID- 3961001 TI - Facilitation of lordosis behavior in ovariectomized estrogen-primed rats by medial preoptic implantation of 5 beta, 3 beta, pregnanolone: a ring A reduced progesterone metabolite. AB - The effect on lordosis behavior of progesterone (P) and some of its ring A reduced metabolites (5 beta pregnane 3 alpha ol 20 one, 5 beta pregnane 3 beta ol 20 one and 5 alpha pregnanes 3 beta ol 20 one) was studied in estrogen primed overiectomized rats by unilaterally implanting them in two brain areas related to the control of lordosis behavior: the ventromedial hypothalamic nucleus (VMH) and the medial preoptic area (mPOA). Of the four pregnanes studied only 5 beta 3 beta pregnanolone consistently induced lordosis behavior when implanted into the mPOA. The present results show that some 5 beta reduced P metabolites can facilitate with a short latency the display of lordosis behavior, probably by depressing the activity of telencephalic neurons inhibitory to sexual behavior. PMID- 3961002 TI - Dose-dependent effects of hydrocortisone on memory in human males. AB - Eighty male undergraduates were administered either glucose or 5, 10, 20, or 40 mg of hydrocortisone in a double-blind procedure. After 60 min they were asked to listen to eight 12 word lists and then asked to recall the words. In addition to the expected effects of rate of presentation, serial position, and practice there was a significant interaction between dose of hydrocortisone and practice. Early recall was facilitated by all doses used whereas later recall was facilitated by treatment with 40 mg and impaired by treatment with 5 mg. These findings are discussed in the context of the effects of pituitary adrenocortical hormones and memory function. PMID- 3961003 TI - The human dive reflex: an experimental, topographical and physiological analysis. AB - This study examined the eliciting conditions, response topography and autonomic nervous system (ANS) control of the dive reflex as evoked in humans. Twenty-four subjects received eight trials in each of the three treatment conditions: breath holding without face immersion (BH); face immersion without breath holding (FI); and the "full dive" FIBH condition. It was the combination of both FI and BH in 23 +/- 0.5 degrees C water that was necessary to elicit the dive reflex. A precise topographical analysis differentiated the FIBH condition from the FI and BH control conditions in terms of the emergence of a secondary component initiated approximately 12 seconds after trial onset. During this secondary component, augmentation of bradycardic (mean = 16.3 bpm) and digital vasoconstrictive (mean = -24.9%) responses were maintained throughout the duration of the 40-second dive. A joint consideration of the heart rate and the T wave amplitude measures as indices of the action of both branches of the ANS suggested that the dive reflex involves concurrent sympathetic and parasympathetic activation. A potential conditioning application of the dive reflex for countering paroxysmal supraventricular tachycardia was discussed. PMID- 3961004 TI - Alteration of food intake following intracerebroventricular administration of plasma from free-feeding domestic fowl. AB - Four experiments were conducted to investigate the presence of a factor in the plasma of the domestic fowl that alters food intake when injected into the lateral cerebral ventricle. Plasma collected from free-feeding and 24-hour fasted birds was lyophilized and reconstituted to 2, 4, or 5 times normal concentration. Stainless steel guide cannulae were stereotaxically implanted into the lateral cerebral ventricle of 8-week-old Single Comb White Leghorn cockerels. Free feeding birds received 10 microliter intracerebroventricular (ICV) injections of normal (Experiment 1) and concentrated (Experiments 2, 3, and 4) plasma collected from free-feeding and 24-hour fasted birds. Artificial cerebrospinal fluid (aCSF) served as the control. Food intake was significantly decreased by ICV injections of 2, 4, and 5 times normal concentration of plasma from fed birds. Plasma from fasted birds did not alter food intake regardless of concentration, but did significantly reduce water intake when concentrated to five times normal. It appears that a satiety factor, which can be detected by the central nervous system, is present in the plasma of free-feeding domestic fowl. PMID- 3961005 TI - Medial preoptic-anterior hypothalamic lesions and sociosexual behavior of male goats. AB - With the aid of x-ray ventriculography, lesions were placed in the medial preoptic-anterior hypothalamic (MP-AH) area of 5 adult male pygmy goats. The lesions resulted in a marked decrement in ejaculatory responses, as they have in previous studies on rats, cats, dogs and rhesus monkeys. The results illustrate the apparent universal effects of MP-AH lesions on copulatory behavior in mammalian species. Male sex-typical non-courtship responses of flehmen, self enurination and penis licking were not altered by the MP-AH lesions. Since the non-courtship responses are displayed most frequently when male goats are sexually aroused, the results point to a specific effect of the lesions in disturbing a male's copulating performance while sparing other expressions of sexual arousal. PMID- 3961006 TI - Maternal dietary sodium chloride levels affect the sex ratio in rat litters. AB - Eighty-eight adult female rats were fed diets containing either 0.08, 0.12, 1, 3, or 4% NaCl for at least one week prior to breeding and throughout gestation. Within 24 hours of birth, all pups were sexed based on anogenital distance, and the number of males and females were recorded. The amount of sodium chloride in mother rats' diets was inversely related to the proportion of phenotypic males in the litter. As dietary salt increased, the proportion of males decreased. These alterations in dietary NaCl affected the sex ratio without disrupting litter size or the general health of the offspring. Dietary mineral content may affect the phenotypic sex ratio through changes in the genotypic sex ratio, or alternatively, via changes in the environment in which the genes are expressed. These findings are important for basic research concerning maternal nutrition and development. PMID- 3961007 TI - Caloric regulation in the rat: control by two factors. AB - These experiments demonstrate that rats can immediately adjust their meal size in response to variations in the caloric density of a novel diet. However, this immediate caloric sensitivity only seems to appear when rats have been adapted to small, calorically insufficient meals. Rats in Experiment 1 were given timed access to unlimited quantities of an oil/water diet during baseline, and they showed no indication of compensating for changes in the caloric density of the oil/water diet during a test meal. Instead, they consumed about the same amount they had consumed during the preceding baseline meal, suggesting that a learned habit of consuming a certain volume of food controlled their meal size. In contrast, rats that were accustomed to receiving only a very small quantity of food for one of their daily meals during baseline immediately responded to the caloric density of an oil/water test diet by consuming a larger meal if the diet was dilute than if it was calorically more concentrated (Experiments 2 and 3). This immediate sensitivity to caloric density occurred whether or not the rats were exposed to the oil/water diet during baseline, suggesting that rats have some way of directly "metering" the caloric density of new foods. Thus, rats' caloric intake during a meal appears to be controlled by two factors: under certain conditions, control is by caloric learning, under other conditions control is by a caloric metering mechanism. PMID- 3961008 TI - Respiratory-phase-related coding of olfactory information in the olfactory bulb of awake freely-breathing rabbits. AB - The "across-neuron pattern" theory of olfactory information coding states that odorants are represented by spatial patterns of activity produced across-neurons in the olfactory bulbs. The present study analyzes the different response patterns encoding olfactory information in both the inspiratory and expiratory phases of the respiratory cycles of awake freely-breathing rabbits. We recorded the single-unit responses of 31 neurons to 5 different odorants, 3 of which were repeatedly delivered 5 times each. These responses were characterized by the change in their mean firing activity during the inspiratory and expiratory phases of the respiratory cycles respectively. Their processing using principal component analyses revealed that both the inspiration- and the expiration-related across-neuron profiles of responses contained information appropriate to the specification of each odorant. It was therefore concluded that there was a dynamic representation of odorants in the olfactory bulb of awake freely breathing animals. This alternate representation of odorants by two profiles and its physiological significance are discussed. PMID- 3961009 TI - Operant drinking in pigs following intracerebroventricular injections of hypertonic solutions and angiotensin II. AB - The effect on operant drinking of intracerebroventricular injections of the following solutions has been investigated; hypertonic saline, hypertonic sugars, angiotensin II (Ang II) dissolved in water or dextrose, and Ang II dissolved in saline. Hypertonic (0.85 M) NaCl caused drinking in all pigs tested, but hypertonic (1.7 M) xylose, glucose or sucrose were less effective, indicating involvement of a cerebrospinal fluid sodium receptor mechanism as well as an osmoreceptor mechanism in the drinking responses. Angiotensin II in 0.15 M NaCl caused drinking in all pigs but when dissolved in water or dextrose it was ineffective. Injection of Ang II with hypertonic NaCl produced drinking similar in volume to the sum of the amount drunk in response to the individual stimuli. These results indicate that, in the pig, drinking in response to Ang II requires the presence of sodium ions. PMID- 3961010 TI - Water adulteration with citric acid: effects on drinking and responsivity to regulatory challenges. AB - Rats with permanent access to a water supply adulterated with citric acid (CA) displayed persistent reductions in fluid intake and fluid/food ratios; and at appropriate concentrations of CA, they also exhibited lowered body weights and drinking deficits after fluid deprivation and after hypertonic NaCl injections. Unlike rats in previous investigations that were forced to consume quinine adulterated water, CA drinkers exhibited less disruption in their ingestive behavior following regulatory challenges, diminished short-term but greater long term abilities in responding to hypovolemia, and an ability to increase fluid intake after fluid deprivation plus hypertonic NaCl. These data reveal that substances which degrade the taste quality of water do not exert a unitary influence on fluid intake, and they further underscore the complexity of ecological factors involved in controlling drinking behavior. PMID- 3961011 TI - Delayed reinforcement of switch-off behavior and amygdaloid lesions in cats. AB - Effects of amygdaloid lesions on the switch-off behavior (SOB) and behavioral changes induced by a delayed reinforcement (DR) for SOB were investigated in 12 cats. The DR consisted of putting a delay time of 1.6 or 2.4 sec between a plate pushing response and the actual termination of hypothalamic stimulation, and it produced a marked prolongation of response time for SOB (delay phenomenon). Bilateral electrolytic lesions of the amygdala had only limited effects on the SOB and the delay phenomenon; they tended to enhance the prolongation of response time induced by DR in 6 cats and it was accompanied by mild prolongation of response time of subsequent immediate reinforcement trials. These effects were interpreted to be due to apparent attenuation of emotion-producing potency of the hypothalamic stimulation, induced by reduction of facilitatory environmental influences on it. PMID- 3961012 TI - Comparison of the effects of testosterone and dihydrotestosterone on the behavior of male cynomolgus monkeys (Macaca fascicularis). AB - To compare the behavioral effects of testosterone propionate (TP) and diyhdrotestosterone propionate (DHTP) at doses producing plasma levels of androgens within the physiological rage, observations were made on 4 castrated male cynomolgus monkeys during successive 4-week treatment periods while they received 25, 50, 100, 200, 400 and 800 micrograms of either TP or DHTP SC/day in counterbalanced order. Males were tested with each of the same 4 female partners (16 pairs, 1024 1-hr behavior tests). Males were injected at 1600 hr and blood samples were obtained at 0800 hr (256 samples, 456 hormone determinations). Physiological plasma levels of T resulted from the 200 micrograms and 400 micrograms TP treatments, and were associated with significantly increased ejaculatory behavior. Physiological plasma levels of DHT resulted from the 50 micrograms and 100 micrograms DHTP treatments, but there were no changes in ejaculatory behavior over the entire DHTP dose range used. This difference in the behavioral effects of TP and DHTP, not previously reported for a primate, could not be accounted for by the effects of treatment order, season, long-term behavioral testing, female sexual motivation or behavior reflecting the peripheral action of androgens. PMID- 3961013 TI - Change in period of free-running rhythms determined by two different tools in blinded rats. AB - Drinking rhythm in 6 rats optically enucleated on the day of birth was determined every one to two weeks after weaning until the age of 28 weeks. Each rat was transferred repeatedly from a cage without a running wheel to one with a running wheel, and vice versa. During the periods when the rats were housed in the former cage, drinking rhythm delayed, while it advanced when they were housed in the latter. The rats, which had a period of free-running rhythm of motor activity longer than 24 hr when measured by an Automex device in a cage without a running wheel, showed a period shorter than 24 hr when measured by a running wheel. These results suggest that the difference in tools for determination of activity may influence the results of animal experiments for free-running rhythm, and warn investigators of risks being caused by the selection of tools. PMID- 3961014 TI - The pre-ejaculatory behavior of male and female rats affects the number of sperm in the vagina and uterus. AB - The number of pre-ejaculatory intromissions a female rat receives affects the probability of becoming progestational and transporting sperm into the uterus. We now report that the number of intromissions a male rat delivers affects his ejaculatory performance. Males and females were given different copulatory experience by switching females during mating. When either the male or female had few intromissions, few sperm were recovered and the copulatory plugs fit less well. Intromission-dependent sperm recovery was also observed in a review of 94 copulatory tests drawn from archival data. Several possible mechanisms are discussed, including poor placement of the copulatory plug and reduced sperm output. The potential significance for reproductive success in social mating situations is discussed. PMID- 3961015 TI - The design and calibration of a startle measurement system. AB - The present study sought to determine appropriate instrumentation for amplification and calibration of cages used to measure the acoustic startle response in rats. Fourier analysis indicated that the characteristic frequency of the rat startle response is about 5-15 Hz. This value was consistent in cages differing widely in resonant frequency, among several different transducers and across a range of large and small startle responses. Given this characteristic frequency range of startle, it is suggested that amplifiers fitted with band pass filters centered at about 10 Hz should be ideal for measuring startle while simultaneously excluding non-startle activity. A device is described which vibrates startle cages at 10 Hz, since this seems most appropriate for calibrating the sensitivity of a startle system. Data are presented showing that this type of calibrator is more valid than an impact-type calibrator. PMID- 3961016 TI - A three-channel swivel for electrical brain stimulation in unrestrained rodents. AB - The construction of an inexpensive, three-channel commutator is described. The unit maintains uninterrupted contact with unrestrained rodents. Rotation requires the application of very little torque because tension is low and because the rotor, weighing about 2.5 g, has negligible inertia. PMID- 3961017 TI - A simple rapid swim test to determine spatial preference in the rat. AB - A swim test is described for the evaluation of spatial preference in untreated male rats. The test is rapid, objective and simple to perform and was able to distinguish right-left preferences in 47 rats. It is encouraged that the swim test be compared to or used in conjunction with other spatial preference tests. PMID- 3961018 TI - An accurate demand feeder for fish, suitable for microcomputer control. AB - This paper describes an easily constructed and inexpensive demand feeder. The feeder is driven by an AC synchronous motor and gearbox and is suitable for microcomputer control. It will operate with inexpensive commercially available pelleted fish food, and will consistently deliver a single pellet for each operation of the motor. The components and materials can be purchased for approximately 23 pounds. PMID- 3961020 TI - [Questionnaire for recording interpersonal value judgments in group psychotherapy]. AB - Interpersonal estimation is a factor that is of importance to both the patient therapeut relationship and the climate prevailing within the psychotherapy group. This contribution describes a questionnaire which permits interpersonal estimations in group psychotherapy to be expressed numerically. It enables identification of differences between the estimations given by different patients and also the patient's reception of other patient's estimations of himself. The questionnaire is used for weekly measurements of changes in connection with the diagnostic work accompanying group psychotherapy for neurotic maldevelopments. PMID- 3961019 TI - [Function of the blood-cerebrospinal fluid barrier and selected biochemical cerebrospinal fluid components in senile dementias of various types]. AB - Some selected CSF and serum components were determined in demental patients classified by the Hachinski test into vascular and primary-degenerative groups. As for the vascular group, the frequency distribution of the serum/CSF albumin ratios characterizing the barrier function corresponds to that of controls, in primary-degenerative cases, however, it is shifted to higher values. In vascular dementia higher CSF LAP activities pointing to actual cell damaging processes in the CNS were found. The concentrations of lactate and some trace metals in CSF and serum are not suitable for differential diagnostic purposes. PMID- 3961021 TI - [Neuromyotonic syndrome]. AB - A syndrome with constant rest activity was observed in the EMG of a 28-years-old female patient. An H-reflex was detected for normal nerve conduction velocity. Hypomagnesemia was striking among the laboratory values. Bioptic investigation yielded centralisation of nuclei, variations in the diameter of muscle fibres and a predominance of type I fibres. The findings and the response to Finlepsin point to neuromyotonic syndrome. PMID- 3961022 TI - [Cervical arteriovenous malformation of the right vertebral artery]. AB - The authors report on a cervical arteriovenous malformation in the current region of the A. vertebralis dextra. The clinical neurological deficiencies improved after ligature of this artery. Attention is drawn to problems of differential diagnosis and the differentiated application of neuroradiological methods of examination. PMID- 3961023 TI - [Does psychiatry need closed wards? Remarks on "Ethical principles and moral standards in psychiatry..."]. PMID- 3961024 TI - [Cognitive therapy of psychogenic sleep disorders: an explanatory and treatment approach]. AB - First the paper presents an explanation for psychogenous sleep disturbances, basing on coincidence of psychophysiological and biorhythmical sleep patterns with special cognitive and emotional variables. Related thereto a concept for prevention and psychotherapy of these sleep disturbances is elaborated. Both concepts content five structuring elements, standing in a circular feed back relationship: 1. subjective misconceptions about the nature of sleep, 2. dysfunctional norms and goals for the own sleep, 3. cognitive misevaluations of the experienced sleep events, 4. development of a dysfunctional self concept, 5. development of dysfunctional patterns and goals of behavior for coping sleep problems. The elements display the structure for development and diagnosis of these sleep disturbances and for the preventive and psychotherapeutic work. Finally, related to this concept, therapeutic strategies were presented, basing on cognitive and behavior therapy. PMID- 3961025 TI - [Behavior therapy of cardiac phobia--a clinical report of experiences in the training of cognitive anxiety management]. AB - We report about a psychotherapeutic approach of intervention with patients suffering of severe cardiac neurosis. The patients treated had panic attacks almost every night. The patients learned cognitive strategies in combination with a self-controlled stimulus exposition. In addition an analysis of the individual learning history was made. We found an anxious, dominant mother in 8 of 10 cases. Two patients had a foster-mother. Six married patients had a tendency of separation and a fear of separation as well. In these cases we recommended a marital therapy or an individual therapy after our hospital treatment. All treated patients lost the panic attacks; agoraphobic tendencies were reduced as well--no longer impairing their every day life. In five cases all clinical symptoms had disappeared completely. In all cases we found the improvements persisting 6 months after treatment. PMID- 3961026 TI - [Use of paradoxical procedures in behavior therapy]. AB - Paradoxical approaches to psychotherapy have reemerged with the development of family therapy. But these techniques are also pertinent to Behaviour Therapy. An historical outline is given. Indication and relevant techniques are described and illustrated with case histories. The ethics of Paradoxical Therapy are discussed. PMID- 3961027 TI - [Introduction of Goldstein therapies for disadvantaged clients in the Netherlands]. AB - In Limburg, Netherlands, a project is going on aiming to implement lower class linked skill-therapies into the regional mental health services. This article elucidates: the poor relationship that exists between contemporary psychotherapy and the lower class clients; various efforts that have been attempted to solve this problem; the basic elements of Goldstein's 'structured learning therapy'; activities and results of the Dutch 'Goldsteinproject'. PMID- 3961028 TI - Evaluating depression in alcoholics. AB - The persistence of untreated depression was evaluated in 49 severely depressed alcoholics. After 2 weeks of sobriety, 80% of patients with initial major depression by Research Diagnostic Criteria were no longer depressed. These patients improved without antidepressant medications, suggesting the need for a 2 week period of sobriety before psychopharmacotherapy for depression is instituted. Many severe depressions in actively drinking or recently sober alcoholics may represent alcohol-induced organic affective syndromes which, unlike major depressive illness, remit spontaneously with sobriety. PMID- 3961029 TI - Effects of S-adenosyl-methionine on plasma norepinephrine, blood pressure, and heart rate in healthy volunteers. AB - S-adenosyl-methionine (SAMe) is currently undergoing trials as a possible antidepressant. Because SAMe's mechanism of action is obscure and norepinephrine (NE) is often implicated in affective disorders, we studied the effects of SAMe on this neurotransmitter in volunteers. Plasma NE and 3-methoxy-4 hydroxyphenylglycol (MHPG) in the supine and standing position were studied before and after acute placebo or a single 400 mg dose of SAMe and following seven daily administrations; concomitant measures were heart rate (HR) and blood pressure. Subjects were unable to distinguish acute drug from placebo, and although chronic SAMe administration was open, they reported no behavioral effects. Standing HR and plasma NE were reduced following chronic SAMe. Qualitatively similar changes are obtained following chronic treatment with monoamine oxidase inhibitors (MAOIs). However, unlike MAOIs, chronic SAMe treatment was not associated with changes in plasma MHPG. Exaggerated standing NE is found in depressed patients; SAMe may reduce this abnormal response, providing a clue for its mechanism of action in depression. PMID- 3961030 TI - Platelet MAO concentration and molecular activity: I. New methods using an MAO B specific monoclonal antibody in a radioimmunoassay. AB - New methods for determination of specific concentration and molecular activity of monoamine oxidase (MAO) in platelets are described and evaluated in parallel with specific activity measures, performed in whole platelets and platelet extracts. Platelet MAO specific concentration is determined in platelet extracts by a radioimmunoassay, using a monoclonal antibody that recognizes human MAO B, the form that occurs in platelets, but not MAO A. All four platelet MAO measures are found to be reliable and stable, and thus are suitable for long-term comparisons of normal and clinical populations, such as those reported in Part II of this report. The new measures of enzyme concentration and molecular activity make available important information about the state of MAO B molecules in a given individual that reflects the genetic expression and control of the enzyme. PMID- 3961032 TI - Menstrual cycle affects plasma HVA. PMID- 3961031 TI - The emotional impact of mastectomy. AB - To learn about the effects of unilateral mastectomy, the emotional responses of four groups of women were compared 1-3 and 10-12 months after surgery: (1) mastectomy group (n = 125)--women who had a unilateral mastectomy for stage I or II breast cancer; (2) biopsy group (n = 65)--women who had a biopsy revealing benign breast disease; (3) cholecystectomy group (n = 75)--women who had a cholecystectomy; (4) healthy group (n = 84)--women who had not had a major surgical intervention. Measures of emotions were: (1) the SCL-90 Analogue; (2) the Global Assessment Scale (GAS); and (3) the Gottschalk-Gleser Content Analysis Scale. The mastectomy group had significantly higher mean Gottschalk-Gleser scores for total anxiety, death and mutilation anxiety, ambivalent hostility, total denial and anxiety denial, and hopefulness. Significant reductions were found in mean total anxiety, mutilation, and shame anxiety in the mastectomy group and in total, death, and mutilation anxiety in the cholecystectomy group between the two postsurgical assessments. The mastectomy group had a significantly higher mean anxiety and depression score than the healthy group on the SCL-90 at both time points. The mastectomy and cholecystectomy groups had lower emotional well-being scores on the GAS than the healthy group over both testing periods. The groups also differed in their amount of change on the GAS over time. All measures, especially the Gottschalk-Gleser scales, showed significantly more psychopathological emotional responses in the mastectomy group, somewhat less in the cholecystectomy group, and the least in the biopsy group. PMID- 3961033 TI - Premenstrual changes: a comparison of five populations. AB - Several studies have suggested that a special relationship exists between premenstrual and major affective disorders. The present report describes the incidence of reported premenstrual symptoms in women with and without prospectively confirmed premenstrual syndrome, women with bipolar or seasonal affective disorder, and controls. The inability of reported symptoms to differentiate women with and without confirmed premenstrual syndrome, as well as the reduced prevalence of reported premenstrual changes in our affective populations relative to previous reports, is discussed. PMID- 3961034 TI - The plasma dexamethasone variable in depression: test-retest studies and early biophase kinetics. AB - A dexamethasone suppression test (DST) was performed in 45 patients during depressive illness and after recovery. Thirty-one samples from patients in whom plasma cortisol was resistant to the suppressive action of dexamethasone contained significantly lower mean (+/- SD) concentrations of the test drug (0.63 +/- 0.39 ng/ml vs 1.10 +/- 0.53 ng/ml) during illness than after recovery and normalization of the DST. In a control group of 14 patients who exhibited adequate DST suppression during the depressive state and after recovery, the dexamethasone concentrations were unchanged (1.54 +/- 0.91 ng/ml vs. 1.30 +/- 0.92 ng/ml). To investigate further the influence of bioavailability or pharmacokinetics of the test drug on DST results, we conducted a catheter study during sleep in 11 endogenously depressed patients who received an oral 1.5 mg dose of dexamethasone at 11 p.m. The half-life of dexamethasone was markedly lower in five DST nonsuppressors (t1/2 = 160 +/- 33 minutes) than in six DST suppressors (t1/2 = 422 +/- 172 minutes). These preliminary results indicate that metabolism of dexamethasone should be controlled in studies evaluating the clinical utility of the DST. PMID- 3961035 TI - The concept of illness behaviour: culture, situation and personal predisposition. PMID- 3961036 TI - Rating reliability for life events and difficulties in the elderly. AB - The inter-rater reliability of Brown's measure of ongoing difficulties ('severity') is shown to be comparable with that of the measure of life events ('long-term threat') when using data from an elderly subject pool. Test-retest reliabilities for both the life event and difficulty measures are shown to be adequate if based on 'consensus' ratings. The question is raised of generalizability of the concepts of 'threat' and 'severity' across the lifespan. PMID- 3961037 TI - Self-incineration: a controlled comparison of in-patient suicide attempts. Clinical features and history of self-harm. AB - A systematic survey of in-patient accidents and injuries in an inner London hospital over 9 years established that, after incisions and overdoses, self incineration was one of the commoner methods of violent self-harm. A case controlled study of in-patient suicide attempts compared a series of 12 self incinerators with 12 patients using other methods. Irrespective of method, the suicide attempt was predominantly a psychotic act of young single people with chronic, severe disorders and considerable past parasuicide, in a setting of escalating self-harm. Younger age, greater psychiatric morbidity, absence of alcoholism, a history of childhood arson, past and current self-burning were the features specific to self-incineration, which had a 25% mortality rate. PMID- 3961038 TI - Psychiatrists' education in psychology: jackdaw or sponge? PMID- 3961039 TI - Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. AB - This study confirms the validity of a Spanish version of the General Health Questionnaire in its scaled 28-item version. The screening instrument was tested on a sample of 100 patients attending an internal medicine out-patient clinic, who were examined independently by psychiatrists standardized in the use of the Clinical Interview Schedule (CIS). The questionnaire correctly identified 85% of 'cases' with a cutting score of 6/7 (sensitivity 76.9%, specificity 90.2%), and 83% of cases with a cutting score of 5/6 (sensitivity 84.6%, specificity 82%), suggesting a discriminative power almost as good as the Spanish GHQ-60. It has the important advantage of being considerably shorter and, although the 4 subscales are by no means independent, its concurrent validity with CIS ratings suggests that they provide additional information concerning anxiety and depression. PMID- 3961040 TI - Emotional distress and satisfaction in life among Holocaust survivors--a community study of survivors and controls. AB - Results are reported from a large population study (of working people) comparing Holocaust survivors and a control group in regard to emotional distress, satisfaction in life and psychosomatic symptoms. It was found that, even 40 years after the traumatic experience, this group of survivors exhibited a slightly higher degree of emotional disorders than controls who were not under Nazi occupation during WWII. These long-term effects were usually more prominent in women than in men, and the relationship to age was minimal. PMID- 3961041 TI - Child psychiatry: the interface between clinical and developmental research. AB - Developmental psychopathology constitutes a research strategy that is concerned with questions about continuities and discontinuities over time (the developmental perspective) and over the span of behavioural variation (the psychopathological perspective). The utility of this approach is discussed in relation to childhood depression, autism and schizophrenia, and the effects of adverse life experiences. PMID- 3961043 TI - Possible determinants, correlates and consequences of high levels of anxiety in primiparous mothers. AB - Groups of highly anxious, moderately anxious and minimally anxious primiparous mothers (N = 147) were obtained on the basis of Spielberger trait anxiety scores in the postpartum period, and subjects were compared. Allocation to those groups appeared to be more likely to reflect constitutional levels of anxiety, rather than recent or current social stressors. Highly anxious mothers were distinguished on a number of presumed correlates of anxiety measured by clinical questions (e.g. terminating of anxious situations), hospital notes (e.g. mood problems noted by nursing staff) and blind rater assessments (e.g. unassertiveness). While highly anxious mothers were more likely to report more recent life events, less social support, and negative interpretations of the pregnancy, the hospital experience and the hospital staff, such variables were less discriminating when neuroticism levels were effectively controlled. This suggests an intrinsic perceptual bias, rather than that the factors were determinants. Highly anxious mothers had more delivery complications, while their babies were more likely to be dysmature and slow to suckle, features we interpret as consequences of the anxiety levels. In the postpartum period these mothers were more depressed, had more concerns about their baby, themselves and their marriage, and were less confident about coping and their parenting capacities. Such variables may be correlates or consequences of anxiety. PMID- 3961042 TI - Preserved reading and spelling ability in psychotic disorders. AB - Standard scores on tests of intelligence, memory and academic achievement were obtained from individuals with either schizophrenic spectrum disorders, mania, alcohol abuse, antisocial personality disorders or no mental disorder. The three cognitive measures were highly and positively correlated in three groups (normal controls, alcohol abusers and antisocial personality disorders), while in the schizophrenic spectrum and manic groups a pattern of average reading and spelling achievement was contrasted with lower intelligence and memory quotients. It was suggested that reading and spelling ability are more accurate predictors of premorbid ability in psychotic disorders than other psychometric scales. This parallels previous findings with organic dementias and raises questions about possible shared aetiological bases between dementias and psychoses. PMID- 3961044 TI - Visual flicker in depression: response criteria, confidence ratings and response times. AB - Differences in response criterion and sensory sensitivity to visual flicker among major depressive patients, dysthymic patients, and normal controls were investigated. Also, signal detection confidence ratings and response times were compared. The results indicated that major depressive patients responded more conservatively (i.e. were less willing to respond 'flicker') than either of the other groups. The groups did not differ significantly on a criterion free measure of flicker sensitivity. The major conclusions are: previously reported visual flicker differences between depressed patients and normal controls were probably due to the more conservative response criterion of the patients and not to flicker sensitivity differences between groups; and confidence ratings and response times yield similar conclusions with respect to visual flicker sensitivity and response criterion. Therefore, interpretations concerning a sensory or perceptual deficit in depression must take into account the differences in response criterion between depressed patients and normal controls. PMID- 3961046 TI - At risk drinking among general practice attenders: validation of the CAGE questionnaire. AB - The CAGE questionnaire was used to screen for at risk drinking among attenders to an inner London health centre. The CAGE functioned most effectively at a cut-off point of two or more affirmative replies, with a sensitivity of 84%, a specificity of 95% and a positive predictive value of 45%. The usefulness of this instrument for screening in general practice is discussed. PMID- 3961045 TI - Transmissible and non-transmissible neurodegenerative disease: similarities in age of onset and genetics in relation to aetiology. AB - In only a few cases is transmissible dementia known to have been acquired by infection from a source outside the individual; the remaining cases can be classified as sporadic, loosely familial, or autosomal dominant. Each group has a characteristic mean age of onset. A range of neurodegenerative diseases (including Alzheimer-type dementia and amyotrophic lateral sclerosis) can also be classified in this way, with similar characteristic mean ages of onset. The emergence of these diseases in later middle age, and the interdependence of age of onset and the type of familial occurrence suggest that these pathological processes are related to those genetic mechanisms which determine senescence. It is argued that the majority of cases of transmissible dementia arise, not from infection, but from the expression of endogenous virogene sequences as part of the aging processes. PMID- 3961047 TI - Computerized tomographic scan changes in early schizophrenia--preliminary findings. AB - Thirty patients who fulfilled DSM-III criteria for schizophrenia but who were within 2 years of presentation were compared with 26 age-matched normal volunteers with respect to CT scan appearances. In the index group the ventricle brain ratio (VBR) was significantly greater. The VBR values were positively correlated with average alcohol intake and with early physical trauma, and negatively correlated with a family history of schizophrenia. The implications of these findings are discussed in the context of the present uncertainty about the meaning of CT scan findings in schizophrenia. PMID- 3961049 TI - Controlled and automatic information processing in senile dementia: a review. AB - The evidence on cognitive decline in senile dementia is reviewed with respect to the distinction between controlled and automatic processing. It is argued that controlled processing, which requires the attentional resources of the individual, declines in early senile dementia. However, automatic processing, which does not require attentional resources, is well maintained until late in the disorder. Implications of this view are drawn for the development of effective screening instruments which can be used for the early detection of dementia in the general population. PMID- 3961048 TI - Investigation of 'weight pathology' of 58 mothers of anorexia nervosa patients and 204 mothers of schoolgirls. AB - 'Weight pathology'--defined by Kalucy et al. (1977) as 'deviations in weight, shape, eating behaviour and activity'--has been hypothesized to be unduly common in families with anorexia nervosa. It was investigated in this study by means of questionnaires evaluating both weight history and attitudes towards weight related matters in 58 mothers of anorexia nervosa patients and 204 mothers of schoolgirls of similar age and socioeconomic status (SES). No support was found for the hypothesis. A family history of aberrant weight and mother's current weight and past weight histories showed no significant differences between the groups. 142 other mothers of schoolchildren and 446 attenders at Weight Watchers also completed the questionnaire on attitudes towards weight-related matters. Mothers of patients showed a lower concern on all scales than did all other groups. The findings are discussed in relation to earlier controlled studies of family factors in anorexia nervosa. PMID- 3961050 TI - Sustained attention under thermal stress. PMID- 3961051 TI - Neural dynamics of word recognition and recall: attentional priming, learning, and resonance. PMID- 3961052 TI - Reading strategies for children and adults: a quantitative model. PMID- 3961054 TI - Stress scores of workers by sex and age. PMID- 3961053 TI - Children's attitudes toward the mentally ill: a developmental analysis. PMID- 3961055 TI - Aggressive responses of adolescents to an hypothetical frustrative situation. PMID- 3961056 TI - Anxiety, self-confidence, jealousy, and romantic attitudes toward love in Italian undergraduates. PMID- 3961057 TI - Affect intensity and self-consciousness in college students. PMID- 3961058 TI - Drinking among college students: are consumption rates increasing? PMID- 3961059 TI - Preliminary study of internal dialogue in a training setting. PMID- 3961060 TI - Using group decision to reduce adolescent girls' smoking. PMID- 3961061 TI - National character and rates of personal violence (suicide and homicide). PMID- 3961062 TI - Health-seeking behaviors: public versus public health perspectives. PMID- 3961063 TI - Delusional thinking in psychotics: correlates of religious content. PMID- 3961064 TI - Personal control as a moderator variable of life stress: preliminary inquiry. PMID- 3961065 TI - Physiological effects of petting a companion animal. PMID- 3961067 TI - Psychological and social integration for those labeled schizophrenic. PMID- 3961066 TI - Diagnostic and treatment differences among five ethnic groups. PMID- 3961068 TI - Relationship between family socioeconomic status and cognitive/affective responses to the threat of nuclear war. PMID- 3961069 TI - Selection of the appropriate number of factors: a case of questionable dimensions. PMID- 3961070 TI - College students' drinking problems: 1982-1985. PMID- 3961071 TI - Negative life stress and anxiety: problem solving as a moderator variable. PMID- 3961072 TI - Threat as a determinant of alcohol-related aggression. PMID- 3961074 TI - Primary and secondary illusory control and risk-taking in gambling (roulette). PMID- 3961073 TI - Relationship between neuroticism and circadian rhythms. PMID- 3961075 TI - A possible confounding variable in different versions of the "aggression machine" when used in research on alcohol. PMID- 3961076 TI - Serial organization during posthypnotic amnesia using a modified version of the Stanford Hypnotic Susceptibility Scale. PMID- 3961077 TI - Child molestation and homosexuality. PMID- 3961078 TI - Modal personality and values of medical students. PMID- 3961079 TI - Marihuana use and personality. PMID- 3961080 TI - Initial and follow-up psychological testing on a group of patients with multiple personality disorder. PMID- 3961081 TI - Borderline personality traits in psychiatric inpatients. PMID- 3961082 TI - Respiratory distress during panic attacks associated with agoraphobia. PMID- 3961083 TI - Use of animals in the rehabilitation of psychiatric inpatients. PMID- 3961085 TI - Psychological processes mediating persuasion-inhibiting effect of forewarning in fear-arousing communication. PMID- 3961084 TI - Responses of parkinsonian patients to a successive free word-association test. PMID- 3961086 TI - Agoraphobia: a superstitious conditioning perspective. PMID- 3961087 TI - [Marriages of females with cancer--realities and wishful thinking in psychosomatic cancer research]. PMID- 3961088 TI - [Tumor immunology and psychoimmunology as principles for psycho-oncology]. PMID- 3961089 TI - [Role of the oncologist in the psychologic treatment of his patients]. PMID- 3961090 TI - [The question of causality in psychosocial cancer research]. PMID- 3961091 TI - Controlled study of psychotherapy in chronic peptic ulcer disease. PMID- 3961092 TI - Conversion disorders on a child psychiatry consultation service. PMID- 3961093 TI - Pregnancy, psychotropic drugs, and psychiatric disorders. PMID- 3961094 TI - Seizure and mania after high intake of aspartame. PMID- 3961095 TI - The intensity of competition versus its importance: an overlooked distinction and some implications. AB - The intensity of competition is a physiological concept, related directly to the well-being of individual organisms but only indirectly and conditionally to their fitness, and even more indirectly to the evolution of populations and the structure of communities. The importance of competition is primarily an ecological and evolutionary concept, related directly to the ecology and fitness of individuals but only indirectly to their physiological states. The intensity of competition is not necessarily correlated with the intensities of predation, disturbance, abiotic stress, or other ecological processes. The importance of competition is necessarily relative to the importances of other processes. Intensity refers primarily to the process of present competition, whereas importance refers primarily to the products of past competition. The distinction between the intensity and the importance of competition clarifies two long standing ecological debates. Some ecologists have proposed that competition is greater in more stressful habitats, others the opposite, and still others that no such relationship exists. Evidence cited to refute or support these positions often confuses intensity and importance. Distinguishing between them focuses questions more sharply and indicates what sorts of new evidence should be sought. The more widely known debate over the prevalence of competition as an agent of community structure is a debate about the importance of competition, but evidence about the intensity of competition has often been used by both sides. We argue that intensity and importance need not be correlated, and so measurements of the intensity of competition are not directly relevant to this debate. This distinction also generates testable hypotheses and suggests directions for research. For example, we hypothesize that competition can be unimportant even if it is very intense: no such hypothesis is possible unless importance is distinguished from intensity. We discuss the application of these ideas to methods and theories used to study competition, ecological communities, and the evolution of competitive ability. We advocate a research approach that presumes multiple, interacting causes, including competition, affecting community structure, and we show how the distinction between intensity and importance helps to make this feasible. PMID- 3961096 TI - Radiosensitization by acetohydroxamic acid derivatives of 3-nitropyrazole. AB - A series of acetohydroxamic acid derivatives of 3-nitropyrazole were synthesized and evaluated as radiation sensitizing agents in vitro to test the hypothesis that any increase in sensitizing efficiency over that predicted from electron affinity considerations would be proportional to the rate of isocyanate (R--N = C = O) liberation subsequent to a Lossen rearrangement. EMT-6/Ro cells were exposed to the drugs for 1 h prior to irradiation under aerobic and hypoxic conditions. Sensitizer enhancement ratios (SER) were determined for each compound, and corresponding C1.6 values were plotted as a function of reduction potential (E 1/2). Substitution of acetohydroxamates at the N-1 position of the parent nitropyrazole produced a series of compounds with sensitizing potentials exceeding (9- to 50-fold) those predicted based on their electron affinities. While the current studies do not rule out isocyanate involvement in the enhanced sensitization, they suggest that the enhanced sensitizing ability was not directly proportional to the rate of the Lossen rearrangement. The data suggest that the addition of an acetohydroxamic acid side chain can effectively enhance the sensitizing ability of electron-affinic compounds in excess of that associated with redox potential. PMID- 3961097 TI - Radiation-induced hemopoietic death in mice as a function of photon energy and dose rate. AB - Radiation-induced hemopoietic death was measured in mice exposed to photons of four different energies: 250-kVp X rays, 60Co gamma rays (1.25 MeV), and 6- and 25-MV photons from a linear accelerator. For each radiation source, the lethal dose which killed 50% of the population in 30 days (LD50/30) associated with the hemopoietic syndrome was determined in groups of mice exposed to graded doses from 600 to 1150 cGy at dose rates of 20, 40, and 80 cGy/min. The calculated LD50/30 values for 25 and 6 MV were significantly different from each other at all exposure rates while no difference was observed between 6 MV and 60Co. Using 60Co gamma rays as the standard, the relative biologic effectiveness was as follows: 250 kVp greater than 25 MV greater than 6 MV = 60Co. The data suggest that there may be a greater damage to tissue within the marrow cavities following exposure to very high megavoltage radiation, a factor which must be considered with the increasing utilization of linear accelerators in the clinic and laboratory. PMID- 3961098 TI - Microwave facilitation of methylatropine antagonism of central cholinomimetic drug effects. AB - Pilocarpine-induced hypothermia and oxotremorine-induced tremors in mice are central cholinomimetic drug effects that are readily blocked by the muscarinic antagonist atropine. However, the quaternary ammonium derivative of atropine, methylatropine, is unable to block these cholinomimetic drug effects by virture of its inability to penetrate the blood-brain barrier (BBB) and blood-cerebral spinal fluid barrier (B-CSFB). Dose-response curves for pilocarpine and oxotremorine effects are not appreciably affected either by pretreatment with methylatropine (1.0 mg/kg) or by exposure to moderate-level microwave irradiation (2.45 GHz, 23.7 W/kg, CW, 10-min exposure). However, in mice receiving both the methylatropine pretreatment and microwave irradiation, the dose-response curves for both pilocarpine and oxotremorine effects were significantly shifted to the right, signifying a central anticholinergic action by methylatropine. These data indicate that a single acute exposure to a thermogenic level of microwave irradiation facilitates methylatropine antagonism of centrally mediated cholinomimetic drug effects. One possible explanation for this observation is that microwave radiation may enhance passage of quaternary ammonium compounds like methylatropine across the BBB and B-CSFB. PMID- 3961099 TI - Radiosensitivity of murine hemopoietic colony-forming units assayed in situ in the rib and in other marrow sites. AB - The radiosensitivity of murine hemopoietic colony-forming cells, which produce colonies in situ and which were counted at Day 8 after irradiation in sections of the femur, humerus, sternum, and spleen, is characterized by a D0 value of 91 +/- 9 cGy. The radiosensitivity of such cells in the rib was assessed using a new technique measuring regeneration or ablation of marrow in transverse sections of ribs observed at Day 8 after irradiation. The mean D0 value over a range determined using several different criteria was 108 cGy. These results provide evidence for the common assumptions that radiosensitivity measured using conventional transplantation assays reflects radiosensitivity in situ, and that the radiosensitivity of stem cells in different medullary marrow sites is similar. The techniques could be used with other species where assays for stem cells are not available. PMID- 3961101 TI - Re: Private communication from a reviewer. PMID- 3961100 TI - Macrophage depletion of mouse lung following inhalation of 239PuO2. AB - Changes in the free-cell population of the lungs of two strains of mice (SAS/4 and CBA/H) were studied up to 4 months after inhalation exposure to a sized fraction of 239PuO2 particles (1.5 micron AMAD) to give initial alveolar depositions (IADs) ranging from 17 to 810 Bq. A sample of the free-cell population of the lung was recovered by bronchoalveolar lavage, and a radiometric method was used to estimate the total number of pulmonary alveolar macrophages (PAM) in the lung. The response of the lung to 239PuO2 was characterized by an initial, dose-dependent depression in the total number of PAM following an IAD as low as 50 Bq. At IADs greater than 150 Bq, the initial depression continued for longer, merging into a chronic phase in which the PAM were larger and were accompanied by a minor infiltration of leukocytes. These findings were confirmed by histology, which also revealed focal accumulations of Type II pneumocytes. The results indicate that inhaled alpha-emitting particles are effective at producing a depletion in the alveolar macrophage population at relatively low IADs and that chronic effects on the cells can be produced by higher concentrations. PMID- 3961102 TI - Effect of pH and cell cycle progression on development and decay of thermotolerance. AB - Synchronous Chinese hamster ovary cells were heated in G1 and incubated at 37 degrees C at pH 6.75 or pH 7.4 before they were heated a second time. The magnitude and rate of development and decay of thermotolerance were greatly reduced at pH 6.75. This was also observed for asynchronous cells. Furthermore, the heat-induced delay in cell cycle progression was greatly enhanced at low pH and correlated with the reduced rate for development and decay of thermotolerance. However, studies with [3H]TdR to kill cells entering S phase showed that the decay of thermotolerance is relatively independent of the cell cycle. Therefore, low pH apparently slows many cell processes, including those associated with heat-induced cell cycle delay and the rate of development and decay of thermotolerance. PMID- 3961103 TI - Correlations between 31P NMR spectroscopy and 15O perfusion measurements in the RIF-1 murine tumor in vivo. AB - The tumor physiological environment is one of the least understood and most important factors in determining the response of solid tumors to cancer therapy. To examine several important characteristics of the tumor physiological environment we have used in situ photon activation-15O decay measurements (perfusion characteristics) and 31P surface coil-NMR spectroscopy (metabolic characteristics) to observe in vivo subcutaneous RIF-1 tumors grown in female C3H/Anf mice. The following correlations between the 15O perfusion characteristics and the 31P NMR metabolic characteristics in individual tumors were observed: a negative correlation between pH, as measured by NMR (pHNMR), and the inorganic phosphate to nucleosides triphosphate peak height ratio (Pi:NTP); for the well-perfused fraction of the tumor there is a positive correlation with both pHNMR and the phosphocreatine to nucleosides triphosphate peak height ratio (PCr:NTP), and a negative correlation with Pi:NTP. These correlations are interpreted as evidence for a direct relationship between the distribution of cellular physiological environments and the tumor metabolic state. Because these physiological characteristics affect tumor response to various therapeutic modalities and both measurements can be made on humans, it is suggested that these techniques may be of prognostic value in the clinical management of human cancer. PMID- 3961104 TI - Lack of association between glutathione content and development of thermal tolerance in human fibroblasts. AB - Thermal tolerance is a transient state of heat resistance occurring in cells and tissues after exposure to sublethal heat or certain chemicals. Although the mechanism of such resistance is unknown, it has been recently shown that preceding its development, cellular glutathione (GSH) levels rise. We have used a glutathione synthetase-deficient [GSH(-)] human fibroblast line to study the relationship between glutathione content and thermal tolerance. The GSH(-) cells had approximately 6% as much GSH as normal fibroblasts. Normal and GSH(-) fibroblasts showed similar survival after exposure to 45 degrees C. Exposure of normal fibroblasts to heat (45 degrees C for 15 min) led to a prompt rise in cellular GSH content as well as development of transient thermal tolerance. Similar treatment of GSH(-) fibroblasts produced no change in the very low GSH levels but was associated with a degree of thermal tolerance similar to that of normal cells. Thermal tolerance decayed more rapidly in GSH(-) cells than in normal fibroblasts. We conclude that the development of thermal tolerance in human fibroblasts is independent of GSH content. PMID- 3961105 TI - Effect of hyperthermia on the plasma membrane structure of Chinese hamster V79 fibroblasts: a quantitative freeze-fracture study. AB - Hyperthermia in the range 41-45 degrees C can induce wide biochemical, physiological, and morphological changes in mammalian cells both in vivo and in vitro. In general, its effects on membranes, particularly on the plasma membrane, are still poorly understood. To investigate the effects of heat on this cell structure, Chinese hamster V79 fibroblasts were exposed to 43 degrees C hyperthermia for 1 h, immediately fixed with glutaraldehyde after treatment, and freeze-fractured for electron microscopic examination. Particular attention was given to the density and size of intramembranous particles (IMPs) on both protoplasmic (PF) and external (EF) fracture faces of the plasma membrane. The quantitative study performed by an interactive image analyzer on the IMPs, generally reported as plasma membrane proteins, showed in heat-treated cells a statistically significant increase in their density and size on both fracture faces. The differences observed demonstrate that in our experimental conditions, hyperthermia in plasma membranes produces structural changes whose biological significance has to be clarified. Moreover, our findings seem to support recent data indicating an involvement of membrane proteins in the cell response to hyperthermia. PMID- 3961106 TI - Repair of gamma-ray-induced DNA base damage in xeroderma pigmentosum cells. AB - The repair of DNA damage produced by 137Cs gamma irradiation was measured with a preparation from Micrococcus luteus containing DNA damage-specific endonucleases in combination with alkaline elution. The frequency of these endonuclease sensitive sites (ESS) was determined after 54 or 110 Gy of oxic irradiation in normal and xeroderma pigmentosum (XP) fibroblasts from complementation groups A, C, D, and G. Repair was rapid in all cell strains with greater than 50% repair after 1.5 h of repair incubation. At later repair times, 12-17 h, more ESS remained in XP than in normal cells. The frequency of excess ESS in XP cells was approximately 0.04 per 10(9) Da of DNA per Gy which was equivalent to 10% of the initial ESS produced. The removal of ESS was comparable in XP cells with normal radiosensitivity and XP3BR cells which have been reported to be moderately radiosensitive. PMID- 3961107 TI - DNA lesions in hyperthermic cell killing: effects of thermotolerance, procaine, and erythritol. AB - When HeLa S3 cells were subjected to 45 degrees C hyperthermia, DNA lesions were detected by the use of the alkaline unwinding/hydroxylapatite method. The number of lesions formed was not affected when the cells were made thermotolerant by either an acute (15 min 44 degrees C + 5 h 37 degrees C) or a chronic (5 h 42 degrees C) pretreatment before 45 degrees C hyperthermia. The presence of 10 mM procaine (heat sensitizer) or 0.5 M erythritol (heat protector) during hyperthermia also had no effect on the rate of formation of heat-induced alkali labile DNA lesions. These observations do not support a concept where DNA lesions are considered to be the ultimate cause of hyperthermic cell killing. Both drugs, however, influenced the rate of repair of radiation-induced strand breaks when present during preirradiation heat treatment. We conclude that the initial number of heat-induced alkali labile DNA lesions is not directly related to cell survival. It cannot be excluded, however, that differences in posthyperthermic repair of these lesions may lead to a positive correlation between residual DNA damage and survival after the different experimental conditions. PMID- 3961109 TI - Magnetic resonance imaging may influence treatment of AIDS. PMID- 3961108 TI - Protection of Chinese hamster ovary cells from hyperthermic killing by cycloheximide or puromycin. AB - Cycloheximide (CHM) and puromycin (PUR) were used at various concentrations up to maxima of 10 micrograms/ml and 100 micrograms/ml, respectively, which inhibited protein synthesis by 95% without any cytotoxicity. The drugs were added to the cells for a maximum period of 7 h, with various combinations for treatment before, during, and after heating. Maximum protection, i.e., a 10,000-fold increase in survival from 5 X 10(-6) to 5 X 10(-2) after 4 h at 43 degrees C, required both 1-2 h of treatment before heating and 1-2 h of treatment during heating. For treatments at 45.5 degrees C, the protection was less, i.e., a 100 fold increase in survival from 10(-5) to 10(-3). Little or no protection was observed if after treatment, the drug was removed before heating, or if the drug was added at the start of heating and left on for 5 min to 3 h after heating. For both drugs, the amount of protection increased as inhibition of protein synthesis increased. However, the amount of protection from the drugs was the same only at about 95% inhibition; at 60-85% inhibition, CHM afforded more protection than PUR. Therefore, the modes of action of the drugs might be common at high drug concentrations, but different when intermediate concentrations are used. PMID- 3961110 TI - Population room dose in radiodiagnosis: its assessment and importance. PMID- 3961111 TI - New radiation quantities for practical use in radiological protection. PMID- 3961112 TI - Patients and radiotherapy. 3. Patients' experiences after discharge. PMID- 3961113 TI - Patients and radiotherapy. 4. How can patients be helped. PMID- 3961114 TI - The place of rotational tomography in dentistry. 2. Orthodontics. AB - The OPG view is the radiograph that gives the most information to the orthodontist. If an OPG cannot be taken the alternative is: Two oblique laterals (Figure 11) These views must show from upper canine to lower third molar. Frequently this is not possible and additional intra-oral views have to be taken to show the upper canines. As the oblique lateral views are difficult to position, the OPG is preferred. However, it must be noted that the oblique lateral, at its best, is clearer and has a greater depth of field. Upper standard occlusal and vertex occlusal: Figures 12a and 12b show the difference in technique between the two occlusal views. As can be seen the vertex occlusal is a true view of the shape of the upper arch and the relative positions of the teeth. A cassette is required to take this view. Cephalometric lateral skull is a lateral view of the jaws and facial bones taken with the patient in a craniostat (Figure 13). Subsequent films can then be taken in the same position. A lead shield must be used down the front of the face or placed on the source of radiation so that the soft tissues can be seen. PMID- 3961115 TI - A paediatric accessories pack. PMID- 3961116 TI - Computer assisted radiology. Report of the international seminar held in the Federal Republic of Germany. PMID- 3961117 TI - Planning for change in a department of radiodiagnosis. PMID- 3961118 TI - Supplementary projection to demonstrate the thoracic inlet. PMID- 3961119 TI - Thyroid protection--neonatal chest radiography. PMID- 3961120 TI - Radiography for the spinally injured. PMID- 3961121 TI - A professional public relations viewpoint. PMID- 3961122 TI - Use of computers in radiology. PMID- 3961123 TI - Automation of film library functions. AB - The use of computer routines in the film library has resulted in tremendous improvements in the prompt interpretation of radiologic studies with comparison studies and in the furnishing of radiologic studies on demand to referring physicians. The four most important aspects of this automation are the simultaneous immediate availability of patient information upon inquiry at a terminal; maximum advance notification of the need for a new folder or a master folder on a returning patient; master folder, subfolder, and examination folder tracking; and the management of extradepartmental loans. PMID- 3961124 TI - Information integration for the imaging specialist. AB - Medical imaging is an information business of rapidly increasing complexity. Imaging practice and imaging information support systems are inseparable. How both operate and how they ought to operate can be considered productively in terms of system theory. This concluding article on some practical system principles, therefore, presents one way of thinking about the rest of the volume. PMID- 3961125 TI - Radiology reporting. AB - Several different computer methods have been developed to assist in the production of radiology reports. Some systems require the radiologist to interact directly with the computer; in other departments, it is the transcriptionist who types the report into a computer terminal. Automated reporting systems, if they are well designed, offer a significant benefit to most departments, providing an efficient method to produce, store, and distribute radiology reports. PMID- 3961126 TI - Monitoring department efficiency and quality. AB - Effective radiology management requires accurate, timely data about the ongoing operation of a department. Computers provide a method to assemble detailed information, and well-designed management reports can then provide the department administrator with summarized information that can be useful in identifying problems and initiating changes to reduce costs and improve the quality of patient care. PMID- 3961127 TI - Digital image management: networking, display, and archiving. AB - The requirements for implementing a radiology imaging network are similar to those for local area networks now being designed for other purposes to manage large data films. A radiology department serving a 500-bed hospital generates about 927 megabytes of digitally formatted data per working day. These data are expected to be on line for the patient's hospitalization period. The retrieval rate of these data among the interactive diagnosis display stations requires data throughput rates of between 2 and 5 megabits per second. This throughput rate requires signaling rates of between 20 and 50 megabits per second. Analog hard copy generation of the images on the network is required by the referring physician for selected images that support the consultation report. Digital laser recorders using paper may be quite satisfactory. Long-term archiving must be low in cost and requires a database scheme capable of managing more than a terabyte of image data. Radiology networks must be required to bridge with other hospital information systems. PMID- 3961128 TI - The registration and scheduling processes. AB - The entry of patient information via a computer registration system eliminates the manual and repetitive handling of patient information in many different operations. Present scheduling systems range to the very sophisticated that not only smooth peaks and valleys but also eliminate examination conflicts and unnecessary, similar, and duplicate examinations to increase departmental productivity using the existing radiographic rooms and technologic staff. PMID- 3961129 TI - Teleradiology. AB - Teleradiology refers to the transmission of radiographic images from one location to another. Most of the work to date has involved scanning of conventional radiographs at clinics and other medical facilities with no full-time radiologist and transmitting the images to a medical center or hospital, where they are viewed on a television monitor and interpreted by a diagnostic radiologist. In this article, the author describes the 1982 and 1984 Teleradiology Field Trials, the objectives of which were (1) to compare the quality of film and video images in the field, which involved determination of sensitivity, specificity, and overall accuracy under both sets of viewing conditions; (2) to evaluate the reliability, maintenance, and communication functions of the teleradiology system; (3) to determine the costs involved in developing such a system and for day-to-day operation; and (4) to formulate recommendations for hardware, software, communication protocols, operating procedures, staff qualifications, and training requirements for future systems. Today, commercially available systems include high-speed digitization of radiographs, data compression, local storage, automatic transmission, selective retrieval, image enhancement, and interfacing with conventional computer systems. PMID- 3961130 TI - Visual perception and image display terminals. AB - It should be clear that there is no prescription for an ideal picture terminal or for an ideal image work station. Image informativeness, the ability to transmit the relevant diagnostic information to the viewer, is the most important medical consideration that has an impact on the individual patient, but short of doing extensive observer performance studies, there is no way of being absolutely sure that any given display method is transmitting visual information optimally. Certain principles are clear, however. Pixel clutter should be eliminated, and stochastic noise should be minimized. Contrast should be maximized, but there must be a rational relationship between the intensity of the stored image and the luminance of the displayed image. In my opinion, there should be a monotonically increasing relationship. Cross-sectional images and projection images, especially those of large body parts such as the chest, may not be analogous with regard to the method for contrast enhancement. Windowing, which works well for cross sectional images, may produce bizarre appearances in projection images because of the nonlinearities in image intensity that are caused by overlapping structures. There is little objective information about the best format for displaying single images of large body parts or multiple images of any type. Although the development of picture terminals will undoubtedly be driven by economics and by the available technology, it might prove very fruitful to make the effort required to define the specifications for a picture terminal on the basis of the optimal transfer of visual information. Fortunately, people are highly adaptable and can learn to use almost anything to their advantage, but it would be a pity if digital image readers of the future have to decide which terminal or station is best on the basis of image aesthetics rather than diagnostic performance. PMID- 3961131 TI - Office automation. AB - By now, the term "office automation" should have more meaning for those readers who are not intimately familiar with the subject. Not all of the preceding material pertains to every department or practice, but certainly, word processing and simple telephone management are key items. The size and complexity of the organization will dictate the usefulness of electronic mail and calendar management, and the individual radiologist's personal needs and habits will determine the usefulness of the home computer. Perhaps the most important ingredient for success in the office automation arena relates to the ability to integrate information from various systems in a simple and flexible manner. Unfortunately, this is perhaps the one area that most office automation systems have ignored or handled poorly. In the personal computer world, there has been much emphasis recently on integration of packages such as spreadsheet, database management, word processing, graphics, time management, and communications. This same philosophy of integration has been applied to a few office automation systems, but these are generally vendor-specific and do not allow for a mixture of foreign subsystems. During the next few years, it is likely that a few vendors will emerge as dominant in this integrated office automation field and will stress simplicity and flexibility as major components. PMID- 3961132 TI - [Factors determining the detection of detail in x-ray images]. PMID- 3961133 TI - [Clinical evaluation of a combination of radiocardiography and radiopulmonography for studying the pulmonary circulation]. PMID- 3961134 TI - [Experimental tests during the development of a new high-density contrast medium (Falibaryt HD) for double-contrast examination of the stomach]. PMID- 3961135 TI - [Relief imaging of the colonic mucosa using Falibaryt]. PMID- 3961136 TI - [Diagnostic quality criteria for x-ray examinations]. PMID- 3961137 TI - [Quality assurance and quality control in x-ray diagnosis]. PMID- 3961138 TI - [Quality problems of x-ray diagnosis from the medical point of view]. PMID- 3961139 TI - [Analysis of a quality assurance program]. PMID- 3961140 TI - [Measurement and control of x-ray tube voltage in clinical radiologic practice--a contribution to quality control in x-ray diagnosis]. PMID- 3961141 TI - [Measurement of dose output from medical x-ray diagnostic equipment]. PMID- 3961142 TI - [Measurement of objective parameters of image quality of film-screen combinations]. PMID- 3961143 TI - [Procedure for optimizing radiation exposure during the use of ionizing radiation in medicine]. PMID- 3961144 TI - [Image quality measurements on x-ray image-enhanced television links]. PMID- 3961145 TI - [Estimation of organ doses during standardized x-ray examinations based on ICRP Report 34]. PMID- 3961146 TI - [Check lists for the acceptance of new x-ray equipment]. PMID- 3961147 TI - Using the same exposure factors for wet and dry casts. AB - This article presents laboratory and clinical findings that suggest the exposure factors for wet and dry casts should be the same and the selection of factors should be based on cast thickness rather than water content. PMID- 3961148 TI - Reporting incidents with medical devices: procedures for radiologic technologists. AB - Because of some fairly new rules established by the Federal government, the judgment of radiologic technologists concerning incidents with medical devices has become extremely important. This article explains the rules and their consequences, describes the responsibilities of technologists to report incidents, and includes a checklist for technologist use when submitting a report. PMID- 3961149 TI - The Grenz Ray technique for painting analysis. AB - A Grenz Ray unit was used in conjunction with standard medical radiographic film to accomplish a detailed analysis of a painting from the 16th century. This procedure demonstrates the application of basic radiographic technique to a nonmedical field. The resulting radiographic analysis demonstrated the required information and saved the museum time and money. PMID- 3961150 TI - Breast protection during intravenous pyelography. PMID- 3961151 TI - Humanized care: a professional responsibility. PMID- 3961152 TI - [Examination and patient management in x-ray diagnosis using a computerized hospital communication system]. AB - Concept, realization and our 2-year experiences in the routine use of a computerized data-processing communications system supporting the central radiology department in a 1,625-bed, municipal hospital are discussed. Via the hospital ward-linked terminal network, routine X-ray examination is so ordered that individual medical case information is provided, which certifies qualified clinical and diagnostic procedure along with good patient preparation and transportation. Complete information and documentation are also ensured. It was shown that good motivation among involved radiologists and their close working association with other departments are mandatory from the start to maintain exact time schedules and satisfactory completion of ordered X-ray procedures. Subsequently, the assistence of computerized data processing is accepted for routine use, as time goes by, insofar as it is appropriate by used. PMID- 3961153 TI - [X-ray and endoscopic diagnosis of ulcerative colitis and Crohn disease]. AB - The indication for radiologic or endoscopic examinations in ulcerative colitis and Crohn's disease depends on the stage of the disease. Advantages of the colonoscopy are the possibility to take biopsies, the coloured few of lesions and the avoidance of X-rays in the management of young patients. Radiology is superior to endoscopy in estimating shortening of the bowel, stenoses and fistulas. PMID- 3961154 TI - Spontaneous aorto-cisterna chyli anastomosis. AB - A case of a spontaneous aorto-cisterna chyli communication is presented in a 65 year old patient who was admitted to the Hospital with severe abdominal pain simulating a dissecting aneurysm of the aorta. The diagnosis was suspected on a CT examination and established by a free flow aortogram and selective catheterization of the cisterna chyli through the aorta. PMID- 3961155 TI - Carcinoid infiltration and fibroplastic changes of the mesentery as a cause of malabsorption. AB - The presentation of carcinoid involvement of the mesentery is described, with clinical manifestation of severe malabsorption: angiographically it resembled retractile mesenteritis. The special biologic activity of the carcinoid cells inducing fibroblastic activity with secondary alterations of vascular, lymphatic and neural structures of the mesentery is discussed in relation to the altered physiology and morphology of the intestine, causing the clinical picture of sprue. PMID- 3961156 TI - [Primary coronary artery fistula]. AB - We report a primary congenital coronary artery fistula with left-to-right shunt to the coronary sinus in a 71 year old female. The angiographic proof was by supravalvular aortography. PMID- 3961157 TI - [CT diagnosis of traumatic injuries of the temporal bone]. AB - 73 patients with 78 fractures of the temporal bone were examined by high resolution computed tomography (CT). Analysis of the CT-findings disclosed 55 longitudinal, 12 transverse, 8 combined and 3 atypical fractures. For determination of the fracture type, axial sections usually proved sufficient. However, for precise topographic analysis of the course of the fracture additional coronal sections were necessary in most of the cases. In the radiologic evaluation of temporal bone fractures detection of associated complications is clinically important since these can be surgically corrected. In this series 20 lesions of the ossicular chain were demonstrated by the combined performance of axial and coronal sections and sagittal reformations. High resolution CT demonstrated a lesion of the facial nerve canal in 79% of a patient group with traumatic facial nerve palsy. The most frequent site of injury of the facial nerve canal was the region of the geniculate ganglion. With the use of metrizamide-CT-cisternography the site of cerebrospinal fluid leakage was demonstrated in 7 of 9 patients with liquorrhea. It is concluded that high resolution CT is the radiologic method of choice for both topographic evaluation of temporal bone fractures and detection and precise localization of fracture complications. PMID- 3961158 TI - [Pure osteoblastic metastases of a bladder carcinoma]. PMID- 3961159 TI - [X-ray diagnostic procedures for orbital tumors]. AB - The combination of sonography (A and B mode) and computed tomography with direct axial and coronal cuts allows excellent differentiation of almost all orbital tumors. At the same time it significantly increases information about the lesions' etiology. PMID- 3961161 TI - [Diagnostic imaging potentialities of nuclear resonance tomography. Changes in vertebrae, ligaments and intervertebral disks in comparison with computed tomography]. AB - This is a study of 49 patients with lesions of the spine excluding primary tumors of the spinal cord. All patients were examined by computed tomography and magnetic resonance imaging. Comparing both methods we observed slight diagnostic advantages for magnetic resonance imaging in inflammatory and neoplastic disease. Especially for evaluation of the spinal cord and subarachnoid space MR-imaging is far superior to computed tomography. PMID- 3961160 TI - [Radiological contribution to the treatment of primary and secondary liver tumors]. AB - The prognosis of patients with primary and secondary liver tumors has been improved recently by more aggressive operative, chemotherapeutic and embolization treatments. In a personal series of 40 patients with liver metastases from colorectal cancer, regional intra-arterial chemotherapy was superior to systemic intravenous treatment, with a tumor remission rate of 66% in comparison to 48% of the cases. But the benefit of intra-arterial chemotherapy is still questionable considering the higher complication rate and the absence of prognostic data of the procedure. PMID- 3961163 TI - New concepts in the non-Hodgkin lymphomas: radiologic implications. AB - Non-Hodgkin lymphomas are a heterogeneous group of neoplasms believed to be derived in the majority of cases from a common ancestor, the lymphocyte. The clinical and radiologic implications of the newer concepts in the classification, staging, and treatment of these neoplasms form the basis for this review. The disease course, staging requirements, and treatment strategies are determined by histologic classification, prognostic grade of the tumor, disease presentation in a nodal or extranodal site, and clinical stage. The unique and common radiologic features of these neoplasms are reviewed in each of the major anatomic regions of the body. PMID- 3961162 TI - [Forms of tumor growth in the lung]. AB - Tumors in the lung present not only a different biological behavior, but multiple facets of roentgenographic appearance, as well. The aspects of tumor propagation into the surrounding tissues and secondary vascular disturbances and reactions are investigated. Characteristic roentgen signs of some special tumor types are described with the aid of radiographs of formalin steam fixed specimens. PMID- 3961164 TI - Ischemic colitis: serial changes in double-contrast barium enema examination. AB - Serial double-contrast barium enema examinations were performed in 40 patients with nongangrenous ischemic colitis, 15 with the stricturing form and 25 with the transient form. Thumb-printing was observed in 30 cases (75%); it appeared within 9 days after the onset of the disease in patients with the stricturing form and within 6 days in those with the transient form. Thumb-printing disappeared about 10 days after the onset, but it lasted considerably longer in two patients with the stricturing form (21 and 29 days, respectively). Longitudinal ulcers were observed in 24 patients (60%), and healing was confirmed on day 20 or later in patients with the stricturing form and on day 9 or later in those with the transient form. Eccentric deformity was found in 19 patients (48%), sacculation in 12 (30%), and transverse ridging in five (13%). These results indicate that longitudinal ulcers and thumb-printing are both characteristic findings of ischemic colitis. The double-contrast study is useful for visualization of the ulcer. PMID- 3961165 TI - Hepatic parenchymal gas after blunt trauma. AB - Hepatic parenchymal gas was demonstrated by computed tomography in a boy who had sustained severe blunt trauma to the abdomen 12 hours earlier. There was no clinical evidence of infection. Although previous reports have suggested that hepatic parenchymal gas indicates the presence of infection, such gas may also be a manifestation of severe blunt trauma without infection. PMID- 3961166 TI - Gastric tuberculosis: a manifestation of acquired immunodeficiency syndrome. AB - A Haitian man with acquired immunodeficiency syndrome (AIDS), fever, malaise, and diarrhea is described. A computed tomographic (CT) scan showed a retrogastric mass with an associated ulcer. An upper gastrointestinal tract study showed an ulcer with both benign and malignant features. Endoscopy revealed a malignant appearing ulcer, but cultures and histologic examinations of surgical biopsy specimens indicated gastric tuberculosis. The relationship between tuberculosis and AIDS is discussed. PMID- 3961167 TI - Hepatosplenic fungal infection: CT and pathologic evaluation after treatment with liposomal amphotericin B. AB - Disseminated fungal disease, predominantly involving liver and spleen, developed in eight patients with hematologic malignancies. Because the patients failed to respond to standard antifungal drugs, they were treated with liposomal amphotericin B (L AmpB). Before therapy began, the diagnosis was confirmed histologically and the patients underwent abdominal computed tomography (CT), which indicated hepatosplenomegaly with or without multiple microabscesses in the liver and spleen. After each course of treatment with L AmpB, patients underwent CT, followed by either open or CT-guided percutaneous aspiration biopsy of the liver. Post-treatment CT showed partial regression of lesions in six patients and persistence in two. In all patients a liver biopsy confirmed that the lesions noted after treatment were due to granulomas or focal areas of fibrosis compatible with healing. Thus, the persistence of multiple defects on enhanced scans in two patients was not an indication of persistent abscesses. Clinical response was an additional important factor. Close clinical and pathologic correlation in addition to CT scanning are required in the follow-up of hepatosplenic fungal infections. PMID- 3961168 TI - Gold storage in the liver: appearance on CT scans. AB - The authors present one case in which high attenuation values in the liver parenchyma on computed tomographic scans were found in a patient who had been previously treated with colloidal gold for rheumatoid arthritis. Reticuloendothelial storage of gold was proved by biopsy. PMID- 3961169 TI - Duodenal hematoma: the ring sign in MR imaging. AB - Proper management of duodenal hematoma requires that an accurate diagnosis be made using noninvasive radiological methods. Conventional imaging may be nonspecific if there is no history of trauma or coagulopathy. Two cases of duodenal hematoma that were imaged by magnetic resonance (MR) and computed tomography (CT) are described. In both cases the hematoma had a well-defined concentric ring configuration on MR images, a finding which helped establish the diagnosis. MR imaging may provide tissue-specific characterization of duodenal hematomas. PMID- 3961170 TI - Ventilation-perfusion scintigraphy in suspected pulmonary embolism: correlation with pulmonary angiography and refinement of criteria for interpretation. AB - Retrospective analysis of 139 ventilation-perfusion (V/Q) lung scans obtained for suspected pulmonary embolism (PE) was undertaken, using the Biello criteria for interpretation. All scans were correlated with chest radiographs obtained within 24 hours and with pulmonary angiograms obtained within 72 hours of the V/Q study. The prevalence of PE in the high-, intermediate-, and low-probability groups was 89.5%, 49.3%, and 3.6%, respectively. Using minor modifications of these criteria, V/Q scans interpreted as high or low probability had a sensitivity of 97.1%, specificity of 94.3%, and accuracy of 95.7%. Perfusion defects corresponding to radiographic abnormalities that were present for at least 10 days were less likely to be associated with PE. Separate analysis of 27 perfusion only lung scans that met all other criteria for inclusion in the study confirmed the nonspecificity of perfusion-only lung imaging and indicated the need for ventilation imaging with Tc-99m-DTPA aerosol or Kr-81m gas for portable studies. PMID- 3961171 TI - Role of chest radiography in predicting the extent of airway disease in patients with suspected pulmonary embolism. AB - An independent evaluation of the chest radiographs and ventilation-perfusion (VP) scintigrams of 119 patients (121 studies) was performed to assess the ability of radiographic findings to indicate the extent of ventilation abnormalities in patients suspected of having pulmonary embolism (PE). VP scans were obtained with krypton-81m in 72 cases and with xenon-133 in 49. All scintigrams showing ventilation abnormalities in greater than 50% of the lung were considered indeterminate for PE, owing to an increased likelihood of false-negative interpretations, as reported in previous studies. Indeterminate VP studies were found in all 21 patients who had radiographic findings of widespread obstructive pulmonary disease (OPD), in 35% with radiographic findings of focal OPD (P less than .001), and in only 18% with no OPD seen radiographically (P less than .001). VP scintigraphy is likely to be indeterminate for PE when widespread OPD is seen by chest radiography and ventilation imaging may not be warranted in these patients. PMID- 3961172 TI - Cardiophrenic angle adenopathy: update of causes and significance. AB - Of 21 cases of cardiophrenic angle adenopathy (CAA) detected on computed tomography (CT) examination, 12 were due to malignant lymphomas, seven to carcinomas, and two to mesotheliomas. Of the nine lesions that were not malignant lymphomas, four were of supradiaphragmatic and five of infradiaphragmatic origin. On average, CAA was detected 4.6 years after the primary neoplasm was diagnosed. Only 29% of the patients were alive 14 months after CAA was detected on CT scans. Radiography was inferior to CT in the detection of CAA, with only 35% of radiography results clearly positive. Malignant lymphoma is a major but not exclusive cause of CAA, and it must be differentiated from lymphatic seeding of supradiaphragmatic and infradiaphragmatic malignancies. Unilateral CAA may point to supradiaphragmatic neoplasms or, if right-sided, to ovarian carcinoma, and bilateral CAA may indicate another neoplasm of infradiaphragmatic origin. PMID- 3961173 TI - Initial pulmonary artery involvement in Takayasu arteritis. AB - Although the pulmonary artery is involved in many cases of Takayasu arteritis, few cases have been reported in which the pulmonary artery was initially involved. Two such cases are reported here. Both of these cases had been initially diagnosed as chronic pulmonary embolism. The importance of considering Takayasu arteritis in cases of chronic pulmonary arterial obstruction of unknown cause is emphasized. Bronchial-pulmonary artery communication and coronary bronchial artery communication in Takayasu arteritis are also discussed. PMID- 3961174 TI - MR gated subtraction angiography: evaluation of lower extremities. AB - We report the first clinical experience with a new method for projective imaging of blood vessels (angiography) using magnetic resonance. Vascular contrast is produced noninvasively by the phase response of moving protons. Diastolic and systolic gated images produce, respectively, flow signal and flow void; the difference image is a map of the pulsatile flow: an arteriogram. Preliminary studies are presented of the lower extremities of one healthy volunteer and four patients (one each with occlusive disease, soft-tissue tumor, arteriovenous malformation, and venous femoral-popliteal graft). Patient data are compared with accompanying conventional arteriograms, and the new method is discussed. PMID- 3961175 TI - Pericardial abscess: diagnosis using two-dimensional echocardiography and CT. AB - Two cases of pericardial abscess were identified preoperatively using two dimensional echocardiography and computed tomography (CT). In one patient the diagnosis was confirmed by needle aspiration of pus under CT guidance. Findings in both cases were similar, which suggests a common pathogenetic mechanism. Because purulent pericardial fluid collections are an uncommon condition associated with a high mortality, early echocardiography and if necessary CT should be performed, as prompt institution of appropriate therapy is the best hope for decreasing mortality. PMID- 3961176 TI - Bifid origin of the left vertebral artery. AB - Two patients demonstrating a bifid origin of the left vertebral artery are described. The embryologic origin of this anomaly is reviewed together with diagnostic and therapeutic implications, emphasizing the importance of knowledge and recognition of the anomaly. It is suggested that this anomaly is not as rare as previously thought. PMID- 3961177 TI - Osteoporosis: radiographic detection of fluoride-induced extra-axial bone formation. AB - New bone formation in the peripheral skeleton was detected radiographically in 67% (22/33) of patients studied for new periarticular pain among 72 patients with osteoporosis being treated with fluoride, 66-88 mg/d, for 6 or more months. Changes included periosteal and endosteal new bone formation as well as trabecular thickening and were localized in areas of high mechanical stress. Sufficient mineral deposition for radiographic detection required 6 or more months of fluoride treatment. Radiologists must differentiate fluoride-induced new bone formation from other-processes, such as fractures and tumor, and elicit information on fluoride intake in suspicious cases. PMID- 3961178 TI - Influence of vertebral fat content on quantitative CT density. AB - Single- and dual-energy (85 and 130 kVp) computed tomographic (CT) measurements of bone density were made in 74 lumbar (L-3) vertebral specimens. Single-energy CT densities at 130 kVp consistently underestimated actual ash density by about 25 mg/cm3 in men and 40 mg/cm3 in women. CT densities overestimated age changes by 73% in women and 26% in men. These errors of the single-energy CT approach seemed due to increased marrow fat caused by age. At 130 kVp, there was a large decrease in apparent bone density (13 mg/cm3) for each increase of 100 mg/cm3 in fat content, but the decrease was lower at 85 kVp (11 mg/cm3), suggesting the use of lower energies for quantitative CT. In the vertebrae from the younger subjects (up to age 69), the relative error was 20%-31%, but in the oldest group it amounted to 31%-45%. The 95% confidence interval for an individual determination was +/- 38 mg/cm3. Dual-energy CT greatly reduced the above errors. Ash density was predicted with only a small accuracy error (7 mg/cm3) using a postprocessing dual-energy calculation, but the prediction error was 19 mg/cm3 for determinations at 130 kVp. The large uncertainty in the fat content of marrow (+/ 110 mg/cm3) and the variability in distribution of fat make dual-energy approaches necessary for accurate determinations of vertebral mineral density. PMID- 3961179 TI - Segond tibial condyle fracture: lateral capsular ligament avulsion. AB - Avulsion fractures in the appendicular skeleton are a result of stress on a specific structure that is firmly attached to bone. A small avulsion fracture from the directly lateral surface of the lateral tibial condyle results from excessive tension on the lateral capsular ligament of the knee joint. Recognition of this fracture on an anteroposterior radiograph of a traumatized knee represents substantial evidence of major injury to the lateral joint capsule. This fracture also has a strong association with rupture of the anterior cruciate ligament. The avulsed tibial fragment is remarkably constant in site and appearance. The typical fragment is isolated by a longitudinal fracture line separating a small piece of bone from the lateral tibia. It is elliptical in outline (10 X 3 mm), with its proximal border lying 4 mm distal to the subarticular cortex of the lateral tibial condyle. A hemarthrosis of the knee joint is consistently visible. PMID- 3961180 TI - Paget disease with contraction of long bones. AB - The evolution of Paget disease characterized both by expansion and subsequent contraction of the long bones of the ipsilateral upper extremity over a 10-year period is described. PMID- 3961181 TI - Glioblastoma: catheter techniques for isolated chemotherapy perfusion. AB - Techniques have been developed for isolated perfusion of chemotherapeutic agents in patients with glioblastoma. Three catheters that facilitate crossing the carotid siphon have been developed; two are based on an everting or toposcopic principle, and one uses microjets for deflectability and improved mixing. Blood from the ipsilateral jugular vein is aspirated at high volumes (300 ml/min) for extracorporeal circulation through an adsorption column (for recovery of carmustine) or dialysers (for recovery of cisplatin). Preliminary experience in 10 patients suggests that high doses of chemotherapeutic agent can be administered using these catheters, with reduced retinal and systemic toxicity. PMID- 3961182 TI - Parkinson plus syndrome: diagnosis using high field MR imaging of brain iron. AB - The distribution of iron in the brain was analyzed using high field strength (1.5 T) magnetic resonance (MR) imaging in 14 healthy control individuals and six patients with Parkinson plus syndromes (multisystem atrophy and progressive supranuclear palsy) who were unresponsive to antiparkinsonian therapy. The normal topographic distribution of iron in the brain as indicated by high field MR images coincided precisely with the distribution of iron in the brain as determined by Perls staining for ferric iron. In Parkinson plus syndromes, there were abnormally increased concentrations of iron (decreased T2 relaxation times) in the putamen, and less prominent increases in the caudate nucleus and lateral pars compacta of the substantia nigra. In high field strength MR images of normal patients, the decreased signal intensity in the globus pallidus is more prominent than that of the putamen. In MR images of patients with Parkinson plus syndromes, the decreased signal intensity of the putamen is more prominent than that of the globus pallidus. PMID- 3961183 TI - Multiple system atrophy (Shy-Drager syndrome): MR imaging. AB - The Shy-Drager syndrome (SDS) is a form of progressive autonomic nervous system failure (PAF) with orthostatic hypotension and associated extrapyramidal involvement that is often mistaken for Parkinson disease. SDS includes olivopontocerebellar atrophy and striatonigral degeneration which is attended by PAF. Eight patients with SDS were studied on a 0.5-T superconducting system utilizing T1-weighted inversion recovery (IR) and T2-weighted spin-echo pulse sequences and also on a 1.5-T system using spin-echo sequences. With IR sequences, atrophy of the putamina was demonstrated in patients with SDS that is consistent with findings of neuronal loss in these nuclei reported on postmortem examinations. An abnormal decrease in signal intensity of the putamina, particularly along their lateral and posterior portions, was also detected, predominantly on T2-weighted sequences, and in three cases on T1-weighted spin echo sequences. Abnormalities were detected on both imagers but were shown with greater clarity on the 1.5-T device. SDS is the first disease in which convincing basal ganglia changes have been shown in vivo exclusively by MR imaging. PMID- 3961184 TI - Nasal airway obstruction: CT assessment. AB - Twenty-one cases of nasal airway obstruction were analyzed using computed tomography (CT) at the Children's Hospital in Boston between 1980 and 1984. Seven of these patients had stenosis of the entire nasal passage, two had stenosis of the anterior nasal cavity, and 12 had atresia of the posterior choanae. The spectrum of these abnormalities and the optimum technique for CT scanning are discussed. PMID- 3961185 TI - Chronic pulmonary embolism in children. AB - Chronic pulmonary embolism with pulmonary hypertension in children is rarely diagnosed clinically; literature review yielded only 17 recorded cases. To demonstrate the radiographic features as well as to encourage the diagnostic consideration of chronic pulmonary embolism in children, this report focuses on three additional children with chronic pulmonary embolism. Of these 20 total cases, only two were not catheter-related; 17 patients had emboli as a complication of ventriculoatrial shunting, and one had emboli secondary to indwelling venous hyperalimentation. Analysis of the information available on the 20 cases revealed the following radiographic features: cardiomegaly (19 cases), large central pulmonary arteries with rapid distal tapering (15 cases), oligemia (five cases), "infiltrate" (three cases), and effusion (two cases). With increasing use of central catheterization as treatment for children with chronic illness, the incidence of chronic pulmonary embolism will likely increase; therefore, clinical diagnosis should reflect this increase. The radiologist in particular should be aware of the clinical and radiologic features of chronic pulmonary embolism in children. PMID- 3961186 TI - Distal femoral epiphysis: normal standards for thickness and application to bone dysplasias. AB - Flattening of the epiphysis of the long bones is seen in several bone dysplasias. It is the hallmark of multiple epiphyseal dysplasia and is an important sign in the diagnosis of spondyloepiphyseal dysplasias, diastrophic dysplasia, and pseudoachondroplastic dysplasia. The goal of this study was to determine norms for the height of the distal femoral epiphysis and to apply these standards to patients with bone dysplasias. Ratios of the distal femoral epiphysis height to both the distal femoral metaphysis width and the distal femoral epiphysis width were obtained from 640 radiographs of healthy children of different ages. Application of these standards to 41 patients with the bone dysplasias mentioned above proved useful in ascertaining decreased height of the distal femoral epiphysis. These standards are of particular value in subtle or early cases in which the thinning of the epiphysis may not be apparent upon simple observation. Obtaining three simple measurements from the anteroposterior knee radiographs allows determination of the presence or absence of flattening of the epiphysis. PMID- 3961187 TI - Paramagnetic macrocyclic complexes as contrast agents for MR imaging: proton nuclear relaxation rate enhancement in aqueous solution and in rat tissues. AB - Paramagnetic macrocyclic chelates show promise as magnetic resonance (MR) imaging contrast agents due to stability and relaxivity comparable to those of DTPA-type chelates. For the three copper and manganese macrocyclic complexes studied in aqueous solution, T1 and T2 relaxivities ranged from 0.14 to 5.88 mM-1sec-1 at 6.25 MHz. In rats, the intravenous administration of 16 mumol/kg of Mn(cyclam) caused the liver T1 relaxation rate to double at 15 minutes after injection. T1 measurements by pulsed MR imaging and manganese analyses on excised tissue showed that both relaxation rate (1/T1) and manganese content of liver and kidney increase linearly with the dosage of Mn(cyclam). The linear relationship between 1/T1 and manganese content can be considered an "in tissue" relaxivity plot for the agent. The resulting relaxivity is 54 mM-1sec-1 in liver, compared with 3.1 mM-1sec-1 in aqueous solution. Although this work is preliminary, the implication for medical MR imaging applications is that macrocyclic contrast agents can be effective at approximately one-tenth the current typical dose used for gadolinium DTPA. PMID- 3961188 TI - Digital beam attenuator technique for compensated chest radiography. AB - The feasibility of producing patient-specific beam attenuators for chest radiography has been investigated using an anthropomorphic phantom and a human volunteer. A low-dose test exposure is digitized, processed, and used to print a small cerium filter, which is placed in the x-ray beam near the collimator. The final radiograph is recorded on film. The technique results in relatively uniform film exposure, so that structures in all regions of the chest are simultaneously displayed with optimal film contrast. The equalized exposure improves image quality in the normally underpenetrated regions and reduces the role of cross scatter from the lungs. The image is analogous to optical or computer-processed unsharp masking techniques, but the processing is accomplished in the x-ray beam and results in an improved exposure distribution, giving advantages that cannot be achieved with image processing techniques alone. PMID- 3961189 TI - Esophageal fistula associated with intracavitary irradiation for esophageal carcinoma. AB - Fifty-three patients with esophageal carcinoma were treated with high-dose-rate intracavitary irradiation following external irradiation. Ten patients developed esophageal fistula. Perforations were found in the bronchus (four), major vessels (four), pericardium (one), and mediastinum (one). The frequency of fistula occurrence in these patients was not remarkably different from that in 30 other patients treated only with greater than or equal to 50 Gy external irradiation. From the time of the development of esophageal fistula, intracavitary irradiation did not seem to accelerate the development of fistula. The fistulas in our ten patients proved to be associated with tumor, deep ulcer (created before intracavitary irradiation), chemotherapy, infection, and trauma rather than the direct effect of intracavitary irradiation. PMID- 3961190 TI - Movable core guide wire: evaluation of improved model. AB - Six commercially available movable core guide wires were compared with each other and with a new design in glass models simulating tortuous vessels. The results demonstrate a wide variability in performance of the commercially available wires and the superiority of the new design. PMID- 3961191 TI - Transhepatic removal of obstructed Carey-Coons biliary endoprosthesis. AB - A criticism of the use of an endoprosthesis for relief of biliary obstruction has been the difficulty of removing or exchanging the endoprosthesis if it becomes obstructed. We present a simple method of removal that has been successful in four of five patients who presented with an obstructed endoprosthesis 3-7 months after placement. PMID- 3961192 TI - Safer, more expensive iodinated contrast agents: how do we decide? AB - The advantages of the new, safer, but more expensive iodinated contrast agents are discussed, and opinions on which patient groups should receive the agents are presented. PMID- 3961194 TI - Intracranial hematomas: imaging by high-field MR. PMID- 3961193 TI - Catalog of intravascular contrast media. AB - The ionic intravascular contrast media formulations now commercially available are presented, along with those new formulations, nonionic and ionic, that have a significant reduced osmolality compared with those previously available. PMID- 3961195 TI - Radiology department management system: technologists' costs. PMID- 3961197 TI - Hepatic echinococcal cyst: successful percutaneous drainage. PMID- 3961196 TI - Breast cancer screening: the underuse of mammography. PMID- 3961198 TI - Pharmacokinetic drug interaction with cimetidine. PMID- 3961199 TI - Effects of indomethacin on cardiac output distribution in normal and asphyxiated piglets. AB - We determined the effect of breathing 9% CO2/10% O2/81% N2 (asphyxia) on cardiac output distribution (microspheres) in 4-5 day old unanesthetized, chronically instrumented piglets prior to and following intravenous indomethacin administration. Thirty minutes of asphyxia caused PaCO2 to increase from 35 +/- 2 mmHg to 66 +/- 2 mmHg, PaO2 to decrease from 73 +/- 4 mmHg to 41 +/- 1 mmHg, and pH to decrease from 7.52 +/- 0.05 to 7.21 +/- 0.07. Arterial pressure was increased slightly but cardiac output was not changed significantly. Asphyxia caused blood flow to the brain, diaphragm, liver, heart, and adrenal glands to increase while causing decreases in blood flow to the skin, small intestine, and colon. Blood flows to the stomach and kidneys tended to decrease, but the changes were not significant. Treatment with indomethacin during asphyxia did not alter arterial pressure or cardiac output but decreased cerebral blood flow to the preasphyxiated level and decreased adrenal blood flow about 20%. Indomethacin did not alter blood flow to any other systemic organ. At this time the piglet was allowed to breathe air for 2.5 hr undisturbed. Two and a half hours after indomethacin administration, blood flows to all organs returned to the preasphyxia control levels with the exception of cerebral blood flow which was reduced (93 +/- 13 to 65 +/- 7 ml/100 g X min). Three hours after indomethacin administration, the cerebral hyperemia caused by asphyxia was less (134 +/- 17 ml/100 g X min) than prior to indomethacin (221 +/- 15 ml/100 g X min). Indomethacin did not alter the asphyxia-induced changes to any other systemic organ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961200 TI - Role of prostaglandins in development of porcine blastocysts. AB - Rapid elongation of porcine blastocysts between Days 11 to 12 of pregnancy coincides with an increase in uterine luminal content of prostaglandins. The present study evaluated the effect of two prostaglandin synthesis inhibitors (indomethacin and flunixin meglumine) on elongation of porcine blastocysts from spherical to filamentous forms between Day 11 to 12 of pregnancy. Gilts were hemi hysterectomized on Day 11 of pregnancy. The excised uterine horn was flushed with 0.9% saline and diameter of blastocysts recovered were measured. Immediately following surgery, pregnant gilts were assigned to receive either: 1) vehicle every 4 h, 2) flunixin meglumine (banamine) every 4 h, or 3) indomethacin every 12 h. The remaining uterine horn was removed and flushed after the time of blastocyst elongation estimated for each gilt on basis of blastocyst development in the first horn. Uterine flushings were analyzed for total calcium, protein, acid phosphatase activity, estrone, estradiol-17 beta and prostaglandin F. Pretreatment blastocyst diameter was similar for all groups and ranged from 1 mm to 20 mm. Treatment of gilts with either banamine or indomethacin effectively inhibited (P less than 0.001) the increase in uterine luminal content of PGF. Total calcium, estrone and estradiol-17 beta were not influenced by treatment. Total uterine luminal protein and acid phosphatase activity were reduced (P less than 0.05) in banamine treated gilts compared to those receiving vehicle or indomethacin treatments. Although total PGF recovered in uterine flushings was reduced during the period of blastocyst elongation, treatment with PGF synthetase inhibitors failed to block rapid elongation of blastocysts from the spherical to filamentous forms. PMID- 3961201 TI - Measurement of prostaglandin E3 and other eicosanoids in biologic samples using high pressure liquid chromatography and radioimmunoassay. AB - A method to measure PGE3 in biologic samples is described. Complete resolution of PGE3 from PGE1 and PGE2 is achieved by reversephase high pressure liquid chromatography. Quantification is carried out by radioimmunoassay using an antibody directed against PGE2 that has high cross-reactivity with PGE3. Using this method, a marked increase in PGE3 production by mouse kidney tissue and in rat urine was demonstrated after supplemental feeding of omega-3 fatty acids. This method can also be applied to measurement of 6-keto-PGF1 alpha and TXB2 in the same samples. PMID- 3961202 TI - [Reality and fantasy. Remarks on the dream concept of Sigmund Freud]. PMID- 3961203 TI - [Empirical research on the effect of trauma in children and adolescents. Critical aspects and information on an again current topic]. PMID- 3961204 TI - [Freud's theory of insight]. PMID- 3961205 TI - [Ethnopsychoanalytic elaboration of the cultural space of the female]. PMID- 3961206 TI - [Relation of psychoanalysis and Geneva constructivism: primary process, secondary process and cognitive structure]. PMID- 3961207 TI - [Psychoanalytic and family dynamic aspects of learning handicaps]. PMID- 3961208 TI - A philosophical and empirical analysis of subjects' modes of inquiry in Wason's 2 4-6 task. PMID- 3961209 TI - Developmental dysgraphias. PMID- 3961210 TI - [Multiplanar computerized angiotomography in the evaluation of aneurysms of the posterior inferior cerebellar artery]. AB - Two cases of posterior inferior cerebellar artery aneurysms are reported. The diagnosis was made by dynamic multiplanar computerized tomography and afterwards confirmed by angiography and surgery. The role of CT in the diagnosis and follow up of subarachnoid hemorrhage is discussed. Intracranial posterior fossa aneurysms are nicely demonstrated and localized by dynamic multiplanar CT. PMID- 3961212 TI - [Usefulness of CT in the evaluation of hematoma of the iliopsoas muscle in hemophiliacs]. AB - Four iliopsoas hematomas in hemophiliacs are reported, evaluating the diagnostic role of CT. The specificity of the method is stressed in showing the morphological and densitometric patterns, which allow to localize the hematoma, to state the originating structures, and to follow its evolution. Comparing the obtained results to those found in literature, the authors suggest the use of CT in any hemophiliac in which a retroperitoneal hematoma is suspected. PMID- 3961211 TI - [Computerized tomography in the diagnosis and follow-up of 3 cases of primary suprasellar germinoma]. AB - Three cases of primitive suprasellar germinomas are reported: the tumors show typical clinical signs (diabetes insipidus, visual disturbances and anterior pituitary dysfunctions), but CT findings are not so specific. It is very important to reach a correct diagnosis based on clinical and radiological findings, because of a very high radiosensibility of the tumor. The accuracy of preoperative diagnosis has been enhanced by CT in addition to conventional neuroradiological examinations. Due to the possible risk of meningeal spreading following biopsy, some authors prefer to avoid biopsy and to treat directly the patient by radiotherapy; a rapid reduction of the tumor size at the dose of 30 Gy suggests a possible germinoma. PMID- 3961213 TI - [Statistical analysis of individual doses absorbed by occupationally exposed personnel at the Messina University Polyclinic 1975-1984]. AB - A statistical evaluation of the individual monitoring of occupationally exposed workers in the Policlinico Universitario of Messina during the years 1975 divided by 1984 is presented. Collective dose equivalent, average dose equivalent pro capite, ratio of the fraction of the collective dose due to annual doses above 1.5 cSv for the observed distribution to the fraction for the reference distribution and other interesting parameters are analyzed. The cumulative percentage of individual dose equivalents were plotted on log-probability graphs. Short considerations on the status of radiation protection for workers are also provided, using the last ten years as reference. PMID- 3961215 TI - [Clinical results of a radiotherapy-surgery program analyzed in relation to risk factors in cancer of the breast]. AB - In the Radio Institute "O. Alberti" of Brescia from 1.1.73 to 31.12.79, 976 patients were treated with postoperative radiotherapy after radical mastectomy. The impact of therapy has been observed on the NED survival and evaluated for prognostic factors. The involvement of axillary lymph nodes appears to be the most relevant prognostic factor; the hormonal perimenopausal status was associated with a poorer prognosis both regarding the high frequency of axillary metastatic nodes and because in N+ 1-3 cases the probability of relapse is different and higher in comparison to post and premenopausal status. The site of origin of the primary tumor does not appear to be a significant prognostic factor related to the same number of nodes involved. Direct correspondence exists between diameter of the primary tumor and metastatic regional nodes. In N- patients the evaluated prognostic factors are not significant; in N+ patients the cases with a significantly different risk of relapse were identified for N+ 1-3 by the perimenopausal status and for N+ greater than or equal to 4 by the diameter of tumor. Postoperative radiotherapy alone seems to be able to modify the prognosis of operable breast cancer. The combination of local radiotherapy and adjuvant medical therapy could be a logical approach not only in order to improve the local control but also to prevent metastases. PMID- 3961214 TI - [Results of interstitial curietherapy and combined transcutaneous radiotherapy curietherapy in 150 patients with carcinoma of the tongue and/or mouth floor]. AB - The authors report their experience on the treatment of carcinoma of the oral tongue and floor of the mouth with interstitial brachytherapy, alone or in combination with external irradiation. One hundred and fifty patients were treated; among these, 116 with brachytherapy alone, 34 with combined treatment. The five years local control in those patients treated with brachytherapy alone was 72.5% in T1, 61.2% in T2 and 35% in T3; in those patients treated with external irradiation and brachytherapy the global five years control was 42.5%. The global five years survival was 64% in the patients treated with brachytherapy alone and 48% in the patients treated with combined therapy. PMID- 3961217 TI - [Persistence of the proatlantal artery. Presentation of a case]. PMID- 3961216 TI - [Treatment of stage I and II cervix carcinoma with radiotherapy alone or with combined radiation-surgery]. AB - From 1975 to 1982, among 138 patients affected by stage IB and IIA-B cervical carcinoma, 93 were treated with radiotherapy and surgery, while 45 were treated with radiotherapy alone. 137Cs applied with individual "moulages" was used for uterine-vaginal brachycurietherapy, while telecobalt therapy was used in external beam radiotherapy. Surgery consisted of either a classical Wertheim-Meigs procedure or a hysterosalpingo-oophorectomy with pelvic lymphadenectomy. Dosage methods for remote-loading curietherapy with 137Cs are discussed. Actuarial survival at 5 years in the 56 patients in stage IB was 90.2% +/- 3; in the 37 patients in stage IIA was 75% +/- 5; and in the 45 patients in stage IIB was 46.2% +/- 7.5. Average follow-up was 6.5 years, with a minimum of 3 years. Survival results in patients undergoing radiotherapy alone were not substantially different. Causes for therapeutic failure were pelvic relapse in 9.4% of the cases, distant metastases in 3.6% and relapse plus metastases in 8.6% of the cases. Severe complications were seen in 2.8% of the cases; mild complications in 8.6% of the cases. PMID- 3961218 TI - [Unusual finding of a calcified mediastinal mass of tuberculous origin]. PMID- 3961219 TI - [A long letter to the editor and...to the readers]. PMID- 3961220 TI - [Traumatic rupture of the thoracic artery]. PMID- 3961221 TI - [Quo vadis: bupivacaine 0.75%]. PMID- 3961222 TI - [Postspinal headache. Is 24-hour flat bedrest a preventive measure?]. AB - Spinal anaesthesia was performed with a 22-gauge needle on 112 consecutive patients above fifty years of age admitted for transurethral surgery. Patients were randomly allocated to either 24 h of recumbency (group A) or ambulation as soon as the spinal had worn off (group B). Postspinal headache was found in 14% of the patients in the recumbency group and in 11% of the patients in the group of early ambulation. There were no differences between the groups regarding incidence, time of onset and duration of postspinal headache. Based on the literature and the present investigation, early ambulation is therefore recommended. PMID- 3961223 TI - [Plexus anesthesia with a bupivacaine-mepivacaine mixture. Clinical results and blood level]. AB - A mixture of 0.2% bupivacaine and 0.75% mepivacaine was employed for brachial plexus block in 20 patients scheduled for surgery of the forearm-hand-region. Volumes of 40-60 ml were given. The spread of motor and sensory block was monitored during 80 min. The first postoperative pain sensation was reported about seven hours after injection of the local anaesthetic. The results are compared to those obtained with 1% plain mepivacaine. The spread of the block was slightly slower after the mixture than after plain mepivacaine. Blood levels after the mixture showed a maximum 30 min after injection. PMID- 3961225 TI - [Postoperative early mobilization of the knee joint following arthrolysis using continuous catheter peridural anesthesia]. PMID- 3961224 TI - [Effect of different injection technics on the blood level of lidocaine following intravenous regional anesthesia]. AB - Nine volunteers received two intravenous regional anaesthetics in the right arm. The first anaesthetic consisted of an injection of 0.5% lignocaine (0.5 ml/kg body wt.), immediately followed by 0.9% NaCl (0.5 ml/kg body wt.). The second anaesthetic consisted of 0.25% lignocaine (1.0 ml/kg body wt.). Just prior to pressure release of the cuff and 30 s, 2, 5, 10, and 20 min afterward, venous blood samples were taken from the contralateral cubital vein in both groups. Lignocaine blood levels were determined by the fluorescence polarization method with the Abbott-TDx. As expected, in the first 2 min after cuff deflation, the blood levels were significantly lower in the first group. However, the peak levels did not differ significantly between groups (5-10 min). Therefore, one can expect slightly less toxicity using the combined injection technique. No significant systemic side effects of the drug were observed. On the basis of this investigation, 0.5% lignocaine (0.5 ml/kg body wt.) followed immediately by 0.9% NaCl (0.5 ml/kg body wt.) can be recommended for IV regional anaesthesia, as this seems to be less toxic than the diluted lignocaine that is usually used. PMID- 3961226 TI - [Effect of spinal CSF dynamics on the subarachnoid diffusion of a substance applied close to the spinal cord]. AB - In order to better understand the effects and side effects of intraspinal administration of morphine we studied the rostral spread of a comparable substance within the cerebrospinal fluid (CSF). This study was performed in connection with nuclear medical diagnostics ruling out possible rhinorrhoea or disturbances of CSF-circulation in 14 patients: Following lumbar intrathecal injection of the tracer 111-Indium-DTPA, the radioactivity over the medulla oblongata was measured continuously for 2 1/2 hours with a single probe scintillation counter; thereafter the distribution of activity over the total spinal canal was determined; finally the spread of activity was registered with the gamma scintillation camera in the 3rd, 24th and 48th hour. The diffusion of the tracer was followed in a model of the subarachnoid space. A few minutes after injection, activity over the medulla oblongata could be detected; initially it increased markedly, later less so; at the end of the 2 1/2 h observation time, approximately 8% of the total activity had reached this level. The timing of activity increase and the peak activity over the medulla oblongata varied between the individuals. Up to 48 hours the activity continued to shift from the spinal canal to the endocranium. Diffusion played a secondary role. These results are further evidence that morphine is transported cephalad within the CSF rather quickly and may act on cervical spinal cord and brainstem. PMID- 3961228 TI - [Quantitative relation between transferrin and total iron fixation capacity in patients carrying heterozygous A2 and F thalassemia]. PMID- 3961227 TI - [Effect of glucose concentration in bupivacaine solutions on the distribution of local anesthetics in cerebrospinal fluid during spinal anesthesia]. AB - In two groups (ten patients each) catheter spinal anesthesia was performed with 3.0 ml bupivacaine hyperbaric (5% and 8% glucose was added). With special reference to the early phase following intrathecal injection, local anesthetic concentrations were measured by gas chromatography. A control group received 3.0 ml of isobaric bupivacaine intrathecally. With increasing specific gravity of these solutions, the CSF concentration of the local anesthetic decreased, which is interpreted as a consequence of inhomogeneous intrathecal distribution. PMID- 3961229 TI - [Tumors and sarcoidosis: considerations apropos of a 4-year follow-up of 39 cases of sarcoidosis]. PMID- 3961230 TI - [Is the use of skin tests of delayed hypersensitivity valid in nutrition evaluation?]. PMID- 3961231 TI - [Cryoglobulinemia in multiple myeloma. Presentation of a case of exceptional clinical expressivity]. PMID- 3961232 TI - [Acquired cystic renal disease and an associated renal carcinoma]. PMID- 3961233 TI - [Acquired cystic renal disease]. PMID- 3961234 TI - [Primary hypothyroidism]. PMID- 3961235 TI - [Dissecting aneurysm of the aorta: presentation with pleural pain and dysphagia]. PMID- 3961236 TI - [Disorders of potassium and tetraparesis: Apropos of 2 cases]. PMID- 3961237 TI - [Maintenance treatment with cimetidine in duodenal ulcer]. PMID- 3961238 TI - [Steinert disease and hypothyroidism]. PMID- 3961239 TI - [Postradiation constrictive pericarditis]. PMID- 3961240 TI - [Intra-ampulla ampullomas in endoscopic retrograde cholangiopancreatography]. PMID- 3961241 TI - [Various considerations on lead poisoning]. PMID- 3961242 TI - [Endoscopic characteristics of bronchopulmonary carcinomas. Study of 226 endoscopies]. PMID- 3961243 TI - [Hepatic hydatidosis. Diagnosis by the indirect hemagglutination test]. PMID- 3961244 TI - [Complications of fine-needle percutaneous transhepatic cholangiography]. PMID- 3961245 TI - [Differential macroscopic characteristics of gastric adenomyoma]. PMID- 3961246 TI - [Proximal gastric vagotomy in duodenal ulcer. I: Indications, technic, gastric emptying and complications]. PMID- 3961247 TI - [Phytobezoar: apropos of 5 cases. Etiopathogenic review and treatment]. PMID- 3961248 TI - [Evaluation of the course of Crohn disease and ulcerative colitis (chronic intestinal inflammatory disease): activity indexes]. PMID- 3961249 TI - [Appendiceal carcinoid tumor. Apropos of 5 cases]. PMID- 3961250 TI - [Surgical indications in gastroesophageal reflux]. PMID- 3961251 TI - [Etiology of cancer of the esophagus in today's China and other Afro-Asian countries]. PMID- 3961252 TI - [Duodeno-colonic fistula caused by carcinoma of the gallbladder. Review of the etiology and of the literature]. PMID- 3961253 TI - [Traumatic avulsion of the spleen]. PMID- 3961254 TI - [Intestinal ischemic complication caused by carcinoid tumor]. PMID- 3961255 TI - [Irritable colon syndrome]. PMID- 3961256 TI - [Conservative surgery of the spleen]. PMID- 3961257 TI - [Hemobilia of late occurrence as a complication of percutaneous hepatic biopsy]. PMID- 3961258 TI - [Peritoneal pseudomyxoma. Apropos of 2 new cases]. PMID- 3961259 TI - [Evaluation of portal hypertension by hepatic gammography with the gamma camera]. PMID- 3961260 TI - [Rehabilitation of psychiatric patients and mentally handicapped offenders--a long-term study (1969-1984)]. AB - Described is a group of 40 mentally ill offenders, discharged from hospital an average 9 years ago. This group had been served for an average of two years at the rehabilitation department of the Karl-Bonhoeffer-Nervenklinik in Berlin, with the majority having been placed in insurable, performance-adapted outside employment and discharged home or into other appropriate living situations. A follow-up study was carried out in March 1984 concerning renewed delinquency, employment, financial and living situation. Two of the rehabilitees had committed some offence, which resulted in their conditional discharge being revoked. In 1984, 15 of the former clients were found to continue in insurable employment, 5 former patients had died in the intervening years. Some hypotheses are given to explain the successful outcomes attained. PMID- 3961261 TI - Self-help advocacy movement: a promising peer-support system for people with mental disabilities. PMID- 3961262 TI - The self-help movement: evolution of a dystonia chapter. PMID- 3961263 TI - Acute effects of various diuretics on lithium clearance. Studies in rats on medium and low sodium diet. AB - Previous studies have shown that the clearance of lithium (CLi) is a quantitative measure of the delivery of tubular fluid to Henle's loop in rats given food with an ordinary or high sodium content, but not in rats given food with a low sodium content, because under these latter circumstances lithium is also reabsorbed to some extent in the distal nephron. The present study examines the effect of acetazolamide, hydrochlorothiazide, furosemide, and amiloride on the distal reabsorption of lithium in conscious rats with hereditary diabetes insipidus fed standard diets with medium (300 mmol Na/kg) and low (5 mmol Na/kg) sodium contents, respectively. Low sodium diet induced distal Li reabsorption, as apparent from the decrease in CLi and a fall in the urine/plasma lithium concentration ratio (U/P)Li, to below 1.0. Amiloride and furosemide abolished the distal Li reabsorption. Acetazolamide also abolished distal Li reabsorption and, in addition, it increased the fluid output from the proximal tubules. Hydrochlorothiazide was unable to abolish distal Li reabsorption. PMID- 3961265 TI - Recent progress in renal physiology. Abstracts of the Vth Colloquium on Renal Physiology. Frankfurt/Main, June 1985. PMID- 3961264 TI - Micropuncture study of the superficial nephron of Cercopithecus aethiops. AB - Clearance and micropuncture experiments were performed on male Cercopithecus monkeys weighing between 2 and 4 kg to evaluate the function of the superficial nephron. The mean glomerular filtration rate was 4.47 +/- 0.32 ml/min. The fraction of filtered sodium, potassium, calcium, magnesium, and phosphate remaining at the end of the accessible proximal tubule were 54 +/- 3, 64 +/- 4, 70 +/- 3, 79 +/- 5, and 39 +/- 5%, respectively. The concentration of magnesium and calcium in the tubule fluid rose significantly along the length of the proximal tubule. The tubule fluid bicarbonate concentration was measured by determination of total CO2 with microcalorimetry. The tubule fluid to blood bicarbonate ratio fell to 0.48 +/- 0.06 at the late proximal tubule collection site, as the tubule fluid to ultrafiltrable chloride concentration ratio rose to 1.08 +/- 0.02. Thus, bicarbonate is reabsorbed in preference to chloride in the superficial proximal tubule of the monkey, to provide a potential driving force for water and salt absorption. By the time the tubular fluid reached the distal tubule sampling site, most of the filtered sodium potassium, calcium, magnesium, and chloride was reabsorbed, suggesting the loop of Henle as a major site of ion reabsorption. Segments beyond the distal tubule collection site reabsorbed little of the delivered ions. These studies indicate that the function of the superficial nephron resembles that of species previously studied, except that calcium reabsorption is demonstrably diminished in the proximal convoluted tubule relative to other mammals. PMID- 3961266 TI - Inhibition of monoamine oxidase activity by phenylpropanolamine, an anorectic agent. AB - Phenylpropanolamine (PPA) can cause hypertensive crisis in the event of abusive overdosage. It would be interesting to know if this is related to inhibition of monoamine oxidase (MAO) activity. PPA was found to inhibit both human brain and rat liver mitochondrial MAO activities in vitro, i.e. Ki's were 150 microM and 800 microM with respect to serotonin (Type A substrate) and beta-phenylethylamine (Type B substrate). The inhibition is competitive and reversible. PPA can also inhibit MAO-A activity in vivo at relatively high dose (50 mg/kg, i.p.), which was determined from an observation that PPA can protect MAO from the irreversible MAO inhibitor clorgyline. p-Tyramine levels were found to be increased in the urine after i.p. administration of PPA. Chronic administration of PPA does not induce any accumulative inhibitory effect on rat brain and liver MAO activities. PMID- 3961268 TI - Impaired antibiotic entry into lung tissue following acid injury. AB - The purpose of this study was to compare the lung tissue burden of intravenous (i.v.) and intrabronchial (i.b.) cefazolin, using a standardized hydrochloric acid injury to the lungs. Ten mongrel dogs were anesthetized with pentobarbital and artificially ventilated. Following administration of cefazolin i.v. (N = 5) or i.b. (N = 5), lung biopsies were obtained at 6 hourly intervals. Simultaneous serum levels were also determined. The effective time (Teff) was defined as the period during which all serum and lung specimens demonstrated antibiotic activity exceeding 8 mcg/gm. These levels should provide comprehensive coverage of common lung and wound pathogens that are sensitive to cefazolin. Teff for the i.v. group was 1 hour, while aerosolized cefazolin never produced lung levels exceeding 8 mcg/gm. Thus, these findings suggest an explanation for cefazolin failure in gram negative pneumonia. PMID- 3961267 TI - Changes in lung tissue and lavage fibronectin after paraquat injury in rats. AB - Lung lavage fibronectin is known to be elevated after experimental lung injury; however, changes in lung tissue fibronectin content probably more directly reflect tissue injury and repair. We injured rat lungs with a single injection of paraquat and serially measured the fibronectin content of both lung lavage fluid and lung tissue. Changes in lung ultrastructural morphology and collagen content were also assessed. Although both lavage and tissue content of fibronectin increased, the temporal patterns of increase were very different. Lavage fibronectin peaked at 1 day post-injury, was normal by 7 days, and paralleled changes in lavage albumin. Tissue fibronectin was normal at 1 day post-injury, peaked at 4 days and was still high at 7 and 14 days. The period of increased tissue fibronectin coincided with electron microscopic evidence of cell injury and repair at 7 days. By 14 days post-injury the lungs appeared virtually normal. Lung collagen content remained normal throughout the period of injury and repair. We conclude that increases in lung lavage fibronectin do not necessarily correlate with changes in lung tissue fibronectin and that the latter may more accurately reflect lung tissue repair. In addition, even large increases in both measurements do not necessarily predict the development of post-injury fibrosis. PMID- 3961269 TI - Methylglyoxal-tubulin interaction: studies on the aldehyde effects on hepatoma, liver and purified microtubular protein. AB - Methylglyoxal antiproliferative action is well known; this action may be exerted by a non-enzymic mechanism and may directly involve the microtubular system. Our purpose was to verify this hypothesis, by studying the aldehyde effect on normal and tumour microtubular protein. Methylglyoxal incubation of normal and tumour liver cell homogenates causes inhibition of colchicine binding activity above all at higher concentrations. The aldehyde administration to the purified microtubular protein induces alterations in some tubulin properties already at lower concentrations. These results show a possible tubulin-methylglyoxal interaction, also if the reaction mechanism is so far unclear. PMID- 3961270 TI - Inhibitory effect of cytochalasins on the motility of rat epididymal spermatozoa in vitro. AB - Cytochalasins A, B, C, D and E at a concentration of 5.0 microgram/ml significantly inhibited the motility of spermatozoa collected from the cauda epididymidis of rats when diluted in Hank's solution containing BSA by 21.6-38.1% within a few min incubation. The motility was significantly inhibited (approx. 16.7%) by Cyto. E at a concentration as low as 1.0 microgram/ml within 30 min. This inhibitory effect of Cyto. E was a dose-dependent at the concentrations ranging from 1.0-20.0 microgram/ml. These findings demonstrate that cytochalasins are powerful inhibitors on the motility of rat epididymal spermatozoa. PMID- 3961271 TI - Ethanol-induced alterations in lecithin: cholesterol acyltransferase (LCAT) activity in vitro. AB - Our recent experiments demonstrated that squirrel monkeys fed ethanol (ETOH) at 12% of calories (Low ETOH) had significantly higher plasma lecithin: cholesterol acyltransferase (LCAT) activity than monkeys fed ETOH at 24% of calories (High Ethanol). Control animals had LCAT activity intermediate between that of Low and High ETOH primates. To test whether alcohol directly altered cholesterol esterification in vitro, LCAT activity was measured in pooled primate plasma incubated with ETOH at final concentrations of 60, 80, 160, and 240 mg/dl. A similar experiment was performed using incremental doses of ETOH's major metabolite, acetaldehyde. Peak cholesterol esterification occurred at 60 mg/dl which was comparable to plasma alcohol levels detected in Low ETOH monkeys (63 mg/dl) while LCAT activity was significantly depressed at 160 mg/dl which was similar to blood ETOH monitored in High ETOH primates (159 mg/dl). Maximum cholesterol esterification occurred at an acetaldehyde concentration of 0.45 mumoles/l. Our data indicate that ETOH can either stimulate or inhibit LCAT activity in vitro depending upon concentration and suggest that circulating blood alcohol may induce similar alterations in cholesterol esterification in vivo. PMID- 3961272 TI - Partial purification of cytochrome P-450 from human normal granulocytes. AB - Cytochrome P-450 was partially purified from human normal granulocytes, using four different purification procedures. PEG-6000 and ammonium sulfate fractionation of human granulocyte post-mitochondrial supernatant (S1) fraction resulted in 3.9 and 2.25 fold purification of cytochrome P-450 respectively. On the other hand, granulocyte S1 fractions subjected to noctylamino sepharose 4B and DEAE cellulose column chromatography separately revealed about 11 fold purification of cytochrome P-450. When these fractions were submitted to SDS polyacrylamide gel electrophoresis, PEG-6000 and ammonium sulfate precipitated fractions showed multiple protein bands whereas n-octylamino sepharose 4B and DEAE eluates were relatively pure showing one or few bands. There was no indication of the existence of multiple P-450 species in the partially purified human granulocyte cytochrome P-450. PMID- 3961273 TI - Uterine fibrinolysis and unilateral insertion of devices in rats. AB - The validity of a frequently used experimental model for evaluating the effect of different intrauterine devices (IUDs) on uterine fibrinolysis in rodents was investigated in 42 rats. In this model, an IUD is inserted into one horn by a surgical procedure including laparotomy and uterotomy, while the other empty horn is used as a control. In the present investigation, the fibrinolytic activity in different parts of the IUD-containing and control horn was related to the localization of the IUD. The fibrinolytic activity as determined according to Todd's histochemical fibrin slide method was significantly increased in the endometrium in direct contact with the IUD as well as in the uterine segment opposite to the IUD. The enhancement of fibrinolysis in the opposite segment of the control horn was independent of the localization of the IUD, suggesting that neurogenic mechanisms may underlie the stimulation of uterine fibrinolysis in the empty horn. It was concluded that this experimental model is less suitable for evaluating the effect of IUDs on uterine fibrinolysis, since the presence of an IUD in one uterine horn also influences the fibrinolytic activity of the other horn. PMID- 3961275 TI - The role of vagus nerve on histamine- and acetylcholine-induced bronchoconstriction (experiments on cats). AB - During administration of highly concentrated acetyclcholine and histamine aerosol (20-40 min), different effects on tidal volume, respiratory rate, and bronchial tone could be demonstrated. Inhalation after vagotomy neither showed changes in respiratory rate nor in tidal volume. These results point out the importance of the nervus vagus in case of bronchoconstriction caused by mediators. It is discussed to which degree vagus activity is required for the direct effect of different mediators in living animals. PMID- 3961274 TI - Hypersplenism--effect on haemostasis. An experimental study in the rat. AB - Hypersplenism induced by methylcellulose given to rats i.p. was characterized by splenomegaly, anaemia, leucocytopenia and thrombocytopenia. Hb, Hct and WBC count were normalized, and platelet count rose to supernormal values by splenectomy. At a standardized liver resection, the hypersplenic rats had an increased blood loss and prolonged bleeding time in comparison with control rats. Removal of the large spleen normalized these abnormalities. Hypersplenism also shortened APT time and impaired ADP and collagen-induced platelet aggregation, findings not normalized by splenectomy. PMID- 3961276 TI - Preservation of myocardium in transient ischemia by the thromboxane synthetase inhibitor UK 38.485. AB - This study was performed to examine potential protective effects of UK 38.485, an inhibitor of thromboxane synthetase, in canine myocardium stressed by transient ischemia. On anesthetized open-chest mongrel-dogs (n = 9) repeated ischemia (3 min) was produced by proximal, intermittent occlusion of the left anterior descending artery. A total of 18 occlusions after 3 mg UK 38.485/kg body wt. and 12 occlusions after 5 mg UK 38.485/kg body wt. were compared to a total of 24 occlusions under control conditions. In each experiment, 2-3 control occlusions and 3-4 therapy occlusions were performed. The drug was applied i.v. in a dose of 3 or 5 mg/body wt. 30 min before the first therapy occlusion. In both groups, hemodynamics and energetics did not significantly change as compared to control. The efficiency of the drug in protecting ischemically stressed myocardium was examined by (a) quantification of oxygen debt and oxygen repayment in the occlusion and reperfusion periods and (b) the amounts of inorganic phosphate, lactate, and potassium released in the first minute of reperfusion. Compared to control occlusions, premedication with either 3 or 5 mg UK 38.485 led to a significantly reduced oxygen debt combined with a significant decrease of the release of inorganic phosphate, lactate, and potassium. The protective effect is suggested to be mainly due to enhanced flow to ischemic areas. Data obtained in this study suggest protective effects of the compound in the preservation of myocardium in transient ischemia and attest to the concept that thromboxane A2 may aggravate the metabolic and energetic situation of myocardium in circumstances with reduced oxygen supply. PMID- 3961277 TI - Evaluation of acute stress-induced regional myocardial ischemia: comparison of regional contractile and metabolic indices to easily accessible global left ventricular indices. AB - In clinical studies stress-induced myocardial ischemia in patients with coronary artery disease is used to evaluate the severity of this disease. The discussion on the importance of some parameters measured during this intervention is controversial, other parameters are difficult to obtain. On the basis of an experimental model of stress-induced myocardial ischemia, we tried to find an index that reflects best this cardiac state. We therefore compared in eight anesthetized open-chest dogs control conditions with three other hemodynamic states with increasing imbalance between myocardial oxygen demand and oxygen supply: severe stenosis on circumflex coronary artery, 60 s cardiac sympathetic nerve stimulation (CSNS) with a severe stenosis on circumflex coronary artery, and 60 s complete occlusion of circumflex coronary artery. Using a one-way analysis of variance, we found two significantly changed parameters during the stress-induced ischemia: Regional lactate extraction was turned to production (32 +/- 4 vs. -4 +/- 1%) and the ratio of dP/dtmin to dP/dtmax was decreased (1.13 +/ 0.05 vs. 0.67 +/- 0.05; control vs. CSNS with a severe stenosis on circumflex coronary artery). We conclude that the ratio of dP/dtmin to dP/dtmax is an easily accessible, sensitive, and dynamic index for characterization of an stress induced myocardial ischemia. PMID- 3961278 TI - Lipopolysaccharide-induced colitis in rabbits. AB - An experimental animal model of human ulcerative colitis using lipopolysaccharide (LPS) was studied. Rabbits were skin-sensitized by LPS and challenged with intrarectal instillation of LPS after 1% formalin enema. The course of experimental colitis was followed by performing serial colonofiberscopic examinations and biopsy. Petechiae appeared from the 8th hour, and ulcers and bleeding on the 3rd day. Mild macroscopic changes continued for about 2 weeks. By repeating the LPS enema after the initial treatment, the colitis was maintained for over 1 month. Control groups without formalin enema revealed no macroscopic changes, and the groups with only formalin enema showed mild transient changes. The endotoxin level in the blood during the experiment increased (36 pg/ml) at 24 h after the treatment in the LPS-sensitized group, while non-sensitized control rabbits had higher levels of endotoxin. Though fibrinogen and PTT levels had increased at 24 and 72 h, these levels were marked in the control rabbits. The direct reaction of LPS was minimal, and local immune reaction by LPS seems to play an important role in the perpetuation of experimental colitis. Tissue fibrinolysis of the colon increased significantly as the mucosal damage appeared. This experimental colitis with LPS may be useful as a model of human ulcerative colitis. PMID- 3961280 TI - Arterial oxygenation and oxygen transport during exercise in patients with chronic obstructive pulmonary disease. AB - Twenty patients with chronic obstructive pulmonary disease (COPD) walked on the treadmill until symptoms limited further exercise. Ventilation, pulmonary gas exchange, arterial and mixed venous blood gas and haemodynamic variables were measured during steady state. It was not possible to predict from any resting cardiopulmonary variables (including static lung function tests) which patients would develop a decline in arterial PO2. In spite of variable PvO2 values at symptom-limited exercise, a good correlation was obtained between arterial haemoglobin saturation with oxygen and the venous admixture fraction. The directional change in PaO2, however, did not always follow that of the total oxygen transport to the tissues as gauged by either the PvO2 or the efficiency of oxygen delivery (oxygen flux/oxygen consumption) when expressed as a percentage of the value predicted for the level of exertion. This was due to the variable and unpredictable response of the cardiac output on exercise. It is concluded that there is a need to assess each patient individually both at rest and on exercise when evaluating arterial oxygenation and oxygen transport. The pattern of exercise-induced change in these oxygen indices is not predictable from resting data and they may even follow opposite directional trends. PMID- 3961279 TI - Erythrocyte Na+-Li+ countertransport and blood viscosity in arterial hypertension. AB - The aim of this study was to evaluate together the main hemorheologic parameters and one of the transmembrane ion transport systems in erythrocytes of subjects with normal and elevated blood pressure. Three sex-, age-, and weight-matched groups consisting of 15 normotensive subjects (NT) with no parental hypertension, 15 patients with essential hypertension (EH) at stage 1-II WHO, and eight patients with secondary hypertension (Sec.H), respectively, were studied. Red blood cell Na+-Li+ countertransport (CTT), blood viscosity (eta B) at shear rates of 230 X S-1, 115 X S-1, and 46 S-1 and plasma viscosity (eta P) at shear rate of 46 X S-1 were measured. Plasma proteins and fibrinogen were also evaluated. CTT was higher in EH than in NT (P less than 0.01), while no significant difference was found between NT and Sec. H patients. eta B at 115 X S-1 and 46 X S-1 was higher in EH, but not in Sec. H, than in NT patients (P less than 0.05). No difference in eta P, plasma proteins and fibrinogen levels was observed between EH and NT. Elevated eta B and/or CTT may indicate a structural alteration in the erythrocyte membrane of some essential hypertensive patients. This is consistent with the hypothesis that a widespread membrane disorder is involved in the pathogenesis of primary hypertension. PMID- 3961281 TI - [What are the implications of high pulmonary compliance?]. AB - We studied 19 patients with abnormally high static lung compliances, which had been discovered during a routine pulmonary function test, changes in elastic lung properties and smoking habits after 4 years. We did not observe, as is usually reported in the literature, that cessation of smoking normalizes lung compliance. A falsely normalized lung compliance may be due to lung zones that cease to ventilate. High lung compliances in nonsmoking patients, without clinical and radiological pulmonary abnormalities, are not always pathological but must be supervised. PMID- 3961282 TI - A simplified procedure for exponential fitting of pressure-volume curves of normal and diseased lungs. AB - Exponential fitting of mammalian pressure-volume curves requires least squares approaches, using computer facilities. We have developed a simplified fit procedure which can be performed by hand or by a small pocket calculator. First the asymptotic value of the volume axis, Vm, is estimated from a series of volume data at equal pressure-intervals. Subsequently, the 'pressure constant' (comparable with a time constant) and the intersection of the curve with the pressure axis (Po) are determined graphically. A comparison of the fit parameters with those obtained from a non-linear least squares procedure, performed on a medium-size computer, yielded an accuracy sufficient for practical purposes. We conclude that the simplified fit procedure may be a valuable tool for a quick and accurate interpretation of mammalian pressure-volume curves in pulmonary function routine. PMID- 3961283 TI - Functional evaluation in stage I pulmonary sarcoidosis. AB - A functional evaluation was performed in 9 non-smoking patients suffering from sarcoidosis characterized, on chest roentgenograms, by hilar adenopathies (stage I). Frequency dependence of compliance (5 cases) and decreased conductance of the upstream segment (3 cases) were the major findings. From this it is concluded that, even at stage I, small-airway impairment may be documented in some patients, suggesting the existence of peribronchiolar granulomatous infiltration. PMID- 3961285 TI - Febarbamate-induced pulmonary eosinophilia: a case report. AB - Subacute pulmonary hypersensitivity to febarbamate is reported, manifested by peripheral eosinophilia, skin rash and pulmonary bilateral infiltrates. Bronchoalveolar lavage showed an increased eosinophil count, and transbronchial biopsy an intraalveolar and interstitial eosinophil infiltration. The reaction cleared on cessation of the drug, and a rechallenge test with febarbamate induced peripheral eosinophilia and skin rash. PMID- 3961284 TI - The pathophysiology and response to steroid therapy in sarcoidosis. AB - Fourteen patients with early sarcoidosis were prospectively studied over a period of 12-24 months. After baseline physiologic measurements they were treated with 40 mg of prednisone daily for 8 weeks and the measurements were repeated. Thereafter, the steroid dosage was reduced to 0-10 mg every other day and the measurements were repeated between the 12th and 24th month. Relatively normal lung volumes (VC, FRC, RV, TLC) and low DLCO increased with 8-week intensive steroid treatment and fell to below the pretreatment levels when the steroid was either tapered or stopped. The Vmax50-air, Vmax50-He, FEF25-75, upstream conductance (Gus) increased during intensive treatment whereas the RL fell and the FEV1/FVC ratio did not change. The CC/TLC, CV/VC, delta N2, CLdyn/CLst, delta Vmax50 were abnormal in many patients and did not change after 8 weeks of steroid treatment. We concluded that the obstructive defect is common in early sarcoidosis, predominantly in small airways and patchy in nature; the functional derangement is always improved by intensive and adequate steroid therapy and worsened when the drug is tapered or stopped. PMID- 3961286 TI - [Spirometry and flow volume curve]. PMID- 3961287 TI - [Pulmonary diffusing capacity for CO]. PMID- 3961288 TI - [Fundamentals in the standardization of pulmonary function tests]. PMID- 3961289 TI - [Control of breathing]. PMID- 3961290 TI - [Clinical, electrophysiological and long-term follow-up studies in patients with His bundle block]. PMID- 3961291 TI - [Comparison of the effects of defecation using a bedpan and a bedside commode on heart rate and oxygen consumption]. PMID- 3961292 TI - [Pulmonary vascular disease with pulmonary hypertension in collagen disease]. PMID- 3961293 TI - [Serial changes in thallium-201 myocardial images in a patient with nontransmural myocardial infarction]. PMID- 3961294 TI - [Anomalous origin of the left coronary artery from the pulmonary artery: sudden death 16 years after simple ligation of an aberrant left coronary artery]. PMID- 3961295 TI - Effects of sodium cyanide and nicotine on upper airway resistance in anesthetized dogs. AB - The purpose of this study was to determine whether pharmacologic interventions which increase respiratory drive could also reduce flow resistance in the upper airway. Studies were performed in twelve anesthetized supine dogs. In six animals breathing spontaneously through the intact upper airway, intravenous administration of respiratory stimulants (sodium cyanide and nicotine) produced a dose-related decrease in upper airway. In nine animals, upper airway resistance was measured across the isolated upper airway. The stimulants produced a dose related decrease in upper airway resistance. In both preparations inspiratory resistance fell at lower doses than expiratory resistance. Eventually a dose could be given which resulted in comparable, minimal values of resistance during both inspiration and expiration. Mechanisms for changes in resistance were clarified using lateral radiographs of the neck and transbronchoscopic views of the upper airway. Pharmacologic challenge resulted in a change in the route of airflow (from nose only to nose-and-mouth breathing) as well as a change in caliber of the airway at the level of the naso-pharynx and hyoid apparatus. In anesthetized dogs, respiratory stimulants will decrease upper airway resistance by increasing activation of upper airway muscles which may enlarge the airway, change the route of flow, and thus overcoming collapsing forces produced by increased chest wall muscle activation. PMID- 3961296 TI - Time course of pulmonary vasoconstriction with repeated hypoxia and glucose depletion. AB - To examine the effect of hypoxia on pulmonary vascular smooth muscle, rabbit lobar pulmonary artery was suspended in a glucose free solution and both chronologic changes in tension and ATP content were determined together at 30 min intervals after repeated hypoxic challenge (PO2 = 11 +/- 2 mm Hg). The pulmonary artery contracted and its ATP content decreased with hypoxia. This contraction was not inhibited by nifedipine, Ca++ -free EGTA, procaine, phentolamine, isoproterenol, diphenhydramine, prostaglandin E1, atropine or nitroglycerin. Upon reoxygenation (PO2 = 104 +/- 3 mm Hg), the elevated resting tension decreased in a biphasic fashion and the ATP content of the lobar pulmonary artery increased. When hypoxic challenges were repeated, the rate of constriction on hypoxia increased, while the relaxation rate on reoxygenation, tension developed by 30 min of hypoxia and the total amount of ATP decreased. These results suggest that the ATP content in the lobar pulmonary artery is very sensitive to in vitro acute hypoxia and that the Ca++ transport process is more easily impaired by reduction in ATP levels than is the contractile machinery. PMID- 3961297 TI - Distribution and uptake of helium, carbon monoxide, and acetylene in the lungs during high frequency oscillatory ventilation. AB - In order to obtain a better understanding of intrapulmonary gas mixing and alveolar-capillary gas transport during high frequency oscillatory ventilation (HFO), we measured insoluble gas (He) equilibration, and soluble gas (CO, C2H2) uptake in the lungs of ten anesthetized dogs during closed system HFO (i.e. no fresh gas bias flow). These gases were introduced as a bolus into the lumen of an endotracheal tube and their concentrations were subsequently measured for 20-25 sec from a catheter in the distal end of this tube. Analysis of He concentrations over time was performed using a two compartment series model to calculate a value for effective ventilation (Veff). This Veff was found to range from 0.83 to 23.8 L/min and was directly related to oscillator output (f X VT product, r = 0.77). Analysis of CO and C2H2 concentrations during HFO using a similar two-compartment model having alveolar capillary gas transport in series with Veff allowed for the calculation of pulmonary capillary blood flow (QHFO) and lung diffusing capacity (DHFO). These values for QHFO were found to be not significantly different from simultaneous thermodilution determinations of cardiac output and these values for DHFO were found to be not significantly different from single breath or rebreathing determinations of CO diffusing capacity. Moreover, QHFO and DHFO did not vary with Veff. We conclude that this two compartment in series model is a reasonable way to characterize insoluble and soluble gas behavior during HFO, that Veff is related to oscillator output, and that QHFO and DHFO are not affected by HFO over the range of Veff studied. PMID- 3961298 TI - Effects of hyperoxia on ventilatory and metabolic rates of newborn mice. AB - Newborn mammals of medium or large sized species have ventilatory rates, expressed per kg body weight, larger than adults of corresponding size, while newborns of the smallest species do not. We hypothesized that the oxygen consumption of the smallest newborns is limited by the supply of oxygen and reasoned that if this were the case, an increase in Po2 of the inspired air should decrease their ventilation/oxygen consumption (VE/Vo2) ratio. We exposed 1 2 days old newborn mice for 5 min to 21% O2 in N2 or 100% O2, then measured their breathing pattern, by flow plethysmography, and Vo2 with an isovolume closed system. During hyperoxia the VE/Vo2 ratio dropped in average 36%, since VE decreased in 14 out of 18 animals and Vo2 increased in all the animals tested. The drop in VE was due to a prolongation of the expiratory time, with no changes in inspiratory time or tidal volume. During expiration, interruptions of the expiratory flow and tendency to maintain the lung inflated, a characteristic of neonatal respiration, were more pronounced with 100% O2 than 21% O2 breathing. We conclude that the resting metabolic rate of newborn mice is limited by the supply of oxygen; when Po2 is raised, metabolism increases and ventilatory rate decreases in favor of a breathing pattern aimed to preserve lung volume elevated. PMID- 3961300 TI - Influence of pulmonary blood flow and O2 flux on DO2 in avian lungs. AB - O2 diffusing capacity (DO2) was measured in anesthetized, unidirectionally ventilated ducks during hypercapnic hypoxia. DO2 averaged 78.2 mumol X (min X Torr)-1. This value increased to 97.3 mumol X (min X Torr)-1 after correction for ventilation-perfusion inequality. DO2 increased when pulmonary O2 exchange (MO2) and pulmonary blood flow (Q) were increased by either 2,4 dinitrophenol (DNP,ca. 5 mg/kg i.v.) or temporary unilateral pulmonary artery occlusion (TUPAO). DO2 increased with MO2 42.4 mumol X (mmol X Torr)-1 (R = 0.664), and with Q 80.3 mumol X (L X Torr)-1 (R = 0.895). Since there is evidence against expansion of membrane diffusing capacity through recruitment and distention of pulmonary capillaries in avian lungs, we suggest that the close coupling of DO2 to Q reflects a reduction of functional lung heterogeneity at higher blood flows, perhaps due to better matching of V to D, or D to Q. PMID- 3961299 TI - Myoglobin-dependent oxidative metabolism in the hypoxic rat heart. AB - The role of myoglobin in facilitating O2 diffusion for oxidative energy production was investigated at high (0.9 mM) and low (0.1 mM) O2 tensions in the Langendorff-perfused rat heart. 31P nuclear magnetic resonance was used to monitor the intracellular pH and concentrations of high energy phosphates. NaNO2 or phenylhydrazine was used to inactivate greater than 85% of intracellular myoglobin. During hypoxia, ATP and phosphocreatine were depleted significantly more rapidly in hearts with reduced concentrations of functional myoglobin than in control hearts. However, at 0.9 mM O2, myoglobin inactivation did not limit oxidative energy metabolism. It is concluded that facilitation of O2 diffusion by cardiac myoglobin plays a significant role in O2 delivery to the mitochondria at low O2 tensions. PMID- 3961301 TI - Some criteria for laminar conditions during HFV. AB - Assessment of the type of flow regime-laminar, transitional or turbulent-present in the central airways during high-frequency ventilation (HFV) can assist in identification of the predominant gas transport mechanisms for a particular species and set of HFV conditions. In this study, we use published empirical relationships, developed to identify the initial change from oscillating laminar flow to oscillating turbulent flow in tubes, to derive the limiting relationships between a dimensionless stroke volume and the Womersley number for maintenance of laminar conditions. When used with morphometric lung models for man and dog, these limiting relationships predicted maximum stroke volumes at experimental frequencies that either exceeded or agreed within 20% with the stroke volumes reported for steady-state ventilation of humans and dogs using HFV. Based on these limiting relationships, stroke volume-frequency combinations reported to demarcate the decline of PaO2 and alveolar ventilation were associated with nonlaminar conditions. It is expected that this approach may be useful in selecting the stroke volume-frequency pairs for HFV when a specific type of flow regime is desired as well as for analysis of HFV data. PMID- 3961302 TI - Gas exchange efficacy of high-frequency oscillatory ventilation studied by helium washout from dog lungs. AB - The gas exchange efficacy of high-frequency oscillatory ventilation (HFOV) was assessed from an analysis of helium washout from lungs in anesthetized paralyzed supine dogs. Piston stroke volumes (Vs) were varied from 20 to 40 ml, frequencies (f), from 10 to 40 Hz and mean airway opening pressures from 2 to 10 cm H2O. The time course of washout could be described as the sum of three exponential components. Based on a series model comprising a proximal and a distal lung compartment, two component conductances, a 'distal' conductance (Gd) and a 'proximal' conductance (Gp) and an overall conductance of the lung (Gl) could be calculated. Gd, Gp and Gl increased with f up to a maximum value remaining constant or decreasing at higher f; the frequency at which the maximum occurred depending on Vs and on the diameter of the endotracheal tube (ET). With increasing Vs generally the G values increased, but decreased at higher f with the smaller ET. The insoluble inert gas washout is shown to be a useful method for assessing the ventilatory gas exchange conductance of lungs during HFOV. PMID- 3961303 TI - Preinspiratory lung volume dependence of the slope of the alveolar plateau. AB - Nine healthy subjects performed He-SF6 single-breath washouts. The inspired gas contained 90% O2, 5% He and 5% SF6 and the slope of the alveolar plateau for N2, He and SF6 was computed. Each subject performed three times in the seated position four different maneuvers: inspiration of both 1 L and a full inspiration from a preinspiratory lung volume (PILV) equal to residual volume (RV) + 1 L and RV + 2 L. The main experimental observation was that for an inspired volume of 1 L, the slopes decreased by approximately a factor of 2 when PILV increased from RV + 1 L to RV + 2 L, the He-SF6 slope difference decreasing significantly more. Previous results can be explained if intraregional parallel units play an important role in the genesis of the alveolar plateau. Furthermore, comparisons with simulations of a multibranch-point model of the acinus suggest that those units are, at least in part, intra-acinar and that the acini do not expand homogeneously. The present work also suggests that the more informative maneuver to obtain data reflecting acinar behavior from single-breath washouts, consists in an inspiration not larger than 1 L from a PILV situated between functional residual capacity and closing volume. PMID- 3961306 TI - Initial presentation of acute myocardial infarction and the relation to short term clinical course. AB - To be able to predict the clinical course of an acute myocardial infarction (AMI) at the first visit to the patient would be of great importance to a general practitioner considering home treatment for this disease. Therefore, we have analysed the presenting signs and symptoms and their relation to the course in 53 patients with AMI. Twenty-seven of the patients had an uncomplicated course, while 26 suffered continuous pain, cardiac failure, arrhythmias, or death during their hospital stay. The presenting signs and symptoms were remarkably similar in the two groups, the only significant difference being a higher incidence of abnormal pulse rate in the group with complications. We conclude that the initial presentation of AMI does not reliably predict later occurrence of complications. Doctors who want to treat patients with AMI at home must take this uncertainty into consideration. PMID- 3961304 TI - Adrenergic mechanisms in oxygen chemoreception in the cat aortic body. AB - Sixteen cats were studied to test the hypothesis that oxygen chemoreception in the cat aortic body is dependent on the beta-adrenergic mechanism. The chemoreceptor activity was measured from a few aortic chemoreceptor afferents in each cat, anesthetized with alpha-chloralose (60 mg X kg-1). Three types of experiments were conducted. Aortic chemoreceptor responses to steady-state hypoxia (PaO2 range, 100-30 Torr) were measured (a) before and during intravenous infusion of the beta-receptor agonist, isoproterenol (0.5 micrograms X kg-1) in nine spontaneously breathing cats, and (b) before and after intravenous injection of the beta-receptor antagonist, propranolol (1 mg X kg-1) in seven cats which were paralyzed and artificially ventilated. In the third category (c) the stimulatory effect of hypotension on aortic chemoreceptor activity was measured in six of the seven cats in group (b) before and after propranolol injection. Isoproterenol infusion only moderately stimulated aortic chemoreceptor activity. This stimulation was blocked by propranolol. However, propranolol did not attenuate aortic chemoreceptor responses to hypoxia or to hypotension. We conclude that the beta-receptor adrenergic mechanism does not mediate oxygen chemoreception in the cat aortic body. PMID- 3961305 TI - Consumption pattern of infant foods by Turkish immigrants. AB - Fifty-nine Turkish infants in metropolitan Stockholm and two adjacent communities have been studied regarding food consumption pattern. The infants were breastfed for a shorter period than expected in Turkey and shorter than in Swedish children. Illiterate mothers breastfed longer than those who had received some kind of education. Formula feeding was extensively used. Supplementary semisolid feeding was introduced, mainly at 4-6 months of age, much earlier than in Turkey but rather later than in Swedish families. Some problems were noted with the bottle feeding, most importantly with regard to hygienic practices, dangerous especially on summer visits to Turkey. Unsatisfactory handling of bottle feeding was linked to the mother's educational level. Further interest in nutrition education for this and other immigrant groups is important. PMID- 3961307 TI - Evaluation research in care of the elderly. Some Swedish experiences. AB - Research projects in order to evaluate social and health care programmes are unusual in Sweden. Evaluation studies have had little or no discernible effect on the planning of services for the elderly which is largely the product of convention rather than rational thinking. It is difficult to carry out evaluation studies in a field that is rapidly changing. The variations in elderly care between different areas, between institutions and over time makes it difficult to devise general methods of evaluation. Of five recent and current Swedish studies two are treating innovations inside institutions, two deal with innovations outside institutions and one is a relocation study. One thing common to these studies is that they are administered by university departments. However, evaluation is too important to be a matter just for university disciplines. We should also encourage local initiatives to start more evaluation of 'their' interventions. It will then be a task for more centrally placed researchers to educate and guide the administrators and representatives from other areas in what respects the result of a local study can be generalized. PMID- 3961308 TI - An intervention study among elderly people. Methodological and practical experiences. AB - Based on a three years controlled intervention study among elderly subjects, aged 75 years or more and living in their own homes, the methodological and practical experiences achieved through interdisciplinary cooperation is described. The combination of social, medical and psychological interventions within the framework of a clinical controlled trial has documented remarkably favourable consequences for the intervention group. The planning, intervention, work up and publication periods of the study are described in the wish that future necessary intervention studies may be guided to an easier procedure. PMID- 3961309 TI - International classification of primary care. AB - "Health for all by year 2000" was the subject of the WHO Conference at Alma-Ata in 1978. It was evident that good primary care was a requirement to reach this goal. However, knowledge about this was scanty, and the instrument, an acceptable classification for analyses of primary care, was lacking. Since 1978 a WHO Working Party on Classifications of Primary Care has been working on a Reason for Encounter Classification. A RFEC test form was produced. In 1983 a feasibility study was conducted in nine countries: Australia, Barbados, Brazil, Hungary, Malaysia, The Netherlands, Norway, the Philippines, and the USA. The results of this were changing the original proposal very much. In addition, the WONCA/WHO Classification of Health Problems in Primary Care was included in the final version. In 1984 this final version was accepted by WONCA Classification Committee. This is called ICPC = The International Classification of Primary Care. ICPC is biaxial with the chapters of organ/organ systems along the one axis, in addition of three chapters: General, Mental, and Social problems. The other axis comprises seven components: Complaints, Process and Diagnosis. An alphanumeric code is used. The feasibility study of RFEC comprised ten test sites, and 138 primary care professionals recorded a total of 100 452 reasons for encounter. The English version of the RFEC was translated into five other languages, and these versions were used during the study. ICPC is a comprehensive, simple and practicable classification which can be used in medical records and in different areas of primary care research. PMID- 3961310 TI - Dental health behaviour among 25-44-year-old Danes. AB - The purpose of the present investigation was to describe dental health behaviour in an adult Danish population and to study whether oral hygiene habits and consumption of sweets were affected by living conditions. The study group comprised 749 persons in the age group 25-44 years (82% of the original sample) and data on general health behaviour and dental health behaviour were collected by interviews. Regular dental visits were reported by 86%, 83% declared that they brush their teeth at least twice a day and toothbrushing after breakfast was reported by 51%. Regular use of toothpicks was reported by 45%, while dental floss was used by 22%. Dental visits varied according to education, income, work in shifts, sex, and self-assessment of dental health, while toothbrushing habits were affected by urbanization, sex, education, number of children in family, and self-assessment of dental health. Daily consumption of cakes/pastry was reported by 10%, six per cent consumed chocolate/liquorice every day, while soft drinks were drunk every day by 10%. Consumption of sweets varied according to education, shift work, sex, strained life situations, and the number of children in family. Among the regular dental visitors, oral hygiene habits were also influenced by living conditions. Thus, the challenges to general dental practice as regards dental health education are great. PMID- 3961311 TI - A predictive approach to selecting the size of a clinical trial, based on subjective clinical opinion. AB - The 'textbook' approach to determining sample size in a clinical trial has some fundamental weaknesses which we discuss. We describe a new predictive method which takes account of prior clinical opinion about the treatment difference. The method adopts the point of clinical equivalence (determined by interviewing the clinical participants) as the null hypothesis. Decision rules at the end of the study are based on whether the interval estimate of the treatment difference (classical or Bayesian) includes the null hypothesis. The prior distribution is used to predict the probabilities of making the decisions to use one or other treatment or to reserve final judgement. It is recommended that sample size be chosen to control the predicted probability of the last of these decisions. An example is given from a multi-centre trial of superficial bladder cancer. PMID- 3961312 TI - The value of latent class analysis in medical diagnosis. AB - Assessment of the value of diagnostic indicators such as symptoms and laboratory tests results from calculation of the sensitivity and specificity of the indicators. Knowledge of the rate of occurrence of the disease allows for additional calculations of the error rates in using an indicator. These calculations are accurate only when the data on which they are based are reliable. If the diagnosis, which is used as the criterion for computing the sensitivity and specificity, is not accurate, then the resulting calculations will be in error. We show how a statistical method, latent class analysis, allows for the estimation of the characteristics of indicators even when an accurate diagnosis is unavailable. In addition, the method deals with several indicators at once, and provides a way to combine the information from all the indicators to make a diagnosis. PMID- 3961313 TI - Choosing the number of controls in a matched case-control study, some sample size, power and efficiency considerations. AB - This paper investigates the efficiency of using multiple controls in a case control study, when there is a single binary exposure variable. Specifically, we consider the asymptotic power of the Cochran test statistic against non-local alternatives of interest. When it is desirable to take multiple controls per case, we show that the marginal return rapidly diminishes as the number of controls per case increases. The effect is as strong, if not stronger, for non local alternatives as it is for local alternatives. Hence, it is rarely worth choosing more than three controls per case. We also provide a table of sample sizes necessary to achieve 80 per cent power for some odds ratios not equal to one. We extend the results to a special case when there are two binary exposure variables. PMID- 3961314 TI - Box-Jenkins modelling of some viral infectious diseases. AB - During the last few years Box-Jenkins models have become of increasing importance in such fields as economics and industry. They have been used for forecasting and for detecting relations between different time series. Similar applications are also relevant in epidemiology. Since many people who are concerned with the analysis of medical data are not familiar with this subject, a short non technical introduction to Box-Jenkins models is given. The model-building process is demonstrated in some detail using monthly case reports of the two seasonal endemic diseases chicken-pox and mumps, and the relation between these two time series is investigated. It is found that both diseases may be represented by simple models which have basically the same statistical structure and that they are related at time-lag 0 but not at other time-lags. PMID- 3961315 TI - Statistical methods for relating several exposure factors to several diseases in case-heterogeneity studies. AB - Statistical methods for characterizing risks are now well-developed, although little attention has focussed on the problem of risk identification, as in the surveillance of adverse drug reactions or occupational cancers. In this paper we consider the analysis of studies in which one ascertains and compares cases of several disease groups in terms of exposure histories. We address the problem of adjusting each risk for the confounding effects of all the other risks in the data. Data analysis consists of multidimensional contingency tables or polychotomous logistic regression. The latter approach focuses attention on the exposure-disease relations of primary interest rather than on those among the exposure factors and higher-order interactions, and applies easily to many exposure variables and to continuous exposure variables. We describe a stepwise approach to selecting effects for inclusion in the model. Application to preliminary data from a study aimed at identification of hitherto unsuspected occupational carcinogens illustrates the general approach. PMID- 3961316 TI - Cause-deleted proportional mortality analysis and the healthy worker effect. AB - This paper evaluates the relationships between various indices of proportional mortality, used in occupational and other settings where denominator data are unavailable. In particular, we examine the necessary conditions for validity of the proportional mortality ratio (PMR) and mortality odds ratio (MOR) as estimates of the standardized mortality ratio (SMR), in general and for the situation where one considers only a subset of deaths, with certain causes of death deleted from the data. We may exclude data in this way to avoid the inflationary effect on the PMRs for some causes of death (e.g. cancer) that results from a 'healthy worker effect' for other causes of death (e.g. heart disease). We find that cause-deleted PMRs and MORs may be unbiased estimates of their corresponding SMR, and these indices appear most useful for specific hazards of employment or relatively infrequent causes of death. PMID- 3961318 TI - Tables of the number of patients required in clinical trials using the logrank test. PMID- 3961317 TI - Regression analysis of censored survival data with the generalized F family--an alternative to the proportional hazards model. AB - We show that the generalized F family is a useful tool for regression analysis with censored survival data. We discuss maximum likelihood estimation and give asymptotic procedures for calculating confidence intervals, tests of significance for the parameters, life expectancy, quantiles and survival rates. Survival data on 704 ovarian carcinoma patients serve to demonstrate the utility of the model. PMID- 3961319 TI - Comparison of two statistical techniques for the surveillance of birth defects through a Monte Carlo simulation. PMID- 3961320 TI - Vaginal surgery. PMID- 3961321 TI - Anatomy for vaginal surgery. PMID- 3961323 TI - Transvaginal closure of the bladder neck. PMID- 3961322 TI - Vesicovaginal and urethrovaginal fistulae. PMID- 3961324 TI - Complications of vaginal surgery. PMID- 3961325 TI - Preoperative, intraoperative, and postoperative management of vaginal surgery. PMID- 3961326 TI - [Gastroduodenal ulcer and pregnancy (apropos of a case observed in Brazzaville)]. PMID- 3961327 TI - [Echocardiography. IV. Contrast echocardiography]. PMID- 3961328 TI - [Multiple myeloma and renal insufficiency: apropos of 2 cases]. PMID- 3961329 TI - [Neuralgic amyotrophy, or the Parsonage-Turner syndrome]. PMID- 3961330 TI - [Osteomalacia: etiology, clinical aspects, physiopathology and therapy]. PMID- 3961331 TI - [Problems of ERCP and endoscopic papillotomy--clinical experience and practical suggestions]. PMID- 3961333 TI - [The wire-guided papillotome: its use in unfavorable anatomical conditions of Vater's ampulla]. PMID- 3961332 TI - [Endoscopic sphincterotomy of Vater's ampulla in acute biliary pancreatitis]. PMID- 3961334 TI - [Endoscopic insertion of endoprostheses in benign bile duct calculi. Description of 4 cases]. PMID- 3961335 TI - [Neo-gallbladder after cholecystectomy]. PMID- 3961336 TI - [Transformation of a percutaneous-transhepatic drainage method into a wide-lumen endoprosthesis by means of endoscopic implantation]. PMID- 3961337 TI - [Crohn disease and ulcerative colitis: internal medicine aspects of diagnosis and therapy]. PMID- 3961338 TI - [Ulcerative colitis and Crohn disease--surgical aspects]. PMID- 3961339 TI - [Therapy of the anal complications of Crohn disease]. PMID- 3961340 TI - [Unusual forms of chronic inflammatory diseases of the large intestine]. PMID- 3961341 TI - [Extraintestinal manifestations in chronic inflammatory intestinal diseases]. PMID- 3961342 TI - [Cardiotoxic risks from drugs and environmental chemicals]. PMID- 3961343 TI - [Mitral prolapse. A morphologic study]. PMID- 3961344 TI - [Structure of the Federal Office for Social Insurance. Listing of the basic laws and providing disability insurance]. PMID- 3961345 TI - [Occupational noise-induced hearing loss]. PMID- 3961346 TI - [The recipient of disability insurance]. PMID- 3961347 TI - [Problems of coordination between the Swiss Accident Insurance Agency and the Disability Insurance Agency]. PMID- 3961349 TI - [Diet and arterial hypertension]. PMID- 3961348 TI - [Current aspects of surgery for urolithiasis]. PMID- 3961351 TI - [Dyspnea, edema]. PMID- 3961350 TI - [Consumption of antihypertensive drugs and costs of treatment of arterial hypertension at a Swiss medical polyclinic (1975-1985)]. PMID- 3961352 TI - [A case from practice (51). Patient: S.A., born 1951, Spanish laborer (Klinefelter's syndrome)]. PMID- 3961353 TI - [Recourse to alternative medicine according to a survey of the French-speaking Federation of Consumers in 1984]. PMID- 3961354 TI - [Status of parallel physicians in developed countries: legal aspects]. PMID- 3961356 TI - [Acupuncture in a surgical practice]. PMID- 3961355 TI - [Recourse of practicing physicians from Vaud and Fribourg to so-called alternative therapies]. PMID- 3961357 TI - [Homeopathy as seen by a general practitioner]. PMID- 3961358 TI - [The Soleil Foundation]. PMID- 3961359 TI - [Parallel medicine in oncology]. PMID- 3961360 TI - [The systematic evaluation of medical procedures. Apropos of the effectiveness of parallel medicine]. PMID- 3961361 TI - [The consumers and alternative therapies. The opinion of the French-speaking Federation of Consumers]. PMID- 3961362 TI - [Penitentiary medicine: an active type of medicine. Apropos of medical entrance examinations in the penitentiary environment]. PMID- 3961363 TI - [Tuberculous bronchopneumonia]. PMID- 3961364 TI - [Recourse to alternative medicine in Switzerland. Results of recent research]. PMID- 3961365 TI - Modification of paradoxical sleep following transections of the reticular formation at the pontomedullary junction. AB - A retractable wire knife was employed to transect the reticular formation at the pontomedullary junction in order to assess the respective importance of pontine and medullary reticular neurons and their pathways in paradoxical sleep. Thirteen cats were implanted with a standard array of electrodes for polygraphic recording of sleep-wakefulness states during 3 days in baseline condition and during 21 days after transections. Average electroencephalographic (EEG) amplitude, average electromyographic (EMG) amplitude, and ponto-geniculo-occipital (PGO) spike rate were measured per 1-min epoch for each day. A trivariate computer graphics display of 1 day's data revealed three major clusters of points that corresponded to wakefulness, slow wave sleep, and paradoxical sleep in baseline. (a) After transections through the entire reticular formation at the pontomedullary junction, paradoxical sleep was no longer evident in the trivariate computer graphics or polygraphic record, either by the presence of a high PGO spike rate or by that of muscle atonia in association with a low-amplitude EEG. These results indicated that the reticular fibers that pass through the pontomedullary junction and interconnect the pontine tegmentum and the medullary reticular formation are necessary for generating the cluster of electrographic variables that normally characterizes paradoxical sleep. (b) After transections through the dorsal half of the reticular formation, paradoxical sleep was still evident, though with a reduced PGO spike rate, and muscle atonia was normal. These results indicated that the descending noradrenaline locus coeruleus fibers and the "longitudinal catecholamine bundle," which course through the dorsal tegmentum, are not necessary for the generation of muscle atonia or the state of paradoxical sleep. (c) After transections through the ventral half of the reticular formation, paradoxical sleep was still apparent by the association of a moderate, though reduced, rate of PGO spiking in association with low-amplitude EEG activity and a high-amplitude EMG, indicating a loss of muscle atonia. The duration of the PS episodes, however, was greatly reduced. These results indicated that the descending "tegmentoreticular" and ascending reticulotegmental pathways, which course ventrally through the pontomedullary junction and interconnect the dorsolateral pontine tegmentum and the ventromedial medullary reticular formation, are essential for the muscle atonia of paradoxical sleep and important for the normal cyclic generation and maintenance of the state of paradoxical sleep. PMID- 3961366 TI - Persistent psychophysiologic (learned) insomnia. AB - Persistent psychophysiologic (learned) insomnia (PPI) is an objectively verifiable sleep disturbance that develops secondary to chronic, somatized tension and negative conditioning. Twenty-two patients diagnosed as PPI were compared on sleep and psychological questionnaires to 22 normal subjects (Ns) and to 19 insomnia patients with dysthymic disorders (DD). PPI patients typically had difficulties initiating and maintaining sleep, as did the DDs, but showed normal sleep staging. While PPIs were similar to Ns on most psychological tests, they typically were repressors and sensation avoiders. Many PPI patients suffered from tension-related symptoms such as headaches. PPI patients and Ns revealed less psychopathology than DD patients on almost all psychological scales. PMID- 3961367 TI - Familial nocturnal cramping. AB - A familial syndrome of painful nocturnal cramping and jerking in members of three generations is described. All-night polysomnograms demonstrated both myoclonic jerks and sustained muscular activity in three family members, a 4-year-old girl, who presented with frequent episodes of painful awakenings; her 7-year-old brother, who had similar but less severe symptoms; and the 28-year-old mother, who had suffered nocturnal cramping and awakenings for much of her life. To the authors' knowledge, this is the first description of a familial disorder characterized by exclusively nocturnal intermittent cramping and myoclonus of brainstem or spinal origin. PMID- 3961368 TI - Treatment of a case of advanced sleep phase syndrome by phase advance chronotherapy. PMID- 3961369 TI - Significance of slow wave sleep: considerations from a clinical viewpoint. AB - Previous experimental observations, almost exclusively carried out with young healthy subjects, have been interpreted as showing a particular restorative role for human slow wave sleep (SWS). This article considers whether findings from polygraphic sleep studies in patients and elderly subjects lead to similar inferences about the meaning or "function" of SWS. The question was approached in three different ways: (a) by presenting results from a long-term study in elderly subjects whose SWS data were correlated with baseline medical and psychometric findings and with 5-year follow-up results; (b) by correlating nonmanipulated wake-time during days with parameters of SWS on subsequent nights in a group of 30 demented inpatients undergoing 72-h continuous sleep-wake recording; (c) by reviewing and comparing published polygraphic sleep studies for a number of psychiatric conditions. None of these three approaches provided unequivocal evidence for a clinically significant role for SWS. Reasons for the different outcome of SWS studies in young experimental subjects and clinical populations are discussed. PMID- 3961370 TI - [Pathology of the isthmo-interstitial segment of the oviduct, tubal pregnancy and microsurgery]. AB - With regard to the retrospective and prospective analysis of two series of patients, a first series concerning 180 patients presenting pathology of the isthmo-interstitial segment of the oviduct, and a second series concerning 149 patients operated on for extrauterine pregnancy, the authors have established the responsibility of the pathology of the proximal segment in a very large number of cases of sterility regarded as inexplicable, and in a certain number of cases of extrauterine pregnancy. Medical treatment with danazol gives remarkable results. In cases of failure of medical treatment, microsurgery involves isthmo-ostial reimplantation. PMID- 3961371 TI - [Endometriosis and extra-uterine pregnancies]. AB - Although endometriosis appears as a rare cause in long series of cases of extrauterine pregnancy, the study of pregnancies which survive after treatment of endometriosis show a significant increase of extrauterine pregnancy, especially in cases of proximal lesions. The authors thinks that careful anatomo pathological examination of tubes resected because of extrauterine pregnancy undoubtedly permit a large number of endometriosis lesions to be found. PMID- 3961372 TI - [Celioscopic treatment of extra-uterine pregnancy]. AB - The treatment of extrauterine pregnancy by coelioscopy is the most extreme refinement of coelioscopic surgery. It is recorded in the modern context of endoscopic surgery. This technique was received with reserve some years ago, when we presented the first case. After more than 250 cases the validity of the treatment has been established, and it has been adopted by other groups, foreigners in particular. It is applicable to non-ruptured tubal pregnancies, and necessitates an early diagnosis. Compared with techniques carried out by laparotomy, it offers the advantage of considerable gain of operative time, and of a considerable reduction in hospitalization, with excellent results on later fertility. PMID- 3961374 TI - [Breast hamartomas. Mammographic and histologic aspects. Apropos of 5 cases]. AB - Five observations of hamartomas are reported, and compared with the data in the literature. We recall the principal radiological and histological aspects. PMID- 3961373 TI - [The value of an antiprogesterone steroid in the treatment of extra-uterine pregnancy. Preliminary results]. AB - The aim of this work is to study the effects of an antiprogesterone drug (RU 486) on extrauterine pregnancy and to draw from it possible inferences for therapy. The study was carried out on 28 patients presenting an extrauterine pregnancy, the levels of plasma chorionic gonadotrophins of whom were higher than or equal to 250 mIU/ml. Different modes of administration were employed and a coelioscopic salpingotomy was carried out for a pathological study. PMID- 3961375 TI - [Importance of the systematic cytologic examination of breast secretions: 60 cancers diagnosed in 2120 discharges examined]. AB - The systematic collection of breast secretions by manual expression of the breast and nipple in 2 120 patients examined for breast diseases has led to the following results: 529 (25%) disclose epithelial papillary hyperplasia, 136 of which underwent surgical control. Epithelial hyperplasia without cellular atypias was found in 9 fibroadenomas, 42 fibrocystic diseases, 29 papilloma/papillomatosis and 21 cancers. Atypical or malignant hyperplasia was observed in 42 cases. Out of 60 cancers, thus investigated, 31 (51%) had malignant cells in such induced nipple discharge, 8 (13%) atypical cells and 21 (35%) concomitant papillary hyperplasia. Systematic cytological examination of breast secretion allows to control intraductal epithelial hyperplasia and to eventually disclose malignant tumor. PMID- 3961376 TI - [Instruments necessary for safe laser microsurgery]. AB - Special instruments have been perfected for the laser microsurgery. Those instruments must not exceed 18 centimeters in length in order to reduce the possibility of infection through the middle part (microslad) tied up to the microscope. The instruments must be blackened to reduce the casual reflection of the laser ray over the intra-abdominal structures. Molybdenum mirrors with specifically outlined angles to reflect laser rays towards the inaccessible spots and also to strike the aimed tissue at the right place, have been perfected. In the same way, quartz straight and angular rods stronger to the laser fatigue than the pyrex are necessary to absorb laser energy during the vaporization and the excision of intra-pelvic adhesions. Thanks to these adapted instruments, the micro surgeon gynecologist will be able to practise his laser surgery with more safety, less eyestrain and less difficulties. PMID- 3961377 TI - [Extra-uterine pregnancy and in vitro fertilization]. AB - About 10 p. cent of pregnancies which develop after in vitro fertilization and implantation of the ovum in the uterus are extrauterine. This surprising statement evokes several explanations and the authors consider that their prevention by preliminary tubal sterilization is quite excessive. PMID- 3961378 TI - [Medico-legal risks of human voluntary sterilization]. PMID- 3961379 TI - [Tubal histology in extra-uterine pregnancies]. AB - 141 patients affected by tubal pregnancy have been treated by total salpingectomy at the Port-Royal university clinic between the 1st January 1977 and the 31st January 1984. Tubal pregnancy occurred in the majority of cases in a pathological Fallopian tube, of which the histological state was unrelated to the clinical observations made at laparotomy. Ampullary pregnancy (88% of cases) is secondary to a pathological ampulla in 94 p. cent of cases. The latter was chronic salpingitis in 92 p. cent of cases. Isthmic pregnancy (12% of cases) appears to us to be secondary to isthmic pathology in all cases, and is generally associated with ampullary lesions. There also chronic salpingitis preponderates, whilst endometriosis is very rare. The great frequency of pre-existing lesions which we have noted explains perfectly the high level of recurrences in situ observed after conservative surgery of the gravid tube. PMID- 3961380 TI - [Voluntary female sterilization]. PMID- 3961382 TI - [Contraception a year after voluntary interruption of pregnancy]. AB - At the time of conception leading to a RLA, 94 percent of the women were not using medical contraception (intra-uterine contraceptive device or estroprogestin drug). One year after the RLA, only 12 percent of the patients were found not to be using medical contraceptives. Thus, RLA is an event which modifies considerably the contraceptive habits of the patients. It is remarkable that one year after a RLA, 3/4 of the patients continue to use the contraceptive prescribed immediately after RLA. PMID- 3961381 TI - [Traumatic retroplacental hematomas]. AB - In this study the authors present 4 observations of traumatic retroplacental hematomas recorded in the department of obstetrics and gynecology of the general hospital at Meaux between 1979 and 1984. The 4 cases are related to serious injury to the circulation as is shown by a detailed study of the observations. The frequency of these traumatic retroplacental hematomas seems clearly to be on the increase if comparison is made with earlier statistics. The problem of the security girdle is evoked again; the authors themselves think that it should be worn until pregnancy reaches its term. Emergency ultrasonography is the indispensable complement to the obstetric examination carried out on arrival of every pregnancy presenting a trauma enclosed in the abdomen; it may modify the order of the operations to be carried out by the various specialists who are responsible for the surveillance and treatment of these patients; together with monitoring it remains the best means of surveillance of the foetus following a road accident. PMID- 3961383 TI - [Spermatic cord torsion in the neonatal period]. AB - Four cases of torsion of the spermatic cord in the neonatal period were examined. In the light of the literature, the authors present the diagnostic approach and their conclusions concerning therapy. They insist on the necessity of a complete examination in the labour room and on the use of transillumination. Orchidectomy must be examined in relation to the intensity of the lesions and of the earliness of the diagnosis. The fixation of the contralateral testicle is considered necessary but must involve an efficacious technique, combined with a turning up of the tunica vaginalis. PMID- 3961384 TI - [Management of podalic delivery]. AB - A study has been made of obstetric assistance in 1 796 podalic version labors between 1966 and 1982, with 12.4% of cesarean sections, an extremely conservative criterion. The corrected intra-and postnatal mortalities were 141.1% and 26.6% for premature and mature deliveries respectively. 744 children were examined between 4 and 10 years after birth, using clinical studies, intelligence quotient measurements by the method of Wppsi or WISC (according to age), EEG observations if necessary and stimulatory, motor and behavioral neurological tests. The results are compared with those of a similar study using 418 control children whose cephalic version births were spontaneous and completely normal. Care should be taken in interpretation of births through the vaginal canal in order to exclude the 30%-50% of cases with a wide safety margin, in which the danger is essentially zero in mature fetuses and in premature fetuses of 2 to 2.5 kg. Cesarean section should be performed almost systematically when the fetus weighs less than 2 kg, so as to avoid any possible danger to the child. PMID- 3961385 TI - [A new technic for early prenatal diagnosis: trophoblast biopsy. Preliminary study]. AB - The authors report a preliminary study of chromosomal analysis made on chorionic villosities. The samples were taken by means of biopsy forceps. The "direct" method was used to determine the karyotype. Since then two diagnoses have been made on progressive pregnancies. PMID- 3961386 TI - [Acceleration of cervix dilatation: the role of diazepam]. AB - Diazepam was administered to 100 parturients in labour with a view to accelerating the dilatation of the cervix. The result was found to be encouraging. The indications for it are: prolonged or stationary dilatation, oedema of the cervix, poorly stimulated cervices, cervix retracted after giving birth to first of twins, block of the last head in breech deliveries resulting from a cervical spasm, prolapse of the umbilical cord requiring instantaneous complete dilation, foetal distress, etc. Diazepam weakens neither uterine contractions nor maternal efforts of expulsion. There is no harmful effect to mother and child. In the study there were 58 primiparas and 42 multiparas. PMID- 3961387 TI - [Epidemiological study of eclampsia at Mont Amba (Zaire) University Hospitals. Apropos of 28 case reports from 1981 to 1982]. AB - The authors report the results of a retrospective epidemiological study of 28 cases of eclampsia observed from 1981 to 1982 in the maternity ward of the University Clinic of Mont Amba (Zaire). Three essential points are revealed by the analysis: the incidence of the disease is 1 case in 417 confinements, that is 0.24 per cent; the pregnant women at high risk are primiparae, those with a twin pregnancy and those of the A and B blood groups, the mean age being 22.7 +/- 2.9 years (S.D.); the disorder is particularly frequent in the dry season and does not seem to be affected by prenatal consultations. The morbidity and mortality rates among the mothers and children are low. PMID- 3961388 TI - [Fibroma and pregnancy. Apropos of 51 case reports surveyed from April 1976 to December 1984]. AB - The study is based on 51 observations of fibromas of diameter 3 cm or more associated with pregnancy. The authors report the characteristics of this pathology, which occurs at a frequency of one in two in women over 35 years of age, half of whom are primiparae. The frequency varies with the size of the fibroma and falls between 0.3 and 2%. The circumstances of detection vary but echography both improves detection and allows the development of the fibroma to be monitored. The only frequent complication is aseptic necrobiosis (25% of cases), but it is usually latent or moderate. Abortions, low insertions of the placenta and faulty presentations are more frequent, especially where large fibromas are involved, but nonetheless 3/4 of such pregnancies come to term without any serious problems. Fetal prognosis is, therefore, excellent and perinatal mortality is close to that of a control population. The proportion of cesarean sections is high (30 to 75%) and depends on the circumstances, the size of the fibroma and the occurrence of dystocias. Myomectomy should remain exceptional during pregnancy but will be frequently used towards the end of a cesarean section; indications for hysterectomy on the other hand remain very limited. PMID- 3961389 TI - [Computer tomography in injuries of the cervical vertebrae]. AB - 32 patients with traumatic injuries of the cervical spine were investigated by CT. All patients were initially examined by plain films. CT was definitely superior to conventional radiology in compressive fractures of vertebral bodies. In flexion-extension injuries CT was useful showing fractures of the posterior elements in great detail. Conventional tomography was superior to CT in patients with complex dislocations of vertebral bodies. In the absence of fracture CT failed to detect disruptions of ligaments, which were readily shown by functional examination. PMID- 3961390 TI - A comparison between barium enema and a modified double-contrast technique as a routine examination of the colon with regard to the diagnosis of colonic polyps. AB - A modified double-contrast technique has been used as a routine examination instead of the barium enema and the double-contrast technique a.m. Welin. The number of polyps reflects the quality of the technique and the method showed a polyp rate of 4,6%. This is a considerable increase of diagnosed polyps compared to the barium enema, but an improvement in the diagnosis of polyps can be achieved by improving the cleansing procedure prior to the examination. PMID- 3961391 TI - [Experiences with the radiologic diagnosis of small acoustic neuromas]. AB - The authors report on their experience with air-CT cisternography in diagnosing small neurinomas of the auditory nerve. Although this examination method has been very successful, false-positive findings are possible. Recent experiments with RM tomography are described and the ranking of this new method is discussed. PMID- 3961392 TI - [CT study of aortic aneurysms with complications]. AB - Two case reports demonstrate the value of CT examination in abdominal aortic aneurysms with complications where the diagnosis is doubtful although an acute operation is not indicated. The method is non-invasive, rapid, does not require anaesthesia, and yields detailed anatomical information on vascular and other structures as desired. It is variable in accordance with the problems to be solved. PMID- 3961393 TI - [Chylopericardium as a rare cause of a "large" heart shadow--2 case reports]. AB - Two cases with the diagnosis of asymptomatic chylopericard were evaluated. One was a 20-year old girl who had been operated on for intrathoracic lymphangioma and chylopericardium that existed since birth, and who developed a chylothorax after the operation. The second case report concerns a 22-year old man who had been suffering from a posttraumatic asymptomatic chylopericardium for two years and who is being treated conservatively "Low-fat diet"). PMID- 3961394 TI - [Disk hernia of the lumbar spine. Radiologic study with special reference to the technic and value of nuclear magnetic resonance tomography]. AB - Degenerations of the spinal disc especially in the lumbar region are the most frequent degenerative diseases in orthopedics. As diagnostic proceedings to discover disc herniation myelography and computerized tomography have been proven to be very usefull. Each of those methods show a high sensitivity and accuracy. Computerized tomography seems to be the first procedure because of the lac of any risk. Myelography has been reserved for the second approach, if there is any doupt in diagnosis. This paper will especially discuss advantages and disadvantages of MRI-tomography for the diagnosis of disc herniation. In MRI tomography we have no radiation, there is no risk for the patient and we have the possibility of slices in different orientations with the sagittal orientation having priority in diagnosis of disc herniation. A more pronounced contrast in MRI relatively to the computerized tomography with nearly the same spatial resolution is an other important fact in favour for MRI. The value of MRI diagnosis of the spine depends however mainly on the use of special surface coils and on the use of high magnetic fields which provides a good signal to noise relation and which would permit us to use a thin-slice technique. PMID- 3961395 TI - [Geriatrics, geriatric medicine, gerontology]. PMID- 3961396 TI - [Pharmacology of the elderly]. PMID- 3961397 TI - [Anesthesia and peri-operative care of the elderly]. PMID- 3961398 TI - [Cardiac insufficiency in the elderly]. PMID- 3961399 TI - [The aged population at the beginning of the 3rd millenium: presentation and comments of a demographer]. PMID- 3961400 TI - [Dopaminergic agonists in Parkinson disease]. PMID- 3961402 TI - [Rehabilitation of the surgically-treated hip]. PMID- 3961401 TI - [Antispastic agents]. PMID- 3961403 TI - [Rehabilitation of the knee]. PMID- 3961404 TI - [Practical suggestions for prescriptions. Nomenclature]. PMID- 3961405 TI - Attempts to reduce risk factors of cerebral postangiographic accidents. PMID- 3961406 TI - Affective syndromes in a student population--relative prevalence of various forms, types and subtypes. Considerations on evolution and recovery possibilities. PMID- 3961407 TI - EEG spectral reaction curve (SPRC): uses and practice. PMID- 3961409 TI - Brain damage following repeated electroshocks in cats and rats. Effect of artificial respiration and vitamin E. PMID- 3961408 TI - Orienting response extinction in nocturnal enuresis. (II). PMID- 3961410 TI - Effect of melatonin-free pineal extract on sialic acid in hemicastrated and testosterone-treated rats. AB - Administration of a melatonin-free pineal extract to hemicastrated rats in doses of 2 ml/day/animal induced a statistically significant decrease in their serum and testicular sialic acid after 3 days but not after 30 days of treatment. Unilaterally castrated rats receiving testosterone (6 injections) showed 10 days post-castration a statistically significant decrease in sialic acid in their serum and testes but not in the epididymis. Twenty-one days post-castration, time in which 11 testosterone injections were given, the sialic acid was low in the epididymis as well. Concomitant administration of testosterone and pineal extract caused a total reduction in the serum and partial reduction in the testes, of the lowering effect of testosterone on sialic acid. The return to the normal values of the serum sialic acid, to almost normal values of the testicular sialic acid and the increase over the normal values of the epididymal sialic acid shows the equilibrating role played by the pineal extract on the sialic acid in the hemicastrated rat treated with testosterone. The role of the melatonin-free pineal extract on sialic acid, a biochemical index involved in reproduction, is discussed. PMID- 3961411 TI - Influence of thyroid hormones and of methylthiouracil upon collagen content in the liver of rats with hepatic fibrosis. AB - Influence of the administration of thyroid extract and of methylthiouracil on the collagen content in the liver and on hydroxyproline level in serum in rats with or without carbon tetrachloride-induced fibrosis of the liver was investigated. A decrease of collagen content in the liver was found in hyperthyroid rats and an increase of the liver collagen content was observed in hypothyreosis. Similar results were found in animals with fibrosis of the liver. PMID- 3961413 TI - The value of thyroglobulin (TGL) assay in following the post-therapeutic course of differentiated thyroid cancer. AB - Serum TGL was assayed in 32 patients with total thyroidectomy performed on account of differentiated thyroid cancer, and in whom postoperative serum TGL values were above 60 ng/ml. The purpose of the study was to demonstrate the specific TGL response in differentiated thyroid cancer relapse and metastases, and the value of serum TGL assay as a test for early diagnosis of relapse and metastasis in this form of cancer. The results were compared to those from the following lots: 15 euthyroid volunteers, 15 patients with differentiated thyroid cancer diagnosed postoperatively whose serum TGL values were under 60 ng/ml and, 14 patients with non-thyroid cancer metastases. PMID- 3961412 TI - Prevalence of endemic goiter in Mures County. AB - A number of 20,000 children representing 91.19% of all the enlisted children aged 6-14 years were examined. The clinical status of each child was assessed according to the WHO criteria. Goiter was found in 3,363 (16.81%) children. Of these, 1504 (44.72%) were boys and the zero degree, 2,137 (63.54%) to the 1 degree and 84 (2.49%) to the 2nd degree. As related to the total number of children examined, the zero degree goiter was found in 5.71%, the ist degree in 10.68% and the 2nd degree in 0.42% of the cases. The incidence of goiter in rural and urban areas was in the range of 6.80%-38.46%. Only in 2 areas the incidence was higher: 42.33% and 60%. A predominantly increased incidence was found in those areas which were not screened in 1951 and consequently prophylaxis was not constantly applied. PMID- 3961415 TI - [Excretion of 131I-labeled bromsulphalein in rats with experimental liver injury]. PMID- 3961414 TI - Trisomy 8 syndrome. A report of 2 cases. AB - Two new cases of trisomy 8 mosaicism are reported. Both patients present the "evocative facial traits" of trisomy 8; large square face, everted lower lip, deep skin furrows on the palms and soles, joint rigidity and psychomotor retardation. The whole literature on trisomy 8 is reviewed. PMID- 3961416 TI - [HLA antigens in hypertrophic cardiomyopathy]. PMID- 3961417 TI - [Relation between changes in the diameter of both the inferior vena cava or the aorta and pulmonary edema in an animal experiment. II. Hemodynamic changes in complete occlusion of the inferior vena cava under or between the branching of the renal veins in induced pulmonary edema in a chronic experiment in rabbits]. PMID- 3961418 TI - [Relation between changes in the diameter of both the inferior vena cava or the aorta and pulmonary edema in an animal experiment. III. Hemodynamic changes in partial or complete occlusion of the inferior vena cava below the branching of the renal veins and after induction of pulmonary edema in acute and chronic experiments]. PMID- 3961419 TI - [Relation between changes in the diameter of both the inferior vena cava or the aorta and pulmonary edema in an animal experiment. IV. Hemodynamic changes in stenosis of the abdominal aorta below the branching of the renal arteries and after induction of pulmonary edema in acute and chronic experiments]. PMID- 3961420 TI - Prevalence and clinical effects of delta agent. Infections in Norwegian population subgroups. AB - The distribution of antibodies against the delta agent was studied in different groups of hepatitis B patients in Norway. Such antibodies were detected only in drug addicts, predominantly among chronic HBsAg carriers. The results support the notion that the delta agent was introduced into Scandinavia in 1970-75. Although the proportion of anti-delta positive individuals among chronic HBsAg carriers increased, the annual increase of new anti-delta carriers was essentially stable. One death caused by hepatic failure was registered among 43 anti-delta negative and none among 21 anti-delta positive chronic HBsAg carrier addicts. PMID- 3961421 TI - Cerebrospinal fluid white cell, glucose and protein changes during the treatment of Haemophilus influenzae meningitis. AB - 298 cerebrospinal fluid (CSF) samples obtained from 116 children with ongoing Haemophilus influenzae meningitis were analyzed in order to determine the kinetics of the white blood cell (WBC) count and the glucose and protein concentrations--parameters for which there are no "reference values" available for the convalescence period of meningitis. The values determined during the first 10 days of treatment are presented as percentile distribution graphs. CSF WBC counts increased slightly for the first 24 h but declined thereafter without reaching, however, the normal value (less than or equal to 5/microliter) within 10 days in the majority of cases. Low CSF glucose concentrations usually increased to a normal or almost normal level within 48 h. CSF protein concentrations declined steadily throughout the treatment. Extremely high CSF WBC or low CSF glucose concentrations suggested neurological complications or treatment failure. The value of sequentially determined CSF WBC, glucose and protein in monitoring recovery from H. influenzae meningitis is, however, so vague that routine spinal taps do not seem indicated after CSF has become sterilized. PMID- 3961422 TI - Serotype distribution of Streptococcus pneumoniae strains isolated from blood and cerebrospinal fluid in Sweden. AB - 215 strains of Streptococcus pneumoniae isolated from blood or cerebrospinal fluid at 3 different laboratories in Sweden were serotyped by coagglutination and subtyped by the capsular reaction test. 78% of the strains belonged to serotypes which are included in or completely cross-immunogenic with serotypes included in the 14-valent vaccine while serotypes included in the 23-valent vaccine covered 89% of the isolates. Types 7F, 14 and 33F, which cannot be detected by counterimmunoelectrophoresis constituted 19% of all strains. PMID- 3961423 TI - Schizophrenia in children: a review of European research. AB - European literature on childhood schizophrenia is divergent and vast. The topic itself is controversial and complex. The article reviews selected European literature on childhood schizophrenia and presents the most important trends of research from the literature. Extensive work has been devoted in tracing and defining the boundaries of childhood schizophrenia from infantile psychosis, autism, organic psychoses, and borderline states, and of mapping out the condition. The factor of development as an important variable when studying diagnostic criteria and the course of the condition was singled out by many researchers. The evidence from the research on etiological factors was also reviewed, and most authors seem to agree on a nature-nurture interaction model. The different treatment modalities and approaches are also presented and discussed. Finally, a proposal is made for comparative studies to be carried out that will cover course and followup. PMID- 3961424 TI - Schizophrenia as a semiotic disorder. AB - Lanin-Kettering and Harrow (1985) argue the traditional position that schizophrenia is a thought disorder. Chaika and Lambe (1985) counter that it is a speech disorder at the syntactic-discursive level, and not a thought disorder. On the basis of state-of-the-art research in linguistics, it is suggested that the symptoms of schizophrenia are evidence of neither a thought disorder nor a syntactic-discursive disorder but a semiotic disorder. Semiotic structures have the form of saying something about something to someone and involve speech act, reference, pragmatics, and interpretation. Therefore, it appears that schizophrenic disorder is located in this structure. PMID- 3961425 TI - The inpatient care of the chronically mentally ill. AB - The inpatient treatment of the chronically mentally ill as it has been practiced in the past, is practiced at the present, and may be practiced in the future is discussed. The reasons for admitting the chronically ill to inpatient services; the steps of such treatment and treatment modalities employed; and considerations for discharge are presented. In addition, the indications as well as pros and cons for long-term inpatient hospitalization are included. PMID- 3961426 TI - The contribution of European case registers to research on schizophrenia. AB - Psychiatric case registers have become important instruments for epidemiological research and for the evaluation of care provided for persons suffering from schizophrenia. Under the condition of a sufficient provision of care, case registers permit relatively reliable estimates of "treated" incidence and prevalence, and enable the investigation of associations between morbidity risks, disease courses, and variables such as ecological, social, and occupational factors. The linkage with twin, adoption, and birth registers provides new opportunities for the investigation of the impact of genetic versus environmental factors on the probability of becoming ill with schizophrenia. On the basis of long-term utilization figures, case registers enable a valid measure for controlling utilization, effectiveness, quality, and costs of care. Because case registers take demographic and regional factors into account, they enable better planning of mental health services--a task that grows more important with the shift from hospital-based to community-based treatment, especially for the chronic patients. PMID- 3961428 TI - Measurement of negative symptoms. AB - The issue of the dimensionality of negative symptoms is addressed. In reference to data reported by Lewine, Fogg, and Meltzer (1983), it is suggested that the nonsignificant correlation between a SADS-C negative symptom scale and a NOSIE negative symptom scale, both independently developed using the Rasch model, is evidence for the multidimensionality of negative symptoms. Additional data supporting the multidimensionality of negative symptoms using confirmatory factor analysis is also discussed (Gibbons et al. 1985). A new theory for the structure of negative symptoms is needed, which specifies the number of dimensions, their classification, and their pattern of intercorrelation. PMID- 3961427 TI - Epidemiology of schizophrenia: a European perspective. AB - Since its inception, the concept of dementia praecox and, later, of schizophrenia has been one of the most disputed entities in modern medicine. Schizophrenia was, and still is, defined by its clinical symptoms and their characteristic evolution over time. No external validating criteria for the diagnosis have been established, in spite of a host of suggestive biological findings, among which the genetic data carry most weight. This absence of clear-cut substrate markers and indicators underscores the importance of the epidemiological perspective in the study of the disorder. The European contributions to the epidemiological description and understanding of schizophrenic morbidity are numerous. They range from community surveys and studies of pedigrees to case-control designs for assessment of risk factors and long-term followup investigations of course and outcome. This review focuses on epidemiological approaches to schizophrenia that have attempted to highlight the essential attributes of a disease: its incidence and prevalence, ecology, and associated features. It is difficult to generalize about European epidemiological research in schizophrenia, because of the coexistence of a variety of "schools," traditions, and approaches. It is nevertheless possible to discern several clear trends in European epidemiological investigations of schizophrenia that can, to some extent, be contrasted to North American developments. PMID- 3961429 TI - Research on schizophrenia in Southern European countries. AB - The research on schizophrenia during the last 50 years in the Latin language countries of Southern Europe is briefly surveyed. Particular emphasis is given to the contributions of French authors to the diagnostic concept of schizophrenia, as well as to the phenomenological studies concerning the "essence" of schizoidia/schizophrenia, and some initial schizophrenic "Erlebnisse." The development of biological, psychological, and sociological theories concerning the etiology of schizophrenia is outlined, and contributions such as the "aminotoxic theory" of V. M. Buscaino and the theoretical principles of "alternative psychiatry" are examined in detail. Lastly, the role of French, Italian, Spanish, and Portuguese psychiatrists in the introduction and improvement of somatic treatments is described. PMID- 3961430 TI - Reversible non-oliguric impairment of renal function during azapropazone treatment. AB - An impairment of the renal function was observed in three patients who received azapropazone for various rheumatic disorders with simultaneous hyperuricaemia. A distinct increase in serum creatinine occurred in all patients. In one case the renal biopsy suggested a hypersensitivity reaction with a consequent acute tubulo interstitial nephritis as the mechanism of the impaired renal function. The renal insufficiency was reversible in all cases after the withdrawal of azapropazone. PMID- 3961431 TI - Influence of weather on stiffness and force in patients with rheumatoid arthritis. AB - A simple instrument has been developed for quantitative measurement of stiffness (elasticity) and maximum force of the fingers and was tested in a series of 122 out-patients with RA and 101 healthy controls. Values measured for stiffness were higher in RA patients and were scattered more widely than in controls and the mean values for force in the RA patients were lower than in controls. RA patients with an elevated ESR have significantly less strength than those with low ESR. We evaluated the influence of the time of day and weather (humidity and air temperature on the wards and outside the hospital, barometer pressure) on stiffness and force. In 13 in-patients with definite or classical RA and 12 controls, measurements were performed in the morning and afternoons, over periods of 3 weeks. In RA patients, both stiffness and force increased with outside air humidity (p less than 0.05), confirming the clinical experience that stiffness increases in damp weather. In the controls, force decreased with a higher air humidity on the wards (p = 0.05) and increased with higher barometer pressure (p less than 0.05). In the controls joint stiffness was higher in the morning than in the afternoon (p less than 0.05). In the RA group, rather unexpectedly, the reverse was found (p = 0.06), possibly explained by the time of the day the investigation was done. Only in the controls was a significant increase in force noted during the 3 weeks of investigation (p less than 0.005). No correlation was seen between force and stiffness. No correlation was found between disease activity as expressed in ESR, Hb, Rose titre, ARA grading and stiffness or force. PMID- 3961433 TI - Determination of larger urinary peptides in osteoarthrosis by high-performance liquid chromatography. AB - Urinary peptides larger than 4000 were fractionated by HPLC on reversed phase. Urines of osteoarthrotic patients were compared with those of healthy persons and rheumatoid patients. The profile of urinary peptides of patients with mild form of osteoarthrosis differed significantly from that of other groups studied. The results of patients with rheumatoid arthritis were similar to those of patients with activated or severe form of osteoarthrosis. PMID- 3961432 TI - Scanning electron microscopical study of the effects of crystalloid and water soluble glucocorticoids on articular cartilage. AB - A comparative scanning electron microscopical study on the topical effects of glucocorticoids on rat knee cartilage was undertaken. Water-soluble and crystalloid 'depot'-form glucocorticoids were tested. Cartilage destruction was dependent on the number of injections and was clearly more pronounced in the knees injected with crystalloid glucocorticoid. We conclude that repeated injection of the joint with glucocorticoids should be given only after careful consideration of the clinical state. PMID- 3961434 TI - Incorporation of [35S]sulphate and [3H]thymidine into isolated bovine articular chondrocytes in vitro. Effect of autogenous conditioned synovial medium. AB - The present work is a part of a study series concerned with the metabolic events taking place in the synovial joint tissues. We have previously reported that synovial products not only enhance the degradation of articular cartilage proteoglycans but also inhibit the synthesis of articular cartilage proteoglycans, and that these cellular interactions may be partly modulated by arachidonic acid metabolites. In the experiments reported here we show that the addition of conditioned synovial medium to confluent monolayer cultures of articular chondrocytes not only inhibits the synthesis of proteoglycans, measured as the incorporation of radiosulphate into cartilage proteoglycans but also inhibits the synthesis of DNA, measured as the incorporation of radiothymidine into the chondrocytes, in a dose-dependent manner. In our culture system, calf knee-joint synovial tissue produces PGE, and it has been reported that previous exposure to PGE2 affects the ability of the cell to respond to that same hormone. In these experiments, previous exposure to conditioned synovial medium affected neither the inhibition of the incorporation of radiosulphate nor the inhibition of the incorporation of radiothymidine. PMID- 3961435 TI - Bioavailability of D-penicillamine in a patient with gastrointestinal progressive systemic sclerosis. AB - D-penicillamine pharmacokinetics were studied in a patient with gastrointestinal progressive systemic sclerosis possibly complicated by malabsorption. D penicillamine bioavailability was examined after oral, duodenal, intravenous and rectal administration. No D-penicillamine was detectable in plasma after administration to the gastrointestinal tract. The pharmacokinetics after intravenous administration agreed closely with the corresponding situation in healthy volunteers. PMID- 3961436 TI - Selenium and rheumatoid arthritis. PMID- 3961437 TI - A cohort mortality study of painters and allied tradesmen. AB - A cohort study was conducted of the membership of a large international union of painters and allied tradesmen. The union membership consisted of both painters and associated trades such as glaziers and tile and carpet layers. The study examined the mortality experience of 57 175 current and former union members in four states (California, Missouri, New York, and Texas) in the United States (US) from 1975 through 1979. No excess mortality was observed for the total union membership when compared to that of all US white males. When the study population was subdivided by the trade affiliation, members of locals comprised primarily of painters exhibited a significant elevation in mortality from all malignant neoplasms, lung cancer, and stomach cancer, compared to all US white males. To reduce the impact of potential nonoccupational differences between the study population and all US white males, the data were also analyzed using the entire cohort as the standardization population. Significant elevations continued to be observed for all malignant neoplasms and lung cancer among the membership of painting locals compared to other locals. In addition there was a statistically significant difference in mortality from leukemia and cancer of the bladder observed between the groups. PMID- 3961438 TI - Mortality and cancer incidence among Swedish dock workers--a retrospective cohort study. AB - The study originates from the arousal of suspicions that, in connection with loading and unloading work involving the use of trucks, exposure to diesel exhaust fumes may be carcinogenic. This report describes a register study in which a broad mapping of the cause-of-death pattern and cancer morbidity has been carried out through the matching of locally compiled personal data with those from a central register, the Cause-of-Death Register, and the Cancer Register. The results obtained thus far show a low total mortality--irrespective of cause of death--but a tendency towards an excess risk for cancer morbidity, mainly due to lung cancer. PMID- 3961439 TI - Oral cavity and laryngeal cancers among man-made mineral fiber production workers. AB - From 1975 to 1984, the incidence of cancer was determined among workers employed in a French man-made mineral fiber (MMMF) production plant. The cohort, including 1 374 fully active or retired men, represented 12 793 person-years. Forty-one patients had cancer, 19 of which were in the upper respiratory and alimentary tract and five of which were lung cancers. The number of lung cancers observed did not significantly differ from that expected [standardized incidence ration (SIR) 0.7]. However the incidence of upper respiratory and alimentary tract cancers was significantly higher (SIR 2.2), especially for those in the larynx (SIR = 2.3), pharynx (SIR 1.4), and buccal cavity (SIR 3.0). The relative risk of cancers in the upper respiratory and alimentary tracts seemed to increase with the length of exposure to glass fibers and exceeded the value of 3.0 for more than 10 years of exposure. This result does not seem to be attributable to an excess of tobacco and/or alcohol consumption. No previous survey of the MMMF industry has shown such a risk, except in Italy. Thus this finding has to be confirmed. PMID- 3961440 TI - Respiratory disease in cotton textile workers in the People's Republic of China. I. Respiratory symptoms. AB - The prevalence of byssinosis and nonspecific respiratory symptoms was studied in 887 textile workers with at least two years of employment in two cotton mills and one silk mill in Shanghai, the People's Republic of China. A standardized respiratory questionnaire was used, and environmental sampling was performed with vertical elutriators and colorimeter grading. Eight percent of the cotton textile workers complained of byssinosis. The reports of byssinosis were mostly mild (grade 1/2), more prevalent among women, and unrelated to duration of employment or elutriator dust levels. Nonspecific respiratory symptoms were significantly more prevalent among cotton textile workers than silk workers. After adjustment for age, gender, and smoking in logistic regression models, the odds ratios for the effect of working in cotton textile mills on chronic bronchitis, chronic cough, and frequent chest illness were 3.3, 2.9 and 4.7, respectively. Although none of the symptoms were related to current dust levels, the range of exposures was narrow, and information was only available on current levels of cotton dust. This study represents the first respiratory survey of the textile industry in China using diagnostic criteria similar to that used in the United States and England; it defines a cohort for prospective investigation. PMID- 3961441 TI - Respiratory disease in cotton textile workers in the People's Republic of China. II. Pulmonary function results. AB - Pulmonary function tests were performed pre and post workshift on 887 textile workers with at least two years of employment in two cotton mills and one silk mill in Shanghai, the People's Republic of China. Environmental sampling was performed with vertical elutriators, and pulmonary function was performed with standardized techniques. Cotton textile workers were found to have greater across shift decrements in forced expiratory volume in 1 s (FEV1.0) than silk workers. Increasing duration of exposure resulted in increasing acute decrements in FEV1.0, although significant acute decrements were found in workers with less than five years of exposure. The acute changes in FEV 1.0 were noted in both symptomatic and asymptomatic cotton workers, though the difference between the across-shift change in FEV1.0 (delta FEV1.0%) of the byssinotics and nonbyssinotics increased as work duration increased. There was no difference in preshift FEV1.0 between the cotton and silk workers, but several selection factors likely influenced the observations. PMID- 3961442 TI - Estimates of the proportion of bladder cancers attributable to occupation. AB - In order to estimate the proportion of bladder cancers attributable to occupation in different countries, three criteria were defined, each with a different degree of strictness, for the inclusion of job titles or industrial activities in the estimates. Such criteria were applied to the available case-referent studies, the range for the less severe criterion estimates being 0-19% and that of the strictest being 1-19%. The variability was greater among the studies than among the criteria of inclusion of occupations; therefore the study design and time- and place-specificity of exposures play an important role in the magnitude of such estimates. PMID- 3961443 TI - Determination of N-methylmorpholine in air samples from a polyurethane foam factory. Comparison between two methods using gas chromatography and isotachophoresis for analysis. AB - The N-methylmorpholine levels in workroom air in a polyurethane foam factory were determined by two methods in which midget impinger flasks were used for sampling. The analyses were performed by gas chromatography and isotachophoresis. The values obtained by the gas chromatographic method were 19% higher than those of the isotachophoretic method. Determinations of the amine in samples generated in laboratory experiments showed no statistical difference between the two methods. The mean air concentrations of N-methylmorpholine in different work areas of the factory ranged from 7 to 22 mg/m3. Urine was collected from seven workers and analyzed for N-methylmorpholine by gas chromatography. The amine concentrations and the excretion rates increased considerably during the workday. PMID- 3961444 TI - Biological monitoring of styrene metabolites in blood. AB - Ten men occupationally exposed to styrene in two glass-fiber reinforced plastics factories were studied during three consecutive workdays. The mean external exposure level was 99 mg/m3. The total pulmonary uptake of styrene was estimated from measurements of the styrene concentration in inspired air, the pulmonary ventilation, and the relative uptake. A gas chromatographic method based on electron capture detection was used to quantify styrene glycol, as well as styrene-7,8-oxide, in blood. The concentration of styrene glycol appeared to be linearly related to the preceding uptake of styrene. When the uptake during 5 h immediately before the blood sampling was considered, the correlation coefficient (r) obtained the value of 0.90. The concentration of styrene-7,8-oxide was at the detection limit of 0.02 mumol/l in most samples. A weaker correlation between the concentration of styrene in blood and the uptake during the hour immediately preceding the blood sampling was obtained (r = 0.71). PMID- 3961445 TI - Re: "Occupational cancer: Where now where next?". PMID- 3961446 TI - [The "clumsy" child: differential diagnosis and therapeutic indications. A review]. AB - In "clumsy" children, minimal cerebral palsy, isolated muscle hypotonia, disorders of sensory integration and behavior disturbances can be distinguished as separate clinical syndromes. A review is presented of investigative techniques, diagnostic criteria, treatment indications and prognosis in these patients. PMID- 3961447 TI - [Mitral prolapse syndrome: clinical, electrocardiographic and angiocardiographic correlations. Study of 100 patients with healthy coronary vessels]. AB - Mitral valve prolapse frequently resembles coronary heart disease. Retrospective clinical, ECG and angiographic analysis of 100 consecutive patients with mitral prolapse and normal coronary arteries, but complaining of anginal pain, shows how difficult it is to establish the correct diagnosis. When resting, 44% of patients have nonspecific ECG disorders of repolarization phase. During periods of chest pain 3 patients experienced transient ST segment changes very similar to acute myocardial ischemia. The exercise test was positive in 39% of cases, and in 2 patients during exercise a sudden drop in blood pressure suggested coronary perfusion failure. In all patients the coronary arteries were normal, but left ventriculography showed mitral valve prolapse predominantly on the posterior leaflet. At rest, 35% of patients had diastolic compliance failure, 32% had left ventricular hyperkinesia and only in 3% was slight hypokinesia present. Finally, early systolic relaxation of the anteroapical wall was observed in 75% of patients. PMID- 3961448 TI - [Optimal dosage of chlorthalidone in the prevention of the recurrence of nephrolithiasis is 25 mg per day]. AB - Thiazides are considered to be effective in preventing recurrence of various types of nephrolithiasis, but the optimum dosage has not been established. To address this issue, 5 idiopathic stone formers with hypercalciuria on low Ca diet received chlorthalidone (CT) in 3 different oral doses and were randomly assigned either to the sequence 25-50-100 mg/day or the reverse (2 months per dose, monthly blood and urine measurements). The anticalciuric effect of CT was significant only at 50 and 100 mg/day, at the expense of a dose-dependent decrease in U-citrate excretion. We also observed a dose-dependent decrease in blood levels of K, increases in those of HCO3 and urate, as well as in U-pH, a tendency for blood levels of Mg and U-oxalate excretion to fall, and no change in U-urate excretion. Therefore, to derive the optimal CT dose the Tiselius' risk index was applied, which is based on the values of urinary [Ca], [oxalate], [Mg], [citrate] and volume. CT produced a decrement in risk index which was similar at each of the doses tested. Thus, raising CT doses beyond 25 mg/day does not hold out the prospect of improved prophylaxis. This agrees with Ettinger's preliminary data (Urol. Res., 1984) showing a similar protective effect of CT at 25 and 50 mg/day despite the absence of a significant anticalciuric effect at 25 mg/day. PMID- 3961449 TI - [Depressive states in the elderly and their treatment]. AB - The clinical classification of depressive states has undergone considerable modification in the past few years. More particularly, the various clinical forms described earlier in relation to age or dubious etiological hypotheses have been reorganized within the framework of general categories of depression established according to clinical criteria. This development has been largely due to the work accomplished by the American Psychiatric Association Task Force and its Diagnostic and Statistical Manual of Mental Disorders, which has become a standard reference work worldwide. With its precise criteria, this classification enables clinicians to adjust therapeutic indications more readily to each particular case. Monotherapy is the rule of thumb for the pharmacological treatment of depression, particularly in the elderly. Combination of medications in the treatment of agitated or melancholic depressive states must be limited to situations in which it is absolutely necessary, and in such cases it is even more important to monitor blood levels than in monotherapy. When there is a significant psychotic component to major depression (hallucinations, delusions), it is advisable to undertake specific antipsychotic treatment before initiating antidepressant medication. In the majority of cases it is possible to treat depressive states in the elderly by appropriate selection of both medication and dosage, and by careful clinical attention to the patients' physical and psychological well-being. PMID- 3961450 TI - [Significance of the determination of teichoic acid antibodies in the diagnosis of Staphylococcus aureus bacteremia]. AB - Sera of 47 patients with serious Staphylococcus aureus infections, 55 patients with septicemias caused by other organisms and 147 healthy controls were examined for teichoic acid antibodies by ELISA, counterimmunoelectrophoresis (CIE) and immunodiffusion (ID). The specificity and the predictive value of positive results for metastatic-septic complications were 100% each for ELISA, 93%/88% for CIE and 87%/80% for ID. The low sensitivity with all three test methods of 50-60% relates to single sera. The indication for prolonged antibiotic treatment should therefore be derived only from the analysis of consecutive serum samples. With 12% of the controls above the cut-off, the ID test seems not a very good screening test. PMID- 3961451 TI - [Video-microscopic studies of telangiectases in Osler's disease and scleroderma]. AB - 4 patients with hereditary hemorrhagic telangiectasia (Osler's disease) have been studied by clinical means and by fluorescence videomicroscopy. The capillaroscopic image was characterized by convolutes of giant capillaries (diameter up to 150 micron, normal value up to 15 micron) between capillaries of normal shape and size. After intravenous injection of Na-fluorescein the enlarged capillaries filled rapidly and in some loops flow direction changed at irregular intervals. These findings are in contrast to those observed in systemic sclerosis, where generalized microangiopathy with avascular fields, microbleedings, enlarged capillaries and increased transcapillary and interstitial diffusion of the fluorescent dye are typical. In borderline cases capillaroscopy contributes to differential diagnosis of the telangiectatic form of scleroderma and Osler's disease. PMID- 3961452 TI - [The role of colorimetry strips in routine urine analysis in ambulatory practice]. AB - Study of 1249 routine urinalyses showed that proteinuria-, leukocyturia- and hematuria-detecting dipsticks are fully reliable. Dipsticks therefore render superfluous microscopic examination of normal samples, which represents more than half of the analyses performed in ambulatory care. PMID- 3961453 TI - [Quantitative liver function tests in porphyria cutanea tarda: improvement under therapeutic phlebotomy]. AB - Quantitative liver function was assessed before and after therapy in 4 patients with porphyria cutanea tarda. Three patients underwent phlebotomy, which produced clinical and biochemical remission. Concomitantly, functional liver cell mass, as measured by galactose elimination capacity, normalized. In the last patient, treated with chloroquine, liver function did not improve during therapy. The aminopyrine breath test, a measure of microsomal function, was inconclusive. These results show that decreased hepatic function in porphyria cutanea tarda is reversible and emphasize the potential role of iron accumulation in the pathogenesis of hepatic dysfunction in porphyria cutanea tarda. PMID- 3961454 TI - [Self-monitoring of physicians for the detection of iatrogenic diseases]. AB - Iatrogenic diseases are defined as illnesses due to diagnostic or therapeutic procedures. The authors explore the possibility of recording iatrogenic diseases by a physician self-monitoring system. The responsible physician himself records his/her patients' iatrogenic complications on hospital discharge, after which the authors examine retrospectively all charts of the patients involved and a random sample of patients not included. The results show that in one year 208 of 1618 patients were recorded as having an iatrogenic disease which was severe in 88. 7.1% of these cases were not confirmed retrospectively (false positives). On the other hand, about one third of iatrogenic illnesses were not recorded (false negatives), though these were less severe cases only. We calculated that 17% of our patients had iatrogenic diseases, 22% of these were predictable. About a third of the patients had iatrogenic disease before hospital admission, and these patients had more severe, and other, iatrogenic diseases than those who acquired them during hospitalization. Iatrogenic complications affect other organ systems than non-iatrogenic acquired diseases. On average, patients with iatrogenic diseases were 6 years older and hospitalized 10 days longer than other patients. Although not all cases may be recorded, we believe that physician self-monitoring is preferable to other systems for recording iatrogenic diseases, since it may have a direct teaching effect on those who cause the illness. PMID- 3961455 TI - [Malignant pericardial effusion--a sign of unfavorable prognosis?]. AB - Malignant pericardial effusion (MPE) resulting in cardiac tamponade is a rare complication in neoplastic disease. From January 1975 to December 1984 the authors observed 22 patients with cytologically verified malignant pericardial effusion. The most frequent primary tumors were non-small cell lung cancer (6), breast cancer (5), non-Hodgkin lymphoma (4) and mesothelioma (4). 50% of the patients presented with MPE as the initial manifestation of the tumor. In the other group of patients MPE appeared after an average of 11 months following the diagnosis of malignant disease. The most frequent symptoms and clinical findings were dyspnea (100%), jugular venous distention (91%), and tachycardia (82%). During the first 24 hours after pericardiocentesis a median volume of 675 ml of predominantly serosanguinous effusion was drained. Besides intrapericardial drug instillation, patients also received local radiotherapy and systemic chemotherapy. At the time when MPE was diagnosed 77% of the patients exhibited advanced malignant disease. Mean survival time was 140 days. Malignant pericardial effusion is therefore regarded as an unfavorable prognostic factor. PMID- 3961456 TI - [Indication of the urinary citrate levels in idiopathic renal calculosis]. AB - The reported incidence of hypocitraturia among stone formers (SF) varies between 15 and 50%. It is not known whether this incidence depends on the subtype of SF. The recent simplification of the method of measurement of U-citrate (Boehringer Mannheim kit) led us to address this issue in 118 male idiopathic (I) SF, with either idiopathic hypercalciuria of the renal (n = 6), absorptive (n = 19) or dietary (n = 41) type, or with normocalciuria (n = 52). Results were compared with those of 42 normal male volunteers. 9 patients had hypocitraturia (less than 215 mg/24 h), all of whom belonged to the group of normocalciuric ISF; only this group of patients had mean U-citrate X V significantly lower than controls (p = 0.025). The cause of hypocitraturia in these patients remains unknown: there were no significant correlations between U-citrate X V and U-pH or blood HCO3 or Cl. Moreover, the patients with hypocitraturia had neither urinary infection nor signs of distal tubular acidification dysfunction as assessed by fasting morning urinary pH. Extended to our whole population of ISF (250 patients) 75% of whom have idiopathic stone disease, it appears that measurement of U-citrate decreased the number of ISF without detectable disorder from 34 to 26, i.e. to 10% of the whole population of stone formers. Since hypocitraturia can easily be corrected by oral administration of citrate, routine measurement of U-citrate in normocalciuric ISF appears a promising method. PMID- 3961457 TI - [Effect of physical exercise on adaptation to energy expenditure in multiple sclerosis]. AB - The ability to walk and the activities of daily life in patients with multiple sclerosis may be impaired by metabolic and cardiorespiratory factors, since an energy cost of walking (Cw) more than twice the normal value has recently been demonstrated. In 12 clinically stable patients (9 men, 3 women, age 38 +/- 7 years) resting pulmonary functions, walking performance and cardiorespiratory response to walking on a treadmill at slow speed were examined before and after a 24 +/- 6 days period of rehabilitation. There was a significant improvement (p less than 0.01) in walking distance (+31%), endurance time (+26%), maximal speed (+15%) and oxygen pulse at the maximal speed (+18%). The heart rate/oxygen consumption and minute ventilation/oxygen consumption ratios and Cw were above normal and were unchanged after the period of rehabilitation. The respiratory muscle strength was decreased by 38% (p less than 0.05 from a control group) and did not change. From these preliminary results it is concluded that a 3-4 week period of rehabilitation improves walking performance. This improvement is probably the result of improved cardiorespiratory fitness due to the training effect. PMID- 3961458 TI - [Recurrence of myocardial infarct after discontinued administration of oral anticoagulants: fatal rebound for certain risk groups?]. AB - Four cases of myocardial infarction after termination of anticoagulant therapy are presented. The controversy on the clinical relevance of the "rebound phenomenon" is discussed: although laboratory parameters seem to suggest a rebound, the phenomenon may be of clinical importance only in certain subpopulations at risk. In these patients withdrawal of the anticoagulant therapy should be gradual. PMID- 3961459 TI - [Prospective evaluation of coagglutination and latex agglutination in the diagnosis of bacterial meningitis in childhood]. AB - Two simple and low-priced kits to detect bacterial antigens in cerebrospinal fluid (CSF) specimens from patients with suspected meningitis have recently become available. Methods employed by these kits are staphylococcal coagglutination (COA) and latex agglutination (LA). The COA "Phadebact CSF-kit" (Pharmacia) detects Haemophilus influenzae type b (HIb), Neisseria meningitidis (NM) groups A, B, C, Y and W 135 and Streptococcus pneumoniae (SP), whereas the LA "Slidex Meningite-kit" (BioMerieux) includes HIb, NM A, NM C and SP. These two diagnostic tests were compared with the standard methods for analyzing CSF specimens from children with suspected meningitis. A total of 336 CSF specimens were tested. Forty-three were from children with bacterial meningitis due to HIb, NM or SP obtained before antimicrobial therapy. Thirty-four of them (79%) were correctly detected by COA, 23 (54%) by LA, and 42 (97%) by microscopic analysis of stained smears. There were 65 CSF samples of such meningitis cases obtained after initiation of antimicrobial therapy: COA detected 26 (40%), LA 17 (26%) and staining 26 (40%). With culture-positive CSF specimens from patients before therapy, the best sensitivities were obtained with LA for SP (100%) and COA for HIb (87%), whereas the results for NM antigen detection were only 43% with COA and 0% with LA (no reagent against NM B). Cross-reactions with other bacterial antigens were frequent with COA (26%) and rare with LA (2%), resulting in false positive findings in 6 of the 66 positive tests with COA (9%) but in none of the 40 positive tests with LA (0%). One of the 48 specimens from aseptic meningitis cases was false-positive for HIb by COA, whereas all 172 normal specimens were negative with both methods. With 5 culture-negative CSF specimens from patients with unequivocal purulent meningitis COA detected bacterial antigen in 5 and LA in 2. CONCLUSIONS: The two kits evaluated cannot replace standard methods for analyzing CSF specimens, in view of insufficient sensitivity (mainly LA) or frequent cross-reactions and false-positive values (COA). However, due to their simplicity, rapidity, and possible identification of bacterial pathogens after initiation of antimicrobial therapy, these kits are recommended as an useful addition to standard methods. PMID- 3961460 TI - [Ergotism with cerebral complications. Case report and review of the literature]. AB - Abuse of ergotamine-containing suppositories was followed by generalized vessel stenoses in a pregnant 29-year-old migraine patient and led to a space-occupying great brain infarction in the area supplied by the right internal carotid artery. Impressive improvement of clinical, computed tomography and ultrasound findings was observed during treatment with nimodipine. The literature about cerebral symptoms of ergotism is reviewed. PMID- 3961461 TI - [The 50 most frequent results of consultation with the general practitioner]. AB - Analysis of the fifty most frequent results of consultation with the general practitioner suggests that a clearcut diagnosis is possible in only about 10% of all cases. In about a third of the patients the symptoms are attributed to a more or less clearcut disease entity; such attribution, however, fails to attain the value of a scientifically based diagnosis. In more than 50% of all cases, a careful patient history and clinical examination will yield neither a firm diagnosis nor a more intuitive association with a known disease entity, and the physician is left with a descriptive record of symptoms. In these cases it seems particularly important to exclude all potentially serious or dangerous conditions, to keep an eye on the patient and to stay "watchfully exspectant". Although these problems are not specific to the general practitioner, they are- for obvious reasons--quantitatively more important in a family practice than in other medical specialties. PMID- 3961462 TI - [Significance of autopsy. Continuous evaluation of autopsy findings by internists]. AB - To continuously monitor the impact of autopsy results, a short questionnaire was forwarded with each list of autopsy diagnoses to the clinician who had requested the autopsy. This continuous feedback between clinician and pathologist reveals unsolved problems and provides the opportunity for their interdisciplinary evaluation. The 1188 autopsies were done from 1980 to 1984 at the Institute of Pathology for the Medical Clinic, Cantonal Hospital, Lucerne, an acute-care medical teaching hospital department containing about 200 beds. The autopsy rate was 52% for in-hospital deaths. The clinician deemed that about 9/10 of all autopsies had confirmed his diagnosis. About 3/4 of all autopsies disclosed previously unknown and clinically important findings. Major discrepancies between clinical diagnosis and autopsy findings were noted in about 10% of all autopsies. Further, in approximately 1/10 of all autopsies the findings were considered to be of potential therapeutic relevance had they been known before death. The results confirm the relevance of autopsy for the practice of controlled clinical medicine based on objective criteria. PMID- 3961463 TI - [Neurologic manifestations of Borrelia burgdorferi infections]. AB - Lyme disease, first recognized in 1975, typically begins in summer with erythema chronicum migrans (ECM) followed some months later by neurological symptoms (meningoencephalitis, cranial neuropathy), associated with carditis and arthritis. Bannwarth's syndrome is characterized by an ECM followed by radicular pain and radicular sensory and motor disturbances, accompanied by aseptic meningitis. In both cases the cerebrospinal fluid typically shows marked lymphocytic pleocytosis accompanied by an oligoclonal reaction. Despite differences in the clinical symptoms, a borrelia isolated from ticks has been implicated as the etiologic agent of both diseases, and specific antibody titers usually reach a peak between the third and sixth week after onset of the disease. Investigations in 5 patients who developed neurologic symptoms after tick-borne borrelia infection revealed specific antibodies (IgM, IgG) against Borrelia burgdorferi in all sera, and all the patients recovered, one of them without treatment and the others under penicillin or tetracyclines. None developed major complications (carditis, arthritis). PMID- 3961464 TI - [The relatively frequent incidence of severe sulfonylurea-induced hypoglycemia in the last 25 years in Switzerland. Results of 2 surveys in Switzerland in 1969 and 1984]. AB - In 1969 and 1984 all emergency wards in Switzerland were asked to report on the incidence of severe episodes of hypoglycemia (HE) during treatment with sulfonylureas. Each of the two surveys referred to a ten-year period (period A 1960-1969, period B 1975-1984). The number of HE reported was 78 for period A and 116 for period B. The number of diabetics treated with sulfonylurea preparations was established on the basis of tablet consumption, which amounted to 35,000 in period A and 47,500 in period B. The incidence of hypoglycemia in each period was comparable (period A 0.22, and period B 0.24 per 1000 patient years), but differed with regard to the sulfonylurea preparations used. In period A hypoglycemic episodes occurred more frequently under chlorpropamide than under tolbutamide and carbutamide. In period B the incidence of episodes under chlorpropamide and glibenclamide was comparable, but was significantly higher than under tolbutamide and glibornuride. The risk of hypoglycemia occurring is thus significantly higher under glibenclamide and chlorpropamide than under glibornuride and tolbutamide. 6.5% of HE were fatal in period A, compared with 4.3% in period B. Advanced age proved to be a risk factor in HE: 77% of patients with HE were over 69 years of age, whereas only 50% of all diabetics treated with sulfonylurea preparations were in this age group. Further risk factors were impaired renal function (21%) and possible drug interactions (27%). There was less likelihood of recurrence of a hypoglycemic episode in period B than in period A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961465 TI - The "stress" of being born. PMID- 3961466 TI - Dioxin. PMID- 3961467 TI - Valvar aortic stenosis in adults: an update. PMID- 3961468 TI - Intracoronary thrombolytic therapy performed within a coronary care unit: one year's experience. AB - Acute myocardial infarction is associated with a high incidence of occluding coronary arterial thrombi. Thrombolytic therapy has been advocated to restore coronary artery blood flow and to reduce myocardial damage. Coronary arteriography and intracoronary thrombolytic therapy was administered to 61 patients admitted to a Coronary Care Unit within eight hours of symptoms. Successful reperfusion was obtained in 38 of 46 single vessel occlusions associated with a first coronary attack. Failure of reperfusion occurred in patients with two vessel occlusions or with cardiogenic shock. This study demonstrates the feasibility of applying this technique within a Coronary Care Unit with low capital and running costs, and suggests that its widespread application is possible even within the setting of a District General Hospital. PMID- 3961469 TI - Drinking patterns and alcohol related admissions of acute medical patients in Stracathro Hospital. AB - A study has been made of the drinking patterns of male and female patients admitted to the acute medical wards of a rural district general hospital. Thirty four per cent of males and 18.5 per cent of females were regular drinkers, while 54 per cent of males and 70.5 per cent of females never, or rarely drank. The young drank more frequently than the elderly. Alcohol ingestion was the determining factor in 7.9 per cent of the male admissions and 7.5 per cent of the female admissions. Drug overdosage was the single most common associated problem. PMID- 3961470 TI - An unusual presentation of variant angina. AB - A previously well 46-year-old man presented with ventricular fibrillation as an initial complication of Prinzmetals variant angina. Coronary angiography subsequently demonstrated normal coronary arteries. PMID- 3961471 TI - Aortic stenosis presenting with predominant right heart failure. AB - Two cases of severe aortic stenosis presenting with pure right heart failure and unimpressive cardiac murmurs are reported. Both responded well to aortic valve replacement. The mechanism of right heart failure is discussed as is the need for urgent surgery. PMID- 3961472 TI - Permanent non-insulin dependent diabetes mellitus after congenital transient neonatal diabetes. PMID- 3961473 TI - The syndrome of hypertension and hyperkalaemia without renal failure: long term correction by thiazide diuretic. AB - An excellent response to treatment with thiazide diuretic for twelve years is described in a patient with Gordon's Syndrome, the first to be reported from Scotland, and only the second to manifest the full clinical picture of short stature, hypertension, hyperkalaemia and hyperchloraemic acidosis without renal failure. The hypertension and biochemical abnormalities were reversed during therapy. Temporary withdrawal after seven years was followed by the immediate return of all the biochemical abnormalities, but not of the hypertension. PMID- 3961474 TI - Small bowel ulceration and perforation by a gallstone. AB - Gallstone ileus is a well recognised entity and is responsible for approximately 3 per cent of intestinal obstructions. It is, however, quite rare for a gallstone to cause numerous ulcerations of the bowel mucosa and perforation especially in the absence of prior clinical or radiological signs of obstruction (1). We report a case of ulceration and perforation of the ileum by a gallstone and presenting as acute peritonitis rather than obstruction. PMID- 3961475 TI - Career advice for medical students. PMID- 3961476 TI - Analysis of chlorinated styrenes in environmental samples using negative ion chemical ionization mass spectrometry. AB - A method for the separation and identification of chlorinated styrene isomers with fully chlorinated aromatic nuclei in environmental samples is presented. Gas chromatography combined with negative ion chemical ionization mass spectrometry is used. The method has been applied to a combined fish liver and filet extract. All the possible chlorostyrenes with fully chlorinated aromatic nuclei were detected in the sample. PMID- 3961477 TI - Identification of chlorinated compounds in the spent chlorination liquor from differently treated sulphite pulps with special emphasis on mutagenic compounds. AB - About 80 compounds present in the spent chlorination liquor from the bleaching of sulphite pulp have been identified. A comparison has been made between these compounds and those identified in kraft bleaching effluent, with special emphasis on mutagens. The influence of oxygen delignification, before chlorination and alkali treatment of the spent bleach liquor, on the composition of the liquors has also been investigated. PMID- 3961478 TI - Heavy metals and essential elements in livers of the polar bear (Ursus maritimus) in the Canadian Arctic. AB - Polar bear (Ursus maritimus) livers (67) from six Management Zones in the western and central Canadian Arctic were analysed for 22 elements. Several, Ba, Be, Co, Mo, Ti, V and Zr, were near the detection limit in all cases. Baseline data were obtained for the remaining elements, Ag, As, Ca, Cd, Cu, Fe, Hg, K, Mg, Mn, Na, P, Se, Sr and Zn. No statistically significant effect of age, sex or geographical location was found for any of the elements, except Cd, Hg and Se, for which age and geographical location effects were found. The frequency distribution of Zn levels was bimodal. The second peak in the distribution appeared to be related to elevated levels of Cu. The average level of Cu was 104 mg kg-1 (dry wt.), higher than other marine mammals. Average levels of Cd were significantly higher in the eastern zones, but were always less than 1.0 mg kg-1 (dry wt.), significantly lower than their prey species. This may be due to the preference of polar bears for eating seal skin and fat which is low in Cd. Mercury levels tended to be higher in the western zones bordering the Beaufort Sea, which may be related to a higher proportion of bearded seal in their diet. Mean Hg levels ranged from 20 mg kg-1 in the eastern zones were related to age by the expression: Hg (mg kg-1 dry wt.) = 15.7 + 8.0 Age (years). Mercury levels in the most northerly zone near Melville Island were very high: Hg (mg kg-1 dry wt.) = 18.4 + 27.5 Age (years). Levels of Hg and Se were very highly correlated, with a molar ratio of 1.27:1, Hg/Se. PMID- 3961479 TI - Trace elements in precipitation over an industrial area of Bombay. AB - An extensive rainwater sampling program was carried out in the Chembur Trombay industrial belt of Bombay to assess the elemental composition of precipitation. The analytes included Hg, Cr, Sb, Pa, Fe, Sc, Sm, La, Eu, As, Co, Zn, Na, K, Ca, Mg, Br and Cl originating from marine, crustal and industrial sources. For comparison, their concentrations at a non-polluted coastal site (Alibag) were also studied. The elemental excesses were determined by calculating the enrichment factors with respect to Sc in the crust, and their probable sources have been examined. PMID- 3961480 TI - The distribution of mercury in the Indian population. AB - Data have been obtained for the distribution of mercury in a non-occupationally exposed Indian adult group and compared with data available from other regions. The biological elimination half time for mercury of 33 days obtained here is in good agreement with the corresponding value for inorganic mercury compounds. The present work indicates that the relationship between dietary intake and blood concentration is only meaningful when long-term blood concentrations are measured. PMID- 3961482 TI - Psychosexual development. PMID- 3961481 TI - The relationship between the mass concentrations of sulphate and sulphur dioxide in air polluted with cement dust. AB - The relationship between the mass concentrations of sulphate and SO2 in air was studied over a 1-year period in an area polluted by cement dust. The relationship is described by the equation y = axb, where y is the percentage of sulphate sulphur in total sulphur (sulphate and SO2) and x is the mass concentration of the total sulphur content of the air. According to our previous results, coefficients a and b are characteristic of urban and industrial areas. In the investigated area polluted by cement dust, coefficients a and b characteristic of industrial areas were obtained only during the summer period when cement dust particles predominated. In the winter and over the 1-year period, the influence of other particulate components, which were probably products of fuel combustion, predominated. They were detected because the measuring site was located about 1 km from urban settlements. PMID- 3961483 TI - Tight money squeezes out animal models. PMID- 3961484 TI - Solid phase synthesis. PMID- 3961485 TI - Uncoupling translocation from translation: implications for transport of proteins across membranes. AB - The segregation of secretory proteins into the cisternae of the endoplasmic reticulum (ER) is normally tightly coupled to their synthesis. This feature distinguishes their biogenesis from that of proteins targeted to many other organelles. In the examples presented, translocation across the ER membrane is dissociated from translation. Transport, which is normally cotranslational, may proceed in the absence of chain elongation. Moreover, translocation across the ER membrane does not proceed spontaneously since, even in the absence of protein synthesis, energy substrates are required for translocation. These conclusions have been extended to the cotranslational integration of newly synthesized transmembrane proteins. PMID- 3961486 TI - Regulation of erythrocyte cation and water content in sickle cell anemia. AB - The pathophysiological events in sickle cell disease are critically dependent on the intracellular concentration of hemoglobin S, which varies inversely with cell cation and water content. Erythrocytes of SS homozygotes exposed to oxygen or carbon monoxide decrease their potassium and water content through a pathway for potassium transport that is activated by both cell swelling and decrease in internal pH. This pathway is not inhibited by ouabain either with or without bumetanide. When SS erythrocytes were separated according to density, the pH- and volume-dependent potassium transport was greatest in the least dense fraction and was reduced in the densest cells. This pathway, which does not depend on polymerization of sickle hemoglobin, may be important in regulating the cation and water content of SS erythrocytes. PMID- 3961487 TI - Suprachiasmatic nucleus vasopressin messenger RNA: circadian variation in normal and Brattleboro rats. AB - In situ hybridization of an oligonucleotide probe complementary to vasopressin messenger RNA (mRNA) in sections from normal or Brattleboro rat hypothalami revealed hybridization densities in each of three vasopressin-rich nuclei: the supraoptic, paraventricular, and suprachiasmatic. When entrained to a daily light dark cycle, each rat strain displayed diurnal variation in hybridizable mRNA in the suprachiasmatic, but not in the supraoptic or paraventricular nuclei. The higher values for suprachiasmatic mRNA in the morning correlate well with previously elucidated morning increases in vasopressin immunoreactivity in the cerebrospinal fluid. These results support the utility of in situ hybridization techniques for elucidating physiological influences on regional peptidergic function, are consistent with a prominent role for vasopressinergic suprachiasmatic neurons in generating the cerebrospinal fluid vasopressin rhythm, and suggest that regulation of this mRNA rhythm is not dependent on release of intact peptide. PMID- 3961488 TI - Androgens regulate the dendritic length of mammalian motoneurons in adulthood. AB - Sex steroid hormones have been thought to alter behaviors in adulthood by changing the activity of neural circuits rather than by inducing major structural changes in these pathways. In a group of androgen-sensitive motoneurons that mediate male copulatory functions, decreases in androgen levels after castration of adult rats produced dramatic structural changes, decreasing both the dendritic length and soma size of these motoneurons. These changes were reversed by androgen replacement. These results imply a surprising degree of synaptic plasticity in adult motoneurons and suggest that normal changes in androgen levels in adulthood are associated with significant alterations in the structure and function of these neurons. PMID- 3961489 TI - Researchers hunt for Alzheimer's disease gene. PMID- 3961490 TI - Biochemical and genetic evidence for the hepatitis B virus replication strategy. AB - Hepatitis B viruses synthesize their open circular DNA genomes by reverse transcription of an RNA intermediate. The details of this process have been examined with the use of mammalian hepatitis B viruses to map the sites for initiation and termination of DNA synthesis and to explore the consequences of mutations introduced at short, separated direct repeats (DR1 and DR2) implicated in the mechanisms of initiation. The first DNA strand to be synthesized is initiated within DR1, apparently by a protein primer, and the completed strand has a short terminal redundancy. In contrast, the second DNA strand begins with the sequence adjacent to DR2, but its 5' end is joined to an oligoribonucleotide that contains DR1; thus the putative RNA primer has been transposed to the position of DR2. It is now possible to propose a detailed strategy for reverse transcription by hepatitis B viruses that can be instructively compared with that used by retroviruses. PMID- 3961491 TI - Molecular analysis of the t(2;14) translocation of childhood chronic lymphocytic leukemia. AB - Two rare cases of chronic lymphocytic leukemia (CLL) in children have been studied; both are associated with a previously undescribed chromosomal translocation [t(2;14) (p13;q32)]. In one patient the translocation was reciprocal and the breakpoint on chromosome 14 occurred just 5' of the C gamma 2 region on the productive immunoglobulin heavy-chain allele. The breakpoint on chromosome 2 does not involve the K locus but lies within an uncharacterized region that coincides with the position of a constitutive fragile site that occurs within normal lymphocytes. Data on the second patient are consistent with these findings and suggest that these cases represent a rare but distinct subgroup of CLL's with a specific cytogenetic change. PMID- 3961492 TI - Bioavailability of dioxin in soil from a 2,4,5-T manufacturing site. AB - Dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin, TCDD) is a highly toxic contaminant produced in the manufacture of phenoxy herbicides. Despite its high TCDD content, soil from a contaminated area associated with a 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) manufacturing site in Newark, New Jersey, did not induce acute toxicity when administered to guinea pigs (the most sensitive species) by gavage. Analysis of liver samples demonstrated low bioavailability of TCDD from this soil. A comparative analysis of soils showed that Soxhlet extraction was necessary for the determination of TCDD on Newark soil, whereas solvent extraction was sufficient for soil from Times Beach, Missouri. The difference in the bioavailability of TCDD from these soils is correlated with TCDD extractability and may be related to the different compositions of the soils. PMID- 3961493 TI - The neuroendocrine thymus: coexistence of oxytocin and neurophysin in the human thymus. AB - Immunoreactive oxytocin and neurophysin were identified and measured by radioimmunoassay in human thymus extracts. Serial dilutions of extracts paralleled the appropriate standard curves. Thymus-extracted oxytocin and neurophysin eluted in the same positions as reference preparations on Sephadex G 75. Authenticity of oxytocin was confirmed by biological assay and high performance liquid chromatography analysis. In most instances, thymus contents of oxytocin and neurophysin were far greater than those expected from known circulating concentrations and declined with increasing age. The molar ratio of oxytocin to neurophysin in thymus was similar to that found in the hypothalamo neurohypophyseal system, which strongly suggested with the other data a local synthesis of oxytocin. These findings indicate the presence of neurohypophyseal peptides in the human thymus and further support the concept of a neuroendocrine function integrated in an immune structure. PMID- 3961494 TI - Cerebellar vermis: essential for long-term habituation of the acoustic startle response. AB - The acoustic startle response in rats shows both short-term habituation, which recovers in seconds or minutes, and long-term habituation, which is effectively permanent. Lesions of the cerebellar vermis significantly attenuated long-term habituation without affecting the short-term process or altering initial response levels. In this response system the cerebellar vermis is part of an essential circuit for long-term habituation. PMID- 3961495 TI - A fluorescence photobleaching assay of gap junction-mediated communication between human cells. AB - Gap junction-mediated communication between contiguous cells has been implicated in the regulation of cell proliferation and differentiation. This report describes a new technique to measure cell-cell communication, gap fluorescence redistribution after photobleaching, which is based on the diffusion-dependent return of 6-carboxyfluorescein-mediated fluorescence in a photobleached cell that is in contact with other fluorescently labeled cells. Fluorescence recovery rates are interpreted as dye transport across gap junctions. Results of experiments on normal human fibroblasts and human teratocarcinoma cells show that this technique can measure rapid dye transfer and detect inhibition of communication (between teratocarcinoma cells) by the tumor promoters 12-O-tetradecanoyl-phorbol-13 acetate and the pesticide dieldrin. PMID- 3961497 TI - Homelessness: experts differ on root causes. PMID- 3961496 TI - Pressure to cut the deficit creates uncertainty for biomedical research. PMID- 3961498 TI - Manic-depression: is it inherited? PMID- 3961500 TI - Researchers seek melanoma gene. PMID- 3961499 TI - Characterization of the supernumerary chromosome in cat eye syndrome. AB - Most individuals with cat eye syndrome (CES) have a supernumerary bisatellited chromosome which, on the basis of cytogenetic evidence, has been reported to originate from either chromosome 13 or 22. To resolve this question, a single copy DNA probe, D22S9, was isolated and localized to 22q11 by in situ hybridization to metaphase chromosomes. The number of copies of this sequence was determined in CES patients by means of Southern blots and densitometry analysis of autoradiographs. In patients with the supernumerary chromosome, four copies were found, whereas in one patient with a duplication of part of chromosome 22, there were three copies. Therefore, the syndrome results from the presence of either three or four copies of DNA sequences from 22q11; there is no evidence that sequences from other chromosomes are involved. This work demonstrates how DNA sequence dosage analysis can be used to study genetic disorders that are not readily amenable to standard cytogenetic analysis. PMID- 3961501 TI - Defective sialic acid egress from isolated fibroblast lysosomes of patients with Salla disease. AB - Normal fibroblasts exposed to N-acetylmannosamine yielded lysosome-rich granular fractions loaded with free (unbound) sialic acid, whose velocity of egress increased with increasing initial loading. Fibroblast granular fractions of patients with Salla disease exhibited negligible egress of sialic acid, whether endogenous or derived from N-acetylmannosamine exposure. Salla disease represents the first disorder demonstrated to be caused by defective transport of a monosaccharide out of cellular lysosomes. PMID- 3961502 TI - Karyotype analysis of Leishmania species and its use in classification and clinical diagnosis. AB - Chromosomes of four species of Leishmania represented by ten different geographic isolates were analyzed by pulsed field gradient gel electrophoresis (PFG) to assess chromosome stability in these parasitic protozoans. Among different geographic isolates of the same subspecies, more than two-thirds of chromosomes had similar sizes, ethidium bromide staining intensities, and locations of alpha,beta-tubulin genes. However, among New World Leishmania, members of different species or subspecies have fewer than one-third of their chromosomes in common. Therefore, PFG karyotypes of Leishmania exhibit intraspecific variability similar to that reported for other parasitic protozoans. The greater similarities of the karyotypes of members of the same Leishmania subspecies may indicate that they represent valid taxa. These similarities also allowed the use of PFG in clinical diagnosis for rapid and accurate typing of patient isolates. PMID- 3961503 TI - The mechanism of binding of a polynucleotide chain to pancreatic ribonuclease. AB - The crystalline complex of pancreatic ribonuclease (RNase) with oligomers of d(pA)4 has been solved by x-ray diffraction methods and refined by standard procedures to a conventional crystallographic R factor of 0.22 at 2.5 angstrom resolution. The asymmetric unit is a complex of one RNase molecule associated with four d(pA)4 oligomers. Although the DNA in this complex is segmented, and therefore shows some discontinuities, it nevertheless traces a continuous path 12 nucleotides in length that passes through the active site cleft of the enzyme and over the surface of the protein. The DNA makes a series of eight to nine electrostatic bonds between its phosphate groups and lysine and arginine residues on the protein, as well as specific chemical interactions at the active site. The path described by the sequence of nucleotides is likely to be that taken by an extended polynucleotide chain when it is bound by the enzyme. PMID- 3961504 TI - Mechanism of action and monitoring of anticoagulants. PMID- 3961505 TI - Laboratory control of anticoagulant therapy. PMID- 3961506 TI - Heparin-induced thrombocytopenia. PMID- 3961507 TI - Nonhemorrhagic complications of anticoagulant therapy. PMID- 3961508 TI - Risks and benefits of anticoagulant therapy. PMID- 3961509 TI - Toxic oil syndrome: a syndrome with features overlapping those of various forms of scleroderma. AB - Thirty-two toxic oil syndrome (TOS) patients were selected because they presented with scleroderma-like changes and were observed during the first 36 months of evolution of the disease. Initially, these patients presented with a noncardiogenic pulmonary edema, eosinophilia, arthralgia/arthritis, peripheral edema, and myositis. Histologic investigations showed a widespread chronic interstitial infiltrate with lymphocytic vasculitis. They subsequently developed peripheral neuropathy, joint contractures, scleroderma-like changes, Raynaud phenomenon, pulmonary hypertension, sicca syndrome, and liver disease. Biopsy studies during this stage showed fibrosis and obliterating arteriopathy. Late features of TOS are musculoskeletal pain, cramps, livedo reticularis, carpal tunnel syndrome, and digital tuft changes. TOS is a new chemically induced scleroderma-like syndrome with features overlapping those of eosinophilic fasciitis, systemic sclerosis, and forms of localized scleroderma. PMID- 3961510 TI - [Medial femur neck fracture. Classification and therapy]. PMID- 3961511 TI - [High-pressure injection injuries of the hand]. PMID- 3961512 TI - [Results of a follow-up study of surgically-treated cases of patellar chondropathy]. PMID- 3961513 TI - Dose-response models and methods of risk prediction and causation estimation. AB - Dose-response models are mathematical expressions that describe the relationship between absorbed dose and radiogenic effects. The limited quality and quantity of human dose-response data make it necessary to use fairly simplistic models. Most current low-LET data support the linear-quadratic model in which radiogenic effects are linearly dependent at low doses and then become quadratically curved at higher doses. Some types of effects never exhibit a quadratic component, remaining linear over a wide range of absorbed dose. Future progress in developing more refined dose-response models is more likely to come from a better understanding of the fundamentals of radiation carcinogenesis rather than better data or better curve-fitting techniques. The risk of radiation injury is a prospective estimation of the probability that some harm will result in the future as a consequence of having been irradiated. Quantitative risk estimates for the carcinogenic, genetic, and fetal effects of low level radiation that have been determined by national and international organizations are of the order of magnitude of one chance fatality in 10,000/rem. Causation estimation is the retrospective analysis of the probability that cancer observed in an irradiated individual was caused by radiation as opposed to some other agent. Depending on the dose type of cancer, gender, age at time of irradiation, and time since irradiation, the probability of causation can range from 0% to 100%. Methods for calculation of the probability of causation for certain types of cancer and irradiation circumstances have been developed recently by the National Institutes of Health. PMID- 3961514 TI - Guidelines for radiation protection. AB - Guidelines for radiation protection originate from numerous federal, state, and local agencies. Webster defines a guideline as a line by which one is guided, especially as an outline (as by a government) of policy or conduct. Guidelines in radiation protection can be either mandatory or advisory. Regulations by federal, state, and local governments for the use of radioactive materials define operating practices. Adherence to these regulations is required by law and there are penalties for noncompliance. Regulations generally constitute the minimum requirements for good practice and are usually supplemented by less formal recommendations from regulatory agencies and advisory groups. The regulatory guides published by the Nuclear Regulatory Commission (NRC) and by radiation control groups of agreement states are intended to assist the user of radioactive material in maintaining compliance with regulations. These guides recommend good practice but are not mandatory in that the user can propose alternatives to the regulatory agencies to meet the regulations. Many groups serve in an advisory capacity in formulating reports and recommendations for the safe use of radioactive material. The most prominent and influential among these are the National Council in Radiation Protection and Measurements (NCRP) and the International Commission on Radiological Protection (ICRP). Often the recommendations of these advisory groups evolve into either regulatory guidelines or regulations for the use of radioactive materials. At the present time, the backbone of the Nuclear Regulatory Commission's regulations relating to the medical use of radionuclides, "Standards for Protection Against Radiation" (10CFR20) and "Human Use of Byproduct Material (10CFR35), are undergoing extensive review with major revisions anticipated within the very near future. These proposed changes could have a significant impact on the practice of nuclear medicine. The changes will have some influence on radiation safety practice as it relates to the radiation worker, the patient, and the environment. PMID- 3961515 TI - ALARA and an integrated approach to radiation protection. AB - Exposures of individuals to ionizing radiation have been restricted for many years by a number of guidelines and rules developed by various advisory and regulatory groups. Accompanying these restrictions has been an evolving principle that exposures to individuals and groups should be kept "as low as reasonably achievable" (ALARA), consistent with provision of the benefits of radiation use to society. Although the ALARA concept is a laudable goal in principle, its implementation in a clinical facility has not been a straightforward process. Problems of implementing ALARA have been confounded further by the efforts of regulatory agencies to incorporate the ALARA concept into regulations governing radiation exposures. To facilitate the implementation of ALARA as a workable construct in a clinical facility, guidelines are needed for its application to both individual and collective exposures to radiation. The provision of such guidelines, including action and inaction levels for both individual and collective exposures, are presented here. PMID- 3961516 TI - Lateral compression fractures of the pelvis: the importance of plain radiographs in the diagnosis and surgical management. AB - The management of pelvic fractures varies according to the nature of the disruptive force and hence the type of injury. Stabilization with compression devices or slings, which may be warranted in some injuries are contraindicated in lateral compression fractures due to the exacerbation of pelvic collapse they will induce. The diagnosis of this type of fracture is therefore of the utmost importance, and yet is frequently missed due largely to ignorance of this type of injury and its significance. Despite mention of this entity in surgical publications, there is a paucity of information in the radiologic literature, and no definitive radiologic appearances have been described. Forty-three patients with lateral compression fractures admitted to the Shock Trauma Unit of the University of Maryland were studied, and the radiologic features, together with diagnostic signs specific to this injury are presented. PMID- 3961517 TI - Ivory and dense epiphyses of the hand: Thiemann disease in three sisters. AB - Three sisters with ivory epiphyses as well as dense epiphyses of the phalanges of the hand are presented. The difference between ivory and dense epiphyses, the radiologic differential diagnosis, and recently proposed diagnostic criteria for Thiemann disease are discussed. PMID- 3961518 TI - Disuse osteoporosis: mimic of neoplastic disease. AB - Disuse osteoporosis, a common sequela to immobilization, consists of bony changes that may mimic neoplastic disease. This paper describes the different types of cortical and medullary demineralization that can be manifested radiologically and the histopathologic basis for these alterations. Six cases are included that exemplify these changes, and comparison is made with multiple myeloma. PMID- 3961519 TI - Magnetic resonance imaging of avascular necrosis of the femoral head. AB - This study investigates the role of magnetic resonance imaging (MR) in identifying avascular necrosis (AVN) of the femoral head and in monitoring its therapy. The detection of AVN, particularly in its early stages, is imperative to give therapeutic intervention the best opportunity for successful management. The results of magnetic resonance imaging are compared with those of the standard diagnostic modalities in evaluation of patients with the lesion. Examinations were performed at 0.12T with a repetition time (TR) of 143 ms and times to echo (TE's) of 10 or 20 ms. This study represents a retrospective review of 90 hips which were examined in 45 consecutive patients. Of these, 52 hips were biopsied as part of treatment. MR was shown to be sensitive in the detection of AVN. Comparison of MR with radionuclide imaging showed comparable sensitivity and specificity. MR was also noted to be sensitive in the detection of early AVN. Preliminary results suggest that MR can monitor treatment of the affected hip, and may even be able to predict patient response to therapy. Although further work is necessary to determine the role of MR in the evaluation of the patient presenting with hip pain, MR is a sensitive method in detecting AVN and in monitoring its course in patients suspected of having the disease. PMID- 3961520 TI - Idiopathic osteonecrosis of the first metatarsal sesamoid. AB - Four patients with histologically confirmed osteonecrosis of the first metatarsal sesamoid are presented. No patient was an athlete, nor recalled any noticeable trauma or significant stress as having occurred to the feet. No foot deformities or joint malalignments were found. Excellent results were obtained by excision of the affected sesamoid in all patients, after follow-up periods of 1 to 12 years. Microscopic findings were compatible with those seen in idiopathic osteonecrosis of the femoral head. PMID- 3961522 TI - Case report 341: Os accessorium supracalcaneum of the left hind foot (also present, but to a lesser extent, on the right). PMID- 3961521 TI - Radiographic appearances following surgical correction of the partially fused epiphyseal plate. AB - Surgical correction of partial post-traumatic fusion of an epiphyseal plate by resection of the bony bridge across the plate and replacement of the bridge by a fat implant causes a characteristic radiographic appearance which is illustrated by two patients and an animal model. Failure to recognize this characteristic postoperative pattern may lead to a misdiagnosis of infection or other bone pathology. PMID- 3961523 TI - Case report 350: Multiple myeloma--blastic type. PMID- 3961524 TI - Case report 351: Aggressive osteoblastoma of the third lumbar vertebra. PMID- 3961525 TI - Case report 352: Osteonecrosis of the femoral shaft (probably steroid-induced). PMID- 3961526 TI - Case report 353: Giant cell tumor of distal end of the femur, containing a fluid level as demonstrated by computed tomography. PMID- 3961527 TI - Case report 354: Chondroma of soft tissues with dystrophic calcification. PMID- 3961528 TI - Case report 355: Delayed closure of the right olecranon epiphysis in a right handed, tournament-class tennis player (post-traumatic). PMID- 3961530 TI - Medical sociology and the WHO's programme for Europe. PMID- 3961529 TI - Bone mineral changes in primary hyperparathyroidism. AB - We studied 34 patients with primary hyperparathyroidism in order to assess their bone mineral status, to determine its relationship to biochemical parameters (serum calcium and parathyroid hormone) and surgical status, and to determine the relationship between peripheral cortical bone and spinal trabecular bone in this disease. These patients were studied with radiogrammetry of the metacarpals, Norland-Cameron photon absorptiometry of the radius, quantitative computed tomography (QCT) of the spine, industrial radiography of the hands, and conventional radiography of the thoracolumbar spine. We also calculated a spinal fracture index from thoracolumbar spine films. We found that the appendicular measurements correlated well together, but less well with spinal QCT. The spinal fracture index correlated best with QCT (r = -0.55), although significant dispersion was noted. We found that, in general, these hyperparathyroid patients had statistically significant decrements in bone mineral content in both the appendicular and the axial portions of the skeleton. However, the decrement in the appendicular skeleton did not correlate well with that in the axial skeleton. Therefore we conclude that it is necessary to measure both peripheral and central bone mineral content in order to reliably assess the skeletal demineralizing effects of primary hyperparathyroidism in an individual patient. PMID- 3961531 TI - Life-styles and health. PMID- 3961532 TI - [Who wants, in France, a healthier lifestyle?]. AB - Changes in lifestyles are strongly suggested by Health Education. However, a major problem appears when these suggestions are transformed into actuality: is it possible to identify the groups which are convinced that a change is necessary? In France, an investigation about the rationality of administrative authorities, of physicians and of lay individuals shows the acuity of the question. The article first deals with administrative interests in lifestyle matters. It provides the evidence of incompatibility between Public Health Planning and short term management in the French social system. The second section sheds light on the concern of the medical profession with lifestyles. Physicians' attitudes seem to be dependent on the background of daily activities. Moreover, the problems of income and professional legitimacy faced by some sections of the profession in the Private Sector explain how and why they are in favour with prevention and Health Education. The final section focuses upon public awareness of changes in lifestyles. It provides a brief description of different ways of defining health among social classes, and of different health beliefs. Beyond this heterogeneity, the various conceptions of health are an expression of individual resources and social backgrounds; they are always related to actual working conditions and status. PMID- 3961533 TI - Inequalities in access to health care in Hungary. AB - 'Crisis' in health care systems has become a widely discussed issue in the last 10 years. The claim for change is argued from various points of view, and according to manifold interests throughout the industrialized world. However, the present tensions of the national health service system of Hungary can be looked upon only partially in the broader terms of some 'world-phenomenon'. There are a great number of similar features, there is the great importance of temporal co incidence, but the roots seem totally different in several respects. The paper focuses on those structural processes (historical, as well, as current), that have lead to increasing tensions and a dysfunctional working of the system, that shape the social inequalities of access to it. The main form of deeper structural tensions is the widening gap between needs and the conditions to meet them. This paper analyzes the consequences of the double pressure put on the system at its start after the war. The rapid extension of legal entitlements for free medical care was not followed by a similar extension of available resources for developing the institutions and services of the health care system. The long-term priorities given to forced industrialization and, later, to other spheres of production led to a chronic situation of 'residual' handling of various spheres of communual consumption and to the infrastructure, including programmes of health care, the pressure of rapid extension of rights and permanent scarcity of the resources has lead to a chronic shortage, overuse and 'substitutional, temporary solutions'.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961534 TI - Inequalities in health and gender. AB - Gender inequalities in health are studied in Denmark, Finland, Norway and Sweden on the basis of survey data on morbidity and symptoms of anxiety, and of mental hospitalization statistics. Women have higher rates of illness than men in countries where, and in periods when, they have to a great extent stayed at home as full-time housewives. Participation in paid economic activity and the resulting economical independence thus seems to be beneficial to women's health on the macro-level of society. On the micro-level of individual families, inequality in morbidity by gender is smaller in families with two economical providers than in families where the wife stays at home. The anxiety rates of employed wives are, however, relatively high compared with those of men and non employed wives. Only in Sweden is the mental health of employed wives good, perhaps because of supportive social policies favouring women's work outside the home. The strain involved in combining family and work among women thus becomes manifest in the appearance of symptoms of anxiety but not in physical morbidity nor mental hospitalization. PMID- 3961535 TI - Inequalities in health: strategies. AB - It is the purpose of this article to identify strategies of overcoming inequalities in health. However, equality in health is a goal hardly to be achieved in unequal societies. In addition, the perception of as well as action against health inequalities depend highly on the underlying paradigms of health and disease. Therefore, three models (the traditional medical, the epidemiological as well as the socio-political model) of health are discussed. The second part shows structural tendencies and new strategies. Structural tendencies like professionalization, bureaucratization, medicalization as well as sophisticated technologies are likely to aggravate already existing inequalities whereas the impact of new approaches is not so certain. The primary health care program as a strategy formulated by WHO could be a viable approach to overcome health inequalities. This holds also for a great variety of policy oriented proposals contained in the 'Black Report' in Great Britain. Basic organizational concepts or prerequisites for an egalitarian health policy as functional integration of health and social services, interdisciplinary cooperation, the necessary link between theory and practice in health programs as well as the various approaches of community participation are also discussed in this article. In a selective way the important problem areas of particular social and political concern are dealt with: youth and health as well as workers' health. PMID- 3961536 TI - [New concepts in mental health]. AB - To what extent can one speak to-day of new concepts in the mental health field? There have existed for a long-time (since, for example, the Mental Hygiene Movement and the tendency Preventive Psychiatry in the United States) new programmes for the administration of care which aim at going beyond the 'repair model' (Goffman) of classical psychological medicine, and at developing a 'positive concept' of health (after William A. White in 1930). In the same spirit, psychoanalysis has promoted a dynamic concept of psychic disturbance which transcends the static opposition of health and illness. Finally, the insistence on systematic prevention of risks also follows the tendency to transcend the medical relationship. Thus, the conditions for bringing about, conserving and developing mental health have long ceased to be susceptible to thinking out from the base of clinical psychiatric concepts. These important transformations in the conceptions of mental health do not, however, guarantee their establishment in practice. We have chosen to emphasize here the point of view of the application (or non-application) of 'new concepts' in effective policies, rather dealing only with the theoretical text from which they have emerged, or declarations of intention that proclaim their merits. This article attempts firstly an evaluation of the reform movements that have developed since the end of the Second World War, mainly in the United States and in France with the following question as point of departure: "To what extent have modern mental health policies been innovative in relation to classical psychiatry dominated by a medical conception of mental health, that is to say a model that is "repair oriented" or curative rather than positive or preventive"? Firstly, the achievements of the Community Health Centres in the United States and the Policy of the Sector (politique de secteur) in France is analysed. In both cases the 'theoretical' programmes of the promoters are compared to that which has been accomplished in fact. What, concretely, has happened to the will to "enlarge the conception of mental health to include concepts that no longer include mental disorder", as proclaimed by Leonard J. Duhl in summing up the spirit of the Community Mental Health Centres and Retardation Act? The article attempts this evaluation on a three-fold level: new theoretical models envisaged, new forms of intervention put into practice and the institutional transformations that have been introduced during the last 30 years.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3961537 TI - Mental health care and the opposition movement in The Netherlands. AB - In The Netherlands, there is a more or less recognized movement in the field of mental health care which is referred to as the psychiatric opposition movement or the patients movement. The nucleus of the Dutch movement consists of patients and ex-patients. As far as mental health professionals are participating in the movement, they do so as more or less passive supporters of a movement dominated by patients and ex-patients. This article is dealing with two questions. The first question is how and to what degree the opposition movement in The Netherlands has succeeded in breaking through or at least questioning the closed nature of Dutch mental health care system. The second question will be whether the dilemma between resistance and dependence in the position of patients and ex patients is visible in the activities of the opposition movement, and whether this dilemma acted as an obstacle to their efforts to influence the mental health care debate in The Netherlands. An effort is being made to answer this question by describing the position of the opposition movement with respect to the Insanity Law and with respect to the organization of mental health care. In conclusion, three stages were found to be crucial in the development of Dutch opposition movement. In the 1970s, the opposition movement appeared to operate within the borders of a closed system in which the medical profession had a high degree of autonomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961538 TI - A new-modelled medicine? Comments on the WHO's regional strategy for Europe. AB - The paper considers the concept of health and underlying medical model contained within the WHO's regional strategy for Europe. It argues that, for all its virtues and despite the switch from pure bio-medicine towards a more bio-social approach, the strategy is still and perhaps not too surprisingly, technocratic, ahistorical, apolitical and unreflexive. PMID- 3961539 TI - Health professions: the origin of species. AB - Specialization is an important feature of post-World War II health sector development. Its value is indisputable. On the other hand, unchecked specialization also brings problems, notably of cost escalation and service profile twisting. To exploit the potentials of highly specialized medicine without neglecting the everyday problems that constitute the bulk of medicine, one needs a carefully constructed policy. To design such a policy, one needs, among other things, to understand the whys and hows of specialization. This reports discusses three different approaches to the understanding of the process of specialization: the sociological (S is a reflection of the selfish interests of the professions), the medical (S is the natural response to scientific and technological progress), and the economic (S is a result of increased market demand). Much is to be said in favour of the sociological explanation. Occupational groups do pursue interests of their own, centering on the construction and defence of job monopolies. The histories of the professions readily lend themselves to this kind of interpretation, and its gives, beyond doubt, valuable insight into the ways in which occupational groups relate to each other, to clients and to the surrounding society. This report, however, argues that the sociology of the professions is largely concerned with phenomena secondary to the process of specialization. It explains the behaviour of occupational groups, once they have been established. It does not, however, explain why they came into being in the first place. For that purpose, the perspective of medicine and, in particular, that of economy, may be more suitable. I support this position by data on the specialization of the health service system of Norway. PMID- 3961540 TI - The state and health in France. AB - The Health Service in France (as indeed must be the case in many other countries) has been affected by a new technical dimension, which now adds its weight to the two main criteria, social and economic, which influence health provision. In the technical domain, new methods in research and treatment have transformed the nature of medical practice, which is more and more prey to disruption at the sudden appearance of ever more complex technologies. Medical treatment can be said to have become fragmented in some sense, and the process of division of labour within medicine to have undergone considerable development. As a result of these modifications, but also because of changes in society as a whole (the ageing of the population, altered needs and expectations), the amounts spent on health provision are growing at a higher rate than the Gross Domestic Product. This is leading the participants who control and finance the system (the State, Social Security) to think in terms of selectivity and efficiency and the medical profession itself to be willing to consider the economic implications of its activities. Moreover, the Health Service is highly valued by public opinion, as shown by a number of polls. It is a major social priority for the population, represented by the health insurance organizations whose function is to make use of their funds, raised by obligatory contributions, to strive to ensure equal access for all to the most advanced treatments and techniques. It can be shown that the evolution of the Health Service has been shaped by three differing types of underlying logic: the professional (because the technical side is chiefly represented by the professionals who personify the scientific and technical aspects of health problems), the social and the economic. Until about 1968, the social and professional rationales prevailed. From then until the change in political majority that culminated in the arrival in power of the left in May 1981, economic criteria outweighted social, and the autonomy of the professionals was strongly curtailed. Finally, in the current phase, social factors tend to have priority over economic, though without their importance being overlooked, and there is an effort to group the professionals around projects aimed at fulfilling social needs and aspirations. PMID- 3961541 TI - Health sector structures: the case of Belgium. AB - In Belgium, the formal framework of health care is a composite of public and private practice forming a policy that is the product of negotiation between differing power groups. An inter-university and inter-disciplinary research and development project was set up in 1974 by the Government, in order to inform and prepare a primary health care (PHC) policy. A preliminary evaluation of the project shows that it made major contributions to the development of an acceptable framework of PHC, to political, professional and lay support for PHC, to the development of organizational models for PHC, and to an increase of research capability within PHC. Overall, the project is a clear demonstration that research can be a strategic agent for innovation. PMID- 3961542 TI - Health sector structures: the case of Spain. PMID- 3961543 TI - Sex differences in factors associated with use of medical care and alternative illness behaviors. AB - In many previous investigations of illness behavior the dependent variable has been restricted to use or nonuse of physicians' services. The purpose of this study was to determine how males and females differ in the tendency to respond to their symptoms when self-treatment and lay consultation as well as medical care are considered. The sample consisted of all white, married individuals (n = 532) participating in a household survey who reported at least one symptom episode during a 4-week recall period. An important feature of this survey data set is that there were no proxy respondents. Similar distributions of behavioral responses to symptom episodes were found for men and women. Multinomial logit analysis was used to identify the factors associated with specific illness behaviors. The independent variables were: characteristics of the individual and family such as number of children, social class and employment status; characteristics and perceptions of the symptom episode including discomfort, disability and belief that a physician could do something to relieve it; and access to, and attitudes toward medical care. Belief that a physician could do something to relieve the symptoms, number of days of disability and number of component symptoms in the complex were positively related to use of medical care and duration of the symptom episode was negatively related to use of medical care for both men and women. Several of the independent variables affected only one sex group or had differential effects on males and females. Sex differences were most pronounced with respect to use of lay consultants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961544 TI - Primary health care for whom? Village perspectives from Nepal. AB - Over the last decade, many developing nations have embraced Primary Health Care (PHC) within their national health plans. PHC, in contrast to earlier approaches to national health development, emphasizes community participation and basic health care for the poorer segments of society. The research reported here finds that in the enthusiasm for the PHC concept in Nepal, important sociocultural processes have been overlooked. This paper describes the relationship between certain sociocultural factors and PHC activities in rural Central Nepal. It reveals a contradiction between the stated PHC intentions to address local interests and promote community participation on the one hand, and the actual approach taken on the other hand. Specifically it argues that PHC is encountering problems in Nepal for three reasons: (1) PHC fails to appreciate villagers' values and their own perceived needs. In particular, PHC is organized primarily to provide health education, whereas villagers value modern curative services and feel little need for new health knowledge. (2) PHC views rural Nepali culture only pejoratively as a barrier to health education. Alternatively, local cultural beliefs and practices should be viewed as resources to facilitate dissemination and acceptance of modern health knowledge. (3) In attempting to incorporate Nepal's traditional medical practitioners into the program, PHC has mistakenly assumed that rural clients passively believe in and obey traditional practitioners. In fact, clients play active roles and are themselves in control of the therapeutic process. Thus, instead of attempting to recruit traditional practitioners to do its work, PHC should recognize the precedent for community participation in Nepal's traditional medical system and develop the respect for villagers' own ideas and values that traditional practitioners already possess. PMID- 3961545 TI - Organizational growth, survival and death in the U.S. hospital industry: a population ecology perspective. AB - This article develops an analytic framework for predicting organizational survival, growth and death in the U.S. hospital industry. The population ecology perspective is used to identify the environmental conditions under which health service organizations with specialist or generalist characteristics will survive. Hypotheses derived from the framework focus on the particular form hospitals and multihospital systems will take, how they are likely to develop and the configuration of the health care delivery system under different assumptions about the environment. PMID- 3961546 TI - Agreement among judges on the severity of different morbidity states. AB - In order to scale their severity, different states of morbidity are presented to subjects of six professional groups. By comparing the obtained scale scores with those assigned by legal institutions, bias in the subjective judgments can be detected. The judgment process is found to fall under a psychophysical law, Stevens' power law. The ordering of the morbidity states forms a basis to investigate if the subjects are likely to agree on their judgments. It is found that the medical professional groups not only assign other relative values to severity states but also order them in a different way. PMID- 3961547 TI - Health care decisions at the household level: results of a rural health survey in Kenya. AB - The observed visits to health care providers are an outcome of patients' health care decision-making process. Unlike the visits, this process is not observable. The paper first outlines this process, and then presents patterns of patients' visits to health care providers in a particular rural area in Kenya. The visit patterns are shown to vary greatly according to type of illness and to the stage of the illness. The paper has two main results. The first result is that in the study area, the majority of the patients sought medical treatment outside the 'free' government health care system. The other finding is that for a given illness episode, there is a very high likelihood of a patient consulting more than one provider for advice or treatment. PMID- 3961549 TI - Financing health development projects: some macro-economic considerations. AB - The paper briefly discusses the importance of macro-economic policy in health sector financing. The ways in which monetary and fiscal policy (macro-economic policy) affect interest rates, price levels and aggregate output are presented. The main portion of the paper considers a variety of methods for public financing of health and development projects. These approaches are analyzed in light of distributional and efficiency considerations. One way of increasing health sector resources is through reallocation from other sectors of the economy. The potential for redistribution from the defense to the health service industry is briefly considered. PMID- 3961548 TI - The demand for adult outpatient services in the Bicol region of the Philippines. AB - The absence of demand analysis for primary health care services has hampered efforts to finance these services and to make them permanent parts of Third World medical systems. This paper introduces a demand model for adult outpatient services, describes the types of data required for estimating it, and presents the results of a preliminary estimation using data from a poor rural region of the Philippines. The results indicate that prices and distance are not nearly as important as determinants of demand in this sample as has usually been assumed by planners. There appears to be considerable room for full or partial financing of outpatient services from user fees. PMID- 3961550 TI - State-sponsored primary health care in Africa: the recurrent cost of performing miracles. AB - In this paper the author suggests that the design and execution of ongoing and future primary health care (PHC) interventions in Africa could be improved by more comprehensive and realistic assessments of the recurrent costs of alternative approaches to providing given levels of health care benefits. He develops the distinction between development and recurrent cost elements; distinguishes between marginal and average costs of interventions; identifies elements of social opportunity cost that are frequently overlooked in assessing project costs and shows how their inclusion magnifies the aggregate social cost of interventions featuring recurrent involvement of state agents; suggests that the perception of benefits conveyed by state-sponsored PHC programs to rural populations is limited, especially in relation to the true social costs; and discusses the implications of the above analysis for future PHC strategy. PMID- 3961551 TI - [Recognition of plant poisons used in Viet Nam, Laos and Cambodia]. PMID- 3961552 TI - [Detection of urinary substances in stains from amniotic fluid, urine and the blood of pregnant women using thin-layer chromatography]. AB - When examining traces of biological origin it is possible to draw conclusions from the findings of some urinary constituents in a stain produced by urine; via foetal urine, however, in the spots also amniotic fluid can be detected. By chromatographic analysis on a thin layer the authors are able to detect in spots from amniotic fluid urea without hippuric acid, in urine spots urea, creatinine and hippuric acid; in blood stains under equal conditions none of the above constituents is detected. The results, using the above method, can be considered a contribution which helps to differentiate these traces and it can be also used to detect amniotic fluid in stains. PMID- 3961553 TI - [Determination of group substance ABH in hair]. AB - The effect of chemical adjustment of the hair by some common chemical agents for the demonstration of group substances in the hair. The authors draw attention to some problems in the interpretation of the results of examination. PMID- 3961554 TI - [Experience in organizing mass endoscopic studies of dispensary patients]. PMID- 3961555 TI - [Organization of medical care for trade workers]. PMID- 3961556 TI - [Methodological problems in training public health management personnel]. PMID- 3961557 TI - [Noninfectious pathology among the population of the developing countries of Asia]. PMID- 3961558 TI - [Improvement in the structure and organizational forms of the work of prophylaxis departments]. PMID- 3961559 TI - [Chronic intestinal ischemia in erythremia]. PMID- 3961560 TI - [Acute exudative pericarditis with rapid onset of constriction]. PMID- 3961561 TI - [Surgical treatment of cancer of the esophagus in patients 60-years-old and older]. PMID- 3961562 TI - [Computer tomography in the diagnosis of tumors of the minor pelvis]. PMID- 3961563 TI - [Surgical endoscopy and its prospects in gastroenterology]. PMID- 3961564 TI - [Conservative treatment of fractures of the leg using early axial loading]. PMID- 3961565 TI - [Transcutaneous transhepatic cholangiography and hepatocholangiostomy under computer tomographic control]. PMID- 3961566 TI - [Gas-liquid chromatography in non-clostridial anaerobic infection]. PMID- 3961567 TI - [Purulent-necrotic lesions of the foot in diabetes mellitus]. PMID- 3961568 TI - [Prevention of cardiovascular diseases. Problems and prospects]. PMID- 3961569 TI - [Preventive examination of patients with ischemic heart disease]. PMID- 3961570 TI - [Comparative evaluation of nifedipine and propranolol in ischemic heart disease]. PMID- 3961571 TI - [Apex cardiography in rheumatic lesions of the heart]. PMID- 3961572 TI - [Hemodynamics of the systemic circulation and pulmonary ventilation in pulmonary tuberculosis]. PMID- 3961573 TI - [Surgical treatment of the sequelae of multiple injuries of the bones of the extremities]. PMID- 3961574 TI - [Complex treatment of suppurative processes of the bones and joints]. PMID- 3961575 TI - [Hepatoportal sclerosis]. PMID- 3961576 TI - [Appendicular pylephlebitis]. PMID- 3961577 TI - [Quantitative bacteriologic characteristics of the milk of puerperants in the group at risk for the development of lactation mastitis]. PMID- 3961578 TI - [Treatment of erysipelas in late middle-aged patients]. PMID- 3961579 TI - [Achalasia of the cardia in children]. PMID- 3961580 TI - [Active methods of treating acute mushroom poisoning]. PMID- 3961581 TI - [Interaction of various specific mortality rates for alcoholic cirrhosis with ecological indicators in the state of Tabasco, Mexico]. PMID- 3961582 TI - [Nosocomial infections: features of the problem at the Instituto Nacional de la Nutricion Salvador Zubiran and in Mexico]. PMID- 3961583 TI - [Importance of chronic degenerative diseases in the current epidemiological panorama in Mexico]. PMID- 3961584 TI - [Human pulmonary paragonimiasis in Mexico]. PMID- 3961585 TI - [Outbreak of trichinosis occurring in a government office. Federal District, Mexico, 1985]. PMID- 3961586 TI - [Alzheimer's dementia. Incidence of the disease at the Hospital Psiquiatrico de Agudos Fray Bernardino Alvarez. Neuropathological aspects]. PMID- 3961587 TI - [Effect of social and biological factors on family size and the secondary sex ratio in 2 human generations in Monterey, Nueva Leon]. PMID- 3961588 TI - [Current status of the pharmacological management of scorpion bites]. PMID- 3961589 TI - [Prospects for health services following the earthquakes of September 1985]. PMID- 3961590 TI - [Value of arthrography in comparison with delayed-exposure films in the diagnosis of injuries to the ankle ligaments]. PMID- 3961591 TI - [Giant pseudopolyposis in the transverse colon in Crohn disease]. PMID- 3961592 TI - [Determination of tube voltage in x-ray equipment]. PMID- 3961593 TI - [Future outlook for clinical nuclear magnetic resonance tomography]. PMID- 3961594 TI - [High-resolution surface-coil nuclear magnetic resonance tomography. Coil design and physical bases]. PMID- 3961595 TI - [Possibilities and value of percutaneous radiotherapy of malignant thyroid tumors]. PMID- 3961596 TI - [Current problems in the treatment of varices of the lower extremities and their complications in Czechoslovakia]. PMID- 3961597 TI - [Esophageal ulcers]. PMID- 3961598 TI - [Complications of pseudocysts of the pancreas]. PMID- 3961599 TI - [An unusual complication of a stress ulcer]. PMID- 3961600 TI - [Radiotherapy as a part of the comprehensive treatment of carcinoma of the rectum and rectosigmoid]. PMID- 3961601 TI - [Prevention of thromboembolic episodes at the 1st Surgical Clinic of the Medical School Hospital in Olomouc]. PMID- 3961602 TI - [The present state of treatment of Zollinger-Ellison syndrome]. PMID- 3961603 TI - [Treatment of sacral decubiti using musculocutaneous flaps]. PMID- 3961604 TI - [Musculocutaneous flaps in the treatment of chronic osteomyelitis of the leg]. PMID- 3961605 TI - Adolescent health. PMID- 3961606 TI - The choice between intravenous N-acetylcysteine and oral methionine in paracetamol poisoning. PMID- 3961607 TI - Value of steroid hormone receptor analysis in predicting time to treatment failure in operable breast cancer. AB - An analysis of prognostic factors for predicting time to treatment failure (TTF) was performed on 246 patients who were referred for adjuvant chemotherapy after mastectomy. Oestrogen receptor (ER) and progesterone receptor (PgR) analyses were carried out on 172 and 102 patients respectively. Prognostic factors predicting for TTF were, in decreasing order of significance: nodal status, tumour size, ER status and age of the patient. Comparison of TTF for ER+ and ER- (without categories of other prognostic factors) showed that ER status is prognostic irrespective of nodal status. ER is prognostically significant within both categories of PgR. PgR predicted significantly for TTF only in patients without nodal involvement. PMID- 3961608 TI - Biliary atresia--surgical management. A 10-year review. AB - The surgical results in 39 children operated on for biliary atresia at Red Cross War Memorial Children's Hospital between January 1975 and January 1985 are reported. The mean age at operation was 12.8 weeks (range 6 weeks-6 months). In the first 4 years no patient had sustained bile drainage after operation. Since 1979 16 of 32 patients (50%) have had significant bile drainage. Of these, 8 are alive and have been followed up from 6 months to 6 years after operation. Five are jaundice-free and well. The other 3 are mildly jaundiced, have evidence of ongoing liver damage, and have a poor prognosis. The deaths were due to progressive liver damage with liver failure, portal hypertension, and intercurrent infection. Cholangitis after 'successful' porto-enterostomy was the main cause of poor prognosis and can be related to the age at referral and the presence of cirrhosis of the liver at the time of surgery; thus bile drainage does not necessarily equate with cure. Early referral of infants with conjugated hyperbilirubinaemia to a major centre is of paramount importance if we are to improve the prognosis. PMID- 3961609 TI - Results of the in vitro fertilization programme at Tygerberg Hospital, phases II and III. AB - Phases II and III of the human in vitro fertilization programme at Tygerberg Hospital are presented. In phase II, 42 laparoscopies were performed and oocytes were obtained from 76% of the follicles aspirated, but with a fertilization rate of only 37%. The viable pregnancy rate per embryo transfer was 4%. Important changes took place in the programme, which led to a fertilization rate of 77% in phase III. Of the 78 patients subjected to laparoscopy, 65 (83%) reached the embryo transfer stage, resulting in a clinical pregnancy rate per embryo transfer of 23%, and with a 19% pregnancy rate per laparoscopy. The changes, methods and results of phases II and III are discussed. PMID- 3961610 TI - Hospital information systems--a need to re-evaluate the roles of management. AB - Hospital information systems are now entering a third generation, not only as regards new technology but more significantly with regard to the role of those involved in their design and implementation. This new emphasis requires a re evaluation of the roles of the designer and user. In the design of a hospital information system, its unique nature--relating central management to a number of independent clinical specialties--must be recognized. One way to achieve this is the establishment of a minimum basic data set dictated by the specific needs of top management interacting with independent clinical subsystems. PMID- 3961611 TI - Tonometry in general practice--its use in early detection of primary open-angle glaucoma. AB - The intra-ocular pressure of 1078 general practice patients aged over 45 years was measured with the Schiotz tonometer. Primary open-angle glaucoma was found in 29 patients (2.7%) and ocular hypertension in 40 (3.7%). The technique of using the tonometer is described and a plea is made for general practitioners to make more use of it in screening their patients for glaucoma. PMID- 3961612 TI - Tracheal rupture--an anaesthetic mishap? A case report. AB - We present the case of a 21-year-old primigravida who died after an uneventful caesarean section. We believe that this death was due to pre-eclamptic toxaemia rather than related to the finding of a tracheal tear at autopsy. PMID- 3961613 TI - Who nose where it was? An unusual case of airway obstruction. AB - An unusual case of airway obstruction is presented. The importance of communication between all physicians caring for a patient is stressed. The need for correct and precise documentation of procedures performed is highlighted. PMID- 3961614 TI - Rational therapy for hyperuricaemia. PMID- 3961615 TI - Confusion in the reporting of low birth weight. PMID- 3961616 TI - Prevalence of helminthic infestation in cane-cutters. PMID- 3961617 TI - Button-battery ingestion. PMID- 3961618 TI - [Prognostic parameters in patients with advanced non-Hodgkin's lymphoma]. AB - Ninety-five patients with advanced non-Hodgkin's lymphoma (NHL) were studied to evaluate parameters affecting their survival. The median survival time was 52 months (range 3-107 months). The log-rank test was used to analyse the data. Favourable parameters that significantly influenced actuarial survival were nodular histology (P = 0.01), age less than 50 years (P = 0.002), good performance status (P = 0.006), and normal serum lactate dehydrogenase, SGOT and alkaline phosphatase levels. The absence of systemic symptoms, namely weight loss in excess of 10%, fever or night sweats, had less prognostic implication. Sex and stage (III or IV) did not significantly affect survival. PMID- 3961619 TI - Seasonal activity and hosts of the vectors of Crimean-Congo haemorrhagic fever in South Africa. AB - The seasonal activity and hosts of two species of Hyalomma, H. marginatum rufipes and H. truncatum, were studied in a Crimean-Congo haemorrhagic fever (CCHF) zone near Bloemhof in the western Transvaal. The study was conducted at the S.A. Lombard Nature Reserve, where a child had died from this disease. It was found that adults of the two species are very common during summer while the immature stages were active during winter and also demonstrated a second peak of activity in November. H. marginatum rufipes adults fed mainly on eland and zebra, while H. truncatum preferred black wildebeest, springbok and blesbok as hosts. Immature specimens of H. truncatum fed on hares and rodents and those of H. marginatum rufipes on hares, rodents and guinea-fowl. It appears that the immature stages pick up the virus from hares and other small mammals, but it is the adult ticks who transfer the virus to man. The epidemiology of tick-borne CCHF is discussed. PMID- 3961620 TI - Mycotoxicological investigations on maize and groundnuts from the endemic area of Mseleni joint disease in Kwazulu. AB - Samples of home-grown maize and groundnuts from the endemic area of Mseleni joint disease (MJD) during four seasons (1980-1983) were examined mycologically. The mycoflora of these dietary staples included Fusarium poae and F. oxysporum, which have been implicated in the aetiology of Kashin-Beck or Urov disease, another osteo-arthrosis endemic in Siberia and China. Two other species of Fusarium, i.e. F. moniliforme and F. equiseti, implicated in syndromes of abnormal bone development in animals, were also present. The predominant fungus associated with maize kernels was F. moniliforme; two other fungi relatively frequently isolated from Mseleni maize, i.e. F. compactum and Lasiodiplodia theobromae, have not previously been reported in maize in southern Africa. The predominant fungi associated with groundnut kernels were Penicillium spp., L. theobromae, Macrophomina phaseolina and F. oxysporum. The incidence of certain fungi, particularly F. compactum, F. oxysporum and L. theobromae, appeared to be higher in dietary staples from households affected by MJD than from non-affected ones. The numbers of samples examined were, however, small and these findings need to be confirmed. Cultures of 120/322 isolates of fungi from Mseleni dietary staples proved toxic to ducklings, the most toxic species being F. compactum, F. moniliforme, F. oxysporum and Phomopsis sp. The characteristic pathological changes of MJD have, however, not been induced in experimental animals with cultures of any of these fungi. A diet containing maize and groundnuts from households affected by MJD also failed to induce the characteristic osteo arthritic changes of MJD in rats. The dietary staples used in this experiment were, however, collected during seasons of abnormally low rainfall at Mseleni.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961621 TI - Inherited disorders in the black population of southern Africa. Part III. Multifactorial, chromosomal and congenital conditions. PMID- 3961622 TI - Body cooling as a method for reducing hyperthermia. An evaluation of techniques. AB - The most important objective in the treatment of heatstroke and related conditions is to reduce the body core temperature to safe levels. Subjects performed at an external work rate of 54 W in hot, humid conditions (dry-bulb 40 degrees C, wet-bulb 35 degrees C), and a recent innovation to achieve body cooling, i.e. strategically placing instant cold packs (ICPs) (Coldpak; Medac) over the large vessels of the neck, axillae and groin, was evaluated under controlled laboratory conditions. We found that this procedure was not significantly more effective (P greater than 0.5) than passive body cooling in bringing about a 2 degrees C reduction in rectal temperature. Moreover, covering the whole body with ICPs plus induced evaporative cooling produced higher cooling rates than those achieved by the strategic placement of ICPs (0.0340 degrees C/min and 0.0344 degrees C/min respectively) (P less than 0.01). PMID- 3961623 TI - Budd-Chiari syndrome. A report of 3 cases. AB - Three patients with the Budd-Chiari syndrome are presented. This is a rare condition characterized by hepatomegaly, progressive and refractory ascites, distension of the abdominal wall veins, abdominal pain and leg oedema. These features are attributed to congestion of the liver and portal hypertension. The condition has been notoriously difficult to treat medically. Surgical measures are directed towards relieving the liver congestion and lowering pressure in the portal system by portal-systemic shunting operations. In some cases refractory ascites may be treated by peritoneovenous shunting with a Le Veen shunt. In a select group of patients orthotopic liver transplantation has proved to be worth while. PMID- 3961625 TI - The death certificate--fact or fiction? PMID- 3961624 TI - Spontaneous perforation of the rectum. A case report. AB - A case of spontaneous perforation of the rectum is reported. The incidence, clinical picture, diagnosis and treatment of this rare condition is briefly discussed. PMID- 3961626 TI - Therapeutic protocol No. 2. Management of paracetamol overdose. PMID- 3961627 TI - Death from the 'visna variant' of AIDS. PMID- 3961628 TI - Safety of plasmapheresis. PMID- 3961629 TI - Diagnosis of fractures using sound conduction in bone. PMID- 3961630 TI - Low birth weight and health in the preschool years. PMID- 3961631 TI - Blood lead levels in preschool children in Cape Town. AB - Blood lead levels were assessed in 293 children aged between 4 and 6 years attending preschool centres in metropolitan Cape Town in order to establish the degree of lead absorption. Anthropometric data, blood count, zinc protoporphyrin and blood lead level were obtained for each child. A questionnaire was used to determine socio-economic status, dietary habits and history of pica. Thirteen children, or 4,4% of those sampled, had blood levels of greater than or equal to 30 micrograms/dl. The majority of these children lived in close proximity to one another in a socially deprived inner urban environment. Environmental sampling for lead was carried out in the homes of children with the highest blood levels as well as in the homes of a matched control group with low levels living in the same area. The only difference was a significantly higher incidence of pica in the children with high levels. PMID- 3961632 TI - Parkinsonian symptoms in tardive dyskinesia. A prevalence study. AB - Of 49 unselected patients with tardive dyskinesia (TD) 28 (57%) exhibited various parkinsonian signs. Isolated tremor was encountered in 11 patients, tremor with hypokinesia and rigidity in 13 patients, and hypokinesia and rigidity alone in 4. Tremor was detected among patients with scorable peripheral signs of TD. Hypokineto-rigidity, with or without tremor, was attributed to high doses of neuroleptics--notably fluphenazine. This study confirmed reports that isolated parkinsonian signs occurring concurrently with TD must be considered a regular phenomenon even when questionable cases (e.g. tremor in lithium-treated patients, action-tremor in the elderly) are disregarded. However, given the 'fragmentation' of the parkinsonian syndrome, often atypical tremor and signs of anosognosia in TD patients, the final diagnosis may necessitate pharmacological testing (discontinuation of neuroleptic medication, administration of anticholinergics). PMID- 3961633 TI - Effects of nifedipine on the peri-operative ECG, as determined by continuous Holter monitoring. A double-blind study. AB - A double-blind study was performed on 50 elderly patients undergoing hip replacement surgery under general anaesthesia; 26 were given nifedipine and the remaining 24 placebo to determine effects on the continuously monitored (Holter) ECG during the 4 peri-operative days. Drugs were only administered during the latter 3 days of the observation period. Surgery was performed on the morning of the 3rd day. A striking feature was the high incidence of arrhythmias in both groups of patients, a finding previously documented in both 'normal' and elderly people. A decrease in ST-segment changes was expected in the nifedipine-treated patients. An unexpected finding, therefore, was the lack of protection against cardiac ischaemic changes in the nifedipine-treated patients compared with the placebo patients. Interpretation of the ST segment as seen in the Holter monitored ECG remains controversial. We have no clear explanation for the lack of protection against ischaemic changes. The effects of profound vasodilatation produced by nifedipine in elderly patients subjected to major surgery, general anaesthesia including administration of enflurane, and a variable amount of blood loss in the postoperative period may be important factors. In conclusion, one should perhaps be cautious of nifedipine administration under these circumstances. PMID- 3961635 TI - Endomyocardial biopsy technique in infants and small children. AB - Endomyocardial biopsy is performed when a histological diagnosis is required, e.g. in patients with cardiac failure due to unknown causes, in anthracycline toxicity, and to evaluate cardiac transplant rejection. Right ventricular endomyocardial biopsy has been carried out in 10 infants and small children (average age 14 months); the technical aspects of the procedure are discussed. Performed by a paediatric cardiologist endomyocardial biopsy in infancy is as safe as a routine cardiac catheterization. PMID- 3961634 TI - A new povidone-iodine cream for the treatment of burns. Comparison with a standard topical regimen. AB - A remarkable improvement in the rate of burn healing has been achieved with a mixture of povidone-iodine ointment (Betadine) and malic, benzoic and salicylic acids (MBS) (Aserbine). A study was undertaken to compare the effects of a new povidone-iodine formulation (Betadine cream) with and without MBS with povidone iodine ointment plus MBS. All preparations were easy to apply and were readily removed, causing only mild discomfort on application in the majority of cases. A significant difference in healing times was observed between povidone-iodine cream and povidone-iodine cream plus MBS. There was also a significant difference in the decrease in the number of positive bacterial cultures between these two treatments. This applied to both superficial and deep burns. No skin sensitivity reactions were reported with any of the preparations. The addition of MBS to povidone-iodine cream did not produce as significant an improvement in results as its addition to povidone-iodine ointment. PMID- 3961636 TI - Prosthetic valve endocarditis. A clinicopathological study of 31 cases. AB - Prosthetic valve infective endocarditis was found in 31 out of 275 autopsies on patients with valvular prostheses. Mean postoperative survival was 332 days. Thirty patients had mechanical valves and only 1 had an infected tissue valve. The commonest pathogens were staphylococci, followed by Gram-negative bacilli and fungi. In all the patients with mechanical valves the infection was situated at the host-prosthesis sewing ring interface, and most also had vegetations on the prosthetic struts or cage. The infected tissue valve had vegetations on the prosthetic cusps only. Ring abscesses were present in one-third of cases and had destroyed the bundle of His in 1 patient. Clinically recognized pre-operative infective endocarditis was present in only 3 out of the 31 patients. Seven of the 31 patients died because of malfunction of the prosthesis, 10 died of systemic embolism, 4 of ruptured mycotic aneurysms, and the remaining 10 of other causes including myocardial failure, pyaemic abscesses and toxaemia. PMID- 3961637 TI - Pyloric stenosis presenting as severe prolonged jaundice. A case report. AB - A 17-day-old infant with pyloric stenosis presenting with severe neonatal jaundice is described. The bilirubin level rose to 371 mumol/l and an exchange transfusion was considered. No history of frequent or forceful vomiting was given and the usual symptoms and signs of pyloric stenosis were absent. Radiographic studies revealed features typical of hypertrophic pyloric stenosis. At laparotomy a pyloromyotomy was performed and the jaundice subsided rapidly. PMID- 3961638 TI - Arterial embolism and fibrinolysis. A case report. AB - Medicinal lysis with an intra-arterial streptokinase infusion was used in a patient who had suffered multiple embolic occlusions 2 weeks after a myocardial infarction. The good outcome, as verified by arteriography, and the experience of other groups, makes it clear that there is a specific place for this therapy in such patients. Concomitant arterial stenosis should be treated by transluminal angioplasty to prevent re-thrombosis. PMID- 3961639 TI - Miliary tuberculosis causing pancytopenia. A report of 2 cases. AB - Tuberculosis is a common disease in South Africa, but the diagnosis may be difficult when it presents in the miliary form. Two cases of miliary tuberculosis with pancytopenia are described. PMID- 3961640 TI - Anticoagulation during pregnancy. PMID- 3961641 TI - Summer aseptic meningitis in Cape Town, 1981-1986. PMID- 3961642 TI - Prevention of hypoglycemia during prolonged exercise by ingestion of carbohydrate rich solutions. PMID- 3961643 TI - The South African Defence Force physical training programme. Part I. Effect of 1 year's military training on endurance fitness. AB - The effect of the South African Defence Force's (SADF) military training on the endurance fitness of recruits was investigated. Pre-military training maximal O2 consumption (53,14 ml/kg/min) did not change significantly during the study. In contrast, lactate turnpoint (ml O2/kg/min) and treadmill performance time were moderately enhanced (7,5% and 8% respectively; P less than 0,05) by the initial 10-week basic training programme. Further analysis of the results showed this endurance-training effect to be limited to recruits of average and, in particular, below-average fitness. The salutary effect of basic training on fitness levels was, however, transient, the values on completion of 1 year's military training being unaltered from those before conscription. This preliminary assessment of the SADF physical training programme suggests a need for the introduction of changes during and, in particular, after basic training. PMID- 3961644 TI - The South African Defence Force physical training programme. Part II. Effect of 1 year's military training on muscular strength, power, power-endurance, speed and flexibility. AB - The effect of the South African Defence Force (SADF) military training on recruits' muscular strength, power, power-endurance, speed and flexibility was investigated. In the entire study group, a significant enhancement by basic training was observed for the isokinetic muscular strength of the right elbow extensors alone (17% increase; P less than 0,05). Stratification of training responses on the basis of initial fitness levels revealed significant improvements with basic training for all measures of muscular strength, power, power-endurance and speed, but not flexibility, in the below-average fitness recruit. For all variables the training effect was transient and values documented on completion of 1 year's military training differed insignificantly from those recorded before conscription. In contrast, with the exception of elbow extensor muscular strength, fitness levels of the average and above-average recruits were not increased by basic training. While further research to assess physical requirements of various military work and emergency situations is needed to evaluate the desirability of this observed selective enhancement of recruit fitness levels during basic training, it is evident that greater emphasis should be placed on flexibility training, and physical conditioning after basic training. PMID- 3961645 TI - The South African Defence Force physical training programme. Part III. Exertion related injuries sustained at an SADF basic training centre. AB - The incidence and nature of exertion-related injuries were studied at a South African Defence Force basic training centre. A total of 404 separate injuries were sustained by 359 of 947 recruits during the 10-week basic training cycle. Of these injuries, 18,3% were sustained with (group 1) and 81,7% without (group 2) an obvious sudden precipitating event. Exertion-related injuries were responsible for a loss of 2711 recruit-days of basic training. While the knee sustained the largest number of group 2 injuries, lower leg trauma resulted in the greatest loss of basic training time. Forty-two separate radio-graphically confirmed stress fractures were incurred by 39 recruits, an incidence of 4,12%, which is considerably higher than that in the US Army. These data leave little doubt that the present training programme is costly in terms of training-time lost and may prevent large numbers of recruits from deriving the optimum conditioning benefits. PMID- 3961646 TI - Ceftriaxone therapy in adults with severe lower respiratory tract infections. AB - Ceftriaxone, a third-generation cephalosporin with a wide spectrum of antimicrobial activity and a long half-life of 8 hours permitting administration every 24 hours, was evaluated in 33 patients with severe lower respiratory tract infections. Twenty-nine patients showed a favourable clinical response and 2 failed to respond to therapy. In 2 patients the clinical response was impossible to assess. In 19 of the 23 patients in whom it was possible to assess bacteriological response, there was a favourable outcome. Serum ceftriaxone levels were well maintained above the minimal inhibitory concentrations of sensitive organisms for the entire dosage interval whether the drug was given by intramuscular or intravenous injection. There were no side-effects that could be attributed to ceftriaxone, which was highly effective in the immediate treatment of both community and nosocomial acquired severe lower respiratory tract infections. PMID- 3961647 TI - Entrapment of platelets in the penis during and after erection. AB - Because of the development of hypercoagulability and the deposition of fibrin in the penis during erection a study of the possible role of platelets in this process was undertaken. Platelet response was studied in 9 adult chacma baboons (Papio ursinus) using autologous in vitro indium-111-labelled platelets and sequential scintigraphy of the penis during erection. The blood pooling pattern was obtained using in vivo technetium-99m-labelled red cells in a similar investigation. A statistically significant retention of platelets occurred during and after erection, which could not be attributed to blood pooling (P less than 0,05). Entrapment of platelets could lead to enhanced activity and activation, and might play a significant role in hypercoagulability and fibrin deposition during erection. Therefore platelets could be an important factor in the pathogenesis of ageing impotence. PMID- 3961648 TI - The simultaneous determination of cerebrospinal fluid and plasma adenosine deaminase activity as a diagnostic aid in tuberculous meningitis. AB - The simultaneous determination of cerebrospinal fluid (CSF) and plasma adenosine deaminase (ADA) activity was evaluated as a diagnostic aid in tuberculous meningitis (TBM). CSF and plasma ADA activity were determined in four groups of patients: (i) a 'no meningitis' group of 174 children investigated for possible meningitis, but found to be uninfected; (ii) an aseptic meningitis group of 40 children; (iii) a bacterial meningitis group of 31 children; and (iv) a TBM group of 27 patients (24 children and 3 adults). CSF ADA alone was determined in a further 23 children with aseptic meningitis, 19 with bacterial meningitis and 13 children and 7 adults with TBM. Both the CSF/plasma ADA ratio and the absolute CSF ADA activity were raised in TBM (mean values 0,24 and 12,61 U/I respectively) and bacterial meningitis (mean values 0,59 and 15,43 U/I respectively), but not in the aseptic meningitis group (mean values 0,06 and 2,00 U/I) or the 'no meningitis' group (mean values 0,04 and 1,51 U/I). Both values will distinguish TBM from aseptic meningitis, but do not appear to hold any marked advantages over conventional CSF criteria in the diagnosis of TBM. PMID- 3961649 TI - 'Kissing sequestra'--a forgotten manifestation of osteo-articular tuberculosis. A case report. AB - Osteo-articular tuberculosis may be difficult to diagnose radiologically. A male patient with pain in the left hip presented with radiological features of the disease--narrowing of the joint space, peri-articular osteopenia, subchondral erosions and cavity formation. In addition 'kissing sequestra' were present in the adjacent femoral head and acetabular joint surfaces. This radiological feature, described as common by Phemeister and Pomerantz in 1933, has been largely overlooked in recent literature. The presence of 'kissing sequestra' is a valuable diagnostic aid and should not be overlooked. PMID- 3961650 TI - Septic abortion complicated by rhinocerebral phycomycosis (mucormycosis). A case report. AB - A patient with septic abortion complicated initially by hepatorenal failure and later by rhinocerebral phycomycosis (mucormycosis) is described. It is believed that the outcome was fatal because the patient was diabetic and had been extensively treated with antibiotics. PMID- 3961651 TI - Employment of retired-worker women. PMID- 3961652 TI - Routine appendectomy in extensive gynecologic operations. AB - Based upon past clinical experience, a policy was established in a teaching service to remove the appendix whenever encountered during extensive gynecologic operations. Retrospectively, all patients operated upon during the subsequent 54 month period were reviewed to determine the success of instituting the policy of mandatory elective appendectomy and to assess the pathologic findings. We found that 93 per cent of the time the policy was followed and appendectomy performed. Definite pathologic findings were found in 14.6 per cent of the specimens and equivocal pathologic findings in an additional 14 per cent. No procedure related morbidity occurred. The incidence of metastasis to the appendix from specific gynecologic malignant diseases is discussed herein. PMID- 3961653 TI - Biochemical and morphologic changes in hepatocytes from the shock injured liver. AB - It has been proposed that the isolated hepatocyte is an excellent model for the study of cellular changes during and after hemorrhagic shock. To investigate this proposition the biochemical and morphologic changes in the isolated hepatocyte of shock injured rats were documented. Use of the isolated hepatocyte allows direct measurement of intracellular biochemical changes which we find corroborates the results of basic shock studies done on rats using liver slices, perfused liver or specimens taken at biopsy. Morphologic changes in the shocked liver of the rat are noted using transmission electron microscopy (TEM) and scanning electron microscopy (SEM). The results are correlated with the biochemical changes. SEM of the isolated hepatocyte reveals marked swelling immediately after shock with some scattered blebs. The cells show some recovery at two hours with near complete normality restored at 24 hours. TEM of tissue and isolated cells reveal vacuolization and mitochondrial changes in the early post shock period with return to normality at 24 hours after shock. The shock injured hepatocyte is a reasonably faithful representative of the events which have taken place in the liver from which it is isolated. It can be used as a model for treatment in vivo or as a device for comparison of the effects of different environments in vivo or in vitro. PMID- 3961654 TI - Carotid endarterectomy in the elderly patient. AB - Although the segment of the population at the highest risk for cerebral ischemic events is more than 75 years old, there has been hesitancy in performing carotid revascularization in these patients because of an increased risk of perioperative morbidity. Over a period of 54 months, 77 (16 per cent) of 470 carotid endarterectomies performed were upon patients more than 75 years old. There were no differences between age groups with respect to perioperative morbidity or mortality, with three strokes (3.9 per cent) and no deaths in the patients more than 75 years old and 12 strokes (3.1 per cent) and two deaths (0.5 per cent) in the patients less than 75 years old. Postoperative follow-up study ranged from 30 days to five years (a mean of 25 months) in elderly patients. The over-all three and five year survival rate was 78 and 60 per cent, respectively. No patient experienced a stroke during follow-up study. Recurrent symptoms developed in 18 per cent of the elderly patients at three years of follow-up study, and the occurrence was dependent upon the preoperative symptom category (hemispheric 10 per cent and nonhemispheric 33 per cent). We conclude that the low perioperative morbidity and mortality, and subsequent results of carotid endarterectomy in the elderly patient justify operative intervention when significant lesions are encountered. PMID- 3961655 TI - Benign disorders of the breast in older women. AB - Five hundred and eighty-one women over the age of 55 years with a benign disorder of the breast have been studied out of a total of 4,379 consecutive consultations for a perceived mammary problem. The relative age specific incidence of benign disorders of the breast dropped dramatically after menopause. Eighty per cent of older patients seen with these phenomena were between 55 and 69 years of age. Older women with benign disorders of the breast were more likely to have had a previous benign finding at biopsy or aspiration than younger patients. The use of hormonal supplements in these women was no different than that believed to occur in the regular population, except in the patients with cysts of the breast. The most common complaint was nodularity with or without pain. Cysts and fibroadenomas were proportionately much less common than in younger women and one half of the patients who had cysts were taking hormonal supplements. In women more than 55 years of age, papillomas of the duct are responsible for approximately one-third of the nipple discharges, although the most common cause is ectasia of the duct. The postmenopausal involution makes the breast much easier to examine, both clinically and roentgenographically so that diagnosis of benign disorders can be made with reasonable confidence. Cysts can be safely aspirated because cystic carcinomas which do occur in this age group can be fairly easily recognized by gross clinical features. PMID- 3961656 TI - Factors influencing prognosis in carcinoma of the stomach. AB - Prognostic factors were prospectively sought in a consecutive group of 223 patients with carcinoma of the stomach observed for a minimum of seven years. Age, race and mode of presentation did not influence survival time. Statistically improved seven year survival rates were observed in females (p less than 0.01) and patients with several features: symptoms lasting more than six months (p less than 0.01); absence of an abdominal mass (p less than 0.01); T1 versus T3 Stage of disease (p less than 0.001); absence of nodal involvement (p less than 0.01) and when curative resection was possible (p less than 0.01). PMID- 3961657 TI - An improved method for construction of loop colostomy. PMID- 3961658 TI - A new technique for temporary transparietocecal ileal diversion in the prevention of anastomotic leakage in colonic operations. AB - A new technique of temporary transparietocecal ileal diversion in the prevention of anastomotic leakage in colonic operation is presented. The results of this new procedure, particularly with regards to the incidence of anastomotic leakage, morbidity and mortality, has been encouraging. There has not been a single instance of clinical anastomotic dehiscence in 73 patients in whom this technique was done. The postoperative course has been remarkably smooth. There has been no complications associated with this technique. This procedure is a simple and safe method of fecal diversion in planned colonic resections. PMID- 3961659 TI - Recurrence of meningiomas after operation. AB - The authors reviewed 53 consecutive patients who underwent surgical removal of a meningioma within a 10-year period. The removal was graded macroscopically as either a total removal (types I-III) or a subtotal removal (type IV). The patients were observed for an average period of 5.3 years, during which time there was a 9.5% recurrence after type I removals and an 18.4% recurrence after type II. There was regrowth in 20% of the subtotal group. There was no correlation with age or sex, but histology was important. Syncytial tumors tended to recur, and mitosis and area of focal necrosis were associated with a tendency towards recurrence. The significant features associated with recurrence are discussed. PMID- 3961660 TI - Consideration of the operative indications for posterior fossa venous angiomas. AB - The case of a patient with a venous angioma located in the midline of the posterior fossa and responsible for a cerebellar hemorrhage is reported. The patient had a good recovery after removal of the hematoma. We reviewed this and seven other cases of venous angioma in the posterior fossa reported in the literature. It appears that those venous angiomas that occur in the cerebellar hemisphere and produce a cerebellar hematoma can be successfully removed. PMID- 3961661 TI - Anterior transposition for advanced ulnar neuropathy at the elbow. AB - Previous studies have shown good clinical results after anterior transposition of the ulnar nerve for compression neuropathy. However, it has been suggested that younger patients with a shorter duration of preoperative symptoms benefit most from surgical therapy. To determine what factors adversely affect the prognosis in patients with advanced disease, 23 of 24 anterior transpositions performed consecutively over 6 years were observed at a mean of 33.2 months. The mean age was 52.1 years. Symptoms were present for a mean of 11.3 months. Before the operation, 30% were graded moderate and 70% severe. After the operation, 70% of the patients improved, with 40% having a good result and 30% fair. Advanced age, duration of preoperative symptoms, diabetes, hypertension, alcoholism, etiology, type of transposition, tourniquet time, or atrophy did not predict a poor outcome. Severe clinical findings confirmed by electrophysiologic studies did not contraindicate surgery or preclude a reasonable rate of success in this small but relatively homogeneous group of patients. PMID- 3961662 TI - Benign tumors and tumorlike conditions of the spine. Radiological features, treatment, and results. AB - A series of 44 benign tumors and tumorlike conditions of the spine treated surgically between 1952 and 1982 is reported. We have focused on their radiodiagnosis, treatment, and long-term results. The radiologic features considered pathognomonic of skeletal tumors, and frequently found in tumors outside the spine, are less common in the spinal variety. In fact, the radiologic findings in spinal tumors are, as a rule, nonspecific. The long-term results in this series are considered satisfactory, despite two recurrences of a giant cell tumor and late malignant degeneration of an osteochondroma. The prognosis was good, and recurrence rare even after conservative excision of the lesion. More aggressive treatment is nonetheless recommended nowadays for giant cell tumors and osteoblastomas, even if vertebral stability has to be sacrificed and fusion performed, as this affords the best chance of permanent cure. Conservative excision without radiotherapy remains the treatment of choice for other benign tumors. Spinal instability is a serious risk especially in younger patients who have undergone radiotherapy and have residual neurological deficits. Provision should be made against this risk by planning a fixation procedure either in the same operation as ablative surgery or at a later stage. PMID- 3961663 TI - Traumatic hematomas of the posterior fossa. A clinicopathological spectrum. AB - Eight patients were found to have traumatic hematomas of the posterior fossa during a 6-year period. There were four patients with extradural hematomas, one patient with a subdural hematoma, and four patients with intracerebellar hematomas. In one patient, clinically significant hematomas were found both in the extradural space and in the cerebellum. Clinical or radiologic evidence of skull fracture was present in each case, and computed tomography scans were diagnostic of a posterior fossa hematoma in all cases. In six of the eight patients, there was clinical deterioration prior to surgical treatment, and in three cases, this was abrupt. All patients underwent suboccipital craniectomy. Six patients survived; four made a good recovery. Our experience indicates that early operation is usually indicated for these lesions. PMID- 3961664 TI - Intraluminal clot of the carotid artery. A clinical-angiographic correlation of nine patients and literature review. AB - Between March 1980 and March 1985, intraluminal thrombi of the carotid artery were noted in 9 of 2250 patients undergoing arteriography for symptoms of cerebral ischemia. Five patients had transient ischemic attacks, and four had acute cerebral infarctions. Six patients had surgery, but a thrombus was only found in five. Two patients had new neurological deficits after surgery. Three patients received only medical therapy, and all remained stable. Intraluminal thrombus is an uncommon radiographic finding in patients with cerebral ischemia. Not all clots are confirmed at operation. The optimal treatment of this situation is not known. Both surgical and medical treatments deserve further investigation. PMID- 3961665 TI - Lateral sinus pericranii. AB - Most reported cases of sinus pericranii have been situated near the midline. This report describes a case of laterally situated sinus pericranii and discusses its origin. PMID- 3961666 TI - Diastematomyelia in adults. AB - The authors report two cases of diastematomyelia in adults. One patient had a congenital kyphoscoliosis; the other had undergone surgery at birth for a myelomeningocele. The occurrence of diastematomyelia in patients with congenital scoliosis and myelomeningocele is discussed. Diastematomyelia is regarded as one of the causes of late deterioration of neurological function in such cases. PMID- 3961670 TI - Medical malpractice. PMID- 3961668 TI - Preoperative spinal localization using the hook wire technique. AB - Surgeons are increasingly required to resect disk herniations. Methods for preoperative or perioperative localization of such lesions require precision. This is difficult to achieve using the usual methods. We propose the use of a preoperative invasive technique: needle and marker wire. Its precision has been proved for preoperative localization of nonpalpable breast lesions. PMID- 3961669 TI - Movements in the hemiplegic half of the body. PMID- 3961667 TI - Chondrosarcoma arising from the falx cerebri. AB - A chondrosarcoma arising from the falx cerebri in a 15-year-old boy is reported. The patient had been suffering from convulsive seizures and weakness of the limbs on the left side for about 7 months prior to admission. A high-density mass attached to the falx was demonstrated by computed tomographic scan. Clinically it was very similar to a falx meningioma, and the final diagnosis was obtained from histopathological examination. The tumor was completely excised at operation, which is extremely important to prevent both local recurrence and distant metastasis. PMID- 3961671 TI - The future of photochemotherapy. PMID- 3961672 TI - [3-year complete remission of a 15 cm-long esophageal carcinoma after accelerated fractionated radiotherapy]. AB - The remission rate in the radiotherapy of esophageal carcinoma might probably be increased by accelerated fractionation. A 3 and a half year during complete remission of a 15 cm long tumor is reported. PMID- 3961673 TI - [Computed tomographic determination of the target volume of tumors in the pharyngeal and laryngeal areas]. AB - Computed tomography plays an important role in radiotherapy, especially in the delimitation of a target volume. For the oncologist, tumor and lymph node regions form a therapeutic unity. A direct imaging of the normal lymph node regions is not possible by CT. A method is described which allows an indirect presentation of lymph nodes in the head and neck area and, consequently, a better delimitation of the target volume. A three-dimensional presentation of the target volume is obtained by a certain quantity of CT scans which show various irregular forms making evident that a two-dimensional consideration of a single scan is no longer justified. Therefore five to seven scans are required for a more precise, three dimensional determination of a target volume in the head and neck area. PMID- 3961674 TI - [Calculation of the dose distribution for ultrahard X-ray bremsstrahlung]. AB - The dose distribution of the 42 MV X-ray bremsstrahlung of the betatron is represented by reference dose, depth dose and transverse dose. The method used to determine the parameters of a system of functions to approximate reference dose and depth dose is described and the coefficient schemes of the functions are indicated. The standardized equivalent field surface and the opening ratio of the useful radiation stop of the betatron serve as variables for the approximation. PMID- 3961675 TI - [Neuraminic acid (NANA) in the serum as an indicator in breast cancer]. AB - The serum concentration of neuraminic acid and the carcino-embryonic antigen (CEA) were measured in 178 patients with diagnosed mammary carcinoma and 114 control patients. Among these 178 patients, 16 showed a local recurrence, 68 were tumor-free, and 94 had distant metastases. Only 42 out of these 94 patients kept the check-up appointments. During six months, they were regularly examined and treated with cytostatic drugs. The neuraminic acid levels corresponded mostly to the clinical state and the response to chemotherapy of these patients. All of the 94 patients with generalized mammary carcinoma had a significantly increased neuraminic acid concentration in the serum (p less than 0.001). The serum levels were not modified in 16 patients with local recurrences and in 68 tumor-free patients. The CEA values did not correspond to the serum neuraminic acid levels and the clinical state of the patients. The increase of the neuraminic acid concentration in the serum of these 42 patients with metastatic mammary carcinomas show that this parameter is a valuable indicator for the progression of this disease. PMID- 3961676 TI - Histological examination of combined effects of chemotherapeutical agents and differently fractionated irradiations in transplanted solid Ehrlich carcinoma of mice. I. Observations after adriamycin treatment. AB - 4 X 3 mg/kg body weight adriamycin treatment induced histological damages in solid Ehrlich carcinoma, which increased on the effect of the parallel applied 10 X 5 Gy dose local fractionated X-ray irradiation. Comparing the effect of differently fractionated irradiations of the same total dose combined with adriamycin treatment, it can be stated that daily given less radiation fractions induce more severe damage than relatively higher ones applied in three to four days interval. PMID- 3961677 TI - Protection of monkeys against prolonged gamma-irradiation. AB - The radioprotective effect of the Bulgarian drug Adeturone was tested on prolonged irradiated monkeys. The animals were gamma-irradiated (137Cs) in a dose of 8.3 Gy (exposure rate 3.95 X 10(-3) mA.kg-1; (0.92 R.min-1]. Adeturone, given by i.v. injection at a dose of 100 mg.kg-1 body weight according to a pre- and postradiation scheme will afford protection to monkeys by ensuring 50% survival and mitigating the severity of some symptoms of radiation disease. A similar effect was obtained with ATP-administration by two i.m. injections of 37 mg.kg-1 body weight. The survival in control group was only 5% (LD95/45). PMID- 3961678 TI - [Familial gout]. AB - The authors observed 10 patients from 4 families with hereditarily determined gout and detected some specific features in its course. The familial disease was sex-unrelated, its first signs manifested themselves early acquiring a subsequent severe course; purine metabolic derangement was of a metabolic type, a urolithic form of nephropathy was seldom observed. A morphological picture was characterized by a glomerular lesion looking like focal segmental mesangiocapillary or mesangioproliferative glomerulonephritis with noticeable changes in the tubules, stroma and vessels causing early renal insufficiency. Pathogenetic therapy with uricodepressants made it possible to improve the course of nephropathy. The authors described a pedigree of 3 generations of a family in which gout developed in its 10 out of 17 members, in 6 with chronic renal insufficiency. PMID- 3961679 TI - [Renal osteodystrophy and its possible correction in patients on chronic hemodialysis]. AB - Results of diagnosis and treatment of renal osteodystrophy are discussed concerning 162 patients with chronic renal failure treated by hemodialysis. In most cases (15%) osteopenia and hyperparathyroidism were revealed. Roentgenologic investigation revealed metastatic calcification mostly in foot vessels, whereas microscopic study of internal organs in the lungs. The increase of calcium concentration in dialysate from 1.75 to 2.5 Mmol/l was not followed by greater calcinosis in patients with hyperphosphatemia. Uremic pruritus was treated by ultraviolet irradiation and administration of prednisolone for 3-5 days. The effect of I alpha-hydroxy-vitamin D3 was studied in 30 patients. Improvement of clinical status and, principally, relief of muscular pains in the extremities was observed as well as positive changes in blood serum biochemical indices. PMID- 3961680 TI - [Means for optimizing the diagnosis of diabetic angiopathies]. AB - Diagnostic algorithms for the recognition of diabetic angiopathies have been developed: an algorithm for the recognition of the most important syndromes of vascular involvement in patients with diabetes mellitus; an algorithm for the recognition of stages of diabetic retinopathy, and an algorithm for the recognition of stages of nephropathy. The algorithms are intended for a wide clinical use and mainly based on simple methods of research. More sophisticated methods extend the probability of the recognition of angiopathies. The use of the algorithms raise the efficacy of the recognition of angiopathies in demonstration experiments for teaching purposes. PMID- 3961681 TI - [Apathetic form of thyrotoxicosis]. AB - Two cases of the apathetic form of thyrotoxicosis in women aged 39 and 54 were described. The disease was characterized by the absence of typical signs of thyrotoxicosis in the presence of ptosis, cardiovascular disorders and thyrotoxic myopathy confirmed by EMG findings. Clinical symptoms were not registered after surgical therapy or chemotherapy with mercazolyl. PMID- 3961682 TI - [Case of the familial form of hyperchylomicronemia]. PMID- 3961683 TI - [Principles of treating hypertension patients with diuretics]. PMID- 3961684 TI - [Possibilities for the outpatient evaluation of the structure and function of the renal arteries by 2-dimensional Doppler echo scanning]. PMID- 3961685 TI - [The female climacteric and hypertension. An assessment of physical work capacity during treatment]. AB - Bicycle ergometry was used for a study of physical working capacity in 114 women with hypertension, of them in 63 concomitant menopause was diagnosed. A noticeable decrease in physical working capacity and efficacy of functioning of the cardiovascular system during muscular work was demonstrated in patients with hypertension combined with menopause. An opportunity of restored tolerance to physical exercise in most of the patients with hypertension and in more than half of the patients with hypertension combined with menopause was shown during prolonged 6-month hypotensive therapy. PMID- 3961686 TI - [Early detection of arterial hypertension and ischemic heart disease in mass screening at the polyclinics of large industrial enterprises]. PMID- 3961687 TI - [Arterial tonus in men 40 to 59 with hypercholesterolemia, arterial hypertension and ischemic heart disease]. AB - A study was made of the rate of pulse wave spreading (RPWS) in the elastic type vessels (the aorta, femoral artery) and in the muscular type vessels (the radial artery) at rest and in treadmill exercise in 363 men aged 40 to 59 residing in the Petrogradsky District of Leningrad and in 62 patients with previous transmural myocardial infarction (TMI). A distinct rise of RPWS in the elastic type vessels was established in persons with hypercholesterolemia without CHD and in CHD irrespective of a cholesterol level in the blood. In the patients after TMI, RPWS did not differ from that in healthy men indicating correlation between RPWS values and myocardial contractility. PMID- 3961688 TI - [Significance of atherosclerotic risk factors in the development of preatherosclerotic changes in the human aorta]. AB - A study of the effect of the main risk factors of atherosclerosis in coronary patients on the prevalence of lipoidosis and prelipid changes in the aortal intima showed a week interrelationship between the studied risk factors and prevalence of lipoidosis. A noticeable significant interrelationship of the prevalence of prelipid changes in the aortal intima, patient's age, the IRI level and alpha-XC concentration in the blood plasma was established. An equation was described. A nomogram was presented permitting determination of the prevalence of prelipid changes in the aortal intima and, consequently, the phase of a course of atherosclerosis during the patient's lifetime on the basis of the above risk factors. PMID- 3961689 TI - [Nutrition and dyslipoproteinemias in schoolchildren aged 13 to 16]. AB - In current studies of dyslipoproteinemia (DLP) development great emphasis is laid on the type of nutrition, its quantitative and qualitative characteristics, harmful habits, their formation in childhood and an attempt to influence them. However the problem of the start of stable DLP development and the role of dietary habits is yet to be solved. A random subsample of 169 school children aged 13 to 16 in the Krasnopresnensky District of Moscow was examined, among them 73 boys and 96 girls. High values of mean alimentary cholesterol, total and saturated fats and low mean amounts of consumed polyunsaturated fats were revealed. It could be inferred that the examined population was characterized by a high risk of the formation of atherogenic DLP stability. An analysis of the findings showed a considerable increase in the consumption of total and saturated fats as well as food rich in cholesterol in the group of children with stable DLP forms confirming the effect of the environmental factors including the alimentary ones, on processes of DLP formation in childhood. Further investigation of DLP in children should be conducted in the form of prospective studies otherwise design of activities in early prevention of atherogenic DLP seems impossible. PMID- 3961690 TI - [Bicycle ergometry test and the work incapacity of men 40 to 59]. AB - The purpose of the investigation was to study the relationship between indicators of the bicycle ergometry test and temporary disability degree in males aged 40 to 59 residing in the area of 2 district outpatient clinics in Moscow. Disability (temporary, stable) was studied by a method of standard interviewing. The bicycle ergometry test was applied to each patient using a standard scheme. The investigation showed an inverse ration between physical exercise tolerance and disability degree. PMID- 3961691 TI - [Chronobiological approach to the diagnosis and therapy of cardiovascular diseases]. AB - Some aspects of chronodiagnosis and chronotherapy of cardiovascular diseases were described. To reveal circadian cycles each examined person was observed for 3-5 days, the indices studied being measured every 4 h. The evaluation of a rhythm period was done using the dispersion analysis for the detection of non-sinusiodal rhythms and the approximation method for the detection of sinusoidal rhythms with a preset period (the cosignor analysis) and an unknown period (the least square method combined with the iteration method). Opportunities for the detection of changes or disorders of the time structure of examined function and approaches to chronotherapy were studied on clinical material. PMID- 3961693 TI - [Importance of the transesophageal electrocardiostimulation test in the differential diagnosis of ischemic heart disease and alcoholic cardiomyopathy]. AB - Hemodynamics was studied during transesophageal pacing test in 49 coronary patients and 22 patients with alcoholic cardiomyopathy by means of impedance plethysmography. Sinus node dysfunction, impaired ventricular contractility and decreased cardiac output were detected in the coronary patients. PMID- 3961692 TI - [Myocardial infarct morbidity among men and women in Krasnoyarsk from the viewpoint of age]. AB - A comparative analysis of the time course of age-related acute myocardial infarction incidence rates among men and women was based upon the results of an epidemiological study in Krasnoyarsk. Myocardial infarction incidence rates in men aged 20 to 69 (general as well as primary and secondary infarction incidence) were twice as high as in women of the same age. The time course of primary and secondary myocardial infarction incidence had common regularities. Under 60, incidence rates in men were higher than in women, over 60 just the opposite. Incidence rates in younger age groups were higher than in older age groups. No growth in the general morbidity of myocardial infarction was established in the period of the study. However its significant growth in men aged 50 to 59 ("rejuvenation" of myocardial infarction) was revealed. PMID- 3961694 TI - [Changes in the indices of carbohydrate metabolism, of the lipoprotein spectrum and of the blood coagulation system in men with ischemic heart disease undergoing long-term propranolol treatment]. AB - The paper is concerned with evidence of the time course of blood sugar, lipoprotein spectrum and some values of the blood coagulation system in patients with CHD on prolonged propranolol therapy in comparison with their natural time course in a similar group of patients with CHD receiving no therapy. Propranolol therapy for 2 yrs. produced no changes in the lipoprotein spectrum and blood fibrinogen. The level of blood sugar on an empty stomach rose 6 and 12 mos after treatment and did not differ from the control one in 24 mos, and the coagulation index significantly exceeded the control one in 24 mos. The results obtained are suggestive of a necessity of control over the level of blood sugar and hemocoagulation during a prolonged and continuous intake of propranolol. PMID- 3961695 TI - [Spiroergometric assessment of the reserves of the heart pumping function at different times following closed mitral commissurotomy]. AB - The paper is concerned with the results of a spiroergometric study of cardiac pumping function reserves (an ability of the heart to increase its output in response to physical load of maximum intensity) and physical working capacity in 35 patients after closed mitral commissurotomy during a dynamic follow-up in the first year after operation. Altogether 30 healthy subjects were entered into a control group. The data obtained made it possible to reveal residual hemodynamic disorders retained for the entire follow-up period and noted with physical load (a decrease in cardiac pumping function reserves) among the examined patients. The disorders determined lowered physical working capacity. The time course of cardiac pumping function reserves and physical working capacity was studied during the first half year after operation. There was no significant change of the studied values in the second half year. PMID- 3961696 TI - [Clinical and diagnostic characteristics of the early forms of stomach cancer]. AB - Clinical and diagnostic problems of early stomach cancer were considered for 157 patients with diagnosis confirmed after operation. Gastroenterological diseases were not mentioned in the past medical history of 22.9% of the patients only. 48.4% of the patients had the so-called stomach precancerous diseases, 28.7% other diseases of the alimentary tract. At diagnosis of carcinoma, 51.6% of the patients had clinical signs of previous diseases. The importance of prophylactic medical examination in the diagnosis of early stomach cancer was emphasized (cancer was detected actively in 84.7%). Since the gross appearance of early stomach cancer looks like benign lesions, the x-ray and endoscopic methods might not be quite informative. Morphological examination of the spot biopsy material raised preoperative diagnostic accuracy up to 92.3%. PMID- 3961697 TI - [Errors in the diagnosis of chronic pancreatitis]. AB - Basing on the results of long-term studies on 850 patients with different forms of chronic pancreatitis, specific variants of hypo- and hyperdiagnosis of this disease have been considered. Incidence and causes of the nonrecognition of chronic pancreatitis and complicating incretory and excretory pancreatic insufficiency, some secondary clinical pancreatogenic syndromes under out- and in patient conditions are analysed. Errors in the determination of a type of chronic pancreatitis and the major causes of its development are noted. The practical value of various diagnostic errors in patients with chronic pancreatitis have been specified. PMID- 3961698 TI - [Effectiveness of local treatment in recurrent duodenal peptic ulcer]. AB - The paper is concerned with a comparative assessment of the efficacy of employment of various methods of drug administration with the help of an injection needle through a gastric fibroscope in the multimodality therapy of duodenal ulcer patients. The assessment of the administration of gastrosol to 33 patients, solcoseryl to 27 and the granulocyte concentrate to 42 showed that most effective was administration of the granulocyte concentrate in the presence of antacids and cholinolytics. The employment of this method in multimodality therapy of duodenal ulcer made it possible to reduce the time of cicatrization and obtaining a good clinical remission. PMID- 3961699 TI - [Late changes in the lungs after a history of acute pneumonia]. PMID- 3961700 TI - [Analysis of the effectiveness of the dispensary care of patients with internal diseases in a city polyclinic]. AB - Ample untapped reserves of the improvement of dispensarization of the population lie in the strengthening of cooperation between High Medical Schools and medical institutions. Organization of chairs and independent courses of outpatient therapy, daily regular activities of professors, teachers and senior students in outpatient clinics introduce new opportunities for setting up outpatient rehabilitation centers in cities where there are High Medical Schools. The development of new organizational forms, adequate medical recording and the improvement of criteria for the evaluation of dispensarization will contribute to raising the quality of health care of the population in a city outpatient clinic. PMID- 3961701 TI - Placental laceration and stillbirth following motor vehicle accident with legal ramifications. PMID- 3961702 TI - Endurance of cyclists given carbohydrate solutions during moderate-intensity rides. PMID- 3961703 TI - Physician's referral to cleft palate teams in Texas. PMID- 3961704 TI - Guidelines for feeding the child under two years of age. Medical and Scientific Committee of the American Heart Association, Texas Affiliate, Inc. PMID- 3961705 TI - TDH rules on hospital transfers take effect April 1. PMID- 3961706 TI - Emergency services to survivors of sexual assault. PMID- 3961707 TI - The doping of athletes. PMID- 3961708 TI - Multilocus model of sympatric speciation. III. Computer simulations. AB - In the previous papers some analytical results were obtained for the limit stages of sympatric speciation. The present paper aims at finding the scope of validity for these results. The Monte Carlo computer model of this process was created and studied. We deal with two aspects of the speciation process: the development of reproductive isolation between the forming species and the extinction of the intermediate individuals. It has been shown that the advantage of the allele of reproductive isolation increases with the growth of its frequency. The extinction of the intermediates goes differently with various numbers of loci involved in speciation. If reproductive isolation is due to differences in two or four loci, then the completion of extinction of the intermediates requires the strongest disruptive selection, so that the necessary conditions for speciation found previously are also proved to be sufficient. But with eight and probably with a larger number of loci, the selection required to promote speciation in a population that is far from it is considerably stronger than selection needed at the last stage of speciation. Consequently, under some intensities of disruptive selection the final state of a population depends initial state. The conditions under which the stationary state of a population is characterized by bimodal distribution of phenotypes are also found. PMID- 3961709 TI - Character displacement and niche shift analyzed using consumer-resource models of competition. AB - This paper analyzes the adaptive responses to competition (both character displacement and niche shift) in a two consumer-two resource model. The model includes density dependence that is unrelated to the resources that are explicit in the model. This could be due to another resource dimension, parasites, or interference competition. Competitors adapt by changing their relative consumption rate constants on the two resource types. This model can result in mutually divergent, parallel, or mutually convergent displacement of competitors. Parallel displacement may entail net divergence, net convergence, or no net change. Parallel change with net convergence is most likely when the competitors have similar constraints on the possible values of consumption rate constants, unequal allopatric abundances, and significant intraspecific density dependence. Numerical calculations of displacements are presented for several models and the effect of a number of different possible alterations of the model are discussed. The evolution of resource handling and processing efficiency, and displacement in the presence of additional selective pressures on the character are considered in detail. The results have implications for questions about maximization of population size, the relationship of character displacement and the competition coefficient, and "null" models in the study of competition. Differences between this and previous theoretical works are discussed. It is argued that conditions allowing parallel or convergent displacement are not biologically unlikely, and possible examples are discussed. Data on resource partitioning seem to be more consistent with the results reached here than with previous theory. PMID- 3961710 TI - Optimal allocation of energy to growth and reproduction. AB - The optimal allocation of energy to growth and reproduction is considered for three different cases, i.e., a single reproduction (semelparity), reproduction through repeated discrete clutches, and continuous reproduction. The problem reduces to optimizing age and size at maturity. The best strategy is to continue growth until the change of production rate with respect to increasing body size, multiplied by life expectancy for those attaining adulthood and reproducing successfully, is greater than one. The time at which semelparous species reproduce may also be optimized; for the other modes of reproduction only physiological factors or seasonality can limit the maximum age. A brief growing season or high mortality rate are factors leading to early maturity and small adult body size. PMID- 3961711 TI - The effects of refuges on predator-prey interactions: a reconsideration. AB - Prey refuges are widely believed to prevent prey extinction and damp predator prey oscillations. A review of the empirical evidence suggests that refuges are indeed capable of playing the former role. But the conditions under which they do so are not understood, nor is there any solid evidence for an effect on population fluctuations. The intuitive view that refuges act to stabilize equilibria and damp predator-prey oscillations is based in several theoretical studies of extremely simple models. Using a more realistic model, I show that several kinds of refuges can exert a locally destabilizing effect and create stable, large-amplitude oscillations which would damp out if no refuge was present. This finding contrasts sharply with the usual view. I argue that current evidence is tol weak, and the range of theoretically possible effects is too broad, to justify any simple characterization of refuge effects in nature. Manipulative empirical studies are an important first step toward correcting this situation, and I discuss some important factors to consider in their design. PMID- 3961712 TI - Frequency-dependent selection in logistic growth models. AB - This paper describes the dynamics of a continuously reproducing diploid population with two alleles at one locus. The dependent variables are allele frequency and population density. We modify the basic density-dependent logistic growth model by inserting three possible types of frequency dependence in the fitness functions. These models are analyzed and contrasted with the purely density-dependent situation. Examples are given of periodic fluctuations in allele frequency and population density, which would be impossible for purely density-dependent fitness functions. PMID- 3961713 TI - [A new treatment of outpatient psoriasis: short-term dithranol therapy]. PMID- 3961714 TI - [Primary headache (vasomotor headache, migraine, cluster headache) and its relation to EEG and epilepsy]. PMID- 3961715 TI - [Cephalic neuralgias]. PMID- 3961716 TI - [Pain in the back of the neck and head]. PMID- 3961717 TI - [The gynecologist and the headache]. PMID- 3961719 TI - [Headache in neurological and neurosurgical diseases]. PMID- 3961718 TI - [Headache in the practice of internal medicine]. PMID- 3961720 TI - [Ophthalmogenic headache]. PMID- 3961721 TI - [Headache in the otorhinolaryngological practice]. PMID- 3961722 TI - [Treatment of analgesic-induced headache]. PMID- 3961723 TI - [The psychiatrist and the headache]. PMID- 3961724 TI - Contaminating fibrin in CPD-blood: solubility in plasma and distribution in blood components following separation. AB - In order to estimate the solubility of contaminating fibrin in CPD-blood, thrombin induced fibrin polymerzation in CPD-plasma was examined by light scattering and fibrinopeptide A (FPA) determinations. In addition, I125 fibrin monomer enriched CPD-blood was used to investigate fibrin monomer retention in blood bags and transfusion filters (170 microns) and fibrin distribution in blood components derived from CPD-blood. Initial fibrin polymerization in CPD-blood occurred after conversion of 15 per cent of the fibrinogen to fibrin, implying that substantial amounts of fibrin may be kept solubilized in CPD-blood bags. Only minor amounts of I125 fibrin monomers were retained in blood bags (2.4 per cent) and in transfusion filters (2.9 per cent) after sham transfusions. After separating I125-fibrin monomer enriched CPD-blood into its constituent components, the major part of fibrin (75.0 per cent) could be traced in the cryoprecipitate. PMID- 3961725 TI - Increase in monocyte procoagulant activity with age. PMID- 3961727 TI - Half life and incorporation into venous thrombi of the normally occurring plasma fibrinogen fractions HMW and LMW. AB - The main plasma fibrinogen species, high molecular weight fibrinogen (HMW, mw. 340,000) and LMW (mw. 305,000), displaying different in vitro properties, were examined as to half-life and incorporation into venous thrombi (DVT). Total plasma fibrinogen and relative amounts of HMW were measured pre- and postoperatively in eighteen patients undergoing total hip arthroplasty, and related to the occurrence of deep vein thrombosis, as determined by the fibrinogen uptake test (FUT). Total fibrinogen and HMW did not disclose significant differences between scan-negative and scan-positive groups. HMW and LMW, prepared from purified fibrinogen, were labelled with I125 and I131, injected simultaneously and the incorporation into thrombi registered by leg scanning. In 5 patients demonstrating a positive FUT, HMW as well as LMW were incorporated approximately to the same extent. This result implies that neither of these fibrinogen fractions offer any advantage as compared to ordinary fibrinogen when used for FUT. The half-lives of HMW and LMW were calculated from the elimination curves of the plasma clot-radioactivity. In all the surgical patients (n = 10) as well as in the two medical DVT-patients and in two healthy volunteers the half-life of LMW was approximately 10% longer than that of HMW. PMID- 3961726 TI - In vitro neutralization of heparin in plasma prior to the activated partial thromboplastin time test: an assessment of four heparin antagonists and two anion exchange resins. AB - This study was carried out to investigate the effects on the activated partial thromboplastin time test (APTT) when heparin in plasma was neutralized with protamine, Polybrene(R), poly-DL-lysine, or heparin neutralizing activity (HNA) extracted from platelets; or removed by means of the anion exchange resins TEAE cellulose or ECTEOLA cellulose. The effect on the APTT of adding the polycations protamine, Polybrene or poly-DL-lysine to citrated plasma was examined. The formation of heparin/polycation complexes was studied by means of their light scattering properties. The low yields of platelet HNA obtained excluded this from practical use as an in vitro heparin antagonist. ECTEOLA cellulose was unable to remove plasma heparin at levels as low as 1 U/ml by the technique employed. TEAE cellulose was able to efficiently remove at least 40 U of heparin from 1 ml of plasma but also caused a non-specific prolongation of the APTT. The polycations protamine, Polybrene, and poly-DL-lysine, possessed clot promoting activity at low concentrations and acted as anticoagulants in their own right at higher concentrations. At a plasma heparin concentration of 4 U/ml, protamine was the most efficient neutralizer of heparin, while at 10 U/ml, Polybrene was the most effective in this respect. It was concluded that care must be taken in the interpretation of the APTT after heparin neutralization or removal as heparin antagonist induced non-specific effects may be present. PMID- 3961728 TI - Protein/platelet interaction with an artificial surface: effect of vitamins and platelet inhibitors. AB - Protein adsorption and platelet adhesion are two important biological processes arising at the blood-prosthetic interface. The effect of Vitamins and antiplatelet drugs to modulate the surface induced platelet adhesion to polycarbonate was investigated using washed calf platelets in presence and absence of fibrinogen. This study also demonstrated the effects of Vitamins and antiplatelet drugs towards protein adsorption to an artificial surface. It seems Vitamin B6, Vitamin E, combinations of Aspirin-Persantine, Aspirin-Vitamin C, a synthetic Polyelectrolyte and Galactosamine reduced the fibrinogen (fg) surface concentration from a mixture of proteins. These antiplatelet agents also enhanced the albumin surface concentration. This itself may be one of the parameters to reduce the platelet adhesion towards an artificial surface. A combination of Aspirin-Vitamin C-Vitamin B6-Vitamin E inhibited the fibrinogen surface binding, which might be beneficial to improve the blood compatibility of an artificial surface. PMID- 3961729 TI - A simple one-step HPLC procedure for the purification of the NH2-terminal plasmin derived B beta 1-42 peptide of human fibrinogen. AB - Simplified procedures were developed to produce and isolate the plasmin-derived B beta 1-42 fragment from human fibrinogen. Peptides generated from fibrinogen by plasmin were separated by reverse phase HPLC chromatography. Two distinct peaks were identified as having amino acid compositions identical to B beta 1-42. The average final yield of HPLC-purified B beta 1-42 was 1.2 mg per 100 mg of fibrinogen. Recovery of the peptide (40-45% when compared to the theoretical yield) was significantly higher than yields obtained by open column techniques demonstrating the advantages of this simple one-step HPLC procedure. PMID- 3961731 TI - The development of rabbit coagulation protein activity during acute phase inflammatory reaction and in experimental nephropathy. PMID- 3961730 TI - Effect of calcium and calcium antagonists on [3H]-Paf-acether binding to washed human platelets. AB - [3H]-Platelet activating factor (Paf-acether, 1-O-octadecyl-2-acetyl-sn-glycero-3 phosphocholine) binds to washed human platelets in a specific, dose-dependent, and saturable manner. Scatchard analysis reveals a high affinity site with a KD value of 0.25 +/- 0.033 nM (245 +/- 30 sites per platelet), and a second low affinity site with a KD value of 9.22 +/- 1.17 nM (1616 +/- 165 sites per platelet). Binding to the high affinity site is independent of buffer calcium concentration, inhibited on an equimolar basis by unlabelled 1-O-octadecyl-Paf acether, but remains unchanged in the presence of 1-O-octadecyl-lyso-Paf-acether. The relative inhibitory effect of four calcium antagonists on [3H]-Paf-acether high affinity binding correlates closely with their respective anti-aggregatory activity against Paf-acether induced responses in human PRP; order of potency being (+)-cis diltiazem greater than (+/-)-verapamil greater than (-)-cis diltiazem greater than nifedipine. In the case of (+)-cis diltiazem, the effect is competitive, stereo-specific and progressively reversed by addition of calcium (1.0 mM and 5.0 mM). A close spatial relationship may thus exist between the Paf acether receptor and membrane calcium channels in the human platelet. PMID- 3961732 TI - Problems associated with radiolabeled proteins in binding and kinetic studies. PMID- 3961733 TI - Aggregation of human neutrophils by heparin. AB - Commercial heparin preparations induce the aggregation of human polymorphonuclear neutrophils (PMNs). The minimum aggregating concentration (MAC) of different heparin lots was measured under standardized conditions. It was found to vary between 0.3 and 15 units/ml. Gel filtration of heparin showed that the aggregating activity eluted in a sharp peak with a pattern different from heparin. When heparin was bound to antithrombin III-Sepharose, the aggregating activity eluted totally in the high-affinity fraction. When PMNs are partially aggregated with heparin, further aggregation by N-formyl-methionyl-leucyl phenylalanine (FMLP) or phorbol myristate-acetate (PMA) is not affected. Pretreatment of PMNs with a low-aggregating heparin fraction, inhibits further aggregation by a high-aggregating heparin fraction. These results suggest that the PMNs have binding sites for heparin different from those for PMA and FMLP. Binding of heparin is not enough for inducing aggregation. Certain structural requirements of the heparin molecule are probably essential for aggregation. PMID- 3961734 TI - Evidence that the rat is not an appropriate model to study the role of prostaglandins in normal or abnormal platelet aggregation. AB - Abnormal platelet aggregation seen in experimentally induced diabetic, hypercholesterolemic and spontaneously hypertensive rats (SHR) has been linked with increased prostaglandin synthesis. The present study was conducted to examine the role of prostaglandins in rat platelet activation using normal Wistar Kyoto (WKY) and SHR rats. Up to 30 microM ADP did not induce secondary phase of platelet aggregation in rat PRP and up to 30 microM epinephrine did not produce any response in rat PRP. In other experiments ADP (1.0 microM) and epinephrine (2.0 microM) induced typical biphasic aggregation responses in human PRP. Up to 20 microM U46619, a stable analog of prostaglandin H2, did not induce platelet aggregation in rat PRP or washed rat platelets. In contrast 2.0 microM U46619 caused maximal aggregation in human PRP and washed human platelets. Arachidonic acid (1.5-2.0 mM) induced aggregation in washed rat platelets. However, this was associated with excessive (67% and 94%) loss of cytoplasmic LDH. The low concentrations of thrombin (0.04 and 0.05 U/ml), induced two to three-fold increase in aggregation response in SHR platelets as compared to WKY platelets. Higher concentrations of thrombin (0.1 and 0.3 U/ml) induced similar aggregation responses in SHR and WKY platelets. Thrombin (0.04-0.3 U/ml) induced serotonin secretion in a concentration dependent manner. The extent of secretion was the same in SHR and WKY platelets at all concentrations. Thrombin-induced synthesis of thromboxane A2 (TXA2) in WKY and SHR platelets was quantified using a radioimmunoassay for TXB2. Thrombin (0.04-0.3 U/ml) produced TXB2 in WKY and SHR platelets in a concentration dependent manner. The SHR platelets produced significantly larger amounts of TXB2 as compared to WKY platelets. In other experiments aspirin (500 microM) inhibited thrombin (0.05 U/ml) induced TXB2 synthesis by 75% in both WKY and SHR platelets but failed to inhibit aggregation or secretion in either WKY or SHR platelets. Based on these data it is suggested that: (a) rat platelets inspite of their ability to synthesize TXA2 do not require TXA2 for aggregation; and (b) the rat may not be an appropriate model to study the role of prostaglandins in normal or abnormal platelet aggregation. PMID- 3961735 TI - Management of anti-thrombin III deficiency during pregnancy without administration of anti-thrombin III. AB - We report a patient with hereditary antithrombin III deficiency who was successfully treated with heparin throughout pregnancy. Functional antithrombin III levels fell to 0.32 U/ml during heparin treatment, but it was possible to achieve a heparin effect, measured by the activated partial thromboplastin time, thrombin clotting time and heparin assay with subcutaneous heparin in doses of 30,000 U to 35,000 U/24 hours. This achieve an long term heparin effect was obtained without the need for antithrombin III infusions. PMID- 3961736 TI - Interaction of factor XI and sulfatide. PMID- 3961738 TI - Particle volume changes associated with light transmittance changes in the platelet aggregometer: dependence upon aggregating agent and effectiveness of stimulus. AB - The increase in light transmittance of aspirin-treated platelet-rich plasma caused by addition of non-saturating doses of ADP and, at earlier times, of adrenaline is correlated with formation of aggregates having a volume in the range 490-8580 fl. and containing 100-2000 platelets. The disappearance of single platelets and the formation of aggregates having volumes less than 490 fl. makes no significant contribution to the increase in light transmittance. Similar relationships are observed on addition of saturating doses of ADP and adrenaline except that the formation of aggregates larger than 8580 fl. contributes significantly to the initial phase of the increase in light transmittance and is more closely correlated with the overall change in this parameter. PMID- 3961737 TI - Determination of "in vitro" degradation of protamine in plasma by three different methods. AB - Three techniques for the quantitative or semi-quantitative determination of the degradation of protamine in plasma are described. One is based on the measurement of liberated arginine, since arginine is the single most important constituent of protamine (80% in weight). The second utilizes successive estimations of protamine by addition to a secondary heparinized medium in which excess heparin is measured by thrombin time and polybrene titration. The third method employs electrophoresis on cellulose acetate, and offers direct visualization of the soluble complexes formed between protamine and albumin, and of their degradation. When applied to an incubation mixture containing diluted plasma (1 : 8) and protamine 0.8 mg/ml, the first two methods were well correlated and showed that protamine degradation proceeded linearly with time. The third method had good semiquantitative agreement with the two former. The rate of protamine degradation was different when estimated by each of the three methods, due probably to the different physico-chemical reactions involved. PMID- 3961739 TI - Studies on the effect of PEG-modified urokinase on coagulation-fibrinolysis using beagles. AB - Urokinase (UK), a human urinary plasminogen activator, was modified by the covalent attachment of methoxypolyethylene glycol (PEG) of 5,000 daltons. There were observed changes in substrate specificity and an increase in molecular weight in PEG-modified UK (PEG-UK). We evaluated PEG-UK by ex vivo study using beagles, and found that UK activity in the blood was well maintained over hours after intravenous injection, and that fibrinolysis was more activated compared with native UK by coagulation-fibrinolysis studies. PMID- 3961740 TI - A new model of arterial thrombosis. AB - A new model of arterial thrombosis in rats was based on a combination of a localizing hemodynamic factor /partial mechanical constriction of aorta/, generalized mild endothelial lesion /i.v.hypotonic saline/ and a humoral factor/i.v. serotonin/. The resulting aortic occlusion was indicated by measuring rectal temperature. Nicotine and oral methionine were similarly active as hypotonic saline. Histamine had to some extent similar activity as serotonin. The possible contribution of serotonin vasoactivity to the vascular obstruction was contradicted. PMID- 3961741 TI - The effect of antithrombotics in a new model of arterial thrombosis. AB - A series of drugs representing several groups of antithrombotics was tested in a new model of arterial thrombosis in rats. Thrombosis was produced in the aorta by the combination of local partial obstruction and systemic administration of hypotonic saline with serotonin. High efficacy was demonstrated with heparin, acetylsalicylic acid, troxerutin, prenylamine, antiserotonin agents /pizotifen, ketanserin/ and particularly with the combinations of antiserotonins and the above mentioned antithrombotic drugs. The model showed high sensitivity to all tested drugs in the clinical dose range. PMID- 3961742 TI - Unsaturated platelet-activating factor: influence on aggregation, serotonin release and thromboxane synthesis of human thrombocytes. AB - Unsaturated platelet-activating factor (paf-acether) aggregated thrombocytes of healthy male volunteers like saturated paf-acether. Unsaturated paf-acether released serotonin in the presence of imipramine. Within one minute the release increased depending on the concentrations of unsaturated paf-acether up to 45% of the serotonin. Human thrombocytes synthesized only a small amount of thromboxane B2 (TXB2) after aggregation induced by unsaturated paf-acether. Unsaturated paf acether prevented the binding of radiolabelled saturated paf-acether to intact washed thrombocytes in the same extent as saturated paf-acether. PMID- 3961743 TI - A plasminogen activator from benign ovarian cystadenoma: partial purification and characterization. AB - A plasminogen activator has been partially purified from benign serous cystadenomas by a combination of Sephadex G-200 gel filtration, CM-Sephadex ion exchange, Concanavalin A-Sepharose and arginine-Sepharose affinity chromatographies. Its apparent size was very large and could not penetrate Sepharose 6B or 5% SDS polyacrylamide gel. It hydrolyzed plasminogen in a manner similar to that of urokinase in terms of their apparent Michaelis constants, although a one-minute lag period had to be allowed for this activation before the hydrolysis of plasminogen. It was very sensitive to reducing agent such that 5 mM dithiothreitol could completely destroy its activity. The activator crossreacted with anti-uterine plasminogen activator IgG, but did not react with anti urokinase at all. It also bound fibrin well. In the absence of plasminogen, the activator was devoid of amidolytic activity towards S-2251, S-2302 and S-2288 but had a small but measurable activity against S-2444. PMID- 3961744 TI - [Medical records in acute abdomen. Effective registration of clinical findings]. PMID- 3961745 TI - [Lymph nodes with reactive changes. What does this condition mean and what prognostic information can it give in patients with malignant epithelial disease?]. PMID- 3961746 TI - [Cervical bruit and carotid artery stenosis]. PMID- 3961747 TI - [Campylobacter jejuni. Infections in northern Norway in 1980-84]. PMID- 3961748 TI - [Primary intraspinal tumors in children]. PMID- 3961749 TI - [Surgical microscope in general practice]. PMID- 3961750 TI - [A study of child mortality in the Riserboo area, eastern Bhutan]. PMID- 3961751 TI - [Taurine--an interesting amino acid]. PMID- 3961752 TI - [Cervical bruit. Neurovascular examination and practical consequences]. PMID- 3961753 TI - [Large prolactinomas treated with bromocriptine]. PMID- 3961754 TI - [Psychological reactions connected to AIDS]. PMID- 3961755 TI - [Contraceptive agents and antithrombin III. New causes of thrombosis]. PMID- 3961756 TI - [Cancer of the esophagus and cardia. Surgical treatment]. PMID- 3961757 TI - [Pneumonia patients in need of intensive care]. PMID- 3961758 TI - [Treatment of dens fractures]. PMID- 3961759 TI - [Volar luxation of the lunate]. PMID- 3961760 TI - [Fatal verapamil poisoning]. PMID- 3961761 TI - [Amiodarone--a dangerous wonder drug. Review of the literature and personal experiences]. PMID- 3961762 TI - [Convulsions in children. Diagnosis of metabolic causes]. PMID- 3961763 TI - [Theophylline poisoning]. PMID- 3961764 TI - [The third generation of cephalosporins or aminoglycosides?]. PMID- 3961765 TI - [Patient information at a hospital surgery department]. PMID- 3961766 TI - [Scopoderm depot plasters--confusions and hallucinations]. PMID- 3961767 TI - [Acute self poisoning. Use and benefits of the determination of serum concentrations of drugs and poisons as an immediate help]. PMID- 3961768 TI - [Acute self poisoning. The Stavanger region in 1980 and 1981. Sociomedical and psychiatric aspects]. PMID- 3961769 TI - [Wide visual damage in glaucoma. Why does it arise and how can it be prevented?]. PMID- 3961770 TI - [Colonic perforation. Treatment and mortality]. PMID- 3961771 TI - [Creatine kinase isoenzyme MB in myocardial infarction]. PMID- 3961772 TI - [Reduction of arterial PO2 after discontinuing oxygen therapy]. PMID- 3961773 TI - [Corn starch glove powder. A life-threatening peritoneal reaction]. PMID- 3961774 TI - [Peroral small intestinal biopsy in children]. PMID- 3961775 TI - [The medical students' extracurricular work. The extent and educational value]. PMID- 3961776 TI - [Homeopathy. The medicine of today]. PMID- 3961777 TI - [Cancer in situ of the uterine cervix. Increased perinatal death and prematurity after conization]. PMID- 3961778 TI - [Poliomyelitis--an acute disease only?]. PMID- 3961779 TI - [Magnesium deficiency. A clinical review]. PMID- 3961780 TI - [Magnesium deficiency. An underdiagnosed condition?]. PMID- 3961781 TI - [Magnesium and cardiovascular diseases]. PMID- 3961782 TI - [Billroth II resection in acute gastroduodenal hemorrhage]. PMID- 3961783 TI - [Closed-circuit anesthesia]. PMID- 3961784 TI - [Treatment of advanced squamous cell carcinoma of the maxillary sinus]. PMID- 3961785 TI - [Implanted subcutaneous injection port. When is continuous venous access needed]. PMID- 3961787 TI - [Folk medicine]. PMID- 3961788 TI - [Paracetamol and cancer risk]. PMID- 3961786 TI - [Dangerous alcohol consumption. How should it be detected?]. PMID- 3961789 TI - [Epidemiological studies in veterinary practice]. AB - Veterinarians in small animal practices are constantly confronted with problems concerning the aetiology, diagnosis and prognosis of certain diseases. Those who would like to do epidemiological studies, are inclined not to choose just a single item, but to approach matters on a large scale. The possibilities offered by computers give rise to the belief that, provided a lot of time is spent on recording, the answers to various questions will roll out of the machine almost of their own accord. And this is not true. Adequate studies start with a single relevant statement of a problem. Ample attention should then be paid to the planning of the study, including all merits and demerits. Studies solely concerned with the occurrence of a disease are usually dull and not very informative, Investigations will not become interesting as a rule until efforts are made to relate forms of disease to particular risk factors, signs and symptoms or prognostic factors. Instances are given in the present paper. The relevance of studies associated with small animal practices is considerably increased when investigations are also carried out in these practices. Finally, the fact is stressed that a beginning veterinarian-investigator will be better off on purchasing a good textbook of epidemiology than a personal computer. PMID- 3961790 TI - [Cutaneous asthenia, a congenital skin disease in a Burmese cat]. AB - The symptoms and the course run by cutaneous asthenia, a skin disease which is congenital and probably hereditable, are reported in a Birmese tomcat. PMID- 3961791 TI - [People are always saying...]. AB - In his address, delivered on the occasion of his farewell as extraordinary professor of food microbiology and hygiene at the University of Agriculture in Wageningen, the author discussed a number of features of current problems in the field of disease caused by foods. It was pointed out that the risks constituted by chemicals and additives in foods are usually strongly exaggerated by consumers, whereas there is far too little understanding of and information concerning infectious diseases which are transmissible to man by foods. As regards this last-mentioned fact, attention is drawn to the increase, and that which can be anticipated, of cases of food infection and poisoning in Europe. It was stressed that the consumer is an important factor in regard to these forms of disease in view of the fact that a large proportion of these infections may be prevented by a number of relatively simple measures such as cooling or heating of food and adequate hygiene in the kitchen. PMID- 3961792 TI - Lysosomes in the cessation of vitellogenin secretion by the mosquito fat body; selective degradation of Golgi complexes and secretory granules. AB - A massive and selective degradation of Golgi complexes, secretory granules, and RER is the mechanism responsible for the rapid termination of Vg secretion by trophocytes of the mosquito fat body. These cells are involved in an intensive synthesis of a glycoprotein, vitellogenin (Vg), which is accumulated by developing oocytes as yolk protein. Previously, assays for lysosomal enzymes have demonstrated that the cessation of Vg synthesis is characterized by a sharp increase in lysosomal activity; and fluorescent microscopy has shown that, during this intense lysosomal activity, Vg concentrates in lysosomes. In this report, electron microscopy combined with cytochemistry for lysosomal enzymes and localization of Vg with colloidal gold immunocytochemistry has shown that this lysosomal activity is directed towards selective degradation of Vg and organelles associated with its synthesis and secretion. Three organelles undergo lysosomal breakdown: the Golgi complex, Vg-containing secretory granules, and RER. The degradation of Golgi complexes occurs in two steps similar to that for RER: first, the organelle is sequestered by double isolation membranes, and the resulting pre-lysosome then fuses with a primary or secondary lysosome. In contrast, mature Vg-containing secretory granules fuse with lysosomes directly. This combination of crino- and autophagy is a specific, highly intense, and precisely timed event. PMID- 3961793 TI - Avian epidermal differentiation: role of lipids in permeability barrier formation. AB - Though avian skin is known to possess a highly lipogenic epidermis, little is known about its permeability barrier function. We correlated epidermal barrier function, fine structure and lipid biochemistry in the pigeon, Columbia livia, and compared these features with terrestrial mammalian systems. Whereas barrier function, as assessed by transepidermal water loss was not as efficient as in mammals, both groups shared certain morphological features including substantial compartmentalization of lipids in stratum corneum intercellular domains. Avian intercellular lipids derive from extrusion of intracellular non-membrane-bound droplets from lowermost corneocytes, rather than by secretion of lamellar discs from multigranular bodies, as previously reported in some avians, and in mammals. Instead, both the internal lamellae and the limiting membranes of multigranular bodies appear to degenerate, leading to the formation of non-membrane-bound droplets. The lipid content of avian epidermis and stratum corneum demonstrates important similarities to terrestrial mammals, i.e. abundant sphingolipids, a paucity of phospholipids, and abundant neutral lipids, but also certain striking differences, i.e. persistence of glycosphingolipids and triglycerides into the stratum corneum. Thus, avian stratum corneum forms a two-compartment system of lipid-depleted cells embedded in non-polar-lipid enriched intercellular domains, analogous to mammals. But, in contrast to mammals, the highly attenuated corneocytes of avians, which results from a paucity of keratin filaments, produce a 'straws-and-mortar' tissue, rather than the 'bricks-and-mortar' tissue of mammals. PMID- 3961794 TI - Quantitative evaluation of diabetic autonomic neuropathy by using heart rate variations: relationship between cardiac parasympathetic or sympathetic damage and clinical conditions. AB - It was previously suggested that respiratory heart rate (HR) variations were predominantly affected by the parasympathetic nerve and HR increase to standing was predominantly affected by the sympathetic nerve. To compare parasympathetic and sympathetic nerve function in diabetics, these two tests were performed in 95 diabetics and 38 controls by use of an instantaneous-HR-change continuous recorder. All subjects were between 40 and 59 years-old. As indices of autonomic nerve function, the mean difference between maximal and minimal HR during deep breathing (delta I-E) and the HR increase on standing (delta HR) were determined. The mean delta I-E and delta HR in the diabetics were 9.4 beats/min and 15.1 beats/min, respectively. These values were significantly lower than those in the controls (delta I-E 14.4, delta HR 20.5 beats/min). delta I-E correlated negatively to duration of diabetes and mean fasting blood glucose during the last 6 months in the diabetics, but delta HR did not correlate to them at all. Diminished delta I-E was found in the patients with insulin treatment, retinopathy or persistent proteinuria. Diminished delta HR, however, was found only in the patients with long-standing complicated diabetes. Thus, both cardiac parasympathetic and sympathetic nerve function were significantly impaired in the diabetics as compared with the controls and that parasympathetic nerve damage occurred early whereas sympathetic innervation was preserved. PMID- 3961795 TI - Familial idiopathic hypoparathyroidism and progressive sensorineural deafness. AB - Three cases from two families with idiopathic hypoparathyroidism and progressive sensorineural deafness are described. Cases 1 and 2 were siblings. Case 3 was one of four siblings from another family. All of them had both idiopathic hypoparathyroidism and progressive sensorineural hearing loss. There was no evidence to suggest involvement of autoimmune mechanism in these cases except for the associated Graves' hyperthyroidism in case 3. Human leukocyte antigen A9 and A11 were positive in both families. The sensorineural hearing loss was progressive even after the treatment for hypoparathyroidism. As the familial idiopathic hypoparathyroidism is a very rare entity, it is unlikely that this disease is associated with familial progressive sensorineural deafness by chance. The combination of these two diseases may compose a new syndrome. PMID- 3961796 TI - The dopaminergic regulation of plasma growth hormone secretion in normal subjects. AB - The role of endogenous dopamine (DA) on plasma GH secretion was studied using domperidone (DA receptor blocker which does not cross blood brain barrier) in 16 normal subjects. After a bolus injection of domperidone (10 mg, i.v.), plasma PRL in 11 cases rose quickly and markedly from the basal level of 9.5 +/- 1.2 ng/ml (Mean +/- S.E.) to a maximum of 76.3 +/- 10.6 ng/ml at 30 min. In contrast, plasma GH in these cases showed a delayed and slight increases to domperidone injection where the values at 90 min and 120 min (3.5 +/- 0.8 ng/ml and 3.7 +/- 1.0 ng/ml) were significantly higher than those in control study (1.2 +/- 0.2 ng/ml and 1.0 +/- 0.1 ng/ml; p less than 0.05; n = 8). Domperidone infusion (0.22 mg/min/3 hr) was performed in the remaining 5 subjects. The plasma PRL responses were similar to those in the bolus injection of domperidone. These PRL responses were not modified when L-dopa was administered 30 min after the start of iv infusion of domperidone. Plasma GH showed slight but significant increases 135 min after the infusion compared to control study (4.3 +/- 1.2 ng/ml vs. 1.0 +/- 0.1 ng/ml; p less than 0.05). By the prior infusion of domperidone plasma GH responses to L-dopa was delayed and blunted, i.e., the occurrence of elevation and peak value of GH delayed by 15 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961797 TI - Effect of proprioceptive neuromuscular facilitation on EEG activation induced by facilitating position in patients with spinocerebellar degeneration. AB - The shift of mean power in alpha band of EEG due to postural changes was examined in five patients with spinocerebellar degeneration, using EEG topography, before and after proprioceptive neuromuscular facilitation (PNF) maneuver. Normal EEG response to postural changes, i.e., an increase in the mean power at facilitating position compared to neutral position, was observed in only one patient before PNF maneuver, but in four after PNF maneuver. The improvement of motor function by PNF-treatment was clinically noticed in the patients with normal EEG response to postural changes after PNF maneuver. PMID- 3961798 TI - Estimation of a drug effect by a simplified radioaerosol inhalation lung cine scintigraphy: bromhexine on mucociliary clearance mechanisms. AB - A proposed simplification of radioaerosol inhalation lung cine-scintigraphy, namely 60 min measurement of radioactivity without repeating measurement at 24 hr later and calculation of alveolar deposition ratio (ALDR) by the regression formula of ALDR = -48.08 + 0.47 X FEV1.0% + 0.59 X LRR60, was found useful and applicable even to the evaluation of a drug on mucociliary clearance mechanisms. The simplified method indicated a very similar evaluation of the effect of bromhexine on airway clearance efficiency with those actually revealed by the original method. PMID- 3961799 TI - Mucociliary clearance mechanism in interstitial lung disease. AB - To evaluate mucociliary clearance mechanisms of the lungs, 14 patients with pulmonary interstitial fibrosis and 8 with sarcoidosis were studied by lung function tests and radioaerosol inhalation lung cine-scintigraphy. Although all these patients showed interstitial densities on chest x-rays, only the patients with pulmonary interstitial fibrosis indicated restrictive and diffusion abnormalities by lung function tests and those with sarcoidosis did not show either of these functional abnormalities. Mucociliary clearance mechanisms were well maintained qualitatively and quantitatively in these patients with interstitial lung disease. PMID- 3961800 TI - Morphological study of the sensory innervation of the rat labial mucosa. AB - The sensory innervation of the rat labial mucosa was investigated by means of methylene blue vital staining and osmic acid staining. Sensory receptors in this region were of three kinds (free nerve endings, encapsulated corpuscles and bush like nerve endings) which constituted separate sensory units respectively. The encapsulated corpuscles were observed in the deep part of lamina propria, and distributed mainly in the margin of labial mucosa. Almost all (78.8%) of encapsulated corpuscles were of a simple type which had a non-branched axon terminal. No clew-like type corpuscles or glomerular-Meissner corpuscles were observed. The bush-like nerve endings were located in the lamina propria close to the epithelium, and localized in the central part of labial mucosa where the formation of papillae was remarkable. The density of the encapsulated corpuscles in the entire mucosa was 3.5-5.3/mm2, and that of the bush-like nerve endings in the densely distributed area was 38.9-60.6/mm2. PMID- 3961801 TI - Production of group I pepsinogen by gastric carcinoma. AB - Group I pepsinogen levels were determined in the homogenized supernatant of the lymph nodes with metastasis of the gastric carcinoma by radioimmunoassay. Mean levels of group I pepsinogen were 941 ng/g and some of the lymph nodes showed very high levels compared with those of non-metastatic lymph nodes, 269 ng/g. They were also significantly higher than those of the sera in the same subjects, that is, the production of group I pepsinogen by gastric carcinoma was clarified. PMID- 3961802 TI - The role of equity financing in today's health care environment. PMID- 3961803 TI - The dynamics of leveraged buy-outs, conversions, and corporate reorganizations of not-for-profit health care institutions. PMID- 3961805 TI - Health care joint ventures and private offering exemptions under state and federal securities laws. PMID- 3961804 TI - Raising health care capital through the public equity markets. PMID- 3961806 TI - Joint venture structures and legal issues. PMID- 3961807 TI - New restrictions on leasing deals where tax-exempt entities are involved. PMID- 3961808 TI - Gastrointestinal absorption of inorganic mercuric compounds in vitro. AB - Effects of intraluminal pH on the intestinal absorption and tissue binding of HgCl2 and HgO were studied in the everted sac of rat small intestine. The sac was incubated in media containing HgCl2 or HgO (10(-5 M] at different pH values. With an increase in pH, the uptake of HgCl2 in the intestinal tissue decreased and the transport of HgCl2 through the tissue increased. Similar pH dependence was observed in the uptake of HgO. The transport of HgCl2 seemed to be correlated with mercury bound to a protein (molecular weight between 440,000 and 669,000) and to be inversely correlated with that bound to intestinal metallothionein. These results suggest that the increase of intraluminal pH promotes the absorption of HgCl2 accompanied by a change in the binding of HgCl2 to the everted tissue sac. PMID- 3961809 TI - Fate of erythrocyte Cd-metallothionein in mice. AB - Degradation of metallothionein (MT), which appears in erythrocytes following cadmium (Cd) administration, was investigated in mice. Cd-MT underwent only slight decomposition by hemolysate in an in vitro experiment unlike an 800g supernatant fraction of the liver homogenate. In an in vivo study, [3H]diisopropylfluorophosphate was given to mice which had received 109CdCl2 to investigate the relationship between the decay of 109Cd-MT in the erythrocyte and the life span of the erythrocyte. A similar reduction pattern of radioactivity of 109Cd and 3H was observed. Erythrocytes containing 109Cd-MT obtained from mice preadministered with 109CdCl2 was transfused to normal mice. The 109Cd radioactivity of erythrocytes decreased in a manner similar to Cd in erythrocytes of 109CdCl2-administered mice. Contrary to this decrease of erythrocyte Cd in the transfused mice, Cd concentration of the spleen increased markedly. Cd increased also in the liver. These results indicate that erythrocyte MT degrades along with the erythrocyte. The Cd from this MT is deposited in the spleen and liver where blood cells are catabolized. PMID- 3961810 TI - Biochemical and neuropathological assessment of triphenyl phosphite in rats. AB - The putative neurotoxicity of the organophosphorus compound triphenyl phosphite (TPP) was examined in Long Evans, adult male rats. Animals were exposed to two 1.0 ml/kg (1184 mg/kg) injections (sc) of TPP spaced 1 week apart and sampled for biochemical and neuropathological examination. At the time of sampling, rats displayed dysfunctional changes including tail rigidity, circling, and hindlimb paralysis. Neuropathic damage was confined to the lateral and ventral columns of all spinal levels and consisted of myelin ellipsoids and giant axonal swellings filled with smooth endoplasmic reticulum. Wallerian-like degeneration was observed in the spinal roots, the sciatic nerve, and tibial branches. Biochemical assessment of brain acetylcholinesterase (AChE) and neurotoxic esterase (NTE) activity was determined 1, 4, 24, 48, and 72 hr after the second TPP treatment. Both enzyme activity concentrations were depressed maximally at 48 hr postexposure by 30 and 39%, respectively. Serum cholinesterase, sampled 48 hr after the second TPP exposure was depressed by 33%. Data from this study indicate that subchronic exposure to the organophosphite TPP results in severe neurotoxic consequences which differ from those previously described in rats with organophosphorus-induced delayed neuropathy. PMID- 3961811 TI - Induction of metallothionein after lead administration by three injection routes in mice. AB - The amount of induced hepatic metallothionein (MT) and the alterations of calcium (Ca) and lead (Pb) concentrations in plasma, liver, kidney, and spleen were compared in male mice after iv, ip, and sc injections of lead acetate at a dose of 30 mg Pb/kg body wt. The amount of hepatic MT at 1 day was in the order of ip greater than iv greater than sc injection approximately 0, despite the hepatic Pb concentration in the order of iv greater than ip greater than sc injection. Heat stable Pb-binding MT was not detected following any injection route. After the iv injection, a transitory hypercalcemia with hyperphosphatemia was observed. As for the tissue Pb concentration after the iv and ip injections, liver and spleen showed a high concentration, while kidney concentration was relatively low. The high tissue Pb was accompanied by an increase of tissue Ca in most cases. Only 10 to 15% of the total Pb accumulated in the liver at 1 day was recovered from the supernatant fraction after ultracentrifugation. The increase of hepatic Ca was ascribed to that in the sediment fraction. After the sc injection, the tissue Pb concentration was very low and no alterations were observed in tissue Ca concentrations. PMID- 3961812 TI - Alteration of hepatocellular structure and function by thallium chloride: ultrastructural, morphometric, and biochemical studies. AB - The effects of thallium chloride (TlCl3.4H2O) on hepatocyte structure and function were studied in male rats at 16 hr following treatment by ip injection with doses of 0, 50, 100, and 200 mg/kg. Ultrastructural examination of hepatocytes from thallium-treated rats showed a dose-related loss of ribosomes from the endoplasmic reticulum and proliferation of the rough endoplasmic reticulum segment. Generalized mitochondrial swelling and increased numbers of electron-dense autophagic lysosomes were also observed. Morphometric analysis of hepatocytes from thallium-treated rats disclosed a 3-fold increase in the volume density of the lysosomal compartment and a 1.3-fold increase in the volume density of mitochondrial. Surface density measurements of mitochondrial and endoplasmic reticulum membranes showed dose-related increases in the surface density of both inner and outer mitochondrial membranes as well as of the rough endoplasmic reticulum. These structural changes were associated with pronounced increases in the specific activities of the mitochondrial membrane-associated enzymes monoamine oxidase and ferrochelatase to 145 and 144% of control values, respectively, and a 42% decrease in the activity of aminolevulinic acid (ALA) synthetase. Similarly, structural alteration of the endoplasmic reticulum in thallium-treated rats was associated with concomitant impairment of the microsomal enzymes NADPH cytochrome c (P-450) reductase, aniline hydroxylase, and aminopyrene demethylase to a maximum of 49, 43, and 77% of activities seen in untreated controls, respectively. In contrast, the non-membrane-bound enzymes malate dehydrogenase, ALA dehydratase, and uroporphyrinogen I synthetase were unaltered in vivo following thallium treatment at any doses. These results indicate that thallium-induced alteration of hepatic biochemical processes may arise from physical disruption of the membranal integrity of subcellular organelles with which those processes are functionally associated. These findings are consistent with those from previous studies in demonstrating a positive quantitative correlation between metal-induced subcellular organelle membrane structural injury and impairment of associated biological functions in vivo. PMID- 3961813 TI - Dose-related beneficial and adverse effects of dietary corticosterone on organophosphorus-induced delayed neuropathy in chickens. AB - Tri-ortho-tolyl phosphate (TOTP), 360 mg/kg, po, and 0,0'-diisopropyl phosphorofluoridate (DFP), 1 mg/kg sc, were administered to adult White Leghorn chickens 24 hr after they were placed on diets containing 0 to 300 ppm corticosterone. Supplemented diets were continued until clinical signs and lesions of delayed neuropathy appeared. Although low concentrations (less than or equal to 50 ppm) of corticosterone had beneficial effects on TOTP-induced neuropathy, greater than or equal to 200 ppm exacerbated clinical signs in chickens given either TOTP or DFP. Neurotoxic esterase activities 24 hr after TOTP or DFP were less than 20% of values measured in chickens not given organophosphorous compounds. Chickens given 200 ppm corticosterone without TOTP or DFP had significantly elevated activity of plasma cholinesterase and significantly inhibited activity of liver carboxylesterase. Degenerating myelinated fibers were also evident in distal levels of the peripheral nerves of chickens given TOTP or DFP. PMID- 3961814 TI - Biochemical mechanisms of cephaloridine nephrotoxicity: time and concentration dependence of peroxidative injury. AB - These experiments were designed to elucidate the initiating biochemical events mediating cephaloridine (CPH) nephrotoxicity. Renal cortical slices from naive male Fischer-344 rats were incubated at 37 degrees C in a phosphate- or bicarbonate-buffered medium containing 0, 1, 5, or 10 mM CPH. Slices were incubated for 15, 30, 45, 60, 90, 120, and 180 min and evaluated for accumulation of organic ions [p-aminohippurate (PAH) and tetraethylammonium (TEA)], pyruvate stimulated gluconeogenesis, malondialdehyde (MDA) production, and reduced glutathione (GSH) content. Renal cortical slice accumulation of PAH and TEA was decreased by 5 and 10 mM CPH as early as 120 and 90 min of incubation, respectively. CPH-induced MDA production by renal cortical slices preceded the effects of CPH on organic ion accumulation. Coincubation of CPH with the antioxidants promethazine and N,N'-diphenyl-p-phenylenediamine inhibited CPH induced lipid peroxidation and changes in organic ion accumulation. In contrast, 5 or 10 mM CPH inhibited gluconeogenic capacity at all time points examined, an effect which was not influenced by antioxidant treatment. Depletion of renal cortical GSH by 5 or 10 mM CPH was evident following 30 min of incubation and was also unaffected by antioxidant treatment. These results support the hypothesis that lipid peroxidation mediates the effects of CPH on renal organic ion transport. The early and profound inhibition of gluconeogenesis by CPH suggests that the biochemical pathways of gluconeogenesis are either proximal to or represent a primary target for CPH nephrotoxicity. PMID- 3961815 TI - Effect of sodium selenite upon bromobenzene toxicity in rats. I. Hepatotoxicity. AB - The effects of sodium selenite on bromobenzene hepatotoxicity were examined in male rats. Rats pretreated with sodium selenite (12.5 or 30 mumol/kg, ip) 72 hr prior to injection of bromobenzene (7.5 mmol/kg, ip) showed a marked reduction in bromobenzene-induced liver injury as evidenced by decreased plasma alanine and aspartate transaminase values, sorbitol dehydrogenase activity, and reduced histologic damage. Administration of bromobenzene did not affect the selenium content of blood or liver. At 72 hr after treatment with selenite, hepatic reduced (GSH) and oxidized (GSSG) glutathione values or GSH synthetic and degradation enzyme activities were not altered. However, from 3 to 12 hr following bromobenzene administration, hepatic GSH and cysteine amounts declined less rapidly in selenite-treated rats compared to control. Thus, acute selenite treatment ameliorated bromobenzene hepatotoxicity in a manner suggesting facilitation of hepatic GSH production by selenite for use in bromobenzene detoxication. PMID- 3961816 TI - Effect of sodium selenite upon bromobenzene toxicity in rats. II. Metabolism. AB - The effects of sodium selenite (12.5 or 30 mumol/kg, ip) upon bromobenzene metabolism were examined in male rats treated with selenite at 72 hr prior to bromobenzene exposure (7.5 mmol/kg, ip). The inhibitory nature of selenium treatment upon xenobiotic metabolism and increased production of hepatic thiol suggested that selenite might affect metabolic activation and detoxification of bromobenzene. Selenite treatment lowered in vivo covalent binding of [14C]bromobenzene while the in vitro covalent binding of [14C]bromobenzene in microsomes isolated from selenite-treated rats was unaffected compared to control. When the rate of [14C]bromobenzene decline in whole blood was evaluated in selenite-treated rats over 48 hr after bromobenzene administration, no significant differences were observed when compared to control. Furthermore, values of glutathione conjugates and hydroxylated metabolites of bromobenzene were similar in urine samples collected over 48 hr from selenite and control rats. Mechanistically, reduction of bromobenzene hepatotoxicity by selenite is not mediated through an altered metabolism of bromobenzene, but by alteration of cellular events occurring after metabolic activation. PMID- 3961817 TI - Reversal of acetaminophen toxicity in isolated hamster hepatocytes by dithiothreitol. AB - The toxicity of acetaminophen in freshly isolated hamster hepatocytes was investigated. Cells exposed to 2.5 mM acetaminophen for 90 min, followed by washing to completely remove unbound acetaminophen, and resuspension in fresh buffer, showed a dramatic decrease in viability over the ensuing 4.5 hr by which time only 4% of the cells could still exclude trypan blue. During the initial 90 min incubation, there was a substantial depletion of glutathione, to 19% of control values, covalent binding of [14C]acetaminophen to cellular proteins, and evidence of morphological changes consistent with some disturbance of the plasma membrane. During subsequent incubation of these cells, covalent binding did not change nor did lipid peroxidation, despite the decrease in viability that occurred. Subsequent incubation of cells exposed to acetaminophen for 90 min in buffer containing 1.5 mM dithiothreitol (DTT), a disulfide-reducing agent, largely prevented the decrease in cell viability and reversed the morphological changes that occurred during the first 90-min incubation. However, there was no change in lipid peroxidation, glutathione content, or covalent binding. It is concluded that acetaminophen interacted with some critical target in the cell, and that this left unchecked, led eventually to the death of the cell. DTT prevented and reversed this effect. The toxicity of acetaminophen, and its reversal by DTT, appear independent of either covalent binding of acetaminophen or lipid peroxidation. In addition, the effect of DTT was independent of the concentration of glutathione, most probably acting by directly reducing oxidized SH-groups in critical enzymes, possibly membrane-bound ATP-dependent Ca2+ translocases. PMID- 3961818 TI - Elimination kinetics of 2-butoxyethanol in the perfused rat liver--dose dependence and effect of ethanol. AB - The elimination kinetics of 2-butoxyethanol (ethylene glycol monobutyl ether, EGBE) were studied in the once-through isolated perfused rat liver system in the presence and absence of ethanol. Dose-dependent Michaelis-Menten kinetics in the elimination of EGBE were observed in the investigated concentration range. The apparent Michaelis constant range from 0.32 to 0.70 mM while the maximum elimination rate ranged from 0.63 to 1.4 mumol/min/g liver (parallel tube model) in six different experiments. The maximum intrinsic clearance varied between 0.7 and 2.0 ml/min/g liver. In the presence of 17.1 mM ethanol (0.1%) the extraction ratio of EGBE decreased from 0.44 to 0.11. The results support the hypothesis that EGBE is mainly metabolized via oxidation by alcohol dehydrogenase in the rat liver. The concentration dependence occurred at plausible in vivo doses. PMID- 3961819 TI - Glutathione- and cysteine-mediated cytotoxicity of allyl and benzyl isothiocyanate. AB - Ally isothiocyanate has been reported to be a bladder carcinogen in male rats. On the other hand, benzyl isothiocyanate is an anti-carcinogen. These contradicting properties led us to investigate the cytotoxicity of these compounds in RL-4 rat hepatocytes. Since conjugation with glutathione plays an important role in the metabolism of these isothiocyanates, the glutathione and L-cysteine derivatives were also tested for cytotoxicity (electron microscopy, trypan blue exclusion, cell attachment, and inhibition of cell division). Both types of conjugates caused considerable toxicity: allyl isothiocyanate conjugates gave effects comparable to the parent compound, but benzyl isothiocyanate was more toxic than its conjugates. Addition of excess glutathione (greater than 4mM) to the free isothiocyanates as well as their conjugates abolished cytotoxicity up to the highest concentration tested (250 microM). Addition of excess L-cysteine (5 to 20 mM) lowered the effects but did not abolish them. The reaction of thiols with isothiocyanates was readily reversible: 15 min after dissolving the conjugates in buffer, pH 7.4, an equilibrium was established in which 9 to 15% of the conjugates was converted to free isothiocyanate. Two hours after addition of 1 mM of the L-cysteine conjugates to medium containing 5 mM glutathione, 80% of the total conjugates was present as the glutathione derivatives. The glutathione conjugates were similarly converted to L-cysteine conjugates. Glutathione conjugates are not able to enter the cell, thus their toxicity is presumably due to the release of free isothiocyanate, and in the presence of excess glutathione no toxicity was observed. L-cysteine derivatives are able to cross the cell membrane, thus excess L-cysteine diminishes cytotoxicity, since less free isothiocyanate is present outside the cells, but does not completely protect the cells. Glutathione and cysteine can be regarded as transporting agents for the isothiocyanates through the body. Initial detoxification can be followed by release of the reactive compound at some other site. PMID- 3961820 TI - Intermediary metabolism of the mature rat following 2,3,7,8-tetrachlorodibenzo-p dioxin treatment. AB - Changes in body weight, feed intake, hepatic cellularity, and intermediary metabolism were assessed in the mature male (450 g) rat following 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) administration. All animals were schedule-fed (8-hr feeding period/24 hr) and treated with a single oral dose of either TCDD (75 micrograms/kg) or vehicle. Blood and tissues were sampled 16 to 18 hr following the end of the feeding period on 2, 4, 6, and 8 days post-treatment. Mature rats treated with TCDD exhibited a slight but progressive reduction in both body weight and feed intake throughout the 8-day experimental period. An increase in liver mass that was apparent at 2 days and plateaued by 4 days after TCDD treatment was associated with a decrease in the concentration of DNA per gram of wet liver. However, the total liver content of DNA in TCDD-treated rats remained similar to pair-fed animals. Thus, TCDD treatment produced liver enlargement in the mature rat that was the result of hepatocellular hypertrophy and not an increase in cell number. Hepatic glycogen content in TCDD-treated rats was threefold higher than their pair-fed counterparts at 2 to 6 days post treatment, and this augmentation would account, in part, for the hypertrophy of the liver cell found after administration of TCDD. Plasma glucose and lactate concentrations were similar in TCDD-treated and pair-fed rats, suggesting that the Cori cycle remained unaltered following TCDD administration. Likewise, heart and gastrocnemius glycogen concentrations were similar in all experimental groups. Urinary excretion of urea, ammonia, and creatinine was comparable in TCDD treated rats and their pair-fed counterparts, indicative of a nitrogen balance that was not disturbed by TCDD. Plasma glutamine concentrations in TCDD-treated rats tended to be reduced and were significantly lower at Day 6 post-treatment when compared to those of pair-fed counterparts, suggestive that amino acid release from muscle was not enhanced in TCDD-treated rats. Likewise, plasma concentrations of branched-chain amino acids, which are metabolized to a large extent in muscle, tended to be lower on Day 6 following TCDD treatment. Yet at Day 6 post-treatment, the circulating concentrations of amino acids that are metabolized by the liver were elevated in TCDD-treated animals. TCDD administration also resulted in an increase in total hepatic protein concentration which was evident at 4 days and increased progressively at 6 and 8 days post-treatment. Liver content of phospholipids also increased gradually following administration of TCDD.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3961821 TI - The effects of sulindac and its metabolites on acute stress-induced gastric ulcers in rats. AB - Rats were given a single intragastric administration of the prodrug sulindac (4.0 mg/kg) or its sulfide (1.0, 2.0, 4.0, or 8.0 mg/kg) or sulfone (1.0, 2.0, 4.0, or 8.0 mg/kg) metabolites and were then subjected to acute stress in the form of immobilization for 3 hr in a cold environment. Control rats received an equal volume of propylene glycol vehicle or nothing po. Other rats received 200 mg/kg acetylsalicylic acid (ASA) with or without stress, to compare the gastrointestinal effects of sulindac metabolites with those of a known non steroidal anti-inflammatory agent. The sulfide metabolite exacerbated stress induced gastric glandular ulcer incidence and severity in a dose-related manner relative to all groups except the ASA-stress group, which exhibited the greatest amount of gastric damage. The sulfone metabolite did not potentiate ulcer incidence or severity beyond control (stress only) levels at lower doses. However, at 4.0 and 8.0 mg/kg, the observed ulceration was greater than that seen in stressed but otherwise untreated animals. Sulindac, vehicle, and otherwise untreated rats exhibited a similar degree of stress-induced gastric damage. It appears that the prodrug does not significantly enhance stress-related gut disease, but that the active sulfide metabolite does. Although the clinical literature suggests that the sulfone metabolite is inactive, the present results suggest otherwise. While this metabolite did not, by itself, induce gastric damage at higher doses, sulfone did exacerbate stress ulcer formation. This is the only report of which we are aware, indicating a possible toxic effect of the sulfone metabolite. PMID- 3961822 TI - Isolated perfused lung histamine release, lipid peroxidation, and tissue superoxide dismutase from rats exposed to normobaric hyperoxia. AB - Female Sprague-Dawley inbred rats were exposed to either 1 atm of 100% O2 for 24 h, or 65% O2 for 5 days, with or without pretreatment with disulfiram, an inhibitor of lung CuZn-SOD. After O2 exposure, the rats were killed, the lungs removed, and isolated perfused lungs (IPLs) prepared. The IPLs were perfused with modified Krebs-Henseleit buffer, and perfusate histamine, malondialdehyde (MDA), and lung tissue CuZn-SOD activity examined. Disulfiram administration decreased the LT50 of O2-exposed rats from 65 to 36 h. Histamine and MDA in the perfusate from the IPL prepared from rats exposed to 100% O2 for 24 h were markedly increased. When rats were pretreated with disulfiram and exposed to 100% O2 for 24 h, histamine and MDA were increased an additional 77% and 45%, respectively. In separate experiments, 100% O2 exposure significantly decreased lung CuZn-SOD activity by 40% while IPL histamine and MDA were significantly increased. However, exposure of rats to 65% O2 for 5 days decreased lung CuZn-SOD by 69% but did not affect IPL histamine release or perfusate MDA. These studies suggest that IPL histamine release and/or MDA may be an early biochemical marker for pulmonary O2 toxicity, that lung CuZn-SOD activity may not be the only determinant in O2 toxicity, and other defense mechanisms may play a vital protective role during sublethal O2 exposures. PMID- 3961823 TI - Effects of cadmium and lead on oxidative metabolism and phagocytosis by mouse peritoneal macrophages. AB - We investigated the effects of cadmium and lead on the oxidative metabolism of mouse peritoneal macrophages induced either by phagocytosis of zymosan particles or by membrane perturbation with phorbol myristate acetate (PMA) without phagocytosis. Oxidative metabolism activity was measured by chemiluminescence in the presence of lucigenin. Furthermore, cell viability was tested by dye exclusion test and phagocytic activity was measured by ingestion of latex particles. Within the first hour of exposure to the metals the effects of cadmium and lead in peritoneal macrophages were the same. The oxidative metabolism induced by PMA was enhanced by both metals, the zymosan-induced oxidative metabolism was reduced, markedly by cadmium and weakly by lead. Cell viability was not affected. After 20 h of exposure the effects of cadmium and lead were different. Cadmium did not alter either the oxidative metabolism induced by zymosan and PMA or phagocytosis of latex-particles. Lead concentration dependently suppressed the oxidative metabolism induced by zymosan and PMA as well as phagocytosis of latex-particles. However, cadmium reduced cell viability concentration-dependently in contrast to lead that reduced cell viability only slightly. PMID- 3961824 TI - Manipulation of mouse organ glutathione contents. II: Time and dose-dependent induction of the glutathione conjugation system by phenolic antioxidants. AB - After 14 days of oral butylated hydroxyanisole (BHA) administration (1000 mg/kg/day) the tissue glutathione levels of male NMRI mice were increased by 74 141% in liver, lung, duodenum and intestine and after similar butylated hydroxytoluene (BHT) treatment by 18-85% in the liver, lung, spleen and the gastrointestinal tract. Doses of 100 mg/kg/day significantly elevated the glutathione content in the lung (BHA, BHT), duodenum (BHA) and intestine (BHA), while 10 mg/kg/day affected only lung glutathione content (BHA). BHA treatment (1000 mg/kg/day) induced GST activities significantly (138-1335%) in all organs investigated except the spleen, i.e. liver, lung, kidney and the entire gastrointestinal tract, while a similar dose of BHT increased GST activities in the liver, duodenum, intestine and colon by 26-339%. Daily doses of 100 mg/kg/day significantly induced GST activities only in the liver (BHA, BHT), lung (BHA) and kidney (BHA). Lower doses of BHA or BHT did not significantly affect GST activities in the organs investigated (except 10 mg BHA/kg/day in the lung). Comparison of the time course of induction of the glutathione conjugation system in various organs after different doses of antioxidants indicated no change between 5 and 14 days of treatment with all doses used (1-1000 mg/kg). Only the lung glutathione level showed a tendency to increase with low dose BHA by extending the time of treatment. The time course of the liver glutathione content between single doses of 100 mg/kg BHA or BHT revealed an initial decline followed by an increase above control values 2 days (BHA) or 5 days (BHT) after the first application. The glutathione levels of the lung and the duodenum increased without a preceding decline. Only the second dose of BHT caused a temporary decrease to control values of the elevated glutathione level in the duodenum. All animals (at any dose of BHA or BHT) showed control values of serum transaminase activities. These results suggest: The induction threshold of the glutathione conjugation system in various mouse organs is greater than or equal to 100 mg/kg for BHA and BHT. Chronic administration of these compounds did not change these results (except the lung glutathione level after low dose BHA). Elevated hepatic glutathione levels might be the result of an activated synthesis caused by a preceding loss of glutathione. Chronic BHA or BHT treatment did not cause hepatotoxic effects, as evaluated by serum transaminases, in male mice. PMID- 3961825 TI - Stroke data banks. PMID- 3961826 TI - Changes in cerebral blood flow and recovery from acute stroke. AB - We prospectively studied 14 patients with acute cerebral infarctions using serial 133Xenon inhalation cerebral determination (133Xe-rCBF), scored neurological examinations, and neuropsychological testing. All patients underwent the same battery of tests at 3 days, 1 week, 2 weeks, and 4 weeks after cerebral infarction to determine the prognostic value of early rCBF studies and the chronological relationship of changes in rCBF to clinical status. Baseline rCBF within 3 days of symptoms of acute stroke did not correlate with clinical neurological outcome (r = -0.17, p less than 0.30; r = -0.18, p less than 0.28, for the two indices of rCBF used). Among the 11 patients demonstrating neurological recovery, 7 improved at 1 week, significantly before increases in rCBF (p less than 0.05). We conclude that early baseline rCBF does not predict clinical outcome in patients with acute cerebral infarctions and that return of neurological function precedes rather than follows increases in rCBF. PMID- 3961827 TI - The Italian Multicenter Study of reversible cerebral ischemic attacks: IV--Blood pressure components and atherosclerotic lesions. AB - Utilizing the initial BP assessment in the 462 patients who entered the Italian Multicenter Study of reversible cerebral ischemia, an analysis of the effect of each BP component in respect of presence, extent and severity of atherosclerotic lesions, as displayed by angiography, was carried out separately for lesions located at either intra- or extracranial level. In a multivariate statistical model, among the following variables: sex, age, systolic BP, diastolic BP, cholesterol and smoking, systolic BP was found the best predictor of extent and severity of atherosclerotic lesions at extracranial level. None of the same variables was predictive of the severity of intracranial atherosclerosis. The results of this clinical study may confirm the indication, coming from physiopathologic observations, of a predominant role of systolic hypertension in the process of maintenance and acceleration of atherosclerosis in the large pre cerebral arteries. PMID- 3961828 TI - Biological defence mechanism in the pathogenesis of prolonged cerebral vasospasm in the patients with ruptured intracranial aneurysms. AB - We examined the relationship between the biological protective mechanisms of scavengers and free radicals that are elicited by subarachnoid hemorrhage (SAH) in the pathogenesis of prolonged vasospasm following ruptured intracranial aneurysm. The study included 25 patients treated by early surgery (within 72 hours after SAH). Lipid peroxides concentrations and the activities of superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-px) in the cerebrospinal fluid (CSF) were measured. The concentration of lipid peroxides increased significantly more (p less than 0.05) during the first 4 days after SAH in patients with symptomatic vasospasm than in those without. Patients with symptomatic vasospasm had a marked decrease in SOD activity on Days 3 and 4 followed by a gradual decrease, whereas the patients without spasm showed little change (difference between the groups, p less than 0.05). There was a significant difference in catalase activity reversal to SOD activity, but no difference in GSH-px activity. Thus, correlation was close between the increased lipid peroxides concentration and the decrease in SOD activity in CSF (p less than 0.05), suggesting an important mechanism in the pathogenesis of vasospasm. PMID- 3961829 TI - The effect of nicardipine on neuronal function following ischemia. AB - In cerebral ischemia, it has been proposed that calcium influx into neurons results in irreversible cellular injury during reperfusion. We administered nicardipine, a dihydropyridine calcium entry blocker, by continuous subcutaneous infusion to twenty five rats beginning before (PR) or following (PO) ischemia, and compared somatosensory evoked potentials (SEPs) to twenty eight ischemic control animals. Comparable ischemic cellular changes were seen in the hippocampi of all animals. SEP amplitude was higher in both the PR (p less than .005) and PO (p less than .0005) groups compared to controls. This effect was found in all three components (P1, N1, P2) of the evoked response. Plasma nicardipine levels of 6-10 ng/ml were associated with mild hypotension. We conclude that nicardipine improved neuronal function as measured by SEPs when administered before or after ischemia, most likely by interrupting the cytotoxic events occurring in cortical neurons during reperfusion. PMID- 3961830 TI - Changes in cerebral blood flow and metabolism following intraarterial or local administration of nimodipine, before and after experimental subarachnoid hemorrhage in baboons. AB - Experimental subarachnoid hemorrhage (SAH) was induced in baboons by repeated injections of autologous blood into cisterna chiasmatis and cisterna magna, a total of 14-33 ml being injected over 3-4 days. Cerebral blood flow (CBF; 133xenon clearance) and cerebral metabolic rate of oxygen (CMRO2) were measured before, and 7 days after, the first blood injection. The effect of the calcium channel blocker, nimodipine, used in a commercially available form for clinical application, was studied following continuous i.a. infusion (0.1 microgram X kg-1 X min-1) for an interval of 45 min, and also 20 and 60 min after intrathecal administration of 1 microgram X kg-1. During the infusion experiments, CBF was increased by 25-30% both before and after the cisternal blood injection. CMRO2 was also enhanced, but much less. Nimodipine in doses given did not alter systemic blood pressure. Following intrathecal application, CBF and CMRO2 slightly increased at 20 min only before experimental SAH. PMID- 3961831 TI - Effect of topical nimodipine versus its ethanol-containing vehicle on cat pial arteries. AB - Nimodipine and its solvent containing ethanol were tested in a randomized in vivo study by local administration to the outer vessel wall surface of pial arteries and veins in 15 anesthetized cats. Reactions were studied through a cranial window. Diameter variations of 90 arterial and 78 venous vessel segments were continuously analyzed using a multichannel videoangiometer. The solvent alone caused minor though statistically significant (p less than 0.001) 7.6% dilatation, 8% in small and 7% in large arteries, which returned to their resting state after stopping treatment. 2.4 X 10(-5) M nimodipine plus solvent induced a 21% pial arterial dilatation (p less than 0.001), 26% in small and 17% in large arteries; dilatation induced by nimodipine plus solvent was significantly greater than dilatation by the solvent alone (p less than 0.001). After ceasing topical administration, arteries remained dilated by some 5%. Pial veins exhibited only minor reaction, i.e. a 6% (statistical n.s.) dilatation of large veins during nimodipine, and an 8% dilatation of small veins 20 minutes after stopping nimodipine. During solvent-administration rCBF, as estimated with the hydrogen clearance technique, remained unchanged. It is concluded that the dilatatory effect of the investigated compound on pial arteries is predominantly due to nimodipine. PMID- 3961832 TI - The effects of nifedipine and felodipine on cerebral blood flow during anoxic episodes. AB - Cerebral blood flow (CBF) in the rat was monitored by a venous outflow technique with an extracorporeal circulation, which allows for the continuous recording of flow over periods of several hours. Brief periods of anoxia increase the rate of flow. The dihydropyridine calcium antagonists did not affect basal flow rate and depressed the increase in CBF elicited by anoxia. These findings may have significant implications for the therapeutic use of dihydropyridine calcium antagonists in brain ischaemia. PMID- 3961833 TI - Trends in mortality from cerebrovascular disease in Italy, 1955-78. AB - Trends in age-specific and age-standardized death certification rates from all cerebrovascular diseases and various diagnostic subcategories in Italy during the period 1955-78 have been analysed. In both sexes, a decrease in excess of 25% was evident in the overall age-standardized cerebrovascular disease mortality. However, rates were roughly stable in males up to age 50 and in females up to age 45, and slightly but consistently increasing in the younger age groups (under 40), mostly in females. The largest downward trends were for both sexes in the 55 to 74 age groups, and the declines were more marked in females, averaging 3% per year. Since death certification is most reliable in the younger age groups and it is difficult to imagine any modification of risk factors which should affect mortality in later middle age but not in younger age groups, there is no obvious and simple interpretation of this pattern of trends. A comparison with similar trends in ischemic heart disease and other causes of death suggests that the decline in overall cerebrovascular disease mortality might be partially or largely artefactual, though a between-sexes comparison indicates that at least part of the decrease registered in females may well be real. The extent of the decline, however, has been almost certainly more limited in Italy than in most other Western countries. Only in the younger age group (30-34) did rates show a larger increase in females, which might be related to increased prevalence of cigarette smoking, or the use of oral contraceptives. PMID- 3961834 TI - Screening for depression in stroke patients: the reliability and validity of the Center for Epidemiologic Studies Depression Scale. AB - This study examined the inter-observer reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) as a measure of depressive symptomatology in stroke patients, and its utility as a screening tool for depression in this population. The CES-D Scale is a brief questionnaire originally designed for use in community surveys. Twenty-seven non-aphasic patients enrolled in the Stroke Data Bank at the University of Maryland were interviewed by a research nurse using the CES-D. On the same day, each patient was independently evaluated by a research assistant using a psychiatric battery for depression and measures of cognitive, physical, and social functioning. Forty one percent (11/27) of the patients were depressed according to clinical criteria for major or minor depression. With a cutpoint corresponding to the upper (most severe) 20% in community surveys, the CES-D Scale picked up 73% (8/11) of the depressed patients. In this sample no nondepressed patient scored over 16 on the CES-D (no false positives). The CES-D Scale scores correlated significantly with the other depression measures (r = .57 to r = .82, p less than .002) and did not correlate with the measures of cognitive, physical, or social functioning. Based on 24 patients who received a CES-D Scale score from both the nurse and the research assistant, inter-rater reliability was high (r = .76, p less than .001). Thus, the CES-D was found to be reliable and valid as a screening tool for assessing depression in stroke patients. PMID- 3961835 TI - Polymorphonuclear leukocyte accumulation in brain regions with low blood flow during the early postischemic period. AB - In an anesthetized canine model in which ischemia was induced by incremental air embolism, 16 animals were exposed to 1 hr of ischemia and monitored for 10 min (n = 4), 60 min (n = 6), or 240 min (n = 6). Fourteen animals were observed for corresponding periods without being subjected to ischemia 70 min (n = 4), 120 min (n = 4), or 300 min (n = 6). Autologous granulocytes were labeled with 111In and reinfused just before ischemia. At the conclusion of each experiment, a 14C iodoantipyrine autoradiographic blood flow study was performed. Granulocyte accumulation measured by gamma scintigraphy (cpm/gm) occurred in the injured hemisphere of ischemic animals at 60 min in anterior brain segments and at 240 min in anterior, middle, and posterior segments. By means of a double-label autoradiography technique, clustering of punctate granulocyte images was detected in regions of low flow or heterogeneous flow in half of the animals at both 60 min and 240 min postischemia. Granulocyte clustering did not occur in the autoradiograms of nonischemic animals. The results implicate granulocyte participation in the acute phase of ischemic brain injury and signal a convergence of hemostatic and inflammatory processes during the immediate postischemic period. PMID- 3961836 TI - Quantification of cerebral infarct size by creatine kinase BB isoenzyme. AB - Creatine Kinase BB isoenzyme (CKBB) has been shown to rise in the serum and CSF following acute cerebral injury. To test the hypothesis that brain infarct size could be estimated from the appearance and disappearance of CKBB in the serum and CSF, strokes of varying size were produced in twelve mongrel dogs by silastic emboli. The rate of disappearance, Kd of CKBB (-.00732 +/- 0.001 min-1 mean +/- SE, N = 8) was determined by injecting purified CKBB (25 IU) intravenously then measuring its disappearance. Following the embolic stroke, serum samples were taken hourly for 24 hours and then at intervals for up to 160 hours for measurement of CKBB by radioimmunoassay until the animals were sacrificed. The brains were then removed, fixed in formalin, cut in 2 mm sections and photographed. The area of the infarct was measured using high pad digitizer interfaced with an Apple computer. The infarct size was then calculated from the area and thickness. Using a one-compartment mathematical model, the infarct size was estimated from the amount of CKBB appearing in the serum, the Kd of CKBB, and the amount of CKBB depleted from tissue. The computed infarct size correlated well (r = 0.94) with the measured infarct size. This model may have value in testing therapeutic modalities in the intact animal. PMID- 3961837 TI - Cerebral blood flow and tissue metabolism in experimental cerebral ischemia of spontaneously hypertensive rats with hyper-, normo-, and hypoglycemia. AB - The present study was designed to clarify the effect of blood glucose level on cerebral blood flow and metabolism during and after acute cerebral ischemia induced by bilateral carotid ligation (BCL) in spontaneously hypertensive rats (SHR). Blood glucose levels were varied by intraperitoneal infusion of 50% of glucose (hyperglycemia), insulin with hypertonic saline (hypoglycemia) or hypertonic saline (normoglycemia). Cerebral blood flow (CBF) in the parietal cortex and thalamus was measured by hydrogen clearance technique, and the supratentorial metabolites of the brain frozen in situ were determined by the enzymatic method. In non-ischemic animals, blood glucose levels had no influence on the supratentorial lactate, pyruvate or adenosine triphosphate (ATP) concentrations. In ischemic animals, however, cortical CBF was reduced to less than 1% of the resting value at 3 hours after BCL. However, there were no substantial differences of CBF during and after ischemia among 3 glycemic groups. Cerebral lactate in the ischemic brain greatly increased in hyperglycemia (34.97 +/- 1.29 mmol/kg), moderately in normoglycemia (23.43 +/- 3.13 mmol/kg) and less in hypoglycemia (7.20 +/- 1.54 mmol/kg). In contrast, cerebral ATP decreased in hyperglycemia (0.93 +/- 0.19 mmol/kg) as much as it did in normoglycemia (1.04 +/ 0.25 mmol/kg), while ATP reduction was much greater in hypoglycemia (0.45 +/- 0.05 mmol/kg). At 1-hour recirculation after 3-hour ischemia, ATP tended to increase in all groups of animals, indicating the recovery of energy metabolism. Such metabolic recovery after recirculation was good in hypo- and normoglycemia, and was also evident in hyperglycemia. Our results suggest that hyperglycemia is not necessarily an unfavorable condition in acute incomplete cerebral ischemia. PMID- 3961838 TI - Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. I: Goals, objectives, and data collection procedures. AB - In order to assess the impact of variations in stroke care on outcomes, and to make geographic comparisons, the three Community Hospital-Based Stroke Programs in North Carolina, Oregon, and New York, aggregated their data on 4,132 hospitalized stroke patients. Complete demographic data or "Major Profile" were obtained on 2,390 (57.8%) of the 4,132 stroke patients. This includes those patients on whom informed patient and physician consents were obtained during the hospitalization. Of the major profile patients, 1,490 (62.3%) were followed for periods up to one year, 502 (21.0%) were lost to followup and 398 (16.6%) died within the one year followup period. Incomplete demographic data or "Minor Profile" were observed on 1,742 (42.1%) of the 4,132 patients. Minor profile includes those who died before comprehensive interviews were completed or those for whom informed consent for an interview could not be obtained. Of the minor profile group, 813 (46.7%) died in hospital, and 929 (53.3%) were alive when discharged from the hospital. This paper, which describes the programs, data collection procedures, and study cases, also highlights specific issues on stroke diagnosis, risk factors associated with stroke, and the influence of interventions on stroke outcomes. We conclude that: 1) the merging of data on hospitalized stroke cases from rural and urban hospitals in geographically distinct regions can be used in the study of stroke diagnosis, the use of diagnostic tests, and the effect of interventions on stroke outcomes; and 2) these data are consistent with the hypothesis that part of the national decline in mortality from stroke is due to a decline in stroke severity. PMID- 3961839 TI - Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. III. Factors influencing survival after stroke: proportional hazards analysis of 4219 patients. AB - The possible effect of age, race, sex, consciousness upon admission, geographic location, and history of selected risk factors on the survival after stroke due to infarction or hemorrhage was determined using proportional hazards analysis (Cox regression). For each diagnostic category the most significant prognostic factor was consciousness upon admission. Increasing age, cardiac disease, or previous stroke also decreased the survival time of patients with infarctions. For patients with cerebral hemorrhage, no other variable was significant after control for consciousness level. PMID- 3961840 TI - Characterization of muscarinic cholinergic receptors in human and dog cerebral arteries. AB - Various concentrations of acetylcholine (ACh) produced dose dependent relaxations of isolated, helical preparations of human cerebral arteries and these responses were blocked by atropine. The median effective concentration (EC50) of ACh was 6.1 +/- 0.2 X 10(-6)M. ACh produced dual responses in isolated dog cerebral arteries. ACh in low concentrations produced relaxation, and contraction occurred when the concentration was raised to 1 X 10(-5)M. The EC50 of ACh which produced relaxation, in dog cerebral arteries was 7.2 +/- 0.2 X 10(-7)M. Muscarinic cholinergic receptors in these arteries were analyzed directly using 3H-QNB as the ligand. The specific 3H-QNB binding to the arteries was saturable and of KD = 1.5 nM and Bmax = 93 fmol/mg protein in human cerebral arteries and KD = 0.59 nM, Bmax = 340 fmol/mg protein in dog cerebral arteries. Specific binding of 3H-QNB was displaced by muscarinic cholinergic agents. Ki values and Hill coefficients were as follows: QNB, 1.0 X 10(-9)M, 0.89; atropine, 1.1 X 10(-8)M, 0.95; ACh, 0.8 X 10(-8)M and 2.1 X 10(-6)M, 0.54; carbachol, 1.2 X 10(-7)M and 4.3 X 10( 5)M, 0.33 in human cerebral arteries and QNB, 0.55 X 10(-9)M, 0.85; atropine 0.9 X 10(-9)M, 1.00; ACh, 0.9 X 10(-9)M and 1.1 X 10(-6)M, 0.43; carbachol 6.3 X 10( 8)M and 1.1 X 10(-5)M, 0.36 in dog cerebral arteries. Endogenous choline acetyltransferase (ChAT) activity was 1.6 +/- 0.4 nmol/mg protein/hr in human cerebral arteries and 3.7 +/- 0.1 nmol/mg protein/hr in dog cerebral arteries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961841 TI - Neurological deficit and cerebral infarction after temporary middle cerebral artery occlusion in unanesthetized cats. AB - Forty-four unanesthetized cats underwent temporary middle cerebral artery (MCA) occlusion with an implanted, externally controlled balloon cuff occluder. The occlusion was reversed to allow reperfusion of the MCA after 2 min to 24 hr of ischemia. Fourteen cats had temporary occlusions lasting 2 min to 3 hr; their neurological deficits improved or resolved after reperfusion, and brain sections showed only scattered microscopic areas of necrosis. After a 4-hr occlusion, five of nine cats (55%) recovered completely within 24 hr; two had persistent deficit when sacrificed, 10 days later, and each had a circumscribed infarct. All 18 cats undergoing 5-, 6-, 8-, and 24-hr occlusions sustained permanent neurological deficits. Three 3-hr occlusions at 2-day intervals in three cats resulted in permanent deficits and infarcts that were 25% larger than those after single 8-hr occlusions. Ten cats underwent permanent MCA occlusion; three deteriorated neurologically and died, and the survivors showed no improvement. Infarcts after 5-, 6-, and 8-hr occlusions followed by reperfusion were 66% smaller (p less than 0.05) than those after permanent occlusion; reperfusion after 24 hr of occlusion did not reduce infarct size. Hemorrhagic infarction occurred after two permanent occlusions, but after only one 5-hr temporary occlusion. The results obtained with this method of temporary regional ischemia indicate that restoration of flow after 1-8 hr, but not after 24 hr, of MCA occlusion resulted in less severe neurological deficit and smaller infarcts than did permanent occlusion. The infarct size correlated with the duration of MCA occlusion (p less than 0.05) rather than with the degree of deficit during occlusion. PMID- 3961843 TI - Clinical use of nuclear magnetic resonance imaging in stroke. AB - There are many positive aspects to the use of MRI in the evaluation of cerebrovascular disease. First, the MR imaging technique appears to be essentially without hazard. It does not rely on ionizing radiation, and no intravenous injections of contrast agent are necessary. MRI exploits the tissue's inherent biophysical characteristics to provide superior contrast. Infarctions are well delineated by MRI, often better and earlier than CT. Because of the lack of MRI signal from bone and thus the lack of transverse artifact from bone often seen with CT, lesions in the posterior fossa are very well visualized. With MRI it is possible to obtain images in the transverse, coronal, and sagittal planes, which provides for good evaluation of lesion size and extent. Arteriovenous malformations have been visualized by MRI, but it is still too early to know whether MRI has any detection capability over CT in this disorder. Subdural hematomas have been well visualized by MRI, including cases of isodense subdurals not visualized by CT. On the other hand, MRI has not proven to have any advantage over CT in the evaluation of intracerebral hemorrhage, hemorrhagic infarction, and subarachnoid hemorrhage. In fact, for detection of intracerebral hemorrhage and subarachnoid hemorrhage, CT may be better at the present time. In chronic infarction the surrounding area of Wallerian degeneration may cause the area of infarction to appear larger than it actually is. Hopefully, with further research into the use of different pulse sequence techniques and with good neuropathological correlation, the present limitations of MRI can be eliminated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961842 TI - Temporal arteritis-like presentation of carotid atherosclerosis. AB - A 68 year-old woman presented with a two-week history of amaurosis fugax, ipsilateral fronto-temporal headache and jaw claudication suggesting carotid giant cell arteritis. However, this syndrome proved to be due to atherosclerosis causing complete occlusion of the external carotid artery at its origin and narrowing of the internal carotid artery. Combined external and internal carotid endarterectomy relieved the symptoms. The symptom complex of temporal arteritis may be rarely mimicked by carotid atherosclerotic occlusive disease. PMID- 3961844 TI - Should lumbar puncture be part of the routine evaluation of patients with cerebral ischemia? PMID- 3961845 TI - Evaluation of contraceptive history data in the Republic of Korea. AB - The consistency of retrospective and current status data on contraceptive use from a series of national fertility surveys carried out during the 1970s in Korea is investigated. Aggregate consistency is examined among random samples from the same cohort or cohorts of women interviewed in each survey. The results indicate that estimates of trends in contraceptive use from a retrospective history in one survey, or from cross-sectional estimates in a series of surveys, can each yield misleading findings. Data from the 1974 Korean National Fertility Survey (KNFS) appear to be more reliable than those from other surveys, possibly because an interval-by-interval contraceptive history was used, explicit definitions of contraceptive methods were given prior to taking the contraceptive history, and the KNFS involved longer interviewer training and, perhaps, less time pressure during interviews. PMID- 3961846 TI - Maintaining family planning acceptance levels through development incentives in Northeastern Thailand. AB - The results of a two-year longitudinal study of the effect that development program incentives have upon family planning in Northeastern Thailand are presented. These incentives, implemented by the Population and Community Development Association, Thailand, included animal raising and agricultural, home industry, and environmental activities. An experimental design including baseline and follow-up surveys supplemented by a continuous monitoring system was utilized to test hypotheses on the family planning impacts of the incentives. Findings indicate that the incentives contributed significantly to the maintenance of high levels of family planning practice through the program period 1982-1984. PMID- 3961848 TI - [Determination of the optimal area for measuring cadaver body temperature for establishing the time of death]. PMID- 3961847 TI - Contraceptive prevalence in the slums of Rio de Janeiro. AB - A community-based family planning operations research project was undertaken in selected low income communities of Rio de Janeiro; project field work began in February 1982. Prevalence data were collected and service delivery strategies were tested, including home visits promoting family planning, home distribution of condoms, and the introduction of community family planning depots. A high baseline contraceptive prevalence rate (CPR) of 70.1 percent was found for nonpregnant women currently in union, as well as substantial use of the private sector for contraceptive supply, despite the presence of free or subsidized sources within the communities. However, the most economically disadvantaged subgroups made the greatest use of the subsidized sources. The provision of additional service delivery sites may have contributed to a small increase in contraceptive prevalence noted over the life of the project; however, the high baseline CPR precluded a large increase in contraceptive use as a result of the program. PMID- 3961849 TI - [Effect of the environmental temperature on the dynamics of the blood immune indices in the postmortem period]. PMID- 3961850 TI - [Forensic medical research on the ground beneath a corpse]. PMID- 3961851 TI - [Possibilities of reconstructing the circumstances of a fatal injury in a fall from a height]. PMID- 3961852 TI - [Injury to airplane crews by atmospheric electricity]. PMID- 3961853 TI - [Fractographic research on fractures of the long tubular bones in establishing the mechanisms of the injury]. PMID- 3961854 TI - [Characteristics of injuries to the bones of the cranial vault in childhood]. PMID- 3961855 TI - [Current aspects of forensic medical expertise in submersion in water]. PMID- 3961856 TI - [Causes for the appearance of unusual haptoglobin electrophoregrams]. PMID- 3961857 TI - [Effect of cleansing agents on the detection of individual serum proteins in blood stains]. PMID- 3961858 TI - [Determination of steroid hormones in material evidence of biological origin by thin-layer chromatography]. PMID- 3961859 TI - [Conclusions in expert testimony on disputed paternity]. PMID- 3961860 TI - [Objective characteristics of the color of human head hair]. PMID- 3961861 TI - [Determination of the ethanol concentration in various parts of the vascular system of a cadaver]. PMID- 3961862 TI - [Use of IR spectrophotometry by experts in poisonings]. PMID- 3961863 TI - [Isolation and detection of fluoracizine in biological material]. PMID- 3961865 TI - [Determination of veratrine in blood and urine]. PMID- 3961864 TI - [Detection of Leponex (clozapine) in biological material]. PMID- 3961866 TI - [Determination of acetone and dichloroethane in cadaveric material by gas-liquid chromatography]. PMID- 3961867 TI - [Quantitative determination of fluoracizine in biological material]. PMID- 3961868 TI - [Control of the knowledge of students in the Department of Forensic Medicine of the Central Institute of the Order of Lenin for the Advanced Training of Physicians]. PMID- 3961869 TI - [Use of photograms in studying microslivers of glass]. PMID- 3961870 TI - [Use of television technology in microscopic research in forensic medicine]. PMID- 3961871 TI - [Use of anti-A-Hp (Helix pomatia) reagent for studying dried blood]. PMID- 3961872 TI - [Severing of the body in automobile injury]. PMID- 3961874 TI - [Forensic medical service in the Mongolian People's Republic]. PMID- 3961873 TI - [Gliftor poisoning]. PMID- 3961875 TI - [Vulgar biologization in forensic medicine in the capitalist countries]. PMID- 3961876 TI - A critical look at our adolescence: notes on turning 18 (and 75). AB - Within the contexts of both the American Association of Suicidology's (AAS's) history and the history of associating suicidologists, an integrative identity based on the tenets of science is urged for the AAS. Two propositions are made: first, that we must promote and adopt more discriminative, standardized terminology; second, that we must promote and implement standards of informational competency for professionals and paraprofessionals alike. PMID- 3961877 TI - The significance of Nico Speijer's suicide: how and when should suicide be prevented? AB - On the morning of September 29, 1981, while attending a meeting of the World Health Organization on suicide, held in Athens, I was suddenly called out of the meeting room. The reason was a telephone call from the Ministry of Health in my country, The Netherlands, announcing that my mentor and friend Professor Nico Speijer had died the night before. He and his wife had put an end to their lives. Apart from my personal feelings, Nico Speijer's way of death touched profoundly upon all of us present at the meeting. Speijer was the grand old man of suicidology in the Netherlands, and, more, he was an outstanding member, even an honorary member, of the International Association for Suicide Prevention. From the birth of this organization in 1960 on, he had been an active and colorful participant in practically all of its meetings. As can be expected in the case of a man of Speijer's status and reputation, his suicide evoked reactions nationwide. The leading newspapers and even the national TV networks made extensive mention of it. Though people's comments on the event were quite diverse, the underlying tone was generally one of understanding and sympathy. At the time of his death Speijer had been very ill with intestinal cancer and had been in great pain. His wife, herself disabled, had preferred to die with him rather than to be left behind. When I returned home from Athens, among the waiting mail, there was a letter written to me in the handwriting that had become so familiar over the previous 10 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3961878 TI - Sex difference trends in completed suicide. AB - The recent suicide literature increasingly has contained statements suggesting that the differences in completed suicide between the sexes are lessening. A compilation of official suicide data for 1933-1980 verifies such a trend from the 1950s through 1971. However, increased differences (as measured by the ratio of male to female rates) were consistently observed from 1971 to 1980. These trends were found for data for the nation, for whites and nonwhites, for numbers of suicides, for crude rates, and for age-adjusted rates. Decreased sex differences were obtained for those 35-44, 45-54, 55-64, and for 65+ years of age, but increased sex differences were observed for those aged 15-24 and 25-34. Possible explanations for these findings are presented. PMID- 3961879 TI - Selected behavioral features of patients with borderline personality traits. AB - Selected behavioral features felt historically and empirically to be significant in the borderline personality disorder were evaluated in 4,800 psychiatric inpatients. Variables measured included number of hospitalizations and type of discharge, suicidal behavior, physical violence, and outcome after discharge. A statistical analysis was performed to determine the relationship between depth and severity of borderline traits and the aforementioned behavioral features. Results indicated that irregular discharges, frequent suicide attempts, first suicide attempt prior to age 40, violence within and outside the hospital, and gradual deterioration in social and occupational functioning were found significantly more often in patients with high levels of borderline personality traits. PMID- 3961880 TI - Incidence of near-death experiences following attempted suicide. AB - Near-death experiences (NDEs), profound subjective experiences occurring during a close brush with death and containing transcendental or mystical elements, have been reported to reduce suicidal ideation, despite their "romanticization" of death. Among 61 consecutive hospital admissions for attempted suicide, 16 patients (26.2%) reported NDEs precipitated by the attempt. NDEs were not significantly associated with any demographic factors. In light of the frequency of NDEs following attempted suicide, further studies are indicated in regard to the effect of those experiences on subsequent suicidal behavior. PMID- 3961881 TI - Trends in attempted suicide in Denmark, 1976-1980. AB - The object of the present study was to estimate proportions and changes in the incidence of suicide attempts in Denmark. Case sheets concerning all admissions in 1976-1979 (total 6,650) at the Department of Psychiatry, Odense University Hospital (the catchment area of which provides a representative sample of the Danish population), were examined with a view to establishing the reasons for admission. Rates of suicide attempts by age and sex in 1976-1979 were calculated, and estimated rates of the suicide attempts in 1980 added. Trend analysis showed an increase in the mean rates from 1976 to 1979 of 48%, followed by a decrease in 1980 of 13%. There were high increases among the adolescents, but the increase was above all due to the fact that more and more men attempted suicide; the study suggests as a new phenomenon more male than female suicide attempters. We stress the fact that incidences calculated on the basis of hospital admissions only underestimate the real proportions of self-destructive behavior. PMID- 3961882 TI - A proposed curriculum on suicide care for psychiatry residency. AB - This paper discusses suicide care as a core curriculum component of psychiatry residency. The reasons for formal conceptualization of suicide care education are discussed, and a model curriculum is offered. The model is in no way intended to be restrictive, but is offered as a reference point for residency programs to compare their own activities in this important area of psychiatry. The paper grew from discussion of this topic in the Core Curriculum Committee of the American Association Directors of Psychiatric Residency Training. PMID- 3961883 TI - Suicide and euthanasia--special types of partner relationships. PMID- 3961884 TI - Suggested recommendations for the study of suicide and other life-threatening behaviors. PMID- 3961885 TI - Concerns about the Food and Drug Administration guidelines for neonatal theophylline dosing. PMID- 3961886 TI - Comparison between theophylline analysis by nephelometric inhibition immunoassay and high performance liquid chromatography. AB - Rate nephelometric inhibition immunoassay (NIIA) was used to determine 94 serum theophylline concentrations, and these results were compared with those obtained using high performance liquid chromatography (HPLC) as a reference method. The measurements obtained by the nephelometric method were, on the average, 20% higher than those obtained by the chromatographic method (p less than 0.001). The coefficient of variation of the nephelometric method was 12.3%, compared with 3.9% for the chromatographic reference method. In the group of subjects having a serum concentration of caffeine greater than or equal to 0.5 microgram ml-1, the difference in serum theophylline concentration found between NIIA and HPLC correlated with serum caffeine concentration (r = 0.3755, df = 46, p less than 0.01). NIIA theophylline concentration was 8.8 +/- 3.2 micrograms ml-1 in serum from six additional patients receiving theophylline 9.1 +/- 3.4 micrograms ml-1 after adding 10 micrograms caffeine (NS), and 13.1 +/- 3.5 micrograms ml-1 after adding 10 micrograms 1,3-dimethyluric acid (p less than 0.001). We conclude that (a) the results obtained by the NIIA method are more variable and consistently higher than those obtained by the HPLC method and (b) 1,3-dimethyluric acid (a caffeine and theophylline metabolite) is responsible for this overevaluation. PMID- 3961887 TI - Pharmacokinetics of rifampin in children. I. Multiple dose intravenous infusion. AB - The pharmacokinetics of intravenous rifampin (280 +/- 78 mg/m2) were investigated during multiple dose administration in 12 pediatric patients aged 3 months to 12.8 years. Serum rifampin concentration data were fit to a linear one compartment model. There was a significant effect of duration of therapy on rifampin clearance (Cl) and half-life (t1/2) (p = 0.027 and p = 0.048, respectively). A mean increase of 52.0% in Cl (3.10-4.72 L/h/m2) and a mean decrease of 27.0% in t1/2 (2.38-1.73 h) were observed when data collected during the first 2 days of therapy were compared with data collected following 8 or more days of therapy. Peak concentrations extrapolated to the end of infusion were 27.0 +/- 8.2 micrograms/ml, and concentrations at 8 h after the dose were only 1.9 +/- 1.5 micrograms/ml. There was no significant effect of duration of therapy on these concentration values. There was no correlation between Cl and age or administered dose. Intrapatient variation in Cl was great, as evidence by the lack of correlation of initial Cl values with subsequent values in individual patients (r = 0.259). It would appear that dosage intervals may need to be shortened from 12 to 8 h during continuous therapy, and that periodic measurement of rifampin concentration may be required. PMID- 3961888 TI - Evaluation of a fluorescence polarization immunoassay procedure for quantitation of methotrexate. AB - A fluorescence polarization immunoassay (FPIA) procedure for measuring methotrexate was evaluated. The dynamic range of the assay is from 0.05 to 810 microM, and the calibration curve can be stored for at least 2 weeks. The FPIA procedure is automated and rapid; one result can be obtained in 18 min and five results in 25 min. There was no interference from hemoglobin (800 mg/dl), triglycerides (500 mg/dl), bilirubin (20 mg/dl), and protein (12.1 g/dl). Cross reactivity with 7-hydroxy methotrexate and 2,4-diamino-N-methylpteroic acid was 0.6 and 44%, respectively. The coefficient of variation for the within-run and between-run precision was less than 5.0%. For the comparison studies, the samples were divided into four groups. The methotrexate concentrations in group 1 were 0.05-2.1 microM; in group 2, 2.2-9.3 microM; in group 3, 10-80 microM; and in group 4, greater than 80 microM. Linear regression analysis of the results obtained with the FPIA procedure and the enzyme multiplied immunoassay gave a correlation coefficient of at least 0.95 for all groups. PMID- 3961889 TI - Cyclosporin A: variation in whole blood levels related to in vitro anticoagulant usage. PMID- 3961890 TI - Influence of methodological factors in determining the accuracy and precision of measurements of tricyclic antidepressant drug concentrations in serum. PMID- 3961891 TI - Pharmacokinetics of rifampin in children. II. Oral bioavailability. AB - The absolute bioavailability of oral rifampin was determined in 20 pediatric patients. Intravenous doses of rifampin (mean 287 mg/m2) were compared with p.o. doses (mean 324 mg/m2). Serum concentrations of rifampin, 25-O desacetylrifampicin, and 3-formylrifamycin SV were determined by high performance liquid chromatography. Following a 1/2-h intravenous infusion, serum rifampin concentrations declined in a monoexponential fashion. Pharmacokinetic analysis of the rifampin serum concentration data indicated that only 50 +/- 22% of a freshly prepared p.o. suspension was absorbed. The rifampin elimination half-life following i.v. administration (2.25 +/- 0.64 h) was not different from that observed following p.o. dose administration (2.61 +/- 1.35 h). Peak rifampin concentrations were significantly higher following i.v. administration when corrected to a 300 mg/m2 dose (27.4 vs. 9.1 micrograms/ml, respectively, p less than 0.0001) than after p.o. administration. The peak concentration following a p.o. dose occurred at 2.0 +/- 0.9 h. The ratio of desacetylrifampicin to rifampin areas under the curves were similar for i.v. and p.o. routes of administration (0.23 vs. 0.19), suggesting linear metabolism of rifampin to this metabolite. 3 formylrifamycin SV concentrations were lower than those of desacetylrifampicin and were detectable in less than half of the patients. The results of this study indicate the need for larger p.o. doses when serum concentrations similar to those obtained following intravenous doses are desired. PMID- 3961892 TI - Plasma nor1-chlorpromazine concentrations: effects of age, race, and sex. AB - Plasma nor1-chlorpromazine (nor1-CPZ) and chlorpromazine concentrations were measured by gas chromatography--mass fragmentometry in 15 inpatients receiving stable doses of chlorpromazine. Nor1-CPZ concentrations averaged 20% of chlorpromazine concentrations and were highly correlated with them. Relative concentrations of nor1-CPZ increased with age. Nor1-CPZ concentrations per milligram dose were higher in black than in white patients. PMID- 3961893 TI - Effect of total drug concentration on the free fraction in uremic sera. AB - The effect of total drug concentration on the free fraction was studied in vitro using sera of uremic and nonuremic subjects. Both therapeutic and toxic concentrations of radiolabeled phenytoin, diazepam, and propranolol were used. The free fraction was separated by a pressure ultrafiltration method at 37 degrees C and determined from 200-microliters aliquots of serum and the ultrafiltrate. Sera from 11 acutely uremic and 10 chronically uremic patients and from 10 healthy control subjects were used. Only slight increases in the free fraction were found over the concentration range studied in both nonuremic and uremic subjects. The concentration-dependent increases in the unbound fraction of phenytoin and diazepam were quite negligible compared with the two- to threefold increases caused by uremia itself. Thus, variation in total concentrations of phenytoin, diazepam, and propranolol does not change the free fractions to a clinically significant degree even in uremic patients with a compromised binding capacity. PMID- 3961894 TI - Heparin kinetics during hemodialysis: variation in sensitivity, distribution volume, and dosage. AB - A method to assess heparin kinetics and individualize dosages was examined in 27 patients during chronic hemodialysis. Pretreatment heparin sensitivities were determined to establish the relationship between heparin concentration and activated clotting times (ACTs). Distribution volume was calculated by dividing the heparin loading dose by the 5-min heparin concentration. Assessments were made during three different dialysis periods. There was a 10-fold range in pretreatment heparin sensitivities. Intrapatient heparin sensitivity remained relatively consistent between dialysis periods. The degree of heparin sensitivity was significantly correlated to baseline ACT. Patients post-splenectomy were more sensitive to heparin. Large intra- and interpatient variation in distribution volume was also observed. Men, patients less than 60 years old, and patients post splenectomy represented variables that contributed to higher heparin dose requirements. PMID- 3961895 TI - Therapeutic monitoring of chlorpromazine. III: Minimal interconversion between chlorpromazine and metabolites in human blood. AB - Chlorpromazine (CPZ), chlorpromazine sulfoxide (CPZSO), and chlorpromazine N oxide (CPZNO) were each incubated (37 degrees C), for various timed intervals up to 60 min, with pooled human whole blood. Plasma and red blood cells were then separated and analyzed by a high performance liquid chromatographic method that avoids the use of alkaline extraction procedures. It was found that CPZ, CPZSO, and CPZNO were remarkably stable in whole blood under physiological conditions. CPZ was converted into CPZSO to a small extent (1%). Reports of 15-50% conversion of CPZ into CPZSO are largely due to artifacts, which result when red blood cell materials come into contact with alkali. CPZNO was recovered (85%) unchanged from the plasma. A small portion (1%) of the CPZNO was reduced to CPZ in the red blood cells. Thus, on the basis of these in vitro data, blood does not appear to be an important tissue for the metabolism of CPZ, CPZSO, or CPZNO. PMID- 3961896 TI - Factors influencing theophylline disposition in 179 newborns. AB - The pharmacokinetics of intravenous theophylline were prospectively studied in 179 premature babies. Interrelated variables were analyzed for their influence on theophylline serum clearance. Gestational age, gender, duration of treatment, body weight, and Apgar scores were not found to correlate significantly with theophylline clearance. Weak but statistically significant correlations were found between serum clearance and postnatal (p less than 0.005) and postconceptional age (p less than 0.01). No significant difference in mean serum clearance (Cls) values was found between small-for-gestational-age (SGA) patients (Cls = 17.9 +/- 5.3 ml/kg/h) and appropriate-for-gestational-age (AGA) patients (Cls = 18.8 +/- 5.8 ml/kg/h). Conversely, asphyxiated patients had significantly lower mean clearance values than nonasphyxiated patients (16.4 +/- 5.3 ml/kg/h vs. 20.2 +/- 5.4 ml/kg/h, respectively, p less than 0.001). Volume of distribution for theophylline (n = 147) was 0.77 +/- 0.17 L/kg; there was no significant difference in distribution volumes between asphyxiated and nonasphyxiated patients or between SGA and AGA patients. Step-wise multiple regression analysis revealed postnatal age as the most important determinant of theophylline clearance among the variables analyzed (p less than 0.01). Postconceptional age had a statistically significant association with theophylline clearance in the entire group (n = 179, p less than 0.05). Duration of treatment had a small and statistically borderline effect (p less than 0.10) on theophylline clearance among nonasphyxiated infants when age factors were considered. Analysis of covariance confirmed the statistical effects of both postnatal age and asphyxia on theophylline serum clearance. PMID- 3961897 TI - Paracetamol (acetaminophen) analysis by high performance liquid chromatography: interference studies and comparison with an enzymatic procedure. AB - A simple, robust, high performance liquid chromatographic method for serum paracetamol determination in both the therapeutic and overdose concentration ranges is described. The within- and between-batch precision of the method was better than CV 5% at both micromolar and millimolar concentrations, and recovery of added paracetamol from drug-free serum exceeded 96%. No interference from any of the other drugs, drug metabolites, and dietary constituents tested was found. Performance data in the overdose concentration range has been compared with that from the enzymatic kit procedure, and results from the two assays showed good correlation (r = 0.97). PMID- 3961898 TI - Simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone. AB - A gas-liquid chromatographic method for the simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone in serum is described. The drugs and the internal standard, prilocaine, are extracted from 1 ml of serum. The procedure involves a two-step extraction and injection of the extract into a gas chromatograph equipped with a 10-ft OV-11 glass column and a nitrogen-phosphorus detector. The temperature gradient program results in a run time of 16 min and retention times for meperidine, prilocaine (internal standard), lidocaine, etidocaine, mepivacaine, methadone, and bupivacaine of 3.8, 5.4, 6.0, 8.7, 11.0, 11.7, and 14.8 min, respectively. Standard curves for all drugs were linear over the 80 to 2,000-ng/ml range and recovery of all components averaged 97 +/- 2% with the lowest detection limit of 10 ng/ml for all drugs except meperidine and methadone, which were 20 ng/ml. The within-day coefficients of variation ranged from 12 to 8% at 500 ng/ml. The day to-day coefficients of variation of the slope and intercept values ranged from 2 to 0% and 130 to 3%, respectively. Response factors of the nitrogen-specific collector varied with the drug analyzed and resulted in peak area variation at constant offset and attenuation of 30%. This method is intended and adequate for therapeutic monitoring of chronically treated pain patients who are being given various combinations of local anesthetic and/or narcotic agents. PMID- 3961899 TI - Second-set allograft responses in the earthworm Lumbricus terrestris. Kinetics and characteristics. AB - Second-set Lumbricus terrestris allografts from the same donor to the same recipient undergo accelerated rejection if transplanted less than 10 days after first-set allografts. In contrast, second-set allografts, transplanted at longer intervals (20-90 days) show no accelerated rejection. Accelerated rejection of allotransplants under these kinetic conditions agrees with earlier intrafamilial xenotransplant results obtained in earthworms affirming an essential experimental variable: the time of second-set transplantation. Accelerated rejection, weak specificity, and short-term "memory" are three characteristics of the earthworm's allogeneic cellular defense/immune system. These reactions probably result from intense responses (although of short duration) of coelomocytes activated by first transplants that are still present at the time of second-set grafting but absent or inactive at later periods. PMID- 3961901 TI - The Transplantation Society of Australia and New Zealand. Third scientific congress. PMID- 3961900 TI - Asymptomatic extravasation of contrast material in the unused bladder. PMID- 3961902 TI - Human monoclonal antibody production by xenohybridomas. PMID- 3961903 TI - Effect of immunosuppressive drugs on cell kinetics and DNA synthesis in mouse epidermis. PMID- 3961904 TI - Plasma concentrations of retinol and vitamins E and C during the first twelve months of post natal life. AB - Concentrations of retinol, vitamins E and C in cord and maternal blood samples were studied in rural health centres, polyclinics and maternities in Cross River State, Nigeria. Plasma concentrations of retinol, vitamins E and C were followed up for 12 months of post natal life. At birth cord blood levels of retinol and vitamin E were significantly lower than the maternal levels but vitamin C levels were higher. During the first twelve months of post natal life, there was a significant increase in the levels of these fat-soluble blood components but the mean was still less than one-third of the mother's level either at birth or at six weeks. However, vitamin C levels in infants showed a decrease at three months. The results are discussed in terms of nutritional and non-nutritional factors. PMID- 3961905 TI - Plasma concentration of urate, urea and creatinine in Nigerian primigravidae with pre-eclampsia. AB - Single estimations of plasma urea, uric acid and creatinine were made in late pregnancy in 34 Nigerian primigravidae with mild/moderate or severe pregnancy induced hypertension, and in 34 matched primigravidae with uncomplicated pregnancy. The differences in mean plasma concentrations of uric acid and creatinine between the pre-eclamptic patients and the normotensive controls were statistically significant, while that in mean urea levels was not. Patients with severe (proteinuric) pre-eclampsia showed significantly higher plasma urea and urate concentrations than women with mild/moderate (aproteinuric) disease, but the difference in mean plasma creatinine values between the two groups was not significant. In the pre-eclamptic group, changes in the plasma concentrations of the substances were more prominently correlated with the degree of proteinuria than the level of hypertension. Of the three substances examined, changes in the blood urate concentrations were the most pronounced. The slight fall in the mean blood urea level in patients with mild/moderate pre-eclampsia followed by an abrupt and significant rise as pre-eclampsia became severe might reflect variations in fluid distribution rather than raised urea production or impaired excretion. High blood uric acid and urea levels in women with proteinuric pre eclampsia are associated with increased fetal risk and should be an indication for closer monitoring of the function of the feto-placental unit. PMID- 3961906 TI - Serum sodium and potassium values in pregnant urban Nigerian and Caucasian women. AB - Serum sodium and potassium values were determined in the same laboratory for 250 pregnant urban Africans, 31 non-pregnant urban Africans and 155 pregnant Caucasians. The non-pregnant urban African women had significantly higher average serum sodium concentration than both pregnant groups. There was a progressive decline in serum sodium in both groups of pregnant women starting from the end of the first trimester to term. The decline in sodium concentration did not approach the level of hyponatraemia as previously reported. The fall in serum sodium concentration during pregnancy is probably a general phenomenon for pregnant women. The serum potassium concentration of the pregnant African women was not significantly higher than that of their non-pregnant counterparts. However, in pregnant Caucasians it was significantly higher than in pregnant and non-pregnant Africans. Serum potassium concentrations showed no significant variation during pregnancy. PMID- 3961907 TI - The epidemiology of onchocerciasis in Northwestern Ethiopia. AB - The prevalence of onchocerciasis has been investigated by means of quantitative skin snips for the first time in Northwestern Ethiopia. One thousand three hundred and seventy people (10%) of the population of five villages near the Sudan border were surveyed. There were 267 microfilaria carriers (19.5%) and 21 (1.5%) nodule carriers. The mean number of microfilariae per infected person was 3.6 mf/mg of skin. The infection rate in men was about three times that for women. The extent of this focus needs to be delineated. PMID- 3961908 TI - Experimental infection of humans with Ancylostoma ceylanicum: clinical, parasitological, haematological and immunological findings. AB - Experimental infection of two human volunteers with Ancylostoma ceylanicum produced patent infection. Following percutaneous infection with 1200 infective larvae, there was no evidence of skin eruption, however, severe abdominal discomfort was experienced by both subjects coincidently at various intervals. Eggs appeared in the faeces five weeks after infection; low level excretion continued until termination of the infection 30 weeks after inoculation. Infection had no significant effect on haemoglobin concentrations, total white cell counts, platelet levels or spontaneous and phytohaemagglutinin-induced lymphocyte transformations in either of the infected volunteers. Persistent eosinophilia began four weeks after infection in both infected persons; lymphocytes from one subject responded transiently to stimulation with larval antigen while lymphocytes from both infected subjects responded to stimulation with adult worm antigen. Specific IgM and IgG antibodies appeared two and six weeks after infection, respectively, and persisted for the duration of the experiment. PMID- 3961909 TI - Ventilatory function in normal Saudi Arabian adults. Observations and comparison with some Western and Eastern reference values. AB - Ventilatory function was studied in healthy non-smoking Saudi Arabian adult males from Riyadh area, and findings compared with those of some Western and Eastern populations. It was found that while the FVC and FEV1 in our subjects were lower than in American, Canadian, Jordanian, and Hongkong Chinese, these were higher than in Indian and Singapore Chinese. Most parameters of expiratory flowrate (e.g. PEF, MEF75, MEF50), however, were equal to or higher in our subjects than in American, Canadian, and Jordanian, as well as Indian and Chinese subjects. Compared to the findings in normal subjects from Jeddah, Saudi Arabia, FVC was equal to, but FEV1 and FEF 25-75 were higher in our subjects. PMID- 3961910 TI - Studies on ascorbic acid and cholesterol levels in Nigerian nomadic groups. AB - Studies on plasma and leukocyte ascorbic acid and cholesterol concentrations in 102 nomads from rural communities in Oyo State of Nigeria, as well as in 88 controls, showed no significant differences between study group and controls with respect to leukocyte ascorbic acid values; no correlation was found between ascorbic acid and cholesterol levels; no cases of clinical scurvy were observed. These findings are compared with similar results from Kenya and elsewhere. The findings suggest low but acceptable levels of plasma ascorbic acid in nomadic groups; there was no correlation between ascorbic acid and cholesterol concentrations in cases where plasma vitamin C deficiency was mild or moderate with close to normal levels of leukocyte ascorbic acid; prolonged low levels of plasma ascorbic acid may exist without overt clinical manifestations of scurvy. PMID- 3961911 TI - Prevalence and subtype of hepatitis B surface antigen (HBsAg) in the Saudi population. AB - Prevalence of HBsAg was studied in 5467 Saudi Arabians (2588 males, 2879 females) of various age groups from the Riyadh area, Central Province. Prevalence was found to be almost the same (6.3%-6.7%) in children less than 3 years of age in both sexes and reached its peak in the 10-14 years old for males (7.8%) and in the 3-9 years old for females (5.3%). The overall prevalence rate in males (5.2%) was significantly higher than that in Saudi females (3.7%); p less than 0.025. The predominant subtype in the Saudi population is ay (91%). Prevalence of HBsAg in 2140 Saudi blood donors was compared with that in 580 Filipino, 677 West European and 286 Yemeni blood donors. Prevalence was highest among Filippino males (12.1%) and lowest among West Europeans (0.4%). Prevalence among male Saudi blood donors was close to that among Yemeni blood donors (4.9%). In all three groups prevalence of HBsAg was higher in males than in females. PMID- 3961912 TI - Unilateral glaucoma. AB - A prospective study of 161 consecutive glaucoma patients conducted from June 1983 to May 1984 showed that 81 (50.3%) had unilateral glaucoma. The causes of the unilateral disease were primary open-angle glaucoma (38.3%) and secondary glaucoma (61.7%). During this year long study primary angle-closure glaucoma was not observed. The relatively frequent occurrence of unilateral primary open-angle glaucoma poses a riddle for which I have no explanation to offer. PMID- 3961913 TI - Oral labetalol in the urgent treatment of severe hypertension. AB - 15 hypertensive patients presenting with diastolic blood pressures (DBP) of 130 mmHg or higher were hospitalised and treated with oral labetolol. They all received a diuretic and 400 mg of labetolol orally initially and subsequent doses at 2, 6, 12, 18 and 24 hours depending on the level of diastolic pressure. The mean of systolic/diastolic blood pressure dropped from 241/130 mmHg to 191/125 mmHg 30 minutes after the initial dose, and to 157/103 mmHg after six hours. Of the patients 73% had DBP of 115 mmHg or less six hours after the initial dose. Oral labetolol is recommended in hypertensive emergencies when sodium nitroprusside, diazoxide or trimethaphan cannot be used as an alternative to other agents. PMID- 3961914 TI - Wilson's disease in the Commonwealth of Dominica, a case report. AB - The first case reported in Dominica of Wilson's disease is described. This is possibly the first successfully treated case in the West Indies. Wilson's disease, though rare, may occur in an unexpected setting. PMID- 3961915 TI - Neuromyelitis optica: a case report from India. AB - A young Indian male was admitted for paraplegia of acute onset and with bilateral optic neuritis. The diagnosis of neuromyelitis optica was made. This is possibly the first case report of its kind from India. PMID- 3961916 TI - Myiasis due to Dermatobia hominis in Trinidad. A case report. PMID- 3961917 TI - Thyroidectomy for life threatening giant familial goitre. AB - Urgent thyroidectomy for giant multinodular goitre causing airway obstruction was necessary in the mater familias of a family with a high prevalence of non-endemic goitre. Post operative complications are briefly discussed. Family screening revealed a 100% incidence of nodular goitre in eight first generation descendants with hyperthyroidism in one. A euthyroid pattern was found in 6 of these, as well as in 5 of 19 second generation descendants tested. In two of the first generation descendants dyshormonogenesis was excluded as an aetiological factor by the perchlorate discharge test. PMID- 3961918 TI - Lectins as surrogates for the water of Castalia: for the anatomist, pathologist, or both. PMID- 3961919 TI - Ultrastructure of the kidney in acute interstitial nephritis. AB - Fifteen percutaneous renal biopsies from patients with acute renal failure due to acute interstitial nephritis (AIN), in almost all cases due to drugs, were studied by electron microscopy. Differential counting of interstitial cells showed an average of 69% lymphocytes (small and large) and 11% macrophages. Plasma cells and eosinophils were comparatively rare. The infiltrate resembled that of acute rejection, suggesting a cellular hypersensitivity reaction. Proximal and distal tubules were severely affected focally. Migration of lymphocytes through the tubular basement membrane of otherwise well-preserved tubules was considered to be the first phase. Other tubules showed extreme thinning of the tubular basement membrane, with still intact cellular walls. Rupture of the tubular basement membrane and necrotic disintegration of tubular epithelial cells are probably late phenomena. The non-necrotic tubules displayed severe reduction of proximal brush border and proximal as well as distal tubular basolateral infoldings. Focal tubular disintegration leading to tubular block and/or backleak as well as decrease of proximal tubular sodium resorption leading to a decreased glomerular filtration (a mechanism probably also acting in ischemic acute renal failure) may all be factors responsible for the acute renal failure in AIN. PMID- 3961920 TI - Fine cytofilaments in a metastatic juvenile rhabdomyosarcoma (UP 6:341-346, (1984) PMID- 3961921 TI - Cytochemistry and ultrastructure of normal and neoplastic cells exfoliated from the human uterine cervix. AB - Cells exfoliated from the uterine exocervix from normal women at different stages of the reproductive period and from patients with invasive carcinoma were studied. Cell pellets were fixed in aldehydes and two different concentrations of OsO4, and embedded in methacrylate or Epon. Semithick sections were used for general light microscopic study and for the visualization of glycogen. Ultrathin sections were used for conventional electron microscopy, high resolution analysis of the plasma membrane, and the demonstration of glycogen and cell surface glycoconjugates by the Thiery method. Semithick sections stained with the Thiery method and viewed under the electron microscope were used for the study of surface projections. Based on the size, shape, nuclear characteristics, amount and distribution of glycogen, type of surface protrusions, density and distribution of surface glycoconjugates, and plasma membrane fine structure, the cells exfoliated from all normal uterine cervices were grouped into five cell types. It is suggested that these types correspond to cells located in the different layers of the exocervical epithelium and, consequently, represent different degrees of normal differentiation. The plasma membrane of carcinoma cells shared most of the characteristic of that of the least differentiated normal cells, indicating an early deviation of the differentiation process in carcinoma cells. PMID- 3961922 TI - Ultrastructural study of a clear cell sarcoma suggesting schwannian differentiation. AB - A clear cell sarcoma that developed on the left back of a 19-year-old Japanese female was studied ultrastructurally. The findings included basal laminae, desmosomelike junctions, cytoplasmic interdigitations, lamellar bodies, and immature melanosomes. These findings suggest schwannian differentiation of this tumor, since they are not usual features of malignant melanoma except for melanosomes. Therefore this tumor seems to be more akin to malignant schwannoma than to malignant melanoma. PMID- 3961923 TI - Ultrastructure of sinusoidal cells in a benign liver cell adenoma. AB - A typical benign liver cell adenoma was removed from a 25-year-old female taking an oral contraceptive. The biopsy was perfusion-fixed, allowing good visualization of sinusoids and sinusoidal cells. Kupffer cells were seldom seen. Endothelial cells were of irregular thickness; most of them had few fenestrae and were attached to each other by well visible junctions. Normal perisinusoidal cells (PSC) were not seen but were replaced by myofibroblast-like cells with thick subendothelial processes. A basement membrane often underlaid endothelial cells and the processes of PSC. The enlarged Disse space with a flattened sinusoidal hepatocyte membrane contained occasional red blood cells and an abundant extracellular matrix but few collagen fibers. These sinusoidal abnormalities leading to the capillarization of sinusoids, either the cause or the consequence of the disease, indicated a loss of normal hepatocyte homeostasis. PMID- 3961925 TI - Crystallization in soft tissue neoplasm. PMID- 3961924 TI - Ultrastructure of fibrous dysplasia of bone: a study of its fibrous, osseous, and cartilaginous components. AB - Eight cases of fibrous dysplasia were evaluated by electron microscopy and the findings were correlated with the light microscopy. Fibroblasts and myofibroblasts were the cells seen in the fibrous component. The osseous component consisted of immature woven bone trabeculae lined by abnormal osteoblasts with a fibroblastlike appearance. The cartilaginous component resembled hyaline cartilage. The process of mineralization of both osseous and cartilaginous tissues appeared similar to normal bone and cartilage. In fibrous dysplasia there is a slow turnover of bone, and this correlates well with the flattened shape of the bone-lining cells. When compared with normal ossification, the process of bone formation appears to be arrested after an early stage resembling membranous ossification. It is possible that the abnormal osteoblastic maturation of the bone-forming mesenchyme is one of the most important alterations of this condition. PMID- 3961926 TI - Immunohistochemistry and diagnostic electron microscopy. PMID- 3961927 TI - Campylobacter-like organisms and surface epithelium abnormalities in active, chronic gastritis in humans: an ultrastructural study. AB - A prospective light and electron microscopic study of repeated endoscopic gastric biopsy specimens obtained from 10 patients presenting at the first examination for long-standing erosive gastritis was performed. In nearly all specimens from 7 patients, spiral bacteria were found in close contact to the surface epithelial cells and associated with active inflammatory changes. These organisms appeared similar to those recently described as gastric "campylobacter-Like organisms" (GCLO). It is possible that they are related to unusual anaerobic spirochetes. In the specimens obtained after antibiotic-therapy the bacteria were few in number and damaged. At the ultrastructural level, the presence of cell necrosis and autolytic intracytoplasmic vacuoles combined with damaged bacteria may suggest a relationship between GCLO surface colonization and erosive epithelial abnormality. Such colonization does not occur in normal mucosa. PMID- 3961928 TI - Soft tissue tumor with prominent leptomeric fibrils and complexes. AB - A recurrent soft tissue tumor from the groin in a 37-year-old male is described. The tumor cells contain many leptomeric structures, both fibrils and complexes, but none of the other characteristic features of striated muscle: alternating parallel thick and thin myofilaments with Z-line material. A review of one rhabdomyoma and six rhabdomyosarcomas demonstrates that leptomeric structures are present in large amounts in the rhabdomyoma but are very infrequent in only three of the six rhabdomyosarcomas. A careful search for leptomeric structures is indicated when the ultrastructural diagnosis of either rhabdomyoma or rhabdomyosarcoma is being considered. PMID- 3961929 TI - Heterogeneity of epithelial cells and reactive components in thymomas: an ultrastructural and immunohistochemical study. AB - Fourteen thymomas were studied by electron microscopy and immunohistochemistry. Based on the ultrastructure of the neoplastic epithelial cells in comparison with normal thymic epithelium, four cortical-, three mixed-, five medullary-, and two corpuscular-type tumors were categorized. Histologically the tumors of cortical type showed prominent lymphocytic infiltration, but scant interdigitating reticulum cells (IDCs) were demonstrated by immunoperoxidase method on paraffin sections with anti-S-100 protein antiserum. Fewer lymphocytes but more IDCs were present in the tumors of medullary and corpuscular types, although variable in those of mixed type. This corticomedullary difference among thymomas was confirmed in some of them by the immunoperoxidase method on frozen sections with monoclonal antibodies. The cortical-type tumors were HLA-DR positive in tumor cells and infiltrated predominantly with cortical thymocytes (OKT-6+, OKT-3-, both Leu 3a/3b+ and OKT-8+), whereas the medullary- and corpuscular-type tumors were HLA-DR positive primarily in IDCs but not in tumor cells and were infiltrated more with medullary thymocytes (OKT-6-, OKT-3+, either Leu 3a/3b+ or OKT-8+). The classification of thymomas based on neoplastic epithelial cells will serve to refine the traditional classification based on reactive lymphocytes. PMID- 3961930 TI - An ultrastructural study of mast cell interactions in hemangiomas. AB - Hemangiomas, the most common tumors of infancy, are characterized by a postnatal period of rapid growth, followed by a phase of gradual involution. The proliferative phase is characterized by increased numbers of endothelial and mast cells and thickened basement membrane. Ultrastructural analysis of hemangiomas in the late proliferative phase showed that mast cells had numerous fingerlike processes aligned parallel to the outer lamina of the thickened basement membranes surrounding the vessels and to the surfaces of opposing cell membranes. We found evidence of different types of interactions between mast cells and adjacent connective tissue cells (fibroblasts, macrophages, multinucleated giant cells, and plasma cells) in the perivascular regions of the lesions. Intercellular contacts were observed in areas where these mast cell processes were in close association to the opposing cell membrane. Areas of membrane fusions were seen between cell types. Coated vesicles and pinocytotic vesicles were present along the periphery of cells adjacent to mast cells. Occasionally, cytoplasmic bridges were found between mast cells and fibroblasts. These ultrastructural findings suggest the proliferation and involution of hemangiomas are determined by interactions between the various types of cells found in the lesions. PMID- 3961931 TI - Unusual endocervical polypoid tumor with endocrine cells: an immunohistochemical and ultrastructural analysis. AB - Light microscopic, immunohistochemical, and ultrastructural features of an unusual polypoid tumor of endocervix are reported. Numerous polypeptide hormone and amine-producing endocrine cells were disclosed. Main conventional characteristics were the architectural growth pattern, with infolding glands giving rise to small secondary glands, the hypermucinous benign-appearing epithelium of endocervical type, and, possibly, the stromal smooth muscle. Ultrastructural analysis showed a highly differentiated tumor. Glandular elements were surrounded by a basal lamina. Mucinous cells, several endocrine cell types, amphicrine cells, nonsecretory ciliated cells, ciliated mucinous cells, and possible reserve cells were observed. This tumor departs appreciably from normal mucosa and common varieties of endocervical polyp, particularly its distinctive endocrine profile. The present case does not correspond to a well-defined type of endocervical neoplasia. It shares morphologic analogies with mucinous tumor of ovary. The malignant potential of this lesion as well as its relationship with minimal deviation adenocarcinoma remain questionable. PMID- 3961932 TI - [Pain is most frequently of organic origin]. PMID- 3961933 TI - [Resistance to treatment in duodenal ulcer]. PMID- 3961934 TI - [Visual acuity tests for non-verbal children: preferential looking]. PMID- 3961935 TI - [Femoral neuropathy secondary to hematoma or aneurysm]. PMID- 3961936 TI - [Cytogenetic and occupational medicine study of 28 laboratory technicians in a research laboratory]. PMID- 3961937 TI - [Talocrural alloplastic operation in painful arthrosis of the ankle joint]. PMID- 3961938 TI - [Screening for breast cancer. A pilot study, planning, course and preliminary results]. PMID- 3961940 TI - [Hepatic silicosis]. PMID- 3961939 TI - [Re-mediastinoscopy]. PMID- 3961941 TI - [Botulism in the Faeroe Islands]. PMID- 3961942 TI - [Functions of industrial medical officers in Norway and Sweden]. PMID- 3961943 TI - [A model of interpretation of disease in the population. Populations' attitude to disease illustrated by an epidemiological study among persons aged 45 in the county of Copenhagen]. PMID- 3961944 TI - [Mortality among gas workers]. PMID- 3961945 TI - [Connection between weight and gestational age in Danish children born in 1983]. PMID- 3961946 TI - [Paracetamol poisoning]. PMID- 3961947 TI - [Difficulties in diagnosing aplastic anemia in children]. PMID- 3961948 TI - [Perineometer for the measurement of vaginal pressure]. PMID- 3961949 TI - [Diabetic hyperosmolar non-ketotic coma. A retrospective study from a central hospital of patients admitted over a 20-year period]. PMID- 3961950 TI - [Duration of the self reported period of limitation of function after sprains and fractures]. PMID- 3961951 TI - [Traumatic fracture of the cartilage of the ear without accompanying skin lesion]. PMID- 3961952 TI - [Extensive acute transmural myocardial infarction without change in the QRS complex]. PMID- 3961953 TI - [Bartter's syndrome in 2 triplet sisters treated for 7 years with indomethacin]. PMID- 3961954 TI - [Neurosyphilis in a patient treated with benzathine penicillin (Penilente) for positive syphilis serology]. PMID- 3961955 TI - [Avascular necrosis of the head of the humerus]. PMID- 3961956 TI - [Vascular changes in carcinoid tumors of the small intestine]. PMID- 3961957 TI - [Maximal corrosive stenosis of the esophagus. Retrograde dilatation of the esophagus after alkaline corrosion followed by prolonged autodilatation]. PMID- 3961958 TI - [Ethinyl estradiol in therapeutic and occupational situations]. PMID- 3961959 TI - [Occurrence of psychiatric disease in a Danish population group aged 40]. PMID- 3961960 TI - [Survival of patients admitted to hospitals for somatic disease]. PMID- 3961961 TI - [Female alcoholics. Occurrence and characteristics]. PMID- 3961962 TI - [Mortality in Greenland 1968-1983]. PMID- 3961963 TI - [Ischemic colitis]. PMID- 3961964 TI - [Genetic diagnosis and counseling in perinatal death]. PMID- 3961965 TI - [Trismus]. PMID- 3961966 TI - [Employment of calcium antagonists in extracardial diseases]. PMID- 3961967 TI - [Gynecomastia]. PMID- 3961968 TI - [Occurrence of intolerance to coloring agents in children with eczema]. PMID- 3961969 TI - [Elbow replacement in patients with rheumatoid arthritis]. PMID- 3961970 TI - [Inhalation anesthesia in a completely closed circuit. A method of reducing the amount of anesthetic]. PMID- 3961971 TI - [Coccygodynia treated by excision of the coccyx]. PMID- 3961972 TI - [Ischemic colitis and ergotamine abuse]. PMID- 3961973 TI - [Children's anxiety about nuclear war]. PMID- 3961974 TI - [Psychological and sexual problems following male sterilization]. PMID- 3961975 TI - [Riding accidents in the County of Fredriksborg. A one-year prospective study]. PMID- 3961976 TI - [Primary venous thrombosis of the arm]. PMID- 3961977 TI - [Deep venous thrombosis of the upper extremity. A radiographic evaluation]. PMID- 3961978 TI - [The effect of urethropexy by the Lapides method in incontinent women]. PMID- 3961979 TI - [Registration of research results by means of microcomputers]. PMID- 3961980 TI - [A study of word material in clinical speech audiometry]. PMID- 3961981 TI - [Tympanoplasty on the sole hearing ear]. PMID- 3961982 TI - [Anemia in crural ulcers. A retrospective study]. PMID- 3961983 TI - [The nutritional status of patients with alcoholic cirrhosis]. PMID- 3961984 TI - [Poisoning with Hexite smoke ammunition]. PMID- 3961985 TI - [Bronchial asthma--precipitated by zinc chloride]. PMID- 3961986 TI - [Polyneuropathy in benign monoclonal gammopathy]. PMID- 3961988 TI - [Agenesis of the veriform appendix and cecum]. PMID- 3961987 TI - [Lichen planus in primary biliary cirrhosis treated with penicillamine]. PMID- 3961989 TI - [General practitioners and home childbirth]. PMID- 3961990 TI - [Adverse reactions during therapy with non-steroidal anti-inflammatory preparations in Denmark over a 15-year period]. PMID- 3961991 TI - [Mammographic examinations in Denmark in 1984]. PMID- 3961992 TI - [Mineral fiber content in the indoor atmosphere of a day institution. Determination of the 24-hour variation]. PMID- 3961993 TI - [Occurrence of epileptic syndromes in children. Employment of a new diagnostic list studied in a Danish county in a retrospective study of medical records]. PMID- 3961994 TI - [Accidents caused by winter sports. Injuries and occurrence]. PMID- 3961995 TI - [Dihydroergotamine in connection with surgery]. PMID- 3961996 TI - [Clinical aspects of hemostatic balance]. PMID- 3961997 TI - [Continuous peritoneal dialysis of diabetic patients with end-stage renal insufficiency]. PMID- 3961998 TI - [Incorrect diagnosis of ovarian pregnancy at surgery]. PMID- 3961999 TI - [Baclofen (Lioresal) poisoning. A case report of baclofen poisoning]. PMID- 3962000 TI - [Changes in the sense of taste in glucocorticoid-induced adrenal cortex insufficiency]. PMID- 3962001 TI - [Hospital autopsies are omitted to an increasing extent. The incidence of autopsies in Odense Hospital 1975, 1979 and 1984]. PMID- 3962002 TI - [The influence of various factors on the age for the commencement of the menopause]. PMID- 3962003 TI - [First aid requirements at large youth soccer rallies]. PMID- 3962004 TI - [Health services in Eritrea ravaged by war and stricken by drought]. PMID- 3962005 TI - Lack of effect of pulsed ultrasound on ABO antigens of human erythrocytes in vitro. AB - The efficacy of pulsed ultrasound in removing ABO blood group antigens from human erythrocytes was investigated in vitro. Cell suspensions were exposed to 5.25 MHz focused ultrasound with 1.23 microseconds pulses, at 0, 20, and 37 degrees C using spatial peak, pulse average intensities of 11, 126, and 1000 W/cm2 and pulse spacings of 10, 100, and 1000 microseconds. A second experiment involved application of 7.5 MHz pulses of 0.77 microseconds duration and 8 W/cm2 SPPA intensity which were spaced 1.25 ms apart. Exposed cells were tested for agglutination by antibody to determine changes in antigen expression. In addition, supernates from exposed cells were tested for the presence of soluble antigen. A sensitive capillary tube agglutination technique was developed for these experiments. No detectable antigen removal occurred as a result of any of the pulsed ultrasound exposures as compared to sham exposures. A positive control, which employed antigenic material prepared from cells disrupted by ultrasonic cavitation, indicated that the assay could detect the soluble antigen equivalent of about one cell in 10,000. PMID- 3962006 TI - Ultrasonically induced intravascular streaming and thrombus formation adjacent to a micropipette. AB - Ultrasonically induced microstreaming around bubbles of gas have been shown to cause damage to biological materials in vitro at clinical exposure levels. The potential for ultrasonically induced cavitation and microstreaming in mammalian systems is of interest with respect to the safe application of clinical ultrasound. Ultrasonically induced intravascular microstreaming and formation of thrombi at 1 MHz is demonstrated adjacent the tip of a micropipette in contact with a mesenteric vessel of the mouse. These effects occur at or above therapeutic levels. PMID- 3962007 TI - Absorption of longitudinal and shear waves and generation of heat in soft tissues. AB - The author analysed the oblique incidence of a longitudinal plane wave and the generation of a shear wave at a boundary between a soft tissue and a gas, considering a viscoelastic model (Voigt solid) of the medium. From the data measured by Frizzell et al. (J. Acoust. Soc. Am. 60, 1409-1411) for shear waves, the average velocity 30 m/s and the average absorption coefficient 7.7 X 10(3) cm 1 at the frequency of 5 MHz were assumed for calculations. The amplitude and the intensity of the generated shear wave were obtained and hence the rate of heat production per unit volume was determined. At the boundary, this quantity was found to be of the same order of magnitude for the generated shear wave as for the incident longitudinal wave. In the case of the shear wave, which propagates almost perpendicularly to the boundary, it decreases rapidly with the distance. Therefore, the temperature increase caused by shear waves was negligible in respect to longitudinal waves in spite of the extremely high absorption coefficient. This conclusion could be confirmed by solving the inhomogeneous equation of heat conductivity for the case under consideration. PMID- 3962008 TI - Phased array ultrasound imaging through planar tissue layers. AB - Conventional ultrasound imaging devices are designed based on the assumption of a homogeneous tissue medium of constant acoustic velocity = 1540 m/sec. However, the body consists of tissue layers of varying thicknesses and velocities which range from 1470 m/sec in fat to 3200 m/sec in skull bone. Refraction effects from these layers degrade ultrasound image quality. In this paper, pulse-echo ultrasound imaging is modeled as imaging an organ of interest through an intervening planar tissue layer, such as liver through fat in the abdomen or brain through skull bone in the adult head. Refraction effects from planar tissue layer interfaces are analyzed using Snell's law and measured using phantoms. We also introduce an on-line phased array correction technique based on planar tissue layers to restore ultrasound image quality. We conclude that fat/organ planar interfaces do not degrade image quality significantly. However, refraction effects at a skull/brain planar interface degrades resolution and target acquisition and introduces geometric distortion. Our plane layer phased array correction technique significantly improves image quality in phantoms through lucite aberrators and improves adult cephalic ultrasound image quality when used through the top of the adult skull. The correction technique is robust even in the presence of inaccurate estimates of skull thickness. PMID- 3962009 TI - [Determination of rotational defects of the femur by computer tomographic determination of the antetorsion angle of the femoral neck]. AB - The first of all unexplained but persisting static complaints after femoral fractures are due to rotational deformities. The clinical examination can only sustain the suspicion of a rotational deformity but can not determine its exact extent. The usual X-ray determination of the anteversion angle in the technique of Dunn and Rippstein as a measure for torsional deformities is often very difficult, because of the exact positioning conditions of patients with posttraumatic axial deformities, soft tissue contractures and painful motility restrictions. With the total body computertomography we have a safe and quick technique, independent of the patient's positioning, to determine the anteversion angle without problems. In comparing the two sides, the rotational deformity can be recognized and its extent can exactly be measured. Because of the simple technique and the exact determination of rotatory deformity a computertomographic measuring of the anteversion of the femoral head always should be made before planning a corrective osteotomy to fix the extent of correction, whenever a total body scan is available. PMID- 3962010 TI - [Deficient precision in medical treatment--role of the expert witness in the liability process]. AB - The medical expert as evidence in a liability process is himself under the criteria of accuracy which he has to proof by the doctor of his choice, for presentation at court. To know the viewpoints and circumstances are an assumption to judge the apparent lack of accuracy of the concerned person. PMID- 3962011 TI - [Perfectionism or practicability in osteosyntheses--limits of the carefulness responsibility]. AB - The discussion of these complex themas can only partially try to show the way to successful osteosynthesis for not only the patient as also for traumatologists and orthopedic surgeons. "Perfection or practicability"-this question is to be answered so that exaggerated perfection, as seen overall in surgery, is not foundation of the successful result. On the contrary, osteosynthesis procedures conceived so that they are generally practicable and employable for those colleagues who are experienced and have confidence with the material. Perfection should not be isolated as bare organ surgery. At the same time it is clearer that it is not possible to stop the specialization in bone surgery. In its place arises the necessity of an interdisciplinary cooperation of all surgical specialties. These demands will justify our current concept of treatment under the condition that the surgeon realizes his limitations in difficult situations and behaves accordingly. Practicable and even to perfection is however the relationship of the bone surgeon to the patient who is injured in an accident. The professional assessment of the true or the apparent failures after osteosynthesis must observe the written laws. Mistakes, which reveal the ignorance and which grossly contradict the limiting prerequisites of the guidelines for the execution of osteosynthesis are to be appraised as such. The professional consultant, himself, must be so confident with the practice of osteosynthesis so that he can implement an objective and critical estimation of the situation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962012 TI - [Liability problems in endoprosthetics]. AB - The alloarthroplasty is a successful operation in coxarthrosis. It is a procedure not including alone the possibility of alternative treatment but also many certain and uncertain risks. Patients wishes are not always to realise so increased number of demands are in this way to expect. PMID- 3962013 TI - [Medical responsibility for disclosure in legal cases of the German federal court]. AB - The principles herein discussed show yet again that in determining the physician's duty of disclosure, courts rely on general standards and statutory provisions which they then apply more particularly to the facts of the individual case. Physicians, however, are apprehensive of such flexibel criteria, and perhaps even prejudiced against "the lawyers" who, rather than directing their attention to the needs of the individual doctor-patient relationship, tend to think in terms of the principles involved. To quote a distinguished English judge, "It is always easy to be wise after the event". This, of course, is one thing the physician cannot afford to be. Although courts may have the benefit of hindsight, a physician must assess the patient's informational needs at the outset: a problem he has to learn to live with and for which the lawyer must develop a greater understanding. But in so doing, the lawyer must not lose sight of the patient, who is at the mercy of the physician and can easily fall victim to his lack of diligence. In summary, in defining the extent of the physician's duty to inform, particularly in respect of possible or as yet unknown side effects, the general standards referred to above must be applied, bearing in mind the facts of the individual case, such as the urgency of the proposed treatment, its severity and inherent risks, possible side effects, and the patient's educational background, as well as the possible effect of disclosure on his mental and emotional well-being. PMID- 3962014 TI - [Practice of medical disclosure: protection of the patient--protection of the physician]. AB - In practice, the information given to the patient prior to surgical procedure has to be adjusted to the individual case - and this not only because it is required by law. Although all protective measures taken by the physician against his patient may be useful from the juridical point of view, they often turn out to be insufficient in case of legal action when the burden of proof regarding the information given to the patient lies on the physician. This is due to the fact that a lack of understanding can be conceded even to the most emancipated patient, despite his personal signature, because the psychical conditions under which such a conversation is held are difficult to assess. The conversation without witness, the substance of which is then discussed in the presence of the patient has proved to be at least as sufficient as any signed form. This procedure avoids to strain the relation between physician and patient with juridical problems, a situation which is not at all desired by the wellminded patient seeking for help as well as by the responsible physician. PMID- 3962016 TI - Simulation of physiological ureteral peristalsis. AB - Occlusive ureteral peristalsis is simulated in an enlarged technical model of the ureter with a lobe-shaped lumen. The local pressure pulse is measured with catheters of different caliber and the influence of the catheters size and position on the uromanometrogram (UMG) is examined. The measurements are compared with UMGs at pathologically changed conditions (stagnation, residual urine depot etc.) and suggestions are given concerning size and shape of catheters to be used for urodynamic measurements. PMID- 3962015 TI - [Conservative or operative fracture treatment--alternative information in relative indications]. AB - The aim of every treatment of bone fractures is the recovery of function. The treatment - conservative or operative - assumes the consent of the patient. This consent is only effective, if the patient is well informed about course and risks of the treatment. In case of alternative indication the information has to be alternative in reference to the typical risks. The information of the patient before immediate operative treatment and alternative indication might be problematic. It is possible to renounce any information but renunciation of information assumes a basic knowledge of both possible kinds of treatment. PMID- 3962017 TI - Clinical reevaluation of the effect of oxybutynin chloride on uninhibited neurogenic and reflex neurogenic bladder. AB - Oxybutynin chloride has been clinically used for the relief of symptoms associated with voiding in patients with uninhibited neurogenic and reflex neurogenic bladder in the USA. The present clinical and urodynamic studies were the first meticulously in patients with uninhibited neurogenic and reflex neurogenic bladder in Japan. A single oral dose of oxybutynin chloride (3 or 6 mg) did not induce any change either in subjective symptoms or in urodynamic studies; however, in the continual administration study, 7 of 9 patients showed an improvement in the symptoms associated with voiding. The drug reduced urinary frequency, urgency and incontinence, and significantly increased the volumes at the first desire to void (FDV) and maximum desire to void (MDV) in cystometry. Furthermore, no serious adverse reactions were observed, and hence the drug seems to be of clinical significance. PMID- 3962018 TI - Coecocystoplasty: an evaluation of operative results. AB - Coecocystoplasty for substituting or augmenting the bladder is a relatively common operation in the United States, but not in Scandinavia. In order to focus the attention on this voiding-preserving operation we evaluated the late postoperative results of 8 patients. Median follow-up was 5 years. Seven of the patients had symptoms from a contracted bladder and 1 patient with epispadias was undiverted from a ureteroileocutaneostomy. There were some early postoperative complications. Two patients had a revision of the coecocystoplasty, 1 patient ended up with a ureteroileocutaneostomy and 1 patient needed a nephrectomy because of a perirenal abscess. The patient with epispadias later had an artificial urinary sphincter because of persisting incontinence. At follow-up time all patients found that they had a better life than prior to operation since the invalidating symptoms from the contracted bladder had disappeared. One patient with residual urine had chronic urinary tract infection. All patients were continent at daytime, 3 patients had nocturnal incontinence. Urodynamic studies showed no infravesical obstruction and bladder capacity between 75 and 380 ml H2O. Three patients had decreased renal function. Based on our limited material we conclude that coecocystoplasty is a reasonable, though not unproblematic, treatment in patients with severe symptoms from a small contracted bladder and a therapeutical alternative in patients with a previously defunctionalised bladder and that this method should always be taken into consideration before a urinary diversion. PMID- 3962019 TI - Simultaneous measurement of pressure profile and pull-through force in the urethra of 25 female patients. AB - Simultaneous registration of urethral pressure profile and pull-through force was performed to study the dynamics of sphincteric function in 25 female patients. Three separate types of catheters of six different sizes were used. A 6-French smooth catheter was used to measure maximal urethral closure pressure, functional profile length and length to maximal urethral pressure. The results were divided into three groups (A, B and C) with significantly different closure pressure values, only correlated to the age of the patient. In all three groups (A, B and C), the mean maximal urethral closure pressure increased in linear correlation to the catheter diameter and did not bear any relation to the shape of the catheter tip, either of the bulb or the ball type. A significant exponential correlation was demonstrated between pull-through force and catheter diameter. Also the correlation between force and length of the pull-through force curve was exponential, while only the mean values of closure pressure and force correlated exponentially. No further correlations were found, even after force values were ranked to form three other groups (I, II and III). In contrast to the groups A, B and C, no distinct differences in clinical diagnosis was noticed between groups I, II and III. The pressure and force curves can be explained on a physical basis, despite the variety in pathology. On the basis of this evidence it appears that a more accurate measurement of sphincter function in the female can be obtained by measuring pressure and force simultaneously with different sizes of catheters, especially with a diameter of 15 French or more. PMID- 3962020 TI - Incontinence operation for postprostatectomy incontinence. AB - The pathophysiological considerations for regaining continence are discussed first. Our operation method for postprostatectomy incontinence is described and the results enumerated. The success rate is approximatively 80%. PMID- 3962021 TI - Value of clinical decision on antibiotic treatment of fever episodes following transurethral resection of the prostate. AB - The value of clinical decision on antibiotic treatment of fever episodes following transurethral resection of the prostate was assessed in 134 patients. Besides bacteriuria, need of blood transfusions and various catheter problems were associated with a significant number of fever episodes. The majority of patients with fever not given antibiotic therapy had negative urine cultures (90%), whereas 41% of the patients with fever treated with antibiotics showed negative urine cultures indicating an overtreatment of these patients. Out of the total number of patients, only 10% with subsequent negative urine cultures received antibiotics, a figure which should be compared to the inevitable rate of overtreatment when general antibiotic prophylaxis is preferred. PMID- 3962022 TI - Unilateral pyonephrosis with septic thrombosis of the renal vein and vena cava. AB - A case of unilateral abscess-forming pyonephrosis with thrombosis of the renal vein and of the adjacent wall of the vena cava will be presented. This septic thrombosis as a consequence of an antecedent septicemia appears to be a late complication of pyonephrosis. In the differential diagnosis renal carcinoma could not be excluded whether pre- nor intraoperatively. PMID- 3962024 TI - The use of the large and small bowel in urologic surgery. PMID- 3962023 TI - An active artificial ureter with autonomous energy supply. AB - For long-term ureteral replacement an artificial ureter has to be able to pump against the outflow resistance into the bladder at any physiological flow rate (0.2-2.0 ml/min). This demand is satisfied only by active prostheses. The active prosthesis described in this paper is driven by the intra-abdominal pressure fluctuations caused by the respiratory movements. The comparison of in vitro results with the parameters of physiological peristalsis proves the applicability of the prosthesis at physiological conditions. Compared to active prostheses with foreign energy supply, this concept promises less burden for patients. PMID- 3962025 TI - Transverse colon conduit diversion. AB - The versatility and other advantages of the transverse colon conduit for urinary diversion have been described and implemented in 50 patients. Because most patients considered for this procedure will be at high risk because of a history of significant pelvic irradiation, underlying malignancy, poor renal function, fistula, and so forth, the technical details of surgery and patient selection cannot be minimized. The transverse colon segment is indicated for primary supravesical diversion as well as for salvage of problems related to ileal conduits. Adenocarcinoma of the colon is an unlikely long-term complication of this form of diversion because the fecal stream is absent. Now that the transverse colon conduit has been used for more than 10 years, meaningful comparisons with ileal segments should soon be available. PMID- 3962026 TI - Ileocecal segment for temporary and permanent urinary diversion. AB - The ileocecal conduit and its antirefluxing component have functioned well and have prevented many of the upper-tract complications associated with other forms of diversion. Its future role remains to be determined. Today, continent forms of diversion, such as the Koch pouch and the continent ileocecal reservoir, are being studied and are becoming popular. A continent antirefluxing form of urinary diversion is the ideal we are striving to achieve. PMID- 3962027 TI - Continent ileal urinary reservoir (Kock pouch). AB - The Kock pouch has three major limitations at the present time: The efferent nipple valve remains by far the weakest link in the procedure. A 10 to 20 per cent failure rate is too high, and it remains to be seen whether further modifications will be successful in the long run. The long-term function is unproven, and it is possible that deleterious effects may be seen as additional follow-up is obtained. Theoretically, the low-pressure system afforded by the Kock pouch may be superior in long-term safety to that provided by reservoirs made from other bowel segments. A stoma is still necessary. In spite of the above, there is a need for this type of procedure. We cannot remain content with the ileal conduit and should continue to search for better functional diversions. It is a debatable issue relative to the superiority of an internal functional reservoir to the urethra, which may lead to night-time incontinence, versus a Kock pouch with a stoma, which must be intubated. Improvement in overall survival from bladder cancer may be hard to come by, unless effective systemic chemotherapy is available; one means is to perform the surgery without delay in patients with potentially lethal cancers. To do this on a large scale, we must make the surgery as safe as possible and provide the least disruption of lifestyle. In some patients an internal intestinal reservoir attached to the urethra will be possible. Other patients may elect for a Kock pouch, whereas others may even be best served by standard ileal conduit. The growth pains of the Kock pouch have been significant but not without a reward. PMID- 3962028 TI - Radical cystectomy with preservation of sexual and urinary function. Use of the ileocolonic pouch ("Le Bag"). AB - Current surgical technique allows radical cystectomy to be performed with preservation of both sexual and urinary function. An ileocolonic pouch (Le Bag), is created to replace the bladder, with anastomosis directly to the urethra. Continence depends on the inherent function of the residual sphincter mechanism. The ileocolonic pouch results in a highly compliant, low-pressure reservoir with a reliable antireflux ureteric implantation. PMID- 3962029 TI - Use of the Mitrofanoff principle in urinary reconstruction. AB - The catheterization of a urinary reservoir by way of a narrow conduit such as appendix or ureter has proved a very successful additional technique in urinary reconstruction. The Mitrofanoff principle can be added to our armamentarium in a variety of clinical settings. Closure of the vesical neck, as indicated in previous reports, is not necessarily required. PMID- 3962030 TI - The Boyce-Vest operation for exstrophy of the bladder. 35 years later. AB - Twenty-four patients with exstrophy of the urinary bladder (23 patients) or epispadias (1 patient) who were treated by the Boyce-Vest operation have been followed for a total of 482 patient-years (range 3 to 34 years, mean 22 years). In all patients upper urinary morphology and renal function have remained normal, and those with preoperative compromise have stabilized or improved. Postoperatively, no patient has developed an electrolyte imbalance or metabolic acidosis requiring treatment, urinary calculi, or malignant change in the vesicorectal reservoir. Although the procedure and the exstrophy-epispadias complex present many unresolved of management. The infant with exstrophy of the urinary bladder appears best served by early neonatal closure of the exstrophic bladder as described by Jeffs, 6,8 with attempts at establishing urinary continence later in childhood. 6,8,11 When other methods to establish urinary continence are unsuccessful and satisfactory anal continence has been demonstrated, the Boyce-Vest procedure offers an acceptable long-term alternative to establish sphincteric urinary continence. Properly managed, the newborn with uncomplicated exstrophy should have a life expectancy equal to that of any other neonate. More importantly, it is within our ability to provide such patients with adult social acceptability and relative freedom from urinary disease. PMID- 3962031 TI - Use of bowel in undiversion. AB - Urinary undiversion is becoming an uncommon procedure because fewer patients are being diverted. The lessons learned from undiversion, however, have made possible early primary reconstructions in patients who would previously have been candidates for diversion. Intermittent clean catheterization and the use of bowel to augment or form a compliant storage vessel for urine have permitted reconstruction in patients with abnormal bladder and urethral function. Thus patients with neurogenic bladder or with severe lower urinary tract abnormalities can look forward to healthy kidneys and urinary continence without the use of appliances. Certainly there are yet many lessons to be learned, but the potential is just starting to be appreciated. PMID- 3962032 TI - Contractile behaviour of the human pyelo-ureteral musculature. I. Contraction frequency/force relationship. AB - 405 normal and pathological ureteral and pyelic strips were electrically stimulated according to different schemes. Reflux strips produced stronger contractions than normal ones; transversally excised strips contracted stronger than longitudinal ones. The amplitude of a test pulse after a series of stimuli increased with increasing delay until a constant value (at 30 s). The first contraction after a rest period had a lower latency and higher amplitude ("rest contraction"). The time to peak force of contractions was constant. Elongation of the strips increased the amplitude but not the latency of the contractions. In the discussion the similarities between the contractile behaviour of the pyeloureteral muscle and of the heart are discussed. PMID- 3962033 TI - "Open perineal cryosurgery" in carcinoma of the prostate--a possible curative alternative. AB - 101 Patients with different stages of carcinoma of the prostate underwent "open perineal cryotherapy" between September 1976 and December 31, 1983. The age of the patients varied between 44 and 80 years. The benefit of this method was a lower rate of complications than in radical prostatectomy with a similar cummulative survival rate in stage B disease. No immunological response was found in this study. Neopterin values--an easily detectable parameter for the T lymphocyte-macrophage-activity and urinary neopterin excretion immediately after cryosurgery remained in the normal range. In stage D patients no metastases disappeared. Further studies showed no effect on the pituitary gonadal axis after cryotherapy of the prostate. PMID- 3962034 TI - Contractile behaviour of the human pyelo-ureteral musculature. II. Repetitive electrical stimulation effects. AB - In normal proximal and distal pyeloureteral human strips and in pathological reflux or obstructive segments the influence of repetitive electrical stimulation at frequencies between 0.01 and 200 Hz on their contractile behaviour was studied. Between 0.01 and 1 Hz baseline tone and maximum amplitude of contraction were dependent on stimulation frequencies, but some strips showed an irregular response pattern. At frequencies between 1 and 200 Hz half of the strips showed a typical "on" and "off" contraction (at the beginning and end of the stimulus period respectively) separated by a plateau. We consider the "off" reaction to be a response to an ionic displacement at the end of the stimulus. Spontaneous activity was mostly observed in Tyrode solution and in calix and pyelum. Transmural nerve stimulation did not change the contraction patterns. PMID- 3962035 TI - The effect of ritodrine and glucagon on the acutely obstructed canine ureter. AB - The effects of 22 micrograms/kg/h glucagon and 240 micrograms/kg/h ritodrine infusions on the electrical activity and the intraluminal pressure of an acutely obstructed canine ureter have been studied. Acute obstruction of the ureter increased the rate of peristalsis from 7.05 (+/- 0.61) to 19.87 (+/- 0.47) per minute and the intraluminal pressure rose to a maximum of 124 cm water. Glucagon and ritodrine infusions reduced the rate of peristalsis to 6.32 (+/- 0.73) and 5.83 (+/- 0.84) respectively, whilst the intraluminal pressure was reduced by 43% during the glucagon infusion and 51% during the ritodrine infusion. The effect of ritodrine was more prolonged than that of glucagon. PMID- 3962036 TI - The effect of various drugs on canine ureteric peristalsis. AB - Using an intact concious animal model the effect of various drugs on the rate of canine ureteric peristalsis was studied. The drugs found to reduce consistently the rate of ureteric peristalsis were diazoxide, terbutaline, and ritodrine. Ritodrine was the most consistent, having a prolonged effect and reducing the rate of ureteric peristalsis to 50% of the rates observed in control experiments. PMID- 3962037 TI - An evaluation of contractility parameters determined from isometric contractions and micturition studies. AB - In a group of 110 patients of mixed pathology 218 micturitions were investigated. Using an on-line computer, two contractility parameters were calculated: the parameter U/l, which is derived from the isometric pressure rise in the detrusor before micturition actually started, and the parameter wmax, which is derived from flow and pressure during micturition. It was found that neither of the parameters conforms to the definition of an ideal contractility parameter. Both parameters are subject to the influence of the urethral resistance or the degree of neurogenic stimulation of the bladder, and both measure to some degree the actual performance of the detrusor during a given micturition instead of its myogenic properties. Nevertheless, by dividing patients into groups according to these two measured values, it was shown that clinically relevant types of detrusor behaviour can be distinguished. PMID- 3962038 TI - [Radiotherapy of urinary bladder cancers]. AB - Stagnation in the therapeutic results obtained in treating bladder carcinomas and the very similar results of all treatment methods show that essentially it is not the primary treatment but the stage and biological potency of the tumor that determines the course of the disease. From a radio-oncological viewpoint, it therefore seems appropriate to suggest a treatment concept based on these prognostic criteria, which is adjusted according to the possible therapeutic benefit. The value of radiotherapy as an alternative to cystectomy or as a combination procedure with radical surgical interventions is discussed on the basis of the current literature and our own treatment results. PMID- 3962039 TI - [Radiotherapy of prostate cancer]. AB - The following describes indications, type and extension of percutaneous irradiation according to tumor stage as well as technique of radiotherapy. A special form of radiotherapy--interstitial implantation of iodine-125-seeds--is described. The attainable treatment results of percutaneous and interstitial irradiation and their early and late side effects are discussed. PMID- 3962040 TI - [Radiotherapy of penis and urethral cancers]. AB - A stage dependent combined procedure of surgery and radiotherapy should be performed in penile carcinoma. Including all stages a local tumor control rate of 85% can be achieved if a radiation dosage of at least 55-60 Gy is applied. Surgery of recurrences is not impaired after radiotherapy. Prophylactic irradiation of regional lymph nodes should be performed in all tumors with more than T2 extension and in tumors located at the base of the Penis. Carcinoma of the urethra in general should be treated primarily by surgery, but in advanced tumors and in old patients a combined procedure of surgery and irradiation can be recommended. Prophylactic irradiation of the regional lymph nodes should be performed in tumors located in the proximal part of the urethra. In certain cases of infiltration of the bladder iliac lymph nodes should be irradiated as well. The results of 63 patients with penile carcinoma and 13 cases of carcinoma of the urethra are reported. PMID- 3962041 TI - [Urologic complications following curative radiotherapy of gynecologic cancers]. AB - Seventy-nine patients with urological complications after radiotherapy of their gynecological carcinomas are presented. Twenty-eight patients underwent operation before irradiation. The time between radiotherapy and occurrence of urological complications varied from 0.5 to 27 years (mean 5.3 years). One third of the patients showed a combination of at least two side effects of radiotherapy. There were good results of infiltration therapy with orgotein in patients with radiation cystitis. Because of the unsatisfactory result from primary operation of fistulas, suprapubic urinary diversion is preferred. Gynecologic operation prior to radiotherapy did not influence the results of urological treatment. Seven patients (8.8%) died from urological complications or from complications after urologic treatment. 6 patients (7.6%) showed cancer of the radiated region (3 bladder cancers, 3 colon cancers) within 6 to 20 years after radiotherapy. PMID- 3962042 TI - [Radiotherapy of kidney cancer]. AB - The benefit of low-dose preoperative radiotherapy in hypernephroma has not been proven in phase-II studies. Medium-dose preoperative radiotherapy many transform inoperable to operable tumors in numerous cases. In a randomized study, no prolongation of survival has been found, however. Many retrospective studies, in part with questionable design, have found no value of routinely used postoperative irradiation. Presently, it is indicated in advanced local tumor stages (pT3 and pT4) and residual tumors. Postoperative radiotherapy in high-risk patients using defined techniques and preoperative radiotherapy applying modern diagnostic equipment for treatment planning remains to be evaluated. For palliation, radiotherapy is useful treating brain-, lung- and bone metastases and inoperable primary tumors. PMID- 3962043 TI - [The so-called liposarcoma of the kidney. A case report and review of the literature]. AB - A case of perirenal liposarcoma is described. The pathological criteria for diagnosis are discussed. A strict separation of perirenal liposarcomas, intrarenal hamartomas and sarcomatoid renal cell carcinomas is required. The diagnostic and therapeutic modalities are reviewed according to the recent literature. PMID- 3962044 TI - [Adjuvant topical chemotherapy with cisplatin in superficial bladder cancer]. AB - During a period of 6 weeks we applied a weekly dosage of 50 mg of cis-platinum as an intravesical instillation treatment to 30 patients with superficial carcinomas of the urinary bladder. Prior to this treatment these patients had undergone a transurethral differentiated resection of their tumours by multiple biopsies (mapping). Persistent tumours were found in 3 patients (10%). After an observation time of 22 months the relapse rate in pTa tumours was 5.5 and in pT1 tumours 7.6. PMID- 3962045 TI - [Chemo-immunoprevention in superficial bladder cancer]. AB - We performed chemoimmune prophylaxis in 130 patients with superficial urothelial transitional cell carcinoma of the bladder. Two weeks after complete TUR 700 mg Cyclophosphamide (CTX)/m2 were injected intravenously followed by 6 weekly intravesical instillations of 120 mg BCG/50 ml saline together with BCG skin scarifications two weeks later. After 5 years the calculated frequency of recurrence was 18% in the treated group compared with 54% in the untreated historical control group. In a sub-group of 48 patients with recurrent tumors the CTX/BCG treatment success was well documented by comparison of the tumor recurrences during the appropriate time intervals before and after chemoimmune prophylaxis. The progression rate of the disease was generally more favourable in patients treated by CTX/BCG. No significant side effects of this treatment were noticed. PMID- 3962046 TI - [Malignancy grade and clinical stage T0-T3 in prostate cancer]. AB - The frequency of malignancy grade I-III (grading system according to Bocking and Sommerkamp, 1980) and of clinical stages T0-T3 in 393 unselected prostatic carcinomas (227 punch biopsies and 166 transurethral resections) were investigated over a period of 2 years. G III carcinomas were represented most frequently in the whole material (54%) as well as in punch biopsies (62%). G I carcinomas with a favorable prognosis make up 20% of the tumors in the whole material and only 10% in punch biopsies. In contrast, 54.9% of incidental carcinomas (T0) are G I tumors, 18.6% G III carcinomas with an unfavorable prognosis. The advanced clinical stages T2 and T3 predominate in the whole material with 62.4%, compared to stages T0 and T1 comprising 37.6%. Malignancy grade and clinical stage are clearly correlated in the whole material. In incidental carcinoma, there is also a correlation between malignancy grade and histologic extension. The percentage of higher malignancy grades G II and G III increases with age. This is true for incidental carcinoma as well. The findings emphasize the prognostic significance of the grading system. PMID- 3962047 TI - [Determination of steroid receptors in prostate cancer: possibilities and limits]. AB - In most cases, the prostatic carcinoma (PCA) is a hormone-dependent malignant tumor. Since sexual steroids seem to act upon their target organs by means of specific steroid receptors the determination of receptor concentration in PCA is of great theoretical and practical interest. The state of art of receptor research in PCA can be summarized as follows: 1. The prognostic relevance of receptor determinations in PCA is controversial. The contradictory assessments of the value of receptor measurements may be mainly caused by methodical problems. 2. A possible heterogeneity of the receptor distribution in PCA tissue can not be detected by biochemical receptor determinations. 3. This heterogeneity could be one reason for a lack of response to endocrine therapy in cases which are biochemically receptor-rich (selection of receptor-poor cell clones). 4. The available (immuno)histochemical fluorescence techniques, which have been developed for direct detection of heterogeneous receptor distribution in the tissue, are neither sufficiently sensitive nor specific. 5. It is an open question whether the development of an appropriate (immuno)histochemical method will succeed. PMID- 3962048 TI - [Exogenous heat exposure--a cause of subfertility]. AB - In the diagnostics of subfertility three main factors have to be considered: Endogenous testicular heat exposure, genitourinary tract infection and endocrinologic abnormality. The possibility of exogenous heat exposure is emphasized. An exact anamnesis is important, because exogenously induced subfertility is reversible in general. PMID- 3962049 TI - [Persistent retrograde ejaculation following incision of the bladder neck for functional bladder neck stenosis? Side effects of the Turner-Warwick bladder neck incision]. AB - Twenty patients, between 20 and 51 years of age suffering from bladder neck dysfunction, were treated by bladder neck incision as proposed by Turner-Warwick. Good results and only minor side-effects were noticed. There was no case of permanent retrograde ejaculation. PMID- 3962050 TI - [Radiotherapy of kidney pelvis and ureteral cancers]. AB - The indications and possibilities of radiotherapy in carcinomas of the renal pelvis and the ureter are demonstrated. Based on the literature and our own experience in 22 cases, postoperative radiotherapy should be performed in cases of deep infiltrating carcinomas, after subtotal surgery, and in cases with lymph node metastases. The radiation dose applied should be 50-55 Gy to the tumor bed and 45 (-50) Gy to the regional lymph nodes. Local recurrences can be greatly diminished without severe complications. Therefore, postoperative radiotherapy in carcinomas of the renal pelvis and the ureter can be recommended. PMID- 3962051 TI - [Radiotom 804--a new high frequency surgical instrument in urology]. AB - This paper presents a new high-frequency electrosurgical unit with better adaptation to the patient and more exact adjustment of the output. This high frequency electrosurgical unit was tested in more than 1000 open and transurethral operations and was found reliable. PMID- 3962052 TI - Renal cell carcinoma: survival and prognostic factors. AB - Three hundred twenty-six patients treated at New York University from 1970 to 1982 were studied for survival in relationship to surgical stage, type of therapy, and pathologic characterization of the primary tumor. At the time of diagnosis 25.5 per cent of tumors were Stage I, 15 per cent Stage II, 28.5 per cent Stage III, and 31 per cent Stage IV. The retrospective study showed that patients with tumor confined within the capsule achieved the highest five- and ten-year survivals of 88 per cent and 66 per cent, respectively. Survivals decreased as tumor invaded perirenal fat (67% and 35%) or regional lymph nodes (17% and 5%). Tumor invasion into the renal vein alone did not significantly change five-year survival (84%) but lowered ten-year survival to 45 per cent. Patients with metastases at the time of nephrectomy did poorly regardless of site of metastases or kind of adjuvant therapy, except for those managed by surgical extirpation of the secondary lesion. Certain tumor characteristics were associated with a better prognosis, e.g., size below 5 cm in diameter, lack of invasion of collecting system, perirenal fat or regional lymph nodes, and predominance of clear or granular cells growing into a recognizable histologic pattern. PMID- 3962053 TI - Comparative evaluation of National Prostatic Cancer Treatment Group and Gleason systems for pathologic grading of primary prostatic cancer. AB - Multivariable analysis was used to investigate the relationship between risk of disease progression or death in patients who were treated with adjuvant therapy after definitive treatment for prostatic adenocarcinoma and the components of the National Prostatic Cancer Treatment Group (NPCTG) and Gleason systems for pathologic grading of prostatic cancer. Data were available for 203 patients who were treated on NPCTG Protocols 900 and 1,000, which involve surgical and radiation therapy as definitive treatment. Since less than 10 per cent of these patients have died, analysis of survival was not attempted. The study focus was progression-free survival, which is the minimum of time to progression or death. The analysis demonstrates that a new measure, the NPCTG score (the sum of the glandular and nuclear grades) is superior to the previously reported NPCTG grade (the maximum of the two grades). In addition, the Gleason score is somewhat superior to the new NPCTG score. All of this, however, applies only to the primary tumor and not the nature of any present or future metastatic lesions. PMID- 3962054 TI - Evaluation of therapeutic efficacy in psychogenic impotence by means of logarithmic scoring. AB - In an attempt to develop as objective a method for the evaluation of impotence as possible, the authors assigned numerical values to four parameters considered essential to sexual function, namely, libido, erection, ejaculation, and orgasm, and used the sum totals of these scores, collected before and after initiation of therapy, as indicators of overall sexual function. Numerical values were assigned according to a logarithmic scale, in four stages from 0 to 10, i.e., 0, 1, 3, and 10; a score of 0 signified "normal" and a score of 10, "abnormal." By comparing sum totals of scores computed before and after initiation of therapy, the authors were able to evaluate therapeutic efficacy on the basis of changes in these sum totals. Using this method, the mean total score for a control group of 24 normal subjects was 1.67 +/- 0.26 (mean +/- standard error). For the test group, which consisted of 24 patients of psychogenic impotence, the mean total score prior to initiation of therapy was 16.46 +/- 3.55, an extremely high score in comparison with the control group. After four weeks of therapy, the mean total score dropped to 9.37 +/- 1.77, indicating a statistically significant (p less than 0.05) decrease over the pre-therapy mean total score. PMID- 3962055 TI - Testing for neurogenic impotence: a challenge. AB - The bulbocavernosus reflex and pudendal evoked responses were obtained in a group of control patients and impotent men in an attempt to assess their reliability and objectivity in diagnosing neurogenic erectile dysfunction. PMID- 3962056 TI - Psychiatric treatment of erectile dysfunction in urology outpatient clinic. AB - This study examined the feasibility of establishing a satellite psychiatry service in a urology outpatient clinic for the express purpose of engaging men with inhibited sexual excitement in psychiatric treatment. This approach appeared to be more successful as judged by complete referrals and symptom remission than referral to a psychiatry clinic. PMID- 3962057 TI - Vasectomy: what are community standards? AB - Vasectomy has become an increasingly popular mode of contraception in our society. It is also a procedure which places the urologist at an uncommonly high risk for litigation. To better assess the manner in which urologists within a geographical region treat their vasectomy patients, a survey was conducted of the members of the New England Section, American Urological Association. The results of that survey are presented. PMID- 3962058 TI - Percutaneous antegrade flexible ureteroscopy. AB - A flexible endoscope has been used for antegrade percutaneous ureteroscopy after percutaneous lithotripsy. The instrument, the ACMI Flexiscope, is 2.5 mm in diameter and has fiberoptic bundles for illumination and visualization but no channel for irrigation. Techniques for introduction and irrigation are considered. The use of this instrument demonstrates the need for deflectability in a ureteroscope. PMID- 3962059 TI - Micturition syncope: an atypical case. AB - A forty-nine-year-old man had episodes of micturition syncope associated with an asymptomatic urinary tract infection. Treatment of the infection resolved the syncopal episodes. Micturition syncope occurs in the standing position; physical, electrocardiographic, and electroencephalographic studies usually have normal results. The case reported here is atypical in that micturition syncope was the only apparent symptom of urinary tract infection. PMID- 3962060 TI - Adult testicular torsion. AB - A case of testicular torsion is described in a sixty-four-year-old man. Although unusual in this age group, the diagnosis of testicular torsion should be considered in older patients presenting with unilateral testicular pain. Early recognition and surgical intervention may reverse testicular ischemia and avert unnecessary orchiectomy. PMID- 3962061 TI - Case profile: large bladder calculus--postcervical cerclage. PMID- 3962062 TI - 5-microtransducer catheter in evaluation of neurogenic bladder function. AB - Recent use of the multiple microtransducer catheter in the evaluation of neurogenic bladder due to spinal-cord injuries leads us to believe that the use of the inferior edge of the symphysis pubis as the zero point for resting bladder pressure is more accurate than its superior edge, changes in resting bladder pressure at various volumes are influenced more by body position than by intravesical position of the sensor, back-to-back microtransducers indicate significant pressure difference at the external sphincter zone, and detrusor bladder neck dyssynergia during autonomic dysreflexia in patients with spinal cord injury is more likely of skeletal than of smooth muscle origin. PMID- 3962063 TI - [Humoral immunity of primary glaucoma patients]. PMID- 3962064 TI - [Lipid peroxidation in the blood of primary glaucoma patients]. PMID- 3962065 TI - [Relation of central and regional hemodynamics in open-angle glaucoma patients]. PMID- 3962066 TI - [Role of biomicroscopy in determining the indications for a measured dissection of the anterior capsule and its use in fixing an intraocular lens]. PMID- 3962068 TI - [Vitrectomy in primary persistent hyperplastic vitreous body]. PMID- 3962067 TI - [Angiographic research on the sequelae of fragmentation injuries of the eye]. PMID- 3962070 TI - [Autoallergic reactions to retinal S-antigen in various clinical forms of uveitis]. PMID- 3962069 TI - [Method of assessing the cosmetics status in ophthalmic plastic surgery]. PMID- 3962071 TI - [Effect of tobacco smoking on visual work capacity]. PMID- 3962073 TI - [Method of forming a lacrimal point in atresia]. PMID- 3962072 TI - [Potentials of a system for preventing strabismus]. PMID- 3962074 TI - [Principles of outpatient follow-up in ocular hypertension]. PMID- 3962075 TI - [A case of complicated chronic suppurative dacryocystitis]. PMID- 3962076 TI - [Outpatient care of patients with an artificial crystalline lens]. PMID- 3962077 TI - Cytochemical reactions in cells from leukemic dogs. AB - Leukemic cells from 17 dogs with spontaneous leukemia were stained with leukocyte alkaline phosphatase, alpha naphthyl acetate esterase with and without fluoride, peroxidase, and periodic acid-Schiff. Cytochemistry was necessary for identification or confirmation of leukemic cell type in most dogs and resulted in changing the light microscopic morphologic diagnosis in eight of 17 dogs. Leukemic cell types diagnosed were myelomonocytic leukemia in seven dogs, monocytic leukemia in five dogs, lymphocytic leukemia in four dogs, and myelocytic leukemia in one dog. PMID- 3962078 TI - Induction and reversibility of thyroid proliferative changes in rats given an antithyroid compound. AB - Sixty Fischer 344 rats were fed a diet containing 90 ppm methimazole, a known antithyroid compound. Following exposure to the test compound, groups of ten animals were terminated at 1, 3, and 6 months. Similar groups of ten treated animals were given control diet for a reversibility period of 2, 3, and 6 months, respectively. Groups of ten control rats were terminated after 1, 3, 6, and 12 months. Except for the expected effect on body weight, the treated animals had no physical signs of toxicity. The weight of thyroids increased with the duration of exposure, becoming in males after 6 months about ten times the weight of thyroids from control rats. Thyroids of treated rats after 1 and 3 months had a diffuse homogeneous hypertrophy and hyperplasia of follicular cells, decreased colloid, and increased vascularity. After 6 months' exposure to the antithyroid compound, there was diffuse hyperplasia but also a heterogeneity in the size and morphology of follicles, protrusion of follicular tissue through the gland capsule and into vascular spaces, and the development of follicular nodules. Treated rats placed on control diet, allowing for reversibility, had thyroids which were decreased in size with large follicles and flattened epithelium, and a complete remodeling of most nodules with no evidence of progression. Although the nodules produced after prolonged administration of the antithyroid compound had many of the characteristics of neoplasia, the biologic behavior supports the diagnosis of nodular hyperplasia. PMID- 3962079 TI - Feline mammary sarcoma composed of cells resembling myofibroblasts. AB - A recurrent mammary sarcoma from an 11-year-old, female domestic cat was studied by light and electron microscopy and immunohistochemistry. The tumor consisted of interlacing bands of spindle cells with elongated blunt-ended nuclei and variable amounts of stroma. Multinucleated tumor giant cells and mitoses were common. Ultrastructurally, tumor cells had abundant rough endoplasmic reticulum with dilated cisternae, a prominent Golgi complex, frequent mitochondria, bundles of intracytoplasmic filaments with focal densities, and discontinuous basal lamina like material and cell junctions. These findings suggest that myofibroblast-like cells were the predominant type of tumor cell. Failure to demonstrate immunoreactivity for cytokeratins attested to the non-epithelial origin of these neoplastic cells. Uniform immunoreactivity with anti-vimentin antibodies and specific labelling of some tumor cells with antiserum to actin are compatible with an origin of this tumor from modified fibroblasts (i.e., myofibroblast-like cells). Tumors composed largely of myofibroblasts may be unique and warrant separate classification from other types of fibroblastic tumors in animals. PMID- 3962080 TI - Focal mucinosis in dogs: seven cases and review of cutaneous mucinoses of man and animals. AB - Seven dogs had one or more asymptomatic nodules, papules, or plaques on the skin or oral mucosa. The primary histologic feature was the accumulation of excess mucin within the dermis or submucosa. Based upon the clinical presentation and the histopathologic changes, it was proposed that these lesions represent the canine analogue of focal mucinosis in man, and that the same name be applied to the lesion in dogs. The criteria for the diagnosis of focal mucinosis were: (1) the presence of a single (rarely multiple) papule, nodule, or plaque which may be firm, rubbery, or soft, (2) the accumulation of mucin which disrupts and separates collagen fibers, (3) mild to extensive fibroblast proliferation, and (4) a mild mononuclear cell infiltration. The mucinoses of man and animals were reviewed. PMID- 3962081 TI - Hereditary copper toxicosis in West Highland white terriers. AB - Histologic, histochemical and atomic absorption studies on liver tissue from 71 West Highland white terriers are reported. Twenty-seven dogs had histologically normal liver and copper concentration comparable to mongrel control dogs. Forty four dogs had hepatic copper concentrations up to 22 times the mean copper concentration found in clinically normal mongrel dogs. Hepatitis, hepatic necrosis and cirrhosis were associated with the increased copper concentration in some dogs. Matings between dogs with high liver copper concentration produced pups with high liver concentration. The copper storage defect is inherited. PMID- 3962082 TI - Carotid body tumor: an incidental finding in older ranch mink. AB - Carotid body tumors were found incidentally at necropsy in 15 ranch mink (Mustela vision), mostly royal pastels, kept for studies on slow viral diseases. The mink, five males and ten females, were 77 to 135 months old (mean age 107 months). Loosely or firmly attached at the bifurcation of the common carotid artery, and 11 larger tumors were smooth-surfaced, discrete, pale brown, globoid masses that varied from 2.5 to 16 mm in diameter. Four tumors of microscopic size occurred in otherwise normal-looking carotid bodies. All were composed of densely packed polygonal cells disposed in sheets and cords or arranged in clusters by a reticulin meshwork rich in blood vessels. Always unilateral, the tumors had not invaded locally or metastasized. As seen in the smallest tumors, the neoplastic cells usually arose centrally in the carotid body and formed an expansive growth that replaced much of the normal parenchyma without necessarily enlarging the organ beyond normal limits. The cause of the tumors was not apparent. All tumor bearing mink had lived at an elevation of 1,100 meters, and none had suffered from any obvious chronic cardiopulmonary disease. PMID- 3962083 TI - A clinicopathologic and ultrastructural study of undifferentiated malignant tumors of the oral cavity in dogs. AB - Undifferentiated malignant tumors of the oral cavity were diagnosed in six dogs under 2 years of age. The dogs were examined because of pain and swelling of the upper molar or premolar areas. In all six dogs, the tumors were initially misdiagnosed as infections or carnasal abscesses. The differential diagnosis included malignant lymphoma, osteosarcoma, mesenchymal chondrosarcoma, embryonal rhabdomyosarcoma, and malignant melanoma. Electron microscopy of three neoplasms showed that there were no specific features characteristic of carcinoma or sarcoma. Immunoperoxidase studies for cytokeratins, epithelial membrane antigen, actin, myosin, desmin, and vimentin were also negative. We conclude that these tumors be designated undifferentiated malignant tumors of the oral cavity until histogenesis is established. PMID- 3962084 TI - Spermatid giant cells, tubular hypospermatogenesis, spermatogonial swelling, cytoplasmic vacuoles, and tubular dilatation in the testes of normal rabbits. AB - Testes of 36 normal New Zealand white rabbits (8, 15, 18, 26, and greater than 52 weeks of age) were examined by light and electron microscopy. The incidence and number of affected tubules were determined for spermatid giant cells, focal tubular hypospermatogenesis, cytoplasmic swelling of spermatogonia, intracytoplasmic vacuoles in seminiferous epithelium, and tubular dilatation. Spermatogenesis commenced at 15-18 weeks of age and was present in all rabbits by 18 weeks. Spermatid giant cells occurred in 96% of rabbits 15 weeks of age and older. Focal hypospermatogenesis was present in 14-57% of testes once active spermatogenesis began. Ninety-seven percent of testes in all age groups combined had spermatogonial swelling. Infrequent dilated seminiferous tubules were present in five rabbits. Ultrastructurally, spermatid giant cells were round cells with multiple nuclei that appeared to arise by widening of narrow intercellular bridges that normally connect spermatogenic epithelial cells. Pale-staining spermatogonia consisted of cytoplasmic and nuclear swelling with disruption of plasma and nuclear membranes. Tubules with spermatogonial swelling were more numerous in 15- and 18-week-old rabbits. There were no significant differences in incidence or extent of spermatid giant cells, focal hypospermatogenesis, cytoplasmic vacuoles, or tubular dilatation between age groups after spermatogenesis commenced. Although the cause of these changes is not known, they were frequent findings in normal rabbits 15 weeks of age and older. PMID- 3962085 TI - Salmonella osteomyelitis in a rhesus monkey. AB - An adult male rhesus monkey (Macaca mulatta) developed clinical signs of severe osteomyelitis of the left femur 42 days after onset of enteritis. Salmonella sp. were cultured from feces, blood, and femoral lesions. Response to antibiotic therapy was poor, and the animal was euthanized. The left femur, with pathologic fracture and involucrum, and the right femur, tibia and fibula were most severely affected. Additionally hepatic microgranulomas, mild tubulointerstitial nephritis, medullary histiocytosis and erythrophagocytosis in the lymph nodes, and a mild colitis were diagnosed microscopically. The severity of the disease and serum electrophoresis findings were suggestive of lowered resistance to the organism, possibly due to anemia or polychlorinated biphenyl toxicosis. PMID- 3962086 TI - Lethal short-limbed dwarfism in a rhesus monkey. PMID- 3962087 TI - Feline large granular lymphoma. PMID- 3962088 TI - Undifferentiated spindle cell carcinoma of the thyroid in a dog. PMID- 3962089 TI - Squamous cell carcinoma of the oral, pharyngeal and nasal mucosa in the horse. PMID- 3962090 TI - Cerebral cryptococcosis in a horse. PMID- 3962091 TI - Glomerular lipid emboli in a diabetic dog. PMID- 3962093 TI - Histologic alterations in the testes of laboratory rabbits. PMID- 3962092 TI - Biclonal gammopathy in a dog with myeloma and cutaneous lymphoma. PMID- 3962094 TI - An ovine mammary adenoma. PMID- 3962095 TI - Developments in the Codex Alimentarius Commission regarding drug residues in foods. PMID- 3962096 TI - The welfare of deer at slaughter in New Zealand and Great Britain. PMID- 3962097 TI - Consultancy fees. PMID- 3962098 TI - Effect of wet weather on lameness in dairy cattle. AB - The incidence of lameness in cows recorded by five veterinary practices over one year and one practice over four years was plotted with rainfall and potential soil moisture deficit. Correlation coefficients calculated between lameness, rainfall and potential soil moisture deficit over two-week periods showed the incidence of lameness in summer to be significantly related to the potential soil moisture deficit in the same two-week period and rainfall in the previous two week period. Differences in patterns of lameness incidence among practices and years were also partly explained by differences in rainfall and potential soil moisture deficit; however, these effects were small compared with those of other factors that affect lameness incidence such as herd size, age and stage of lactation. PMID- 3962099 TI - Avian paramyxovirus type 1 infections of racing pigeons: 4 laboratory assessment of vaccination. AB - The immune response and protection from challenge afforded to adult pigeons by four different vaccination schedules were assessed. Intravenous challenge with a field pigeon isolate was done four weeks after the second of two doses of vaccine given four weeks apart. Little difference in protection was seen between two 0.25 ml and two 0.5 ml doses of oil emulsion vaccine, although the latter produced a slightly higher immune response. In both cases one of 10 challenged pigeons became sick and died. One dose of Newcastle disease virus B1 live vaccine followed four weeks later by 0.5 ml oil emulsion vaccine gave a comparable immune response to two 0.25 ml doses of oil emulsion but only six birds survived challenge. Two doses of Newcastle disease virus B1 vaccine gave a poor immune response and little protection from challenge; all 10 birds became sick and eight died. Assessment of the onset of protection following one dose of either 0.5 ml oil emulsion vaccine or Newcastle disease virus B1 indicated some partial protection in the latter group as early as five days after vaccination. Both groups showed protection at 10 days but by 21 days, although protection was sustained in the oil emulsion group, birds receiving live vaccine were fully susceptible. Measurement of the duration of protection in pigeons given two 0.5 ml doses of oil emulsion vaccine indicated that protection had begun to wane by 40 weeks after the first dose. PMID- 3962100 TI - Rodenticide-induced signs simulating Rift Valley fever in sheep and goats in Egypt. AB - Epidemic Rift Valley fever is generally recognised when a higher than expected frequency of abortions and haemorrhages occurs in sheep and other livestock. Other infectious agents can cause similar clinical signs. In Egypt, an outbreak of abortions and haemorrhages in sheep and goats in 1982 was traced to intoxication with the rodenticide brodifacoum. The epidemic lasted for three weeks and resulted in 120 deaths. The end of the epidemic coincided with a heavy rainstorm. This outbreak demonstrates the need for the strict control of the use of rodenticides and widens the differential diagnosis of epidemic abortion in sheep and goats. PMID- 3962101 TI - Monitoring herds for Streptococcus suis type 2: chance contamination of slaughter pigs. PMID- 3962102 TI - Survival of Streptococcus suis type 2 in pig carcases. PMID- 3962103 TI - Resistance to benzimidazole of Haemonchus contortus utkalensis in sheep on Martinique. PMID- 3962104 TI - Belgian blue cattle. PMID- 3962105 TI - Levamisole-resistant nematodes. PMID- 3962106 TI - Scottish veterinary investigation service. PMID- 3962108 TI - Don't tell your wife. PMID- 3962107 TI - Immobilon advertisement. PMID- 3962109 TI - Sales restrictions. PMID- 3962110 TI - A successful initiative. PMID- 3962111 TI - When crime strikes. PMID- 3962112 TI - Exercise and the height of horses. AB - The heights of 89 horses were measured at the withers before and after half a furlong of trotting exercise. The mean (+/- sd) height increase after exercise was 1.75 +/- 0.86 cm and the horses returned to their resting height within seven minutes. There was no linear relationship between gain in height and pre-exercise height. PMID- 3962113 TI - Definition of a non-alert downer cow syndrome and some case histories. AB - The clinical, blood biochemical and autopsy findings on a cow affected by a 'non alert downer cow syndrome' are described in detail and compared with brief clinical and biochemical details from six similar cases attended elsewhere. The significance of the biochemical observations is discussed in relation to the observations from many other clinical milk fever cases in a dairy practice in Victoria. This syndrome developed in 1.9 per cent of 584 cases of milk fever. The essential findings in the syndrome were that all cows had an initial clinical episode suggestive of milk fever but showed an unsatisfactory clinical response to calcium borogluconate therapy. After a day or two all cows became laterally recumbent, some exhibited expiratory moaning and all developed mucoid faeces which, in many cases contained spots of blood. All cases had significantly lower erythrocyte and plasma potassium concentrations than those in milk fever cases which responded to treatment. PMID- 3962114 TI - Detection of Haemophilus pleuropneumoniae antigens using the coagglutination test. PMID- 3962115 TI - Isolation of influenza A viruses from domestic ducks in Malaysia. PMID- 3962116 TI - Antimicrobials in milk and meat. PMID- 3962117 TI - Possible adverse reaction to metronidazole. PMID- 3962118 TI - Differential efficacy of levamisole and oxfendazole. PMID- 3962119 TI - Wind examination in yearlings. PMID- 3962120 TI - Multiple drug resistance in Trypanosoma vivax in Kenya. PMID- 3962121 TI - Carcase damage. PMID- 3962122 TI - Uveodermatological syndrome in the Japanese akita. PMID- 3962123 TI - Examinations in cardiology and dermatology. PMID- 3962125 TI - Image of the profession. PMID- 3962126 TI - Difficult decisions for the schools. PMID- 3962124 TI - Financing the veterinary surgeon's car. PMID- 3962127 TI - Use of a colouring agent in approved dips as an aid in identifying dipped sheep. AB - A fat soluble dye was identified as a suitable colourant for mixing with approved dips during the statutory winter dipping period. The optimum concentration of the dye was 0.4 per cent. It uniformly dyed the sheep and depending on the breed persisted on the fleece for three to six months. Any dye that remained on the wool at shearing (six to eight months after dipping) was washed out by scouring solutions containing non-ionic and anionic detergents. The dye did not alter the efficacy of the commonly used insecticides. PMID- 3962128 TI - Use of sodium hydroxide treated selenium deficient barley to induce vitamin E and selenium deficiency in yearling cattle. AB - Selenium deficient barley grown in Northern Ireland was treated with sodium hydroxide to deplete it of vitamin E. Housed cattle fed a complete diet based on this treated barley developed nutritional degenerative myopathy, showing that spontaneous myopathy in yearling cattle can be the result of vitamin E and selenium deficiency alone. The diet used is as effective and cheaper than others presently in use for inducing degenerative myopathy. PMID- 3962129 TI - Protection of chickens against challenge with the variant virus responsible for Newcastle disease in 1984 by conventional vaccination. PMID- 3962130 TI - Effect of chemical immobilisation on the heart rate and haematological values in captive gazelles. PMID- 3962131 TI - 180 degree rotation of the head of a dead bovine fetus. PMID- 3962132 TI - Anthelmintic drugs. PMID- 3962133 TI - Gastric dilation in bloodhounds. PMID- 3962134 TI - Rabies. PMID- 3962135 TI - Rationalisation of veterinary education. PMID- 3962136 TI - Vaccination against leptospiral abortion and renal carriage. PMID- 3962137 TI - Our violent society. PMID- 3962138 TI - Advertising and the profession. PMID- 3962139 TI - Veterinary nurse certificates for RANAs. PMID- 3962140 TI - Effects of low and high calcium intake prepartum on calcium mobilization rate around parturition in dairy cows. AB - Forty-one dairy cows were fed a low (LCa-13 g/d) and a high (HCa-83.5 g/d) calcium ration in the 8 weeks prior to parturition and the effect on the Ca mobilization rate around parturition was studied. Plasma Ca values were stable in the LCa group around parturition. In the older cows of the HCa group a very slight decrease in the mean plasma Ca was observed: 2.58 mmol/l at 12-36 h ante partum decreased to 2.38 mmol/l at parturition. Hypocalcaemia, which commonly occurs around parturition, did not occur in 40 of the cows. A subclinical hypocalcaemia (1.8 mmol/l) occurred in one cow (parity 10) from the HCa group. To assess the efficiency of Ca mobilization, a severe hypocalcaemia (1.0 mmol/l) with clinical signs was induced by means of Na2EDTA infusion (0.90 mmol/min), starting at 10 h post-partum. The older cows in the LCa group required more Na2EDTA than those in the HCa group. Higher urinary hydroxyproline excretion in the week before parturition in the LCa than in the HCa group suggested a higher bone turnover. Plasma PTH levels around parturition were not significantly different between the groups. The amount of colostrum milked out in the first 10 h post-partum did not influence Ca homeostasis around parturition. The results contradict those of many other experiments in which hypocalcaemia was observed in cows ingesting high levels of Ca. It is concluded that the restricted feed intake prepartum possibly had a favourable effect on Ca homeostasis. PMID- 3962141 TI - Influence of prepartum calcium intake on calcium mobilization rate around parturition in dairy cows fed at a high prepartum feeding level. AB - The influence of a low and a high prepartum calcium (Ca) intake on Ca mobilization rate around parturition was studied in 44 dairy cows fed a ration sufficient for 1.90 times maintenance requirements during the dry period. The plasma Ca level declined on the day of parturition in the group fed the low Ca intake (LCa: 26.4 g/d) as well as in the group fed the high Ca intake (HCa: 87.2 g/d). Plasma Ca levels of the HCa group were lower at parturition, and in this group 1 cow had milk fever after parturition. In the HCa group 6 cows had a plasma Ca level less than or equal to 2.0 mmol/l at parturition and/or 10 h post partum (pp), versus 1 cow in the LCa group. Na2EDTA was intravenously infused at 10 h pp to induce hypocalcaemia to a level of plasma Ca not bound to EDTA of approximately 1.0 mmol/l. The LCa groups tended to require more Na2EDTA than the HCa groups, however the difference was significant only in the younger cows. After the Na2EDTA infusion 7 cows of the HCa group and 1 of the LCa group did not recover spontaneously and needed to be treated. The mean plasma PTH levels of the LCa group ante-partum were slightly higher than those of the HCa group. The Ca level of the prepartum ration did not influence urinary hydroxyproline excretion, which suggests that the Ca intake of 26.4 g/d was too high to stimulate bone turnover. Comparison of the present results with those of an earlier experiment in which the prepartum Ca intake at a low feeding level (1.12 times maintenance) was studied, led to the conclusion that higher prepartum feed intake has a clear negative influence on Ca homeostasis around parturition. PMID- 3962142 TI - Right aortic arch in a lamb and two pigs. AB - The necropsy findings of right aortic arch in a lamb, a mini-pig foetus and a mini-pig are described, and the pathogenesis of the vascular pattern found in these animals is discussed. PMID- 3962143 TI - The cycle index, an alternative to the farrowing index converted to a yearly basis. AB - The farrowing index is an important parameter for the evaluation of sow productivity. The value of the farrowing index calculated over a relatively short period of time and converted to a yearly basis, depends largely on the number of litters produced during this period. Random differences in the numbers of litters produced in subsequent periods will strongly influence the farrowing indices of these periods. The cycle index is designed to obtain a more valuable and consistent parameter. The cycle index is based on reproductive data of sows that farrowed during a certain period and the number of production days lost because of culling of sows during that period. PMID- 3962144 TI - The efficacy of mesenteric lymph node biopsy in the eradication of paratuberculosis from an infected dairy farm. AB - Lymph node biopsy was performed on animals older than nine months on a dairy farm which carried 223 animals and was severely affected by paratuberculosis. Biopsies were examined histologically and bacteriologically for the presence of M. paratuberculosis infection. In this way paratuberculosis infection was diagnosed in 29 animals, in which other diagnostic methods (serum complement fixation test, intradermal johnin test and microscopic examination of the faeces) produced negative results. The value of lymph node biopsy is the early detection of infected animals. In the two years after the biopsies, no further cases of clinical paratuberculosis were detected on the affected farm, although infection with M. paratuberculosis persisted. PMID- 3962145 TI - An outbreak of caseous lymphadenitis in dairy goats: first report of the disease in the Netherlands. AB - An outbreak of caseous lymphadenitis in which three herds of goats were involved is described. Corynebacterium pseudotuberculosis was shown to be the causative organism. The outbreak was associated with imported goats. As this first report of C. pseudotuberculosis causing caseous lymphadenitis as a clinical entity in small ruminants in the Netherlands, clinical and epizootiological aspects as well as possible methods of control are discussed. PMID- 3962146 TI - Heredity of navicular disease. AB - Bone structure, nutrient canals, form and definition, and a total evaluation of both fore navicular bones were radiologically evaluated in 169 three- and four year-old Dutch warmblood mares divided into eleven daughter (half sister) groups. On the basis of the 'total evaluation', differences between the three- and four year-old horses were detectable. Using the 'total evaluation', significant differences were found between daughter groups consisting of three-year-old mares. These differences support the theory that podotrochleosis may be (partly) due to the presence of genetic factors. The possibilities concerning selection are presented. The results of the radiological evaluation of the stallion do not have predictive value as far as his progeny is concerned. PMID- 3962147 TI - Pox-like lesions in a colony of carp (Cyprinus carpio). AB - Twelve carp (Cyprinus carpio) out of a total of 100 were affected with skin nodules, mainly located on the dorsal and lateral surface. Post mortem examination of six of the worst affected fish showed the nodules consisting of white gel-like outgrowths. No abnormality was apparent in any other tissue examined. Microscopically, the nodules were formed by proliferating hyperplastic epidermal cells. The other six fish were left for recovery and their nodules regressed spontaneously. The possible aetiological factors are listed. PMID- 3962148 TI - Electrocution of pigs infected with notifiable diseases. AB - In order to combat certain notifiable diseases eradication programs have been developed, which include the destruction of an infected or suspected herd. Experiments were conducted to develop a method for euthanasia of large numbers of pigs. The electrocution experiments under laboratory conditions were performed in a wooden sided box with a steel floor and a curtain of chains. When the pigs touched the chain curtain with their noses, they received a current flow which lasted for more than 2 seconds, and they developed cardiac arrest or fibrillation. The pigs which touched the chain curtain with their rumps vocalised and became recumbent immediately. An automatic electrocution unit was constructed with a conveyor (negative electrode) and 3 curtains of chains (positive electrodes). Over 6000 pigs infected with a notifiable disease were killed with the apparatus. Only 2 piglets younger than 1 week old were not killed by the current (1000 V, greater than 2 s.). From the point of view of animal welfare the automatic electrocution apparatus is an efficient method for killing large numbers of pigs (older than 1 week of age) infected with a notifiable disease. PMID- 3962149 TI - Incidence, economic effects, and control of Haemophilus pleuropneumoniae infections in pigs. AB - This thesis synopsis reports the results of investigations on: the incidence of clinical and subclinical H. pleuropneumoniae infections on pig farms in North Brabant; the economic loss on fattening farms; the effect of husbandry; the possibility of eradicating H. pleuropneumoniae on infected breeding farms on the basis of serological testing; the possibility of control on fattening farms by means of vaccination. The principal findings were as follows: Clinical and subclinical H. pleuropneumoniae infections are widespread on pig farms in North Brabant: The greatest economic loss was due to mortality and veterinary fees; the daily weight again was not found to be affected. The effect of husbandry. Less mortality occurred: on farms where the animals were not shifted during the fattening period; in compartments where the all-in all-out method was systematically used; in compartments with thermostatically controlled warming of the incoming air; in compartments meeting all standards of a good housing climate. Various sanitation measures on infected breeding farms were not successful. Only one experimental vaccine afforded good protection, but because of a high percentage of injection abscesses this vaccine was unsuitable for use in practice. PMID- 3962150 TI - Teaching veterinary parasitology throughout the world. AB - In order to understand how the teaching of parasitology in veterinary schools and faculties in the world is carried out, a questionnaire was sent to all centres listed in the W.H.O. World Directory. A total of 91 replies were received. Additional information was obtained from the report of a symposium held in Hannover, Germany in 1978 and from the Education Committee of the American Association of Veterinary Parasitologists in 1981. The academic level, the place of parasitology in the veterinary curriculum, textbooks and practical instruction, evaluation techniques, teaching staff, institute organization and publications are discussed. PMID- 3962151 TI - Control of strongylosis in horses by alternate grazing of horses and sheep and some other aspects of the epidemiology of Strongylidae infections. AB - Alternate grazing of horses and sheep as a control measure for gastrointestinal helminthiasis was studied in three grazing experiments in 1981, 1982 and 1983. Each year a group of three mare yearling Shetland ponies, which were kept on a small pasture from spring to autumn, were compared with a similar group which grazed a similar or the same pasture until July and were subsequently removed to a similar pasture which had been grazed by sheep from April to July. In addition both groups were treated with an anthelmintic when the latter group was removed to the sheep pasture. Pasture larval counts and worm counts and, in 1982 and 1983, faecal egg counts, clinical condition, total protein, albumin and beta globulin levels demonstrated that the groups removed to sheep pasture acquired considerably lower burdens of nematodes of the subfamilies Cyathostominae and Strongylinae, but considerably higher burdens of Trichostrongylus axei than the groups which were not moved. These T. axei infections resulted in higher serum pepsinogen levels in the former groups compared to the latter in 1981 and 1982. At necropsy an important part of the T. axei burdens and, in 1982 and 1983, the Cyathostominae burdens consisted of inhibited early third stage larvae. A total of 20 species of the subfamily Cyathostominae and 7 species of the Strongylinae were found. Generally the composition of species was in agreement with other observations in western Europe, the most common species being: Cylicostephanus longibursatus, Cylicostephanus minutus, Cylicostephanus calicatus, Cylicostephanus goldi, Cylicostephanus poculatus, Cyathostomum labratum, Cyathostomum coronatum, Cyathostomum catinatum, Cylicocyclus leptostomus, Cylicocyclus nassatus, Cylicocyclus insigne, Strongylus edentatus and Strongylus vulgaris. PMID- 3962152 TI - Relationship between blood iron parameters and trichinellosis in swine. AB - Reduced levels of total iron binding capacity and unsaturated iron binding capacity were observed in the blood of trichinous and iron-injected trichinous pigs. No change was observed in their serum iron and saturation concentration levels. Also, reduced iron concentration levels were observed in the livers of trichinous pigs, while increased iron concentration levels were observed in the spleens of trichinous pigs and the livers and spleens of iron-injected pigs. No difference was found with regard to weight gains, number of larvae per gram of tissues, or histologic characteristics of 'nurse cells'. PMID- 3962153 TI - The use of injectable rafoxanide against natural ovine nasal myiasis. AB - Rafoxanide (Flukanide), 7.5 mg kg-1 b.w. was administered to a group of 17 sheep naturally infected with Oestrus ovis larvae. A similar untreated control group was simultaneously observed for changes in clinical signs and body weights. Three animals from each group were slaughtered and examined for the presence of larval instars of O. ovis. While no larvae were recovered from the treated group, a total of 26 larvae, predominantly first and third instars, were recovered from nasal sinuses of the untreated group. There was clinical recovery and additional weight gain (+3.52 kg) after 2 months in the treated animals and a noticeable clinical deterioration of the untreated animals. The effect of the drug lasted for greater than 25 days. PMID- 3962154 TI - Transmission of a Trypanosoma sp. to cattle by the tick Hyalomma anatolicum anatolicum. AB - Hyalomma anatolicum anatolicum engorged nymphs and flat adults were collected from two areas in northern Sudan. Various developing stages of Trypanosoma theileri-like flagellates were observed in the engorged nymphs, freshly moulted adults and mature adults partially engorged on rabbits. When these ticks were applied to two calves, one calf became infected with the trypanosome. The parasites were observed for one day in the enlarged lymph node nearest to the tick-feeding site 5 days after the tick application. Subsequently the trypanosomes were re-isolated in vitro from the infected calf. Inoculation of a ground-up tick supernatant suspension from the infected batch of ticks containing 10(4) trypanosomes into a calf did not produce a patent infection. PMID- 3962155 TI - A computer simulation of the effects of specific environmental factors on the development of the sheep tick Ixodes ricinus L. AB - A previously developed technique for predicting field development rates of the tick, Ixodes ricinus, has been modified and used in an attempt to test interpretations of field data and to gain further insight into the population dynamics of I. ricinus. The results of this study have provided encouraging evidence of the validity of the predictive technique, identified certain areas in the biology of I. ricinus which require further investigation and, in general, supported the suggestion that in Ireland a continuous interchange of ticks between spring and autumn populations occurs. This technique requires further refinement but it appears to have considerable potential for predicting the behaviour of tick populations in different localities and under the influence of different weather conditions. PMID- 3962156 TI - The susceptibility of the goat to Fasciola hepatica infections. AB - Mixed breed goats were infected with metacercariae of Fasciola hepatica and the resulting worm burdens were quantitated after primary and secondary exposure of the goats to the parasite. Mean length and width of the parasite recovered after all primary exposures were 1.91 +/- 0.2 cm and 0.91 +/- 0.2 cm, respectively. A mean of 71.8 +/- 5.9% of the flukes were recovered from all of the primary infections. In the secondary infections, the mean length and width of the flukes from the physically smaller population was 0.88 +/- 0.27 cm and 0.53 +/- 0.19 cm, respectively. A mean of 67 +/- 6.7% of the flukes were recovered from this secondary infection. It appears that the goat is susceptible to challenge infections with F. hepatica and that its response to this infection is much like that of sheep. PMID- 3962157 TI - A tongue biopsy technique for the detection of trichinosis in swine. AB - A tongue biopsy technique developed for the detection of Trichinella spiralis infection in swine involves taking a deep core biopsy of the tongue musculature, and examination of the sample by digestion. Using this procedure, 31 of 52 (60%) swine from an Indiana herd were found to be infected with T. spiralis. The average biopsy weighed 0.42 g, and the intensity of infection averaged 180 larvae per gram (range 2-1157). The biopsy was quick and easy to perform and the tongues healed well following the procedure. This technique may have applicability for Trichinella detection in epidemiological, control and research studies on swine and other animals. PMID- 3962158 TI - Control of trichostrongylid pasture infestation in spring by the periparturient anthelmintic treatment of housed ewes prior to or at the time of turn out. AB - Ewes, housed in late November and lambing in late February and March, were divided into three groups of eight, six and eight animals, and received a single treatment with ivermectin (approximately 200 micrograms kg-1) in late February (Group I), on 15 April (Group II), or on 1 May (Group III), respectively. The egg output of the ewes and, subsequently, of eight lambs (Group IV) was measured at 2 weekly intervals by counting and identifying the larvae after culture. Group I showed a small rise in larva output in March, with counts less than 100 larvae per gram of faeces (l.p.g.) whereas the other groups showed considerable increase with counts greater than 500 l.p.g. Treatment of Groups II and III just before turn out in April and May reduced the output to zero for at least 6 wk. The lambs did not show any evidence of trichostrongylid infection until the middle of July. The major parasite identified was Haemonchus contortus. The results of this trial demonstrate that 1) ivermectin treatment in February reduced but did not completely eliminate a spring rise in egg output and 2) treatment in mid-April eliminated further egg output. Ewes treated and turned out in mid-April or later were not a significant cause of pasture contamination in spring or early summer. PMID- 3962159 TI - Morphological changes of Trypanosoma vivax in mice. AB - Morphological changes were observed in the blood forms of Trypanosoma vivax strain Y486 in mice on Days 12-13 of infection, following the peak parasitaemia. During this period elongate trypomastigotes, 25-40 micron long, were observed, most showing an anterior movement of the kinetoplast towards the nucleus and some having a blunt posterior end. In a few parasites a complete transformation to the epimastigote form, 40-42 micron long, was observed. Small sphaeromastigotes were also present, especially in the fine capillaries of various organs. Smears and electron microscopy suggested the presence of extra-vascular forms in the spleen. PMID- 3962160 TI - Observations on histamine, serotonin, cortisol and cortisol binding globulins in bovine anaplasmosis. AB - Changes in histamine, serotonin, cortisol and cortisol binding globulin (CBG) levels were observed in Anaplasma marginale-infected bovine calves. In addition, packed cell volume (PCV), platelet number and percentage parasitaemia were also recorded. The whole blood histamine and serotonin values rose significantly (P less than 0.01 and P less than 0.025, respectively) during the acute stage of Anaplasma infection. Higher serum cortisol and CBG levels (P less than 0.05) were observed in acute and carrier infections, respectively. A sharp drop in thrombocyte count (59%) and PCV (33%) was also noticed in clinical anaplasmosis. The results suggest that the higher levels of biogenic amines which are known to produce increased vasodilation, capillary permeability and tissue anoxia and hypercortisolaemia to protect animals from stress and cell damage may play a similar role in the pathogenesis of acute anaplasmosis. PMID- 3962161 TI - Effect of strains of mice and challenge dose on the infectivity and virulence of Trypanosoma vivax. AB - Factors influencing the infectivity and virulence of clone-derived Trypanosoma vivax for mice were investigated using a titration technique capable of recognizing differences in magnitude of about 10-fold. Marked differences were observed in the susceptibility and duration of infection in four inbred strains of mice after low dose (10(2.2)ID63) challenge. Only mild differences in survival period were observed when challenge doses of 10(3.2) and 10(4.2)ID63 per mouse were used. In all tests, Balb/C mice were most susceptible while CBA mice were most resistant. Long survival of infected mice was highly correlated with frequent occurrence of remission of parasitaemia. Infectivity of T. vivax isolates varied during the course of an infection, being high at the early stages of the infection and very low at later stages. PMID- 3962162 TI - Host serum proteins in Taenia saginata metacestode fluid. AB - Taenia saginata cyst fluid was examined for host proteins; IgG1 and IgG2 as well as haemolytic complement activity were detected. Polyacrylamide gel electrophoresis revealed differences in proteinograms among the samples taken from 1-, 4-, and 10-month old cysts. Fluid from older cysts had fewer protein components and showed a weaker antigenic reaction with sera of bovines infected with T. saginata than that of younger cysts. The roles of antibody and complement in initiating degeneration of the parasite are discussed. PMID- 3962163 TI - Interaction of bovine complement with Fasciola hepatica. AB - The host-parasite relationship of Fasciola hepatica in cattle was characterized by determining the effects of the parasite on the bovine complement system. Phosphosaline extracts of F. hepatica adults inhibited both the classical and alternative pathways of complement activation in normal bovine and human sera in a protein dose-dependent manner. The in vitro reaction of viable newly excysted juveniles (NEJ) with bovine serum (NBS) and with bovine serum containing antibodies specific to F. hepatica (IBS) resulted in no detectable changes in serum hemolytic complement activity for either pathway. This lack of complement consumption occurred even though these same flukes incubated in IBS for at least 24 h developed a precipitate that adhered to the parasite tegument, a feature that may reflect antibody--antigen reactions. PMID- 3962164 TI - Effects of concurrent copper deficiency and gastro-intestinal nematodiasis on circulating copper and protein levels, liver copper and bodyweight in sheep. AB - Sheep were rendered hypocupraemic using parenteral ammonium tetrathiomolybdate (ATM). Fifteen thousand third stage larvae of Trichostrongylus axei and T. colubriformis in the ratio 1:1 were administered three times per week for six weeks, starting four weeks after cessation of ATM treatment. The changes in liver and plasma copper (Cu), caeruloplasmin activity, serum proteins, faecal nematode egg counts and total nematode counts were measured in the sheep for 10 weeks after infection. Decreases in liver Cu, plasma Cu and caeruloplasmin activities were detected soon after infection. There was a significant (P less than 0.05) interaction of the effects of Cu deficiency and nematode infection on these changes. Hypoproteinaemia, attributed to serum albumin loss, was demonstrated seven weeks after infection, but this was not associated with the interaction of Cu deficiency and nematode infection. No changes in serum globulins were detected. Although the results support the contention that gastro-intestinal nematodiasis can significantly exacerbate an existing Cu deficiency in sheep, there was no evidence that hypocuprosis would predispose sheep to higher nematode burdens. PMID- 3962165 TI - An egg-hatch assay for resistance to levamisole in trichostrongyloid nematode parasites. AB - An in vitro technique is described for detecting resistance of nematodes to the anthelmintic levamisole hydrochloride. Samples of eggs are developed under controlled temperature conditions until just prior to the commencement of hatching. They are then exposed to different concentrations of the drug and, when hatching is almost complete, the test samples are killed and preserved. The proportion of unhatched eggs at each drug concentration can then be counted at leisure. Provided a suitable range of drug concentrations is chosen for each test isolate, this assay provides results which may be satisfactorily fitted to a log concentration-probit regression model. Comparisons with in vivo anthelmintic assays have shown that the technique provides an accurate reflection of the resistance status of parasite populations. PMID- 3962166 TI - Comparative susceptibility of Romanov and Lacaune sheep to gastrointestinal nematodes and small lungworms. AB - The susceptibility of Romanov and Lacaune sheep to nematode parasites was studied in a permanent flock grazing an extensive pasture. The output of strongyle eggs and protostrongyle larvae was higher in Romanov ewes. Faecal samples of the Romanov ewes more often harboured Nematodirus eggs while the larvae recovered from cultures of these samples contained a higher percentage of Teladorsagia. Romanov tracer lambs had a significantly heavier adult Teladorsagia burden. This higher natural susceptibility of the Romanov breed was confirmed by experimental infections with T. circumcincta and N. spathiger but not with Trichostrongylus colubriformis. In infections with Muellerius capillaris and Protostrongylus rufescens, the worm burdens were similar but parasite fertility (larvae per adult) seemed to be higher in Romanov tracer lambs. PMID- 3962167 TI - Anthelmintic evaluation of a thiabendazole-resistant strain of Ostertagia circumcincta recovered from sheep in England. AB - A total of 35 worm-free lambs were infected with a strain of Ostertagia circumcincta isolated earlier from sheep in Cheshire, England, and found to be resistant to thiabendazole (TBZ). When patency was established the sheep were divided into groups of six, and dosed orally with either TBZ (44 mg kg-1, 88 mg kg-1), fenbendazole (FBZ; 5 mg kg-1) or levamisole (7.5 mg kg-1) or not treated. Three of the remaining five animals were dosed with FBZ at 10 mg kg-1. Egg hatch tests, post-dosing faecal egg counts and post-mortem worm counts confirmed resistance to TBZ, and a degree of side-resistance to FBZ was also revealed. Only levamisole gave the clearance expected of modern anthelmintics. PMID- 3962168 TI - Characterization of monoclonal antibodies directed against swine leukocytes. AB - Hybridomas were produced from fusions of the SP2/0 mouse myeloma with splenic cells from: 1) an outbred Sprague Dawley rat immunized with swine peripheral blood mononuclear (PBM) cells; 2) a (CBA/NDub X BALB/c Dub) F1 mouse immunized with concanavalin A (Con A) activated swine PBM cells and 3) a (BALB/c Dub X C3H/He Dub) F1 mouse immunized with swine thymocytes. The resulting supernatants were screened by a microcytotoxicity assay for activity against swine PBM cells. Four hybridomas (MSA1, MSA2, MSA3 and MSA4) were selected, cloned and characterized by their cell reactivity and effect on mitogenic assays. MSA1 and MSA2 belong to the rat IgG2b subclass. MSA3 and MSA4 are of the mouse IgG2a subclass. These monoclonal antibodies reacted in the following manner: MSA1 with monocytes, granulocytes, red blood cells and bone marrow cells; MSA2 with subset of T cells; MSA3 with B cells and subsets of T cells and monocytes (class II molecule) and MSA4, a pan-T cell reagent (E-rosette receptor). The involvement of the various cell types reactive to the different monoclonal antibodies in the mitogenic response of swine PBM cells to Con A, phytohemagglutinin (PHA) or pokeweed mitogen (PWM) was investigated by cellular depletion with monoclonal antibody plus complement. Cellular depletion of PBM cells with the following monoclonal antibodies plus complement treatment resulted in: MSA1, almost total reduction in the mitogenic response to low doses of Con A or PWM; MSA2, partial reduction in the proliferative responses to any concentration of Con A, PHA or PWM; MSA3, partial reduction in proliferative responses to low concentrations of Con A or PWM and 4) MSA4, total elimination of any proliferative response to Con A, PHA or PWM. PMID- 3962169 TI - Effects of cyclosporin A administration in cats. AB - Cyclosporin A was administered orally to 10 cats for 28 consecutive days at a dosage of 20 mg/kg body weight daily divided into 2 equal doses. Serum trough CyA concentrations ranged from 134 to 902 ng/ml with a mean of 567 +/- 249 ng/ml (means +/- SD). Immunosuppression by CyA was suggested in 5 cats by significantly depressed lymphoblast transformation responses. Various hematologic, serum chemical, and urinalysis parameters were monitored on a weekly basis in 10 cats. Serum urea nitrogen concentration increased significantly from baseline values on days 7, 14, and 21, but not on day 28. Urine concentrating ability was unimpaired. Alanine aminotransferase activity was decreased significantly from baseline values at each sample period during CyA administration. Drug-related side effects were minor; one cat developed gingival hypertrophy which regressed within 21 days of CyA withdrawal. PMID- 3962170 TI - Immunosuppression of lymphocyte blastogenesis in cattle infected with Ostertagia ostertagi and/or Trichostrongylus axei. AB - Twenty 4-month-old calves were infected with O ostertagi and/or T axei and the responses to phytolectins were evaluated. Whole blood cultures were incubated with phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM). The blastogenic response was determined by tritiated thymidine uptake with results presented as counts per minute (cpm), stimulation indices (SI) and a mononuclear cell responsive index determined by dividing the phytomitogen induced cpm by the absolute mononuclear cell number per ul. The control group results were adjusted to 100 percent and changes in the percentage difference by the parasitized calves was determined. There was a decline in lymphocyte responsiveness to PHA beginning at the time of infection. Significant depression of responses to PHA was observed in all parasitized calves 8 weeks after infection although clinical signs of parasitism did not occur. Lymphocyte responses to PW, were not different in infected calves from the control, although the O ostertagi group had significantly higher PWM mean upon than the calves infected with T. axei. A slight depression in response to Con A was also observed at 8 weeks after infection followed by a significant increase after 10 weeks. The immunosuppression appeared to be a feature of gastrointestinal parasitism and related to infections with O. ostertagi and/or T. axei. PMID- 3962171 TI - Immunity of specific pathogen-free lambs to challenge with an aerosol of Pasteurella haemolytica biotype A serotype 2. Pulmonary antibody and cell responses to primary and secondary infections. AB - Specific pathogen-free (SPF) lambs previously exposed to an aerosol of P. haemolytica biotype A serotype 2 (A2) were immune to subsequent challenge with an aerosol of P. haemolytica A2. Untreated control lambs were not immune to this challenge. The local immune responses of the lung to these challenges were examined. High IgG and IgA titres to P. haemolytica and high levels of opsonizing antibody against P. haemolytica were present in the lung washings from previously infected immune lambs at autopsy, seven days after the second infection. Lung washings from control lambs, 7 days after challenge with P13 virus and P. haemolytica A2, had no IgG titres, very little opsonizing activity but did have IgA titres which were significantly higher than in unchallenged control lambs. The cellular response of animals challenged with P13 virus and P. haemolytica was significantly greater than that of unchallenged controls or of lambs exposed only to P. haemolytica. However, this finding was complicated by the response to P13 virus. Lymphocytes from lung washings of all lambs failed to respond in a lymphocyte stimulation test to phytohaemagglutinin while blood lymphocytes did respond. There was little specific response to P. haemolytica antigen in the test. PMID- 3962172 TI - Systemic and local immune responses of gnotobiotic calves to respiratory infection with Mycoplasma bovis. AB - Gnotobiotic calves were inoculated by the intratracheal route with Mycoplasma bovis and the specific antibody response in sera and tracheo-bronchial washings examined by radioimmunoassay. In sera an IgM response which reached a peak two weeks post infection was followed by IgG1 and IgG2 antibody responses. Low levels of IgA antibody were detected in sera three and four weeks after infection. The predominant antibody in tracheo-bronchial washings 2 weeks after infection was IgA. Four weeks after infection IgG1 antibody predominated, but IgG2 and IgA antibodies were also present. Cells containing Ig were present in the cellular accumulations around the necrotic zones produced by M. bovis in the lung parenchyma two and four weeks after infection. IgG1 containing cells predominated in these cellular infiltrates. IgG2 producing cells were the next in frequency. It is concluded that the lung lesion caused by M. bovis is partly due to the host's immune response, presumably contributing to the control of the infection, and that the cells infiltrating the lung are a major source of the local and systemic IgG antibody that is detected after infection. IgA staining cells were observed in the submucosa of tissues from nasal cavity and trachea. These cells are probably the source of IgA in tracheo-bronchial washings and sera since IgA producing cells were not a predominant component of the lesion in the lung parenchyma. PMID- 3962173 TI - Intestinal atresia and stenosis: a review comparing its morphology. AB - A review of the literature on intestinal atresia of domestic animal species and humans was done. The 5 types of intestinal occlusions described in human infants are atresia type 1, atresia type 2, atresia type 3, stenosis, and the "apple peel" or "Christmas tree" deformity. The intestinal defects described in domestic animal species such as the bovine, equine and porcine are similar to those of human infants. The "T-formation", an intestinal defect of the bovine resembling atresia type 3, and rectal stricture, an acquired intestinal defect of the porcine resembling stenosis, were described recently. Intestinal atresia is similar in several species and these similarities raise the questions as to whether the pathogenic mechanism and possibly etiologies of intestinal atresia are similar in these species. PMID- 3962174 TI - The effect of thiaminase-induced subclinical thiamine deficiency on growth of weaner sheep. AB - Three experiments were performed to examine for causes of poor growth of young Merino sheep. Weekly testing of animals 42 weeks of age for 10 weeks revealed that 90% of clinically poor animals were excreting high levels of thiaminase in their faeces; low levels of activity were present in 20% of clinically normal animals. There were significant differences in the mean erythrocyte transketolase activity of the thiaminase excreting poor animals and the thiaminase free normal animals. Other known causes of poor growth could not be demonstrated. Weekly monitoring of thiaminase activity in the faeces from 80 lambs 6 weeks of age showed 23% to be excreting significant levels of enzyme (greater than 3mUg-1 DM) throughout a 10 week test period. Mean growth rates of these lambs were significantly below those of lambs not excreting thiaminase or excreting low levels intermittently. Supplementation of thiaminase excreting lambs with intra muscular injections of thiamine HCl was associated with a statistically significant improved growth rate (P less than 0.01) compared to unsupplemented sheep excreting thiaminase. Mean growth rates of lambs not excreting thiaminase on a continuous basis (sampled weekly) were the same with or without thiamine HCl supplementation. High thiaminase levels were found in the ruminal fluids of trial animals excreting the enzyme in their faeces, confirming this previously established association. Bacillus thiaminolyticus was isolated from faeces and ruminal fluids from clinically poor animals and is the most likely source of the thiaminase. Subclinical thiamine deficiency was indicated by low erythrocyte transketolase activities and elevated TPP effects and is proposed as the cause of the poor growth by the young sheep. PMID- 3962175 TI - Decrease in mass of slow and fast tenotomized muscles of guinea pigs: role of nerve impulses and neurogenic factors. AB - The role of nerve impulses and neurogenic factors in the decrease in muscle mass following tenotomy was investigated in 30 adult (15 males, 15 females) guinea pigs. Unilateral tenotomy, neurectomy and simultaneous tenotomy and neurectomy of slow and fast hindlimb muscles were performed in 3 groups respectively. Each group comprised 10 guinea pigs. The unoperated hindlimb of each animal in each group served as control. The weight loss occurred in both slow and fast muscles but was greater in the slow soleus muscle as compared to the fast gastrocnemius muscle. In each muscle the weight loss was least in the tenotomized group. This was followed by the weight loss in the neurectomized group. The greatest weight loss was observed in the simultaneously tenotomized and neurectomized group. These observations agree with the suggestion of other workers that a possible neurogenic factor flowing from the nerves to the muscles was very significant in maintenance of muscle fibre stability. It indicated also that simultaneous neurectomy and tenotomy did not prevent degenerative changes in slow and fast muscles and that it was not nerve impulses reaching the tenotomized muscles that were responsible for degenerative changes observed but that other factors were responsible. PMID- 3962176 TI - Effect of surfactants on weight gain in mice. AB - A study was conducted to determine if four surfactants can induce increased weight gain in the mouse. Basic-H, Triton X-100, Amway All Purpose Adjuvant and X 77 were put in water and fed to various groups of ICR 21 day old female mice for a period of 43 days. All the mice were clinically normal throughout the study period. Pathological examination of a random sample of the mice revealed no gross pathological changes. Similarly, histopathological examination of the lungs, livers and intestines did not reveal any visible lesions. Basic-H and Amway surfactants induced weight gain, though not significantly, better at 0.1% (V/V) concentration while X-77 and Triton X-100 induced weight gain better at 0.4% (V/V) concentration. Overall results show that none of the surfactants tested induced significant weight gain. PMID- 3962178 TI - Optimum age for measles immunization in Romania. AB - From 1979 to 1985 a serological survey was carried out to evaluate the opportunity to start measles vaccination at the age of 9 months. The following aspects were investigated: the persistence of maternal measles antibodies in 188 infants aged 1-8 months: such antibodies could not be detected over 7 months of age; the antibody response to measles vaccination in 181 infants vaccinated at the age of 9-11 months versus 291 children vaccinated when aged more than 12 months: no significant differences were found between the two groups; the age specific persistence of vaccine-induced hemagglutination-inhibiting antibodies during the 1-4 years following vaccination: no significant difference was found in terms of the children's age upon vaccination. The results lend support to the recommendation to consider 9 months as a satisfactory age to initiate measles immunization in Romania. PMID- 3962177 TI - Intestinal atresia and stenosis: a review comparing its etiopathogenesis. AB - Two theories were proposed originally to describe the development of congenital intestinal atresia. The theory of imperfect recanalization, the theory of vascular insufficiency, and studies which have been performed to validate each of these theories were reviewed. Specific causes of the development of vascular insufficiencies in different species were reviewed if literature was available. In utero vascular accidents have been incriminated as the major cause of congenital intestinal atresia distal to the duodenum. There was relatively little evidence to show that intestinal atresia is inherited in any species. Duodenal atresia may be caused by either an embryologic defect for which there is some evidence of inheritance or by a vascular accident. The pathogenic mechanism for intestinal atresia may be similar in most species. PMID- 3962179 TI - Sensitivity of lymphocytic choriomeningitis and Tacaribe viruses to several physical factors. AB - A comparative study was performed as regards the behaviour of lymphocytic choriomeningitis virus (LCMV)--strains Fo-2 and 522--and of Tacaribe virus (strain Tr 11573) at different temperatures and pH values. All the three arenavirus strains had a high thermosensitivity and were rapidly inactivated in an acid medium. LCMV was more sensitive to UV irradiation than Tacaribe virus. The effect of sonication was also investigated. PMID- 3962180 TI - Influence of several chemical reagents on lymphocytic choriomeningitis and Tacaribe viruses. AB - The sensitivity of lymphocytic choriomeningitis virus (LCMV) and Tacaribe virus to several chemical reagents was investigated. The viruses were sensitive to lipid solvents (ether, chloroform) and to detergents (sodium desoxycholate and Triton X-100); they were rapidly inactivated by formalin, beta-propiolactone, hydrogen peroxide and chloramine B. The results obtained contribute to a more complete characterization of the biological features of the arenavirus group and may be useful for scientific research and manufacturing of viral preparations. PMID- 3962182 TI - Influence of organic solvents and pH on some characteristics of influenza virus A(H1N1). Note 2. Effect of pH on some spectral and structural characteristics of influenza virus A(H1N1). AB - Spectrophotometric determinations as regards absorption at 280 nm, 260 nm and 224 237 nm, emission at 280-350 nm and light scattering at 550 nm were performed with suspensions of influenza virus A/Brasil/11/78 (H1N1) over a pH range from 2 to 12. The results obtained proved that changes in spectral parameters were minimal in the pH range from 6 to 10, a fact which could be correlated both with the preservation of the intact virion structure (as visualized by electron microscopy) and with the domain of biological stability of influenza virus. PMID- 3962181 TI - Effect of several unpurified milk preparations on experimental influenza infection in mice. AB - Investigations were performed as regards the effect of the in vitro contact of influenza virus A/PR/8/34 (H1N1) with different milk preparations: boiled milk, milk acidified with lactic acid, supernatant from boiled yoghourt. It was the latter preparation that had the highest efficacy as regards the reduction of hemagglutinating (HA) titer following direct in vitro contact and the course of experimental influenza infection in mice. In the case of animals inoculated with influenza virus exposed to yoghourt supernatant HA titers in the lung homogenates were lower, mortality rates were reduced and the mean survival time was longer than in controls infected with untreated virus. Considerations are made on the possible mechanisms of the antiinfluenza action of yoghourt supernatant. PMID- 3962183 TI - Preliminary data on the prevalence of anti-delta in Romania. PMID- 3962184 TI - Adenovirus DNA synthesis in vitro is inhibited by the virus-coded major core protein. AB - The effects of the adenovirus type 2 (Ad2) structural proteins on Ad DNA synthesis in vitro have been examined. Both of the viral core proteins, polypeptides V and VII were shown to inhibit Ad2 DNA synthesis in vitro; however, only the major core protein, polypeptide VII, inhibited DNA synthesis at a ratio of protein to DNA proportional to the number of polypeptide VII molecules associated with the Ad2 DNA in the mature virion. In addition, fractions containing the precursor to polypeptide VII, pVII, were capable of inhibiting Ad2 DNA replication in vitro to the same extent as polypeptide VII. Purified polypeptide VII bound to double-stranded DNA with no apparent sequence specificity. In addition, polypeptide VII protected Ad2 DNA from digestion with micrococcal nuclease. The binding of polypeptide VII was probably responsible for the inhibition of Ad2 DNA synthesis in vitro by virtue of rendering the DNA inaccessible to viral replication proteins. These results suggest that the core proteins must be removed from the Ad2 genome before the template can function in genome replication and that assembly of pVII on Ad2 DNA can terminate the replication process. PMID- 3962185 TI - Anti-idiotypic antibodies to monoclonal antibodies that neutralize coxsackievirus B4 do not recognize viral receptors. AB - We have made anti-idiotypic antibodies in rabbits against three mouse monoclonal neutralizing antibodies with specificities for independent epitopes on Coxsackievirus B4. Each of these anti-idiotypic antibodies was found to react specifically with the immunizing monoclonal antibody in radioimmunoassays and did not react with the other monoclonal antibodies. In addition, the anti-idiotypic antibodies specifically inhibited the function (i.e., virus neutralization) of the immunizing antibody. These anti-idiotypic antibodies were tested for their ability to recognize receptors for Coxsackievirus B4 as measured by their ability to inhibit the attachment of radiolabeled virus to cellular receptors. The anti idiotypic antibodies did not block the binding of Coxsackievirus B4 to monkey kidney cells. Moreover, when tested for their ability to bind to other receptor positive cells, none of the anti-idiotypic antibodies bound above control levels. Anti-idiotypic antibodies did induce a small anti-anti-idiotypic antibody response in mice when tested by radioimmunoassay; however, little if any virus neutralizing activity was found in the sera of these mice. Our results contrast to those reported for anti-idiotypic antibodies in several other virus systems and suggest that not all anti-idiotypic antibodies made against neutralizing antibodies are capable of eliciting an antiviral immune response or binding to viral viral receptors on cells. PMID- 3962186 TI - Separation of the functions controlled by adenovirus 2 lp+ locus. AB - The adenovirus lp+ locus is located within early region E1b (map position 4.5 11.2) and codes for a 19-kDa tumor antigen (175R). Genetic analysis of the viral mutants that map within this region indicates that the lp+ locus controls multiple functions in cell transformation and in productive viral infection. Viral mutants mapping within the lp+ locus produce wt-like cytopathic effect (cyt+) or a cytocidal (cyt) effect. Earlier results have shown that many of the viral mutants that produce cyt phenotype in infected cells are transformation defective. In the present studies we show that one of the cyt mutants, cyt 106 which has a single amino acid substitution at position 20 transforms the established rat embryo cell line, CREF, at somewhat reduced frequency. Nonetheless, the cyt106-transformed cells appear to be fully transformed when compared with Ad2 wild type transformed cells. Unlike most other cyt mutants, cyt 106 is dominant over Ad2 wild type in mixed infections as judged by the plaque morphology in infective center assays and by the cytopathic effect. The dominant nature of the mutation may contribute to the observed transformation characteristics. Earlier we have shown that a cytocidal mutant, dl250 is partially defective in viral DNA synthesis in human KB cells. Now we show that two other cyt mutants cyt 5 (with a chain termination mutation near the C terminus) and cyt 6 (with a single amino acid substitution at position 44) are also partially defective in viral DNA synthesis in human KB cells. In contrast to these mutants, mutant cyt 106 induces normal replication of viral DNA. The DNA replication defect in mutants cyt 5 and 6 can be complemented in trans in 293 cells that constitutively express the 175R T antigen. Our results also indicate that a domain of this protein around the 44th amino acid is important for efficient viral DNA synthesis in KB cells. PMID- 3962188 TI - Messenger RNA of the M segment RNA of Rift Valley fever virus. AB - The putative messenger RNA (mRNA) of the M segment RNA of the phlebovirus Rift Valley fever virus (RVFV) has been characterized using S1 nuclease mapping and oligonucleotide primer extension procedures. These experiments revealed that the 3' end of the mRNA lacks approximately 112 nucleotides of the M genomic RNA sequences, and that the 5' end of the mRNA possesses all of the sequences present at the 3' end of the M RNA but is further extended beyond the end of the genome by some 12-14 nucleotides of unknown origin. The implications of these data are discussed in relation to the replication and expression strategy of this virus. PMID- 3962187 TI - Overproduction and purification of the products of bacteriophage T3 genes 18 and 19, two genes involved in DNA packaging. AB - The products of gene 18 (gp18) and gene 19 (gp19) of bacteriophage T3 are noncapsid proteins involved in DNA packaging. A restriction fragment containing gene 18 or 19 was cloned into the plasmid vector pNT45 under the control of the inducible leftward promoter (PL) of phage lambda. Induction of transcription of gene 18 or 19 by derepression of the PL promoter led to the synthesis of a high level of gp18 or gp19. By using complementation of T3 DNA packaging in vitro as an assay, gp18 and gp19 were purified to near homogeneity. The overall yields of gp18 and gp19 were 1.4 mg and 0.35 mg, respectively, from 1 g wet wt cells. Addition of gp18 to the in vitro DNA packaging system resulted in increased phage production with increasing amounts of gp18 until 10% of the DNA was packaged into infectious phage particles. In contrast, addition of gp19 to the packaging system initially caused an increase in phage production, but increasing amounts of gp19 inhibited DNA packaging. PMID- 3962189 TI - Lymphocytic choriomeningitis virus. IX. Properties of the nucleocapsid. AB - Nucleocapsids (NC) of lymphocytic choriomeningitis (LCM) virus were obtained by treatment of purified infectious virus with detergent and salt at high concentrations, followed by gradient centrifugation. NC thus prepared contained 31 S RNA, 23 S RNA, and a protein with an apparent mol wt 63,000 and an isoelectric point pH 5.7 (p63), assumed to be the nucleoprotein. We had previously observed that the intact LCM virus contained two kinds of protein with mol wt 63,000 separable by their isoelectric points which were pH 5.7 and 7.7, respectively. We now found that the latter component was removed from the NC together with the glycoproteins, and labeling studies revealed that it was closely associated with the viral envelope. We have named the protein with a mol wt of 63,000 and an isoelectric point pH 7.7 p63E (E for envelope). By limited proteolysis both viral components of mol wt 63,000 could not be distinguished, indicating that they are basically identical. It appears that p63E is the phosphorylated form of p63. PMID- 3962190 TI - [Metabolic aspects in internal medicine]. PMID- 3962192 TI - [Cardiomyopathy and endomyocardial biopsy under the optical microscope]. PMID- 3962191 TI - [Left ventricular function in patients undergoing regular dialysis treatment]. PMID- 3962193 TI - [Disorders of lipid metabolism as a risk factor for atherosclerosis in patients with chronic kidney insufficiency]. PMID- 3962194 TI - [Atherosclerosis in long-term hemodialysis patients]. PMID- 3962195 TI - [Chronic activity of cholestatic liver disease in alcoholics]. PMID- 3962196 TI - [Changes in the metabolism of zinc and copper in chronic liver diseases]. PMID- 3962197 TI - [The effect of ajmaline and amiodarone on the heart conduction system]. PMID- 3962198 TI - [Use of the Fenwal CS-3000 automatic blood cell separator for cytopheresis (review)]. PMID- 3962199 TI - [Wegener's granulomatosis with bilateral necrotizing scleritis]. PMID- 3962200 TI - [Experience with etozolin, a new diuretic]. PMID- 3962201 TI - [The myelodysplastic syndrome]. PMID- 3962202 TI - [Chromosome findings in the myelodysplastic syndrome]. PMID- 3962203 TI - [Clonal culture of hematopoietic cells in patients with the myelodysplastic syndrome]. PMID- 3962204 TI - [Diastolic time intervals and the calibrated A wave of the apex cardiogram in patients after myocardial infarct]. PMID- 3962205 TI - [Comparison of the thallium heart scan and coronary radiography in patients with ischemic heart disease]. PMID- 3962206 TI - [The importance of one-dimensional echocardiography for the evaluation of left ventricular function in patients after an acute myocardial infarct]. PMID- 3962207 TI - [Adverse effects of Cordarone in a study in rats]. PMID- 3962208 TI - [The effect of a single dose of magnesium on systolic time intervals]. PMID- 3962209 TI - [Incidence of obesity and hypertension in relatives of diabetics]. PMID- 3962211 TI - [Necrosis of the bone marrow]. PMID- 3962210 TI - [Thrombotic and hemorrhagic complications in polycythemia vera]. PMID- 3962212 TI - [Implantation of skin metastases due to pericardial puncture]. PMID- 3962213 TI - [Reliability of HLA typing in transported blood]. PMID- 3962214 TI - [Ambulatory oxygen therapy enriched with oxygen]. PMID- 3962215 TI - [Method of conducting studies with medical students concerning the development and organization of the work of the medical dispensary of a regiment in the field]. PMID- 3962216 TI - [Reconstruction of the larynx after extensive injuries]. PMID- 3962217 TI - [State of immunity of patients with chronic viral diseases of the liver]. PMID- 3962218 TI - [Organization of sanitary inspection during the conduct of gamma- and roentgenodefectoscopy]. PMID- 3962219 TI - [Medical provisions for flights conducted by young pilots]. PMID- 3962220 TI - [Reasons for the occurrence of specific diseases of divers]. PMID- 3962221 TI - [Experience with in the prevention of drunkeness and alcoholism]. PMID- 3962222 TI - [Changes in hemodynamics under general anesthesia following traumatic injuries]. PMID- 3962223 TI - [Prognostic criterion in evaluating the course of the postoperative period]. PMID- 3962224 TI - [Experience with the rehabilitation of patients with ischemic heart disease at a cardiologic sanatorium]. PMID- 3962225 TI - [Stability of solutions of izonitrozin during storage]. PMID- 3962226 TI - [Determination of the erythrocyte deformability index in patients with ischemic cerebrovascular disorders]. PMID- 3962227 TI - [Changes in lactate dehydrogenase isoenzyme activity in the serum and urine of patients with endemic nephropathy]. PMID- 3962228 TI - [Echotomography of the brain. New diagnostic possibilities]. PMID- 3962229 TI - [Transformation of human fetal skin fibroblasts in the presence of kidney cells from patients with endemic nephropathy]. PMID- 3962230 TI - [Endoscopic removal of gastric polyps]. PMID- 3962231 TI - [Determination of histamine in fish using the thin-layer chromatography method]. PMID- 3962232 TI - [Rationale for radiodiagnosis in the abdominal organs]. PMID- 3962233 TI - [Antibiotic prophylaxis in surgery]. PMID- 3962234 TI - [Viral hemorrhagic fevers. Basic epidemiologic characteristics]. PMID- 3962236 TI - [Isolated tuberculous spondylitis in the older person as a diagnostic problem]. PMID- 3962235 TI - [Post-traumatic psychoses]. PMID- 3962237 TI - [Laryngocele as a problem in differential diagnosis]. PMID- 3962238 TI - [Nonbacterial pneumonia. Possibilities of the early determination of its etiologic diagnosis]. PMID- 3962240 TI - [Working classification of spinal tumors and their surgical treatment]. AB - A working classification of vertebral tumors is discussed. The classification is based on tumor process expansion, presence of soft-tissue component and the degree of vertebral and neurologic complications. The extent and type of surgical procedure are determined in accordance with the authors' approach to tumor process staging. PMID- 3962239 TI - [Morphometric analysis of the free stromal cells of nevi and malignant melanomas]. AB - A morphologic study of 114 cases of pigmented skin tumors was carried out. The cases were divided into 5 groups on the basis of the degree of nevus proliferation and depth of melanoma invasion. The percentage and correlation between different types of free stromal cells were obtained for different skin zones in 6 cases of each group. Correlation analysis established the set character of cell cooperation at different stages of tumor growth. Diagrams illustrating correlations between free stromal cells and pigmented formations patterns are discussed. The results of the study may be helpful in running diagnostic tests of nevi for malignancy as well as identifying the depth of melanoma invasion whenever visual morphologic examination is insufficient. PMID- 3962241 TI - [Changes in the lymphatic vessels of the upper extremity following a radical mastectomy (based on lymphographic data)]. AB - The study group included 171 patients suffering from postmastectomy syndrome which had developed either after combined treatment for breast cancer or after radical mastectomy alone. Lymphographic examination of 146 cases carried out long after treatment for primary treatment revealed frequent roentgenologic features characteristic of all patterns of secondary obstructive lymphatic edema. In 20 patients, lymphographically-detectable changes were followed at early stages (until day 40 after radical mastectomy) before edema became clinically apparent. Radiation therapy and erysipelatous inflammation were shown to have an effect on lymphatic lesions. PMID- 3962242 TI - [Adenocarcinoma of the anal canal]. AB - Adenocarcinoma of the anal canal is a rare pattern accounting for 1.5% of rectal malignancies. Mucinous and poorly-differentiated carcinomas are predominant. The said tumors are highly pernicious, with prognosis being poor even in radically- operated cases. Long-term treatment results are extremely unsatisfactory. PMID- 3962243 TI - [Quality of the information obtained by a questionnaire survey in studying the epidemiology of malignant neoplasms]. AB - The quality of the data collected in a retrospective cohort breast cancer study in Estonia was evaluated. Two separate approaches were used to investigate possible biases in the study. Firstly, a similar questionnaire was mailed to a sample of 86 women twice during an interval of one week to six months. Overall questionnaire reliability was 83.4%. Secondly, comparisons of the data obtained by postal questionnaires about past history of lung tuberculosis with hospital medical record information revealed that 2.5% of women with severe forms of the disease and 30.3% with milder forms (controls) had denied their previous disease. These findings show that more attention must be paid to the quality control procedures in cancer epidemiology studies. PMID- 3962245 TI - [Clinical and prognostic significance of determining the carcinoembryonic antigen in patients with gastrointestinal cancer]. AB - The paper discusses the results of a radioimmunologic assay of carcinoembryonic antigen (CEA) levels in 100 cases of gastrointestinal cancer. CEA--PRIST kits (Phadebas, Sweden) and NGR-603 automatic gamma-unit (Tesla, Czechoslovakia) were employed. The test proved to be highly instrumental in the preoperative evaluation of prognosis and early detection of recurrence and metastasis. CEA concentrations within 30-50 ng/ml are highly suggestive of recurrence or metastases, whereas 50-100 ng/ml should serve an indicator of organ dissemination. The test is useful in assessing the effectiveness of treatment in the course of follow-up. PMID- 3962244 TI - [Precancerous and cancerous lesions of the esophagus and forestomach in mice with skin exposure to a heavy catalytic gas oil]. AB - Painting with heavy catalytic gas oil was followed by skin tumor development in 97 (84.3%) mice: benign lesions--21 and carcinoma--76 cases. Pathologic changes in the upper part of the digestive tract were found in 55 out of 106 mice (51.9%): precancerous lesions (leukoplakia, dysplasia and papilloma) in 54 cases and cancer in one animal. Frequency of development of papilloma in the cardia was 27 times that in the esophagus. Multicentric growth was typical of precancerous lesions. Papilloma of the cardia was found in one control animal. Resorptive as well as direct action of gas oil seem to have been the causative factors of the development of precancerous and neoplastic lesions of the upper part of the gastrointestinal tract. The agent found its way into the digestive tract as animals licked each other in the course of the experiments. PMID- 3962246 TI - [Results of the endoscopic observation of patients operated on for cancer of the large intestine]. AB - 219 patients radically operated on for large bowel cancer were followed up for 1 16 years. Polyps were detected in 81 patients (37%) (malignant ones--9.6%), relapse in anastomosis--9 (4.1%) and metachronous tumors in 5 (2.3%). Cases operated on for cancer of the rectum and left half of the colon were at particularly high risk for recurrence development. PMID- 3962247 TI - [Metastases of kidney cancer (based on autopsy data)]. AB - The paper deals with the data on 1,248 autopsied cases of renal cancer. Metastases were detected in 87.1% (lung--48.2, lymph nodes--43.6, bones and joints--29.1 and liver--28.7%). 90 out of 139 cases of brain metastases died of the lesion. Metastases into the operative scar (most likely, implantation ones) were registered in 8 out of 224 (3.6%) previously nephrectomized cases. In some patients, nephrectomy produced an inhibitory effect on metastatic spread; 13% of the nephrectomized patients survived 5-20 years after surgery. PMID- 3962248 TI - [Detection of thermostable tissue esterases in the lung tissue and sputum of lung cancer patients]. PMID- 3962249 TI - [Metachronous unilateral lung cancer]. PMID- 3962250 TI - [Optimization of the surgical treatment of stomach cancer by the cryogenic method]. PMID- 3962251 TI - [Pathomorphosis of cervical cancer with different methods of radiation treatment]. AB - The report deals with a comparison of the results of cytologic and clinical evaluation of the effectiveness of different methods of radiotherapy in 93 cases of cervical carcinoma. A correlation established between cytologic data and clinical manifestations suggested that cytologic procedures be used as a criterion for ascertaining tumor radiosensitivity. The advantages offered by application of modifiers of tumor radiosensitivity are discussed. PMID- 3962252 TI - [Risk factors and choice of treatment method with uterine choriocarcinoma patients]. AB - An analysis of the results of uterine choriocarcinoma treatment versus the degree of risk is presented. Chemotherapy alone was found to be sufficient in 70.2% of cases free of risk, as compared with only 31.2% in case of four and more factors. Application of chemotherapy alone proved, on the whole, to be more beneficial than that of surgery plus chemotherapy modality, as evidenced by the death rates of 13.8 +/- 3.4 and 32.5 +/- 5.4% (t = 2.9), respectively. Polychemotherapy of cases with 1-4 factors of risk or more gave significantly better results than monochemotherapy, regardless of the former being a sole treatment or a component of combined therapy. PMID- 3962253 TI - [Individual prognosis of uterine choriocarcinoma patients]. AB - A model for making individual prognosis in uterine choriocarcinoma was developed using clinical data on 166 cases. The Neumann-Pearson method was employed to determine the role of varying presence of 20 most significant prognostic factors which describe the peculiarities of the body, tumor process and its response to therapy. A comparison in a control group showed a 95% coincidence between prognosis and actual survival. PMID- 3962254 TI - [Clinical aspects of a synchronous cancerous lesion of the corpus uteri and the ovaries]. AB - The results of a clinical study of 42 cases of synchronous endometrial and ovarian tumors are discussed. Clinical manifestations of synchronous cancer were found to be similar to those of endometrial carcinoma. Postmenopausal patients showed a favorable course of tumor process, thus suggesting its primary multiple origin, slightly more frequently than reproductive or climacteric females. As far as the findings on the distant end results went, multiple lesions should not be regarded as an indisputably unfavorable factor of prognosis. PMID- 3962255 TI - [Evaluation of the prognostic factors in patients with stage-I and -II ovarian cancer treated by an operation + irradiation variant]. AB - The results of combined treatment (surgery and postoperative radiotherapy) in the group of 240 patients with stage I and II ovarian carcinoma were evaluated. The following factors were found to be important for prognosis: (I) removal of clinically detectable cancer sites during primary surgery (60.7% of 5-year survivals versus 19.4% of cases of surgery described by the surgeon as non radical); (2) stage of tumor: 62.2% of survivals at stage I as compared with 28.3% at stage II; 73.9% at stage I without changes in the capsule of tumor against 56.9% in the other groups with the same stage; 45.5% at stage IIa versus 22.9% at stages IIb and IIc; (3) low differentiation of ovarian carcinoma which reduces curability to 44.9% in cases of stage I and IIa tumors. Five-year survival rates were higher, though statistically insignificant in those patients with stage Ia(i) and Ib(i) in whom intravaginal radium was applied (81.8%), and in those with stages Ia(ii), Ib(ii) and Ic in whom the whole abdomen was irradiated (64.5%). No statistically significant differences in relation to age, type of surgery, size of tumor identified during the first operation or type of teleradiotherapy (conventional roentgenotherapy or telecobalt therapy) were found. PMID- 3962256 TI - [Factors affecting the incidence of metastasis of malignant epithelial tumors of the ovaries]. AB - Clinico-morphological data on 714 cases of epithelial ovarian malignancy were evaluated. 558 patients (78.2%) revealed metastases at various sites in the course of primary treatment. Frequency of dissemination was significantly higher in patients over 40 years, postmenopausal ones and those with a shorter history of disease (duration of symptoms). A significantly higher frequency of metastatic spread was also observed in cases of bilateral involvement of the ovaries, invasion through the tumor capsule and into adjacent tissues and organs, adhesions, ascitis, hydrothorax, cystic-solid, solid and papillary growth patterns (vs relatively lower frequency for cystic tumors). Histologic type of tumor was of major importance, too. PMID- 3962257 TI - [Proliferative mucosal changes of the corpus and cervix uteri in women using intrauterine contraceptives]. AB - The paper discusses the incidence and peculiarities of proliferative changes in cervical and uterine mucosa of women with a record of using polyethylene intrauterine contraceptives (Lipps' loop) under 12 years. Intrauterine contraception is not conducive to a rise in the frequency of either precancer or cancer of the uterine cervix; nor is it responsible for endometrial malignancies. PMID- 3962258 TI - [Combined and complex treatment of patients with II-stage malignant skin melanoma using hyperthermia]. AB - Combined and complex treatment for stage II (T3-4N1M0) malignant melanoma of the skin was carried out 111 cases. In 73 of them, local and/or general hyperthermia was employed as cytostatic and radiotherapy modifier. Local super-high frequency hyperthermia was shown to potentiate the antitumor action of ionizing radiation on melanoma cells. Its effect increased with temperature rising from 42 to 43 degrees C. Application of hyperthermia in the said treatment was followed by a considerable increase in 5-year survival, viz. 49.4%. It was significantly higher than with standard treatment procedures (P less than 0.05). PMID- 3962259 TI - [Surface condition of erythrocytes in the dynamics of the tumor process]. AB - Both clinical and experimental malignant growth was found to involve echinocytosis at early stages. The glycoprotein layer of erythrocytic membrane showed distinct reaction at initial blastogenesis which leveled off as tumor advanced. PMID- 3962260 TI - [Induction of stomach cancer by the chronic action of arsenic]. AB - Out of 18 albino rats which survived 17-24 months after implantation in a partially isolated glandular stomach compartment of a perforated polyethylene capsule containing 8 mg arsenic trioxide in a fat-wax mixture as vehicle, two developed muconodular adenocarcinoma and one--mucoid cystic adenocarcinoma in that gastric compartment; metastasis into the liver was detected in one animal. No malignant tumors were found in 9 rats with the same post-surgical survival time after implantation of a control capsule containing the same mixture without arsenic. Since spontaneous gastric cancers practically fail to appear in laboratory rats, nor have they ever been reported by other authors after control capsule implantation but developed in some rats after implantation of a carcinogen-containing one, the results of the present investigation may be interpreted as an experimental proof of the carcinogenicity of arsenic which was previously assumed on epidemiologic evidence. PMID- 3962261 TI - [Effect of blood serum proteins and glucose on the polyamine content of the liver of rats with Guerin's carcinoma]. AB - The paper deals with an evaluation of the levels of polyamines (putrescin, spermidine and spermine) in the liver tissue of rats bearing Guerin's carcinoma, after injection of blood serum proteins and glucose. Tumor growth was followed by an increase in polyamine levels in the liver tissue of tumor-bearing rats. Injection of blood serum or glucose prevented the development of the said changes. It was inferred that tumor-induced changes in polyamine profile of the host liver are nonspecific. They are compensatory and intended for correction of homeostasis of the host. PMID- 3962262 TI - [Determination of the volume of surgical intervention in cancer of the corpus uteri]. AB - Clinical, cytologic, histologic and X-ray procedures were used in examining 120 patients with endometrial carcinoma. The results of pre- and intraoperative determination of clinical stage were compared in 65 cases of uterine extirpation with appendages and lymphadenectomy. Errors in preoperative identification of the extent of tumor expansion were made in 9 cases (13.8 +/- 4.3%). It was found that determinations of the site and expansion of tumor make the case for hystero cervical-angiolymphography whereas identification of tumor pattern and degree of cell differentiation--for cytologic and histologic assays. PMID- 3962263 TI - [Effects of a series of food substances on motor and emptying function of the gastric stump and diverting intestinal loop after stomach resection and truncal vagotomy]. AB - Altogether 253 patients operated on for peptic ulcer were examined for the action of 30 foods on motor and evacuatory function of the gastric stump and efferent intestinal loop. 213 patients were subjected to gastric resection after Hofmeister-Finsterer and 40 patients to antrum resection and truncal vagotomy. Proceeding from the action on motor function of the gastric stump and efferent intestinal loop the foods were distributed into three groups: with a stimulation, inhibitory of weak effects on the function. The first group included beef and fish broths, boiled meat, rye bread, cabbage, tomato, apple, cherry and black currant juices, rhubarb infusion, fresh kefir, carrot and pumpkin purees. The group of foods producing an inhibitory action comprised milk and milk whey, cottage cheese, sugar, butter, sunflower oil, lard, rice and oat decoctions, mashed potatoes and potato juice, buckwheat porridge and semolina, wheat bread, raw eggs, and honey. The action of the same foods was found to be different as regards the effect on the gastric stump and efferent intestinal loop, on tonic and contractile functions of the organs. The dietetic management of patients undergoing gastric operations should be carried out on a strictly individualized basis with allowance made for the functions of the gastric stump and intestinal loop and for the action of foods on the organs. PMID- 3962264 TI - [Changes in body functional state of man receiving ready-to-use food concentrate bricks]. AB - During 3 days 8 young volunteers received briquet food concentrates ready for use. The concentrates made up the pocket diet to be employed on an individualized basis. The mass of the diet was 600 g. It included 118.4 g protein, 39.9 g fat, and 370.8 g carbohydrates. The test subjects ate up their food appraising the gustatory qualities of the diet constituents. The loss of the body mass amounted to 0.77 kg during the first day, 0.22 kg during the second, and 0.19 kg during the third day of being kept on the diet. Medical and physiological studies did not reveal any substantial alterations in body function of the test subjects during the entire observation period. No allergic reactions were recorded. PMID- 3962265 TI - [Factual nutrition and several indicators of health status of urban schoolchildren of the regions of Ukraine]. AB - Altogether 2334 schoolchildren (first-, fifth- and eighth-graders) were examined for the factual nutrition, health status and physical development. The diet received by the schoolgirls of the above grades and that of the first-grade boys correlated well with the recommended physiological standards, whereas the diet of the eight-grade boys and five-grade boys in particular was slightly lower as compared to those standards. Attention is drawn to an ever increasing number of obese children, which has an adverse effect on the percentage of harmoniously developed children, reducing it to 66.7%. To improve the nutrition of schoolchildren, the authors have developed sets of foods and exemplary menus which have been included into the methodological instructions for organization of schoolchildren's catering in nonspecialized schools of the Ukrainian Soviet Socialist Republic. PMID- 3962266 TI - [Hygienic approaches to effective nutrition of students in the North]. AB - Investigations made by the author permitted derivation of the physiological standards of nutrition and energy expenditures for the students of different ages at boarding schools and industrial-engineering colleges. The indicators of the disease incidence among the students and their health status served as criteria of the efficacy of the standards offered. PMID- 3962267 TI - [Chemical methods of evaluating the quality of dietary proteins]. AB - The author suggests a method for computation of the difference coefficient of the amino acid score (DCAS) which indicates the mean percentage of the utilization of essential amino acids contained by food protein not to be used for plastic needs. The magnitude of the 100-DCAS is equal to the indicator of the biological value of protein. PMID- 3962268 TI - [Effects of different types of nutritional imbalance on lipid peroxidation and viscosity of membrane lipids]. AB - For 90 days male August rats were kept on 5 diets: (I) balanced semisynthetic, (II) with amino acid unbalance, (III) with excess polyunsaturated fatty acids (PUFA), (IV) with vitamin E deficiency, and (V) polyunbalanced (amino acid unbalance, excess PUFA, vitamin E deficiency). In liver microsomes, the authors studied the kinetics of malonic dialdehyde accumulation in the course of NADPH dependent lipid peroxidation (LP) and microviscosity of the lipid phase of microsomal membranes according to eximerization of the pyrene fluorescent hydrophobic probe. The microsomes of the animals fed diets I, III and IV showed on the average a 50 to 55% increase in the rate of MDA formation, whereas those of rats on diet V a 78% increase as compared with appropriate characteristics in the animals fed diet I. A good correlation was established between the decrease in the pyrene eximerization rate and accumulation of lipid peroxides: r = 0.09 (P less than 0.05). The possibility of affecting LP in the membranes by the goal oriented modification of the diet is discussed. The participation of proteins, lipids and tocopherol in the maintenance of the membrane structure is described. PMID- 3962269 TI - [Phospholipid composition of membrane lipids of hepatic subcellular structures in rats under the effects of different nutrition and phosphorus and fluorine compounds]. AB - A study was made of the phospholipid composition of the membranes of the rat liver nucleus, mitochondria and microsomes under the effect of different nutrition, hydrogen fluoride and phosphine. It was established that prolonged exposure to hydrogen fluoride and phosphine resulted in alterations of the phospholipid composition of the membranes of the liver nucleus, mitochondria and microsomes. The pattern of nutrition, the diet content of retinol, tocopherol, ascorbic acid and essential amino acids (lysine, methionine, threonine) determined not only the quantitative and qualitative composition of phospholipids but also the action of the foreign substances under study on the cell membranes. The enrichment of the diet with retinol, tocopherol, ascorbic acid and thiamine reduced the membrane-damaging action of hydrogen fluoride and phosphine. PMID- 3962270 TI - [Effects of diets including an active vitamin D 3 metabolite and different contents of calcium and phosphorus on the state of blood free amino acids in hypokinetic rats]. AB - Some aspects of amino acid metabolism in rats exposed to 30 days of hypokinesia were explored. The animals were placed on the diets with varying Ca/P ratio, containing 24, 25-dihydroxycholecalciferol (24, 25 (OH)2)D3, an active vitamin D3 metabolite. It was demonstrated that high consumption of phosphorus brought about an appreciable reduction in the blood amino acid pool, thus aggravating the body response characteristic for hypokinesia. The use of 24, 25 (OH)2D3 promoted the recovery of the amino acid status of hypokinetic rat blood, while the optimization of the Ca and P content in the diet was absolutely indispensable. PMID- 3962271 TI - [The spectrum of fatty acids in blood lipids and lymph of the small intestine in dogs with hypercholesterolemia]. AB - Experimental alimentary hypercholesterolemia in conditions of thyroid blocking was attended by accumulation of esterified fatty acids (EFA) in the atherogenic lipoproteins of the blood plasma and lymph in the intestine. Rearrangement of EFA pool depended to a great measure on the reduction of linoleate share in cholesterol phospholipids and ethers. The concentration of free linoleate decreased. Arteriovenous difference in the content of free linoleate was detected only in intact animals. It is supposed that changed parameters of penetration of free linoleate into enterocytes are related to enhanced endocytosis of the blood plasma lipoproteins and to intracellular accumulation of fatty acids, that may be responsible for similarity of EFA composition in hypercholesterolemia. As a result, a part of free linoleate pool, normally engaged in lipid synthesis, is spent for energy purposes. This may predetermine a relative depletion of blood plasma lipoprotein linoleate in hypercholesterolemia. PMID- 3962272 TI - [Level of thiamine diphosphate in the liver of tumor-bearing animals kept on a diet including an excessive amount of vitamin B 1]. AB - In mice bearing solid Ehrlich's carcinoma, food consumption did not differ from that in intact animals throughout the whole experiment. In mice with Ehrlich's ascites carcinoma and in rats bearing Walker's carcinosarcoma 256, the daily feed consumption decreased 2-fold by the terminal period of tumor development. In rats, the amount of vitamin B1, calculated per unit of the feed consumed, exceeded the daily requirements of vitamin B1. The content of thiamine diphosphate in the liver of tumor-bearing animals was 35% as reduced whatever the method of inoculation and site of tumor development (under the skin or inside the abdominal cavity). In rats with Walker's carcinosarcoma 256, transketolase activity was 17% as lowered (P less than 0.01). In mice with Ehrlich's carcinoma, the activity of the enzyme was 21% as decreased (P less than 0.01; an ascitic variety) or 17% as decreased (P less than 0.01; subcutaneously inoculated tumor). PMID- 3962273 TI - [Effects of different contents of selenium in the food on the growth of transplanted and chemically induced tumors]. PMID- 3962274 TI - [Methods of the determination of the residual amount of actellic in poultry products]. PMID- 3962276 TI - [Unified system of public health control over the residual amount of pesticides in food products using automated data processing]. PMID- 3962275 TI - [Element composition of pollen collected in the Lithuanian S.S.R]. PMID- 3962277 TI - [Study of oxidative stability and antioxidant activity of lipids]. PMID- 3962278 TI - Two examples of low ionic strength-dependent autoagglutinins with anti-Pr1 specificity. AB - Two low ionic strength-dependent autoagglutinins were studied and found to have anti-Pr1 specificity. This specificity was determined by studies with enzyme treated and neuraminidase-treated human red blood cells (RBCs), animal RBCs and chemically-modified sialoglycoproteins, all suspended in a low ionic strength solution (LISS). Both IgM complement-binding cold agglutinins had a wide thermal range and caused in vitro hemolysis of some LISS-suspended RBCs at 37 degrees C. Compatible blood was found for these patients by using techniques that did not employ LISS. PMID- 3962279 TI - An unusual sialoglycoprotein associated with the Webb-positive phenotype. AB - This paper presents the results of a study on the erythrocyte membrane proteins from Webb-positive individuals. The membrane proteins were separated by polyacrylamide electrophoresis and stained using a Silver stain as well as Coomassie blue and PAS stains. All Webb-positive individuals exhibited a decrease in the beta-sialoglycoprotein beta SGP band along with the appearance of a new SGP 3,000 daltons less than beta SGP. It is postulated that this band is an abnormal beta SGP possibly lacking the N-linked oligosaccharide that is normally present in beta-SGP. PMID- 3962280 TI - A family demonstrating inheritance of the Leach phenotype: a Gerbich-negative phenotype associated with elliptocytosis. AB - The proposita of a Canadian family and 2 of her sibs have the rare Leach phenotype and provide the first evidence that the Leach phenotype is an inherited condition. Their red cells are Ge: -2, -3 and fail to react, by the antiglobulin test, with the monoclonal antibodies GERO, BRIC 4 and BRIC 10. The minor sialoglycoproteins beta, beta 1 and gamma are apparently absent from their red cell membranes. A proportion of their red cells are elliptocytes indicating that beta and/or beta 1 and/or gamma have a function in maintaining normal red cell shape. PMID- 3962281 TI - Application of network planning methodology to workflow analysis in a reference laboratory. AB - Efficient organization of the workflow in a reference laboratory is essential to timely resolution of serological problems. This study investigated the usefulness of network planning methods to streamline workflow in a blood center reference laboratory. The investigation of a patient serological problem which included a positive direct antiglobulin test was chosen for analysis. Individual steps in the resolution process were identified. All possible logical sequences of these steps were investigated to determine which steps were along the 'critical path', the sequence of steps which is rate-limiting. By implementing new procedures for these steps, faster resolution of a problem should result. The Program Evaluation Review Technique predicted that altering procedures to shorten 3 steps (autoadsorption, antibody identification panel at 37 degrees C and screening for antigen-negative units) would result in a decrease in the time required to complete a patient problem by 29%. Time-motion studies documented a 35% improvement in problem resolution time with the new procedures (p greater than 0.05). Utilization of the network planning techniques in an immunohematological laboratory may allow for more efficient and expedient operation. PMID- 3962282 TI - Morphological changes associated with pH changes during storage of platelet concentrates in first-generation 3-day container. AB - The platelet injury and loss of viability that has been shown to occur with storage of platelet concentrates (PC) under conditions with increasing or falling pH were examined using scanning and transmission electron microscopy. After storage, samples were taken for measurement of pH value, platelet count and size distribution, release of lactate dehydrogenase (LDH) into plasma, and for SEM and TEM. Increased levels of LDH were observed in PC with pH above 7.3 and below 6.1. In PC with pH above 7.3 this was related to an increased number (23%) of platelets that were lysed or had a swollen disintegrated internal structure (balloons) as seen with TEM. SEM and Coulter counter studies also showed that platelet fragmentation and formation of microvesicles were prominent in PC with pH above 7.3. The electron microscopic pictures confirmed previous suggestions that platelet disc-to-sphere transformation and cytoplasmic swelling occur when pH falls below 6.7-6.8 during storage. SEM studies showed that concomitant with this change, folds and bulky projections appeared on the platelet surface. In PC with pH below 6.1 the morphological change was irreversible with the appearance of more than 90% lysed and balloon platelets. In conclusion, these studies suggest that the loss of viability observed with PC with pH above 7.3 or below 6.1 after storage is related to an increased percentage of lysed and balloon platelets. PMID- 3962283 TI - Evaluation of hemoglobin screening methods in prospective blood donors. AB - This study evaluates the performance characteristics of the copper sulfate screening test in routine bloodmobile operations and compares the performance of the copper sulfate test with that of a miniphotometer method of hemoglobin measurement. The copper sulfate and miniphotometer tests provide equivalent pass/fail classification of male donors with a high sensitivity and total efficiency. For female donors, both test methods show substantially lower sensitivity and total efficiency than for male donors; however, the miniphotometer is significantly more sensitive than the copper sulfate test in identifying eligible female donors. The distribution of donor hemoglobin values relative to cutoff values for acceptance may explain the male-female differences in screening test performance characteristics. PMID- 3962284 TI - [Experimental study of the immunological reactivity of inbred mice with varying sensitivity to the tick-borne encephalitis virus]. AB - Immunological responsiveness of two lines of inbred mice, BALb/c and CBA, was studied by immunization of the animals with concentrated tick-borne encephalitis vaccine, and the role of cell-mediated immunity in formation of resistance of the two genetic lines of mice was evaluated. Determinations of the minimal immunizing dose of the vaccine revealed differences in parameters of the immunizing effect. Studies of the effect of TBE vaccine on the status of cell-mediated immunity by lymphocyte blastogenesis test led to a conclusion that vaccination of BALb/c mice contributed to the realization of the mitogenic effect of the antigen used to much greater extent. PMID- 3962286 TI - [Reproduction of amyotrophic leukospongiosis in laboratory animals]. AB - Amyotrophic leukospongiosis (ALSP) was produced in laboratory animals: hamsters, rabbits, guinea pigs. Guinea pigs were found to be a most suitable laboratory model for the study of ALSP pathogenesis with the longest incubation period. The data are obtained verifying the role of previously isolated unconventional virus in the ALSP etiology. PMID- 3962285 TI - [Characteristics of the biological and antigenic properties of reference strains of the influenza B virus at various periods of isolation]. AB - The results of a comparative analysis of biological and antigenic properties of reference influenza B virus strains, B/Lee/40, B/Singapore/222/79, and B/USSR/100/83, are presented. The most marked changes were found in the antigenic properties of hemagglutinin and neuraminidase. Hemagglutinins of the strains under study were found to have both common antigens and qualitatively different strain-specific determinants. The degree of intensity of immunity to the challenge B/Singapore/222/79 Pm+ virus corresponded to the intensity of antigenic relationship in the strains under study. PMID- 3962288 TI - [Pharmacokinetics of interferon administered rectally]. AB - Human leukocyte and recombinant interferon administered rectally to rabbits in a dose of 10,000 units per kilo body weight was found in the blood serum within 30 min. A certain level of interferon persisted for 5 hours after which time it disappeared from the serum. Recombinant interferon was eliminated more rapidly than leukocyte interferon. Repeated administrations of interferon at 5-hour intervals increased the time of its presence in the serum. The rectal method of interferon administration was used clinically in infants under one year. Its pharmacokinetics did not differ from that after administration by other routes. PMID- 3962287 TI - [Delta infection in patients with chronic viral hepatitis B]. AB - The results of examination for anti-delta antibodies in the blood of 86 patients (33 children and 53 adults) with chronic persisting hepatitis (CPH) and chronic active hepatitis (CAH) verified by morphological examinations of liver biopsy specimens are presented. Delta infection was found in 43 (31.5%) of patients with CAH, only anti-HBe being demonstrable in the blood. In this group of patients, marked enzymatic disorders and more intensive changes in the morphological picture of the liver were demonstrated. PMID- 3962289 TI - [Incidence of antibodies to the delta antigen in chronic hepatitis patients]. AB - Elisa was used to study the rate of detection of antibodies to delta antigen in 74 patients with chronic HBsAg-positive hepatitis. These antibodies were found in 33.8% of the subjects examined including 60.9% of the patients with chronic active hepatitis and 20.0% of patients with chronic persisting hepatitis. PMID- 3962291 TI - Clinical, hemodynamic and endomyocardial biopsy findings in idiopathic restrictive cardiomyopathy. AB - Restrictive cardiomyopathy is uncommon and in its overt form is associated with heart failure, characterized primarily by abnormalities in diastolic function and preserved or nearly preserved systolic function. It may be associated with amyloidosis, hemochromatosis or endomyocardial fibrosis. We describe five patients with restrictive cardiomyopathy, ages ranging from 35 to 71 (mean 49), three of whom were men. Fatigue, dyspnea on exertion and chest pain were the most frequent symptoms. Only one patient had overt heart failure, and three had normal or near-normal hemodynamics at rest that became greatly abnormal with exercise. Four of the five patients are alive now 9 to 77 (mean 33) months following the onset of symptoms. Despite prior emphasis on specific causes, restrictive cardiomyopathy in this series had no definable cause. Moreover, the presence of a "latent" form of restriction (abnormalities only with exercise) suggests that the incidence of the disease may be higher than previously appreciated. PMID- 3962290 TI - [Immunochemical characteristics of the antigens of a variant tick-borne encephalitis virus adapted to Hyalomma plumbeum ticks]. AB - A comparative study of immunochemical properties of a preparation of the virion antigen of a variant of tick-borne encephalitis (TBE) virus adapted to H. plumbeum ticks (clone 718/574) and the parental TBE strain revealed the following features: (1) immunoelectrodiffusion test revealed no immunoprecipitation rockets directed towards cathode in the clone 718/574 preparation; anodic precipitates differed in shape from those of the parental strain; (2) diffuse precipitation in agar showed a reaction of incomplete identity between the virion antigen of clone 718/574 and the parental strain antigen, the clone 718/574 antigen forming only one precipitation band in contrast to two precipitation bands of the parental strain; (3) immune electron microscopy demonstrated a peculiar nature of the halo overlay by immunoglobulins of clone 718/574 virions differing from that of the parental strain. PMID- 3962292 TI - Linked outbreaks of hepatitis A in homosexual men and in food service patrons and employees. AB - Outbreaks of hepatitis A among patrons and employees of two food service establishments in Anchorage, Alaska, in November 1982 and April 1983 were linked to male food handlers infected with the virus. By case finding and contact tracing, we established that the food handlers in both outbreaks were associated with an epidemic of hepatitis A that was transmitted among Anchorage homosexual men for more than six months. Lacking specific serologic findings, physicians treating several of these homosexual men had incorrectly diagnosed the illness as hepatitis B, delaying recognition of the epidemic. PMID- 3962293 TI - The value of skin testing for penicillin allergy diagnosis. AB - Skin testing is reliable and useful to rule out penicillin allergy in most patients who have a history of previous reactions. When we tested 291 inpatients in the University of Washington hospitals for the presence or absence of penicillin allergy, of 97 with a history of penicillin allergy, 12 (12.4%) had positive skin tests. Of 194 patients with no or an unknown history, only 4 (2%) had positive skin tests. Two of the 16 who had positive skin tests (12.5%) reacted only to minor determinant mixtures. Of the skin test-negative patients, 261 were treated with one of the penicillins and only two had any reactions. PMID- 3962294 TI - Latrodectism--effects of the black widow spider bite. AB - Latrodectism-envenomation by the black widow spider, Latrodectus mactans-has been reported in virtually every state. The spider is particularly prevalent in the Southwest, Southeast and California, and symptoms from its bite are painful and may be confusing to clinicians. Prompt improvement can be expected in most cases with administration of calcium and muscle relaxant, but some patients may require treatment with antivenin. No deaths occurred in our series of 11 patients, although one case was complicated by serum sickness. PMID- 3962295 TI - Tympanostomy tube complications and efficacy in children of a rural community. AB - In the pediatric group practice and the otolaryngologic practice of our rural community, 41 patients were seen in 1984 with 49 episodes of suppurative discharge after tympanostomy tube insertion. Streptococcus pneumoniae was the most common organism after upper respiratory tract infection. Staphylococcus or enteric organisms were most frequently encountered after bathing or swimming. Most patients regained hearing within normal limits. The benefits of tympanostomy tubes in terms of good hearing and reduced incidence of suppurative otitis media outweigh the risk of transitory suppuration for most patients. PMID- 3962296 TI - Clinical implications of serum creatine kinase levels in acute asthma. AB - An elevated serum creatine kinase (CK) level is common in patients being treated for acute asthma, but such an elevation should not lead to further investigation unless otherwise clinically warranted. Moreover, serum CK levels need not be routinely measured in young patients with an uncomplicated exacerbation of asthma. PMID- 3962297 TI - Campylobacter jejuni septicemia--epidemiology, clinical features and outcome. AB - In 33 cases of Campylobacter jejuni septicemia, the disease was more common at the extremes of age: infants made up a third of the reported cases while 24% of patients were older than 50 years. Fever was noted in more than 80% of patients and chills in about a fourth. Enteritis was present in 70% of cases, and the gastrointestinal tract was the principal source of septicemia. Half of the patients did not have significant underlying disease but were at extremes of age, which may reflect relative host impairment. Mortality (25%) owing to C jejuni septicemia occurs mostly in compromised hosts. PMID- 3962299 TI - Thoughts on the coming computerization in health care. PMID- 3962298 TI - Extraintestinal Campylobacter infections. PMID- 3962300 TI - Human anaphylaxis. PMID- 3962301 TI - Severe iron deficiency anemia. An example of covert child abuse (Munchausen by proxy). PMID- 3962302 TI - Metoclopramide-induced reversible impotence. PMID- 3962304 TI - AIDS--the responsibility of health workers to assume some degree of personal risk. PMID- 3962303 TI - Bronchial stenosis. A complication of healed endobronchial tuberculosis. PMID- 3962305 TI - Male infertility. PMID- 3962306 TI - 2020 glimpses through the anesthesia retroprospectroscope. The 1985 John J. Bonica lecture. AB - The Department of Anesthesiology at the University of Washington has grown steadily throughout its first 25 years. Personal reminiscences of old-fashioned anesthesia induction lead to philosophizing on the role of the larynx in the evolution of the human mind and the limited future of computerized administration of anesthesia. Machines will never substitute for the alliance between science and the humane that characterizes modern anesthesiology. PMID- 3962307 TI - Misdiagnosis of common medical problems in patients referred to an AIDS clinic- 'pseudo-AIDS'. PMID- 3962308 TI - Mitral valve prolapse in children. PMID- 3962309 TI - [Complications and results following transseptal or retrograde transaortic catheterization of the left ventricle in patients with aortic valve stenosis]. AB - Retrograde transvalvular left heart catheterization was successful in 46 cases out of 71 consecutive patients with severe valvular aortic stenosis. In 16 patients the transseptal route was used and in the remaining 9 patients surgery was performed without left ventricle pressure recordings. There were no differences in aortic valve area or in pressure gradients in pure stenosis (n = 29) whether retrograde catheterization succeeded or not. In combined aortic valve disease with prevalence of stenosis (n = 42) transaortic catheterization succeeded less frequently in patients with higher pressure gradients. The complication rate increased with duration of catheterization, but without adverse consequences for any patient. PMID- 3962310 TI - [Potassium-sparing effect of triamterene in a 3-component combination preparation for the therapy of hypertension]. AB - A new fixed-dose combination drug, Minotensin (1 film-coated tablet contains 120 mg bupranolol, 2.5 mg bendroflumethiazide and 25 mg triamterene) was tested in a long-term study. 20 patients with mild to moderate primary hypertension were treated for 6 months. Items of investigation were: influence on low range serum potassium, influence on serum magnesium concentration, blood pressure lowering effect, tolerance and side effects. Initial dosage of 1 tablet b.i.d. could be reduced to 1 tablet in the morning in 4 patients. The mean serum potassium concentration rose from 3.79 +/- 0.3 mmol/l to 4.15 +/- 0.55 mmol/l (p less than 0.01) after 4 weeks, and to 4.26 +/- 0.37 mmol/l (p less than 0.001) after 6 months of treatment, all single values remaining within normal limits. The serum magnesium concentration rose to a small, insignificant extent. Systolic and diastolic blood pressure were lowered highly significantly from 177 +/- 12/103 +/ 7 mm Hg by 19/11 mm Hg. The mean values were within normal limits (less than 160/95 mm Hg) after treatment. Heart rate fell simultaneously by 11 beats per minute, on average (p less than 0.01). Atrioventricular conduction time was slightly prolonged in 2 cases. Serum levels of sodium, BUN and creatinine rose slightly, but remained within the normal range during treatment. Uric acid and lipids were not influenced significantly. 1 patient complained of transient gastrointestinal discomfort. Generally the drug was tolerated very well. PMID- 3962311 TI - [R spike potentials in ergometric stress: patients with dilated cardiomyopathy in comparison to coronary heart disease]. AB - R-wave amplitude changes during exercise were compared in patients with cardiomyopathy (n = 32), patients with coronary artery disease (n = 58) and controls (n = 12). Patients with cardiomyopathy (CMP) had a smaller R-wave amplitude (RWA) at rest than those with coronary artery disease (CAD). At comparable levels of exercise patients with CMP showed no change in RWA, while those with CAD demonstrated an increase in RWA. Controls showed a decline in RWA. In patients with CAD changes in RWA during exercise were more sensitive in the detection of disease than ST-segment changes. Left ventricular function was the major determinant of the direction and magnitude of RWA changes both in patients with CMP and CAD, with lesser changes in RWA in patients with more severely reduced left ventricular function. PMID- 3962312 TI - [Prognostic significance of initial loss of consciousness in cerebrovascular disorders]. AB - An initial loss of consciousness is of grave prognostic significance in patients with acute ischaemic cerebrovascular disorders, both as regards the early course as well as the long-term prognosis. The aim of this study was to assess the prognostic importance of an initial loss of consciousness in patients who had survived the acute stage. Thus, 133 out of 139 patients suffering from ischaemic cerebrovascular disorders who survived the first 3 weeks after a stroke were clinically re-examined after a mean follow-up period of more than two years. The other 6 patients had died as a result of a second stroke in the post-acute period. Patients with an initial loss of consciousness suffered cerebrovascular disturbances or fatal strokes in the follow-up period slightly more frequently than patients without an initial loss of consciousness. However, there were no convincing differences between the two groups. Indeed, on follow up, patients with an initial loss of consciousness were slightly less socially disabled than patients without an initial loss of consciousness. The results suggest that an initial loss of consciousness is no longer a factor of prognostic importance in patients who have survived the initial stage. PMID- 3962313 TI - [Cardiovascular reflex evaluation for detecting autonomic neuropathy in chronic dialysis patients]. AB - 3 cardiovascular reflexes were tested in 25 patients on regular haemodialysis: measurement of the beat-to-beat variation in heart rate in the supine position and during deep breathing, measurement of heart rate response to change in posture (30:15 ratio). 8 patients (32%) had abnormal results in at least two of the tests, 3 patients (12%) had abnormal results in all 3 tests. Beat-to-beat variation was found to be the most sensitive test, the heart rate difference during deep breathing showing a direct correlation to the nerve conduction velocity of the peroneal nerve. Hence, a common cause can be postulated in the pathogenesis of the autonomic lesions and the sensorimotor polyneuropathy in the patients under investigation. Furthermore, the group with the most severe radiological calcification due to Monckeberg's medial sclerosis had a significantly lower mean heart rate difference during deep breathing than the group with no radiological calcification. A similar correlation between autonomic neuropathy and Monckeberg's medial sclerosis has recently been described in diabetic patients. PMID- 3962314 TI - [Lead intake from drinking water in the city of Vienna]. AB - Daily lead intake from drinking water was estimated on the basis of lead concentrations in running and boiled drinking water samples of 42 Viennese households and reported drinking water consumption of adults living in those households. Lead concentration (means, SD, median) in running water samples (15.3 (37.9) micrograms Pb/l, median 6.3) was significantly higher (p less than 0.005) than in boiled water samples (6.4 (11.1) micrograms Pb/l, median 4.1). The highest lead concentrations in running water samples were found in houses built before 1945. Reported drinking water consumption was 1306 (576) ml/day (median 1242); more than 70% of drinking water was consumed at home. Calculated lead intake from drinking water in Vienna was 11.8 (22) micrograms Pb/day (median 5.2). Lead intake from drinking water was highest (19.5 (31.3) micrograms Pb/day, median 7.3) in houses built before 1945. Lead intake with food was calculated using published data on lead concentrations in food items and on food intake and data from the present study. Calculated average lead intake with food (206 micrograms Pb daily) was far below the estimated safe lead intake proposed by WHO 1972. We conclude that lead intake from drinking water in Vienna is low in most households. However, lead intake may be close to toxic levels if persons living in houses built before 1945 are consuming extremely large amounts of drinking water. PMID- 3962315 TI - [The 1984/85 rubella epidemic in Austria]. AB - As a consequence of the rubella epidemic in Austria in 1979, prophylaxis against this disease was intensified. In spite of this measure, however, there was an increase in cases of rubella in 1984/85. The peak incidence in both years occurred in May. In 1984, most cases were found in Vienna, Lower and Upper Austria, and Salzburg, whereas in 1985, Styria and Vienna were most affected. The clinical diagnosis of rubella was confirmed serologically in 685 patients. Of these, 151 were pregnant women and 104 were women of childbearing age who gave no information as to pregnancy. Due to the virtually complete recognition of cases, which usually led to therapeutic abortion, only 7 cases of intrauterine rubella infection were recorded. In spite of the vaccination of all prepuberal schoolgirls, of women at occupational risk, and of seronegative women after delivery, 10% of women of childbearing age still have no reliable immunity (HI titre 1:32) to rubella. This situation can be improved only by testing women at around 20 years of age for immunity (irrespective of their vaccination status) and vaccinating them if necessary. PMID- 3962316 TI - [Nephrology for general practice--roentgenologic diagnosis]. AB - Radiologic diagnostic in urology has to be considered according to the new imaging modalities as sonography and computertomography. The basic investigation is still the modern high dose urography. Sonography is of special value, because many pathological changes in the kidneys can be seen during screening investigations of the abdomen. Indications and values of different methods will be discussed on the basis of clinical situations. PMID- 3962317 TI - [Drug therapy of the kidney patient]. AB - In patients suffering from renal failure pharmacological therapy is performed to influence the causal disease, to mitigate symptoms of the uremic syndrome, or to treat additional illness. Immunosuppressive therapy may be initiated in patients with rapidly progressive glomerulonephritis. Anemia and osteopathia have to be treated in most patients with renal insufficiency. Medication with antibiotics and digitalization shows special aspects in patients with impaired renal function. PMID- 3962318 TI - [Nephrology for general practice--significance of the laboratory]. AB - When anamnesis and clinical findings are suspicious of renal disease, laboratory examinations have to be performed, which are also necessary in evaluating the course of the disease. The first steps are urinalysis, blood sedimentation rate, red and white blood cell count, creatinine, supplemented by urea, electrolytes, acid-base-status, serum-protein with electrophoresis, cholesterol, triglycerides. For special questions beyond this immunological examinations are necessary (i.g. antibodies to basal-membrane, immunocomplexes). Among the renal function tests the concentration test is of some value. The endogenous clearance of creatinine can be determined with sufficient accuracy from the serum creatinine concentration alone by a formula. PMID- 3962319 TI - [Detection and treatment of chronic renal failure in general practice, central problem of the responsibilities of the nephrology specialist]. AB - Renal failures develops independently from different primary kidney diseases into the uniform syndrome of uremia. Many partial functions or regulatory systems of the organism are involved (anemia, hypertension, polyneuropathy, mineral and electrolyte metabolism, glucose tolerance etc.). Responsibilities of nephrological guidance are early diagnosis and compensatory treatment of such deviations in order to lower risks during the still conservatively treatable phase of the disease. Prognosis and quality of life in renal replacement therapy can be improved. PMID- 3962320 TI - [Mechanical therapy of terminal renal failure--outdated, proven and new procedures]. AB - The arsenal of mechanical techniques, which is presently a part of the nephrological daily routine, has become so extensive, that it seems essential to differentiate between those methods which are out-dated, proven, or new. This differentiation can be summarized as follows: The subcutaneous Cimino fistula is preferred in 95% of dialysis patients. The Scribner shunt remains applicable for exceptional situations. In peritoneal dialysis the flexible Teckhoff catheter has replaced the "repeated puncture technique" which used rigid teflon catheters. Hemodialysis, especially in its cost efficient application as limited care or home dialysis, has proven itself reliable and now accounts for the majority of treatments. Hemofiltration and hemodiafiltration offer significant advantages, however, their application is growing slowly, apparently due to the higher costs involved. CAPD represents an alternative treatment which is applicable to 10% of end-stage renal failure patients. PMID- 3962321 TI - Choledochal cyst: complications of anomalous connection between the choledochus and pancreatic duct and carcinoma of the biliary tract. PMID- 3962323 TI - The current status of biliary tract surgery: an international study of 1072 consecutive patients. PMID- 3962322 TI - Effect of parathyroid surgery on cartilage calcification. PMID- 3962324 TI - Rupture of splanchnic artery aneurysms. PMID- 3962325 TI - Total gastrectomy: is the early postoperative morbidity and mortality influenced by the choice of surgical procedure? PMID- 3962327 TI - Stomal ulcer complicating bypass for duodenal Crohn's disease. PMID- 3962326 TI - Rapid progressive dissemination of hemangiosarcoma of the spleen following spontaneous rupture. PMID- 3962328 TI - Traumatic bilateral patellar tendon rupture with chronic renal disease. PMID- 3962330 TI - A multidisciplinary team--the physician's perspective. PMID- 3962329 TI - Lumpectomy or mastectomy. PMID- 3962331 TI - 'Required request' for organ donation--a plea for caution. PMID- 3962332 TI - Fibrodysplasia ossificans progressiva: an infant neck mass. PMID- 3962333 TI - The metabolism of 1-phenyl-2-(N-methyl-N-furfurylamino)propane (furfenorex) in the rat in vivo and in vitro. AB - The metabolism of 1-phenyl-2-(N-methyl-N-furfurylamino)propane (furfenorex) was studied in the rat in vivo and in vitro. Nine metabolites with only traces of the unchanged drug were obtained from urine after oral administration of furfenorex to rats. The major metabolite was an acidic compound, isolated and identified as 1-phenyl-2-(N-methyl-N-gamma-valerolactonylamino)propane. Amphetamine, methamphetamine and their hydroxylated metabolites were excreted as minor metabolites. Metabolites excreted in two days after administration of the drug amounted to about 20% of dose. The acidic metabolite, a major metabolite in vivo, was not detected after incubation of furfenorex with rat-liver microsomes. The major metabolic routes of furfenorex in vitro were N-demethylation and N defurfurylation which produced 1-phenyl-2-(N-furfurylamino)propane (furfurylamphetamine) and methamphetamine, respectively. The formation of furfurylamphetamine and methamphetamine were catalysed by rat-liver microsomes supplemented with NADPH and O2, and were inhibited by either SKF 525-A or CO. The formation of both metabolites were inhibited by 2-methyl-1,2-bis-(3-pyridyl)-1 propanone (metyrapone), but not by 7,8-benzoflavone. They were enhanced by pretreatment of rats with phenobarbitone, but not with 3-methylcholanthrene. These data suggested that N-demethylation and N-defurfurylation of furfenorex were mainly mediated by cytochrome P-450 but not cytochrome P-448. PMID- 3962334 TI - Effects of several factors on urinary excretion of methamphetamine and its metabolites in rats. AB - Effects of dose, route of administration, and sex and strain differences on the metabolism of methamphetamine in vivo were investigated in rats. Excretion of p hydroxymethamphetamine was decreased with increasing dose of methamphetamine, while that of unchanged methamphetamine and amphetamine increased with dose. Subcutaneous injection instead of oral administration of methamphetamine increased the urinary excretion of unchanged drug and amphetamine, and decreased the excretion of p-hydroxymethamphetamine. No marked sex difference was observed in the urinary excretion of methamphetamine and metabolites. The Donryu strain of rats excreted unchanged methamphetamine and p-hydroxylated metabolites to a lesser extent than did Sprague-Dawley and Wistar strains. PMID- 3962335 TI - Absorption, elimination and metabolism of trichloroethylene: a quantitative comparison between rats and mice. AB - The absorption, elimination and metabolism of 14C-trichloroethylene (Tri) was studied in adult female Wistar rats and NMRI mice after administration of 200, 20 and 2 mg/kg Tri. Dose-dependent biotransformation of Tri to metabolites was observed in both species. Induction of hepatic mono-oxygenases by phenobarbital or polychlorinated biphenyls resulted in a higher rate of biotransformation after a single oral dose of 200 mg/kg 14C-Tri to rats. An increase in radioactivity covalently bound to liver and kidney macromolecules of induced rats as compared to control rats parallels the toxic effects of Tri on these organs after induction of cytochrome P-450. The urinary metabolites were analysed by h.p.l.c. In both species, 1,1,1-trichlorocompounds (trichloroacetic acid, trichloroethanol and its glucuronide, comprising 88.9-93.5% of the radioactivity excreted in the urine) constituted the main metabolites; in addition, N-(hydroxyacetyl) aminoethanol (4.1-7.2%), dichloroacetic acid (0.1-2.0%) and oxalic acid (0.7 1.8%) were identified. The pattern of metabolites in the 72 h urine remained constant for each species in the dose range studied and no change was induced by pretreatment. The percentage of radioactivity exhaled as 14CO2 increased with dose in mice, which may indicate dose-dependent formation of dichloroacetic acid and saturation of deactivating mechanisms for reactive intermediates in mice. PMID- 3962336 TI - Microsomal oxidation of 2-dimethylamino-3-chloro-1,4-naphthoquinone. The possibility of substrate activation by cytochrome P-450. AB - 2-Dimethylamino-3-chloro-1,4-naphthoquinone (DCNQ) is bound to microsomal cytochrome P-450 as a type I substrate (lambda max = 391 nm, lambda min = 420 nm). The Ks is 40.5 microM. In a rat-liver microsomal system, the N-demethylation of DCNQ produces formaldehyde (rate 225 pmol/min per mg of protein). Induction by phenobarbital increases the rate of formation, while addition of metyrapone and SKF-525A into the system decreases the rate by 52% and 35%, respectively. The microsomal N-demethylation of DCNQ is not inhibited by CO. Under full anaerobiosis, the microsomal oxidation of DCNQ again gives formaldehyde (rate 416 pmol/min per mg of protein). The anaerobic oxidation of DCNQ is inhibited by metyrapone and SKF-525A. The microsomal, chemical and electrochemical reduction of DCNQ to the corresponding semiquinones and hydroquinones have been studied. Non-enzymic DCNQ reduction is insufficient for the formation of formaldehyde. Under anaerobic conditions the microsomal DCNQ oxidation is assumed to occur via the intramolecular oxazole bond which is then hydrolysed, yielding formaldehyde. This may be a new example of substrate activation by cytochrome P-450. PMID- 3962337 TI - Sex differences in salicylic acid metabolism in Nigerian subjects. AB - The urinary metabolites of a single dose (1 g) of salicylic acid were investigated in black Nigerian subjects (78 females 44 males). Qualitatively, the major metabolites were the glycine and glucuronic acid conjugates. Quantitatively, there was a statistically significant difference in the level of these metabolites between female and male subjects (P less than 0.001) (using Student's t-test). The results of the present study compared with earlier published data show a statistically significant quantitative difference between black Nigerians and Caucasians (P less than 0.001). The results suggest possible racial and sex differences in the metabolism of salicylic acid. PMID- 3962338 TI - The microbial metabolism of condensed (+)-catechins by rat-caecal microflora. AB - The metabolism of 2,3-trans-3,4-trans-3,5,7,3',4'-pentahydroxy-4-(2,4,6-trihydrox yphenyl)-flavan and 2,3-trans-3,4-trans-3,5,7,3',4',-pentahydroxy-4-(2,3-trans 3,5,7,3 ', 4'-pentahydroxyflavanyl-[8])-flavan in vitro by rat-caecal microflora was investigated. Metabolites were extracted and enriched by column chromatography and preparative h.p.l.c., while structural determination was carried out using comparative g.l.c.-mass spectrometry and p.m.r. spectrometry. The metabolites identified were derivatives of benzoic acid, phenylacetic acid, phenylpropionic acid and phenyllactic acid in addition to phloroglucinol, delta (3-hydroxyphenyl)-gamma-valerolactone and 1-(3-hydroxyphenyl)-3-(2,4,6 trihydroxyphenyl)-propan-2-ol. An additional metabolic route, which differs from the expected severance of the (+)-catechin-phloroglucinol bond and well documented total heterocyclic ring degradation of flavanoids, is proposed. PMID- 3962339 TI - Equivocal test results and prognostic staging uncertainties in the evaluation of patients with cancer of the prostate. AB - In the staging of cancer, equivocal test results may occur in subjectively evaluated imaging procedures whose interpretations raise the possibility of metastases but are too uncertain to rule in or rule out metastatic spread, and in tests whose repetitions in the same patient yield conflicting results about dissemination. We assessed the frequency and prognostic correlates of test results giving equivocal evidence of disseminated (Stage IV) disease in an inception cohort of 280 patients receiving initial treatment for prostatic cancer between 1973-76. Among tests used for clinical staging, lymphangiograms (equivocal in 28 percent of tested patients), bone scans (equivocal in 25 percent of tested patients), and bone radiographs (equivocal in 20 percent of tested patients) most frequently yielded interpretations that equivocally suggested metastatic spread. Eighty-three (45 percent) of the 185 patients without clear cut dissemination (Stages I-III) had at least one equivocal test result that suggested dissemination and that remained unresolved at the time of selection of therapy. Five-year survival (30 percent) for the 20 patients with local extracapsular spread (Stage III) and multiple equivocal results suggesting dissemination was identical to that for patients with clear-cut dissemination. In contrast, other patients with equivocal dissemination in Stages I-III had survival rates similar to those patients in the same stage and lacking equivocal dissemination. Unresolved equivocal staging results frequently complicate management decisions for patients with prostatic cancer. Survival analyses aid these decisions by demonstrating that equivocal findings of dissemination are prognostically unimportant unless they are multiple and occur in the context of unequivocal extracapsular spread. PMID- 3962340 TI - Bilateral otitis media and hearing loss in an adult. AB - Bilateral otitis media, an uncommon entity in adults, may represent the initial manifestation of a life-threatening systemic disease. Prompt recognition and treatment of the underlying disease is needed to preserve auditory function and prevent involvement of other organ systems. We present the case of a thirty-four year-old male with bilateral serous otitis media and progressive hearing loss, which was refractory to antimicrobial therapy and middle ear drainage. A mastoid biopsy revealed necrotizing granulomatous inflammation. The differential diagnosis and probable cause of this unusual finding are discussed. PMID- 3962341 TI - The use of endoscopic biopsy in evaluation of polypoid lesions of the colon. AB - Use of flexible endoscopes affords biopsy sampling of polypoid lesions of the colon, especially within the rectum and sigmoid colon by flexible fiberoptic sigmoidoscopes. Histologic examination of colonic biopsies usually allows division of polyps into neoplastic and non-neoplastic categories. There are significant limitations to such biopsies, however, due to sampling error and inability to reach deep submucosal cores of polyps where malignant invasion may occur. When properly aware of its limitations, the endoscopist will find the endoscopic biopsy a valuable aid in planning the therapeutic approach to a polypoid lesion of the colon. PMID- 3962343 TI - [The spelling of medical terms]. PMID- 3962342 TI - The teaching house officer. AB - Although medical students on clinical ward rotations receive a large part of their education from house officers, very often house officers themselves have had little formal preparation as teachers. Because students and teachers work closely together under special conditions, unique educational situations are created where much more than factual information is conveyed. Although some house officers are "natural" teachers, others find such activities uncomfortable or burdensome. Most people, however, can be taught to be effective teachers, and preparation for teaching and teaching itself are beneficial for house officers and their patients as well as their students. House officers who teach enjoy the rewards that all teachers know as well as several others which are particular to the setting in which they teach. Mechanisms are suggested to maintain and develop interest in house staff teaching. PMID- 3962344 TI - [Post-traumatic wrist joint complaints and functional disorders]. PMID- 3962345 TI - [Personal observations on the pathogenesis and therapy of headache syndromes]. PMID- 3962346 TI - [Electrode extraction by continuous traction in pacemaker patients with septic complications]. PMID- 3962347 TI - [Production methods and health protection of the population--an objective dialectic unit in a socialistic social order]. PMID- 3962348 TI - [Treatment of gastric and duodenal ulcer]. PMID- 3962349 TI - [Differential diagnosis and therapy of ejaculation disorders]. PMID- 3962351 TI - [Typical and atypical facial neuralgias from the viewpoint of ambulatory care]. PMID- 3962350 TI - [Leading clinical symptoms of rare endocrinologic diseases]. PMID- 3962352 TI - [Sudden deafness--an emergency?]. PMID- 3962353 TI - [Retroperitoneal duodenal rupture following blunt abdominal trauma in childhood]. PMID- 3962354 TI - [The Rockstock longitudinal study on risk children--a contribution to the dialectics of biological, psychological and social aspects]. PMID- 3962356 TI - [Information processing and performance level in relation to cortical steady potential shifts]. PMID- 3962355 TI - [The Marxist human image, the dialectic of individuality and society and problems of socialist health protection]. PMID- 3962357 TI - [Cognitive disorders in schizophrenic patients]. PMID- 3962359 TI - [Initial experiences with the Nevermann instrument for measuring room climate]. PMID- 3962358 TI - [Methodological studies for the optimal description of the space-time structure of the emission field in communities with high population density. I. Determination of measurement values in characterizing emission status]. PMID- 3962360 TI - [Occupational health and other industrial factors influencing disease status in a slaughter and processing industry]. PMID- 3962361 TI - [Gas chromatography determination of 2-ethylhex-2-en-1-al and its metabolites in grain]. PMID- 3962362 TI - [Quantitative and selected qualitative results of measuring dust in animal production]. PMID- 3962363 TI - [Measuring blood pressure in the ankle in sedentary work]. PMID- 3962364 TI - [Construction and use of a measuring device for heart rate-controlled ergometry]. PMID- 3962365 TI - [Contributions of occupational psychology to the scientific establishment of threshold values]. PMID- 3962366 TI - [Effects of noise, chlorine and ammonia on the performance of activities with demanding attention. Performance behavior by the individual and the effect of noise, chlorine and ammonia]. PMID- 3962367 TI - [Suitability of various culture media for medium-term storage of Campylobacter jejuni/coli strains]. PMID- 3962368 TI - [Study of the effectiveness of preventive influenza vaccination based on NYHA stages in patients with cardiovascular diseases]. PMID- 3962369 TI - [Possibilities and criteria for evaluating the quality and effectiveness of medical inpatient services in the Cottbus district hospital--internal occupational comparison of performance]. PMID- 3962370 TI - [Professional motivation of future nurses]. PMID- 3962371 TI - [Developmental status of the occupational rehabilitation of patients with rheumatic diseases in the Gera district]. PMID- 3962372 TI - [Dimethylnitrosamine (DMNA): a carcinogen in food]. PMID- 3962373 TI - [Development status of the social rehabilitation of patients with rheumatic diseases in the Gera district]. PMID- 3962374 TI - [Developmental status of the medical rehabilitation of patients with rheumatic diseases in the Gera district]. PMID- 3962376 TI - [Psychodiagnostic study results following chronic halothane exposure--a report of experiences]. PMID- 3962375 TI - [Physiologic studies of children's clothing with different percentages of polyacrylonitrile fibers]. PMID- 3962378 TI - [Possibility for the evaluation of spinal stress caused by whole body vibration in experimental conditions]. PMID- 3962377 TI - [Toxicity of 1,4-bis(trichloromethyl)benzene--a new rubber chemical]. PMID- 3962379 TI - [Broad-band stochastic whole body vibration--an experimental study of evaluation procedures]. PMID- 3962380 TI - [Organization of health and performance-promoting occupational conditions in industrial poultry production]. PMID- 3962381 TI - [Results and experiences with the complex analysis of industrial health in large health service facilities]. PMID- 3962383 TI - [Effectiveness of audiometric monitoring for the prevention of noise-induced hearing loss]. PMID- 3962382 TI - [High-frequency hearing, an early indicator of the development of environmentally induced inner ear damage]. PMID- 3962384 TI - [Analysis of epidemiologic studies based on logit models]. PMID- 3962385 TI - [Effect of noise and vibration on residents living near railway lines]. PMID- 3962386 TI - [Electric train transportation of the German Reichsbahn and its peculiarities in relation to changes in the environment]. PMID- 3962387 TI - [Method for the preparation of epidemiologic data in the evaluation of danger caused by chronically acting pollutants (exemplified by chronic carbon disulfide poisoning)]. PMID- 3962388 TI - [Experimental asbestos-induced mesotheliomas--character and peculiarities]. PMID- 3962389 TI - [Comparison of particle size distribution of lung dust in exposed miners and of the respirable fraction of mine dust]. PMID- 3962390 TI - [Evaluation of methods for the determination of particle size distribution of lung dusts]. PMID- 3962391 TI - [Significance of hemodynamics and hemorheology in microcirculation disorders]. AB - The angioarchitecture of the terminal vascular system and the rheologic properties of the flowing blood lead to its inhomogeneous distribution in the so called microcirculation. Together with the spatial disproportion in the vascular pattern, a temporal inhomogeneity becomes quantitatively and qualitatively measurable with the help of intravital microscopy in animal experiments. Vasomotion in the precapillary vessels of resistance and further local regulation mechanisms are discussed, particularly the factors caused by blood fractions and their fluidity. The correlation between blood fractions, plasma and vascular wall is quantifiable by capillary microscopy with the help of dynamic morphometry. Useful consequences for prophylaxis and therapy are summarized in surveys. PMID- 3962392 TI - [Frequency of a positive result in the chlorpropamide-alcohol flush test in type I and type II diabetes]. AB - 146 newly manifested diabetics (91 type I, 55 type II) and 20 non-diabetics were examined with the help of the chlorpropamide alcohol flush test. Also under different criteria of valuation of the increase of skin temperature (1.5 and 1.8 degrees C, respectively) no significant differences between the positive findings of the test in type I and type II diabetics were the result. Decisive for a positive result is according to our investigations the pre-existing initial temperature of the skin area, the room temperature and the air humidity. In such a case the initial temperature of the skin area depends on the moment of the last food intake. PMID- 3962393 TI - [Echocardiography evaluation of left ventricular function in mitral valve stenosis]. AB - It is reported on results of echocardiographic investigations concerning the left ventricular function in 60 patients with mitral stenosis (30 patients in stage II, 30 patients in stage III of the classification after NYHA) and the results are compared with those of 30 normal persons. The echocardiographic parameters 'systolic shortening fraction of the left ventricle' (FS), mean circumferential shortening speed of the fibre (mVCF) and the ejection fraction (EF) are suitable for the assessment of the functional condition of the left ventricle. On the basis of these parameters a determination of the degree of severity of the mitral stenosis is not possible, since there are no significant differences between the degrees of severity. The clear restriction of the left ventricular function in mitral stenoses which is partly described in the literature cannot be confirmed. In the two stages the parameters investigated lie widely within the norm. Significant differences in comparison to normal persons can be realized only in the determination of the early diagnostic filling speed of the left ventricle in the two stages. PMID- 3962394 TI - [Significance of the "21-day cough" and the patient with "variable bronchitis"]. AB - The word formations "21-day-cough" and "contrast-articular bronchitics" have become a fixed term in the practice of pneumology. They signal possible pulmonary diseases, especially tuberculosis or bronchial carcinoma. In many countries they have become the method of choice for recognition of several pulmonary diseases, particulary pulmonary tuberculosis. PMID- 3962395 TI - [Erythema ab igne (livido reticularis e calore): a skin manifestation of chronic pancreatic diseases]. PMID- 3962396 TI - [Methodological aspects of the use of the hydrogen (H2) breath test]. AB - Normalization of the breath hydrogen (H2) concentration by simultaneous determination of breath carbon dioxide (CO2) and the addition of lactulose to a liquid meal have been recommended to improve the reproducibility of the hydrogen breath test. To assess the clinical relevance of these recommendations, we studied 64 children of 4 different age groups and 12 adults. Simultaneous determination of CO2 concentration and normalization of breath H2 resulted in a marked decrease of intestinal transit time and its variation in children; in adults, however, this correction was negligible. With lactulose alone, the mean coefficient of variation within individuals was only 11.7% and 13.2%, with and without H2 normalization, respectively. Therefore, the addition of a liquid meal does not seem to be necessary. PMID- 3962397 TI - [New observations in a case of Cronkhite-Canada syndrome]. AB - We report about a 76 years old patient with Cronkhite-Canada syndrome. The diagnosis has been found with the following clinical symptoms: diarrhea, anorexia, alopecia, and onychotrophia. Laboratory values: severe hypoproteinemia (total serum protein 4.3 g/dl, albumin 2.4 g/dl); endoscopical and radiological findings: a generalized polyposis which involved the whole intestine except the oesophagus. As far as we saw in our literature-overview of 55 patients with Cronkhite-Canada syndrome, this patient had for the first time a carcinoma of the urinary bladder and a Bricker operation 17 years before the onset of his disease. Further we remarked a lack in the resorption of the enterally administered thyroidal hormones. The progress was fatal despite a parenteral hyperalimentation and a treatment with antibiotics and glucocorticoids. PMID- 3962398 TI - [Entero-gastric reflux after distal stomach resection--an animal experiment study]. AB - The experiments were carried out in 125 Wistar rats. The entero-gastric reflux was estimated quantitatively with reference to the bilirubin and the cholic acid (radiolabeled by C 14). The animals were submitted to distal partial gastrectomy in groups after Billroth I operation, after Billroth II operation with and without enteroanastomosis, as well as Billroth II operation with enteroanastomosis and vagotomy. RESULTS: The statistical difference was significant between Billroth I and Billroth II operation with clear smaller reflux in Billroth I. The added enteroanastomosis decreased or increased the reflux of some animals at a time. The additional vagotomy reduced the number of the anastomotic ulcer. PMID- 3962399 TI - [Peripheral venous pressure in acute and chronic femoral-pelvic vein occlusion- an experimental study]. AB - The behaviour of the peripheral venous pressure was checked after starvation of the venous main vessel of the pelvic limb in 34 mongrel dogs in long-term course about 40 weeks. The influence of recanalisation processes on the pressure development was excluded by the ligature model. The pressure measurements took place continuously statically and dynamically in horizontal and in oblique posture. They produced a changed pressure characteristic with a chronically increased resting pressure and a decreased drop in pressure with load. The insufficient transport capacity of the spontaneously originated collateral circulation could be pointed out. PMID- 3962400 TI - [pH measurement in tissue--a reliable criterion for the registration of acute arterial circulatory disorder in animal experiments]. AB - An arterial ischemia was carried out step by step in the right pelvic extremity of the dog. The ph level was measured continuously in the lateral vastus of the femoris muscle on both sides by means of a glass-one-rod measuring equipment. The pH value decreased to 6.43 ninety minutes after a total interruption of the arterial circulation. The initial value amounted to 7.20. The tissue-pH-values increase quickly during the following phase of recirculation. PMID- 3962401 TI - [Angiographic demonstration of the medullary space and callus vessels during secondary bone fracture healing; animal experiments]. AB - The artery nutritia ruptured in a closed transverse fracture of the tibia in 86% during the fracture trauma. Because blood vessels go through between the periost and the metaphysial medullary space it does not come to an ischemia in the medullary space of the distal fragment. The periosteal and paraosseous revascularisation increased with the extension of the fragment shifting. The artery nutritia is recombinated spontaneously in the complete cross section after 10 weeks. A good demonstration of the callus vessels is attainable by lumbar aortography with barium sulphate. PMID- 3962402 TI - [Experiences with the early discharge of mother and child following hospital delivery]. AB - During the past five decades the number of hospital deliveries has increased to such an extent that today only about 1% of all births in the Federal Republic of Germany take place outside the hospital. Parallel to this development there has been an improvement in the mortality and morbidity rate. Psychological factors in obstetrics have partially disappeared. Intensive management of obstetrics with apparatus has today become the object of public discussion. As a background to this over the past few years a small percentage of women have expressed the desire to have a house delivery. The early discharging of mother and child after hospital delivery is a compromise between delivery in hospital and delivery at home. This study contains numerical material, giving an evaluation of early discharging after hospital delivery as well as the risks and advantages of this procedure. The study covers 157 women who were delivered at the Women's Hospital Neukolln from 1979 to 1981 and who were discharged early, as well as a control group of 80 women, who had a lying-in period in the hospital. The obstetrical data and also the assessments and experiences of the women are compiled in the form of a questionnaire. In our Hospital during the period reported, the so called "out-patient delivery" was made on 2% of the patients. According to the opinions expressed in the literature, 5-10% of women are able to make use of the early discharge after hospital delivery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962403 TI - [Cardiotocographic changes in epidural analgesia with bupivacaine]. AB - During the first stage of labor in a large number of births, temporarily pathologic patterns become manifest in the cardiotocogram after epidural analgesia. Statistical comparisons showed a significant level of correlation (in the region of 1%) between pathologic heart rate pattern and a fall in blood pressure after the main epidural dose (in all cases, premedication was given before commencement of analgesia). This jeopardy to the fetus in the first 20-30 minutes after administration of the main dose, visible in the cardiotocogram, makes it imperative for the clinician to pay the utmost attention to all women in labor during this period, not just those regarded as risk patients. After 10-20 minutes, labor is intensified, and this can coincide with possible jeopardy to the fetus. As this change in the course of labor manifests itself inordinately strongly in the labor-frequency parameter, and since absolute intrauterine pressure did not represent a threat to life in any of the cases described here, the authors feel that monitoring of labor by external tocometry is sufficient for clinical needs. PMID- 3962404 TI - [Classification of subpartal fetal heart rate oscillations by tcpO2 measurement]. AB - There is no uniform opinion on the clinical value of FHR variability. It is possible to study connections between FHR variability and fetal oxygen tension by means of tcpO2 measurement. 856 episodes from 64 tcpO2 CTGs with more than 2 300 single characteristics were used for analysis. 31% of the fetuses examined exhibited signs of intrauterine growth retardation. The frequency of variability revealed a statistically significant correlation with oxygen tension (p less than 0,001). In hypotrophic fetuses the amplitude of variability was significantly correlated with oxygen tension (p less than 0,001). Silent and narrowly undulatory oscillations reached the significantly lowest oxygen tension values of 11,8 mmHg (1,6 kPa) and 15,2 mmHg (2,03 kPa), respectively, as compared to 20,5 mmHg (2,73 kPa) and 24,2 mmHg (3,23 kPa) for undulatory and saltatory oscillations, respectively. The control group of eutrophic fetuses revealed an inversely proportional, statistically significant behaviour of the amplitude of variability and fetal oxygen tension (p less than 0,001). Classification by means of tcpO2 limits (less than or equal to 11 mmHg = hypoxemic and greater than or equal to 12 mmHg = non hypoxemic) confirmed the traditional classification of the amplitude of variability in fetal growth retardation. PMID- 3962406 TI - [Acute febrile neutrophilic dermatosis (Sweet syndrome). Phototherapy of persistent, postlesional erythemas]. AB - We report a 31-year-old male patient suffering from Sweet's syndrome. The particularities of the case are the long period between onset of the disease and establishment of the diagnosis-the cutaneous lesions having persisted all the time, and the marked persistence of postlesional erythemas showing positive improvement by means of selective ultraviolet phototherapy (SUP). PMID- 3962405 TI - [Osseous choristoma in vitiligo]. AB - This article deals with a typical case of both the conditions vitiligo and osseous choristoma of the intraoral soft tissue. Because of the close association between vitiligo and other diseases, it is very important to have each patient thoroughly examined with regard to thyroid diseases, pernicious anemia, diabetes mellitus, and autoimmune phenomena. We have detected a very rare tumescence of mature bony tissue, such as described in literature in only 25 cases, so far. PMID- 3962407 TI - [Tigason in hyperkeratosis lenticularis perstans (HLP)--a case report]. AB - A case of hyperkeratosis lenticularis perstans was successfully treated with etretinate. Following a short period of aggravation of the condition, an almost total clearing of the lesions was observed after 10 weeks of treatment. PMID- 3962408 TI - [Senile pruritus]. PMID- 3962409 TI - [Squamous epithelial and basal cell carcinomas in naevus sebaceus (Jadassohn)]. AB - Investigation of 181 nevi sebacei (Jadassohn) revealed the development of basal cell carcinoma in 21 cases, prickle-cell carcinoma in 1 patient. 2 basal cell carcinomas had been taken from different parts of the same systematized nevus. All these secondary tumors had developed in postpubertal patients. PMID- 3962410 TI - [Granuloma disseminatum partim anulare partim papulosum. Clinical variant of granuloma anulare disseminatum--therapeutic trial with etretinate]. AB - We report on a clinically and morphologically interesting case of generalized granuloma anulare showing disseminated lichenoid papules as well as anulare formations. Histopathology confirmed the clinical diagnosis. Under oral application of etretinate, the lesions decreased significantly within 3 weeks; complete remission was noticed after 5 months. PMID- 3962411 TI - [Topical treatment of glucocorticoid-sensitive dermatoses with diflorasone diacetate]. AB - Treatment with diflorasone diacetate ointment and cream (0.05%) was strikingly successful in a multicenter clinical trial involving 4,651 patients in total suffering from various corticosteroid-sensitive dermatoses. According to the clinical evaluation, 93% of the patients were cured or much improved. Approximately 7% of the patients questioned rated the local tolerance of the two forms of administration as good to very good. Only 4% of the patients rated the tolerance of the ointment or cream as moderate or bad. None of the patients showed any systemic side-effects. The molecular structure of diflorasone-17,21 diacetate and the specific pharmaceutical properties of the ointment and cream evidently guarantee a good bioavailability of the glucocorticosteroid in the skin. Clinical and experimental results confirm that diflorasone diacetate belongs to the group of highly active corticosteroids. PMID- 3962412 TI - [Clinical course of 470 patients with mitral valve prolapse]. AB - The clinical relevance of the echocardiographic finding of mitral valve prolapse (MVP) is largely unclear. Therefore we made a prospective study of 470 patients with MVP established by M-mode echocardiography (63.7% holosystolic, 36.3% late systolic) over an average period of 2.7 years, corresponding to an observation period of 1,269 patient years. Patients with hemodynamically relevant mitral insufficiency were excluded from the study, as were patients with additional cardiac disorders. Three patients died, two of non-cardiac causes, but one probably in sudden cardiac death. 54.8% complained of angina pectoris, 15.6% of dyspnea. 14.4% suffered from non-orthostatic vertigo. 23.3% had one or more syncopes, 14.9% for the first time during the period of observation. 43.4% suffered from rhythm disturbances, 10.2% for the first time during the period of observation. Patients with rhythm disturbances experienced non-orthostatic vertigo (p less than 0.01) and syncopes (p less than 0.01) more frequently than patients without rhythm disturbances. During the study none of the patients developed endocarditis and none had an arterial embolism. Patients with late systolic MVP and a click experienced syncopes more frequently than those with holosystolic MVP without a click (p less than 0.05). Further correlations between the echocardiographic picture, auscultatory findings, age, sex and weight on the one hand and clinical progress on the other hand, were not found. Thus prognosis for MVP with regard to survival seems to be good. Nonetheless, complaints, even potentially threatening syncopes, are frequent. Neither clinical nor echocardiographic findings permit a prognostic statement. PMID- 3962413 TI - [Echocardiography detection of reduced left ventricular diastolic posterior wall motion in patients with constrictive pericarditis--incidence and correlation with hemodynamics and clinical course]. AB - In 24 patients with chronic constrictive pericarditis (CP) proven by right and left heart catheterization, the amplitude of diastolic left ventricular posterior wall motion was evaluated by M-mode echocardiography and compared with the results of 14 healthy volunteers. The amplitude was significantly less in CP patients than in normal controls (0.3 mm vs. 4.0 mm, p less than 0.001) and no CP patient showed a higher value than 2 mm whereas none of the normal subjects had an amplitude less than 3 mm. In 11 of 13 CP patients undergoing pericardectomy, an increase in amplitude was observed; in 6 of them the amplitude was within normal limits following surgery. No significant correlation between the degree of heart failure or the level of left ventricular end-diastolic pressure and the reduction of the amplitude could be found. In addition, the level of the amplitude did not allow a clear separation between patients who could be treated medically and those requiring pericardectomy. It can be concluded that the reduction of diastolic left ventricular posterior wall motion is a valuable echocardiographic parameter for the noninvasive diagnosis of CP. PMID- 3962414 TI - [The pattern of regional disorders of wall motion in primary dilated cardiomyopathy]. AB - Regional left ventricular wall motion was measured in 41 patients with dilated cardiomyopathy (DCM) and 30 healthy normal controls. Global and regional left ventricular function was noninvasively determined by radionuclide angiography (RNA). The amplitudes and phases of the first Fourier coefficient of the regional time-activity curves were used to measure regional wall motion. The normal left ventricle has its strongest contractions in the apical and distal antero-septal regions. In contrast, the left ventricle of patients with DCM contracts the least in these segments. These regional wall motion impairments are parallel to the reduced global left ventricular function. Since such a typical pattern of reduced wall motion can already be demonstrated in patients with mild DCM, determination of regional left ventricular wall motion can help to improve the early detection of DCM. PMID- 3962415 TI - [Electrophysiologic and hemodynamic effects of the new bradycardia-inducing substance AQ-A 39]. AB - AQ-A 39 is a new agent with specific bradycardic action on the sinus node. In this study the electrophysiologic and hemodynamic effects of this compound were investigated in 24 patients with various cardiac diseases. The results show: AQ-A 39 causes a significant decrease in enhanced sinus rate. The bradycardic action is more profound at higher sinus rates. In sinus rhythm of normal frequency or, in sinus bradycardia, sinus rate remains unchanged or increases even in the case of sick sinus node syndrome. Conductivity of the AV-node is significantly improved. QT- and QTc-interval increase dose dependently. Other cardiac conduction times and refractory intervals are not significantly changed. In exercise-induced myocardial ischemia increased left ventricular filling pressures are diminished. The extent of this decrease parallels the reduction in heart rate. AQ-A 39 appears to be suitable to reduce inadaequate increases in sinus rate, and seems to be of particular interest in surgical cases or intensive care emergencies as well as in acute ischemic heart disease. PMID- 3962416 TI - [Benefits of endocarditis prevention in patients with prosthetic heart valves]. AB - The beneficial effect of prophylaxis for IE was studied in 229 patients with prosthetic heart valves in whom 287 diagnostic or therapeutic interventions were performed. The prevention used was similar to that recommended by the American Heart Association. Prosthetic valve endocarditis was not observed in any of these patients. This result was compared with that of 304 patients with prosthetic heart valves, in whom without any prevention 390 similar interventions were performed during the same observation period. The incidence of prosthetic valve endocarditis occurring within 14 days after the intervention was 1.5/100 interventions (n = 6). All patients had to be reoperated. One patient died perioperatively. Two more patients developed prosthetic valve endocarditis 8 and 13 weeks, respectively, after the initial intervention. This retrospective study documents the benefit of the prophylaxis for IE used. PMID- 3962417 TI - [Preservation at low temperature of subcellular particles of the cerebral cortex]. PMID- 3962418 TI - [Lipoprotein lipase and its activation in post-heparin guinea pig serum]. PMID- 3962419 TI - [Preliminary results of a laboratory-diagnosis research program for persons suspected, by serial radiographic examinations, of having cardiovascular diseases]. PMID- 3962420 TI - [In vitro effect of endotoxin on lipid peroxidation of rat liver mitochondria]. PMID- 3962421 TI - [Model of the interpretation process in the visual analysis of orienting tests]. PMID- 3962422 TI - [Comparative studies on the determination of albumins in serum by dye-binding methods]. PMID- 3962423 TI - [Linearity of the lactate dehydrogenase reaction. 2. Direction of the reaction lactate pyruvate (L to P)]. PMID- 3962424 TI - [Diurnal variations in superoxide dismutase (EC 1.15.1.1) activity and malondialdehyde concentration in the rat brain and striatum]. PMID- 3962425 TI - [Computer-supported test for the normal distribution of measured values]. PMID- 3962426 TI - [Flow cytometry for the determination of glucose using an amperometric measuring principle in the flow system]. PMID- 3962427 TI - [Energy metabolism of human platelets. 1. Incorporation of 14C-adenine into the adenine nucleotide metabolic pool]. PMID- 3962429 TI - Three Egyptian trematodes of fish-eating mammals of family Cyathocotylidae (Poche, 1926). AB - Fifty-eight specimens of cyathocotylid flukes were collected from dogs fed on the fish Clarias lazera: 10 Duboisia, 27 Mesostephanus appendiculatus; and 21 Prosostephanus industrius. This is the first time that these genera have been identified as parasites of C. lazera. The danger of human infection with these trematodes by means of C. lazera and other commercially important fish is stressed. PMID- 3962428 TI - Pathological changes induced by Pomphorhynchus laevis Muller (Acanthocephala) in the gut of rainbow trout, Salmo gairdneri Richardson. AB - The consequences of infection of rainbow trout, Salmo gairdneri Richardson, by an acanthocephalan, Pomphorhynchus laevis Muller, have been studied using light and electron microscopy. The mucosal epithelium, of the gut adjacent to the metasoma of the worm suffered compression and abrasion. The praesoma of P. laevis penetrated the mucosal epithelium, lamina propria, stratum compactum, stratum granulosum, muscularis and serosa of the gut wall, and was invested by a fibrous capsule of inflammation tissue. This was composed of four principal cell types: eosinophilic granular cells (EGCs), type A cells, type B cells and fibroblasts. Some melanocytes and lymphocytes were also present. The role of the EGCs in the inflammation response is not known, but may not be an active one. The type A cells resembled neutrophils of other fish species, and have tentatively been placed in this category. The type B cells, with large cisternae formed by the RER, resembled plasma cells and may have been involved in a humoral response to the acanthocephalan. The integument of P. laevis did not appear to be damaged by the cells of the inflammation tissue, and it seems likely that this host response was incapable of rejecting the parasite. PMID- 3962430 TI - Evidence of the growth factor in mouse serum infected with Spirometra erinacei plerocercoids. AB - To investigate the action of the growth factor secreted by Spirometra erinacei plerocercoids, various organ weights, body weight and head-body length were measured in Snell normal and dwarf mice after injection with the serum from mice and rats. Serum from mice infected with the plerocercoids caused significant increases in the weights of the liver and spleen, in the same manner as mice infected with the plerocercoids. However, serum from rats infected with plerocercoids did not cause significant changes in these parameters. The growth factor in the serum of mice infected with plerocercoids was stable at -20 degrees C for at least 6 months and easily passed through the peritoneum. PMID- 3962431 TI - Further studies on prevalence of hydatidosis in slaughtered animals from North Jordan. AB - Examination of 471 sheep, 118 goats, 157 cattle and 56 camels slaughtered in abattoirs in North Jordan was carried out during March-May 1984. Drought conditions that prevailed during the preceding winter led to slaughtering old female sheep (greater than or equal to 4 years) due to scarcity of food, which allowed us to analyse the prevalence of hydatidosis in various age groups of sheep. An overall infection rate of 27.8, 1.7, 5.8 and 10.7 percent was found in sheep, goats, cattle and camels, respectively. The infection rate was as low as 1.5 percent in male and 1.9 percent in female sheep under 2 years of age. However, the rate of hydatid infection increased with age and reached as high as 63.7 percent in ewes 4 years of age and older. The percentage of animals with fertile cysts was also highest in sheep (68.7 percent of infected animals) and increased with age reaching 100 percent in ewes which were 10 years of age or older. Analysis of all cysts recovered from the livers and lungs of infected ewes from various age groups revealed a sharp increase in the mean total number of cysts in age groups over 8 years of age. The fertility rate of the cysts in the liver was significantly greater in ewes 6 years old or more (64.8--78.6 percent) than in younger age groups (8.7-46.2 percent). In the lung, the fertility rate increased progressively with age reaching as high as 97.9 percent in ewes 10 years old or more. These findings of high infection and fertility rates of hydatid disease in sheep, particularly of older age groups, prompt plans for further epidemiological studies and control programmes. PMID- 3962432 TI - [Preradiologic stage of idiopathic femur head necrosis demonstrated by intraosseous pressure measurement]. AB - Early identification is the focal point of efforts aimed toward efficient diagnosis and treatment of osteonecrosis. With the intraosseous pressure measurement method of Ficat and Arlet it is possible to determine the onset of this disease at the preradiological stage. At the Vienna-Speising Orthopedic Clinic 11 out of a total of 66 cases of idiopathic necroses of the femoral head were diagnosed at the preradiological stage. The only treatment given in these cases was decompression by removal of a bone cylinder. The follow-up examination after an average of 22 months revealed very good results in all cases, both subjectively and roentgenologically (stage deterioration did not occur in a single case). PMID- 3962433 TI - [Value of myelography and computer tomography in problem cases of lumbar intervertebral disk diagnosis]. AB - The accuracy of myelographic and computerized tomographic findings in lumbar layer diagnostic techniques is examined in a total of 133 patients suffering from root compression syndrome. The comparatively high percentage of accurate results 94% (myelogr.) and 90% (ct) in 93 cases where the findings were operatively substantiated,--sinks when the problem cases are considered apart. In 22% of our patients, one method alone was not sufficient for satisfactory preoperative diagnosis. The value of myelography and ct in the diagnosis of problem cases in herniated lumbar disk disease is different. Because of specific advantages (Tab. 1) in the representation of the spinal canal the techniques have their own position. When clinical and computertomographical results are clear and corresponding, myelography-as an invasive diagnostic technique--is unnecessary. In problem cases, however, both methods should be used to complement one another. PMID- 3962434 TI - [Catheterized peridural anesthesia as a procedure for intra- and postoperative pain therapy in chemonucleolysis]. AB - In 13 patients scheduled for intradiscal therapy with chymopapain we performed continuous lumbar epidural anaesthesia as a method of intra- and postoperative pain relief. In all patients epidural anaesthesia provided a sufficient analgesia by the use of bupivacaine 0.75% intraoperatively. In contrast to chemonucleolysis under general anaesthesia only half of the patients needed postoperative pain therapy, which was achieved by the epidural injection of bupivacaine 0.25%. PMID- 3962435 TI - [Anatomic principles of lumbar intervertebral disk operations]. AB - The important anatomical structures and the topographic relationships of lumbar disc surgery are described. Recent examinations about the epidural venous plexuses, the vascular supply of the spinal cord and nerve roots in the spinal canal enlarged our knowledge. Anterior and posterior spinal nerve roots differ in reaction to horizontally directed pull. The prevertebral anatomical structures which can be damaged by iatrogenic ventral perforation of the lumbar disc are demonstrated and their clinical importance is discussed. PMID- 3962436 TI - [Planimetric studies of the lumbar intervertebral space following nucleotomy by straight and angled rongeur]. AB - Persisting, floating intervertebral disc sequesters after lumbar nucleotomy are one reason for recidivation of disc prolapses. For this reason, planimetric experiments at a lumbar intervertebral disc's cross-section are made using straight and angled forceps to estimate the maximum possible amount of curetted intervertebral material. The results show that, at the very best, no more than 70% of the intervertebral area can be reached by the common straight and angled forceps. PMID- 3962437 TI - [Spontaneous occlusion of a thoracic duct fistula following leftsided shoulder girdle amputation]. AB - Reference is made to the anatomy and variant courses of the thoracic duct, as well as to possibilities of surgical and conservative therapy. A chylous fistula developed in a 53-year old man after his left shoulder girdle had been amputated because of a recurrent low grade chondrosarcoma. Nineteen liters of chyle were excreted over a 5-week period. It was possible to achieve a spontaneous occlusion of the fistula by means of repeated punctures, compression bandages, and a low fat diet. PMID- 3962438 TI - [A rare case of habitual lateral clavicular dislocation in the dorsal subacromial direction (case report)]. AB - A spontaneous dislocation in the acromioclavicular joint, in dorsal subacromial direction, in a 22-year-old woman. Since there is no history of trauma in this case the dislocation is interpreted as a habitual lateral dislocation of the clavicle. PMID- 3962439 TI - [Tuberculosis of the shoulder joint]. AB - In contrast to specific shoulder girdle processes tuberculoses of the shoulder joint are observed relatively frequently. From 1955 up to and including 1980, 50 patients with omarthritis tuberculosa were surgically treated at the authors' clinic. Thirty were male, 20 female, 42 were Germans, 8 immigrant workers. Arthrodeses were performed in 28 cases, removal of bone or soft-tissue foci, or a combination of these, in 22. The left joint was affected in 26 cases (52%) and the right in 24 (48%). The youngest patient was 9, the oldest 78 years of age (average age 42.6 years). The time from the onset of complaints to diagnosis was about 1.6 years. Twenty-eight patients (56%) had previously had treatment for tuberculosis and 9 (18%) also had active tuberculosis localized elsewhere. Even though there were clear radiological changes in all cases, abscesses and fistulae or a combination of these in 27 cases (54%), the 1-hour ESR was normal or only slightly elevated (under 20 mm acc. to W.) in 29 patients (58%). The recurrences which occurred immediately after surgery or in the subsequent course of the disease healed without sequelae after secondary interventions. While they prolonged hospitalization they did not influence the result of surgery. Of the 38 (76%) patients who were followed up on average 3 years after the end of inpatient treatment, 30 (79%) had returned to work on average 1.1 year after being discharged from the hospital. Three had meanwhile been retrained for lighter work. In the discussion the etiology and pathogenesis, incidence, side localization, age and sex distribution, complaints, clinical and radiological findings, diagnosis, therapy, prognosis, and differential diagnosis of shoulder joint tuberculosis are reported on with reference to the relevant literature. PMID- 3962440 TI - [Computer tomography determination of the torsion angle of the humerus]. AB - A simple and easy method of CT-measurement of humeral torsion is proposed. This requires a transverse section of the proximal and distal epiphyses. The optimal site of cross-sectioning with reliable construction of the joint axis was determined in ten humeral bones. The variability of the angle was 2 to 3 degrees. Comparing CT-measurements in 50 humeri with anthropometry showed excellent correlation. Varation in humeral torsion on either side was approx. 50 degrees with the same mean value in right and left humeri of our specimens. Deviations in bone positioning within the gantry of up to 15 degrees in two different planes had little effect on the measurements. Habitual dislocation of the shoulder as well as assessment of postfractural malrotation of the humerus might be indications for measurement of humeral torsion. PMID- 3962441 TI - [Endoprosthetic replacement of the shoulder joint. Possibilities and their analysis]. AB - Functional and anatomic characteristics of the shoulder girdle are special problems, that have to be solved in the process of using an artificial joint replacement to improve the function of a painful shoulder, which is restricted in movement. Seen from a biomechanical point of view, besides a safe fixation of the prosthesis the stability and kinematic of the artificial joint are of considerable importance for the success of the endoprosthetic treatment. The efforts of meeting these requirements by a respective prosthesis design led to a variety of prosthesis types. This study shows the possibilities for prosthetic replacement of the shoulder joint and comprises an analysis of all systems, which are available on the market, as well as of the patent applications of the past 15 years. The prostheses are listed according to their stability. Relative to the state of destruction of the joint unconstrained prosthesis types with completely free and partially restricted mobility, as well as constrained types of joints are being discussed. PMID- 3962442 TI - [Shear fracture stress of the spongiosa and pressure fracture stress of cortical bone of cadaveric vertebrae]. AB - By biomechanic examinations of the vertebrae of human dead bodies the ultimate stress due to shearing (Schubbruchspannung) of the spongy substance could be found out with 1.80 N/mm2 and the ultimate stress due to compression (Druckbruchspannung) of the cortical-belonging to the thick of cortical--with 280 N/mm2. Both measuring results are important for the ultimate strength of the connection (Verankerungsfestigkeit) of screws in vertebae. PMID- 3962443 TI - [Morphometric measurements in the area of the epiphyseal groove of the parietal vertebra in experimentally-induced scoliosis in rabbits]. AB - In 3 rabbits we provoked a short-curved dorsolumbal scoliosis by costo-lumbal cerclage. In order to quantify with morphometric methods the morphologically by various authors described effect of pressure parallel to the axis of epiphyseal growth under Hueter-Volkmann's law, we measured the height and area of different parts of the epiphyseal plate in frontal semi-thin sections (Alcian-blue) by means of a pictoral analysis system based on a mini-computer. On the concave side, the side of increased pressure, we found a relative atrophy of the epiphyseal plate of 40% and a diminished area of 49%. PMID- 3962444 TI - [Growing process of a vertebra in negative bone scintigram]. AB - A hyperdense zone in the 3rd lumbal vertrebra grew during four years. Bone scans showed no augmentation of activity in this region. Differentialdiagnosis includes a local hyperostosis and enostoma. PMID- 3962445 TI - [Value of punch and puncture drill biopsy in the diagnosis of tuberculous spondylitis]. AB - Thanks to a specially designed guide instrumentarium, punch and drill aspiration biopsy for the vertebrae and intervertebral spaces have become routine diagnostic procedures which any patient can be expected to tolerate. With the authors' puncture technique material can be obtained from a single vertebra at various heights or simultaneously from different segments with the drilling cannula. For an experienced osteopathologist histologic assessment of the tissue cylinders obtained or of aspirated material presents no problems. Percutaneous removal of samples by this method avoids an open diagnostic intervention with its considerably greater attendant risks, or enables a therapeutic intervention to be prepared with greater precision. The authors report on their own experience of drill aspiration biopsy in 35 fully documented patients and discuss considerations regarding indication and confirmation of the diagnosis. PMID- 3962446 TI - [Spondylitis brucellosa]. AB - The authors report on three cases of spondylitis brucellosa, and their course over a period of more than two years. The clinical and radiological characteristics of spondylitis brucellosa are described, as well as possible ways of distinguishing it diagnostically from tubercular and other non-tubercular types of spondylitis. In the main, confirmation of diagnosis will be provided by immunologic investigations, and these should be routine in any differential diagnostic identification of spondylitis. PMID- 3962448 TI - The devil and the deep blue sea. PMID- 3962447 TI - Safety and immunogenicity of a polyvalent Klebsiella capsular polysaccharide vaccine in humans. AB - A polyvalent Klebsiella vaccine composed of six serotypes of capsular polysaccharides (K2, K3, K10, K21, K30, and K55) was developed and its safety and immunogenicity evaluated in humans. Highly purified capsular antigens were treated in 0.1 N NaOH in 95% ethanol to detoxify trace amounts of contaminating lipopolysaccharide (LPS). The vaccine was nontoxic and nonpyrogenic for animals. A total of 40 individuals received either 25 or 50 micrograms of each represented antigen subcutaneously. Reactions to vaccination, where noted, were transient and mild in nature. An immunizing dose of 50 micrograms of each antigen (300 micrograms total) elicited a fourfold or greater immunoglobulin G (IgG) response to all vaccine antigens in greater than 80% of vaccinees. Generally, the serospecificity of the antibody response was limited to those capsular antigens included in the vaccine. IgG isolated from the serum of vaccinees was found to be highly protective against fatal experimental Klebsiella K2 burn wound sepsis indicating that the functional antibody is elicited following vaccination. PMID- 3962450 TI - Effect of low level immunity on response to live rubella virus vaccine. AB - Serum specimens of 1075 young adults representing nursing and medical staff were collected for determination of rubella immunity using the radial haemolysis (RH) technique, also know as the haemolysis in gel (HIG) test. Of the sera 84 (7.8%) were negative (RH titre less than 4 mm) and an additional 93 (8.7%) gave an RH titre of 4-5 mm, which was regarded as the limit of immunity. Initially, 64 persons of these 177 were vaccinated with the RA27/3 strain of live attenuated rubella virus. Their serum samples were collected at the time of vaccination and at three weeks and three months after vaccination. Altogether 54 vaccinees could be followed for their immune response throughout the study. It became obvious that vaccination generally caused seroconversion only after three months rather than within three weeks. Only one person remained seronegative - even after a booster dose of vaccine. The mean final antibody titres in individuals with pre existing low level immunity was 6 mm whereas in initially seronegative persons the antibody titre after vaccination was 8.5 mm on average. Thus a pre-existing low level immunity will effectively block the immune response to live rubella virus vaccine and this phenomenon may explain some apparent vaccination failures. PMID- 3962449 TI - Adjuvant and antitumour activities of synthetic lipid A analogues. AB - The biological activities of synthetic glycolipids, which were chemically synthesized and based on the structure of lipid A of the lipopolysaccharide (LPS) from Escherichia coli, were examined with special reference to their adjuvant activity on the induction of delayed-type hypersensitivity, activity on the induction of tumour necrotic factor (TNF) and tumour regressive activity on line 10 hepatoma in strain 2 guinea pigs. Among them, a compound structurally corresponding to free E. coli lipid A (compound 506) as well as LPS exhibited potent adjuvant activity in the induction of delayed-type hypersensitivity in guinea pigs and TNF inducing activity in the sera of mice which were presensitized with Propionibacterium acnes. Compound 506 showed potent lethal toxicity in the intravenous administration of BALB/c mice presensitized with P. acnes. The regressive activity on line 10 hepatoma was observed by the multiple intralesional injection of squalane-treated compounds 504 and 505 in strain 2 guinea pigs. PMID- 3962451 TI - In vitro production of anti-influenza virus antibody after simultaneous administration of H3N2 and H1N1 cold-adapted vaccines in seronegative children. AB - Sixteen doubly seronegative (H3N2 and H1N1) young children were recently enrolled in a study of live, attenuated cold-adapted influenza A vaccines. Twelve children received simultaneously H3N2 and H1N1 live, attenuated influenza vaccine intranasally and four received saline as placebo controls. Peripheral blood lymphocytes (PBL) were obtained sequentially from all children and the in vitro production of anti-influenza H3N2 and H1N1 antibody from unstimulated and influenza stimulated cells was measured by ELISA. In vitro antibody studies were performed at 0, 2, 4, and 12 weeks after immunization. PBL from six of 12 children spontaneously produced H3N2 antibody and eleven of 12 produced H1N1 antibody. Influenza stimulation of PBL induced antibody production in 8/12 for H3N2 and 12/12 for H1N1. PBL from all four placebo immunized children failed to produce specific influenza antibody in vitro at any time studied. In vitro antibody produced after immunization was primarily of the IgG isotype with peak production occurring at 4-12 weeks, supporting the primary nature of the response. The correlation between the presence of positive serum HAI and ELISA titres, and the production of in vitro antibody was good for both H3N2 and H1N1 vaccines. In summary, the simultaneous administration of two attenuated influenza A vaccines into the upper respiratory tract of seronegative children resulted in the stimulation of PBL capable of secreting both H3N2 and H1N1 influenza specific antibody in vitro. PMID- 3962452 TI - Biochemical and antigenic analysis using monoclonal antibodies of a series of of influenza A (H3N2) and (H1N1) virus reassortants. AB - Reassortant influenza A viruses with high growth capacity in eggs and suitable as candidate vaccine strains or as standard reagents for influenza HA quantification were prepared using the high yielding A/PR/8/34 (H1N1) as one parent and a number of 'wild' strains of influenza A (H1N1) or (H3N2) viruses as the other parent. The genetic and antigenic composition of the reassortants was determined. The parental derivation of genes in the reassortants was established by electrophoretic analysis of virus RNA and virus induced polypeptides. The haemagglutinin (HA) antigens of the three H1N1 viruses (NIB-6, NIB-7 NIB-12) were found to resemble those of the parental viruses when tested against a panel of monoclonal antibodies and using the HI test. A similar correspondence between the antigenic characteristics of the HA of the influenza A (H3N2) reassortants (NIB 1, NIB-4, NIB-5, NIB-8 and NIB-11) and parental viruses was noted. Therefore laboratory manipulations to produce the reassortants did not result in the selection of significant antigenic variants. PMID- 3962453 TI - [Scientific analysis of phleboprophylaxis]. PMID- 3962454 TI - Quantification of arterial stenoses by simultaneous measurement of blood pressure and blood velocity in the common femoral artery. PMID- 3962456 TI - Changes in intramuscular pressure in the leg during surgery. A study of a possible mechanical factor for the development of deep vein thrombosis. PMID- 3962455 TI - Pathogenetic key position of thromboangitis: the endothelial cell. Serum dependent proliferation studies of endothelial cells in obliterative angiopathies. PMID- 3962457 TI - [Clinical aspects of essential thrombocythemia. A review of the literature]. PMID- 3962458 TI - Bilateral retroperitoneal exposure for aortoiliac thrombendarterectomy. A new alternative. PMID- 3962459 TI - PGE1 treatment of severe skin ischemia in patients with peripheral arterial insufficiency--the effect on skin microcirculation. PMID- 3962460 TI - Results of systemic thrombolysis with streptokinase for recurrent arterial occlusion in the aorto-iliaco-femoral region: a long-term trial. PMID- 3962461 TI - Long-term results of local low dose thrombolytic therapy of arterial embolism of the lower limb. PMID- 3962462 TI - [Vibration syndrome--a case report of a metal grinder]. PMID- 3962463 TI - The epigastric steal syndrome. PMID- 3962464 TI - [Chief problems in the surgical treatment of complex congenital heart defects in patients more than 3-years-old]. PMID- 3962465 TI - [Angiographic diagnosis and systematics of stenosing lesions of the pulmonary arteries]. PMID- 3962466 TI - [Problem of surgery and intensive care for infants with congenital anomalies of the heart in critical condition]. PMID- 3962467 TI - [Echocardiographic diagnosis of congenital heart defects in newborn infants in critical condition]. PMID- 3962468 TI - [Intravascular catheterization roentgenosurgery]. PMID- 3962469 TI - [Diagnosis and surgical treatment of combined lesions of the coronary arteries and heart valves]. PMID- 3962470 TI - [Epicardial electropulse destruction of accessory atrio-ventricular connections- new method of surgical treatment of the ventricular pre-excitation syndrome]. PMID- 3962471 TI - [Relation between the survival and mortality of surgically treated and surgically untreated patients with ischemic heart disease and arrhythmias and the nature of the coronary artery lesion]. PMID- 3962472 TI - [Current principles of treatment of acute coronary circulatory disorders]. PMID- 3962473 TI - [Hypoplasia of the thoraco-abdominal aorta with a coarctation syndrome (clinical picture, diagnosis and surgical treatment]. PMID- 3962475 TI - [Prolonged (20-24 hours) preservation of donor hearts]. PMID- 3962474 TI - [Computerized history of the disease designed for use in heart surgery]. PMID- 3962476 TI - [Ultrastructural characteristics of the peripheral blood neutrophilic leukocytes and the quantitative assessment of the cytoplasmic granules in eczema patients]. PMID- 3962477 TI - [Corrective effect of laser therapy on functional defects in the neutrophilic leukocytes in neurodermatitis patients]. PMID- 3962479 TI - [Lysozyme in chronic dermatoses]. PMID- 3962478 TI - [Changes in the enzyme activity of lysosomes in the skin of psoriasis patients]. PMID- 3962480 TI - [PUVA therapy of mastocytosis patients]. PMID- 3962481 TI - [Electron microscopic assessment of the biomechanism of laser radiation action on the microflora in xerotic obliterating balanoposthitis]. PMID- 3962482 TI - [Basic research trends in dermatology and venereology in the coming years]. PMID- 3962483 TI - [Development of a rhabdomyosarcoma at the site of a pemphigus process]. PMID- 3962484 TI - [Anetoderma]. PMID- 3962485 TI - [Skin metastasis of an adenocarcinoma of the large intestine]. PMID- 3962486 TI - [Pemphigus vulgaris in children]. PMID- 3962487 TI - [Gottron's carcinoid papillomatosis of the skin]. PMID- 3962488 TI - [Characteristics of skin pathology among the inhabitants of Afghanistan]. PMID- 3962489 TI - [Allopurinol in the treatment of psoriasis patients]. PMID- 3962490 TI - [Dynamics of the causative agents of dermatophytoses in Bukovina over 14 years (1970-1983)]. PMID- 3962492 TI - [Treatment of chronic prostatitis at the Morshin health resort]. PMID- 3962491 TI - [Phagocytic activity of the neutrophilic granulocytes of patients with chronic generalized (granulomatous) candidiasis]. PMID- 3962493 TI - [A case of a red phagedenic hard chancre]. PMID- 3962494 TI - [Papulous uveoretinitis in a female patient with secondary recurrent syphilis]. PMID- 3962495 TI - [Air pollution and lung diseases in adults]. AB - Short-time exposure to air pollutants and in particular to sulfur dioxide, nitrogen oxides and photochemical oxidants may cause respiratory symptoms similar to acute bronchial asthma. In healthy adults however the concentrations required to evoke significant bronchial obstruction lie still above the level of atmospheric air pollution usually observed in our country. In contrast patients with preexisting pulmonary diseases or with impaired bronchopulmonary defense mechanisms may show harmful reactions even at concentrations which actually occur in urban and rural atmospheres. In addition there is evidence of on increased prevalence of chronic obstructive pulmonary diseases in countries with high chemical pollution indicating that long-term exposure of ambient air pollution may cause chronic illness as well. Since air pollution is accepted to produce adverse health effects, emergent efforts are required to improve air quality in order to avoid further injuries in man. PMID- 3962496 TI - [Air pollution and respiratory tract diseases in children]. AB - Children are particularly susceptible for respiratory diseases, this is why studies on health effects of air pollution are often investigating children. Children have some other advantages: they do not smoke and they are not exposed to potentially noxious environment at work, also they spend their time fairly constantly in their usual environment. Studies from England and the United States show higher incidence of acute and a higher prevalence of chronic respiratory disease in children living in areas with higher concentration of air pollutants than in groups living in areas with lower concentration of pollutants. Some studies show these effects in concentration similar to those observed in swiss townships. Nevertheless specific studies in Switzerland are indicated in order to investigate the effect of the particular composition of pollutants in Switzerland and to assess effects of future possible improvements of the air quality. PMID- 3962497 TI - [Extent and evaluation of air pollution in Switzerland]. AB - The measurements of atmospheric pollution carried out in Switzerland during the last years revealed that high concentrations are not only found in city centers but in suburbs as well. The emission limits which should be respected in order to protect health and environment are very often exceeded. The pollution through nitrogen dioxide is specially crucial as well as that of sulfur dioxide during the winter months. Ozone concentrations are remarkably high in summer--ozone being formed by photochemical reactions of nitrogen oxides and hydrocarbons--and can be transported far away, even in rural areas. It is urgent to take the necessary steps now to reduce the atmospheric pollution in order to protect the population against possible health damages. PMID- 3962498 TI - [Measures against air pollution]. AB - The Swiss Environmental Protection Law provides the legal basis for an efficient confinement of the air pollution. The concept of the Swiss air pollution control policy is based on two steps. In a first step, all emissions are limited providently. In a second step, the emissions have to be limited more severely, if it is certain or if it can be expected that the air pollution is harmful or annoying to human health or to the environment. The new ordinance on air pollution control is of great importance in abating air pollution. This ordinance will enter into force on March 1st, 1986. Is contains regulations for industrial sources and for heating systems, for instance emission limits for a number of pollutants, regulations for construction and operation of stationary installations, limits for the maximum content of pollutants in fuels. Moreover, stringent exhaust regulations for new passenger cars will enter into force on October 1st, 1987. Although important measures to reduce air pollution have already been taken in Switzerland, further efforts are necessary to guarantee a sufficient protection of human health and environment. PMID- 3962499 TI - [Effect of meteorologic and atmospheric health factors on acute diseases of the respiratory tract in children--as exemplified by the Biel region]. AB - In the region of the small town of Biel, cases of various acute respiratory illnesses among children were recorded and correlated with measured parameters of meteorology and air pollution (sulfur dioxide, dust) during a period of one and a half years. An increase of cases was noted during the fall and winter months, by low temperatures, high humidity and meteorological conditions with northerly synoptic winds. Also the correlation of the cases to SO2 deposition values revealed a significant connection that may possibly be simulated by identical seasonal changes. No significant connection could be found between concentrations of SO2 respectively dust values and frequency of illness. PMID- 3962500 TI - [Health effects of air pollutants]. AB - Air pollutants can exhibit both acute and chronic effects. Acute effects mainly occur during smog situations in industrial areas when atmospheric concentrations of hazardous substances are extremely high. This leads to an increase of morbidity and mortality especially in old and ill people. Chronic effects are the consequence of a longlasting exposition to low doses of noxious substances. Epidemiological studies have shown that frequency of respiratory diseases is higher in air polluted areas; this effect is particularly evident in smokers. Biological monitoring is used to determine the individual heavy metal burden. Lead is a danger especially for the developing central nervous system. Cadmium accumulates in the renal cortex during lifetime and may cause disturbances of renal function if a certain concentration is reached. The risk groups for heavy metals are young children and pregnant women in the case of lead and old people in the case of cadmium, respectively. Lung cancer incidence is higher in large cities than in rural areas. Carcinogenicity of city smog extracts was proved in vitro and in vivo. These findings suggest that urban air pollution may play a role as a causal factor in respiratory cancer. PMID- 3962501 TI - [The creation of an indicator for the health effect of air pollutants]. AB - The department of social and preventive medicine of the University of Basle is conducting an epidemiologic study on the health effect of air pollution on preschool children. Nitrogen dioxide in childrens' immediate surrounding measured with personal samplers is used as reference substance for air pollution. Meteorologic and Data on air pollution of all permanent air quality control stations are included in the analysis. Health data are collected by means of a diary in which parents record daily respiratory symptoms of their child. Physicians in pediatric services record daily attendance of children with respiratory diseases. PMID- 3962502 TI - [A data bank of international studies on pollution. Possibilities for its use by Switzerland]. AB - GRID (Global Resource Information Data Base) is part of GEMS (Global Environment Monitoring System), which is controlled by the United Nations in its programme on the protection of the environment. Recently, GRID-processor premices have been provided by the University of Geneva. The main preoccupation of GRID is to capture, analyse and distribute data concerning environment: soil types, water resources, vegetation, animal population, human settlements, socio-economical data and, what is more important to us, data on air pollution. GRID facilities are at the disposal of international organisations which are concerned by the environment, as well as all research workers involved in this field of research. In our article, the organisational as well as modelling possibilities of GRID are presented and illustrated. A proposal is made to use GRID's facilities for Swiss epidemiological studies, on the effects of air pollution on human health. PMID- 3962503 TI - [Criteria for the establishment of emission limit values]. AB - The Swiss Environmental Protection Law provides the setting of Air Quality Standards to assess the harmfulness or annoyance of air pollutants. Moreover the law contains some criteria which have to be taken into account for setting the standards. It is essential that protection of man and his environment are the only criteria to determine the level of the Air Quality Standards, whereas economic and political considerations haven't to be taken into account. Particular emphasis has to be given to the information obtained from risk groups of higher susceptibility with respect to pollutants. Problems arising from the transformation of scientific knowledge and experience into measurable and controllable Air Quality Standards which meet the legal requirements are pointed out. PMID- 3962504 TI - [National Observation Network for Air Pollutants. Measurements up to now--planned extensions]. AB - Since 6 years a Swiss national emission monitoring network measures several air pollutants (sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, suspended particulates, particle deposition and precipitations) at 8 sites with different pollution levels (Dubendorf, Zurich, Basel, Sion, Payerne, Lugano, Tanikon, Jungfraujoch). The emission concentrations of sulfur dioxide, nitrogen dioxide and ozone exceed the limit values proposed by federal legislation at several sites, though the monitoring stations are not located at sites with extreme exposure. At present the network is extended for two or three new stations in forests as a part of a Swiss research programme concerning air pollution and forest damages. A further extension of the NABEL will comprise improvements of the measuring programme at the existing stations as well as new stations. PMID- 3962505 TI - [Formation and transport of ozone and other photochemical oxidants]. AB - Photochemical oxidants (O3, PAN, HCHO) are the typical pollutants in photochemical Smog. They can be formed as the result of the sunlight induced oxidation of precursor pollutants emitted into the atmosphere (NOx, CxHy). Other important precursor substances and reactive intermediates are compounds of the organic hydroxyl group (-O-H, for instance the methoxy radical CH3O), hydroxyl radical .OH, hydroperoxy radical HO2, and singlet oxygen O. For the production of photochemical oxidants in smog, especially ozone, NOx primarily act as catalysator. But CxHy serve as "combustibles". The quantities of the several formed photooxidants are mainly dependent on intensity and duration of daily sunshine, temperature, oxidant concentrations at the beginning of a build-up period, and on emission rates and concentrations of primary pollutants (NO, CxHy). Maximum mixing ratios of secondary pollutants often occur at certain distances downwind of primary pollutant sources, dependent on meteorological conditions (wind velocity, rel. humidity, etc.) and on rate constants for oxidant formation cycles. During the period of July 5 to 11, 1984, for instance, 6 kilometers SW from Zurich we found maximum ground-level mixing ratios of about 150 ppbv ozone, 4 ppbv PAN and 9 ppbv formaldehyde, that is 5 (ozone) to 10 (PAN) times above the supposed oxidant concentrations of unpolluted continental air. The increase in ozone in the late morning and early afternoon is accompanied by an increase in PAN and HCHO and by a decrease in NOx. This shows that in this case HCHO originates from photochemical reactions rather than being emitted directly to the atmosphere from vehicles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962506 TI - [Pollution of room air]. AB - In the last decade the significance of indoor air pollution to human health has increased because of improved thermal insulation of buildings to save energy: air turnover is reduced and air quality is impaired. The most frequent air pollutants are tobacco smoke, radioactive radon gas emanating from the soil, formaldehyde from furniture and insulation material, nitrogen oxides from gas stoves, as well as solvents from cleaning agents. The most important pollutants leading to health hazards are tobacco smoke and air pollutants which are emitted continuously from building materials and furniture. Such pollutants have to be eliminated by reducing the emission rate. A fresh air supply is necessary to reduce the pollutants resulting from the inhabitants and their activities, the amount depending on the number of inhabitants and the usage of the room. The carbon dioxide level should not exceed 1500 ppm. PMID- 3962508 TI - Barium enema examination in neonates with suspected necrotising enterocolitis. AB - Sixteen neonates with suspected necrotising enterocolitis (N.E.C.) underwent a contrast enema examination as part of their initial assessment. It confirmed the presence of N.E.C. in 12 patients, and showed more extensive disease than suggested by plain x-ray in 4 patients. This has resulted in an alteration of their management. Two neonates showed colonic perforation, the contrast confirmed the presence of an established perforation with absence of free intraperitoneal gas in one and initiated a perforation in the other. Both underwent immediate laparotomy and colostomy. Restorative surgery was performed a month later with no subsequent intestinal problems. The use of a contrast enema examination in neonates with suspected N.E.C. has generally been discouraged (1). The role of this examination in the acute phase of N.E.C. is discussed. PMID- 3962507 TI - [Atmospheric pollution and chronic respiratory diseases]. AB - A national cooperative study was conducted from 1974 to 1976 in twenty-four areas located in six French cities, in order to investigate the relationships of air pollution to ventilatory function and the prevalence of respiratory symptoms. The concentrations of the following pollutants were daily measured: SO2, suspended particulates, NOx. The population included men and women, non manual workers, aged 25 to 59, and children, aged 6 to 10. The respiratory symptoms and other characteristics of the subjects were recorded and their ventilatory function was measured with a dry expirograph. The main results were as following: a) in adults of both sexes, the pollution in SO2 was associated with the prevalence of lower respiratory symptoms. b) in children, it was associated with the prevalence of upper respiratory symptoms. c) in both adults and children, the higher the SO2 concentration, the lower the FEV1. d) no other pollutant was related to respiratory diseases. PMID- 3962509 TI - Vater association and anorectal malformations. AB - In a twenty-year series of 208 patients with anorectal malformations there were 39 infants with three or more Vater association anomalies. The neonatal mortality of Vater association patients was 28%; beyond the neonatal period only two patients died. Most early deaths were associated with the combination of cardiac anomalies and oesophageal atresia. The incidence of prematurity (30%) and lethal anomalies (15%) was high. High and complex anorectal anomalies were frequent (85%) and some kind of urogenital malformation was present in 95% of the patients. Despite the grave early prognosis and multiple hospitalisations and surgical procedures required in the management of these patients, the long-term outlook and quality of life does not differ significantly from other patients with corresponding anorectal anomalies. PMID- 3962510 TI - [Polar resection in double kidneys in childhood]. AB - 78 cases of double kidneys without vesico-uretero-renal reflux, in which a heminephrectomy was done, were histologically investigated. The histopathological results were compared with the clinic and the urogram. It could be demonstrated that the results did not correspond in some cases. As a consequence of these discrepancies, we conclude that intravenous urography is not sufficient to indicate a primary heminephrectomy. Therefore, additional studies, such as a diethylenetriaminopentaacetate-T-99m scintigram and a preoperative kidney biopsy under sonographic control, are suggested. PMID- 3962512 TI - Brain abscess: a complication of oesophageal dilatations. AB - A 16-month-old boy underwent oesophageal dilatations following an unsuccessful attempt to locally resect a 3 cm long lye stricture. He then developed a brain abscess which was surgically drained. Subsequently, a right colon interposition was performed to bypass the stricture. Following oesophageal dilatations, bacteraemia and fever are common but the occurrence of metastatic brain abscesses is rare. This serious complication should be kept in mind when long-term treatment by repeated oesophageal dilatations is planned. PMID- 3962511 TI - Acetylcholinesterase activities in association with congenital malformation of the terminal ureter in infants and children. AB - Acetylcholinesterase activity was found to be higher than normal in intravesical segments of ureters taken from children with vesicoureteral reflux. The ratio of acetylcholinesterase activity to total cholinesterase activity was also found to be high. Acetylcholinesterase activity was normal in intravesical segments taken from the constricted area of ureters from children with obstructive megaureter but it was high in segments taken from the juxtavesical part, immediately adjacent to the constricted area. These findings complement histological studies which have revealed a hyperplasia of cholinergic nerve fibres in the tunica muscularis of reflux ureters whereas obstructive megaureters show a hypoplasia of the beta-adrenergic system. PMID- 3962513 TI - An unusual alimentary duplication cyst at the floor of the mouth--a proposal of new criteria for alimentary duplications. AB - In a 11-month-old boy, a cyst lined with non-keratinising stratified squamous epithelium and surrounded by striated muscle bundles with respiratory elements was found at the floor of the mouth. The cyst was excised without complications. As the cyst wall resembles the structure of the upper oesophagus, we think that this may be an alimentary duplication cyst, although it does not satisfy Lister's proposed criteria for alimentary duplications. To our knowledge, intraoral duplication cysts similar to the upper oesophageal tissue have not been reported previously. From the experience of this case, we propose new criteria for alimentary duplications. PMID- 3962514 TI - [Aberrant course of the left pulmonary artery--a contribution to a rare disease picture]. AB - An anomalous left pulmonary artery obstructs the right main bronchus and/or the trachea. Depending on the severity of the obstruction, symptoms range from a more or less disturbing stridor over attacks of shortness of breath to a life threatening or even lethal apnoea. An 18-month-old girl suffering from a mild form of this anomaly is presented. The diagnostic and therapeutic possibilities are discussed. After exact clarification of the characteristics of the pulmonary sling, exclusion of associated aberrations, and considering good experience with a former case a conservative approach is recommended if the patient is not substantially impaired. PMID- 3962515 TI - Bridging a gap in oesophageal atresia using Rehbein's technique: dilatation of a thread canal. AB - During the last 12 years, operations were performed on 144 infants with oesophageal atresia. In 18 of them who were suffering from an atresia with long gap between segments, perlon threads were laid surgically. Continuity of the oesophagus was attempted using Rehbein's technique. The newborn had type II and IIIb atresia according to Vogts' classification. 11 of these 18 infants survived the third week of life. The fibroepithelial canal that had developed along the perlon thread, was dilated in steps in 6. The clinical course and results are reported. PMID- 3962516 TI - Duodenal duplication--a case with special features. AB - A duodenal duplication almost as large as the stomach proper was found along the greater curvature of the stomach in a 6-month-old Caucasian girl. There was a wide communication with the proximal part of the duodenum, from which the duplication blood supply originated. The duplication and the stomach shared the serosal lining, but had individual, full thickness walls. The duplication was removed in toto, and the communication with the duodenum was closed by transverse suture. The luminal lining of the duplication consisted of corpus type of gastric mucosa. There was a 1 X 1 cm mucosal ulceration in the region of which respiratory tract elements were found. The condition is interpreted as a duodenal duplication with ectopic gastric mucosa and respiratory tract elements. To our knowledge, the occurrence of respiratory tract elements in an intestinal duplication BELOW the diaphragm is being reported for the first time. It offers a challenging explanation for the ulceration found within this duplication. PMID- 3962517 TI - Pancreoblastoma in a neonate associated with Beckwith-Wiedemann syndrome. AB - A cystic abdominal mass was removed from a male child born at 32 weeks gestation. Histological examination showed this to be a pancreoblastoma. Both clinical and histological features of Beckwith-Wiedemann syndrome developed within the first 12 weeks of life. The child remains well and thriving with no tumour recurrence at 10 months of age. PMID- 3962518 TI - [Changes in the parameters of the urethral pressure profile by measuring the patient in supine and sitting position]. AB - For testing the influence of the examination position on the parameters of the urethrocystometry 124 findings of urethrocystometry of 103 female patients were evaluated in 3 groups. In these cases slight alterations develop when changing between lying and sitting position, whereby in sitting position a greater differentiation of an existing component of stress incontinence becomes possible. On the basis of our examination findings and the references in literature it seems to be advisable to perform the urethrocystometry in the same session both in lying and in sitting position for further improvement of the indication for therapy. PMID- 3962519 TI - [A foreign body in the urinary bladder]. AB - A case concerning the problems of the foreign bodies of the urinary bladder is demonstrated. The 6-year indwelling stay of the foreign body without consultation of a physician and the oral intake at first reported, which was later on revised, are unusual. PMID- 3962520 TI - [Ensuring quality in the analyses of urinary calculi by a comparison of methods. 3d International Ring Trial]. AB - Of 5 analysis tests of the 3rd International Ring Experiment for the control of the quality of methods of the analysis of urinary calculi 38 findings compiled according to 9 different techniques came in from 12 countries. The average deviation per component concerning all 5 analysis tests is considerably low with 0.10 mol proportions. The average quality measure SQ concerning all participants is approximately 2.00; it deteriorates from the X-ray diffraction method over the IR-technique to the other quantitative methods used. Advantages and disadvantages of the X-ray diffraction and IR-spectroscopic analysis are discussed. A methodically homogeneous and centralized performed analysis of urinary calculi shows advantages in the quality of the analyses. PMID- 3962521 TI - [Osteomyelitis following surgical treatment of femoral shaft fractures. Results of a community study]. AB - A retrospective analysis was made of 3,280 diaphyseal femur fracture surgically treated in 73 medical centres of the GDR. The conclusion drawn from this quality check was that the high osteomyelitis rate of 5.6 per cent had been primarily attributable to shortcomings in osteosynthesis techniques but also to inadequate choice of methods. The following conclusions may be derived from the study reduction of bone infections: The osteomyelitis rate in the wake of Kuntscher's nailing was as low as 2.2 per cent. This was the best result in the context of simple fractures with closed soft-part trauma. The advantages of covered intramedullary nailing were particularly felt in cases in which optimum protection against infection was impossible for the given surrounding conditions. Plate osteosynthesis has proved to be the most effective approach to open fractures, provided careful wound dressing, non-invasive surgical techniques, and generous indication in favour of autogenic spongiosa transplantation. Interlocked nailing is considered to be the optional technique of osteosynthesis to cope with comminuted fractures. External stabilisation is urgently indicated in cases of massive traumatisation of the femoral diaphysis in conjunction with severe open lesions of soft parts. PMID- 3962523 TI - [Surgical treatment of habitual elbow joint dislocation]. PMID- 3962522 TI - [Experiences with alloplasty repair of defects of the skull calotte with modern artificial materials]. AB - There are controversial views on alloplastic repair of skull cap defects. This has prompted the authors to report their own experience from indirect cranioalloplasty, using polymethylmethacrylates (PMMA). Seventy-two implantations were performed on patients, within 13 years, most of them for traumatic defects. Immediate repair was carried out in four cases, following neurosurgical interventions. Two implants had to be removed for cosmetic reasons and four for infections. Hence, the rate of complications amounted to six per cent. The brain dura region was improved, accompanied by positive effects on seizure problems. Cosmetic results were good to very good in 54 patients. Ten patients could move from part-time to full-time employment, following plastic repair. Benefits and setbacks of the method are discussed. PMID- 3962524 TI - [Stress stability of osteosynthesis-treated femoral neck fractures. Experimental study with cadaveric bones]. PMID- 3962525 TI - [Reconstruction following extensive cervicothoracic tracheal resection for benign stenosis]. PMID- 3962526 TI - [Drugs in pregnancy and lactation]. AB - A review is given about the use of drugs during pregnancy and breast feeding. The paper include 2 tables about vaccination during pregnancy and about the known drugs causing malformations. PMID- 3962527 TI - [Pregnancy monitoring with the Westin gravidogram. II. Symphysis-fundus measurement and the cervix score]. AB - In 830 healthy pregnant women with delivery after the 37th week and parturation of a new-born normal for date (NFD) the Symphysis-Fundus-Measurement (SFM) was established and a standard curve was constructed. The curve is a nearly identic one with that given by the Swedish author Westin. There are significant deviations from the standard curve in patients with large for dates fetuses (LFD) and in those with small for dates fetuses (SFD). For LFD the difference is to make ensure statistically in the 24th and for SFD in the 31th week of pregnancy. Both parameters leave the +/- 1s--Standard-deviation in the 33th week of pregnancy. The +/- 2 s--Standard-deviation is not to be passed over. In twin pregnancies the +/- 2 s--Standard-deviation is crossed after the 18th week of pregnancy. In obese pregnant women the SFM is to be seen significantly over that of pregnancies with normal body-weight. In conclusion we believe, that by consideration of the +/- 1 s--Standard-deviation and of the values for obese women in the curve of the SFM the distinctive sensitivity for detection of SFD pregnancies is to be improved. By assessment of the registered dates of 308 Nulligravidae and 260 Multigravidae showing an undisturbed progress of pregnancy and a term--delivery the Westin--Score of the cervix uteri and its underlying single parameters have been ascertained and graphically recorded. The values concerning the Multiparae are a bit higher positioned than those of the Nulliparae. The inclination of both curves are otherwise similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962528 TI - [Outcome of pregnancy following treatment of marital sterility]. AB - Report on 37 women, who became pregnant after treatment of 100 sterile couples. 11 of all pregnancies have been terminated as abortion or tubal pregnancy. The analysis of psychological factors ascertained during treatment showed important disturbances of couple's relationship in 10 of these women. On the other hand, such factors have not been observed in women with successful pregnancies. The possible correlations, the psychosomatic mechanisms of abortion and therapeutical problems are discussed. PMID- 3962529 TI - [Malate dehydrogenase and lactate dehydrogenase in trematodes and turbellarians]. AB - Studies have been made on the activity and properties of malate and lactate dehydrogenases from the cattle rumen trematodes Eurytrema pancreaticum, Calicophoron ijimai and the turbellarian Phagocata sibirica which has a common free-living ancestor with the trematodes. All the species studied have a highly active malate dehydrogenase, its activity in the reaction of reducing oxaloacetate being 6-14 times higher than in the reaction of malate oxidation. The affinity of malate dehydrogenase to oxaloacetate was found to be higher than that to malate. The activity of lactate dehydrogenase (reducing the pyruvate) was lower than the activity of malate dehydrogenase, the difference being 50 times for C. ijimai, 4 times for E. pancreaticum and 10 times for P. sibirica. PMID- 3962530 TI - [Electron microscopic study of the tegmentum vasculosum of the cochlear canal in chick embryos]. AB - Ultrastructural studies have been made on the three types of cells composing the tegmentum vasculosum in the cochlea of chick embryos as well as on the growth of capillaries within the tegmentum. Inside the tegmentum, specific intercellular cavities were found filled with a fibrillar network. Temporal correlation is discussed between the development of the auditory function of the cochlea and differentiation of the tegmentum. Possible functional role of different cell types and of the described cavities is also discussed. PMID- 3962531 TI - [Connections of the representational area of the distal section of the forelimb in the rat sensorimotor cortex]. AB - Using horseradish peroxidase, studies have been made on the distribution of retrogradely labeled nervous cells in the sensorimotor cortex of rats. The enzyme was injected into electrophysiologically identified zone of representation of the distal part of the forelimb in areas S2 and S1. It was found that this zone in S2 contains afferent connections mainly from representation of the same extremity in S1 and only a few afferents from other areas of S1, S2 and M1 of the same hemisphere. Single labeled neurones were found in areas S2, S1 and M1 of the contralateral hemisphere. Representation of the forelimb in S1 receives mainly cortical afferents from the same region of S1 and from single cells of homologous zones S2 of the same and S1 of the contralateral hemisphere. Connections from S1 to S2 are more numerous than the opposite ones. In contrast to cats and monkeys, in rats afferent cortical fibers to zone S2 pass not only from the third layer, but also from the fifth and sixth layers of the cortex. It is suggested that during progressive development of the neocortex in mammals, the increase in the degree of separation of neurones (which give origin to corticofugal and cortical connections) among different layers of the cortex takes place. PMID- 3962532 TI - [Creatine kinase of the human placenta]. AB - Studies have been made of the activity and isoenzymic spectrum of creatine kinase from human placenta at various stages of its development. Pure preparation of the enzyme was obtained which exhibited low specific activity and intermediate (between MB and BB isoenzymes of creatine kinase) electrophoretic mobility. Some of the properties of this enzyme are described and compared to those of creatine kinase from the brain of rabbits. PMID- 3962533 TI - [Isolation and properties of Citrobacter bacteriophages]. AB - Four phages differing in their antigenic properties, thermosensitivity and spectrum of action have been obtained from Citrobacter lysogenic cultures. To prepare the suspension of Citrobacter phages, phagolysates may be treated with chloroform 1:10 for 30 minutes. The isolated phages have proved to be highly specific. The possibility of distinguishing Citrobacter cultures by means of the phages under study has been shown. PMID- 3962535 TI - [Biological properties of opportunistic enterobacteria isolated from healthy persons and from patients with intestinal dysbacteriosis]. AB - The comparative study of the signs of pathogenicity in 724 enterobacterial strains and in some species of nonfermenting microorganisms isolated from the feces of 115 somatic patients with intestinal dysbacteriosis and 80 healthy persons (565 strains) has revealed that microorganisms belonging to the same species may essentially differ in their occurrence, in the activity of the enzymes (DNAase, RNAase, phosphatase) which they release into the culture medium, as well as in their capacity to give the positive reaction with Congo red. At the same time, the cultures isolated in cases of intestinal dysbacteriosis have been found to be biologically more active. PMID- 3962534 TI - [Kinetics of the processes of Streptococcus pneumoniae batch cultivation in relation to the physiological state of the inoculum]. AB - The present investigation, carried out with the use of S. pneumoniae as a model, has shown that the kinetics of cultivation processes depend on the preparation of the seed culture. The use of the seed culture, taken at the end of the exponential phase of growth, leads to high initial and maximum specific growth rates and a shorter lag phase, high productivity of the process and the economic coefficient of the yield of the biomass. If pH and pO2 are maintained at a set level, the most operative parameter of the process is the redox potential. A new informative characteristic of the cultivation process (T) is proposed. This characteristic permits the comparison of growth processes and indicates the time in which the fluctuations of Gibbs's free energy per 1000 million cells decrease to a definite level. PMID- 3962536 TI - [Interrelation of the enterotoxigenic properties and the antigenic structure of Escherichia]. AB - The enzymatic signs and serological characteristics of Escherichia enterotoxigenic strains isolated from patients with acute intestinal diseases and from healthy persons were studied. The cultures were subdivided into 24 enzymatic variants and classified with 48 serogroups and 61 serovars. The enterotoxigenic properties of the strains were compared with their serological characteristics and enzymatic signs. The strains, isolated from different persons and classified with the same serovar, belonged to the same variant with respect to the type of enterotoxin they produced (only thermostable enterotoxin, only thermolabile enterotoxin, or both), were similar in the degree of their toxigenicity and belonged, as a rule, to the same enzymatic variant. The data on the presence of manifest interrelation between the enteropathogenicity of Escherichia and their structure, as well as on the stability of the enterotoxigenic properties of these organisms, indicate that in acute intestinal diseases the determination of Escherichia enterotoxigenic strains can be carried out by common bacteriological techniques with the use of specific agglutinating sera. PMID- 3962537 TI - [Interrelation of morbidity with acute intestinal infections and the biological pollution of water reservoirs]. AB - The simultaneous study of fecal samples from persons bathing and not bathing in the sea, as well as samples of sea water, was carried out in recreational zones. The presence of enterobacterial contamination was more frequently detected in persons who bathed in the sea than in those who did not bath (13.5% and 0.9% respectively). PMID- 3962538 TI - [Epidemiological characteristics of new methods of preventing omphalitis]. AB - The prophylaxis of purulent omphalitis is an urgent problem of epidemiology and obstetrics. A high morbidity rate in omphalitis and umbilical sepsis has been noted after the treatment of the umbilical bed by commonly used methods. As revealed in our investigations, two new treatment methods have proved to be highly effective for this purpose: treatment with the preparation Narine-phi containing the metabolic products of lactobacterial strain 317/402 Narine and treatment with the film-forming preparation Lifuzol. Both methods have made it possible to achieve a significant decrease in the contamination of the umbilical bed of newborns by hospital microorganisms and in morbidity rate in purulent omphalitis as compared with those in the control group. PMID- 3962539 TI - [Structural characteristics of staphylococcal populations with various immunobiological exposures in an experiment]. AB - Staphylococcal populations isolated from patients have been found to be heterogeneous with respect to their medicinal resistance and biological properties. Due to the action of the protective factors of the body, a decrease in the number of clones resistant to tetracycline and erythromycin and, after immunobiological procedures (specific immunization, levamisole), also in the number of clones having hemolytic and DNAase activity occurs among staphylococcal populations isolated from the kidneys of infected animals. PMID- 3962540 TI - [Stimulation of the immune response to immobilized antigen in an in vitro system with B-activin]. AB - The influence of B-activin, the preparation of immunomodulating myelopeptides, on the level of antibody formation after the primary immunization of mouse splenocyte cultures with immobilized antigens has been studied. The treatment of the cells with B-activin on the third day of their cultivation in the presence of peroxidase immobilized on polystyrene or protein M1 of influenza virus has been found to increase antigen-specific antibody formation by several times, while having practically no effect on the total level of IgG secretion. The stable level of the stimulation of antibody formation and the possibility of its quantitative evaluation in the enzyme-linked immunosorbent assay makes this immune response inducing system a convenient model for testing the biological activity of myelopeptides and other immunostimulators. PMID- 3962541 TI - [Development of an immunoenzyme method for detecting Francisella tularensis]. AB - The conditions permitting the determination of F. tularesis cells by means of the enzyme immunoassay (EIA) in 3-5 hours have been established. Ways for enhancing the reliability of results obtained in the assay of the least possible amount of the test material have been proposed. The sensitivity and specificity of the rapid EIA technique permitting the determination of F. tularensis cells at a concentration of 20 000 cells/ml in the presence of other bacterial cells in 100 fold excess have been shown. PMID- 3962543 TI - [Effect of hyperbaric oxygenation on total water content of brain tissue in experimental traumatic edema of the brain]. AB - Experiments were conducted on 30 rabbits with dosed injury inflicted on the brain; 15 animals were treated by means of hyperbaric oxygenation (HBO), the other 15 animals were not given treatment. The amount of total water in the brain tissue (separately in the grey and white matter) in various areas was determined by dessicating samples to constant weight. A significant reduction in the amount of tissue water in the brain in its traumatic edema occurred under the effect of HBO; a course of 10 sessions proved to be more effective than a course of 6 sessions. PMID- 3962542 TI - [Correction of intracranial pressure in patients with traumatic intracranial hemorrhages]. AB - Therapeutical correction of intracranial pressure changes were conducted in 14 patients suffering from traumatic intracranial hematomas by endolumbar administration of physiological solution. The distinguishing feature of this method is the possibility of continuous control of the intracranial pressure level by means of long-term graphic recording of epidural pressure. This makes it possible to perform endolumbar administration of physiological solution in a dose which is determined by the initial level of epidural intracranial pressure. Therapeutic correction of intracranial pressure by endolumbar injection of physiological solution proved successful in the initial stages of dislocation of the brain and in stable intracranial hypotension. PMID- 3962544 TI - [Clinical picture and microsurgical treatment of meningiomas of the clivus blumenbachii]. AB - The clinical signs, modern methods of diagnosis, and microsurgical management of meningiomas of Blumenbach's clivus are discussed in detail. Three variants of predominant direction of meningioma growth are distinguished. Adequate approaches were used according to the direction of the growth: subtemporal transtentorial in oral growth, paramedian in growth into the cerebellopontine angle, and a combined approach in total growth. PMID- 3962545 TI - [Role of computer tomography in the surgical treatment of metastatic brain tumors]. AB - The authors analyse the results of computed tomography (CT) and the operative findings in 107 patients with metastatic tumors of the brain. The computer tomographic image was studied in comparison with the size, macro- and microscopic structure of the removed metastases and in 15 cases of metastases discovered on autopsy. The results showed that CT makes it possible to determine the number, size, and location of the metastases, the attendant edema of the cerebral tissue, and the developmental stage of the tumorous node. With consideration for the duration of metastasis growth, these data, in a relatively favourable somatic condition of the patient, enable one to determine the indications for removing a solitary as well as one or two neurologically "resounding" tumorous nodes in multiple metastases if the others are in the subclinical stage of development. PMID- 3962546 TI - [Results of surgical treatment of intracranial arterial aneurysms]. AB - The results of surgery for arterial aneurysms of the brain are analysed. It was found that the severity of the patient's condition rather than the time of the operation had an effect on the outcome of surgery. The severity of the patient's condition and the outcome of the operation were determined first of all by the presence of the intracranial hematoma, cerebrovascular spasm, escape of blood into the ventricles of the brain, and the degree of manifestation of subarachnoid hemorrhage. The advantage of early operations for the prevention of repeated ruptures of the aneurysm is pointed out. PMID- 3962547 TI - [Clinico-roentgenologic evaluation of the efficacy of extra-intracranial microvascular anastomoses in patients with stenoses in the internal carotid artery system]. AB - The authors analyse the results of clinical and X-ray examination of 20 patients with stenosing lesions in the system of the internal carotid artery after operations for establishing extra-intracranial microvascular anastomoses (EICMA). Marked stable neurological symptomatology was encountered before the operation in arterial stenosis of a high degree (more than 50%) and the presence of brain infarctions. In functioning EICMA, evolution of stenoses in the system of the internal carotid arteries was found, which was characterized both by their increase (even to the development of thrombosis) and by their involution. Evolution of the stenoses did not occur if the EICMA failed to function. The operation leads to a less marked character of the neurological symptoms or has no particular effect on their dynamics. Changed amplitude and volume of active movements, muscular tone and strength, as well as of speech function, were found to be the most sensitive indicators of the operation efficacy. Regression of the neurologic symptoms after the operation was observed even in extensive brain infarctions and long standing of the disease. PMID- 3962548 TI - [Possibilities for preventing complications of epidurography]. AB - The spinal epilepsy syndrome developed in 17 of 494 patients who were subjected to epidurography. Its cause was analysed in all cases. This syndrome develops evidently when a water-soluble iodine-containing contrast medium gains entry into the subarachnoid space or due to chance puncture of the dura mater during the manipulation or when the contrast medium flows through an opening in it which failed to close after a previous lumbar puncture. To prevent convulsions, epidurography should be conducted under careful control of the position of the needle in the epidural space and no earlier than 10 days after lumbar puncture. Because these rules were observed, none of the 216 epidurography procedures conducted since 1981 were complicated by spinal epilepsy. PMID- 3962549 TI - [Various problems in autotransplantation after injuries to peripheral nerves of the extremities]. AB - From clinical experience and the results of anatomical study, the authors suggest repairing defects in the large nerve trunks with segments of cutaneous nerves found within the boundaries of the main operative wound. As a result the commonly performed additional intervention on the healthy extremity for obtaining the graft is avoided. After the ends of the injured nerve are separated into bundles, the donor nerves are sutured to the groups of bundles so that the defect is repaired along the perimeter. Knowledge of the specific features of the fascicular structure of nerves allows the possibilities of microsurgery to be used more rationally neuroplasty. PMID- 3962550 TI - Synthesis of three 3-C-hydroxymethylpentoses with the D-ribo-, D-xylo- and L-lyxo configurations. Identification of the latter with a monosaccharide isolated from phase I Coxiella burnetii lipopolysaccharide. AB - Three 3-C-hydroxymethylpentoses with the D-ribo-, D-xylo and L-lyxo configurations, were synthesised via nitromethane addition for the first two and 1,3-dithiane addition for the last one, to appropriate 3-ulose derivatives. 3-C Hydroxy-methyl-L-lyxose is identical with a monosaccharide component previously isolated from hydrolysates of the phase I Coxiella burnetii lipopolysaccharide. PMID- 3962551 TI - Bilirubin/rat serum albumin interaction. AB - Essential differences are demonstrated between bilirubin binding to rat serum proteins and to albumin in human serum. Acidimetric titration of rat serum with and without added bilirubin shows that binding of bilirubin acid in the range of pH from 6.8 to 8.8 takes place with release of less than one hydrogen ion per molecule of bound bilirubin. With human serum, two hydrogen ions are released, indicating binding of bilirubin dianion. The binding equilibrium of N-[4-[(4 aminophenyl)-sulfonyl]phenyl]-acetamide (MADDS) to rat serum albumin is influenced slightly by cobinding of bilirubin whereas MADDS and bilirubin bind competitively to human serum albumin. Finally, the rate of oxidation of bilirubin with hydrogen peroxide and peroxidase is decreased moderately by addition of rat serum albumin and strongly by the human protein, indicating that biliribin in its complex with rat serum albumin is subject to oxidation while the complex with human serum albumin is protected. These differences should be considered when rats are used as a model in experimental studies aiming at prevention of bilirubin encephalopathy in human neonates. PMID- 3962552 TI - Metal ion binding to parvalbumin. A proton NMR study. AB - The 1H NMR spectra of carp parvalbumin saturated with Ca2+, Cd2+, La3+ and Lu3+ were compared, using 2D 1H NMR techniques as well as conventional 1H NMR spectra. The Ca2+ and Cd2+ saturated parvalbumin (with both high affinity Ca2+-binding sites occupied) gave rise to very similar spectra. This shows that these two species have almost identical protein conformations. The 1H NMR spectrum from the Ln3+ saturated parvalbumins deviated from the other two and it was therefore concluded that Cd2+ is a better probe for Ca2+ than Ln3+ in parvalbumin and probably also for related calcium binding proteins. The addition of excess of divalent metal ions, such as Mg2+ or Ca2+, causes small changes in the chemical shift of some methyl resonances. This is presumably caused by binding of these metal ions to a third site close to the CD site which is made up of the carboxylic groups from Glu 60 and Asp 61. PMID- 3962553 TI - [Inguinal hernia]. PMID- 3962554 TI - [Results of conservative surgery of the bulging dome in hydatid cyst of the liver (apropos of 183 cases)]. AB - The authors report the short interval results of a series of 183 patients operated on for hydatic cyst of the liver; all had undergone "the conservative operation" of resection of the bulging dome. Mortality and morbidity rates are similar to those of recently published studies on radical treatment. The benignity and the results explain the value of this routine method of treatment of hydatic cyst of the liver. PMID- 3962555 TI - [Isolated rupture of the small intestine in abdominal contusions]. AB - Four patients with isolated perforation of the jejunum following blunt abdominal trauma are presented. The discussion gives attention very briefly to some specific problems of that condition. PMID- 3962556 TI - [Infrarenal abdominal aneurysms. Course and their effect on perioperative mortality. A 23-year study]. AB - The perioperative mortality rate in elective aneurysmectomy progressively declined to 2%; despite the fact that the percentage of patients with risk factors has increased. Important is that this perioperative mortality is not related to the age of the patients. In acute situations the perioperative mortality has increased to 30 a 50%. This can be explained by the increasing number of ruptured aneurysms and the influence of increasing age at the time of surgery. These results support the concept of elective resection of abdominal aortic aneurysms. PMID- 3962557 TI - Composite graft replacement of the aortic root and ascending aorta for annuloaortic ectasia. AB - Eighteen patients with annuloaortic ectasia were surgically treated during a six year period. Cystic media-necrosis was present in 17 patients, five of them presented with Marfan syndrome. All patients received a composite graft with reversed mitral Bjork-Shiley or St-Jude prosthesis and reimplantation of the coronary ostia or venous bypass grafts. Combined profound selective hypothermia and hyperkalemic cardioplegia was the preferred myocardial protection technique. There was one early postoperative and two late deaths. The fifteen survivors, with a follow-up between 6 and 72 months did not present conduit related complications and clinical results are excellent; all patients are NYHA class I (11) or II (4). PMID- 3962558 TI - [Aneurysm of the popliteal vein]. AB - The authors present a saccular aneurysm of the popliteal vein. The clinical findings, the diagnosis and the operative treatment are described. The authors suggest a possible etiology for the genesis of the aneurysm. Literature is reviewed. PMID- 3962559 TI - [The treatment of chronic osteitis using genta-PMMA chains]. AB - Disulphine blue vital staining, cancellous bone grafts to Papineau and local implantation of genta-PMMA-chains are new procedures in treatment of chronic osteitis. Between May 1978 and December 1984 a total of 24 patients underwent surgery for osteitis. The mean follow up was 25 months (range 17 m. and 35 m.). Good results were obtained in 70.8% (17/24). PMID- 3962560 TI - [Contribution of epidural anesthesia and general anesthesia to colon surgery]. AB - The authors, having clinically observed favourable post operative effects on patients operated under combined general and epidural anaesthesia in digestive surgery, have proceeded to a retrospective and comparative study of the last 50 colic resections. They have observed: a +/- 50% reduction of the quantity of morphine used; a +/- 50% reduction of the time required for peristaltic resumption; a +/- 50% reduction of the time required for gastric intubation thereby contributing to carefree post-operation effects in colic surgery where a series of known complications are usually to be expected. They are of opinion that the benefit of epidural anaesthesia is due essentially to the preponderance of the para sympathetic nervous system allowing the release of some hormones with intestinal tropism as well as the disappearance of the negative action of the splanchnic vaso-constriction. PMID- 3962561 TI - [Recurrent retroperitoneal liposarcoma, diagnostic and therapeutic problems]. AB - Retroperitoneal liposarcomes are characterised by their tendency to recurrence, Eight cases are related, from which no one get out of this rule. Late diagnosis is due to their silent growth and poor symptomatology. Ancillary procedures, particularly computerised tomography, and histological examination, allow to confirm diagnosis. The main treatment is surgery, it must be as aggressive as possible, it allows to confirm histologically the nature of the tumor. Postoperative radiotherapy is helpful and chemotherapy can be associated, if it seems that complete excision has not been possible or if metastasis are detected. Histologically, these sarcomes seem to derive from a pluripotential mesenchymatous cell, it explains their polymorphic differentiation. A clinical prognosis, based on histology, seems to be illusive. PMID- 3962562 TI - Fasciitis necroticans. AB - Fasciitis necroticans (F.N.) is a rapidly progressing necrotizing process of subcutaneous tissue and fascia which results in large soft tissue defects and severe systemic toxicity. During the last five years nine patients with F.N. were admitted at our department of surgery. Antibiotic prophylaxis immediately after the eliciting trauma was associated with a significant delay in treatment. Early recognition and surgical treatment are the most important factors influencing survival. PMID- 3962563 TI - The use of muscle flaps in leg soft tissue defects. AB - The use of muscle transpositions following the technique of Ger is discussed in fifteen cases where important soft tissue defects in the leg, some of them combined with complicated fractures, made spontaneous healing or coverage with split skin grafts impossible. PMID- 3962564 TI - Conversion of CSF monomeric growth hormone to large growth hormone with exposure to serum. AB - We have found a dissociation between CSF and serum growth hormone heterogeneity in a patient with suprasellar extension of a growth hormone-secreting pituitary tumour. When CSF was studied using gel chromatography, virtually all the growth hormone eluted as monomeric growth hormone with only 2.4% eluting before albumin as large growth hormone ('big, big' growth hormone). In contrast, the large component comprised 15.4% of the total immunoreactivity in simultaneously obtained serum. When the CSF specimen was incubated with growth hormone-poor serum, the elution pattern changed remarkably with 16% of the total immunoreactivity eluting as large growth hormone causing it to resemble the serum elution pattern. We also measured growth hormone heterogeneity in the inferior petrosal vein (a site very close to pituitary venous drainage) during inferior petrosal venography in 3 patients. As the growth hormone concentration increased, the percentage eluting as monomeric growth hormone increased, whereas that eluting as large growth hormone decreased. When the growth hormone concentration fell towards baseline, the percentage of growth hormone eluting as monomeric growth hormone fell while that eluting as large growth hormone increased. Thus, our studies suggest that large growth hormone results from binding of monomeric growth hormone to serum proteins or aggregation of monomeric growth hormone in the presence of protein. Our studies also show that when blood is sampled at a site close to the pituitary, the growth hormone is released primarily as monomeric growth hormone. PMID- 3962565 TI - Serum melatonin is not affected by glucocorticoid replacement in congenital adrenal hyperplasia. AB - Recently a hypothesis has been proposed suggesting a negative feedback in the regulation of cortisol (F) and melatonin (Mel). To study a possible influence of F on Mel regulation we examined 13 children with congenital adrenal hyperplasia (CAH) on two occasions: once 3 days after cessation of F substitution (group 1; n = 13) and once during treatment with dexamethasone (1 mg/m2/day) and fludrocortisone (0.1 mg/m2/day) (group 2; n = 11) 11 children matched by sex and age served as controls (group 3). While serum 17 OH-progesterone levels, an indicator for the activation of the hypothalamo-pituitary-adrenal axis in CAH, were significantly (P less than 0.001) elevated in untreated patients (group 1), serum Mel levels were not different among the 3 groups nor was the diurnal secretion pattern of Mel affected. Nocturnal serum Mel concentrations, however, correlated with the age of the subjects (r = 0.55, P less than 0.001 at 23.00 h), displaying high values in early childhood that declined with progressing age. The presented data do not support the view of a classical feedback mechanism in the regulation of Mel and F in humans. However, it confirms the description of a tremendous fall of nocturnal Mel concentrations during childhood. PMID- 3962566 TI - Oestrogen agonistic effects of tamoxifen in the uterus of newborn guinea pigs after short and long treatment. Biological and histological studies. AB - Tamoxifen (TAM) alone or combined with oestradiol (E2) or progesterone (P) was administered to newborn guinea pigs (2 days old) for short (2 days) or a long (12 days) treatment period. TAM alone provoked a great stimulatory effect on uterine growth and DNA content and the effect was particularly intense after the long treatment. These actions were markedly enhanced when TAM was administered together with E2. Following short treatment, the values of the uterine wet weights (mg +/- SD) were as follows: control animals, 142 +/- 15; animals treated with TAM, 298 +/- 53; E2, 335 +/- 15; (TAM + E2), 362 +/- 16. The values after the long treatment were 177 +/- 30, 555 +/- 93, 709 +/- 117 and 1263 +/- 222, respectively. Histological studies showed that TAM provoked morphological changes in both the endometrium and the myometrium. The effects were particularly great on the height of the luminal epithelial cells and on the uterine glands. After 2 days of treatment with E2, TAM and P, the thickness of the luminal epithelium, which was 13.5 micron +/- 1.5 in the control animals, increased as follows: TAM, 19 microns +/- 1.7; E2, 20.3 microns +/- 3.3; (TAM + E2), 30.5 microns +/- 5; P, 12 microns +/- 0.9 and (P + TAM), 19.7 microns +/- 1.2. The values after the 12 day treatment were: controls, 20.8 microns +/- 1.8; TAM, 27.4 microns +/- 2.1; E2, 32 +/- 3; (TAM + E2), 43 microns +/- 5; P, 17.8 microns +/- 1.2 and (P + TAM), 23.6 microns +/- 1.5.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962567 TI - Long-term hormone implant therapy--effects on lipoproteins and steroid levels in post-menopausal women. AB - Lipoprotein and steroid hormone levels were measured in 61 bilaterally oophorectomised women who had been treated for 3 years with implants containing either oestradiol alone or oestradiol plus testosterone. The lipoprotein levels associated with each of the two therapy regimens were compared. In addition, lipoproteins were measured in 67 untreated bilaterally oophorectomised age matched women and compared with those of the treated women. Despite the high oestradiol levels produced by both types of implant, the only significant finding was a reduced LDL cholesterol in the oestrogen/testosterone treated group as compared with that of the untreated group. PMID- 3962568 TI - Effects of cortisol suppression by etomidate on changes in circulating metabolites associated with pelvic surgery. AB - The effects of cortisol suppression by etomidate on the changes in circulating metabolites associated with pelvic surgery were investigated in healthy female patients. The use of etomidate resulted in the inhibition of cortisol secretion for 24 h compared with a control group of patients. However, the inhibition of steroidogenesis was not associated with a significant effect on blood glucose, blood lactate and plasma nonesterified fatty acid values, although the glycaemic response to surgery was consistently less in those patients who received etomidate. Heart rate and arterial pressure were significantly decreased during surgery in the etomidate group compared with the control group, but were similar in the postoperative period when the difference in plasma cortisol between the groups was greatest. The results suggest that cortisol has only a minor role in determining changes in circulating metabolites associated with surgery. PMID- 3962569 TI - Premedication administered to anesthesiologists as patients: their evaluations of its effect and its influence on premedication prescribing habits. AB - Inquiries were sent to practising Austrian anesthesiologists to ascertain their premedication-prescribing habits and their assessment of premedicants that they received as patients. The 143 replies received showed meperidine/promethazine (M/P) as most used n = 83 and received (n = 54) drug (combination), followed by fentanyl/droperidol (F/D) n = 33 (n = 21), benzodiazepines (BZ) n = 17 (n = 10) and several other drugs (combinations) n = 10 (n = 14). There was no significant difference in the premedication habits of the 82 anesthesiologists who had received premedication and those (61) who had no personal experience with premedicants. The former judged M/P to be significantly superior to F/D and other schemes; however there was no significant difference from the judgement of the BZ. Unpleasant side effects have been described in 9% of M/P, 10% of BZ, 24% of F/D and 21% of other premedicants. On future occasions 10% of BZ-, 13% of the M/P , 24% F/D- and 21%-receivers of other combinations would reject the same drug. Seven F/D and five M/P users converted their prescription schemes after they had received the same drug for their own premedication. The prescription habits were not influenced by dependency on departmental or hospital orders. Of those who had received it 75% desired premedication and 25% accepted premedication, suggesting that anesthesiologists believe in the positive effects of premedication. However, the overall incidence of 10% unpleasant side effects, even in the better ranked drugs, shows that the available premedicants do not yet seem to be satisfactory. PMID- 3962570 TI - Perivascular axillary block VI: the distribution of gelatine solution injected into the axillary neurovascular sheath of cadavers. AB - Axillary perivascular injection of 50 ml blue-stained gelatine was made in 20 cadavers, and a total dissection of the axilla was performed. The distribution of injected gelatine and the contact between nerves and gelatine were examined on cross-sections of the neurovascular bundle. The spread of gelatine was characterized by: restriction of gelatine to the neurovascular bundle, an upper border of the gelatine which was constantly found to be proximal to the coracoid process, and bulging of the gelatine towards the medial part of the axillary space. Cross-sections of the neurovascular bundle showed the nerves and vessels to be located in the periphery of the gelatine and in close contact with the lateral wall of the axillary space. The median and the ulnar nerves were in all dissections found to be in direct contact with the gelatine, whereas the radial, the musculocutaneous, and the axillary nerves did not always have direct contact with the gelatine. Abduction of the arm to 90 degrees brings the stretched neurovascular bundle close to the lateral wall of the axilla and this compromises perivascular circumferential spread of the injected gelatine. On the basis of the present investigation, it is hypothesized that insufficient circumferential spread is the cause of incomplete axillary blockades, and the perivascular injection of local anaesthetic should consequently be made with the arm along the side of the body. PMID- 3962571 TI - Inaccuracy of peranesthetic gastric intubation for emptying liquid stomach contents. AB - To assess the accuracy of the method of peranesthetic gastric intubation for emptying the liquid stomach contents, this procedure was tried on 80 patients undergoing general anesthesia. Half of the patients had a double-barrelled 16F Argyle Salem sump tube, length 120 cm, size 16 CH, and the other half had a single-barrelled stomach tube, length 80 cm, size 25 CH. After emptying the stomach with the tubes 25 ml of glucose was given through the gastric tube to half of the Salem tube group and half of the stomach tube group. Similarly 100 ml of glucose was given to half of the Salem tube group and half of the stomach tube group. After instillation of glucose 25 ml or 100 ml, the Salem tube recovered 21.0 +/- 9.1 ml (mean +/- s.d.), median 24 ml, range 6-36 ml or 86.8 +/- 26.9 ml, median 92 ml, range 18-136 ml, respectively, and the stomach tube 17.1 +/- 10.8 ml, median 18 ml, range 2-34 ml or 54.0 +/- 28.5 ml, median 50 ml, range 14-104 ml, respectively. This indicates that the method of gastric intubation for emptying the liquid stomach contents is inaccurate. PMID- 3962572 TI - Prophylactic and delayed treatment with indomethacin in a porcine model of early adult respiratory distress syndrome induced by endotoxaemia. AB - The effects of prophylactic and delayed treatment with indomethacin were evaluated in a porcine model of early adult respiratory distress syndrome (ARDS) induced by endotoxaemia. Spontaneously breathing pigs under ketamine anaesthesia were infused i.v. with E. coli endotoxin (10 micrograms . h-1 . kg-1) over 6 h. Twenty animals received endotoxin without treatment. Eight animals were pretreated with indomethacin i.v., 5 mg . kg-1 in 30 min, followed by further infusion at a rate of 2 mg . h-1 . kg-1. Ten animals received the same dosage of indomethacin beginning 2 h after the start of endotoxin infusion. Pretreatment with indomethacin inhibited the endotoxin-induced impairment in pulmonary gas exchange, but did not prevent pulmonary oedema. The pulmonary hypertension was counteracted. Oxygen delivery did not improve, because of a marked reduction in cardiac output (Qt). Systemic vascular resistance (SVR) increased markedly, and mean arterial pressure (MAP) was higher. Survival was improved. Delayed indomethacin treatment prevented a further deterioration in pulmonary gas exchange and restored it towards the baseline level. The pulmonary oedema was not counteracted, while the pulmonary hypertension was reduced. O2 delivery was not restored, owing to the greater decrease in Qt compared with the untreated endotoxin group. SVR increased considerably, and MAP was better maintained. Survival was not improved. These results indicate that cyclo-oxygenase inhibitors might benefit pulmonary gas exchange in human ARDS. Drugs which interfere with arachidonate metabolism will probably be of great importance in the prophylaxis, in particular, and also in the treatment of ARDS. PMID- 3962573 TI - Anaesthesia for colonoscopy. An examination of the anaesthesia as an element of risk at colonoscopy. AB - The importance of anaesthesia as an element of risk at colonoscopy has been examined retrospectively over a 10-year period from 1975 to 1984. The colonoscopic examinations were made by surgical gastroenterologists and anaesthesiologists working in cooperation. In 1242 cases the patients received diazepam/fentanyl anaesthesia during the colonoscopy (Group I) and in 126 cases they received general anaesthesia (Group II). The incidence of perforations of the large bowel in Group I was 0.8% (95% confidence limits: 0.4-1.5%) and in Group II 0.0% (95% confidence limits: 0.0-2.9%). Statistically the difference is not significant (P = 0.38). The groups were comparable with a view to the patients' age, weight, the duration of the colonoscopy and the number of times that polypectomy had been performed. All anaesthesia was administered by staff qualified by training and experience to administer anaesthesia, and did not cause any complications. However, four patients had vasovagal reflexes due to manipulation of the colonoscope. The dosing in the patients in Group I averaged: diazepam as premedication 9.2 mg, intravenous diazepam 12.4 mg, intravenous fentanyl 0.14 mg, and the duration of the colonoscopy was 36.5 min. The medication and the duration of the colonoscopy did not vary significantly in the patients with perforation of the large bowel. Our conclusion is that diazepam/fentanyl anaesthesia, administered by experienced staff, is harmless, and that general anaesthesia for colonoscopy did not involve an increased risk of perforation of the large bowel. PMID- 3962574 TI - Effect of induced hypotension on serum concentrations of atropine after intramuscular administration. AB - The serum concentrations of atropine after a single intramuscular injection of 0.01 mg/kg were determined by radioimmunoassay in nine general surgical patients during and after a combination anaesthesia and compared with those of 13 neurosurgical patients operated on during induced hypotensive anaesthesia (sodium nitroprusside plus trimetaphan). Surprisingly, comparable serum levels were found in both patient groups. We conclude that this kind of induced hypotension cannot be used as a model of drug absorption in such clinical situations as cardiac failure, haemorrhage or anaphylactic drug reactions. PMID- 3962575 TI - Cardiac effects of thoracic epidural morphine caused by increased vagal activity in the dog. AB - This study was carried out in order to investigate possible side-effects of thoracic epidural morphine on cardiac electrophysiology, haemodynamics and metabolism. In pentobarbital-anaesthetized dogs, intracardiac conduction times were determined by His bundle electrography, and refractoriness by programmed electrical stimulation; monophasic action potential recordings were obtained from the right ventricle by the suction electrode technique. Cardiac output, left ventricular and aortic blood pressures were measured, as well as plasma concentrations of morphine, free fatty acids, glycerol, glucose and lactate. Thoracic epidural morphine (0.12 mg X kg-1) reduced spontaneous heart rate, prolonged atrioventricular nodal conduction time and refractoriness, and reduced left ventricular dP/dt max. Bilateral vagotomy reversed these effects. Intra atrial, His Purkinje and intraventricular conduction times, atrial and ventricular refractoriness and action potential duration, stroke volume and mean aortic blood pressure, as well as the metabolic variables, were not significantly influenced by thoracic epidural morphine with or without vagotomy. Peak plasma morphine levels of 12-25 ng X ml-1 were measured 10 min after morphine injection. In conclusion, this study demonstrates depressive side-effects of epidural morphine on cardiac function, mediated by an increased vagal activity. PMID- 3962576 TI - Response of the mandibular joint to loss of incisal function in the rat. AB - In a study of the rat mandibular joint (MJ), Simon [Acta anat. 97: 351-360 (1977)] suggested that reduction in condylar cartilage thickness noted in animals subjected to removal or trimming of incisors resulted from the lessening of joint reaction forces produced during incision. In order to explore this question further, the microanatomy of the MJ in 47-day-old rats whose incisors had been trimmed every other day was compared to that in control animals and in a third group fed a soft diet as a control for reduced joint reaction forces. Both the incisor-clipped and soft-diet groups exhibited reduced size and density of bony trabeculae underlying the condylar cartilage and diminished staining for alcian blue. The thickness of the prechondroblastic layer of the condylar cartilage was significantly (p less than or equal to 0.01) reduced relative to controls in both experimental groups on the superior aspect of the cartilage, but was reduced in the more posterior parts of the cartilage only in the incisor-clipped group. While not denying that joint reaction forces may affect MJ response, the reduced proliferative response noted in the posterior region of the condylar cartilage in incisor-clipped animals is perhaps best explained by a decrease in the frequency and extent of protrusion of the lower jaw due to a lack of incisal preparation of food items. PMID- 3962577 TI - Secretory cells in the nucleus pulposus of the adult human intervertebral disc. A preliminary report. AB - A light microscopical study was conducted to ascertain the type of cells in the nucleus pulposus of the adult human intervertrebral disc. Three lumbar intervertebral discs were removed from each of 15 male and female adults at autopsy (ages ranged from 19 to 62 years). The tissue was fixed in formalin, decalcified in formic acid, dehydrated in a graded series of ethanol, embedded in paraffin, and serially sectioned at 7-10 micron. Tissue sections were affixed to albuminized glass slides and stained either by hematoxylin and eosin or hematoxylin and Van Gieson's stain. The cells of the bulk of the nucleus pulposus consisted of chondrocytes and a few fibroblasts; however, the subchondral matrix of the nucleus pulposos contained numerous stellate cells with (from 1 to 8) unusually long (up to 80 micron) primary cytoplasmic processes that often branch into secondary processes. The cell processes contained cytoplasmic varicosities at various intervals along their lengths; and their endings often expanded into bulbous, vesicle-filled process terminals. The surrounding extracellular matrix usually contained numerous, vesicle-filled, eosinophil matrix bodies. Morphological similarities of cytoplasmic varicosities, process terminals, and matrix bodies, as well as the apparent budding of process terminals, suggest that these previously unidentified cells are secreting an unknown matrix component into the subchondral matrix of the nucleus pulposus of the adult human. PMID- 3962578 TI - Light and electron microscopic studies of diet-induced hepatic changes in mice. AB - Adult mice were fed a choline-deficient ethionine enriched (CDE) diet for 24, 48 or 72 h. They were then fasted for 24 or 48 h prior to sacrifice. All tissues were studied by light and electron microscopy. Animals fed the CDE diet for 24 h exhibited cells with vacuolated cytoplasm, and the accumulation of lipid in these cells was clearly abnormal. Animals fed the CDE diet for 24 h and subsequently a regular diet for 48 h displayed normal hepatocytes, suggesting that the alterations at 24 h were reversible. Following 48 or 72 h of feeding the CDE diet, abundant lipid-laden cells were observed in the hepatic lobules, and at the electron microscope level these cells were undergoing frank degeneration. Evidence indicated that changes after 48 or 72 h were irreversible. PMID- 3962579 TI - Scanning electron microscopical observations on the differentiating mesonephros of the chick embryo. AB - Chick embryos were staged according to the method of Hamburger and Hamilton [1951] and fixed. Cross sections through the cephalic fourth of the mesonephric ridges were examined by scanning electron microscopy. The steps in glomerular differentiation could be observed with ease. The first foot processes to appear in podocytes arose directly from the basal surface of the cell body. In a second step, lateral branches appeared and gave off secondary or even tertiary branches that interdigitated with those from neighbouring podocytes, following a pattern that was very similar to the one previously described by other authors in metanephric nephrons. Endothelial pores appeared in the glomerular capillaries at very early stages of the glomerular differentiation. The differentiation of the epithelium of proximal tubules was characterized by the growth of apical microvilli and of finger-like evaginations from the lateral membranes. At stages 20 and 21, the most differentiated glomeruli had only basal foot processes; only after stage 25 did the first generation nephrons reach full maturity. Because during this period the mesonephros is known to produce urine, our results indicate that nephrons start to function before they have completed their differentiation. PMID- 3962580 TI - Relative growth of the anulus fibrosus and nucleus pulposus in human and kitten fetuses. AB - Growth in volume of the anulus fibrosus (AF) and nucleus pulposus (NP) was quantified using serial histological sections of human and kitten fetuses. Fetal intervertebral discs were studied that had clearly outlined AF and NP. Regression equations were calculated and graphs plotted by microcomputer. An increase in surface areas of these intervertebral structures was also recorded; however, volume was a better indicator of relative growth than was surface area. The AF volume of the fetal human increased more in proportion to the intervertebral disc than it did for the fetal kittens. There was significantly slower growth of the human NP compared to the kitten NP when related to the total intervertebral disc. The analysis for each species was done separately. Comparisons of the growth relationships of humans and kittens for the AF and NP were related to crown-rump length as the independent variable, and were different at the p less than or equal to 0.01 level of significance. The thoracic intervertebral discs were emphasized due to species-specific differential growth of the AF. The intercapital ligament (IC) was separated from mesenchyme over the dorsal surface of the kitten AF, and this affected the relationships of AF and NP volumes when compared to humans. Use of human histological sections is essential in the study of differential growth of the human vertebral column because fetal kittens have an IC that affects relative growth of both AF and NP. PMID- 3962581 TI - Myocardial ultrastructural changes in alloxan-induced diabetes in rabbits. AB - The ultrastructural changes in the left ventricles of rabbits with alloxan (100 mg/kg i.v.)-induced diabetes were examined. Injection of alloxan resulted in a diabetic state characterized by increased hemoglobin glycosylation, blood and urine glucose and a significant depression of serum insulin levels. Electron microscopic examination of 10-week diabetic hearts revealed a spectrum of abnormalities ranging from mild to severe. Cardiac muscle cells in diabetic hearts showed some myofibrillar damage and varying degrees of contraction. The most prominent findings, however, were alterations in the mitochondria. Swollen and fragmented mitochondria containing amorphous dense bodies were evident upon electron microscopic examination. The cristae in the mitochondria appeared distorted and in some cases were completely lysed. A marked increase in lipid droplets and glycogen granules was also apparent. In addition, the sarcoplasmic reticulum was dilated and contained varying degrees of electron-dense material. These ultrastructural alterations suggest that the cardiomyopathy observed in alloxan-induced diabetic rabbits could be due to alterations in the vasculature or may be secondary to a number of metabolic alterations previously reported in this model. PMID- 3962582 TI - Os penis of the rat. V. The distal cartilage process. AB - The morphogenesis and morphology of the distally positioned cartilage of the os penis, the processus cartilagineus, are described in rats aged from 1 to 100 days. Based on observations of metachromacy of the process stained with toluidine blue it was found that a processus cartilagineus only exists in the period between 35 and 50 days of age. Before 35 days, the structure consists of connective tissue proper, and after 50 days the cartilage starts to calcify partially. The present paper also initiates studies of experimentally caused alterations of the normal development of the processus cartilagineus by subjecting 35-day-old rats to castration, with subsequent sacrifice at 100 days. Castration at that age causes a complete interruption of normal development of the processus cartilagineus as the structure in 100-day-old castrated rats has distinct morphological characteristics in common with those of 35-day-old normal rats. The present paper, thus, confirms that normal development of the processus cartilagineus seems to be male-hormone-dependent. PMID- 3962583 TI - [Late posttraumatic syringomyelic syndromes. Pathogenetic theories apropos of 3 cases]. AB - Three patients with a post-traumatic spinal cord cavity are described: clinical signs are identical to those of syringomyelia, but pain is more frequent. Diagnosis is made easier by magnetic resonance imaging (MRI) and a syringoperitoneal shunt is proposed for treatment. Nevertheless, if results are good, they seem worse than in idiopathic syringomyelia. The main pathogenic theories are discussed: the rupture and coalescence of microcysts developed at a distance of 1 or 2 mm from the transected spinal cord, subsequently leads to syrinx formation; haemorrhagic or ischemic post-traumatic areas could also lead to syrinx formation. Hydrodynamic factors could be expected and make the pathogenesis not far from syringomyelic one. PMID- 3962584 TI - Diagnosis of communicating intracranial arachnoidal cysts by 111-In-Ca-DTPA cisternography. AB - The distinction between communicating and non-communicating intracranial arachnoidal cysts is important in medical management. Mainly the latter type will benefit from surgery which aims at establishing a communication between the cyst and the subarachnoidal space or ventricular system. We report the case history of two patients in whom congenital cerebral arachnoidal cysts are diagnosed at adult age and illustrate the role of scintigraphy with 111-In-Ca-DTPA to prove the communication of the cysts with the subarachnoidal space. This technique is safe and simple and gives less irradiation and discomfort to the patient than other methods. PMID- 3962585 TI - Clinical evaluation of the first 365 patients studied with a 0.15 tesla resistive MRI system. AB - Evaluation of the first 365 neurological patients examined with a 0.15 tesla resistive nuclear magnetic resonance (MRI) installation is reported. Plus points of MRI compared with the diagnostic possibilities of computed tomography are presented. PMID- 3962586 TI - The blood-brain barrier to horseradish peroxidase at the onset of bicuculline induced seizures in hypothalamus, pallidum, hippocampus, and other selected regions of the rabbit. AB - Rabbits were subjected to bicuculline-induced generalized seizures of 15-min duration to elucidate the mechanism by which the macromolecule horseradish peroxidase (HRP) traverses the blood-brain barrier (BBB) in specific brain areas. Transendothelial pinocytosis at the level of arterioles was the main route of passage. In addition, in thalamus and hippocampus pinocytotic vesicles were observed in capillaries. In thalamus, hypothalamus and septum vesicles in the endothelium of venules were also present. Repeatedly, pinocytotic vesicles were ejecting their content into the interendothelial clefts, so that the presence of HRP reaction product between adjacent tight junctions cannot be considered a conclusive evidence for their opening. The HRP, which had reached the neuropil due to the seizure-evoked BBB opening, accumulated in the interstitial spaces and penetrated the synaptic cleft. Uptake of the tracer in vesicular form into presynaptic boutons, presumably excitatory ones as diagnosed by their ultrastructural features, was observed in all brain regions. The uptake was rare in septum, periaqueductal gray, hypothalamus, and cerebellar cortex; frequent in pallidum, hippocampus, and medulla oblongata; and very intense in thalamus. Uptake in postsynaptic dendrites was present mostly in the vicinity of boutons. Incorporation into glial processes was rare and confined to perivascular astrocytes. It is suggested, that HRP traverses the BBB by regionally selective, transmitter-controlled pinocytotic transport and that the neuronal uptake of the foreign protein is at least partially dependent on the involvement of synapses of particular brain regions in the paroxysmal activity during the generalized seizures. PMID- 3962588 TI - Pathology of skeletal muscle and intramuscular nerves in infantile neuroaxonal dystrophy. AB - Biopsies of the biceps muscle and sural nerve were taken from a girl aged 2 years with infantile neuroaxonal dystrophy (INAD). In addition to the typical axonal spheroid bodies in a number of the i.m. nerve fibers, the neuromuscular junctions (NMJs) and motor nerve endings also contained axonal swellings. The sural nerve, except for three dystrophic fibers, was almost completely normal. A teased nerve preparation showed four additional abnormal fibers with focal axonal enlargement similar to those in giant axonal neuropathy (GAN). These results suggest that a biceps muscle biopsy may be more useful than a sural nerve biopsy for the diagnosis of INAD, because the muscle contains abnormal peripheral nerves and NMJs in high frequency. PMID- 3962587 TI - Distribution of 109Cd in the nervous system of rats after intravenous injection. AB - The distribution of i.v. injected 109Cd within the nervous system was studied in rats 24 h and 1 week after the injection. Measurements by gamma scintillation showed a high uptake of cadmium in peripheral sensory and autonomic ganglia, whereas the uptake was low in the brain, cerebellum, and spinal cord. The accumulation of cadmium in the sciatic nerve was significantly higher than in the brain and spinal nerve roots, but lower than in ganglia. At autoradiography no labeling was seen in the major part of the brain parenchyma, but an accumulation of the metal was observed in structures outside of the blood-brain barrier (BBB), such as the hypophysis, meninges, choroid plexus and pineal gland. Within the peripheral nervous system (PNS), autoradiography showed accumulation of cadmium in the dorsal root ganglia. The results show that the distribution of 109Cd within the nervous system is correlated to regional variations in vascular permeability, blood vessels of different regions permitting penetration of different amounts of the protein-bound cadmium into the nervous tissues. The accumulation of cadmium in certain nervous structures may have relevance for some of the neurotoxicologic effects of this metal that have been demonstrated in animal experiments. PMID- 3962589 TI - Hypertrophy of the olivary nucleus. An ultrastructural study. AB - The fine structure of the hypertrophic olive is reported in a case of progressive supranuclear palsy, the cause of which would be attributed to extensive symmetrical lesions in the dentate nuclei of the cerebellum and central tegmental tracts of the pons. Ultrastructurally, the enlarged neurons and their processes showed massive aggregations of neurofilaments, large accumulations of concentric laminated bodies, and occasional abnormal neurofibers (paired helical filaments and straight tubules). Their implications are briefly discussed in relation to olivary hypertrophy. Eosinophilic globules were seen in a neuron. Glomeruloid bodies were not seen. PMID- 3962590 TI - Regional metabolism of experimental brain tumors. AB - Experimental brain tumors were produced in rats by stereotactical implantation of various neoplastic cell lines (RG 2, RG1 2.2, G 13/11, F 98, RN 6, B 104, and E 367). Using autoradiographic, bioluminescence, and fluoroscopic methods, the following regional hemodynamic and metabolic parameters were measured on intact brain sections: blood flow, glucose utilization, pH, and the tissue content of ATP, glucose, and lactate. Tumors exhibited a considerable diversity of regional blood flow and metabolic activity which did not correlate with the implanted cell line, location, or growth pattern. In solid regions of tumors the most consistent finding was a higher glucose utilization rate, a higher lactate, and a higher pH than in the surrounding brain tissue. Tumor ATP was slightly higher and glucose slightly lower than in the brain. In large spherical tumors a declining gradient of blood flow, glucose, and ATP from the periphery to the central parts was frequently observed, the decline being more pronounced for glucose than for ATP. In regions with high ATP tissue pH was usually higher than in the brain, but it decreased in areas in which ATP was depleted. The results obtained indicate that tumors are able to control tissue pH despite increased glycolysis and lactate production, as long as the energy state is not impaired. The mechanisms of pH regulation, therefore, have to be considered for establishing therapeutic procedures which intend to lower tumor pH for induction of tissue necrosis. PMID- 3962591 TI - Melanotic neurofibroma: a case report with ultrastructural study. AB - The authors report a case of a solitary melanotic neurofibroma involving the temporomalar area in a 17-year-old man. Light-microscopic study reveals a benign neurofibroma including melanin deposits. Electron microscopy shows typical premelanosomes and melanosomes within Schwann cell cytoplasm. The literature is reviewed, and theories of histogenesis for this unusual tumor are discussed. PMID- 3962592 TI - DNA-flow fluorescence--cytometry of ependymomas. Report on ten surgically removed tumours. AB - The distribution of DNA is estimated from flow cytometric histograms in surgical specimens of ten ependymomas of different location and varying anaplasia. In three cerebral tumours grade I--II, including one ependymoma of the 4th ventricle, only limited elevation of the 4 C maxima was a prominent feature, corresponding to the microscopical frequency of typical mitoses. Four grade-III ependymomas showed aneuploid or polyploid histograms with stem lines. One frontal tumour was classified as "transitional" because of more numerous mitoses and abnormally elevated S and G2 + M phases, which increased in tissue culture. A correlation between the degree of anaplasia with the DNA pattern was difficult to pursue in two spinal ependymomas obviously lacking microscopical mitoses: Both- one a so-called tanycytic variant of grade I--II, and the other probably a metastasis from a cerebellar tumour--had a clear polyploid DNA histogram with a strikingly increased proliferation index, similar to the more malignant tumours of grade III. Also flow DNA measurements probably allow the decoding of heterogenous mixtures of tumour cells which are not always benign in ependymomas of lower grades of anaplasia microscopically. PMID- 3962593 TI - Neuronal ceroidosis (ceroid-lipofuscinosis) in a Blue Heeler dog. AB - Neuronal ceroidosis was observed in an 18-month-old male Blue Heeler dog which was euthanized after showing a progressive gait and behavior abnormality, depression, paresthesia, and vision deterioration. The brain was slightly atrophic. Histopathology revealed autofluorescent, periodic acid-Schiff, luxol fast blue, and oil red O-positive intracytoplasmic granules in the neurons of the brain and spinal cord. There was a moderate diffuse reduction in the number of cerebellar and cerebrocortical neurons. Ultrastructurally, these neuronal cytosomes were diverse with preponderance of membranous profiles and granular matrix. PMID- 3962594 TI - The role of Schmidt-Lanterman incisures in Wallerian degeneration. AB - The number of the Schmidt-Lanterman incisures and their intrasegmental distribution were studied at 36 h after transection of the rat sciatic nerve. Examination of teased, proximo-distally oriented, myelinated nerve fibers revealed no difference between the distal and the proximal stump. The results indicate that no proliferation of the incisures is required for the fiber fragmentation: numerous incisures are normally available in the midinternodal area where the degeneration begins. PMID- 3962595 TI - Regional morphology and biochemistry in experimental brain abscesses. AB - Brain abscesses were induced experimentally in six cats by stereotactic inoculation of Staphylococcus aureus A8 into the white matter of the left cerebral hemisphere. Seven days later, the brains were frozen in situ with liquid nitrogen and subsequently sawn into coronal sections of 5 mm thickness, while being cooled with liquid nitrogen. Thin slices were taken from those sections containing the largest expanse of abscess: slices of 5 micron thickness were stained histologically, and in adjacent 20 micron slices the regional distribution of ATP and glucose was mapped using substrate-specific bioluminescence methods. Furthermore, the NADH fluorescence from the surface of the tissue section was recorded. Six layers could be distinguished histologically in the abscess capsule, five of which showed different substrate patterns. Only in two layers a low metabolic activity could be observed, as shown by slight ATP bioluminescence. The pattern of the biochemical substrates in the white matter surrounding the abscess indicated a reduction in the cellular oxygen availability. PMID- 3962596 TI - Gliomyosarcoma. Report of a case of rhabdomyosarcoma arising in a malignant glioma. AB - The development of sarcoma within a glioblastoma is a well recognised complication: in the majority of cases it is a fibro-sarcoma originating in the tissues of the proliferating hyperplastic blood vessels. In the case described here the tumour is a rhabdomyosarcoma, apparently derived from abnormal prolific vascular mesenchyme. Only one comparable example has been recorded previously. PMID- 3962597 TI - Exogenous silver in dorsal root ganglia, peripheral nerve, enteric ganglia, and adrenal medulla. AB - Following intraperitoneal (i.p.) or oral administration of silver salts, the anatomic distribution of silver in the peripheral nervous system (PNS) has been studied. The structures examined were dorsal root ganglia, peripheral nerve (N. ischiadicus), enteric ganglia, and adrenal medulla. Four days after an i.p. injection of silver lactate, silver deposits were found in these structures. The silver content remained stable during the observation period (45 days). The localization of silver deposits in the orally treated animals was independent of the administered silver salt (silver nitrate or silver lactate). The silver deposits in neurons and chromaffin cells were located in the cytoplasm. In all organs silver was present in large amounts in connective tissue membranes, macrophage-like cells, vascular basal laminae, and supporting cells. Satellite cells of the dorsal root ganglia were always heavily stained, while less stain was present in Schwann cells of the peripheral nerves. Intracellular deposits were invariably located in lysosomes, whereas extracellular grains were found in connective tissue fibers and basement membranes. PMID- 3962598 TI - Effect of an extract of Ginkgo biloba on triethyltin-induced cerebral edema. AB - The effect of an extract of Ginkgo biloba was studied on cerebral edema in rats intoxicated with triethyltin chloride (TET). Brains of TET-treated rats showed elevated water and sodium levels and a significant increase in the sodium/potassium ratio. Animals treated with TET plus the extract did not show water and electrolyte changes. The course of intoxication and treatment was studied light- and electron-microscopically. A severe edema with extensive vacuolization was seen in the cerebral and cerebellar white matter. Morphometric measurements revealed a significant decrease in these manifestations of the cytotoxic edema when the animals were treated with an extract of Ginkgo biloba. Thus, we conclude that this extract has a protective effect on the development of a cytotoxic edema in the white matter of the brain. PMID- 3962599 TI - Skeletal muscle pathology in X chromosome-linked muscular dystrophy (mdx) mouse. AB - Histological, histochemical, and morphometric analyses were performed chronologically on muscles from mutant mice with X chromosome-linked muscular dystrophy (mdx), and the findings were compared with those in nondystrophic control animals (C57BL/10ScSn). Massive grouped muscle fiber destruction, followed by complete regeneration, occurred abruptly at 20 days of age. There were no preceding changes in body weight, the number and mean diameter of fibers, and fiber type differentiation before the initial episode of muscle fiber necrosis. Muscle fiber necrosis decreased in intensity after 60 days of age. Even after repeated muscle fiber necrosis and regeneration, the most striking finding was that interstitial fibrosis and adipose tissue replacement were minimal, and there was no apparent fiber loss. Since the necrosis was probably well compensated by the active regenerative process, the mdx mice developed no obvious muscle weakness and thus differed from human and other animal muscular dystrophies with the exception of the dystrophic hamster. PMID- 3962600 TI - Lectin histochemistry of scrapie amyloid plaques. AB - Peroxidase-labeled lectins were used for detection of specific monosaccharide residues in amyloid plaques in brains of scrapie-infected mice. The lectins tested recognize the following residues: beta-D-galactosyl (Ricinus communis agglutinin 120, RCA-1), alpha-D-galactosyl and alpha-D-galactopyranoside (Bandeirea simplicifolia aggl., BSA), alpha-D-mannosyl and alpha-D-glucosyl (Concanavalin A, Con A), N-acetylglucosaminyl and sialyl (Wheat germ aggl., WGA), sialoglycoconjugates (Limulus polyphemus aggl., LPA), alpha-L-fucosyl (Ulex europeus aggl., UEA-1 and Tetragonolobus aggl., TPA), N-acetyl-D-galactosaminyl (Helix pomatia aggl., HPA). The most intense staining reaction in amyloid plaques was observed with BSA and WGA; it was less intense with RCA-1, Con A, and HPA. This indicates that the plaque material contains glycoproteins with abundance of accessible residues of alpha- and beta-galactose, N-acetyl-D-glucosamine and N acetyl-D-galactosamine, and some types of sialo-glycoconjugates recognized by WGA. Such residues, like alpha-L-flucosyl recognized by UEA-1 and TPA, were almost undetectable in the examined plaques. There were also some differences in the staining intensity between small and large plaques (WGA and HPA) and between central and peripheral areas of the plaques. In the wall of micro-blood vessels relatively strong staining reaction was observed with RCA and BSA and less intense with WGA and Con A. PMID- 3962601 TI - Cerebellar changes of the female mice heterozygous for brindled gene. AB - The brindled mutation is an X-linked neurological mutation in mice. Male mice hemizygous for the brindled gene have metabolic defects homologous with kinky hair disease in humans. Neuropathologically, the mutation is characterized by extensive neuronal degeneration associated with pronounced mitochondrial changes in cerebral cortex and abnormal arborization of Purkinje cell dendrites, which are most pronounced in the rostral vermis or anterior lobules. In the cerebellum of female mice heterozygous for brindled gene, Purkinje cells with abnormal dendritic arborization and with unusually enlarged mitochondria were also observed. Morphological changes in affected Purkinje cells in young heterozygotes were similar to those of young hemizygotes. However, in older heterozygotes, the changes were far less conspicuous, indicating the presence of some extrinsic factor(s) to compensate expression of the mutant gene in heterozygous brains. PMID- 3962602 TI - Experimental study on pathogenesis of the fetal brain damage by acute carbon monoxide intoxication of the pregnant mother. AB - The pathogenesis of fetal brain damage caused by acute maternal carbon monoxide (CO) intoxication was experimentally investigated in cats; 11 pregnant cats in various gestational stages were exposed to 0.2-0.3% CO/air gas for 76-150 min; thereafter, 29 live and stillborn neonates and 14 fetuses removed by cesarean section were observed pathologically. In the full-term or late-gestational-stage fetuses and neonates, the most vulnerable areas were the cerebral white matter and brain stem, followed by the basal ganglia and thalamus, and then the cerebral cortex. No changes were found in the cerebellum. From the distribution and nature of the brain changes, a hypoxic-ischemic mechanism was proposed as the pathogenesis of fetal brain damage. In the fetuses or neonates in middle and early gestational stages, the frequency and severity of the brain changes were generally lower than in those in the late gestational stage, and the cerebral white matter and basal ganglia were most often involved, but the thalamus, brain stem and the cerebral cortex were spared. The severity and extent of the brain changes were not the same among all littermates, but varied from normal to severely damaged animals. Among the maternal physiological factors measured during the CO exposure, only the severity of acidosis was correlated with the grade of fetal brain damage. PMID- 3962603 TI - Multinucleated giant cells in brain: a hallmark of the acquired immune deficiency syndrome (AIDS). AB - Multinucleated giant cells (MGCs) were found in the brains of two patients with the acquired immune deficiency syndrome (AIDS), but were absent in five other AIDS brains. In one case there was a distinctive distribution of MGCs in disseminated clusters; damage of brain parenchyma was minor or absent. In another case, MGCs were restricted largely to the perivascular spaces and were accompanied by lesions of toxoplasmosis and cytomegalovirus infection. In paraffin sections, morphological and histochemical-staining characteristics of MGCs were similar to those of macrophages. Occasional immuno-labeling of MGCs with monoclonal antibody to leukocyte common antigen suggested a hematogenous origin. MGCs were not stained by immunocytochemistry for neural markers glial fibrillary acidic protein, S 100 protein, neurofilament proteins, neuron specific enolase, and myelin basic protein and, therefore, appear unlikely to originate from the neuroepithelium. In the absence of evidence of other infections in case 1, the peculiar tissue reaction found could be a direct result of infection by the AIDS retrovirus. The formation of MGCs is likely to represent a cytopathic effect of the virus on lymphoid or monohistiocytic cells infiltrating the brain (infection of these cells could occur before or after they entered the brain). These assumptions are supported by the finding of similar MGCs in permissive lymphoid cell cultures after infection with the AIDS retrovirus. PMID- 3962604 TI - Distribution of demyelinating lesions in pontine and extrapontine myelinolysis- three autopsy cases including one case devoid of central pontine myelinolysis. AB - Three autopsy cases of pontine and extrapontine myelinolysis are reported; one, a malignant lymphoma in a man of 66 years, the other an alcoholic liver cirrhosis in a man of 54 years, and an esophageal cancer in a woman of 68 years who presented only with extrapontine myelinolysis, but lacked central pontine myelinolysis (CPM). The extrapontine lesions in these three cases revealed a characteristic and common localization; they occurred mostly in the bundles of myelinated fibers in the gray matter, such as in the pons, basal ganglia, and thalamus; and in the white matter surrounded by massive gray matter, such as the deeper layers of the cortex and subjacent white matter of the crowns and sides of the cerebral gyri, the white matter of the cerebellar folia and internal, external, and extreme capsules. Therefore, the third patient was classified as a subtype of pontine and extrapontine myelinolysis, which may be called the "extrapontine form" because of absence of CPM. Moreover, bilateral demyelination of the mamillary body was found in all cases, and laminar cortical astrocytosis and necrosis similar to Morel's cortical laminar sclerosis in two of them. From the clinical and pathologic findings, the significance of the changed osmolarity of the blood as a cause and the importance of some specificity of the tissue architecture in the pathogenesis are discussed. PMID- 3962605 TI - Morphometric evaluation of post-ischemic capillary perfusion in selectively vulnerable areas of gerbil brain. AB - In gerbils the hemispheric blood flow was interrupted for 5 min by bilateral carotid artery occlusion to produce delayed selective destruction of the CA 1 sector of hippocampus. The influence of hemodynamic factors was studied by evaluating the microcirculation before and at two times after ischemia (3 min and 7 days), using Evans blue as an intravital vascular tracer. The density of perfused capillaries and the fractional volume of circulating blood were determined by quantitative morphometry and the values for the vulnerable CA 1 sector compared with those for the resistant CA 3 sector and cerebral cortex. In control animals the number of perfused capillaries in the CA 1 sector was about 20% lower, and the volume of circulating blood about 30% lower, than in the CA 3 sector or cerebral cortex. This difference was markedly enhanced after 5-min ischemia. During the early recirculation phase, capillary perfusion improved in the cortex, whereas in the CA 1 sector (and to a lesser degree also in the CA 3 sector) it declined. After 7 days, the density of perfused capillaries and the volume of circulating blood had returned to control levels in the cerebral cortex and CA 3 sector of hippocampus. In the CA 1 sector, in contrast, the microcirculation had further deteriorated. The density of perfused capillaries was less than 30%, and the circulating blood volume even less than 50%, of that in the cerebral cortex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962606 TI - A case of cerebellar hamartoma suggesting abnormal cell migration. AB - A rare case of hamartoma of the left cerebellar hemisphere was recognized in an 11-month-old male infant whose mother had a history of unspecified medication in the early gestational period and had a difficult delivery. A notably large head and marked developmental disorders, like hypotonic cerebral palsy, were observed soon after birth. A computed tomogram revealed an iso-minimally enhanced large mass in the left cerebellar hemisphere, which deformed the fourth ventricle and compressed the right cerebellum, as well as moderate cerebral atrophy. Histologically, the border between the cerebellar cortex and this tumor was not apparent. The main tumor, located in the cerebellar white matter, was composed of numerous scattered Purkinje cell-like neurons and glial cells surrounded by abundant GFAP-positive matrix. The small part of the tumor, located near the choroid plexus, was composed of intensely proliferated capillaries such as in capillary hemangioma, and numerous fibrocytes, which were intermingled with several large Purkinje cell-like neurons and some with several large Purkinje cell-like neurons and some GFAP-positive glial cells. The cerebellar cortex showed a thin molecular layer with some residual external granular cells, a marked decrease of Purkinje cells and a moderate decrease in the internal granular layer, in which large Purkinje cell-like neurons were scattered. Purkinje cells and large Purkinje cell-like neurons scattered in the internal granular layer, cerebellar white matter and choroid plexus showed positive immunoreactivity for anti-Leu-4 monoclonal antibody, which is known to be a marker for Purkinje cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962607 TI - The effects of cisplatin on rat spinal ganglia: a study by light and electron microscopy and by morphometry. AB - Cisplatin given in doses of 0.5-2 mg to Wistar and to Sprague-Dawley rats produced nucleolar segregation of the dense fibrillar from the granular component in spinal root ganglion cells. The nucleolar segregation, found to the same extent in large and small neurons, was confirmed by specific silver staining and by electron microscopy. After repeated doses of 1 mg or 0.5 mg, up to 40% of affected nucleoli were observed by light microscopy. Focal clearing of the nucleoplasm of nuclei also occurred. Disorganisation of ribosomes was found in more severely intoxicated animals, especially in large light cells with shrinkage of the Nissl substance and apparent increase in neurofilaments, the latter occasionally distending the initial segment of the axon, but never extending further. Hypertrophy of the satellite cells with increase in the perineuronal intercellular spaces, often associated with irregular, scalloped nuclear and cell outlines, suggested that neuron shrinkage had occurred. This was confirmed by morphometry and marked alterations were found in nucleolar-to-nuclear and nucleolar-to-cell diameter ratios, nuclear and cell diameters were also somewhat reduced without change in the nucleus-to-cell ratios. Peripheral sensory nerve degeneration was not seen, and the animals died from non-neural causes. The probable role of these events in the production of sensory neuropathy is discussed. PMID- 3962608 TI - Changes in human skeletal muscles due to ageing. Histological and histochemical observations on autopsy material. AB - Morphological changes in human skeletal muscle with ageing are reported. Samples from the deltoid and the vastus lateralis muscles from 126 subjects, aged 20-80 years, were studied by light microscopy. The patients died suddenly due to accidents or from fatal diseases. Until their death, they had preserved normal physical activity corresponding to their age. Chronic diseases, inactivity or neuromuscular diseases which are known to lead to changes in the muscles were excluded. The frequency of neurogenic changes of muscles increased with increasing age. These results correlated with electrophysiological and morphological changes in the peripheral nerves due to ageing reported by other investigators. The neurogenic changes in persons over 70 years were overlapped by a type-2 fibre atrophy. PMID- 3962609 TI - Transplantation of pacinian corpuscles of the rat into the brain. AB - In adult inbred rats of the AVN strain, branches of the crural interosseous nerve were dissected out from donors and transplanted into the brain of recipients, together with a cluster of Pacinian corpuscles, (either into a suction cavity or the cerebral cortex) into a slit 1-2 mm deep. The grafts were fixed and processed for electron microscopy 10 days to 6 months after the operation, and their ultrastructure was examined. Sporadic axons of small diameter grew into the nerve branches of some of the grafts from 11 days onward, and became myelinated during the 2nd month after the operation, but none of the transplanted Pacinian corpuscles became reinnervated. The corpuscles, however, survived denervation and grafting. Most of them retained a well-preserved inner core and an intact capsule, consisting of a normal complement of 29.2 +/- 1.0 (mean +/- SE) capsular layers (n = 8), as did the corpuscles previously examined after denervation in situ. Some of the corpuscles underwent degenerative changes, presumably due to a delayed or restricted revascularization. In this group of corpuscles, the inner core underwent disintegration and was gradually replaced by collagen fibrils, whereas the capsule remained preserved but the number of its layers eventually reduced by 40%. It is assumed that the lack of reinnervation of the grafted Pacinian corpuscles was due to the paucity of regenerating axons, and their failure to form correct projections along those Schwann cell columns connected with the corpuscles. PMID- 3962610 TI - Thrombosis of a saccular microaneurysm causing cerebral (pontine) lacunae. AB - The authors present the case of a hypertensive patient with a thrombosis of a saccular microaneurysm (SMA) and underlying cerebral (pontine) lacunae. This SMA lay at the junction between the main vessel and two small feeding arteries penetrating into the necrotic territory. Microhemorrhages were observed in and outside the aneurysmal wall. Very sinuous narrow channels of recanalization crossed the thrombosis between the upstream and downstream vessels. The anatomical relationship between the SMA and the lacunae has been histologically demonstrated. PMID- 3962611 TI - Neurotrophic factor for central cholinergic neurones is present in both normal and Alzheimer brain tissue. AB - Reaggregate cultures of foetal rat brain grown in a serum-free medium were used to determine the presence or absence of cholinergic neurotrophic factors in Alzheimer's disease brain tissue. These preliminary data show that both normal and Alzheimer's disease brain contain factors which elevate choline acetyltransferase activity in the reaggregate cultures. PMID- 3962612 TI - Pelizaeus-Merzbacher disease in a brother and sister. AB - A brother and sister developed a slowly progressive neurological disorder with cerebellar and pyramidal signs and mild dementia. The brother developed symptoms at 6 months and died aged 11 years; the sister developed symptoms at 3 years and died aged 18 years. At post-mortem both had severe widespread central nervous system demyelination with islands of preserved myelin, and small amounts of sudanophilic lipid products. Metachromatic material, globoid cells, and adrenal abnormalities were not seen. The features were those of Pelizaeus-Merzbacher disease (PMD). It has been proposed, on the basis of only a few family studies, that PMD is an X-linked recessive disorder. These cases suggest that autosomal recessive inheritance may occur. PMID- 3962613 TI - Photorefraction: a useful tool to detect small angle strabismus. AB - Forty patients with small angle strabismus and 30 straight eyed controls were examined by photorefraction in order to establish the validity of this method to detect strabismus. The sensitivity of the method was based on detection of asymmetry of the corneal light and/or fundus reflexes. All cases with a deviation of 2 degrees or more were detected, and 2 controls were falsely considered to be strabismic patients. The sensitivity of the method decreased when the patient wore optimal correction. Photorefraction therefore is considered to be a reliable, simple, and cheap tool with high sensitivity and specificity in screening for strabismus as well as refractive errors. PMID- 3962614 TI - Mass screening of children for strabismus or ametropia with two-flash photoskiascopy. AB - 169 non-selected 1-5 year-old children (338 eyes) were screened by two-flash photoskiascopy with an autofocus camera for strabismus, high anisometropia and high ametropias without cycloplegia. The photography was performed by nurses or technicians and the photographs were analyzed by an optician. The sensitivity of the method for the refractive errors was tested with an optical demonstration eye. FINDINGS: 5 esotropias, 1 exotropia, 1 straight-eyed hypermetropic anisometropia of 4 diopters; 1 false positive high hyperopia (of +2.5 diopters) of both eyes. The examination of the photographs showed slight refractive errors in 33 cases (66 eyes; 19.5%): two of them of symmetrical myopia of -1.0 and -1.75 diopters and 31 of symmetrical hyperopia of +0.25 to +4.25 diopters in retinoscopy. 128 cases (256 eyes; 76%) were normal on the photographs. Of these, 37 non-selected cases (74 eyes) were checked clinically and were symmetrical cases of -1.0 to +3.25 diopters on retinoscopy. No false negative cases appeared among these control cases. 2,4% of the photographs failed technically or because of noncooperation of the children. Two-flash photoskiascopy, performed by technicians or nurses provides a valuable tool for mass screening of infants for strabismus and/or ametropia causing amblyopia. PMID- 3962615 TI - Hypotony and retinal detachment. AB - The present work has been based on the assumption that the decreased intraocular pressure in eyes with retinal detachment is due to an abnormal posterior aqueous outflow, in addition to the normal anterior pathways. Subretinal fluid may leak out either through the peri-optic connective tissue or across the retinal pigment epithelium. In order to test the validity of these alternatives against clinical observations, a fluid dynamic model has been developed to calculate intraocular pressure-drop versus detached area in both cases. In contrast to the choroidal alternative, the numerical results from the peri-optic route exhibit qualitative agreement with clinical observations. It is concluded that both clinical and theoretical findings lend support to the hypothesis that the intraocular pressure drop in eyes with retinal detachment is due to drainage of subretinal fluid via the peri-optic tissue. PMID- 3962616 TI - Myopia and diabetes mellitus with special reference to adult-onset myopia. AB - A significant preponderance of myopia has been reported in adult Danish diabetics as compared to non-diabetics. This suggestion of a special type of diabetic myopia is evaluated in the present study. Comparing myopia pattern (degree and age at onset) in diabetics and non-diabetics, 80 of each, the assessment is based mainly on personal information about refractive history, gained through interviews of patients referred from other departments for routine eye examination. With a concise memory as inclusion criterion, the resulting sample is hardly representative, and the significant findings are to be considered tendencies only. In the whole sample there were more cases of late myopia onset and progression than expected from textbooks; 31% were of adult onset, i.e. after the age of 20 year. Most late-onset cases were of a low order, a type more prevalent in diabetics (40%) than in the non-diabetic controls (22.5%). Otherwise there was no indication of a special type of diabetic myopia. PMID- 3962617 TI - Influence of exfoliation syndrome on prognosis in ocular hypertension greater than or equal to 25 mm. A long-term follow-up. AB - Data on 144 patients who in 1969-1973 were found to have ocular hypertension greater than or equal to 25 mmHg without glaucomatous damage were collected retrospectively. Intraocular pressure-lowering treatment was prescribed with few exceptions. Thirteen out of 37 patients (35%) with exfoliation syndrome developed glaucomatous damage during the follow-up periods ranging from 5 to 14 years (mean 9.4 years). The corresponding result for patients without exfoliation syndrome was 20 out of 111 subjects (18%, mean follow-up 11.7 years, range 5-15 years). Low average intraocular pressure during the follow-up seemed to prevent the eyes from developing glaucomatous damage. This was especially evident for eyes with the exfoliation syndrome. The long-term effect of medical therapy on the pressure level of hypertensive eyes was often negligible. PMID- 3962618 TI - Goniodysgenesis in elderly glaucoma and non-glaucoma patients. A masked slit-lamp and gonioscopy study. AB - The aim was to elucidate whether goniodysgenesis is more frequently observed in elderly patients with glaucoma, and furthermore, which signs of goniodysgenesis are of importance and most unanimously detected. Thus, 3 examiners evaluated 21 glaucoma patients and 19 non-glaucoma patients in a masked fashion. None of the patients had a first-degree heredity. Gonioscopy, slit-lamp examination and measurements of the corneal and pupillary diameter were performed, in all 26 variables. Significantly (P less than 0.05) more frequent in glaucoma were an increased corneal diameter, scleral overriding, hypoplasia of the pupillary seam, abnormal Schwalbe's line and an opaque pretrabecular membrane (one examiner). Less frequent were a peripupillary yellow pigment ring and pigment stars on the lens. Inter-observer variation was small regarding e.g. corneal diameter but rather large regarding e.g. the pretrabecular membrane. PMID- 3962619 TI - Effect of honan intraocular pressure reducer on ocular and optic nerve blood flow in phakic rabbit eyes. AB - The Honan Intraocular Pressure Reducer (HIPR) was applied to rabbit eyes for 30 min at pressure settings of 0, 30, 50, or 100 mmHg. Ocular blood flow was measured using (85Sr) radioactively labelled 15 micron microspheres either with the HIPR applied to the eye or 15 min after removal. Intraocular pressure was measured before applying the HIPR, immediately after removal, or 15 min after removal. At all pressure settings, the HIPR significantly lowered the IOP (P less than or equal to 0.05) both immediately and 15 min after removal. At all pressure settings, except 0 mmHg, blood flow was significantly (P less than or equal to 0.05) both immediately and 15 min after removal. At all pressure settings, except 0 mmHg, blood flow was significantly (P less than or equal to 0.05) lower with the HIPR applied compared to 15 min after removal. PMID- 3962620 TI - Effect of digital massage on intraocular pressure and ocular and optic nerve blood flow. AB - The effect of digital massage on intraocular pressure and ocular and optic nerve blood flow was studied in anaesthetized rabbits. Digital massage was performed for 15 min, with pressure release for 15 seconds after each 45 seconds of massage. Blood flow was measured in the iris, ciliary processes, choroid, retina, and optic nerve using (85Sr)-labelled microspheres. Blood flow was determined during massage, 2 min after, or 15 min after massage. Intraocular pressure was measured before, immediately after, and in one group, 15 min after massage. Immediately after digital massage, intraocular pressure was significantly lower, but 15 min after it was not significantly reduced. At both 2 min and 15 min after digital massage, compared to during massage, blood flow was significantly higher in all tissues studied. PMID- 3962621 TI - Nuclear vacuoles in nuclear cataract. AB - The human lens nucleus has always been described as a homogeneous part of the lens, and if any distinct opacities are found, these are considered to be congenital. However, in lenses with nuclear cataract, both of senile type and those induced by hyperbaric oxygen, we have found relatively transparent vacuoles in the nucleus of similar appearance as cortical vacuoles. In cataracts induced by hyperbaric oxygen the vacuoles were reversible to some extent. The vacuoles have been investigated with slit-lamp photography and quantitative microradiography. Nuclear vacuoles were found in 11 out of 25 patients treated with hyperbaric oxygen compared to 19 out of 100 pre-operatively examined senile nuclear cataracts. In the microradiographs the vacuoles appeared as dark rounded areas with a lower dry mass content (approximately 0.30 g X cm-3) than the surroundings (approximately 0.50 g X cm-3). PMID- 3962622 TI - The effect of polyvinylpyrrolidone-iodine as an disinfectant in eye surgery. AB - 105 patients admitted for cataract surgery were treated pre-operatively with polyvinylpyrrolidone-iodine (PVP-I) as a disinfectant, and consecutive bacterial cultures were obtained before initiating surgery and at the end of the operation. A control group (n = 99) only had a standard disinfection procedure of the eye (including instillation of Terramycin cum polymyxin B cream in the conjunctival sac the evening before surgery). The cultures obtained from the conjunctival sac of the control group principally showed growth of Staph. albus and Staph. aureus, and to a minor degree diphtheroids (Corynebacterium species). Proteus mirabilis, Escherichia coli and micrococci. There was a significant quantitative diminished growth (P less than 0.05) of bacteria in the group of patients treated with PVP-I compared to the control group. Concerning the growth of Staph. albus, this was reduced to almost one third and other bacteria were almost eliminated in the group receiving PVP-I. As we disclosed no toxic or allergic reaction post operatively which could be related to the use of PVP-I as a disinfectant, this agent seems to constitute an effective pre-operative antimicrobial treatment, taking into consideration the broad antimicrobial spectrum of PVP-I shown by other authors. PMID- 3962623 TI - Topical anaesthetic and tear film stability. AB - The effect of unpreserved topical anaesthetic on tear film stability (0.4% oxybuprocaine hydrochloride) was investigated in a double masked randomised study in 12 healthy volunteers, using a noninvasive tear film break up technique (NIBUT). It was found that the topical anaesthetic did not reduce the pre-corneal tear film stability, contrary to the electron microscopic evidence. PMID- 3962624 TI - The concentration of lactoferrin in tears of normals and of diabetics. AB - The tear lactoferrin content and the tear secretion rate was determined in 105 normal subjects (age range: 15-93 years) and 21 diabetic patients (age 21-78 years). Tear sampling was performed using glass capillaries and the lactoferrin concentration in tears was tested employing an enzyme-linked immunosorbent assay. Tear secretion rate was measured using standardized Halberg filter paper placed in the inferior fornix for 5 min. The lactoferrin level of normal tears showed a significant inverse correlation with age, the mean value of the 8th decade (0.81 mg/ml) constituting only about half the value of the lactoferrin level found in the 3rd decade (1.48 mg/ml). The tear secretion rate also displayed a significant decrease with age, but no correlation could be demonstrated between the tear secretion rate and lactoferrin concentration. No difference was found in lactoferrin level between men and women. We were not able to demonstrate any correlation between lactoferrin content of tears and the duration of diabetes in the 21 diabetic subjects, and there was no difference between the level of lactoferrin in normal tears compared to the concentration in diabetic tears. No difference was found between the tear secretion rate in normals and in diabetics. PMID- 3962625 TI - Labelling of retinal capillaries in mice by repeated [3H]thymidine injections. AB - Injections of [3H]thymidine intraperitoneally to mice on 3 consecutive days label a small number of retinal vascular cells. A single dose of the tracer is not sufficient for adequate cell marking. Retinal capillaries from obese hyperglycemic mice of different ages examined by this method showed no significant difference of the labelling index compared to their normal, lean controls. The present method is simple and leaves the eyes undisturbed. It may be considered well suitable for experimental studies on cell replication in the retinal capillaries. PMID- 3962626 TI - The significance of using different methods for analysing photokeratoscopic data. AB - With the photokeratoscope of Wesley-Jessen, 45 pictures were taken from the right eye of 18 normal persons and analysed by 2 different methods. The first method is based on the assumption that radius of the corneal curvature is constant between 2 points of reflection, the second method is without such a preliminary assumption on the corneal contour. The parameters estimated: radius of the central curvature (K) and the coefficient of radius variation (RV) are compared. A difference in K at 1.5% corresponding in case to 0.6 diopters and a difference in RV at 46% are demonstrated. The differences are correlated to the error introduced by the assumption on constant radius. Further it is established that K measured by the keratometer of Javal-Schiotz is about 0.14 mm larger (in case 0.7 diopters) than K estimated by the method of photokeratoscopic data analysis without preliminary assumption. PMID- 3962627 TI - Extra-abdominal desmoid tumors. AB - A follow-up study of 53 patients with extra-abdominal desmoid tumor is presented. Fine-needle aspiration biopsy seemed to be valuable in the differentiation between a desmoid tumor and a truly malignant soft tissue tumor. The angiographic pictures did not differ from those of other soft tissue tumors, but valuable topographic information was obtained from the angiography in the preoperative planning. The overall local recurrence rate was 17/44, and 15 of the recurrences occurred within the first 2 years. Complete removal of the affected muscle or muscle group is recommended. Local control can be achieved by non-ablative surgery even after multiple recurrences. Only one out of 53 patients died of the tumor disease. Radiotherapy can be attempted in extensive tumors, and amputation should be reserved for tumors which have failed to respond to this treatment. PMID- 3962628 TI - Bone fixation of ceramic-coated and fiber titanium implants. A study in weight bearing rats. AB - We compared the fixation of glass ceramic-coated titanium and fiber titanium implants using a simple weight-bearing model in rats. The chemical composition of the glass ceramic was similar to 45S5F Bioglass. One hundred and eight male Wistar rats were operated on. A segment of their right tibias was replaced by a disc-shaped implant with a central hole. A stable osteosynthesis was completed by means of an intramedullary nail and a tension band. Thirty-six rats received glass ceramic-coated and 36 fiber titanium implants. In 36 rats osteotomies were performed. All animals survived without complications until scheduled sacrifice at 3, 12 and 26 weeks, postoperatively. The ultimate bending moments of the fiber titanium-bone interfaces and the osteotomies increased with time, and approached the levels of the contralateral, intact tibias at the 12th and 26th week. Also, the ultimate bending stresses increased from the 3rd to 12th week. After 26 weeks the fiber titanium-bone interfaces had reached about 45 per cent, and the osteotomies about 75 per cent of the strength of the intact tibias. All the glass ceramic-coated implants were loose, and at 26 weeks there was no coating left. PMID- 3962629 TI - Hip fracture incidence in Stockholm 1972-1981. AB - We studied the incidence of cervical and trochanteric hip fractures in Stockholm, Sweden from 1972 through 1981. The material, selected from a computerized medical information register, consisted of 11 812 cervical fractures and 8094 trochanteric fractures. The incidence did not change in the age group 50-74 years. In males 75 years of age and older, the incidence of both fracture types caused by moderate trauma increased annually by 5-6 per cent. In females 75 years and older, the incidence of trochanteric fractures caused by moderate trauma increased annually by 6 per cent, whereas the incidence of cervical fractures increased only marginally. PMID- 3962630 TI - Trabecular osteopenia in Colles' fracture. AB - Bone density was measured in 23 postmenopausal women with Colles' fracture. Trabecular spine density was measured by quantitative computed tomography. The bone mineral density in the distal radius and in the diaphysis of the radius and ulna was measured by the gamma ray attenuation method. Compared with age-matched controls, the patients were found to have reduced trabecular bone mass in the spine and distal radius, but no osteopenia in the diaphysis of the radius and ulna. The mean age-corrected decrease was 0.7 SD in the spine and 0.5 SD in the distal end of the radius. The results suggest that patients with Colles' fracture have trabecular but not cortical osteopenia. PMID- 3962631 TI - Joint forces in extension of the knee. Analysis of a mechanical model. AB - A two-dimensional model of the tibio-femoral joint was constructed by using the results of cadaver knee dissections together with radiographic landmarks on healthy knees loaded at various angles of flexion. The tibio-femoral compressive force during isometric knee extension had the same magnitude as the patellar tendon force. The tibio-femoral shear force changed direction from posterior at full flexion to anterior when the knee was extended, indicating that high forces may arise in the anterior cruciate was extended, indicating that high forces may arise in the anterior cruciate ligament in the straight knee. Women developed some 20 per cent higher knee joint forces than men for the same extending muscular moment higher knee joint forces than men for the same extending muscular moment, since women's patellar tendon moment arms were found to be shorter. The model presented may be used for quantifying tibio-femoral forces during knee extending activities. PMID- 3962632 TI - Subchondral bone strength in arthrosis. Cadaver studies of tibial condyles. AB - We measured the axial penetration strength of subchondral cancellous bone in a close, regular pattern at the tibial resection surface of five valgus and seven varus human, cadaveric knees. The strength patterns obtained were illustrated by pseudo-three-dimensional reconstructions of strength values as a function of the location on the resection surface. The varus knees had high strength values towards the medial margin of the medial condyle. Three qualitatively different strength patterns were distinguished in the valgus knees: two knees showed a near normal strength distribution with higher peak values medially; two knees with centrolateral bony attrition had high bone strength values at the center of the lateral condyle; and one knee with moderate posterolateral bony attrition showed a high strength area at the posterolateral aspect of the lateral condyle. In both types of malalignment, there was a decrease of bone strength with the depth from the resection surface. PMID- 3962633 TI - Arthroscopy of the elbow. Diagnosis and extraction of loose bodies. AB - Arthroscopy of the elbow was performed in 35 cases of suspected loose bodies. Loose bodies were found in 13 cases. Preoperative radiographs were falsely negative in two cases and falsely positive in 12. In ten cases arthroscopic removal was attempted; it succeeded in six cases. When no loose bodies were found, the most common diagnosis was degenerative joint disease. Arthroscopy is recommended for diagnosis and treatment of loose bodies in the elbow joint. PMID- 3962634 TI - Mechanics of knee and ankle bandages. AB - Different types of bandages were tested mechanically and clinically. Four elastic and three elastic adhesive bandages were mechanically tested. The former proved better. Seven different ankle bandages and three knee bandages were tested in a simulated clinical situation, measuring the pressure which developed while walking for 15, 50 and 100 min, and immediately after application of the bandage. The bandages slackened most markedly during the first period of walking. The compression pressure of the padded adhesive ankle bandage was lower than that produced by most other bandages. The padded adhesive and elastic bandages proved to be most suitable for clinical use. The padded knee bandage produced a lower compression load than the elastic bandage tested. On the basis of this trial we recommend the use of a padded knee bandage. PMID- 3962635 TI - Effects of sex hormones on congenital kyphosis in Ishibashi rats. AB - We examined the influence of estrogen and testosterone on the development of congenital kyphosis in Ishibashi rats. Neither hormone caused a growth spurt. Estrogen suppressed the spinal growth and the progression of kyphosis in both sexes, and accelerated narrowing of the epiphyseal plates, which became apparent at 6 weeks after birth in females and 8 weeks in males. In both sexes, maturity of the spine was accelerated and trabeculae were hypertrophied by estrogen. Testosterone suppressed the progression of kyphosis in males, but not in females. Histologically, testosterone had no effects on growth cartilage, but did produce thinning of the bone trabeculae in males. PMID- 3962636 TI - Bone changes after castration in rats. A model for osteoporosis. AB - Bone changes 6-12 weeks after castration have been studied in 25 female and 27 male middle-aged rats. Castrated female rats gained more weight than their controls, but had decreased bone density and calcium and hydroxyproline content per cm3 bone volume of tibia. Castrated male rats did not differ from controls regarding body weight and the bone parameters. No influence of castration on the mechanical strength of the femora could be detected in either sex. At 2 weeks after castration, the circulating levels of immunoreactive calcitonin (iCT) were decreased in female rats compared to controls. In contrast, iCT was increased both in castrated male and female rats 10 weeks later. We conclude that castration of 6-month-old female rats causes osteoporosis, and therefore represents a promising experimental model for studying postmenopausal bone loss. PMID- 3962637 TI - Radical synovectomy with muscle release for the rheumatoid elbow. AB - Twenty-three synovectomies of the elbow with concomitant muscle release at the humeral epicondyles were performed in 21 patients with rheumatoid arthritis. Ten elbows were classified as anatomical Stage 2, 12 as Stage 3, and one as Stage 4. The patients were followed from 1 to 8 years. Postoperative clinical results showed improved relief of pain, and range of motion, and activities of daily living. Increased range of motion with improvement of flexion contracture was obtained in most cases by releasing the muscle insertions around the humeral epicondyles and by resecting the radial head and bony spurs of the coronoid and the olecranon. The operation was beneficial even at advanced stages. PMID- 3962638 TI - Spondylolysis in Eskimo skeletons. AB - Spondylolysis was found in 25 of 46 spines of Eskimos from Greenland, at L1 in one case, at L3 in five cases and at L4 and L5 in 14 cases each. Two spondylolytic vertebrae were seen in the same spine in nine cases. Among young individuals, spondylolysis was found in 2 out of 15 spines and in older in 23 out of 31. The prevalence of spondylolysis was higher, the fourth vertebra was more commonly affected, and spondylolysis occurred at an older age in Eskimos than in other ethnic groups. PMID- 3962639 TI - Mortality after cervical hip fracture. 3002 patients followed for 6 years. AB - In 3002 patients with a femoral intracapsular neck fracture occurring during a 3 year period in the Stockholm area, 79 per cent were admitted from home and the remainder from different types of institutions. The mortality among these fracture patients was higher than in the general population. Patients admitted from institutions had a three to four times higher mortality rate than those coming from home. After 6 years, 54 per cent of the patients admitted from home were still alive compared with only 16 per cent of those admitted from institutions. PMID- 3962640 TI - Correlation of fetal posture and congenital dislocation of the hip. AB - A statistical study was carried out on the incidence of CDH associated with mechanical factors in the uterus, including congenital genu recurvatum. There were 72 cases of CDH among 6559 infants (1.1 per cent). The incidence of CDH was 0.7 per cent in cephalic presentation, 2 per cent in footling presentation and 20 per cent in single-breech presentation. In another series, CDH was found in six of seven infants with congenital genu recurvatum. These findings suggest that a fetal posture with the hip flexed and the knee extended predisposes to the development of CDH. PMID- 3962641 TI - Notochord action on spinal development. A histologic and morphometric investigation. AB - Forty-seven human embryos and fetuses of a gestational age from 5 to 13 weeks were studied histologically and histomorphometrically in an attempt to elucidate the possible action of the notochord on spinal development, in particular as it relates to segmentation. Segmentation occurred first in the tissue surrounding the notochord and not in the notochord itself; notochordal development at its most cranial part lagged behind that of its surrounding tissue. We also found that in later stages the decrease of notochordal cells at the level of the body was due to degeneration and not to migration of cells toward the intervertebral space. This observation puts into doubt the theory of squeezing or migration of notochordal cells from their vertebral position into the intervertebral disc space. PMID- 3962642 TI - Thiemann's finger or toe disease. Follow-up of seven cases. AB - Thiemann's disease is a non-inflammatory disorder of unknown etiology, affecting the epiphyses of the phalanges of the fingers and the first toe in children. We have re-examined seven patients after up to 18 years. Two patients had had pain in the affected digits for several years. In four patients radiographs after closure of the growth plates showed normal phalangeal dimensions without arthrosis. We conclude that different degrees of severity of epiphyseal disturbance consistent with the type described by Thiemann may be encountered. It is possible that trauma may worsen the prognosis by deformation of a susceptible epiphysis. PMID- 3962643 TI - Voluntary hip subluxation examined by computed tomography. PMID- 3962644 TI - Nasal mucosa changes after acute and long-term exposure to dicumylperoxide. An experimental study on animals. AB - Workers exposed to dicumylperoxide at a chemical plant had crusting and increased occurrence of visible superficial mucosal vessels in the anterior part of the nasal septum. To elucidate the pathogenesis of their symptoms we examined rabbits after acute and long-term experimental airway exposure to dicumylperoxide. An increased amount of mucus containing red blood cells were seen after one hour exposure, as were many club-shaped or distorted cilia. Areas lacking cilia but still covered with microvilli and with goblet cells appeared after a week. After one month's exposure scattered islands with metaplastic, non-ciliated cells were observed and many of the ciliated and microvilli-covered cells, not only the cilia per se, appeared distorted. Goblet cells, scarce in the controls, were observed in increased frequency. Blood vessels with thick, non-fenestrated endothelium were observed in increased frequency and remained two months after the exposure. Free radical scavengers seem to reduce the extent of damage supporting our hypothesis of peroxides as damaging agent. PMID- 3962645 TI - Respiration-related movements of the nose in dogs. AB - We studied the respiration-related movements of the canine nose by examining the respiratory oscillations of intranasal balloon pressure and EMG activities of the dilator nares in dogs. Under spontaneous respiration, balloon pressure decreased and EMG activities increased during the early inspiratory phase. These respiratory movements of the nose differed and changed reciprocally in strength between the two sides of the body spontaneously, after painful stimulation or intranasal histamine administration. When the muscle relaxant was administered and the respiration was controlled by the ventilation pump, the intranasal balloon pressure increased during the inspiratory phase. This phenomenon had a completely inverted pattern compared with that during spontaneous respiration. Furthermore, even when the ventilation pump was stopped, respiration-like spontaneous oscillations of the intranasal balloon pressure were recognized. These were abolished by sectioning of the ipsilateral cervical sympathetic nerve trunk. From these findings, the respiration-related movements of the nose were thought to be controlled not only by the cardiac output and the vagal nerve reflexes but also by respiratory activities in the nervous systems controlling the nose, which might be originated from the medullary respiratory centres. PMID- 3962646 TI - Pneumococcal antibodies of different immunoglobulin subclasses in normal and IgG subclass deficient individuals of various ages. AB - The distribution of pneumococcal antibody activity of the IgG and IgA subclasses was determined in healthy individuals of various ages using monoclonal antibodies in an enzyme linked immunosorbent assay (ELISA). High IgG 2 antibody activity was found in cord blood and in serum from adults. IgG 1 activity was most pronounced in serum from young children and virtually lacking in serum from adults. Anti pneumococcal antibodies were found to be low in IgG 2 deficient donors and normal in IgG 3 deficient donors. A maturation from relatively low IgG 1 and IgG 2 antipneumococcal activity in young children to high IgG 2 levels in adults was found in healthy individuals. IgA subclass antipneumococcal activity was correlated to age. Evaluation of the distribution of pneumococcal antibody activity of various subclasses offers a new possibility for studying the immune response to infection and immunization. PMID- 3962647 TI - Saccular and cochlear endolymphatic potentials in experimentally induced endolymphatic hydrops of guinea pigs. AB - Saccular and cochlear endolymphatic potentials (SEP and CEP) were recorded in 33 normal animals. We confirmed that SEP is not produced in the saccule per se, but is a potential leak from the cochlea. CEP was reduced to one-tenth of the original value when it reached the saccule. Endolymphatic hydrops was provoked in 32 animals, and CEP and SEP were successfully recorded in 29 and 20 cases, respectively. The measurements were performed in the 2nd, 4th and 12th postoperative week. Both CEP and SEP decreased in magnitude as time elapsed after the surgery. This reduction is attributed to the strial dysfunction. In advanced hydrops, CEP transmission to the saccule is greatly inhibited. It is concluded that the saccular dysfunction can occur in the hydropic ear. PMID- 3962648 TI - Morphology of the seagull's inner ear. AB - The morphology of the seagull ear was investigated and found to be generally similar to that of other Aves. Several specific outer middle and inner ear features were found to be sufficiently different as to be remarkable. Most notably, the dual membranes of the external auditory meatus: one, a collecting (and possibly amplifying and reflecting) parabolic membrane chamber situated immediately anterior to the slightly deeper tympanic membrane. The convex tympanic membrane attaches a cartilagenous extracolumella and a thick osseous columella, which is less thin and fragile than that observed in domestic fowl of comparable body size. The columella footplate and round window are completely covered with a second middle ear membrane which apparently serves as an H2O seal and hydrostatic pressure matcher. The short, hard seagull cochlea houses an elaborate basilar papilla which contains thousands of short and tall hair cells, each with a systematic arrangement of stereocilia bundles. In the seagull, the length of the basilar papilla and the length, width, and number of stereocilia, features which affect the transduction process and frequency resolution, are different from those reported for certain other Aves. PMID- 3962649 TI - Effect of diuretics on endolymphatic hydrops. AB - The effect of diuretics on endolymphatic hydrops, which was produced by obliteration of the endolymphatic duct and sac in guinea pigs, was determined by statistical analysis of volumetric changes in the scala media. When acetazolamide was administered orally at 159 to 434 mg/kg per day for a period of 30 days, endolymphatic hydrops did not reach the extent of distension shown in animal ears without drug treatment. No difference was seen in animals with one month of drug treatment followed by three additional months without treatment. This result suggests that acetazolamide has the effect of reducing endolymphatic hydrops only during the period of drug administration. On the other hand, there appeared to be no effect, statistically, on hydrops in animals which were treated with chlorthalidone 72 to 182 mg/kg every other day for one month with survival times varying from one to four months. The effect of this drug favorably reported for the treatment of Meniere's disease symptoms is not demonstrated on endolymphatic hydrops, but rather is likely to involve other mechanisms. There was no essential difference in the extent of cochlear sensory and neural atrophy in the inner ears of animals with or without these drug treatments. PMID- 3962650 TI - Comparative ototoxicity of furosemide and piretanide. AB - The purpose of these studies was to compare the ototoxicity of piretanide to that of furosemide in the chinchilla. Chinchillas weighing 400 to 700 g were anesthetized with ketamine plus pentobarbital. Endocochlear potential (EP) was measured continuously by the round window approach using glass microelectrodes. Piretanide or furosemide injected through a jugular vein catheter in adults range from 10-100 mg/kg. Little or no change in EP was noted with doses below 15 mg/kg of either diuretic. The overall pattern of decline of EP was rather similar in piretanide-treated and furosemide-injected animals, and it was interesting to find that the dose-ototoxicity response curve for piretanide was similar to that for furosemide. The diuretic effect of equal ototoxic doses of either diuretic was equivalent. Both diuretics cause a decrease of endocochlear potential when applied locally to the round window membrane of the chinchilla as well as by systemic administration. These findings suggest that piretanide and furosemide have approximately the same propensity for ototoxicity. PMID- 3962651 TI - Cis-platin ototoxicity in previously noise-exposed guinea pigs. AB - The ototoxic effect of Cis-platin on guinea pigs was assessed with frequency specific brainstem audiometry in the frequency range 0.8-20 kHz. The animals had a noise-induced hearing loss in one ear before Cis-platin treatment. The loss of threshold showed a large inter-individual variability, with a rapid increase above a hypothetic threshold dose. In the noise-exposed ear the total loss was larger, but the additional ototoxic effect was smaller than on the non-exposed side. The hearing loss was independent of pigmentation. in conclusion, there is no potentiation between noise-induced hearing loss and Cis-platin. The data support regular audiometric control before and during Cis-platin treatment for easy detection of incipient hearing loss, before the speech frequency range is affected. PMID- 3962652 TI - Fine structure of the rat tympanic membrane after treatment with local anaesthetics. AB - The tympanic membrane of the rat was studied ultrastructurally after application of a local anaesthetic--lidocaine spray. Already after 10 min, degenerative changes--or even necrosis--were observed on both epithelial surfaces of the eardrum. Later on, a marked hyperplasia of the epidermal layer was most characteristic, as was a proliferation of the fibroblasts of the subepithelial connective tissue. After 3 weeks the eardrum had not regained its normal appearance. No perforations were encountered and only minute substructural changes could be detected within the fibrous layer. PMID- 3962653 TI - Our changing comprehension of infectious diseases. PMID- 3962654 TI - A simplified model for adjustment of gentamicin dosage in newborn infants. AB - In a retrospective study of 72 neonates during treatment with gentamicin, poor correlation was found between dosage based on body weight and gentamicin serum concentrations. Calculation of adequate gentamicin dosage regimen during steady state based on individual pharmacokinetic parameters according to Gibaldi & Perrier was then studied in 35 newborn infants during therapy. Predictions were based on gentamicin serum concentrations taken prior to and 1, 3, and 5 hours after the first (n = 8) or second (n = 12) dose (group A), or only prior to and one hour after dose (group B, n = 15). Half-life (t1/2), apparent volume of distribution (Vd), body clearance (Clbody) and elimination rate constant (beta) were not significantly different when calculated after the first or second dose or during steady-state. The correlation between predicted and observed gentamicin concentration was high in both groups (p less than 0.005) and the slopes congruent with unity. After dose or interval correction, 73% of the observed predose concentrations (mean 2.0 micrograms/ml) were within 1 microgram/ml of predicted values. One hour after dose the predicted (mean 5.7 micrograms/ml) and observed (mean 6.2 micrograms/ml) values were not significantly different. Higher precision was noted when the predictions were based on 4 samples (group A) compared to 2 (group B). Since the calculations may be performed by a simple desk calculator rapid advice may be given to the clinical staff on adequate gentamicin dosage even in small severely ill preterm infants. PMID- 3962655 TI - Breastfeeding among Turkish mothers living in suburbs of Istanbul and Stockholm- a comparison. AB - The infant feeding pattern among 96 Turkish mothers living in a suburb of Istanbul and 30 living in a suburb of Stockholm, both with working class characteristics, was determined. The duration of breastfeeding among the Turkish immigrant group living in the Stockholm suburb was significantly reduced compared with the group with a similar social background but living in a native urban area. Infant feeding pattern among the Turkish immigrant mothers was more similar to that of Swedish populations. Attitudes to breastfeeding among the immigrant group had changed. Early weaning, reliance on commercially available infant foods and bottle feeding characterized their infant feeding practices. The majority of the infants of this group showed a tendency to overweight. PMID- 3962656 TI - Selenium content of breast milk sampled in 1978 and 1983 in Sweden. AB - Selenium in human milk sampled at different intervals after parturition was analyzed on two occasions five years apart. The selenium content of colostrum and transitional milk was higher than that of mature milk. Mature milk sampled in 1983 contained more selenium than mature milk sampled in 1978 (11.9 (0.8) vs. 9.4 (0.5) micrograms/l, mean (SD), p less than 0.01). The selenium and protein content in milk were positively correlated, which may be explained by the occurrence of seleno-amino acids in proteins. The selenium content was not correlated to that of tocopherol or of highly unsaturated fatty acids in mature milk. The values for the selenium content in human milk found here are lower than those previously reported from other countries. PMID- 3962657 TI - Renal involvement in the Laurence-Moon-Biedl syndrome. Functional and radiological studies. AB - The renal abnormality of the Laurence-Moon-Biedl syndrome (LMBS) was investigated in six patients. The glomerular filtration rate (CIn) and the effective renal plasma flow (CPAH) were evaluated by standard clearance techniques and the single injection method, and the maximal concentration capacity was estimated by the ddAVP test. The kidney surface area and length were related to the body surface area, as well as the lumbar vertebrae L1-L3, and the relationship with the GFR was studied. All six patients showed renal abnormalities: Five had small kidneys with reduced GFR and concentrating ability, and one had hyperaminoaciduria (but normal kidney size). Two patients developed terminal renal failure (one of them was successfully transplanted), illustrating the progressive character of the renal lesion. Three of the patients had had recurrent urinary tract infections, but the radiological changes of the kidneys were of the same character as in the others (symmetrical and irregular parenchymal reduction, and blunting and clubbing of the calyces). Since renal abnormalities, with considerable risk for progression to terminal renal failure, are common in the LMBS, regular urine cultures and blood pressure measurements are probably of great importance. PMID- 3962658 TI - Normal growth of nephrotic children during long-term alternate-day prednisone therapy. AB - Statural growth has been evaluated in 20 prepubertal nephrotic children who received alternate-day prednisone therapy for a year at least. Bone age was assessed in 16 of these children after 1-4 years of therapy. During the follow-up 12 children showed variations in height standard deviation score (SDs) below 0.5, 7 gained more than 0.5 SDs and 1 lost 0.5 SDs. Bone age fell within the normal range for chronological age in all the children studied. On the while alternate day prednisone therapy does not affect statural growth and bone maturation of children with lipoid nephrosis. PMID- 3962659 TI - Growth pattern in Krabbe's disease. AB - The growth of nine infants with Krabbe's disease was followed longitudinally by repeated measurements of head circumference, length and weight. All infants showed early slowing and then arrest of growth, leading progressively to microcephaly and severe failure to thrive. PMID- 3962660 TI - Factors affecting development: similarities and differences among children who were small, average, and large for gestational age at birth. AB - The development of 118 small-for-gestational age (SGA), 137 average-for gestational age (AGA), and 118 large-for-gestational age (LGA) children was assessed at 7 years. The contributions of different factors to the variance in developmental scores were investigated by multiple regression analyses. All three groups showed the powerful influence of social class on intellectual ability at this age; and in the SGA and AGA groups the gross and fine-motor skills of girls were superior to boys. Smoking had a small effect in the AGA group, and in the two extreme groups first-born children did slightly better than later-born. Hypertension was associated with reduced scores in the SGA group, and LGA children who had spontaneous vaginal deliveries had higher scores than those delivered instrumentally or by caesarean section. There was a significant positive correlation between gestational age and developmental scores in the AGA group; but in the SGA group the relationship was in the reverse direction. Social class and sex affect the development of most children aged 7 years. Other factors seem to manifest an effect only under specified conditions. PMID- 3962661 TI - HLA antigens, jejunal morphology and associated diseases in children with dermatitis herpetiformis. AB - Forty-five Hungarian and Finnish children from 1.5 to 15 years with dermatitis herpetiformis were studied for HLA antigens, jejunal morphology on gluten containing diet and associated diseases in the patients and their relatives. A strong association with HLA-B8 was found in patients of both nationalities, the relative risks were 12.8 and 9.6, respectively. The Hungarian patients were also typed for HLA-DR locus, and an association with DR3 but not with DR7 was observed. Patients with subtotal villous atrophy had slightly more often HLA-B8 and DR3 than those with milder intestinal lesions. Atopic eczema occurred in 20% of the patients and family history of atopy seemed to have an inverse correlation with HLA-B8 and DR3. PMID- 3962662 TI - Leucocyte migration inhibition in cow's milk protein intolerance. AB - The leucocyte migration inhibition (LMI) was determined in an assay after in vitro challenge with beta-lactoglobulin. The assay was considered positive when migration inhibition index was greater than 20% (mean +3 SD of healthy infants). Ninety-eight infants with protracted diarrhoea and failure to thrive, 16 healthy, 12 malnourished, and 16 infants suffering from acute gastroenteritis were studied. Of the 98 patients with protracted diarrhoea, 12 fulfilled Goldman's criteria for cow's milk protein intolerance, 63 had lactose malabsorption, and in 15 no associated causative factor was identified. The mean index of migration inhibition in the cow's milk allergic group (58.83 +/- 11.98) was higher than in healthy controls (8.25 +/- 3.91), the difference being statistically significant (p less than 0.05). The test was positive in all patients with cow's milk protein intolerance. The assay was also positive in four other patients suffering from protracted diarrhoea, two of whom had lactose malabsorption. All the infants with acute gastroenteritis and malnutrition had values within the normal range. The migration inhibition index in five patients with cow's milk intolerance had declined to 24.74 +/- 4.87 in assays performed 1-6 weeks after return of clinical tolerance to cow's milk (p less than 0.05) but the test was still within the positive range in three of the five infants. These results suggest that this cell mediated immune assay is a sensitive test for the diagnosis of cow's milk protein intolerance in infants. The specificity needs to be reassessed in the light of more objective criteria for the diagnosis of cow's milk protein intolerance. PMID- 3962663 TI - Reye's syndrome in Denmark. A retrospective study. AB - We tried to determine the incidence of Reye's syndrome (RS) in Denmark in a retrospective study. As RS is often preceded by influenza B, we chose the year 1979, where an epidemic of influenza B was registered in Denmark. All children aged 1 month to 18 years, who died, were identified, excluding children who died from accidents or malignant diseases. Two hundred and forty-two children died in hospital. Review of the records revealed one case of RS. One hundred and five died outside hospital. Reviewing death certificates and autopsy reports, none of these fulfilled the criteria for RS. All paediatric departments were asked if they had made a diagnosis of RS. None had. In 1979 approximately 1.1 mill. children aged 1 month to 14 years lived in Denmark. This gives an incidence of 0.09 per 100 000 for 1979. Although this is a minimum figure, the incidence of RS in Denmark, for unknown reasons, seems very low. PMID- 3962664 TI - Circumcision for phimosis--indications and results. AB - A follow-up study including all boys (n = 117) operated with circumcision for phimosis during 1976 was performed. Most patients were operated on an outpatient basis. Early complications like bleeding or infection were few and mild. In 13 cases there was a postoperative stricture of the urethral orifice which had to be widened. Five patients had complaints about the cosmetic result. Eight boys expressed shyness and unwillingness to undress in school gym. In no instance were there any signs of a more serious psychological disorder. The operative indications are discussed and it is concluded that worried parents of boys with phimosis can be safely advised to have their boys circumcised if the prepuce is scarred or there has been recurrent balanitis, or if the boy has reached school age and the foreskin is still unretractable. PMID- 3962665 TI - Relationship between urine and plasma osmolality in newborn infants. PMID- 3962666 TI - Severe growth failure associated with atrophic intestinal mucosa and ring chromosome 15. AB - Ring chromosome 15 was detected in a boy with severe growth failure and no dysmorphic features who had previously been found to have an atrophic intestinal mucosa, a finding not observed in about 300 patients with ring autosome reported so far. Of the 137 metaphases examined, 8.1% had secondary aneuploidy produced by the structural and behavioural instability of the ring. Ring derivatives could also be seen in lymphocytes after only one cycle in the culture, indicating that such cells are also generated in vivo. We observed an increased cell death rate in fibroblast culture by Trypan Blue exclusion. These results suggest that there is a continuous in vivo generation of cells with increased mortality resulting in both growth failure and atrophic intestinal mucosa in the patient. The atrophic intestinal mucosa might be a manifestation of ring instability. PMID- 3962667 TI - Late mucosal relapse in a boy with coeliac disease and cow's milk allergy. AB - A case of coeliac disease where exceptionally long gluten challenge was needed to produce mucosal relapse is presented. An initial diagnosis of intestinal cow's milk allergy with total villous atrophy was made at the age of 3.5 months. The lesion healed after the child was put on a diet free of cow's milk and gluten. After 4.3 years on a normal diet his jejunal structure was still normal but at the age of 10.9 years, after 8.7 years of gluten ingestion, total villous atrophy was again observed. On a gluten-free diet the small intestinal structure is completely normal at the age of 17.1 years. PMID- 3962668 TI - Congenital toxoplasmosis after maternal infection before or slightly after conception. AB - We report a newborn with typical lesions of congenital toxoplasmosis. Retrospectively, the time of infection could be located to or even before conception. A diagnostic work-up should be performed in every newborn whose mother presents persistent high antibody titers against toxoplasma during pregnancy. PMID- 3962669 TI - Mallory body-like structures in the lung. AB - Mallory body-like structures (MBLs), which resemble Mallory body (MB) in the liver, were observed in lungs of 4 cases showing interstitial pneumonitis. MBLs were found in the cytoplasm of especially swollen alveolar epithelial cells. MBLs and MBs had almost similar characteristics morphologically and tinctorially under the light microscopy. MBLs were composed of intermediate type fine fibrils which were positive for anti-keratin antibody. These findings suggested that MBLs were a kind of pathological keratinization of alveolar epithelial cells. Although the origin of MBL containing cells could not be clarified, they were closely related to type 2 alveolar epithelial cells. PMID- 3962670 TI - Ultrastructural study on an appendiceal carcinoid tumor showing intra-nerve fiber growth. AB - Ultrastructural and immunohistochemical studies on an appendiceal carcinoid tumor in a 53-year-old man disclosed an intimate association of nerves and tumor cells. Electron microscopy revealed that the tumor nests were composed of neurosecretory cells containing neurosecretory granules and peripherally-located Schwann cells encasing axons. Some tumor nests were continuous with nerve fibers invested in the common basal lamina. These findings suggest that at least some carcinoid tumors of the appendix show intra-nerve fiber growth, and that the neurosecretory cells might be present in the nerve fibers from the beginning or infiltrated into the nerve fibers at a very early stage of neoplastic transformation. PMID- 3962671 TI - Cornelia de Lange syndrome with intracranial germinoma. AB - An autopsy case of Cornelia de Lange syndrome with intracranial germinoma is reported. Clinically, the patient was diagnosed as having this syndrome at one year of age, she was found to be suffering from diabetes insipidus at 18 years of age and soon she had an accidental death. The autopsy disclosed that the tumor grew from the hypothalamus to the optic nerve and the posterior lobe of the hypophysis. Microscopically, this tumor was a germinoma with a "two cell pattern". On the other hand, examination by peroxidase-antiperoxidase complex (PAP) method of the anterior lobe of the hypophysis demonstrated that thyroid stimulating hormone (TSH) and follicle-stimulating hormone (FSH) producing cells had decreased. PMID- 3962672 TI - Suppression of in vivo granulopoiesis by anti-asialo GM1 serum. AB - In vivo effects of anti-asialo GM1 (GA1) serum on hemopoiesis were studied by morphological examination of the blood, bone marrow, and spleen and by measuring the number of granulocyte-macrophage colony-forming units (CFU-GM) per femur after injecting of the anti-serum into mice intraperitoneally. The number of circulating lymphocytes markedly decreased 2 days after injection and then recovered, but circulating granulocytes gradually declined and reached a nadir at 6 days, then rapidly recovered. Granulopoietic activity in the bone marrow was reduced on day 2, but recovered profusely from day 4, followed by marrow neutrophilia on day 10. The spleen showed marked extramedullary granulopoiesis on days 6 and 10. CFU-GM per femur increased by 24 hours, reaching a maximum value 250% of normal on day 3, then returned to the normal level. CFU-GM growth was not affected by the treatment of anti-GA1 serum plus complement in vitro. These results suggest that the proliferating compartment of the myeloid series in the bone marrow was eliminated by anti-GA1 serum injection that led to a decrease in granulocytes and an increase in CFU-GM. PMID- 3962673 TI - The relationship between arteriosclerosis and the wave line of aorta. AB - The wave line is a structure that is frequently observed in aorta. Grossly this structure (wave line), measuring 0.3-0.5 cm in width and 5-10 cm in length, runs longitudinally or spirally along the long axis of the aorta. The distribution and the relation with arteriosclerotic plaque of wave line were studied. The wave line had three predilection sites: A) the wave line running down from closure of Botallo duct to ostium of 6-8th intercostal artery, B) the wave line between ostium of both renal arteries, C) the wave line running down from lumbar artery to iliac arteries. The wave line observed in the aortae of neonates gradually increased with age. Its frequency is about 80-100% in the second and the third decades. The association of arteriosclerosis with the wave line was frequently observed, especially on "C" region. Fifty-five percent of arteriosclerotic plaques in the fourth decade corresponded with the wave line. PMID- 3962674 TI - Electron microscopic studies of macrophages in early human yolk sacs. AB - Distribution and fine structure of macrophages were studied in 10 human embryos in the 6th and 7th week of gestation, 5.5 to 12 mm in crown-rump length. The yolk sac macrophages were found in the extravascular mesenchymal tissues and intravascular spaces long before the first appearance of bone marrow and lymphatic tissues in the embryos. In addition to the macrophages, the fibroblastic cells and the cells of erythropoietic series were also present in the extravascular space. The macrophages showed a variety of cellular structures suggesting transition from immature cell type with no heterophagolysosomes to mature cell type in phagocytosis. The mature macrophages avidly phagocytized the primitive erythroblasts and occasionally platelets. They were positively stained for lysosomal enzymes and were characterized by numerous pleomorphic heterophagolysosomes which exhibited various stages of digestion of phagocytized blood cells. The origin of intravascular macrophages may be in either migrated extravascular macrophages or phagocytic endothelial cells. The phagocytosis and degradation of erythroblasts appear to be one of the main functions of yolk sac macrophages. The presence of the macrophages in mitosis indicates their proliferation in situ. PMID- 3962675 TI - Comparison of seven cell lines derived from human gastric carcinomas. AB - In an attempt to elucidate various histological features of gastric cancers, seven human gastric adenocarcinomas were studied in vitro and in nude mice. Growth pattern of each cultured cell line in vitro corresponded well to the histological type of parent tumor. The cell lines, MKN7, MKN74, and MKN28 derived from differentiated carcinomas showed morphological characteristics of intestinal differentiation in cell polarity and microvilli with core-filaments in vitro as well as in nude mice. However, they gradually diminished the characteristics in course of time. The cell lines, MKN 45 and OKAJIMA, derived from undifferentiated carcinomas, had natures of not only ordinary gastric mucosa but also intestinal metaplastic mucosa. They seem to have multipotentiality for differentiation, and preserved well the natures for long periods of culture. The KWS-I cell line composed of undifferentiated cells in vitro displayed the potential for differentiation in nude mice. However, the differentiation of KATO-III cells derived from a signet-ring cell carcinoma was suppressed in nude mice. The common abnormality of chromosome was not found, and the growth rate in vitro was not dependent on the histological type of parent tumor. PMID- 3962676 TI - Metabolic bone disease and aluminium contamination in 38 uremic patients. A bone histomorphometric study. AB - Iliac crest biopsies from 38 uremic patients, 26 hemodialysis, and 12 chronic uremics from a nephrology department with verified aluminium free dialysis water were investigated with histomorphometric method and aluminium-specific staining. For both the uremic and the dialysed group the results showed a high incidence of both metabolic bone disease (75%, 69% respectively) and aluminium contamination (25%, 62%). PMID- 3962677 TI - Silent pituitary adenomas. An ultrastructural study. AB - Thirty cases of silent pituitary adenomas were studied clinico-morphologically and classified into 4 groups according to their fine structural characteristics. Tumors poor in organelles (7 cases) and typical oncocytomas (6 cases) produced pituitary insufficiency significantly more frequently than did tumors with moderately oncocytic changes (10 cases) and non-oncocytic, organelle-rich adenomas (7 cases). The latter 2 groups were more prone to proliferate suprasellarly. Postoperative, short-term follow-up studies showed that intrasellar disease was common in all groups, whereas suprasellar disease was more frequent among the latter 2 than in the former 2 types of adenomas. Hence, it seems possible from the fine structure to deduce a subgrouping of clinical significance. PMID- 3962678 TI - Mammary carcinoma: comparison of DNA-content in the primary tumor and the corresponding axillary lymphnode metastases. AB - Twenty primary mammary carcinomas and their corresponding axillary lymphnode metastases were studied. The DNA-content of individual tumor cells was measured in sections from the original paraffin embedded specimens. Comparison between the DNA-patterns obtained from the primary tumor and the corresponding metastases showed very close agreement in all but one case. Both euploid and aneuploid tumors were represented. In spite of having lymphnode metastases at operation, 8 patients survived more than 10 years after operation. All of these patients had euploid tumors, in contrast to 11 patients who died within 2 years, in whom all but one of the tumors showed aneuploid DNA-patterns. The results suggest that tumor progression in terms of lymphnode metastases is usually not associated with major changes in tumor nuclear DNA-content. PMID- 3962679 TI - Rheumatoid pleurisy. Specificity of cytological findings. AB - The cytological findings in pleural exudates from patients with rheumatoid arthritis are epithelioid cells, giant cells, cholesterol crystals and an amorphous granulated material. An important additional feature, we find, is lack of mesothelial cells. Based on 23 pleural fluids from 7 patients with rheumatoid arthritis and 44 pleural fluids from patients with various other diseases, a blind study showed, that these typical cytological findings in combination with lack of mesothelial cells were specific in pointing towards the determined diagnosis rheumatoid pleurisy. PMID- 3962680 TI - Precancerous changes in the anal canal epithelium in resection specimens. AB - Systematic histological examination for precancerous changes was carried out on 139 anal canals resected for anal or colo-rectal tumours or for inflammatory bowel disease. Severe squamous dysplasia or carcinoma in situ were found in 13 of 16 anal canals harbouring variants of squamous carcinoma but not in others. The lesions were mainly or totally located to the anal transitional zone (ATZ) in 11 cases and only in 2 cases exclusively to the squamous zone below the dentate line. Dysplastic areas separate from the tumour were found in 6 of the 13 cases. Junctional melanocytic activity and atypical melanocytic hyperplasia located in the ATZ as well as the squamous zone were present in 1 of 3 cases of malignant melanoma. The findings underline the close relationship between dysplasia and invasive carcinoma in the anal canal. Further they support the concept that basaloid, mucoepidermoid and some ordinary squamous carcinomas arise in the ATZ, and that this may also be the point of origin for malignant melanoma. A search for precancerous changes for anal canal tumours should therefore include the whole ATZ, i.e. in some cases up to 2 cm above the dentate line and it should be borne in mind that the lesions may be spotty. PMID- 3962682 TI - TGF-mediated oscillations in the proximal intratubular pressure: differences between spontaneously hypertensive rats and Wistar-Kyoto rats. AB - A highly sensitive oscillatory tubulo-glomerular feedback (TGF) response has previously been demonstrated in normotensive Sprague-Dawley rats. The purpose of the present study was to examine whether such as oscillating TGF-response could be elicited in Wistar-Kyoto rats (WKY) and genetically hypertensive rats (SHR) and furthermore if any differences in the TGF-response characteristics between SHR and WKY rats could be detected. The closed loop function of the TGF-system was studied. In 12-18-week-old WKY rats regular oscillations in the intratubular pressure occurred spontaneously. The median frequency were 29.7 mHz (range 20 46.7 mHz). In SHR rats, spontaneous oscillations also occurred, but these were highly irregular. Spontaneous oscillations were more frequent in WKY than in SHR (88% vs. 54%). In both strains, oscillations could be elicited by free flow microperfusion with artificial tubular fluid (ATF). When furosemide was added to the ATF in a concentration of 0.1 mM, the oscillations were abolished in both strains of rats. It is concluded that, in both strains of rats the oscillatory phenomena depend upon TGF activity. It is suggested that the irregular pattern of the oscillations observed only in SHR rats may represent a chaotic process. PMID- 3962681 TI - Ionic transport in individual renal epithelial cells from adult and young rats. AB - Renal epithelial cells were isolated from the outermost superficial cortex of adult and young rats. The cells, likely of proximal origin, were plated on silicon pieces, and cultured during 1-3 days. Intracellular content and concentrations of K, Na, Cl, and P, and the kinetics of change in intracellular content, after inhibition of Na-K ATPase by incubation with ouabain or in K-free medium, were measured in individual cells in small populations using electron probe analysis. In control medium, concentrations in mM were approximately: K, 130; Na, 15; Cl, 28; P, 140. After 6 h inhibition of Na-K ATPase, cells exchanged all K for Na, and the intracellular Na concentration increased to 139 mM in K free medium. The Cl concentration increased at most to 46 mM. The sum of intracellular K + Na + Cl did not increase more than 25% after 24 h incubation in K-free medium. There were no differences in intracellular K, Na, and Cl for adult and young rat cells in similar conditions. The half-times of K efflux and Na influx after inhibition of Na-K ATPase measured in adult rat were approximately 16-20 min. In the absence of serum, in K-free medium, the half-times of K efflux and Na influx in young rat cells were approximately 30 min, significantly higher than the half-time in the presence of serum, and with ouabain, being approximately 13 min. Histograms of distributions of K and Na content showed that the cells behaved as a single functional population. Ouabain Ki was estimated to be 10(-4) M. After 24 h preincubation in K-free medium, when returned in 5 mM K containing medium, adult rat cells recovered rapidly normal intracellular K and Na concentrations. Using this approach, expression of the kinetics ionic transport properties of renal epithelial cells during development, and the hormonal influences on terminal differentiation may be studied. PMID- 3962683 TI - A study of proximal tubular compliances in normotensive and spontaneously hypertensive rats, and the effect of anaesthesia on the compliance. AB - Proximal tubular compliance (C) was measured in free flow microperfusion experiments from the initial slope of the increase in proximal luminal pressure divided by the step input of volume flow delivered from a microperfusion pipette inserted in a downstream proximal convolution. Five groups of rats were studied: Munich Wistar (WU, n = 11) and Sprague-Dawley rats (SPRD, n = 6) anaesthetized with inactin; and SPRD (n = 11), Wistar Kyoto (WKY, n = 9), and spontaneously hypertensive rats (SHR, n = 11) anaesthetized with halothane. In the inactin groups, C was: 0.309 +/- 0.161 and 0.266 +/- 0.136 nl mm Hg-1, respectively. In the halothane groups, C was: 0.125 +/- 0.023, 0.125 +/- 0.029, and 0.119 +/- 0.0127 nl mm Hg-1, respectively. The means in the inactin groups were significantly higher than those from the halothane groups (P less than 0.001). It is concluded that the choice of anaesthetics has a profound influence on the proximal tubular compliance in the rat, and that the compliance of SHR is equal to that of normotensive rats. PMID- 3962684 TI - Myogenic and neurogenic control of electrical and mechanical activity in human oviductal smooth muscle. AB - Isolated strips from isthmic and ampullary muscle layers of the human fallopian tube were investigated with the sucrose-gap technique and in organ baths. Generally good correlation existed between electrical and mechanical activity, but dissociation was also noted. The isthmic external longitudinal layer (IEL) was characterized by slow waves of depolarization and broad 'spikes'. Tonic contraction followed depolarization, and phasic waves followed the spikes. In the other layers, regular spikes and phasic contractions dominated. Late in the menstrual cycle, more irregular patterns and slow waves, which could synchronize spike activity, were found. Automaticity tended to be highest in the late proliferative phase. Active response to stretch was best demonstrated in IEL. Excitatory alpha-adrenergic responses (hypopolarization, firing and contraction) to noradrenaline and nerve stimulation dominated in the IEL. In the other layers, beta-adrenergic inhibition prevailed. Non-adrenergic, non-cholinergic neurogenic inhibition was demonstrated. Decrease in spike frequency and hyperpolarization seemed to be as prominent as during beta-adrenergic inhibition. Muscarinic stimulation by acetylcholine was recorded as depolarization, spikes and contraction. However, a role for cholinergic nerves could not be defined. Thus, the human oviductal smooth muscle belongs to the single unit category; its activity can be modified during the menstrual cycle, by stretch and by excitatory and inhibitory nerves. PMID- 3962685 TI - The influence of maternal protein deprivation on the developmental pattern of serum immunoreactive insulin-like growth factor 1 (IGF-1) levels. AB - The influence of maternal protein deprivation on body and brain growth and on serum immunoreactive insulin-like growth factor I (IGF-I) levels was examined in rats during development. The offspring of protein-deprived mothers were significantly growth-retarded postnatally and showed an altered developmental pattern of serum immunoreactive IGF-I levels. In contrast to control animals, between days 5 and 20 postnatally, a significant elevation in serum immunoreactive IGF-I levels which peaked at day 15 was found. However, in adult growth-retarded rats a significant reduction in serum immunoreactive IGF-I levels was found. These findings suggested the preweaning period to be critical for the development of the mature somatomedin system. PMID- 3962687 TI - Some observations made by intracellular recordings in a primary astrocyte culture and a glioblastoma '138 MG'. AB - Intracellular recordings were performed in a primary astrocyte culture from rat brain and in a human glioblastoma cell line, 138 MG. The technique proved insufficient to verify the heterogeneous composition of the primary astrocyte culture, since this study shows most cells present in the culture to have similar resting membrane potential, membrane impedance, membrane potential/impedance relationship and K+-sensitivity. With the exception of macrophages, identified by their response to externally applied yeast particles, the results do not allow the identification of different cells that are known to be present. The membrane potential of the primary astrocyte was -68 +/- 14 mV, and the membrane potential of the 138 MG cells -37 +/- 15 mV. The membrane potential of cells in the primary culture have a K+-sensitivity resembling that of astrocytes in situ, whereas the K+-sensitivity of 138 MG more resemble that of a dedifferentiated cell. A reduction of 0.95 mm Ca2+ to o mM depolarizes the astrocyte with 9.6 mV and hyperpolarizes the glioma cell 2.6 mV. PMID- 3962686 TI - Sympathetic inhibition after surgical reversal of renovascular hypertension in rats. Role of vagal nerves. AB - The present study was undertaken to study the changes in efferent renal sympathetic nerve activity (RSNA) and heart rate (HR) during the acute fall in blood pressure after surgical reversal of two-kidney, one-clip renovascular hypertension in rats, and to explore if cardiopulmonary vagal afferents can influence sympathetic outflow in this situation. In 14 rats with a MAP of 199 +/- 6 mmHg the renal artery clip was surgically removed and after 90 min MAP had decreased to 109 +/- 7 mmHg. The HR had then decreased by 26 +/- 15 beats min-1 (P less than 0.05) and RSNA did not increase as expected, but was somewhat reduced (84 +/- 8% of control). In contrast, lowering pressure with nitroprusside to the same extent produced large and significant increases in HR and RSNA in seven other renal hypertensive rats. Acute bilateral vagotomy was performed in seven of the declipped rats, which induced an immediate increase in MAP (+35 +/- 10 mmHg, P less than 0.05), HR +28 +/- 10 beats min-1, P less than 0.05) and RSNA (+51 +/- 19%, P less than 0.05). A few minutes afterwards the vagotomy pressure again started to fall and was, after another 90 min 107 +/- 10 mmHg together with slight reductions in HR and RSNA. Another group of six rats were initially exposed to bilateral vagotomy. In these vagotomized rats declipping also induced hypotension (204 +/- 10 to 95 +/- 7 mmHg, P less than 0.001), together with tendencies of decreases in HR (425 +/- 17 to 397 +/- 17 beats min-1) and in RSNA (-4 +/- 6%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962688 TI - Effects of hypotension induced by adenosine on brain surface oxygen pressure and cortical cerebral blood flow in the pig. AB - Six pigs were anaesthetized with ketamine in combination with fentanyl and droperidol and paralysed with pancuronium. The pigs were tracheotomized and ventilated mechanically. Mean arterial blood pressure, MABP, was lowered from 97 +/- 21 mmHg stepwise to 58 +/- 2, 33 +/- 4 and 22 +/- 4 mmHg by intravenous infusion of adenosine (4-8 mg kg-1 min-1). Regional cerebral blood flow (rCBF) was measured directly onto the cortex of the brain by local atraumatic application of 133xenon. Brain surface oxygen pressure (PtO2) was obtained using a multiwire oxygen surface electrode. At the level of 60 mmHg, rCBF showed a significant increase, while flow values were not changed from initial values with further hypotension. Ten minutes after adenosine was discontinued, rCBF showed a rebound effect with higher values than initially. During normotension mean cortical PtO2 varied between 2.1 KPa and 3.9 kPa. During adenosine infusion PtO2 was increased at MABP-levels of 60 and 30 mmHg, while at 20 mmHg a decrease was seen in all animals. After discontinuation of the adenosine infusion, PtO2 values were higher than those measured at the initial normotension, a similar rebound phenomenon as seen with rCBF. During the experiments all hypotensive levels could be maintained at constant level without progressively increasing infusion rates, indicating no tachyphylaxis during these time periods. After discontinuation of the drug, blood pressure did not fully reach pre-hypotensive level within 10 min. Thus, hypotension induced by adenosine down to a MABP of 30 mmHg in animal experiments does not cause deterioration in either cerebral blood flow or oxygen pressure. PMID- 3962689 TI - [Modification of pattern A]. AB - Taking into account the follow-up of coronary heart disease patients from the acute phase of illness up to the social reinsertion the author proposes an approach whose goal is to modify Pattern A Behavior. Various approaches as behaviorism, dynamic psychology and psychoanalysis are complementary and have each one its importance in order to treat these "serious psychosomatic patients" as are coronary heart disease patients. PMID- 3962690 TI - [Prognostic significance of the type A behavior pattern]. AB - In a clinical study on cardiac rehabilitation, the authors point out that the outcome of coronary heart disease patient is profoundly conditioned by the intensity of Pattern A behavior. The need to modify this behavior is evident. PMID- 3962691 TI - Methodological problems of body image research in anorexia nervosa patients. AB - The significance of the disturbed body image as a psychopathological phenomenon in anorexia nervosa patients is quite evident to clinicians. It appears to be difficult, however, to assess this disturbance in a more objective way. The studies on body image perception discussed here make use of objective psychometric methods of measurement: image marking procedure, visual size estimation apparatus, distorting photograph technique, and video distortion. The following methodological problems are discussed: reliability, validity, experimental situation, and selection of subjects. Experimental data are presented on 52 anorectic patients as well as 210 control subjects, studied with three different perceptual tasks. PMID- 3962693 TI - Towards a better delineation of ejaculatory disorders. AB - The inconsistent use of the term "retarded ejaculation" demonstrates the conceptual confusion in the literature on ejaculatory dysfunctions. Therefore, a classification system is proposed which comprises three major groups of ejaculatory disorders: unsatisfactory timing of ejaculation (premature and retarded ejaculation), absence of ejaculation (partial and complete ejaculatory inability), and ejaculation without pleasure (ejaculatory anhedonia and painful ejaculation). A more accurate descriptive delineation of ejaculatory disorders has considerable implications for treatment which in some dysfunctions, especially primary complete ejaculatory inability, still has limited possibilities. PMID- 3962692 TI - [Psychosomatics in dermatology. Beginning with psoriasis]. AB - The psychosomatic practice is first to question the psychosomatician's place, here around a psychosomatic phenomenon, Psoriasis. That is to listen to the patient, in other words to start from words of moan to bascule to his request, where all the Subject resides, in conscious and inconscious dimensions. "To support the subjective request" so specifies the psychosomatic attitude. The psychosomatic practice obliges to the exactness of the message. Metaphorically the envelope is not the entire letter. Finally, it remains the enigma of the inscription of the Psychosomatic Phenomenon (P.P.), that is to say the inscription of the inconscious, particularly reported to the body and to the look. PMID- 3962694 TI - Emotional distress in a first-year university population. AB - An investigation of the emotional distress was conducted among a large sample of first-year university students. Results of the study indicate the presence of high levels of emotional distress. The data also show evidence of strong significant intercorrelations among the variables of emotional concern. It is concluded that there exists a high risk group of first-year university students, who complain of various emotional symptoms. PMID- 3962695 TI - [Certain reflections of a child psychiatrist on school failure]. AB - School failure is an important phenomenon about which not only the teachers are very much concerned, but also the sociologists and the political authorities. As it is the main reason why people consult them, child psychiatrists, psychologists and professionals in mental health are led to consider, beside the specific psychopathological factors, the socio-cultural and pedagogical aspects involved in different ways everytime a child meets difficulties at school. The programs of intervention resulting from this dynamic approach raise the question of the limits of the psychiatrists' competence and practice. The cooperation with the school in particular should take into account the risks arising from any confusion between therapeutic and pedagogic responsibilities. Finally, serious school failure leads us to question how special education works, when considering inadaptation only as a consequence of deficits. We should compare the advantages of such a system in connection with the possibilities-still to be imagined- of integration through the channel of ordinary school teaching. PMID- 3962696 TI - [Case of drug pseudoincompatibility]. PMID- 3962697 TI - A nosological study of patients presenting with somatic complaints. AB - The nosological status of patients presenting with multiple somatic complaints with reference to ICD-9 was examined in the present study. In 22% of the cases it was not possible to arrive at a single ICD-9 diagnosis. The majority of these cases had combinations of somatic, anxiety and depressive symptoms. Nine percent of the cases could not be given any psychiatric diagnosis using ICD-9. These cases had very few psychological symptoms and were not identified as psychiatric cases by the present state examination. The various possible factors responsible for this diagnostic uncertainty have been highlighted. PMID- 3962698 TI - A validity study of a new rating scale for psychiatric patients. AB - A criterion validation of a new scale, REHAB (Rehabilitation Evaluation Hall And Baker) (1) is described. Forty-three long-stay psychiatric patients from two wards were observed by a psychologist over a 2-week period using a time sampling procedure. The observed behaviour was coded into predetermined categories based on Blunden & Kushlick's (2) concept of engagement. Also during this period the ward nurses rated the 43 patients using the REHAB assessment. The time sampled observations were correlated with REHAB factors and items. Five hypotheses about the relationship between the two measures were tested. Four of the five hypotheses were supported by the data. Overall, despite certain limitations of the study, it is concluded that evidence is provided for the criterion validity of REHAB. PMID- 3962699 TI - Diagnostic reliability among French psychiatrists using DSM-III criteria. AB - The reliability of French psychiatrists using DSM-III axis I disorders was studied using videotaped semi-structured diagnostic interviews, 136 psychiatrists with different levels of clinical experience classified 11 cases into six preselected diagnostic categories: Schizophrenia, Major Depressive Episode, Dysthymic Disorder, Cyclothymic Disorder, Other Psychiatric Diagnosis, No Present Psychiatric Diagnosis. A modified Kappa coefficient for multiple observers was used to calculate agreement and thereby estimate reliability. We obtained an overall Kappa of 0.55 for six categories, and when the Dysthymic and Cyclothymic Disorders were combined into one class, i.e. other specific affective disorders, the Kappa value increased to 0.64. The Kappa value for individual categories was best for Schizophrenia and Major Depressive Episode, and poor for Dysthymic and Cyclothymic Disorders. Clinical experience or prior knowledge of DSM-III criteria did not have a significant effect on reliability. PMID- 3962700 TI - Validating an experiential measure of parental style: the use of a twin sample. AB - A study of monozygotic (MZ) and dizygotic (DZ) twins was undertaken to assess further the properties of the Parental Bonding Instrument (PBI), a self-report measure of parental care and overprotection, to examine for associations between PBI and mood (trait anxiety and depression) scores, and to assess the genetic contribution to anxiety and depression scores. Mean correlations on the PBI scales were high and strikingly similar for the MZ and DZ twin pairs, supporting the construct validity of the PBI as a measure of parental characteristics. Higher mood scores were linked with less parental care and greater parental protection, the associations being stronger with anxiety than depression. Finally, methodological limitations in estimating heritability are noted. PMID- 3962701 TI - The paranoid quotient. A BPRS ratio for exploring subtypes in schizophrenia. AB - A paranoid quotient developed from two items of the Brief Psychiatric Rating Scale, suspiciousness and disorganized speech, is presented as a novel method for estimating the degree of paranoia of chronic schizophrenic patients. The mean quotient for paranoid schizophrenic patients was 70 which significantly exceeded that of non-paranoid patients (mean quotient = 47, P less than 0.002). This difference proved more discriminatory than that obtained by examining the constituent items alone. Hence, the quotient strategy offers a promising way to quantify paranoid symptoms in a population of patients in whom diagnostic subtyping is often difficult. PMID- 3962702 TI - Visually stimulated saccadic eye movements in patients treated with lithium. AB - Saccadic eye movements were stimulated with the aid of 11 light spot stimuli, 10 of which were arranged at 3 degrees, 6 degrees, 9 degrees, 12 degrees, and 15 degrees to the left and right of the central stimulus. The parameters average and maximal eye movement velocity and latency were precisely investigated. 19 patients averaging 6.6 years on lithium prophylaxis were compared with 23 healthy controls. Significant differences between the two groups could not be found at this level of function. PMID- 3962703 TI - The role of ward structure on nursing staff behaviours: an observational study of three psychiatric wards. AB - Variable rates of staff-patient interaction were found between three wards, which differed in the degree of programme structure, staff-patient ratios, and patient chronicity. Highest rates of staff-patient interaction occurred where a highly structured ward programme operated in a closed ward with chronically disturbed patients, and this was more likely to increase as staff-patient ratios decreased. The lowest staff-patient interaction rates occurred in acute, open and closed wards. Further, acute ward patients received negligible attention from nurses in terms of staff-patient interaction after 10 days following admission. PMID- 3962704 TI - Is lithium justified after one manic episode? AB - Fifty-seven per cent of patients with a DSM III diagnosis of mania were discharged on lithium after the first admission. This group differed from those not prescribed lithium in terms of length of admission, severity of symptoms, sex and social class. Outcome was not influenced by prescription of this drug even though it was shown to be an effective prophylactic. The reasons for this are discussed and recommendations for future clinical practice are made. PMID- 3962705 TI - To keep the alcoholic in out-patient treatment. A differentiated approach through treatment contracts. AB - Eighty-two alcoholics were offered a 2-year out-patient programme characterized by stressing the patients' own decisions both in joining the programme and in the choice of objectives and methods, by repeated feedbacks through treatment evaluations, and by relapse prevention. The 58 patients who accepted were more often married than the others. All but eight completed the programme. The most important treatment components were ranked by the patients. Individual counselling was ranked highest, followed by evaluations of contract with therapist, disulfiram and biofeedback by means of gamma-GT. Patients with alcohol dependence more often preferred instrumental components, such as disulfiram and gamma-GT, while the others more often preferred psychological components, such as individual counselling and contract evaluations. Preference of psychological components was not found to be related to degree of personality disturbances. It is suggested that to effectively keep the patients in treatment in the present programme depends on the combination of patients' active engagement, continuous feedback and individualized treatment objectives. PMID- 3962706 TI - Fatigue and anxiety in surgical patients. AB - In 15 patients fatigue was assessed by an arbitrary scale, anxiety by the State Trait Anxiety Inventory and concentration by various concentration tests before and 10 and 30 days after uncomplicated elective, abdominal surgery. Preoperatively, fatigue correlated to state-anxiety (r = 0.68) and trait-anxiety (r = 0.66). From pre- to postoperatively, fatigue had increased on both day 10 and day 30. State-anxiety decreased, while trait-anxiety was unchanged. Increase in fatigue 30 days after surgery correlated to increased state-anxiety (r = 0.65), but not significantly to trait-anxiety (r = 0.38). No correlation was found between increase in fatigue 30 days after surgery and the preoperative degree of state- and trait-anxiety, (r = -0.09, r = -0.29); respectively. Neither pre- nor postoperative performance during concentration tests correlated to postoperative fatigue. It is concluded that preoperative anxiety may not be decisive for the development of postoperative fatigue. Postoperative fatigue may be considered a symptom of deterioration in cardiovascular function, neuro muscular performance and nutritional status rather than psychological factors. PMID- 3962707 TI - A brain syndrome associated with delayed neuropsychiatric sequelae following acute carbon monoxide intoxication. AB - A summary of clinical data is presented on 34 men and 52 women patients with brain syndrome associated with delayed neuropsychiatric sequelae following acute carbon monoxide intoxication. Their ages ranged from 34 to 82 years, with peak incidence in the sixth and seventh decade. Possible etiological factors were age, duration of unconsciousness on acute intoxication, and previous physical illness. The onset was relatively sudden after the apparent clear period which ranged from 2 to 40 days (mean 22.5 days). The most frequent symptoms were apathy, dull facial expressions, dementia, such as amnesia and disorientation, hypokinesia, mutism, irritable distractibility, urinary and/or fecal incontinence, gait disturbance and abnormal neurological signs and reflexes. EEG was abnormal in 33 of the 57 cases (58%). Of 27 patients who were given a computed tomographic brain scan, 15 patients were abnormal. The prognosis was relatively good in the follow up study of 56 patients. Only age was related to a better prognosis. PMID- 3962708 TI - Personality and psychosis: use of the Standardized Assessment of Personality. AB - The Standardized Assessment of Personality, a semistructured interview for use with an informant, was used with a relative or a close friend to determine the premorbid personality of 100 consecutive patients admitted with major psychiatric disorders - major affective disorders (18 manics, 35 depressives), schizophrenia (28) and other functional psychoses (19). Forty-four per cent of the entire sample had an abnormal personality as defined by the presence of one of 10 prominent traits to a marked degree. A further 6% had the same traits to a lesser degree. The proportion of patients with an abnormal personality (all types) was comparable across the four diagnostic groups (manics 39%, depressives 54%, schizophrenics 39%, other functional psychotics 37%). However, if one included all traits (marked and mild), patients with an affective disorder had more between them than did the non-affective groups. This difference was largely accounted for by cyclothymic, anxious and obsessional traits. The schizophrenics and other functional psychotics had surprisingly few prominent traits and, in particular, a schizoid personality rarely preceded a schizophrenic illness. PMID- 3962709 TI - Prevalence of depressive and other symptoms in elderly Finnish men. AB - The prevalence of depressive and other symptoms were studied in Finnish men aged 65 to 84 years and living either in eastern (n = 310) or in southwestern (n = 378) Finland. The Zung self-rating depression scale showed depressed affect, fatigue and suicidal thoughts to be more common in the east, but indecisiveness to be more prevalent in the south-west. The mean of the sum scores in the Zung scale was 37.8 (+/- 8.4) for the eastern and 37.2 (+/- 8.3) for the south-western population, and no differences were found between the areas in this respect. However, many of the other symptoms, including somatic and psychosomatic (such as pains, dyspnea, nausea, impaired memory, apathy, itching skin and sight disturbances) were more common among men living in eastern Finland. The former findings support the idea that there are differences in the affects between men living in the east and men living in the south-west, but, as a whole, depressive symptoms are equally prevalent in both elderly male populations. The latter finding may reflect the well-known differences in the prevalences of somatic diseases between these two areas. PMID- 3962710 TI - The axial view of the patello-femoral joint. Description of a new radiographic method for routine use. AB - A new and simple method for the axial view of the patello-femoral joint is described. The patients are examined in the erect position with a standardized inclination of the lower leg of 15 degrees. If a high or a low vertical position of the patella occurs, the device allows a change of the inclination of the lower leg with optimum axial views as a result in more than 94 per cent of 300 knee examinations. The device is recommended for standardized and reproducible examinations of the patello-femoral joint. PMID- 3962711 TI - Bone mineral measurement with a continuous roentgen ray spectrum and a germanium detector. AB - A new technique for determination of the bone mineral content in the vertebral body by means of a laterally directed roentgen ray beam is presented. By using a stable high voltage for the roentgen tube and a stable detector with very high energy resolution, the amount of bone mineral in the path of the radiation beam can be determined with correction for both fat and lean soft tissue. The results so far indicate that the technique is useful for objective determination of the bone mineral content in the vertebral body. PMID- 3962713 TI - Proton magnetic resonance relaxation times T1 and T2 related to postmortem interval. An investigation on porcine brain tissue. AB - In order to establish the validity of in vitro determination of the proton magnetic resonance (MR) relaxation times T1 and T2 in brain tissue at increasing time delay after death or operative excision, 81 brain tissue samples from 23 pigs were analyzed repeatedly. These samples, representing cortex, caudate nucleus and white matter, were studied microscopically after MR measurements. The T1 values exhibited no time dependence and the T2 values decreased slightly during the interval 2 to 90 hours after death. The samples were stored at +8 degrees C between the measurements. These results indicate that reliable in vitro measurements can be obtained in autopsy or surgical brain tissue specimens within 90 hours after death or excision, if handled properly. PMID- 3962712 TI - Anatomic variations of the human cochlear aqueduct. A radioanatomic investigation. AB - The cochlear aqueduct follows a course through the petrous pyramid that varies from straight and steeply vertical to a curvilinear and horizontal. Its course and length are correlated to the pneumatization of the pyramid and also to the volume of the jugular fossa. These two factors influence the radiographic reproduction of the cochlear aqueduct, especially in computed tomography in the axial transverse projection but to a far lesser degree in multidirectional tomography. PMID- 3962714 TI - Occurrence of an intrahepatic porto-arterial shunt after hepatic artery embolization with Gelfoam powder in rats and rabbits. AB - Postmortem perfusion studies were carried out following hepatic artery embolization (HAE) with Gelfoam powder in rats (n = 17) and rabbits (n = 10). The inflow of barium particles into the hepatic arteries after portal vein injection (porto-arterial shunt: P-A shunt) was analyzed by stereomicroscopic and histologic examinations. A P-A shunt was observed in 12 of 17 rats (71%) following HAE (embolization group). The difference in occurrence rates of P-A shunt between control (1/12 = 9.2%) and embolization groups was statistically significant (chi 2, p less than 0.01) in rats. In rabbits, a P-A shunt was seen in only one of 10 animals in the embolization group. P-A shunting may have an important role in reconstructing the blood supply to hepatic tumors after HAE, and administration of anticancer drugs via the portal vein following HAE might be effective. However, the differences among different species of animals should be considered before clinical application. PMID- 3962715 TI - Morphologic changes following nephrostomy track dilatation. An experimental investigation in the pig. AB - The effect on the renal parenchyma caused by rapid dilatation of a nephrostomy track to 24 F to 30 F was studied on 9 kidneys in 5 pigs. Angiography at different intervals up to 5 weeks was used in combination with histology. Moderate bleeding and short lacerations were observed around the puncture site in all kidneys. Complications included one transient pyelovenous reflux, one organized abscess following perforation of the upper pole, and two cases of hydronephrosis caused by abscess and inflammation. These infections were probably due to the prevailing sanitary conditions. No arteriovenous fistula formation was seen. Minimal scars were encountered after 4 to 5 weeks follow-up. Transparenchymal access to the pelvocaliceal system through percutaneously established large tracks seems to cause limited damage which resolves in minor scars provided perforations are avoided by an optimum technique and infections are prevented or treated appropriately. PMID- 3962716 TI - Radiologic findings after fundoplication compared with a pH reflux test and symptoms. AB - In a follow-up after fundoplication, 61 patients underwent a double contrast examination of the stomach and a radiologic examination to detect any gastro oesophageal reflux. The radiologic findings were compared with pH reflux test and symptoms. Gastro-oesophageal reflux was found in 7 patients at radiologic examination. None of these patients had an adequate fundoplication at a double contrast examination of the stomach and all had symptoms indicating reflux. Recurrence of gastro-oesophageal reflux may be shown at the radiologic examination and predicted by the morphologic appearances at the double contrast examination. PMID- 3962717 TI - Interobserver variation in the radiographic diagnosis of duodenal ulcer disease. AB - Interobserver variation was estimated in radiologists' detection of duodenal ulcer and deformity of the duodenal bulb. A consecutive series of 156 patients with upper abdominal pain had a double contrast barium examination. The films were first read by routine by a specialist in radiology. A second reading was performed by another specialist who did not know the result of the first reading. Overall agreement between the two readings in the detection of duodenal ulcer and deformity of the duodenal bulb was 0.91 and 0.94, respectively. The overall agreement was adjusted for the expected chance agreement and kappa values were calculated. Kappa was 0.63 for the detection of duodenal ulcer and 0.85 for the detection of deformity of the duodenal bulb. PMID- 3962718 TI - Food-stimulated gastro-oesophageal reflux demonstrated by barium examination. AB - A prospective investigation on gastro-oesophageal reflux in 97 consecutive patients has been carried out by means of a barium examination employing the conventional method and after food stimulation. Gastro-oesophageal reflux was observed in 38 patients with and 15 patients without oesophageal symptoms. Gastro oesophageal reflux was induced by two mechanisms, an active component after food stimulation and a passive component after the conventional method including respiratory manoeuvres and leg raising. In 32 patients, only the active component could be demonstrated and in 6 patients only the passive component. In the remaining 15 patients both active and passive components occurred. The clinical significance of the active and passive components in gastro-oesophageal reflux needs further investigation. PMID- 3962719 TI - Ovarian radiation dose during dynamic cystourethrography using videorecording and photofluorography. AB - The ovarian radiation dose in dynamic cystourethrography was estimated by thermoluminescence dosimetry in a phantom and in 26 patients. The urodynamic examination technique was standardized and included fluoroscopy with videorecording and rapid sequence 100 mm fluorography. The examination was performed in the lateral position with dosimeters in the vagina, uterine cavity and rectum. The total dose in the midline was 13 mGy per examination, which compares with 12 mGy in urography. PMID- 3962720 TI - A method for control of the target at aspiration biopsy of non-palpable breast lesions. AB - A method for two-dimensional localization of non-palpable lesions in the breast has been evolved. Even if the depth of a lesion is unknown a good idea of it can be gained from a craniocaudal and a lateral projection. For biopsy, a light intersection guides the biopsy needle during its insertion. Deviation of the needle due to the bevelled surface of the needle tip can be avoided by rotation of the needle. Immediately following the aspiration biopsy, a small amount of contrast medium is injected through the biopsy needle. Marking the depth by means of a contrast medium makes it possible to control the biopsy site in all three dimensions. The flattening and spreading of the breast tissues occurring during compression of the breast may influence the position of a lesion. The flattening can be demonstrated in a cyst. The present report refers to a series of 108 consecutive aspiration biopsies. Diagnostic material was obtained in 92.6 per cent of the cases. PMID- 3962722 TI - Radiography of the carpal scaphoid. An experimental investigation evaluating the use of oblique projections. AB - An experimental investigation demonstrating the value of oblique projections in radiographic examination of possible scaphoid fractures is described. Three cadaver specimens were used, fractured in different places, and radiographs were obtained at different angulations with respect to the vertical plane. Even nondislocated fractures were well demonstrated and it was concluded that a p.a. projection with the tube tilted about 40 degrees distally should always be included in radiographic examination of the carpal scaphoid. PMID- 3962721 TI - Ureteral diameter in low-risk vesicoureteral reflux in infancy and childhood. AB - In order to improve the accuracy of the grading of vesicoureteral reflux (VUR), reference values for ureteral diameter at micturition cystourethrography (MCUG) were established in infants and children with low-risk VUR. Low-risk VUR was defined as VUR not associated with infection, obstruction, calculi, duplication, malformations (except for hypospadia) or neurogenic bladder disturbances. Forty six children (age 1 day-14 years) were selected by examining the records of 12000 MCUG:s performed 1960-1983. Ureteral diameter was measured at the widest point of the ureter on the films from MCUG:s and urographies. Ureteral diameter was slightly larger at MCUG than at urography in the same individuals but the difference was not significant. The ureteral diameter at MCUG also correlated closely to normal values at urography in a previous study. It is proposed that the reference values obtained at MCUG in the present investigation can be used for the differentiation between dilatation and no dilatation in the grading of VUR. PMID- 3962723 TI - [Disorders of heart rhythm in the cervicothoracic syndrome]. PMID- 3962724 TI - Exposure to man-made mineral fibers and respiratory effects in users industry: shipbuilding. PMID- 3962725 TI - Risk factors in infants with paresis of the brachial plexus. PMID- 3962726 TI - Characteristics of recovery of patients with aplastic anemia. PMID- 3962727 TI - Dermatoglyphics in gonadal dysgenesis: analysis of palmar patients. PMID- 3962728 TI - Assay procedures for cathepsin B, H and L activities in rat tissue homogenates. AB - Cathepsin B, H and L activities in small amounts of rat tissue homogenates corresponding to 10 micrograms protein were determined with 7-amino-4-methyl coumarin conjugates as substrates. A new procedure for serum cathepsin H activity was also developed. High cathepsin B and H activities were found in kidney, spleen and liver. Liver cathepsin B, H and L activities in D-galactosamine injured rats were decreased concomitantly with an increase in serum cathepsin H activity. PMID- 3962729 TI - Modified inverse square sensitometry for the determination of the characteristic curve of radiographic screen/film systems. AB - To determine the characteristic curve of the radiographic screen/film systems in a short focal spot-film distance, the inverse square sensitometric method was modified by changing the radiation intensity with two kinds of filters. The characteristic curves obtained in the two exposure series with these two kinds of filters were overlapped to obtain a complete one. The characteristic curve thus obtained was almost the same as the one obtained by the original inverse square sensitometric method. The accuracy of the characteristic curves obtained by the modified method was well-reflected in the clinical radiographs. PMID- 3962730 TI - Improvement of ventilatory function by spa therapy in patients with intractable asthma. AB - Twenty-five patients with intractable asthma had swimming training in a hot spring pool for 3 months. The subjects were divided into three groups according to their clinical symptoms and ages. Changes of ventilatory function during swimming training were observed in in each group. The ventilatory function test revealed that free swimming training in a hot spring pool for 30 min did not induce bronchoconstriction in any of the groups. The values of ventilatory parameters such as FEV 1.0%, %PEFR, %V50 and %V25 were improved after the 3-month swimming training. The improvement of ventilatory parameters, especially %MMF, %V50 and %V25, by the training was most remarkable in the type II asthma group. The percent increase in %MMF, %V50 and %V25 was highest in patients more than 61 years of age, and higher in patients aged 40 to 60 years than in younger patients. PMID- 3962731 TI - The prevalence of hypothyroidism in the elderly. PMID- 3962732 TI - Prognosis in treated hypertension. AB - The aim of this study has been to demonstrate to what extent antihypertensive treatment reduces the survival gap between hypertensives and the general population. In 673 outpatients treated for arterial hypertension, the 10-year survival has been assessed by actuarial methods and compared with expected survival of a matched background population computed from the life tables of the Danish population. In primary hypertension WHO stage I, survival did not differ from that of the background population, a congruence which of course may be a mere chance but excludes any major difference. However, when severe organ involvement was present, as in WHO stage III and renal hypertension, treatment did not eliminate the survival gap. The survival rate did not differ between sexes or between patients with high and low body mass, but decreased with increasing age. Myocardial infarction was the most frequent single cause of death, whereas stroke accounted for less than 10% of all fatalities. PMID- 3962733 TI - Distribution of high density lipoprotein cholesterol according to relative body weight, cigarette smoking and leisure time physical activity. The Cardiovascular Disease Study in Finnmark 1977. AB - The relationship between HDL cholesterol and relative body weight, cigarette smoking and leisure time physical activity were examined in 7338 healthy men and 6768 healthy women aged 20-53 years, living in Finnmark County, Northern Norway. The independent effects of the three factors were examined by an analysis of covariance. In both sexes a strong and almost linear negative association was observed between relative body weight and HDL cholesterol. HDL cholesterol was lower in smokers than in non-smokers, the difference being more pronounced in females than in males. A weak but significant positive association was observed between leisure time physical activity and HDL cholesterol in both sexes. PMID- 3962734 TI - Prognosis in glomerulonephritis. II. Regression analyses of prognostic factors affecting the course of renal function and the mortality in 395 patients. Calculation of a prognostic model. Report from a Copenhagen study group of renal diseases. AB - The course of the renal function and mortality were analysed in 395 patients with biopsy-proven glomerulonephritis (GN), using Cox's proportional hazards model. Seventeen clinical, biochemical and histopathological parameters were analysed for prognostic information. The patients were grouped according to their serum creatinine levels. Increase in serum creatinine, decrease in serum creatinine, cure and death were used as endpoints for the analysis. Caplan Meyer curves were made for 7 transitions between different groups and the variables were reduced by a step-wise procedure to a final model. Thirteen of the variables considered offered significant prognostic information (p less than 0.05) for at least one of the transitions. Short duration of disease, young age, non-nephritic urinary sediment and preceding streptococcal infection were predictors of cure. Extracapillary, membranoproliferative and unclassifiable GN, old age and arterial hypertension predicted increase in serum creatinine in patients with low serum creatinine, while male sex, short duration of disease and pathological electrocardiogram favoured a further increase in patients with high serum creatinine. A later decrease in serum creatinine was signified by a preceding streptococcal infection, short duration of disease, absence of arterial hypertension and low urinary protein excretion. Death without uremia was predicted by high age, connective tissue disease and extracapillary GN. Using these parameters and the models, it is possible to make a prognostic forecast for the individual GN patient. Examples of such a forecast are described. PMID- 3962735 TI - Yellow nail syndrome--the triad of yellow nails, lymphedema and pleural effusions. A review of the literature and a case report. AB - The yellow nail syndrome, combination of yellow discoloured nails, lymphedema and pleural effusions, is a rare clinical condition. A review of the literature, including 97 patients, is presented. Most patients developed yellow nail syndrome in early middle age, and the overall male:female ratio was 1.1.6. The etiology of the syndrome is obscure, while the pathogenesis seems to involve impaired lymphatic drainage. A patient, whose recurrent pleural effusions were effectively controlled by chemical pleurodesis, is also presented. PMID- 3962736 TI - A case of esophageal spasms in amyloidosis. AB - Impairment of esophageal peristalsis in amyloidosis is well known. A patient in whom esophageal spasms and orocricopharyngeal dyscoordination accompanied myeloma associated amyloidosis is presented below. The different possible mechanisms producing these abnormalities are discussed. PMID- 3962737 TI - Hepatotoxicity of amiodarone. AB - Amiodarone has proved very effective in the treatment of otherwise resistant cardiac tachyarrhythmias. The use of amiodarone has, however, been limited due to its serious side-effects. A patient with cholestatic hepatitis due to amiodarone treatment is presented below and a review of the hepatotoxicity of amiodarone is given. It is concluded that solid evidence exists of hepatic injury due to amiodarone treatment, including steatosis, alterations resembling alcoholic hepatitis, cholestatic hepatitis and micronodular cirrhosis of the liver. Patients receiving amiodarone should be regularly screened with respect to hepatic enzyme levels. Therapy should be discontinued on the suspicion of cholestatic injury or hepatomegaly. PMID- 3962738 TI - Influence of neomembranous organisation, cortical expansion and subdural pressure on the post-operative course of chronic subdural haematoma--an analysis of 201 cases. AB - The post-operative clinical course of a series of 201 patients with chronic subdural haematoma has been analyzed with respect to neomembranous organisation, cortical expansion and subdural pressure in the form of a prospective (53 cases) and retrospective (148 cases) study. With the exception of one patient (primary craniotomy and membranectomy) all other 200 cases were treated according to a standardized treatment protocol consisting of burr-hole craniotomy with (170 cases) or without (30 cases) closed-system drainage. Post-operative mortality (within one month after surgery) was 2%. There was a 4.5% recurrency rate and a 2% infection rate. Morbidity solely related to chronic subdural haematoma was 2% and was characterized by a mild neurological deficit. The level of subdural pressure had no influence on the post-operative clinical course, whereas marked intra-operative cerebral re-expansion favoured a more rapid clinical improvement. Although standard deviations were within a broad range, a nearly linear inverse relation could be assumed between the amount of peri-operative cerebral expansion and the degree of neomembranous organisation of the haematomas. Subdural neomembranes seem to represent the crucial opponents to cerebral re-expansion and they prolong the duration of neurological restitution. PMID- 3962740 TI - Comparison of somatosensory evoked responses from root and cord recorded by skin and epidural electrodes using stimulation of the median nerve in cervical radiculopathy and radiculomyelopathy. AB - Somatosensory evoked potentials (SEPs) were recorded by stimulating the median nerve at the wrist from the skin and epidural space of the 7th cervical spine in patients suffering from cervical radiculopathy or radiculomyelopathy. The patients were divided into four subgroups according to the severity of the disease. Skin and epidural SEPs were calculated and compared with each other and with control values. Usually only one negative potential N13 was identified in the skin recording, but two potentials N11 and N13 occurred in the epidural recording. Lower amplitudes were obtained from the skin than from the epidural space. In the skin SEPs the mean of the central latency of N13 was significantly prolonged in the severe radiculomyelopathy groups, while the mean of the amplitude N13 showed only a tendency to decrease. In contrast, in the epidural SEPs a significant decrease in the mean of the N11 and N13 amplitudes together with a significant prolongation in the mean of the central latency of N13 could be found. In the epidural recording the amplitude changes in particular increased with the severity of the disease, but the highest number of abnormalities (61%) could be seen in the central latency of N13. PMID- 3962739 TI - Herniated cervical discs. Analysis of a series of 230 cases. AB - Over a period of 18 years the authors have collected together 230 cases of herniation cervical discs. Multifactor analysis of the results of the various therapies is given. Surgical decompression has been done, mostly using an anterior approach, and it effectively treats the radicular damage; it stabilizes and improves spinal cord deficits whether the herniation is spontaneous or traumatic, acute or chronic. Computed tomography facilitates its anatomical identification and the decision regarding the therapy to apply. PMID- 3962741 TI - Brain swelling and brain oedema in acute head injury. AB - Chronological changes in diffuse brain swelling and brain oedema were studied in repeated CT studies following a closed head injury. These findings were compared with changes in intracranial pressure (ICP). The grades of diffuse brain swelling were classified into mild, moderate and marked according to the CT findings. Planimetry of low density areas of brain oedema was carried out on repeated CT images. Diffuse brain swelling was recognized in 71% of patients shortly after the head injury and subsided within days 3-5. Brain oedema first appeared 24 hours post injury and did not reach its maximum size and distribution before days 5-8. Thus, these two events can be clearly separated. The intracranial pressure reflected the course of the brain swelling and was not very high during the presence of maximum oedema. PMID- 3962742 TI - Activity of peripheral sympathetic efferent nerves in experimental subarachnoid haemorrhage. Part I: Observations at the time of intracranial hypertension. AB - The origin and pathomechanism of vegetative disturbances in patients suffering from subarachnoid haemorrhage are not completely clarified. Since some of these alterations in vegetative functions may well be attributed to acute changes in sympathetic activity, we initiated a study to investigate this modality in experimentally induced subarachnoid haemorrhage. Experiments were performed on 51 cats, anaesthetized with alpha-chloralose and urethane, immobilized and artificially ventilated. Compound electrical discharges of the left vertebral, cardiac and renal sympathetic nerves, ECG, EEG, end-tidal CO2, systemic arterial blood pressure and intracranial pressure were recorded on a polygraph. Subarachnoid haemorrhage was simulated by the injection of 1-5 ml of fresh, autologous blood into the cisterna magna. Mock cerebrospinal fluid was also injected as a control. Our results showed that in induced subarachnoid haemorrhage, not the blood itself but the intracranial pressure elevation might be responsible for the strong increase in sympathetic efferent activity. With the direct recording of the electrical activity of the three sympathetic nerves, we were able to verify the sympathetic overactivity underlying the cardiovascular disturbances during intracranial pressure elevation. Regarding the mechanism of the overactivity, most probably not the ischaemia or hypoxia, but the mechanical distortion of the medulla could be the adequate stimulus of the sympathetic overactivity and the Cushing response during intracranial pressure elevation. PMID- 3962743 TI - Effects of an expanding supratentorial mass on the auditory brain-stem responses in baboons. AB - This study was carried out to investigate the effects of an expanding supratentorial mass on auditory brain-stem responses (ABRs). A balloon was inserted into the supratentorial epidural space of seven baboons (in two cases, in the right occipital area; in five cases, in the right temporal area). The balloons were inflated at a rate of 0.2 ml/minute to increase intracranial pressure (ICP). ICP (right frontal epidural pressure) and blood pressure (BP) were continuously recorded. Recordings of ABRs (vertex to mastoid on both sides) were made serially. Pupillary changes were also recorded. At 30 mmHg ICP, the amplitude of wave V on the right side was observed to be significantly attenuated (p less than 0.02). At 50 mm Hg ICP, the latency of wave V on the right side was significantly prolonged compared with that at 30 mm Hg ICP (p less than 0.02). At 70 mmHg ICP, significantly decreased amplitude of wave V on the left side was also observed (p less than 0.02, from the control), associated with significant increased latency of wave IV on the right side (p less than 0.01, from the control; p less than 0.05, from 50 mm Hg ICP). Finally, waves IV and V on both sides substantially disappeared at 100 mm Hg ICP. Anisocoria appeared in four animals at 30-50 mm Hg (mean +/- SD; 45 +/- 8.7) ICP. The amplitude of wave V was significantly decreased in these circumstances (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962744 TI - Evaluation of the Ar+ laser thermal effect in rabbit brain tissue by means of optical absorption coefficients. Photoacoustic measurements. AB - In predicting Ar+ laser-neural tissue interaction a determination of the optical absorption properties of brain parenchyma appears indispensable. In this study a determination of absorption spectra of different areas of rabbit brain at the wavelength of an Ar+ laser beam is made. The areas considered in the study are frontal and occipital gray and white substance, thalamus, basal ganglia, cerebellar cortex and choroid plexus. Specimens of these areas measuring 2 X 3 X 3 mm were obtained from coronal sections 1 cm thick of 20 rabbit brains. The analysis of optical properties was made by means of a photoacoustic spectrometer which appears the only suitable technique for testing the optical absorption properties of biological materials. The absorption coefficient results were similar in magnitude and constant in all the areas examined, measuring approximately 50 cm-1. The prediction of lack of any selective effect for the different areas is confirmed by the sizes of lesions made in cerebral specimens of the same areas of the contralateral hemisphere by means of Ar+ laser: the lesions increase in size in proportion to the increase in output power and exposure time, independently of the areas considered. Also the histological examination of the areas shows the same morphology to be independent of the variations of both output power and exposure time. The only differences were the presence for short exposure time and low output power of a carbonized layer inner to the layer of coagulative necrosis. PMID- 3962745 TI - Brainstem glioma: an analysis of 85 cases. AB - The study analyses 85 cases of brainstem glioma in the past 35 years, 69 of which include patients under 16 years of age. The incidence of brainstem glioma was 2.4% of all intracranial tumours, and 9.4% of intracranial tumours in children. There were two peaks in age distribution, in the first and in the fourth decades. In children, the tumours were located mainly in the pons, so VIth and VIIth cranial nerve palsies, and pyramidal and cerebellar signs were frequently seen. In adult cases, the tumours ranged in location from the midbrain to the medulla, so neurological symptoms caused by lesions of the whole brainstem axis were seen. The left side was dominant in both age groups. The choice of treatment was steroid administration and radiation. Chemotherapy was not effective. Even after these treatments, the median survival period from onset was no longer than 10.5 months. We conclude that the treatment of brainstem gliomas in children should be distinguished from adult cases, which in the latter may be considered to be merely one of the gliomas which may occur at any other sites. Since brainstem gliomas in children may be congenital, we must redirect our treatment of these lesions to treatment of congenital tumours. PMID- 3962746 TI - Indications for surgical treatment of cerebellar haemorrhage and infarction. AB - This report summarizes the outcome of 56 patients with cerebellar lesions of vascular origin, 40 patients with cerebellar infarction, and 16 with spontaneous cerebellar haemorrhage. All patients had computerized tomography: occlusive hydrocephalus was diagnosed in 75% of patients with cerebellar haemorrhage and in 23% with cerebellar infarction. Nine out of 10 patients survived after early surgical evacuation of the haematoma and 4 of them recovered completely. Two patients underwent only external ventricular drainage (EVD), one died after 2 days, and the other recovered with a moderate deficit. Three of 4 medically treated patients died within one week; all had developed occlusive hydrocephalus. The fourth medically treated patient recovered completely; consciousness had never deteriorated nor had occlusive hydrocephalus developed. Among 40 patients with cerebellar infarction, 13 developed progressive deterioration of consciousness; 7 of them underwent decompressive craniectomy of the posterior fossa and survived. One patient had only external ventricular drainage and died. Four out of the 5 medically treated patients died during the acute phase. From these observations and several reports in the literature, it is concluded that both cerebellar haemorrhage and infarction should be operated on as soon as progressive deterioration of consciousness develops. This occurs more frequently in patients with cerebellar haemorrhage than with cerebellar infarction. Individual decision-making in each case necessitates intensive neurosurgical observation. PMID- 3962747 TI - Clinical and CT scan assessment of benign versus fatal spontaneous cerebellar haematomas. AB - We have studied 15 cases of spontaneous intracerebellar haematomas in 9 males and 6 females. A significant correlation between the clinical presentation and the CT scan features of benign and fatal haemorrhages of the cerebellum is presented. Diagnostic computerized tomographic studies were performed in a mean interval of 31 hours after the initial symptoms. 60% were diagnosed and treated in less than 24 hours; 11 patients had haematomas larger than 3 cm, and 5 (45%) of these cases died with evidence of irreversible brain-stem damage. Twelve (80%) showed compression of the fourth ventricle, 9 (60%) obliteration of the brain-stem cisterns and 8 (53%) ventricular dilatation. 8 cases were treated with surgery; 50% of them showed neurological improvement, including two cases with signs of brain-stem compression. 7 patients who were treated conservatively were followed closely with repeated CT scans, which showed that resolution of the mass effect and isodensity of the haematomas larger than 3 cm (73%), hydrocephalus (45%) and intraventricular haemorrhage (40%). Smaller haematomas without CT scan evidence of obliteration of the brain-stem cisterns or hydrocephalus had a better outcome. PMID- 3962748 TI - Intracranial repair of interrupted facial nerve in course of operation for acoustic neurinoma by microsurgical technique. AB - The microsurgical refinement of the lateral suboccipital approach is, in our opinion, the most satisfactory operative technique for achieving total removal of acoustic neurinomas of all sizes. In this series of 164 operated cases, large or very large tumours accounted for 64% of the cases (105 patients). The facial nerve was sacrificed in about 19% of the cases. In 81% of the cases the facial nerve was respected (65%) or repaired (16%) by direct intracranial suture performed immediately after tumour removal. Good or fair functional results were obtained in about 65% of the cases by this last procedure, which has to be considered as the treatment of choice for facial nerve repair. The results are compared with those of other series and with those obtained by different nerve substitution procedures. PMID- 3962749 TI - Unruptured intracranial aneurysms in polycystic kidney disease. AB - To detect unruptured intracranial aneurysms, we performed cerebral angiography in five patients with polycystic kidney disease (PKD) who had no neurological deficits and no history of subarachnoid haemorrhage. Three of the five patients had unruptured intracranial aneurysms and two underwent surgery with no mortality or morbidity. Our review of the literature revealed that the surgical risk of unruptured intracranial aneurysms is smaller than the risk of bleeding in conservatively treated patients. We discuss the importance of an early diagnosis, and early operation for unruptured aneurysms in patients with polycystic kidney disease and stress the need for intensive care for their renal dysfunction and hypertension during and after the operation. PMID- 3962750 TI - Paroxysmal lateralized epileptiform discharges (PLEDS). Clinical-EEG correlations in twenty cases. PMID- 3962751 TI - Semilobar holoprosencephaly: embryologic, CSF dynamics and radiological considerations. PMID- 3962752 TI - Orphenadrine plasma levels and amelioration of extrapyramidal side effects in schizophrenic patients treated with haloperidol. PMID- 3962753 TI - Computerized tomography in 53 patients with lacunar syndromes. PMID- 3962754 TI - Alternative strategy for reading aloud. A case report. PMID- 3962755 TI - WAIS testing in degenerative and multi-infarct dementia. PMID- 3962756 TI - Syphilitic aneurysm of the descending thoracic aorta with radicular pain. PMID- 3962758 TI - Glucose tolerance following strokes in the elderly. AB - Two standard 75 g oral glucose tolerance tests (OGTT) were performed on each of 16 patients, aged 65-84 years, presenting with a thrombotic stroke, and not previously known to have diabetes mellitus. The tests were performed within the first week and 12 weeks after the initial episode. There was no significant difference in the plasma glucose values between the tests. Six patients were diagnosed diabetic on the basis of both OGTTs being abnormal. Of the remaining ten, there was no worsening of glucose tolerance immediately following a stroke. It is concluded that an abnormal glucose tolerance soon after a stroke in the elderly represents true diabetes mellitus rather than 'functional diabetes'. PMID- 3962757 TI - Morbidity and mortality in an initially healthy elderly sample: findings after five years of follow-up. AB - This report summarizes morbidity and mortality data for 263 initially healthy elderly men and women from the beginning of this study through five years of follow-up. The mortality rate for this sample averaged approximately 1.8% per year and the duration of terminal illness averaged 4.9 months. The cancer incidence rate has increased whereas new diagnoses of cardiovascular disease and degenerative conditions have declined. The data support the potential for maximizing vigour and health well into the seventh and eighth decades of life. PMID- 3962759 TI - Burnley relatives' clinic. AB - The organization of a clinic for relatives of geriatric patients is described, including a retrospective study of the reasons for referral to the clinic and a discussion of its value to patients, relatives and the geriatric team. PMID- 3962760 TI - The effect of a vinyl floor surface and a carpeted floor surface upon walking in elderly hospital in-patients. AB - Fifty-eight elderly hospital patients walked along a 10-m length of carpeted corridor and a 10-m length of vinyl-tiled corridor. Gait speed and step length were significantly greater on the carpeted than on the vinyl surface. PMID- 3962762 TI - Low-dose subcutaneous heparin in the prevention of deep-vein thrombosis and pulmonary emboli following acute stroke. AB - Venous thrombo-embolism is a major and often unrecognized cause of morbidity and mortality in patients after acute strokes. Three hundred and five elderly patients were randomly allocated to either control (161) or treatment (144) with 5000 units calcium heparin subcutaneously 8-hourly for two weeks. A reduction in deep-vein thrombosis rate from 72.7% in the control group to 22.2% in treatment patients was achieved. In patients who died (84), post-mortem examination to look for pulmonary emboli was performed in 71. Comparison between treated and untreated patients showed significantly fewer deaths and pulmonary emboli in the treated group. Most of the beneficial effect on mortality was seen in patients with lighter strokes. When patients with pulmonary emboli at post-mortem were excluded, there was no significant difference in the death rate in treatment (17) and control (14) groups. At post-mortem, 9.9% of the strokes were haemorrhagic (4 in the treatment and 3 in the control group). Low-dose calcium heparin given subcutaneously following acute stroke reduced the number of deep-vein thromboses, pulmonary emboli and deaths without increasing the number of haemorrhagic strokes in this study. PMID- 3962761 TI - Abnormal indices of nutrition in the elderly: a study of different clinical groups. AB - Anthropometric and biochemical indices of nutrition were measured in 450 elderly women in six groups spanning a wide range of physical dependency. Data from the group of active subjects living at home was used to derive reference ranges for elderly women. Although the index values of this group did not differ greatly from those seen in young subjects, there were large differences between this and some of the other elderly groups where the frequency of low values was as high as 50% for some parameters. Food intakes were measured in four of the six groups and relationships were found between energy, protein and vitamin C intake and body weight, plasma protein levels and vitamin C concentration, respectively. Our findings suggest that, among elderly women, low levels of nutrient intake make a significant contribution to poor anthropometric and biochemical nutritional status. Improvements in diet should be reflected in the indices measured and might, in turn, have beneficial effects on health. PMID- 3962763 TI - Atrial fibrillation and stroke in elderly hospitalized patients. AB - Of 4100 consecutive admissions to the Department of Geriatric Medicine, 414 patients (10.1%) were identified as having atrial fibrillation (AF); 138 (33%) had transient AF and 276 (67%) had constant AF. In the constant group, 41.7% of patients had had a stroke compared with 26.8% in the transient group (P less than 0.01). A random sample of 200 patients in sinus rhythm from the 4100 admissions had a stroke prevalence of 19%. This study suggests that constant AF has a greater association with stroke than transient AF. PMID- 3962764 TI - Symptoms of myocardial infarction in old age: clinical case, retrospective and prospective studies. AB - In a clinical case study (n = 71), a retrospective study (n = 96), and a prospective study (n = 60, 10 cases and 50 controls)--all of a duration of three years--prevalence and kind of symptoms of myocardial infarction in geriatric long term care patients were studied. The findings suggest a low diagnostic accuracy of acute myocardial infarction in the elderly. The clinical features seem to be different compared to those of younger patients. Intense dyspnoea, syncope and weakness are more common than chest pain. PMID- 3962765 TI - Corticosteroids and inflammation. 7th European Workshop on Inflammation. Capri, Italy, April 18-19, 1985. PMID- 3962766 TI - Effects of glucocorticoids on carbohydrate metabolism. PMID- 3962767 TI - Isolation and characterization of lipocortin (lipomodulin). AB - Lipocortin is a phospholipase inhibitory protein whose synthesis is induced in various cells by glucocorticoids. At least three species with molecular weights of 40,000, 30,000, and 15,000 are presently known. This protein mimics the anti inflammatory action of glucocorticoids in vitro as well as in vivo. The synthesis of the protein appears to be associated with the MHC genes. PMID- 3962768 TI - Lipocortin in renal cells (renocortin): has lipocortin a physiological relevance in the kidney? PMID- 3962769 TI - Affinities of glucocorticoids for glucocorticoid receptors in the human lung. PMID- 3962770 TI - Glucocorticoid receptors in cultured fibroblasts from inflammatory sites. Preliminary results. PMID- 3962771 TI - The inhibitory profiles of hog pancreatic and human rheumatoid synovial cell phospholipases A2. PMID- 3962772 TI - Failure of anti-inflammatory steroids to inhibit prostaglandin release from the hydronephrotic rabbit kidney. AB - The release of prostaglandins E2, F2 alpha, I2 and thromboxane A2 from isolated perfused normal and hydronephrotic rabbit kidneys was investigated by extraction and radioimmunoassay. In both types of kidneys, basal PG efflux increased with time and was not altered by co-perfusion with dexamethasone or hydrocortisone. Several vasoactive substances at 1 to 4 micrograms (e.g., bradykinin, angiotensin II, substance P, noradrenaline and vasopressin) caused release of additional amounts of prostaglandins. PGE2 and 6-keto PGF1 alpha were the major prostanoids detected, but substantial amounts of PGF2 alpha were also found. Thromboxane A2 was not released from normal kidneys. In hydronephrotic kidneys there was greatly augmented release of prostaglandins E2 and I2, some increases in PGF2 alpha, and the appearance of substantial amounts of thromboxane A2 (measured as immunoreactive TXB2) when the kidneys were challenged with angiotensin, bradykinin and vasopressin, and smaller augmentation of the response to noradrenaline and substance P. There was no evidence that these evoked increases in renal PG output could be inhibited by dexamethasone or hydrocortisone. Some explanations for the failure of steroids to alter prostanoid metabolism from arachidonate in rabbit kidney are discussed, and it is proposed that there are clear exceptions to the concept that steroids inhibit prostaglandin generation in intact tissues. PMID- 3962773 TI - Methylprednisolone inhibition of leukotriene-dependent airway anaphylaxis in the guinea pig in vivo. PMID- 3962774 TI - The effect of glucocorticoids on lyso-PAF formation in vitro and in vivo. PMID- 3962776 TI - Ultrastructural and morphometrical studies on the articular cartilage of rats: the destructive effect of dexamethasone and the chondroprotective effect of Rumalon. PMID- 3962775 TI - Effect of a steroidal antiinflammatory agent on the proliferation of mouse embryo fibroblasts in culture. PMID- 3962777 TI - Dose related effects of dexamethasone treatment on the ultrastructure of articular cartilage in rats. AB - Corticosteroid administration is known to cause degenerative changes in articular cartilage interfering with the cell metabolism of chondrocytes. The present study analyzes the ultrastructural changes in chondrocytes after systemic dexamethasone acetate treatment in relation to dosage, using a standardized morphometrical method. Five male Wistar rats of 300 g body weight in each experimental group were subjected to 3, 4 and 5 mg dexamethasone acetate by intramuscular injections of 1 mg per week. 1000 electron micrographs of single chondrocytes in the middle zone of hyaline cartilage from the knee joints were evaluated with standardized morphometry and nonparametric statistics. With increasing dexamethasone dosage the amount of rough endoplasmic reticulum and Golgi apparatus decreased. Considerably increased glycogen granula and clusters indicated a severe change in glycolytic pathways. Lysosomes duplicated in number. Degenerative changes were also manifested in lipid droplets and myeloid bodies, which, like the amount of microfilaments, exhibited a clear dosage-dependent increase under dexamethasone treatment. The ratio of dead versus living chondrocytes increased in relation to dosage up to 25% cell mortality. PMID- 3962778 TI - Problems and results in testing the possible general mode of action of glucocorticoids in rat adjuvant arthritis. AB - The antiinflammatory action of dexamethasone in both phases of rat adjuvant arthritis was significantly reduced by injection of the RNA synthesis inhibitor actinomycin D into the inflamed paw. This effect is apparently caused by inhibition of RNA/protein synthesis and not by actinomycin D irritant activity. Thus, the present data support the view of indirect glucocorticoid activity via gene expression also in subacute and chronic adjuvant arthritis. The dexamethasone-induced antiinflammatory protein seems to be synthetized at the site of inflammation. PMID- 3962780 TI - Tissue culture methods for the investigation of anti-inflammatory drugs. AB - Tissue culture methods are used increasingly in the investigation of anti inflammatory drugs. Compared to in vivo experiments they offer the advantages of a) relative reproducibility, b) reduced cost, and c) simplified interpretation of results. Moreover, tissue culture methods can be applied without major ethical concern. The disadvantage of cell culture techniques is the need to re-check in vivo the medical relevance of all data obtained. A few applications of cell culture methods are exemplified by results obtained in our laboratory from experiments using macrophages, endothelial cells and chondrocytes. PMID- 3962781 TI - The croton oil ear test revisited. PMID- 3962779 TI - Animal models for the study of atypical anti-inflammatory agents. AB - In contrast to the approach focusing on aspirin and cortisone as models for research, a physiopathologically-oriented approach provides the rationale for developing animal models suitable for detecting anti-inflammatory agents with a profile of therapeutic and side effects unlike that of currently used drugs. The so-called 'primary' anti-inflammatory agents have a marked efficacy in animal models of acute inflammation and lack significant anti-PG effects. Clinically, they relieve the symptoms of acute inflammatory conditions, both topically and systemically, are practically inactive in rheumatic disorders and have a profile of side-effects different from that of aspirin or cortisone. Available data suggest that their characteristic profile of side and therapeutic effects reflect qualitative, rather than quantitative differences, from aspirin and cortisone. The so-called 'secondary' anti-inflammatory agents affect the conditioning factors for some inflammatory diseases, including rheumatoid arthritis, rather than the inflammatory process itself. Besides the derangement of the immune system and the consequent development of immunomodulators, the role of specific protein changes as a conditioning factor is discussed and animal models are illustrated focusing on this phenomenon. The possibility is also discussed that protein denaturation is not only responsible for the formation of new antigenic determinants, but also for necrotic lesions accompanying some inflammatory disorders. Results obtained with animal models of conditioned inflammation with marked necrotic lesions are presented. The interest for this approach is that conditioning factors for inflammation appear a more specific target for drug treatment, rather than inflammation itself. PMID- 3962782 TI - Experimental allergic arthritis in mice: effects of local enzyme therapy with native and cationic derivatives. PMID- 3962785 TI - Determination of reactivity of resistance blood vessels in the isolated perfused legs of animals with inflammation as exemplified in adjuvant arthritis. AB - Vasodepression was found ex vivo in the isolated perfused hind legs of rats, mice and guinea-pigs with paw inflammation using maximum pressure amplitude, EAm, pD2 value and intrinsic sensitivity (i.s.) as the test parameters of dose-response curves of vasopressor substances (noradrenaline, lys- and arg-vasopressin, angiotensin II, substance P, Na2-ATP). Vasodepression is strong in the anaphylactic and dextran paw edema, moderate in the carrageenin paw edema and adjuvant arthritis, but weak in the pertussis vaccine and kaolin paw edema. It is partly long-lasting, does not closely correlate with edema strength and can also be shown in the contralateral non-inflamed leg. Thus, a vasoreactivity depressing factor(s) must be liberated from the site of inflammation and reach the general circulation. Here, the method is described using the adjuvant arthritis as an example. PMID- 3962784 TI - A rat model for testing anti-inflammatory action in lung and the effect of glucocorticosteroids (GCS) in this model. PMID- 3962783 TI - Dermatosis in magnesium-deficient hairless rats: effects of steroidal and non steroidal anti-inflammatory drugs. AB - Dermatosis in magnesium-deficient hairless rats has been described as a reproducible model of skin inflammation. It was therefore felt of interest to search for the effects of various anti-inflammatory compounds on this model. Results showed that 1) Dexamethasone acetate completely abolished the rash, 2) Indomethacin, a Non-Steroidal Anti-Inflammatory Drug (NSAID), inhibitor of the cyclooxygenase pathway was quite inactive, 3) Benoxaprofen, a NSAID inhibitor of both cyclooxygenase and lipoxygenase pathways only slightly modified the development of the pathology. Activity of steroidal anti-inflammatory drugs on this model may be related to their immunosuppressive effects. PMID- 3962786 TI - Inhibition of experimentally induced microvascular injury by rosmarinic acid. PMID- 3962787 TI - Rosmarinic acid inhibits external oxidative effects of human polymorphonuclear granulocytes. PMID- 3962788 TI - Anti-inflammatory activity of the flavonoid fraction of khat (Catha edulis Forsk). AB - The administration of the flavonid fraction, isolated from Khat (Catha edulis Forsk), in a dose of 200 mg/kg orally, produced a significant anti-inflammatory activity against the carrageenan induced paw oedema and cotton pellet granuloma in albino rats. The results were comparable with the standard anti-inflammatory drug oxyphenbutazone. PMID- 3962790 TI - [Differential diagnosis of prostatic tumors. A rare etiology]. PMID- 3962789 TI - Inflammatory action of PAF-acether in the rat pleural cavity. AB - The injection of PAF-acether into the pleural cavity of the rat induced a maximal exudate after 30-60 min which then decreased and disappeared after 24 hours. In addition, the mediator produced a decrease in the number of leukocytes in the pleural cavity 30 min after injection and an increase in the number of cells after 6 hours. PMID- 3962791 TI - Isolated tuberculous epididymitis. A case report. PMID- 3962792 TI - [Hemodynamic role of the tunica albuginea in erection]. PMID- 3962793 TI - Urogenital tumors in Kinshasa. An overview of 25 years experience. PMID- 3962794 TI - [Urinary crystalluria. A debatable problem]. PMID- 3962795 TI - [A case of uretero-uterine fistula following cesarean section treated by uretero ureterostomy]. PMID- 3962796 TI - [Endoscopic treatment of vesico-ureteral reflux in children]. PMID- 3962797 TI - [Hydrocele following surgical treatment of varicocele]. PMID- 3962798 TI - [Nephrogenic adenoma of the bladder]. PMID- 3962799 TI - Pheochromocytoma of the urinary bladder. PMID- 3962800 TI - Tethered cord syndrome in an adult. Pharmacological treatment of the urological symptomatology by oxybutynin. PMID- 3962801 TI - [Tumor factors influencing the prognosis of renal cell carcinoma]. AB - Fifty six patients, 40 males and 16 females, received radical nephrectomy and were diagnosed to have renal cell carcinoma pathologically at Asahi General Hospital between January, 1972 and September, 1984. The five and ten year survival rates were 44.2 and 35.7% respectively. The cancers were classified according to pTNM category and their cell type and grade were estimated. The relationship between these factors and the patient's prognosis was studied. We recognized a close correlation among pT, cell type and grade, and found that they had a serious influence on prognosis. There was a close correlation between grade and pV, but no relationship between pN, pM and grade. Cases with a positive lymph node or distant metastasis had poor prognosis. Therefore, we suggest the possibility of false negative evaluation of pN and pM, because pN and pM were estimated clinically. Consequently, we believe that the pTNM category is a good classification for evaluation tumor expansion and the prognosis. PMID- 3962802 TI - [A clinical study on primary renal pelvic tumors]. AB - Sixteen cases of primary renal pelvic tumor treated at our Department between July, 1971 and June, 1984, were reviewed. The sixth decade predominated over other age groups and occupied 47.3% of all cases (average: 63.9 years). The sex ratio was 4.3:1 with male patients predominating over female patients. The incidence of the affected side was equal; 8 cases in the right and 8 cases in the left renal pelvis. The most common initial symptom was macroscopic hematuria in 13 cases (81.2%), followed by flank pain in 2 cases (12.5%). The major findings in IVP were filling defect in 11 cases (68.7%) and non-visualizing kidney in 4 cases (25.0%). Positive urinary cytology was obtained in 6 cases (49.1%) by voided urine specimen and 4 cases (50.0%) by catheterized urine specimen. Histologically, all cases were transitional cell carcinoma; 11 of them were low stage and 5 were high stage at the initial diagnosis. Nine patients(56.1%) were treated by total nephroureterectomy associated with partial cystectomy. The over all survival rate at 1,2,3,4 and 5 years was 86%, 78%, 78%, 68% and 68%, respectively, by the Kaplan-Meier method. The five year survival rate was 80% for the low stage group and 0% for the high stage group. (p less than 0.05, generalized Wilcoxon test). The five year survival rate was 83% for the low grade group and 40% for the high grade group. (p less than 0.05, Generalized Wilcoxon test) Among several factors, stage and grade of the tumor were the most influencing factors for prognosis. PMID- 3962803 TI - [Primary papillary adenocarcinoma of the prostate: a case report]. AB - A case of prostatic papillary adenocarcinoma is reported. A 70-year-old male was admitted with the complaint of urinary retention. Suprapubic prostatectomy was performed on July 17, 1984 under the diagnosis of benign prostatic hypertrophy. The bilobes of prostate were 4 X 3 X 3 cm in size and 60 gm in weight. They were very soft and yellow-red. The histopathological examination revealed papillary adenocarcinoma of prostate. Glands were lined by a single or two layers of cuboidal cells with dark cytoplasm and a clear nucleolus. It seemed to arise from the prostatic duct, since serum level of prostatic acid phosphatase was elevated. But it was thought that prostatic carcinoma of acini grew in the papillary pattern, too. Therefore, it was difficult to identify the origin. Only hormone therapy (Honvan) was performed as postoperative anticancer therapy. During the follow up at the clinic, there have been no abnormal findings. PMID- 3962804 TI - [A case of 46, Xp+, Y with gonadal dysgenesis]. AB - A case of 46, Xp+, Y with gonadal dysgenesis is described. The patient was a 14 year-old boy with short status (129 cm) complaint of underdeveloped testicle. IVP and cystourethrogram showed no abnormality. Chromosomal analysis of peripheral lymphocytes revealed 46, Xp+, Y. Histological examination of the specimen obtained by testicular biopsy revealed an immature tubule-like structure without spermatogenesis. Chromosomal study on his mother who was also short status revealed a karyotype of 46, X, Xp+ in peripheral lymphocytes. PMID- 3962805 TI - [Clinical studies of efficacy of piperacillin against complicated urinary tract infections]. AB - Clinical efficacy of piperacillin against 74 cases with complicated urinary tract infection was examined. Piperacillin was administered at the dose of 4 g (2 g twice daily) through intravenous drip infusion. The overall clinical value was rated in "excellent", in 9 cases, "moderate" in 34 cases and "poor" in 31 cases with a total efficacy of 58.1%. In the analysis of clinical values based on background, its efficacy was statistically significantly lower in the patients at a higher age, those with complication of diabetes mellitus, and those with indwelling catheter. In operated cases compared to non-operated cases, it was suggested to be more effective for improving the disturbances in urinary flow as a result of the removal of the underlying conditions by the operation. As to bacteriological efficacy, 64 out of 95 strains (67.4%) isolated were eradicated following its administration. Microbes which appeared after its dosing belonged to 9 classes of 18 strains, of which 5 strains (27.8%) of Serratia were identified. Side effects were 2.5% (3/119), no serious cases appeared. Changes in laboratory examination results were elevated GOT (2.5%), GPT (1.7%), and ALP (0.8%) values, all being transient hanges. PMID- 3962806 TI - [Effect of the administration of liver extract after surgical operations in urology]. AB - The effect of liver extract administered to 22 patients after urological operations was evaluated with reference to 19 controls. No significant difference was observed between the cases and the controls. We rather supposed, however, that the liver extract was effective as a liver protection drug, because the results of liver function in the cases were less changed than the controls throughout the post-operative course. PMID- 3962807 TI - [A clinical study on primary ureteral tumors]. AB - Twenty-two cases of primary ureteral tumors treated at our Department between July 1971 and December 1984, were reviewed. The patients ranged from 28 to 83 years old (average 63.6 years). There were 17 males and 5 females (3.4:1). The affected side was predominantly the left (15) than the right (7). The most common site of the tumor growth was at the lower third of the ureter (14 cases, 63.6%). The most common initial symptom was macroscopic hematuria, which was seen in 17 cases (77.3%). The major finding of IVP was non-visualizing kidney in 11 cases (50.0%) and filling defect in 7 cases (31.8%). Positive urinary cytology was obtained in 9 cases (52.9%) by voided urine and 6 cases (66.6%) by catheterized urine. Total nephroureterectomy associated with partial cystectomy was performed in 14 cases (63.6%). Histologically, 19 cases were transitional cell carcinoma (86.8%). Associated growth of urothelial tumor in the bladder was found in 4 cases preoperatively and in 3 cases during the course of postoperative follow up. All of them were treated by transurethral resection. Overall survival rate at 1,2,3,4 and 5 years was 84, 71, 55, 46 and 35%, respectively, by the Kaplan-Meier method. The five year survival rate was 54% for the low stage group and 0% for the high stage group; 54% for the low grade group and 26% for the high grade group. (p value = not significant, generalized Wilcoxon test). PMID- 3962808 TI - [Double channel chemotherapy with intra-arterial infusion of DDP and concurrent intra-venous infusion of sodium thiosulfate (STS) in bladder cancer]. AB - Ten patients with bladder cancer were treated with double channel chemotherapy which included intra-arterial infusion of DDP and concurrent intra-venous infusion of STS, a neutralizing agent against DDP. The method allows the administration of a relatively high dose of DDP to localized malignant tumors by protection from systemic cytotoxicity of DDP by STS. DDP in a dose of 100-150 mg/m2 of body surface was infused either to the internal iliac artery at a portion close to the superior vesical artery or to the aortic bifurcation by the Seldinger technique over 30 minutes, and infusion of 20 g STS to the peripheral vein was simultaneously started and continued for 2-3 hours. One patient achieved a complete response and 2 patients achieved a partial response. The response rate was 30%. Histopathologically, 4 out of 8 patients showed an effect of 2 grades or more by Oboshi-Shimosato's criteria. Invasive or hypervascular tumors seem to be more responsive to the present treatment than superficial or hypovascular ones. Side effects were relatively mild inspite of a large dose of DDP. It should be noted that concurrent STS infusion efficiently counteracts the renal toxicity of DDP. PMID- 3962809 TI - [Preoperative management of pheochromocytoma with prazosin: report of three cases]. AB - We used prazosin (alpha-blocker) for preoperative management of three patients with pheochromocytoma. All patients had episodic hypertension with headache and palpitation. The first dose of prazosin caused blood pressure to drop in one of three patients, but no significant hypotension was observed. By the daily dose of 6-8 mg prazosin with or without propranolol, subjective symptoms of the patients were improved and the frequency of the hypertensive attack was decreased Operations were carried out without significant complications, but phentramine and nitroprusside were required because of rapid rise of blood pressure during induction of anesthesia and surgical manipulation. PMID- 3962810 TI - [Three cases of primary aldosteronism including one case with postoperative ventricular tachycardia]. AB - Three patients with primary aldosteronism were treated surgically between February and September 1984. All patients had suffered from hypertension with U waves in ECG and laboratory examinations revealed hypokalemia, hyperaldosteronemia and suppressed plasma renin activity. The localization of the adrenal tumor was diagnosed accurately in all 3 patients by adrenal vein sampling and in 2 of the patients by PRP, CT scan, adrenal scanning with 131I-iodo cholesterol and adrenal venography. Adrenal tumors were surgically removed by unilateral adrenalectomy through the flank approach in all cases. Histological examinations of removed specimens showed adrenocortical adenoma. Removal of the adenoma caused a prompt reversal of the laboratory serum abnormalities and hypertension was normalized within 2 weeks postoperatively in all cases. Severe ventricular tachycardia (Torsades de Pointes) was observed suddenly in one of the patients after about 5 hours postoperatively. Therapy including conventional antiarrhythmic drugs, such as lidocaine or procainamide, and potassium administration failed to prevent the arrhythmia. Ventricular tachycardia was successfully treated and disappeared with the use of magnesium sulfate (MgSO4) intravenously. The serum potassium concentration was normal during the episode and the serum magnesium concentration, which was not detected before or just after the operation, was under the limit of normal range (1.4 mEq/l) after the use of magnesium sulfate. Hypomagnesemia which is retrospectively thought to be the result of primary aldosteronism may be responsible for the episode of postoperative ventricular tachycardia. PMID- 3962811 TI - [Two cases of metastatic renal tumor]. AB - In this report, two cases of metastatic renal tumor are described. The first case is a 58-year-old female who had branchiogenic carcinoma. She had found a left neck tumor, before asymptomatic macrohematuria developed. The second case is a 25 year-old female who had choriocarcinoma. She had no urological symptoms. In both cases, unilateral nephrectomy was performed. Seventy nine cases of metastatic renal tumor in survivals have already been reported. PMID- 3962812 TI - [Percutaneous nephrostomy for unusual complications occurring in patients with ureteral stones: a report of two cases]. AB - The first case is a 59-year-old man who had left flank pain and nausea. KUB, excretory urograms and CT scan showed a left ureteral stone at the ureterovesical junction associated with spontaneous rupture of the left renal pelvis. Percutaneous nephrostomy was performed. The ureteral stone was spontaneously discharged on the 4th postoperative day and extravasation of contrast medium from the left renal pelvis disappeared. The second case is a 42-year-old man who was admitted with bilateral flank pain, nausea and vomiting. KUB and excretory urograms showed bilateral hydronephrosis due to small bilateral ureteral stones. Serum BUN and creatinine had risen to 41 and 5.1 mg/dl, respectively, on the day after admission. Percutaneous nephrostomy to the left kidney was performed. BUN and creatinine were normalized immediately and the bilateral ureteral stones were spontaneously discharged by the 9th postoperative day. After the nephrostomy catheters were removed, no complications occurred in either case and KUB and excretory urograms showed normal findings. PMID- 3962813 TI - [Cancer of the bladder in a patient with spinal cord injury]. AB - A case of cancer of urinary bladder in a 39-year-old incomplete C7 paraplegic male is reported. He was injured in 1962, and was admitted to our department in August, 1982 because of macrohematuria. Intravenous pyelography showed dilation of right ureter and pelvis. Cystography revealed filling defect on the right wall of bladder, but vesicoureteral reflux was not seen. Endoscopically, we found the tumor on the right wall, which seemed to invade to the trigone and right ureteral orifice. CT scan and pelvic angiography showed that the tumor extended extramurally of the bladder and metastasized to lymph-nodes. In November, 1982, bilateral ureterocutaneostomy, and 30 days later, total cystectomy were performed. The removed bladder demonstrated transitional cell carcinoma with undifferentiated tumor cells. The patient died of recurrence of the tumor in the small pelvic cavity, 60 days later. Ten cases of bladder cancer in patients with spinal cord injury were collected from Japanese literature including ours, and the importance of periodic cytology, cystoscopy and random biopsy for early diagnosis of bladder cancer on paraplegics were discussed. PMID- 3962815 TI - Nifedipine in exercise-induced asthma. AB - The calcium entry blockers may inhibit EIA in patients with bronchial asthma, but it is not demonstrated that they produced bronchodilation once the crisis is established. Nine patients with exercise induced asthma were studied. We carried out an exercise test for ten minutes with constant load and the following were measured; FVC, PEF, MEF25 and sGaw before and after test. All the values fell 20% or more than the initial values. A 20 mg was administered without modifying the studied parameters and only the administration of 400 micrograms of metaproterenol by inhalation made the sensation of dyspnea recur in all patients. PMID- 3962814 TI - Sensitivity and tolerance to tartrazine in aspirin-sensitive asthmatics. AB - The occurrence of sensitivity to tartrazine was examined in 51 patients with asthma and aspirin sensitivity. All patients underwent oral challenge tests with aspirin and tartrazine. Sensitivity to tartrazine was found in 16 i.e. 31.4% of tested asthmatics. The symptoms of sensitivity to tartrazine were similar to those of aspirin. Tolerance to tartrazine was induced in 5 aspirin and tartrazine sensitive asthmatics. Sensitivity to both substances was manifested in these 5 persons as dyspnea but 2 of them had additional extrabronchial symptoms. A good tolerance of 40 mg tartrazine was achieved in all the challenged patients who did not refer any dyspnea and extrabronchial symptoms. It was also proven that, being in the aspirin tolerance state the patients could be given tartrazine with no sensitivity symptoms. The authors think that the possibility of inducing tartrazine and aspirin tolerance, as well as the course of sensitivity reaction to both substances, both point to a similar pathogenetic background. PMID- 3962816 TI - [Seasonal variation of allergy-causing fungi in the southern part of Mexico City]. AB - The presence of mycotic flora in atmospheric medium has always been an interesting field for allergologists and ecologists interested in the problems of environmental contamination. In 1904 Saito in Japan demonstrated that certain spores of fungus when inhaled by susceptible individuals can produce severe respiratory processes. Since then many studies have been performed to determine the generic and species of causative fungus responsible for respiratory allergy, as well to understand its growth, movement and seasonal variations and its relation with the habits of man. Fungi which may produce allergy were investigated in 6 zones of the south of Mexico City, from November, 1981 to October, 1982. In each zone 108 samples were taken. Petri dishes containing Sabouraud medium were exposed during 10 minutes. The number of colonies per Petri dish; 27.6 per cent of the micro-organisms isolated corresponded to allergy producing fungi. The highest frequency of fungal isolation (6,512 colonies) was obtained in summer and the least (1,397 colonies) during winter. The principal genera isolated were: Rhodotorula: 2,418 (16.7%); Phialophora: 2,071 (14.4%); Penicillium: 743 (5.1%); Alternaria: 111 (0.7%). The most frequent species of the Aspergillus were: A. niger, A. fumigatus and A. flavus. The paper discusses the importance of the different factors which can influence the frequency and the seasonal variations of these fungi. PMID- 3962817 TI - Allergens of chrysanthemum pollen. AB - Chrysanthemum pollen extracts analyzed by means of crossed radioimmunoelectrophoresis (CRIE) and RAST-inhibition. Thirty-eight antigens were identified and out of them 10 were able to bind IgE antibodies from sera of patients with pollinosis elicited by these pollens. An allergenic relationship of Chrysanthemum pollen to mugwort pollen was detected in the RAST-inhibition experiments. PMID- 3962818 TI - Listeriosis. PMID- 3962819 TI - Ethyl alcohol induced esophagitis. PMID- 3962821 TI - Planning for tax reform. PMID- 3962820 TI - Air transport of critical patients in Alabama. The first four years' experience. PMID- 3962822 TI - Surgical aspects of lesions involving the connective tissue of the retroperitoneum. PMID- 3962823 TI - No granny-bashing--yet. PMID- 3962824 TI - Failure of vitamin E and delayed muscle soreness. PMID- 3962825 TI - Permanent epidural catheter. PMID- 3962826 TI - Hypertrophic pyloric stenosis: a review of 216 cases from 1980 to 1984. PMID- 3962827 TI - A survey of family physicians providing obstetrical care: a preliminary report. PMID- 3962828 TI - Coagulase-negative staphylococcal bacteremia--a leading cause of sepsis at a community hospital. PMID- 3962829 TI - Tetracycline induced esophagitis. PMID- 3962830 TI - Suicide attempt by drug overdose. AB - Suicide attempts by drug overdose are a growing health care problem, now reaching epidemic proportions. The patient who attempts suicide is typically a young, single adult female with interpersonal conflicts who takes an overdose of a prescribed drug, frequently a benzodiazepine. Patients who have recently been separated or divorced and those who are alcoholic, depressed or previously suicidal are also at risk. The family physician is in the best position to prevent suicide. PMID- 3962831 TI - Preventing wound infections. AB - Quantitative bacterial studies have demonstrated that successful wound closure and healing can be expected if fewer than 10(5) bacteria per gram of tissue are present. The aim of wound management techniques is to reduce bacterial counts. Among the techniques are pulsatile jet lavage, with or without mechanical debridement; the application of biologic dressings; meticulous hemostasis and evacuation of hematomas, and antimicrobial therapy. PMID- 3962832 TI - Juvenile laryngotracheal papillomatosis. PMID- 3962833 TI - Drug-alcohol interactions. AB - Drug-alcohol interactions can be potentially life-threatening. These fall into three broad categories: the disulfiram reaction, which can lead to vasodilation, flushing, headache and tachycardia; central nervous system depression, which can lead to excessive sedation and respiratory depression, and a miscellaneous category of drug-alcohol interactions. PMID- 3962835 TI - Pseudomyxoma peritonei. AB - In pseudomyxoma peritonei, mucinous implants develop on peritoneal surfaces and omentum, often resulting in gelatinous ascites. Definitive treatment has not been established. Adjunctive radiation therapy or chemotherapy following laparotomy has improved survival in some patients. PMID- 3962834 TI - Slipped capital femoral epiphysis. AB - Slippage of the capital femoral epiphysis typically presents as hip pain in a child. Radiographic examination demonstrates translocation of the upper femoral epiphysis away from its normal anatomic position on the neck of the femur. Slipped capital femoral epiphysis can result in permanent deformity if it is not promptly corrected. Closed pinning is the treatment for acute slips, but treatment options are complex when the condition is chronic. PMID- 3962836 TI - Evaluation of insomnia. AB - The effective treatment of patients with a complaint of insomnia requires an appreciation of the range of etiologic factors underlying the symptom of insomnia, as well as sound clinical judgment and appropriate application of available therapeutics. Systematic inquiry regarding nocturnal and daytime aspects of a patient's life is helpful in narrowing the range of diagnostic possibilities. Specialized evaluation at a sleep disorders center may be useful in cases of chronic insomnia that remain refractory to initial interventions. PMID- 3962837 TI - Palpable purpura in leukocytoclastic vasculitis. AB - Palpable purpura is a clinical finding that represents antigen-antibody deposition along small cutaneous vessels, resulting in extravasation of blood cells into the interstitium. The most common cause of palpable purpura is leukocytoclastic vasculitis, a disease involving cutaneous postcapillary venules. Although often idiopathic, leukocytoclastic vasculitis has been associated with numerous infections, drugs, rheumatic diseases and malignancies. PMID- 3962839 TI - Syncope and sinus arrest. PMID- 3962838 TI - Guide to the history in enuretic children. AB - In evaluating a child with enuresis, an organized approach to the history leads to a working diagnosis and an appropriate treatment plan. Questions are grouped in nine categories: perinatal complications, complications in infancy, toilet training, voiding pattern (assessed with a voiding diary), micturition pattern, urinary infection, defecation pattern, perineal symptoms and food sensitivities. Structural abnormalities must be evaluated cautiously to assure that a functional problem is not overlooked. PMID- 3962840 TI - Yellow fever in Asia. PMID- 3962841 TI - Endotracheal intubation. PMID- 3962842 TI - Americans call for affordable, accessible, quality health care. PMID- 3962843 TI - The war against tobacco. PMID- 3962844 TI - Reye syndrome and salicylates: update for pharmacists. PMID- 3962846 TI - Will patients soon be self-treating hypertension with calcium? PMID- 3962845 TI - Diphenhydramine. PMID- 3962847 TI - New drugs of 85. PMID- 3962848 TI - Why join the APhA-PAC? PMID- 3962850 TI - The importance of PACs. PMID- 3962849 TI - APhA's response to HCFA's pharmacists incentive program. PMID- 3962851 TI - Making the most of an internship: a guide for interns and preceptors. PMID- 3962852 TI - A new perspective on policy and its development. PMID- 3962854 TI - Professional development through involvement. PMID- 3962853 TI - What about a visiting clinical rotation? PMID- 3962855 TI - Pharmacists can make the difference--with Medic Alert. PMID- 3962856 TI - Communication awareness: Rx for angry patients. PMID- 3962857 TI - Importance of the distance and velocity of electrical forces in the diagnosis of inferior wall healed myocardial infarction: a vectorcardiographic study. AB - The vectorcardiograms of 41 patients with angiographically proved inferior myocardial infarction (MI) and 51 normal subjects were analyzed to determine whether it is the time (in milliseconds) or the distance (in millivolts) of the initial superiority directed forces of ventricular depolarization that is increased more by inferior MI, and whether parameters derived from both the initial superior time and distance can be used to detect inferior MI. The 10 best individual and the 10 best paired criteria for inferior MI involve superior distance, either alone or used in the calculation of average velocity (in volts per second), and the product of initial superior time and distance (in millivolts per second). The 2 best individual criteria for inferior MI are: inferior velocity more than 0.0065 V/s (sensitivity 71%, specificity 100%) and superior distance more than 0.39 mV (sensitivity 68%, specificity 100%). These diagnostic performances are superior to those of the best criterion that involves only the duration of the initial superior forces, i.e., initial superior time longer than 28 ms (sensitivity 49%, specificity 98%) (chi 2 = 8.42, p less than 0.005 and chi 2 = 6.31, p less than 0.025, respectively). Initial superior distance and parameters calculated from both initial superior distance and time are better vectorcardiographic criteria for inferior MI than are criteria that involve only initial superior time. PMID- 3962858 TI - Incidence, timing and prognostic value of left ventricular aneurysm formation after myocardial infarction: a prospective, serial echocardiographic study of 158 patients. AB - Serial 2-dimensional echocardiography was performed prospectively in 158 consecutive patients with first acute myocardial infarction (AMI) to determine the incidence of left ventricular (LV) aneurysm formation and the time course required for, and the clinical significance of, onset of LV aneurysm formation. Studies were performed throughout the first 5 days and after 3 months and 1 year. LV aneurysm was defined as an abnormal bulge in the LV contour during both systole and diastole. Eighty-four patients had anterior, 68 posterior and 6 anteroposterior AMI defined echocardiographically. During the study period, LV aneurysm was found in 35 of 158 patients (22%): in anterior AMI in 27, in posterior AMI in 6 and in anteroposterior AMI in 2. No new aneurysm developed after 3 months. Early aneurysm formation, during the first 5 days after AMI, was seen in 15 patients with anterior infarction. Twelve of these 15 (80%) died within 1 year (10 within 3 months), in contrast to 5 (25%) of the remaining 20 patients with LV aneurysm (p less than 0.05). Dyskinesia of the anterior wall in the acute stage usually resulted in aneurysm formation. Thus, LV aneurysm formation is seen in 22% of mostly anterior AMI and occurs within 3 months after AMI. Early aneurysm formation is associated with a high 3-month (67%) and 1-year (80%) mortality rate. PMID- 3962859 TI - Usefulness of early exercise testing after non-Q-wave myocardial infarction in predicting prognosis. AB - The value of an early symptom-limited maximal exercise test in predicting coronary anatomy, left ventricular ejection fraction and hemodynamics was assessed prospectively in 64 patients after an acute non-Q-wave myocardial infarction (MI). Exercise tests and cardiac catheterization were performed at a median of 6 and 7 days, respectively, after non-Q MI. Forty-one percent of the patients had a negative exercise test response (no angina, less than 1 mm of ST depression and normal blood pressure responses). Twenty-five percent had a positive response (1 to 1.9 mm of ST depression or angina); 34% had a "strongly positive" exercise test response (at least 2 mm of ST depression or abnormal blood pressure responses). A negative response predicted the absence of 3-vessel disease (at least 70% stenosis) or critical stenoses (at least 90% stenosis) involving major coronary arteries (negative predictive accuracy 92%), whereas a strongly positive response predicted their presence (positive predictive value 77%, specificity 88%). Cardiac index and mean pulmonary artery wedge pressure did not vary significantly among the 3 exercise groups, whereas left ventricular ejection fraction was slightly higher in the exercise test group with a positive response (p less than 0.025). Thus, in patients who have had a non-Q MI, early exercise testing can be used to predict the extent and severity of coronary artery disease, and the decision to perform coronary angiography should be guided by the exercise test results. PMID- 3962860 TI - Phase II intensive monitored cardiac rehabilitation for coronary artery disease and coronary risk factors--a six-session protocol. AB - To evaluate phase II intensive monitored cardiac rehabilitation using a 6-level, 6-session protocol, 31 patients were placed in a progressive 6-level exercise protocol with careful supervision and assessment of heart rate, rhythm, blood pressure and perceived exertion. Duration after the cardiac event ranged from 12 days to 8 years (median 10 months). Each exercise prescription was based on exercise testing with oxygen consumption determinations. Exercise activities were individually prescribed according to percentages of maximal MET level achieved on the exercise test. Each exercise session incorporated calisthenics, treadmill exercise, and bicycle and arm ergometry with progressively greater workloads on the various stations. All patients completed the 6 levels within 6 sessions of approximately 1 hour each, and achieved their designated 50 to 75% target heart rate with perceived exertion level 13 or less. There were no critical cardiac events, i.e., high-grade ventricular arrhythmias or myocardial infarction. All completed the 6-level protocol and progressed to a nonmonitored exercise program with no difficulty. The results of this short-term method of telemetry-monitored rehabilitation suggest benefits of proper exercise instruction, successful achievement of the 50 to 75% exercise target heart rate, detection of minor new arrhythmias and alterations of blood pressure response, adequate use of the perceived exertion scale, and a safe and effective transition to subsequent exercise programs. PMID- 3962861 TI - Evaluation of left ventricular thrombi by contrast-enhanced computed tomography and two-dimensional echocardiography. AB - Contrast-enhanced computed tomography (CT) was compared with 2-dimensional echocardiography (2-D echo) for evaluation of left ventricular (LV) thrombus. Thirteen patients with coronary artery disease who had LV thrombus initially documented by 1 of the 2 techniques were then studied with the other technique. The findings of the studies were concordant in 8 of 13 patients, with a similar description of the presence, location and size of the LV thrombus and associated regional LV wall abnormalities. In 5 of 13 patients, the 2 techniques produced discordant data. Of these, 2 patients had false-negative results on 2-D echo owing to poor visualization of the LV apex; 1 patient had a false-positive result on 2-D echo related to misinterpretation of a prominent papillary muscle; 2 patients had false-negative CT results, 1 related to insufficient contrast infusion. The findings demonstrate that CT is a useful technique for evaluating LV thrombus, and may be particularly helpful when 2-D echo is technically limited or equivocal. PMID- 3962862 TI - Comparison of macroscopic, postmortem, angiographic and two-dimensional echocardiographic findings of coronary aneurysms in children with Kawasaki disease. AB - To assess why the results of 2-dimensional echocardiography (2-D echo) for diagnosis of coronary aneurysm in patients with Kawasaki disease differed from those of cineangiography, the macroscopic, postmortem, angiographic and 2-D echocardiographic findings of 8 autopsied hearts of infants and children with Kawasaki disease were compared. Postmortem angiography and 2-D echo yielded similar results in aneurysms in which there was no thrombus, organization or marked thickening of the arterial wall. However, in aneurysms with complete or incomplete occlusion of the dilated cavity due to thrombi, organization or marked thickening of arterial wall, angiographic results reflected only the free cavity of the coronary aneurysm, but could not detect the original aneurysm. Two dimensional echocardiography disclosed an echo-free space representing the original aneurysm, in which some materials, suggesting thrombi or organization, were found. However, it did not reveal whether the aneurysm was occlusive. This finding indicates that the discrepancies between the results of cineangiography and 2-D echo are attributable to the formation of large thrombi, organization or marked thickening of the arterial wall in the aneurysmal cavity. It is clinically important to know these limitations of angiography and 2-D echo. PMID- 3962864 TI - Acute electrophysiologic effects of pirmenol in normal subjects and in patients with Wolff-Parkinson-White syndrome. AB - The acute electrophysiologic effects of pirmenol are reported in 8 normal subjects and in 8 patients with Wolff-Parkinson-White (WPW) syndrome. Standard electrophysiologic testing was performed before and after a 50-mg intravenous bolus and a 60-minute infusion of 150 mg of pirmenol. After pirmenol administration, AH interval, atrial refractory period, atrioventricular (AV) nodal functional refractory period and Wenckebach cycle length did not change; however, sinus cycle length decreased from 743 +/- 169 to 650 +/- 133 ms (p less than 0.001), sinoatrial conduction time from 103 +/- 35 to 78 +/- 37 ms (p less than 0.05) and AV nodal effective refractory period from 308 +/- 51 to 272 +/- 23 ms (p less than 0.01). Pirmenol increased the HV interval from 43 +/- 5 to 48 +/- 6 ms (p less than 0.05) and ventricular functional refractory period from 247 +/- 21 to 260 +/- 21 ms (p less than 0.005). Anterograde effective refractory period of the accessory AV pathway increased in 4 of 6 patients with ventricular preexcitation and retrograde effective refractory period increased in all patients. Pirmenol treatment prolonged the shortest preexcited RR interval from 253 +/- 38 to 459 +/- 19 ms (p less than 0.05) and the average RR interval from 354 +/- 26 to 421 +/- 60 ms (p less than 0.01) during atrial fibrillation in all 6 patients with preexcitation. Pirmenol did not influence the inducibility or cycle length of AV reciprocating tachycardia in the patients with WPW syndrome. The pirmenol infusions were well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962863 TI - Dipyridamole-echocardiography test in patients with exercise-induced ST-segment elevation. AB - Fourteen consecutive patients with exercise-induced ST-segment elevation in the absence of previous infarction and basal left ventricular asynergy at rest performed a dipyridamole test (infusion of dipyridamole, 0.14 mg/kg/min intravenously for 4 minutes) during 12-lead electrocardiographic (ECG) and 2 dimensional echocardiographic monitoring. In 7 of the 14 patients, dipyridamole infusion consistently induced ST-segment elevation in the leads that showed ST elevation on effort; reversible asynergy (occurring in the region corresponding to the ECG leads with diagnostic changes) could always be documented by echocardiography. In 2 patients dipyridamole induced reversible asynergy in presence of ST-segment depression. In these 9 patients angiography invariably revealed a severe organic stenosis in the coronary artery feeding the region that became transiently asynergic after dipyridamole. In the other 5 patients (all of whom had either spontaneous or ergonovine-induced ST-segment elevation), the dipyridamole test yielded no significant echocardiographic or ECG change; coronary angiography showed absent (2 patients) or significant (3 patients) coronary artery disease. In conclusion, dipyridamole may induce transmural ischemia in humans, as detected by the electrical hallmark of ST elevation; this ECG pattern, in contrast to ST depression, reliably predicts the presence and site of transient regional asynergy. When dipyridamole induces ST-segment elevation, severe basal stenosis is invariably present in the coronary artery supplying the transiently asynergic myocardial region. PMID- 3962865 TI - Comparison of exercise and ajmaline tests with electrophysiologic study in the Wolff-Parkinson-White syndrome. AB - Ajmaline test (50 mg intravenously over 1 minute) and ergometric exercise test were performed in 24 patients with the Wolff-Parkinson-White syndrome. The effects of both tests on the conduction in the accessory pathway (AP) were correlated with the anterograde effective refractory period (ERP) of the AP. Ajmaline caused transient anterograde block in the AP in 15 patients, 14 with an ERP of more than 250 ms and 1 with an ERP of 250 ms. Ajmaline failed to abolish preexcitation in 9 patients, all with ERP of the AP of 250 ms or less. Exercise testing caused anterograde block in the AP in 5 patients, in 2 during exercise (ERP of 340 and 360 ms) and in the remaining 3 patients during the recovery phase (ERP of 600, 520 and 460 ms). Of the 10 patients with an ERP of 250 ms or less, ajmaline did not abolish preexcitation in 9 and exercise did not abolish it in any of them. Of the 7 patients with an ERP of 330 ms or more, ajmaline abolished preexcitation in 7 and exercise abolished it in 5 patients. Of the 7 patients with ERP of the AP more than 250 ms but less than 330 ms, ajmaline but not exercise abolished preexcitation in all. Thus, ajmaline and exercise testing can detect patients with short and long ERPs of the AP, respectively, and the effects of ajmaline and exercise tests combined may be useful in the noninvasive assessment of various ranges of ERP of the AP. PMID- 3962866 TI - Use of flecainide acetate for refractory junctional tachycardias in children with the Wolff-Parkinson-White syndrome. AB - The response of sustained supraventricular tachycardia to intravenous and oral flecainide acetate was investigated in 5 children, aged 5.5 to 11.5 years, who had tachycardias associated with Wolff-Parkinson-White syndrome. All children had failed to respond to at least 2 conventional agents. The effect of flecainide was studied using intracardiac techniques. Intravenous flecainide terminated tachycardia in all 5 patients. After drug infusion, slow, sustained tachycardia could be initiated in 1 patient. With oral treatment, slow, sustained tachycardia was started in 2 children and nonsustained in 2. One child had no inducible tachycardias. In 4 of 5 patients, long-term treatment has reduced the frequency of episodes and the drug is well tolerated. Thus, flecainide may be used to terminate and suppress junctional tachycardias in children who have failed to respond to conventional therapy. PMID- 3962867 TI - Optimal mode of transesophageal atrial pacing. AB - The optimal mode of transesophageal atrial pacing was determined by clinical electrophysiologic studies in 15 healthy adult volunteers. The point at which the unipolar atrial electrogram was biphasic and largest in amplitude (35.4 +/- 1.6 cm from the incisors) was considered the best stimulation site for atrial pacing. The stimulation threshold on bipolar pacing (using the proximal pole as cathode and the distal pole as anode) at this site was 27 +/- 7 mA, which was significantly lower (p less than 0.001, n = 10) than that on unipolar cathodal stimulation (41 +/- 8 mA). Although the stimulation threshold tended to be higher with a No. 10Fr electrode catheter (30 +/- 5 mA) than with a No. 6Fr catheter (27 +/- 7 mA), the difference was statistically insignificant (n = 9). When the interpolar distance in bipolar stimulation was varied in 5 steps from 12 to 80 mm, the threshold was lowest at the distance of 24 mm. Of the 10 pulse durations tested, ranging from 0.25 to 128 ms, 8 ms appeared most desirable in minimizing the total amount of current and chest discomfort accompanying the pacing. With the optimal site, interpolar distance and pulse duration, transesophageal atrial pacing was successfully performed in all patients, without producing significant complications such as chest pain. Transesophageal atrial pacing is noninvasive, technically simple and efficient, and may be valuable in the diagnosis and treatment of various cardiac arrhythmias. PMID- 3962868 TI - Prevalence of retrograde conduction in heart block after DDD pacemaker implantation. AB - Electrophysiologic studies were performed before DDD pacemaker implantation in 50 patients with symptomatic heart block. The patients were separated into 2 groups. Group I consisted of patients with intact retrograde conduction and group II consisted of patients with blocked retrograde conduction. After pacemaker implantation, postventricular atrial refractory periods in patients in group I were programmed at 50 to 100 ms, in excess of the retrograde conduction times measured during electrophysiologic studies. In group II patients, postventricular atrial refractory periods were routinely programmed at 300 ms. During follow-up, patients visited the outpatient clinic at 3-month intervals for noninvasive assessment of the prevalence of retrograde conduction, and to test the inducibility of pacemaker-mediated tachycardias. The mean follow-up of group I (15 patients) was 27 +/- 10 months, whereas the mean follow-up of group II (35 patients) was 19 +/- 9 months. The mean number of noninvasive tests performed during follow-up was 8 +/- 3 per patient for group I and 5 +/- 3 per patient for group II. In group I, retrograde conduction remained intact in 12 patients (p less than 0.01). In 29 of 31 patients in group II, retrograde conduction remained absent (p less than 0.01). In 4 patients in group II, chronic atrial fibrillation occurred during follow-up. Chronic atrial fibrillation did not occur in any patient in group I. During serial electrophysiologic testing, no pacemaker mediated tachycardias could be induced in any patient in group I or II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962869 TI - Frequency of angiographically significant coronary arterial narrowing in mitral stenosis. AB - Ninety-six consecutive patients older than 40 years with severe mitral stenosis were retrospectively analyzed to determine the relation of angina pectoris (AP) and coexistent coronary artery disease (CAD). Of the 96 patients, 27 (28%) had angiographically significant CAD, 10 (37%) with AP and 17 (63%) without AP. Of the 96 patients, 21 had AP, 10 (48%) with angiographically significant CAD and 11 (52%) without (CAD). Of 75 patients without AP, 17 (23%) had angiographically significant CAD AP had a specificity of 84% and a sensitivity of 37% in its ability to detect significant CAD. The pulmonary artery systolic, diastolic and mean pressures and the pulmonary vascular resistance did not differ between patients with and those without AP (p greater than 0.05). It is concluded that coexistent CAD is commonly found in patients older than age 40 with severe MS, and is usually clinically silent. PMID- 3962870 TI - Maturation of pulmonary input impedance spectrum in infants and children with ventricular septal defect. AB - To determine whether pulmonary vascular disease can be detected in infants with ventricular septal defect (VSD) by the presence of an increase in the frequency of the impedance modulus minimum of the pulmonary input impedance spectrum, as has been implied for older children, spectra of 25 infants (2 years or younger) (group 1) were compared with spectra of 20 children (ages 2 to 7 years) (group 2). Groups were subdivided according to mean pulmonary artery (PA) pressure: those with moderate pressure levels (35 mm Hg or less, groups 1A and 2A) and those with high pressure levels (at least 40 mm Hg, groups 1B and 2B). Pulmonary vascular resistance, characteristic impedance and frequency of the modulus minimum were significantly lower in group 2A than in group 1A. The decrease in pulmonary vascular resistance and characteristic impedance with increasing age was consistent with body surface area increases; however, the shift in frequency of the modulus minimum could be more easily related to a decrease in the pulse wave velocity than to a shift in the primary reflection site. Pulmonary vascular resistance, characteristic impedance and the frequency of the first modulus minimum were comparable in groups 1B and 2B; however, none of the patients in group 1B had evidence of pulmonary damage, whereas 3 of 4 group 2B patients had microscopically apparent pulmonary vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962871 TI - Frequency of various congenital heart diseases in Chinese adults: analysis of 926 consecutive patients over 13 years of age. AB - A retrospective analysis was performed in 926 consecutive Chinese persons, aged 14 to 68 years, in whom congenital heart disease had been diagnosed and catheterization had been performed over the past 24 years. The incidence of various congenital cardiac malformations was compared with that in other series reported world-wide. About 60% of the 926 patients underwent surgery, and anatomic details of the malformations were examined. Congenital aortic valvular stenosis and coarctation of the aorta were uncommon (2.4% and 1.2%, respectively) among the Chinese adults, and the ethnic differences with Western countries in the incidence of these 2 defects were apparent and real. In contrast, aneurysm of the sinus of Valsalva, either ruptured or nonruptured, was more common (4.3%) and the incidence of outlet muscular type (or type 1) of ventricular septal defect was 4 to 9 times as common as has been reported in the West. Genetic differences rather than environmental factors or dietary habits may explain these special features. PMID- 3962872 TI - Pulsed Doppler flow characteristics of ductus arteriosus in infants with associated congenital anomalies of the heart or great arteries. AB - Pulsed Doppler echocardiography (PDE) from the suprasternal approach was used to assess flow characteristics of ductus arteriosus (DA) in 145 infants (aged 1 day to 6 months) with major congenital heart disease. Direct ductal Doppler interrogation was possible in 138 patients and serial studies before and after medical treatment were performed in 28 infants. According to pulmonary artery pressure and associated heart lesions, 3 ductal shunting patterns were identified. An isolated left-to-right shunt, observed in isolated DA or in right ventricular outflow tract obstruction, was characterized by a continuous flow with a peak velocity in late systole. An isolated right-to-left shunt, observed in persistent fetal circulation and aortic arch abnormalities, was characterized by a continuous flow with a peak velocity in early systole. In patients with a bidirectional ductal shunt, the right-to-left shunt always occurred in systole and the left-to-right shunt began in late systole and extended into diastole. A systolic right-to-left shunt always corresponded to the presence of significant pulmonary hypertension. Ductal flow changes could be documented after prostaglandin E1 therapy in patients with ductus-dependent heart disease or after tolazoline therapy in patients with persistent fetal circulation. Thus, PDE with direct ductal Doppler interrogation is an important complement to the echocardiographic evaluation of DA. It is a safe noninvasive approach to ductal shunt and permits convenient evaluation of the effects of drugs on pulmonary artery resistance (tolazoline) and ductal patency (prostaglandin E1). PMID- 3962873 TI - Systemic vasoconstrictor effects of oxygen administration in obliterative pulmonary vascular disorders. AB - Although oxygen is frequently administered to patients with obliterative pulmonary vascular disorders (OPVD) for diagnostic and therapeutic purposes, its hemodynamic effects in these patients have not been systematically evaluated. The response to administration of 50 to 70% oxygen was studied in 14 patients with pulmonary hypertension secondary to OPVD. Mean pulmonary artery pressure decreased (from 62 +/- 5 to 57 +/- 5 mm Hg, p less than 0.01) after oxygen inhalation secondary to a decrease in cardiac index (1.9 +/- 0.2 to 1.8 +/- 0.2 liters/min/m2, p less than 0.01), without changes in pulmonary arteriolar resistance. This decline in forward output appeared to result from a systemic vasoconstrictor effect of oxygen (change in systemic vascular resistance from 1,965 +/- 275 to 2,297 +/- 336 dynes s cm-5, p less than 0.01), which decreased heart rate (from 93 +/- 3 to 89 +/- 2 beats/min, p less than 0.01) by stimulation of baroreceptor reflexes and decreased stroke volume (from 22 +/- 3 to 21 +/- 2 ml/beat/m2, p less than 0.05) by increasing impedance to left ventricular ejection. The decrease in left-sided cardiac output likely led to a decline in venous return to the right side of the heart and, consequently, to a decrease in right atrial and pulmonary arterial pressures. Accordingly, the percent decrease in mean pulmonary artery pressure varied linearly and directly with the percent increase in systemic vascular resistance (r = 0.84), but not with changes in pulmonary arteriolar resistance (r = 0.15).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962874 TI - Comparison of Doppler-determined elevated pulmonary arterial pressure with pressure measured at cardiac catheterization. AB - This study assesses use of pulsed Doppler echocardiography to measure pulmonary artery (PA) pressure. PA flow at the right ventricular (RV) outflow tract was analyzed in 51 patients. Attention was focused on PA flow morphologic pattern, RV systolic intervals, time to peak flow and acceleration time index. Correlation was made with PA pressure and total pulmonary resistance. Three morphologic patterns of PA flow were found: type I indicates normal PA pressure (sensitivity 85%, specificity 100%) and types II and III indicate PA hypertension (sensitivity 100%, specificity 85%). The RV preejection/RV ejection ratio, time to peak flow and acceleration time index show a good correlation coefficient improved when a logarithmic function was applied. The best correlation was achieved with time to peak flow (r = -0.77 with PA pressure, r = -0.79 with total pulmonary resistance), and especially with acceleration time index (r = -0.84 with PA pressure, r = -0.87 with total pulmonary resistance). Analysis of pulmonary flow is a reliable new tool for evaluating PA pressure and is even better for evaluating total pulmonary resistance. Acceleration time index is the parameter that correlates best with these 2 variables. PMID- 3962875 TI - Improved in vivo magnetic resonance imaging of acute myocardial infarction after intravenous paramagnetic contrast agent administration. AB - Gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA), a paramagnetic relaxation agent, has been used in vitro to improve the detection of acute myocardial infarction (MI) by magnetic resonance imaging (MRI). In this study, the ability of Gd-DTPA to improve in vivo magnetic resonance imaging of MI was examined. Ten dogs with MI caused by left anterior descending coronary artery ligation were imaged 1 to 5 days after infarction. Imaging was performed before and for 2 hours after intravenous administration of 0.34 mmol/kg Gd-DTPA. One to 2 days after MI, Gd-DTPA improved visualization of the infarct in 3 of 4 dogs. This effect was more prominent in dogs imaged 4 to 5 days after MI, when 6 of 6 dogs showed substantially improved infarct definition after Gd-DTPA. At both times the intensity ratio, an objective measure of contrast between infarcted and normal tissue that is defined by the ratio of image intensity of infarcted area to that of noninfarcted area, was significantly better after Gd-DTPA administration. The intensity ratio at 24 to 48 hours after infarction was 1.4 +/ 0.2 (mean +/- standard deviation) before Gd-DTPA, and 1.7 +/- 0.6 after Gd-DTPA (p = 0.03). The intensity ratio at 4 to 5 days after infarction was 1.5 +/- 0.3 before Gd-DTPA, and 1.8 +/- 0.5 after Gd-DTPA (p less than 0.001). Thus, Gd-DTPA administration improves in vivo visualization of MI by MRI. PMID- 3962876 TI - The Holter electrogram as an occasional alternative to electrophysiologic study. PMID- 3962877 TI - Unipolar pacer artifacts induced failure of an automatic implantable cardioverter/defibrillator to detect ventricular fibrillation. PMID- 3962878 TI - Polymorphic ventricular tachycardia secondary to hypothyroidism. PMID- 3962879 TI - Subvalvular mitral calcium as a cause of surgically correctable ventricular tachycardia. PMID- 3962880 TI - Long-term follow-up of transvenous cardiac pacing in children. PMID- 3962881 TI - Cardiac rupture, abdominal aneurysmal rupture and dissecting aortic rupture: a preventive trio. PMID- 3962882 TI - Safety of nifedipine in severe congestive heart failure. PMID- 3962884 TI - On the diagnostic significance of the rate of ascension of R2 in inferior myocardial infarction. PMID- 3962883 TI - Fatal acute circulatory failure in pulmonary valve endocarditis. PMID- 3962885 TI - Pericarditis after acute myocardial infarction. PMID- 3962886 TI - Safety of ibuprofen for acute myocardial infarction pericarditis. PMID- 3962888 TI - Verapamil in wide complex tachycardia. PMID- 3962887 TI - Electrocardiographic enzymatic and scintigraphic criteria for diagnosis of acute myocardial infarction. PMID- 3962889 TI - Arrhythmias in mitral regurgitation. PMID- 3962891 TI - "New" projection in pediatric two-dimensional echocardiography. PMID- 3962890 TI - Significance of intraluminal filling defects in unstable angina. PMID- 3962892 TI - Noninvasive detection of coronary artery patency using continuous ST-segment monitoring. AB - Continuous ST-segment Holter recordings were analyzed from 46 patients with acute myocardial infarction (AMI) receiving intracoronary streptokinase (SK) during the first 48 hours of hospitalization. Changes in ST deviation and the time periods of these changes were quantitated and correlated with angiographic evidence of reperfusion. Thirty-six patients had total occlusion of the infarct vessel and 10 had subtotal occlusion. Of the 36 vessels that were totally occluded, 19 were reperfused and 17 were not. In patients in whom reperfusion was successful, an ST steady state was achieved 55 +/- 32 minutes after SK administration. In patients in whom it was not successful, a steady state was achieved in 219 +/- 141 minutes (p less than 0.001). Achievement of steady state within 100 minutes after SK reperfusion indicated successful reperfusion with 89% sensitivity and 82% specificity. All patients with subtotal occlusion achieved an ST steady state before SK infusion. No patient with total occlusion achieved a steady state before SK. Achievement of ST steady state before SK infusion was 100% sensitive and 100% specific for subtotal occlusion at initial angiography. Continuous, quantitative ST-segment analysis is a sensitive and specific noninvasive technique for following coronary artery patency during AMI. PMID- 3962893 TI - Reliability of Q-wave formation and QRS score in predicting regional and global left ventricular performance in acute myocardial infarction with successful reperfusion. AB - The frequency of electrocardiographic Q-wave formation and the relation of Q wave and QRS score to regional and global left ventricular (LV) performance were determined in 131 patients with acute myocardial infarction (AMI) receiving thrombolytic therapy. Thrombolytic therapy was successful in reperfusing the occluded infarct artery in 100 patients and was unsuccessful in 31. The number of patients who had 1 or more Q waves (88 vs 87%) and 2 or more Q waves (70 vs 74%) was similar. In contrast, normal wall motion was significantly more common in the infarct area in patients in whom reperfusion was successful (42 vs 15%, p less than 0.05). Total QRS scores were similar in patients in whom reperfusion was successful and in those in whom it was not (6.0 +/- 3.2 vs 6.4 +/- 4.2). Despite similar QRS scores, successfully treated patients had significantly higher LV ejection fraction (53 +/- 13% vs 46 +/- 15%, p less than 0.05). Thus, Q-wave formation after successful thrombolytic therapy for AMI is common but does not faithfully reflect regional or global LV performance. Electrocardiographic analysis alone is not a reliable method to assess efficacy of reperfusion therapy. PMID- 3962894 TI - Rate of left ventricular functional recovery by radionuclide angiography after exercise in coronary artery disease. AB - To characterize determinants of the rate of recovery of left ventricular (LV) function after exercise-induced ischemia, sequential postexercise radionuclide angiography was performed prospectively in 38 consecutive patients with documented coronary artery disease (CAD). In each patient new or increased regional asynergy developed or absolute ejection fraction decreased at least 4% during exercise. Twenty patients showed immediate recovery of LV function after exercise (group 1) and 18 showed delayed recovery (group 2). Ejection fraction in the first postexercise period was significantly greater in group 1 (65 +/- 12%) than in group 2 (55 +/- 11%) (p less than 0.01). The mean number of coronary arteries with at least 70% diameter narrowing was greater in group 2 (2.7 +/- 0.5) than in group 1 (2.0 +/- 0.9) (p = 0.026); CAD score was also greater in group 2 than in group 1 (p = 0.005). The increase in LV end-diastolic volume from rest to end exercise was greater in group 2 than in group 1 (p = 0.005); neither the change in LV volume nor the change in heart rate or blood pressure after exercise separated the groups. The only independent predictor of the rate of functional recovery was the degree of exercise-induced regional myocardial asynergy (p less than 0.001). Thus, exercise radionuclide angiography in patients with CAD provides a model for evaluating postischemic myocardial function. Delayed functional recovery is associated with extensive exercise-induced regional asynergy as a result of severe CAD and is not primarily influenced by hemodynamic changes. PMID- 3962895 TI - Is there a universal antitachycardia pacing mode? AB - A pacing mode using automatically increasing number of stimuli with adaptive coupling intervals was evaluated prospectively as a possible universal pacing mode, because a universal mode would save extensive testing and tailoring time. In group 1, which included 7 patients with implanted antitachycardia pacemaker systems, the test mode was compared with the previously tested and tailored mode. In group 2, which included 11 patients undergoing invasive electrophysiologic study, the test mode was compared with the scanning and asynchronous burst mode. There were 4 patients in group 3. The mode was tested prospectively in these 4 patients. Three of these patients were tested after pacemaker implantation (in supine and upright body position and after moderate exercise). The fourth patient had recurring episodes of VT, which were terminated with the test mode via an external lead. Of 209 tachycardias (156 supraventricular tachycardia [SVT] and 53 with VT) studied with the test mode, 1 episode of nonsustained atrial fibrillation was induced from the ventricle and 1 episode of VT was not terminated using the test mode and long coupling intervals. Two episodes of VT in patients with a recent myocardial infarction (MI) required direct-current countershock: due to acceleration in 1 patient and due to VF in 1. All other tachycardias were terminated promptly by the test mode without prior knowledge about successful coupling intervals or number of stimuli. Of the remaining 106 tachycardias studied (69 SVT, 37 VT) the scanning mode failed to terminate 2 episodes of SVT with up to 4 atrial premature beats and induced acceleration of VT in 1 patient with a recent MI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3962896 TI - Measurement of the AH and HV interval and His bundle duration: interobserver and intraobserver variation. AB - Conduction system intervals measured during intracardiac electrophysiologic testing influence clinical decisions. To evaluate measurement reliability, interobserver and intraobserver variation for AH, HV, and His bundle duration measurements from 50 patients were evaluated. The square of the correlation coefficient (r2) was used as the index for measurement reliability. Three investigators performed the measurements. The r2 for interobserver variation of the AH interval ranged from 0.55 to 0.68 and for intraobserver variability from 0.60 to 0.88. The standard error of measurement based on intraobserver measurements ranged from 10.2 to 18.0 ms. The r2 for interobserver variation of the HV interval ranged from 0.42 to 0.63 and for intraobserver variation from 0.489 to 0.73. The standard error of measurement was 6.2 to 9.9 ms. For the His bundle duration, the r2 for interobserver variation ranged from 0.42 to 0.52 and for intraobserver variation from 0.19 to 0.52. The standard error of measurement was 3.1 to 5.2 ms. Although there is measurement variation for AH and HV intervals, their use in conjunction with the history and the surface electrocardiogram to make clinical decisions is appropriate. His bundle duration cannot be measured reliably using the standard recording technique and should not be used for clinical decision making. PMID- 3962897 TI - Effects of intracoronary injection of acetylcholine on coronary arterial diameter. AB - The effects of intracoronary injection of acetylcholine on coronary arterial diameter was examined by coronary arteriography in 30 adult patients (13 men, 17 women), aged 23 to 67 years (mean 51), with normal or almost normal coronary arteriographic findings. Patients with angina pectoris, myocardial infarction and other severe cardiac diseases were excluded. Two minutes after injection of 30 to 100 micrograms of acetylcholine into the left coronary artery, significant diffuse narrowing (more than 25% reduction in diameter) of the left main trunk, the proximal, mid- and distal left anterior descending artery, and the proximal, mid- and distal left circumflex artery occurred in 1 (4%), 5 (20%), 3 (12%), 9 (36%), 6 (24%), 8 (32%) and 3 (12%) of 25 patients, respectively. After injection of 30 to 50 micrograms of acetylcholine into the right coronary artery, significant diffuse narrowing of the proximal, mid- and distal right coronary artery occurred in 5 (25%), 7 (35%) and 10 (50%) of 20 patients, respectively. However, significant diffuse dilatation (more than 25% increment in diameter) appeared in the left main trunk, left anterior descending, left circumflex and right coronary arteries in a few patients. These results indicate that acetylcholine induces coronary vasoconstriction in a significant number and coronary vasodilatation in a small number of adult humans, and that response of the coronary artery to acetylcholine varies along the course of the coronary artery. PMID- 3962898 TI - Left thoracic sympathectomy for treatment of refractory reentrant tachycardia in concealed Wolff-Parkinson-White syndrome. PMID- 3962899 TI - Ventricular dysrhythmias associated with congenital left ventricular aneurysms. PMID- 3962900 TI - Retinoyl beta-glucuronide: an endogenous compound of human blood. AB - The occurrence of retinoyl beta-glucuronide and retinoic acid as normal endogenous components of vitamin A reserve in human blood has been demonstrated. Use of high-performance liquid chromatography, coupled with a sensitive detector and integrator, has enabled us to quantitate nanogram quantities of the two retinoids. Serum concentrations of retinoyl glucuronide and retinoic acid in all the volunteers studied ranged from 1.5 to 5.1 ng/ml (mean 2.42 ng/ml) and from 1.0 to 3.2 ng/ml (mean 1.80 ng/ml) serum, respectively. The identity of retinoyl beta-glucuronide was confirmed by its conversion to retinoic acid by the action of beta-glucuronidase and by study of the mass spectrum of the methylated derivative. PMID- 3962901 TI - Effects of smoking cessation on weight gain, metabolic rate, caloric consumption, and blood lipids. AB - Thirteen sedentary adult females successfully quit smoking cigarettes for 48 days. Mean daily caloric consumption increased 227 kcal and mean weight gain was 2.2 kg. There were no measurable acute effects of smoke inhalation and no chronic net effects of smoking cessation on resting metabolic rate, as determined by oxygen consumption and respiratory exchange ratio. After 1 yr, subjects who continued to abstain gained an average of 8.2 kg. HDL-cholesterol increased 7 mg/dl in 48 days; however, this effect was lost in those who returned to smoking. Increased caloric consumption accounted for 69% of weight gained immediately following smoking cessation. Factors other than changes in caloric consumption and metabolic rate may be responsible for a significant proportion (31%) of the weight gained in individuals who quit smoking. PMID- 3962902 TI - Changes in specific nutrients in breast milk during extended lactation. AB - An increasing trend towards breast-feeding infants beyond 6 mo of age has been observed in this country. The present study was designed to examine the effect of extended lactation on the concentrations of vitamins B6 and C, free and total folacin, calcium, zinc, and magnesium. Forty mothers were studied from 7 months of lactation until they stopped breast-feeding. Subjects were requested to collect milk samples monthly at a morning feeding between 7 AM and 10 AM. Between 7 and 25 mo of lactation, levels of zinc, calcium, vitamin B6, and vitamin C tended to decrease, whereas levels of free and total folacin remained unchanged. Magnesium levels decreased only after 18 mo of lactation. The decrease in concentrations of zinc and calcium paralleled the decrease in feeding frequency. Changes observed in this study on the composition of human milk may reflect physiological changes in the mammary gland during weaning. PMID- 3962904 TI - Low glycemic response to traditionally processed wheat and rye products: bulgur and pumpernickel bread. AB - To look at the effect of processing wheat and rye on blood glucose responses with special reference to bulgur and pumpernickel bread, groups of 9-12 Noninsulin dependent (NIDDM) and 5-6 Insulin-dependent diabetic volunteers (IDDM) were fed test meals containing 50 g carbohydrate portions of four wheat and three rye products. Glycemic indices for IDDM and NIDDM combined, calculated as the incremental area under the blood glucose response curve, where white bread = 100, demonstrated values of 96 +/- 5 for wholemeal wheat bread, 89 +/- 6 for wholemeal rye bread, 78 +/- 3 for pumpernickel bread, 65 +/- 4 for bulgur, 63 +/- 6 for whole wheat kernels and 48 +/- 5 for whole rye kernels. Results for IDDM and NIDDM were similar (r = 0.96, p less than 0.01). It is concluded that traditional processing of cereals, such as parboiling (bulgur) or the use of wholegrains in bread (pumpernickel) may result in the low GI value associated with the unmilled cereal. Cereal foods processed in these ways may form a useful part of the diet where a reduction in postprandial glycemia is required. PMID- 3962903 TI - Effect of the level of dietary protein on the utilization of alpha ketoisocaproate for protein synthesis. AB - The efficiency of alpha-ketoisocaproate (KIC) as a dietary substitute for leucine in rats on varying protein intake was estimated by an isotopic method, previously shown to yield the same results as comparative growth experiments. 14C-KIC and 3H leucine are injected orally. Six hours later the ratio, R, of 14C/3H in isolated proteins, divided by the same ratio in the injectate is measured. This ratio has been shown to be approximately equal to nutritional efficiency of KIC relative to leucine. As dietary protein increased from 6.3% to 48.3%, whole body protein R decreased from 0.515 +/- 0.045 to 0.299 +/- 0.016. Variations with protein intake were noted in R of protein isolated from individual organs. The magnitude of R in these organs varied two-fold, in the following sequence: brain greater than heart greater than or equal to skeletal muscle greater than or equal to salivary gland greater than or equal to kidney greater than liver. Whole body protein R could be confidently predicted (r2 = 0.992) from R in the protein of kidney and muscle. Thus the nutritional efficiency of KIC as a dietary substitute for leucine in individual organs as well as in the whole animal is strongly dependent on the level of protein intake. PMID- 3962905 TI - Plasma lipids and apolipoprotein A-I and A-II levels in alcoholic patients. AB - This prospective study compared total plasma lipids, high-density lipoprotein cholesterol (HDL-C), and apolipoproteins A-I (apo A-I) and A-II (apo A-II) in 72 alcoholic patients and in 285 nonalcoholic controls. The HDL-C in the alcoholic group was not significantly different from that in the nonalcoholic controls. Alcoholic men had significantly higher levels of cholesterol and triglycerides and lower levels of apo A-I when compared with nonalcoholic controls. Alcoholic women had significantly higher levels of cholesterol and apo A-II when compared with nonalcoholic controls. Serial measurements in 25 alcoholic patients showed a significant decline in HDL-C, apo A-I, and apo A-II levels during the 4-wk hospital stay. HDL-C demonstrated its expected inverse relationship with plasma triglyceride level and its direct relationship with apo A-I, apo A-II, and the hepatic enzyme aspartate aminotransferase. PMID- 3962906 TI - Fat in the diets of adolescent girls with emphasis on isomeric fatty acids. AB - To determine the amount of isomeric fatty acids in the diets of a segment of the American population, daily food intake was collected, using the duplicate portion method, from eight healthy white adolescent girls for 7 days. The fifty-six diets were analyzed for fatty acids by gas-liquid chromatography. The amount of trans isomers of octadecenoic acid (18:1t) in the diets of the eight girls ranged from 3.5 to 8.2% of total fatty acids with an average of 5.3%. Other trans fatty acids included trans isomers of 14:1 and 16:1, and cis,trans and trans,cis isomers of 18:2. No measurable amounts of trans,trans octadecadienoic acid (18:2tt) were found in the diets of the girls. The total trans fatty acid content of the diets averaged 6.5% of total fatty acids. The daily consumption of total trans fatty acids by the eight girls over a 1 wk period averaged 3.1 g, with 2.6 g of this being 18:1t. PMID- 3962907 TI - Design and data quality of a mixed longitudinal study to elucidate the role of dietary calcium and phosphorus on bone mineralization in pre-, peri-, and postmenopausal women. AB - The study design and data quality control of an ongoing study (10 yr duration) in a few hundred women are presented. Good variables with respect to their longitudinal usefulness are: body weight, body height, and span-width. Reasonable variables are the bone parameters of the radius (BMC, BW, and BMC/BW). Poor variables are: dietary calcium and phosphorus intake, dietary calcium-to phosphorus ratio, urinary calcium-to-creatinine ratio, urinary sodium-to creatinine ratio, hematocrit, serum alkaline phosphatase activity, serum gamma-GT activity, and serum parathyroid-hormone concentration. Bad variables are: urinary phosphorus-to-creatinine ratio, urinary hydroxyproline-to-creatinine ratio, creatinine clearance, hemoglobin, MCHC, serum calcium, serum ionized calcium, serum phosphorus, serum total protein, serum albumin, and serum creatinine. In conclusion, it is possible to relate bone loss to food intake and to changes in anthropometric variables on an individual basis. However, quantification of the metabolic process is not possible. PMID- 3962908 TI - Iron deficiency and behavioral development in infants and preschool children. AB - This paper selectively reviews the main findings of studies on the possible effects of iron deficiency on cognitive function among infants and preschool children published after 1976, and presents data from a study recently conducted in rural Guatemala. In comparison to infants without signs of sideropenia, infants with iron deficiency with and without anemia tend to score lower in the Bayley Scale of Mental Development; conversely, there is no evidence for an association between iron deficiency and delayed motor development. Iron repletion therapy implemented over a period of 7 to 10 days is likely to result in an improvement in mental development scale scores among infants with iron deficiency with or without anemia. In comparison with preschool children without sideropenia, preschool children with iron deficiency with or without anemia are less likely to pay attention to relevant cues in problem solving situations. PMID- 3962909 TI - Plasma pyridoxal phosphate concentrations and coenzyme stimulation of erythrocyte alanine aminotransferase activities of white and black adolescent girls. AB - The vitamin B6 status of 96 white and 90 black female adolescents was assessed utilizing plasma pyridoxal phosphate concentrations, coenzyme stimulation of erythrocyte alanine aminotransferase activities, and vitamin B6 intakes. These values were similar for the two race and three age groups. Fifty-eight percent of the girls reported consuming less than 0.02 mg vitamin B6/g protein daily. The mean coenzyme stimulation and pyridoxal phosphate values of the subjects were 13.5% and 45.2 nM. Coenzyme stimulation values greater than 25% were observed in 18% of the girls and values between 16 and 25%, in 23%. Plasma pyridoxal phosphate concentrations less than 34.4 nM were observed in 26% of the girls and values from 34.4 to 40.5 nM, in 14%. Vitamin B6 inadequacy was prevalent among white and black southern adolescent girls participating in this study as indicated by plasma pyridoxal phosphate concentrations, coenzyme stimulation of erythrocyte alanine aminotransferase activities, and vitamin B6 intakes. PMID- 3962910 TI - Comparison of nutrient intakes of selected populations in the United States and Israel: the Lipid Research Clinics prevalence study. AB - Nutrient intakes of 2,772 US and 2,680 Jerusalem participants of the Lipid Research Clinics Program were assessed by 24-h dietary recall in men aged 15-19 and 40-59 yr and women aged 15-19 and 35-59 yr. Energy intake was higher in the US than in Jerusalem. In Jerusalem intake of total fat ranged between 32.2-33.7% of kcal, of saturated fatty acids (SFA) between 9.8-10.9%, of polyunsaturated fatty acids (PFA) between 7.9-8.6%, of carbohydrates between 50.5-53.9%, and of starch between 24.0-30.5%. The P:S ratio ranged between 0.80 and 1.01. The corresponding ranges for the US were 38.8-40.8% for fat, 14.3-15.9% for SFA, 5.9 6.8% for PFA, 38.9-46.2% for carbohydrates, 17.0-17.9% for starch, and 0.40-0.53 for the P:S ratio. Intake of cholesterol (mg/1000 kcal) was higher in Jerusalem than in the US. These data address the feasibility of reducing fat in diets of free-living, Western populations. PMID- 3962911 TI - Dimensions of the issue of explicit health claims on food labels. PMID- 3962912 TI - Aminophylline and gentamicin-2. PMID- 3962913 TI - Plasma lipid and lipoprotein response of humans to beef fat, coconut oil and safflower oil. PMID- 3962914 TI - Effect of beef fat on plasma lipid and lipoprotein values. PMID- 3962915 TI - Towards the utilization of traditional medicine in national health services. PMID- 3962916 TI - Two-year experience with "San-Huang-Hsieh-Hsin-Tang" in essential hypertension. AB - In this paper, the long-term effects of the ancient Chinese formula of San-Huang Hsieh-Hsin-Tang on patients with essential hypertension were reported. San-Huang Hsieh-Hsin-Tang could significantly improve the hyperkinetic states of the cardiovascular system, improve the accompanying sympathetic symptoms, lower serum norepinephrine and have no apparent side effects. PMID- 3962917 TI - Pharmacological action of hachimijiogan (Ba-wei-wan) on the metabolism of aged subjects. AB - In order to elucidate the active mechanism of traditional Chinese medicine, we investigated the effects of Hachimijiogan which has been alleged to restore the function of old degenerated organs. After administering Hachimijiogan to aged rats and mice, we examined the lipid and glutathione metabolism. The cholesterol and triglyceride levels in the mice liver were significantly decreased in the Hachimijiogan treated group. The cholesterol turnover was examined using labeled cholesterol in aged mice, and Hachimijiogan may increase the turnover of cholesterol metabolism. The lenticular glutathione levels and enzyme activities concerned with glutathione metabolism were investigated in aged rats given Hachimijiogan, suggesting that Hachimijiogan may offer protective and therapeutic effects against senile cataract. From our study, Hachimijiogan is considered to improve the lipid and glutathione metabolism as a result of its complicated in vivo compound effects. PMID- 3962918 TI - The effect of needle stimulation of acupuncture loci Tienshu (St-25) Chung-Wan (CV-12) on the immune response in sensitized mice against experimental cholera. AB - The effects of stimulation of acupuncture loci from Tien-Shu (St-25) piercing through Chung-Wan (CV-12) on the Leukocytes and immune response were assessed in mice (that is, the anatomical equivalent of these loci of human acupuncture points). The leukocyte count increased and reached its highest level two hours after needling, then restored to normal level 24 hours later both in normal mice and immunized mice. Statistical analysis showed no significant variation on the lymphocyte/total leukocyte ratio in normal mice or immunized mice before, during and after needling. The effects of acupuncture on the production of anti-Vibrio cholerae in serum of the immunized mice can not be found, but produced positive effects in small intestine both on production of SIgA and antagonism to cholera. Furthermore these enhanced effects were higher by needling after oral (p.o.) boosting than that before oral boosting. PMID- 3962919 TI - Clinical studies on neurophysiological and biochemical basis of acupuncture analgesia. AB - From November 1965 to December 1978, about 10,635 cranio-cerebral operations were performed under acupuncture anesthesia in 24 neurosurgical departments in China. The extensive clinical practices have proved that acupuncture surely has analgesic effect. So far most researches upon the mechanism for analgesia by acupuncture were based on animal experiments, but not confirmed or evidenced in human beings. For this reason, a series of clinical studies upon the neurophysiological and biochemical basis for acupuncture analgesia has been made utilizing the facilities of a neurologic clinic provided that the patient's condition is not adversely affected and therapeutic efficiency is enhanced. The results are summarized as follows. PMID- 3962920 TI - Rejection of deeply implanted foreign body induced by acupuncture treatment in patient suffering intractable pains lasting ten years following traumatic injury to the left scapular region during a road accident. AB - Upper back pains lasting ten years were promptly improved in a 63 year old woman following the rejection of a forgotten foreign glass body, through a scar located over the left scapula, and treated by acupuncture. The patient insisted on having this treatment after unsuccessful prolonged and multi-disciplinary formal medical interventions culminating in preparations for exploratory surgery. The acupuncture directed to the scar induced an inflammatory reaction characterized by a sterile granulomatous reaction which surrounded a large piece of glass, apparently implanted in the soft tissue of the suprascapular area during a severe road accident which occurred ten years previously. The surgical intervention was avoided. PMID- 3962921 TI - Prescriptions for a new generation: early life interventions. PMID- 3962922 TI - The importation, transmission, and moderation of stress in the family system. AB - Despite its importance in community psychology, the stress process is still viewed primarily as an individual-level phenomenon, little research being conducted on the dynamics of stress in a social system such as the family. Propositions derived from a model of family stress were tested using data from a cross-sectional survey of family triads (father, mother, and adolescent). Two measures of distress were related significantly to both macro-and microstressors, and perceived social support did not buffer this relationship. Stressors endogenous to the family were significantly associated with those exogenous to the family (stressor importation hypothesis); contrary to prediction, this relationship did not vary across family members or family types (high vs. low cohesion). Distress in some family members was significantly associated with stressors experienced by other family members (stress transmission hypothesis); this relationship did not vary across family types but did vary across family members to some extent in that stress was transmitted from adolescents to parents to a greater degree than vice versa. PMID- 3962923 TI - Events of parental divorce: stressfulness ratings by children, parents, and clinicians. AB - The stressfulness, for the "typical" child, of 62 events that occur to children of divorce was rated by children of divorce (n = 58), their custodial parents (n = 58), and clinicians (n = 50). In addition, a larger group of children (n = 123) rated the goodness or badness of the events that had happened to them. The rank orderings of the mean stress ratings for the typical child made by children, parents, and clinicians were highly correlated. However, when the absolute stress value of the events was compared across raters, children rated 10 events as significantly less stressful than did parents (p less than .05); parents' and clinicians' ratings differed for 9 events, parents rating 7 as less stressful (p less than .05). Children rated 19 events as less stressful than did clinicians (p less than .05). The rank ordering of the children's mean ratings of events actually experienced correlated highly with the rank orderings of the children's mean ratings of the negative events for the typical child. PMID- 3962924 TI - Assessment of stress-buffering effects of social networks on psychological symptoms in an inner-city elderly population. AB - Social network researchers have been divided into two camps: those who propose that social networks have a direct effect on subsequent psychological symptoms and those who posit a stress-buffering effect as well. Previous research has been limited by rudimentary measures of social interaction and the absence of longitudinal data as well as by different approaches to the assessment of possible buffering effects. In the present study, using 19 social network variables, the authors followed 133 elderly residents of mid-Manhattan SRO hotels for 1 year. Three different methods of determining buffering effects were examined: Dividing the sample into high- and low-stress groups and contrasting differences in percentage variance accounted for by social networks between the two groups; Examining the group as a whole to assess if any Network Variable X Stress interactional terms are significant; Examining the group as a whole to assess whether there is a reduction in the beta value of stress with respect to psychological symptoms when network variables are added to the analysis. Method 1 indicated a direct network effect, but none of the methods indicated a buffering effect. Of clinical relevance was the nonlinearity of the network effects, that is, depending upon a person's stressor level, different network dimensions must be emphasized and strengthened. PMID- 3962925 TI - Social support as a multifaceted concept: examination of important dimensions for adjustment. AB - Four commonly used operationalizations of the social support concept: network contact frequency, satisfaction with support (including nine dimensions), perceived availability of support, and use of support, were related to two measures of psychological adjustment (Beck Depression Inventory and Symptom Checklist-90) and to one measure of physical adjustment (Cornell Medical Index). Subjects were 68 45- to 85-year-old, highly stressed care-givers to spouses with Alzheimer's disease. Results indicate that of the four operationalizations, Satisfaction with Support was the only significant predictor of depression and general psychopathology. The set of four support variables showed the strongest relationship to depression level, next strongest to general psychopathology, and least to physical health. The satisfaction with nine social support dimensions related differentially to the types of adjustment. Results suggest the importance of specificity (sample, support operationalization, dimensions, adjustment measures) in social support research. PMID- 3962926 TI - Nutrient intakes from cow's milk and infant formula. PMID- 3962927 TI - Health--ill health in the rich and the poor. PMID- 3962928 TI - Penicillin treatment of streptococcal pharyngitis. PMID- 3962929 TI - Further reports of urinary tract involvement in EEC syndrome. PMID- 3962931 TI - Statement on time-limited certification. PMID- 3962930 TI - Group B streptococcal supraglottitis in a 3-month-old infant. PMID- 3962932 TI - The pertussis epidemic in Oklahoma. A warning for the future. PMID- 3962933 TI - Skin, joint, and pulmonary changes in type I diabetes mellitus. AB - Three hundred seventy-five patients with diabetes mellitus were examined for the presence of sclerodermalike skin changes, limited joint mobility, and vital capacity changes. Nineteen percent of patients had vital capacities 2 SDs below the mean of predicted values. There was no significant relationship between decreased vital capacities and duration of diabetes, sclerodermalike skin changes, limited joint mobility, smoking history, proteinuria, or retinopathy. Cutaneous involvement consisting of thickening, tightening, and/or a waxy quality of the skin was noted in 190 patients (51%). The severity of skin involvement correlated positively with the patients' duration of diabetes, age, severity of joint contractures, and diabetic retinopathy. Thus, sclerodermalike skin changes appear to reflect generalized connective tissue alterations in diabetes and may indicate increased risk for diabetic microvascular complications. PMID- 3962934 TI - Arthritis in children with bacterial meningitis. AB - Forty-eight patients with arthritis and meningitis were identified by hospital chart review among 2,089 cases of bacterial meningitis treated between 1969 and 1984. The etiologic agents were Haemophilus influenzae in 38 cases (79%), Neisseria meningitidis in nine cases (19%), and Staphylococcus aureus in one case (2%). Thirteen patients had more than one joint affected: two affected joints, ten patients; three affected joints, two patients; and four affected joints, one patient. The elbow (34%) and knee (29%) were most frequently affected. Joint fluid aspirations were done in 44 patients; 22 cases (50%) had bacteria or bacterial antigen identified in joint fluid by culture, Gram's stain, or counter immunoelectrophoresis: H influenzae (20 cases), N meningitidis (one case), and S aureus (one case). Of the 48 patients, 14 patients were noted to have arthritis at the time of diagnosis of meningitis, 16 patients on the first to sixth day, and 17 patients on the seventh day of treatment or later; one patient developed arthritis 12 days after treatment of H influenzae meningitis had been stopped. Fourteen cases with a culture-proved bacterial etiology of the arthritis developed arthritis within four days of treatment; the exception was a patient who developed arthritis after treatment of meningitis was stopped. Of the 21 patients with culture-negative joint fluid and who developed arthritis later in the course of treatment, 19 patients were considered to have possible immune complex arthritis. Management consisted of antibiotic therapy in all patients, open incision and drainage in 17 patients (36%), and multiple aspirations in 12 patients (25%). Of the remaining 19 patients, 15 patients had a single arthrocentesis performed and four patients had no aspiration. Early-onset arthritis appeared to be related to bacteremia whereas late-onset arthritis may be immune complex mediated. PMID- 3962935 TI - Pneumococcal septicemia despite pneumococcal vaccine and prescription of penicillin prophylaxis in children with sickle cell anemia. AB - Although polyvalent pneumococcal vaccine and prophylactic penicillin are used to prevent overwhelming Streptococcus pneumoniae septicemia in infants and young children with sickle cell anemia, infection rates remain high. We have reviewed our seven-year experience with a regimen of twice daily oral penicillin V potassium prophylaxis in 88 affected children. The median age at the start of prophylaxis was 10 months, and the median duration of prophylaxis was 29 months (range, three months to seven years). The total period of observation of patients who were prescribed penicillin was 248 person-years. Most patients also received one or two doses of polyvalent pneumococcal vaccine. Despite penicillin prophylaxis and pneumococcal vaccine, eight episodes of S pneumoniae septicemia have occurred and three have been fatal. Four episodes were in children older than 3 years. Suboptimal compliance with the prescribed oral penicillin regimen was usually apparent. With one possible exception, the infections occurred when penicillin had not been taken during the previous 24 hours. The S pneumoniae septicemia rate in this patient population, 3.2 per 100 person-years, is somewhat less than that described in previous reports of children not receiving penicillin but is still unacceptably high. Vigorous advocacy of a penicillin prophylaxis regimen does not eliminate the risk of pneumococcal septicema in this patient population. PMID- 3962936 TI - Pertussis epidemic in Oklahoma. Difficulties in preventing transmission. AB - From Jan 1 to Dec 31, 1983, 351 cases of pertussis were reported in Oklahoma. Overall, 59% of the cases were among children 3 months to 6 years of age, the target age group for pertussis vaccination; only 42% of the patients in this age group were appropriately immunized for age with diphtheria and tetanus toxoids and pertussis vaccine (DTP). A survey of 185 households in the neighborhoods of three cases found that only 65% of 57 children 3 months to 6 years of age were appropriately immunized for their age. Aggressive control of the outbreak was attempted in Oklahoma County with recommendations for widespread vaccination against pertussis. However, the effort failed to immunize 82% of the 931 children in the initial target group. Nonetheless, analysis of the reported cases suggested that less than one fourth of the cases were potentially preventable by a single additional dose of DTP, ie, in individuals 3 months to 6 years of age with a history of at least one prior dose of DTP who were not appropriately immunized for age. The optimal solution to outbreak control is outbreak prevention by ensuring that the maximal number of children younger than 7 years of age receive routine age-appropriate DTP vaccination. PMID- 3962937 TI - Pasteurella multocida meningitis in infancy. An avoidable infection. AB - Pasteurella multocida is a common commensal in the upper respiratory tracts of cats and dogs. Infection with P multocida in humans usually follows infected bite wounds; however, infection in humans unrelated to animal bites is rare. We describe two infants with P multocida meningitis in whom infection was probably related to nontraumatic facial licking by household pet dogs. Both patients recovered fully. Although the risk is low, parents should be informed that mucous membrane exposure to household pets may expose an infant to the risk of systemic P multocida infection. PMID- 3962938 TI - Picture of the month. Benign neonatal hemangiomatosis. PMID- 3962939 TI - Acquired tracheomegaly in very preterm neonates. AB - Proximal airways are compliant structures at early gestational ages and may be susceptible to pressure-induced deformation following prolonged ventilatory support. Sixteen neonates (mean +/- SD gestational age, 27.0 +/- 0.6 weeks; mean +/- SD birth weight, 847 +/- 68 g) were studied to assess tracheal volume deformation. The neonates received ventilatory support for a mean +/- SD duration of 25.4 +/- 4.9 days. During this period the maximum peak inspiratory pressures ranged from 15 to 25 cm H2O, and respirations ranged from 20/min to 60/min. These neonates were studied at seven days postextubation and were individually matched for body weight with 16 nonventilated neonates. The width of the tracheal air column was measured at the lower border of the first thoracic (T-1) and third thoracic (T-3) vertebrae. The average tracheal width (average of T-1 and T-3) was significantly (38%) wider in the ventilated group, and the mean +/- SD tracheal width values were 3.79 +/- 0.29 mm, as compared with the control values of 2.74 +/- 0.31 mm. Based on these data it was estimated that the tracheal volume was 91% greater in the ventilated group. These observations demonstrate tracheal volume deformation and acquired tracheomegaly in neonates who have received mechanical ventilatory support. In addition to increased dead space ventilation, these findings also indicate underlying mechanical deformation of the tracheal wall. PMID- 3962940 TI - The value of skin biopsies in febrile, neutropenic, immunocompromised children. AB - We assessed the value of 41 skin biopsy specimens obtained from 32 immunocompromised patients with fever and neutropenia. Fifty-six percent (23/41) of these biopsy specimens resulted in a specific diagnosis. These diagnoses included infection in 12 cases, graft-vs-host disease in nine, leukemic infiltrate in one, and drug reaction in one. The remaining 18 biopsy specimens showed either nonspecific changes or normal tissue. The infectious agents identified included Aspergillus in nine patients, Candida in three patients, and Staphylococcus aureus in one patient. As a result of the biopsy findings, therapy was altered in 49% (20/41) of the cases. The most frequent therapeutic change was initiation of amphotericin B for a demonstrated fungal infection. We found skin biopsies to be a valuable diagnostic tool in the assessment of the febrile, neutropenic, immunocompromised patient with skin lesions. PMID- 3962941 TI - Partially ventilated endotracheal suction. Use in newborns with respiratory distress syndrome. AB - Ventilator adapters that permit endotracheal suction without disconnection from mechanical ventilation may overcome several of the theoretical contributors to the hypoxia and bradycardia associated with neonatal endotracheal suction. Such an adapter allows for partially ventilated endotracheal suction (PVETS) as opposed to traditional, nonventilated endotracheal suction. To test the clinical value of PVETS using an endhole adapter, changes in transcutaneous partial pressure of oxygen and heart rate were compared during paired PVETS and nonventilated endotracheal suction events on 32 occasions in 11 premature neonates with respiratory distress syndrome. Partially ventilated endotracheal suction was associated with a significant decrease in the incidence and severity of hypoxic events. Partially ventilated endotracheal suction, however, did not affect the incidence of bradycardic events; PVETS had a small but statistically significant effect on reducing the severity of bradycardia. No clear relationship between bradycardic and hypoxic events was evident. PMID- 3962942 TI - Hypercapnea and hypoxia challenge tests in infants at risk for sudden infant death syndrome. AB - Infants who have almost died of sudden infant death syndrome (SIDS) and infants who are siblings of SIDS victims constitute groups at increased risk for SIDS. Management dilemmas are common among physicians caring for these infants. To assess the usefulness of hypoxia (17% oxygen) and hypercapnea (3% carbon dioxide) challenge tests as predictors of outcome, we reviewed the records of 102 infants who underwent these tests. During hypoxia tests, we found that periodic breathing and respiratory pauses frequently developed among the infants in these high-risk groups, but also developed among control infants. During hypercapnea testing, some infants failed to increase their minute ventilation (usually measured by volume of breath X breaths per minute), but control infants showed this poor response just as often as high-risk infants. Our findings suggest that hypoxia and hypercapnea stress tests are of limited usefulness in planning management of infants at risk for SIDS. PMID- 3962943 TI - Short-term protein loading in diabetics with a ten-year duration of disease. AB - The concept of renal functional reserve has recently been introduced. To test this ability of the kidneys to increase the glomerular filtration rate (GFR) above the baseline level, the GFR response to short-term protein load was measured. Recent studies have provided conflicting data concerning the GFR response to a protein load in insulin-dependent diabetics who are known to have increased baseline GFRs. Thus, we studied nine insulin-dependent diabetics with a disease of at least a ten-year duration (none were hypertensive or proteinuric) and compared their data with those of five nondiabetic controls with normal renal function. All the diabetics, except one, showed a significant increase in GFR (mean +/- SEM, 60 +/- 9 to 74 +/- 14 mL/min/sq m); the controls also had increased GFRs (mean +/- SEM, 53 +/- 6 to 69 +/- 6 mL/min/sq m). The one patient who demonstrated no rise in the GFR had the lowest GFR measured, 33 mL/min/sq m. To explore the mechanism of this response, we measured the plasma levels of putative mediators glucagon and human growth hormone. Although glucagon showed the expected rise after the protein meal, the variability was so large that no statistically significant relationship could be identified. Human growth hormone remained constant and low in the controls and showed more variability and was higher in the diabetics; again, no relationship to the GFR could be demonstrated. Thus, our data demonstrated a normal response to a short-term protein load by a group of well-defined diabetic subjects who would be at risk to show subtle renal abnormalities. PMID- 3962944 TI - Prognosis of herpes zoster in healthy children. AB - Previous investigators have suggested that herpes zoster may be the presenting sign of a malignancy. However, no data have been available concerning the prognosis of herpes zoster in normal children. To assess outcome and prognosis for healthy children with a diagnosis of herpes zoster, we collected and reviewed 22 cases of herpes zoster from 90 pediatric practices in our community. In all cases, the illness was of short duration and resolved completely. Patients were followed up by their pediatricians for a mean of 4.2 years, and in no case did malignancy manifest subsequent to the zoster infection. We conclude that herpes zoster is a relatively benign infection in children and, given the period of follow-up, the onset of zoster does not appear to herald the occurrence of malignancy in this population. PMID- 3962945 TI - Initial laboratory evaluation of infants with 'presumed near-miss' sudden infant death syndrome. AB - We reviewed the cases of 201 infants hospitalized for "presumed near-miss" sudden infant death syndrome over a recent five-year period to determine the value of routine initial laboratory investigations in establishing diagnosis or altering therapy. A total of 1,278 measurements were performed on 163 patients aged 3 days to 6 months; 276 (22%) of the results were outside the normal limits for age. The most common abnormalities were hyperchloremia (58% of infants tested), hypermagnesemia (43%), hypobicarbonatemia (33%), and hyperkalemia (27%). There were no instances of polycythemia, hypochloremia, hypokalemia, hyperbicarbonatemia, or uremia. Only six (0.5%) of the abnormal values in four patients were useful in diagnosing or treating the apneic episodes. Infants with respiratory symptoms at the time of presentation had a statistically greater incidence of abnormal values than patients who were asymptomatic. Because of the low yield of useful information, we conclude that the use of a routine battery of laboratory investigations in the initial evaluation of infants with presumed near miss sudden infant death syndrome should be questioned. PMID- 3962946 TI - Child behavior and accidental injury in 11,966 preschool children. AB - Social and behavioral characteristics of 11,966 British children, aged 5 years, and mothers' reports of accidental injuries between birth and age 5 years were analyzed. Aggressive behavior was associated with all accidental injuries after controlling psychosocial variables including social class; crowding; mother's psychological distress, age, and marital status; and child's sex. Overactivity was associated only with injuries not resulting in hospitalization after control of the covariates. The relative risk of injuries resulting in hospitalization was 1.9 among children with both high activity and high aggression scores compared with children with low scores on both behavioral scales. The findings support the inference that aggression and overactivity are independently associated with accidents. The associations between child behavior and injuries were stronger than the associations between injuries and the social factors including social class and crowding. This finding suggests that interventions aimed at high-risk groups may be effective supplements to environmental interventions. PMID- 3962947 TI - Gastrointestinal complications in critically ill patients: the intensivists' overview. AB - The critical care environment may be characterized by invasive monitoring, vasoactive drugs, and major interventions which may have adverse effects on gastrointestinal function. Furthermore, conditions such as heart failure or sepsis may compromise oxygen delivery to gastrointestinal organs. Life threatening illness from a variety of causes may produce endoscopically evident gastritis or ulceration in up to 100% of patients, and clinically evident bleeding in 20%. Clinical studies suggest that antacids or H2 receptor blockers may reduce the frequency of this complication. Other conditions are associated with a spectrum of hepatic dysfunction ranging from the cholestatic jaundice of reactive hepatopathy during sepsis to centrilobular necrosis and hepatitis of shock liver. Additionally, many drugs used in the critical care setting may adversely affect mesenteric oxygen delivery and result in ischemia or infarction of the bowel. An increased awareness and understanding of these and other gastrointestinal complications in critically ill patients will, it is hoped, lead to earlier detection and better therapy than is now available. PMID- 3962948 TI - Evolution of HBeAg/anti-HBe status and its relationship to clinical and histological outcome in chronic HBV carriers in childhood. AB - Fifty-five Japanese HBV carriers under 15 yr of age were followed for 12 months or longer, during which time we investigated the evolution of HBeAg/anti-HBe status and clinical and histological aspects of the liver disease. Of 45 cases positive for HBeAg at the initial examination, 34 remained positive for HBeAg during the follow-up periods, while the remaining 11 lost HBeAg and eight of these seroconverted to anti-HBe. At the final observation, HBeAg positivity in serum was found in as many as approximately 90% of the HBV carriers under 6 yr, but had fallen to 48% in carriers between 12 and 15 yr. The serum transaminase values in 11 cases who lost HBeAg were abnormally elevated for variable periods, but eventually returned to normal. In six of these 11 who had liver dysfunctions, liver biopsy was performed during the HBeAg positive phase or shortly after the disappearance of HBeAg. The histologies of liver were chronic persistent hepatitis in two cases and chronic active hepatitis in four. Repeat liver biopsies of two cases with chronic active hepatitis at the first examination showed nonspecific reactive hepatitis 2 and 4 yr after seroconversion or disappearance of HBeAg. These results indicate that HBeAg-positive HBV carriers with overt liver dysfunctions in childhood are prone to lose HBeAg or to seroconvert to anti-HBe, followed by a marked histological regression, and therefore that special antiviral therapy is probably unnecessary. PMID- 3962949 TI - Herpetic esophagitis: a diagnostic challenge in immunocompromised patients. AB - Viral esophageal infection is common in immunocompromised patients. Twelve patients with esophagitis secondary to herpes viruses are described. Odynophagia, dysphagia, and gastrointestinal bleeding were the most common symptoms. Multiple infections particularly with candida were present in three of the 12 cases (25%). Typical "volcano ulcers" at endoscopy and discrete diffusely scattered shallow ulcers seen on double contrast esophagram are highly suggestive of herpetic esophagitis. Single contrast esophagram plays no specific role in the diagnosis of herpetic esophagitis. An analysis of clinical, endoscopic, radiological, and pathological features is presented. PMID- 3962950 TI - Biliary dyskinesia with associated high amplitude esophageal peristaltic contractions. AB - A 60-yr-old woman with recurrent biliary-type pain and pancreatitis was found to have abnormal biliary manometrics. Sphincter of Oddi basal and phasic contraction pressures were significantly elevated. Esophageal manometrics revealed high amplitude peristaltic contractions that were unassociated with chest discomfort. High amplitude dysmotility syndromes may perhaps represent a spectrum of disease involving the entire gastrointestinal tract. PMID- 3962951 TI - Intestinal transit in insulin-requiring diabetics. AB - Intestinal transit was assessed in 25 insulin-requiring male diabetics and 15 healthy controls by measuring the breath hydrogen appearance time after the ingestion of both the liquid and the solid meal containing nonabsorbable carbohydrate. Three groups of patients were studied: nine patients without peripheral or autonomic neuropathy or retinopathy; nine patients with peripheral neuropathy; and seven patients with peripheral and autonomic neuropathy. Eight patients complained of gastrointestinal symptoms, including three with watery diarrhea. Intestinal transit of the solid meal was more prolonged than the liquid meal in normal and diabetic subjects. There was no significant difference in intestinal transit between normal controls and any group of diabetics; however, one-third of the diabetics had abnormal intestinal transit of the liquid test meal (four rapid, four delayed); only one patient with diarrhea had rapid intestinal transit. These data suggest that abnormal intestinal transit is common in diabetics. Altered intestinal transit is not a prerequisite of diabetic diarrhea. PMID- 3962952 TI - Endoscopic anatomy of choledochoduodenostomy in relation to clinical observations. AB - Thirty patients having undergone choledochoduodenostomy for benign biliary diseases were studied by means of endoscopy. The endoscopic anatomy of the anastomosis was classified into two types. Inflammatory changes of the choledochal mucosa adjacent to the stoma were found in nine cases. Endoscopy of the proximal and distal (blind) segment of the common bile duct was accomplished in 19 and nine patients, respectively. It is very probable that these inflammatory mucosal changes could lead to complications. PMID- 3962953 TI - Common bile duct obstruction caused by hydatid daughter cysts--management by endoscopic retrograde sphincterotomy. AB - Four patients with cholestatic jaundice due to ruptured hydatid liver cyst into the biliary tract underwent endoscopic retrograde sphincterotomy with clearance of the bile ducts. Prompt relief of jaundice followed the produced and no complications occurred. After the procedure all patients received medical treatment (Mebendazole) for 3-4 months and were well at a mean follow-up of 8 months. We conclude that endoscopic retrograde sphincterotomy is a safe and effective treatment for cholestatic jaundice caused by hydatid daughter cysts obstructing the bile ducts. This method may serve as an alternative to surgery in selected, high risk, patients. PMID- 3962954 TI - Granulomatous appendicitis: is it Crohn's disease? Report of a case and review of the literature. AB - Primary granulomatous inflammation of the appendix is a rare entity. When fungi, parasites, foreign bodies, and obstruction secondary to fecalith, mucocele, or tumor have been eliminated histologically as causes, fewer than 80 cases have been reported in the literature since 1932. Various diseases have also been suggested, including tuberculosis, sarcoidosis, Crohn's disease, and Yersinia pseudotuberculosis. A case of primary granulomatous inflammation of the appendix is presented, and 61 cases reported in the literature since 1953 are reviewed. Patients presented with pain in the right lower quadrant of the abdomen frequently associated with a mass and a protracted preoperative course. Of the 61 patients, 31 were men, 24 were women, and the sex of six of the patients was not reported. The median age of patients was 21 yr. The majority (77%) underwent simple appendectomy. Of patients undergoing ileocolectomy, five of 14 (36%) had concurrent granulomatous ileal involvement. The majority of specimens exhibited appreciable transmural thickening with fibrosis, noncaseating granulomas, formation of Langhans giant cells, and mucosal ulceration. No operative deaths and no postoperative fecal fistulas occurred. In patients without concurrent or synchronous granulomatous disease elsewhere who were followed from 1 to 16.8 yr (mean 5.2 yr), the incidence of recurrence approximated 14%. Therefore, patients with granulomatous appendicitis appear to have a favorable prognosis but require careful long-term observation. PMID- 3962955 TI - Torsion of leiomyosarcoma of Meckel's diverticulum. AB - A rare case report of leiomyosarcoma of Meckel's diverticulum, which caused torsion and strangulation of the diverticulum, is presented. The clinical picture was similar to acute appendicitis, which was the working diagnosis when the 42-yr old Arab woman was sent to surgery. Although rare, leiomyosarcoma is the most common tumor of Meckel's diverticulum, and has to be considered in the differential diagnosis of right lower abdominal pain. PMID- 3962956 TI - Extrahepatic biliary obstruction complicating a diaphragmatic hiatal hernia with intrathoracic gastric volvulus. AB - Gastric volvulus is an uncommon condition in which an acquired torsion of the stomach results in acute or chronic gastrointestinal symptoms. We report a case of an intrathoracic organoaxial gastric volvulus presenting as a cholestatic syndrome, secondary to partial obstruction of the common bile duct by the diaphragm at the level of the hiatus. This entity has not been reported. PMID- 3962957 TI - Exercising the gut--therapy or complications? PMID- 3962958 TI - Microlithiasis of the cystic duct. PMID- 3962959 TI - Alcohol consumption and ovarian cancer risk. AB - To study the influence of alcohol consumption on the risk of ovarian cancer in women under age 55, the authors examined data collected in a multicenter, population-based case-control study--the Centers for Disease Control's Cancer and Steroid Hormone Study. Between August 1981 and December 1982, 433 women 20-54 years of age with newly diagnosed ovarian cancer and 2,915 women 20-54 years of age selected at random from the same geographic areas were asked about their consumption of alcoholic beverages during the previous five years. Women who drank any alcohol during the five-year period had a risk of ovarian cancer of 0.9 (95% confidence interval (CI) = 0.7-1.2) compared with nondrinkers. Risk was not associated with the type of alcoholic beverage consumed, nor were the results affected by controlling for demographic characteristics and oral contraceptive use. Although there was no association between moderate alcohol consumption and ovarian cancer, women who drank more than about 20 drinks per week had a relative risk of ovarian cancer of 0.5 (95% CI = 0.2-0.9) compared with women who did not drink. PMID- 3962960 TI - A study of the effect of weight and dietary fat on breast cancer survival time. AB - Female breast cancer patients who had participated in a case-control study conducted during 1973-1975 were followed up, using record linkage to the Statistics Canada mortality data base, to the end of 1980. A number of variables recorded for the case-control study, in particular body weight and daily intake of dietary fat near the time of diagnosis, were examined to see if they had any bearing on breast cancer mortality. The data were analyzed using the methods of Mantel and Cox. Dietary fat was not found to be related to patient survival. However, cases with greater than average body weight experienced a shortened survival time. PMID- 3962961 TI - Sedentary jobs and colon cancer. AB - The association between physical job activity and colon cancer was examined in a 19-year follow-up study of 1.1 million Swedish men. The relative risk (RR) of colon cancer in men employed in sedentary occupations was estimated at 1.3 (1.2 1.5, 90% confidence interval), with the highest risk for the transverse colon including flexures (RR = 1.6) and the lowest risk for the sigmoid (RR = 1.2). The relative risk for rectal cancer was not elevated. Age, population density, and social class did not confound the relative risk and were controlled for, whereas marital status and geographic region did not. Furthermore, food habits and physical activity during leisure time were examined in the same occupations in another sample and it was judged unlikely that confounding from these factors could explain the association. PMID- 3962962 TI - Serum retinol and retinol-binding protein levels do not predict subsequent lung cancer. AB - Retinol and retinol-binding protein levels were measured in sera previously obtained, and stored in the frozen state, at multiphasic health checkups from 151 persons subsequently found to have lung cancer (cases) and 302 persons who remained free of cancer (controls). Two controls were matched to each case for sex, skin color, age, date of multiphasic health checkup, and aspects of the smoking habit. Mean levels in cases and controls were, respectively, retinol: 82.17 and 82.37 micrograms/dl (p = 0.93), and retinol-binding protein: 6.04 and 6.00 mg/dl (p = 0.81). Mean differences between cases and controls were, retinol: 0.195 micrograms/dl with 95% confidence limits, -3.91 and 4.30 micrograms/dl; retinol-binding protein: -0.033 mg/dl with 95% confidence limits, -0.31 and 0.24 mg/dl. No significant trend in relative risk of lung cancer was observed when the retinol or retinol-binding protein distribution was divided into quintiles. No significant associations were observed in subgroups based on age, sex, histologic type of cancer, cigarette consumption, or interval between blood drawing and cancer diagnosis. In this large study, retinol and retinol-binding protein levels were not useful in predicting the subsequent development of lung cancer. PMID- 3962963 TI - A case-control study of amyotrophic lateral sclerosis. AB - The authors conducted a study of 518 amyotrophic lateral sclerosis patients identified between 1977 and 1979 and 518 controls to investigate putative risk factors for this disease. Occupations at risk of electrical exposure were reported more often by patients (odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.4-13.0) as were electrical shocks producing unconsciousness (OR = 2.8, 95% CI = 1.0-9.9). Although an overall excess of physical trauma associated with unconsciousness was observed in the amyotrophic lateral sclerosis patients (OR = 1.6, 95% CI = 1.0-2.4), the effect was inversely associated with duration of the unconscious episodes, suggesting an effect of recall bias. Only slight differences were found for surgical traumata to the nervous system. Parkinsonism was reported more often among first degree relatives of cases (OR = 2.7, 95% CI = 1.1-7.6). The frequencies of prior poliomyelitis or other central nervous system diseases were similar for patients and controls. Occupational exposure to selected toxic substances was similar for patients and controls except for the manufacture of plastics (OR = 3.7, 95% CI = 1.0-20.5), although few details of these exposures were provided. No differences in occupations with exposure to animal skins or hides were observed. PMID- 3962964 TI - Blood pressure concordance between spouses. AB - In 1982, 4,474 noninstitutionalized residents of Connecticut who were 18 years or older were interviewed as part of the Connecticut High Blood Pressure Program. This cross-sectional study was undertaken to determine the prevalence of hypertension among the 2.1 million adults in the state. Spouse correlations for systolic and diastolic blood pressures were examined in 1,260 white spouse pairs. Upon demonstrating a significant correlation in blood pressure between spouses (r = 0.262 for systolic and 0.248 for diastolic, p less than 0.001), subsequent stepwise multiple regressions were used to determine which aspects of the shared marital environment might influence the spouse concordance. Variables related to each spouse as well as variables reflecting similarity between spouses were analyzed. When spouse concordance in blood pressure was examined controlling for age, obesity, dietary salt intake, socioeconomic status, income, education, occupation, smoking, and exercise of both spouses and similarities in these variables, the correlations between spouses' blood pressures remained significant. PMID- 3962965 TI - The role of behavioral variables and fat patterning in explaining ethnic differences in serum lipids and lipoproteins. AB - Mexican Americans have been previously reported to have greater adiposity, higher triglyceride levels, and lower high density lipoprotein (HDL) cholesterol levels than Anglos. This study investigated the relationship between behavioral variables (caloric balance, cigarette and alcohol consumption, exercise, postmenopausal estrogen or oral contraceptive use) and fat patterning (central vs. peripheral distribution of adiposity) in the San Antonio Heart Study (1979 1982) (n = 2,102) to explain the ethnic difference in lipids and lipoproteins. Adjustment for caloric balance (as reflected by body mass index) narrowed the ethnic difference in triglyceride and HDL levels for both sexes, while adjustment for smoking widened the ethnic difference. For females, the ethnic difference was also decreased by adjustment for alcohol and estrogen use. However, adjustment for these behavioral variables did not completely eliminate the ethnic difference in lipids and lipoproteins in either sex. Increased central adiposity, more characteristic of Mexican Americans than Anglos, was positively associated with triglycerides and negatively associated with HDL levels, especially in females. Fat patterning made a more important contribution to the prediction of triglyceride and HDL levels than did the other behavioral variables (except for caloric balance) and, in general, eliminated ethnic differences in lipids and lipoproteins. Epidemiologists should consider the use of a centrality index to distinguish different types of adiposity since it is easy and inexpensive to measure. PMID- 3962966 TI - The epidemiology of sarcoidosis in Rochester, Minnesota: a population-based study of incidence and survival. AB - Using the unique data resources of the Rochester Epidemiology Project, a community-based study of clinically diagnosed sarcoidosis was conducted. In this population-based study, the 75 Rochester, Minnesota, residents with sarcoidosis initially diagnosed between 1946 and 1975 (incidence cohort) were followed through their comprehensive medical records in the community to January 1, 1982. The age- and sex-adjusted incidence of sarcoidosis was 6.1 per 100,000 person years. The age-adjusted incidence of sarcoidosis was similar in males (5.9) and females (6.3), with a peak incidence in males 30 to 39 years old (18.7) and in females 40 to 49 years old (15.6). A secular increase in sarcoidosis incidence was noted in the period 1946-1975 for females, with a marked increase in the number and percentage of biopsy-documented cases. Seasonal variation in sarcoidosis incidence was minimal, with a seasonal peak of 31% of the Rochester cases being diagnosed during the spring (March-May). Survival, compared with that of the North Central United States, was unimpaired in this sarcoidosis incidence cohort. PMID- 3962967 TI - Motor vehicle trauma in northeastern Ohio. I: Incidence and outcome by age, sex, and road-use category. AB - Hospital emergency department visits for motor vehicle trauma occurring in a midwestern metropolitan region (Cleveland and Lorain-Elyria, Ohio Standard Metropolitan Statistical Areas; 2.2 million population) were analyzed to determine the incidence and outcome by age, sex, and road-use category. A 50% incidence sample (n = 20,752) of motor vehicle trauma events to residents of this region was identified from the emergency department records of 41 participating hospitals for a one-year period, 1977. These hospitals accounted for 98% of all emergency department cases in the region. The annual motor vehicle trauma incidence rate per 100,000 population was 1,871. The highest annual incidence rate (4,462) was for ages 20-24; the lowest rates were for infants under one year (837) and for the elderly over 74 years (667). Incidence rate rank-ordered road use categories were as follows: passenger car occupant, motorized cycle rider, other enclosed vehicle occupant, pedestrian, and pedal cyclist. Above age 4, age specific male incidence rates significantly exceeded female incidence rates for most road-use categories. There were 80 admissions and 7 fatalities per 1,000 motor vehicle trauma incidence cases. Case-admission ratios were highest for pedestrians (266), riders of motorized cycles (184), and pedal cyclists (115); they were lowest for occupants of partially or fully enclosed vehicles (65). Case fatality ratios per 1,000 cases were also highest for pedestrians (43) and riders of motorized cycles (11). Male case-fatality ratios exceeded female ratios for each road-use category in nearly all age groups, and male case-admission ratios exceeded those for females ages 10-54. For ages 75 and over, the admission ratios and fatality ratios were nearly twice as high as in any other age group. PMID- 3962968 TI - The Widal slide agglutination test, a valuable rapid diagnostic test in typhoid fever patients at the Infectious Diseases Hospital of Jakarta. AB - The Widal slide agglutination test was evaluated as a rapid diagnostic test in typhoid fever patients at the Infectious Diseases Hospital, Jakarta, Indonesia from 1980-1982. The results of the test can be available within 45 minutes of patient admission. The study showed that, among 229 patients with Salmonella typhi-positive typhoid fever and 179 control fever patients, when the Widal O antibody titer was greater than or equal to 1:20 the sensitivity was 53%, the specificity 98%, the positive predictive value 96%, and the negative predictive value 68%. A negative Widal test (O antibody titer less than 1:20) does not provide useful information, but when the O antibody titer is greater than or equal to 1:20 the clinician at the Infectious Diseases Hospital of Jakarta can be 96% certain that the patient has typhoid fever. PMID- 3962969 TI - A hospital discharge code review of toxic shock syndrome in Wisconsin. AB - The Wisconsin Division of Health conducted a review of discharge coding for 142 (97%) of the state's general care hospitals for the period 1980-1983 to evaluate the use of International Classification of Diseases codes for toxic shock syndrome and to estimate completeness of reporting of recognized hospitalized cases of the syndrome to the Division of Health. Hospital use of code 040.89 (other bacterial diseases-other) recommended for toxic shock syndrome by the National Center for Health Statistics in January 1981 increased from 23% of Wisconsin hospitals in 1980 to 92% in 1983. The sensitivity of this code for toxic shock syndrome increased from 54% to 85% from 1981 to 1983; study population specificity was stable at approximately 95%, and the predictive value was 65% in 1981 and 70% in 1983. The use of codes 785.50 (shock, unspecified) and 785.59 (nontraumatic shock-other) frequently assigned to toxic shock syndrome was also assessed; all measures of their utility decreased in proportion to the increasing use of 040.89. The coding review identified 20 previously unreported cases of toxic shock syndrome; the 10 confirmed and 10 probable cases represent 4% and 21% of the state's 223 confirmed and 47 probable cases with onsets in 1980 1983. Results indicate that a National Center for Health Statistics coding recommendation for a disease of emerging significance can result in relatively uniform coding of the illness, which can provide a tool for case finding and surveillance evaluation for hospitalized cases. PMID- 3962970 TI - Comparison of contemporaneous and retrospective estimates of food consumption made by a dietary history method. AB - In 1983 the relative validity of a retrospective dietary history method was assessed against a current dietary history taken seven years previously in 1976 and a second current dietary history taken in 1983. In total, 44 men and 58 women, aged 38 to 62 years, participated in the study. For energy intake and for most nutrients, the relative difference between the results obtained with the retrospective dietary history and the current dietary history in 1976 was below 15% and for six of the 11 nutrients below 10%. When the three macronutrients (protein, fat, and carbohydrate) were expressed as a proportion of energy intake, the relative difference was also below 10%. Similar results were found for food groups. The data obtained retrospectively correlate rather well with the results of the current dietary history taken in 1983, suggesting an effect of contemporaneous food habits on retrospective reporting. PMID- 3962971 TI - Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. AB - To assess the validity of self-reported illnesses, medical records were reviewed for participants reporting major illnesses on the biennial follow-up questionnaires used in a prospective cohort study which began in 1976. In over 90% of cases of cancer of the breast, skin, large bowel, and thyroid, histopathology reports confirmed the subjects' self-report. Lower levels of confirmation were obtained for cancers of the lung, ovary, and uterus. Application of strict diagnostic criteria also gave lower levels of confirmation for myocardial infarction (68%) and stroke (66%). Among random samples of women reporting fractures and hypertension all records obtained confirmed self-reports. For self-reported elevated cholesterol levels 85.7% of self-reports were confirmed. Self-report is a valuable epidemiologic tool but may require additional documentation when the disease is diagnostically complex. PMID- 3962972 TI - Efficient selection of controls for multi-centered collaborative studies of rare diseases. AB - An increasing number of epidemiologic studies of rare diseases are being conducted as collaborative ventures among several institutions in different geographic areas. Geographic area must be accounted for in the analysis, along with age and other potential confounders. This paper shows that it may not be possible to accurately predict the distribution of persons with rare diseases by age and geographic area. Therefore, selecting controls by matching on age group and geographic area is more efficient than selecting controls in all age and geographic area strata based on prior estimates of expected numbers of cases. PMID- 3962973 TI - Epidemiologic programs for computers and calculators. Simple algorithms for the representation of deterministic and stochastic versions of the Reed-Frost epidemic model using a programmable calculator. AB - Two programs are described for the emulation of the dynamics of Reed-Frost progressive epidemics in a handheld programmable calculator (HP-41C series). The programs provide a complete record of cases, susceptibles, and immunes at each epidemic period using either the deterministic formulation or the trough analogue of the mechanical model for the stochastic version. Both programs can compute epidemics that include a constant rate of influx or outflux of susceptibles and single or double infectivity time periods. PMID- 3962974 TI - Giardiasis in a great blue heron (Ardea herodias) in New York State: another potential source of waterborne giardiasis. PMID- 3962975 TI - Development of a Computerized Occupational Referent Population System (CORPS) for epidemiologic studies. PMID- 3962976 TI - Re: "Mortality among employees engaged in chemical manufacturing and related activities". PMID- 3962977 TI - Association of paternal occupation with childhood cancer. PMID- 3962978 TI - Proceedings of Third International Workshop on Growth in Children With Renal Disease. Warrenton, Virginia, May 3-5, 1985. PMID- 3962979 TI - Fluid and electrolyte imbalances in children with chronic renal failure. PMID- 3962980 TI - Issues in pediatric dialysis. PMID- 3962981 TI - Animal models of chronic renal failure: influence of nutrition on growth. PMID- 3962982 TI - Assessment of growth. PMID- 3962983 TI - The environment of the workplace and human values. May 20-22, 1982. PMID- 3962984 TI - Present and future questions: causation, litigation, and federalization. PMID- 3962985 TI - Values and scientific assessment. PMID- 3962986 TI - A businessman's view of occupational health and human values. PMID- 3962988 TI - The environment of the workplace and human values. Foreword: dialogue as a tool of the real world. PMID- 3962987 TI - Human values and social responsibility: a response to Mr. Ward. PMID- 3962989 TI - Human rights and the workplace. PMID- 3962990 TI - The moral, economic, and political status of labor in American society. PMID- 3962991 TI - Pragmatic labor: an empirical response to Professor Vidich. PMID- 3962992 TI - The place of laboratory animal testing in occupational and preventive medicine. PMID- 3962993 TI - Human values and the judicial role: a response to Professor Schauer. PMID- 3962994 TI - Pulmonary reference standards in occupational medicine. PMID- 3962995 TI - Occupational health as an international discipline. PMID- 3962996 TI - Occupational health in developing countries with special reference to Egypt. PMID- 3962997 TI - Mortality of a municipal worker cohort: II. Females. AB - Women have become an increasingly important segment of the total work force, yet there are very few published occupational mortality studies of female workers. This paper reports the findings of a retrospective cohort mortality study of 1,371 full-time female municipal employees of the City of Buffalo, New York, who were employed at least 1 day between January 1, 1950, and October 1, 1979, and who worked a minimum of 5 years. Vital status was ascertained for 88% of the female cohort, resulting in the identification of 214 observed deaths. This predominantly white-collar, service-oriented female cohort demonstrated significantly lower mortality than that expected based on U.S. mortality rates for white females. This strong "healthy-worker effect" was consistent across the time period of the study, across cause-specific mortality especially for all malignant neoplasms and all diseases of the circulatory system, and across different workers groups. Findings are discussed in light of the methodological issues involved in occupational studies of female workers. PMID- 3962998 TI - Long-term mortality study of oil refinery workers: V. Comparison of workers hired before, during, and after World War II (1940-1945) with a discussion of the impact of study designs on cohort results. AB - The mortality experience of a large refinery cohort (1937-1978) was examined by dividing it into three subcohorts according to hire dates: those hired before 1940, those hired during the period 1940-1945, and those hired after 1945. These three periods are approximately equivalent to before, during, and after World War II and span a total hiring period of more than 75 years. The results showed that a substantial portion of the cohort (3,330 or 27%) had been recruited during 1940 1945, and they contributed 980 or 28% of the total deaths. However, their mortality experience was quite different from the rest. A series of significant increases were seen among the external causes for accidents, suicide, and homicide. In terms of overall mortality and in contrast to the rest of the cohort, no "healthy worker effect" was seen (SMR = 1.00). They also showed increases in several types of cancer including cancers of the pancreas and prostate and leukemia. These unusual experiences cannot be explained either on the basis of their war-related deaths or on their period of employment (one-half were terminated within 1 year from date of hire), and data is insufficient to separate the role of hiring practices or their socioeconomic status. However, their life-styles were probably quite different judged from the fact that alcoholism-related deaths were increased as much as fivefold. Almost two-thirds of the total deaths occurred among 4,080 workers in the before 1940 subcohort. Further, the 5,117 workers of the after-1945 subcohort contributed only 5% of the total deaths. Thus, the results of the original refinery cohort (1937-1978) primarily reflect the experience of those employees hired before 1940. Given the same cohort method (historical prospective), cohort results vary widely according to different study designs, and this has implications for "generalizable" risk assessment or risk projections. A prospective study of new hires with 30 years of follow-up is rather inefficient because it would yield only a small number of deaths, with a strong healthy worker effect. The same is true for studies based on active workers with a short period of follow-up. Studies based on time of hire, however, provide a means for controlling time-related occupational exposures. PMID- 3962999 TI - An analysis of mortality follow-up through the National Death Index for a cohort of refinery and petrochemical workers. AB - Along with our submission to the National Death Index (NDI) of a cohort of more than 23,000 petrochemical and refinery workers, we included 1,449 known U.S. deaths to determine the completeness of death ascertainment through the NDI. A number of factors that may affect follow-up were examined including sex, race, age and reporting area. Overall, NDI detected 97.1% of known deaths. Follow-up was slightly better for males (97.2%) than for females (92.0%) and was significantly better for whites (97.6%) than for nonwhites (92.0%). Analyses by reporting area showed very complete follow-up from all locations (93.4%-100%) except for the New York City area (71.4%). These findings indicate that NDI is an extremely useful source for vital status follow-up, though follow-up may be somewhat less complete for certain subgroups of an occupational study cohort. PMID- 3963000 TI - A proportionate mortality study of granite cutters. AB - Several recent studies (animal and human) have suggested an association between lung cancer and silica exposure. To test the hypothesis, we have studied death benefit records of 1,905 members of the Granite Cutters Union. A proportionate mortality analysis (PMR) was conducted, using U.S. deaths as a comparison population. Statistically (PMR) was conducted, using U.S. deaths as a comparison population. Statistically significant excesses were observed for death from nonmalignant respiratory significant excesses were observed for death from nonmalignant respiratory disease (largely silicosis) (183 obs, 43.7 exp) and for tuberculosis (largely silicotuberculosis) (262 obs, 19.3 exp). Other significant excesses were observed for bone cancer (6 obs, 1.9 exp) and arthritis (5 obs, 1.5 exp). A significant decrease was observed for leukemia (5 obs, 13.0 exp). For lung cancer a slight but nonsignificant excess was observed (97 obs, 81.1 exp, PMR = 1.19, 95% CI 0.97-1.46). A proportionate cancer mortality analysis (PCMR) showed similar results for lung cancer (PCMR = 1.09, 95% CI 0.89-1.33). Lung cancer mortality also failed to show any trend with either calendar time or duration of exposure. Although no significant excess of lung cancer was observed for the entire silica-exposed cohort, there was an indication that those who were silicotic had an excess risk of lung cancer, based on a review of contributing causes on the death certificate. PMID- 3963002 TI - Bhopal and after. PMID- 3963001 TI - An unusual type of keratopathy observed in polyurethane workers and its reproduction in experimental animals. AB - We have reported two cases of keratopathy in polyurethane workers that appear to be identical to those described by previous authors. We have been able to produce similar findings in the corneas of cats by exposing the eyes of anesthetized animals to the vapor of two of the amines used as catalysts in polyurethane manufacture. We were unable to reproduce these results with toluene diisocyanate. Therefore we support the previous suggestion that the amine catalysts are responsible for the distinctive keratopathy in polyurethane workers. We are unable to substantiate the claim that toluene diisocyanate is responsible for this phenomenon. PMID- 3963003 TI - Bronchial hyperreactivity and occupational asthma. PMID- 3963004 TI - In vivo bone lead measurements: a rapid monitoring method for cumulative lead exposure. AB - Lead concentrations (microgram/g wet weight) in human bone (tibia) were measured noninvasively in vivo employing an X-ray fluorescence technique. Forty-five workers who had been subjected to chronic industrial exposure were found to have a mean bone lead content of 52.9 micrograms/g wet weight (0 to 198 micrograms/g). In addition to bone lead content, blood lead, body burden of lead as assessed by urinary lead excretion after EDTA chelation, zinc protoporphyrin, and unstimulated urinary lead excretion were evaluated. The results suggest that the in vivo measurement of tibia lead content may serve as an acceptable indicator of body lead burden and provide a practical technique for lead screening purposes. The correlation coefficient between X-ray fluorescence findings and lead excretion following Ca-EDTA administration is 0.69; p less than 0.001. PMID- 3963005 TI - Effect of aerosol size on the blood lead distribution of industrial workers. AB - The size distribution measurements of lead aerosol from a brass foundry and primary lead smelter are used to simulate blood lead distributions applying a pharmacokinetic model developed by Bernard. The predicted distribution of blood lead levels determined using the actual size distribution of lead aerosol are compared to the blood lead levels predicted according to the model assumptions adopted in setting the OSHA lead standard. In the furnace area of the smelter and the pouring area of the foundry the predicted mean blood lead level is higher than that found in the standard whereas, in the smelter's sintering and mixing operation the blood lead level is less than that suggested by the standard. The data support the conclusion that size-selective sampling needs to be considered for incorporation into the OSHA lead standard. PMID- 3963006 TI - The role of atopy in potroom workers' asthma. AB - A study was performed to clarify a possible role of atopy in the occurrence of acute bronchoconstrictive impairment observed in some workers in a plant using the Alu-Swiss process for the electrolytic extraction of aluminum. Of 227 workers examined the percentage of those with a history of atopy and positive skin tests for common allergens was within the expected range. Six had positive patch test with 2% NaF. Among seven workers with paroxysmal wheezing and dyspnea, of whom three were only light smokers, three had positive skin test with common allergens but only one of them had an increased IgE value. The same worker also had positive patch test for 2% NaF. The average age of workers with paroxysmal wheezing and dyspnea was 32.6 years, and only two had symptoms defined as chronic bronchitis. Although their forced expiratory volumes, with two exceptions, measured at the beginning of work shift were within normal limits, in most of those workers bronchial hyperreactivity was also objectively assessed using nonspecific bronchoprovocative tests with histamine (or metacholine). The results support our previous findings that acute respiratory impairment in some workers is most probably based on bronchial hyperreactivity and not on an allergic mechanism. PMID- 3963007 TI - Acute-onset sarcoidosis presenting as workplace-related hyperreactive airway disease. AB - Bechtel et al [Am Rev Respir Dis 124:759-761, 1981] have reported a high prevalence of positive methacholine challenge tests in patients with sarcoidosis. We report a patient with sarcoidosis who was identified because of symptoms resulting from exposure to workplace irritants. The presence of hyperreactive airways was confirmed by a positive methacholine challenge. PMID- 3963008 TI - A critical load for nocturnal high-density road traffic noise. AB - Eighteen female and 18 male students (21-30 years) slept in the lab during 12 consecutive nights each, where a high-density road traffic noise was played back with four intensities. EEG and EOG were recorded continuously throughout the nights. In the morning the subjects assessed their sleep and completed a reaction time test. The following conclusions were made: Performance was not affected by noise. REM sleep decreased abruptly as soon as the sound pressure level exceeded 44 dBA. With increasing noise, sleep was assessed as increasingly worse. Noise induced sleep disturbances were not related to sex. The equivalent sound pressure level measured for high-density road traffic seems to be a valuable predictor for subjective sleep disturbances as long as the maximum levels do not exceed it by more than 8-10 dBA. On the basis of the assessment of sleep and supported by the abrupt decrease of REM sleep, an equivalent noise level of 40 dBA indoors was defined as a critical load, above which nocturnal noise cannot be tolerated any longer. PMID- 3963009 TI - Health effects of work at waste water treatment plants: a review of the literature with guidelines for medical surveillance. AB - Potential health hazards associated with work at waste water treatment plants include bacteria, viruses and protozoa in domestic waste and heavy metals and other hazardous substances in industrial wastes. The primary exposure route for hazardous material is through inhalation of aerosols generated in the secondary phase of water treatment that contain pathogenic organisms. Although few epidemiological studies have investigated the health of waste water treatment facility workers, hazards noted have been limited to acute, self-limited gastrointestinal illnesses. Due to the potential for long term or subtle adverse health effects, a medical surveillance program is proposed that includes attention to infectious diseases, such as hepatitis and to illness/absenteeism records. PMID- 3963010 TI - Cancer risk among artistic painters. AB - An association between bladder cancer and employment as an artistic painter was found in two study populations. A proportionate mortality analysis of death certificates of professional artists indicated a greater than twofold excess for bladder cancer mortality among painters. This association was further investigated in a large case-control interview study of bladder cancer patients where an overall relative risk estimate of 2.5 was found among artistic painters. Excess deaths from leukemia and arteriosclerotic heart disease also occurred in the proportionate mortality study. Information was not available to determine exposure to specific substances that may have been responsible for these observations; however, efforts should be made to limit exposure to art materials known to be hazardous. PMID- 3963011 TI - Occupation and risk of cutaneous melanoma. AB - Occupational mortality from cutaneous malignant melanoma was evaluated for deaths occurring in British Columbia from 1950-1978 by using age standardised proportional mortality ratios (PMR). For males, significantly elevated PMRs for melanoma were seen in managers and owners, accountants, architects, chemical engineers, and gardeners and nursery workers. Female school teachers were also at elevated risk of death from cutaneous melanoma. PMID- 3963012 TI - Control of acute and chronic pain with Ansaid (flurbiprofen). PMID- 3963013 TI - Pharmacokinetics of flurbiprofen. AB - Both radiolabeled and nonlabeled drug have been used to study the pharmacokinetics of flurbiprofen (Ansaid, Upjohn). Drug absorption is rapid, drug disappearance half-life is independent of oral dose, and the area under the plasma drug concentration versus time curve increases with increasing oral dose. Elimination of intact drug from the peripheral circulation is biphasic and rapid. Following a single oral dose of 100 mg of flurbiprofen, drug bioavailability is equivalent using regimens of four 25-mg tablets, two 50-mg tablets, or one 100-mg tablet once daily. Long-term administration of flurbiprofen appears neither to inhibit nor induce the drug's metabolism. PMID- 3963014 TI - Flurbiprofen in rheumatoid arthritis: duration of analgesic effect. PMID- 3963015 TI - Analgesic efficacy in osteoarthritis: twice-daily dosing. PMID- 3963016 TI - The pain of ankylosing spondylitis. PMID- 3963017 TI - Flurbiprofen in the treatment of ankylosing spondylitis. A comparison with phenylbutazone. AB - Flurbiprofen (Ansaid, Upjohn), a potent new analgesic and anti-inflammatory agent, was compared with phenylbutazone in 90 patients with ankylosing spondylitis. In this double-blind, randomized, 26-week study, a total daily dose of 200 mg of flurbiprofen, administered three times daily, was as effective as 300 mg of phenylbutazone in controlling the pain and other symptoms of ankylosing spondylitis. In some patients, symptoms were adequately controlled by 150 mg of flurbiprofen per day, administered twice daily. There were no statistically significant differences between flurbiprofen and phenylbutazone in the investigators' and patients' assessments of improvement at all key follow-up periods. In addition, there were no consistently significant differences between drugs in the efficacy pain scales and quantitative measurements studied. Flurbiprofen was well tolerated in doses of up to 300 mg per day, and no clinically significant laboratory abnormalities were detected. Flurbiprofen appears to be an excellent alternative to phenylbutazone in the management of patients with ankylosing spondylitis. PMID- 3963018 TI - Flurbiprofen in the treatment of ankylosing spondylitis. A comparison with indomethacin. AB - In this randomized, double-blind study, 57 patients with ankylosing spondylitis were evaluated after 26 weeks of treatment with either flurbiprofen (Ansaid, Upjohn) or indomethacin. Flurbiprofen administered four times a day in a total daily dose of 200 mg was effective in controlling the pain and associated symptoms of ankylosing spondylitis. Pain was adequately controlled in some patients following a total daily dose of 100 mg of flurbiprofen administered twice a day. Flurbiprofen was as effective as indomethacin in most key efficacy measurements analyzed. The drug was well tolerated in doses of up to 300 mg per day, and no clinically significant laboratory abnormalities were detected. Flurbiprofen is an excellent treatment for the control of pain and inflammation in patients with ankylosing spondylitis. PMID- 3963019 TI - The pain of acute gout. PMID- 3963020 TI - Flurbiprofen in the treatment of acute gout. A comparison with indomethacin. AB - The relative efficacy and safety of flurbiprofen (Ansaid, Upjohn) and indomethacin were compared in 29 patients with monoarticular gouty arthritis of less than 48 hours' duration. A loading dose of 400 mg of flurbiprofen or 200 mg of indomethacin was administered for 24 hours, followed by 200 mg of flurbiprofen per day or 100 mg of indomethacin per day for a maximum of five days. Based on global assessment of improvement, at least 50 percent of patients in both treatment groups showed improvement within 24 hours. There were statistically significant improvements in pain, swelling, erythema, and skin temperature in both groups of patients within 48 hours of treatment. By 72 hours, the proportion of patients with improvement in the flurbiprofen group was equal to or greater than the proportion in the indomethacin group for all clinical efficacy parameters. At the end of treatment, eight of 15 patients in the indomethacin group and five of 14 patients in the flurbiprofen group were asymptomatic. There were no statistically significant differences between indomethacin and flurbiprofen in the percentage of asymptomatic patients at the end of treatment. Side effects were mild in both groups. No clinically significant between treatment differences were noted in vital signs or in the results of laboratory assays. PMID- 3963021 TI - The pain of acute bursitis/tendinitis of the shoulder. PMID- 3963023 TI - Review of the dosing regimens for flurbiprofen. A potent analgesic/anti inflammatory agent. AB - Flurbiprofen (Ansaid, Upjohn) is an effective analgesic and anti-inflammatory agent. At dosages of 50 mg administered every four to six hours as needed, flurbiprofen's analgesic efficacy has been confirmed in patients with postoperative pain as well as in those with postpartum pain and dysmenorrhea. Data also suggest that flurbiprofen administered 30 minutes before surgery reduced the severity of postoperative pain. In patients with rheumatoid arthritis, osteoarthritis, and numerous other inflammatory disorders, 100 to 200 mg of flurbiprofen in two to four divided doses has led to significant clinical improvement. Studies indicate that 100 mg of flurbiprofen at bedtime effectively decreased night pain and the duration of morning stiffness in patients with rheumatoid arthritis. PMID- 3963022 TI - European experience with flurbiprofen. A new analgesic/anti-inflammatory agent. AB - Numerous European clinical trials begun more than 12 years ago have clearly demonstrated flurbiprofen's safety and efficacy as an analgesic, anti inflammatory, and antipyretic agent. In preclinical studies, flurbiprofen was at least as potent as indomethacin, and approximately 200 times more potent than aspirin. For patients with rheumatoid arthritis, a review of several trials found flurbiprofen often superior to aspirin and naproxen, and equivalent to indomethacin and ibuprofen in efficacy. Acetaminophen appeared no more effective than placebo for patients with rheumatoid arthritis. For patients with ankylosing spondylitis, flurbiprofen was also shown to be equivalent or superior to indomethacin and phenylbutazone. For patients with osteoarthritis of the peripheral joints, spine, hip, and knee, flurbiprofen was again found equal to ibuprofen, diclofenac, indomethacin, and naproxen. Side effects with flurbiprofen were few and predominantly related to the gastrointestinal tract. PMID- 3963024 TI - Safety of flurbiprofen in the treatment of ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis. A summary of liver and kidney assay data. AB - The safety of flurbiprofen (Ansaid, Upjohn) was assessed after pooling data on kidney and liver function collected from nine separate phase III clinical trials involving 1,677 patients (941 receiving flurbiprofen and 736 receiving comparison drugs) with ankylosing spondylitis, osteoarthritis, or rheumatoid arthritis. Multiple categories were created to discern the effects of treatment, disease, age (under 60 and 60 years or older), and duration of exposure to flurbiprofen. No clinically significant trends in kidney or liver function were detected in any category following the administration of flurbiprofen. PMID- 3963026 TI - The pain of cancer. PMID- 3963025 TI - Effects of flurbiprofen and aspirin on the gastric and duodenal mucosa. An endoscopic comparison. AB - A single-blind, randomized endoscopic tolerance study was conducted to compare daily doses of flurbiprofen (Ansaid, Upjohn) at 100, 150, and 200 mg per day with 2,600 mg of aspirin per day. Ten normal volunteers were enrolled in each of the flurbiprofen groups, and five were enrolled in the aspirin group. Analysis of the mean gastric mucosal injury scores obtained on day eight revealed statistically significant lower mean scores (p = 0.05) in the 100-mg and 150-mg flurbiprofen treatment groups when compared with the 200-mg flurbiprofen group and the aspirin group. No significant differences were found between any of the treatment groups in duodenal mucosal injury scores. Mean scores for gastric mucosal injury in the three groups receiving flurbiprofen showed a definite dose relationship. The aspirin-treated subjects had significantly decreased uric acid levels (p = 0.006) and a significantly higher incidence of tinnitus (p = 0.04) compared with the flurbiprofen treatment groups. There was a poor correlation between subjective symptomatology and endoscopic pathologic findings. PMID- 3963027 TI - The pain of rheumatoid arthritis. PMID- 3963028 TI - Flurbiprofen in the treatment of rheumatoid arthritis. A comparison with aspirin. AB - This large-scale, double-blind study compared 200 mg per day of flurbiprofen (Ansaid, Upjohn) with 4,000 mg per day of aspirin in 822 patients with definite or classical rheumatoid arthritis who were evaluated for up to 52 weeks. Overall response to therapy was similar in both groups. By the end of the study, however, significantly more patients remained in the flurbiprofen (54 percent) than in the aspirin group (40 percent). Significant differences were also found in the incidence and severity of adverse reactions: 36 percent of flurbiprofen-treated and 63 percent of aspirin-treated patients reported side effects. Severe adverse reactions occurred in 6.7 percent of the flurbiprofen-treated patients compared with 16.5 percent of the aspirin-treated patients. Withdrawals that were due at least in part to adverse reactions were more than twice as frequent in the aspirin group (21.4 percent) than in the flurbiprofen group (10.2 percent). Laboratory data collected throughout the study showed no clinically significant abnormalities in either group. This study suggests that flurbiprofen effectively controls the pain and other symptoms of rheumatoid arthritis, and is superior in safety to aspirin in the treatment of patients with acute and chronic disease. PMID- 3963029 TI - The pain of osteoarthritis. PMID- 3963030 TI - Treatment of osteoarthritis of the knee. A comparison of flurbiprofen and aspirin. AB - The analgesic efficacy of flurbiprofen (Ansaid, Upjohn) and aspirin were compared in a 12-week, double-blind, randomized, parallel, multicenter study of 147 patients with osteoarthritis of the knee. Flurbiprofen (73 patients) was administered two, three, or four times a day in total daily doses of 100, 150, or 200 mg; aspirin (74 patients) was also given two, three, or four times a day in total daily doses of 2,000, 3,000, or 4,000 mg. Flurbiprofen was found effective in controlling pain and other symptoms of osteoarthritis. In general, the flurbiprofen group showed greater improvement in efficacy variables than did the aspirin group. Statistically significant improvements were noted in the flurbiprofen-treated patients for disability at week 12, and in the clinicians' assessment of response to therapy and disability at the final evaluation. Many flurbiprofen-treated patients (46 percent) completing the trial followed a relatively low dosage regimen of 50 mg twice daily for more than half the study. Flurbiprofen was well tolerated, and no significant laboratory abnormalities were detected. PMID- 3963031 TI - Effects of long-term administration of buspirone and diazepam on driver steering control. AB - The effects of buspirone, diazepam, and placebo on tracking control were investigated over a nine-day period, using three groups of subjects, each with eight females and eight males. Subjects were tested using an interactive, computer-based driving simulator on days one, eight, and nine of the treatment period. On day nine, subjects received alcohol with their drug treatment. Measures of steering control were derived from car-driver transfer functions. Tracking performance was also measured. Diazepam was found to adversely affect steering control measures in comparison with placebo. This was true both after doses on the first as well as the eighth day of treatment. Thus, there was no evidence of behavioral tolerance to diazepam. In contrast, buspirone was not found to have any adverse effects on steering control; in fact, some evidence of improved tracking control was found. When alcohol was added to each treatment on the ninth day, differences between the drug treatment groups were less pronounced but in the same direction as on the first and eighth days. PMID- 3963032 TI - Investigation of the abuse liability of buspirone in alcohol-dependent patients. AB - By use of the Addiction Research Center Inventory, the Amphetamine Self-Rating Scale, the Single-Dose Questionnaire, and selected physiologic measures (blood pressure, pulse and respiratory rates, oral temperature, and pupil diameter), the abuse liability of buspirone (10, 20, and 40 mg) was compared with that of diazepam (10 and 20 mg) and placebo in 19 subjects who were hospitalized for the treatment of alcohol dependency. Each treatment was given as a single dose at intervals of at least three days according to a double-blind, six-period, crossover Latin square design. Neither buspirone nor diazepam had any effect on blood pressure, pulse and respiratory rates, or body temperature. A small, transient pupillary constriction was evident in the 20- and 40-mg buspirone groups, but it dissipated within two hours after dosing. Both buspirone and diazepam had only a small stimulating effect on appetite. On the Pentobarbital Chlorpromazine-Alcohol Group and Sedation subscales of the Addiction Research Center Inventory, the 40-mg dose of buspirone yielded effects suggestive of a mild sedative-type drug. Only the 20-mg dose produced a significant effect on the Euphoria scale. Diazepam appeared to be more active as a sedative-hypnotic type of drug, by virtue of its effects on both the Amphetamine and Euphoria subscales and its greater effects on the Morphine-Benzedrine Group, Pentobarbital Chlorpromazine-Alcohol Group, and Sedation subscales, suggesting euphoria. Not only does the lack of effect of buspirone on the Amphetamine and Morphine Benzedrine Group subscales indicate lack of a euphorigenic property, but the score on the Lysergic Acid Diethylamide subscale, especially in the 40-mg group, suggests a dysphorigenic property at high doses. On the Amphetamine Self-Rating Scale, buspirone and diazepam affected only the sleep factor and only the 40-mg buspirone dose was distinguishable from placebo. On the Single-Dose Questionnaire, both buspirone and diazepam tended to be rated more as sedative type drugs, but buspirone was generally less well liked than diazepam. Overall, the results, which suggest a lack of euphoria and the presence of dysphoria at high doses, indicate that buspirone has only limited, if any, abuse liability. PMID- 3963034 TI - The adult medicine specialist. PMID- 3963033 TI - Neuroendocrine effects of buspirone in patients with generalized anxiety disorder. AB - This study investigated a therapeutic regimen of buspirone, a new anxioselective drug, in patients with generalized anxiety disorder. The single-blind study, conducted in 23 outpatients, consisted of 28 days of buspirone treatment followed by four days of placebo treatment. Patients received a single 10-mg dose of buspirone on study day one, which was titrated to 10 mg three times daily by study day seven and which remained at 10 mg three times daily through study day 28. Blood samples were drawn on days one, 14, 28, and 32 for determination of plasma levels of prolactin, growth hormone, and cortisol. The therapeutic effect of buspirone was assessed by standard psychometric rating scales. When titrated to a total daily dose of 30 mg per day (10 mg three times daily), buspirone provided effective antianxiety therapy and had no significant effect on plasma levels of prolactin, growth hormone, or cortisol. PMID- 3963035 TI - The jaundiced view: dirt. PMID- 3963036 TI - Predicting outcome in coronary disease. Statistical models versus expert clinicians. AB - To study the accuracy with which long-term prognosis can be predicted in patients with coronary artery disease, prognostic predictions from a data-based multivariable statistical model were compared with predictions from senior clinical cardiologists. Test samples of 100 patients each were selected from a large series of medically treated patients with significant coronary disease. Using detailed case summaries, five senior cardiologists each predicted one- and three-year survival and infarct-free survival probabilities for 100 patients. Fifty patients appeared in multiple samples for assessing interphysician variability. Cox regression models, developed using patients not in the test samples, predicted corresponding outcome probabilities for each test patient. Overall, model predictions correlated better with actual patient outcomes than did the doctors' predictions. For three-year survival, rank correlations were 0.61 (model) and 0.49 (doctors). For three-year infarct-free survival predictions, correlations with outcome were 0.48 (model) and 0.29 (doctors). Comparisons by individual doctor revealed Cox model three-year survival predictions were better than those of four of five doctors (model predictions added significant [p less than 0.05] prognostic information to the doctor's predictions, whereas the converse was not true). For infarct-free survival, the Cox model was superior to all five doctors. Where predictions were made by multiple doctors, the interphysician variability was substantial. In coronary artery disease, statistical models developed from carefully collected data can provide prognostic predictions that are more accurate than predictions of experienced clinicians made from detailed case summaries. PMID- 3963037 TI - Mechanism of acute lower extremity pain syndrome in fluoride-treated osteoporotic patients. AB - Acute pain in the lower extremity, which has previously been attributed to synovitis or fasciitis, develops in about 15 percent of osteoporotic patients treated with sodium fluoride. This report describes 11 osteoporotic women in whom this syndrome developed while they were being treated with sodium fluoride (mean dose 78 mg per day; range, 60 to 90). [99mTc]Hydroxymethylene diphosphonate scintiscanning showed an increased number of foci of abnormal uptake in the lower extremities (p less than 0.05), when compared with results of scintiscanning in 12 nonsymptomatic osteoporotic women treated with sodium fluoride and 12 osteoporotic women treated with oral calcium carbonate only. The increased uptake was not restricted to the areas of pain. Roentgenography revealed stress microfractures in five of the 11 symptomatic patients. It is concluded that the acute lower extremity pain syndrome during fluoride therapy usually results from intense regional bone remodeling, which may be complicated by stress microfractures. PMID- 3963038 TI - Increased susceptibility to Mycoplasma infection in patients with hypogammaglobulinemia. AB - The incidence and morbidity of Mycoplasma infections were examined in a group of 23 patients with hypogammaglobulinemia. Among this group of patients, 18 had one or more episodes of acute respiratory illness during which Ureaplasma urealyticum, Mycoplasma orale, or Mycoplasma pneumoniae were isolated from sputum. Resolution only followed institution of specific antibiotic therapy and elimination of the Mycoplasma. In addition to respiratory illness, U. urealyticum was isolated from the urine of two patients with urinary tract infection and from an area of cellulitis in another patient. M. pneumoniae was isolated from the joint of a patient with arthritis. In six patients with chronic lung disease, Mycoplasma was frequently isolated and clinical improvement, albeit transient, coincided with negative Mycoplasma culture results. These findings emphasize the unique susceptibility to Mycoplasma infection in patients with hypogammaglobulinemia. PMID- 3963039 TI - Effect of alcohol ingestion on breathing and oxygenation during sleep. Analysis of the influence of age and sex. AB - Breathing and oxygenation were monitored in 78 asymptomatic volunteers on two successive nights of sleep. Four groups of subjects were recruited: 20 young men, 20 young women, 20 men older than 40 years, and 18 postmenopausal women. In random order, subjects ingested either 2 ml/kg (body weight) of 100-proof vodka in orange juice or a similar amount of water in orange juice before bedtime. Alcohol ingestion shortened sleep in the older men and in the postmenopausal women. No effect of alcohol ingestion on breathing or oxygenation during sleep was seen in any group of women. In men, alcohol ingestion increased the numbers of desaturation episodes and caused more severe oxygen desaturation during sleep. The effect of alcohol ingestion on breathing and oxygenation during the sleep of asymptomatic volunteers appears to be limited to men. PMID- 3963040 TI - Marijuana smoking as cause of reduction in single-breath carbon monoxide diffusing capacity. AB - To investigate the effects of chronic marijuana smoking on lung function, pulmonary function tests including single-breath carbon monoxide diffusing capacities were performed in 15 healthy women who smoked 1.7 +/- 1.4 (mean +/- SD) marijuana cigarettes per day for 235 +/- 135 days per year for a mean of 10.5 +/- 3.7 years. Control groups included 27 nonsmoking and 26 tobacco-smoking women. Results revealed that marijuana smoking with or without tobacco is associated with a reduction in the single-breath carbon monoxide diffusing capacity to 74 +/- 20 percent of predicted, which was significantly different from that in the nonsmoking control subjects (92 +/- 11 percent; p less than 0.05). The subset of subjects who smoked marijuana and tobacco had a further reduction of the single-breath carbon monoxide diffusing capacity to 65 +/- 17 percent, which was significantly different from that in both nonsmoking and smoking control subjects (80 +/- 7 percent). These results suggest that heavy marijuana smoking when added to tobacco smoking may damage the gas exchange surface of the lung. PMID- 3963042 TI - Interface between membrane biology and clinical medicine. AB - Many enzymes that are embedded within membranes of cells are sensitive to the chemical and physical properties of the lipid components of the membrane. Because of this, the functions of these integral membrane-bound enzymes can be regulated to some extent by changes within the lipid portions of biologic membranes. That the functions of membrane-bound proteins can be manipulated by modifications of their intimate environment is not surprising. It is well known, for example, that the properties of the surrounding aqueous phase can modulate the function of proteins that are soluble in the cytosol of cells. In contrast, whereas significant changes in the chemical composition and physical properties of the aqueous portion of the cell (e.g., ionic strength and pH) are not allowed, normally tolerable fluctuations of diet appear to influence significantly the composition and properties of the lipid portions of intracellular membranes to the extent of altering the function of some membrane-bound enzymes. In addition, it appears that changes of this type can be induced by diseases that alter dietary intake and/or intermediary metabolism. In other words, it is likely that the functions of at least some integral membrane proteins can be manipulated in patients. Such manipulations may prove to be efficacious. Alternatively, the importance of diet and processes of intermediary metabolism for altering the course of certain diseases may not be fully appreciated. It is worthwhile to review, therefore, current ideas of how the lipid portion of a membrane interacts with integral proteins. The property of the lipids that appears to be most important in this regard is their viscosity. The types of manipulations of function of membrane-bound enzymes that can be achieved are illustrated by in vitro effects secondary to varying the lipids used to reconstitute pure, delipidated forms of these enzymes. The functions of pure delipidated enzymes are discussed for the hepatic drug-metabolizing enzyme uridine diphosphoglucuronyltransferase. In addition, data are presented to indicate that the function of this enzyme can be modified extensively in intact animals by changing the diet. PMID- 3963041 TI - Spontaneous hypercalcemia in patients undergoing dialysis. Etiologic and therapeutic considerations. AB - Ten dialysis-treated patients with hypercalcemia (11.5 +/- 0.3 mg/dl, mean +/- SE) due to renal osteodystrophy were compared with 30 control dialysis-treated patients who were not hypercalcemic (9.5 +/- 0.1 mg/dl). The hypercalcemic patients were more disabled than the control patients. Fifty percent of the hypercalcemic patients and 37 percent of the control patients had a mineralization defect (p greater than 0.6). In the control group, intact parathyroid hormone level was significantly higher in patients with osteitis fibrosa than in those with osteomalacia (247 +/- 39 pg/ml versus 60 +/- 20 pg/ml, respectively, p less than 0.005) whereas in the hypercalcemic patients, parathyroid hormone measurements did not discriminate between these two types of bone disease. Osteomalacia was more severe and bone aluminum staining was stronger in the hypercalcemic patients than in the control patients (2.02 +/- 0.47 versus 0.35 +/- 0.11 mm/mm2 tissue area, p less than 0.001). The mean serum calcium level fell from 11.2 +/- 0.2 mg/dl to 10.5 +/- 0.3 mg/dl (p less than 0.01) in eight hypercalcemic patients treated with 24,25-dihydroxyvitamin D. It is concluded that hypercalcemia in patients undergoing dialysis is associated with an increase in bone aluminum level, and with more severe osteomalacia. Intact parathyroid hormone levels are useful for predicting bone histomorphometric parameters but only when hypercalcemia is not present. The drug, 24,25-dihydroxyvitamin D, was effective in lowering the serum calcium level. PMID- 3963043 TI - To redeem them from death. Reactions of family members to autopsy. AB - Attitudes towards autopsy were examined in family members of 102 subjects who died in a university teaching hospital. The majority of responding families (88 percent) considered autopsy beneficial. Families permitting autopsy identified advancement of medical knowledge, comfort in knowing the cause of death, and reassurance that all appropriate care was given as the most important benefits. Fifty-five percent of the families of 40 subjects not undergoing autopsy declined permission and 45 percent had not been asked for such permission. The most frequent reasons given for not wanting autopsy were disfigurement of the body, stress of permitting autopsy, lack of information about autopsy, and family members' objections. Twenty-seven percent of 62 families permitting autopsy did not learn its results. Family members receiving results complained about long delays in receiving and complex terminology of autopsy reports. These findings suggest need for improvement in obtaining consent for autopsy, reporting autopsy results, and educating and counseling families of dying patients. PMID- 3963044 TI - Cirrhosis in a 19-year-old man. PMID- 3963045 TI - Lung abscess due to Corynebacterium equi. Report of the first case in a patient with acquired immune deficiency syndrome. AB - A lung abscess and persistent bacteremia due to Corynebacterium equi are described in a bisexual man with the acquired immune deficiency syndrome (AIDS). Eleven of the 12 previously reported cases have occurred in immunocompromised humans. The occurrence of this infection in a patient with AIDS has not been previously described. Development of resistance to beta-lactam antibiotics was noted following initial therapy. Because this organism resembles nonpathogenic organisms, it may easily be overlooked despite its ability to cause serious infection and persist even with aggressive antimicrobial and surgical therapy. PMID- 3963046 TI - Severe liver injury due to phenelzine with unique hepatic deposition of extracellular material. AB - Severe acute and chronic hepatic damage occurred in a white man who had taken phenelzine sulfate (Nardil) 45 mg daily for 70 days. Liver biopsy showed a mixed hepatitic and cholestatic pattern with extracellular deposition of a unique homogeneous collagenous substance. Portal cirrhosis developed and has persisted. The patient was found to have a "rapid acetylator phenotype" and high rate of metabolism of antipyrine. These innate factors may have predisposed to hepatic injury due to phenelzine. PMID- 3963047 TI - Pulmonary manifestations of familial dysautonomia in an adult. AB - A patient with familial dysautonomia (Riley-Day syndrome) who illustrates the multiple and varied pulmonary manifestations of this disorder is described. Since many of these patients are now surviving well into adulthood, knowledge of this condition among physicians should be propagated. PMID- 3963048 TI - Dermatomyositis and Hodgkin's disease. Case report and review of the literature. AB - The association between dermatomyositis and Hodgkin's disease has been infrequently reported. A patient with advanced Hodgkin's disease and dermatomyositis is presented and an additional 11 cases obtained from the world literature are reviewed. The clinical features, response to treatment, and outcome of these diseases are discussed. PMID- 3963049 TI - Mucocutaneous lymph node syndrome in adults. Differentiation from toxic shock syndrome. AB - Since infantile mucocutaneous lymph node syndrome was first reported in the United States in 1974, a number of cases of so-called Kawasaki syndrome have been reported in adults. A patient with characteristics of both mucocutaneous lymph node syndrome and toxic shock syndrome is described, and 12 cases reported in the American literature are reviewed in an attempt to clarify the differential diagnosis. Most cases initially reported as Kawasaki syndrome are probably toxic shock syndrome. PMID- 3963050 TI - Streptococcus bovis catheter infection and the short bowel syndrome. AB - Streptococcus bovis bacteremia has been associated with several gastrointestinal disorders, most notably carcinoma of the colon. This report describes a 57-year old woman with short bowel syndrome in whom S. bovis bacteremia and an infection of an indwelling parenteral nutrition catheter developed. A barium enema revealed diverticula and a foreshortened small intestine. This case implicates the short bowel syndrome in the pathogenesis of S. bovis bacteremia and supports empiric antibiotic coverage for both skin flora and enteric pathogens in patients with Hickman catheter sepsis and known gastrointestinal pathologic conditions. PMID- 3963051 TI - Acquired immune deficiency syndrome in homosexual men with Hodgkin's disease. Three case reports. AB - Fatal opportunistic infections developed in three homosexual men with Hodgkin's disease. Widely disseminated Kaposi's sarcoma developed in one, and another had persistent lymphadenopathy with a biopsy specimen showing benign follicular hyperplasia two years before the diagnosis of Hodgkin's disease. Physicians are alerted to the possible association of Hodgkin's disease and the acquired immune deficiency syndrome (AIDS). They are cautioned to consider the diagnosis of Hodgkin's disease in homosexual men with lymphadenopathy and warned of the risk of serious infections in homosexual men receiving therapy for Hodgkin's disease. PMID- 3963052 TI - Hemoglobin SC disease and alpha-thalassemia. Prolonged survival and mild clinical course. AB - An 86-year-old black woman admitted for an elective cataract extraction was found to have moderate hypochromic microcytic anemia. Hematologic evaluation disclosed the presence of hemoglobin SC disease and heterozygous alpha-thalassemia-2 (alpha alpha/alpha-). A red cell density profile of the patient's peripheral blood revealed an absence of the typical uniform shift toward higher-density values seen in hemoglobin SC disease, indicating a "normalization" in the distribution of intracellular hemoglobin types. It is suggested that the co-inheritance of hemoglobin SC disease and heterozygous alpha-thalassemia-2, probably by decreasing the tendency toward intracellular hemoglobin S polymerization, contributed to her prolonged survival and relatively mild clinical course. PMID- 3963053 TI - Cryptosporidiosis. Case report in a health team worker. AB - Cryptosporidium is a coccidial protozoan of the intestinal tract; cryptosporidiosis in veterinarians has been reported as a cause of diarrhea. It has also been reported as a cause of diarrhea in marrow transplant recipients. Cryptosporidiosis has gained attention recently because of its occurrence in patients with the acquired immune deficiency syndrome (AIDS). A healthy intensive care unit nurse who acquired cryptosporidiosis from a bone marrow transplant recipient with diarrhea caused by cryptosporidiosis is described. Results of laboratory examination, including T lymphocyte subsets, were normal. She was treated with bed rest and a liquid diet and her symptoms completely resolved after 15 days. Health care workers should be aware that cryptosporidiosis can be transmitted to them from patients and should follow precautions to avoid acquiring the disease. PMID- 3963054 TI - Familial Miller-Dieker syndrome associated with pericentric inversion of chromosome 17. AB - Recently it has been shown that most cases of the Miller-Dieker syndrome (MDS) are caused by deletion 17p13.3. All familial cases have been associated with a balanced reciprocal translocation in a carrier parent and unbalanced translocations in their affected offspring. We report a new case of familial MDS in whom the mother carries a pericentric inversion of chromosome 17. She has had two children with MDS, one of whom was shown to carry a recombinant 17 consisting of dup(17q) and del(17p). The high frequency of familial MDS and its consistent association with balanced chromosomal rearrangements in one of the parents makes it important to do high-resolution chromosome analysis on all patients with MDS and possibly all patients with lissencephaly. Finding a familial balanced rearrangement makes prenatal diagnosis of this condition feasible. PMID- 3963055 TI - Interstitial deletion of the long arm of chromosome 1 [del(1)(q32q42)]. AB - A severely malformed girl died 7 days after birth and was found to have de novo interstitial deletion of 1q (1q32----1q42). Clinical abnormalities included microcephaly, encephalocele, small eyes with unilateral esotropia, hypertelorism but small prominent nose, highly arched palate, micrognathia, abnormal cry, apparently abnormal low-set ears, short neck with low posterior hair line, narrow shoulders, congenital heart defect, hypoplastic nails, overlap of toes with flat feet, and single umbilical artery. PMID- 3963056 TI - Granulomatous nephritis and chronic renal failure in sarcoidosis. Long-term follow-up studies in two patients. AB - Sarcoid granulomatous nephritis was observed in 2 patients. Renal failure was present in both patients in the absence of hypercalcemia or nephrocalcinosis. Specific tubular dysfunction manifested as an acquired Fanconi syndrome in 1 patient. Steroid therapy was effective in causing regression of the renal granuloma, but there were significant interstitial changes on repeat renal biopsy which were accompanied by persistent tubular dysfunction. Sarcoid granulomatous nephritis may be a not infrequent cause of renal dysfunction in sarcoidosis. PMID- 3963057 TI - Density changes in leukocytes following hemodialysis or exposure to chemotactic factors. AB - Analysis of standard Ficoll-Hypaque separation profiles of peripheral WBC from patients undergoing hemodialysis (HD) demonstrated that dialysis caused a marked alteration in the number of cells found at both the interface between the Ficoll Hypaque and plasma which normally contains mononuclear cells and the cell pellet which normally contains granulocytes. By 30 min into dialysis, there was a 175% increase in white blood cells in the mononuclear band with a corresponding decrease in the number of cells obtained from the cell pellet. When peripheral blood samples from normal donors were pumped through various types of hemodialyzers, a shift in the cell separation profiles similar to that of patients undergoing HD was observed. Differential analysis of the cells obtained from both the interface between the Ficoll-Hypaque and plasma and the cell pellet showed that by 30 min into dialysis, the 'mononuclear' band contained 40-50% polymorphonuclear neutrophils (PMN). To ascertain whether the cell separation changes were possibly due to C5a generation resulting from complement activation by the HD membrane, whole blood was incubated with the purified chemotactic factors C5a, C5ades arg, and formyl-methionyl-leucyl-phenylalanine. This resulted in similar alterations in PMN densities. This study demonstrates that both in vivo and in vitro exposure of human peripheral blood to HD membranes as well as the chemotactic factors C5a, C5ades arg, and formyl-methionyl-leucyl phenylalanine results in density changes in PMN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963058 TI - Effect of intravenous infusion of low-dose dopamine on renal function in normal individuals and in patients with renal disease. AB - A low dose of dopamine was infused in 28 normal volunteers and in 137 patients with varying degrees of renal insufficiency during a routine measurement of the glomerular filtration (GFR) and the effective renal plasma flow (ERPF). Dopamine infusion led to an increase in ERPF and GFR and to fall in the filtration fraction. The effect of dopamine on renal function was most pronounced if the baseline GFR was normal. However, healthy individuals showed greater increases in both ERPF and GFR than renal patients with a comparable baseline GFR. In renal patients no effect was observed if the baseline GFR was below 50 ml/min/1.73 m2. Firstly, it is concluded that already early in renal disease there exists a diminished reserve filtration capacity. Secondly, if the GFR is less than 50 ml/min/1.73 m2, the renal reserve filtration capacity seems to be exhausted. PMID- 3963059 TI - Renal pathology forum. PMID- 3963060 TI - Progressive systemic sclerosis with the nephrotic syndrome and acquired factor X deficiency. AB - A patient with progressive systemic sclerosis (PSS) involving skin, digit, esophagus, and lung developed the nephrotic syndrome and rapidly progressive renal insufficiency. Renal pathology revealed capillary collapse, cellular crescents, arteriolar hyaline deposition, and mesangial proliferation. On immunofluorescence IgM, C3, and fibrinogen were present in mesangium and capillary walls. Prebiopsy coagulation screening revealed a factor X deficiency which caused substantial prolongation of the partial thromboplastin time without an overt bleeding diathesis. The acquired factor X deficiency resolved after fresh frozen plasma and vitamin K administration, although some spontaneous improvement was noted. Nephrotic syndrome may occasionally be seen in the acute fulminant form of PSS and should not deter diagnosis of PSS. PMID- 3963061 TI - Renal lesions in familial lecithin-cholesterol acyltransferase deficiency. Ultrastructural heterogeneity of glomerular changes. AB - Renal lesions of a new case of lecithin-cholesterol acyltransferase deficiency in an 18-year-old male are described. Large mesangial deposits and a sieve-like transformation of the peripheral basement membrane were the main glomerular lesions. Immunofluorescence identified C3 deposits in the mesangium. A heterogeneous pattern of ultrastructural findings was observed by electron microscopy. Thread-like structures with faint cross-striation and irregular tubular structures embedded in an amorphous material were found in mesangial and subepithelial sites. Mesangial areas and peripheral basement membranes showed irregular holes sometimes containing highly osmiophilic lamellar bodies. It is suggested that many mechanisms may be involved in the production of renal lesions induced by the lipoprotein abnormalities characteristic of the disease. PMID- 3963062 TI - IgM nephropathy associated with penicillamine. AB - In this report we describe the development of idiopathic nephrotic syndrome with an IgM nephropathy in a 53-year-old patient undergoing treatment for active rheumatoid arthritis with D-penicillamine. The use of D-penicillamine in the treatment of rheumatoid arthritis is known to be complicated by the development of various glomerulonephritides. However, in this report we describe for the first time the development of IgM glomerular alterations consistent with a nephropathy in a patient undergoing D-penicillamine therapy. PMID- 3963063 TI - Discontinuation of dialysis therapy in the demented patient. PMID- 3963064 TI - Partial purification of relaxin from human seminal plasma. AB - Human seminal plasma contains approximately 50 ng/ml of relaxin (specific activity = 1.3 ng/mg protein). During preliminary purification, semen plasma was delipidated, rehydrated, and loaded onto small octadecyl silica columns that were eluted with a TEAF/acetonitrile gradient system. Results were monitored by radioimmunoassay. The resultant partially purified human relaxin demonstrated biologic activity in the rat uterine segment bioassay. Nine liters of semen plasma was delipidated, rehydrated in TEAF, and subjected to high-performance liquid chromatography by a step gradient followed by a linear gradient. The active eluate was further purified by ion exchange chromatography. Pooled recovery fractions provided a total of 45.8 micrograms of relaxin. An aliquot flash evaporated and desalted by gel filtration chromatography provided 1.85 micrograms of relaxin in 25.2 mg protein, specific activity 73.4. This material is being used as immunogen in the production of antihuman relaxin antibodies by monoclonal technique. Our procedure represents the first and only successful partial purification of human relaxin to yield sufficient quantity and purity for antibody production. PMID- 3963065 TI - Human ovarian oxytocin: its source and relationship to steroid hormones. AB - To determine the site of oxytocin in human ovaries and its relationship with ovarian steroids, oxytocin and steroid hormones were measured in ovarian tissues, ovarian vein, and peripheral blood. Corpus luteum had significantly higher oxytocin, estrone, estradiol, and progesterone concentrations than corpus albicans and ovarian stroma (p = less than 0.01 to less than 0.001). Oxytocin concentrations in corpus luteum correlated significantly with estrone, estradiol, and progesterone. Oxytocin in corpus luteum increased from 14.0 +/- 1.8 ng/gm of wet weight in early to 30.8 +/- 0.9 ng/gm in midluteal phases (p = less than 0.001). Reverse phase high pressure liquid chromatography showed similarity between oxytocin in corpus luteum and synthetic oxytocin. Ovarian vein draining corpus luteum had significantly higher plasma oxytocin (11.8 +/- 1.5 pg/ml) than those without corpus luteum (2.1 +/- 0.2 pg/ml) or in the peripheral blood (2.9 +/- 0.3 pg/ml) (p = less than 0.001). Oxytocin in corpus luteum correlated significantly with its ipsilateral ovarian vein level of oxytocin, estrone, progesterone, and 17 alpha-hydroxyprogesterone. Our findings demonstrate that oxytocin is present and probably produced in corpus luteum and secreted into its ovarian vein; it may regulate corpus luteum release of progesterone, 17 alpha hydroxyprogesterone, and estrone. PMID- 3963066 TI - The relationship between antepartum fetal heart rate, intrapartum fetal heart rate, and fetal acid-base status. AB - The relationships between antepartum baseline fetal heart rate, baseline variability, accelerations, decelerations, and fetal movement and intrapartum fetal heart rate, fetal acid-base assessment at delivery, and Apgar scores 1 and 5 minutes after delivery were studied in 290 mature pregnancies. There was a significant relationship between antepartum and intrapartum baseline fetal heart rate and baseline variability. There was no relationship between antepartum and intrapartum accelerations or decelerations. There was no correlation between antepartum fetal heart rate or fetal movement and fetal acid-base status at delivery or Apgar scores 1 and 5 minutes after delivery. There was a trend for decreased accelerations and decreased fetal movements to be associated with a low Apgar score 1 minute after delivery. PMID- 3963067 TI - The need for flexibility in preparing clinician-scientists for academic careers. PMID- 3963068 TI - Experience with flexibility in an academic residency program. PMID- 3963069 TI - Response on the need fro flexibility in academic obstetric-gynecologic residencies. PMID- 3963070 TI - Response on the need for flexibility in academic obstetric-gynecologic residencies. PMID- 3963071 TI - Risk factors for the development of diethylstilbestrol-associated clear cell adenocarcinoma: a case-control study. AB - Factors related to the risk of developing clear cell adenocarcinoma in diethylstilbestrol-exposed women were investigated in 156 patients in the United States with clear cell adenocarcinoma and documented diethylstilbestrol exposure (Registry cases) and 1848 diethylstilbestrol-exposed women of similar age without cancer (National Cooperative Diethylstilbestrol Adenosis Project). Diethylstilbestrol dosage patterns, the use of other hormones, mother's age and pregnancy history, and daughter's birth month, birth weight, and age at menarche were compared. The relative risk was higher for those whose mothers began diethylstilbestrol before the twelfth week of pregnancy and for those who were born in the fall (winter conception). Maternal history of at least one prior spontaneous abortion elevated the risk. Supportive evidence for the difference in birth month distribution was also found by a comparison with United States vital statistics. Each factor was confirmed to be significant in a multivariate logistic model that examined all of them with region and year of birth adjusted. PMID- 3963072 TI - Effect of induced oligohydramnios on fetal lung development. AB - To investigate the impact of oligohydramnios on fetal growth, development, and lung function, amniotic fluid was shunted from alternate gestational sacs into the maternal peritoneal cavity at 23 days' gestation in the fetal rabbit. Uninstrumented fetuses served as controls. Oligohydramnios was confirmed at the time of planned cesarean delivery on either day 26 or 28. Fetuses subjected to prolonged oligohydramnios had significantly decreased body weight at 26 (p = 0.002) and 28 days (p = 0.007). Similarly, lung weight was decreased at 26 (p = 0.02) and 28 days (p = 0.005). There was a trend toward decreased maximum lung volume for instrumented fetuses at 28 days (p = 0.07). Deflation limbs of the pressure-volume curves revealed significantly increased air trapping for instrumented fetuses at 28 days. These studies suggest not only a detrimental effect of oligohydramnios on fetal body and lung weight but also a beneficial effect of premature rupture of membranes on fetal lung function. Analysis of phospholipid and histologic changes is currently under way. PMID- 3963073 TI - Temporal and receptor correlates of the estrogen response in sheep. AB - Uterine blood flow and uterine cytosol and nuclear estrogen receptors were measured at critical times during estradiol-induced vasodilatation in acute anesthetized and chronic conscious sheep preparations at estradiol bolus injection frequencies from 1 to 24 hours. During acute experiments, the uterine blood flow response was muted and cytosol estrogen receptor replenishment did not occur whereas full replenishment occurred in 12 hours in conscious ewes. In ewes treated with daily estradiol that had a stable daily uterine blood flow response, the uterine blood flow response 24 hours after uterine biopsy was similar to the preoperative one. Analysis of the duration of peak uterine blood flow levels and the rate of uterine blood flow descent from peak levels showed that an interval of 18 hours between estradiol injections was necessary for the uterine blood flow response to approximate that observed after 24 hours. These observations suggest: (1) that uterine vascular receptor replenishment is delayed compared with that of the total uterus; (2) that operative stress compromises cytosol estrogen receptor metabolism and possibly nuclear estrogen receptor function; (3) that the delayed maximum uterine blood flow response to estradiol in ewes previously untreated with estradiol is due to a trophic uterine effect of daily estradiol stimulation. PMID- 3963074 TI - An analysis of the obstetric outcome of 125 consecutive pregnancies conceived in vitro and resulting in 100 deliveries. AB - One hundred twenty-five consecutive pregnancies conceived in vitro resulted in 100 deliveries of 115 babies. There were 23 clinical abortions (18.4%) and two tubal pregnancies. During the same interval 30 preclinical pregnancies occurred, but these pregnancies did not progress. There were 26 multiple pregnancies (37.1%) before the twelfth week; these reduced spontaneously to 14 (22.2%) multiple births at delivery. Eight infants were delivered prematurely, and three of these died. Three babies had some congenital abnormality. Vaginal bleeding occurred during pregnancy in 59% of patients. Cesarean section was the method of delivery in 56% of patients. Other complications of pregnancy were similar to those of comparable populations. PMID- 3963075 TI - Focal vulvitis: a characteristic syndrome and cause of dyspareunia. Features, natural history, and management. AB - Based on the study of 67 affected women during a period of 15 years, we report the clinical features and natural history of focal vulvitis, a unique syndrome characterized by severe and persistent superficial dyspareunia and the presence of one to 11 (median three) minute, exquisitely tender areas of focal inflammation or ulceration on the mucosa of the vestibule. Three fourths of all lesions occur around the Bartholin gland ducts or between them posteriorly. Histopathologic study of tissues from seven patients has not shown a characteristic pattern of inflammation and fails to confirm a reported association between these lesions and the minor vestibular glands. These histologic studies and an in-depth clinical and epidemiologic investigation in nine patients, including microbiologic studies to identify infection by herpes simplex virus. Neisseria gonorrhoeae, Staphylococcus aureus, beta-hemolytic streptococci, Chlamydia trachomatis, mycoplasmas, Candida sp., trichomonads, or Mycobacterium sp., have not established an infectious etiology for this syndrome or evidence that it represents an unusual form of an autoimmune disease or Behcet's syndrome. Treatment with topical antimicrobial or corticosteroid creams, antibiotics given systemically, or cryotherapy has not been of demonstrable benefit. Approximately one half of patients eventually experience spontaneous remission but many appear to remain symptomatic indefinitely. Surgical excision of the hymenal ring and contiguous mucosa of the vestibule has brought relief and permitted resumption of sexual activity in seven of eight treated patients. While promising, operation should be reserved for patients who have experienced unremitting dyspareunia associated with the characteristic focal inflammatory lesions for at least 6 months. PMID- 3963076 TI - An epidemic of maternal thrombocytopenia associated with elevated antiplatelet antibody. Platelet count and antiplatelet antibody in 116 consecutive pregnancies: relationship to neonatal platelet count. AB - Twenty-eight (24%) of 116 pregnant women studied prospectively during an 8-month period in 1983 had platelet counts of less than 150,000/mm3 at least once during pregnancy. Thirteen of these were thrombocytopenic in both the prenatal and the peripartum period. Eighteen were restudied 3 to 12 months after delivery. One woman, who was pregnant again, had a platelet count of 140,000/mm3. In the others, platelet counts were in the normal range. Platelet-associated immunoglobulin G and serum antiplatelet antibody levels were elevated in 79% and 61%, respectively, of these 28 women on at least one occasion. However, 59% of 73 pregnant nonthrombocytopenic women had increased platelet-associated immunoglobulin G levels and 59% had positive serum antiplatelet antibody test results. Twenty women who had increased platelet-associated immunoglobulin G levels and positive serum antiplatelet antibody test results were normal 6 to 10 months after delivery. Of 105 infants studied, 10 were thrombocytopenic. Neonatal thrombocytopenia was not predicted by maternal platelet count, platelet associated immunoglobulin G, or serum antiplatelet antibody. By the fall of 1984, the incidence of thrombocytopenia had dropped to two in 280 consecutive pregnancies. We conclude that (1) epidemics of thrombocytopenia can occur in pregnant women and (2) if a women is found to be thrombocytopenic for the first time during pregnancy, she should not be subjected to the measures advocated for the management of pregnancy in women with autoimmune thrombocytopenic purpura. PMID- 3963077 TI - Longitudinal study of platelet indices during normal pregnancy. AB - The purpose of this longitudinal, prospective study was to define platelet indices during normal pregnancy and to compare them to normal nonpregnant values. Indices evaluated included platelet count, mean platelet volume, and platelet distribution width. No significant change occurred in the mean platelet count or mean platelet volume from the second to the third trimester; however, platelet distribution width increased progressively and significantly during this interval (p less than 0.0001). Mean platelet volume versus platelet count showed a significant inverse relationship (p less than 0.0001) and was congruent with normal nonpregnant values. Mean platelet volume versus platelet distribution width exhibited a significant direct relationship (p less than 0.03) that differed remarkably from normal nonpregnant values. These data support the concept of normal pregnancy as a compensated state of progressive platelet consumption. These findings may have important diagnostic and prognostic applications in discerning acute states of platelet consumption superimposed on the compensated consumption of normal pregnancy. PMID- 3963078 TI - Aortic function during normal human pregnancy. AB - Arterial rupture and dissection have been observed in both normal and complicated pregnancies. To understand how arterial mechanical properties might change during pregnancy, we measured aortic root diameter by M-mode echocardiography and obtained simultaneous cuff blood pressures during systole and diastole at rest and during isometric exercise. Measurements were obtained in 19 women at the end of normal gestation and again 3 to 6 months post partum. The aorta is larger and more compliant during normal human pregnancy, and these changes may not revert to prepregnant levels post partum. Increased aortic compliance, combined with decreased vascular resistance, may enhance left ventricular performance in normal pregnancy. Conversely, the presumed structural alterations leading to increased compliance may weaken diseased vessels leading to dissection or rupture during pregnancy. PMID- 3963079 TI - External cephalic version of the breech presentation under tocolysis. AB - External cephalic version with tocolysis at or near term has been advocated to avoid cesarean birth for breech presentation. In our institution this maneuver was successfully performed in 207 of 304 parturients without major complications, and all but six had vertex presentation at delivery. The success of version was inversely correlated with gestational age but was not correlated with ease of version, number of attempts, or placental location. When this 3-year period was compared with the previous three years (1979 to 1981), there was a significant reduction in the number of breech presentations during labor, whereas the total delivery rate remained relatively constant over the 6-year period. It appears that in a carefully selected population, external version near term can be used safely to reduce the need for abdominal birth because of breech presentation. PMID- 3963080 TI - Prophylactic tocolysis of twins. AB - The prophylactic use of oral terbutaline was studied in 28 normal, healthy, low risk women with twin gestations. The mean birth weights were significantly increased over those in a similar group of control patients. PMID- 3963081 TI - Epidemiology of hydatidiform mole during early gestation. AB - Different methodologic approaches have resulted in a wide variability in the reported incidence of hydatidiform mole in the United States. We studied the epidemiology of hydatidiform mole among 84,318 women obtaining legal abortions in the United States during the period 1975 to 1978. Our estimated rate of 7.5 hydatidiform moles per 10,000 pregnancies was similar to most reported rates for the United States. The rate was significantly higher for women 14 years or younger and those 45 years or older. Race, number of previous pregnancies, and number of previous spontaneous abortions were not found to significantly affect the risk of having the disease. The incidence was slightly (but not significantly) higher for women obtaining abortions during the first trimester than for those obtaining abortions during later gestation. This study minimizes the errors encountered in estimating the total number of pregnancies and the number of hydatidiform moles at later stages of gestation. Hydatidiform mole, although relatively the number of hydatidiform moles at later stages of gestation. Hydatidiform mole, although relatively uncommon, represents a complication of pregnancy that is of public health importance. PMID- 3963082 TI - Two-dimensional and M-mode echocardiographic findings in hypertensive pregnant women. AB - Two-dimensional and M-mode echocardiograms were obtained during the thirty-second week of gestation from 69 women classified as follows: group I, 22 normotensive primigravid women; group II, 16 primigravid women with pregnancy-induced hypertension; group III, 21 percent women with essential hypertension; and group IV, 10 normotensive nonpregnant control subjects. Systolic, diastolic, and mean arterial pressures were higher in groups II and III than in groups I and IV (p less than 0.001). Echocardiographic dimensions were significantly increased in group III compared with the other groups (p less than 0.01). No significant differences were observed among the other groups in the echocardiographic parameters or in the indices of ventricular performance studied. In echocardiographic studies, chronic hypertensive pregnant women are distinguished from patients with pregnancy-induced hypertension because the former have ventricular hypertrophy resulting from the pressure overload exerted for a long period of time. Our patients with essential hypertension experienced no changes in left ventricular performance because of the early stage of their hypertensive disease. PMID- 3963083 TI - Sodium excretion in human pregnancy: a role for arginine vasopressin. AB - Plasma arginine vasopressin concentration was measured before and after 1 week's dietary sodium loading (greater than 250 mmol/day) or deprivation (less than 50 mmol/day) in 50 second-trimester and 34 third-trimester primigravidas. A significant rise in plasma arginine vasopressin was observed only in second trimester subjects following sodium loading (5.6 +/- 0.5 to 6.6 +/- 0.5 pg/ml; p less than 0.05). Plasma sodium concentration and blood pressure did not alter, and plasma volume increased slightly in this group (24.4 +/- 0.5 to 25.9 +/- 0.7 ml/cm height; p less than 0.01). Hence the observed increment in plasma arginine vasopressin concentration in this group could not be explained by alterations to the major factors regulating arginine vasopressin release. It is suggested that arginine vasopressin secretion increases to assist natriuresis following dietary sodium loading in the second trimester of human pregnancy. PMID- 3963084 TI - Profound hypotension complicating magnesium therapy. AB - Two preeclamptic women became profoundly hypotensive while receiving magnesium sulfate. No evidence of toxic levels was present in either. In both, preeclampsia induced hypovolemia was extreme. That nontoxic magnesium levels can cause severe hypotension is an alarming possibility. Acknowledgment of this complication and expeditious reversal of the problem is essential. PMID- 3963085 TI - Electrocardiographic changes associated with ritodrine-induced maternal tachycardia and hypokalemia. AB - One hundred twelve patients in preterm labor were followed prospectively, with electrocardiograms taken before ritodrine therapy and at 6 and 24 hours of treatment. Ninety-six percent of patients developed sinus tachycardia. Other changes were seen in 79% of the study group. These changes included ST segment depression in 70%, T wave flattening or inversion in 55%, and prolongation of the QT interval in 35% of our sample. None of the electrocardiograms showed the presence of a significant axis deviation, a change in QRS interval, or arrhythmia. No correlation was seen between symptoms of ischemia and electrocardiographic changes. A drop in potassium concentration was noted initially, but a direct correlation between potassium concentrations and frequency of electrocardiographic changes was not present. We conclude that the electrocardiographic changes that are often observed during myocardial ischemia may be frequent in asymptomatic patients treated with ritodrine and that these changes may be a physiologic expression of ritodrine-induced tachycardia or hypokalemia. The validity of the use of the presence of electrocardiographic changes as the only criterion for discontinuation of ritodrine therapy is questioned. PMID- 3963086 TI - Ritodrine-induced neutropenia. AB - Ritodrine hydrochloride, a beta-sympathomimetic treatment for premature labor, has been associated with the development of pulmonary edema, various metabolic derangements, myocardial ischemia, and infarction. We present the first reported case of absolute neutropenia after prolonged intravenous administration of ritodrine with rapid, spontaneous reversal once the medication was discontinued. PMID- 3963087 TI - Meningoencephalitis caused by Histoplasma capsulatum complicating pregnancy. AB - We report what appears to be the first established case of disseminated histoplasmosis in pregnancy. Involvement of the central nervous system made treatment difficult, and the course of disease required iatrogenic preterm delivery of an uninfected fetus. Aspects of pathogenesis, diagnosis, interaction with pregnancy, and treatment for this common infection, hitherto unreported in pregnancy, are presented. PMID- 3963088 TI - Cesarean delivery of the second twin after vaginal delivery of the first twin. AB - Cesarean birth of twin B after the vaginal delivery of twin A is an infrequent event. There is little information in the literature documenting outcome of vaginal-abdominal delivery. We reviewed our 10-year experience in the management of such cases and compared outcomes with twins delivered by repeat cesarean section and vaginal delivery in the same time period. Twenty-one cases of combined vaginal-cesarean section deliveries were managed at our institute in a 10-year period. There was no apparent increase in maternal and perinatal morbidity and mortality when twin B was delivered by cesarean section after vaginal delivery of twin A. PMID- 3963089 TI - Lactation suppression and puerperal fever. AB - Seventy-five puerperal women who did not wish to breast-feed were treated with bromocriptine mesylate (Parlodel) or placebo in a prospective, randomized, double blind study. Results revealed a puerperal fever incidence of 18.6%, 13.3% of which was due to breast engorgement and 5.3% to an infectious process. Parlodel prevented puerperal fever in 87.9% of patients. If Parlodel was given within 18 hours of delivery, physiologic puerperal fever was prevented in 100% of cases. PMID- 3963090 TI - Atraumatic delivery in cases of malpresentation of the very low birth weight fetus at cesarean section: the splint technique. AB - A technique to assist in the atraumatic delivery of the very low birth weight fetus in cases of malpresentation at cesarean section is described; the technique minimizes potential trauma associated with version and/or extraction techniques. Use of uterine relaxing anesthetic agents and subsequent risk of hemorrhage are avoided. PMID- 3963091 TI - Cytosol estrogen receptor content of female parietal peritoneum. AB - The ovarian and peritoneal mesothelium are believed to derive from the same embryonal coelomic epithelium. Neoplastic proliferation of these epithelia is sometimes grossly and histologically similar. Recently estrogen receptors have been identified in gynecologic neoplasms. With the use of standard techniques, the parietal peritoneum was assessed for estrogen receptor content in 17 women undergoing celiotomy for various reasons. All peritoneal specimens were negative for estrogen receptor content. This suggests a heterogeneous origin of the peritoneal surface epithelium and that peritoneum may not be mullerian in origin. PMID- 3963092 TI - Another technique for resolution of shoulder dystocia. PMID- 3963093 TI - Prostaglandins and endometriosis. PMID- 3963094 TI - Cigarette smoking and endometrial cancer. PMID- 3963095 TI - Testosterone levels and androgen-producing neoplasms. PMID- 3963096 TI - In defense of the vertical uterine incision. PMID- 3963097 TI - Additional comment on combination conization. PMID- 3963098 TI - Maternal and fetal surveillance for older pregnant women. PMID- 3963099 TI - Sterilization failures. PMID- 3963100 TI - Bilateral angle-closure glaucoma in association with the acquired immune deficiency syndrome. AB - Two homosexual men, 35 and 42 years old, had bilateral acute angle-closure glaucoma in association with the acquired immune deficiency syndrome. In one patient, the angle-closure attack was the initial manifestation of AIDS. Choroidal effusion with secondary anterior rotation of the ciliary body at the scleral spur appeared to be the pathophysiologic mechanism. Pupillary block, angle crowding, and inflammatory synechial angle closure must be differentiated from anterior rotation of the ciliary body as the mechanism of the angle closure to provide optimal treatment. Whereas primary angle closures are treated with miotics and iridectomy, secondary angle closure may be worsened with this treatment. Cycloplegics and, if necessary, drainage of suprachoroidal fluid may be curative in AIDS-related angle closure associated with a choroidal detachment. Both patients died before the long-term efficacy of this treatment could be assessed. PMID- 3963101 TI - Intraocular lenses and diabetes mellitus. AB - I reviewed the records of 74 consecutive, unselected diabetic patients (91 eyes) who had cataract extraction with intraocular lens implantation. The retinopathy status remained unchanged in 79 eyes. Of the 12 in which retinopathy status changed, four eyes without previous retinopathy developed mild background retinopathy, seven eyes that had had mild background retinopathy progressed to moderate background retinopathy, and one eye that had had background retinopathy developed mild proliferative retinopathy. Sixty-four eyes (70.3%) achieved visual acuities of 20/40 or better. The examination, photography, and photocoagulation treatment of the retina were not affected by the presence of an intraocular lens. PMID- 3963102 TI - Ulcerative keratitis associated with contact lens wear. AB - A review of 573 cases of ulcerative keratitis cultured at the Bascom Palmer Eye Institute from January 1977 through September 1982 showed that 118 cases (21%) were associated with contact lens wear; of these, 64 were culture-positive. Of these culture-positive cases, 50 (78%) were caused by gram-negative bacteria, nine (14%) by gram-positive organisms, and two (3%) by fungal organisms. Of the 264 culture-positive ulcers not associated with contact lens wear, 119 (45%) were caused by gram-negative bacteria, 74 (28%) by gram-positive organisms, and 63 (24%) by fungal organisms. These statistically significant differences suggested that the organisms associated with ulcerative keratitis within our geographic region are modified by contact lens use. Pseudomonas was the organism most frequently isolated from ulcers associated with contact lenses and was responsible for nearly two thirds of the culture-positive cases. PMID- 3963103 TI - Association of fungi with extended-wear soft contact lenses. AB - Fungi were isolated from 11 extended-wear soft contact lenses. In two cases, fungi had penetrated through the contact lens and the same fungus was cultured from corneal ulcers. In four cases, fungal growth on and in the soft contact lens matrix was associated with conjunctivitis and punctate fluorescein staining of the corneal epithelium. PMID- 3963104 TI - Incidence of Moraxella conjunctival infection. AB - Thirty-three cases of Moraxella conjunctival infection, many incorrectly diagnosed as Chlamydia, epidemic keratoconjunctivitis, and herpes simplex infections, were confirmed by bacterial cultures and Giemsa staining during a one year period. Although Moraxella conjunctivitis is associated with adolescent girls, 13 of our 27 female patients with Moraxella infection (48%) were 20 years or older. Although corneal involvement, preauricular adenopathy, and ocular nodules are not classically associated with Moraxella conjunctivitis, these symptoms were present in 15 cases (45%). PMID- 3963105 TI - Immunohistochemical and ultrastructural study of unusual IgM lambda lymphoplasmacytic tumor of the lacrimal gland. AB - A 72-year-old man developed a slowly enlarging mass involving the left lacrimal gland. Excisional biopsy disclosed a lymphoplasmacytoid tumor which was found by immunohistochemistry techniques to be a monoclonal proliferation, expressing cytoplasmic IgM lambda. However, serum protein immunoelectrophoresis disclosed a monoclonal spike in the gamma-globulin region with IgG lambda. The patient was still systemically well with no evidence of lymphoma almost ten years after the initial recognition of the lacrimal gland mass. This unusual case demonstrated the difficulty of classifying orbital lymphoid tumors and the problems of accurately predicting the clinical course and prognosis in affected patients. PMID- 3963106 TI - Posterior uveal melanomas in aphakic and pseudophakic eyes. AB - Of 650 eyes with posterior uveal melanomas that were accessioned at the Armed Forces Institute of Pathology from 1975 to 1983, 28 were aphakic and eight were pseudophakic. In ten of these 36 cases, the cataract had been unilateral. Only two patients had been examined with preoperative A-scan ultrasonography to obtain the axial length of the eye. None of the patients had been examined for possible intraocular tumors by either A- or B-scan ultrasonography. We believe that in many of these cases the tumor was large enough to have been detected at the time of cataract surgery. Thus, if the lens is too opaque for the fundus to be viewed, B-scan ultrasonography should be used before cataract extraction. PMID- 3963107 TI - Computerized quantitative analysis of kinetic visual fields. AB - Kinetic perimetry is still a widely accepted and used means of assessing the visual field. Attempts at quantifying the area of vision for given isopters have been limited to area measurements on visual field charts, which are azimuthal equidistant polar map projections of the inside surface of the perimetry bowl. Such measurements distort the true size of scotomas (or seeing areas) when the boundaries measured are farther from the center of the field on the chart because of cartographic distortion inherent with this projection. We believe that the solid angle in steradians subtended by the scotoma or the seeing area is a more appropriate measure of the visual field than area on a flat representation. We used a simple computer program to determine the solid computer program to determine the solid angle for given isopters of graphed perimetric visual field data. PMID- 3963108 TI - Computerized scoring and graphing of the Farnsworth-Munsell 100-hue color vision test. AB - The Farnsworth-Munsell 100-hue test is a sensitive and accurate test of color discrimination. A major disadvantage of the test is the laborious and time consuming calculation needed to score the results and plot them on a chart for interpretation. We present a computer program, written in Microsoft's BASIC language, that performs the calculation and reports both the individual color cap error scores (from which the graph is plotted) and the total error score. If used with an IBM personal computer (or compatible) capable of graphics, the program plots a graph in a modified polar coordinate format that can be printed on a dot matrix printer. PMID- 3963109 TI - Lymphocyte subpopulations in uveal malignant melanoma. PMID- 3963110 TI - Cyanoacrylate adhesive in retinal detachment surgery. PMID- 3963111 TI - Wedge implant used as exoplant. PMID- 3963112 TI - Bilateral symptomatic multiple evanescent white-dot syndrome. PMID- 3963113 TI - Congenital trichomegaly, pigmentary retinal degeneration, and short stature. PMID- 3963114 TI - Unilateral internuclear ophthalmoplegia after head trauma. PMID- 3963115 TI - Fibrin as a major constituent of ligneous conjunctivitis. PMID- 3963116 TI - Management of Cogan's syndrome. PMID- 3963117 TI - Transient myopia induced by sulfonamides. PMID- 3963118 TI - Myiasis palpebrarum. PMID- 3963119 TI - A simplified method for viewing slides stereoscopically. PMID- 3963120 TI - A fiberoptic slit-lamp attachment. PMID- 3963121 TI - Long-term visual acuity results after penetrating and perforating ocular injuries. PMID- 3963122 TI - Pigmentary glaucoma associated with posterior chamber intraocular lenses. PMID- 3963123 TI - The effects of hypotonic and hypertonic solutions on the fluid content of hydrophilic contact lenses. PMID- 3963124 TI - Diagnosis and pathogenesis of retinal pigment epithelial tears. PMID- 3963125 TI - Liberal arts: the foundation for occupational therapy education. AB - Occupational therapy lacks a consensus regarding its theory base, technical tools, contribution to society, ethical stance, and relationship to medicine. This study proposes steps to achieve a new consensus and to resolve the crisis focus on entry-level education. The proposed steps include the critical assessment of the educational foundation for practice, the recognition that a liberally educated occupational therapist can serve patients better and meet pressing societal needs, and the pursuit of closer relationships with liberal arts colleges by occupational therapy academic departments. A "new breed" of occupational therapists, that is, therapists who are liberally educated, will be capable of thinking in broad categories and will be open to new ideas and aware of ethical implications; they will be familiar with principles, able to practice from a knowledge base, and prepared to improve the profession's practice: they will possess the skills to be leaders. PMID- 3963126 TI - Procedures for designing an occupational therapy consultation contract. AB - Occupational therapists have been asked with increasing frequency to function as consultants, yet most of the research on consultation has been published in other fields. Issues that have been investigated include negotiating consultation sponsorship, conducting needs assessments, and evaluating the consultant's effectiveness. For the purposes of our research the literature was used to generate a list of steps for designing a consultation package. The steps were then used in a six-month pilot contract to assess their usefulness for occupational therapy practice. PMID- 3963127 TI - The Purdue Pegboard: norms for 14- to 19-year-olds. AB - The purpose of this study was to collect normative data on the Purdue Pegboard, a test of finger dexterity, for individuals aged 14 to 19 years. Three trials were administered to 176 subjects from the seven-county Milwaukee area. Results indicated that females performed better than males on three out of four subtests, suburban subjects scored better than urban subjects on two of four subtests, and scores increased with age. The normative data collected provide a means of comparing a patient's score with normal individuals of the same sex and age and aid in determining a patient's need for therapy and in setting appropriate treatment goals. PMID- 3963128 TI - A positioning seat for the neonate and infant with high tone. AB - Positioning and seating are important for premature and young infants with tonal problems. Positioning with pillows and sandbags, the use of special handling techniques (Bobath's neural developmental treatment), as well as other specialized approaches, have not proved satisfactory in reducing tone or spasticity in these infants. We developed an adaptive seat designed to reduce extensor tone through proper positioning. This seat has also been helpful in diminishing agitation. Without these benefits, infants are often immobilized in extension and cannot actively explore their environments. Diminution in agitation has also been important in increasing interaction with nurses. PMID- 3963129 TI - Promise in nonparametrics. AB - This paper proposes the use of nonparametric statistical methods as a way to increase the quality and quantity of research in occupational therapy. Assumptions underlying parametric versus nonparametric methods are compared and the conditions under which nonparametric methods may be preferred are specified. Finally, a synopsis of equivalent nonparametric procedures for common parametric methods is presented. PMID- 3963130 TI - Case report: occupational therapy with a traumatic bilateral shoulder disarticulation amputee. AB - This report describes the application of occupational therapy to a patient with traumatic bilateral shoulder disarticulation. Treatment goals and methods for acute care, preprosthetic training, and prosthetic training are described and illustrated. PMID- 3963132 TI - Occupational therapy and public policy. PMID- 3963131 TI - A gauntlet work splint. PMID- 3963133 TI - Faculty research: a pluralistic approach. PMID- 3963134 TI - Prediction of methylphenidate (Ritalin) responsiveness through sensory integrative testing. AB - Seventeen children previously judged to be good or poor responders to methylphenidate (Ritalin) were tested on sensory integrative measures while in the off-drug state. The tester was unaware of the children's drug response category. Results showed that children who were poor responders to Ritalin showed prolonged scores on and an adverse reaction to the Southern California Postrotary Nystagmus Test and had poorer equilibrium reactions and lower double tactile stimuli scores than the children judged good responders to Ritalin. These findings suggest that it might be possible to identify good and poor responders to Ritalin before the medication is given, something not previously thought possible. The current method for making this distinction is through a drug trial. These findings also indicate that there are at least two discernible types of hyperactivity associated with attention deficit disorders (ADD) that are theoretically related to differences in vestibular processing: one related to underaroused or overinhibited lower brain centers, and another related to deficient inhibition from higher brain centers. The good responders to Ritalin appear to be the underaroused group, the same population that responds to sensory integrative occupational therapy techniques. This implies that perhaps occupational therapy could be used to reduce the medication needs of these children. PMID- 3963135 TI - Theories of motivation in occupational therapy: an overview. AB - The motivational theories behind five theoretical approaches in occupational therapy that claim to be generic are explained. With the exception of the occupational behavior approach, the motivational perspectives are only implied features of the following other occupational therapy approaches discussed: object relations analysis, action consequence approach, recapitulation of ontogenesis, and developmental facilitation. These motivational explanations are developed and then applied to a case example. Finally, the occupational therapy approaches are analyzed in terms of the viability of their motivational perspectives to determine their adequacy as generic approaches for the profession. PMID- 3963136 TI - A hospital-connected halfway house program for individuals with long-term neuropsychiatric disabilities. AB - A three-month, hospital-connected halfway house program was established by two occupational therapists at the Sepulveda Veterans Administration Medical Center, Sepulveda, California. The program emphasized living skills and social skill training for chronic neuropsychiatric patients. The 19 graduates of the program were able to make the transition from the hospital to the community and to maintain themselves in the community for longer periods of time with shorter rehospitalizations. The 5-year follow-up also indicated that for the majority of the patients the quality of community living improved as measured by their satisfaction with their occupational choices (vocational, avocational) and their living arrangements. PMID- 3963137 TI - The relationships between volition, activity pattern, and life satisfaction in the elderly. AB - This study examines the relationships between the volition subsystem, activity pattern, and life satisfaction of 60 elderly individuals. The volition subsystem includes an individual's interests, values, and personal causation. The Occupational Questionnaire (OQ) was developed to measure volition subsystems and activity patterns, and it was pilot tested for reliability and validity. Scores on the OQ were compared with measures of subjects' life satisfaction. Results of the study identified several aspects of the subjects' occupations that were related to their level of life satisfaction. The most important findings were the positive correlations between the degree of interest, value, and personal causation in occupation and life satisfaction. Time spent in work and leisure was found to be correlated more highly with high levels of life satisfaction than was time spent in daily living tasks and rest. Although further verification of these results is needed, these findings indicate that occupational therapists may enhance the life satisfaction of their elderly patients by emphasizing interests, values, personal causation, work, and leisure in their treatment programs. PMID- 3963138 TI - Treating the patient with digital hypersensitivity. AB - Digital hypersensitivity is a functionally disabling condition, which often responds to conservative treatment with structured sequential desensitization. This case study describes the treatment hierarchy as the patient responds with objective improvement at each stage. PMID- 3963139 TI - Monocular and binocular acuity estimation in 18- to 36-month-olds: acuity card results. AB - The acuity card procedure is a useful method for measuring visual acuity in infants 1 to 12 months of age. The results of the present study indicate that the procedure is also a viable method for estimating acuity in children 18 to 36 months of age. Monocular and binocular estimates of acuity were obtained with the acuity card procedure on 36 normal children, 9 each at ages 18, 24, 30, and 36 months. At each of the ages, means and SD's of acuity estimates agreed well with acuity norms from established operant procedures. Mean durations for monocular and binocular estimates averaged 2 to 4 min, and nearly 100% of children were tested successfully both monocularly and binocularly. The flexibility of the required response and the short test times make the acuity cards a promising test of visual acuity in this typically difficult-to-test age range. PMID- 3963140 TI - Eye and head contribution to gaze at near through multifocals: the usable field of view. AB - Presbyopes show that for targets presented within a 28 degrees clear field of view, gaze is accomplished by head and eye movements with head movements making an average contribution of 24%. A clear field of view which incorporates the factor of segment width provides an underestimation because of the factor of head movements. By including the effect of head movements, a fixed segment width provides a much wider clear field of view which we term the usable field of view. PMID- 3963141 TI - Comparison of subjective lens preference to objective refractive error measurements in pigtail macaques. AB - Two measurements can be taken to determine the refractive error in human beings: a subjective, lens preference measurement and objective retinoscopy. This study determined the subjective refractive error in eight pigtailed monkeys by placing lenses of different powers in front of peepholes in a solid wall cage and recording the amount of time each subject used the holes. Retinoscopy measurements were then taken and compared to the subjective findings to determine the degree of similarity between these two refraction methods. The results showed a high correlation between the subjective measurements and the vertical ocular refraction (VOR) and spherical equivalent (SE) (rho = 0.96), further supporting generalizations made from nonhuman primate vision studies to human beings. PMID- 3963142 TI - Suppression behavior analyzed as a function of monovision addition power. AB - Monovision, the use of a monocular addition for near viewing, is a clinical technique sometimes used to correct presbyopia. This technique attempts to maintain binocular function while requiring a degree of central suppression. We examined suppression behavior in spectacle monovision as a function of addition power. Suppression behavior was determined by measuring the length and frequency of periods of suppression for a range of monocular addition powers. Testing was conducted at viewing distances of 6 m and 40 cm. The most striking result is the existence of a near/distance differential: the monocular addition power required to stabilize suppression at near is greater than at distance. It was also found that suppression behavior may be stable even in the presence of a relatively high level of stereoscopic acuity. The relation between the contradictory needs for suppression and binocular functioning under monovision conditions is discussed. PMID- 3963143 TI - Low contrast charts effectively differentiate between types of blur. AB - Test charts with three different contrast levels were used to measure acuity of six subjects at distance and near. Reduction in measured acuity as a result of refractive defocus was shown to be independent of contrast level. Reduction in measured acuity with diffusive blur was greater on the medium and low contrast charts than on the high contrast chart. We advocate the use of charts with two different contrast levels to help differentiate between causes of visual degradation. PMID- 3963144 TI - Apparent path of a Pulfrich target as a function of the slope of its plane of motion: a theoretical note. AB - A theoretical equation is derived to predict the apparent path of a Pulfrich target moving with constant velocity in a plane that intersects the pupillary plane of an observer. Generally, the predicted apparent path is a hyperbola. However, if the angle between the two planes is zero, or they intersect at a pupillary center, then the predicted apparent path is a line. Other theoretical equations are derived that describe the apparent size and orientation of a line target that is parallel to the pupillary plane and receding from the observer. PMID- 3963145 TI - Wide-field fusional stimulation in strabismus. AB - The effectiveness of wide-field fusional stimulation was evaluated on 57 strabismics and 29 patients with convergence insufficiency. The strabismics had fusion, normal retinal correspondence (even if it coexisted with anomalous retinal correspondence), a deviation not exceeding 30 delta, and visual acuity of 6/7.5 or better. The strabismics included intermittent exotropes, surgically overcorrected intermittent exotropes, and accomodative esotropes. Of these strabismic patients, 42 responded to therapy in which tropias were converted to phorias or the frequency of the manifest deviation was significantly reduced, fusional amplitudes were significantly enlarged, and in many cases, stereoacuity improved as well. In 16 cases, surgery that was recommended before treatment is no longer being considered. Of the patients with convergence insufficiency, 23 responded to therapy which resulted in the enlargement of fusional amplitudes and the alleviation of symptoms. Follow-up visits (for up to 5 years) confirm that the improvement persists, which indicates the utility and effectiveness of this technique. PMID- 3963146 TI - Prelesional events in atherogenesis. Accumulation of extracellular cholesterol rich liposomes in the arterial intima and cardiac valves of the hyperlipidemic rabbit. AB - Biochemical, physiologic, and ultrastructural modifications which appear in the aortic intima and atrioventricular valves before monocyte diapedesis and foam cell formation were investigated in rabbits fed a cholesterol-rich diet. In the first 2 weeks of the diet, while plasma beta-VLDL cholesterol was increased up to 15-fold, the intima showed an enhanced uptake and deposition of dietary 3H cholesterol, 125I-beta-VLDL, and the fluorescent beta-VLDL-1,1'-dioctadecyl 3,3,3',3'-tetramethylindocarbocyanine conjugate. beta-VLDL-gold complex perfused in situ was transcytosed across endothelium by plasmalemmal vesicles. Concomitantly, within the intima, a progressive accumulation of extracellular densely packed uni- or multilamellar vesicles took place. These commonly occurred in cell-free subendothelial spaces and were not associated with any sign of cytolysis. In freeze-fracture preparations, these vesicles appeared as smooth surfaces, suggesting the absence of translamellar proteins. Upon incubation with filipin, these extracellular liposomes (EL) displayed characteristic approximately 20 nm filipin-sterol complexes, revealing the presence of preparations unesterified cholesterol in the phospholipid lamellas. EL deposition was paralleled by proliferation of basal lamina-like material, microfibrils, and proteoglycans, and continued to increase during foam cell formation. For the entire period of our experiments, the endothelium was morphologically intact, and no platelet involvement was detected. The results show that an early prelesional ultrastructural change in lesion-prone aortic and valvular areas is the accumulation of extracellular phospholipid liposomes rich in unesterified cholesterol. PMID- 3963147 TI - Role of nonciliated cells in renewal of the bronchial epithelium of rats exposed to NO2. AB - The purpose of the present study was to identify the proliferative cell types in the nonciliated cell population of the upper airways and determine the capacity of each to act as progenitor cells. Sprague-Dawley rats (30 days old) were exposed to 20 ppm NO2 for 24 hours to stimulate cell division, given injected tritiated thymidine (3H-TdR), sacrificed 1 hour and 1, 3, 5, and 7 days later, and prepared for light- and electron-microscopic autoradiography. One hour after injection of 3H-TdR, the mean labeling index (LI) was 1.6% in control animals and 5.2% in exposed animals. Mean grain counts per cell decreased from 15.6 at 1 hour after 3H-TdR to 6.9 on the third day, indicating that the labeled cell population had divided. Labeled cells in the control and exposed cell populations were identified with electron microscopy. At 1 hour after injection of 3H-TdR, basal cells and nonciliated columnar cells were labeled. However, only nonciliated columnar cells were stimulated to divide by NO2. The labeled nonciliated columnar cell population was made up of serous, "intermediate" and goblet cells. Each of these cell types was stimulated to divide to the same degree. After cell division (1-7 days) labeled cells of all types were observed with labeled ciliated cells appearing on the third day. It was concluded that the basal cell is not a primary progenitor cell. The primary progenitor cell for epithelium in the upper airway is the total columnar secretory cell population (serous, "intermediate," and goblet cells). PMID- 3963148 TI - Respiratory epithelial cell necrosis is the earliest lesion of hyaline membrane disease of the newborn. AB - The pathogenesis of hyaline membrane disease of the newborn remains controversial. In an attempt to identify early morphologic lesions of hyaline membrane disease, the authors reviewed the histologic sections of lung of all infants that survived for 12 hours or less and all stillborns on which autopsies had been performed at the Johns Hopkins Hospital between 1975 and 1983. Subjects showing more than trivial autolysis or with major congenital malformations were excluded from the study. Among the 70 live births included in this study, 10 (14%) surviving for 7-12 hours had typical hyaline membranes, which are composed of predominantly necrotic epithelial cells. Nine (13%) subjects surviving for 1 10 hours had hyaline membranes plus intraairway necrotic epithelial cell clumps, and 15 (21%) subjects surviving for 10 seconds to 4 hours had only intraairway necrotic epithelial cell clumps. Among the 44 stillborns, 3 (7%) had intraairway necrotic epithelial cell clumps, and 1 of them given resuscitation had hyaline membranes in addition. The results suggest that the initial lesion of hyaline membrane disease of the newborn is necrosis of respiratory epithelial cells, and that this process may begin before birth. PMID- 3963149 TI - Minimal invasive carcinoma of the colon in rats. AB - The careful histologic examination of the macroscopically normal colon in rats treated 8 months previously with a single dose of the colonotropic carcinogen dimethylhydrazine (DMH) demonstrated atypical colonic glands in normally occurring lymphoid mucosal patches. The atypical glands were characterized by the absence of cytoplasmic mucus, hyperchromatic cell nuclei, cell stratification, and increased number of mitotic figures. In 61.7% of the experimental animals, atypical colonic glands were found beyond the boundary of the muscularis mucosae, but in none of the controls. Thus, microinvasive adenocarcinoma of the colon seems to be a common finding in rats treated with a single dose of DMH. These adenocarcinomas remain, however, undetected at macroscopic examination. Measurements performed in consecutive lymphoid aggregates demonstrated that 50% of rats receiving DMH had thicker lymphoid aggregates than control animals. In spite of this, no tumor was recorded at naked eye examination in these areas. The macroscopic examination appears to be an unreliable method of ruling out malignancy in experimental rats treated with a single dose of the above-mentioned carcinogen. PMID- 3963150 TI - Chronic gentamicin nephrotoxicity. Continued tubular injury with preserved glomerular filtration function. AB - After an initial episode of acute tubular necrosis, apparent resistance to gentamicin nephrotoxicity develops in rats during prolonged drug administration. The authors studied this phenomenon by examining the autoradiographic distribution of 3H-gentamicin and 3H-thymidine during 5 weeks of gentamicin treatment and by analyzing renal structure and function after a 12-week course of treatment. These studies show that regenerating cells exclude gentamicin, but concentrate it again after maturation, and that the rate of thymidine incorporation is still high well after recovery from acute toxic injury. After 12 weeks of gentamicin, the glomerular filtration rate was only modestly diminished, whereas in vitro cortical organic ion transport was substantially impaired. Light and electron microscopy demonstrated all phases of injury and recovery among cells of most proximal tubules and evidence of chronic tubulointerstitial disease. It is concluded that "resistance" to gentamicin is a state of persistent tubular cell injury obscured functionally by preservation of the glomerular filtration rate and histologically by asynchrony of cell necrosis and regeneration. PMID- 3963151 TI - Macrophage-parasite interaction in the lesions of cutaneous leishmaniasis. An ultrastructural study. AB - Localized cutaneous infections with Leishmania, which demonstrate complex host parasite interactions, were studied ultrastructurally in 16 patients at phases ranging from onset to resolution. In the early lesions the host macrophages were 1) heavily parasitized and vesiculated, 2) undifferentiated, or 3) large and active, with fewer organisms. Progressive activation and epithelioid transformation of incoming monocytes was associated with the elimination of parasites. Killing and degradation appeared to take place simultaneously within the phagolysosome, but lysosomal fusion did not prevent survival into the activated cell stage. Host cell lysis, the alternative mechanism of parasite elimination, was accomplished following contact of the macrophage with plasma cells or its engulfment by a large granular cell. Lysis was either sporadic, proceeding from the periphery, or total in a central mass; and in each case macrophage lysis was preceded by connective tissue damage. The externalized parasites appeared to enhance both the activation and lytic processes, but degraded extracellular organisms were associated with dendritic-like cells more than with macrophages. This needs further study. PMID- 3963152 TI - Cigarette smoke increases the penetration of asbestos fibers into airway walls. AB - For study of the penetration of asbestos fibers into airway walls, guinea pigs were given amosite asbestos by intratracheal instillation. Half of the animals were also exposed to cigarette smoke. Animals were sacrificed at 1 week and 1 month, and numbers of fibers in airway walls were counted in histologic sections. In both smoke-exposed and nonexposed groups, numbers of fibers per square millimeter of airway wall increased from 1 week to 1 month in the respiratory bronchioles. At each time period, smoke-exposed animals had significantly higher numbers of fibers in the airway walls, compared with nonexposed animals. It is concluded that 1) continued transport of fibers into interstitial tissues may be the reason that asbestosis can progress after cessation of exposure; 2) cigarette smoke increases the penetration of fibers into airway walls. This effect may play a role in the increased incidence of disease seen in smoking, compared with nonsmoking, asbestos workers. PMID- 3963153 TI - Use of the California Consonant Test in evaluating hearing aids. AB - The California Consonant Test (CCT) was used to evaluate different hearing aids for twelve listeners with mild to moderate sensorineural hearing losses. The CCT was mixed with white noise at signal-to-noise ratios (S/Ns) of +30 (quiet), +15, +5, and O dB and presented through hearing aids for each listener; the quiet condition was retested. Significant differences were found between mean test scores for the high and low S/Ns. Intralistener hearing aid differences were found most frequently in the quiet condition. Truncation errors were frequent for the low S/Ns. These findings indicate that the sensitivity of the CCT is decreased rather than increased by mixing it with noise. Critical differences of 5% or more between hearing aids were more frequent as the S/N improved; the greatest number of differences occurred for the quiet condition. PMID- 3963154 TI - Anticholinergics and human brain stem auditory evoked potentials. AB - The effect of premedication with morphine and anticholinergic drugs on absolute and interpeak latencies of brain stem auditory evoked potentials was studied in thirty patients. Two commonly used anticholinergics, glycopyrrolate and scopolamine, given in combination with morphine were studied. Patients premedicated with morphine alone served as a control group. No significant change in either absolute or interpeak latencies was noted in patients premedicated with either morphine alone or morphine and glycopyrrolate. Results in patients premedicated with morphine and scopolamine are inconclusive because of large intersubject variability. PMID- 3963155 TI - Metastatic carcinoma to the temporal bone. AB - We present a case report of a woman with adenocarcinoma of the breast and metastasis to the temporal bone. The diagnosis of metastasis to the temporal bone may be difficult to make, for the symptoms and findings may mimic those of chronic infection. A high-resolution computed tomography scan is mandatory for complete investigation. PMID- 3963156 TI - Sodium fluoride: effectiveness of treatment for cochlear otosclerosis. AB - We examined the effectiveness of sodium fluoride in treatment of cochlear otospongiosis in ninety-four patients with cochlear otosclerosis and ninety-eight patients with stapedial otosclerosis and sensorineural hearing loss. The drug halted or slowed the progression of sensorineural hearing impairment in 63% of the patients with cochlear otosclerosis and 46% of the patients with stapedial otosclerosis. The single factor that best predicted which patients would respond most favorably to treatment was rate of progression before treatment. Sodium fluoride therapy was successful for 79% of the patients losing their hearing at a rate of 5 dB or more per year at one or more of the speech frequencies. The finding that patients with more rapid rates of progression responded most favorably to sodium fluoride therapy suggests that patients with the most active otospongiotic processes will be the most responsive to treatment. PMID- 3963157 TI - External ear canal cholesteatoma. AB - External ear canal cholesteatoma (EECC) is a rare otologic entity. Erosion of the inferior canal wall and accumulation of keratin debris are consistent findings. In the past there had been confusion between EECC and keratosis obturans, and they were thought to represent the same disease process. Currently, based on clinical and pathologic findings, it is believed that they are two different entities. In this article we present our experience in treating eight patients with EECC. For limited lesions, local debridement and curettage of necrotic bone is effective management. For more extensive lesions, canalplasty or tympanomastoidectomy is indicated. PMID- 3963158 TI - Histology of the endolymphatic sac of the rat ear and its relationship to surrounding blood vessels: the "endolymphatic glomerulus". AB - Histologic and histochemical studies of the endolymphatic sac of full-term rat fetuses were undertaken to clarify the anatomy of the endolymphatic sac, and the mechanism of endolymph circulation and regulation. Hitherto undescribed structure enveloping the sac with blood vessels extending from the sigmoid sinus resembling the kidney glomerulus was seen. This endolymphatic "glomerulus" is believed to provide a means of active exchange of water and electrolytes between blood vessels and the endolymphatic sac. PMID- 3963159 TI - The permeability barrier of the endolymphatic sac. A hypothesis of fluid and electrolyte exchange based on freeze fracturing. PMID- 3963160 TI - Anatomic findings one year after combined approach tympanoplasty. AB - Fifty-six patients were treated surgically for middle ear cholesteatoma using the combined approach tympanoplasty technique. One year later a second-look procedure was performed in all the patients, which permitted the anatomic effects of the combined technique to be mapped out before ossicular reconstruction was performed. At three, six, and twelve months after the first operation the development of retraction pockets was also studied. Recurrent cholesteatoma was found in twelve cases (21.4%), and residual cholesteatoma in fourteen (25%). The posterior tympanotomy was closed in 31 cases (55.4%), whereas the mastoidectomy cavity was overgrown and closed in 22 (39.4%). Twelve months after the first operation (just before the second look), a retraction pocket was found in twenty one cases (37.5%), and at the second-look operation twelve of these were proven to be a manifest recurrent cholesteatoma. The formation of new retraction pockets was found to be time-dependent, that is, to increase almost linearly during the control interval between the operations. The investigation shows the necessity for standardizing the presentation of results after cholesteatoma operations and the importance of determining a convenient postoperative time for reporting the incidence of cholesteatoma recurrences. PMID- 3963162 TI - The University of Texas Health Science Center at Dallas. PMID- 3963161 TI - Aids on poorly discriminating ears: surprises can happen! A case report. PMID- 3963163 TI - Adverse reaction to acoustic reflex testing. PMID- 3963164 TI - Bilateral facial paralysis. AB - Bilateral facial paralysis is a rare disorder, and its work-up should include a complete neurotologic assessment plus neurologic consultation and lumbar puncture. The various causes and their treatment are discussed and the treatment of longstanding facial paralysis is reviewed. PMID- 3963165 TI - Speed-dependent variations of lower-limb joint angles during walking. A graphic computerized method showing individual patterns. AB - A method for obtaining a synthetic representation of the joint angle time-courses at different walking velocities is presented, based on a computerized procedure. Hip, knee and ankle joint angles are measured by electrogoniometric devices and checked on line for their reliability. One stride only for each walking speed is selected as representative of the adopted cadence. For each joint a tridimensional representation of angle time-course versus stride frequency or versus gait speed is performed so that speed-dependent variations can be analyzed. Ten normal (seven males and three females) and three prosthetized subjects have been tested by this method. In normal as well as in pathological subjects individual features could be easily detected and the method proved to be useful for a functional gait evaluation. PMID- 3963166 TI - Amyloidosis complicating the rehabilitation of a patient with a right cerebrovascular accident. AB - Physiatrists are rarely presented with a case of amyloidosis. Its unrelenting course must be appreciated in order to speed the process of rehabilitation and help in setting appropriate and rapidly achievable goals. These rehabilitation challenges are discussed with respect to a patient with amyloidosis and a right cerebrovascular accident. The need for medical management of the systemic symptoms of amyloidosis is also addressed. It is felt that the addition of such a progressive terminal disease to the diagnosis of stroke leads to unique interactions among the rehabilitation staff, the patient, and the patient's family, and the need for an aggressive approach to goal-setting and discharge planning. PMID- 3963167 TI - Effect of ankle position on isometric quadriceps strengthening. AB - A prospective study of 20 normal subjects was undertaken to determine the effect of three ankle positions (active dorsiflexion, active plantar flexion, natural or rest position) on comfort and facilitation of quadriceps contraction in isometric strengthening in a supine position with the hip and knee fully extended. Surface EMG activity was found to be greatest for the vastus lateralis followed by the vastus medialis and least for the rectus femoris. Equal facilitation was apparent with either active ankle dorsiflexion or plantar flexion. Both were superior to the natural (rest) position. In situations where isometric quadriceps exercises are required, the authors recommend either active ankle dorsiflexion or plantar flexion to facilitate quadriceps strengthening. The choice between the two positions should be based on patient comfort. PMID- 3963168 TI - Strength and range of motion in the ankle in two age groups of men and women. AB - Strength and range of motion of the ankle were measured in 20 normal men and 20 normal women divided equally into two age groups (25-35 and 50-60 years). Total range of dorsiflexion/plantar flexion averaged 75 degrees and the total range of inversion/eversion averaged 28 degrees. Few significant differences in range of motion were found between age groups, between men and women, or between dominant and nondominant limbs. Mean torque values for the men were greater than those for the women for all four muscle groups tested (plantar flexors, dorsiflexors, invertors and evertors). Strength of the women ranged from 62 to 70 percent of that of the men, depending upon muscle group. A multiple regression analysis showed that after the variability in muscle strength due to height and lean body weight had been taken into account, the additional variance accounted for by gender was very small. Differences in torque between age groups were not statistically significant. Differences in strength between dominant and nondominant limbs were significant only for the plantar flexors and dorsiflexors of the men. PMID- 3963169 TI - Alterations in active Na-K transport during mineralocorticoid-salt hypertension in the rat. AB - Studies have been conducted to determine which, if any, of the parameters governing active Na-K transport (K and/or ouabain sensitive) are altered in vascular smooth muscle during mineralocorticoid-salt hypertension. Rats with one kidney removed were treated with either aldosterone or deoxycorticosterone acetate plus saline for 3-4 wk. Ion transport was measured in arteries incubated in a physiological salt solution for periods of 4-6 h. Increased active Na efflux was observed in femoral arteries and aortas from the hypertensive group. This alteration resulted primarily from an elevation in the saturation or maximal capacity of the active transport mechanism, which operated with no significant change in cell Na concentration. The transport parameters related to ion selectivity, cooperativity, and temperature dependence were not significantly altered. Measures of active Na efflux and K influx in the same aortic strips indicated that both fluxes were elevated in the hypertensive group. The ratio of Na to K for active transport was significantly greater than one but was unchanged in the hypertensive rats. These studies provide evidence for the electrogenic operation of the Na-K pump in arterial smooth muscle and for the operation of the pump at a higher level during mineralocorticoid-salt hypertension. This alteration may result from increased turnover of individual sites or possibly the incorporation of more sites into the membrane as a result of mineralocorticoid salt treatment. PMID- 3963170 TI - Dissociation between muramyl dipeptide-induced fever and changes in plasma metal levels. AB - A fall in plasma iron level and an increase in copper level were observed in rabbits subsequent with the febrile response induced by an intravenous administration of muramyl dipeptide, AcMur-L-Ala-D-isoGln (MDP). The pyrogenic activity of MDP was due partly to the induction of circulating endogenous pyrogen (EP). EP produced in vitro by activated macrophages also elicited changes in iron and copper levels in rabbits. Nonpyrogenic MDP derivatives murabutide [MDP(Gln) OnBu] and the stereoisomer of MDP [MDP(D,D)] did not cause any change in blood metal levels. Another adjuvant and nonpyrogenic analogue, murametide [MDP(Gln) OMe], elicited hypoferremia and hypercupremia. Murametide, which has been previously shown to induce secretion of circulating EP but prevents in vivo fever response, was unable to prevent an EP-induced effect on plasma metal concentrations. Injection of supernatant fluids of macrophages incubated with these different glycopeptides showed that only compounds able to induce EP release were capable of evoking hypoferremia and hypercupremia. The EP-containing fluid was 10-fold more active on change in temperature and in plasma metal levels when it was given intracerebroventricularly compared with intravenously. In contrast, a pyrogenic dose of MDP that can act directly on the central thermoregulatory structures did not modify iron and copper levels when it was injected intracerebroventricularly. PMID- 3963171 TI - Potassium-chloride cotransport in resealed human red cell ghosts. AB - Furosemide-inhibitable K influx is threefold higher in resealed ghosts of human erythrocytes than in intact cells. The enhancement is specific for K in that furosemide-inhibitable Na influx is the same in resealed ghosts and intact cells. The enhanced K influx resembles K-Cl cotransport in intact cells in that it requires Cl but not Na. N-ethylmaleimide (NEM), which stimulates furosemide inhibitable K influx in intact cells, is without effect (or slightly inhibitory) in resealed ghosts. The failure of NEM to enhance the flux was not due to low ATP in the ghosts. These findings suggest that enhancement of the K flux in ghosts occurs by oxidation of membrane protein sulfhydryl groups, known to occur with lysis, the same sulfhydryl groups at which NEM acts by alkylation. This conclusion is supported by two observations: dithiothreitol completely prevents the increase in K influx in ghosts; this agent inhibits both oxidation of sulfhydryl groups and alkylation of them by NEM; and K influx in resealed ghosts is sensitive to changes in cell volume, just as it is in NEM-treated intact cells. PMID- 3963173 TI - Calcium dependence of myosin phosphorylation and airway smooth muscle contraction and relaxation. AB - The time course and the steady-state calcium dependence of myosin phosphorylation and isotonic shortening velocity were studied during contraction and relaxation of canine tracheal smooth muscle. Dephosphorylation of myosin coincided with the decay of isotonic shortening velocity during rapid relaxation following agonist washout. However, the decay of shortening velocity preceded dephosphorylation during a slow relaxation induced by Ca2+-free physiological salt solution (PSS). Carbachol dose-response curves for isometric stress development and myosin phosphorylation were superimposable but shifted to the left of the shortening velocity dose-response. The steady-state Ca2+ dependence of myosin phosphorylation was defined using carbachol and K+ as agonists. There was a significant dissociation of dephosphorylation and relaxation following a stepwise reduction of extracellular CaCl2 concentration. This result was related to muscarinic activation because the dissociation of relaxation and dephosphorylation was reduced by atropine in muscles stimulated with K+. Myosin phosphorylation was completely dissociated from contraction when muscles were stimulated with carbachol in Ca2+-free PSS and contracted by readmission of CaCl2. Mechanisms in addition to myosin phosphorylation appear to regulate airway muscle tone and shortening velocity, and two possibilities are discussed. PMID- 3963174 TI - Electroneutral secretion of bicarbonate by guinea pig gallbladder epithelium. AB - Transepithelial HCO3- movement in guinea pig gallbladder was investigated in vitro. Absorptive (JHCO3ms) and secretory (JHCO3sm) HCO3- fluxes, determined by use of the pH-stat method were approximately 1.0 and 2.1 mumol X cm-2 X h-1, respectively. The resultant net secretion equaled in magnitude, and balanced electrically, the excess in net absorption of Cl- over that of Na+ X JHCO3sm was dependent on luminal Cl- and serosal Na+; it was inhibited by mucosal 4-acetamido 4'-isothiocyanostilbene-2,2'-disulfonic acid (SITS; 10(-3) M) and serosal ouabain (3 X 10(-5) M) but not by serosal amiloride (10(-3) M) and scarcely by bilateral methazolamide (10(-4) M). JHCO3ms was reduced by mucosal Cl- but enhanced by serosal Cl-; it was dependent on mucosal Na+ and inhibited by mucosal amiloride and bilateral methazolamide. Our findings are consistent with a model in which 1) serosal HCO3- enters the cell in cotransport with Na+ and is then extruded into the lumen by Cl-(-)HCO3- exchange at the apical membrane; 2) mucosal HCO3- enters the cell secondary to apical membrane Na+-H+ exchange and recycles into the lumen via Cl-(-)HCO3- exchange or is, to a lesser extent, absorbed across the basolateral membrane. PMID- 3963172 TI - Limited proteolysis of rabbit cardiac procathepsin D in a cell-free system. AB - Rabbit cardiac cathepsin D is initially synthesized as an inactive, apparent molecular weight (Mr) 53,000, pI 6.6 precursor (procathepsin D) that is proteolytically processed during intracellular transport to produce the Mr 48,000 isoforms of active cathepsin D found in cardiac lysosomes. To examine potential proteases responsible for intracellular proteolytic processing, biosynthetically labeled procathepsin D was isolated from rabbit ventricular tissue perfused for 30 min with [35S]methionine. Procathepsin D was then incubated in vitro (40 degrees C, 1-240 min) with active cathepsin D, papain, and cathepsin B, either singly or sequentially, and the reaction products analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and two-dimensional electrophoresis. Incubation of 35S-labeled procathepsin D with active cathepsin D produced a single reaction product (Mr 51,000; pI 6.2). This limited proteolysis occurred at pH 3-5 and was inhibited by pepstatin. Incubation of 35S-labeled procathepsin D with papain or cathepsin B produced a major reaction product (Mr 48,000; pI 6.4) and a minor form (Mr 50,000; pI 6.0). These reactions occurred at pH 4-7 and were inhibited by leupeptin but not pepstatin. Only the Mr 48,000, pI 6.4 products of papain and cathepsin B-mediated proteolysis comigrated with the most basic isoform of active cathepsin D found in cardiac tissue. In addition, the Mr 51,000 intermediate produced by cathepsin D was susceptible to further limited proteolysis by cysteine proteases with resultant production of a Mr 48,000 product. Thus the intracellular proteolytic processing of rabbit cardiac procathepsin D does not result solely from autocatalysis but requires at least one other protease, possibly cathepsin B. PMID- 3963176 TI - Changes in intracellular sodium with chloride secretion in dog tracheal epithelium. AB - Na-selective microelectrodes were employed to investigate the mechanism of Cl secretion by canine tracheal epithelium. In control tissues with a mean short circuit current (Isc) of 30.1 microA/cm2, the intracellular Na activity (aiNa) was 10.7 mM. Following steady-state stimulation of Cl secretion with epinephrine (Isc = 126.4 microA/cm2), aiNa was 21.3 mM. These data indicate that there is sufficient energy in the Na gradient to drive Cl secretion by this tissue. When analyzed with simple kinetic models for the Na-K pump, they also suggest that the basolateral entry step involves the Na-K-2Cl cotransporter. PMID- 3963175 TI - Role of monosaccharide transporter in vitamin C uptake by placental membrane vesicles. AB - Dehydroascorbic acid (DHA), the reversibly oxidized form of vitamin C, was taken up much more rapidly than L-glucose into membrane vesicles prepared from the maternal face of the human placental syncytiotrophoblast. DHA uptake was sensitive to inhibition by cytochalasin B and was independent of a sodium concentration gradient. At equilibrium, the concentration of DHA in the vesicles did not exceed that of the medium. DHA and the D-glucose analogue, 3-O-methyl-D glucose (3-O-MG) appeared to compete with one another for the transporter. The 3 O-MG and DHA inhibitory constants were indistinguishable. Vesicles loaded with a high concentration of 3-O-MG and suspended in low 3-O-MG displayed a marked, transitory enhancement of DHA, but not L-glucose uptake. These findings suggest that DHA is taken into the first cellular boundary of the placenta between maternal and fetal circulations by the sodium-independent monosaccharide transporter. In contrast to DHA, L-ascorbic acid, the reversibly reduced form of vitamin C, was taken into these vesicles much more slowly. This uptake was not affected by cytochalasin B nor by a sodium concentration gradient; it appeared to occur by simple diffusion. PMID- 3963177 TI - Na+-Ca2+ exchange contributes to increase of cytosolic Ca2+ concentration during depolarization in heart muscle. AB - The possible role of Na+-Ca2+ exchange in contributing to depolarization-induced increase in cytosolic Ca2+ concentration ([Ca2+]i) of isolated rat ventricular myocytes was investigated. Measured with the Ca2+-sensitive indicator quin 2, [Ca2+]i increased from 177 +/- 12 (mean +/- SE, n = 11) to 468 +/- 41 nM when cells were depolarized with solutions containing 50 mM KCl [high extracellular K+ concentration ([K+]o)]. Approximately 73% of this high-[K+]o-induced increase in [Ca2+]i was abolished by the Ca2+ channel blocker verapamil (5 microM). For cells pretreated with 10 mM caffeine to deplete the Ca2+ stored in sarcoplasmic reticulum, 50 mM KCl still produced an increase in [Ca2+]i, even in the presence of 5 microM verapamil. However, if extracellular Na+ was replaced by Li+ or tris(hydroxymethyl)aminomethane, this increase was completely abolished. The results suggest that, in addition to voltage-sensitive Ca2+ channels, voltage sensitive Na+-Ca2+ exchange can also contribute to the increase in [Ca2+]i on depolarization. Therefore both Ca2+ transport systems may play important roles in regulating cardiac excitation and contraction. PMID- 3963179 TI - Effects of local administration of GH and IGF-1 on longitudinal bone growth in rats. AB - The effect of local administration of growth hormone (GH) and insulinlike growth factor 1 (IGF-1) on longitudinal bone growth was studied in the proximal tibia of hypophysectomized rats, by using the tetracycline method. Human GH (hGH) stimulated local bone growth when administered into the epiphysial growth plate, into the epiphysis through an implanted cannula, or into the knee joint intraarticularly. In contrast, hGH administration into the metaphysis did not cause such a stimulation. The effect of hGH was dose dependent, and the lowest daily dose of hGH that caused a stimulation was 50 ng. hGH produced by cloned bacteria was as effective as pituitary-derived hGH, excluding the possibility of a pituitary growth factor being the active compound. GH from other mammalian species (rat GH, ovine GH, and bacterially produced bovine GH) also stimulated local bone growth. Ovine prolactin (oPRL) stimulated local bone growth but the threshold dose of oPRL was approximately 100 times higher than that of hGH, suggesting that contamination of this preparation by GH may account for the stimulation. Reduced carboxymethylated human GH, that has a greatly reduced anabolic activity, did not stimulate local bone growth. Local administration of 5 micrograms of bacterially produced human IGF-1 per day produced a small but significant effect on unilateral bone growth. Simultaneous administration of hGH had no additive effect with, nor did it potentiate, the stimulatory effect of IGF 1. The present study confirms and extends earlier investigations, showing that local injection of GH at the site of the epiphysial growth plate stimulates unilateral bone growth. The study also shows that local administration of IGF-1 stimulates longitudinal bone growth. PMID- 3963178 TI - Effect of ovarian sex steroids on osmoregulation and vasopressin secretion in the rat. AB - Effects of sex steroids on osmoregulation were studied in intact and ovariectomized Sprague-Dawley rats treated for 2 wk with subcutaneously implanted hormone pellets containing 0.5 mg 17 beta-estradiol (E2) alone (group 1) or combined with 50 mg progesterone (PG; group 2) and 5.0 mg E2 alone (group 3) combined with PG (group 4). An additional group (5) of animals was given 14 daily injections with 100 micrograms/100 g body weight of E2. Controls for each group received vehicle alone. There were no alterations in basal plasma osmolality (Posmol) or vasopressin (PAVP), except for group 3 in which a small (2.5 mosmol/kg) decrement in Posmol was observed. However, mean PNa was decreased (0.9 3.4 meq/l) in hormone-treated rats, and alterations in Pglucose and/or Purea could not explain the Na-osmolal discrepancy. Intraperitoneal hypertonic saline resulted in stepwise increases in both Posmol and PAVP. Regression analysis of PAVP on Posmol demonstrated similar osmotic thresholds for AVP release in estrogen and control rats, but the slope (sensitivity of the response) was significantly (P less than 0.005) greater in hormone-treated animals. In contrast, the PAVP response to isosmotic volume depletion was not altered by estrogen. The enhanced response to osmotic stimuli could not be explained by alterations in plasma volume or pituitary AVP content and differed from PAVP Posmol relationships observed by us previously in gravid rats. In other experiments Posmol and PAVP were similar during all stages of the estrus cycle, while Posmol was approximately equal to 10 mosmol/kg lower in 21-day gravid rats. These data demonstrate that, although estradiol has little effect on basal osmoregulation or hemodynamically mediated AVP release, PAVP responses to osmotic stimuli are markedly enhanced. These osmoregulatory effects, however, differ from those observed during rodent gestation. PMID- 3963180 TI - Refined carbohydrate increases blood pressure and catecholamine excretion in SHR and WKY. AB - In spontaneously hypertensive (SHR) and normotensive (WKY) rats fed different diets, blood pressure (BP) increased significantly in both strains when the carbohydrate (CHO) source was from refined rather than from natural ingredients. This BP increase was observed whether sucrose, glucose, or starch was the principal CHO. Urinary excretion of norepinephrine, dopamine, and, to some extent, epinephrine also increased, while myocardial concentrations were unaffected. Despite a comparable elevation of catecholamine excretion in both SHR and WKY rats fed high amounts of refined CHO, the BP increases were greater in the former. The strain differences were explained by the known dissimilar response of their blood vessels to catecholamines. The results suggest that BP elevation after high CHO ingestion is mediated via increased catecholamine production and/or release, thus implying a neurogenic mechanism. PMID- 3963181 TI - Removal of infused amino acids by splanchnic and leg tissues in humans. AB - To compare the contributions of splanchnic and skeletal muscle tissues to the disposal of intravenously administered amino acids, regional amino acid exchange was measured across the splanchnic bed and leg in 11 normal volunteers. Postabsorptively, net release of amino acids by leg (largely alanine and glutamine) was complemented by the net splanchnic uptake of amino acids. Amino acid infusion via peripheral vein (0.2 g X kg-1 X h-1) caused a doubling of plasma insulin and glucagon levels and a threefold rise in blood amino acid concentrations. Both splanchnic and leg tissues showed significant uptake of infused amino acids. Splanchnic tissues accounted for approximately 70% of the total body amino acid nitrogen disposal; splanchnic uptake was greatest for the glucogenic amino acids but also included significant quantities of branched-chain amino acids. In contrast, leg amino acid uptake was dominated by the branched chain amino acids. Based on the measured leg balance, body skeletal muscle was estimated to remove approximately 25-30% of the total infused amino acid load and approximately 65-70% of the infused branched-chain amino acids. Amino acid infusion significantly stimulated both the leg efflux and the splanchnic uptake of glutamine (not contained in the infusate). We conclude that when amino acids are infused peripherally in normal humans, splanchnic viscera (liver and gut) are the major sites of amino acid disposal. PMID- 3963182 TI - Glucose turnover and oxidation are increased in the iron-deficient anemic rat. AB - To test the hypothesis that glucose metabolism is altered by iron deficiency, rates of glucose turnover and oxidation were assessed concurrently with the metabolic rate (VO2) in iron-deficient anemic rats and in normal rats at rest. Male Sprague-Dawley rats, 21 days old, were fed a diet containing either 6 mg iron/kg feed (iron-deficient group) or 50 mg iron/kg feed (iron-sufficient control group) for 3-4 wk. After dietary treatment the iron-deficient group was anemic, with hemoglobin levels of 5.8 +/- 0.2 g/dl, compared with 13.8 +/- 0.4 g/dl for controls. To study glucose metabolism, rats received a 90 min primed continuous infusion of [6-3H]-and [U-14C]glucose via an indwelling jugular catheter. Serial blood samples were removed from a carotid catheter for determination of glucose concentration and specific activity. Expired air was monitored for VO2, VCO2, and 14CO2. The VO2 (ml X kg-1 X min-1) of iron-deficient rats was 20% higher than controls. Iron-deficient rats had a greater rate of glucose turnover (94 +/- 4 vs. 52 +/- 3 mumol X kg-1 X min-1) and a greater glucose recycling rate, even when normalized to VO2. Despite a higher blood glucose concentration (5.5 +/- 0.6 vs. 4.1 +/- 0.1 mM), the metabolic clearance rate was greater in iron-deficient animals (18 +/- 1 vs. 13 +/- 1 ml X kg-1 X min 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963183 TI - Circulating forms of somatostatinlike immunoreactivity in human plasma. AB - Circulating forms of somatostatinlike immunoreactivity (SLI) in humans were characterized using several chromatographic techniques. After gelfiltration chromatography on Bio-Gel P-6 columns greater than 90% of circulating SLI was of high molecular weight (MW) and eluted in the void volume. When plasma samples were passed through protein A-Sepharose columns, more than 85% of the high MW SLI was removed, indicating that this form of plasma SLI is mainly due to cross reacting immunoglobulins. Extraction of 10-ml plasma samples from normal subjects on octadecyl silyl silica cartridges eliminated the high MW material. In addition, this extraction technique concentrated the two lower MW forms of SLI, which coelute on gel filtration chromatography with somatostatin-28 (S-28) and the tetradecapeptide form of somatostatin (S-14), respectively. Extracted plasma SLI was further analyzed by high-pressure liquid chromatography (HPLC). The results confirmed the identity of S-28 and demonstrated that S-14 is converted, in part, to Des-Alasomatostatin (S-13) following secretion into the circulation. At least four forms of SLI are thus present in human plasma: cross-reacting immunoglobulins, S-28, S-14, and S-13. Concentrations of SLI forms in the plasma of normal controls and patients with renal failure or cirrhosis were measured to assess the role of circulating somatostatin in health and disease. High MW SLI was elevated above normal in the plasma of patients with cirrhosis, but was not significantly elevated in patients with chronic renal failure. On the other hand, concentrations of plasma S-28 and S-13/14 (total concentrations of S-13 plus S 14) were elevated in patients with either chronic renal failure or cirrhosis. PMID- 3963184 TI - Increased pulmonary uptake of exogenous polyamines after unilateral pneumonectomy. AB - Alterations in pulmonary uptake of the naturally occurring polyamine spermidine and of an exogenous polyamine substrate analogue, methylglyoxal bis(guanylhydrazone) (MGBG), were investigated during the early phase of compensatory lung growth after partial pneumonectomy (PNX) in rats. In lungs perfused in situ 3 days after left PNX, when a small (14%) but significant (P less than 0.01) increase in right lung mass could be detected, uptake of [14C]spermidine and of [14C]MGBG from the pulmonary circulation was increased. MGBG uptake exhibited saturation kinetics (1-50 microM MGBG), both in lungs of control animals apparent Km, 11.3 microM; Vmax, 479 pmol X g-1 X min-1) and on the 1st and 3rd post-PNX days. In both PNX groups, the apparent Km of the uptake pathway was decreased somewhat (8.5 microM), while Vmax increased progressively to 584 and 678 pmol X g-1 X min-1 at days 1 and 3, respectively. The effects of PNX on MGBG uptake were detected as early as 3 h after lung resection and were no longer evident when compensatory lung growth was completed 14 days after surgery. In rats adrenalectomized 5 days before left PNX, an accelerated onset and increased rate of lung restoration were associated with a doubling of the effect of PNX alone on MGBG uptake. PMID- 3963185 TI - Blood flow distribution in tissues of perfused rat hindlimb preparations. AB - Aerobic muscle metabolism during concentrations requires adequate blood flow and oxygen delivery. Since the perfused rat hindquarter (HQ) has become widely used for muscle stimulation, we examined the blood flow distribution, using 15 microns radiolabeled microspheres, and oxygen consumption of the HQ, using different commonly used perfusion protocols. Perfusion via the abdominal aorta resulted in well-matched (r = 0.90) blood flows between tissues of both hindlimbs that were proportional to total perfusion inflow. Blood flows to the high-oxidative fast twitch and slow-twitch red muscle sections were three- to fourfold greater than flows to sections of low-oxidative fast-twitch white muscle. However, a large fraction (28%) of the total inflow went to the trunk region, even though all apparent arterial branches to the trunk region were ligated. This trunk mass accounts for at least 40% of the total metabolic responses of the HQ and diverts a large blood flow that is often presumed to supply the hindlimbs. As a result, muscle performance of the distal hindlimb muscle during stimulation can be inordinately poor. Ligation of the iliac artery to the contralateral limb improves blood flow to the remaining hindlimb but does not eliminate trunk blood flow. In contrast, perfusion via the femoral artery restricted 95% of the inflow to the single hindlimb, thereby reducing the tissue mass perfused. Blood flow to the distal limb musculature was high, resulting in an enhanced muscle performance. Thus single hindlimb perfusion provides a preparation where the contracting muscle is a large fraction of the total tissue, and the venous effluent better reflects the metabolic events in the contracting muscle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963186 TI - Oxygen cost of twitch and tetanic isometric contractions of rat skeletal muscle. AB - The distal muscles of a rat single hindlimb preparation, perfused at 14-15 ml/min, were stimulated sequentially for 10-min intervals at 12, 24, 36, 48, 60, 75, and 120 twitch/min (8 V, 0.05 ms) or at 7.5, 15, 30, 45, 60, 75, and 90 tetani/min (100-ms train, 100 Hz). Oxygen consumption (VO2) of the whole muscle increased up to 6- and 10-fold over rest during twitch and tetanic conditions, respectively. Tension development during each stimulation interval decreased sequentially at the higher contraction frequencies. VO2, corrected for this loss in tension development, increased linearly with contraction frequency with a slope of 0.037 +/- 0.003 mumol O2 X g-1 X twitch contraction-1 and 0.260 +/- 0.034 mumol O2 X g-1 X tetanic contraction-1. This sevenfold difference in slopes, which represent the O2 cost of a single contraction without fatigue, corresponds to the difference in developed tension between twitch and tetanic contractions. Anaerobic metabolism was negligible during tetanic contractions, but was significant during some twitch conditions. These values probably represent the O2 cost for fast-twitch muscle, since this is the predominant type (greater than 90%) in the rat hindlimb. However, an approximate fourfold difference in blood flow (determined with microspheres) between the white and red gastrocnemius sections (predominantly fast-twitch white and fast-twitch red, respectively) suggested a disparity in metabolic response. Estimates of the peak VO2 for each fiber type, for our perfusion conditions, are 6- and 30-fold above rest, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963187 TI - Regulation of interorganal glutamine flow in metabolic acidosis. AB - Metabolic acidosis redirects interorgan glutamine flow from hepatic utilization to renal ammoniagenesis at the expense of ureagenesis. The roles of arterial glutamine load and organ glutaminase capacity in the regulation of glutamine balance across the gut, liver, and kidneys were studied in control and chronically acidotic rats. In control rats these organs combined to remove 733 nmol glutamine X min-1 X 100 g-1 in agreement with their respective glutaminase content, gut greater than liver greater than kidneys. In chronic metabolic acidosis renal glutamine extraction alone increased to 1,158 nmol X min-1 X 100 g 1 associated with an increased glutaminase capacity. However, the total glutamine deficit across these organs rose to only 1,043 nmol glutamine consumed X min-1 X 100 g-1 as a consequence of hepatic glutamine uptake reversing to net release. This reversal was not dependent on increased hepatic glutamine synthetase capacity, but rather appears to be dependent on the combined effect of reduced portal venous glutamine load and increased ammonia load. The reduction in portal glutamine load is, in turn, a consequence of renal glutamine extraction and reduced arterial glutamine concentration in metabolic acidosis as well as maintained gut glutamine extraction. Elevating arterial glutamine concentration in metabolic acidosis has no effect on renal uptake, but enhances splanchnic bed extraction with the restoration of ureagenesis. Thus the interorgan flow of glutamine and deposition of N into either urea or ammonia appears to be dependent on arterial glutamine concentration and hence glutamine availability in chronic metabolic acidosis in the rat. PMID- 3963188 TI - Involvement of glutathione oxidation reduction in parathyroid hormone secretion. AB - This study determines whether calcium affects glutathione metabolism and whether glutathione metabolism may influence parathyroid (PTH) secretion in collagenase dispersed bovine parathyroid cells. Reduced glutathione (GSH) and glutathione disulfide (GSSG) were measured fluorometrically and enzymatically while PTH secretion was determined by radioimmunoassay. The total GSH and GSSG content of parathyroid cells was found to range from 1.59 to 1.71 micrograms/mg cell protein, and this did not vary significantly with changes in extracellular calcium. An increase in the medium calcium concentration from 0.5 to 2.0 mM did, however, cause an increase in GSSG from 0.43-0.54 to 1.19-1.20 micrograms/mg protein with a concomitant decrease in GSH. The compound 2-cyclohexen-1-one was used to deplete the cells of GSH at a low-calcium medium (0.5 mM) to levels seen in high-calcium medium (2.0 mM). This treatment was found to inhibit PTH secretion in the low-calcium medium, as if the cells were incubated in high medium calcium. Both 2-cyclohexen-1-one and calcium caused a rapid decrease in reduced GSH levels and in hormone secretion. The ketone was not found to affect cellular protein synthesis, indicating that there was no nonspecific toxic effect of this treatment on the cells. These results suggest that changes in the calcium concentration of the medium affect the GSH/GSSG ratio of dispersed parathyroid cells. Changes in the GSH/GSSG ratio induced by calcium may be related to changes in PTH secretion. PMID- 3963189 TI - Secretion of pyruvate and lactate in pancreatic juice induced by acetazolamide or secretin. AB - In vivo studies using pentobarbital sodium-anesthesized dogs were performed to investigate whether a transport pathway for pyruvate and lactate is present in the exocrine pancreas. Concentrations of both acids were measured in peripheral blood and pancreatic juice before and after intravenous 15-min administration of 2.25 mmol/kg DL-lactate, superimposed on continuous intravenous infusion of 3 U X kg-1 X h-1 secretin. The concentration ratio of lactate to pyruvate in pancreatic juice was found to be approximately 1, a lower value than found in other tissues or body fluids. D-lactate, not detected in either blood or juice during basal periods, rapidly appeared in both fluids in parallel with the physiological isomer L-lactate, after the infusion of DL-lactate. Further addition of acetazolamide or a high dose of secretin caused a marked secretory response of pyruvate and lactate with no increase in juice bicarbonate levels. We conclude that these acids can be transported from blood to lumen when the transmembrane pH gradient across the duct cell membranes is augmented by stimulants via a proton pump mechanism involving a CO2-HCO3-buffer system. PMID- 3963190 TI - Intestinal calcium transport in the spontaneously hypertensive rat: response to calcium depletion. AB - We previously found intestinal Ca2+ transport to be lower in the spontaneously hypertensive (SH) as compared with the Wistar-Kyoto control (WKY) rat. These animals were fed a relatively high (1%) Ca2+ diet, and the concentration of 1 alpha,25-dihydroxycholecalciferol [1 alpha,25(OH)2D3] in serum was the same in both groups. In the present experiment we tested the possibility that the lower Ca2+ transport in the SH rat was the result of unresponsiveness to 1 alpha,25(OH)2D3. We fed diets high and low in Ca2+ and measured serum 1 alpha,25(OH)2D3 and Ca2+ transport. Serum 1 alpha,25(OH)2D3 increased in response to Ca2+ depletion at both 5 and 12 wk in both the WKY and SH rat. With high-Ca2+ diet, Ca2+ transport was lower in SH than in WKY when studied 1) in vitro in duodenum at 5 wk of age, and 2) in vivo in proximal and distal small intestine at 12 wk of age. Ca2+ transport increased in SH in response to Ca2+ depletion, but not in WKY, except in distal small intestine in vivo at 12 wk. In summary, although Ca2+ transport is lower in the SH as compared with the WKY rat when vitamin D activity is basal through feeding a high-Ca2+ diet, Ca2+ transport increases in the SH rat in response to the increase in 1 alpha,25(OH)2D3 produced by feeding a low-Ca2+ diet. We conclude that 1) the vitamin D-regulated component of mediated Ca2+ transport is intact in the SH rat and is unrelated to hypertension, and 2) mediated Ca2+ transport under basal conditions, i.e., nonvitamin D-regulated, differs in the SH and WKY rats and may be related to hypertension. PMID- 3963191 TI - Intestinal sugar transport: does the Na+ gradient provide all the energy? AB - It has not yet been established that the energy released from the Na+ gradient during Na+-sugar cotransport by small intestine is sufficient, by itself, to drive uphill sugar transport under conditions in which other sources of energy are available and in which sugar is being vigorously transported. This work attempts to test the thermodynamic sufficiency of the Na+ mechanism under such conditions using hamster jejunum in vitro. From data on tissue uptake of D galactose and unstirred layer considerations, the concentration ratio for galactose across the apical membrane during mucosal-to-serosal galactose transport was estimated to be at least 50 when concentration in the bulk mucosal solution was 2.2 mM. This estimate and reasonable assumptions regarding intracellular Na+ activity and apical membrane potential were used to calculate the minimum physiological coupling ratio (i.e., the ratio of coupled net fluxes of Na+ and galactose) required if all the energy necessary for galactose transport is transferred from Na+. The minimum physiological coupling ratio required was roughly 1.4. An estimate based on the ratio of transepithelial chord permeabilities to galactose, instead of the apical concentration ratio, would be higher. The measured physiological coupling ratio (0.4) was considerably less than that required. For reasons discussed, this result should be interpreted with caution. It can be concluded that the issue of energetic adequacy is not yet settled. PMID- 3963192 TI - Dehydroascorbic acid and ascorbic acid transport systems in the guinea pig ileum. AB - The transport properties of dehydroascorbic acid and ascorbic acid in membrane vesicle preparations of guinea pig ileum were evaluated. Na-dependent transport of ascorbic acid in the brush-border membrane was confirmed, and an Na independent mechanism was found in the basolateral membrane. The electrically neutral oxidized form of vitamin C is transported by an Na-independent mechanism at both cell surfaces. Transport of each substrate is saturable and exhibits cis inhibition and trans-stimulation in the presence of structural analogues. Additional studies on ascorbate metabolism will be necessary to support a comprehensive model of intestinal handling of vitamin C. PMID- 3963193 TI - Active potassium secretion by rabbit proximal colon. AB - Fluxes of K from mucosa to serosa or serosa to mucosa have been examined in stripped preparations of rabbit proximal and distal colon in vitro under short circuit conditions in Ussing chambers. Results from these studies demonstrate that steady-state radioisotopic fluxes of K are achieved after 90 min and remain constant for at least 2 h. Determination of the K concentration dependence of the serosal-to-mucosal K flux revealed that this flux contains both saturable and nonsaturable components. Addition of ouabain (0.1 mM) abolished the saturable component of the serosal-to-mucosal K flux. The mucosal-to-serosal K flux is a linear function of K concentration between 1 and 20 mM under basal conditions. In paired tissues, serosal-to-mucosal K flux is always greater than mucosal-to serosal flux under basal conditions resulting in net K secretion. However, addition of barium (2 mM) to the mucosal or serosal bathing solution had no significant effect on either unidirectional or net K fluxes. In addition, mucosal bumetanide (0.1 mM) or removal of Cl from both bathing solutions had no significant effect on unidirectional or net K fluxes. In rabbit distal colon, Cl removal from the bathing solutions significantly reduced serosal-to-mucosal K flux, resulting in net K absorption. These results indicate that rabbit proximal colon like rabbit distal colon actively secretes K. However, unlike distal colon the proximal colon does not possess an active K uptake mechanism at the apical cell membrane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963194 TI - Importance of interstitial matrix hydration in intestinal chylomicron transport. AB - We have shown previously that lymph flow has a profound effect on intestinal chylomicron transport. However, since lymph flow both determines the rate of convective movement of chylomicrons within the interstitium and reflects the degree of hydration of the interstitial matrix, we were unable to determine which factor was more important for the inverse relation between the chylomicron appearance time and lymph flow. In this investigation, we measured the chylomicron appearance time in rats with a normal lymph flow and expanded matrix (study A), in rats with a reduced lymph flow but expanded matrix (study B), and finally in rats with a dehydrated matrix (study C). The chylomicron appearance times were 11.7, 13.6, and 21.7 min for the rats from studies A-C, respectively. Thus, the data obtained from this study indicate that the matrix hydration may exert a more significant influence on chylomicron movement than lymph flow per se. In conclusion, the reduced chylomicron appearance time produced by expansion of the mucosal interstitium results from a diminished resistance of the interstitial matrix to chylomicron movement rather than a decreased transit time due to an enhanced convective flux of chylomicrons. PMID- 3963195 TI - Vagal control of canine postprandial upper gastrointestinal motility. AB - The role of the vagus nerves in the control of postprandial motility in the upper gastrointestinal tract was investigated in four dogs by use of a bilateral cervical cooling blockade technique. On administration of food, the fasting migrating motor complex (MMC) was replaced by the postprandial (feeding) pattern. Feeding pattern duration varied in a dose-dependent manner with either total volume or calories of food. During the feeding pattern, oscillations in lower esophageal sphincter (LES) pressure occurred at time intervals equivalent to the MMC cycle period. Twenty-one control feeding experiments and 17 postprandial vagal blockade experiments were performed, with a minimum of three of each type in each dog. Vagal blockade, initiated at times ranging from 15 min to 4 h after feeding and maintained for up to 5 h, abolished the postprandial activity in the upper gastrointestinal tract. During postprandial vagal blockade, LES pressure was abolished and bursts of contractions were observed only in the upper small bowel, a pattern resembling that observed during vagal blockade in the fasted state. These bursts occurred at the expected times relative to, and their cycle period was not significantly different from, that of the MMCs recorded prior to feeding. Vagal blockade started prior to feeding prevented initiation of the fed pattern, which appeared immediately on termination of the blockade. We conclude that initiation and maintenance of the postprandial pattern in the upper gastrointestinal tract with concurrent inhibition of the fasting MMC normally require vagal integrity. The "clock" controlling the MMC cycle period is not reset by feeding, but its effect on motility is suppressed. PMID- 3963196 TI - Role of ethanol metabolism in the ethanol-induced increase in splanchnic circulation. AB - In this study we report the effect on splanchnic hemodynamics of acute oral ethanol at doses ranging from 0.25 to 4.0 g/kg body wt. Flows were determined by use of a radioactive microsphere technique. Ethanol was found to increase portal blood flow by 23-57%. In awake rats this increase reached a plateau at the 0.5 g/kg dose. In ketamine-anesthetized rats, the increase was observed only at doses of 3.0 g/kg or more, with the response at doses of 0.5, 1.0, and 2.0 g/kg being suppressed by ketamine. Inhibition of alcohol dehydrogenase by intra-arterial administration of 4-methylpyrazole resulted in suppression of the liver blood flow increase after ethanol was administered to awake animals. Ethanol in the range of doses studied did not result in changes in blood glucagon levels. Rats fed ethanol-containing diets for 4 wk and withdrawn for 18 h had the same response to acute oral ethanol as did naive rats. It is suggested that ethanol metabolism mediates the effects of ethanol on splanchnic blood flow. An increase in splanchnic blood flow when concurrent with an increase in liver O2 consumption induced by ethanol might protect the liver from hypoxic damage. PMID- 3963197 TI - Chronic portal hypertension: effects on gastrointestinal blood flow distribution. AB - The intramural distribution of blood flow in the gastrointestinal tract was measured in shamoperated control and portal vein-stenosed rats. Total organ blood flow, measured via the radioactive microsphere technique, was elevated in the esophagus (66%), stomach (102%), duodenum (42%), jejunum (52%), ileum (54%), and colon (79%) of portal-hypertensive rats. Histological evaluation of carbonized nonradioactive 15-microns microspheres allowed for fractionation of blood flow within the wall (mucosa, submucosa, and muscularis externa) of each organ. The microsphere distribution pattern indicates that intramural blood flow distribution in all organs was not dramatically affected by chronic portal hypertension. These findings further define the characteristics of the factors responsible for the gastrointestinal hyperemia produced by chronic portal hypertension. PMID- 3963198 TI - Pentagastrin on neurotransmitter enzyme activities in the rat gastrointestinal tract. AB - The effects of three doses (5, 100, and 250 micrograms/kg) of pentagastrin on the activities of choline acetyltransferase (ChAT) and acetylcholine esterase (AChE), the neurotransmitter enzymes that synthesize and degrade acetylcholine, and monoamine oxidase (MAO), the degradation enzyme for catecholamines, were investigated. Enzyme activities were assayed in 6 gastrointestinal segments of 21 and 28-day-old and adult rats. All animals were injected intraperitoneally for 7 days with pentagastrin, and the results were compared with age-matched controls receiving saline for 7 days. Plasma and adrenal corticosterone levels were measured. No consistent differences in adrenocortical variables existed between pentagastrin- and saline-treated animals. Similarly, no consistent pentagastrin dose responses of ChAT, AChE, and MAO activities were evident. However, at the highest dose pentagastrin generally produced increases in ChAT activities in 21- and 28-day-old rats, while producing decreases in AChE and MAO activities in 21 day-old rats and increases in 28-day-old animals. There were few significant differences in enzyme activities in adult rats receiving pentagastrin as compared to saline. PMID- 3963199 TI - Electrolyte handling by the superficial nephron of the rabbit. AB - A micropuncture study of the rabbit was performed to evaluate the function of the superficial nephron. The mean glomerular filtration rate of the left micropunctured kidney was 4.0 +/- 0.8 ml/min. The concentration profile of electrolytes within the proximal tubule was similar to that of species previously investigated except for potassium. The mean tubular fluid (TF)-ultrafilterable (UF) concentration ratios were as follows: sodium, 1.01 +/- 0.03; chloride, 1.14 +/- 0.04; calcium, 1.12 +/- 0.04; magnesium, 1.47 +/- 0.08; and phosphate, 0.94 +/- 0.09, with a mean TF-plasma (P) inulin concentration ratio of 1.78 +/- 0.14 (n = 32). The TF/UF potassium value significantly increased in association with TF/P inulin to a mean value of 1.26 +/- 0.06. Accordingly, 29% of the filtered potassium was reabsorbed in the superficial proximal tubule compared with 43% of the filtered sodium. The loop of Henle reabsorbed 55-60% of the filtered sodium, chloride, and calcium, whereas considerably less magnesium (33%) was reabsorbed. Segments beyond the distal tubule collection site reabsorbed little of the delivered magnesium, which supports the notion that the loop of Henle is the principal segment accounting for adjustments in magnesium balance. These studies indicate that the superficial nephron of the rabbit performs similar to other species reported, except potassium reabsorption is significantly less in the proximal convoluted tubule. PMID- 3963200 TI - Human renal response to meat meal. AB - Glomerular filtration rate (GFR) increases after a meat meal in several species. The mechanism of this phenomenon is unknown and the excretory and metabolic responses largely unexplored. We examined in humans the nature of the hemodynamic response to a meat meal, the role of salt and water load in this response, and the associated renal excretory responses. Ten normal volunteers were studied after eating an average of 3.5 g/kg body wt of lean cooked beef steak and, on a separate day, after ingesting an amount of sodium and water equivalent to that in the steak. Average GFR increased by 28% for the entire 3 h after the meat meal compared with the same time period after the control salt solution (90 +/- 8 vs. 114 +/- 6 ml X min-1 X 1.73 M-2, mean +/- SE, P less than 0.05) and by 15% compared with the base-line periods, although this difference was not of statistical significance. However, not all subjects demonstrated an increase, and in those eight who did the degree was variable from 5 to 46% for the 3-h mean above the basal value. During the hour of peak GFR, the increment was associated with a nearly proportional increase in renal plasma flow and renal blood flow (all P less than 0.05). The increase in renal blood flow was entirely due to a significant fall in renal vascular resistance. The vasodilation was not accompanied by any change in prostaglandin E excretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963201 TI - Reversal of renal and smooth muscle actions of the thromboxane mimetic U-44069 by diltiazem. AB - U-44069 is a stable prostaglandin (PG) H2 analogue and a potent vasoconstrictor. Its in vivo and in vitro actions mimic those of thromboxane A2. We have studied the effects of the calcium antagonist diltiazem upon the vasoconstriction induced by U-44069 using isolated rat aortic smooth muscle and isolated perfused rat kidney (IPRK). The administration of 10(-6)M U-44069 elicited maximally effective contractions in isolated aortic rings and increased 45Ca uptake from a control value of 285 +/- 6 mumol/kg to 344 +/- 8 mumol/kg. Diltiazem reduced U-44069 induced tension development and 45Ca uptake of isolated aortic smooth muscle 73 +/- 2 and 91 +/- 3%, respectively. The dose dependency of each of these effects of diltiazem was similar (EC50 = 369 nM and 334 nM for tension and 45Ca flux, respectively). When administered to the IPRK, 10(-6) M U-44069 caused a 82 +/- 3% decrease in glomerular filtration rate (GFR) and a 80 +/- 4% decrease in filtration fraction but reduced renal perfusate flow (RPF) only 13 +/- 8% (P less than 0.005). Diltiazem completely reversed the actions of U-44069 on the IPRK (EC50 = 288 nM and 323 nM for GFR and RPF, respectively). Diltiazem thus inhibited U-44069-induced tension development and 45Ca uptake by vascular smooth muscle and increased GFR within identical dose ranges. The contractile response of isolated rat glomeruli was also assessed. U-44069 reduced the volume of isolated glomeruli, but this action was neither prevented nor reversed by diltiazem. These results are consistent with the hypothesis that diltiazem increased GFR by inhibiting U-44069-induced Ca influx at preglomerular vessels. PMID- 3963202 TI - Ascorbic acid transport in mammalian kidney. AB - Ascorbic acid is known to circulate free in the plasma of several species and is therefore filtered in the kidney; reabsorption subsequently takes place and prevents urinary loss. However, no specific mechanism of renal ascorbic acid transport has previously been presented. In the present study, rat and guinea pig kidney were incubated as slices or as isolated tubules in vitro in the presence of low concentrations of [14C]ascorbic acid. The kidneys of both species handle ascorbic acid similarly. Ascorbic acid accumulates in the renal tissue to a concentration three to four times that present in the bathing media. Recently absorbed ascorbic acid diffuses freely from the kidney and is predominantly nonmetabolized during absorption. Uptake is reduced following replacement of bathing solution sodium by lithium or cesium, or when incubation is performed in the presence of metabolic inhibitors or at low temperatures. The results indicate that ascorbic acid is reabsorbed in the kidney by a sodium-dependent active transport mechanism that operates by concentrating ascorbic acid in the cellular fluid. Renal slices and tubules both appear to transport ascorbic acid and galactose across the brush-border membrane; this indicates that the tubular lumens in these preparations are not collapsed or sealed off. PMID- 3963203 TI - Water permeability and fluidity of renal basolateral membranes. AB - Water and nonelectrolyte permeability in basolateral membrane vesicles (BLMV) isolated from rat and rabbit renal cortex were characterized. Osmotic water (Pf) and solute (Ps) permeabilities were determined from the time course of scattered light intensity in response to osmotic gradients. In rabbit BLMV, Pf = 2.5 X 10( 2) cm/s, Purea = 1.2 X 10(-6) cm/s, and sigma urea = 0.95 (23 degrees C). Relative solute permeabilities were urea, 1; thiourea, 0.83; ethylene glycol, 9.7; glycerol, 4.6; formamide, 20; and acetamide, 12. Pf and Purea were not altered by organic mercurials, phloretin, urea, and high-affinity urea analogues. delta H (12-50 degrees C) was 10.7 and 2.5 kcal/mol for Purea and Pf, respectively; in contrast, reported delta H for Pf in rabbit brush-border membrane vesicles (BBMV) was 2 kcal/mol (T less than 33 degrees C) and 14 kcal/mol (T greater than 33 degrees C). To examine whether membrane fluidity changes were associated with this difference, fluorescence anisotropy decay was measured using 1,6-diphenyl-1,3,5-hexatriene (DPH). In both BLMV and BBMV, DPH rotation was hindered at all temperatures (5-53 degrees C). Changes in steady state anisotropy were attributable to changes in DPH rotational freedom rather than to changes in DPH rotational rate without evidence for a definitive membrane thermotropic phase transition. These results suggest that BLMV urea transport occurs by lipid diffusion and that osmotic water transport is rapid and may be facilitated. A comparison of transepithelial Pf with BLMV and BBMV Pf is consistent with transcellular osmotic water flow in the proximal tubule. PMID- 3963204 TI - Evidence for electroneutral sodium chloride transport in rat proximal convoluted tubule. AB - One- to two-thirds of NaCl absorption in the late proximal convoluted tubule (no luminal organic solutes present) is inhibited by cyanide and thus is dependent on active transport. To examine whether this active transport-dependent NaCl transport is electrogenic or electroneutral, the effect of cyanide on transepithelial potential difference (PD) was measured in the rat proximal convoluted tubule microperfused in vivo. In the presence of an ultrafiltrate-like luminal perfusate containing glucose and alanine, cyanide addition caused the transepithelial PD to change from -0.44 +/- 0.04 to -0.05 +/- 0.03 mV (P less than 0.001). In the presence of a late proximal tubular fluid (high chloride, low bicarbonate, no organics), the transepithelial PD was 1.23 +/- 0.06 mV and was unchanged at 1.19 +/- 0.05 mV after cyanide addition (NS). To eliminate the possibility that an effect of cyanide on a putative acidification-dependent lumen positive PD was concealing an effect on an electrogenic sodium transport dependent lumen-negative PD, the above studies were repeated in the presence of acetazolamide. Cyanide did not affect the transepithelial PD (1.17 +/- 0.05 vs. 1.07 +/- 0.06 mV, NS). We conclude that, although cyanide-inhibitable NaCl transport is electrogenic in the presence of luminal organic solutes, it does not generate a transepithelial PD in their absence and therefore is electroneutral. PMID- 3963205 TI - Renal mitochondrial glutamine metabolism during K+ depletion. AB - We studied changes in renal mitochondrial glutamine metabolism during the development of and recovery from K+ depletion in rats. Significant increase in mitochondrial NH3 production was noted after 3 days of K+-free diet. Ammoniagenesis in K+-depleted animals reached maximal level within 2 wk of K+ deprivation when there was 64% increase in NH3 production. In contrast to the pattern of changes in mitochondrial ammoniagenesis, phosphate-dependent glutaminase (PDG) activity increased within the first 48 h of K+ deprivation, before there was any increase in NH3 production, and did not plateau even after 2 wk of K+-free diet. The disparity between NH3 production and PDG activity cannot be explained by the difference in matrix glutamate level, thus raising the possibility that mitochondrial glutamine entry may be a rate-limiting step for ammoniagenesis during K+ depletion. Recovery from K+ depletion was studied in animals prefed with K+-free diet for 2 wk prior to the initiation of K+ supplemented diet. Muscle K+ content of K+-depleted animals returned to normal after 1 wk of K+ replacement. Mitochondrial NH3 production decreased concomitantly with the attenuation in K+ deficit but did not reach the base-line value even after K+ deficit was completely corrected. Additional experiments with isolated cortical tubules also showed persistent increase in NH3 production after the correction of K+ deficit. Thus, unlike earlier studies in rats during the recovery from metabolic acidosis, which showed only increased ammoniagenesis in isolated mitochondria but not in cortical slices, animals recovered from K+ depletion demonstrated augmented NH3 production both in isolated mitochondria and intact renal tissues. PMID- 3963206 TI - Chronic metabolic acidosis augments acidification along the inner medullary collecting duct. AB - The inner medullary collecting duct (IMCD) of the rat is a major site of acidification. However, previous micropuncture studies have failed to demonstrate acidification along the terminal IMCD during chronic acid feeding. To more completely evaluate this question we used the microcatheterization method in rats fed ammonium chloride for 3-7 days. Arterial pH was 7.30 +/- 0.015, and PCO2 was set at 40 +/- 0.6 mmHg. The IMCD data were analyzed as a function of IMCD length between 40% and the tip. Equilibrium pH decreased from 6.21 +/- 0.11 to 5.47 +/- 0.03, whereas PCO2 was unchanged (28 +/- 1 mmHg between the deep samples and tip). Bicarbonate delivery decreased from 92 +/- 14 to 10 +/- 1 nmol/min, titratable acid increased from 462 +/- 33 to 762 +/- 40 nmol/min, and ammonium delivery increased from 2,235 +/- 121 to 3,528 +/- 140 nmol/min. Thus estimated net acid increased from 2,638 +/- 134 to 4,303 +/- 161 nmol/min. To determine whether increasing delivery of buffer to the IMCD would stimulate acid secretion in acute acidosis, rats were studied during the infusion of HCl and creatinine. Arterial pH was 7.18 +/- 0.02. IMCD acidification was not increased compared with our previously published studies during HCl infusion [Am. J. Physiol. 241 (Renal Fluid Electrolyte Physiol. 10): F669-F676, 1981]. We conclude that chronic ammonium chloride ingestion stimulates IMCD acidification and that this increase may be an intrinsic modification of the acidification mechanism of the IMCD. PMID- 3963207 TI - Tubuloglomerular feedback responses in the rat during calmodulin inhibition. AB - Previously, we have suggested that a cytosolic calcium system participates in the transmission of signals between distal tubular fluid and the glomerular vascular elements. Since the Ca-binding protein calmodulin has been implicated in the intracellular actions of cytosolic Ca, we evaluated the effects of the calmodulin antagonists trifluoperazine (TFP) and calmidazolium (R24571) on tubuloglomerular feedback responses. In the rat, stop-flow pressure (SFP) was measured during retrograde perfusion into the distal tubule at 15 nl/min for 5 min. Perfusion with an isotonic Ringer solution resulted in a decrease in SFP of 12 +/- 1.1 mmHg (n = 34). With the addition of 50-75 microM TFP, SFP was decreased by 11 +/- 1.0 mmHg (n = 24); with 500 microM TFP, SFP feedback responses were 10 +/- 1.2 mmHg (n = 7). During perfusion with 20 microM R24571, SFP decreased by an average of 12 +/- 1.1 mmHg (n = 18). Single-nephron glomerular filtration rate feedback responses during retrograde microperfusion were also unaltered by R24571 (delta 15 +/- 2.5 vs. delta 14 +/- 2.6 nl/min). In the SFP experiments it was observed that the recovery of SFP toward preinfusion values after cessation of perfusion was significantly prolonged in tubules perfused with the calmodulin antagonists. SFP recovery times averaged 65 +/- 5.5 s (control), 104 +/- 9.9 s (50-75 microM TFP), 154 +/- 9.6 s (500 microM TFP), and 116 +/- 9.9 s (20 microM R24571). Accordingly, these results suggest that activation of calmodulin is not required for the transmission of tubuloglomerular feedback signals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963208 TI - Increases of cell ATP produced by exogenous adenine nucleotides in isolated rabbit kidney tubules. AB - The effects of exogenous nucleotides on adenine nucleotide metabolism and cell cation levels in normal and O2-deprived isolated rabbit kidney tubules were studied to gain insight into ways in which exogenous nucleotides could contribute to ameliorating O2 deprivation-induced injury. In control oxygenated tubules, 250 microM exogenous ATP, ADP, or AMP resulted in two- to threefold increases of cell ATP over 75-90 min of incubation and smaller relative increases of ADP and AMP. GTP was not increased. Exogenous adenosine, inosine, and hypoxanthine were substantially less effective at increasing intracellular nucleotides than equimolar concentrations of exogenous nucleotides. Nucleotide-treated cells had higher levels of Ca2+ and Mg2+ than untreated cells. Treatment of O2-deprived tubules with exogenous Mg-ATP improved recovery of ATP levels following O2 deprivation, and tubules with mild injury increased their ATP levels to supranormal values such as those seen in control oxygenated tubules treated with nucleotides. Increases of tubule cell ATP levels required ongoing oxidative metabolism and thus were not evident until the reoxygenation recovery period. Exogenous ATP produced some improvement of other injury-associated metabolic parameters but did not substantially alter the overall pattern of tubule susceptibility to lethal cell injury. Allopurinol did not affect the behavior of oxygenated or O2-deprived tubules irrespective of the presence of exogenous ATP. These data clarify the potential for manipulating intracellular ATP levels with exogenous nucleotides and the functional consequences of such manipulation in oxygenated and O2-deprived renal tubule cells. PMID- 3963209 TI - Occluding junctions in a renal cell line (LLC-PK1) with characteristics of proximal tubular cells. AB - At confluency, LLC-PK1 monolayers develop a transepithelial electrical resistance of 127 omega X cm2 and a spontaneous electrical potential that very seldom exceeds 1 mV. The monolayer shows a linear current-voltage relation in symmetrical solutions. The total conductance increases linearly with increases in the electrolyte concentration of the bathing solution. These characteristics indicate that the membrane that controls the permeability properties of the monolayer is a single membrane that it does not contain very weakly charged sites and it is sufficiently thick to obey the principle of microscopic electroneutrality. The sodium-to-chloride permeability determined from dilution potentials or from direct measurements of unidirectional Na+ and Cl- flux are 0.30 and 0.38, respectively, almost identical to the ratio obtained in the straight segment of the renal proximal tubule. The steady-state value of the electrical resistance depends on the Ca2+ concentration in the incubation medium with an apparent Km of 0.1 mM. A transitory opening of the occluding junctions results in a more uniform distribution of the Na+-dependent sugar transport system, which is normally confined to the apical membrane of the epithelial cell. This result indicates that the occluding junctions in LLC-PK1 monolayers act as a mechanical barrier, preventing the intermixing of extrinsic as well as intrinsic membrane proteins. PMID- 3963210 TI - A servo-system for constant pressure perfusion of the isolated rat kidney. AB - A technical difficulty in perfusion of the isolated rat kidney has been the regulation of perfusion pressure. Since perfusion pressure is an important determinant of renal function, this parameter should be well regulated for experimental consistency. A servo-system is described that uses analog circuitry to calculate and maintain the cannula tip pressure for perfusion of the isolated kidney. The system is sufficiently responsive to maintain a constant perfusion pressure during the rapid changes in renal resistance caused by addition of angiotensin II or epinephrine to the perfusate. Analog outputs are provided for the recording of perfusion flow rate, perfusion pressure, and renal resistance. PMID- 3963211 TI - Terminology for mass transport and exchange. AB - Virtually all fields of physiological research now encompass various aspects of solute transport by convection, diffusion, and permeation across membranes. Accordingly, this set of terms, symbols, definitions, and units is proposed as a means of clear communication among workers in the physiological, engineering, and physical sciences. The goal is to provide a setting for quantitative descriptions of physiological transport phenomena. PMID- 3963212 TI - Vagally mediated regulation of renal function in conscious primates. AB - The effects of vagal denervation (VD) were examined on responses of Na+ and water excretion to acute volume expansion (18 ml/kg of 6% dextran in saline) in six conscious rhesus monkeys with chronic sinoaortic denervation (SAD). After SAD, volume expansion increased mean arterial pressure (from 95 +/- 6.6 to 119 +/- 7.5 mmHg), right atrial pressure (from 1.3 +/- 0.7 to 5.9 +/- 1.8 mmHg), urine flow (from 0.08 +/- 0.01 to 0.68 +/- 0.20 ml/min), and Na+ excretion (from 1.30 +/- 0.45 to 29.51 +/- 10.40 mueq/min). After VD, volume expansion increased mean arterial and right atrial pressures similarly, but induced significantly lower (P less than 0.05) increases in urine flow (from 0.05 +/- 0.01 to 0.19 +/- 0.03 ml/min) and Na+ excretion (from 0.87 +/- 0.27 to 11.50 +/- 6.13 mueq/min). Thus vagal mechanisms appear to play an important role in mediating excretion of Na+ and water in response to acute volume expansion in the conscious primate. PMID- 3963213 TI - Role of adenosine in coronary autoregulation. AB - The role of cardiac interstitial adenosine as an important metabolite in coronary autoregulation has not been established. We therefore measured steady-state cardiac interstitial adenosine concentration at a high and a low coronary inflow pressure using an epicardial diffusion well in anesthetized dogs. Although coronary resistance for the high and low pressure points showed highly significant differences (P less than 0.001), adenosine averaged 302 +/- 98 and 286 +/- 91 (SD) pmol/ml for the high and low pressure points, respectively (P greater than 0.20). Cardiac interstitial adenosine concentration was then measured with and without an intracoronary infusion of adenosine deaminase catalytic subunit. Adenosine averaged 28 +/- 21 (SD) pmol/ml during the infusion compared with 281 +/- 68 during control conditions (P less than 0.001). Finally, pressure-flow relations were obtained with and without the adenosine deaminase infusion, and there was no loss of autoregulation in the pressure of adenosine deaminase. These findings indicate that intracoronary adenosine deaminase markedly reduces interstitial adenosine concentration, that cardiac interstitial adenosine concentration remains constant during autoregulation, and that the coronary bed autoregulates normally when interstitial adenosine is reduced to levels close to zero. We conclude that cardiac interstitial adenosine concentration is not an important component in coronary autoregulation. PMID- 3963214 TI - Effects of digitalis intoxication on pacemaker rhythm and synchronization in rabbit sinus node. AB - Toxic doses of digitalis can induce severe arrhythmias in the sinus node. Since digitalis is known to induce electrical uncoupling in heart tissues, it is possible that the arrhythmias may be mediated by cell-to-cell uncoupling leading to desynchronization of pacemaker cells. We investigated this possibility using intracellular recordings and two different preparations of isolated rabbit sinus node. First, the whole sinus node region with the crista terminalis and a portion of right atrium were exposed to 2 microM ouabain in the presence of atropine (0.09 microM) and propranolol (0.77 microM). With ouabain superfusion, there was a gradual increase in spontaneous discharge, conduction delay, pacemaker shifts, and arrhythmias associated with multiple pacemaker sites. Interaction between pacemakers rapidly decreased, and finally atrial arrest was observed. Second, thin strips of sinus node were placed in a three-compartment bath. Superfusion of the central segment (1.0-1.5 mm) with 1-5 microM ouabain led to tachycardia and apparent conduction delay, followed by asynchronous firing and phasic interactions between pacemakers across the central segment. These interactions diminished in the course of intoxication, indicating a gradual increase of electrical uncoupling induced by the drug. All effects were reversible on washout. We conclude that digitalis-induced arrhythmias in the sinus node result from cell-to-cell uncoupling and loss of synchrony between pacemaker cells. The pattern of arrhythmias can be predicted by the phasic interactions between the pacemakers. PMID- 3963215 TI - Adenosine deaminase attenuates canine coronary vasodilation during systemic hypoxia. AB - The hypothesis that adenosine mediates the coronary vasodilatory response to hypoxia was tested by determining if intracoronary infusion of the adenosine degrading enzyme, adenosine deaminase (ADA), would attenuate this response. Efficacy of ADA was also evaluated by examining its effect on the coronary responses to exogenous adenosine and to 20-s myocardial ischemia. Experiments were conducted in 14 anesthetized, open-chest dogs ventilated 3-5 min with 3% O2 5% CO2-92% N2 to induce systemic hypoxia. Under control, pre-ADA conditions, hypoxia (arterial PO2 19 +/- 2 mmHg) caused left anterior descending (LAD) coronary blood flow to increase from 100 +/- 12 to 382 +/- 47 ml X min-1 X 100 g 1 (+282%). After infusion of ADA (5 U X kg-1 X min-1 for 8-10 min) into the LAD, equally severe hypoxia (arterial PO2 18 +/- 3 mmHg) caused a significantly smaller increase in LAD flow, 79 +/- 9 to 234 +/- 41 ml X min-1 X 100 g-1 (+195%). Oxygen consumption in the LAD perfusion field was unchanged by hypoxia before ADA but fell significantly during hypoxia after ADA. ADA also attenuated significantly the coronary vasodilatory response to exogenous adenosine and to 20 s ischemia. The results of this investigation demonstrate a significant role of adenosine in the coronary vasodilatory response to systemic hypoxia. PMID- 3963216 TI - End-systolic pressure-diameter relationships during pulsus alternans in intact pig hearts. AB - Pulsus alternans has previously been ascribed to variations in end-diastolic fiber length and/or an alternating contractile state. In six paced, whole blood perfused, intact, working pig hearts, left ventricular internal diameters were measured with ultrasonic crystals, and left ventricular pressures were measured with a micromanometer-tipped catheter. Pulsus alternans was induced with propranolol (24-51 micrograms X kg-1 X min-1). End-systolic pressure-diameter relationships were determined during pulsus alternans from a series of consecutive, variably volume-loaded beats using a previously described technique. Beats analyzed prior to any change in loading conditions revealed a left ventricular pressure of 62.7 +/- 8.7 mmHg for the strong beats and 55.2 +/- 7.0 for the weak beats (P less than 0.050). The end-diastolic diameter prior to the stronger beats was larger than that prior to the weaker beats (24.80 +/- 2.73 vs. 23.82 +/- 2.82 mm, P less than 0.025), but there was no significant difference in the corresponding end-diastolic pressures. The maximum dP/dt of the strong beats was 1,275 +/- 249 mmHg/s compared with 1,038 +/- 222 for the weak beats (P less than 0.025). The slope of the end-systolic pressure-diameter relationship, which provides an index of contractility independent of end-diastolic diameter, averaged 42.3 +/- 6.4 mmHg/mm for the strong beats and 24.4 +/- 6.8 for the weak beats (P less than 0.025). These data support an alternating contractile state as an independent mechanism for pulsus alternans in the intact animal. PMID- 3963217 TI - Contractile responses to ouabain and K+-free solution in aorta from hypertensive rats. AB - This study characterizes isometric force development in response to ouabain and K+-free solution in isolated aortic strips from spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats. SHR aortas were more sensitive to ouabain than those from WKY (threshold: SHR, 3.1 X 10(-5) M; WKY, 25.6 X 10(-5) M), and force development in response to 10(-3) M ouabain was greater in SHR (SHR, 586 +/- 51 mg; WKY, 245 +/- 24 mg). Monensin, a Na+ ionophore, potentiated contractile responses to ouabain, whereas amiloride, a Na+ channel blocker, and low Na+ solutions depressed contractile responses to ouabain. Contractile responses of SHR aortic strips to K+-free solution were faster than those of WKY aortic strips [time to half-maximal response (t1/2): SHR, 24 +/- 5 min; WKY, 47 +/- 4 min]. Maximal force development by aortic strips from SHR in response to K+-free solution was not different from that of WKY aortic strips (SHR, 808 +/- 34 mg; WKY, 750 +/- 37 mg). Monensin (10(-5) M) increased the rate of force development to K+-free solution to a greater extent in WKY aortic strips than in those from SHR (t1/2: SHR, 3 +/- 1 min; WKY, 4 +/- 2 min). Amiloride and low Na+ solution depressed contractile responses to K+-free solution in both SHR and WKY aortic strips. These observations demonstrate that SHR aortas are more responsive to ouabain and K+-free solution compared with WKY aortas. Contractile responses to ouabain and K+-free solution were sensitive to experimental interventions that alter transmembrane Na+ movements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963218 TI - Left ventricular relaxation in the filling and nonfilling intact canine heart. AB - We studied left ventricular relaxation in the filling and transiently nonfilling working hearts of seven open-chest pentobarbital-anesthetized dogs by totally occluding the mitral annulus during one systole. In the completely isovolumic nonfilling cycle, the ventricle relaxes to a lower pressure minimum (usually negative) than in the normal filling cycle. By clamping the ventricle at end systole, we determined the pressure asymptote (Poo) under dynamic conditions. With this information, we evaluated the validity of a monoexponential characterization of relaxation. P = (P0 - Poo) exp(-t/T) + Poo (T, time constant, P0, pressure at t = 0). Plots of In(P-Poo) versus t are nonlinear and concave to the origin, thereby revealing that late relaxation is more rapid than predicted by a monoexponential relation. Nevertheless, the monoexponential T remains a useful index of relaxation and correlates well with other temporal indexes (isovolumic relaxation time and relaxation half-time). When T is calculated from a filling cycle by assuming a zero pressure asymptote, i.e., the conventional way, there is no significant difference with the true value based on the nonfilling cycle. PMID- 3963219 TI - Effect of canine cardiac nerves on heart rate, rhythm, and pacemaker location. AB - In open-chest dogs, right- and left-sided cardiac nerves were stimulated to determine their effect on heart rate, rhythm, and pacemaker location. The majority of the nerves produced chronotropic changes; 72% of the induced rhythms originated from within the atrial pacemaker complex. Ten percent of the stimulations produced an atrio-ventricular (AV) nodal rhythm; most of the time this was induced by the left posterior and anterior ansae and ventrolateral nerves. The dominance of a lateral right atrial pacemaker was observed in 8% of the stimulations; the dorsal cardiac and innominate nerves induced this rhythm the majority of the time. The general trend was for a cranial shift in the location of the pacemaker within the pacemaker complex with sympathetic stimulation and a caudal shift with parasympathetic stimulation. Exceptions to the pattern may be explained by the preferential effect of the nerves on the pacemakers in the right atrium. The study demonstrates, in the canine model, that in addition to the sinus and AV nodes, there is a system of pacemakers controlled by the cardiac nerves. PMID- 3963220 TI - Postrest inotropy in rabbit ventricle: Na+-Ca2+ exchange determines sarcoplasmic reticulum Ca2+ content. AB - To determine whether Na+-Ca2+ exchange is a physiologically significant Ca2+ efflux mechanism in rabbit ventricle, we investigated the effects exerted on postrest contractions by interventions that alter the transmembrane distribution of Na+ or Ca2+ so as to retard Ca2+ efflux via this system. Contractions elicited after rest periods of 0.25-10 min in duration were studied. The following interventions increased postrest contractions much more than those elicited by rhythmic stimulation: 1) Na+ pump inhibition by cardiac glycosides or by a reduction in extracellular K+, 2) reduction of extracellular Na+ (maintaining a constant [Ca2+]-to-[Na+]2 ratio), and 3) elevation of extracellular Ca2+. In contrast, isoproterenol, norepinephrine, and histamine produced comparable increases in both rhythmically stimulated and postrest contractions, suggesting that the postrest contractile potentiation was not just the result of a general increase in inotropic state. Ryanodine, which appears to antagonize sarcoplasmic reticulum (SR) Ca2+ release in cardiac muscle, markedly reduced the amplitude of the postrest contractions, but only modestly decreased rhythmically stimulated responses. Results suggest 1) that Ca2+ released from SR is involved in postrest response, 2) that Na+-Ca2+ exchange serves as a Ca2+ efflux pathway in normally polarized resting rabbit ventricle, and 3) that this activity in part determines the amount of Ca2+ available for release from SR. PMID- 3963221 TI - Aortic caliber changes during development of hypertension in freely moving rats. AB - The availability of a chronically implanted electrolytic strain gauge has permitted us to monitor, for the first time in freely moving rats, sequential changes of both resting caliber and mechanical properties of the aorta during onset and maintenance of sustained hypertension. Normotensive rats were subjected to subdiaphragmatic aortic constriction under ether anesthesia. There was an immediate and sustained rise of pressure (on average a 50% increase over base line mean arterial pressure of 101 +/- 4 mmHg), whereas mean aortic caliber (6.552 +/- 0.142 mm) dilated gradually with no significant change at 6 h and had a significant dilation of 3.4 and 6.8% after 24 and 48 h, respectively. On the 2nd day of hypertension, dilation of the aorta was accompanied by a marked increase in both mean distensibility and dynamic distensibility of the aortic wall (7-fold and 1.5-fold increase over basal values of 0.128 +/- 0.015 and 0.056 +/- 0.005 X 10(-6) dyn/cm2, respectively). No further dilation was observed for up to 5 days, but the dynamic distensibility of the aorta returned to normal values on the 3rd day of hypertension. Maximal dilation at 48 h was produced by the increase of both pulsation and diastolic caliber of the aorta with the displacement of diastolic caliber (94.8%) being the major determinant of aortic dilation. Thus the time required for the aorta to achieve the new resting diastolic position during the development of sustained hypertension (48 h) coincides with the time course of complete resetting of aortic baroreceptors as we demonstrated before in the same preparation. These two findings taken together suggest that alterations in the geometry of the aortic wall play an important role in the resetting process. PMID- 3963222 TI - Measurement of instantaneous viscoelastic properties by impedance-frequency curve of the ventricle. AB - We developed a method for estimating the instantaneous viscoelastic properties of the left ventricle (LV). This impedance-curve method is based on the instantaneous impedance-frequency curve of the left ventricle generated by a rapidly oscillating mechanical impulse applied to the epicardial surface of the heart. The theoretical basis of the method and experimentally obtained instantaneous impedance-frequency curves were examined to evaluate the validity of our basic assumptions. Using these impedance-curve data, we calculated the instantaneous viscoelastic properties of the LV during the cardiac cycle. The impedance curve shows a configuration that is almost the same as the theoretical curve based on the assumption that an RCL (R, resistor; C, capacitor; L, inductor) parallel circuit is the electrical analog for the LV. The impedance curve varied moment by moment during the development of instantaneous LV pressure. The elastic and viscous coefficients, calculated from the impedance curve, increased with increase of LV pressure. We concluded that the impedance curve method can delineate the instantaneous viscoelastic properties of the ventricle (especially of the ventricular myocardium). PMID- 3963223 TI - Assessment of slope of end-systolic pressure-volume line of in situ dog heart. AB - The purpose of this study was to establish a new method of assessment of the slope (Emax) of the end-systolic pressure-volume line (ESPVL) of the in situ heart. In anesthetized open-chest dogs, an isovolumic contraction was produced by an aortic occlusion after steady-state ejecting contractions in the left ventricle. We plotted ventricular pressure measured with a catheter-tip manometer against time integral of aortic flow measured with an electromagnetic flowmeter of the last ejecting and the first isovolumic contraction, assuming the same end diastolic volume. ESPVL was drawn from the peak isovolumic pressure-volume point tangential to the left upper corner of the +/- 3.0 (SE) mmHg/ml (n = 9 dogs) in control run and was increased by 59 +/- 19% under isoproterenol and decreased by 47 +/- 9% after propranolol. Emax was little changed by atrial pacing. We conclude that Emax by this aortic occlusion method is useful for assessment of left ventricular contractility of the in situ dog heart. PMID- 3963224 TI - Extra-abdominal pressure alters food intake, intragastric pressure, and gastric emptying rate. AB - Compression of the animal stomach gives rise to vagal discharges that could signal satiety. To test a noninvasive method of inducing compression of the human stomach, we first employed extra-abdominal pressure levels of 0, 10, and 20 Torr, counterbalanced for sequence, in six lean and obese subjects. A large blood pressure cuff was wrapped around the abdomen of the subject with the air bladder over the epigastrium. The bladder was inflated before ingestion of a liquid meal by the subject until satiated. Relative to 0 Torr, pressures of 10 and 20 Torr significantly reduced spontaneous food intake (P less than 0.03) without producing discomfort. In a second study, extra-abdominal pressure of 20 Torr also raised intragastric pressure by a mean of 5.5 Torr (P less than 0.03). In a third study, extra-abdominal pressure of 20 Torr did not alter gastric emptying rate during meal ingestion but ultimately enhanced emptying rate when this pressure was maintained for greater than 100 min after meal completion (P less than 0.01). PMID- 3963225 TI - Effect of amine on temperature-responsive neuron in slice preparation of rat brain stem. AB - Using slice preparations we investigated the effect of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) on thermoresponsive neurons in the hypothalamus, midbrain, and the medulla oblongata. NE inhibits the activities of most of the warm-responsive neurons (11 out of 13 neurons) but 5-HT activates the warm responsive neurons (10 out of 11 neurons) in the hypothalamus. However, the direction of neuronal response of the midbrain was opposite of that in the hypothalamus when 5-HT was applied. In the medulla oblongata, 5-HT facilitates both warm- and cold-responsive neurons and NE facilitates or inhibits these neurons in equal proportions. Furthermore, the dose-response relationships were determined using slice preparations. In the hypothalamus and the midbrain, NE and 5-HT started to effect the warm-responsive neurons at the minimum concentration of 5 X 10(-6) M, whereas the maximum responses were obtained at the concentration of 5 X 10(-5) M. In the medulla oblongata, NE or 5-HT changed the activities of the warm-responsive neurons in the range of 5 X 10(-5) to 10(-3) M or 10(-6) to 10(-5) M, respectively. It is concluded that the thermoresponsive neurons respond to 5-HT and NE in different ways, at both various levels in the central nervous system and the applied concentration of amines. PMID- 3963227 TI - Reoxygenation injury in isolated hepatocytes: effect of extracellular ATP on cation homeostasis. AB - The aims of this study were to determine 1) the effects of anoxia and reoxygenation on electrolytes and ATP content of isolated hepatocytes and 2) whether exogenous ATP-MgCl2 has any beneficial effects on the cellular alterations that are produced during the reoxygenation period. After 90 min anoxia, intracellular Na and inorganic phosphate (Pi) increased, K and ATP decreased, whereas Ca and Mg did not change. After 60 min of reoxygenation, intracellular Mg and Na levels decreased, Ca increased, and Pi levels returned to normal, but ATP levels remained low. These results suggest that the plasma membrane is relatively impermeable to divalent ions such as Ca2+, Mg2+, and HPO2 4 during anoxia but becomes permeable to them after reoxygenation. When anoxic cells were treated with ATP-MgCl2 during reoxygenation, intracellular ATP and Mg levels increased, but accumulation of Ca and Pi was also observed. Thus enhancement of Mg transport and specific stimulation of Ca-Pi sequestration occurs with ATP-MgCl2 treatment. Na and K levels exhibited biphasic reciprocal dose-response changes to ATP-MgCl2 treatment; i.e., 0.1 mM ATP-MgCl2 (low-dose) treatment increased K and decreased Na, whereas 1 mM ATP-MgCl2 (high-dose) treatment decreased K and increased Na. These results indicate that although addition of a single high-dose ATP-MgCl2 was deleterious over a period of 60 min, low-dose ATP-MgCl2 accelerates the recovery of postanoxic cellular electrolyte homeostasis. PMID- 3963226 TI - Enhanced noradrenergic activity in kidney of Brattleboro rats with diabetes insipidus. AB - The possibility that sympathetic nervous system activity may be altered in Brattleboro rats with diabetes insipidus (DI) was studied using the norepinephrine (NE) turnover technique. Female DI and Long-Evans rats were used. NE turnover in peripheral organs was calculated by measuring the decline in tissue [NE] after inhibition of tyrosine hydroxylase with alpha-methyltyrosine. NE turnover was increased significantly in the kidney of DI rats but was not significantly altered in other peripheral organs examined (heart, duodenum, skeletal muscle). Both NE and epinephrine concentrations in the adrenal gland were significantly higher in the DI rats. Treatment of DI rats for 7 days with vasopressin tannate (Pitressin, 100 mU/100 g) or 1-deamino-[8-D-arginine] vasopressin (DDAVP, 250 ng X kg-1 X day-1) reversed the changes in renal NE turnover and also decreased the turnover in other tissues. The results of these studies suggest that, compared with Long-Evans rats, DI rats have a selective increase in NE turnover in the kidney and the potential to release more catecholamines from the adrenal glands. The apparently nonspecific effect of antidiuretic therapy on NE turnover in DI rats is probably mediated by the epithelial receptor for vasopressin, because both Pitressin and DDAVP produced similar results. PMID- 3963228 TI - Excitatory and inhibitory interactions among renal and cardiovascular afferent nerves in dorsomedial medulla. AB - Central interactions between renal afferent nerves (RN) and carotid sinus (CSN) and aortic (AN) nerves were investigated by recording extracellular action potentials from single units in and around the nucleus tractus solitarius (NTS) in alpha-chloralose-anesthetized cats. Forty-nine units were activated by electrical stimulation of the renal nerve; twenty-seven of these also were excited by CSN, AN, or both. Summation of inputs was demonstrated during simultaneous subthreshold or suprathreshold stimulation of RN and CSN or AN. In 10 units excited by simultaneous stimulation of RN and AN or CSN, a conditioning stimulus (333 Hz for 10 ms) applied to RN caused prolonged (up to 150 ms) inhibition of responses to stimulation of AN or CSN; reciprocal inhibitory interactions were also shown. These studies show that renal afferent input interacts with cardiovascular afferent input at neurons in the NTS region of dorsal medulla and suggest that the outcome of these interactions at the single cell level may be critically dependent on the temporal relationships among afferent impulses converging on common central synapses. PMID- 3963229 TI - Renal proximal tubule of flounder. I. Physiological properties. AB - The proximal segment of the winter flounder, Pseudopleuronectes americanus, was investigated. Isolated tubules net secrete fluid, although at low rates, 37 pl X min-1 X mm-1. The dominant ions in secreted fluid are Na and Cl, with [Cl] significantly higher than in the bath. Mg and SO4 concentrations in secreted fluid are more than 10-fold greater than in the bath. The transepithelial voltage (-1.9 mV) and resistance (26 omega X cm2) indicate an electrically leaky epithelium, and transepithelial diffusion potentials suggest the Na selectivity of the paracellular pathway. Transepithelial electrochemical potentials point to active transport of Mg, SO4, and probably also Cl and to transepithelial equilibrium of Na. Failure to observe any secretory transport in tubules perfused in vitro at the commonly used perfusion rates illustrates the necessity of low, preferably subnanoliter, perfusion rates in detecting and studying low-capacity epithelial transport systems by the method of Burg. PMID- 3963230 TI - Renal proximal tubule of flounder II. Transepithelial Mg secretion. AB - The kinetics of transepithelial Mg secretion were studied in isolated perfused proximal tubule II of the flounder, Pseudopleuronectes americanus. To detect measurable changes of luminal [Mg] as a function of bath [Mg], the lumen had to be perfused at subnanoliter rates. Transepithelial Mg secretion did not obey first-order reaction kinetics; hence values for half saturation of transport (0.22 mM) and transport maximum (1.5 pmol X min-1 X mm-1) are apparent and suggest a high-affinity low-capacity transport system. Because all experiments were done in the absence of bath SO4, the independence of Mg transport from SO4 transport is established. In the absence of perfusion, when tubules secrete fluid spontaneously, secreted fluid contained Cl (156 +/- 3 mM), Na (130 +/- 6 mM), and Mg (27 +/- 5 mM), all significantly different from the bath. Rates of Cl, Na, and Mg secretion were all positively correlated with fluid secretion, but Na and Mg concentrations in secreted fluid were inversely proportional. The results indicate that NaCl secretion provides basal rates of fluid secretion, and when MgCl2 is secreted in addition, fluid secretion increases with the effect of generating inverse relationships between luminal Na and Mg concentrations. PMID- 3963232 TI - Canine renal responses to atrial stretch or intravenous saline are not attenuated at night. AB - Primates develop a diuresis and natriuresis in response to stimuli that increase central blood volume. However, the renal response is markedly attenuated when these same experimental stimuli are applied at night. The purpose of the present study was to determine whether a quadruped, specifically the dog, also demonstrates attenuated renal responses to similar stimuli given at night. Two experimental protocols were performed on conscious dogs at night: 1) left atrial distension by partial mitral valve obstruction and 2) intravenous saline administration. Results from these experiments were compared with results from comparable experiments performed on the same dogs during the day. Each experimental intervention produced increases in urine flow and sodium excretion and decreases in urine osmolality during both day and night experiments (all P less than 0.05). The responses obtained during the night did not differ significantly from those obtained during the day. Thus the dog does not demonstrate an attenuated renal response to central volume expansion during the night. This contrasts with the adaptive response in primates that serves to minimize fluid loss when the intrathoracic blood pool is increased during prolonged recumbency at night. Presumably quadrupeds, with trunks horizontal both day and night, do not require nocturnal adaptive mechanisms to conserve body fluids. PMID- 3963231 TI - Effects of testosterone, estradiol, and temperature on neurons in preoptic tissue slices. AB - Thermosensitive preoptic neurons have been implicated in the regulation of body temperature. Testosterone- and estrogen-sensitive preoptic neurons have been implicated in reproductive behavioral and endocrine responses. In this study, rat preoptic tissue slices were used to examine the specificity of these neurons by determining their individual firing rate responses to both temperature and reproductive steroids. Of the 180 neurons classified according to thermosensitivity, 37% were warm sensitive, 8% were cold sensitive, and 55% were temperature insensitive. Ninety-three neurons were tested for their responses to perfusion media containing either testosterone or estradiol (30 pg/ml). Of the cells tested with both steroids, testosterone or estradiol affected half of the thermosensitive neurons and one-third of the temperature-insensitive neurons. This indicates that the population of temperature-insensitive neurons does not contain the majority of the steroid-sensitive neurons. There was much specificity, however, between the two types of steroid-sensitive neurons; testosterone and estradiol rarely affected the same neuron. Although these findings do not indicate a strong specificity between thermosensitive and steroid sensitive neurons, they do support previous studies suggesting interactions between thermoregulatory and reproductive systems. PMID- 3963233 TI - Osmotic and volemic regulation of plasma arginine vasotocin in conscious domestic fowl. AB - Recently developed radioimmunoassay methods were utilized to quantitatively characterize secretion of the avian antidiuretic hormone [arginine vasotocin (AVT)] by the hypothalamo-neurohypophyseal system (HNS) of the conscious domestic fowl. The functional characteristics of the osmoreceptor-HNS were evaluated during independent experimental manipulations of extracellular osmolality or volume. Simultaneous measurements of plasma AVT (PAVT) and either plasma osmolality (Posm) or blood volume (BV) in these experiments permitted determination of osmoreceptor sensitivity to independent osmotic or volemic stimuli and set point of the AVT secretory system under conditions of normal hydration. In normally hydrated birds, PAVT and Posm averaged 2.7 +/- 0.2 microU/ml (12.9 +/- 1.0 pg/ml) and 308.1 +/- 0.6 mosmol/kg H2O, respectively (means +/- SE). Characterization of AVT secretion revealed that Posm is a primary determinant of AVT secretion by the HNS of the domestic fowl. Highly correlated and significant relationships between Posm and PAVT exist both above and below the observed basal Posm of normally hydrated birds, with an apparent osmotic threshold for AVT secretion at a Posm of 288.8 mosmol/kg H2O. Analysis of the data also suggested that the HNS is insensitive to changes in BV less than or equal to 10%, because neither isotonic expansion nor reduction of BV altered PAVT. Comparison of past and present avian data with that of the mammalian HNS indicates that 1) the osmotic regulation of antidiuretic hormone secretion is qualitatively and quantitatively similar in birds and mammals, and 2) the volemic regulation of antidiuretic hormone secretion is substantially more important in mammals than in birds. PMID- 3963234 TI - Regulation of plasma arginine vasotocin in conscious water-deprived domestic fowl. AB - Radioimmunoassay methods were employed to quantitatively characterize secretion of the avian antidiuretic hormone [arginine vasotocin (AVT)] by the hypothalamo neurohypophyseal system (HNS) of the conscious domestic fowl in response to chronic dehydration. Water deprivation permitted characterization of AVT secretion in response to the combined stimuli of extracellular hyperosmolality and hypovolemia; the subsequent repletion of extracellular volume permitted separation of potential osmotic and volemic factors involved in the regulation of AVT secretion. In normally hydrated birds, plasma AVT (PAVT) and plasma osmolality (Posm) averaged 2.2 +/- 0.3 microU/ml (10.5 +/- 1.4 pg/ml) and 309.3 +/- 0.7 mosmol/kg H2O, respectively (means +/- SE). With water deprivation, PAVT and Posm of the birds increased in parallel in a curvilinear manner to maxima of 13.1 +/- 0.6 microU/ml (62.4 +/- 2.9 pg/ml) and 346.6 +/- 2.0 mosmol/kg H2O, respectively, at 96 h of dehydration. The isosmotic repletion of extracellular volume at 96 h by acute intravenous infusion failed to alter 96-h PAVT values. The results indicate that AVT secretion is closely linked to the state of hydration during negative fluid balance in the domestic fowl. Analysis of the data indicated that increases in PAVT that occur with dehydration are mediated primarily by extracellular hyperosmolality and that the HNS of the domestic fowl is relatively insensitive to the simultaneous hypovolemia incurred with fluid deprivation. PMID- 3963235 TI - Physical and metabolic correlates of sexual inactivity in aged male mice. AB - The object of this study was to identify specific syndromes of sexual loss in aged male mice. Emphasis was placed on uncovering syndromes that involve physical as opposed to motivational deterioration. To this end, 30-mo-old CBF1 male mice were subjected to a large battery of tests, each of which was designed to detect sensory, neuromuscular, metabolic, or sexual deficits. Over 50 measures were obtained on each of 63 males. A group of 23 6-mo-old males were studied simultaneously to establish base lines of normal performance. Old males routinely showed evidence of deterioration in some tests but not in others. Some old males actually performed as well as young males in some tests, including an exhaustive test of sexual capacity. Ten nonsexual measures were significantly correlated with sexual activity. Further analyses then suggested seven distinct syndromes of reproductive loss, each with its own specific cause and unique manifestation. Six of these syndromes manifested themselves as behavioral deficits; one was related to a failure to eject sperm. Our data also suggest the possible existence of two more syndromes, but these remain to be verified more fully. Although additional syndromes undoubtedly will be found in male mice, the present testing paradigm can be exploited to isolate and study the functional bases of each of these specific facets of reproductive loss. PMID- 3963236 TI - Dose-related suppression of feeding by intraportal glucagon infusion in the rat. AB - Continuous intraportal infusion of pancreatic glucagon during a feeding test conducted in the dark phase of the circadian photoperiod produced a dose-related suppression of feeding in rats. At the end of the 30 min of infusion, food intake was suppressed 10% at the infusion rate of 0.33 micrograms X kg-1 X min-1 and 45% at the highest infusion rate studied (100 micrograms X kg-1 X min-1). At infusion rates of 33 and 100 micrograms X kg-1 X min-1, the suppression of cumulative intake persisted for 30 min after the termination of the infusion, but no effect on 24-h intake was observed. Glucagon's glycemic effects were measured for two glucagon doses (1 and 10 micrograms X kg-1 X min-1) in the absence of food using a paradigm similar to that used for the feeding tests. In contrast to the suppression of food intake, the hyperglycemic effects of glucagon were not dose related for the two doses tested. The hyperglycemia was similar in magnitude 5 min after the start of the infusion at both infusion rates. Subsequently, plasma glucose concentrations declined more rapidly at the higher than at the lower glucagon dose. This difference in the effect of glucagon on glucose disposal may be important for glucagon's satiating effect. PMID- 3963237 TI - Glucagon-induced inhibition of feeding is impaired by hepatic portal alloxan injection. AB - Subdiabetogenic doses of alloxan injected into the hepatic portal vein of rats abolished glucagon-induced inhibition of feeding (glucagon satiety) both in daytime tests using a palatable food and in nighttime tests using their standard pelleted diet. In contrast, inhibition of food intake by cholecystokinin and epinephrine and stimulation of feeding by 2-deoxy-D-glucose were not impaired by alloxan. Alloxan-induced deficits in glucagon satiety did not appear to result from generalized hepatocellular necrosis, because satiety deficits outlasted histological signs of toxicity and because furosemide, which produced a similar degree of hepatotoxicity, did not impair glucagon satiety. In addition, alloxan's effects were not associated with impaired glycogen storage or mobilization. Recovery of glucagon satiety occurred in some animals but not until 3-6 mo after alloxan. The degree of recovery was inversely related to alloxan dose. Our results indicate that, when administered into the hepatic portal vein, alloxan may be a relatively specific toxin for cells involved in the mediation of glucagon satiety. The specificity of the deficit and the time course of recovery suggest that the alloxan-sensitive cells may be hepatic vagal neurons. PMID- 3963238 TI - Critical radius of endotherms. AB - The critical radius effect for insulation, well known in the engineering literature, was used by other authors to explain the lack of insulation on newborn endotherms. If that effect existed in small animals, they would lose less heat if nude than if fur or feathers were present. We show 1) that the previous analysis, although incomplete, yields the same result as a solid insulation model with the required sophistication and 2) that a proper model of fur is a porous media model. Neither of two porous media versions yield a critical radius effect. No critical radius effect occurs because simultaneous heat transfer by conduction and radiation makes it impossible to obtain the required logarithmic increase in thermal resistance with increasing insulation radius in a porous medium. PMID- 3963239 TI - Response of hamster circadian system to transitions between light and darkness. AB - The effects of exposure to sudden transitions from dark to light (DL) and light to dark (LD) were determined on the free-running circadian activity rhythm of Syrian hamsters. The activity rhythm was phase delayed by 1-2 h by DL transitions provided during the 12-h interval before activity onset (subjective day). In contrast, DL transitions produced phase advances of approximately 1 h 2-12 h after activity onset. LD transitions tended to produce phase advances throughout the circadian cycle. During the subjective day, LD transitions resulted in phase advances of up to 4 h. After the onset of activity, LD transitions produced phase advances of a lesser magnitude than during the subjective day. In addition, some phase delays were also observed. When the phase shifts produced by DL and LD transitions were combined additively these transitions could account for the phase shifts previously reported for brief pulses of light. PMID- 3963240 TI - Resetting of mammalian respiratory rhythm: existence of a phase singularity. AB - The purpose of this study was to use topological methods of analysis to determine if a phase singularity exists for the neural respiratory oscillator. We studied resetting behavior of central respiratory rhythm, measured as phrenic nerve activity, by using brief stimulations of the superior laryngeal nerve in anesthetized paralyzed adult cats. The strength and timing of stimuli were varied, and the times of onset of subsequent breaths were measured. Two distinct types of phase resetting were identified: type 1 resetting for weak stimuli and type 0 resetting for strong stimuli. With stimuli of intermediate strength, we obtained a series of phase-resetting curves that defined a helicoid-resetting surface having a phase singularity near the transition between late expiration and early inspiration. In this domain resumption of breathing occurred at highly variable resetting times. The mammalian respiratory oscillator thus has qualitative characteristics of response to brief stimuli that are similar to those of other biological oscillators. PMID- 3963241 TI - Intravascular pulmonary macrophages: a novel cell removes particles from blood. AB - Clearance of radiolabeled gold colloid from the blood and relative organ distribution of retained colloid and magnetic iron oxide particles were compared between rats and calves. When unanesthetized calves 1 wk of age were injected intravenously with these two particle types, uptake was predominantly pulmonary. In contrast, in the rat there was overwhelming hepatic uptake. Similar pulmonary localization of injected particulate material was found in adult goats. When lung tissue was examined by electron microscopy, injected iron oxide was found within intravascular pulmonary macrophages. The mononuclear phagocyte system removes particulate material of both exogenous and endogenous origin from the circulation; hepatic and splenic uptake of such material usually predominates. We found that, unlike the species previously studied, ruminants have actively phagocytic cells within the pulmonary vasculature. Thus pulmonary intravascular macrophages constitute an important part of the mononuclear phagocyte system in some species. PMID- 3963242 TI - Senescence and baroreflex control. PMID- 3963243 TI - The dying psychotherapist. AB - A previously unpublished paper by a dying psychotherapist describes the therapeutic use of the ensuing grief reactions of five patients to his terminal illness to help them deal with the effects of their previous losses, deprivations, and abandonments. Follow-up interviews with these patients and their subsequent psychotherapists shed light on the efficacy of such therapeutic efforts, the character of the communication of the terminal illness, the transference and countertransference reactions that interfered with the inevitable separation, and conclusions by previous authors regarding patients' reactions to the deaths of their therapists. PMID- 3963244 TI - Comprehensive analysis of change after brief dynamic psychotherapy. AB - This report provides data on symptom levels by using group means as well as categories of clinical relevance as they change over the course of treatment and also examines change "beyond symptoms" as levels of adaptive functioning. This approach allows a more comprehensive analysis of change in a series of patients with pathological grief reactions treated with brief dynamic psychotherapy. The different perspectives on outcome of the patient, the evaluating clinician, the treating clinician, and independent judges are compared. The findings from all perspectives indicate that major symptom relief occurred in the majority of patients, with less change in adaptive abilities. PMID- 3963245 TI - Psychiatric reactions to disaster: the Mount St. Helens experience. AB - Following the 1980 Mount St. Helens volcanic eruption, psychiatric reactions were studied in the disaster area and in a control community. Using the new criterion based diagnostic method for psychiatric epidemiologic research, the Diagnostic Interview Schedule, the authors found a significant prevalence of disaster related psychiatric disorders. These Mount St. Helens disorders included depression, generalized anxiety, and posttraumatic stress reaction. There was a progressive "dose-response" relationship in the comparison of control, low exposure, and high-exposure groups. The dose-response pattern occurred among both the bereaved and the property-loss victims. PMID- 3963246 TI - ECT and memory: brief pulse versus sine wave. AB - The authors evaluated the effects on memory of ECT given with either unilateral or bilateral electrode placement and with brief-pulse or sine-wave stimulus waveform. Clinical criteria determined the mode of ECT and the treatment parameters. As expected, right unilateral ECT produced less memory impairment than bilateral ECT. Brief-pulse ECT resulted in less memory impairment than sine wave ECT during the first hour after treatment but had similar effects on memory after the first hour. Brief-pulse ECT might produce less memory impairment than conventional sine-wave ECT; however, this can probably be achieved in clinical practice only if treatment parameters that keep stimulation close to the seizure threshold are developed individually for each patient. PMID- 3963247 TI - Psychophysiological evidence for cerebral laterality effects in a high-risk sample of students with subsyndromal bipolar depressive disorder. AB - The authors compared bilateral recordings of electrodermal activity and conjugate lateral eye movements in two groups (10 men and 10 women each) of college students: high-risk nonpatients with subsyndromal depression and normal control subjects. Like acutely depressed patients, the high-risk subjects showed smaller right- than left-hand skin conductance response amplitudes to neutral tones. This group also showed a bias toward left-tending conjugate lateral eye movements in response to various cognitive problems. Control subjects showed symmetrical responses on all electrodermal activity measures and question-specific conjugate lateral eye movements. These data are tentatively interpreted as reflecting right hemisphere hyperexcitability in affective illness. PMID- 3963248 TI - Posttraumatic stress disorder as an insanity defense: medicolegal quicksand. AB - A growing awareness of posttraumatic stress disorder has led to recent use of the disorder as a legal defense against criminal responsibility for both violent and nonviolent crimes. Diagnosis of posttraumatic stress disorder is difficult because the symptoms are mostly subjective, often nonspecific, usually well publicized, and, therefore, relatively easy to imitate. Accurate psychiatric testimony in such cases requires diligent searching for collateral sources of information. The authors argue that the insanity defense is appropriate only in the rare instance that a dissociative episode related to posttraumatic stress disorder directly leads to criminal activity. PMID- 3963249 TI - The role of proximity, immediacy, and expectancy in frontline treatment of combat stress reaction among Israelis in the Lebanon War. AB - The authors examined the effectiveness of the prevailing treatment doctrine stressing the principles of proximity, immediacy, and expectancy for combat stress reaction among Israeli soldiers in the Lebanon War. Two treatment outcomes were measured: return to military unit and presence of posttraumatic stress disorder. All three treatment principles were associated with a higher rate of return to the military unit. The beneficial effect of frontline treatment was also evidenced by lower rates of posttraumatic stress disorder. The authors suggest that these principles can also be effective in treating other forms of posttraumatic stress disorder. PMID- 3963250 TI - The psychological effects of being a prisoner of war: forty years after release. AB - Forty years after the end of World War II, the authors compared a random sample of former Japanese-held Australian prisoners of war (POWs) with a group of non POW combatants of the same era. The POWs were significantly more depressed than were the control subjects, but the two groups did not differ in prevalence of anxiety symptoms or alcohol problems. Apart from a higher rate of postwar duodenal ulcer in the POWs, the two groups had similar degrees of medical morbidity. PMID- 3963251 TI - Is Briquet's syndrome a heterogeneous disorder? AB - A structured interview that identified 78 female psychiatric outpatients as having Briquet's syndrome also indicated that 77 of the 78 fulfilled inclusive diagnostic criteria for one or more other psychiatric syndromes. If, as this finding suggests, Briquet's syndrome represents a heterogeneous disorder, its various components should be evaluated and patient responses to treatments should be assessed. Until such studies are done, the general and psychiatric physician should be aware that the diagnosis of Briquet's syndrome does not rule out the possibility of other psychiatric illnesses that may be more amenable to treatment. PMID- 3963252 TI - Childhood and family characteristics in panic and generalized anxiety disorders. AB - The author compared 32 patients who had generalized anxiety disorders with 29 patients who had panic disorder and agoraphobia with panic attacks. He observed that patients with generalized anxiety disorder more often had lost their fathers and/or mothers before the age of 16 years, whereas patients with panic disorder and agoraphobia with panic attacks had more often experienced chronic anxiety in childhood. More parents and siblings of patients with panic disorder had affective disorders and alcohol abuse than did parents and siblings of patients with anxiety disorders. PMID- 3963253 TI - An annual rhythm in the battering of women. AB - Over 27,000 reports about women abused by their live-in male partners were provided by 23 shelter organizations in five locations in the United States. Cosinor analyses revealed statistically significant annual rhythms in the frequencies of abuse, with maxima in the summer. The rhythms were closely related to annual changes in ambient temperature in these locations, and the time of the maxima was similar to those previously reported for assaults and rapes. The findings support the hypothesis that violence by men toward women increases in summer independently of any major seasonal changes in the opportunity for contact between perpetrator and victim. PMID- 3963254 TI - Persistent anticipatory nausea, vomiting, and anxiety in cured Hodgkin's disease patients after completion of chemotherapy. AB - Six to 140 months after completion of chemotherapy, 63% of 60 Hodgkin's disease survivors experienced anticipatory nausea, 80% had anxiety, and 5% reported vomiting. Time since treatment and treatment severity were significantly associated with pervasiveness of nausea but not of anxiety. PMID- 3963255 TI - Cocaine precipitation of panic disorder. AB - The authors describe three patients whose panic disorder began during recreational use of cocaine and continued autonomously even after the drug was stopped. Theoretical and practical implications are discussed. PMID- 3963256 TI - Lactate-induced panic in primary affective disorder. AB - Intravenous sodium lactate was given to seven patients with primary depression and secondary panic attacks and 26 patients with panic disorder or agoraphobia with panic attacks. The two groups had similar rates of panic response. These results challenge the diagnostic specificity of lactate-induced panic. PMID- 3963257 TI - Focal neurologic symptoms in panic attacks. AB - Among 350 referrals to a neurology service, 19 (5%) had panic attacks manifesting as focal neurologic symptoms. Diagnostic clues included multiple symptoms, normal results on neurologic examination, personal stress, dietary extremes, age 20-50 years, and symptom reproduction by hyperventilation. Focal neurologic symptoms should not exclude a diagnosis of panic attack. PMID- 3963258 TI - Does carbamazepine-induced reduction of plasma haloperidol levels worsen psychotic symptoms? AB - Seven psychotic patients' plasma haloperidol levels, determined with gas-liquid chromatography, fell a mean of 60% when carbamazepine treatment was instituted. Two patients' levels became undetectable, and their symptoms worsened. Haloperidol level monitoring may be required for patients given both haloperidol and carbamazepine. PMID- 3963259 TI - A reanalysis of arrest rates. PMID- 3963260 TI - Cultural diversity versus cultural uniformity. PMID- 3963261 TI - A spectrum is not a continuum. PMID- 3963262 TI - A caution against use of verapamil in phencyclidine intoxication. PMID- 3963263 TI - Phase delay and hypersomnia. PMID- 3963264 TI - Use of lithium and flupenthixol in a patient with pervasive developmental disorder. PMID- 3963265 TI - A psychiatric staff response to acquired immune deficiency syndrome. PMID- 3963266 TI - Painful postcoital testicular retraction linked with desipramine. PMID- 3963268 TI - Individualism and democracy--are they likely to exist in their present form in a postindustrial society? PMID- 3963267 TI - Adinazolam-induced mania. PMID- 3963269 TI - Patients' reactions to humorous interventions in psychotherapy. AB - This study explores the preference of patients for humorous or nonhumorous therapist interventions. Hysterical, obsessive, and depressive patients were presented with three functional kinds of humorous interventions: emotional confrontation, anxiety reduction and perspective development. The data indicate that the patients consistently favored the nonhumorous interventions, but the degree of this preference varied according to personality style. Obsessive patients stood out in their ardent repudiation of humorous interventions. The results suggest that the desirability of utilizing humor in therapy depends on a multiplicity of parameters. PMID- 3963270 TI - Law versus clinical treatment: the case of L.C.. AB - This paper defines certain conflicts between the clinical treatment process of borderline pathology in severely disturbed adolescents and the legal "patients rights" issues. It shows how these conflicts become part of the externalization of the internal splitting process in hospitalized borderline patients. It also demonstrates the sabotaging aspects of legal interventions in a treatment program that is structured for a locked inpatient unit. One case example is used to explicate these points. PMID- 3963271 TI - Psychotherapy and cognitive style. AB - Patients who have a concrete cognitive style are psychotherapeutically best treated by methods that take into account their cognitive style, whether it is defensive or results from a cognitive developmental arrest. Concrete thinking, while an obstacle to insight-oriented therapy, is no obstacle to changing attitudes and behaviors by means that do not involve the development of insight into unconscious conflict or motivation. PMID- 3963272 TI - Treating the patient who "can't" versus treating the patient who "won't". AB - Patients who can't do what they need to do should be treated differently than those who won't take responsibility for themselves. Mistakenly treating one as the other leads to a confusing sense of failure or may foster regression, and the clinical disagreement between colleagues readily takes on a characteristic moral tone. PMID- 3963273 TI - The hidden psychotherapeutic dilemma: spouse of the borderline. AB - The spouse of the borderline often presents for individual psychotherapy. This patient manifests a variety of ego-defenses and reactions. Several psychotherapeutic themes and strategies are discussed. PMID- 3963274 TI - Principles common to different short-term psychotherapies. AB - Short-term psychotherapy is a technique with a long history of development and a some solid data supporting its effectiveness. There is also some evidence for cost effectiveness in terms of medical utilization. Certain broad principles involving patient selection, relative contraindications, and treatment appear common across different therapeutic styles. PMID- 3963275 TI - Communicating the relational shift: separation among adult twins. AB - In reviewing the literature on twin separation, the authors argue that achieving a "relational shift" (the ability to separate yet retain feelings of closeness), may be problematic for this sibling group. A descriptive communication framework is presented using the concepts of relational redefinition and types of verbal and nonverbal codes. Implications are presented for twins developing third-party relationships, inseparable twins, therapy, and research. PMID- 3963276 TI - Influenza and nursing homes. PMID- 3963277 TI - How many nurse practitioners are enough? PMID- 3963278 TI - An outbreak of influenza A in a nursing home. AB - An outbreak of influenza A occurred in an elderly population in a Maryland nursing home between December 8, 1980 and January 13, 1981 and involved 76 of the 170 residents. Throat swabs from two of 10 acutely ill residents yielded influenza A virus similar to the A/Taiwan/1/79 strain. Fourfold or greater increases in the titer of complement-fixing (CF) or hemagglutination-inhibiting (HI) antibodies were detected in paired sera from four of five ill residents and from none of four well residents. One hundred (62.9 per cent) of 159 residents with known vaccination histories had been vaccinated with trivalent influenza virus vaccine in October and November 1980. Crude illness attack rates and mortality rates were similar in vaccinees and nonvaccinees. Various risk factors and hypotheses were examined in an attempt to explain the apparent lack of vaccine efficacy. PMID- 3963279 TI - Accuracy of consumer performed in-home tests for early pregnancy detection. AB - We investigated the accuracy of the in-home pregnancy test in early pregnancy detection. A total of 109 women volunteered to perform their own pregnancy test using one of three brands. Kit accuracy ranged from 45.7 per cent to 89.1 per cent (95 per cent confidence interval), differing from the 97.4 per cent average of manufacturer claims. Sensitivity was calculated at 56 per cent, while specificity was 83 per cent. Predictive value of a negative result was 56 per cent and the predictive value of a positive test was 83 per cent. PMID- 3963280 TI - Mental health and social characteristics of the homeless: a survey of mission users. AB - Selected mental health and social characteristics of 51 homeless persons drawn as a probability sample from missions are compared to those of 1,338 men aged 18-64 years living in households from the NIMH Epidemiologic Catchment Area survey conducted in Eastern Baltimore. Differences between the two groups were small with respect to age, race, education, and military service but the differences in mental health status, utilization patterns, and social dysfunction were large. About one-third of the homeless scored high on the General Health Questionnaire which measures distress. A similar proportion had a current psychiatric disorder as ascertained by the Diagnostic Interview Schedule (DIS), with the homeless exhibiting higher prevalence rates in every DIS/DSM III diagnostic category compared to domiciled men. Homeless persons reported higher rates of hospitalization than household men for both mental (33 per cent vs 5 per cent) and physical (20 per cent vs 10 per cent) problems but a lower proportion received ambulatory care (41 per cent vs 50 per cent). Social dysfunction among the homeless was indicated by fewer social contacts and higher rates of arrests as adults than domiciled men (58 per cent vs 24 per cent), including multiple arrests (38 per cent vs 9 per cent) and felony convictions (16 per cent vs 5 per cent). Implications of these findings are discussed in terms of research and health policy. PMID- 3963281 TI - IUD use and subsequent tubal ectopic pregnancy. AB - As part of a case-control study of tubal ectopic pregnancy (TEP), we sought to evaluate the possible etiologic role of use of an intrauterine device (IUD) prior to conception. We interviewed 155 women who had a tubal ectopic pregnancy treated at one of five Seattle, Washington hospitals between 1975-79 regarding their reproductive, contraceptive, and medical histories; 456 women who delivered a baby in King County during the same period were identified from vital records and interviewed as controls. An elevated risk of TEP was detected among former users of the Dalkon Shield (adjusted OR = 2.5; 95% CI = 1.3-4.7). Women who had used other IUDs did not have an excess risk of TEP. PMID- 3963282 TI - Characteristics of hazardous material spills from reporting systems in California. AB - Data on hazardous material releases that occurred between January 1, 1982 and September 30, 1983 in California were obtained from the California Highway Patrol (CHP) and the US Department of Transportation (DOT). The majority of incidents involved highway transport of hazardous materials, although some information was available on air, rail, and stationary facility releases. Vehicle accidents and failure of or damage to the container were the most frequent causes of releases. Proportionately more hazardous materials incidents occurred in early summer than at other times of the year, during weekdays, and daytime hours. The largest proportions of incidents involved the chemical categories of corrosives and fuels. Reported exposures and injuries to response personnel and other people at the scene were relatively few; no fatalities were reported. Few incidents were reported in both data sources, suggesting that the examination of only one data source would yield a gross underestimate of the total number of hazardous materials incidents in California. The lack of available denominator data limits the interpretation of the findings. PMID- 3963283 TI - Occupational and worksite norms and attitudes about smoking cessation. AB - The relationship of worksite and occupational norms about smoking to workers' attitudes toward smoking cessation was studied in a defined population. From smokers identified in a self-administered questionnaire circulated to all employees of 10 worksites in suburban Minneapolis, 447 smokers were randomly selected and interviewed. Attitudes and social norms about smoking cessation were compared by occupation and worksite using analysis of covariance, controlling for age, sex, and education. Similarly, the relationships of social norms to attitudes were examined using multiple regression analysis. Interest in quitting smoking, confidence in the ability to quit, and coworker support of prior quit attempts were equally pervasive among workers from blue collar and white collar occupations. Yet substantial differences between worksites in attitudes and norms about smoking cessation suggest the importance of the unique social milieu of individual worksites. Of particular importance is the impact of coworker discouragement of prior quit attempts, which varied across worksites and was directly related to confidence in the ability to quit and the desire to seek formal help in future quit attempts. These findings point to the relevance of intervention programs aimed at changing worksite norms about smoking and smoking cessation. PMID- 3963284 TI - Public health responsibilities, roles, and realities. PMID- 3963285 TI - Reporting the results of epidemiologic studies. PMID- 3963286 TI - Significance tests have a role in epidemiologic research: reactions to A. M. Walker. PMID- 3963287 TI - Health status and access to health services among the urban homeless. AB - Self-reported health status and access to care were reported for 238 homeless adults in Los Angeles. One-third reported their health as fair or poor; women reported more health problems than men. Half (53 per cent) of the sample reported no regular source of care, and most (81 per cent) were without health insurance. Lack of financial resources and health insurance were reported as important barriers to care. PMID- 3963288 TI - Increasing incidence of toxic shock syndrome in the 1970s. AB - To determine if there was a true increase in the incidence of toxic shock syndrome (TSS) or just increasing recognition of an old problem, we reviewed 2,145 charts of patients between the ages of 10 and 30 years with discharge diagnoses compatible with signs and symptoms of TSS. No cases were identified in 1970 and 1975, but eight cases were found in 1979 and 1980. The data suggest that an increase of TSS in this age group occurred in the late 1970s. PMID- 3963289 TI - Chemical industry accidents, liability, and community right to know. PMID- 3963290 TI - The San Francisco experience with regulation of smoking in the workplace: the first twelve months. PMID- 3963291 TI - Confidence intervals vs significance tests: quantitative interpretation. PMID- 3963292 TI - FDA's comments on in-home pregnancy tests. PMID- 3963294 TI - Content, adequacy of sex education programs. PMID- 3963293 TI - 'Totally safe sex' or AIDS. PMID- 3963295 TI - A commentary on 'The oral health of older Americans'. PMID- 3963296 TI - Analysis of antibodies against mouse spermatozoa using an enzyme-linked immunosorbent assay (ELISA). AB - Conventional techniques used for the analysis of antisperm antibodies are not suited to the mouse model because of their requirements for relatively large amounts of serum and their inability to handle large numbers of samples. This has inhibited use of the mouse as an experimental model in areas involving antisperm immunity. As the ELISA technique has been successfully applied to analysis of antisperm antibody in human sera, we investigated its use as an assay for screening antisperm antibody in mouse serum. This report describes a simplified version of the ELISA technique that we have found to be successful for this purpose. The assay described can assess levels and classes of antisperm antibody in mouse serum and can also be used as a screening assay for monoclonal antibodies to mouse sperm. It should facilitate use of the mouse in experimental work in areas involving assessment of immunity to sperm. PMID- 3963297 TI - Effect of H-2 complex on the growth of embryo-derived teratomas in mice. AB - Seven-day-old embryos of several H-2 congenic strains were transplanted under the kidney capsules of syngeneic adult recipients to determine the genetic factors(s) governing the in vivo growth of embryo-derived teratomas. A.TH(H-2t2) and A.TL(H 2t1) strains showed significantly greater tumor weights than A.BY(H-2b) and A.SW(H-2s) strains. The A(H-2a) strain was intermediate in tumor size. A comparison of the genic constitution of the H-2 complex in each congenic strain suggested that the H-2D locus and/or its distal regions affected the growth of embryo-derived teratomas. The teratoma induced in the B10.A(H-2a) strain was smaller than that in the A(H-2a) strain, indicating that the genetic background of the A strain is favorable for teratoma growth. Histological observations demonstrated that the existence of embryonal carcinoma cells was necessary for the growth of teratomas. A radiation-sensitive immunological factor in the recipient probably plays a role in stimulating teratoma growth. PMID- 3963298 TI - Inhibitors of complement-mediated cytotoxicity in normal and secondary aborter sera. AB - Sera from patients with secondary (2 degrees) spontaneous abortions contain complement-dependent cytotoxic (CDC) antibodies with specificity for paternal lymphocytes. These lymphocytotoxins are not anti-HLA (human lymphocyte antigen) as shown by their polyspecificity on HLA select cell panels and by their removal following absorption with HLA-negative trophoblast membranes. They are predominantly IgG and have been designated as trophoblast-lymphocyte cross reactive (TLX) antibodies. Normal and homologous 2 degrees aborter sera contain a CDC inhibitor that does not bind to paternal cells and must be present when complement is added to antibody. The inhibitor does not manifest anticomplement effects and appears to be species specific. Inhibitory capacity is increased by heating (56 degrees C for 30 min) and by absorption with heparin. When chromatographed on G-200 Sephadex, inhibitor appears in the void volume, suggesting a molecular weight of more than 250,000. It can be isolated from diethylaminoethyl cellulose into an euglobulin fraction that does not contain IgG, but does contain IgM, though no studies indicate the inhibitor to be IgM. We suggest that the inhibitor is under the control of a regulator molecule, probably an inhibitor-of-inhibitor, and that in 2 degrees aborter sera the equilibrium is unbalanced between antibody, inhibitor, and regulator. PMID- 3963299 TI - Hypothesis: blocking factors and human pregnancy: an alternative explanation for the success of lymphocyte transfusion therapy in abortion-prone women. AB - Recent evidence has demonstrated that the non-specific immunosuppression that develops during pregnancy is not due to the de novo synthesis of immunosuppressive factors (ISF) but is a result of the activation of pre-existing molecules. The latter are present in normal sera as inactive complexes with a molecule which is specifically depleted following conception resulting in the activation of the ISF; the depleted molecule is termed the pregnancy-depleted immunoregulatory factor (pdIRF). Since non-specific ISF are detected in various diseases, it is proposed that the ISF-pdIRF relationship observed in pregnancy is a universal phenomenon and that the depletion of pdIRF and the activation of ISF can be achieved by a variety of stimuli. It is further proposed that abortion prone women fail to adequately deplete their pdIRF levels so that the ISF are not activated. However, owing to the universal nature of the system, lymphocyte transfusion therapy supplies the necessary stimuli so that the pdIRF levels are depleted and the ISF activated which ensures a successful outcome to the pregnancy. PMID- 3963300 TI - Endotoxin: routes of transport in experimental peritonitis. AB - A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account, the thoracic duct carries 34 ng/hour and the protal vein 49 ng/hour after 2 hours of peritonitis. Endotoxin quantities transported by the portal vein never exceed the proposed endotoxin filtrating capacity of the liver. Furthermore, the onset of systemic endotoxemia parallels the appearance of endotoxin in the thoracic duct. The hypothesis put forward is that the development of systemic endotoxemia is mainly mediated by lymphatic transport. The results also indicate that endotoxin is normally absorbed from the intestine and transported by portal blood. PMID- 3963301 TI - Mechanisms of clearance from the peritoneal cavity. PMID- 3963302 TI - Histopathologic high risk factors influencing the prognosis of patients with early breast cancer (T1N0M0). AB - A retrospective study of 78 women with early breast cancer was undertaken with the aim of detecting histopathologic risk factors that would influence the prognosis of these patients. Histologic tumor type, nuclear grade of tumor, tumor margin, and lymphoid infiltration near the tumor as well as blood vessel invasion and lymphatic tumor emboli were evaluated. The overall 10 year survival rate was 79.2 percent. In correlating the aforementioned criteria against survival rate, it was found that the patients without any of the histopathologic risk factors had a 100 percent rate, whereas those with one risk factor had a 79 percent rate and those with two or more risk factors a 66 percent rate. Nuclear grade and lymphoid infiltration were found to have the highest significance in regard to recurrence and the mortality rate. The findings of this study suggest that in patients classified as having T1N0M0 disease without any of the histopathologic risk factors, operation is the only treatment indicated. Patients with one or more positive risk factors should receive adequate adjuvant therapy in order to increase their survival rate. PMID- 3963303 TI - Early discharge after modified radical mastectomy. AB - Thirty-nine patients underwent modified radical mastectomy and were discharged with their suction drains and sutures in place after a mean postoperative stay of 4.7 days. Drains and sutures were removed at the first office visit. There were no infections, and late seromas developed in only 21 percent of the patients. Another group of patients were hospitalized until drainage effluent from their tubes was less than 30 ml/day, at which time the drains were removed and the patients discharged. This group had a mean postoperative stay of 9.5 days, and an incidence of late seroma of 43 percent. These data suggest it is both safe and effective to discharge patients 3 to 5 days after mastectomy at considerable potential cost savings due to the reduced hospital stay. PMID- 3963304 TI - Evaluation of nonpalpable breast lesions. Experience in a training institution. AB - Biopsy directed by needle localization is a safe and relatively simple method of obtaining abnormal tissue for histologic examination without sacrificing surrounding normal breast tissue. In the setting of a training institution, accurate results can be expected as technical skills are obtained by a variety of housestaff. In this series of 70 biopsies, the lesion targeted on mammography was removed on the initial attempt in all but 1 instance, for an overall accuracy of 99 percent. PMID- 3963305 TI - Small bowel allografts. Sequence of histologic changes in acute and chronic rejection. AB - Using a rat model of accessory small bowel transplantation, the histologic sequence of both acute and chronic rejection in intestinal allograft rejection has been defined. Histologically, all allografts were normal for the first 5 postoperative days. Allografts with caval venous drainage were subject to acute rejection. By 6 to 7 days postoperatively, plasma cells and lymphocytes infiltrated the lamina propria of these grafts (phase I). By 8 to 9 days postoperatively, the cellular infiltration intensified and was associated with villous blunting and scattered epithelial sloughing (phase II). By the 10th day, complete mucosal destruction developed, with heavy transmural infiltration by lymphocytes, plasma cells, and polymorphonuclear leukocytes (phase III). This histologic end point of acute graft rejection was accompanied by death of the host. Grafts with portal venous drainage underwent a similar, although less rapid, sequence of histologic changes (phase I 6 to 9 days, phase II 10 to 13 days, phase III 13 or more days) resulting in graft fibrosis and encapsulation. Some variability was seen among different areas of a given circumferential cross section taken from grafts in phases I and II. Studying circumferential cross sections allowed correct classification into the appropriate phases. PMID- 3963306 TI - Intestinal transit time is delayed by artificial sphincters after massive enterectomy in dogs. AB - Artificial sphincters were created in three groups of dogs after the resection of 87.5 percent of the intestine in each animal. Intestinal transit time was measured after 6 weeks by observing the passage of a radiopaque medium through the animals' intestinal tracts. No statistically significant differences were found between the intestinal transit times of dogs with one artificial sphincter and control animals. In dogs with two artificial sphincters there was a delay in the radiologically monitored intestinal transit time that was statistically significant compared with that of the control group. PMID- 3963307 TI - Clinical and manometric evaluation of anal sphincter function in patients with rectal prolapse. AB - We studied 27 patients with rectal prolapse (7 men and 20 women). Eight patients were continent, 8 were partially incontinent, and 11 were totally incontinent. Perineal descent and an absent anocutaneous reflex were common findings, implying damage to the external anal sphincter and the pelvic floor muscles. Both partially and totally incontinent patients had significantly lower basal and voluntary contraction pressures compared with those of control subjects, which is in accordance with previous reports on the subject. Our continent patients had normal voluntary contraction pressures, but basal pressures were lower than those of the control subjects (p less than 0.02). This suggests that there may be dysfunction of the internal anal sphincter before the development of clinical symptoms of incontinence. The internal anal sphincter reflex was present in 19 patients (70 percent). It was absent in patients with very little tone of the anal canal. It seems that absence of the internal anal sphincter reflex is not invariably connected with rectal prolapse. The results of this study indicate that rectal prolapse is often associated with dysfunction of the anal sphincters, leading to incontinence. PMID- 3963308 TI - Repair of large diffuse lumbar hernias by an extraperitoneal binder technique. AB - Lumbar hernias may be classified into two broad groups. The small protrusions of fat which appear in the superior or inferior lumbar triangles and large diffuse hernias which involve the entire flank. The small hernias are easily cured by simple closure of the defect similar to the treatment of small epigastric hernias. The surgical treatment of large lumbar protrusions, utilizing fascial and prosthetic onlay grafts, is ineffective. The new technique described, which employs a large sheet of polypropylene mesh as a binder in the extraperitoneal space, effectively bridges the large defect and provides firm support for the lumbar region. PMID- 3963309 TI - A technique for safe transanal passage of the circular end-to-end stapler for low anterior anastomosis of the colon. AB - Two techniques are currently available for the creation of low anterior rectal stapled anastomoses. The first technique requires the placement of a pursestring suture at the superior margin of the rectal cuff, which is technically difficult. In the second technique, the rectal cuff is closed with a linear stapler. The circular end-to-end stapler, with the anvil removed, is then passed through an enterotomy in the rectal remnant. We describe an easy and safe method that obviates difficulties during the transanal passage of the stapler and minimizes the risk of injury to the rectum. This method uses an inexpensive and readily available rubber catheter and metal guide. PMID- 3963310 TI - Mesothelial cysts of the round ligament simulating inguinal hernia. Report of four cases and a review of the literature. AB - Cysts of the mesothelial investment of the round ligament are rare and occur in women in their late third or fourth decades. They are relatively painless, mobile, may be perceived to be reducible, and should be included in the differential diagnosis of groin masses in women. Differentiation of these cysts from a small indirect inguinal hernia, with which they are frequently associated, is difficult and may be made only at the time of operation. They are likely to be less symptomatic than inguinal hernias. Cysts should not change in size with the Valsalva maneuver, although they may become more conspicuous with coughing. The clinical manifestations of cysts of the round ligament in four patients are described, along with a discussion of their embryologic and pathologic characteristics and a summary of the world literature. An embryologic mechanism of cyst formation is proposed and diagnostic criteria are presented. Symptomatic cysts of the inguinal ligament should be excised and the inguinal canal should be explored for possible associated indirect inguinal hernias. In the absence of symptoms or of a progressive increase in size, surgical removal of a cyst of the round ligament is not mandatory. PMID- 3963311 TI - Some functional and morphologic correlates in inner ear pathologies: first observations using electrically evoked/pure tone derived potentials. AB - After reviewing a typical example of functional and morphologic correlations in a cochlear and vestibular comparative study of three aminoglycosidic antibiotics and discussing clinical and experimental observations in Meniere's disease and experimental endolymphatic hydrops, some difficulties in studying morphofunctional correlations are discussed. A particular electrophysiologic method, based on electrical stimulation of the ear and acoustic masking, notably with continuous pure tones, is illustrated in normal and pathologic experimental conditions in the guinea pig. This method, which allows the observation of frequency-specific compound responses, whatever the frequency, should find useful experimental and clinical applications, particularly because it allows accurate measurements at low frequencies. PMID- 3963312 TI - Guinea pig tectorial membrane profile in an in vitro cochlear preparation. AB - The guinea pig cochlea was examined under high-magnification light microscopy in an in vitro preparation. After extraction of the otic capsule, the bulla was opened widely and a small hole made into the fourth turn of the scala vestibuli. The organ of Corti was visualized under artificial endolymph at 600 X magnification. Added 1-micron titanium dioxide particles settled on the upper surface of the transparent tectorial membrane. Particle positions showed that much of this upper surface lay in a flat sheet that extended centrifugally almost to the Hensen's cells, giving the impression it was attached there. The sheet extended at least to the level of the inner hair cells, where a tectorial membrane thickness of about 40 micron was reached. Titanium dioxide particles were seen regularly in immediate proximity to the hair cell cilia, indicating that scala media is continuous with the subtectorial space. Upon mechanical manipulation, Hensen's cells proved to be extremely cohesive and elastic. It is suggested that hair cell stereocilia provide major mechanical connections for the tectorial membrane. PMID- 3963313 TI - Differential otomanometry. AB - Management of otitis media, both acute and chronic, is one of the most common problems in clinical medicine. Among the many unresolved issues in otitis media research is accurate diagnosis which, in turn, depends heavily on valid otoscopic observation. Yet even today clinical otoscopy remains more of an art than a science. Because precise therapy is predicated on precise diagnosis, efforts to improve the validity and reliability of otoscopic techniques are warranted. Of great importance to the otoscopist is the visual estimate of tympanic membrane mobility secondary to hand-generated pneumatic pressure (pneumotoscopy). The degree of motion is usually graded in relative terms. In addition to pneumotoscopy, tympanometry is also used to assess the status of the middle ear. This is done indirectly through the plot of induced pressure versus acoustic immitance (tympanogram). Thus, both procedures depend on the differential application of induced pneumatic pressure on the tympanic membrane. If the middle ear is air-containing and the tympanic membrane is normal, even a slight pressure rise in the ear canal will displace the membrane. If the middle ear is fluid filled, even large amounts of pressure produce no motion of the tympanic membrane. The pressure gradients, normal threshold, and optimal frequency of application for pneumotoscopy have not been studied previously in humans. Data are presented to compare the sensitivity, specificity, and predictive value of pneumotoscopy and tympanometry in the detection of effusion due to chronic secretory otitis media. In addition, preliminary data obtained by a new procedure, quantitative pneumotoscopy, are discussed. PMID- 3963314 TI - Reproducibility of standardized bronchial allergen provocation test. AB - Standardized bronchial allergen provocation was performed twice (with an interval of median 14 days (range 14-44)) in 19 extrinsic, well-defined asthmatic patients to study the reproducibility of the bronchial response. Smoking and medications were strictly withheld prior to the provocation. Ten-fold increasing concentrations of allergen solution 0.9 ml were inhaled by tidal volume breathing for 5 min at 10-min intervals. The actual dose given was expressed by the concentration of the solution used. Forced expiratory volume in the first second (FEV1) was used to determine responses, and the provocation continued until an allergen concentration (allergen PC20) was reached which caused at least 20% decrease of the post-saline FEV1. All provocations were followed by a bronchial reaction within clinically acceptable limits. The reproducibility was high, evaluated by the Spearman rank correlation coefficient Rho = 0.90 (P less than 0.01). It is concluded that bronchial provocation with allergens performed as outlined in this study represents a reproducible test which can be applied in routine allergy diagnostics, and in further investigations concerning specific bronchial reactivity. PMID- 3963315 TI - Food and fasting absorption of a single dose of a sustained release theophylline sprinkle formulation in children. AB - The bioavailability and absorption pattern of theophylline from a single dose of a slow release theophylline sprinkle product (Somophyllin) were investigated in 10 asthmatic children both in fasting conditions and after a standardized breakfast. Theophylline given intravenously was used as a reference. The fasting absorption of Somophyllin was rather fast with peak serum theophylline levels 3-5 h (mean 3.7 h) after dosing. Food produced a small but statistically significant reduction in the rate of absorption of theophylline, so that the mean time to peak serum theophylline level was 5.6 h (range 4-8 h) after food. In no case was there any important difference between the absorption profiles on the test days, and the bioavailability was complete after both fasted and fed intake of the product (92.5% and 105%, respectively). It is suggested that to obtain the optimum absorption profile children should take Somophyllin with food rather than between meals. PMID- 3963317 TI - [Effect of isoflurane on respiratory mechanics]. AB - The effects of the inhalational anaesthetic, isoflurane, on two major parameters of respiratory mechanics--resistance and compliance--were studied in a total of 30 patients. With increasing inspiratory concentrations of isoflurane, resistance was measured in 5 spontaneously breathing patients using the oscillation method. In 16 mechanically ventilated patients resistance and compliance were calculated from airway pressure, gas flow, and tidal volume. In 9 patients with asthma or COPD the course of resistance and compliance was recorded intraoperatively. An increase in resistance of up to 117% of the initial volume occurred during spontaneous respiration, and was caused by a decrease in tidal volume. During mechanical ventilation with constant tidal volume, no definite changes in resistance or compliance were seen with increasing isoflurane concentrations. In the patients with elevated airway resistance there were only minor, statistically non-significant changes in resistance and compliance. The results show that the effects of isoflurane on respiratory mechanics do not differ from those of halothane or enflurane. Therefore, isoflurane may be considered appropriate for use in patients with impaired airway resistance. PMID- 3963318 TI - [Equivalence of oral and intramuscular premedication. I. Oral versus intramuscular premedication]. AB - In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral NaCl solution; intramuscular pethidine, intramuscular droperidol/fentanyl, and intramuscular NaCl solution) were administered to 600 patients, to determine the equal efficacy of oral and intramuscular application. The results show a significantly better mode of action of oral premedication. PMID- 3963316 TI - Predictors of atopic disease: cord blood IgE and month of birth. AB - The cumulated incidence of atopic disease before 7 years of age was highly influenced by the cord blood IgE concentration and moderately influenced by the month of birth: obvious atopic disease was more than twice as common in children with high cord blood IgE and born in May than in children with a similar IgE and born in November (P less than 0.05). There was no similarly increased risk for atopic disease among those born in May with low cord blood IgE. Environmental factors thus seem important merely for a high risk population. The findings lend support to family planning when there is especially high genetic risk for atopic disease. PMID- 3963319 TI - [Equivalence of oral and intramuscular premedication. II. Effect of various conventional premedication drugs]. AB - In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral physiological NaCl solution, intramuscular pethidine, intramuscular droperidol/fentanyl, intramuscular physiological NaCl solution) were administered to 600 patients to determine the equal efficacy of the premedicative drugs in oral or parenteral administration. Patients gave the best rating to the oral application of flunitrazepam. The differences in the assessment of application and effect of the drugs are contrasted by the statement that most patients do not feel any direct influence on their preoperative anxiety by premedication. However, it is easier for them to cope with anxiety because premedication pacifies the patients, whereas each of the dependent variables, such as apprehension, is influenced differently. Oral premedication again proves superior to parenteral premedication. PMID- 3963320 TI - [Dangers in the use of high-frequency surgical instruments in anesthesiologic monitoring]. AB - Although the use of high-frequency units is routine in all surgical disciplines, there is still a justification for reminding users of the attendant risks. The most common injuries sustained by patients are burns caused by fault currents. Such risks increase when a combination of several electric devices is used, and in particular when the operation is performed with simultaneous anesthesiologic monitoring. All electrically conductive, direct or indirect contacts between the patient and the ground lead potential, and all connections resulting in a low resistance or a shorter distance between the active and "neutral" high-frequency electrode than the correct current pathway, may become competing "neutral" electrodes with high current densities. It is therefore imperative that all those involved should strictly observe the safety rules. The systematization of problem points is intended to introduce greater clarity into the relatively long list of admonitions, and to indicate possible organizational solutions. PMID- 3963321 TI - [Ability to cough following large upper abdominal and thoracoabdominal interventions]. AB - In 40 patients who underwent large abdominal or thoraco-abdominal operations, the efficacy of intentional coughing was determined by recording the peak expiratory flow rate (PEFR) of two consecutive coughs. The measurements were made preoperatively and then 1, 2, 24, and 36 hrs. postoperatively. They consisted of two series, the first one completely uninfluenced, the second one following detailed instruction and manual assistance by the therapist. Before instruction, PEFR of the first cough averaged 5070 ml/s. and statistically significantly increased to 7100 ml/s. after instruction. The postoperative values decreased to about 30% of those found preoperatively. It was not before the first postoperative day that the values began to improve to above 40%. In all instances, the absolute PEFR-values of the first cough were significantly higher by 16 to 60% than those of the second one. From the results it is concluded that, after abdominal or thoraco-abdominal surgery, continuous instruction and assistance by the personnel are crucial for the efficacy of coughing. PMID- 3963322 TI - [Determination of dobutamine levels in human plasma--methodological and clinical aspects]. AB - We developed a simple method for the routine determination of dobutamine in human plasma. With a relatively small amount of equipment--such as HPLC pump, RP 18 column, sample valve, fluorescence detector and an integrator--dobutamine levels could be determined quickly after a simple extraction procedure on Bond-Elut-CN columns. In the case of critically ill patients suffering from different kinds of shock we found a wide variation of plasma levels in arterial blood samples. Even with an exact application of dobutamine in relatively low doses of about 2.5 micrograms/kg BW/min to 5 micrograms/kg BW/min, levels reached from 26.8 to 181 micrograms/ml. In our opinion, one reason for these variations might be a differing volume of distribution caused by varying intravascular volumes in critically ill patients. A further possibility might be a different degree of sulfoconjugation of dobutamine. Therefore, the occasional occurrence of tachycardia under dobutamine therapy could be caused by relatively high plasma levels of free dobutamine. PMID- 3963323 TI - [A new compression container for pressure infusion. A modification of the Norfolk and Norwich infusion box]. PMID- 3963324 TI - [Changes in water balance and kidney function caused by cardiopulmonary bypass]. AB - The authors studied in 42 patients, 35 normotensives and 7 hypertensives, undergoing open-heart surgery, the perioperative behaviour of renal function and fluid balance. Before cardio-pulmonary bypass (CPB), there was a prerenal impairment of renal function caused by reduced fluid intake. During CPB a marked osmolal diuresis without tubular failure occurred. The amount of positive fluid balance was proportional to the duration of CPB. In those hypertensive patients in whom CPB perfusion pressure was below 50 mmHg, the creatinine clearance decreased by 67% during this period. The results indicate that the extent of CPB induced renal dysfunction is tolerable and does not result in renal failure provided an adequate perfusion pressure is maintained. However, the consequences of marked water retention for undisturbed vital organ function must be taken into consideration. PMID- 3963325 TI - [Antithrombin III behavior in open heart operations in infancy and early childhood]. AB - Antithrombin III activity was evaluated preoperatively, intraoperatively and postoperatively in the plasma of 54 children with congenital heart disease undergoing open heart surgery. The patients were divided into an acyanotic and a cyanotic group. A comparison of these two groups indicated a significantly decreased AT III activity in cyanotic children as compared to acyanotic children throughout the perioperative phase. AT III levels decreased in the cyanotic group from 71.9 +/- 3.77% preoperatively to 61.5 +/- 2.15% (p less than 0.01) postoperatively and rose to 69.6 +/- 2.36% (p less than 0.01) on the first and to 78.9 +/- 2.24% (p less than 0.01) on the second postoperative day. In the acyanotic group AT III levels decreased from 84.3 +/- 1.98% to 73 +/- 2.97% (p less than 0.01) postoperatively and increased to 78.5 +/- 2.96% (p less than 0.01) on the first and to 90.2 +/- 3.06% on the second postoperative day. A few acyanotic patients, too, showed decreased values of AT III. However, they were never found to be as low as in the cyanotic group. Preoperative AT III values as well as the severity of underlying disease, the success of corrective surgical treatment and postoperative complications proved to be the predominant influencing factors of AT III activity. PMID- 3963326 TI - A crisis of learning in anaesthesia. PMID- 3963327 TI - Plasma cholinesterase changes during the puerperium. AB - Changes in plasma cholinesterase activity during the puerperium were studied in 16 women who received epidural analgesia for labour followed by vaginal delivery, and in five women who underwent elective Caesarean section under epidural analgesia. A consistent fall in cholinesterase activity was demonstrated during the first 2 to 3 days post partum, followed by a rise to approximately normal nonpregnant values by the end of the puerperium. An additional patient who manifested prolonged paralysis following an emergency Caesarean section under general anaesthesia, including a suxamethonium infusion, was also studied. Possible mechanisms by which the transient decrease in cholinesterase activity is produced, and its clinical significance, are discussed. PMID- 3963328 TI - Diabetes mellitus and open heart surgery. A simple, practical closed-loop insulin infusion system for blood glucose control. AB - A method, based on bedside determinations of blood glucose by nursing staff, was designed to control the administration of insulin to diabetic patients during and following open heart surgery. A computer-controlled intravenous infusion pump was used to deliver the insulin. Excellent control of the hyperglycaemia normally associated with open heart surgery was achieved, with 84 percent of measured blood glucose values falling within 2 mmol/litre of the target value of 6 mmol/litre. The method proved to be simple, effective, and safe. PMID- 3963329 TI - Anxiety levels in junior anaesthetists during early training. AB - Trait anxiety levels (predisposition to anxiety) and personality profiles were recorded in four novice anaesthetists prior to the start of their training in anaesthesia. State anxiety (the extent of anxiety at the moment of testing) was also assessed before and after the transition from accompanied to solo anaesthetic practice. There was no demonstrable difference in anxiety scores as a result of 'going solo' in any subject. PMID- 3963330 TI - Blood glucose in anaesthetised children. Comparison of blood glucose concentrations in children fasted for morning and afternoon surgery. AB - Blood glucose levels were measured immediately after induction of anaesthesia and again intraoperatively in 26 children fasted overnight for operations in the morning and 28 children fasted from 8.00 a.m. for afternoon surgery. The mean post-induction glucose concentration of the afternoon surgery group was significantly lower than that of the morning group. However, no child in either group was hypoglycaemic. Anesthesia and surgery caused significant increases in blood glucose levels. It is concluded that pre-operative fasting is well tolerated in healthy pre-school children, regardless of the timing of surgery. PMID- 3963331 TI - Intubating conditions following pre-induction priming with alcuronium. AB - Three priming doses of alcuronium have been investigated and, using a logistic transformation technique, the priming dose required to produce adequate intubating conditions in 99% of patients at 60 seconds following the second dose of alcuronium has been deduced. This dose, 106.5 micrograms/kg is extremely high and may be unsafe if used, since 30% of our patients complained of side effects when given a priming dose of only 50 micrograms/kg. PMID- 3963332 TI - Pressure changes in tracheal tube cuffs. PMID- 3963333 TI - The stability of preservative-free morphine in plastic syringes. AB - The stability of preservative-free morphine in plastic syringes over 36 hours in the range of concentrations commonly used in our hospital to provide continuous morphine infusions was investigated. The morphine concentration remained at 100% (SD 1.5 percent) of the control values over 36 hours and demonstrates that the concentration of morphine is not reduced with time in these circumstances. PMID- 3963334 TI - The Nellcor N-101 pulse oximeter. A clinical evaluation in anaesthesia and intensive care. AB - The accuracy of the Nellcor N-101 pulse oximeter has been evaluated in adult patients receiving general anaesthesia or intensive care. Readings obtained noninvasively with this instrument were compared with measurements made on arterial blood using a Radiometer OSM2 oximeter. The pulse oximeter was easy to use and within the range tested (70-100 percent saturation of haemoglobin with oxygen) the readings were within I digit of the values obtained by in vitro measurement. PMID- 3963335 TI - Force exerted by epidural catheters. AB - In a study of epidural catheters, it was found that catheter material and catheter diameter both influenced in force exerted. Catheters made of nylon exert less force than those made of polyethylene. Diameter is proportional to the logarithm of force exerted. PMID- 3963336 TI - Halothane and trichloroethylene. Two agents in a single vaporizer. AB - The vapour pressures of static mixtures of halothane and trichloroethylene and the output of the two vapours from an Oxford Miniature Vaporizer filled with mixtures of the two liquids have been studied. In a small pilot study, a mixture of halothane and trichloroethylene was used for drawover anaesthesia in patients having minor surgery; this seems to work satisfactorily and may have some limited applications. PMID- 3963337 TI - Clinical automatic control of neuromuscular blockade. AB - A simple feedback control technique has been used to automatically deliver pancuronium to anaesthetised surgical patients. The dosage rate is automatically adjusted at 10-second intervals, according to the measured evoked, rectified, integrated electromyogram. When set to demand 80 percent blockade, in 40 patients, the controller maintained blockade at a steady mean level of 72.9 percent (consuming pancuronium at a mean rate of 0.47 microgram/kg/minute). The main clinical practical problems involved protection against electrical noise and the need to spend time setting up the equipment. PMID- 3963338 TI - Accuracy of the Datex Normac anaesthetic vapour analyser. PMID- 3963339 TI - Recurrent failure of a monitored dial mixer. PMID- 3963340 TI - Emergency anaesthesia in a patient with plasma cholinesterase deficiency. PMID- 3963341 TI - Depression and anxiety in pain clinics. PMID- 3963342 TI - The 'wake-up test'. PMID- 3963343 TI - Formalin toxicity in hydatid liver disease. PMID- 3963344 TI - High frequency jet ventilation through a Robertshaw double lumen tube. PMID- 3963345 TI - Hallucinations after oral lorazepam in children. PMID- 3963346 TI - Puncture of the ascending aorta--a complication of subclavian venous cannulation. PMID- 3963347 TI - Eye to eye with Murphy's law. PMID- 3963348 TI - The end of the crystalloid era? PMID- 3963349 TI - Inhalation of a minitracheotomy tube. PMID- 3963350 TI - [Effect of prior operations on fear of anesthesia and surgery in young children]. AB - From the standpoint of behavior therapists three different prognoses are possible for the behavior of preschool-children with prior operations when they undergo a new operation: 1. The pain of the prior operation has led to classical conditioned surgical phobias (conditioning paradigm); 2. during prior operations the pain was suppressed by anaesthetics, therefore a classical conditioning of surgical phobias cannot have happened, and as a consequence the behavior before a new operation is not predictable; 3. prior operations have led to habituation and extinction of phobias (habituation paradigm). By comparing two groups of children all aged between 2 and 6 years, one group with at least one prior operation, the other undergoing the first operation in their lives, an empirical decision between the proposals is sought. N = 66 children (none with an acute indication for surgery) were observed immediately before premedication and again immediately before anaesthetization; the anxiety of the children was scaled on 8 rating scales. Posthoc the children were classified as prior operated or first operated according to their medical history. Statistical analysis of the data reveals that children with prior operations in their lives behave significantly more anxiously immediately before premedication compared with first operated children. After premedication immediately before anaesthesia the difference between the two groups is at random. The authors conclude that prior operations must have been associated with pain, which led to the conditioning of surgical phobias; they cannot exclude the possibility that conditioning could have happened both before and after surgery. Implications for post-surgery-care are discussed. PMID- 3963351 TI - [High-dose piritramide basal anesthesia in experimental anesthesia and surgery]. AB - On the basis of investigations of three groups of dogs (7 in each) the effects of high dosage piritramide anesthesia were analyzed. Using a standardized technique no significant changes in hemodynamics and microcirculation were found during 4 h. So variations in the "steady-state" must be attributed to additional medication or therapeutic intervention. High dosage piritramide anesthesia has been applied in more than 250 animal experiments. PMID- 3963352 TI - [Pulse oximetry as a continuous, noninvasive monitoring procedure. Comparison of 2 instruments]. AB - Pulse oximetry allows continuous registration of the arterial oxygen saturation by using the light absorption in a wave range between 600 and 1,000 nm. In addition the peripheral pulse is determined by a plethysmographic method. Two new devices, the Biox III pulse oximeter and the Nellcor pulse oximeter were compared for the following three items: 1. The accuracy in comparison with a simultaneously determined arterial oxygen saturation. Concerning the Biox III instrument, the correlation coefficient resulted in r = 0.90, for the Nellcor device in r = 0.92. 2. The onset time for registering a suddenly appearing hypoxia: For the Biox III oximeter we found a time lag between 6 and 42 s (median 21 s), for the Nellcor Oximeter between 12-39 s (median 21 s). 3. The pulse frequency corresponded very well with the simultaneously registered heart rate of the ECG. Our results indicate that pulse oximetry--a continuous and noninvasive method--is a reliable monitor for oxygen saturation, and provides trend informations about circulation, both of which are particularly appropriate for patients breathing spontaneously. PMID- 3963353 TI - [Initial experiences with the new LF-1 intubation fiberscope]. AB - A new fiberoptic endoscope is presented for the special situation of endotracheal intubation only in anesthesiological and intensive care. There is quite an improved cost efficiency due to decreased price, considering its variety of uses. PMID- 3963354 TI - [Decubitus ulcer prevention in the nasal ala using Silastic foam in nasotracheal intubated patients]. AB - One of the most frequent causes of early reintubation through the other nostril or a tracheostomy is necrosis due to pressure in the region of the nares. Based on experience in 85 long-term intubated patients, prophylaxis with Silastik foam appears to be most efficient. It is inexpensive and easy to handle and can therefore be highly recommended. PMID- 3963355 TI - [Hemodynamic effects of nalbuphine in patients with acute respiratory insufficiency]. AB - Examination of haemodynamic changes, after 20 mg nalbuphine had been administered IV to 11 ventilated patients with acute respiratory failure, showed that on average pulmonary arterial mean pressure increased by 8% of the initial value. This increase was reversed after the test dosage was doubled from 20 mg to 40 mg nalbuphine. Regression analysis of the correlation between changes in pulmonary arterial mean pressure and patient age resulted in an increase in mean pressure by 0.1 mmHg per year after 20 mg nalbuphine. These findings suggest that nalbuphine must be carefully monitored in elderly and pulmonary risk patients. PMID- 3963356 TI - [Effect of nalbuphine on respiration]. AB - The respiratory depressant effects of 0.25 mg/kg nalbuphine were analyzed in detail in seven healthy volunteers by determining the CO2 response (Read's method) and the mouth occlusion pressure (Whitelaw's method) before and 10, 30 and 60 min after administration of the drug. Minute ventilation VE (PACO2 = 55 mm Hg) decreased after nalbuphine by a maximum of 36.4% (P less than 0.05). Simultaneously, the slope of the right-shifted CO2 response curve was diminished by 21.1% (NS) while the mouth occlusion pressure decreased by 36.3% (P less than 0.05), respectively. There were only slight changes in mean inspiratory flow rate. These findings demonstrate that nalbuphine does not lead to relevant impairment of central respiratory regulation or respiratory mechanics. PMID- 3963357 TI - [German Anesthesia Congress 1986. Annual meeting of the German Society for Anesthesiology and Intensive Care Medicine. Wiesbaden, 4-9 March 1986. Abstracts]. PMID- 3963358 TI - [Aortofemoral bifurcation bypass. Effect of the anesthesia procedure (NLA, thoracic continuous catheter peridural anesthesia) on circulation, respiration and metabolism. Homeostasis and oxygen transport]. AB - 50 patients were investigated during induction of anaesthesia and infrarenal aortic bypass surgery. 26 were operated on under neuroleptanaesthesia (NA group) and 24 under continuous epidural combined with a light general anaesthesia (epidural group). Blood losses were replaced with 5 per cent human albumin, red cell concentrates, and fresh frozen plasma. Ringer lactate solution was used to replace the functional extracellular fluid volume. During induction and maintenance of anaesthesia body temperature fell (NA group from 36.7 to 35.3 degrees C; epidural group from 36.7 to 34.9 degrees C) but no statistically significant difference could be found between the groups, in spite of better surface perfusion of the lower part of the body in the epidural group. The increase of plasma glucose concentration was lower in the epidural group as compared to the NA group. Stress mediated hypokalaemia was of the same degree in both groups, the median values of the plasma potassium concentrations being in the lower reference range (3.5-3.7 mmol X 1(-1], although large amounts of red cell concentrates were given. During clamping of the aorta a moderate compensated acidosis developed in both groups. Declamping caused a more marked increase of paCO2 and a greater fall of pH in the NA group as compared to the epidural group. Induction of anaesthesia was followed by a fall in oxygen uptake (NA group from 221 to 163 ml X min-1; epidural group from 230 to 189 ml X min-1) which appears to be delayed in the epidural group, with a short lasting statistically significant difference between the groups after eventration of the gut (NA group: 162 ml X min-1 less than epidural group 184 ml X min-1). Later on, oxygen uptake was equal in both groups, with no further changes due to clamping or declamping of the aorta. At the end of the operation, when nitrous oxide had been turned of, the oxygen uptake increased considerably in several patients, despite continuing artificial ventilation and intravenous hypnotics and analgesics having been given. Eventration and exterioration of the gut caused the most marked changes in haemodynamics and oxygen transport with significant differences between the groups. Immediately after eventration there was a sudden fall in paO2 in both groups (NA group from 99 to 83 mm Hg; epidural group from 96 to 84 mm Hg) and an increase of the calculated intrapulmonary right-to-left-shunt (NA group from 7 to 21%; epidural group from 10 to 19%).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3963359 TI - Purification of small oligonucleotides by polyacrylamide gel electrophoresis and transfer to diethylaminoethyl paper. AB - The application of polyacrylamide gel electrophoresis with subsequent electroelution onto DEAE paper for the purification of small oligonucleotides is described. We demonstrate that synthetic DNAs and hydrolyzed RNAs as small as three nucleotides in length can be purified by this technique. The product is undegraded and homogeneous in length. PMID- 3963360 TI - Recovery of tryptophan from 25-minute acid hydrolysates of protein. AB - It was found that thioglycolic acid prevents destruction of tryptophan during rapid hydrolysis of protein with a trifluoroacetic acid/HCl mixture (1:2, v/v) at 166 degrees C for 25 or 50 min. The addition of 5% (v/v) thioglycolic acid gave the maximum tryptophan recovery (88.3%) for a 25-min hydrolysate of lysozyme. Tryptophan recoveries varied slightly among three different proteins; 88% for lysozyme, 73% for alpha-chymotrypsinogen A, and 85% for apomyoglobin. However, when extrapolated to zero time, the values were close to one another: 94, 87, and 88%, respectively. The addition of thioglycolic acid was also advantageous for recovering amino acids other than tryptophan. Particularly, yields of carboxymethylcysteine and methionine were greatly improved. This modified rapid hydrolysis method gave satisfactory results without the need for separate analyses of tryptophan and cysteine, provided proteins were reduced and carboxymethylated prior to hydrolysis. PMID- 3963361 TI - Determination of the critical micelle concentration of surfactants using the fluorescent probe N-phenyl-1-naphthylamine. AB - The fluorescence quantum yield of N-phenyl-1-naphthylamine (NPN) increases about 10-fold and the wavelength of maximum fluorescence emission is blue-shifted when this molecule partitions into the apolar core of micellar structures from the aqueous phase. This property allowed the utilization of NPN as a fluorescent indicator of micelle formation by 14 different surfactants belonging to the families of alkyltrimethylammonium halides, alkylsulfates, alkylbetaines, alkylglucosides, and bile salts. The critical micelle concentrations (CMCs) determined with NPN agreed well with literature values. In this work NPN was used at a concentration of 10(-6) M which allowed determination of CMCs in the range between approximately 10(-5) and greater than 10(-2) M. With high-sensitivity instrumentation considerably lower NPN concentrations can be used and consequently considerably lower CMCs can be rapidly and accurately determined. PMID- 3963362 TI - Determination of the concentration and specific activity of acetone in biological fluids. AB - The concentration of acetone dissolved in liver perfusion medium was determined by injection of the sample into a gas chromatograph equipped with a Carbopack/Carbowax-packed glass column. Interference from labile acetoacetate which readily decomposes to acetone was eliminated by treating the samples with NaBH4 prior to the analysis. Acetone was detected and quantified as 2-propanol. Separation of labeled 2-propanol in the sample by high-performance liquid chromatography allowed the determination of its specific activity. These methods make possible the convenient and rapid determination of acetone concentration and specific activity in biological samples. PMID- 3963363 TI - Sizing and separation of liposomes, biological vesicles, and viruses by high performance liquid chromatography. AB - The ability of an HPLC gel exclusion column (TSK G6000PW) to separate lipid vesicles, viruses, and biological vesicles according to size was tested and compared with separations on Sephacryl S1000. The columns were calibrated using vesicular Stokes radii determined by quasielastic light scattering. The vesicles separated according to size on both types of column and remained intact during elution. Viruses of known diameters and clathrin-coated vesicles were also eluted as a function of size. The TSK G6000PW column was able to separate larger particles (greater than 500 nm) than the Sephacryl S1000, and, when used in combination with the TSK G5000PW column, gave more discrete separations of smaller particles (10 to 30 nm diameter). Moreover, the HPLC columns can be run significantly faster (10-20 min vs several hours) and give more precise results than Sephacryl S1000. Therefore, HPLC using a G6000PW column alone, or in combination with a G5000PW column, provides a rapid and accurate means of sizing and selecting specifically sized biological and artificial vesicles. PMID- 3963364 TI - Genomic 5-methylcytosine determination by 32P-postlabeling analysis. AB - A simple and sensitive method for the quantitation of 5-methyldeoxycytidine in DNA has been developed by the adaptation of the Randerath 32P-postlabeling technique. Nucleic acids were digested to 3'-monophosphate nucleotides, which were converted to 32P-labeled 3',5'-bisphosphate nucleotides, the 3'-phosphate was cleaved by the action of nuclease P1, and the resultant 5'-[32P] monophosphate nucleotides were separated by two-dimensional thin-layer chromatography. Less than 1 microgram of DNA was required for the precise quantitation of 5-methyldeoxycytidine content to a detectable limit of 0.01% of the total cytidine residues methylated. The genomic 5-methyldeoxycytidine content may thus be quantitated in tissue samples, small or selective cell populations, senescing or terminally differentiating cells, or DNA from any source. We report here, for the first time, the genomic 5-methyldeoxycytidine content of normal human bronchial epithelial and normal human pulmonary mesothelial cells. The chromatographic separation of all of the normal and some of the rare monophosphate deoxyribonucleotides and ribonucleotides has been characterized. Thus, 5-bromodeoxyuridine and the RNA contamination of DNA or the DNA contamination of RNA can also be quantitated during the same analysis. PMID- 3963366 TI - Technique and apparatus for automated fractionation of the contents of small centrifuge tubes: application to analytical ultracentrifugation. AB - An automated method is described for dividing the contents of small cylindrical centrifuge tubes into fractions deriving from laminae of solution as thin as 0.1 mm in the direction of the cylindrical axis. Experimental data are presented to demonstrate that fractions as small as 1 microliter may be prepared with a standard deviation of less than 3% in volume delivery and that negligible mixing occurs between the contents of adjacent fractions during the fractionation procedure. The method has been used to quantitate the gradients of a variety of radiolabeled proteins formed in sedimentation velocity and sedimentation equilibrium experiments. Sedimentation coefficients and molecular weights calculated from the gradients obtained agree well with literature values and with values obtained by optically scanning the centrifuge tubes (A.K. Attri and A.P. Minton, 1983, Anal. Biochem. 133, 142-152; 1984, Anal. Biochem. 136, 407-415). The present technique combines a spatial resolution equal to that of optical methods of gradient measurement with a sensitivity which may be several orders of magnitude greater, depending upon the specific activity of labeled solute. PMID- 3963365 TI - Determination of impurities in nucleoside 3'-phosphoramidites by fast atom bombardment mass spectrometry. AB - Negative-ion fast atom bombardment mass spectrometry is quite useful for the identification of products and by-products formed during the synthesis of nucleoside 3'-phosphoramidites. The data show that detritylation and oxidation are side reactions which occur during the synthesis of monomeric units used in the construction of oligodeoxyribonucleotides by the phosphite triester method. PMID- 3963367 TI - Biotinylated proteins as molecular weight standards on Western blots. AB - Protein molecular weight standards were biotinylated by reaction with biotinyl-N hydroxysuccinimide ester. The biotinylated proteins were resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and electrophoretically transferred to nitrocellulose paper. The resolved protein bands were detected by formation of a streptavidin-biotin/horseradish peroxidase complex and reaction with 4-chloro-1-naphthol and hydrogen peroxide. The biotinylated proteins are easy to prepare and are useful as molecular weight standards with most procedures employing immunodetection of proteins following transfer to nitrocellulose paper. PMID- 3963368 TI - Determination of a particle's radius by two-dimensional agarose gel electrophoresis. AB - Electrophoresis in an agarose gel dilute enough to be almost nonretarding, followed by electrophoresis in an orthogonal direction into a more concentrated agarose gel, has been developed as a procedure to determine the radius of spherical particles. Unlike procedures of unidirectional electrophoresis in a single gel, the above procedure can be used to compare the radii of particles that differ in solid-support-free electrophoretic mobility. Accuracy of 0.3 nm has been achieved with particles 30 nm in radius. It was found that the apparent radius of the spherical capsid of bacteriophage P22 decreased by 3% during elevated temperature-induced ejection of DNA from the capsid. Though originally designed for use with multimolecular particles, the procedure described here should also be useful with monomolecular particles. PMID- 3963369 TI - Quantifying adductive modification of hemoglobin from mice exposed to benzo[a]pyrene. AB - The present work describes a method for the detection of minute amounts of benzo[a]pyrene, as the diolepoxide metabolite, bound covalently to the hemoglobin of erythrocytes isolated from mice previously exposed to the carcinogen. The technique consists of the acid-induced removal of the pyrenyl moiety from the hemoglobin as the strongly fluorescent free tetrols and their isolation by bonded phase extraction methods and subsequent quantitation by fluorescence/HPLC. With this procedure as little as 5 pg of tetrol can be detected. The assay was used to determine the amount of benzo[a]pyrene-hemoglobin adduct formation in mice bearing a carcinogen-induced fibrosarcoma. PMID- 3963371 TI - Immobilization of uricase on protamine bound to glass beads and its application to determination of uric acid. AB - Uricase was found to be stabilized by protamine from salmon testis. Protamine was then bound to controlled-pore glass beads aminohexyl CPG 500 using glutaraldehyde. Microbial uricase was readily immobilized on the protamine bound to glass beads. The immobilized uricase proved to be stable even at 70 degrees C, whereas free uricase was inactivated at 45 degrees C and showed activity over a broader pH range than free uricase. Automated analysis of uric acid was facilitated using the immobilized uricase. The standard curve for uric acid was linear in the range of 2 to 10 micrograms/sample and passed through the origin. This automated procedure was also applicable to the determination of uric acid in human serum. Protamine bound to glass beads is expected to be useful for the simple immobilization and stabilization of enzymes. PMID- 3963370 TI - A small-scale five-hour procedure for isolating multiple samples of CsCl-purified DNA: application to isolations from mammalian, insect, higher plant, algal, yeast, and bacterial sources. AB - A rapid and simple procedure is described for obtaining CsCl-purified DNA from multiple small samples of cells or tissue. The DNA is recovered in a high molecular-weight form (greater than or equal to 50 kb) that is readily cleaved with restriction enzymes. Sufficient quantities of DNA (10-50 micrograms) are recovered to allow multiple analyses by Southern blotting and most cloning procedures. The isolation procedure involves addition of intact cells or powders of frozen tissues directly to a simple lysis buffer containing detergent (sodium dodecyl sulfate or sodium sarcosinate) and high concentrations of EDTA. Ultra high-speed centrifugation of CsCl gradients allows the isolation of DNA from 10 different samples in as little as 5 h. Applications are described for mammalian cells (HeLa cells), insect tissues (Drosophila melanogaster adults and pupa, Manduca sexta pupa, and Musca domestica pupa), higher plant tissues (Vicia faba leaves and meristems), algal cells (walled and wall-less Chlamydomonas reinhardi), yeast cells (Saccharomyces cerevisiae), and bacterial cells (Escherichia coli spheroplasts for preparation of both chromosomal and plasmid DNA). The procedure can be scaled up with larger sample sizes and longer centrifugation times to provide bulk quantities of DNA. PMID- 3963372 TI - Quantitative fluorographic detection of 3H and 14C on two-dimensional thin-layer chromatographic sheets by an ultra-high-sensitivity TV camera system. AB - A method for quantitative detection of 3H and 14C on thin layers is described. After impregnation of the TLC sheet with 50% 2,5-diphenyloxazole-tetrahydrofuran, quantitative imaging of the distribution of weak beta-ray-emitting isotopes on the chromatogram was carried out at room temperature by using a TV camera system, which consisted of a two-stage microchannel plate image intensifier, a low-lag vidicon, and an image processor. The method is applicable for 14C- and 3H-labeled samples on TLC sheets (10 X 10 cm) emitting more than 0.17 and 7.5 Bq/mm2, respectively. The method is rapid and has a dynamic range far greater than that of film. PMID- 3963373 TI - Studies on the Amadori rearrangement in a model system: chromatographic isolation of intermediates and product. AB - The pH profile of the reaction of glyceraldehyde with either valylhistidine or alanylhistidine exhibits an optimum near pH 6.5. One of the intermediates in the reaction, the Schiff base (aldimine), can be readily detected on an amino acid analyzer. The product of the reaction, the ketoamine formed after Amadori rearrangement of the aldimine, has been isolated by chromatography on Dowex 50. Its structure has been established by elemental analysis, amino acid analysis, and the relative amounts of carbonyl and histidine moieties. These chromatographic systems should facilitate studies on the mechanism of this reaction as it relates to peptides and proteins. PMID- 3963374 TI - An isoelectric focusing procedure for erythrocyte membrane proteins and its use for two-dimensional electrophoresis. AB - Procedures are described and evaluated for one-dimensional isoelectric focusing of erythrocyte membrane dissolved in lysine, urea, and Triton X-100 without using sodium dodecyl sulfate (SDS) and for two-dimensional electrophoresis with SDS in the second dimension. The membrane was completely dissolved, most of the proteins including the anion porter(s) entered the focusing gel, and complex, well resolved patterns were seen. Ampholines, 2-mercaptoethanol, or SDS in the applied sample each seriously reduced focusing resolution and phenylmethylsulfonyl fluoride blurred the patterns. The two-dimensional patterns showed more and sharper spots than did patterns obtained from membrane initially dissolved with SDS. Anion porter spots were seen with both procedures. However, major cytoskeletal proteins were much less well recovered with the former procedure than with the latter. PMID- 3963375 TI - Determination of beta-phenylethylamine concentrations in human plasma, platelets, and urine and in animal tissues by high-performance liquid chromatography with fluorometric detection. AB - A highly sensitive method for the determination of beta-phenylethylamine in human plasma, platelets, and urine and in mouse tissue is described. The method is based on a two-step isolation using cation-exchange columns followed by reverse phase high-performance liquid chromatography with fluorometric detection. The recovery of the amine through the whole procedure was almost complete, ranging from 99 to 101%. The calibration graph appeared linear over the range of 50 to 5000 pg/injection. Urinary excretion of beta-phenylethylamine in humans ranged from 0.93 to 51.20 ng/mg creatinine. The amine was also detectable in plasma and platelets. Of the various mouse tissues examined, the highest concentrations were found in the small intestine, followed by the blood and liver. Concentrations of about 5 ng/g wet wt were detected in brain tissue, which increased remarkably after inhibition of monoamine oxidase by pargyline. PMID- 3963376 TI - 3-Hydroxybenzo[a]pyrene glucuronidation by cells: a direct fluorometric assay in culture medium. AB - A direct fluorometric assay for measuring the glucuronidation by cultured cells using 3-hydroxybenzo[a]pyrene (less than 1 microM) as substrate is described. The method is based on the different characteristics in the fluorescence spectra of 3 hydroxybenzo[a]pyrene and benzo[a]pyrene-3-glucuronide. The analytical procedure operates directly on the culture medium without extraction steps. The sensitivity of detection is 1 nmol glucuronide/1 mumol substrate. PMID- 3963377 TI - Single-step, quantitative derivatization of amino, carboxyl, and hydroxyl groups in iodothyronine amino acids with ethanolic pivalic anhydride containing 4 dimethylaminopyridine. AB - Reaction of thyroxine with ethanol and pivalic anhydride in the presence of 4 dimethylaminopyridine quantitatively forms N,O-dipivalyl thyroxine ethyl ester. Other iodothyronines react similarly and the procedure is moisture insensitive. Apparently this reaction is successful, in contrast to similar procedures reported for the derivatization of alpha-amino acids, because it overcomes the problem in other procedures of irreversible side reactions arising from an oxazolone intermediate. PMID- 3963378 TI - Immunoaffinity purification of the lipid transfer protein complex directly from human plasma. AB - The human cholesteryl ester (CE) and triglyceride (TG) exchange protein (denoted LTC or lipid transfer complex) was isolated in a single step from plasma using immunoaffinity batch extraction. Antibodies were raised against two preparations of conventionally purified LTC. LTC-I and LTC-II (purified 20,000-fold and 3500 fold, respectively) were used as immunogens. The antiLTC antibodies were isolated by anion-exchange chromatography and coupled to Affi-Gel 10. Chromatography of plasma on antiLTC Affi-Gel removed all of the CE and TG transfer activity. Moreover, LTC prepared from both antiLTC-I and antiLTC-II-Affi-Gel matrices were identical when analyzed by sodium dodecyl sulfate-polyacrylamide gel LTC electrophoresis. LTC exhibited two protein bands of Mr (apparent) 67,000 and 58,000 and a broad, faintly staining region at greater than 150,000. Analysis of LTC by immunoblotting indicated that both antiLTC-I and antiLTC-II antibodies recognized the same LTC proteins. Isoelectric focussing of LTC gave two pI values, 5.2 and 8.7. These data suggest that LTC is a complex of specific proteins and perhaps lipid. Specific CE and TG exchange activities of immunoaffinity-purified LTC were comparable, although the activities were low with respect to that of the antigen used to generate antiLTC-I. This is not due to contamination of LTC by albumin, lecithin:cholesterol acyltransferase, or apolipoproteins AI, AII, B, CIII, D, or E. PMID- 3963379 TI - Quantitation of biological retinoids by high-pressure liquid chromatography: primary internal standardization using tritiated retinoids. AB - A single method is described for quantitation of 14 retinoids found in biological material. The method consists of reversed-phase HPLC, internal standardization, and carrier extraction procedures with three synthetic retinoids. Primary standardization of HPLC uv detector is achieved using tritiated all-trans retinoic acid, all-trans-retinol, all-trans-retinyl palmitate, and all-trans retinyl acetate. Extraction methods are standardized by correlating the uv absorbance of retinoids at 340 nm with radioactivity of tritiated retinoids of known specific activity. Quantitation of 10 pg of tritiated or 5 ng of nonradioactive retinoid per 0.1 g sample in a polarity range from 4-oxo-retinoic acid to retinyl stearate can be achieved in a single, 50-min chromatographic run. A single HPLC pump, a C18 reversed-phase analytical column, a multistep three solvent gradient, and inexpensive solvents based on methanol, water, and chloroform comprise this cost-effective chromatographic system. Our primary standardization method allows investigators employing different procedures to compare results between laboratories by standardizing the HPLC uv detector with commercially available tritiated retinoids. With this method we were able to quantitate nanomolar amounts of endogenous retinoic acids and retinyl esters, that "HPLC uv only" conditions usually would not detect in the circulation and liver of rats under physiological conditions. PMID- 3963380 TI - Purification, solubility, and pKa of veratridine. AB - The alkaloid neurotoxin veratridine is widely used by cell physiologists to increase membrane sodium permeability. The compound is only sporadically available from commercial sources, but can be purified (Kupchan et al., 1953, J. Amer. Chem. Soc. 75, 5519-5524) from veratrine, a mixture of several alkaloids. We describe here a purification procedure only slightly modified from that of Kupchan et al., and include important details not mentioned in the original paper. Ultraviolet and infrared spectra are presented. We have also determined the pKa and solubility of veratridine in 150 mM NaCl at 25 degrees C. The solubility is steeply pH dependent, ranging from 0.61 +/- 0.02 mM above pH 12 to 18.5 mM at pH 8.07. The pKa, determined from the solubility versus pH curve, was found to be 9.54 +/- 0.02. PMID- 3963381 TI - High-performance liquid chromatographic analysis of 2-aminofluorene and its metabolites in monolayer cultures of rat hepatocytes. AB - A high-pressure liquid chromatography method was developed to separate 2 aminofluorene and several ring-hydroxylated metabolites. The acetylated derivatives of these compounds and N-hydroxy-2-acetylaminofluorene were also separated simultaneously. HPLC analyses were performed using a Dupont Zorbax C-8 HPLC column and a solvent mixture of 0.02 M acetic acid and isopropanol. Isopropanol concentrations were increased from 27 to 100% over 45 min using a concave gradient system. Desferal mesylate was added to the aqueous component to improve the resolution of several hydroxylated arylamine metabolites. The method was used to quantitate the metabolites of 2-aminofluorene in monolayer cultures of rat hepatocytes. PMID- 3963382 TI - Determination of short-chain acyl-coenzyme A esters by high-performance liquid chromatography. AB - A method for the determination of short-chain acyl-CoA esters in tissue extracts by HPLC has been developed. The acyl-CoA esters were extracted from freeze clamped rat livers with perchloric acid. The extract was applied to a Sep-Pak C18 cartridge. The cartridge was washed with acidic water, pH 3, followed by petroleum ether, chloroform, and methanol. Then the acyl-CoA esters were eluted from the cartridge with ethanol/water (65:35) containing 0.1 M ammonium acetate. By this procedure, the acyl-CoA esters were concentrated and partially purified. The eluate was analyzed by HPLC using reverse-phase columns of Develosil ODS (0.46 X 15 cm plus 0.46 X 25 cm). The separation of the acyl-CoA esters was conducted with a linear gradient (1.75 to 10%) of acetonitrile. The CoA compounds (malonyl-CoA, succinyl-CoA plus CoASH, methylmalonyl-CoA, 3-hydroxy-3 methylglutaryl-CoA, acetyl-CoA, acetoacetyl-CoA, and propionyl-CoA) were identified and determined by monitoring at 260 nm. Isobutyryl-CoA was used as an internal standard, since the content of this CoA ester was negligible in livers from rats with several metabolic conditions. The lower limit of detection of individual acyl-CoA esters was approximately 50 pmol. Using this analytical method, short-chain acyl-CoA esters were determined in livers from normal and fasted rats. PMID- 3963383 TI - Evaluation of the micromethod for determination of glutathione using enzymatic cycling and Ellman's reagent. AB - Evaluation of the kinetic parameters of the various reactions involved in the determination of glutathione provided the rationale for a modification of the frequently used assay (F. Tietze, 1969, Anal. Biochem. 27, 502-522) whereby the enzymatic reaction is no longer rate limiting. At pH 6.0, the nonenzymatic thiol interchange reaction of reduced glutathione (GSH) with Ellman's reagent becomes rate limiting, and inhibition of glutathione reductase up to 50% has no influence on the accuracy of the determination. The lower level of sensitivity is 10(-10) mol glutathione with a linear response up to 5 X 10(-9) mol. For determination of glutathione disulfide, GSH is alkylated by N-ethylmaleimide (NEM), and excess NEM is removed by extraction with ethyl acetate. Since the glutathione adduct is not stable, extracted samples are kept deep-frozen prior to analysis. Using this precaution, less than 0.05% of GSSG was determined in GSH-containing samples which had been previously freed from GSSG. PMID- 3963384 TI - Detection and quantitation of cellulase by Congo red staining of substrates in a cup-plate diffusion assay. AB - A simple, inexpensive, and sensitive cellulase assay which allows simultaneous enzyme quantitation for many samples has been developed. Radial diffusion of enzyme into substrate incorporated in an agar gel produces zones of hydrolysis which can be visualized by staining undegraded substrate with Congo red dye. Comparisons were made between this and other commonly used cellulase assays based on accuracy, sensitivity, and ease of use. PMID- 3963385 TI - Mass spectrometry and chromatography of t-butyldimethylsilyl derivatives of cytokinin bases. AB - Di-(t-butyldimethylsilyl) derivatives of the cytokinin bases zeatin, cis-zeatin, and dihydrozeatin may be prepared quantitatively in the presence of dimethylaminopyridine. These derivatives have good gas chromatographic properties and are very suitable for gas chromatography-mass spectrometry analysis of cytokinin bases. The t-butyldimethylsilyl (tBuDMS) group at N-9 may be selectively hydrolyzed and the resulting mono-O-silyl derivatives are sufficiently stable to be subjected to thin-layer chromatography and high performance liquid chromatography. The mass spectral fragmentation of the mono- and di-tBuDMS derivatives of adenine, zeatin, cis-zeatin, and dihydrozeatin and also of the mono-tBuDMS derivatives of N6-isopentenyladenine and 6 benzylaminopurine have been rationalized. The 9-tBuDMS moiety was characterized by an elimination of isobutene (M-56) and of isobutene plus a methyl radical (M 56-15). PMID- 3963386 TI - Measurement of 5-aminolevulinic acid synthase activity in whole and fractionated human bone marrow: effect of myeloid cell lysis by monoclonal antibody. AB - A sensitive radiochemical assay for the measurement of bone marrow and erythroblast 5-aminolevulinic acid (ALA) synthase (EC 2.3.1.37) was developed and optimized with respect to sample preparation and reagent concentration. Succinylacetone (4,6-dioxoheptanoic acid) was used to prevent ALA utilization during the incubation period. Sample purification on a Sep-Pak cartridge (Waters Associates) followed by reverse-phase high-performance liquid chromatography (HPLC) allowed rapid isolation of pure ALA-pyrrole, free from radioactive succinate and other contaminants. ALA synthase activity was measured in unfractionated bone marrow and in samples from which myeloid cells had been removed by monoclonal antibody-mediated cell lysis. Myeloid-derived ALA synthase was calculated and found to contribute approximately half of the total unfractionated marrow enzyme activity. This suggests that results from previous studies using unfractionated bone marrow which have assumed that myeloid cells are an insignificant source of ALA synthase require reappraisal. PMID- 3963387 TI - Purification of ribulose-1, 5-bisphosphate carboxylase/oxygenase with high specific activity by fast protein liquid chromatography. AB - A rapid procedure for the purification of ribulose-1, 5-bisphosphate carboxylase/oxygenase (rubisco) (EC 4.1.1.39) by fast protein liquid chromatography (FPLC) is described. Chloroplasts isolated mechanically from spinach leaves were used as the source of a stromal extract enriched in rubisco. By subsequent fractionation of this extract on ion-exchange FPLC, highly purified rubisco (sp act 2.10-2.76 mumol/mg protein X min) was obtained in less than 30 min. The high specific activity and excellent stability of the final preparation can be attributed to the use of chloroplasts as a starting material and the short time required for the chromatographic separation, both of which minimize proteolytic activity. PMID- 3963388 TI - Split-peak affinity chromatographic studies of the immobilization-dependent adsorption kinetics of protein A. PMID- 3963389 TI - Application of precolumn reaction to high-performance liquid chromatography of qinghaosu in animal plasma. PMID- 3963390 TI - Scanning on-column voltammetric detector for open-tubular liquid chromatography. PMID- 3963391 TI - Automated flow-injection phenol red method for determination of bromide and bromide salts in drugs. PMID- 3963392 TI - Bioluminescent continuous-flow assay of adenosine 5'-triphosphate using firefly luciferase immobilized on nylon tubes. PMID- 3963393 TI - Pentafluorobenzylation of O4-ethylthymidine and analogues by phase-transfer catalysis for determination by gas chromatography with electron capture detection. PMID- 3963394 TI - Neutralization agents for neutralization-reionization mass spectrometry. PMID- 3963395 TI - Reionization agents for neutralization-reionization mass spectrometry. PMID- 3963396 TI - Cellulose acetate coated mercury film electrodes for anodic stripping voltammetry. PMID- 3963397 TI - Versatile video tape system for storage and selective retrieval of ion images for digital acquisition and processing. PMID- 3963398 TI - Determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin in human milk at the 0.1-10 parts-per-trillion level: method validation and survey results. PMID- 3963399 TI - Determination of polychlorinated dibenzo-p-dioxins using capillary gas chromatography with microwave-induced plasma detection. PMID- 3963400 TI - Detection of mass 16 241 ions by Fourier-transform mass spectrometry. PMID- 3963402 TI - Immobilized enzyme electrode for the determination of oxalate in urine. PMID- 3963401 TI - Intracellular localization of diffusible elements in frozen-hydrated biological specimens with ion microscopy. PMID- 3963403 TI - Fast atom bombardment mass spectrometry of 12 marine toxins isolated from Protogonyaulax. PMID- 3963404 TI - Preserving toxicologic activity during chromatographic fractionation of bioactive complex mixtures. PMID- 3963405 TI - Improved flow field-flow fractionation system applied to water-soluble polymers: programming, outlet stream splitting, and flow optimization. PMID- 3963406 TI - Subambient temperature high-performance liquid chromatographic determination of the enantiomers of (+/-)-((6,7-dichloro-2,3-dihydro-2-methyl-1-oxo-2-phenyl-1H- inden-5-yl)oxy)acetic acid. PMID- 3963407 TI - Ontogenetic development of the nervus terminalis in toothed whales. Evidence for its non-olfactory nature. AB - For the first time in cetaceans, the development of the terminalis system and its continuity between the olfactory placode and the telencephalon has been demonstrated by light microscopy. In the early development of toothed whales (Odontoceti) this system is partially incorporated within the fila olfactoria which grow out from the olfactory placode. As the peripheral olfactory system is reduced in later stages, a strongly developed ganglionlike structure (terminalis ganglion) remains within the primitive meninx. Peripherally it is connected via the cribriform plate with ganglionic cell clusters near the septal mucosa. Centrally it is attached to the telencephalon (olfactory tubercle, septal region) by several nerve fibre bundles. In contrast to all other mammalian groups, toothed whales and dolphins are anosmatic while being totally adapted to aquatic life. Therefore the remaining ganglion and plexus must have non-olfactory properties. They may be responsible for the autonomic innervation of intracranial arteries and of the large mucous epithelia in the accessory nasal air sacs. The morphology, evolution and functional implications of the terminalis system in odontocetes and other mammals are discussed. PMID- 3963408 TI - The elasmobranch kidney. III. Fine structure of the peritubular sheath. AB - In the kidney of two elasmobranch fish, the little skate (Raja erinacea) and the spiny dogfish (Squalus acanthias), each tubular bundle is wrapped by a continuous sheath of extremely flattened cells which are ordered in several closely superimposed layers. Thin sections and freeze-fracture replicas demonstrate that extensive tight junctions exist between the cells of this peritubular sheath. The sheath cells lie on a discontinuous basement membrane which suggests that they do not belong to the connective tissue. Conceivably, each peritubular sheath segregates the milieu inside the sheath (surrounding the bundle of 5 tubules and capillaries which form the countercurrent system) from the milieu outside the sheath (connective tissue matrix in which the bundles are embedded). PMID- 3963409 TI - The transverse tubular system of rat myocardium: its morphology and morphometry in the developing and adult animal. AB - The three dimensional arrangements of the T system in the developing and adult animal were investigated by means of high voltage electron microscope stereoscopy using Golgi treated materials. The rat myocardial T system was composed of three major group elements: the transverse tubules, longitudinal tubules and flattened cisternae, which were classified according to their orientation and to their morphological features. It was found, as the growth of the rats proceeded, that the longitudinal tubules increased in number and that the transverse tubules were arranged more regularly and densely at the level of the z band. The flattened cisternae transiently increased in number during the 2-9 weeks, and then decreased gradually. Electron microscopy also revealed that all the transverse, longitudinal tubules and flattened cisternae of the T system had the chance of forming a coupling with the sarcoplasmic reticulum irrespective of its morphology and orientation to the myofibrils. Quantitative analysis of the rat T system from the stereo images indicated that the surface area (0.299 micron2/micron3) was considerably greater than previously reported. PMID- 3963410 TI - Quantitative electron microscopic observations on Paneth cells of germfree and ex germfree Wistar rats. AB - Ultrastructural changes of Paneth cells of germfree (GF) rats which had been inoculated with bacteria-containing feces from conventionally-reared (SPF) rats were quantitatively examined. 12 and 24 h after inoculation, the Paneth cells showed a striking decrease in the number of secretory granules and the occurrence of large vacuoles. Phagosomes containing bacteria were not seen. After 4 days, the secretory granules reaccumulated and smooth-surfaced apical vesicles increased in number. It is discussed that the large vacuoles may be related to membrane-retrieval events following the massive extrusion of secretory granules whereas the apical vesicles appear to serve this function when exocytosis is not pronounced. In addition to the large secretory granules ca. 10% of Paneth cell profiles contained a few dense-cored vesicles measuring about 150 nm in diameter which resemble peptidergic neurosecretory granules. PMID- 3963412 TI - Dendrite bundles in lamina II/III of the rabbit neocortex. AB - The present investigation systematically analyzes the course and arrangement of dendrites in lamina II/III of the visual and the motor cortex of the rabbit on the basis of Kluver-PAS stained 10 micron paraffin sections, 1 micron plastic embedded semithin sections and ultrathin sections. In both areas the dendritic pattern of lamina II/III is characterized by vertical bundles reminiscent of the pattern in lamina IV/V. The bundles form in the upper half of lamina II/III. They consist mainly of apical dendrites from lamina II/III pyramidal cells and receive branches from dendrite bundles in lamina IV/V, i.e., branches from apical dendrites arising from lamina V pyramidal cells. Besides these features in common, the lamina II/III bundles in the visual cortex on the one hand and in the motor cortex on the other differ with regards to the size and shape of individual bundles as well as to the extent of connections with bundles in lamina IV/V. PMID- 3963411 TI - Topographic distribution of callosal neurons and terminals in the cerebral cortex of the cat. AB - This investigation had four goals: First, to study the general topography of the corpus callosum (CC) of the cat. Second, to study the columnar organization of CC terminals and map their banding pattern in the cortex. Third, to examine the relation between CC neuron density and the presence of CC terminal columns. Fourth, to determine whether CC and anterior commissure (AC) neuron distributions are intermixed. Eight adult cats were subjected to partial commissurotomies, and then to large injections of horseradish peroxidase to one cerebral hemisphere. Processing with tetramethyl benzidine revealed retrogradely labelled cells and anterogradely labelled terminals in the cortex of the uninjected hemisphere. The distributions of these cells and terminals were examined by light microscopy and analyzed by computer microscopic methods. The genu of the CC interconnects frontal portions of the cortex, the body interconnects mostly dorsal portions of the cortex, while the splenium interconnects the temporal and occipital cortices. Reconstructions of the CC terminal columns reveal intricate banding patterns in several non-primary areas of the cortex. CC cell density is greater within than outside the terminal columns. CC and AC neurons intermix in the infragranular layers of the neocortex. PMID- 3963413 TI - Inverse behaviour of "synaptic" ribbon and spherule numbers in the pineal gland of male guinea-pigs exposed to continuous illumination. AB - There is increasing evidence that pineal "synaptic" ribbons are a heterogeneous population of organelles. In addition to "synaptic" ribbons (SR) sensu stricto, which consist of an electron-dense rod surrounded by electron-lucent vesicles, "synaptic" spherules (SS) exist, the electron-dense core of which is round and much wider than that of the SR. In the guinea-pig SR and SS numbers exhibit an inverse day/night rhythmicity. To gain more insight into the functional significance of SR and SS, guinea-pigs were exposed to continuous illumination for approximately 4 months (LL) and the respective structures in the pineal gland were quantitated under the electron microscope and compared with control animals kept under a lighting regimen of 12 h light and 12 h dark. It was found that SR numbers increase following LL whereas SS numbers decrease. The proximal, intermediate and distal parts of the dumbbell-shaped organ respond differently. The increase in SR numbers is significant in the distal and intermediate regions only, whereas the decrease in SS numbers is significant in the proximal and the intermediate regions only. Within each pineal region analyses of parenchymal subareas measuring 65 microns by 65 microns exhibit an inverse correlation of SR and SS numbers indicating that there are parenchymal domains in which either SR or SS predominate. Morphometric analyses of a number of pinealocytic parameters reveal minor differences between different pineal regions and that exposure to LL does not strikingly affect the pinealocyte perikarya. By contrast, the numbers of pinealocyte processes increase significantly after LL in the distal and intermediate, but not the proximal region of the pineal gland.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963414 TI - Convoluted bile ducts in the liver of the larval lamprey, Petromyzon marinus L. AB - The three-dimensional structure of the bile ducts and their relationship to the blood vessels were studied in the larval lamprey by scanning electron microscopy of the intact tissue and of biliary and vascular casts. The intrahepatic gall bladder is situated in the cephalic portion of the liver and a cystic duct is connected to a straight intrahepatic common bile duct, which extends to the extrahepatic bile duct at the caudal end of the liver. Several smaller intrahepatic common bile ducts are connected directly to the intrahepatic common bile duct, are convoluted or serpiginous and are surrounded intimately by sinusoids. This arrangement enables the bile ducts to have increased surface area exposed to blood vessels. The functional significance of this arrangement is discussed with respect to the modification of bile through the transport of solutes and the similarity of this bilio-vascular relationship to the peribiliary vascular plexus of the mammalian liver. PMID- 3963415 TI - Large myelinated club endings on the Mauthner cell in the goldfish. A study with thin sectioning and freeze-fracturing. AB - Thin sectioning and freeze-fracturing have revealed the distribution of gap junctions and chemical synapses in the synaptic interface of the large myelinated club endings on the lateral dendrite of the goldfish Mauthner cell. In 12 samples of club endings fractured completely or nearly completely, the apposed synaptic membrane area averaged 39.090 microns2, of which 16.6% was occupied by gap junctions and about 4 to 5% by the active zones of chemical synapses. The numerical profile density (number per unit area of the synaptic membrane) of gap junctions varied greatly, from 1.78 to 6.30, and was mostly in inverse proportion to their size. The chemical synapses were located mainly in two places: in the circumferential rim of the synaptic membrane next to the widened extracellular space, and in the margins of intraterminal invaginations of the synaptic cleft. The axoplasm of the preterminal axon, just after losing its myelin sheath, was filled with microtubules, among which neurofilaments gathered into many small bundles. The correlation between the areas of gap junctions and the chemical synapses and the amplitude of the excitatory postsynaptic potentials (EPSP) is discussed. PMID- 3963416 TI - On the ultrastructure of the developing elastic cartilage in the rat external ear. AB - Selected ultrastructural features of chondrocytes and the extracellular matrix in the developing elastic cartilage of the external ear were studied in rat fetuses and young animals. The cytoplasmic lipid droplets were first observed in the 19 day fetus. They increase in number and size during the first post-natal week. The elastogenesis proceeds in the sequence: oxytalan fibers (17-day fetus), elaunin fibers (1-day rat), elastic fibers (5-day rat). Intermediary stages between the randomly oriented individual microfibrils and bundles of microfibrils (oxytalan fibers) were also observed. PMID- 3963418 TI - American Association of Anatomists. Ninety-ninth annual meeting. Reno, Nevada, April 6-10, 1986. Abstracts. PMID- 3963419 TI - A new approach to quantification of Sertoli cells that avoids problems associated with the irregular nuclear surface. AB - A new approach to quantification of Sertoli cells is described. The number of Sertoli cells per testis was calculated from the number of spermatids per testis, the number of spermatids per Sertoli cell apex, and the correction for the lifespan of spermatids enumerated per testis. To evaluate this method under different physiological conditions, testes from 28 adult (4-20-year) stallions obtained in the nonbreeding season (December-January) and from 28 adult stallions in the breeding season (June-July) were compared. Number of Sertoli cells per gram parenchyma was similar between seasons. However, the number of Sertoli cells per testis was significantly greater in the breeding season. In verification of this method, the number of spermatids per Sertoli cell apex was similar to that calculated as the ratio of spermatids to Sertoli cell in the same stallions. Likewise, absolute values similar to those of other approaches further verify the validity of this approach. PMID- 3963420 TI - Ultrastructure of the secretory response of male mouse submandibular gland granular tubules. AB - The organization and fine structure of granular convoluted tubule cells (GCT) from male mouse submandibular glands have been examined in controls and in animals injected with adrenergic and cholinergic secretagogues. Control submandibular glands exhibited a single population of GCT cells with numerous homogeneous granules filling the apical two-thirds of the cytoplasm. A zone of transition cells, exhibiting characteristics of both GCT and striated duct cells, was found between the agranular intercalated duct and GCT segments. These transition cells possessed apical granules of variable size as well as prominent basal striations. Dramatic changes in the morphology of GCT cells followed administration of the alpha-adrenergic agent, phenylephrine. The extensive degranulation involved formation of "secretory pools" of fused granules and release of secretory material into the lumen. The appearance of numerous smooth vesicles near luminal membranes suggested extensive membrane retrieval. Intracellular membrane-limited aggregates of membrane fragments suggested that much of the retrieved membrane was destined for degradation. Rough endoplasmic reticulum was highly dilated but there was no indication of increased size or activity of the Golgi complex. Ultrastructural evidence indicated that the secretory responses to isoproterenol, a beta-adrenergic agent, and to pilocarpine, a cholinergic agent, were much more modest, but it is clear that some secretory response to these agents does occur. The other cell types of the duct and tubule system did not exhibit comparable morphological changes in response to the agents used. PMID- 3963421 TI - A proposed alveolar model for adult human lungs: the regular dodecahedron. AB - In an endeavor to delineate an alveolar configuration that would reasonably mirror the natural state, polygonal shapes of normal alveoli were tabulated in histological sections from inflation-fixed specimens of 16 men aged 16-48 years. The resulting alveolar population varied from three- to ten-sided polygons with a preponderance of tetragons, pentagons, and hexagons. These observations were compared with the possible combinations of polygonal sections through various polyhedral models proposed by other workers and the five classical regular polyhedrons. The potential types of sections through the regular dodecahedron, i.e., a twelve-sided shape with faces consisting of pentagons, seemed to fit best with present findings, and this is suggested as an idealized configuration that might be useful in various geometric determinations, e.g., estimates of alveolar surface area and volume. PMID- 3963417 TI - Diencephalic and mesencephalic afferents of the rat claustrum. AB - The retrograde fluorescent tracers Fast Blue (FB) and Diamidino Yellow (DY) have been used to study subcortical afferents of the claustrum. DY or FB was injected into the claustrum. The greatest amount of labeled cell bodies were observed in the posterior thalamic nuclear complex. They were especially abundant in its caudal part, lying between the medial geniculate body and the pretectal area. In comparison to the numerous labeled cells near the diencephalic-mesencephalic junction, the number of fluorescing neurons in the brain stem was considerably lower. These neurons were mostly concentrated in the monoaminergic cell groups. The results indicate the presence of a substantial projection from the posterior thalamic and anterior pretectal region to the claustrum. PMID- 3963422 TI - The development of the Syrian hamster cheek pouch. AB - The objective of this study was to provide a detailed account of the morphogenesis and early cytodifferentiation of the hamster cheek pouch. Although the newborn "cheek pouch" is used for in vitro studies of the effects of retinoids and carcinogens, its rudimentary structure has not been adequately described. Complete paraffin serial sections of the heads of 14- and 15-day fetuses were cut in three planes to determine the location and shape of the earliest pouch rudiments. Complete paraffin serial sections were prepared from pouch rudiments dissected from hamsters at birth and at daily intervals from 3 to 12 days postnatal. Semithin Epon sections were examined by light microscopy and ultrathin sections by transmission electron microscopy. The pouch can appear in the fetus as two solid epithelial ingrowths from the lining of the oral cavity. They are the margins of an ingrowing sheet of oral epithelium which becomes leaflike at about the time of birth, as it grows caudad into the tissue of the cheek. The central cells of the ingrowth accumulate large quantities of glycogen before differentiating as a stratum spinosum 5 days after birth. Within the stratum spinosum, groups of cells containing keratohyalin granules initiate the stratum granulosum. Keratinized cells appear within the stratum granulosum areas. Spaces appear between keratinized cells, and the spaces coalesce to form the pouch cavity between 7 and 12 days postnatal. Soon afterward, this cavity opens to the oral cavity to make a pouch, and the ultrastructure of the cheek pouch epithelium closely resembles that of the adult. PMID- 3963423 TI - The ontogeny of nexuses (gap junctions) in the ovary of the fetal mouse. AB - Nexuses (gap junctions), the morphological correlates of direct cell-to-cell communication, were consistently detected between granulosa cells of primordial follicles in the ovaries of adult cycling, juvenile, or neonatal mice. To examine the ontogeny of these intercellular channels, the cellular interactions occurring during the fetal stages of folliculogenesis, which culminate in the formation of primordial follicles, were analyzed in ovaries from fetal days 13, 15, 17, and 19. On fetal day 13, the ovary is characterized by clusters of germinal cells and invading rete ovarii cells. The rete cells progressively penetrate the ovary and wall off clusters of oocytes by fetal day 17, at which time rete cells can be recognized as presumptive granulosa cells. Gap junctional contacts can be recognized between rete cells on day 13 and these contacts persist as the cells become recognizable as presumptive granulosa cells throughout ovarian histogenesis. Quantification of junctional contacts from days 15-19 indicated that the number of gap junctions increases with fetal age. In addition heterocellular gap junctional contacts were detected between oocytes and presumptive granulosa cells as early as fetal day 17, indicating that the potential for direct intercellular communication between granulosa cells and oocytes is established from the earliest contact. PMID- 3963424 TI - Effects of denervation and delayed amputation on forelimb regeneration in Xenopus laevis froglets. AB - Left forelimbs of postmetamorphic Xenopus laevis froglets were repeatedly denervated prior to and following amputation. Amputations were performed 14, 21, 28, or 42 days after the original denervation. A tissue-regenerative response resulting in the formation of a spike-shaped, heteromorphic outgrowth was found in the sham-denervated and control animals, but dedifferentiation of the stump tissues was not apparent. Tissue-regenerative outgrowths were not observed in the denervated cases; instead, dermal wound healing and stump and scar formation occurred. In both control and experimental cases, however, a periosteal proliferative response to amputation injury led to the development of a greatly thickened periosteum the length of the amputated radius-ulna as well as a cap of cartilage at the distal end of these bones. We conclude from these results that forelimbs of postmetamorphic froglets are incapable of adjusting to a prolonged nerveless state sufficient to allow the normal tissue-regenerative response of spike outgrowth formation. PMID- 3963425 TI - The development of the ovine small intestine. AB - Intestinal development was noted from 27 days gestation. By 50 days gestation the ovine small intestine shows the beginning of villus formation. The lumen becomes patent by 70 days. Proximal regions mature earlier than distal regions. Vacuolation of enterocytes occurs in all regions of the small intestine at some stage during development. Mature-looking enterocytes can be found in proximal regions by 125 days gestation while in distal regions immature vacuolated cells can still be found just prior to birth. Enterocytes lining the villi are more mature at the villus tip than those at the base in all regions. This gradient of maturation is consistent with a suggestion of the early establishment of adult patterns of proliferation and migration of enterocytes in the sheep fetus. PMID- 3963426 TI - On nerves and teeth in the lower jaw of the cichlid Tilapia mariae. AB - The anatomy of the teeth and tooth-related nerves in the lower jaw was examined in the cichlid Tilapia mariae. This was done in order to establish a basis for studies on dental neuroplasticity in a polyphyodont vertebrate. The region of interest was explored in specimens fixed by glutaraldehyde perfusion, and by using X-ray photography, maceration, scanning electron microscopy, gross dissection, and light microscopic examination of serial sections. The results show that the lower jaw carries some 60-65 functional teeth. In addition, numerous replacement teeth and tooth germs in various stages of development are located in a cavity in the dentary bone. Numerous nerve bundles are present in immediate relation to the dental follicles of tooth germs. Unerupted teeth do not contain light-microscopically discernible pulpal axons, but the pulps of functional teeth contain myelinated axons. Both perifollicular and pulpal nerve bundles derive from a nerve plexus, which is formed by branches from r. mandibularis trigemini. This nerve is easily accessible to experimental manipulation, where it courses through the adductor mandibulae muscular complex. Thus, the lower jaw of T. mariae seems to represent a suitable system for the study of tooth-nerve interactions in a polyphyodont species. PMID- 3963427 TI - The accessory nerve nucleus in the baboon. AB - In the savanna baboon, Papio cynocephalus, the accessory nerve nucleus was identified by using a mixture of 20% free horseradish peroxidase (HRP) and 2.5% HRP conjugated to wheat germ agglutinin (WGA) in a 5% aqueous detergent solution (Nonidet P-40). Following surgical exposure of the appropriate nerve branch to the sternocleidomastoid or trapezius muscle, the nerve was transected, placed in an Argyle tubing collar, and bathed in 5-10 microliter of the tracer. After a 48 hour survival time and vascular perfusion-fixation, 40-micron sections of the lower medulla oblongata and the cervical spinal cord were treated according to the tetramethyl benzidine (TMB)-HRP method of Mesulam (J. Histochem. Cytochem. 26: 106-117, 1978). The accessory nucleus extends as a distinct column of neurons from lower medullary levels into the rostral part of C5. One to ten labeled cells were present in each section, and all labeled neurons were located on the side of the bathed nerve. The rostral portion of the accessory nucleus occupies a central position, its intermediate portion occupies a lateral position, and its caudal portion occupies a central position within the ventral horn. All labeled neurons were confined to Rexed's lamina IX, ranged from 15 to 75 micron in diameter, and were either distinctly round (oval) or stellate in shape. Neurons within the baboon accessory nucleus supplying the sternocleidomastoid muscle were located from lower medullary to upper C2 spinal cord levels, while those supplying the trapezius muscle extended from C2 to C5. PMID- 3963428 TI - Regional and global myocardial function in the dog when nitrous oxide is added to halothane in the presence of critical coronary artery constriction. AB - The effect of substituting 66% nitrous oxide for nitrogen on global and regional myocardial function before and after critical constriction of the left anterior descending coronary artery (LAD) was studied in six open-chested dogs anesthetized with 1% halothane (inspired). Regional myocardial function was measured in the region of the LAD and in the region of the left circumflex artery using sonomicrometry, and LAD blood flow was measured. Administration of nitrous oxide produced moderate depression of global performance. Regional shortening in both myocardial segments was reduced, and dysfunction also appeared in the LAD segment. This dysfunction was observed in the presence of both normal coronary blood flow, and after critical constriction. The appearance of dysfunction when coronary blood flow was unimpaired suggests that ischemia may not be the only cause of regional myocardial dysfunction. PMID- 3963429 TI - Cardiovascular toxicity of local anesthetics: an alternative hypothesis. AB - The current study examined the possibility that high local anesthetic concentrations within the central nervous system could contribute to the toxic cardiovascular effects observed clinically after an accidental intravenous injection. Equal numbers of molecules of lidocaine (1.6 microliter of a 2% solution) and bupivacaine (1.0 microliter of a 4% solution) were injected at three vasomotor and cardioactive areas in the rat medulla by means of a 28-gauge hypodermic needle and a microsyringe. These areas were the C1 region, the intermediolateral column (IML), and the nucleus tractus solitarius (NTS). Both lidocaine and bupivacaine at C1 significantly decreased mean arterial pressure and, at IML, resulted in significant bradycardia and hypotension. At NTS, both lidocaine and bupivacaine caused significant bradycardia and hypotension, which were accompanied by ventricular arrhythmias in 55% of the animals. In all animals in whom ventricular arrhythmias were associated with lidocaine, the arrhythmias spontaneously reverted to normal sinus rhythm. In 50% of animals developing ventricular arrhythmias after bupivacaine, the arrhythmias resulted in death. Using an equal number of molecules of lidocaine and bupivacaine, all three regions studied demonstrated that bupivacaine was 2-4 times more potent than lidocaine in producing cardiovascular effects. These data demonstrate that direct application of local anesthetics within the medullary region of the central nervous system can result in hypotension, bradycardia, and ventricular arrhythmias similar to what may be seen in humans after accidental intravenous injections of local anesthetics. Moreover, the sites and mechanisms of action appear to be identical for bupivacaine and lidocaine. Thus bupivacaine does not appear to be an aberrant local anesthetic, as some have suggested, but rather produces more profound effects related to its potency and physicochemical properties. PMID- 3963430 TI - Intracellular mechanism of action of isoflurane and halothane on striated muscle of the rabbit. AB - Studies were conducted on the effects of isoflurane and halothane on intracellular mechanisms of striated muscle contraction: Ca2+ activation of the contractile proteins and Ca2+ uptake and release from the sarcoplasmic reticulum. Functionally skinned muscle fibers (sarcolemma disrupted by homogenization) from isolated papillary muscle (PM), soleus (SL) (slow-twitch skeletal muscle), and adductor magnus (AM) (fast-twitch skeletal muscle) of rabbits were mounted on a photodiode tension transducer. They were immersed in control solution (saturated with N2), then in test solution (saturated with anesthetic-N2 mixture), and in control solution again. The following two studies were carried out: 1) in the study of Ca2+ -activated tension development of the contractile proteins, free Ca2+ concentration in the bathing solution was controlled by the use of a high EGTA (7 mM), and 2) in the study of Ca2+ uptake and release from the sarcoplasmic reticulum (SR), Ca2+ was loaded into the SR and released with caffeine and the resulting tension transients were measured. Isoflurane (1-4%) decreased (6-9%) the maximal Ca2+ -activated tension development in PM and SL but more in PM than in SL. In AM, however, isoflurane and halothane (1-3%) produced no change. Isoflurane decreased submaximal Ca2+ -activated tension development in PM, but effected no change in it in SL. Isoflurane and halothane increased the tension development in AM to the extent of producing a shift to the left in the pCa tension curves of less than or equal to 0.1 pCa unit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963431 TI - Interaction of halothane and verapamil in isolated papillary muscle. AB - The combined depressant effects of verapamil and halothane on myocardial contractility were studied using isolated papillary muscle from the rabbit. Verapamil alone (0.5 microM) significantly decreased peak developed tension (PDT) by 15 +/- 2%, time to peak tension (TPT) by 10 +/- 1%, and maximum rate of increase of tension (+dT/dt) by 5 +/- 1%, but not maximum rate of decrease of tension (-dT/dt). Halothane alone (0.8%) significantly decreased PDT by 56 +/- 2%, TPT by 11 +/- 2%, +dT/dt by 53 +/- 2%, and -dT/dt by 56 +/- 2%. During the exposure period, the combination of verapamil and halothane together produced a simple additive effect (no significant interaction effect by two-way analysis of variance), with PDT decreased by 68 +/- 2%, TPT by 20 +/- 3%, +dT/dt by 62 +/- 2%, and -dT/dt by 65 +/- 2%. The reversibility of halothane-induced depression was also studied. Peak developed tension showed complete reversibility 30 min after discontinuing halothane. In the presence of verapamil, however, the reversibility of halothane-induced depression was not complete, and significant residual depression of PDT (19 +/- 3%) was observed. We conclude that the acute depressant effect of verapamil plus halothane in isolated papillary muscle is additive, but reversibility of halothane-induced depression may be impaired or prolonged in the presence of verapamil. PMID- 3963432 TI - Effect of clonidine on sympathoadrenal response during sodium nitroprusside hypotension. AB - Supplementation of the antihypertensive action of the peripheral vasodilator sodium nitroprusside (SNP) with clonidine, a centrally-acting agent, was studied in ten dogs anesthetized with isoflurane to evaluate the efficacy of clonidine for reducing the amount of SNP required during induced hypotension. The dose of SNP required to lower mean arterial blood pressure (MAP) by 40% was determined prior to the administration of intravenous clonidine (control), and after incremental doses of 1, 4, and 15 micrograms/kg. After each dose of clonidine, hypotension was induced with SNP and maintained for 30 min, followed by a 30-min recovery period. Plasma levels of norepinephrine (NE) and epinephrine (EPI) were determined before hypotension, at 5 min and 30 min during hypotension, and at 5 min and 30 min during recovery. During the control period (no clonidine), SNP induced hypotension resulted in increases in plasma catecholamine levels, with larger increases in EPI (from 70 +/- 26 to 851 +/- 140 pg/ml, at 30 min) than NE (from 171 +/- 26 to 334 +/- 58 pg/ml, at 30 min). There was no significant difference between the control MAP and the MAP after each incremental dose of clonidine. In these anesthetized dogs with low sympathetic tone there was no significant decrease in EPI levels after administration of up to 20 micrograms/kg of clonidine. Increasing doses of clonidine correlated inversely with depression in catecholamine output during induced hypotension and the dose of SNP required to produce this hypotension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963433 TI - Influence of moderate hypothermia on posterior tibial nerve somatosensory evoked potentials. AB - Posterior tibial nerve somatosensory evoked potentials (PTN-SSEP) were recorded in eight patients during cardiac surgery with cardiopulmonary bypass and moderate hypothermia (25-28 degrees C). There was no correlation between changes in amplitude and temperature; however, latencies of potentials recorded over the tibial nerve in the popliteal fossa, the lumbar spinal cord, and the cortex increased linearly as temperature decreased. Latency changes correlated well with nasopharyngeal temperature, but only poorly with rectal and lower limb muscle temperatures. During perioperative monitoring of spinal cord function by means of PTN-SSEP, an increase of the first positive cortical peak (P1) greater than 3 msec is considered an indication for intervention. In this study P1 prolonged 1.15 msec/degree C (r = 0.89, P less than 0.001). This implies that a temperature decrease of 2-3 degrees C may prolong P1 latency by more than 3 msec. PMID- 3963434 TI - The effect of cimetidine on anesthetic metabolism and toxicity. AB - Because the H2-receptor antagonist cimetidine has been shown to inhibit drug metabolism, the effects of cimetidine on anesthetic metabolism and toxicity were investigated in a rat model. Cimetidine decreased inorganic plasma fluoride production after methoxyflurane administration both in 21% oxygen (P less than 0.001) and in 100% oxygen (P less than 0.001). Phenobarbital produces an increased fluoride formation after methoxyflurane anesthesia, and this fluoride formation is also reduced by cimetidine (P less than 0.005). There was no significant difference between the plasma fluoride levels in rats anesthetized with halothane or enflurane. Although cimetidine inhibited the in vivo defluorination of methoxyflurane, fluoride levels were still within the nephrotoxic range, and cimetidine is not likely to play a role as part of a preanesthetic regimen that would permit the increased clinical use of methoxyflurane. Cimetidine also inhibited the oxidative metabolism of halothane; cimetidine decreased (P less than 0.05) trifluoroacetic acid concentrations after halothane anesthesia in 21% oxygen and in 100% oxygen and decreased (P less than 0.05) bromide concentrations after halothane anesthesia in 100% oxygen. Trifluoroacetic acid levels were less (P less than 0.02) after halothane anesthesia in 14% oxygen as compared with 100% oxygen, indicating a reduction in oxidative metabolism under hypoxic conditions. However, bromide concentrations were maximal after halothane anesthesia in 21% oxygen, and significantly (P less than 0.001) less after halothane anesthesia in 14% and 100% oxygen. Bromide production, therefore, seems to be inhibited by both hypoxia and hyperoxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963435 TI - Tubocurarine sensitivity of the diaphragm after limb immobilization. AB - The effect of immobilization of a limb on subsequent sensitivity of the diaphragm to d-tubocurarine was examined in the guinea pig. A forelimb was immobilized in a plaster cast for 1 or 3 weeks. An isolated nerve-diaphragm preparation was then set up and the sensitivity to d-tubocurarine measured. Parallel assays on a nerve lumbrical muscle preparation from the limb in the cast were also examined for comparison. The diaphragm from unimmobilized animals showed the normal decreased sensitivity relative to the lumbrical. After immobilization the sensitivity of the lumbrical decreased, whereas that of the diaphragm did not change. Thus in contrast to previously observed behavior in limb muscles, changes in d tubocurarine sensitivity produced by immobilization do not involve the diaphragm. PMID- 3963436 TI - Intravenous fluid temperature, shivering, and the parturient. AB - The effect of warmed vs room-temperature intravenous fluids is examined for decreasing shivering in parturients undergoing epidural anesthesia for elective cesarean sections. Forty-four women were studied, 22 receiving warmed and 22 receiving room-temperature fluid therapy for preblock prophylaxis of hypotension and intraoperative maintenance and replacement. Of those given room-temperature balanced salt solutions, 64% shivered, as opposed to 14% in the warm fluid group, an observation significant at less than a P of 0.005 by chi 2-analysis. PMID- 3963438 TI - Delayed cephalad spread of a lidocaine spinal anesthetic causing ventilatory failure. PMID- 3963437 TI - Epidural morphine for postoperative pain relief in anorectal surgery. AB - Postoperative analgesia and side effects of a single dose of 20 ml of 2% epidural prilocaine followed immediately by either morphine (3 mg in 3 ml saline) or saline (3 ml) were studied in 79 patients scheduled for anorectal surgery. Pain relief was evaluated by a linear scale for 24 hr and by an assessment of the requirement for parenteral analgesics. Of the patients given epidural morphine, 25% did not require analgesics, whereas all patients given prilocaine alone asked for additional analgesia. Remaining patients given morphine were pain-free for a mean duration of 7.6 +/- 5.1 hr (SD). Only 9% of patients given morphine required a maximum of three analgesic parenteral injections in 24 hr. Urinary retention was the most prominent side effect observed in patients given epidural morphine. No early or delayed respiratory depression was noted in our patients. PMID- 3963439 TI - Improved remote cardiorespiratory monitoring during radiation therapy. PMID- 3963440 TI - Normeperidine toxicity. PMID- 3963441 TI - Resistance to pancuronium. PMID- 3963442 TI - Controlled drug accountability. PMID- 3963443 TI - Static and dynamic considerations in gastric barotrauma. PMID- 3963444 TI - Postoperative sagittal sinus thrombosis after spinal anesthesia. PMID- 3963445 TI - Difficult removal of epidural catheters in the sitting position. PMID- 3963446 TI - Transillumination of the trachea with a lighted stylet. PMID- 3963447 TI - Psychomotor tasks and recovery from anesthesia. PMID- 3963448 TI - Are the requirements for hepatic injury with halothane and enflurane in rats really different? PMID- 3963449 TI - Isoflurane anesthesia and arterial oxygenation during one-lung ventilation. PMID- 3963450 TI - Influence of isoflurane on hypoxic pulmonary vasoconstriction in dogs. AB - The authors studied the influence of locally administered isoflurane anesthesia on the pulmonary vascular response to regional alveolar hypoxia (hypoxic pulmonary vasoconstriction [HPV]) over a range of cardiac outputs (COs) in seven mechanically ventilated, closed-chest dogs. The right lung was ventilated with 100% O2 throughout the study. The left lung was ventilated with either 100% O2 (normoxia) or an hypoxic gas mixture (hypoxia). Different alveolar concentrations of isoflurane (0, 1, and 2.5 MAC) were administered to the left lung in a randomized sequence. The CO was altered by opening and closing surgically produced arteriovenous fistulae, at all isoflurane concentrations, and by hemorrhage at 0 MAC isoflurane. The magnitude of the HPV response was measured by differential CO2 elimination in the absence of isoflurane and by venous admixtures in all phases. During normoxia, the left lung effective flow (QL%) measured from differential CO2 excretion was 39.9 +/- 1.2% of the total blood flow and decreased to 18.8 +/- 2.6% when ventilated with the hypoxic gas mixture. Venous admixture (QVA/QT%) was significantly correlated with QL% during hypoxic ventilation in the absence of isoflurane. QVA/QT% was 22.3 +/- 2.7% during hypoxia with normal CO, and it increased significantly to 27.7 +/- 1.1% when the CO was increased 43%. It was not significantly altered (23.6 +/- 3.6%) when the CO was decreased by 54%. Isoflurane 2.5 MAC significantly increased QVA/QT% during hypoxic ventilation of the left lung to 33.9 +/- 2.6% with low CO and 35.4 +/- 1.7% with normal CO. Isoflurane 1 MAC increased QVA/QT% to 27.2 +/- 2.7% with normal CO and 28.1 +/- 2.6% with high CO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963451 TI - Canine cerebral function and blood flow after complete cerebral ischemia: effect of head position. AB - It has been reported that animals exposed to relatively "bloodless" cerebral ischemia have improved cerebral function post-ischemia. This suggests the possibility that large variations in cerebral blood volume during complete ischemia might affect outcome following reperfusion. The purpose of this study was to determine whether changes in dog head position (and therefore cerebral blood volume) during complete cerebral ischemia produced by occluding the aorta and venae cavae affect post-ischemic cerebral blood flow (CBF), cerebral metabolic oxygen requirements (CMRO2), or neurologic outcome. Two dogs were transfused with 111In-labeled red blood cells. Gamma camera images taken during complete cerebral ischemia showed 45-degree head-up dogs to have 30% of the cranial blood volume of a 10-degree head-down dog. CBF and CMRO2 90 min post ischemia were not significantly different between the head-up and head-down groups in the 14 dogs studied. There was also no significant difference in neurologic outcome at 48 h post-ischemia between head-up and head-down dogs. The authors conclude that head position during complete cerebral ischemia has a major effect on cranial blood volume, but no effect on post-ischemic CBF, CMRO2, or neurologic outcome. PMID- 3963452 TI - Vasodilators worsen gas exchange in dog oleic-acid lung injury. AB - The authors studied the effects of vasodilator treatment with either hydralazine or minoxidil on gas exchange and lung water accumulation over a 5-h period in canine oleic acid-induced pulmonary edema. Thirty dogs were given intravenous oleic acid 1 day prior to study to produce a stable, diffuse lung injury. On the day of study, one group of animals was given minoxidil, a potent systemic and pulmonary vasodilator. A second group was given hydralazine, a potent systemic vasodilator but weak pulmonary vasodilator, and a third group was not treated. Hemodynamic and gas exchange variables were assessed prior to treatment, and again after 5 h of treatment. Both drugs caused an increase in cardiac output and a decrease in peripheral vascular resistance. Minoxidil increased venous admixture from 17 +/- 4 to 55 +/- 6% (P less than 0.05), whereas hydralazine treated dogs had a smaller increase, from 26 +/- 5 to 47 +/- 6% (P less than 0.05), and untreated animals did not show a significant change. Lung water increased 27 +/- 12% in the untreated animals over the course of the study, 43 +/ 18% in the hydralazine animals, and 60 +/- 16% (P less than 0.05 vs. untreated) in the minoxidil animals. The authors conclude that adverse effects may result from peripheral vasodilators in animals with permeability pulmonary edema, but the extent and severity of these effects may vary, depending on the drugs' effects on the pulmonary circulation. PMID- 3963453 TI - Electrophoresis of muscle proteins is not a method for diagnosis of malignant hyperthermia susceptibility. AB - The authors used denaturing polyacrylamide slab gel electrophoresis, employing 7.5-20% and 15-20% polyacrylamide gradients, to compare total skeletal muscle proteins of 12 normal and 19 malignant hyperthermia (MH)-susceptible individuals. The patients' MH status was determined by contracture testing. No consistent qualitative or quantitative differences could be detected. Because MH is believed to be triggered by a loss of control of sarcoplasmic [Ca2+], the authors compared: 1) the Ca2+-binding proteins of eight normal and ten MH muscles using Ca2+-dependent electrophoretic mobility shifts and a transblot/45CaCl2 overlay technique; and 2) the total protein composition of a heavy sarcoplasmic reticulum fraction isolated from five normal and nine MH muscles. Again, no differences were detected. Finally, a similar electrophoretic study was conducted to compare the total protein composition of five normal and six MH-susceptible, central core disease-affected human muscles. No significant differences could be observed. It appears, therefore, that simple electrophoretic techniques cannot be applied in the diagnosis of MH susceptibility. PMID- 3963454 TI - Cerebral oxygen tension in rats during deliberate hypotension with sodium nitroprusside, 2-chloroadenosine, or deep isoflurane anesthesia. AB - Thirty-four male Sprague-Dawley rats were divided into four groups: control animals and those receiving sodium nitroprusside (SNP), 2-chloroadenosine, or a high, inspired concentration of isoflurane to produce deliberate hypotension to a mean arterial blood pressure of 50 mmHg. Ventilation was controlled (FIo2 = 0.3); control animals and those treated with sodium nitroprusside or 2-chloroadenosine breathed isoflurane 1.4 vol%, whereas isoflurane, 3.9 vol%, was required to produce hypotension by deep anesthesia alone. Multiple tissue oxygen tension values (PtO2) were measured at intervals of 10 micron over a distance of 2 mm by advancing an oxygen microelectrode through the parietal cerebral cortex of all animals. The frequency of low tissue PO2 values (less than 10 mmHg) was increased with all forms of deliberate hypotension, but the magnitude of this change (a shift to the left in the frequency histogram) was significantly different among techniques. The shift toward lower PtO2 values during hypotension was least in animals receiving deep isoflurane anesthesia, intermediate in those receiving SNP, and greatest in those treated with 2-chloroadenosine. In rats, areas of the brain appear to be at risk for significant tissue hypoxia during hypotension produced by 2-chloroadenosine. PMID- 3963455 TI - The pharmacokinetics of droperidol in anesthetized patients. AB - A pharmacokinetic study of droperidol was performed in ten anesthetized patients receiving an intravenous bolus dose of 150 micrograms/kg of droperidol. Plasma concentrations were measured using a specific radioimmunoassay method. The pharmacokinetics of droperidol can be described according to a three-compartment open model. The mean (+/- SD) half-life for the rapid (t 1/2 pi) and slow distribution t 1/2 alpha) phases was 1.4 +/- 0.5 min and 14.3 +/- 6.5 min, respectively. The mean elimination half-life, t 1/2 beta was 103.8 +/- 20.2 min. The mean (+/- SD) total body clearance was 14.1 +/- 4.4 ml X min-1 X kg-1, and the total apparent volume of distribution (Vd beta) was 2.04 +/- 0.50 l/kg. The short terminal half-life of droperidol does not correlate with the well-known, relatively prolonged duration of its pharmacologic action. PMID- 3963456 TI - Status of women in academic anesthesiology. AB - The authors compared anesthesia faculties with the rest of medical school faculties at each of four academic ranks and found a significant difference in proportion of men and women anesthesia faculty members at the assistant professor rank only (P less than 0.001). When the faculty status of women and men academic anesthesiologists was examined a significant difference was found in rank distribution in age groups 40 to 44 (P less than 0.005) and 45 to 49 (P less than 0.001), where there was a deficit of professors and a surfeit of instructors among women. Significant differences in distribution continued at age 50-54 (P less than 0.01), 55-59 (P less than 0.001), and 60-64 (P less than 0.005), primarily at professor and assistant professor ranks. In addition, there was significantly lower prevalence of board certification (P less than 0.001) and level of responsibilities for women (P less than 0.001). There was no significant difference in tenure status. PMID- 3963457 TI - Lidocaine depresses synaptic activity in the rat hippocampal slice. AB - The direct effect of the local anesthetic lidocaine was studied using the hippocampal slice preparation in order to assess the involvement of this structure in lidocaine-induced seizure activity. Changes in the evoked field potential amplitude and latency were used to measure the effect of the drug. A dose-dependent depression of the evoked field potentials was observed at lidocaine concentration of 10(-4)M and greater. No synchronized population bursting (seizures) was observed at any of the concentrations tested (10(-6)M to 10(-3)M). However, the hippocampal slice preparation is capable of producing seizure activity, as was demonstrated following application of penicillin G. The results suggest that the hippocampus is not the site of lidocaine-induced seizure activity. PMID- 3963459 TI - Facial paresis after general anesthesia. Report of an unusual case: Heerfordt's syndrome. PMID- 3963458 TI - Heparin resistance prior to cardiopulmonary bypass. PMID- 3963460 TI - Difficult endotracheal reintubations: a simple technique. PMID- 3963462 TI - Succinylcholine and open eye injury. PMID- 3963461 TI - Pulmonary air embolism in the pediatric patient undergoing central catheter placement: a report of two cases. PMID- 3963463 TI - Confusion regarding experimental studies of intravenous regional anesthesia. PMID- 3963464 TI - Use of pulse oximetry for assessment of collateral arterial flow. PMID- 3963465 TI - Morphine-induced cardiac pain? PMID- 3963466 TI - A technique of laryngoscopy for difficult intubation. PMID- 3963467 TI - Delivering bronchodilators into the anesthesia circuit. PMID- 3963468 TI - Monitoring neuromuscular function. PMID- 3963469 TI - Seizure following stellate ganglion block after negative aspiration and test dose. PMID- 3963470 TI - A tidy adjunct to arterial cannulation. PMID- 3963471 TI - Local anesthetics administered topically: sterile or not? PMID- 3963472 TI - A simple, inexpensive method to prevent heel sores. PMID- 3963473 TI - Epidural block for chronic pain management facilitated by field block. PMID- 3963474 TI - Intubation technique--a health hazard for the anesthesiologist. PMID- 3963475 TI - Solving a difficult intubation. PMID- 3963476 TI - Cardiovascular effects of and interaction between calcium blocking drugs and anesthetics in chronically instrumented dogs. I. Verapamil and halothane. AB - In order to assess the interaction between halothane and verapamil on the cardiovascular system, mongrel dogs were instrumented so that the following measurements could be made awake and under the influence of the drugs: aortic, left ventricular, and left atrial blood pressures; myocardial segment length shortening; heart rate and rhythm; and coronary, carotid, and renal blood flows. The effect of two infusion doses of verapamil (3 micrograms X kg-1 X min-1 and 6 micrograms X kg-1 X min-1 after 200 micrograms X kg-1 bolus) were examined awake. On a different day in the same dogs, two concentrations of halothane (1.2-low and 2.4-high % end-tidal) and the effect of the two infusion doses of verapamil during low and high halothane were studied. Thirty minutes of either infusion dose of verapamil produced only heart rate and electrocardiographic P-R interval increases in conscious dogs. Halothane produced dose-related decreases in mean aortic pressure, left ventricular maximum rate of tension development (dP/dt), and segment length shortening and increases in heart rate and left atrial pressure. Carotid blood flow was increased by low halothane concentrations and returned to control with high halothane concentrations. There were no significant changes in coronary or renal blood flow produced by halothane. Verapamil infusion during low halothane concentration produced minimal effects. However, both the 3 and 6 micrograms X kg-1 X min-1 verapamil doses further depressed hearts already depressed by the high concentrations of halothane and decreased renal and carotid blood flows.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963477 TI - Cardiovascular effects of and interaction between calcium blocking drugs and anesthetics in chronically instrumented dogs. II. Verapamil, enflurane, and isoflurane. AB - The effects of enflurane and isoflurane on the cardiovascular system and cellular calcium kinetics are somewhat different. Consequently, the interaction with the calcium channel blocking drug, verapamil, may also differ. In order to compare the anesthetics, the authors studied the effects of two infusion doses of verapamil (which produced plasma levels of 90 and 180 ng X ml-1) on cardiovascular dynamics and regional blood flow in awake dogs. On two other days, in the same dogs, the effects of approximately 1.1 and 2 MAC enflurane and isoflurane were first studied and then the same verapamil dose regimens while the same anesthetic concentrations were maintained. Verapamil produced only increases in heart rate and the P-R interval in the awake animal. The high dose of both anesthetics markedly decreased mean aortic pressure and left ventricular rate of tension development (dP/dt), and increased heart rate. However, only enflurane also decreased myocardial segment length shortening and increased left atrial pressure. Neither anesthetic alone affected coronary or renal blood flow, while both increased carotid blood flow at the low dose. Verapamil infusion during 1.2 MAC enflurane was more depressant than during 1.2 MAC isoflurane, but the combination of verapamil with 2 MAC concentration of both anesthetics was equally depressant. Both doses of both anesthetics increased plasma verapamil levels compared with the same verapamil dosing regimen awake. When these results are compared with those previously reported for halothane, the effects of verapamil during all three anesthetics are more similar than different.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963478 TI - Creatinine clearance of early detection of posttraumatic renal dysfunction. AB - Acute renal failure develops insidiously in the presence of normal urine output and vital signs. A prospective study was carried out to find whether renal impairment can be detected in the immediate postoperative period and to determine the renal function test best predicting the development of renal dysfunction. Forty patients with multiple trauma who required more than 10 units of blood and had a systolic blood pressure less than 80 mmHg on admission were studied. Creatinine clearance (Ccr), free-water clearance (CH2O), fractional excretion of Na+, blood urea nitrogen (BUN), urine flow rate, and vital signs were measured and compared in seven patients who developed renal dysfunction within a week of trauma (Group 1) and 33 patients who maintained normal renal function (Group 2). In all Group 1 patients Ccr remained less than 25 ml/min and CH2O greater than 15 ml/h for 6 h following surgery. None of the Group 2 patients had Ccr less than 25 ml/min for longer than 4 h following surgery. However, CH2O values were greater than -15 ml/h in 15 of the 33 Group 2 patients during the first 24 postoperative hours. Ccr values less than 25 ml/min were present, despite normal urine flow rate and blood pressure, in patients who subsequently developed renal dysfunction. Patients who have Ccr values less than 25 ml/min within 6 h following trauma and surgery may develop renal dysfunction, and some of them may proceed to acute renal failure. CH2O was not as good a predictor of development of renal dysfunction as Ccr. PMID- 3963479 TI - Maternal and fetal effects of epinephrine in gravid ewes. AB - Intravenous cannulation by an epidural catheter may complicate epidural anesthesia. Local anesthetic solutions containing epinephrine produce tachycardia and hypertension when given intravenously and may identify intravenous placement. The authors studied the maternal and fetal effects of intravenous epinephrine containing solutions in ten chronically instrumented gravid ewes. While continuously monitoring maternal and fetal effects, epinephrine 5, 10, or 20 micrograms iv bolus was injected. Solutions of bupivacaine 5 mg and bupivacaine 5 mg combined with epinephrine 10 micrograms given iv were also examined. All epinephrine-containing solutions produced a significant increase (P less than 0.001) in maternal mean arterial pressure, which returned to baseline after 1 min. Maternal heart rates decreased transiently and returned to baseline after 1 min. All epinephrine-containing solutions decreased uterine blood flow (UBF) (P less than 0.001), and, for doses of 10 to 20 micrograms, this decrease lasted more than 3 min. Fetal heart rate and mean arterial blood pressure did not change following any test solution, nor did maternal or fetal arterial blood gas values. The authors conclude that small intravenous boluses of epinephrine decreased UBF in these animals. PMID- 3963481 TI - Intraoperative tension pneumopericardium with tamponade after ligation of patent ductus arteriosus in a premature neonate. PMID- 3963480 TI - Impaired systolic thickening associated with halothane in the presence of a coronary stenosis is mediated by changes in hemodynamics. AB - Myocardial ischemia results when halothane is administered to animals with severe coronary stenosis. This study was done to separate the effect of halothane, per se, on myocardial ischemia from indirect cardiovascular effects, primarily hypotension, that might cause ischemia by altering the oxygen supply-demand balance. Eight dogs underwent sterile surgery for implantation of sonomicrometer crystals and atrioventricular (A-V) heart block. One week later, each dog was anesthetized with morphine and chloralose. Heart rate was controlled by ventricular pacing and altered in five steps from 50 to 150 beats/min. Arterial blood pressure was controlled by blood withdrawal or phenylephrine infusion at four levels of arterial pressure (60 to 120 mmHg). Regional myocardial contraction was measured at each of the resulting 20 points as an indicator of myocardial ischemia. Twenty points were collected under each of four conditions in each animal: control, halothane (1% inspired), stenosis, halothane plus stenosis. Systolic thickening in the presence of stenosis was divided, on a point by-point basis, by values obtained in the absence of stenosis to obviate the direct effects of blood pressure and heart rate on thickening. A separate normalization was done for data obtained in the presence of halothane. The normalized data demonstrate impaired systolic contraction at low arterial pressures and high heart rates. Multiple regression analysis failed to demonstrate a significant effect of halothane on systolic contraction once the effects of blood pressure, heart rate, and the negative inotropic effect of halothane were taken into account. Thus, the contraction failure that occurred during halothane and severe stenosis was mediated by changes in hemodynamics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963482 TI - An alternative method to secure an endotracheal tube in infants with midline facial defects. PMID- 3963483 TI - Detection of venous air embolism by airway pressure monitoring. PMID- 3963484 TI - Unexpected hyperthermia manifesting during outpatient anesthesia. PMID- 3963486 TI - Bilateral uterine displacement device. PMID- 3963485 TI - Effect of lidocaine on ICP response to endotracheal suctioning. PMID- 3963487 TI - Alarms: help or hindrance? PMID- 3963488 TI - Differences in costs: how much can we save? PMID- 3963489 TI - In defense of trimethaphan for use in preeclampsia. PMID- 3963490 TI - Do not use the "innovated" cylinder valve handle for cracking the valve. PMID- 3963491 TI - Anesthetic management of patients with AIDS. PMID- 3963492 TI - Erroneous cardiac output determination due to pulmonary artery catheter proximal port dysfunction. PMID- 3963493 TI - Frozen pulmonary artery catheter: a complication associated with cryoablation of the ventricle. PMID- 3963494 TI - Anesthesia for acute epiglottitis. PMID- 3963495 TI - Difficult pediatric intubation. PMID- 3963496 TI - Continuous intercostal nerve block. PMID- 3963497 TI - [Rational stabilization of the blood during surgery with extracorporeal circulation in patients with cyanotic tetralogy of Fallot]. PMID- 3963498 TI - [Clinical structure of the pain syndrome after inferior laparotomy in cancer patients]. PMID- 3963499 TI - [The use of assisted blood oxygenation in acute respiratory insufficiency]. PMID- 3963500 TI - [Critical level of oxygen transport during the early postoperative period after heart valve prosthesis]. PMID- 3963501 TI - [Relation between the intrapulmonary shunt and other parameters of oxygenation]. PMID- 3963502 TI - [Normo- and hyperventilation regimens of artificial ventilation during meconium aspiration in neonates]. PMID- 3963503 TI - [Dynamics of spectral-correlation characteristics of EEG during the development of hypoxia and in the early post-resuscitation period]. PMID- 3963504 TI - [Clinical classification of acute respiratory insufficiency after blunt chest injuries]. PMID- 3963505 TI - [Formalization of decision making for drug therapy in resuscitation]. PMID- 3963506 TI - [The state of central hemodynamics and oxygen supply in different methods of artificial ventilation during surgical treatment of pulmonary diseases]. PMID- 3963507 TI - [Blood coagulation, fibrinolysis and kininogenesis in infectious-toxic shock in peritonitis patients]. PMID- 3963508 TI - [Non-invasive evaluation of the stroke volume from the phase structure of the left ventricular systole]. PMID- 3963510 TI - [Identification of the epidural space]. PMID- 3963509 TI - [Approaches to the reducing of the complications of transcutaneous the catheterization of large veins]. PMID- 3963512 TI - [Combined general anesthesia with ketamine and spontaneous air respiration during non-cavitary surgery under reduced atmospheric pressure]. PMID- 3963511 TI - [Premedication with seduxen in combination with different doses of sodium oxybutyrate in preoperative psycho-emotional stress]. PMID- 3963513 TI - [A case of laryngospasm caused by hypomagnesemia]. PMID- 3963514 TI - [Regional changes in blood circulation during short-term ketamine anesthesia]. PMID- 3963516 TI - [Internal carotid artery aneurysm and atheromatous stenosis of the carotid bifurcation. Apropos of a case surgically treated]. PMID- 3963515 TI - [Evaluation of long-term results in axillo-femoral prostheses]. PMID- 3963517 TI - [Effects of cod liver oil on lipids, lipoproteins and platelet function in patients with atherosclerotic vasculopathy. 1. Atherosclerosis. Therapy. Basic concepts. 2. Clinical study. Conclusions]. PMID- 3963518 TI - [Lymphography of the upper extremities in the diagnosis of neoplasms]. PMID- 3963519 TI - Wiskott-Aldrich syndrome with fever of unknown origin. PMID- 3963520 TI - Evidence of mountain cedar pollen in Tulsa. AB - Over the past five winters atmospheric Juniperus (cedar) pollen was collected in December and January in Tulsa, Oklahoma. Evidence from phenology, wind patterns, and plant distribution indicate that this pollen is from Juniperus ashei (mountain cedar) populations in south central Oklahoma and possibly Texas. The presence of this highly allergenic pollen in the Tulsa atmosphere indicates the potential for allergy problems among sensitive individuals in northeast Oklahoma. PMID- 3963521 TI - The effect of birth season on pollenosis. AB - The purpose of this paper is to examine whether exposure to antigens in the early months of life can increase or decrease subsequent sensitization. With this aim in mind, 304 subjects undergoing hyposensitization were randomly selected in an out-patient study: 207 of them had pollenosis (seasonal asthma, rhinitis, and positive skin tests to grass pollen) and 97, house dust respiratory allergy (perennial asthma and rhinitis with positive skin tests to house dust mites). The results of the study show a statistically significant association (P less than .005) between birth in grass pollen season and pollenosis. The region of birth (north or south Italy) appeared to be a "deterministic" effect modificator; the odds ratio due to the birth season was 5.099 in the northern and 0.997 in the southern Italian regions. The main effect of the region of birth was not significant, neither was sex, age, and the region of birth of the parents (main, polinomial and interaction effects). It is likely that there is a real relationship between the month of birth of atopic subjects and the prevalence of the pollenosis. The precise reason(s) of the different degrees of association between month of birth and pollenosis in subjects born in northern and southern Italy is not clear. PMID- 3963522 TI - The use of methacholine inhalation, methacholine skin testing, distilled water inhalation challenge and eosinophil counts in the evaluation of patients presenting with cough and/or nonwheezing dyspnea. AB - Twenty-four patients presenting with cough and/or nonwheezing dyspnea were evaluated with methacholine inhalation challenge (MC), distilled water inhalation challenge (DC), intracutaneous tests to varying concentrations of methacholine, total eosinophil counts (TEC), sinus and chest x-rays. We found a statistically significant difference (P less than .005) in the mean TEC in those patients with a positive MC test and those with a negative test. Hyperreactivity of the airways to methacholine in asthmatics is not found in the skin. Distilled water inhalation did not serve to substitute for MC as a test of hyperreactive airways. The TEC is an excellent screening test as a predictor of patients with cough or dyspnea who have hyperreactive airways. PMID- 3963523 TI - Cold urticaria associated with C4 deficiency and elevated IgM. AB - Various immunologic abnormalities have been implicated in cold urticaria. This is the first report of cold urticaria associated with C4 deficiency and elevated IgM. A 12-year-old male developed urticaria upon exposure to cold. He denied fever, purpura, hemoglobinuria, Raynaud's disease, or arthralgias. Family history was negative for cold urticaria. Immunologic studies revealed elevated IgM (186 mg/dL) as well as decreased CH100 and C4 (8.0 mg/dL). C1, C2, and C3 were normal. Ice cube skin test was positive, but passive transfer tests were negative. Biopsy was not diagnostic for vasculitis, although it revealed a few immunofluorescent deposits of IgM and C4. Complement genetic studies revealed deficiency of two half-null C4 haplotypes expressed as C4A*3QO and B*2QO. PMID- 3963524 TI - Hypersensitivity to chromated catgut sutures: a case report and review of the literature. AB - Chromated catgut sutures are used extensively in general surgical procedures. Although delayed hypersensitivity reactions to this material are difficult to diagnose post-operatively--ie, they may be interpreted as non-specific complications of surgery--the condition can be readily evaluated by patch testing with chromate or intracutaneous placement of the actual suture material. Multiple reports in the literature suggested that there was an increased frequency of post operative adhesions, wound dehiscence, infection, and even intestinal obstruction along the line of suture material to which the patient had been sensitized during a previous surgery. Particularly with the widespread availability of fully synthetic suture materials, which appear to be less sensitizing, an increased awareness of chromate hypersensitivity in patients undergoing repeated surgical procedures may decrease the frequency of subsequent inflammatory post-operative complications. We report a patient with a history of multiple abdominal surgical procedures, eosinophilic cystitis surrounding the suture material, prolonged post operative pain, and inflammatory masses at the sites of previous surgery associated with a positive delayed hypersensitivity skin reaction to patch test chromate and to intradermal chromic catgut. PMID- 3963525 TI - Prospective survey of local and systemic reactions to immunotherapy with pollen extracts. AB - To assess the relative risk of local and systemic reactions to injections of pollen extracts and to examine the predictive value of these local reactions for systemic reactions, a prospective survey of local and systemic reactions was performed from October 1981 to June 1983 at a large military allergy clinic. Four hundred and sixteen patients received 26,645 injections of pollen extracts. Of the total, 25,508 injections (95.7%) were not associated with reactions, 1,055 injections (4.0%) were associated with local reactions (669, less than 2 cm in diameter; 279, 2 to 5 cm; and 107 greater than 5 cm), and 82 injections (0.3%) were associated with systemic reactions. Seventy patients experienced 82 systemic reactions. Of these, 25 (36%) had no prior local reactions. Eighteen males and 52 females had systemic reactions. The sensitivity of local reactions as a predictor of systemic reactions was 64%, the specificity was 1.2%, the positive predictive value was 12%, and the negative predictive value was 14%. Proportionally, more women than men experienced systemic reactions, P less than 0.05. We made the following conclusions. Most injections of pollen extracts were not associated with local or systemic reactions. The majority of reactions were local. The presence of local reactions was not helpful in predicting which patients would develop systemic reactions. Women appeared to be at greater risk for systemic reactions than men. PMID- 3963526 TI - The migration inhibition factor test for identification of hypersensitivity reactions to drugs. AB - The migration inhibition factor (MIF) test detects the in vitro release of lymphokine from lymphocytes in in vitro contact with a drug that had sensitized them in vivo. The specificity and sensitivity of the MIF test in identifying a drug inducing an allergic reaction is presented. The MIF test detected the drugs responsible for 20 out of 21 allergic episodes (95.2%) while the basophil degranulation test detected only eight of them (P less than .001). The sensitivity of a positive MIF test was 95.2% and its specificity was 76.9%. The specificity of a negative MIF test was 94.7%. The positive MIF test assisted the physician in indicating the drugs responsible for an allergic reaction in half of the patients. The drugs for which the MIF test was negative could be considered innocent in 95% of the cases. It is concluded that although the results of the present studies are encouraging, the clinical utility of the MIF test is still limited and improvement of the test specificity is required. PMID- 3963527 TI - Intractable sneezing with a specific psychogenic origin. AB - A case of intractable sneezing due to a specific psychogenic cause is described. Identification of the cause led to resolution of the symptoms which had not otherwise responded to maximum pharmacologic intervention. PMID- 3963528 TI - Methotrexate in the treatment of steroid-dependent asthma. AB - A 63-year-old woman with refractory psoriatic arthritis and asthma, requiring intermittent steroid therapy, was treated with methotrexate (MTX). Her arthritis responded rapidly and it was noted that her asthma required no further steroid therapy. Six patients with established steroid-dependent asthma were then treated with 7.5 to 15.0 mg of MTX per week, after protocols used to treat psoriasis and rheumatoid arthritis. Five patients reduced their steroid usage while on MTX. Side effects were minimal while taking MTX. It was concluded that MTX may have a role in reducing cortisone requirements in steroid-dependent asthma. PMID- 3963529 TI - An analysis of medical care at mass gatherings. AB - Emergency medical care at public gatherings is haphazard at best and dangerous at worst. The Arizona chapter of the American College of Emergency Physicians, through the Chapter Grant Program, studied the level of medical care provided at public gatherings in order to develop guidelines for emergency medical care at mass gatherings. The study consisted of a survey of medical care at 15 facilities providing events for the public. The results of these surveys showed a wide variation of medical care provided at mass events. Of the 490 medical encounters reviewed, 52.2% were within the realm of care of paramedics, but not basic emergency medical technicians. The most common injuries/illnesses were lacerations, sprains, headaches, and syncope. Problems noted included poor documentation and record keeping of medical encounters, a tendency for prehospital care personnel to make medical evaluations without transport or medical control, and variability of care provided. Based on this survey and a literature review, guidelines for medical care at mass gatherings in Arizona were determined using an objective-oriented approach. It is our position that event organizers have the responsibility of ensuring the availability of emergency medical services for spectators and participants. We recommend that state chapters or National ACEP evaluate the role of emergency medical care at mass gatherings. PMID- 3963530 TI - Medical care at the 1982 US Festival. AB - The 1982 US Festival, a three-day outdoor rock music festival, attracted close to 410,000 people. Through a private contractor, a group of physicians participated in the design, administration, and implementation of medical care for this event. Basic ambulatory care was provided by a multitiered approach, using emergency medical technicians, registered nurses, medical health counselors, and physicians. A total of 2,623 encounters required examination and evaluation by health professionals. Thirty-eight percent (1,014 cases) involved minor surgical trauma. Extreme environmental conditions, including temperatures exceeding 114 F, high winds, and unusually high dust concentrations, were thought to be responsible for 361 (13.6%) cases of reactive airway disease and 184 (7%) cases of heat exhaustion. There were 91 transports, of which 12 were classified as major casualties; there were no deaths. PMID- 3963531 TI - Care of the elderly in the emergency department. AB - We prospectively examined the care provided to 234 elderly patients (age greater than or equal to 65) and an equal number of nonelderly patients visiting the emergency department of an urban teaching hospital. Sociodemographic, treatment, cost, and outcome data were collected through ED record reviews and follow-up telephone interviews. The elderly comprised 19% of the ED population and were often nonwhite (31%), Medicaid recipients (39%), living alone (41%), and multiply and chronically impaired. Among old-old patients (age greater than or equal to 75), the most frequent reasons for visiting the ED (19%) were a self-care problem, a fall, or dehydration. Forty-five percent of old-old patients' visits were for true medical emergencies or urgencies. Compared to the nonelderly, the old-old more often were admitted (47% versus 18%, P = .0001), stayed a longer time in the ED (three hours versus 1.9 hours, P = .0001), and incurred a higher charge ($324 versus $208, P = .0001) Twenty-nine percent of these old-old patients who were not initially admitted returned within 14 days (recidivated). The recidivism rate for nonelderly patients was only half as high (15%) (P = .02). PMID- 3963532 TI - Occupational stress within the paramedic profession: an initial report of stress levels compared to hospital employees. AB - We report a study of occupational stress in 374 paramedics. Results indicate that this profession experiences a high degree of job-related stress relative to other medical personnel. In a component analysis of this stress the results show that job stress manifests itself as job dissatisfaction, organizational stress, and negative patient attitudes, but not as frequently as somatic distress. PMID- 3963533 TI - Evaluation of venous distension device: potential aid for intravenous cannulation. AB - A device designed to augment venous filling by applying a vacuum to the upper extremity during tourniquet application was evaluated. Ten healthy adult male volunteers with clinical normovolemia were studied for changes in forearm volume and dorsal hand vein turgor during use of an elastic tubing tourniquet, a blood pressure cuff tourniquet, and a vacuum-assisted cuff tourniquet. Use of the device for 30 seconds was not associated with petechia formation and resulted in a significant increase in venous turgor, as measured by an ophthalmologic tonometer, in comparison to the other tourniquet techniques (P less than .005). Use for 60 seconds was associated with mild to moderate subjective discomfort in all volunteers and petechiae in all nine white volunteers. All petechiae resolved in three days. Venous engorgement as reflected by volume displacement was significantly greater for the vacuum device and blood pressure cuff tourniquet combination than other techniques at 30 and 60 seconds of tourniquet application (P less than .005). Brief application of a vacuum to the arm during tourniquet use increases venous turgor and engorgement in normovolemic volunteers. PMID- 3963534 TI - Promptness of antibiotic therapy in acute bacterial meningitis. AB - We reviewed 135 cases of acute community-acquired bacterial meningitis at a municipal teaching hospital during a six-year period, with special emphasis on promptness of initial antimicrobial therapy. Overall mortality was 5% for the 121 childhood cases, compared to 43% for the 14 adult cases (P less than .001). The mean duration between arrival in the emergency department and the administration of appropriate antibiotics was 2.1 hours for the pediatric cases, compared to 4.9 hours for the adult cases (P less than .02). Factors that may contribute to delays in institution of appropriate antimicrobial therapy for adult patients with meningitis include the relative infrequency of this condition, the presence of concomitant disease processes, and the frequent practice of obtaining a computed tomography scan prior to performing lumbar puncture. Prompt institution of antimicrobial therapy for acute meningitis, especially for adult pneumococcal meningitis, remains a major challenge for emergency physicians. PMID- 3963535 TI - Saline cathartics and the adsorptive capacity of activated charcoal for aspirin. AB - The influence of three saline cathartics and tap water on the adsorption characteristics of activated charcoal for aspirin was studied with adsorption isotherms. Compared with distilled water, the adsorptive capacity of activated charcoal for aspirin was not significantly altered by magnesium sulfate, sodium sulfate, or tap water. Pretreating activated charcoal with magnesium citrate reduced the adsorptive capacity of activated charcoal by 15% (P less than .05). There was no significant correlation between mean pH values and adsorptive capacities in all test solutions. None of the saline cathartic solutions apparently displaced aspirin that already was adsorbed by activated charcoal. PMID- 3963536 TI - Effect of technique of administration on plasma lidocaine levels. AB - There are many clinical situations in which IV access is unavailable, and the endotracheal route is a valuable alternative route for drug therapy. The optimal technique of endotracheal drug administration, however, has not been determined. Twenty-nine dogs were divided into five groups and given endotracheal lidocaine at two doses, 2 mg/kg and 4 mg/kg, by differing techniques: control, undiluted lidocaine in a syringe was given as a bolus; needle, the drug was given through a needle attached to the syringe; dilution, lidocaine was diluted approximately 1:1 with normal saline and the entire dilution was given as a bolus; normal saline (NS) followup, lidocaine in a syringe was given as a bolus, followed immediately by an equal bolus of normal saline; and catheter, the drug was given through a catheter that was placed inside and extended just beyond the endotracheal tube. Mean plasma lidocaine levels (microgram/mL) at five minutes were as follows (at a 2-mg/kg endotracheal lidocaine dose): control, 0.64; needle, 0.0; dilution, 3.1; and (at a 4-mg/kg endotracheal lidocaine dose) control, 1.0; needle, 0.6; dilution, 6.2; NS followup, 1.9; and catheter, 1.9. At all time periods with either dose of lidocaine (2 or 4 mg/kg), the highest plasma lidocaine levels occurred with dilution and the lowest with the needle method. These results were highly significant (P less than .001). The highest plasma lidocaine levels may be attained by diluting the drug with normal saline. Higher levels were achieved when the drug was given through a catheter or when the drug was followed with a bolus of normal saline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963537 TI - A practical score for the early diagnosis of acute appendicitis. AB - We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis. PMID- 3963538 TI - A dosing nomogram for continuous infusion intravenous naloxone. AB - Naloxone hydrochloride is extremely valuable for diagnosing and managing the opioid overdose. Due to naloxone's short half life and a long duration of action of most opioids, repeated naloxone dosing often is required to prevent the recurrence of respiratory depression. An alternative to repeated bolus administration is a continuous IV infusion. We conducted a two-phase study to determine the pharmacokinetics of naloxone and to develop a continuous dosing nomogram. In the first phase seven patients were given an IV bolus dose alone and serial plasma naloxone levels were determined. Naloxone elimination was found to be biexponential with the mean beta half life equal to 0.023 +/- 0.002 reciprocal minutes in two patients and 0.015 +/- 0.02 reciprocal minutes in five patients. In the second phase ten volunteers were given either a 2-mg or a 4-mg bolus dose followed by a 1.5-mg/hr or a 3-mg/hr continuous infusion. The mean volume of distribution of the central compartment was found to be 0.806 +/- 0.408 L/kg. The mean beta rate constant of elimination was found to be 0.036 +/- 0.027 reciprocal minutes. A computer simulation of the pharmacokinetic parameters determined in our study found that a continuous infusion of two-thirds of the bolus dose that resulted in reversal each hour will maintain the plasma naloxone levels equal to or greater than the naloxone levels that would have existed 30 minutes following the bolus dose. PMID- 3963539 TI - Mental confusion in an elderly, chronically ill patient. PMID- 3963540 TI - Acute plastic bowing fractures in children. AB - We report the cases of two children with acute plastic fractures of the long bones following trauma. Bowing deformity was evident clinically and radiographically in both cases. The unique radiologic features consisted of absence of fracture lines and of periosteal new bone formation during the healing phase. The mechanism of injury as well as possible complications in management of acute plastic bowing fractures are discussed. PMID- 3963541 TI - Occult transorbital intracranial penetrating injuries. AB - Emergency physicians who are confronted with orbital injuries must recognize that the transorbital route offers little resistance to intracranial penetration. Neither direct inspection of an orbital wound nor plain radiographs are sufficient to evaluate the extent of penetration beyond the orbital confines. A high index of suspicion is critical to the proper assessment and subsequent management of such injuries. We present two cases of penetrating injury. In the first, an arrow caused a hematoma in the superior cerebellar peduncle after passing through the medial orbit and superior orbital fissure. In the second, a wire entered the upper lid, fractured the orbital roof, and caused a frontal hematoma. PMID- 3963542 TI - Benztropine-induced acute dystonic reaction. AB - We report an unusual case of benztropine-induced acute dystonia and dyskinesia without findings of acute anticholinergic toxicity in a 20-month-old child. Laboratory analysis of blood, urine, and gastric contents demonstrated the presence of an atropinic compound and diphenhydramine only, suggesting the association of benztropine and acute dystonia. Effects of benztropine on neuronal uptake of dopamine may represent a possible mechanism for this unusual adverse effect. PMID- 3963543 TI - Cardiopulmonary arrest secondary to lightning injury in a pregnant woman. AB - A young woman who was seven months pregnant was struck by lightning, resulting in cardiopulmonary arrest. Bystander CPR was begun at the scene. Vital signs were restored by the time the rescue squad arrived. The patient was comatose on arrival in the emergency department and fetal death was apparent. The patient's neurological status improved markedly, with a small residual motor deficit. PMID- 3963545 TI - Triage to trauma centers. PMID- 3963544 TI - Medical care at mass gatherings. PMID- 3963546 TI - Is emergency medicine built to self destruct by 1992? PMID- 3963547 TI - Cervical radiographic evaluation following blunt trauma. PMID- 3963548 TI - Locked-in syndrome. PMID- 3963549 TI - Ts and blues. PMID- 3963550 TI - Initial reaction to FRMTs in the CML. PMID- 3963551 TI - Identification of antigens of two isolates of Anaplasma marginale, using a western blot technique. AB - Antigens of the Illinois (IAM) and Florida (FAM) isolates of Anaplasma marginale were analyzed, using the western blot technique and antiserum from A marginale infected calves. Crude antigens were prepared from the parasitemic blood of each. Antiserum was collected after the primary and recrudescent parasitemias. Antigens were separated, using sodium dodecyl sulfate polyacrylamide gel electrophoresis. Antigens were then transferred onto nitrocellulose membranes and exposed to test sera. Antibodies attached to the membrane-bound antigens were detected, using an avidin/biotin peroxidase assay and biotinylated rabbit anti-goat immunoglobulin G. Antigens detected were of a high molecular weight group (108 to 91 kilodaltons [kd]) or of a low molecular weight group (47 to 27 kd). The IAM antigens were 100 kd, 96 kd, 47 kd, 38 to 43 kd, and 27 kd; these antigens were detected, using anti-IAM and anti-FAM antibodies, but the anti-FAM antibodies had a strong reaction to only the 100-kd and 38- to 43-kd antigens of IAM. The FAM antigens were 108 kd, 91 kd, 47 kd, 38 to 43 kd, and 27 kd; these antigens were detected, using anti-FAM antibodies and, except the 91 kd antigen, anti-IAM antibodies. Because the 91-kd antigen was detected only in the FAM antigen and detected only by sera from FAM-infected calves, this isolate-specific antigen may be associated with the ability of FAM to induce disease in an IAM-immune animal. Sheep anti-A ovis antibodies reacted only to the 38- to 43-kd antigens of each isolate, indicating that these antigens may be genus-specific.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963552 TI - Comparison of two techniques for quantitation of encysted cyathostome larvae in the horse. AB - Haustral portions of intestine of 6 horses were isolated by excising the taeniae coli from the cecum and the ventral colon. Uniform 5-cm X 5-cm sections were cut from the haustra and were illuminated from the serosal side with a strong light source (mural transillumination). Cyathostome larvae encysted in the mucosa and submucosa were observed at 15 X magnification and counted. Two separate counts of the larvae in 80 replicates of tissue by the mural transillumination technique (MTT) revealed no significant (P less than 0.05) difference between sample means. Larvae in tissue sections were counted in situ by MTT, and the mucosal scrapings of the tissue sections were digested in pepsin and HCl to determine larval yields for comparison with the MTT counts. Numbers of larvae recovered by pepsin and HCl digestion for 3 and 6 hours were significantly (P less than 0.01) lower than were numbers originally determined by MTT. Larvae recovered by tissue digestion for 3 or 6 hours were examined individually and given objective scores for morphologic damage. Distribution of scores was time-dependent; increased damage to larvae was associated with a longer time of digestion. Individual 4th-stage cyathostome larvae were dissected from cysts in the large intestinal wall and were incubated in water, 0.9% saline solution, 1.1% HCl, or pepsin (7,000 U of activity/ml). Significantly fewer (P less than 0.05) larvae were recovered from all solutions after 3 and 6 hours. The proportion of dissected larvae that were given high scores after exposure to pepsin was significantly (P less than 0.01) greater than were those held in HCl, saline solution, or water for both periods. PMID- 3963553 TI - Anatomic distribution of encysted cyathostome larvae in the horse. AB - The large intestines of 6 horses were divided by length into 12 segments, and each segment was washed and weighed. At least 5% by weight of each segment was examined by mural transillumination, and encysted cyathostome larvae were counted. Total numbers of larvae in each segment were calculated. Encysted larvae (98%) were present in the proximal 7 segments of the large intestine (cecum and proximal 75% of the ventral colon), and 2% were present in the distal 25% of the ventral colon and entire dorsal colon. Encysted larvae (6%) were located in the dorsal colon of 1 heavily infected horse. Larval density was greatest in the cecum, which harbored 57% of encysted worms yet contributed only 27% to the total weight of the large intestine. Larvae dissected from tissue cysts consisted of species that were highly prevalent as adult worms. However, there were few Cylicostephanus longibursatus, probably because of the small size and fragility of its 4th-stage larvae. PMID- 3963554 TI - Effect of irradiation on the viability of Toxoplasma gondii cysts in tissues of mice and pigs. AB - Muscles from tongue, heart, and limbs of 14 pigs inoculated orally with Toxoplasma gondii oocysts were irradiated with 10, 20, 25, and 30 krad of gamma (cesium-137 and cobalt-60) irradiation. Viability of T gondii cysts was assayed by feeding porcine muscles to T gondii-free cats and/or by inoculation of sediment from acid-pepsin digested porcine muscle into mice. Cats fed 500-g samples of muscles irradiated with up to 20 krad shed T gondii oocysts. Cats fed muscles irradiated with 25 or 30 krad did not shed oocysts. Mice were inoculated with 8 isolates of T gondii, and tissue cysts in their brains irradiated with up to 40 krad were infective to mice; however, there was a 10,000-fold reduction in the viability of organisms in tissue cysts irradiated with 40 krad, compared with that in nonirradiated cysts. At 50 krad of gamma irradiation, there were no detectable infective organisms in infected mouse brains. PMID- 3963555 TI - Epidemiologic aspects of bovine anaplasmosis in semiarid range conditions of south central Idaho. AB - The prevalance of Anaplasma marginale-infected cows, as determined by use of the modified rapid card agglutination (MRCA) test, was measured during a 4-year period (1980-1983). The prevalence of A marginale-infected cows, defined as positive reactors on the MRCA test, remained constant (31%-37%). The apparent incidence of A marginale transmission to susceptible cows was approximately 7% from 1980 to 1981, 8% from 1981 to 1982, and no transmission from 1982 to 1983. The occasional MRCA-positive cow became negative on the MRCA test, and 1 cow was determined to be free of A marginale infection by subinoculation of 100 ml of the cow's blood into a susceptible, splenectomized calf. Dermacentor andersoni, a known vector of A marginale, was often found on the cattle and in their environment. However, A marginale was not transmitted to susceptible, splenectomized calves, using collected ticks. Of 56 calves born to MRCA-positive cows, 82% were MRCA-positive within the first 3 months of life. These calves converted to MRCA-negative status and were determined to be free of A marginale infection by subinoculation of their blood into susceptible, splenectomized calves, indicating the passive transfer of colostral antibodies. PMID- 3963556 TI - Adherence of neutrophils from dogs with diabetes mellitus. AB - Adherence of neutrophils from dogs with type I (insulin-dependent) diabetes mellitus controlled by insulin administration was compared with that from control dogs. Neutrophil adherence in whole blood decreased with increased serum glucose concentration, but was not different from normal cell adherence when isolated cells were examined. The decreased adherence in whole blood was considered to be the result of media factors and not dependent on altered neutrophil function. PMID- 3963557 TI - Standardization of enzyme-linked immunosorbent assay for avian influenza virus antibodies in turkeys. AB - The signal-to-noise ratio was useful in determining the optimal dilution of rabbit anti-turkey conjugate. Optimum dilution for rabbit anti-turkey conjugate to be used in the enzyme-linked immunosorbent assay (ELISA) was 1:1,000. The avian influenza virus antigen concentration was 128 hemagglutinating units (0.3 microgram of protein) per well, as determined by checkerboard titration. Bovine serum albumin fraction V increased nonspecific binding of conjugate and was not used to coat the plates in subsequent tests. Using ELISA, nonspecific binding to avian influenza virus-coated plates were not found with antibodies to Newcastle disease virus, infectious bursal disease, Salmonella, or Escherichia coli. Chromogens o-phenenediamine, and 2,2'-azino-di-(3-ethyl-benz-thiazoline sulfonic acid) were almost equal in sensitivity for detecting released oxygen from the H2O2. The substrate plate was more sensitive than was the polystyrene plate. Dual wavelength was reliable in reading ELISA results. PMID- 3963558 TI - Conduction velocities and myelinated fiber diameter spectra of the infraorbital and palpebral nerves of the dog. AB - Maximum conduction velocities of compound-action potentials of the infraorbital (ION) and palpebral (PN) nerves were determined by averaging potentials evoked and recorded through subcutaneous needle electrodes. The specificity of the stimulating and recording sites was verified by recording before and after cutting the nerves. Conduction times for orthodromically and antidromically conducted potentials of the ION were essentially the same. The unipolarly recorded antidromic compound-action potentials of the ION were of higher peak-to peak amplitude and were more reliably recorded than were the bipolarly recorded orthodromic action potentials. Areas of cutaneous innervation were not found for the PN. Neuromuscular blockade eliminated the volume-conducted muscle action potentials that were recorded after PN stimulation, allowing triphasic nerve action potentials to be recorded unobscured. Mean conduction velocities were: ION = 83.9 +/- 3.5 m/s; PN = 56.4 +/- 2.8 m/s. Distributions of the external diameters of myelinated fibers within the ION and the PN were determined. PMID- 3963559 TI - Pathologic findings in the oviducts of mares. AB - Oviducts from 325 mares were evaluated macroscopically, and oviducts from 124 mares were evaluated microscopically. Two hundred and eighty-five (87.69%) of the mares had at least 1 macroscopic lesion and 116 (93.54%) had at least 1 microscopic lesion. The most frequently seen macroscopic lesions were adhesions, paraovarian cysts, and thick fibrous bands. Microscopically, intraepithelial cysts, slight, focal lymphocytic infiltration in the infundibular-ampullary region, and proteinoid material in the oviductal lumen were the most common findings. In general, the proximal segments of the oviduct were more affected than were the distal segments. Forty-nine (90.74%) of the 54 pairs of oviducts collected from pregnant mares had at least 1 macroscopic or microscopic lesion. PMID- 3963560 TI - Histologic findings in the gastrointestinal tract of horses with colic. AB - Thirty horses were admitted to the University of Georgia Veterinary Medical Teaching Hospital with colic severe enough to warrant surgery and/or euthanasia. Gastrointestinal tracts of these 30 horses were histologically examined for morphologic changes. The horses were grouped according to cause of the colic (ie, simple obstruction, strangulation obstruction, thromboemboli, and inflammation). Lesions were graded as to severity, and grade scores were correlated with survival or nonsurvival. Mucosal changes developed distal and proximal to the primary lesion site and, although there were some differences between groups, changes characteristic of ischemia were common to all groups. The predictability of lesion grades of 2 or higher for nonsurvivability (90%) indicates that intestinal biopsy may have prognostic value in the postsurgical evaluation and management of equine colic. PMID- 3963561 TI - Heterotransplantation of equine carcinoma cells in athymic (nude) mice. AB - Nondifferentiated equine carcinoma cells from a primary lesion were implanted subcutaneously in athymic (nude) mice. The cells were implanted at 2 sites each in 3 mice. At 1 of the 6 inoculation sites, a tumor developed, which invaded surrounding tissues, as shown by histopathologic examination. Karyotype analysis verified that the tumor was of equine origin. Cells from this tumor were serially heterotransplanted 20 times without change in growth rate. Once established in nude mice, this equine carcinoma cell line was stored cryogenically and then was successfully reimplanted into nude mice. All of the implants developed into tumors, over 20 generations. Preliminary screening of antineoplastic drugs indicated that this tumor line is sensitive to cyclophosphamide. Because of its ease of handling and high reimplantation efficiency, this tumor line should prove useful in equine cancer research. PMID- 3963562 TI - Infectious bovine keratoconjunctivitis: contact transmission. AB - The transmission of Moraxella bovis was studied in calves in the absence of the face fly (Musca autumnalis) or environmental conditions that might insult the eye. Thirty calves were placed in 10 groups of 1 experimentally infected calf and 2 contact calves each. Over 40 days, only 1 eye in 1 contact calf developed clinical infectious bovine keratoconjunctivitis. The organism was recovered in only 8 of 20 contact calves, whereas infection and disease occurred in all experimentally infected calves. Transmission of M bovis occurring in the absence of some other intervening factor was probably of minimal importance. Seemingly, herd preventive treatment would be most effective when flies and environmental factors are at a minimum. PMID- 3963563 TI - Genotypic characterization of type-2 variants of canine adenovirus. AB - Two canine adenovirus (CAV) isolates, apparently distinct from type-1 (Utrecht) and type-2 (Toronto A26/61) reference strains in their biochemical and/or immunologic properties, were submitted to DNA-restriction endonuclease analysis. Both isolates, designated IAF-81-2116 and IAF-75-95, appeared as genotypic variants of CAV-2. Isolate IAF-81-2116 was recovered from the intestine of a young pup with diarrheal disease. Seemingly, relatively small changes in the original CAV-2 DNA sequence allowed the virus to replicate at an unusual site in the dog. PMID- 3963564 TI - Cardiopulmonary effects of acepromazine and of the subsequent administration of ketamine in the dog. AB - Cardiopulmonary consequences of acepromazine (0.2 mg/kg of body weight, IV) followed by IV administration of ketamine (10 mg/kg) were evaluated in 13 dogs. Acepromazine caused significant decreases in arterial blood pressure, stroke volume, left ventricular work, left ventricular stroke work, breathing rate, minute ventilation, and oxygen consumption. Subsequent administration of ketamine caused significant increases in heart rate, effective alveolar volume, alveolar arterial Po2 gradient (transient increase), venous admixture (transient increase), and PaCO2 and PVCO2 (transient increases), and caused significant decreases in stroke volume, minute ventilation, physiologic dead space, and arterial and venous PO2 (transient decreases). PMID- 3963565 TI - Xylazine and xylazine-ketamine in dogs. AB - The cardiopulmonary consequences of IV administered xylazine (1.0 mg/kg) followed by ketamine (10 mg/kg) were evaluated in 12 dogs. Xylazine caused significant decreases in heart rate, cardiac output, left ventricular work, breathing rate, minute ventilation, physiologic dead space, oxygen transport, mixed venous partial pressure of oxygen, and oxygen concentration. It caused significant increases in systemic blood pressure, central venous pressure, systemic vascular resistance, tidal volume, and oxygen utilization ratio. The subsequent administration of ketamine was associated with significant increases in heart rate (transient increase), cardiac output, the alveolar-arterial PO2 gradient and venous admixture (transient increase), and arterial PCO2 (transient increase). It caused significant decreases in stroke volume (transient decrease), left ventricular stroke work (transient decrease), effective alveolar ventilation, arterial PO2 and oxygen content (transient decrease). PMID- 3963566 TI - Age and dosage dependency in the plasma disposition and the renal clearance of sulfamethazine and its N4-acetyl and hydroxy metabolites in calves and cows. AB - Plasma disposition, protein binding, urinary recovery, and renal clearance of sulfamethazine (SMZ), its N4-acetylsulfamethazine (N4-SMZ), and its 2 hydroxy metabolites--6-hydroxymethylsulfamethazine (SCH2OH) and 5-hydroxysulfamethazine (SOL)--and the glucuronide of the latter were studied in 7 cows and 7 calves to determine the relationship between these values and the age of the animal and dosage applied. A capacity-limited hydroxylation of SMZ into SCH2OH was observed in cows and calves given dosages of 100 to 200 mg/kg. A biphasic SMZ elimination curve and steady state in SCH2OH plasma concentration (6 to 15 micrograms/ml) were observed. The N4-SMZ plasma concentration-time curve was parallel to that of SMZ at the dosages and in all animals. The total body clearance and the cumulative urinary recovery (expressed as percentage of the dose) for SMZ and its metabolites depended on drug dosage and age of the animals. At dosages of SMZ less than 25 mg/kg, the main metabolite in the urine of calves and cows was SCH2OH (23% to 55.2%), whereas in calves given a larger dosage (100 mg/kg), the N4-SMZ and SOH percentages increased. The plasma protein binding of SMZ and its metabolites depended on the SMZ plasma concentration. Hydroxylation lowered the protein binding (from 75-80%) to 50%. The renal clearance of SMZ was dependent on urine flow in all animals. The renal clearance of the SCH2OH metabolite was 2 to 3 times greater than the creatinine clearance value; thus, this compound was excreted by glomerular filtration and partly by tubular secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963567 TI - Bovine peritoneum: fibrinolytic activity and adhesion formation. AB - The fibrinolytic activity of peritoneum was evaluated in 4-month-old calves before and after peritoneal trauma. In each calf, a peritoneal resection, abrasion, sutured incision, and nonsutured incision were performed. These 4 trauma sites were evaluated for fibrinolytic activity and adhesion formation at 1 of 6 posttrauma intervals (1, 2, 3, 5, 8, or 14 days). Peritoneal plasminogen activator and fibrinolytic inhibitor activities from pre- and posttrauma samples were evaluated, using a fibrin-slide incubation technique. Calf peritoneal specimens consistently had fibrinolytic inhibitor activity, but did not have plasminogen activator activity. Significant differences were not found between fibrinolytic activity before or after trauma and a significant correlation was not found between fibrinolytic activity and the presence of or severity of adhesions. PMID- 3963568 TI - Quantitation of the pharyngoesophageal sphincter in the dog. AB - The pressure and length of the pharyngoesophageal sphincter were studied in 5 healthy dogs that were awake and then immobilized with xylazine. During successive tests, a single side-hole catheter was mechanically withdrawn and rotated 90 degrees. Similar pressures were measured, regardless of the orientation of the catheter side hole. The mean pressure and length of the pharyngoesophageal sphincter of the awake dogs were 18 mm of Hg and 1.8 cm, respectively. After the dogs were immobilized with xylazine, the mean pressure and length were 8 mm of Hg and 1.7 cm, respectively. In 2 dogs immobilized with xylazine, there was no change in the maximum resting pharyngoesophageal sphincter pressure or length of the pressure zone after IV administration of edrophonium chloride, succinylcholine chloride, or thiamylal sodium. Seemingly, xylazine was not a suitable agent for immobilization of clinical patients for pharyngoesophageal manometry. PMID- 3963570 TI - A newly designed tensiometer. AB - A newly designed tensiometer is described in detail. The tensiometer was used to test the tensile strengths of skin wounds on the trunks of 12 female laboratory Beagles at 5, 9, and 14 days after operation. The tensile strengths increased significantly from day 5 to day 14. The newly designed tensiometer could be used to obtain accurate in vivo measurements of the tensile strengths of skin wounds. PMID- 3963569 TI - Comparison of porous titanium-surfaced and standard smooth-surfaced bone plates and screws in an unstable fracture model in dogs. AB - Bilateral midshaft femoral osteotomies were fixed with a 3-mm fracture gap in 6 dogs. In each dog, one femur was fixed with a porous titanium-surfaced bone plate and screws, whereas the opposite femur was fixed with a standard smooth-surfaced bone plate and screws. The mean removal torque for porous titanium-surfaced screws (32.3 kg X cm) was significantly (P less than 0.01) greater than the mean removal torque for standard screws (4.4 kg X cm). Osseous tissue ingrowth into the surface of porous titanium-surfaced screws was verified by histologic examination of the bone-screw interface. Radiographic and histologic examinations of the osteotomy gaps showed accelerated primary gap healing in osteotomies fixed with porous titanium-coated implants, compared with slower callus healing seen in osteotomies fixed with standard smooth-surfaced implants. PMID- 3963572 TI - Preferential grazing by cattle on glyphosate-treated fescue pastures. AB - Cattle grazing preferences on fescue pastures treated with the herbicide glyphosate at a rate of 2.52 kg/ha by surface application were determined, and the time course of the effect was characterized. An initial grazing preference for treated pasture was observed for the first 5 to 7 days. Over the next 15 days, this preference was lost because of decreasing amounts of herbicide on the herbage and/or desiccation of the herbage. PMID- 3963571 TI - Familial nonspherocytic hemolytic anemia in poodles. AB - Nonspherocytic hemolytic anemia, characterized by marked reticulocytosis, hepatosplenomegaly, hemosiderosis of reticuloendothelial organs and bone marrow myelofibrosis, and osteosclerosis, was diagnosed in 5 related Poodles. The unremitting anemia was clinically evident by 1 year of age, and was fatal as early as 3 years of age. Despite intense diagnostic endeavors including RBC fragility studies, RBC enzyme assays, and hemoglobin electrophoresis, the cause of this nonspherocytic hemolytic anemia remains to be determined. PMID- 3963573 TI - Effect of ascorbic acid on neutrophil function. PMID- 3963574 TI - Survival of Corynebacterium pseudotuberculosis in axenic purulent exudate on common barnyard fomites. AB - Several inanimate surfaces (eg, plastic, wood, and steel) and particulate fomites (eg, wood shavings, hay, straw, and feces), common to the environment of confined small ruminants, were inoculated with Corynebacterium pseudotuberculosis in axenic purulent exudate that had been surgically removed from a naturally occurring case of caprine caseous lymphadenitis. Each inoculated fomite was incubated at 37, 22, and 4 C, and the length of time that C pseudotuberculosis survived was determined by isolation of bacteria from the fomite. The organism remained viable longer when caseous lymphadenitis abscess contents were mixed with particulate fomites than when spread on surfaces. Incubation at lower temperatures generally extended the survival potential of C pseudotuberculosis. Depending on the particulate fomite and the incubation temperature, viable C pseudotuberculosis organisms were isolated for mean periods ranging from 7 to 55 days, whereas recovery of bacteria from surfaces varied from 1 to 8 days. PMID- 3963575 TI - Pasteurella haemolytica leukotoxin: physicochemical characteristics and susceptibility of leukotoxin to enzymatic treatment. AB - Sterile, concentrated culture supernatant from Pasteurella haemolytica (biotype A, serotype 1) strain 630 was subjected to physical, chemical, and immunologic treatments to determine their influence on leukotoxin (cytotoxin) activity contained in the supernatant. Each treated sample contained approximately 8 chemiluminescence inhibitory units of leukotoxin. Treatment effects were evaluated for their ability to inactivate leukotoxin activity. Leukotoxin activity in treated samples was determined by inhibition of the luminol-dependent chemiluminescence response of bovine neutrophils. Optimal leukotoxin synthesis by P haemolytica occurred when the bacteria were at the logarithmic growth phase, whereas stationary phase cultures contained minimal amounts of leukotoxin activity in their culture supernatant. Leukotoxin activity was heat labile; activity was substantially decreased when concentrated culture supernatant samples containing leukotoxin activity were incubated at 37 C for several hours. When concentrated culture supernatant was incubated at progressively decreasing temperatures, there was a progressive increase in the length of time that the leukotoxin retained its biologic activity. Samples stored at -70 C retained activity for at least 2 months. Leukotoxin activity was nondialyzable and was able to withstand considerable extremes in hydrogen ion concentration. Leukotoxin activity could not be pelleted when subjected to forces of 100,000 X g for 1 hour. Chemical and enzymatic studies suggested that P haemolytica leukotoxin contained carbohydrate and protein moieties. Chemical treatment with 0.2% sodium lauryl sulfate, 0.5% sodium deoxycholate, 7.5 mM EDTA and 8M urea with 8 mM 2 mercaptoethanol and enzymatic treatment with lipase, ribonuclease, and deoxyribonuclease had no discernible effect on leukotoxin activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963576 TI - Pasteurella multocida isolated from rabbits and swine: serologic types and toxin production. AB - Pasteurella multocida isolates from rabbits and swine of different geographic origins were serologically grouped and typed. Similar capsule serogroups and somatic serotypes were common to both species. Selected serotypes of both serogroups A and D were tested for toxin production. Toxin-producing isolates from both rabbits and swine were found in serogroup D, but not serogroup A. A correlation was not found between somatic serotype and the capability of an isolate to produce toxin. Noncapsulated variants derived from parent capsulated toxin-producing isolates also produced toxin. The capability of an isolate to produce a toxin did not necessarily make it virulent. The toxins from rabbit and swine P multocida of different geographic origins were antigenically similar. Cell lysis was compared with sonication as a method to release cell-associated toxin for biochemical purification. The toxin was purified from lysates by ammonium sulfate precipitation, followed by ion exchange and gel-filtration chromatographic procedures. The purified toxin had a molecular weight of 112,000 to 158,000 and an apparent isoelectric point of 4.65 to 4.8. The toxin precipitated at pH near its isoelectric point. Electrofocusing-electrophoresis titration curves of the purified toxin preparation showed it consisted of 2 similar proteins which varied in their capabilities to stain with Coomassie brilliant blue. The proteins precipitated together near their apparent isoelectric point and interacted at pH 9.7. PMID- 3963577 TI - Detection of antibody in rams with contagious epididymitis, using the enzyme linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay, using whole-cell and sonicated antigens prepared from Brucella ovis, Actinobacillus seminis, and Actinobacillus seminis like cultures isolated from rams in Wyoming, was able to detect antibody to these antigens in rams with epididymitis. The whole-cell antigens used in this procedure gave lower background values, compared with those of the sonicated antigens. The procedure was able to detect antibody in rams before clinical signs of epididymitis became apparent. PMID- 3963578 TI - Use of tolazoline as an antagonist to xylazine-ketamine-induced immobilization in African elephants. AB - A group of 15 African elephants (Loxodonta africana) were immobilized with a combination of xylazine (0.2 mg/kg of body weight, IM) and ketamine (1 to 1.5 mg/kg of body weight, IM). Ten of the African elephants were allowed to remain recumbent for 30 minutes and the remaining 5 elephants, for 45 minutes before they were given tolazoline (0.5 mg/kg of body weight, IV). For the group of 15, the mean induction time (the time required from injection of the xylazine ketamine combination until onset of recumbency) was 14.2 +/- 4.35 minutes (mean +/- SD), and standing time (the time required from the tolazoline injection until the elephant stood without stimulation or assistance) was 2.8 +/- 0.68 minutes. All of the elephants were physically stimulated (by pushing, slapping, shouting) before they were given tolazoline, and none could be aroused. After tolazoline was given and the elephant was aroused, relapses to recumbency did not occur. Recovery was characterized by mild somnolence in an otherwise alert and responsive animal. Failure (no arousal) rates were 0% (95% confidence interval, 0 to 0.3085) for elephants given tolazoline after 30 minutes of recumbency and 100% for elephants that were not given tolazoline. There was no significant (P less than 0.05) difference in standing time 30 or 45 minutes after tolazoline injection. PMID- 3963579 TI - Pharmacokinetics and body fluid and endometrial concentrations of cephapirin in mares. AB - Six healthy adult horse mares were each given a single injection of sodium cephapirin (20 mg/kg of body weight, IV), and serum cephapirin concentrations were measured serially over a 6-hour period. The mean elimination rate constant was 0.78 hour-1 and the elimination half-life was 0.92 hours. The apparent volume of distribution (at steady state) and the clearance of the drug were estimated at 0.17 L/kg and 598 ml/hour/kg, respectively. Each mare was then given 4 consecutive IM injections of sodium cephapirin (400 mg/ml) at a dosage level of 20 mg/kg. Cephapirin concentrations in serum, synovial fluid, peritoneal fluid, CSF, urine, and endometrium were measured serially. After IM administration, the highest mean serum concentration was 14.8 micrograms/ml 25 minutes after the 4th injection. The highest mean synovial and peritoneal concentrations were 4.6 micrograms/ml and 5.0 micrograms/ml, respectively, 2 hours after the 4th injection. The highest mean endometrial concentration was 2.2 micrograms/g 4 hours after the 4th injection. Mean urine concentrations reached 7,421 micrograms/ml. Cephapirin did not readily penetrate the CSF. When cephapirin was given IM at the same dose, but in a less concentrated solution (250 mg/ml), serum concentrations peaked at 25.0 micrograms/ml 20 minutes after injection, but the area under the serum concentration-time curve was not significantly different (P greater than 0.05). The bioavailability of the drug was greater than or equal to 95% after IM injection. PMID- 3963580 TI - Dose-dependent pharmacokinetics of gentamicin in sheep. AB - Dose-related changes in the pharmacokinetics of gentamicin sulfate were investigated in 9 sheep given 3, 10, or 20 mg/kg of body weight IV in a crossover design with a 24-day washout period. The pharmacokinetics of the 3 mg/kg single dose were compared with that of the terminal phase pharmacokinetics of 3 mg of gentamicin/kg IV every 8 hours for 7 days in 8 additional sheep. Serum concentrations were monitored for 21 to 24 days after the dose. Polyexponential equations were fit to each data set. The number of exponential terms was determined by optimizing the fit for each data set. The pharmacokinetics of the 3 mg/kg single dose were mainly described by triexponential equations. The 10 mg/kg and the 20 mg/kg single doses and the 3 mg/kg multiple-dose data were described by a tetraexponential equation. The elimination rate constant was significantly smaller (P less than 0.05) after the larger single doses, and the serum gentamicin clearance increased as the dose increased (P less than 0.05). The crossover design sequence had a significant effect on serum gentamicin clearance and the area under the curve normalized to unit dose (P less than 0.01). The final exponential phase was not detectable with the present assay sensitivity under the 3 mg/kg single dose. The triexponential equation underpredicted the terminal serum concentrations determined after the 3 mg/kg multiple dose, whereas the 4 phase equation overpredicted the same terminal serum concentrations, perhaps reflecting saturation of the tissue pools that were mirrored by the serum gentamicin concentrations after 24 hours. The present study emphasized the complexity of the terminal phase gentamicin. pharmacokinetics and acknowledged the need for a long-term washout period when using the crossover design for gentamicin pharmacokinetic studies. PMID- 3963581 TI - Concentrations of penicillin, streptomycin, and spiramycin in bovine udder tissue liquids. AB - Concentrations of benzylpenicillin and spiramycin adipate were determined in bovine plasma and milk and in lymph draining the udder tissue after IM or IV administration. Combined benzylpenicillin and dihydrostreptomycin sulfate concentrations were also determined in the same fluids after intramammary injection. A superficial parenchymal lymph vessel, afferent to the supramammary lymph gland of the left quarters, was cannulated with a polythene catheter from which the lymph was allowed to drain freely. After injections of 9.5 mg of benzylpenicillin/kg of body weight IM, a mean peak concentration (PC) in lymph (3.7 micrograms/ml), constituting 77% of the PC in plasma (4.8 micrograms/ml), was obtained 0.5 to 1 hour after PC in the plasma. The benzylpenicillin lymph concentration was close to that in plasma for about 7 hours after injection. Thereafter, the benzylpenicillin lymph concentration continued to exceed that in plasma, but not that in milk. After IV administration of spiramycin adipate, the lymph concentration was almost identical to that in plasma. After intramammary injection of procaine benzylpenicillin (400 mg), in combination with the same amount of dihydrostreptomycin sulfate, into 2 udder quarters each, mean PC in the lymph of 3.5 micrograms/ml and 8.4 micrograms/ml, respectively, were obtained 6 hours after injection. In plasma, the mean PC of benzylpenicillin (0.07 micrograms/ml) and of dihydrostreptomycin sulfate (0.85 micrograms/ml) were obtained after 4 and 6 hours, respectively. In milk from the nontreated quarters, a mean concentration of 5 ng of benzylpenicillin/ml was obtained, whereas dihydrostreptomycin sulfate (greater than or equal to 0.3 microgram/ml) was not detected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963582 TI - Electrocardiographic evaluation of the healthy raccoon (Procyon lotor). AB - Leads I, aVF, V3, and V10 ECG were obtained from 12 healthy raccoons anesthetized with xylazine and ketamine. Intervals and amplitudes of component deflections were remarkably uniform among the individuals. Vector orientation of QRS mimicked that for the dog; but the relatively low voltages to QRS mimicked those of cats. The QT interval varied inversely with heart rate, whereas the PQ interval varied directly with body weight. Relationship between heart rate and body weight was not significant (P greater than 0.05). PMID- 3963583 TI - Copper inhibition of the thiobarbituric acid reaction in Bedlington terriers. AB - The effect of copper on thiobarbituric acid (TBA) reaction values, an index of lipid peroxidation, was examined in Bedlington Terriers, healthy dogs, and rats. High hepatic concentrations of copper appeared to lower TBA values in the inherited, chronic, progressive hepatic degeneration of Bedlington Terriers, a disease associated with copper toxicosis. The suspected TBA inhibition was confirmed when Cu2+ was added to homogenates of healthy dog or rat liver or a malondialdehyde standard. The amount of copper added approximated that in diseased Bedlington Terriers. Because of the interference by copper, the TBA test was judged to be an inappropriate test for the evaluation of lipid peroxidation in samples containing high copper concentrations such as those in diseased Bedlington Terriers. PMID- 3963584 TI - Multielement assays of canine serum, liver, and kidney by inductively coupled argon plasma emission spectroscopy. AB - Inductively coupled argon plasma emission spectroscopy was used to measure Al, As, Ca, Cd, Cr, Cu, Fe, Pb, Mg, Mn, Hg, Mo, P, K, Se, Na, Tl, and Zn in canine specimens (70 serum, 270 liver, and 200 kidney). Mean concentrations of each of these elements in detectable amounts in these samples were established, and histograms of the concentration distributions of elements in the samples were developed. PMID- 3963585 TI - Electroencephalogram and evoked potentials in naturally occurring scrapie in sheep. AB - Electroencephalogram (EEG), brain stem auditory-evoked potential, and flash visual-evoked potential recordings were taken from healthy sheep and from 3 sheep with scrapie, a CNS slow virus infection. The EEG changes included semi-periodic, polyphasic, high-voltage sharp waves (bilaterally synchronous and symmetric in all channels), and a cyclic alternating pattern consisting of a high-voltage low frequency phase, followed by a low-voltage high-frequency phase. The high-voltage phase occurred with increased arousal, and the low-voltage phase occurred with decreased arousal. Myoclonic jerks were coincident with EEG sharp waves in one sheep with scrapie. Several spontaneous focal seizures were observed. Wave-form amplitudes were greatly reduced in the brain stem auditory-evoked potential and flash visual-evoked potential; degree of reduction did not always correlate with disease severity. The EEG and evoked potential changes were seen in an exposed sheep that had not yet developed clinical signs of scrapie. PMID- 3963586 TI - Location of the instantaneous center of joint rotation in the normal canine stifle. AB - Locations of 3 instantaneous centers of joint rotation (ICR) were found in the stifles of 6 healthy dogs. A novel algorithm, verified by computer simulation, was used to determine ICR from radiographs. Comparisons of ICR locations were made between flexion and extension, between left and right limbs, and between living and dead dogs, using analysis of variance. All stifles were examined for evidence of lesions, but all were normal. The normal location of the ICR in the stifle is near the joint surface, indicating that there is a predominantly rolling type of motion. As the limb flexes, the ICR moves caudally; as the limb extends, the ICR moves cranially. Significant differences in ICR position were not found between left and right limbs or between living and dead dogs. The average ICR position was significantly more caudal during extension than it was during flexion. Knowing the normal ICR position is a preliminary to diagnosing joint abnormalities, using the ICR. PMID- 3963587 TI - Assessment of lymphocyte function during vitamin A deficiency. AB - Two variables of immune status were measured in vitamin A-deficient (A-), vitamin A-sufficient pair-fed (A + PF), and healthy control (A+) rats to examine the mechanisms of immune regulation by vitamin A. Parallel samples were run in bovine fetal serum (BFS)-containing medium and serum-free medium to control BFS-origin vitamin A in the cultures. Splenocytes derived from A- rats showed significantly depressed blastogenic response to all lectins tested in both mediums when compared with responses of A + PF and A+ rats. The splenocyte blastogenic response of A + PF rats was significantly lower than that of A+ (control) rats only when cultured in BFS medium and stimulated by lentil lectin, lipopolysaccharide, or concanavalin A mitogens. Thymic lymphocyte blastogenic transformation assays were equivocal. Splenic immunosuppression could not be linked to significant reductions in surface glycoprotein receptor availability, since splenocytes of A- rats, as well as thymocytes, were capable of binding fluorescein isothiocyanate-conjugated lectins in the same capacity as splenocytes of A+ and A + PF rats. The combination of depressed cellular function and adequate lectin binding to viable cells implies that the regulation of immunohomeostasis by vitamin A was achieved through intracellular mechanisms, possibly selective genomic expression. PMID- 3963588 TI - Neutrophil chemotaxis in rhesus macaques (Macaca mulatta). AB - Chemotactic responses of isolated peripheral blood neutrophils from rhesus macaques (Macaca mulatta) were studied, using a micropore filter method. Cell migration toward zymosan-activated serum was similar to that of human cells, whereas the response to N-formyl methionyl leucyl phenylalanine (FMLP) was weaker than was that in human cells, requiring higher concentrations of FMLP for maximal migration. Optimal FMLP concentrations for attraction of rhesus neutrophils and human neutrophils were 5.0 X 10(-7)M and 1.0 X 10(-8)M, respectively. The chemotactic responses of the 2 neutrophils to complement (zymosan-activated serum) were similar. However, rhesus neutrophils required a higher concentration of the formyl peptide, FMLP, for maximal migratory response. PMID- 3963589 TI - Pathogenesis of simian AIDS in rhesus macaques inoculated with the SRV-1 strain of type D retrovirus. AB - Type D retrovirus was isolated from rhesus macaques with simian acquired immunodeficiency syndrome (SAIDS) and transmitted to healthy rhesus macaques with tissue culture medium containing the virus. The clinical, immunologic, and lymph node morphologic changes were observed in 9 rhesus macaques for 52 weeks after inoculation. A spectrum of clinical signs developed including early death, persistent SAIDS, and apparent remission. Animals that died or developed persistent SAIDS had characteristic lymphoid depletion, persistently depressed peripheral blood mononuclear cell (PBMC) mitogenic response, and decreased serum immunoglobulins. The SAIDS retrovirus (SRV) was recovered from PBMC of 8 of the animals after inoculation. Virus could not be recovered from PBMC of one animal in remission, but this animal developed serum-neutralizing antibodies to SRV after inoculation. Seven of the animals seroconverted to SRV after inoculation, all 9 were seronegative for human T-lymphotropic virus-III, and 5 animals tested were seronegative to human T-lymphotropic virus-I. These findings support the etiologic role of the type D retrovirus in SAIDS and further define the pathogenesis of this disease. PMID- 3963590 TI - Screen for anthelmintics, using larvae of Ascaris suum. AB - A multiwell culture system was used to assay the effects of 12 known anthelmintic compounds on Ascaris suum larval development from 2nd-stage (L2; hatched from eggs) to early 3rd-stage (L3) and from in vivo-derived late L3 to early 4th-stage (L4). Larval survival, development, and motility were monitored for drug effects. Development of L2 to L3 was sensitive to thiabendazole, albendazole (ABZ), ABZ/sulfoxide, ABZ/sulfone (SO), mebendazole, L-tetramisole, D-tetramisole, piperazine, or closantel at a concentration of 0.01 microgram/ml; however, the effects of these drugs on larval development did not correlate well with known effects in vivo. The development of L3 to L4 was blocked by ABZ or mebendazole at 0.01 microgram/ml, by thiabendazole or ABZ/sulfoxide at 0.1 microgram/ml, and by ABZ/SO at 1.0 microgram/ml; however, except for ABZ/SO, most larvae were viable at these concentrations. In contrast, L-tetramisole or morantel appeared to inhibit development of L3 to L4 and to reduce survival at concentrations of greater than or equal to 1 microgram/ml; however, D-tetramisole was at least 10 times less effective. Haloxon, ivermectin, and closantel blocked development of L3 to L4 at 0.1, 1, and 10 micrograms/ml, respectively, in the absence of serum, but their activity was reduced by the presence of serum. Seemingly, in vitro development of A suum larvae was a convenient and sensitive bioassay for anthelmintic activity and could serve as a screen for anthelmintic residues in edible tissues. PMID- 3963591 TI - Experimental Cryptosporidium infections in chickens: oocyst structure and tissue specificity. AB - Oocysts of an avian isolate of Cryptosporidium were used to inoculate 21 chicks orally and 7 chicks intratracheally to determine the tissue specificity of this organism. Oocysts were passed in the feces 4 to 5 days after inoculation. Oocysts (6.8 by 5.0 microns) were fully sporulated and they were passed for at least 17 days by infected chicks. The mode of inoculation did not influence the distribution of cryptosporidia within the digestive tract. Cryptosporidia were found in the cloaca (100%), bursa of Fabricius (95.7%), terminal portion of the colon (26.1%), and cecum (4.3%) of chicks that were positive for developmental stages. Of 21 chicks inoculated orally, 4 had cryptosporidia in their trachea, whereas 6 of 7 chicks inoculated intratracheally had cryptosporidia in the trachea, bronchi, and air sacs. Cryptosporidium was found in the ducts of the salivary glands and nasal turbinates of chicks inoculated intratracheally that had clinical signs of respiratory tract disease. None of the chicks died or had intestinal disease. PMID- 3963592 TI - Onchocerca spp: frequency in Thoroughbreds at necropsy in Kentucky. AB - Examination of the ligamentum nuchae for Onchocerca spp was completed in 523 Thoroughbreds (1 to 29 years old) at necropsy in Kentucky during a 13-month period (1984 to 1985). Onchocerca spp were found in 306 (59%) of the horses. Frequencies of this parasite were 3%, 17%, 40%, 43%, and 42% in 1-, 2-, 3-, 4-, and 5-year-old horses, respectively. For 6- to 29-year-old horses, frequency varied from 71% to 100%, except for 26-year-old horses (50%); 87% of the 304 horses examined in the 6- to 29-year-old age groups was infected. The suspensory ligaments and flexor tendons from fetlocks (thoracic limb only) of 100 Thoroughbreds (3 to 24 years old) were examined at necropsy during a 4-month period (1984) for Onchocerca spp. Infected horses were not found. PMID- 3963593 TI - Blood, urine, and ruminal fluid changes associated with metabolic alkalosis induced by duodenal obstruction. AB - Two Holstein heifers and a steer fitted with ruminal and duodenal cannulas were used to determine acid-base and electrolyte changes associated with metabolic alkalosis induced by duodenal obstruction. Obstruction was induced distally to the pylorus, but proximally to the common bile duct entrance. Ruminal fluid, blood, and urine samples were obtained before and after obstruction was induced. Duodenal obstruction resulted in increased blood pH, bicarbonate concentration, and base-excess values. Severe hypochloremia and hypokalemia were evident in 48 hours. Serum sodium concentration decreased only slightly. Packed cell volume and serum concentrations of urea nitrogen, creatinine, glucose, and inorganic phosphate increased, whereas calcium concentration showed no change. Renal chloride excretion reached near zero in 24 hours, whereas sodium and potassium excretions decreased in the steer, but were unchanged in the heifers. Urine creatinine concentration increased markedly in the heifers and steers. Acid urine was not evident up to 96 hours. Ruminal fluid pH decreased and chloride concentration increased in the steer, but remained unaffected in the heifers. Duodenal obstruction had no effect on rumen sodium, calcium, and magnesium concentrations, but the potassium concentration increased in the heifers. The degrees of alkalosis and electrolyte changes were greater in the steer than in the heifers. PMID- 3963594 TI - Antithrombin III activity in horses with large colon torsion. AB - A chromogenic peptide substrate assay was used to determine serially plasma antithrombin III (AT III) activity in 4 groups of horses. Group I consisted of healthy, mature horses in which AT III activity was determined twice daily for 7 consecutive days. Groups 2 and 3 contained healthy horses in which AT III activity was monitored for 7 days after controlled, but varying, conditions of general anesthesia and surgery (median celiotomy). Group 4 was made up of patients with a presurgical diagnosis of colonic torsion. In healthy awake horses (group I), there was no difference in AT III values over time. Postoperative AT III activity in the halothane-anesthetized horses (group 2) and in the sham operated horses (group 3) was not significantly (P = 0.05) different from base line values at any time. A significant decrease (P = 0.05) in AT III activity was observed on postoperative days 1 through 3 in the group of horses with large colon torsion, but returned to preoperative values by day 4 after surgery in the horses that survived. In those horses that did not survive, AT III activity remained below base-line values for the duration of observation. Seemingly, plasma AT III activity in horses was not significantly affected by halothane anesthesia or surgery. Serial evaluation of AT III activity may be useful for predicting survival in horses with large colon torsion. PMID- 3963595 TI - Effects of phenobarbital treatment on 3-methylindole toxicosis in ponies. AB - To study the role of cytochrome P-450-dependent mixed function oxidase reactions in equine 3-methylindole (3MI) toxicosis, ponies were given 20 mg of phenobarbital/kg of body weight at 72, 60, 48, 36, and 24 hours before 100 mg of oral 3MI/kg to induce cytochrome P-450 or no treatment (controls). Maximal 3MI plasma concentration was decreased and clearance was faster in phenobarbital treated ponies. Plasma 3MI was still detectable 12 and 36 hours after dosing in phenobarbital-treated and control ponies, respectively. Phenobarbital treatment induced a distribution phase with transition from a 1-compartment to a 2 compartment extravascular model. Bronchiolitis occurred in all ponies 72 hours after 3MI, but was more severe in those treated with phenobarbital. Appearance of a distribution phase, increased total body clearance, and more severe bronchiolitis in phenobarbital-treated ponies indicated that mixed function oxidases are involved in metabolism and conversion of 3MI to a toxic metabolite. PMID- 3963596 TI - Effects of estradiol on hematopoietic and marrow adherent cells of dogs. AB - Hematopoietic and marrow adherent cells were examined in 5 ovariohysterectomized dogs treated once with 1.5 mg of 17 beta-estradiol cyclopentylpropionate/kg of body weight. All dogs initially developed thrombocytopenia and neutrophilic leukocytosis, with megakaryocytopenia and an increased myeloid/erythroid ratio of the marrow. Later, 2 dogs became thrombocytopenic and neutropenic, with megakaryocytopenia, decreased myeloid/erythroid ratio, and increased concentration of plasma cells and mast cells in the marrow. The concentration of marrow granulocyte-macrophage colony-forming units (CFU-GM) was decreased at 2 and 3 weeks in all dogs after estradiol treatment. The concentration of marrow fibroblast CFU-F was decreased in all estradiol-treated dogs at 1 and 2 weeks. The ability of marrow adherent cells to support CFU-GM colony formation was unchanged in estradiol-treated dogs. Estradiol sulfate at final concentrations of 10(-8) to 10(-4)M did not affect the in vitro growth of CFU-GM and CFU-F, or the hematopoietic ability of marrow adherent cells from nontreated dogs. PMID- 3963597 TI - Effects of radiofrequency hyperthermia on the healthy canine cornea. AB - Radiofrequency hyperthermia was used to induce axial corneal lesions in the eyes of 10 dogs. Clinical observations were continued for up to 6 months, using biomicroscopy and indirect ophthalmoscopy. Eyes were harvested at intervals for light and electron microscopic evaluation. Clinical alterations included immediate corneal opacification and epithelial disruption at the site of electrode contact. Ulcerative keratitis persisted for 4 to 6 days, accompanied by anterior uveitis. Additional corneal changes included stromal thinning, edema, and vascularization. Final evaluation revealed negligible alterations in corneal contour or clarity 6 months after treatment. Microscopically, epithelial and superficial stromal necrosis preceded epithelial loss. Stromal alterations included edema (associated with focal endothelial detachments), vascularization, and inflammatory cell infiltration. Recovery was characterized by keratocytic hyperplasia and hypertrophy, epithelial proliferation, and stromal condensation. PMID- 3963598 TI - Comparative changes in a rat liver abscess model induced with three Fusobacterium necrophorum strains. AB - Viable cultures of 3 bovine Fusobacterium necrophorum strains were inoculated into the hepatic portal veins of rats. The experimentally produced hepatic necrobacillosis lesions were examined beginning at 15 minutes after inoculation was done and continuing for 4 weeks. Fusobacterium necrophorum 2101 (FN 2101), a biotype A, was the most virulent; F necrophorum 2030 (FN 2030), a biotype AB, was of intermediate virulence; and F necrophorum 2035 (FN 2035), a biotype B, was the least virulent. Gross lesions were first observed at 2, 8, and 18 hours after inoculation in the FN 2101-, FN 2030-, and FN 2035-inoculated rats, respectively. Gross and histopathologic descriptions of the FN 2101 and FN 2030 hepatic necrobacillosis lesions were similar, but were markedly different from those of the FN 2035 lesions. Abscesses produced by FN 2101 and FN 2030 attained maximal diameter (1 cm) in the hepatic parenchyma. Subcapsular abscesses were produced by FN 2035 and attained a diameter of 2 to 3 mm (maximal). PMID- 3963599 TI - Bovine longissimus muscle glycogen concentration in response to isometric contraction and exogenous epinephrine. AB - Isometric contraction was elicited in cattle by electrical stimulation (electrical immobilization) and was used as a means of investigating the interaction between muscle contraction and epinephrine-induced muscle glycogen degradation. At 0.5 and 24 hours after a 15-minute period of continuous muscle contraction, glycogen content of longissimus muscle specimens collected via needle biopsy was not different from precontraction concentrations. Epinephrine (13.2 mg/kg of body weight) given subcutaneously resulted in a 30% to 35% reduction of muscle glycogen. Reduction of muscle glycogen was slightly greater when epinephrine was used in conjunction with isometric contraction, compared with epinephrine treatment alone. Muscle glycogen increased, and free glucose, lactate, and glucose-6-phosphate decreased, with increases in body weight. In younger, lighter cattle (370 kg), epinephrine decreased muscle glycogen and lactate concentrations and generally decreased muscle glucose concentrations. Muscle-free glucose and lactate concentrations were increased in older, heavier cattle (446 kg) by contraction and epinephrine injection when the animals were immobilized for 30 minutes, with intermittent periods of muscle relaxation. In these cattle, muscle glycogen concentration slightly decreased with isometric contraction. Data indicate that reports of increased glycogenolysis observed in cattle subjected to stress by mixing strange animals or exercise is due to dynamic muscle contraction and not due to isometric muscle contraction. PMID- 3963600 TI - Effect of yohimbine hydrochloride on serum prolactin concentration in the rat: possible antagonist for fescue toxicosis. AB - Yohimbine hydrochloride is an indole alkaloid which blocks alpha 2-adrenergic and dopamine receptors and stimulates serotonergic receptors. Yohimbine was selected for testing as a possible antagonist in fescue toxicosis. Reduced body weight gains in cattle with chronic fescue toxicosis may be due to ergot alkaloids produced by fungi which infect the fescue grass. Ergot alkaloids stimulate dopamine receptors, antagonize serotonin, and lower serum prolactin concentrations. It was hypothesized that yohimbine may reverse or counteract the effects of the toxic fescue. Investigation was made of the treatment effects of multiple doses of yohimbine given in rats by intraperitoneal and oral routes. Given intraperitoneally once a day for 8 days, yohimbine hydrochloride increased serum prolactin concentrations. When given orally in feed for 7 days, the drug decreased the serum prolactin concentration. The effects of yohimbine on prolactin concentrations were dependent on the dosages and routes of administration. The inability of yohimbine, when given orally, to increase serum prolactin levels decreased its potential usefulness for prolonged treatment of fescue toxicosis. PMID- 3963601 TI - Morphologic changes induced by photoperiod in eyes of turkey poults. AB - Large White commercial tom poults were grown from 1 day to 8 weeks of age in the following light treatments: (i) continuous incandescent light (24LL); (ii) 23 hours of incandescent light and 1 hour of darkness/day (23L:1D); (iii) 12 hours of incandescent light and 12 hours of darkness/day (12L:12D); or (iv) natural decreasing day lengths (natural). At 8 weeks of age, significant (P less than 0.05) morphologic changes in eyes occurred. Poults exposed to the 24LL or 23L:1D had heavier eyes than did poults exposed to the 12L:12D or natural day length. In addition, the eye size (anterior to posterior diameter and horizontal width) exposed to the 24LL treatment was greater than those exposed to 23L:1D, 12L:12D, or natural day length. Cornea heights of poults exposed to 24LL or 23L:1D were smaller than cornea heights of those exposed to 12L:12D or natural day length. Marked differences did not occur in intraocular pressure among treatments. PMID- 3963602 TI - DNA homology studies of leptospires of serogroups Sejroe and Pomona from cattle and swine. AB - Hybridization studies of chromosomal DNA from leptospiral strains representing Leptospira interrogans, serogroups Sejroe and Pomona from cattle and swine were performed to determine the degree of homology among their DNA sequences. Chromosomal DNA isolated from leptospires of the Sejroe and Pomona serogroups was radiolabeled and used to probe DNA isolated from other strains in these serogroups. Serovars hardjo (hardjoprajitno), hardjo (hardjo-bovis), balcanica (1627 Burgas), pomona (pomona), and kennewicki (LT-1026) were probed to determine the degree of homology among their chromosomes. Serovars pomona and kennewicki were homologous to each other. They also had a high degree of homology with hardjo (hardjoprajitno) and, to a lesser extent, with hardjo (hardjo-bovis) strains. However, hardjoprajitno and hardjo-bovis had little homology to each other. Serovar balcanica had a high degree of homology with hardjo-bovis isolates, but little homology with hardjoprajitno. Although serologically indistinguishable, the reference strain hardjoprajitno was genetically dissimilar to hardjo-bovis strains isolated from North American cattle. PMID- 3963603 TI - Plasmid profiles of Moraxella bovis isolates. AB - Two-hundred isolates of Moraxella bovis were selected at random and examined for the presence of plasmid DNA by a rapid alkaline-detergent lysis method. All isolates contained from 1 to 6 plasmids, with varying agarose-gel electrophoretic migration patterns. Most (80%) isolates carried 2 to 4 plasmids, which ranged in molecular weight from 2.6 to 80 megadaltons. Seemingly, plasmid profiles can be used as a simple, reliable epizootiologic tool to establish a strain identification scheme for M bovis. PMID- 3963604 TI - Lymphangiographic evaluation of experimentally induced chylothorax after ligation of the cranial vena cava in dogs. AB - Ligation of the cranial vena cava (CrVC) distal to the entrance of the azygous vein resulted in chylothorax in 7 of 10 dogs. Of the remaining 3 dogs, 1 developed a serosanguineous effusion that did not become chylous, and 2 dogs did not develop pleural effusion. In 2 of the 7 dogs developing chylothorax, the pleural effusion became serosanguineous within 2.5 weeks after CrVC ligation. Mesenteric lymphangiography was performed 2 to 6 weeks after ligation of the CrVC. Lymphangiectasia was seen in 4 dogs with chylothorax, but was not seen in the 3 dogs with serosanguineous effusions or the 2 dogs that did not develop effusions. One dog with chylothorax died prior to repeat lymphangiography. Less dye entered the thoracic duct, and alternate lymphaticovenous communications to the caudal vena cava were evident in the dogs without chylothorax. Ligation of the thoracic duct at the lymphaticovenous junction was performed in 3 dogs. These dogs did not develop pleural effusion. Lymphangiography was performed immediately after ligation and indicated filling of abdominal lymphatics but not of the thoracic duct. Lymphangiographic findings 6 weeks after ligation also indicated filling of intestinal lymphatics. Results of the present study indicated that ligation of the CrVC causes chylothorax, and that thoracic lymphangiectasia is a consistent finding in animals with experimental chylothorax. Obstruction of the thoracic duct did not induce lymphangiectasia or chylothorax. Impedence of thoracic duct flow into the CrVC may be a cause of clinical chylothorax in the dog. PMID- 3963605 TI - Need to distinguish between erythrophagocytosis and antibody-dependent cytotoxicity. PMID- 3963606 TI - Psychotherapy research: a special issue. PMID- 3963607 TI - The scientific study of counseling and psychotherapy. A unificationist view. PMID- 3963608 TI - Psychotherapy. Research, practice, and public policy (how to avoid dead ends). PMID- 3963609 TI - What comes after traditional psychotherapy research? PMID- 3963610 TI - Sexual attraction to clients. The human therapist and the (sometimes) inhuman training system. PMID- 3963611 TI - "Are all psychotherapies equivalent?". PMID- 3963612 TI - Utilization of psychotherapy research by practicing psychotherapists. PMID- 3963613 TI - Use of psychotherapy research by professional psychologists. PMID- 3963615 TI - Attributional conceptions in clinical psychology. PMID- 3963614 TI - THe development of a microcomputer-based mental health information system. A potential tool for bridging the scientist-practitioner gap. PMID- 3963616 TI - Amnesia and crime. How much do we really know? PMID- 3963618 TI - Professional psychology and private health services. Developing trends in the Federal Republic of Germany. PMID- 3963617 TI - Child development research and the Third World. A future of mutual interest? PMID- 3963619 TI - Clinical psychologists in the primary health care system in the Netherlands. PMID- 3963620 TI - Cardiac dysfunction during acute lung injury induced by oleic acid in dogs. AB - Circulatory abnormalities are common during the adult respiratory distress syndrome and contribute importantly to the high mortality seen with this illness, but what causes them is not well characterized. Oleic acid-induced acute lung injury is an experimental model of the human syndrome in which hemodynamic changes are also common. To characterize a possible link between lung injury and cardiac dysfunction in this model, we evaluated cardiac function in mongrel dogs after oleic acid administration. Stroke volume index decreased, the radionuclide ventriculographically determined ejection fraction decreased, and end-diastolic volume increased after oleic acid. These results suggested a decrease in myocardial contractility, a conclusion confirmed when other experiments demonstrated a consistent rightward displacement of the end-systolic pressure diameter relationship after oleic acid. Histologic examination of the myocardium showed little evidence of vascular injury, and myocardial tissue wet-to-dry weight ratios were normal. Thus, although the pulmonary effects of oleic acid are due to microvascular injury, similar mechanisms are not responsible for the depression in myocardial contractility. PMID- 3963621 TI - A four-year prospective study of the respiratory effects of volcanic ash from Mt. St. Helens. AB - This report describes the 4-yr follow-up of 712 loggers exposed over an extended period to varying levels of fresh volcanic ash from the 1980 eruptions of Mt. St. Helens. Concerns related to the irritant effect the ash might have on the airways and also to its fibrogenic potential if exposures were intense and continued over many years. Our subjects were divided into 3 groups: high, low, and no exposure. Baseline testing was begun in June 1980, 1 month after the major eruption, and follow-up testing continued on an annual basis through 1984; 88% of the loggers have been tested at least 3 times. Analysis of lung function data showed that a significant, exposure-related decline in FEV1 occurred during the first year after the eruption. The decline was short-lived, however, and by 1984 the differences between exposure groups were no longer significant. Self-reported symptoms of cough, phlegm, and wheeze showed a similar pattern. No ash-related changes were seen in chest roentgenograms taken in 1980 and in 1984. Our findings are consistent with the hypothesis that the inhaled ash caused mucus hypersecretion and/or airway inflammation that reversed when the exposure levels decreased. The ash levels to which the loggers were exposed were low compared with permissible occupational levels for nuisance dusts, but generally higher than the total suspended particulate levels permissible in ambient air. PMID- 3963622 TI - Regional distribution of macroscopic lung disease in cystic fibrosis. AB - We used macroscopic morphometry and multivariate analysis (Hotelling's T2) to quantitate the extent of chronic lung disease and its regional distribution in formalin-inflated right lungs obtained at autopsy from 17 young adults with cystic fibrosis (CF) and 5 without CF as control subjects. Lungs were point counted, by lobe, for 6 anatomic variables: parenchyma, nonparenchyma, bronchi, vessels, cysts, and emphysema, and the results were expressed for each as volume proportion (Vv). Considering all 6 variables simultaneously, CF lungs differed significantly from control lungs (p = 0.003). For individual variables, Vv bronchus was significantly elevated and Vv parenchyma was significantly reduced in the CF group. Within the CF lungs, there was a significant difference between upper and lower lobes when all variables were considered together (p = 0.001). For individual variables, Vv parenchyma and Vv vessels were significantly less, and Vv bronchus was significantly greater in the upper compared with the lower lobe. There was no difference in the upper versus lower lobe Vv for any variable in the control group. These results indicate that lung disease and remodeling are irregularly distributed in CF and that the upper lobe is disproportionately severely involved. PMID- 3963623 TI - The diagnosis of emphysema. A computed tomographic-pathologic correlation. AB - To assess the accuracy of computed tomography (CT) in the diagnosis of emphysema, we performed CT on 32 patients prior to surgery for removal of suspected tumors. The CT scans were assessed visually for emphysema by 2 independent radiologists and 1 chest physician. Intraobserver and interobserver variation were assessed. Pathologic emphysema was graded on the resected lung specimens. These grades were correlated with the CT scores and with pulmonary function tests obtained prior to surgery. Significant correlation was found between the pathologic grade on resected lung specimens and the preoperative CT score of both the resected lobe (r greater than or equal to 0.57, p less than 0.001) and the whole lung (r greater than or equal to 0.63, p less than 0.001). Compared with pulmonary function tests, CT was a better predictor of emphysema and distinguished patients with moderate emphysema from patients with normal lungs. We conclude that CT is a useful adjunct in assessing the presence and severity of emphysema. PMID- 3963624 TI - The effects of combined morphine and prochlorperazine on ventilatory control in humans. AB - Recent studies have shown that the antiemetic neuroleptic drug, prochlorperazine, is a potent stimulant of the ventilatory response to hypoxia. To investigate whether or not this effect persisted in the presence of central depression of ventilatory drive, the effects on ventilatory control of morphine with and without prochlorperazine were studied in 12 normal humans. Measurement of resting ventilation and the ventilatory responses to progressive hypercapnia and to transient asphyxia were made before and 15 min after morphine (0.15 mg/kg) given intravenously. Prochlorperazine (12.5 mg) was then administered intravenously to 6 study subjects and saline to 6 control subjects. After a further 10 min, resting ventilation and chemoreceptor function were remeasured. After the administration of morphine, resting ventilation, the ventilatory response to hypercapnia, and the ventilatory response to asphyxia were all significantly decreased (p less than 0.01 in each case; mean effect in control and study group were, respectively, -16 and -17%, -50 and -32%, -46 and -55%). Administration of saline produced no significant additional changes in the 6 control subjects. By contrast, administration of prochlorperazine to the 6 study subjects markedly increased the ventilatory response to asphyxia to levels significantly greater than postmorphine values (p less than 0.005; 2.38 +/- 0.22 L . min-1 . % Sao2 versus 0.80 +/- 0.14 L . min-1; mean +/- SEM). Resting ventilation and ventilatory response to hypercapnia were not significantly affected by prochlorperazine. These results were not explained by differences in end-tidal PCO2 at which hypercapnic hypoxic tests were performed. It is concluded that prochlorperazine reverses the depression of the ventilatory response to asphyxia caused by morphine. PMID- 3963625 TI - Subclinical pulmonary involvement in collagen-vascular diseases assessed by bronchoalveolar lavage. Relationship between alveolitis and subsequent changes in lung function. AB - Collagen-vascular disorders (CVD) are commonly associated with chronic interstitial lung disease. Clinicopathologic observations suggest that inflammatory process of the lower respiratory tract may appear prior to fibrosis. Subclinical pulmonary involvement, as assessed by bronchoalveolar lavage (BAL) was evaluated in 61 patients with various CVD but free of clinical pulmonary symptoms and with normal chest roentgenograms. Eight of 61 had abnormal pulmonary function tests (PFT) at entry to the study. Total BAL cell yield from nonsmokers was greater in patients with abnormal than in those with normal PFT (p less than 0.05). Abnormal differential count of BAL cells was noted in 29 of 61 patients (48%). Lymphocyte alveolitis (lymphocytes greater than or equal to 18%) was a characteristic finding in patients with primary Sjogren's syndrome (11 of 25) or Sjogren's syndrome associated with another CVD (4 of 8). Neutrophil alveolitis (neutrophils greater than 4%) with or without increased percentage of lymphocytes occurred in patients with CVD classically associated with pulmonary fibrosis: progressive systemic sclerosis (6 of 10), rheumatoid arthritis (1 of 4), dermatopolymyositis (2 of 3), and mixed connective tissue disease (3 of 8). An increased percentage of eosinophils was detected in 1 patient with progressive systemic sclerosis. Bronchoalveolar lavage abnormalities were more frequently detected in patients with active and severe extrapulmonary disease. On follow-up PFT 12 months later, 11 patients with normal BAL and 10 patients with lymphocyte alveolitis had not deteriorated. In marked contrast, the presence of neutrophils in BAL was associated with a progressive deterioration of PFT in 6 of 7 untreated patients, whereas 4 corticosteroid-treated patients with neutrophil alveolitis had not deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963626 TI - Breathing pattern during and after maximal exercise in patients with chronic obstructive lung disease, interstitial lung disease, and cardiac disease, and in normal subjects. AB - Inspiratory muscle fatigue and pulmonary edema are both known to cause rapid shallow breathing. It has been suggested that exercise tolerance in patients with pulmonary disease and cardiac disease may be limited by the development of inspiratory muscle fatigue and pulmonary edema, respectively, at maximal exercise. If these hypotheses are correct, breathing pattern during recovery from maximal exercise in these patients should be rapid and shallow compared with that during exercise. This study was performed to test these hypotheses. Seven patients with chronic obstructive pulmonary disease (COPD), 8 patients with interstitial lung disease (ILD), 7 patients with cardiac disease (CD) (mitral valve disease or left ventricular dysfunction) and 8 normal (NR) subjects each performed maximal incremental exercise on a cycle ergometer. Exercise breathing pattern was compared with that during recovery by calculating the mean difference in tidal volume (at the same levels of minute ventilation) between exercise and recovery for each subject. Recovery breathing pattern was similar to that during exercise for the COPD, ILD, and NR subjects. In contrast, breathing pattern during recovery was rapid and shallow compared with that during exercise for the CD patients; recovery tidal volume was less than that during exercise for the same level of minute ventilation. The fact that rapid shallow breathing does not develop during recovery from maximal exercise in patients with COPD or ILD suggests that inspiratory muscle fatigue does not limit their exercise tolerance. The relative rapid shallow breathing during recovery from maximal exercise in patients with CD is probably due to the development of pulmonary edema at maximal exercise, but further studies are needed to confirm this.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963627 TI - Synthesis of type IV procollagen in lung explants. AB - Pulmonary basement membranes are believed to play important roles in lung morphogenesis, in maintenance of lung alveolar architecture, and in repair after pulmonary injury. However, very little is known about the synthesis and matrix deposition of lung basement membrane macromolecules. Accordingly, we have investigated the synthesis of type IV procollagen, the major collagenous component of basement membranes, in slices of adult rat lung. After a 4-h labeling with [3H]proline, type IV procollagen chains were extracted from lung homogenates with 2 M guanidine-HCl and purified by salt fractionation and ion exchange chromatography. The chains comigrated with authentic type IV chains by SDS-PAGE and were selectively coprecipitated with antibodies to type IV collagen. Peptide mapping confirmed their identity as pro alpha 1(IV) and pro alpha 2(IV), and suggested that the chains are predominantly assembled as heteropolymers. There was no evidence for proteolytic processing of the newly synthesized type IV procollagen even though type I and III procollagens were rapidly processed to lower molecular weight intermediates and collagen. Type IV procollagen accounted for approximately 40% of the extracted radiolabeled collagen, suggesting that there may be a relatively high turnover of lung basement membrane collagen in vivo. PMID- 3963628 TI - External high frequency oscillation in cats. Experience in the normal lung and after saline lung lavage. AB - In an effort to develop a method of assisted ventilation that would avoid endotracheal intubation, 11 anesthetized, paralyzed, nonintubated adult mongrel cats with normal lungs were externally oscillated by means of a thoracoabdominal chamber connected to a vacuum source and a high frequency oscillator. Chamber pressure was adjusted to the desired negative pressure using the vacuum source, and the animal was then oscillated above and below this pressure. The lowest PaCO2 and AaPO2 were observed at 3 Hz. Tidal volume (VT) fell (p less than 0.001) with increases in frequency, and lung volume (VL) rose with increased negative chamber pressure (p less than 0.001). In 11 additional tracheostomized cats, a stiff lung was created by repeated saline lung lavage. External high frequency oscillation (EHFO), using pressures comparable to those used for conventional mechanical ventilation (CMV), was associated with a significant increase in PaO2 (p less than 0.001), and a significant fall in AaPO2 (p less than 0.01) compared with that during CMV. Lung volume was significantly higher during EHFO (p less than 0.001) and, as in the normal lung, VT fell with increasing frequencies to 15 Hz (p less than 0.001). There were no significant frequency-dependent variations in gas exchange or VL. An increasingly negative mean chamber pressure was associated with a significant increase in PaO2 (p less than 0.05) and VL(p less than 0.005) and a significant decrease in PaCO2 (p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963629 TI - The relationship between pleural pressures and changes in pulmonary function after therapeutic thoracentesis. AB - The purpose of this study was to determine whether changes in pulmonary function after therapeutic thoracentesis are related to the pleural pressure or to changes in pleural pressure during thoracentesis. Spirometry was obtained before and 24 h after thoracentesis in 26 patients. Pleural pressures were measured with a U shaped manometer initially and after each 400-ml aliquot of pleural fluid was removed. Thoracentesis was continued until the patient developed severe symptoms (chest pain or coughing), the pleural pressure dropped below -20 cm H2O, or no more fluid could be obtained. The mean vital capacity improved 410 +/- 390 ml in this group of patients who had 1,740 +/- 900 ml fluid removed. The improvement in the VC most closely correlated with the pleural pressure after 800 ml fluid had been withdrawn (r = 0.57, p less than 0.005). The ratio of the improvement in the VC to the amount of fluid removed most closely correlated with the pressure change after 800 ml fluid had been removed (r = -0.43, p less than 0.05). From this study we conclude that the improvement in the FVC after therapeutic thoracentesis is small relative to the amount of fluid withdrawn. Patients with higher pleural pressures after the removal of 800 ml pleural fluid and patients with smaller decreases in the pleural pressure after removal of 800 ml pleural fluid have greater improvements in their pulmonary functions after thoracentesis. PMID- 3963630 TI - The effects of posture on obstructive sleep apnea. AB - To determine whether the adoption of a more upright sleep posture would improve breathing and gas exchange in patients with obstructive sleep apnea syndrome (OSAS), 13 male patients with OSAS were studied during an all-night polysomnographic study while lying supine or sitting at a 60-degree angle. In the upright posture, the frequency of obstructive apnea was decreased (lying, 48.9 +/ 5.4/h; sitting, 19.6 +/- 6.9/h; p less than 0.0005) and arterial oxyhemoglobulin saturation (Sao2) was increased (nREM; mean lying, 90.6 +/- 0.8%; mean sitting, 92.1 +/- 0.5%, p less than 0.005; minimum lying, 64.8 +/- 3.2%, minimum sitting, 80.8 +/- 2.1%, p less than 0.005). In approximately half the patients studied, obstructive sleep apnea was essentially abolished by the postural intervention. These patients were more obese and had lower Pao2 and higher Paco2 values awake than the remaining patients in whom the response was either incomplete or absent. Arousal from sleep was less frequent in the upright posture, but sleep efficiency and overall sleep architecture were unchanged. This simple maneuver may be useful for treating some patients with OSAS. PMID- 3963631 TI - The effect of low frequency fatigue on endurance exercise in the sternomastoid muscle of normal humans. AB - It is not certain to what extent low frequency fatigue affects the performance of a muscle. We studied the endurance capacity of the sternomastoid muscle to undergo repetitive isometric neck flexion contractions for 2 s every 4 s at 35% of its maximal voluntary contraction force (MVC) in 5 normal subjects starting with different levels of fatigue. The endurance time, the duration the subjects were able to achieve the target force before exhaustion, was measured in each subject on 3 occasions: Study 1: in the fresh state, with a normal frequency/force curve and 20:50 ratio (ratio of force response at 20 Hz to that at 50 Hz) before the start of the endurance exercise; Study 2: with a moderately reduced 20:50 ratio before the start of endurance exercise (mean +/- SEM reduction in 20:50 ratio 11.4 +/- 0.8%); Study 3: with a substantially reduced 20:50 ratio before the start of the endurance exercise (29.2 +/- 3.7%). These reductions in 20:50 ratio were produced by the subjects performing 150 isometric neck flexion contractions at 50% of their MVC, followed by a period of rest to allow the 20:50 ratio to recover to approximately 10% of the starting value in Study 2, and to within 20 to 40% of the starting value in Study 3. Endurance exercise was then carried out.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963632 TI - Aminophylline and fatigue of the sternomastoid muscle. AB - We examined the influence of intravenously infused aminophylline on the contractility of the sternomastoid muscle in 8 subjects. The muscle was stimulated directly using bipolar surface electrodes at 1, 10, 20, and 50 pulses per second (pps), and the force response was recorded. The ratio of force produced at 20 pps and 50 pps (20/50 ratio) was calculated. The effect of aminophylline on the 20/50 ratio was assessed at 2 dosages producing different blood serum levels (10.7 mg/L and 15.3 mg/L). At the lower dosage of aminophylline the potential prophylactic and curative influence of aminophylline was tested using 3 different experimental paradigms performed on separate days: (1) Baseline force frequency responses were determined before and 15 and 35 min after a headlifting maneuver; headlifting resulted in a decrease in the 20/50 ratio (low frequency fatigue). (2) The same sequence as in (1), with the addition of a continuous infusion of aminophylline started after the baseline force frequency responses. (3) The same sequence as in (1) except that the aminophylline infusion was begun only after the headlifting maneuver. After the fatiguing maneuvers, there were comparable and significant falls in the 20/50 ratio on all experimental days. The infusion of aminophylline did not significantly affect the baseline 20/50 ratio. In addition, aminophylline did not prevent the fatigue-related decrease in the 20/50 ratio or enhance its recovery. Experimental paradigms 1 and 2 were repeated at the higher aminophylline levels. Again, aminophylline did not prevent or reverse sternomastoid fatigue. We conclude that aminophylline in therapeutic dosages does not prevent or reverse low frequency fatigue of the sternomastoid muscle. PMID- 3963633 TI - The relationship between alveolar oxygen tension and the single-breath carbon monoxide diffusing capacity. AB - The effects of alveolar oxygen tension (PAO2) on the single-breath carbon monoxide diffusing capacity (DLCO) were quantified and a factor was derived to accommodate for differences in PAO2 over commonly encountered altitudes and/or varying concentrations of oxygen in the test gas mixture (FIO2) We performed duplicate measurements of DLCO in 7 normal subjects with 6 different oxygen fractions (0.176, 0.196, 0.211, 0.22, 0.25, and 0.27). The PAO2 for each test was measured as the PO2 in the alveolar gas sample bag. DLCO varied inversely with PAO2 and changed by 0.35% for each mmHg change in PAO2 (r = -0.62, p less than 0.001). At an FIO2 of 0.25, PAO2 varied between subjects and was highly correlated with each subject's residual volume to total lung capacity ratio (r = 0.84, p less than 0.001). We suggest that laboratories can adjust the measured DLCO when PAO2 is not congruent to 120 mmHg by the following formula: DLCO (corrected = DLCO (measured) x [1.0 + 0.0035 (PAO2 - 120)]. PMID- 3963634 TI - The dead space to tidal volume ratio in the diagnosis of pulmonary embolism. AB - In order to assess the value of the measurement of the physiologic dead space (VD) to tidal volume (VT) ratio in pulmonary embolism (PE), a prospective study was performed in hospital inpatients suspected to have PE (n = 110; mean age +/- SD, 52.2 +/- 15.5 yr). In 16 of 29 patients in whom the diagnosis of PE was excluded on the basis of a normal radioisotope perfusion scan and/or normal pulmonary angiogram, VD/VT was less than 40%; in the other 13 patients, a VD/VT greater than 40% was associated with an abnormal spirogram. In all patients in whom PE was angiographically diagnosed (n = 16), VD/VT was greater than 40%. In the remaining 65 patients, a high probability of PE was rarely (6%) associated with a normal VD/VT, whereas in patients with a low probability of PE, 71% had normal VD/VT values. These data indicate that a VD/VT value of less than 40% makes the diagnosis of PE extremely unlikely, whereas VD/VT value greater than 40% in the presence of a normal spirogram is highly suggestive of PE. The diagnostic sensitivity of a VD/VT greater than 0.4 with a normal spirogram as a positive test of PE, and a VD/VT less than 0.4 excluding the diagnosis of PE was 100%, whereas the specificity was 94%; applying Bayesian analysis, the probability of a correct diagnosis of PE using these criteria in a similar population would be 90.5%, and of excluding PE, 96.7%. Thus, as a diagnostic test in PE, VD/VT measurement is comparable, in terms of sensitivity and specificity, to radioisotope lung scanning. PMID- 3963636 TI - Lingula lung biopsy: is it representative? PMID- 3963635 TI - Pulmonary toxoplasmosis. PMID- 3963637 TI - Airway hyperexcitability in asthmatics. PMID- 3963638 TI - Oxalate crystals in sputum of patients with aspergilloma. PMID- 3963639 TI - Oxalic acid level in BAL fluid from patients with invasive pulmonary aspergillosis. PMID- 3963640 TI - [Mycoplasma pneumoniae infection in childhood respiratory pathology. Respiratory, extrarespiratory manifestations and immunological findings. A 2-year study]. AB - "Mycoplasma pneumoniae" respiratory infection was diagnosed by completed fixation assay in 81 ages 8 months to 14 years. Seventy had pneumonia and ten had bronchitis. The "Mycoplasma pneumoniae" represented the 25% of all pneumonia of any aetiology. Seventy per cent of cases occurred during spring and summer months. Rashes developed in 13 (16%) patients (maculo-papular, 6; Stevents Johnson, 2; purpuric-acular, 2; petechial, 1; urticarial, 1; erythema nodosa, 1). Other nonrespiratory complications were: hemolytic anemia, 2 cases; hepatitis, 5 cases; aseptic meningitis, 2 cases, and Guillain-Barre syndrome, 1 case. The white blood cell counts and ESR were normal or slightly raised in most of patients. Serum samples from 46 children were tested for cold agglutinins and positive titers were found in 19 (41%). The roentgenographic pattern of "Mycoplasma pneumoniae" was alveolar and/or mixed in 57 patients, and interstitial in the remainder. The lower lobes were more frequently involved. Twenty one per cent of patients with pneumonia had mediastinal lymphadenopathy. The outcome was favorable in all children except in one who developed irreversible pulmonary damage. PMID- 3963642 TI - [Prevention of atherosclerosis]. PMID- 3963641 TI - [Mitral atresia. Anatomical study and surgical implications]. AB - We present the pathological study of 17 cases of mitral atresia with patent aortic valve and their surgical implications. The study is based on the type of atrioventricular connection, presence or absence of ventricular septum, size of the left ventricle and relation of the aorta with the aforementioned ventricle. We have classified mitral atresia into two groups by assessing these data. Group A) Both ventricles and atrioventricular connections are present and there is ventricular septal defect. The aorta may connect with an either normal or hypoplastic left ventricle or it may emerge in double outlet from the right ventricle. Group B) Absent left ventricle and atrioventricular connection. The aorta emerges from the single ventricle or the rudimentary chamber. Thirteen cases belonged to group A and four to group B. The pathological structure of mitral atresia requires the decompression of the left atrium by atrioseptostomy during the neonatal period to enable survival. On a second stage a palliative correction should be carried out, which; depending on ventricular size and outlet of the vessels, will be a valvular prosthesis left atrium-left ventricle or the modified atriopulmonary technique connecting the new left atrium with the systemic ventricle and aorta after resecting the auricular septum and connecting the right atrium with the pulmonary artery. PMID- 3963643 TI - [Cardiac surgery in the neonatal period. 17 years' experience]. AB - Although the mortality rate with cardiac surgery in the neonatal period has decreased in the last years, due to the development of the neonatal intensive care units and the routinary use of prostaglandins, it remains higher than in whatever other ages. Since october 1967 to may 1984, 321 consecutive cases were operated on. Ages ranged between 12 hours and 31 days. In 301 cases closed cardiac surgery was performed, and cardiopulmonary bypass was employed in the remaining 20 cases. Taking off the mortality rate by periods of time, first (1968 1974), second (1975-1979), third (1980-1984), and by surgical groups (closed and open heart surgery) we found a statistically significant decrease in the mortality rate comparing the results over the time with the current period (1980 1984) having 114 cases of closed surgery and a 27% of mortality rate and 11 cases of open heart surgery with 2 deaths, 18% of mortality rate. Follow up was possible in 184 out of the 203 survivors, representing a 91% with a range between 3 month a 15 years. Medical and surgical management and long term follow up is described. PMID- 3963644 TI - [Achalasia of the cricopharyngeal muscle in the infant]. AB - Two patients with Cricopharyngeal achalasia have been treated at the Clinica Infantil "La Paz" (Madrid) in the last 20 years. They were one and a half, and four and a half months old at the time of operation. The postoperative period and follow-up has been satisfactory. Clinical symptoms in both of them were cough, cyanosis, regurgitation and aspirative pneumonia. One of them came with the diagnosis of congenital esophageal stenosis, and the other one with the diagnosis of tracheoesophageal fistula. The diagnosis was confirmed by endoscopy and barium X-ray. Section of the Cricopharyngeus muscle was curative and recovery of the normal function has been complete. PMID- 3963645 TI - [Aicardi's syndrome. Presentation of 4 cases and new associated abnormalities]. AB - Four cases of Aicardi's syndrome are presented, reporting in two of them angiographic and bone abnormalities such as arterial microaneurysm and scapula displacement, that have not been previously reported in the literature. PMID- 3963646 TI - [Childhood depressions. Interview between a non-hospital affiliated pediatrician and 2 child psychiatrists]. AB - The present report reviews the problem of depression in children by means of an interview made by a pediatric to two paidopsychiatrists: concept, incidence, etiology and clinic, emphasizing un those features of interest and related to the pediatric and based on a bibliographic revision and the own experience of the authors, referring fifty cases of recent study. It is also showed the main exploratory and diagnosis methods: psychological, clinical and biological, as the evolution, treatment and some aspects of suicide in children. PMID- 3963647 TI - [Surgical treatment of pneumothorax in the newborn infant]. AB - Tension pneumothorax refractory to thoracocentesis is a serious consequence of the greater refinements of neonatal intensive care. Various techniques have been recently proposed for solving this problem, such as selective intubation or surgical treatment. We present our experience with the surgical treatment of refractory pneumothorax compared to conservative methods. In the 3 operated cases a notable improvement of ventilatory conditions was observed without the need of posterior drainage. PMID- 3963648 TI - [Sustained-release theophylline: study in a child population]. AB - The study was done in 37 children. Their age ranged between 2 and 12 years, and their body weight between 12 and 36 kg. All had a diagnosis of bronchial asthma with practically permanent symptoms. All received a controlled treatment with sustained-release theophylline (SRT). All the patients began with a dose of about 15 mg/kg/day. Two groups without significant differences in age or weight, were made. The average doses given to the first group were 16.73 +/- 1.56, that were well tolerated, being the theophylline blood levels, five hours after dosing 14.79 +/- 2.34. In the second group (n = 22) due to different causes the SRT dose had to be reduced, averaging 11.98 +/- 1.48 and the theophylline blood levels 12.5 +/- 5.04. The clinical results were evaluated by a quantitative method in both groups. The theophyllinemia curves grouped in 6 patients showed the following values: 13.98 +/- 2.95 after 3 hours, 14.5 +/- 1.95 after 5 hours and 9.5 +/- 3.31 after 12 hours. The average theophylline concentrations in the saliva were 10.53 +/- 2.5 (3 hours); 9.81 +/- 1.80 (5 hours) and 6.01 +/- 1.92 (12 hours). The clinical results were good in the 37 children, even with suboptimal theophyllinemia values. The authors conclude by recommending an initial SRT pattern of 12-14 mg/kg/day for children weighting between 12 and 24 kg and of 11-12 mg/kg/day for weights between 25 and 35 kg. With these doses, theophylline levels over 10 mcg/ml in 24 hours are guaranteed in most patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963649 TI - [Fraccaro's syndrome: 49XXXXY sexual polysomy. Apropos of 2 cases]. PMID- 3963651 TI - [Febrile convulsions]. PMID- 3963650 TI - [Analysis of the Greulich-Pyle atlas using the TW2 and TW2-A method]. AB - Authors analyze Greulich and Pyle's atlas, using TW2 and TW2-A methods, in their three respective modalities (20B, C, RUS). They observe that there are differences between three variables and GP. Results are compared with those of other authors concluding that use of numerical methods adapted to population in study are the ideal ones. PMID- 3963652 TI - [Cerebellar tuberculoma. Clinical and radiological course]. AB - A six-year-old child with intracranial hypertension is described. Cranial computed tomography showed an expansive mass surrounded by a contrast enhancement ring in the right cerebellar hemisphere. Chest roentgenograms showed signs of pulmonary tuberculosis. Intracranial lesion was diagnosed as a tuberculoma and treated with tuberculostatic agents. Serial computed tomography scans showed a reduction of size of tuberculoma and appearance of a residual calcified image. PMID- 3963653 TI - [Gastric leiomyoblastoma in infancy. Report of a new case]. PMID- 3963654 TI - [Simple epidermolysis bullosa. A case in twins]. PMID- 3963655 TI - [Myocarditis in juvenile rheumatoid arthritis]. PMID- 3963656 TI - [The general pediatrician. A vanishing species?]. PMID- 3963657 TI - [Pediatric emergencies. An insoluble problem?]. PMID- 3963658 TI - [Incidence of urocystographic abnormalities in urinary infection in the neonatal period]. AB - Fifty-six children with ages between 3 hours and 45 days of life (median age 13.9 days), 39 of which were males and 17 females, have been studied. Urinary tract infection was diagnosed after two consecutive urine cultures with more than 100,000 colonies of the same pathogen obtained by sterile plastic bag. Whole urocystographic study was practised to every one of them, finding abnormalities in 17 of the patients (30.35%). Pathologic findings in 8 of them were considered important abnormalities (ureterohydronephrosis and/or vesicoureteral reflux grade IV) which makes 14.28% of the total. From their sample authors conclude that it is mandatory to practice whole urocystographic study to all children diagnosed of urinary tract infection in the neonatal period. PMID- 3963659 TI - [Serum DNA of hepatitis B virus in children with chronic infection]. AB - Viral replication has been studied in 44 children with chronic infection induced by hepatitis B virus (HBV) investigating HBV-DNA by molecular hydridization technique, correlating its presence with immunological markers and activity of liver disease. HBV-DNA presence is correlated to HBe Ag detection, but this antigen was also found in absence of viral DNA (7 cases of 31). That can mean viral replication diminishes or disappears before the seroconversion. No differences were found in viral replication phases as for clinical manifestations in children. In presence of viral DNA, serum aminotransferases were higher (p less than 0,005) and active hepatic lesions more frequent. Therefore, more cytolysis an inflammation are found in presence of circulating virus. On the other, more developed lesions (inactive cirrhosis and hepatocellular carcinoma) have been found in viral replication absence. PMID- 3963660 TI - Detection of aortic insufficiency by standard echocardiography, pulsed Doppler echocardiography, and auscultation. A comparison of accuracies. AB - To determine the relative sensitivity and specificity of noninvasive methods for detecting aortic insufficiency, we compared the accuracy of auscultation, echocardiography, and pulsed Doppler echocardiography in detecting aortic insufficiency in 106 patients in whom the presence or absence of the lesion was shown by supravalvular aortography. The sensitivity and specificity for the diagnosis of aortic regurgitation was 96% and 96% for pulsed Doppler echocardiography, 73% and 92% for auscultation, 43% and 91% for two-dimensional echocardiography, 46% and 81% for anterior mitral leaflet flutter, and 9% and 96% for ventricular septal flutter, respectively. Auscultation was more sensitive than either M-mode or two-dimensional echocardiography in the diagnosis of aortic insufficiency (p less than 0.01). Pulsed Doppler echocardiography was significantly more sensitive than auscultation (p less than 0.0001) and was positive in 19 patients in whom no murmur was found. Thus, pulsed Doppler echocardiography is the optimal noninvasive marker for aortic insufficiency. PMID- 3963661 TI - Acute febrile cerebrovasculitis: a syndrome of unknown, perhaps rickettsial, cause. AB - In late 1983, five patients living near Charlottesville, Virginia, were treated for an unusual syndrome of fever, headache, altered mentation, multifocal neurologic signs, and cerebrospinal fluid pleocytosis. Clinical signs of brainstem disease developed in four patients. All five had had recent exposure to forests or wood and contact with flea-infested dogs. Two patients died; one survivor has had recurrent seizures. Brain biopsy samples in two patients and autopsy findings in another showed cerebral vasculitis and perivasculitis involving mostly venules and capillaries. In the autopsy, the severest vascular lesions involved the brainstem and thalami, where they were accompanied by acute fibrinoid necrosis, but discrete vascular lesions of lesser intensity were randomly distributed in the white matter and cortex. Serologic studies on paired specimens in four patients showed significant cross-reacting antibody responses to rickettsial (typhus-group) antigens in the indirect hemagglutination, latex agglutination, and IgM microimmunofluorescence tests, but no agent was visualized or isolated. The cause of this serious inflammatory disorder is unknown. PMID- 3963662 TI - Nosocomial transmission of delta hepatitis. AB - A previously asymptomatic carrier of hepatitis B virus receiving chronic hemodialysis developed acute delta hepatitis. The patient regularly received dialysis treatments on the same machine as a parenteral drug abuser with hepatitis B surface antigen (HBsAg)-positive chronic hepatitis whose serum was strongly positive for delta antibody. The drug abuser had a major bleeding episode that caused extensive environmental contamination 3 months before onset of illness in the index patient. No other patients receiving dialysis or staff members had evidence of delta infection. A surgeon previously infected with hepatitis B from the same parenteral drug abuser also had delta antibody. Testing for delta virus is indicated for both HBsAg-positive parenteral drug abusers and patients with hemophilia receiving chronic hemodialysis. All patients who are HBsAg- and delta-positive should receive dialysis separately from patients who are HBsAg-positive and delta-negative. Susceptible patients on dialysis and staff should receive hepatitis B vaccine to protect against both hepatitis B and delta virus infection. PMID- 3963663 TI - Risk of nosocomial infection with human T-cell lymphotropic virus type III/lymphadenopathy-associated virus in a large cohort of intensively exposed health care workers. AB - To assess the risk of nosocomial transmission of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), we prospectively evaluated a cohort of 531 health care workers. One hundred fifty of these employees reported percutaneous or mucous membrane exposures to blood or body fluids from a patient with the acquired immunodeficiency syndrome (AIDS) during the treatment of 238 such patients since 1981. None of these 150 employees had serologic evidence of HTLV-III/LAV infection on follow-up from 6 to 46 months after exposure. Of the 150, 46 were studied immunologically and 29 had lymphocytes cultured for HTLV-III/LAV. Results of all studies were normal. Of the 531 employees, 3 (0.56%) had serologic evidence of HTLV-III/LAV infection. All were seropositive at the time of study entry; none reported adverse nosocomial exposures. All acknowledged membership in one or more established risk groups for AIDS. This study provides strong evidence that the risk of nosocomial transmission of HTLV-III/LAV is extremely low. PMID- 3963664 TI - The effects of erythromycin in patients treated with cyclosporine. PMID- 3963665 TI - Large intracranial arteritis with giant cells in systemic lupus erythematosus. PMID- 3963668 TI - Geriatric assessment. PMID- 3963666 TI - New guidelines on foregoing life-sustaining treatment in incompetent patients: an anti-cruelty policy. AB - When certain ailments are an overwhelming and irremediable encumbrance, treatment directed at other curable ailments, although life-saving, cannot effectively achieve the goals of medicine. We are morally constrained from perpetuating the effects of a hopeless injury without prospect of benefit to the patient. An anti cruelty policy is proposed as a new guideline for foregoing life-sustaining treatment that transcends the doctrines of "substituted judgment" or "reasonable persons" for certain incompetent patients. We propose the use of "anti-cruelty care" as an active chart order or progress note, and suggest that institutional ethics committees or governing bodies recommend its implementation. PMID- 3963667 TI - Sudden cardiac death--1986. PMID- 3963669 TI - Vaccination against pneumococcal infection. PMID- 3963670 TI - Hypocitraturic calcium-oxalate nephrolithiasis. PMID- 3963671 TI - Carcinoembryonic antigen. PMID- 3963672 TI - Neurosyphilis and cerebrospinal fluid tests. PMID- 3963673 TI - Prayer-meeting cardioversion. PMID- 3963674 TI - Calcium and alcohol-associated hypertension. PMID- 3963675 TI - Apparent anaphylaxis from labetalol. PMID- 3963676 TI - Hypercoagulable states and the toxic oil syndrome. PMID- 3963677 TI - Ibuprofen and aseptic meningitis. PMID- 3963678 TI - Posttraumatic convergence insufficiency. AB - Convergence insufficiency was encountered following closed head trauma in 23 patients. The most common complaints included difficulty reading and diplopia at near. The severity of the head trauma varied. There was no correlation between the severity of the head trauma and the severity of the convergence insufficiency. A normal near point of convergence was encountered in six of the 23 patients; all six patients had abnormal convergence reserves when measured with prisms. Treatment consisted primarily of convergence exercises and prisms. Bilateral medial rectus resections were required in two patients. Response to therapy was variable and often incomplete. The anatomic localization of convergence insufficiency secondary to head trauma remains unknown, although lesions in the occipital lobe and upper midbrain both seem capable of producing this syndrome. PMID- 3963679 TI - Single silicone intubation for repair of single canaliculus laceration. AB - A method is described and illustrated for managing the surgical problem that occurs when intubation of the canalicular system is desired, but for various reasons only single intubation is to be performed as opposed to double intubation. To provide the necessary fixation of the single tube (fixation is usually provided with a double-tube system by knotting it in the nose), and at the same time to avoid unsightly scars and difficulties that result from fixation to the skin, it is suggested that the end of the tube be buried and sutured into the inferior fornix or alongside the caruncle. At this site, it is possible to maintain the tube's position for the necessary three- to six-month period without the problems associated with other methods of fixation. PMID- 3963680 TI - Sudden loss of vision in a monocular patient, caused by visual cortex infarction. AB - Infarction of the occipital cortex usually causes loss of the contralateral half of the visual field in both eyes. Although cases with complete transient loss of vision have been described, this is due to involvement of the second half of the cortex in the pathologic process. We report a case of a one-eyed patient with almost complete loss of vision in her only eye because of an infarction of the ipsilateral occipital cortex. During the patient's hospitalization, the temporal half of the visual field recovered. The case is of interest because of the difficulties in diagnosing cortical blindness in a one-eyed patient. PMID- 3963681 TI - Retinal-vein occlusions: carotid artery evaluation indicated. AB - In patients presenting with retinal-vein occlusion there is a 50% likelihood that there is concomitant carotid artery disease. Six of 12 patients originally presenting with retinal vein disease were subsequently diagnosed as having carotid artery disease. The implication is clear: Patients with retinal vein occlusions merit careful carotid artery evaluation. PMID- 3963682 TI - Reform and revolution in medicine: Part II. PMID- 3963683 TI - Mitosis and cell division in human corneal endothelium. AB - During routine morphologic evaluation of nine human corneas, obtained from cadavers of persons older than 40 years, numerous endothelial cells were observed undergoing changes similar to those seen during mitotic cell division. An inverted phase-contrast microscope was used to examine the corneal endothelium, and trypan blue vital stain was used to assess cellular viability. Changes noted within the cell and the nucleus were documented photomicrographically. These findings support the hypothesis that cell division and mitosis do occur in human corneal endothelium. PMID- 3963684 TI - Selective killing of laryngeal carcinoma cells by a monoclonal immunotoxin. AB - To overcome the lack of selectivity of present anticancer drugs, an alternative approach is described for laryngeal carcinoma cells. An immunotoxin is synthesized containing the toxic chain from ricin coupled to a monoclonal antibody against a laryngeal carcinoma cell line. The newly formed monoclonal immunotoxin selectively kills cells from laryngeal carcinoma cell lines, whereas various normal living cells are not affected. Control experiments rule out the possibility that toxicity can be attributed to contaminating traces of whole ricin toxin. The results indicate that minute amounts of the immunotoxin are selectively cytotoxic for living laryngeal carcinoma cells in vitro. PMID- 3963685 TI - Current modifications of the salivary bypass tube and tracheal T-tube. AB - Recent changes in the salivary bypass tube and the silicone tracheal T-tube (Montgomery Safe-T-Tube) are reported. The esophageal tube, a precursor of the salivary bypass tube, was introduced as a device to bridge the gap between the pharyngostome and esophagostome following laryngoesophagectomy and the first stage reconstruction of the cervical esophagus. It has continued to serve this function as well as others and has been modified a number of times. The salivary bypass tube, a silicone modification, is currently available in four sizes. Illustrations and descriptions for inserting, maintaining, and removing this tube are presented. The silicone tracheal T-tube has been modified to prevent accidental displacement of the extraluminal portion of the T-tube into the trachea. Although this complication has been rare in 21 years of usage, it can be fatal. Ridges and grooves have been constructed on the extraluminal portion of the T-tube so that a ring can be attached to prevent posterior displacement. Drainage grooves have also been added along the long axis to aid in the drainage of secretions and to differentiate the T-tube from the silicone tracheal cannula on which there is only one longitudinal groove. PMID- 3963686 TI - Histologic study of the vestibulocochlear nerve. AB - The vestibulocochlear nerve was studied histologically in cross section from the brain stem to the lateral fundus of the internal within the posterior cranial fossa. The cochlear fibers were denser and darker than the vestibular. This difference created double staining of the eighth cranial nerve in the posterior cranial fossa. At the porus acusticus, the nerve fibers became myelinated. Myelin appeared on vestibular fibers more medially than on cochlear fibers. A discrete point of vestibular-cochlear separation was consistently identified in the lateral portion of the internal auditory canal near Scarpa's ganglion. These results suggest that the most reliable point for discrimination of cochlear from vestibular nerves occurs inside the internal auditory canal. PMID- 3963687 TI - Congenital stapes ankylosis by elongation of the pyramidal eminence. Communication. AB - This report confirms the existence of an isolated congenital stapes ankylosis caused by an elongated bony pyramidal eminence. The moderate degree of conductive hearing loss in the patient and the simple surgical procedure needed to produce a normal hearing level are noteworthy. PMID- 3963688 TI - Dynamics of otosclerosis-like lesions in LP/J mice. AB - The LP/J inbred mouse is the first known animal to spontaneously develop otosclerosis-like bone lesions in the middle and inner ear. These abnormal bone foci resemble human otosclerotic lesions, are inherited, and produce a progressive hearing loss. On the basis of histological evaluation alone, it was unclear whether these otosclerosis-like lesions in LP/J mice develop suddenly or gradually as in human otosclerosis. To study the dynamics of lesion formation, four different colored fluorochrome bone labels were given in sequence to postpubertal LP/J mice and CBA/J mice as normal controls. All of the otosclerosis like lesions incorporated at least one fluorochrome, and half were labeled with two or more markers indicating continuous lesion growth over many weeks. It appears that otosclerosis-like lesions in LP/J mice develop during early adulthood and progress gradually as in human otosclerosis. PMID- 3963689 TI - Atypical Cogan's syndrome: an autoimmune disease? AB - A 22-year-old woman is described with gastrointestinal complaints, sclerokeratitis, and a bilateral progressive hearing loss. The clinical picture, the outcome of lymphocyte stimulation tests against S antigen (retina soluble antigen), outer rod segment, and scleroprotein, and the successful administration of corticosteroids after a partial spontaneous hearing improvement, are suggestive of an autoimmune disease. PMID- 3963691 TI - Aerodynamic studies of laryngectomees after the Amatsu tracheoesophageal shunt operation. AB - Ten speakers with tracheoesophageal shunts were subjected to aerodynamic investigation. Measurements were made of tracheal pressure, airflow rate, and intensity and fundamental frequency of voice. Airway resistance, pulmonary power, acoustic power, and efficiency of voice were calculated from the data. It was found that intensity and airflow rate showed a tendency to augment with increased tracheal pressure, while fundamental frequency remained almost unchanged as tracheal pressure increased. Airway resistance of the tracheoesophageal speakers ranged from about 100 to 1,200 dyne s/cm5 and tracheal pressure ranged from 12 to 80 cm of water, while efficiency of voice ranged from 0.3 X 10(-4) to 6.5 X 10( 4). These results revealed that compared to the normal larynx, efficiency of voice was approximately the same, although airway resistance and tracheal pressure were substantially greater. PMID- 3963690 TI - A reexamination of experimental type II collagen autoimmunity: middle and inner ear morphology and function. AB - Type II collagen autoimmunity has been reported to result in a number of middle and inner ear morphological and functional abnormalities. We investigated the immunological, electrophysiological, and anatomical effects of this autoimmune state in well-established Wistar-Furth rat models of type II collagen autoimmune arthritis. Seventeen animals immunized with bovine type II collagen were divided into short term (1-3 months postimmunization) and long term (9-11 months) groups. Thirty-three experimental ears were tested electrophysiologically and were compared to nine ears of unimmunized Wistar-Furth rats. No hearing loss was found in the immunized animals, except for four animals that showed middle ear abscess formation consistent with spontaneous, purulent otitis media. All immunized animals showed very significant serum and perilymph antibody titers to type II collagen. No morphological abnormalities of the external, middle, or inner ears could be identified in the noninfected experimental animals. These findings do not support previously reported observations that type II collagen autoimmunity results in ear disease. PMID- 3963692 TI - Primary intralabyrinthine schwannoma. AB - This paper describes a case of primary intralabyrinthine schwannoma removed by transmastoid labyrinthectomy. This case, together with a review of other cases, suggests that the tendency to preserve hearing by surgical treatment of Meniere's disease and the tendency for these tumors not to be discovered unless a labyrinthectomy is performed may mask their occurrence rate. Furthermore, I would hereby introduce both surgical and pathologic evidence suggesting that there may be a predilection in the site of origin of such solitary tumors. PMID- 3963693 TI - Extended high frequency hearing sensitivity. A normative threshold study in musicians. AB - Sixty members of the Minnesota Orchestra (aged 24 to 64 years) and 30 nonmusicians (aged 20 to 69 years) were evaluated for hearing sensitivity within the conventional audiometric range (0.25 to 8 kHz) and within the extended high frequency audiometric range (9 to 20 kHz). Threshold data were evaluated by age, sex, and musician-nonmusician categories for the respective frequencies, and data were compared to other studies. Musician hearing appeared no poorer than nonmusician hearing, suggesting no major hearing loss from musicians exposure to orchestral noise. Hearing acuity of the two groups was similar to some normal groups reported in the world literature but appeared poorer in comparison to some normal groups defined by a very restrictive definition of normal hearing. Issues relating to the definition of normal hearing are explored. A mathematical model descriptive of the extended high tone hearing sensitivity for musicians and non musicians evaluated was calculated. The formula is presented from which typical age-specific extended high frequency thresholds may be calculated for the 90 subjects evaluated. PMID- 3963694 TI - Absence of later auditory brain stem response components, congenital horizontal nystagmus, and hypotonia in male infants. AB - Five male infants, all of whom showed findings of wave I or waves I and II only of the auditory brain stem response (ABR), congenital horizontal pendular nystagmus, and hypotonia of head and limbs in the early infantile period with later paresis, are discussed. Their ages ranged from 3 to 13 months at the first examination, at which time neither head control, sitting, nor walking had been attained. Follow-up studies of ABRs revealed persistent abnormalities with neither remission nor progression. In spite of these abnormalities, these infants responded well to voices and other sounds. The congenital nystagmus in each case was demonstrated by electronystagmography to have a frequency of 2 to 3 Hz. The correlation between clinical signs and ABR is uncertain as yet. However, our findings are strongly indicative of nonprogressive inborn abnormalities in the lower brain stem. PMID- 3963695 TI - A new adult microlaryngoscope. AB - A new "slimline" binocular microlaryngoscope has been designed for use in adults in whom the larynx is difficult or impossible to visualize with standard microlaryngoscopes. PMID- 3963696 TI - Cutaneous malignant lymphoma of the nasal tip. AB - Cutaneous lymphomas are relatively rare malignant lesions. Lymphomas limited to the skin are uncommon and most patients have a generalized disease. The head and neck are the most common sites of presentation. This lesion is diagnostically problematic since histologic distinction from several benign cutaneous lymphocytic infiltrates is occasionally difficult and thus its clinical behavior is unpredictable. The most common histopathologic subtype is diffuse histiocytic lymphoma and therapy is analogous to that for lymphomas arising elsewhere. The prognosis of lymphoma presenting in the skin is dependent upon the initial extent of the disease and probably upon histology. A case of cutaneous malignant lymphoma arising at the nasal tip, surgically treated, is presented. PMID- 3963697 TI - Carcinomas of the submandibular and sublingual glands. AB - Neoplasms of the submandibular and sublingual salivary glands are much less numerous than those of the parotid gland, but they are more often malignant: nearly 50% for the submandibular and 80% for the sublingual glands. A submandibular gland origin also imparts to a given carcinoma a higher degree of biologic malignancy than is expressed by similar tumors in the parotid gland. PMID- 3963698 TI - [Asthmatic syndrome and gastro-esophageal reflux in children more than 30-months old. Apropos of 12 cases]. PMID- 3963699 TI - [Corticotherapy: too dangerous a treatment for bronchopulmonary dysplasia?]. PMID- 3963700 TI - [Hypoacusis of the perceptive type and congenital hypothyroidism]. PMID- 3963701 TI - [Amyotrophic neuralgia of the shoulder in children. Clinical and electromyographic study]. PMID- 3963702 TI - [Abdominal pain in the child. Attempt at psychological interpretation]. PMID- 3963703 TI - [Malnutrition, delayed height and weight gain, zinc deficiency, anemia and geophagia]. PMID- 3963704 TI - [Proximal trisomy 14. Clinical and cytogenetic study. Apropos of a new case]. PMID- 3963705 TI - [Hernia of a lung into the neck. Case report]. PMID- 3963706 TI - [Acute pentoxifylline poisoning in children]. PMID- 3963707 TI - [Craniostenosis and the Turner syndrome: unusual combination]. PMID- 3963708 TI - [Mediastinal adenopathy as a sign of sarcoidosis in a child with sickle cell thalassemia]. PMID- 3963709 TI - [Ketotifen in the prevention of bronchial asthma of allergic origin in children]. PMID- 3963710 TI - ["Hepatitis" indicative of congenital ornithine carbamoyltransferase deficiency]. PMID- 3963711 TI - [Hyper-IgE syndrome and recurrent infections (Buckley syndrome). Association with genu varum]. PMID- 3963712 TI - [Extensive colonic necrosis indicative of a hemolytic and uremic syndrome]. PMID- 3963713 TI - [Wiskott-Alrich syndrome. Apropos of a case]. PMID- 3963714 TI - [Spontaneous recurrent hypothermia and megalencephaly. Case report. Review of the literature]. PMID- 3963715 TI - [A double operation for the repair of anal incontinence]. PMID- 3963717 TI - [Influence of growth on the pharmacokinetics of drugs in newborn infants, infants, and children]. PMID- 3963716 TI - [Bacteriologic diagnosis of acute pneumopathies in children. Value of determining urinary bacterial antigens by counterimmunoelectrophoresis]. PMID- 3963718 TI - [True hermaphroditism]. PMID- 3963719 TI - [Medulloblastoma of the cerebellum. Apropos of 120 cases from 1953 to 1982]. PMID- 3963720 TI - [Cervicobrachial paralysis and neuralgia of tumoral origin: contribution of combined myelography and x-ray computed tomography]. PMID- 3963721 TI - [Congenital renal malformations in x-ray computed tomography. Apropos of 25 cases]. PMID- 3963722 TI - [X-ray computed tomographic study of laryngoceles]. PMID- 3963723 TI - [Structuralist analysis of the transverse canal]. PMID- 3963724 TI - [Intra-arterial chemotherapy. Radiological technic for inserting a silicone microcatheter]. PMID- 3963725 TI - [Value of esophageal manometry with the methylergometrin maleate test in angina with normal coronarography. The concept of esophageal angina]. AB - 22 patients presenting an "angina with normal coronarography" and 5 control subjects were subjected to a manometric exploration of the oesophagus in the basal state and under methylergometrine maleate (MEM) treatment. The MEM test is shown to be a good one for the induction of painful oesophageal dyskinesias, particularly in patients who had suffered in an inexplicable manner when that substance was administered for coronarography. PMID- 3963726 TI - [Evaluation of the effect of Royat thermal gas in arteriopathy of the legs using thallium-201 muscular scintigraphy]. AB - 12 patients (group II) suffering from an arteriopathy of the lower limbs, stage II, were examined by thallium 201 muscular scanning. The aim of this study was to look for a possible muscular effect of Royat thermal gas injected subcutaneously. A preliminary study was conducted at rest, and consisted of recording the initial decay curve of thallium in the thighs and the study of the muscular fixation by different segments of the limbs, including the determination of the ratios of amounts fixed by the muscular and non-muscular zones. The results were compared with those obtained in 11 healthy subjects (group I) and no significant difference was noted between the two groups at rest. On the other hand, a considerable improvement of the fixation in the legs was observed after subcutaneous injection of thermal gas. The results are discussed in relation to the clinical and paraclinical data. PMID- 3963727 TI - [Partial interauricular block. Apropos of a case]. AB - An observation of an inter-auricular conduction disorder is reported. This disorder concerned the median part of the left atrium as shown by evidence provided by stepped oesophageal recordings, which suggest an auricular depolarisation normally descending in the upper part of the left atrium but abnormally retrograded into the lower part. This suggests that interauricular conduction is blocked at the median inter-auricular passage but that it occurs by the tract of Bachmann at the upper part of the left atrium and by retrograde passage to the lower part. On the surface electrocardiogram, the wave P is diphasic + - in D2, D3 and aVF, of normal duration with a normal PR space. PMID- 3963728 TI - [Orthostatic arterial hypotension and giant aneurysm of the basilar trunk]. AB - The authors report two observations of giant aneurysm of basilar artery, where the first neurological signs were preceded or escorted by a postural hypotension. They emphasize the place of rhombencephon in the control of blood pressure and they bring together their cases with those reporting a postural hypotension revealing a lesion of medulla. They insist upon the necessity to look a peripheric and central neurological lesion in front of a postural hypotension. PMID- 3963729 TI - [Hypertrophic myocardiopathy and tetralogy of Fallot. Study of 2 cases]. AB - The authors report two observations of concentric hypertrophic cardiomyopathy associated with Fallot's tetralogy in one case and with pulmonary atresia complicated by atrial septal defect in the other. The association of Fallot's tetralogy with hypertrophic cardiomyopathy is rare, as only 5 cases have been reported in the literature. In this connection, the mechanism of myocardial hypertrophy and the therapeutic problems posed by this association are discussed. PMID- 3963730 TI - [TM-mode echocardiography in the evaluation of ventricular function in convalescent patients after recent infarction. Correlations with hemodynamic parameters recorded at rest and after a cycloergometric test]. AB - 133 patients (50 +/- 11 years), under observation at 1 to 2 months after the acute episode (38 +/- 10 days) and in the absence of medical treatment in most cases (90%), underwent the same day a maximal cycloergometric test, limited to symptoms of clinostatism with hemodynamic monitoring (Swan-Ganz 7F for pressure and thermodilution), and a good quality echocardiogram in TM mode (semi-automatic reading) in order to identify every valvular lesion. The ECHO-TM parameters of the left ventricular function (LV) taken into consideration (circumferential velocity of shortening of LV : CVSLV, percentage of systolic shortening of LV, telediastolic dimension of LV,E-septum distance, PR-AC, relation between the intervals Q-mitral block and aortic block-mitral point E,QC/A2E, left auricular dimension and mitral point B) have shown a low correlation (0.31) with the telediastolic pulmonary arterial pressure (TDPAP) at rest and after effort. The ECHO-TM parameters have not demonstrated significant differences when the patients are grouped according to the locus of the infarction (76 inferior, 50 anterior and 7 antero-inferior) and age (36 younger than 45 years, 87 aged between 45 and 64 years and 10 older than 64 years), whereas significant differences were found on segregating the patients according to the value of the last level at a threshold of 75 watts (44 patients did not attain 75 watts and 89 exceeded it).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963731 TI - Serum calcitonin in thyroid disorders and in pheochromocytoma kindred. AB - Serum calcitonin was determined by RIA in 59 healthy subjects (Group 1), 49 randomly selected patients with treated or untreated thyroid disorders (Group 2), and in 12 kindred of a pheochromocytoma index case (Group 3). Although most subjects in Group 2 had normal calcitonin levels, there were significant (p less than 0.001) differences between all three groups. Of the five patients in Group 2 with high serum calcitonin, one had medullary cancer of the thyroid, one had multiple endocrine neoplasia, one had acromegaly, and two remained undiagnosed. Increased serum calcitonin levels were also found in seven of 12 normotensive relatives of a patient with pheochromocytoma. It is therefore concluded that high serum calcitonin levels in patients with thyroid disorders strongly suggest the presence of C-cell neoplasia or medullary cancer of the thyroid. PMID- 3963732 TI - Abnormal cytodifferentiation in leiomyosarcomas induced with injection of nickel subsulfide into skeletal muscles of rats. Light and electron microscopic observations. AB - Seven leiomyosarcomas, induced individually with a single injection of nickel subsulfide (0.4 mg) into skeletal muscles of Fisher 344 male rats were studied with the light and with the electron microscope. The tumors consisted of fibroblast-like cells lacking the cytoplasmic filaments found in normal maturing and mature smooth muscle, and of cells in which the appearance of these filaments occurred in the following sequence: first, actin filaments in concomitance with intermediate filaments; second, myosin filaments. According to work from several laboratories, normal embryonic smooth muscle was derived from fibroblast-like cells and a characteristic of their early differentiation was the appearance of filaments in a sequence similar to that in the present tumors. Similarities between normal and neoplastic muscle were also observed in the orientation of the filamentous components and in the changes in quantity occurring in them during the course of differentiation. However, in the neoplastic cells, nonfilamentous structures, such as gap junctions which normally increase in number with advancing cell maturation, were rarely detected. In addition, the sarcoplasmic reticulum was constantly far less developed than in the normal mature prototypes. The present observations suggest that the differentiation of the neoplastic cells in the early stages is similar to that under normal conditions of smooth muscle development, but it becomes abnormal in the advanced stages. PMID- 3963733 TI - Effect of profound hypothermia on leukocytes and platelets. AB - Seventeen patients who underwent aortic arch replacement were subjected to profound hypothermia and circulatory arrest. At maximum cooling, platelet count dropped from 184 +/- 122 to 37 +/- 30 thousand per microliter, and the total leukocytic count fell from 6.27 +/- 4.0 to 1.47 +/- 0.6 thousand per microliter. The thrombocytopenia was partially reversed with rewarming. The total white cell count consistently returned to precooling values or higher (10.5 +/- 4.0). The mechanism for this cold induced phenomenon is not well understood. PMID- 3963734 TI - Nodular regenerative hyperplasia of the liver with and without portal hypertension: a comparison. AB - The clinical and the pathologic features of seven patients with nodular regenerative hyperplasia of the liver are analyzed and compared with those of 37 patients reported in the literature in an attempt to distinguish the features of those with portal hypertension from those without. Severe degrees of obliterative portal venopathy usually associated with the portal hypertension were found among the various pathological features. The association of nodular regenerative hyperplasia with a variety of chronic diseases suggests a heterogeneous group of pathogenic mechanisms. Our study reveals that only some of these mechanisms lead to the hepatic changes that cause portal hypertension. PMID- 3963735 TI - Further studies on aldosterone metabolism. The Claude P. Brown memorial lecture. PMID- 3963736 TI - [Behavior of the patient with functional colon disease: types, analytical methods and therapeutic significance]. AB - A proper clinical examination should provide psychological data that enriches the patient-physician relationship. Video recording and its analysis do not disturb the patient and provide for objective awareness. This technique confirms the idea that the behaviour and psychological structure of the colopath fall into two major and basic types: compulsive obsessionals and hysterophobics, types that should lead the practitioner to provide different sorts of psychological care. This care can form the basis for the treatment of the colopath. PMID- 3963737 TI - [Pneumatosis cystoides intestinalis manifested by pneumoperitoneum]. AB - We report the case of a female patient, suffering from chronic respiratory insufficiency and treated with steroids, in whom the discovery of pneumoperitoneum led to exploratory laparotomy. The plain abdominal X-rays demonstrated gas in the walls of the stomach as well as in the peritoneal cavity. Intraoperative exploration revealed the existence of pneumatosis cystoides of the stomach and small intestine. This observation is a reminder that not all cases of pneumoperitoneum are surgical, and notably this is the case for cystic intestinal pneumatosis. PMID- 3963738 TI - [Weakened condition of gastric mucosa barrier and hypersthenic dyspepsia]. AB - Many patients, who suffer of heartburn or non ulcerous dyspepsia, seem to have a normal gastric mucosa (gastroscopy or histology). Potential difference is a measurement of the efficacity of mucosal barrier, and it drops when healthy volunteers ingest aspirin. By this method it is shown that patients with non ulcerous dyspepsia have a weakness of gastric mucosal barrier. Compare to controls or irritable bowel syndrome, basal potential difference is lower and time to return to basal value after aspirin is longer. This test shows that a trouble of the mucosal barrier exists even if the mucosa seems to be normal at gastroscopy and histology. PMID- 3963739 TI - [Pancreatic lithogenesis]. AB - The first lesion of chronic calcifying pancreatitis (CCP), the most frequent form of chronic pancreatitis is the formation in the ducts of plugs build up of protein and calcium carbonate which are at the origin of pancreatic calculi. Pancreatic juice is supersaturated in calcium carbonate. A novel protein, the pancreatic stone protein (PSP) has been purified from human pancreatic juice and its amino-acid composition has been determined. It is biosynthesized in the acinar cell as well as enzymes. PSP prevents the formation of calcium carbonate crystals in a supersaturated solution. Its secretion is decreased in patients presenting with CCP. It is proposed that this decrease plays an important part in the pathogenesis of CCP. PMID- 3963740 TI - [Diagnostic discussion: chronic diarrhea in a Haitian]. PMID- 3963741 TI - [Endoscopic excision of malignant colorectal polyps. Study of a series of 82 cases]. AB - The management of malignant colonic polyps removed by endoscopic polypectomy is a controversial subject. We reported a series of 81 patients with 82 malignant polyps removed by endoscopic polypectomy between 1977 and 1984. 15 polyps contained carcinoma in situ and were treated by endoscopic polypectomy alone. 36 polyps contained superficial cancer; 35 were treated by EP alone; 1 was treated by endoscopic polypectomy and colectomy. 26 polyps contained invasive carcinoma and 2 were classified as polypoid adenocarcinomas. 19 had clear resection margins at polypectomy and seven had involved resection margins: 17 were treated by endoscopic polypectomy alone, 9 were treated by endoscopic polypectomy and colectomy. The patients were followed with colonoscopy. Follow-up has been 6 to 74 months (mean 32 months). The patients whose polyps were treated by endoscopic polypectomy alone, had had no evidence of recurrent tumor at the polypectomy site. Of the 12 patients undergoing colectomy, 4 had residual tumor at the polypectomy site. No patients had involved lymph nodes. There was no evidence of recurrence in any of these cases. Polyps containing contained carcinoma in situ and superficial cancer, polyps containing invasive carcinoma and clear resection margins can be treated with endoscopic polypectomy alone. Polyps with invasive carcinoma and involved resection margins should undergo segmental colonic resection. This approach must be weighed against the age of the patient, the medical status and the morbidity and mortality of the surgical procedure. PMID- 3963742 TI - Social-class gradients in menarcheal age in Poland. AB - In a sample of approx. 19 000 Polish schoolgirls from the three largest cities of the Upper Silesia conurbation, menarcheal age was studied in relation to parental education (four levels) and father's occupation (12 groups). Menarcheal age tends to increase with decreasing parental education, although the gradient is not steep. When families below a certain level of economic standing are discarded from the best-educated and the least-well-educated groups, mean menarcheal age, surprisingly, decreases much more in the former than in the latter. Mean menarcheal ages for girls from different occupational groups range from 12.82 to 13.30 years and form the following sequence, in increasing order: managers- police--non-technical professionals--engineers, technicians and foremen--skilled industrial workers and small businessmen--unskilled workers--coal-miners. Mean menarcheal age for an occupational group is strongly dependent upon the group's socio-economic status, the latter being defined in terms of parental education, family income, family size, and dwelling conditions. However, daughters of men in the police force mature significantly earlier, and daughters of coal-miners significantly later, than would be expected from each group's rank in socio economic status. The findings are compared with the results of other recent studies of social gradients in menarcheal age in Poland. PMID- 3963743 TI - Cephalometric and craniometric age changes in adult humans. AB - Thirty-three cephalometric and craniometric measurements were made on lateral radiographs of 154 males and 199 females, aged 21-83 years, from Vienna, Austria. The measurements were studied in age-groups by univariate and multivariate analyses. The results showed that the height dimensions of the face and viscerocranium increase up to the fourth decade but then decrease, while the height dimensions of the neurocranium decrease progressively with advancing age. However, the latter findings could possibly also reflect a secular trend. The thickness of the soft tissues showed continuous increases throughout the series, especially along the lower face. Although the age changes were greater in cephalometric than in the craniometric dimensions, those of the skull were also statistically significant. Using discriminant analysis on the cephalometric data results in correct assignment of 63.32% of females to their age-group but only 58.44% in males. The higher correct assignment of the females could have been due to their larger sample size. PMID- 3963744 TI - Comparisons of the intra- and inter-individual variability in sex hormone levels of men. AB - Six blood samples were taken from each of 33 healthy young men during the course of 2 weeks. From these, the testosterone, dihydrotestosterone, and oestradiol levels were determined. In addition, free testosterone was measured using saliva samples obtained from 23 of the subjects. Both coefficients of variation and variance analyses showed that the inter-individual variability is greater than the intra-individual for all of the hormones. No influence of the day of the week could be ascertained. However, it was discovered that the serum hormone levels dropped with age (weakly significant for oestradiol, insignificant for the androgens) in spite of the subjects being in or near their third decade. The pooled intra-individual correlations between the hormones all fell within the moderate to middle-high positive domain, whereas the inter-individual correlations ranged between highly positive (testosterone to dihydrotestosterone), middle highly positive (free testosterone to total testosterone), and slightly negative (free testosterone to oestradiol). PMID- 3963745 TI - Growth of urban schoolchildren in Botswana. AB - Urban Tswana schoolchildren (721), aged 6 to 14 years, were measured for height, weight, triceps skinfold and upper arm circumference. Boys and girls at all ages exhibited mean heights and weights less than the 50th percentile values of American and British reference standards, with large numbers of children falling into the 10th percentile or lower based N.C.H.S. (National Center for Health Statistics) values. Weight-for-height percentile distributions did not show such large numbers in the lowest percentiles. Triceps skinfolds were smaller than those of British children and changed little in boys over the measured age range. Girls' skinfold values were more variable than boys', and in older girls approached British means. For both boys and girls, skinfolds showed a developmental pattern similar to those of other African children. Arm circumferences also developed as those of other urban African children, and by later ages were similar to those of British references. Differences between Batswana and Europeans may be due to smaller heights and weights of young Tswana adults when compared with their counterparts in developed countries, and also to growth tempo differences. Such tempo differences also exist between Batswana and other African groups. PMID- 3963746 TI - The pattern of early menstrual cycles in Nigerian girls. AB - Between October 1980 and June 1981 a total of 2528 recorded menstrual cycles were collected from 422 girls in four girls' secondary schools at Enugu and Nuskka in Anambra State, Nigeria. The mean and standard deviation for all cycles were 30.9 and 18.60 days, respectively. The results support the findings from other parts of the World that menstrual cycles are highly irregular during the first few years after menarche and that the variability of these cycles decreases as menstrual life continues. A comparison between the pattern of irregularity indicated in our study and those of earlier studies in North America and Europe at different time points suggests that socio-economic development, with its attendant improvements in nutrition and the elimination of infectious diseases, may be helping to bring about a reduction in the variability of early menstrual cycles, the reduction being particularly significant in respect of very long cycles. PMID- 3963747 TI - Rapid adaptation of pancreatic enzyme secretion in the conscious rat. II. Effects of fasting and dietary modulation. AB - The influence of fasting and dietary modulation on basal and stimulated pancreatic enzyme secretion was studied in conscious rats with cannulated pancreatic ducts. Two days' fasting decreased pancreatic secretion by about 30%. After stimulation of the secretion rate by acute derivation of pancreatic juice or by intravenous infusion of cerulein (0.2 micrograms/kg/h) no rapid change of enzyme composition was found. In further experiments, two groups of rats were fed with carbohydrate-rich and carbohydrate-poor diets, respectively. After pancreatic duct cannulation and a postsurgical recovery period, the diets were interchanged. An adaptation of pancreatic enzyme secretion to the new diet was observed in pancreatic juice. Stimulation of the secretion rate during the adaptation process by acute derivation of the juice or by intravenous infusion of either cerulein, secretin, carbachol or cerulein plus secretin did not further modify the composition of pancreatic proteins. 'Nonparallel' secretion of enzymes was never found when sufficient time for recovery from pancreatic duct surgery was allowed. PMID- 3963748 TI - Influence of the linoleic acid content of the diet on tumor growth in transplantable rat tumor models. AB - Diets high (17.7 cal%) and low (3.3 cal%) in linoleic acid were given to groups of Brown Norway female rats before and after inoculation of syngeneic tumor models with different characteristics, with regard to tumor spread, malignancy, immunogenicity, growth rate, rat strain, and histopathological features. Despite the differences in characteristics, in most tumor models, tumor growth was identical in both experimental groups. However, in 2 tumor models, an adrenal cortical carcinoma and a myeloid leukemia, differences in growth were noted. In rats given the diet low in linoleic acid, growth of the cortical carcinoma was significantly increased, whereas the opposite effect was seen in rats with myeloid leukemia. PMID- 3963749 TI - Acute effects of dietary cod liver oil and cream on plasma lipoproteins. AB - Plasma lipoprotein concentration and composition of 6 healthy subjects were studied before and 3 h after a fatty meal (900 kcal) consisting of either cream (mainly saturated fatty acids) or cod liver oil (CLO; rich in n-3 polyunsaturated fatty acids). The plasma triglyceride concentration was increased after both meals. This was caused by an increase in both chylomicron and very-low-density lipoprotein (VLDL) triglycerides. Plasma total cholesterol was unchanged. The cholesterol content was also increased in low-density lipoproteins and in VLDL after cream intake, but was reduced in high-density lipoproteins (HDL), whereas no changes were observed in these fractions after CLO. The fatty acid composition of the diet was reflected in the plasma and in the chylomicron fraction. Both fatty meals reduced the relative concentration of plasma linoleic acid. Fatty acid composition in HDL suggested dietary fatty acid transfer from the chylomicrons and VLDL to the HDL after CLO, but not after the cream diet. The results suggest that in the postprandial state the fatty acid transfer between the triglyceride-rich lipoproteins and HDL depends on the quality of the fatty acids and that the n-3 polyunsaturated fatty acid may increase such transfer. PMID- 3963750 TI - Influence of different dietary fatty acid sources on erythrocyte lipids and plasma and liver essential fatty acids in hamsters fed ethanol. AB - Hamsters fed ethanol were given three different dietary sources of essential fatty acids; safflower oil, evening primrose oil (both mainly n-6 fatty acids) or linseed oil (mainly n-3 fatty acids). After 7 weeks, plasma, erythrocyte and liver lipids and fatty acids were analyzed. Plasma and liver lipids were not significantly different in the ethanol-fed hamsters compared to the controls. Erythrocyte total phospholipid was increased only in the ethanol-fed groups given n-6 but not n-3 fatty acids. Some fatty acid changes induced by ethanol were predictable, e.g. lower 20:4 n-6 in hamsters fed n-6 fatty acids, but others were not predictable, e.g. higher 22:6 n-3 in all the ethanol-fed groups. The effect of ethanol on hamster lipids and fatty acid composition appears dependent on the predominant class of dietary fatty acids. PMID- 3963751 TI - Brown adipose tissue thermogenesis during pregnancy in mice. AB - The thermogenic activity of interscapular brown adipose tissue has been assessed at different stages of pregnancy in mice. In late pregnancy there was a hypertrophy of the tissue which reversed at parturition. Neither the total protein content nor the total cytochrome oxidase activity of the tissue changed significantly throughout pregnancy or into early lactation (2-3 days, post partum). However, mitochondrial GDP binding, an index of the activity of the proton conductance pathway, was significantly decreased at the end of pregnancy with a further decrease in early lactation. Moderate food restriction had no effect on either cytochrome oxidase activity or mitochondrial GDP binding at the end of pregnancy, as compared with pregnant animals fed ad libitum. Food restriction did, however, prevent the hypertrophy of brown adipose tissue in late pregnancy. It is concluded that brown adipose tissue thermogenesis is not significantly decreased in the pregnant mouse until shortly before parturition, even in animals subject to food restriction. It is also concluded that the normal dietary stimulation of thermogenesis in response to hyperphagia is suppressed in the pregnant animal. PMID- 3963752 TI - Determination of protein in polysaccharide-antibody complexes. AB - We describe a simple and sensitive method for determining antibody protein complexed with polysaccharide using binding of Amido-black to antigen-antibody complexes and bovine serum albumin as protein standard. The method, which is a modification of the method used for the determination of total nitrogen or the protein concentration in milk, has shown a consistent quantitative relationship with the Lowry procedure and has been developed for its particular application to serological precipitates. PMID- 3963753 TI - The concept of functional idiotype network for immune regulation mocks all and comforts none. PMID- 3963754 TI - Is there a germ-line network? The "GAT" case. PMID- 3963755 TI - Spontaneous dissection of the cervical internal carotid artery. AB - We studied 36 patients (21 women and 15 men) with spontaneous dissection of the internal carotid arteries. The ages of these patients ranged from 21 to 63 years. Focal unilateral headache was the most common symptom. Other common clinical manifestations (in decreasing order of frequency) included focal cerebral ischemic symptoms, oculosympathetic paresis, bruits, light-headedness, and neck pain. Less common symptoms were syncope, amaurosis fugax, scalp tenderness, swelling in the neck, and dysgeusia. Common angiographic manifestations (in decreasing order of frequency) were elongated, irregular, and frequently tapered narrowing of the lumen; abrupt luminal reconstitution (often at the carotid canal); aneurysms; intimal flaps; slow internal carotid artery--middle cerebral artery flow; tapered occlusion; and distal branch occlusions. The incidence of hypertension in these patients was considerably higher than that in the general population. Angiographic evidence of fibromuscular dysplasia was found in 14% of the patients, but atherosclerotic changes were uncommon. Follow-up ranged from 14 to 140 months (mean, 58.5 months). Twenty-three patients with 29 dissected internal carotid arteries were also restudied angiographically. The stenosis of the internal carotid artery either completely resolved or substantially improved in more than 85% of the dissected vessels. About two-thirds of the dissecting aneurysms either resolved or decreased in size. Clinically more than 85% of the patients had an excellent or complete recovery. Recurrence of the dissection or rupture of a dissecting aneurysm was not noted. Despite their disconcerting appearance on angiography, spontaneous dissections of the internal carotid arteries are often associated with a good prognosis. PMID- 3963756 TI - Systematic regional differences in the cholinergic innervation of the primate cerebral cortex: distribution of enzyme activities and some behavioral implications. AB - Choline acetyltransferase and acetylcholinesterase enzymatic activities were measured in 33 cytoarchitectonic subregions of the cerebral cortex in two rhesus monkeys. As expected, the hippocampus and amygdala were rich in these enzymes. In addition, the paralimbic (mesocortical) regions of the brain (e.g., parahippocampal, insular, caudal orbitofrontal, and temporopolar areas) also contained high levels of both enzymes. In contrast, the concentration of these cholinergic markers was the lowest within all frontal and temporoparietal association areas. As a group, the primary sensory and motor regions contained an intermediate level of choline acetyltransferase activity. Both cholinergic markers also showed a gradual increase from the isocortical toward the more primitive periallocortical subsectors of paralimbic areas. These anatomical patterns have potential implications for the role of cholinergic pathways in the memory process and in the pathogenesis of Alzheimer's disease. PMID- 3963757 TI - Joseph's disease: clinical and pathological studies in a Japanese family. AB - Joseph's disease is a hereditary ataxia found among descendants of Portuguese from the Azores Islands. We describe the clinical and pathological features of 4 members of a Japanese family who were diagnosed as having Joseph's disease. The illness began with cerebellar ataxia between the ages of 18 and 45 years. Nystagmus, dysarthria, and pyramidal signs were early manifestations. External ophthalmoplegia, dystonia and/or athetotic movements, and muscular atrophy appeared in the late stages. Neuropathological findings in one patient revealed degeneration of the dentatorubral and pallidoluysian systems, substantia nigra, pontocerebellar system, Clarke's column and spinocerebellar tracts, and anterior horn cells, as well as the cranial nuclei in the brainstem. Neurons in the inferior olivary nuclei, Purkinje's and granule cells, the cerebral cortex, thalamus, and striatum were spared. Involvement of the dentatorubral and pallidoluysian systems seems to be a characteristic feature of this disease in Japan. PMID- 3963758 TI - Atrial size, atrial fibrillation, and stroke. AB - M-mode and two-dimensional echocardiographic images were reviewed retrospectively in 20 patients with atrial fibrillation and ischemic stroke with no known valvular disease and in 20 patients with atrial fibrillation without known stroke. Left atrial size was measured and analyzed without knowledge of patient grouping. Two-dimensional echocardiography showed that 90% of the stroke patients had left atrial enlargement compared with only 20% in the nonstroke group. This finding suggests that left atrial enlargement may convey additional stroke risk in patients with atrial fibrillation. PMID- 3963759 TI - Periodic leg movements of sleep (nocturnal myoclonus): an electrophysiological study. AB - Six patients with periodic leg movements of sleep (PLMS) were studied electrophysiologically. All patients had normal results on routine nerve conduction studies and electromyography. In 5 patients the blink reflex consisted of three components, and in 1 patient it consisted of four components, with two components being normal. The second component of their blink reflex did not habituate. Other abnormalities included long-latency responses in the extremities in 2 patients, release of H-reflexes from flexor hallucis brevis muscle in 2 patients, and an Hmax/Mmax ratio of 98% in 2 patients. One patient's median nerve somatosensory-evoked response had a markedly enlarged P22 wave. These electrophysiological abnormalities suggest a disorder of the central nervous system producing increased excitability of segmental reflexes. To produce increased excitability of both brainstem and spinal cord reflexes, the disorder must be operative at the pontine level or rostral to it. Since long-latency components of blink reflexes occurred in all our patients, this may be a helpful diagnostic test when PLMS is suspected. PMID- 3963760 TI - Progressive encephalitis three months after resolution of cutaneous zoster in a patient with AIDS. AB - A 37-year-old homosexual man with the acquired immune deficiency syndrome (AIDS) developed progressive, ultimately fatal, neurological deficits 12 weeks after a course of cutaneous zoster. Premortem radiological procedures and cerebrospinal fluid analyses were nondiagnostic. At postmortem examination, several opportunistic infections associated with AIDS were recognized. Throughout the brain, necrotic and demyelinative lesions were present, suggestive of progressive multifocal leukoencephalopathy. However, light microscopical examination showed numerous Cowdry type A intranuclear inclusions in astrocytes, oligodendrocytes, and neurons near the periphery of the lesions. Herpes zoster encephalomyelitis was diagnosed and confirmed by electron microscopy, peroxidase-antiperoxidase staining, and by Southern blot analysis of DNA extracted from brain tissue. This case provides insight into the pathogenesis of zoster-associated encephalomyelitis and suggests another agent to be considered in the differential diagnosis of encephalopathy in patients with AIDS and other disorders of immunological impairment. PMID- 3963761 TI - Normal myelination of regenerating peripheral nerve sprouts despite circulating antibodies to galactocerebroside in rabbits. AB - Rabbits were immunized with galactocerebroside and a crush lesion was created in the tibial nerve before the onset of experimental allergic neuritis. Normal regeneration and myelination of distal peripheral nerve sprouts occurred and was identical to that of controls, although circulating antigalactocerebroside antibodies were present and nerve roots showed typical signs of beginning experimental allergic neuritis. PMID- 3963762 TI - Topical therapy for oropharyngeal symptoms of myasthenia gravis. AB - Inhibitors of acetylcholinesterase are commonly used in the treatment of myasthenia gravis. We studied a patient with mainly bulbar myasthenia gravis who did not tolerate oral pyridostigmine despite a clear clinical response. Treatment with nebulized pyridostigmine reduced her symptoms without systemic side effects. This route of therapy may benefit other patients. PMID- 3963763 TI - Status epilepticus: divergence of sympathetic activity and cardiovascular response. AB - To study changes in plasma catecholamine concentrations and their relationship to changes in systemic and pulmonary vascular pressures, we induced status epilepticus by intravenous administration of bicuculline in 5 anesthetized, paralyzed, ventilated adult sheep. Status epilepticus was accompanied by marked elevations in plasma epinephrine and norepinephrine levels (390-fold and 163 fold, respectively) and by marked elevations in systemic and pulmonary vascular pressures. Vascular pressure returned to normal in 60 minutes, despite plasma catecholamine levels that remained elevated for the 3-hour duration of the study. Mild metabolic acidosis and hyperkalemia were also noted. We discuss the implications of these findings with regard to the management of hypotension during status epilepticus. PMID- 3963764 TI - Signs of focal posterior cerebral abnormality in early subacute sclerosing panencephalitis. AB - In 16 cases of subacute sclerosing panencephalitis (SSPE), praxis and visual spatial capacities were more impaired early in the disease than were language functions. Together with the electroencephalographic findings, this suggests that the early lesions in SSPE are more pronounced in the parietooccipital area than in the classic language areas. Other reports also support such a localization. Detection of the disease in its early phase when dressing apraxia and visual impairment predominate is important in conducting clinical trials of different therapeutic agents. PMID- 3963765 TI - "Mineral transporter" therapy for multiple sclerosis complicated by bacterial endocarditis. PMID- 3963766 TI - Intravascular contrast media and neuromuscular junction disorders. PMID- 3963767 TI - Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. AB - We reviewed the clinical, neuroradiological, and serological findings in 27 patients with cerebral toxoplasmosis complicating the acquired immune deficiency syndrome, 19 of whom were also analyzed neuropathologically. The clinical manifestations of this disorder varied, ranging from headache and fever to coma. However, the characteristic presentation included focal neurological symptoms and signs, usually of subacute onset. In addition, two-thirds of the patients exhibited more generalized cerebral dysfunction with confusion and lethargy. The computed tomographic (CT) scan most commonly revealed ring contrast enhancement, which appeared to correlate best with the histological presence of vascular proliferation and inflammation surrounding the abscesses. However, in 5 patients the CT scan revealed either homogeneous enhancement or no enhancement, and in 3 patients the scans were negative. In general, CT scans underrepresented the number of lesions eventually documented pathologically. Double-dose contrast administration and preliminary experience with magnetic resonance imaging suggested that these techniques were superior to standard CT scanning in detecting Toxoplasma lesions. All patients were seropositive for IgG antibody against Toxoplasma gondii in blood, both before the onset of illness and at the time of presentation, although titers in some patients were as low as 1:8 and most patients did not exhibit rising titers. Prompt therapy resulted in rapid clinical improvement, documented by CT scan, associated with the development of an organizing tissue response in the host and elimination of free organisms. Response to treatment was sufficiently rapid in most patients to allow a trial of therapy as the favored approach to diagnosis. PMID- 3963768 TI - Abnormal platelet glutamate dehydrogenase activity and activation in dominant and nondominant olivopontocerebellar atrophy. AB - Glutamate dehydrogenase (GDH) activity and its allosteric modulation by purine nucleotides were studied in platelet preparations from 4 patients with a nondominant form of adult-onset olivopontocerebellar atrophy (OPCA) and in affected and nonaffected members of two families with a dominant form of OPCA. A partial deficiency of GDH activity (40 to 50% of control values) was present in 3 patients with nondominant OPCA and in 2 patients, father and son, with a dominant form of OPCA. Platelet GDH from these patients and controls was regularly inactivated by 2 mM guanosine-5'-triphosphate (GTP) and simulated one- to twofold by 2 mM adenosine-5'-diphosphate (ADP). In the presence of 0.2% Triton X-100, the activating effect of ADP was enhanced four- to sixfold. The partial deficiency in maximum catalytic activity observed in these patients persisted under all conditions used for enzyme assay. In affected members, but not in one unaffected member of another family with a dominant type of OPCA, GDH activity was in the control range but was not activated by ADP in either the presence or absence of Triton. These results suggest that there may be at least two possible alterations of GDH in patients with OPCA: one which decreases the maximum catalytic activity and one which impairs the regulatory properties of the enzyme. Furthermore, this study suggests that platelet GDH determination in patients with OPCA may provide a simple and useful tool to classify these disorders and to understand the basic pathophysiological mechanisms involved. PMID- 3963769 TI - Distribution of the molecular forms of acetylcholinesterase in human brain: alterations in dementia of the Alzheimer type. AB - Acetylcholinesterase (AChE), the enzyme that degrades acetylcholine, is a heterogeneous enzyme that can be separated into multiple molecular forms. A tetrameric membrane-bound form (G4) and a monomeric soluble form (G1) are the two predominant enzyme species in mammalian brain. The distribution of AChE molecular forms was defined by sucrose density gradients of 11 anatomical regions of postmortem brains from 10 patients with dementia of the Alzheimer type (DAT) and 14 nondemented controls of similar ages. The results demonstrate an overall loss of protein and enzyme activity in all areas of the DAT brains studied and a selective loss of the G4 form of AChE in Brodmann areas 9, 10, 11, 21, 22, and 40, and the amygdala. There was no change in the G4/G1 ratio in areas 17 and 20, in the hippocampus, or in the cerebellum. There was a high regional correlation of the G4/G1 ratios with published values for choline acetyltransferase activity but lower correlation with total AChE activity. We propose that there is a predominant loss of the G4 form of AChE in DAT and that this loss is correlated with the degeneration of presynaptic elements. PMID- 3963770 TI - A white matter disorder in dementia of the Alzheimer type: a pathoanatomical study. AB - In cases of Alzheimer's presenile and senile dementia, Alzheimer's disease (AD) and senile dementia of the Alzheimer type (SDAT), respectively, we have observed, in addition to the gray matter degeneration, a lesion that has the character of an incomplete infarction confined to the white matter. It is encountered in 60% of both groups, with mild changes in two thirds and moderate or severe changes in one third. It involves the deep white matter symmetrically, tapering off toward the cortex. It is characterized by partial loss of myelin, axons, and oligodendroglial cells; mild reactive astrocytic gliosis; and sparsely distributed macrophages as well as stenosis resulting from hyaline fibrosis of arterioles and smaller vessels. No complete or cavitating infarctions and no hypertensive vascular changes were observed. The white matter changes are thought to be due to hypoperfusion of the concerned white matter territories since, in addition to the white matter hyaline vascular stenosis, these cases show signs of cardiovascular disease, usually with hypotension. The white matter disorder also occurs independent of the gray matter process of AD and SDAT and may be seen as the sole brain lesion in non-AD subjects. Its occurrence is thus neither regularly related to the severity nor to the regional appearance and accentuation of the cortical Alzheimer process and is thus not likely to be just the result of a wallerian degeneration. Histologically it is similar in several respects to Binswanger's disease, although with some distinct differences. It is thus related to the cerebrovascular group of disorders in addition to AD and SDAT. In view of its frequency and severity, this white matter lesion is important to define, to diagnose, and ultimately to prevent or cure. PMID- 3963771 TI - Urinary sediment dolichols in the diagnosis of neuronal ceroid-lipofuscinosis. AB - Long-chain polyisoprenol alcohol (dolichols) levels are significantly increased in the urinary sediment of patients with infantile, late-infantile, and juvenile forms of neuronal ceroid-lipofuscinosis (NCL). The values in obligate heterozygotes for these diseases are similar to those in patients with other neurological diseases and in healthy controls. Antioxidant treatment of patients with juvenile NCL has no effect on dolichol values. The rate of false-negative results is 13.9% in infantile, 7.5% in late-infantile, and 15.0% in juvenile NCL. False-positive results were found in 8.2 to 14.3% of patients with other neurological diseases and in 15.4% of healthy controls. The test is of considerable value in the diagnosis of NCL and in decisions on whether to perform a biopsy. It is not useful in the screening of random samples, however. PMID- 3963772 TI - Deficits in orofacial sensorimotor function in Parkinson's disease. AB - Orofacial sensorimotor function was assessed in patients with Parkinson's disease and in age-matched controls. Tests were designed to assess sensory function, motor abilities, and the integration of sensory information for the performance of specific movements. Patients with Parkinson's disease and normal subjects both made more errors with increasing age; however, overall, patients with Parkinson's disease made significantly more errors in our tests than did normal subjects. Interestingly, patients with Parkinson's disease showed greater deficits in tests of sensory function and sensorimotor integration than in tests of motor function. These results suggest that one aspect of Parkinson's disease consists of complex deficits in the utilization of specific sensory inputs to organize and guide movements. The results are further discussed in relation to a proposed sensory gating or filtering schema of basal ganglia motor functioning. PMID- 3963773 TI - Swallowing and speech production in Parkinson's disease. AB - Videofluoroscopy was used to examine movement patterns during swallowing and speech production in 6 parkinsonian subjects and 6 age-matched controls. Motility patterns for liquid and semisolid swallows were documented. We performed temporospatial analyses of oropharyngeal structures, particularly the velum, which is prominently involved in both motor speech production and swallowing. Differences were found between groups and conditions. All of the parkinsonian subjects exhibited abnormal oropharyngeal movement patterns and timing during the volitional oral as well as the pharyngeal stage of swallowing; only 50% of these subjects admitted to any swallowing difficulty upon questioning. Two of the subjects with Parkinson's disease aspirated liquids. Duration of velar movement during speech production significantly differentiated the groups (p less than 0.01), reflecting reduced range of velar motion. Our findings suggest that rigidity and bradykinesia underlie the volitional speech abnormality as well as the disordered oral and pharyngeal stages of swallowing. Findings indicate that parkinsonian patients may be "silent aspirators" with decreased cough reflexes and lack of awareness of aspiration. The clinical value of videofluoroscopic monitoring of swallowing is that aspiration may be detected and managed early. PMID- 3963774 TI - Cerebellar infarction: comparison of computed tomography and magnetic resonance imaging. AB - We correlated clinical, computed tomographic (CT), and magnetic resonance imaging (MRI) findings in 14 patients with cerebellar infarctions. Before MRI, the diagnosis of cerebellar infarction was made in only 7 patients on the basis of clinical and CT evidence. Cerebellar infarction was bilateral in 3 patients and was associated with brainstem infarction in 6. Infarction occurred in the territory of the posterior inferior cerebellar artery (PICA) in 12 patients. The territory of the superior cerebellar artery (SCA) was involved in 1 patient, and 1 infarction encompassed the watershed between the PICA and the SCA. In patients with infarction of the PICA territory, the medial and intermediate hemispheric segments were most frequently involved. Involvement of the lateral hemispheric segment was infrequent and was independent of brainstem involvement. Because of its fine demonstration of anatomical detail, its lack of bony artifact, and its ability to visualize infarctions readily within the first 24 hours, MRI is an excellent method for demonstrating cerebellar infarction. PMID- 3963775 TI - Blink-induced saccadic oscillations. AB - A patient with a neurodegenerative disease had abnormal saccades only when he blinked. These saccades were hypermetric and were followed immediately, without any intersaccadic interval, by a large, oppositely directed saccade (dynamic overshoot). To explain these findings, we hypothesize that a blink-related neural signal can modulate the activity of pause cells that normally inhibit saccadic burst neurons during fixation. In pathological circumstances, abnormal function of pause cells could lead to large-amplitude saccadic oscillations. In normal subjects, blinks could induce short bursts of low-amplitude flutter. PMID- 3963776 TI - Benign versive or circling epilepsy with bilateral 3-cps spike-and-wave discharges in late childhood. AB - Twenty-eight of 920 patients seen between the ages of 8 and 20 years for a first seizure manifested versive or circling events associated with bilateral rhythmic 3-cps spike-and-wave discharges. In 21 (75%), the seizures appeared between the ages of 10 and 14 years. Paroxysmal adversion or gyration was always toward the same side in a given patient. "Break of contact" during the ictus was found in 70% of the seizures, and secondary generalization occurred in half. Ictal electroencephalographic recordings failed to show a focal hemispheric origin. Additional features were: absence of prior major diseases; normal results of neurological and neuroradiological examinations; excellent response to anticonvulsant treatment with sodium valproate and/or phenobarbital; frequent family history of epileptic seizures (25% of patients); and association with generalized seizures (57.2% of patients). We conclude that versive or circling epilepsy with bilateral rhythmic 3-cps spike-and-wave discharges represents a benign form of primary generalized epilepsy in late childhood. PMID- 3963777 TI - Association between familial tremor and Parkinson's disease. PMID- 3963778 TI - Delayed postirradiation lower motor neuron syndrome. PMID- 3963779 TI - The regulation of body weight. PMID- 3963781 TI - The biology of learning. PMID- 3963780 TI - Infancy. AB - Research on the psychology of infancy in the 1980s was prolific and diverse. At least four different perspectives have been taken. The first views the infant as information processor, adopts the methods and assumptions of experimental psychology, and focuses on such fundamental processes as attention, perception, emotion, learning and memory, search and exploration, and cognition. The second views the infant as an infant, as part of the natural world, and focuses on the important developmental milestones that uniquely characterize the period of infancy, such as walking, talking, forming relationships, and developing a sense of self. The third perspective views the infant as an eventual adult, emphasizes differences among individuals, and focuses on continuities across age and experiences such as biological risk factors, characteristics of rearing environments, and planned intervention that influence the kinds of adults infants will turn out to be. The fourth perspective focuses not on the infant per se, but on the general process of development; the issues examined concern the description and explanation of development, in terms of the existence of shifts and stages, the relationship of early attainments to later ones, the bidirectional influence of genes and environments, the timing of experience, individuals' contributions to their own experiences, and the reversibility of development. Synthesis across perspectives is difficult, but remains possible. The field of infancy research is a microcosm of psychology, but one that retains a view of the organism as holistic being. As such, the study of infancy produces insights of considerable relevance to psychology as a whole. PMID- 3963782 TI - Diagnosis and clinical assessment: the current state of psychiatric diagnosis. PMID- 3963783 TI - Visual sensitivity. PMID- 3963784 TI - The neurochemistry of behavior. PMID- 3963785 TI - [Physical and psychological changes in relation to the period before and after onset of the menarche]. AB - This cross-sectional study on 452 girls between 11 and 16 years of age examines the physical and psychological changes in the period 30 months before and 60 months after onset of menarche. Indicators of maturity showed the strongest alterations around menarche. In the majority of the physical characters (e. g. thickness of skinfold) adult values are achieved only a longer period after menarche, whereas others (e. g. dimensions of the head) terminate growth already largely by onset of menarche. We found out a minimum in development of thickness of skinfold at the time of menarche indicating a "second loss of body fat" in girls. In four different dimensions of personality (health, anxiety, neuroticism, power of concentration) menarche causes an interruption of the psychic development, and that in an adverse sense. PMID- 3963788 TI - [4 anthroposcopic markers in the Northern Greece population: hand folding, arm folding, tongue rolling and tongue folding]. AB - Four anthroposcopic traits, namely hand clasping, arm folding, tongue rolling and tongue curling have been studied in a total of 7763 individuals from Thessaloniki and its surroundings, representing a sample of the population of Northern Greece. The statistical analysis of the data indicates significant sex differences only concerning tongue rolling. The frequencies obtained for the four traits under study are compared with data from the literature. PMID- 3963786 TI - Proportion of low birth weight infants in Visakhapatnam (India) and its relationship with maternal age, parity and infants survival. AB - The percentage of low birth weight infants (LBWI) weighing less than 2270 g in Visakhapatnam (Andhra Pradesh) is relatively higher (12.8%) than in other parts of India. The frequency of LBWI is high at birth order 1 and 2. Thereafter the curve does not show any consistency although the mean per cent of LBWI is lesser than in birth order 1 and 2. The minimum frequency is at birth order 3. The maternal classes less than or equal to 20-29 years show a gradual decrease in the frequency of LBWI with increasing age. For mothers of greater than or equal to 30 39 years of age a general U-shaped relation is found. The overall distribution of neonatal deaths is bimodal, with a peak at less than 1350 g and at 1810 g. PMID- 3963787 TI - Anthropological studies in Assam, India. 3. Observations on three Brahmin groups. AB - Three Brahmin groups from Lower, Middle and Upper Assam (Kamrup, Darrang, Sibsagar) have been investigated for the distribution of anthropometric and dermatoglyphic traits as well as for that of ABO blood groups and PTC taste sensitivity. The intergroup variability is discussed. PMID- 3963789 TI - Seasonality of birth and sex ratio in Tehran, Iran. AB - 234 218 births (1975-1983) from a hospital in Tehran have been analysed for seasonality of birth and sex ratio. The results show more births in winter and less births in fall. The sex ratio is higher in summer and lower in fall. The occurrence of multibirths shows higher twinning and triplet rates in spring and fall, respectively, whereas lower twinning and triplet rates occur in winter and summer, respectively. It could be demonstrated that geographical factors influence the rates of births and multibirths as well as the sex ratio. PMID- 3963790 TI - A study of sutural bones in Gujarati (Indian) crania. AB - 370 adult crania were examined to find the incidence of sutural bones in Gujarati (Indian) crania and to compare it with other populations to establish the distance between them. The mean measure of difference between Indian and other populations was statistically significant. Comparison of cranial capacity in skulls with and without sutural bones showed no significant difference, and this is interpreted as indicating that sutural bones are not formed secondary to stress. PMID- 3963791 TI - Quantitative hematological characteristics in MZ and DZ twins. AB - The level of several biochemical hematological characteristics was determined- using colorimetric methods--in a group of 111 twins, aged 16-22 years. Significant variance differences between MZ and DZ twin pairs were observed in metabolites and serum enzyme levels. The intrapair differences of the variance of ions and protein levels were comparable in MZ and DZ twins. The validity of quantitative determination of heterability of biochemical characteristics is discussed. PMID- 3963792 TI - [Control and correction of the blood sugar in diabetes with concomitant ischemic heart disease using the artificial beta-cell apparatus employing glucose oxidase as the enzyme]. AB - The apparatus "Artificial Beta-Cell" or "Biostator" was used in treatment of 115 patients with diabetes mellitus and concomitant ischemia of the heart. At the same time 30 patients with diabetes mellitus and ischemia of the heart were treated for diabetes mellitus with the routine methods. Hormones such as ACTH, STH, hydrocortisone, immunoreactive insulin and S-peptide, lipid metabolism and glycosylated hemoglobin were investigated in the time course of the treatment. It was shown that adequate correction of glycemia with the "Biostator" promoted renormalization of the levels of ACTH and hydrocortisone. The results were especially favourable in the group of patients with myocardial infarction and chronic ischemia of the heart with the signs of cardiac insufficiency. Moreover, in the patients of the main group there was a tendency for normalization of lipid metabolism and glycosylated hemoglobin. The results of carbohydrate metabolism compensation in patients of the control group were not always satisfactory and the periods of compensation were longer. The clinico-biochemical indices reflected the favourable effect of the use of the "Biostator" and its advantages over the routine methods in treatment of diabetes mellitus. PMID- 3963793 TI - [Purification and properties of staphylococcal hyaluronidase]. AB - Microbial hyaluronidase (EC 4.2.2.1) was isolated from the culture fluid of Staphylococcus aureus 0-15 with purification by precipitation with 1 volume of ethyl alcohol, chromatography on DEAE cellulose and ultrafiltration through DA type membranes with the pore size of 0.65 micron ("Millipore") and PM-10 membranes ("Amicon"). The specific activity of the enzyme averaged to 2700 turbidimetric units or 32130 IU. 6585-fold purification of the enzyme was performed. The optimum action on hyaluronic acid was observed at pH 5.0-6.5. Hyaluronidase was inhibited by Fe3+, Fe2+ and Cu2+, activated by Ca2+ and stabilized by 0.15 M NaCl. It was detected that the enzyme had two molecular forms with the isoelectric points of 5.4 and 6.5 and the molecular weights of 55 000 and 24 0000 D respectively. The glycoprotein nature of the enzyme was shown. The immobilized form of hyaluronidase on activated polyglucin, a soluble biocompatible polymer was prepared. The form is characterized by higher thermostability. PMID- 3963794 TI - [Bioluminescent analysis in medicine and biotechnology]. AB - The possible applications of the immobilized bioluminescent systems of bacteria and fireflies in microassay are shown. The immobilization resulted in 10-100-fold stabilization of luciferases permitting their multiple use in flow column reactors. Reagents containing luciferases coimmobilized with other enzymes were used for determination of the picomolar concentrations of ATP, AMP, ADP, NADH2 and NAD+. ATP-metry was used for monitoring the growth of the microorganisms, determination of the biocide effect and estimation of the activity of ATP dependent enzymes such as creatine kinase in medical diagnosis. PMID- 3963796 TI - Effects of scheduled food and water deprivation on food intake, water intake and body weight of cage-adapted and cage-naive rats. AB - The first experiment examined the effects of four food-deprivation schedules and four water-deprivation schedules on body weight, food intake and water intake of adult rats over ten days of deprivation and two days of recovery. During food deprivation, water intake was gradually reduced. During water deprivation, daily food intake was initially depressed but eventually returned to ad libitum levels. Consumption of restricted commodities increased over the deprivation phase. Experiment 2 showed that mutual deprivation of food and water are more apparent in rats not previously adapted to the test environment and the final experiment indicated that this was due to the inexperience of cage-naive rats in feeding under novel conditions. The results are evaluated in relation to the environmental factors that may play as great a role as physiological processes in regulating the feeding/drinking behaviour of laboratory rats. PMID- 3963795 TI - Specific postoperative syndromes after total and selective vagotomies in the rat. AB - Male Sprague-Dawley rats which survived bilateral subdiaphragmatic vagotomy (with hepatic branch intact) exhibited an acute syndrome of hypophagia, hypodipsia and severe loss of body weight when maintained on solid food and water for 14 days after vagotomy. This postvagotomy syndrome was attenuated when rats were maintained on a liquid diet (116EC) chosen to minimize postvagotomy dysphagia and abnormal gastric retention of food; vagotomized rats were hypophagic and lost body weight, but the degree of weight loss was not so severe as for vagotomized rats eating solid food. When rats with total subdiaphragramatic vagotomy were maintained on palatable sweet milk food, the acute postvagotomy syndrome was abolished; these vagotomized rats ate and drank as much as rats with sham vagotomy and they did not lose weight. When rats that underwent selective hepatic, gastric or coeliac vagotomy were maintained on the sweet milk diet, three different postoperative syndromes occurred: after selective hepatic vagotomy, rats were hyperphagic, hyperdipsic and gained body weight at a greater than normal rate; after selective gastric vagotomy, rats lost weight despite relatively normal food and water intakes; and after selective coeliac vagotomy, there was no change in food or water intakes or body weight. These results demonstrate that a sweet milk diet abolishes the anorexia, hypodipsia and weight loss that usually occur in vagotomized rats maintained on pellets and water. Use of this sweet milk diet revealed different acute syndromes after bilateral and selective vagotomies. The differences among the syndromes suggest that hepatic, gastric and coeliac vagal branches serve different functions in the control of food and water intake and body weight. PMID- 3963797 TI - Can rats learn to associate a flavour with the delayed delivery of food? AB - Associations between a specific flavour and access to food were studied using a discrimination procedure devised by Holman (1975). This involved giving rats one flavour (e.g. cinnamon) of saccharin solution on some days, and following this by delivery of food, and a second flavour (e.g. wintergreen) on other days which was never followed by food. Experiment 1 used glucose delivered after a 30-min delay and a slight increase in preference for the paired flavour was detected. Using a 20-min delay Experiment 2 varied the kind of food used; some evidence for discrimination learning was again found in the glucose group, but there was no evidence that rats could associate a flavour with starch solution or solid chow over this delay. To check that the general procedure was a sensitive one, in Experiment 3 one flavour was added to glucose i.e. without delay, and this produced large shifts in a subsequent preference test. Overall the results threw doubt on claims that rats as readily form flavour-calorie associations over delays as they do flavour-toxicosis associations. PMID- 3963798 TI - Food deprivation fails to potentiate intravenous self-administration of fenfluramine in naive rats. AB - Recent findings show that in animals, i.v. self-administration of D-amphetamine, cocaine and phentermine, which act predominantly upon catecholamine (CA) containing neurons, is potentiated following chronic restricted feeding. The objective in this experiment was to determine whether food deprivation would potentiate self-administration of fenfluramine, an anorectic compound which acts predominantly upon serotonin (5HT) containing neurons. When saline and five doses of fenfluramine were made available for i.v. self-administration to naive free feeding (FF) rats or food-restricted (FR) rats at 80% free-feeding weight, the rate of fenfluramine-reinforced responding did not differ significantly from saline-reinforced responding at any dose or deprivation state. These data suggest that the potentiation of responding which occurs under conditions of chronic restricted feeding is specific to compounds which act predominantly upon CA containing neurons. PMID- 3963799 TI - Suppression of drinking but not feeding by central eledoisin and physalaemin in the rat. AB - The tachykinins, eledoisin and physalaemin, given by intracerebroventricular (i.c.v.) injection have been shown to be potent antidipsogenic agents in rats. To evaluate their selectivity of action on rat ingestive behaviors, we compared their effects following i.c.v. injection on the intake of water, of milk containing 3.5 or 15% fat, and of solid food. The two tachykinins inhibited water intake induced by i.c.v. angiotensin II or by cellular dehydration, but did not reduce the intake of 15% fat milk or of solid food. The intake of 3.5% fat milk was inhibited only by the highest dose (1000 ng/rat) of eledoisin which also increased grooming and locomotion. The present findings suggest that in adult rats central eledoisin and physalaemin exert a selective suppressive effect on drinking behavior without affecting feeding. PMID- 3963800 TI - Environmental effects on the intake of overweight and normal-weight men. AB - The effects of changes in portion size and social condition on food intake were compared for overweight and normal-weight men. Subjects believed they were participating in a luncheon test of the acceptability of lasagna. In Study 1, under conditions designed to mimic social dining in a cafeteria, subjects were given either 255 or 426 g of lasagna. All subjects at a particular session received the same size portion and could ask for as many helpings as they wished. While overweight subjects ate more than normal-weight subjects, changes in portion size had no significant effects on intake. In Study 2, the effects of social vs. isolated dining were compared. Overweight subjects ate more than normal-weight subjects, and both overweight and normal-weight subjects eating socially ate more than subjects eating alone. In both studies there was a significant relationship between preference rating and intake for overweight subjects but not for normal-weight subjects. The results support the existence of differences in intake between overweight and normal-weight individuals and also indicate the potential importance of environmental factors in the intake of both groups. PMID- 3963801 TI - Effects of changes in palatability on food intake and the cumulative food intake curve in man. AB - This study was undertaken to quantify the relationship between palatability ratings and food consumption and to determine whether the initial rate of eating was affected by changes in food palatability without a change in nutrient content. Both men and women were given small samples of foods at a brief exposure taste test and asked to rate how much they liked or disliked them on a 9-point scale (like extremely to dislike extremely). Those who gave at least a 2-point difference in rating between a banana colada frozen yogurt drink with and without adulteration with cumin were given these foods to eat to satiety on non consecutive days, and the same 9-point scale was used to rate these foods after they had been eaten as meals. Cumin was used as an adulterant because it is not intrinsically unpalatable, but is not liked by many individuals in yogurt-based foods. Intake was approximately 100 g different for every unit of difference on the scale, and higher for liked than disliked food. Intake was significantly different between the adulterated and unadulterated meals. The percentage of variance explained by the difference in palatability was 34% of the total variance but was 67% of the variance within subjects. Correlation between intake and ratings were poor across subjects for both palatability levels (i.e. adulterated and unadulterated). The initial rate of eating was significantly higher under the better liked than under the less liked food. These results indicate that quantification of effects of hedonic ratings on intake within subjects is possible, but that hedonic ratings may not be good discriminators of intake differences between subjects. The initial rate of eating reflects partly on palatability. PMID- 3963802 TI - The effect of exercise on non-restricted caloric intake in male joggers. AB - This study examined the effects of both increasing and decreasing normal energy expenditure over periods of one week on the self-reported caloric intake of seven male joggers (22-27 years). The three levels of energy expenditure were: no exercise, regular exercise and double exercise. Despite significant difference in energy expenditure across conditions, self-reported caloric intake did not differ significantly, suggesting that energy intake was not affected by short-term changes in energy expenditure. PMID- 3963803 TI - Acquisition, maintenance, and generalization of productive intraverbal behavior through transfer of stimulus control procedures. AB - The acquisition of productive intraverbal behavior involving the emission of thematically related responses was evaluated. Three mentally retarded children participated in this study and a multiple-probe design was used in training productive intraverbal behavior (three stimulus classes). Training was conducted using an errorless discrimination procedure (prompt delay) and a variation of this to transfer vocal responses from control of visual stimuli (tact behavior) to verbal stimuli (intraverbal behavior). Reinforcement probability was equal for correct responses prior to and following a prompt and incorrect responses were ignored. Acquisition criteria were reached when subjects emitted 80-100% correct responses and more than four different responses per session during three consecutive sessions. These criteria were achieved in all three subjects. Prompt delay procedure produced no incorrect responses, decreased acquisition criteria slightly over time, produced responses generalization during training, and increased comprehensive intraverbal behavior after training productive intraverbals. Variations in prompt delay procedure produced the same results except a low rate of errors and chaining of different responses per trial appeared when an additional prompt was implemented. PMID- 3963805 TI - Neonatal network: a model for interagency service coordination for very-low-birth weight infants and their families. AB - The Neonatal Network, a model program for interagency service coordination for primarily indigent, minority very-low-birth-weight infants and their families is described. The Neonatal Network has been an effective service delivery coordination system and training mechanism that should be applicable and easily replicable in other communities with the same or different target populations. PMID- 3963804 TI - Self-injurious behavior: a state-wide prevalence survey of the extent and circumstances. AB - A state-wide prevalence survey was conducted to determine the extent and circumstances of self-injurious behavior (SIB) among institutionalized mentally retarded individuals with 13.6% of the population (1,352 individuals) identified as being self-injurious from the approximately 10,000 clients in Texas' 13 residential facilities serving the mentally retarded. It was found that: (a) 89.8% of the clients were severely and profoundly mentally retarded; (b) differential therapeutic treatment modalities may have occurred according to the sex of the client; (c) 58.4% of the clients engaged in more than one SIB response topography; (d) 57% of the clients emitted SIB at least once per day; (e) 55% of all clients were aggressive toward others, with a higher incidence of aggression, property destruction, and sleep disturbances among clients who received psychoactive medication; and (f) 33.1% of the clients were on formalized positive treatment programs and 6.8% of the clients were on formalized aversive programs. Discussion highlights the extent and circumstances to which SIB exists and the need to implement effective and appropriate programming. PMID- 3963806 TI - Simulation procedures for teaching independent menstrual care to mentally retarded persons. AB - Four mentally retarded adolescent females participated in a program for assessment and training of independent menstrual care skills. Three task analyses served as the basis for instruction: (a) menstrual stain on underwear, (b) menstrual stain on a sanitary pad, and (c) menstrual stain on both sanitary pad and underwear. During individual training sessions, subjects were taught to perform correct sequences via simulation training with a small doll, in which a trainer utilized instructions, praise, modeling, and corrective feedback. Three types of assessment probes were conducted prior to training, upon completion of specified mastery criteria, and during post-training follow-up sessions. Doll probes assessed performance with the toy doll, self-probes assessed naturalistic performance but under conditions of simulated menstruation, and in vivo probes assessed performance during actual menstruation. Results of a multiple baseline analysis indicated that subjects emitted few correct responses during baseline probes, but showed consistent improvements that corresponded to the introduction of training. Generalization to untrained skills was noted with all subjects. Follow-up assessments indicated maintenance of skills for periods up to 30 weeks following termination of training. PMID- 3963807 TI - Naturalistic observations of classrooms serving severely handicapped persons: establishing evaluative norms. AB - A naturalistic, observational analysis was conducted of 43 self-contained classrooms serving severely handicapped students. The primary focus of the observations was on levels of on-task student performance and student involvement in functional educational tasks. Results indicated that during designated instructional periods, slightly less than half of all student time was spent on task. When students were on-task, almost two-thirds of their time involved nonfunctional instructional tasks. Results are discussed in terms of establishing norms for evaluating and improving educational services for the severely handicapped. Additionally, future research directions are noted, with a particular emphasis on investigating means of assisting educators in providing more useful teaching tasks for severely handicapped students. PMID- 3963808 TI - The immediate and long-term effectiveness of overcorrection in treating self injurious behavior in a mentally retarded adult. AB - A brief positive practice overcorrection procedure was used as a method of eliminating head-banging in a profoundly mentally retarded adult. Treatment produced an immediate reduction in head-banging episodes, with near zero occurrence of behavior during the third phase of treatment. One year later data collection was resumed on the subject for an 11-week period. Data from the long term follow-up revealed that head-banging continued to occur, but mean weekly levels of episodes (M = 5.8) were still well below those recorded during the baseline period (M = 18.8). The overcorrection procedure produced immediate short term effects and, in this case, was also effective in the long-term. Variables related to the maintenance of response suppression are discussed with respect to this intervention's success. PMID- 3963809 TI - Teaching a functional leisure skill cluster to rehabilitation clients: the art of macrame. AB - Disabled people often do not use leisure time productively. Past research has focused on teaching specific recreational activities isolated from related skills that would provide subjects a functional independent living repertoire. In the present study disabled subjects were taught the art of macrame. Additionally, they role-played related shopping skills such as buying materials, engaging in appropriate social-interpersonal skills, making monetary transactions, and securing their own transportation to and from the store. Subjects were taught six basic macrame knots using an instructional manual, series of error-correction procedures, and social reinforcement. After mastering those basic knots they independently used the instructional materials to make three complete macrame projects without direct instruction on the projects themselves. Subjects also demonstrated skill maintenance and generalization by making a novel project after independently engaging in all relevant shopping behavior. Two varieties of the multiple baseline design were employed. The importance of teaching a leisure skill cluster and adapting instructional materials were emphasized. PMID- 3963811 TI - Serotyping of Vibrio anguillarum. AB - A serotyping scheme based on the detection of O antigens by slide agglutination in fish-pathogenic strains of Vibrio anguillarum is presented. Over a period of 5 years 270 Vibrio strains from feral and cultured fish, 189 strains from the environment, and 36 strains from invertebrates were collected. The strains were divided into 10 distinct serotypes (O1 through O10). More than 90% of the fish pathogenic strains, but only 40% of the environmental strains, were typable; 71% of the strains isolated from cultured rainbow trout were serotype O1, whereas 78% of the strains isolated from feral fish were serotype O2. No dominating environmental serotype was found. A serotyping system for V. anguillarum is proposed. A total of 90 strains received from culture collections and laboratories in different countries were typed according to the present system. PMID- 3963810 TI - Investigation of cadmium resistance in an Alcaligenes sp. AB - The mechanisms of metal resistance of a cadmium-resistant Alcaligenes sp. were studied. Growth in a defined medium was unaffected by cadmium at concentrations up to 0.1 mM, while at concentrations up to 2.5 mM, growth occurred after an extended lag phase. The increase in length of the lag phase was abolished by repeated subculturing at these higher concentrations. However, subculture in the absence of cadmium reversed the adaptation process. Plasmid DNA was not detected in adapted cells, suggesting that adaptation is not plasmid mediated. Increased sulfide production in response to cadmium was observed, although the levels were too low to account fully for cadmium resistance. Adaptation of cells to cadmium resulted in the appearance of a major new membrane protein (molecular weight, 34,500) whose presence was not dependent upon the method of membrane preparation. This protein was induced at cadmium concentrations of 0.1 mM and above, but below this level the protein was absent. The onset of growth at concentrations above 0.1 mM was coincident with the appearance of this protein, which was also induced by zinc (0.4 mM) but not by manganese or nickel. The protein was only solubilized by a sodium dodecyl sulfate-2-mercaptoethanol mixture. Similar solubility properties were shown by a second major membrane protein (molecular weight, 33,000). These two proteins proved to be similar by peptide-mapping experiments and amino acid analysis. The appearance of the 34,500-molecular-weight protein and its possible role in cadmium resistance are discussed. PMID- 3963812 TI - Microbiological evaluation of the intraruminal in sacculus digestion technique. AB - The influence of nature of the feed sample, feeding frequency and pore size on the influx of bacteria and protozoa into synthetic fiber bags suspended in the rumens of sheep fed different diets was studied. Counts of total culturable bacteria in bags with a pore size of 10 microns were less than 30% of the ruminal counts for animals that were fed the lucerne hay and high-roughage diets. The maximum count (62 and 82% of the ruminal count) for these specific diets was obtained by using bags with a pore size of 53 microns. Protozoal counts in bags with pore sizes of 30 and 53 microns were equal to or higher than the ruminal counts for the lucerne hay and high-roughage diets but less than half of the ruminal count for the low-roughage diet. An interaction between incubation time, feeding frequency of the host animals, and the microbial populations developing inside the bags was also demonstrated. The results clearly show that the microbial population inside the bag differed from that of the surrounding ruminal ingesta and that caution must be taken in interpreting results on feed evaluation and especially on rates of degradation when using the in sacculus technique. Factors influencing the influx of bacteria and protozoa into bags with different pore sizes and containing a variety of substrates are discussed together with suggestions for the use of this technique. PMID- 3963813 TI - Sulfur regulation of heparinase and sulfatases in Flavobacterium heparinum. AB - Sulfur regulation of heparinase synthesis and sulfatase synthesis was studied in Flavobacterium heparinum. Heparinase synthesis was strongly repressed by sulfate and L-cysteine, while the activity of this enzyme showed little or no inhibition by these compounds. Heparinase was synthesized in the absence of heparin when L methionine was used as the sole sulfur source. The sulfatases produced by F. heparinum, which include the sulfatases involved in heparin catabolism, were also studied. At least some of the sulfatase activity was regulated by sulfur compounds in a manner similar to heparinase regulation. L-Cysteic acid and taurine were not suitable sulfur sources to support the growth of F. heparinum. PMID- 3963814 TI - Heme requirement for growth of fastidious atypical strains of Aeromonas salmonicida. AB - The growth of fastidious atypical strains of the fish pathogen Aeromonas salmonicida on both solid and liquid media was dependent specifically on a source of heme which was apparently required for initiation of growth at low inoculum densities. Thus, hemin enhanced the plating efficiencies of such strains on solid medium and significantly reduced their inoculum-size-dependent lag times in broth. The heme requirement could also be satisfied by hematoporphyrin and, less effectively, by hemoglobin. Since the requirement was a stable property of all 17 strains tested, it may prove to be another taxonomic criterion by which the atypical strains can be differentiated from the typical strains of A. salmonicida. PMID- 3963815 TI - Activation of spinach chloroplast NADP-linked glyceraldehyde-3-phosphate dehydrogenase by concerted hysteresis. AB - Kinetic analysis of glyceraldehyde-3-phosphate dehydrogenase showed that the enhancement of the NADP-linked activity by specific chloroplast modulators is a concerted process; either a selected second metabolite or the couple dithiothreitol/thioredoxin-f lowers the concentration of primary modulators (ATP, NADPH, inorganic phosphate, 1,3-diphosphoglycerate) required for maximal stimulation (A0.5). Organic solvents also stimulate NADP-glyceraldehyde-3 phosphate dehydrogenase in the absence of any modulator; the concentration for the highest specific activity correlates inversely with the respective octanol water partition coefficient. On the other hand, alcohols also enhance enzyme activity by lowering the A0.5 for primary modulators. Another compound--spermine- inhibits both the ATP- and the inorganic phosphate-mediated activation, but it does not influence the NADPH-induced process. PMID- 3963816 TI - Interaction of oxamate with the gluconeogenic pathway in rat liver. AB - Oxamate, a structural analog of pyruvate, known as a potent inhibitor of lactic dehydrogenase, lactic dehydrogenase, produces an inhibition of gluconeogenic flux in isolated perfused rat liver or hepatocyte suspensions from low concentrations of pyruvate (less than 0.5 mM) or substrates yielding pyruvate. The following observations indicate that oxamate inhibits flux through pyruvate carboxylase: accumulation of substrates and decreased concentration of all metabolic intermediates beyond pyruvate; decreased levels of aspartate, glutamate, and alanine; and enhanced ketone body production, which is a sensitive indicator of decreased mitochondrial free oxaloacetate levels. The decreased pyruvate carboxylase flux does not seem to be the result of a direct inhibitory action of oxamate on this enzyme but is secondary to a decreased rate of pyruvate entry into the mitochondria. This assumption is based on the following observations: Above 0.4 mM pyruvate, no significant inhibitory effect of oxamate on gluconeogenesis was observed. The competitive nature of oxamate inhibition is in conflict with its effect on isolated pyruvate carboxylase which is noncompetitive for pyruvate. Fatty acid oxidation was effective in stimulating gluconeogenesis in the presence of oxamate only at concentrations of pyruvate above 0.4 mM. Since only at low pyruvate concentrations its entry into the mitochondria occurs via the monocarboxylate translocator, from these observations it follows that pyruvate transport across the mitochondrial membrane, and not its carboxylation, is the first nonequilibrium step in the gluconeogenic pathway. In the presence of oxamate, fatty acid oxidation inhibited gluconeogenesis from lactate, alanine, and low pyruvate concentrations (less than 0.5 mM), and the rate of transfer of reducing equivalents to the cytosol was significantly decreased. Whether fatty acids stimulate or inhibit gluconeogenesis appears to correlate with the rate of flux through pyruvate carboxylase which ultimately seems to rely on pyruvate availability. Unless adequate rates of oxaloacetate formation are maintained, the shift of the mitochondrial NAD couple to a more reduced state during fatty acid oxidation seems to decrease mitochondrial oxaloacetate resulting in a decreased rate of transfer of carbon and reducing power to the cytosol. PMID- 3963818 TI - Inhibition of the biosynthesis of uroporphyrinogen and heme in rat liver during obstructive jaundice produced by bile duct ligation. AB - Altered hepatic microsomal drug metabolism has been reported to occur in afflicted with hyperbilirubinemia. Similarities of the chemical structures of hydroxymethylbilane, an intermediate in the biosynthesis of uroporphyrinogen, to bilirubin prompted investigations of the effect of bilirubin on the activity of uroporphyrinogen I synthase (porphobilinogen deaminase, EC 4.3.1.8) and the biosynthesis of heme. Bilirubin was found to be a reversible, noncompetitive inhibitor of uroporphyrinogen I synthase. The inhibition constant (Ki) for bilirubin was 1.5 microM. Bile acids had no effect on rat hepatic uroporphyrinogen I synthase activity. Hyperbilirubinemia was achieved in rats by biliary ligation in order to investigate whether elevated levels of bilirubin impair the biosynthesis of hepatic heme in vivo. The relative rate of heme biosynthesis, as measured by the rate of incorporation of delta-[4 14C]aminolevulinic acid into heme, was decreased 59% 24 h after biliary obstruction. The levels of hepatic microsomal heme and cytochrome P-450 were decreased by 43 and 40%, respectively, 72 h after biliary obstruction. The activities of hepatic delta-aminolevulinic acid synthase and uroporphyrinogen I synthase were increased by 39 and 46%, respectively, 72 h after biliary obstruction. During the 48- to 72-h period following biliary obstruction, the urinary excretion of porphobilinogen and uroporphyrin was increased 3.0- and 3.5 fold, respectively, whereas, the urinary excretion of delta-aminolevulinic acid was not altered. During this 48-to 72-h time interval following biliary obstruction, 100% of the uroporphyrin was excreted as isomer I. These results indicate that bilirubin is capable of depressing the biosynthesis of rat hepatic heme and thus cytochrome P-450-mediated drug metabolism by inhibition of the formation of uroporphyrinogen. These findings are a plausible mechanism for reports of impaired clearance of various drugs in patients afflicted with hyperbilirubinemic disease states. PMID- 3963817 TI - The effect of substrate on the expression of activity catalyzed by cytochrome P 450: metabolism mediated by rabbit isozyme 6 in pulmonary microsomal and reconstituted monooxygenase systems. AB - The content of cytochrome P-450, isozyme 6, in the rabbit pulmonary microsomal fraction was estimated by immunochemical methods to be 1 to 3% of the total cytochrome P-450. Following treatment of rabbits with 2,3,7,8-tetrachlorodibenzo p-dioxin, the pulmonary microsomal concentration of isozyme 6 increased 16-fold. Isozyme 6 was also detected by immunochemical methods, but not by electrophoresis and staining for protein, in preparations of isozyme 5 isolated from the pulmonary microsomal fraction of untreated rabbits. The metabolism of benzo[a]pyrene in these preparations was found to be catalyzed by isozyme 6, not by isozyme 5 as previously concluded. Cytochrome P-450, isozyme 4, was not detected in the pulmonary microsomal fraction from untreated or 2,3,7,8 tetrachlorodibenzo-p-dioxin-treated rabbits. Although benzo[a]pyrene and 7 ethoxyresorufin are both substrates for isozyme 6, the pulmonary microsomal metabolism of these compounds was not increased to the same extent by treatment of rabbits with 2,3,7,8-tetrachlorodibenzo-p-dioxin (about 13-fold for 7 ethoxyresorufin and less than 2-fold for BP). However, lack of agreement between increases in isozyme 6 content and activity, and between the relative increases of the activities with the two substrates, was overcome by the addition of purified NADPH-cytochrome P-450 reductase to the microsomal incubations. When alpha-naphthoflavone, at the minimum concentration required for greater than 90% inhibition of isozyme 6 catalysis, was present in the incubations, no increases in activity were obtained by the addition of purified reductase. The turnover numbers of isozyme 6 in microsomal preparations incubated with purified reductase were similar to those of the purified isozyme in a reconstituted monooxygenase system. The relevance of our results to determinations of the substrate specificities and the microsomal concentrations and activities of isozymes of cytochrome P-450 is discussed. In addition, these parameters are used to assess the extent to which the catalytic potential of isozyme 6 is expressed in the rabbit pulmonary microsomal fraction. PMID- 3963819 TI - Race:cultivar-specific induction of enzymes related to phytoalexin biosynthesis in soybean roots following infection with Phytophthora megasperma f. sp. glycinea. AB - Primary roots of soybean [Glycine max (L.), cv Harosoy 63] seedlings were inoculated with zoospores from either race 1 (incompatible, host resistant) or race 3 (compatible, host susceptible) of Phytophthora megasperma f. sp. glycinea (Pmg) and the activities of phenylalanine ammonia-lyase (PAL), chalcone synthase (CHS), isoflavone synthase, and dihydroxypterocarpan 6a-hydroxylase related to phytoalexin (glyceollin) biosynthesis, and of glucose-6-phosphate dehydrogenase (Glc-6-PDH) and glutamate dehydrogenase (Glu-DH) were determined at various times after inoculation. About 2-4 h after inoculation with race 1, the activities of PAL, CHS, and pterocarpan 6a-hydroxylase were higher than after inoculation with race 3 and increased considerably thereafter. In contrast, activities of these enzymes in the compatible interaction were equal to or only slightly higher than in the controls over the entire infection period investigated (2-8 h). Isoflavone synthase did not increase until 7 h after inoculation with race 1. There were no significant differences in activities for Glc-6-PDH and Glu-DH between inoculated roots and controls. The results show that infection of soybean roots with zoospores of Pmg race 1 causes a race:cultivar-specific early induction of enzymes involved in glyceollin synthesis, whereas such an induction does not occur with zoospores of race 3. These findings are in agreement with the race:cultivar-specific accumulation of glyceollin in soybean roots reported previously [M. G. Hahn, A. Bonhoff, and H. Grisebach (1985) Plant Physiol. 77, 591-601]. PMID- 3963820 TI - Active site mechanics of liver microsomal cytochrome P-450. AB - For a set of 10 para-substituted toluene derivatives, three enzymatic constants were determined describing their interaction with purified rabbit liver microsomal P-450LM2. The three constants were the catalytic rate constant (Kcat) for hydroxylation, the apparent dissociation constant (Kd) for the enzyme substrate complex, and the interaction energy (delta Gint) between the substrate binding and spin-state equilibria. The para-substituents of the toluene substrates were: hydrogen, fluoro, bromo, chloro, iodo, nitro, methyl, cyano, isopropyl, and t-butyl. Linear free energy correlations were sought between the enzymatic constants and several physical constants of the individual substrate molecules. These correlations would be useful both for empirical prediction purposes and for insight into active site chemistry and mechanics. Catalytic rates were correlated by a linear combination of the Hansch pi hydrophobic constant and the Hammett sigma value. A deuterium isotope effect (DV) of 2.6 for d8-toluene compared to d0-toluene confirmed that hydrogen abstraction was partially rate-limiting with this series of substrates. Apparent dissociation constants were predicted by a linear combination of the molar volume and pi, while the spin-state interaction energies were best predicted by a linear combination of the Hansch pi hydrophobic constant and the reciprocal of the dielectric constant. PMID- 3963821 TI - 13C-NMR evidence of bacteriochlorophyll a formation by the C5 pathway in Chromatium. AB - The 13C-NMR spectra of bacteriochlorophyll a formed in the presence of L-[1 13C]glutamate and [2-13C]glycine in Chromatium vinosum strain D were analyzed. The isotope in the glutamate was specifically incorporated into eight carbon atoms in the tetrapyrrole macrocycle derived from the C-5 of 5-aminolevulinic acid (ALA), and the 13C in glycine was incorporated into the methyl carbon of the methoxycarbonyl group attached to the isocyclic ring of bacteriochlorophyll a. These labeling patterns provide evidence for the exclusive operation of the C5 pathway in ALA biosynthesis in the bacterium. The 13C chemical shifts of two quaternary carbons (C-9 and C-16) of bacteriochlorophyll a were reassigned in the present study. PMID- 3963822 TI - Association constants for the interaction of double-stranded and single-stranded DNA with spermine, spermidine, putrescine, diaminopropane, N1- and N8 acetylspermidine, and magnesium: determination from analysis of the broadening of thermal denaturation curves. AB - The effect of Mg2+, putrescine, diaminopropane, N1-acetylspermidine, N8 acetylspermidine, spermidine, and spermine on the thermal denaturation of calf thymus DNA was investigated. As in a previous study with magnesium [W.F. Dove and N. Davidson, (1962) J. Mol. Biol. 5, 467-478], these ligands were found to raise the thermal denaturation temperature of the DNA and to broaden the thermal denaturation curve dramatically at the point where 10 to 20% of the DNA charge had been neutralized. At higher levels of charge neutralization the curves became sharper again. This behavior was due to differential binding of the ligands to single- and double-stranded DNA. The broadening was used to determine the ratio of the association constants of each ligand to the two forms of DNA using either an independent sites model of binding or an excluded sites model. The results show that the primary mode of binding of the ligands to DNA is electrostatic but that important secondary, nonelectrostatic, effects are also present. PMID- 3963823 TI - Partial purification and characterization of two forms of malonyl-coenzyme A:acyl carrier protein transacylase from soybean leaf tissue. AB - Investigation of malonyl-CoA:acyl carrier protein transacylase from soybeans has shown that this fatty acid biosynthetic enzyme occurs in at least two isozymic forms. Both forms exist as soluble, low-molecular-mass polypeptides (approx 43 kDa) which catalyze one of the first committed steps in the synthesis of C16 and C18 fatty acids. We have partially purified the two forms of this enzyme from soybean leaf tissue 1200- and 3900-fold respectively. Isozyme 1 does not adhere to ion-exchange or blue dye affinity chromatographic supports and elutes from a polybuffer exchanger column at a pH of 7.3. Isozyme 2 requires salt to be eluted from ion-exchange and affinity matrices and elutes from a polybuffer exchanger column at a pH of 5.3. The two forms of malonyl-CoA:acyl carrier protein transacylase also differ in their sensitivity to catalytic inhibitors, heat treatment, and inhibition by acyl-CoA ester substrates. Both forms utilize malonyl-CoA as the preferred substrate, and polyacrylamide gel electrophoresis of reaction products indicated that malonyl-acyl carrier protein was the major product formed. Analysis of developing soybean seeds indicates that only one form (isozyme 1) is predominant, whereas leaf tissue possesses both isozymes. PMID- 3963824 TI - The interaction of melittin with calmodulin and its tryptic fragments. AB - Melittin has been found to interact with both the N- and C-terminal half molecules of calmodulin, as well as the intact molecule, in the presence of Ca2+. The interaction results in a major change in the microenvironment of Trp-19, which is in a more nonpolar, solvent-shielded, and immobilized microenvironment in the complex. The properties of Tyr-99 and Tyr-138 of calmodulin are altered by complex formation. From measurements of the efficiencies of radiationless energy transfer from Trp-19 to the nitro derivatives of Tyr-99 and/or Tyr-138, it is concluded that Trp-19 is located in proximity to the C-terminal lobe of calmodulin in the complex. PMID- 3963825 TI - Regulation of collagen synthesis and mRNA levels in articular cartilage of scorbutic guinea pigs. AB - Previous studies suggested that decreased type I collagen synthesis in calvaria of ascorbate-deficient guinea pigs was correlated with weight loss rather than defective proline hydroxylation. The generality of this correlation was examined in articular cartilage, which synthesizes mainly type II collagen, by measuring collagen synthesis and proline hydroxylation in vitro in tissue from ascorbate supplemented and scorbutic guinea pigs. Ascorbate concentrations in tissues were almost completely depleted after 1 week of deficiency, but proline hydroxylation remained normal until after approximately 3 weeks, when it had decreased only by 10%. At that point collagen synthesis had decreased to about 50% of the control value. There was little additional effect on proline hydroxylation but collagen synthesis decreased further to 20% of normal. Procollagen mRNA levels in cartilage, as measured by dot-blot hybridization with a type II-specific cDNA probe, were unchanged after 2 weeks of scurvy, which correlated with the lack of effect on collagen synthesis during that period. Thereafter, during the period when collagen synthesis decreased, procollagen mRNA levels decreased to 20% of control values. Refeeding ascorbate to acutely scorbutic animals led to reversal of defective proline hydroxylation within 24 h with a slower increase in collagen synthesis and mRNA levels. Collagen synthesis returned to the normal level after 4 days with no further increase, while mRNA levels continued to increase to 2.7 times the control values after 7 days. Thus the major mechanism for regulation of collagen synthesis in articular cartilage during scurvy and ascorbate repletion occurs independently of the effect on proline hydroxylation and is associated with changes in mRNA levels. The lack of precise coordination between collagen synthesis and mRNA levels during repletion, however, suggests that there may be additional regulation through post-transcriptional mechanisms. PMID- 3963826 TI - Characterization of rat brain microsomal acyl-coenzyme A ligases: different enzymes for the synthesis of palmitoyl-coenzyme A and lignoceroyl-coenzyme A. AB - Palmitic acid solubilized with Triton WR-1339 was converted to palmitoyl-CoA by microsomal membranes but lignoceric acid solubilized with Triton WR-1339 was not an effective substrate even though the detergent dispersed the same amount of these fatty acids and was also not inhibitory to the enzyme [I. Singh, R. P. Singh, A. Bhushan, and A. K. Singh (1985) Arch. Biochem. Biophys. 236, 418-426]. This observation suggested that palmitoyl-CoA and lignoceroyl-CoA may be synthesized by two different enzymes. We have solubilized the acyl-CoA ligase activities for palmitic and lignoceric acid of rat brain microsomal membranes with Triton X-100 and resolved them into three separate peaks (fractions) by hydroxylapatite chromatography. Fraction A (palmitoyl-CoA ligase) had high specific activity for palmitic acid and Fraction C (lignoceroyl-CoA ligase) for lignoceric acid. Specific activity of palmitoyl-CoA ligase for palmitic acid was six times higher than in Fraction C and specific activity of lignoceroyl-CoA ligase for lignoceric acid was four times higher than in Fraction A. At higher concentrations of Triton X-100 (0.5%), lignoceroyl-CoA ligase loses activity whereas palmitoyl-CoA ligase does not. Lignoceroyl-CoA ligase lost 60% of activity at 0.6% Triton X-100. Palmitoyl-CoA ligase (T1/2 of 4.5 min) is more stable at 40 degrees C than lignoceroyl-CoA ligase (T1/2 of 1.5 min). The pH optimum of palmitoyl-CoA ligase was 7.7 and that of lignoceroyl-CoA ligase was 8.4. Similar to our results with intact membranes, palmitic acid solubilized with Triton WR-1339 was converted to palmitoyl-CoA by palmitoyl-CoA ligase whereas lignoceric acid when solubilized with Triton WR-1339 was not able to act as substrate for lignoceroyl-CoA ligase. Since solubilized enzyme activities for synthesis of palmitoyl-CoA and lignoceroyl-CoA from microsomal membranes can be resolved into different fractions by column chromatography and demonstrate different properties, we suggest that in microsomal membranes palmitoyl-CoA and lignoceroyl-CoA are synthesized by two different enzymes. PMID- 3963827 TI - beta-D-xyloside-mediated alteration in the synthesis of basement membrane proteoglycan. AB - The effect of nitrophenyl-beta-D-xyloside (xyloside), a synthetic initiator of glycosaminoglycan synthesis, on proteoglycan and glycosaminoglycan synthesis by a basement membrane producing tumor was studied. While xyloside markedly stimulated the formation of chondroitin sulfate chains, it depressed the formation of a basement membrane heparan sulfate proteoglycan and caused only little formation of free heparan sulfate chains. However, when the synthesis of the core protein of the proteoglycan was inhibited by cycloheximide, heparan sulfate chains were produced by xyloside treatment. These heparan sulfate chains had a sulfate content higher than that of heparan sulfate found on the proteoglycan. The data indicate that xyloside can substitute for the heparan sulfate initiation site on the core protein of the proteoglycan and that this initiation is enhanced in the absence of core protein. This suggests that under normal conditions the formation of heparan sulfate chains may be tightly linked to the production of the core protein. PMID- 3963828 TI - Hexokinase A from mammalian brain: comparative peptide mapping and immunological studies with monoclonal antibodies. AB - Immunological reactivity of partially purified hexokinase A (ATP:D-hexose 6 phosphotransferase, EC 2.7.1.1) from brain of several vertebrate species has been compared by using enzyme-linked immunosorbent assay and seven monoclonal antibodies raised against the rat brain enzyme. The epitopes recognized by three of these antibodies have been rather widely conserved among the species examined (rat, mouse, guinea pig, rabbit, cat, dog, sheep, cow, pig, chicken), while this was not the case for the epitopes recognized by the other antibodies, which differed markedly in their distribution among these species. The domain structure of these enzymes has been examined by peptide mapping (after limited tryptic digestion) in conjunction with immunoblotting techniques employing monoclonal antibodies. The results indicate that the overall domain structure of these enzymes is similar to that previously described for rat brain hexokinase A, but that there are significant differences in the size of these domains in enzymes from different species. PMID- 3963829 TI - Coordinate regulation of collagen and proteoglycan synthesis in costal cartilage of scorbutic and acutely fasted, vitamin C-supplemented guinea pigs. AB - The effects of ascorbic acid deficiency and acute fasting (with ascorbate supplementation) on the synthesis of collagen and proteoglycan in costal cartilages from young guinea pigs was determined by in vitro labeling of these components with radioactive proline and sulfate, respectively. Both parameters were coordinately decreased by the second week on a vitamin C-free diet, with a continued decline to 20-30% of control values by the fourth week. These effects were quite specific, since incorporation of proline into noncollagenous protein was reduced by only 30% after 4 weeks on the deficient diet. The time course of the decrease in collagen and proteoglycan synthesis paralleled the loss of body weight induced by ascorbate deficiency. Hydroxylation of proline in collagen synthesized by scorbutic costal cartilage was reduced to about 60% of normal relatively early, and remained at that level thereafter. Neither collagen nor proteoglycan synthesis was returned to normal by the addition of ascorbate (0.2 mM) to cartilage in vitro. Administration of a single dose of ascorbate to scorbutic guinea pigs increased liver ascorbate and restored proline hydroxylation to normal levels by 24 h, but failed to increase the synthesis of collagen or proteoglycan. Synthesis of both extracellular matrix components was restored to control levels after four daily doses of ascorbate. A 96-h total fast, with ascorbate supplementation, produced rates of weight loss and decreases in the synthesis of these two components similar to those produced by acute scurvy. There was a linear correlation between changes in collagen and proteoglycan synthesis and changes in body weight during acute fasting, scurvy, and its reversal. These results suggest that it is the fasting state induced by ascorbate deficiency, rather than a direct action of the vitamin in either of these two biosynthetic pathways, which is the primary regulatory factor. PMID- 3963830 TI - Biosynthesis and processing of a variant surface glycoprotein from Trypanosoma brucei brucei. AB - Iowa trypanosome antigen type (IaTat) 1.2 variant surface glycoprotein (VSG) is synthesized in vitro as a Mr 54,000 preprotein that contains a 31-amino-acid signal peptide. Translation of mRNA in the presence of either dog pancreas or trypanosome microsomal membranes results in cotranslational cleavage of the signal peptide and addition of core oligosaccharide side chains to the protein. Analysis of these products on sodium dodecyl sulfate (SDS)-gels indicates that removal of the signal peptide (Mr 3200) is almost exactly compensated for by an increase in molecular weight due to carbohydrate addition. Pulse-chase experiments in cultures of isolated trypanosomes indicate that two IaTat 1.2 VSG species (Mr 58,000 and 60,000) occur in vivo. When glycosylation is inhibited by incubation of trypanosomes with tunicamycin, a single Mr 50,000 polypeptide is immunoprecipitated. The multiple protein species, therefore, arise from heterogeneity in carbohydrate side chains whose synthesis and transfer to the protein are tunicamycin sensitive. Sequence analysis verified that both species of VSG contain identical amino-terminal sequences. Further post-translational processing of IaTat 1.2 VSG includes addition of phosphate and myristic acid residues, both of which have been shown to be located in the immunologically cross-reactive determinant at the carboxyl terminus of the protein. Exposure of this attachment site requires post-translational proteolytic removal of a 17 amino-acid peptide from the carboxyl terminus of an intermediate form of VSG. PMID- 3963831 TI - Metabolic and stereoselective formations of non-K-region benz(a)anthracene 8,9- and 10,11-epoxides. AB - The non-K-region benz[a]anthracene (BA) 8,9- and 10,11-epoxides were isolated by normal-phase high-performance liquid chromatography as rat liver microsomal metabolites of BA. The identities of these epoxides were established by ultraviolet and mass spectral analyses and were further validated by the microsomal epoxide hydrolase catalyzed conversion to BA trans-8,9-dihydrodiol and trans-10,11-dihydrodiol, respectively. Circular dichroism spectral analyses of the metabolically formed non-K-region epoxides and dihydrodiols and mass spectral analyses of metabolically formed 18O-labeled non-K-region dihydrodiols and their acid-catalyzed dehydration products indicated that BA (8R,9S)-epoxide and (10S,11R)-epoxide were the predominant enantiomers formed in the metabolism at the 8,9- and 10,11- aromatic double bonds of BA, respectively, by rat liver microsomes. This is the first example demonstrating the direct detection and stereoselective metabolic formation of non-K-region epoxides of a polycyclic aromatic hydrocarbon. PMID- 3963832 TI - The influence of side chain modifications of the heme moiety on prosthetic acceptance and function of rat hepatic cytochrome P-450 and tryptophan pyrrolase. AB - The relative potential of various structural isomers (III, XIII) and various 2,4 side chain modified analogs of heme (iron-protoporphyrin IX) to incorporate into rat liver hemoproteins, cytochrome P-450(s), and tryptophan pyrrolase was examined. Such assessments for hepatic cytochrome P-450 relied on generation of reconstitutible apocytochrome(s) P-450 by suicidal alkylation of the existing prosthetic heme moiety by allylisopropylacetamide (AIA) in vivo. Subsequent replacement of the prosthetic heme was brought about by incubating the apocytochrome(s) P-450-enriched preparations with a particular heme isomer or analog. Structure-function relationships of the reconstituted isozymes were assessed in microsomal preparations by monitoring cytochrome P-450 content (structure) and its mixed function oxidase activity (function). In parallel, the relative ability of these heme isomers and analogs to functionally constitute hepatic tryptophan pyrrolase was also assessed by monitoring the relative increase in holoenzyme activity when preparations deliberately enriched in constitutible apoenzyme were incubated with each of these compounds. The findings reveal that 2,4-side chain modifications on the heme IX skeleton markedly influence the function of the constituted hemoproteins possibly by affecting their structural assembly through steric, electronic, and/or hydrophobic interactions with the corresponding apoproteins. Furthermore, these studies not only reveal that the structural specifications of the active prosthetic site of rat liver cytochrome P-450(s) differ from those of tryptophan pyrrolase, but also that the structural specifications of these mammalian hemoproteins for their prosthetic heme differ considerably from those reported for their bacterial counterparts. PMID- 3963833 TI - Metabolism of platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3 phosphocholine) in human fetal membranes and decidua vera. AB - We have previously reported that platelet-activating factor (PAF) is present in human amniotic fluid obtained from women in labor. We have also demonstrated that PAF, lyso-PAF, and alkyl acyl-sn-glycero-3-phosphocholine (AA-GPC) are present in human amnion tissue. In the reported study, we have investigated the enzymes involved in PAF metabolism in amnion tissue and their regulation. A phospholipase A2 activity has been demonstrated in amnion tissue which cleaves alkyl acyl (long chain) sn-glycero-3-phosphocholine. The enzyme activity is not altered by Ca2+ and is distinctly different from the phospholipase A2 that we have previously characterized in this tissue. Amnion tissue contains acetyltransferase activity which requires Ca2+ and is associated with the microsomal fraction. Acetylhydrolase is also present in the cytosolic fraction of amnion tissue. Acetylhydrolase activity has also been demonstrated in amniotic fluid. The affinities of acetyltransferase (for lyso-PAF) and acetylhydrolase (for PAF) were unaffected by Ca2+. In the presence of Ca2+, however, the specific activity of acetyltransferase was increased four- to fivefold while that of acetylhydrolase was unaffected. Acetyltransferase and acetylhydrolase activities in fetal membranes and decidua were similar and were unchanged with gestational age. The possible role of PAF in the initiation of human parturition is discussed. PMID- 3963834 TI - [Genetic factors in carcinogenesis]. AB - A genetically high risk group for cancer may consist of persons with the following characteristics. Deficient or reduced capacity for repair of DNA damage, mostly occurring in patients with cancer-prone hereditary diseases, and possibly heterozygotes with the autosomal recessive genes of these diseases. The presence of chromosomal diseases with high incidence of cancer (e. g. Down's syndrome). The presence of autosomal dominantly inherited cancer-prone diseases. Efficient capacities for metabolic activation of potential carcinogens or reduced capacities for decomposition of carcinogens. Although the number of persons with a hereditary high risk may be small, heterozygotes of cancer-prone hereditary disease genes may account for a few percent of the general population. Relative risk, however, may be much lower in these heterozygotes than in patients, judging from the epidemiological data for ataxia telangiectasia and xeroderma pigmentosum. Correlation between cancer-proneness in these genetically high-risk groups for cancer and mutability in the cells originating from these persons has not been clearly demonstrated. Family studies and twin studies may provide further aspects for consideration of genetic factors. PMID- 3963836 TI - [Chromosome translocations and cellular oncogenes in hematologic neoplasms]. AB - Chromosome translocations found in hematologic malignant diseases are correlated with the cytologic and histologic features of the neoplastic cells as well as with clinical features, such as the patient's age, response to therapy and prognosis. Thus, the 8; 21 and 15; 17 translocations, respectively, are associated with acute myeloblastic and acute promyelocytic leukemias. Likewise, the 8q24 translocations including 8; 14, 2; 8, and 8; 22 translocations seen in Burkitt's lymphoma, and the 1; 19 and 11; 14 translocations seen associated with pre-B-cell and T-cell leukemias, respectively, are examples of similar correlations with regard to lymphoproliferative disorders. With the exception of the cases of 9; 22 (Ph1) and 11q23 translocations, each of which is found in both myeloid and lymphoid neoplasms, any one abnormality is rarely encountered in association with both categories of malignancy. Recent studies indicate that, with regard to many of the known chromosome translocations, the break occurs at a point close to the location of a specific cellular oncogene. Thus, c-myc and c abl, which reside in 8q24 and 9q34, respectively, are known to undergo rearrangement in cases of 8q24 and 9; 22 translocations. These rearrangements have been proved to give rise to the production of an abnormal protein, which seems to cause the malignant transformation of cells with such chromosome translocations. Chromosome translocations are now believed to be directly related to oncogenesis through the mechanism of activation of the cellular proto oncogene. PMID- 3963835 TI - [Hereditary tumors and chromosome aberrations with special reference to retinoblastoma]. AB - An absence of gene(s) on the Rb locus of chromosome 13 or a disturbance of its normal expression in the retinoblasts of the embryonic retina predisposes an individual to the development of retinoblastoma. Chromosome aberrations involving 13q14 comprised about 14% of newly arising germinal mutations. Chromosome analysis of retinoblastoma tumor cells revealed that the generation of an extra copy of the long arm of chromosome 1 or the short arm of chromosome 6 is an early event in many of the tumors and plays a significant role in engendering tumorigenicity of retinoblasts already having one mutation at the Rb locus. PMID- 3963837 TI - [Oncogene amplification in human neuroblastomas]. AB - N-myc, which has partial sequence homology to the oncogene c-myc, was isolated from human neuroblastoma cell lines. We have surveyed amplification of N-myc, clone 8 and pG21 in human neuroblastoma cell lines, xenografts and in primary tumors and found that amplification frequently occurred in tumors classified as stage III and IV. In situ hybridization studies demonstrated that in neuroblastomas, chromosome aberrations such as HSR (homogeneously staining region) and DMs (double minutes) are cytological manifestations of the amplification of these clones. The N-myc-related gene seems to contribute to cell growth or differentiation of the nerve cell and its amplification with enhanced expression promotes the progression of the tumor with poor prognosis. PMID- 3963838 TI - [Fragile sites on human chromosomes and cancer-specific chromosomal rearrangements]. AB - Heritable fragile sites are specific points on human chromosomes which appear as nonstaining gaps or breaks under certain physiological conditions and are inherited in a Mendelian codominant fashion. Recent findings of a correlation between fragile sites and breakpoints involved in specific chromosomal rearrangements seen in some neoplasias suggest that fragile sites may be unique sites particularly susceptible to chromosome breakage and rearrangement under in vivo physiological conditions. The majority of known fragile sites, including fragile X, are classified in the folate-sensitive group and are expressed under conditions of thymidylate stress. In thymidine-auxotrophic somatic cell hybrids constructed by cell fusion between fragile X cells and thymidylate synthase negative mouse mutant cells, we have shown that thymidine deprivation alone can induce the expression of fragile X, suggesting that the primary DNA structure itself is responsible for its expression. Elucidation of the DNA structure of fragile sites may provide a clue to the understanding of genetic instability in the human genome and its possible involvement in cancer-specific chromosomal rearrangements. PMID- 3963839 TI - [Tumor killing in cooperation with actinomycin D and neutrophils]. AB - Actinomycin D can induce neutrophils at the site of injection, in a similar way to biological response modifiers. Various tumor cells were killed by the cooperative action of actinomycin D with neutrophils (drug-dependent cellular cytotoxicity; DDCC). A soluble factor derived from neutrophils can be substituted for neutrophils, and this factor was detected at the site of neutrophil infiltration. PMID- 3963840 TI - [Immunomodulation by antitumor antibiotics]. AB - Antibiotics exhibiting immunomodulatory activities were found among antitumor antibiotics. These antibiotics had antileukemic activity. Neothramycin and mazethramycin, which are classified as anthramycin-group antibiotics, activated macrophages so that they became antitumor effector cells. Aclacinomycin and oxanosine inhibited generation of suppressor cells in tumor-bearing mice and oxanosine enhanced antitumor effector cells. Therapy using spergualin produced specific antitumor immunity in cured mice. The immunomodulatory activities of auromomycin and bactobolin were also reported. PMID- 3963841 TI - [Elimination of suppressor macrophages in tumor-bearing mice by 6-mercaptopurine and its therapeutic contribution]. AB - 6-Mercaptopurine inhibited suppressor macrophages and induced antitumor monocytes in L1210-bearing mice. Although these antitumor monocytes did not neutralize L1210, they augmented the antitumor response in L1210 vaccine-primed recipient mice against a subsequent inoculation of live L1210. These results led to the trial of a novel immunochemotherapy regimen in which L1210 vaccine and 6 mercaptopurine in combination produced a synergistic therapeutic effect. In contrast, cyclophosphamide did not inhibit suppressor macrophages, nor did it induce antitumor monocytes in L1210-bearing mice. Consequently, the combination of L1210 vaccine and cyclophosphamide did not produce any further improvement in therapy. These results showed that modulation of macrophages and monocytes was associated with immunotherapeutic effect. PMID- 3963842 TI - [Abnormal sugar chains found in tumor glycoproteins]. AB - Comparative study of the asparagine-linked sugar chains of hCGs purified from urine of pregnant women and of choriocarcinoma patients revealed that extensive and structural changes occur common in the sugar chains of tumor hCGs. The changes can be ascribed to enhancement of an alpha-fucosyltransferase that forms the Fuc alpha 1----6GlcNAc group in the sugar chains and the appearance of N acetylglucosaminyltransferase IV. PMID- 3963843 TI - [On the mechanisms of actions of tumor promoters]. AB - Development of cancers requires a long time and multiple steps, which is understood as tumor promotion and has been studied experimentally using tumor promoters, especially phorbol ester tumor promoters, e.g., TPA. Discovery of Nishizuka that protein kinase C is a receptor to phorbol esters initiates a new era in the study of tumor promotion. This symposium is organized for reviewing recent progresses in mechanisms of actions of tumor promoters. PMID- 3963844 TI - [Role of cell-cell interaction in tumor promotion]. AB - Before a potentially tumorigenic cell meets a carcinogenic stimulus, its proliferation and differentiation are under tight control along with other neighbouring cells and their functions are well coordinated. In other words, cells in a given tissue form an orderly society and a cancer cell is a rebel against such a society. Therefore, it is important to study how the cellular society is maintained and how carcinogenic stimuli produce chaos in that society. The hypothesis that cell-cell interaction plays an important role in carcinogenesis has recently been reinforced by the finding that the prototype tumor promoter, phorbol esters, inhibits junctional intercellular communication. We present here several lines of evidence which suggest that block of intercellular communication is an important determinant in carcinogenesis, especially during tumor promotion process. PMID- 3963845 TI - [Intra-abdominal administration of CDDP in the management of carcinomatous peritonitis]. AB - Seven patients with carcinomatous peritonitis were intraperitoneally treated with CDDP. This procedure does not require specific hydration transfusion and much less diuretic. According to Koyama and Saito's criteria, one patient showed complete response, 5 showed partial response and one no change. Following this therapy, 4 patients have lived for more than 6 months. Renal toxicity, which is considered to be the most serious side effect of CDDP, was not found. Alimentary symptoms (nausea, vomiting) were noted in all patients and myelosuppression and abdominal bleeding were recognized in a small number of patients. In conclusion, our method is considered to be advantageous in the treatment of carcinomatus peritonitis. PMID- 3963846 TI - [Results of follow-up studies on prognosis after immunotherapy with bestatin in acute nonlymphocytic leukemia]. AB - We have recently performed a prognostic investigation of a randomized controlled trial with bestatin for acute non-lymphocytic leukemia in adults. Out of 115 patients registered in this study, 101 patients (48 in a bestatin group and 53 in a control group) were evaluated as eligible. The 50% remission duration was 20.4 months for the bestatin group compared with 11.3 months for the control group. Long-term remission rate at 4 years was 36.5% for the bestatin group compared with 24.1% for the control group, and their respective 50% survival time were 33.0 and 18.1 months, while the long-term survival rate at 4 years was 46.0% for the bestatin group compared with 25.5% for the control group. The bestatin group had a longer remission duration and survival time than the control group. The remission duration and survival time in patients under 49 years of age were not different between the groups. However, in patients over 50 years of age, the bestatin group had a significantly longer remission duration and survival time than the control group. Side effects of bestatin were mild and transient. These data suggest the usefulness of bestatin for the treatment of adult acute nonlymphocytic leukemia. PMID- 3963847 TI - [Pharmacokinetic study of cisplatin and sodium thiosulfate in two-route-infusion chemotherapy]. AB - In seven patients with head and neck cancer, two-route-infusion chemotherapy using cisplatin (CDDP) and sodium thiosulfate (STS) was performed and their pharmacokinetics were studied. As for the time of administration of STS, the treatment courses were classified into 4 groups: STS was given 10 minutes after the administration of CDDP in group I, 30 minutes in group II, 60 minutes in group III and the same schedule as group II in addition to prior loading of STS in group IV. The peak level of plasma CDDP was 1.27-3.33 micrograms/ml and the half-lives of the alpha-phase in groups I, II, III and IV were 58, 97, 126 and 44 minutes, respectively. The peak level of plasma non-protein-bound CDDP was 1.00 +/- 0.45 micrograms/ml and the half-life was 53 minutes. The peak level of plasma STS was 32.2 and 33.3 mg/dl and the half-life was 95 minutes. No serious side effect was observed but slight nausea and anorexia occurred in two courses. This study suggests that the liberation of CDDP from protein-bound CDDP was achieved by administration of STS and that the urinary excretion of CDDP from the plasma was also increased immediately after the administration of STS. The mechanism of relief of CDDP side effects by STS is supposed to involve both a neutralizing action CDDP and reversal of CDDP-induced, cross-linked DNA. PMID- 3963848 TI - [Phase II study of (2''R)-4'-O-tetrahydropyranyldoxorubicin (THP) in patients with advanced gastrointestinal cancer--a report of the Tohoku THP Study Group]. AB - A phase II study of THP was performed in patients with advanced gastrointestinal cancer. The dose schedule was 25 to 40 mg/m2 i.v./cycle repeated every 3 to 4 weeks. One partial (PR) and one minor response (MR) were achieved in 16 evaluable patients with stomach cancer. A case of PR had previously been shown to be resistant to doxorubicin and a case of MR resistant to aclarubicin, respectively. No objective responses were observed in 19 evaluable patients with other tumor sites in the gastrointestinal tract. Forty-eight patients were evaluable for toxic effects. Leukopenia (less than 4 X 10(3)/mm3) occurred in 54% of the patients and was dose-limiting. Thrombocytopenia (less than 10 X 10(4)/mm3) was less frequently observed (13%) than leukopenia. However, no cumulative marrow suppression was observed in repeated courses of the therapy. Non-hematologic toxic effects consisted of gastrointestinal disturbances (23%), hair loss (10%), general malaise (8%), fever (6%), ECG changes (4%) and hepatic dysfunction (2%). Further trials with a high dose schedule (40 mg/m2, q 3-4 weeks) in good-risk patients are necessary to validate the antitumor activity of THP against advanced gastrointestinal cancer. PMID- 3963849 TI - [Histopathological changes in endometrial cancer treated with tamoxifen]. AB - Eight cases of endometrial adenocarcinoma, including 7 well differentiated cases (stage Ia three, stage Ib three, stage II one) and I poorly differentiated case (stage IVb), were treated with Tamoxifen (20 mg/day) for 7-14 days. The average age of these patients was 59.1 +/- 10.9 years old and they were all postmenopausal for between 6 months and 30 years. The endometrial tissue was biopsied before Tamoxifen administration and half of it was investigated for progestin receptor (PR) and estrogen receptor (ER) while the remainder was used for histopathological examination. After surgical treatment, some tissue fragments of the endometrium were taken for investigation of PR and ER. The effect of Tamoxifen was then studied for the amount of PR, ER and histopathology. The result was that the amount of PR was increased in well differentiated cases whereas it was unchanged in poorly differentiated ones, and the amount of ER was decreased in all cases. Meanwhile, obvious histopathological changes were noted as follows decrease of glandular epithelial stratification, increased secretory activity, increased epithelial cell size with columnar cell type, increase of transparent, vacuolated cytoplasm, increase of nuclear size with variable shape and prominent nucleoli with marginal aggregation of chromatin. However, no stromal change was noted. Furthermore, the greater the increase in the amount of PR, the more conspicuous histopathological change was noted. It was concluded that Tamoxifen could produce both functional (PR, ER) and morphological (histopathology) changes in endometrial cancers. PMID- 3963851 TI - [Changes in peripheral lymphocyte subsets before and after OK-432 administration in liver cancer]. PMID- 3963850 TI - [Phase II study of (2''R)-4'-O-tetrahydropyranyladriamycin (THP) in patients with solid tumors. Multi-Institutional Cooperative Study]. AB - A Phase II Study of (2''R)-4'-O-tetrahydropyranyladriamycin (THP) in patients with various solid tumors was carried out by 44 cooperative study institutions. Seven hundred fifty-six patients administered the drug intravenously were entered into this study. Of these, 499 patients were evaluated for objective responses. THP was given mainly at a dose of 40 to 60 mg/body every 3 to 4 weeks or 20 to 30 mg/body once a week. Response rates were 18.8% for head and neck cancer, 13.1% for stomach cancer, 21.4% for breast cancer, 22.2% for bladder cancer, 30% for renal pelvic and urinary tract tumor, 26.8% for ovarian cancer and 24.2% for uterine cancer. Overall response rate was 15.4% including 10 complete responses and 67 partial responses. Adverse reactions were similar to those previously reported in the phase I study, including gastrointestinal toxicities and myelosuppression. Alopecia and stomatitis, which are major side effects of other anthracyclines, were rather mild. Incidence of ECG changes was 2.8% and no congestive heart failure was observed. PMID- 3963852 TI - [Effect of induced hypertension on regional cerebral blood flow in rats with brain tumor]. PMID- 3963853 TI - [Criteria for the determination of efficacy of cancer chemotherapy--internal and radiotherapy of stomach cancer]. PMID- 3963855 TI - [Present status of brachytherapy]. AB - High dose rate, remote-afterloading intracavitary irradiation (RALS) and low dose rate, interstitial irradiation were discussed. In Japan, RALS is now a standard treatment for uterine cervix carcinoma. In interstitial radiotherapy, radium sources, because of their poor conditions of protection and excessively long half life, are being replaced by several new radioactive elements, such as 60Co, 125I, 125Cs and 192Ir. These have suitable characteristics for afterloading and safety protection. Among them 192Ir has become common source, not only for intraoral cancer, but also various other tumors including rectal, breast, and bile duct cancers. PMID- 3963854 TI - [The United States and Japan Cooperative Cancer Research Program]. AB - The U.S.-Japan Cooperative Cancer Research Program was initiated in 1974 between the National Cancer Institute (NCI) and the Japan Society for the Promotion of Science (JSPS), with a view to eventually conquering cancer. The two countries respectively developed cancer research under different academic systems, and, furthermore, the cancers in the two countries show different characteristics from the viewpoint of geographic pathology. The special significance of cooperative study between the two countries with such different backgrounds was therefore mutually recognized. The cooperative program has involved scientific seminars, mutual dispatch of scientists, and exchange of research materials and information, covering specified areas of cancer research. In the program, four major areas for cooperation were established, resulting in an effective and flexible methodology for carrying out cooperative research. These areas were etiology of cancer, biology and diagnosis of cancer, treatment of cancer, and interdisciplinary areas of cancer research. Notable progress was witnessed throughout the ten years of the program. Especially, the program made it possible for a large number of cancer researchers from the two countries to become acquainted with each other through personal contact in cooperative investigations. After termination of the second term in 1983, the program entered into its third five-year period in 1984, and is currently still in progress. PMID- 3963856 TI - [Radiation sensitizers: with special reference to hypoxic cell sensitizers]. AB - Recent advances in radiation chemistry and radiation biology have led to the combined use of radiosensitizing agents with radiation in the treatment of radioresistant tumors. Various chemicals, including cancerocidal drugs, are used, although radiation sensitizers are defined as drugs which can increase cellular radiosensitivity but have no direct cancerocidal effect. At least four classes of agents, pyrimidine analogues, hypoxic cell sensitizers, PLDR inhibitors and thiol depleting agents, can modify radiosensitivity and have potential for differential sensitization. Pyrimidine analogues are incorporated into DNA in replicating tumor cells, and can sensitize these cells to radiation up to a factor of 3. Results of clinical trials of intra-arterial infusion of BUdR have not proved satisfactory, especially with regard to long-term survival, possibly because of the existence of non-replicating cells in the tumor. The latter two are still in the experimental stage of study. The radioresistance of hypoxic cells in tumor has been regarded as one of the limiting factors in the local control of cancer by radiation. Attempts to improve the situation involve high-LET radiation and combined use of chemicals, such as oxygen, prefluorochemicals and electron affinic compounds, with low-LET radiation. Although some clinical trials in head and neck cancer and in cervical cancer have yielded positive results in patients treated using hyperbaric oxygen, attempts have been made to devise other methods, such as those using perfluorochemicals with normobaric oxygen, because of the technical difficulty involved with the former method. A more promising and easier method is the combined use of electron-affinic chemicals, which like oxygen can sensitize the hypoxic cells. Misonidazole (alpha 2-nitroimidazole derivative) was found to be an excellent sensitizer of this kind in cultured mammalian cells and in some rodent tumors. Several randomized clinical trials to determine its efficacy have been carried out on a word-wide scale, but most of them failed to demonstrate any beneficial effect, mainly because of the drug's neurotoxicity which limits its dose. After misonidazole, many researchers have made every effort to develop more efficient hypoxic cell sensitizers. The present state and future prospects of study were reviewed with special reference to studies currently being undertaken in Japan. PMID- 3963857 TI - [Hyperthermia in the treatment of cancer]. AB - We have clinically experienced 192 cases of superficial tumors treated by combination hyperthermia and radiation therapy. Analysis of their treatment results has indicated various advantages of this combination therapy, as summarized in the following items. Mutual differences among pathological findings of treatment effectiveness are small. The smaller tumors are more effectively treated. However, even larger tumors more than 10 cm in size have good responses. There is a clear correlation between tumor temperature and treatment results. Even a small dose between 20 and 40 Gy brings a good response, and this is especially recognized in cases of recurrence after radiation therapy. Further studies are yet to be conducted for improvement of the heating device, thermal dose, and thermal mapping. PMID- 3963858 TI - [The clinical value of long-term administration of OK-432 in head and neck cancer]. AB - In order to evaluate the clinical effect of longer-term administration of OK-432, 72 cases of head and neck squamous cell carcinoma with stage III and IV were divided into two groups: a shorter-term group (25 cases), given OK-432 for less than 6 months mainly during the period of admission, a longer-term group (47 cases), given OK-432 for more than 6 months not only for the period of admission but also during ambulation. The immunological parameters and the cumulative survival rates were compared between the two groups. In the longer-term group, the absolute number of peripheral lymphocytes was significantly higher and the positive rate of skin reaction with PPD was higher than in the shorter-term group. However there was no difference in the positive rate of skin reaction with Su-PS between the two groups. OKT4/OKT 8 ratio and PHA blastogenic rate were higher, although not to a statistically significant extent, in the longer-term group. The cumulative survival rate was significantly higher up to 12 months (p less than 0.01) and 18 months (p less than 0.05) in the longer-term group than the shorter-term group. These results of the immunological parameters and the cumulative survival rates suggest the clinical efficacy of longer-term administration of OK-432. PMID- 3963859 TI - [Etoposide (VP 16/NK 171) and cytosine arabinoside combination chemotherapy in refractory childhood leukemia]. AB - Combination chemotherapy consisting of etoposide and cytosine arabinoside (Ara-C) was given to 38 children with hematological malignancy. They included 18 patients with acute lymphocytic leukemia (ALL), two with non-Hodgkin's lymphoma (NHL), one with myeloproliferative disorder (MPD), and one with histiocytic medullary reticulosis (HMR), all of whom had relapsed or not responded to initial treatment. Sixteen patients with nonlymphocytic leukemia (ANLL), 13 in remission, two in relapse, and one in induction failure, were also studied. The drug combination was administered by intravenous infusion twice a week for two consecutive weeks at a dosage of 150 mg/m2 for each drug. Among the 18 patients with ALL, seven complete responses and three partial responses were achieved. Six of the seven complete responders relapsed at 0.5-3 months, and the remainder has been in remission for 2.5+ months. None of the patients with refractory ANLL, NHL, MPD or HMR achieved complete remission; however, two of three ANLL patients and one HMR patient demonstrated partial response. Among the 13 ANLL patients in remission, 9 patients have continued remission for more than 4 months with a median of 26+ months, ranging from 6+ months to 40+ months, while 4 relapsed within 4 months after the administration of this regimen. The toxic effects were tolerable. Results indicate that an etoposide and Ara-C combination is effective especially in refractory ALL in childhood. PMID- 3963860 TI - [A multi-center trial of MY-1, a new biological response modifier, on the immunological parameters of postoperative gastric cancer patients]. AB - A multi-center study was performed to clarify the immunological effects of MY-1, a new biological response modifier, on postoperative gastric cancer patients. A total of 90 patients were randomly allocated either to an MY-1 treated or an untreated group. MY-1 was given 3 times a week from the 4th postoperative day for a period of 3 weeks. Immunological parameters of the patients, such as lymphocyte subsets measured with flow cytometry using various monoclonal antibodies, blast transformation responses against PHA, ConA, and PPD, natural killer activity of peripheral lymphocytes, and skin test for MY-1 and PPD, were evaluated preoperatively, before and after MY-1 treatment. The results of the two color staining method with flow cytometry showed that the population of lymphocytes positive for both OKT8 and Leu15 antigens (suppressor cells) was statistically less, and that the population of lymphocytes positive for OKT8 and negative for Leu15 antigens (killer cells) was statistically increased in patients treated with MY-1 compared with the control group. PMID- 3963861 TI - [Phase I study of human lymphoblastoid alpha-interferon on malignant tumor]. AB - A phase I study with human lymphoblastoid alpha-interferon (IFN-alpha) was conducted in 31 patients with malignant tumors. IFN-alpha was administered by intravenous drip infusion, intramuscular injection or local injection. In each patient, the dose was increased in 6 steps from 3 X 10(6) IU/body up to 54 X 10(6) IU/body for the purpose of investigating the safety, optimal regimen, pharmacokinetics and antitumor effect. The following findings were obtained: 1) Fever as a side effect was most frequently (in about 80%) found. However, the temperature did not exceed 40 degrees C in most cases and, on the next day, spontaneously fell to normal. 2) The dose-limiting factors (DLF) may include the subjective symptoms of anorexia, general fatigue and nausea/vomiting and the objective symptom of pancytopenia. 3) The maximum tolerated dose (MTD) was estimated to be between 36 X 10(6) and 54 X 10(6) IU/body per dose. 4) As for the route of administration, the intramuscular one was considered most suitable on the basis of the plasma concentration profile of INF-alpha. It was therefore concluded that the drug may be further submitted to a phase II study which is to be conducted with due consideration of its safety. PMID- 3963862 TI - [ABEP chemotherapy in the treatment of advanced non-Hodgkin's lymphomas]. AB - Nineteen patients with refractory non-Hodgkin's lymphoma were treated with a combination of N4-behenoyl-1-beta-D-arabinofuranosylcytosine (150-200 mg/m2), aclacinomycin (15 mg/m2), etoposide (70 mg/m2 i.v. or 100 mg/m2 p.o) and prednisolone (20 mg/m2) (ABEP regimen). Patients who achieved complete remission (CR) received 10 courses of consolidation therapy with ACOP-E chemotherapy (adriamycin, cyclophosphamide, vincristine, prednisolone and etoposide). Seven patients achieved CR and three partial remission. Twelve patients with fresh non Hodgkin's lymphoma stage IV were treated with ABEP regimen. CR was obtained in eight patients (66.7%). The median duration of CR was 11+ alpha months. Hematological toxicity was a dose-limiting factor but this was manageable. PMID- 3963863 TI - [Biochemical modulation of 5-FU by thymidine and N-phosphoacetyl-L-aspartate: the relation between 5-FU incorporation into RNA and its cytocidal effect]. AB - We attempted to study the relation between 5-FU incorporation into RNA or DNA and the cytocidal effect of 5-FU using thymidine (TdR) and the effect of N phosphoacetyl-L-aspartate (PALA) on the cytotoxicity of 5-FU. A mouse mammary carcinoma cell line FM3A was used in all of the experiments. The results showed that: addition of TdR to cell cultures resulted in an increase of 5-FU incorporation into RNA and although 5-FU incorporation into nucleic acid decreased, addition of 10(-3) M TdR induced of complete incorporation of 5-FU into only RNA as revealed by alkaline hydrolysis and cesium gradient analysis; no addition of TdR caused 5-FU to be completely incorporated into DNA only; cytocidal effect of 5-FU, in a clonogenic assay, occurred only during the time when TdR was added to the cell culture; PALA possessed the capacity to enhance the cytocidal effect of 5-FU in a clonogenic assay. These results confirmed that 5-FU incorporation into RNA is necessary for the cytocidal effect of 5-FU and that both TdR and PALA are available as 5-FU-modulating agents for enhancement of the cytocidal effect. PMID- 3963864 TI - Sugar free medicines--are you using them? PMID- 3963865 TI - Incidence and mechanism of bradycardia during apnoea in preterm infants. AB - Bradycardia occurred during 363 of 1520 apnoeas of 10 seconds' duration recorded in 28 preterm infants. The incidence increased with increasing duration of apnoea (10% of 10-14 seconds, 34% of 15-20 seconds, and 75% of greater than 20 seconds, p less than 0.001). This was similar for each type of apnoea--central, mixed, and obstructive. During 133 apnoeas in five infants the time from the start of the apnoea to the onset in the fall in oxygen saturation (mean 6.9 seconds) was significantly related to the onset of the fall in heart rate (mean 9.3 seconds) (r = 0.67, p less than 0.001). Recovery in heart rate coincided with resumption of air flow rather than breathing efforts and preceded the recovery in oxygen saturation. These results suggest that bradycardia occurs during apnoea as a response to falling oxygen saturation, probably through a peripheral chemoreceptor reflex that is manifest when breathing efforts are absent or ineffective. PMID- 3963866 TI - Pulmonary air leak in extremely low birthweight infants. AB - The incidence of pulmonary air leak in 230 infants with a birth weight of 500-999 g who were ventilated was 41%. Pulmonary interstitial emphysema occurred in 35%, pneumothorax in 20%, pneumomediastinum in 3%, and pneumopericardium in 2%. The survival rates in those with or without pulmonary air leak were not significantly different in the first four years of the study period (46% v 53%). As the survival improved in infants without air leak during the second four years the difference in survival rates in infants with or without air leak became significant (30% v 71%). Effective measures of preventing pulmonary air leak are required before further improvement in the outcome of these extremely low birthweight infants can be achieved. PMID- 3963867 TI - Cotside EEG monitoring using computerised spectral analysis. AB - The application and interpretation of computerised spectral analysis of the neonatal electroencephalogram (EEG) using the Neuroscience Berg Fourier Analyser (BFA) is described. Recordings are immediately available at the cotside. Electrophysiological changes can be recognised by individuals with no previous experience in EEG technology. The compact nature of the analysis allows long periods of recording to be viewed within minutes. In addition to the unequivocal demonstration of both clinical and subclinical seizures, the BFA is useful in the evaluation of interseizure activity--that is, disturbance of sleep patterns, electrical output, and hemisphere asymmetry. PMID- 3963868 TI - Oral desmopressin in central diabetes insipidus. AB - Seven paediatric patients with central diabetes insipidus were studied in an open dose ranging study in hospital followed by a six month study on an outpatient basis to assess the efficacy and safety of peroral administration of DDAVP (desmopressin) tablets. In the dose ranging study a dose dependent antidiuretic response was observed. The response to 12.5-50 mcg was, however, less effective in correcting baseline polyuria than were doses of 100 mcg and above. Patients were discharged from hospital on a preliminary dosage regimen ranging from 100 to 400 mcg three times daily. After an initial adjustment in dosage in three patients at one week follow up, all patients were stabilised on treatment with tablets and reported an adequate water turnover at six months. As with the intranasal route of administration dosage requirements varied from patient to patient, and a dose range rather than standard doses were required. A significant correlation, however, was found for the relation between previous intranasal and present oral daily dosage. No adverse reactions were reported. No clinically significant changes were noted in blood chemistry and urinalysis. All patients expressed a preference for the oral over existing intranasal treatment. Treatment with tablets offers a beneficial alternative to the intranasal route, particularly in patients with chronic rhinitis or impaired vision. PMID- 3963869 TI - The development of performance and cost indicators for preschool immunisation. AB - The organisation, premises, and staffing of three child health clinics of different types in an inner city area have been studied and related to information on immunisation derived from their computerised child register and other returns, together with some simple estimates of cost. Differences were found between overall uptake of different antigens, consent rate, compliance after consent had been given, and the median age at immunisation for children allocated to each clinic. Thus consent to pertussis immunisation varied from 90% in one clinic to 69% in the other two. In the clinic with the high consent rate, however, only 66% of those whose parents had consented actually received all three doses compared with 82% and 85% in the other clinics. The median age of immunisation also showed pronounced differences between the clinics--314, 351, and 375 days, respectively, for the third dose of the triple course. There were differences in characteristics of the clientele served by each clinic and in staffing and facilities, which led to differences in costs, as well as contributing towards the variable patterns of uptake. We suggest that indicators such as these, largely available from the child health computer system, are used systematically to identify ways of improving uptake and increasing cost effectiveness. PMID- 3963870 TI - Development of secretory immunity in breast fed and bottle fed infants. AB - Samples of saliva and nasal secretions were collected sequentially from 15 breast fed and 15 bottle fed infants on five occasions between 6 days and 9 months of age. Total immunoglobulin concentrations of G, M, and A classes, and class specific antibodies to tetanus toxoid and a pool of commensal strains of Escherichia coli were measured by solid phase radioimmunoassay and expressed per milligram of total protein. There were significant differences between feeding groups, which changed with age. Total IgM and IgA concentrations and IgA antibodies to E. coli were higher in the saliva and nasal secretions of breast fed infants at 6 days. There followed a rapid increase in IgM and IgA concentrations in secretions from all infants, and between 6 weeks and 9 months concentrations were higher in the saliva (but not in the nasal secretions) of the bottle fed group. There were no significant differences between the feeding groups for total IgG, specific G, M, and A antibodies to tetanus toxoid, and G and M antibodies to E. coli. These results suggest that breast feeding enhances secretory immunity in the early neonatal period only. By 6 weeks, local antigens are the main source of stimulation for production of immunoglobulin in the respiratory mucosa and thus may be obscuring any additional stimulation by growth factors in breast milk. PMID- 3963871 TI - Histological abnormalities in biopsies from macroscopically normal colonoscopies. AB - One hundred and nineteen children with gastrointestinal symptoms underwent colonoscopy during the course of one year. Out of 39 children that were reported as yielding normal results on endoscopic examination, six had disease detectable only by histology. The pathology included cases of microscopic colitis, Crohn's disease, and indeterminate colitis. To exclude large bowel inflammation as a cause of gastrointestinal symptoms biopsy specimens should always be taken at endoscopy. PMID- 3963872 TI - Adjustment to the death of a sibling. AB - Despite the recent increase in interest in terminally ill children and their families and the post death adjustment of parents, there has been little research examining the adjustment and self concept of surviving siblings in such families. This paper discusses the results of a preliminary descriptive study of 28 children (from 14 families) whose brother or sister had died of cancer between 18 and 30 months previously. Behaviour checklists were completed by parents and teachers and self concept scales administered to the children. A lengthy semistructured interview was carried out, and measures of parental adjustment were gathered. A high percentage of children were found to be exhibiting emotional or behavioural difficulties, or both, and the results indicated that low self esteem was common. Parental and child adjustment were not found to be related inter se, nor did they seem to relate to the child's self esteem. Thus for many children the loss of a sibling might cause long term distress. Further, many children who did not manifest overt difficulties perceived themselves unfavourably in comparison with either their ideal or their dead sibling. PMID- 3963874 TI - Monitoring spontaneous respiration in the ventilated neonate. AB - A technique for monitoring the ventilated neonate's own respiratory efforts using a pneumatic capsule apnoea alarm is described. PMID- 3963873 TI - Acquired immunodeficiency with disseminated cryptococcosis. AB - A 9 year old Portuguese boy presented with severe wasting and a disseminated cryptococcal infection that resolved after massive doses of intrathecal and parenteral antifungal agents. Clinical and laboratory findings were consistent with AIDS. Apart from neonatal blood transfusions, there were no identified risk factors for HTLV III infection. PMID- 3963875 TI - Home care team in accident and emergency. AB - We describe experience with a community paediatric service designed to provide more convenient follow up for children and their families and to reduce the number of children returning unnecessarily to the accident and emergency department. PMID- 3963876 TI - Efficiency of manual resuscitators at birth. AB - The effectiveness of five neonatal/paediatric manual resuscitators was assessed in a group of babies born by caesarean section. Results showed that devices incorporating a large volume reservoir produced the greatest tidal volume, while those with smaller volume reservoirs could not be considered satisfactory for routine use during neonatal resuscitation. PMID- 3963877 TI - Confidentiality and paediatric practice. PMID- 3963878 TI - Turner syndrome. PMID- 3963879 TI - A service for problem families. PMID- 3963880 TI - Plasma fibronectin concentrations in mucocutaneous lymph node syndrome. PMID- 3963881 TI - The relationships of aerosol deposition, lung size, and the rate of mucociliary clearance. AB - Although the effect of deposition pattern of an inhaled aerosol upon subsequent mucociliary clearance is well recognized, the influence of lung size on the rate of clearance has not been clearly defined. To examine the relationships of lung size in terms of the forced vital capacity (FVC) and aerosol deposition pattern to the rate of mucociliary clearance, we measured lung retention of an inhaled 8 micron aerosol for 120 min using a gamma camera in 13 healthy nonsmoking volunteers. The deposition pattern of the inhaled aerosol was defined in terms of the initial skew of the distribution of retained activity within the right lung (skew) and the percent retained at 24 hr (R24). Multiple regression analysis showed that FVC was responsible for approximately 36% of the variability in bronchial retention with time, with a lesser contribution from variations in deposition pattern (skew and R24). Mucociliary clearance was significantly slower (i.e., greater bronchial retention) in male subjects than in female subjects which can probably be attributed to the differences in FVC. Variations in lung sizes as well as deposition pattern should therefore be considered when making between subject comparisons of the mucociliary clearance rate. PMID- 3963882 TI - A pilot epidemiologic study of possible health effects associated with 2,3,7,8 tetrachlorodibenzo-p-dioxin contaminations in Missouri. AB - In 1971, 2,3,7,8-tetrachlorodibenzodioxin (TCDD)-containing waste oils were sprayed for dust control on residential, recreational, and work areas in Missouri. In several of these areas, the magnitude and the extent of this environmental contamination were not known until late 1982 or 1983. In the first phase of the investigation, a group of persons considered to be at highest risk of exposure and an appropriate comparison group were selected from reviews of Health Effects Survey screening questionnaires. These persons received complete medical examinations and a series of laboratory tests focused on detecting presymptomatic effects in key target organ systems (i.e., hepatic, dermatologic, immunologic, and neurologic effects). Comparisons of these two groups did not produce any firm indications of increased disease prevalence directly related to the putative exposures; of significance is the fact that no cases of chloracne or porphyria cutanea tarda were seen. Nevertheless, no overall definitive conclusion should be based just on this initial pilot study. Insights were provided that are being examined in more refined epidemiologic studies using different designs and strategies--especially of larger, more homogeneous population groups in which exposure status can be better characterized--focused primarily on discerning any potential effects on the urinary tract, liver, neurological, and immune systems. Concurrently, research into the development of replicable laboratory analytical methods and reference ranges for measuring TCDD body burden are being pursued. PMID- 3963883 TI - An investigation of mortality from cancer and other causes of death among workers employed at an east Texas chemical plant. AB - The cause-specific mortality of 2,510 males employed at an east Texas chemical plant was examined in a historical prospective study to evaluate a suspected increase in deaths from multiple myeloma and brain cancer. Potential exposures from chemicals, either used in manufacturing processes or produced during the study period 1952-1977, included the fuel additive tetraethyl lead, ethylene dibromide and dichloride, inorganic lead, and vinyl chloride monomer. Overall mortality for all workers (156 observed vs. 211.14 expected) and for workers first employed between 1952 and 1959 (131 observed vs. 167.33 expected) when tetraethyl lead was the single major product was lower than expected when compared to the United States general population. There were no significant increases in mortality from malignancies or other causes of death. The deficits may be due to the small number of total deaths, and the low power for detecting excess risk of mortality from multiple myeloma (Z1-beta = 27, alpha = .05), brain cancer (Z1-beta = 31, alpha = .05), or other rare causes of death; lack of complete workplace exposure data for production workers; and the absence of historical measurements on the extent of environmental exposure to tetraethyl lead and other chemicals. PMID- 3963885 TI - Thyroid cancer incidence in relation to volcanic activity. AB - Environmental or genetic factors are sought to explain the high incidence of thyroid cancer in Iceland. At present, it is impossible to cite any environmental factor, particularly one related to the volcanic activity in the country, which could explain the high incidence of thyroid cancer in Iceland. However, the thyroid gland in Icelanders is very small due to the high intake of iodine from seafood. It is, therefore, easier for physicians to find thyroid tumors. Furthermore, genetic factors are very likely to be of great importance in the small, isolated island of Iceland. PMID- 3963884 TI - Mortality from asthma and chronic bronchitis associated with changes in sulfur oxides air pollution. AB - Death certificates issued in Yokkaichi, Japan, during the 21 yr from 1963 until 1983 were surveyed to determine the relationship between changes in air pollution and mortality due to bronchial asthma and chronic bronchitis. The following results were obtained. In response to worsening air pollution, mortality for bronchial asthma and chronic bronchitis began to increase. Mortality due to bronchial asthma decreased immediately in response to improvement of pollution, whereas mortality due to chronic bronchitis decreased to the level in the control area 4 to 5 yr after the concentration of sulfur dioxide (SO2) began to satisfy the ambient air quality standard. In the polluted area, mortality due to bronchial asthma in subjects who were 20 yr of age was higher during the period in which higher concentrations of sulfur oxides were prevalent. PMID- 3963886 TI - Personal exposure and health effect relationship for NO2 with urinary hydroxyproline to creatinine ratio as indicator. AB - Establishment of an exposure-effect relationship was attempted between personal nitrogen dioxide (NO2) exposure and urinary hydroxyproline to creatinine ratio of approximately 800 adult women, who were mothers of primary schoolchildren living in two communities around Tokyo. Daily average of the personal NO2 exposure (ENO2) was measured during wintertime by a newly developed personal monitor exposed for 24 hours. The hydroxyproline to creatinine ratio (HOP:C) in the urine sample collected early in the morning of the day for ENO2 measurement was used as a biochemical indicator of the health effect of NO2 exposure. The HOP:C was found to have significant correlation with ENO2 and number of cigarettes smoked actively and passively. ENO2, however, had no correlation with the intensity of the smoking levels; they might affect HOP:C independently. Stepwise multiple regression analysis revealed that HOP:C could be predicted by ENO2 and smoking habits at a high confidence level. The regression analysis of the active smokers' group indicated that a few cigarettes was enough to increase the HOP:C, while in the case of passive smoking, HOP:C increased proportionally to the number of cigarettes. PMID- 3963888 TI - Toward the year 2000. The state of the archives? PMID- 3963887 TI - Cigarettes as a source of some trace and heavy metals and pesticides in man. AB - Trace and heavy metal and pesticide contents of different tobacco brands sold in Finland during 1920 to 1984 were determined by atomic absorption spectroscopy and gas chromatography-mass spectrometry with the purpose of investigating the variation in contents over time. In addition, the following were studied: the effect of commercial filters in cigarettes in preventing the inhalation of metals, the transfer of metals and pesticides to the mainstream smoke; and the correlation between the cadmium content of adipose tissue of smokers and their smoking habits. No differences were found in trace and heavy metal contents of different brands and packs from different decades. The pesticide residues in tobacco have followed the pattern of their use in the tobacco plantation. The dichlorodiphenyltrichloroethane (DDT) content of tobacco has decreased during the past 20 yr to about 1/200 of the peak value, i.e., from 34.5 to 0.17 micrograms/g. Cigarette filters significantly prevent the inhalation of cadmium, lead, magnesium, and iron. The mean content of cadmium in fat tissue of male smokers was four times that of non-smokers. The difference was statistically significant. PMID- 3963889 TI - Dose-response relationships for traffic noise and annoyance. AB - The annoyance due to road traffic noise was studied in 18 areas in five countries. A total of 1379 interviews was performed and noise measurements were made in each area. The relation between Leq and the extent of the population expressing that they were "very annoyed" was poor (rxy = 0.03). An augmentation of the number of heavy vehicles from 1000/24 hr up to greater than 3000/24 hr did not increase the extent of annoyance. The highest correlation was obtained for the maximum noise level. The dose-response relationship implies that the number of events above a certain limit will not increase the extent of annoyance: it is determined by the highest noise level from single vehicles. It is suggested that this model for the human reaction to environmental noise, which has now been demonstrated for aircraft, train, and traffic noise, should be considered for the establishment of standards. PMID- 3963890 TI - Fetal activity in pregnancies complicated by systemic lupus erythematosus. AB - Fetal movements were assessed in 7 cases of systemic lupus erythematosus (SLE). The daily fetal movement count was lower than normal in 4 cases. Three patients with renal disease and raised blood pressure had decreased fetal movements until cessation and poor fetal outcome. Uncomplicated cases of SLE did not manifest cessation of fetal movement, and their fetal outcome was favorable. When a decrease in fetal movements becomes apparent and the condition is verified by other biophysical tests, the patient should be delivered provided the fetus is viable. PMID- 3963891 TI - Correlation between umbilical vein blood flow and umbilical blood viscosity in normal and complicated pregnancies. AB - Umbilical vein blood flow (UVBF) was studied during the last 24 h before delivery using a combination of real-time and Doppler ultrasonic equipment in 64 normal and pathological pregnancies and the results were correlated with the values of whole blood viscosity taken from the umbilical vein after delivery. UVBF was reduced in the subgroup with chronic fetal distress (n = 14) (P less than 0.001) and the hypertensive pregnancies (n = 17) (P less than 0.05), whereas umbilical blood viscosity was increased only in the subgroup with chronic fetal distress (P less than 0.01) as compared with the normal pregnancies (n = 24). A significant positive correlation was observed between the umbilical blood viscosity and haematocrit values in all the groups of patients. UVBF and blood viscosity had a significant negative correlation in chronic fetal distress (P less than 0.001) and in hypertensive pregnancies (P less than 0.05), but not in normal or diabetic pregnancies (n = 9). Thus haemoconcentration leading to increased fetal blood viscosity may act as an aetiological factor in the reduction of UVBF in developing fetal distress. PMID- 3963893 TI - Perineal electromyographic patterns in urge incontinence. AB - The EMG patterns of anal sphincter and periurethral striated musculature were analyzed in 55 women with urge incontinence during cystometry. Six had a sensory urge and 49 a motor urge incontinence. In 18 cases the unstable bladder contractions were accompanied by an intense EMG activation and in 31 cases by a decrease of perineal activity. During bladder filling a progressive decline of activity was found in 9 cases and an irregular EMG pattern and urethral pressure in 18 cases. Five patients had abnormal EMG action potentials while 16 out of 39 patients had an abnormal evoked sphincter reaction. Although the EMG of the perineal muscles during bladder filling is often abnormal in women with urge incontinence, it does not give any additional information on the causes of the urethral and bladder instability. PMID- 3963892 TI - Staphylococcus aureus--toxic shock syndrome toxin-1 antibody titers in serum of German women. AB - In a prospective study the distribution of Toxic-1 (TSST-1) antibody titers was proved by 236 menstruating, tampon using volunteers. They are divided in 7 different age groups. Up to 11% of the volunteers under 25 years had no TSST-1 antibody-titers at all. Over 25 years of age this could be detected. In the group over 40 years of age 98% were found with antibody-titers up than 1:100. So it may be suggested that there is no general causal relationship between any type of tampon on TSS. PMID- 3963894 TI - Esophageal replacement with colon interposition in children. AB - During a 21-year period, 39 colon interposition operations were performed on 37 children at the UCLA Medical Center and the Childrens Hospital of Los Angeles. The average age at the time of operation was 5.8 years. The indications for operation were esophageal atresia in 23 patients and other benign strictures in 14 patients. The duration of patient follow-up ranged from 6 months to 21 years (mean: 9.7 years). The most common complications were esophagocolonic anastomotic leak (12), esophagocolonic anastomotic stricture (14), pneumonia, and pneumothorax. Fourteen of the 25 patients with retrosternal colon interposition had complications (56%), whereas 10 of 14 patients with left thoracic colon interposition had complications (71%). One patient died (mortality: 3%) after left thoracic interposition because of severe respiratory distress associated with other malformations. Each of the 18 patients with isoperistaltic colon interposition showed rapid transit and emptying, provided that obstruction or extensive dilatation did not occur; reverse colon segments were more dilated and emptied more slowly. The 25 patients with retrosternal colon segments had less colonic distension with better emptying than did the 14 patients with left thoracic interposition. Thirty-two of the 36 children increased their weight percentile after colon interposition. Within 2 years after cervical anastomotic stricture or leak, 78% of these children were asymptomatic and gaining weight. Thirty-one of the 37 patients (84%) had excellent results with colon interposition, with a mean follow-up of 9.7 years. Most of the major postoperative complications occurred within the first few weeks and were corrected during the first few months after operation. Preservation of the esophagus should be the surgeon's first priority; however, prolonged attempts to elongate the esophagus for anastomosis in certain patients with long-gap esophageal atresia have been more hazardous in our experience than has colon interposition. PMID- 3963895 TI - Inhibited muscle amino acid uptake in sepsis. AB - Amino acid uptake in vivo was determined in soleus (SOL) muscle, diaphragm, heart, and liver following intravenous injection of [3H]-alpha-amino-isobutyric acid ([3H]-AIB) in rats made septic by cecal ligation and puncture (CLP) and in sham-operated controls. Muscle amino acid transport was also measured in vitro by determining uptake of [3H]-AIB in incubated extensor digitorum longus (EDL) and SOL muscles. Results were expressed as distribution ratio between [3H]-AIB in intracellular and extracellular fluid. AIB uptake in vivo was reduced by 90% in SOL and cardiac muscle and by 45% in diaphragm 16 hours after CLP. In contrast, AIB uptake by liver was almost four times higher in septic than in control animals. AIB uptake in vitro was reduced by 18% in EDL 8 hours after CLP but was not significantly altered in SOL at the same time point. Sixteen hours after CLP, AIB uptake was significantly reduced in both muscles, i.e., by 17% in EDL and by 65% in SOL. When muscles from untreated rats were incubated in the presence of plasma from septic animals (16 hours CLP) or from animals injected with endotoxin (2 mg/kg body weight), AIB uptake was reduced. Addition of endotoxin in vitro (2 200 micrograms/ml) to incubated muscles did not affect AIB uptake. The results suggest that sepsis leads to marked impairment of amino acid transport system A in muscle and that this impairment is mediated by a circulating factor that is not endotoxin. Reduced uptake of amino acids by skeletal muscle during sepsis may divert amino acids to the liver for increased gluconeogenesis and protein synthesis. PMID- 3963896 TI - Results of portal systemic shunts in Budd-Chiari syndrome. AB - Nine patients with Budd-Chiari syndrome (BCS) were treated by a portal systemic shunt. One had thrombosis of the superior mesenteric vein (SMV) and another had complete obstruction of the retrohepatic inferior vena cava (IVC). All other patients had a marked stenosis of the retrohepatic IVC with caval pressure ranging from 12 to 24 mmHg (mean: 17 mmHg). Seven patients had an interposition mesocaval shunt using an autologous jugular vein. The patient with a thrombosed SMV had a portoatrial shunt. The patient with an obstructed IVC had a cavoatrial shunt after an erroneous portacaval shunt had failed to relieve ascites. There were no operative deaths and no major postoperative complications. One patient died 19 months after operation of acute leukemia complicating polycythemia rubra vera. All other patients were alive and well 8 months to 6 years after operation. None of them had encephalopathy. These results suggest several comments: Portal systemic shunts are a good treatment for BCS and have a low operative risk. The mesocaval shunt is an efficient procedure, even when there is stenosis of the IVC with high caval pressure; shunts to the right atrium should be performed only in the case of complete obstruction or inaccessibility of the IVC. The long-term prognosis is excellent, except in patients with potential malignancies. Therefore, portal systemic shunts should be indicated early in patients with symptomatic BCS. PMID- 3963897 TI - A technique for profunda femoris artery reconstruction. Hemodynamic assessment and functional results. AB - A modified technique of profunda femoris artery reconstruction is presented. In case of occlusion of the superficial femoral artery, the proximal segment of this vessel is rolled over the profunda femoris artery as a patch after an endarterectomy has been performed. This technique has been performed in 110 patients (131 limbs) during the last 14 years. Five-year actuarial patency rate (life-table method) was 65.3%. With measurements obtained from nine biplanar angiograms, glass models of three different methods of profunda femoris reconstruction were constructed. The model representing this modified technique of profundaplasty showed less turbulence than the others. The results of this study validate the use of this type of profundaplasty in clinical practice. PMID- 3963898 TI - En bloc pelvic lymphadenectomy and sphincter preservation in the surgical management of rectal cancer. AB - From 1968-1976, 412 patients were operated on for rectal cancers. One hundred fifty-six underwent abdominoperineal resection (APR) and 256 underwent low anterior resection (LAR). One hundred ninety-two underwent en bloc pelvic lymphadenectomy in conjunction with their resection, while 220 patients underwent more conservative or conventional resection. Thirty-day hospital mortality was 1.7%. The cancer-related 5-year survival was 58.8% for all patients. The proportion of patients surviving 5 years after LAR (62.8%) was significantly better than those surviving after APR (52.4%), p = 0.008. Statistically significantly superior survival was observed after extended dissection when compared to conventional resections in Dukes' A, B, and C patients as a whole (63.8 and 54.3%) and in Dukes' C patients in particular. Superiority of en bloc pelvic lymphadenectomy versus conventional resection was observed in all cases of Dukes' Stage C, Astler-Coller Stage C1, Level II (adjacent) lymph nodes, and Level I (proximal) lymph nodes and was most effective in combination with sphincter-preserving operations. Patient groups were compared for bias and/or case selection, using both contingency tables and Cox-based multiple covariant linear regression analysis, and none was found. In the face of current adjuvant therapy, which is of questionable benefit and which carries its own treatment morbidity, en bloc pelvic lymphadenectomy is advocated as an adjunct to the curative operations for rectal cancer. To improve the overall benefit, patients can be selected for pelvic lymphadenectomy as an adjuvant to resection when preoperative examination suggests that the rectal cancer penetrates the bowel wall. Accurate preoperative staging may help to define a more restricted group of patients warranting (pelvic lymphadenectomy) (PLND). A control randomized trial of the effectiveness of PLND is appropriate to further test its value. PMID- 3963899 TI - Water and electrolyte absorption from a human Thiry-Vella ileal loop. Responses to systemic administration of gastrin, glucagon, secretin, and cholecystokinin. AB - Water and electrolyte flux in response to systemic administration of four different gastrointestinal hormones were studied in a human with a chronic Thiry Vella ileal loop. Gastrin infusion with a pharmacological dose of 4 micrograms/kg hr has no effect. Responses to glucagon were proportional to infused doses with directly increased absorption of water and electrolytes (except bicarbonate). However, when gastrin was infused simultaneously with glucagon, the enhanced absorption was inhibited. Secretin only transiently increased absorption of fluid and electrolytes. In contrast to its effects on jejunum, CCK increased both water and electrolyte absorption from the ileum. PMID- 3963901 TI - Surgical reconstruction in intrinsic palsy of the fingers. A study of hundred cases. AB - The authors analyze the results obtained by surgical treatment in 100 cases of intrinsic palsy of the hand. The distribution of the surgical procedures performed under regional anesthesia was as follows: Brand II: 41, Palande's lasso: 14, Zancolli: 15, Palande: 13, Littler: 13, Brand I: 2. Results were satisfactory in 74 p. cent, unchanged in 20 p. cent and poor in 6 p. cent of cases. The analysis of this series showed a significant difference in the results obtained in the little finger with better results when Palande's and the lasso procedures were used (for the hand in the lumbrical and open positions). Indications have thus been defined according to the degree of nerve damage and environmental factors. Physical therapy is essential for good integration of tendon transfers. PMID- 3963900 TI - Healing of esophagojejunal anastomoses after experimental total gastrectomy. A comparative study using manually sutured or stapled anastomoses. AB - In construction of the eosphagojejunostomy after total gastrectomy, the EEA stapled (US Surgical Corporation, Norwalk, CT) and the two-layer interrupted 3-0 Dexon anastomoses are compared concerning the radiological appearance, breaking strength, circulation, and collagen concentration. Thirty female pigs were used. After total gastrectomy and Roux-en-Y preparation, the pigs were randomized to achieve sutured or stapled anastomoses. 141Ce-labeled microspheres were used for measurements of anastomotic blood flow. After the pigs were killed, the breaking strength of the anastomosis was recorded, the collagen content determined, and an anastomotic index calculated comparing two perpendicular diameters in the anastomosis and 5 cm above. Breaking strength, leakage frequency, and anastomotic index were the same in the two groups. One week after surgery, there was a significant increase in anastomotic circulation (p less than 0.05) in both the sutured and the stapled anastomoses compared to controls. Collagen increased equally with time in the two groups (p less than 0.01). The stapled esophagojejunostomy was faster to perform (20 min) than the sutured (28 min) (p less than 0.05). PMID- 3963902 TI - Functional results of seventy-six cases of phalangeal and metacarpal fractures studied using a hand emergency computer card system. AB - Over a two-year period, the authors analyzed 76 records using a "hand" computer card divided into two parts: "work-up of the initial lesions" and "functional results". Analysis of 102 cases of fractures in this manner led to the conclusion that outcome was most often favorable when the fracture was extra-articular whatever the treatment, except in the case of complex compound fractures. In contrast, treatment of articular fractures often required secondary surgery (50% of cases) and led to 20% poor or average results. This was the case whatever initial treatment (functional, orthopedic or operative) had been undertaken. PMID- 3963903 TI - Reanimation of thumb opposition by the extensor pollicis longus. Report of sixteen cases. AB - Among some 65 techniques for restoring thumb opposition found in literature, the authors chose the extensor pollicis longus transfer (EPL) onto the abductor pollicis brevis (APB) through the interosseous membrane. This technique described by Duparc et al. in 1971 was codified by Bureau et al. in 1980 using a series of 9 cases. The sufficient force and length of this transfer, associated with its direct course by redirection through the interosseous membrane make it a docile, reliable motor unit as shown by the 16 cases studied. Performed on 11 median ulnar palsies, 6 isolated median palsies and on one complete avulsion of lateral thenar muscles, only 16 of these 18 transfers could be satisfactorily followed and reviewed from 7 to 35 months later. In our series, 14 of the 16 cases have recovered functional opposition and are using it. After a review of the surgical technique the authors emphasize some practical aspects: dissection of the EPL which may be delicate, resection of the IM which should be adequate, and choice of the reflexion pulley and how to construct it. Results as well as sequelae linked to the choice of the EPL are then analysed. PMID- 3963904 TI - The actual indications of cross finger flaps in finger injuries. AB - More than thirty years after its description, the cross finger flap is still widely in use. Its main technical data are reviewed. The follow-up show that this procedure remains indicated in deep losses of substance of the palmar aspect of the basal or middle phalanx. Its use on the terminal phalanx remains controversial, but it is still useful when elaborated microsurgical procedures are contraindicated or not available. PMID- 3963905 TI - Evaluation of deformities in Dupuytren's disease. AB - The method for classification of Dupuytren's disease, established by R. Tubiana, J. Michon and J.M. Thomine, which translates ray by ray the localization and intensity of lesions, was partly modified and completed. These modifications give a more precise evaluation of the thumb and first web space deformations, indicate the skin's state, eventual post-operative stiffness, and provide numbers which can be used in computers. The pre-operative classification described in the first half of this article is very simple and practical, and may be used effectively by all physicians who are presented with Dupuytren's disease. Supplementary indicators in the second half of the paper provide further precision which permits objective judgement of operative results. They are especially useful to surgeons who desire to review their observations and to establish statistics. PMID- 3963906 TI - Reoperation for carpal tunnel syndrome. A retrospective analysis of forty cases. AB - The causes of unsatisfactory results after surgery for carpal tunnel syndrome were retrospectively analysed in forty cases. The most common pathological finding was fibrosis and adhesions in the carpal canal. Technical errors were found in 43%. In 30% other neuropathies were present and bilateral operations had been performed in 55%. It is possible that there is a tendency to develop CTS in these patients. The results after epineural dissection or internal neurolysis were comparable to those after external neurolysis. PMID- 3963907 TI - [Traumatic rupture of flexor tendons. Apropos of 12 cases]. AB - Traumatic rupture of flexor tendons is uncommon. The authors report on twelve cases. The ulnar fingers, especially the ring finger (5 cases), are the most frequently involved. Isolated rupture of the flexor profundus tendon (10 cases), usually at the level of the distal phalanx (9 cases), is the most common lesion. In two cases, both the superficialis and profundus tendons of the little finger were involved. Rupture usually occurs because of severe hyperextension or opposed flexion; more rarely it results from direct trauma. The mean age of patients (male for the most part) was 35 years old. Transosseous reinsertion (5 cases) was performed in acute cases for ruptures of the flexor profundus tendons. When seen secondarily, and according to the functional impairment encountered, the authors performed as follows: one case of arthrodesis, two cases of excision of the profundus with tenolysis of the sublimis, and two cases of tendon grafts. Functional results are good when repair of the rupture is performed within the first few days after injury. PMID- 3963908 TI - [Case of volar dislocation of 4 ulnar metacarpals]. AB - A case of volar dislocation involving the four ulnar metacarpals treated by open reduction and fixation with Kirschner wires is reported. A review of the literature leads the authors to suggest several pathogenic hypotheses. The mechanism may be direct or indirect according to whether the trauma is sustained on the metacarpal heads or on the bases of the metacarpals. Emergency treatment by open reduction and fixation usually provides excellent results. PMID- 3963909 TI - [Clinical test of apposition and counter-apposition of the thumb]. AB - In order to test the opposition and the counter-opposition (reposition) of the thumb, the method proposed here does not require the measuring of angles; rather, the hand itself is used as the system of reference. The opposition test consists of touching the four long fingers with the tip of the thumb: the score is 1 for the lateral side of the second phalanx of the index finger, 2 for the lateral side of the third phalanx, 3 for the tip of the index finger, 4 for the tip of the middle finger, 5 for the ring finger and 6 for the little finger. Then, moving the thumb proximally along the volar aspect of the little finger, the score is 7 when it touches the DIP crease, 8 on the PIP crease, 9 on the proximal crease of the little finger and 10 when it reaches the distal volar crease of the hand. This test is valid only if the first stages are possible: a crawling thumb in the palm is not an opposition motion. The counter-opposition test (or reposition test) needs the other hand as a reference system. The hand to be tested is set upon the table palm-down while; the other hand is laid on the table on its medial side, close to the tip of the first hand thumb; now this thumb is actively drawn up as high as possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963910 TI - [Surgical indications in the treatment of spastic hand]. AB - Spasticity is the loss of tonus control of some muscles. It is caused by cerebral disorders occurring mostly in children. Their I.Q. and compartmental response to the environment must be considered in evaluating the surgical possibilities. These depends on the types of spasticity which have been classified by Zancolli. Surgical possibilities are not many but should usually improve function. They range from hyponeurotisations to muscle-slide operations or tendons lengthening. Tendon transfers may be useful to rebalance the thumb. Results are evaluated on finger motion, thumb and wrist position, but only in a purely functional standpoint. PMID- 3963911 TI - [Surgical approach to the carpal tunnel]. PMID- 3963912 TI - Importance of coronary artery anomalies in operations for congenital heart disease. AB - A congenital coronary artery anomaly influenced operative management of 21 children (34 operations) during a recent 8-year interval. This group represented 1.3% of cardiothoracic operations performed. Survivors included 5 of 10 children having correction of the left coronary artery from the pulmonary artery and 11 children having correction of intracardiac defects associated with major coronary arteries crossing the right ventricular outflow tract. Two children survived primary repair of injured major coronary arteries. Isolated coronary artery anatomy must be considered during management of intracardiac defects. Intraoperative injury to a major coronary artery requires meticulous repair. PMID- 3963913 TI - Spectral analysis of small-amplitude electrical activity in the cold potassium arrested heart. AB - Recent reports have suggested that small-amplitude electrical activity may persist following the administration of potassium cardioplegia. This report confirms the presence of small-amplitude electrical activity in the potassium arrested heart and describes a canine model that may be used to measure microvolt plunge-electrode potentials during ischemic arrest. Thirty-one adult mongrel dogs were placed on cardiopulmonary bypass and underwent 90 minutes of ischemic arrest. The heart was arrested with 10 ml per kilogram of body weight of crystalloid cardioplegia (20 mEq of KCl/L) at 4 degrees C. Core temperature was maintained at 26 degrees C and myocardial temperature, within a range of 8 degrees to 10 degrees C with topical ice-slush saline solution. Cardioplegic solution, 10 ml/kg, was reinfused every 30 minutes during the 90 minutes of ischemia. Electrical activity and transmural temperature were continuously monitored over the anterior surface of the left ventricle with specially designed plunge electrodes. Visual electrical and mechanical activity ceased in each animal after the infusion of cardioplegic solution, and was associated with an isoelectric electrocardiogram. However, microvolt (10(-6)V) small-amplitude electrical activity was recorded at a myocardial temperature of 10 degrees C in each animal during ischemic arrest, and the activity from 6 animals was stored on magnetic tape. Spectral analysis of electrical activity during cardioplegic arrest indicated that the fundamental frequency of small-amplitude electrical activity was in the range of 3.25 Hz. These data confirm the presence of small amplitude electrical activity in the cardioplegia-arrested heart at 10 degrees C. PMID- 3963914 TI - Evaluation of serum creatine kinase and lactate dehydrogenase in experimental myocardial infarction, atriotomies, and thoracotomies. AB - Myocardial infarction causes elevation of the serum myocardial-associated isoenzyme of creatine kinase (CK-MB) and a serum isoenzyme of lactate dehydrogenase (LDH1). Since atrial myocardium has as much CK-MB as ventricular myocardium, surgical manipulation of the atrium could cause elevation of serum CK MB in the postoperative period. The distribution of LDH isoenzymes is different between atrial and ventricular myocardium. Hence, surgical procedures on the atrium could, theoretically, cause different changes in serum LDH isoenzymes than those seen after acute myocardial infarction. This study was conducted to ascertain whether surgical manipulation of the atrium could cause changes in these two serum enzyme systems that might be confused with those seen after acute myocardial infarction. Right thoracotomies were performed on 20 dogs. Each dog then was assigned randomly to one of four groups: thoracotomy (control), placement of atrial pursestring sutures, atriotomy, or acute perioperative myocardial infarction. Serum total and isoenzyme distributions of CK and LDH were measured for 48 hours in all animals. The results suggest that significant elevations of serum CK-MB occurred even after small atriotomies. Confirmation of a ventricular myocardial origin of postoperative serum CK-MB bands was obtained by analysis of serum LDH isoenzymes in that the ratio of LDH1 to LDH2 and the absolute value of serum LDH1 became elevated only after acute perioperative myocardial infarction and not after atriotomy. PMID- 3963916 TI - Complete correction of total anomalous pulmonary venous drainage: experience with 53 patients. AB - From January, 1973, to August, 1984, 53 infants with total anomalous pulmonary venous drainage (TAPVD) underwent a corrective operation in our unit. TAPVD was of the supracardiac type in 41% of the patients, cardiac in 17%, infracardiac in 36%, and mixed in 6%. Overall operative mortality was 23%; it was highest at 42% in the infracardiac group. Factors determining the outcome were the anatomical type of the lesion, the degree of pulmonary venous obstruction, the severity of pulmonary hypertension, and the young age of the patients. In addition, surgical experience appears to be an important factor in determining the outcome. During the study, hospital mortality decreased considerably to 11%. A corrective procedure offers the only chance of survival for patients with TAPVD. With some experience, excellent results can be obtained. PMID- 3963915 TI - Results of total correction in complete atrioventricular septal defects with congenital or surgically induced right ventricular outflow tract obstruction. AB - The outcome of total repair in 29 children who had complete atrioventricular septal defect (AVSD) and congenital or surgically induced right ventricular outflow tract obstruction (RVOTO) is reviewed. All 11 patients with congenital RVOTO had normal pulmonary artery (PA) pressure before the complete repair. Of the 18 children who had undergone PA banding, seven had PA pressure above 30 mm Hg (mean, 53.5). Two had elevated pulmonary vascular resistance (greater than 3 units). Early mortality was 18.2% for the patients with congenital RVOTO and 44.4% for those who had undergone PA banding (p not significant). After a mean follow-up of 5 years, the results are good in the survivors of both groups. Analysis of multiple-risk factors indicate that, for the total group of patients, death was significantly more common in children less than 5 years of age (p less than 0.01) or less than 15 kg (p less than 0.02) than in older or larger patients. PMID- 3963917 TI - Oxygen utilization during isovolumic pressure-volume loading: effects of prolonged extracorporeal circulation and cardioplegic arrest. AB - In canine hearts supported by cardiopulmonary bypass, isovolumic peak developed pressure (PDP, mm Hg) and myocardial oxygen consumption (MVO2, ml O2 X 10( 2)/beat/100 gm left ventricular [LV] weight) were determined at 5-ml increments of LV balloon inflation before and after either 2 hours of potassium cardioplegic arrest (ischemia, N = 7) or a comparable period of normothermic perfusion without ischemia (control, N = 6). The sensitivity of MVO2 as a marker of ischemic injury was compared with preservation of both adenosine triphosphate (ATP) stores and systolic pump function. Over a physiological range of end-diastolic volumes (5 to 35 ml) and end-diastolic pressures (0 to 18 mm Hg), the Frank-Starling curves were not depressed following both cardioplegic arrest and prolonged nonischemic perfusion. Although ATP stores decreased by 26% and 22% (ischemia and control groups, respectively; not significant), these levels did not distinguish the effects of cardioplegic arrest from prolonged perfusion. At the preinterventional measurement in both groups, PDP between 50 and 200 correlated with MVO2 from 3.0 to 10.0 (r = +0.84). Following cardioplegic arrest, postischemic MVO2 increased 137 +/- 6% when measured over the PDP range of 75 to 200 mm Hg (p less than 0.01). This change was not evident at a PDP of less than 75, in the empty beating heart, or in control hearts subjected to nonischemic extracorporeal perfusion. These data suggest that increased utilization of oxygen to develop physiological pressures may be a more sensitive indicator of ischemic injury than shifts in the pressure-volume relationship or depletion of adenine nucleotide stores. PMID- 3963918 TI - Postoperative long-term results in total correction of tetralogy of Fallot: hemodynamics and cardiac function. AB - Late results were assessed in 63 patients who underwent complete repair of tetralogy of Fallot. These patients were divided into four groups. Group I-A included 13 who had a transannular patch with a monocusp, and whose cross sectional area index (CSAI) was less than 2.5 cm2/m2; group I-B included 11 with the patch and with a CSAI greater than 2.5 cm2/m2. Group II included 27 patients who underwent pulmonary valvotomy. Group III included 9 who had not undergone valvotomy and 3 who had undergone pulmonary valve replacement. Late death occurred in 1 patient, and reoperation was done on 3. Mild pulmonary stenosis (PS) was present in 73%, moderate PS in 17%, and severe PS in 10% of the patients. A significant pulmonary regurgitation (PR) of grade 3 or 4 was present in 33% of the patients in group I-A, and in 87% of group I-B, 17% of group II, and 0% of group III. Right ventricular end-diastolic volume was normal in patients with a PR of grade 2 or less, and it was higher in patients who had a significant PR. The ejection fraction was generally decreased, regardless of the grade of PR. Left ventricular function was normal in those with a PR of grade 3 or less and was impaired in those with a PR of grade 4. Thus, late postoperative hemodynamics and ventricular function were excellent in patients with a mild PS and a PR of grade 2 or less and it was poor in those with a moderate PS and a significant PR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963920 TI - Repair of aortic coarctation in the first three months of life: immediate and long-term results. AB - The optimum surgical procedure for treatment of coarctation of the aorta in the neonatal period remains controversial. To assess immediate and long-term results of using primarily the subclavian flap angioplasty procedure (SFA), we reviewed our initial 5-year experience. The average follow-up was 6 years. From 1977 to 1981, 25 infants under 3 months of age (1 to 86 days, mean 21) required emergency surgery for repair of coarctation of the aorta. Three groups of patients were identified. Group I consisted of 10 patients with or without patent ductus arteriosus. In group II, 10 patients had coarctation association with one or multiple ventricular septal defects (VSDs) without other congenital defects. In group III, 5 patients had coarctation associated with more complex congenital heart lesions. Twenty-three SFAs and two patch aortoplasties were performed. No patient with isolated VSD was banded. All patients except one in group III with an associated atrioventricular canal survived initial hospitalizations. Four late deaths occurred, all in patients with associated complex heart defects. There were three recurrent coarctations requiring surgery or balloon angioplasty (12%)- one in each group, with a total rate of 0.77 recurrences per 100 patient-months. SFA for coarctation in the neonatal period is a safe and effective operation with a low initial mortality (4%, 0-19%, 70% confidence limits) well tolerated in this group of ill patients. Long-term outcome is primarily related to the presence of associated complex congenital defects. Infants with VSD associated with coarctation did not require pulmonary artery banding unless primary intracardiac repair was not feasible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3963919 TI - Hemodynamic, metabolic, and morphological effects of cardiopulmonary bypass with a fluorocarbon priming solution. AB - Systemic perfusion, myocardial contractility, and morphological changes during and after cardiopulmonary bypass (CPB) were investigated in 22 greyhounds; Fluosol-DA 20% (FDA) and normal saline (NaCl) were compared as priming solutions for hypothermic (25 degrees C) CPB. Hemodynamic and oxygenation indices were similar in all groups. Animals with fluorocarbon primes had higher serum lactate concentrations (mean +/- standard error of the mean [SEM]) during CPB (NaCl 1.64 +/- 0.2, FDA 2.39 +/- 0.3, p less than 0.01), representing an increase over the control of 12% and 319% in the NaCl and FDA groups, respectively. After CPB, serum lactate concentration remained elevated in the FDA group, but it returned to the level of the control in the NaCl group (NaCl 1.49 +/- 0.5, FDA 2.29 +/- 1.1, p less than 0.01); increases over the control level were 7% and 302% in the NaCl and FDA groups, respectively. Myocardial contractility after CPB, expressed as dP/dt[40], was similar in the two experimental groups. Three weeks after CPB, a histological examination by light microscopy of multiple organs obtained from a separate group of 12 animals treated similarly was performed, demonstrating no significant morphological differences between animals primed with fluorocarbon or with saline. The results suggest that FDA is a satisfactory priming agent for hypothermic CPB. It adequately preserves myocardial function and causes no adverse morphological changes, but a persistent, as yet unexplained, elevation in serum lactate concentration occurs. PMID- 3963922 TI - Venous cutdown for pacemaker implantation. AB - Two hundred sixty-eight dual-chamber pacemaker implants using polyurethane leads for atrium and ventricle were analyzed for the vein of entry for both atrial and ventricular leads. The cephalic vein was used for both leads in 61.2%, the external jugular vein for both leads in 8.6%, both veins in 7.8%, and the subclavian vein alone in 16.4%. The total for venous cutdown alone was 77.6%. There were no complications relevant to the vein of approach for the venous cutdown leads, but there was one pneumothorax requiring thoracic intubation for the subclavian puncture route. Venous cutdown is satisfactory for dual-chamber pacing requiring two lead systems. PMID- 3963921 TI - A logical approach to chest wall neoplasms. AB - Thirty chest wall tumors were evaluated over a 3-year period at two major medical centers; a nonradical excisional biopsy technique was used. The majority of the lesions were benign; the small number of malignancies consisted of either plasmacytomas or metastatic neoplasms. These findings support a limited excisional biopsy as the recommended initial diagnostic approach for all chest wall tumors. PMID- 3963923 TI - Origin of the left coronary artery from the right pulmonary artery: a report of successful surgery in a 3-month-old child. AB - Successful reimplantation into the aorta of an anomalous left coronary artery arising from the right pulmonary artery is described in a 3-month-old child. Preoperative and postoperative angiograms are included, and serial echocardiography demonstrates the marked improvement in left ventricular function. PMID- 3963924 TI - Pericardiophrenic hernia secondary to a surgically created peritoneal and pericardial window. AB - Intrapericardial herniation is rare; 40 cases have been reported. To our knowledge, this is the first report of a case resulting from a recently developed surgical procedure: the pericardial and peritoneal window technique. Diagnostic modalities included plain films, barium studies, and a computed tomography scan. PMID- 3963925 TI - Simplified technique for pericardial patch of the right ventricular outflow tract. AB - Pericardial patching to enlarge the right ventricular outflow tract is often required in congenital cardiac surgery in lesions such as tetralogy of Fallot, pulmonary atresia, pulmonary stenosis, and pulmonary artery repair following removal of a palliative pulmonary artery band. A method of simplifying the attachment of the pericardial patch onto the right ventricular outflow tract is described. PMID- 3963926 TI - Surgical treatment of H-type tracheoesophageal fistula diagnosed in an adult. AB - A new method is described for the repair of a congenital tracheoesophageal fistula in an adult. This technique uses a fiberoptic bronchoscope and passes a flexible vascular guidewire across the tracheoesophageal fistula. This maneuver then simplifies the intraoperative identification of the tracheoesophageal fistula, which is exposed and repaired through a left transcervical approach. PMID- 3963927 TI - Blind esophagectomy for extrinsic carcinoma of larynx. AB - Esophagectomy without thoracotomy has several advantages in those patients requiring laryngectomy and in whom the stomach is used for replacement. A two team approach is advocated. The posterior mediastinal route is preferred. PMID- 3963928 TI - Ostium primum atrioventricular septal defect: an anatomical and surgical review. AB - The results of surgical repair of ostium primum atrioventricular septal defect show continued improvement. This improvement reflects the advances in open-heart surgery in general and, in particular, the better understanding of the anatomy of the conduction tissue and the morphology and function of the left atrioventricular valve. We have corrected this defect in 84 patients over a ten year period. There were 2 early deaths (2.4%) and 2 late deaths (2.4%). Two patients had problems related to conduction. Our surgical approach has been to place the interatrial baffle in such a way as to avoid the displaced atrioventricular node and thereby leave the coronary sinus in the left atrium. Our approach to repair of the so-called cleft in the left atrioventricular valve (in reality the space between the ventricular components of the bridging leaflets), is based on the unequivocal triple-leaflet morphology of this valve. PMID- 3963929 TI - Iodine toxicity. PMID- 3963930 TI - Maximizing mammary artery length. PMID- 3963931 TI - No dissection of left internal mammary artery pedicle. PMID- 3963932 TI - Protective actions of carbocromene against amitriptyline-induced cardiotoxicity in anesthetized rats. AB - This study was designed to analyze the effects of carbocromene on circulatory and electrophysiologic failure in rats anesthetized with urethane. Amitriptyline was infused at 0.4 mg/kg/min (n = 12) until death of the animals at 30 +/- 6.7 min due to vascular collapse. Following initial heart rate increase and QRS prolongation, this was characterized by progressive hypotension, bradycardia, intraventricular conduction delay, S-T segment elevation and A-V block. In the initial 31 rats, carbocromene was administered i.v. with 4 mg/kg followed in two groups by 40 (n = 13) and 80 micrograms/kg/min (n = 18) i.v., respectively. The drug was effective in protecting the animals against the acute cardiovascular failure induced by amitriptyline. The preservation was associated with a diminution of the hypotension, negative chronotropic actions, S-T segment elevation and the incidence of A-V block produced by amitriptyline. Survival time of the rats increased to 46 +/- 5.3 min (p less than 0.05 vs. amitriptyline controls) and 63 +/- 6.5 min (p less than 0.01) with infusion of 40 and 80 micrograms/kg/min carbocromene, respectively. These results suggest that carbocromene is an effective treatment of amitriptyline-induced cardiotoxicity by massive overdose with beneficial effects largely due to hemodynamic and metabolic oxygen-sparing impact on the heart. Membrane stabilizing antiarrhythmic carbocromene effects may be contributory factors in its protective value in the treatment of acute amitriptyline poisoning. PMID- 3963933 TI - Electrocardiographic effects of toluene in the anesthetized rat. AB - The influence of inhalation of near lethal quantities of toluene on some ECG parameters, as well as the possible cardiac sensitizing effect of the solvent, were determined in chloralose-anesthetized rats. These actions were compared with those of its close analogue benzene. Both solvents produced tachycardia; toluene increased the duration of QRS and specially PR, while benzene decreased P wave duration. No other systematic changes in ECG morphology or evidence of arrhythmia were observed. Toluene appeared to decrease the number of ectopic beats induced by epinephrine, in contrast to benzene, which increased it markedly. These results suggest that toluene administered by inhalation up to near lethal doses is devoid of untoward ECG effect in the chloralose-anesthetized rat, its only action being a decrease in intraventricular and particularly AV conduction. It does not share the myocardial sensitizing properties of benzene and in fact appears to elicit some protection from the arrhythmogenic effects of epinephrine, although no definite conclusions as to this action can be derived due to limitations in the experimental model used. PMID- 3963934 TI - Electrophysiological effect of trapidil on rabbit sinoatrial node cells. AB - Effects of trapidil on the membrane potentials and currents of rabbit sinoatrial node cells were investigated by means of conventional microelectrode and double microelectrode voltage clamp methods. Trapidil (1 X 10(-4) M) increased the spontaneous firing frequency, the maximum rate of rise, action potential amplitude and the slope of the pacemaker depolarization. Action potential duration was shortened by the drug application. Voltage clamp experiments showed that trapidil increased both the slow inward current (isi) and the potassium outward current (iK). Trapidil fastened the recovery time constant of isi, while the drug did not change the time course of the outward current tail. The hyperpolarization-activated current (ih) was also increased by the drug. The results obtained indicate that at relatively high concentration trapidil produces a positive chronotropic effect on the sinoatrial node cells by mediating an increase in isi, iK and ih. PMID- 3963935 TI - Effect of butalbital and phenobarbital pretreatment on antipyrine clearance in the rat. AB - The disposition kinetics of antipyrine after a single i.v. dose (75 mg/kg) of [14C]antipyrine were examined in control rats and in rats pretreated with butalbital and phenobarbital. Blood antipyrine data indicated that daily administration of phenobarbital (50 mg/kg) for 14 days resulted in significantly more rapid elimination of antipyrine than that observed after equal doses of butalbital, which was in turn significantly faster than the control values. Results of additional antipyrine tests after phenobarbital pretreatment for 2 and 5 days showed considerable enzyme induction after only 2 days of exposure to phenobarbital; the mean antipyrine clearance after the 2-day pretreatment was not significantly different from those after the 5- and 14-day pretreatments. The data suggested that the maximum increase in antipyrine clearance, ca. 190% of the control value, was achieved after approximately 5 daily doses of phenobarbital and maintained until the end of the 14-day pretreatment period. The subsequent decline in the induced enzyme activity, assessed by the antipyrine clearance values on days 1, 3, 6, and 9 post-phenobarbital treatment, appeared to be mono exponential with a half-time of 3.8 days. Thus, the enzyme activity would return to baseline at ca. 15 days after the last dose of phenobarbital. In these studies, consistent increases in liver weight with increasing antipyrine clearance were observed, while no apparent relationship between antipyrine distribution volume and barbiturate pretreatment was found. PMID- 3963936 TI - Action of L-acetylcarnitine on different cerebral mitochondrial populations from hippocampus. AB - The maximal rate (Vmax) of some mitochondrial enzymatic activities related to the energy transduction (citrate synthase, malate dehydrogenase, NADH cytochrome c reductase as total, cytochrome oxidase) and amino acid metabolism (glutamate dehydrogenase) were evaluated in non-synaptic (free) and synaptic mitochondria from rat brain hippocampus. Three types of mitochondria were isolated from rats subjected to single i.m. treatment with L-acetylcarnitine (308 mg X kg-1) or to sub-chronic i.m. treatment with L-acetylcarnitine at three different dose levels (38; 154; 614 mg X kg-1, 5 days a week, for 4 weeks). With respect to the enzymatic pattern of three types of non-synaptic and synaptic mitochondria, in hippocampus a different maximal rate of both total NADH-cytochrome c reductase and cytochrome oxidase was observed, these activities being lower in "synaptic heavy" mitochondrial subfraction rather than that in both "free" and "synaptic light" ones. This confirms that in various types of brain mitochondria a different metabolic machinery exists. Acute treatment with L-acetylcarnitine decreased citrate synthase and glutamate dehydrogenase activities only in mitochondria obtained from synaptosomes. The sub-chronic treatment with L acetylcarnitine decreased the activity of citrate synthase and total NADH cytochrome c reductase activities only in the same type of mitochondria, i.e. synaptic mitochondria. Therefore in vivo administration of L-acetylcarnitine mainly affects some specific enzyme activities (suggesting a specific molecular trigger mode of action) of the intrasynaptic mitochondria (suggesting a specific subcellular trigger site of action). PMID- 3963937 TI - Noradrenergic and non-noradrenergic relaxation at basal and high tone levels in the guinea-pig tracheal smooth muscle. AB - Responses to the beta-adrenoceptor agonist, 1-isoprenaline, and to transmural (electrical) stimulation of the guinea-pig tracheal muscle were evaluated at basal and high levels of carbachol or potassium-induced (K+) tone. The sensitivity of guinea-pig tracheal preparations to 1-isoprenaline was reduced by approximately 7-fold when high level tone was induced by carbachol or K+. Propranolol also shifted the dose-response curves to the right, but was apparently more potent in preparations with basal tone than in tissues where high tone was induced by carbachol or K+. Transmural (electrical) stimulation of tracheal strips produced an initial contraction followed by a longer lasting relaxation. At high level of tone produced by carbachol or K+, the contractile component was almost abolished while the relaxant response was unaltered. Relaxation induced by transmural stimulation was decreased to similar extents by propranolol at both basal and high tone levels. These results suggest that the potency of 1-isoprenaline and propranolol is affected by tonic conditions of tracheal muscle but the proportion of noradrenergic to non-noradrenergic components in the relaxation induced by neural stimulation may be unaltered at basal and elevated tone levels. PMID- 3963938 TI - Analysis of the relaxing effect of dopamine on the isolated rat jejunum. AB - The relaxing effect of dopamine on the rat isolated jejunum has been studied. Dopamine was found 170 times less potent than noradrenaline and 3 times more potent than tyramine. The relaxing effect of dopamine does not show the tachyphylaxis phenomenon, is present in preparations from rats pretreated with reserpine and is not influenced by cocaine. These results indicate that dopamine has a direct action. To characterize the receptor(s) through which dopamine causes intestinal relaxation the alpha-blocker phentolamine, the beta-blocker propranolol and the dopamine receptor blockers haloperidol and cis-alpha flupenthixol, alone or in combination have been tested. 40% of inhibition of the response to dopamine was obtained with phentolamine, 25% with propranolol and 30% with haloperidol or cis-alpha-flupenthixol. Combining together three antagonists acting on three different receptors it was possible to obtain 70% of inhibition of the responses to dopamine. It is concluded that alpha and beta adrenoceptors and specific dopamine receptors are involved in the direct relaxing action of dopamine. PMID- 3963940 TI - Systemic and regional hemodynamic effects of E614 (tripamide) as studied in conscious SHR. AB - Experiments were conducted on 53 conscious young male spontaneously hypertensive rats utilizing radiolabeled microspheres to analyze the acute and chronic hemodynamic effects of a newly synthesized antihypertensive drug, E614. The hemodynamic variables were observed on the 1st and 6th days of E614 treatment (p.o., once daily) in separate groups of rats. When the drug was given at a smaller dose (10 mg/kg body weight) over 6 days, the hypotensive action of E614 was found to be due mainly to a reduction of the total peripheral vascular resistance with no significant change in the cardiac output (CO). A supra pharmacological dose (100 mg/kg), however, lowered the mean arterial pressure (AP) due mainly to a significant reduction of the CO in both the acute and chronic treatments. We found little influence of the drug on heart rate, and the coronary and renal vascular beds in any of the present experimental settings. The cerebral blood flow appeared not to change significantly unless the AP fell to such an extent that a fall in cerebral blood flow took place despite the autoregulatory mechanism of the brain blood vessels. The tissue perfusion was also well preserved in the gastrointestinal tract. PMID- 3963939 TI - The effects of adenosine, ATP and ADP on ventricular automaticity induced by a local injury in the isolated right ventricle of the rat. AB - The effects of adenosine, adenosine triphosphate (ATP) and adenosine diphosphate (ADP) on ventricular automaticity induced by a local injury have been studied in the isolated right ventricle of the rat. Adenosine in low concentrations (10(-10) -10(-8) M) increased ventricular automaticity but in high concentrations (10(-5)- 10(-4) M) decreased it. ATP and ADP decreased consistently ventricular automaticity, ATP being more effective than ADP. Theophylline in a concentration (5 X 10(-4) M) devoid of effect on ventricular automaticity antagonized both the excitatory and the inhibitory effects of adenosine. A high calcium solution (5.4 mM calcium) also prevented both the excitatory and the inhibitory effects of adenosine. The results suggest that adenosine in low concentrations might contribute to ventricular dysrhythmias, and that ATP and ADP as well as high concentrations of adenosine might have antidysrhythmic effects. The effects of adenosine appear to be mediated through calcium-dependent theophylline-sensitive receptors: the high affinity receptor operating the excitatory effect and the low affinity adenosine receptor operating the adenosine inhibitory effect on ventricular automaticity. PMID- 3963941 TI - Effects of arterial pH and HCO-3 concentration on HCO-3 secretion in the isolated blood-perfused dog pancreas. AB - We examined the effects of plasma pH and plasma HCO-3 concentration on pancreatic HCO-3 secretion in resting state and in stimulated state by secretin, pancreozymin or dopamine, using the isolated blood-perfused dog pancreas. Secretin- or pancreozymin-induced HCO-3 secretion was sensitive to changes in both plasma pH and HCO-3 concentration. On the other hand, neither plasma pH nor plasma HCO-3 concentration affected dopamine-induced HCO-3 secretion and spontaneous HCO-3 secretion. These results suggest that secretin- or pancreozymin induced pancreatic HCO-3 secretion is induced by the active H+-pump, but dopamine induced or spontaneous pancreatic HCO-3 secretion may be caused by different mechanisms. PMID- 3963942 TI - Adverse drug reactions. The clinician's role in reporting. PMID- 3963943 TI - Epidemiologic studies of mortality in patients with ulcerative colitis. PMID- 3963944 TI - Clinical experience with timolol maleate monotherapy of hypertension. AB - Beta-adrenergic blocking drugs are gaining acceptance as initial therapy for patients with mild to moderate hypertension. In a postmarketing surveillance study, 5,190 hypertensive patients received timolol maleate monotherapy and were evaluated by 1,355 physicians. A total of 1,057 patients did not complete the study: 28% of these patients experienced an adverse event. Mean systolic and diastolic blood pressure readings were reduced 20 and 13 mm Hg, respectively. Mean diastolic blood pressure was reduced 11% for patients with mild hypertension; larger mean reductions were noted for patients with moderate (17%) and severe hypertension (22%). The effect in black and elderly patients was less than in other groups. Although 22% of all patients experienced an adverse event, less than 2.2% of all patients experienced events related to beta-adrenergic blockade, ie, respiratory difficulty, heart failure, bradycardia, and cold extremities. Fatigue, dizziness, and nausea were the most frequently reported adverse events requiring discontinuation of therapy. Timolol monotherapy is a well-tolerated and effective treatment for a broad range of hypertensive patients. PMID- 3963945 TI - Hypertrophic cardiomyopathy in the elderly. A frequently misdiagnosed disease. AB - In 20 elderly patients (mean age, 76 years; range, 70 to 86 years), hypertrophic cardiomyopathy was diagnosed echocardiographically. Although the disease was moderate to severe in all patients, the diagnosis was not suspected in 19 patients prior to echocardiography. Inappropriate therapy consisting of potentially harmful drugs, such as digitalis, nitrates, and diuretics, was commonly used, often for unclear indications. Since echocardiography can easily and accurately diagnose hypertrophic cardiomyopathy, an increased awareness of its occurrence in the elderly and use of echocardiography would reduce diagnostic and therapeutic errors. PMID- 3963946 TI - Acute hemodynamic effects of levothyroxine loading in critically ill hypothyroid patients. AB - To evaluate the acute cardiovascular effects of high-dose levothyroxine sodium therapy, the hemodynamic findings in eight critically ill hypothyroid patients treated with high-dose levothyroxine were compared with those in two critically ill hypothyroid and nine critically ill euthyroid patients not receiving this therapy. The initial cardiac index was significantly lower in the hypothyroid group; all other hemodynamic values were similar to those of the euthyroid patients. Following levothyroxine loading, the free thyroxine index increased to normal while the free triiodothyronine index was unchanged; all patients had a significant rise in cardiac index but no consistent changes in the other hemodynamic values. Cardiac index correlated positively with heart rate (three patients) and/or stroke volume index (six patients). Increases in stroke volume index correlated with decreases in systemic vascular resistance (five patients), but not with increases in pulmonary artery wedge pressure. No consistent patterns of hemodynamic changes were observed in the untreated hypothyroid or the euthyroid patients. PMID- 3963947 TI - Hemorrhage vs rethrombosis after thrombolysis for acute myocardial infarction. AB - To determine whether or not the timing of heparin infusion affects either bleeding or reocclusion following intracoronary streptokinase for acute myocardial infarction, heparin was infused immediately after streptokinase in 89 patients and was delayed for 12 hours in the subsequent 93. Bleeding occurred in 22 immediate-heparin patients and was major in five (one fatal); there were 14 hemorrhages in the delayed-heparin group, all minor. At discharge, reocclusions were observed in 18% (12/68) of immediate-heparin patients, and 11% (3/27) of the latter. Bioassayed fibrinogen levels displayed sustained depression regardless of bleeding for 20 hours after streptokinase; however, defibrinogenation measured by immunoassay was much less striking. This suggests that high levels of fibrinogen degradation products spuriously affect the bioassay of fibrinogen. We conclude that bleeding is related to the anticoagulant effects of fibrinogen degradation products interacting with heparin, and may be largely independent of hypofibrinogenemia. Delaying heparin for 12 hours may decrease the risk of bleeding while little affecting the risk of reocclusion. PMID- 3963948 TI - Diagnostic value of antithrombin III and aminopyrine breath test in liver disease. AB - To assess the value of the aminopyrine breath test (ABT) and antithrombin III (AT III) determinations in liver disease, both tests were performed on 77 consecutive patients who underwent liver biopsies for increased values of liver enzymes and in 20 patients with clinical cirrhosis. The mean values of AT III and ABT were significantly lower in cases of liver cirrhosis than in cases of steatosis and steatofibrosis. The AT III and ABT values were abnormal in, respectively, 83.9% (26/31) and 90.3% (28/31) of the patients with cirrhosis and 22.7% (15/66) and 28.8% (19/66) of the patients without cirrhosis. The association of the two tests increased the specificity without modifying the sensitivity. Both the AT III test and the ABT can be used as noninvasive diagnostic procedures for cirrhosis in patients for whom the liver biopsy is not available or contraindicated. PMID- 3963949 TI - Further studies of lipid peroxidation in human paraquat poisoning. AB - In patients with subacute toxic reactions from paraquat poisoning (death within 11 to 41 days), the extent of lipid peroxidation, expressed as serum malondialdehyde level, was 2.7-fold higher (12.33 +/- 4.42 nmole/mL) before pulmonary fibrosis than that in normal controls (4.55 +/- 1.23 nmole/mL). The extent of lipid peroxidation in patients with acute toxic reactions (death within one to three days) was not elevated; these patients died of pulmonary edema and hemorrhage (acute respiratory distress), liver failure, renal failure, and adrenal necrosis. Remarkable high levels of paraquat (greater than 5 mg/L) were found in the urine, serum, and tissues of patients with acute toxic reactions; a small amount of paraquat was found in the serum or urine of patients with subacute toxic reactions five to 11 days after ingestion. Patients who survived had no elevation in lipid peroxidation. Administration of vitamin E (100 to 4,000 mg/day from the first hospital day) had no effect on survival. PMID- 3963950 TI - Partially reversible osteopenia after surgery for primary hyperparathyroidism. AB - Bone mineral content of the radius in 30 patients with primary hyperparathyroidism was determined by single-photon absorptiometry before and one year after the removal of a parathyroid adenoma. When compared with normal age- and sex-matched subjects, preoperative bone mineral content was decreased by more than 1 SD in 24 patients 3 cm from the styloid apophysis (distal site) and in 23 patients 8 cm from the styloid apophysis (proximal site). The decrease at the distal site, where there is more trabecular bone, was significantly greater than at the proximal site (74% +/- 13% of the normal mean vs 79% +/- 13%). Bone mineral content values were not different in the female and male populations. One year after surgery, the bone mineral content was significantly increased but was still lower than normal at both sites (81% and 84% of the normal mean, respectively). In some patients, seen up to three years after surgery, the bone mineral content remained lower than normal. We conclude that primary hyperparathyroidism causes an osteopenia that affects both cortical and trabecular bone and that is only partially reversible, even in the long term. PMID- 3963951 TI - Measures of bone loss in rheumatoid arthritis. AB - Patients with rheumatoid arthritis (RA) are prone to develop osteoporosis, especially women receiving steroid hormone therapy. Inhibition of bone formation and/or excessive bone resorption may be responsible. Bone gamma-carboxyglutamic acid-containing protein (BGP), the major noncollagen protein of bone and a plasma marker of bone formation, was measured in 81 consecutive RA patients and 79 age- and sex-matched control subjects, in addition to the hormone regulators of bone metabolism, calcitonin, parathyroid hormone, and 1,25-dihydroxyvitamin D. Mean (+/- SE) BGP levels (picomoles per milliliter) were lower for RA men (1.46 +/- 0.14) and women (1.52 +/- 0.2) compared with their respective controls (2.05 +/- 0.17 for men, 2.47 +/- 0.22 for women). Women taking steroids had the lowest levels (1.13 +/- 0.22) and, in contrast to men, this value was lower than the nonsteroid-treated group. Steroid treatment appears to be a major determinant of low BGP levels; the effect of RA itself is suspected but not proved in this study. Calcitonin levels were lower in RA men as well as in all women. Diminution of BGP in these subjects supports the view that "low-dose" corticosteroid treatment may suppress bone formation, especially in women. Prevention or remediation of osteopenia may be monitored by BGP, if further studies validate this hypothesis with other measures of skeletal mass. PMID- 3963952 TI - Focal glomerulosclerosis and proteinuria in patients with solitary kidneys. AB - We have studied ten normotensive patients (nine male and one female, aged between 28 and 51 years) who each had a solitary functioning kidney and proteinuria. Six had undergone unilateral nephrectomy, and four unilateral renal agenesis. In each case, intravenous pyelography revealed only one functioning kidney with compensating hypertrophy. Mild to moderate chronic renal failure was present in six, and microhematuria in two. Proteinuria ranged from 1.10 to 4.10 g/24 hr, being in the nephrotic range in three patients. In seven patients, a renal biopsy showed focal glomerulosclerosis. Immunofluorescence studies demonstrated granular deposits of IgM in three and C3 in six cases, over the sclerotic areas. We suggest that the appearance of proteinuria and focal glomerulosclerosis in a patient with a solitary kidney could be due to chronic glomerular hyperfiltration. PMID- 3963953 TI - Functional dyspepsia and chronic idiopathic gastric stasis. Role of endogenous opiates. AB - Chronic idiopathic gastric stasis can be responsible for unexplained dyspepsia. Because exogenous opiates inhibit gastric emptying and endogenouslike substances are present in the gastrointestinal tract, we tested the hypothesis that increased endogenous opiate activity may be responsible for chronic idiopathic gastric stasis. Eighteen patients with chronic idiopathic gastric stasis and ten healthy volunteers were studied by gastrointestinal manometry. Scintigraphic technique also was used, during which either intravenous saline or naloxone hydrochloride were infused. Manometry showed gastric hypomotility in ten patients and duodenal hyperdyskinesia in the remaining eight patients. Naloxone did not alter gastric emptying in healthy subjects or corrected gastric stasis in patients with gastric hypomotility, while it normalized gastric emptying in patients with duodenal dyskinesia. It seems that either gastroparesis or duodenal dyskinesia can promote gastric stasis and chronic dyspepsia, and endogenous opiates participate in the pathogenesis of gastric stasis in patients with duodenal dyskinesia. PMID- 3963955 TI - Feasibility and usefulness of depression screening in medical outpatients. AB - Depression is common in medical outpatients, but the diagnosis is frequently missed. We introduced the Beck Depression Index into our clinic as a screening tool to determine the feasibility of depression screening, the prevalence of depression in our patients, and the clinical usefulness of the depression index. The questionnaire was easily implemented and well accepted by the 375 patients screened. Moderate or severe depression was identified in 32% of our patients. By several measures, the Beck Depression Index proved to be a highly useful clinical tool. It provided information significant enough to change the plan in 20% of the entire population of patients screened. The severity or presence of depression would probably have been missed without the screening. Depression screening should be considered in all primary care settings. PMID- 3963954 TI - Oxygen saturation with sleep in patients with sickle cell disease. AB - Ear oximetry was used to monitor arterial oxygenation in seven patients who had a history of frequent admissions for sickle cell crisis and were taking narcotic analgesics. Five full-night studies and seven daytime "nap" studies were performed in which sleep state was monitored by electroencephalography, and respiratory rate and tidal volume were monitored by inductance plethysmography. For all patients the mean (+/- SEM) of the median oxygenation values was 93.3% +/ 0.4% during wakefulness and 91.4% +/- 0.8% during sleep. During wakefulness the lowest saturation was 90% +/- 0.5%; during sleep there was a fall in the lowest oxygen saturation to 86.5% +/- 0.9%. In all patients a fall in oxygen saturation was associated with a decrease in respiratory depth without a change in respiratory frequency. The results indicate that in sickle cell disease oxygen saturation is lower during sleep than during wakefulness and that hypoxemia can be attributed to a fall in tidal volume. PMID- 3963956 TI - Effect of long-term azathioprine administration in adults with minimal-change glomerulonephritis and nephrotic syndrome resistant to corticosteroids. AB - Thirteen adult patients with nephrotic syndrome resistant to corticosteroid administration were treated with azathioprine daily for four years. Progressive improvement occurred in all 13 patients so that they were in complete remission after one to three years. The onset of apparent improvement was earlier and the rate of progressive improvement more rapid in patients who had selective proteinuria before therapy than in those whose proteinuria was nonselective. One patient who stopped therapy after 20 months suffered relapse but again responded when azathioprine treatment was restarted. Observation after the four-year therapeutic period ranges from three to 15 years; there have been no relapses during this time. PMID- 3963957 TI - The relevance of IgA deposits in vessel walls of clinically normal skin. A prospective study. AB - Granular deposits of IgA are known to occur in the walls of superficial vessels in apparently healthy skin of patients with primary IgA nephropathy, Henoch Schonlein purpura, or alcoholic liver disease, but the specificity of the finding is still a matter of debate. We investigated the disease specificity of these deposits in the skin of patients with kidney and liver diseases. The sensitivity of the finding for the diagnosis of primary IgA was 75%, the specificity was 88%. The sensitivity for the diagnosis of alcoholic liver disease was 71%, but the specificity was only 60%. The specificity for the diagnosis of Henoch-Schonlein purpura, primary IgA nephropathy, or alcoholic disease (in a group of 1,030 patients with various diseases) was 94%. Immunoelectron-microscopic investigation showed the IgA deposits localized within the endothelial cell and in the subendothelial rim. PMID- 3963959 TI - Overtreating the deficiency anemias. PMID- 3963958 TI - Crohn's disease in the elderly. A statistical comparison with younger patients matched for sex and duration of disease. AB - To better characterize Crohn's disease in the elderly, 24 patients ranging in age from 64 to 85 years were reviewed and compared with a younger group (20 to 61 years of age) matched for sex and duration of disease. Forty-one variables encompassing clinical, laboratory, and radiologic data and medical and surgical aspects of treatment were analyzed. The older group was characterized by a longer delay in diagnosis, more hematochezia, and a higher incidence of diverticular and cardiovascular disease. Elderly patients had less pain, less often a palpable abdominal mass, less small-bowel disease, less drug treatment, and no family history of inflammatory bowel disease. Otherwise, the disease in the two groups had similar manifestations, and no discriminating features to enable easy diagnosis in the elderly were found. Crohn's disease must be considered when evaluating older patients with diarrhea, abdominal pain, weight loss, and bleeding. PMID- 3963960 TI - Simple approach to an apparently chaotic arrhythmia. AB - Deciphering complex arrhythmias requires a strict, systematic approach. In a step by-step analysis of an electrocardiogram recorded from a patient with severe metabolic disturbances, we present a few simple suggestions that may often be helpful in electrocardiographic interpretation. PMID- 3963961 TI - Successful high-dose intravenous cytarabine treatment of parenchymal brain involvement from malignant lymphoma. AB - A patient with systemic recurrence of large-cell malignant lymphoma developed radiologic evidence of parenchymal brain metastasis. Treatment with systemic high dose cytarabine resulted in complete regression of peripheral adenopathy and complete radiologic response in the central nervous system, with normalization of the brain computed tomographic scan. This case further demonstrates the ability of high-dose cytarabine to penetrate the blood-brain barrier and achieve therapeutic drug concentrations in the central nervous system, an area that might otherwise remain a pharmacologic sanctuary for tumor cells. PMID- 3963962 TI - Abrupt change from propranolol to verapamil. Safety and feasibility in stable angina pectoris. AB - To study the safety and feasibility of abruptly changing antianginal therapy from propranolol hydrochloride to verapamil, we gave propranolol to ten patients with stable angina and coronary artery disease for 14 days, then, on day 15, we began verapamil therapy, which continued for 14 more days. Anginal frequency and nitroglycerin use were similar throughout the study. No patient had symptomatic bradycardia or atrioventricular block. Such crossover therapy is effective when propranolol is replaced by verapamil abruptly. PMID- 3963963 TI - Chest pain associated with mitral valve prolapse. Evidence for esophageal origin. AB - The cause of chest pain associated with mitral valve prolapse remains unclear. A young woman with chest pain ascribed to mitral valve prolapse is described. Response of chest discomfort to atenolol therapy had been poor. The patient's chest discomfort and concomitant esophageal spasm were provoked by intravenous infusion of edrophonium chloride during esophageal manometry. A Bernstein acid infusion test also induced her chest pain. Review of systems revealed intermittent dysphagia and postprandial heartburn. In certain patients with mitral valve prolapse, esophageal motility disorders may be the cause of chest discomfort. PMID- 3963964 TI - Methotrexate-induced pneumonitis: diagnostic value of bronchoalveolar lavage cell data. PMID- 3963965 TI - Spacer inhalers. PMID- 3963966 TI - An apparent cluster of aplastic anemia: credible science? PMID- 3963968 TI - Infarction in Wolff-Parkinson-White syndrome. Evolution of Q-wave-T-wave vector concordance. AB - Wolff-Parkinson-White syndrome often mimics myocardial infarction. Q-wave-T-wave discordance (upright T waves in the inferior leads with inferior Q waves) is normally found in Wolff-Parkinson-White syndrome as a result of secondary repolarization changes. We evaluated Q-wave-T-wave concordance as a result of an inferoposterior infarction and documented it with electrocardiographic, enzyme, and catheterization data. PMID- 3963967 TI - Use of cimetidine. PMID- 3963969 TI - Streptococcal myositis. PMID- 3963970 TI - Ankylosing spondylitis and steroid therapy. PMID- 3963971 TI - Magnesium depletion and thiazide hypokalemia. PMID- 3963972 TI - Group G streptococcal infections. PMID- 3963973 TI - Defensive law. A new perspective on informed consent. PMID- 3963974 TI - Establishing therapeutic equivalency. What is a clinically significant difference? PMID- 3963975 TI - Successful treatment of hyperuricosuric calcium oxalate nephrolithiasis with potassium citrate. AB - Calcium stone (renal) formation in patients with hyperuricosuria has been ascribed to the urate-induced crystallization of calcium oxalate. Citrate (0.5mM), added to synthetic medium metastably supersaturated with respect to calcium oxalate, was shown to inhibit heterogeneous nucleation of calcium oxalate by monosodium urate (2 mg/mL). Long-term trial with potassium citrate (60 to 80 mEq/day) was therefore undertaken to determine whether induced hypercitraturia would prevent calcium oxalate stone formation in 19 patients with hyperuricosuria. The treatment produced a sustained rise in urinary pH by 0.55 to 0.85 to the high normal range (6.5 to 7.0). Urinary citrate levels rose by 249 to 402 mg/day to approximate the normal mean value of 643 mg/day. Commensurate with these changes, urinary saturation of calcium oxalate (relative saturation ratio) and the amount of undissociated uric acid declined significantly. However, the urinary uric acid and saturation of monosodium urate remained elevated. Stone formation declined from 1.55 +/- 2.70 per patient-year to 0.38 +/- 1.22 per patient-year during mean treatment period of 2.35 +/- 0.88 years. Stones ceased to form in 16 of 19 patients during treatment. The results provide physicochemical and clinical evidence for the utility of potassium citrate in the management of hyperuricosuric calcium oxalate nephrolithiasis. PMID- 3963976 TI - Magnesium and acute myocardial infarction. Transient hypomagnesemia not induced by renal magnesium loss in patients with acute myocardial infarction. AB - Serum magnesium concentrations and the rate of urine magnesium excretion were studied in 24 patients with suspected acute myocardial infarction (AMI). Blood and urine samples were taken on admission, at three-hour intervals for the first 24 hours after admission, and every eight hours for the next 24 hours. Thirteen of the patients were found to have AMI, and the 11 who did not have AMI served as a control. During the first 32 hours, the AMI group had significantly low serum magnesium concentrations. The serum magnesium concentrations were unchanged in the control group. Results of the urine samples disproved our hypothesis that the drop in serum magnesium concentrations was due to an increased renal magnesium loss. These results indicate a magnesium migration associated with AMI, from extracellular to intracellular space. PMID- 3963977 TI - Liver involvement in the sulfone syndrome. AB - A patient being treated with dapsone developed a hypersensitivity reaction with typical features of the "sulfone syndrome," including fever, malalse, and hepatitis. All abnormalities rapidly reversed with discontinuance of the dapsone regimen and institution of prednisone therapy. Hepatic involvement may be a prominent feature of the sulfone syndrome and may be of the hepatocellular or cholestatic type. Based on our review of the Food and Drug Administration reports, this syndrome appears to be relatively uncommon, but physicians need to recognize that expression of this syndrome may be incomplete. More clinical data are necessary to better define the incidence and pathogenesis of sulfone-induced liver disease. PMID- 3963978 TI - Thalidomide effects in Behcet's syndrome and pustular vasculitis. AB - Pustular vasculitis is a new disease concept that links cutaneous, and possibly systemic, aspects of Behcet's, bowel bypass, bowel-associated dermatosis arthritis, and disseminated gonorrhea syndromes. The pathomechanism of pustular vasculitic lesion generation may relate to circulating immune complex (CIC) mediated vessel damage and serum enhancement of neutrophil migration. Thalidomide, an oral pharmaceutical available on strict protocol, has therapeutic effects based on proposed modulation of CIC- and neutrophil-mediated cytotoxicity. Thalidomide therapy was started for four patients with significant morbidity from Behcet's syndrome and for one patient with bowel-associated dermatosis-arthritis syndrome. Clinical benefit was dramatic in all patients who completed sequential four-week "on" and "off" thalidomide therapeutic cycles. In three of four patients, in vivo testing for CIC after histamine injection immunopathology converted from positive (immunoreactant deposition in dermal vasculature [four hours after histamine] and CIC-mediated vasculitis [24 hours after histamine]) to negative during therapy. No effects were noted on neutrophil migration or on the LFA-1/Mac-1/p150,95 family of glycoproteins associated with neutrophil adherence as assessed qualitatively by tritium labelling of neutrophil cell surfaces. In this small patient group, thalidomide was a clinically effective, safe (with rigid monitoring) therapy whose mechanism of action may relate more to inhibitory effects on CIC-induced vasculitis than to effects on neutrophil-mediated cytotoxicity. PMID- 3963979 TI - Minoxidil, nadolol, and a diuretic. Once-a-day therapy for resistant hypertension. AB - We tested a once-a-day antihypertensive regimen using minoxidil, nadolol, and a diuretic in 55 patients with resistant hypertension. Forty-seven patients had evidence of end-organ damage. Twelve had mild renal insufficiency (serum creatinine concentration, 2.5 +/- 0.3 mg/dL). In 34 patients, treatment with nadolol and a diuretic was started with minoxidil added one to four weeks later. In the remainder, minoxidil, nadolol, and a diuretic were begun simultaneously because of severe hypertension. Initial supine and standing blood pressure (BP) in the 55 patients were 186 +/- 4/111 +/- 2 and 180 +/- 4/108 +/- 2 mm Hg, respectively. After 7 +/- 1 weeks, BP was controlled in 46 patients (84%) with the supine and standing BP reduced to 140 +/- 3/80 +/- 1 and 134 +/- 3/80 +/- 1, respectively. In six patients, BP was controlled but intolerable side effects occurred, making the regimen therapeutically successful in 40 patients (73%). The BP remained controlled during a follow-up of 43 +/- 5 weeks. In 31 patients, BPs measured 24 hours after the last dose were not different from random measurements. Mean serum creatinine levels remained stable in the 12 patients with renal insufficiency. PMID- 3963980 TI - Peritoneal lymphomatosis with ascites. A characterization. AB - Three patients had autopsy-proved peritoneal lymphomatosis with ascites. Ascitic fluid analysis was characteristic in that the total protein level was greater than 2.5 g/dL, the lactate dehydrogenase level was greater than 225 mU/mL (the upper limit of normal for serum), and the glucose level was less than 50 mg/dL in all patients. Atypical cells were noted on ascitic fluid cytologic studies, and peritoneoscopic biopsy specimens were diagnostic of lymphoma in all three cases. Gut ulceration was present in all patients; a gastric ulcer, a duodenal ulcer, and a colonic ulcer were found to have invasion by lymphoma at autopsy. No patient lived long enough to receive chemotherapy. Perhaps if the diagnosis of lymphoma could have been made earlier, their lives could have been prolonged. PMID- 3963981 TI - Branhamella catarrhalis as a lower respiratory tract pathogen in patients with chronic lung disease. AB - To determine the possible role of Branhamella (formerly Neisseria) catarrhalis as a respiratory pathogen, we screened quality sputa (defined by cellular criteria) that showed numerous gram-negative cocci on Gram's stain for the presence of B catarrhalis. In an eight-month period, 52 isolates of B catarrhalis were identified in adults attending a hospital for chest diseases. During this period B catarrhalis was the third most common potential pathogen isolated from sputa. Twenty-two patients (42%) had associated patchy bronchopneumonic or lobar infiltrates. All had negative blood cultures and a generally mild clinical course. The majority of strains (73%) of B catarrhalis produced beta-lactamase and were resistant to penicillin and ampicillin. Isolates (including beta lactamase-producing strains) were susceptible to erythromycin, tetracycline, and trimethoprim-sulfamethoxazole. These studies demonstrate that in patients with chronic lung disease, the presence of B catarrhalis in sputum can be suspected on the basis of a Gram's stain and may be associated with the development of new pneumonic infiltrates. Since these organisms frequently produce beta-lactamase, empiric antimicrobial therapy should include agents other than the penicillins. PMID- 3963982 TI - Erythromycin ototoxicity and acute psychotic reaction in cancer patients with hepatic dysfunction. AB - Two cases of severe hearing loss due to intravenous administration of erythromycin lactobionate are described. Documented, bilateral sensorineuronal hearing loss developed in both patients and gradually improved when the dose of erythromycin was decreased. Neither patient had severe renal dysfunction (documented clearances of 25 to 30 mL/min), but both had hepatic dysfunction with elevated bilirubin levels. Additionally, both were receiving other ototoxic drugs concurrently. Both patients also had an acute psychotic reaction that was temporally related to the ototoxicity and high-dose erythromycin therapy. PMID- 3963983 TI - Therapy of Mycobacterium marinum infections. Use of tetracyclines vs rifampin. AB - We describe four patients with Mycobacterium marinum infections who did not respond to two- to six-week courses of therapy with tetracycline, minocycline, and doxycycline. All four patients had prompt responses to therapy with either rifampin alone (two patients) or rifampin in combination with ethambutol. Results of antimicrobial sensitivity tests may be helpful in guiding therapy. Rifampin may be the drug of choice for treatment of these infections. PMID- 3963985 TI - Medical house staff performance in physical examination. AB - One hundred twenty patients admitted to the medical service and presented at one of two teaching conferences were examined to evaluate the nature of errors made in physical examination by house officers. The overall mean error rate per patient was 5.8% +/- 0.6% for residents and 6.4% +/- 0.6% for interns. The mean error rate for cardiac examination was significantly worse than for respiratory, abdominal, or thyroid examinations. An additional 40 patients selected for abnormal cardiac or neurologic findings were found to have a significantly higher mean error rate in those areas than did the first group of patients with less abnormal findings. Agreement in physical findings between investigators was significantly better than between investigators and house officers. Resident performance in physical examination correlated with estimates of relative time spent by attending physicians at the bedside reevaluating physical findings, but not with class-ranking and inservice examination scores. Educational implications are discussed. PMID- 3963984 TI - Occult ectopic secretion of corticotropin. AB - The clinical, biochemical, radiographic, and morphologic features of ectopic corticotropin (ACTH)-dependent Cushing's syndrome are often indistinguishable from those of Cushing's disease (pituitary-dependent Cushing's syndrome). We encountered ten patients whose ectopic ACTH-secreting neoplasms were not clinically apparent for two months to 12 years after the diagnosis of hypercortisolism or in whom the site remains unknown. Five of these patients underwent unnecessary pituitary microsurgery, and a sixth was referred for surgery. The occult ectopic ACTH syndrome occurs with equal frequency in men and women and hypokalemia is present in 60%, in contrast to the female predominance and rarity of hypokalemia in Cushing's disease. We emphasize the importance of selective venous sampling for ACTH to establish the correct diagnosis. Thirty nine similar cases from the literature help characterize this syndrome further. PMID- 3963986 TI - Hyperosmolar coma treated with intravenous sterile water. A study of three cases. AB - Three patients with hyperosmolar coma were treated with intravenous isotonic saline, dextrose, and hypotonic saline solutions. The development of pulmonary edema and increasing hypernatremia precluded the further use of sodium solutions, and the presence of severe hyperglycemia made the further use of dextrose solutions undesirable. To provide further solute-free fluid, intravenous sterile water was administered through a central venous catheter. The hyperosmolar state improved, and all patients survived without biochemical evidence of hemolysis or clinical evidence of cerebral edema. PMID- 3963987 TI - Some issues in the design and interpretation of 'negative' clinical studies. AB - The objective of most comparative trials is to show a "positive" result whereby one treatment is significantly better than another. However, the motivation behind some trials is to demonstrate a "negative" result that two treatments are equally effective. Such "equivalence" trials usually arise in comparing a new conservative treatment with an effective but more intensive standard therapy that has potential adverse side effects. Retrospective sample-size tables were provided to determine whether a completed study showing no significant difference between treatment effects is large enough to justify a true-negative conclusion. In this article, the sample sizes given in the decision-making tables are compared with those derived using a confidence-interval approach, the method we recommend for interpreting completed trials in order to judge the range of true treatment differences that is reasonably consistent with the observed data. Some implications of this comparison are discussed in respect to the interpretation of negative studies. Selected biostatistical principles involving the proper use of the tables are also presented. Finally, we distinguish between a completed negative study and an equivalence study, which is designed from the onset to demonstrate the comparability of different treatments. Important design considerations and sample-size tables are given for planning equivalence trials. We show that very large numbers of patients are usually needed to establish with a high degree of confidence that two treatments have comparable efficacy. PMID- 3963988 TI - Canada-Cronkhite syndrome associated with systemic lupus erythematosus. AB - A 43-year-old woman with a history of systemic lupus erythematosus manifested severe diarrhea, generalized gastrointestinal polyposis, pigmentation, and onychodystrophy, which were typical of Canada-Cronkhite syndrome. The exacerbation of systemic lupus erythematosus, presenting with hemolytic anemia and subsequently with profound proteinuria, was seen during the course of this syndrome. The patient achieved complete symptomatic remissions of both entities for more than four years following prednisolone therapy; the resolution of the gastrointestinal polyps was confirmed histologically. This case showed that this syndrome could be completely reversible in its course and that it might have an exogenous cause, as previously suggested. PMID- 3963989 TI - [Missing persons with hidden corpse. Criminalistic and criminologic aspects for practice and research]. PMID- 3963990 TI - [Reconstruction of a suicide by a homemade firearm]. AB - A 34 years old man shot himself by a selfmade muzzle-loader. He pluged one end of a waterpipe, used a cylindrical lead shot (Cal. 1.2 cm, length 2.15 cm, mass 22.7 g), special black powder (about 4 g, from fire-crackers; powder with an admixture of aluminium) and kindled the weapon in front of his chest by a slowmatch. He died immediately by retained missile of chest. The weapon flew away like a rocket. Unused projectils and powder (found in the flat) and the uninjured pipe allowed to copy the event. Velocity and energy of shot and weapon were determined, also the recoil of the pipe and the highest force of a hand to hold it fast. Experimental investigations and calculations correspondet well to the findings af the case. PMID- 3963991 TI - [Postmortem gastrointestinal ruptures in burn cadavers]. AB - The report informs on ruptures within the area of the gastro-intestinal tract of two siblings (2 and 3 years of age) that were fatally burned in their apartment. The ruptures are obviously pointing to an "explosive-like" evaporation of the watery part of the gastro-intestinal contents under the influence of the heat, at impeded pressure balance through shrinking of the esophagus caused by the heat in the upper area and the closure of the pylorus. Of significance here is surely also the shrinking of the gastro-intestinal wall caused by the heat and the thin abdominal walls which were not likely to have acted as "heat insulators". These findings are a supplement to the burn hematoma of the stomach as described by Berg and Schumann (1985). PMID- 3963992 TI - Suboptimal growth with hyper-accurate ribosomes. AB - Mutant bacteria with hyperaccurate ribosomes support their excessive accuracy of translation in vitro by dissipating 1.5 to 2.5 cognate ternary complexes per peptide bond formed. This is to be compared with a dissipation rate close to 1.1 for wild-type ribosomes. Here, we have tested the hypothesis that a corresponding loss of translational efficiency in vivo would lower the growth rate of the mutants. Such a growth inhibitory effect would explain why the lower accuracy of wild-type ribosomes is more fit. Our data show that as expected the mu of the hyperaccurate mutants is smaller than that of wild-type bacteria. In contrast, during glucose-limited growth in chemostats there is not the same simple correlation between growth yield and ribosomal efficiency for the hyperaccurate mutants. PMID- 3963993 TI - [Characteristics of pathogens and clinico-epizootiological features of Mycoplasma dependent bronchopneumonia of swine]. PMID- 3963994 TI - Mycoplasma infections. PMID- 3963995 TI - Significance of ureaplasma infection in infertility of turkeys. PMID- 3963996 TI - Investigation of goose mycoplasmas. PMID- 3963997 TI - [Experimental studies on Mycoplasma pneumoniae antigen detection by enzyme-linked immunosorbent assay (ELISA)]. PMID- 3963998 TI - [Pathogenicity of Ureaplasma urealyticum]. PMID- 3963999 TI - [Etiological role of genital Mycoplasma in non-gonococcal urethritis and complications]. PMID- 3964000 TI - [Prevalence of Mycoplasma hominis and Ureaplasma urealyticum in patients with impaired fertility]. PMID- 3964001 TI - Detection of mycoplasmas in cell cultures and biologicals. PMID- 3964002 TI - [Serological diagnosis of Mycoplasma infection of swine]. PMID- 3964003 TI - [Demonstration of Mycoplasma bovis as a contaminant in live virus vaccine]. PMID- 3964005 TI - Experiences from eradication of Mycoplasma hyopneumoniae infection by tiamulin treatment. PMID- 3964004 TI - Decontamination of cell lines by selective elimination of mycoplasmas. PMID- 3964006 TI - [Effect of Acholeplasma laidlawii on the bacterial infection of white mice]. PMID- 3964007 TI - [Importance and control of Mycoplasma bovis as a pathogen of mastitis and diseases in calves and young cattle in contaminated regions]. PMID- 3964008 TI - [Occurrence of Mycoplasma in cattle in the Potsdam area]. PMID- 3964009 TI - Arthritis in calves caused by mycoplasmas. PMID- 3964010 TI - [Killing of Mycoplasma bovis in milk by heat]. PMID- 3964011 TI - [Mycoplasma bovis abortion of cows following experimental infection]. PMID- 3964012 TI - [Virulence of Mycoplasma californicum for the udder]. PMID- 3964013 TI - [Manifestation of Mycoplasma californicum in cattle organs]. PMID- 3964015 TI - [Virulence of bovine Mycoplasma species for cattle udders]. PMID- 3964014 TI - The use of ELISA for detection of antibodies against mycoplasmas and ureaplasmas in milk of mastitic cows. PMID- 3964016 TI - Frequency of mycoplasmae in the semen of reproduction bulls. PMID- 3964017 TI - [Antibiotic sensitivity of ureaplasma of cattle]. PMID- 3964018 TI - Diagnosis of Mycoplasma meleagridis infection on turkey-rearing farm. PMID- 3964019 TI - Efficacy of some Mycoplasma meleagridis antigens in the rapid diagnosis of mycoplasmosis in turkeys. PMID- 3964020 TI - The family history approach to diagnosis. How useful is it? AB - Determining the rate to which various psychiatric illnesses are familial is one widely used method for validating diagnostic categories and determining the likelihood of genetic or nongenetic patterns of transmission. Data for these studies can be collected through direct interview of all available relatives (the family study method) or by obtaining information indirectly from the patient and other family members (the family history method). Information based on direct interview is usually considered to be more accurate, although the family history method permits collection of data on a larger and more comprehensive group of relatives. We explored the extent to which data collected by these two methods were in agreement. In general, the results confirmed the usefulness of the family history method. Although it has some limitations, such as underreporting, it has respectable sensitivity for many major diagnoses when broad but well-specified criteria are used. PMID- 3964021 TI - Understanding the clinical heterogeneity of major depression using family data. AB - For major depression, putative subgroups have been defined by age at onset, clinical severity, symptom patterns, or the presence of other disorders (comorbidity), yet the high degree of overlap in clinical presentation makes it difficult to determine which combination of criteria for defining subgroups best predicts familial aggregation. In dealing with this overlap, we found that only early age at onset, or major depression with an anxiety disorder or secondary alcoholism, were independently related to increased risk of major depression in relatives. Once the effects of these proband factors had been taken into account, endogenous, delusional, melancholic, or autonomous symptom patterns, recurrent depression, history of hospitalization, and suicidal ideation or attempts in probands were not associated with increased risk of major depression in relatives. PMID- 3964022 TI - Long-term reliability of diagnosing lifetime major depression in a community sample. AB - Limited information is available on the reliability of diagnostic assessments in community populations. This study analyzed the 18-month test-retest stability of lifetime major depression determined from the Schedule for Affective Disorders and Schizophrenia-Lifetime Version using the Research Diagnostic Criteria. Overall, the reliability among the 391 female subjects was poor. Clinical status during the 18-month interval influenced reliability, while demographic, psychosocial, and interviewer characteristics were unrelated. The women who reliably reported lifetime episodes of depression were consistent about details such as medication use, but were inconsistent about other features, eg, number of episodes, length of longest episode, and age at first episode. The results suggest the need for caution in analyzing data on the lifetime prevalence of depression in community samples. PMID- 3964023 TI - Inventory identification of cyclothymia. IX. Validation in offspring of bipolar I patients. AB - We present the ninth in a series of validation studies that support the effectiveness of the General Behavior Inventory (GBI) in identifying cyclothymia. This study assessed the potential utility of the GBI in family and offspring studies by evaluating its ability to satisfy three prerequisites for use in such research: (1) identification of cyclothymia familially related to bipolar I disorder, (2) use with young adolescents, and (3) "insensitivity" to the effects of nonaffective psychopathology and parental nonaffective disorder in the offspring of control probands. The GBI and a blind, structured diagnostic interview were administered to 37 offspring of bipolar I patients and 21 offspring of psychiatric control patients, Twenty-seven percent of the offspring of bipolar patients, but none of the control offspring, were found to have bipolar forms of affective disorder, primarily cyclothymia (24%). Concordance between the GBI and interview-derived diagnoses was 95% to 97%, with 98% specificity and 80% to 90% sensitivity, depending on cutting score location. Together with the results of previous studies, the findings suggest that the GBI holds promise for the identification of cyclothymia in several research and clinical contexts. PMID- 3964024 TI - Reliability and validity of the symptoms of major depressive illness. AB - In two consecutive studies, we examined the interrater reliability and then the concurrent validity of interview ratings for individual symptoms of major depressive illness. The concurrent validity of symptoms was determined by assessing the degree to which symptoms observed or reported during an interview were observed in daily behavior. Results indicated that most signs and symptoms of major depression and melancholia can be reliably rated by clinicians during a semistructured interview. Ratings of observable symptoms (signs) assessed during the interview were valid indicators of dysfunction observed in daily behavior. Several but not all ratings based on patient report of symptoms were at variance with observation. These discordant patient-reported symptoms may have value as subjective reports but were not accurate descriptions of observed dysfunction. PMID- 3964025 TI - Reliability of follow-up assessments of depressed inpatients. AB - Twenty-one depressed inpatients were followed up for six months after hospital admission. One rater assessed the patients at monthly intervals, and an independent rater assessed symptoms and treatment for the same period at the end of the six-month follow-up. Ratings of audiotapes of the monthly interviews by a third rater achieved excellent reliability. Fair to excellent agreement was also found between the monthly and six-month interviews. Reliability was lowest during the first month of the follow-up period. Unexpectedly, at the six-month interview more rather than fewer symptoms were reported for the most remote part of the follow-up interval. Our results suggest that at the six-month interview patients had reevaluated their functioning for the immediate postdischarge period. PMID- 3964026 TI - Lithium Information Center. One model of a computer-based psychiatric information service. AB - The Lithium Information Center has been functioning as a specialized psychiatric information service for nearly ten years. Over the years, the center has disseminated information about the medical uses of lithium to psychiatrists and other physicians, to patients, to the family and friends of patients, and to a host of other individuals and organizations including pharmacists, lawyers, nurses, social workers, mental health centers, clinics, and support groups. To encourage the development of similar psychiatric information services, we outline the center's methods of acquiring, organizing, and disseminating lithium information. PMID- 3964027 TI - Hypochondriacal fears and beliefs in medical and law students. AB - We administered two validated scales of hypochondriacal concerns (the Illness Behavior Questionnaire and the Illness Attitude Scales) to 60 medical students and matched law students. Medical students took more precautions about their health and attended more to somatic symptoms, but the prevalence of hypochondriacal fears, beliefs, and attitudes did not differ significantly between the two groups. Five students (8.3%) in each group scored in the range of patients with hypochondriacal neurosis. Most of the students were free of these concerns. The prevalence of hypochondriacal concerns in medical students was substantially lower than the previously reported incidence over four years of study; this supports the previous observation that most of these reactions are short lived. PMID- 3964029 TI - Genetics of somatoform disorders. AB - I investigated the contribution of hereditary factors in somatoform disorders. Fourteen monozygotic and 21 dizygotic index twins and their co-twins were personally interviewed. The results showed a concordance of 29% in monozygotic and 10% in dizygotic pairs. However, similarity in childhood experience seemed to influence the concordance rates. Thus, even if somatoform disorders appear familial, the transmission may be environmental. Furthermore, the study showed a high frequency of anxiety disorders, especially generalized anxiety disorders, in the co-twins of somatoform-disordered twins. PMID- 3964028 TI - Hypochondriasis. An evaluation of the DSM-III criteria in medical outpatients. AB - We attempted to integrate the DSM-III criteria for hypochondriasis with the clinical literature and derived six positive and two negative diagnostic criteria. Seven of these were assessed in a random sample of 92 medical outpatients by means of a self-report questionnaire, structured interview, and medical record audit. The results are in accord with previous work: there appears to be considerable internal validity and consistency in the syndrome in that disease conviction, disease fear, bodily preoccupation, and somatic symptoms are significantly intercorrelated. The three hypochondriacal attitudes (conviction, fear, and preoccupation) were not statistically related to the number of medical diagnoses in the patients' medical records. Depressive symptoms, as measured by the Beck Depression Inventory, were highly correlated with the other hypochondriacal symptoms. The hypochondriacal syndrome in these patients appears to be consistent with the clinical disorder described in DSM-III. PMID- 3964030 TI - Cell cycle peculiarities of the Ehrlich ascites tumour as revealed by cell counting and flow cytometry. AB - Based on own investigations general principles of cell cycle analysis by quantitative microscopic methods are discussed. Cell cycle peculiarities of the Ehrlich ascites tumour (EAT) are demonstrated. The numerical data yield information on the underlying type of growth expressed by the logistic function (Verhulst-Pearl). The effective tumour development starts with an exponential phase. In EAT the 5th day is regarded as representative for this stage. Then after a transition phase a steady state is reached. The 11th day after transplantation reflects best this phase of tumour development. By flow cytometric measurements DNA frequency distributions can be obtained in dependence of tumour age. The interpretation of the practically useful height of the second frequency peak in the histograms is discussed in relation to the underlying type of growth. The evaluation of the measurements reveals a characteristic change of the relative duration of the cell cycle phases G1, S, G2 and of the percentage of cells within these phases. Multiparameter single cell measurements complete the cytometric cell cycle analysis in relation to the position of cells in the cell cycle and allow a distinction between quiescent and proliferating cells. Finally the application of the parameters assayed on the biological model is extended to tumours in man. PMID- 3964031 TI - Biochemical markers in ovarian cancer. AB - Fucose and sialic acid were measured in 41 patients with malignant ovarian tumors and in 25 patients with benign tumors. Supplementary, serial determinations done in 20 patients, with advanced ovarian cancer subjected to primary or secondary surgery (optimal tumor debulking) and subsequent chemotherapy enables to suggest the possibility to use these parameters as markers in monitoring ovarian cancer evolution and treatment. PMID- 3964032 TI - Epidemiologic characteristics of gastric stump cancer in the GDR 1971-1980. AB - Epidemiologic features of carcinoma of the gastric remnant are described based on 3024 such cases reported to the National Cancer Registry of the German Democratic Republic from 1971 to 1980. Although the incidence of gastric cancer in general declined during this period this was not the case with gastric stump carcinoma. The sex ratio of gastric stump carcinoma showed a male predominance of 5.9: 1(2,583: 441). The age at diagnosis of gastric remnant cancer was somewhat lower than that of other gastric cancers. Some regional differences were discerned in its frequency which could not readily be explained. Approximately 20% of cases were diagnosed in stages I and II but radical surgery was only possible on 14% of all cases. The crude five year survival rate in 1975 was 2.5% overall and 15% on the radically operated patients. The epidemiologic data concerning gastric stump cancer demonstrate its importance in the context of the entire picture of stomach cancer and make clear the unsatisfactory diagnostic and therapeutic situation with respect to this form of carcinoma. PMID- 3964034 TI - [Drug analysis by polarographic methods. 26. Polarographic determination (DPP) of the antileprosy agent diaphenylsulfone (dapsone)]. PMID- 3964033 TI - Carcinogenicity of 1-methyl-3(p-chlorophenyl)-1-nitrosourea and its 1-methyl trideuterated derivative in rats. AB - The carcinogenic activity of 1-methyl-3(p-chlorophenyl)-1-nitrosourea (Cl-MPNU) and its 1-methyl trideuterated analog (Cl-MPNU-d3) was compared by intragastric administration to hooded rats of equimolar doses of both compounds. A 100% frequency of forestomach tumors was observed in both groups. However, the mean latency period of the animals treated with Cl-MPNU-d3 was significantly longer (P less than 0.01). The results suggest the occurrence of a deuterium isotope effect in nitrosoureas but not as distinct as in nitrosamines. PMID- 3964035 TI - [Structure-activity relationships of acronycin]. PMID- 3964036 TI - [Anti-inflammatory 2,3-dihydro-1H-pyrrolizines. 3. Aminomethylation and arylthiolation of 6,7-diaryl-2,3-dihydro-1H-pyrrolizines]. PMID- 3964037 TI - [Quantitative determination of gelatin in pharmaceutical formulations by HPLC with fluorometric detection]. PMID- 3964038 TI - Metacarpophalangeal subluxation: locked finger. AB - The so-called locked finger is a rarely reported condition that can be easily recognized when its typical picture is borne in mind: painful locking of a finger, making it impossible to fully extend the metacarpophalangeal joint, and a lateral displacement of the extensor tendon at this level. Radiological findings may include abnormal shape of the metacarpal head, free intra-articular bodies, sesamoid bones at the volar plate level and degenerative changes in the metacarpophalangeal joint. There is consistently a previous history of repeated light manual effort. This condition generally affects men, aged 50 or older. Two of the three cases presented (three of the four affected fingers) were successfully treated by means of gentle manipulation under regional nerve blocking. The patient who refused treatment remains with a painless locked finger 1 year later. There has been no recurrence with either of the two manipulated patients (three fingers). PMID- 3964039 TI - EMG-biofeedback therapy for rupture of the extensor pollicis longus tendon. AB - EMG-biofeedback therapy was attempted in five cases of EPL tendon rupture with residual postoperative functional disabilities such as weakness of extension or extension lag of the thumb, and improvement was obtained in muscle strength, range of motion, and performance of daily activities. EMG-biofeedback therapy is a method which, utilizing visual or auditory information, supplements and facilitates the intrinsic feedback mechanism in the human body. This method is applied as a treatment to improve motor dysfunction. The effectiveness of the therapy is elucidated by a neural motor control theory based on the sensory-motor feedback loop. PMID- 3964040 TI - Continuous passive motion after knee-joint arthrolysis under catheter peridural anesthesia. AB - The results of arthrolysis of a stiff knee are often poor because postoperative pain prevents the early active mobilization that is so essential. Adequate analgesia may be ensured by the use of continuous anesthesia via a peridural catheter; in combination with continuous passive motion, such analgesia is able to maintain, and often improve, the range of movement obtained at surgery. Twenty two patients treated in this way showed improvement in the range of movement between 39 degrees and 120 degrees. Patients with post-traumatic knee stiffness achieved an average improvement in the range of movement of 93%, while those with stiffness following infection improved by only 55% on the average. The preoperative loss of movement does not appear to determine the end result; the etiology of the stiffness is more important. PMID- 3964041 TI - The total condylar knee prosthesis: a review of 71 operations. AB - Seventy-one operations are reviewed, in which knees were replaced with the total condylar prosthesis. The follow-up period ranged between 1 and 7 years, with an average of 3.25 years. Osteoarthritis was diagnosed preoperatively in 53 knees and rheumatoid arthritis in 18. The results obtained in cases of osteoarthritis were better than those in cases of rheumatoid arthritis. The prognosis was adversely affected by obesity, preoperative flexion contracture of 30 degrees or more, wound-healing problems, wound infection, and postoperative manipulation under general anesthesia. The overall results were excellent in 48% of cases (34 knees), good in 28% (20 knees), fair in 11.3% (eight knees), and poor in 4.3% (three knees). Failure was experienced in 8.4% of cases (six knees). PMID- 3964042 TI - The static stabilizing function of the popliteal tendon in the knee. An experimental study. AB - We investigated the importance of the anterior cruciate ligament (ACL), its two components (the AMP and PLP), and the lateral compartment ligaments with special attention to the popliteal tendon (PT) in relation to valgus-varus, axial rotation, and anterior-posterior instability. Mobility patterns were drawn from 15 osteoligamentous knee preparations after successive transection of the structures. Even when combined lesion involved the lateral collateral ligament (LCL), the PT, and the posterolateral capsule (PLC), anterior tibial displacement was not effected until the ACL was cut. The lateral structures acted as secondary restraints to anterior displacement, and prevented simultaneous anterolateral rotation during application of the anterior force. LCL and PLC transection affected varus stability in full extension, and instability improved on additional section of the PT, even if the ACL remained intact. Maximum instability after combined lateral lesion occurred at 40 degrees of flexion, whether the ACL was transected or not. Further flexion caused a rapid decrease of instability. The PT was shown to effectively restrain varus instability from 0 to 90 degrees of flexion. It was experimentally established with regard to axial rotation that marked posterolateral instability was impossible with an intact PT. Maximum instability was recorded at 30 degrees of flexion after combined lesion to the lateral structures. Even in the extension, considerable posterolateral instability was observed. The restraining effect of the PLC was prominent in extension. PMID- 3964043 TI - Cyclic impacts on heel strike: a possible biomechanical factor in the etiology of degenerative disease of the human locomotor system. AB - The cyclic impacts induced by heel strike when walking were studied using both a high-resonance-frequency force plate and a low-mass skin-mounted accelerometer. The data were computer analyzed. The results showed that during normal human walking, the locomotor system is subjected to repetitive impact loads at heel strike, lasting about 5 ms and consisting of frequency spectra up to and above 100 Hz. The natural shock-absorbing structures in the musculoskeletal system have viscoelastic time-dependent mechanical behavior, which is relatively ineffective in withstanding sudden impulsive loads. Degenerative joint diseases may thus be seen as a late clinical result of fatigue failure of the natural shock absorbers, submitted to deleterious impacts over a period of time. PMID- 3964045 TI - The operative treatment of fresh ruptures of the acromioclavicular joint (Tossy III). AB - We give a preliminary report of ten patients with fresh dislocations of the acromioclavicular joint (Tossy III). All ten were operated with suture of the torn ligaments and indirect fixation of the acromioclavicular joint with a monocerclage wire passed around the coracoid process and the clavicle. Removal of metal was done 8 weeks later. None of the wires broke, and there were no problems with wound healing. Control X-rays under stress revealed stable acromioclavicular joints in all cases. PMID- 3964044 TI - Scar formation after skeletal muscle injury. A histological and autoradiographical study in rats. AB - The formation of a connective tissue scar was studied autoradiographically 2-42 days following standard contusion injury in the gastrocnemius muscle of 30 rats. The rats were injected intraperitoneally with 3H-labeled proline 4 h before the muscle samples were taken. On day 2 the majority of cells in the injured area were identified as inflammatory without radioactive labeling. Abundant labeling was observed, however, over the extracellular substance, and moderate labeling with 3H-proline in the cells identified as fibroblasts or their precursors. During the first 2 weeks the number of fibroblasts increased and the majority of them were labeled with silver grains, which were also present over the connective tissue matrix. Six weeks after injury only a few fibroblasts showed labeling, and no labeling was observed extracellularly in the connective tissue. Thus, it seems that the synthesis of extracellular connective tissue components in injured skeletal muscle occurs as early as 2 days after trauma, is intensive between days 5 and 21 after trauma, and decreases markedly during the following 3 weeks. PMID- 3964046 TI - Gas-producing infections after lower-limb amputation because of ischemia. AB - During the period 1972-1982, 22 patients with gas-producing infections after lower-limb amputation because of ischemia were reviewed. In 16 cases bacteria of the genus Clostridium could be cultured. Treatment consisted of hyperbaric oxygen, surgical debridement, and antibiotics. The incubation period was 1-11 days after the primary amputation, and the duration of the infection 2-31 days, significantly lower among 14 patients with diabetes mellitus. There was no difference in the course of clostridial and nonclostridial infections. No deaths were attributable to gas-forming infection. PMID- 3964047 TI - Patellar height and patellofemoral congruence. AB - The patellar tendon/patella ratio and the patellofemoral congruence was estimated in 118 knees. There was a statistically significant positive correlation between the two measurements, high-riding patella occurring with patellofemoral incongruence. PMID- 3964048 TI - Aggressive fibromatosis. Report of two cases with rare clinicopathological manifestations. AB - Two cases of aggressive fibromatosis are described, one with tricentric origin and with the first tumor originating in the hand, the other with malignant transformation into a myxoid fibrosarcoma, grade III. The primary treatment of aggressive fibromatosis should be wide excision, and the follow-up should be long, taking into account the possibility of multicentricity and the risk of malignant transformation. PMID- 3964049 TI - Recurrent traumatic dislocation of the hip in a child: significance of early hip arthrography. AB - The authors describe a case of a recurrent posterior traumatic dislocation of the hip in a child in whom early arthrography demonstrated a large defect of the posterior capsule. The authors emphasize the necessity of prolonged immobilization and long-term follow-up. The operation of the patient was performed on the 7th day after the third recurrence of the dislocation. Revision and suture of the capsular defect from Gibson's approach were done. PMID- 3964050 TI - Entrapment of the median nerve and brachial artery after supracondylar fractures of the humerus in children. AB - Four patients, all children, with dislocation and entrapment of the median nerve and brachial artery following supracondylar fractures of the humerus are described. Circulation and neural function were restored in all cases by operation. Exploration of the neurovascular structures is recommended if dislocation and entrapment of the median nerve and brachial artery are suspected. PMID- 3964051 TI - Fractures of the proximal femur in patients with total hip endoprostheses. AB - Between October 1982 and October 1983 three patients were admitted to the Orthopedic Clinic of the University of Vienna who had suffered complicated fractures of the proximal femur, with concomitant loosening of previously implanted total hip endoprostheses. To replace them we used the KMFTR Endoprosthesis. The Kotz Modular Femur and Tibia Reconstruction Endoprosthesis was originally developed for the surgical management of bone tumors. The implantation followed the principle of intramedullary splinting and transfer of force. Fragments of bone adhering to the surrounding muscles were positioned around the endoprosthesis and the periosteum was carefully reconstructed. After a follow-up period of 1 year on the average the patients were very content with the results and were essentially not restricted in their scope of activities. Walking capacity and mobility were satisfying at last checkup. Radiographically, a consolidation of the femur with solid bony incorporation and a firm fit of the prosthesis were observed. PMID- 3964052 TI - Subperiosteal osteoid osteoma: a case report. AB - A 32-year-old woman with persistent knee pain, similar to that caused by a meniscus tear, was found to have a subperiosteal osteoid osteoma of the medial condyle of the knee. Osteoid osteoma with this presentation and location does not seem to have been reported previously. PMID- 3964053 TI - The surgical treatment of the upper quadrant syndrome. PMID- 3964054 TI - Treatment of fecal incontinence in children with spina bifida: comparison of biofeedback and behavior modification. AB - Two experiments compared the effects of biofeedback training to behavior modification in the treatment of 33 children aged 5 to 16 who had fecal incontinence secondary to myelomeningocele. Biofeedback involved providing visual feedback and rewards for successively stronger sphincter contractions during training sessions and requiring 50 sphincter contraction exercises daily. Behavior modification involved attempting to defecate immediately after the evening meal each day, receiving a reward for defecating in the toilet without an enema or suppository, and receiving an enema if unsuccessful for two consecutive days. In experiment I, eight children were offered biofeedback alone in an attempt to replicate previous studies. Biofeedback alone was found insufficient; addition of behavior modification was necessary. Experiment II systematically investigated the relative contribution of these two treatments. Overall, patients who received only behavior modification for three months showed as much clinical improvement as patients who received behavior modification plus biofeedback. This suggests that previous reports, because they have not controlled for nonspecific treatment effects, have overestimated the value of biofeedback in this population. However, a subgroup of patients (27%) were identified for whom biofeedback provided additional, specific benefit. These were children who had spinal cord lesions below L-2 and who initially had two or more bowel movements daily. The combination of behavior modification and biofeedback resulted in a greater than 50% reduction in the frequency of incontinence for 64% of patients, and results were well maintained at follow-up one year later. PMID- 3964055 TI - Cervical motion assessment: a new, simple and accurate method. AB - Accurate assessment of head motion can be a useful tool in clinical studies. Since the head moves on a combination of axes in the cervical spine, evaluation of neck motion is difficult. Assessment of cervical mobility is further complicated because of inadequate reference points on the head from which to measure. Hence, numerous methods for approximating cervical range have been devised. These methods include visual estimation, radiographic analysis, schematography, photography, and a variety of goniometer devices. Disadvantages of these techniques are lack of accuracy and objectivity, radiation exposure, expense, time consumption, and equipment availability. To measure cervical mobility, a standard gravity goniometer with spirit level and head adapter was used, which allowed stabilization. The gravity goniometer can be obtained in a variety of sizes at most hardware stores. The head adapter consists of a wood block into which an arc is carved and elastic straps suspended for securing on the head. The reliability of this instrument was tested and compared to the universal goniometer, and correlation coefficients were determined. When two experienced examiners used the universal goniometer to assess cervical motion, significant intraclass correlation coefficients (ICC) were found with three of the six criteria measures (p less than 0.05). When one experienced and one novice examiner used the gravity goniometer with head adapter, highly significant ICC values were found for all six criteria measures (p less than 0.01). A single experienced examiner comparing both instruments on the same subjects produced significant ICC values in four of the six criterion measures (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964056 TI - Functional independence in quadriplegia: critical levels. AB - The purpose of this study was to examine the self-care abilities of individuals with quadriplegia at two critical functional levels, once they resumed community living. Twenty-nine individuals with quadriplegia (17 with wrist extensors as the lowest functional muscle and 12 with triceps), were surveyed three months to four years after discharge, to determine self-care independence and change in ability since discharge in ten self-care areas. Personal care assistance, use of equipment, and present living situation also were surveyed. Results indicated that subjects with triceps as the lowest functioning muscle had significantly greater independence levels in self-care activities than those with wrist extensors. Changes in abilities from discharge to follow-up were noted for both groups, especially in the areas of bowel and bladder care, dressing, and mobility activities. Most subjects lived at home with their family and used personal care assistance to accomplish part of their self-care. Equipment use was decreased upon community living for both groups. It is concluded that the functioning of triceps is a significant determinant for functional independence in self-care tasks. PMID- 3964057 TI - Dynamic splinting: a systematic approach to the selection of elastic traction. AB - Elastic traction is an important but occasionally misapplied component of upper extremity dynamic splints. Information regarding a systematic approach for selection of elastic traction has been limited. A biomechanical analysis of dynamic splinting methods was done to identify factors that might help educate therapists in the proper application of elastic traction. Material properties of elastic traction were measured with a mechanical testing system capable of accurately identifying physical properties of various substances. Results of this analysis indicated that specific spring constant values for clinically used bands ranged from 134 to 531 g, original length values ranged from 0.7 to 3.2 in., the consistency of bands labeled as identical by the manufacturer was generally very good, and each band's ability to maintain its material properties with repeated elongation was similar from band to band and showed gradual diminution after several hundred repetitions. These data were combined with theoretical constructs of splint fabrication to devise a simple and logical method for analysis and determination of elastic traction requirements for various diagnostic applications. A goniometer, ruler, and spring scale are the only tools necessary to perform the analysis. Simple charts depicting forces and moments provide identification of the appropriate rubber band for application. PMID- 3964058 TI - Disability scales: assessment of reliability. AB - Modified or newly developed disability scales have to be assessed for their validity in terms of an appropriate standard and for reproducibility--inter- and intraobserver variability and intrasubject variability. For ordinal scales with more than two points or categories, correlation or regression coefficients are appropriate estimates of validity. An assessment of the sensitivity and specificity of such a scale is not feasible. Indices of proportion agreement or correlation analysis are frequently used to assess the reproducibility of disability scales. These procedures do not, however, correct for chance-expected agreement between two or more sets of observations. In a study of a 31-point ADL (activities of daily living) index used to measure the level of disability in patients with chronic diseases, scores independently rated by two observers were strongly correlated (r = 0.962), yet the two sets of observations were significantly different. An estimate of kappa statistic, that corrects for chance agreement, showed that there was in fact a poor (36.3%) overall agreement between the observers. It is concluded that the correlation coefficient often overestimates the degree of true agreement, may conceal significant disagreements, and may give misleading information about reproducibility. The kappa statistic should always be used in the assessments of reproducibility of disability scales. Agreement between more than two sets of observations can also be assessed by estimating kappa. PMID- 3964059 TI - Aphasia: its effect on marital relationships. AB - The primary purpose of this study was to determine if a relationship exists between marital satisfaction and knowledge of aphasia of the spouse of a stroke patient. Other factors such as the severity of the aphasia, length of time poststroke, and length of marriage were also examined. The subjects, 16 spouses of aphasic patients, were grouped according to severity of the aphasia (mild, moderate, severe). Spouses completed a Knowledge of Aphasia questionnaire and pre/poststroke forms of a Marital Satisfaction Scale (MSS). The questionnaire measured spouse understanding of aphasia, while the MSS examined changes in spouse attitudes toward their marriages after the patients became aphasic. Neither spouses' knowledge of aphasia nor its severity was related to their marital satisfaction. However, there was a significant negative change between the pre/poststroke MSS scores. Spouses of mildly impaired patients were less knowledgeable about aphasia than were those of severely impaired patients. Results are discussed in terms of the counseling needs of families of aphasic patients. PMID- 3964060 TI - Mobile arm supports: criteria for successful use in muscle disease patients. AB - Twenty-nine subjects who had been fitted with mobile arm supports 6 months to 11 years prior to the initiation of this study were evaluated to determine criteria for successful use of such supports. All subjects were diagnosed as having Duchenne muscular dystrophy or spinal muscular atrophy. Three methods were used to collect data: 1) review of medical charts, 2) interview with patient and family member(s), and 3) observation of the patient in his wheelchair for sitting stability, adjustment and control of the mobile arm support, and speed and efficiency in self-feeding with and without the support. The physical criteria previously established for optimal use were met by the successful users in the sample except for presence of elbow flexion contractures. Among those who had curvature of the spine, spinal fusion increased the percentage of successful users of mobile arm supports. Successful use declined with muscle grades of below poor in elbow flexors. The incidence of success was greater when the tasks of self-feeding, driving a motorized wheelchair and performing leisure skills could be accomplished only with the support. Primary reasons for early rejection of the support were related to attitude toward the equipment, influence of the social support system, and patterns of activities performed with the equipment. PMID- 3964062 TI - Prosthetic rehabilitation in unilateral high above-elbow amputation and brachial plexus lesion: case report. AB - Rehabilitation in persons with high above-elbow amputation presents a considerable prosthetic problem, especially in those who also have brachial plexus lesion. A case is reported of a patient having left above-elbow amputation and left brachial plexus lesion who was successfully fitted with a hybrid prosthesis with a myoelectric hand. PMID- 3964061 TI - Renal function in spinal cord injury: a preliminary report. AB - To investigate the effect of current bladder management techniques on renal function in spinal cord injury (SCI), we followed 99 patients by frequent examinations, excretory urograms, and iothalamate short renal clearances. Fifty eight percent of the subjects emptied their bladders by catheter-free methods (bladder retrained), 32% by intermittent self-catheterization, and 10% by indwelling urethral catheters. All remained clinically well, but more and earlier excretory urogram abnormalities occurred in the intermittent self-catheterization group. Twenty-one percent of the intermittent self-catheterization group but only 5% of the bladder retrained group had excretory urogram abnormalities. Declines of more than 10% in short renal clearance values were noted in 30% of intermittent self-catheterization patients and in 15% of bladder retrained patients. Our preliminary data support the need for close surveillance and follow up after SCI rehabilitation, even in patients appearing clinically well. These data also suggest that renal function can be preserved with current bladder management methods, with bladder retraining having a slight edge over intermittent self-catheterization. PMID- 3964063 TI - Low anterior counterweights to improve static rear stability of occupied wheelchairs. AB - Rear tipping accidents in wheelchairs are a common problem, the likelihood of which may be increased by the combination of a wheelchair with low stability and an occupant with altered body morphology, such as a person with lower limb amputations. This study tests the hypothesis that counterweights on the wheelchair footrests significantly increase static rear stability. In addition to pilot work indicating the amount and positioning of effective counterweights, ten normal subjects were studied on a tilting platform in both lightweight and conventional wheelchairs, with and without a 5-kg weight on the footrests. The angles at which the front casters lifted off the platform increased from a mean of 28.6 (+/- 2.7) degrees to 34.8 (+/- 3) degrees in the conventional wheelchair (p less than 0.01) and from 18.2 (+/- 2.7) degrees to 24.6 (+/- 2.5) degrees (p less than 0.0001) and 15.5 (+/- 2) degrees to 23.4 (+/- 2.2) degrees (p less than 0.0001) in the lightweight chair with the axle in the low-posterior and low anterior positions, respectively. A 5-kg weight on the footrests increased the average rear stability of lightweight and conventional chairs by 6.2 degrees (31.9%). PMID- 3964064 TI - Acoustic myography as a control signal for an externally powered prosthesis. AB - Contracting skeletal muscle produces sounds that are easily recorded with a standard microphone. The recording of these sounds is known as acoustic myography, or AMG. As a control signal for an externally powered prosthesis, some advantages of AMG over surface EMG are: there is no need for direct skin contact; the AMG signal is unaffected by changes in skin impedence; AMG intensity is high enough to produce a 50 mV output from a standard microphone, requiring less amplification and electrical shielding; the AMG signal is qualitatively less sensitive to placement on the muscle than EMG. Disadvantages, such as the susceptibility of AMG to interference by extraneous environmental noise, are relatively easy to overcome. To demonstrate this, we have constructed a myoacoustically controlled prosthetic hand, whose tristate control via a single microphone (vs differential control) proves its feasibility in the more difficult case. The control circuitry for this device costs less than $50. The existing device utilizes a free-standing hand; a prosthetic shell which will allow comparison of AMG vs EMG control is currently being designed. The two patients who have tried it have learned to open and close the hand reliably after only three minutes of practice. Protocols are being established for functional assessment of AMG control. PMID- 3964065 TI - Ethics in rehabilitation medicine. PMID- 3964066 TI - Gonadal denervation. PMID- 3964067 TI - Nocturnal penile tumescence and serum testosterone levels. AB - Ten patients with chronic epilepsy were selected; five had high and five had low total serum testosterone levels. Each patient slept for two nights in the sleep laboratory. EEG monitoring and measurements of nocturnal penile tumescence were carried out during sleep. A clear relationship between both total and free serum testosterone levels were found with nocturnal penile tumescence. FSH, LH, SHBG, and prolactin showed no relationship. The five patients with low serum testosterone levels all showed reduced sexual activity. PMID- 3964068 TI - Males disposed to commit rape. AB - The hypothesis that the preferential rape pattern belongs among the courtship disorders like voyeurism, exhibitionism, and toucheurism was tested. The study consisted of two experiments. The first compared 11 rape-prone males, who were most likely afflicted with the preferential rape pattern, with 11 sexually normal controls on penile response to narratives that depicted scenes in which the individual engaged in behavior typical of voyeurs, exhibitionists, or toucheurs. Narratives depicting normal tactile interaction (short of intercourse) with a genuinely participating woman, normal intercourse, and sexually neutral scenes were also presented. The rape-prone males responded more to the voyeuristic situations than did the controls. The standing of the normal intercourse situations on the scale of erotic value, relative to the other above-mentioned situations, was lower for the rape-prone males than for the normal controls. A second experiment compared 12 rape-prone males, who most likely demonstrated the preferential rape pattern, with 12 males with (other) courtship disorders and 12 sexually normal controls. Penile response to narratives depicting the individual involved in pretactile erotic activity, in tactile sexual activity short of intercourse, or in having intercourse was compared. Each situation was presented in two modalities depicting either a genuinely participating woman or a woman fearful of the individual. The penile responses of the rape-prone males, as well as those of males with other courtship disorders, differentiated less between sexual interaction with a fearful woman and such interaction with a participating woman than did the penile responses of normal controls. There was no significant difference in this respect between the rape-prone males and males with other courtship disorders. PMID- 3964069 TI - Level of postassault sexual functioning in rape and incest victims. AB - In a systematic study, 372 sexual assault survivors and 99 women with no history of sexual assault were interviewed with regard to their sexual histories to determine the incidence and types of sexual dysfunctions in these two samples. The women also completed the Sexual Arousability Inventory. Of the sexual assault survivors, 58.6% of the women were experiencing sexual dysfunctions, with 71% of them reporting that their sexual assaults were related to their development of sexual problems. In contrast, only 17.2% of the nonassaulted women reported experiencing any sexual problems. Differences in the types of sexual problems experienced by the two samples are noted, as are treatment implications. The sensitivity of the Sexual Arousability Inventory to assault-related sexual dysfunctions was affected by the educational level of the sexual assault survivors. PMID- 3964070 TI - On the expression of H-Y antigen in transsexuals. AB - Histocompatibility-Y (H-Y) antigen, the presumptive inducer of the mammalian testis, is present in the cells of normal males and not in the cells of normal females. Recent reports have implied that patients with transsexualism exhibit H Y antigen phenotypes at variance with those of normal males and females and, thus, that H-Y serology might provide a tool for the diagnosis and study of the transsexual condition. We therefore evaluated blood and testicular cells from 21 male-to-female transsexuals using conventional and monoclonal H-Y antibodies. We found no evidence of abnormal H-Y phenotype. Five of the patients were interviewed postoperatively by two examiners and rated for the diagnosis of transsexualism. Three of the five were rated primary transsexual by one or both examiners, and two were rated secondary transsexual. PMID- 3964071 TI - Endocrine evaluation of forty female-to-male transsexuals: increased frequency of polycystic ovarian disease in female transsexualism. AB - A retrospective study of 40 female-to-male transsexuals was performed to investigate the frequency of endocrine dysfunction prior to hormonal treatment with testosterone. Two patients had laparoscopic evidence of polycystic ovarian disease (PCOD) prior to androgen treatment. Nine additional subjects had clinical evidence of PCOD, including ultrasonographic evidence of multicystic and enlarged ovaries in three patients and/or evidence of hirsutism and oligomenorrhea associated with increased androgen levels and/or an increased plasma luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio. Two subjects had evidence of gonadal dysgenesis. Plasma levels of testosterone, prolactin, LH/FSH ratio, and dehydroepiandrosterone sulfate were significantly increased in 30 female transsexuals prior to testosterone treatment when compared to normal adult female controls studied in the early follicular phase of the menstrual cycle. These data indicate that female transsexuals have an increased incidence of endocrine dysfunction (32.5%) which should be investigated prior to hormonal treatment. PMID- 3964072 TI - Sex of interviewer, place of interview, and responses of homosexual men to sensitive questions. AB - Effects of sex of interviewer and place of interview on the responses of 57 AIDS patients and 145 other homosexual men were studied. Data on sensitive topics were collected by five male and three female medical officers at places convenient to respondents. Male physicians recorded fellatio more frequently, but female physicians recorded younger ages of initiating homosexual activities and more frequent use of certain recreational drugs. These differences apparently were due to different patterns of sexual contact and drug use in four cities. Patients with AIDS tended to be interviewed in hospitals and doctors' offices, other men tended to be interviewed in hotel rooms, and patients tended to be different from other men. After adjustments were made for confounding, sex of interviewer and place of interview seemed to have little influence on the answers obtained. PMID- 3964073 TI - Childhood cross-gender behavior and adult homosexuality. PMID- 3964074 TI - In vitro studies on the embryotoxic potential of (bis[tri-n-butyltin])oxide in a limb bud organ culture system. AB - (Bis[tri-n-butyltin])oxide (TBTO) was studied for its toxic potential on prenatal development. The effect of this substance on limb differentiation (mouse embryos) in organ culture was evaluated. In the organ culture system using mouse limb buds, TBTO interfered with morphogenetic differentiation at doses as low as 0.03 microgram/ml (5 X 10(-8)M). This is one of the lowest concentrations of a substance ever found to be active in this in vitro system. The in vitro studies suggest a high embryotoxic potential of TBTO. The low embryotoxicity found in the in vivo studies may be due to limited exposure of the embryos by the original unmetabolized substance. PMID- 3964075 TI - Effects of cadmium exposure on zinc and copper distribution in neonatal rats. AB - Tissue zinc and copper concentrations undergo marked changes in the neonatal rat during the first several weeks of life and it was of considerable interest to study the effect of cadmium exposure on these ontogenic changes. Long evans rats received either 2 or 10 mumol cadmium chloride per kg SC at 9 days of age and were sacrificed at 20 or 36 days of age. Tissue copper and zinc concentrations in cadmium-treated rats were compared to those of age-matched controls for statistically significant changes. The tissue affected, the element altered and the direction of change in concentration, increased (+) or decreased (-), are summarized for the two dosing groups (age at dosing, age at sacrifice in days): 2 mumol/kg (9, 20): kidney Zn (+), blood Zn (-), cerebral Cu (-), cerebellar Cu (+); 2 mumol/kg (9, 36): blood Zn (-); 10 mumol/kg (9, 20); liver, kidney, cerebral and cerebellar and blood Zn (-), cerebellar Cu (+); 10 mumol/kg (9, 36): liver and heart Zn (+), blood Zn (-); liver and heart Zn (+), blood Zn (-); kidney, cerebral, cerebellar and heart Cu (+). Changes in tissue zinc or copper concentrations produced by cadmium treatment could not be accounted for by the direct replacement of these elements by cadmium and may be due to alterations in transport of these elements. These results indicate that early life exposure to low levels of cadmium can have large and persistent effects on the distribution of the essential metals, copper and zinc. PMID- 3964076 TI - Acute renal dysfunction by cadmium injected with cysteine in relation to renal critical concentration of cadmium. AB - In order to study the critical concentration of cadmium (Cd) in acute renal dysfunction following Cd, male mice were injected IV with Cd complexed with cysteine. The critical concentration was 10 micrograms Cd/g wet weight in whole kidney and it was the same as that for Cd-thionein (Cd-Th), which may suggest that the toxicity of Cd-Th is due to Cd ions liberated from Cd-Th in the kidneys. Renal Cd concentration was at first higher than the critical concentration, but decreased to the critical concentration by 24 h after administration. As an index for renal dysfunction, the uptake of p-aminohippurate (PAH) by renal cortical slices in vitro was sensitive, and showed the different time-course from those of urinary protein and glucose levels. The results suggest the usefulness of PAH uptake as an index. Incidental to the renal dysfunction, renal calcium levels exhibited a marked increase. PMID- 3964077 TI - Transformation of prostatic epithelial cells and fibroblasts with cadmium chloride in vitro. AB - Primary cultures of fibroblasts and epithelial cells were established from rat ventral prostate (RVP), canine (CP), baboon (BP), and human (HP) prostates, and were used in an assay system to evaluate cadmium chloride (CdCl2) cytotoxicity in vitro. Fibroblasts were always more susceptible to CdCl2 cytotoxicity than the epithelial cells of the same species. There was a distinct species variability to CdCl2 cytotoxicity, with RVP cells being greater than 200 times more susceptible than HP. Primary cultures treated with CdCl2 were subcultivated to establish cell lines. Only RVP fibroblast and epithelial cells resulted in permanent cell lines. Two fibroblast and two epithelial cell lines were derived from CdCl2-treated RVP cell cultures. The epithelial cell lines possessed tonofilaments, desmosomes and keratin. All four cell lines were resistant to CdCl2, had different karyotypes and an excess of chromosome 13. These results demonstrate the transforming potential of cadmium on prostate cells. The role of metallothionein and the significance of extra chromosomes 13 are discussed as possible factors of cadmium resistance. PMID- 3964078 TI - Induction of chromosomal aberrations in the Syrian hamster by insecticides tested in vivo. AB - The insecticides demeton, dimetoat, dichlorovos, endosulfan, trichlorofon, carbaryl, lindane, methoxychlor, propoxur and malathion were examined for their ability to induce chromosomal aberrations in the bone marrow cells of the Syrian hamster (Mesocricetus auratus) treated in vivo. Mutagenicity of commercial preparations was examined at four doses: LD50; 1/2, 1/5 and 1/10 LD50. The positive control was an IP injection of cyclophosphamide to hamsters at a dose of 40 mg/kg body wt. Demeton, dichlorovos and endosulfan gave positive results. Malathion, dimethoate and the mixture of methoxychlor and propoxur were weakly clastogenic; at some doses these compounds induced statistically significant increases in the number of aberrations. Trichlorfon and the mixture of carbaryl and lindane were negative in this test. PMID- 3964079 TI - Modulation of lectin-stimulated lymphocyte agglutination and mitogenesis by estrogen metabolites: effects on early events of lymphocyte activation. AB - Pharmacological doses of estrogens such as 17-beta estradiol (17-beta E) and diethylstilbestrol (DES) suppress cell-mediated immunity in vivo. In this report, we investigated the direct in vitro effects of 17-beta E and its major metabolites on lymphocyte proliferation in response to the T cell lectin phytohemagglutinin (PHA). PHA-induced lymphocyte agglutination, an early event indicative of active, cytoskeletal-dependent membrane alterations, was monitored in conjunction with blastogenesis. Without exception, the effects of individual estrogen metabolites on the PHA-induced agglutination occurring within minutes were accompanied, at every concentration of compound, by equivalent effects on the blastogenic response of activated cells measured after several days. This observation suggested a role for estrogens in modulating lymphocyte activation at the cell surface rather than through cytosolic receptor-mediated events. As suggested by previous studies with quinone metabolites of benzene, the catechol estrogen metabolite 2-OH estrone (2-OH E) was significantly more potent than the parent compound at suppressing lymphocyte proliferation in vitro and in vivo. PMID- 3964080 TI - Influence of ethanol on the in vivo and in vitro metabolism of nitriles in mice. AB - The effect of ethanol on metabolism of 20 nitriles was studied in vivo and in vitro in mice. The hepatic microsomal metabolizing activity for nitriles was at a maximum 13 h after ethanol dosing (4.0 g/kg). Using microsomes from mice pretreated with ethanol under the above conditions, enhancement of the in vitro metabolism of nitriles was 1.00-1.83 compared with the glucose-treated control. When mice were orally given nitriles 13 h after dosing with either ethanol (4.0 g/kg) or glucose (7.0 g/kg), the hepatic metabolizing activity of nitriles for the ethanol-treated group was always higher than that for the glucose group, although no change in the content of hepatic microsomal P-450 was observed between the two groups. However, ethanol added to the incubation mixture inhibited the in vitro metabolism of most nitriles. The results in the present study suggest that ethanol can enhance the acute toxicity of nitriles. PMID- 3964081 TI - Feeding of butylated hydroxytoluene to rats caused a rapid decrease in blood coagulation factors II (prothrombin), VII, IX and X. AB - Male Sprague-Dawley rats were fed a diet containing 1.2% butylated hydroxytoluene (BHT) for 1-7 days, and blood coagulation factors II, VII, VIII, IX and X, and platelet aggregation were measured. The plasma concentrations of factors II, VII, IX and X were significantly reduced in a time-dependent fashion when BHT was administered for 2-7 days and haemorrhages in epididymis were found in rats given BHT for 4-7 days. On the contrary, thrombin-induced and calcium-required aggregation of washed platelets was unchanged throughout the experiment. These results suggest that factors II, VII, IX and X rapidly decrease immediately after the administration of BHT, but hypoaggregability of washed platelets reported previously may be a secondary defect caused by bleeding. PMID- 3964082 TI - Pharmacokinetics of pentachlorophenol in man. AB - Pentachlorophenol (PCP) was given orally to three volunteers at single doses of 3.9, 4.5, 9, and 18.8 mg. Daily urinary excretion of PCP and PCP conjugated to glucuronic acid was monitored using gas chromatography with electron capture detection (GC/ECD). Based on first-order elimination kinetics an elimination half life of 20 days was derived. To eliminate interference by the uncontrolled absorption of PCP from the environment 0.98 mg 13C-PCP was taken by one of the volunteers. PCP levels in urine and plasma were determined using mass spectrometry (GC/MS) with negative chemical ionization. An elimination half-life of 17 days was found in both urine and blood. The collected data were used to calculate the clearance of PCP: a value of 0.07 ml/min was found. The long elimination half-life of PCP is explained by the low urinary clearance due to the high plasma protein binding (greater than 96%) and the tubular reabsorption. The pH-dependency of the elimination of PCP was investigated, and a distinct increase in the daily excretion was observed following alkalinization by oral administration of sodium bicarbonate. In order to elucidate the role of the enterohepatic circulation as a possible pool for PCP in humans, the bile of cholelithiasis patients with postoperative T-drainage was investigated for PCP and compared with the corresponding urine and plasma levels, but no accumulation of PCP in the enterohepatic circulation could be observed. The daily elimination and plasma levels of PCP in a group of individuals without a specific exposition were found to range from 10 to 48 micrograms/day and 19 to 36 micrograms/1, respectively. PMID- 3964083 TI - Biocompatibility of haemoperfusion. AB - To evaluate the influence of haemoperfusion on haemodynamics, complement system, leucocyte and thrombocyte concentration, a controlled study was performed in three groups of five dogs each. During the first 30 min of haemoperfusion with columns containing cellulose-coated activated charcoal, a significant decrease of mean aortic pressure, cardiac output and stroke volume was observed, while heart rate and total systemic resistance decreased. A comparable phenomenon, although to a much lesser extent, was observed during perfusion using columns containing polystyrene resin. Perfusion with columns containing cellulose-coated activated charcoal caused a significant decrease in total haemolytic complement, indicating activation of the complement system. A significant decrease in the leucocyte and thrombocyte concentration due to sequestration of granulocytes and thrombocytes in the columns was observed during the first 30 min of perfusion in both groups. Pulmonary leucostasis, without decrease of arterial oxygen tension, occurred during perfusion with columns containing cellulose-coated activated charcoal. Both the simultaneous occurrence and the transient character of the haemodynamic changes, complement activation and sequestration of granulocytes and thrombocytes in the perfusion column suggest a relationship between these various changes. The results stress the importance of close monitoring of the haemodynamic parameters of the intoxicated patient, particularly during the early phase of haemoperfusion. PMID- 3964084 TI - Hydroxylation of dibutylnitrosamine in the human liver and intestinal microsomal fractions. AB - The metabolism of the bladder carcinogen N-nitroso-di-n-butylamine (NDBA) was studied in microsomal preparations of tissues of patients of both sexes, aged 59 69 years undergoing abdominal surgery. Samples of liver, ileum, and colon were of normal histological appearance. For comparison, samples of rat liver and small intestinal mucosa microsomes were included in the study. Using 1-14C-labeled NDBA, the biotransformation to hydroxylation products retaining the nitroso group, NDBA-2-OH, NDBA-3-OH, and NDBA-4-OH, respectively, was investigated by reversed phase HPLC. In order to separate these metabolites, pooled samples were analysed by normal phase HPLC. The rate of hydroxylation of NDBA was found to be 5.5 times higher in rat liver microsomes compared to those from human liver (2.86 +/- 0.29 vs 0.52 +/- 0.03 nM X min-1 X mg-1). NDBA-3-OH proved to be the major metabolite formed (greater than 80% of total metabolites). The metabolism of NDBA was low but detectable in seven out of nine specimens of human gut, 0.1-0.5 nM X mg-1 in 1 h of incubation, and of the same order of magnitude in rat intestinal tissue (0.4-0.6 nM X mg-1). PMID- 3964085 TI - Lead content of fetal tissues after maternal intoxication. AB - A female employee was exposed to lead dust for 8 h daily from 4. 5. 1982 to 20. 5. 1982. During this time conception occurred (1st day of last menses 4. 5. 82). Acute symptoms of lead intoxication were not observed in this subject but were in other employees. Measurements of lead content were started after the end of exposure and continued for 6 months until normal values were obtained. Because of the half-life of nearly 20 days for lead elimination from blood the estimated body burden at the end of exposure was about 1200 ppb. The fetal tissue samples contained between 0.4 (brain) and 7.9 (liver) micrograms lead/g dry weight. The fetal lead was mainly stored in bone, blood and liver. From the results given a delayed elimination of fetal lead is suggested. PMID- 3964086 TI - [Changes in the myocardial mitochondria in the dynamics of ventricular fibrillation (based on scanning electron microscopic data)]. AB - Left ventricle of the rabbit heart was studied in the scanning electron microscope 1,2 and 5 minutes after the heart fibrillation induced by an impulse electrical current. It is found that as long as the fibrillation developed the degree of the structural heterogeneity of the heart muscle increased, the swelling of mitochondria and rough damage of their membranes occurred. PMID- 3964087 TI - [Pulmonary artery stenosis with an intact interventricular septum]. AB - 15 hearts with pulmonary artery stenosis with an intact interventricular septum (PAS with IIVS) were studied morphologically and morphometrically. The results were evaluated separately according to the type of the defect: with a noncomplicated valvular stenosis of pulmonary artery (PA); with a combined valvular and infundibular stenosis of PA. Every of these types of PAS with IIVS has characteristic features of morphological structure and all possess common anatomical signs: constriction at one of the levels of circulation from the right ventricle to the lesser circulation, normal geometric structure of the cone and myocardial hypertrophy of the right ventricle. Leading cause of the obstruction of the right ventricle effluent part, regardless of the PAS with IIVS type, is a hypertrophy of the supraventricular crest and its parietal projection. As distinct from the defects on the conus-truncus, complex of PAS with IIVS is characterized by a normal spatial orientation of the supraventricular crest. PMID- 3964088 TI - [Morphology of cancer of the cervix uteri and surrounding tissues after preoperative intracavity therapy with high-energy 252Cf radiation sources and 60Co]. AB - Comparative morphological study of uterine cervix carcinoma in 21 patients after a intracavity radiotherapy by 252Cf and in 18 patients treated with 60Co is performed. Total focal dose in a point A in both cases was 30 Gy. Morphometric study with the calculation of a volume correlation between stroma and tumour parenchyma in the two main groups and a control (untreated) group with a subsequent determination of a damage index has been done for the assessment of therapy. Both sources of radiation had an approximately similar efficiency in the treatment of superficial exophytic forms of tumour growth. 252Cf was biologically more efficient in the treatment of the deeply invasive forms of growth. The index of damage in 252Cf and 60Co was 96.5 and 84, respectively. Likewise the alterations in the surrounding normal uterine tissues after the intracavity irradiation with fast neutrons were more pronounced than those provoked by 60Co. PMID- 3964089 TI - [Morphometric equivalents of progesterone-induced changes in the endometrium]. AB - The progesterone level in the peripheral blood and morphometrical analysis of the endometrial functional layer were carried out in 8 cases of surgically removed intramural uterine sarcoma. A statistically significant high correlation between the two indexes allow recommending morphometrical methods for practical use if more precise knowledge of the lutein body hormonal deficiency is needed. PMID- 3964090 TI - [Reye's syndrome]. AB - An observation of Reye's syndrome in a 4.5-years-old boy developing against the background of varicella and disturbed immune status is described. Ultra-acute evolution of the syndrome prevented clinical diagnosis. Brain oedema, fat degeneration of the liver, kidney, and heart were found at the necropsy. PMID- 3964091 TI - [Neuroseptic form of listeriosis in a 19-year-old man]. AB - Information on the spread of listeriosis, enzymatic and immunological properties of the genus Listeria are given. Morphology and clinical course of the neuro septic form of listeriosis in a man of 19, is described. The disease developed rapidly and resulted in the patient's death due to destructive encephalitis in the region of paraventricular parts of the brain and cerebellum destruction. Acute monocytic (histiocytic) granulomas are found in the internal organs. PMID- 3964092 TI - [Neurocutaneous melanoblastosis]. AB - An observation of a congenital dysontogenetic disease--neurocutaneous melanoblastosis in a 1-year 9-month-old girl is described. The condition was characterized by multiple skin nevi and infiltration of meninges and brain matter with pigment-forming cells. The death occurred from brain damage. PMID- 3964093 TI - [Dilatation of the coronary arteries and coronary heart disease in middle and old age]. AB - The study of the main coronary arteries dilatation of 500 patients who died from different forms of coronary heart disease in the advanced and senile age is performed. Combined coronarographic and WHO standard anatomical method as well as a back-sight morphometrical analysis were used. It is established that the dilatations of main coronary arteries are of a focal-segmentary type with a decreasing frequency of a segmental damage in a distal direction. The anterior interventricular branch of the left coronary artery is most liable to dilatation. Close correlation between the main coronary arteries dilatation and myocardial infarction in aged and senile persons are revealed. PMID- 3964094 TI - State-of-the-art immunomodulation. PMID- 3964095 TI - Zinc transport during hemodialysis. AB - Zinc transfer during hemodialysis and plasma zinc concentrations in hemodialysis patients were examined. Fifteen volunteer outpatients undergoing hemodialysis showed significant increases in plasma zinc from 74.0 +/- 7.8 to 88.1 +/- 9.7 micrograms/dl after a 5-h dialysis. The increase was mainly the result of hemoconcentration as evidenced by a significant increase in the hematocrit and total serum protein during dialysis, but was also due to diffusion. To study the changes resulting from diffusion, zinc was measured in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. There was a significant (p less than 0.01) increase in the plasma zinc of the arterial blood from 74.7 +/- 8.1 to 80.2 +/- 6.5 micrograms/dl, but a nonsignificant decrease in the dialysate zinc from 10.6 +/- 2.5 to 9.5 +/- 5.9 micrograms/dl. Zinc diffused across the dialyzer from the dialysate to the blood in 12 cases and into the dialysate in three others. PMID- 3964096 TI - Can plasma concentration of middle molecules contribute to assessment of adequate dialysis treatment? AB - The aim of this study was to confirm or to reject whether plasma concentrations of individual fractions of middle molecular weight substances can become parameters for an adequate dialysis treatment and whether there exists a relation between that and some symptoms and signs in patients on regular dialysis. No changes in clinical condition, plasma concentration of middle molecules, or metabolic state after 5 years of short-time dialysis schedule were established. No difference was found in the plasma concentration of middle molecules after 6 months of continuous ambulatory peritoneal dialysis and in patients undergoing hemodialysis treatment. There was also no difference in glomerular filtration rate, blood urea concentration, dialysis index, and duration of regular dialysis treatment in patients with a middle molecular fraction 2 level lower and higher than 5.5 U/L. Elimination of fractions 2-4 and 6 by a 1-m2 Cuprophan coil dialyzer was similar to the elimination of creatinine. Only patients with acute respiratory infection had a fraction 2 higher than controls. Neither conventional parameters nor plasma concentrations of middle molecules can be indicators of an adequate dialysis. The well-being of patients and their metabolic state are the only criteria. PMID- 3964097 TI - Membrane plasma separation through small-area, hollow-fiber filters. AB - The filtration capabilities of small polypropylene hollow-fiber plasma filters with membrane areas ranging from 100 to 1,000 cm2 have been investigated. It is found that the filtration flux per unit membrane area is approximately proportional to the wall shear rate gamma w at least up to gamma w = 7,500 s-1. As a result, the total filtration flow rate increases very little when the number of fibers is increased as the increase in membrane area is offset by the decrease in shear rate, but it increases with the fiber length L as L 2/3. Hemolysis occurs when the transmembrane pressure exceeds a certain threshold, but this threshold is itself an increasing function of shear rate. As a result, it is possible to circulate high blood flow rates even in very small filters (100 cm2) without hemolysis, provided the fiber length is below a critical value. PMID- 3964098 TI - Electrophoretic control of concentration polarization in membrane plasmapheresis. AB - Membrane plasmapheresis is the separation of plasma from whole blood using microfiltration membranes. A major operating problem of membrane plasmapheresis is concentration polarization, the buildup of retained cells or solutes on the membrane surface. In this study, an electric field was used to control concentration polarization by transporting the negatively charged cells and solutes away from the membrane surface. Plasma flux and protein concentrations were measured before and after an electric field was applied. The electric field strength ranged from 0.32 to 1.50 V/cm, and the process conditions of blood hematocrit, transmembrane pressure drop, and average shear rate at the membrane surface were kept constant at 30%, 63.5 mm Hg, and 550 s-1, respectively. The plasma flux increased (10-50%) linearly with the increases in electric field strength, but the plasma protein concentrations in the ultrafiltrate decreased. The electric field dispersed the concentration polarization layer only enough to allow solvent (electrolytes and water) to pass, thus diluting the plasma and decreasing the protein concentration. PMID- 3964099 TI - A central venous (W-B-W) catheter for multipurpose vascular access in children. AB - A central venous (W-B-W) catheter has been developed for vascular access in children of all ages and sizes. The catheter design and implantation technique permit nonsurgical bedside adjustment of catheter position and ease of removal. Multiple possible uses include intravenous fluid administration, blood sampling, central venous pressure monitoring, and plasma exchange therapy in addition to hemodialysis. Twenty-seven W-B-W catheters were placed in 24 patients in a 12 month period. The catheter provided adequate blood flow for hemodialysis. Seven catheters were removed nonelectively in five patients. One episode of catheter associated sepsis occurred after renal transplantation in a patient on immunosuppressive therapy. It is concluded that the W-B-W catheter is a relatively safe, multipurpose, pain-free acute vascular access for children, which may also suffice for chronic hemodialysis. PMID- 3964100 TI - Determination of plasma C3a des Arg levels after blood contact with foreign surfaces. AB - The products of complement activation, including C3a, C4a, C5a, and their des Arg derivatives, have been used by many investigators as indicators of blood or foreign surface bioincompatibility, e.g., during hemodialysis. One problem encountered is that after extracorporeal circulation over some dialysis membranes very high C3a levels (5,000-10,000 ng/ml) are generated. To the authors' knowledge the only presently available C3a des Arg RIA kit is provided by Upjohn Diagnostics (Kalamazoo, MI, U.S.A.), which covers an assay standard range of 20 500 ng/ml. Since Upjohn's assay procedure manual does not contain a recommended dilution technique the authors undertook a study to determine the best method. The diluents tested include physiologic saline, normal plasma, phosphate-buffered saline-gelatin, and the Upjohn precipitating agent provided in their kit. The results show that only dilution by normal plasma gave reliable results. The use of the other three diluents resulted in an overestimation of C3a levels. Therefore it is important to know the dilution technique used when comparing the results of membrane C3a generating ability presented by different authors. Furthermore, comparison of different membranes where plasma samples in some cases do not require dilution (e.g., polyacrylonitrile membranes) with those requiring dilution (e.g., regenerated cellulose membranes) will lead to distorted results if an accurate technique is not used. PMID- 3964101 TI - Colostomy control device. AB - Temporary or permanent colostomy produces many difficulties such as continuous fecal flow, odor, skin irritation, rash, edema, and uncleanliness. Efforts to resolve these difficulties have not had much success. The present work describes the development of a new colostomy control device and its successful application to eight patients. The device is removable and allows the patients to empty their bowels naturally. Following the bowel movement and cleaning of the stoma, the device is reapplied. The patient remains continent and experiences a psychological uplift from being able to feel the urge for bowel movements. The application of the device is easy and leads to no complications. PMID- 3964102 TI - Phonocardiographic evaluation of total artificial heart valve movement. Correlation with pressure waveforms. AB - Two categories of inflow and outflow valve closure sounds are present in the Jarvick-7 model of the Utah total artificial heart. A presystolic inflow valve closure sound occurs at the end of ventricular filling, resulting from a transient rise in intraventricular pressure above that in the atrium. A second inflow valve closure sound follows, associated with the onset of mechanical systole with a rapid rise in intraventricular pressure. A mid- to late systolic outflow valve closure sound occurs at the end of ventricular ejection, resulting from a transient fall in intraventricular pressure below that in the aorta. A second outflow valve closure sound follows, associated with the onset of mechanical diastole with a rapid fall in intraventricular pressure. Under operating conditions where either ventricular filling or ejection is not complete, the presystolic and midsystolic sounds are absent. Thus, regulated heart driver parameters as well as preload and afterload to the extent that they influence ventricular filling and emptying will determine the presence and sequence of valve sounds. PMID- 3964103 TI - Abstracts from the International Symposium on Therapeutic Plasma Exchange and Selective Plasma Separation. June 18-20, 1985, Homburg/Saar, F.R.G. PMID- 3964104 TI - Persistent vegetative state and behavioral deficit. PMID- 3964105 TI - Persistent vegetative state and head trauma. PMID- 3964106 TI - Benign focal amyotrophy. PMID- 3964107 TI - Involvement of the nervous system in hairy-cell leukemia. PMID- 3964108 TI - Clinical and oculographic examinations of saccadic eye movements in the diagnosis of multiple sclerosis. AB - Saccades were examined clinically and with an improved version of infrared reflection oculography in 79 patients with multiple sclerosis (31 definite, 17 probable, 31 possible cases). With regard to employing saccade recordings in the diagnosis of multiple sclerosis, suitability of saccadic parameters and examination technique for routine use was investigated. Accuracy and peak velocity of 30 degrees and 20 degrees saccades detected mild abnormalities most reliably. Latencies were not reliable enough for routine examinations. The yield of pathology with infrared reflection oculography was improved by using separate normal ranges for abduction, adduction, and interocular differences. Additional examination of vestibulo-ocular reflex suppression seemed to be a reliable supplement to saccade testing, while smooth-pursuit testing cannot be recommended for routine diagnosis. Clinical examination of saccades revealed about half of the dissociated and half of the conjugate hypermetric disorders. PMID- 3964109 TI - Evoked potentials in trigeminal neuralgia associated with multiple sclerosis. AB - A 49-year-old man with definite multiple sclerosis suffered an episode of right sided trigeminal neuralgia (TN) of two weeks' duration, unaccompanied by any other clinical symptoms or signs of exacerbation. Serial evoked potentials, obtained before, during, and after TN, demonstrated developing abnormalities in brain-stem auditory evoked potentials from the right ear that disappeared in a delayed fashion after the clinical symptoms of TN had subsided. This rare combination of clinical and electrophysiologic abnormalities suggests a pontine demyelinating plaque involving the right trigeminal sensory root and the right lateral lemniscus. PMID- 3964110 TI - Monosymptomatic sensory symptoms and cerebrospinal fluid immunoglobulin levels in relation to multiple sclerosis. AB - Of 53 patients with monosymptomatic paresthesiae, 55% had oligoclonal bands and 28% an elevated cerebrospinal fluid (CSF) IgG index. Over a mean observation period of 64 months, nine patients developed clinically definite multiple sclerosis (MS); all of these patients had IgG bands, illustrating the prognostic importance of this CSF aberration. Two lumbar punctures more than one year apart were performed in 31 of the patients, of whom 20 had oligoclonal bands. This abnormality was constant between the time of punctures in all subjects except one, thus behaving as in MS. Similarly, the CSF findings in the 11 patients without oligoclonal bands remained normal over the observation period. The majority of patients with oligoclonal bands had cells in their CSF producing immunoglobulin of one or more of the three main classes, while none of those without oligoclonal bands displayed immunoglobulin-producing cells in CSF. Occurrence of oligoclonal bands in CSF is common in patients with paresthesiae and increases the risk for future development of MS. PMID- 3964111 TI - Silent brain lesions in patients with isolated idiopathic optic neuritis. A clinical and nuclear magnetic resonance imaging study. AB - Eight of 16 patients with isolated idiopathic optic neuritis were found to have one to several brain lesions by nuclear magnetic resonance scanning. The brain lesions were predominantly located in the periventricular white matter; their appearances, locations, and extents were similar to those seen in recent nuclear magnetic resonance studies of patients with definite multiple sclerosis. All of these brain lesions were clinically silent and were missed by computerized tomography. Idiopathic optic neuritis may be the only manifestation of a multicentric disease process that is disseminated in the central nervous system in the majority of cases. PMID- 3964112 TI - Correlates of brain-stem oculomotor disorders in multiple sclerosis. Magnetic resonance imaging. AB - Three patients with focal brain-stem oculomotor disturbances (nuclear sixth nerve syndrome, sixth nerve palsy, bilateral internuclear ophthalmoplegia) as a consequence of multiple sclerosis have been studied with high-volume delayed computed tomography and high-field magnetic resonance imaging. In all of them, high-volume delayed computed tomography was inconclusive in the brain stem, but magnetic resonance imaging showed an area of prolonged T1 and/or T2 in the region appropriate to the oculomotor findings. Magnetic resonance imaging is the imaging technique of choice of small plaques in the brain stem. It can considerably aid clinicotopographic correlation in multiple sclerosis. PMID- 3964113 TI - Meningeal leukemia diagnosed by cytocentrifuge study of cerebrospinal fluid. A study of 631 cerebrospinal fluid samples from 87 patients. AB - Owing to improved therapy and lengthened life span, the incidence of neuromeningeal involvement in leukemia is increasing. Careful examination of the cerebrospinal fluid (CSF) is important for an early diagnosis. Among the available techniques, the use of cytocentrifugation enables us to demonstrate central nervous system leukemia even if the white blood cell count in the CSF is under 10/cu mm. We describe the results obtained by examining 631 CSF samples from 87 patients affected by acute leukemia; central nervous system luekemia was found in 22.7% of the patients suffering from acute lymphocytic leukemia and in 6.4% of those with acute nonlymphocytic leukemia (ANLL), but this ratio is higher in ANLL compared with the survival as measured in months (a ratio of 2.0 in ANLL compared with 0.50 in acute lymphocytic leukemia). A "leukemic" CSF was found in 51.5% of prophylactically treated patients and in 73.1% of the untreated ones. PMID- 3964114 TI - Dual personality associated with epilepsy. AB - Two individuals with well-defined seizure problems developed dual personalities. One personality was irritable and hostile, the other placid; in each case, a major seizure preceded the shift from the former to the latter. Each personality was amnesic for the other. The incidence of seizures in patients with multiple personality disorder is higher than expected, and these cases demonstrate a direct relationship. PMID- 3964115 TI - Surgical decompression of the facial nerve in the treatment of chronic cluster headache. AB - The nervus intermedius (NI) appears to be the main conduit for the associated symptoms of cluster headache (CH) and perhaps for the pain as well. Subtle injury of the facial nerve and NI might initiate mechanisms responsible for CH. Five patients with chronic CH unresponsive to medication underwent surgical decompression of the root exit-entry zone of the facial nerve, and in two patients the trigeminal nerve root was also decompressed. In two patients, the pain syndrome was markedly relieved for as long as two years. In one patient, initial improvement was obscured by narcotic addiction. In two patients, the operation was a failure. The NI was identified as a separate bundle in only one of five patients and decompressions may not have affected that component of the facial nerve. PMID- 3964116 TI - Computed tomographic scan hemispheric asymmetries in right- and left-handed male and female subjects. AB - Patterns of computed tomographic scan asymmetries in the frontal and occipital regions of the brain were examined in 172 right- and left-handed male and female subjects; these patterns were compared with those published previously to determine which asymmetries were reliable across studies. The patterns observed appeared to be unrelated to handedness or sex and suggested that, especially in the posterior region of the brain, the majority of individuals have left hemispheres longer and wider than their right hemispheres. If anatomic asymmetries are indeed substrates for functional asymmetries, it appears more likely that they are related to at least some aspects of language dominance than to cerebral dominance for handedness. PMID- 3964117 TI - Chronic periodic lateralized epileptiform discharges. AB - Six patients with chronic epilepsy had persistent periodic lateralized epileptiform discharges (PLEDs) in their interictal electroencephalographic recordings. Three patients had complex partial seizures, two had infantile spasms, and one had multifocal seizures. Four patients had cerebral pathologic changes consisting of tuberous sclerosis (two patients), a porencephalic cyst (one patient), and a chronic brain abscess (one patient). Although PLEDs are usually seen in association with an acute or subacute disturbance of cerebral function, the findings in this group of patients show that chronic PLEDs also can occur in patients with long-standing seizure disorders or chronic brain lesions. PMID- 3964118 TI - Neurological deficit from an inoperable arteriovenous malformation. An indication for therapeutic embolization? PMID- 3964119 TI - Neurological deficit from an inoperable arteriovenous malformation. An indication for therapeutic embolization? PMID- 3964120 TI - Possible role of collagen in transverse myelitis and chymopapain-induced paraplegia. AB - We studied the effect of nucleus pulposus (NP) on platelet aggregation. Our in vitro experiments showed that NP extract produced platelet aggregation and the addition of collagenase to the NP extract abolished this response. It was further shown that chymopapain did not affect the activity of the extract. We assume that collagen is the active platelet aggregant in the NP extract. Intravascular release of collagen may cause platelet aggregation, vascular obstruction, ischemia, and cord necrosis in a patient with acute transverse myelitis. Intradiskal chymopapain is known to cause transverse myelitis and it is possible that collagen released during the action of the enzyme initiates a similar chain of events. PMID- 3964121 TI - Pseudotumor cerebri due to partial obstruction of the sigmoid sinus by a cholesteatoma. AB - A 62-year-old man with pseudotumor cerebri (PTC) syndrome was discovered to have a cholesteatoma of the left mastoid. The mass indented the sigmoid sinus without occluding it. The PTC resolved postoperatively. To our knowledge, PTC has not been previously reported in association with a cholesteatoma. Additionally, this case demonstrated that a partial obstruction of the venous drainage of the brain may be sufficient to increase intracranial pressure. PMID- 3964122 TI - Chronic human colchicine neuropathy and myopathy. AB - A 43-year-old woman who indiscriminately took colchicine for five years developed a progressive multisystem syndrome that included severe axonal neuropathy and a pathologically striking myopathy. The neuropathy and myopathy were similar to experimental animal colchicine-induced neuromuscular toxicity. PMID- 3964123 TI - Dementia with cerebral Lewy bodies. A mesocortical dopaminergic defect? AB - We describe a patient with dementia who at postmortem examination was found to have Lewylike bodies throughout the cerebral cortex associated with typical Lewy bodies in the pigmented brainstem nuclei. Moderate numbers of senile plaques but no neurofibrillary tangles were found in the neopallium or in the limbic areas. A positive correlation was found between the distribution of the cortical Lewylike bodies and the proposed distribution of dopamine terminals in the cerebral cortex. Cell loss in the ventral tegmental area and the basal nucleus of Meynert suggest abnormalities in the dopaminergic and cholinergic innervation of the cerebral cortex. The relative lack of senile changes of Alzheimer type make these two proposed abnormalities a more plausible explanation for the dementia in this patient. PMID- 3964124 TI - Skin cancers. PMID- 3964125 TI - AIDS: a Judaeo Christian approach. PMID- 3964126 TI - Religion and medicine. Jewish medical ethics. PMID- 3964127 TI - Management of AIDS in general practice. Part 1. PMID- 3964129 TI - Doctor in politics. PMID- 3964128 TI - AIDS: two case histories. PMID- 3964130 TI - Common sexual problems in general practice. PMID- 3964131 TI - Community attitudes to artificial insemination by donor. PMID- 3964132 TI - AIDS: new case definition for Category A. PMID- 3964133 TI - Thyroid function. PMID- 3964134 TI - Systolic or diastolic hypertension: making decisions. PMID- 3964135 TI - Postnatal care: principles and complications. PMID- 3964136 TI - Stimulation of neutrophil respiratory burst and iodination reaction by opsonized microfilariae of Dirofilaria immitis. AB - It has been shown that the interaction of Dirofilaria immitis microfilariae (Mf) opsonized with sera from infected but amicrofilaraemic dogs (occult dogs) stimulated the respiratory burst and degranulation of neutrophils as measured by chemiluminescence and iodination. Sera from normal and microfilaraemic dogs gave either low level or non-significant reactions. Since the sera required were also those required for neutrophil-mediated cytotoxicity to D. immitis Mf in vitro, the results suggested that the products of oxygen reduction as well as the myeloperoxidase system could be involved in the killing of Mf by neutrophils. However, whether these pathways have a major role to play in neutrophil-mediated cytotoxicity to Mf is uncertain, as various chemical and enzymatic inhibitors of the products of the respiratory burst were unable to prevent or reduce cytotoxicity. Azide, which is a known inhibitor of the iodination reaction, also failed to reduce cytotoxicity. PMID- 3964137 TI - Purification and properties of lactate dehydrogenase from Plasmodium knowlesi and erythrocytes of the rhesus monkey. AB - Lactate dehydrogenase, E.C.1.1.1.27 (LDH) from the simian malarial parasite, Plasmodium knowlesi, and from normal rhesus monkey erythrocytes has been purified using Blue Sepharose affinity chromatography, and the properties of the purified enzyme from these two sources have been compared. The enzyme from the host and parasite were different in their kinetic properties, viz., substrate and pH optima, thermostability and isoenzymic behaviour. Partially purified LDH of the erythrocytes resolved into three isomeric bands on polyacrylamide gel electrophoresis, whereas the parasite LDH moved as a single enzyme band of different mobility from the host LDH. The molecular mass of the parasite enzyme was estimated as 117,500 daltons. PMID- 3964138 TI - Effect of administration of carnitine on the severity of myocardial infarction induced by isoproterenol in rats. AB - The effect of administration of carnitine on the severity of myocardial infarction in rats induced by isoproterenol was studied by following histopathological and biochemical parameters. Carnitine afforded partial protection against myocardial infarction. Serum aspartate amino transferase (GOT) and creative phospho kinase (CPK) values, serum, heart and aortic lipids, serum protein-bound hexose and sialic acid and glycosaminoglycans in the heart were lower in the carnitine-treated rats. Histopathological examination showed very little necrosis in the carnitine-treated rats when compared to the extensive necrosis in the untreated controls. PMID- 3964139 TI - Seasonal activity and abundance of the arbovirus vector Culex annulirostris skuse near Echuca, Victoria, in the Murray Valley of Southeastern Australia 1979-1985. AB - Abundance of Culex annulirostris in a state forest near Echuca, northern Victoria, was sampled with a dry ice-baited EVS trap from 1979 to 1985, generally on a fortnightly basis. The species regularly became active from October, the population reached peak abundance in mid summer and then declined to become undetectable from late May. Abundance varied between years, related to availability of larval habitats. The results confirm a pattern of seasonal activity in the Murray Valley that is relevant to arbovirus epidemiology and to vector control. PMID- 3964140 TI - Quality of veterinary pharmaceuticals. PMID- 3964141 TI - The EEC and growth promotants. PMID- 3964142 TI - Prevalence and distribution of caseous lymphadenitis in feral goats. AB - A total of 2,920 feral goats from pastoral areas of Western Australia were examined and the prevalence of caseous lymphadenitis was estimated to be 7.8 +/- 0.9% in goats presented for slaughter. Head, body and visceral lesions were present in 49.3%, 46.7% and 12.3% of affected goats, respectively. A comparison with previously reported data from sheep has been made and significant differences are discussed. Lung lesions were relatively uncommon in goats, whereas the distribution of carcase lesions was similar between the species. Multiple lesions appear to be less common in goats than in sheep. PMID- 3964143 TI - Multiple anthelmintic resistance in Trichostrongylus colubriformis. AB - Following the failure of anthelmintic treatment to control an outbreak of trichostrongylosis in sheep, multiple resistance to levamisole and oxfendazole was confirmed in field strains of Trichostrongylus colubriformis at the CSIRO Pastoral Research Laboratory, Armidale. Resistance in Trichostrongylus spp to levamisole was also confirmed on an adjoining farm. From the results of an experiment where lambs were treated at the recommended dose rate with one or both anthelmintics, it was estimated that 32% of T. colubriformis were resistant to levamisole, 19% to oxfendazole, and 12% to both drugs. Simultaneous administration of levamisole and oxfendazole resulted in an additive anthelmintic effect. Naphthalophos (36.6 to 51.2 mg/kg) was 93% efficient against the multiple resistant strain. The similar histories of anthelmintic usage at the CSIRO Pastoral Research Laboratory and on the northern tablelands of New South Wales generally, suggest that multiple anthelmintic resistance in T. colubriformis may soon emerge as a problem on the northern tablelands. PMID- 3964144 TI - Multiple congenital malformations of the face, nervous system and musculoskeletal system of pigs. AB - Multiple congenital malformations occurred in 21 of 26 pigs (81%) in 3 litters from 2 piggeries. Two of 26 pigs (7%) were mummified while 3 of 26 (11%) were normal. Cheiloschisis was seen in all malformed pigs and was accompanied by various combinations of palatoschisis, arhinencephaly, hypoplasia of the spinal cord, arthrogryposis of the pelvic limbs, polydactyly, renal lesions and cauliflower ears. Histological examination suggested that arthrogryposis was due to neurogenic muscular atrophy. The teratogen was not identified. PMID- 3964145 TI - Left abomasal displacement and ulceration in an eight-week-old calf. AB - Left displacement of the abomasum was diagnosed radiographically in an 8-week-old female Friesian calf. At surgery, a 4 cm ulcer was repaired and an abomasopexy performed during closure of the abdomen. Recovery from surgery was slow, and regurgitation of rumen contents occurred. Despite medical treatment, the calf died 4 days later. Left abomasal displacement is a well documented disease of dairy cattle (Robertson 1968; Coppock 1974; Martin et al 1978a; Poulsen 1976), but in young calves the condition is rare (Dirksen 1981). This report describes a case of left abomasal displacement with ulceration in an 8-week-old female Friesian calf. PMID- 3964146 TI - Disseminated aspergillosis in dogs. AB - Clinical and pathological findings are reported from a series of 12 cases of disseminated aspergillosis (A. terreus) in 11 German Shepherd dogs and one Dalmatian referred to Murdoch University Veterinary Hospital (MUVH) over the period 1980 to 1984. A preliminary study of humoral and cell mediated immune components and complement levels revealed no consistent abnormality in 9 dogs tested apart from raised IgG levels. Serum IgA levels were depressed in 30% of cases. Serial data from one extensively monitored case is presented. The unusual epidemiological and pathogenetic features of the disease are discussed. PMID- 3964147 TI - Immunisation of cattle against interdigital dermatitis (foot-rot) with an autogenous Bacteroides nodosus vaccine. PMID- 3964148 TI - Observations on the aversion of sheep to electro-immobilisation and physical restraint. PMID- 3964149 TI - The drug abuse epidemic. PMID- 3964150 TI - Head-up/head-down transition: measurement of transition times. AB - A method was developed to measure transition times between a head-up signal and a response given to a head-down display. Various arrangements of motor response (vocal, hand) and HDD images were used. In the first experiment, vocal and manual response times were recorded in a current fighter aircraft mock-up situation. The shortest times were obtained for voice responses. The time elapsed between a HUD signal and the simple response to the HDD was approximately 1600 ms. The time for physical transition where accommodation changes occur was 700 ms. In the second experiment, two types of images were displayed on the HDD: a "positive" contrast (green symbol on black background), and a "negative" contrast (black symbol on green background) in order to compare accommodation to structured and unstructured backgrounds. Perception time was significantly shorter for the "positive" contrast, and transition times were similar to those measured in the first experiment. This method permits the evaluation in a dynamic aeronautical environment of the acquisition and processing of information. Changes in psychological conditions (heavier information processing) and/or physiological conditions (changing accommodation, gaze axis, convergence) can be evaluated in future research. PMID- 3964151 TI - Decompression sickness and intravenous bubble formation using a 7.8 psia simulated pressure-suit environment. AB - The purpose of this study was to determine the minimum spacesuit pressure required to prevent decompression sickness (DCS) during operational conditions in a 50% oxygen/50% nitrogen environment. In this study, 30 male volunteer subjects were exposed in groups of three, to three consecutive daily extravehicular activity (EVA) simulations at 7.8 psia (5,031 m altitude equivalent) for a continuous period of 6 h. During each altitude exposure, the subjects participated in similar exercise workloads expected to be experienced by astronauts during a typical EVA scenario. Precordial Doppler monitoring revealed that 73.3% of the subjects had intravenous bubbling during at least 1 d of the 3 d of exposure, with 26.7% remaining bubble-free during the entire study. No correlation was found between either body fat or age and incidence of bubble formation. One case of DCS occurred during the study indicating that 7.8 psia is not sufficient pressure to totally preclude DCS in a 50% oxygen/50% nitrogen environment. The necessary pressure awaits further study. PMID- 3964152 TI - Transdermal scopolamine: human performance and side effects. AB - The effect of transdermal scopolamine on performance was tested on 23 naval volunteers. Performance was evaluated by using a battery of professional (naval related) and cognitive tests. For all tests performed there were no significant differences between the scores obtained in placebo and transdermal scopolamine conditions. These results were in close agreement with subjective estimations of performance. Transdermal scopolamine significantly reduced salivary flow, whereas mood state, visual acuity, and eye accommodation for near vision were not affected. We conclude that transdermal scopolamine administration is not accompanied by decrement in performance abilities and can safely be used by naval crews. PMID- 3964153 TI - Performance overnight in shiftworkers operating a day-night schedule. AB - Performance was measured during the day (0800-1700 hours) and during the night (1700-0800 hours) of a day-night schedule, and the effect of caffeine (300 mg) was studied during the overnight periods of work. The sleep electroencephalogram was recorded together with oral temperature and urinary electrolyte excretion. Impairment of performance within 9 h after the beginning of the daytime work period was minimal, and was limited to a test of continuous performance, but impairment of performance within 9 h after the beginning of the overnight work period was more pronounced and included lowered vigilance. Impaired performance overnight was related to time on task and circadian rhythmicity, and was alleviated to some extent by the use of caffeine. PMID- 3964154 TI - Changes in glycolytic intermediates in rat erythrocytes during exposure to simulated high altitude. AB - Regulatory mechanisms of erythrocyte glycolysis and 2,3-diphosphoglycerate (2,3DPG) metabolism under hypoxia were studied in rats exposed to a simulated altitude of 18,000 ft (5,486 m) for 5 d. Changes in erythrocyte glycolytic intermediates were determined by enzymatic analysis. Marked alterations of glycolytic intermediates were found during 1 d of exposure which were quite different from those observed during exposure for 2, 3, and 5 d. Alterations of intermediates seem to be highly correlated with blood pH changes; however, pH alone cannot explain the overall changes in intermediates. Results suggested that overall intermediate changes are the results of the combined effect of alterations of cellular pH and hemoglobin desaturation. Increased 2,3DPG at initial stages of exposure (within 1 d) may be caused mainly by the increased cellular pH; sustained elevation of 2,3DPG at later stages could be attributed to the relief of product inhibition of diphosphoglycerate mutase by deoxygenation. PMID- 3964155 TI - Hysterical deafness: an unusual presentation of stress in an air traffic control officer. AB - A case is described of an air traffic control officer who presented with paradoxical hearing loss, the aetiology of which is thought to have been functional. A review of the literature reveals no comparable case. PMID- 3964156 TI - Ship/rig personnel abandonment and helicopter crew/passenger immersion suits: the requirements in the North Atlantic. AB - Protection from hypothermia and drowning are the primary requirements for an immersion suit system during ship, rig, or helicopter abandonment in the North Atlantic. In order to achieve this, the suit must be dry and comfortable. The problems involved in manufacturing such a suit are discussed and the fact is that there is still not a suit in existence that fulfills all the criteria. PMID- 3964157 TI - Risk of an accident from cardiovascular-caused inflight incapacitation. PMID- 3964158 TI - Comparison of human impact response in restraint systems with and without a negative G strap. AB - A test program to assess the influence of a negative G strap on restraint dynamics and human impact response was conducted at AFAMRL. There were 131 experimental-level impact tests with volunteer subjects performed in eight different test conditions. Forward-facing (-Gx) impacts were carried out on a horizontal accelerator, while vertical (+Gz) impact tests were done on a vertical drop tower facility. In both axes, the experimental exposure was an approximate half-sine waveform with peak acceleration up to 10 G and velocity change up to 9.2 m X s-1. Subjects were restrained to the test vehicle using either the PCU 15/P torso harness and lap belt, which is used operationally in such aircraft as the A-20 and F-15, or a conventional double shoulder strap and lap belt configuration. In one half of the test conditions, fixed-length negative G straps were incorporated into these restraint systems. In the other test conditions, the unmodified restraint systems were evaluated. Adding the negative G strap to either restraint system had clearly beneficial effects. These included decreasing the tendency toward submarining in forward-facing impacts, providing better occupant-seat coupling during free falls, and improving vertical impact protection. Sufficient benefits appear to result from use of the negative G strap to warrant a recommendation for its incorporation into selected USAF restraint systems, such as the PCU-15/P torso harness and lap belt. Additional data analysis revealed that the conventional double shoulder strap and lap belt restraint provided better forward-facing and vertical impact protection than the PCU-15/P torso harness and lap belt configuration. Further research at AFAMRL is planned to identify restraint harness features which may improve the performance of current and future impact protection systems. PMID- 3964159 TI - Hemodilution of polycythemic mountaineers: effects on exercise and mental function. AB - We studied the effects of acute, isovolemic hemodilution on the exercise ability and mental function of four polycythemic mountain climbers (mean hematocrit 58 +/ 1.25%) during the American Medical Research Expedition to Mt. Everest (AMREE). The subjects were studied at 5400 m (PB = 400 mm Hg). Approximately 15% of their blood volume was removed and replaced with an equal volume of 5% human albumin solution. Final hematocrits were 50.5 +/- 1.5%. Before and after hemodilution, the subjects performed psychological and exercise tests. Maximum work level, oxygen uptake, minute ventilation, and blood oxygen saturation did not change. After hemodilution, heart rate increased slightly at all work levels, and there was a small but significant improvement on the psychological tests. It is concluded that this degree of hemodilution was well tolerated and that a hematocrit of greater than 50% conferred no advantage for exercise and may have impaired cerebral function. Although, in these circumstances, isovolemic hemodilution improved cerebration, we feel that this potentially hazardous maneuver is rarely indicated. PMID- 3964160 TI - Mild hypoxia and visual performance with night vision goggles. AB - Military night vision goggles (NVGs) are image intensifiers normally used when the human operator's visual capabilities are unimpaired by oxygen deprivation. However, mountain search team members and aviators sometimes operate with NVG augmentation at altitudes where hypoxic visual decrement is documented. The objective of this research was to investigate the effects of mild hypoxia on monocular visual performance with NVGs. It was found that mild oxygen deprivation significantly affects unaided square-wave grating visual acuity but does not significantly affect NVG-augmented performance. Large differences between visual sensitivities at different spatial frequencies were not differentially affected by mild hypoxia. Supplemental oxygen did significantly improve naked-eye but not NVG-augmented night resolution acuity up to a simulated altitude of 13,000 ft (3,962 m) above sea level (ASL). PMID- 3964161 TI - Effect of simulated weightlessness on exercise-induced anaerobic threshold. AB - Ventilation (VE), CO2 output (VCO2), oxygen uptake (VO2), respiratory exchange ratio (R), and the ventilatory equivalents for VO2 and VCO2 were measured during graded exercise before and after 10 d of continuous bed rest (BR) in the -6 degrees head-down position to determine the effect of deconditioning on the anaerobic threshold (AT), i.e., the highest workrate or VO2 which was achieved without evidence of lactic acidosis, as judged from the profile of ventilatory and gas exchange responses. Ten healthy male subjects performed a supine graded cycle ergometer test before (pre) and after (post) BR which consisted of 4 min of unloaded pedaling at 60 rpm followed by an increased workrate of 15 W X min-1 until volitional fatigue (max). VE, VCO2, VO2, R, VE/VO2 and VE/VCO2 were measured every 30 s and used collectively to identify the AT. Plasma (PV) and blood (BV) volumes were measured pre- and post-BR by T-1824. Following BR, VO2max decreased from 2.42 +/- 0.17 to 2.25 +/- 0.13 L X min-1 (7.0%, p less than 0.05). BR significantly (p less than 0.05) reduced the AT from 1.26 +/- 0.09 to 0.95 +/- 0.05 L X min-1 VO2; from 52.2 +/- 2.0 to 42.6 +/- 1.6% VO2max; and from 93 +/- 9 to 65 +/- 6 W. A correlation coefficient (r) of -0.11 (NS) was found between the change in VO2max and change in AT. A decrease in BV of 8.8% (p less than 0.05) was due to the 11.0% reduction in PV; red cell volume remained constant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964162 TI - Systolic time intervals in pilots and non-pilots during 70 degree head-up tilt. AB - Nine highly experienced Indian fighter pilots in current flying practice and 11 healthy non-pilots underwent head-up tilt (HUT) to 70 degrees for 20 min. Heart rate and blood pressure response to tilt stress was similar in the two groups as was the contractile function of the left ventricle measured by systolic time intervals. The highest PEP/LVET ratio of 0.402 seen at the end of HUT was considerably lower than the values seen in other studies (5,11). This suggests that myocardial contractility of Indians adjusts better to tilt stress than that of western subjects not adapted to heat. PMID- 3964163 TI - Adapted head- and eye-movement responses to added-head inertia. AB - Adaptation to inertia added to the head was studied in man by mounting masses on a rigidly attached helmet. Two- to ten-fold increases of inertia were thus produced, while an overhead suspension compensated for the weights. Eye and head positions and corresponding velocities were simultaneously recorded during eye head tracking of a target stepping at 0.2 Hz in the horizontal direction. Without added inertia, fast gaze movements are type III, the accelerated head movement coming early and the resulting VOR truncating the simultaneous eye movement saccade in both amplitude and velocity. Head oscillations are fast and overcompensated by higher gain VOR. With added inertia, the adapted head movement is slowed and delayed. This permits the eye movement saccade to be completed before head movement begins and to escape truncation; the saccade is normal or slightly increased in amplitude. Head oscillations are slow and compensated by normal gain VOR. Either truncation of the saccade or overcompensation of the VOR leads to eye movement and gaze position error that is corrected for by secondary corrective saccades. These same two errors in gaze coordination could explain the cause of the perceived oscillopsia. Oscillopsia, or continual displacement or instability of the visual worlds, is a symptom of breakdown of space constancy, and was prominent and consistent in perceptual reports of our subjects. Adaptation resulting from adding inertia to the head occurred much faster than that induced by adding prisms or lenses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964164 TI - Analysis of the potential association between noise-induced hearing loss and cardiovascular disease in USAF aircrew members. AB - Questions have been raised concerning the possible impact on health of populations exposed to excessive noise in their work- and leisure-time environments. The purpose of this investigation was to explore the relationship between noise-induced hearing loss and cardiovascular disease by examining the medical records of 2,250 Air Force aircrew members. In this correlative analysis, high-tone hearing loss diagnosed with a high probability of being noise-induced was interpreted as an indirect indicator of noise exposure. Cardiovascular function was measured in terms of recorded systolic and diastolic blood pressure and clinical diagnoses of cardiovascular diseases. Analyses consisted of comparing cardiovascular parameters in maximum and minimum hearing loss groups including polynomial regression curves for blood pressure data, and determining relative risk and attributable risk associated with noise-induced hearing loss for development of cardiovascular disease. Our analyses consistently failed to indicate any association between the degree of noise-induced hearing loss and cardiovascular function in the aircrew population. PMID- 3964165 TI - Systolic blood pressure in fighter pilots after 12-15 years service. AB - Systolic blood pressure (SBP) was measured at entry and after 12-15 years in 112 fighter pilots and compared to 112 transport and helicopter pilots. The pilots were 20-24 years old on entry into the study. Mean SBP +/- 1 S.D. on entry was 122 +/- 12 mm Hg in fighter pilots and 124 +/- 12 mm Hg in transport and helicopter pilots. After 12-15 years follow-up the mean SBP was 118 +/- 12 mm Hg in both groups. We conclude that the stress of flying fighter aircraft for 12-15 years is not associated with an increased risk of hypertension. PMID- 3964166 TI - Retrospective analysis of Naval Special Boards of Flight Surgeons, 1974-83. AB - The Naval Special Board of Flight Surgeons was established in 1956 for the evaluation of Navy, Marine Corps, and Coast Guard problem aeromedical cases. This paper examines a sample 248 of these cases for the period of 1974-83 with respect to the characteristics of those referred, their referral diagnostic category, and the recommendation of the Special Board regarding return to a flying status. Those cases with a referral diagnostic category of ENT and Ophthalmology were less likely to be returned to flight status. Older, more senior pilots, and pilots with more total flight time were less likely to be returned to unrestricted flying than were their younger, more junior, and less experienced counterparts. Otherwise, no significant difference in outcome based on age, rank, marital status, branch of service, specialty, or flight hours was detected. Overall, 61% of those evaluated by the SBFS were returned to flight status. PMID- 3964167 TI - Training of aerospace medicine physicians in the Soviet Union and the United States of America. AB - The Union of Soviet Socialist Republics and the United States of America operate major aerospace medicine programs; each country has taken specific measures to assure the development of an adequate number of trained aerospace medicine physicians. This jointly prepared paper emphasizes the training of aerospace medicine physicians related to civil aerospace activities. Those working in the field of aerospace medicine will find of interest the aerospace medical approaches taken by the U.S.S.R. and the U.S.A. in achieving their respective aerospace objectives. PMID- 3964168 TI - Cases from the aerospace medicine residents' teaching files. Case #11. New left bundle block on screening exam. AB - New left bundle block on screening exam. Presentation, evaluation, and relevant aspects of chloroquine-induced LBBB in the aviator are discussed. PMID- 3964169 TI - Saliva: a way to obtain specimens in an operational setting. PMID- 3964170 TI - The effects of naloxone and cage size on social play and activity in isolated young rats. AB - The effects of large and small housing environments as well as naloxone on social play (as defined by pinning behavior) in isolated postweanling male rats were investigated. Animals housed in small cages played significantly more than those housed in larger cages. This effect was not observed when cage size was reversed. Administration of 0.5, 1.0, and 5.0 mg/kg of naloxone resulted in significant decreases in play behavior as compared to saline controls, both before housing environments were switched, and after. Animals in both isolation conditions were also compared to animals that were socially housed. Isolation was found to increase social play as well as the time spent in active social interaction, but had no effect on locomotor activity. While housing in a small cage increases play behavior, it had no effect on the amount of time spent in active social interaction or on activity. While administration of 0.5, 1.0, and 5.0 mg/kg naloxone to habituated animals differentially housed did not result in an overall decrease in activity, when compared with saline controls, only those animals housed in small cages and injected with the high dose of naloxone differed significantly from controls. In animals having no prior play experience, the activity of animals housed in the large and small cages differed significantly from each other only in the saline and 5.0 mg/kg naloxone conditions. Since naloxone's effect on play behavior was strong, but its effect on activity was not profound, our data suggest that naloxone primarily affects the affective component of play rather than altering activity levels. PMID- 3964171 TI - Scopolamine effects on memory retention in mice: a model of dementia? AB - Scopolamine-treated normal young human subjects exhibit memory dysfunctions analogous to those observed in demented patients. The dysfunctions are reversible by physostigmine but not by d-amphetamine which suggests that the memory impairment is specifically related to reduced cholinergic transmission caused by scopolamine. Scopolamine-induced amnesia has been proposed as a model for dementia where reduced cholinergic function is the suspected cause. We report seven experiments in young adult mice which examine scopolamine's effects on memory retention and whether its amnestic effects are specifically blocked by cholinergic agonists or cholinomimetics. Young adult mice were trained to avoid footshock in a T maze and their retention tested 1 week after training. Pretraining subcutaneous injection of scopolamine improved retention scores of "undertrained" mice at a dose of 0.01 mg/kg but impaired at a dose of 0.1 mg/kg. Post-training injection showed no effect at 0.01 mg/kg, enhanced retention scores at 0.1 mg/kg, and impaired at 1.0 mg/kg. The impairment by 1.0 mg/kg was blocked by injection 45 min post-training of each of two cholinergic drugs but was also counteracted by six drugs which act upon five other neural systems (catecholamine, serotonin, glycine, GABA, and hormonal). When scopolamine was injected 40 min pretraining, and each of eight drugs was injected immediately after training, the amnestic effect of scopolamine was only partially counteracted. This suggests that scopolamine impaired acquisition, in addition to some impairment of memory processing. This was confirmed by a direct study of acquisition rates of the avoidance response; 0.1 mg/kg of scopolamine impaired acquisition. The overall results indicate that pretraining administration of scopolamine impairs learning and to some degree memory processing. Counteracting scopolamine-induced amnesia, by either pretraining or post-training drug administration, is not specific to the cholinergic system. PMID- 3964172 TI - Serial stressors: prior exposure to a stressor modulates its later effectiveness on gastric ulceration and corticosterone release. AB - Several studies have focused on the proactive effects of prior exposure to a stressor on ulcerogenic and endocrine responses to exposure to a similar final stressor. In the present study, we explored the effects of prior exposure of Moll Wistar rats to water-restraint stress on gastric ulceration and corticosterone responses to a final stressor. The number of prior exposures to water-restraint challenge was varied from one to four, and the durations of the prior exposures varied from 30 min to 2 h. The duration of the final stress challenge was 75 min. The two indices of the stress response to the final stressor challenge yielded different results. For neither index was the duration of prior exposures a significant factor in modulating the response to the final challenge. For gastric ulceration, those animals receiving one prior exposure, but not four, exhibited less gastric ulceration than animals receiving no prior exposure. These animals also developed less ulceration than those receiving four prior exposures. For corticosterone, those animals receiving four prior exposures exhibited a lower adrenocortical response to the final stressor than did animals receiving no prior exposure, or only one prior exposure. The results indicate the complexity of proactive effects of earlier stress experience on responses to a final stressor challenge. PMID- 3964173 TI - Disrupted patterns of consummatory behavior in rats with fornix transections. AB - The feeding and drinking behavior was examined in male rats with fornix transections and sham-operated control rats. Total food and water consumption was recorded but supplemented by a pattern analysis of feeding and drinking behavior. The behavior of the rats was continuously monitored during four hour morning and afternoon sessions under ad lib access and during a two hour session following adaptation to a restricted access feeding schedule. Rats with fornix transections were more active and exhibited increased frequencies of rearing, eating and drinking. The increased meal frequency in rats with fornix transections was accompanied by decreased meal durations and a reduction in the length of intermeal intervals. Total food and water consumption was unaffected by fornix transection as were the duration of sleep bouts and the frequencies of grooming, sleeping and carrying shavings. Fornix transections also reduced food carrying and food hoarding but only under conditions of restricted food access. The results suggest that fornix transection does not alter major homeostatic regulatory mechanisms nor does it alter the components of feeding and drinking behavior. Fornix transection alters, instead, the organization of microregulatory feeding and drinking patterns. PMID- 3964174 TI - Preserved spatial memory in old rats survives 10 months without training. AB - Aged rats with extensive prior training on the radial maze retain the capacity for accurate spatial working memory (WM) for at least 3 months without practice. To investigate the temporal limits of this influence of prior experience we compared the reacquisition of spatial WM by a group of experienced 21.5-month-old rats to the original acquisition by naive 3-month-old rats. The aged rats had received 225 radial maze tests between 3 and 11 months of age. Despite 10 months without practice the old rats rapidly reacquired critical performance. Their reacquisition was markedly superior to original learning by the young rats, even when delays as long as 5 h were imposed between the rats' fourth and fifth choices during the daily tests in the eight-arm maze. Additional tests showed that neither young nor old rats employed a response strategy to maintain accurate spatial WM performance. Experience clearly confers long-lived protection against the otherwise deleterious effects of aging on spatial WM, but the mechanism by which this influence arises is unknown. PMID- 3964175 TI - Maternal separation alters later consumption of novel liquids in the squirrel monkey. AB - The consumption of novel, fruit-flavored drinks was measured in juvenile squirrel monkeys that had either had their mother removed from the home cage for 2 h on 80 occasions prior to weaning or had not undergone this separation procedure. Among previously separated animals, males drank more than did females during the first 30 min following presentation, whereas there was no difference in the drinking of nonseparated males and females at this time. Further, the amount of liquid consumed during the 20 h following presentation increased across days of exposure in the nonseparated, but not in the previously separated monkeys. These results show that brief maternal separation can affect the later behavior of squirrel monkeys, and are consistent with findings in rhesus macaques that maternal separation alters later exploratory behavior. PMID- 3964176 TI - The relationship of marital adjustment to agoraphobia treatment outcome. PMID- 3964177 TI - The components of pain behaviour report. PMID- 3964178 TI - Obsessions and compulsions in three kinds of headache sufferers: analysis of the Maudsley Questionnaire. PMID- 3964179 TI - Psychopathology and personality characteristics of nonclinical compulsive checkers. PMID- 3964180 TI - Factors influencing the retrieval and control of negative cognitions. PMID- 3964181 TI - A group social skills training program with psychiatric patients: outcome, drop out rate and prediction. PMID- 3964182 TI - Cognitive and physiological reactivity and the effects of different behavioral methods in the treatment of social phobia. PMID- 3964183 TI - Children's self-speech and self-regulation during a fear-provoking behavioral test. PMID- 3964184 TI - Autogenic training and progressive relaxation in the treatment of three kinds of headache. PMID- 3964185 TI - Panic disorder: a test of the separation anxiety hypothesis. PMID- 3964186 TI - 'Preparedness' and the severity and outcome of clinical phobias. PMID- 3964187 TI - Evaluation of an electronic sphygmomanometer suitable for the self-monitoring of blood pressure. PMID- 3964188 TI - Parent training outcome: does active parental involvement matter? PMID- 3964189 TI - Sex, sex-role stereotyping and agoraphobia. PMID- 3964190 TI - Computer simulation of Freud's counterwill theory: extension to elementary social behavior. AB - A model is presented describing decision processes of a living system at the level of the individual, together with its interpersonal relationship context (organism, subsystems, and suprasystem). The beginning point was the 1977 system dynamics model of Wegman, which was itself characterized by quantitative cross level hypotheses concerning both physiological and psychological levels of functioning within the individual personality system. The extension process was accomplished by synthesizing concepts from many different theories in personality and social psychology into equations linking two multiple-loop feedback systems to form a suprasystem. Each individual model was found to have several distinct operational modes, and the dyadic model had a number of interesting combinations of these modes which correlated with clinical descriptions of steady-state behavior and subjective experience in human marital dyads. For example, under certain conditions an individual operating in an unstable mode could achieve personal system stability within a dyadic relationship. In some cases, two unstable individuals could form a stable system. The process of extending the original model supports the utility of a synthetic approach to the construction of quantitative theories concerning small social systems. This process also suggests new approaches to planning future empirical research on small social systems using methods more appropriate to the study of complex, dynamic systems. PMID- 3964191 TI - Increasing oral reading proficiency. A comparative analysis of drill and positive practice overcorrection procedures. PMID- 3964192 TI - Parametric reinforcement effects in a programmed activities environment for the severely retarded. PMID- 3964193 TI - Social skills training with hearing-impaired children and adolescents. PMID- 3964194 TI - Positive practice overcorrection. Effects of reinforcing correct performance. PMID- 3964195 TI - Home safety with families being treated for child abuse and neglect. PMID- 3964196 TI - [Histo- and biochemical muscle changes in Fontaine stage IV chronic arterial occlusive disease (III.)]. PMID- 3964197 TI - [Evaluation of occupationally-induced spinal diseases]. PMID- 3964198 TI - [The complex treatment of aseptic necrosis of the femur head]. PMID- 3964199 TI - [Should Perthes diseases be treated surgically?]. PMID- 3964200 TI - [Surgical treatment of coxitis in adulthood]. PMID- 3964201 TI - [Scintigraphic studies following Harrington spondylodesis]. PMID- 3964202 TI - [Distal biceps tendon rupture--a rare event]. PMID- 3964203 TI - Studies on microorganisms secured from different organs of slaughtered sheep with special reference to the microbial load in certain muscles. AB - A total of 312 samples collected from different organs and muscles of dead, disabled, diseased, dying, and normal carcasses of sheep were examined bacteriologically to determine the different species of microorganisms as to their public health significance. In addition, the aerobic plate count (APC) and most probable number (MPN) coliform/g were determined of Musculus biceps brachii, Musculus quadriceps femoris, and Musculus longissimus dorsi. The mean bacterial load was higher in summer than in winter in dead and in normal sheep. Moreover, the APC was higher in winter 3 hours after slaughtering than after 24 h cooling. The bacterial load decreased in that order in the muscles of dead, disabled, diseased, and dying sheep carcasses. The lowest bacterial load was recorded in the Musculus longissimus dorsi. The most predominant isolates recovered from different organs and muscles were Escherichia coli (60), staphylococci (33), Proteus vulgaris (12), Enterobacter aerogenes (11), Corynebacterium ovis (9), Alcaligenes faecalis (7), Actinomyces israelii (5), Citrobacter freundii (4), pneumococci (3), and enterococci (2). The importance is discussed of the isolated strains as zoonotic agents and for assessing the hygienic meat quality. PMID- 3964204 TI - [Sexuality in social change. An empirical comparative study of students 1966 and 1981]. PMID- 3964205 TI - [Mycoplasma infection--factors interfering in toxicologic experiments on reproduction]. PMID- 3964206 TI - [Sensitivity of Mycoplasma bovis field strains to various antibiotics and chemotherapeutic agents]. PMID- 3964207 TI - [Detection of previously unknown Mycoplasma species in female dogs with fertility disorders]. PMID- 3964208 TI - [Isoxsuprin therapy in horses with podotrochlosis and arthroses of the toe joints]. PMID- 3964209 TI - [Thermophilic Campylobacter species from the veterinary medicine viewpoint--a review of references]. PMID- 3964210 TI - [Glanders outbreak in lions in the Istanbul zoological garden]. PMID- 3964211 TI - [Cellular reactions to bacterial groups isolated from milk on the estimation of udder pathogens]. PMID- 3964212 TI - [On the contribution of H. Bogner and P. Matzke on the "Amputation of antlers in Cervidae from the point of view of ethology and protection of animals"]. PMID- 3964213 TI - Nutrition and neurobiology. 23rd symposium of the Group of European Nutritionists on Nutrition and Neurobiology. Bonn, May 9-11, 1985. PMID- 3964214 TI - Influence of vitamin B1, B6, and B12 on the control of fine motoric movements. PMID- 3964215 TI - Senile dementia in relation to nutritional factors. PMID- 3964216 TI - Substrate dependency of acetylcholine biosynthesis and its implications. PMID- 3964217 TI - Plasma neutral amino acids and food preferences: possible implications in normals and depressives. PMID- 3964218 TI - B vitamins in epileptics. PMID- 3964219 TI - Nutritional implications of the diabetic neuropathy. PMID- 3964220 TI - Postnatal brain growth and behavior: evaluation of environmental factors. PMID- 3964221 TI - Iodine deficiency and brain development. PMID- 3964222 TI - Tyrosine and hypertension. PMID- 3964223 TI - Uptake of tryptophan into the brain: dietary influences on serotoninergic function. PMID- 3964224 TI - Nutrition and sleeping behavior. PMID- 3964225 TI - Effects of suboptimal vitamin status on behavior. PMID- 3964226 TI - Genetic variation of an acid phosphatase (Acp-2) in the laboratory rat: possible homology with mouse AP-1 and human ACP2. AB - A genetic locus controlling the electrophoretic mobility of an acid phosphatase in the rat (Rattus norvegicus) is described. The locus, designed Acp-2, is not expressed in erythrocytes but is expressed in all other tissues studied. The product of Acp-2 hydrolyzes a wide variety of phosphate monoesters and is inhibited by L(+)-tartaric acid. Inbred rat strains have fixed either allele Acp 2a or allele Acp-2b. Codominant expression is observed in the respective F1 hybrids. Backcross progenies revealed the expected 1:1 segregation ratio. Possible loose linkage was found between the Acp-2 and the Pep-3 gene loci at a recombination frequency of 0.36 +/- 0.06. PMID- 3964227 TI - Variant-specific differences in human unsaturated transcobalamin II. AB - Electrophoresis and subsequent autoradiography of 57Co-cobalamin (57 Co-Cbl) labeled serum show intensity differences between the genetic variants of human transcobalamin II (TC2), suggesting differences in the unsaturated (apo-) TC2 concentration. In order to distinguish between variant-specific differences in the Cbl binding affinity and those in the total-TC2 concentration, techniques were developed to determine total, apo-, and holo-TC2. Prolonged incubation at 37 degrees C with a 20-fold excess of 57Co-Cbl resulted in an almost complete exchange of endogenously bound Cbl, which allowed determination of the total TC2. The holo-TC2 concentration of both gene products in TC2 heterozygotes could be estimated by comparison of the labeling levels of apo- and total TC2, using densitometric quantification of the autoradiographs. By means of ion-exchange chromatography, TC2 could be separated from other Cbl-binding proteins, permitting a simple quantitative assay of apo- and total TC2, the results of which correlate fairly well with those measured by an immunoadsorption assay. The results obtained in the present investigation indicate that the variant-specific variation in the apo-TC2 concentration is caused by differences in the total-TC2 concentration rather than in the Cbl binding affinity. PMID- 3964228 TI - Specific activity of alpha-L-fucosidase in sera with phenotypes of either low, intermediate, or high total enzyme activity and in a fucosidosis serum. AB - The quantity of alpha-L-fucosidase activity in human serum is determined by heredity. An individual may inherit either low, intermediate, or high serum enzyme activity. An enzyme-linked immunoabsorbent assay has been developed that can detect 0.3 ng of alpha-L-fucosidase protein. Enzyme protein in serum of 102 individuals ranged from 20 to 835 ng/ml. The group included individuals with low, intermediate, and high enzyme activity. The specific activity of alpha-L fucosidase within this group was statistically the same (mean +/- SD = 11,002 +/- 1051 U/mg). Thus, individuals with low and intermediate enzyme activity in serum had lower amounts of enzyme protein with the same specific activity as in individuals with high enzyme activity. Fucosidosis is a rare inherited disease in which alpha-L-fucosidase activity in tissues and body fluids is low or absent. The concentrations of enzyme protein in sera of a fucosidosis patient and parents were 76,565, and 604 ng/ml, respectively, and the specific activities of enzyme were 1316, 8938, and 8858 U/mg, respectively. Thus, the fucosidosis serum probably contained a structurally altered enzyme with reduced catalytic activity. The somewhat low specific activities in the parents suggested that their sera contained both structurally altered and normal protein. PMID- 3964229 TI - Characterization of three electrophoretic variants of human erythrocyte triosephosphate isomerase found in Japanese. AB - Three new electrophoretic variants of human erythrocyte triosephosphate isomerase (TPI) have been partially purified and compared with the normal isozyme with respect to stability, kinetics, and immunological properties. TPI 2HR1, an anodally migrating variant, was less stable than normal in guanidine denaturation and thermodenaturation tests, although it exhibited normal kinetic properties. The level of enzyme activity in erythrocytes from the proband with the phenotype TPI 1-2HR1 was about 60% of the normal mean. The variant allozyme TPI 2NG1, an anodally migrating allozyme associated with normal activity, was very thermolabile at 55 and 57 degrees C. It was also much more labile than normal in stability tests in buffers at pH 5 and pH 10, although it exhibited normal kinetic and immunological properties. TPI 4NG1, a cathodally migrating variant associated with normal activity and normal kinetic as well as immunological properties, was more stable than normal in pH 5 buffer. Family studies demonstrated that the unique characteristics of these variants are genetically transmitted. In two-dimensional electrophoresis of purified isozymes the variant subunits were separated from the normal in the pI axis. However, there is no difference between the variants and the normal in the molecular weight axis, suggesting that the variants result from single amino acid substitutions. PMID- 3964230 TI - Elucidation of the B-genome donor to Triticum turgidum by unique- and repeated sequence DNA hybridizations. AB - In vitro DNA:DNA hybridizations and hydroxyapatite thermal-elution chromatography were employed to identify the diploid Triticum species ancestral to the B genome of T. turgidum. Unique and repeated sequences from the various Triticum species were separated by hybridization and thermal elution on hydroxyapatite. Unique- and repeated-sequence fractions of labeled T. turgidum var. durum DNA were hybridized to the corresponding fractions of unlabeled DNAs of T. searsii, T. speltoides, T. longissimum, T. sharonensis, and T. bicorne. Thermal stability profiles were constructed to evaluate base-sequence complementarity between T. turgidum var. durum and the diploid Triticum species. The heteroduplex thermal stabilities indicated that, of the five species examined, T. searsii was the most closely related to the B genome of T. turgidum var. durum. The thermal stability profiles further indicated that the repeated DNA fractions from the Triticum species are more similar than the unique-sequence fractions. This indicates that all of the Triticum species are very closely related and, in all probability, have diverged from a single progenitor species. PMID- 3964231 TI - Symposium on basic and applied aspects of muscle physiology. October 1-4, 1985, DDR--Reinhardsbrunn. PMID- 3964232 TI - Characteristics of muscle-cellular adaptation to intense physical loads. AB - We studied the influence of a 5-weeks training program, mainly with intense work loads in form of explosive power, on the skeletal muscle system in 7 male sports students. Muscle biopsy specimens from m. vastus lateralis were analysed histochemically, biochemically and by means of electron microscopy. After the training of several weeks, a clear hypertrophy of FT-fibres (24%, p less than 0.05) and ST-fibres (20%, p less than 0.05) became evident. The fibre composition was not affected by the training program. The increase of mean cross-sectional areas of muscle fibres was not connected with any shifting of volume proportions of cellular compartments (volume density of mitochondria, myofibrils and sarcoplasm) at ultrastructural level. Only in the peripheric fibre region mitochondrial volume density increased from 5.9 +/- 2.5 to 8.3 +/- 1.2% in tendency. Contrary to endurance athletes and untrained subjects, power athletes show higher values of sarcoplasmic volume density in their muscle fibres. Results will be discussed in connection with specific demands of explosive powerful muscular performances. PMID- 3964233 TI - The significance of the detection of alkaline phosphatase in the diagnosis of neuromuscular diseases. AB - The occurrence of alkaline phosphatase was observed in regenerating muscle fibres, especially in polymyositis and muscular dystrophy. No differences in the appearance of this enzyme were seen in these diseases. Alkaline phosphatase was not encountered in neurogenic atrophy, with the exception of cases of an accompanying myopathy. These cases show a clear picture without problems in the morphological differential diagnosis. The histochemical demonstration of the enzyme is helpful in the differential diagnosis of neurogenic atrophy and muscular dystrophy of benign type. It is of no use to distinguish between muscular dystrophy of malignant type and parenchymatous polymyositis. PMID- 3964234 TI - Regeneration of mammalian striated muscle. AB - Six main factors limit the regeneration of mammalian striated muscles: the myogenic cells, the basal membranes, the vascular supply, the innervation, the mechanical forces and the functional utilization. Their role is shortly discussed. PMID- 3964235 TI - Investigation into the functional characteristic of m. quadriceps femoris in man with "stimulation mechanography". AB - The force and positive slope under isometric conditions produced by electrically evoked contractions of the m. quadriceps femoris in man were measured during two days without physical work and on two days with different kind of exercise. The relationship between force and slope is described by a logarithmic function. The changes after exercise were different in dependence of the kind of exercise. PMID- 3964236 TI - Contribution to the diagnostic reliability of the combined stimulation myographic/mechanographic method applied to the musculus quadriceps femoris. AB - The left and right quadriceps femoris muscle (QFM) of 11 to 13-years old children and of 10 adult sportmen was stimulated supramaximally by a single shock. Simultaneously the muscle action potential (MAP) and the mechanogramm (MG) was recorded. In the MG of both groups several maxima appeared with averaged contraction times (CT) between 43-47 ms, 80-86 ms and 115-126 ms in the left as well as right position. In some cases maxima of approximately 65 ms and between 140-160 ms were found. The CT from test to retest varied about 1-7% and the amplitude about 7, 5% and 4%. The maxima of the left QFM having a CT of about 47 ms and 84 ms were significantly higher than on the right one. At the left muscle an aerobic load of 1 W/kg body mass elicited a significant reduction of the maximum by 84 ms. The remaining difference to the right muscle is 10-15%. It was concluded, that the maxima of the mean CT of 43-47 ms and 80-86 ms are those of the FTF- and STF-populations. The maxima of 65 ms should be due to the FTO-fibres and the maxima higher than 100 ms must be explained by evoked responses of the motoneurones. The reaction of the ST-amplitudes is due to extensibility changes and the remained difference shows the higher potential strength of the STF at the left muscle. Within the potentiation of the formerly recruited FTF. PMID- 3964237 TI - Controversial aspects of skeletal muscle tone. AB - It is being proposed that "muscle tone" comprises at least two mechanisms: a) reflex, neurogenic ("extrinsic") tone which is graded by reflex pathways and mediated by action potentials, and b) resting, myogenic ("intrinsic") tone which is not mediated by conducted action potentials, but is dependent upon local conditions in the muscle and is given by the number of sarcomeres and their mean length. PMID- 3964238 TI - Possible role of caldesmon in the regulation of smooth muscle and nonmuscle motile systems. PMID- 3964239 TI - The mobility of smooth muscle isomyosins. AB - The two isomyosins of smooth muscles, G1 and G2, were extracted from various visceral organs of chicken, mice, rats, rabbits and dogs. They were separated by electrophoresis in pyrophosphate polyacrylamide gels. Their mobility was the same for all samples, being higher than the mobility of several isomyosins of striated muscles obtained from leg, eye, middle ear, heart ventricle or newborn rat leg. PMID- 3964240 TI - The effect of stimulus interval variation on action potential repolarization of atrial muscle preparations in normotensive (NWR) and spontaneously hypertensive rats (SHR). AB - Action potential (AP) repolarization was tested in atrial preparations of adult NWR and SHR. Prolongation of pause interval interposed in the basic driving frequency of 2 Hz caused a shortening of the early phase and a prolongation of the final phase of repolarization in both NWR and SHR. AP's in SHR exhibited longer durations compared to NWR. However, at pause prolongation the relative increment of AP-duration at the 70% repolarization level (APD70) was less in SHR. This might indicate a positive correlation between electrical and mechanical restitution kinetics. The Na-Ca-exchange could be a possible link for an interpretation of this correlation. PMID- 3964241 TI - Stimulation pattern dependent contractions of myocardial preparations after lipid diets. AB - Lipid diets modify the electro-mechanical coupling. To characterize the regulation of the supply of Ca for the activation of the contraction the influence of the stimulation pattern on the development of tension was investigated after diets containing cholesterol (Ch), rape oil (RO) and cholesterol-oil (ChO). The sequence of increasing inotropic states produced was compared with a control group (C). In ChO high resting potentiation, low postextrastimulatory potentiation (PEP) and a delayed Ca supply for interpolated extra contractions (EC) are typical features. The positive inotropic effect of rising extracellular Ca grows parallel to the sequence of the inotropic states. The maximum rate of contraction and relaxation correlates linearly with the tension development. Some of the results are similar in RO. In both groups a more pronounced involvement of the sarcoplasmic reticulum in the Ca regulation should be responsible for the effects. Especially in C the Ca loading effect of paired stimulation shortens the latent period and increases the rate of contraction and relaxation. In Ch the highest values of PEP are reached. These results reflect the involvement of a high sarcolemmal fraction of Ca in the activation. PMID- 3964242 TI - Influence of varying afterload upon left ventricular contractility. AB - In open-chest rabbits under pentobarbitone anaesthesia the left ventricular afterload was varied by occlusion of the carotid arteries, descending aorta and both of them together in alternating sequence when the aortic nerves and cardiac vagal nerves were cut. Ascending aortic flow AF was recorded by means of a flow probe around the aortic root, the left ventricular pressure LVP by direct canulating of the heart and the aortic blood pressure AP via catheter through the left subclavian artery. From the LVP the systolic and diastolic values LVSP and LVEDP, the contractility index CI = (dp/dt/p)max and from the AF the stroke volume SV and strokework W were evaluated. At mild afterload elevation (carotid or aortic occlusion alone) the CI appears to be enhanced, SV diminished, LVEDP only little raised, and W improved. At combined occlusions a drastical rise of LVEDP, decrease of SV and impairment of W is observed whereas the CI remains elevated and the LVSP increases with AP. From the pump function diagram ensues that at mild afterload increase the operational point is shifted towards the strokework optimum whereas at high afterload it is far away. After discharge of the ventricle all alterations are rapidly and completely restituted. PMID- 3964243 TI - Comparative investigations of right and left ventricular contractility in the rabbit. AB - In pentobarbitone-anaesthetized open-chest rabbits the left and right ventricular pressures were measured. The contractilities of the left and right ventricle were expressed by the contractility index CI = (dp/dt/p)max. Evaluation of left and right ventricular systolic pressure and CIs was done before and at aortic nerve stimulation as well as with pacing and without pacing of the heart. Pressures and CIs appear to be four times greater in the left ventricle than in the right one. The values of the pressure ratio LVSP/RVSP resp. CI ratio CILV/CIRV are adequate before and after aortic nerve stimulation. Any effect difference between the left and the right aortic nerve stimulation does not exist. In the paced heart the left and right ventricular pressure and the left ventricular CI are lower than without pacing. The effect time courses of the left and right ventricle appear to be adequate. Hence is follows that the left rabbit ventricle predominates in contraction development. PMID- 3964244 TI - Quick release by shortening both ends of the muscle fibre. AB - A method is described allowing in quick release experiments the sensing of tension transients as well as the release on each of both ends of the muscle simultaneously. Preliminary results indicate a delay and differences in the time course of the tension transients between the released end and the fixed end. The delay corresponds to the propagation velocity of the mechanical wave. The elasticity of the muscle computed from the propagation velocity is compared with the elasticity determined by Young's modules. PMID- 3964245 TI - Myosin light chain functions. AB - The two regulatory light chains (RLC) of fast-twitch skeletal muscle myosin from rabbit are digested proteolytically at different rates. In purified actomyosin where the heads bind to actin in rigor, both RLC are digested at the same rate. Removal of both RLC does not affect the ATPase activities of myosin. Morphological studies by the electron microscope on spread and rotary shadowed myosin preparations as well as hydrodynamic studies by gel filtration technique revealed that upon removal of both RLC the shape of the head portions changes, the heads of one molecule tend to form intramolecular aggregation and, in addition, intermolecular aggregates, mostly dimers, are formed. These interactions are hydrophobic in nature and cannot readily be dissociated. These results could imply that one of the functions of the RLC is to keep the two heads of an individual myosin molecule apart from one another in muscle. PMID- 3964246 TI - Motoneuronal location and acetylcholine sensitivity of developing rat slow and fast twitch muscle fibres. AB - The postnatal changes of the extrajunctional acetylcholine (ACh) sensitivity of fast twitch (extensor digitorum longus muscle, EDL) and slow twitch (soleus muscle, SOL) of the rat were investigated in vitro. As a measure of the ACh sensitivity serves the threshold dose of ACh necessary to evoke a contracture. Immediately after birth rat muscles show a high extrajunctional ACh-sensitivity, but the SOL exhibits a somewhat higher sensitivity (threshold dose 0.5-5 microM ACh/l) than the EDL (threshold dose 5-20 microM ACh/l). These sensitivities are unchanged up to the 8th (EDL) or 10th (SOL) day of life, afterwards the ACh sensitivity decreases. Values of adult EDL (unsensitivity against ACh in the bathing solution) and SOL (threshold dose 1-5 mM ACh/l) are reached around the 16th (EDL) and 20th (SOL) day after birth. Fast twitch muscles innervated by motoneurons of the cervical spinal cord (sternomastoideus muscle or biceps brachii muscle) show an accelerated decrease of ACh-sensitivity in comparison to fast twitch EDL innervated by motoneurons located in the lumbar spinal cord according to the cranio-caudal relation of the development of the spinal cord. PMID- 3964247 TI - Motor unit potentials at high muscle activity recorded by selective electrodes. AB - The selectivity of different kinds of electrodes for recording of single motor unit potentials was theoretically evaluated. A new type of selective "branched", superficial and subcutaneous wire electrodes was described. The discharge of single alpha motoneurons during movements against elastic resistance was investigated studying motor unit potentials in m. biceps brachii and m.interosseus dorsalis l. Depending on the velocity of the movement, the following pattern of discharge was found: 1) At slow velocity the frequency of discharge increased and new motor units were recruited. 2) At higher velocity the frequency of discharge was constant. The muscle force increased only when new motor units were recruited. 3) At very quick ballistic movements the frequency of discharge decreased during the movement. PMID- 3964248 TI - Motor unit activity during different functional states of the neuromuscular system. AB - The study showed that the mean interspike interval (ISI) and the variability of ISIs increased with fatigue for both low and high threshold motor units (MUs). The recruitment threshold tension decreased for both the low and high threshold MUs while the recruitment threshold in % of maximal voluntary contraction changed selectively because of decrease of muscle force. During ischaemia after an initial decrease of mean ISI and ISIs' variability there was an essential increase of variability of ISIs at almost the same mean ISI followed by a considerable final increase of both parameters. MUs' recruitment thresholds lowered with ischaemia more rapidly in the beginning and especially in the final stage of ischaemia. PMID- 3964249 TI - Muscle fibre conduction velocity during fatiguing and nonfatiguing isometric arm contractions. AB - In the present study the behaviour of muscle fibre conduction velocity was investigated by means of a new method for the continuous registration from surface EMGs. During fatiguing isometric arm contractions at 40% of maximum voluntary contraction close relations between conduction velocity and spectral parameters of surface EMG were found. In short nonfatiguing contractions at 15%, 30%, 45%, 60%, and 75% of maximum force no significant differences of conduction velocity could be observed. An example of continuous registration of the parameters is given. PMID- 3964250 TI - On local muscular endurance capacity in repeated isometric work dependent on the interspersed rest periods. AB - Rest periods according to the so-called "rest allowance" assessed by the formula of Rohmert are insufficient to ensure adequate working capacity in repeated static work at force levels between 50% to 80% MVC. PMID- 3964251 TI - Sex- and age-related behaviour of the integrated EMG during one-arm cranking. AB - There are load-dependent increases in the bioelectrical activity (iEMG) of muscles of the shoulder and the right upper extremity and selected parameters of the cardiopulmonary system. At comparable loads the amplitudes of the EMG were higher in the group of men than in the group of women. The iEMG values were found to be higher in the younger group of women than in the older one. The higher values of iEMG of the younger women corresponded to a higher oxygen uptake and higher heart rate as well as to a lower physical endurance. The physical endurance limit (derived from behaviour of the EMG) was estimated at 5 watts (women) and 10 watts (men). PMID- 3964252 TI - Investigations of the time series structure of the EMG during sustained isometric contractions of back muscles. AB - The experiment aimed at elucidating electromyographic signs of fatigue of lumbar muscles. On two days, 4 subjects had to hold 4 different target forces to fatigue. Bipolar surface EMG's were derived at the L3 level. The time series structure of the EMG's was characterized by means of autoregressive models. The r.m.s.- value did not reveal uniform time-dependent changes, except for an increase during the highest force level. The variance explained by a linear stochastic process systematically increased during the sustained contractions. The mean power frequencies exhibited similar changes. PMID- 3964253 TI - Adaptation of skeletal motor drives under isometric, isokinetic and isotonic working conditions. AB - As a result of cybernetic and physiological concepts the importance of goal directed formulation of a motor task with a specific load within the training process is outlined. Selected experiments of adaptation of skeletal motor drives to specific loads under isometric, isokinetic and isotonic working conditions are represented. PMID- 3964254 TI - Biochemistry of muscle fatigue. AB - Fatigue--or decrease in force generation--is a reduction of simultaneously attached cross-bridges in the force generating state. Two processes are necessary for the force generation: Firstly Ca++ release from the sarcoplasmic reticulum to the sarcoplasm and the binding of Ca++ by the troponin molecule and secondly the turnover of myosin-actin cross-bridges. These processes require energy in at least three different ATPase reactions and can consequently be inhibited when ATP hydrolysis is decreased, i.e. when ATP content is to low or when the reaction products (ADP, Pi and H+) reach inhibiting levels or when muscle pH has decreased to values inhibiting actomyosin ATPase activity (22). Low pH will also decrease Ca++ release and Ca++ affinity by troponin (23). In isometric contraction the force is well preserved as long as ADP phosphorylation can be provided by both PCr degradation and anaerobic glycolysis. When the PCr store is exhausted the force starts to decline and if muscle activation is maintained the force will continue to decrease along with falling glycolytic rate. ADP phosphorylation rate decreases successively and ATP content falls with an at least transient increase in ADP. The ATP decrease, apart from the minor increase in ADP, is balanced by an equimolar increase in IMP. Lactate accumulation produces an increasing acidity with muscle pH values down to 6.25. Early changes in free ADP content cannot be excluded as reason for the initial decrease in force production followed by more pronounced inhibition of ATPase activity during continued contraction due to both substrate lack and product inhibition together with pH effect on the excitation- contraction mechanism. In dynamic exercise with supramaximum work intensity the relation between fatigue development and metabolism is similar. In prolonged dynamic exercise relying on oxidative metabolism without lactate formation the point of fatigue is reached when the glycogen store is exhausted. Again ADP phosphorylation rate is decreased when the energy substrate is changed from carbohydrate to fat with lower maximum rate of ATP resynthesis. PMID- 3964255 TI - 17O NMR investigation of the hydration of L-alanine and L-proline in water/Me2SO mixtures. AB - The hydration state of L-Alanine and L-Proline has been assessed via 17O NMR. At neutral and basic pH, two water molecules are hydrogen bonded at the carboxylate group, one to each oxygen, whereas a third water molecule is hydrogen bonded to the protonated COOH group at acidic pH, via the hydroxyl hydrogen. The possible formation of dimers and/or higher complexes in DMSO is indicated not only from the chemical shift but also from the linewidth of the amino acids. PMID- 3964256 TI - The interaction of calmodulin with melittin. AB - Studies utilizing the interaction of melittin with the 1-106 fragment of calmodulin, the protection of calmodulin from tryptic digestion by melittin, and the interaction of the carbocyanine dye Stains-all with the calmodulin-melittin complex have indicated that complex formation of calmodulin with melittin involves the alpha-helical connecting bridge joining the N- and C-terminal lobes of calmodulin. PMID- 3964257 TI - [3H]mepyramine binding to histamine H1 receptors in bovine retina. AB - The promethazine-sensitive [3H]mepyramine binding was used to determine the presence of histamine H1 receptors in membranes from bovine retina. Specific mepyramine binding to retinal membranes was reversible, saturable and of high affinity. The apparent dissociation constant (KD = 2.2 +/- 0.4 nM) and the density of binding sites (Bmax = 60.9 +/- 5.1 fmol/mg protein), obtained in equilibrium studies, were similar to those found in bovine brain cortex. Binding was stereospecific and the inhibitory potencies of H1 and H2 antagonists indicated that [3H] mepyramine binding sites in the retina have characteristics of H1 receptors. PMID- 3964258 TI - Characterization of an insulin-related factor secreted by a teratoma cell line. AB - The teratoma-derived insulin-independent cell line 1246-3A produces and secretes polypeptide mitogens in its culture serum-free medium. Mitogenic activities were separated by Sephadex G-50 chromatography into two fractions eluted, one in the void volume region, another one with an apparent Mr of 6 kDa. Only the 6 kDa mitogen presents properties similar to pancreatic insulin as estimated by radioimmunoassay, radio-receptor assay, and biochemical characterization. As a consequence, this factor is called insulin-related factor (IRF). Evidence presented in this paper indicate that ectopic IRF binds to insulin receptors on the producer cells, 1246-3A and acts in an autostimulatory manner. PMID- 3964259 TI - Human brain-derived acidic and basic fibroblast growth factors: amino terminal sequences and specific mitogenic activities. AB - Extended amino terminal sequence determinations, made on both acidic and basic fibroblast growth factors from human brain, showed extensive homology with each other and with their respective bovine counterparts. Both human growth factors in the presence of heparin have equivalent specific mitogenic activities on human umbilical vein endothelial cells in culture whereas in the absence of heparin, the acidic mitogen is less than 1% as active as the basic growth factor. PMID- 3964260 TI - H1-histaminergic activation stimulates inositol-1-phosphate accumulation in chromaffin cells. AB - Adrenal medullary chromaffin cells maintained in vitro were prelabeled with [3H]inositol and the accumulation of [3H]inositol-1-phosphate, was determined following stimulation with a variety of pharmacological agents. Carbachol, bradykinin, and histamine produced significantly greater accumulation of [3H] inositol-1-phosphate over basal levels, with histamine producing the greatest effect. H1-histamine receptor antagonists, mepyramine, pyrilamine, tripelennamine and clemastine were all able to reduce or completely block the histamine response. The two specific H2-histamine receptor antagonists, cimetidine and ranitidine, had no effect on this response. Histamine dose-response characteristics in the presence of mepyramine and clemastine suggest the H1 antagonism to be competitive in nature. PMID- 3964261 TI - Regulation of carnitine palmitoyltransferase activity in the liver and brown adipose tissue in the newborn rat: effect of starvation and hypothermia. AB - The overt activity of hepatic carnitine palmitoyltransferase (CPT1) increased during the last day of gestation in the foetus and after prolonged starvation in the newborn kept at 37 degrees C. Its sensitivity to inhibition by malonyl-CoA decreased during the perinatal period studied. Brown fat CPT1 increased under the same experimental conditions. However, its sensitivity to malonyl-CoA remains unchanged. Hypothermia at 24 degrees C decreased in the liver and increased in brown adipose tissue CPT1 activity in response to fasting. Glucose injection at birth decreased CPT1 activity in the liver but did not have any effect in the presence of mannoheptulose. This effect of glucose was non-significant in brown adipose tissue. PMID- 3964262 TI - High affinity binding of divalent cation to actin monomer is much stronger than previously reported. AB - Monomeric actin is known to bind tightly one divalent cation per molecule. We have quantitatively reinvestigated the affinity of actin for Ca++ and Mg++ using the fluorescent Ca++ chelator Quin2 to induce and measure the dissociation of Ca++ from Ca-actin, supporting these studies with measurements using 45Ca. We found that the KD for Ca-actin is actually 1.9 +/- 0.7 nM. Kinetic analysis supported this result and demonstrated a dissociation rate constant (k-) of 0.013 s-1 and an association rate constant (k+) of 6.8 X 10(6)M-1 s-1 for Ca-actin. Competitive binding studies indicated that the binding affinity of actin for Ca++ is 5.4 times that for Mg++, yielding a calculated KD for Mg-actin of about 10 nM. Thus, the tight-binding of divalent cations to actin is 3-4 orders of magnitude stronger than previously thought. PMID- 3964263 TI - Isolation and primary structure of a peptide from the corpora cardiaca of Heliothis zea with adipokinetic activity. AB - An adipokinetic hormone was isolated from the corpora cardiaca of the corn ear worm moth, Heliothis zea, and purified by reversed phase high performance liquid chromatography. The primary structure, pGlu-Leu-Thr-Phe-Thr-Ser-Ser-Trp-Gly-NH2, was determined by automated gas-phase Edman degradation of the peptide deblocked with pyroglutamic aminopeptidase, and by fast atom bombardment mass spectrometry. The hormone was synthesized and the natural and synthetic material had identical chromatographic, spectroscopic, and biological properties. The peptide was found to have lipid mobilizing activity in H. zea adults. PMID- 3964264 TI - Application of reverse micelles for the extraction of proteins. AB - The solubilization of proteins in hydrocarbon solutions of reverse micelles is examined at the aim of establishing whether this process can be utilized for the separation and extraction of proteins. Two techniques of solubilization are considered, the phase transfer of proteins from an aqueous solution into a supernatant micellar solution and the direct extraction of the protein powder into the micellar solution. Basic questions concerning the influence of structural parameters of the proteins, as well as the influence of external parameters (pH, salt concentration) on the specificity of the solubilization process are discussed. PMID- 3964265 TI - Discrimination between duroquinol oxidase activity and the terminal oxidation step of the cyanide-resistant electron transport pathway of plant mitochondria. AB - Comparison of the cyanide-resistant duroquinol oxidase activity of sub mitochondrial particles from Arum maculatum L. with their ability to carry out a cyanide-resistant oxidation of NADH and succinate shows that heat-inactivation of the duroquinol oxidase activity does not proportionally affect NADH and succinate oxidation. Moreover, 1 microM antimycin inhibits duroquinol oxidase activity by 50% while not decreasing the rates of NADH and succinate oxidation. Therefore, the cyanide-resistant electron transport does not appear to be mediated by a "duroquinol oxidase", and a convincing proof of the existence of a specific protein acting as a cyanide-resistant oxidase in plant mitochondria is still lacking. PMID- 3964266 TI - A new potent inhibitor of lipid peroxidation in vitro and in vivo, the hepatoprotective drug anisyldithiolthione. AB - The drug anisyldithiolthione (ADT) acted as a good inhibitor of lipid peroxidation induced in rat liver microsomes either chemically by FeSO4 and reducing agents (cysteine or ascorbate) or enzymatically by NADPH and CC14. ADT was found as potent as propylgallate with IC50 around 2 microM and much more potent than vitamin E and levamisole. ADT was also found as a good inhibitor of ethane exhalation by rats treated by CCI4 (ID50 approximately 5mg per kg) and by mice intoxicated by acetaminophen (ID50 approximately 0.7 mg per kg). At doses as low as 5 mg per kg it completely suppressed ethane exhalation by acetaminophen intoxicated mice and also protected them very efficiently against mortality caused by acetaminophen overdose. The inhibitory effect of ADT toward lipid peroxidation seems to be linked to the presence of its dithiolthione function. PMID- 3964267 TI - Demonstration of a fluorometrically distinguishable intermediate in calcium binding by calmodulin-mastoparan complexes. AB - Observations on the intrinsic fluorescence of a high affinity calmodulin-binding peptide, Polistes mastoparan, reveal a spectroscopically distinct peptide complex present at maximum concentration when 2 mol Ca+2 are bound per mol calmodulin. The intermediate is detectable only in solutions where calcium is limiting. The results are consistent with cooperative binding of the first two equivalents of calcium by calmodulin. PMID- 3964268 TI - Labile oligomeric structure of human placental 15-hydroxyprostaglandin dehydrogenase. AB - NAD-dependent 15-hydroxyprostaglandin dehydrogenase has been isolated from human term placenta. About 9,000-fold enrichment was achieved with a yield of 7.6%. Electrophoretic analyses suggested that glycerol stabilized an active structure of the enzyme, and sodium dodecyl sulfate might dissociate it. The instability of the enzyme activity may relate to its labile oligomeric structure which is easily dissociated into subunits. PMID- 3964269 TI - Copper-albumin: what is its functional role? AB - The small copper fraction in animal blood that is bound to albumin protein is generally considered to have a transport role for the metal. However, several studies have concluded that copper ion incorporation into copper-enzymes requires caeruloplasmin to act as the transport form. The kinetic rates of Cu(albumin) reactions are also not in keeping with a general transport function. Only in the portal bloodstream does the Cu(albumin) appear to have a well-established transport role, i.e. in delivering the metal ions from the intestine to the liver. Thereafter the evidence as to its function is less certain; it could act as a storage form of the metal or have no role at all. Similar considerations apply to other metal-albumin fractions e.g. those of zinc and nickel. PMID- 3964270 TI - A novel mass spectrometric procedure to rapidly determine the position of O acylated residues in the sequence of naturally occurring oligosaccharides. AB - A novel procedure is described for the assignment of the position of O-acylated residues in the sequence of oligosaccharides. The procedure is both rapid and sensitive and complements existing carbohydrate techniques. The procedure involves the use of derivatisation, using conditions under which naturally occurring O-acyl groups are stable, and subsequent fast atom bombardment mass spectrometric analysis of the derivatised product. The derivatisation enhances and directs fragmentation providing unambiguous sequence data. The protocol described is shown to be applicable to acetyl groups and to more complex acyl groups such as long chain fatty acids. PMID- 3964271 TI - Localization of the exchangeable nucleotide binding domain in beta-tubulin. AB - Limited proteolysis of tubulin by alpha-chymotrypsin cleaved the beta-subunit preferentially at Tyr 281, generating primarily 35 kD and 17 kD fragments which were located in the amino terminal and the carboxy terminal regions, respectively. A small amount of a 19 kD fragment from the C-terminal end was also produced. Alpha-Chymotrypsin-treated tubulin retained the ability to exchange GTP and covalently incorporate nucleotide by direct photoaffinity labeling. SDS-PAGE and autoradiography analysis of the [alpha-32P] GTP-labeled alpha-CT-treated tubulin showed that the 35 kD fragment was almost exclusively labeled, indicating that the exchangeable GTP binding domain resides in the amino terminal region of the beta-subunit. PMID- 3964272 TI - GTP influences the binding of vincristine in human tumor cytosols. AB - The influence of GTP on the formation and stability of [3H] vincristine (VCR) tubulin complexes in cytosols from two human rhabdomyosarcoma xenografts which have different sensitivities to VCR has been evaluated. After removal of endogenous GTP the initial rate of [3H]VCR binding and the maximal level of bound drug were 2- to 3-fold higher in the presence of 0.1 mM GTP than in its absence. Similarly, the stability of complexes was GTP-dependent. Complex formed from Rh18 tumors, only moderately sensitive to VCR, dissociated at 37 degrees in the absence of GTP with a half-time of 67 min; complex from Rh12 tumors (exquisitely sensitive to VCR) was more stable. Neither complex dissociated in the presence of 0.1 mM GTP over 2 hr examined. PMID- 3964273 TI - Amino terminal sequence analysis of human placenta aromatase. AB - The amino acid composition and the amino-terminal amino acid sequence from position 1 to 21 of human placenta aromatase were determined. In addition, a cysteine containing peptide with a sequence homologous to those of peptides containing the cysteine residue which was suggested to provide the proximal thiolate ligand to the heme in other cytochrome p-450 isozymes, was identified. The results indicate that aromatase is a cytochrome p-450 protein, probably derived from a new cytochrome p-450 family. PMID- 3964274 TI - Myosin light chain phosphorylation and evidence for latchbridge formation in norepinephrine stimulated canine veins. AB - The role of 20000 dalton myosin light chain phosphorylation in mediating venous smooth muscle contraction was studied in isolated preparations of canine jugular and femoral vein. One min 10(-5) M norepinephrine-induced contraction was accompanied by significant increases in phosphorylation (jugular - 21 to 46%; femoral - 19 to 54%) which were reversed within 10 min after agonist washout. During 40 min stimulation, phosphorylation and isometric force redevelopment rates declined to near basal levels while force was maintained. These findings implicate light chain phosphorylation as a prerequisite for initial tension development by crossbridge cycling in venous smooth muscle. However, long term tension can be maintained through a process similar to the latchbridge state in tracheal and arterial smooth muscle. PMID- 3964275 TI - Lipoprotein affinity of human apolipoprotein A-IV during cholesterol esterification. AB - We have studied the lipoprotein distribution of human apo A-IV during cholesterol esterification by the action of endogenous lecithin-cholesterol acyltransferase. Using immunologic and radiotracer techniques at 4 degrees C, apo A-IV was found in two discrete monomeric and dimeric populations, unassociated with plasma lipoproteins. With incubation at 37 degrees C, apo A-IV initially associated with the high density lipoprotein-3 fraction, but thereafter dissociated from its surface, and reappeared as unbound protein and in association with a complex in the low density lipoprotein size range. Inclusion of LCAT inhibitors in the incubations abolished these changes. We conclude that the changes in lipoprotein distribution of human apo A-IV closely parallel the formation and exchange of plasma cholesteryl esters. PMID- 3964276 TI - Rhythmic change of myocardial phosphate metabolite content in cardiac cycle observed by depth-selected and EKG-gated in vivo 31P-NMR spectroscopy in a whole animal. AB - The newly developed pulse width modulation method for the depth-selected in vivo NMR under high magnetic field (6.4 Tesla), sectional magnetic resonance (SMR), enabled us to selectively obtain and follow time sequence of P metabolism of rat heart in a whole body. An EKG-gated 31P-SMR spectroscopy at every 30 m sec, after the R wave, with calibrating the resonance intensity by an external standard, demonstrated a synchronous oscillation of both contents of creatine phosphate (CP) and beta-ATP: minimal at the early 2/3 of the systole as was identified by the aortic pressure measurement and maximal at the last 1/3 of the diastole, while inorganic phosphate content varied antiphasically to CP or ATP without obvious change of intracellular pH in cardiac cycle. This is the first report that described an in vivo detection of cyclic change of phosphate metabolites in the heart. PMID- 3964277 TI - Effect of quinine on mitochondrial K+ and Mg++ flux. AB - Quinine decreases rates of unidirectional K+ flux into and out of respiring rat liver mitochondria. K+ efflux is more sensitive to quinine than K+ influx. The data are consistent with the proposal that two separate mechanisms may mediate K+ influx, only one of which is sensitive to quinine. Effects on K+ flux of the stereoisomer quinidine are similar to effects of quinine. The smaller quinuclidine causes at most a slight inhibition of K+ efflux under the same conditions. Mg++ flux exhibits a pattern of inhibition by quinine similar to that of K+ flux. Mg++ efflux is more sensitive to quinine than is Mg++ influx. These and earlier findings indicate marked similarities between liver mitochondrial transport mechanisms for K+ and Mg++. PMID- 3964278 TI - Phosphatidylinositol-dependent activation of DNA polymerase alpha. AB - DNA polymerase alpha was activated in vitro by cAMP-independent, phospholipid dependent, protein kinase catalytic subunit. Of the phospholipids examined, phosphatidylinositol showed the greatest potential for interaction with protein kinase and ATP to activate DNA polymerase alpha in vitro. DNA polymerase alpha was directly activated by phosphorylated phosphatidylinositol in the absence of protein kinase and ATP. Activation of DNA polymerase alpha as a function of phosphorylation was demonstrated using 32P-ATP as the phosphate donor. In vitro treatment of the enzyme with phosphatidylinositol produced Linweaver-Burk plots showing noncompetitive kinetics of enzyme activation, suggesting that activation occurs prior to binding of the enzyme to DNA template/primer. These data indicate that DNA polymerase alpha may be activated in vitro in the presence of protein kinase, ATP, and phosphatidylinositol, and suggest that phosphorylation of the enzyme may constitute an intracellular mechanism of enzyme activation. PMID- 3964279 TI - Is uracil misincorporation into DNA of mammalian cells a consequence of methotrexate treatment? AB - We have carried out an exhaustive analysis to determine if uracil is incorporated into DNA of different mammalian cells exposed to methotrexate. Both HeLa and human lymphoblastoid cells (CCRF-HSB2) were incubated in medium containing [5-3H] deoxyuridine and 10 microM or 100 microM methotrexate. In some experiments non radioactive 10mM uracil was present to inhibit uracil-DNA-glycosylase and thus facilitate the subsequent detection of uracil in the DNA. This was extracted and freed of RNA, ribonucleotides and protein with the use of phenol, RNAase, pronase, ethanol precipitation and Sephadex chromatography. DNA was enzymically degraded to nucleosides which were analysed directly by HPLC. We did not detect uracil in the DNA in over 12 different experiments under various conditions and times of drug-treatment. In view of this we caution against ready acceptance of the notion that uracil is incorporated to any significant extent, or indeed at all, in all types of cells exposed to methotrexate. PMID- 3964280 TI - Oxidation of an organosulfur xenobiotic by microsomes from soybean cotyledons. AB - Methiocarb, an aromatic-alkyl sulfide insecticide was enzymatically oxidized into its sulfoxide by microsomes from soybean cotyledons. No further oxidation into sulfone was detected. Distribution of the sulfoxidase activity was studied in soybean seedlings and found maximal in cotyledons. Subcellular fractionation of cotyledons homogenates indicated that the activity was almost entirely associated with the microsomal fraction. Sulfoxidation of methiocarb did not require cofactors such as NAD(P)H. Nevertheless, the sulfoxidase did not act as a peroxidase. PMID- 3964281 TI - Identification of two activities of (ADP-ribose)n glycohydrolase in HeLa S3 cells. AB - HeLa S3 cells contained two activities (form I and II) that degrade (ADP-ribose)n exo-glycosidically. Form I was extracted from nuclei only by sonication in high ionic strength, while form II was soluble in cytosol. The two active forms differed in chromatographic behaviors, in their Km values for (ADP-ribose)n, and in their pH and salt requirements for optimal activity, although both forms exhibited properties characteristic of (ADP-ribose)n glycohydrolase such as requirement of sulfhydryl compounds and sensitivity of ADP-ribose and cAMP. Form I and II had apparent molecular weights of 72,000 and 53,000, respectively, as determined by gel filtration on Sepharose CL-6B. PMID- 3964282 TI - Activities of cardiac and hepatic pyruvate dehydrogenase complex are decreased after surgical stress. AB - The work investigated the effects of surgical stress on the activities of cardiac and hepatic pyruvate dehydrogenase complex (active form, PDHa) in fed rats. PDHa activities in heart and liver were decreased within 4h of surgery with maximum inhibition at 24h after surgery. PDHa activities remained low until the fourth (liver) and eighth (heart) post-operative days. The decreased activities found at 4h and 24h after surgery were associated with increased plasma fatty acid concentrations, and inhibition of lipolysis resulted in reactivation of the enzyme complex. The results are discussed with reference to the control of pyruvate dehydrogenase activities by the oxidation of fat fuels and multisite phosphorylation in stress states, and its possible importance in glucose conservation after surgery and trauma. PMID- 3964283 TI - Immobilization of fatty acyl-CoA synthetase: effect on its stability and substrate specificity. AB - Fatty acyl-CoA synthetase purified from rat liver microsomes was immobilized on either CNBr-activated Sepharose 4B or activated CH-Sepharose 4B, and the enzymatic activities of the syntheses of CoA esters from lignoceric acid (C24:0) and palmitic acid (C16:0) were studied and compared. The ratio of activities of the synthesis of lignoceroyl-CoA to palmitoyl-CoA increased 4.5 fold with CH Sepharose, but only slightly with CNBr-Sepharose. The effects of a detergent and chaotropic agent on both substrates were significantly altered by the immobilization. The results of this study thus indicate that the stability and fatty acid specificity of fatty acyl-CoA synthetase are significantly affected by the physical state of the enzyme. PMID- 3964284 TI - Changes of fluorescence spectra of 2'-deoxyguanosine in aqueous solution by radiation. AB - Aqueous solution of 2'-deoxyguanosine (5 X 10(-4) M, pH 7.0) was irradiated with 60Co gamma-rays under O2, N2, N2O, and t-BuOH-N2, respectively. A marked increase in fluorescence emission intensity was observed under all atmospheric conditions as was observed in aqueous solutions of adenine and 2'-deoxyadenosine. However, the fluorescence yield from 2'-deoxyguanosine with radiation was lower under O2 and much higher under t-BuOH-N2 than that from 2'-deoxyadenosine though it was not so different both under N2 and N2O. Such high fluorescence yield from 2' deoxyguanosine especially under t-BuOH-N2 suggests that guanine base has a specific reactivity with hydrated electron or t-butanol radical differing from the other nucleobases. PMID- 3964285 TI - A kinetic method for the simultaneous determination of isoenzymes activities in mixture. Application to A2 and A3 horseradish peroxidases. AB - A graphical method for the simultaneous determination of the activity of two isoenzymes in a mixture, is presented. The method is based on the different kinetic behaviour of the isoenzymes to the changes in the substrate concentrations. Having determined the reaction rates for the enzyme mixture at different substrate concentrations, the activity of both isoenzymes can be derived graphically. An algebraic method for two or more isoenzymes is mentioned, as well. The applications of the graphical and the algebraic method to A2 and A3 horseradish isoperoxidases demonstrated that the difference between the actual activities of the two isoperoxidases and those determined by the proposed method was around 5% of the actual activities. The scope of application of this method could be extended to isoenzymes of clinical importance. PMID- 3964286 TI - ADP-ribosylation induced changes in the conformation of the chromatin of the brain of developing rats. AB - Conformational changes in the chromatin of the cerebral hemisphere of 3-, 14- and 30-day old developing rats were studied before and after its ADP-ribosylation using DNase I and micrococcal nuclease (MNase). The rate and extent of digestion of chromatin by DNase I are the highest at 3-day and decline progressively thereafter. The rate and extent of digestion by MNase do not change during development. ADP-ribosylation of chromosomal proteins was carried out by incubating nuclei with NAD+ for 30 min and was followed by endonuclease digestion. Both the rate and extent of digestion by DNase I and MNase were enhanced after ADP-ribosylation which was the maximum for 3-day rats. PMID- 3964287 TI - The acute effects of ethanol on protein synthesis in isolated rat liver cells are pH-dependent. AB - Acute administration of ethanol to isolated rat liver cells induced a pH dependent inhibition of protein synthesis. The effect of the alcohol was highest at pH 7.0 and nil at pH 7.8. 4-methyl-pyrazole partially reversed the action of ethanol only below pH 7.4. Time-course experiments suggested that ethanol could act preventing the initiation of new polypeptide chains stimulated by D-glucose, and that this effect is abolished at pH 7.8. PMID- 3964288 TI - The distances separating Tyr-69 from the high-affinity nucleotide and metal binding sites in actin. AB - The nucleotide binding site in actin was occupied with the fluorescent analogue formycin A 5' triphosphate which acted as a fluorescent donor for the acceptor chromophore dansyl chloride attached to Tyr-69. The distance separating the two chromophores was calculated to be 2.1 nm from the fluorescence energy transfer measurements. Similar measurements were made of the distances separating dansyl chloride, acting as donor, on Tyr-69 from Co2+ occupying the metal binding site. A distance of 2.1 nm was similarly obtained. PMID- 3964289 TI - Peroxidized lipids isolated by HPLC from atherosclerotic aorta. AB - Conjugated dienes of fatty acids were detected in cholesterol esters in lipid droplets prepared from atherosclerotic aorta of WHHL rabbits. Two peroxidized fatty acids were recovered by reverse phase HPLC. These peroxidized fatty acids showed maximum absorption at 233 nm, suggesting that they were peroxidized lipids containing cis-trans conjugated diene, and one of them was shown to be 13-hydroxy octadecadienoic acid. PMID- 3964290 TI - Use of a new methylene blue derivative for determination of lipid peroxides in foods. AB - To determine lipid peroxides in chloroform-methanol extracts of foods, a simple and sensitive colorimetric method using a new leucomethylene blue derivative was adopted. The amounts obtained by this method coincided well with those by the iodometric method and paralleled those by the thiobarbituric acid method. PMID- 3964291 TI - Effect of lutein on the transport of Ca2+ across phospholipid bilayer and mitochondrial membrane. AB - Lutein (3,3'-dihydroxy alpha-carotene), a xanthophyll present in plant chloroplasts, increases the permeability of phospholipid vesicles to Ca2+, even though the pigment does not bind the metal ion. Energy-dependent uptake of Ca2+ by mitochondria is inhibited by lutein, which permits a rapid efflux of the ion from Ca2+-loaded mitochondria. These results are consistent with the view that the deleterious action of lutein on mitochondrial oxidative phosphorylation results from its destabilizing action on membrane structure. PMID- 3964292 TI - Structural requirements for cocaine congeners to interact with dopamine and serotonin uptake sites in mouse brain and to induce stereotyped behavior. AB - We report here saturation analysis of [3H]cocaine binding in various mouse brain regions, and the necessary structure-activity relationships for cocaine congeners to inhibit Na+-dependent [3H]cocaine binding and [3H]dopamine uptake in the mouse striatum, and to inhibit [3H]cocaine binding that cannot be stimulated by Na+ and [3H]serotonin uptake in the mouse cerebral cortex. Generally similar structure activity relationships were noted for all these processes. The ester linkage between the tropane and phenyl rings was not required for activity, in contrast to the configuration of the groups on C2, and to a lesser extent C3, in the tropane ring. Stereospecificity was evident from the differences between cocaine and (+)-pseudococaine, and between WIN 35,065-2 and WIN 35,065-3. There were remarkable differences between the above structure-activity relationships and those for local anesthetic activity of cocaine congeners, indicating that sodium channels were not labeled to a measurable extent with [3H]cocaine under the present conditions. Preliminary data indicated a significant correlation between the potencies of cocaine congeners in inhibiting the Na+-dependent binding of [3H]cocaine and their potencies in inducing stereotyped sniffing upon intraventricular administration. PMID- 3964293 TI - Metabolic consequences of dietary 2,3-dichloro-1,4-naphthoquinone (CNQ) in the rat. Alteration in anti-oxidant enzyme activities. AB - Dietary exposure of rats to a high concentration of 2,3-dichloro-1,4 naphthoquinone (CNQ) (2 g/kg diet) for 60 days altered cardiac mitochondrial function and activities of anti-oxidant enzymes in hepatic and cardiac tissue. CNQ moderately depressed the cardiac mitochondrial respiratory control ratio (RCR) to 85% of control; this was exacerbated to 60% of control in animals fed alpha-tocopherol-deficient diets. Dietary CNQ increased hepatic superoxide dismutase (SOD) and catalase activities and increased cardiac SOD activity, but depressed cardiac glutathione reductase and hepatic glutathione peroxidase activities. These effects are consistent with previous in vitro findings that CNQ induces oxidative stress. No significant differences in heart weight or body weight were observed in rats fed CNQ as compared to untreated controls. PMID- 3964294 TI - Further studies on substituted quinazolines and triazines as inhibitors of a methotrexate-insensitive murine dihydrofolate reductase. AB - Data are presented on the systematic analysis of thirty-five quinazoline and substituted triazine compounds as inhibitors of a methotrexate-insensitive form of dihydrofolate reductase purified from methotrexate-resistant L5178Y murine leukemia cells. Several of the compounds were found to be more potent inhibitors of this enzyme activity than was methotrexate. Two of the triazine compounds had IC50 values approaching 10nM, which is close to that of methotrexate for the normal drug-sensitive dihydrofolate reductase. In addition, some of these compounds, especially the triazines, exhibit a specificity of inhibition for the methotrexate-insensitive enzyme as compared to the normal methotrexate-sensitive dihydrofolate reductase derived from the same cell line. These compounds may, therefore, be potentially useful in the treatment of those methotrexate-resistant tumours which express an altered, methotrexate-insensitive dihydrofolate reductase. PMID- 3964295 TI - Age-dependent propranolol clearance in perfused rat liver. AB - The effect of age on the hepatic clearance of propranolol was studied by perfusing the liver isolated from 3- to 104-week-old rats. Propranolol levels in the recirculating perfusate declined biexponentially with time in all age groups. When the liver isolated from 7-week-old rats was perfused with propranolol (1 microgram/ml, 100 ml), hepatic clearance of this drug by the perfused liver (CLperf) increased from 0.589 to 1.14 ml X min-1 X (g liver)-1 with the increase of the perfusion flow rate from 1.0 to 2.0 ml X min-1 X (g liver)-1, confirming evidence of "perfusion-limited" hepatic clearance for this drug. Furthermore, there was no initial concentration(dose)-dependence in CLperf up to 2.5 micrograms/ml (i.e. 250 micrograms/organ). The effect of age on CLperf was then investigated by perfusing the isolated liver with 1.0 micrograms/ml propranolol at 2.0 ml X min-1 X (g liver)-1. Elimination of this drug from the perfusion medium was relatively rapid in 5- to 7-week-old rats, yielding the highest CLperf in these relatively young rats [approximately 1.0 to 1.1 ml X min-1 X (g liver) 1]. In contrast, CLperf values in both immature and older rats were 0.5 ml X min 1 X (g liver)-1 or less. The in vitro intrinsic hepatic clearance estimated in 5- and 7-week-old rats was about ten times as high as that in 104-week-old rats. PMID- 3964296 TI - Kinetics and substrate specificity of human and canine cytidine deaminase. PMID- 3964297 TI - Effect of doxorubicin on calcium binding sites in guinea-pig heart. PMID- 3964298 TI - A re-evaluation of the competitive protein binding assay for methotrexate binding to dihydrofolate reductase. PMID- 3964299 TI - Dissociation of increased lauric acid omega-hydroxylase activity from the antilipidemic action of clofibrate. AB - Clofibrate, an antilipidemic drug that acts by a still obscure mechanism, is known to specifically increase up to 30-fold the activity of the hepatic cytochrome P-450 isozyme that omega-hydroxlates lauric acid. The thesis that accelerated catabolism of medium-length fatty acids initiated by omega hydroxylation contributes significantly to the antilipidemic action of clofibrate has been examined by measuring the impact on serum triglyceride levels of coadministering clofibrate and a suicide substrate that inactivates the hydroxylase. The results suggest that the antilipidemic action of clofibrate does not depend critically on the enhanced omega-hydroxylation of fatty acids. PMID- 3964300 TI - Binding of DNA to albumin and transferrin modified by treatment with water soluble carbodiimides. AB - N-Acylurea derivatives of albumin and transferrin prepared with the water-soluble carbodiimides N-ethyl-N'-(3-dimethylaminopropyl)carbodiimide and N-ethyl-N'-(3 trimethylpropylammonium)carbodiimide iodide have been found to bind different types of DNA. The two proteins were reacted with varying amounts of carbodiimide in water at pH 5.5 for 36-60 hr at 20 degrees, and then purified. In the case of iron-loaded transferrin, reactions with carbodiimides were in phosphate-buffered saline (pH 7.5) to prevent loss of iron from the protein. [3H]N-Ethyl-N'-(3 trimethylpropylammonium)carbodiimide iodide was used for the determination of covalently attached N-acylurea groups in the modified proteins, and gel electrophoresis for changes in charge and possible aggregation through cross linking. Binding of DNA to N-acylurea proteins was studied by means of gel electrophoresis and nitrocellulose filter binding. N-Acylurea albumin and N acylurea transferrin at low concentrations retarded the migration of lambda-Pstl restriction fragments, pBR322 plasmid and M13 mp8 single-stranded DNA on agarose gels, while at higher concentrations of modified protein the N-acylurea protein DNA complexes were unable to enter the gel. Nitrocellulose filter assays showed that binding pBR322 DNA and calf thymus DNA to N-acylurea proteins is rapid and dependent on protein concentration and the ionic strength of the medium. N Acylurea albumins prepared with each each of the two carbodiimides gave comparable plots for DNA bound versus protein concentration. On the other hand, binding of DNA by N-acylurea transferrins differed according to the carbodiimide used in the synthesis. N-Acylurea CDI-tkransferrin (prepared with tertiary carbodiimide) was less effective than either of the two N-acylurea albumins in binding DNA. In contrast with these results, N-acylurea Me+-CDI-transferrin (prepared with quaternary carbodiimide) was far more effective in binding DNA and in this respect was similar to the N-acylurea albumins. On the basis of experiments in which N-acylurea protein-DNA complexes were treated with heparin, two types of binding could be distinguished. These were a weak binding occurring in the initial stages of interaction and a tight binding which developed on further incubation of the complexes. These studies show that binding of DNA by N acylurea proteins is a reversible process dependent on ionic strength; interaction appears to be electrostatic in nature, although other forms of binding might be involved.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3964301 TI - Glucocorticoid inhibition of fibroblast contraction of collagen gels. AB - When skin fibroblasts are grown in culture on collagen gels, the collagen gels contract. We have studied the effects of various steroids on the contraction process. Cortisol, beta-estradiol and dexamethasone inhibited fibroblast-mediated gel contraction at low (10(-8) to 10(-9) M) concentrations whereas dihydrotestosterone was without effect. These effects were time and concentration dependent and could be reversed if the steroids were removed. This system may be useful for assaying the activities of various steroids in terms of their activities and modulating effects on connective tissue. PMID- 3964302 TI - Affinity of heavy metal ions to intracellular Ca2+-binding proteins. AB - Parvalbumin, troponin C and vitamin D dependent Ca2+-binding proteins (CaBP type I and II) share the property of calmodulin to interact with some heavy metal ions. In flow dialysis and in spot tests the affinities of Cd2+ and Pb2+ to these proteins were comparable to those of Ca2+. The relative affinities were for calmodulin: Pb2+ greater than Ca2+ greater than Cd2+, for troponin C: Ca2+ greater than Cd2+ greater than Pb2+, for CaBP I: Ca2+ approximately Pb2+, for CaBP II; Ca2+ greater than Pb2+ greater than Cd2+, and for parvalbumin: Cd2+ approximately Ca2+ greater than Pb2+. Upon gel filtration of the supernatant of a pig mucosal homogenate, binding for both Pb2+ and Ca2+ appeared in the MW range of 10,000, together with CaBP II. We conclude that the investigated proteins bind heavy metal ions, in particular Pb2+ and Cd2+, similar to calmodulin. Their role in transport, storage and toxicity remains to be assessed. PMID- 3964303 TI - Induction of rat liver microsomal cytochrome P-450 by muscone (3 methylcyclopentadecanone). PMID- 3964304 TI - Effect of a perfluorochemical emulsion on prednisolone binding by human albumin. PMID- 3964305 TI - Studies on rat liver cytochrome P-450s involved in the metabolism of antipyrine: phenobarbital- and 3-methylcholanthrene-inducible isozymes possessing 4 hydroxylase activity. PMID- 3964306 TI - [Comparative characteristics of soluble and membrane brain aminopeptidases. I. Isolation, physico-chemical properties, catalytic activity]. AB - The methods were worked out for isolating of the bovine brain soluble and membrane-bound aminopeptidases in highly purified state. One of the stages involved a biospecific-type chromatography on aminohexyl-Sepharose. Both enzymes were found to have equal molecular masses (ca. 100-107 kD) and isoelectric points (pI 4,6). None of the enzymes possessed a subunit structure. Both aminopeptidases were inactivated by omicron-phenanthroline and by an SH-reagent, p hydroxymercuribenzoate. The catalytic constants for the hydrolysis of a specific substrate, L-leucine p-nitroanilide, were identical for the two enzymes. So far no differences in the physico-chemical or enzymatic properties of the soluble and membrane-bound enzymes were disclosed. PMID- 3964307 TI - [Comparative characteristics of soluble and membrane brain aminopeptidases. II. Substrate specificity]. AB - Comparative studies on substrate specificity of the soluble and membrane-bound aminopeptidases from bovine brain were carried out. A series of p-nitroanilides and beta-naphthylamides of amino acids, di- and tripeptides with the aminoterminal phenylalanine residue, as well as a biologically active pentapeptide--[Leu5]enkephalin--were used as substrates. The soluble and membrane bound aminopeptidases manifested identical specificity towards the employed substrates. The aminopeptidases were equally effective towards the p nitroanilides of amino acids and peptides, whereas beta-naphthylamides were more susceptible to hydrolysis by both aminopeptidases than p-nitroanilides and peptides. Taking into account physico-chemical characteristics of these enzymes, it was concluded that the soluble and membrane-bound aminopeptidases are quite similar or perhaps identical. Their role in the regulation of nervous system functioning was discussed. A comparison of specificities for brain aminopeptidases and leucine aminopeptidase from bovine lens led to the conclusion that they belong to different groups. This feature allows planning the synthesis of selective inhibitors. PMID- 3964308 TI - [DNA-polymerase alpha from human placenta. Effectiveness of interaction between oligothymidylates of different lengths and the template-binding site]. AB - Modification of human placenta DNA polymerase alpha by (pT)2pC[Pt2 + (NH3)2OH].(pT)7 was investigated. The linear time dependence of the enzyme activity logarithm suggested a pseudo-first order for modification. Kd value of enzyme-affinity reagent complex (0.5 microM) was estimated. The enzyme inactivation by the affinity reagent and protection from inactivation in the presence of oligonucleotides of varying length were used for determining Kd values of the enzyme-ligand complexes. Oligonucleotide d(pT)2pC(pT)7 (Kd 0.15 microM), d(Tp)9T (Kd 0.15 microM) and [d(Tp)9]ddT (Kd 0.15 microM) protected the enzyme from inactivation with equal efficiency. The protective action of oligothymidylates d(Tp)nT (where n changes from 3 to 14) strongly depended on the chain length, the Kd values diminishing from 5.3 to 0.0091 microM in the geometrical progression. The addition of one link to the oligothymidylate chain resulted in 1.71-fold increase in the oligonucleotide affinity for the enzyme specific site. Such a change corresponds to Gibbs energy change of about 0.32 kcal/mole. It is supposed that the monomer units of pentadecathymidylate (at least beginning with the third one) in d(Tp)14T-enzyme complex form neither hydrogen bonds nor electrostatic linkages with the enzyme. Kd values of oligonucleotides as templates are shown to reflect quite well the true affinity of template for the enzyme. This affinity increases in the presence of a primer. However, the ratio of the affinity for different oligonucleotides does not change in the presence or absence of a complementary primer. PMID- 3964309 TI - [Primary structure of the full-size DNA copy of the NP gene of influenza virus A/Kiev/59/79 (H1N1)]. AB - The complete nucleotide sequence of the cloned full-length DNA copy of A/Kiev/59/79 (H1N1) influenza virus nucleoprotein gene has been determined. This strain is shown to be the natural recombinant that inherited its nucleoprotein gene from contemporary H3N2-influenza strains. The comparison with other NP-genes reveals the probable localization of antigenic determinants and phosphorylation site of the NP-protein. PMID- 3964310 TI - [Primary structure of the full-size DNA copy of the hemagglutinin gene of influenza virus A/Kiev/59/79 (H1N1)]. AB - The complete nucleotide sequence of the cloned full-length DNA copy of A/Kiev/59/79 (H1N1) influenza virus hemagglutinin gene has been determined. The comparison with the other hemagglutinin structures reveals the divarication of evolutionary pathway of the H1N1-influenza viruses. PMID- 3964311 TI - Enhanced phospholipase activity in peripheral blood monocytes from patients with rheumatoid arthritis. AB - Peripheral blood monocytes (PBM) from patients with rheumatoid arthritis (RA) produce greater amounts of prostaglandins (PG) than do control cells. To further explore the reasons for the increased PG production, we assessed the phospholipase activities in these cells. We found that PBM from patients with severe RA expressed greater phospholipase A2 (PLA2) and phospholipase C (PLC) activities than did the control cells. Enhanced PLA2 activities were observed in RA patient cells when phosphatidylcholine (PC) or phosphatidylethanolamine (PE) were used as substrates. Enhanced PLC activities also were seen when PC, PE, and phosphatidylinositol (PI) were used as labeled substrates. Increased PLC activity was observed whether linoleic acid or arachidonic acid was esterified to the 2 position of the phospholipid substrate used. Because all patients with RA were treated with nonsteroidal antiinflammatory drugs, we examined the effects of aspirin ingestion on phospholipase activities. Aspirin had no consistent effect on PLA2 activities but markedly inhibited PLC activities against PC, PI, and PE with arachidonic acid in the R2 position. That aspirin enhanced PLC activities against PC and PI with linoleic acid in the R2 position, suggests that PLC activity may be regulated in part by the R2 fatty acid. Our results indicate that increased phospholipase activities exhibited by PBM from RA patients may help explain the increased PG production by these cells. The increased phospholipase activities in PBM from RA patients do not appear to be due solely to nonsteroidal antiinflammatory drug therapy. PMID- 3964312 TI - Progressive multifocal leukoencephalopathy complicating systemic lupus erythematosus. AB - Two patients with systemic lupus erythematosus who developed progressive multifocal leukoencephalopathy (PML) are described. Although the time of PML onset could not be determined with certainty, it probably developed after steroid induced immunosuppression. However, high-dose corticosteroids appeared to produce transient amelioration in the neurologic disorder. We suggest that PML is an important addition to the list of conditions to be considered in the differential diagnosis when a patient with systemic lupus erythematosus develops neurologic abnormalities. PMID- 3964313 TI - Low density lipoprotein inhibits the physical interaction of phlogistic crystals and inflammatory cells. AB - Low density lipoprotein (LDL) is the major plasma inhibitor of neutrophil oxidative and lytic responses to monosodium urate crystals and may function to modulate acute gouty inflammation. LDL inhibited apparent phagocytosis of urate crystals by human neutrophils, suggesting it may interfere with early events in the crystal-induced stimulation of neutrophils. The effects were not specific for neutrophils, since human platelet secretory and membranolytic responses to urate crystals were also inhibited by purified LDL in doses as low as 10 micrograms/ml. As with neutrophils, the inhibitory activity of LDL was stimulus-specific. Since LDL binds to urate crystals and specifically inhibits a range of cellular responses to them, including phagocytosis, we hypothesized that LDL interferes with the initial crystal-cell interaction. We measured platelet interaction with urate crystals and found that LDL was a potent inhibitor of crystal-induced platelet sedimentation and was 10-100-fold more active than lipoprotein-depleted plasma or purified high density lipoprotein. In summary, LDL inhibits a broad range of responses of a number of inflammatory cell types to certain inflammatory surfaces, and this effect appears to be due to inhibition of physical association of crystals with cell membranes. PMID- 3964314 TI - Evaluation of arthritis self-management courses led by laypersons and by professionals. AB - We compared the relative effectiveness of 2 arthritis patient education interventions. One intervention was modeled after that developed by Lorig, whereas the other had similar content but used health professionals rather than laypersons as instructors. Both interventions resulted in an increase in patients' knowledge of arthritis and in their use of exercise compared with a control group that received no intervention. However, neither intervention was any more effective than nonintervention in lessening patients' pain, improving their functioning, enhancing social support systems, lessening their depression, or improving their health behaviors beyond that of exercise. No differences in outcome measures were found between groups led by professional instructors and those led by lay instructors. PMID- 3964315 TI - Fibronectin in acute and chronic inflammation. AB - Recent evidence suggests that fibronectin (Fn), a high molecular weight glycoprotein, may be used as an indicator protein in rats with adjuvant-induced arthritis. Rocket immunoelectrophoresis, using purified goat anti-rat Fn, provided a specific and sensitive means of measuring plasma Fn in rats during the development of various inflammatory disease states. It was shown that normal rat plasma Fn levels of approximately 400 micrograms/ml double within 24 hours after injection of adjuvant. Plasma Fn levels in this model of chronic systemic inflammatory joint disease were tracked for more than 4 months and remained significantly higher than normal. On the other hand, a carrageenan-induced inflammatory response in the pleural cavity of rats resulted in a large local accumulation of leukocytes, but no change in plasma Fn levels. A carrageenan induced model of acute inflammation resulted in increased paw swelling within 6 hours and enhanced plasma Fn levels within 24 hours; plasma Fn levels returned to normal within 1 week. Quantitation of plasma Fn levels in the rat may provide a useful biochemical parameter for the study of chronic systemic inflammatory diseases. PMID- 3964316 TI - Progesterone secretion in the rat in response to an adjuvant arthritis challenge. AB - This study was undertaken to determine if progesterone is secreted in response to an adjuvant-induced arthritis challenge in the rat. While the arthritic rat paw volume increased 33%, the plasma progesterone concentration increased from 502 pg/ml in the control rats to 1,202 pg/ml in the arthritic animals. A strong positive correlation was found between the degree of edema and the plasma progesterone concentrations. We suggest that progesterone may play an antiinflammatory role in adjuvant arthritis in the rat. PMID- 3964317 TI - Handedness in systemic lupus erythematosus. PMID- 3964318 TI - Concurrence of subacute cutaneous lupus erythematosus and rheumatoid arthritis. PMID- 3964319 TI - Treatment of gold-induced thrombocytopenia by high-dose intravenous gamma globulin. PMID- 3964320 TI - A familial syndrome of pericarditis, arthritis, camptodactyly, and coxa vara. PMID- 3964321 TI - The camptodactyly-arthropathy-pericarditis syndrome: case report and literature review. PMID- 3964322 TI - Long-term colchicine administration leading to colchicine toxicity and death. PMID- 3964323 TI - Poor clearance of gold using peritoneal dialysis for the treatment of gold toxicity. PMID- 3964324 TI - Nailfold capillary abnormalities and organ involvement in scleroderma. PMID- 3964325 TI - Juvenile primary fibromyalgia syndrome. PMID- 3964326 TI - The effect of coenzyme Q10 against the attack of phospholipase to myocardial membrane. AB - This study was designed to clarify the biochemical and electrophysiological influences of phospholipase (PLase) A2 and PLase C on canine myocardial membrane and to investigate the effect of coenzyme Q10 (CoQ10) against the action of these enzymes. Nine different species of free fatty acids (FFA), i.e., lauric, myristic, palmitic, palmitoleic, stearic, oleic, linoleic, arachidonic and docosahexaenoic acids were detected in myocardial membrane preparations by a high performance liquid chromatography. Incubation of the membrane with PLase A2 increased all of the unsaturated FFA, but not the saturated FFA. Incubation with PLase C increased all of the detected FFA. While PLase A2 and PLase C induced deleterious effects on myocardial membrane potentials, such as decreasing in the resting potential and in the magnitude of action potential, and shortening of the action potential duration. Premedication with CoQ10 significantly prevented all of these biochemical and electrophysiological changes induced by the action of PLases, suggesting that CoQ10 exerts a protective effect on myocardial membrane against the attack of PLases. PMID- 3964327 TI - Pharmacodynamics of straight-chain and branched-chain acidic triamterene derivatives. AB - The diuretic, natriuretic and antikaliuretic properties of several straight-chain and branched-chain acidic triamterene derivatives were investigated in male Wistar rats. Among the straight-chain compounds the ether of hydroxytriamterene with five C atoms in the side chain (S3) revealed the maximum effects. The iso compounds (derivatives of 4-carboxymethoxy triamterene S1) showed much better water solubility than the n-acids, but they increased the natriuresis only slightly and had no effect on kaliuresis when they were injected intravenously alone; whereas the isocompound Si4 showed potassium retaining properties when it was administered together with furosemide. From these results it can be suggested that the negative charge in the side chain has to be in a distinct distance from the pteridine ring to produce antikaliuretic effects. PMID- 3964328 TI - [The effect of prednisolone bisuccinate on the prenatal development of the Wistar rat]. AB - The action of prednisolone bisuccinate (Prednisolut) was tested on Wistar rats during two stages of prenatal development (embryonal development and early fetogenesis). Prednisolone application leads to phase-specific and dose-dependent disturbances in normogenesis (increased rate of resorption and retardation). PMID- 3964329 TI - Studies on the embryotoxic risk of drug treatment during the preimplantation period in the mouse. AB - For risk evaluation of exposure to drugs in early pregnancy the dose-response relationship for embryotoxicity was determined in mice during the preimplantation period using cytotoxic drugs (cyclophosphamide, mitomycin, vinblastine) and therapeutic drugs which are embryotoxic in laboratory animals or in humans during organogenesis (diazepam, doxycycline, phenobarbital, rifamycin, tolbutamide). No malformations but only signs of retardation and a dose related increase in the resorption rate could be detected after treatment with some of the drugs at term even at dose levels close to the maternal LD50 (MLD50). A comparison of the embryolethal dose during the preimplantation period (ELD50) with the MLD50 revealed no risk for the therapeutic drugs, a slight risk for mytomycin and vinblastine and an unusually high risk for cyclophosphamide. The ELD50 for all drugs in this study was higher than the embryotoxic doses during organogenesis which is routinely determined for all drugs. It is concluded that for therapeutic drugs additional testing for embryotoxicity during early pregnancy is not required. PMID- 3964330 TI - Chemotherapeutically active anthraquinones. II. Aminomethylanthraquinones. AB - Basically substituted 2,6- and 2,7-bis-amino-methylanthraquinones have a pronounced in vitro and in vivo effect against Entamoeba hystolytica (extraintestinal amoebiasis in golden hamsters) and marked interferon-inducing properties. In 2,6- and 2,7-bis-aminomethyl-anthraquinones only the introduction of hydroxyl groups in 1,5 or 1,8 position led to an additional high systemic activity against Trichomonas foetus in NMRI mice, but it also resulted in the loss of the interferon-inducing effect. Both substance classes included several compounds whose effects against E. histolytica or T. foetus were either comparable or superior to those of standard compounds ornidazole and tinidazole. PMID- 3964331 TI - Major routes of naftifine biotransformation in laboratory animals and man. AB - Following dermal or oral administration to laboratory animals and man (E)-N methyl-N-(1-naphthylmethyl)-3-phenyl-2-propen-1-amine- hydrochloride (naftifine), the antifungal constituent of Exoderil, is quantitatively biotransformed into, and excreted as metabolites devoid of antifungal activity. The structures of 15 metabolites were elucidated. In rat urine and bile these metabolites represent 70% of the orally absorbed dose. The biotransformation routes are: N dealkylation, oxidation or reduction of the aldehyde intermediates from a) to the corresponding carboxylic acid- or alcohol-type metabolites, arene oxide formation in the phenyl- and naphthalene moieties of Naftifine, and conjugation, mainly with glucuronic acid and glycine. Similar metabolite patterns were obtained after oral and parenteral administration. The same pathways of naftifine biotransformation were observed in all species investigated, i.e. in man, rat, dog, rabbit and guinea pig, the last two species most closely resembling to man with respect to overall kinetics and urinary metabolite pattern. PMID- 3964332 TI - Pharmacokinetics and bioavailability of three different galenic nifedipine preparations. AB - In a randomized three-way crossover study with twelve volunteers the bioavailability and main pharmacokinetic parameters of three different galenic formulations of nifedipine (hard gelatine capsule with pellets = preparation A, soft gelatine capsule with liquid nifedipine = preparation B, retard-tablet = preparation C) were determined. Plasma concentrations of nifedipine were measured by capillary gas-liquid chromatography up to 24 h after single dosing as well as up to 48 h after multiple doses of the drugs (steady state). Statistically significant differences between the preparations were found for AUC, Cmax, and Tmax. In all respects preparation A was intermediate to the other preparations. Plasma levels of 40 ng/ml or more were reached for most subjects within the first half hour after application of a single dose of preparation A and under steady state conditions plasma concentrations of 25 ng/ml or more could be upheld with this preparation for a longer time than with the reference retard tablet (preparation C). No accumulation of nifedipine in plasma occurred following multiple dosing. PMID- 3964333 TI - [The effect of cardiac glycosides on the visual system of man measured with cortical evoked potentials]. AB - The effect of beta-acetyldigoxin (Novodigal) on color vision in normal, healthy subjects was studied using cortical evoked potentials. Initial results indicate a significant latency increase of one component of the visual evoked potential (VEP) and a dose dependency following a change of color from blue to red. The Farnsworth-Munsell-100-Hue test, however, showed no significant changes in color vision. It is postulated that the VEP is an even more sensitive measurement of color vision than subjective tests are. PMID- 3964334 TI - [Gastroduodenal tolerability of indomethacin and acetaminophen. A comparative endoscopic study in healthy subjects]. AB - The effect of a 5- and 10-day treatment with indometacin and acemetacin (Rantudil) on the gastroduodenal mucosa was endoscopically evaluated in 16 healthy volunteers. In a randomised double-blind cross-over fashion the volunteers received 50 mg t.i.d. indometacin as well as 60 mg t.i.d. acemetacin. Acemetacin evoked after 5 and 10 days significantly less gastroduodenal lesions than indometacin. Possible reasons for this apparently better tolerability of acemetacin in man are discussed. PMID- 3964335 TI - [The problem of the impairment of the action of parasympatholytic substances. Ophthalmologic criteria and methods]. AB - The parasympatholytic effects on the eye were investigated in 12 healthy volunteers. In a randomized cross-over double-blind trial 20 or 40 mg N butylscopolaminium bromide (Buscopan) or placebo was given by i.v. injection. Pupillary light reaction, range of accommodation, visual acuity, and nyctometer values were measured up to 45 min after injection. RESULTS: 1. The mydriatic effect of both dosages of the drug is moderate. Pupil diameters at the end of the light reaction are only slightly greater under the influence of the drug than in control experiments. The dynamics of the reaction remains unaltered. 2. The range of accommodation diminishes in a dose-dependent manner. 9-15 min after the injection the inhibition is maximum. 45 min after injection, even of the 40 mg dosage, only a small effect remains. 3. Visual acuity and nyctometer values are not affected by N-butylscopolaminium bromide. The findings were discussed with respect to the ability to meet the requirements of road traffic. PMID- 3964336 TI - [Molecular mechanisms of malignant transformation by oncogenic products]. PMID- 3964337 TI - Asha interviews. Kam Mirmelstein-Lemberger, Rona Mirmelstein, and Charles Berlin. PMID- 3964338 TI - Dietary interventions in north Karelia, Finland and south Italy. Modification of thromboxane B2 formation in platelets of male subjects only. AB - The effects of dietary interventions, based on changes of total fat, saturated fatty acids and cholesterol contents and of the polyunsaturated/saturated (P/S) fatty acid ratio of the diet, were studied in normal male and female subjects, living in North Karelia, Finland, and South Italy. In North Karelia the increase of P/S ratio (from 0.15 to 1.2) of the diet for a 6-week period resulted in reduced thromboxane B2 (TxB2) production by collagen-stimulated platelets only in male subjects, whereas plasma total, LDL and HDL cholesterol were reduced in both sexes. After a 6-week return to the original diet, plasma lipid levels were restored in all subjects. In the South Italy study, changes in platelet TxB2 production were observed only after return to the original diet in male subjects. Total and LDL cholesterol were significantly increased during the dietary intervention and returned toward baseline levels after switch back to the original diet. These data indicate that the increase of the P/S ratio in the diet reduces platelet TxB2 formation only in men. PMID- 3964339 TI - Fatty acid composition of serum cholesteryl esters in relation to serum lipids and apolipoproteins in 3-18-year-old Finnish children and adolescents. AB - Serum cholesteryl ester (CE) fatty acids, serum lipids and apolipoproteins were analysed from 1348 Finnish children aged from 3 to 18 years. The study was part of a comprehensive survey of coronary heart disease risk factors and their determinants in Finnish children and adolescents. The percentage of CE linoleate (18:2) had significant negative correlations with the serum concentrations of total and LDL cholesterol, triglycerides as well as apo B. The associations of HDL to CE fatty acids were weak, although there was a significant positive correlation of CE-18:2 to HDL cholesterol and apo A-I. The ratio of HDL to total cholesterol and the ratio of apo A-I to apo B increased strongly in quintiles of increasing percentage of CE-18:2. In conclusion, the present results show significant associations between serum CE fatty acid composition and the different components of serum lipoproteins among free-living Finnish children and imply a relation between the quality of dietary fats and serum lipoproteins within this population. PMID- 3964340 TI - HDL2 and HDL3 lipid levels in coronary artery disease. AB - The concentrations of cholesterol (C) and phospholipid (PL) levels in the high density lipoprotein (HDL) fraction and the HDL2 and HDL3 subfractions were determined in 74 men with incapacitating angina pectoris and coronary artery disease (CAD) verified by angiography. An equal number of randomly sampled healthy men matched for age, occupation and place of living constituted the control group. The HDL2 and HDL3 fractions were separated by a combination of ultracentrifugation and precipitation. The levels of HDL-C and HDL-PL were reduced in the CAD patients. The reduction of HDL lipids was attributed to both the HDL2 and HDL3 fractions. Proportionally there was a greater reduction of C and PL in HDL2 than in HDL3. The decrease of HDL2-C and HDL3-PL were significant also after allowance for the influences of obesity and triglyceride level. The reductions of HDL2 and HDL3 were significant as well in smoking as in nonsmoking CAD patients and both in patients with and without beta-adrenoceptor blocking drugs. PMID- 3964341 TI - Rapid decrease in high density lipoprotein subfractions and postheparin plasma lipase activities after cessation of chronic alcohol intake. AB - Regular intake of alcohol is associated with elevated levels of high density lipoproteins (HDL). Opinions differ, however, on the HDL subfraction which is preferentially influenced by alcohol. In the present study we measured the HDL subfraction lipid and protein concentrations and postheparin plasma lipase activities in chronic alcohol users immediately after cessation of drinking and sequentially during one week of total abstention. The HDL2 mass concentration decreased significantly already during two abstinent days the decline continuing until the 8th day. At this time the mean HDL2 concentration had decreased by 38% from the initial value (P less than 0.05). The HDL2 cholesterol, phospholipid and protein concentrations decreased in approximately similar proportions, whereas the HDL2 triglyceride increased by 40%. The HDL3 mass concentration decreased by 13% but this change was not significant. Also in HDL3 the cholesterol, phospholipid and protein contents decreased to a similar extent but the triglyceride content rose. The postheparin plasma lipoprotein lipase activity decreased by 41% and the hepatic lipase by 37% during the abstention. It is concluded that in chronic alcoholics HDL2 accounts for the major part of the increase in HDL. PMID- 3964342 TI - Arterial intimal embrittlement. A possible factor in atherogenesis. AB - Sections of aorta, coronary artery, basilar artery and vena cava were collected at autopsy. Macroscopically normal intimal specimens were removed by stripping. Intimal collagen was measured as hydroxyproline. Intimal film embrittlement was measured in vitro by a bursting volume distensibility test developed in our laboratory. There was an average increase of over 100% in the collagen content of apparently lesion-free human arterial intima on aging over a fifty-year period. This includes an increase of 113% for aortic intima, 49% increase for coronary artery intima, and an increase of 158% in collagen in basilar artery intima. In contrast the collagen level in the vena caval intima decreases on aging, by 42% in fifty years. The large increase in collagen in arterial intima is accompanied by a large increase in intimal embrittlement. The decreasing collagen content of the venous intima on aging results in increased distensibility. Increased aortic intimal film embrittlement (lower distensibility) correlates with age (R = 0.699), but even better with intimal collagen (R = 0.911), suggesting that aortic intimal collagen level is a more important determinant of intimal embrittlement than age. Men, older than 55, have significantly higher aortic intimal collagen levels than women. Embrittlement of arterial intima should make it more susceptible to injury under the pulsatile pressure of the blood. Decreased venous intimal collagen and greater distensibility on aging could be factors in the development of venous valvular insufficiency and varicose veins. However, our study of veins was performed primarily as a control in this instance. Fundamental elements in the atherogenic process are increased intimal collagen, increased intimal brittleness, endothelial injury, followed by intimal cell proliferation. In the vena caval intima on aging there is decreased collagen, increased intimal distensibility, no injury due to increased pulse or blood pressure, and, therefore, no cell proliferation and no intimal lesion. PMID- 3964343 TI - Atherosclerotic lesions from the reduction of pulmonary emboli. AB - Seventy-five intimal arterial thickenings (from 58 subjects) related to pulmonary emboli were examined. Many showed residua derived from the emboli (fibrin, platelets, haemosiderin) and proliferation of elastica and smooth muscle cells. Features resembling those of atherosclerosis were the frequent presence of extracellular lipid and apolipoprotein-B containing lipoproteins (LpB) which corresponded closely in distribution; and (in about 40% of the thickenings) collections of fat-filled (foam) cells. Platelet antigens were often detected within foam cells in some cases, in company with LpB. The results indicate that at least some intimal thickenings originating from pulmonary emboli undergo transformation to atherosclerotic plaques. The role of pulmonary hypertension in the process was investigated. Mechanisms relevant to this transformation and to theories of atherogenesis are discussed. PMID- 3964344 TI - Stimulation of collagen secretion by factors released from injured arterial smooth muscle cells in culture. AB - Collagen secretion stimulating activity (CSSA) of bovine arterial smooth muscle cells (SMC) was released to the culture medium after injury of cultured SMC by dimethylsulphoxide-soluble particles from cigarette smoke, but not from uninjured cells. Total protein secretion and DNA synthesis were not stimulated in new SMC by the conditioned medium containing the CSSA. The presence of protease inhibitors before assay did not influence CSSA, but this activity was completely abolished if protease inhibitors were present before injury was induced. The sensitivity to trypsin and heat suggested a protein nature of the activity. CSSA exhibited marked charge and size heterogeneity when subjected to ion exchange and gel chromatographies, and the fraction procedures revealed CSSA peaks with approximate molecular weights greater than 1.5 X 10(6), 450 000, 250 000, 15 000 and less than 10 000, respectively. No CSSA peaks were seen when conditioned medium from uninjured cells was used. It is concluded that SMC injured by dimethylsulphoxide extractable material from cigarette smoke release protein(s) stimulating secretion of newly synthesized collagen, but not of total protein and DNA synthesis, in new SMC cultures. PMID- 3964345 TI - Comparison of experimental hypercholesterolemia and atherosclerosis in Gottingen mini-pigs and Swedish domestic swine. AB - Mini-pigs of the Gottingen strain and domestic swine of the Swedish Landrace were compared with respect to their susceptibility to alimentary hypercholesterolemia and experimental atherosclerosis. Hypercholesterolemia was produced in both strains by adding 11.2% egg yolk and 0.5% cholesterol to the diet. The plasma cholesterol rose significantly faster and reached a higher level in the mini-pigs than in the domestic swine. In both strains most of the elevated plasma cholesterol was found in the low density lipoprotein fraction. The basal plasma triglyceride level was higher in the mini-pigs and increased transiently in this strain when the lipid-rich diet was given. After 18 months of hypercholesterolemia all animals were killed and the aorta and the coronary arteries were examined for atherosclerotic lesions. The arterial content of free and esterified cholesterol, triglycerides and phospholipids were determined. From colour photographs of the aorta the percentage area of visible atherosclerosis in the abdominal part was calculated. Coronary arteries from both strains were sectioned and stained for microscopic investigation. Atherosclerotic lesions were found in the abdominal aorta in both strains and in the coronary arteries in the mini-pigs. In the coronary arteries from domestic swine no macroscopically visible atherosclerosis was found and the content of all arterial lipids was lower than in the mini-pigs. Microscopically, the coronary arteries from the mini pigs showed pronounced intimal proliferative atheromatous lesions, whereas no atheromas were observed in the domestic swine. In the thoracic and abdominal aorta, however, there were no differences between the two strains, either with regard to the cholesterol and phospholipid content or in the atherosclerotic area. The content of triglycerides was somewhat higher in the abdominal aorta from mini-pigs than in that from domestic swine. PMID- 3964346 TI - Hypertrophy of liver peroxisomes in type II and type IV hyperlipoproteinemia. AB - A morphometric study on liver biopsies from patients with primary hyperlipoproteinemia (IIa n = 4, IIb n = 7, IV n = 7) and in controls (n = 7) was performed by light and electron microscopy. We found hypertrophy of peroxisomes in all subjects with hyperlipoproteinemia. As none of our patients had been given lipid-lowering drugs, this increase in volume seems to be due to hyperlipoproteinemia. Hypertrophy of peroxisomes in hyperlipoproteinemia may constitute a response of the hepatocyte to a disturbed metabolic state. Alterations of peroxisomes in hyperlipoproteinemia may thus occur prior to any lipid-lowering therapy. PMID- 3964347 TI - Cardiovascular risk factors and hemorheology. Physical fitness, stress and obesity. AB - To date there is little information about hemorheological data in the presence of secondary risk factors. Inter- and intraindividual comparisons of hemorheological parameters show that fitness has a significant influence on blood fluidity as quantified by ex vivo measurements of blood and plasma viscosity, red cell filterability and red cell aggregation. In fitter individuals blood is more fluid. Similar observations can be made with stress. Prolonged psychoemotional stress leads to a loss in blood fluidity and red cell filterability. Finally a comparison between excessively obese patients and healthy controls reveals a deterioration in hemorheological parameters in the obese group. These results, together with reports from the literature suggest that all accepted cardiovascular risk factors are associated with abnormalities in the flow properties of blood. It is proposed that partly the same phenomena are involved in the genesis of atherosclerotic lesions and influence rheological properties of blood. PMID- 3964348 TI - Inflammatory infiltrates in human coronary atherosclerosis. AB - The nature and density of coronary arterial inflammatory infiltrates were studied in autopsy material from 53 patients with no clinical or pathological evidence of ischaemic heart disease and from 22 acute cardiac deaths. Adventitial aggregates of inflammatory cells were present in 46% of cases and were slightly more frequent in arteries from patients with ischaemic heart disease. The majority of these cells were lymphocytes and immunohistochemical studies with monoclonal antibodies indicated that both B and T cells were present. Staining with polyclonal antibodies to macrophage antigens confirmed that some adventitial cells were macrophages. The reactions of foam cells within the atheromatous plaques were extremely variable but some foam cells gave unequivocably positive reactions with macrophage antibodies. There was a good overall correlation between the numbers of intimal and medial foam cells and the density of the adventitial lymphocytic infiltrates. It is suggested that these infiltrates develop as a secondary feature of atheromatous lesions and are unlikely to play a major role in their initiation or in the development of complications. PMID- 3964349 TI - Quantitation of the relationship between aortic endothelial intercellular cleft morphology and permeability to albumin. AB - The aortic endothelial intercellular cleft (AEC) is a determinant of permeability to macromolecules. This study compared the surface density and frequency of AEC profile types between areas of rat aorta that were permeable/impermeable to albumin-bound Evans Blue dye (EBD). Five adult male Wistar rats were given saturating i.v. doses of EBD and 30 min later were perfusion, fixed and their aortae excised. Samples of impermeable (White) and permeable (Blue) areas were prepared for EM. Sections were coded randomly and all AEC profiles observed were assigned to 4 different morphological classes. Ten to 15 micrographs per sectioned sample, per area, per rat were taken to determine the surface density of AEC's relative to the endothelial cell layer. The frequency distribution of AEC profile types from Blue areas was significantly (P less than 0.01) different from that of the White areas. The Blue regions had relatively more AEC profiles of a less complex structure than did the White areas. The majority of cleft profiles in the Blue areas were of the simple 'overlap' type, whereas the commonest in the White areas were the 'mortise' type. The mean surface density of the AEC's in Blue areas was 0.066 +/- 0.002 micron-1, which was significantly (P less than 0.05) less than in White areas (0.11 +/- 0.002 micron-1). These findings confirm earlier qualitative observations and indicate that AEC's in areas permeable to macromolecules, such as albumin, are less complex in structure and of lower surface area than those in areas relatively impermeable to such macromolecules. PMID- 3964350 TI - Binding and degradation of heavy and light subfractions of low density lipoprotein by cultured fibroblasts and macrophages. AB - The heavy and light subfractions of low density lipoprotein (LDL) were bound to the same extent and with the same affinity by the LDL receptors of cultured human fibroblasts, both when assayed at 4 degrees C and when assayed at 37 degrees C. They were also degraded similarly by the low affinity, LDL-receptor-mediated pathway exhibited by normal human monocyte-derived macrophages maintained in medium containing whole serum. Neither of the subfractions was taken up by the 'scavenger' pathway in mouse peritoneal or human monocyte-derived macrophages. Assuming that the LDL particles were not altered during isolation, the results provide no evidence to suggest that the higher fractional catabolic rate of light LDL observed in vivo can be explained by any preferential catabolism through LDL receptor-mediated pathways. PMID- 3964351 TI - Effect of bacterial lipopolysaccharide on serum lipids and on the development of aortic atherosclerosis in rabbits. AB - The effect of repeated intravenous administration of bacterial lipopolysaccharide (LPS) on serum lipids and on aortic atherosclerosis was studied in rabbits on basal diet and on hypercholesterolemic diets containing 0.15-1.0% cholesterol. LPS (10 or 100 ng/kg body weight) was administered 3 times per week for 3 or 6 weeks. No difference was observed in serum lipid levels or in aortic atherosclerosis between LPS- and saline-treated animals. These observations do not support the hypothesis that LPS has an effect on the progression of atherosclerosis. PMID- 3964352 TI - The association of hyperlipoproteinemia with dysimmunoglobulinemia. AB - In a study of the immunoglobulin concentrations in an urban population and in patients with hyperlipoproteinemia we observed significant positive correlations between serum triglycerides and IgA independent of sex, age and body weight. In men serum triglycerides also correlated with IgG and IgM, and serum cholesterol with IgA. The prevalence of hyper- and hypoimmunoglobulinemia was significantly higher in hyperlipidemic than in normolipemic subjects. We propose that the occurrence of hyperlipoproteinemia with hypoimmunoglobulinemia may be caused by different pathobiological mechanisms than the occurrence with hyperimmunoglobulinemia. PMID- 3964353 TI - Experimental hypothyroidism modulates the expression of the low density lipoprotein receptor by the liver. AB - The effect of experimental hypothyroidism on the catabolism of plasma lipoproteins and on the expression of low density lipoprotein receptors by the liver was investigated in rats made hypothyroid by surgery. The animals developed mild hypercholesterolemia, mainly due to an increase of plasma low density lipoprotein, while other lipoprotein classes were only marginally affected. Kinetic studies using [125I]LDL indicated that a decreased fractional catabolic rate of the lipoprotein was responsible for this finding in agreement with the in vitro observation of a reduced binding of lipoproteins to liver membranes from hypothyroid rats and with the demonstration, by ligand blotting analysis, of a decreased expression of lipoprotein receptors in liver membranes. These data suggest that hypothyroidism affects lipoprotein distribution also by decreasing the catabolism of low density lipoproteins by the liver. PMID- 3964354 TI - Insulin-like growth factor-I in type 2 (non-insulin-dependent) diabetics with myocardial infarction and without macroangiopathy. AB - In order to evaluate whether insulin-like growth factor-I (IGF-I) is associated with the development of diabetic macroangiopathy, we measured its plasma concentration in type 2 diabetics with definite myocardial infarction (MI), in type 2 diabetics without macroangiopathy (MA), and in non-diabetic healthy controls. We also compared plasma IGF-I concentration in non-diabetics with definite MI to that in non-diabetics without MA. There was a large interindividual variation in plasma IGF-I concentration in all groups of subjects studied. The median values were as follows: 0.60 IU/ml in diabetics with MI, 0.59 IU/ml in diabetics without MA, 0.48 IU/ml in non-diabetics with MI and 0.76 IU/ml in non-diabetic healthy controls. The only statistically significant difference between the groups was that between non-diabetics with MI and non-diabetics without MA. In diabetics, irrespective of MA, no significant correlation existed between plasma IGF-I level and the degree of glycemic control, renal function or various risk factors for atherosclerosis. The results of this study suggest that the high prevalence of macroangiopathy in type 2 diabetics cannot be imputed to IGF-I. PMID- 3964355 TI - Depressed plasma pyridoxal-5'-phosphate levels in tobacco-smoking men. AB - Tobacco-smoking men (n = 106) showed considerably lower plasma pyridoxal-5' phosphate levels (P less than 0.001) than non-smoking controls (n = 143). A previously reported inverse relationship between plasma pyridoxal-5'-phosphate levels and age is confirmed by using new and sensitive high-performance liquid chromatography methodology for pyridoxal-5'-phosphate determinations. Plasma pyridoxal levels were neither lower in tobacco-smoking men nor could any relationship between pyridoxal levels and age be demonstrated. Two major risk factors for coronary artery disease, tobacco-smoking and increasing age, are thus associated with lower plasma pyridoxal-5'-phosphate levels. PMID- 3964356 TI - Denatured bovine immunoglobulin pathogenic in atherosclerosis. AB - Evidence is related supporting the hypothesis that heat-denatured bovine immunoglobulin (BGG) may be a major risk factor in the pathogenesis of atherosclerosis; it is shown that not only does the consumption of denatured BGG correlate at all three major epidemiological levels--historical, international and social class--but this highly reactive and invasive molecule also seems to possess the biological and/or pathological properties from which could evolve the main pathological changes found not only in atherosclerosis but also in some of its complications. PMID- 3964357 TI - Feasibility of pre-hospital fibrinolytic therapy in acute myocardial infarction. AB - Intravenous streptokinase (STK) was given in the field by a physician-staffed mobile intensive care ambulance to 13 patients. Patients waited 33 +/- 17 minutes to call the ambulance, arrival time was 5 +/- 3 minutes, and a further work-up time of 32 +/- 8 minutes elapsed. The average time from the onset of pain until administration of STK was 66.7 minutes. Patients were transferred to hospital without important side effects or complications. Eleven of 12 of the infarction related arteries were patent on subsequent coronary angiography. Three patients had minor hematomas and two had microscopic hematuria. This pilot study shows that intravenous STK can be given with relative ease and safety at home by an experienced physician capable of treating any complications. PMID- 3964358 TI - Myocardial contusion diagnosed by first-pass radionuclide angiography. AB - Myocardial contusion, (traumatic myocardial dysfunction) is a relatively common complication of blunt trauma. The diagnosis is often elusive. Studies using clinical and laboratory parameters often fail to detect patients with significant myocardial injury. No constellation of clinical signs, electrocardiographic findings, or cardiac enzymes has been sensitive or specific enough to evaluate such patients accurately. Recently, radionuclide angiography was found to be a sensitive indicator of myocardial dysfunction. The authors studied ten patients with blunt thoracic or multisystem trauma who had myocardial dysfunction documented by first-pass radionuclide angiography. Follow-up study within five weeks demonstrated normalization or improvement in ejection fraction and wall motion abnormalities in all patients. Radionuclide angiography is cost effective, can be performed in the emergency department, and can assist in the management of patients with blunt thoracic or multisystem trauma. PMID- 3964359 TI - Polyurethane and silver sulfadiazene dressings in treatment of partial-thickness burns and abrasions. AB - Epi-Lock, a 1-mm-thick semipermeable sheet of modified polyurethane dressing material, was compared with silver sulfadiazene cream (Silvadene) in a prospective, randomized, cross-over-controlled study in which 50 patients alternated changing antibiotic cream daily with leaving the polyurethane sheet in place for a week. Overall, patient and physician preference for Epi-Lock was statistically significant (P less than 0.004), based on less pain, easier care, and faster healing. The collection of fluid under the polyurethane dressing and the necessity of leaving the wound covered for a week were less well accepted. Epi-Lock represents a major advance in wound dressing materials and should eventually gain wide application in outpatient treatment of partial thickness burns and abrasions. PMID- 3964360 TI - Terbutaline-induced hypotension in a pregnant asthmatic patient. AB - A known asthmatic patient who was 38-39 weeks pregnant was being treated for asthma in an emergency department. After treatment with subcutaneous terbutaline, she developed a hypotensive episode that lasted almost 30 minutes. Emergency physicians should understand the underlying hemodynamic changes in pregnancy and in the therapy of asthma, and should be aware of the potential for this unusual complication. PMID- 3964361 TI - Human overdose with the veterinary tranquilizer xylazine. AB - Three patients self-injected the veterinary tranquilizing agent xylazine (Rompun). The first patient developed mild bradycardia and hypotension, miosis, and a feeling of disorientation. The other two patients became apneic and required intubation and mechanical ventilation. Initial mild hypertension followed by mild hypotension and a mildly elevated blood glucose was seen in the second patient, whereas both the second and third patients developed mild bradycardia. Xylazine has structural similarity to the phenothiazines and pharmacological activity similar to clonidine. With increasing veterinary use, the availability and potential for human exposures may also increase. PMID- 3964362 TI - Pneumococcal cellulitis. AB - A 42-year-old man with pneumonia was admitted for rhabdomyolysis. Streptococcus pneumoniae was isolated from the cellulitis surrounding the muscular necrosis. Subcutaneous localisation of S. pneumoniae in the course of a septicemia has never been described, although rhabdomyolysis may be associated with bacterial infections. PMID- 3964363 TI - Esophageal spasm following propranolol overdose relieved by glucagon. AB - A case of propranolol overdose complicated by esophageal spasm preventing extrication of an orogastric lavage tube and relieved by intravenous glucagon is presented. Esophageal spasm is an infrequent complication of beta-adrenergic over dose. Possible mechanisms of esophageal spasm and its relief with glucagon are discussed. PMID- 3964364 TI - Simultaneous Colles' and scaphoid fractures: treatment by combined internal and external fixation. AB - The authors present the case of a young woman who sustained ipsilateral scaphoid and Colles' fractures that were treated by a combination of Herbert screw fixation of the scaphoid fracture and external fixation of the colles' fracture. This form of treatment provides optimal conditions for both the early return of wrist function and for the maintenance of the manipulated position. PMID- 3964365 TI - Acute urinary retention secondary to an incarcerated gravid uterus. AB - Acute urinary retention has many etiologies. In the pregnant patient, especially at the end of the first trimester, an incarcerated gravid uterus is a rare but possible cause. The patient discussed is a 30-year-old, gravida 4, para 2012, woman who was 14 weeks pregnant and who presented complaining of lower abdominal pain, urinary frequency, urgency, and nocturia. Based on the patient's symptoms, a diagnosis of a urinary tract infection was made, and antibiotic therapy was begun. Her symptoms failed to resolve, however, and she was referred for further evaluation, which eventually revealed an incarcerated gravid uterus. The patient was referred to an obstetrician who re-positioned her uterus without difficulty, and she subsequently had an uneventful pregnancy. PMID- 3964366 TI - Injury to the upper cervical spine: fracture versus congenital anomaly. AB - As skull and cervical spinal radiographs are being obtained routinely on head and neck injuries, more incidental anomalies of the neck region are being detected. The differentiation of congenital anomaly from fracture can be difficult. The importance of this, however, cannot be underestimated because of the dire consequences of a missed cervical fracture. A case of such an anomaly and its presentation following injury is presented. PMID- 3964367 TI - Combined effect of catheter and tubing size on fluid flow. AB - Several studies have evaluated the effect of large-bore tubing and various intravenous (IV) catheters on rapid fluid resuscitation. This study combines available equipment, which has been demonstrated to increase IV flow rate, into a system. This system is then compared with one commonly used for IV fluid infusion in hypovolemic patients. The new system requires significantly less (P less than 0.0005) time for both drainage of fluid and changing of IV containers. The improvement in flow rate can be attributed to the use of a rapid inflation/deflation pneumatic pressure device instead of the conventional hand pumped pressure bag and the decrease in resistance through both the large-bore IV tubing and 12-gauge catheter. The rapid manipulation of IV bags is made possible by the rigid structure and the rapid inflation/deflation ability of the external pump. The possibility of faster change of IV bags and an increase in flow rate make this system a practical tool in the treatment of severely hypovolemic patients. PMID- 3964368 TI - Castor bean poisoning. AB - Although the highly toxic nature of castor bean (Ricinus communis) is well recognized, reports of human toxicity in the English medical literature are scarce. The potentially lethal doses reported for children and adults are three beans and four to eight beans respectively. Recent experience with two cases provides added insight into the expected course of toxicity. In both cases, repeated vomiting, diarrhea, and transiently elevated serum creatinine occurred. Dehydration was much more pronounced in the second case. Both patients recovered uneventfully. Other reported manifestations of castor bean toxicity, such as hepatic necrosis, renal failure, erythrocyte hemolysis, convulsions, and shock, did not occur. PMID- 3964369 TI - Pericarditis mimicking acute myocardial infarction. PMID- 3964370 TI - Pediatric critical-care drugs: a systematic approach. PMID- 3964371 TI - Management protocol for sickle-cell disease patients with acute pain: impact on emergency department and narcotic use. PMID- 3964372 TI - Hospital governing boards. PMID- 3964373 TI - Defibrillation in the field: should EMTs interpret rhythms? PMID- 3964374 TI - Randomized clinical trials: alternatives to conventional randomization. AB - The randomized allocation format remains an exceedingly powerful tool for clinical research. Because humans are the subjects in clinical research, this area of scientific study must operate within the limits dictated by such basic principles as individual autonomy, justice, and beneficence. As randomized studies have become more common in clinical research, it has become apparent that there is often need for modification of the basic randomized format or for alternatives. The most widespread modification is the use of sequential analyses to monitor the progress of a trial and ensure early identification of either unanticipated adverse effects or more pronounced differences than expected. Although this modification does not affect the basic randomized allocation format, it does provide a protection that is lacking in the conventional trial and should be utilized whenever feasible. Modifications that do affect the basic structure of the randomized trial include adaptive allocation and pre randomization. The former is attractive and useful but limited to studies in which results from early enrollees are known before late enrollees are allocated. The greater the linkage between preceding subject results and subsequent assignments, the greater is the protection afforded by such a format. Pre randomization, more universally applicable than adaptive allocation, suffers from pronounced cross-over potential and has been criticized on ethical grounds, a combination of weaknesses that raises questions of whether pre-randomization truly offers advantages to conventional randomized formats. True alternatives to the randomized format include the self-controlled study and the historical control design. Both possess significant ethical advantages over the simple randomized study. Unfortunately, both are at some methodological disadvantage when the same comparison is made. The self-controlled study is limited to the study of conditions sufficiently stable or recurrent that they permit two or more treatment courses in a single patient. In emergency medicine and critical care, this description fits only a small proportion of the illness spectrum. This design is underutilized in clinical research focused on less severe problems of the type seen in ambulatory and primary-care settings. Such problems can be suitable topics for research by emergency medicine specialists. Historical control studies are eminently applicable in the emergency and critical-care setting.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3964375 TI - Emesis versus lavage for poisoning victims. PMID- 3964376 TI - Conservative correction of hyponatremia. PMID- 3964377 TI - Radiological eclipse. PMID- 3964378 TI - The vitamin C status of formula-fed preterm infants. AB - Forty-two pairs of maternal and cord plasma vitamin C levels were determined after term, preterm, and multiple gestation pregnancies and 95 determinations of plasma ascorbate were performed on 36 premature infants who were fed a recommended infant formula throughout the first month of life. There were no significant changes of the cord or maternal ascorbate levels or of the cord/maternal ascorbate ratio between term, preterm, and multiple gestation cases. A significant negative correlation was found between the maternal ascorbate levels and the cord/maternal ascorbate ratio, supporting previous observations that high fetal blood levels of vitamin C are maintained even in cases where the maternal vitamin nutrition is poor. A rapid decline from cord levels was evident during the first week of life, followed by maintenance of relatively low plasma ascorbate levels, despite supplementation of recommended vitamin nutrition. Further monitoring of ascorbate levels in premature infants is suggested for better adjustment of the recommendations for vitamin C supplementation. PMID- 3964379 TI - An evaluation of the relative risks of a trial of labor versus elective repeat cesarean section. AB - A retrospective study of a trial of labor (TOL) after prior cesarean section was conducted over 18 months in a patient population that is homogeneous with regard to race, socioeconomic class, gestational age, and medical complications. Of 171 women who had undergone previous cesarean sections, 75 were offered a TOL. Thirty five of these patients had an elective repeat cesarean section, while 40 agreed to a TOL. Thirty-two of the latter patients delivered vaginally (80%). The criteria for offering a TOL and a protocol for TOL are presented. A comparison of the maternal and neonatal morbidity associated with repeat cesarean section versus TOL do not strongly favor either method of delivery in our population. The patients who had undergone cesarean section for cephalopelvic disproportion (CPD) had the lowest acceptance and the lowest success rate of a TOL. The hospital charges and hospital stay of the two groups are presented. The financial aspects of the two methods of delivery and the impact of Diagnosis Related Groups (DRGs) on the management of these patients are discussed. Careful selection of patients for a TOL is essential to maintain the quality of medical care while responding to pressures to reduce the cesarean section rate and to reduce the costs of medical care. PMID- 3964380 TI - Preterm labor in the quadriplegic parturient. AB - The occurrence of preterm labor is not uncommon in the pregnant quadriplegic. Early diagnosis is hampered by the inability of most quadriplegics to sense uterine contractions in the usual way. A patient we recently treated for preterm labor learned to recognize contractions by the associated symptoms of autonomic hyper-reflexia: flushing, headache, and piloerection. Tocolytic therapy was successful and a favorable neonatal outcome occurred. Increased awareness by the physician and the pregnant quadriplegic patient is encouraged so that symptoms of autonomic hyper-reflexia may be recognized as potentially indicative of uterine contractions. PMID- 3964381 TI - Intrapleural inoculation of candida in an infant with congenital cutaneous candidiasis. AB - Though several pathologic processes can produce large denuded skin lesions in very low birthweight infants, trauma is often diagnosed without further investigation. Failure to consider other causes may prevent institution of appropriate specific treatment and may contribute to the development of serious complications, as described in the present case report of a premature infant with congenital cutaneous candidiasis. PMID- 3964382 TI - Alloimmune thrombocytopenia. PMID- 3964383 TI - Designing for reduced operating costs in a maternity unit. AB - Operating costs of hospitals make great demands on resources. This paper describes the possibility of using the methodology of linear systems to find ways for designing for reduced operating costs in a maternity unit in England. The organizational framework of the United Kingdom National Health Service, and its capital planning processes are outlined. Capital cost control methods used in building English hospitals are explained and then the early stages of an experiment in which the step response of an injection of capital to a capital building project are described. The project itself is in a maternity unit. Maternity has been chosen because it is particularly suitable for this kind of experiment having a relatively well defined input and output, and well established indicators of clinical outcome. It is hoped that insight into the step response will shed light on new ways of designing for reduced operating costs. PMID- 3964384 TI - Developing ACOG district and section computer science committees. Local framework for definition and solution of information processing needs. PMID- 3964385 TI - An integrated perinatal information system and telecommunications networking. AB - The integrated perinatal information system in Albany Medical Center has two significant features: that of a flexible user-definable database and ease of networking both locally and regionally. The unified perinatal record is structured in Ansi standard MUMPS and resides on the College Vax 750. A special set of program tools ensures effective multi-split screen display, moving pointers, and corresponding multiple choice entries. Because it is self contained, it has the ability to create complex data structures without programming. A powerful math/statistical library has been incorporated. In house, the use of existing PABX wire allows for simultaneous voice/data traffic. Linkage to the regional system is made by modem connection. The system is compatible with the demands of both clinical and regional management. PMID- 3964386 TI - Implementation of a statewide perinatal automated medical network (PAM/NET) for Michigan. AB - PAM/NET is a computerized data base and conferencing system used by nine neonatal intensive care units in Michigan and Illinois. The system depends on the timesharing resource of a large university mainframe computer. The data base functions are managed by a sophisticated inverted file relational data base management system capable of mass storage and rapid and specific retrieval of individual cases or summary data. Data stored in the system are used to generate admission, discharge and developmental assessment clinic summaries that serve as such for the medical record and as letters to primary physicians. We report here the early experience in the design and dissemination of this database network to the participating hospitals. Conflicting goals of sharing and confidentiality of clinical data are addressed in the design of this system. PMID- 3964387 TI - Imaging case of the month. Neonatal enterolithiasis. PMID- 3964388 TI - Risk of late first and second trimester miscarriage after induced abortion. AB - A cohort of 3110 women anticipating delivery were interviewed after their first prenatal visit at private obstetric practices and HMOs in Connecticut. In all 19.57% reported a prior induced abortion. The research participants were followed to determine whether the pregnancy was miscarried or delivered. In all, 2.19% miscarried in the late first or second trimester. The association of a prior induced abortion on risk for late miscarriage was analyzed by pregnancy history. Women who aborted their first pregnancy had no increased risk (RR = 0.56, 95% CI = 0.16, 1.92) of miscarriage compared with women pregnant for the first time, or compared with women experiencing their second pregnancy after delivering the first (RR = 0.69, 95% CI = 0.18, 2.60). No evidence was found for an increased risk of multiple induced abortion on subsequent miscarriage. PMID- 3964389 TI - Prenatal shunting of fetal ascites in nonimmune hydrops fetalis. AB - A case of severe nonimmune hydrops fetalis presenting at 24 weeks gestation is presented. Ultrasound, echocardiographic, and fetal ascitic fluid studies were nondiagnostic. Because of massive fetal ascites an indwelling peritoneal amniotic cavity shunt was placed. Despite functioning of the shunt, a fetal death in utero occurred. PMID- 3964390 TI - Physiologic changes induced by endotracheal instillation and suctioning in critically ill preterm infants with and without sedation. AB - Endotracheal instillation and subsequent suctioning produces fluctuations of intracranial pressure (ICP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) in sick preterm infants. In an attempt to observe if these fluctuations could be minimized using sedation, we studied a group of seven sick mechanically ventilated preterm infants with and without sedation. Continuous monitoring of ICP, MAP, heart rate, CPP, and arterial oxygen tension (PaO2) were obtained. The statistical analysis of the data revealed significant blunting of fluctuations of MAP, ICP, and CPP with sedation. PMID- 3964391 TI - [Problems in the monitoring of lung function in intensive care medicine]. PMID- 3964392 TI - [A respiratory monitoring device with a thermistor base for children with tracheal cannulae]. PMID- 3964393 TI - [Analgesic asthma from the viewpoint of the anesthesiologist]. PMID- 3964394 TI - [Use of long-term infusion of etomidate in the treatment of withdrawal delirium]. PMID- 3964395 TI - [Mechanism of occlusion of microaggregate filters in the passage of whole blood and erythrocyte concentrate storage]. PMID- 3964396 TI - [Experience with the infected ear in infants and pre-school children]. PMID- 3964397 TI - [Retinoblastoma. Anatomical study of 406 cases]. PMID- 3964398 TI - [Familial hemophagocytic lymphohistiocytosis. Presentation of 2 cases in one family]. PMID- 3964399 TI - [Thanatophoric dysplasia]. PMID- 3964400 TI - [Cystic dilatation of the choledochus in the neonatal period]. PMID- 3964401 TI - [Preparation of tables in editing medical writing]. PMID- 3964402 TI - [Results of the treatment of non-Hodgkin's lymphoma in children. The modified L278 protocol]. PMID- 3964403 TI - [Iron overload in hereditary atransferrinemia]. PMID- 3964404 TI - The mechanics of pigeon eye movements--are they like other vertebrates? AB - The lateral rectus muscle of the pigeon eye was driven by stimulation of the abducens nucleus. Eye rotation was measured with an opto-electronic movement detector. Eye position was linearly related to stimulation frequency in the range 40-110 Hz and saturated at frequencies above 250 Hz. Maximum eye velocity of 240 degrees/s was obtained with a stimulation frequency of 360 Hz. Stimulation with sinusoidally modulated pulse frequencies (40-110 Hz) over the modulation frequency range 0.01-6.0 Hz were used to determine the gain and phase relationships of the oculomotor system. The response approximates a first order low pass frequency model with a characteristic frequency of 0.45 Hz at high frequencies. There is an additional phase lag equivalent to a time delay of 9.8 ms. The results are compared with similar experiments performed on the dogfish and cat oculomotor systems. PMID- 3964405 TI - The effects of hippocampal lesions upon spatial and non-spatial tests of working memory. AB - A series of experiments examined the proposal that the primary effect of hippocampal damage in rats is to disrupt working memory. Although extensive hippocampal lesions produced a severe impairment in forced-choice alternation--a test of spatial working memory--the same lesions did not impair the acquisition of a non-spatial test of working memory--delayed non-matching-to-sample. This test of object recognition required the rats to select that arm in a Y-maze which contained unfamiliar stimuli. Rats with hippocampal lesions were able to learn and perform this task at normal rates, even with retention delays of as long as 60 s. Two additional experiments helped confirm that the animals had indeed learnt a non-spatial test of working memory. The final experiment examined whether hippocampal lesions resulted in an increased sensitivity to proactive interference. It was found that repetition of test stimuli within a session, which increased interference, did attenuate recognition performance but there was no evidence that the animals with hippocampal lesions were differentially affected. PMID- 3964406 TI - The topography of the locomotor effects of haloperidol and domperidone. AB - The neuroleptics are currently the primary mode of treatment for schizophrenia. Unfortunately, the study of the behavioral effects of these drugs has been hampered by inadequate methodology. Researchers have lacked means sensitive enough to detect the neuroleptic's spontaneous behavioral effects at low doses. Consequently, most previous studies have measured the ability of these drugs to block the effects of various dopamine agonists. In an attempt to remedy this, the present study employed one of the recently developed automated animal activity monitors. This system was used to measure the spontaneous nocturnal behavioral effects of the neuroleptic haloperidol (0.0, 0.1, 0.5, 1.0 mg/kg) on 12 male Sprague-Dawley rats. The behavioral effects of domperidone (0.0, 0.1, 0.5, 1.0 mg/kg) were also studied in order to compare the effects of central and peripheral dopamine antagonism. The results showed that haloperidol depressed all aspects of behavior studied--even at the lowest dose--while domperidone depressed only average speed. These results suggest that all of the locomotor variables studied, save average speed, are centrally mediated. Average speed, though influenced by central mechanisms, seems primarily a peripheral function. PMID- 3964407 TI - The convulsant and anticonvulsant effects of phencyclidine (PCP) and PCP analogues in the rat. AB - The pro- and anticonvulsant effects of phencyclidine (1-[1 phenylcyclohexyl]piperidine HCl, PCP), a number of its analogues, and SKF 10047 were investigated in rats. The PCP analogues were compounds produced by substitutions for the phenyl and piperidine rings of PCP and were selected to elucidate the structure-activity relationships existing between PCP and its pro- and/or anticonvulsant effects. All of the compounds, except ketamine, induced convulsions at high (12.8-25.6 mg/kg, i.v.), yet almost always sublethal doses. Ketamine failed to induce convulsions, even at lethal doses (51.2 mg/kg, i.v.). The acute pro- or anticonvulsant actions of PCP were then investigated. Rats were subjected to transorbital electroconvulsive shock subsequent to i.p. injections of saline or 0.625, 2.5, 5.0, 10.0 or 20.0 mg/kg PCP. It was found that PCP induced an acute, dose-dependent anticonvulsant effect. The acute pro- and/or anticonvulsant actions of the remaining compounds were then investigated by administration of electroconvulsive shock subsequent to i.p. injections of saline or one of two doses of each compound. The low and high doses of each compound were selected to be behaviorally equivalent to 2.5 and 10.0 mg/kg PCP i.p., respectively. With one exception, each dose of each drug induced an acute anticonvulsant action, with no difference in efficacy between the compounds tested. However, PCA (produced by substitution of an amine for the piperidine ring of PCP) induced a statistically greater anticonvulsant action at the higher, compared to the lower, dose. In addition, PCA was the only compound to eliminate all motor signs of the electrically induced seizure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964408 TI - Pineal lesion produces bilateral visual and auditory inattention in the rat. AB - Unilateral lesions in such brain regions as medial frontal cortex and superior colliculus produce polysensory neglect contralateral to the lesion. Since the pineal gland is an unpaired brain structure, both electrophysiologically and hormonally responsive to visual and auditory stimulation, it may modulate bilateral sensory attention mechanisms. Long-Evans male rats were given pineal or sham lesions and were tested behaviourally. Sensory assessment revealed that in comparison to sham animals rats with pineal lesion exhibited unilateral visual and auditory neglect to stimuli presented on either side of the body. Animals with pineal lesions were more likely than sham-lesioned animals to demonstrate visual allesthesis and, compared to sham-lesioned rats, showed extinction on the left side to bilateral simultaneous visual stimulation. This is the first report that midline neuroendocrine damage can produce bilateral sensory inattention. PMID- 3964409 TI - The formation of finger grip during prehension. A cortically mediated visuomotor pattern. AB - The pattern of finger grip formation during natural prehension movements was described in normal subjects with the help of a quantified film technique. Movements were studied in one condition with visual feedback from the moving hand available, and one condition without visual feedback. The studied parameters, including the maximum size of the anticipatory grip and the final size of the grip before contact with the object, were not affected by shifting from one condition of visual feedback to the other. The same technique was applied to a group of patients with cerebral lesions. In two patients with unilateral lesions involving the motor cortex, grip formation with the hand contralateral to the lesion, was found to be severely affected, in that fingers and particularly the index finger, remained stretched until contact with the object was made. In two patients with unilateral lesions in the posterior parietal cortex, grip formation of the contralateral hand was absent specifically in the no-visual feedback condition. The same result was obtained in two other patients with a lesion (subcortical in one case, cortical in the other) of somatosensory pathways corresponding to one hand. These results are interpreted as evidence for the role of cerebral cortex in the control of finger grip formation during prehension of visual objects. Integration at cortical level of visual and somatosensory cues from the involved hand is a necessary condition for grip formation to be adapted to the grasp. PMID- 3964410 TI - Properties of the two circadian oscillators influencing the rabbit's food intake pattern. AB - Continuous recordings of the pattern in food approaches during ad libitum-feeding were obtained from 15 rabbits which were exposed, for periods of 3-7 months, to continuous illumination (200-250 Lux), total darkness, light-dark alternations of L1:D23 h and L12:D12h and were blinded afterwards. It appears that the circadian pattern in food intake differs markedly in these circumstances and that it is governed by 2 loosely coupled circadian oscillators. These widely diverge in their effect on the eating pattern, in the response of their free-running periods to changes in steady state condition of the retina, and in their entrainment to either the onset or the ending of the illumination phases of 24-h LD regimens. The results indicate that the hypothalamic centres controlling the rabbit's food intake pattern must be strongly influenced by the retinal maintained 'dark' discharge. PMID- 3964411 TI - Recovery of function after neonatal or adult hemispherectomy in cats: I. Time course, movement, posture and sensorimotor tests. AB - Cats with removal of the left hemitelencephalon (hemispherectomy) as neonates (n = 12) or in adulthood (n = 14), were compared using a battery of 16 neurological and behavioral tests given when they were young adults (kittens) or at least 5 months after the lesion (adults). The neonatal-lesioned subjects grew normally and performed markedly and significantly better than adult-lesioned cats in 13 tests covering the wide range of movement, posture and sensory functions which were assessed. None of the animals recovered tactile placing of the right forelimb or a normal vision in the right visual field. However, the overall recovery was outstanding for all cats such that the neonatal-lesioned were hard to differentiate from intact controls in their spontaneous, daily activities. Because the lesions were similar in the two age-at-lesion groups, and since numerous functions were followed for prolonged, comparable postlesion time, we conclude that, after hemispherectomy in the cat, there definitely is greater functional recovery if the lesion is sustained early in life. We propose that the enhanced recovery of function in neonatal-lesioned cats is largely due to the extensive anatomical reorganization which we have demonstrated in ongoing studies, and which contrasts with a lesser remodeling in adult-lesioned cats. PMID- 3964412 TI - Interocular transfer of learning in the pigeon: visuo-motor integration and separation of discriminanda and manipulanda. AB - Interocular transfer (IOT) of visual information in pigeons has been shown to vary according to the training paradigm. In the present experiment 6 groups of pigeons were trained on a color discrimination using 6 different training paradigms. It was found that a successive discrimination with a single key and a simultaneous discrimination with either two keys arranged horizontally or with two keys arranged vertically, all produced successful interocular transfer of learning. On the other hand, the other 3 training paradigms, in which the discriminative stimulus was presented on 'stimulus key' and the pecking response was made by a separate 'response key', all failed to show IOT. The geometric relationship between the stimulus key and the response key (upper, lower or side) does not appear to be crucial. Thus, the spatial separation of the response key and the stimulus key produced the failure of interocular transfer. These results support the idea that visuo-motor integration has the most important role in descrepancy of results of the pigeon's IOT experiments. PMID- 3964413 TI - The effects of postoperative physical environment on novelty seeking behaviour and maze learning in rats with hippocampal lesions. AB - The effects of different postoperative physical environments on novelty seeking and maze learning were tested in rats that sustained dorsal hippocampal lesions at 30 days. After surgery, rats were isolated for one month, either with objects or without objects in their cages. All rats were moved daily to new cages and observed during the first 5 min; during these periods, sham-operated rats and rats with lesions interacted similarly with their environment. At the end of the differential housing period, rats were tested for their reactions towards a novel object introduced to their familiar environment (test 1) and towards a novel environment they were free to explore or to avoid (test 2). In test 1, rats with lesions made more contacts with the novel object than did intact rats, and rats previously housed with objects, whether they sustained lesions or not, climbed on the novel object more often than rats reared without objects. In test 2, rats with lesions made no clear distinction between the novel and familiar environments irrespective of their postoperative treatment; in contrast, intact rats housed with objects differed from intact rats housed without objects in their preference for the novel and familiar environments and in the locomotor activity they displayed in these environments. Following these two tests, learning performance was assessed in an 8-arm radial maze. Rats with lesions made more errors than the intact rats, and within the rats with lesions those reared with objects tended to make fewer errors than those reared without objects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964414 TI - Sleep-wake behavior of newborn rats recorded with movement sensitive method. AB - The aim of this study was to determine criteria for classification of sleep-wake behavior in newborn rats by recording total body and respiratory movements with a static charge sensitive bed (SCSB). Initially, the sleep-wake behavior was simultaneously observed visually and recorded by the SCSB mattress, from the fourth to the twenty-second postnatal days. Thus, the criteria for scoring the SCSB recordings were obtained by comparison of the behavioral scorings with the SCSB tracings. To further validate this movement sensitive method for neonatal sleep studies in rats, deep neck muscle electrograms were studied at the age range of 8-13 days, and electroencephalograms as well as electromyograms from the age of 12-17 days, simultaneously with the SCSB recordings. Finally, the sleep wake behavior of other rat pups was recorded only with the SCSB from the fourth to the twenty-second postnatal days. These latter recordings were afterwards scored by using the criteria defined in the first part of this study. The results thus obtained indicate that the SCSB method is sensitive and reliable in recording and classifying the sleep-wake behavior of newborn rats. PMID- 3964415 TI - Pituitary-adrenal correlates of schedule-induced polydipsia and wheel running in rats. AB - To investigate the pituitary-adrenal correlates of schedule-induced behaviours, rats were submitted to a fixed-time 60-s schedule of food reinforcement, with free access to either a water spout or a running wheel. Schedule-induced water drinking (polydipsia) was accompanied by an important drop in plasma corticosterone levels, while wheel running resulted in a significant increase in plasma corticosterone concentrations. This contrast between the pituitary-adrenal consequences of schedule-induced drinking and wheel running was not due to functional differences between the two activities since wheel running was shown to display all the characteristics of schedule-induced activities, mainly excessiveness, differential time distribution and dependance on deprivation level and reinforcement rate. PMID- 3964416 TI - Memory impairment in monkeys following lesions limited to the hippocampus. AB - This study addressed the question of how severe a memory impairment is produced by a lesion limited to the hippocampus. Monkeys with circumscribed hippocampal lesions were tested on the delayed-nonmatching-to-sample task, a test of recognition memory that is sensitive to amnesia in humans. Monkeys were given no preoperative training and were given no postoperative experience prior to training on the delayed-nonmatching-to-sample task. A marked deficit was observed. The results, taken together with those from previous studies, also provided information about the role of several factors that could potentially influence the level of memory impairment following hippocampal lesions. The level of impairment does not appear to be due to any of the following factors: time of testing after surgery, prior postoperative testing, surgical techniques, species differences, or behavioral training methods. However, preoperative training experience does appear to reduce the severity of the impairment, and this factor may account for the observation that the memory impairment associated with hippocampal lesions is sometimes very mild. Finally, a recent case of human amnesia studied in this laboratory is discussed in which a bilateral lesion limited to a portion of the hippocampus produced a well-documented memory deficit. PMID- 3964417 TI - Failure of hippocampectomy to facilitate classical conditioning at an optimal interstimulus interval is not due to a "ceiling effect". AB - The effects of amphetamine injection, hippocampal lesions, and cortical lesions were examined during classical conditioning of the rabbit nictitating membrane response. An optimal interstimulus interval was employed. Whereas neocortical and hippocampal damage had no significant effect on the rate of acquisition, amphetamine treatment produced a marked facilitation. A control group of amphetamine-treated animals, which received explicitly unpaired presentations of the conditioned stimulus and unconditioned stimulus, failed to exceed spontaneous response rates throughout training. The failure of hippocampectomy to accelerate conditioning under an optimal interstimulus interval (ISI) does not appear to be due to a "ceiling effect." Rather, it was suggested that the response system is predisposed to conditioned responses of a given latency. Optimal ISIs may fall within this range. Thus, in short or long intervals, temporal aspects of the motor response must be adjusted to conform to the stimulus configuration. It appears that the hippocampus is a likely source of response modulation. Thus, loss of hippocampal input accelerates conditioning under nonoptimal intervals at the expense of proper timing. Conditioning under an optimal interval would occur at normal rates because no modulation is required. PMID- 3964418 TI - Korsakoff's syndrome: a study of the relation between anterograde amnesia and remote memory impairment. AB - Patients with Korsakoff's syndrome were evaluated with nine tests of new learning ability and three tests of remote memory to determine the correlation between anterograde amnesia and remote memory impairment. There was no correlation between the severity of anterograde amnesia and either the overall severity of remote memory impairment (1940s-1970s) or the impairment observed for more remote time periods (1940s-1950s). However, the correlation between remote memory impairment and anterograde amnesia became progressively stronger with the recency of the time period and was significant for the 1960s-1970s or the 1970s alone. The results support the view that the extensive remote memory impairment in Korsakoff's syndrome is, at least in part, distinct from and unrelated to anterograde amnesia. The more severe impairment observed for more recent time periods could be related to anterograde amnesia in that it reflects anterograde amnesia that was either already in place or progressively developing during recent years. The ability to recall very remote events seems therefore to depend on brain mechanisms distinct from those required for new learning or for recall of more recent events. PMID- 3964419 TI - Brain stem reticular formation neuronal correlates of stimulus significance and behavior during discriminative avoidance conditioning in rabbits. AB - Multiple-unit activity in the reticular formation of the midbrain and pons was recorded in rabbits during discriminative conditioning of locomotor (wheel running) avoidance behavior. The conditional stimuli (CS+ and CS-) were pure tones of different auditory frequency, and the unconditional stimulus (US) was a constant-current footshock (1.5-2.5 mA) delivered through the grid floor of the wheel. The pontine, but not the midbrain, sites manifested development during behavioral acquisition, of brief-latency (10-40-ms) discriminative neuronal discharges (i.e., greater discharges to the CS+ than to the CS-). The greatest magnitude of the discriminative discharges in the rostral pontine loci occurred in the first conditioning session. The discriminative response in the caudal loci developed more slowly, and it persisted to the criterial stage of training. Both rostral and caudal pontine loci, during the interval from CS onset to US onset, manifested a progressive build-up of neuronal firing in anticipation of the behavioral response. The occurrence in the rostral and caudal pontine areas, respectively, of early- and late-developing discriminative discharges is analogous to effects observed in past studies in the limbic mesocortical and thalamic systems. These findings provide a basis for establishing the possible functional relatedness or independence of these analogous effects. PMID- 3964420 TI - Long-term effects of leucine-enkephalin on active avoidance responding in mice. AB - The effects of peripherally administered leucine-enkephalin on the acquisition and retention of active avoidance behavior was studied in mice. Mice received 4 training trials on Day 1, 24 test trials on Day 2, and 10 test trials on Day 5. Leucine-enkephalin impaired the aquisition of avoidance behavior when administered before testing on Day 2. Impairment of retention was demonstrated on Day 2 and Day 5 when leucine-enkephalin was administered immediately after training on Day 1, results indicating the long-term nature of the enkephalin effect. There was no effect of leucine-enkephalin when administered just prior to testing on Day 5. The impairing effect was attenuated but not blocked by naloxone. The pattern of the results from the different tests supports the hypothesis that leucine-enkephalin impairs both acquisition of learning and memory consolidation. PMID- 3964421 TI - Factors modulating the effects of teleost telencephalon ablation on retention, relearning, and extinction of instrumental avoidance behavior. AB - Two experiments on the nature of avoidance behavior in the goldfish are reported. In the first experiment, a master/yoked design was used to determine the degree to which Pavlovian conditioning would generate acquisition of a shuttle response by goldfish. Results indicated that the mere sequence of signal-shock pairings experienced by the avoidance animals is not in this situation sufficient to explain the development of the instrumental avoidance responding. The second experiment was conducted to study the effects of three variables on the retention and extinction of the avoidance response. First, unilateral lesions of the telencephalon produced a transient deficit from which the subjects recovered to normal levels. Retention of the avoidance response after bilateral telencephalon ablation was impaired and never fully recovered with additional training. Second, this deficit was reduced under higher intensities of electric shock. Third, overtraining on the task before the ablation had only a nonsignificant enhancing effect on retention levels. Extinction was always poorer following ablation, independent of the type of ablation, intensity of shock, degree of overtraining, and terminal retention level of performance. The results are discussed in terms of various theories of telencephalic function in fish. PMID- 3964422 TI - The role of narrowly tuned taste cell populations in lobster (Homarus americanus) feeding behavior. AB - A whole-animal behavioral assay was developed to measure responses to chemical stimulation of the walking leg (taste) receptors of lobsters. Lesions of only the taste receptors abolished the dactyl clasping response, a result demonstrating that such receptors are necessary to elicit this response. Then the stimulatory effectiveness of natural and synthetic mixtures was determined, particularly of 6 single compounds (glutamate, glutamine, NH4Cl, betaine, aspartate, and taurine) for which the legs have prominent, narrowly tuned receptor cell populations. The results showed that a synthetic mixture of the 22 principal amino acids and amines present in mussel tissue is as powerful a stimulus as either a homogenate of such tissue or its purified extract. Of the single compounds, only NH4Cl was stimulatory at the behavioral level; glutamate was not despite the fact that glutamate receptors are the predominant cell population known in lobster legs. Even a mixture of the 6 single compounds in their natural mixture ratio was not very stimulatory (it was even less stimulatory than the sum of the responses to each single compound), a result suggesting the occurrence of suppressive interactions. The complementary mixture, that is, the synthetic mixture without the 6 single compounds, was equally unstimulatory. It is unlikely that mixture suppression alone is responsible for the poor behavioral responses to single compounds such as glutamate, and to the partial mixtures that were tested. Full response to the more complex mixture of 22 compounds demonstrates that special mixture combinations can "override" mixture suppression. Such signal mixtures may represent the lobster leg's picture of food. PMID- 3964423 TI - The propensity for nonregulatory ingestive behavior is related to differences in dopamine systems: behavioral and biochemical evidence. AB - Previous research has shown that animals predisposed to eat and drink in response to electrical stimulation of the lateral hypothalamus (ESLH) are similarly predisposed to drink excessively when tested for schedule-induced polydipsia. The eating and drinking elicited by both experimental paradigms appears to be unrelated to homeostatic need and has been called nonregulatory ingestive behavior. In this study, the relation between properties of dopaminergic neural systems and the predisposition to exhibit nonregulatory ingestive behavior was investigated. It was found that rats that eat and drink during ESLH show greater behavioral sensitization to a series of amphetamine injections that those that do not exhibit ingestive behavior during ESLH. In addition, footshock stress produced a greater increase in forebrain dopamine utilization in rats that engaged in nonregulatory ingestive behavior. This evidence is consistent with the hypothesis that there are individual differences in the responsiveness of forebrain dopamine systems that are related to the behavioral predisposition to exhibit nonregulatory ingestive behavior. PMID- 3964424 TI - Changes in self-stimulation at stimulation-bound eating and drinking sites in the lateral hypothalamus during food or water deprivation, glucoprivation, and intracellular or extracellular dehydration. AB - These studies were designed to examine the effects of "hunger" induced by food deprivation, 2-deoxy-D-glucose (200 mg/kg), or insulin (2 U/kg) and "thirst" induced by water deprivation, sodium chloride (4 M), or polyethylene glycol (5 ml of 30% w/w) on lateral hypothalamic self-stimulation in 40 male Long-Evans rats. Changes in self-stimulation were evaluated at electrodes that produced stimulation-bound eating and/or drinking or neither behavior. Daily 30-min test sessions consisted of three 5-min periods of self-stimulation alternated with three 5-min periods when bar presses resulted in a 5-s time-out from experimenter delivered stimulation (stimulation escape). Food deprivation significantly increased self-stimulation; insulin, 2-deoxy-D-glucose, and sodium chloride significantly suppressed self-stimulation; water deprivation mildly inhibited self-stimulation; and polyethylene glycol had no effect. This pattern of findings was noted at electrodes that did and those that did not elicit eating and/or drinking. These findings argue against the hypothesis that the magnitude of lateral hypothalamic self-stimulation is differentially and predictably controlled by specific drive mechanisms indexed by the consummatory behaviors also elicited by the stimulation. PMID- 3964425 TI - Effect of medial preoptic lesions on sexual behavior of female rats is determined by test situation. AB - The sexual behavior of female rats with bilateral lesions in the medial preoptic area (MPOA) was examined in two testing conditions. In the first condition, in which the female could not leave the vicinity of males (no-exit test), lordosis quotients (LQs) were elevated in relation to baseline levels. In the second condition, in which the female could control her proximity to males (exit test), LQs were not different from control levels, and experimental subjects permitted fewer copulatory contacts, exhibited less frequent solicitational behavior, and spent less time with males than the controls did. These findings suggest that the higher LQs seen in no-exit tests as a result of MPOA damage are not due to a lesion-induced potentiation in the females' preference to engage in sexual contacts with males. PMID- 3964426 TI - Epinephrine proactive retardation of amygdala-kindled epileptogenesis. AB - Recent findings indicate that a single injection (ip) of epinephrine can proactively retard the development of amygdala-kindled seizures. In these experiments, these findings were extended by examining the dose and temporal properties of this phenomenon. Rats were prepared with stimulating electrodes placed in the amygdala. At 30 min or 24, 48, or 72 hr before the first kindling trial, the animals received an epinephrine injection (0.01-1.0 mg/kg). The results indicate that the high epinephrine dose delayed the onset of kindling when injected within 24 hr before kindling, the intermediate dose delayed kindling when injected at 30 min before the first kindling trial, and the low dose was ineffective at all intervals. Injections administered after kindling had been established had no effect on later seizures, although injections during early kindling stages had a small effect on the further development of seizures. Examination of the time courses of increases in plasma catecholamine levels, blood pressure, and heart rate demonstrated that long-term changes in these measures cannot account for the retardation of kindling. The findings of these experiments indicate that although epinephrine does not directly affect seizure production with these procedures, the hormone does have long-lasting proactive effects on kindled epileptogenesis. PMID- 3964427 TI - Effects of antidepressant drugs on the behavior of olfactory bulbectomized and sham-operated rats. AB - Removal of the main olfactory bulbs in rats has been shown to alter neuronal function in brain areas involved in emotional regulation and homeostasis. These neuronal alterations result in maladaptive behavioral patterns and elevated plasma corticosterone that are suggestive of the symptom profile of patients with primary unipolar depression. Moreover, the endocrine and behavioral deficits of bulbectomized rats are reversed by the chronic administration of drugs that reverse the symptoms of depression in people when given chronically. However, the therapeutic improvements seen in patients with depression are not directly due to molecules of the antidepressant drug but rather to some relatively long-lasting compensatory change induced in the neuronal substrate by the drug. The present research demonstrates that the reversal of the olfactory bulb lesion deficits following chronic antidepressant drug administration in rats is not due to molecules of the drug per se but rather to some drug-induced change in the neuronal substrate that continues for at least 5 days after the last dose of drug. These endocrine, behavioral, and pharmacological similarities suggest that the study of rats with olfactory bulb ablation may make significant contributions to the understanding of the neuroscience of primary unipolar depression in humans. PMID- 3964428 TI - Social play soliciting by male and female juvenile rats: effects of neonatal androgenization and sex of cagemates. AB - Male and female juvenile rats were individually exposed to nonplayful juvenile social stimuli in a novel test of play-soliciting behavior to examine hormonal and experiential determinants of sex differences. In Experiment 1, neonatally androgenized females engaged in play soliciting at a level equal to that of male controls and greater than that of nonandrogenized female controls. In Experiment 2, males and females were reared in unisexual and bisexual groups in order to compare long-term sex-related social experience effects on juvenile play soliciting. Males exposed only to other young males engaged in greater play soliciting than males exposed to both sexes; females, in contrast, were unaffected by sex of cagemates. Within rearing conditions, however, males engaged in greater play soliciting than females. The combined results suggest that perinatal gonadal androgen exposure effects on social play are prepotent and contribute essentially to sex differences in the initiation of social play behavior. PMID- 3964429 TI - Recovery of spatial alternation deficits following selective hippocampal destruction with kainic acid. AB - Elimination of hippocampal CA3 and CA4 pyramidal cells with kainic acid (KA) induces a performance deficit on a forced-choice alternation task, which recovers over time. In order to determine whether superior cervical ganglion (SCG) fibers sprouting into the hippocampus contribute to behavioral recovery, 31 Sprague Dawley rats were first trained on a forced-choice task. After reaching criterion performance levels, animals received either KA or saline injections into the hippocampus and were again tested on the forced-choice task. Half of the rats had their SCG removed 35 days after injections, and all were again tested on the forced-choice task. Analysis of variance showed animals receiving KA took significantly longer to reach criterion following injections. Removal of the SCG after recovery reintroduced the performance deficit of KA-treated rats on the alternation task; no other group showed any effect for SCG removal. Results are interpreted as indicating that the SCG may have a modulatory effect in behavioral recovery, although other mechanisms may also be operating. PMID- 3964430 TI - Thyroxine treatment reduces the anorectic effect of estradiol in rats. AB - In order to examine a possible interaction between thyroxine and estradiol in the control of feeding, 14 ovariectomized adult female rats were given daily injections of 9.8 micrograms/100 g of body weight of 1-thyroxine (T). Another 14 rats received 0.15 ml of saline (S) subcutaneously each day, and food intake was measured for both groups daily. After 15 days of treatment, 8 rats from each group were also given a single injection of 6 micrograms of estradiol benzoate (EB), and the remaining 6 rats of each group received peanut oil vehicle. It was found that T-treated rats showed a significantly smaller drop in food intake after EB than did S-treated rats. This thyroxine-induced decrease in responsiveness to EB did not appear due to any changes in body weight per se but may be related to effects of thyroxine on general metabolism. PMID- 3964431 TI - Prenatal ethanol exposure fails to affect stimulus reactivity in the rat. AB - Three groups of male Long-Evans rats, that were the offspring of dams maintained throughout pregnancy on a liquid diet in which 35% of the calories were derived from ethanol, pair fed an isocaloric liquid diet that had maltose-dextrin substituted for the ethanol, or maintained on lab chow and water were used as subjects. All subjects were nursed by foster mothers maintained on lab chow and water throughout pregnancy and lactation. The groups were not found to differ on open field activity or number of approaches to four stimulus objects in an open field at 26-30 days of age, on spontaneous alternation at 50-55 days of age or on response to a novel alley at 55 days of age. It was concluded that in the rat, prenatal ethanol exposure does not result in demonstrable changes in responsivity to stimuli in rats tested after 26 days of age. PMID- 3964432 TI - Striatal dopamine does not appear involved in the voluntary intake of ethanol by rats. AB - Ethanol preferring and non preferring rats were selected. Ethanol preferring rats showed a constant voluntary intake of a 12% ethanol solution during 14 days (about 5 g/kg body weight daily) while the non preferring rats drank less than 1 g/kg body weight daily. Preferring rats were daily IP injected with 5 or 10 mg/kg of nomifensine, an inhibitor of dopamine uptake. Their intake of ethanol solution remained constant during the 14 days of treatment. Dopamine uptake into striatal synaptosomes was identical in ethanol preferring and non preferring rats. These data, as others, led us to suppose that striatal dopamine is not involved in the voluntary intake of ethanol by rats. PMID- 3964433 TI - Pre-pregnancy alcohol experience attenuates typical decrease in gestational alcohol consumption in mice. AB - The influence of pre-pregnancy alcohol consumption on alcohol self-selection during pregnancy and lactation was examined in C57BL mice. One group of animals was given a two-bottle choice between water and a 10% w/v ethanol solution for three weeks prior to breeding, throughout pregnancy, and during lactation, while a second group was given the alcohol-water choice beginning on the first day of pregnancy. Relative alcohol intake (g ethanol/kg body weight) as well as alcohol "preference" decreased below pre-pregnancy levels during both pregnancy and lactation. That is, voluntary alcohol consumption was attenuated in pregnant and lactating mice, regardless of strain-typical pre-pregnancy high consumption. However, mice given a choice between alcohol and water prior to pregnancy did not decrease their alcohol consumption during pregnancy as much as mice not given the pre-pregnancy alcohol choice. There was no correlation between pre-pregnancy alcohol consumption and subsequent intake. The mechanism underlying decreased voluntary alcohol consumption during pregnancy remains to be elucidated, but it is clear that prior experience with alcohol influences the phenomenon. PMID- 3964434 TI - Dose and time dependent cerebrovascular and metabolic effects of ethanol. AB - The purpose of these experiments was to determine the effect of ethanol dose and time of administration on cerebral blood flow (CBF) and cerebral oxygen consumption (CMRO2). CBF and CMRO2 were measured in Sprague-Dawley rats 30 and 90 minutes after intraperitoneal injections of ethanol. Blood alcohol concentrations ranged from 1 to 3 mg/ml and were equivalent at both time periods. Ethanol produced small but significant increases in CBF and CMRO2 with blood alcohol concentrations. The above changes were not time dependent and were similar between 30 and 90 minute testing periods. The dose dependent effects of ethanol on cerebral metabolism are consistent with in vitro studies suggesting a dose related effect of ethanol on neuronal metabolism. The time of application appears to have little effect on the cerebral metabolic effects of alcohol. PMID- 3964435 TI - Learned alcohol aversions in rats: gustatory and olfactory components. AB - The gustatory and olfactory basis of learned alcohol aversions was examined by testing rats with either gustatory neocortex ablations, olfactory bulb ablations, or a combination of both ablations. In the first experiment operated rats were compared with control rats in the acquisition of a learned alcohol aversion. In the second experiment, the effect of ablations on preoperatively-learned alcohol aversions was examined. Rats lacking gustatory neocortex learned and retained alcohol aversions normally although these rats extinguished the aversions faster than normal rats. Olfactory bulb ablation alone failed to disrupt normal aversion learning but completely eliminated retention of a previously acquired aversion. Combination ablations produced severe deficits both in acquisition and retention of learned alcohol aversions. The results indicate that, besides having gustatory qualities, the odor quality of alcohol is important in determining the associative and memorial characteristics of alcohol. PMID- 3964436 TI - Chronic alcohol dependence and water-electrolyte status. AB - Altered water-electrolyte status resulting from chronic alcohol dependence has been reported, although the nature of any such derangement is controversial. To illuminate this problem, four groups of rats were exposed chronically to schedule induced polydipsia conditions with a single fluid available: 5% ethanol, 0.9% NaCl solution of 5% ethanol, 0.9% NaCl solution, or distilled water. An ad lib control group was also used. The water-electrolyte status of these groups was evaluated in two ways. First, the diuretic response to hydrochlorothiazide doses (8-12 mg/kg) was measured after 3.5 months of chronic polydipsia. Second, after approximately two additional months of polydipsia, extracellular fluid volume, as well as plasma volume and electrolytes were measured. Both alcohol-intake groups drank approximately 11.5 g ethanol/kg/day over the course of the experiment. Urinary volume response to the diuretic agent did not reveal that chronic ethanol led to either water retention or dehydration, even when extra NaCl intake was imposed chronically (NaCl-EtoH group). Animals that were overdrinking either water or the 0.9% NaCl solution had extracellular fluid volumes that were greater than the NaCl-EtOH-polydipsic group, but they were not significantly larger than ad lib controls. There were no significant differences with respect to serum electrolyte concentration measures among the groups. In conclusion, animals that drank ethanol chronically in a pattern known to produce physical dependence revealed no altered water-electrolyte status when evaluated by acute responses to a diuretic agent, a chronically-imposed extra NaCl load, or body fluid compartment and electrolyte concentration measures. PMID- 3964437 TI - Consumption of ethanol solution is potentiated by morphine and attenuated by naloxone persistently across repeated daily administrations. AB - For 29 days, rats were given a daily opportunity to take a sweetened ethanol solution (ES) or water when deprived of water. Under this regimen, and throughout all procedures, rats gained weight normally. They eventually took considerable amounts of ethanol (E). Across the next days of the regimen, one group was given an injection of morphine (MOR), 2.5 mg/kg, 30 min before each of 6 consecutive daily opportunities to drink. MOR enhanced intake of ES on every day of injections. Naloxone (NX) (2.5 mg/kg, 10 min before opportunity to drink) was given to rats having had many daily opportunities to take ES. NX reduced intakes day after day. Rats given NX from the first opportunity to take ES did not develop an avidity for ES as other rats given placebo-injections. MOR increased intakes among rats not deprived of water, among rats housed in groups as well as individually, among rats taking unsweetened ES, and among rats presented with various flavors of ES as the only solution during an hour-long session. The data confirm and extend the conclusion that small doses of MOR enhance E-intake, indicate that the effects of opioids on E-intake do not tolerate with repeated administrations, and generally support the idea that an endogenous opioid system is involved in the reinforcement derived from E. PMID- 3964438 TI - Neural and behavioral responsivity to ethyl alcohol as a tastant. AB - Three experiments were designed to study the sensory properties of ethyl alcohol (EtOH) in the rat. In Experiment 1, a conditioned taste aversion (CTA) was produced to 3%, 6% or 9% EtOH. None of these aversions generalized to any of the 4 basic tastants. However, rats in the 6% and 9% EtOH groups did generalize the CTA to a mixture of sucrose-QHCl but not to a mixture of NaCl-HCl. In Experiment 2, a CTA was produced to 6% EtOH and animals were then tested with all 6 combinations of the basic tastants. The CTA was found to generalize significantly to sucrose-QHCl and marginally to sucrose-HCl. In Experiment 3, single unit responses to gustatory stimuli were recorded in the nucleus of the tractus solitarius. Solutions of NaCl, HCl, sucrose, QHCl, 6% and 9% EtOH were bathed over the rostral tongue through a plastic flow chamber. Approximately half of the units responded to 9% EtOH. Analysis of the across-unit patterns of response revealed a weak relationship between responses to EtOh and sucrose in the first 1.0 sec of response. PMID- 3964439 TI - Elevation by ethanol and its metabolites of liver adenosine monophosphate. AB - Acute ethanol administration significantly increased the concentration of adenosine monophosphate (5'-AMP) in the intact freeze-clamped rat liver regardless of the ethanol dose administered. The increase was abolished by the alcohol dehydrogenase inhibitor 4-methylpyrazole, but was also seen after direct infusion of acetaldehyde into the portal vein. Administration of acetate to give hepatic levels similar to those seen during ethanol oxidation failed, however, to cause an increase in AMP. After ethanol administration there was a highly significant positive correlation between individual AMP levels and 3-OH butyrate/acetoacetate ratios. The results suggest that the increase in liver AMP reflects activation of ethanol-derived acetate by acetothiokinase in the mitochondrial matrix. Ethanol, but not acetate inhibits the citric acid cycle, as reflected by the shift in the mitochondrial redox state. This could inhibit production of GTP needed for AMP phosphorylation by GTP-AMP phosphotransferase, thus explaining the accumulation of AMP by ethanol. PMID- 3964440 TI - Circadian drinking rhythms and blood alcohol levels in two rat lines developed for their alcohol consumption. AB - The circadian drinking behavior of the AA (Alko Alcohol) and ANA (Alko Non Alcohol) rat lines developed for high and low voluntary alcohol consumption was studied by using a microcomputer lick-counting system. The blood alcohol concentrations of AA rats were measured during the drinking peaks. The results showed that AA rats voluntarily drink intoxicating amounts of alcohol. The highest blood alcohol levels were about 25 mmol/l. Differences in circadian drinking rhythms between AA and ANA lines were also found. AA rats had a trimodal drinking pattern for alcohol intake during the dark period but ANA rats drank alcohol rather evenly throughout the period. PMID- 3964441 TI - Differences in the sleep-wake patterns of the AA and ANA rat lines developed for high and low alcohol intake. AB - The sleep-wake patterns of the AA and ANA rat lines, developed for high and low voluntary alcohol consumption by genetic selection, were studied at the age of 10 days with a movement sensitive mattress, and at the age of four months with a monitor for anesthesia and brain activity. The amount of REM sleep was significantly higher in the ANA rats than in the AA rats both as newborns and as adults. The total sleep times, however, were the same in both rat lines. These findings suggest that the differences in alcohol drinking observed in the AA and ANA rats may be related to REM sleep, possibly due to differences in cerebral monoaminergic activity. PMID- 3964442 TI - Studies of enzyme-ligand complexes using dynamic fluorescence anisotropy. II. The coenzyme-binding site of malate dehydrogenase. AB - The coenzyme-binding site in mitochondrial malate dehydrogenase from pig heart was studied using dynamic fluorescence anisotropy decay. The dynamics of the fluorescent ligands NADH and 6-cyano-7-hydroxy-4,8-dimethylcoumarin were used to detect conformational changes at the dihydronicotinamide-and at the adenosine binding sites, respectively. Addition of the natural substrate L-malate to the complex from enzyme and NADH does not influence the complete immobilization of the dihydronicotinamide group, whereas the stereoisomer D-malate and the substrate-analogue hydroxymalonate form ternary complexes with highly mobile dihydronicotinamide. The dynamics of the fluorescent adenosine-analogue are not influenced by formation of complexes with substrate and substrate-analogues. Thus the conformational changes at the dihydronicotinamide-binding site remain local and are not transmitted to the adenosine-binding site. PMID- 3964443 TI - Features of glycogen phosphorylase from the body wall musculature of the lugworm Arenicola marina and the mode of activation during anoxia. AB - The activities of glycogen phosphorylases a and b from the body wall musculature of the marine worm Arenicola marina (Annelida, Polychaeta) were determined after various periods of anoxia. Already under normoxic conditions one third of the total activity was produced from the a form. During anoxia the ratio of both forms as well as the total activity did not change. The activity of soluble phosphorylase kinase was comparatively low in this tissue 4.3 +/- 1.2 nmol . min 1 . (g wet wt.)-1; the fast twitching tail muscle of shrimps, e.g., had a 10-fold higher phosphorylase kinase activity, whereas phosphorylase activities in both tissues were about the same 2.3 +/- 0.5 mumol . min-1 . (g wet wt.)-1. Glycogen phosphorylase b was purified from the body wall tissue of the marine worm in one step by 5'-AMP-Sepharose resulting in a single protein band in SDS-PAGE. This preparation was accepted as substrate by the phosphorylase kinase from rabbit muscle but a complete phosphorylation could not be achieved. The molecular mass of native phosphorylase was approximately 216 kDa, that of subunits 95 kDa indicating that the enzyme exists as a dimer. There were no isozymes in this preparation, the RF-value (0.17) of the single band in PAGE ranged between those of the isozymes from mice hearts. The activities of phosphorylases b and a were similarly dependent on pH and temperature but differed drastically in the affinities to phosphate and AMP. In presence of 1 mM AMP the app. Km of phosphorylase a for phosphate was 16 mM, that of phosphorylase b above 100 mM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964444 TI - Primary structure of adult hemoglobin of white-throated capuchin, Cebus capucinus. AB - The alpha and beta chains of White-Throated Capuchin (Cebus capucinus) hemoglobin were separated and digested by trypsin. The tryptic peptides were isolated and sequenced by conventional methods. The peptides in each chain were aligned by the homology of their sequences with those of human adult hemoglobin. The primary structures thus deduced are compared with those of other primate hemoglobins, and we discuss the molecular evolution of hemoglobins, in particular the rate of evolution in New World monkey hemoglobins. PMID- 3964445 TI - Interaction of allosteric effectors with alpha-globin chains and high altitude respiration of mammals. The primary structure of two tylopoda hemoglobins with high oxygen affinity: vicuna (Lama vicugna) and alpaca (Lama pacos). AB - Polyacrylamide gel electrophoresis and ion-exchange chromatography revealed one hemoglobin component for vicuna (Lama vicugna) and alpaca (Lama pacos). Following chain separation by chromatography on carboxymethyl-cellulose, the amino-acid sequences were elucidated for the alpha- and beta-chains of both hemoglobins using automatic Edman degradation of the chains and the tryptic peptides. Vicuna and alpaca have identical beta-chains showing no substitutions to llama (Lama glama) either. In the alpha-chains alpaca differs from llama by the exchange of one amino-acid residue: alpha 122(H5)Asp----His. The same substitution is present in vicuna too, but in addition we found two more exchanges: alpha 10(A8)Ile--- Val and alpha 130(H13)Ala----Thr. The close relationship between llama and alpaca suggests that they both originate from the wild guanaco, and there is no domesticated form of vicuna. The sequence data show that the higher oxygen affinity in vicuna compared to llama and alpaca must be due to the alpha-chains as the beta-chains are identical. The significance of the substitutions in alpha 122(H5), an alpha 1/beta 1-contact, and alpha 130(H13) is discussed. PMID- 3964447 TI - The International System of Units (Systeme International) PMID- 3964446 TI - Modern aspects in protein chemistry. Third Conference of the Study Group "Chemical Analysis of Proteins" of the Gesellschaft fur Biologische Chemie. Heidelberg, October 28-30, 1985. Abstracts. PMID- 3964448 TI - Surface coil magnetic resonance imaging of the normal larynx. AB - The use of specialized surface coils has made it possible to obtain high-signal, high-resolution magnetic resonance (MR) images of the neck. We describe the normal anatomy of the larynx imaged with surface coils and a technique adapted from respiratory gating to reduce motion from swallowing and coughing. Compared with computed tomography, MR has superior discrimination of tissues that on computed tomography appear to be of similar density. The intrinsic laryngeal muscles and carotid sheath are well seen. Multiplanar imaging capability allows easy distinction of false and true cords and optimal evaluation of the preepiglottic and paralaryngeal spaces. Computed tomography is easier to perform than MR and is superior to MR in depicting the laryngeal cartilages. However, with improved technology, MR may become the imaging modality of choice in evaluation of the larynx and adjacent hypopharynx and subglottic regions. PMID- 3964449 TI - Sensorineural hearing loss in chronic adhesive otitis. AB - The incidence and degree of sensorineural hearing loss were analyzed in 67 patients operated on for adhesive otitis. Median observation time was 11 years. The difference in bone conduction between the treated ear and the untreated ear was assessed for each frequency, before operation and late after operation. A sensorineural hearing impairment of 5 dB was found in the frequency region of 500 to 2,000 Hz and of 10 dB at 4,000 Hz. The hearing did not deteriorate during the postoperative period. In 76% of the patients, the bone conduction in the treated ear compared with the healthy ear was at least 10 dB poorer at one or more frequencies. There are great problems in analyzing sensorineural hearing loss in chronic otitis, which often is or has been bilateral. PMID- 3964450 TI - Bone resorption induced by middle-ear implants. AB - The pressure produced by expanding aural cholesteatomas has been implicated as a causal factor in the induction of osteoclastic resorption of adjoining bone. This concept is supported by observations of osteoclastic bone resorption produced by expansive tympanic implants. We induced osteoclastic bone resorption in gerbils with tympanic implants of autologous and homologous cartilage, silicone rubber, and Teflon, which exerted pressure only by forces of gravity and surface tension. We estimated that the pressure exerted by these implants ranged from 2.1 X 10(-3) to 8.0 X 10(-3) dynes/sq cm (1.6 to 6.0 mm Hg). These pressures are within the range of pressures known to be exerted by cholesteatomas. PMID- 3964451 TI - Tympanograms in ears with small perforations of the tympanic membranes. AB - It has been believed that in an ear with a perforation, the tympanogram becomes a straight line due to the lack of compliance change in response to the pressure change in the external auditory meatus. Recently, however, we found two types of tympanogram with distinctive characteristics in ears with small perforations. In the first tympanogram type, when the external auditory meatus pressure was changed in the decreasing direction, the compliance peak was formed in the positive-pressure area, whereas it was formed in the negative-pressure area when it was changed in the increasing direction. The difference of the pressure at which compliance peak was obtained was great. The second tympanogram type was unique, with multiple notches similar to those of electronystagmographic recordings of the jerky nystagmus. Knowledge of these tympanograms helps in recognizing small tympanic-membrane perforations. PMID- 3964452 TI - Tetracycline sclerotherapy for chylous fistula following neck dissection. AB - In chylous fistulas following radical neck dissections, we have found reexploration to be unrewarding, with infrequent identification of a specific leakage site intraoperatively and persistent fluid accumulation postoperatively. As an alternative, we injected tetracycline hydrochloride into the supraclavicular wound bed. This procedure resulted in a rapid, sustained decline in fistula output in two of three cases, avoiding surgical intervention. Tetracycline sclerotherapy has been described for treatment of intrathoracic and other intracavitary fluid collections. We believe that tetracycline sclerotherapy is an effective adjunct in the management of chylous fistulas following radical neck dissections and that this therapy should be attempted before surgical reexploration. PMID- 3964453 TI - Upper aerodigestive tract metastases in disseminated malignant melanoma. AB - Cutaneous malignant melanoma sometimes metastasizes to the upper respiratory and digestive tracts. It may cause significant local symptoms such as airway obstruction and dysphagia, and, in some cases, may represent the initial manifestation of disseminated disease. Of the 8,823 patients with cutaneous malignant melanoma seen at The University of Texas-M.D. Anderson Hospital and Tumor Institute at Houston between 1944 and 1983, metastases to this region developed in 54 patients. The most common sites involved were the tonsil, tongue, nasopharynx, larynx, and lip. Five of ten cases in which an autopsy was performed were noted to have previously undiagnosed metastatic mucosal lesions. We conclude that metastases to the upper aerodigestive tract in patients with cutaneous malignant melanoma is a distinct possibility. Melanoma patients who manifest symptoms localized to this region should be carefully examined to exclude the possibility of metastatic tumor, since alternative treatment may be required. Local endoscopic treatment may be necessary to relieve airway or digestive tract obstruction. PMID- 3964454 TI - Metastatic melanoma to the ethmoid sinus. AB - Malignant melanomas comprise approximately 1.5% of all malignant tumors and one fifth of these will involve the head and neck. The surgeon who operates in this region should be familiar with all aspects of this disease. The most common site of metastasis to the nose and paranasal sinuses is via the maxillary sinus. Often these metastases are of renal origin, with pulmonary metastases being the second most common source. The most frequent presenting symptoms are epistaxis, a nasal mass, or nasal obstruction. Review of the English literature to date has not revealed any reports of isolated metastatic melanoma to the ethmoid sinus. Batson, in 1940, proposed a plausible mechanism of such hematogenous metastasis via a valveless vertebral venous bed. PMID- 3964455 TI - Paget's disease of the bone presenting as an apparent oral antral fistula. AB - Paget's disease of the bone is a chronic, slowly progressive condition commonly evidenced by bowing of the legs and enlargement of the skull. Its lesions are usually multiple and result in thickened but weakened areas within the involved bones. A case of Paget's disease presented as an apparent oral antral fistula. The patient also exhibited other signs and symptoms of the disease. PMID- 3964457 TI - Pathologic quiz case 1. Relapsing polychondritis. PMID- 3964456 TI - Anaphylactic reaction to lidocaine. AB - Lidocaine hydrochloride is an amide-type local anesthetic, commonly used for facial plastic as well as other surgical procedures. In an unusual case of reproducible anaphylactic reaction to lidocaine, early treatment with epinephrine, oxygenation, and intravenous fluid resuscitation resulted in relief of the symptoms. This case demonstrates the importance of sensitivity testing and choosing an appropriate alternative local anesthetic in a patient with a history of possible allergy to lidocaine. PMID- 3964458 TI - Pathologic quiz case 2. Cholesterol granuloma. PMID- 3964459 TI - Device to locate facial nerve during surgery. PMID- 3964460 TI - Impacted ear wax--a cause for unexplained cough? PMID- 3964461 TI - Nasal glow in atrophic rhinitis. PMID- 3964462 TI - Treatment of acute bacterial sinusitis. PMID- 3964463 TI - A comparison of the acylation of 1-acyl-sn-glycero-3-phosphoinositol and 1-acyl sn-glycero-3-phosphocholine in neuronal nuclei in vitro using radioactive arachidonate and oleate. AB - A neuronal nuclear fraction (N1) was isolated from cerebral cortices of 15-day old rabbits. Samples of N1 were incubated with a radioactive fatty acid ([3H]arachidonate or [14C]oleate), acylation cofactors, and 1-acyl-sn-glycero-3 phosphoinositol (1-acyl-GPI) or 1-acyl-sn-glycero-3-phosphocholine (1-acyl-GPC). In competition studies, both radioactive fatty acids were incubated with one lysophospholipid or the two lysophospholipids were incubated with one radioactive fatty acid. Using [3H] arachidonate and one lysophosphoglyceride, a maximal rate of incorporation into phosphatidylinositol (PI) was found at a relatively low concentration of 1-acyl-GPI (10 microM), while increasing rates of incorporation into phosphatidylcholine (PC) were seen with increasing concentrations of 1-acyl GPC (to 65 microM). At low concentrations of lysophosphoglyceride (less than or equal to 25 microM) the rate of arachidonate incorporation into PI greatly exceeded rates of arachidonate incorporation into PC. This higher rate of arachidonate incorporation into PI was also seen in incubations where both lysophospholipids were present. For oleate, greater rates of incorporation into PC were found in comparison with rates of labelling of PI in assays using relatively high concentrations of one or both lysophospholipids. When comparing arachidonate and oleate, in assays with one or both fatty acids, the polyunsaturate showed at least threefold higher rates of incorporation into PI. For PC labelling higher rates of arachidonate incorporation were evident at the higher concentrations of 1-acyl-GPC and the superiority over oleate was not as marked as that seen in PI labelling. PMID- 3964464 TI - The effect of developing hypertension on the synthesis and accumulation of elastin in the aorta of the rat. AB - This report describes an investigation of the effects of developing hypertension on the synthesis and accumulation of insoluble elastin in the thoracic aorta of young rats. Uninephrectomized male rats were made hypertensive by administration of deoxycorticosterone acetate and addition of 1% NaCl to their drinking water. Divergence of systolic blood pressures between treated and control animals and hypertrophy of the vessel began after about 2 weeks of treatment. Coincident with the appearance of hypertrophy, there was an increased accumulation of insoluble elastin in the aorta and a large increase in the capacity of the aortic tissue to synthesize elastin. However, in spite of continued increases in blood pressure and vessel hypertrophy, this effect on elastin synthesis and accumulation was transient. The results of this study suggest that synthesis of elastin in aortic tissue of young rats is highly sensitive to alterations in blood pressure. PMID- 3964465 TI - Modifications of lipid structure and their influence on mesomorphism in model membranes: the influence of hydrocarbon chains. AB - The influence of hydrocarbon chains on the temperature (TG-LC) of the gel to liquid-crystalline phase transition of model membranes has been investigated over an extensive variety of phosphatidylcholines (PC). The TG-LC is dependent upon the length of the hydrocarbon chains, on whether or not the chains are saturated or have been modified in some way, and on the position of any modification along the chain. For PC having two different acyl chains (heteroacid PC) in the sn-1 and sn-2 positions, the TG-LC is dependent on the chain position and on the inequivalence of chain penetration into the bilayer. Positional isomers of PC have different TG-LC. The first two double bonds introduced in each chain of a PC cause a much greater reduction in TG-LC and in the enthalpy change of the transition than does the subsequent introduction of additional double bonds. Dipolyunsaturated PC have uncooperative (broad) transitions that occur at low temperatures and have small enthalpy changes. While each PC has unique transitional characteristics, there are a number of patterns in the TG-LC which emerge on consideration of all the available data. One such pattern may be useful in predicting TG-LC from analytical data on the composition and positions of acyl chains of various lipids. PMID- 3964466 TI - Metabolism and control of lipid structure modification. AB - The lipid composition characteristic of a particular cellular membrane can become significantly altered, sometimes quite suddenly, when the cell is placed under environmental stress. In the majority of cases examined, the alterations seem to return the membrane's physical state towards that existing prior to imposition of the stress. The compositional changes are often diverse in their nature and also in their site of origin within the cell. Certain modifications, such as changes in the degree of phospholipid acyl chain unsaturation and in the reordering of fatty acid pairing on specific phospholipids, are now recognized as crucial first responses to stress, while others (e.g., fluctuations in relative proportions of different phospholipid classes and in the sterol:phospholipid ratio) develop more slowly and may represent secondary adjustments to the initial lipid changes. The factors directly responsible for modifying membrane lipid composition are generally unknown at the molecular level, but recent advances provide new clues favoring involvement, in some cases, of the ubiquitous mediator Ca2+. In other cases, the physical state of a membrane may directly modulate the activity of lipid-metabolizing enzymes embedded therein. PMID- 3964467 TI - Influence of maternal mineral deficiency on the hepatic metallothionein and zinc in newborn rats. AB - The effects of maternal Zn, Cu, or Fe deficiencies during late gestation on hepatic levels of metals and metallothionein (MT) and the binding of Zn and Cu to protein fractions were investigated in newborn rats. Timed pregnant rats were fed one of the following diets: Zn deficient (Zn-D), Cu-D, Fe-D, or control from day 12 of gestation until birth. The specific nutritional deficiency status of the dams was confirmed by low plasma levels of the deficient metal. Livers from pups were analyzed for MT, metal content, and metal-protein binding. Maternal Zn-D resulted in a greater than 50% reduction of hepatic MT levels in pups, whereas Cu D and Fe-D had no significant effects. Pups in each deficient group showed a significant decrease in the hepatic levels of the respective metals. Fractionation of hepatic cytosols from the pups by Sephadex G-75 gel filtration showed that in both Fe-D and Cu-D pups the respective metals were depleted from the high molecular weight protein fraction, whereas in Zn-D pups the Zn was depleted mainly from the MT fraction (Ve/V0 approximately 2). Incorporation of [35S] cysteine into MT fractions was significantly lower in Zn-D pups as compared with control pups. These results indicate that there is a specific effect of the maternal Zn-D on the hepatic storage of Zn as MT in newborn rats. PMID- 3964468 TI - Prolegomena to the use of the tachistoscope in neuropsychological research. PMID- 3964469 TI - Psychophysics of lateral tachistoscopic presentation. AB - Human visual performance depends upon the retinal position to which a target is delivered. A general finding is that performance measured in a variety of psychophysical tasks deteriorates as a target is presented to more eccentric retinal regions. One purpose of this paper is to describe differences between foveal and peripheral vision in a number of psychophysical tasks. A second purpose is to review studies which have attempted to account for the fall off in visual performance between central and peripheral target presentations. A third purpose is to consider the contribution of the periphery to perception since targets which are sufficiently large project not only on receptors in the fovea but also on those in the periphery. In addition, stimuli presented to the peripheral retina can influence the processing of a target presented to the central retinal region. A fourth purpose is to review studies which have attempted to compensate for foveal and peripheral differences by scaling the target in size or some other attribute in proportion to the cortical magnification factor. A final purpose of this paper is to consider whether the fovea and the periphery are specialized for different functions. PMID- 3964470 TI - Transfer of visual information after unilateral input to the brain. AB - Visual callosal connections are more numerous and widespread in the association areas than in the primary visual cortex and adjoining visual areas. In keeping with this, the amount of "wrong" ipsilateral visual field that is represented in the various cortical areas of primates and cats increases as one goes from primary visual cortex to extraoccipital areas. Therefore it can be argued that transfer of unilaterally presented visual stimuli occurs mainly at the temporal and parietal cortical level. PMID- 3964471 TI - Role of input factors in visual-field asymmetries. AB - This paper examines the implications of lateral tachistoscopic presentation of information for the processing efficiency of the intact cerebral hemispheres. Considering that the understanding of the processes underlying the particular competences of each hemisphere may require, as a preliminary step, the specification of the characteristics of the input on which the brain operates, anatomical, physiological, and psychophysical consequences of briefly stimulating the retinal periphery for the representation of information in the brain are outlined, with special reference to the spatial-frequency spectral composition of the stimuli. Retinal eccentricity and brief exposure duration converge to making the representation of information qualitatively different from the information that the brain normally operates on, which constrains the interpretation of findings with respect to the normal functions of the cerebral hemispheres. A review and discussion of empirical findings relevant to these issues suggest that manipulation of procedural variables may differentially affect the processing efficiency of the cerebral hemispheres and indicate that a given pattern of visual-field asymmetry may be overdetermined by a multitude of variables interacting in complex ways. PMID- 3964472 TI - Role of task factors in visual field asymmetries. AB - Any tachistoscopic study of cerebral hemisphere asymmetry imposes a variety of task demands on the participants, ranging from demands imposed by specific viewing conditions to demands imposed by response output requirements. The present article discusses the role of several task factors that influence processing after the initial reception of the stimulus input, suggests a theoretical rationale for some of the effects of these task factors, and considers implications for future studies of visual laterality. The task factors discussed include both those that are relevant for minimizing artifacts that have nothing to do with hemispheric asymmetry and those that are relevant for interpreting hemispheric asymmetry in terms of specific perceptual and cognitive processes. PMID- 3964473 TI - Cerebral asymmetries and experimental parameters: real differences and imaginary variations? AB - The basic conditions and stimulus parameters of the paradigm usually used to study visual field-hemisphere differences are reviewed. An argument is presented that a majority of published reports using this paradigm are, in fact, the same basic experiment. The similarity of many parameters over experiments constitutes a set of effects whose influence on our interpretations are not determinable since these parameters are seldom varied. Examples of unsuspected effects on lateralization are drawn from three studies carried out by the author and his colleagues. PMID- 3964474 TI - Fresh fields and postures new: a discussion paper. AB - By their very nature, studies of visual hemifield differences in normals are biased toward the discovery of hemispheric asymmetries that occur early in visual processing, and may consequently give a narrow and distorted view of human laterality as a cultural and evolutionary phenomenon. One saving factor, however, is that hemifield differences may in some cases actually represent differences between the two sides of phenomenal space, and thus represent cerebral asymmetries at a relatively late stage in processing. It may therefore be important to develop techniques for distinguishing retinal effects from higher order spatial ones. PMID- 3964475 TI - Politics, ethics and the Royal Australian College of Ophthalmologists. PMID- 3964476 TI - Alternatives to enucleation in the management of choroidal melanoma. AB - Over the past 15 years 140 patients with choroidal melanoma have been treated by local surgical resection of the tumour. The method appears worth considering for tumours up to 15 mm in diameter not involving more than one-third of the ciliary body. Sixty percent of patients retained useful vision and 25% good vision. Eighty-two percent retained a cosmetically satisfactory eye. The total tumour related mortality in this group of patients was 9%, almost all of the 12 patients dying having had tumours larger than would now be recommended for local resection. The five-year survival rate among patients undergoing local resection was 84%. Low-energy long-exposure laser has been used to treat a small number of choroidal tumours. The technique appears useful for tumours up to 10 mm in diameter and not more than 3 mm in thickness. Ruthenium plaque therapy has also been used in some cases and appears a suitable method of treatment for tumours up to 10 mm in diameter and not more than 6 mm in thickness. The options for conservative management of choroidal tumours are greater with small tumours than with large ones except in only eyes, tumours of over 15 mm in diameter are best treated with enucleation. The long-term survival after all forms of conservative management has not yet been established. At present the use of controversial techniques such as local resection should be restricted to a few centres so that adequate statistical evaluation of the method may be made. PMID- 3964477 TI - Malignant melanoma of the eyelid and conjunctiva. AB - Four patients with malignant melanoma of the eyelid skin and 14 patients with conjunctival malignant melanoma are presented. Surgery was recommended for eyelid lesions and local excision followed by cryotherapy for conjunctival lesions. One patient with an eyelid skin malignant melanoma died and two patients with extensive malignant melanoma of the conjunctiva died. Nodular lesions involving the lid margin have the worst prognosis of eyelid skin malignant melanomas, and the greater the extent of conjunctival involvement the worse the prognosis for conjunctival malignant melanomas. The complications of cryotherapy are minor, but the follow-up period in this series is too short to comment on survival times. PMID- 3964478 TI - Mass screening of the optic disc for glaucoma: a follow-up study. AB - Because of the high false positive and negative rates for detection of suspects when screening for glaucoma by tonometry, we screened 12 156 subjects over the age of 40 years or with a stated family history of glaucoma by examining the optic discs. This was followed by Schiotz tonometry. Eight hundred and twelve (6.7%) suspects were referred to their primary physician for investigation by an ophthalmologists. A database program was used to send out follow-up letters to both suspects and ophthalmologists. Three hundred and seventy-nine replies were received from ophthalmologists: 100 (26.4%) of these suspects had ocular hypertension and 68 (17.9%) had glaucoma. Of these 68, 60 (15.8%) had chronic simple glaucoma, five (1.3%) had secondary open-angle glaucoma, and three (0.79%) had primary closed-angle glaucoma. The prevalence of all types of glaucoma in this group for which follow-up was obtained was at least 0.56% of the total number screened. Assuming that the prevalence was similar for the group for whom no replies were obtained, the prevalence of glaucoma in this population is approximately 1.19%. Screening by optic disc examination is therefore likely to detect most cases of glaucoma. PMID- 3964479 TI - Ocular manifestations of adult Niemann-Pick disease: a case report. AB - Niemann-Pick Disease Type B in a 33-year-old man is described. No family, racial or hereditary factors were noted in this case as in other reports in the literature. The ocular abnormalities in our patient were mild myopia, a mild generalized colour abnormality, and fundi showing a lipid ring-form opacity about the foveolas resulting in minimal visual impairment. Sphingomyelinase deficiency was found with the resulting deposition of phospholipid occurring most probably in the Muller cell. No neurological features were present and the patient was otherwise well. PMID- 3964480 TI - Surfboard-related ocular injuries. AB - Three cases of ocular trauma caused by surfboards are reported. The severe nature of the injuries is discussed and the prevalence of this type of injury is reviewed. PMID- 3964481 TI - Ocular leprosy: a case report and discussion of the pathology. AB - Although leprosy is considered rare in Australia outside the Northern Aboriginal population, its presence within Indian and Southeast Asian migrant groups must be considered. A case of ocular leprosy is presented in which the definitive diagnosis was delayed because lid changes had been diagnosed as senile ectropion. The pathology of ocular leprosy is discussed, together with relevant therapeutic considerations. PMID- 3964482 TI - Congenital lower nasolacrimal duct anomaly: a case report. AB - A congenital anomaly of the nasolacrimal system not previously described is reported. The apposition of the distal end of the nasolacrimal duct was not with the nasal cavity as normally occurs prior to birth but to the external skin. As a result the child presented with difficulty with tear drainage and consequent infection--"neonatal conjunctivitis" followed by a facial abscess at the left lower border of the nose. Recent embryological studies suggest that this anomaly is due to failure of complete separation and migration of the epithelial rod most distal from the surface ectoderm to the inferior meatus of the nasal cavity. This distal remnant of the nasolacrimal duct thus remains juxtaposed to the surface ectoderm of the face on the lateral aspect of the alar nares. The modern concept of the embryological development of the nasolacrimal system is reviewed. PMID- 3964483 TI - Infection after retinal detachment surgery. AB - In 250 consecutive retinal detachment operations performed by the author, there were 14 cases (5.6%) of infection of the scleral buckle. The commonest infecting organism was Staphylococcus aureus. The surgery in these infected cases took longer than average, and utilized more than the usual amount of silicone sponge; a higher proportion were reoperations. After an average follow-up of 22 months, only six of the 14 had vision of 6/36 or better and of these, two had persisting inferior traction detachments. On the basis of this study and others, the preferred management of infected scleral buckles is to remove the sponge as soon as the diagnosis is made. The risk of redetachment is a lesser evil than the sequelae of prolonged inflammation which include traction retinal detachment, massive periretinal proliferation, and premacular fibrosis. PMID- 3964484 TI - Congenital cataract surgery: a retinal surgeon's viewpoint. AB - Rhegmatogenous retinal detachments presenting many years after surgery for congenital cataracts frequently present formidable problems in management. The techniques and results of treatment are being presented and the implications for modern-day congenital cataract surgery are discussed. PMID- 3964485 TI - Oculinum: an ocular therapeutic use for a notorious toxin. PMID- 3964486 TI - [A comparative study of free amino acid levels in the serum and cerebral cortex in hepatic failure rats]. AB - In order to elucidate the role of amino acid changes in hepatic encephalopathy, free amino acids in serum and cerebral cortex were measured in the experimental hepatic failure models. The acute and chronic models were produced in adult male Wistar rats by carbontetrachloride (CCl4) administration. Acute model was produced by a single intraperitoneal injection of CCl4 (0.35 ml/100 g, B.W.) after the daily pretreatment of phenobarbital (6 mg/100 g, B.W.) for 4 days, while chronic model was established by successive injections CCl4 (0.20 ml/100 g, B.W., twice/week) for 13 weeks. They were confirmed to develop chemical changes compatible with hepatic failure, showing markedly elevated serum levels of NH3, GOT and ALP. Animals were killed by decapitation during fasting and the brains were removed immediately. The parietal cortexes were homogenized in 75% ethanol and deproteinized with water saturated chloroform. The supernatants were subjected to amino acid analyzer. In serum, almost all amino acid concentrations were elevated in acute hepatic failure, reflecting massive release of amino acids from severely damaged liver cells. Chronic hepatic failure rats, however, showed moderately elevated levels of valine and leucine and markedly high levels of phenylalanine and tyrosine, which eventually led to a reduction of the ratio of branched chain amino acids to aromatic amino acids. Regarding urea cycle related amino acids, there were decreases of aspartate and arginine and an increase of ornithine, while citrulline was not affected. In cerebral cortex, no different pattern was observed in acute heptic failure with the exception of increases in threonine, glycine and leucine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964487 TI - [Characteristics of brain tissue damage in kaolin-induced infantile rat hydrocephalus]. AB - Experimental hydrocephalus was induced by an intracisternal injection of 4% or 40% kaolin suspension in 2 days old Wistar rats. They were examined histologically and microangiographically 2 weeks after the injection of kaolin. Hydrocephalic rats were classified into 2 groups, severe hydrocephalic group A and mild hydrocephalic group B. In group A, a marked enlargement of the entire ventricular system with a thinning of the cerebral mantle was observed. On the other hand, the dilatation of the fourth ventricle was more pronounced compared with the other ventricles in group B. In group A, a spongy appearance of brain tissue was observed in the periventricular white matter accompanied with an intracerebral cavity. In these edematous areas, the lack of carbon black perfusion was apparent indicating an occurrence of microcirculatory disturbances. These microcirculatory disturbances and mechanical compression to the cerebral parenchyma may produce defective brain tissue (intracerebral cavity formation). The ependymal cell walls and subependymal glial cell layers were well preserved in spite of the damaged periventricular white matter. In group A, kaolin was present in the fourth ventricle and Sylvian aqueduct. Subependymal gliosis containing macrophages and newly produced blood vessels were observed in the region between the periventricular brain tissue and kaolin granules. These findings indicate that kaolin may produce changes in the ependymal cell and cerebral parenchyma as well as fibrosis and meningitis in the subarachnoid space. PMID- 3964488 TI - [Evaluation of intracranial calcification associated with aging by computerized tomography]. AB - Computerized tomography (CT) scans of 450 standardized normal persons from 5000 consecutive patients were examined to study the relationship between the incidence of intracranial calcification and aging process. The 450 subjects were classified into 9 groups according to age. In people older than 30 years, calcification in the pineal region including pineal body and habenular commissure was found in about 70%. Calcified choroid plexus seems to be characteristic of aging process because the rate of its calcification increased in proportion to aging. Calcification of the falx cerebri was also found to increase in proportion to aging. Calcified cerebral arteries were observed in advanced-aged groups. The fact that people in the ninth decade had a smaller incidence in calcification of the cerebral artery than those in the eighth decade indicates the possibility that longer-lived people had less incidence of cerebral arterial calcification. PMID- 3964489 TI - [Effect of hypoxia and hyperoxia on cortical oxidative metabolism in relation to cerebral blood flow autoregulation]. AB - Our earlier studies have shown that local cortical blood flow (CoBF) in the rabbit has been autoregulated in a narrow range of mean arterial blood pressure (MABP) and autoregulation of cortical oxygen tension (bPO2) has been maintained in a wider range (75-110 mmHg) than that of CoBF. In the present studies, bPO2, NAD/NADH redox state, and CoBF were measured under the various conditions of hypoxia and hyperoxia to discuss the critical level of cortical oxidative metabolism and autoregulation of CoBF in relation to oxidative metabolism. New Zealand white rabbits were anesthetized with pentobarbital sodium intraperitoneally and paralyzed with gallamine triethiodide intravenously. They were ventilated artificially maintaining normal blood gas analysis. NAD/NADH redox state was measured with a compensated fluorometer with a reflectance device to correct for hemodynamic artefacts and bPO2 was monitored continuously with the polarographical method. They were measured simultaneously. CoBF was monitored with the thermal diffusion cerebral blood flow monitor of Flowtronics. Hypoxia and hyperoxia were produced by decreasing or increasing the inspired oxygen concentration. Arterial blood samples were obtained for blood gas determination before and during the episode of hypoxia or hyperoxia. A definite reduction of NADH began at a 50% decrease of PaO2. It corresponded to 70 mmHg of PaO2. Below 50% decrease of PaO2, NADH was reduced largely. This was statistically significant (p less than 0.01). Although, the oxidation of NADH occurred in the moderate hyperoxic state, no oxidation of NADH occurred more than 6.1% of full scale even in the condition of higher PaO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964490 TI - [Progressive dysautonomia in hemangioblastoma in the region of the fourth ventricle]. AB - Tumors of the posterior fossa presenting orthostatic hypotension are rare and only nine cases have been reported so far. The locations of almost all these tumors were near the fourth ventricle and three of them were hemangioblastoma. A case of a tumor of the fourth ventricle showing autonomic disturbances mainly composed of orthostatic hypotension is reported. A 42-year-old male was admitted to the Department of Neurology of Chiba University Hospital on June 25th, 1981 because of three years' history of autonomic disturbances including orthostatic syncope, impotence, urinary disturbance and bowel dysfunction such as vomiting, diarrhea and constipation. He also complained of weight loss and staggering of gait to the left side. On admission, the patient was emaciated being 50 kg in weight and 172 cm in height. Neurological examination revealed hippus of bilateral pupils in light reflex, saccadic eye movement, slightly hypoactive deep tendon reflexes, mild terminal oscillations in bilateral finger-to-nose test, oscillation in the left heel-to-knee test, staggering tendency of gait to the left, slightly impaired tactile and thermal sensations in distal parts of the legs. Autonomic disturbances were showed by orthostatic hypotension (BP 104-50 in supine and 70-40 in sitting position), impotence, weight loss, anorexia, decrease of sweating, spontaneous yawning and loss of sensation of bladder fullness. About 5 weeks after admission, he began to complain of temporal headache and showed impairment of memory, drowsiness, paroxysmal apnea and papilledema.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964491 TI - [A case of intracranial amelanotic melanoma]. AB - Malignant melanoma is usually black in color because of the existence of melanin pigments in it. Differing from such a usual melanoma, amelanotic melanoma, which has no melanin pigments and is not black-colored, is rarely described in literature. In this report, a case of intracranial amelanotic melanoma of unknown origin is presented and discussed. This represents the seventh case report of an intracranial amelanotic melanoma. On May 28, 1984, a 55-year-old man was admitted to our department because of repeated left hemiconvulsion. Neurological and physical examination disclosed left hemiparesis, poor concentration and right inguinal tumors. CT scan revealed a right posterior frontal mass with ring like enhancement. On June 7, the patient underwent craniotomy. The brain tumor, partly emerged from right frontal lobe, was reddish and easy to bleed. Macroscopically there were no abnormal findings over leptomeniges. The right inguial tumors, that were lymph nodes, were also removed simultaneously. Microscopic interpretation at that time was that of a malignant tumor of ectodermal origin. Although no melanin pigments were demonstrated in any specimens except for a part of lymph nodes, dopa reaction was positive in both specimens from the brain tumor and the inguial lymph nodes, strongly suggesting amelanotic melanoma. Postoperative course was uneventful, but CT scan of Aug. 31 again showed multiple intracerebral enhanced lesion and ventricular hemorrhage. Aphasia, right hemiparesis and consciousness disturbance developed gradually, and he died on Sept. 21, 1984. Autopsy demonstrated multiple intracerebral hematomas, containing much tumor cells in lung, thyroid and subcutaneous tissue. Primary lesion remained unknown in spite of an extensive examination in autopsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964492 TI - Intermittent radiographic changes of rickets without defective trabecular bone mineralization in a case of spondylometaphyseal dysplasia. AB - Although a variety of metaphyseal and spondylometaphyseal dysplasias have been identified, the natural course of the skeletal defects in these disorders has not been well characterized. We describe an 8-year-old girl with spondylometaphyseal dysplasia, most closely resembling the Kozlowski type, in whom rachitic metaphyseal involvement underwent dramatic radiographic healing when she wore leg braces; discontinuation of the braces was followed by recurrence of the growth plate abnormalities. A generalized disturbance in mineral metabolism or skeletal remodeling to explain these radiographic changes was excluded by extensive biochemical studies and histologic examination of an undecalcified iliac crest specimen. Our observations suggest that the defect in endochondral bone formation in the spondylometaphyseal dysplasias may be responsive to mechanical factors and that interventions that alter stress and strain on the skeleton, such as immobilization or use of orthopedic braces, may considerably modify the radiographic appearance of the growth plate disturbance. PMID- 3964493 TI - Urinary-free amino acids in osteogenesis imperfecta. AB - Free urinary amino acids were analyzed in patients with osteogenesis imperfecta to determine whether there were any abnormalities that could be used to improve the diagnosis and classification of this syndrome. The results obtained from 15 patients, who had either the type 1, 2, or 3 form of osteogenesis imperfecta, were compared to the values obtained from 115 age-matched controls. Elevated free amino acid levels were not found in any patient with osteogenesis imperfecta. PMID- 3964494 TI - Mechanisms underlying the effects of phosphate and calcitonin on bone histology in postmenopausal osteoporosis. AB - The aim of this study was to evaluate the mechanism underlying the beneficial effect of phosphate combined with calcitonin on trabecular bone mass in postmenopausal osteoporosis. Histomorphometric parameters of trabecular bone formation and resorption were assessed blindly on sections from tetracycline labeled iliac crest bone biopsies from 44 women with postmenopausal osteoporosis obtained before and after 6 months of treatment with phosphate (n = 9), calcitonin (n = 13), combined therapy (n = 13), or double placebos (n = 9). Treatment with phosphate (1.5 g/day) increased the osteoblastic surface in correlation with the fractional trabecular surface with double tetracycline labeling. The mean wall thickness of the basic structural units increased significantly only in the two groups of patients treated with phosphate. Thus, oral phosphate therapy stimulated bone formation by increasing both the bone forming surfaces and bone matrix production. The mean interstitial bone thickness, which is inversely related to the depth of resorbing cavities, was increased in the two groups treated with calcitonin (50 IU X 5 days every third week), indicating that calcitonin therapy partially inhibited the resorbing activity of osteoclasts. The combination of calcitonin and phosphate produced a reduction in bone resorption associated with a stimulation of bone matrix production. This effect resulted in a 22.1% increase in the thickness of the trabeculae and a 31.1% increase in trabecular bone volume. The data show that calcitonin combined with phosphate increased the trabecular bone volume in postmenopausal osteoporosis through reduction of bone resorption associated with stimulation of bone formation along the trabecular bone surface. PMID- 3964495 TI - Quantitative measurement of periosteal and cortical-endosteal bone formation and resorption in the midshaft of female rat femur. AB - Morphologic and modeling parameters were studied in the diaphysis of female rats femora between 60 and 850 days of age. Modeling rates were measured by the vital labeling technique. With the data obtained, a mathematical bone model has been developed that describes the cross section of the femur midshaft by two ellipses, defined by four time-dependent functions of the radii, and one drift function that describes the movement of the whole diaphysis in the transverse direction. With increasing age the apposition(MF), forming(BF), and resorbing(BR) rates decrease continuously from 2.5 mm/year(MF), 850%/year(BF), and 450%/year(BR) at 60 days to 0.05 mm/year(MF), 10.6%/year(BF), and 6.7%/year(BR) at 850 days, whereas the endosteal and periosteal diameters increase. In young animals the fraction of forming and resorbing areas of the periosteal and cortical-endosteal surfaces is comparable, whereas in old rats most of periosteal surface is forming and most of the cortical-endosteal surface is resorbing. PMID- 3964496 TI - Quantitative measurements of periosteal and cortical-endosteal bone formation and resorption in the midshaft of male rat femur. AB - Morphologic and modeling parameters have been studied in the femoral diaphysis of male rats between 60 days and 840 days of age. The modeling rates were measured by use of a vital labeling technique with calcein. The mathematical bone model that was developed for the midshaft of female rats was used also for male rats. The two ellipses, defined by four time-dependent functions of the radii, and one drift function that describes the movement of the whole diaphysis in the transverse direction have been adapted to the new data sets obtained for male rats. With increasing age the apposition(MF), forming(BF), and resorbing(BR) rates decrease continuously from 5.4 mm/year(MF), 960%/year(BF), and 540%/year(BR) at age 60 days to 0.038 mm/year(MF), 8.4%/year(BF), and 6.3%/year(BR) at age 850 days, whereas the endosteal and periosteal diameters increase. Between age 60 days and 550 days, formation rate, resorption rate, apposition rate, and the growth rate of the bone volume and body weight are greater in male than in female rats, but after this age they are comparable. The average cumulative radiation dose near bone surfaces after contamination with alpha-emitting bone surface-seeking radionuclides is greater in the diaphysis of female rats than in the corresponding male rats. In young animals it is greater initially on the cortical-endosteal surfaces, but after age 250 days the dose on the periosteal surface becomes predominant. PMID- 3964497 TI - Dipyridamole combined with exercise for thallium-201 myocardial imaging. AB - A new stress test for thallium-201 myocardial imaging in which pharmacological coronary vasodilatation with dipyridamole is combined with dynamic exercise is described. In 38 patients with coronary artery disease the sensitivity, total number of defects, degree of redistribution, and visual quality of thallium-201 imaging were greater after dipyridamole with exercise testing than after exercise alone. When the data from these 38 patients were combined with the results of dipyridamole-exercise imaging in 49 patients in whom exercise electrocardiography had been inconclusive then the technique gave a sensitivity for coronary disease of 87% and a specificity of 92%. Dipyridamole also increased the sensitivity of the exercise electrocardiogram, so that no patient with coronary disease had a strictly negative dipyridamole-exercise stress test. Only five of 214 patients who have now undergone this test have had complications requiring reversal of vasodilatation with aminophylline. The combined use of dipyridamole and exercise in this simple technique is a reliable and safe improvement on standard thallium 201 imaging tests. PMID- 3964498 TI - Deaths from ischaemic heart disease in Belfast. AB - There were 1323 deaths due to ischaemic heart disease in Belfast from 20 July 1981 to 19 July 1982. Some 496 (37%) of these were in persons aged less than 70 years. By World Health Organisation criteria 247 (19%) of these deaths were classified as definite myocardial infarction and 749 (57%) as possible myocardial infarction. Dyspnoea, collapse, and typical pain were the main symptoms at the onset of the fatal attack. In hospital only 12% of deaths in persons aged less than 70 years and 14% of those aged greater than or equal to 70 years were due to presumed primary rhythm disturbance, whereas outside hospital these proportions were 78% and 59% respectively. The median survival time was 84 minutes and was shortest in men aged less than 70 years (62 minutes). Outside hospital a relative was the most likely aid sought initially (70%) and the median delay time from onset of symptoms to calling for medical aid was eight minutes. Among 128 witnessed deaths in persons aged less than 70 years occurring outside hospital due to presumed primary rhythm disturbance the median survival time was 8 X 25 minutes. Improvements in facilities available for resuscitation including public education could result in the prevention of a proportion of deaths caused by primary rhythm disturbances. PMID- 3964499 TI - Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system. AB - A transducer tipped catheter and simple recording system were used for the continuous measurement of ambulatory pulmonary artery pressure. The pulmonary artery pressure was recorded on a miniaturised tape recorder and replayed via an optical writer. Pulmonary arterial systolic and diastolic pressures can be analysed on a beat to beat basis. Continuous ambulatory monitoring was performed for a total 288 hours in 13 patients who were undergoing routine investigation for coronary artery disease. There was less than 1% zero drift and 0.25% linearity error per full scale pressure. The frequency response of the entire system was flat to 8 Hz with a linear phase delay. The transducer tipped catheter and a conventional fluid-filled system were used to measure left ventricular and pulmonary artery end diastolic pressures in eight patients. The correlation between the results obtained by the two methods was excellent. This method could be used at any centre equipped for ambulatory electrocardiographic monitoring. PMID- 3964500 TI - Ultrafiltration in the management of refractory congestive heart failure. AB - Ultrafiltration was performed in nine patients with congestive cardiac failure that was refractory to conventional medical treatment. A mean of 12 X 7 litres of fluid was removed, and there was a sustained symptomatic improvement in all patients. Weight loss continued after ultrafiltration and a sustained increase in serum sodium concentration was also noted. A transient fall in right atrial pressure was seen only at four hours after ultrafiltration. No adverse haemodynamic effects were seen four and eighteen hours after fluid removal. Intracardiac dimensions measured by echocardiography remained unchanged. Ultrafiltration can be used to relieve symptoms in patients with refractory congestive heart failure and gross oedema. PMID- 3964501 TI - Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function. AB - The diagnosis of autonomic neuropathy frequently depends on results of tests which elicit reflex changes in heart rate. Few well-documented normal ranges are available for these tests. The present study was designed to investigate the effect of age upon heart rate variability at rest and in response to a single deep breath, the Valsalva manoeuvre, and standing. A computerised method of measurement of R-R interval variation was used to study heart rate responses in 310 healthy subjects aged 18-85 years. Heart rate variation during each procedure showed a skewed distribution and a statistically significant negative correlation with age. Normal ranges (90% and 95% confidence limits) for subjects aged 20-75 years were calculated for heart rate difference (max-min) and ratio (max/min) and standard deviation (SD). Heart rate responses were less than the 95th centile in at least one of the four procedures in 39 (12.6%) out of the 310 subjects, and were below this limit in two or more tests in five (1.6%) subjects. In view of the decline in heart rate variation with increasing age, normal ranges for tests of autonomic function must be related to the age of the subject. PMID- 3964502 TI - Mitral valve closure and left ventricular filling time in patients with VDD pacemakers. Assessment of the onset of left ventricular systole and the end of diastole. AB - The effect of mitral valve closure on left ventricular filling time and its relation to the onset of systole were assessed from mitral valve echocardiograms and simultaneous apex cardiograms in 21 normal subjects, 11 patients with left bundle branch block, and 19 patients with VDD pacemakers programmed for atrioventricular intervals of 50, 150, and 250 ms. The interval between the electrocardiograph Q wave and the apex cardiogram upstroke was similar in normal subjects and patients with left bundle branch block, but was significantly longer in patients with VDD pacemakers at all atrioventricular intervals. Similarly there was little difference in the time interval between the Q wave and mitral valve closure in normal individuals and patients with left bundle branch block but this was considerably delayed in VDD pacemaker patients with the atrioventricular interval set at 50 ms. With increasing atrioventricular intervals the mitral valve closed significantly earlier, whereas the onset of left ventricular systole and the timing of mitral valve opening remained unchanged. Thus as a result of earlier mitral valve closure left ventricular filling time decreased progressively as the atrioventricular interval was increased. Since the onset of left ventricular systole, with respect to left ventricular stimulation, is considerably delayed in VDD pacemaker patients a short atrioventricular interval is required in these patients to maintain the normal time relations between atrial and ventricular contraction and hence maximise left ventricular filling. PMID- 3964503 TI - Auscultatory characteristics of normally functioning Lillehei-Kaster, Bjork Shiley, and St Jude heart valve prostheses. AB - Auscultatory and echocardiographic and phonocardiographic studies were performed on 26 patients who had a total of 11 Lillehei-Kaster, 16 Bjork-Shiley, and 18 St Jude heart valve prostheses functioning normally in the aortic or mitral positions or both. With all types and positions of prostheses a distinct closing sound was always detected. It was frequently heard in two parts which, according to echocardiographic and phonocardiographic studies, resulted from the onset and completion of the valve closure. An opening sound could be heard from all Bjork Shiley and St Jude valves but from only four of the 11 Lillehei-Kaster valves. The opening sounds due to mitral prostheses consisted of two to three closely spaced clicks detected as a faint early diastolic crackle on auscultation. Echocardiography with phonocardiography indicated that they were related to the onset and termination of the disc opening excursion. In the aortic position the valves always produced early to mid-systolic murmurs, and a soft early diastolic murmur was also heard in seven of 23 patients. A mid-diastolic rumble was heard in 12 of 22 patients with mitral prostheses. Normally functioning tilting disc valve prostheses produce characteristic auscultatory findings, and familiarity with these findings will be useful in clinical evaluation of patients with these prostheses. PMID- 3964504 TI - Late results of right ventricular outflow tract reconstruction with Bjork-Shiley valved conduits. AB - Between 1971 and December 1976, 27 children with congenital heart disease underwent right ventricular outflow tract reconstruction with conduits incorporating a Bjork-Shiley valve. The conditions corrected were pulmonary atresia with ventricular septal defect (14 patients), truncus arteriosus (6 patients), and complex disease (7 patients). At operation the children were aged from 12 days to 16 years (five patients were less than one year old). Overall mortality for the group was high (52%). There were nine early deaths and five late ones. Actuarial survival till death or reoperation was 55% at four years, 35% at eight years, and 28% at 12 years. Ten children subsequently underwent reoperation for conduit stenosis caused by neointimal proliferation and valve obstruction. The new conduits incorporated a biological valve. Mortality was highest in patients aged less than one year, and in those with truncus arteriosus, severe pulmonary hypertension, or complex heart disease. Mechanical valves should be avoided in conduit reconstruction of the right ventricular outflow tract for congenital heart disease. PMID- 3964505 TI - Accessory mitral valve tissue causing left ventricular outflow tract obstruction. AB - Although left ventricular outflow tract obstruction is commonly associated with congenitally corrected transposition of the great vessels, this obstruction is seldom caused by accessory mitral valve tissue. Three cases in which accessory mitral valve tissue caused left ventricular outflow tract obstruction in children are described. Two had congenitally corrected transposition and one had normally connected great vessels. The accessory leaflet tissue, which was identified by echocardiography and angiography, was attached by chordae tendineae to normally sited papillary muscles and herniated into the left ventricular outflow tract during systole. Operation was successful in these patients. The accessory valve tissue was excised via an arteriotomy in the great vessel that arose from the left ventricle. The obstructive tissue was excised close to its peripheral attachments in the outflow tract and its chordae tendineae were divided. Resection was performed without injury to the abnormally placed conduction system or to the normal valve structures. PMID- 3964506 TI - Doppler ultrasound in the estimation of the severity of pulmonary infundibular stenosis in infants and children. AB - Pressure gradients estimated by Doppler echocardiography were compared with values obtained at cardiac catheterisation in 31 children (aged seven days to 16 years, mean 2 years 7 months) with pulmonary infundibular stenosis including 16 with tetralogy of Fallot. Various parasternal and subcostal positions were explored to obtain the maximum velocity of blood flow and the obstructive gradient was calculated from the modified Bernoulli formula. The gradient across the obstruction could be measured directly at the time of catheterisation in only 21 patients. The correlation coefficient for the Doppler and total measured gradients was r = 0.90 for catheter entry and r = 0.77 for catheter withdrawal. Doppler ultrasound, by measuring the total gradient from the right ventricle to the pulmonary artery, provides a non-invasive assessment of the severity of pulmonary stenosis, and in those with infundibular obstruction allowance need not be made for possible energy losses caused by the elongated obstruction or the presence of narrowing at more than one level. PMID- 3964507 TI - Effect of long term oxygen treatment at home in children with pulmonary vascular disease. AB - Inhalation of 100% oxygen by nine children with pulmonary vascular disease increased pulmonary blood flow measured at cardiac catheterisation; there was no significant change in pulmonary artery pressure. Fifteen children with pulmonary vascular disease that was severe enough to preclude corrective cardiac operation were studied to determine the effect of long term oxygen treatment on pulmonary vascular disease. Nine received long term domiciliary oxygen for a minimum of twelve hours a day for up to five years. Though the untreated group closely resembled the treated group their survival was significantly less good. All nine treated children are alive whereas five of the six children who did not receive oxygen have died. PMID- 3964508 TI - Echocardiographic evaluation of verapamil in Friedreich's ataxia. AB - Nine patients with hypertrophic cardiomyopathy associated with Friedreich's ataxia were treated with the calcium antagonist verapamil, which is known to reduce myocardial hypertrophy and improve diastolic function in patients with idiopathic hypertrophic cardiomyopathy. Daily oral doses of 7 mg/kg were given for a mean (SD) of 24 (8) months. M mode echocardiography performed at the start of the study and at the end of follow up showed no significant difference between the treated group and an untreated control group of nine patients. Verapamil produced no changes in left ventricular wall thickness, mass index, left ventricular internal diameter, fractional shortening, peak normalised lengthening rate, peak rate of septal and posterior wall thinning, and time from minimum ventricular cavity dimension to mitral valve opening. Myocardial calcium overload has been suggested as a cause of cardiac disease in Friedreich's ataxia; however, verapamil had no beneficial effect on these patients with established myocardial hypertrophy. PMID- 3964509 TI - Cross sectional echocardiographic appearance in presumed congenital absence of the left pericardium. AB - An unusual and new cross sectional echocardiographic feature, bulging of the inferior left ventricular wall during diastole, is described in a 35 year old woman with congenital total absence of the left pericardium. The diagnosis was made on the characteristic clinical, electrocardiographic, echocardiographic, and radiological findings. PMID- 3964510 TI - Left coronary artery dissection: an unusual presentation. AB - Primary dissecting aneurysm of the left main stem coronary artery is a rare cause of coronary arterial occlusion that usually presents as sudden death or myocardial infarction in a young woman. A 32 year old woman with no signs of cardiac disease who died as the result of a right cerebral infarction was found to have coronary dissection and myocardial infarction at necropsy. PMID- 3964511 TI - Ductus arteriosus associated with an anomalous left coronary artery arising from the pulmonary artery: catastrophe after duct ligation. AB - Chronic left ventricular failure developed two months after ligation of an apparently uncomplicated large ductus arteriosus in a one year old girl. Two years later deterioration had progressed to a terminal stage. An anomalous left coronary artery arising from the pulmonary artery had not been recognised before duct ligation. This anomaly was diagnosed two years after ligation and was then treated by surgical redirection, but the patient died of severe left ventricular dysfunction. PMID- 3964512 TI - The challenge and the reproach of infective endocarditis. PMID- 3964513 TI - Myocarditis confirmed by biopsy presenting as acute myocardial infarction. PMID- 3964514 TI - Emergency intubation of the trachea facilitated by suxamethonium. Observations in obstetric and general surgical patients. AB - The relationship between the time of onset of neuromuscular blockade and the time at which laryngoscopy was attempted was studied in patients presenting for emergency obstetric or emergency general surgical procedures. "Train-of-four" stimulation and visual observation of the evoked twitch response in the hand were used as a measure of the degree of neuromuscular blockade. The attendant anaesthetist was unaware of the response to the peripheral nerve stimulator. Intubation preceded complete neuromuscular blockade; in the obstetric patients there was no correlation between the two times. The use of a peripheral nerve stimulator should allow the anaesthetist to perform intubation in emergency situations with a greater degree of safety. PMID- 3964515 TI - Effect of heat conservation during and after major abdominal surgery on muscle protein breakdown in elderly patients. AB - Changes in mean body temperature and muscle protein metabolism were studied in elderly patients undergoing large bowel surgery. Two groups were studied: in one, efforts were made to maintain the patients normothermic during and after surgery by warming the fresh gases, the i.v. fluids, by placing warmed cotton padding around the exposed parts of the body and by covering the patients with a metallized plastic sheet in the recovery period. The other group received routine management. Otherwise the anaesthetic technique was comparable. The excretion of the amino acid 3-methylhistidine (3-MeH), an indicator of muscle protein breakdown, and urea nitrogen loss were measured in the urine collected the day before, and on the 2nd and 4th postoperative days. Prevention of heat loss during and after surgery caused a significant decrease in muscle protein degradation and nitrogen loss. PMID- 3964516 TI - "Patient demand" postoperative analgesia with buprenorphine. Comparison between sublingual and i.m. administration. AB - A randomized, double-blind, placebo-controlled study of buprenorphine was carried out in 20 patients after cholecystectomy. The drug was given on "patient demand" either i.m. (0.15 mg) or sublingually (0.2 mg) with a minimum dose interval of 30 min. Over the 24-h study period the mean demand by the sublingual route was 0.8 mg (range 0.6-1.2 mg) and by the i.m. route 0.66 mg (range 0.45-0.9 mg). Pain relief, by visual analogue scales and grading, was similar. Plasma buprenorphine concentrations varied more after sublingual administration. Either route was effective for the treatment of pain when administered by "patient demand". PMID- 3964517 TI - Effects of chronic inhalation of halothane, enflurane or isoflurane in rats. AB - Male Fischer 344 rats were exposed to halothane, enflurane or isoflurane vapour 20 p.p.m., or air, for up to 30 weeks. None of the anaesthetic agents led to hepatocellular necrosis. Exposure to halothane resulted in slight increases in serum alanine aminotransferase activity, an increase in the size of the liver, an increase in hepatic microsomal cytochrome P-450 content and a minimal amount of fatty change in the liver. None of these effects were observed during exposure to enflurane or isoflurane. Urinary fluoride excretion was increased during exposure to either enflurane or isoflurane. Using this increase as an index of anaesthetic biotransformation, we found that the extent of biotransformation of isoflurane was only slightly lower than that of enflurane. PMID- 3964518 TI - Effect of nitrous oxide on placental methionine synthase activity. AB - Methionine synthase activity was measured in 11 placentae after Caesarean section during which nitrous oxide had been used as an anaesthetic agent, and compared with that from 20 placentae after normal vaginal delivery with no exposure to nitrous oxide. There was no significant difference in enzyme activity between the two series. PMID- 3964519 TI - Effect of halothane and nitrous oxide anaesthesia on natural killer lymphocytes from patients with benign and malignant breast disease. AB - The effect of halothane and nitrous oxide on the capacity of natural killer (NK) lymphocytes from female patients with benign and malignant breast disease to kill the tumour cell line K562, was studied in vitro. There was no depression of activity of NK lymphocytes when exposed to 2% halothane and 66% nitrous oxide either alone or in combination. However, NK lymphocyte activity was depressed at higher concentrations of halothane and the decrease in activity was significant (P less than 0.01) when 4% halothane was used. These findings suggest that exposure to clinically-used concentrations of halothane and nitrous oxide does not interfere with the NK lymphocyte response of the host. PMID- 3964520 TI - Alcohol increases the solubility of anaesthetics in the liver. AB - Liver/gas partition coefficients for isoflurane, enflurane, halothane and methoxyflurane increased two-fold in rats killed 16 h after a single injection of 15% ethanol 7 g kg-1. In contrast, blood/gas and brain/gas partition coefficients did not change. Chronic (21 days) ingestion of ethanol increased liver/gas partition coefficients four-fold, although this increase was largely attributable to nutritional changes rather than to a direct effect of ethanol. Only minimal changes (usually not more than 15%) occurred in blood/gas and brain/gas partition coefficients. On account of this effect of ethanol on anaesthetic solubility in the liver, the ingestion of ethanol may modestly increase uptake of anaesthetic during the induction of anaesthesia. PMID- 3964521 TI - Control of end-tidal halothane concentration. Part B: Verification in dogs. AB - Conventional anaesthetic techniques do not allow for the automatic control of end tidal halothane concentration and, therefore, brain concentration cannot be predicted. In this study, eight dogs were ventilated with halothane in oxygen using a new closed-loop anaesthetic breathing system which provided a constant end-tidal concentration. During the first 60 min the end-tidal concentration was maintained at 0.87 vol% (1 MAC). Then followed 60 min of halothane wash-out and a further 120-min period of halothane at 1.74 vol% (2 MAC). Halothane concentrations were measured in the inspired and expired air, and in the arterial, cerebral venous and mixed venous blood. Haemodynamic and respiratory variables were measured. The system reached 95% of the target end-tidal concentration within 6 min without over-shooting. After 2 h of wash-in, significant gradients still persisted between end-tidal, arterial and cerebral venous blood concentrations. Measured uptake differed from theoretically calculated uptake by 18.3-57.6%, depending on the model used. Measured arterial and cerebral venous concentrations differed from theoretically calculated values by 7% and 17.5%, respectively. It was shown that the required end-tidal concentrations can be obtained rapidly and accurately, and that brain tissue concentrations can be predicted within certain limits. PMID- 3964522 TI - Naloxone--friend or foe? PMID- 3964523 TI - Hypoacousis following extradural injection. PMID- 3964524 TI - Prolonged apnoea with ketamine. PMID- 3964525 TI - Spinal anaesthesia in prolonged Q-T interval syndrome. PMID- 3964526 TI - Suxamethonium-induced cardiac arrest as an initial manifestation of Duchenne muscular dystrophy. PMID- 3964527 TI - Normal pregnancy following nitrous oxide exposure in the first trimester. PMID- 3964528 TI - Pharmacokinetics of ranitidine in critically ill patients. AB - The plasma pharmacokinetics of ranitidine (50 mg i.v.) have been studied in 17 critically ill patients in an intensive care unit. Measurements of gastric aspirate pH were also made in 16 of these patients. Ranitidine therapy was part of the patients' normal drug regimen. Ranitidine plasma concentration was measured by high performance liquid chromatography and appropriate polyexponential equations were fitted to concentration-time data to enable calculation of relevant pharmacokinetic parameters. Values of the volume of the initial dilution space (median = 89 ml kg-1) and volume of distribution at steady state (median = 1.54 l kg-1) were about 60% of corresponding mean literature values for healthy controls. Plasma clearance (median = 4.22 ml min-1 kg-1) and terminal half-life (median = 4.7 h) were about 2-3 fold less and 2-3 fold greater, respectively, than values for healthy controls. There was wide interpatient variation in all the pharmacokinetic parameters. Renal impairment was considered to be largely responsible for the low plasma clearance. Gastric aspirate pH was measured at 0, 1 and 7 h after ranitidine administration and 58% of samples were found to be above pH 4. Four patients had gastric pH values which were consistently below pH 4 despite average trough plasma ranitidine concentrations equal to or greater than those required for a 50% suppression of gastric acid secretion in normal volunteers. PMID- 3964529 TI - Abnormal vitamin K metabolism in the presence of normal clotting factor activity in factory workers exposed to 4-hydroxycoumarins. AB - The case histories of two patients exposed to the novel anticoagulants brodifacoum and difenacoum are reported. Abnormal vitamin K1 metabolism, as indicated by elevated vitamin K1 2,3-epoxide plasma concentrations after i.v. administration of vitamin K1, could be detected for more than 18 months after exposure to the anticoagulants. There was a marked prolongation of prothrombin time (greater than 50 s) in both cases, at the time of exposure. However, subsequent haematological investigations (prothrombin time and vitamin K dependent clotting factor activity) have been shown to be normal in both cases for at least 18 months. These cases confirm the long-acting nature of brodifacoum and difenacoum and present an apparent dissociation between the effect of coumarin anticoagulants on vitamin K1 metabolism and clotting factor activity. PMID- 3964530 TI - Gastrointestinal side effects after intravenous erythromycin lactobionate. AB - Ten healthy normal volunteers received an intravenous infusion of erythromycin lactobionate over 60 min to a total dose of 800 mg (n = 9), and 524 mg (n = 1). Blood samples were collected at 10 min intervals for 100 min and gastric contents aspirated, via a nasogastric tube, from pre-dose to 105 min after start of infusion. Incidence and severity of three gastrointestinal symptoms (nausea, stomach discomfort and feelings of hunger), two CNS symptoms (dizziness and faintness) and a 'control' symptom (back pain) were measured using 100 mm visual analogue scales. Rate of infusion and plasma erythromycin concentration correlated with nausea (P less than 0.001) and stomach discomfort (P less than 0.001); plasma erythromycin concentration was also correlated with dizziness (P less than 0.05). Concentrations of active erythromycin in the aspirate were pH dependent. In one subject the concentration of erythromycin in the aspirate exceeded that in the plasma by 100 fold. Bile staining of samples containing the highest levels of microbiologically active erythromycin makes the origin of the erythromycin in these samples uncertain. PMID- 3964531 TI - Dose independent pharmacokinetics of mexiletine in healthy volunteers. AB - In 12 healthy volunteers who received orally 100, 200, 300, 400 and 600 mg mexiletine at weekly intervals, the maximum plasma concentration of mexiletine and AUC increased linearly with the dose of mexiletine. Between doses there were no significant differences in the values for clearance and volume of distribution of mexiletine but there were for plasma elimination half-life. These results indicate that the kinetics of mexiletine are linear. PMID- 3964532 TI - The effect of chloroquine on paracetamol disposition and kinetics. AB - The effect of chloroquine on paracetamol kinetics and disposition was investigated in six healthy male Ghanaian volunteers. Chloroquine administration shortened the time taken to reach peak plasma paracetamol concentration (tmax) in five of the volunteers. Peak plasma paracetamol concentration (Cmax) was significantly increased by chloroquine administration. The area under the plasma paracetamol concentration-time curve was also significantly increased by chloroquine administration. There was, however, no effect of chloroquine on paracetamol metabolism. PMID- 3964533 TI - Tobramycin pharmacokinetics in very low birth weight infants. AB - Tobramycin is commonly used at a dose of 2.5 mg kg-1 12h-1, but this regimen often results in trough serum concentrations exceeding 2 mg l-1. Because of limited data in infants weighing less than 1,000 g at birth, we studied eight newborn infants (gestational age 24-30 weeks; postnatal age 3 X 4 days; birth weight 0.60-0.97 kg) at a modified dosing regimen of 2.5 mg kg-1 18 h-1 or 3.0 mg kg-1 24 h-1. Tobramycin peak and trough serum concentrations ranged from 6.0-10.8 (7.8 +/- 1.5) mg l-1 and 1.2-2.4 (1.7 +/- 0.4) mg l-1, respectively. Serum concentration exceeded 2 mg l-1 in seven of eight patients at 12 h and two of eight at 18 h; none had a trough serum concentration above 2 mg l-1 at 24 h. Total body clearance ranged from 0.55 to 0.82 (0.69 +/- 0.10) ml min-1 kg-1; apparent volume of distribution ranged from 0.44 to 0.71 (0.59 +/- 0.10) 1 kg-1; and elimination half-life ranged from 7.7 to 12.6 (9.9 +/- 1.5) h. These data indicate that the modified dosage regimen of 2.5 mg kg-1 18 h-1 or 3.0 mg kg-1 24 h-1 appears to be more acceptable than the current regimen in achieving effective and safe peak and trough serum concentration of tobramycin in newborn infants weighing less than 1 kg at birth. PMID- 3964534 TI - The effect of vehicle on the oral absorption of cyclosporin. AB - Twelve healthy volunteers received four separate doses of cyclosporin (5 mg kg 1). On three occasions the neat oil suspension (Sandimmun) was given dispersed in a different liquid vehicle and on one occasion the suspension was taken directly. Measurement of whole blood cyclosporin concentrations by radioimmunoassay showed no significant difference in the pharmacokinetic parameters of absorption between the neat preparation and the three dispersants used (milk, milk + chocolate flavouring and orange juice). PMID- 3964535 TI - The plasma protein binding of metoclopramide in health and renal disease. AB - The plasma protein binding of metoclopramide was measured after addition of the drug (60 ng ml-1) to plasma from 18 patients with renal disease and 18 age and sex matched healthy individuals. The mean free fraction in renal disease (0.59 range 0.41-0.71) was not significantly different from controls (mean 0.6 range 0.56-0.69). In both groups the binding ratio of metoclopramide was significantly related to plasma alpha 1-acid glycoprotein (AAG) concentration but not to albumin or plasma non-esterified fatty acids concentration. Metoclopramide bound to human serum albumin (HSA) to a limited extent and to human AAG to a greater extent indicating that AAG is the major binding protein for the drug in plasma. PMID- 3964536 TI - Effect of a high protein meal on the bioavailability of verapamil. PMID- 3964537 TI - The clinical significance of flow cytometric c-myc oncoprotein quantitation in testicular cancer. AB - A sensitive flow cytometric assay has been developed using a monoclonal antibody, Myc 1-6E10, to quantitate c-myc oncoprotein levels in nuclei isolated from wax embedded testicular tumours. The oncoprotein (p62c-myc) level increased significantly with increasing teratoma differentiation. Patients with intermediate and undifferentiated tumours who developed recurrence had lower p62c myc levels than those who were disease free since their initial treatment. Such quantitative biochemical methods may provide new prognostic indices for cancer patients. PMID- 3964538 TI - Influence of glucose and oxygen supply conditions on the oxygenation of multicellular spheroids. AB - The interrelationship among external O2 and glucose supply, oxygenation status, oxygen consumption rates and cellular viability in tumour microregions was studied using the multicellular spheroid model. For chronic exposure to various supply conditions multicellular EMT6/Ro spheroids were cultured in stirred media equilibrated either with 20% (v/v) or 5% (v/v) oxygen and containing four different glucose concentrations ranging from 0.8 mM to 16.5 mM. Spheroids were investigated using histology and O2-sensitive microelectrodes for measuring oxygen tension (PO2) values. A chronic decrease of the glucose concentration in the medium is associated with a substantial reduction in the thickness of the viable rim of cells and with a persistent increase in the cellular respiration rate. In general, both viable rim size and respiration are decreased through restriction of O2 supply during spheroid growth at a given external glucose concentration. The O2 consumption in spheroids appears to decrease with increasing spheroid size under most of the growth conditions investigated. These findings provide evidence for a large capacity of the spheroid cells to chronically adapt their metabolic rates to different supply situations. The experimental data and theoretical considerations indicate that necrosis may develop in the centre of these spheroids due to the lack of O2 and/or glucose under some of the growth conditions, but central necrosis can also occur despite sufficient O2 and glucose supply. Consequently, cellular metabolism and viability in tumour microregions may not be determined by the diffusion limitation of O2 or specific substrates alone, such as glucose, but may be influenced by a complex interaction of factors in the micromilieu the majority of which are still unknown. PMID- 3964539 TI - Arterial chemoembolization with cisplatin microcapsules. AB - Cisplatin (CDDP) was microcapsulated with ethylcellulose. Sustained release of CDDP from the microcapsule, particularly non-protein-bound CDDP, which should have antitumour activity, was demonstrated by an in vitro test. Using a bioassay, it was proven that the biological activity of CDDP was not affected by the microencapsulation process. When CDDP-mc were infused into the maxillary artery of patients with carcinoma of the maxillary sinus or oral cavity, the CDDP level in the circulating blood was significantly lower than that of the patients given non-encapsulated CDDP intravenously. However, a significantly higher CDDP concentration in tumour tissue was found in patients treated with CDDP-mc. These results suggest that selective arterial infusion of CDDP-mc could exert intensive topical antitumour effects on lesions through microinfarction effects, and prolonged drug release, with minimum systemic side effects. PMID- 3964540 TI - The potential of carboxypeptidase G2-antibody conjugates as anti-tumour agents. I. Preparation of antihuman chorionic gonadotrophin-carboxypeptidase G2 and cytotoxicity of the conjugate against JAR choriocarcinoma cells in vitro. AB - Carboxypeptidase G2, a zinc metalloenzyme isolated from Pseudomonas sp. strain RS 16, which catalyses the hydrolytic cleavage of reduced and non-reduced folates to pteroates and L-glutamate, has been linked to a monoclonal antibody (W14A) raised to human chorionic gonadotrophin. The coupling efficiency and retention of antibody and enzymatic activities are compared for three separate methods of preparing 1:1 conjugates. Preliminary in vitro studies on the cytotoxicity of the free enzyme and the conjugated enzyme towards JAR choriocarcinoma cells are reported. Despite the limitations of the in vitro model, it could be demonstrated that a significant proportion of 10(6) choriocarcinoma cells lost viability when exposed to either free or conjugated enzyme for 72 hours at concentrations of carboxypeptidase G2 of 1-3 units ml-1 of medium. PMID- 3964541 TI - Rising incidence of lymphoid malignancies--true or false? AB - The report contrasts the ascertainment of cases by the regional cancer registry with a specially designed search for records and pathology material which was then submitted to critical review irrespective of the original diagnosis. Boundary changes over the intervening years were accounted for and the results contrasted between time periods and with the cancer registry records. A large proportion of cancer registry cases were never subjected to histopathological diagnosis and comparisons between the new data and records are not easy to undertake. The study describes a probable true rise in the incidence of follicular non-Hodgkin's lymphoma in certain parts of Yorkshire over the last 20 years; there is less evidence of a similar change in Hodgkin's disease incidence over the same period of time. PMID- 3964542 TI - A retrospective study on malignant neoplasms of bladder, lung and liver in blackfoot disease endemic area in Taiwan. AB - A total of 69 bladder cancer, 76 lung cancer and 59 liver cancer deceased cases and 368 alive community controls group-matched on age and sex were studied to evaluate the association between high-arsenic artesian well water and cancers in the endemic area of blackfoot disease (BFD), a unique peripheral vascular disease related to continuous arsenic exposure. According to a standardized structured questionnaire, information on risk factors was obtained through proxy interview of the cases and personal interview of the controls. A positive dose-response relationship was observed between the exposure to artesian well water and cancers of bladder, lung and liver. The age-sex-adjusted odds ratios of developing bladder, lung and liver cancers for those who had used artesian well water for 40 or more years were 3.90, 3.39, and 2.67, respectively, as compared with those who never used artesian well water. Multiple binary logistic regression analyses showed that the dose-response relationships and odds ratios remained much the same while other risk factors were further adjusted. PMID- 3964543 TI - Culture in soft agar of melanoma cells separated from human peripheral blood. PMID- 3964544 TI - The in vitro properties of dermal papilla cell lines established from human hair follicles. AB - The in vitro properties of cells cultured from the dermal papilla of human hair follicles were studied and compared with those of lines of dermal fibroblasts derived from the same material. In serial subcultures, the dermal papilla cells displayed a spread out, polygonal cellular morphology at stationary growth phases and a tendency to form multi-layered aggregates before reaching confluence. Aggregation was particularly marked when papilla cells were grown on collagen gels. In contrast, dermal fibroblasts grew as branching, parallel arrays of spindle-shaped cells which remained as monolayers until confluence. Compared with dermal fibroblasts, papilla cells also exhibited a shorter in vitro survival time. The properties of cultured human papilla cells are similar to those of rat vibrissa papilla cells. PMID- 3964545 TI - Occupational exposure to ultraviolet radiation in dermatology departments. AB - The ultraviolet radiation (UVR) doses received by staff who are occupationally exposed to artificial sources of UVR found in dermatology departments have been measured using personal UV monitors. The results show that staff may receive actinic (UVB and UVC) doses which are in excess of recommended maximum permissible limits for occupational exposure, but that the UVA doses are well within these limits. PMID- 3964546 TI - A new device for the treatment of hyperhidrosis by iontophoresis. AB - A new device for the treatment of hyperhidrosis by iontophoresis is described. Twenty-five patients have so far been treated, six with hyperhidrosis of the palms, 13 with hyperhidrosis of the soles and six with axillary hyperhidrosis. In 21 cases there was an excellent result. The effect of the treatment usually lasted for several weeks. Maintenance treatment every 4-6 weeks was found to be required. PMID- 3964547 TI - Carbon dioxide laser vaporization of plaque psoriasis. AB - The treatment of circumscribed plaque psoriasis with a carbon dioxide (CO2) laser as an outpatient procedure is reported in three patients. The growth of new tissue over the healed laser vaporized area was similar to normal skin and has remained free of psoriasis during a follow-up of 3 X 5 years. Laser vaporization appears to be a simple and effective alternative to conventional therapy in cases of plaque psoriasis. PMID- 3964548 TI - Hydroquinone concentrations in skin lightening creams. AB - Forty-one over-the-counter skin lightening creams were analysed for hydroquinone content, and the accuracy of tables of contents supplied with these products was assessed. Eight of the 41 were found to contain more than 2% hydroquinone, the maximum concentration permitted by the U.K. Cosmetic Products Regulations. Eighteen of these preparations failed to comply with labelling requirements. A list is given of those products containing less than 2% hydroquinone which are adequately labelled. PMID- 3964549 TI - Wallace's line. PMID- 3964550 TI - Association between lichen sclerosus et atrophicus and primary biliary cirrhosis. PMID- 3964551 TI - Cartilaginous naevus on the glabella. PMID- 3964552 TI - Short-contact dithranol therapy. PMID- 3964553 TI - Pseudoporphyria due to naproxen. PMID- 3964554 TI - Elevated serum aminoterminal procollagen type III peptide in methotrexate-induced hepatic fibrosis. PMID- 3964555 TI - Nodular prurigo. PMID- 3964556 TI - Orally active alpha-ketohydroxy pyridine iron chelators intended for clinical use: in vivo studies in rabbits. AB - Increased daily iron excretion from iron overloaded, 59Fe lactoferrin labelled rabbits was observed following the intragastric administration of 1,2-dimethyl-3 hydroxy pyrid-4-one (L1) or 1-ethyl-2-methyl-3-hydroxy pyrid-4-one (L1-NEt) at doses of 200 mg/kg. 59Fe excretion induced by these drugs was predominantly faecal and was comparable to that caused by similar doses of subcutaneous or intramuscular desferrioxamine. The effectiveness of the two alpha-ketohydroxy pyridine chelators was confirmed by repeated administration, intragastrically or by subcutaneous or intramuscular injection, to the same or other rabbits. Examination of the urine during the administration of the chelators revealed their high specificity for iron but not for copper, zinc, calcium or magnesium. PMID- 3964557 TI - The value of a 51Cr platelet lysis assay as crossmatch test in patients with leukaemia on platelet transfusion therapy. AB - Current platelet crossmatch testing still results in a significant percentage of false positive or false negative results in oncological patients during platelet support. A 51Cr platelet lysis assay was used for the detection of platelet alloantibodies. We determined the predictive value of this assay as crossmatch procedure on 28 occasions in 14 patients who received random single donor platelet transfusions. To deal with the problem of spontaneous lysis we included a panel of 10 control sera from normal individuals and applied several methods of statistical analysis to these data. It appeared that the use of only one control serum was sufficient when the percentage relative counts was used as the criterion variable, which is of advantage in the practical application of the test. The test values were retrospectively compared with the clinical transfusion response, determined as the 1 h post-transfusion platelet recovery. The 51Cr platelet lysis crossmatch showed false negative results in 1/21 cases and false positive results in 1/7 cases. These data indicate that the 51Cr platelet lysis assay adds a useful dimension to the solution of the problem of selecting compatible platelet donors. Spontaneous lysis of target platelets appeared not to be a problem in the interpretation of test results. PMID- 3964558 TI - Transient activation of the acetyltransferase necessary for paf-acether biosynthesis in thrombin-activated platelets. AB - Thrombin-activated platelets formed paf-acether (1-0-alkyl-2-acetyl-sn-glyceryl-3 phosphorylcholine), a molecule susceptible to play a role in haemostasis and thrombosis, and its deacetylated analogue, lyso paf-acether, a biologically inactive molecule. We presently show the presence in human and rabbit platelet lysates of an acetyltransferase which transfers the acetyl moiety of acetyl coenzyme A (acetyl-CoA) onto synthetic lyso paf-acether, yielding the fully active paf-acether molecule. Under our optimal standard conditions, 0.36 +/- 0.23 nmol paf-acether/10 min/mg proteins was formed by the acetyltransferase from resting human platelets. Upon thrombin stimulation, the acetyltransferase activity doubled within 30 s, reaching a maximum at 2 min (1.17 +/- 0.31 nmol paf acether/10 min/mg proteins) and decreased progressively. Similar results were obtained using rabbit platelets. In addition we demonstrated that the activation and deactivation of the acetyltransferase correlated with the kinetics of paf acether formation by thrombin-activated rabbit platelets. It is hypothesized that this enzyme may represent one of the regulating mechanism of paf-acether formation by platelets. PMID- 3964559 TI - Chromosome and cell culture studies in eosinophilic leukaemia. AB - A cytogenetic analysis was carried out on bone marrow cells from 11 patients who presented with hypereosinophilia and the clinical features of the idiopathic hypereosinophilic syndrome. One of these patients was found to have trisomy 8 affecting the myeloid series, including eosinophils. In this patient, marrow eosinophils also showed asynchrony of nuclear-cytoplasmic maturation, and there were increased numbers of myeloid progenitor cells in the blood. Six months later, blast cell transformation occurred, and he died soon afterwards. These findings show that abnormalities in the karyotype of bone marrow cells and culture of blood progenitor cells may help to identity eosinophilic leukaemia among patients who present with features of the idiopathic hypereosinophilic syndrome. PMID- 3964560 TI - A study of the haematological and haemorheological consequences of venesection. AB - A study has been made of a number of haematological and haemorheological factors following venesection therapy. Haematocrit was very effectively reduced by the venesection regimen and led to a fall in whole blood viscosity in spite of the microcytosis that was eventually induced in all the subjects. No clinically significant coagulation changes were observed. It is concluded that a simple venesection regimen without volume replacement is a safe procedure for improving blood rheology. PMID- 3964561 TI - The incidence and possible relevance of Bence-Jones protein in the sera of patients with multiple myeloma. AB - We present results showing that the detectable incidence of Bence-Jones protein in the sera of patients with multiple myeloma is equivalent to the highest detectable incidence of Bence-Jones protein in highly concentrated urine when tested by immuno-isoelectric focusing. In a series of 25 multiple myeloma patients, immuno-isoelectric focusing showed the incidence of Bence-Jones proteinemia to be 68% compared with a detectable incidence of Bence-Jones proteinuria of 32-64% by immunoelectrophoresis and immuno-isoelectric focusing depending upon the urine concentration factor. In view of the variability of factors governing urinary Bence-Jones protein levels, such as renal catabolism, reabsorption and losses during concentration, we suggest that monitoring of serum Bence-Jones protein by immuno-isoelectric focusing should be carried out in conjunction with measurements of urinary Bence-Jones protein in multiple myeloma. PMID- 3964562 TI - Platelet-associated IgG in idiopathic glomerulonephritis and the nephritis of systemic lupus erythematosus. AB - We studied platelet-associated IgG (PAIgG) in patients with the nephritis of systemic lupus erythematosus (SLE) and with idiopathic glomerulonephritis (IGN), and found no increase in PAIgG in the patients with IGN, and an increase in only a minority of patients with SLE, all of whom had active disease. Patients with IGN and a nephrotic syndrome had both a low serum IgG and a low PAIgG. The increase in PAIgG in the patients with SLE correlated with the titres of antibody against dsDNA in the serum, but not with the platelet-agglutinating immune complexes also present. Intraplatelet serotonin, however, was reduced in both groups, and this correlated with the amounts of platelet-agglutinating complexes in the serum of the SLE patients. Immune complexes may associate with platelets in vivo to cause this release, but if so this must be a reversible phenomenon ('hit and run' immune platelet injury); alternatively, the Fc binding to the platelet surface may be weak and insufficient to survive the ex vivo washing procedures. PMID- 3964563 TI - In vitro culture of proerythroblasts: characterization of proliferative response to erythropoietin and steroids. AB - This study characterized variables affecting the in vitro liquid culture of proerythroblasts. When bone marrow from mice depleted of haemoglobin containing cells, was cultured in vitro in the presence of human urinary erythropoietin (Ep) a significant degree of erythroid cell proliferation and maturation occurred as measured directly by 3H-thymidine (3H-TdR) incorporation into DNA (autoradiographical measurement). Proliferation increased in direct proportion to the dose of Ep added to the culture. We also demonstrated a highly significant positive correlation between proliferation measured directly by 3H-TdR incorporation into DNA or indirectly by 59Fe incorporation into haem. Ep was a potent stimulator of proerythroblast proliferation. We also examined the role of the androgenic and non-androgenic steroids on in vitro proliferation. All the hormones tested were stimulatory but only in the presence of Ep. The androgenic steroids primarily affected the more mature erythroid precursors whereas the glucocorticoids were more general growth promoters. Their addition in physiologic concentration to liquid culture reduced Ep requirements. Thus when both testosterone and hydrocortisone were added to culture the Ep concentration that produced the same degree of proliferation as a culture containing Ep alone was decreased by 90%. This finding is important as it indicates that in vitro culture conditions can be created that more closely mimic in vivo erythropoiesis where Ep requirements are far less. PMID- 3964564 TI - Prenatal diagnosis of hereditary red cell membrane defect. AB - The red cells of a severely anaemic 2-year-old child of a white British family showed high haemolytic fragility with poikilocytosis. The cells showed markedly impaired thermal stability. The mother was phenotypically normal, but the father's red cells showed mild elliptocytosis. The spectrin from the latter, extracted at low temperature, was 30% dimeric (cf. 5-10% in normals). Tryptic digests of the spectrin from both father and daughter showed a reduction in the fragment of 80,000 molecular weight, derived from the terminus of the alpha chain, and the elevation of a fragment of molecular weight 46,000, as well as one of 53,000. These characteristics and the autosomal recessive inheritance lead to a diagnosis of type II hereditary pyropoikilocytosis, so far reported only in two black American families (Lawler et al, 1983). The spectrin from the father was examined with respect to thermal conformational stability, and was found to be normal. The spectrin from the cells of the daughter gave evidence of the presence of oxidative (disulphide) cross-links, as well as of extensive noncovalent aggregation. Blood was obtained from the umbilical cord vein of the 19-week fetus of the pregnant mother: 250 microliters of blood was used for preparation of red cell membranes for SDS-gel electrophoresis and for extraction of spectrin. Analysis of the spectrin by gel electrophoresis in the native state revealed that the proportion of dimer was within the normal range, and the fetus therefore did not possess the hereditary pyropoikilocytosis phenotype. It is suggested that the procedures described could be generally applied to the prenatal identification of phenotypes associated with severe haemolytic anaemias. PMID- 3964565 TI - Erythrocyte vacuoles in hereditary spherocytosis. PMID- 3964566 TI - Platelet membrane glycoprotein abnormalities in myeloproliferative disease. PMID- 3964568 TI - Platelet suppressive therapy in clinical medicine. PMID- 3964567 TI - Correlation of in vivo alloantibody significance or insignificance with an in vitro monocyte-macrophage phagocytosis assay. PMID- 3964569 TI - Chemical pollution, verbal pollution, and paratoxicology. PMID- 3964570 TI - Airway constrictor response to cotton bract extracts in the absence of endotoxin. AB - Crude and purified aqueous extracts of cotton bracts shown to cause airway constriction in naive subjects were assayed for endotoxin content. Pulmonary function measured by flow changes on partial expiratory flow volume curves was used to assess airway responses to the bract extracts after their inhalation by a panel of volunteers. These responses are similar to the acute responses experienced by cotton textile workers. Crude aqueous extracts from various bracts harvested before and after senescence of the cotton plant displayed endotoxin concentrations ranging widely from 0.086 to 50 micrograms/ml. No correlation was found between these differences in endotoxin content and the severity of the airway constrictor response. Purifying the bract extract by a series of procedures that included precipitation of polymeric material by addition of methanol and chromatography on an anion exchange column of DEAE-Sephacel resulted in the elimination of almost all the endotoxin. The partially purified extract contained less than 1 ng/ml of endotoxin. The panel of volunteers responded to this purified bract extract, however, with a decrease in pulmonary function which was more than 60% of that seen with the crude extract of bracts. It is concluded that aqueous extracts of cotton bract contain an agent(s) other than endotoxin that causes acute airway constriction in people. PMID- 3964571 TI - Cancer incidence among workers in the Norwegian ferroalloy industry. AB - The total mortality and the incidence of cancer was studied among a cohort of employees at the six oldest ferrosilicon and ferromanganese plants in Norway. The cohort consisted of 6494 men employed for more than 18 months before 1970 and has been followed up from 1953 to 1982. The standardised incidence ratio (SIR) for cancer (all sites) was 0.94. The observed number of cancers was as expected for lung cancer (SIR = 0.99) and for most of the other cancer sites studied. A statistically significant reduction of stomach cancer was found (SIR = 0.72). There was an increased incidence of lung cancer (SIR = 1.75) and cancer of the prostate (SIR = 1.56) in the workers at one ferrosilicon plant and of colonic cancer (SIR = 1.90) at another ferrosilicon plant. PMID- 3964572 TI - Incidence of cancer among workers producing calcium carbide. AB - The overall mortality and the incidence of cancer have been studied among male employees at a plant producing calcium carbide. The cohort was defined as all men employed at the plant for at least 18 months in the period 1953 to 1970 and was classified according to 10 occupational categories. The 790 men have been observed from 1953 to 1983 and the incidence of cancer in the cohort has been compared with national incidence rates. A significant excess of colonic cancer (standardised incidence ratio, SIR = 2.09) and of prostatic cancer (SIR = 1.78) was found, and also a slight excess of lung cancer among furnace and maintenance workers (SIR = 1.56). The possible exposure of the workers to polycyclic aromatic hydrocarbons, asbestos, and cadmium is discussed. PMID- 3964574 TI - Biliary tract cancer and occupation in Sweden. AB - Using the Cancer-Environment Registry, which links the incidence of cancer (1961 79) and the 1960 census data on industry and occupation for all employed individuals in Sweden, the occurrence of biliary tract cancer (ICD 7th rev 155.1 .9) was systematically assessed according to occupational and industrial classifications. Data are presented separately for cancer of the gall bladder (ICD 155.1) and other cancers of the biliary tract (ICD 155.2-.9) including cancers of the extrahepatic bile ducts, ampulla of Vater, and unspecified bile passages. Statistically significant increased risks for cancer of the gall bladder were observed for men employed in petroleum refining, papermills, chemical processing, shoemaking, and repairing, and for both men and women employed in textile work. A significant increase in the incidence of other cancers of the biliary tract (mostly cancers of the bile duct) was found for such asbestos related employment as shipbuilding and in the wholesale construction materials industry and among insulation workers. These findings should be considered only as clues to aetiological factors, although several are consistent with earlier observations from other countries. PMID- 3964573 TI - Investigation of the potential carcinogenicity of a range of chromium containing materials on rat lung. AB - Twenty one chromium containing materials were examined for carcinogenic activity in a two year study using an intrabronchial pellet implantation system whereby pellets loaded with test material were surgically implanted into the lower left bronchus of rats. The principal aim of the study was to extend our knowledge of the carcinogenic potential of chromium compounds and, in particular, chromates (Cr6+). A statistically significant incidence of treatment related lung tumours was found with some sparingly soluble chromate materials. All tumours were large keratinizing squamous carcinomas of the left lung, except for a single left lung adenocarcinoma and two left lung anaplastic carcinomas. No bronchial carcinomas (0/100) were seen in the negative control group (blank pellet loaded with cholesterol), whereas bronchial carcinomas (22/48 and 25/100) occurred in the two positive control groups which received pellets loaded with 20-methylcholanthrene and calcium chromate respectively. Among the 20 test materials, only three groups gave statistically significant numbers of bronchial carcinomas. Two of these were groups receiving different samples of strontium chromate which gave 43/99 and 62/99 tumours. The third group, zinc chromate (low solubility), gave 5/100 bronchial carcinomas. A further zinc chromate group (Norge composition) produced 3/100 bronchial carcinomas which was not statistically significant. A few lung tumours were observed in other test groups. PMID- 3964575 TI - Total population study of factors affecting chronic bronchitis prevalence in the coal mining industry of New South Wales, Australia. AB - The period prevalence of simple chronic bronchitis (SCB) (mucus hypersecretion), defined as chronic cough and sputum production by the MRC respiratory symptom questionnaire administered by occupational physicians and of obstructive chronic bronchitis (OCB) (airflow obstruction) (defined as SCB plus FEV1 less than 80% predicted) have been measured over the period 30 June 1977-30 June 1980 in the entire work force aged between 21 and 60 of the coal industry of New South Wales, Australia (12 357 men). Four dimensional contingency table analysis by a logistic transform method showed highly significant (p less than 0.001) additive affects of age (exposure duration), site of work, smoking, and alcohol consumption on development of overall chronic bronchitis (SCB + OCB). Odds ratios were face work:surface work = 1.78:1, smoker:non-smoker = 4.23:1, alcohol greater than 300 g/wk:alcohol less than 300 g/wk = 2.13:1. There was no evidence for synergistic effects of these factors on the development of mucus hypersecretion. When OCB was analysed separately, the effect of site of work, although in the same direction, was not statistically significant and this was assumed to be due to a "healthy worker" effect or a "swamping" effect of smoking. Age, smoking, and alcohol effects were highly significant (p less than 0.0001) and there was a sharp increase in prevalence of OCB in the age groups 41-50 and 51-60. Odds ratios were face work:surface work = 1.11:1, smoker:non-smoker = 2.66:1, alcohol greater than 300 g/wk:alcohol less than 300 g/wk = 2.91:1. There was no evidence of synergistic effects. These results are consistent with a hypothesis of additive effects of smoking, alcohol, and coal mine dust and fumes on the development of chronic mucus hypersecretion leading to airflow obstruction or a hypothesis of similar additive effects on the development of two separate conditions--mucus hypersecretion with airflow obstruction and mucus hypersecretion without airflow obstruction. PMID- 3964576 TI - Notifications of industrial chemical cyanosis poisoning in the United Kingdom 1961-80. AB - In 325 cases of industrial chemical cyanosis notified to Her Majesty's Factory Inspectorate for 1961-80 the incidence of poisonings showed considerable seasonal variation with substantially greater numbers occurring in the summer months. A correlation between the number of poisonings in any one year and the hotness of that summer was also shown. The vast majority of incidents occurred during the manufacture of chemicals or dyestuffs, and two particular workplaces were responsible for 70% of the cases. Poisoning by amino compounds appear to produce early cyanosis whereas poisoning by nitro compounds tended to produce delayed cyanosis. These latter compounds were also more likely to produce anaemia. Methaemoglobin was determined in 45% of cases with results ranging from less than a few per cent to over 50%. Despite concentrations of MetHb over 50%, several workers complained only of headache and their blue appearance. PMID- 3964577 TI - Vibration white finger and digital systolic pressure during cooling. AB - A cold provocation test (measurement of finger systolic pressure during combined body and local finger cooling) was performed on 111 male patients exposed to vibration and with a typical history of cold induced white finger. A new method of calculating the test result is described--namely, digital systolic blood pressure in the cooled test finger as a percentage of the systolic pressure in the arm (DP%). The conventional way of calculating the result, the systolic pressure in the cooled test finger as a percentage of the systolic pressure in the test finger when heated to 30 degrees C, corrected for changes in systemic pressure by the use of a reference finger (FSP%), requires the measurement of the systolic pressure in a reference finger. The two ways of calculating the test results give a similar sensitivity (74% for FSP%, 79% for DP% if all histories are regarded as true) but the new method does not require pressure measurements in a reference finger. This makes the test easier to perform and the result easier to understand. PMID- 3964578 TI - Assessment of vibration induced white finger: reliability and validity of two tests. AB - The reliability and validity of two tests (cold water and reactive hyperaemia) designed to confirm a patient's history of vibration induced white finger were studied. The cold water test is a measure of digital rewarming after hand immersion in cold water. Reactive hyperaemia consists of measuring digital rewarming after cold water immersion plus temporary ischaemia imposed on the hand. For ten weeks, ten healthy male volunteers were submitted once a week to both tests to study their reliability. The results showed a strong inter and intraindividual scattering. The mean value for the whole group, however, did not differ significantly from one week to the next. Fifty two subjects exposed to hand/arm vibration were submitted to both tests to estimate their validity. They were classified, according to their medical history, into three groups: A = no symptoms, B = tingling or numbess, or both, C = Raynaud's phenomenon. Both tests agreed with the clinical staging. For reactive hyperaemia, however, the differences between the groups were statistically significant only when the test was performed at 10 degrees C. These tests are more useful to study a group than an individual case. Time has no significant effect on the mean result of a group. PMID- 3964579 TI - Relationships between the object focus of therapist interpretations and outcome in short-term individual psychotherapy. AB - The relationships between the object (person) focus of therapist interpretations and outcome were examined for 21 patients who received short-term individual psychotherapy. Percentages of single objects and linked objects, e.g. therapist parent link, were derived from an analysis of the therapy sessions. Patients, therapists and an independent assessor provided pre-therapy, post-therapy and six month follow-up outcome scores. Contrary to other reports in the literature little evidence was found to support the hypothesis of a direct linear relationship between object focus and favourable outcome. Several explanations for the findings are discussed. PMID- 3964580 TI - The influence of social desirability on the Ai3 measure of anal character. AB - The probability of item endorsement in the Ai3 test of anal character was found to be significantly related to item social desirability, but total scores on the test were unrelated to measures of social desirability. It is concluded that the test is adequately free of social desirability effects and that the experimental findings strengthen claims for the construct validity of the Ai3. PMID- 3964581 TI - The psychotherapy of mania. AB - Focal dynamic psychotherapy with acute manic patients has been a neglected treatment modality. In young adults with sound premorbid personalities and well developed ambition systems, focal dynamic psychotherapy is useful in the manic stage; it shortens the process of elaboration of major conflicts related to self image and self-ideal. Three young Israeli soldiers' case material is discussed in whom, due to different growth constellations, the hope to serve in the army in specific capacities had been a central motivating and consolidating factor in their personality development. Their confrontation with the realities and frustrations of military life caused them to react with a manic syndrome which brought them to treatment. Therapeutic insight led to the reshaping of their ambition to a more adaptive level. PMID- 3964582 TI - Oedipal determinants in differential outcome of bereavement. AB - According to psychoanalytic theory, a bereaved individual's prior relationship with the lost person affects his vulnerability to bereavement. Freud attributed the vulnerability to the intensity of ambivalence, and Fenichel saw Oedipal rivalry as one example of that ambivalence. It is argued that, after the death of a parent, reality testing, crucial to the resolution of the Oedipus complex, is disrupted differently for children of the same sex, from those of the opposite sex. Based on Freud's and Fenichel's clinical observations, the effects of disrupted reality testing were transformed into a testable hypothesis. The predictions were validated by testing them against the data supplied by patients before they had any professional contact, when two-thirds of bereaved psychotherapy patients exhibited different effects when the deceased parent was of the same sex, from when he/she was of the opposite sex. A majority of the same sex children develop an unconscious sense of guilt, which blocks their expression of Oedipal attitudes towards both parents and which attacks their capacity to function adequately at work, and in their sex-linked roles; while the opposite sex children maintain their preference for the dead parent, aversion to the alive one, and have idealized expectations of their lovers or spouses. PMID- 3964583 TI - The management of a sexually charged clinical problem: social structural and psychoanalytic functionalist approaches in a therapeutic community. AB - An event in a therapeutic community is examined from the perspectives of the structuralism of Durkheim and the functionalism of psychoanalysis. Although these two approaches might appear theoretically contradictory, analysis of the evidence shows them to be clinically complementary. The role of social structure in therapeutic communities requires deliberate conceptualization if such communities are to be demonstrably therapeutic. PMID- 3964584 TI - The concept of character: moral and therapeutic considerations. AB - This paper discusses the relationship between the psychoanalytic concept of character and the moral considerations of 'character'. Both psychoanalysis (and dynamic psychotherapy) as well as moral philosophy are concerned with judgements of right and wrong. Though psychotherapists take a non-judgemental attitude toward those in treatment, there are implicit judgements based on the expectation of a developmental progression toward 'maturity' and the ability to value actions which go beyond the self. The history of the term character in the psychoanalytic literature is reviewed to show how character is dealt with in psychodynamic psychotherapy as well as the similarity of the concerns of the psychotherapist and the moral philosopher. PMID- 3964585 TI - Facilitators and regulators: conscious and unconscious processes in pregnancy and early motherhood. AB - A model is presented, based on clinical experience, mother-child observations and survey data, delineating two different maternal orientations towards babies and motherhood. The essential difference in orientation is that the Facilitator mother adapts to her baby while the Regulator mother expects the baby to adapt. On a behavioural level these two orientations are manifest in differing maternal practices: the Facilitator mothers exclusively, responding spontaneously to her baby's needs as they arise, whereas the Regulator establishes a routine to foster predictability and shares mothering with her partner or other caretakers. This paper explores three areas within the different maternal orientations of the Facilitator and Regulator: conceptualization: conscious beliefs and expectations of motherhood and babies; practice: observable differences in adaptation to pregnancy, labour, birth and early weeks of motherhood, and differential postnatal vulnerability to psychosocial provoking factors; unconscious processes: identifications, phantasies and defences underlying these practices. The psychogenesis of the two maternal orientations is explored. It is suggested that unconscious identifications between various aspects of the mother's internal world and the foetus determine the maternal orientations, with the Facilitator mother employing idealization and manic reparation to sustain her maternal beliefs while the Regulator engages in manic defence and dissociation. Conscious and unconscious processes operate in conjunction with current socio-economic circumstances to determine maternal practice. PMID- 3964586 TI - Stress and arousal during pregnancy and childbirth. AB - Sixty primigravidae were assessed on the short form of the Stress-Arousal Adjective Check List (SACL) at the commencement of the third trimester of pregnancy. Fifty-four of these were also administered the SACL in the labour ward and at three days after birth. On the first assessment the mean levels for the group of mothers were above normative levels of stress but not normative levels of arousal. In labour there was a significant increase in stress accompanied by a significant decrease in arousal. On the third day stress and arousal means were at approximately normative levels. Of those women stressed antenatally, four fifths were also stressed in labour and half were stressed postnatally. Correlates of stress and arousal are examined and the utility of the measures discussed. PMID- 3964587 TI - Self-esteem in depression: a controlled repertory grid investigation. AB - Repertory grids were used to investigate self-esteem and social perception in three groups: depressed in-patients, non-depressed psychiatric in-patients and a general hospital control group. Depression was measured by the Beck Depression Inventory. Depressives had significantly lower self-esteem and more negative social perception and negative feelings associated with 'actual self', as predicted by Beck's cognitive theory. Repertory grids are potentially useful tools for the development of cognitive theories of depression, and may also have a role in clinical practice using cognitive techniques. PMID- 3964588 TI - Faculty differences in psychological disturbance among undergraduates on arrival at university. AB - A model of psychological preselection is proposed to account for findings of higher psychiatric morbidity among Arts students than in other faculties. The predictions of this model and a competing 'course factor' model are tested. Arts students are found to show more evidence of anxiety, insomnia, depression and poorer relationships with parents before academic courses have begun. Some of these differences are found to be constructed from distinct sex-linked components. Certain aspects of the preselection model were not supported by the findings, and refinements to the model are presented. It is suggested that the preselection may be based on an interconnection between clarity of identity, cognitive style and educational choice. The data also support the view that adolescent 'storm and stress' may be the experience of the relatively few. PMID- 3964589 TI - The type A behaviour pattern as a precursor to stressful life-events: a confluence of coronary risks. AB - Both the Type A Behaviour Pattern (TABP) and the presence of stressful life events have been independently established as precursors to the onset of coronary heart disease (CHD). The thematic character of the TABP suggests, however, that the two phenomena might be linked, to the extent that features of the TABP may place an individual in social, occupational and personal circumstances which enhance the probability of encountering stressful life-events. Evidence from survivors of clinical CHD gives some support to this idea. The present study extends the hypothesis to a large sample of healthy males, screened for CHD risk factors. These results, too, support the idea that the TABP and encounters with stressful life-events are not entirely independent phenomena. Associations between the TABP and a range of measures of life-events were most evident in the occupational aspects of the latter, though not exclusively so. The data do point to the need, in future epidemiological studies of CHD risk, to treat the TABP and stressful life-events as related measures of CHD risk. PMID- 3964590 TI - Type As who think they are type Bs: discrepancies between self-ratings and interview ratings of the type A (coronary-prone) behaviour pattern. AB - The study described here explored discrepancies between self-ratings and interview ratings of Type A behaviour. A total of 281 patients referred for diagnostic coronary angiography underwent a comprehensive psychological assessment including the Type A structured interview (SI), the Minnesota Multiphasic Personality Inventory (MMPI) and two self-report measures of Type A behaviour, the Jenkins Activity Survey (JAS) and the Type A Self-Rating Inventory (TASRI). Two subgroups of patients were identified--Type A subjects whose Type A self-ratings were consistent with the SI classification, and subjects who obtained low self-rating scores and yet were classified as Type A by the SI. A comparison of the MMPI profiles showed that the discordant Type As scored lower on MMPI scales 9 (Ma) and 4 (Pd), and higher on scales 0 (Si), 2 (D) and F. The personality attributes associated with this MMPI pattern are more consistent with individual self-reports of Type A behaviour than observer ratings during the SI. PMID- 3964591 TI - Assessment of cancer pain by the McGill Pain Questionnaire: results of two scoring methods in a sample of British patients and comparison with previous studies. AB - Pain experienced by 29 British cancer patients was evaluated by the McGill Pain Questionnaire. The questionnaires were analysed according to the traditional and a newly proposed scoring method. The results were compared with previously published studies. Scores relating to the sensory and affective components of pain were found to be similar for all groups of cancer pain patients. On the contrary, differences between groups were found for evaluative scores of the overall experience of pain. A previously observed pattern of pain intensity complexity correlation in cancer pain patients was reproduced. Interpretations of the similarities and discrepancies among groups of patients are discussed. PMID- 3964592 TI - Effect of pre-appointment inquiries on dental patients' post-appointment ratings of pain. AB - In order to test the possibility that an investigator's inquiries about dental patients' anxiety and expectations of pain will enhance their subsequent discomfort, two groups of 51 patients were asked after their appointment about the amount of pain they had experienced, but only one group was interviewed beforehand. No difference between these groups was found. PMID- 3964593 TI - The effect of maternal ethanol intoxication on fetal cardiotocography: a report of four cases. AB - Fetal cardiotocography revealed no or poor variability and no reactivity to fetal movements and or external stimuli in four drunken women. This was taken as a sign of fetal hypoxia in one patient and led to emergency caesarean section although, the infant was not hypoxic. In the other three patients, cardiotocography normalized within 11-14 h when the mothers became sober. PMID- 3964594 TI - Prediction of size of infants at birth by measurement of symphysis fundus height. AB - Symphysis fundus heights (SF) were measured approximately 15 times during pregnancy in a consecutive series of 2941 women with regular menstrual cycles and known last menstrual period. A reference SF chart from 17 to 40 weeks of pregnancy was derived from measurements in 1350 of these women who were healthy, and heights and pre-pregnancy weights within the 10th and 90th centiles and were delivered vaginally of healthy infants with a birthweight/length ratio within +/- 2 SD. The reference chart was used to predict fetal growth deviations in the unselected series of pregnancies. The effectiveness of SF measures to detect fetuses with an infant birthweight/length ratio below -2 SD or a birthweight below the 10th centile was low; the sensitivity was only 16.7 and 26.6% and the predictive value of positive screening result was 1.8 and 18.0%, respectively. Corresponding values for fetuses with an infant birthweight/length ratio above + 2 SD or a birthweight above the 90th centile were 31.8 and 37.5% and 3.3 and 24.5%, respectively. Symphysis fundus (SF) measurement has thus been found to be of limited value as a screening method to detect abnormal size at birth. PMID- 3964595 TI - An audit of the detection and management of small-for-gestational age babies. AB - The detection and management of small-for-gestational age babies (SGA) was assessed in a case record review of 1302 randomly selected pregnancies. Of the 129 babies with birthweights below the 10th centile for gestational age, 34 (26%) were identified antenatally. For every two correctly identified SGA babies there were three false positive predictions. In-patient monitoring and early elective delivery occurred both in the correctly identified pregnancies (24%) and in the false positives (12%). The management of suspected pregnancies bore no apparent relation to test results and appeared arbitrary. Mortality and morbidity, as measured by nursery admission for greater than 48 h and retention in the nursery after the mother's discharge, were higher in SGA babies than in the hospital population as a whole. The number of ill babies was small, however, reflecting the heterogeneous aetiology of small size for gestational age. Moreover, antenatal detection had little influence on these measures of outcome. It is concluded that tests for detection of SGA babies remain imprecise in practice, gestational weight alone correlates poorly with fetal well-being, and the need remains for sensitive tests to detect babies with genuine morbidity. PMID- 3964596 TI - Apgar score, meconium and acidaemia at birth in relation to neonatal neurological morbidity in term infants. AB - The relation between Apgar score, meconium and acidaemia at birth and neonatal neurological morbidity was investigated in 805 vaginally born term infants whose birthweight was appropriate-for-dates (AFD). Presence or absence of meconium stained amniotic fluid was not related to the neonatal neurological condition. The 1-min and 3-min Apgar scores and the umbilical artery pH were related, but the variances explained in neonatal neurological optimality score were very low (0.9 and 0.5% respectively). Combination of Apgar score and pH slightly increased these percentages to 1.5. The highest frequency of neurologically deviant infants was, on the other hand, found in the group with a normal pH but low Apgar score. It is concluded that in AFD term infants nowadays the predictive value of a low Apgar score, acidaemia at birth and/or presence of meconium for the neonatal neurological morbidity is poor. Most neonatal neurological abnormalities must be due to other factors. PMID- 3964597 TI - Aetiology of non-immune hydrops: the value of echocardiography. AB - Forty-eight pregnancies, five of them multiple, were referred for fetal cardiac assessment following the detection of non-immune hydrops fetalis; there were 52 hydropic fetuses in total. A cardiovascular aetiology was found in 21 of these 52 (40%); structural heart disease was present in 13, tachyarrhythmia in the remaining eight. The accurate delineation of these causes was possible using fetal echocardiography, and enabled rational management to be instituted. This included termination of pregnancy, pharmacological control of arrhythmias and appropriate timing of delivery. PMID- 3964598 TI - The obstetric management of non-immunological hydrops. AB - During the past 8 years, non-Rhesus hydrops has been observed in 31 pregnancies extending beyond 28 weeks gestation. Only three of the babies survived. Antenatal diagnosis is possible by ultrasound examination and although 27 of our patients had at least one indication for this procedure, only 22 were so investigated and in 13, fetal hydrops was demonstrated. Twenty-three were delivered before 36 weeks gestation, 10 by caesarean section of whom none survived; 16 babies were stillborn. Fourteen infants had major cardiovascular anomalies and six had other major malformations. In five infants, infection was thought to be causally related to fetal hydrops and in only four could no cause for the hydrops be found. In five pregnancies the cause of hydrops was discovered antenatally; this influenced subsequent management and two of the five survived. The unexpected appearance of a very abnormal fetal heart rate pattern requires the exclusion of fetal anomaly and non-immunological hydrops. When a diagnosis of non-immune hydrops is made its underlying cause should be sought without delay so that specific treatment may be instituted in the few cases where this is appropriate. A high incidence of complications of the third stage of labour should be anticipated. Subsequent pregnancies are likely to be normal. PMID- 3964599 TI - Transcapillary fluid balance in pre-eclampsia. AB - The fluid transport between the plasma and interstitial fluid compartment is governed by the Starling forces, i.e. the capillary pressure (Pc), interstitial fluid hydrostatic pressure (Pi) and colloid osmotic pressure in plasma (COPp) and interstitial fluid (COPi). Interstitial fluid was collected from subcutaneous tissue on the thorax and ankle by implanted wicks and Pi was measured using the 'wick-in-needle' technique. In pre-eclampsia, COPp is reduced due to hypoproteinaemia and this predisposes towards loss of fluid from the vascular compartment. An important oedema-preventing mechanism is reduction of COPi, which serves as a homeostatic buffer against increased capillary filtration. This mechanism works in moderate, but not in severe pre-eclampsia. A higher COPi was found both at the thorax (8.3 vs 7.0 mmHg) and ankle (5.9 vs 3.9 mmHg) in the group with severe pre-eclampsia compared with the group moderate pre-eclampsia, in spite of a significant reduction in COPp (15.5 vs 19.9 mmHg). These findings suggest that an increased microvascular permeability of plasma proteins to subcutaneous tissue contributes to COPp reduction in severe pre-eclampsia. PMID- 3964600 TI - The intraventricular conduction time of fetal heart in pregnancies with suspected fetal growth retardation. AB - Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small-for-gestational-age at birth and 44 exhibited QRS duration values below -2 SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below -4 SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth-retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below -4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15). PMID- 3964601 TI - Effect of epidural analgesia on maximum and minimum blood pressures during the first stage of labour in primigravidae with mild/moderate gestational hypertension. AB - One of the arguments used in favour of epidural analgesia for hypertensive patients in labour is its effect on mean arterial blood pressure, although the fetal and maternal risk from hypertension is more closely linked to maximum recorded levels. We have therefore assessed the effect of epidural analgesia on maximum blood pressure. There was no change in the maximum systolic or diastolic blood pressure after epidural analgesia when compared to baseline values or levels in untreated hypertensive controls. We conclude that this form of analgesia should be offered to hypertensive patients purely for its analgesic effect and not as a method for blood pressure control. PMID- 3964602 TI - Results of donor insemination related to specific male infertility and unsuspected female infertility. AB - Apparently normal but infertile women were treated by artificial insemination using fresh donor semen. In 228 couples in which the male partner was azoospermic the average monthly conception rate was 13.3% and the 12-month cumulative rate was 82.2% (SE 2.7%). In 116 couples in which the partner was oligospermic the monthly rate was 8.7% and the 12-month rate 66.6% (SE 5.0%, P less than 0.01). Previous smaller studies have given rise to conflicting or inconclusive results, but the reduced conception rates in the partners of oligospermic men in this large study suggests that unexplained female factors, discussed in the paper, contribute to their infertility in up to a third of patients. PMID- 3964603 TI - Ovulatory disorders and inflammatory adnexal damage: a neglected cause of the failure of fertility microsurgery. AB - Failure of reconstructive tubal surgery is usually attributed to pre-existing endosalpingeal damage, recurrent adhesion formation or progressive inflammatory disease. We studied ovarian follicle development and ovulation by ultrasound in 25 infertile patients with laparoscopically proven sequelae of pelvic inflammatory disease. Failure of the follicle to rupture was seen in 13, although luteinization occurred. The mean mid-luteal progesterone concentration in cycles with an unruptured follicle was significantly lower than the concentrations both in ovulatory cycles in the same patients and in a comparison group of 45 normally ovulating women (P less than 0.01). Microsurgical adhesiolysis did not seem to influence the occurrence of the ovulation disorder. PMID- 3964604 TI - Do pregnant women need zinc supplements? PMID- 3964605 TI - Fetal heart function in response to short-term maternal exercise. AB - Fetal cardiac reactions to maternal exercise were studied in the fetuses of 22 healthy pregnant women between 18 and 36 weeks of gestation. Before and 5 min after a bicycle ergometer load test of 75 W each fetus was studied with M-mode echocardiography. Fetal cardiac dimensions, ventricular ejection times and heart rate were recorded and indices of left ventricular heart function (fractional shortening, mean velocity of fractional shortening, stroke volume and cardiac output) were calculated. While median maternal heart rate acceleration reached 68% of expected maximum heart rate, no significant alterations in fetal heart rate, fetal cardiac dimensions or fetal ventricular function were observed. The results indicate that short-term moderate maternal exercise can be performed without fetal cardiac distress. PMID- 3964606 TI - Fetal heart rate variability changes and fetal behavioural cycles during labour. AB - In a study of 301 consecutive fetal heart rate (FHR) recordings of greater than or equal to 6 h duration, consecutive episodes of low and high FHR variability consistent with cycles of quiet and active fetal behaviour were found in 38% of spontaneous and 68% of induced labours at term (P less than 0.0001). Quiet periods (episodes of low FHR variability) had durations of 12-93 min (mean 25, SD 11 min) and in 48% of cardiotocographs (CTGs) these episodes had a long-term variability of less than 5 beats/min. The implications of these findings are discussed in relation to the use of FHR recording for intrapartum surveillance. PMID- 3964607 TI - Serum protein binding of diazepam and propranolol in the feto-maternal unit from early to late pregnancy. AB - Paired samples of maternal and fetal serum were obtained in 65 pregnancies between 13 and 41 weeks gestation. Concentrations of albumin, alpha 1-acid glycoprotein (alpha 1-AGP) and free fatty acids (FFA) were estimated in all samples and the in-vitro binding of diazepam and propranolol was estimated. The free fraction of diazepam in fetal serum was very high in early gestation and decreased with advancing gestation to reach maternal values around the 30th week. After 35 weeks gestation, values were generally lower in fetal than in maternal serum. Fetal serum binding of diazepam correlated with fetal albumin levels and gestational age. The ratio of the fetal/maternal free diazepam fraction correlated negatively with the fetal/maternal serum albumin concentration ratio. The maternal/fetal free diazepam fraction ratio correlated positively with gestational age. The free fraction of propranolol in fetal serum was higher than in maternal serum in early pregnancy and decreased with advancing gestation but always remained higher than the maternal values. The fetal/maternal free propranolol fraction ratio was negatively correlated with the fetal/maternal alpha 1-AGP serum concentration ratio. The maternal/fetal free propranolol fraction ratio was positively correlated with gestational age. Serum protein binding of propranolol was correlated with serum albumin concentrations in fetal samples but not in maternal samples. Serum FFA concentrations were not correlated with serum protein binding except for maternal serum binding of diazepam. For toxicological reasons it is advisable to monitor maternal blood for free concentrations of drugs that exhibit concentration-dependent protein binding or which can be displaced from binding sites by other drugs or endogenous compounds such as FFA. PMID- 3964608 TI - Fluid therapy for induced labour under epidural analgesia: biochemical consequences for mother and infant. AB - Two types of fluid regimen were provided for patients having labour induced under epidural analgesia. Reasons for the infusion were to pre-load the circulation before the epidural, and subsequently to sustain maternal hydration. Both fluids were isotonic, one was predominantly saline based (Hartmann's solution) and the other contained both saline and dextrose. Blood glucose and serum sodium, lactate and beta-hydroxybutyrate were measured before the start of induction, at delivery and in the cord sample. Blood glucose and serum sodium were measured in the babies at 12 and 24 h of age. The dextrose-saline fluid caused small but significant changes in blood glucose and serum sodium which did not exceed the normal reference limits for either. The use of Hartmann's solution was associated with considerable rises in maternal serum beta-hydroxybutyrate at delivery. Neither fluid had any significant effect on the blood glucose or serum sodium in infants at 12 and 24 h of age. PMID- 3964609 TI - Womens' views on keeping fetal movement charts. AB - This study reports the views of 132 women on filling in fetal movement charts during pregnancy. All appeared to have received an adequate explanation of how to fill in the chart. Although just over half the sample of women were reassured by filling in the chart, 23% were worried by it and 16% made other unfavourable comments on its use. Analysis of the comments made suggests that women are probably not given an adequate explanation for the reasons for keeping a kick chart regularly, or of the possible importance of a reduction in fetal activity. PMID- 3964610 TI - Late terminations of pregnancy following second trimester amniocentesis. AB - We sought information from 34 chromosome laboratories in Britain about the frequency during 1982 of late amniocentesis, late reports of prenatal diagnosis results and late resultant terminations of pregnancy. Thirty-one laboratories provided data on a total of 20 840 pregnancies. Gestational age at report was recorded in 14 795 and 510 subsequent terminations of pregnancy were recorded. The data were subdivided into three categories according to the primary indication for amniocentesis: (i) the detection of chromosomal abnormalities, (ii) risk of neural-tube defect, (iii) 'other' reasons. Overall 4.0% of diagnostic amniocenteses were performed at greater than or equal to 21 weeks, 12.7% of reports were made at greater than or equal to 22 weeks gestation, and 13.1% of terminations were performed at greater than or equal to 22 weeks. Late amniocentesis (greater than or equal to 21 weeks) occurred nearly five times more often when the primary indication was the detection of neural tube defects than when it was the detection of chromosomal abnormalities. Approximately two-thirds of 'late' terminations were performed after amniocentesis at greater than or equal to 19 weeks gestation. A total of 3896 (26.3%) of women undergoing prenatal diagnosis had to wait until greater than or equal to 21 weeks gestation before a report was available. PMID- 3964611 TI - Late venous function in the leg after deep venous thrombosis occurring in relation to pregnancy. AB - The frequency of deep venous insufficiency was investigated in 23 patients 3-10 years (mean 7 years) after they had developed an objectively diagnosed deep venous thrombosis (DVT) during pregnancy or the first week after delivery. Investigations included clinical examination, listing of symptoms and plethysmography, venous pressure and Doppler ultrasound. At follow-up there were clinical signs or symptoms of venous insufficiency in 35% of the legs with earlier DVT but in none of the non-thrombosed contralateral legs. Objective evidence of venous insufficiency was present in 15 (65%) of the legs with earlier DVT and in only five (22%) of the non-thrombosed legs. The differences between thrombosed and non-thrombosed legs are statistically significant. There was no correlation between objectively measured venous insufficiency and extent of the DVT. It is concluded that a DVT during pregnancy often leads to venous insufficiency and the risk seems to be higher than after DVT occurring in other groups of patients. PMID- 3964612 TI - Pre-operative magnetic resonance imaging of stage 1 endometrial adenocarcinoma. AB - Twelve women with stage I endometrial adenocarcinoma were examined by magnetic resonance imaging before definitive surgery. Using this technique the depth of myometrical invasion, tumour site and cervical involvement were assessed and the results compared with the operative and pathological findings. Magnetic resonance imaging is a unique non-invasive method of assessing the early stages of endometrial adenocarcinoma before radiotherapy and surgery. PMID- 3964613 TI - Perineal pad weighing versus videographic analysis in genuine stress incontinence. AB - A comparison was made of the sensitivity of perineal pad testing and the videographic diagnosis of genuine stress incontinence (GSI) in postmenopausal women. The 99% upper confidence limit for pad weight gains in 90 normal women was 1.4 g. Ninety-nine women with urodynamically proven GSI were studied and 14 had false negative pad tests. There was no significant correlation between the videographic assessment and the gain in pad weight. We recommend the use of the pad test to confirm incontinence only in the absence of imaging facilities as the latter is more sensitive. PMID- 3964614 TI - The pattern of female genital tuberculosis in Riyadh, Saudi Arabia. AB - An analysis of 40 patients with genital tuberculosis in the Maternity and Children's Hospital, Riyadh, Saudi Arabia, showed that female genital tuberculosis occurred in 0.45% of all gynaecological admissions, a much higher rate than those reported from Western countries with a similar economic background. These 40 women accounted for 4.2% of a total of 945 infertile women studied during the same period, and where infertility was due to a tubal factor, 1 in 7 was afflicted with tuberculosis. Most patients were young nulliparae and in 13 the disease was florid. Complete cure was achieved with chemotherapy in 77% of the patients, but tubal patency was restored in only five of 35 patients followed up (14%). There were only two tubal pregnancies and no intrauterine pregnancy. Genital tuberculosis should be considered as a possible cause of infertility and excluded before embarking upon tubal surgery or ovulation induction therapy. PMID- 3964615 TI - Cervical intraepithelial neoplasia treated by perilesional injection of interferon. AB - Twelve patients with cervical intraepithelial neoplasia (CIN) were studied by colposcopy and cervical smears to elucidate the local response to interferon alpha and beta given by perilesional injections and to assess long-term disease remission. In all patients, local inflammatory response was seen and persisted throughout the treatment period. Selective toxic effect was evident by exfoliation of increasing proportion of degenerate to viable dyskaryotic cells, while the normal epithelial cells appeared unaffected, and by the progressive regression of the lesion. Interferon alpha induced complete remission in six of seven (85.7%) patients but three had recurrence 12 to 24 months later, while interferon beta induced complete remission in only two of five (40%) patients. PMID- 3964616 TI - Thrombocythaemia and recurrent late abortions: normal outcome of pregnancies after antiaggregatory treatment. Case report. PMID- 3964617 TI - Spontaneous rupture of the oesophagus following severe vomiting in early pregnancy. Case report. PMID- 3964618 TI - Seat belt hazards in pregnancy. Case report. PMID- 3964619 TI - Cloacal reconstruction and use of bilateral ischiocavernosus muscle flap for construction of the perineal body. Case report. PMID- 3964620 TI - Serum cytidine deaminase assay--some pitfalls. PMID- 3964621 TI - Can the fetus listen and learn. PMID- 3964622 TI - Lacrimal streams: the demonstration of human lacrimal fluid secretion and the lacrimal ductules. AB - The clinical demonstration of the ductular orifices of the human lacrimal gland is reported. Lacrimal fluid secretion can be shown after instillation of 2% sodium fluorescein. Ductular orifices are visible on biomicroscopy. In keratoconjunctivitis sicca the lacrimal fluid streams appear normal, or to be diminished or absent. PMID- 3964623 TI - Does unidirectional vesicular transport occur in retinal vessels? AB - This paper challenges the hypothesis that the smooth 80 nm plasmalemmal caveolae found in abundance at the abluminal aspect of the endothelium in retinal blood vessels participate in a unidirectional vesicular transport mechanism. Evidence is presented which indicates that horseradish peroxidase, when introduced to the extracellular space of the retina via the vitreous body, may enter the intravascular compartment through junctional incompetence which occurs at or after enucleation of the eye. It is proposed that the plasmalemmal caveolae at the abluminal plasma membrane of endothelial cells in retinal blood vessels are static structures which facilitate the transport of small solutes and ions across the blood retinal barrier. PMID- 3964624 TI - Acute posterior multifocal placoid pigment epitheliopathy associated with diffuse retinal vasculitis and late haemorrhagic macular detachment. AB - A 20-year-old healthy man suffered rapid loss of bilateral central vision with placoid lesions at the level of the retinal pigment epithelium and choriocapillaris scattered in the posterior pole of the fundus. In addition, acute vasculitis of the retinal veins was remarkable and widespread throughout the posterior pole and midperiphery. These inflammatory signs subsided in several weeks and were succeeded by recovery of the normal visual acuity with residual pigment derangements in the deep retina. Sixteen months after the onset of the disease choroidal neovascular membranes developed in the macular region of the left eye, followed by haemorrhagic macular detachment and marked visual loss. Significant increases in the serum cold agglutinin titre occurred as isolated laboratory findings concurrently with the acute stage of the disease and the late macular complication, though no clinical or other laboratory sign suggested viral infection. PMID- 3964625 TI - Improvement of photostress recovery testing after extracranial-intracranial bypass surgery. AB - A patient with carotid occlusive disease experienced episodes of light-induced amaurosis in an eye with changes of venous stasis retinopathy. Though his macula appeared normal on examination, the macular photostress test (MPST) was prolonged. After anastomosis of a superficial temporal artery with the middle cerebral artery his symptoms resolved and his MPST returned to normal. The MPST may serve as a diagnostic stress test for the retinal circulation in cases of carotid disease. PMID- 3964626 TI - Delayed-onset chloroquine retinopathy. AB - Delayed-onset chloroquine retinopathy was diagnosed in a patient seven years after cessation of treatment by a total dose of 730 g of chloroquine for rheumatoid arthritis. Visual functions continued to deteriorate after the diagnosis. Periodic examinations by ophthalmoscopy and by functional tests such as EOG and visual fields should be continued in patients at risk of delayed-onset chloroquine retinopathy after discontinuance of the drug. PMID- 3964627 TI - Light microscopic and electron microscopic histopathology of an iris microhaemangioma. AB - A patient who had been observed to have an iris microhaemangioma (capillary haemangioma), confirmed on fluorescein iris angiography, came to cataract surgery. The lesion was excised at the time of surgery and submitted to light and electron microscopic study. It had the features of a hamartoma of the capillary haemangioma type, with its characteristics being specific for vessels seen in iris tissue. PMID- 3964628 TI - Iridotomy with red krypton laser. AB - Iridotomy with red krypton laser instead of blue-green argon laser was performed on 68 eyes with various types of angle-closure glaucoma. Patent iridotomy was obtained in all the eyes, mostly in one working session. In eight eyes secondary closure by pigment needed reopening with a few applications at the iridotomy site. There were no immediate or late complications of importance, the main advantage of the technique being the avoidance of the corneal epithelial and endothelial burns which commonly occur during argon laser iridotomy, particularly when the anterior chamber is shallow. PMID- 3964629 TI - Intraocular injection of depomedrone. AB - A case of inadvertent intraocular injection of Depomedrone (methylprednisolone acetate) and its management by vitrectomy is discussed, with a review of previously reported cases. PMID- 3964630 TI - Oral doxycycline in the treatment of adult chlamydial ophthalmia. AB - Ninety-three consecutive patients with adult chlamydial ophthalmia were treated with four different regimens of oral doxycycline. In patients treated with a single dose of 5 mg/kg of body weight (300 mg) of doxycycline the severity of clinical signs was reduced, and in half of the patients shedding of the infective agent was stopped. Treatment with a weekly dose of 300 mg of doxycycline for three weeks or a daily dose of 1.5 mg/kg of body weight (100 mg) for one week produced a clinical and microbiological cure in 100% of patients. However, in some of these patients mild to moderate papillary responses were present up to six months from completion of the treatment. The best results were obtained with a daily dose of 100 mg for two weeks, which produced rapid clinical and microbiological cure in all patients. PMID- 3964632 TI - Arabic reading types. AB - Greatly needed Arabic reading types for testing near visual acuity are suggested. They are based on reading types adopted by the Faculty of Ophthalmologists of the United Kingdom. PMID- 3964631 TI - Probably Norrie's disease due to mutation. Two sporadic sibships of two males each, a necropsy of one case, and, given Norrie's disease, a calculation of the gene mutation frequency. AB - Two sibships, each with two affected males but no other affected family members, are described. All four patients at birth had small eyes with white masses visible behind clear lenses. Support for a diagnosis of Norrie's disease lies in the probable mental retardation and sudden death of one child and mental retardation in the other in one of the families, and strong support in the sensorineural deafness in one child in the other family. A necropsy was performed on the dead child. Both eyes showed the retinae to be totally non-attached. The optic nerves were thin. If the diagnosis is Norrie's disease (highly probable), the birth of the second affected child in each family supports the postulate of a mutation in the X chromosome of a germ cell of a maternal grandparent or an earlier maternal ancestor, no previous member of the family having been affected. That implies a 50% risk of the disease in future male siblings and a 50% risk of the carrier state in female sibs. When only one child is affected, the explanation could also be a mutation in that individual. Given Norrie's disease, we have calculated a mutation rate of 3.9 per million chromosomes in the Scottish population--remarkably similar to the mutation rates calculated for many dominant diseases. A diagnosis of autosomal recessive non-attachment of retina implies a 25% risk to later siblings. PMID- 3964633 TI - The Dunlop test and reading in primary school children. AB - Using the Dunlop synoptophore test we have examined the reliability of vergence control for small fusion targets in 753 primary school children aged 7-11, and we have compared these results with the reading performance of 451 of them. 30% of the total sample of children had unstable responses in the Dunlop test. The proportion decreased with age, ranging from 49% of 5-year-olds to only 11% of 10 year-olds. The reading of children who had developed accurate vergence control was on average 6.3 months in advance of those who had not. Those with unstable Dunlop test responses were much more likely to be backward or low normal readers than children with stable responses. We conclude that in experienced hands the Dunlop test is a useful indicator of the development of vergence control and that immaturity of vergence control may contribute to children's reading problems. PMID- 3964634 TI - Radiation chorioretinopathy. AB - Three cases of postradiation retinopathy are reported. The findings are analysed. The exudates described by many authors are really infarcts of the choroid lobules. Chorioretinopathy is proposed as a better descriptive term, and three types are suggested. Diagnosis of the condition is important to spare unnecessary enucleation, as the infarcted areas may resemble a recurrence. Predisposing factors are discussed. PMID- 3964635 TI - Pattern electroretinograms become abnormal when background diabetic retinopathy deteriorates to a preproliferative stage: possible use as a screening test. AB - The pattern electroretinogram (PERG) and other tests were given to a selected group of patients with diabetes, ranging from those who had no retinopathy or funduscopic changes to those in the preproliferative state. None had visual symptoms. The PERG was found to be normal in patients with microaneurysms and a few blot haemorrhages. However, when cotton-wool spots and angiographic evidence of areas of capillary non-perfusion were present, the PERG was reduced below the normal value. Similar changes occurred with the oscillatory potentials of the ERG evoked by an intense flash, but the results were more variable. So in the individual patient the test is not a reliable indicator of the progress of the retinopathy. The value of the PERG in screening is discussed. PMID- 3964636 TI - Endocytosis in the retinal and choroidal microcirculation. AB - The endocytosis of horseradish peroxidase (HRP) by the vascular cells of retinal and choroidal blood vessels was compared in immersion and perfusion fixed eyes from individual rats. The mechanisms of endocytosis of HRP appeared identical in both retinal and choroidal vessels. The bulk of internalised tracer occurred in macropinosomes 300-400 nm in diameter. Tracer was localised to a 20-30 nm layer on the internal aspect of the limiting membrane. This layer was coincident with the glycocalyx of the luminal plasma membrane as revealed by ruthenium redosmium tetroxide staining. Horseradish peroxidase was also internalised by a small scattered population of vesicles (100-130 nm in diameter). The size of these vesicles suggested that they may have arisen from clathrin coated regions of the plasma membrane. It is suggested that the endocytosis of HRP in retinal and choroidal vascular endothelium occurs as a function of plasma membrane recycling. Horseradish peroxidase may also be internalised as a 'contaminant' of the glycocalyx in coated pits involved in receptor mediated endocytosis. The smooth 80 nm plasmalemmal caveolae of the retinal and choroidal vascular endothelial cells did not appear to participate either in absorptive endocytosis or vesicular transport. PMID- 3964637 TI - Ocular toxicity of desferrioxamine: light microscopic histochemical and ultrastructural findings. AB - This study documents for the first time light and electron microscopical changes in the retinal pigment epithelium (RPE) following treatment with high dose desferrioxamine for systemic iron overload. The changes include loss of microvilli from the apical surface, patchy depigmentation, vacuolation of the cytoplasm, swelling and calcification of mitochondria, and disorganisation of the plasma membrane. In addition, Bruch's membrane overlying degenerate RPE cells appeared abnormally thickened owing to the accumulation of large amounts of mature elastic fibres, pre-elastic oxytalan, and long spacing collagen. The specificity of these changes and the mechanism of toxicity are discussed. PMID- 3964638 TI - One-step extracapsular cataract extraction and silicone oil-injection in the management of proliferative vitreoretinopathy. AB - A combined technique of extracapsular cataract extraction and silicone oil injection is described. The anterior capsule is preserved to prevent movement of the silicone oil from the vitreous cavity to the anterior chamber. An anterior chamber tap ensures that the vitreous cavity is completely filled with silicone oil, while a peripheral iridectomy prevents postoperative pupillary block glaucoma. PMID- 3964639 TI - Respiratory epithelium lined cysts presenting in the orbit without associated mucocele formation. AB - Three patients presented with orbital cysts lined with upper respiratory tract epithelium. In each case there was no evidence of an associated mucocele. Two patients had a past history of orbital trauma, and the third had had preceding sinus surgery. It is postulated that these cysts were caused by traumatic herniation of nasal sinus epithelium cells into the orbit. PMID- 3964640 TI - Chronic lymphangiectasis in Turner's syndrome. AB - A 3 1/2-year-old female presented with Turner's syndrome and Nonne-Milroy-Meige disease. Ocular findings included strabismus and bilateral chemosis which was unchanging and persisted throughout the four years the patient was followed up. Histopathological findings included diffuse lymphangiectasia and dense connective tissue surrounding the dilated lymph channels. Although the association between congenital lymphoedema and Turner's syndrome is common, the lymphoedema usually disappears by the first year of life. The persistence of the lymphoedema beyond this age is rare, as is the presence of the persistent chemosis. This report represents the first histopathological documentation of congenital lymphangiectasis in association with Turner's syndrome. PMID- 3964642 TI - Intrinsic uncoupling of mitochondrial proton pumps. 2. Modeling studies. AB - The thermodynamic and kinetic properties associated with intrinsic uncoupling in a six-state model of a redox proton pump have been studied by computing the flow force relations for different degrees of coupling. Analysis of these relations shows the regulatory influence of the thermodynamic forces on the extent and relative contributions of redox slip and proton slip. Inhibition has been introduced into the model in two different ways, corresponding to possible modes of action of experimental inhibitors. Experiments relating the rate of electron transfer to delta microH at static head upon progressive inhibition of the pumps have been simulated considering (1) the limiting case that the nonzero rate of electron transfer at static head is only due to intrinsic uncoupling (no leaks) and (2) the experimentally observed case that about 30% of the nonzero rate of electron transfer at static head is due to a constant proton leakage conductance in parallel with the pumps, the rest being due to intrinsic uncoupling. The same simulations have been performed for experiments in which the rate of electron transfer is varied by varying the substrate concentration rather than by using an inhibitor. The corresponding experimental results obtained by measuring delta microH and the rate of electron transfer at different succinate concentrations in rat liver mitochondria are presented. Comparison between simulated behavior and experimental results leads to the general conclusion that the typical relationship between rate of electron transfer and delta microH found in mitochondria at static head could certainly be a manifestation of some degree of intrinsic uncoupling in the redox proton pumps.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964641 TI - Comparison of 7S nerve growth factor and nerve growth factor I from mouse submandibular glands. AB - 7S nerve growth factor (7S NGF) and nerve growth factor I (NGFI) are NGF containing protein complexes isolated from mouse submandibular glands by different protocols, and reports suggest that the molecules differ chemically. In this study, we compared the molecular properties and subunit compositions of the two proteins. Purified 7S NGF and NGFI electrophoresed to identical positions on polyacrylamide gels in nondissociating buffers, with electrophoretic mobilities indistinguishable from that of unpurified NGF in salivary gland extracts. Ultraviolet absorption curves were identical, and sedimentation coefficients were similar (7.3 +/- 0.25 S for 7S NGF; 7.2 +/- 0.2 S for NGFI) as determined by sedimentation velocity analysis. By sedimentation equilibrium analysis, molecular weights of 135 000-140 000 were obtained for both complexes at protein concentrations in the centrifuge cell greater than 85 micrograms/mL; when protein concentrations within the centrifuge cell ranged from approximately 30 to 100 micrograms/mL at equilibrium, both complexes dissociated. Molecular weight values determined by gel filtration on Bio-Gel P300 and Sephadex G200 resins were similar for both proteins, and the values determined on Sephadex agreed with those obtained by ultracentrifugation. The subunit compositions of the complexes were also similar as determined by nonequilibrium isoelectric focusing, NGFI being composed of proteins that migrated to positions identical with those of the alpha, beta, and gamma subunits of 7S NGF. Furthermore, the stoichiometry of the subunits was similar in the two complexes as determined by radioimmunoassays to each of the subunits and by densitometric analysis of electrophoretic gels. Both methods showed that the complexes contain approximately 2 mol of the alpha and gamma subunits per mole of beta-NGF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964643 TI - Analysis of the order of free energy couplings between ligand binding and subunit assembly in human hemoglobin. AB - The concept of free energy couplings has been extensively used in studies of the ligand-linked subunit assembly of oligomeric proteins such as human hemoglobin A [cf. Ackers, G. K. (1980) Biophys. J. 32, 331-346]. Recently, the concept of "order" of free energy couplings has been introduced as a description of the number of protein subunits that must be liganded to effect changes in intersubunit interactions [Weber, G. (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 7098-7102]. That report utilized the concept of order of free energy couplings to analyze a set of previously published equilibrium constants derived from data pertaining to the chemical equilibrium between oxygen and stripped hemoglobin A [Mills, F. C., Johnson, M. L., & Ackers, G. K. (1976) Biochemistry 15, 5350 5362]. The Weber report claims to have "unequivocally" demonstrated that the coupling between oxygenation and subunit assembly in hemoglobin A is "first order". In the present report, it is demonstrated that free energy couplings of both the first and second order are capable of describing the original oxygen binding data. PMID- 3964644 TI - Thermodynamics of gallium complexation by human lactoferrin. AB - Equilibrium constants for the successive binding of 2 equiv of Ga3+ to human lactoferrin have been measured by difference ultraviolet spectroscopy in 0.1 M 4 (2-hydroxyethyl)-1-piperazineethanesulfonic acid containing 5 mM bicarbonate at pH 7.4 and 25 degrees C. Ethylenediamine-N,N'-diacetic acid was used as the competing chelating agent. Values of the effective binding constants for the stated experimental conditions are log K1 = 21.43 +/- 0.18 and log K2 = 20.57 +/- 0.16. Comparison of these results with literature values for the gallium transferrin binding constants indicates that lactoferrin binds gallium more strongly by a factor of approximately 90. The ratios of successive binding constants for the two proteins are essentially identical. A linear free energy relationship (LFER) for the complexation of gallium(III) and iron(III) has been prepared and used to estimate an iron(III)-lactoferrin binding constant for pH 7.4. The LFER prediction is compared with thermodynamic data on iron binding at pH 6.4 and gallium binding at pH 7.4. The results indicate that the ratio of iron binding constants for lactoferrin and transferrin is likely in the range of 50 90. PMID- 3964645 TI - Molecular basis for the anti-sickling activity of aromatic amino acids and related compounds: a proton nuclear magnetic resonance investigation. AB - High-resolution proton nuclear magnetic resonance spectroscopy and relaxation techniques have been used to investigate the interactions of sickle cell hemoglobin (Hb S) and human normal adult hemoglobin (Hb A) with p-bromobenzyl alcohol, L-phenylalanine, L-tryptophan, and L-valine. With the exception of valine, all these compounds inhibit the polymerization of deoxy-Hb S [Noguchi, C. T., & Schechter, A. N. (1978) Biochemistry 17, 5455)). Using transferred nuclear Overhauser effects among the proton resonances of the compound of interest and the corresponding longitudinal relaxation rates (T1(-1], we have shown that the binding of each of the compounds investigated to deoxy-Hb S is comparable to that to deoxy-Hb A. Intermolecular transferred nuclear Overhauser effects have been observed between proton resonances of the anti-sickling compounds and specific protons situated in the heme pockets of Hb. On the basis of these results, we suggest that one binding site, common to all compounds with anti-sickling activity, is at or near the heme pockets in the alpha and beta chains of both deoxy-HB S and deoxy-Hb A. The proton T1(-1) values of the histidyl residues situated over the surface of the hemoglobin molecule indicate that a second binding site is located at or near the beta 6 position, containing the mutation in Hb S (beta 6Glu----Val). The binding of the compounds investigated to the latter site induces conformational changes in the amino-terminal domains of the beta chains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964646 TI - Polymorphic phase behavior of unsaturated lysophosphatidylethanolamines: a 31P NMR and X-ray diffraction study. AB - The polymorphic phase behavior of aqueous dispersions of 1-oleoyl-, 1-linoleoyl-, and 1-linolenoyl-sn-3-glycerophosphoethanolamine (1-C18:1c-PE, 1-C18:2c-PE, and 1 C18:3c-PE, respectively) has been investigated by 31P NMR, small-angle and wide angle X-ray diffraction, and freeze-fracture techniques in response to changes in temperature and pH. Between -20 and 0 degrees C at pH 7, NMR and X-ray data indicate that 1-C18:1c-PE adopts a lamellar phase. Above 20 degrees C, the X-ray diffraction from 1-C18:1c-PE reveals no long-range lattice order, whereas the NMR data indicate lamellar structure to 90 degrees C. Freeze-fracture electron microscopy shows that 1-C18:1c-PE at pH 8.2 forms closed multilamellar vesicles upon dispersion and also that large unilamellar vesicles produced by extrusion techniques (LUVETs) can be made from 1-C18:1c-PE at pH 7. Such LUVETs can trap [3H]inulin and support a K+ diffusion potential for up to 4 h. At pH 8.5 and above, 1-C18:1c-PE forms optically clear, fluid dispersions with NMR and X-ray characteristics consistent with a micellar (noninverted) phase structure. Attempts to prepare LUVETs from 1-C18:1c-PE at pH 9 result in structures that can neither trap [3H]inulin nor support a membrane potential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964647 TI - Transmembrane electrical potential affects the lipid composition of Acholeplasma laidlawii. AB - In membranes of Acholeplasma laidlawii, lipid composition is regulated as a function of several stimuli affecting the volume and length of the hydrocarbon chains and the hydrocarbon-water interfacial area. This regulation is vizualized as changes in the relative amounts of the major polar lipids monoglucosyl diglyceride and diglucosyl diglyceride. These lipids form reversed hexagonal and lamellar phases with water, respectively. However, mixtures of the two lipids, in the molar proportions found in the A. laidlawii membrane, form a lamellar phase. By adjustment of the glycolipid ratio as a response to environmental stimuli, a certain stability of the lamellar membrane is maintained. In growing cells with oleoyl membrane lipids, a transmembrane electrical potential of approximately -50 mV (inside negative), but no transmembrane pH difference, was found. Addition of the K+ ionophore valinomycin caused a rapid and dose-dependent hyperpolarization remaining for at least 7 h. Simultaneously, a rapid and lasting metabolic decrease in the ratio monoglucosyl diglyceride/diglucosyl diglyceride occurred. The increase in potential and the decrease in the lipid ratio were both reversed in a dose-dependent manner by extracellular KCl. Likewise, the lipophilic cation tetraphenylphosphonium caused a dose-dependent decrease in membrane potential and an increase in the monoglucosyl diglyceride/diglucosyl diglyceride ratio, respectively. The ionophores monensin and particularly nigericin had similar but less pronounced effects on the potential and lipid ratios as valinomycin. The uncoupler carbonyl cyanide m-chlorophenylhydrazone had no effect on cell growth, membrane potential, or lipid regulation at 10 microM. These dissimilar structures and the low concentrations used make a direct disturbance of drug molecules on lipid packing in membranes less likely.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964648 TI - Fluid-phase assembly of the membrane attack complex of complement. AB - The dynamics and protein stoichiometry of the fluid-phase assembly of the membrane attack complex of complement were characterized by using light scattering intensity measurements. The assembly proceeded in an ordered manner with generation of stable and highly reproducible intermediates. In the absence of phospholipid or C8, mixtures of C5b-6 and C7 self-associated to fluid phase C5b-7 which had a weight-average molecular weight of (4.1 +/- 0.2) X 10(6). This corresponded to an average of nine C5b-7 complexes per particle. The particles appeared heterodisperse on sucrose gradients with S20,W values ranging from 21 to 39 S. Addition of C8 and C9 caused no further aggregation or disassembly of the particles. When excess C8 was added to the aggregated C5b-7, the ratio of C8 incorporated per C5b-7 moiety was 0.98 +/- 0.03. At saturating levels of C9, the C9/C5b-8 ratio in the particles was 7.2 +/- 0.6. Incorporation of C8 caused a small increase in the Z-averaged particle diffusion coefficient [(9.9-10.3) X 10( 8) cm2/s], indicating that it added in a manner that "filled in the gaps" in the C5b-7 particles. C9 caused only small decreases in the particle diffusion coefficient and substantially decreased the f/fmin ratio. The time course for C9 incorporation into fluid phase-C5b-8 indicated an initial rapid phase followed by a slow phase. The rapid phase corresponded to the incorporation of about one C9 for every two C5b-8 complexes. This suggested that one C9 binding site was accessible on about half of the C5b-8 complexes. This may imply that only about half of the C5b-8 complexes were capable of C9 polymerization so that the ratio of C9 incorporated per functional C5b-8 was (14 +/- 2)/1. The initial velocity of the slow phase of C9 addition gave an activation energy of 37 kcal/mol. The activation energy for C5b-8-independent polymerization of C9 had a similar value of 41 kcal/mol. Light-scattering intensity measurements seemed to be a highly reliable method for quantitative characterization of the fluid-phase assembly. PMID- 3964649 TI - Assembly of the membrane attack complex of complement on small unilamellar phospholipid vesicles. AB - Light-scattering intensity was shown to be a reliable, direct, and quantitative technique for monitoring the assembly of the membrane attack complex of complement (proteins C5b-6, C7, C8, and C9) on small unilamellar phosphatidylcholine vesicles. The assembly on vesicles occurred in a simple fashion; complexes of C5b-7 bound noncooperatively to the vesicles, and final assembly of C5b-9 did not induce vesicle aggregation or fragmentation. When C5b-6 and C7 were mixed in the presence of vesicles but at molar protein/vesicle ratios of less than 1, there was quantitative binding of C5b-7 to the vesicles with no concomitant aggregation of C5b-7. If C7 was added at a slower rate, quantitative binding was obtained at molar C5b-7/vesicle ratios of up to 5. The latter observations (a) were consistent with the proposal that C5b-7 aggregation and membrane binding were competitive events and (b) defined conditions under which light-scattering intensity measurements could monitor C5b-9 assembly on vesicles without contribution from the fluid-phase assembly. The C8/C5b-7 ratio in the phospholipid-C5b-8 complex was 0.97 +/- 0.12, and the maximum ratio of C9/C5b-8 in the final complex was 16.2 +/- 2.0. One C9 molecule associated rapidly with each phospholipid-C5b-8, followed by slower incorporation of the remaining C9 molecules. The initial velocity of the slow phase of C9 addition was easily saturated with C9 and gave an activation energy of 37 kcal/mol. This was identical with the value measured for the analogous process in the fluid-phase assembly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964650 TI - Interaction of lipoprotein lipase with phospholipid vesicles: effect on protein and lipid structure. AB - The interaction of lipoprotein lipase (LpL) and a nonhydrolyzable phosphatidylcholine, 1,2-ditetradecyl-rac-glycero-3-phosphocholine (C14-ether PC), has been studied by several physical methods. Analysis of the circular dichroic spectrum of LpL gave the following fractional conformation: 35% alpha helix, 30% beta-pleated sheet, and 45% remaining structure. No significant change in the circular dichroic spectrum of LpL was observed on addition of C14-ether-PC vesicles. The quenching of LpL fluorescence by acrylamide and iodide ion was decreased only slightly by addition of C14-ether-PC vesicles. Addition of LpL to sonicated C14-ether-PC vesicles containing entrapped carboxyfluorescein caused the release of less than 15% of the vesicle contents in 20 min, indicating that the enzyme did not disrupt the structure of the lipid. In contrast, greater than 80% of the vesicle contents were released with the addition of apolipoprotein A-I to an identical vesicle preparation. The temperature dependence of the fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene incorporated into C14 ether-PC vesicles was not significantly altered by the addition of LpL. When LpL is added to vesicles, the bilayer structure of the vesicles is not disrupted as observed by freeze-fracture electron microscopy. However, at low ionic strength (0.1-0.25 M NaCl) significant aggregation of intact vesicles is observed by light scattering and electron microscopy. Vesicle aggregation is prevented and reversed by 1 M NaCl and by heparin. These data demonstrate that LpL binds to the surface of a lipid interface, without dramatic changes in lipid bilayer or protein structure. PMID- 3964651 TI - Acylation of cellular proteins with endogenously synthesized fatty acids. AB - A number of cellular proteins contain covalently bound fatty acids. Previous studies have identified myristic acid and palmitic acid covalently linked to protein, the former usually attached to proteins by an amide linkage and the latter by ester or thio ester linkages. While in a few instances specific proteins have been isolated from cells and their fatty acid composition has been determined, the most frequent approach to the identification of protein-linked fatty acids is to biosynthetically label proteins with fatty acids added to intact cells. This procedure introduces possible bias in that only a selected fraction of proteins may be labeled, and it is not known whether the radioactive fatty acid linked to the protein is identical with that which is attached to the protein when the fatty acid is derived from endogenous sources. We have examined the distribution of protein-bound fatty acid following labeling with [3H]acetate, a general precursor of all fatty acids, using BC3H1 cells (a mouse muscle cell line) and A431 cells (a human epidermoid carcinoma). Myristate, palmitate, and stearate account for essentially all of the fatty acids linked to protein following labeling with [3H]acetate, but at least 30% of the protein-bound palmitate in these cells was present in amide linkage. In BC3H1 cells, exogenous palmitate becomes covalently bound to protein such that less than 10% of the fatty acid is present in amide linkage. These data are compatible with multiple protein acylating activities specific for acceptor protein fatty acid chain length and linkage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964652 TI - Stability and substructure of cardiac myosin subfragment 1 and isolation and properties of its heavy-chain subunit. AB - The substructure and the thermal stability of the subunit interactions of bovine cardiac myosin subfragment 1 (SF1) have been examined. The results are in agreement with previous reports that the cardiac protein is cleaved in a very similar manner [Flink, I. L., & Morkin, E. (1982) Biophys. J. 37, 34; Korner, M., Thiem, N. V., Cardinaud, R., & Lacombe, G. (1983) Biochemistry 22, 5843-5847] but at a much faster rate [Applegate, D., Azarcon, A., & Reisler, E. (1984) Biochemistry 23, 6626-6630] than the skeletal protein. Additionally, it is found that the long-lived, steady-state intermediates formed by these proteins with MgATP at high ionic strength differ in their susceptibilities to tryptic attack especially at the 27K/50K junction of the associated heavy chains, suggesting a different conformation for these intermediates of the cardiac and skeletal SF1's. The thermal stability of the subunit interactions under conditions approaching the physiological state was examined by thermal ion-exchange chromatography of cardiac SF1 at 39.5 degrees C in the presence of MgATP. This results in the separation of part of the protein as the isolated heavy chain which is found to exhibit high levels of ATPase activity in the absence and presence of actin. Tryptic digestion of cardiac SF1 prior to thermal ion-exchange chromatography produces greater dissociation, with the heavy chain in this case being isolated as a complex of 27K, 50K, and 18-20K fragments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964653 TI - Tetanus toxin is labeled with photoactivatable phospholipids at low pH. AB - The mechanism of cell penetration by tetanus toxin is unknown; it has been suggested that the toxin may penetrate into the lipid bilayer from a low-pH vesicular compartment. In this work, the interaction of tetanus toxin with liposomal model membranes has been studied by following its photoinduced cross linking with either a nitrene or a carbene photolytically generated from corresponding light-sensitive phosphatidylcholine analogues. The toxin was labeled only at pHs lower than 5.5. The low pH acquired hydrophobicity of tetanus toxin appears to be confined to its light chain and to the 45-kDa NH2-terminal fragment of the heavy chain. Negatively charged lipids promote the interaction of this toxin with the hydrocarbon chain of phospholipids. The relevance of the present findings to the possible mechanism of nerve cell penetration by tetanus toxin is discussed. PMID- 3964654 TI - Metal anthracycline complexes as a new class of anthracycline derivatives. Pd(II) adriamycin and Pd(II)-daunorubicin complexes: physicochemical characteristics and antitumor activity. AB - Pd(II) complexes of two anthracyclines, adriamycin and daunorubicin, have been studied. Using potentiometric absorption, fluorescence, and circular dichroism measurements, we have shown that adriamycin can form two complexes with Pd(II). The first complex (I) involves two molecules of drug per Pd(II) ion; one of the molecules is chelated to Pd(II) through the carbonyl oxygen on C12 and the phenolate oxygen on C11, and the other one is bound to Pd(II) through the nitrogen of the amino sugar. This complexation induces a stacking of the two molecules of drug. In the second complex (II), two Pd(II) ions are bound to two molecules of drug (A1 and A2). One Pd(II) is bound to the oxygen on the carbons C11 and C12 of molecule A1 and the amino sugar of molecule A2 whereas the second Pd(II) ion is bound to the oxygen on C11 and C12 of molecule A2 and the amino sugar of molecule A1. The same complexes are formed between Pd(II) and daunorubicin. The stability constant for complex II is beta = (1.3 +/- 0.5) X 10(22). Interaction with DNA has been studied, showing that almost no modification of the complex occurred. This complex displays antitumor activity against P-388 leukemia that compares with that of the free drug. Complex II, unlike adriamycin, does not catalyze the flow of electrons from NADH to molecular oxygen through NADH dehydrogenase. PMID- 3964655 TI - Light-scattering investigation of the subunit structure and dissociation of octopoda hemocyanins. AB - The molecular weights, subunit dissociation, and conformation in solution of the hemocyanins of three species of octopi were investigated by light-scattering, ultracentrifugation, absorbance, and circular dichroism methods. The molecular weights of the hemocyanins of Octopus bimaculoides, Octopus bimaculatus, and Octopus rubescens obtained by light scattering were 3.3 X 10(6), 3.4 X 10(6), and 3.5 (+/- 0.3) X 10(6), respectively. The average molecular weights of the fully dissociated hemocyanins of the same octopi, investigated at alkaline pH and in the presence of 8 M urea and 6 M guanidinium chloride (GdmCl), were found to be close to one-tenth of those of the parent proteins, with average molecular masses of 3.4 X 10(5), 3.3 X 10(5), and 3.3 (+/- 0.3) X 10(5). These findings confirm the earlier observations of van Holde and co-workers with other cephalopod hemocyanins that the basic cylindrical assembly of molluscan hemocyanins consists of 10 subunits. Circular dichroism and absorbance measurements suggest that the dissociated subunits at alkaline pH and in concentrated urea solutions retain their native, multidomain folding. Fairly concentrated GdmCl above 3-4 M is necessary to unfold fully the dissociated hemocyanin chains. Molecular weight measurements studied as a function of reagent concentration with the urea and Hofmeister salt series as dissociating agents show that the ureas are very effective dissociating agents, while the salts are ineffective to moderately effective reagents for octopus hemocyanin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964656 TI - Neoglycoproteins: preparation and properties of complexes of biotinylated asparagine-oligosaccharides with avidin and streptavidin. AB - Neoglycoproteins in which the oligosaccharide moieties are attached noncovalently to the protein through a high-affinity ligand have been prepared from biotinylated oligosaccharides and avidin or the nonglycosylated microbial analogue streptavidin. One of the asparagine-oligosaccharides purified from Pronase-digested ovalbumin (Man6-GlcNAc2-Asn) was reacted with an excess of the hydroxysuccinimide ester of biotin or, for the purpose of quantitation, [3H]biotin. Derivatives were also prepared with an extension "arm", a 6 aminohexanoyl group, between biotin and asparagine. When the purified biotinyl Asn-oligosaccharide was added to avidin or streptavidin, a complex was formed containing 3 mol of oligosaccharide/mol of protein. The complexes were stable at neutral pH in the absence of biotin and could be dialyzed for 2 weeks without any significant loss of ligand. In the presence of biotin, or under denaturing conditions, the oligosaccharide derivative was released and could be quantitatively recovered. To assess the influence of the protein matrix on the reactivity of the oligosaccharide units, free biotinyl-Asn-oligosaccharide and the corresponding avidin and streptavidin complexes were exposed to alpha mannosidase in parallel experiments. The rate of hydrolysis of the free derivative was severalfold faster than that of the two protein complexes, and at the time when about 90% of the free derivative had all five alpha-mannosyl residues removed, the majority of the protein-bound derivatives contained two to four undigested alpha-mannosyl residues and also had a significant amount of undigested starting material. The ease of preparation and the properties of these neoglycoproteins suggest that they should be excellent models for the study of glycoprotein-receptor binding and glycoprotein processing. PMID- 3964657 TI - Fusion and phase separation monitored by lifetime changes of a fluorescent phospholipid probe. AB - The sensitivity of the fluorescence lifetime of 1-palmitoyl-2-[[2-[4- (6-phenyl trans-1,3,5-hexatrienyl)phenyl]ethyl]carbonyl]- 3-sn-phosphatidylcholine (DPHpPC) to its local concentration in lipid bilayers was used to monitor both lipid mixing and phase separation occurring during membrane vesicle fusion. Vesicles containing 2 mol % DPHpPC were mixed with a 10-fold excess of vesicles devoid of probe. Upon addition of a fusogen, mixing of bilayer lipids associated with fusion was followed as an increase in the fluorescence lifetime of DPHpPC. Ca2+ induced fusion of phosphatidylserine vesicles served to test the method and was shown to have an exponential half-time of 7 s. Phase separation (between the phosphatidylserine head groups of bulk lipid and the phosphatidylcholine head groups of the probe) was monitored by DPHpPC under the same conditions used to follow lipid mixing due to fusion. Phase separation was not significant until 10 min after Ca2+ addition and was completely reversible by disodium ethylenediaminetetraacetate addition. Vesicle aggregation induced by Ca2+ addition to mixed phosphatidylserine/phosphatidylcholine vesicles did not alter the DPHpPC lifetime, indicating that close association of vesicles did not promote intervesicular exchange of the probe. In addition, we have investigated the effects of CA2+ on the fluorescence properties of this probe and of the head group-labeled fluorescent probes N-(4-nitro-2,1,3 benzoxadiazolyl)phosphatidylethanolamine and N-(lissamine Rhodamine B sulfonyl)dioleoyl-phosphatidylethanolamine, which are used in the fluorescence energy transfer assay of Struck et al.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964658 TI - Structural studies of the O6meG.C interaction in the d(C-G-C-G-A-A-T-T-C-O6meG-C G) duplex. AB - One- and two-dimensional nuclear magnetic resonance (NMR) experiments have been undertaken to investigate the conformation of the d(C1-G2-C3-G4-A5-A6-T7-T8-C9 O6meG10-C11-G12) self-complementary dodecanucleotide (henceforth called O6meG.C 12-mer), which contains C3.O6meG10 interactions in the interior of the helix. We observe intact base pairs at G2.C11 and G4.C9 on either side of the modification site at low temperature though these base pairs are kinetically destabilized in the O6meG.C 12-mer duplex compared to the G.C 12-mer duplex. One-dimensional nuclear Overhauser effects (NOEs) on the exchangeable imino protons demonstrate that the C3 and O6meG10 bases are stacked into the helix and act as spacers between the flanking G2.C11 and G4.C9 base pairs. The nonexchangeable base and H1', H2', H2'', H3', and H4' protons have been completely assigned in the O6meG.C 12-mer duplex at 25 degrees C by two-dimensional correlated (COSY) and nuclear Overhauser effect (NOESY) experiments. The observed NOEs and their directionality demonstrate that the O6meG.C 12-mer is a right-handed helix in which the O6meG10 and C3 bases maintain their anti conformation about the glycosidic bond at the modification site. The NOEs between the H8 of O6meG10 and the sugar protons of O6meG10 and adjacent C9 exhibit an altered pattern indicative of a small conformational change from a regular duplex in the C9-O6meG10 step of the O6meG.C 12-mer duplex. We propose a pairing scheme for the C3.O6meG10 interaction at the modification site. Three phosphorus resonances are shifted to low field of the normal spectral dispersion in the O6meG.C 12-mer phosphorus spectrum at low temperature, indicative of an altered phosphodiester backbone at the modification site. These NMR results are compared with the corresponding parameters in the G.C 12-mer, which contains Watson-Crick base pairs at the same position in the helix. PMID- 3964659 TI - Structural studies of the O6meG.T interaction in the d(C-G-T-G-A-A-T-T-C-O6meG-C G) duplex. AB - High-resolution proton and phosphorus NMR studies are reported on the self complementary d(C1-G2-T3-G4-A5-A6-T7-T8-C9-O6meG10-C11-G12) duplex (henceforth called O6meG.T 12-mer), which contains T3.O6meG10 interactions in the interior of the helix. The imino proton of T3 is observed at 9.0 ppm, exhibits a temperature independent chemical shift in the premelting transition range, and broadens out at the same temperature as the imino proton of the adjacent G2.C11 toward the end of the helix at pH 6.8. We observed inter base pair nuclear Overhauser effects (NOEs) between the base protons at the T3.O6meG10 modification site and the protons of flanking G2.C11 and G4.C9 base pairs, indicative of the stacking of the T3 and O6meG10 bases into the helix. Two-dimensional correlated (COSY) and nuclear Overhauser effect (NOESY) studies have permitted assignment of the base and sugar H1', H2', and H2'' nonexchangeable protons in the O6meG.T 12-mer duplex. The observed NOEs demonstrate an anti conformation about all the glycosidic bonds, and their directionality supports formation of a right-handed helix in solution. The observed NOEs between the T3.O6meG10 interaction and the adjacent G2.C11 and G4.C9 base pairs at the modification site exhibit small departures from patterns for a regular helix in the O6.meG.T 12-mer duplex. The phosphorus resonances exhibit a 0.5 ppm spectral dispersion indicative of an unperturbed phosphodiester backbone for the O6meG.T 12-mer duplex. We propose a model for pairing of T3 and O6meG10 at the modification site in the O6meG.T 12 mer duplex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964660 TI - Direct NMR evidence that prolidase is specific for the trans isomer of imidodipeptide substrates. AB - The in vitro hydrolysis by porcine kidney prolidase of the imidodipeptide L alanyl-L-proline was monitored by using 1H high-resolution NMR spectroscopy. The dipeptide exists as an equilibrium mixture of isomers with cis or trans conformation about the peptide bond. The 13C and 1H NMR spectra of the dipeptide displayed well-resolved resonances for each isomer. Inversion-transfer NMR spectroscopy, with a recently developed pulse sequence, was used with a range of temperatures to calculate the unitary rate constants for the exchange between isomers. A new analytical procedure was introduced for directly obtaining estimates of the unitary rate constants from inversion-transfer data. Arrhenius analysis yielded an activation energy for the isomerization of 87.0 +/- 4.1 kJ mol-1. 1H NMR time courses of the prolidase-catalyzed hydrolysis of L-alanyl-L proline showed a faster removal of the trans isomer as the [enzyme]/[substrate] ratio was increased. The transient-kinetic information coupled with the steady state kinetic parameters of the enzyme was used to develop two possible models of the overall hydrolytic reaction. Numerical integration of the relevant differential equations using the experimentally determined rate constants gave simulated progress curves that enabled selection of one of the proposed schemes as being the most likely; this proposal entailed absolute specificity of prolidase for the trans isomer of L-alanyl-L-proline. Finally, on the basis of the present work, and information from the literature, we have proposed a new model of the active site of the enzyme. PMID- 3964661 TI - Development of a radioimmunoassay for quantitation of calregulin in bovine tissues. AB - Experimental conditions are described for a convenient and simple one-step method for radioimmunoassay (RIA) of the calcium binding protein calregulin [Waisman, D.M., Salimath, B.P., & Anderson, M.J. (1985) J. Biol. Chem. 260, 1652-1660]. The radioimmunoassay utilizes 125I-labeled calregulin and pansorbin cells (Staphylococcus aureus) coated with rabbit anti-calregulin antibody. Binding equilibrium is attained in 30 min, and the total time of the assay is 1 h. The assay is sensitive to about 30 fmol of calregulin. Calregulin was quantitated in various bovine tissue extracts and was detected in all tissues except erythrocytes. It was present in particularly high amounts in pancreas (540 micrograms/g of tissue), liver (375 micrograms/g of tissue), and testis (256 micrograms/g of tissue). While about 80% of the total tissue calregulin is soluble, about 20% of this protein was found to be associated with particulate fractions. Unmasking of particulate calregulin required the presence of nonionic detergent. Gel permeation chromatography of bovine brain 100 000 g supernatant in the presence or absence of calcium has resolved a single peak of calregulin by RIA. In addition, the distribution of calregulin in the soluble or particulate fraction of bovine brain was unaffected by the presence or absence of calcium during homogenization, suggesting that calregulin does not form either calcium dependent or calcium-independent association with soluble or particulate proteins. These results identify calregulin as a major tissue Ca2+ binding protein. PMID- 3964662 TI - Hydration of cellobial by exo- and endo-type cellulases: evidence for catalytic flexibility of glycosylases. AB - New insight has been obtained into the catalytic capabilities of cellulase. Essentially homogeneous preparations of exo- (or Avicelase-) type and endo- (or CMCase-) type cellulases from Irpex lacteus and Aspergillus niger, respectively, were shown to hydrate the enolic bond of cellobial to form 2-deoxycellobiose. The A. niger enzyme also synthesized a small amount of a 2-deoxycellobiosyl-transfer product from cellobial. By use of digests conducted in deuterated buffer and 1H NMR spectra for product analysis, both cellulases were found to protonate (deuterate) the double bond of cellobial from below the si face of the D-glucal moiety, i.e., from a direction opposite that assumed for protonation of the beta D-glycosidic linkages of cellulose and cellodextrins. The exo enzyme, which hydrolyzes the latter substrates primarily to cellobiose, rapidly catalyzed cellobial hydration to produce the beta-anomer of beta-D-glucopyranosyl(1----4)-2 deoxy-D-glucose-2(e)-d. The A. niger cellulase produced the same 2 deoxycellobiose-d from cellobial, though too slowly for its configuration to be determined. However, evidence was obtained for the formation of a beta-2 deoxycellobiosyl-d-D-glucose-transfer product by the enzyme. Thus, it is likely that all of the observed reactions with cellobial represent trans additions at the double bond. In any case, the anomeric configuration of products is created de novo. Separate mechanisms are described for the reaction of cellobial hydration and for the stereochemically different reaction of cellulose hydrolysis catalyzed by the present enzymes, assuming an arrangement of their catalytic groups analogous to that found in lysozyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964663 TI - Comparison of the triacylglycerol hydrolase activity of human post-heparin plasma lipoprotein lipase and hepatic triacylglycerol lipase. A monolayer study. AB - Interfacial catalysis of hepatic triacylglycerol lipase (H-TGL) and lipoprotein lipase (LpL) isolated from human post-heparin plasma was investigated with mixed monolayers of trioleoylglycerol (TO) and egg phosphatidylcholine. Rates of enzyme catalysis were dependent on surface pressure, substrate concentration, apoC-II (the activator protein for LpL), and cholesteryl oleate (CO). LpL showed a surface pressure optimum between 22 and 24 mN m-1, whereas H-TGL activity decreased at pressures greater than 20 mN m-1. LpL activity was enhanced greater than 10-fold by apoC-II; 1 M NaCl inhibited enzyme activity. ApoC-II, apoC-III, apoA-I, apoA-II, and 1 M NaCl had no effect on H-TGL activity. The substrate (TO) dependency was different for the two lipases. For LpL, there was a marked enhancement of enzyme activity between 2 and 4 mol % TO, whereas for H-TGL, enzyme activity increased linearly between 1 and 10 mol % TO. LpL activity toward monolayers containing 2 mol % TO was enhanced 2.6-fold by the addition of 5 mol % CO; cholesteryl ester had no effect on H-TGL activity. These findings suggest that the two lipolytic enzymes have different interfacial properties, which may have relevance to the rates of hydrolysis of triacylglycerols at a lipoprotein interface. PMID- 3964664 TI - Androgen induction of messenger RNA concentrations in mouse kidney is posttranscriptional. AB - The concentrations of several mRNAs in mouse kidney increase in response to testosterone. To determine if the increases are generated at the level of gene transcription, we have assayed transcription rates for several androgen-inducible mRNAs in kidney nuclei in vitro. No significant changes were found in the synthesis of three mRNAs whose concentrations increase 10-20-fold during testosterone treatment. Kinetic analysis of changes in transcript levels after testosterone administration and withdrawal suggests that mRNA stabilization is a major factor in the inductions. Thus, the androgen-mediated induction of these kidney mRNAs is generated predominantly at the posttranscriptional level. PMID- 3964665 TI - Crystal structure of the promutagen O4-methylthymidine: importance of the anti conformation of the O(4) methoxy group and possible mispairing of O4 methylthymidine with guanine. AB - O4-Methylthymidine (O4medT) is a promutagen. To correlate its biological properties to changes in the electronic, geometric, and conformational properties of the pyrimidine base resulting from the keto to enol shift arising from methylation, an X-ray study of O4medT was undertaken. The crystal data are a = 4.950 (2) A, b = 12.648 (1) A, c = 19.305 (2) A, space group P2(1)2(1)2(1), Z = 4, and R = 0.042. The D-deoxyribofuranosyl ring is puckered in the uncommon 1T2 twist conformation with the phase angle of pseudorotation P = 133.8 (5)degrees. The amplitude of puckering tau m = 31.4 (3)degrees shows that the ring is considerably flattened. The base is in the anti conformation [chi CN = 40.6 (4)degrees], and the exocyclic C(4')-C(5') bond (psi) is gauche+ [46.2 (5)degrees]. Methylation produces cytosine-like conjugation for the thymine base. The methoxy group takes the syn-periplanar conformation. Two types of mispairings with guanine are possible, and both require the anti conformation for the O(4) methoxy group. Semiempirical energy calculations have been carried out and reveal that the anti conformation can be energetically assumed in the double helix by widening the exocyclic angles C(5)-C(4)-O(4) and C(4)-C(5)-C(7) and the angle C(4)-O(4)-C(8) at the methoxy group. Such coordinated expansion relieves unfavorable interactions between the C(7) and C(8) methyl groups. PMID- 3964666 TI - Excited-state proton transfer of equilenin and dihydroequilenin: interaction with bilayer vesicles. AB - The two-state excited-state proton-transfer process for d-equilenin [d-3 hydroxyestra-1,3,-5(10),6,8-pentaen-17-one] and dihydroequilenin is found to depend both on pH and on proton acceptor concentration. Both the protonated and deprotonated forms of the excited molecule are fluorescent. As is the case for 2 naphthol, the excited-state pKa (pKa*) is substantially lower than the ground state pKa. Fluorescence decay studies have been performed as a function of emission wavelength in aqueous solutions at pH 6.9 in the presence of acetate anion (0.1 M). At this pH, both back-reaction from the excited-state and ground state heterogeneity are minimal. A monoexponential decay is found in the blue region of the spectrum and a biexponential decay on the red edge. The lifetimes measured across both regions are constant, with a negative preexponential term, characteristic of an excited-state reaction, evident at longer wavelengths. Decay associated spectra (DAS), the preexponential terms associated with the measured lifetimes, have been acquired for these aqueous solutions. Equilenin and dihydroequilenin are found to adsorb to dimyristoyllecithin (DML) vesicles. Rates for excited-state proton transfer are greatly reduced when dihydroequilenin adsorbs to vesicles. The accessibility of the bound probe to acetate as a proton acceptor depends on the cholesterol content of the vesicles. PMID- 3964667 TI - Spontaneous transmembrane insertion of membrane proteins into lipid vesicles facilitated by short-chain lecithins. AB - Functional reconstitution of the membrane protein bacteriorhodopsin into lipid vesicles is achieved by mixing aqueous suspensions of long-chain lecithins and purple membrane with the short-chain lecithin diheptanoylphosphatidylcholine (20 mol % of total lipid). The membrane protein is transmembranously inserted in the lipid bilayer of the vesicle and highly active as a light-energized proton pump. This rapid, easy, and gentle procedure might allow functional reconstitution of other membrane systems and isolated membrane proteins as well. PMID- 3964668 TI - Isolation and characterization of a soybean lectin having 4-O-methylglucuronic acid specificity. AB - A new lectin from soybeans having specificity toward the extracellular 4-O-methyl D-glucurono-L-rhamnans produced by certain strains of Rhizobium japonicum has been purified and characterized. Isolation was accomplished initially by isoelectric precipitation of contaminating globulins and subsequently by affinity chromatography on partially hydrolyzed glucuronorhamnan covalently coupled to amino-hexylagarose. Residual globulins were removed by adsorption of the lectin on concanavalin A-agarose and elution with methyl alpha-mannoside. The lectin is a glycoprotein (3-5% carbohydrate) with a molecular weight of approximately 175 000. It is a tetramer with subunit molecular weights of 45 000 when dissociated with sodium dodecyl sulfate. Reverse-phase high-pressure liquid chromatography analysis indicates the presence of two types of subunits, both having equivalent molecular weights. According to amino acid analyses, the lectin is rich in acidic but low in sulfur-containing amino acids. The carbohydrate portion of the lectin contains mannose; no hexosamines could be detected. Chemical modification of the lectin indicated that neither sulfhydryl groups nor amino groups participate in binding. Quantitative binding studies of the lectin with various carbohydrate haptens showed that specificity was directed toward 4-O-methyl-D-glucuronic acid, D-glucuronic acid, and their methyl glycosides with 4-O-methyl-D-glucuronic acid 3-4-fold more effective. In each instance, the methyl glycoside is a more effective hapten. PMID- 3964669 TI - In vitro collagen fibril assembly in glycerol solution: evidence for a helical cooperative mechanism involving microfibrils. AB - Glycerol inhibits the in vitro self-association of monomeric collagen into fibrils and induces the dissociation of fibrils preassembled from NaBH4-reduced collagen. These effects were investigated in an effort to understand the mechanism of fibril assembly of the protein. In PS buffer (0.03 M NaPi and 0.1 M NaCl, pH 7.0) containing 0.1-1.0 M glycerol, the self-association of type I collagen from calf skin took place only if the protein concentration was above a critical value. This critical protein concentration increased with increasing glycerol concentration. Velocity sedimentation studies showed that below the critical protein concentration and under fibril assembly conditions, the collagen was predominantly in a monomeric state. Electron microscopic examinations revealed that the collagen aggregates formed above the critical concentration consisted mostly of microfibrils of 3-5-nm diameter along with some banded fibrils were found. Collagen treated with pepsin to remove its nonhelical telopeptides also self-associated into microfibrils and fibrils in the presence of glycerol, but the reaction did not exhibit any critical concentration. These results are consistent with a mechanism of in vitro collagen fibril assembly which involves the initial formation of microfibrils through a helical cooperative mechanism. They also suggest that contacts of the nonhelical telopeptides of each collagen with its neighboring molecules provide the necessary negative free energy change for the cooperativity and that subsequent lateral association of the microfibrils leads to banded fibrils. PMID- 3964670 TI - Interaction of calf skin collagen with glycerol: linked function analysis. AB - Glycerol stabilizes the triple-helical structure of solubilized calf skin collagen. The equilibrium melting temperature of the protein increased linearly from 38.0 degrees C in AS buffer (0.01 M NaOAc and 0.02 M NaCl, pH 4.0) to 43.0 degrees C in AS and 6 M glycerol buffer. To understand the thermodynamic basis of this effect on the equilibrium melting temperature and the glycerol inhibition of collagen self-association, the preferential interactions of native and denatured calf skin collagens in AS buffer containing 1.5, 3, and 4.5 M glycerol were measured with a precision densimeter. The results indicated that native collagen binds glycerol preferentially whereas denatured collagen neither binds nor repels glycerol. The preferential binding of glycerol by native collagen, when interpreted in terms of the three-component solution thermodynamics, suggests that the surface interaction of native collagen with glycerol is energetically more favorable than its interaction with water. By use of the Wyman linked function, the negative chemical potential change of collagen derived from its preferential binding of glycerol can account for both the glycerol stabilization of the triple-helical structure of collagen and the inhibition of in vitro self association of monomers into fibrils. PMID- 3964671 TI - Spectroscopic study of environment-dependent changes in the conformation of the isolated carboxy-terminal telopeptide of type I collagen. AB - The C-terminal telopeptide of the alpha 1 chain of type I collagen from bovine skin was isolated from a bacterial collagenase digest. Two forms of the telopeptide were obtained, one with two and the other with three residues of tyrosine. In both of these, the single lysyl residue had been oxidized to alpha aminoadipic delta-semialdehyde. Circular dichroism spectra of the telopeptide in aqueous solution at neutral pH were interpreted as indicating the presence of little regular secondary structure. However, sodium dodecyl sulfate at a concentration of 40 mM induced some alpha helix, as predicted from the sequence, and trifluoroethanol also induced secondary structure, probably a mixture of alpha helix and beta sheet. A major feature of the circular dichroism spectra of the telopeptide in sodium dodecyl sulfate, in denaturing agents, and in sodium phosphate buffer at low temperature was a positive band at 227 nm due to tyrosine side-chain chromophores. The disappearance of this band on heating and at high pH was ascribed to the adoption by the telopeptide of a specific tertiary structure. Poly(ethylene glycol) 1000 used as a perturbant in UV difference spectroscopy caused conformational changes resulting in decreased accessibility of tyrosine side chains and transfer of these to a less polar environment. A structural model in which the four aromatic side chains of the telopeptide are arranged in two pairs with the rings antiparallel is proposed to account for these results. PMID- 3964672 TI - DNA synthesis in BalB/C-3T3 ts 2 cells is restricted by a temperature-sensitive function of late G1 phase. AB - ts 2 BalB/C-3T3 mouse fibroblasts are cdc mutants, which arrest late in G1, at or near the G1/S traverse, upon full expression of the heat-sensitive lesion. The kinetics of temperature inhibition of DNA synthesis in logarithmically growing cultures reveal three stages of heat inactivation. During the first generation time equivalent, normal semiconservative, semidiscontinuous replication proceeds but is reduced as cells exit and do not reenter S phase. During a second such period, a minimal rate of normal DNA synthesis is maintained. Thereafter, as the cells move into a third aborted cell division cycle, the rate of DNA synthesis increases. However, all semiconservative synthesis is then replaced by DNA repair replication. Temperature inactivation of the ts 2 protein results in shutdown of nuclear DNA synthesis. In contrast, normal replication of mitochondrial DNA proceeds at control rate throughout the first stage of temperature inactivation. Synthesis of this organellar genome is quantitatively reduced as the cells move into the second phase of heat inhibition. Titration of chromatin-bound DNA with ethidium bromide revealed that wild-type cells exhibit a changing DNA topology as the temperature is raised. Temperature-inactivated ts 2 cells behave as though their DNA has been topologically frozen in the configuration of control cells at or near entry into S phase. PMID- 3964673 TI - Proton nuclear magnetic resonance investigation of the spin-state equilibrium of the alpha and beta subunits in intact azidomethemoglobin. AB - The hyperfine-shifted proton NMR spectra of human azidomethemoglobin were examined at 300 MHz in the 2-60 degree C range. From analysis of the temperature dependent heme methyl shifts, the thermal spin-state equilibria of the alpha and beta subunits were independently analyzed in the intact tetramer. The thermodynamic values of the spin equilibrium of the alpha and beta subunits were comparable, suggesting that the spin equilibrium properties of the constituent subunits are similar to each other. Examination of the azidomethemoglobins reconstituted with deutero- or mesohemin further shows that the alpha and beta subunit difference is still small in these hemoglobins probably due to the smallness of the steric and electronic difference of the heme 2,4-substituents of the examined porphyrins. The similarity of the spin equilibrium profiles of the subunits indicates that the strain imposed from the globin to the heme iron is of comparable magnitude for the alpha and beta subunits within the azidomethemoglobins. PMID- 3964674 TI - Peroxidase-catalyzed covalent binding of the antitumor drug N2-methyl-9 hydroxyellipticinium to DNA in vitro. AB - In the presence of DNA, the antitumor drug N2-methyl-9-hydroxyellipticinium (elliptinium; NMHE) [Le Pecq, J. B., Gosse, C., Dat-Xuong, N., & Paoletti, C. (1975) C. R. Seances Acad. Sci., Ser. D 281, 1365-1367] is oxidized by the horseradish peroxidase-hydrogen peroxide (HRP-H2O2) system to the quinone imine derivative N2-methyl-9-oxoellipticinium (NMOE) [Auclair, C., & Paoletti, C. (1981) J. Med. Chem. 24, 289-295], which interacts with DNA according to the intercalation mode. When excess H2O2 was used, the major part of the quinone imine was further oxidized to the o-quinone N2-methyl-9,10-dioxoellipticinium [Bernadou, J., Meunier, G., Paoletti, C., & Meunier, B. (1983) J. Med. Chem. 26, 574-579]. In the presence of stoichiometric amounts of H2O2 (H2O2/NMHE = 1), NMOE reacts with DNA, yielding a fluorescent compound irreversibly linked to the nucleic acid, which is related to the covalent binding of the ellipticinium chromophore. Under optimal reaction conditions, NMHE binding occurs according to a first-order process (k = 4.3 X 10(-3) min-1) with a linear increase with respect to drug to nucleotide ratio up to a maximum binding of 1 NMHE per 20 base pairs (r = 0.05). The fluorescence spectra (ex, 330 nm; em, 548 nm) of NMHE bound to DNA, the occurrence of energy transfer from the DNA to the drug, and the DNA length increase of the DNA-NMHE adduct suggest that the binding occurs at the intercalating site with limited denaturation of the DNA helix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964675 TI - X-ray absorption studies of myoglobin peroxide reveal functional differences between globins and heme enzymes. AB - X-ray absorption studies of myoglobin peroxide show that although it is not identical with compound I or II of horseradish peroxidase [Chance, B., Powers, L., Ching, Y., Poulos, T., Yamazaki, I., & Paul, K. G. (1984) Arch. Biochem. Biophys. 235, 596-611], it has some structural features in common with both. As seen in compound I, the Fe-O distance is short, but the iron-pyrrole nitrogen distance is contracted with a longer iron-histidine distance like compound II. The iron has a higher oxidation state than Fe3+, suggesting an oxyferryl ion type species. Comparison of the structures of various peroxidase and myoglobin compounds points out systematic differences that may explain the catalytic activity of the pi cation radical as well as some of the differences between globins and heme enzymes. PMID- 3964676 TI - Creatine kinase isoenzymes in Torpedo californica: absence of the major brain isoenzyme from nicotinic acetylcholine receptor membranes. AB - Creatine kinase, actin, and nu 1 are three proteins of Mr 43 000 associated with membranes from electric organ highly enriched in nicotinic acetylcholine receptor. High levels of creatine kinase are required to maintain adequate ATP levels, while actin may play a role in maintaining the synaptic cytoskeleton. Previous investigations have prompted the conclusion that postsynaptic specializations at the receptor-enriched membrane domains in electroplax contain the brain form of creatine kinase rather than the form of creatine kinase predominantly found in muscle. We have examined this conclusion by purifying Torpedo brain creatine kinase to virtual homogeneity in order to examine its immunochemical, molecular, and electrophoretic properties. On the basis of immunological cross-reactivity and isozyme analysis, the receptor-associated creatine kinase is identified to be of the muscle type. When the molecular characteristics of Torpedo brain and muscle creatine kinase are compared, the brain enzyme is positioned at a more basic pH during chromatofocusing and on two dimensional gel electrophoresis (pI = 7.5-7.9). Furthermore, electrophoretic mobilities of the brain and muscle forms of creatine kinase differ in sodium dodecyl sulfate electrophoresis: the brain isozyme of creatine kinase has lower apparent molecular weight (Mr 41 000) when compared with the muscle enzyme (Mr 43 000). On the basis of the results of our current investigations, the hypothesis that the brain isozyme of creatine kinase is a component of the postsynaptic specializations of the Torpedo californica electroplax must be abandoned. Recent sequence data have established close homology between Torpedo and mammalian muscle creatine kinases. On the basis of electrophoretic criteria, our results indicate that a lower degree of homology exists between the brain isozymes. PMID- 3964677 TI - Synthesis of DNA polymerase alpha analyzed by immunoprecipitation from synchronously proliferating cells. AB - Synchronously proliferating TC7 monkey and 3T3 mouse cells were pulse labeled with [35S]methionine. Radioactively labeled DNA polymerase alpha was immunoprecipitated with polymerase-specific monoclonal antibodies. The precipitated polypeptides were identified by gel electrophoresis and fluorography. The increase in DNA polymerase alpha activity during S phase was accompanied by an increased synthesis of the enzyme. Some DNA polymerase alpha was synthesized in growth-arrested TC7 cells whereas the synthesis of the large polymerase subunit in 3T3 cells was strictly coupled to the replicative phase of the cell cycle. We also found that DNA polymerase alpha was more prone to proteolysis in TC7 cells than in 3T3 cells. In 3T3 cells, a polymerase subunit with an apparent molecular weight of 186 000 was observed; this subunit was most probably associated with two smaller subunits of Mr 74 000 and 52 000. Synthesis of these three polymerase-associated polypeptides appeared to be regulated differently. PMID- 3964678 TI - Ricinus communis agglutinin-mediated agglutination and fusion of glycolipid containing phospholipid vesicles: effect of carbohydrate head group size, calcium ions, and spermine. AB - The glycolipids galactosylcerebroside (GalCer), lactosylceramide (LacCer), and trihexosylceramide (Gb3) were inserted into phospholipid vesicles, consisting of phosphatidylethanolamine and phosphatidic acid. The extent to which their carbohydrate head groups protruded beyond the vesicle surface and their interference with membrane approach were examined by determining vesicle susceptibility toward type I Ricinus communis agglutinin (RCA1) induced agglutination and Ca2+- and spermine-induced aggregation and fusion either in the presence or in the absence of the lectin. The initial agglutination rates increased in the order GalCer much less than LacCer less than Gb3, while a reversed order was obtained for Ca2+- and spermine-induced aggregation and fusion, indicating an enhanced steric interference on close approach of bilayers with increasing head group size. The lectin-mediated agglutination rates for LacCer- and Gb3-containing vesicles increased by an order of magnitude when Ca2+ was also included in the medium, at a concentration that did not induce aggregation per se. Charge neutralization could not account for this observation as the polyvalent cation spermine did not display this synergistic effect with RCA1. Addition of Ca2+ to preagglutinated vesicles substantially reduced the threshold cation concentration for fusion (micromolar vs. millimolar). Quantitatively, this concentration decreased with decreasing carbohydrate head group size, indicating that the head group protrusion determined the interbilayer distance within the vesicle aggregate. The distinct behavior of Ca2+ vs. spermine on RCA1-induced agglutination on the one hand and fusion on the other indicated that Ca2+ regulates the steric orientation of the carbohydrate head group, which appears to be related to its ability to dehydrate the bilayer. As a result, lectin agglutinability becomes enhanced while fusion will be interrupted as the interbilayer distance increases, the threshold head group size being three carbohydrate residues (Gb3). Finally, GalCer-containing vesicles were not agglutinated by RCA1 at ambient temperature, irrespective of the presence of Ca2+. Above 25 degrees C, RCA1 facilitated Ca2+-induced fusion of the vesicles, which was abolished by the haptenic sugar lactose. Since Gb3- and LacCer containing vesicles displayed a similar behavior, a temperature-induced alteration in the supporting lipid matrix is suggested, which apparently affects lectin/glycolipid interaction. PMID- 3964679 TI - X-ray diffraction evidence for fully interdigitated bilayers of 1 stearoyllysophosphatidylcholine. AB - X-ray diffraction experiments have been performed on 1 stearoyllysophosphatidylcholine or C(18):C(0)PC as a function of hydration at temperatures below the order/disorder transition (Tm = 26.2 degrees C). At these temperatures, hydrated C(18):C(0)PC forms lamellae. The bilayer thickness, as determined by the saturation hydration method and electron-density profile, is 35 36 A, and the average area per C(18):C(0)PC molecule at the lipid/water interface is 45.5 A2. The packing geometry of C(18):C(0)PC in the lamella is proposed to adopt a fully interdigitated model in which the long C(18) acyl chain extends across the entire hydrocarbon width of the bilayer. Thus far, three different types of interdigitated bilayers are known for phosphatidylcholines. These various types of chain interdigitation are discussed in terms of the chain length difference between the sn-1 and sn-2 acyl chains. PMID- 3964680 TI - Structure-function relationship of islet-activating protein, pertussis toxin: biological activities of hybrid toxins reconstituted from native and methylated subunits. AB - Islet-activating protein (IAP), pertussis toxin, is a hexameric protein composed of an A protomer and a B oligomer, the residual pentamer having such a subunit assembly that two different dimers, dimer 1 and dimer 2, are connected with each other by means of the smallest C subunit. Incubation of IAP with formaldehyde and pyridine-borane produced the modified toxin in which most of the free amino groups were dimethylated. The methylated and nonmethylated (native) IAP were disintegrated into their respective constituent components, which were then cross combined to reconstitute hybrid toxins with the original hexameric structure. The binding of the B oligomer to the mammalian cell surface via dimer 2 was, but the binding via dimer 1 was not, seriously impaired by methylation of amino groups in the protein. The binding of the B oligomer allowed the A protomer to enter cells and to catalyze ADP-ribosylation of a membrane Mr 41 000 protein. The diverse biological activities of IAP occurring by this mechanism were mimicked by not only methylated IAP but also all hybrid toxins, indicating that the free amino groups in the protein were not essential for the enzyme activity of the A protomer and that the A protomer was able to enter cells if the B oligomer bound to cells "monovalently" via dimer 1. An additional effect of the B oligomer binding, i.e., the direct stimulation, without the transport of the A protomer, of cells leading to mitosis in lymphocytes in vitro or increases in circulating lymphocytes in vivo, was not mimicked by hybrid toxins containing methylated dimer 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964681 TI - Phosphorylation of L-cell glucocorticoid receptors in immune complexes: evidence that the receptor is not a protein kinase. AB - Two phosphoproteins are absorbed to protein A-Sepharose when cytosol from 32P labeled L-cells is incubated with a monoclonal antibody against the glucocorticoid receptor: one is a 98K phosphoprotein that contains the steroid binding site, and the other is a 90K non-steroid-binding phosphoprotein that is associated with the molybdate-stabilized receptor [Housley, P. R., Sanchez, E. R., Westphal, H. M., Beato, M., & Pratt, W. B. (1985) J. Biol. Chem. 260, 13810 13817]. In this paper we have incubated L-cell cytosol with rabbit antiserum against the mouse glucocorticoid receptor and show that incubation of protein A Sepharose-bound immune complexes with [gamma-32P]ATP and Mg2+ results in phosphorylation of the 98K steroid-binding protein but not of the 90K receptor associated protein. Phosphorylation occurs regardless of whether the receptor is unoccupied or is present as the untransformed or transformed steroid-receptor complex. No phosphorylation occurs in the presence of Ca2+ instead of Mg2+. If protein A-Sepharose-bound immune complexes prepared with a monoclonal antibody against the receptor are incubated with [gamma-32P]ATP and Mg2+, neither protein is phosphorylated. If the protein A-Sepharose pellet is obtained from molybdate stabilized cytosol that has been incubated both with monoclonal antibody to provide the 98K receptor and its 90K associated protein and with preimmune rabbit serum, which causes the nonspecific adsorption of an L-cell protein kinase, then incubation with [gamma-32P]ATP and Mg2+ causes receptor phosphorylation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964682 TI - Thermodynamic properties of oxidation-reduction reactions of bacterial, microsomal, and mitochondrial cytochromes P-450: an entropy-enthalpy compensation effect. AB - An optically transparent thin-layer electrode cell with a very small volume was used for determination of the formal reduction potentials of bacterial, microsomal, and mitochondrial cytochromes P-450. At an extrapolated zero concentration of dye, the bacterial cytochrome from Pseudomonas putida catalyzing the hydroxylation of camphor and the adrenal mitochondrial cytochrome catalyzing the cholesterol side-chain cleavage reaction had formal reduction potentials of 168 and -285 mV (pH 7.5 and 25 degrees C), respectively. The oxidation-reduction potentials for the rabbit liver microsomal cytochrome P-450 induced by 3 methylcholanthrene and the mitochondrial cytochrome for steroid 11 beta hydroxylation were found as -360 and -286 mV, respectively. Potential measurements at different temperatures allowed documentation of the standard thermodynamic parameters for cytochrome P-450 reduction for the first time. All cytochromes tested were found to have a relatively large negative entropy change upon reduction. The extent of these changes is comparable to that observed for the ferric-ferrous couple of cytochrome c. An entropy-enthalpy compensation effect was observed among the four cytochromes P-450 examined although the correlation is weaker than that observed with cytochrome c isolated from various sources. PMID- 3964683 TI - Histone hyperacetylation: its effects on nucleosome conformation and stability. AB - We have prepared nucleosome particles from HeLa cells that have been subjected to butyrate treatment. Fractions containing different levels of acetylation have been obtained within the range 7-17 acetyl groups per nucleosome. We have put special emphasis in the characterization of the particles with the highest level of histone acetylation. At low to physiological ionic strengths, these nucleosomes exhibit only small differences in hydrodynamic behavior and circular dichroism from control particles with minimal acetylation. There are, however, significant differences in thermal denaturation and nuclease sensitivity. In terms of stability toward high salt, the hyperacetylated and control particles behave identically. A model that reconciles these results is proposed. The major conclusion from our results, however, is that, at physiological ionic strength and in the absence of factors other than acetylation, the highly hyperacetylated nucleosomes remain essentially folded. PMID- 3964684 TI - Effects of denaturants on amide proton exchange rates: a test for structure in protein fragments and folding intermediates. AB - A method for detecting structure in marginally stable forms of a protein is described. The principle is to measure amide proton exchange rates in the absence and presence of varying concentrations of a denaturant. Unfolding of structure by the denaturant is reflected by an acceleration of amide proton exchange rates, after correction for the effects of the denaturant on the intrinsic rate of exchange. This exchange-rate test for structure makes no assumptions about the rate of exchange in the unfolded state. The effects of 0-8 M urea and 0-6 M guanidinium chloride (GdmCl) on acid- and base-catalyzed exchange from model compounds have been calibrated. GdmCl does not appear to be well-suited for use in the exchange-rate test; model compound studies show that the effects of GdmCl on intrinsic exchange rates are complicated. In contrast, the effects of urea are a more uniform function of denaturant concentration. Urea increases acid catalyzed, and decreases base-catalyzed, rates in model compounds. The exchange rate test is used here to study structure formation in the S-protein (residues 21 124 of ribonuclease A). In conditions where an equilibrium folding intermediate of S-protein (I3) is known to be populated (pH 1.7, 0 degree C), the exchange rate test for structure is positive. At higher temperatures (greater than 32 degrees C) I3 is unfolded, but circular dichroism data suggest that residual structure remains [Labhardt, A. M. (1982) J. Mol. Biol. 157, 357-371].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964685 TI - Halo enol lactones: studies on the mechanism of inactivation of alpha chymotrypsin. AB - In a previous investigation [Daniels, S. B., Cooney, E., Sofia, M. J., Chakravarty, P. K., & Katzenellenbogen, J. A. (1983) J. Biol. Chem. 258, 15046 15053], we demonstrated that alpha-aryl-substituted five- and six-membered ring halo enol lactones were effective inhibitors of chymotrypsin, and we proposed that they reacted by an enzyme-activated mechanism: acyl transfer to the active site serine generates a halomethyl ketone that remains tethered in the catalytic site until it alkylates an accessible nucleophilic residue. In this study, we have investigated in greater detail the process of chymotrypsin inactivation by an alpha-naphthyl-substituted five- and six-membered bromo enol lactone. Inactivation by both compounds appears to be active site directed, since the time dependent inactivation is retarded by competing substrate. The possible involvement of a paracatalytic mechanism for inactivation (generation of a free, rather than active site bound, inactivating species) was investigated by comparing the inactivation efficiencies of the lactones with that of the bromomethyl keto acid hydrolysis products. The bromomethyl ketone derived from the five-membered lactone is ineffective, whereas that derived from the six membered lactone is highly efficient. However, the possible involvement of the free keto acid in chymotrypsin inactivation by the six-membered lactone is ruled out by experiments involving selective scavenging. The long-term inactivation of chymotrypsin requires the presence of the bromine substituent and appears to involve an alkylation rather than an acylation reaction (hydrazine resistant). Furthermore, a 1:1 lactone:enzyme stoichiometry is demonstrated with the 14C labeled six-membered lactone. These results are consistent with the mechanism based inactivation process previously presented. PMID- 3964686 TI - A theoretical analysis of the effect of phosphate on apparent H+/O stoichiometries in oxygen-pulse experiments with rat liver mitochondria. AB - It is now generally accepted that, in oxygen-pulse experiments on rat-liver mitochondria suspended in KCl-based media, the rapid import of H+ with phosphate leads to an approx. 33% lowering of apparent H+/O stoichiometry. However, in low K+ media, N-ethylmaleimide has no effect on stoichiometry, and there appears to be no import of H+ with phosphate. In this paper the quantitative effect of extramitochondrial phosphate on apparent H+/O stoichiometry is calculated theoretically, on the basis of internal and external buffering powers. The lack of appreciable phosphate uptake in low-K+ media is quantitatively explained in terms of several factors, including the initial pH gradient and initial phosphate distribution. PMID- 3964687 TI - The transport of glutamine into rat mesenteric lymphocytes. AB - The transport of glutamine into isolated rat mesenteric lymphocytes was studied. This transport appears to be dependent upon the Na+ gradient. The Km for glutamine transport was about 1.0 mM. A large number of amino acids were shown to inhibit the rate of transport of both serine and glutamine into lymphocytes. The transport of glutamine was competitively inhibited by serine and that for serine was similarly inhibited by glutamine. In contrast, histidine and 2 (methylamino)isobutyrate inhibited the transport of both serine and glutamine noncompetitively. It is concluded that glutamine is transported into rat mesenteric lymphocytes by a process similar to System ASC described for other cells. PMID- 3964688 TI - Maintenance of glucagon-stimulated system A amino acid transport activity in rat liver plasma membrane vesicles. AB - Plasma membrane vesicles prepared from intact rat liver or isolated hepatocytes retain transport activity by systems A, ASC, N, and Gly. Selective substrates for these systems showed a Na+-dependent overshoot indicative of energy-dependent transport, in this instance, driven by an artificially-imposed Na+ gradient. Greater than 85% of Na+-dependent 2-aminoisobutyric acid (AIB) uptake was blocked by an excess of 2-(methylamino)isobutyric acid (MeAIB) with an apparent Ki of 0.6 mM. Intact hepatocytes obtained from glucagon-treated rats exhibited a stimulation of system A activity and plasma membrane vesicles isolated from those same cells partially retained the elevated activity. Transport activity induced by substrate starvation of cultured hepatocytes was also evident in membrane vesicles prepared from those cells. The membrane-bound glucagon-stimulated system A activity decays rapidly during incubation of vesicles at 4 degrees C (t1/2 = 13 h), but not at -75 degrees C. Several different inhibitors of proteolysis were ineffective in blocking the decay of transport activity. Hepatic system N transport activity was also elevated in plasma membrane vesicles from glucagon treated rats, whereas system ASC was essentially unchanged. The results indicate that both glucagon and adaptive regulation cause an induction of amino acid transport through a plasma membrane-associated protein. PMID- 3964689 TI - The rate of lateral diffusion of phospholipids in erythrocyte microvesicles. AB - 31P-NMR spectra of phospholipids in membranes of erythrocyte microvesicles isolated from outdated blood units were recorded in the temperature range 5 to 55 degrees C. Within that range the lineshape is strongly influenced by an increasing rate of lateral diffusion of phospholipids. At 36 degrees C a diffusion constant, D, of (2 +/- 1) X 10(-12) m2/s was obtained. The diffusion rate is by a factor of 3 to 10 greater than in erythrocyte membranes measured by the photobleaching technique and is comparable with values obtained for several lipid model membranes. The differences in lateral diffusion rates are probably connected with the depletion of microvesicle membranes in membrane proteins. PMID- 3964690 TI - Galactose uptake by human platelets in vitro. AB - Galactose transport by human platelets has been studied by measuring the cellular accumulation of the radiolabeled sugar during brief periods of suspension in varying concentrations of galactose. Weighted least-squares regression curves fitted to the measurements (initial velocity versus galactose concentration) indicate that a kinetic model with two saturable components is statistically more consistent with the data than a model based upon a single process (P less than 0.001). For the two-component model Km1 = 0.29 mM, V1 = 1.2 mmol/min per 10(15) platelets, Km2 = 46 mM, V2 = 117 mmol/min per 10(15) platelets. The fact that galactose metabolites did not accumulate during the initial phase of uptake indicates that the uptake process is not mediated by enzymatic catalysis. Surface binding also appears inadequate to explain the uptake. The most likely basis for the kinetic data, therefore, is membrane transport. The kinetics are consistent with transport by coexistent membrane structures as well as with transport by a single structure manifesting negative cooperativity. PMID- 3964691 TI - The relationship between high-affinity noncatalytic binding of snake venom phospholipases A2 to brain synaptic plasma membranes and their central lethal potencies. AB - The basic phospholipase A2 from Naja nigricollis (African spitting cobra) snake venom is enzymatically less active but more toxic than the acidic phospholipase A2 from Naja naja atra (Taiwan cobra) snake venom, following injection into the right lateral ventricle of the brain of rats. When radiolabeled with 125I, these phospholipases A2 retained enzymatic activities and lethal potencies. Both enzymes bound with high affinity and specificity to brain synaptic plasma membrane preparations in vitro even in the absence of calcium, suggesting a non catalytic binding. The acidic enzyme, in a calcium-free medium, had two binding components with Kd values of 1 X 10(-10) and 2.75 X 10(-8) M and Bmax values of 6 X 10(-13) and 3.4 X 10(-11) mol/mg, respectively. Multiple specific and nonspecific binding components were observed for each phospholipase A2; saturability for all of the binding sites was conclusively demonstrated only for the N. naja atra phospholipase A2 in a calcium-free medium (Bmax = 3.4 X 10(-11) mol/mg). The levels of specific and total binding were 150 pmol/mg and 450 pmol/mg, respectively, for the comparatively toxic enzyme and 15 pmol/mg and 35 pmol/mg, respectively, for the comparatively nontoxic enzyme at a concentration of 2.5 X 10(-8) M. These levels of binding (both total and specific) were directly correlated with the intraventricular lethal potencies of the phospholipases A2 (0.5 and 5.0 micrograms/rat for the N. nigricollis and N. naja atra phospholipases A2, respectively), suggesting a possible relationship between binding and lethal potency. Carbamylation of lysines reduced the levels of binding and the lethal potencies of both enzymes to a greater extent than their enzymatic activities. Pretreatment with high temperature, proteinases, phospholipases A2 or C suggested that radiolabeled phospholipase A2 binds to phospholipids rather than proteins. However, only the N. naja atra phospholipase A2 manifested a strict dependence on a divalent cation (Ca2+ or Sr2+) for most of its binding. The N. nigricollis enzyme demonstrated a much lower rate of dissociation from synaptic plasma membranes than did N. naja atra phospholipase A2, suggesting that hydrophobic interactions are more important in the binding of the more toxic enzyme as compared to the less toxic enzyme. It is proposed that differences in the extent of high-affinity noncatalytic binding to membrane phospholipids may be at least partly responsible for the marked difference in central toxicities of these two phospholipases A2. PMID- 3964692 TI - Biotin uptake mechanisms in brush-border and basolateral membrane vesicles isolated from rabbit kidney cortex. AB - Biotin transport was studied using brush-border and basolateral membrane vesicles isolated from rabbit kidney cortex. An inwardly directed Na+ gradient stimulated biotin uptake into brush-border membrane vesicles and a transient accumulation of the anion against its concentration gradient was observed. In contrast, uptake of biotin by basolateral membrane vesicles was found to be Na+-gradient insensitive. Generation of a negative intravesicular potential by valinomycin-induced K+ diffusion potentials or by the presence of Na+ salts of anions of different permeabilities enhanced biotin uptake by brush-border membrane vesicles, suggesting an electrogenic mechanism. The Na+ gradient-dependent uptake of biotin into brush-border membrane vesicles was saturable with an apparent Km of 28 microM. The Na+-dependent uptake of tracer biotin was significantly inhibited by 50 microM biotin, and thioctic acid but not by 50 microM L-lactate, D-glucose, or succinate. Finally, the existence in both types of membrane vesicles of a H+/biotin- cotransport system could not be demonstrated. These results are consistent with a model for biotin reabsorption in which the Na+/biotin- cotransporter in luminal membranes provides the driving force for uphill transport of this vitamin. PMID- 3964693 TI - The phosphatidylcholine transfer protein from bovine liver discriminates between phosphatidylcholine isomers. A monolayer study. AB - The activity of the phosphatidylcholine transfer protein from bovine liver toward phosphatidylcholine isomers carrying a long and a short fatty acyl chain on either the sn-1- or sn-2-position was determined by way of the monolayer-vesicle assay. In this assay equimolar mixtures of the isomers were spread at the air/water interface and their transfer measured to the vesicles in the subphase initiated by addition of the transfer protein. The following isomers were tested: 1-decanoyl-2-[3H]oleoyl-sn-glycero-3-phosphocholine (C10:0/[3H]C18:1-PC) and 1 oleoyl-2-decanoyl-sn-glycero-3-phospho[14C]choline (C18:1/C10:0-[14C]PC); 1 lauroyl-2-[3H]oleoyl-sn-glycero-3-phosphocholine (C12:0/[3H]C18:1-PC) and 1 oleoyl-2-[14C]lauroyl-sn-glycero-3-phosphocholine (C18:1/[14C]C12:0-PC); 1 myristoyl-2-[3H]oleoyl-sn-glycero-3-phosphocholine (C14:0/[3H]C18:1-PC) and 1 oleoyl,2-myristoyl-sn-glycero-3-phospho[14C]choline (C18:1/C14:0-[14C]PC). It was found that the protein transferred C10:0/[3H]C18:1-PC twice as fast as C18:1/C10:0-[14C]PC. Similar differences in rate were observed for C12:0/[3H]C18:1-Pc and C18:1/[14C]C12:0-PC but not for the isomers carrying myristic acid. We propose that the transfer protein can discriminate between PC isomers due to the presence of distinct binding sites for the sn-1- and sn-2-acyl chain (Berkhout et al. (1984) Biochemistry, 23, 1505-1513). PMID- 3964694 TI - High performance agarose gel chromatography in sodium dodecyl sulfate of integral membrane proteins from human red cells, with special reference to the glucose transporter. AB - Integral membrane proteins from human red cells were fractionated in sodium dodecyl sulfate solutions by high performance gel filtration on the small-bead cross-linked agarose gel Superose 6. The components were identified by acrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The combination of Superose chromatography with electrophoresis afforded high resolution. As expected the gel filtration elution volumes depended essentially on the molecular mass, but the elution volumes decreased stepwise as the detergent concentration was increased from 0.6 to 100 mM, with the largest decrease for the glucose transporter. The resolution increased as the flow rate was decreased from 60 to 1 ml X cm-2 X h-1. The Mr values for the anion and glucose transporters as estimated by Superose 6-chromatography at 50 mM detergent were 75-80% of the corresponding Mr values obtained by electrophoresis. At 50 mM dodecyl sulfate the proteins were resolved into four fractions (a-d) which mainly contained: (a) dimer and (b) monomer of the anion transporter, (c) the glucose transporter and (d) components of Mr below 40 000. Monoclonal antibodies that possibly are directed against the glucose transporter (Lundahl, P., Greijer, E., Cardell, S., Mascher, E. and Andersson, L. (1986) Biochim. Biophys. Acta 855, 345-356) interacted only with part of the 4.5-material in fraction c in immunoblotting (Western blotting). Superose 6-chromatography of red cell glucose transporter that had been partially purified on DEAE-cellulose and Mono Q resolved one major and two minor fractions. Electrophoretic analysis showed that components of Mr 90,000, 50,000, and 25,000 had been separated from the major Mr-55,000-4.5 material and revealed size heterogeneity within the major chromatographic fraction. Heating of the glucose transporter in the presence of dodecyl sulfate caused an unexpected retardation of monomeric transporter on Superose 6. The apparent Mr decreased from 44,000 to 29,000. PMID- 3964695 TI - Interactions of antibiotics of the iturin group with human erythrocytes. AB - The peptidolipid antibiotics, iturin A and bacillomycin L have a disrupting effect on erythrocyte membrane leading to a simultaneous release of K+ ions and hemoglobin. The formation of ghosts is accompanied by a partial solubilisation of lipid components. Binding experiments with radioactive antibiotics show that about 7 X 10(7) molecules of iturin A and 4 X 10(7) molecules of bacillomycin L are bound to one erythrocyte at the concentration giving 100% hemolysis. This concentration is reduced by about 20% after treatment of erythrocytes by phospholipase A2. Scatchard plots show that the affinity for erythrocyte membrane is higher with bacillomycin L than with iturin A. This difference is probably correlated to the differences in their peptide moieties. The substitution of tyrosyl residue leads to a ten-fold increase of the concentrations giving 100% hemolysis, probably due to a low distribution coefficient of derivatives between the membrane and the solvent. This result and the humped Scatchard curves obtained with both antibiotics may be related to the self-association of the compounds in aqueous solutions. PMID- 3964696 TI - Iodoacetylated and biotinylated liposomes: effect of spacer length on sulfhydryl ligand binding and avidin precipitability. AB - Because of the sustained interest in liposomes as immunogens and vehicles for drug delivery, the present investigation was designed to reevaluate the iodoacetyl group as a means of binding sulfhydryl-containing substances to liposomes in thioether linkage, and to develop an alternative method by which liposomes with bound ligand can be conveniently and rapidly separated from free ligand. For the purpose of the first goal, we synthesized a homologous series of dimyristoylphosphatidylethanolamine (DMPE) derivatives in which the iodoacetyl (IA) function was separated from the phospholipid amino group by either 0, 1, or 2 aminoethylthioacetyl (AETA) spacers. Results show that liposomes prepared with IA-DMPE can not bind 125I-radiolabeled rabbit IgG which had been thiolated by reaction with S-acetylmercaptosuccinic anhydride. Significant IgG attachment was, however, obtained with liposomes containing either IA-AETA-DMPE or IA-(AETA)2 DMPE, and the amount bound was directly related to spacer length. In contrast, spacer length had no effect on the covalent binding of a low molecular weight hapten, N-dinitrophenylcysteine. Other parameters (incubation time, IgG concentration, density of IA-(AETA)2-DMPE, sulfhydryl inhibitors) were also examined. To achieve the second objective, biotinyl-(AETA)2-DMPE was incorporated into the same liposomal bilayers that contained the iodoacetylated derivatives. Thus, liposomes with bound ligand could be readily precipitated by avidin, and washed free of unreacted IgG by low speed centrifugation. Comparative experiments with liposomes containing biotinyl-DMPE revealed that spacer length also had a pronounced effect on the avidin precipitability of liposomes in the presence of proteins that may be non-covalently absorbed or covalently bound to the model membrane surface. PMID- 3964697 TI - Ethanol-induced alterations of plasma membrane assembly in the liver. AB - The effects of acute ethanol administration on the assembly of glycoproteins into the hepatic plasma membrane were studied in the rat. When [14C]fucose and N acetyl[3H]mannosamine, a sialic acid precursor, were injected following an acute dose of ethanol, the incorporation of these precursors into the total pool of membrane glycoproteins was minimally affected. This finding indicated that ethanol treatment did not appreciably alter the glycosylation of proteins in the Golgi apparatus. However, the assembly of labeled fucoproteins and sialoproteins into the plasma membrane was markedly inhibited in the ethanol-treated animals. This inhibition of plasmalemmal glycoprotein assembly was accompanied by a corresponding accumulation of labeled glycoproteins in the cytosolic fraction of the hepatocyte. The content of labeled glycoproteins in the Golgi complex was not significantly altered by ethanol treatment. These results indicate that ethanol administration impairs the late stages of hepatic plasma membrane assembly and further suggest that ethanol administration interferes with the flow of membrane components from the Golgi apparatus to the surface membrane. PMID- 3964698 TI - Characteristics of D-galactose transport systems by luminal membrane vesicles from rabbit kidney. AB - The characteristics of renal transport of D-galactose by luminal membrane vesicles from either whole cortex, pars recta or pars convoluta of rabbit proximal tubule were investigated by a spectrophotometric method using a potential-sensitive carbocyanine dye. Uptake of D-galactose by luminal membrane vesicles prepared from whole cortex was carried out by an Na+-dependent and electrogenic process. Eadie-Hofstee analysis of saturation-kinetic data suggested the presence of multiple transport systems in vesicles from whole cortex for the uptake of D-galactose. Tubular localization of the transport systems was studied by the use of vesicles derived from pars recta and pars convoluta. In pars recta, Na+-dependent transport of D-galactose and D-glucose occurred by means of a high affinity system (half-saturation: D-galactose, 0.15 +/- 0.02 mM; D-glucose, 0.13 +/- 0.02 mM). These results indicated that the "carrier' responsible for the uptake of these hexoses does not discriminate between the steric position of the C-4 hydroxyl group of these two isomers. This is further confirmed by competition experiments, which showed that D-galactose and D-glucose are taken up by the same and equal affinity transport system by these vesicle preparations. Uptake of D galactose and D-glucose by luminal membrane vesicles isolated from pars convoluta was mediated by a low-affinity common transport system (half-saturation: D galactose, 15 +/- 2 mM; D-glucose, 2.5 +/- 0.5 mM). These findings strongly suggested that the "carrier' involved in the transport of monosaccharides in vesicles from pars convoluta is specific for the steric position of the C-4 hydroxyl group of these sugars and presumably interacts only with D-glucose at normal physiological concentration. PMID- 3964699 TI - The effect of gluconeogenesis on phospholipid turnover in isolated chick proximal tubule cells. AB - Previous work from this laboratory has shown that isolated chick renal proximal tubule cells possess an Na+-dependent Pi transport system and that Pi uptake is stimulated under gluconeogenic conditions. It is shown in the present paper that gluconeogenesis is associated with a rapid incorporation of Pi into membrane phospholipids, particularly phosphatidylinositol, and some evidence has been obtained for a change in the relative amounts of phosphatidylinositol polyphosphates under gluconeogenic conditions. There is no increase in the total phospholipid phosphate content however, suggesting that pyruvate-induced incorporation of Pi into phospholipids represents accelerated turnover rather than a net increase in synthesis. It is suggested that the stimulation of Na+ dependent Pi uptake by pyruvate is related to the increased rate of phospholipid turnover. Thus Pi transport may be a further example of a physiological system that is influenced by phosphatidylinositol metabolism. The role of phosphatidylinositol phosphates could be to stimulate transfer of transporter molecules from internal stores to the brush-border membrane of the cell. PMID- 3964700 TI - Quantitative relationships between the measurable transport resistances of membrane carriers: theory and experiment. AB - A theoretical analysis is made of the possible quantitative relationships between the transport resistances that characterise membrane carrier systems. It is shown that there exist only five possible patterns in which to rank the four transport resistances. Symbolising these as A, B, C and D, the five possible patterns are (i) A = B = C = D; (ii) A = B much greater than C, D; (iii) A = B much greater than C = D; (iv) A = B = 2C = 2D; (v) A = 2B = 2C much greater than D. A survey of the available experimental data shows that pattern (ii) is the most prevalent, pattern (v) is often found and pattern (iii) has been identified. None of the ten transport systems so far analysed experimentally failed to fit one of the predicted patterns. PMID- 3964701 TI - The effects of monensin on membrane lipids of cultured human skin fibroblasts. AB - We have investigated the effects of monensin, a monovalent cationophore, on the metabolism of neutral lipids, fatty acids, ceramide and phospholipids in cultured human skin fibroblasts. Treatment with 1 microM monensin for 18 h reduced the cellular cholesterol ester content to less than one-third of untreated cells, and incorporation of [3H]acetate into cholesterol ester was also reduced, to less than one-fifth. Concomitantly, a greater conversion of [3H]acetate into free cholesterol occurred. There was a moderate increase in free fatty acids, but no change in triacylglycerol content, although the content of the latter appeared to increase in the presence of fetal calf serum in the culture medium. Phosphatidylcholine decreased in content and phosphatidylserine increased among the phosphatides, but ceramide remained unchanged after monensin treatment. These findings suggest that monensin influences the metabolic interrelationships of structural lipids in fibroblasts. PMID- 3964702 TI - Concentration- and time-dependence of amphotericin-B induced permeability changes across ergosterol-containing liposomes. AB - The effect of amphotericin B on the permeability properties of liposomes prepared by reverse-phase evaporation was examined by using an osmotic method. This study has revealed that the magnitude and type of the alterations in permeability induced by amphotericin B in liposomes made of egg phosphatidylcholine and ergosterol depend not only on the amphotericin B concentration in the external aqueous solution but also on the time elapsed after mixing. Thus, low amphotericin B concentrations (from 0.2 to 1.2 microM) led to, (1) an small increment of the total extent of shrinkage of liposomes suspended in non electrolytes such as urea or salts like KNO3, (2) an enhancement of urea and salt permeabilities at the same time scale at which volume changes were measured (ms to s), (3) a maximal blocking by tetraethylammonium of amphotericin B-induced urea permeability and (4) an enhancement of glucose permeability but only after liposomes were incubated with amphotericin B for some minutes before mixing. The high amphotericin B concentration regime (beyond 1.2 microM) led to, (1) a decrease of the total extent of shrinkage of liposomes immediately after rapid mixing of liposomes with urea solutions containing amphotericin B and (2) a 50% reduction of the tetraethylammonium blocking of amphotericin B-induced urea permeability. These results are explained by assuming that amphotericin B may form in ergosterol-containing liposomes two types of active channel differing in internal diameter. PMID- 3964703 TI - Uptake of adriamycin into large unilamellar vesicles in response to a pH gradient. AB - Previous work has shown that adriamycin can be accumulated into large unilamellar vesicle (LUV) systems in response to K+ diffusion potential established by valinomycin. It is demonstrated here that adriamycin can also be rapidly and efficiently accumulated into egg phosphatidylcholine (egg PC) and egg PC cholesterol (1:1) LUVs in response to a transmembrane pH gradient (interior acidic) in the absence of ionophores. This 'active' loading gives rise to trapping efficiencies as high as 98%, interior drug concentrations as high as 100 mM and significantly enhances drug retention within the vesicles. This procedure may be of general utility for loading liposomal systems for in vivo drug delivery. PMID- 3964704 TI - Does diamide treatment of intact human erythrocytes cause a loss of phospholipid asymmetry? AB - Diamide-treated human erythrocytes have been compared with native red cells as to the accessibility of their amino phospholipids to both phospholipase A2 hydrolysis and fluorescamine labeling. In agreement with observations by others (Haest, C.W.M., Plasa, G., Kamp, D. and Deuticke, B. (1978) Biochim. Biophys. Acta 509, 21-32), treatment of intact human erythrocytes with diamide resulted in considerably enhanced degradation of amino phospholipids upon subsequent incubation of the cells with bee venom phospholipase A2. The hydrolysis of phosphatidylethanolamine (PE) in control cells reached a plateau value at 5% after 10 min. In diamide-treated cells, on the other hand, PE hydrolysis did not level off. Contrastingly, dose-response curves recorded for the labeling of PE with the very fast reacting NH2-group-specific reagent, fluorescamine, showed identical results for both native and diamide-treated erythrocytes. In each of these two cases, a plateau was reached after approx. 15% of the PE had been labeled. These results strongly suggest that the enhanced phospholipase-A2 induced hydrolysis of amino phospholipids in diamide-treated erythrocytes may reflect a destabilization of the lipid bilayer, rather than an in situ loss of phospholipid asymmetry. PMID- 3964705 TI - Detection of low-density cell-surface molecules using biotinylated fluorescent microspheres. AB - Biotinylated fluorescent microspheres have been developed as a reagent for studying antigens and receptors expressed at the cell surface. Labeling of antigen or receptor was accomplished by crosslinking biotinylated microspheres through streptavidin to corresponding biotinylated antibodies or ligands. Detection of labeled cells by flow microfluorimetry provided an extremely sensitive means for the analysis and potential manipulation of heterogeneous cell populations. The data indicate that cells bearing fewer than 200 surface antigen antibody complexes per cell are readily detectable by this approach. Crosslinked to a selected biotinylated peptide immunogen, biotinylated fluorescent microspheres also allowed the labeling and detection of hybridoma cells bearing antigen-specific surface immunoglobulin. PMID- 3964706 TI - The rate of uptake and efflux of phosphatidylcholine from human erythrocytes depends on the fatty acyl composition of the exchanging species. AB - The rate of uptake of radioactive phosphatidylcholine molecules of different fatty acid composition in intact erythrocytes as facilitated by a phosphatidylcholine-specific transfer protein has been studied. When trace amounts of radiolabeled phosphatidylcholine molecules are present in donor vesicles consisting of egg phosphatidylcholine and cholesterol, the transfer of the radiolabeled species depends strongly on their fatty acyl composition: dipalmitoylphosphatidylcholine is transferred at the lowest rate, 1-saturated-2 unsaturated species are transferred faster and the highest rate is observed for dioleoyl phosphatidylcholine. Transfer of the various phosphatidylcholine molecules was measured furthermore using donor systems in which the bulk phosphatidylcholine was varied in its fatty acyl composition. Also in this type of experiment, the transfer protein preferentially stimulated transfer of unsaturated phosphatidylcholine molecules, especially from an environment containing more saturated molecules. Finally, the efflux of labeled phosphatidylcholine from intact erythrocytes to plasma in the absence of the phosphatidylcholine-specific transfer protein was studied and it became clear that in this case the nature of the effused molecules itself, rather than the composition of the bulk lipids, determined the effuse rates. An important conclusion to be drawn from these experiments is that radiolabeled phosphatidylcholine molecules, when used as markers for phospholipid exchange or transfer, should resemble in their fatty acid composition the composition of the bulk lipid in order to provide reliable data on rates and extents of the process studied. PMID- 3964707 TI - The effect of temperature on lipid-n-alkane interactions in lipid bilayers. AB - The partitioning of n-alkanes between an egg-phosphatidylcholine bilayer and its torus was studied for alkanes with ten to sixteen carbon atoms using measurements of membrane capacitance. The partition coefficient was found to decrease with increasing alkane chainlength and to increase with increasing temperature. This is consistent with a well-known statistical model of lipid alkane bilayers in the liquid crystalline state. It was found that n-decane was unsuitable as a solvent in these experiments because significant partitioning of n-decane into the aqueous phase and atmosphere occurred and this could not be adequately controlled. Egg-phosphatidylcholine bilayers containing negligible amounts of solvent could be produced using a method similar to the 'freeze-out' method of White (Biochim. Biophys. Acta 356 (1974) 8-16). Bilayers formed using n hexadecane were found to be virtually solvent-free at temperatures below 30 degrees C. The partition coefficient of n-alkanes in the bilayer was also found to depend on the alkane mole fraction. Thus it was concluded that the assumption of ideal mixing between acyl and alkane chains in the bilayer was not valid when the alkane mole fraction exceeded 40% (with respect to the acyl chains of the lipid). The variation of the standard chemical potential with temperature was measured for alkanes of different chainlengths and it was concluded that the enthalpy and entropy of the alkanes in the bilayer are in themselves temperature dependent. This indicates that the state of the hydrophobic interior of lipid bilayers varies with temperature. PMID- 3964708 TI - Nuclear magnetic resonance of protamines. A 1H-NMR study of the interaction of clupeine fractions with mononucleotides. AB - The interaction of the three clupeine fractions, YI, YII, Z, and salmine fraction AI with mononucleotides has been examined by means of 1H nuclear magnetic resonance. The results obtained are interpreted in terms of electrostatic interactions between positive arginine guanidinyl groups and negative nucleotide phosphates. In addition, clupeine fraction YI and salmine fraction AI exhibit with guanine and adenine nucleotides a more specific interaction that leads to the formation of large aggregates in solution. The experimental data presented in this work demonstrate that the strength of interaction between clupeine YI and salmine AI with mononucleotides follows the order: 5'-dTMP approximately equal to 5'-dCMP much less than 5'-dAMP less than 5'-dGMP approximately equal to 5'-GMP. PMID- 3964709 TI - Methylation of chromatin in vitro. AB - The endogenous DNA methylase in nuclei isolated from growing mouse cells preferentially methylates DNA in micrococcal nuclease-resistant regions probably as a result of the location in these regions of the preponderance of hemimethylated sites. Added mouse ascites cell DNA methylase catalyses the methylation of exposed, nuclease-sensitive DNA in chromatin from growing or non growing mouse or insect cells. The poor acceptor ability of nuclease-resistant regions in this situation is due to the presence of histone proteins which block de novo methylation. Transcriptionally active regions of chromatin are selectively methylated in vitro by either endogenous or added DNA methylase. PMID- 3964710 TI - Termination of paroxysmal supraventricular tachycardia with a single oral dose of diltiazem and propranolol. AB - The efficacy of a single oral dose combination of 120 mg diltiazem and 160 mg propranolol in terminating paroxysmal supraventricular tachycardia (PSVT) was evaluated in 15 patients. All 15 patients underwent electrical induction of PSVT that lasted longer than 15 min, and all underwent randomized crossover placebo and diltiazem and propranolol studies on 2 consecutive days. On each day PSVT was induced and placebo or diltiazem and propranolol was administered 15 min later. Electrical conversion of PSVT was performed when severe symptoms occurred or at the end of 240 min. With placebo PSVT lasted 164 +/- 89 (mean +/- SD) min; four patients had spontaneous conversion. With diltiazem and propranolol PSVT lasted 39 +/- 49 min (p less than .001); 14 patients had spontaneous conversion in an average of 27 +/- 15 min. None of the 14 patients had electrical reinduction of sustained PSVT after conversion. The sinus nodal recovery time during spontaneous or electrical conversion of PSVT was 911 +/- 459 msec with placebo and 1076 +/- 270 msec with diltiazem and propranolol (NS). Two patients developed transient second-degree atrioventricular block and junctional rhythm while on diltiazem and propranolol. Serum diltiazem and propranolol levels (ng/ml) after diltiazem and propranolol in five patients were, respectively, 49 +/- 26 and 108 +/- 101 at 15 min, 232 +/- 147 and 228 +/- 148 at 30 min, 254 +/- 169 and 370 +/- 393 at 45 min, 280 +/- 115 and 209 +/- 189 at 60 min, 188 +/- 72 and 268 +/- 264 at 120 min, and 118 +/- 57 and 265 +/- 148 at 240 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964711 TI - Digitalis-induced augmentation of cardiopulmonary baroreflex control of forearm vascular resistance. AB - We sought to determine whether digitalis augments cardiopulmonary baroreflex control of forearm vascular resistance in normal young men. Cardiopulmonary baroreceptor input was reduced with lower body negative pressure (LBNP) at 10 and 20 mm Hg, which decreased central venous pressure but did not alter blood pressure or heart rate. Decreases in forearm blood flow and increases in forearm vascular resistance with LBNP were greater after administration of lanatoside C (Cedilanid) than before, and the slope of the regression line relating changes in central venous pressure and those in forearm vascular resistance was steeper after lanatoside C. Vasoconstrictor responses to the cold pressor test did not differ before and after lanatoside C, which suggested that augmented responses to LBNP after the drug were not caused by a generalized change in reflex control. These results suggest that lanatoside C augments the tonic inhibitory influence of cardiopulmonary baroreceptors in normal men. PMID- 3964712 TI - Sustained improvement of pulmonary hemodynamics in patients at rest and during exercise after thrombolytic treatment of massive pulmonary embolism. AB - This study assessed the long-term effects of thrombolytic treatment in patients with acute massive pulmonary embolism (PE). Seven patients with PE that followed deep-vein thrombosis underwent pulmonary angiography and pressure measurements before and 6 +/- 3 days (mean +/- SD) and 15 +/- 4 months after treatment with intrapulmonary infusions of urokinase (average dose 1724 U/kg X hr) and heparin (average dose 17 U/kg X hr). Treatment was guided by daily measurements of pulmonary arterial (PA) pressure and was continued until PA pressure had normalized (average of 6 days). Late after treatment patients returned for pulmonary angiographic examination, right heart catheterization at rest and during bicycle exercise, and phlebography of the deep veins of both legs. Pulmonary angiograms showed massive obstruction before therapy (Walsh index 15 +/ 2 points of a maximum of 18 points), which was improved 6 days (3 +/- 3 points) and 15 months (1 +/- 2 points) after therapy. Mean PA pressure declined from 37 +/- 9 to 13 +/- 3 mm Hg after 6 days and to 15 +/- 3 mm Hg after 15 months. No recurrence of PE was observed. In six of seven patients at rest and during bicycle exercise (up to 100 W) in the supine position mean PA pressure and total pulmonary resistance remained within normal limits. Over the short term all patients showed clinical signs of deep-vein thrombosis; 15 months later four patients had normal deep veins, but three patients had still phlebographic signs of old thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964713 TI - Factors influencing probability of reperfusion with intracoronary ostial infusion of thrombolytic agent in patients with acute myocardial infarction. AB - A multivariate logistic regression equation was used to evaluate variables related to successful intracoronary thrombolytic therapy. One hundred seventeen patients with a totally occluded infarct-related artery were randomly given ostial infusions of urokinase or streptokinase in a blinded study. The opening rate was 57%. The agent used and time from onset of symptoms to beginning of treatment did not significantly influence opening rate (p greater than .25). The site of occlusion was a strong predictor of opening rate (p = .0004). The anterior descending coronary artery was successfully opened more frequently than the left circumflex or right coronary artery (p = .012). Presence of collaterals adversely affected the recanalization rate in all groups (p = .0004). These variables had an additive effect on the probability of opening. Patients with proximal anterior descending occlusion and no collaterals had a 90% recanalization rate, while those with distal occlusions in vessels other than the anterior descending and with collaterals had only a 24% chance for reperfusion. Thus location of occlusion and presence or absence of collaterals may strongly influence opening rates. PMID- 3964714 TI - Comparison of Doppler echocardiographic peak frequency and turbulence parameters in the quantification of aortic stenosis in a pulsatile flow model. AB - To test the relative accuracy of Doppler echocardiographic peak frequency and turbulence parameters in assessing aortic stenosis, we constructed a pulsatile flow model that simulated human left ventricular and aortic pressures, flow, and anatomy. Continuous wave-measured peak frequencies and pulsed Doppler-measured turbulence were determined in the model ascending aorta for nine stenotic valve areas for each of five different flow rates. The mean squared systolic peak frequency (MSPF) and turbulence spectral envelope area (SEA) were regressed against the mean systolic gradient (r = .94, SEE = 5.6 mm Hg; and r = .96, SEE = 1.2 mm Hg, respectively). SEA was more accurate than MSPF at moderate-to-high degrees of stenosis and exhibited a smaller standard error. MSPF was more accurate than SEA in mild stenoses, where SEA tended to overestimate gradients. When flow data were included in a multiple regression analysis, both MSPF and SEA provided fair predictions of actual effective valve areas (r = .90 and r = .94, respectively). Use of high pulse-repetition-frequency Doppler echocardiography significantly reduced aliasing problems common to pulsed Doppler techniques. PMID- 3964715 TI - Automated impedance-based energy adjustment for defibrillation: experimental studies. AB - In defibrillation, current flow depends on the energy selected and the transthoracic impedance. If transthoracic impedance is high, current flow may be inadequate to defibrillate. We developed a method by which high transthoracic impedance is automatically compensated for by an increase in operator-selected energy when impedance is high. Transthoracic impedance was predicted in advance of the first shock by passing a low-level current between the defibrillator electrodes during the defibrillator charge cycle; a microprocessor monitored current flow and determined impedance. In 28 mongrel dogs we manipulated transthoracic impedance by placing glycerin-soaked gauze pads between the paddle electrodes and the chest. If the predicted impedance exceeded a preset value, the delivered energy was automatically increased by 40% or 100%. Using this impedance based energy adjustment technique, we found significant improvements in current flow and success rate of shocks when energy was automatically increased to compensate for high transthoracic impedance. The use of transthoracic impedance as a basis for energy adjustment appears a promising technique to minimize the hazards of high electrical energy; it allows low-energy shocks in most patients while avoiding inappropriate low energies in patients with high impedance. Clinical trials are justified. PMID- 3964716 TI - Spontaneous mitral valve prolapse in a breeding colony of rhesus monkeys. AB - Mitral valve prolapse was observed in 26 of 92 animals in a harem breeding colony of rhesus monkeys (Macaca mulatta). The affected animals had a systolic murmur best auscultated over the mitral region with the animal in a sitting position. Mid-to-late systolic clicks were also heard. Phonocardiographic examination also demonstrated systolic murmurs and clicks in six of 16 animals. Twenty-three of the animals were studied by M mode and/or two-dimensional echocardiography. The diagnosis was confirmed in 12 animals that had a murmur during the examination. Electrocardiograms revealed T wave abnormalities in five animals and left or right ventricular hypertrophy in five. Four adult animals that died during the course of the study were confirmed at necropsy as having prolapse of the posterior and/or anterior mitral valve leaflets into the atrium. Analysis of the breeding records suggested that mitral valve prolapse was a dominant genetic trait with an approximate birth incidence of 16% to 20% in the colony. The existence of mitral valve prolapse in a nonhuman primate species provides a unique opportunity to study the disease in an experimental animal. PMID- 3964717 TI - The hemodynamic effects of cardiac tamponade: mainly the result of atrial, not ventricular, compression. AB - We studied the hemodynamic effects of surgically induced regional cardiac tamponade in anesthetized dogs. Tamponade restricted to either the right or the left ventricle was compared with tamponade of either ventricle and both atria. Intrapericardial pressures were elevated to approximately 20 mm Hg. With tamponade of the right ventricle alone, aortic pressure rose from 161 +/- 3.8 to 164 +/- 3.4 mm Hg (p greater than .05) and cardiac output fell from 149.4 +/- 16.1 to 134.9 +/- 11.9 ml/kg/min (p greater than .05). However, tamponade of the right ventricle plus both atria decreased mean aortic pressure from 152.5 +/- 3.6 to 115.9 +/- 8.7 mm Hg (p less than .01) and cardiac output fell from 118 +/- 14.8 to 38.9 +/- 4.8 ml/kg/min (p less than .01). With tamponade of the left ventricle alone, aortic mean pressure changed significantly from 158.5 +/- 6.1 (control) to 148.9 +/- 5.0 mm Hg (tamponade) (p less than .05) and cardiac output was 135.5 +/- 28.3 (control) and 111 +/- 24.7 ml/kg/min (tamponade) (p greater than .05). However, when the atria were included, mean aortic pressure fell significantly more from 155.5 +/- 5.4 to 105.5 +/- 10.4 mm Hg (p less than .01) and cardiac output fell from 142.2 +/- 16 to 47.8 +/- 6.4 ml/kg/min (p less than .01). Atrial pressure rose when the atria were included, but not with tamponade of the left ventricle alone. Right but not left atrial pressure rose slightly with isolated right ventricular tamponade. We conclude that the principal hemodynamic effects of cardiac tamponade are not the result of compression of either the right or the left ventricle, but are the consequence of compression of the atria and/or the venae cavae and the pulmonary veins. PMID- 3964718 TI - Assessment of pericardial constraint in dogs. AB - To determine the better method of measuring pericardial constraint, pericardial pressure was recorded by a liquid-filled open-ended catheter and a liquid containing flat balloon in six open-chest anesthetized dogs. Left ventricular pressure was measured by a micromanometer-tipped catheter and left ventricular anteroposterior diameter was measured by sonomicrometry. Left ventricular end diastolic pressure was raised to 20 +/- 1.7 (mean +/- SD) mm Hg by intravenous saline. Left ventricular diastolic pressure-diameter loops were constructed (1) with incremental amounts of saline (0 to 50 ml) in the resealed pericardium, (2) with several small holes in the pericardium, and (3) with the pericardium widely open. Measured pericardial pressures were compared with what was assumed to be the correct pericardial pressure, i.e., the calculated difference between left ventricular diastolic pressure (at a given left ventricular diameter) before and after opening the pericardium. Pressure recorded by the flat balloon was similar to the calculated pericardial pressure at all pericardial liquid volumes. Pressure recorded by the open-ended catheter, however, was significantly lower (p less than .05) than the calculated pressure unless there was at least 30 ml of liquid in the pericardium. After several holes had been made in the pericardium it still exerted a constraining effect, as shown by a marked rightward or downward shift of the left ventricular diastolic pressure-diameter relationships after completely opening the pericardium. After holes were made in the pericardium pressure recorded by the flat balloon was still similar to the calculated pericardial pressure. However, pressure recorded by the open-ended catheter was significantly (p less than .02) lower than the calculated pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964719 TI - Effect of diltiazem and propranolol on left ventricular segmental relaxation during temporary coronary arterial occlusion and one month reperfusion in conscious dogs. AB - Using sonar microcrystals implanted in conscious dogs, we have characterized left ventricular segmental relaxation (LVSR) by measuring the mean rate to half end diastolic thinning (RHEDT) and the late diastolic thinning fraction (TF). In protocol 1 (five nonischemic dogs), RHEDT correlated with changes in left ventricular dP/dt (r = .87) and systemic arterial pressure (r = -.80) but not with alterations in heart rate. Only systemic arterial pressure importantly influenced TF (r = -.65). In protocol 2 (21 dogs), LVSR paralleled net systolic segmental wall thickness (NET) during both 2 and 4 hr of coronary occlusion followed by 1 month reperfusion. Both LVSR and NET remained depressed during 2 and 4 hr of coronary occlusion and through 24 hr of reperfusion, but both also gradually improved afterwards. In protocol 3, 31 dogs underwent 4 hr of coronary occlusion with 1 month of reperfusion. Among these animals, 11 dogs (group S4) received saline after 1 hr of occlusion, nine dogs (group P4) received propranolol, and 11 dogs (group D4) received diltiazem. Drug therapy was stopped at 2 hr of reperfusion. In segments with mildly and moderately depressed NET, LVSR was significantly increased in group D4 vs group S4 animals during the diltiazem infusion. Expressed as mean percentage of control value +/- SEM, RHEDT of moderately dysfunctional segments in group D4 compared with group S4 measured 53 +/- 10% vs 25 +/- 5%, respectively, at 2 hr of occlusion of the left anterior descending coronary artery (p = .03), 76 +/- 17% vs 28 +/- 8%, respectively, at 4 hr of occlusion (p = .01), and 74 +/- 11% vs 33 +/- 10%, respectively, at 1 hr of reperfusion (p less than .05). The differences in TF at these same time points were 106 +/- 10% vs 70 +/- 9% (p less than .03), 105 +/- 7% vs 65 +/- 16% (p less than .02), and 106 +/- 11% vs 74 +/- 13% (p less than .05), respectively. The improvement in LVSR occurred independently of changes in NET. The values of LVSR in the diltiazem-treated dogs fell to the levels of groups S4 and P4 within 24 hr of stopping the intervention. Propranolol did not significantly alter LVSR over the short or long term. The increase in LVSR during administration of diltiazem did not appear to be mediated by changes in contractility or regional myocardial blood flow, but were probably mediated in part by afterload reduction and possibly by a reduction in calcium entry into ischemic myocardium. PMID- 3964720 TI - Treatment of hypertension and its effect on cardiovascular risk factors: data from the Framingham Heart Study. AB - Analysis of the Framingham Heart Study experience between 1958 and 1970 showed a progressive increase in the rate of treatment and control of hypertension. With cross-sectional criteria to define diastolic hypertension, the treatment rate rose from 35% in 1958 through 1960 to 69% in 1968 through 1970 (p less than .001), and the treatment rate for sustained hypertension rose from 55% in 1958 through 1960 to 85% in 1968 through 1970 (p less than .001). Treated hypertensive subjects had higher pretreatment values of blood pressure but not of other cardiovascular risk factors than untreated hypertensive subjects. Treatment was more successful in controlling hypertension in later years (p less than .001), but in all years treatment reduced systolic and diastolic blood pressure without causing significant changes in mean serum cholesterol or glucose levels. In treated hypertensive subjects, the 8 year predicted risk of coronary heart disease declined by 2.3 events per 100 people compared with that in untreated hypertensive subjects (p less than .0001). The observed incidence of coronary heart disease was consistent with these predictions and suggested that treatment may be especially beneficial in subjects who have systolic blood pressures of 180 mm Hg or higher and who are treated for more than 2 successive years. PMID- 3964721 TI - Evaluation of relationship between myocardial contractile state and left ventricular function in patients with aortic regurgitation. AB - We studied the relationship between myocardial contractile state and left ventricular functional response to exercise in 14 asymptomatic patients with isolated moderate-to-severe aortic regurgitation and six control subjects. The slope of the systolic blood pressure-left ventricular end-systolic volume (pressure-volume) relationship determined by radionuclide ventriculography during angiotensin infusion was used as an indirect measure of myocardial contractility and was compared with left ventricular ejection fraction at rest and during both isometric handgrip and dynamic bicycle exercise. The slope of the pressure-volume relationship was significantly lower in patients with aortic regurgitation than in the control subjects (1.75 +/- 0.57 vs 2.78 +/- 0.42, p less than 0.01). The slope correlated exponentially with resting ejection fraction and was linearly related to changes in left ventricular ejection fraction during both handgrip and bicycle exercise. In patients with aortic regurgitation, resting ejection fraction may overestimate myocardial function. The slope of the pressure-volume relationship measured during afterload stress and left ventricular ejection fraction response to exercise intervention more reliably reflect the degree of left ventricular dysfunction. PMID- 3964722 TI - Evaluation of energy metabolism in skeletal muscle of patients with heart failure with gated phosphorus-31 nuclear magnetic resonance. AB - Exertional fatigue is a major limiting symptom in patients with heart failure. To investigate the metabolic basis of this fatigue, we used gated nuclear magnetic resonance spectroscopy to compare inorganic phosphate (Pi), phosphocreatine (PCr) and pH levels, and fatigue (1 to 4+) during mild forearm exercise in eight normal men and nine men with heart failure. Wrist flexion every 5 sec for 7 min was performed at 1, 2, and 3 J (average power output = 0.2, 0.4, and 0.6 W). In both groups linear relationships were noted between power output and Pi/PCr; the slope of this relationship was used to compare PCr depletion patterns. At rest both groups had similar Pi/PCr ratios (normal subjects 0.12 +/- 0.06, those with heart failure 0.15 +/- 0.03) and pH (normal subjects 7.04 +/- 0.13, those with heart failure 7.10 +/- 0.11). In normal subjects exercise resulted in a progressive increase in Pi/PCr (slope = 1.17 +/- 0.20 Pi/PCr units/W), a reduction in pH only at 0.6 W (0.2 W: 7.03 +/- 0.10, 0.4 W: 7.01 +/- 0.10, 0.6 W: 6.88 +/- 16) and moderate fatigue (0.2 W: 0 +/- 0, 0.4 W: 1.3 +/- 0.5, 0.6 W: 1.9 +/- 0.6). In patients with heart failure exercise resulted in significantly greater fatigue at all workloads (0.2 W: 1.0 +/- 0.5, 0.4 W: 1.9 +/- 0.6, 0.6 W: 2.9 +/- 0.5).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964723 TI - Slow regional clearance of myocardial thallium-201 in the absence of perfusion defect: contribution to detection of individual coronary artery stenoses and mechanism for occurrence. AB - As a result of the "spatially relative" nature of perfusion defect analysis of stress-redistribution thallium-201 (201Tl) scintigrams, hypoperfused myocardial segments may not appear as perfusion defects but they may demonstrate a slow washout rate of 201Tl that can be analyzed in a "spatially nonrelative" manner. Quantitative analysis of perfusion defects and slow washout rate of 201Tl was performed on scintigrams from 116 consecutive patients with adequate exercise tests, defined as achievement of 85% or more of age-predicted maximum heart rate or development of angina or ST segment depression. A total of 232 diseased and 116 nondiseased vessels were found in the patients. Additional analysis of slow washout rate significantly (p less than .05) improved sensitivity for detection of disease in the left anterior descending (from 74% to 82%), left circumflex (from 40% to 61%), and right coronary arteries (from 78% to 90%) without significant loss of specificity. This improvement resulted from the additional detection of 32 of 232 (14%) diseased vascular distributions when the isolated slow washout rate of 201Tl was also determined. In nine of these 32, isolated slow washout rate was associated with another region with isolated slow washout rate in the contralateral myocardial segment. Coronary arteriography revealed similar degrees of stenosis in the vessels supplying these segment pairs. In 13 of 32 cases, a perfusion defect and a slow washout rate were found in the contralateral segment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964724 TI - Vascular responses to K+ in essential hypertension. PMID- 3964725 TI - Sodium pump activity in thymocytes of rats with Goldblatt hypertension. AB - Sodium transport has been studied in thymocytes of one-kidney, one-clip (1K, 1C) and two-kidney, one-clip (2K, 1C) models of hypertension in the rat. No differences of intracellular sodium or sodium transport could be demonstrated in either model when compared with sham-operated controls. The experiments provide no evidence to support the concept that an inhibitor of sodium transport is associated with the development of hypertension in the one-kidney, one-clip rat. A previously unrecognized effect of incubation time and cell density on thymocyte sodium metabolism is reported. PMID- 3964726 TI - Effect of two models of portal hypertension on splanchnic organ blood flow in the rat. AB - Splanchnic organ blood flow and cardiac output were measured by the microsphere method in fasted rats with prehepatic portal hypertension due to portal vein stenosis, in rats with intrahepatic portal hypertension due to bile duct ligation, and in unoperated normal rats. Portal venous pressure was higher in both groups of portal hypertensive rats than in normal rats. Cardiac output was significantly higher in portal hypertensive rats than in normal rats. In rats with portal vein stenosis, splanchnic blood flow was higher than in controls. This increase was caused by increased perfusion of all organs drained by the portal vein, and by increased hepatic arterial blood flow. In rats with bile duct ligation, splanchnic blood flow was not significantly higher than in normal rats: haemoperfusion of all organs contributing to the portal circulation decreased, whereas hepatic arterial blood flow increased. As cardiac output rose similarly, the differences observed between the two types of portal hypertension depend mainly on the difference in distribution of flow within the splanchnic bed. PMID- 3964727 TI - Association of secondary hyperparathyroidism with red cell survival in chronic haemodialysis patients. AB - 51Cr red cell mass (RCM), 51Cr red cell survival (RCS) and plasma parathyroid hormone (PTH) levels were measured in 27 stable chronic haemodialysis patients with a variable degree of clinical secondary hyperparathyroidism. Included were five patients who had had total parathyroidectomy. The results showed a strong negative correlation between PTH and RCS (r = -0.67, P less than 0.001) and a positive correlation between RCS and RCM (r = +0.53, P less than 0.005). However, the negative correlation between PTH and RCM was weak (r = -0.45, P less than 0.02). When the 13 patients with normal PTH levels (mean 0.18 +/- 0.12 microgram/l) were compared with the 14 patients with raised levels (mean 1.35 +/- 0.71 micrograms/l), there was a marked difference in RCS (P less than 0.005) but no difference in RCM. PMID- 3964728 TI - Intracellular chloride in essential hypertension. AB - In 25 patients with untreated essential hypertension and 25 healthy controls, erythrocyte intracellular Cl- concentration and activity as well as Na+ activity were measured. Intracellular Cl- concentration in essential hypertensive patients was 70.6 +/- 11.3 as compared with 84.4 +/- 9.5 mmol/l in the controls (P less than 0.001). Intracellular Cl- activity was 77.5 +/- 13.0 mmol/l of cell water in hypertensive patients, the control value being 100.8 +/- 11.0 mmol/l of cell water (P less than 0.001). In the hypertensive group intracellular Na+ activity was 14.3 +/- 4.1 as compared with 7.1 +/- 1.8 mmol/l of cell water in the normotensive group (P less than 0.01). From these results it is suggested that in essential hypertension not only disturbances of cation metabolism, but also of anion metabolism, occur. Possibly the Cl- changes reflect a decreased Cl- inward transport due to an altered Na-K cotransport. PMID- 3964729 TI - Gas transfer for carbon monoxide in polycythaemia secondary to hypoxic lung disease. AB - The transfer factor for carbon monoxide and its subdivisions, the membrane diffusing capacity (Dm) and the pulmonary capillary blood volume (Vc), were measured in 16 patients with polycythaemia secondary to chronic hypoxic lung disease and in ten hypoxic non-polycythaemic control subjects. The mean pulmonary capillary blood volume was significantly lower in the polycythaemic patients (31.6 ml, SD 11.2) compared with the control group (65.2 ml, SD 22.5) (P less than 0.001). Erythrapheresis, as a method of isovolaemic haemodilution, was performed in 15 of the polycythaemic patients. The mean packed cell volume fell from 58 (SD 5)% to 47 (SD 5)% after treatment, with significant reductions in blood viscosity at both high and lower shear rates (P less than 0.001). The mean pulmonary capillary blood volume increased from 32.3 ml (SD 11.3) before treatment to 48.7 ml (SD 18.7) after erythrapheresis (P less than 0.01), with no significant change in membrane diffusing capacity. The rise in pulmonary capillary blood volume is another potential physiological advantage of the reduction of packed cell volume in patients with polycythaemia secondary to hypoxic lung disease. PMID- 3964730 TI - Enhancement of the urinary excretion of non-sulphated and sulphated radioactive bile acids by sodium acetate in the bile duct obstructed rat. AB - The renal clearances of [14C]glycocholate, [14C]taurocholate and [3H]glycochenodeoxycholate-3-sulphate were determined in bile duct obstructed rats. Comparisons of the bile acid clearances with glomerular filtration rates (GFR) indicate that most of the filtered bile acids are reabsorbed. Inhibition studies with p-aminohippurate (PAH) and probenecid suggest that a proportion of the bile acids in urine is secreted. Attempts were made to increase the renal clearance of the bile acids by the administration of pharmacological agents. An infusion of sodium acetate (0.3 mol/l) increased the clearance of the radioactive bile acids and augmented the urinary excretion of endogenous 3 alpha-hydroxy bile acids and reduced their concentration in plasma. PMID- 3964731 TI - Plasma catecholamine responses to change of posture in alcoholics during withdrawal and after continued abstinence from alcohol. AB - Plasma catecholamine, blood pressure and heart rate responses to standing were measured in ten alcoholics during withdrawal, ten alcoholics after 2-7 weeks of abstinence from alcohol, six abstinent alcoholics with orthostatic hypotension and ten normal control subjects. Withdrawing alcoholics had supine and standing heart rates and plasma noradrenaline and adrenaline concentrations that were higher than in abstinent alcoholics or control subjects. Supine blood pressures were also higher in withdrawing alcoholics than in abstinent alcoholics or control subjects, but on standing blood pressures in withdrawing alcoholics fell, four patients having a fall of more than 30/5 mmHg. Abstinent alcoholics without orthostatic hypotension had higher basal and standing concentrations of noradrenaline than control subjects but normal heart rates and adrenaline concentrations. Abstinent alcoholics with orthostatic hypotension showed a wide range of basal plasma noradrenaline concentrations and were found to have variable plasma noradrenaline responses to standing, three subjects having normal responses and three subjects having no or little increase in plasma noradrenaline on standing. It is concluded that alcohol withdrawal is associated with increased sympathetic nervous activity, as reflected by raised supine and standing plasma concentrations of catecholamines, and that even after 2-7 weeks of abstinence from alcohol plasma noradrenaline concentrations may be higher than in control subjects. Despite increased sympathetic nervous responses to standing, alcoholics during withdrawal have impaired blood pressure control and some may exhibit orthostatic hypotension. Orthostatic hypotension may also be observed in alcoholics during continuing abstinence from alcohol; in some of these patients failure of reflex noradrenaline release in response to standing may contribute to orthostatic hypotension. PMID- 3964732 TI - Effects of acipimox, a nicotinic acid derivative, on lipolysis in human adipose tissue and on cholesterol synthesis in human jejunal mucosa. AB - The mode of action of acipimox (5-methyl-pyrazine carboxylic acid 4-oxide), an hypotriglyceridaemic agent, was examined in human adipose tissue and intestinal mucosa. The rates of release of fatty acids and glycerol from human adipose tissue were measured in vitro. The release of fatty acids and glycerol from adipose tissue maximally stimulated by isoprenaline (10(-5) mol/l) fell by 40 and 25% respectively (P less than 0.025 and P less than 0.025) in the presence of acipimox (10(-5) mol/l). In submaximally stimulated adipose tissue (isoprenaline 10(-7) mol/l) acipimox (10(-4) mol/l) fully inhibited release of fatty acids (P less than 0.05) and glycerol (P less than 0.025) to basal rates. In unstimulated adipose tissue acipimox (10(-3) mol/l) reduced the rate of glycerol release (P less than 0.05), but not the rate of fatty acid release. Cholesterol synthesis in jejunal mucosa was measured in vitro by the incorporation of [2-14C]-acetate into sterols. Addition of cholesterol to the incubation reduced [2-14C]acetate incorporation into sterols from 8.7 +/- 2.1 (mean +/- standard error) to 3.7 +/- 1.0 pmol h-1 mg-1 of tissue (P less than 0.01). Acipimox at 10(-4)-10(-2) mmol/l had no consistent effect on cholesterol synthesis. Acipimox appears to exert its main hypolipidaemic effect by reducing lipolysis and free fatty acid flux to the liver, thereby reducing the precursor pool size of very low density lipoprotein (VLDL)-triglyceride and VLDL synthesis. PMID- 3964733 TI - Frusemide-sensitive sodium and potassium transport by human leucocytes. AB - Frusemide-sensitive sodium and potassium transport by normal human leucocytes has been studied in vitro by both isotopic and net flux techniques. In physiological media the leucocyte exhibits a frusemide-sensitive influx of sodium and potassium of equal magnitude compatible with a 1:1 co-transport system. Cells exposed to zero external sodium and potassium (osmolality maintained with choline) demonstrated a frusemide-sensitive sodium and potassium efflux. Frusemide sensitive potassium influx was dependent on the presence of external sodium but frusemide-sensitive sodium influx persisted unchanged in the absence of external potassium. Frusemide-sensitive potassium influx was dependent on external chloride but frusemide-sensitive sodium influx was chloride-independent. These last two observations make it likely that the frusemide-sensitive pathway is capable of operating in modes other than sodium-potassium co-transport. PMID- 3964734 TI - Advances in the diagnosis and treatment of asthma. PMID- 3964735 TI - Decision making in asthma self-management. PMID- 3964736 TI - Evaluation of an asthma summer camp program. PMID- 3964737 TI - Methods for bronchoalveolar lavage in asthmatic patients following bronchoprovocation and local antigen challenge. AB - We employed bronchoalveolar lavage (BAL) of subsegmental airways to study the local inflammatory effects of aeroallergen bronchoprovocation (BPC) and local instillation of allergen in allergic asthmatic patients, allergic rhinitis patients, and normal subjects. Two protocols were used: (1) BAL was performed in three subsegments following BPC or during spontaneous seasonal exposure, and (2) 5-ml aliquots of increasing doses of allergen were instilled into a single subsegment until there was at least 30 percent closure of the airway; the airway was then immediately lavaged. A subsegment in the opposite lung was lavaged as a control site. These same two segments were lavaged again two to 14 days later and the cells and fluid analyzed. Fifty-five lavages have been performed without complications. Pulmonary function tests (FEV1) were not significantly disturbed by either local challenge or lavage procedures. Cells were examined using light and electron microscopy and showed inflammatory cells in alveolar airways and dissolution of mast cell and eosinophil granules. Using selected criteria, we were able to use these methods in mildly, seasonally asthmatic patients to obtain safely cells and fluid for analysis. These techniques may permit studies which further our understanding of the mechanisms responsible for allergic asthma. PMID- 3964738 TI - One definition of asthma. PMID- 3964739 TI - Clinical and physiologic evaluation of asthma. PMID- 3964741 TI - Pregnancy and asthma. PMID- 3964740 TI - Distinguishing among asthma, chronic bronchitis, and emphysema. AB - The history holds the central role in distinguishing among asthma, chronic bronchitis, and emphysema. A personal or family history of atopy, a history of seasonal worsening of disease in response to a known environmental agent, perhaps seasonal, and marked variability in the severity of airflow obstruction, often with dramatic responsiveness to bronchodilator drugs, strongly support the diagnosis of asthma. Exacerbation of wheezing by exposure to cold air or following the ingestion of a drug, and asthma variants, such as nocturnal cough responsive to bronchodilator agents or exercise-induced asthma, all support the diagnosis of asthma. Peripheral blood eosinophilia or sputum eosinophilia support the diagnosis of asthma providing other known causes of eosinophilia can be excluded. Positive skin tests are helpful in establishing the atopic state and indicating its possible etiology. An elevated serum IgE level supports the diagnosis of asthma; a normal one does not exclude it. Cigarette smoking is a common background factor in both chronic bronchitis and emphysema, and both diseases are infrequently observed in the absence of this history. Long-standing mucous hypersecretion preceding airflow obstruction suggests the presence of chronic bronchitis. Progressive dyspnea on effort as the predominant symptom suggests the possibility of emphysema. Reversibility of airflow obstruction suggesting the presence of asthma can be obtained either from physical examination or serial pulmonary function studies. Apart from this, neither of these techniques is very useful in differential diagnosis. Evidence of emphysema in the chest roentgenogram and a low value of the Dco/VA are sensitive tests for the presence of emphysema but are not highly specific. The main value of making the differentiation among these three conditions now lies in establishing a prognosis and guiding the use of corticosteroid therapy. As new information accumulates on the pathogenesis, prevention, and treatment of asthma, chronic bronchitis, and emphysema, precise diagnosis is likely to acquire increased significance. PMID- 3964742 TI - Introduction to self-management of asthma programs. PMID- 3964743 TI - ACT (asthma care training) for kids. A childhood asthma self-management program. PMID- 3964745 TI - Sexual differentiation of positive feedback: effect of hour of castration at birth on estradiol-induced luteinizing hormone secretion in immature male rats. AB - In the male rat, a dramatic increase in hypothalamic testosterone and estradiol concentrations occurs during the first few hours of postnatal life. These experiments sought to determine whether such increases participate in the defeminization of positive estrogen feedback effects on LH secretion. Newborn male rats were castrated either in utero (0 h males), or 10 or 24 h after birth. Some males were castrated at 0 h in utero and injected at the time of surgery with 1,2.5, or 5 micrograms testosterone propionate. A group of females was ovariectomized at 0 h in utero (0 h females). The control group consisted of male and female rats sham gonadectomized at 0 h in utero which were either gonadectomized at 21 days of age or left intact. The experimental groups were challenged before puberty to determine if estrogen induced a release of LH using two different types of estrogen treatment. The first treatment consisted of an injection of 0.2 microgram estradiol benzoate (EB) on day 28 followed by a second 10 micrograms injection of EB on day 29. This treatment resulted on the afternoon of day 30 in a surge of LH in intact females. Normal males, 0 h males, or females castrated at 21 days did not have a significant LH surge. The second test consisted of the daily injection of 0.05 microgram EB on days 23-27; on day 28 the rats were injected with 2.5 micrograms EB. Zero hour male and female rats showed a large LH surge on the afternoon of day 29; sham castrated males never responded to this treatment. No sex difference was observed in the mean size of the LH surge providing the males were castrated at 0 h in utero. The effect of the hour of castration on the day of birth also was studied. Males castrated at 10 or 24 h after birth showed either no LH surge or the magnitude of the surge was greatly reduced compared to that obtained in the 0 h males (P less than 0.001). The fact that 0 h males injected with 1 microgram testosterone propionate never showed an LH surge after prepuberal treatment with estrogen suggests that 0 h is a time during which the newborn is sensitive to the defeminizing effect of androgens. These results are consistent with the idea that the testicular hyperactivity which occurs at the time of birth could influence the defeminization of the LH surge mechanisms. PMID- 3964744 TI - 19-Nor-deoxycorticosterone metabolism by rat adrenal glands: evidence for the formation of 19-nor-corticosterone and 19-nor-18-hydroxydeoxycorticosterone. AB - Incubation of rat adrenal homogenates with tritiated and unlabeled 19-nor deoxycorticosterone yielded, in addition to unconverted starting substrate, two major radioactive conversion products. These two products were purified by TLC and HPLC and subjected to mass spectrometry and nuclear magnetic resonance analysis. The interpretation of the spectra was consistent with the structures to be 19-nor-corticosterone and 19-nor-18-hydroxydeoxycorticosterone. The possible biological significance of these two compounds is discussed. PMID- 3964746 TI - On the presence of nonfunctional uterine estrogen receptors in middle-aged and old C57BL/6J mice. AB - The nuclear binding kinetics of uterine 17 beta-estradiol (E2) receptors (UER) were studied throughout aging in intact and castrated (OVX) mice. When compared to young animals, 15- to 18-month-old mice showed a significant reduction in their total cytosolic (0.526 vs. 0.405 pmol/uterus; P less than 0.05) and nuclear (0.37 vs. 0.16 pmol/uterus; P less than 0.01) UER content, whereas the affinity (Ka) for estrogens remained constant (0.8-1.6 X 10(9) M-1). This age-related decrease in UER was preceded by a blunted and retarded nuclear binding of UER at 10-14 months of age, which was further accentuated after transition from perimenopause. Ovariectomy (OVX), whether performed neonatally or in adulthood, reduced the total concentration of cytosolic and nuclear UER in each age group studied, but did not prevent this reduced nuclear binding observed in middleaged mice. However, when standardized per tissue protein, the mean number of cytosolic UER from young and middle-aged, but not old, mice was reduced by 50% after neonatal OVX (176.5, 178.4, and 218.8 fmol/mg protein, respectively), whereas it remained unchanged when OVX was performed in adulthood and the animals subsequently studied at peri- and postmenopausal ages (326.3 and 283.3 fmol/mg protein, respectively). Daily administration of a physiological dose of E2 for 7 days to OVX mice of each age group induced maximal synthesis of UER in young animals, but not in peri- and postmenopausal ones; in peri- and postmenopausal animals, this was paralleled by reduced uterotropic responses despite similar increments in plasma E2. These results suggest an age-related, gonad-independent decline in the number of functional UER early in reproductive aging. PMID- 3964747 TI - Effect of a nonsteroidal antiandrogen, flutamide, on androgen receptor dynamics and ornithine decarboxylase gene expression in mouse kidney. AB - The mechanisms by which nonsteroidal antiandrogens such as flutamide (alpha, alpha, alpha-trifluoro-2-methyl-4'-nitro-m-propionotoluidide) influence androgen receptor distribution and androgen-regulated gene expression are poorly understood. Therefore, we studied acute and long-term effects of flutamide, administered alone or in combination with testosterone, on androgen receptor dynamics in mouse kidney. Nuclear androgen receptors were measured using 5 mM pyridoxal 5'-phosphate extracts of renal nuclei isolated with the hexylene glycol method. Androgen-regulated ornithine decarboxylase (ODC) and ODC-messenger RNA were used as biological markers for hormone action. A single dose of flutamide increased the measurable concentration of renal nuclear androgen receptors in a dose-dependent manner by 1 h after treatment, although to a lesser extent than a comparable dose of testosterone. When 5 mg flutamide was given concomitantly with a submaximal dose of testosterone (0.1 mg), nuclear androgen receptor concentration was similar to that achieved with flutamide alone; this inhibitory effect of the antiandrogen was reversed by a 10-fold higher dose of testosterone. The influence of flutamide on the steady-state receptor levels in renal nuclei achieved by continuous androgen administration was investigated by giving a single dose of this compound to mice with testosterone-releasing implants. In these animals, flutamide administration decreased nuclear androgen receptor concentration with an initial half-life of about 3.3 h. This half-life was similar to that after cycloheximide administration, but significantly longer than that measured (1.3 h) upon removal of the implant. During treatment of female mice for 8 days with testosterone-releasing implants (40 micrograms/day), both the immunoreactive and catalytically active ODC concentration increased about 300 fold. In contrast, there was no stimulation of ODC during the prolonged administration of flutamide, although this treatment resulted in a dose-dependent increase in the nuclear androgen receptor concentration. However, flutamide (up to 650 micrograms/day) given concomitantly with testosterone (40 micrograms/day) almost completely abolished the testosterone-induced increase in ODC. The changes in ODC-messenger RNA concentration, as measured by hybridization to a complementary DNA probe, paralleled those of the enzyme protein suggesting that flutamide action involves inhibition of transcription of androgen-regulated gene(s). We conclude that 1) nuclear androgen receptor turnover in mouse kidney is a relatively rapid process and 2) nonsteroidal antiandrogens such as flutamide have an intrinsic ability to form PMID- 3964748 TI - Paradoxical effects of thyrotropin on diffusion of thyroglobulin in the colloid of rat thyroid follicles after long term thyroxine treatment. AB - Autoradiographs of human goiters demonstrate that the speed of diffusion of newly iodinated thyroglobulin (Tgb) molecules through the colloid space may vary widely from one follicle to another. Since the mechanisms which govern the mixing of the colloid are unknown, we investigated the effect of TSH on these processes in rat thyroid glands. Autoradiographs were prepared from thyroids of rats killed 1 h after 125I or 4 h after [3H]leucine injection. In animals treated with T4 for 2 days, 70% of all follicles showed ring labeling of the colloid periphery with both isotopes, indicating slow mixing of newly synthesized and newly iodinated Tgb molecules with preexisting ones. TSH markedly enhanced the mixing process, thereby diminishing the incidence of ring reactions to roughly 10% of all follicles. These results were expected. Unexpected however, was, the nearly total absence of rings in thyroids treated with T4 for 25 days. Semiquantitative autoradiography revealed a higher absolute number of both newly iodinated and newly synthesized Tgb molecules in the core of follicles in chronically suppressed compared to acutely suppressed thyroids. Moreover, after chronic T4 pretreatment, the effect of TSH on diffusion was the opposite of that observed in acutely T4-treated glands, since 0.5 IU TSH injected twice daily between days 21 and 25 caused the reappearance of 125I and [3H]leucine labeled rings in 44% and 33%, respectively, of all follicles. We conclude that acute TSH suppression slows intraluminal diffusion of thyroglobulin molecules and acute TSH injection accelerates the mixing process, whereas, in contrast, chronic TSH suppression improves and acute TSH action on chronically suppressed follicles impairs diffusion. Therefore, the impact of TSH-mediated processes on the hydrodynamic properties of colloid, and thereby on the intraluminal iodination and coupling process, is more complex than hitherto thought. PMID- 3964749 TI - Secreted mouse prolactin (PRL) and stored ovine PRL. I. Biochemical characterization, isolation, and purification of their electrophoretic isoforms. AB - The biochemical nature of the electroisomers of secreted mouse PRL and stored ovine PRL were compared. When examined on alkaline polyacrylamide gels, they exhibited electrophoretic heterogeneity. The electrophoretic isomers had the same molecular size by examination of Ferguson plots and therefore differed only in net negative charge at alkaline pH. There was no apparent charge heterogeneity in the PRL preparations when they were electrophoresed at a pH below the pKa of the side-chain carboxyl groups of aspartic acid and glutamic acid; however, they exhibited size heterogeneity owing to aggregation. The slowest migrating electroisomers (from alkaline gels) converted spontaneously into faster migrating forms at 37 C in either acid (pH 4.0) or alkaline (pH 8.0) environments. The rate constant (determined at 37 C) for the transformation of the native PRL into faster migrating isoforms was 10.76 X 10(6) sec-1 at pH 8.0 and 0.50 X 10(6) sec 1 at pH 4.0. When secreted mouse PRL was incubated in alkaline (pH 10.0) conditions at 25 C, ammonia was released as the conversion reaction occurred. These results indicate that the electroisomers separated at alkaline pH are charge isoforms differing only in the number of free carboxyl groups of glutamic and/or aspartic acid residues. The des-amido isoforms were fractionated and purified. Polyacrylamide gel electrophoresis at alkaline pH was used to separate the charge isomers from each other. Each isoform was then excised from the separating matrix and recovered via electrophoretic elution. The homogeneity of each isoform was monitored by polyacrylamide gel electrophoresis. PMID- 3964750 TI - Effect of restricted nutrition on puberty in the lamb: patterns of tonic luteinizing hormone (LH) secretion and competency of the LH surge system. AB - The effects of undernutrition on the timing of puberty and regulation of LH secretion by the inhibitory and stimulatory feedback action of estradiol were examined in female sheep. The first experiment determined that maintenance of low BW (ca., 20 kg, four lambs) between 10 and 45 weeks of age prevented initiation of ovulation at the usual time (30 weeks of age). Ad libitum feeding of such growth-retarded lambs (n = 7) resulted in rapid catch-up growth and onset of reproductive cycles. The second experiment determined the effects of level of nutrition on tonic LH secretion in the presence and absence of inhibitory steroid feedback. Detailed LH patterns were obtained from agonadal lambs (ovariectomy at 20 weeks) that either remained undernourished (ca., 20 kg, 10-39 weeks of age) or were initially undernourished (10-27 weeks) and subsequently fed ad libitum (28 39 weeks). In undernourished lambs (n = 7), LH pulse frequency was slow, and only an occasional LH pulse was detected in the absence of steroid negative feedback; chronic treatment with low levels of estradiol (Silastic capsule), beginning at ovariectomy, prevented pulsatile LH secretion (six lambs). Ad libitum feeding (six lambs) produced a progressive severalfold increase in LH pulse frequency. Estradiol during ad libitum feeding (six lambs) markedly reduced amplitude of LH pulses and retarded the increase in LH pulse frequency. The third experiment, conducted at 40 weeks of age, determined the response to the stimulatory feedback action of estradiol. LH surges were readily induced in undernourished (20 kg) ovariectomized lambs (peak height 51 +/- 16 ng/ml, n = 6 of seven); chronic pretreatment with estradiol markedly reduced the magnitude of the LH surge (peak height 7 +/- 3 ng/ml, four of six). These findings raise the possibility that severe undernutrition prevents ovulation in the lamb by impairing the system governing GnRH secretion and its production of high-frequency LH pulses for follicular development to the preovulatory stage and its establishment of sufficient pituitary LH reserves for release by estradiol stimulatory feedback. PMID- 3964751 TI - Optimized kinetics of reverse-triiodothyronine distribution and metabolism in the rat: dominance of large, slowly exchanging tissue pools for iodothyronines. AB - We have estimated numerous physiological parameters of production, interpool transport, distribution, and metabolism of rT3 in the major rT3 pools of the unanesthetized male Sprague-Dawley rat. These results also have been combined with similar results for T3 and T4, generating a composite model for all three iodothyronines. Three different approaches were used to analyze the rT3 data, determined from five optimally timed blood samples collected in new tracer kinetic studies and processed by Sephadex chromatography and RIA. A model structure independent approach generated a plasma clearance rate of 2.82 (ml/min)/100 g BW, a plasma turnover rate of 1.05 min-1, a plasma-to-total tissue flux of 0.107 (ng/min)/100 g BW and a plasma appearance rate (PAR) of 0.061 (ng/min)/100 g BW, the latter being the product of the plasma clearance rate and the endogenous rT3 plasma concentration. Multicompartmental analysis resulted in additional parameters of physiological interest, many only as ranges or minimum and maximum possible values, owing to complex factors intrinsic in rT3 kinetics. Whole body rT3 production can be as low as 0.061 (=PAR), and as high as 0.377 (ng/min)/100 g BW, i.e. possibly as much as 5 times greater than the PAR, the conventional estimate of production rate. Plasma contains only 3-12% of total body rT3 (Qtot); slow tissue pools, that exchange rT3 slowly with plasma, possibly muscle, skin, and brain, contain 63-95% of Qtot, and produce more than 42% of total body rT3 from T4 locally; and fast tissues like liver and kidney contain 2-26% of Qtot, and produce more than 12% of total body rT3 from T4 locally. The plasma equivalent distribution volume (VD) of rT3 is 38-146 ml/100 g BW, and its whole body mean residence time is only 14-52 min, both of which are an order of magnitude smaller than corresponding T3 values; but VD for rT3 and T4 are roughly the same. Noncompartmental analysis underestimated VD and mean residence time by somewhere between a factor of 1.2 and 4.6. Overall, these results indicate that tissue pools that exchange rT3 slowly with the plasma pool contain the majority of rT3, T3, and T4 in steady state; and these tissues also are implicated as major sites of T4 monodeiodination, to both rT3 and T3. PMID- 3964752 TI - Some quantitative changes in iodothyronine distribution and metabolism in mild obesity and aging. AB - Effects of high fat diet (HFD)-induced obesity and moderate aging on iodothyronine kinetics were studied in young adult (3 month old) chow-fed male rats and two groups of older 9- to 11-month-old) male rats, one on chow and the other on HFD. Labeled T4, T3, and rT3 were each injected via an intraatrial double lumen catheter in unanesthetized rats. Serial blood samples were collected according to optimally designed schedules, and labeled iodothyronines in serum were quantified with three different Sephadex gel chromatographic systems. Comprehensive kinetic analyses indicated the following. Several T4 metabolic indices were markedly different between the two older groups (chow vs. HFD), most notable, increased plasma T4 clearance rate (0.098 vs. 0.15 ml/min), decreased plasma T4 concentration (23 vs. 15 ng/ml), and a plasma T4 fractional turnover rate 2 times greater (0.10 vs. 0.19/min), all in the HFD group. There was also a high negative correlation between T4 concentration and body weight (r = 0.77), but not with age. However, the three groups manifested no significant differences in T4 secretion rates (2.0 vs. 2.2 vs. 2.3 ng/min) or whole body pool sizes (2.1 vs. 2.3 vs. 2.4 micrograms). Accounting for metabolic body size, there still were no differences in T4 secretion rate or pool sizes. For T3, we found an almost 3 fold increase in T3 whole body production rates, and a greater than 2-fold increase (from about 25% to 60%) in the percentage of T4 converted to T3 in both older groups relative to that in the young rats. There were almost no significant differences in T3 kinetics between older HFD and older chow-fed groups, and differences in rT3 kinetics among the three groups revealed no clear pattern. Our results suggest that age-related correlations in T4 concentration are a consequence of body weight differences, not age as such. However, the metabolic fate of T4 changes with age, with more than twice as much converted to T3 in older animals. Constancy of T4 production rate and total pool size in young and older animals, independent of body weight, together with the apparent increase in T4 conversion to T3 suggest that the metabolic needs of the animal are being met by regulation of T3 production from T4 conversion, not by regulation of T4 production as such. PMID- 3964753 TI - Cerebrospinal fluid and plasma vasopressin in the fetal lamb: basal concentration and the effect of hypoxia. AB - The concentrations of vasopressin in the plasma and cerebrospinal fluid (CSF) of the chronically catheterized fetal lamb were measured under basal and hypoxic conditions. Under basal conditions, samples were obtained from 13 fetal lambs of 117-146 days gestation. The mean +/- SEM vasopressin level in CSF was 19.5 +/- 1.5 pg/ml; the mean plasma vasopressin level of 1.9 +/- 0.2 pg/ml was significantly less (P less than 0.001). No consistent change in concentrations of vasopressin in CSF was observed with gestational maturation in 3 animals sampled sequentially or in individual samples obtained over the last 32 days of gestation. The mean vasopressin concentration in the CSF of the pregnant ewe was 5.1 +/- 0.4 pg/ml. The gradients for osmolality, sodium, and potassium between fetal plasma and CSF were: osmolality, 298.4 +/- 1.6 to 304.3 +/- 1.4 mosmol/kg; sodium, 140.9 +/- 0.5-142.5 +/- 0.5 meq/liter; and potassium, 4.3 +/- 0.1 to 3.3 +/- 0.1 meq/liter. Fetal hypoxia was induced by exposure of the ewe to 10% O2 in N2 for 30 min. The concentration of vasopressin increased from 1.7 +/- 0.3 to 277 +/- 144 pg/ml (P less than 0.001) in fetal plasma and from 21.4 +/- 3.8 to 47.1 +/- 9.9 pg/ml (P less than 0.04) in fetal CSF. When the ewe was exposed to room air under comparable experimental conditions, no similar changes in plasma or CSF vasopressin levels were observed in the fetus. Infusion of vasopressin into the fetal jugular vein at 1.0 mU/min for 30 min increased plasma concentrations from 2.3 +/- 0.5 to 83 +/- 17 pg/ml, while the CSF vasopressin values were 31.9 +/- 5.9 (basally) and 30.7 +/- 4.8 pg/ml (after infusion). Mean plasma and CSF osmolality, sodium, and potassium were not changed by any of these experimental interventions. We conclude that 1) under basal conditions, high concentrations of vasopressin are present in the CSF of the fetal lamb, the blood-CSF barrier appears to be impermeable to vasopressin, and concentrations of the hormone in fetal plasma are less than those in CSF; and 2) hypoxia is a potent stimulus of vasopressin release in both fetal plasma and CSF. The route of vasopressin released into the fetal CSF may be distinct from that released into plasma. PMID- 3964754 TI - Androgen and estrogen receptors in fetal rhesus monkey brain and anterior pituitary. AB - In this study, we sought to identify and characterize cytosolic androgen and estrogen receptors in the brain and anterior pituitary gland (AP) of fetal rhesus monkeys using the technique of DNA-cellulose chromatography. Cytosolic extracts were prepared from fetal monkey (days 135-162 of gestation) tissues including hypothalamus-preoptic area/amygdala (HPOA/AMG), cerebral cortex, and AP. Extracts were incubated with [3H]testosterone, [3H]5 alpha-dihydrotestosterone, or [3H] 17 beta-estradiol and applied to DNA-cellulose columns. [3H]Androgen- and [3H]estrogen-binding activities from cytosolic extracts adhered to DNA-cellulose. After elution with a linear salt gradient (10-500 mM NaCl) [3H]androgen-binding activity exhibited elution maxima between 130-150 mM NaCl, while [3H] estrogen binding activity exhibited elution maxima between 200-220 mM NaCl. These elution patterns were similar in every region examined and were characteristic of putative androgen and estrogen receptors found in other vertebrate species. Additional experiments established the high affinity-low capacity nature of both androgen- and estrogen-binding activities, as well as their inhibition by known competitors of receptor binding. Estimates of binding activity at ligand concentrations that approximated saturation suggested that the concentration (moles specific bound per mg cytosolic protein) of both androgen and estrogen receptor were highest in the AP, intermediate in the HPOA/AMG, and lowest in the cerebral cortex. Comparisons of androgen- and estrogen-binding activities revealed that in the AP, apparent concentrations of the estrogen receptor exceeded those of androgen. Androgen and estrogen receptor concentrations were roughly equivalent in the HPOA/AMG, whereas, in the cerebral cortex, androgen receptor concentration was greater than estrogen. Collectively, these data demonstrate that in the fetal primate brain and AP, distinct androgen and estrogen receptors are present which might mediate the action of gonadal steroids on sexual differentiation. PMID- 3964755 TI - Characterization of the early stages of diabetic retinopathy by vitreous fluorophotometry. AB - We compared insulin-dependent diabetic patients with minimal (16 eyes of 9 patients) or no retinopathy (45 eyes of 27 patients) to normal volunteers (20 eyes of 12 subjects) using a commercial vitreous fluorophotometer and different procedures for artifact correction. The influence of background autofluorescence was minimized through the use of a software program that subtracted a fluorophotometric scan obtained before administration of fluorescein from that obtained after its injection. We also compared two programs designed to minimize the contribution of the chorioretinal peak spread function to the readings in the vitreous. The fluorescein concentration in the posterior vitreous was then averaged within two different regions. We then assessed the influence of these data-processing methods on the spread of the results of the different groups. The clinical study showed that only the posterior vitreous concentration of fluorescein is relevant in the evaluation of the blood-retinal barrier. However, since there is a gradient of fluorescein concentration in the posterior vitreous, one needs a scanning device so that one can measure at a precise location in front of the retina. The posterior vitreous concentration of fluorescein was significantly increased in diabetic subjects with one or no aneurysms as compared with normals. Moreover, the eyes with minimal retinopathy, as judged by the presence of microaneurysms, had higher values than those without retinopathy. The clear differences among these three groups were not present when the midvitreous values were used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964756 TI - Altered bile acid metabolism in nonobese, spontaneously diabetic (NOD) mice. AB - Cholesterol and bile acid metabolism was examined in nonobese, spontaneously diabetic (NOD) female mice before and after the development of diabetes. After the development of glucosuria, the plasma and liver cholesterol levels, gallbladder bile weight after 5-h fasting, biliary cholesterol, phospholipid and bile acid concentrations, the lithogenic index, the pool size of bile acids, and fecal sterol excretion markedly increased, but fecal bile acid excretion and fractional turnover rates for the cholic acid and chenodeoxycholic acid groups decreased. The distribution percentage of bile acids in the small intestine did not change, but it increased in the gallbladder and decreased in the large intestine. One striking finding was a change in the bile acid composition: increases were recorded in cholic and deoxycholic acids while decreases occurred in bile acids derived from chenodeoxycholic acid, such as beta-muricholic and ursodeoxycholic acids in the bile and alpha-muricholic, beta-muricholic, omega muricholic, and hyodeoxycholic acids in the feces. Therefore, the cholic acid group/chenodeoxycholic acid group (CA/CDCA) ratio increased in the bile, feces, and small and large intestines after the development of diabetes. These changes were very similar to those observed in alloxan-treated mice, suggesting that the changes found in NOD mice are caused by insulin deficiency. PMID- 3964757 TI - Metabolism of low-density lipoprotein from patients with diabetic hypertriglyceridemia by cultured human skin fibroblasts. AB - To test whether triglyceride-enriched low-density lipoprotein (LDL) obtained from subjects with diabetic hypertriglyceridemia is metabolized normally by cells, LDL was separated from seven healthy control subjects (fasting plasma glucose [FPG] 91 +/- 10 mg/dl [mean +/- SD], triglyceride [TG] 110 +/- 47 mg/dl), six diabetic normolipidemic patients (FPG 218 +/- 65 mg/dl; TG 139 +/- 75 mg/dl), six diabetic hypertriglyceridemic patients (FPG 214 +/- 71 mg/dl; TG 1915 +/- 1680 mg/dl), and five nondiabetic hypertriglyceridemic patients (FPG 92 +/- 8 mg/dl; TG 2013 +/- 1889 mg/dl). Binding of 125I-labeled LDL from hypertriglyceridemic subjects with and without diabetes to cultured skin fibroblasts was significantly decreased to 74 +/- 19% and 78 +/- 14% of that seen with LDL from normolipidemic nondiabetic subjects and diabetic normolipidemic controls (100 +/- 0%, 101 +/- 25%; P less than 0.005). Unlabeled LDL from hypertriglyceridemic subjects with and without diabetes failed to suppress LDL receptor activity and sterol synthesis from 14C acetate as efficiently as unlabeled LDL from healthy subjects. The ability of LDL from hypertriglyceridemic subjects, whether diabetic or not, to suppress LDL binding was inversely related to the ratio of triglyceride to protein in LDL (r = 0.71, P less than 0.01) and showed a positive correlation with the LDL cholesterol/protein ratio (0.69, P less than 0.01). Thus, LDL from patients with hypertriglyceridemia, with or without coexistent diabetes, shows impaired binding to LDL receptors and less ability to downregulate LDL receptor activity and sterol synthesis than does LDL from normolipidemic diabetic and nondiabetic subjects. These findings suggest that factors associated with hypertriglyceridemia rather than with diabetes result in altered metabolism of LDL in these disorders. PMID- 3964758 TI - Comparative esophageal and anorectal motility in scleroderma. AB - Esophageal and anorectal pressures were recorded in 26 patients (4 men and 22 women) with scleroderma. Eleven patients suffered from a localized form of the disease and 15 from progressive systemic sclerosis. The latter only had marked functional abnormalities in esophageal and anorectal motility. Mean resting pressure at the lower esophageal sphincter of patients with progressive system sclerosis and controls was, respectively, 6 +/- 2 and 25 +/- 1 mmHg (p less than 0.001); mean closing pressure was 5 +/- 5 and 48 +/- 3 mmHg (p less than 0.001); coordination of opening the lower esophageal sphincter with the oncoming contraction in the distal esophagus was 0% and 68% +/- 5% (p less than 0.001); and relaxation (fall of the lower esophageal sphincter pressure to resting levels in the stomach) was 18% +/- 12% and 98% +/- 1% (p less than 0.001). The rectoanal inhibitory reflex was of lesser amplitude than normal in 74% of patients with progressive system sclerosis and was absent in 13%. Quantitative analysis demonstrated a significant reduction in response to rectal distention with 20 or more ml of air (p less than 0.001). There was a correlation between the amplitude of the lower esophageal sphincter relaxation and the amplitude of the rectoanal inhibitory reflex in response to rectal distention with 30-50 ml of air (p less than 0.05 to p less than 0.025). Our data show that in systemic sclerosis, anorectal motility is as frequently abnormal as esophageal motility. PMID- 3964759 TI - Nausea, vomiting, and abdominal pain after Roux-en-Y anastomosis: motility of the jejunal limb. AB - The Roux-en-Y anastomosis is a surgical procedure performed to divert the pancreaticobiliary juices from the gastric pouch in patients who have alkaline reflux gastritis or esophagitis, or both, that develop after vagotomy and Billroth I or II operations. After the Roux-en-Y procedure the inflammation subsides but is often replaced by a characteristic group of symptoms--chronic abdominal pain, nausea, and vomiting worsened by eating. Using a semiconductor recording probe, we investigated the Roux limb in 7 subjects who were fasted and then fed (liquid and solid meals). In the fasted state the migrating motor complex was either completely absent or grossly disrupted. Only 1 subject converted to a fed-state motility pattern in the Roux limb after a liquid meal (Osmolite), and all 7 subjects failed to convert to a fed state after a solid meal. These studies suggest that the Roux-en-Y syndrome of pain, nausea, and vomiting is secondary to a defect in motor function and that the Roux limb is acting as an area of functional obstruction. PMID- 3964760 TI - Cholelitholysis using methyl tertiary butyl ether. AB - We tested methyl tertiary butyl ether both in vitro and in vivo to evaluate its efficacy as a potential cholesterol gallstone solvent for direct instillation into the human gallbladder or bile duct. Like diethyl ether, methyl tertiary butyl ether is an aliphatic ether with an excellent cholesterol-solubilizing capacity. However, unlike diethyl ether which vaporizes at body temperature, methyl tertiary butyl ether remains a liquid having a boiling point of 55.2 degrees C. In vitro, methyl tertiary butyl ether dissolved human gallstones (40% 94% cholesterol) within 60-100 min. In contrast, monooctanoin, an established gallstone solvent, required greater than 50 h to dissolve similar stones. By direct catheter instillation in 6 dogs, methyl tertiary butyl ether required only 4-16 h to dissolve gallstones surgically implanted in the gallbladder. The dogs tolerated methyl tertiary butyl ether with only minor clinical, biochemical, or histologic effects. We conclude that further evaluation of methyl tertiary butyl ether for dissolution of human gallbladder and biliary duct cholesterol stones is warranted. PMID- 3964761 TI - Increased biliary lipid secretion in celiac disease. AB - Direct measurements of biliary lipid outputs, cholesterol absorption, and fecal steroids were carried out in celiac patients before and during a gluten-free diet to show whether an enhanced flux of cholesterol into the gut (found earlier in these patients) is due to increased biliary output or mucosal secretion of cholesterol, or both. The bile flow rate and the secretion of biliary cholesterol, phospholipids, and bile acids were significantly increased in celiac disease and appeared to be normalized by effective gluten-free diet. A significant amount of cholesterol originated from the intestinal mucosa, but the amount was not consistently increased in the celiac patients. Fractional absorption of cholesterol was low, but due to enhanced biliary secretion the amount of cholesterol absorbed was mostly within the normal limits so that fecal neutral steroids of biliary origin and cholesterol synthesis were markedly increased in celiac disease. Despite high biliary bile acid secretion, fractional absorption of bile acids was enhanced. Thus, the effective ileal conservation of bile acids could have contributed to increased bile acid-dependent secretion of biliary cholesterol. The enhanced biliary and fecal output of cholesterol should ultimately be balanced by augmented cholesterol synthesis, but the closer site of the synthesis and regulatory mechanisms between cholesterol and lipoprotein metabolism need further exploration. PMID- 3964762 TI - Pathogenesis of precirrhotic portal hypertension in alcohol-fed baboons. AB - To study mechanisms and anatomic correlates of precirrhotic portal hypertension, we measured portal pressure either at laparotomy (in the portal vein) or by hepatic vein catheterization (wedge pressure) in 24 pairs of baboons fed 50% of energy either as ethanol or isocaloric carbohydrate (controls) for 4 mo-9 yr. On liver biopsy 7 had simple fatty liver; none had portal pressure exceeding the control range (2.7-13.0 cmH2O). The remaining 17 alcohol-fed baboons had fibrous tissue deposition around the terminal hepatic venules and adjacent sinusoids. The mean portal pressure was significantly increased (15.0 +/- 1.4 cmH2O) compared with the value in baboons with fatty liver (9.6 +/- 0.9 cmH2O) and in controls (8.0 +/- 0.6 cmH2O), with 8 animals exceeding the control range. Estimated hepatic blood flow was unchanged. Alcohol feeding resulted in increased hepatocyte size in both the fatty liver and fatty liver with fibrosis group; however, portal pressure did not correlate with alterations of cell size, liver volume, hepatic triacylglycerol, and protein contents. By contrast, for veins of comparable size, there was a significant correlation (r = 0.6666, p less than 0.01) between the thickness of the perivenular fibrous rim and portal pressure. Perivenular fibrosis was commonly associated with adjacent perisinusoidal fibrosis and this lesion also correlated with portal pressure. Furthermore, if one postulates that increased cell size causes enhanced pressure with secondary fibrosis, the latter should have first occurred "upstream," in the mid and portal zones. Sequential biopsy specimens, however, showed that fibrosis first appeared in the perivenular areas, suggesting that, in most instances, increased pressure is in fact secondary to the perivenular fibrosis. PMID- 3964763 TI - Factors influencing postexposure immunoprophylaxis of hepatitis B virus infection with hepatitis B immune globulin. High deoxyribonucleic acid polymerase activity in the inocula of unsuccessful cases. AB - Hepatitis B immune globulin was given intramuscularly to 102 staff members of a dialysis unit within 48 h after the accidental needlestick exposure to blood containing hepatitis B surface antigen (HBsAg). Hepatitis B virus (HBV) infection developed in 11 of 56 persons (20%) who had been exposed to blood containing hepatitis B e antigen (HBeAg). Among 56 HBeAg-positive inocula, HBsAg-associated deoxyribonucleic acid polymerase activity in the 11 inocula that transmitted HBV infection was significantly higher than that in the remaining 45 inocula that did not (log counts per minute 3.27 +/- 0.57 vs. 2.09 +/- 1.19, p less than 0.001). These 11 HBeAg-positive inocula revealed higher hemagglutination titers of HBsAg (geometric mean 13.5 +/- 1.4 vs. 11.2 +/- 3.2, p less than 0.001). The receptor for polymerized human serum albumin was detected significantly more often in the inocula that transmitted HBV infection than those that did not (10/11 vs. 24/45, p less than 0.05). Based on the results obtained, the failure in protecting all of those exposed to HBeAg-positive blood would be attributable to a high concentration of HBV in some HBeAg-positive inocula and the inability of intramuscular injection to raise a protective level of antibody in the circulation immediately. PMID- 3964764 TI - Abnormal clearance of immune complexes from the circulation of patients with primary sclerosing cholangitis. AB - The ability of fixed macrophages of the reticuloendothelial system to clear circulating immune complexes was studied in 6 patients with primary sclerosing cholangitis, 5 patients with various other forms of chronic liver disease, and 12 normal control subjects. Autologous red cells were radiolabeled with 51Cr and sensitized with anti-Rh(D) immunoglobulin G in vitro. After intravenous infusion of the labeled antibody-coated red cells, the radioactivity content of timed blood specimens was measured. The time required by the reticuloendothelial system to clear one-half the labeled cells from the circulation (t1/2) was then determined. The t1/2 clearance times were significantly prolonged in all 6 patients with primary sclerosing cholangitis, whereas the clearance times in 4 of the 5 liver disease control patients were either normal or shortened. Serum immunoglobulin G and immunoglobulin M immune complex levels did not correlate with t1/2 clearance times. These results suggest that in primary sclerosing cholangitis there is a defect in the ability of fixed macrophages of the reticuloendothelial system to mediate clearance of circulating particles that have been opsonized with immunoglobulin G. This finding further supports recent data that incriminates the immune system in the pathogenesis of primary sclerosing cholangitis. PMID- 3964765 TI - Hepatic hydrothorax in the absence of clinical ascites: diagnosis and management. AB - Two cases of right hepatic hydrothorax occurring in the absence of clinical ascites are reported. Diagnosis was confirmed by the intraperitoneal and intrapleural injection of radioisotope 99mTc-sulfur colloid that demonstrated the one-way transdiaphragmatic flow of fluid from the peritoneal to pleural cavities. In contrast, radioisotope injected into the peritoneal cavity of 5 patients with pleural effusions secondary to pulmonary or cardiac disease failed to traverse the diaphragm and localize in the pleural space. Medical therapy with salt and water restriction and diuretics resulted in both of the patients with hepatic hydrothorax developing signs of intravascular volume depletion without significant mobilization of the pleural fluid. Thoracotomy allowed identification of the diaphragmatic defects that were repaired by chemical and traumatic pleurodesis followed by postoperative peritoneal and pleural drainage. This therapy resulted in complete resolution of the pleural effusions, which have not recurred despite the subsequent development of clinical ascites in both patients. PMID- 3964766 TI - Organ specificity of LSP. PMID- 3964767 TI - Familial incidence of Crohn's disease. PMID- 3964768 TI - 111In-leukocytes in Crohn's disease. PMID- 3964769 TI - Serum bile acids, intrahepatic shunting, and total hepatic blood flow. PMID- 3964770 TI - Severe idiopathic constipation is associated with a distinctive abnormality of the colonic myenteric plexus. AB - We analyzed the clinical, radiographic, esophageal manometric, and pathologic features of 26 women with severe, idiopathic constipation. Twenty-four patients were between 19 and 39 yr of age. Stool frequency was once every 5-28 days. On barium enema examination, 9 of 24 patients had colons of increased length and 4 of these 9 patients had colons of increased width (greater than 10 cm). Radionuclide solid-meal gastric-emptying studies were normal in 23 patients tested. Esophageal manometry demonstrated high-amplitude waves in 10 of 22 patients and long-duration waves in 3 of these 10 patients. Rectal biopsy specimens showed normal submucosal neurons in all patients and melanosis coli in 6. Twelve patients underwent subtotal colectomies for constipation. Conventional light microscopy using hematoxylin and eosin serial sections showed (a) melanosis coli in 4 patients; (b) normal smooth muscle in 11; (c) thinning of the circular muscle in 1; and (d) no apparent abnormalities of the myenteric plexus in any. In contrast, silver stains of the myenteric plexus showed (a) quantitatively reduced numbers of argyrophilic neurons in 10 patients; (b) morphologically abnormal argyrophilic neurons in 11; (c) decreased numbers of axons in 11; and (d) increased numbers of variably sized nuclei within ganglia in all 12. A coded analysis of the silver stains of colons from 8 patients with constipation and 19 control cases demonstrated that the pathologic abnormalities of severe idiopathic constipation could be differentiated from controls. Thus, severe idiopathic constipation is associated with a pathologically identifiable abnormality of the myenteric plexus. This abnormality appears different from anything previously described in intestinal pseudoobstruction. PMID- 3964772 TI - Simultaneous assessment of fat maldigestion and fat malabsorption by a double isotope method using fecal radioactivity. AB - [14C]Triolein and [3H]oleic acid are useful tracers of dietary triglycerides and free fatty acids. The combustion/liquid scintillation counting technique was found a practicable method of estimating the fecal activity of these tracers. When ingested with the nonabsorbable marker 51CrCl3, the fecal excretion of 14C and 3H could be estimated accurately from samples of two stools. This technique was investigated as a test of lipid assimilation in a prospective, blind study of 84 consecutive patients suspected of malassimilation. The fecal excretion of 14C was a useful alternative to fecal fat: the patients with "normal lipid assimilation" excreted less than or equal to 10.4% of the dose ingested, whereas 25 of the 26 patients with steatorrhea ("unequivocal malassimilation") excreted greater than 10.4%. Fecal fat was normal in 18 patients who exhibited other signs of malassimilation ("equivocal malassimilation"); in 5 of these patients fecal excretion of 14C was greater than 10.4%. Lastly, there was a significant correlation between fecal 14C and fecal fat (r = 0.82, p less than 0.001). The fecal 14C/3H ratio was found useful as an index of pancreatic digestive function, being less than 1.3 in patients with "normal" lipid digestion and greater than or equal to 1.3 in 18 of the 19 patients with pancreatic steatorrhea and in 19 of the 27 patients with severely reduced exocrine pancreatic function. The test result was found widely independent either of the amount of carrier fat or the quality of the fecal collections and was therefore useful as an outpatient test. As it provided information about the pathogenesis of malassimilation and was at least as sensitive and specific as a fat "balance study," the test may be a useful alternative to fecal fat measurement. PMID- 3964771 TI - Role of aldosterone and dietary potassium in potassium adaptation in the distal colon of the rat. AB - The present experiments were designed to differentiate the effects of aldosterone and chronic potassium loading in the mechanism of colonic potassium adaptation, using a recently described animal model that permits systematic manipulation of aldosterone and dietary potassium. Unidirectional 42K fluxes were performed under short-circuit conditions across isolated distal colonic mucosa from rats with intact adrenal glands and in adrenalectomized, hormone-replaced animals. Administration of a potassium-enriched diet reversed net potassium absorption (+0.43 +/- 0.10 muEq/h.cm2) in intact animals to net potassium secretion (-0.76 +/- 0.08 muEq/h.cm2). Infusion of aldosterone in adrenalectomized animals, in an amount equivalent to that produced by potassium loading in intact rats, reduced JnetK to zero (-0.03 +/- 0.06 muEq/h.cm2). Similarly, zero net potassium transport (-0.14 +/- 0.08 muEq/h.cm2) was observed when experimental rats were fed a potassium-enriched diet and maintained with basal aldosterone levels. Therefore, both elevated aldosterone levels and a potassium-enriched diet had an effect on net potassium transport, but neither produced the full effects of chronic potassium loading. An increase in net potassium secretion (-0.57 +/- 0.07 myEq/h.cm2) comparable to that of intact potassium-loaded animals did, however, occur when potassium loading and elevated aldosterone levels were combined in experimental animals. These studies demonstrate that (a) chronic potassium loading alters active potassium transport by an aldosterone-independent mechanism and (b) the mechanism of chronic potassium adaptation represents the additive effects of increased dietary potassium and aldosterone. PMID- 3964773 TI - Chromoendoscopic observations on extension and development of fundal gastritis and intestinal metaplasia. AB - The development and extension of fundal gastritis and intestinal metaplasia were investigated by the endoscopic Congo red-methylene blue test in 44 healthy subjects, 106 patients with gastric ulcer, and 26 patients with gastric polyp. Follow-up chromoendoscopic examinations were made an average of 3.4 yr (range 1 10 yr) after the initial endoscopic assessment. Fundal gastritis and intestinal metaplasia developed or became more extensive with time in only 3 (6.8%) and 2 (4.5%) healthy subjects, respectively. In patients with gastric ulcer and in those with gastric polyp, fundal gastritis and intestinal metaplasia developed or extended significantly more frequently and more rapidly than in healthy subjects. Fundal gastritis and intestinal metaplasia developed or became more extensive, respectively, in 26 (24.5%) and 23 (21.7%) patients with gastric ulcer and in 10 (38.5%) and 10 (38.5%) patients with gastric polyp. Fundal gastritis and intestinal metaplasia extended with time mainly in an upward direction. PMID- 3964774 TI - Etiology of acute infectious diarrhea in a highly industrialized area of Switzerland. AB - During an 18-mo period between 1981 and 1982, a prospective study was conducted in 119 adult patients with acute diarrhea. A diarrhea-inducing microorganism or toxin could be identified in 38.7% of the patients. Salmonella sp and Campylobacter jejuni were the leading agents that caused diarrheal illness in 25% of the investigated population. Clostridium difficile was found in 6%, mainly after previous antibiotic therapy. Rotavirus was rarely isolated and enterotoxigenic Escherichia coli were not found. Clinical features in patients in whom an invasive agent was isolated did not differ from those in patients in whom no enteropathogens were found, although the occurrence of fecal leukocytes and positive hemoccult tests in the former group was significantly more frequent. More than 30% of the patients with negative stool cultures, however, showed fecal leukocytes and positive occult blood, which is suggestive of the existence of one or more invasive agent(s) so far unknown or not recognized. PMID- 3964775 TI - Sex differences in peptic ulcer disease. AB - As recently as 1968, twice as many men as women had peptic ulcer disease in the United States. To determine the current pattern of ulcer disease frequency in men and women, we examined data from the National Center for Health Statistics. These data show that the male predominance in peptic ulcer disease has changed. The male to female ratio is now 1.0 for self-reported period prevalence, and 1.3 for hospitalization and mortality. Ulcer prevalence rates for women have increased whereas rates for men have decreased. For hospitalizations and mortality, the changing sex ratios are primarily due to a more rapid decrease in duodenal ulcer rates for men than for women. Gastric ulcer hospitalizations for women have shown a marked increase for those greater than 65 yr old. PMID- 3964776 TI - Intracellular microelectrode studies of Necturus antral mucosa. Effect of aspirin on cell membrane potentials. AB - Intracellular microelectrode techniques were used to determine the effects of luminal aspirin on epithelial cell membrane potentials of Necturus antral mucosa. In this tissue, prolonged stable intracellular impalements were obtained with 15 50-M omega microelectrodes filled with 3 M KCl. In acidic mucosal solution (pH 4.0) the addition of aspirin at 5.0 mM resulted in a significant decrease of apical cell membrane potential (Vmc) from -36.8 +/- 2.2 to -22.2 +/- 2.1 mV (p less than 0.001) and basolateral cell membrane potentials (Vcs) from -38.8 +/- 1.7 to -25.3 +/- 2.1 mV (p less than 0.001). Upon removal of aspirin from the mucosal solution, both cell membranes hyperpolarized for a brief period before returning to their original potentials. In neutral mucosal solutions (pH 7.0), addition of aspirin (5.0 mM) resulted in a significant increase in apical cell membrane potential (Vmc) from -40.0 +/- 2.4 to -46.8 +/- 3.3 mV (p less than 0.001) and basolateral cell membrane potential (Vcs) from -41.5 +/- 2.0 to -49.7 +/- 2.5 mV (p less than 0.001). This hyperpolarization of the cell was associated with an increase in transmucosal potential from -1.5 +/- 1.8 to -2.9 +/- 1.8 mV (p less than 0.001) and an increase in the ratio of apical to basolateral membrane resistances from 2.2 +/- 0.4 to 3.1 +/- 0.7 (p less than 0.05). These changes in membrane potentials and the ratio of membrane resistances may be caused by a change in ionic conductance of the cell membranes induced by aspirin. PMID- 3964777 TI - Role of blood flow in gastric and duodenal mucosal injury in the rat. AB - The hemorrhagic hypotension model in anesthetized rats was used to study the relationship between gastric and duodenal mucosal blood flow and susceptibility to acid-induced injury. Mucosal blood flows measured by the hydrogen gas clearance technique in the corpus, antrum, and duodenum all showed a significant linear correlation with mean blood pressure, decreasing progressively as blood pressure fell. Significant gastric mucosal lesions occurred only after mean blood pressure and hence, mucosal blood flow was reduced to below 40% of baseline values. In contrast, duodenal mucosal lesion formation was related in a linear manner to decrease in mean blood pressure or blood flow. We conclude that mild reductions in blood flow are more important in the duodenum than in the stomach in increasing susceptibility of the mucosa to acid-induced injury. PMID- 3964778 TI - Effect of 16,16-dimethyl prostaglandin E2 on the surface hydrophobicity of aspirin-treated canine gastric mucosa. AB - The canine gastric mucosa has a uniquely hydrophobic or nonwettable surface that is rapidly disrupted by damaging agents such as aspirin. In this study we investigated the effects of acidified aspirin on the wettability of the luminal surface of gastric mucosae mounted in Ussing chambers in the presence of varying concentrations of 16,16-dimethyl prostaglandin E2. It was determined that surface hydrophobicity of the stomach, as measured by contact angle measurements, could be reduced by 50% with an aspirin concentration of 5 mM in the mucosal bath and that this change could be completely and significantly reversed by the addition of 16,16-dimethyl prostaglandin E2 (1 microgram/ml) to the nutrient compartment. 16,16-Dimethyl prostaglandin E2 at this dose was less effective in restoring the surface hydrophobicity in response to a higher concentration of aspirin (20 mM) that abolished the nonwettable property of the tissue. The reduced surface hydrophobicity in the presence of 5 mM aspirin could be increased in a dose response relationship to the nutrient 16,16-dimethyl prostaglandin E2 concentration, with an effect being seen at doses as low as 1 ng/ml. These results support the concept that prostaglandins may protect the stomach by the maintenance of a nonwettable hydrophobic lining between damaging agents in the lumen and the gastric epithelium. PMID- 3964779 TI - Evaluation of the protection of rat gastric mucosa by a prostaglandin analogue using cellular enzyme marker and histologic techniques. AB - Damage to the rat gastric mucosa after oral administration of ethanol and the effect of pretreatment with a prostaglandin analogue has been evaluated using histologic and enzyme-marker techniques. Rat whole stomachs were incubated in vitro and the intraluminal release of the cytoplasmic enzyme lactate dehydrogenase and the lysosomal enzymes acid phosphatase and beta-glucuronidase was determined by spectrophotometric techniques. Ethanol irrigation in vivo for 10 min significantly elevated the subsequent intraluminal release of both cytoplasmic and lysosomal enzymes in vitro. Pretreatment with 16,16-dimethyl prostaglandin E2 (0.1-1.25 microgram/kg p.o.) in doses that substantially inhibited the formation of macroscopically apparent necrotic lesions failed to prevent enzyme release. However, higher doses of the prostaglandin analogue (2.5 20 micrograms/kg) did significantly reduce the intraluminal release of the cellular enzymes, with the lysosomal enzymes being more readily inhibited. Histologic studies confirmed that the lower doses of the prostanoid prevented deep tissue necrosis and vasocongestion, yet did not protect surface epithelial cells from ethanol-induced damage. However, with the highest dose of 16,16 dimethyl prostaglandin E2 (20 micrograms/kg) a significant reduction in the extent of damage to the superficial epithelial cells was observed, suggesting a correlation with the findings using enzyme markers of cell damage. The apparent protective mechanisms of this prostanoid under the present conditions may involve mucus and fluid effusion that could allow restitution of the surface epithelial layer. PMID- 3964780 TI - Cytoprotection by prostaglandin occurs in spite of penetration of absolute ethanol into the gastric mucosa. AB - Several prostaglandins are cytoprotective for the stomach; they prevent mucosal necrosis and hemorrhages produced by noxious agents, such as absolute ethanol. One possible mechanism of cytoprotection would be that the prostaglandin may prevent penetration of the necrotizing agent into the gastric mucosa. To test this hypothesis, 2 ml of 100% ethanol containing tracer amounts of 14C at carbon 1 was given orally to rats, after ligating the pylorus. [14C]Ethanol was measured in the gastric mucosa and in plasma from 2.5 to 60 min after ethanol administration. 16,16-Dimethyl prostaglandin E2 was given orally at a cytoprotective dose (10 micrograms/kg) 15 min before 100% ethanol. The level of [14C]ethanol (disintegrations per minute per gram of tissue) in the gastric mucosa of 16,16-dimethyl prostaglandin E2-treated animals were not different from those of control animals. The plasma levels were slightly lower during the first 10 min, but the area under the curve for the entire 60 min was the same in both groups. We conclude that (a) 16,16-dimethyl prostaglandin E2 does not prevent entry of ethanol into the gastric mucosa; (b) 16,16-dimethyl prostaglandin E2 protects the cells located deep in the gastric mucosa from necrosis, in spite of the fact that these cells are in contact with as much ethanol as cells of untreated animals; (c) gastric cytoprotection is probably due to a defense mechanism at the cellular level. These findings minimize the importance of luminal factors, such as an increase in mucus or bicarbonate, in the mechanism of cytoprotection. PMID- 3964781 TI - Prostaglandin protection of the gastric mucosa against alcohol injury--a dynamic time-related process. Role of the mucosal proliferative zone. AB - The aim of the present study was first to resolve controversies regarding the extent of prostaglandin protection ("cytoprotection") of the gastric mucosa against injury produced by 100% ethanol and second to determine time sequence and histologic, ultrastructural, and functional features of this protection. Fasted rats received intragastrically (A) 0.9% NaCl alone as a control, (B) 5 micrograms/kg of 16,16-dimethyl prostaglandin E2 dissolved in 0.9% NaCl, and (C) 100 micrograms/kg of 16,16-dimethyl prostaglandin E2 dissolved in 0.9% NaCl. Thirty minutes later, 2 ml of 100% ethanol was instilled. The gastric mucosa was assessed macroscopically, by quantitative histology, and by scanning and transmission electron microscopy for [3H]thymidine uptake, mitotic activity, ion fluxes, and gastric potential difference determined at several time intervals (between 10 min and 16 h) after ethanol administration. Between 10 min and 16 h after ethanol administration macroscopic necrosis involved 27% +/- 3% to 41% +/- 4% of the mucosal area in controls (group A), but necrosis was prevented in groups receiving 16,16-dimethyl prostaglandin E2 (groups B and C). In the control group, histology and electron microscopy showed extensive disruption of the surface epithelium and deep necrosis (greater than 0.2 mm) involving greater than 46% +/- 4% of the mucosa between 15 min and 16 h after ethanol administration. Deep necrotic lesions were completely prevented by either dose of 16,16-dimethyl prostaglandin E2 (groups B and C). The mucosal proliferative zone was severely damaged in controls (68% +/- 5%) within the first hour after ethanol administration, whereas 16,16-dimethyl prostaglandin E2 protected the zone from damage (less than 5% +/- 1%). Neither dose of 16,16-dimethyl prostaglandin E2 prevented the occurrence of initial (at 15-30 min) morphologic and functional disruption of the surface epithelium after ethanol administration. However, initial disruption of the surface epithelium by 16,16-dimethyl prostaglandin E2 (groups B and C) was followed by migration of cells from the mucosal proliferative zone; the result was prompt restoration of the surface epithelium and resumption of its barrier and transport functions. PMID- 3964782 TI - Effects of 16,16-dimethyl prostaglandin E2 on ethanol-induced and aspirin-induced gastric damage in the rat. Scanning electron microscopic study. AB - Ethanol and aspirin were administered orally to fasted rats and the effects of 16,16-dimethyl prostaglandin E2 (given orally as a pretreatment) were studied using scanning electron microscopy. Gastric secretory studies (pylorus ligation for 2 h) showed that 3 and 30 micrograms/kg of 16,16-dimethyl prostaglandin E2 were nonantisecretory doses and that 100 micrograms/kg was an antisecretory dose. 16,16-Dimethyl prostaglandin E2, given orally at 3-100 micrograms/Kg, induced no appreciable changes in the gastric surface epithelial cells. Oral administration of 1 ml of 50% ethanol invariably induced, within 10 min, extensive exfoliation of surface epithelial cells throughout the corpus and antrum and exposed the lamina propria. 16,16-Dimethyl prostaglandin E2, given orally at 3, 30, and 100 micrograms/kg 30 min before ethanol treatment, had no protective effect. Aspirin, given orally at 30 or 100 mg/kg, also damaged the surface epithelium of both the corpus and the antrum within 10 min. This damage ranged from apical cellular erosions to widespread exposure of the lamina propria. 16,16-Dimethyl prostaglandin E2, given orally at 3 or 30 micrograms/kg 30 min before aspirin treatment, significantly inhibited the gastric damage induced by both 30 and 100 mg/kg of aspirin. The inhibition of damage index was about 50%-60% at either 30 or 100 micrograms/kg of 16,16-dimethyl prostaglandin E2. The mechanism of the protection seen with 16,16-dimethyl prostaglandin E2 remains to be determined. PMID- 3964783 TI - Effects of water immersion restraint stress and chronic indomethacin ingestion on gastric antral and fundic epithelial proliferation. AB - We studied the effects on gastric fundic and antral epithelial proliferation of acute water immersion restraint stress in rats and of chronic indomethacin ingestion in rats and humans using autoradiographic methods. Acute stress appeared to inhibit fundic epithelial proliferation but had no effect on antral proliferation in rats. We conjecture that this inhibition of fundic epithelial proliferation may help explain the development of stress-related mucosal lesions, which are more likely to occur in fundic mucosa. Chronic indomethacin ingestion stimulated fundic epithelial proliferation but had no effect on antral proliferation in both rats and humans. From these observations we conjecture that the failure of antral epithelial proliferation to respond to indomethacin may account in part for the ulcerogenic action of this drug. PMID- 3964784 TI - Effect of gamma-irradiation on the healing of gastric biopsy sites in monkeys. An experimental model for peptic ulcer disease and gastric protection. AB - The acute effects of gamma-irradiation on the gastric mucosa have been studied in a primate model. Fiberoptic gastroscopies were performed in 6 rhesus monkeys in the basal state as well as 3 h and 3, 7, and 9 days after total body irradiation (800 rads). Gastric biopsy specimens (diameter 1 mm) obtained during each session were examined using light microscopy and scanning electron microscopy; in addition, subsequent healing of the biopsy sites was assessed visually. Gastric biopsy sites were completely healed in 3 days in the basal state; in contrast, ulcer craters (diameter 1 mm) were still present at the site of the biopsies 3, 7, and 9 days after the biopsies were performed in irradiated animals. Light microscopic examination of the biopsy specimens demonstrated only lymphocytic infiltration of the lamina propria. In contrast, scanning electron microscopic examination revealed that the size and number of microvilli of the gastric surface epithelial cells were increased on the day of irradiation compared to basal; 3-9 days later, numerous gastric surface epithelial cells were damaged or had disappeared so that bare areas of the lamina propria were visible in the specimens taken outside of the ulcer craters. These changes may reflect inadequate protection of insufficient regeneration of gastric mucosal cells which, in turn, would explain the persistence of ulcers after gastric biopsies were performed in irradiated monkeys. PMID- 3964785 TI - Melatonin is metabolized to N-acetyl serotonin and 6-hydroxymelatonin in man. AB - To investigate whether melatonin (aMT) can be metabolized to N-acetyl serotonin (NAS), a low dose of deuterated aMT was administered to four normal subjects, and their urine samples were analyzed for the presence of deuterated NAS and deuterated 6-hydroxymelatonin (6-HaMT). In one set of experiments, the urine samples were subjected to column chromatography to separate the glucuronide and sulfate conjugates for independent analysis. In another, an internal standard (NAS-sulfate) was used for quantification and total conjugate analysis. Measurement was by gas chromatography-mass spectrometry, and the molecular ions of deuterated and nondeuterated NAS and 6-HaMT were monitored. Deuterated aMT was metabolized to deuterated NAS and deuterated 6-HaMT. The proportion of NAS was less in the sulfate than in the glucuronide conjugates and, overall, represented 15% of the total. Since demethylation is not a pathway that occurs with other pineal methoxyindoles, even at a much larger dose, it seems to be a significant finding with regard to aMT. Thus, it may be important to elucidate the differential metabolism of aMT at different time points and in different age groups. PMID- 3964786 TI - Hyperprolactinemia induced by an estrogen-progesterone synergy: quantitative and temporal effects of estrogen priming in monkeys. AB - We evaluated the quantitative and temporal characteristics of the estrogen component of an estrogen-progesterone synergy, which can induce hyperprolactinemia in macaques. In Exp I, six groups of monkeys were treated for 2 weeks with various doses of estradiol benzoate (EB), which resulted in peripheral estradiol concentrations of 250-1500 pg/ml, followed by 2 weeks of combined estrogen and progesterone treatment. In each of the groups, regardless of the dosages of estradiol benzoate alone, PRL concentrations remained within normal limits (approximately 18 ng/ml). In contrast, during the subsequent period of combined EB and progesterone therapy, hyperprolactinemia developed. The resultant PRL concentrations were not dependent on the dose of EB administered. In Exp II, three groups of monkeys were treated with EB (25 micrograms/kg) alone for various intervals and subsequently with both EB and progesterone for 14 days. When initiation of progesterone therapy was preceded by a 9- or 6-day period of estrogen priming, PRL concentrations were significantly (P less than 0.05) elevated within 3-4 days; in contrast, when the EB and progesterone treatments were initiated simultaneously, 8 days elapsed before the PRL elevations were significant. In a third experiment, to determine whether decidualized endometrium accounted for the increased PRL levels following estrogen and progesterone treatment, a hysterectomized monkey was treated with EB followed by combined EB and progesterone treatment. The PRL response was not different from that of intact monkeys similarly treated. From these findings we conclude 1) that the estrogen-progesterone synergy promoting PRL secretion is not of endometrial origin; 2) that approximately 1 week of estrogen priming is required for progesterone to induce PRL secretion; 3) and that the mode of action of estrogen is not dose dependent, but, rather, is a threshold effect. PMID- 3964787 TI - Relaxin in the pregnant baboon: evidence for local production in reproductive tissues. AB - We examined the nonluteal production of relaxin in the pregnant baboon. In experimental animals (n = 5), the corpus luteum-bearing ovary was removed in early pregnancy (days 25-30), and intact pregnant baboons served as controls. In both groups of baboons, peripheral, uterine, and ovarian venous blood samples and amniotic fluid were collected immediately before hysterotomy, which was performed late in pregnancy (days 139-142). After hysterotomy, samples of reproductive and control tissues were obtained (placenta, decidua, myometrium, fetal membranes, and omentum). Relaxin concentrations were determined in all samples using an antiporcine relaxin RIA. In unilaterally oophorectomized pregnant baboons, peripheral plasma levels of relaxin were below the limits of detection (less than 157 pg/ml) for 100 days following corpus luteum removal, while levels in control pregnant baboons were greater than 1000 pg/ml. Relaxin levels in uterine venous plasma were comparable to peripheral plasma levels in each group. Relaxin concentrations in amniotic fluid of both groups were below the limits of detection (less than 157 pg/ml). Relaxin was found in decidua, placenta, and myometrium in those pregnant baboons in which the corpus luteum-bearing ovary had been removed over 100 days earlier. This finding together with the absence of a relaxin gradient in uterine venous plasma and undetectable relaxin levels in amniotic fluid is a strong indication of local relaxin production in reproductive tissues without contribution to peripheral plasma levels. PMID- 3964788 TI - Endometrial and pituitary responses to the steroidal antiprogestin RU 486 in postmenopausal women. AB - The effects of the antiprogestin RU 486 on the human endometrium were investigated. Seventeen postmenopausal women were injected with estradiol (E2) benzoate (0.625 mg/day) for 15 days. Progesterone (P) (25 mg/day) and/or RU 486 (100 or 200 mg/day) were given to groups of 2-3 women during the last 6 days of E2 benzoate treatment. Serial blood samples were drawn for the measurement of plasma E2, P, and LH and FSH. An endometrial biopsy was performed on the last day of treatment, and processed for histology or for assays of DNA polymerase alpha, E2-dehydrogenase (E2DH), and P receptor (PR). Treatment with E2 benzoate alone resulted in a marked decrease of plasma gonadotropins; in those patients who received either P, RU 486, or both, in addition to E2 benzoate, the concentrations of plasma LH and FSH were further decreased to premenopausal levels. In absence of glycerol, the affinity of RU 486 for the endometrial PR (Kd = 0.8 nM) was higher than that of P (Kd = 1.2 nM). Glycerol decreased markedly the affinity of RU 486, whereas the affinity of P for the PR was unchanged. RU 486 had negligible affinity for plasma transcortin. Either P or RU 486, but not both together, induced secretory changes in the endometrium as determined from histologic sections of tissue biopsies. Either P or RU 486 decreased DNA polymerase alpha and increased E2-DH activities in the endometrium. Unexpectedly, when P and RU 486 were given together. E2-DH activity remained at the level found in E2-treated women. In vitro cultures of proliferative endometrium treated with the synthetic progestagen R 5020 or with RU 486 also had increased E2-DH activity; RU 486 counteracted R 5020 effects. We conclude that, contrary to previous results with experimental animals, the anti-P RU 486 has some progestomimetic activity in humans under specific conditions. Paradoxically, when given together with P, RU 486 lost most of its progestomimetic activity in the endometrium and behaved as a pure antagonist. PMID- 3964789 TI - Contrast analysis for the evaluation of the circadian rhythms of plasma cortisol, androstenedione, and testosterone in normal men and the possible influence of meals. AB - To evaluate the circadian rhythms of plasma androstenedione (delta) and testosterone (T), we used continuous blood withdrawal at 30-min intervals for 24 h to obtain integrated concentrations in six normal men. The data were submitted to contrast analysis as well as to a graphical method with smoothing of the variations between samples. As reference, cortisol (F) levels also were measured, since they have a well defined circadian rhythm. Integrated F concentrations had a circadian rhythm, with the highest levels between 0500 and 0900 h, nadir values between 2000 and 300 h, and secretory peaks coincident with lunch and dinner hours, suggesting the influence of food ingestion on secretion. Integrated androstenedione concentrations also had a circadian rhythm, with the highest levels between 0530 and 0930 h and the lowest between 1900 and 0230 h. There also were peaks with lunch and dinner, however, occurring some minutes before the corresponding ones for F. Integrated T concentrations had a circadian rhythm, with the peak values between 0100 and 1130 h and the lowest levels between 0700 and 2100 h. There were no peaks of the T integrated concentrations during the meal periods as found with F and delta. Furthermore, no correlation was found between the integrated concentrations of T and F or delta. PMID- 3964790 TI - Effects of aging and obesity on aromatase activity of human adipose cells. AB - Adipose tissue is the principal site of estrogen formation in postmenopausal women; with advancing age as well as with increased body weight, there is an increase in the fractional conversion of circulating androstenedione to estrone. We have studied the effects of aging as well as body weight on aromatase activity of adipose tissue specimens taken from 50 women of various ages and weights. Since aromatase activity of adipose tissue is detectable primarily in stromal cells, these cells were incubated with [1-3H]androstenedione (150 nM), and estrogen formation was assayed by measuring the incorporation of tritium into [3H]water. The aromatization rate, when normalized on the basis of equal numbers of cells, increased with increasing age (P less than 0.03; r = 0.43). In contrast, when expressed as a function of body weight, no change in aromatase activity of adipose stromal cells were found. Aromatization of androstenedione by cells from young women who had undergone oophorectomy was not increased compared with that of cells from young women with normal ovarian function, indicating that the onset of menopause per se and the accompanying increase in circulating gonadotropin levels were not causative factors in the increased aromatase activity of adipose stromal cells. We conclude, therefore, that increased estrone production associated with aging may result from an increase in the specific activity of the aromatase enzyme in adipose stromal cells and is not affected by changes in gonadotropin concentrations associated with menopause. On the other hand, the increase in estrogen formation as a function of obesity is probably due to increased numbers of adipose cells, rather than to an increase in the specific activity of aromatase in those cells. PMID- 3964791 TI - Naloxone-induced prolactin secretion in women: evidence against a direct prolactin stimulatory effect of endogenous opioids. AB - Because both opioids and ovarian steroids influence PRL secretion, the relationship between these inputs to PRL control was investigated. Infusion of the opiate receptor antagonist naloxone (1.6 mg/h for 4-8 h) failed to alter serum PRL levels in hypogonadal women or normal women in the early follicular or late luteal phase. In contrast, a prompt and sustained naloxone-induced release of PRL was found in the late follicular and midluteal phases of the cycle, with maximum increments (mean +/- SE) of 16.9 +/- 5.3 and 9.7 +/- 3.2 ng/ml, respectively. In the luteal phase women, the number of PRL pulses was significantly (P less than 0.001) greater during naloxone than during saline infusion (3.4 vs. 1.6 pulses/8 h), and a positive linear correlation was found between the integrated PRL response to naloxone and the levels of circulating estradiol (r = 0.62) and progesterone (r = 0.95). When serum LH concentrations were determined in the same samples, a significantly (P less than 0.001) greater synchrony of PRL with LH pulses during naloxone infusion (96%) compared to that during saline infusion (36%) was found in the luteal phase women. Thus, naloxone infusion induced an increase in pulsatile PRL release which was synchronized with LH pulses. These findings, not previously reported, suggest that a common neuroendocrine mechanism is involved in the opioidergic control of PRL and LH secretion and that this effect of naloxone is manifested only during high ovarian steroid environments. PMID- 3964792 TI - Adrenal rest tumor of the liver causing Cushing's syndrome: treatment with ketoconazole preceding an apparent surgical cure. AB - Ketoconazole, an imidazole derivative known to inhibit cytochrome P450-dependent adrenal enzymes was given to a patient with a functioning adrenal rest tumor of the liver in preparation for surgery. The drug was administered in a stepwise manner for 42 days starting with 400 mg and reaching 1 g the last 4 weeks of the trial. Clear clinical improvement was evident early in the trial and was associated with evidence of amelioration of her hypercortisolism and striking changes in serum and urinary levels of steroid hormones and metabolites. Sex steroids in serum and urine fell dramatically from the first day to the end of the trial. Urinary 17-ketosteroid excretion fell from a basal average of 139 mg/24 h to near normal levels within a week of therapy; serum testosterone fell from a basal level of 2.4 to 0.18 ng/ml; serum 17 beta-estradiol fell likewise from 1096 to 150 pg/ml. In contrast, cortisol levels in serum and urine increased in the first 2 weeks of the trial and subsequently fell to values below the basal levels. Similarly, serum 17 alpha-OH-progesterone levels increased 63% above the basal levels by day 6 of the trial and declined afterwards. Nine months after successful tumor resection the patient is apparently cured as judged by steroid hormone levels and physical appearance. We conclude that ketoconazole was effective in blocking tumoral steroidogenesis which resulted in clinical benefit. PMID- 3964793 TI - A novel oxytocin-like and vasotocin-like peptide in human plasma after administration of estrogen. AB - Using three antisera to oxytocin (OT Pitt Ab-1, OT Pitt Ab-2, and TOR OT Ab), we found comparable levels of OT in response to infant suckling and during infusion of synthetic OT, and identical standard curves with biological and synthetic standards of OT. Pitt Ab-1, but not Pitt Ab-2 or TOR OT Ab, measured increased OT in response to estrogen. Using an arginine vasotocin RIA (TOR AVT Ab), we found an increase in AVT immunoreactivity after estrogen treatment. Mean basal OT levels measured with OT Pitt Ab-2 in plasma of men [0.75 +/- 0.06 (+/- SEM) microU/ml] and women (0.8 +/- 0.09 microU/ml) were lower than OT measured with Pitt Ab-1 (1.7 +/- 0.09 microU/ml in men and 1.7 +/- 0.07 microU/al in women; P less than 0.001). Mean OT measured with Pitt Ab-2 in the plasma of women given estrogen chronically (0.8 +/- 0.04 microU/ml) and acutely (0.6 +/- 0.15 microU/ml) were not significantly different from basal levels. OT levels measured with Pitt Ab-1 in the same samples were 4.6 +/- 0.5 and 4.3 +/- 0.5 microU/ml, respectively, both significantly increased from basal levels (P less than 0.001) and significantly higher than OT measured with Pitt Ab-2 (P less than 0.001). Mean OT measured with Pitt Ab-1 in the plasma of pregnant women was 8.6 +/- 1.02 microU/ml, significantly higher than OT measured with Pitt Ab-2 (1.0 +/- 0.3 microU/ml; P less than 0.001). Men given 25 mg diethylstilbestrol had significant increases in OT measured with Pitt Ab-1 and in AVT measured with TOR AVT (P less than 0.01), but not in OT measured with Pitt Ab-2. Plasma from a man given diethylstilbestrol was prepared for high performance liquid chromatography and applied to a C18 muBondapak reverse phase column. The plasma contained two peaks of immunoreactivity detected as OT with Pitt Ab-1 and as AVT using TOR AVT Ab. The material was not detected by Pitt Ab-2 or TOR OT Ab and did not coelute with standards of OT, AVT, or AVP. Pregnancy plasma, thioglycolic acid, chymotrypsin, and trypsin reduced Pitt Ab-1, Pitt Ab-2, and TOR OT immunoreactivity of synthetic OT. The percent recovery of OT immunoreactivity was not significantly different with Pitt Ab-1 vs. Pitt Ab-2. A novel peptide, which is increased in response to administered estrogen, is present in human plasma and is detected by some antisera to OT and AVT. The observation explains the wide variability in OT levels in the estrogen-primed state and provides a new mechanism to study estrogen-related physiology and pathophysiology. PMID- 3964794 TI - The prediction of anatomical morphology of primary aldosteronism using serum 18 hydroxycorticosterone levels. AB - Serum 18-hydroxycorticosterone, aldosterone, and potassium were measured under basal conditions in 34 patients with documented primary aldosteronism, 10 patients with essential hypertension, and 9 normal subjects. The results revealed that 22 of 23 patients with aldosterone-producing adenomas had 18 hydroxycorticosterone levels greater than 100 ng/dl, and all 9 patients with idiopathic adrenal hyperplasia had plasma levels less than 100 ng/dl. Two patients with unusual macromicronodular hyperplasia of the adrenal glands had levels greater than 100 ng/dl. We found a significant relationship between serum potassium and the ratio of 18-hydroxycorticosterone to aldosterone in patients with idiopathic adrenal hyperplasia, but not in those with an aldosterone producing adenoma. We conclude that measurement of serum 18-hydroxycorticosterone is a useful predictor of the etiology of primary aldosteronism. PMID- 3964795 TI - A prospective study of bone mass in patients with type I diabetes. AB - Sixty-nine patients with type I diabetes mellitus were followed for from 1-4 yr (mean, 3 yr). Their overall growth, as measured by height and weight, was normal; however, repeated measurements of their bone mass using photon absorptiometry and radiogrammetry showed that, relative to normal subjects, the patients had a persistent bone deficit throughout the course of the study. This deficit was not attributable to bone width, which was normal. On the average, the magnitude of the deficit did not change with time; furthermore, an individual's rate of change in bone mass deficit during the study was not correlated with the patient's glucose control, as measured by hemoglobin A-1 or fasting blood glucose levels. Initial levels of serum ionized calcium and magnesium were decreased in the patients with diabetes. During the study, the mean level of ionized calcium increased, but that of magnesium decreased further, compared to the initial values. In a group of 19 patients with newly diagnosed diabetes, bone mass was found to be significantly below normal among the girls, but not among the boys. PMID- 3964796 TI - Comparison of clinical variables and variables derived from a limited predischarge exercise test as predictors of early and late mortality after myocardial infarction. AB - An exercise test limited to 5 METS or 70% of age-predicted maximal heart rate was performed 1 day before hospital discharge by 225 survivors of acute myocardial infarction, all of whom were subsequently followed up for at least 5 years. The mortality rate was 11.1% during the first year, but averaged only 2.9% per year from the second to fifth year. Over the entire follow-up period, the five variables that predicted mortality by multivariate analysis were QRS score, an exercise-induced ST segment shift, previous infarction, failure to achieve target heart rate or work load and ventricular arrhythmia during the exercise test. Because mortality differed markedly before and after 1 year, Cox regression analyses were performed separately for both of these periods. The factors that were predictive of mortality during the first year were an exercise-induced ST shift (p less than 0.0001, relative risk 7.8), failure to increase systolic blood pressure by 10 mm Hg or more during exercise (p = 0.0039, relative risk 4.3) and angina in hospital 48 hours or longer after admission (p = 0.0046, relative risk 3.4). None of these three variables was predictive of mortality after 1 year. Previous infarction (p = 0.0007), QRS score (p = 0.0042) and ventricular arrhythmia during the exercise test (p = 0.016) were predictive of mortality after the first year. Thus, clinical and exercise test variables are complementary predictors of mortality after myocardial infarction. An abnormal ST segment response during an early limited exercise test and angina in the hospital are common strong predictors of mortality to 1 year, but not thereafter. Late mortality correlates with markers of poor left ventricular function. PMID- 3964797 TI - Pharmacokinetic evaluation of the digoxin-amiodarone interaction. AB - Amiodarone is known to raise serum digoxin levels. This study was designed to evaluate the pharmacokinetic basis of this interaction in 10 normal subjects. The pharmacokinetic variables for digoxin were determined after a 1.0 mg intravenous dose of digoxin in each subject, before and after oral amiodarone, 400 mg daily for 3 weeks. During amiodarone administration, systemic clearance of digoxin was reduced from 234 +/- 72 ml/min (mean +/- standard deviation) to 172 +/- 33 ml/min (p less than 0.01). This was due to reductions in both renal clearance (from 105 +/- 39 to 84 +/- 15 ml/min) (p less than 0.05) and nonrenal clearance (from 130 +/- 38 to 88 +/- 20 ml/min) (p less than 0.01). Digoxin half-life of elimination was prolonged from 34 +/- 13 to 40 +/- 16 hours (p less than 0.05). Digoxin volume of distribution was not significantly changed. Amiodarone caused a three- to fivefold increase in serum reverse triiodothyronine levels, but changes in thyroid function were not quantitatively related to the changes in digoxin pharmacokinetics. These alterations in digoxin pharmacokinetics produced by amiodarone explain the increase in serum digoxin level that has been observed when this drug combination has been used clinically. PMID- 3964798 TI - Ventricular septal defect associated with aneurysm of the membranous septum. AB - The most common variety of ventricular septal defect, a perimembranous defect, is frequently associated with a so-called aneurysm of the membranous septum. Previous studies have suggested that ventricular septal defects associated with an aneurysm of the membranous septum tend to spontaneously decrease in size or close more than defects without such an aneurysm. To better define the natural history of this entity, clinical and catheterization data from 87 patients with ventricular septal defect and aneurysm of the membranous septum were reviewed. The initial evaluation was made at a median age of 0.3 years (range 0.1 to 11), with the final evaluation at a median age of 10 years (range 1.5 to 20) and a median duration of follow-up of 8.6 years (range 1.2 to 18.8). Approximately 75% of the ventricular septal defects had a small or no left to right shunt at last evaluation. Overall, 48 patients (55%) had no significant change in the size of the defect, and 39 (45%) showed improvement during the period of observation. Only four patients (5%) had spontaneous closure of the defect. Of the 49 patients who presented with a large left to right shunt, with or without congestive heart failure, 23 (47%) had persistence of a shunt large enough to warrant surgery. When spontaneous improvement occurred, it did so by 6 years of age in all but one patient. Therefore, a continued tendency for a ventricular septal defect associated with an aneurysm of the membranous septum to spontaneously decrease in size or close after this age may be less likely than previously suggested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964799 TI - Surgical management of refractory supraventricular tachycardia in infants and children. AB - Sixty-seven children underwent attempted surgical correction of refractory supraventricular arrhythmias using a combination of intraoperative electrophysiologic mapping followed by surgical division or cryoablation of an aberrant conduction pathway or atrial ectopic focus. The patients ranged in age from 4 months to 18 years (mean 11.4 years). Fifty-five patients (82%) had an abnormal conduction pathway crossing the atrioventricular junction (Kent bundle). Thirty-six (65%) of these 55 patients had classic Wolff-Parkinson-White syndrome with a delta wave of pre-excitation on the surface electrocardiogram. Nineteen (35%), however, demonstrated only retrograde conduction across the Kent bundle and had a normal surface electrocardiogram when tachycardia was not present. Kent bundles were isolated to the following locations: right anterior or lateral in 19 (34.5%), left posterior or lateral in 22 (40%), posteroseptal in 10 (18%), anteroseptal in 2 (4%) and both right and left in 2 (4%). Follow-up evaluation of as long as 8 years (mean 34.9 months) has shown seven immediate failures and one late recurrence of arrhythmia (14.5%). Recent refinements in technique and the use of cryoablation for septal aberrant pathways have improved these results. There have been two failures (8%) in the last 25 attempts. Twelve patients underwent surgery for an atrial ectopic focus by the following techniques: cryoablation in seven patients, excision in one patient and both excision and cryoablation in four patients. At a mean follow-up of 16.6 months, there was one late recurrence in the group with an atrial ectopic focus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964800 TI - Wolff-Parkinson-White syndrome and supraventricular tachycardia during infancy: management and follow-up. AB - The records of 90 patients with Wolff-Parkinson-White syndrome who presented with supraventricular tachycardia in the first 4 months of life were reviewed. Among these, 63% were male. Structural heart disease was present in 20%, most commonly Ebstein's anomaly. All patients presented with a regular narrow QRS tachycardia, and pre-excitation became evident only when normal sinus rhythm was established. Only one infant had atrial flutter and none had atrial fibrillation. Type A Wolff Parkinson-White syndrome was most common (49%), with heart disease occurring in only 5% of these patients. In contrast, heart disease was identified in 45% of those with type B syndrome. Initially, normal sinus rhythm was achieved in 88% of the 66 infants treated with digoxin with no deaths. Normal sinus rhythm resumed after electrical countershock in 87% of the 15 infants so treated. Maintenance digoxin therapy was used in 85 patients. The Wolff-Parkinson-White pattern disappeared in 36% of the patients. Four infants died of cardiac causes during the mean follow-up period of 6.5 years. Two of these four infants had congenital heart disease; the third, with a normal heart initially, developed ventricular fibrillation and died from a cardiomyopathy considered related to resuscitation. The remaining infant, with a normal heart, died suddenly at 1 month of age. All were receiving digoxin. A wide QRS tachycardia later appeared in three patients, all with heart disease, one of whom died.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964801 TI - Two-dimensional echocardiographic spectrum of univentricular atrioventricular connection. AB - The spectrum of anomalies in hearts having a univentricular atrioventricular (AV) connection was examined by two-dimensional echocardiography in 183 patients and the anatomic findings were compared with angiography. The mode of AV connection was found to be of three types: double inlet via two AV valves; single inlet via one AV valve with absence of the other (left or right AV valve atresia); and common inlet via a common AV valve. Identification of an accessory chamber by two dimensional echocardiography was possible with 90% sensitivity, but it was limited compared with angiography in patients with severely hypoplastic anterior chambers and pulmonary valve atresia. All patients with subaortic outlet foramen obstruction were detected. Great artery position and the presence of obstruction to pulmonary flow were correctly predicted in all but one patient. Two dimensional echocardiography was superior to angiography for the detection of AV valve abnormalities which were present in 27% and included abnormal chordae, hypoplasia or dysplasia of either valve. Two-dimensional echocardiography should play an essential role in the complete preoperative assessment of patients with univentricular AV connection. PMID- 3964802 TI - Double atrial responses to a single ventricular impulse due to simultaneous conduction via two retrograde pathways. AB - Electrophysiologic studies were performed in two patients. In one patient (Case 1) with ventricular pre-excitation and paroxysmal supraventricular tachycardia, studies after diltiazem administration showed two QRS responses to a single atrial stimulus during atrial pacing at a cycle length of 300 ms. The first QRS response with full pre-excitation and short PR interval was consistent with accessory pathway conduction, while the second QRS response with a normal duration and an atrio-His bundle interval of 350 ms was consistent with normal pathway conduction. The second QRS response was followed by initiation of supraventricular tachycardia. Studies after verapamil administration on a separate day disclosed two atrial responses to a single QRS complex during ventricular pacing at cycle lengths between 330 and 280 ms, suggesting simultaneous retrograde accessory and normal pathway conduction. In Case 2 with a supraventricular tachycardia using a fast atrioventricular nodal pathway for anterograde and a slow ventriculoatrial pathway for retrograde conduction, two atrial responses to a single QRS complex were observed during ventricular pacing at cycle lengths between 500 and 400 ms. The first atrial response showed a stimulus to atrial interval of 120 ms and an atrial activation sequence with the low septal right atrium being earlier than other atrial sites, suggesting retrograde fast pathway conduction. The second atrial response showed a stimulus to atrial interval of 505 ms and an atrial activation sequence with low septal right atrium being simultaneous with the proximal coronary sinus, suggesting retrograde slow pathway conduction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964803 TI - Noninvasive detection of aortic insufficiency in patients with mitral stenosis by pulsed Doppler echocardiography. AB - In patients with mitral stenosis, routine noninvasive techniques are insensitive for the detection of coexistent aortic insufficiency. The ability of pulsed Doppler echocardiography to detect the presence or absence of angiographically demonstrated aortic insufficiency was evaluated in 45 patients with rheumatic mitral stenosis. Pulsed Doppler echocardiography correctly identified the presence of aortic insufficiency in 97% of the 35 patients with documented aortic regurgitation. More important, pulsed Doppler echocardiography disclosed aortic insufficiency in all 7 patients in whom it was not suspected on physical examination and in 28 of the 29 patients in whom it was not suspected by M-mode echocardiography. Pulsed Doppler echocardiography also demonstrated excellent specificity, correctly detecting the absence of aortic insufficiency in 9 of the 10 patients who had no angiographic evidence of aortic insufficiency. It is concluded that in patients with mitral stenosis, pulsed Doppler echocardiography is a useful noninvasive diagnostic test for evaluating the presence of aortic insufficiency, even when this lesion is not detectable by physical examination or M-mode echocardiography. PMID- 3964804 TI - Doppler echocardiographic features of ventricular septal rupture in myocardial infarction. AB - Doppler echocardiography was used to evaluate the features of interventricular septal rupture in six patients with acute myocardial infarction and to substantiate the hemodynamic data and morphologic findings at surgery or autopsy. Although echocardiographic visualization of the septal rupture was obtained in only two of the six patients, unusual Doppler flow signals were detected in the apical portion of the right ventricle in all six patients. Five patients had unusual flow signals during both systole and diastole; one had such signals only during systole. The location of these unusual flow signals coincided with the site of septal rupture confirmed at surgery or autopsy. The pattern of the flow signals in one cardiac cycle was very similar to that of the pressure difference between the left and right ventricular cavities. These findings indicate that the unusual flow signals represent the left to right shunt flows resulting from septal rupture. In conclusion, Doppler echocardiography may be a very useful tool for diagnosing interventricular septal rupture easily and noninvasively in patients with acute myocardial infarction. PMID- 3964805 TI - Severe hypoxemia due to shunting through a patent foramen ovale: a correctable complication of right ventricular infarction. AB - A patient with recent inferior myocardial infarction with right ventricular involvement developed severe hypoxemia unresponsive to 100% oxygen. Contrast two dimensional echocardiography revealed right to left shunting through an aneurysmal fossa ovalis with a patent foramen ovale. This was confirmed by cardiac catheterization. Surgical closure of the defect was probably life-saving. This case report illustrates that right to left shunting through a foramen ovale should be considered in the differential diagnosis of hypoxemia in patients presenting with inferior myocardial infarction. PMID- 3964806 TI - Right ventricular function at rest and during exercise in aortic and mitral valve disease. AB - Right ventricular function at rest and during exercise was examined in a group of patients with symptomatic aortic or mitral valve disease, or both. The right ventricular ejection fraction was less than 45% in 22 of 36 patients at rest and in 12 of 17 subjects at symptom-limited, supine bicycle exercise. The right ventricular ejection fraction failed to increase more than 5% with exercise in 17 of 17 patients. The central venous pressure was greater than 5 mm Hg in 18 of 36 patients at rest and in 13 of 17 patients at maximal exercise. There was a significant inverse relation between rest right ventricular ejection fraction and mean pulmonary artery pressure (r = -0.47, p less than 0.05) and between rest right ventricular ejection fraction and mean central venous pressure (r = -0.39, p less than 0.05). There was no significant relation between the exercise values of these variables. In individual patients, the changes in right ventricular ejection fraction and pulmonary artery pressure with graded exercise were nonlinear. It is concluded that right ventricular function is not a simple function of pulmonary artery pressure at rest or during exercise in aortic and mitral valve disease. Less than one-quarter of the variation in right ventricular ejection fraction at rest can be explained by the variation in pulmonary artery pressure, and the finding of a normal (greater than 45%) right ventricular ejection fraction does not reliably exclude the possibility of pulmonary hypertension in a patient with valvular heart disease. PMID- 3964807 TI - Total correction of tetralogy of Fallot at age 40 years and older: long-term follow-up. AB - Whether total surgical correction of tetralogy of Fallot in adults aged 40 years old or older has acceptable operative risk and gratifying long-term results is unknown. The Mayo Clinic experience (June 1960 to May 1982) with 30 patients 40 to 60 years old (mean 47) who had total surgical correction of tetralogy of Fallot was reviewed. Preoperatively, 4 patients (13%) were in functional class I, 9 (30%) in class II and 17 (57%) in classes III and IV. Eight patients (27%) had had preoperative complications: five had a cerebrovascular accident and three had infective endocarditis. Only 11 patients (37%) had had palliative surgery 16 to 34 years (mean 22) before total surgical correction. Total surgical correction was successful in all patients. Right ventricular to left ventricular (RV/LV) pressure ratio of 0.65 or less was achieved in 28 (93%) of the 30 patients. One patient died of ventricular fibrillation (RV/LV ratio = 0.8) 2 days postoperatively, one had complete heart block and one had a cerebrovascular accident 7 days after operation. At follow-up of 5 to 266 months (mean 110), there were seven late deaths: two sudden at 5 and 21 years, respectively, after operation, one from myocardial infarction at 11 years, one from cerebrovascular accident at 11 years, one from congestive heart failure (RV/LV ratio = 1.0) at 8 years and two from noncardiac causes. Of the 22 patients who survived, 16 are in class I, 5 are in class II and 1 is in class III.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964808 TI - Sustained symptomatic sinus node reentrant tachycardia: incidence, clinical significance, electrophysiologic observations and the effects of antiarrhythmic agents. AB - The clinical, electrocardiographic and electrophysiologic determinants and effects of antiarrhythmic agents on sustained sinus node reentrant tachycardia remain poorly defined. Of 65 consecutive men undergoing electrophysiologic studies for symptomatic paroxysmal supraventricular tachycardia over a 4 year period, 11 (16.9%), who ranged in age from 39 to 76 years, demonstrated sustained sinus node reentrant tachycardia. On the surface electrocardiogram, before electrophysiologic studies, the following diagnoses were considered in the 11 patients: sinus node reentrant tachycardia on the basis of an RP'/P'R ratio of greater than 1 and P wave configuration similar to that of sinus P waves (7 patients); atrioventricular (AV) nodal reentrant tachycardia on the basis of an RP'/P'R ratio of less than 1 (3 patients); and paroxysmal atrial tachycardia with AV block (1 patient). All 11 patients had a history of recurrent palpitation, 4 had syncope, 2 had dizzy spells and 9 had organic heart disease. Sustained sinus node reentrant tachycardia could be reproducibly induced in all 11 patients during atrial pacing or premature atrial stimulation, or both, over a wide echo zone. The tachycardia could be terminated by carotid sinus massage, atrial pacing and premature atrial stimulation. Characteristics of tachycardia included: high low activation sequence; cycle lengths of 250 to 590 ms with wide fluctuations of 20 to 180 ms in individual patients; RP'/P'R ratio of greater than 1 in 8 (73%) of the 11 patients and a ratio of less than 1 in 3 (27%). Induction of sustained sinus node reentrant tachycardia was prevented by intravenous ouabain (0.01 mg/kg body weight) in two of two patients, by intravenous verapamil (10 mg) in two of two patients and by intravenous amiodarone (5 mg/kg body weight) in four of four patients. In contrast, intravenous propranolol (0.1 mg/kg body weight) did not affect induction of sustained sinus node reentrant tachycardia in two of two patients. It is concluded that sustained sinus node reentrant tachycardia, seen in 16.9% of the study patients with paroxysmal supraventricular tachycardia, is not as benign as previously believed; it is frequently associated with organic heart disease; it demonstrates wide variations in cycle length, unlike other forms of paroxysmal supraventricular tachycardia; it can masquerade as AV nodal reentrant tachycardia and paroxysmal atrial tachycardia with AV block on the surface electrocardiogram in 36% of patients; and it is responsive to intravenous administration of ouabain, verapamil or amiodarone. PMID- 3964809 TI - Coronary angiographic significance of left anterior fascicular block during acute myocardial infarction. AB - The clinical and angiographic significance of isolated left anterior fascicular block occurring during the early stage of acute myocardial infarction was studied in 141 consecutive patients who underwent cardiac catheterization before hospital discharge. Left anterior fascicular block occurred in 15 of the 62 patients with an anterior wall infarction and in 13 of the 79 with an inferior infarction. None of the clinical characteristics differed among patients with or without left anterior fascicular block. The number of coronary vessels with significant stenosis, the Friesinger and the Gensini scores for severity of stenosis and the ejection fraction were also similar in the two groups. Patients with left anterior fascicular block had more severe narrowing of the coronary artery supplying the infarct zone (88 +/- 21 versus 70 +/- 35%, p less than 0.001) and tended to have less developed collateral circulation (collateral score 0.7 +/- 0.8 versus 1 +/- 0.8, p = 0.10). A significant stenosis of the left anterior descending coronary artery was found as frequently in patients with as in those without left anterior fascicular block (64 versus 65%); 29% of the patients with inferior wall infarction and left anterior fascicular block had left anterior descending coronary artery stenosis compared with 47% of the patients without this conduction disturbance (no significant difference). When the infarction was located anteriorly, a significant stenosis of the proximal segment of the left anterior descending coronary artery was present in 47% of the patients with and in 45% of the patients without left anterior fascicular block.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964810 TI - Immunoglobulin subclass (IgG3) restriction of anti-P and anti-Pk antibodies in patients of the rare p blood group. AB - Serum antibodies against globoside and ceramide trihexoside, two major glycolipids in human erythrocytes, were investigated in 29 individuals with the rare p blood group. Antibodies of the IgM and of the IgG3 classes were detected. In AB Rh(-) blood donors, who were not of the p blood group, low levels of antibodies of the IgM class were found against P and Pk, whereas no antibodies were detected in cord blood. The increased number of spontaneous abortions and stillbirths observed among the p individuals may relate to the presence of IgG3 antibodies, because such antibodies pass the placental barrier and are efficient in complement activation and in mediating antibody-dependent cytotoxicity. PMID- 3964811 TI - Effects of ultraviolet radiation on human epidermal cell alloantigen presentation: initial depression of Langerhans cell-dependent function is followed by the appearance of T6- Dr+ cells that enhance epidermal alloantigen presentation. AB - The effects of ultraviolet radiation (UV) on the immune parameters of human epidermis were studied. We determined the effects of both in vitro and in vivo UV on human epidermal cell surface markers and on epidermal immune function in the allogeneic epidermal cell-lymphocyte reaction (ELR). Epidermal cells obtained immediately after in vitro and in vivo UV exposure exhibited a dose-dependent decrease in alloantigen-presenting function in the ELR. This was not the result of a decrease in the number of T6+ Dr+ Langerhans cells but was due to their being less efficient at alloantigen presentation than equivalent numbers of Langerhans cells from unirradiated skin. The reduced stimulation in the ELR immediately after UV was not reversible by the addition of exogenous IL 1 or indomethacin and thus appeared to be due to a direct effect of UV on the alloantigen-presenting function of Langerhans cells. In contrast to this suppression of the epidermal immune function when epidermal cells were obtained immediately after UV, epidermal cells harvested 24 hr or later after in vivo UV exhibited a dose-dependent enhancement of allostimulatory capacity in the ELR that peaked 3 days after UV. The time course of the enhancement of allostimulation in the ELR after in vivo UV coincided with a decrease in the percentage of Langerhans cells and the appearance within the epidermis of T6- Dr+ cells, which are derived from the bone marrow, as evidenced by their expression of the bone marrow derivation markers HLe 1 and T200. Removal of Dr+ cells but not of T6+ cells from epidermal cell suspensions harvested 3 days after in vivo UV abrogated allostimulation in the ELR, demonstrating that the T6- Dr+ cells were responsible for the observed UV-induced enhancement of alloantigen presentation. Taken together, the results indicate that the timing and dosage of UV exposure are critical factors determining whether suppression or enhancement of epidermal immune function follows UV. PMID- 3964812 TI - Potential Z-DNA-forming elements in serum DNA from human systemic lupus erythematosus. AB - DNA fragments were isolated from serum of a patient with systemic lupus erythematosus. The majority of the DNA was between 150 and 250 base pairs in length. The DNA was cloned into phage M13, and 10 recombinants were sequenced. The average GC content of the DNA was higher than total human DNA (43% against 38%), with some fragments as high as 63%. This DNA is rich in alternating purine pyrimidine segments that are potentially Z-DNA-forming regions. PMID- 3964813 TI - Hybridoma anti-DNA autoantibodies from patients with rheumatoid arthritis and systemic lupus erythematosus demonstrate similar nucleic acid binding characteristics. AB - Hybridoma anti-DNA antibodies have been generated from the fusion of the GM 4672 lymphoblastoid line with peripheral blood lymphocytes from four normal subjects, nine patients with rheumatoid arthritis (RA), and 13 patients with systemic lupus erythematosus (SLE). A total of 441 hybridoma clones were obtained, of which 37 secreted anti-DNA autoantibodies. The nucleic acid binding characteristics of the anti-DNA antibodies produced by two hybridomas from normal subjects, nine hybridomas from RA patients, and 18 hybridomas from SLE patients are reported. The hybridoma anti-DNA antibodies from all three groups showed similar antigen binding characteristics for denatured DNA (dDNA), native DNA (nDNA), poly(I), poly(dT), and cardiolipin, by both direct binding and competitive binding analyses. One difference noted between normal-derived anti-DNA antibodies and autoimmune-derived antibodies was the inability of the former to react with z DNA. However, this requires further substantiation with larger numbers of normal derived clones. The broad overlap of reactivity to nucleic acid antigens among individual anti-DNA autoantibodies found in two clinically different autoimmune diseases, namely RA and SLE, suggests that the pathogenicity of anti-DNA autoantibodies may bear no relationship to their nucleic acid antigen-binding characteristics. PMID- 3964814 TI - Effects of short-term administration of sex hormones on normal and autoimmune mice. AB - The effects of short-term administration (2 to 4 wk) of sex hormones on the immune system of normal (C57BL/6) and autoimmune (C57BL/6-lpr, C3H/lpr, B/W) strains of mice were investigated. Both estrogen (E2) and testosterone (Te) had significant effects on the numbers of T and B cells as well as on the density of cell surface antigens as demonstrated by flow cytometry. For example, Te depleted Thy-1.2+ thymocytes in normal mice and brought about a shift to lower density cells. Lyt-2+ cells appeared to be the main target cells of hormonal modulation in normal and autoimmune mice. Both sex hormones significantly depleted these cells in the thymus but had differential effects in the peripheral lymphoid organs, particularly in the spleen. In general, E2 depleted Lyt-2+ cells, whereas Te increased or maintained this subpopulation of cells in spleen and lymph nodes. Similarly, the suppressor cell activity and IL 2 production on a per cell basis in E2-treated animals was diminished, whereas Te-treated animals had normal or enhanced activity. The relevance of these findings to differential sex susceptibility in autoimmune diseases is discussed. PMID- 3964815 TI - Characterization of mononuclear phagocyte subpopulations in the human lung by using monoclonal antibodies: changes in alveolar macrophage phenotype associated with pulmonary sarcoidosis. AB - Current concepts of pulmonary sarcoidosis suggest that the alveolar macrophage plays a central role in the pathogenesis of the disease. To help define the population of alveolar macrophages in sarcoidosis, we compared the surface phenotype of alveolar macrophages from patients with sarcoidosis and from normal individuals by using monoclonal antibodies (63D3, OKM1, M phi P-9, M phi S-1, 61D3, and M phi S-39) that detect surface antigens on cells of monocyte/macrophage lineage. Although almost all blood monocytes expressed surface antigens detected by each of these antibodies, only a minority of normal alveolar macrophages expressed the same surface antigens (p less than 0.05, each comparison). However, in sarcoidosis, the percentage of alveolar macrophages expressing these surface antigens was increased (p less than 0.05, each comparison with normal alveolar macrophages). Several findings supported the conclusion that the increased expression of these monocyte-lineage surface antigens on sarcoid alveolar macrophages resulted from increased recruitment of monocytes to the lung in sarcoidosis and not from abnormal "activation" of alveolar macrophages. First, alveolar macrophages expressing these antigens had an immature morphology. Second, in vitro cultivation of blood monocytes and alveolar macrophages in the presence of immune and inflammatory mediators, including mediators known to be present in the lung in sarcoidosis, did not prevent the loss of expression of monocyte-lineage surface antigens from monocytes or induce reexpression of monocyte-lineage surface antigens on alveolar macrophages. Third, the expression of monocyte-lineage surface antigens was only increased on sarcoid macrophages from patients whose lower respiratory tract contained an increased number of T lymphocytes, cells known to release monocyte chemotactic factor in sarcoidosis. Consistent with the knowledge that corticosteroids usually suppress the alveolitis of active sarcoidosis, when the expression of alveolar macrophage surface antigens was evaluated before and during therapy, the percentage of alveolar macrophages expressing monocyte lineage surface antigens returned to normal after 1 to 3 mo of therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3964816 TI - T15 D region germ line amino acid sequences distinguished by monoclonal anti idiotope antibody. AB - Monoclonal antibody NL16, prepared with phosphorylcholine (PC)-binding myeloma protein C.BBPC3 (C3), identified an idiotope (C3-16 Id) that was present on T15 IdX+ myeloma proteins (MP) C3, T15, and H8, but not the T15 IdX- MP M167 and M603. The binding of C3 to NL16 is PC inhibitable, indicating that C3-16 Id is site associated. Inhibition studies with PC-specific hybridoma proteins (HP) demonstrated that the T15-type L chain VK22 and elements of the H chain were required for C3-16 Id expression. Studies of amino acid sequences of these PC binding HP and MP showed that VK22+, T15 IdX+ HP, and MP that use the T15 D region (YYGSS) sequences were always C3-16 Id+. However, the reverse was not true, because all but one VK22+, T15 IdX+ HP with D region sequence changes were C3-16 Id-. This suggested that NL16 defined a specificity mainly determined by the D region of the H chain. A direct test of this hypothesis with heterologous heavy/light chain recombinant molecules obtained from C3-16 Id+ and C3-16 Id- HP of known sequence, showed that the D region was critical to idiotope expression. Additionally, an examination of the amino acid sequences of VK22+, T15 IdX- HP, HPCG14, and HPCM6 suggest that profound changes in the D region may also alter the expression of T15 IdX (an Id defined by a multispecific antiserum from A/He mice). The C3-16 Id+ was found in anti-PC serum of most Ig haplotype-inbred strains except for CBA/J, C3H, and PL, which are all of the Igh-Cj haplotype. Amino acid sequences of PC-binding CBA and PL HP showed marked changes in the D region from the T15 type, and this may account for the C3-16 Id- character of Igh Cj strains. PMID- 3964817 TI - A linkage between the hemostatic and immune systems embodied in the fibrinolytic release of lymphocyte suppressive peptides. AB - Some cellular immune responses initiate the coagulation protease cascade and promote the formation of fibrin. Local fibrin deposition is requisite for the induration associated with delayed hypersensitivity reactions. The deposited fibrin also is catabolized. In the present study we demonstrate that plasmic cleavage of fibrinogen results in the generation of immunosuppressive activity in vitro that is not expressed by the intact molecule. This property is associated with small dialyzable peptides recovered from advanced plasmic digests of fibrinogen. The peptides inhibit phytohemagglutinin-, pokeweed mitogen-, and allogeneic cell-stimulated blastogenesis as well as proliferation in a dose dependent fashion. The suppression of lymphocyte responses does not result from loss of cells or their viability. Suppression requires the presence of the peptides at the time of, or immediately after, the exposure of cells to the appropriate stimulus, and is manifest as both a delay and an absolute inhibition of [3H]thymidine uptake. Human peptides inhibit the response of murine spleen cells to mitogens, and B and T lymphocyte classes appear to be equally sensitive to suppression. Thymidine uptake by two continuous lymphoblastoid cell lines also is inhibited by the peptides, indicating a direct effect of the fibrinogen derived peptides on lymphocytes. In contrast, the peptides stimulate thymidine uptake by a diploid fibroblast line, suggesting selectivity in the biologic effects of the peptides. These observations indicate that in addition to its primary role in hemostasis, the participation of fibrinogen and its derivative fibrin in inflammatory lesions includes the release of lymphocyte-suppressive peptides. This may play a role in regulation of the evolution of immunologic lesions in vivo. PMID- 3964818 TI - Binding and activation of hemolytic complement by IgG antibodies: cooperativity between antibodies of different hapten specificity. AB - The ability of IgG antibodies with different hapten specificities to fix C1 and activate C as a function of hapten density on a red cell surface was investigated. Rabbit anti-methotrexate and anti-folinic acid IgG antibodies in a mixture were highly efficient in fixing C1 and activating C when cells carried simultaneously high levels of both haptens. We wished to find out whether in a C activating IgG complex both IgG molecules had to be in a form that could activate C1. By reducing hapten density of one of the haptens on a double labeled cell, complexes were generated where only one in a pair of IgG molecules was in the activating form; such a pair had the same activating efficiency as a pair in which both IgG molecules were in the activating form. It was concluded that cooperative activation of C in C1-binding IgG complexes required only one IgG in the complex to be in the activating form. PMID- 3964819 TI - The membrane attack complex of complement: C5b-8 complex as accelerator of C9 polymerization. AB - Polymerization of C9 occurs spontaneously or can be induced by the tetramolecular complex C5b-8. Spontaneous C9 (0.15 mg/ml) polymerization required more than 3 days at 37 degrees C. In the presence of C5b-8, C9 polymerization was complete within 10 min. The molar C9:C5b-8 ratio determined the extent of tubular poly C9 formation by C5b-8-bearing phospholipid vesicles. When this ratio was 9:1 or 12:1, 72% of complex-bound C9 was present as SDS resistant tubular poly C9 (Mr = 1.1 X 10(6]. At lower C9:C5b-8 ratios, poly C9 was bound primarily in nontubular form. Tubular poly C9, as part of C5b-9, could also be generated on rabbit erythrocytes by using whole human serum as a complement source. At limiting serum concentration (molar C9 to C8 ratio approximately 2), no SDS-resistant tubular poly C9 was detected. At high serum concentration or when using serum that was supplemented with C9, up to 40% of the C9 was SDS-resistant tubular poly C9, and the rest was poly C9, which was incompletely polymerized. It is suggested that the C5b-8 complex acts as an accelerator of C9 polymerization, and that its relative concentration to C9 determines the ultrastructure of the C5b-9 complex. PMID- 3964820 TI - Enhanced reactive lysis of paroxysmal nocturnal hemoglobinuria erythrocytes by C5b-9 does not involve increased C7 binding or cell-bound C3b. AB - The most complement (C)-sensitive type of erythrocytes (E) occurring in paroxysmal nocturnal hemoglobinuria (type III PNH E) have previously been found to exhibit approximately twofold to fourfold greater lysis than normal human E when exposed to isolated human C5b6, C7, C8, and C9 (reactive lysis), in the absence of a known source of C3- or C5-convertases or fluid-phase C3. In further studies on the mechanism of this phenomenon, we now report that C5b6-dependent binding of 125I-C7 to two samples of PNH E (greater than 95% type III) is equal to that found with normal human E at each of several C5b6 inputs tested. Lysis developed by excess C8 and C9, however, was consistently greater for the PNH E. Thus, the exaggerated sensitivity of type III PNH E to reactive lysis cannot be explained by abnormally high uptake of C5b6 or C7 from the fluid phase. Rather, the data indicate that cell-bound C5b67 sites are converted to effective hemolytic sites with greater efficiency on type III PNH E than on normal human E, assuming that the distribution of cell-bound C7 throughout both cell populations is similar. In related studies we have addressed the proposal by other investigators that C3b putatively bound to PNH E in vivo might account for their increased sensitivity to reactive lysis in vitro, by analogy to prior observations on C3b-potentiated reactive lysis of sheep E. The latter hypothesis was made more appealing by the recent discovery that type III PNH E lack an integral membrane protein, decay-accelerating factor (DAF), which in normal E accelerates the decay of membrane-bound C3 convertases. Against this hypothesis, however, is our present finding that preincubation of PNH E with four different goat or rabbit polyclonal antibodies to human C3 failed to inhibit the subsequent reactive lysis of these cells. Under these same conditions, the C3b-dependent increment in reactive lysis of sheep EAC4b3b was abrogated by pretreatment with similar dilutions of these anti-C3 antibodies, generally in association with agglutination. Furthermore, sheep EAC4b3b displayed increased 125I-C7 binding in proportion to augmented lysis, in contrast to the findings with PNH E. Therefore, deficiency of DAF in type III PNH E does not adequately explain their supranormal sensitivity to reactive lysis unless DAF can modulate the terminal lytic steps by a mechanism distinct from its effect on C3 convertase decay. Alternatively, type III PNH E could have a more general abnormality in which DAF deficiency is one manifestation and increased sensitivity to reactive lysis is another. PMID- 3964822 TI - In vitro mutagenesis of a mouse MHC class I gene for the examination of structure function relationships. AB - Oligonucleotide-directed, site-specific mutagenesis has been employed to elucidate the role of individual amino acids on the expression and function of a MHC class I antigen. Two oligonucleotides were synthesized to introduce single amino acid substitutions in the murine H-2Ld gene. The highly conserved glycosylation site at amino acid position 86 was changed from asparagine to lysine to remove the carbohydrate moiety from the first external domain of the H 2 molecule, and the phenylalanine at position 116 was changed to tyrosine, replacing the Ld residue with the Kb type amino acid analogous to Kb mutants: bm5 and bm16 mutants derived from the Kb antigen have the Ld-type residue at this position. The mutant genes were constructed by annealing the mutagenic oligomers to the single stranded H-2Ld gene, followed by chain elongation reaction. The expected mutations were confirmed by DNA sequence determination. The mutant genes were introduced into mouse L cells by DNA-mediated gene transfer. Both mutant genes expressed the antigens on the cell surface, as detected by antibody binding; these antigens were reactive with the cytotoxic T cells specific for the H-2Ld antigen. Detailed examination with 16 monoclonal anti-H-2Ld antibodies revealed that the binding of some antibodies was significantly reduced in the glycosylation mutant, implying a certain contribution of the carbohydrates to the antigenic activity of some determinants. No detectable changes have been observed in the mutant of the substitution at position 116 by the parameters we tested. PMID- 3964821 TI - Nerve growth factor: a chemotactic factor for polymorphonuclear leukocytes in vivo. AB - Previous studies have shown that mouse submandibular gland nerve growth factor (NGF) stimulates chemotactic migration of human polymorphonuclear leukocytes in vitro. The results of the present study demonstrate that subdermal injection of NGF in mice also stimulates rapid and marked chemotactic recruitment of leukocytes. This property of NGF is manifest in the nanomolar range of concentrations, it requires the known serine class protease activity of the growth factor, and it does not require participation of the fifth component of complement. Another, as yet unrecognized, C5-independent pathway must be involved. Chemotactic stimulation of cells involved in the early inflammatory response to injury may help to explain earlier observations that NGF can accelerate the rate of contraction of experimentally induced wounds in mice. PMID- 3964823 TI - Transcriptional regulation of HLA class II and invariant chain genes. AB - Class II (Ia) antigens are coded for by a family of genes located in the human MHC (HLA). These genes are regulated in a complex manner, being constitutively expressed, inducibly expressed, or not expressed, depending on the cell type examined. 6.1.6 is a variant of a normal B lymphoblastoid line that has lost expression of all class II molecules and has previously been shown to have a defect in the regulation of class II genes. In this report, we have examined those genes by Southern and Northern blotting and have found that 6.1.6 is severely deficient in mRNA for all class II genes examined, although the genes are structurally intact. P30, a partial revertant of 6.1.6, re-expresses mRNA for a subset of class II genes. mRNA for the class II-associated invariant chain is substantially reduced but not absent in 6.1.6. PMID- 3964824 TI - Effects of antimycin, glucose deprivation, and serum on cultures of neurons, astrocytes, and neuroblastoma cells. AB - The resistance of cultured mouse neuroblastoma cells, primary cultures of rat cerebellar neurons, and rat brain astrocytes to a block of aerobic metabolism was studied. Parameters such as lactate production and ATP content were measured in the presence of antimycin A and under various conditions of glucose, oxygen, and serum supply. The following conclusions can be drawn: (1) All cell types studied were characterized by an active production of lactate; (2) Incubation of the various cell types in the absence of glucose at normal oxygen tension did not affect ATP levels; (3) Respiration blocked by antimycin led to a Pasteur effect; (4) Neuroblastoma cells, but not the other cell types, were fully resistant to inhibition of respiration provided that sufficient glucose was supplied; (5) In the absence of glucose no stores of energy or utilizable substrate were present in the cell types studied when respiration was blocked; (6) In the presence of fetal calf serum anoxic neurons showed irreversible signs of degeneration. PMID- 3964825 TI - Hydrophobic regions in myelin proteins characterized through analysis of "hydropathic" profiles. AB - Computer-generated "hydropathic" profiles were constructed for graphic comparison of the amino acid sequences for P2 protein, 18.5 kilodalton (kDa) myelin basic protein (BP), and myelin proteolipid protein (PLP). Profiles were also obtained for cytochrome b5, a membrane protein known to be capable of reversible association with lipid bilayers and of a size comparable to that of the myelin BPs. Analysis of the PLP sequence produced profiles generally compatible with the suggestions that PLP has three transbilayer and two bilayer intercalating segments. Profiles for P2 and 18.5 kDa BP were found to contain hydrophilic segments separated by relatively short hydrophobic regions. Whereas hydropathic indices in hydrophobic regions of P2, 18.5 kDa BP, and PLP fall in the value ranges recently reported for cores of globular proteins and intrabilayer domains of membrane proteins, hydrophobic sections of P2 and 18.5 kDa BP have hydropathic indices similar to those in the hydrophobic core (transprotein) regions of globular proteins. None of them are comparable to the region of cytochrome b5 known to anchor that protein in its membrane or to the segments of PLP sequence proposed as intrabilayer domains. This comparison suggests that neither BP has structural characteristics compatible with insertion into the hydrocarbon core of the myelin lipid bilayer, a conclusion that is consistent with a recently published study that identified the bilayer penetrating proteins of myelin with a hydrophobic probe. The above findings suggest an enhancement for some details of myelin architecture and a cautious approach to interpreting data for BP intercalation into bilayers. PMID- 3964826 TI - Identification of the adenosine uptake sites in guinea pig brain. AB - Nitrobenzylthioinosine (NBMPR), a potent and specific inhibitor of nucleoside transport, was employed as a photolabile probe of the adenosine transporter in guinea pig brain membranes. Reversible, high-affinity binding of [3H]NBMPR to a crude preparation of guinea pig brain membranes was demonstrated (apparent KD 0.075 +/- 0.012 nM; Bmax values of 0.24 +/- 0.04 pmol/mg protein). Adenosine, uridine, dipyridamole, and nitrobenzylthioguanosine inhibited high-affinity binding. Low concentrations of cyclohexoadenosine (10-300 nM) had no effect on NBMPR binding. These properties of the high-affinity NBMPR binding sites were consistent with NBMPR binding to the nucleoside transport protein. Exposure of brain membranes in the presence of [3H]NBMPR and dithiothreitol, a free-radical scavenger, to ultraviolet light resulted in covalent incorporation of 3H into polypeptides of apparent MW 66,000-45,000, a value similar to that for the human erythrocyte nucleoside transporter. Covalent attachment of [3H]NBMPR was inhibited by adenosine, dipyridamole, and nitrobenzylthioguanosine. PMID- 3964827 TI - Properties and partial purification of choline acetyltransferase from the nematode Caenorhabditis elegans. AB - We have stabilized and studied choline acetyltransferase from the nematode Caenorhabditis elegans. The enzyme is soluble, and two discrete forms were resolved by gel filtration. The larger of these two forms (MW approximately 154,000) was somewhat unstable and in the presence of 0.5 M NaI was converted to a form indistinguishable from the "native" small form (MW approximately 71,000). We have purified the small form of the enzyme greater than 3,300-fold by a combination of gel filtration, ion-exchange chromatography, and nucleotide affinity chromatography. The purified preparation has a measured specific activity of 3.74 mumol/min/mg protein, and is free of acetylcholinesterase and acetyl-CoA hydrolase activities. The Vmax of the purified enzyme is stimulated by NaCl, with half-maximal stimulation at 80 mM NaCl. The Km for each substrate is also affected by salt, but in different manners from each other and the Vmax; the kinetic parameter Vmax/Km thus changes significantly as a function of the salt concentration. PMID- 3964828 TI - Identification of neuron-specific enolase and nonneuronal enolase in human and rat brain on two-dimensional polyacrylamide gels. AB - The location of the enzymes neuron-specific enolase and nonneuronal enolase on two-dimensional gels generated from tissue samples obtained from fresh human and rat cortex has been identified. This identification is based upon the following criteria: comigration on polyacrylamide gels with the appropriate purified protein and staining on nitrocellulose protein blots of human and rat cortex using antibodies specific for each protein. The results show that our preparation of neuron-specific enolase from rat and human brain is highly pure, as only one spot is obtained on two-dimensional gels. Further, the antiserum to neuron specific enolase is highly specific, as it reacts only with neuron-specific enolase on nitrocellulose blots derived from two-dimensional gels of cortical tissue. The location of these proteins is of interest because it positively identifies two major brain proteins on two-dimensional polyacrylamide gels of fresh cortical tissue. This information will be useful in a variety of future studies aimed at both identifying specific proteins on two-dimensional gels and observing the effects of experimental manipulations on brain and other neuronal proteins. PMID- 3964829 TI - Release of purines, noradrenaline, and GABA from rat hippocampal slices by field stimulation. AB - Labelled adenine, noradrenaline (NA), and gamma-aminobutyric acid (GABA) were taken up by the transversely cut hippocampal slice. [3H]NA and [14C]GABA were retained as such, [3H]- (or [14C]-) adenine mainly as adenine nucleotides. There was a spontaneous overflow of all three types of compounds ranging from 0.1 (GABA) to 0.21 (NA) %/min. The rate of [3H]NA overflow increased rapidly during electrical field stimulation. The release rate was well maintained over a 15-min period. The rate of [14C]GABA release also increased rapidly but it was not maintained over a 15-min period even if uptake and/or metabolism was inhibited by nipecotic acid (1 mM) and aminooxyacetic acid (AOAA, 0.1 mM). The bulk of the purines was released after the stimulation period. For all compounds the amounts released were frequency- and calcium-dependent. At a frequency of 3 Hz a 10 V stimulation was sufficient to cause a maximal [3H]NA release and 20 V to cause maximal [14C]GABA release, but 14C-purine release was increased further by increasing the voltage to 40 V. The evoked purine release was inhibited by a nucleoside uptake inhibitor (dipyridamole). On stimulation of [3H]NA-labelled slices the released radioactivity was composed of greater than 95% unchanged NA. The specific activities of NA in the slice and in the superfusate were practically identical. In [3H]adenine-labelled slices the released radioactivity was composed of adenosine, inosine, and hypoxanthine, but the activity in the slice of ATP, ADP, and AMP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964830 TI - Two-step immunoaffinity purification of acetylcholinesterase from rabbit brain. AB - Acetylcholinesterase (AChE; EC 3.1.1.7) extracted in 1% Triton X-100 from rabbit brain was purified 2,000-fold by chromatography on agarose conjugated with a monoclonal antibody directed against human red blood cell cholinesterase. After elution from the immunoadsorbent with pH 11 buffer, the preparation was purified further by affinity chromatography on phenyltrimethylammonium-Sepharose 4B with decamethonium elution. Overall yield of purified enzyme was 37% of the AChE originally solubilized, with a specific activity of 2,950 units/mg protein. Electrophoresis under reducing conditions in 7.5% sodium dodecyl sulfate polyacrylamide gels revealed only one silver-staining polypeptide band. A streamlined purification procedure enabled the isolation of electrophoretically homogeneous AChE to be completed in fewer than 7 days, at yields exceeding 50%. Electrophoretic analysis of purified AChE indicated an apparent MW of 71,000 for the monomeric subunit. Gel filtration and sucrose density gradient centrifugation in the presence of Triton X-100 showed little difference between the properties of the native and the purified enzyme. The molecular mass of the main species was estimated from the gel filtration and sedimentation data to be 280,000 daltons. Kinetic parameters of the purified protein (Km = 0.16 +/- 0.01 mM) were close to those of the native enzyme (Km = 0.12 +/- 0.01 mM) when examined with acetylthiocholine iodide as substrate. The two-step immunopurification procedure presented in this communication offers a convenient route to homogeneous neural AChE in quantities useful for detailed biochemical and immunochemical study. PMID- 3964831 TI - Muscarinic cholinergic receptors in human foetal brain: characterization and ontogeny of [3H]quinuclidinyl benzilate binding sites in frontal cortex. AB - Twenty-two frontal cortices from normal human foetal brains of gestational ages ranging from 16 to 40 weeks and five postnatal brains ranging from 5 to 50 years were analysed for the ontogeny of muscarinic receptors using [3H]quinuclidinyl benzilate (QNB) as the ligand. QNB binding sites were shown to be stable up to 4 1/2 months of storage at -70 degrees C. QNB binding was characterized in frontal cortices of 28-week-old foetal brains as muscarinic receptors by the following criteria: (1) it was localised mainly in particulate fraction; (2) binding was saturable at a concentration of 1.5 nM; (3) the cholinergic antagonists atropine and scopolamine competed for the binding, with IC50 values of 1 and 0.8 nM, respectively. The agonists oxotremorine, carbachol, and pilocarpine gave IC50 values of 1, 15 and 18 microM, respectively. Nicotinic receptor ligands and noncholinergic drugs could not compete for the binding. Bimolecular association and dissociation rate constants for the reversible binding are 6.23 X 10(8) M-1 X min-1 and 2.0 X 10(-2) X min-1, respectively. The equilibrium dissociation constant is 33 pM. The KD obtained by saturation binding data is 103 pM. Ontogeny of muscarinic receptors showed three distinct phases: In phase I, they appear between 16 and 18 weeks [average concentration 109 fmol/mg protein of total particulate fraction (TPF)] and slowly increase up to 20 weeks (average concentration 147 fmol/mg protein TPF). Phase II is a lag period between 20 and 24 weeks at which time receptor concentration does not change perceptibly (average concentration (67 fmol/mg protein TPF).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964832 TI - GABA-modulin: a synaptosomal basic protein that differs from small myelin basic protein of rat brain. AB - GABA-modulin, a basic protein that allosterically inhibits the high-affinity binding of GABA to its recognition sites, has been extracted and purified from the synaptosomal fraction of rat brain where it represents approximately 0.5% of the total synaptosomal proteins. GABA-modulin has characteristics in common to the class of highly basic proteins isolated from myelin, in particular to the rat small myelin basic protein (SMBP). However, GABA-modulin is located selectively in synaptosomes, whereas the SMBP is located in myelin. Moreover, synaptosomal GABA-modulin is different from SMBP in amino acid composition (it contains more Glx and Lys and fewer Arg residues) and in apparent molecular weight (17,000 and 15,000 for GABA-modulin and SMBP, respectively). Synaptosomal GABA-modulin fails to bind [3H]muscimol per se but noncompetitively inhibits (IC30 approximately 0.5 microM) the binding of [3H]muscimol to purified synaptic membranes. Cyanogen bromide treatment generated a 13,000 MW major fragment from both SMBP and GABA modulin. These two fragments were compared and showed differences in amino acid composition and sequence. Moreover, the peptide maps generated from GABA-modulin and SMBP by trypsin and staphylococcal V8 protease digestion are different. The high concentration of GABA-modulin in synaptosomal membranes, its high potency in the inhibition of GABA binding, and its neuronal specificity suggest that GABA modulin plays an important role in neuronal membrane function linked to the modulation of GABA and perhaps other neurotransmitter receptors. PMID- 3964833 TI - Dopamine autoreceptor stimulation increases protein carboxyl methylation in striatal slices. AB - We have investigated the possibility that protein carboxyl methylation is involved in coupling dopamine autoreceptor stimulation to intracellular events such as inhibition of dopamine synthesis or release. The dopamine agonists apomorphine and TL-99 were found to stimulate methyl ester formation in striatal slices preloaded with [3H]methionine. The stimulatory effects of apomorphine were dose-dependent, were not due to changes in [3H]methionine uptake or S-[3H] adenosylmethionine formation, and were blocked by the stereospecific dopamine antagonist (+)-butaclamol. Stimulation of methyl ester formation by dopamine agonists is readily observed only when slices are prepared from rats pretreated with reserpine to deplete endogenous brain catecholamines. This suggests that in slices prepared from normal rats endogenous dopamine (DA) released during slice preparation and incubation masks the effects produced by exogenously administered dopamine agonists on protein carboxyl methylase (PCM) activity. Additional experiments suggested that the effects of apomorphine were mediated via an interaction with DA autoreceptors rather than with postsynaptic DA receptors. Destruction of monoamine neurons and their associated autoreceptors by injecting 6-hydroxydopamine into the area of the medial forebrain bundle abolished the stimulatory effects of apomorphine on methyl ester formation in striatal slices. Furthermore the putative selective DA autoreceptor agonist EMD 23 448 was also found to stimulate methyl ester formation in striatal slices. These findings, discussed in terms of calcium-dependent functions, support the hypothesis that PCM may be a key component in the biochemical transduction of DA autoreceptor stimulation. PMID- 3964834 TI - Separation of recycling and reserve synaptic vesicles from cholinergic nerve terminals of the myenteric plexus of guinea pig ileum. AB - Acetylcholine-rich synaptic vesicles were isolated from myenteric plexus longitudinal muscle strips derived from the guinea pig ileum by the method of Dowe, Kilbinger, and Whittaker [J. Neurochem. 35, 993-1003 (1980)] using either unstimulated preparations or preparations field-stimulated at 1 Hz for 10 min using pulses of 1 ms duration and 10 V . cm-1 intensity. The organ bath contained either tetradeuterated (d4) choline (50 microM) or [3H]acetate (2 muCi . ml-1); d4 acetylcholine was measured by gas chromatography-mass spectrometry. As with Torpedo electromotor cholinergic vesicle preparations made under similar conditions the distribution of newly synthesized (d4 or [3H]) acetylcholine in the zonal gradient from stimulated preparations was not identical with that of endogenous (d0, [1H]) acetylcholine, but corresponded to a subpopulation of denser vesicles (equivalent to the VP2 fraction from Torpedo) that had preferentially taken up newly synthesized transmitter. The density difference between the reserve (VP1) and recycling (VP2) vesicles was less than that observed in Torpedo but this smaller difference can be accounted for theoretically by the difference in size between the vesicles of the two tissues. At rest, a lesser incorporation of labelled acetylcholine into the vesicle fraction was observed, and the peaks of endogenous and newly synthesized acetylcholine coincided. Stimulation in the absence of label followed by addition of label did not lead to incorporation of labelled acetylcholine, suggesting that the synthesis and storage of acetylcholine in this preparation and its recovery from stimulation is much more rapid than in Torpedo. PMID- 3964835 TI - Occupation of dopamine receptors by N-n-propylnorapomorphine or spiperone and acetylcholine levels in the rat striatum. AB - In an attempt to quantify the interactions between dopaminergic and cholinergic processes, the consequences of complete or partial activation (with N-n propylnorapomorphine) or blockade (with spiperone) of dopamine receptors for the acetylcholine levels in the rat striatum were studied. The number of specific striatal binding sites (receptors) of spiperone was nearly three times that of N n-propylnorapomorphine (76 and 26 pmol g-1 wet weight, respectively). The agonist produced a significant increase in the striatal levels of acetylcholine, but there was no simple relationship between receptor binding and these levels. A linear negative correlation was found between the striatal levels of acetylcholine and specific spiperone binding, showing that further receptor blockade induces a decrease in acetylcholine levels, which is independent of the receptors already occupied by the antagonist. The results of this study are evidence that one striatal dopamine receptor regulates the metabolism of at least 400 molecules of acetylcholine. PMID- 3964836 TI - Rat brain S100b protein: purification, characterization, and ion binding properties. A comparison with bovine S100b protein. AB - We purified to homogeneity rat brain S100b protein, which constitutes about 90% of the soluble S100 protein fraction. Purified rat S100b protein comigrates with bovine S100b protein in nondenaturant system electrophoresis but differs in its amino acid composition and in its electrophoretic mobility in urea-sodium dodecyl sulfate-polyacrylamide gel with bovine S100b protein. The properties of the Ca2+ and Zn2+ binding sites on rat S100b protein were investigated by flow dialysis and by fluorometric titration, and the conformation of rat S100b in its metal free form as well as in the presence of Ca2+ or Zn2+ was studied. The results were compared with those obtained for the bovine S100b protein. In the absence of KCl, rat brain S100b protein is characterized by two high-affinity Ca2+ binding sites with a KD of 2 X 10(-5) M and four lower affinity sites with KD about 10( 4) M. The calcium binding properties of rat S100b protein differ from bovine S100b only by the number of low-affinity calcium binding sites whereas similar Ca2+-induced conformational changes were observed for both proteins. In the presence of 120 mM KCl rat brain S100b protein bound two Zn2+-ions/mol of protein with a KD of 10(-7) M and four other with lower affinity (KD approximately equal to 10(-6) M). The occupancy of the two high-affinity Zn2+ binding sites was responsible for most of the Zn2+-induced conformational changes in the rat S100b protein. No increase in the tyrosine fluorescence quantum yield after Zn2+ binding to rat S100b was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3964837 TI - Alterations of the eicosanoid synthetic capacity of rat brain microvessels following ischemia: relevance to ischemic brain edema. AB - To know the mechanism underlying ischemic brain edema, a time-course analysis of the eicosanoid synthetic capacity of brain microvessels was carried out using unilateral, middle cerebral artery (MCA)-occluded rats. Concomitant with the development of brain edema the synthetic capacity of all products, including cyclooxygenase and lipoxygenase products, increased significantly. Next the effects of 15-hydroperoxyarachidonic acid (15-HPAA) on the synthetic capacity of microvessels were examined. The drug caused a generalized increase of each product, the profile of which was similar to that obtained with ischemic hemispheres, although the ratios of each product differed somewhat among them. The enhanced synthesis of eicosanoids by 15-HPAA was markedly suppressed by radical scavengers such as alpha-tocopherol, hydroquinone, and 1,2 bis(nicotineamide)-propane. Furthermore, the evolution of brain edema was virtually suppressed by the systemic administration of 1,2-bis(nicotineamide) propane. The above result suggests that the enzyme activity of the arachidonic acid (AA) cascade of microvessels is stimulated by its own products. Such a mechanism will form a vicious cycle that accelerates the accumulation of free radicals within microvessels and thus may play a role in the progressing disruption of the blood-brain barrier (BBB) following ischemia. PMID- 3964838 TI - Regional acetylcholine metabolism in brain during acute hypoglycemia and recovery. AB - Insulin-induced hypoglycemia in normothermic rats caused progressive neurological depression and differentially altered regional cerebral acetylcholine metabolism. Reductions of plasma glucose from 7.7 mM (control) to 2.5-1.7 mM (moderate hypoglycemia associated with decreased motor activity) or 1.5 mM (severe hypoglycemia with lethargy progressing to stupor) decreased glucose concentrations in the cerebral cortex, striatum, and hippocampus to less than 10% of control. Moderate hypoglycemia diminished acetylcholine concentrations in cortex and striatum (21% and 45%, respectively) and reduced [1-2H2, 2-2H2]choline incorporation into acetylcholine (62% and 41%, respectively). Severe hypoglycemia did not reduce the acetylcholine concentration or synthesis in cortex and striatum further. The concentrations of choline rose in the cortex (+53%) and striatum (+130%) of animals that became stuporous but a similar rise in [1-2H2, 2 2H2]choline left the specific activities of choline in these structures unchanged. Even severe hypoglycemia did not alter the hippocampal cholinergic system. In rats that developed hypoglycemic stupor and were then treated with glucose, the animals recovered apparently normal behavior, and the concentrations of acetylcholine and the incorporation of [1-2H2, 2-2H2]-choline into acetylcholine returned to control values in the striatum but not in the cerebral cortex. Thus, impaired acetylcholine metabolism in selected regions of the brain may contribute to the early symptoms of neurological dysfunction in hypoglycemia. PMID- 3964839 TI - Management of lipomyelomeningoceles. Experience at the Hospital for Sick Children, Toronto. AB - Ninety-seven children with lipomyelomeningoceles were operated on at the Hospital for Sick Children between January, 1960, and December, 1982. The most common factor that caused these patients to seek help was the cosmetic effect of the mass on their back. However, 22 patients had urinary incontinence and 15 patients had a deformed or weak leg. Sixty of the 97 patients were female and 37 were male. The patients presented for treatment between 6 days and 18 1/2 years of age with a median age of 7 1/2 months. Fifty-six patients presented before the age of 6 months and 35 of these were perfectly normal at the time of presentation. On the other hand, of the 41 patients who were brought for treatment after the age of 6 months, only 12 were normal prior to surgery. When patients were appropriately treated at an early age, with their spinal cords untethered and their dura securely closed with a dural graft, then they remained unchanged neurologically or even improved. However, when treatment was delayed or not done appropriately then they were left with significant neurological sequelae. Lipomyelomeningoceles are serious lesions which without appropriate therapy can result in gross impairment of neurological function. PMID- 3964840 TI - Verbal memory deficits after left temporal lobectomy for epilepsy. Mechanism and intraoperative prediction. AB - Verbal memory deficits remain a major complication of dominant hemisphere temporal lobectomy for epilepsy. The extent of this deficit was assessed preoperatively and 1 month and 1 year postoperatively with the Wechsler Verbal Memory Scale (WMSV) in 14 adults undergoing left temporal lobectomy. Intraoperative localization of language and verbal memory was also performed by electrical stimulation mapping. The WMSV score decreased an average of 22% at 1 month (13 cases), and 11% at 1 year (10 cases), even though in the majority of cases the medial extent of the resections had been significantly modified as a result of preoperative memory changes in response to intracarotid amobarbital perfusion testing. Memory decline was greater in patients who were not seizure free, and correlated with the lateral (but not the medial) extent of the resection. The memory deficit could be predicted intraoperatively with 80% accuracy from the relationship of the resection to sites identified by electrical stimulation mapping as essential to naming or input or storage aspects of memory. This technique was applied prospectively in two additional cases with left temporal epileptic foci and complete verbal memory loss with left hemisphere amobarbital inactivation. These resections were tailored to avoid the essential naming and memory sites; the WMSV score increased 1 month postoperatively in both cases. This study identifies a lateral cortical component for verbal memory. Sites essential for that component can be localized intraoperatively with stimulation mapping; when they are spared in a resection, verbal memory deficit following dominant hemisphere temporal lobectomy can be prevented even in high risk cases. PMID- 3964841 TI - Neuropathological changes related to the transorbital application of ethyl 2 cyanoacrylate adhesive to the basal cerebral arteries of cats. AB - The long-term toxic effects of ethyl 2-cyanoacrylate adhesive were evaluated histologically in 25 cats. Fresh medical- or commercial-grade adhesive was introduced transorbitally into the subarachnoid space in the vicinity of the right middle cerebral artery. Three sham-operated animals served as controls. The animals were sacrificed at intervals ranging from 2 days to 6 months. For both medical- and commercial-grade adhesive, neuropathological examination disclosed acute and chronic granulomatous inflammation of the meninges and evidence of severe vascular damage, including vessel wall necrosis, inflammation, thrombosis, and occasionally hemorrhage. Most animals showed cerebral infarcts of variable size in the territories of distribution of the basal arteries which were in contact with adhesive. The results of this study show that ethyl 2-cyanoacrylate is capable of producing severe arterial and parenchymal damage. The risk of its deleterious effects should be weighed against its potential benefits. Clinical experience would suggest that ethyl 2-cyanoacrylate can be used in difficult situations as long as care is taken to protect the brain and local blood vessels. PMID- 3964842 TI - Spinal cord contusion injury: experimental dissociation of hemorrhagic necrosis and subacute loss of axonal conduction. AB - Previously reported experimental models for spinal cord contusion injury do not allow the independent control of compression and contact velocity required for interpretation of experimental data relating kinematics of vertebral injury to spinal cord injury. Therefore, controlled dynamic compression of the spinal cord was used to study compression and contact velocity as independent variables. Cord conduction was assessed using the latency of somatosensory evoked potentials in response to hindlimb stimulation. The latency increase at 4 hours after contusion differed significantly between control and 50% compression results, and between 25% and 50% compression results. A small nonsignificant increase in latency was observed with increase in contact velocity. The extent of hemorrhagic necrosis correlated with contact velocity rather than with the amount of compression. This study demonstrates, for the first time, a dissociation between hemorrhagic necrosis and loss of neuronal conduction in the subacute phase. Although long term effects of hemorrhagic necrosis on cord structure and conduction remain to be evaluated, the data suggest that delayed loss of neuronal conduction seen clinically may result from moderate levels of cord compression at high contact velocity. Such an injury is not reproducible by weight-drop techniques for cord injury. PMID- 3964843 TI - One-stage excision of high-flow arteriovenous malformations. AB - The authors describe two cases of high-flow arteriovenous malformations which illustrate a new technique to reduce the risk of brain swelling and diffuse hemorrhage during or after operation. This technique, used in the latter of the two cases, includes occlusion of the shunt, followed by the progressive tightening of a Selverstone clamp placed on the cervical internal carotid artery, lowering of the systemic arterial pressure, and the use of barbiturate anesthesia. Clamping and anesthesia are maintained for a 24-hour period after surgery. PMID- 3964844 TI - Craniopharyngioma with erosion and drainage into the nasopharynx. An autobiographical case report. AB - This physician had a craniopharyngioma which was treated by radiation therapy in 1938, with relief of headaches and return to professional activity. Later, penetration of the tumor through the sphenoid sinus into the nasopharynx resulted in the intermittent drainage over 30 years of cystic parts of the tumor into the nasopharynx and from there to the oropharynx without any meningeal rupture. Radiation therapy was the initial mode of treatment, later combined with steroid and thyroid replacement therapy. A professional career was possible in spite of the patient's health problems. PMID- 3964845 TI - Vertebral artery rupture associated with closed head injury. Report of two cases. AB - The authors report two patients with closed head injury who suffered laceration with rupture of the third portion of the vertebral artery. One patient died suddenly, with angiographic evidence of bilateral vertebral artery rupture. The mechanism of injury to the C1-2 segment of the vertebral artery relating to head and neck injury is discussed. PMID- 3964846 TI - Spontaneous bilateral extradural hematomas. Case report. AB - Spontaneous extradural hematomas are rare and may be caused by pericranial infections, bleeding tendencies, or vascular abnormalities of the dura mater. The authors describe a case of spontaneous bilateral extradural hematomas assumed to be caused by a bleeding tendency with hypofibrinogenemia. A brief review of the literature is reported. PMID- 3964847 TI - Conus ganglioglioma in a 2 1/2-year-old boy. Case report. AB - Gangliogliomas are rare tumors, primarily seen in patients under the age of 30 years. They occur least commonly in the spinal cord. This report presents a 2 1/2 year-old boy who harbored an intramedullary conus tumor with the light microscopic appearance of a ganglioglioma. The neurobiological behavior of this tumor is yet to be determined. PMID- 3964848 TI - Oligodendroglioma and cerebral cavernous angioma. Case report. AB - The authors report a case of frontal lobe oligodendroglioma associated with a cavernous angioma. The patient presented with signs and symptoms of raised intracranial pressure. Computerized tomography with contrast enhancement failed to detect the vascular component. The clinical and pathological significance of the presence of this vascular malformation in an oligodendroglioma is discussed. PMID- 3964850 TI - Brain-death. PMID- 3964849 TI - Neurocutaneous melanosis with hydrocephalus and syringomyelia. Case report. AB - The authors report the investigation, treatment, and progress of a unique case of neurocutaneous melanosis with syringomyelia. The suspected etiology, the pathology, and the variable clinical manifestations of this rare phakomatosis are recounted. The potential for malignant change and the possible mechanisms of syrinx development in this syndrome are discussed. PMID- 3964851 TI - Hormonal receptors in meningiomas. PMID- 3964852 TI - Thalamotomy for Parkinson's disease. PMID- 3964853 TI - Meningioma: analysis of recurrence and progression following neurosurgical resection. AB - The rates of survival, tumor recurrence, and tumor progression were analyzed in 225 patients with meningioma who underwent surgery as the only treatment modality between 1962 and 1980. Patients were considered to have a recurrence if their studies verified a mass effect in spite of a complete surgical removal, whereas they were defined as having progression if, after a subtotal excision, there was clear radiological documentation of an increase in the size of their tumor. There were 168 females and 57 males (a ratio of 2.9:1), with a peak incidence of tumor occurrence in the fifth (23%), sixth (29%), and seventh (23%) decades of life. Anatomical locations were the convexity (21%), parasagittal area (17%), sphenoid ridge (16%), posterior fossa (14%), parasellar region (12%), olfactory groove (10%), spine (8%), and orbit (2%). The absolute 5-, 10-, and 15-year survival rates were 83%, 77%, and 69%, respectively. Following a total resection, the recurrence-free rate at 5, 10, and 15 years was 93%, 80%, and 68%, respectively, at all sites. In contrast, after a subtotal resection, the progression-free rate was only 63%, 45%, and 9% during the same period (p less than 0.0001). The probability of having a second operation following a total excision after 5, 10, and 15 years was 6%, 15%, and 20%, whereas after a subtotal excision the probability was 25%, 44%, and 84%, respectively (p less than 0.0001). Tumor sites associated with a high percentage of total excisions had a low recurrence/progression rate. For example, 96% of convexity meningiomas were removed in toto, and the recurrence/progression rate at 5 years was only 3%. Parasellar meningiomas, with a 57% total excision rate, had a 5-year probability of recurrence/progression of 19%. Only 28% of sphenoid ridge meningiomas a second resection, the probability of a third operation at 5 and 10 years was 42% and 56%, respectively. There was no difference in the recurrence/progression rates according to the patients' age or sex, or the duration of symptoms. Implications for the potential role of adjunctive medical therapy or radiation therapy for meningiomas are discussed. PMID- 3964854 TI - CBF and time thresholds for the formation of ischemic cerebral edema, and effect of reperfusion in baboons. AB - Ischemic cerebral edema has been studied in 41 baboons, with regional cerebral blood flow (CBF) determined by hydrogen clearance, and edema measured by microgravimetry. A threshold of ischemia has been identified for baboon cortex and subcortical white matter, which has to be crossed before edema formation begins. This threshold is 40.5% of normal CBF in cortex, and 34.4% of normal flow in subcortical white matter. A time threshold has also been determined, and the baboon brain can withstand 30 minutes of ischemia of the middle cerebral artery without significant edema formation. Reperfusion of ischemic brain has no effect on tissue water if the ischemic flow and time thresholds have not been crossed. Reperfusion of cortex, where water has begun to accumulate, exacerbates the water accumulation in proportion to the extent of the reperfusion. If these results are applicable to man, restoration of flow should not be attempted after an ischemic insult that reduces flow to less than 40% of normal unless it can be accomplished within 30 minutes of the insult. Provided CBF can be restored to above the 40% threshold within 30 minutes, reversal of the neurological deficit and prevention of ischemic edema can be expected. PMID- 3964855 TI - Regional CBF, intraventricular pressure, and cerebral metabolism in patients with ruptured intracranial aneurysms. AB - Regional cerebral blood flow (rCBF), cerebral metabolic rate of oxygen (CMRO2), intraventricular pressure, and lactate/pH levels in the cerebrospinal fluid (CSF) were measured in 38 patients with ruptured intracranial aneurysms between the 3rd and 13th day after subarachnoid hemorrhage (SAH). Angiography was performed following the rCBF study and the degree of vasospasm was measured on the angiograms. The patients were graded clinically according to the system of Hunt and Hess. Cerebral vasospasm significantly influenced rCBF: global reductions and focal changes (ischemia, hyperemia, and tissue peaks) were commonly associated with vasospasm. Patients with severe diffuse spasm always had global ischemia (21 +/- 5 ml/100 gm/min), and cerebral infarctions were demonstrated subsequently, The CMRO2 was more reduced than rCBF, indicating an uncoupling between flow and metabolism. This relative luxury perfusion was associated with CSF lactic acidosis and intracranial hypertension. The arteriovenous difference of oxygen was equally reduced in all categories of patients, probably due to the primary insult of SAH. The CMRO2 decreased concomitantly with arterial caliber, indicating a secondary impairment of cerebral metabolism due to vasospasm. PMID- 3964856 TI - Dorsal root entry zone lesions for post-amputation pain. AB - Chronic pain following an amputation may involve the stump, the phantom limb, or both. Operations such as rhizotomy, cordotomy, stump revision, and dorsal column stimulation have been unsuccessful in treating this condition. This study evaluates the effectiveness of dorsal root entry zone (DREZ) coagulation for this pain problem. The authors studied 22 patients with amputations due to trauma, gangrene, or cancer. All developed post-amputation pain, underwent a DREZ procedure, and were followed from 6 months to 4 years after surgery. Overall, only eight (36%) of these 22 patients had pain relief. However, good results were obtained in six (67%) of nine patients with phantom pain alone, and in five (83%) of six patients with traumatic amputations associated with root avulsion. Poor results were obtained in patients with both phantom and stump pain, or stump pain alone. The DREZ procedure has a limited, but definite, place in the treatment of post-amputation pain. PMID- 3964857 TI - Intracranial pressure changes in arrested hydrocephalus. AB - Continuous intracranial pressure (ICP) monitoring was used to assess 46 children and adolescents in whom a clinical diagnosis of arrested hydrocephalus had been made. Thirty patients (Group A) had previously been treated with cerebrospinal fluid diversion and 16 patients (Group B) had no prior treatment of their hydrocephalus. All patients in Group A either had a confirmed nonfunctioning shunt or had undergone shunt removal. Continuous ICP monitoring showed that 80% of the patients in Group A and 63% of those in Group B had episodic or persistent intracranial hypertension. In four patients (25%) whose initial ICP had been normal or equivocal, repeat ICP monitoring later revealed decompensation or reversal of arrest. When serial psychometric testing demonstrated a fall in cognitive functioning, ICP monitoring revealed abnormal ICP's in 88% of patients. This study shows that many patients with apparent arrest of hydrocephalus in fact have an insidiously progressive disorder. Monitoring of ICP and serial psychometric evaluation are therefore valuable tools in the continuing assessment of arrested hydrocephalus. PMID- 3964858 TI - Brain tissue pressure in focal cerebral ischemia. AB - Twenty-three anesthetized cats underwent permanent middle cerebral artery occlusion in a study of the relationships of regional cerebral blood flow, ventricular fluid pressure, brain tissue pressure, and ischemic edema formation. A pressure gradient of 8 mm Hg developed between ischemic tissue and normally perfused tissue during a 4-hour observation period after occlusion. Brain water accumulated as tissue pressure rose, while blood flow in the same area fell. The data suggest, but do not prove, that ischemic brain edema causes tissue pressure to rise focally, and that blood flow to the ischemic zone is compromised further by the resultant hydrostatic pressure gradient. PMID- 3964859 TI - Evolution and outcome in malignant astroglial neoplasms of the cerebellum. AB - Malignant astroglial neoplasms of the cerebellum are rare and the clinical behavior of these tumors is unpredictable. The authors describe the histological characteristics and clinical outcome in 10 patients; eight had malignant cerebellar astrocytomas, and one each had an astroblastoma and a true polar spongioblastoma. Malignant glial tumors involving the cerebellum usually behave very aggressively. Cerebellar astroblastomas and polar spongioblastomas are too rare to predict their natural history. Some hypotheses are proposed concerning the evolution and interrelationship of malignant glial tumors of the cerebellum. PMID- 3964860 TI - Anatomic variations of venous sinuses in the region of the torcular Herophili. AB - In this study of 110 cranial cavities from adult cadavers, the superior sagittal sinus was found to divide into two channels. In most cases, the division was associated with a dural partition. Essentially, the variations as observed in this study could be grouped into three types: Type 1 includes those specimens in which the sagittal sinus drains into one lateral sinus and the straight sinus into the other, with no connection between the two. Type 2 includes those specimens in which the superior sagittal sinuses and the straight sinus fork, and the forks from both sinuses join to form the lateral sinuses. Type 3 includes those specimens in which a confluence of sinuses exists, varying from a common pool to merely a potential confluence, depending upon the presence of pads, incomplete partitions, and complete partitions of dura mater. Rare findings previously not reported consist of double straight sinuses draining into one transverse sinus; the superior sagittal sinus dividing into three channels with two transverse sinuses on one side; a transverse sinus originating from a tentorial vein; and drainage of a tentorial vein into the confluence of sinuses. PMID- 3964861 TI - Axonal degeneration induced by experimental noninvasive minor head injury. AB - Minor head injury or concussion was produced in experimental animals by an acceleration-deceleration non-impact injury. The animals sustained a brief loss of consciousness and no sequelae were observed. The brains were examined at 7 days by means of the Nauta and Fink-Heimer techniques. Degenerating axons were noted in the inferior colliculus, pons, and dorsolateral medulla. Degeneration was not seen in the subcortical white matter, thus suggesting a primary brain stem locus for concussion. These findings also suggest that, in some instances, minor head injury or concussion can be associated with organic damage to the central nervous system. PMID- 3964862 TI - Penile denudation injuries after circumcision. AB - We present 3 cases of iatrogenic phallic denudation that were managed successfully nonoperatively. The concept of conservative, nonoperative management should be considered in denudation injuries. PMID- 3964863 TI - An unusual case of testicular ectopia. AB - We report a case of testicular ectopia, which represents the first instance of an ectopic testicle located cranial and lateral to the internal ring between the external and internal oblique musculature. PMID- 3964864 TI - Teratoma of the testis in a pubertal child. AB - We report an adult benign teratoma of the testis in a 12-year-old boy, which, to our knowledge, is the first reported instance of such a tumor developing during puberty. After radical inguinal orchiectomy all pathological sections proved to be consistent with a benign adult teratoma. This child is being followed closely. PMID- 3964866 TI - Ectopic prostatic tissue. AB - A case is described in which a nodule of ectopic prostatic tissue was found in the pericolic fat, a previously undescribed site. A possible explanation for such a site is discussed with reference to the normal embryology of the region. PMID- 3964865 TI - Testicular tumors in subfertile men: report of 4 cases with implications for management of patients presenting with infertility. AB - We report on 4 men attending our infertility clinic in whom seminomas developed. A review of testicular biopsies performed for investigation of subfertility in 2 patients revealed in situ and early invasive carcinoma. Infertile men have a prevalence of carcinoma in situ in the range of 1 per 100 to 200, with a high risk of progression to invasive germ cell tumor (50 per cent within 5 years of diagnosis). Biopsy is the only method of detection of the in situ lesion and, therefore, is recommended in the investigation of oligospermic and azoospermic male subjects. The surgical approach to and diagnostic sensitivity of testicular biopsy are reviewed, and the management of carcinoma in situ is discussed. PMID- 3964867 TI - Re: Meatal advancement and glanduloplasty: an operation for distal hypospadias. PMID- 3964868 TI - Re: Neonatal circumcision in the United States in 1982. PMID- 3964869 TI - Artificial sphincter pressure versus detrusor leakage pressure. AB - Increasing urethral occlusion pressures were created with an artificial sphincter in fresh bladder-urethra specimens of adult pigs. Detrusor leakage pressures remained about 25 per cent below the associated sphincter cuff pressures. The same relation was found when, during abrupt variations of cuff pressure, the detrusor leakage pressures were measured with antegrade urethral perfusion pressure measurement through a new sleeve catheter. Side-hole perfusion pressure measurements showed 100 per cent transmission of abrupt variations of cuff pressures to the inner urethral wall. No rotational differences could be detected. From the results it has been concluded that a probable pressure loss of about 25 per cent must be taken into account when converting artificial sphincter pressures into bladder pressures at which leakage will occur. PMID- 3964870 TI - Effect of diuresis and glucagon on upper urinary tract dynamics in the dog. AB - The effect of glucagon on upper urinary tract peristalsis during extreme diuresis was studied in an unsedated dog preparation. In all experiments glucagon inhibited the peristaltic contraction waves without affecting urine propulsion, suggesting that peristalsis, at least for short periods, is not necessary for effective urine transport during extreme diuresis. PMID- 3964871 TI - Effects of magnesium on calcium oxalate crystallization. AB - We evaluated the effect of a range of physiological concentrations of magnesium on calcium oxalate crystallization from artificial urine in a continuous mixed suspension mixed product removal crystallizer at 37C. Magnesium was found to decrease both the growth and nucleation rates of calcium oxalate crystals in the simulated renal environment. PMID- 3964872 TI - Extracorporeal replacement of the renal artery: techniques, indications and long term results. AB - Extracorporeal repair of the renal artery was done in 24 patients for complex lesions extending to branches of the renal artery (9 dysplasias, 5 atheromas and 10 aneurysms). The renal artery and its branches were replaced by a hypogastric branched autograft in 20 patients and a saphenous vein graft in 4. Indications for an extracorporeal operation were hypertension, preservation of renal function against progressive deterioration and extension of the lesion to more than 2 branches of the renal artery. Of 76 peripheral anastomoses 68 were patent postoperatively. Two secondary nephrectomies were performed. Mean followup was 54 months. Hypertension was cured in 19 patients and improved in 2, while 2 failed treatment and 1 died. An extracorporeal operation may represent the best alternative for treatment of renal arterial lesions involving more than 2 branches. PMID- 3964873 TI - A preliminary in vivo assessment of acrylic acid graft-copolymers in the urinary tract. AB - Polymers such as polyethylene, polytetrafluorethylene and polypropylene may be copolymerized with acrylic acid by radiation initiation to produce copolymers which are cationic hydrogels and thus possess physical properties different to the base polymers from which they are derived. The present preliminary study was undertaken to determine whether this class of material may have potential application for use within the urinary tract. Inserts of such copolymers in sheet form (5 mm. square) and their corresponding base polymers were placed in the bladders of male Wistar rats as free floating grafts and left in situ for 3 months. Stone formation and/or encrustation occurred on 12 of the 16 radiation graft copolymers and on 9 of 11 of the corresponding base polymers. The altered physical properties of the tested acrylic acid graft copolymers appear to offer no additional resistance to encrustation although their plasticity and ability to swell in water may provide some advantages over more conventional polymeric materials. PMID- 3964874 TI - Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. AB - A total of 25 patients with renal cell carcinoma underwent angioinfarction of the tumor using absolute ethanol. An average of 15 ml. absolute ethanol was injected into the main renal artery through a balloon occlusion catheter. Complete cessation of renal arterial flow could be demonstrated in all cases. The post embolization syndrome of pain, nausea, vomiting, hypertension and fever was minimal compared to other methods of renal artery occlusion. Of the patients 21 underwent post-infarction transabdominal radical nephrectomy without intraoperative or postoperative complications attributable to the injection of absolute ethanol. No damage to extrarenal tissue was noted at operation. Subsequent surgical dissection was facilitated, particularly in cases of large tumors when control of the renal pedicle often is difficult. Median blood loss was 725 ml. In light of recent reports concerning the benefit of angioinfarction and nephrectomy in metastatic disease a similar approach may be applicable to localized disease. This pilot study shows the safety of preoperative angioinfarction with absolute ethanol and may be used as a reference for future randomized prospective studies comparing angioinfarction and nephrectomy to nephrectomy alone for localized renal cell carcinoma. PMID- 3964876 TI - Sarcoma and carcinosarcoma of the bladder in adults. AB - Sarcomas of the bladder occur rarely in adults. As a result, the natural history of these unusual tumors and the best methods of treatment are uncertain. We reviewed our experience with 13 patients presenting between 1970 and 1980 (5 had leiomyosarcoma, 5 had carcinosarcoma and 3 had rhabdomyosarcoma). Gross hematuria nearly always was the presenting symptom. Patients treated by partial cystectomy fared poorly, while 7 treated by radical cystectomy and supravesical urinary diversion had an excellent prognosis: 6 (86 per cent) have been free of disease for more than 1 year, including 4 who have survived more than 45 months without evidence of recurrence or metastasis. PMID- 3964875 TI - Estimation of ABO(H) isoantigen expression in bladder tumors. AB - ABO(H) isoantigen expression was estimated semiquantitatively with the red cell adherence test on single epithelial cell suspensions from 89 bladder tumor and 7 normal bladder specimens. Correlations of red cell adherence counts positive for antigen with the pathological findings of the bladder (histology and stage of tumor) were made in a blind fashion at the end of the study. The mean count positive for antigen from normal bladders was 86.0, which was significantly different (p less than 0.001) from those of muscle-invading lesions (12.6) and flat carcinoma in situ (21.6). This study shows a good correlation among the cell counts positive for antigen, histological findings and stage of disease, and provides the basis for a prospective study that may help to determine the role of ABO(H) isoantigen measurement in bladder tumor patients. PMID- 3964877 TI - The vascularized skin island urethroplasty: its role and results in urethral stricture management. AB - We report 11 vascularized island skin flap urethroplasties. Results appear to be excellent when the procedure is used for strictures of the pendulous urethra. Use of vascularized skin flap urethroplasties for the repair of bulbar and membranous strictures has been complicated by pseudodiverticula and stone formation, and in this portion of the urethra the technique probably should be reserved for cases in which local factors mitigate against alternative 1-stage procedures. PMID- 3964878 TI - Effect of vasectomy on high density lipoproteins. AB - Primate research has associated vasectomy with accelerated rates of atherogenesis. We have evaluated the effect of vasectomy on serum lipoprotein profiles in healthy men. There was a decrease in high density lipoprotein levels, which was greatest in men with a family history of atherosclerotic disease. With the great number of variables known to affect high density lipoprotein levels further studies are needed to determine if this change can be attributed to the vasectomy. PMID- 3964879 TI - Operable prostatic carcinoma: correlations among clinical stage, pathological stage, gleason histological score and early disease-free survival. AB - We investigated the relationships among clinical and pathological stages, Gleason histological score and early disease-free survival of 75 patients with localized prostatic carcinoma treated by radical prostatectomy. Carcinoma was confined histologically to the prostate in 81 per cent of the patients with clinical stage A2, 79 per cent with B1N, 38 per cent with B1 and 0 per cent with B2 tumors. The Gleason score correlated directly with clinical and pathological stages, estimated extent of intraprostatic tumor and invasive capacity of the primary tumor. Of the tumors with a Gleason score of 8 or more 81 per cent extended beyond the prostatic capsule. Of 12 patients who suffered distant metastases 9 had tumors that extended beyond the prostatic capsule and 5 had tumors with Gleason scores of 8 or more. PMID- 3964880 TI - Treatment of prostatic cancer: effects on serum lipoproteins and the cardiovascular system. AB - We studied 32 patients with prostatic cancer before, and after 1 and 6 months of treatment with orchiectomy, estramustine phosphate or conventional estrogens (polyestradiol phosphate plus ethinyl estradiol). Lipid metabolism was evaluated by lipoprotein analysis and the intravenous fat tolerance test. Effects on the cardiovascular system were studied by exercise electrocardiography, blood volume estimation and thoracic electrical impedance measurement, a sensitive method to detect early signs of fluid retention. Present treatment programs for prostatic cancer seem to result in effects on lipoprotein metabolism that probably are of minor importance for the development of atherosclerotic manifestations. Measurement of thoracic impedance may be of value to detect fluid retention in individual patients. PMID- 3964882 TI - The inflatable penile prosthesis: the case for the medical device data base. PMID- 3964881 TI - Do the imidazoles have a role in the management of genitourinary fungal infections? AB - The imidazoles have demonstrated antifungal activity against a number of fungi that are pathogenic for man. Effective clinical use has been demonstrated in patients with cutaneous and systemic candidiasis, aspergillosis, blastomycosis, coccidioidomycosis, cryptococcus and systemic candidiasis, aspergillosis, blastomycosis, coccidioidomycosis, cryptococcus and histoplasmosis. We report our experience with the oral imidazole agent ketoconazole in the management of 8 patients with significant urinary candidiasis as judged by elevated urinary candidal counts (greater than 15,000/ml.). Only 4 of the 8 patients had resolution of candiduria with ketoconazole therapy. Intravenous miconazole, another imidazole, has been available for treatment of systemic and genitourinary fungal infections. Limited success (50 per cent) with intravenous miconazole has been noted in the treatment of systemic candidiasis with urinary involvement. Miconazole also has been used as a systemic and local irrigant in the treatment of bladder and renal candidiasis. Based on these observations and our own studies, we believe that the imidazoles have a limited role in the management of patients with significant fungal involvement of the urinary tract. PMID- 3964883 TI - Bilateral milk-of-calcium urine and hydronephrosis. AB - Milk-of-calcium urine associated with hydronephrosis is rare, with only 8 unilateral cases reported previously. We report the first case of bilateral occurrence. Upright films are necessary for making the diagnosis. Although previous reports indicate that the involved kidney has little or no function our patient had only slight impairment of renal function. Nephrectomy should not be done without evaluation of renal function, since some function may be preserved by removing the obstruction that is associated with milk-of-calcium urine and hydronephrosis. PMID- 3964884 TI - Bilateral renal oncocytoma: report of 2 cases and literature review. AB - We report on 2 patients with bilateral renal oncocytoma treated in the last 5 years. One patient underwent bilateral partial nephrectomy for a solitary tumor in each kidney. Both tumors were confirmed to be renal oncocytomas by light and electron microscopic examination. After 4 years this patient had no evidence of local recurrence or distal metastasis. The second patient presented with bilateral multiple renal oncocytomas. Transabdominal bilateral renal exploration revealed 2 tumors in the right kidney and 3 tumors in the left kidney. Right radical nephrectomy and enucleation of the left renal tumors were performed. Examination by light and electron microscopy confirmed that all tumors from both kidneys were oncocytomas. Only 8 cases of bilateral renal oncocytoma have been reported in the literature, including our 2 cases. In 6 of these 8 cases the tumors were multicentric, which may be a characteristic of bilateral renal oncocytoma. Recognizing the coexistence of multicentricity and bilaterality is important because more conservative treatment is required. However, a favorable prognosis may still be anticipated. PMID- 3964885 TI - Infiltrating recurrent renal angiomyolipoma with fatal outcome. AB - Renal angiomyolipomas are considered to be benign mesenchymal tumors despite histological findings often remarkable for cellular pleomorphism and mitoses. We report a renal angiomyolipoma in a 49-year-old white woman. Surgical treatment was followed by massive recurrence with perforation of the colon and invasion of the diaphragm. The patient died despite surgical debulking and radiation therapy. A review of the literature revealed 1 case of massive recurrence following partial resection of the tumor and 2 in which the tumor showed marked local invasion. We believe that patients with renal angiomyolipoma should be monitored carefully for aggressive tissue infiltration and recurrent tumor. PMID- 3964886 TI - Youssef's syndrome: a case report. AB - Youssef's syndrome, or menouria following a vesicouterine fistula, has been reported rarely. This case differs from the previously reported cases in that the menouria was caused by a double vesicocervical fistula and that, in contrast to the generally preferred transabdominal approach, a transvaginal approach was used for successful surgical repair of the fistulas. PMID- 3964887 TI - Cystectomy: a catastrophic complication of herniorrhaphy. AB - Injury to the bladder is a known complication of inguinal herniorrhaphy. Infants less than 6 months old may be more at risk because the medial aspect of indirect inguinal hernia sacs are associated closely with the wall of bladder ("bladder ears"). We report 2 cases of almost complete excision of the bladder during routine herniorrhaphy. In 1 patient bilateral ureteroileocecoplasty provided a course of management free of complication. PMID- 3964888 TI - Nephrogenic adenoma in children. AB - Nephrogenic adenoma is a rare, benign lesion of the bladder, occurring as an epithelial response to infection or trauma. Characteristically, it presents as a papillary lesion resembling a low grade, low stage transitional cell carcinoma. Although usually occurring in adults, there have been 5 reports in children, in whom the adenoma occurred following either surgery or localized inflammation. We report on 2 additional children with nephrogenic adenoma, including one who presented with a bladder mass and total occlusion of the ipsilateral ureter, while in the other it was found incidentally during closure of a vesicovaginal fistula. Successful treatment consisted of transurethral resection and low dose suppressive antibiotics. Nephrogenic adenoma, while rare in children, appears to be a uroepithelial metaplastic response to trauma or inflammation and is treated best by conservative management. PMID- 3964889 TI - Leads from the MMWR. Measles--United States, first 39 weeks, 1983. PMID- 3964890 TI - Identification of xanthochromia. PMID- 3964891 TI - Oliguria and increased intra-abdominal pressure. PMID- 3964892 TI - Proper interpretation of radioisotope lung scans. PMID- 3964893 TI - Irritable bowel syndrome and mitral valve prolapse syndrome. PMID- 3964894 TI - Thermography for breast cancer diagnosis. PMID- 3964895 TI - Changing intravenous tubing containing burettes. PMID- 3964896 TI - A new contraindication for obesity surgery. PMID- 3964897 TI - Relevance and utility of courses in medical ethics. A survey of physicians' perceptions. AB - In the last decade the teaching of medical ethics has become almost universal in American medical schools. Its effectiveness is, however, just beginning to be evaluated. A stratified random sample of 3,000 practicing physicians who were graduated between 1974 and 1978 was surveyed to evaluate their perceptions of the utility and relevance of medical ethics teaching. Those who had courses in medical ethics perceived it to be of substantial benefit in confronting the actual ethical issues they encountered in daily practice. They favored the continuation and expansion of the teaching of medical ethics and had suggestions for its improvement. Data were also obtained on the relative frequency of specific ethical issues in practices and on the relative influence of home, personal values, medical education, medical practice, and ethics courses on respondents' approaches to ethical issues. PMID- 3964898 TI - 'Do not resuscitate' orders. Incidence and implications in a medical-intensive care unit. AB - "Do not resuscitate" (DNR) decisions were examined in a medical intensive care unit (MICU) of a 1,000-bed hospital. Seventy-one (14%) of 506 study patients were designated DNR; nine survived hospitalization. Severity of illness, age, and prior health were predictive of DNR orders; race and socioeconomic factors were not. The DNR patients consumed more resources, both before and after DNR orders. Interventions started before DNR designation were continued in at least 76% of patients. Documented justifications of DNR decisions included poor prognosis (59%), poor quality of life (24%), and patients' wishes (15%). There were no written justifications for the DNR decisions in 30 cases (42%). Although willingness to write DNR orders in an MICU and continued active treatment of DNR patients are both reassuring in a general sense, they raise questions about the consistency of treatment plans and goals for individual patients. PMID- 3964899 TI - Excess mortality among psychiatric patients. The Iowa Record-Linkage Study. AB - Of 5,412 patients admitted to the University of Iowa Psychiatric Hospital between Jan 1, 1972, and Dec 31, 1981, three hundred thirty-one died during the follow-up period, significantly more than expected. The risk for premature death was greatest among women and the young, especially those between the ages of 30 and 39 years. Risk was associated with all psychiatric diagnoses and was significantly higher among patients of either sex with an organic mental disorder or schizophrenia; women with acute schizophrenia, depressive neuroses, alcoholism, drug abuse, and psycho-physiologic disorders and special symptoms; and men with neuroses. Suicide and accidental death were more frequent than expected and were responsible for two thirds of the excess deaths. During the total time of follow-up, women were at risk for natural deaths but men were not. Our most important finding was that 99% of the excess deaths occurred within two years of discharge. During this period there were undue numbers of both "natural" and "unnatural" deaths. The first two years after discharge are a time of great risk for psychiatric patients, particularly women. PMID- 3964900 TI - The computer in medicine. Its application to medical practice, quality control, and cost containment. PMID- 3964901 TI - David the "Bubble Boy' and the boundaries of the human. PMID- 3964902 TI - Deciding against resuscitation: encouraging signs and potential dangers. PMID- 3964903 TI - "Bubble Boy'. PMID- 3964904 TI - Treatment of multifocal atrial tachycardia with verapamil. PMID- 3964905 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 1-1985. A 21-year-old woman with hemoptysis and pulmonary cavities. PMID- 3964906 TI - The treatment of supraventricular tachycardias. PMID- 3964907 TI - Nephrotoxicity of cyclosporine. PMID- 3964908 TI - Psychosocial influences on mortality after myocardial infarction. PMID- 3964909 TI - "Normal" blood cholesterol levels. PMID- 3964910 TI - Cardiopulmonary monitoring. PMID- 3964911 TI - Control of hospital costs. PMID- 3964912 TI - Transmission of hepatitis B without transmission of AIDS by accidental needlestick. PMID- 3964913 TI - A crisis in Australian medicine. Doctors' response to the introduction of government-sponsored universal health care. PMID- 3964914 TI - Infusion-related phlebitis--is the in-line filter the solution? PMID- 3964915 TI - Prevention of melanoma by recognition of its precursors. PMID- 3964916 TI - Hemolytic uremic syndrome--then and now. PMID- 3964917 TI - Fibrinogen as a risk factor in cardiovascular disease. PMID- 3964918 TI - Transient myocardial ischemia resulting from gastric volvulus. PMID- 3964919 TI - Treatment of lupus nephritis. PMID- 3964920 TI - Antemortem diagnosis of disseminated fungal infection. PMID- 3964921 TI - Case 38-1984: traumatic hemorrhage of the adrenal gland. PMID- 3964922 TI - The teaching hospital's modern deathbed ritual. PMID- 3964923 TI - Acquired precursors of cutaneous malignant melanoma. The familial dysplastic nevus syndrome. PMID- 3964924 TI - Renal trauma: radiological studies. Comparison of urography, computed tomography, angiography, and radionuclide studies. AB - Excretory urography, computed radionuclide urography, angiography, and both conventional and dynamic computed tomography (CT) were compared with regard to accuracy, sensitivity, and specificity in 388 patients with renal trauma. Used as the triage examination, urography established the absence of significant renal injury with an accuracy of 87%, obviating further evaluation. Dynamic CT proved to be the best method of assessing parenchymal injuries, establishing the correct diagnosis in 129 out of 130 cases compared to 116/130 for conventional CT. Angiography was the procedure of choice for diagnosis and categorization of renal artery injuries, which were diagnosed correctly in all 43 cases. The choice between dynamic CT and angiography as the second examination rests upon careful evaluation of clinical and urographic findings for signs of renal artery injury which would mandate angiographic assessment. PMID- 3964925 TI - Nephrolithiasis in premature infants. AB - The clinical records of ten premature infants with nephrolithiasis were reviewed. The probable mechanism of stone formation was hypercalciuria due to furosemide therapy (nine patients) and congenital hyperparathyroidism (one patient). The relatively high rates of urinary excretion of calcium from immature kidneys predisposed these neonates to the development of calcium stones. Renal calculi in neonates are complications of distinct, treatable conditions, and premature babies receiving furosemide treatment should be screened by ultrasonography for renal calcifications. PMID- 3964926 TI - Colon polyps and carcinomas: prospective comparison of the single- and double contrast examination in the same patients. AB - Single-contrast (SC) and double-contrast (DC) colon examinations were compared in 425 consecutive patients for detection of polyps and stricturing carcinomas. Each patient was examined with both SC and DC during the same session. In patients with carcinoma, there was no significant difference between the two modalities. DC was far superior to SC for detection of rectal or colonic polyps (p less than 0.05); however, the techniques appeared to be complementary in the sigmoid and cecum. The authors conclude that DC is superior to SC as a means of screening for polyps of the rectum and colon, with SC being useful as an adjunct in problem areas such as the sigmoid and cecum. PMID- 3964927 TI - Intracerebral pneumatocele: CT findings. AB - Two cases of intracerebral pneumatocele following trauma are presented. One to two months after initial treatment both patients had deteriorating neurologic status. The diagnosis was made by radiography. When a pneumatocele is suspected clinically, computed tomography can play a vital role in determining the precise location of the gas collection, its relationship to the fracture site, and the amount of mass effect on the brain. PMID- 3964929 TI - Bony spinal canal changes that differentiate conjoined nerve roots from herniated nucleus pulposus. AB - CT examinations of the lumbar spine in 12 consecutive patients with conjoined nerve roots were reviewed. Asymmetry of the bony spinal canal, seen as slight dilatation of the ipsilateral lateral recess, was present in all cases. This finding, which is not typically associated with extruded free intervertebral disk fragments, should serve to distinguish these two entities. PMID- 3964928 TI - Intracerebral pneumatoceles following facial trauma: CT findings. AB - Three patients with delayed frontal intracerebral pneumatoceles following facial injury are presented. In one patient an unusual appearance of bilateral and symmetrical frontal lobe pneumatoceles was demonstrated. While diagnosis is not difficult on routine radiographs, CT is valuable for determining effects on the brain and clearly delineating the fracture site; CT shows the location of the pneumatocele and may show an associated air-fluid level, mass effect or surrounding edema, or rim enhancement following administration of contrast material. The radiological appearances in conjunction with the clinical findings are highly characteristic and should not be mistaken for gas-forming cerebral abscesses. PMID- 3964930 TI - Temporomandibular joint clicking with nonreducing anterior displacement of the meniscus. AB - Patients who have temporomandibular joint (TMJ) clicking and pain are assumed to have an anterior displacement of the meniscus with reduction on opening of the jaw. On the basis of this assumption, these patients are treated nonsurgically with splint therapy. Of 301 TMJs examined, 108 (36%) produced clinically audible clicks on opening, closing, or both. Fluoroscopy and arthrotomography studies for 16 (15%) showed anteriorly displaced menisci without reduction. The mean age of this group was 32 years, with a range of 17-51 years. The duration of the patients' symptoms ranged from three months to eight years (mean 3.7 years). Bilateral degenerative joint disease was noted in 8/16 (50%). Operative findings in four patients suggested the cause of the clicking sound as a frictional impact between the degenerated surface of the condyle and the hypertrophied displaced meniscus. These observations demonstrate that an audible click may not imply a reduction of a displaced meniscus. PMID- 3964931 TI - Internal derangements of the temporomandibular joint: findings in the pediatric age group. AB - Findings in 31 pediatric patients with pain and dysfunction of the temporomandibular joint (TMJ) are reported. The average age was 14 years (range, 8-16) and the average duration of symptoms was 21.4 months (range, 3 mo.-5 yr.). Internal derangements were found in 29 patients (94%) and degenerative arthritis in 13 (42%). In 12 patients (39%), the problem could be traced to an injury to the jaw. Secondary condylar hypoplasia was associated with the meniscal abnormality in 3 patients (10%). Further awareness of internal derangements of the TMJ in the pediatric population should permit greater recognition of their etiology. It is important that treatment be initiated as soon as possible, not only to minimize the development of osseous disease in young adults but also to prevent facial growth deformities. PMID- 3964932 TI - Infected aortoiliofemoral grafts: magnetic resonance imaging. AB - Three patients with proved infected aortoiliofemoral grafts were examined by magnetic resonance (MR) imaging using a spin echo technique. MR clearly identified the perigraft abscess, the involvement of adjacent structures, and the longitudinal extent of the process in all patients. The MR findings were: Abscesses create a high signal intensity, somewhat less than fat. The perigraft abscess has a great contrast with the signal void of flowing blood in the graft. Inflammatory changes cause an inhomogeneous intermediate signal, slightly more intense than muscle. Both abscesses and edematous areas increase their signal intensity with long repetition rates and long echo delays. Areas of gas appear black. They cannot be distinguished from calcified plaques. Additional information is gained about the graft patency. Although the specificity has to be proved, MR imaging is sensitive in the detection of infected grafts and for defining the longitudinal extent of the perigraft abscess. PMID- 3964933 TI - Magnetic resonance imaging and spectroscopy of hepatic iron overload. AB - Experimental animals that had been given excess iron in their diet were studied by magnetic resonance (MR) imaging in vivo and by magnetic resonance (MR) spectroscopy in vitro. Hepatic iron overload in patients with transfusional iron excess was studied by MR imaging, and isolated iron protein fractions were studied in vitro by MR spectroscopy. The spin echo image intensity of livers with iron overload was decreased because of the extreme decreases in T2 compared with normal; T1 was decreased only moderately. The relaxation rates 1/T2 and 1/T1 both showed a linear relationship to hepatic iron levels. Ferritin solutions showed moderate decreases in T2 and mild decreases in T1. The T2 relaxivity of ferritin, which is due to the iron core rather than the apoferritin protein shell, does not appear sufficient to account for the extreme decrease in T2 observed in hepatic iron overload. Low molecular weight cytosol iron is present in lower concentrations than ferritin but potentially has much greater relaxivity and may contribute to the MR findings. These techniques may be useful in other studies of iron metabolism. PMID- 3964934 TI - Magnetic resonance imaging following unilateral occlusion of the renal circulation in rabbits. AB - Magnetic resonance studies at 0.12 T were performed following acute unilateral occlusion of the renal artery or vein in rabbits. Prior to occlusion, in vivo and in vitro relaxation times of the renal cortex and outer medulla were similar. After venous occlusion, T1 and T2 were prolonged on the occluded side, while the contralateral side remained unchanged. After arterial occlusion, the outer medulla of both the occluded and contralateral kidney exhibited prolonged relaxation times. There was a significant linear correlation between T1, T2, and the water content of the tissue. The authors conclude that quantitative in vivo relaxation times may eventually prove to be useful in diagnosis, although at present they are less reliable than those obtained in vitro. PMID- 3964935 TI - Histogram equalization of CT images. AB - Histogram equalization for display of clinical CT images was evaluated. In theory, histogram equalization makes optimal use of an available grey scale to display an image, and its use could circumvent the problem of selecting specific window settings for each image. In several clinical images, the use of a spatially variable histogram equalization technique limited to that portion of the CT image occupied by the patient did appear to increase the visibility of anatomic structures. However, using the technique also increased displayed image noise and artifacts. Although radiologists found this to be objectionable, it did not decrease the detectability of simulated low-contrast liver metastases. Further evaluation of histogram equalization for displaying CT images is being pursued. PMID- 3964936 TI - Chronic osteomyelitis examined by CT. AB - CT examination of 25 patients who had acute exacerbations of chronic osteomyelitis allowed for the correct identification of single or multiple sequestra in 14 surgical patients. Plain radiographs were equivocal for sequestra in seven of these patients, because the sequestra were too small or because diffuse bony sclerosis was present. CT also demonstrated a foreign body and five soft tissue abscesses not suspected on the basis of plain radiographs. CT studies, which helped guide the operative approach, were also useful in treating those patients whose plain radiographs were positive for sequestra. We review the potential role of CT in evaluating patients with chronic osteomyelitis. PMID- 3964937 TI - Synovial cysts of the knee: CT evaluation. AB - Eight patients with synovial cysts about the knee were studied by computed tomography (CT). Six of the eight patients had cysts in atypical locations, four medial and two anterior. Knee arthrography, performed on five patients, demonstrated the cyst in only two cases. In all patients CT defined the location and extent of the cyst, demonstrating the following benign features: a well defined homogeneous mass with attenuation values approximating that of water, preservation of adjacent soft-tissue planes, and absence of bone involvement. The authors conclude that CT is useful in the evaluation of a suspected synovial cyst when its position is atypical or when arthrography fails to demonstrate or completely delineate the cyst. CT provided diagnostic accuracy and determination of the optimal operative approach. PMID- 3964939 TI - Oblique views of the heart by magnetic resonance imaging. AB - We describe a simple method that uses patient positioning to obtain oblique views of the human heart by magnetic resonance (MR) imaging. These views provide MR images that directly correlate with conventional anterior or posterior oblique radiography. PMID- 3964938 TI - Multispectral analysis of magnetic resonance images. AB - Magnetic resonance (MR) imaging systems produce spatial distribution estimates of proton density, relaxation time, and flow, in a two dimensional matrix form that is analogous to that of the image data obtained from multispectral imaging satellites. Advanced NASA satellite image processing offers sophisticated multispectral analysis of MR images. Spin echo and inversion recovery pulse sequence images were entered in a digital format compatible with satellite images and accurately registered pixel by pixel. Signatures of each tissue class were automatically determined using both supervised and unsupervised classification. Overall tissue classification was obtained in the form of a theme map. In MR images of the brain, for example, the classes included CSF, gray matter, white matter, subcutaneous fat, muscle, and bone. These methods provide an efficient means of identifying subtle relationships in a multi-image MR study. PMID- 3964940 TI - A comparison of saddle-shaped and solenoidal coils for magnetic resonance imaging. AB - Differences in magnetic resonance (MR) imaging signal-to-noise (S/N) performance between saddle-shaped and solenoidal coils have been postulated. Each coil shape is tied to a particular magnetic field configuration, so that they are not typically interchangeable except in special situations. The solenoidal coil is predicted to have a two- to three-fold advantage over the saddle-shaped coil. Simple basic arguments raise a dispute with this assertion. Experiments show that both coils produce essentially equivalent S/N levels. PMID- 3964941 TI - Thin spinal or biopsy needle guidance. AB - The thin needles that are used for myelography or biopsy are easily deflected in the body. We describe a simple method used to guide the tip of these needles to the target area using needle-hub rotation. This procedure was successfully used in more than 260 direct C1-C2 punctures for cervical myelography. PMID- 3964943 TI - Distal splenic artery embolization with a flow-directed balloon catheter. AB - We describe the improved ability to catheterize the distal splenic artery consistently using a flexible, flow-directed, 5-F, Swan-Ganz catheter so as to embolize the spleen beyond any pancreatic branch origins to achieve the safe treatment of hypersplenism. PMID- 3964942 TI - Hyperthermia induction with thermally self-regulated ferromagnetic implants. AB - We have developed a self-regulating thermoseed for interstitial hyperthermia treatment of tumors. The seeds are made of a 70.4% nickel-29.6% copper alloy, and they have a Curie point at 50 degrees C. When exposed to an oscillating magnetic field (90 kHz, 50 Oersted amplitude), these seeds show a sharp drop in the rate of heat production at temperatures above the Curie point. In a simulated treatment of a small visceral mass that had negligible blood flow, the tissue temperature stabilized at the Curie point of the alloy with good temperature homogeneity throughout the volume heated by an array of thermoseeds. PMID- 3964944 TI - The subcutaneous injection port: a new chest-wall artifact. AB - A totally implanted central venous catheter with a subcutaneous injection port is now in use in patients in whom long term venous access is required. This injection port creates a new artifact that can mimic a pulmonary lesion on chest radiographs. PMID- 3964945 TI - Use of a T tube as an endoprosthesis for internal biliary drainage. AB - A technique is described for the percutaneous transhepatic placement of a T tube into the bile ducts. The short limbs are placed in the right and left hepatic ducts, and the long limb is passed through the malignant obstruction into the duodenum, creating an endoprosthesis for internal drainage. PMID- 3964946 TI - A simple pressure injector for contrast material. AB - The use of a standard carpenter's caulking gun as a pressure injector is described. Contrast material can be infused intravenously through small caliber needles with relative ease and safety. PMID- 3964947 TI - Pneumonitis after amiodarone therapy. PMID- 3964948 TI - Intrahepatic portal vein branches studied by percutaneous transhepatic portography. AB - Percutaneous transhepatic portography was performed in 31 patients. Based on the anterior and lateral images, the authors have concluded that the portal vascular system described in most anatomy textbooks does not correspond to the anterior portogram. A more practical nomenclature and order of branches are proposed, in which the first order includes the proximal portal vein branches; the second order includes the right anterior and posterior segmental branches, the umbilical portion of the left lobe, and most of the caudate veins; and the third order includes the peripheral (subsegmental) branches. The liver is divided accordingly into three main segments and one secondary segment (the caudate lobe), with each of the main segments being divided into two subsegments. The authors suggest that this new nomenclature will be helpful in both diagnosis and surgery. PMID- 3964949 TI - Lyme arthritis: radiologic findings. AB - Lyme disease is a newly recognized, multi-system disorder that may be associated with chronic arthritis. Of 25 patients with severe arthritic manifestations the most frequent radiographic finding was knee joint effusion. Intra-articular edema was often accompanied by a continuum of soft-tissue changes involving the infrapatellar fat pad, periarticular soft tissues, and the entheses, which were sometimes thickened, calcified, or ossified. Later in the illness, the joints of some patients showed typical changes of an inflammatory arthritis, including juxta-articular osteoporosis, cartilage loss, and cortical or marginal bone erosions. Less commonly, other patients demonstrated changes more characteristic of degenerative arthritis, including cartilage loss, subarticular sclerosis, and osteophytosis. Joint involvement of Lyme disease has similarities to juvenile arthritis and Reiter syndrome, but can usually be distinguished clinically and serologically from these entities. PMID- 3964951 TI - Fractures of the hook of hamate: radiographic signs. AB - Isolated fractures of the hamulus, formerly considered rare, are being seen more frequently. Many of these injuries are sports related, particularly in golf, tennis, racquetball and baseball players. Failure to make an early diagnosis can result in severe pain and sometimes incapacitating disability. We studied the clinical and radiological findings in 12 patients who had fracture of the hook of the hamate. We propose three radiographic signs of fracture that are readily seen on routine PA projections: "absence" of the hook of the hamate; "sclerosis" of the hook; and lack of cortical density, i.e., a barely visible outline, of the hamulus. PMID- 3964950 TI - Clear cell chondrosarcoma. AB - The clinical, radiologic, and histopathologic features of three cases of clear cell chondrosarcoma are described. On radiographs, this rather benign-appearing tumor resembles a chondroblastoma when it occurs at the end of a long bone, and may occasionally show a calcified matrix. However, it has distinctive tumor cells with a centrally placed vesicular nucleus surrounded by clear cytoplasm. The lesion has a low-grade malignancy and is amenable to en bloc surgical resection, which results in a much better prognosis than that of conventional chondrosarcoma. PMID- 3964952 TI - Wegener granulomatosis of the breast. AB - Two cases of Wegener granulomatosis of the breast are reported. In both cases, this rare disease was detected on mammographic examination and was diagnosed for the first time by a fine-needle aspiration biopsy of the breast. The mammographic findings can lead to misinterpretations and can be confused with advanced mammary carcinoma or the alterations caused by lymphoblastoma, leukemia, or Hodgkin disease. The total regression of the tumorlike lesions in the breast, evidence of involvement of the lung with only slight clinical symptoms, and a very protracted course of the disease were remarkable in both cases. PMID- 3964953 TI - Coronary artery steal: demonstration by digital coronary radiography. AB - The authors, using a new digital coronary radiographic technique, report the demonstration of contrast-material-induced coronary artery steal. Attempts to measure myocardial blood flow using arteriographic techniques in the setting of complex coronary anatomy can be complicated by heterogeneous flow patterns. PMID- 3964954 TI - Varices from portal hypertension: correlation of CT and angiography. AB - Two hundred abdominal CT and angiographic examinations were performed on 137 patients with portal hypertension. These patients were being evaluated before or after a distal splenorenal shunt. CT increased the detection of umbilical and retroperitoneal varices. Angiography better detected peripancreatic varices and cavernous transformation. Both modalities together added more information than either alone in identification of coronary and/or gastroesophageal, retrogastric, and perisplenic-mesenteric varices. This additional anatomic information helped in the patient's management pre- and postoperatively. PMID- 3964955 TI - Percutaneous gastrostomy: further experience. AB - Percutaneous gastrostomy was performed in nine patients, bringing to 17 the total number of such procedures now performed in the authors' department. As a result of this additional experience, the authors have further refined the technique and have had the opportunity to follow a number of patients for extended periods. Percutaneous gastrostomy appears to be an effective alternative to surgical gastrostomy. PMID- 3964956 TI - Streptokinase therapy: complications of intra-arterial use. AB - An inordinately high rate of renal complications was encountered among 35 patients treated for thrombotic or thromboembolic occlusion of the leg by injection of streptokinase into a bypass graft or native artery. Five patients demonstrated massive myoglobinuria following restoration of flow to ischemic and necrotic tissues; acute tubular necrosis developed in 2 of them, and 1 patient died as a result of renal shutdown, electrolyte imbalance, hypofibrinogenemia, and mediastinal and retroperitoneal hemorrhage. Massive myoglobinuria was also noted in 5 out of 13 patients with compartment syndrome but no evidence of ischemic necrosis. This complication could be lessened by fasciotomy and resection of the upper third of the fibula. Although myoglobinuria and complications such as acute tubular necrosis are only rarely reported, they are not unexpected following muscular ischemia. Attempts to salvage irreparably damaged tissues by re-establishing circulation appear to carry an unacceptably high risk of renal complications and may even threaten the life of the patient. PMID- 3964957 TI - The perception of speech in early infancy. PMID- 3964958 TI - Direct imaging of live human platelets by flash x-ray microscopy. AB - A 100-nanosecond pulse of long-wavelength x-rays was used to produce high resolution stop-motion images of living human platelets. Although some aspects of the structure conform to those seen in dehydrated specimens, novel features are apparent. The technique should permit detailed stop-motion examination of the interaction of platelets with their surrounding medium as well as exploration of the phagocytic and secretory activities of a wide variety of other cells. PMID- 3964960 TI - Selective loss of a family of gene transcripts in a hereditary murine cataract. AB - The eye lens of the Fraser mouse contains a dominantly inherited cataract with reduced amounts of seven distinct but homologous gamma crystallins encoded by a family of gamma-crystallin genes. The results of experiments with cultured lenses, cell-free RNA translation, and Northern blot hybridization indicated a specific loss of the family of gamma-crystallin messenger RNA's in the Fraser mouse lens. Southern blot hybridization of genomic DNA's from normal and Fraser mice showed no differences in gamma-crystallin coding sequences. PMID- 3964959 TI - Peroxisomal defects in neonatal-onset and X-linked adrenoleukodystrophies. AB - Accumulation of very long chain fatty acids in X-linked and neonatal forms of adrenoleukodystrophy (ALD) appears to be a consequence of deficient peroxisomal oxidation of very long chain fatty acids. Peroxisomes were readily identified in liver biopsies taken from a patient having the X-linked disorder. However, in liver biopsies from a patient having neonatal-onset ALD, hepatocellular peroxisomes were greatly reduced in size and number, and sedimentable catalase was markedly diminished. The presence of increased concentrations of serum pipecolic acid and the bile acid intermediate, trihydroxycoprostanic acid, in the neonatal ALD patient are associated with a generalized diminution of peroxisomal activities that was not observed in the patient with X-linked ALD. PMID- 3964961 TI - Behavioral facilitation of reproduction in sexual and parthenogenetic Drosophila. AB - In a normal bisexual laboratory strain of Drosophila mercatorum, females housed with either fertile or sterile males lay more eggs than do females housed in pairs or as isolates. Females of a derived parthenogenetic strain have suffered genetic loss of this behavioral facilitation of egg production, a loss comparable to the loss of sexual receptivity. Despite these losses there has been a large increase in fecundity in the parthenogenetic strain. These findings are compared with those in a parthenogenetic lizard. PMID- 3964962 TI - Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy. AB - This study compares postoperative gastric emptying after pancreaticoduodenectomy with antrectomy (Whipple operation) or with preservation of the antrum and pylorus (Longmire operation). Six of eight patients with antrectomy were able to tolerate full solid feedings within ten days (a mean for the group--9.8 days). Only one of eight patients with preservation of the antrum and pylorus reached this point within ten days (a mean for the group--16 days, p less than 0.05). Average-time from operation to discharge from the hospital was seven days longer for patients in the latter group. Routine placement of a gastrostomy tube in anticipation of the prolonged need for gastric drainage reduced a potentially bothersome problem to a well-tolerated level. Although one patient had bleeding jejunal ulcers develop which required vagotomy and antrectomy one year after a Longmire operation; the long term nutritional and functional advantages of this new technique for pancreaticoduodenectomy seem to outweigh the short term costs. PMID- 3964963 TI - Surgically-related applications of computerized operating room data. AB - ORMIS data are currently used in a wide range of surgically-related applications- surgical activity reporting, graduate education and residency reporting, clinical research, surgically-related administration and surgical suite administration. Use of the system within Henry Ford Hospital has been increasing as it becomes better known and as its potential usefulness becomes better understood. Willingness to use ORMIS data depends, in large part, upon the perceived accuracy of the stored data and the ease with which these data can be retrieved and reported in a useful form. A high degree of confidence in ORMIS data has been achieved through considerable surgical staff involvement in the ongoing operation of the system. Surgeons participate in the coding of operative procedures, and the provision of surgeon-specific logs has established a feedback loop whereby surgeons can easily verify the accuracy of ORMIS data. Furthermore, special care has been taken to maintain the integrity of ORMIS data by developing extensive error detection and correction facilities. The multifaceted, successful applications reported herein show the increasing importance and usefulness of computerized data in contemporary surgical services. PMID- 3964964 TI - Perforation of the gastrointestinal tract and peritonitis in the neonate. AB - A review of 60 neonates with perforation of the gastrointestinal tract and peritonitis was undertaken to evaluate efficacy of current treatment. Perforation was most frequently associated with necrotizing enterocolitis, spontaneous gastric perforation, intestinal obstruction and feeding tube perforation of the duodenum. Primary closure of proximal gastrointestinal tract perforations and resections with diversion for distal perforations were the commonly used operative procedures. Mortality was 33 per cent, with most deaths (80 per cent) a result of sepsis or its complications. Increased risk of mortality was associated with lower birth weight and lower weight for gestational age, males, initial serum pH less than 7.30, delay in surgical treatment and feeding tube perforation. Peritoneal cultures were dominated by aerobic and facultative organisms with only 21 per cent yielding mixed aerobic-anaerobic cultures. No anaerobes were retrieved from post-operative wound infections or abscesses, and only one of 22 positive blood cultures yielded an anaerobe. Antibiotic therapy included combinations of aminoglycoside beta-lactam antibiotics and clindamycin. Improving survival in this population, particularly in infants less than 1 kilogram birth weight, was demonstrated. PMID- 3964965 TI - The role of resection margin frozen section in the surgical management of Crohn's disease. AB - The use of frozen section examination of resection margins in selecting the site for an ileocolonic anastomosis was evaluated in patients with Crohn's disease. Seventy-nine patients with ileitis or ileocolitis who underwent first resection with removal of all apparent disease and primary ileocolonic anastomosis were studied. The patients with a resection margin examined by frozen section (FS group, n = 38) and those with margins chosen on the basis of visual inspection alone (NO-FS group, n = 41) were compared. Frozen section examination was found to be poor at detecting margin involvement: although 60 of 61 margins examined by frozen section were reported as negative at the time of operation, 20 of 61 were actually involved by Crohn's disease. Furthermore, despite the use of frozen section examination, the prevalence and severity of margin involvement in the FS and NO-FS groups were not statistically significantly different. Short term and long term clinical outcome were also not statistically different; the incidence of postoperative anastomotic leakage and obstruction was 13 per cent in the FS group and 5 per cent in the NO-FS groups (p NS). Clinical recrudescence rates by life table analysis in the FS and NO-FS groups were 37 +/- 9 per cent and 50 +/- 8 per cent, respectively, at five years, and 60 +/- 12 per cent and 66 +/- 9 per cent at ten years (p NS). Reoperation rates were 18 +/- 8 per cent at five years in both groups and 36 +/- 13 per cent in the FS group and 32 +/- 12 per cent in the NO-FS group at ten years. The findings support conservative resection to achieve grossly uninvolved margins rather than sacrifice of functional intestine in an attempt to achieve histopathologically uninvolved margins on frozen section. PMID- 3964966 TI - Modification of the catheterization procedure for the totally implantable infusion pump. AB - The totally implantable infusion pump is a new and expensive device. Once this pump is unpacked and is in contact with a patient, it is impossible to have it resterilized. For this reason, we suggest the use of a separate catheter for catheterization. Once the catheter is successfully placed in the appropriate artery, then the pump can be unpacked and attached to this catheter. If catheterization proves impossible, the pump is still sterile and can be used for the next patient. PMID- 3964967 TI - Improved tunneling procedures for bypass grafting. AB - A tunneling design and procedure for femoropopliteal, femorocrural, femorofemoral and axillofemoral bypass operations is described. The usefulness and importance is the prevention of tortuosity, kinking and torsion of the bypass and the protection of the graft from damage. PMID- 3964968 TI - Use of the Amplatz heparin-coated wire guide to facilitate placement of the Hickman catheter. AB - We describe herein a technique in which a special type of j wire guide and fluoroscopy are used to facilitate the placement of Hickman catheters in patients in whom this is technically difficult. This method is quick and safe and allows for direct visualization in the placement of the catheter. PMID- 3964969 TI - Operative treatment of cecal volvulus combining cecopexy with intestinal tube decompression. AB - A new operative approach for non-gangrenous cecal volvulus combining transrectal Baker tube colonic decompression with peritoneal flap cecopexy has advantages over previously described operations. PMID- 3964970 TI - Combined vessel loop vascular control and exposure for Cimino-Brescia fistulas. AB - A simple method of combined atraumatic vascular control and apposition of vein and artery which facilitates performance of a Cimino-Brescia arteriovenous fistula for angioaccess is described herein. PMID- 3964971 TI - Prophylactic cholecystectomy during splenectomy for beta thalassemia homozygous in Greece. AB - The impact of prophylactic cholecystectomy upon early mortality and morbidity of splenectomy for patients with beta TH H was investigated. The results of our study suggested that it is a safe procedure that is not associated with any increase in operative mortality and postoperative complications. This was true even when beta TH H was complicated by pigment cirrhosis and ascites. In view of increasing longevity of those patients with beta TH H, as well as the increased risk for gallstones even after splenectomy, we recommend the use of prophylactic cholecystectomy as a standard approach for all patients undergoing splenectomy for beta thalassemia homozygous. PMID- 3964972 TI - Cerebral arterial dolichoectasia associated with moyamoya vessels. AB - We report two cases of cerebral arterial dolichoectasia associated with stenosis of the middle cerebral artery and "moyamoya" vessels. Neuroradiologic findings of these cases are presented, and pathogenesis is discussed. PMID- 3964973 TI - Giant cell tumor of the skull. AB - Two cases of giant cell tumor of the skull are reported. The first patient had a radical operation for a giant cell tumor of the temporal base followed by radiation therapy. The second patient had a partial removal of a giant cell tumor of the occipital bone followed by radiation therapy. The pertinent literature on giant cell tumors originating from the cranial bones other than the sphenoid bone is reviewed. PMID- 3964974 TI - Primary intracranial lymphomas. AB - We reviewed the cases of 16 patients with primary intracranial lymphomas. The clinical and radiological data proved to be helpful in suggesting the diagnosis, but only tumoral biopsy provided unequivocal diagnosis. In our cases radiotherapy proved to be the most effective treatment. PMID- 3964975 TI - Ventriculocholecystic shunt. A mortality report. AB - Ventriculocholecystic shunts are not commonly used for the treatment of hydrocephalus. We present a case of a child who underwent such a procedure and died of unusual complications. This case represents a unique juxtaposition of uncommon neurosurgical entities and complications including acquired communicating hydrocephalus, bilious ventriculitis secondary to a ventriculocholecystic shunt, and pulmonary edema. The unusual features of this case are discussed and emphasis is placed on the pathophysiologic findings. PMID- 3964976 TI - Vasospasm after acoustic neuroma removal. AB - A case of a acoustic neuroma with a two-stage removal due to severe bleeding is presented. The patient remained drowsy after the second operation and by the 8th day deteriorated quickly with progressive right hemiplegia and aphasia. The cerebrospinal fluid was bloody, vasospasm was shown in the angiograms, and an ischemic area was disclosed in the computed tomography scan. The outcome and the neuroradiologic examinations suggested that blood in the basal cisterns caused the vasospasm and the brain ischemia. A review of the literature disclosed only one similar case. PMID- 3964977 TI - Management of polyuria subsequent to pituitary surgery based on the diurnal pattern of urinary excretion. AB - Polyuria subsequent to pituitary surgery was studied in 64 cases. Most cases of postoperative polyuria were due to diabetes insipidus. These cases showed a triphasic pattern in daily urinary volume. Observation of hourly urinary volume in polyuria revealed four diurnal patterns of urinary excretion: rhythmic, continuous, transient, and unspecific. Clinical observation of diurnal patterns has an advantage, in terms of simplicity of procedure, in immediately determining the nature of the polyuria, prognosticating diabetes insipidus, and eliminating inappropriate procedures in treatment. Indomethacin suppository is considered to be a favorable agent in reducing polyuria without disturbing the diurnal pattern in diabetes insipidus. PMID- 3964978 TI - Decerebrate posturing with the syndrome of inappropriate secretion of antidiuretic hormone. AB - Decerebrate and/or decorticate posturing have not yet been described as possible features of the syndrome of inappropriate secretion of antidiuretic hormone. Cerebral edema and loss of brain electrolytes are contributing factors resulting in altered excitability of the neural membrane. We describe a patient who, on the eighth day after a head injury, presented with decerebrate posturing, which coincided with the development of the syndrome of inappropriate secretion of antidiuretic hormone, and which rapidly reversed with the correction of the hyponatremia. We believe that the syndrome of inappropriate secretion of antidiuretic hormone should be included in the differential diagnosis of abnormal posturing in the head-injured patient. PMID- 3964979 TI - Astrocytomas in childhood: a population-based study. AB - A population-based study of astrocytomas occurring in children is reported. A population-based study eliminates referral bias and the bias of a series based on the experience of a given medical center or a particular surgeon. In a 42-year period, 179 such cases were diagnosed. The average age at diagnosis was 8.9 years. Over one-half of the astrocytic tumors were located in the cerebellum. A peak in the number of astrocytomas was noted between 1965 and 1970. Cumulative probability of survival of children with intracranial astrocytomas at 6 months and at 1, 2, and 5 years was 0.824, 0.752, 0.732, and 0.667; by 10 years and 20 years the cumulative probability of survival had fallen to 0.607 and 0.538. The shortest survival was observed with brainstem tumors, with an average survival of 19 months. Longer survivals were noted with tumors of the cerebral hemispheres: 0.779, 0.748, 0.678 and 0.628 at 1, 2, 5, and 10 years, respectively. The longest survivals were in those children with cerebellar astrocytomas: at 1 year they had an 0.837 probability of survival and at 20 years, 0.675. PMID- 3964980 TI - Giant mucocele of paranasal sinuses. AB - A large mucocele of the frontal and ethmoidal sinuses with extracranial, intracranial, and intraorbital extension accompanied by total destruction of the left frontal sinus was treated successfully. We chose a two-stage surgical procedure for radical removal of the lesion. It is important to ascertain the degree of dural involvement, not only because extensive involvement of the dura mater presents technical surgical difficulties, but also because this knowledge provides clues regarding the pathology of the lesion. Even after surgical treatment, the mucocele may recur if the patent sinus ostium is exposed to the dura mater, or if the ostium subsequently becomes blocked. PMID- 3964981 TI - Congenital cerebellar medulloblastoma. AB - Congenital cerebellar medulloblastoma is extremely rare. Reported here is a female infant who presented her first abnormal clinical manifestations on the sixth day of life and who was subsequently found to have medulloblastoma at operation. Electron microscopy revealed glial filaments and short cytoplasmic projections in some neoplastic cells and the presence of junctional complexes between neoplastic cells with and without glial filaments, which suggests the astrocytic differentiation of the tumor. Including our own case, there have been only 21 reported cases of congenital cerebellar medulloblastoma. A strong female preponderance and some familial occurrence are noted in congenital cerebellar medulloblastoma. PMID- 3964982 TI - The spine: neurosurgery versus orthopedics. PMID- 3964983 TI - Central herniated intervertebral disks. PMID- 3964984 TI - Anterior sacral meningocele. Current diagnosis. AB - One hundred fifty cases of anterior sacral meningocele have been reported in the world literature. This rare pathologic entity was first recognized and described by Bryant in 1837. We report a patient with an incidental anterior sacral meningocele. Our patient is the oldest reported in the literature. The incidental feature of this malformation is uncommon. We review the literature and discuss the clinical aspect, diagnosis, and treatment. Emphasis is placed on the current and optimal method of radiologic evaluation using computed tomography scan combined with metrizamide myelography. PMID- 3964985 TI - Infection with Chlamydia trachomatis in female college students. AB - Chlamydia trachomatis was isolated from genital specimens from 21 (4.9%) of 431 female college students. Antibody to C. trachomatis was found in the genital secretions of 52 (11.9%) of 437 women. Multiple logistic regression analysis showed race, number of sexual partners, and use of barrier methods of contraception to be predictive of infection with C. trachomatis. Logistic regression analysis found race, number of sexual partners, use of barrier methods of contraception, and presence of cervical erythema to be predictive of local chlamydial antibody. White participants were infected less often (12 of 388 (3.1%)) than black participants (9 of 43 (20.9%)) (p less than 0.001) and were less likely to have local chlamydial antibody. None of the sexually inexperienced women were infected or had local antibody. Among the sexually experienced women, chlamydial infection and local chlamydial antibody increased with increasing number of sexual partners only for women who were not using barrier methods of contraception. Sexually experienced women who used barrier methods of contraception (condom, diaphragm) were less likely to be infected (one of 105 (1.0%)) than were sexually experienced women who used other contraceptive measures or who did not use contraception (20 of 276 (7.2%)) (p = 0.031). Women who used barrier methods of contraception also were less likely to have local chlamydial antibody. Women with cervical erythema were more likely to have local chlamydial antibody (4 of 11 (36.4%)) than women without cervical erythema (48 of 426 (11.3%)). Vaginal colonization with other sexually transmitted microorganisms (Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis) was noted more often among women with chlamydial infection than among uninfected women. PMID- 3964986 TI - Hyperuricemia as a risk factor of coronary heart disease: The Framingham Study. AB - Uric acid values were obtained on subjects of the original Framingham cohort at their fourth and 13th biennial examinations. The mean uric acid value for men was 5.0 mg/dl at the fourth examination and 5.7 mg/dl at examination 13 and was 3.9 mg/dl and 4.7 mg/dl, respectively, for women. This secular trend was due to both "laboratory drift" and increasing use of diuretics. Serum uric acid values were consistently higher in subjects of both sexes who were taking antihypertensive drugs at both examinations. Serum uric acid values correlated with systolic and diastolic blood pressure in both sexes; the relationship was stronger in women than in men and for systolic than for diastolic pressure. Correlations were stronger at examination 4 than at examination 13 when more antihypertensive treatment was used. Examination 4 serum uric acid predicted the subsequent development of coronary heart disease, in general, and myocardial infarction, in particular, but not angina pectoris. The uric acid relationship with myocardial infarction was equally strong in both sexes, even correcting for antihypertensive treatment. However, in multivariate analysis, including age, systolic blood pressure, relative weight, cigarette smoking, and serum cholesterol, serum uric acid did not add independently to the prediction of coronary heart disease. PMID- 3964987 TI - Effects of intraindividual and interindividual variation in repeated dietary records. AB - In this study 5,115 daily diet records were collected from 151 women on two randomly selected days per sampling month (29 days) over a two-year period. Yearly estimates of the ratios of intraindividual (sigma w2) and interindividual (sigma b2) variance components were calculated for dietary intake of 15 nutrients and for dietary intake + vitamin/mineral supplements. From one year to the next, corresponding ratios of sigma w2/sigma b2 were nearly identical. Intraindividual variation in dietary intake of all 15 nutrients was greater than interindividual variation (sigma w2/sigma b2 greater than 1). Variance component ratios for highly supplemented nutrients such as iron, vitamin C and B vitamins were less than one (sigma w2/sigma b2 less than 1). Using the ratios of sigma w2/sigma b2, it was calculated that between six and 99 repeated records measuring dietary intake and between two and 31 records measuring total intake may be needed per individual to ensure that the estimate of the population correlation (rho DF) between an individual's "usual" dietary intake or total intake of a dietary risk factor and an individual's mean or usual level of a physiologic risk factor was within 10% of the true population correlation coefficient (rho xy). It was also found that twice as many dietary records per individual were required to estimate the population slope (beta xy) within 10%. These results have serious implications for the design and analysis of prospective nutritional studies. PMID- 3964988 TI - Problems in the use of dead controls in case-control studies. I. General results. AB - A recently completed case-control study in the Minneapolis-St. Paul area using population-based living controls and dead controls afforded the opportunity to compare these two control groups on their exposure histories. Detailed information was obtained by interview from 697 living controls and the next of kin of 493 dead controls. The dead controls of both sexes were reported to have been significantly heavier cigarette smokers compared with living controls, as well as heavier consumers of hard liquor, beer, and drugs, and to have had more adulthood diseases. There were no consistent differences between the control groups for consumption of nonalcoholic beverages, some aspects of diet, ethnic and religious background, usual occupation, and residential history. It appears that exposures associated with premature death are overrepresented in dead controls compared with living controls, while those variables not associated with premature mortality are distributed more or less similarly between the two groups. PMID- 3964989 TI - Conditions for confounding of the risk ratio and of the odds ratio. AB - There are disagreements in the literature about the criteria to be used to ascertain whether or not a measure of association is confounded. The authors postulate the general principle that a crude unconfounded measure of association is structured as a weighted average of the stratum-specific values of the measure. They examine the relationships between stratum-specific measures of association, crude overall measures, and weighted averages of stratum-specific measures, and indicate how these relationships may be used to define criteria for the assessment of confounding in cohort studies in which the exposure, disease, and stratification variables are classified dichotomously. The criteria presented differ for the risk ratio and for the disease-odds ratio. In other words, one can reach different conclusions about the confounding effect of a given extraneous variable, depending on which measure of association is chosen. This view differs from that of Miettinen and Cook (Confounding: essence and detection. Am J Epidemiol 1981;114:593-603) who postulated one set of criteria for the assessment of confounding, which was applicable to both measures of association. These different approaches may lead to different conclusions about the presence or absence of confounding. PMID- 3964990 TI - Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study. AB - The Baltimore-Washington Infant Study is a regional epidemiologic study of congenital heart disease. Among Infants born in the study area in 1981 and 1982, 664 had a diagnosis of congenital heart disease confirmed in the first year of life by echocardiography, cardiac catheterization, cardiac surgery, or autopsy. The prevalence rate was 3.7/1,000 livebirths for all cases and 2.4/1,000 livebirths for cases confirmed by invasive methods only. Diagnosis-specific prevalence rates of congenital heart disease are compared with those of eight previous case series. Changing diagnostic categorizations in the time span covered and methodological differences resulted in great variation of the data. However, the data of the New England Infant Cardiac Program which used the same case discovery methods showed similar occurrences of major morphologic abnormalities, suggesting that these are stable basic estimates in the eastern United States. For all case series, the rate of confirmed congenital heart disease was approximately 4/1,000 livebirths over the 40-year time span. PMID- 3964991 TI - Passive smoking in adulthood and cancer risk. AB - Overall cancer risk from adult passive smoking has been examined using smoking by spouse as the measure of exposure. Information on smoking by spouse was obtained for 518 cancer cases and 518 noncancer controls. Cancer cases were identified from a hospital-based tumor registry in North Carolina. Cases included all sites except basal cell cancer of the skin and were between the ages of 15 and 59 years at the time of diagnosis. Cancer risk among individuals ever married to smokers was 1.6 times that among those never married to smokers (p less than 0.01). This increased risk was not explained by confounding by individual smoking habits, demographic characteristics, or social class. Elevated risks were seen for several specific cancer sites and were not limited to lung cancer or other "smoking-related" tumors. Risks from passive smoking appeared greater among groups generally at lower cancer risk (females, nonsmokers, and individuals younger than age 50 years), but were not limited to these groups. PMID- 3964992 TI - Mortality and cancer morbidity after heavy occupational fluoride exposure. AB - A cohort of 431 male cryolite workers employed for at least six months between 1924 and 1961 was identified from personnel records at the Copenhagen cryolite factory. During this period, heavy fluoride exposure resulted in at least 74 cases of skeletal fluorosis. All workmen in the cohort were followed up in Denmark until July 1, 1981. During 1941-1981, 206 men died, while only 149.3 deaths were expected from national mortality statistics. Significant excesses were seen in the following causes of death: violent death and all cancers, in particular cancer of the respiratory system. When compared with specific mortality rates for the Copenhagen area, violent death (and suicide taken alone) remained in significant excess among employees hired before 1940. Cancer morbidity data for the 35-year period 1943-1977 showed 78 cases of malignant neoplasms in the cryolite workers against 53.2 expected for Denmark as a whole and 67.9 for Copenhagen. The excess was almost entirely due to an excess number of respiratory cancers. Cancer morbidity showed no apparent correlation with length of employment or time from first exposure. Because detailed information on predictors for respiratory cancer was unavailable, a possible residual effect of fluoride cannot be excluded. However, any major carcinogenic effect of heavy fluoride exposure would be very unlikely. PMID- 3964993 TI - Dietary vitamin A deficiencies and stomach cancer. AB - The hypothesis of vitamin A intake deficiencies serving as an antecedent factor in the development of stomach cancer was assessed employing a case-control design. Interviews of proxy informants for 111 cases and a pair-matched control group were conducted using a food frequency questionnaire from which an averaged vitamin A intake index was calculated. Stomach cancer cases showed a significantly higher proportion with lowered total vitamin A intake levels (odds ratio = 1.71) which remained constant across sex and socioeconomic status groupings. These results demonstrated a consistency with previous related studies vis-a-vis the strength and specificity of the putative association, a moderate (but statistically nonsignificant) dose-response curve, proper temporal association, and biologic plausibility. PMID- 3964995 TI - Physical activity assessment methodology in the Five-City Project. AB - Previous measures of physical activity for epidemiologic studies were considered inadequate to meet the needs of a community-based health education trial. Therefore, new methods of quantifying the physical activity habits of communities were developed which are practical for large health surveys, provide information on the distribution of activity habits in the population, can detect changes in activity over time, and can be compared with other epidemiologic studies of physical activity. Independent self-reports of vigorous activity (at least 6 metabolic equivalents (METs) ), moderate activity (3-5 METs), and total energy expenditure (kilocalories per day) are described, and the physical activity practices of samples of California cities are presented. Relationships between physical activity measures and age, education, occupation, ethnicity, marital status, and body mass index are analyzed, and the reliabilities of the three activity indices are reported. The new assessment procedure is contrasted with nine other measures of physical activity used in community surveys. PMID- 3964994 TI - The development of benign prostatic hyperplasia among volunteers in the Normative Aging Study. AB - This study describes the development of benign prostatic hyperplasia among 2,036 volunteers in the Veterans Administration Normative Aging Study, a longitudinal study of human aging situated in Boston. Men were followed from enrollment in the study (between 1961 and 1970) until their last examination prior to May 15, 1982. Two indications of benign prostatic hyperplasia were considered: 1) a clinical diagnosis made at a uniform physical examination, and 2) surgical treatment. Incidence rates for both a clinical diagnosis and surgery for benign prostatic hyperplasia increased through the eighth decade. Life table analysis estimated the lifetime probability of surgical treatment to be 0.29. Known risk factors for cardiovascular disease and diabetes as well as marital and socioeconomic status, religion, cigarette smoking and alcohol and coffee consumption were evaluated as risk factors. Controlling for age in proportional hazards models, statistically significant predictors of surgery were prior clinical diagnosis, lower socioeconomic status, Jewish religion, and not currently smoking cigarettes; whereas only body mass index was a significant predictor of a clinical diagnosis. Although a prior clinical diagnosis was an important predictor of surgery (adjusted odds ratio 3.52, 95% confidence interval = 1.93-6.42), this diagnosis is neither sensitive nor specific in its association with surgery. PMID- 3964996 TI - Epidemiology of fatal tricyclic antidepressant ingestion: implications for management. AB - Although there is a large body of literature documenting the lethal cardiotoxic complications of tricyclic antidepressant (TCA) overdose, the absence of reliable predictive signs has led to a policy of admitting even trivial-appearing overdoses for inpatient observation. A study of 18 fatal cases revealed that with the exception of two that received clearly inadequate medical care, all fatal ingestions developed major signs of toxicity mandating admission within two hours of arrival at the hospital, and the mean time from arrival to death was only 5.43 hours. All patients who died of direct TCA toxicity did so within 24 hours of arrival. In addition, half the fatal cases presented with only trivial signs of poisoning, but deteriorated catastrophically within one hour. These data lead to an algorithm to guide admission of serious cases. PMID- 3964997 TI - Utility of lavage alkaline phosphatase in detection of isolated small intestinal injury. AB - The ability of lavage alkaline phosphatase (LAP) to detect small intestinal injury was studied in 81 patients who underwent diagnostic peritoneal lavage following blunt and penetrating abdominal trauma. Patients with a grossly positive lavage were excluded. The LAP of five patients with small intestinal injury (79.0 +/- 41.7 IU/L) was significantly greater than in 76 cases without (1.2 +/- 0.4 IU/L; P less than .05). LAP greater than or equal to 3 was seen in six patients. Four had isolated small intestinal pathology, and one had combined small and large bowel injury. In three of these five, other lavage values were normal. One possible false positive occurred. The sensitivity of LAP greater than or equal to 3 (100%) exceeded that of usual lavage parameters in the detection of small intestinal injury. LAP may be a sensitive marker for small intestinal pathology in the immediate postinjury period. PMID- 3964998 TI - Clinical evaluation of Epi-Lock--a semiocclusive dressing. AB - Epi-Lock, a new semiocclusive, semipermeable dressing, was evaluated against standard therapy for three common emergency department wounds: partial thickness burns, deep abrasions, and selected lacerations. Comparison was made of quality of wound healing; rate of wound healing; level of pain experienced, postdressing, by the patient; and ease of use by the staff. One hundred patients in each group (standard treatment versus Epi-Lock) included approximately 40 burns, 35 abrasions, and 25 lacerations in each subgroup. The results of this study showed a statistically significant difference (P less than .01) in all categories for Epi-Lock versus standard therapy. Epi-Lock may be a useful new dressing for all types of wounds presenting to the emergency department. PMID- 3964999 TI - A computer-assisted quality assurance system for an emergency medical service. AB - A busy urban emergency medical service answering more than 50,000 calls each year developed a plan for quality assurance using a computer-assisted model designed to employ a full-time quality assurance officer whose work was supplemented with computer evaluation of EMS field reports. The development of standardized reporting formats, protocols and computer programs enabled a significant improvement in detection of errors of documentation and patient care. Investigated cases rose dramatically in the month following implementation of the system, from five patient care errors per month to 35 (P less than .05), and from 50 documentation errors to 265 per month (P less than .05). Our experience indicates that computer-assisted evaluation of field performance, as judged by prehospital records, is a useful tool to ensure standards in patient care and EMS recordkeeping. PMID- 3965000 TI - Mothball differentiation: naphthalene from paradichlorobenzene. AB - In order to develop a rapid, simple test to differentiate toxic naphthalene from the less toxic mothball ingredient paradichlorobenzene, both types of mothballs were dissolved in isopropyl alcohol, ethanol, methanol, and turpentine. Twenty five naphthalene and 25 paradichlorobenzene mothballs were weighed, randomly grouped, and then dissolved in the solvents. After 30 minutes, the mothballs were reweighed. Isopropyl alcohol, ethanol, and methanol did not differentially dissolve the mothballs fast enough to provide a useful test. Turpentine, however, dissolved paradichlorobenzene at a much more rapid rate than naphthalene (P less than .001). After 60 minutes, all of the paradichlorobenzene mothballs had dissolved, while at least 25% of the naphthalene remained. Thus, when confronted with an ingestion of unlabeled mothballs, the physician could gain preliminary information regarding possible toxicity by dissolving a remaining mothball in turpentine for 60 minutes. PMID- 3965001 TI - Comparison of the morbidity of tetanus toxoid boosters with tetanus-diphtheria toxoid boosters. AB - A double-blind randomized trial was performed to compare the subjective morbidity of tetanus toxoid (T) with that of tetanus-diphtheria toxoid (Td). Symptoms occurred in 46 (48%) of 93 patients who received T, and in 75 of 100 patients who received Td (chi 2 = 12.3; P less than .001). The effectiveness of immunization is clear, but with shift from use of T to Td as recommended, adherence to immunization guidelines and taking of adequate immunization histories becomes even more important. PMID- 3965002 TI - Disaster training for emergency physicians in the United States: a systems approach. AB - Disaster strikes more frequently and with greater impact than ever before, and the demand for improved community disaster preparedness rises. The American College of Emergency Physicians (ACEP), in collaboration with the Federal Emergency Management Agency (FEMA), has responded by developing a 16-hour course that prepares emergency physicians and other emergency providers to serve as knowledgeable members of their community's disaster team. The course was developed using a standard instructional design system to cover the basic components of disaster planning and emergency medical operations, including: disaster elements, general planning and organization, victim flow, communication, evacuation modalities, field and hospital management, documentation, public relations, and application to the local community. The 35 national faculty members present the course on a geographic basis across the United States. Further considerations for emergency medicine in the disaster domain include questions of education, research and the formation of a network to coordinate with other medical, health, and nonhealth care sectors nationally and internationally. PMID- 3965003 TI - Digital subtraction angiography: principles and potential applications in emergency medicine. AB - Digital subtraction angiography (DSA) is a new computer-assisted process which enables visualization of arterial structures after intravenous injection of contrast material. Technical requirements of the process mandate total patient cooperation during the filming sequence, which generally lasts five to ten seconds. Because of lower spatial resolution compared with conventional angiography, and difficulty with vessel overlap as a result of nonselective opacification, DSA has not supplanted conventional angiography in evaluation of traumatic vascular injuries. The technology of DSA, currently accepted uses, and potential future uses of DSA are discussed. Future improvements in DSA promise to make it more amenable to the evaluation of traumatic vascular injuries. PMID- 3965004 TI - Acute jaundice with renal failure. PMID- 3965005 TI - Water intoxication with seizures. AB - Presented is the case of a normal two-month-old girl who developed seizures secondary to water intoxication. The infant had been fed 20 to 30 oz of water daily for three days, while her usual formula was withheld because of vomiting and diarrhea. On the day of admission, the infant exhibited signs of water intoxication in the form of lethargy, vomiting, and seizures. Hyponatremia, hypothermia, and hyperglycemia were noted on admission, and are common features of the syndrome. The patient responded well to fluid restriction and salt replacement. Previous reports have attributed water intoxication to feeding mismanagement, vigorous hydration, dilute formulas, and swimming lessons. PMID- 3965006 TI - Acute childhood hemiplegia. AB - A 10-year-old child presented to the emergency department with a sudden onset of right hemiparesis and dysphasia. A thorough evaluation, including CT scan of the brain and cerebral angiography, resulted in a diagnosis of acute childhood hemiplegia. The diagnosis of acute childhood hemiplegia depends on characteristic cerebral angiographic findings. The treatment of this particular entity is supportive, often with incomplete recovery. PMID- 3965008 TI - 24-hour faculty coverage. PMID- 3965007 TI - "Megagroups" are major problem facing emergency medicine. PMID- 3965009 TI - Blind nasotracheal intubation. PMID- 3965010 TI - Combined effect of asbestos and smoking on mortality from lung cancer and mesothelioma in factory workers. AB - The mortality of over 1250 male and 420 female asbestos factory workers was observed over the period 1971-80. Smoking habits were obtained from the subjects in 1971 before the start of the follow up period. Mortality due to lung cancer and to mesothelioma was related to smoking habits. After allowing for the effect of smoking on lung cancer the relative risk due to asbestos was highest for those who had never smoked, lowest for current smokers, and intermediate for ex smokers; the trend was statistically significant (p less than 0.05). There was no significant association between smoking and deaths due to mesothelioma. Data from several studies are reviewed, and although overall non-smokers have a relative risk of lung cancer due to asbestos that is 1.8 times that of smokers, there is some uncertainty on the accuracy of this figure because of possible biases and sampling variation. Overall the evidence is that mesothelioma risk is independent of smoking. PMID- 3965012 TI - Effects of intervention on the cardiovascular mortality of workers exposed to carbon disulphide: a 15 year follow up. AB - The cardiovascular mortality of a cohort of 343 Finnish men exposed for at least five years to carbon disulphide (CS2) in a viscose rayon plant has been monitored prospectively from 1967 to 1982. The results from the first five years of follow up in 1972 showed a 4.7-fold excess mortality for ischaemic and other heart diseases (ICD A83-A84) compared with a comparable reference cohort of paper mill workers. After 1972 a preventive intervention programme instituted at the rayon plant included removing all workers with coronary risk factors from exposure. Thus only 19% of the exposed cohort continued to be exposed in 1977 compared with 53% in 1972. Moreover, exposure levels were reduced after 1972 in compliance with the set hygienic standard of 10 ppm. These measures were reflected in a normalisation of the risk of cardiovascular death; the relative risk was 1.0 in the period after the intervention (1 July 1974 to 30 June 1982), whereas it had previously been 3.2 (from 1 July 1972 to 30 June 1974). The risk of a fatal heart attack remained at 11.6% throughout the 15 year follow up period (95% confidence limits 8.5%-15.4%) among the exposed compared with 7.8% (5.3%-11.2%) among the unexposed. The entire risk difference of 3.8% was accumulated during the first seven years of follow up. Thus we can estimate that 59 CS2-related cardiovascular deaths would have occurred during the next eight years (instead of the actual 19 deaths) had there been no preventive action. Calculations yielded a preventive fraction of 68%. PMID- 3965011 TI - Cytogenetic, immunological, and haematological effects in workers in an ethylene oxide manufacturing plant. AB - Samples of blood were collected from a group of plant workers engaged in the manufacture of ethylene oxide (EO) for periods of up to 14 years and also from a group of control personnel matched by age and smoking habits. Peripheral blood lymphocytes were cultured for cytogenetic analysis. Selected immune and haematological parameters were also investigated. The results of these studies showed no statistically significant difference between the group of plant workers and the control group in respect of any of the biological parameters investigated in this study. Nevertheless, duration of employment in EO manufacturing was positively correlated (p less than 0.05) with the frequency of chromosome breaks and with the percentage of neutrophils in a differential white blood cell count and negatively correlated (p less than 0.05) with the percentage of lymphocytes. As the values of these parameters remained within the normal limits of control populations, the correlations were considered to have no significance for health. Atmospheric concentrations of EO were determined using personnel air samplers and were generally below the detection limit (less than 0.05 ppm) during stable plant operations, although transient concentrations of up to 8 ppm were occasionally recorded. The amount of alkylation (2-hydroxyethyl groups) of the Nt atom of histidinyl residues in haemoglobin was also measured in an attempt to gauge recent individual exposures to EO. Variable but, in most instances, readily measurable amounts of Nt-(2'-hydroxyethyl)-L-histidine (Nt represents the N3 atom of histidine) were found in the haemoglobin of plant workers and in the control group who had not knowingly been exposed to an exogenous source of EO. There was no statistically significant difference between the results obtained in the control group and in the group of plant workers. PMID- 3965013 TI - Morphometric and elemental microanalytical studies of human lung in health and disease. AB - Current methods for determining the fibrogenicity of substances are based on relatively long term exposures of animals to the substance and the evaluation of morphological changes occurring in the lung. The use of inhalation chambers, which produce a more physiological environment, suffer from the need for particularly long exposure times (1-3 years). The present study describes a technique using scanning electron microscopy, energy dispersive analysis, and a digitiser pad with a computer to evaluate the fibrogenicity of silica in cases of known exposure. Scanning electron micrographs taken from silicotic lungs were evaluated for the degree of thickening (fibrosis) and the same areas were analysed for silicon content. Correlations between silicon content and septal thickening were shown to be significant (p less than 0.0001). The study also describes the concentrations of elements found in normal lungs. The technique for establishing correlation curves between elemental concentrations and septal thickening could be of value in determining the fibrogenicity of pure substances after short exposures in an environmental chamber. PMID- 3965014 TI - Mortality of factory workers in east London 1933-80. AB - The mortality of 3000 male factory workers, 1400 laggers, and 700 women factory workers in east London has been studied. The men were first employed between 1933 and 1964, the women between 1936 and 1942. Textiles were produced until the late 1950s as well as other asbestos products. Laggers were employed on contract in increasing numbers in later years. Crocidolite asbestos was used until the late 1950s as well as asmosite and chrysotile. Exposure of workers was graded according to the job into two categories, low/moderate and severe, and subdivided by duration of employment up to two years or longer. Mesothelial tumours accounted for 7.5% of the total mortality in men, and 9% in women with their longer follow up period. Lung cancer accounted for 20% of deaths in men and 14% in women. Both mesothelial tumours and lung cancer showed a dose response relationship. Histopathological examination of a series of predominantly postmortem specimens showed 22% of adenocarcinomas of lung among men and 21% in women. There was an excess of gastrointestinal tumours but no dose response relationship could be shown. Among severely exposed male factory workers there was an excess of deaths from cancer of the larynx and among severely exposed women of carcinoma of the breast and ovary. Twenty four deaths (2%) were due to asbestosis. There is an indication that the incidence of mesothelial tumours is declining but a further period of observation is required for confirmation. PMID- 3965015 TI - Occupational asthma due to an emulsified oil mist. AB - A toolsetter developed occupational asthma due to the oil mist generated by his lathe on which it was used as a coolant. The diagnosis was confirmed by serial measurements of peak expiratory flow at home and work, including a prolonged period away from work. Occupational type bronchial provocation tests were performed using the whole emulsified oil and its components separately. He reacted specifically to the whole emulsified oil and to the reodorant, a pine oil preparation. He also reacted to colophony, a constituent of the emulsifier. PMID- 3965016 TI - Pulmonary function of London firemen. AB - In a longitudinal study of a sample of firemen in London 1006 firemen were interviewed and examined in 1976 and 895 were seen a second time 12 months later. On each occasion a Medical Research Council respiratory questionnaire was administered and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured. The average levels of FEV1, FVC, and FEV1/FVC in both years compared favourably with conventional predicted values. Separate multiple regression analysis for the two years indicated that the FEV1 and FVC fell more rapidly in those aged over 40, and that cigarette smoking had a strong harmful effect on these measures of function. Only among men with over 20 years' service was there possibly any evidence (not statistically significant) of an effect from duration of employment. The comparatively large fall in FEV1 and FVC from 1976 to 1977 was due mainly to instrumental variation. The prevalence of respiratory symptoms was higher in smokers than non-smokers and increased with the number of cigarettes smoked. PMID- 3965017 TI - Effect of commercial diving on ventilatory function. AB - A retrospective analysis of spirometric data from divers attending for annual medical examination at intervals from three to nine years was carried out to examine the long term effect of diving on lung volumes. Those divers with records over a three or four year interval (group 1, n = 224) showed a mean reduction of forced vital capacity (FVC) of 240 ml; those with records over a five or more years interval (group 2, n = 123) showed a reduction of FVC of 400 ml. These reductions remained significant when expressed as a percentage of predicted normal values. The reduction of FVC between records did not correlate with the diver's age, maximum operating depth, duration of diving career, or weight change but was positively correlated with the initial FVC. The reductions in FVC were similar in smokers and non-smokers. The change in forced expiratory volume in one second (FEV1) followed a similar pattern but was less pronounced than the effect on FVC. The decline in FVC associated with diving occurs from values of FVC that are above the predicted normal; few values below predicted normal were observed. The effect may represent either a gradual return towards the predicted normal or a pathological reduction in lung volume. PMID- 3965018 TI - Determination of diethyllead in the urine by flameless atomic absorption spectrometry. AB - A method for the determination of diethyllead in urine by flameless atomic absorption spectrometry after chelation with glyoxal-bis (2-hydroxyanil) and extraction of the formed complex with methyl isobutyl ketone is described. The method is specific in relation to both triethyllead and inorganic lead. The limit of detection was 3.2 micrograms Pb/l and the relative standard deviation in the concentration range 20-100 micrograms Pb/l was 0.076. PMID- 3965019 TI - Effects of radiant heat in fire fighting instructors. PMID- 3965020 TI - Long term follow up of workers exposed to beryllium. PMID- 3965021 TI - On the relative toxicity of asbestos fibres. PMID- 3965022 TI - A problem in looking for relationships between concentrations of urinary components. PMID- 3965023 TI - Herpes simplex conjunctivitis. PMID- 3965024 TI - Polyunsaturated fatty acids and diabetic retinopathy. AB - One hundred and forty nine diabetic patients were ophthalmologically assessed seven years after randomisation to a low carbohydrate or modified fat diet (rich in linoleic acid). Glycaemic control, regardless of the type of diet, was a major determinant of the development of retinopathy. Poorly controlled patients (haemoglobin A1c greater than 8%) with low levels of linoleic acid in cholesterol ester had a significantly greater frequency of retinopathy than well controlled patients or patients with similarly unsatisfactory control but higher levels of linoleic acid. The findings support an earlier suggestion that linoleic acid might protect against diabetic retinopathy. PMID- 3965026 TI - Embolic retinopathy due to Corynebacterium minutissimum endocarditis. AB - Infective embolic retinopathy as a sequela of bacterial endocarditis is described in a 31-year-old woman with mitral valve prolapse. The infective organism, Corynebacterium minutissimum, has not been previously found to cause ocular or multisystem diseases. It is a common mucocutaneous inhabitant which causes erythrasma. In our case report both ocular involvement and septicaemia were present. The infection was confirmed by positive serial blood cultures. Mitral valve prolapse was confirmed by echocardiography. On clinical examination the retinopathy consisted of white intraretinal lesions which resolved with antibiotic therapy. By fluorescein angiography focal areas of hypofluorescence corresponding to the white fundus lesions were present. Optic disc oedema was also seen. PMID- 3965025 TI - Epidemiological and clinical features of primary herpes simplex virus ocular infection. AB - The epidemiological and clinical features of primary herpes simplex virus ocular infection in 108 patients were studied. Of these, 69 (64%) were aged 15 or over and only eight (7%) were under the age of 5. Associated upper respiratory tract infection was found in 38 (35%) patients and systemic disorders such as mild malaise, fever, and aching in 34 (31%) patients. Common symptoms were redness, watering, discharge, itching, irritation, and lid swelling, whereas pain, photophobia, lid vesicles and ulcers, and blurred vision were less frequent. The major signs consisted of vesicles and ulcers on the lids, papillary responses which were more severe in the upper lid conjunctiva, follicles which were more common in the lower lid conjunctiva, fine and coarse epithelial punctate keratitis, and subepithelial punctate keratitis. Dendritic ulcers and disciform keratitis were found in 16 (15%) and two (2%) patients respectively. The clinical forms of primary herpes simplex virus ocular infection varied. Moderate or severe disease was observed in 41 (38%) and 16 (15%) patients respectively. In eight (7%) patients the disease presented as an acute follicular conjunctivitis without characteristic lid or corneal lesions. A chronic blepharoconjunctivitis which lasted for months developed in 16 (15%) patients. The epidemiological and clinical features in our patients were compared with features of the disease reported previously. PMID- 3965027 TI - An unusual case of congenital unilateral Coats's disease associated with morning glory optic disc anomaly. AB - We present the case of a 13-year-old girl with a right congenital esotropia who at the age of 6 months presented an anomaly of the optic disc and retinal vessels in the same eye. In the following year she developed Coats's disease, rubeosis iridis, and neovascular glaucoma that led to enucleation. Pathological examination confirmed the clinical diagnosis. PMID- 3965028 TI - Effect of age on contrast sensitivity function: uniocular and binocular findings. AB - Monocular and binocular contrast sensitivity function for a range of spatial frequencies was measured in two groups of subjects with normal vision. Statistically significant differences in performance between the younger group (age 20-30 years) and the older group (age 50-87 years) were found at all spatial frequencies sampled between 0.40 and 19 X 25 cpd. In the age range 50-87 years there was a linear decline in contrast sensitivity with age for medium and high spatial frequencies, but sensitivity for low spatial frequencies was independent of age. PMID- 3965029 TI - Congenital fibrosis of superior rectus and superior oblique: a case report. AB - A rare case of possible postinflammatory fibrosis of the superior rectus and superior oblique muscles, resulting in marked hypotropia with pseudoptosis, is described, together with the surgical management. PMID- 3965030 TI - Perilimbal vascular anomaly associated with ipsilateral en coup de sabre morphoea. PMID- 3965032 TI - Familial exudative vitreoretinopathy. PMID- 3965031 TI - Retinal pathology in the Kearns-Sayre syndrome. AB - Examination of the retinal tissues obtained at necropsy from a 14-year-old boy with Kearns-Sayre syndrome showed marked photoreceptor and pigment epithelial cell loss in the retinal periphery and around the optic nerve head. Electron microscopy of surviving retinal pigment epithelial (RPE) cells indicated a loss of apical microvilli and basal infoldings. The RPE was unusually devoid of melanosomes and showed no evidence of phagocytosis of photoreceptor debris. The cytoplasm of the RPE contained numerous, often enlarged, mitochondria. These structural changes suggested that a breakdown in the energy dependent interrelationships between the RPE and the photoreceptor layer was responsible for the outer retinal degeneration. The finding of numerous macrophages in the subretinal space suggests a secondary inflammatory component in the retinal degeneration. PMID- 3965033 TI - Tardive dyskinesia: marked predominance of nongenetic schizophrenia. PMID- 3965034 TI - Abnormalities of blink rate in psychoses: a preliminary report. PMID- 3965035 TI - Suicide and the dexamethasone suppression test in adolescence. PMID- 3965036 TI - Methylene blue in treatment of bipolar illness. PMID- 3965037 TI - Structure and function: brain electrical activity mapping and computed tomography in schizophrenia. AB - A computerized topographic technique that maps brain electrical activity is applied to the investigation of neurophysiological abnormalities in medicated and drug-free schizophrenic patients. This topographic approach uses EEG and evoked potentials to provide functional measures of electrophysiological abnormalities. Neurophysiological differences between schizophrenic patients and controls are delineated which add further evidence that frontal lobe dysfunction may be relevant to our understanding of schizophrenia. An initial investigation employs computed tomography to examine the relationship of structural anatomical pathology in schizophrenia with the functional abnormalities that may be defined using brain electrical activity mapping. When schizophrenic patients with and without frontal cortical atrophy were compared, electrophysiological differences were delineated that overlay frontal cortical regions. This preliminary work suggests that in schizophrenia, abnormal electrophysiological function is associated with definable gross morphological abnormalities of the brain. PMID- 3965038 TI - Autonomic responsiveness to affective visual stimulation in temporal lobe epilepsy. AB - Patients with temporal lobe epilepsy (TLE) have been posited by some to manifest a syndrome of interictal personality and behavioral change. Furthermore, this syndrome has been attributed to an underlying mechanism--enhanced affective responsiveness. The purpose of this investigation was to determine whether patients with TLE manifest increased emotional responsiveness relative to appropriate controls. Patients with TLE (n = 23) were compared with non-TLE (n = 7) and healthy controls (n = 16) as to their autonomic nervous system responsiveness to an emotionally stressing film. No differences were found among the groups. These results are related to the larger literature concerning epilepsy and psychopathology. PMID- 3965039 TI - Reliability of a standardized brief-pulse stimulus in ECT. AB - The reliability of a standardized brief-pulse stimulus in eliciting a satisfactory convulsive response was evaluated under normal clinical conditions. A total of 89 patients were given 961 initial treatments. Of these, 757 were at the standardized level with a success rate of 89%. A total of 204 trials were given at higher-than-standardized levels. Treating these as standardized level failures, the overall success rate was 70%. The probability that a standardized stimulus given to any patient at any point in the treatment series would be successful was about 7 chances in 10. Implications for the selection of ECT stimuli were discussed. PMID- 3965040 TI - Factors associated with duration of survival in Alzheimer's disease. AB - With a computerized data base, a data retrieval system, and a computer program using the actuarial method of life-table analysis, we compared survival rates in different subgroups of patients with dementia of the Alzheimer type (DAT; n = 199). Men (n = 71) had a shorter duration of survival than women (n = 128), with 500-day survival (mean +/- SEM) 84 +/- 5% vs. 99 +/- 3%, p less than 0.01; 1000 day survival 49 +/- 10% vs. 96 +/- 8%, p less than 0.001; 50% survival 1000 days vs. 1550 days. Patients younger than 65 years at onset had a decreased relative duration of survival compared with patients over 65 at onset, suggesting a more malignant course. Patients with a longer duration of illness tended to die sooner, but this effect was not statistically significant. The Kahn-Goldfarb mental-status quotient was not a predictor of survival. Patients with high Haycox behavioral score (greater than 20; n = 50), indicating more severe behavioral impairment, had lower survival rates at 500 days than patients with low scores (less than 12; n = 65) (80 +/- 6% vs. 95 +/- 3%, p less than 0.05). Hachinski ischemic score, measuring signs and symptoms of vascular disease, had no correlation with survival. Factors associated with decreased duration of survival in DAT include male sex, presenile onset, and increased severity of behavioral impairment. PMID- 3965041 TI - Poor interrater reliability of MECTA EEG seizure duration measurement during ECT. AB - Seizure duration assessed from the MECTA EEG (mEEG) tape was not found to be a reliable measurement across five independent examiners. Although all examiners agreed that an electrical seizure was demonstrated on the mEEG, the examiners were markedly different in their duration assessments (p less than 0.0001). Criteria are needed for mEEG measurement and interpretation. PMID- 3965042 TI - Low plasma dopamine-beta-hydroxylase in demented schizophrenics. PMID- 3965043 TI - Intensive chemotherapy of hairy cell leukemia in patients with aggressive disease. AB - Seven patients with hairy cell leukemia were treated by intensive chemotherapy because they were considered to have a progressive disease and a poor short-term prognosis. The mean age was 47 years (range, 36 to 58). Six of seven patients had prior splenectomies with minor or transient hematologic responses. One patient had no spleen enlargement. The seven patients had never received any cytotoxic drugs and had prolonged granulocytopenia (less than 300/microL) with recurrent, severe infectious episodes. Chemotherapy included Rubidazone (zorubicine hydrochloride) 450 mg/m2 on day 1, arabinosyl cytosine 200 mg/m2/d from day 1 to day 5, and cyclophosphamide, 2,000 mg/m2 on day 5. Responses were assessed through examination of repeat bone marrow biopsy specimens and blood counts. A complete response was defined as normal blood counts associated with the disappearance of hairy cell infiltration and fibrosis on the bone marrow biopsy specimens. A partial response was defined as normal blood counts with persistence of leukemic cells in the bone marrow. Three patients achieved a complete response, and one patient had a partial response. Three patients died of infectious complications during induction chemotherapy. For the responding patients, the mean duration of aplasia was 37 +/- 5 days. Follow-up for the responding patients has been 44+, 24, 32+, and 23+ months. One patient with a complete response died while on maintenance therapy. We conclude that complete and prolonged histologic remission of hairy cell leukemia can be obtained with intensive chemotherapy. The toxicity of chemotherapy is such, however, that progressive disease after splenectomy needs to be more clearly defined. PMID- 3965044 TI - Common structural genes for platelet and plasma fibrinogen. AB - Fibrinogen from plasma was compared with fibrinogen from platelets using two dimensional electrophoresis. The source of platelet fibrinogen was isolated alpha granules, thrombin- and collagen-released platelet material. The B beta- and gamma-chains from the different sources showed similar two-dimensional patterns, while gamma'-chains were not observed in platelet fibrinogen preparations. Furthermore, the A alpha-chain could hardly be identified in platelet preparations. When individual fibrinogen was studied in persons heterozygous for genetic B beta- and gamma-chain variants, the two-dimensional variant pattern could be demonstrated in plasma fibrinogen as well as in platelet fibrinogen. This observation strongly indicates that the structural genes for plasma and platelet fibrinogen B beta- and gamma-chains are identical. PMID- 3965045 TI - Macrophage factor X activator formation: metabolic requirements for synthesis of components. AB - The in vitro production of factor VII-like material and of tissue factor activity by murine thioglycollate exudate macrophages was measured by amidolytic assays. Tissue factor activity was inducible by endotoxin, and its induction was inhibited by 1 microgram/mL of actinomycin D, 10 micrograms/mL of cycloheximide, and 0.2 micrograms/mL of tunicamycin. Soluble factor VII-like material was secreted by macrophages into culture supernatants. The amount produced was not influenced by further activation of the cells by endotoxin, nor was its production inhibited significantly by 1 microgram/mL actinomycin D or 0.2 micrograms/mL tunicamycin. The production of the factor VII-like material was inhibited by 10 micrograms/mL of cycloheximide, and its appearance in culture supernatants was enhanced significantly by the addition of vitamin K1. When lysates of activated macrophages were suspended in ultracentrifuged culture supernatants, a particulate factor X activator was formed. Centrifugation at 100,000 g pelleted the factor X activator and left no factor VII-like material in the supernatant. The data indicate that thioglycollate-induced exudate macrophages make and excrete factor VII-like material, and this production is not modulated by further activation. However, activation of the macrophages induces tissue factor production. The factor X activator appears to result from the interaction and complexing of the soluble factor VII-like material and the membrane-bound tissue factor. PMID- 3965046 TI - Hemoglobin S polymerization: primary determinant of the hemolytic and clinical severity of the sickling syndromes. AB - We examined the extent to which the intracellular polymerization of sickle hemoglobin (HbS) can account for the severity of anemia and of vaso-occlusive manifestations in the various sickling syndromes. Polymer formation in sickle cell disease depends principally on the intraerythrocytic hemoglobin composition and concentration. In our studies, the polymer fraction in sickle red cells was determined from reported mean values for hemoglobin composition and mean corpuscular hemoglobin concentration (MCHC) in 12 groups of patients with sickle hemoglobinopathies (homozygotes for HbS, with and without coexistent alpha thalassemia or various forms of the hereditary persistence of fetal hemoglobin [HPFH], beta+-, beta 0-, and delta beta-thalassemia, and heterozygotes for HbS with HbA). The calculated HbS polymer fractions at full deoxygenation and at physiologic oxygen saturation values were closely correlated with mean blood hemoglobin concentrations. In addition, polymer fraction correlated with the ranking of the sickling syndromes by vaso-occlusive severity. We find that polymer fraction accounts for about 80% of the variability in hemolytic and clinical severity. The method of analysis presented here provides a quantitative and systematic means of assessing the role of polymer formation in the pathophysiologic manifestations of the sickling syndromes. Our results support the hypothesis that the intracellular polymerization of HbS is the primary determinant of the severity of both anemia and clinical symptomatology in the sickle hemoglobinopathies. PMID- 3965047 TI - The relative importance of thrombin inhibition and factor Xa inhibition to the antithrombotic effects of heparin. AB - The relative importance of antithrombin and anti-factor Xa activities of heparin fractions required to achieve optimal antithrombotic effects is unknown. To study this, we measured the effects of standard heparin, an octasaccharide heparin fraction (anti-factor Xa activity only), and dermatan sulfate (antithrombin activity only) on the prevention of thrombosis and related this to their anticoagulant effects in vivo in rabbits. Thrombosis was measured as the incorporation of 125I-fibrinogen into tissue thromboplastin-induced thrombi using a Wessler-type model. Ex vivo changes in thrombin clotting time (TCT) were used as an index of antithrombin activity, and a chromogenic anti-factor Xa assay was used to measure anti-factor Xa activity. In addition, the ability of the three sulfated polysaccharides to simultaneously inhibit the generation of thrombin activity and to enhance the inactivation of the factor Xa added to initiate thrombin generation in plasma was determined. Standard heparin, in a dose of 10 anti-factor Xa U/kg, inhibited thrombus formation by 90%, prolonged the TCT by two seconds, and resulted in an anti-factor Xa level of 0.32 U/mL. The octasaccharide heparin fraction, in a dose of 10 anti-factor Xa U/kg, inhibited thrombus formation by 41%, had no effect on the TCT, and resulted in an anti factor Xa level of 0.28 U/mL. Higher doses of the octasaccharide resulted in a further increase in the anti-factor Xa levels but had no further effect on thrombus formation. Dermatan sulfate, in a dose of 500 micrograms/kg, inhibited thrombus formation by 95%, but had no affect on the TCT. These results indicate that the antithrombotic effect achieved by inhibiting factor Xa is limited and that better antithrombotic effects are achieved by heparin or heparin-like substances capable of influencing the inactivation and/or the generation of thrombin. PMID- 3965048 TI - A monoclonal antibody that inhibits activation of human Hageman factor (factor XII). AB - A monoclonal antibody to human Hageman factor (HF, factor XII) was derived from BALB/c mouse spleen cells fused with NS-1 mouse myeloma cells. This antibody, purified from ascites fluid, reacted with HF to inhibit the activation of HF, purified or in normal pooled plasma, as measured by a coagulation assay. The antibody did not inhibit the coagulant activity of activated HF. The antibody also inhibited the generation of amidolytic activity in HF-ellagic acid mixtures, but failed to inhibit the amidolytic properties of the carboxy-terminal fragment of HF (HFf). Amidolytic activity, absent in an HF-monoclonal antibody mixture, was generated upon treatment with insoluble trypsin. Monoclonal antibody, bound to CNBr Sepharose 4B gel (Pharmacia Fine Chemicals, Piscataway, NJ), reversibly bound HF in plasma or in buffer, without activating it. HF was then eluted with 4 mol/L guanidine HCI. The passage of 125I-labeled HF enzymatically cleaved by trypsin through a column of monoclonal antibody-CNBr Sepharose 4B gel resulted in flow-through of HFf with a molecular weight (mol wt) of 30,000 and HF fragments of mol wt 12,000. Elution with 4 mol/L guanidine HCI yielded several HF fragments (mol wt 80,000, 52,000, and 40,000) but not HFf. These data suggest that the single determinant recognized by the murine monoclonal antibody is not on HFf, but rather on the amino-terminal fragment thought to be involved in the binding activity of HF. The monoclonal anti-HF bound to CNBr-activated Sepharose 4B gel could be used to artificially deplete plasma samples of HF. PMID- 3965050 TI - Cyclosporine for pure red cell aplasia. PMID- 3965049 TI - Independent stimulation of membrane potential changes and the oxidative metabolic burst in polymorphonuclear leukocytes. AB - Early events of stimulus-response coupling in polymorphonuclear leukocytes (PMNL) reportedly include membrane depolarization as a necessary antecedent to oxidative responses. However, depolarization by nonspecific means (ionophores) is insufficient to elicit an oxidative burst. This apparent conflict might be related to whether depolarization is due to membrane receptor-mediated stimulation of PMNL. We used two fluorescent probes and dual laser flow cytometry to monitor both membrane potential and oxidative product formation in individual PMNL, following stimulation by phorbol myristate acetate (PMA) or formylmethionyl leucyl-phenylalanine (fMLP). Dipentylindocarbocyanine [di-I-C5(3)] is one of a family of dyes that partition between cells and aqueous media as a function of transmembrane potential. The dye appeared stable in the presence of PMNL oxidative products. Oxidation of intracellularly trapped, nonfluorescent dichlorofluorescin (DCFH) to fluorescent dichlorofluorescein (DCF) provided a quantitative assessment of oxidative metabolism (H2O2 production) of stimulated PMNL. Incubating PMNL with both fluorochromes resulted in stable red [di-l-C5(3)] and green (DCF) fluorescence when examined on a Cytofluorograph. Upon stimulation by 0.03 to 0.1 nmol/L PMA, PMNL showed a unimodal apparent depolarization (decrease in di-l-C5(3) fluorescence). Oxidative activity (increased DCF fluorescence) was first seen at a concentration of PMA of 0.17 nmol/L, higher than that required to elicit depolarization. This oxidative burst appeared as a dose-dependent, graded response. Thus, receptor-mediated membrane depolarization, although antecedent to the onset of the oxidative burst, was not in itself sufficient to trigger the oxidative metabolic response. When PMNL were isolated by centrifugation through Ficoll-metrizoate, fMLP caused an apparent depolarization of a variable subpopulation of the cells. However, such purified PMNL appeared relatively unstable and often depolarized spontaneously. PMNL studied without centrifugation through Ficoll-metrizoate were stable. Moreover, fMLP stimulation of such cells did not cause membrane depolarization but did stimulate a two- to six-fold increase in DCFH oxidation. Apparently, membrane depolarization may antecede oxidative responses in PMNL, but appears to depend upon the method of cell preparation and the nature of the stimulus. PMID- 3965052 TI - Abnormal megakaryocytopoiesis in the Belgrade laboratory rat. AB - The Belgrade laboratory rat (b/b rat) has hereditary, hypochromic, microcytic anemia with a variety of red cell abnormalities. Although this anemic syndrome has been recently ascribed to the defective delivery of iron to the developing red cell, the basic hematopoietic defect is still unknown. In this article we present evidence that the b/b rat has an additional hematologic defect. We have found that the megakaryocyte number in the marrow of the b/b rat is decreased to one half that of the normal rat, but the maturation rate of recognizable megakaryocytes is accelerated and the size is increased. The platelet count is moderately reduced. These findings indicate that megakaryocytopoiesis in the anemic b/b rat is abnormal and suggest that the genetic defect may involve the progenitors of the megakaryocyte cell lineage. Alternatively, the megakaryocytic abnormalities may be secondary to the severe anemia. PMID- 3965051 TI - The heterozygous form of 4.1(-) hereditary elliptocytosis [the 4.1(-) trait]. AB - Using clinical, morphological, genetic, and biochemical criteria, we studied ten white and North African families with hereditary elliptocytosis (HE). In four families, elliptocytic individuals displayed a highly significant reduction of band 4.1, which was recorded using two electrophoretic procedures. The 4.1a/4.1b ratio was also significantly reduced, as is usually observed in suspensions enriched in young red cells. This form of HE was invariably associated with the following characteristics: absence of clinical signs; numerous, smooth and well elongated elliptocytes; dominant transmission; and, when investigated, normal osmotic fragility. Its frequency, among all forms of HE, is about one third as a first estimate, at least in whites and North Africans. In the other six families studied, elliptocytic subjects presented normal 4.1 bands. Again, the 4.1a/4.1b ratio was decreased, reflecting the red cell age-dependent changes in these two components. In three of these families, elliptocytosis was accompanied by clinical signs of variable intensity, and the mode of inheritance could not be unequivocally determined. Therefore, HE with a partially reduced band 4.1 defines a homogeneous variety of HE that can be isolated from other forms of HE. We suggest that it be termed the 4.1 (-) trait, so as to correspond with a previously proposed terminology. PMID- 3965053 TI - Patients with a deficiency of natural killer cell activity lack the VEP13 positive lymphocyte subpopulation. AB - Many patients with B-type chronic lymphocytic leukemia (CLL) exhibit a profound defect in their natural killer (NK) cell activity, the basis of which is still obscure. Hence, we analyzed the NK cells from peripheral blood samples from 11 patients with CLL for phenotype and function, after removal of the leukemic cells with a monoclonal antibody (BA-1) plus complement. Phenotypic analysis of these nonleukemic cells with monoclonal antibodies (MoAbs) against NK cells revealed that the CLL patients had higher percentages of HNK-1-positive cells (23.5% compared to controls with 14.7%). In contrast, VEP13-positive cells were absent or low in seven patients (0.8% compared to controls with 11.2%) and normal in four patients (10.5%). When testing NK cell activities against K562 or MOLT 4 target cells, patients with no or minimal numbers of VEP13-positive cells were found to be deficient, while patients with normal percentages of VEP13-positive cells had NK cell activity comparable to controls. Isolation by fluorescence activated cell sorter of HNK-1-positive cells from patients lacking VEP13 positive cells and NK cell activity indicated that the majority of the HNK-1 positive cells in these patients had the large granular lymphocyte morphology that is characteristic of NK cells. Thus, the deficiency of NK cell activity in CLL patients appears to result from the absence of cells carrying the VEP13 marker. PMID- 3965055 TI - Exodus of physicians. PMID- 3965054 TI - Monocytes and macrophages synthesize and secrete thrombospondin. AB - Thrombospondin, one of the major glycoproteins released from alpha-granules of thrombin-stimulated platelets, is a disulfide-linked trimer of 160,000-dalton subunits. Cultured human monocytes secreted thrombospondin (determined by an enzyme-linked immunosorbent assay) into the culture medium in a time-dependent manner (1.45 micrograms/10(6) cells/24 hr); secretion was totally blocked by cycloheximide (1 microgram/mL). 35S-thrombospondin was isolated from 35S methionine-labeled human monocyte postculture medium with rabbit polyclonal anti thrombospondin coupled to protein A-Sepharose. The immunoisolated 35S thrombospondin migrated in sodium dodecyl sulfate-polyacrylamide gels after reduction with a molecular weight of 159,000. Similar results were obtained using mouse resident peritoneal macrophages. Elicited peritoneal macrophages harvested from mice pretreated with endotoxin, casein, or thioglycollate secreted much less thrombospondin than did resident macrophages harvested from control mice. Thus, monocytes and macrophages from two different species synthesize and secrete thrombospondin, and the rate of synthesis of thrombospondin appears to depend on the state of activation of the cells. PMID- 3965056 TI - Digital deformities from frostbite. PMID- 3965057 TI - Unusual manifestation of esophageal foreign body. PMID- 3965058 TI - Kawasaki disease: Canadian update. AB - Kawasaki disease, or mucocutaneous lymph node syndrome, is a multisystem disorder that affects young children. Between 1979 and 1982, 357 patients from 15 university pediatric centres in Canada were reported to have the disease. The diagnosis of Kawasaki disease is based on six clinical features, including fever, conjunctivitis, cracked lips, reddening and swelling of the hands and feet, rash and cervical lymphadenopathy. A scoring system is described that may help predict the development of cardiovascular complications. Coronary artery involvement can be recognized early by two-dimensional echocardiography. Anti-inflammatory therapy, principally with acetylsalicylic acid, is indicated in the acute phase and antithrombotic treatment in the subacute and chronic phases of the disease if coronary artery aneurysms have developed. Prolonged follow-up for patients with aneurysms is necessary. The length of follow-up for patients without aneurysms will depend on the results of studies on patients with Kawasaki disease after they reach adulthood. PMID- 3965059 TI - Blood pressure: distribution in students of junior and senior high schools in Saint John, NB. AB - Blood pressures were recorded for 8950 students (82.4% of the total student population) of the junior high and high schools of Saint John, NB. Among the boys the mean systolic pressure rose from 104 mm Hg at age 12 to 117 mm Hg at age 18; among the girls the rise was from 105 to 110 mm Hg. The mean diastolic pressure also rose, from 61 to 67 mm Hg, in both sexes. These data are similar to those found in epidemiologic studies in Montreal and Bogalusa, Louisiana. However, the mean systolic values are lower by 10 mm Hg than those in an Edmonton study and the norms published by a United States task force. Recording methods could explain some of the observed differences, but population differences may also contribute. The discrepancies suggest that the current standards for children and adolescents need to be reassessed. PMID- 3965060 TI - Vancomycin-induced neutropenia. AB - Although rare, neutropenia associated with long-term vancomycin therapy may occur. A 67-year-old woman with cellulitis and sepsis caused by Staphylococcus aureus was treated initially with cefazolin. Despite in-vitro susceptibility of the organism to this drug, the patient remained febrile, and therapy was changed to vancomycin. On day 17 of therapy with this medication neutropenia was noted; it progressed over the next 3 days, and therapy with the drug was stopped. A rise in the neutrophil count occurred within 5 days of discontinuation. Periodic monitoring of the leukocyte count during longterm vancomycin therapy is recommended. PMID- 3965061 TI - Originality, novelty and priority: three words to reckon with in scientific publishing. PMID- 3965062 TI - Relief of asthma with danazol. PMID- 3965063 TI - Magnetic resonance imaging: clinical research in Canada. PMID- 3965064 TI - Circumpolar health update. PMID- 3965065 TI - Tuberculosis in female nurses in British Columbia: implications for control programs. AB - All 57 cases of active tuberculosis in women in nursing and related assisting occupations (henceforth called nurses) notified in British Columbia between 1969 and 1979 were reviewed. This represented a mean annual incidence of active tuberculosis of 2.6/10 000, similar to that in other women, adjusted for age and birthplace. The rate varied according to birthplace: among nurses born in Canada the rate was 2.0, almost twice that of other women born in Canada, and among those born in Asia it was 24.8, less than half that of other women born in Asia. The nurses born in Canada who had received BCG (bacille Calmette-Guerin) during their training were least likely to contract tuberculosis, the incidence rate being comparable to that among other women. Those whose results of tuberculin testing were negative but who were not vaccinated were twice as likely to contract tuberculosis, whereas those whose results were positive at the start of training were four times as likely to contract tuberculosis. The feasibility and implications of a tuberculosis screening and surveillance program are discussed. PMID- 3965067 TI - Pseudotumour cerebri in association with polyarthritis, urticaria and cryoglobulinemia. AB - Pseudotumour cerebri is a disorder characterized by elevated intracranial pressure in the absence of hydrocephalus and intracranial mass lesions. The cause of this disease remains obscure but has been related to diverse underlying conditions. We report a patient with pseudotumour cerebri, polyarthritis, urticaria, hypocomplementemia and cryoglobulinemia. Serial lumbar punctures were unsuccessful in lowering the cerebrospinal fluid (CSF) pressure. A trial of prednisone, 40 mg daily for 4 weeks, resulted in clinical improvement but was ineffective in lowering the CSF pressure. Circulating immune complexes and complement activation may have played a role in the development of increased intracranial pressure. Cryoglobulinemia should be added to the list of disorders associated with pseudotumour cerebri. PMID- 3965066 TI - Decreased population of Leu-7+ natural killer cells in lymph nodes of homosexual men with AIDS-related persistent lymphadenopathy. AB - Natural killer (NK) cells were studied in the lymph nodes of homosexual men with the persistent lymphadenopathy syndrome (PLS) and other signs of the disease complex related to the acquired immune deficiency syndrome (AIDS). The NK cells were identified by their Leu-7+ phenotype and enumerated in frozen sections of lymph nodes in conjunction with the quantification of T-lymphocyte subsets. Lymph nodes from patients with AIDS-related PLS contained 91% and 81% fewer NK cells than normal lymph nodes and lymph nodes from patients with non-AIDS-related hyperplastic lymphadenopathy respectively. This decrease in NK cells in PLS is consistent with the immune dysregulation leading to persistent infection and neoplasia in AIDS. PMID- 3965069 TI - Nosocomial Legionnaires' disease in the Quebec City area. PMID- 3965068 TI - Toxic encephalopathy in a child after brief exposure to insect repellents. AB - Seizures and acute behaviour change developed in an 8-year-old girl following exposure to Muskol and Off insect repellents. She recovered within 3 days with supportive treatment, including anticonvulsant medication. The assumed toxic agent was N,N-diethyltoluamide. PMID- 3965070 TI - Legionella and domestic water heaters in the Quebec City area. PMID- 3965071 TI - Drunken driving: why so little progress? PMID- 3965072 TI - House style--more than tradition, less than logical. PMID- 3965073 TI - The tragedy of abortion. PMID- 3965074 TI - Head injuries and baby walkers. PMID- 3965075 TI - Failure to thrive in the contented breast-fed baby. PMID- 3965076 TI - Pyruvate kinase in normal human thyroid tissue and thyroid neoplasms. AB - Pyruvate kinase (ATP: pyruvate-2-O-phosphotransferase, EC 2.7.1.40) was studied in human thyroid carcinomas (n = 9), follicular adenomas (n = 32), and normal thyroid tissue (n = 12). The specific activity in carcinomas (mean 0.94 +/- 0.44) is significantly increased (P less than 0.0001) in comparison with pyruvate kinase in normal tissue (mean, 0.14 +/- 0.05). Specific activities of follicular adenomas are rather heterogeneous. When these tumors were divided into three groups of increasing proliferative activity as judged by histopathologic criteria, highest specific activities of pyruvate kinase were found in the group with the highest proliferative activity. On the other hand, specific enzyme activities of the least active tissues (colloid-containing follicular adenomas) were comparable to normal. The isoenzyme composition of normal thyroid tissue is characterized by the presence of K4, K3M, and K2M2 types of pyruvate kinase. In carcinomas, mainly K4 and K3M are found. Undifferentiated tumors express more K4 type compared with follicular and papillary carcinomas. Follicular adenomas with high specific activity show the same electrophoretic pattern as found in follicular carcinomas. Pyruvate kinase from malignant tumors is more inhibited by the amino acid L-alanine than the enzyme from normal thyroid tissue as a consequence of the presence of more K subunits in the malignant tissues. The K4 type from normal thyroid tissue is not kinetically different from the K4 type of carcinomas. PMID- 3965077 TI - Adenocarcinoma of the male urethra with associated nephrogenic metaplasia. Case report and review of the literature. AB - Nephrogenic metaplasia is an uncommon sequela of chronic bladder irritation. The case described herein represents the second reported in the bulbomembranous urethra of the male. Important questions are raised regarding the premalignant potential of nephrogenic metaplasia. A review of the literature on adenocarcinoma of the male urethra and also of nephrogenic metaplasia of the bladder and urethra is presented. PMID- 3965078 TI - Periosteal osteosarcoma. AB - An analysis of 6 patients with periosteal osteosarcoma treated by the authors along with a review of 55 patients reported in the literature demonstrates that periosteal osteosarcoma is distinctly different from conventional osteosarcoma or periosteal chondrosarcoma. Periosteal osteosarcoma is a less aggressive tumor than conventional osteosarcoma. It is a relatively well-differentiated chondroblastic osteosarcoma occurring on the surface of the long bones of the extremities. Three patients demonstrated frank medullary invasion of tumor, two grossly and one microsurgically. Patients treated with marginal resection had a 70% local recurrence rate. Patients receiving wide resection or primary amputation have survived longer with less recurrence of disease. Overall, 10 of 61 patients are dead with metastatic disease with a mean reported follow-up of 6 years and 7 months. Adjunctive therapy has been of no demonstrable aid in terms of prolonging survival. Medullary extension of this tumor should not be used to exclude this diagnosis. The authors believe that the treatment of choice is wide resection without adjunctive chemotherapy. PMID- 3965079 TI - Medulloblastoma. Period of risk reviewed. AB - Collins postulated that patients with Wilms' tumor surviving for a period equal to their age at diagnosis plus 9 months were no longer at risk for a recurrence. Although this no longer holds for Wilms' tumor, it has been applied to patients with medulloblastoma. Case histories of patients who survived a period of risk designated by Collins' rule and later developed a histologically confirmed recurrent medulloblastoma are discussed. Reported cases violating Collins' rule constitute less than 2% of all medulloblastomas. The continued use of Collins' rule is advocated. Patients who have survived this period of risk, are neurologically stable, and have a negative computerized tomography (CT) head scan are exceedingly unlikely to develop a recurrent medulloblastoma. PMID- 3965081 TI - Functional outcome and survival in spinal cord injury secondary to neoplasia. AB - A 12-year retrospective view of patients admitted to the rehabilitation unit for care of spinal cord injury (SCI) secondary to neoplasia was conducted. Twenty seven such patients were identified. One year survival was 58%, and independent functioning achieved in the rehabilitation unit was well-maintained in the survivors. Survival and functional outcome tended to be best in those with less severe neurologic injuries. The study indicated a better 1-year survival in such injuries than has previously been described. Patients with complete SCI had a relatively poor prognosis, especially for independent function. As control of metastatic cancer improves, patients with spinal cord injury caused by neoplasia will probably become a significant part of the SCI population. PMID- 3965080 TI - Prognostic factors influencing relapse of squamous cell carcinoma of the maxillary sinus. AB - In 95 surgically staged patients with squamous cell carcinoma of the maxillary sinus, multivariate regression analyses were employed to identify prognostic factors. Possible prognostic factors for local control were TNM stage and type of surgical procedures: T2 or T3 tumors and use of total maxillectomy showed better local control rates (P less than 0.01). High radiation doses of 40 Gy or more also seemed to be of prognostic significance: P less than 0.2 for 40 to 60 Gy, and P less than 0.1 for 60 Gy or more. The risk of cervical relapse increased when the cheek or alveolus was grossly involved (P less than 0.2). However, since cervical relapse frequently accompanied uncontrollable primary recurrence or distant spread, and since cervical relapse alone was frequently salvaged by radical neck dissection, prophylactic irradiation to the neck is not recommended. Sex, age, nodal state, addition of chemotherapy, total doses of bleomycin or 5 fluorouracil (5-FU), or intra-arterial administration of chemotherapeutic agents did not appear to be of prognostic significance. PMID- 3965082 TI - A retrospective study of earliest indicators of recurrence in patients on Eastern Cooperative Oncology Group adjuvant chemotherapy trials for breast cancer. A preliminary report. AB - A retrospective review of the Eastern Cooperative Oncology Group adjuvant chemotherapy studies EST 5177 and EST 6177 was performed in order to ascertain the first indicator of relapse in women with breast cancer and pathologically positive axillary lymph nodes. Of 856 evaluable patients, 208 have relapsed. In 175 patients who relapsed, the first indicator could be clearly identified: symptoms, 36%; patient self-examination, 18.3%; physical examination by the physician, 19.4%; abnormal blood chemistries, 12%; bone scans, 8%; chest x-rays, 5.1%; and mammograms, 1.1%. Although 74% of recurrences are therefore detected clinically, in a sizable proportion (26%), the ancillary tests were the earliest indicators of relapse. The manner of detection was not influenced by nodal, estrogen receptor (ER), or menopausal status. These results suggest that the follow-up schedule currently employed by ECOG appears reasonable. PMID- 3965083 TI - Primary lymphoma of the liver treated with extended left hepatic lobectomy. AB - Primary lymphoma of the liver is an extremely rare entity; only five cases have been reported in the English language literature. Presented is a case report of a patient with primary hepatic lymphoma successfully treated by major liver resection. The current management trends are reviewed. PMID- 3965084 TI - Laryngeal cancer in Uruguay (1958-1981). An epidemiologic study. AB - According to international comparative data on age-adjusted death rates, male mortality caused by laryngeal cancer in Uruguay is ranked second in the world. This fact has prompted the authors to study time trends and to perform cohort analysis of all deaths due to larynx cancer during the 1958 to 1981 period. Localization as well was investigated by means of incident cases taken from Registry of the University Hospital (1960-1981). Trend analyses have shown an increase in age-adjusted death rates among men. This was largely due to the older age of patients. Cohort analysis showed a decline in mortality among younger patients. As far as anatomic location is concerned, a marked predominance of supraglottic cancer was observed. This was particularly high among those belonging to the low-income group. PMID- 3965085 TI - Syndrome of inappropriate antidiuretic hormone secretion. A complication of high dose intravenous melphalan. AB - Melphalan is now being investigated as an intravenous (IV) bolus chemotherapeutic agent in children with resistant tumors involving the bone marrow. Two patients received 2 mg/kg melphalan, IV bolus; 10 patients received 1 mg/kg. Seven of the ten patients receiving 1 mg/kg had noticeable downward trends in the serum sodium concentrations, whereas both patients receiving 2 mg/kg developed hyponatremia (serum sodium concentration [SNa], mEq/l = 124-125) and inappropriate urinary sodium losses. Syndrome of inappropriate antidiuretic hormone (SiADH) is a previously unreported complication of high dose bolus melphalan therapy. PMID- 3965086 TI - Adjuvant postoperative radiotherapy in carcinoma of the rectum and rectosigmoid. AB - Local recurrence occurs in 30% to 50% of rectal cancer patients treated with surgery alone if there is tumor extension beyond the bowel wall alone or in conjunction with nodal involvement. This analysis is of 97 such patients who received postoperative irradiation (XRT) in prospective and standardized fashion at Massachusetts General Hospital (MGH) (4500 rad in 25 fractions to large fields and minimum dose of 5040 rad in 28 fractions within a boost field). Results were compared with a group of 103 previously analyzed patients treated with surgery alone at MGH. A statistically significant decrease in local recurrence was seen in four of the six irradiated subgroups (modified Astler-Coller Stages B2g, B3, C1 + C2m, and C2g) at an interval 3 years from resection. This improvement was achieved with no increase in small bowel complications (4% with XRT versus 5% with surgery alone) in view of efforts at surgical reconstruction and use of multiple-field XRT techniques, bladder distension, etc. PMID- 3965087 TI - A psychological analysis of cancer patients and their next-of-kin. AB - A supportive family environment is thought to enhance the capacity of cancer patients to adapt to their illness and treatment. But families, like patients, vary in their ability to cope with the impact of a cancer diagnosis in a family member and in their ability to fulfill the patient's needs. Increased understanding of the interrelationships between the family's and patient's responses to illness is of fundamental importance to the care of the patient with cancer. A heterogeneous sample of 201 cancer patients and their relatives were studied to determine compatibility of psychological status and to isolate clinical and demographic variables associated with psychological distress. Self report tests of anxiety, mood disturbance, and mental health were applied. Despite large individual variation, the psychological status of patients and their matched relatives was closely correlated. The patient's treatment status affected both patients and their next-of-kin. Psychological well-being worsened according to whether patients were receiving follow-up care, active treatment, or palliative therapy. These data suggest a mutuality of psychological response between patients and their families. Supportive intervention for the patient or relative who manifests distress, therefore, should benefit both. Because patients and relatives involved with palliative treatment are most in need of psychological assistance, particular attention should be paid to this group, as is attempted in hospice care. PMID- 3965088 TI - Dystrophic and psammomatous calcifications in a desmoid tumor. A light microscopic and ultrastructural study. AB - A desmoid tumor occurring in the abdominal wall of a 6-year-old boy with extensive microcalcifications was documented. Two forms of calcifications were observed: an irregular, amorphous dystrophic calcification of the collagen fibers and an organized, laminated psammomatous calcification (psammoma bodies). Ultrastructural studies revealed that the dystrophic calcification is a result of direct mineralization of individual collagen fibrils with subsequent coalescence to form large, calcified masses. Psammomatous calcification tended to cluster around areas where the collagen fibers assumed a whorled configuration. It is suggested that the circular orientation of the collagen fibers in some way favors the laminar deposition of hydroxyapitite crystals. The cause of the pathologic calcifications is the presence of extensive amorphous eosinophilic degeneration of the collagen fibers. PMID- 3965089 TI - Classification of non-Hodgkin's lymphomas. Reproducibility of major classification systems. NCI non-Hodgkin's Classification Project Writing Committee. AB - An international, multi-institutional, clinical, pathologic study of 1175 cases of non-Hodgkin's lymphoma sponsored by the National Cancer Institute has offered a unique opportunity to investigate issues of reproducibility and agreement in pathologic classification. Teams of experienced hematopathologists reviewed all 1175 cases, with the "experts" utilizing their own classification system and the experienced panelists utilizing all six of the histopathologic classification systems. The fact that 20% of the slides were randomly repeated for a second interpretation allowed assessment of the reproducibility of any one given pathologist. In addition, the agreement between and among pathologists was evaluated. Results of this retrospective study showed that both experts and panelists were able to identify follicular (nodular) or other indolent lymphomas with 95% probability of concurrence between initial and later interpretations. Moreover, individual pathologists agreed with others in identifying and classifying these follicular features with approximately 90% probability of agreement. The reproducibility for individual pathologists, based on the 20% of cases that were randomly repeated, varied from a probability 0.53 to 0.93. Comparisons of intersystem predictability demonstrated that no one system predicted for any of the other systems within any major degree of reliability. This inability to "translate" from one system to another is thought to be a reflection of the problems of both interpathologist agreement and intrapathologist reproducibility. Flaws in study design are discussed and the usage of the working formulation of non-Hodgkin's lymphomas, in addition to classification by traditional schemas, is strongly encouraged. PMID- 3965090 TI - Tissue components of weight loss in cancer patients. A new method of study and preliminary observations. AB - A new approach using anthropometric, radiographic, biochemical, and ultrasonic methods allowed partition of body weight into fat, fat-free mass, skeletal muscle, and volume of heart, liver, kidneys, spleen, and tumor. These methods were used to evaluate body composition longitudinally in a pilot group of nine cancer patients, seven of whom lost weight (greater than 2.5 kg) during the study period. Two control groups also underwent the protocol: (1) healthy subjects (+/- 10% IBW) of similar age, sex, and height; and (2) patients with weight loss due to anorexia nervosa. Weight loss in both the cancer and anorexia nervosa groups could be accounted for primarily by loss in fat and skeletal muscle; although the relative magnitude of these tissue losses were approximately the same in both groups, cancer patients lost relatively less body weight. This was because (1) overt or occult ascites (detected radiographically) was present in cancer patients (3 of 9); (2) tumor bulk increased fat-free mass by up to 1 to 2 kg; and (3) the proportional loss in visceral organ volume was less in cancer patients than in anorexia nervosa patients. In the latter group, heart, liver, kidneys, and spleen were reduced in proportion to body weight, whereas in the cancer group as a whole, these organs (when uninvolved with tumor) lost little (heart and kidneys) or no volume (liver and spleen). This initial study suggests that the principal endogenous energy and nitrogen sources during evolution of weight loss in cancer are primarily adipose tissue triglycerides and skeletal muscle proteins. In some cancer patients, fluid accumulation, a large tumor burden, and the slow rate of visceral organ atrophy make body weight an unreliable index of available energy-nitrogen reserves. PMID- 3965091 TI - Macronutrient requirements in the malnourished cancer patient. How much of what and why? AB - Malnutrition is a prevalent problem in the hospitalized cancer population. Although the pathophysiology of cancer cachexia is incompletely understood, it assumes considerable clinical relevance because malnutrition is a potentially treatable problem associated with poor outcome. Once the clinician has made a decision to initiate enteral or parenteral nutritional support, the practical issue of macronutrient prescription necessitates review of existing animal and human data in order to formulate guidelines for nonprotein energy and nitrogen requirements for efficacious nutritional support in the malnourished cancer patient. PMID- 3965092 TI - Improved survival of patients with metastatic breast cancer receiving combination chemotherapy. AB - Groups of patients with newly diagnosed metastatic breast cancer who were consecutively registered into a breast cancer clinic beginning January 1956 (210 patients), January 1966 (210 patients), and January 1975 (251 patients), were analyzed to determine the impact on survival of the various treatment modalities utilized in each decade. Comparisons of survival were made among subgroups of patients with similar prognostic features. Except for patients with very poor performance status, all subgroups showed a significantly improved survival in the 1970s compared with the earlier decades. Combination chemotherapy was considered to be the major factor in the survival improvement. PMID- 3965093 TI - Results of adjuvant radiation therapy in cancer of the rectum. Thomas Jefferson University Hospital experience. AB - From 1972 to 1981, 174 patients with cancer of the rectum surgically staged as B2 or C disease, underwent surgical resection of the tumors for cure. Eighty-eight patients received surgery only with no further adjuvant therapy, and the remaining 86 patients were treated with a combination of radiation and surgery. Twenty-nine patients received low-dose preoperative radiation (500 rad in one fraction); 26 patients received postoperative radiation (4500 rad in 5 weeks); and 31 patients received combined low-dose preoperative radiation (500 rad) and postoperative radiation (4500 rad in 5 weeks). This experience was analyzed to determine the patterns of failure and the impact of adjuvant therapy on survival. Patients undergoing surgery alone had a 26% incidence of local failure in the pelvis and a 57% incidence of distant metastasis. Patients receiving low-dose preoperative radiation had a reduction in the rate of distant metastasis (24%), but no effect on local failure (34%). On the other hand, patients receiving postoperative radiation had a reduction in the local failure rate (11%), with no effect on distant metastasis (50%). Patients who received the combined preoperative and postoperative treatment had a reduction in both the local recurrence rate (7%), and the rate of distant metastasis (13%), and these patients also had a substantial improvement in survival over surgery alone. Survival of patients undergoing surgery alone was 34% at 5 years and was not substantially different for patients undergoing low-dose preoperative irradiation (48%), or for patients receiving postoperative irradiation (29%). Survival in patients receiving combined preoperative and postoperative irradiation was substantially better (78%) than the other groups of patients. PMID- 3965094 TI - Enolase isozymes in differentiated and undifferentiated medullary thyroid carcinomas. AB - Enolase isozyme composition was studied using both electrophoretic and chromatographic methods in rat medullary thyroid carcinomas (MTC), differing in their degree of differentiation. In well-differentiated rat tumors (DMTC), both the alpha- and gamma-subunits of enolase were expressed, resulting in alpha alpha, alpha gamma, and gamma gamma isozymes. The relatively high amount of alpha gamma and gamma gamma isozymes (neuron-specific enolase [NSE] ) was indicative of the presumed neuroectodermal origin of these tumors. In contrast, highly undifferentiated or anaplastic tumors (AMTC) were characterized by a decrease in expression of the gamma-subunit. Hence, the majority of enolase isozymes were alpha alpha dimers, with only a few percent alpha gamma hybrids remaining. These shifts from neuron-specific to non-neuronal isozymes in rat MTC were compared with human MTC and discussed with respect to neuronal differentiation and the clinical significance of NSE measurements in serum as a marker for amine precursor uptake and decarboxylation cell-derived neoplasms. PMID- 3965095 TI - Mucoepidermoid carcinoma arising in an intraparotid lymph node. AB - A well-differentiated mucoepidermoid carcinoma that was confined to, and apparently arose within, an intraparotid lymph node is reported. Salivary gland ducts and acini often are found within intraparotid lymph nodes, and occasionally within extraparotid nodes. Salivary gland tumors, both benign and malignant, can develop within this ectopic salivary tissue. When a malignant salivary-gland-type neoplasm is found within an intraparotid or periparotid lymph node, the possibility exists that the tumor has arisen within the node and does not necessarily represent a metastasis from some other occult site. PMID- 3965096 TI - Use and limitations of serum total and lipid-bound sialic acid concentrations as markers for colorectal cancer. AB - Concentrations of total serum N-acetyl-neuraminic acid (NANA) by high-performance liquid chromatography (HPLC) and lipid-bound sialic acid (LSA) by resorcinol procedure were evaluated and compared to carcinoembryonic antigen (CEA) as markers for colorectal carcinoma. Elevated concentrations of NANA were found in 32% of patients with nonmalignant disorders, 28% of patients with localized cancer, and 87% of patients with metastatic cancer. All three markers correlated with the extent of metastasis of colorectal carcinoma. Strong correlation was found between NANA and LSA measurements, whereas measurement of the sialic acid markers provide information that can not be derived from the measurement of CEA. NANA and LSA show promise as supplemental markers for staging and monitoring colorectal cancer, but they are neither sensitive nor specific enough for cancer screening. PMID- 3965098 TI - Management of pain in the terminally ill by administration of epidural narcotics. AB - Fifteen patients with chronic malignant intractable pain were given epidural narcotics for periods of up to 280 days. The majority were treated at home. The patients self-administered the narcotics through an indwelling epidural catheter that had been tunneled and brought out onto the anterior abdominal wall. The results are presented together with the problems encountered. PMID- 3965097 TI - The effects of breast self-examination in a population-based cancer registry. A report of differences in extent of disease. AB - This study evaluates the effects of breast self-examination (BSE) on extent of disease in newly diagnosed Iowa Surveillance, Epidemiology, and End Results (SEER) breast cancer cases (population-based) between November 1980 and December 1981. Similar to previous findings, BSE patients are more likely to find their tumors than are non-BSE patients when performed two or more times each year. However, no significant improvement in tumor size, number of lymph nodes, or staging is found. In addition, comparison with age-frequency matched controls, although supporting various breast cancer risk factors, also seems to identify a BSE response bias since cases were significantly more likely to report performing BSE than controls (P less than 0.0001), and BSE cases versus non-BSE cases show no differences in risks of disease to suggest an association between potential awareness of disease risks with altered health behavior (performing BSE). PMID- 3965099 TI - Oral cavity and oropharyngeal cancer in a younger population. Review of literature and experience at Yale. AB - Oral cavity and oropharyngeal cancer in younger adults is a rare entity with an incidence of 2.7% among 1014 patients seen or treated at the Department of Therapeutic Radiology, Yale - New Haven Medical Center between 1958 and 1980. Although there are reports of contrastingly divergent therapeutic experiences, the authors contend that even early stage cancers frequently fail definitive therapy with a rampant course, causing a rapidly fatal outcome. The three-year actuarial survival was a mere 17% at Yale. The authors speculate that younger adult oral cavity and oropharyngeal cancers are possibly related to a genetic disorder or immunodeficiency, and recommend aggressive surgical and radiotherapeutic approaches combined with possible adjuvant immunotherapy. PMID- 3965100 TI - Primary seminoma of the mediastinum. Cancer Control Agency of British Columbia experience. AB - Six patients with primary seminoma of the mediastinum were treated at the Cancer Control Agency of British Columbia during the period from 1970 to 1982. Primary treatment used was external beam radiotherapy. Only one patient received both radiotherapy and chemotherapy. Tumor dose ranged from 3000 cGy in 16 daily fractions in 3 weeks to 3500 cGy in 20 daily fractions in 4 weeks using parallel opposed fields on megavoltage machines. Two patients received additional small volume boost to the superior mediastinum, delivering 500 cGy and 1000 cGy, respectively. All patients had complete resolution of the mediastinal mass after treatment and are alive and free of disease. One patient developed a metastasis to the fifth lumbar vertebra 1 year after treatment. This metastatic lesion was treated with radiotherapy and the patient is alive and free of clinical disease. Mediastinal seminoma is radiosensitive and radiocurable. PMID- 3965101 TI - Diet and other risk factors for cancer of the pancreas. AB - The findings of a case - control study of cancer of the pancreas, which was conducted in the Baltimore metropolitan area, are reported. Two hundred one patients with pancreatic cancer were matched on age (+/- 5 years), race, and sex to hospital and non-hospital controls, the latter selected by random-digit dialing (RDD). All subjects were interviewed regarding diet, beverage consumption, occupational and environmental exposures, and medical and surgical history. Significantly decreased risks were associated with consumption of raw fruits and vegetables and diet soda, and significantly increased risks were associated with consumption of white bread when cases were compared with hospital and RDD controls. A significantly reduced risk was associated with consumption of wine when cases were compared to RDD controls. Risk ratios for consumption of coffee were not significantly different from one, although there appeared to be a dose - response relationship in women. A moderate but statistically nonsignificant increase in relative odds was found for cigarette smoking, and cessation of smoking was associated with a marked reduction in risk. No significant associations were found with particular occupational exposures. Tonsillectomy was associated with a significantly reduced risk, a finding that has been observed for other cancers as well. The current evidence indicates that pancreatic cancer is likely to result from a complex interaction of factors and suggests that the study of its etiology requires a multidisciplinary approach involving both laboratory and epidemiologic components. PMID- 3965102 TI - Microscopic disease at second-look laparotomy in advanced ovarian cancer. AB - During the 11-year interval from January 1971 to January 1982, 50 of 246 patients with advanced (Stage III and IV) epithelial ovarian carcinoma at second-look laparotomy had biopsy or cytologic evidence of persistent microscopic carcinoma. The stage and grade profile include 46 Stage III and 4 Stage IV patients: 4 borderline, 9 grade 1, 20 grade 2 and 17 grade 3 patients. Following second-look laparotomy, 4 patients received no further therapy, 45 received chemotherapy, and 1 received external radiation. No patient was lost to follow-up, and the median interval off therapy was 24 months. Progressive or recurrent disease has manifest in 12 (24%). No recurrences have developed either in patients younger than age 40 or in patients with grade 1 tumors. Two patients died of leukemia, 1 died of heart disease, and 35 (70%) are alive with no evidence of disease. In patients developing recurrence, the median progression-free interval was 17.5 months, with a range of 6 to 46 months. The median interval of survival following disease progression was 7 months. There was no evidence of progression at 2 years and 5 years in 81% and 70% of patients, respectively. The uncorrected 2- and 5-year survival rates were 96% and 71%, respectively. The 5-year survival rates for grades 1, 2, and 3 were 100%, 79%, and 36%, respectively. Other variables analyzed include number of positive foci, residual tumor volume at initial surgery, cytologic findings at second-look laparotomy, type of chemotherapy, and number of courses of chemotherapy before second-look laparotomy. In summary, patients with only microscopic evidence of disease at second-look surgery have a good probability for extended survival. PMID- 3965103 TI - Synovial chondromatosis of the temporo-mandibular joint. Report of three cases and a review of the literature. AB - Synovial chondromatosis of the temporo-mandibular joint is a rare affection, characterized by the formation of cartilage particles in the synovial membrane. These particles can break through and enter the joint compartments. The diagnosis must be considered for patients who complain of slowly progressive swelling, pain, and crepitus in the region of the temporo-mandibular joint. When the changes are not visible on plain X-rays due to absence of ossification, important diagnostic information can be obtained by a technetium 99m (99m Tc) bone scan and a computerized tomography (CT) sialogram. The diagnosis can be established only by histopathologic examination of surgically removed particles or resected synovial membrane. Discussed are 25 cases of histopathologically verified chondromatosis of the temporo-mandibular joint reported in the literature, as well as 3 new cases seen and treated at the University Hospital Groningen since 1970. A good clinical result can be obtained by removal of all particles and synovectomy. Condylectomy is seldom required. PMID- 3965105 TI - Secondary non-hematopoietic cancers arising following treatment of hematopoietic disorders. AB - Aggressive treatment of neoplastic disease has resulted in improved survival and, in some cases, cure of the primary malignancy. One of the most serious complications of such anticancer treatment has been the occurrence of an acute leukemia (primarily non-lymphocytic) several years after the successful treatment of the original neoplasm. Within the last 12 years, the authors have encountered 26 individuals who developed a second non-hematopoietic malignancy (excluding skin cancers) following primary aggressive treatment of a hematopoietic malignancy. All individuals had been treated with chemotherapy (24 of 26 with alkylating agents). The secondary tumors included lung (7), colon (6), gastric (4), bladder (3), esophageal (3), rectal (2) and pancreatic (1) tumors. The average time to development of the second malignancy in this series was 55.1 months, and the survival period following the diagnosis of the second malignancy averaged 7.3 months. It may be that aggressive anticancer treatment may be responsible for the emergence of a host of second non-hematopoietic carcinomas in addition to the now well established association with induced acute non lymphocytic leukemias. PMID- 3965104 TI - Acute non-lymphocytic leukemia following multimodality therapy for retinoblastoma. AB - The genetic form of retinoblastoma carries a high risk of secondary malignant neoplasm, apparently not related to the use of chemotherapy. A child with unilateral non-genetic retinoblastoma who had received chemotherapy and radiation therapy and developed acute non-lymphocytic leukemia (ANLL) is reported. The occurrence of ANLL and retinoblastoma has not been previously reported. PMID- 3965106 TI - Small intestinal adenocarcinoma complicating regional enteritis. AB - Three new cases of small intestinal adenocarcinoma complicating Crohn's disease are reported. Seventy-five other cases have been reported to date. Analysis of these cases in comparison with de novo adenocarcinoma of the small bowel shows that they: (1) occur at a younger age; (2) occur in distal small bowel; (3) show a male predilection; and (4) have a worse prognosis. The increasing number of these cases suggests that small intestinal regional enteritis predisposes to adenocarcinoma. Improved prognosis can only be achieved with earlier diagnosis. PMID- 3965107 TI - Clinical correlations of the 3q21;q26 cytogenetic anomaly. A leukemic or myelodysplastic syndrome with preserved or increased platelet production and lack of response to cytotoxic drug therapy. AB - Three patients presenting with acute leukemic disorder and chromosome 3 rearrangement involving bands q21;q26 are reported, and the literature on chromosome 3q abnormalities is reviewed. All reported patients carrying a paracentric 3q inversion or a translocation 3;3 with breakpoints in q21;q26 had a myelodysplastic or acute leukemic disorder with a normal or elevated platelet count and lack of response to cytotoxic drug therapy. They showed an associated incidence of -7 or 7q- anomalies higher than de novo acute leukemia and appear to constitute a definite subgroup of the leukemic disorders with very poor prognosis. The majority of patients showing other chromosome 3 long arm rearrangements showed evidence of leukemic process, were in blastic crisis, or had been exposed to chemotherapy, exhibiting also a higher incidence of associated -5 or -7 cytogenetic abnormalities than is observed in patients not exposed to toxic agents. PMID- 3965108 TI - Changes of steroid hormone receptor content by chemotherapy and/or endocrine therapy in advanced breast cancer. AB - In several sequences during the progression of cancer, the authors assayed estrogen receptors(ER) in 940 breast cancers and progesterone receptors(PgR) in 773 cancers. The percentages of ER+ and PgR+ cancers diminished according to the progression of malignancy. Sequential assays of ER and PgR were carried out in primary tumors and in the metastatic tumors at the first recurrence in 42 patients. During the disease-free interval, 10 (37%) of 27 ER+ tumors changed to ER- and all 15 ER- tumors remained negative. The hormone receptors were assayed before the treatments and after the tumor relapsed following regression or after the progression of cancer. The change of ER and PgR in 99 patients with advanced breast cancer were studied according to the type of systemic treatments. Through endocrine therapy, marked changes from ER+ to ER-, were noted (by antiestrogens, 47% [7/15]; by adreno-oophorectomy, 61% [11/18]). Almost no breast cancers changed from ER- to Er+ during the endocrine therapy (by antiestrogen, 1/6; by adreno-oophorectomy, 0/10). All of six PgR+ tumors changed to PgR- after therapy. By chemotherapy treatment, 44% (4/9) ER+ cancers became ER-, while 19% (3/16) ER- tumors changed to ER+. After the simultaneous combination of chemotherapy and endocrine therapy, 67% (10/15) of ER+ cancers changed to ER-, and 20% (2/10) of ER- tumors changed to ER+. Through the intervention of more than two kinds of chemotherapy and/or endocrine therapy between the first treatment and the last therapy, 79% (19/24) ER+ breast cancers changed to ER-. Thus, ER and PgR contents of breast cancer gradually became negative as the malignancy progressed, and with some kinds of treatments particularly including endocrine therapy. The significance of changes in hormone receptors after therapy was discussed. PMID- 3965109 TI - The pattern and clinical significance of karyotypic abnormalities in patients with idiopathic and postpolycythemic myelofibrosis. AB - Six of eight (75%) patients with postpolycythemic myelofibrosis (PPMF) and 11 of 20 (55%) patients with idiopathic myelofibrosis (MF), seen at the University of Chicago, had abnormal karyotypes in cells of bone marrow origin. The specific chromosomal findings and their clinical significance in these patients were analyzed. A review of the literature added the findings from abnormal karyotype studies in 10 patients with PPMF and 36 patients with MF to this series. The demonstration of an increased frequency of cytogenetic abnormalities after cytotoxic therapy in polycythemia vera (PV) implies that such therapy may have a role in the development of chromosomal changes seen in treated PV and PPMF. The cytogenetic abnormalities in MF appear to be unrelated to therapy except possibly for an association with partial or complete losses of chromosome 5 or 7. Trisomy 8 is the only finding that is more common in MF than in PPMF. Other abnormalities were more common in PPMF, particularly 20q-, loss of 7 or 7q-, and trisomy 9, and to a lesser extent trisomy 1q and 5q-. Cytogenetic abnormalities do not show a pattern that can be used to distinguish between PPMF and MF, nor are they useful in the prognosis of MF or in initial studies in PPMF. PPMF does appear to have a higher tendency toward leukemic transformation than does MF, and an evolution in karyotype appears to have serious prognostic implications in PPMF in regard to this transition. PMID- 3965110 TI - Prolactin cell carcinoma of the pituitary. Clinicopathologic, immunohistochemical, and ultrastructural study of a case with cranial and extracranial metastases. AB - A patient with a primary adenohypophyseal neoplasm who had a long course marked by multiple surgical resections, radiation therapy, and high-dose dopamine agonist therapy developed local invasion as well as cranial and extracranial osseous metastatic lesions. The serum prolactin levels were greatly elevated, and immunohistochemical studies demonstrated prolactin in the cytoplasm of primary and metastatic tumor cells. Ultrastructural features of lactotrophic differentiation, including misplaced granule exocytosis, were observed. This is the third reported case of prolactin cell carcinoma that metastasized despite high-dose dopamine agonist therapy. Analysis of the patient's serum prolactin showed no abnormality in the chromatographic profile of biologic activity. PMID- 3965111 TI - Effects of intensive clinical exposure on attitudes of medical students toward cancer-related problems. AB - The attitudes of third-year medical students toward cancer and patients with cancer was examined before and after a 6-week clerkship that included contact with pediatric patients with cancer and their families. A 51-item testing instrument was employed, which included pediatric, adult, and general oncology questions. Beginning with positive attitudes toward the importance of early diagnosis, aggressive therapy, and the complete disclosure of prognosis, the clinical exposure appeared to strengthen the two former attitudes and somewhat diminish the latter. Approval of aggressive cancer therapy was stronger for children than for adults; but approval of both aggressive therapy and intensive surveillance of patients in remission was increased in regard to adults as well as children after the clerkship. A comparison with responses of second-year medical students from another institution suggests that third-year students recognize greater personal limitations in respect to management and adopt a more "defensive" position regarding the patient. In general, during the clerkship, the students moved in the direction of attitudes that were previously designated to be appropriate for students by a multidisciplinary committee that was distinct from the instructional staff in oncology. PMID- 3965112 TI - Age at first primary as a determinant of the incidence of bilateral breast cancer. Cumulative and relative risks in a population-based case-control study. AB - This epidemiologic investigation comprised 1351 of 1423 women in a defined geographic area consecutively diagnosed as having a primary breast cancer. Simultaneous bilateral disease occurred in only 1 patient, whereas a history of previous cancer in the contralateral breast was reported by 65 patients. This prevalence was related to that of 23 previous cases in an age-matched control group of 1351 women from the same population. The relative risk of developing a second primary was 2.9 (95% confidence limit, 1.8-4.6) for the whole material and remained seemingly constant over several decades at a level predetermined by age at first diagnosis, namely 9.9 (95% confidence limit, 3.8-25.8) before the age of 50 and 1.9 (95% confidence limit, 1.1-3.2) after that age. The incidence ratio of bilateral to unilateral disease was used as an estimate of the lifetime risk of developing a second primary in this stable and well-defined population. This calculation revealed cumulative risk figures of 13.3% and 3.5% for women younger and older than 50 years, respectively, at first diagnosis. It was concluded that the occurrence of bilateral disease, which reflects a multicentric neoplastic transformation of the breast epithelium, is a characteristic of early-occurring (premenopausal) disease. PMID- 3965114 TI - Long-term survival of 458 young breast cancer patients. AB - The authors report the long-term survival of 458 young breast cancer patients with follow-up times ranging from 20 to 51 years. Patients with distant metastases at diagnosis were not included in the study. An excess breast cancer mortality was observed for at least 40 years after diagnosis. At 40 years, the actuarial breast cancer survival for all patients was 32% +/- 3% (standard error). For patients with localized and regional disease, it was 53% +/- 6% and 19% +/- 3%, respectively. A persistent excess mortality after 40 years, however, could not be ruled out because too few patients remained at risk. It is concluded that a cured fraction of patients defined as a group subject only to normal mortality risks, in practice, can only be identified in young patients with a low expected mortality, since older patients give only minor contributions to long term survival results. In an unselected series of breast cancer patients, an excess breast cancer mortality will probably persist during a period that is longer than the life expectancy of the average patient. A parametric survival model, the log-normal model, was found to provide a good fit to the observed survival data. The cured fraction of patients predicted by the model was similar to the actuarial breast cancer survival at 40 years. These results suggest that the model could be used as a tool for analyzing observed survival patterns in breast cancer. It might thus provide an alternative to the conventional 5- to 10 year rates. The good fit of the model also suggests that late recurrences represent one end of a continuous, broad spectrum of behavior in disseminated breast cancer. PMID- 3965113 TI - Long-term survival following cancer of the male breast in Northern Ireland. A report of 81 cases. AB - Eighty-one patients with cancer of the male breast were studied. The majority (79) presented with a mass in the breast and in 8 patients the tumor was found by chance. Two patients presented with serosanguinous discharge. Average duration of symptoms was 11.9 months. Thirty patients had Stage I, 25 had Stage II, 16 had Stage III, and 8 had Stage IV disease. Fifty-three patients had simple mastectomy, nine had lumpectomy, six had radical mastectomy, and five had biopsy only. Eight had no local surgery. Overall 5- and 10-year survival allowing for all causes of death was 38% and 17%, respectively. Cox's (1972) proportional hazard regression model was used to assess the contribution of various factors to survival. Age at presentation, postoperative hormone therapy, postoperative radiotherapy, site of the primary tumor within the breast, and type of local surgery did not contribute to survival. Only the stage of disease contributed to survival and did so in the expected direction. PMID- 3965115 TI - A population-based study of survival after scrotal carcinoma. AB - In previous reports on scrotal carcinomas, overall 5-year survival rates have varied from 18% to 70% without explanation. In this study, survival was determined through the active follow-up of the Connecticut Tumor Registry for 65 cases of scrotal carcinoma diagnosed in the state from 1935 to 1980. The overall actuarial probability of surviving 5 years was 0.57. Stage and age at diagnosis were statistically significant predictors of survival (P less than 0.001 and P = 0.016, respectively). Survival varied progressively with combinations of these two variables with subjects younger than age 65 years and localized at diagnosis having 5-year survival of 0.75, compared to 0.17 for subjects age 65 years and older with regional or distant spread; these survival outcomes encompassed those of previous reports. With the passage of more than four decades, no improvement in survival was detectable. Initial radiotherapy, given to nine cases, also bore no detectable relationship to survival after adjustment for other variables. The 30 men in metalworking occupations previously shown to be associated with this cancer were not more frequently diagnosed with the cancer in localized stage, and showed a survival similar to that for the 29 men in other occupations. PMID- 3965116 TI - Malignant mesothelioma in British Columbia in 1982. AB - All cases newly diagnosed by a pathologist in 1982 in British Columbia as a malignant mesothelioma of the pleura or peritoneum were reviewed. In men there were 17 cases (incidence rate, 17.0/million/year), and in women 2 cases (1.9/million/year). A history of asbestos exposure (largely in shipyards, construction, or insulation work) was obtained for 14 of 15 men, and 0 of 1 woman. Mineralogic analysis of lung on 6 of the men confirmed that the tumor was associated in every instance with exposure to amosite and crocidolite asbestos; some patients also had elevated levels of tremolite asbestos, presumably reflecting exposure to a chrysotile asbestos product. No unusual levels of asbestos were found in the lungs of the one woman studied. These data show that the incidence rate of mesothelioma in British Columbia has increased nearly six times for men compared to the period 1969 to 1975, but has remained roughly unchanged for women. Almost all of the cases in men in this series could be linked to asbestos exposure. PMID- 3965117 TI - Nomenclature: the Philadelphia chromosome or Ph without superscript. PMID- 3965118 TI - Trisomy 11 in preleukemia. AB - The clinical and cytogenetic findings of a patient with a preleukemic state and trisomy 11 are reported. Trisomy 11 was present as the sole karyotypic alteration at the time of overt leukemia. Trisomy 11 presents an additional chromosomal abnormality not previously described in preleukemia. PMID- 3965119 TI - Chromosomal changes in an ovarian granulosa cell tumor: similarity with carcinoma. AB - The chromosomal changes in an ovarian granulosa cell tumor were studied after short-term culture in defined medium. The abnormalities found included X monosomy, structural rearrangements of chromosome #1, and an interstitial deletion of the long arm of chromosome #6. This pattern is closely related to that found in ovarian carcinoma and argues for the malignant nature of such tumors at the cellular level. PMID- 3965120 TI - Generation of clonal variants in a human ovarian carcinoma studied by chromosome banding analysis. AB - We have utilized detailed chromosome banding analysis to document the selection of variant genetic clones existing in cell populations obtained from a patient with ovarian adenocarcinoma. Cytogenetic analysis was performed on two samples from the patient's malignant ascites obtained over a 9-month interval. Tumor cell lines were also established in monolayer culture from each ascites sample, analyzed by chromosome banding techniques, and compared to the clonogenic population grown from each ascites specimen. Appearance of karyotypically distinct populations were identified from both the in vivo tumor and the tumor cell lines. Tumor colony-forming units (TCFU) evidenced minimal karyotypic change between the original ascites tumor and the ascites sample obtained after a 9 month period in vivo. In contrast, the cell lines derived from these two ascites samples demonstrated markedly different karyotypic populations between samples and progressive chromosome change within each sample following prolonged in vitro growth. PMID- 3965121 TI - G2 chromosomal radiosensitivity of ataxia-telangiectasia heterozygotes. AB - Five lines of skin fibroblasts from individuals heterozygous for ataxia telangiectasia (A-T), compared with six cell lines from age-matched normal controls, show a much higher frequency of chromatid breaks and gaps following x irradiation during the G2 phase of the cell cycle. The magnitude of this difference suggests that G2 chromatid radiosensitivity could provide the basis for an assay to detect A-T heterozygotes. Though clinically normal, A-T heterozygotes share a high risk of cancer with A-T homozygotes and constitute approximately 1% of the human population. Further, we propose that G2 chromosomal radiosensitivity, which appears to result from a DNA repair deficiency, may be associated with a genetic predisposition to cancer. PMID- 3965122 TI - A cytogenetic study of embryonal rhabdomyosarcoma. AB - In the cytogenetic analysis of an embryonal rhabdomyosarcoma after short-term culture, individual cells were found to contain multiple copies of chromosomes #2, #6, #8, #12, #13, #18, #20 and #21, and del(1)(:p21----qter). The tumor was hypotriploid (mode, 56 chromosomes). The relationship between these findings and published reports of karyotypes from rhabdomyosarcoma is discussed. PMID- 3965123 TI - The two-hit theory of neoplasia: implications for the pathogenesis of hyperparathyroidism. AB - Knudson's two-hit or two-mutational-event hypothesis for the initiation of neoplasia suggests that two somatic mutations are necessary for initiation of sporadic neoplasms, and that a genetic plus a somatic mutation are required for hereditary neoplasms. Glucose-6-phosphate dehydrogenase (G6PD) studies of parathyroid tumors of 11 heterozygotes with hyperparathyroidism (HPT), including one with hereditary HPT, have shown both A and B isoenzymes. These findings suggest multicellular development of parathyroid tumors and are compatible with tumors being manifestations of either nonneoplastic hyperplasia or a genetic first mutational event. Parathyroid carcinoma may be the result of a second mutation in cells made susceptible by previous genetic or somatic mutations. Comparison of parathyroid cancer in families with hereditary HPT with sporadic cases from the literature reveals a generally younger onset with hereditary HPT compatible with the two-hit theory. Consideration of these age-of-onset and G6PD findings suggest that hyperparathyroidism may result from either non-neoplastic or mutational-induced processes even though no histologic distinctions have been observed in the hyperplasia associated with these processes. PMID- 3965124 TI - Inv(16) abnormality and eosinophilia in a patient with acute nonlymphocytic leukemia. PMID- 3965125 TI - Heterochromatic variants and their association with neoplasias. II. Preleukemic states. AB - A study of the heteromorphism of chromosomes #1, #9, and #16 was performed in the cells of 55 normal subjects and in those of 40 preleukemic patients including those with refractory anemia (RA) and sideroblastic anemia (SA), classified on the basis of the FAB nomenclature. Heteromorphism was present in 85% of the preleukemic patients, compared with 44% in normal controls (p less than 0.01). The patient population presented an increased incidence of C-band size variants in chromosome #1 (1qh+ and 1qh-), while chromosomes #9 and #16 showed no difference, compared with the findings in the control group. PMID- 3965126 TI - Chromosome aberrations in epithelial cells of the digestive tract of rats induced by 1-methyl-3-nitro-1-nitrosoguanidine. AB - The effect of a gastrointestinal carcinogen, 1-methyl-3-nitro-1-nitrosoguanidine (MNNG), on chromosomes of rat digestive tract epithelial cells was studied. A blind loop of colorectal segment was surgically produced and the epithelial cells of this loop were treated twice with 0.5% and 0.1% MNNG solutions, respectively (5 ml each). After the first treatment, the mucosa revealed severe damage, and repair and mitoses upon regeneration were maximal on days 4-6. Chromosomal aberrations were studied 3-48 hr after the second treatment. Cells with chromosomal aberrations increased progressively from 6 hr on, reaching their maximum level at 15 hr, and gradually returned to the original level at 48 hr. Chromosomal aberrations consisted of gaps, breaks, and exchanges. The above results indicate that gastrointestinal carcinogens induce chromosomal aberrations in target epithelial cells. PMID- 3965127 TI - Stimulation of Rauscher leukemia virus DNA polymerase DNA-directed DNA synthesis by cationic trypanocides and polyamines. AB - Activated DNA-directed DNA synthesis catalyzed by Rauscher leukemia virus (RLV) and other type C mammalian retroviral DNA polymerases is uniquely stimulated by biologically active polyamines. Cationic trypanocides may act as antagonists of polyamine function. As described here, several cationic trypanocides stimulate RLV polymerase-catalyzed DNA-directed DNA synthesis at concentrations significantly inhibiting eukaryotic DNA polymerases. Such stimulation is negated by polyamines. Kinetic analysis of the stimulation of RLV DNA polymerase by three structurally dissimilar cationic trypanocides (Antrycide, Burroughs-Wellcome Compound 64A, and Bayer Compound 1694) suggests that such stimulation is, in part, due to a drug:DNA structural interaction resembling the polyamine:DNA structural complex recognized by the RLV DNA polymerase. PMID- 3965128 TI - Modulation of 5-fluorouracil catabolism in isolated rat hepatocytes with enhancement of 5-fluorouracil glucuronide formation. AB - The catabolism of 5-fluorouracil (FUra), which accounts for 90% of the elimination of this antimetabolite in vivo, has recently been characterized in freshly isolated rat hepatocytes in suspension using a highly specific high performance liquid chromatographic methodology. The present study evaluates the effect of thymine and uracil, which are thought to be catabolized by the same enzymes as FUra, on the metabolism and transmembrane distribution of FUra in isolated rat hepatocytes. Following simulataneous exposure of cells for 5 min to 30 microM [6-3H]FUra and increasing concentrations of either thymine or uracil, dihydrofluorouracil (FUH2) levels decreased in a concentration-dependent manner, and the concentration determined for 50% inhibition of FUra catabolism was 8.0 +/ 0.3 (S.D.) and 67.8 +/- 15.6 microM for thymine and uracil, respectively. Analysis of intracellular and extracellular 3H from 1 min to 2 hr after simultaneous incubation of the hepatocytes with 30 microM FUra and thymine (or uracil) in a 1:7 molar ratio resulted in a decrease of intracellular and extracellular FUH2 and alpha-fluoro-beta-alanine (FBAL), while alpha-fluoro-beta ureidopropionic acid (FUPA) was enhanced. Unmetabolized FUra (not detected in the absence of thymine or uracil) was detected intracellularly in the presence of thymine or uracil and was accompanied by the appearance of a novel metabolite, preliminarily identified as a glucuronide of the FUra base which reached intracellular levels of 44 +/- 9.76 and 27.45 +/- 1.35 microM in the presence of thymine or uracil, respectively, within 1 hr. This metabolite, which penetrates the cell membrane only slowly, accounted for approximately 60% of the intracellular 3H in the presence of 300 microM FUra and 2 mM thymine, whereas FUra catabolism was inhibited by more than 99% under these conditions. The formation of FUra anabolites was insignificant in the presence of thymine and uracil, and incorporation of FUra into RNA was not enhanced. The lack of anabolism of FUra in isolated hepatocytes exposed to either high initial concentrations of FUra or high intracellular FUra concentrations resulting from modulation (inhibition) of FUra catabolism is consistent with the clinical observation of minimal hepatotoxicity with FUra, despite exposure of the liver to high blood levels. These studies indicate that thymine is a more potent modulator of FUra catabolism in hepatocytes than is uracil. Further studies are needed to clarify the biological importance of the glucuronide of the base FUra which accumulates intracellularly as the concentration of FUra increases within the hepatocytes. PMID- 3965129 TI - Decreased NADH-oxidoreductase activities as an early response in rat liver to the carcinogen 2-acetylaminofluorene. AB - Reduced nicotinamide adenine dinucleotide (NADH):ferricyanide reductase and DT diaphorase specific activity in total homogenates of rat liver are markedly decreased as a very early biochemical event of hepatocarcinogenesis induced by the carcinogen 2-acetylaminofluorene (AAF). A 50 to 75% decrease in NADH:ferricyanide reductase was observed after 1 day of AAF (0.025% in the diet) feeding and persisted throughout a 7-week continuum of AAF administration. Carcinogen added directly to cell extracts had no effect. Similar results were obtained with single injections of either AAF or diethylnitrosamine. Xanthine dehydrogenase was also reduced in liver following AAF administration to nearly the same extent as NADH:ferricyanide reductase and DT-diaphorase. Total NADH cytochrome c reductase and mitochondrial activity as estimated from succinic dehydrogenase were not affected by carcinogen administration relative to basal dietary controls. The reduced nicotinamide adenine dinucleotide phosphate:cytochrome c reductase that functions in drug detoxification was elevated. With livers of animals fed 4-acetamidophenol, a hepatotoxin chemically related to AAF, small decreases were noted in NADH:ferricyanide reductase, but not in xanthine dehydrogenase nor in DT-diaphorase. Initial lowering of these activities in the livers of the carcinogen-treated animals is preceded by or concomitant with a reduction in the levels of extramitochondrial pyridine nucleotides known from other studies to result from DNA damage. PMID- 3965131 TI - Promotion by vagotomy of gastric carcinogenesis induced by N-methyl-N'-nitro-N nitrosoguanidine in Wistar rats. AB - The effects of truncal vagotomy after administration of N-methyl-N'-nitro-N nitrosoguanidine on the incidence and number of gastric carcinomas and gastric acid secretion, gastrin secretion, antral pH, and duodenal reflux were investigated in inbred Wistar rats. Rats were subjected to truncal vagotomy after N-methyl-N'-nitro-N-nitrosoguanidine treatment. Vagotomy significantly increased the incidence and number of adenocarcinomas of the glandular stomach. It also resulted in significantly more atypical glandular hyperplasias, which are precursors of gastric cancer. Furthermore, it caused a decrease in gastric secretion and an increase in mucosal pH in the antrum but did not increase duodenal reflux. These findings indicate that vagotomy has a promoting effect on the development of gastric cancers. The reduced gastric acid secretion, but not duodenal reflux, may be related to this increased incidence of gastric cancer. PMID- 3965130 TI - Formation of glutathione conjugates by reactive metabolites of vinylidene chloride in microsomes and isolated hepatocytes. AB - Oxidation of the vinyl halide carcinogen and hepatotoxin vinylidene chloride (VDC) by microsomal cytochrome P-450 yields 2,2-dichloroacetaldehyde, 2 chloroacetyl chloride, 2-chloroacetic acid, and 1,1-dichloroethylene oxide. The roles of these metabolites in covalent modification of proteins and reduced glutathione (GSH) were examined. 2-Chloroacetyl chloride reacted with model thiols at least 10(3)-fold faster than did 1,1-dichloroethylene oxide and at least 10(5)-fold faster than did 2,2-dichloroacetaldehyde or 2-chloroacetic acid. Microsomal covalent binding of [14C]VDC was inhibited by GSH but not by lysine, suggesting that protein thiols, rather than amino groups, are major targets. Liver microsomes catalyzed the formation of three GSH:VDC metabolite conjugates, identified as S-(2,2-dichloro-1-hydroxy)ethylglutathione, 2-(S glutathionyl)acetate, and S-(2-glutathionyl)acetylglutathione, a novel conjugate containing both stable (thioether) and labile (thioester) linkages. The latter two conjugates also were formed in isolated rat hepatocytes and measurable amounts of 2-(S-glutathionyl)acetate were released into the incubation medium. Both 2-(S-glutathionyl)acetate and S-(2-glutathionyl)acetylglutathione were formed with [35S]GSH added to the hepatic medium, indicating that reactive VDC metabolites are capable of crossing the plasma membrane to react with extracellular targets. Unlabeled S-(2-glutathionyl)-acetylglutathione underwent carbonyl substitution with added [35S]GSH, suggesting that this conjugate may participate in modification of protein thiols. This conjugate also underwent hydrolysis with a half-life of approximately 3 hr. GSH:VDC metabolite conjugates may serve as accessible models for labile covalent adducts formed between VDC metabolites and protein thiols. PMID- 3965132 TI - In vivo interaction between radiation and 1-(2-chloroethyl)-3-cyclohexyl-1 nitrosourea in the absence or presence of misonidazole in mice. AB - The effect of combining the radiosensitizer misonidazole (MISO) with 1-(2 chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) prior to radiation on the response of various KHT sarcoma cell subpopulations was evaluated. Centrifugal elutriation was used to obtain homogeneous populations of cells with respect to their cell cycle position from suspensions prepared directly from treated solid KHT tumors. Survival in these subpopulations was determined using an in vivo to in vitro cloning assay. In situ treatment consisted of either (a) CCNU (3.0 mg/kg) plus MISO (1.0 mg/g), (b) radiation (15 Gy) alone, or (c) CCNU plus MISO preceding the radiation by 24 hr. In the latter protocol, one treatment effectively eliminated those cells being preferentially spared by the other. The CCNU-MISO followed by radiation combination not only reduced the treatment resistance due to hypoxia and cell cycle position but also left all cell subpopulations in the tumor equally sensitive to the treatment. To determine the nature of the interaction between these agents in detail, the extent of cell killing following such a treatment regimen was evaluated using isoeffect plot (isobologram) analysis. KHT sarcoma-bearing C3H mice were treated with various doses of CCNU either alone or in simultaneous combination with a 1.0-mg/g dose of MISO 24 hr prior to receiving a range of radiation doses. Combining CCNU and radiation led to significantly enhanced tumor cell killing. When evaluated by isoeffect plot analysis, the data points resulting from this combination fell well below the envelope of additivity, indicating that a supraadditive interaction between these two agents had occurred in the tumor cells. An even greater interaction was observed in the KHT sarcomas when MISO was combined with CCNU prior to irradiation. The findings of effective elimination of treatment-resistant subpopulations along with a supraadditive tumor cell kill offer, at least in part, an explanation for the previously described therapeutic advantage observed for the CCNU-MISO-radiation protocol. PMID- 3965133 TI - Repair synthesis of DNA induced by the urinary N-hydroxy metabolites of carcinogenic arylamines in urothelial cells of susceptible species. AB - Urinary N-hydroxy metabolites of the bladder carcinogens, 2-aminofluorene and 4 aminobiphenyl, were examined for the induction of unscheduled DNA synthesis (UDS) in urothelial cells of several susceptible species. N-Hydroxy-2-aminofluorene, N hydroxy-2-acetylaminofluorene (N-OH-AAF), N-hydroxy-4-aminobiphenyl, N-hydroxy-4 acetylaminobiphenyl, and the N-glucuronides of these two hydroxylamines induced UDS in the urothelial cells of dogs, rats, and rabbits. N-Hydroxy-2 aminonaphthalene, N-hydroxy-2-acetylaminonaphthalene, and the N-glucuronide of the hydroxylamine were not active. The induction of UDS in dog cells by N-OH-AAF or N-acetoxy-2-acetylaminofluorene, but not by N-hydroxy-2-aminofluorene, was inhibited by paraoxon. The microsomal fraction of dog urothelial cells catalyzed the binding of N-OH-AAF to transfer ribonucleic acid; the enzyme activity was completely inhibited by paraoxon, suggesting that N-deacetylase, but not N-,O acetyltransferase, was responsible for the binding. The O-glucuronide of N-OH-AAF did not induce UDS in the urothelial cells of dogs, rats, or rabbits, nor did it bind to tRNA in the presence of dog urothelial enzymes, which suggest that N-OH AAF is detoxified by O-glucuronidation. These results are consistent with the hypothesis that nonacetylated, N-hydroxylated metabolites play a major role in arylamine-induced bladder carcinogenesis. The importance of arylacethydroxamic acid metabolites in bladder carcinogenesis for various species may be inversely related to the rate of hepatic O-glucuronidation. PMID- 3965135 TI - Detection of nuclear anomalies in the colonic epithelium of the mouse. AB - Colon carcinogens produce a variety of nuclear anomalies including pyknotic, karyorrhectic, and micronucleated cells in the colonic epithelium within a few hr. Two model carcinogens, 1,2-dimethylhydrazine and gamma-rays, have been used to determine appropriate techniques, conditions, and scoring criteria for detecting such nuclear anomalies most efficiently. The results show that a rapid and sensitive assay for nuclear anomalies can be conducted with a variety of preparation techniques. We anticipate that the assay will be useful as a screen for potential colon carcinogens in the diet or elsewhere. The assay as recommended by us requires at least five animals per group and takes about 1 hr to analyze. A single sample at 6 or 24 hr after treatment should detect most carcinogens. PMID- 3965134 TI - Deficits in elevating membrane potential of rat fibrosarcoma cells after cell contact. AB - Most cancer cells are known to have lower resting cellular potentials than do their normal counterparts. This study investigates how these potentials establish themselves during growth and cellular contact in tissue culture. Normal quail embryonic fibroblasts and quail fibrosarcoma (QT-35) and normal rat kidney cells and rat fibrosarcoma (from rat fibroblasts chemically transformed by nitroquinoline oxide) were recorded intracellularly using high-impedance micropipets. In high-density high-contact cultures, both quail and rat cancer cells had lower potentials than did normal cells (-20.7 compared to -40.1 mV for quail and -30.7 compared to -61.9 mV for rat). In low-density mitotically synchronous cultures, the rat cells were recorded every 4 hr for 96 hr. Starting at a low density, normal cell membrane potential is maintained at a low level through subsequent cell divisions. Without any additional change in cell density, the potential suddenly elevates to a high level. The membrane potential of cancer cells is by contrast unrelated either to cell density or to time. Cancer cells maintained an intermediate potential from low to very high densities and never elevated their potential to high values. The failure of cancer cells to reach high potentials may be linked to their uncontrolled cell division. PMID- 3965136 TI - Vaccination of adult and newborn mice of a resistant strain (C57BL/6J) against challenge with leukemias induced by Moloney murine leukemia virus. AB - Adult or newborn C57BL/6J mice were immunized with isogenic Moloney strain MuLV induced leukemia cells irradiated with 10,000 rads or treated with low concentrations of formalin. Groups of immunized and control mice were challenged with a range of doses of viable leukemia cells, and tumor deaths were recorded for 90 days after challenge. Then, the doses of challenge cells which produced 50% tumor deaths were calculated for immunized and control mice. The logarithm of their ratio quantified the degree of protection provided by immunization. For adult C57BL/6J mice, a single immunization with MuLV-induced leukemia cells was not effective; either cells plus Bacillus Calmette-Guerin or Corynebacterium parvum, or else two immunizations with irradiated leukemia cells were needed to produce statistically significant increases in the values of the doses of challenge cells which produced 50% tumor deaths. Cross-protection was obtained by immunization with other isogenic MuLV-induced leukemias, but not by immunization with isogenic carcinogen-induced tumors or with an isogenic spontaneous leukemia. For newborn mice, a single injection of irradiated leukemia cells provided 1.3 to 1.5 logs of protection, and admixture of B. Calmette-Guerin or C. parvum increased this protection to 2.4 to 2.7 logs. Since irradiated and frozen-thawed MuLV-induced leukemia cells contained viable MuLV, leukemia cells treated with 0.5 or 1.0% formalin were tested as an alternative. A single injection of formalin-treated isogenic leukemia cells admixed with C. parvum provided between 1.7 and 2.8 logs of protection. These results demonstrate that a single vaccination of newborn animals against a highly antigenic virally induced leukemia produces strong protection against a subsequent challenge with viable leukemia cells. PMID- 3965137 TI - Mechanism of induction of nuclear anomalies by gamma-radiation in the colonic epithelium of the mouse. AB - The induction of karyorrhexis and "nuclear anomalies" in colonic crypt cells has been correlated positively with the induction of colonic tumors by chemical treatment. These nuclear anomalies occur in the proliferative region of the crypt and exhibit a variety of morphological characteristics. Some nuclear anomalies resemble the micronuclei that arise from chromosomal fragments after mitosis. Here, we report that the nuclear anomalies observed within the first few hr of insult with gamma-radiation are independent of mitosis for their expression, as evidenced by failure of colchicine to inhibit their induction, and do not arise from chromosomal material lost during mitosis. PMID- 3965138 TI - Pattern of endogenous lectins in a human epithelial tumor. AB - Salt and detergent extracts of a malignant epithelial tumor, obtained by extraction of acetone powder, were fractionated on different sets of Sepharose columns covalently derivatized with lactose, asialofetuin, melibiose, mannan, fucose, and heparin. Successive elution by chelating reagent and specific sugar resulted in isolation of different Ca2+-dependent and Ca2+-independent endogenous carbohydrate-binding proteins, as analyzed by gel electrophoresis. It appears from the analysis that certain bands represent newly identified proteins capable of binding to lactose (at Mr 64,000), melibiose (at Mr 28,000), and fucose (at Mr 62,000 and 70,000). Other carbohydrate-binding proteins isolated from this human tumor have been identified in normal, especially embryonic, tissues of different nonhuman vertebrates. The carbohydrate-binding proteins are assayable as agglutinin with rabbit erythrocytes and show no detectable enzymatic activity. They can thus be defined as lectins. The presence of a complex pattern of endogenous lectins and their biochemical characteristics may contribute to an understanding of intercellular interaction during the complex process of metastatic spread and may furthermore allow a new tool for diagnosis and a lectin based therapy. PMID- 3965139 TI - Identification of target proteins participating in a lectin-dependent macrophage mediated cytotoxic reaction. AB - Membrane proteins of mouse macrophages and mammary tumor cells having affinity to Sarcophaga lectin were isolated by affinity chromatography. The electrophoretic profiles and antigenicities of lectin-binding proteins from macrophages and tumor cells were different. Antibody raised against tumor cell lectin-binding proteins inhibited both the binding of the lectin to tumor cells and the lectin-dependent macrophage-mediated cytotoxic reaction. However, it did not inhibit the binding of the lectin to macrophages. It was suggested that the same lectin molecule transmitted different stimuli to macrophages and tumor cells via different receptor proteins. PMID- 3965140 TI - Comparison of immunocytochemical and steroid-binding assays for estrogen receptor in human breast tumors. AB - An estrogen receptor immunocytochemical assay which uses monoclonal antibodies to the estrogen receptor protein [Nature (Lond.), 307: 745-747, 1984] was applied to several human tissues, including human breast tumors, and the results were compared to those of steroid-binding assays performed on cytosol extracts of the same tissues. Specific immunoperoxidase staining in fixed, frozen sections was confined to the nucleus of selected cell populations within each tissue examined. In 117 human breast cancers, the presence or absence of nuclear staining was significantly associated with the concentration of cytosolic estrogen receptor. Thirty-eight estrogen receptor immunocytochemical assay-positive tumors were further assessed for several quantifiable features of the staining, including intensity, cellularity, and the proportion of tumor cells stained. Of these, epithelial cellularity showed the highest degree of correlation with the results of steroid-binding assays. PMID- 3965141 TI - Isolation and properties of a human pancreatic adenocarcinoma-associated antigen, DU-PAN-2. AB - This work describes the molecular properties of a human pancreatic adenocarcinoma associated mucin-like antigen defined by a murine monoclonal antibody (DU-PAN-2). DU-PAN-2 antigen is a large molecule, readily detected in the body fluids of patients with pancreatic adenocarcinoma and sensitive to neuraminidase treatment and alkaline reduction. The antigen binding activity of the DU-PAN-2 immunoglobulin M antibody is markedly reduced when coupled to an insoluble matrix. Therefore, the antigen was partially purified from the serum and ascites of patients with pancreatic adenocarcinoma by ammonium sulfate fractionation and Affi-Gel-Blue chromatography to remove most of the serum proteins. Noncovalently associated proteins were further separated on CsCl/CsBr density gradients and noncovalently associated lipids removed by organic solvent extraction. DU-PAN-2 antigen was monitored by a solid-phase competition radioimmunoassay. We have been able to detect antigen reactivity and analyze its electrophoretic pattern following transfer from 1% agarose gel onto nitrocellulose paper and immunoblotting with DU-PAN-2 antibody. Antigen was also labeled metabolically with various radioactive monosaccharides and sulfates. Radioimmunoprecipitation of labeled antigen with DU-PAN-2 antibody showed two distinct broad antigen bands consistent with the immunoblotting signals. The heavily glycosylated and polydisperse nature of this antigen and the results of various enzyme treatments suggest that the DU-PAN-2 epitope is expressed on a mucin-like molecule. PMID- 3965142 TI - Effects of chemotherapeutic drugs on platelet and metastatic tumor cell endothelial cell interactions as a model for assessing vascular endothelial integrity. AB - An in vitro assay for examining the sublethal effects of chemotherapeutic agents on vascular endothelial integrity is described. Using vascular endothelial cell monolayers, the kinetics of binding of radiolabeled platelets or metastatic tumor cells were altered when endothelial cells were pretreated for 2 hr with low, clinically relevant concentrations of certain drugs. Electron microscopic examination by scanning electron microscopy revealed that these same drugs caused endothelial cell retraction and exposure of subendothelial matrix. Platelets and tumor cells were found bound only to the exposed areas of subendothelial matrix. Some drugs (bleomycin, 1,3-bis(2-chloroethyl)-1-nitrosourea, vincristine) induced rapid endothelial cell retraction and increased platelet and tumor cell binding to exposed subendothelial matrix, while one of the drugs tested (Adriamycin) caused delayed (1 to 3 days after a 2-hr drug treatment) endothelial cell retraction and increased cell binding. Of the drugs tested, only 5'-fluoro-2' deoxyuridine which interferes with DNA replication failed to induce endothelial cell retraction and increased tumor cell and platelet binding. The results suggest that certain drug effects on the vascular endothelium can be assessed using the vascular endothelial cell monolayer model. PMID- 3965143 TI - Inhibition of DNA synthesis by chemical carcinogens in cultures of initiated and normal proliferating rat hepatocytes. AB - Rat hepatocytes in primary culture can be stimulated to replicate under the influence of rat serum and sparse plating conditions. Higher replication rates are induced by serum from two-thirds partially hepatectomized rats (Michalopoulos, G., Cianciulli, H. D., Novotny, A. R., Kligerman, A. D., Strom, S. C., and Jirtle, R. L. Cancer Res., 42: 4673-4682, 1982). The effects of carcinogens and noncarcinogens on the ability of hepatocytes to synthesize DNA were examined by measuring the incorporation of [3H]thymidine by liquid scintillation counting and autoradiography. Hepatocyte DNA synthesis was not decreased by ethanol or dimethyl sulfoxide at concentrations less than 0.5%. No effect was observed when 0.1 mM ketamine, Nembutal, hypoxanthine, sucrose, ascorbic acid, or benzo(e)pyrene was added to cultures of replicating hepatocytes. Estrogen, testosterone, tryptophan, and vitamin E inhibited DNA synthesis by approximately 50% at 0.1 mM, a concentration at which toxicity was noticeable. Several carcinogens requiring metabolic activation as well as the direct-acting carcinogen N-methyl-N'-nitro-N-nitrosoguanidine interfered with DNA synthesis. Aflatoxin B1 inhibited DNA synthesis by 50% (ID50) at concentrations between 1 X 10(-8) and 1 X 10(-7) M. The ID50 for 2-acetylaminofluorene was between 1 X 10(-7) and 1 X 10(-6) M. Benzo(a)pyrene and 3'-methyl-4 dimethylaminoazobenzene inhibited DNA synthesis 50% between 1 X 10(-5) and 1 X 10(-4) M. Diethylnitrosamine and dimethylnitrosamine (ID50 between 1 X 10(-4) and 5 X 10(-4) M) and 1- and 2-naphthylamine (ID50 between 1 X 10(-5) and 5 X 10(-4) M) caused inhibition of DNA synthesis at concentrations which overlapped with concentrations that caused measurable toxicity. The ability of hepatocytes to activate 2-acetylaminofluorene to reactive intermediates capable of binding to DNA and inhibiting new DNA synthesis decreased as a function of time in culture. gamma-Glutamyl-transferase-positive hepatocytes from diethylnitrosamine-treated rats were observed to be relatively insensitive to carcinogen inhibition of DNA synthesis. PMID- 3965144 TI - Exceptional lethality for nude mice of cells derived from a primary human melanoma. AB - BRO human melanoma cells, obtained from a biopsy of a highly aggressive and malignant primary tumor, were grown as xenografts in nude mice and in cell culture. These cells were exceptionally tumorigenic and malignant for nude mice. NIH-II nude mice survived 11.0 +/- 0.4 (S.E.) and 14.1 +/- 0.4 days after i.p. inoculation of 10(7) or 10(6) BRO cells, respectively, and lethal tumors developed in all mice inoculated i.p. with only 10(3) cells. The doubling time (2.3 days) of the volume of tumors formed after s.c. inoculation was comparable to the doubling time of these cells in culture. After i.p. or s.c. inoculation, BRO cells metastasized to the diaphragm and lungs, causing respiratory failure in most of the host mice. The original tumor and the cell line derived from it had undifferentiated structures with prominent nuclei and very large nucleoli. Karyotype abnormalities included a gigantic A group chromosome, a large D group chromosome, and an unusual double centromere chromosome not found typically in human melanoma cells. Due to the short and reproducible survival times of nude mice inoculated i.p. with BRO cells, this model system may be useful for rapidly determining the effects of experimental treatment on the survival of hosts bearing human tumor cells. PMID- 3965145 TI - Changes in polypeptide pattern of rat liver cells during chemical hepatocarcinogenesis. AB - Administration of 2-acetylaminofluorene to rats for 12 weeks induces hyperplastic nodules (HPNs) and later well-differentiated hepatocellular carcinomas (HCCs) in the liver. Total cellular proteins from normal liver, HPN, and HCC were analyzed by two-dimensional gel electrophoresis with a high resolution. Several hundred polypeptides were well resolved as seen by Coomassie blue staining, forming a reproducible and characteristic pattern for each tissue. The polypeptide patterns were very similar among normal liver, HPN, and HCC. Especially the proteins of HPN and HCC were almost indistinguishable. These neoplastic lesions, however, were clearly different from control liver in that a new spot p35-6.6 (designated by molecular weight X 10(-3) and pl) appeared, and five polypeptides, p57-6.9, p57-6.7, p26-6.9, p26-6.6, p26-6.4, increased dramatically in amount as compared with normal liver. These last three spots were found to be a new type of glutathione S-transferase as judged from the specific binding to the antibody. The same changes in polypeptide pattern were found in HCCs induced by other chemical carcinogens, diethylnitrosamine and 3'-methyl-4-dimethylaminoazobenzene, but not in regenerating and neonatal livers. Fetal liver showed a rather different pattern than adult liver, but only p26-6.6 was increased among the spots characteristic of HPN and HCC. Protein phosphorylation was also examined for these cells by incubating tissue slices with 32PO4. After alkali treatment of the gels to eliminate serines phosphorylation, several dozens of phosphoproteins were clearly detected. The patterns of the labeled spots were again very similar among control liver, HPN, and HCC. Only the intensity of a spot designated p57 6.6 increased markedly in both HPN and HCC. This spot was further resolved by an expanded pH gradient into four distinct spots, the major one of which contained phosphothreonine. Similar changes in phosphorylation were noted in hepatomas induced by diethylnitrosamine and 3'-methyl-4-dimethylaminoazobenzene but not in regenerating, fetal, and neonatal livers. These changes are discussed in terms of gene expression relevant to malignant transformation of hepatic cells. PMID- 3965146 TI - Generation of monoclonal antibodies reacting with human epithelial ovarian cancer. AB - Fusion of the murine myeloma line P3-X63-Ag8-U1 with spleen cells from a mouse immunized with a membrane preparations (CM) of a mucinous ovarian cystoadenocarcinoma yielded two monoclonal antibodies, MOv1 and MOv2, which reacted by solid-phase radioimmunoassay with immunizing tumor CM but were unreactive with normal kidney CM as well as with plasma proteins and peripheral blood cells from the immunizing carcinoma patient. MOv1 and MOv2 were further tested by solid-phase radioimunoassay on a panel of different CM from fresh surgical specimens of ovarian and nonovarian carcinomas, benign ovarian tumors, normal ovary and kidney tissues, and on various tumor cell lines. In addition, the antibodies were characterized by immunofluorescence on live cells from cell lines and surgical specimens, and on frozen sections of benign and malignant ovarian tumors, of nonovarian tumors, and of normal tissues. The results obtained indicate that MOv1 and MOv2 recognize two different epitopes on molecules present on malignant and benign ovarian mucinous tumors and colonic glands. In addition, the antigen recognized by MOv2 was also detected in carcinmas of lung, colon, stomach, and breast; in gastrointestinal glands; and in the glandular lumina of normal lactating breast. PMID- 3965147 TI - Mutagenic and chemotherapeutic activity in L1210 leukemia of several monofunctional alkylating agents. AB - The mutagenic and chemotherapeutic activities of the following monofunctional alkylating agents were compared in vivo: beta-chloroethylamine, dimethyl- and diethylaminoethyl chloride; methyl- and ethylmethanesulfonate; methyl- and ethylnitrosourea; and procarbazine. The bifunctional alkylating agent diethylamine 2,2'-dichloro-N-methyl-hydrochloride was used as reference. The alkylating activity was assessed by reacting with 4-(p-nitrobenzyl)pyridine, and antitumor activity was determined against L1210 in vitro and in vivo. The L1210 response, which is consistent with useful alkylating reactivity, was very marked with the two nitrosoureas and procarbazine. The nitrosoureas and, to some extent, procarbazine decreased the tumorigenicity of L1210 leukemia as evidenced by the increase in survival times with increasing numbers of treatment generations. After treatment for about five transfers (10(6) cells i.p.) with methylnitrosourea (40 mg/kg i.p. on Days 1, 3, and 5), the untreated control mice consistently survived free of tumor, whereas the treated mice died before Day 30. After treatment with ethylnitrosourea (80 mg/kg), the survival times also increased but more in the treated than in the corresponding control groups. Methylnitrosourea was most efficient in increasing the survival times and abolishing tumor transplantability. Antigenic change and loss of growth potential presumably were the reason for this increase in survival time, as indicated by tests in X-irradiated and nude mice. The fact that nitrosoureas and triazenes, besides reducing tumorigenicity, have similarities in their chemistry in that they decompose or are metabolically converted into diazohydroxides and then to carbonium ions is possibly of significance. PMID- 3965148 TI - Relationship of monoclonal antibody binding to estrogen and progesterone receptor content in breast cancer. AB - Three monoclonal antibodies--H59, H71, and H72--which react with human breast cancers have been developed using the estrogen-dependent human breast cancer cell line, ZR-75-1, as the immunogen. H59 bound only to estrogen receptor-positive, estrogen-regulated breast cancer cells in culture, whereas H71 and H72 bound breast cancer cells irrespective of the estrogen receptor content. All three antibodies have minimal cross-reactivity with non-breast tissue culture cell lines. The three antigens appear to be glycoproteins located on the cell surface. H59 and H72 antigens bound preferentially to the apical surface of duct cells and may be secreted; H71 antigen demonstrated no evidence of an apical orientation or secretion. The binding of the antibodies to fixed cryosections from 152 breast cancer and 111 benign breast disease specimens has been evaluated using a radioimmunoassay. Eighty-five % of breast cancer and almost 100% of benign disease specimens were bound by at least one antibody. H59 bound 39%, H71 bound 51%, and H72 bound 65% of cancer specimens. Estrogen receptor and progesterone receptor analyses were obtained on 141 specimens. H59 bound almost exclusively to tumor specimens which contained estrogen and/or progesterone receptor, but not to all receptor-positive tumors. Therefore, the H59 antigen appeared to be present on a subset of estrogen receptor-positive tumors. Considering that it bound only to estrogen-regulated cells in culture, the antigen may be estrogen regulated, and its presence may predict a response to hormone therapy. H71 and H72 recognized cell surface differentiation antigens but bound tumor specimens regardless of the receptor content. These antibodies may be useful as independent variables for predicting response to therapy and prognosis of patients with breast cancer. PMID- 3965149 TI - Use of monoclonal antibodies to sialylated Lewisx and sialylated Lewisa for serological tests of cancer. AB - A new monoclonal antibody, CSLEX1, directed against sialylated Lewisx was tested in parallel with a monoclonal antibody, CSLEA1, directed against sialylated Lewisa antigen. In tests with a solid-phase radioimmune sandwich assay, the sialylated Lewisx monoclonal antibody detected sera from certain cancer patients that were negative with the sialylated Lewisa monoclonal antibody. Some sera from cancer patients showed the reverse reaction. We conclude that the combined use of these two monoclonal antibodies detects a wider range of sera from cancer patients than the use of a single antibody alone. It should be possible in the future to use multiple monoclonal antibodies to increase detection. PMID- 3965150 TI - Antitumor effects of polyribonucleotides for mouse transitional cell carcinoma enhanced by cyclophosphamide. AB - Mouse bladder tumor (MBT-2), derived from a carcinogen-induced transitional cell carcinoma of the bladder, has proven a useful model for study of pathogenesis and prediction of cytotoxic drug sensitivity of human bladder carcinoma. To define optimal conditions for activity of the potent interferon inducer polyriboinosinic polyribocytidylic acid [poly(I) X poly(C)] in this model, studies of dose, timing, and combinations with a cytotoxic drug were initiated. Poly(I) X poly(C) inhibited MBT-2 growth when 10(5) or 10(6) tumor cells were implanted. Tumor growth reduction was relatively more pronounced in mice inoculated with higher numbers of MBT-2 cells (10(6] than in mice inoculated with an intermediate dose (10(5] or small dose (10(4]. In mice inoculated with 10(5) MBT-2 tumor cells, poly(I) X poly(C) (2.5 or 10 mg/kg i.p.) on Days 5 to 19 every other day reduced tumor size markedly. It had no effect, however, on tumor incidence or the time of their first detection. Treatment for a shorter period (alternate days from Days 11 to 19) resulted in less inhibition of tumor growth. Once treatment was discontinued, tumors grew progressively. Polyriboadenylic:polyribouridylic acid [poly(A) X poly(U)] (10 mg/kg) which inhibited tumor growth but to a lesser degree than poly(I) X poly(C) induced lower, less sustained levels of serum interferon. Cyclophosphamide, injected i.p. on Day 1, resulted in inhibition of tumor incidence and growth in direct proportion to the dose administered (25 to 200 mg/kg), but it was curative only at greater than or equal to 30% lethal doses. When combined with poly(I) X poly(C) (2.5 or 10 mg/kg), cyclophosphamide (50 mg/kg) had an additive antitumor effect. Optimal inhibition of MBT-2 tumor growth occurred by combining cyclophosphamide (100 mg/kg) with poly(I) X poly(C) (2.5 mg/kg); eight of 14 mice were tumor free on Day 60. PMID- 3965151 TI - Cytotoxic activity of human pulmonary alveolar macrophages. AB - The functions of human pulmonary alveolar macrophages (PAMs) have been relatively little studied compared with those of their circulating counterparts, blood monocytes. This study examined the ability of human PAMs to kill primary human tumor cell cultures and control normal fibroblasts in vitro. PAMs were derived by bronchial lavage from patients with lung cancer of various histological types and stages, patients with acute or chronic noncancerous pulmonary disorders, and subjects with a presumed illness who proved to be normal. After extensive washing, the PAMs were cocultured with [3H]proline-labeled tumor cells, principally lung cancers and melanomas, at various effector:target ratios for 60 hr. Cytotoxicity was measured by comparing radioactivity associated with the remaining adherent tumor cells cultured in the presence or absence of PAMs. Twenty-eight of 42 preparations of PAMs from 42 individuals were cytotoxic to one or more short-term primary tumor cultures. All 28 specimens from patients with lung cancer or chronic pulmonary disease were cytotoxic; all of the 14 PAM preparations lacking cytotoxicity were from individuals with acute pulmonary disorders or who were proved free of pulmonary disease. PAMs were cytotoxic even at effector:target ratios of 2.5:1 or 1.25:1. Fibroblasts were unaffected at any ratio. Sarcoidosis patients in remission had noncytotoxic PAMs, whereas the disease in relapse was characterized by cytotoxic PAMs. Serial study of 2 patients confirmed a loss of reactivity during remission. Smoking did not correlate with the presence or absence of spontaneous cytotoxicity and did not influence the degree of cytotoxicity in "reactors." Partially purified alpha interferon enhanced the killing of cytotoxic PAMs in 10 of 21 instances but did not induce cytotoxicity in 9 tests on nonreactive PAMs. We conclude that human PAMs from patients with lung cancer or chronic pulmonary diseases, including active sarcoidosis, were cytotoxic to several recently explanted tumor cell cultures. PAMs from acute pulmonary dysfunctions and those from patients with inactive sarcoidosis were not spontaneously cytotoxic. PMID- 3965152 TI - Pharmacokinetics of vindesine given as an intravenous bolus and 24-hour infusion in humans. AB - The pharmacokinetics of vindesine was examined after the determination of serum drug levels by radioimmunoassay in patients who received the drug either as an i.v. bolus or a 24-hr infusion. After i.v. bolus, vindesine was eliminated from the serum by triphasic decay. The central compartment was approximately 6 times the serum volume. The peak serum level achieved by i.v. bolus was approximately 16 times that achieved by the 24-hr infusion. The post-24-hr-infusion serum decay followed biphasic decay. Pharmacokinetic modeling, assuming a prolonged infusion period, resulted in a triphasic decay curve, with an extremely short distribution phase which would not be clinically detectable. This was due to the incorporation of the distribution phase into the infusion period. This explains the experimental data of a biphasic decay curve observed after 24-hr infusion. Pharmacokinetic parameters for the two phases observed after 24-hr infusion were similar to values calculated from i.v. bolus data. The c X t for 24-hr infusion was identical to that after i.v. bolus; theoretically, the c X t appears constant regardless of infusion time. It is concluded that the rate of elimination and/or the c X t, rather than the peak serum level, played a role in the degree of hematological toxicity. PMID- 3965153 TI - Detection of benzo(a)pyrene:DNA adducts in human white blood cells. AB - Metabolic activation of benzo(a)pyrene (BP) to its ultimate carcinogenic form, 7 beta, 8 alpha-diol-9 alpha, 10 alpha-benzo(a)pyrene epoxide (BPDE), and the binding of BPDE to DNA are important steps in BP carcinogenicity in experimental animals. Since people of certain occupations are exposed to high concentrations of BP, we have used enzyme-linked immunosorbent assay and ultrasensitive enzymatic radioimmunoassay to measure BPDE:DNA adducts in white blood cells from 2 of these occupational groups. Seven of 28 samples from roofers and 7 of 20 samples from foundry workers were positive for BPDE:DNA adducts (range, 2 to 120 fmol BPDE/50 micrograms DNA). In a group of nine volunteers without these industrial exposures to BP, the two positive DNA samples were from cigarette smokers. Control DNA obtained from human lymphocyte cell line RPMI 4265 was negative. These results indicate that the metabolic activation of BP and formation of BPDE:DNA adducts occurs in humans. PMID- 3965154 TI - Organ-specific carcinogenesis in rats by methyl- and ethylazoxyalkanes. AB - Azoxyalkanes are isomeric with nitrosodialkylamines and could be similar in their biochemical and biological actions. To compare the structure-activity relations in the two series, the tumorigenic activities of four azoxyalkanes, azoxymethane, azoxyethane, Z-ethyl-O,N,N-azoxymethane, and Z-methyl-O,N,N-azoxyethane, were compared in male F344 rats by p.o. administration of 0.54 mM and 0.135 mM solutions in drinking water. In most cases, treatment lasted 30 weeks, but at the higher dose of the two ethylazoxy compounds, 24 weeks of treatment were sufficient. Most of the animals died with tumors that could be attributed to the treatments. The two ethylazoxy compounds caused much earlier death from tumors than the corresponding methylazoxy compounds. All four compounds induced a high incidence of liver neoplasms, which were mainly hepatocellular; the two ethylazoxy compounds also induced a large number of hemangiosarcomas in the liver. At both dose levels, azoxyethane induced tumors of the esophagus and nasal cavity, tumors that were not seen in any other group. Other tumors appearing in significant incidence were in the colon and ileum, induced by azoxymethane and Z ethyl-O,N,N-azoxymethane, and kidney tumors induced by azoxymethane and Z-methyl O,N,N-azoxyethane. In F344 rats, azoxyethane was similar in carcinogenic activity to its isomer nitrosodiethylamine, whereas azoxymethane was much less potent than nitrosodimethylamine and induced quite different tumors. These results suggest that the biochemical activation of azoxylkanes is different from the analogous nitrosodialkylamines. PMID- 3965155 TI - Oral vinzolidine as therapy for Kaposi's sarcoma and carcinomas of lung, breast, and colon/rectum. AB - Vinzolidine, a semisynthetic vinca alkaloid, was studied as oral therapy in 30 patients with Kaposi's sarcoma, non-small cell lung cancer, colorectal cancer, and breast cancer. Substantial variations in morbidity were observed among the patients, some patients receiving doses up to 45 mg/m2 without toxicity while others had severe hematologic toxicity at doses as low as 25 mg/m2. Nausea/vomiting and diarrhea also occurred. Responses were seen in two of 11 patients with Kaposi's sarcoma but not in other patients. Unpredictable severe hematologic toxicity led to early closure of this study. The heterogeneity of patient tolerance may relate to variable oral drug bioavailability, and it is conceivable that vinzolidine could be administered more safely by the IV route. PMID- 3965156 TI - In vivo and in vitro metabolism of the new anticancer drug bisantrene. AB - The metabolism of bisantrene, a new anthracene anticancer agent active in the treatment of disseminated breast cancer, was studied in vitro using rat liver S9 preparations and in vivo in patients receiving the drug as treatment for their cancers. 14C-ring labeled bisantrene (248 mCi/40 mg) plus cold bisantrene were administered IV to cancer patients (260-340 mg/m2). Fractional urine samples were collected at various time intervals up to 120 h after drug administration and analyzed by HPLC. The percent of total 14C excreted as unchanged parent drug per ml urine ranged from 37 to 79% in the 0 to 24 h samples. The remainder of the radioactivity appeared chromatographically just prior to the bisantrene peak, indicating that compounds more polar than the parent were present as transformation products. Metabolism of bisantrene was also studied in vitro under oxic (O2) and hypoxic (N2) conditions, using commercially available Aroclor 1254 induced rat liver S9 preparations. Following N2 incubation at 37 degrees C for 1 h there was no evidence of metabolism, whereas there was more than 50% decrease in parent drug within 1 h following O2 incubation in the presence of NADPH generating system, suggesting that the metabolic process involves an oxidative reduction. HPLC chromatogram profiles of the mixtures exposed to the activated S9 system indicated that there were at least 3 polar metabolites. In vitro human tumor clonogenic assay showed that the biological activity of bisantrene decreased greater than 4-fold when the drug was incubated with S9 preparations in the presence of NADPH and O2, indicating that the transformation process leads to relatively inactive bisantrene metabolites. PMID- 3965158 TI - Inhibition of spontaneous and experimental tumor metastasis by the calcium antagonist verapamil. AB - Verapamil, a calcium antagonist, inhibited both experimental (IV inoculation of tumor cells) and spontaneous metastasis (SC inoculation) of the highly metastatic B16 melanoma and colon adenocarcinoma 26 cell lines. Verapamil treatment resulted in a maximum 80% inhibition of metastases, the degree of inhibition varying among the different metastatic systems. Verapamil inhibited platelet aggregation induced by these tumor cell lines, the patterns of inhibition being different for B16 melanoma and colon adenocarcinoma. The inhibition of platelet aggregation induced by tumor cells is proposed as a mechanism by which the calcium antagonist exerts its antimetastatic effect. These results, together with our previous findings that calcium antagonists can increase the cytotoxicity of drugs in tumor cells with induced or inherent drug resistance by inhibiting outward transport of the drug, indicate that calcium antagonists have potential as a new class of adjuvant agents in the field of cancer chemotherapy. PMID- 3965157 TI - Phase II trial of vincristine infusion in acute leukemia. AB - A phase II trial of prolonged IV infusions of vincristine was conducted in 21 patients with refractory acute leukemia. Patients received 0.25-0.50 mg/m2 by infusion daily for 5 days after an initial 0.5-mg bolus. A partial response was observed in one of two patients with acute lymphoblastic leukemia. Of 14 patients with acute nonlymphoblastic leukemia, a complete response lasting for 2.5 months occurred in one patient and a partial response lasting 1.3 months was observed in a second. No objective responses were noted in five patients with blast crisis of chronic granulocytic leukemia. Nonhematologic toxicity was minimal and, when present, generally consisted of a feeling of weakness; constipation, mucositis, and areflexia were also observed. Hematologic toxicity consisted mainly of mild to moderate reduction of platelets in most patients; marked thrombocytopenia (less than 50,000/mm3) occurred in two patients whose pretreatment platelet count was greater than 100,000/mm3. Although generally well tolerated, prolonged infusion of vincristine appears to have limited activity in the treatment of refractory acute nonlymphoblastic leukemia and blast crisis of chronic granulocytic leukemia; further evaluation is needed in acute lymphoblastic leukemia refractory to conventional bolus injection. PMID- 3965159 TI - Human pharmacokinetics of marcellomycin. AB - In conjunction with two phase I clinical trials, we have investigated the pharmacokinetics of marcellomycin (MCM), a new class II anthracycline antibiotic, in nine patients with normal renal and hepatic functions and no third-space fluid accumulation. MCM was infused IV over 15 min at a dosage of 27.5, 40, or 50 mg/m2. Plasma and urine samples were collected up to 72 h. MCM and metabolites were assayed by thin-layer chromatography and quantified by specific fluorescence. The disappearance of total MCM-derived fluorescence from plasma followed first-order kinetics and lacked the rebound in total fluorescence that has been described for the structurally similar agent, aclacinomycin A. After 40 50 mg/m2, the peak MCM concentration in plasma was 1.67 +/- 0.61 microM; MCM disappeared from plasma in a triexponential fashion and was undetectable by 48 h after infusion. The area under the plasma concentration-time plot (AUC), including the infusion time, was 1.11 +/- 0.39 microM X h; plasma clearance of MCM was 1.50 +/- 0.88 l/min/m2. Five other fluorescent compounds were consistently observed in plasma. M2 was a contaminant present in the parent drug. P1 and P2 were conjugates of MCM and M2, respectively. G1 and G2 were aglycones. The peak concentrations of the metabolites were 25% or less or the peak concentration for MCM, but their persistence resulted in higher AUCs than that for MCM. For the dosage of 27.5 mg/m2, fewer data were available; but the pharmacokinetics of MCM and metabolites appeared to be similar to that at higher dosage. Urinary excretion of total fluorescence amounted to 8.0% +/- 1.6% of the total dose at 40-50 mg/m2, and to 7.0% +/- 2.3% at 27.5 mg/m2. No correlation was detected among the various pharmacokinetic parameters and toxicities encountered in these patients. PMID- 3965160 TI - Rescue of rats from large dose cyclophosphamide toxicity using protein A. AB - Cyclophosphamide (Cy) is widely used as an effective cytotoxic drug, but its use is limited because of its toxicity. In this report, we describe for the first time the ability of purified protein A (P) of Staphylococcus aureus to reduce Cy induced toxicity in rats. Protein A-treated animals recover quickly from the toxic effects of Cy. The antitumor property of Cy is not reduced in the P + Cy group. In fact, the latter showed a persistent decrease in tumor volume compared with the Cy group. Protein A may prove to be an effective agent in increasing the therapeutic index of Cy. PMID- 3965162 TI - Analysis of the drug synergism between thymidine and arabinosyl cytosine using mouse S49 T lymphoma mutants. AB - The synergism between arabinosyl cytosine (araC) and thymidine is characterized using two mutant S49 T lymphoma cell populations with altered deoxyribonucleotide metabolism. AraC-1-6 cells are deficient in dCMP deaminase activity resulting in a secondary elevation of intracellular dCTP pools, whereas dGuo-200-1 cells have a mutation in the Ml subunit of ribonucleotide diphosphate reductase, which also results in elevation of dCTP levels. These two mutant cell populations are partially resistant to araC cytotoxicity as compared to the wild type cells. The resistance to araC is contributed to the elevation of dCTP levels in these mutants which prevent araC incorporation into the DNA due to feedback inhibition of deoxycytidine kinase. Addition of extracellular thymidine to dCMP deaminase deficient cells causes a decrease in dCTP levels and in parallel increase their sensitivity to araC. In contrast, extracellular thymidine does not reduce dCTP levels in the mutant cells with altered ribonucleotide reductase and no synergism between araC and thymidine is observed in these cells. The expansion of dTTP pools in the presence of thymidine is similar in the two mutants. These results suggest that the depletion of dCTP pools by thymidine is responsible for the synergistic action of thymidine on araC cytotoxicity and that dTTP does not directly enhance the incorporation of araC into the DNA of T lymphoma cells. PMID- 3965161 TI - Decreased host toxicity in vivo during chronic treatment with 5-flourouracil. AB - Chronic weekly administration of FUra to CD8F1 female mice bearing spontaneous mammary tumors produced body weight loss during the first 2 weeks of treatment, which became less severe during subsequent weeks of therapy. To our knowledge, the development of such a decrease in FUra toxicity in vivo during chronic treatment with the drug has not been described previously, and a study of this phenomenon was therefore undertaken in tumor-free CD8F1 female mice. Weekly administration of FUra at 85 mg/kg resulted in toxicity expressed in body weight loss and in depressed peripheral WBC levels; however, the magnitude of these toxic effects decreased significantly by the 5th week of treatment. Pretreatment of normal mice with FUra for 7 weeks resulted in a dose-related shift in the LD50 of FUra administered as a subsequent challenge. Compared with an LD50 of 240 mg/kg for FUra in normal mice, the LD50 in mice pretreated with FUra at 50 or 85 mg/kg per week was found to be significantly elevated to 370 and 460 mg/kg, respectively. Pretreatment with FUra at 85 mg/kg for 7 weeks did not alter the activity of the enzymes responsible for the activation of FUra, namely uridine kinase or orotate phosphoribosyltransferase, in the intestinal epithelium or bone marrow, but it did decrease the 24-h urinary excretion of intact [3H]FUra by almost 40% (P less than 0.01). In addition, the FUra pretreatment schedule resulted in a 31% (P = 0.14) increase in the activity of dihydrouracil dehydrogenase in the liver. These results suggest that increased degradation of FUra can be induced by chronic treatment with the drug. Finally, knowledge of the development of increased drug catabolism was used to increase the therapeutic effectiveness of FUra by its incorporation into an increasing-dose regimen. Mice bearing 24-h transplants of the murine breast tumor were treated with a constant dose of FUra for 12 weeks or with a dose that was increased, after 7 weeks, to a dose normally causing a high degree of drug-related mortality. The group receiving the incremented FUra dose had a significantly slower tumor growth rate without an increase in drug-related toxicity. These results are discussed in light of their obvious clinical implications. PMID- 3965163 TI - Contragestational profile of the tumor-inhibiting agent, L-alanosine, in the rat and the hamster. AB - L-Alanosine [L-2-amino-3(N-hydroxy-N-nitrosamino)propionic acid], a tumor inhibiting agent, induces pregnancy arrest after single or multiple SC or PO administration to rats and hamsters. Its contragestational effects are dose- and route-dependent, with no important differences in species-sensitivity or administration schedules. L-Alanosine is maximally effective shortly (3-4 days) after implantation. Both placenta and fetus appear to be target tissues. Consistent with previous in vitro findings, adenine but not aspartic acid counteracts the contragestational action of L-alanosine. The 'contragestational test', i.e., the effect on conceptus growth, appears to be an interesting approach for learning more about the antiproliferative activity of an antineoplastic agent. PMID- 3965164 TI - Endomyocardial biopsy: the balance of success and failure. PMID- 3965165 TI - Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension: comparison between urban and rural communities in China. AB - Arterial pulse wave velocity, an established index of arterial distensibility, was measured together with arterial pressure in a group of 524 normal subjects of both sexes 2 months to 94 years old (mean age 45.6 +/- 15.3 years [SD]) in rural Guangzhou, China, an area with known low prevalence of hypertension. Fasting serum lipid levels and overnight Na+ and K+ urinary excretion levels were determined in a subgroup of 104 subjects (ages 8 to 88 years). Comparisons were made with data obtained similarly from normal subjects in urban Beijing, an area with known high prevalence of hypertension. Serum cholesterol levels were similar and low in each group (Guangzhou, 4.34 +/- 0.12 mmol/liter [SE]; BEijing, 4.49 +/ 0.11 mmol/liter). Prevalence of hypertension (WHO criteria) was 4.9% (Guangzhou) and 15.6% (Beijing). In Guangzhou subjects pulse wave velocity was consistently lower in the aorta, arm, and leg, and increased to a lesser degree with age compared with Beijing subjects. Regression equations (x = pulse wave velocity [cm/sec], y = age [years]) were as follows: (1) aorta, Guangzhou: y = 5.1x + 533, r = .552, p less than .05; Beijing: y = 9.2x + 615, r = .673, p less than .001; (2) arm, Guangzhou: y = 0.61x + 817, r = .121, p less than .05; Beijing: y = 4.8x + 998, r = .453, p less than .001; (3) leg, Guangzhou: y = 4.43x + 718, r = .512, p less than .05; Beijing: y = 5.6x + 791, r = .630, p less than .001.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965166 TI - Prognosis after extension of myocardial infarct: the role of Q wave or non-Q wave infarction. AB - We examined whether or not subsets of patients with extension of myocardial infarct were at high risk for early and late mortality. Some data suggest increased risk in patients with non-Q wave infarcts and we hypothesized that infarct extension in this group might be associated with a poorer prognosis than that for patients with extension of Q wave infarcts. A total of 1253 patients with acute myocardial infarction who were included in our data base were followed prospectively. The patients were classified according to electrocardiographic results into the following groups: those with non-Q wave (n = 277) infarcts and those with Q-anterior (n = 462) and Q-inferior (n = 497) infarcts. Extension was diagnosed by two of the following criteria: (1) recurrent chest pain 24 hr or more after admission to the hospital, (2) new persistent electrocardiographic changes, and (3) elevation or reappearance of creatine kinase. By these criteria 85 (6%) patients had extension (8% of non-Q wave infarcts, 6% of Q-anterior infarcts, and 6% of Q-inferior infarcts). Hospital mortality in patients with extension was 15% in those with Q wave infarcts vs 43% in those with non-Q wave infarcts (p less than .01). Nine hundred and fifty-two patients were followed for 1 year. In 24% of those who did not survive 1 year there was extension of infarct; only 6% of survivors had extension (p less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965167 TI - Left ventricular dysfunction in patients with angina pectoris, normal epicardial coronary arteries, and abnormal vasodilator reserve. AB - Thirty-three patients with chest pain despite angiographically normal coronary arteries underwent both coronary flow studies during pacing and resting and exercise gated blood pool scintigraphy. During atrial pacing after administration of ergonovine, those patients developing their typical chest pain demonstrated significantly lower great cardiac vein flow (97 +/- 31 vs 150 +/- 33 ml/min, p less than .001), higher coronary resistance (1.27 +/- 0.43 vs 0.77 +/- 0.18 mm Hg/ml/min, p less than .005), and less lactate consumption (30.5 +/- 22.0 vs 69.7 +/- 41.1 mM . ml/min, p less than .005) and a higher left ventricular end diastolic pressure after pacing (20 +/- 4 vs 12 +/- 1, p less than .001) compared with those without pain and in the absence of significant luminal narrowing of the epicardial coronary arteries. The 26 patients with abnormal vasodilator reserve demonstrated reduced left ventricular ejection fraction during exercise (58 +/- 8%) compared with the seven patients with appropriate vasodilator reserve (66 +/- 4%, p less than .05) and with a group of 52 control patients of similar age and sex distribution and free of known heart disease (66 +/- 10%, p less than .001). In addition, 12 of the 26 patients with abnormal vasodilator reserve demonstrated exercise-induced regional wall motion abnormalities. Many of these patients also manifested impaired left ventricular diastolic filling at rest compared with the control subjects (peak filling rate 2.6 +/- 0.7 vs 3.2 +/- 0.7 end-diastolic volume/sec, p less than .005). Thus, patients with chest pain resulting from abnormal vasodilator reserve demonstrate abnormalities of left ventricular systolic and diastolic function suggestive of myocardial ischemia. PMID- 3965168 TI - Altered effect of the Valsalva maneuver on left ventricular volume in patients with cardiomyopathy. AB - The failure of the blood pressure to fall during the late strain pase of the Valsalva maneuver in patients with heart failure may result from the left ventricle operating on a flat portion of its function curve or from maintenance of left ventricular volume despite decreased systemic venous return. To test these possibilities, we studied the effect of the Valsalva maneuver (40 cm H2O for 15 sec) on left ventricular volume in 12 normal subjects with a mean left ventricular ejection fraction of 0.65 +/- 0.07 (+/- SD) and in eight patients with nonischemic cardiomyopathy, evidence of pulmonary congestion, and a mean left ventricular ejection fraction of 0.23 +/- 0.09. Left ventricular volume and right ventricular area were determined by apical two-dimensional echocardiography. In both groups the right ventricular end-diastolic area decreased during the late strain phase of the Valsalva maneuver. In normal subjects it decreased from 9.3 +/- 1.5 to 5.6 +/- 1.6 cm2 (p less than .001) and in patients it decreased from 13 +/- 2.2 to 10 +/- 2.9 cm2 (p less than .001). In normal subjects, left ventricular end-diastolic volume decreased from the control level during the Valsalva maneuver, and this was apparent in both the four chamber (96 +/- 21 to 68 +/- 18 ml, p less than .01) and two-chamber views (97 +/ 15 to 56 +/- 20 ml, p less than .01). In the patients, left ventricular end diastolic volume was not significantly different from control in either view (199 +/- 70 to 195 +/- 78 and 214 +/- 77 to 218 +/- 86 ml, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965169 TI - Effects of age, sex, and body habitus on QRS and ST-T potential maps of 1100 normal subjects. AB - Body surface potential maps provide more detailed regional cardiac electrophysiologic information than the standard electrocardiogram. We performed a large-scale study of a normal population to form a comparison base for evaluation of the clinical utility of this technique. We analyzed body surface maps from 1113 normal subjects from 10 to 80 years old to detail map features as a function of age, sex, and body habitus. Maps were analyzed by visual inspection and by a spatial and temporal data reduction technique that allows statistical comparison of map features. On average, both QRS and ST-T potentials decreased with increasing age. Potential pattern distributions remained constant from 10 to 40 years. Beyond age 40, larger numbers of maps from normal subjects showed depolarization patterns consistent with delayed activation of the left anterior fasicle, despite normal 12-lead electrocardiograms. Only minor QRS potential amplitude and distribution differences were noted when male and female subjects were compared within groups of similar age and body habitus. Male subjects consistently showed greater average T potential amplitudes. Slender body habitus was associated with a more horizontal "zero" potential line. In female subjects over age 40 there were more extensive low-level negative potentials recorded over the precordium during the ST segment than in men. This study defines the range of normal body surface potential maps in a large clinically normal population and provides a basis for qualitative and statistical comparison with map features of patients with disease. PMID- 3965170 TI - Linking: a dynamic electrophysiologic phenomenon in macroreentry circuits. AB - The term "linking" has been used specifically to describe the mechanism for perpetuation of functional anterograde bundle branch block: namely, repetitive transseptal retrograde concealed penetration by impulses propagating along the contralateral bundle. We present selected examples that demonstrate tht linking type phenomena actually have a wide spectrum of expression in human macroreentry circuits, particularly those incorporating either the bundle branches and His bundle or the normal pathway and Kent bundle. The examples presented are as follows: (1) persistent retrograde functional conduction delays in the His Purkinje system during right ventricular pacing, (2) anterograde Kent bundle condution at rapid rates, dependent on prior block in the normal pathway, (3) persistent anterograde functional infra-His block of atrial impulses during rapid ventricular pacing in the presence of a retrogradely conducting accessory pathway, and (4) transient advancement of His activation with ventricular fusion complexes during overdrive ventricular pacing of bundle branch reentrant tachycardia. Based on these examples, we characterize linking as a generalized electrophysiologic phenomenon in which each successive impulse entering a macroreentry circuit propagates preferentially along one limb because of functional block in the contralateral limb resulting from the effects of the prior impulse. It is proposed that such functional block may be dynamically maintained either by repetitive impulse interference, which perpetuates local refractoriness (examples No. 1 to 3), or by repetitive impulse collision (example No. 4). The general conceptual scheme outlined can be applied to specific electrophysiologic phenomena associated with a wide variety of reentry circuits in man. PMID- 3965171 TI - Quantitative angiography of the left anterior descending coronary artery: correlations with pressure gradient and results of exercise thallium scintigraphy. AB - To evaluate, during cardiac catheterization, what constitutes a physiologically significant obstruction to blood flow in the human coronary system, computer based quantitative analysis of coronary angiograms was performed on the angiograms of 31 patients with isolated disease of the proximal left anterior descending coronary artery. The angiographic severity of stenosis was compared with the transstenotic pressure gradient measured with the dilation catheter during angioplasty and with the results of exercise thallium scintigraphy. A curvilinear relationship was found between the pressure gradient across the stenosis (normalized for the mean aortic pressure) and the residual minimal area of obstruction (after subtracting the area of the angioplasty catheter). This relationship was best fitted by the equation: normalized mean pressure gradient = a + b . log [obstruction area], r = .74. The measurements of the percent area of stenosis (cutoff 80%) and of the transstenotic pressure gradient (cutoff 0.30) obtained at rest correctly predicted the occurrence of thallium perfusion defects induced by exercise in 83% of the patients. PMID- 3965172 TI - Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms. AB - A computer-assisted technique has been developed to assess absolute coronary arterial dimensions from 35 mm cineangiograms. The boundaries of optically magnified and video-digitized coronary segments and the intracardiac catheter are defined by automated edge-detection techniques. Contour positions are corrected for pincushion distortion. The accuracy and precision of the edge detection procedure as assessed from cinefilms of contrast-filled acrylate (Perspex) models were -30 and 90 micrometers, respectively. The variability of the analysis procedure itself in terms of absolute arterial dimensions was less than 0.12 mm, and in terms of percentage arterial narrowing for coronary obstructions less than 2.74%. Short-, medium-, and long-term variability measurements were assessed from repeated coronary angiographic examinations performed 5 min, 1 hr, and 90 days apart, respectively. For all studies the mean differences in absolute diameters were less than 0.13 mm. The variability in obstruction diameter ranged from 0.22 mm for the best-controlled study (medium-term) to 0.36 mm for the least controlled study (long-term); variability in reference diameter ranged from 0.15 to 0.66 mm, respectively. It is concluded that the biological variations are a source of major concern and that further attempts toward standardization of the angiographic procedure are seriously needed. PMID- 3965173 TI - Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/defibrillator. AB - Seventy patients received the automatic implantable defibrillator, five original devices and 72 modified second-generation devices using only bipolar rate sensing and delivering an R wave synchronous cardioverting/defibrillating shock, for either ventricular tachycardia or fibrillation. The primary clinical arrhythmia was sustained ventricular tachycardia in 32 patients, ventricular fibrillation in 20 patients, and both ventricular tachycardia and fibrillation in 18 patients. Before implantation of the device the patients had survived 3.1 +/- 2.3 arrhythmic episodes, including 1.9 +/- 1.7 cardiac arrest, and had received 4.0 +/- 2.1 antiarrhythmic drugs without improvement. Sixty-eight patients ultimately received devices. After a follow-up period of 8.9 +/- 7.7 months (range 1 to 33), 37 patients received a total of 463 discharges. Inability to determine the precise reason for most discharges and the unpleasant nature of the discharges were the major clinical problems encountered. Complications included postoperative death (one patient), lead problems (six patients), inadequate energy requiring explanation (two patients), and pocket infection (one patient. Life-table analysis revealed 6 and 12 month cardiovascular survival of 95.0% and 89.9% and sudden death survival of 98.2%. In our experience, survival with the automatic implantable cardioverter/defibrillator exceeds that with other forms of therapy. PMID- 3965174 TI - Autotransplantation of skeletal muscle into myocardium. AB - In a series of 15 studies in dogs, sternocleidomastoid muscle was used to replace deficits created in left ventricular myocardium and sternohyoid muscle was used to replace portions of right myocardial wall. The five right ventricular autotransplants resulted in a 100% surgical success rate, with animals electively killed between 3 and 55 weeks after surgery. In 10 left ventricular studies excision of areas varying from 12 X 46 mm to 30 X 60 mm and incisions of from 40 mm to 70 mm in length were performed. Left ventricular studies resulted in a 60% surgical success rate, with clinically healthy animals being killed for study between 2 weeks and 50 weeks after surgery. Animals surviving the critical surgical recovery period showed no loss of weight or changes in activity. Gross findings at autopsy confirmed the viability of the skeletal muscle transplants. Borders were well healed and the grafted tissue was pliable. Histologic studies suggest that revascularization of skeletal muscle occurred from the myocardial side, and that there were healthy myocardial and skeletal muscle fibers at the junction, with evidence of regeneration. PMID- 3965175 TI - Alternating contractility in pulsus alternans studied in the isolated canine heart. AB - We examined pulsus alternans in seven isolated, perfused canine left ventricles ejecting into a simulated arterial impedance. Left ventricular pressure-volume loops were measured during pulsus alternans while filing-source pressure was lowered. In all cases two distinct linear end-systolic pressure-volume relationships (ESPVRs) were noted for the strong and weak beats. The slopes of the ESPVRs of the strong beats were significantly greater than those of the weak beats (mean difference 0.9 +/- 0.6 mm Hg/ml, p less than .01), while the intercepts were not significantly different (mean difference 0.06 +/- 0.5 ml). Diastolic pressure-volume relationships for the strong and weak beats were not significantly different, excluding incomplete relaxation as a cause of pulsus alternans. Although the weak beats had both a smaller preceding end-diastolic volume and a larger end-systolic volume, the presence of two distinct ESPVRS for the strong and weak beats shows there is alternating ventricular chamber contractility in pulsus alternans that is not solely due to the Starling mechanism. The magnitude of alternation in pump function parameters such as pressure and stroke volume during pulsus alternans reflects the complex interactions of alternating contractile state with alternations in preload and afterload. PMID- 3965176 TI - Early detection of myocardial infarction in conscious dogs by analysis of plasma MM creatine kinase isoforms. AB - To determine whether myocardial infarction could be detected early after onset by analysis of subforms of the MM isoenzyme (isoforms) of creatine kinase (MM CK) in plasma, we subjected eight conscious dogs to coronary occlusion and quantified isoforms in serial plasma samples by chromatofocusing. The fractions of MMA (isoelectric point [pI] = 7.91), MMB (pI = 7.74), and MMC (pI = 7.51) in plasma samples before coronary occlusion averaged 11.4 +/- 4.8% (SD), 22.3 +/- 5.5%, and 66.3 +/- 9.6% of total MM CK activity. The fraction of MMA, the isoform of MM CK found in myocardium, increased significantly in plasma 1 hr after coronary occlusion, reached a maximum of 49.7 +/- 8.0% in 4.1 +/- 1.3 hr, and returned to baseline in 12.0 +/- 2.3 hr. The fraction of plasma MM CK activity attributable to MMC, an isoform formed slowly in plasma from MMA via MMB as an intermediate, decreased significantly within 1 hr, reached a minimum of 14.0 +/- 4.1% in 4.8 +/ 1.1 hr, and returned to baseline in 13.0 +/- 2.9 hr after coronary occlusion. Total CK activity did not increase significantly until later, i.e., 5 hr after occlusion, and peaked at 1371 +/- 530 IU/liter in 10.9 +/- 1.9 hr. Within the first 4 hr after coronary occlusion, MMA consistently comprised more than 20% of plasma MM CK activity despite insignificant increase of total CK. Changes in isoform proportions were consistent and independent of peak total CK activity and of cumulative CK release over a 10-fold range. Thus initial CK release indicative of infarction is detectable within 1 hr after the onset of ischemia by quantification of plasma MM CK isoforms. PMID- 3965177 TI - Reduced regional myocardial perfusion in the presence of pharmacologic vasodilator reserve. AB - To determine whether reductions in regional myocardial perfusion at reduced coronary arterial pressures reliably indicate maximal vasodilation of the distal vasculature, coronary autoregulation was studied in open-chest dogs at heart rates of approximately 60 beats/min, a level at which metabolic demand, time averaged systolic compressive forces, and transmural vasodilator reserve approximate those found under usual resting conditions. Circumflex pressure was controlled with a programmable pressure source. Regional circumflex inflow was 0.56 +/- 0.04(SEM) ml . min-1 . g-1 when circumflex pressure equaled spontaneous aortic pressure and fell to 0.34 +/- 0.02 ml . min-1 . g-1 when circumflex pressure was reduced to 35 mm Hg. Reductions were similar in each myocardial layer, with endocardial flow falling from 0.68 +/- 0.04 to 0.39 +/- 0.03 ml . min 1 . g-1. During adenosine-induced vasodilation at 35 mm Hg, full-thickness and endocardial flows rose to 0.92 +/- 0.08 and 1.07 +/- 0.10 ml . min-1 . g-1, respectively. When coronary pressure was reduced to 25 mm Hg and autoregulation was again operative, full-thickness and endocardial flows fell to 0.28 +/- 0.03 and 0.28 +/- 0.04 ml . min-1 . g-1. During adenosine vasodilation at 25 mm Hg endocardial flow did not increase significantly but epicardial reserve remained present. These results indicate that significant reductions in regional myocardial perfusion can occur before pharmacologic vasodilator reserve is exhausted. In the absence of tachycardia, endocardial vasodilator reserve can persist to coronary pressures less than 35 mm Hg, but is ordinarily exhausted before epicardial vasodilator reserve. PMID- 3965178 TI - Intrinsic washout rates of thallium-201 in normal and ischemic myocardium after dipyridamole-induced vasodilation. AB - Infusion of dipyridamole has been suggested as an alternative to exercise stress for myocardial perfusion imaging for detection of ischemia, but the mechanism and significance of thallium-201 (201Tl) redistribution after administration of dipyridamole are uncertain. If disparate intrinsic cellular efflux rates of 201Tl from normal and relatively underperfused myocardium in response to dipyridamole induced vasodilation were observed, this could explain delayed 201Tl redistribution. We investigated eht effect of an intravenous infusion of 0.15 mg/kg dipyridamole on the intrinsic myocardial washout rate of 201Tl as measured with a gamma-detector probe after intracoronary injection (50 muCi) of the radionuclide in open-chested anesthetized dogs. In six normal dogs the t 1/2 for intrinsic 201Tl washout from the myocardium was 89 +/- 11 min (SE) at control conditions and became more rapid at 59 +/- 10 min (p = .0001) after dipyridamole. This corresponded to a significant increase in microsphere-determined epicardial (0.95 +/- 0.11 to 2.23 +/- 0.46 ml/min/g; p = .01) and endocardial (0.86 +/- 0.10 to 1.53 +/- 0.27; p = .029) flows. In 12 dogs with a critical coronary stenosis, the 201Tl intrinsic washout rate slowed from 70 +/- 5 to 104 +/- 6 min (p = .0001) after production of the stenosis and slowed even further to 169 +/- 21 min (p = .003) after dipyridamole.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965179 TI - Kinetics of 13N-ammonia uptake in myocardial single cells indicating potential limitations in its applicability as a marker of myocardial blood flow. AB - To study kinetics and principles of cellular uptake of 13N-ammonia, a marker of coronary perfusion in myocardial scintigraphy, heart muscle cells of adult rats were isolated by perfusion with collagenase and hyaluronidase. Net uptake of 13N, measured by flow dialysis, reached equilibrium within 20 sec in the presence of sodium bicarbonate and carbon dioxide (pH 7.4, 37 degrees C). Total extraction, 80 sec after the reaction start, was 786 +/- 159 mumol/ml cell volume. Cells destroyed by calcium overload were unable to extract 13N-ammonia. Omission of bicarbonate and carbon dioxide reduced total extraction to 36% of control. 13N Ammonia uptake could also be reduced by 50 muM 4,4' diisothiocyanostilbene 2,2' disulfonic acid, by 100 micrograms/ml 1-methionine sulfoximine, and by preincubation with 5 muM free oleic acid. These results indicate that in addition to metabolic trapping by glutamine synthetase, the extraction of 13N-ammonia by myocardial cells is influenced by cell membrane integrity, intracellular extracellular pH gradient, and possibly an anion exchange system for bicarbonate. For this reason, the uptake of 13N-ammonia may not always provide a valid measurement of myocardial perfusion. PMID- 3965180 TI - The natural history of regional dysfunction in a canine preparation of chronic infarction. AB - We used a canine preparation of experimental infarction to study the natural course of echocardiographically defined regional wall motion abnormalities in the 6 weeks after acute coronary ligation. Eight dogs underwent serial short-axis echocardiographic evaluation and microsphere blood flow determinations at control, and 30 min, 48 hr, 1 week, 3 weeks, and 6 weeks after acute coronary artery ligation. Wall motion analysis and blood flow calculations were applied to 10 degree radial segments of the left ventricle (short axis) and correlated to the size and extent of infarction as defined histologically at 6 weeks. All animals had at least 50% transmural histologic infarction. The ratio of flow in infarcted tissue vs noninfarcted myocardium fell to 0.40 +/- 0.13 for endocardium and 0.56 +/- 0.13 for epicardium at 30 min after ligation, but recovered to 0.83 +/- 0.15 for endocardium and 1.12 +/- 0.11 for epicardium by 6 weeks. The maximum circumferential extent of abnormal regional wall motion was observed at 48 hr after infarction (mean circumferential extent = 51%), but was resolved to a significant extent by 6 weeks (circumferential extent = 21%, p less than .001). Four animals had virtually normal wall motion by 6 weeks after infarction. Segment-by-segment regional dysfunction correlated highly with the regional transmural reduction in blood flow of 20% )r = .89, p = .0001) for the experiment as a whole, but the echocardiogram tended to underestimate the size of the histologic infarct at 6 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965181 TI - Laser recanalization of occluded atherosclerotic arteries in vivo and in vitro. AB - Controlled laser irradiation was used to recanalize atherosclerotic stenoses in vivo and in vitro. In 15 rabbits with atherosclerotic arteries a catheter was positioned in the distal aorta for angiographic examination and as a guide for a small silica optical fiber. Both Nd-YAG and argon lasers were used for recanalization with varying power and duration. As determined by angiographic studies the severity of iliofemoral stenoses in eight 15 arteries decreased from 78 +/- 18% to 32 +/- 11% (mean +/- SD). In one additional artery the stenosis improved from 45% to 25%, but this was associated with perforation. The other six arteries were perforated (two after fiber manipulation, four after laser discharge) without obvious improvement in severity of stenosis. No angiographic loss of distal circulation was noted. To better define tissue- laser interactions in the live-rabbits, lasing of 15 totally occluded atherosclerotic rabbit arterial segments in vitro was done while the optical fiber was advanced or fixed. When the fiber was fixed, serial sections showed that the new lumen was flame shaped. The width and depth of the lumen increased with increasing laser energy. When the fiber was advanced, histologic examination showed a smooth cylindrical vascular channel with limited lateral tissue damage. This study demonstrated that lasers can recanalize atherosclerotic stenoses in a live animal preparation; however, arterial perforation remains a problem. PMID- 3965182 TI - Multicenter evaluation of assays for estradiol and progesterone in saliva. AB - Blood samples can be difficult to obtain in studies involving serial sampling, especially in developing countries where there may also be logistic, ethical, and cultural constraints that make frequent blood collection impractical. Assays for steroids in saliva may avoid some of these difficulties. A multicenter study involving laboratories in five countries was carried out to compare the results of assays for salivary estradiol and progesterone performed with centrally provided reagents and assay protocols. Concentrations of salivary steroid as obtained by all but one center were comparable with those reported in the literature. We conclude that assays of hormones in saliva are useful adjuncts to those performed on other body fluids. PMID- 3965183 TI - Alternative statistical approach to evaluating interlaboratory performance. AB - We report a new technique for realistic assessment of laboratory performance as measured by proficiency testing. Interlaboratory results accumulated from 129 participants during 18 months provide the baseline data from which we established "state-of-the-art" performance criteria for three ranges of pH, pCO2, and pO2. By concurrent use of two statistical measurement techniques, the cumulative percentile rank and the algebraic and absolute mean error, laboratories can accurately evaluate their performance in terms of acceptable state-of-the-art criteria, total error, or medical usefulness. The approach facilitates assessment of the nature of the errors that have led to inferior performance and identification of probable areas where improvement is possible. If criteria based on regulatory standards or medical usefulness goals are included, the system can provide a basis for licensure or professional quality improvement. PMID- 3965184 TI - Simultaneous determination of uric acid and creatinine in plasma by reversed phase liquid chromatography. AB - Because numerous substances, endogenous compounds as well as xenobiotics, interfere with determination of uric acid and creatinine, we have devised a more nearly specific method by which we can simultaneously determine uric acid and creatinine in plasma by "high-performance" liquid chromatography. We used a mobile phase of ammonium acetate (30 mmol/L) and methanol (156 mmol/L) at pH 7.0 and a flow rate of 1 mL/min. We used a C18 reversed-phase column, and measured absorbance at 235 nm, the wavelength corresponding to the absorption maximum of uric acid and creatinine. Uric acid and creatinine could be determined in less than 5 min by directly injecting plasma diluted fivefold; use of a precolumn eliminated the need for deproteinization. We evaluated the precision, recovery, linearity, specificity, and limit of detection of the method and we checked for analytical interference by 37 currently used drugs. We compared results with those obtained by routine and reference methods. PMID- 3965185 TI - Rapid separation and identification of myoglobin and hemoglobin in urine by centrifugation through a microconcentrator membrane. AB - Urinary myoglobin (Mr = 16 500) is readily separated from hemoglobin (Mr = 64 000) by centrifugation through a microconcentrator membrane with a 30 000-Da cutoff. Myoglobin, but not hemoglobin, will pass through the membrane, after which each fraction may be separately analyzed by spectrophotometry. This technique is advantageous over direct spectrophotometry of urine because it is not restricted to analyzing the oxy forms of these hemoproteins and obviates the difficulty of discriminating small (3 nm) differences in their spectra. In addition, this method of separation is more complete than that attained by differential "salting out" with ammonium sulfate, and it is simpler than gel filtration or ultrafiltration under reduced pressure. PMID- 3965186 TI - Effect of temperature on quantifying glycated (glycosylated) hemoglobin by cation exchange chromatography. AB - As a consequence of nonideal chromatographic conditions, values for stable glycated hemoglobin (HbA1c) determined by cation-exchange chromatography in a commercial minicolumn system (y) or by "high-performance" liquid chromatography (x) differ markedly, yielding the regression line y = 0.82x + 0.6. With use of the protocol specified by the manufacturer, 20% of the HbA1c peak is not collected in the HbA1c fraction. Increasing the ionic strength of the eluting buffer by increasing the operating temperature to 28 degrees C increases the rate of elution from the minicolumn, making results of the two methods more closely comparable (y = 0.98x - 0.22). Because at a given pH the elution volume is determined primarily by the ionic strength, close limits on the composition of the eluting buffer are set by the temperature-dependence of its ionic strength. At a specified temperature and pH the position of a peak can be judged to within a volume of 1 mL if the conductivity of the eluent does not vary by more than +/- 0.05 mS. PMID- 3965187 TI - Pitfalls in, and new methods for, the radioimmunoassay for digoxin in urine. AB - Examining techniques for radioimmunoassay of digoxin in urine, we found that the apparent concentration of digoxin is affected by endogenous substances, independent of the concentration of digoxin itself. We describe a modification of the Becton Dickinson solid-phase RIA that makes it more nearly accurate and more easily performed, and obviates the endogenous interference. Digoxin concentrations from 5.0 to at least 1000 micrograms/L can be measured. PMID- 3965188 TI - Improved determination of estriol-16 alpha-glucuronide in pregnancy urine by direct liquid chromatography with fluorescence detection. AB - In this relatively simple, rapid assay of estriol-16 alpha-glucuronide in pregnancy urine, the urine sample is diluted 20-fold with phosphate buffer (pH 5.2) containing 360 mL of acetonitrile and 2 g of cetyltrimethylammonium bromide per liter, then directly injected into the chromatograph. A sample can be assayed within 14 min. Day-to-day CVs ranged from 2.3% at 45 mg/L to 2.9% at 4.8 mg/L. The limit of sensitivity is 0.4 mg/L. Results by the present method (y) correlated and compared very well with those by a method involving fractionation of estrogen conjugates and gas chromatography (x) for 24 samples of pregnancy urine (y = 1.09x + 0.303; r = 0.947). This assay is inexpensive and suitable for complete automation. PMID- 3965189 TI - Assay of total and free propranolol in plasma by liquid chromatography with fluorometric detection. AB - We report a liquid-chromatographic method for assay of total and free propranolol and its metabolite, propranolol glycol, in plasma. An ultrafiltration device is used to separate the free drugs from the protein-bound drugs. The total and free drugs are isolated from plasma or ultrafiltrate by liquid-solid extraction on a Waters C18 SEP-PAK and the drugs are quantified on a C18 mu-Bondpak radial compression column. The mobile phase consists of equal parts of methanol and a solution of potassium 50 mmol/L phosphate and 2.5 mmol/L 1-pentane-sulfonic acid, pH 5.0. Detection was by fluorescence, with excitation at 296 nm and emission at 338 nm. Time required for sample preparation for total-propranolol assay is 40 min per eight samples. Sample preparation for free-propranolol assay requires an additional 1 h per eight samples. Chromatography requires 15 min per sample. The extraction recovery is approximately 75% and the assay curve is linear from 5 to 400 micrograms/L. The run-to-run CV is 4% for total propranolol, 15% for free propranolol. PMID- 3965190 TI - Continuous-flow analysis for glucose with use of glucose dehydrogenase immobilized in glass tubes. AB - We describe a method for determining glucose in serum with glucose dehydrogenase immobilized on the inner walls of glass tubes. The reactor was incorporated into a channel of a continuous-flow analyzer (the Technicon SMAC) and used daily for four weeks in routine analysis for serum glucose. During this period we tested the linearity, precision, accuracy, and durability of the reactor. Results correlated well (r = 0.9949) with those obtained by routine methods with free (nonimmobilized) glucose dehydrogenase. The method is shown to be practicable for use in the routine laboratory. PMID- 3965191 TI - Determination of serum aspartate aminotransferase with pyridoxal 5'-phosphate in the Technicon SMAC and Du Pont aca compared and correlated with the IFCC recommended method. AB - Inexpensive improvements in continuous-flow analytical apparatus can eliminate some perplexing inconsistencies and limitations in the use of the Technicon SMAC instrument for measuring the activity in serum of aspartate aminotransferase (EC 2.6.1.1) in the presence of pyridoxal 5'-phosphate. In addition, a calibration procedure based on values for this enzyme obtained by a modified IFCC method can be used to calibrate both the Technicon SMAC and the Du Pont aca instruments to produce excellent correlation between the two. PMID- 3965192 TI - Acetaminophen metabolite interferes in analysis for amino acids. PMID- 3965193 TI - Automated dry-film method for phosphorus in serum evaluated. PMID- 3965195 TI - An RIA kit that is more specific for digoxin in serum of newborns. PMID- 3965194 TI - High alpha 1-acid glycoprotein concentrations in serum of epileptic children being treated with carbamazepine. PMID- 3965196 TI - Simple micromethod for determination of erythrocyte electrolyte concentration. PMID- 3965197 TI - Calibration of 3-hydroxybutyrate assays. PMID- 3965198 TI - More on ambiguous description of standardization for beta-hydroxybutyrate. PMID- 3965199 TI - Upper reference limit for creatine kinase. PMID- 3965200 TI - Discordant results for choriogonadotropin: a problem caused by lutropin beta subunit interference? PMID- 3965201 TI - Serum iron as determined in the automated DACOS random access analyzer. PMID- 3965202 TI - More on identifying inherited deficiency of porphobilinogen synthase. PMID- 3965203 TI - Tissue LDH isoenzyme assays in the detection of colonic carcinoma. PMID- 3965204 TI - Threshold of pathological proteinuria measured with Coomassie Brilliant Blue. PMID- 3965205 TI - Isolation of DNA from biological specimens without extraction with phenol. PMID- 3965206 TI - Cephalosporins and urinary protein determination. PMID- 3965207 TI - Lactate dehydrogenase activity in platelets and plasma. PMID- 3965208 TI - Testosterone/dihydrotestosterone kit method for diagnostic use. PMID- 3965209 TI - Enzymic determination of cholesterol in plasma obtained by fingerstick. PMID- 3965210 TI - Mismeasurement of methemoglobin ("methemoglobin revisited") PMID- 3965211 TI - Effect of silicone-separator tubes and storage time on ionized calcium in serum. PMID- 3965212 TI - Interpretation of abnormal serum enzyme activities in occult diseases. PMID- 3965213 TI - Chromium in plasma and urine as measured by electrothermal atomic absorption spectroscopy. PMID- 3965214 TI - Ultrafiltration studies in vitro of serum aluminum in dialysis patients after deferoxamine chelation therapy. AB - Using gel filtration chromatography, we evaluated aluminum bound to albumin, transferrin, and other plasma proteins in the serum of patients on maintenance hemodialysis. The proportion of dialyzable aluminum, as determined by selective membrane ultrafiltration and flameless atomic absorption spectrometry, increased by more than fourfold on treatment with the metal chelator, deferoxamine. This ultrafiltration technique may prove useful for monitoring the proportion of aluminum mobilized during such therapy. PMID- 3965215 TI - Measurement of aluminum in serum, blood, urine, and tissues of chronic hemodialyzed patients by use of electrothermal atomic absorption spectrometry. AB - We describe different methods of electrothermal atomic absorption spectrometry with automatic sampling for determining aluminum in human serum, blood, urine, and tissues. Contamination with Al originating from receptacles and reagents was minimized. Whole-blood Al concentrations were measured after hemolysis of EDTA anticoagulated blood samples with Triton X-100. A straightforward method for tissue destruction was developed. Instrument settings of the graphite furnace and of the atomic absorption spectrometer were adjusted so as to obtain close agreement between direct and standard-additions methodologies. The result is a reliable direct method appropriate for use with multiple samples. Tissue Al measurements showed low detection limits and approximately 100% analytical recoveries. Al concentration in serum of 10 healthy volunteers and of 100 chronic hemodialysis patients were 2.0 (SD 0.4) and 77 (SD 70) micrograms/L, respectively. Blood Al concentrations of 10 controls and of 100 dialysis patients were 12.1 (SD 1.5) and 79 (SD 70) micrograms/L, respectively. Al concentrations in serum and blood of 47 chronic hemodialysis patients were not significantly different. Bone Al concentrations were 8.2 (SD 5.8) micrograms/g of fresh tissue for 10 chronic hemodialysis patients without osteomalacia, as compared with 51 (SD 20) micrograms/g for 10 chronic-dialysis patients with Al-induced osteomalacia. PMID- 3965217 TI - Pregnanediol-3 alpha-glucuronide measured in diluted urine by mass spectrometry with fast atom bombardment/negative-ion ionization. AB - We describe a mass-spectrometric method based on the fast atom bombardment ionization technique in the negative-ion mode for measuring pregnanediol-3 alpha glucuronide in diluted urine from women. The procedure requires addition of testosterone-17 beta-D-glucuronide (2.5 micrograms/25 microL) to the urine sample as internal standard, and the sample is added directly to the fast atom bombardment target with no further manipulation. We have assessed and evaluated the method by the traditional criteria of reliability. PMID- 3965216 TI - A compound from uremic plasma and from normal urine isolated by liquid chromatography and identified by nuclear magnetic resonance. AB - A compound present in normal urine and in ultrafiltrates of uremic plasma in the fraction of so-called "uremic middle molecules" was isolated by liquid chromatography. Preliminary studies, including amino acid analysis, characterization of uronic acids, and ultraviolet spectroscopy, show that the molecule contains glycine, a uronic acid, and an aromatic ring. Characterization by 1H and 13C nuclear magnetic resonance spectrometry shows conclusively that this compound is a double conjugate of glucuronidate--o-hydroxyhippuric acid, which has been previously described by Zimmerman et al., using quite different techniques of isolation and identification (Clin Nephrol 14: 107, 1980; FEBS Lett 129: 237, 1981). PMID- 3965218 TI - Analytical and clinical evaluation of a radioimmunoassay for gastrin. AB - Prior to a study of the pathophysiological significance of chronic atrophic gastritis and hypergastrinemia, we evaluated a new radioimmunoassay kit for serum total gastrin (Diagnostic Products Corp.). The mean intra-assay CV ranged from 2 to 5% (2386 patients' samples in 47 assay runs done during four months). Total CVs for two controls ranged from 4 to 10%. Within-assay bias was 5%. Oleate decreased the values, indicating that intravenous heparin, which releases endothelial lipase, causing in vitro lipolysis, should be avoided if indwelling catheters are used for sampling, e.g., during provocation tests for gastrin release. Of three other commercial kits examined, two were affected by oleate. Other anions such as heparin and EDTA also affected the assay. Values for gastrin in heparinized plasma from surgical patients representing a variety of disorders agreed well with results obtained by a reference laboratory. We confirm the usefulness of this assay for discriminating clinical situations and conclude that ligand assays, besides those for thyroid assessment, should be assessed for interference from nonesterified fatty acids. Preliminary data also suggest a marked age dependence of serum gastrin concentration. PMID- 3965219 TI - Variance estimates and individuality ratios of 25 serum constituents in beagles. AB - Variance components and individuality ratios for each of 25 chemical constituents of serum were estimated in a population of beagles. Ten blood samples were obtained from each of 14 beagles, seven of each sex, approximately weekly during three months. Glucose and phospholipid displayed marked inter-dog variation, as compared with intra-dog variation (individuality ratio less than 1). Triglycerides and nonesterified fatty acids had large intra-dog variances relative to their inter-dog variances (individuality ratio greater than 1). Overall, the estimated individuality ratios exceeded 1 for 20 of the 25 constituents. We conclude that subtraction of pretreatment values in the statistical analysis of the data from assays with individuality ratios greater than 1 may mask small clinically or biologically important changes between treatment groups. When the individuality ratio is greater than 1, pretreatment values should only be used as a population screening tool before a study. PMID- 3965220 TI - Performance of five thyroid-function tests by radioimmunoassays with antibodies attached to paramagnetic micro-particles. AB - We have assessed the analytical and clinical performance of five thyroid-function tests by commercially available radioimmunoassays in which antibodies attached to paramagnetic micro-particles are used (Corning MAGIC assays). We evaluated the methods for measuring thyroxin, triiodothyronine, triiodothyronine uptake, thyrotropin (thyroid-stimulating hormone), and free thyroxin. Precision, patients' results, and clinical correlation of the MAGIC assays were similar to those of the well-established RIAs used as the comparative methods in this study; the MAGIC assays, however, are much faster and easier to perform. PMID- 3965221 TI - New test for urinary glucose (BM33071) evaluated. AB - Results for urinary glucose by the Boehringer Mannheim BM33071 test pad and a hexokinase-based method agree well. The new test, which involves the glucose oxidase/peroxidase reaction, measures as little as 260 mg of glucose per liter. Acetoacetate, beta-hydroxybutyrate, and human hemoglobin do not interfere. PMID- 3965222 TI - Four methods for determining total protein compared by using purified protein fractions from human serum. AB - The proportional bias of four methods frequently used for determining low concentrations of protein was evaluated with human serum protein fractions (Cohn Fractions II, III, IV, and V). Each fraction was assigned a protein concentration value as determined by the biuret method, calibrated with purified human serum albumin monomer. All four methods (Coomassie Brilliant Blue dye-binding, the method of Lowry et al., ultraviolet absorption, and immunonephelometry gave acceptable results for Fraction V (albumin). The ultraviolet absorption and the Lowry methods overestimated the three globulin fractions (II, III, and IV), whereas the other two methods underestimated these fractions. The method of Lowry et al. gave the least proportional bias for the globulin fractions. PMID- 3965223 TI - Thromboplastic activity of cerebrospinal fluid in neurological disease. AB - Estimates of thromboplastic activity in 1100 samples of cerebrospinal fluid indicate that an increased activity of this clotting factor is a nonspecific indicator of abnormality in the central nervous system, much like (e.g.) an increased count of mononuclear cells and an increased protein content. However, the proportion of abnormal results obtained by these three tests can differ markedly in different neurological disorders. Increased thromboplastic activity is about 14-fold more common in bacterial meningitis than in viral meningitis; thus the thromboplastin determination can be of value in discriminating between bacterial and viral meningitis. PMID- 3965224 TI - Effects of serum and serum components on the binding of DNA to thioglycollate stimulated mouse peritoneal macrophages. AB - Binding of ssDNA and dsDNA to thioglycollate-stimulated peritoneal macrophages derived from normal CBA mice was increased not only by ssDNA-specific antibody but also by albumin and gamma-globulin preparations. Fresh mouse serum inhibited ssDNA binding, even if the ssDNA and serum were preincubated at 37 degrees C. Heat decomplemented mouse serum also depressed DNA binding. These results are significant to interpretations of DNA clearance rate data from serum or blood, and subsequent inferences concerning blood DNA levels, autoimmune response, and systemic lupus erythematosus. PMID- 3965225 TI - In vitro migration of tumor cells from human neoplasms: inhibition by lymphokines. AB - We have previously described a noncytotoxic lymphokine, TMIF, with the capacity of inhibiting the in vitro migration of a variety of serially passaged experimental animal tumors, but not non-neoplastic cells. In the present study, we describe conditions for the assay of human tumor cell movement utilizing agarose microdroplets. Using this procedure, we were able to demonstrate that TMIF is as effective in inhibiting the in vitro migration of suspensions of tumor cells obtained from spontaneous human neoplasms, as it is in inhibiting model tumor systems. This finding demonstrates that responsiveness to TMIF is not merely a property conferred on tumor cells by prior serial passage. Also, by demonstrating that tumors of human origin are responsive, the present study raises the possibility that studies of TMIF in neoplastic disease may provide information of prognostic value. Also, they provide the hope that if TMIF proves therapeutically effective in animal models, those results may be translated to human disease. PMID- 3965226 TI - Follow-up of families of neonates in whom life support was withdrawn. AB - Grieving patterns and psychosocial functioning were studied in 20 families who had participated in a decision-making conference regarding withdrawal of support of their newborn in the neonatal intensive care unit and for whom the life support had been withdrawn. Prolonged grieving was reported by one father and pathologic grieving by one grandmother. In the majority of families, grieving patterns and psychosocial functioning were similar to those of other families whose newborns have died. PMID- 3965227 TI - Association of temperature greater than 41.1 degrees C (106 degrees F) with serious illness. AB - In a 9-month prospective study conducted in an urban emergency room, 15 children with rectal temperature greater than 41.1 degrees C (106 degrees F) were evaluated. Seven of the 15 patients were admitted to the hospital. Two children who were discharged home required subsequent admission, and six were managed on an ambulatory basis. Eight (53.3%) children had serious disease: two bacterial meningitis, two bacteremia without meningitis, two pneumonia, one pericarditis with effusion, and one Kawasaki disease. In four, the final diagnosis indicated a much more serious illness than was considered initially. The laboratory studies did not correlate reliably with the final diagnosis or need for admission. Children with a rectal temperature greater than 41.1 degrees C are at high risk for a life-threatening illness and should be evaluated for sepsis and meningitis. PMID- 3965228 TI - The pediatrician's approach to the preschool child with language delay. AB - A systematic approach to the child with suspected language disorder includes screening of expressive language, receptive language, general development, and hearing. Various screening approaches and tools are discussed. Diagnostic categories and associated referral patterns are recommended. PMID- 3965229 TI - Opsomyoclonus and neuroblastoma. AB - Three cases of neuroblastoma with opsomyoclonus are reported, reconfirming favorable prognostic significance of the association. In one case, computed tomography of the abdomen was the only confirmatory diagnostic study. Two of the cases also were unusual in that the patients had a concomitantly inherited genetic disorder not known to be associated with childhood cancer. PMID- 3965230 TI - "Pseudoerysipelas" in a child with Turner's syndrome. PMID- 3965231 TI - A case report of lingual lymphangioma presenting as recurrent massive tongue enlargement. AB - Lymphangiomas are benign congenital tumors that frequently result in macroglossia. Tongue involvement may lead to airway obstruction, swallowing difficulties, mandible-dental deformities, and speech disturbances. This case report demonstrates the many difficulties in diagnosis and management. Reduction in tongue size with preservation of motor and sensory function is best accomplished by wedge resection of the tip of the tongue. PMID- 3965232 TI - Moxibustion. Another traumatic folk remedy. AB - An approach emphasizing an understanding of differing patient and family models of illness and the implementation of culturally appropriate health care is described. The physician who observes a practice such as moxibustion should attempt to gain an understanding of the parents' "model" of illness, develop and maintain rapport with the family, and attempt to develop a culturally appropriate treatment plan which minimizes the injurious practice. Counselors of the same ethnic group who are more acculturated to our society may be very helpful. PMID- 3965233 TI - Mothers of abused children. A comparison study. AB - A group of 36 mothers whose children had suffered from child abuse at an average of 5 1/2 years previously was compared with a group of mothers of similar social class where there had been no reported instances of abuse of their children. There was no significant difference between the two groups with regard to marital, housing, or financial problems or in physical health. Statistically significant differences were found between the abuse and comparison group mothers in the following areas: the abuse group mothers (1) were less likely to have been brought up by their own parents; (2) had more negative feelings towards their fathers; (3) were more likely to have received help for an emotional disorder; (4) had higher expectations for their children; (5) perceived a greater number of personality problems in their children; and (6) were more likely to have assertive, demanding, and suspicious personality traits. It is possible that these maternal factors will influence the emotional development of their children. PMID- 3965234 TI - Effects of age and sex on piroxicam disposition. AB - Piroxicam kinetics were studied after a single, oral, 20-mg capsule was taken by 12 young (six women, six men) and 13 elderly (seven women, six men) healthy subjects. Plasma samples were drawn for 216 hr after dosing. Plasma protein binding was studied in vitro by equilibrium dialysis and piroxicam concentrations were measured by HPLC with ultraviolet detection. The apparent volume of distribution was smaller in elderly women (7.8 +/- 0.4 l) than in young men (11.3 +/- 0.3 l) and elderly men (10.8 +/- 0.8 l). There were no such differences when the apparent volume of distribution was normalized for total body weight. There was a strong correlation between total body weight and apparent volume of distribution in all subjects (r = 0.83). Plasma protein binding of piroxicam ranged from 98.90% to 99.54% bound and was not affected by age or sex. Piroxicam body clearance in elderly women (0.026 +/- 0.002 ml/min/kg) was approximately 33% lower than in young women (0.039 +/- 0.003 ml/min/kg). This difference was reflected in different t1/2s of 61.7 and 44.9 hr. Predicted steady-state plasma piroxicam concentrations were 5.7 micrograms/ml in young women, 5.4 micrograms/ml in young men, 5.7 micrograms/ml in elderly men, and 9.3 micrograms/ml in elderly women. The high value in elderly women results from the lower piroxicam body clearance and total body weight. Our data suggest that healthy elderly women eliminate piroxicam at a slower rate than healthy young women. The clinical significance of these data needs to be assessed in patients. PMID- 3965235 TI - Effects of age on meperidine disposition. AB - Elderly patients appear to be more sensitive to meperidine than younger ones; however, the contributions of altered dynamic and kinetic factors are not clear. Accordingly, seven healthy normal men aged 60 to 79 yr were simultaneously given 25 mg meperidine HCl intravenously and the same dose of deuterium-labeled drug either orally or intramuscularly (deltoid). Blood and urine samples collected over 24 hr were analyzed by gas chromatography-mass spectrometry and kinetic data were compared to those previously obtained in a young cohort. Systemic clearance (8.61 +/- 2.22 ml/min/kg), apparent oral clearance (17.5 +/- 5.5 ml/min/kg), terminal t1/2 (6.98 +/- 1.86 hr), and the blood/plasma concentration ratio (0.97 +/- 0.12) in the elderly did not differ from those in younger subjects. In the elderly, however, the initial (2.4 +/- 0.8 l/kg) and the steady-state (4.6 +/- 0.9 l/kg) volumes of distribution were 300% and 135% values in the young. No age differences were found in absorption profiles or bioavailability after oral (F = 0.49 +/- 0.08) or intramuscular (F = 0.94 +/- 0.04) dosing. It appears that age related alterations in drug disposition per se do not account for changes in clinical efficacy of meperidine in the elderly. PMID- 3965236 TI - Kinetics of intravenous and oral pentoxifylline in healthy subjects. AB - The kinetics of a sustained-release formulation of pentoxifylline were compared with those of a capsule and an intravenous infusion. Ten healthy subjects received each of the oral pentoxifylline formulations (400 mg) three times a day for 9 days in a random crossover fashion. Pentoxifylline (200 mg) was also given intravenously on a separate day. After intravenous pentoxifylline, plasma levels declined in a biphasic manner, with a terminal t1/2 of 1.63 +/- 0.8 hr. Plasma clearance was 1333 +/- 481 ml/min and the volume of distribution was 168 +/- 82.3 l. Cumulation of pentoxifylline in plasma after repeated dosing was minimal. Plasma levels of the active 5-hydroxylated metabolite were generally higher than those of the parent drug after both routes of administration. Urinary excretion of two acid metabolites after oral and intravenous dosing indicated almost complete absorption of drug-related substances from both of the oral formulations, although bioavailability averaged 20% to 30%. PMID- 3965238 TI - Effect of delayed esophageal transit on acetaminophen absorption. AB - Twenty patients awaiting cardiac catheterization swallowed a single tablet containing acetaminophen and barium sulfate. The first 11 subjects swallowed the tablet while supine; its progress down the esophagus was followed by fluoroscopy. In 10 of these subjects, transit of the tablet was delayed in the esophagus. The other nine subjects swallowed the tablet while standing; it entered the stomach immediately. The plasma concentration profile of acetaminophen was measured in all subjects. When there was delayed esophageal transit of tablets, the initial absorption of acetaminophen (measured as the AUC over the first 60 min) was lower than that after normal esophageal transit of tablets. The peak plasma acetaminophen concentration was also lower and occurred on average 70 min later when transit was delayed. These kinetic changes decrease the effectiveness of acetaminophen as an analgesic. We recommend that, to ensure rapid and complete drug absorption, patients be advised to swallow tablets with a large amount of water while standing. PMID- 3965239 TI - Distribution of alpha interferon in serum and cerebrospinal fluid after systemic administration. AB - After intravenous infusion of recombinant leukocyte interferon (rIFN-alpha A) to four subjects with an indwelling reservoir, serial serum and cerebrospinal fluid samples were taken over 48 hr and were analyzed for interferon by an enzyme immunoassay method (ELISA). On separate occasions, 18 and 50 X 10(6) of rIFN alpha A were infused over 10 min. Maximum serum concentrations of rIFN-alpha A ranged from 6720 to 11,000 pg/ml and from 32,900 to 43,400 pg/ml after the 18 and 50 X 10(6) U doses. There was no measurable concentration of rIFN-alpha A in the cerebrospinal fluid of subjects who received 18 X 10(6) U doses. In three of four subjects who received 50 X 10(6) U rIFN-alpha A, concentrations ranged from 17 to 70 pg/ml that were measurable no earlier than 1 hr after the start of the infusion and that in two cases were measurable throughout 24 hr. PMID- 3965237 TI - Effect of heparin on digitoxin protein binding. AB - Reduction of digitoxin binding to plasma proteins after heparin has been reported. Our aim was to determine whether this reduction is an in vivo effect or occurs only after blood collection as a result of heparin-induced lipolysis that increases levels of nonesterified fatty acids in vitro. The effect of heparin on digitoxin protein binding was studied in 10 patients undergoing hemodialysis receiving digitoxin maintenance therapy. Digitoxin free fraction increased after heparin, from 2.5% +/- 0.7% to 4.4% +/- 1.1%, but after inhibition of in vitro lipolysis with diethyl p-nitrophenyl phosphate (2mM), a potent lipase inhibitor, there was no increase in the free fraction (2.3% +/- 0.4% before heparin and 2.4% +/- 0.5% after heparin). Digitoxin salivary levels were also unchanged (0.41 +/- 0.08 ng/ml before heparin and 0.41 +/- 0.08 ng/ml after heparin [n = 8]). These data indicate that the binding of digitoxin to plasma proteins in vivo is not altered by heparin. The reduced binding reported elsewhere was a result of heparin-induced in vitro lipolysis. PMID- 3965240 TI - Plasma concentrations and metabolic effects of intravenous sodium dichloroacetate. AB - Eleven healthy subjects received five doses of intravenous sodium dichloroacetate (DCA) at 2-hr intervals. Determinations of DCA in plasma and of lactate and glucose in blood were made at various times until 24 hr after starting the first infusion. Twenty-four-hour urinary oxalate excretion was also measured. DCA levels rose and fell during and after each dose, with higher levels induced by higher doses. Lactate levels fell as the result of DCA treatment, with greater falls after higher doses, and returned to normal after 24 hr at the two lower dose levels but not at the level of 50 mg/kg. Lactate levels did not change parallel to changes in DCA levels. Only the doses of 50 mg/kg prevented postprandial rises in lactate levels. Blood glucose levels were not altered. The mean DCA t1/2 after the initial doses was 63.3 min (range 15.0 to 112.2 min), while that after the final doses was 374.0 min (range 37.8 to 1386.0 min). The AUC and the DCA-induced increase in urinary oxalate excretion were linearly related to dose. Mean DCA apparent volume of distribution was 0.30 l/kg (range 0.09 to 0.60 l/kg). PMID- 3965241 TI - Cimetidine and/or antacid for the control of gastric acidity in pediatric burn patients. AB - A retrospective study was performed to assess the therapeutic efficacy of cimetidine and antacid, alone and in combination, for the control of gastric acidity and bleeding in pediatric burn patients. The frequency of pH values no greater than 3.5 was significantly greater in the cimetidine group than in the antacid group, and the combined regimen did not enhance the effectiveness of therapy. In all groups, pH values no greater than 3.5 were associated with a significantly higher incidence of positive guaiac tests. In four patients studied prospectively, 63% of the administered dose was detected in the urine 8 h later, compared to the previously reported 24-h delay for normal, healthy adults. Rapid clearance of cimetidine might explain the decreased efficacy of this drug in burn patients. Dosage and schedules for antacid prophylaxis in pediatric burn patients require further study. PMID- 3965242 TI - Adult respiratory distress syndrome associated with miliary tuberculosis. AB - Three patients with respiratory failure resulting from miliary tuberculosis had a characteristic clinical presentation that included a long history of a prominent cough, dyspnea, weight loss, tachycardia, tachypnea, pulmonary adventitious sounds, and hepatomegaly. Hematologic investigation showed a normal white cell count with marked left shift in the morphology of white cells in all three patients, and evidence of disseminated intravascular coagulation in one patient. In only one patient was the initial sputum positive for acid-fast bacilli; in the others, invasive diagnostic procedures including lumbar puncture, bone marrow trephine, and open-lung biopsy were necessary for diagnosis. Miliary tuberculosis should be suspected in patients with adult respiratory distress syndrome of unknown etiology. Simple diagnostic procedures such as sputum, bronchial brushings, and urine examination should be followed by bone marrow trephine, liver biopsy, transbronchial lung biopsy, and lumbar puncture if physical signs of meningitis are present. PMID- 3965243 TI - Treatment of severe hypophosphatemia. AB - A 4-h infusion of 310 to 465 mg (10 to 15 mMol) phosphorus given to 28 of 31 consecutive seriously ill hypophosphatemic patients increased the serum phosphorus level above 1.2 mg/dl in all but one patient. There was no significant change in the mean serum calcium, potassium or blood pressure, no patient deteriorated, and six patients were stronger and more alert after the infusion. In seriously ill patients we recommend a 4-h infusion of 15 mg/kg (0.5 mMol/kg) phosphorus if the serum phosphorus is less than 0.5 mg/dl, or a 7.7-mg/kg (0.25 mMol/kg) infusion if the serum phosphorus is between 0.5 and 1.0 mg/dl. PMID- 3965244 TI - Magnesium deficiency in a medical ICU population. AB - The serum magnesium level was measured in 94 consecutive patients admitted to the medical ICU of Los Angeles County/University of Southern California Medical Center over a 2-month period. Sixty-five percent of patients with serum creatinine concentrations of 1.1 mg/dl or less were hypomagnesemic. Of these, one third had hypocalcemia that was corrected with magnesium supplementation. Physicians should be alert to the high incidence of magnesium deficiency in critically ill patients. PMID- 3965245 TI - Sequential cardiopulmonary changes after oleic-acid injury in dogs. AB - Oleic acid (OA) administered to experimental animals increases pulmonary vascular permeability and produces a condition that pathophysiologically resembles adult respiratory distress syndrome (ARDS) in humans. The present study examined the sequence of cardiorespiratory changes after OA infusion and their similarity to ARDS. After a baseline period, mechanically ventilated and anesthetized dogs were administered 0.18 ml/kg body weight OA into the pulmonary artery while hemodynamic and respiratory changes were monitored. After OA infusion, cardiac output fell by 39%, paralleling a 26% decrease in heart rate. Pulmonary vascular resistance (PVR) increased over 200% without a change in pulmonary capillary wedge pressure and initially without an increase in pulmonary artery pressure (PAP). Within 30 min after OA infusion, dynamic pulmonary compliance (Cdyn) was reduced 32% from baseline values, with a coincident increase in the alveolar arterial PO2 gradient (P[A-a]O2) but without a significant change in the pulmonary shunt fraction (Qsp/Qt). This was followed in 30 min by a further 27% decrease in Cdyn, with a Qsp/Qt in excess of 50%. Both the hematocrit and hemoglobin concentration increased progressively after OA infusion, without a change in plasma protein concentration. The results suggest that the sequence of cardiopulmonary changes after OA injury are initially marked by a decrease in Cdyn and an increase in PVR and P(A-a)O2. This is followed by an increase in Qsp/Qt, PAP, hemoglobin concentration and PCO2. The changes appear related to progressive flooding of the alveolar air space with edema fluid. These findings parallel the sequential cardiorespiratory changes reported to occur in ARDS. PMID- 3965247 TI - Single-breath measurement of lung mechanics in very low birth weight infants. AB - The expiratory time constant of the respiratory system (Trs) and the total respiratory system compliance (Crs) were measured from the analysis of a flow volume loop during relaxed expiration, and the total respiratory system resistance (Rrs) was derived from the relationship: Rrs = Trs/Crs. In ten intubated and mechanically ventilated very low birth weight infants, the values obtained for compliance (0.21 to 0.71 ml/cm H2O) were similar to those found using an occlusion technique during spontaneous breathing. The values of Trs were 0.03 to 0.14 sec. These Trs values were altered by adding known resistive loads. The corresponding derived values for Rrs were close to the values of the added resistance loads, suggesting that resistance values found in this group of ventilated babies (120 to 380 cm H2O/L X sec) were accurate. PMID- 3965246 TI - Efficacy and safety of naloxone in septic shock. AB - We evaluated the effectiveness and safety of iv naloxone in 12 septic patients who remained hypotensive despite volume replacement, appropriate antibiotics, and vasopressor therapy. Only four patients responded positively to naloxone, by increases in mean arterial pressure of between 10 to 15 mm Hg that lasted for 15 to 60 min. These patients could not be distinguished from the others on the basis of underlying illness, laboratory or physical findings, length of preceding hypotension, or glucocorticoid therapy. Four patients had adverse reactions: one developed pulmonary edema, one patient had a grand-mal seizure, and two patients became severely hypotensive. We conclude that in patients with well-established septic shock, naloxone does not reliably improve mean arterial pressure or other physiologic variables, and may cause severe adverse reactions. PMID- 3965248 TI - Treatment of nonocclusive mesenteric infarction after cardiopulmonary resuscitation. AB - Nonocclusive mesenteric infarction is a potentially lethal complication that may follow successful resuscitation of cardiopulmonary arrest. This case demonstrates that the manifestations may be delayed and that urgent surgical intervention may be lifesaving despite the precarious status of these patients. Vigilance for several days is mandatory. PMID- 3965250 TI - Accuracy of the metabolic gas monitor. PMID- 3965249 TI - ICU physician's ethical role in distributing scarce resources. AB - Of several schemes designed to ration scarce resources in the ICU, implicit rationing (i.e., by society at the macro level of resource input) and explicit rationing (i.e., by society at the level of bedside cost output) have the fewest ethical defects. The former (of which the British National Health Service is an example) threatens the traditional loyalty and honesty between physician and patient, and in the USA would probably transfer legal responsibility for any harm done by rationing from government to physician. The latter, structured in a form analogous to the American judicial system, identifies and leaves intact the respective responsibilities of state, physician, and patient, does not co-opt physicians into the bureaucracy, and encourages them to remain their patients' trustworthy advocates. As a basis for discussion, the public-policy statement offered above details at the macro and micro levels what is judged to be an ethically adequate position for the ICU physician facing this problem today. PMID- 3965251 TI - CVP dressings. PMID- 3965252 TI - Prevention and treatment of postoperative atelectasis. Can it and will it be adequately studied? PMID- 3965253 TI - Nicotine: a different approach to treatment of obstructive sleep apnea. AB - Reduced upper airway muscle activity may contribute to the occurrence of obstructive apneas during sleep. There is no uniformly successful treatment of these apneas, and it is possible that agents which increase upper airway muscle activity could reduce the occurrence of obstruction during sleep. Nicotine, a known stimulant of breathing, also increases the activity of muscles which dilate the upper airway proportionally more than it does ventilation. Hence, we evaluated the effect of nicotine on apneas during the first two hours of sleep in eight patients with sleep apnea syndrome. It was concluded that nicotine reduces apneas during the early hours of sleep, and this effect may be caused by its stimulating action on upper airway muscles. PMID- 3965255 TI - Underdrive suppression of the sinus rhythm in man. AB - This report demonstrates unusual responses of the sinus rhythm to atrial pacing. The sinus rhythm failed to become manifest when the heart was driven at a rate slower than the inherent sinus rate. Sinus rhythm returned only after termination of underdrive pacing with the recovery time longer than twice the cycle length of the control sinus rhythm. The largest difference between underdrive and sinus cycle lengths measured 600 msec. To the best of our knowledge, underdrive suppression of the sinus rhythm has not been previously reported in man. PMID- 3965254 TI - Sotalol infusion in the treatment of supraventricular tachyarrhythmias. AB - Sotalol, a noncardioselective beta-adrenergic blocking agent without partial agonist activity, has class-3 antiarrhythmic effects. Twenty-nine patients with supraventricular tachyarrhythmias were treated on 31 occasions to determine the effective therapeutic dosage and optimal method of administration. Fifty percent of patients with paroxysmal supraventricular tachycardia, 33 percent of those with atrial flutter, and 20 percent with atrial fibrillation were restored to sinus rhythm by bolus administration; and when sotalol was given by continuous infusion, sinus rhythm was obtained in 100 percent, 86 percent, and 33 percent, respectively. Comparable dosages were given to both responders and nonresponders in the bolus-treated group and higher dosages to nonresponders than to responders in those treated by infusion. Furthermore, plasma levels in nonresponders tended to be higher than in responders. When responders alone were considered, the average dose required was 0.630 +/- 0.090 mg/kg of body weight (+/- SE), and the plasma level obtained was 0.526 +/- 0.088 microgram/ml. No relationship between plasma levels and therapeutic effectiveness was shown. No serious side effects were observed at the dosages used. These data suggest that while no concordance with plasma levels was observed, sotalol given by infusion is an effective therapy for atrial flutter and supra-ventricular tachycardia. It is less effective in atrial fibrillation, where less than half were responders, but a satisfactory reduction in ventricular rate response was obtained. A controlled trial to further substantiate these findings is indicated. PMID- 3965256 TI - Kaposi's sarcoma of the tracheobronchial tree. Clinical, bronchoscopic, and pathologic features. AB - Two homosexual men with disseminated Kaposi's sarcoma presented with paroxysms of a nonproductive cough probably related to the presence of tumor in the airways. At bronchoscopy, multiple, flat, brightly red to violaceous lesions were seen throughout the tracheobronchial tree. In both patients the bronchial biopsies were nondiagnostic, and one patient had excessive bleeding after the procedure. Autopsies confirmed the presence of Kaposi's sarcoma in the trachea and bronchi. The bronchoscopic appearance of Kaposi's sarcoma of the tracheobronchial tree is characteristic, and bronchial biopsy is probably unnecessary when the diagnosis of Kaposi's sarcoma has already been made by biopsy of more accessible lesions. Furthermore, bronchial biopsy may be hazardous because of excessive bleeding. PMID- 3965257 TI - A "saw-tooth" pattern in Parkinson's disease. AB - A patient with severe Parkinson's disease had a maximum inspiratory and expiratory flow-volume loop showing a "saw-tooth" pattern. It is concluded that this sign is not specific for the sleep apnea syndrome. PMID- 3965258 TI - An unusual thromboembolic complication of a Greenfield vena caval filter. AB - The Greenfield inferior vena caval filter is highly effective in preventing recurrent pulmonary embolism and is associated with a low incidence of complications. We have recently seen a patient with the unusual finding of recurrent pulmonary embolism due to extension of thrombus from the surface of a Greenfield filter. The proximal extension of thrombus from a partially obstructed filter is documented by venacavogram. The proposed mechanism is discussed and principles of management are reviewed. PMID- 3965259 TI - Bronchoalveolar lavage in lymphangitic spread of adenocarcinoma to the lung. AB - We report the results of bronchoalveolar lavage in a patient who had pulmonary lymphangitic spread of adenocarcinoma from an unknown primary. The lavage specimen was remarkable for a large increase in the number of lymphocytes. This observation extends the differential diagnosis of a lymphocyte-predominant lavage specimen. The recovery of large numbers of lymphocytes associated with malignancy in this case suggests that bronchoalveolar lavage may also be useful to study aspects of the immune response to interstitial lymphangitic spread of malignancy to the lung. PMID- 3965260 TI - Local immunopathologic findings in bronchiolitis associated with collagen vascular diseases. PMID- 3965261 TI - Spectrum of advanced upper airway obstruction due to goiters. AB - Five patients with advanced upper airway obstruction due to goiter were identified in our institution. All had symptoms of respiratory insufficiency to such a degree that surgery was clearly indicated. Functional characteristics of this group were compared with prior series of goiter patients who had less severe respiratory symptoms. A peak inspiratory flow less than 1.5 L/sec characterized this group who required surgery. PMID- 3965262 TI - Prognostic significance of field response in out-of-hospital ventricular fibrillation. AB - We reviewed 94 cases of prehospital ventricular fibrillation (VF) to determine aspects of field response that predicted outcome. Only one of 37 patients (3 percent) failing to achieve rhythms other than VF or asystole after the first two defibrillations survived to hospital discharge compared to nine of 57 (16 percent) achieving organized rhythms by this point (p less than 0.05). None of 56 patients failing to achieve pulses prior to transport survived to hospital discharge compared to ten of 38 achieving field pulses (p less than 0.01). However, survival to discharge was not significantly different between patients who developed pulses immediately with their rhythms (5 of 17, 29 percent) and those who were defibrillated into pulseless rhythms but later developed pulses in the field (five of 21, 24 percent). Thus, for prehospital VF, the best field response identifies potential survivors prior to hospital arrival. In addition, the frequent occurrence and potentially favorable outcome of an initially pulseless rhythm necessitates reevaluation of current therapy. PMID- 3965264 TI - Modems and the M.D. The microcomputer as a communications tool. PMID- 3965263 TI - Prevalence of depression and anxiety in patients with COPD. Relationship to functional capacity. AB - The objective of this study was twofold: (1) to document the prevalence of depression and anxiety in patients with moderate or severe chronic obstructive pulmonary disease; and (2) to determine whether the presence of depression or anxiety adversely affected the functional capabilities of the patient as reflected by the distance he could walk in 12 minutes. Forty-five patients with an FEV1 less than 1,250 ml underwent pulmonary function testing including spirometry, single breath diffusing capacity, and arterial blood gas determinations. The degree of depression was assessed by the Beck depression inventory, while the degree of anxiety was assessed by the State-Trait anxiety inventory. Forty-two percent of the patients had significant depression, while only 2 percent of the patients had significant anxiety. There was a highly significant correlation between the depression scores and the anxiety scores (r = 0.81, p less than 0.001). There was no significant correlation between the level of depression or anxiety and the distance that the patient could walk in 12 minutes. From this study, we conclude that the prevalence of depression in patients with moderate or severe COPD approaches 50 percent while the incidence of anxiety is much lower (2 percent). PMID- 3965265 TI - A familial dilated cardiomyopathy associated with cataracts and hip-spine disease. AB - A dilated cardiomyopathy was observed in two generations of a kindred, associated with articular disease and premature cataracts, a unique triad not previously described to our knowledge. The cardiomyopathy was characterized histologically by basophilic PAS-positive granulofilamentous deposits in the myocardium. The articular disease included hip joint degeneration, irregular intervertebral disks, and platyspondyly. The lenticular abnormalities may occur in young adults prior to other manifestations of the triad. Consanguinity was noted in the parents, and inheritance was most compatible with an autosomal recessive trait, with variable penetrance and expressivity. PMID- 3965266 TI - Inspiratory muscle conditioning using a threshold loading device. AB - We demonstrate the effectiveness of a new conditioning technique for increasing the strength and endurance of the inspiratory muscles. The technique employs a threshold loading device which allows for maximization of exercise intensity with a minimum of exercise duration. After ten weeks, with approximately 25 minutes of exercise time per week, four test subjects showed an average increase in maximum inspiratory pressure (PImax) of 50 (+/- 9 SD) cm H2O (p less than 0.02), whereas four control subjects undergoing submaximal inspiratory muscle exercise showed no significant change. The time the test subjects could endure 65 percent of their prestudy PImax increased from an average of 3.58 +/- 1.65 SD min to over 10 min in all four subjects. No significant change was seen in control subjects. Further testing showed the test subjects could endure 100 percent of their prestudy PImax after conditioning for an average duration 5.15 +/- 1.65 min. This technique should be useful for conditioning the inspiratory muscles in subjects with pulmonary disease. PMID- 3965267 TI - Widened E point septal separation in a normal pediatric population. AB - To determine the age and gender distribution of the E point septal separation (EPSS), M-mode echocardiograms were obtained from 121 normal subjects aged four months to 82 years. A small but consistent age factor was found. In subjects less than age 20, EPSS was 3.0 +/- 2.6 mm, whereas in those greater than 20 years, EPSS was 1.4 +/- 1.8 (p less than .001). In females EPSS did not vary appreciably at different ages. By contrast, in males EPSS increased with age, peaking between ages 15 and 19 and then decreasing. Between ages 10 and 19, EPSS was significantly wide in males than in females. Thus, EPSS is wide in male adolescents than in adults. The cause for this phenomenon is unclear, but judging from its age and gender distribution, it may be related to the effect of androgens on the myocardium. PMID- 3965268 TI - Cerebral protection: pathophysiology and treatment of increased intracranial pressure. PMID- 3965270 TI - Effect of metoclopramide on gastric liquid emptying in patients with diabetic gastroparesis. AB - Metoclopramide tablets have been approved for use in the acute and chronic management of diabetic gastroparesis. Its efficacy as an antiemetic has been well documented. We measured the acute and chronic effects of oral metoclopramide on gastric liquid emptying in 12 diabetic patients with symptoms of stasis using scintiscanning techniques. We found that liquid emptying in these subjects was abnormal, as determined by residue area determination when compared to normal volunteers (P less than 0.01). Metoclopramide 10 mg orally acutely enhanced emptying, restoring it to control values (P less than 0.01). In contrast, when gastric emptying was evaluated following one month of chronic liquid metoclopramide use, 10 mg before each meal, the acute effect of the drug on emptying could no longer be demonstrated and residue areas returned to baseline values, suggesting that chronic oral administration of metoclopramide may result in a loss of the gastrokinetic properties of this drug. PMID- 3965269 TI - Acute and chronic effects of domperidone on gastric emptying in diabetic autonomic neuropathy. AB - Gastric emptying was studied with a double radioisotopic method in 12 patients with insulin-dependent diabetes mellitus complicated by autonomic neuropathy and in 22 control subjects. In the diabetics, the acute and chronic effects of oral domperidone on gastric emptying, symptoms of gastroparesis, and glycemic control were assessed. Gastric emptying of solid and liquid was slower in diabetics than controls (P less than 0.001). Acute administration of domperidone increased the rate of both solid and liquid emptying (P less than 0.005). Domperidone was most effective in those patients with the greatest delay in gastric emptying. After chronic administration (35-51 days), domperidone had no significant effect on solid emptying (P greater than 0.05), but was still effective in increasing liquid emptying (P less than 0.025). Symptoms of gastroparesis were less after domperidone (P less than 0.001). PMID- 3965271 TI - Abnormalities of interdigestive motility complex and increased duodenogastric reflux in gastric ulcer patients. AB - Just as cyclic changes in motility and secretions occur during fasting, recent evidence demonstrates that duodenogastric reflux during fasting is also cyclic and related to the motility and secretory variations. We investigated the characteristics of the migrating motility complex and duodenogastric reflux in 17 patients with gastric ulcer and compared these characteristics to those of 16 healthy subjects. We found three abnormalities of the complex in patients with gastric ulcer: (1) the antral motility was significantly decreased during the phase II of the complex (P less than 0.05) when compared to controls; (2) in about two thirds of them, the phase III of the complex was initiated at the duodenum or more distally; and (3) the mean bile salt concentration in the gastric aspirate was significantly higher (P less than 0.05) than that of the controls. We observed no relationship between the ulcer activity, the location of the crater, and the motility or reflux abnormalities. PMID- 3965272 TI - Studies on mechanism of retching and vomiting in dogs. Effect of peripheral dopamine blocker on myoelectric changes in antrum and upper small intestine. AB - In five conscious dogs prepared with a gastric cannula and platinum monopolar electrodes in the antrum, duodenum, and jejunum, the effect of dopamine or copper sulfate on the myoelectric activity was studied. During phase I of interdigestive myoelectric activity, retching, and/or vomiting occurred in 1.6 +/- 0.2 (mean +/- SE) min after intravenous bolus injection of dopamine (50 micrograms/kg) or in 8.7 +/- 1.8 min after intragastric administration of copper sulfate (2%, 50 mg). Immediately prior to the retching and/or vomiting act, a group of disordered myoelectric activities occurred, including retrograde-moving trains of spike activity starting from the jejunum and the subsequent tachyarrhythmia in the antrum. These motility changes also occurred in the two anesthetized dogs so studied. Both the retching and/or vomiting act and the abnormal myoelectric activity which were induced by dopamine and by copper sulfate were prevented by intravenous administration of a peripheral dopamine blocker, domperidone, 5 mg, in 100% and 70%, respectively. Although domperidone could not prevent the retching and/or vomiting induced by copper sulfate in three of 10 experiments, it delayed the onset of vomiting from 8.7 +/- 1.8 to 14.5 +/- 5.3 min. A possible role of peripheral dopamine receptor on the motility disorders associated with retching and/or vomiting has been suggested. PMID- 3965273 TI - Increased colonic motility during exposure to a stressful situation. AB - Colonic smooth muscle spike potentials and contractility were recorded during the periods of stress by a bipolar electrode-perfused catheter apparatus placed in the rectosigmoid colon. Healthy subjects and patients with the irritable colon syndrome (ICS) were exposed to three standardized stressful conditions: (1) ice water immersion, (2) Stroop stimulus differentiation test, and (3) ball sorting. In healthy controls, colonic motility increased after the first exposure to ice water immersion (P less than 0.05), Stroop test (P less than 0.05), or ball sorting. Respiratory frequency also increased after exposure to the stressful stimuli. However, repeat exposures to the stress tests did not stimulate colonic motility. An increase in colonic motility occurred in patients with the irritable colon syndrome pretreated with a placebo after exposure to ice water (P less than 0.05), Stroop Test, or ball sorting (P less than 0.05). However, after exposure to the stressful situations patients pretreated with chlordiazepoxide had a diminished increase in colonic motility or in respiratory frequency. These studies suggest: (1) in healthy controls habituation reduces the stress-related increase in colonic motility, and (2) in patients with the irritable colon syndrome, chlordiazepoxide decreases the stress-related increase in colonic motility. PMID- 3965274 TI - Gastric emptying and pancreatic polypeptide response to carbohydrate meals. AB - This study examined pancreatic polypeptide responses to isocaloric meals of radioactively labeled glucose or starch in six normal and seven vagotomized subjects. Liquid glucose meals were ingested with the subject both erect and supine and starch meals were ingested in the upright posture as a solution and as solid balls. In normal subjects, each meal left the stomach at a similar rate and the resultant pancreatic polypeptide responses were not significantly different from one another. Emptying rates varied markedly in vagotomized subjects depending upon the physical consistency of the carbohydrate ingested and the patient's posture. Despite these differences, pancreatic polypeptide responses to each meal were almost identical. These studies demonstrate that the pancreatic polypeptide response to carbohydrate meals is still present several years after vagotomy and is unaffected by alterations in the rate of gastric emptying after vagotomy and by the physical consistency and chemical nature of the carbohydrate ingested. PMID- 3965275 TI - Effects of chronic alcohol abuse on exocrine pancreatic secretion in man. AB - The effect of chronic alcohol abuse on the secretion of pancreatic exocrine proteins was studied. Pure pancreatic juice (PPJ) was obtained by endoscopic cannulation of the pancreatic duct from 21 healthy, nonalcoholic volunteers and 25 chronic alcoholics. Peak concentration and output of total proteins after sequential stimulation with secretin and cholecystokinin was elevated significantly in chronic alcoholics when compared to nonalcoholic subjects. The most striking change in the secretory proteins investigated was exhibited by the trypsinogens. Although the concentrations of all three trypsinogen variants were elevated significantly in PPJ of chronic alcoholics, most of the increase resulted from an approximately fivefold increase of the anionic variant, suggesting nonparallel alterations in the synthesis of pancreatic exocrine proteins. Whereas the ratio of cationic-anionic trypsinogen in the control group was consistently greater than one, it was, without exception, below one in the chronic alcoholics group. As there was no significant increase in trypsin inhibitor in PPJ of alcoholics, the ratio of trypsinogen-trypsin inhibitor showed a highly significant increase in this group. This distortion of the normal ratio in favor of trypsinogen may facilitate premature activation of pancreatic zymogens as postulated in acute pancreatitis. The concentrations of other zymogens and lysosomal hydrolases in PPJ of chronic alcoholics showed small, but not significant, increases, with the exception of leucine naphthylamidase which was significantly elevated. Nonparallel secretion of some exocrine proteins previously described in healthy nonalcoholic subjects was affected selectively by chronic ethanol ingestion. Thus, in chronic alcoholics the secretory kinetics of trypsinogen and chymotrypsinogen were altered, but trypsin inhibitor secretion remained apparently unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965276 TI - Effect of pancreatic secretions on transit in bypassed loops of intestine in rats. AB - The influence of intraluminal infusions of saline and a pancreatic juice-bile salt mixture on transit was determined in bypassed segments of intestine in rats. Animals underwent bypass of 70% of their jejunoileum and insertion of a catheter into the proximal end of the bypassed segment. After recovery from operation, each animal was placed into a harness that allowed free movement while fluids could be infused into the bypassed segment. Beginning on the first postoperative day, the bypassed loops were infused with either saline or a pancreatic juice bile salt mixture. Transit in these animals was determined on the third day after operation. Other animals received no infusions and were tested either on the third or the 35th day after operation. Animals that received no infusions had low rates of transit when tested either in the fasted or fed condition three days after operation. Saline infusions resulted in a slight increase in transit in fasted animals only. Transit rates were increased to a greater degree following infusion of the pancreatic juice-bile salt mixture than with saline, especially in fasted animals in whom the rates approached those seen in the uninfused, fasted animals that were tested 35 days after operation. These findings are consistent with the hypothesis that the reduced transit seen in the bypassed loops of rats three days after operation may be due to intestinal contents characterized by deficiencies in pancreatic juice and bile salts. PMID- 3965277 TI - Stimulation of gastric acid secretion in the rhesus monkey. AB - Similar maximal rates of gastric acid secretion are achieved with histamine and gastrin stimulation in human, dog, or cat, but gastrin produces higher rates than histamine in the rat. Gastric acid secretion was measured in seven nonsedated, alert, chaired rhesus monkeys (Macaca mulatta). Dose-response studies were performed using intravenous histamine or tetragastrin. These studies showed histamine to be a much more efficacious and more potent stimulant of gastric acid secretion than tetragastrin in the monkey. Both histamine and tetragastrin had similar potency and efficacy in the dog, while tetragastrin, pentagastrin, and hog heptadecapeptide were similarly less active than histamine in the monkey. Background carbachol (4 micrograms/kg/hr) did not affect the histamine or tetragastrin dose-response curves. Histamine stimulation with background tetragastrin (64 micrograms/kg/hr) did not produce a dose-response curve statistically different from histamine alone. Tetragastrin stimulation with background histamine (60 micrograms/kg/hr) increased the tetragastrin dose response curve, with a probable additive effect. We conclude that the rhesus monkey differs from cat, dog, and man in that gastrin and its analogs are not able to stimulate maximal acid secretion to the level achieved by histamine. PMID- 3965278 TI - Unilateral pleural effusion without clinical ascites in Laennec's cirrhosis. PMID- 3965280 TI - [Thr role of antacids in modern ulcer therapy]. PMID- 3965279 TI - [Acute myocardial infarct in a metropolitan area]. AB - In a retrospective study the course of acute myocardial infarction was investigated in 1840 patients treated in 1980 in eleven Hamburg hospitals (90% of hospitals admitting emergencies). 71% of patients were over 60 years of age, infarction frequency reached its peak in the eighth decade. Compared to prior investigations the percentage of women was higher both as a whole and in patients over 70 years of age (ratio men to women = 1.8 : 1). In comparison with the overall population of Hamburg, infarction rate was not increased in certain social classes. Frequency of "silent" infarctions was 4 to 5 times higher in patients of 70 years of age than in younger ones. Left ventricular failure and conduction disturbances increased with age, while extrasystoles occurred at all ages without difference. Hospital mortality of acute infarction was 29% for men and 37% for women. Striking results are the higher mortality of younger women and the considerable increase of mortality in patients over 70 years of age, probably due to change of age structure, the large number of acute reinfarctions (29%), and the short admission time. 40% of patients of all age-groups were admitted within 3 hours after onset of infarction. PMID- 3965281 TI - Abstracts of the sixteenth annual meeting of the Environmental Mutagen Society. Las Vegas, Nevada, February 25-March 1, 1985. PMID- 3965282 TI - Measles immunity in children before one year of age: a pilot study. PMID- 3965283 TI - Pregnancy in Ethiopian diabetic women. PMID- 3965284 TI - Multiple sclerosis--a case report on an Ethiopian. PMID- 3965285 TI - The Kellersberger memorial lecture, 1984. Chemotherapy of leprosy--a tool for leprosy control. PMID- 3965286 TI - Diagnosis and treatment of haemorrhage and shock in musculoskeletal trauma. PMID- 3965288 TI - Cell growth, cell division and cell size homeostasis in Swiss 3T3 cells. AB - By separating large and small 3T3 cells we show here that cell growth (in volume) after stimulation from quiescence is not 'autocatalytic'. Rather, large cells grow significantly more slowly, in relative terms, than small cells. It follows that 3T3 cells do not require a size control mechanism operating at the level of division timing in order to achieve cell size homeostasis. PMID- 3965287 TI - Epidemiology of maternal mortality in Addis Ababa: a community-based study. PMID- 3965289 TI - Equilibrium-driven mechanism for preferential adhesion between chick embryo cells. AB - The experiments presented here confirm the hypothesis according to which, in our experimental system of differential cell adhesion (where we studied the kinetics of the earliest period of adhesion of a suspension of chick embryo neuroblasts to layers of astroblasts or fibroblasts), the mechanism of adhesion appears to consist of two steps, the first of which is a short-term reversible phase corresponding to a binding equilibrium. In fact, adhesion of neuroblasts to each of the two cell layers occurs according to kinetic constants and attains levels which are characteristic for each of the two adhesion systems. In both systems, neuroblasts that have not adhered at equilibrium are able to adhere if inoculated over a fresh cell layer of the same type, as they do during the first inoculation; conversely, neuroblasts that have adhered to a cell layer can be made to de-adhere by substituting cell-free fresh medium to the inoculation medium containing non-adhering neuroblasts. This shows that, as predicted for a reversible equilibrium system, removal of adhering neuroblasts from the system at equilibrium provokes adhesion, and removal of non-adhered neuroblasts provokes de adhesion. Furthermore the level of adhesion at equilibrium is, in all cases, the same. The reversibility of adhesion, which is almost quantitative during the onset of the equilibrium, gradually decreases with time, indicating the presence of a process of irreversible attachment between cells after the first reversible step. The developmental implications of the complete sequential mechanisms are briefly discussed. PMID- 3965290 TI - Actin organization during the cell cycle in meristematic plant cells. Actin is present in the cytokinetic phragmoplast. AB - The distribution and organisation of F-actin during the cell cycle of meristematic root-tip cells of Allium was investigated using a rhodamine-labelled phalloidin to stain F-actin in isolated cell preparations. Such preparations could, in addition, be stained for tubulin by immunofluorescence, enabling a comparison between F-actin and microtubule distributions in the same cell. In interphase, an extensive array of actin-filament bundles was present in the cytoplasm of elongating cells, the bundles generally following the long axis of the cell and passing in close proximity to the nucleus. In contrast, the interphase microtubule array occupied the cortex of the cell and was oriented at right angles to the actin bundles. In smaller, isodiametric cells, microfilament arrays were present but less well developed. During cell division, phalloidin specific staining was seen in the cytokinetic phragmoplast, and co-distributed with microtubules at all stages of cell plate formation; however, neither the pre prophase band nor the mitotic spindle were stained with phalloidin. Co distribution of F-actin and microtubules only occurs, therefore, at cytokinesis. The relationship between microfilaments and microtubules is discussed, together with the possible role of actin in the phragmoplast. PMID- 3965291 TI - Isolation of variants of BALB/c 3T3 cells defective in complex ganglioside biosynthesis. AB - In an attempt to clarify the relationship between altered glycosphingolipid metabolism and other aspects of the transformed phenotype, we have isolated variants of BALB/c 3T3 cells (clone A31) which are defective in synthesis of the more complex gangliosides (GM2, GM1 and GD1a). The selection protocol was based on the specificity of cholera toxin for ganglioside GM1, and the ability to lyse cells which bound toxin using anti-toxin and complement. Following treatment of cells with ethane methane sulfonate (EMS), populations resistant to lysis were obtained after 5-6 rounds of selection, despite a low and rather variable killing efficiency (75-95%). Five out of six clones isolated from such populations showed reduced toxin-binding capacity and loss of gangliosides more complex than GM3, as determined by metabolic labelling with [1-14C] palmitate. An identical phenotype was displayed by a variant isolated from a non-mutagenized population of cells. The phenotype remained stable for several months in culture and for over at least 40 cell doublings. Ganglioside nomenclature is according to Svennerholm [24]. PMID- 3965292 TI - Trichocyst phenotype transformation induced by macronuclear transplantation in Paramecium tetraurelia. AB - A portion of the macronucleus of wild-type cells of Paramecium tetraurelia was removed and was injected into cells homozygous for the ftA mutation. The ftA mutants make defective trichocysts and are unable to perform normal trichocyst exocytosis. After injection, approx. 30% of the surviving cells show a phenotype shift from mutant to wild-type. This shift is stable during subsequent vegetative growth until clonal death. If, however, the hybrid cell lines are brought to autogamy (which discards the existing macronucleus and forms a new one from sexual products derived from a micronucleus), then the lines revert to the ftA phenotype. Since micronuclei were not transplanted, the phenotypic reversion after autogamy is to be expected, and demonstrates that the transformation affects the macronucleus only. A second series of injections involved transfer of a portion of the macronucleus from cells homozygous for the trichocyst ptA mutation into ftA host cells. These two mutations are genetically complementary, so the injection should be genetically equivalent to forming a double heterozygote. Approx. 20% of the injection survivors shift to wild-type. This shift is also vegetatively stable unless autogamy occurs; after autogamy, reversion to the ftA phenotype is seen. These results show that a portion of a macronucleus can be successfully transplanted from one cell to another and that, in the host cytoplasmic environment, normal gene expression and replication of a transplanted macronucleus does occur. The technique of macronuclear transplantation is significant to studies of the macronuclear contribution to clonal aging, and to studies on genetic control over trichocyst development. PMID- 3965293 TI - Micromere-specific cell surface proteins of 16-cell stage sea urchin embryos. AB - Evidence is presented of cell-type specificity of surface proteins from the 16 cell stage sea urchin embryo. The protein composition of the micromere cell surface has been examined by 125I labelling of intact cells followed by SDS-PAGE. In Arbacia punctulata, four high molecular weight (HMW) proteins are detected on the surface of isolated micromeres--but not on mesomere-macromere fractions. In Strongylocentrotus droebachiensis, a micromere-specific protein of 133 K molecular weight (MW) was identified. This 133 K protein binds to wheat germ agglutinin (WGA) but not to concanavalin A (conA). Lectin binding was studied using a new technique. The procedure involves the separation, by SDS-PAGE, of iodinated cell-surface proteins followed by their electrophoretic transfer to lectin-coated nitrocellulose membranes. Using this procedure, cell-type-specific surface proteins which are also lectin-binding-specific, were detected. PMID- 3965294 TI - Oscillations in cell shape and size during locomotion and in contractile activities of Physarum polycephalum, Dictyostelium discoideum, Amoeba proteus and macrophages. AB - Changes in cell shape and size were measured during locomotion, together with the motive force of the protoplasmic streaming, in various amoeboid cells in different stages of their life cycle, and under various environmental conditions. The variations in these measurements with time were examined by Fourier spectral analysis. Notwithstanding a change in cell type in the life cycle of P. polycephalum, myxamoebae and tiny plasmodia showed a similar time pattern of locomotion, exhibiting oscillations having a mixture of several periods. A regular oscillation with protoplasmic streaming appeared in the plasmodium only above a critical cell size. D. discoideum amoebae oscillated with two periods of a few minutes in preaggregation stage, but with a period of 10 min in aggregation stage, the latter being induced by cAMP. Macrophages and A. proteus also oscillated with periods of a few minutes. Periods of all these oscillations were prolonged severalfold by respiratory inhibition with NaCN, but were unaffected by glycolytic inhibition with 2-deoxyglucose. Cell fragments of A. proteus containing fewer granules oscillated more slowly and with a larger amplitude than those containing more granules. Among the granules, the nucleus was excluded as a possible modifier of the oscillation. The oscillation in Physarum plasmodium was reversibly suppressed by combining respiratory and ATPase inhibitions in mitochondria with NaCN and oligomycin, intracellular ATP concentration being kept at an appropriate level. The present results show that amoeboid motility, as well as cell shape, is oscillatory and that mitochondria are involved in time keeping. PMID- 3965295 TI - Glicentin is present in the pig pancreas. AB - Specimens from porcine pancreas and ileal mucosa were extracted in acid/ethanol, subjected to gel permeation chromatography, ion-exchange chromatography, enzymatic peptide degradation, reverse-phase HPLC, and analysed for glucagon-like and glicentin-like immunoreactivity by region-specific radioimmunoassays. Results obtained with all methods were consistent with the hypothesis that glicentin is present in the pig pancreas in small amounts. PMID- 3965296 TI - Binding of benzo(a)pyrene to rat lung glutathione S-transferases in vivo. AB - A highly selective in vivo binding of benzo(a)pyrene to rat lung glutathione S transferases is demonstrated. Benzo(a)pyrene or its metabolites are specifically bound to Ya' and Yc subunits of rat lung glutathione S-transferases. PMID- 3965297 TI - Crystal structure study of Opsanus tau parvalbumin by multiwavelength anomalous diffraction. AB - The crystal structure of a small calcium-binding protein, the parvalbumin IIIf from Opsanus tau in which Tb was substituted for Ca, has been analysed by multiwavelength anomalous diffraction. Data at a resolution of 2.3 A were collected at three wavelengths near the L3 absorption edge of Tb (1.645-1.650 A), using the synchrotron radiation emitted by a storage ring and a multiwire proportional counter. The phases of the reflections were determined from this single derivative, without native data. Prior to any refinement, the resulting electron density map shows a good agreement with the model of the homologous carp parvalbumin in regions of identical amino-acid sequence. PMID- 3965298 TI - Heteromeric nature of glucocorticoid receptors. AB - The wild-type and a mutant receptor of S49.1 lymphoma cells have been shown by photoaffinity labelling to contain steroid-binding polypeptides of Mr 94 000 and 40 000, respectively. We investigated the molybdate-stabilized forms of these receptors and obtained Mr 325 000 and 285 000, respectively, by gel filtration and sedimentation analysis. Mild chymotrypsin treatment of the large wild-type receptor resulted in a form of about Mr 290 000 which contained a steroid-binding polypeptide of Mr 40 000. The data suggest that the high -Mr forms of glucocorticoid receptors are heteromeric in nature and contain one steroid binding polypeptide per complex. PMID- 3965300 TI - Ganglioside headgroups decrease lipid order in reconstituted phosphatidylcholine liposomes. AB - The effect of oligosaccharide carrying lipids on membrane fluidity has been investigated. Gangliosides GM1 and GQ1 were reconstituted into phosphatidylcholine bilayer membranes at low concentrations (less than 5 mol%). A strong fluidizing effect was observed leading to a suppression of the phase transition temperature. This was most pronounced with highly sialylated gangliosides. Ca2+ reverses the effect due to phase separation phenomena. We assume a hydrophilic lipid-lipid interaction in accordance with previously studied glycoprotein-lipid interactions. PMID- 3965299 TI - Structural characterization of a blood group A heptaglycosylceramide with globo series structure. The major glycolipid based blood group A antigen of human kidney. AB - A blood group A glycosphingolipid with the globo-series structure has been isolated from human kidney and structurally characterized. The structure was shown by mass spectrometry and proton NMR spectroscopy of the intact permethylated and permethylated-reduced derivatives together with degradation studies to be, GalNAc alpha 1----3Gal(2----1 alpha Fuc)beta 1----3GalNAc beta 1-- -3Gal alpha 1----4Gal beta 1----4Glc beta 1----1 Ceramide. This glycolipid reacts with both polyclonal and monoclonal anti-A blood group typing antisera and it is the major glycolipid based blood group A antigen present in the human kidney. PMID- 3965301 TI - The effect of a rat plasma high-density lipoprotein subfraction on the synthesis of bile salts by rat hepatocyte monolayers. AB - The effect of a rat high-density lipoprotein subfraction (HDL2) on the synthesis of bile salts by rat hepatocyte monolayers prepared from rats fed a diet containing cholestyramine, was investigated. The synthesis of bile salts as measured by radioimmunoassay of conjugated cholic, chenodeoxycholic and beta muricholic acids was significantly increased when hepatocytes were incubated with a physiological concentration (500 micrograms HDL2 protein X ml-1) of HDL2. PMID- 3965302 TI - On the importance of deoxyribonucleotide pools in the senescence of cultured human diploid fibroblasts. AB - Previous studies have indicated that ribonucleotide reductase may participate in a mechanism of cellular senescence, which involves modifications in deoxyribonucleotide pools, the products of the reductase reaction. Since very little information about the levels of these pools in senescing cells is currently available, an analysis of deoxyribonucleotide levels was carried out in young, old and very old normal human diploid fibroblasts, as well as in a variant human fibroblast strain with an altered replicative life span. These studies indicated that there are marked age-related perturbations in these pools which imply that they may be fundamentally important in a process determining the nonproliferative or senescent state. PMID- 3965303 TI - A simple and rapid method for sequencing DNA. AB - A simplified technique for DNA sequence analysis has been developed, based on modification of a previous method [(1980) Methods Enzymol. 65, 499-560]. It employs an adsorptive immobilization of terminally labelled DNA on DEAE paper followed by G, A+G, C+T and C specific modification and cleavage reactions. This solid-phase technique is faster and more convenient than the original method. The efficiency is comparable. The total processing time taken to produce cleaved fragments loaded on a gel is less than 2 h. PMID- 3965304 TI - Catalytic activity of the membrane-bound methylcholanthrene-inducible cytochrome P-450. AB - The benzopyrene hydroxylase activity of the methylcholanthrene-inducible form of cytochrome P-450 (P-448) has been studied in native and reconstituted liver microsomal membranes. The data obtained show that the molecular catalytic activity of membrane-bound cytochrome P-448 depends on the molar ratio of the cytochrome to NADPH-cytochrome P-450 reductase and that the optimal ratio for maximal activity of cytochrome P-448 in the microsomal membrane essentially differs from the equimolar one. PMID- 3965305 TI - Detection of NADPH diaphorase activity associated with human neutrophil NADPH-O2 oxidoreductase activity. AB - At approximately equimolar concentrations (approximately 70 microM), and in the presence of excess catalase and superoxide dismutase, DCIP, ferricytochrome c and ferricyanide abstracted 21, 6 and 61%, respectively, of the electron equivalents given up by NADPH to the NADPH-O2 oxidoreductase complex derived from phorbol myristate acetate-stimulated human neutrophils. With a 10-fold increase in ferricyanide, all of the electron equivalents given up by NADPH to the oxidoreductase complex were shunted to ferricyanide concomitant with complete inhibition of NADPH-dependent O2 consumption. These results substantiate the existence of intrinsic diaphorase activity associated with the superoxide generating NADPH-O2 oxidoreductase of human neutrophils. PMID- 3965306 TI - Novel heparin-activated protein kinase activity in rabbit skeletal muscle. AB - A heparin-activated protein kinase has been identified in rabbit skeletal muscle. The enzyme, which had a native molecular mass of 70 kDa as judged by gel filtration, was stimulated 3- to 5-fold by heparin, half-maximally at 3 micrograms/ml heparin. The stimulation by heparin was not reproduced by other polyanions such as polyaspartate and polyglutamate. The protein kinase was detected by its ability to phosphorylate glycogen synthase; it was ineffective in phosphorylating caseins, phosvitin, histone, or phosphorylase. Glycogen synthase was phosphorylated to a stoichiometry of 0.7-0.8 phosphates/subunit, exclusively at serine residues located in the COOH-terminal CNBr-fragment of the subunit, with a corresponding reduction in the -/+ glucose-6P activity ratio from 0.96 to 0.43. The activity of the protein kinase was unaffected by the presence of Ca2+ and/or phospholipid, cyclic AMP or heat-stable inhibitor protein of cyclic AMP dependent protein kinase. The enzyme was inhibited about 60% by the presence of glycogen, half-maximal effect at 25 micrograms/ml. The heparin-activated protein kinase is clearly distinguishable from other known glycogen synthase kinases. PMID- 3965307 TI - The effect of Mycoplasma hominis and Ureaplasma urealyticum on hamster egg in vitro penetration by human spermatozoa. AB - The effects of some genital mycoplasmas on the in vitro penetration of human spermatozoa into the master egg were studied. Ureaplasma urealyticum serotypes 4, 8, and 6 showed high interfering activity: 6.3% (P less than 0.01), 12.3%, and 14.5%, respectively, against the 55.6% penetration rate of untreated sperm. Neither a cytotoxic effect of mycoplasmas on gametes nor a masking of the binding sites on the egg surface were demonstrated. In experiments carried out with U. urealyticum serotype 4, the production of diffusible relatively heat-labile factor(s) responsible for the inhibition of sperm penetration was postulated. PMID- 3965308 TI - Characteristics of menstruation in sickle cell disease. AB - The results of this preliminary study indicate that patients with sickle cell disease have shorter menstrual cycles than normal control subjects. Their periods last longer and are heavier, and they have a greater incidence of dysmenorrhea. This study provides some insight into the menstrual characteristics of these patients and, we hope, can contribute to the counseling and management of patients with this disease. PMID- 3965311 TI - Caffeine and human sperm characteristics. PMID- 3965310 TI - Reduction of pain following hysterosalpingogram by prior analgesic administration. PMID- 3965309 TI - Demonstration of a gradient in inhibin activity, estrogen, progesterone, and delta 4-androstenedione in follicular fluid, ovarian vein blood, and peripheral blood of normal women. AB - Ovarian vein serum from 3 subjects during the late follicular phase of the menstrual cycle had detectable inhibin activity, whereas ovarian vein serum of 12 other subjects during the early follicular phase and luteal phase had no detectable inhibin activity in a rat anterior pituitary cell culture assay. Subjects having detectable inhibin activity (102 +/- 47 U/100 microliters) had 1257 +/- 582 U/100 microliters inhibin activity in FF, whereas subjects having no detectable inhibin activity had FF levels of 711 +/- 203 U/100 microliters of inhibin activity. Estrogen levels of FF and ovarian vein serum of the group having detectable inhibin activity in ovarian vein serum were 282 +/- 239 ng/ml and 4.8 +/- 1.77 ng/ml, respectively. The estrogen content of FF and ovarian vein blood of the group having nondetectable inhibin activity in ovarian vein blood was 127 +/0 45 ng/ml and 3.03 +/- 0.6 ng/ml, respectively. PMID- 3965312 TI - Sex ratio associated with natural family planning. PMID- 3965313 TI - Sex ratio and clomiphene treatment. PMID- 3965314 TI - Report on the conference on aging, reproduction, and the climacteric. PMID- 3965315 TI - Psychological evaluation and support in a program of in vitro fertilization and embryo transfer. AB - This report describes the psychological evaluation of 200 couples consecutively seen at a pretreatment consultation in an in vitro fertilization and embryo transfer program. Attitudinal and emotional characteristics of the sample are also described. Half the women and 15% of the men reported that infertility is the most upsetting experience of their lives. On the Minnesota Multiphasic Personality Inventory (MMPI), approximately 20% of the males and females had one or more elevated scale scores, suggesting dysfunctional emotional distress or personality difficulties. Half the sample had high scores on the MMPI Ego Strength scale, which indicated effective functioning and ability to withstand stress. T scores for the Taylor Manifest Anxiety Scale were in the normal range before treatment. Further longitudinal study is needed to define the emotional impact of procedures and reactions to treatment outcomes. PMID- 3965316 TI - Serum carotene levels in female long-distance runners. AB - Hypercarotenemia has been associated with anorexia nervosa and hypothalamic amenorrhea. With the emergence of a spectrum of menstrual dysfunction, including anovulation in women runners, the hypothesis of hypothalamic amenorrhea in these patients has been formulated. Other authors have proposed exercise-associated amenorrhea to be distinct from hypothalamic amenorrhea based on endocrine profiles. Using carotene as an index test of hypothalamic amenorrhea, we have studied female long-distance runners (greater than 25 miles/week) and have found no difference in the carotene levels between ovulatory (midfollicular) and anovulatory runners. These data support other evidence that exercise-associated amenorrhea is distinct from hypothalamic amenorrhea. PMID- 3965317 TI - Reproductive outcome following two ectopic pregnancies. AB - Consideration of reproductive potential following multiple ectopic pregnancies is important in counseling patients and when choosing a conservative surgical approach (salpingotomy, salpingostomy), partial salpingectomy, or in vitro fertilization. The cases of 336 patients at Yale-New Haven Hospital who had ectopic pregnancies between 1976 and 1981 were evaluated. Thirty-two patients (9.5%) had two ectopic pregnancies. Twenty-three patients (71.8%) were followed. Six of these (26.1%) were not able to conceive because of surgical sterilization, and four (17.4%) were not trying to conceive. Of those 13 patients (56.5%) actively trying to conceive and having at least one tube remaining, 4 (30.8%) had term intrauterine gestations. One had a third ectopic gestation, which represented 20% of all conceptions, or 7.7% of those individuals trying to conceive. Our results indicate that although the reproductive potential after two ectopic pregnancies is poor, viable pregnancies do occur, and the repeat ectopic pregnancy rate is not high enough to preclude a repeat conservative surgical approach. PMID- 3965318 TI - Psychological and attitudinal profiles in donors for artificial insemination. AB - Few objective data are available concerning the psychological profiles and attitudes of sperm donors in artificial insemination programs. We studied 30 consecutive new volunteers and 45 established sperm donors using the Cattell 16PF personality profile and an attitudinal survey concerning motives for donation, attitudes toward uses of sperm, desire for knowledge of outcomes, and attitudes toward disclosures of identifying and nonidentifying information between the parties to artificial insemination. Donors differed from the population norms in 7 of 16 first-order and 1 of 4 second-order personality factors, and this difference appeared to reflect their self-selection as donors. The predominant motive for donation was altruism, but secondary motives were also common. Financial motivation was very low in this population with few students. Donors approved of all current and most hypothetical uses of sperm but were not in favor of disclosures of information to other participants in the program. Restriction of disclosures to nonidentifying details was more acceptable. Unmarried donors were more often motivated for nonaltruistic reasons and were more in favor of disclosures. Attitudes of sperm donors were mostly stable over at least 3 years, but an increasing minority with time envisaged circumstances that might lead to their withdrawal from the program. PMID- 3965319 TI - Genetic analysis of developmental mechanisms in hydra. X. Morphogenetic potentials of a regeneration-deficient strain (reg-16). AB - Morphogenetic potentials of hydra tissue involved in head or foot formation were examined in a standard wild-type strain (105) and a mutant strain (reg-16) which has a very low head regenerative but a nearly normal foot regenerative capacity (T. Sugiyama and T. Fujisawa, 1977, J. Embryol. Exp. Morphol. 42, 65-77). Hydra tissue has two types of morphogenetic potentials to control head formation: the potential to form head structure (head-activation potential) and the potential to inhibit head formation (head-inhibition potential). It also has two types of morphogenetic potentials to control foot formation: foot-activation and foot inhibition potentials. A lateral tissue grafting procedure (G. Webster and L. Wolpert, 1966, J. Embryol. Exp. Morphol. 16, 91-104), was used to examine and compare the relative levels of these potentials in the normal and the mutant strains. The potential levels were examined along the body axis of the intact animals and also in the regenerating animals after head removal. The results obtained show that the potentials involved in head formation are highly abnormal, whereas the potentials involved in foot formation are apparently normal in the mutant strain (reg-16). This suggests that the abnormal potentials are related in some way to, and may be responsible for, the reduced head regenerative capacity in the mutant strain reg-16. PMID- 3965320 TI - Effect of the weaver (wv) mutation on cerebellar neuron differentiation. I. Qualitative observations of neuron behavior in culture. AB - A mutant gene dose-dependent inhibition of cerebellar granule cell neuron survival and neurite growth in dissociated cultures of cerebellum from 7-day-old heterozygous (+/wv) and homozygous (wv/wv) weaver mutant mice (M. Willinger, D. M. Margolis, and R. L. Sidman. (1981), J. Supramol. Struc. 17, 79-86) has previously been observed. In the present phase-contrast study time-lapse microcinematography was performed between 10 and 80 hr in culture to determine which properties of neurite growth and neuron migration are affected by weaver gene expression. Neurite growth in +/+ cultures is rapid and discontinuous. Neurites are thin and cylindrical. Membrane movement occurs only at the growth cone. Growth cone contact with cell aggregates or glial somas results in the cessation of cone advancement and the induction of translocation of the neuronal soma toward the astrocyte. In cultures of +/wv and wv/wv cerebellar cells, abnormal neurite growth is characterized by frequent neurite retractions and reinitiations. Neuronal somas and neurite shafts are motile during elongation. Homozygous neurites and cones are pleomorphic. Normal, +/wv, and wv/wv neurons undergo nuclear translocation. Like +/+ neurons, +/wv neurons migrate in response to growth cone-cell soma contact. In contrast, homozygous soma frequently reverse direction and migrate independently of cell contact. Granule cell death occurs with increasing frequency with increasing gene dosage. Neurons are unusually active prior to the rapid onset of cell death. In summary, the weaver mutation impairs granule cell differentiation by affecting neurite maintenance, membrane motility, and neuron morphology. The loss of viability appears to be independent of, or secondary to, these targets of gene action. PMID- 3965321 TI - Effect of the weaver (wv) mutation on cerebellar neuron differentiation. II. Quantitation of neuron behavior in culture. AB - Quantitative measurements of neuron behavior from time-lapse microcinematography of dissociated cultures of normal (+/+), heterozygous weaver (+/wv), and homozygous weaver (wv/wv) 7-day-old mouse cerebellum were performed to identify dose-dependent expressions of the mutant allele. Impaired neurite growth by granule cell neurons is a direct result of a dose-dependent increased frequency of neurite retraction and decreased rate of growth cone advancement. The number of retractions per neurite is 0.2, 1.0, and 2.0 for +/+, +/wv, and wv/wv neurites, respectively. Maximal rates of growth cone advancement are 1041, 443, and 250 micron/day for +/+, +/wv, and wv/wv granule cell neurites, respectively. Neurite initiation is actually increased in wv/wv cultures, though the neurites are not well sustained. The frequency of neurite initiation is 1.0, 1.7, and 2.2 for +/+, +/wv, and wv/wv neurons, respectively. Measurements of oscillations of somal position revealed that the cell center moves increasing distances over short times in proportion to the number of mutant genes. Nuclear translocation, the mode of somal migration in vivo and in vitro, occurs at the same frequency and rate in normal and mutant cultures. Weaver gene expression induces a cytopathology affecting various morphogenetic events rather than producing a block at a specific stage in granule cell differentiation. It is hypothesized that the dose-dependent impairments of cell motility reflect weaver gene action at the cell surface or cytoskeleton. PMID- 3965322 TI - Germinal vesicle contents are required for the cytoplasmic cycle during meiotic division of starfish oocytes. AB - Enucleated oocytes of starfish still show cyclic changes in cortical tension with a temporal pattern similar to that exhibited by intact oocytes during meiotic division, provided that the enucleation is performed a certain time after the breakdown of the germinal vesicle (K. Yamamoto and M. Yoneda, Dev. Biol. 96, 166 172, 1983). If an oocyte is bisected immediately after germinal vesicle breakdown, the resulting nonnucleate fragment shows some change in tension, but the pattern of change is much less regular than that seen in intact oocytes, suggesting that the dispersion of germinal vesicle (GV) contents into cytoplasm is required for the establishment of the cytoplasmic cycle. In order to demonstrate the role of GV contents directly, nonnucleate fragments derived from immature oocytes were injected with GV contents taken from other immature oocytes. On treatment with 1-methyladenine (1-MA) these fragments showed two rounds of increase in tension as is characteristic of intact maturing oocytes. The first rise in tension was always observed 50-70 min after the treatment with 1-MA, similar to the time of first polar body formation in intact oocytes, regardless of the time of injection of GV contents. Even when GV contents were injected into nonnucleate fragments which had been already treated with 1-MA, these fragments showed two rounds of change in tension. The timing of the first rise in tension was found to be 38 +/- 7 min after injection, irrespective of the time of the foregoing treatment with 1-MA. These results prove the indispensability of GV contents for inducing the cytoplasm of the maturing starfish oocyte to initiate its own cyclic activity, and suggest that the normal process of cytoplasmic maturation may consist of two phases, i.e., (1) a GV independent phase initiated by 1-MA treatment, and (2) a second phase initiated by mixing of GV contents with cytoplasm. PMID- 3965323 TI - Experimental evidence for a proteinaceous presegmental wave required for morphogenesis of axolotl mesoderm. AB - Mesoderm of axolotl embryos at various developmental stages was briefly exposed to a calcium-free 0.01% trypsin solution by temporary removal of the epidermis. This treatment was found to disrupt somite segmentation in a localized region and the pronephric duct was unable to migrate through this region. The affected area, consisting of 3.91 +/- 1.04 somites, traveled through the embryo in synchrony with, and 3.55 +/- 0.69-somite widths ahead of segmentation. Trypsinization in the presence of 340 microM calcium resulted in normal duct migration while somite segmentation was still affected. These results demonstrate the existence of a trypsin-sensitive region in the somitic mesoderm and the lateral mesoderm of the duct path that travels in advance of somite segmentation and in synchrony with it. In addition, the trypsin sensitivity of the duct path is calcium dependent whereas that of the somitic mesoderm is not. PMID- 3965324 TI - Developmental regulation of glycosyltransferases involved in synthesis of N linked glycoproteins in sea urchin embryos. AB - Previous in vivo studies using drugs that inhibit the N-glycosylation of proteins have demonstrated that newly synthesized N-linked glycoproteins are required for gastrulation in embryos of two species of sea urchins, Strongylocentrotus purpuratus and Arbacia punctulata. To understand the biochemical events regulating glycoprotein synthesis during gastrulation in S. purpuratus embryos, we examined the in vitro activities of enzymes catalyzing several of the early steps in N-linked glycoprotein synthesis. The activities of glycosyl transferases responsible for production of N,N-diacetylchitobiosylpyrophosphoryldolichol and glucosylphosphoryldolichol, two intermediates in the formation of oligosaccharylpyrophosphoryldolichol (the carbohydrate donor for N glycosylation), were low but detectable in membranes from eggs. After fertilization these activities remained constant or increased slowly up to the blastula stage and thereafter increased rapidly at gastrulation. In agreement with these in vitro findings, in vivo labeling experiments revealed that the rate of incorporation of [3H]Man into oligosaccharylpyrophosphoryldolichol and into protein increased three- to fourfold prior to gastrulation and then slightly more at the prism stage. In contrast, in vitro activity of mannosylphosphoryldolichol synthase, another enzyme in the pathway of N-linked glycosylation, was maximal in membranes from egg and embryos in the early stages of development and declined prior to gastrulation. Furthermore, the level of this activity was at least 100 fold greater than that for enzymes involved in the formation of the chitobiosyl and glucosyl lipids. With the exception of mannosylphosphoryldolichol synthase activity, these data indicate that there is a general activation of the glycosylation apparatus before gastrulation in sea urchin embryos. Possible explanations for the decrease in mannosylphosphoryldolichol synthase activity are discussed. PMID- 3965325 TI - Fibronectin visualized by scanning electron microscopy immunocytochemistry on the substratum for cell migration in Xenopus laevis gastrulae. AB - In amphibian gastrulae, scanning electron microscopy (SEM) has shown the presence of a network of extracellular fibrils on the inner aspect of the ectoderm layer, which serves as the substratum for migration by the presumptive mesoderm cells. In vitro experiments have shown that the fibril network promotes attachment and migration by mesoderm cells, and probably guides the migration by contact guidance. Filopodia of the migrating cells showed preferential attachment to the fibrils. Use of a colloidal gold probe for SEM immunocytochemistry has shown that fibrils observed by SEM contain fibronectin, probably as a major component. This provides direct evidence that the extracellular matrix containing fibronectin provides the substratum and guides cell migration in morphogenetic movement. PMID- 3965326 TI - Spore coat protein synthesis during development of Dictyostelium discoideum requires a low-molecular-weight inducer and continued multicellularity. AB - The major spore coat proteins of Dictyostelium discoideum are synthesized during the culmination stage of development. In an attempt to examine the regulatory mechanisms involved, spore coat protein synthesis by pseudoplasmodia harvested prior to culmination and incubated in submerged culture under various environmental conditions has been monitored. It is reported that the synthesis of spore coat proteins SP170, SP103, SP94, SP82, SP76, and SP55 is dependent upon the presence of a low-molecular-weight (Mr approx 100), heat-stable factor secreted by cells incubated at high density in buffer. Previous studies have implicated cyclic AMP, ammonia, and amino acids in spore cell differentiation. Partial purification of the spore coat protein inducing factor (SPIF), together with attempts to mimic its activity, indicate that SPIF is not identical with any of these molecules and it is probably also distinct from DIF and "fruit juice," two other factors which regulate the spore-stalk decision and the initiation of culmination, respectively, in D. discoideum. In addition to SPIF, the continued expression of the spore coat protein genes also requires that the integrity of the pseudoplasmodium be maintained. Unlike the expression of many other genes after aggregation, this latter requirement cannot be replaced by exogenous cyclic AMP. Termination of spore coat protein gene expression occurs despite the presence of excess exogenous SPIF and hence involves mechanisms other than the destruction or depletion of SPIF. PMID- 3965327 TI - The AGA and changing gastroenterology: architects or pawns? The presidential address. PMID- 3965328 TI - Defective gallbladder emptying and cholecystokinin release in celiac disease. Reversal by gluten-free diet. AB - Normal volunteers (n = 6), patients with untreated celiac disease and subtotal villous atrophy (n = 6), patients with nonresponsive celiac disease (n = 2), and patients with celiac disease on a gluten-free diet with a virtually normal biopsy specimen (n = 6) drank a liquid fat meal after an overnight fast. Gallbladder emptying was monitored by using 99mTc-eHIDA, and blood samples were taken for cholecystokinin estimation by radioimmunoassay after high-performance liquid chromatography. The half-times of gallbladder emptying were 20.4 +/- 2.9 min (mean +/- SEM) for normals and 22.1 +/- 2.8 min in treated patients with celiac disease (NS). In patients with untreated celiac disease half-times were 154.3 +/- 10.3 min (p less than 0.02 vs. normals and treated patients with celiac disease), and in 2 nonresponsive patients, half-times were 40.7 and 37.3 min. Integrated plasma cholecystokinin responses were 473 +/- 87 and 436 +/- 137 pmol X L-1 X 30 min-1 in normals and treated patients with celiac disease (NS). In untreated patients with celiac disease values were 16 +/- 9 pmol X L-1 X 30 min-1 (p less than 0.001 vs. normals and treated patients with celiac disease), and in nonresponsive patients values were 442 and 322 pmol X L-1 X 30 min-1. In 2 patients studied before and during gluten-free diet half-times for gallbladder emptying changed from 168.9 and 302.4 min to 20.1 and 23.4 min, and cholecystokinin responses changed from 0 and 45 to 623 and 298 pmol X L-1 X 30 min-1. Cholecystokinin immunoreactivity cochromatographing with cholecystokinin octapeptide was responsible for 50%-60% of circulating cholecystokinin in normals and in treated patients but the small amount of cholecystokinin that was released in untreated patients with celiac disease cochromatographed with cholecystokinin 33/39. We conclude that there is a reversible defect of gallbladder emptying and cholecystokinin release in celiac disease. PMID- 3965329 TI - Taurolithocholate increases heme catabolism and alters the clearance of antipyrine in the rat. AB - Taurolithocholate has been implicated in human cholestatic syndromes. Its action is believed to be due to an alteration in liver plasma membrane composition. To investigate whether other membranes are similarly affected, we studied the effect of taurolithocholate on hepatic heme turnover by means of a new 14CO breath test. Between 2 and 7 h after taurolithocholate administration, 14CO production was significantly increased, suggesting increased heme catabolism. This was substantiated by the finding of a 47% reduction of microsomal cytochrome P450 content 3 h after taurolithocholate administration. There was a reciprocal increase of 50% in heme oxygenase activity, the key enzyme in heme catabolism. To probe the biological significance of these findings, we measured plasma disappearance of propranolol and antipyrine. Clearance of neither propranolol nor antipyrine was altered by acute taurolithocholate administration. Prolonged administration of taurolithocholate, by contrast, decreased metabolic clearance rate of antipyrine by 48%. This was accompanied by a 25% decrease in microsomal cytochrome P450 content. Our findings suggest that taurolithocholate affects composition and function of the smooth endoplasmic reticulum, and that its action is not limited to the liver plasma membrane. PMID- 3965330 TI - Enterohepatic circulation in the rat. AB - Several compounds, in particular bile acids, undergo enterohepatic circulation (EHC). Limited data are available on the pathophysiologic aspects of this circulation. In the present study we describe a surgical technique in rats that allows a long-term, reversible interruption of the EHC and monitoring of peripheral blood levels without direct surgical intervention. This technique excludes the effects of anesthesia and surgical trauma. The model's validity has been tested extensively. We used this animal model to investigate acute and chronic effects of interruption and subsequent restoration of the EHC on (a) nutritional status, (b) plasma cholesterol levels and hepatic cholesterol synthesis, and (c) biliary bile acid, phospholipid, and cholesterol excretion. Interruption of the EHC resulted in an increased food intake and enhanced fecal energy loss, caused by a less efficient intestinal absorption. Plasma cholesterol concentrations declined immediately after the interruption of the EHC, but returned to almost control values during bile diversion. A marked overshoot followed the subsequent restoration of the EHC. Hepatic cholesterol synthesis showed a five-fold increase after 8 days of bile diversion but returned to control values within 2 days after restoration of the EHC. After interruption of the EHC, bile acid, phospholipid, and cholesterol excretion decreased sharply but stabilized after 3 h at 7.6%, 20%, and 23%, respectively, of their initial values. Bile acid output, representing hepatic synthesis, slowly increased over 4 days, but never exceeded 13% of its value during intact EHC. Subsequent restoration of the EHC could rapidly reverse the observed effects of the interruption. The animal model described in the present study is an excellent tool in studying the acute and chronic effects of disturbances of the EHC. PMID- 3965331 TI - Biliary ascariasis. A common cause of biliary and pancreatic disease in an endemic area. AB - We prospectively evaluated the incidence, clinical features, radiographic findings, and course of biliary and pancreatic disease caused by ascariasis in an endemic area in India. Ascariasis was an etiologic factor in 40 (36.7%) of the 109 patients studied who had biliary and pancreatic diseases. Disease was prevalent in adult women and was associated with recurrent biliary colic in 38 patients (95%), recurrent pyogenic cholangitis in 27 patients (68%), acalculous cholecystitis in 9 patients (23%), and pancreatic disease in 6 patients (15%). Vomiting of roundworms during biliary colic occurred in 19 patients (48%) and often led to confirmation of biliary ascariasis by direct visualization of the biliary tree. Endoscopic retrograde cholangiopancreatography was an excellent diagnostic tool and often demonstrated worms in the dilated common bile duct and intrahepatic ducts. The worms moved actively into and out of the biliary tree from the duodenum. Thirty-six (90%) patients recovered on symptomatic treatment followed by anthelmintic therapy once acute symptoms subsided. Surgery was needed in 4 patients, as the worms were trapped in the ducts and had led to the formation of common bile duct and intrahepatic duct stones with the worm fragment as the nidus. PMID- 3965332 TI - Effects of prostaglandin inhibition on systemic and hepatic hemodynamics in patients with cirrhosis of the liver. AB - The role of prostaglandins in the pathogenesis of the circulatory abnormalities of cirrhosis was investigated by studying the effects of prostaglandin inhibition with indomethacin (50 mg/8 h for 24 h) on the systemic and splanchnic hemodynamics in 13 patients with cirrhosis of the liver. Indomethacin administration significantly reduced cardiac output (from 7.44 +/- 0.7 to 6.78 +/ 0.7 L/min, p less than 0.05) and increased peripheral vascular resistance (from 990 +/- 104 to 1155 +/- 140 dyn X s X cm-5, p less than 0.05). Arterial pressure was not modified. These changes in systemic hemodynamics were associated with a significant reduction in hepatic blood flow (from 1.88 +/- 0.43 to 1.48 +/- 0.3 L/min, p less than 0.05) and with a slight decrease of portal pressure (from 18.8 +/- 1.3 to 17.5 +/- 1.4 mmHg, p less than 0.05). These results suggest that endogenous prostaglandins contribute to the increased cardiac output and diminished vascular resistance observed in cirrhosis of the liver. In addition, by promoting splanchnic vasodilation, prostaglandins may contribute to increased portal pressure in these patients. PMID- 3965333 TI - Effect of aging on the hepatobiliary transport of dimeric immunoglobulin A in the male Fischer rat. AB - Recent studies have suggested that the hepatobiliary transport of serum dimeric immunoglobulin A constitutes an important secretory route for this ligand. However, the information that is currently available has been accumulated from studies in young animals or in patients with liver disease. Aging is known to result in (a) reduced hepatobiliary function(s), (b) an increased incidence of gastrointestinal infectious diseases, and (c) a marked decline in the immune response. We evaluated the effect of aging on the in vivo hepatic capacity to transport dimeric immunoglobulin A from blood to bile. Young adult rats (3-4 mo) secreted 125I-labeled dimeric immunoglobulin A into the bile at a rate sixfold greater than that measured in either mature (12 mo) or senescent (24-25 mo) animals. This age-related decline appears to be relatively independent of bile flow and bile acid secretion. Quantitative light and electron microscopic autoradiographic evidence suggests that aging may impair the rate at which this ligand is translocated across the hepatocytes to the bile canaliculi. PMID- 3965334 TI - Cytochrome P450 of small intestinal epithelial cells. Immunochemical characterization of the increase in cytochrome P450 caused by phenobarbital. AB - We have studied total cytochrome P450 and the major form of cytochrome P450 increased by phenobarbital in small intestinal epithelial cells and livers of male Sprague-Dawley rats. Using an improved method for preparing microsomes from intestinal epithelial cells, we find that concentrations of total cytochrome P450 in intestinal cell microsomes are 10% of those in liver microsomes, and that this percentage is unchanged after phenobarbital treatment. In untreated rats, less than 5% of total cytochrome P450 of liver or intestinal epithelium is the form induced by phenobarbital, as measured by rocket immunoelectrophoresis. In phenobarbital-treated rats, the major phenobarbital-induced form accounts for approximately 50% of the total in both organs. In the small intestine of phenobarbital-treated rats, the concentrations of total cytochrome P450 and of the major phenobarbital-induced form increase concurrently as epithelial cells mature from crypt to upper villus. Concentrations of total cytochrome P450 and of the major phenobarbital-induced form in the proximal two-thirds of the rat small intestine are twofold higher than in the distal third. Immunoblotting performed with a monoclonal antibody to the major phenobarbital-induced form of cytochrome P450 from rat liver revealed a subtle difference between this form in liver and intestine. PMID- 3965335 TI - Cardiopulmonary risk of esophagogastroduodenoscopy. Role of endoscope diameter and systemic sedation. AB - The impact of endoscope diameter and the presence of systemic sedation on the cardiopulmonary risk of esophagogastroduodenoscopy was investigated. One hundred and forty-six patients undergoing elective esophagogastroduodenoscopy were randomly assigned to one of three groups which differed in either endoscope diameter or use of sedation: group 1 (8.5-mm endoscope with no sedation), group 2 (8.5-mm endoscope with diazepam), and group 3 (11.5-mm endoscope with diazepam). Esophagogastroduodenoscopy was tolerated best by group 2, and this group had the fewest electrocardiographic changes observed on a Holter recording during esophagogastroduodenoscopy. The incidence of electrocardiographic changes during esophagogastroduodenoscopy correlated with patient tolerance (p less than 0.001) and the use of the smaller endoscope (p less than 0.05). The most common arrhythmia was sinus tachycardia (49 patients), but more serious electrocardiographic changes were observed in 21 patients. Serious arrhythmias were more common in patients with a prior history of cardiovascular disease compared with patients with no such history (30% vs. 6%, p less than 0.001). Arterial oxygen desaturation (measured by ear oximetry) during intubation and esophagogastroduodenoscopy was usually modest (2%-5%). However, 16 patients receiving diazepam experienced high levels of desaturation exceeding 7%; this small group of patients also experienced more electrocardiographic changes than other patients. The use of diazepam sedation and an 8.5-mm endoscope may offer the safest and most comfortable combination for most patients undergoing esophagogastroduodenoscopy. Diazepam sedation, however, may represent a potential danger to a small number of patients with marginal baseline arterial saturation. PMID- 3965337 TI - Enhanced glucose absorption in the jejunum of patients with cystic fibrosis. AB - After oral D-xylose ingestion, cystic fibrosis patients have significantly higher blood levels of xylose than controls. The aim of this study was to examine whether nutrient absorption at the mucosal level is altered in cystic fibrosis. Steady-state perfusion experiments using isotonic test solutions were performed in 11 healthy controls and 10 cystic fibrosis patients. Net D-glucose absorption was higher in cystic fibrosis when the perfusate contained a glucose concentration of less than or equal to 50 mM. Kinetic analysis by three different methods, including Lineweaver-Burk analysis, revealed a lower apparent Km as well as a lower apparent Vmax in cystic fibrosis as compared with healthy controls (33.9 mM and 52.5 mmol/20 cm . h vs. 81.8 mM and 68.3 mmol/20 cm . h, respectively, p less than 0.01). Absorption of D-fructose and glycine demonstrated a tendency for increased net absorption in cystic fibrosis but the results were not significantly different. L-Xylose absorption and electrolyte movement were not altered in cystic fibrosis. Among several possible mechanisms investigated, a decrease in the apparent Km for glucose absorption would be consistent with a decrease in diffusion barriers overlying the jejunal mucosa in cystic fibrosis. Using an electrical method, the unstirred water layer thickness was significantly decreased in cystic fibrosis (546 +/- 41 micron in cystic fibrosis vs. 780 +/- 110 micron in controls, p less than 0.05). A decrease in the mucosal surface area in the cystic fibrosis group or an intrinsic defect in the mucosal glucose transport system could account for differences in the apparent Vmax values. We suggest, however, that enhanced absorption in cystic fibrosis is most likely due to a decrease in intestinal diffusion barriers possibly due to abnormal mucus overlying the intestinal mucosa. PMID- 3965336 TI - Efficacy of bicozamycin in preventing traveler's diarrhea. AB - Bicozamycin was compared with a placebo in a prospective, randomized, double blind study of the prevention of acute diarrhea among 30 American travelers newly arrived in Guadalajara, Mexico. None of the 11 subjects given bicozamycin orally for 3 wk at a dosage of 500 mg four times a day developed diarrhea as compared with an incidence of 53% diarrhea (10 of 19 subjects) in the placebo group (p = 0.003). Bicozamycin was well tolerated. Studies of changes in predominant aerobic fecal flora among the 11 subjects treated with bicozamycin showed the appearance of only one highly resistant Citrobacter freundii at the end of 1 wk of therapy and only a total of six resistant isolates at the end of 3 wk. All resistant isolates failed to transfer this resistance to a recipient Escherichia coli. Bicozamycin seems to be well suited and safe as a prophylactic agent against traveler's diarrhea. PMID- 3965338 TI - Multipeaked esophageal peristaltic pressure waves in patients with diabetic neuropathy. AB - We evaluated esophageal function in 14 consecutive insulin-dependent diabetic patients who had evidence of peripheral and autonomic neuropathy, but no esophageal symptoms. One to three contraction waves immediately followed a primary peristaltic contraction wave. The majority of these multipeaked pressure complexes consisted of two peaks. Multipeaked contractions were observed with all peristaltic waves in 12 of the 14 diabetic patients and with most of the peristaltic complexes in the remaining 2 patients. Multipeaked peristaltic waves were present in 1 of 6 diabetic patients without neuropathy, in 1 of 100 consecutive nondiabetic patients referred for suspected esophageal disease, and in 1 of 10 healthy volunteers. Double-peaked peristaltic pressure complexes in the nondiabetic control subjects differed from those present in the insulin dependent patients by their low incidence and by a tendency to be limited to the distal esophagus. Pharmacologic responses to edrophonium and atropine suggested a possible increased cholinergic tone as the basis of the multipeaked peristaltic waves in diabetics with autonomic neuropathy. PMID- 3965339 TI - Plasma motilin concentration and interdigestive migrating motor complex in diabetic gastroparesis: effect of metoclopramide. AB - The objective of this study is to determine whether abnormal rhythm and amplitude of the oscillation in plasma motilin concentration are responsible for the abnormal motility observed in patients with diabetic gastroparesis. We also investigated the effect of metoclopramide on plasma motilin concentration and gastrointestinal motility in these patients. In healthy controls, basal plasma motilin concentration fluctuated in phase with the interdigestive migrating motor complex. All patients with diabetic gastroparesis did not have antral phase III activities and had significantly higher basal motilin concentrations, which maintained a normal oscillatory pattern. Administration of metoclopramide initiated antral phase III activities in healthy controls and in patients with diabetic gastroparesis. These were accompanied by a concurrent rise in plasma motilin concentration in healthy controls, contrasting with a fall in plasma motilin concentrations in patients with diabetic gastroparesis. We conclude that diabetic gastroparesis is associated with absence of antral interdigestive migrating motor complex and with elevated plasma motilin concentration with normal cyclic fluctuations. Our studies also show that metoclopramide initiates antral phase III activities in diabetic gastroparesis independent of plasma motilin concentration. PMID- 3965340 TI - Electrophysiologic control of motility in the human colon. AB - Characteristics of electrical activities, and the relationship between electrical and motor activities, were studied in circular and longitudinal (taenia) muscle of the human colon that was obtained from 21 individuals. Recordings were obtained with suction electrodes, the sucrose-gap method, and microelectrodes. The circular muscle electrical activity consisted of oscillatory activity of relatively low amplitude, with a frequency range from 4.5 to 60 cycle/min. Spiking activity was present on most oscillations. Contractile activity was associated with individual oscillations at frequencies below 12 cycle/min. Contractions related to periods of oscillations at frequencies above 12 cycle/min showed summation resulting in prolonged contractions. In these periods, oscillations were either of relatively high amplitude, or had superimposed spiking activity. Longitudinal muscle activity consisted of slow electrical oscillations at frequencies between 24 and 36 cycle/min with spiking activity superimposed on most oscillations. Contractions were related to bursts of such activity. These findings provide the electrophysiologic basis for short and prolonged phasic contractions and for sustained contractions of the human colon muscle layers. Activities in both muscle layers were myogenic in nature, were very sensitive to stretch, and could be initiated or modulated by nervous activity. PMID- 3965341 TI - Vitamin A therapy in patients with Crohn's disease. AB - Vitamin A therapy has been claimed in isolated reports to be of benefit to patients with Crohn's disease. To investigate this further, 86 patients were entered into a long-term double-blind study of vitamin A, 50,000 U twice daily, as compared with placebo. After a mean of 14.1 mo of treatment there was no significant difference between the groups as measured by a variety of activity indices (including the National Cooperative Crohn's Disease Activity Index), the number of acute attacks, and the surgical rate. No toxic effects of vitamin A were observed during the study. In this study vitamin A has not been shown to be of benefit to patients with Crohn's disease who are in remission. PMID- 3965342 TI - Central action of gamma-aminobutyric acid ligands to alter basal water and electrolyte absorption in the rat ileum. AB - The gamma-aminobutyric acid agonist muscimol and the gamma-aminobutyric acid antagonist bicuculline were studied to determine their effects on basal net water and electrolyte transport in the rat ileum. Whereas the intraperitoneal injection of muscimol caused a reversible, dose-dependent decrease in net water absorption, bicuculline produced a reversible, dose-dependent increase in net water and ion absorption. The threshold doses of muscimol and bicuculline were greater than 2.1 and 2.2 micrograms/kg, respectively. Lower doses of muscimol (0.1 microgram) or bicuculline (0.3 microgram) administered into the cerebrospinal fluid had the same effect as higher doses given systemically. Vagotomy prevented the effect of intracerebroventricular muscimol. Atropine (6 micrograms intracerebroventricularly) alone did not alter basal water absorption but abolished the muscimol effect, suggesting that muscimol promoted the release of acetylcholine from central cholinergic neurons. Atropine did not prevent the bicuculline effect. We conclude that (a) muscimol decreases ileal water absorption and bicuculline enhances ileal water absorption by an action at a gamma-aminobutyric acid receptor in the central nervous system, (b) the muscimol effect is due to an alteration in parasympathetic vagal outflow to the intestine, (c) the muscimol effect is mediated by a central cholinergic interneuron, and (d) the bicuculline effect is not mediated by the release of acetylcholine from central cholinergic neurons. PMID- 3965343 TI - Golytely lavage versus a standard colonoscopy preparation. Effect on normal colonic mucosal histology. AB - We prospectively studied the changes of colonic mucosa in patients receiving two different preparations for colonoscopic examination. Eighteen consecutive patients undergoing colonoscopy for polyps or mass lesions, properly age- and sex matched, were randomized to receive Golytely lavage (3-4 L) or a standard preparation (48-h clear liquid diet, 240 ml of magnesium citrate and "X-Prep" senna derivative). Patients with diarrhea or inflammatory bowel disease, or both, were excluded. Biopsy specimens were obtained from normal-appearing mucosa of the right and left side of the colon (none in the distal 10 cm of rectum). Blind review of coded slides was performed with 0-3 scoring for artifact, edema and hemorrhage of the lamina propria, surface epithelial and goblet cells, crypts, and cells in the lamina propria including eosinophils and polymorphonuclear leukocytes. Statistically significant differences were found for preservation of surface epithelial and goblet cells and less edema in favor of patients receiving Golytely. We conclude that the standard form of colon preparation flattens the surface epithelial cells and depletes the goblet cells as well as causes an increase in lamina propria edema, whereas colon lavage preserves normal mucosal histology. PMID- 3965345 TI - Large spontaneous intrahepatic arterioportal fistula demonstrated by rapid sequential computed tomographic scan. Report of two cases. AB - A huge spontaneous intrahepatic arterioportal shunt with regurgitation through the portal vein trunk was demonstrated by computed tomography and confirmed by angiography in 2 patients with liver cirrhosis. Rapid sequential computed tomographic scanning was very useful in the diagnosis and follow-up after arterial embolization. Early visualization of the portal vein and increased attenuation in the ipsilateral lobe bearing the fistula were demonstrated in 1 case, and the same findings were also demonstrated by computed tomography and angiography in the other case. PMID- 3965344 TI - Central and peripheral control of gastrointestinal and colonic motility by endogenous opiates in conscious dogs. AB - The effects of two enkephalin analogues, (D-Ala2, Met5) and (D-Ala2, D-Leu5) enkephalinamide, on gastrointestinal and colonic motility were investigated in conscious fasted and fed dogs using chronically implanted strain gauges. The drugs, abbreviated here with the names DALAMIDE and DADLE, respectively, were administered by using both the intracerebroventricular and intravenous routes at increasing doses. In fasted dogs when administered via the intracerebroventricular route at a dose of 20 ng X kg-1, DALAMIDE disrupted the migrating myoelectric complex pattern. A similar effect was obtained only with a dose 25 times higher (500 ng X kg-1) administered intravenously; at this dosage DALAMIDE administered intravenously also reduced the colonic motility index by 66%. When intracerebroventricularly administered in fed dogs, 2 h after a meal, DALAMIDE (20 ng X kg-1) inhibited gastric motility but restored the jejunal migrating myoelectric complex pattern as "ectopic" complexes for 4-6 h. This effect however was not reproduced by intravenous treatment even at the highest dose used (500 ng X kg-1). Both intracerebroventricular and intravenous administration of DADLE, at doses as high as 100 and 500 ng X kg-1, respectively, affected neither the motility pattern nor the motility index of the antrum and proximal jejunum in the fasted or fed state. However, intracerebroventricular, but not intravenous, administration produced a short (10-15 min) increase of colonic motility. These results suggest that (a) Met-enkephalin influences the gastrointestinal motility predominately by a central action, manifested as a migrating myoelectric complex "reorganizing" effect in fed dogs; (b) Leu enkephalin exerts a predominately centrally mediated stimulation of colonic motility, whereas Met-enkephalin inhibits it probably by a peripheral mechanism. PMID- 3965347 TI - Studies of experimental hepatic encephalopathy. PMID- 3965346 TI - Membranous obstruction of the portal vein. A case report. AB - Membranous obstruction of the portal vein has not been previously reported. This 56-yr-old Indonesian man with a history of a tropical fever 5 yr earlier presented with variceal bleeding. Transhepatic obliteration of the varices was attempted, but the catheter placed in the right portal branch would not pass beyond the porta hepatis. Another catheter was inserted into the portal trunk under ultrasound guidance. Simultaneous opacification through the two catheters demonstrated a complete membranous obstruction of the portal vein at the porta hepatis and a portal-superior mesenteric-venous axis that had lost communication with incoming veins and the left portal branch, most likely because of multiple thrombosis. Other angiographic procedures also revealed marked hepatopetal collaterals (cavernous transformation) entering the liver through the hilum. Liver biopsy showed acute posttransfusion hepatitis superimposed upon portal fibrosis. The possible mechanism for membrane formation in relation to thrombosis is discussed. PMID- 3965348 TI - Prenatal effects of cimetidine. PMID- 3965349 TI - Pain in chronic pancreatitis. PMID- 3965350 TI - Cephalic phase of pancreatic secretion. PMID- 3965351 TI - Budd-Chiari syndrome and the lupus anticoagulant. PMID- 3965352 TI - Lasers and cancer. PMID- 3965353 TI - Geriatric care: can the physician do it alone? PMID- 3965354 TI - Nursing homes: why primary care MDs should get involved. PMID- 3965356 TI - Sudden cardiac death: identifying and managing the patient at risk. AB - When ventricular fibrillation is not associated with a myocardial infarction, the tendency is for recurrence, whereas ventricular fibrillation during the acute phase of infarction may not adversely affect the prognosis. The treatment of ventricular dysrhythmias is mandatory for those who have experienced primary ventricular fibrillation without evidence of acute myocardial infarction. This group is at highest risk for sudden cardiac death. PMID- 3965355 TI - Atherogenesis: why women live longer than men. AB - The total LDL:HDL cholesterol ratio, at higher levels, appears sufficient to account for the risk of clinical atherosclerosis in both sexes. At lower levels, however, women continue to enjoy less risk of atherosclerosis even at LDL:HDL cholesterol ratios equivalent to those in men. Median LDL levels are higher in men than in women until the menopause, beyond which a crossover occurs, and median levels become higher in women. However, though the difference narrows in the post-menopausal years, the LDL:HDL ratio is never higher in women than in men. PMID- 3965357 TI - Treating joint inflammation in the elderly: an update. AB - The abrupt onset of monoarthritis in an older patient--especially knee, but also wrist, elbow, ankle, or shoulder--should alert the clinician to the possibility of pseudogout. Joint damage or synovitis may predispose aged patients to sepsis. Rheumatoid synovium, for example, has altered synovial resistance to bacterial seeding; thus, septic arthritis in rheumatoid patients may be polyarticular. PMID- 3965358 TI - Weakness and 'tiredness': when to suspect myasthenia gravis. AB - Initial complaints of bulbar paresis may be problems with chewing and swallowing. Patients often choose to eat soft puddings and cereals rather than meats or hard fruits because of the fatigue associated with chewing. Immunosuppressive therapy with prednisone can result in a long-lasting remission, and is recommended especially for those patients who are older or are medically unable to tolerate surgical treatment. PMID- 3965359 TI - The delta agent comes of age. PMID- 3965361 TI - Duodenal ulcers that will not heal. PMID- 3965360 TI - Herbal tea induced hepatic veno-occlusive disease: quantification of toxic alkaloid exposure in adults. AB - Four young Chinese women took daily doses of an unidentified 'Indian' herbal tea as treatment for psoriasis. Three (one of whom died), developed ascites, hepatomegaly and biochemical abnormalities within 19-45 days. The fourth patient discontinued herbal tea after 21 days when she developed a skin rash. Two patients had portal hypertension, while all had liver histology showing features of veno-occlusive disease. Pyrrolizidine alkaloids were identified spectrophotometrically in the brewed tea, and in the chopped leaves of the herbal mixture; the mean dose in the tea prepared for consumption being 12 mg/day of alkaloid base and 18 mg/day of N-oxide. The mean cumulative dose of alkaloids (base + N-oxide) before onset of symptoms (three patients), was estimated to be 18 mg/kg. In the asymptomatic patient with histological liver disease only, the corresponding dose was 15 mg/kg. These cases thus provide some measure of pyrrolizidine alkaloid toxicity in adults. PMID- 3965362 TI - Pharmacology of propranolol in patients with cirrhosis and portal hypertension. AB - Ten patients with cirrhosis and protal hypertension received an initial 20 mg oral test dose of propranolol and subsequently 160 mg of a slow release preparation, orally, each day for seven days. Protein binding, serial plasma propranolol concentrations and effects on heart rate were studied. Protein binding was slightly reduced (mean 85%, range 78.9-88.1%) compared with four normals (mean 87.9%). In patients with severe liver disease (serum albumin less than 30 g/l) propranolol remained detectable in plasma 24 hours after the single 20 mg dose and high steady state concentrations (mean 266.5 ng/ml, range 84-406) were observed during regular dosing. At steady state there was a significant correlation between log total plasma propranolol concentrations and the percentage fall in heart rate (r = 0.659, p less than 0.05). We suggest that in patients with severe liver chronic disease (serum albumin less than 30 g/l), propranolol therapy should be initiated in hospital. The starting dose should be low (20 mg of the conventional formulation tds or 80 mg of the slow release preparation daily) and that regular monitoring of the heart rate should be carried out. PMID- 3965363 TI - Plasma glutathione S-transferase measurements after paracetamol overdose: evidence for early hepatocellular damage. AB - Plasma glutathione S-transferase (GST) measurements have been used to study early changes in hepatocellular integrity after paracetamol overdose and treatment with N-acetylcysteine (NAC). Patients admitted within seven hours and successfully treated had raised or equivocal GST on admission and each showed a transient peak in GST approximately 12 hours after the overdose. Similar, though smaller changes in GST, were seen in untreated patients whose paracetamol level fell below the treatment line. The plasma GST concentrations in successfully treated patients were small compared with values found in patients who subsequently developed severe liver damage. The changes in GST concentration observed in patients who developed severe liver damage indicated that distinct early and late phases of paracetamol-induced hepatotoxicity occurred. Although the mechanism by which paracetamol exerts its early toxic effect is unclear, our data suggest that prompt treatment with NAC can successfully prevent both clinical and subclinical hepatotoxicity in this early period. PMID- 3965364 TI - Effect of Rowachol on biliary lipid secretion and serum lipids in normal volunteers. AB - The effect of Rowachol (200 mg tid), an essential oil preparation, on biliary lipid secretion and serum lipids was measured in six healthy male volunteers before and after four weeks of treatment. Biliary cholesterol and phospholipid secretion increased significantly from 113 +/- 36 (SD) mumol/h to 155 +/- 52 mumol/h (p less than 0.05) and from 409 +/- 145 mumol/h to 587 +/- 185 mumol/h (p less than 0.05), respectively. Bile acid secretion increased from 1519 +/- 662 mumol/h to 2287 +/- 1175 mumol/h (p greater than 0.05 and greater than 0.10). This marked increase in biliary lipid secretion was not followed by a change in molar composition of biliary lipids and lithogenicity of bile. Serum cholesterol and triglycerides declined from 4.9 mmol/l to 4.1 mmol/l (p less than 0.05) and from 1.2 mmol/l to 0.9 mmol/l (p less than 0.05) respectively. The ratio of high density-lipoprotein cholesterol to total cholesterol increased from 0.22 to 0.31 (p less than 0.05). Although it has been shown previously that Rowachol could dissolve cholesterol gall stones the present results indicate that Rowachol alone has only weak litholytic properties, at least in normal volunteers, but might have several advantages when combined with chenodeoxycholic or ursodeoxycholic acid. PMID- 3965365 TI - Profiles of bile acids and their glucuronide and sulphate conjugates in the serum, urine and bile from patients undergoing bile drainage. AB - Bile acid profiles in serum, urine, and bile from patients undergoing bile drainage and the changes of serum bile acids after bile drainage were studied. Bile acids were separated into non-glucuronidate-non-sulphate, glucuronidated, and sulphated fractions and were measured by mass fragmentography using conjugates of deuterium labelled bile acids as internal standards. Glucuronidated and sulphated bile acids contribute 14-32% and 16-44% of serum bile acids, 4-11% and 61-82% of urine bile acids and 0.2-1% and 0.3-2% of biliary bile acids respectively. After bile drainage the concentration of serum non-glucuronidated non-sulphated bile acids decreased more rapidly than glucuronidated and sulphated bile acids. There was little biliary excretion of the glucuronidated and sulphated bile acids. Such conjugation appears to have a role in facilitating bile acid excretion by the urinary route. PMID- 3965367 TI - Incidence of colorectal cancer in proctocolitis: a retrospective study of 959 cases over 40 years. AB - The incidence of colorectal cancer was studied by the actuarial method in 959 patients with idiopathic proctocolitis seen from 1942 to 1981. Forty five per cent had rectal, 23% left-sided, and 32% total involvement of the colon. Six cancers were found: one in the rectal, one in the left-sided, and four in the total form of the disease. The risk of cancer per patient year in total colitis was zero per 2151 patient years in the first decade, 1/462 in the second decade, 1/315 in the third decade, and 1/75 in the fourth decade. The cumulative risk of developing cancer was zero at 10 years of duration of the disease, approximately 5% at 20 years, 15% at 30 years, and 20% at 35 years. This increase in risk of cancer is less than reported in some other series. Geographical differences in the incidence of cancer in proctocolitis could influence the risk and therefore also the long-term management of patients with proctocolitis in different geographical areas. PMID- 3965366 TI - Infection with the delta agent in children. AB - Serological evidence of infection with the hepatitis B virus associated delta agent (delta) was found in 34 of 270 Italian children with HBsAg-positive liver disease. In different histological forms of chronic HBsAg hepatitis the prevalence of delta infection increased in parallel with the activity of the disease and was maximal in children with cirrhosis. During two to seven years of follow up the hepatitis deteriorated in 38% of the 34 patients with delta infection and ameliorated only in 9%. By contrast the disease usually ran a mild course in the 236 delta-negative carriers of HBsAg, with remission in 55% of these children and deterioration in only 7%. The outcome of chronic hepatitis associated with delta infection was not influenced by treatment with steroids and azathioprine. Chronic delta infection in children is usually accompanied by serious liver disease, that has a tendency to progress and is unresponsive to conventional immunosuppressive treatment. PMID- 3965368 TI - Histological diagnosis of chronic inflammatory bowel disease in childhood. AB - One hundred and four children were initially assessed by clinical, radiological, and endoscopic criteria as chronic inflammatory bowel disease. All were assessed independently using precise histological diagnostic criteria. Fifty eight patients were diagnosed as Crohn's disease, 25 as ulcerative colitis, 15 remained provisionally categorised as indeterminate colitis and six proved to be normal. Diagnostic granulomas were found in 36% of endoscopic biopsies from the 58 children with Crohn's disease. This appears to be an underestimate as only four of 14 children with granulomatous Crohn's disease operated on had granulomas on endoscopic biopsy. This study shows that there is a spectrum of histological appearances in endoscopic biopsies in chronic inflammatory bowel disease in childhood ranging from definite Crohn's disease to definite ulcerative colitis with indeterminate features in between. Accurate histological diagnosis of chronic inflammatory bowel disease is dependent upon either multiple endoscopic biopsies or assessment of a surgically resected specimen. PMID- 3965369 TI - Methane excretion in man--a study of breath, flatus, and faeces. AB - In this paper aspects of the variability of methane producing status have been examined, and a survey of breath methane excretion in various clinical and control populations is reported. Prevalences of methane excretion were 54% in healthy controls, 53% in non-gastrointestinal patients and 32% in gastrointestinal patients. Patients with Crohn's disease, ulcerative colitis, and pneumatosis cystoides intestinalis had significantly lower prevalences of methane excretion (13%, 15%, and 11% respectively). Faecal constituents and in vitro incubation analysis were similar in breath methane excretors and non-excretors. Several patients did not excrete methane in the breath although methane was present in colonic gas. The results indicate that different gastrointestinal patient groups have different prevalences of breath methane excretion and that all healthy subjects may produce methane but only when the production reaches a threshold does it appear in the breath. PMID- 3965371 TI - Recurrent carcinoma of the vagina following Okabayashi's radical hysterectomy for cervical carcinoma. AB - Between 1962 and 1976, 1847 cases of cervical cancer were treated by Okabayashi's radical hysterectomy. Of these, 42 cases developed vaginal invasive carcinoma and 5 developed vaginal intraepithelial carcinoma thereafter, giving a recurrence rate of 2.5%. The vaginal recurrence rate declined annually during the period 1962-1976, and was thought to be due to the efficacy of routinization of postoperative vaginal cuff irradiation. Of the 47 recurrent cases 33 were discovered within 2 years following the operation. Seventy-two percent of the recurrent cases were asymptomatic. The importance of close follow-up of the patients during the first 2 postoperative years was denoted. The incidence of developing a secondary vaginal cancer in the cases of cervical adenocarcinoma was 10.0%, higher than the 2.2% for squamous cell carcinoma. All the recurrent cases were treated with vaginal cuff irradiation, either alone or with external irradiation and/or chemotherapy. The 3-year survival rate of the patients who had vaginal recurrence alone was 40.0%, better than that of the cases accompanied with recurrence at the other sites. PMID- 3965372 TI - The study of antibodies and antigens dissociated from the immune complexes extracted from ovarian carcinoma ascitic fluid. AB - In previous studies in our laboratory, heteroantisera were produced in rabbits by immunization with extracts of ascitic fluids from ovarian epithelial carcinomas. Reverse passive hemagglutination (RPHA) assay of these sera was used for the immunodiagnosis of ovarian cancer. Antibodies attached to lysed sheep red blood cells were able to detect tumor antigens in 63% of ovarian carcinoma sera. In the present study we have shown that the antigens detected in these assays are in fact contained in circulating immune complexes and are recoverable by disassociation with 8 M urea and separation of antibody and antigen by ion exchange chromatography. The antibodies thus obtained from immune complexes (IC) were assayed by indirect immunofluorescence against a variety of paraffin embedded tissue sections. Poorly differentiated ovarian epithelial carcinomas and papillary serous adenocarcinomas, as well as the tumors grown by implantation of the latter in nude mice, were all positively stained, while the Krukenberg tumor metastatic to the ovary, the benign ovarian cyst, the normal ovary, and the normal fallopian tube were all negative. Complete blocking of immunofluorescence staining by prior absorption of antibody with the dissociated antigen was achieved. The present study demonstrates that the antibodies and antigens dissociated from the immune complexes isolated from the ascitic fluids provide useful reagents for immunodiagnosis. PMID- 3965370 TI - Histological appearances of oesophagus, antrum and duodenum and their correlation with symptoms in patients with a duodenal ulcer. AB - Clinical data and histology from the oesophagus, gastric antrum, and duodenum were collected from 36 patients undergoing surgery for duodenal ulcer. Gastritis was present in 94% of the patients (25% of atrophic type), oesophagitis in 72% and duodenitis in 39%. Abnormal biopsies were present from all three sites in 33% of the patients. Only one patient showed three normal biopsies. The low incidence of duodenitis does not support the theory that duodenitis is part of the same spectrum as duodenal ulcer. Heartburn was related to the presence of gastritis (100%) and oesophagitis (76%) but not to duodenitis (52%). No relationship was found between the length of history, severity of pain, and histological abnormalities. PMID- 3965374 TI - Endolymphatic stromal myosis: a case with positive estrogen and progesterone receptors and good response to progestins. AB - This report describes a case of recurrent and metastatic endolymphatic stromal myosis (ESM), which showed good response to progestin therapy. Metastatic lung nodules regressed after medroxyprogesterone acetate (MPA) treatment, recurred while MPA was stopped, and disappeared again when MPA was restarted. The levels of estrogen and progesterone receptors measured in the resected tumor amounted to 79.5 and 310 fmole/mg protein, respectively. Sex steroid hormone dependency of ESM was reviewed in the literature. PMID- 3965373 TI - Chemoprevention of cervix cancer: Phase I-II: A feasibility study involving the topical vaginal administration of retinyl acetate gel. AB - A Phase I-II clinical trial has been conducted with a retinyl acetate (RA) gel applied cervicovaginally in women having a histopathologic lesion diagnosed as mild or moderate dysplasia. With informed consent, volunteer subjects were observed and followed with Pap smears and colposcopy in a standardized protocol involving a self-administered 7-day treatment course for three successive menstrual cycles. Varying dosages of RA including placebo, 3, 6, 9, and 18 mg per 6 g of an inert vehicle were employed. A total of 50 subjects were monitored for local and systemic side effects. No intolerable side effects or disturbing toxicity was reported or detected at any of these doses. With the 18-mg dosage, significant discomfort was reported by all women. Despite associated side effects and a considerable patient effort involved in carrying out the self administration of the gel, a high level of compliance was achieved in this trial. It has been established that women will voluntarily participate in an intervention clinical trial to determine whether retinyl acetate is an alternative method of therapy of presumed precancerous lesions of the cervix. The analysis of the side effects of the gel at the various dosage concentrations favors the selection of the 9-mg dosage for a multicenter Phase III clinical trial to determine efficacy. PMID- 3965375 TI - Dermatofibrosarcoma protuberans of the vulva. AB - A woman aged 52 years had a tumor of the mons pubis. The morphologic picture, featuring a whirling of spindle cells with long slender, interdigitating cell processes and so-called labyrinth nuclei, conformed to a dermatofibrosarcoma protuberans. Wide local excision is sufficient therapy, but more experience with this rare sarcoma of the vulva is necessary. PMID- 3965379 TI - Hospital offers high-risk mothers option for birthing room delivery. PMID- 3965377 TI - Solitary pelvic neural tumors with high steroid receptor content. AB - Two pelvic benign neural tumors, a neurofibroma and a neurilemmoma, were found to have high levels of cell nuclear estrogen receptors and both cytoplasmic and nuclear progestin receptors. A review of the literature reveals that neurogenic tumors occur predominantly in young women. This observation together with the recent findings of elevated sex steroid receptor proteins in meningiomas supports a hypothesis for the common hormonal dependence of neoplasms arising from the neural supporting tissues. PMID- 3965378 TI - Tax-exempt hospital issues drop again during 3rd quarter of '84. PMID- 3965376 TI - Evaluation of the cerviscope as a screening instrument. AB - The cerviscope has been proposed as a screening tool for use in conjunction with the Papanicolaou smear as a system offering many of the same advantages as colposcopy and cytology. One hundred twenty-five patients were evaluated with the cerviscope who had been referred to this colposcopy clinic with a diagnosis of dysplasia. The purpose of this study was to evaluate the instrument's potential as a screening adjunct in the context of simultaneous evaluation by colposcopy. Thirty-nine percent (49 patients) were unevaluable due to technical problems (defective cervicogram, nonvisualized squamocolumnar junction). Significantly, 67% (26 patients) of the 39 patients reported as having negative cervicograms had a biopsy-proven dysplasia (19 mild, 4 moderate, 3 severe). By the chi 2 method, this is statistically significant (P less than 0.001). PMID- 3965380 TI - Energy programs show creative financing. PMID- 3965381 TI - Creating a market niche. PMID- 3965382 TI - CEOs plan to expand home health, outpatient services. PMID- 3965383 TI - Hospital economic forecast. PMID- 3965384 TI - Medical staff hearings: required procedures. PMID- 3965385 TI - Hospital CFOs see disparity between CEOs' opinions and reality. PMID- 3965387 TI - Historical changes in hospital computer use. PMID- 3965386 TI - How to handle a strike. PMID- 3965388 TI - Insurers' interest in HMOs and PPOs grew through late '84. PMID- 3965389 TI - Departmental contract management grows in response to cost pressures. PMID- 3965390 TI - Pediatric hospital a study of integration. PMID- 3965392 TI - Suppression of in vitro lymphocyte proliferation in C57BL/10 ScN mice vaccinated with phase I Coxiella burnetii. AB - The effect of inactivated phase I and phase II Coxiella burnetii whole cell vaccine (WCV) on the response of murine spleen cells to mitogenic and antigenic stimuli was evaluated in C57BL/10 ScN endotoxin nonresponder mice with an in vitro lymphocyte proliferation assay. Intraperitoneal injection of phase I WCV into mice resulted in marked and persistent suppression of the proliferative response of spleen cells to concanavalin A, phytohemagglutinin, and pokeweed mitogen. This response was time and dose dependent and was not associated with decreased lymphocyte viability. By using a standard dose of 100 micrograms of phase I WCV, suppression of mitogenic responsiveness was first detected 3 days postinjection, attained maximum levels by day 14, and persisted for longer than 5 weeks. Suppression of mitogenic lymphocyte proliferation also was demonstrated after inoculation of animals with viable phase I organisms. The observed hyporesponsiveness of spleen cells from phase I WCV-injected animals was not either the result of a shift in the mitogenic dose optimum or due to a change in the day of in vitro peak response. Spleen cells from phase I WCV-injected mice were negatively regulated with homologous antigen. Investigation of the mechanism of action of phase I WCV, with a 51Cr-release assay, and trypan blue dye exclusion showed that phase I WCV was not directly cytolytic or cytotoxic to spleen cells from normal or vaccinated mice. Phase II WCV did not induce significant mitogenic hyporesponsiveness or negative modulation of spleen cells. These findings extend the observations of adverse host responses associated with the phase I WCV and underscore the need to develop a microbial fraction which possesses protective potency but which lacks the propensity to induce deleterious tissue reactions and immunosuppression. PMID- 3965391 TI - Effects of oxygen on pyruvate formate-lyase in situ and sugar metabolism of Streptococcus mutans and Streptococcus sanguis. AB - The strictly anaerobic metabolism of sugar in strains of Streptococcus mutans and Streptococcus sanguis was studied because deep layers of dental plaque are strictly anaerobic. Galactose-grown cells of these streptococcal strains had higher pyruvate formate-lyase activity than did glucose-grown cells. Among these strains, two strains of S. mutans had a significantly higher pyruvate formate lyase activity than did the others. This enzyme is extremely sensitive to oxygen, and even in situ the enzyme was inactivated by exposure of the cells to air. Lactate was less than 50% of the total end product of the strictly anaerobic incubation of the galactose-grown cells of S. mutans with excess glucose, and a significant amount of formate, acetate, and ethanol was produced through the catalysis of pyruvate formate-lyase. But the cells exclusively produced lactate when exposed to air for 2 min before the anaerobic incubation. The metabolism of sorbitol by S. mutans was seriously impaired by the exposure of the cells to oxygen, and the metabolic rate was reduced to less than 1/20 of that found under strictly anaerobic conditions because of the inactivation of pyruvate formate lyase. S. sanguis produced a smaller amount of the volatile products from glucose than did S. mutans because of the low level of pyruvate formate-lyase. However, the pyruvate formate-lyase in situ in S. sanguis was less sensitive to oxygen than was that in S. mutans. Because of this low sensitivity, S. sanguis metabolized glucose more rapidly under aerobic conditions, whereas the rates of the aerobic and anaerobic metabolism of glucose by S. mutans were similar, which suggests that S. mutans rather than S. sanguis can sustain the rapid sugar metabolism in the deep layers of dental plaque. PMID- 3965393 TI - Comparison of Bacteroides zoogleoformans strains isolated from soft tissue infections in cats with strains from periodontal disease in humans. AB - A total of 11 strains of Bacteroides zoogleoformans were isolated from 11 of 106 different cat subcutaneous "fight wound" abscesses and were among a total of 143 Bacteroides species isolated from these samples. They constituted 3.4% (11 of 325) of all anaerobic isolates. The cat strains and strains of B. zoogleoformans isolated from humans with periodontal disease were similar phenotypically as determined by biochemical reactions, polyacrylamide gel electrophoresis patterns of soluble proteins, and guanine plus cytosine ratios of DNA. Eight cat strains and five human strains tested had 45 to 54% DNA homology with the type strain of B. zoogleoformans. The eight cat strains and five human strains (excluding the type strain) were related by DNA homology at 70 to 77%. There was 85 to 90% intragroup DNA homology among the cat strains and 86 to 89% intragroup homology among the five human strains. The implications for epidemiology and human and animal ecology are discussed. PMID- 3965394 TI - Defective neutrophil and monocyte motility in patients with early onset periodontitis. AB - Several studies have documented suppressed polymorphonuclear neutrophil (PMN) chemotaxis in most patients with juvenile periodontitis. In contrast, data regarding PMN chemotaxis in patients with rapidly progressive periodontitis are very limited, and monocyte (MN) chemotaxis and random migration of PMNs or MNs from these patients have not been studied previously. Accordingly, we examined cell motility of PMNs and MNs from 27 patients with rapidly progressive periodontitis, 5 patients with juvenile periodontitis, and 37 normal control subjects by using a microchamber technique and the synthetic peptide N formylmethionyl-leucyl-phenylalanine (FMLP) as the chemoattractant. As a group, PMNs and MNs from patients with rapidly progressive periodontitis manifested significantly enhanced random migration relative to control cells (P less than 0.001), suppressed directed migration (chemotaxis) at FMLP doses of 10(-9) and 10(-8) M (P less than 0.05), and enhanced directed migration at a dose of 10(-6) M FMLP (P less than 0.01). In contrast, PMNs from patients with juvenile periodontitis exhibited normal random migration, and directed migration was significantly suppressed at all doses of FMLP tested (P less than 0.05). An abnormality of either PMN or MN motility was observed in 26 of 27 patients with rapidly progressive periodontitis. Enhanced random migration was seen in PMNs in 63%, MNs in 39%, and both cell types in 26% of the patients. Suppressed chemotaxis was seen in PMNs in 85%, in MNs in 74%, and in both cell types in 69% of the patients. The prevalence and magnitude of abnormalities in motility were somewhat lower in treated than in untreated patients. Thus, most, if not all, of this subgroup of patients with early onset, highly destructive periodontitis have abnormalities in PMN or MN motility, and these defects may differ from those seen in cells from patients with the juvenile form of the disease. PMID- 3965396 TI - Surface structures (peritrichous fibrils and tufts of fibrils) found on Streptococcus sanguis strains may be related to their ability to coaggregate with other oral genera. AB - We screened 36 strains of Streptococcus sanguis biotype I and 8 strains of S. sanguis biotype II for the presence of surface structures and for their ability to coaggregate with Actinomyces viscosus, Actinomyces naeslundii, and Fusobacterium nucleatum. Negative staining under an electron microscope revealed detectable surface structures on all S. sanguis strains. The majority of strains (38 of 44) carried peritrichous fibrils, which have an irregular profile and no distinct width. They usually appeared as a fringe with a constant width around the cell. Strains selected for measurement had a fringe with an average length of 72.4 +/- 8.5 nm on biotype I strains and 51.6 +/- 3.3 nm on biotype II strains. Some fibrillar biotype I strains carried an additional, longer (158.7 +/- 33.1 nm) type of fibril projecting through the shorter fibrils. Fibrillar density was characteristic for each strain, ranging from very dense on all cells in a population to very sparse on a few cells in a population. A small group of six strains carried tufts of fibrils in a lateral or polar position on the cell. Either one or two lengths of fibril were present in the tuft depending on the strain. One strain carried both peritrichous fibrils and fimbriae. Fimbriae are flexible structures with a constant width (4.5 to 5.0 nm) all along their length but very variable lengths (less than or equal to 0.7 micron) on each cell. S. sanguis I and II both included strains with peritrichous fibrils and tufts of fibrils, but the mixed morphotype strain was confined to biotype II. Fibrils were present on cells at all stages throughout the growth cycle for the strains tested. Freshly isolated fibrillar strains coaggregated consistently well with A. viscosus and A. naeslundii, although some fibrillar reference strains lacked the ability. In addition, all tufted strains could not coaggregate, but the strains with the mixed morphotype coaggregated well. Coaggregation with F. nucleatum was very strong for the fibrillar strains, but less strong for the tufted strains. We discuss the possible correlation between S. sanguis surface structure and ability to coaggregate. PMID- 3965395 TI - Expression of antigens encoded by the virulence plasmid of Yersinia enterocolitica under different growth conditions. AB - The expression of polypeptides of the virulence plasmid of Yersinia enterocolitica serotype O:3 was studied with the immunoblotting technique and specifically absorbed antisera to Y. enterocolitica O:3. At least 16 polypeptides were apparently specified by the virulence plasmid when plasmid-bearing bacterial were grown at 37 degrees C or intraperitoneally in semipermeable capsules. The different growth media used (also with added Ca2+) had quantitatively or qualitatively only a little influence on the expression of these polypeptides, whereas the growth temperature had a stronger influence. The best expression was achieved at 37 degrees C, at 22 degrees C the expression was weak, and at 4 degrees C the plasmid genes were inactive. Two chromosomally encoded polypeptides were expressed only at 37 degrees C, whereas the expression of eight polypeptides expressed at 22 degrees C was repressed at 37 degrees C. The intraperitoneal growth in capsules was used to detect the virulence plasmid-associated polypeptides of Yersinia pestis. Four plasmid-associated polypeptides were detected in Y. pestis with antiserum to Y. enterocolitica virulence plasmid antigens, and three were detected with antiserum to Y. pestis EV76. These results suggested that the virulence plasmid of Y. pestis was activated in the interstitial environment in vivo, where Ca2+ concentration was high, and also that the virulence plasmids of Y. enterocolitica and Y. pestis have three to four immunologically related polypeptides in common. PMID- 3965397 TI - Antigenic evidence for host origin of exudative fluids in lesions of Treponema pallidum-infected rabbits. AB - Mucoid fluid accumulating within syphilitic lesions has been considered to be of Treponema pallidum origin. To test this assumption, we examined testicular exudative fluids from T. pallidum-infected rabbits for the presence of T. pallidum antigens by various sensitive immunochemical methods, including Western blot analysis. Antigenic analysis of these fluids revealed host components but not treponemal antigens. Prolonged immunization of rabbits, guinea pigs, and a goat with this material in complete Freund adjuvant elicited low titers (fluorescent-treponemal-antibody test titer, less than or equal to 10) of antitreponemal antibodies in the rabbits and guinea pigs but not in the goat. The data suggest that these mucoid fluids are of host origin. The presence of mucopolysaccharides in these fluids may be related to the infective process. The possible mechanism by which mucopolysaccharides protect T. pallidum from immune mechanisms and its potential relationship to the pathogenesis of the disease are discussed. PMID- 3965398 TI - Survival and growth of Yersinia pestis within macrophages and an effect of the loss of the 47-megadalton plasmid on growth in macrophages. AB - The survival and growth of Yersinia pestis cells within mouse peritoneal cavities and within mouse peritoneal macrophages maintained in vitro was examined. Two strains were used which differed only in that one (KIM) contained the 47 megadalton plasmid associated with virulence and the second (KIM1) lacked this plasmid. The KIM cells, but not the KIM1 cells, acquired some resistance to phagocytosis during growth at 37 degrees C which was not evident when cells were grown at 26 degrees C. Whether previously grown at 26 or 37 degrees C, however, a substantial portion of the cells of either strain which were phagocytized were apparently killed after phagocytosis in vivo, although this was not observed in vitro. KIM cells which survived phagocytosis proliferated within macrophages in vivo, but no increase in viable cells was seen with the KIM1 cells. Growth of the KIM1 cells within macrophages in vitro required that a complex supportive medium be used in which the bacteria could have grown if extracellular. This was not the case for the KIM cells which proliferated within macrophages supported in medium not permissive to bacterial growth. After phagocytosis of cells of either strain by macrophages maintained in vitro, phagolysosome formation occurred normally, as shown by the acridine orange dye staining technique. KIM and KIM1 cells were equally sensitive to hydrogen peroxide and superoxide anion, although the sensitivity in each case varied with growth temperature. The oxidative burst, as determined by the luminol chemiluminescence assay, was low when compared with that seen after phagocytosis of Escherichia coli cells. Chemiluminescence after phagocytosis of yeast cells by macrophages which had engulfed KIM or KIM1 was also low. We conclude that survival within macrophages is substantially independent of the 47-megadalton plasmid and may be a consequence, as least in part, of blockage of the oxidative burst or rapid removal of the oxidizing compounds formed. The 47-megadalton plasmid is apparently required for subsequent proliferation within the macrophage. PMID- 3965399 TI - Purification and preliminary characterization of exo-beta-D-fructosidase in Streptococcus salivarius KTA-19. AB - Streptococcus salivarius fructosidase (beta-D-fructan fructohydrolase, EC 3.2.1.80) was purified to homogeneity. The molecular weight of the fructosidase was estimated to be 83,000 to 85,000 by gel filtration and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The pH optimum of the enzyme was 7.0, and the isoelectric point was pH 4.7. The purified enzyme preparation hydrolyzed levan, inulin, and several 2-beta-linkage-containing oligosaccharides such as sucrose and raffinose, but not melezitose, dextran, and pseudonigeran. The fructosidase was inhibited by Fe3+, Cu2+, Hg2+, and Ag+, but not by Ca2+, Co2+, Mg2+, and Zn2+, at a concentration of 10(-3) M. Mn2+ was particularly effective in stimulating activity at the same concentration. The presence of either EDTA or KCN also increased fructosidase activity by 20 to 30%. The enzyme was susceptible to sulfhydryl reagents since p-chloromercuribenzoate (10(-7) M) produced 63% inhibition of the activity. However, this inhibition was overcome in the presence of cysteine. This enzyme acts as an exofructosidase since thin-layer chromatographic analysis revealed that D-fructose was formed from levan or inulin by the action of the enzyme. PMID- 3965400 TI - Anaerobic phagocytosis, killing, and degradation of Streptococcus pneumoniae by human peripheral blood leukocytes. AB - Encapsulated Streptococcus pneumoniae of serotypes 2, 9N, 14, 21, and 23F and an unencapsulated variant of type 2 pneumococci were efficiently phagocytosed by both aerobically and anaerobically incubated human leukocytes. In the presence of O2, the pneumococci rapidly lost their viability, whereas during anaerobiosis, killing was considerably delayed. Type 14 pneumococci radiolabeled with [14C]choline or [14C]ethanolamine for cell wall teichoic acid, [14C]uracil for nucleic acids, or [14C]arachidonic acid for unsaturated cytoplasmic membrane lipids were used in studies of the fate of bacterial macromolecules after phagocytosis. The degradation of teichoic acid, RNA, and DNA during anaerobiosis approached that recorded in air at 60 min of incubation (45 to 70% and 55 to 75%, respectively). In contrast, the marked loss of [14C]arachidonic acid from pneumococcal membrane lipids observed in aerobic leukocytes did not occur during anaerobic incubation. Hence, lipid peroxidation could be involved in the rapid aerobic leukocyte killing of pneumococci, whereas a different leukocyte function of as yet unknown nature appears to be responsible for the killing seen in anaerobiosis. Autolysis-resistant type 14 pneumococci were obtained by substituting ethanolamine for choline in a defined culture medium. Differences between such bacteria and normal (autolytic) pneumococci in their killing and degradation by leukocytes were not detected in either the presence or the absence of O2. The aerobic and anaerobic handling of phagocytosed pneumococci by human blood leukocytes thus proceeded independently of the bacterial autolytic system. PMID- 3965401 TI - Genetic resistance to murine cryptococcosis: the beige mutation (Chediak-Higashi syndrome) in mice. AB - The influence of the bgJ and bg2J mutations on the susceptibility of mice to experimental cryptococcosis was studied in inbred mice of the C57BL/6J and C3H/HeJ strains. Although infected animals with the bg/bg genotype had a significantly shorter lifespan than bg/+ or +/+ animals, C3H/He beige-2J mice were less susceptible than C57BL/6 beige-J mice when compared with nonbeige mice of similar background. On days 18 and 19 after infection, quantitation of cryptococci in the brain, liver, and spleen revealed that the overall burden of organisms in infected C57BL/6 beige-J mice was in excess of one log unit above that found in the brain, liver, and spleen of infected C57BL/6 +/+ mice. At that time, C57BL/6 beige-J mice showed a 53% increase in mean brain weight, a 67.8% decrease in mean liver weight, and a 58.6% decrease in mean spleen weight, when compared with uninfected animals of the same age and genetical lineage. The corresponding figures for C57BL/6 +/+ mice were a 32% increase in mean brain weight, a 41.4% decrease in mean liver weight, and a 23.4% decrease in mean spleen weight. From these data, it is concluded that the beige mutation in mice is associated with increased susceptibility to cryptococcosis, the accrued susceptibility of the beige mutant is related to more rapid changes in the weight profile of the target organs as well as to a higher rate of growth or decreased clearance of Cryptococcus neoformans or both, and other autosomal genes are likely to be involved in the genetic control of susceptibility to murine cryptococcosis. PMID- 3965402 TI - Enhancement of experimental bacteremia and endocarditis caused by dysgonic fermenter (DF-2) bacterium after treatment with methylprednisolone and after splenectomy. AB - The dysgonic fermenter-2 bacterium is a newly recognized fastidious gram-negative bacillus that causes bacteremia and sometimes endocarditis in immunocompromised persons after they are bitten by dogs. To develop an experimental model of this infection, we placed polyethylene catheters across the aortic valves of New Zealand white rabbits, which were inoculated intravenously the next day with dysgonic fermenter-2 bacteria. After 1 week, the rabbits were killed and the endocardial vegetations were homogenized for quantitative culture. Large inocula (1.3 X 10(10) to 2.1 X 10(10) viable bacteria) were required to produce infected vegetations. All infected rabbits had negative blood cultures at the time of autopsy and most developed serum agglutinins against dysgonic fermenter-2 bacteria. Three daily injections of methylprednisolone (30 mg/kg), starting the day before inoculation, significantly increased the incidence of endocarditis and the number of bacteria per gram of infected vegetation (P less than 0.05). Treatment with methylprednisolone prolonged the initial bacteremia and caused significant increases in the numbers of bacteria per gram of blood, spleen, and liver compared with those of untreated controls (P less than 0.05). Rabbits that had previously undergone splenectomy showed prolongation of the initial bacteremia but no significant increase in the incidence of infected vegetations. These results showed that the dysgonic fermenter-2 bacterium is a pathogen that causes endocarditis in rabbits but that it requires a large inoculum and produces blood culture-negative infections. Treatment with methylprednisolone enhances infection by prolonging the initial bacteremia and probably by diminishing bactericidal activity in the vegetations. PMID- 3965403 TI - Effect of local and parenteral immunization on implantation of Actinomyces viscosus T6 in rats. AB - Groups of rats immunized in the vicinity of the major salivary glands or immunized intraperitoneally with Actinomyces viscosus T6 and their sham-immunized controls were infected with the homologous bacterium. Significantly higher levels of salivary and serum antibody were induced by intraperitoneal than by salivary gland immunization. There were also significant inverse correlations between the levels of salivary and serum antibody and the levels of implantation of A. viscosus T6. The level of implantation of A. viscosus T6 was significantly lower in the immunized animals than in the controls. However, antibody had limited capacity to inhibit the establishment of this bacterium. PMID- 3965405 TI - Pattern of formylmethionyl-leucyl-phenylalanine-induced luminol- and lucigenin dependent chemiluminescence in human neutrophils. AB - The stimulation of neutrophils by formylmethionyl-leucyl-phenylalanine results in a bimodal luminol-dependent chemiluminescence pattern. We observed, however, only a single peak chemiluminescence pattern in the response to the peptide when we used lucigenin as an amplifying substance. We suggest that lucigenin, the larger molecule, (510 daltons; luminol is 177 daltons) only exerts an extracellular effect. PMID- 3965404 TI - Monoclonal antibodies to leukotoxin of Actinobacillus actinomycetemcomitans. AB - Hybridoma cell lines which produce monoclonal antibodies to a leukotoxin from Actinobacillus actinomycetemcomitans were prepared. The monoclonal antibodies were selected for their ability to neutralize the cytotoxic activity of the leukotoxin and recognize the toxin on nitrocellulose blots. The antibodies belonged to either the immunoglobulin G1 (IgG1) or IgG2 subclass and differed in their ability to bind to the leukotoxin on nitrocellulose blots. However, only slight differences in neutralization titers were observed. Use of the monoclonal antibodies revealed that polymyxin B-extracted or osmotic shock-released leukotoxin could be separated into several high-molecular-weight polypeptides by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Immunoblot analysis with the monoclonal antibodies also demonstrated that the leukotoxin was present in eight oral strains of A. actinomycetemcomitans that had been previously classified by a biological assay as leukotoxic. The availability of these monoclonal antibodies should facilitate and expand studies concerning the role of the leukotoxin in the pathogenicity of A. actinomycetemcomitans. PMID- 3965406 TI - Metabolic and mitochondrial morphological changes that mimic Reye syndrome after endotoxin administration to rats. AB - The administration of sublethal doses of Escherichia coli O111:B4 endotoxin to starved rats results in significant increases in plasma ammonia, free fatty acids, and serum lactate compared with starved controls. These metabolic alterations are associated with Reye syndrome-like histological findings of hepatic microvesicular fatty accumulation and hepatic ultrastructural evidence of mitochondrial pleomorphism with matrix disruption. This sublethal endotoxin model may help elucidate the relationship between the hepatic mitochondrial injury, characteristic metabolic impairment, and encephalopathy seen in patients with Reye syndrome. PMID- 3965407 TI - Interaction of bifidobacterial lipoteichoic acid with human intestinal epithelial cells. AB - Binding of the lipoteichoic acids of Bifidobacterium bifidum to human colonic epithelial cells appeared to be specific, reversible, and cell concentration and time dependent. A single population of approximately 8.3 X 10(8) binding sites per cell was detected, with a dissociation constant of 125 microM. Ester-linked fatty acids are essential for binding. PMID- 3965408 TI - Effect of calcium ions on staphylococcal alpha-toxin-induced hemolysis of rabbit erythrocytes. AB - Calcium in millimolar concentrations protected rabbit erythrocytes from hemolysis caused by staphylococcal alpha-toxin. This effect was maximal at 30 mM CaCl2 and required the continued presence of calcium. The protection was not absolute and could be overcome by increased concentrations of alpha-toxin. Calcium did not block the binding of alpha-toxin to erythrocytes but inhibited the alpha-toxin induced release of small ions from the cell as measured by 86Rb release. The transient removal of calcium was sufficient to abrogate its protective effect, suggesting that its action involves a reversible alteration in the state of the membrane. The three steps of the alpha-toxin-induced hemolytic sequence are: (i) binding to specific receptors, (ii) formation of transmembrane pores, and (iii) cell lysis. We concluded that calcium acted at step ii by impeding the lateral movement of alpha-toxin necessary to form the transmembrane hexamer pores. PMID- 3965409 TI - Decomplementation antigen, a possible determinant of staphylococcal pathogenicity. AB - We report the existence of an extracellular staphylococcal product, designated staphylococcal decomplementation antigen (DA), that causes rapid consumption of early-reacting complement components up to and including C5 in human serum. Complement activation occurs as a consequence of immune complex formation between DA and specific human immunoglobulin G antibodies and proceeds primarily via the classical pathway. The terminal components C7, C8, and C9 are not consumed during the process. Levels of DA production do not correlate with the expression of classical pathogenic factors, such as coagulase, clumping factor, protein A, or alpha-toxin. DA is a nondialyzable macromolecule eluting in a molecular-weight region of 70,000 to 120,000 on Sephacryl S-300 and displaying an apparent sedimentation coefficient of 3 to 4 S on sucrose density gradients. The molecule is remarkably stable and resists destruction upon boiling for 30 min or by treatment with pronase, lysostaphin, DNase, or RNase. We anticipate that DA protects staphylococci from complement attack through induction of abortive, complement-consuming reactions in the fluid phase. PMID- 3965410 TI - Isolation and partial characterization of staphylococcal decomplementation antigen. AB - A substance with potent decomplementation activity was isolated from staphylococcal culture supernatants by polyethylene glycol precipitation, DEAE ion-exchange and Sephacryl chromatography, and preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis. The purified substance exhibited all the characteristics of the decomplementation antigen (DA) previously detected in unfractionated culture supernatants. It contained glucosamine and phosphorus and was provisionally identified as extracellular, water-soluble teichoic acid of Staphylococcus aureus. DA was entirely resistant towards the action of proteases, DNase, RNase, or lysostaphin and withstood boiling for 30 min. Its electrophoretic mobility in agarose gels at pH 8.7 was approximately double that of human serum albumin. The molecule eluted in a molecular-weight region of 70,000 to 120,000 on Sephacryl S-300 and sedimented as a symmetrical 3 to 4 S moiety in sucrose density gradients. It migrated near the dye front on 12.5% sodium dodecyl sulfate-polyacrylamide gels and remained undenatured after boiling in sodium dodecyl sulfate. DA formed a symmetrical immunoprecipitate upon crossed immunoelectrophoresis against pooled human immunoglobulin G. It was identified as the major extracellular antigen present in unfractionated S. aureus culture supernatants that is precipitable by naturally occurring human immunoglobulin G antibodies. Immune complexes forming between DA and human immunoglobulin G exhibited an extraordinary capacity to activate the classical complement pathway. Micro- or nanogram amounts of purified antigen added to antibody-containing human serum effected rapid and complete consumption of C3, C4, and C5. The biochemical and biological properties of DA single out this molecule for an important role in suppressing the opsonizing activity of host complement through induction of abortive complement consumption in the fluid phase. PMID- 3965411 TI - Identification of protein antigens of Legionella pneumophila serogroup 1. AB - Growth of Legionella pneumophila serogroup 1 in yeast extract broth was standardized, and protein profiles of detergent-solubilized cells were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Over 30 protein bands were identified, 6 of which were more prominent both in Coomassie brilliant blue-stained profiles and in fluorograms with intrinsically radiolabeled bacteria. These major proteins were 22,000 dalton (22K), 24K, 43K, 63K, 76K, and 78K. We found that the 24K and 63K major proteins were antigenic, as demonstrated both by radioimmunoprecipitation (RIP) of [35S]methionine-labeled organisms and by immunoblotting with rabbit hyperimmune sera. In addition, both techniques detected antigens migrating at 58K, 72K, 76K, and 78K. The major 22K and 43K major proteins and antigens migrating at 25.5K, 29K, and 46K were only detected by radioimmunoprecipitation, whereas antigens of 19K, 48K, 53K, and 68K were detected only by immunoblotting. Cell-surface localization of the proteins was determined by a modified radioimmunoprecipitation assay designed to react specifically with surface antigens and by the use of hyperimmune sera that had been extensively preabsorbed with intact cells to deplete the sera of antibodies directed against surface components. The 22K, 24K, 43K, 63K, and 78K major proteins and several minor proteins were found to be located on the surface of L. pneumophila cells. PMID- 3965412 TI - Contraceptive method switching among American female adolescents, 1979. AB - Better knowledge about contraceptive use in adolescents is needed if pregnancy prevention is to be improved. Data from the 1979 National Survey of Young Women were used to examine method switching once contraceptive use had begun among 449 never-pregnant young women who reported premarital intercourse more than once. Bivariate chi2 tests and multivariate logit regression were used to examine factors related to switching in four analyses: overall switching; switching among those with one intercourse partner; and switching from nonmedical and medical methods separately. Frequency of intercourse and type of first method had an interactive effect on switching; length of exposure to switching, type of relationship, and reason for choosing the first method were also significant. These results suggest that providers and educators should consider the circumstances under which contraceptive methods are chosen and used by young women when counseling them as to what method may be best for them. PMID- 3965413 TI - Selected psychosocial characteristics of black unwed adolescent fathers. AB - Adolescent fathers and nonfathers were compared as to their belief in a sense of personal control and responsibility for their own lives (locus of control); ability to optimistically trust others (interpersonal trust); taking an active orientation to life's demands and problems (coping style); and family/generational pattern of unwed parenthood. Participants were 24 unwed adolescent fathers and 27 unwed adolescent nonfathers, aged 15-19 years. Each participant completed a questionnaire containing a Rotter Internal-External Locus of Control Scale, the Rotter Interpersonal Trust Scale, the Behavioral Attributes of Psychosocial Competence, and a scale measuring family pattern of unwed parenthood. Results suggest that adolescent fathers are usually older, more likely to have been born out-of-wedlock, and less trusting than nonfathers. The implications for casework with adolescent fathers are discussed. PMID- 3965414 TI - The financial impact of a comprehensive adolescent pregnancy program on a university hospital. AB - This study investigated the financial impact which an adolescent pregnancy program had on one of its sponsoring agencies, the University Hospital, Salt Lake City, UT. Financial data from hospital billings and collections on the 75 teens who delivered during a 12-month period were reviewed. A comparison of the money for salaries supplied to the special program by the hospital with the amount of estimated "new" money generated for the hospital by the program yielded an income to expenditure ratio greater than two. Eighteen teens who were in the lowest self pay category were matched to self-pay teens delivering at the same hospital who received traditional prenatal care. The hospital collection rate for teens in the special program was not significantly greater than that of the comparison group. The investment in an adolescent pregnancy program was beneficial mainly from the viewpoint of recruitment of patients who were brought into the hospital system as a result of the adolescent pregnancy program. PMID- 3965415 TI - Seizures in adolescence. A review of patients admitted in an adolescent service. AB - The admissions of new seizure patients to an adolescent service over a 10-year period were retrospectively reviewed with regard to the patient's etiology, work up, and outcome. Head trauma and pseudoseizures were common, 21% and 19%, respectively. In general, the outcome in adolescents appears to depend more on the underlying diagnosis than on how the seizure presents. PMID- 3965416 TI - Attitudes of high school girls in Israel and the United States toward breast feeding. AB - Newborns are breast fed more frequently in Israel than in the United States (92% vs. 57%). Differences in the attitudes of the two countries might suggest interventions to increase breast feeding. We studied the breast-feeding attitudes of high school girls in Israel and the United States using a 21-item questionnaire. Israeli girls were significantly more positive about breast feeding than U.S. girls. Israeli girls answered 13 items positively more frequently than U.S. girls, while American girls responded positively more frequently than Israeli girls for only two items. Israeli girls were more likely to plan on breast feeding (68.2% vs. 42.4%). We speculate that interventions designed to improve the breast-feeding attitudes of young people may increase the prevalence of breast feeding. PMID- 3965417 TI - Ten-year follow-up of adolescent dyslexics. AB - A follow-up study of 26 dyslexics with an age range from 20 to 28 years revealed that reading and writing problems were essentially unchanged from the time of diagnosis 7-10 years earlier. The intellectual capacity of all subjects was normal. One of the ten who finished high school had started university studies. Sixteen (62%) had completed only the obligatory nine years of schooling. Fourteen (54%) were in practical occupations such as a cook, storeman, and truck driver. Our results suggest that with late diagnosis and no remedial treatment, dyslexia remains. The subjects report that their handicap has interfered with their choice of occupation. PMID- 3965418 TI - Spermarche--the age of onset of sperm emission. AB - Gonad maturation in boys is not characterized by a critical visible event such as menarche in girls. Establishing spermatogenesis by masturbation in maturing boys may be considered inappropriate. In order to estimate the median age of spermarche, a group of 155 normal schoolboys were examined twice (ages 12 and 13 years) for the occurrence of sperm in the first voided morning urine. The boys were requested to bring a daily sample for 10 consecutive days. Over 90% brought at least two samples and 50% brought 5-10 samples. The rate of boys with spermaturia at each age was calculated by the life-table method to adjust for the varying number of samples. New spermaturia was detected with each additional sample in the boys who brought in a greater number of samples. The urine examination carried a considerable false negative rate; even in boys who brought five or more samples, over 40% of boys positive at age 12 were negative at age 13. The rate of spermaturia at age 12 years was 37.5%, and at age 13 it was 68.9%. Our previous report showed the rate at age 11 years to be less than 1%. Because of an uncertain number of false negatives, these are probably under estimates of the true rate of spermatogenesis. The occurrence of spermarche was significantly associated with maturation of secondary sex characteristics. PMID- 3965419 TI - Does ethnicity constitute a risk factor in the psychological distress of adolescents with cancer? AB - To determine if ethnicity constitutes a risk factor in the psychological distress of adolescents with cancer, ethnic comparisons (Hispanic versus Anglo) were made on four psychological measures administered to 54 adolescents with cancer. Data from the largely Mexican-American San Antonio sample were then compared to test scores from a largely Anglo Los Angeles sample. A San Antonio subsample of 25 adolescents with cancer who received behavioral intervention for relief of treatment-related distress were retested on these psychological measures at six months following intervention and test score changes were compared to those found in a similar Los Angeles study. No ethnic differences were found on any measure. The Los Angeles findings of normal trait anxiety and self-esteem in adolescents with cancer and the findings that adolescents with cancer perceive little control over their health and the significant impact of their illness were similar to those in San Antonio. Reasons for the even higher impact of illness found in the San Antonio sample are discussed. Adolescents from both sites demonstrated similar reductions in their trait anxiety scores following behavioral intervention. We conclude that ethnicity per se does not appear to have a major influence on the experience of cancer in adolescents. Nevertheless, our findings suggest that membership in a minority group and a clinic's attitudes toward ethnic differences may play important roles in acceptance or rejection of behavioral intervention and thus merit investigation. PMID- 3965420 TI - Veterinary service fee for military personnel. PMID- 3965421 TI - Tear substitutes and atropine. PMID- 3965422 TI - Unique characteristics of the National Animal Disease Surveillance system. PMID- 3965423 TI - Urinary tract infection associated with long-term corticosteroid administration in dogs with chronic skin diseases. AB - Urinary tract infections were documented in 28 (39%) of 71 dogs receiving long term corticosteroid therapy for chronic skin diseases. There were no significant differences regarding alternate-day versus daily corticosteroid administration, corticosteroid dosage, or duration of therapy when data for the infected and noninfected groups were compared. A significantly (P less than 0.01 and P less than 0.005, respectively) greater frequency of bacteriuria was seen in female dogs and castrated male dogs receiving corticosteroid therapy. Urine sediment analysis alone was not an adequate means of detecting urinary tract infections in these dogs. PMID- 3965424 TI - Thyrotropin stimulation test for evaluation of thyroid function in psittacine birds. AB - Serum thyroid hormone concentrations were determined before and after thyrotropin (thyroid stimulating hormone [TSH]) stimulation in caged psittacine birds to determine whether the TSH stimulation test could be used to evaluate thyroid function in this class of birds. The mean (+/- SD) resting thyroxine concentrations (ng/ml) for the species studied were: cockatoos, 13.63 +/- 6.53 (n = 6); Amazon parrots, 8.19 +/- 6.90 (n = 8); scarlet macaws, 1.34 +/- 0.51 (n = 9); blue and gold macaws, 3.41 +/- 1.78 (n = 8); African gray parrots, 1.42 +/- 0.44 (n = 6); conures, 1.76 +/- 0.77 (n = 5); and cockatiels, 11.83 +/- 6.76 (n = 3). The mean (+/- SD) thyroxine concentrations (ng/ml) 4 to 6 hours after TSH stimulation were 35.10 +/- 13.16, 27.40 +/- 15.93, 6.46 +/- 3.10, 12.36 +/- 6.34, 9.30 +/- 2.90, 13.50 +/- 7.71, and 39.0 +/- 5.66, respectively. Serum tri iodothyronine concentration did not increase significantly after TSH stimulation. The results demonstrated that the TSH stimulation test can be used to evaluate thyroid function in caged psittacine birds. PMID- 3965425 TI - Carpal hyperextension in two-month-old pups. AB - Abnormal carpal configuration was observed in a litter of ten 2-month-old pups raised in a research colony. Five of the pups were exercised daily, and carpal configuration returned to normal within 7 to 10 days. The other 5 pups remained confined, and their carpal configuration returned to normal after 6 weeks. It was concluded that poor muscle tone was responsible for the carpal hyperextension. PMID- 3965426 TI - International aspects of rabies. PMID- 3965427 TI - Pemphigus foliaceus of the footpads in three dogs. AB - Severe hyperkeratinization and villous hypertrophy of the footpads were seen in 3 middle-aged dogs. Peeling, fissuring, swelling, and ulcerations were noted on the margins of severely affected pads. Pain was evident in palpation and ambulation. Lesions were compatible with the traditional diagnosis of "hard pad disease". Histopathologic findings were diagnostic for canine pemphigus foliaceus in all 3 dogs, and direct immunofluorescence in an intercellular pattern was seen in both dogs that were tested. All 3 dogs responded to immunosuppressive dosages of corticosteroids. PMID- 3965429 TI - Chylothorax associated with blastomycosis in a dog. AB - Respiratory distress caused by pleural effusion resulted from chylothorax. Thoracic drainage and lowfat dietary therapy was effective in removing and preventing significant recurrence of the chylothorax; however, the patient died unexpectedly. At necropsy a blastomycotic granuloma found at the precava was considered the cause of the chylothorax. There had been no recognizable antemortem signs of blastomycosis. Blastomycosis can be considered as a rare cause of chylothorax. PMID- 3965428 TI - Blastomycosis in a ferret. AB - An 18-month-old female ferret with an ulcerated metacarpal pad and signs of respiratory illness was diagnosed as having blastomycosis by visualization of organisms on a tissue imprint, an agarose gel immunodiffusion test, and thoracic radiography. The ferret was treated intravenously with amphotercin B at 0.4 to 0.8 mg/kg and orally with ketoconazole at 8 mg/kg for approximately 1 month, during which time clinical and radiographic improvement was noted. A change to SC amphoterocin B therapy resulted in relapse of clinical signs despite continuation of ketoconazole therapy, and necessitated euthanasia. Necropsy revealed granulomatous lesions typical of Blastomyces dermatitidis infection in the lungs, thoracic pleura, spleen, meninges, and brain. Comparisons between this case and canine blastomycosis cases are made and alternative treatment regimes for mustelid blastomycosis are suggested. PMID- 3965430 TI - Polycystic kidneys in a ferret. AB - Polycystic kidneys were found at necropsy in an adult ferret with a history of seizures and a palpable abdominal mass. Both kidneys contained numerous fluid filled cysts of various sizes. The ferret may provide an animal model for the study of polycystic disease in man. PMID- 3965431 TI - Surgical correction of primary pneumothorax in a dog. AB - Surgical repair of primary pneumothorax in a dog was performed by a median sternotomy and partial lung lobectomies using an automatic suturing device. A median sternotomy was performed since the location of the lesion was undetermined preoperatively. The automatic suturing device provided a quick, simple, and secure method of performing the partial lobectomies. Ruptured blebs and subpleural emphysema were present in the excised pulmonary tissue. Mechanical pleurodesis was also performed in an attempt to prevent recurrence. Large-gauge orthopedic wire was used to close the sternotomy in order to minimize postoperative complications. On follow-up evaluation 6 months later, the dog was normal. PMID- 3965432 TI - Prostatic adenocarcinoma in a castrated dog. AB - Atypical prostatic adenocarcinoma was diagnosed in a castrated dog. The gland was of normal size, contrary to what has been reported in most other cases in dogs. Metastases were not seen, even though radiography suggested metastasis to the external iliac lymph nodes and histologic examination revealed the neoplasm to have a moderately malignant character. Even though hormones have been implicated as a cause of prostatic adenocarcinoma in man, the development of such a neoplasm in dogs castrated at an early age, as exemplified by this case, may cast doubt on that hypothesis. PMID- 3965433 TI - Laryngeal carcinoma in a cat. AB - Laryngeal neoplasia was diagnosed in a 5-year-old domestic shorthair cat examined for cough and gagging episodes. Resection of the mass revealed a squamous carcinoma which had invaded the deep floor of the larynx. Primary neoplasia of the feline larynx is a rare condition but needs to be distinguished from other obstructive laryngeal conditions, using radiography, laryngoscopy and biopsy. PMID- 3965434 TI - Infiltrative lipoma in three dogs. AB - Infiltrative lipoma was diagnosed in 3 dogs. The invasive clinical and benign microscopic characteristics of the lipomas were considered in relation to other adipose tissue tumors. Treatment consisted of wide excision or surgical debulking when tumor margins were indistinct. In spite of the aggressive appearance of the lipoma, its benign nature dictated a conservative course of surgical therapy. Accurate and early diagnosis was needed to ensure adequate excision. The tumor recurred if excision was incomplete. PMID- 3965435 TI - Surgical correction of third eyelid prolapse in dogs. PMID- 3965436 TI - Industrial employment of veterinarians. PMID- 3965437 TI - Suicide pacts: international comparisons. AB - Twenty suicide pacts (double suicides) from the Florida Dade County Medical Examiner's Office were identified. These data were compared using a standardized instrument to published suicide pact data from England, Japan, and Bangalore City, India. Results were analyzed using simple statistical methods. Major differences were found between Western suicide pacts and Eastern suicide pacts. In this study, the frequency of suicide pacts was found to be greatest for Japan; lover pacts were found to be typical for Japan; spouse pacts were typical for Dade County and England; and friend pact frequency was greatest for Bangalore City. In addition, it was found that suicide pact victims, in general, choose nonviolent suicide methods. PMID- 3965438 TI - Oral sodium chloride in the management of schizophrenic patients with self induced water intoxication. AB - Hyponatremia is always present in patients with water intoxication and accounts for many of the life-threatening symptoms and signs found in this population. In schizophrenic patients, water restriction, a cornerstone in the treatment of water intoxication, may be impossible to implement over the course of long-term management. The use of oral sodium chloride administration in such patients and its short-term efficacy in preventing major motor seizures are described. PMID- 3965439 TI - Elimination half-life and bioavailability of haloperidol in schizophrenic patients. AB - Haloperidol was administered orally to 6 male schizophrenic patients and intravenously to 3. Elimination half-life (t1/2 beta) and bioavailability (F) were calculated for both groups from haloperidol serum concentrations determined by gas-liquid chromatography. Mean (+/- SD) half-lives were 17.5 +/- 8.7 hours for oral administration and 15.1 +/- 2.5 hours for intravenous; bioavailability was 0.64 +/- 0.23. These values were comparable to those found in normal volunteers. PMID- 3965440 TI - Use of clonazepam in two cases of acute mania. AB - Two cases of mania, one psychotic and one nonpsychotic, were treated with clonazepam, 4 mg p.o. q.i.d. In the nonpsychotic patient, complete alleviation of manic symptomatology was noted with use of clonazepam. The psychotic patient showed a reduction in manic behavior during clonazepam therapy, but without concomitant effect on psychotic features. Implications for the use of this novel psychopharmacologic agent are discussed and a possible mechanism of action is proposed. PMID- 3965441 TI - Prevalence of anxiety disorder among alcoholics. AB - A preliminary study of the prevalence of DSM-III anxiety disorders in a group of inpatients treated for alcohol detoxification is presented. The rating was performed in accordance with the Structured Clinical Interview for DSM-III (SCID). The results showed that nineteen of 84 subjects (22.6%) met criteria for one or more anxiety disorders. In 12 of these subjects drinking followed the onset of anxiety by as long as 19 years. No conclusions can be drawn about the etiologic role of anxiety in alcoholism. However, to the extent that patients with treatable phobic and anxious states can be identified, there is a potential for prevention of alcoholism in some of these individuals. PMID- 3965442 TI - Isolation and characterization of proteoglycans synthesized in ovo by embryonic chick cartilage and new bone. AB - Cartilage proteoglycans have been well characterized in a number of developing systems, both in vitro and in vivo, but the newly synthesized molecules have been analyzed only from culture material. Because of potential culture artifacts, an attempt was made to characterize the proteoglycans newly synthesized in ovo in chick embryo sternum, tibial epiphysis, and tibial shaft. These in ovo synthesized proteoglycans share many structural features with chick proteoglycans synthesized by chondrocytes in culture including average monomer size, chondroitin sulfate chain size, keratan sulfate chain size, and the ability to aggregate with hyaluronic acid. Moreover, the newly synthesized in ovo proteoglycans, notably those of the tibial epiphysis, display reproducible changes in their structure as a function of embryonic age. These changes correlate with similar changes documented for chick cartilage proteoglycans synthesized in culture. Finally, the proteoglycans synthesized in ovo in the day 17 tibial shaft include, in addition to cartilage proteoglycans, one proteoglycan which seems to be characteristic of bone. PMID- 3965443 TI - Recycling of the asialoglycoprotein receptor in isolated rat hepatocytes. ATP depletion blocks receptor recycling but not a single round of endocytosis. AB - Continuous endocytosis of 125I-asialo-orosomucoid (ASOR) mediated by the galactosyl receptor in rat hepatocytes is a cyclic process. 125I-ASOR-receptor complexes are internalized, processed, and the ligand is degraded while the receptor is returned to the cell surface for reutilization. Since a true cycle has a thermodynamic requirement for the input of external energy, we examined the effects of changes in intracellular ATP levels on the function of the receptor cycle. Hepatocytes were depleted of ATP to various extents prior to endocytosis by incubating cells at 15 degrees C in the presence of 2 mM NaF and 0-20 mM NaN3. A luciferase-luciferin bioluminescence assay was used to quantitate the amount of cellular ATP. ATP-depleted cells were allowed to bind 125I-ASOR at 0 degrees C, washed through discontinuous Percoll gradients, and only viable cells were isolated and incubated at 37 degrees C to initiate a synchronous single round of endocytosis. The extent of internalization of this surface-bound 125I-ASOR was unaffected by an ATP depletion to less than 1% of the control level. The rate of internalization of surface-bound ligand was unaffected until the ATP levels decreased to 30% or less; at greater than 98% ATP depletion the initial rate decreased by a maximum of 55% and the kinetics became biphasic. In contrast, continuous endocytosis in the presence of excess ASOR was inhibited by only a 25% decline in cellular ATP content and demonstrated a very sharp threshold response to changing ATP levels. Continuous endocytosis, which requires receptor recycling, was completely inhibited when the total cellular ATP level decreased by only 40%. We conclude that the internalization phase of endocytosis is not dependent on ATP but that the processing and/or externalization phases of the complete receptor cycle are either directly or indirectly dependent on ATP and very sensitive to changes in cellular ATP content. PMID- 3965444 TI - The intracellular accumulation of UDP-N-acetylhexosamines is concomitant with the inability of human colon cancer cells to differentiate. AB - The relationship between the intracellular concentration of various nucleotides as measured by high-performance liquid chromatography analysis, and the differentiation of 2 human colon cancer cell lines was studied. HT-29 cells were induced to undergo both structural and functional enterocytic differentiation (as determined by electron microscopy and the presence of brush-border specific enzymes, respectively) by changing the carbon source or adding Na butyrate to standard tissue culture media. This differentiation occurred after the cells reached confluency when they were cultured in galactose, uridine, inosine, or without nucleosides (all in the absence of glucose) and in the presence of glucose plus Na butyrate. Cells cultured in 25 mM fructose or glucose +/- nucleosides did not differentiate. In all culture conditions where HT-29 cells did not differentite, the intracellular concentrations of 2 compounds which co migrated with UDP-N-acetylglucosamine and UDP-N-acetylgalactosamine rose approximately equal to 10-fold at confluency and remained elevated throughout the stationary phase, whereas their concentrations remained constant and low after confluency in cells that underwent differentiation. This indicated that the accumulation of these compounds is associated with the inability of these cells to differentiate since other nucleotides and nucleotide sugars did not change in a similar fashion. Purification of the presumed UDP-N-acetylhexosamines, followed by the identification of the products from their chemical and enzymatic hydrolysis, confirmed the identity of these two peaks. Nucleotide analysis of Caco-2 cells, which undergo enterocytic differentiation after they reach confluency even when cultured on glucose, revealed the same pattern of UDP-N acetylhexosamine levels as differentiated HT-29 cells, with its concentration remaining relatively constant and very low, even after the cells were confluent. The significance of the accumulation of UDP-N-acetylhexosamines in cells unable to differentiate is discussed. PMID- 3965445 TI - Dexamethasone increases expression of mannose receptors and decreases extracellular lysosomal enzyme accumulation in macrophages. AB - Macrophages express a mannose-specific pinocytosis receptor that binds and internalizes lysosomal hydrolases. Treatment of rat bone marrow-derived macrophages with dexamethasone resulted in a concentration- and time-dependent increase in mannose-receptor activity. The dexamethasone effect was maximal at 24 h. Half-maximal effects were observed at a dexamethasone concentration of 2.5 X 10(-9) M. With 125I-beta-glucuronidase as ligand, a 2.5-fold increase in uptake rate was observed in dexamethasone-treated cells, with no change in Kuptake (2.5 X 10(-7) M beta-glucuronidase). Cell surface binding (4 degrees C) was elevated 2.6-fold following dexamethasone treatment. The increase in ligand binding appeared to be due to an increase in number of sites with no change in affinity. Cycloheximide suppressed the dexamethasone-mediated rise in receptor number, while cycloheximide alone had little effect on receptor activity over 16 h. These results suggest that dexamethasone stimulates synthesis of mannose receptors in macrophages. Extracellular accumulation of hexosaminidase was sharply reduced by dexamethasone treatment, and corresponded with the rise in mannose-receptor activity. Extracellular levels of hexosaminidase from untreated macrophages were modestly increased by the presence of mannan, while the extracellular activity from dexamethasone-treated cells was increased significantly by mannan. Extracellular hexosaminidase, released from zymosan-treated macrophages, was dramatically reduced by dexamethasone pretreatment. Enzyme released from zymosan stimulated macrophages was efficiently endocytosed by dexamethasone-treated cells in co-culture experiments, and this endocytosis was blocked by the addition of mannan. These results suggest that the mannose receptor of macrophages may play a role in regulating extracellular levels of lysosomal enzymes via a secretion recapture mechanism. PMID- 3965446 TI - Contributions of fatty acid and sterol synthesis to triglyceride and cholesterol secretion by the perfused rat liver in genetic hyperlipemia and obesity. AB - The relative importance of fatty acid synthesis in triglyceride secretion by perfused livers from lean (normal control) and obese Zucker rats was investigated. Livers from fed animals were perfused in a recirculating system with tritiated water and a constant infusion of oleic acid. Triglyceride secretion was 5 times greater and cholesterol secretion was 35% greater in the obese rat livers. The very-low-density lipoprotein hypersecreted by perfused livers from obese rats contained more apolipoprotein B and exhibited an increased B-48/B-100 ratio. Apo-B was also elevated in the hypertriglyceridemic plasma of obese rats in both fed and fasting states. The very-low-density lipoprotein isolated therefrom was likewise characterized by an increased B-48/B-100 ratio. Ketogenesis was depressed 40% in the obese rat livers and increased hepatic malonyl-CoA was implicated in this alteration. The de novo synthesis and secretion of newly synthesized cholesterol was moderately increased in the perfused livers from obese rats. Tritium incorporation into fatty acids was 15 times greater in the obese genotype. Most of the synthesized fatty acids remained in the liver and were recovered after perfusion in triglyceride and phospholipids. Newly synthesized fatty acids accounted for only 3 and 15% of the triglyceride secreted by the lean and obese rat livers, respectively. A large portion of the secreted triglyceride fatty acids was derived from endogenous liver lipids. When the turnover of newly synthesized fatty acids in these pools was considered, the contribution of de novo fatty acid synthesis to triglyceride secretion was estimated to be 9% in the lean and 44% in the obese rat livers. Therefore, the altered partition of free fatty acids (Fukuda, N., Azain, M. J., and Ontko, J. A. (1982) J. Biol. Chem. 257, 14066-14072) and increased fatty acid synthesis are both major determinants of the hypersecretion of triglyceride-rich lipoproteins by the liver in the genetically obese Zucker rat. PMID- 3965447 TI - Creatine kinase of heart mitochondria. The progressive loss of enzyme activity during in vivo ischemia and its correlation to depressed myocardial function. AB - It is now appreciated that mitochondrial creatine kinase (CKm) may play an important role in heart high-energy phosphate metabolism and that this isozyme is solubilized in vitro by dilute solutions of Pi. Since an increase in cellular Pi is known to occur with even brief periods of myocardial ischemia, we investigated the relationship between CKm activity and myocardial performance in rabbit hearts subjected to total global ischemia. CKm activity is expressed as a ratio to mitochondrial malate dehydrogenase (MDHm), a stable marker enzyme. A significant decline in this ratio was observed after only 10 min of ischemia, a time prior to changes in total homogenate creatine kinase activity. After 60 min of ischemia, the CKm/MDHm ratio was depressed by more than 70%. Since there was no restoration of activity following 30 min of reperfusion, we correlated changes in enzyme activity to contractile dysfunction following variable periods of total ischemia. The data showed a close correlation between the decline in the CKm/MDHm ratio and the reduction in performance, measured as left ventricular developed pressure. No correlation was observed between State 3 respiratory rates and performance. Using KCl arrest at 27 degrees C or hyperthermic ischemia at 40 degrees C, the CKm/MDHm ratio consistently correlated to the degree of postischemic functional depression, independent of the duration of ischemia. Isoenzyme electrophoresis failed to detect soluble CKm activity in the postischemic supernatant. Therefore, CKm activity appears to be altered rapidly and irreversibly by ischemia. The implications of these observations on the integration of myocardial high-energy phosphate metabolism are discussed. PMID- 3965448 TI - Chloroquine-induced phospholipid fatty liver. Measurement of drug and lipid concentrations in rat liver lysosomes. AB - A method has been developed to measure the concentration of chloroquine in lysosomes isolated from the liver of rats. It employs 3H2O and [U-14C]sucrose to determine the intralysosomal water volume of purified lysosomes obtained by free flow electrophoresis. Twelve h after a single dose, the concentration of chloroquine in lysosomes was 6.3 mM and at 24 h it rose to 16.5 mM. With continued treatment, lysosomal chloroquine concentrations were 61 and 74 mM at 48 and 72 h. The lysosomal concentrations of chloroquine attained were sufficient to block intralysosomal phospholipase A1 activity. The lysosomal content of phospholipid rises 1.7-fold and 2.6-fold over that of control at 12 and 24 h, respectively. At 72 h, lysosomal phospholipid was 3.7-fold greater than that of control. Lysosomes show an increased negative surface charge with chloroquine administration which is due in part to an increased ratio of acidic to neutral phospholipids in the lysosomal membrane. The phosphatidylinositol content of lysosomes rose rapidly with chloroquine treatment and accounted for the early increase in the ratio. Bis(monoacylglycero)phosphate, an acidic phospholipid synthesized only in lysosomes, increased later in the course of chloroquine treatment and accounted for the continued increase in acidic phospholipids. PMID- 3965449 TI - Kinetic studies of calcium and magnesium binding to troponin C. AB - The kinetic mechanism of calcium binding was investigated for the high-affinity calcium-magnesium sites of troponin C (TN-C), for the C-terminal fragment containing only the high-affinity sites (TR2) and for the TN-C:TN-I (where TN-I represents the inhibitory subunit of troponin) complex. Rate constants were measured by the change in fluorescence of the proteins labeled with 4-(N iodoacetoxyethyl-N-methyl-7-nitrobenz-2-oxa-1,3-diazole at Cys 98. Rate constants for calcium dissociation were also measured using the fluorescent calcium chelating agent quin 2. Calcium binding to TR2 at 4 degrees C is a two-step process at each binding site. (formula; see text) A first order transition (k1 = 700 s-1) follows the formation of a weakly bound collision complex (K0 = 2.5 X 10(3) M-1). The two sits of the labeled protein are distinguishable because of a 2-4-fold difference in rate constants of calcium dissociation. The kinetic evidence is consistent with additive changes in structure induced by calcium binding to two identical or nearly identical high-affinity sites. The mechanism for TN-C:TN-I is similar to TR2. TN-C gave complex kinetic behavior for calcium binding but calcium dissociation occurred with the same rate constants found for TR2. Calcium binding to the high-affinity sites of TnC can be interpreted by the same mechanism as for TR2 but an additional reaction possibly arriving from calcium binding to the low-affinity sites leads to a high-fluorescence intermediate state which is detected by the fluorophore. The interactions between the two classes of sites are interpreted by a model in which calcium binding at the high-affinity sites reverses the fluorescence change induced by calcium binding at the low-affinity sites. Magnesium binding to the calcium-magnesium sites of TR2 and TN-C occurs by the same two-step binding mechanism with a smaller value for K0 and a 5-fold larger rate constant of dissociation. PMID- 3965451 TI - Carrier-mediated uptake of lactate in rat hepatocytes. Effects of pH and possible mechanisms for L-lactate transport. AB - The rate of uptake and the distribution ratio between intra- and extracellular compartments of L- and D-lactate were studied in hepatocyte preparations from fed rats. L- and D-lactate uptake apparently depended on both passive diffusion and carrier-mediated components. The apparent Km of the high-affinity carrier for L lactate was in the range of 1.8 mM. The reciprocal competitive inhibitions between isomers of lactate suggest that L- and D-lactate might be transported by distinct carriers. Lactate transport was inhibited by various anions; pyruvate was the most potent anion, whereas only high concentrations of ketone bodies were effective. Acidic extracellular pH enhanced lactate uptake, this effect being more pronounced for L-lactate. At low pH, L-lactate was concentrated into hepatocytes, but its affinity for the carrier appeared unchanged, suggesting the existence of a process gaining energy from the pH gradient across the cell membrane. In the hypothesis of a lactate/H+ symport, the affinity for H+ was not dependent on lactate concentration and the apparent Km for H+ corresponded to a pH of 7.34. No trans-stimulation of lactate uptake after prior loading of the cells with pyruvate or lactate was observed. The present data suggest that, at physiological concentrations, lactate uptake by the liver might be largely carrier-mediated and the rate of transport across the liver cell membrane may be of a magnitude relatively comparable to the rate of metabolism. PMID- 3965450 TI - Kinetic studies of calcium binding to regulatory complexes from skeletal muscle. AB - The kinetic mechanism of the binding and release of calcium by troponin and by the complexes troponin: tropomyosin, troponin:tropomyosin:actin, and troponin (TN)-tropomyosin (TM)-actin:myosin subfraction 1 (SF-1) was investigated using troponin labeled on the TN-I subunit with the fluorophore 4-(N-iodoac etoxyethyl N-methyl)-7-nitrobenz-2-oxa-1,3-diazole. The apparent association constant is five to 10 times smaller for TN:TM:actin compared to TN:TM or TN and saturation of actin sites with SF-1 increased the binding constant approximately to the value for TN:TM. Kinetic measurements on TN or TN:TM fitted a single rate process for association or dissociation which is consistent with a model in which the calcium sites are equivalent and independent and each calcium induces a change in structure of the complex. TN:TM:actin gave biphasic transients for association and dissociation of calcium. The two binding sites are no longer equivalent and independent. The TN:TM:actin:SF-1 complex gave kinetic behavior essentially equivalent to TN:TM. The kinetics of calcium dissociation from the various complexes was also measured by the fluorescent calcium indicator quin 2, which gave the same values for the rate constants as for the labeled protein. The evidence is interpreted in terms of a model in which regulated actin can exist in two states and the binding of each calcium and SF-1 displaces the equilibrium between states. Formation of the complex of TN:TM with actin yielded an enhancement of the fluorescence of the labeled TN-I moiety of approximately 30%. The rate of constant for association of the complex decreased 6-fold in the presence of calcium while the rate constant for dissociation of the protein complex was essentially unchanged. Saturation of actin sites with SF-1 had no effect on the rate constant for association with TN:TM in the presence of calcium. PMID- 3965452 TI - A comparative assessment of lactate dehydrogenase isozymes, LDHk and LDH5. AB - An apparently unique isozyme of lactate dehydrogenase has been reported associated with transformation by Kirsten sarcoma virus, which was also expressed in human cancer. This isozyme was designated LDHk (Anderson, G.R., and Kovacik, W.P., Jr., (1981) Proc. Natl. Acad. Sci. U.S.A. 78, 3209-3213; Anderson, G. R., Kovacik, W. P., Jr., and Marotti, K. R. (1981) J. Biol. Chem. 256, 10583-10591). However, preparations of LDH5 from human placenta and from HeLa cells were later shown to exhibit some of the properties ascribed to LDHk9 and the identify of LDHk as a unique isozyme was questioned (Morin, M. E., and Hance, A. J., (1983) J. Biol. Chem. 258, 2864-2869). Saavadra and Anderson (Saavedra, R. A., and Anderson, G. R. (1983) Science (Wash. D.C.) 221, 291-292) refuted the arguments of Morin and Hance (Morin, M. E., and Hance, A. J. (1983) J. Biol. Chem. 258, 2864-2869) by claiming that commercial preparations of human placental LDH5 were contaminated with LDHk. Re-evaluation of the unique properties which distinguish LDHk from conventional LDH5 indicates that the two isozymes may not be different. Highly purified preparations of LDHk exhibit a single Mr = 34,000 polypeptide subunit on sodium dodecyl sulfate-acrylamide gels, yet retain activity detectable as both LDHk and LDH5. Attempts to separate LDHk and LDH5 by column chromatography or by continuous electrophoresis on a variety of solid support matrices were unsuccessful. Enzyme activity identified as LDHk in imidazole borate-buffered gels migrating toward the cathode was detected as LDH5 activity on re-electrophoresis. LDH5 activity identified by electrophoretic migration toward the anode in Tris-glycine-buffered gels also recorded as LDHk when re electrophoresed toward the cathode in imidazole-borate-buffered gels. Quantitative assays of enzyme activity recovered from the two-gel assay systems, as well as re-electrophoresis of isozyme-enriched preparations, indicated that cross-contamination of isozymes was not responsible for the results obtained. PMID- 3965453 TI - Structural characterization of the oligosaccharides formed by depolymerization of heparin with nitrous acid. AB - Heparin was cleaved with nitrous acid at pH 1.5 and the products were reduced with Na+ boro[3H]hydride to generate a mixture of di- and tetrasaccharides having anhydro-D-[3H]mannitol (AManR) residues on their reducing terminals. The products were purified to homogeneity by gel filtration and high-performance liquid chromatography. For each oligosaccharide, the proportions of D-glucuronic acid (GlcUA), L-iduronic acid (IdoUA), N-acetyl-D-glucosamine (GlcNAc), and AManR and the monosaccharide sequence were determined by quantification of the products of acid hydrolysis. The tetrasaccharide sequences were determined by comparison of the disaccharide units formed by hydrazinolysis and deamination with previously characterized disaccharides. The following new oligosaccharides were identified: GlcUA(2-SO4)-AManR, GlcUA(2-SO4)-AManR(6-SO4), GlcUA-AManR(3,6-diSO4), GlcUA GlcNAc-GlcUA-AManR, IdoUA-GlcNAc-GlcUA-AManR, GlcUA-GlcNAc(6-SO4)-GlcUA-AManR, IdoUA(2-SO4)-GlcNAc-GlcUA-AManR, IdoUA-GlcNAc(6-SO4)-GlcUA-AManR, IdoUA(2-SO4) GlcNAc-GlcUA-AManR(6-SO4), IdoUA-GlcNAc(6-SO4)-GlcUA-AManR(6-SO4), IdoUA-GlcNAc(6 SO4)-GlcUA-AManR(3-SO4), IdoUA-GlcNAc(6-SO4)-GlcUA-AManR(3,6-diSO4), and IdoUA(2 SO4)-GlcNAc(6-SO4)-GlcUA-AManR(6-SO4). Then the disaccharides and the tetrasaccharides were readily resolved by high-performance anion-exchange liquid chromatography and were quantified on the basis of the amount of 3H counts/min in each. The structures are discussed in terms of their implications regarding heparin biosynthesis and anticoagulant activity. PMID- 3965454 TI - Troponin-C-mediated calcium-sensitive changes in the conformation of troponin I detected by pyrene excimer fluorescence. AB - Troponin I (TnI) from rabbit white skeletal muscle was labeled at cysteines 48 and 64 with the fluorescent reagent N-(1-pyrene)maleimide. The fluorescence spectra of pyrene-labeled TnI (pyr-TnI) exhibit peaks characteristic of pyrene in its monomeric form and an additional peak resulting from formation of excited dimers (excimers), indicating that the labeled cysteines are close together. Formation of a pyr-TnI-TnC complex in the absence of Ca2+ has little effect on the spectrum, but when Ca2+ is bound to the low-affinity sites of TnC there is a substantial decrease in excimer and a corresponding increase in monomer fluorescence. The involvement of the low-affinity sites in the Ca2+-induced effect is consistent with the fact that Mg2+ has no effect on pyrene fluorescence. On rapid mixing of the pyr-TnI-TnC complex with Ca2+ in a stopped flow apparatus, most of the excimer decrease is complete within the instrumental dead time, indicating a rate constant k greater than 350 s-1, which is comparable to that of the conformational change in TnC resulting from Ca2+ binding to the low-affinity sites. Rapid mixing of the Mg2-TnC-pyr-TnI complex with Ca2+ yields similar results, suggesting that the type of metal ion present at the high affinity sites has little, if any, effect on the probe. It has been suggested previously that Cys 48 and 64 are located in a TnT-binding region of TnI (Chong P.C.S. and Hodges, R.S. (1982) J. Biol. Chem. 255, 3757). Our results suggest that a Ca2+-induced structural change in the TnI-binding region of TnC could be transmitted to TnT by affecting the TnT-binding region of TnI as part of the chain of events in the regulation of muscle contraction. PMID- 3965455 TI - Triamcinolone acetonide regulates glucocorticoid-receptor levels by decreasing the half-life of the activated nuclear-receptor form. AB - Glucocorticoid-receptor activation in GH1 cells results from the conversion of a 10 S oligomeric cytosolic form to a 4-5 S nuclear-binding species (Raaka, B. M., and Samuels, H. H. (1983) J. Biol. Chem. 258, 417-425). In this study, we report that triamcinolone acetonide (9 alpha-fluoro-11 beta, 16 alpha, 17 alpha, 21 tetrahydroxypregna-1,4-diene-3,20-dione 16,17-acetonide) elicits a time- and dose dependent reduction of total-cell (nuclear + cytoplasmic) receptor. The mechanism of receptor regulation was studied by dense amino acid labeling of receptor using media containing 2H, 13C, and 15N-labeled amino acids. Total cell receptor was extracted with 0.4 M KCl and newly synthesized dense receptor was separated from pre-existing receptor of normal density by centrifugation in gradients of 15-30% sucrose (w/v) in D2O. Receptor levels in cells grown without [3H]triamcinolone acetonide was 260 +/- 19 fmol/100 micrograms of DNA (16,000 molecules/cell), and, with 10 nM [3H]triamcinolone acetonide, this decreased to 130 +/- 14 fmol/100 micrograms of DNA after 30 h. Receptor half-life was 19 +/- 1.9 h in the absence and 9.5 +/- 0.3 h in the presence of triamcinolone acetonide and accounted for the decrease in steady-state receptor levels. Receptor synthesis was 9.7 +/- 0.3 fmol/100 micrograms of DNA/h (580 molecules/cell/h) both in the presence and absence of 10 nM [3H]triamcinolone acetonide. Triamcinolone acetonide reduced the half-life in proportion to the extent of receptor occupancy and activation. During the approach to steady-state conditions, 10 nM [3H]triamcinolone acetonide shortened receptor half-life almost immediately to the value in cells grown with [3H]triamcinolone acetonide for 24 h or longer. Cycloheximide did not prevent the triamcinolone acetonide-mediated decrease in receptor half-life and the shortening of receptor half-life is rapidly reversed by removal of hormone. These studies support a model of receptor regulation in which triamcinolone acetonide converts the unactivated 10 S receptor to the activated 4-5 S form which is degraded at an increased rate by the cell. PMID- 3965456 TI - Lipoprotein composition as a component in the lipoprotein clearance defect in experimental diabetes. AB - The hypertriglyceridemia associated with streptozotocin-induced diabetes in rats is largely reflected in the plasma lipoproteins of density less than 1.006 g/ml. Analysis of the plasma apolipoproteins of these rats indicated marked alterations in both the total levels and in the lipoprotein distribution of the major apolipoproteins. In whole plasma, diabetes was associated with significant increases in apolipoprotein (apo)-AIV, apo-AI, and apo-B (mainly in the intestinally derived apo-B240) and a marked decrease in apo-E. In the d less than 1.006 g/ml lipoprotein fraction (very-low-density lipoproteins (VLDL], there were significant increases in apo-B240, apo-AI, and apo-AIV and decreased levels of apo-E and the C apolipoproteins. The decrease in apo-C was primarily due to lower levels of apo-CII, and the ratio of the lipoprotein lipase inhibitor, apo-CIII, to the lipoprotein lipase activator, apo CII, was significantly increased over that in controls. The comparative clearance of triglycerides of VLDL particles from control and diabetic rat plasma was tested in recirculating heart perfusion in vitro. During 45-min perfusions of hearts from control donor rats, lipolysis of triglycerides of VLDL from diabetic rats was only 63-64% of that using plasma VLDL from control rats. Perfusion of hearts from diabetic rats with VLDL from control rats gave lipolysis values of only 53% of that obtained with normal hearts. Where both the VLDL and hearts were obtained from diabetic rats, lipolysis was 23% of that observed when both the lipoprotein and the organ were from control rats. The data suggest that in addition to depressed lipoprotein lipase activity in the tissue from diabetic rats, there are also major compositional changes in circulating lipoproteins which may contribute to defective triglyceride clearance from the circulation. PMID- 3965457 TI - Tubulin subunit carboxyl termini determine polymerization efficiency. AB - Cleavage of tubulin by subtilisin removes a small (Mr less than 2000) fragment from the C-terminal end of both alpha and beta subunits. The resulting protein is much reduced in negative charge. The cleaved, less acidic protein retains its competence to polymerize in a GTP-dependent and cold-, GDP-, and podophyllotoxin sensitive manner and assembles into sheets or bundles of twisted filaments. The critical concentration for polymerization of the cleaved protein is about 50-fold lower than that for intact tubulin. It is proposed that the C termini of the subunits normally impede polymerization. PMID- 3965459 TI - Purification of a human plasma membrane glycoprotein from human red blood cells by affinity chromatography using a monoclonal antibody. AB - Using the monoclonal antibody LICR-LON-Fib75.1 coupled to Sepharose as an affinity chromatography column, a membrane glycoprotein with an apparent molecular weight of 18,000 on sodium dodecyl sulfate-polyacrylamide gels has been purified from human red blood cells. The purified protein contained 25% carbohydrate by weight, the predominant sugars being galactose, mannose, and glucosamine. Amino acid analysis indicated that the protein was relatively rich in aspartate, glutamate, valine, and leucine and had a low proline and methionine content. The molecule could be removed from intact red blood cells by trypsin and could be labeled with iodine by lactoperoxidase-catalyzed cell surface iodination of red blood cells. The protein could also be labeled using the lipidsoluble photoactivatable reagent 3-(trifluoromethyl)-3-(m-[125I]iodophenyl) diazirine) and partitioned into the lower phase of the phase-separable detergent Triton X 114. During size-exclusion chromatography in different detergents alterations were observed in the apparent molecular weight of the protein. These results suggest that this Fib75.1-binding protein is an external red blood cell membrane glycoprotein which is capable of binding detergent. Proteins with a similar molecular weight have also been isolated from two human tumor cell lines by immunoprecipitation with this monoclonal antibody. PMID- 3965458 TI - Characterization of hog thyroid peroxidase. AB - Several fundamental properties of purified hog thyroid peroxidase (A413 nm/A280 nm = 0.55) were investigated in comparison with bovine lactoperoxidase. The Mr of thyroid peroxidase was 71,000. The prosthetic group of thyroid peroxidase was identified spectrophotometrically as protoheme IX after the enzyme was hydrolyzed with Pronase. Optical spectra of oxidized and reduced thyroid peroxidases and their complexes with azide and cyanide were very similar to lactoperoxidase, except that lactoperoxidase had two reduced forms with the Soret band either at 446 or 435 nm, and thyroid peroxidase lacked a reduced form having the 446-nm band. From comparison of their pyridine hemochrome spectra, epsilon mM at 413 nm of thyroid peroxidase was estimated to be 114, being the same as that of lactoperoxidase. The cyanide inhibition for the reaction of thyroid peroxidase was competitive with hydrogen peroxide and the inhibition constant was in rough accord with the dissociation constant of its cyanide complex measured from spectrophotometric titration. Azide inhibited the reaction with an inhibition constant which was about one one-thousandth of the dissociation constant for its spectrally discernible complex. The azide inhibition was not competitive with hydrogen peroxide and decreased as the reaction proceeded. Aminotriazole inhibited the reaction strongly, and the inhibition was augmented during the reaction. These inhibition patterns of azide and aminotriazole were more or less observed in the reaction of lactoperoxidase, but not in the case of horseradish peroxidase. Characteristics of animal peroxidases are discussed. PMID- 3965460 TI - Ammonia production and amino acid metabolism by rat renal papillary epithelial cells in culture. AB - A significant percentage of excreted ammonium is added to tubular fluid along the medullary collecting duct. However, it is not clear whether this ammonia is produced in the cortex and delivered into the medulla or is produced directly by medullary cells. To address this issue, rat epithelial cells derived from the renal papilla were grown in continuous culture and their ability to generate ammonia was examined. When grown in Dulbecco's modified Eagle's medium with 4 mM glutamine, these cells produced ammonia at a rate of approximately 27 nmol/10(6) cells/h. When these cells were grown in minimum essential medium without glutamine, ammonia production fell to 7 nmol/10(6) cells/ h. Increasing the glutamine concentrations of minimum essential medium to 4 mM increased ammonia production to slightly greater than 30 nmol/10(6) cells/ h. Increasing the media concentration of glutamate, glycine, or asparagine resulted in no significant increase in ammoniagenesis. Analysis of media amino acid concentration revealed that glutamine was the main amino acid consumed while alanine was the predominant amino acid produced. The glutaminase activity of these cells appears to be primarily phosphate-dependent, similar to that observed in vitro in papillary tubules. Alterations of K+ or H+ ion concentration did not alter ammoniagenesis, but addition of 2.5 mM ammonium chloride significantly reduced net ammonia production. It is concluded that rat papillary epithelial cells have the intrinsic ability to utilize glutamine to generate ammonia and alanine. In vivo ammonia produced locally in the medulla may contribute to final urinary ammonium excretion. PMID- 3965461 TI - Domain structure of 3-hydroxy-3-methylglutaryl coenzyme A reductase, a glycoprotein of the endoplasmic reticulum. AB - We present and evaluate a model for the secondary structure and membrane orientation of 3-hydroxy-3-methylglutaryl coenzyme A reductase, the glycoprotein of the endoplasmic reticulum that controls the rate of cholesterol biosynthesis. This model is derived from proteolysis experiments that separate the 97 kilodalton enzyme into two domains, an NH2-terminal membrane-bound domain of 339 residues and a COOH-terminal water-soluble domain of 548 residues that projects into the cytoplasm and contains the catalytic site. These domains were identified by reaction with antibodies against synthetic peptides corresponding to specific regions in the molecule. Computer modeling of the reductase structure, based on the amino acid sequence as determined by molecular cloning, predicts that the NH2 terminal domain contains 7 membrane-spanning regions. Analysis of the gene structure reveals that each proposed membrane-spanning region is encoded in a separate exon and is separated from the adjacent membrane-spanning region by an intron. The COOH-terminal domain of the reductase is predicted to contain two beta-structures flanked by a series of amphipathic helices, which together may constitute the active site. The NH2-terminal membrane-bound domain of the reductase bears some resemblance to rhodopsin, the photoreceptor protein of retinal rod disks and the only other intracellular glycoprotein whose amino acid sequence is known. PMID- 3965462 TI - Characterization of the tissue form of type V collagen from chick bone. AB - Type V collagen was prepared from acetic acid extracts of lathyritic chick bone. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the extracted material demonstrated two collagenous bands of slower mobility than pepsin extracted alpha 1(V) and alpha 2(V) chains. Cyanogen bromide peptide maps of these protein bands identified them as forms of alpha 1(V) and alpha 2(V). Segment long spacing (SLS) crystallite banding patterns of the acid-extracted Type V were identical within the triple-helical domain to the SLS banding patterns of pepsin-extracted Type V collagen, supporting the identification of this material. A globular domain at one end of the triple helix of the acid extracted Type V was visualized by both rotary shadowing and negative staining of SLS crystallites. The molecular weights of the globular terminal peptides were 18,000 and 29,000, respectively, for alpha 1(V) and alpha 2(V), as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis after bacterial collagenase digestion of the isolated alpha chains. The results presented here indicate that fully processed Type V collagen in chick bone exists as a higher molecular weight form than that from pepsin extracts and retains a globular domain at one end of the triple helix. This is in contrast to the interstitial collagens in which only very small non-triple-helical domains (telopeptides) are retained in the fully processed molecules. In vitro aggregation studies demonstrated the intact fully processed form of Type V collagen forms uniform small-diameter fibrous structures. These results suggest that Type V collagen may be present in fibrous structures within tissues. PMID- 3965463 TI - The fate of heterogeneous nuclear ribonucleoprotein complexes during mitosis. AB - Using immunochemical techniques, we have examined the macromolecular state of association of the major heterogeneous nuclear ribonucleoprotein (hnRNP) core proteins in mitotic HeLa cells. We find that these proteins are not free but are associated with high-molecular-weight RNA in the form of particles that sediment as a broad band between 80 and 200 S. We have termed these complexes MhnRNP for mitotic hnRNP protein-containing particles. Their quantity, composition, sedimentation coefficients, buoyant density, and sensitivity to dissociating conditions suggest that they are closely related to the hnRNP complexes of interphase cells and may represent hnRNP complexes containing unprocessed or partially processed heterogeneous nuclear RNA that have been released into the cytoplasm during mitosis. Exogenously added RNA does not associate with the MhnRNP nor does it compete for the major MhnRNP proteins. The MhnRNP remain distinct from other ribonucleoprotein complexes and do not associate with ribosomes even though these structures are not separated by a nuclear envelope during mitosis. PMID- 3965464 TI - Isolation and characterization of an antithrombin III variant with reduced carbohydrate content and enhanced heparin binding. AB - Two distinct forms of antithrombin III were isolated by chromatography of normal human plasma on heparin-Sepharose. The predominant antithrombin species present (AT-III alpha), which eluted from the affinity column in 1 M NaCl, was identified as the antithrombin III form which has been previously characterized. Ionic strength of the buffer was increased to elute a variant form of antithrombin III, designated as AT-III beta. The molecular weight of AT-III beta is less than that of AT-III alpha, but physicochemical studies do not indicate measureable differences in the polypeptide portion of the proteins. Carbohydrate determination revealed the sole detectable structural difference in the two antithrombins: levels of hexosamine, neutral sugars, and sialic acid in AT-III beta were all 25-30% less than in AT-III alpha. Kinetic studies of thrombin inactivation by both antithrombins, in the presence of nonsaturating amounts of heparin, indicated that AT-III beta inhibited thrombin more rapidly. AT-III beta is also distinguishable from AT-III alpha on the basis of heparin-binding affinity estimated from titration of protein fluorescence with heparin. Thus, antithrombin III exists as two molecular entities in human plasma which differ both structurally, in carbohydrate content, and functionally, in their heparin binding behavior. PMID- 3965465 TI - Phosphorylation of the nuclear lamins during interphase and mitosis. AB - The nuclear lamina is a polymeric protein assembly that is proposed to function as an architectural framework for the nuclear envelope. Previous work suggested that phosphorylation of the major polypeptides of the lamina (the "lamins") may induce disassembly of this structure during mitosis. To further investigate the possible involvement of phosphorylation in regulation of lamina structure, we characterized lamin phosphorylation occurring in mammalian tissue culture cells during interphase and mitosis. Phosphorylation occurs continuously throughout all interphase periods (coordinately with nuclear envelope growth), and takes place mainly on the assembled lamina. When the lamina is disassembled during cell division, the lamins are modified with approximately 1-2 molecules of associated phosphate. This level of mitotic phosphorylation is 4-7-fold higher than the average interphase level. Lamin phosphate occurs predominantly as phosphoserine, and is distributed over numerous tryptic peptides, many of which are modified during both interphase and mitotic periods. Significantly, phosphorylation is the only detectable charge-altering postsynthetic modification of the lamins that occurs specifically during mitosis. The results of this study support the notion that phosphorylation is important for regulation of interphase and mitotic lamina structure. PMID- 3965466 TI - Endogenous defenses against the cytotoxicity of hydrogen peroxide in cultured rat hepatocytes. AB - The catalase activity of cultured rat hepatocytes was inhibited by 90% pretreatment with 20 mM aminotriazole without effect on the activities of glutathione peroxidase or glutathione reductase, or on the viability of the cells over the subsequent 24 h. Glutathione reductase was inhibited by 85% by pretreatment with 300 microM 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) without effect on glutathione peroxidase, catalase, or on viability. Both pretreatments sensitized the hepatocytes to the cytotoxicity of H2O2 generated either by glucose oxidase (0.05-0.5 units/ml) or by the autoxidation of the one-electron reduced state of menadione (50-250 microM). Aminotriazole pretreatment had no effect on the GSH content of the hepatocytes. BCNU reduced GSH levels by 50%. Depletion of GSH levels to less than 20% of control by treatment with diethyl maleate, however, did not sensitize the cells to either glucose oxidase or menadione, indicating that the effect of BCNU is related to inhibition of the GSH GSSG redox cycle rather than to the depletion of GSH. With glucose oxidase, most of the cell killing in hepatocytes pretreated with either aminotriazole or BCNU occurred between 1 and 3 h. The antioxidant diphenylphenylenediamine (DPPD) had no effect on viability at 3 h. Catalase added to the culture medium 1 h after the addition of glucose oxidase prevented the cell killing measured at 3 h. The sulfhydryl reagents dithiothreitol (200 microM), N-acetyl-L-cysteine (4 mM), and alpha-mercaptopropionyl-L-glycine (2.5 mM) prevented the cell killing with exogenous H2O2 in hepatocytes sensitized by the inhibition of catalase or glutathione reductase. With menadione, there was no killing of nonpretreated hepatocytes at 1 h, and DPPD did not prevent the cell death after 3 h. Aminotriazole pretreatment enhanced the cell killing at 3 h but not at 1 h, and DPPD was not protective. Catalase added to the medium at 1 h inhibited the cell death measured at 3 h. In contrast, menadione killed hepatocytes pretreated with BCNU within 1 h. DPPD prevented cell death at 1 h, and there was evidence of lipid peroxidation in the accumulation of malondialdehyde in the culture medium. Catalase added with menadione did not prevent the cell killing at 1 h but did prevent it at 3 h. These data indicate that catalase and the GSH-GSSG cycle are active in the defense of hepatocytes against the toxicity of H2O2.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3965467 TI - Proof that the endogenous, heat-stable glucocorticoid receptor-activating factor is thioredoxin. AB - Extraction of rat liver cytosol with charcoal inactivates glucocorticoid-binding capacity and receptors can be reactivated to the steroid-binding state by an endogenous reducing system utilizing NADPH and a Mr = 12,000, heat-stable, endogenous, cytosolic protein (Grippo, J. F., Tienrungroj, W., Dahmer, M. K., Housley, P. R., and Pratt, W. B. (1983) J. Biol. Chem. 258, 13658-13664). In this paper we show that NADPH-dependent conversion of the rat liver glucocorticoid receptor from a nonbinding to a steroid-binding form is blocked in an immune specific manner by antisera raised against purified rat liver thioredoxin reductase or thioredoxin. The inhibition produced by thioredoxin reductase antiserum may be circumvented by dithiothreitol or overcome by addition of purified thioredoxin reductase. These observations prove that the endogenous glucocorticoid receptor-activating factor is thioredoxin and that the enzyme required for generating the steroid-binding conformation of the glucocorticoid receptor by the endogenous receptor-activating system is thioredoxin reductase. PMID- 3965468 TI - Uptake of chemically modified low density lipoproteins in vivo is mediated by specific endothelial cells. AB - Acetoacetylated (AcAc) and acetylated (Ac) low density lipoproteins (LDL) are rapidly cleared from the plasma (t1/2 approximately equal to 1 min). Because macrophages, Kupffer cells, and to a lesser extent, endothelial cells metabolize these modified lipoproteins in vitro, it was of interest to determine whether endothelial cells or macrophages could be responsible for the in vivo uptake of these lipoproteins. As previously reported, the liver is the predominant site of the uptake of AcAc LDL; however, we have found that the spleen, bone marrow, adrenal, and ovary also participate in this rapid clearance. A histological examination of tissue sections, undertaken after the administration of AcAc LDL or Ac LDL (labeled with either 125I or a fluorescent probe) to rats, dogs, or guinea pigs, was used to identify the specific cells binding and internalizing these lipoproteins in vivo. With both techniques, the sinusoidal endothelial cells of the liver, spleen, bone marrow, and adrenal were labeled. Less labeling was noted in the ovarian endothelia. Uptake of AcAc LDL by endothelial cells of the liver, spleen, and bone marrow was confirmed by transmission electron microscopy. These data suggest uptake through coated pits. Uptake of AcAc LDL was not observed in the endothelia of arteries (including the coronaries and aorta), veins, or capillaries of the heart, testes, kidney, brain, adipose tissue, and duodenum. Kupffer cells accounted for a maximum of 14% of the 125I-labeled AcAc LDL taken up by the liver. Isolated sinusoidal endothelial cells from the rat liver displayed saturable, high affinity binding of AcAc LDL (Kd = 2.5 X 10(-9) M at 4 degrees C), and were shown to degrade AcAc LDL 10 times more effectively than aortic endothelial cells. These data indicate that specific sinusoidal endothelial cells, not the macrophages of the reticuloendothelial system, are primarily responsible for the removal of these modified lipoproteins from the circulation in vivo. PMID- 3965469 TI - Chronic denervation of rat hemidiaphragm: maintenance of fiber heterogeneity with associated increasing uniformity of myosin isoforms. AB - During several months of denervation, rat mixed muscles lose slow myosin, though with variability among animals. Immunocytochemical studies showed that all the denervated fibers of the hemidiaphragm reacted with anti-fast myosin, while many reacted with anti-slow myosin as well. This has left open the question as to whether multiple forms of myosin co-exist within individual fibers or a unique, possibly embryonic, myosin is present, which shares epitopes with fast and slow myosins. Furthermore, one can ask if the reappearance of embryonic myosin in chronically denervated muscle is related both to its re-expression in the pre existing fibers and to cell regeneration. To answer these questions we studied the myosin heavy chains from individual fibers of the denervated hemidiaphragm by SDS PAGE and morphologically searched for regenerative events in the long term denervated muscle. 3 mo after denervation the severely atrophic fibers of the hemidiaphragm showed either fast or a mixture of fast and slow myosin heavy chains. Structural analysis of proteins sequentially extracted from muscle cryostat sections showed that slow myosin was still present 16 mo after denervation, in spite of the loss of the selective distribution of fast and slow features. Therefore muscle fibers can express adult fast myosin not only when denervated during their differentiation but also after the slow program has been expressed for a long time. Light and electron microscopy showed that the long term denervated muscle maintained a steady-state atrophy for the rat's life span. Some of the morphological features indicate that aneural regeneration events continuously occur and significantly contribute to the increasing uniformity of the myosin gene expression in long-term denervated diaphragm. PMID- 3965470 TI - Rod cells dissociated from mature salamander retina: ultrastructure and uptake of horseradish peroxidase. AB - To test the effects of isolation on adult neurons, we investigated the fine structure and synaptic activity of rod cells dissociated from the mature salamander retina and maintained in vitro. First, freshly isolated rod cells appeared remarkably similar to their counterparts in the intact retina: the outer segment retained its stack of membranous disks and the inner segment contained its normal complements of organelles. Some reorganization of the cell surface, however, was observed: (a) radial fins, present at the level of the cell body, were lost; and (b) the apical and distal surfaces of the inner and outer segments, respectively became broadly fused. Second, the synaptic endings or pedicles retained their presynaptic active zones: reconstruction of serially sectioned pedicles by using three-dimensional computer graphics revealed that 73% of the synaptic ribbons remained attached to the plasmalemma either at the cell surface or along its invaginations. Finally, tracer experiments that used horseradish peroxidase demonstrated that dissociated rod cells recycled synaptic vesicle membrane in the dark and thus probably released transmitter by exocytosis. Under optimal conditions, a maximum of 40% of the synaptic vesicles within the pedicle were labeled. As in the intact retina, uptake of horseradish peroxidase was suppressed by light. Thus, freshly dissociated receptor neurons retained many of their adult morphological and physiological characteristics. In long-term culture, the photoreceptors tended to round up; however, active zones were present even 2 wk after removal of the postsynaptic processes. PMID- 3965471 TI - Functional determinants in transit sequences: import and partial maturation by vascular plant chloroplasts of the ribulose-1,5-bisphosphate carboxylase small subunit of Chlamydomonas. AB - The precursor of the ribulose-1,5-bisphosphate carboxylase small subunit and other proteins from Chlamydomonas reinhardtii are efficiently transported into chloroplasts isolated from spinach and pea. Thus, similar determinants specify precursor-chloroplast interactions in the alga and vascular plants. Removal of all or part of its transit sequence was found to block import of the algal small subunit into isolated chloroplasts. Comparison of available sequences revealed a nine amino acid segment conserved in the transit sequences of all small subunit precursors. A protease in the vascular plant chloroplasts recognized this region in the Chlamydomonas precursor and produced an intermediate form of the small subunit. We propose that processing of the small subunit precursor involves at least two proteolytic events; only one of these has been evolutionarily conserved. PMID- 3965472 TI - Membrane-related specializations associated with acetylcholine receptor aggregates induced by electric fields. AB - The localization of membrane-associated specializations (basal lamina and cytoplasmic density) at sites of acetylcholine receptor (AChR) aggregation is consistent with an involvement of these structures in receptor stabilization. We investigated the occurrence of these specializations in association with AChR aggregates that develop at the cathode-facing edge of Xenopus muscle cells during exposure to a DC electric field. The cultures were labeled with a fluorescent conjugate of alpha-bungarotoxin and the receptor distribution on selected cells was determined before and after exposure to the field. In thin sections taken from the same cells, the cathode-facing edge was characterized by plaques of basal lamina and cytoplasmic density co-extensive with sarcolemma of increased density. In sections cut in a plane similar to the fluorescence image, it was possible to demonstrate that the specializations were concentrated at areas of field-induced AChR aggregation, and at receptor clusters existing on control cells. This finding further indicates that these structures participate in AChR stabilization, and that the mechanisms involved in AChR aggregation that result from field exposure and nerve contact may be similar. PMID- 3965473 TI - Intracellular translocation of fluorescent sphingolipids in cultured fibroblasts: endogenously synthesized sphingomyelin and glucocerebroside analogues pass through the Golgi apparatus en route to the plasma membrane. AB - When monolayer cultures of Chinese hamster lung fibroblasts are briefly incubated at 2 degrees C with the fluorescent sphingolipid analogue, C6-NBD-ceramide (N- [7 (4-nitrobenzo-2-oxa-1,3-diazole)] aminocaproyl sphingosine), fluorescent labeling of the mitochondria, endoplasmic reticulum, and nuclear envelope occur. During further incubation at 37 degrees C, the Golgi apparatus, and later the plasma membrane, become intensely fluorescent. Within this period, the C6-NBD-ceramide is converted to equal amounts of fluorescent sphingomyelin and glucocerebroside (Lipsky, N. G., and R. E. Pagano, 1983, Proc. Natl. Acad. Sci. USA., 80:2608 2612). In the present study, the intracellular translocation of these metabolites and their subsequent appearance at the plasma membrane were investigated by fluorescence microscopy, the addition of the ionophore monensin, and the technique of "back exchange," in which the amounts and types of fluorescent lipids present at the cell surface are identified after their transfer from the cell surface into recipient vesicles. In control cells, the amount of fluorescent glucocerebroside and sphingomyelin that could be removed from the cell surface by back exchange increased during incubation at 37 degrees C, correlating with the increased fluorescence of the plasma membrane observed by microscopy. In the presence of 10 microM monensin, visible labeling of the plasma membrane was greatly diminished, whereas the Golgi apparatus became highly fluorescent and distended. The ability to remove fluorescent metabolites from the cell surface by back exchange was significantly but reversibly inhibited by monensin. Monensin also increased the total amount of fluorescent sphingomyelin, but not the glucocerebroside found in cells. Subcellular fractions were assayed for their ability to convert radiolabeled and fluorescent ceramides to the corresponding sphingomyelins and glucocerebrosides. The activities of parallel fractions coincided, suggesting that the presence of the NBD moiety did not affect the cellular metabolism of ceramide. Furthermore, the major peak of sphingomyelin- and glucocerebroside-synthesizing activity appeared to coincide with an enriched Golgi fraction. These results strongly suggest that fluorescent sphingomyelin was not synthesized at the plasma membrane as has recently been suggested for endogenous sphingomyelin. Rather, both the sphingomyelin and glucocerebroside analogues were synthesized intracellularly from C6-NBD-ceramide and translocated through the Golgi apparatus to the cell surface. PMID- 3965474 TI - Purification of brain tubulin-tyrosine ligase by biochemical and immunological methods. AB - Tubulin-tyrosine ligase (TTL), the enzyme responsible for the reversible addition of a tyrosine residue at the carboxyl end of alpha-tubulin, has been purified from porcine brain using a purification scheme based on standard biochemical procedures. The enzyme preparation was nearly homogeneous (purity greater than 95%), was free of tubulin, and could be stored in the presence of glycerol for several months without loss in activity. To develop a more convenient purification of TTL, we have isolated mouse hybridoma cells secreting antibodies to TTL. These monoclonal antibodies recognize TTL not only in brain tissue but also in the liver of various mammals. Monoclonal antibodies isolated from ascites fluid allowed a rapid purification of TTL from a crude brain extract. TTL stayed bound to the immunoaffinity column in 1.5 M NaCl and was eluted with 3 M MgCl2. Highly active TTL was recovered nearly quantitatively at greater than 95% purity and could be stabilized in the presence of glycerol. Glycerol gradient centrifugation, SDS gel electrophoresis and immunoblots identified TTL as a monomeric protein with an apparent polypeptide molecular weight of about 40,000. A one to one complex of TTL with alpha beta-tubulin was observed by gradient centrifugation. PMID- 3965475 TI - Identical distribution of fluorescently labeled brain and muscle actins in living cardiac fibroblasts and myocytes. AB - We have investigated whether living muscle and nonmuscle cells can discriminate between microinjected muscle and nonmuscle actins. Muscle actin purified from rabbit back and leg muscles and labeled with fluorescein isothiocyanate, and nonmuscle actin purified from lamb brain and labeled with lissamine rhodamine B sulfonyl chloride, were co-injected into chick embryonic cardiac myocytes and fibroblasts. When fluorescence images of the two actins were compared using filter sets selective for either fluorescein isothiocyanate or lissamine rhodamine B sulfonyl chloride, essentially identical patterns of distribution were detected in both muscle and nonmuscle cells. In particular, we found no structure that, at this level of resolution, shows preferential binding of muscle or nonmuscle actin. In fibroblasts, both actins are associated primarily with stress fibers and ruffles. In myocytes, both actins are localized in sarcomeres. In addition, the distribution of structures containing microinjected actins is similar to that of structure containing endogenous F-actin, as revealed by staining with fluorescent phalloidin or phallacidin. Our results suggest that, at least under these experimental conditions, actin-binding sites in muscle and nonmuscle cells do not discriminate among different forms of actins. PMID- 3965477 TI - The amplified expression of factors regulating myogenesis in L6 myoblasts. AB - A strategy for increasing the expression of the factors regulating myogenesis was developed based upon the observation that increased amounts of regulatory factors could overcome the inhibition of differentiation produced by 5-bromodeoxyuridine (BUdR). L6 rat myoblasts were subjected to multiple cycles of cloning in progressively increasing concentrations of BUdR. The first clones to differentiate were picked and replated for the next cycle of selection. After 28 cycles in BUdR, cells were isolated that could differentiate in the presence of 8 microM BUdR. Cell hybrids between myoblasts subjected to 21 cycles of selection (BU21 cells) and differentiation-defective myoblasts exhibited a high probability of differentiation, consistent with the hypothesis that BU21 cells were overproducing factor(s) involved in the decision to differentiate. The selection of cells able to differentiate in the presence of BUdR may provide a general approach for increasing the expression of the regulatory molecules controlling terminal differentiation. PMID- 3965476 TI - Basal bodies and associated structures are not required for normal flagellar motion or phototaxis in the green alga Chlorogonium elongatum. AB - The interphase flagellar apparatus of the green alga Chlorogonium elongatum resembles that of Chlamydomonas reinhardtii in the possession of microtubular rootlets and striated fibers. However, Chlorogonium, unlike Chlamydomonas, retains functional flagella during cell division. In dividing cells, the basal bodies and associated structures are no longer present at the flagellar bases, but have apparently detached and migrated towards the cell equator before the first mitosis. The transition regions remain with the flagella, which are now attached to a large apical mitochondrion by cross-striated filamentous components. Both dividing and nondividing cells of Chlorogonium propagate asymmetrical ciliary-type waveforms during forward swimming and symmetrical flagellar-type waveforms during reverse swimming. High-speed cinephotomicrographic analysis indicates that waveforms, beat frequency, and flagellar coordination are similar in both cell types. This indicates that basal bodies, striated fibers, and microtubular rootlets are not required for the initiation of flagellar beat, coordination of the two flagella, or determination of flagellar waveform. Dividing cells display a strong net negative phototaxis comparable to that of nondividing cells; hence, none of these structures are required for the transmission or processing of the signals involved in phototaxis, or for the changes in flagellar beat that lead to phototactic turning. Therefore, all of the machinery directly involved in the control of flagellar motion is contained within the axoneme and/or transition region. The timing of formation and the positioning of the newly formed basal structures in each of the daughter cells suggests that they play a significant role in cellular morphogenesis. PMID- 3965478 TI - Bidirectional organelle transport can occur in cell processes that contain single microtubules. AB - Intracellular organelle transport was studied in a new model system, the giant freshwater ameba Reticulomyxa. The ameba extends a large reticulate network of cytoplasmic strands in which various phase-dense organelles can be seen to move at a rate of up to 25 microns/s. This combined light and high voltage electron microscopic study shows that organelles move bidirectionally in even the finest network strands that contain only a single microtubule. In terms of microtubule associated intracellular transport, this observation defines a minimum set of conditions necessary for such movement. The implications of this finding for possible models of force generation are discussed. PMID- 3965479 TI - Isolation of a cell-surface receptor for chick neural retina adherons. AB - Embryonic chick neural retina cells release glycoprotein complexes, termed adherons, into their culture medium. When absorbed onto the surface of petri dishes, neural retina adherons increase the initial rate of neural retina cell adhesion. In solution they increase the rate of cell-cell aggregation. Cell-cell and adheron-cell adhesions of cultured retina cells are selectively inhibited by heparan-sulfate glycosaminoglycan, but not by chondroitin sulfate or hyaluronic acid, suggesting that a heparan-sulfate proteoglycan may be involved in the adhesion process. We isolated a heparan-sulfate proteoglycan from the growth conditioned medium of neural retina cells, and prepared an antiserum against it. Monovalent Fab' fragments of these antibodies completely inhibited cell-adheron adhesion, and partially blocked spontaneous cell-cell aggregation. An antigenically and structurally similar heparan-sulfate proteoglycan was isolated from the cell surface. This proteoglycan bound directly to adherons, and when absorbed to plastic, stimulated cell-substratum adhesion. These data suggest that a heparan-sulfate proteoglycan on the surface of chick neural retina cells acted as a receptor for adhesion-mediating glycoprotein complexes (adherons). PMID- 3965481 TI - Utilization of iron complexes in an animal cell. AB - The ciliate protozoan Tetrahymena thermophila was grown in synthetic nutrient medium in the absence of the iron chelator citrate. Utilization and toxicity of various iron compounds or complexes in iron-starved cells were assessed from the number of cell doublings obtained within a standard time. The compounds tested included complexes formed between ortho-phosphates and two forms of ferric hydroxides, native and cationized ferritin, and tris-acetylacetonato Fe(III). The ferric hydroxo ortho-phosphate particles are toxic and can be removed from the medium by Millipore filtration. Uptake of ferritin and tris-acetylacetonato Fe(III) is independent of food vacuole formation and seems to occur by micropinocytosis and by plasma membrane translocation, respectively. PMID- 3965480 TI - Analysis of pre- and postsynaptic factors of the serotonin system in rabbit retina. AB - [3H]Serotonin is accumulated by a specific set of amacrine cells in the rabbit retina. These cells also accumulate the neurotoxin, 5,7-dihydroxytryptamine, and show signs of necrosis within 4 h of in vivo exposure to the drug. Biochemical analysis of [3H]serotonin uptake reveal a sodium- and temperature-dependent, high affinity uptake system with a Km of 0.94 microM and Vmax of 1.08 pmol/mg protein/min. [3H]Tryptophan is also accumulated in rabbit retinal homogenates by a high affinity process. Accumulated [3H]serotonin is released in response to potassium-induced depolarization of intact, isolated retinas. In vitro binding studies of rabbit retinal homogenate membranes demonstrate specific sets of binding sites with characteristics of the postsynaptic serotonin receptor. These data strongly suggest that rabbit retina contains virtually all of the molecular components required for a functional serotonergic neurotransmitter system. The only significant difference between the serotonin system in rabbit retina and that in the well-established serotonin transmitter systems in nonmammalin retinas and in brains of most species is the relatively low concentration of endogenous serotonin in rabbit retinas, as demonstrated by high-performance liquid chromatography, histofluorescence, or immunocytochemistry. PMID- 3965482 TI - Quantitation of megakaryocytopoiesis in liquid culture by enzymatic determination of acetylcholinesterase. AB - A method has been developed to quantitate megakaryocytopoiesis in culture by measuring acetylcholinesterase synthesized in vitro. Murine marrow cells, treated with diisopropylfluorosphosphate (DFP) to inactivate initial acetylcholinesterase (AchE) present in megakaryocytes and contaminating blood, were set up in Iscove's medium supplemented with 15% DFP-treated horse serum +/- pokeweed mitogen stimulated spleen cell conditioned medium (PWM-SCM) in 96-well microplates. Following the culture period, Triton X-100, dithiobisnitrobenzoic acid (DTNB), and acetylthiocholine iodide were added to each well. AchE synthesized in culture cleaved acetylthiocholine to thiocholine, which stochiometrically reduced the colorless indicator DTNB to a highly colored product. Thirty minutes following the addition of substrate, the plates were assayed for activity with a vertical recording photometer. When platelets, freshly prepared bone marrow cells, or cultured marrow were assayed by this method, a linear relationship was observed between optical density (OD) and the number of cells assayed. Moreover, a linear relationship between the number of AchE-positive megakaryocytes determined histochemically and AchE activity determined spectrophotometrically was observed. Red cells exhibited no activity. Inhibitor studies demonstrated that the activity measured was true AchE. Separation of marrow by density gradient centrifugation showed that the megakaryocyte enriched fraction contained all the AchE while the megakaryocyte depleted fraction contained none. From the data we conclude that this rapid, semiautomated method quantitates megakaryocytic AchE synthesis in culture, and that this method will be a useful assay system for the detection of factors that influence megakaryocytopoiesis. PMID- 3965483 TI - Variant (MDCK) kidney epithelial cells altered in response to inducers of dome formation and differentiation. AB - Confluent cultures of the MDCK kidney epithelial cell line exhibit dome formation, a result of transepithelial fluid transport influenced by cell-cell and cell-substratum interaction. Dome formation was inducible by hexamethylene bisacetamide (HMBA) or dimethylformamide (DMF), compounds known as inducers of cell differentiation (Lever, 1979b). Analysis of the incidence of the dome forming phenotype in colonies derived nonselectively from the MDCK cell line suggested that inducers recruit an increased fraction of the cell population to express dome formation. Variant MDCK cell lines were isolated which differed from the parental line in response to inducers while retaining cuboidal epithelial morphology. In five independently isolated and cloned MDCK variants, dome formation was not inducible by DMF and only marginally increased by HMBA. This phenotype was also associated with increased cell adhesiveness to a plastic substratum. Results from cocultivation experiments suggested that the DMF unresponsive phenotype of variant cells may be partially overcome by cell-cell contact with wild-type cells. Sodium pump transport activity assessed by ouabain sensitive Rb+ uptake was partially inhibited by HMBA and by DMF in a "wild-type" inducer-responsive clone. By contrast, DMF did not inhibit ouabain-sensitive Rb+ uptake in DMF-unresponsive variant clones, and sodium pump inhibition by HMBA was greatly diminished. This close correspondence between altered sodium pump modulation by inducers in variant clones and their altered dome-forming response reinforces our previous conclusions (Kennedy and Lever, 1984) that sodium pump modulation is closely associated with mechanisms of inducer action. Taken together, these findings implicate cell-cell interaction, cell-substratum interaction and sodium pump modulation in regulation of the differentiated phenotype of this cell line. PMID- 3965484 TI - Formation of proliferative tetraploid cells after treatment of diploid cells with sodium butyrate in rat 3Y1 fibroblasts. AB - When randomly proliferating rat 3Y1 fibroblasts were treated with sodium butyrate, more than 90% of their cells were arrested reversibly with a 2C DNA content at least 12 h before the G1/S boundary. When cells synchronized in the early S phase were treated with butyrate, approximately 70% of all cells were arrested with a 4C DNA content. The arrests in both G1 and G2 phases by the single inhibitor suggest that the two phases share a common mechanism. The ability of cells to undergo mitosis on time was quickly lost with time of arrest in the G2 phase. Upon removal of the inhibitor, the cells arrested with a 4C DNA content entered a new S phase without intervening mitosis. The tetraploid cells thus produced kept proliferating as fast as diploid cells. These results suggest that the inhibition of the normal G2 traverse is somehow responsible for the formation of the proliferative polyploid cells. PMID- 3965485 TI - The requirements for ionized calcium and magnesium in lymphocyte proliferation. AB - The extracellular ionized calcium and magnesium requirements for lectin-induced lymphocyte DNA synthesis were measured in a serum-free system. The use of this system permitted measurements of the ionized calcium and magnesium concentrations with ion-selective electrodes. Maximal DNA synthesis was observed at 270 microM ionized calcium and at 100 microM ionized magnesium in phytohemagglutinin-treated lymphocytes. Lymphocyte DNA synthesis was much more sensitive to reduction of external ionized calcium than to reduction of ionized magnesium. In calcium-free medium (ionized calcium 25 microM), DNA synthesis was reduced by 90%, but in magnesium-free medium (ionized magnesium concentration 7 microM) DNA synthesis was reduced by only 30%. Fifty percent of DNA synthesis stimulated by phytohemagglutinin (PHA) and concanavalin A (Con A) was observed at external ionized calcium concentrations of 97 and 43 microM, respectively. When lymphocytes were stimulated with PHA and the external calcium was chelated with EGTA, 50% inhibition of DNA synthesis was observed at 98 microM ionized calcium. This value agreed well with the free calcium required for PHA activation of DNA synthesis (97 microM). Cytoplasmic calcium, measured with the fluorescent probe Quin 2, increased following lectin exposure if the extracellular ionized calcium concentration was greater than 80 microM. No increase in cytoplasmic calcium could be detected in lectin-treated lymphocytes below 80 microM extracellular ionized calcium, although substantial DNA synthesis was sustained. PMID- 3965486 TI - Amino acid analogs while inducing heat shock proteins sensitize CHO cells to thermal damage. AB - Amino acid analogs have been shown to induce heat shock proteins (HSPs). We have examined the effect of these analogs on the thermal sensitivity of Chinese hamster fibroblasts (HA-1) and their stable heat-resistant variants. We found that exposure of HA-1 cells and their heat-resistant variants to canavanine or L azetidine-2-carboxylic acid cause enhanced synthesis of the three major mammalian HSPs (molecular weight 70,000, 87,000, and 110,000 kd). Although the synthesis of HSPs was increased, the analogs did not induce thermotolerance, a transient ability to protect cells from thermal damage. On the contrary, the analog treatment increased the thermal sensitivity of HA-1 cells, but not of the heat resistant strains, when these cells were exposed subsequently to elevated temperatures. Our tentative explanation for these findings is that the incorporation of amino acid analogs into HSPs or other cellular proteins sensitizes HA-1 cells to heat. The heat-resistant strains contain higher levels of constitutive HSPs. The additional functional HSPs in the heat-resistant variants may protect these cells from thermal stress. The presence of some newly synthesized analog-substituted, perhaps nonfunctional, HSPs need not affect this thermal protection. PMID- 3965487 TI - Culture kinetics of glycolytic enzyme induction, glucose utilization, and thymidine incorporation of extended-exposure phytohemagglutinin-stimulated human lymphocytes. AB - Glycolytic enzyme activity is significantly (P less than 0.05) induced between 24 and 48 hours of incubation in phytohemagglutinin-stimulated human lymphocytes. Nonstimulated cultured cells do not show this induction although these cells have an approximate daily doubling of thymidine incorporation. Maximal glycolytic enzyme activity is reached between 96 and 120 hours of culture in stimulated cells (3.5-fold increase) and maintained until at least 168 hours. There is no significant induction of the hexosemonophosphate shunt or the TCA cycle during seven-day transformation. Induction of glucose utilization becomes significantly (P less than 0.05) greater in stimulated as compared to nonstimulated cultures between 48 and 72 hours of culture and is significantly elevated for at least an additional 96 hours. There is a 17% increase in total protein in the stimulated cells after 24 hours of culture and higher levels of protein content are then maintained over the control. Thymidine incorporation is significantly greater in stimulated cells from 24-144 hours of culture but is not significantly different from the nonstimulated cells at 168 hours (P = 0.98) although glycolytic enzyme activity remains elevated in the stimulated cells. There is a greater enzyme induction of the latter phase of glycolysis during transformation and this phenomenon continues in extended cultures. Increases in glycolytic enzyme activity during mitogenesis appear to be an intrinsic phenomenon independent of cell proliferation and glucose transport. The mitogen-induced increase in the activity of the glycolytic enzymes accompanies blastogenesis and the sustained elevated activity of these enzymes to be related to the high metabolic rate of transformed cells. PMID- 3965488 TI - Cleaved prolactin: evidence for its occurrence in human pituitary gland and plasma. AB - A form of PRL that is cleaved in its large disulfide loop has been reported in rat and mouse pituitary glands, but it is not known whether it exists in the human pituitary gland and whether it circulates in blood. Recently, we developed an immunoelectrophoretic technique which is capable of measuring immunoreactive variants of PRL and other hormones in plasma. We describe here detection of cleaved PRL in normal and tumor pituitary tissue from a prolactinoma patient and in the plasma of pregnant women. PMID- 3965489 TI - Metabolism of androsterone and 5 alpha-androstane-3 alpha,17 beta-diol in human lung tissue and in pulmonary endothelial cells in culture. AB - The metabolism of [3H]androsterone and [3H] 5 alpha-androstane-3 alpha,17 beta diol ( [3H] 3 alpha-diol) was studied in slices of human lung tissue and cultures of human pulmonary artery endothelial cells. Lung tissue metabolized [3H]androsterone (0.25 microM) to 5 alpha-androstane-3,17-dione (30.3 pmol 100 mg 1 tissue h-1), isoandrosterone (0.7 pmol 100 mg-1 tissue h-1), 5 alpha dihydrotestosterone (5 alpha-DHT; 0.1 pmol 100 mg-1 tissue h-1), 3 alpha-diol (0.1 pmol 100 mg-1 tissue h-1), and two polar metabolites. Pulmonary arterial endothelial cells produced the same metabolites of [3H]androsterone (0.083 microM), with the exception of the polar compounds [5 alpha-androstane-3,17-dione (1.3 pmol mg-1 protein h-1), isoandrosterone (0.1 pmol mg-1 protein h-1), 5 alpha DHT (0.2 pmol mg-1 protein h-1), and 3 alpha-diol (0.2 pmol mg-1 protein h-1)]. Thus, the principal metabolite of [3H]androsterone in both lung tissue and endothelial cells was 5 alpha-androstane-3,17-dione. Human lung tissue metabolized [3H]3 alpha-diol (0.28 microM) to 5 alpha-DHT (8.8 pmol 100 mg-1 tissue h-1), androsterone (2.2 pmol 100 mg-1 tissue h-1), 5 alpha-androstane-3,17 dione (0.8 pmol 100 mg-1 tissue h-1), isoandrosterone (0.1 pmol 100 mg-1 tissue h 1), and four polar metabolites (0.2 pmol 100 mg-1 tissue h-1). 5 alpha-DHT was the principal metabolite of [3H]3 alpha-diol within the first hour of incubation, but the concentration of this androgen declined thereafter to 3.6 pmol 100 mg-1 tissue after 4 h of incubation. This decline was correlated with increased 5 alpha-androstane-3,17-dione synthesis (6.7 pmol 100 mg-1 tissue 4 h-1). Androsterone formation from [3H]3 alpha-diol, however, was linear with time of incubation for 4 h (8.9 pmol 100 mg-1 tissue 4 h-1). The formation of these products demonstrates that the principal 5 alpha-reduced-C19-steroid-metabolizing enzymes in human lung are 3 alpha-hydroxysteroid oxidoreductase. PMID- 3965490 TI - Effects of aging and illness on the pituitary testicular axis in men: qualitative as well as quantitative changes in luteinizing hormone. AB - Decreased testicular function occurs as a concomitant of aging in men and is accentuated by the presence of systemic illness. Previous studies identified an intrinsic Leydig cell defect, as reflected by high LH to testosterone ratios and impaired hCG responsiveness in older men. This study questioned whether a qualitative change in LH secretion, as reflected by secretion of LH with an altered ratio of biological to immunological LH (B/I) activity, might occur during aging. To examine this possibility, we measured the levels of plasma LH by RIA and rat interstitial cell testosterone bioassay in 67 men, ranging from 20-80 yr of age. Mean LH levels measured by immunoassay were similar in healthy men older than 40 yr [11.4 +/- 1.0 (+/- SE) mIU/ml; n = 22] and those younger than 40 yr (9.4 +/- 0.6; n = 18; P less than 0.01). Mean bioactive LH levels were also similar (30.0 +/- 4.8 vs. 36.7 +/- 3.3). LH B/I ratios, however, were significantly lower in older men (2.52 +/- 0.33) compared to those in younger (4.10 +/- 0.34; P less than 0.01) men. Regression analysis confirmed the expected inverse relationship of B/I ratio with age (r = -0.47; P less than 0.01) and plasma testosterone with age (r = -0.35; P less than 0.05). Systemic illness independently lowered B/I LH ratios. Systemically ill men over 40 yr of age had lower ratios (1.05 +/- 0.08; n = 27) than age-matched healthy men (2.52 +/- 0.33; n = 22; P less than 0.01). The significant changes in B/I ratio among subgroups reflected modest changes in LH immunoactivity and larger alterations in LH bioactivity in certain subgroups. These findings indicate that the qualitative nature of LH secreted by the pituitary, as reflected by altered LH B/I ratios, may vary as a function of aging and illness in men. PMID- 3965491 TI - Dissociation of insulin resistance and decreased insulin receptor binding in Duchenne muscular dystrophy. AB - Duchenne muscular dystrophy (DMD) is an X-linked inherited neuromuscular disease characterized by progressive weakness and severe muscle wasting. Alterations in carbohydrate metabolism are often associated with neuromuscular disorders. We performed oral glucose tolerance tests and insulin binding studies on erythrocytes from 17 DMD and 8 normal males. Furthermore, we measured insulin binding to erythrocytes from 12 normal males and from 11 mothers and 10 sisters of affected males. As a group, DMD patients had mild glucose intolerance and both fasting and postabsorptive marked hyperinsulinemia (insulin resistance). Levels of glucose and insulin, expressed as incremental areas under their respective curves, were significantly elevated in the wheelchair-ridden patients. Incremental areas of glucose (0-2 h) and insulin (0-5 h) were 42 +/- 5 mg/dl X h (mean +/- SEM) and 96 +/- 18 microU/ml X h, respectively, in normal subjects and 71 +/- 6 (P less than 0.05) and 206 +/- 30 (P less than 0.05), respectively, in the wheelchair-confined DMD patients. All of the ambulatory DMD males had normal oral glucose tolerance tests. Insulin binding to erythrocytes was 20-30% lower (P less than 0.01) in all DMD patients than in normal males appropriately matched for age and degree of sexual development. This difference in binding was a result of lower affinity of the insulin receptor in DMD erythrocytes. On the other hand, insulin binding to fibroblasts was the same in normal males and DMD patients, suggesting that the abnormality of erythrocyte binding in DMD is probably not genetically induced. Insulin binding to erythrocytes and monocytes was the same in all females studied, regardless of whether they were carriers of the DMD gene. Our results suggest that abnormal insulin binding in DMD erythrocytes is an acquired rather than genetic abnormality, but insulin binding is not helpful in the identification of carrier females. The defect in insulin binding in DMD is present before the development of insulin resistance, which occurs only in severely immobilized patients. Thus, the cause of the insulin resistance in DMD may reside at steps beyond the binding of insulin to its receptor. PMID- 3965492 TI - Single versus repeated dose human chorionic gonadotropin stimulation in the differential diagnosis of hypogonadotropic hypogonadism. AB - The responses of serum testosterone (T), 17 alpha-hydroxyprogesterone, and 17 beta-estradiol (E2) to four im injections of hCG (5000 IU/1.7 m2) given on days 0, 4, 7, and 10 were studied in 10 prepubertal and 10 pubertal boys with hypogonadotropic hypogonadism (groups O and P, respectively). Serum was obtained before each injection and on day 14. The results were compared with those of controls, 16 prepubertal boys with incomplete testicular descent and 6 pubertal boys with constitutional delay of puberty. Serum T levels increased significantly in groups O and P to 2.0 and 4.6 nmol/liter, respectively, after the first injection, then progressively to 5.8 and 11.2 nmol/liter. Basal T levels of group O did not differ from those of the controls, but were subnormal for group P (P less than 0.001). Stimulated T levels were subnormal in both groups (P less than 0.01 and P less than 0.001), but repeated doses increased the difference from the control value only in group P. A difference in E2 response between patients and controls appeared in puberty; only the pubertal control boys had substantial increases in E2 (P less than 0.001). Our results show that the optimal protocol for a diagnostic hCG test in prepubertal boys is a single dose of hCG, with determination of T levels 4 days later. In puberty, if the basal T levels are inconclusive, repeated doses of hCG should be given with determination of both T and E2. These findings also suggest that the full inhibitory effect of E2 on T synthesis results from a pubertal maturation process, possibly induced by endogenous gonadotropins, which cannot be induced by two weeks of hCG stimulation in prepubertal boys or those with hypogonadotropic hypogonadism. PMID- 3965493 TI - An international cooperative study evaluating serum thyroglobulin standards. AB - A number of research laboratories have reported great variability in the levels of serum thyroglobulin (Tg) in normal subjects, the reason for which is not immediately apparent. The present study was designed to determine how important these variations were by submitting three identical standards to all participating laboratories. Three lyophilized human sera (standards A, B, and C) with increasing concentrations of Tg (5.3, 30.6, and 80.6 ng/ml, respectively) were submitted to 37 laboratories (40 assays) in 18 different countries. Standard A gave detectable values in 19 assays. The mean serum Tg concentration was 6.3 +/ 1.4 (+/- SEM) ng/ml (n = 18). Standard B was detected in all but 3 assays. The mean serum Tg concentration in standard B was 15.7 +/- 1.4 ng/ml (n = 37). All laboratories were able to detect Tg in standard C, and reported a mean serum Tg concentration of 36.5 +/- 3.2 ng/ml (n = 40). Lyophilization affected the recovery of Tg in our assay. This was confirmed by a study in which lyophilized standards A, B, and C and frozen standards were analyzed in the same assays. The remarkable finding was that the variability in serum Tg values reported by the various assays was great despite the submission of an identical set of standards of each of the laboratories. Wide interassay variation raises problems with respect to the applicability of threshold levels proposed by certain studies. The latter is particularly germane to the follow-up of patients with differentiated thyroid cancer. It is concluded that the development of a world standard for Tg may be a first and important step toward standardization of Tg assays, and that other components of the assays may need standardization as well. PMID- 3965494 TI - 5 alpha-Reductase activity in the genital skin of hirsute women. AB - A simplified, rapid, and highly reproducible technique is described for measuring 5 alpha-reductase activity (5 alpha RA) in small skin biopsies. Human genital skin was obtained from 23 nonhirsute and 20 hirsute premenopausal women (HW) and 5 normal men. Skin samples were minced at 4 C and incubated with RPMI-1640 in the presence of 95% O2-5% CO2 and 4.15 nmol [14C]testosterone ([14C]T) for 2 h at 37 C. Steroids were extracted with diethyl ether and separated by Celite and paper chromatography. Radioactivity in specific eluates was quantified, and the mass of each steroid was measured by RIA. The separate formation of 5 alpha-androstane-17 beta-ol-3-one (DHT), 5 alpha-androstane-3 alpha, 17B diol (3 alpha diol), androstenedione, and androsterone from [14C]T was measured. In separate experiments it was demonstrated that an incubation time of 2 h was optimum and that the addition of cofactors was unnecessary. Radiochemical purity was confirmed after chromatography. The mean +/- SE conversion ratio (CR) of T to DHT (in 2 h) in HW was higher than that in normal women (16.80 +/- 1.62% vs. 4.48 +/- 0.36%; P less than 0.01). In men, the CR of T to DHT averaged 31.60 +/- 3.96%. Individual values for the CR of T to DHT in HW and normal women did not overlap. The CR of T to 3 alpha diol was significantly higher in HW (9.66 +/- 0.86%) and men (15.98 +/- 2.0%) compared to that in normal women (2.96 +/- 0.32%; P less than 0.05). The CR of T to androstenedione was significantly greater in HW and men (6.18 +/- 0.42 and 7.28 +/- 1.92%) compared to that in normal women (2.64 +/- 0.64%; P less than 0.05). The CR of T to androsterone was very low and was similar in the three groups. The production of DHT in HW (4.50 +/- 1.0 pmol/mg X 2 h) was significantly greater than that in normal women (0.48 +/- 0.08; P less than 0.01) and was similar to the production in men (6.18 +/- 1.94 pmol/mg X 2 h). There was a significant correlation between the CR of T to DHT and DHT production, and the CR of T to 3 alpha diol and 3 alpha diol production as well as between the CRs of T to DHT and T to 3 alpha diol. These data suggest that measurements of DHT formation are best suited for the assessment of 5 alpha RA and that the measurement of 5 alpha RA in vitro from small skin biopsies is suitable for the clinical evaluation of hirsutism. PMID- 3965495 TI - Pulmonary metastasis of differentiated thyroid carcinoma: treatment results in 101 patients. AB - Well differentiated thyroid carcinoma was diagnosed in 1,127 patients at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston from 1951 to 1981. Of those 1,127 patients, 101 had documented pulmonary metastasis. A retrospective analysis was conducted, and these patients were followed up until 1983. The primary tumors in these patients were histologically classified as papillary (67%), follicular (22%), or Hurthle cell (11%). The age at diagnosis ranged from 5-87 yr. Lung metastasis was diagnosed by both chest x-ray and positive uptake of 131I in 49 patients. Forty-two patients had positive chest x ray results and negative 131I scans, and 10 patients had positive 131I scans and negative chest x-ray results. The patients were treated with radioactive iodine (76%), chemotherapy (9%), external radiotherapy (2%), or supportive care only (14%). Sixty-seven patients subsequently died of thyroid carcinoma. Our studies showed the following. 1) Patients who were younger than 40 yr of age at diagnosis had better prognosis (71% survival) compared with those over 40 yr of age (16% survival; P less than 0.01). 2) Uptake of radioactive iodine by lung metastasis is a favorable prognostic factor, especially in patients with negative radiological findings. Patients treated with radioactive iodine have a longer survival than those not treated with radioactive iodine (P less than 0.002). 3) The incidence of pulmonary metastasis is significantly less in patients who are treated by total thyroidectomy than in those treated with less than total thyroidectomy (P less than 0.03). 4) The incidence of pulmonary metastasis is lowest in patients with papillary carcinoma (9%), compared with that in patients with follicular (13%) or Hurthle cell (25%) carcinoma. PMID- 3965496 TI - Non-specific binding of mouse IgM antibodies to lipid antigens. AB - Galactocerebroside (GC) is a major component expressed on the surface of oligodendrocytes and Schwann cells. It plays a role in neuronal-glial interaction that results in myelinization. In this paper we describe a method to estimate anti-GC antibodies by ELISA. Furthermore we found that IgM antibodies of mice immunized with GC-unrelated antigens, and which are not specific for GC, bind in a non-specific way to this compound. Thus only assays which avoid the detection of IgM antibody can be used to estimate anti-GC antibodies. Moreover, we showed that serum of immunized mice bind also non-specifically to brain cells of newborn mice. PMID- 3965497 TI - Immunological studies on the cerebrospinal fluid in neurological sarcoidosis. AB - The rate of intrathecal IgG synthesis and the degree of permeability of the blood brain barrier in 5 patients with sarcoidosis involving the central nervous system are described. Intrathecal IgG synthesis was unusual but increased leakiness of the blood-brain barrier was common in these patients; a finding which may help differentiate such cases from patients with multiple sclerosis. PMID- 3965498 TI - Interaction between fibrinogen and cultured endothelial cells. Induction of migration and specific binding. AB - It has been suggested that fibrinogen (fg) or its physiological derivatives influence the motility and growth of endothelial cells (ECs), but direct support for this concept is still lacking. In the present study, the capacity of fg to interact with ECs and induce the migration of ECs was examined. The capacity of fg to induce EC migration was studied by means of a modification of the Boyden chamber technique. fg in the lower compartment of the chamber caused a time- and concentration-dependent migration of ECs across filters. fg present in equal concentrations above and below the filter increased EC migration, but the maximal effect invariably occurred in the presence of a gradient between the lower and the upper compartments. Trypsin or plasmin digestion of fg and preincubation of fg with Fab fragments from specific antibody completely abolished fg-induced EC migration. Dialysis of fg to eliminate small peptides that might contaminate the preparation did not modify fg-induced migration. Plasma obtained from healthy donors induced EC migration, but plasma from an afibrinogenemic patient was completely ineffective. The addition of purified fg to afibrinogenemic plasma restored plasma-induced EC migration. Plasmin degradation fragments D and E, of 100,000 and 50,000 mol wt, respectively, did not induce EC migration. However, fragment E caused dose-related inhibition of fg-induced EC migration Direct interaction of highly purified radioiodinated human fg with cultured human and bovine Ecs was observed. The binding was time dependent and plateaued at 10 min. Nonlabeled fg in a large molar excess inhibited the interaction, but unrelated proteins, including fibronectin, ovalbumin, and myoglobin, did not. Monospecific Fab fragments directed to fg inhibited binding by 38% at a 50 to 1 molar ratio whereas nonimmune Fab caused only 2% inhibition at a similar concentration. The binding of 125I-fg with ECs was saturable, and an apparent dissociation constant of 0.23 x 10(-6) M was estimated from binding isotherms. After 30 min of incubation the interaction between 125I-fg and the cells was completely reversible and displaceable by a large molar excess of unlabeled fg. Autoradiography of the display of EC-bound 125I on polyacrylamide gel showed the constitutive B beta- and gamma-chains of the fg molecule, with a partial loss of the A alpha-chain. Purified fragment E and E were tested for their capacity to inhibit fg binding. At a 1 to 400 125I-fg-to-fragment molar ratio, fragment E, which also inhibited migration, competed for binding by 44%, but fragment D was completely ineffective. These data show that fg may specifically associate with ECs and induce migration of these cells; it also appears that the structural requirement of this activity is located in the N-terminal part of the molecule. PMID- 3965499 TI - Regional distribution and alterations of lectin binding to colorectal mucin in mucosal biopsies from controls and subjects with inflammatory bowel diseases. AB - Glycoconjugate composition of colorectal goblet cell mucin was characterized according to the anatomical distribution of lectin-binding sites in mucosal biopsies from 35 control subjects and 55 patients with inflammatory bowel disease. 24 of the controls had mucosal inflammation on biopsy, without clinical evidence of inflammatory bowel disease. These inflamed controls showed a similar rate of presence of lectin-binding sites as the normal noninflamed group. In the controls, the frequency of binding of Ricinus communis agglutinin I to galactosyl residues was consistently higher than that found with either Ulex europaeus agglutinin I to fucosyl or Dolichus biflorus agglutinin to N-acetyl galactosyl groups. A significant proximal to distal gradient for Ulex europaeus agglutinin I binding sites was identified in the controls group. These binding sites were present four times more often in the proximal colon than in the distal colon (P less than 0.025). In the ulcerative and Crohn's colitis groups, this gradient effect was lost, predominantly as a result of decreased availability of fucosyl residues in the proximal colon. In the descending colon of Crohn's colitis tissues, there was a complete absence of Dolichus biflorus agglutinin binding sites compared with the 62.5% incidence in the control group (P less than 0.05). These results demonstrate that the expression of lectin-binding sites in human large intestinal goblet mucin is specifically altered in inflammatory bowel disease, indicating that there are changes in glycosylation of colorectal mucin consistent with alterations in goblet cell differentiation. PMID- 3965500 TI - Variability in purified dysfunctional C1(-)-inhibitor proteins from patients with hereditary angioneurotic edema. Functional and analytical gel studies. AB - C1(-)-inhibitor (C1(-)-INH) proteins from normal persons and members of eight different kindred with dysfunctional C1(-)-INH proteins associated with hereditary angioneurotic edema (HANE) were compared with respect to their inhibitory activity against purified preparations of C1s-, plasma kallikrein, activated forms of Hageman factor, and plasmin. Each dysfunctional C1(-)-INH protein showed a unique spectrum of inhibitory activity against these enzymes. Although none of the dysfunctional C1(-)-INH proteins significantly impaired amidolysis by plasmin, all but one inhibited activated Hageman factor. One purified dysfunctional C1(-)-INH (Ta) inhibited purified C1s- to a normal degree. Another C1(-)-INH (Za) had almost seven times as much inhibitory activity as normal C1(-)-INH against activated Hageman factor, but had decreased activity against C1s- and no activity against plasmin. Analyses of mixtures of plasmin and C1(-)-INH proteins in SDS gel electrophoresis revealed variability in the patterns of complex formation and cleavage of dysfunctional proteins after exposure to C1s- and plasmin. Some bound to plasmin and were cleaved, even though none significantly impaired the amidolytic activity of plasmin. Two were cleaved by C1s-, whereas neither normal or other dysfunctional C1(-)-INH were cleaved. Dysfunctional C1(-)-INH proteins from patients with HANE are thus heterogeneous in their inhibitory properties and there must be different structural requirements for the inhibition of the various plasma enzymes that can be regulated by normal C1(-)-INH. The data suggest that in addition to common sites of interactions between these proteases and C1(-)-INH, there are also points of contact that are specific for each protease. Genetic mutations leading to structural changes at some of these sites may have differing effects on the interaction between individual proteases and abnormal C1(-)-INH proteins. These alterations may allow these proteins to serve as probes for structural requirements for inhibitory actions of normal C1(-)-INH. PMID- 3965501 TI - Stereospecific transport of triiodothyronine from plasma to cytosol and from cytosol to nucleus in rat liver, kidney, brain, and heart. AB - We have investigated the transport of L- and D-triiodothyronine (T3) from plasma to cellular cytoplasm and from cytoplasm to nucleus by estimating the concentration of free hormone in these compartments in rat liver, kidney, brain, and heart. We assessed the distribution of T3 in various tissues and its metabolism by standard isotopic techniques and measured plasma and cytosolic tissue T3 by radioimmunoassay. In addition, we determined the fraction of radiosensitive T3 associated with the cytosol in individual tissues and estimated the cytosolic volume per gram of tissue. Equilibrium dialysis allowed us to determine the binding power of cytosols and plasma, and in vitro saturation techniques provided values for the affinity (ka) for L- and D-T3 of isolated nuclei in aqueous solution at 37 degrees C. We calculated the free cytosolic hormone from the product of cytosolic T3 and the binding power of cytosol for T3, and the free intranuclear T3 from the ka and previously determined ratio of occupied-to-unoccupied binding sites under steady state conditions in euthyroid animals. Our results showed that the free cytosolic/free plasma concentrations for L-T3 and D-T3, respectively, were: liver 2.8, 21.6; kidney 1.17, 63.3; heart 1.31, 1.58; brain 0.86, 0.24. The free nuclear/free cytosolic ratios for L-T3 and D-T3, respectively, were: liver 58.2, 3.70; kidney 55.9, 1.54; heart 80.6, 24.9; and brain 251, 108.6. Our findings suggest that stereospecific transport occurs both from plasma to cytosol and from cytosol to nucleus. The high gradients from cytosol to nucleus imply that there is an energy-dependent process and appear to account for the differences in the nuclear association constant determined in vivo and in vitro. PMID- 3965503 TI - Human monocyte-derived mucus secretagogue. AB - Human peripheral monocytes were stimulated with opsonized zymosan or protein A containing Staphylococcus aureus to examine whether factors might be released that were capable of stimulating mucous glycoprotein release from cultured human airways, as has recently been described with human pulmonary macrophages. While the supernatant from monocytes exposed to opsonized zymosan or protein A containing S. aureus caused an impressive activity was found in the control samples that were cultured in parallel and exposed to nonactivated zymosan or S. aureus that was deficient in protein A. The responsible factor was termed monocyte-derived mucus secretagogue (MMS). The maximum MMS release was reached 4 8 h after stimulation, and the amount of MMS released was dependent on the dose of opsonized zymosan added. Chromatographic analyses of MMS indicate that its molecular weight was approximately 2,000 and that the isoelectric point (pI) was 5.2, with a smaller second peak of 7.4 on isoelectric focusing. MMS itself was not detected in monocyte lysates, nor was it formed by monocytes treated with the protein synthesis inhibitor, cycloheximide, before exposure to activating particles. MMS was not a prostaglandin, could not be extracted into organic solvents, and is probably not an eicosanoid. Based on these observations, we conclude that stimulated human peripheral monocytes synthesize a small, acidic molecule, termed MMS, that is capable of stimulating human airways to secrete mucus and in nearly every respect is identical to pulmonary macrophage-derived MMS. PMID- 3965502 TI - Uncoupling of the membrane skeleton from the lipid bilayer. The cause of accelerated phospholipid flip-flop leading to an enhanced procoagulant activity of sickled cells. AB - We have previously reported that the normal membrane phospholipid organization is altered in sickled erythrocytes. More recently, we presented evidence of enhanced transbilayer movement of phosphatidylcholine (PC) in deoxygenated reversibly sickled cells (RSC) and put forward the hypothesis that these abnormalities in phospholipid organization are confined to the characteristic protrusions of these cells. To test this hypothesis, we studied the free spicules released from RSC by repeated sickling and unsickling as well as the remnant despiculated cells. The rate of transbilayer movement of PC in the membrane of deoxygenated remnant despiculated cells was determined by following the fate of 14C-labelled PC, previously introduced into the outer monolayer under fully oxygenated conditions using a PC-specific phospholipid exchange protein from beef liver. The rate of transbilayer movement of PC in the remnant despiculated cells was significantly slower than in deoxygenated native RSC and was not very much different from that in oxygenated native RSC or irreversibly sickled cells. The free spicules had the same lipid composition as the native cells, but were deficient in spectrin. These spicules markedly enhanced the rate of thrombin formation in the presence of purified prothrombinase (Factor Xa, Factor Va, and Ca2+) and prothrombin, indicating the exposure of a significant fraction of phosphatidylserine (PS) in the outer monolayer. This effect was not observed when the spicules in this assay were replaced by normal erythrocytes, deoxygenated native RSC, or a deoxygenated sample of RSC after repetitive sickling/unsickling. The results are interpreted to indicate that the destabilization of the lipid bilayer in sickled cells, expressed by the enhanced flip-flop of PC and the exposure of PS in the outer monolayer, occurs predominantly in those parts of the membrane that are in spicular form. PMID- 3965504 TI - Isolation of high density lipoproteins from rat intestinal epithelial cells. AB - Previous studies have defined forms of high density lipoproteins (HDL) in rat mesenteric lymph, suggesting that they have a secretory origin. This study describes the isolation and characterization of intestinal intracellular HDL. Two preparations were made as follows: (a) Rat enterocytes were isolated and a Golgi organelle fraction was prepared. (b) Cell homogenates were subjected to nitrogen cavitation and a cytoplasmic fraction was prepared. Lipoproteins were isolated from both preparations by sequential ultracentrifugation. When the HDL fraction (1.07-1.21 g/ml) was subjected to isopyknic density gradient ultracentrifugation, a peak of apoproteins A-I and B (apoA-I and apoB, respectively) was found at a density of 1.11-1.14 g/ml. Electron microscopy of the fraction showed spherical particles ranging in size from 6 to 13 nm. Immunoelectrophoresis revealed a precipitin arc in the alpha region against apoA-I which extended into the pre beta region where a precipitin arc against apoB was also seen. ApoB antisera depleted the pre-beta particles whereas the alpha migrating particles remained. Lipid analysis of the whole HDL fraction revealed phospholipid, cholesteryl ester, and triglyceride as the major lipids. [3H]leucine was then administered into the duodenum and a radiolabeled intracellular HDL fraction was isolated. The newly synthesized apoproteins of the HDL fraction, as determined by gel electrophoresis, were apoB, apoA-I, and apolipoprotein A-IV (ApoA-IV). Immunoprecipitation of the apoB particles revealed apoA-I and apoA-IV in the supernatant. These data demonstrate that there are at least two intracellular intestinal forms of HDL particles, one of which contains apoB. The other particle contains apoA-I and apoA-IV, has alpha mobility, is spherical, and resembles a particle found in the lymph. PMID- 3965506 TI - Sinusoidal efflux of glutathione in the perfused rat liver. Evidence for a carrier-mediated process. AB - Turnover of hepatic glutathione in vivo in the rat is almost entirely accounted for by cellular efflux, of which 80-90% is sinusoidal. Thus, sinusoidal efflux play a major quantitative role in homeostasis of hepatic glutathione. Som preliminary observations from our laboratory (1983. J. Pharmacol. Exp. Ther. 224:141-147.) and circumstantial evidence in the literature seemed to imply that the raising of the hepatic glutathione concentration above normal was not accompanied by a rise in the rate of sinusoidal efflux. Based on these observations, we hypothesized that the sinusoidal efflux was probably a saturable process and that at normal levels of hepatic glutathione the efflux behaved as a zero-order process (near-saturation). We tested our hypothesis by the use of isolated rat livers perfused in situ, single pass, with hemoglobin-free, oxygenated buffer medium at pH 7.4 and 37 degrees C. Preliminary experiments established a range of perfusion rates (3-4 ml/min per g) for adequacy of oxygenation, lack of cell injury, and minimization of variability contributed by perfusion rates. Hepatic glutathione was lowered to below normal by a 48-h fast, diethylmaleate (0.1-1.0 ml/kg i.p.), and buthionine sulfoximine (8 mmol/kg i.p.), and raised to above normal by 3-methylcholanthrene (20 mg/kg x 3 d i.p.) and cobalt chloride (0.05-0.27 g/kg-1 subcutaneously). Steady state sinusoidal efflux from each liver was measured over a 1-h perfusion, during which the coefficient of variation of glutathione in perfusates stayed within 10%. Hepatic glutathione efflux as a function of hepatic concentration was characterized by saturable kinetics with sigmoidal (non-hyperbolic) features. The data were fitted best with the Hill model and the following parameter values were estimated: Vmax = 20 nmol/min per g, Km = 3.2 mumol/g, and n = 3 binding/transport sites. The efflux could be inhibited reversibly by sulfobromophthalein-glutathione conjugate but was not affected by the addition of glutathione to the perfusion medium. The results support our hypothesis that sinusoidal efflux of glutathione is near saturation (approximately equal to 80% of Vmax) at normal (fed and fasted) liver glutathione concentrations. The phenomenon of saturability coupled with the ability to inhibit the efflux leads us to propose that sinusoidal efflux from hepatocytes appears to be a carrier-mediated process. Some recent studies by others, using sinusoidal membrane-enriched vesicles, also support these conclusions. PMID- 3965505 TI - Platelet C1- inhibitor. A secreted alpha-granule protein. AB - In order to characterize which proteins of the contact phase of coagulation interact with platelets, human platelets were studied immunochemically and functionally to determine if they contain C1- inhibitor. By means of monospecific antibody to C1- inhibitor, a competitive enzyme-linked immunosorbent assay (CELISA) was developed to measure directly platelet C1- inhibitor. With the CELISA, from 33 to 115 ng of C1- inhibitor antigen per 10(8) platelets from 15 normal donors was quantified in lysates of washed human platelets solubilized in nonionic detergent. The mean concentration in 10(8) platelets was 62 +/- 33 ng (SD). Plasma C1- inhibitor either in the platelet suspension medium or on the surface of the platelets could account for only from 6.5 to 16% of the total antigen measured in the solubilized platelets. Upon functional studies, platelets contained 84 +/- 36 ng (SD) of C1- inhibitor activity in 10(8) platelets. As assessed by the CELISA, platelet C1- inhibitor antigen was immunochemically identical to plasma and purified C1- inhibitor. In contrast, the mean concentration of platelet C1- inhibitor antigen in platelets from four patients with classical hereditary angioedema was 8.3 ng/10(8) platelets (range, 5.3 to 11.3 ng/10(8) platelets). 25 and 31% of the total platelet C1- inhibitor was secreted without cell lysis from normal platelets after exposure to collagen (20 micrograms/ml) and thrombin (1 U/ml), respectively, and this secretion was blocked by metabolic inhibitors. Platelet subcellular fractionation showed that platelet C1- inhibitor resided mostly in alpha-granules, similar to the location of platelet fibrinogen. Thus, human platelets contained C1- inhibitor, which became available by platelet secretion. The identification of platelet C1- inhibitor suggests that platelets may modulate the activation of the proteins of early blood coagulation and the classical complement pathways. PMID- 3965507 TI - Interaction of antithrombin III with bovine aortic segments. Role of heparin in binding and enhanced anticoagulant activity. AB - Bovine antithrombin III (AT III) interaction with the luminal surface of bovine aortic segments with a continuous layer of endothelium was examined. Incubation of 125I-AT III with vessel segments, previously washed free of endogenous AT III, demonstrated specific, time-dependent binding to the protease inhibitor to the endothelium. Half-maximal binding was observed at an added AT III concentration of 14 nM. Binding of 125I-AT III to the vessel wall was reversible (50% dissociated in 4 min), and addition of either heparin or Factor Xa accelerated displacement of 125I-AT III from the vessel segment. Dissociation of 125I-AT III from the vessel segment in the presence of factor Xa coincided with the formation of a Factor Xa-125I-AT III complex. Inactivation of Factor IXa and Factor Xa by AT III was facilitated in the presence of vessel segments. Pretreatment of vessel segments with highly purified Flavobacterium heparinase precluded the vessel dependent augmentation of AT III anticoagulant activity as well as specific binding of 125I-AT III to the vessel endothelium. In contrast, pretreatment of the vessel segments with chrondroitinases (ABC or AC) had no detectable effect on 125I-AT III binding or on AT III anticoagulant activity. AT III binding to vessel segments was competitively inhibited by increasing concentration of platelet factor 4. Binding of the protease inhibitor to vessel segments was inhibited by chemical modification of AT III lysyl or tryptophan residues. These AT III derivatives retained progressive inhibitory activity. These data suggest that heparin-like molecules are present on the aortic vessel wall and mediate binding of AT III to the vessel surface, as well as enhancing the anticoagulant activity of AT III at these sites. PMID- 3965508 TI - Comparison of hepatic elimination of different forms of cholecystokinin in dogs. Bioassay and radioimmunoassay comparisons of cholecystokinin-8-sulfate and -33 sulfate. AB - The influence of hepatic transit on the ability of exogenous cholecystokinin-8 sulfate and -33-sulfate (CCK-8 and CCK-33, respectively) to stimulate gallbladder contraction and exocrine pancreatic secretion, as well as on the peripheral plasma concentration of each agent, was evaluated in five conscious dogs with pancreatic and gallbladder fistulas and complete portacaval transposition. The gallbladder pressure increments after portal administration of CCK-8 (0.125, 0.25, 0.50, and 1.0 microgram/kg per h for 5 min) were diminished by 36, 45, 39 and 25%, respectively, in comparison with those obtained with systemic administration of identical doses of CCK-8 (P less than 0.05). In a subsequent experiment, the integrated pancreatic juice volume, bicarbonate, and protein secretion were diminished by 22, 32, and 48%, respectively, during a 30-min infusion of CCK-8 (0.10 micrograms/kg per h) into the portal venous system, in comparison with the results obtained with systemic administration of CCK-8 (P less than 0.05). In contrast, the gallbladder pressure and pancreatic exocrine secretory responses to portal administration of CCK-33 did not differ significantly (P greater than 0.05) from the results obtained with systemic administration of CCK-33. Radioimmunoassay for CCK-8 in plasma showed that the integrated CCK-8 value during portal administration was significantly lower (P less than 0.05) than it was during systemic administration. The results for CCK 33, however, did not vary, whether it was given by a systemic or portal route (P greater than 0.05). Thus, the present study demonstrates that CCK-8 is partially inactivated by the liver whereas CCK-33 is not, which suggests that CCK-3 in the circulation may play a significant role in the physiologic regulation of the gallbladder and exocrine pancreas. PMID- 3965509 TI - Platelet-induced neurogenic coronary contractions due to accumulation of the false neurotransmitter, 5-hydroxytryptamine. AB - The purpose of this study was to determine if 5-hydroxytryptamine released from aggregating platelets could be accumulated and released by canine coronary adrenergic nerves, and if the false neurotransmitter resulted in an abnormal response of the smooth muscle to nerve stimulation. Isometric tension was measured in rings of epicardial coronary suspended in organ chambers filled with physiological salt solution. The response to electrical stimulation or exogenously added norepinephrine was elicited after contraction with prostaglandin F2 alpha. Electrical stimulation and exogenous norepinephrine caused beta-adrenergic relaxation of control rings. However, after rings were exposed for 2 h to aggregating platelets or 5-hydroxytryptamine, electrical stimulation caused frequency-dependent contractions. These contractions were prevented by the serotonergic antagonists, cyproheptadine or ketanserin, or by the neuronal uptake inhibitor, cocaine. The relaxation caused by exogenously added norepinephrine was unchanged after exposure to platelets or 5 hydroxytryptamine, indicating that smooth muscle alpha- and beta-adrenergic responsiveness was unchanged. The electrically stimulated overflow of radiolabeled norepinephrine from superfused strips of coronary artery was not altered by prior exposure to 5-hydroxytryptamine, indicating that the effect of exposure on the response to electrical stimulation is primarily at smooth muscle serotonergic receptors. Canine coronary arteries accumulated and metabolized radiolabeled 5-hydroxytryptamine in vitro. The accumulation of 5 hydroxytryptamine was inhibited by cocaine or by adrenergic denervation with 6 hydroxydopamine but unaffected by removal of endothelium, indicating that the adrenergic nerves were the primary site of accumulation. Electrical stimulation of superfused strips of coronary artery preincubated with radiolabeled 5 hydroxytryptamine caused the release of the intact indoleamine; this was blocked by the neurotoxin, tetrodotoxin. These studies suggest that 5-hydroxytryptamine liberated from aggregating platelets may be accumulated by coronary adrenergic nerve endings. Upon its release from the nerves as a false transmitter, the amine can activate serotonergic receptors on the smooth muscle and reverse the action of the adrenergic nerves from dilator to constrictor. PMID- 3965510 TI - Sn-protoporphyrin rapidly and markedly enhances the heme saturation of hepatic tryptophan pyrrolase. Evidence that this synthetic metalloporphyrin increases the functional content of heme in the liver. AB - Sn-protoporphyrin is a potent competitive inhibitor of heme oxygenase, the rate limiting enzyme in heme degradation to bile pigment, and has been successfully utilized to suppress hyperbilirubinemia in a variety of experimental and naturally occurring forms of jaundice in animals and man. The compound is presumed to act in vivo primarily by inhibiting heme oxidation; thus it would be reasonable to expect that preservation of some functional moiety of cellular heme from degradation by heme oxygenase would occur after Sn-protoporphyrin administration. We have examined this question in liver by studying the heme saturation of tryptophan pyrrolase, the heme-dependent enzyme which controls the first and rate-limiting step in the catabolism of L-tryptophan. Sn protoporphyrin, in doses (10 mumol/kg body wt) which entirely suppress neonatal hyperbilirubinemia in the experimental animal, leads to a very rapid (approximately 30-60 min) increase in the heme saturation of tryptophan pyrrolase from normal levels of approximately 50-60% to nearly 100%. The effect peaks at 1 2 h and lasts for at least 12 h. Sn-protoporphyrin is also able to block the rapid and marked decline in heme saturation of tryptophan pyrrolase elicited by inorganic cobalt, a potent inducer of heme oxygenase in liver. These findings establish clearly that after the administration of Sn-protoporphyrin in the whole animal, a functionally active heme pool, the one related to tryptophan pyrrolase, is rapidly increased in liver, confirming that the metalloporphyrin inhibits the degradation of endogenous heme by heme oxygenase. PMID- 3965511 TI - Regulation of parathyroid hormone release and cytosolic calcium by extracellular calcium in dispersed and cultured bovine and pathological human parathyroid cells. AB - Alterations in parathyroid glandular sensitivity to calcium may contribute to the hypersecretion of PTH in hyperparathyroidism. Since the cytosolic calcium concentration may mediate the effects of extracellular calcium on PTH release, we have employed the calcium-sensitive intracellular dye QUIN-2 to examine the relationship between extracellular calcium, cytosolic calcium, and PTH secretion in adult, neonatal, and cultured bovine as well as pathological human parathyroid cells. PTH release was measured using C- and N-terminal radioimmunoassays. Neonatal bovine parathyroid cells showed a greater set-point for secretion (the Ca++ concentration causing half of the maximal inhibition of PTH release) than adult cells (1.27 +/- 0.11 vs. 1.06 +/- 0.11 mM extracellular calcium, P less than 0.01), and a slightly higher extracellular calcium was necessary to raise the cytosolic calcium concentration to a given level in neonatal than in adult bovine parathyroid cells. In individual neonatal and adult cell preparations, there was a close correlation between the set-point for secretion and the "set point" for cytosolic calcium (r = 0.832, P less than 0.001). In cells from five human parathyroid adenomas, which had an increase in set-point for secretion, the extracellular calcium concentration necessary to raise the cytosolic calcium concentration to a given level was slightly greater than in the neonatal cells. In four preparations of human parathyroid cells there was a significant correlation between the set-points for secretion and cytosolic calcium (r = 0.856, P less than 0.01). Because neonatal bovine and pathological human parathyroid glands show cellular hyperplasia, we studied the temporal relationship between cellular proliferation and the regulation of PTH release and cytosolic calcium concentration in cultured bovine parathyroid cells. Cellular proliferation, estimated by 3H-thymidine incorporation, increased significantly in culture from 104 +/- 10.1 counts/well on day 1 (first 24 h in culture) to 588 +/- 188 and 6,156 +/- 649 counts/well on days 2 and 4, respectively. In cultured cells on day 1, highly Ca++ (2-3 mM) inhibited maximal PTH release by 58.8 +/- 3.2%, which decreased significantly (P less than 0.001) to 38.2 +/- 1.9 and 17.1 +/- 3.7% on days 2 and 4, respectively. The cytosolic calcium observed at 3 mM calcium on day 1 was 701 +/- 43 nM, which declined to 466 +/- 60 and 314 +/- 14 nM on days 2 and 4 (P less than 0.05). There was a close correlation between this progressive decrease in maximal inhibition of PTH release and the cytosolic calcium at high extracellular calcium in cultured cells (r = 0.99, P < 0.001). Thus, during active proliferation of cultured cells, there is an alteration in the regulation of cytosolic calcium at a given extracellular calcium concentration, and changes in the regulation of PTH release and cytosolic calcium by extracellular calcium may be related to enhanced cellular proliferation. PMID- 3965512 TI - Characterization of iron-mediated peroxidative injury in isolated hepatic lysosomes. AB - Peroxidative degradation of the lysosomal membrane and the resultant release of hydrolytic enzymes may be responsible for hepatocellular injury in iron toxicity. In this study, highly purified hepatic lysosomes were exposed to iron salts in vitro; the nature of this iron-mediated process of injury and the susceptibility of the lysosomal integrity were studied. Native hepatic lysosomes from rats were isolated by free flow electrophoresis. Incubation of the lysosomes at 37 degrees C with Fe3+-ADP in the presence of ascorbate resulted in rapid generation of malondialdehyde, which approached a plateau at 20 min. Subsequently, the loss of lysosomal latency, determined as an increased percentage free activity of N acetyl-beta-glucosaminidase, also occurred and reached a maximum loss at 30 min. The half-maximal level of ascorbate, required to promote the Fe3+-ADP mediated lysosomal peroxidation, was approximately 10 microM; high concentrations of ascorbate were inhibitory and half-maximal inhibition was achieved at a concentration of 2 mM. The iron-mediated lysosomal peroxidation was not inhibited by most active oxygen scavengers and appeared to depend solely on the generation of Fe2+ species. When a fresh solution of Fe2+ was incubated with the lysosomes, both the extent of lipid peroxidation and the degree of latency loss increased as a function of increasing Fe2+ concentration. High concentrations of Fe2+ stimulated lysosomal lipid peroxidation instantaneously and reached the highest level within 10 min; whereas the subsequent maximum loss of latency was achieved within 20 min. Both the MDA formation and the loss of latency in either the Fe3+ ADP + ascorbate or the Fe2+ system were effectively prevented by the presence of vitamin A or vitamin E. PMID- 3965514 TI - Cryosurgery effective for granuloma faciale. AB - Various treatments have been advocated for granuloma faciale, but experience has demonstrated that cryosurgery is extremely effective and simple in application. PMID- 3965515 TI - Tattoo removal. PMID- 3965513 TI - Characterization of three abnormal factor IX variants (Bm Lake Elsinore, Long Beach, and Los Angeles) of hemophilia-B. Evidence for defects affecting the latent catalytic site. AB - Abnormal factor IX variant proteins were isolated from the plasmas of three unrelated severe hemophilia-B families that had been previously shown to contain functionally impaired molecules immunologically similar to normal factor IX. The families studied were: (1) a patient with markedly prolonged ox brain prothrombin time, designated factor IX Bm Lake Elsinore (IXBmLE); (b) three patients (brothers) with moderately prolonged ox brain prothrombin time, designated factor IX Long Beach (IXLB); and (c) a patient with normal ox brain prothrombin time designated factor IX Los Angeles (IXLA). Each variant molecule comigrates with normal factor IX (IXN) both in the sodium dodecyl sulfate and in the nondenaturing alkaline gel electrophoresis. All three variant proteins are indistinguishable from IXN in their amino acid compositions, isoelectric points, carbohydrate distributions and number of gamma-carboxyglutamic acid residues. Each variant protein undergoes a similar pattern of cleavage by factor XIa/Ca2+ and by factor VIIa/Ca2+/tissue factor, and is activated at a rate similar to that observed for IXN. All of the three variant proteins also react with an anti-IXN monoclonal antibody that interferes with the binding of activated IXN(IXaN) to thrombin-treated factor VIIIC. However, in contrast to IXaN, the cleaved IXBmLE has negligible activity (approximately 0.2%), and cleaved forms of IXLA and IXLB have significantly reduced activity (approximately 5-6%) in binding to antithrombin-III/heparin, and in activating factor VII (plus Ca2+ and phospholipid) or factor X (plus Ca2+ and phospholipid) +/- factor VIII. These data, taken together, strongly indicate that the defect in these three variant proteins resides near or within the latent catalytic site. This results in virtually a complete loss of catalytic activity of the cleaved IXBmLE molecule and approximately 95% loss of catalytic activity of the cleaved IXLA and IXLB molecules. PMID- 3965516 TI - Tumor conference #54. Laser treatment of penile hemangiomas. PMID- 3965517 TI - Multiple pyogenic granuloma-like lesions following hair transplantation. AB - Multiple pyogenic granuloma-like lesions occurring at punch graft sites are an unusual complication of hair transplantation heretofore unreported. While the etiology and pathogenesis of such lesions remain elusive, physicians performing hair transplantations should be aware of this potential sequela. PMID- 3965518 TI - Sebaceous carcinoma of the eyelid: treatment with Mohs surgery. AB - Sebaceous carcinomas of the eyelid are associated with high morbidity and mortality. Recurrence is common following conventional surgical or radiation therapy. Although Mohs surgery remains the treatment of choice, multicentric involvement and pagetoid spread may create outlying noncontiguous foci requiring careful follow-up and possible secondary Mohs procedures. PMID- 3965519 TI - Laboratory evaluation of skin refrigerants used in dermabrasion. AB - Six skin refrigerants were evaluated for maximum cooling temperature. The temperatures produced correlated well with the chemical components and also the gelatin freeze-thaw times. Freon 114 and Freon 114-ethyl chloride mixtures are time-tested, safe skin refrigerants. Some of the newer skin refrigerants are pure sources of Freon 12 or mixtures of Freon 12 and Freon 11. These newer, colder products have the potential to damage the skin and represent a hazard to successful dermabrasion. PMID- 3965520 TI - Estrogen and progesterone receptors in primary cutaneous melanoma. AB - Using a variety of techniques, estrogen and progesterone receptors have previously been identified in variable percentages of malignant melanomas. We examined 10 primary superficial spreading melanomas (SSM) with a fluorescent hormone-binding technique for estrogen and progesterone cytoplasmic receptors. Of these 6 SSM were markedly positive for estrogen and progesterone binding. Patients with dysplastic nevus syndrome (DNS) or a family history of DNS were markedly positive for estrogen and progesterone binding. A single patient with lentigo maligna and another patient with lentigo maligna melanoma were negative for estrogen and progesterone binding. None of the 21 control intradermal nevi examined for estrogen and progesterone binding exhibited marked positivity. PMID- 3965521 TI - Wedge resection of the lip: minimizing problems. AB - The basics of wedge resection of the lower lip are reviewed. The use of an intraoral mental nerve block greatly decreases the pain for the patient. The procedure is simplified by the isolation and ligation of the labial artery prior to excision of the wedge. The best cosmetic results are obtained when the orbicularis oris muscle and vermillion border are carefully repaired. PMID- 3965523 TI - Seborrheic keratosis? PMID- 3965522 TI - Jadassohn's sebaceous nevus. AB - A total of 29 case reports of sebaceous nevus were filed for the years 1970 to 1980 in the Department of Pathology of the National Medical Center of El Salvador. In 2 cases (6.8%), association with basal-cell carcinomas were found. In 1 case, there was also a solitary pilar leiomyoma. Sebaceous nevus was found more frequently in females than in males (2:1 ratio), and the average age was 23.8 years at the time of the consultation. All diagnosed sebaceous nevi were located on the head (48.2% on the scalp), and 82.7% of the patients were under 30 years of age. In connection with the analysis of these cases, a brief review of the clinical, histologic, and evolutionary facts of the sebaceous nevus was carried out. PMID- 3965524 TI - Coexistence of Kaposi's sarcoma and angioimmunoblastic lymphadenopathy. AB - A 66-year-old woman who developed simultaneously angioimmunoblastic lymphadenopathy (AILD) and Kaposi's sarcoma (KS) is reported. A parallel course of the two diseases was evident. After a relatively short course of corticosteroid therapy, the clinical and laboratory signs of AILD regressed, and the patient is in remission 39 months after the beginning of the disease. At the same time a regression of KS lesions was also observed. The frequent association of KS and lymphoproliferative disorders in the same patient is discussed. As AILD is a lymphoma-like syndrome, it is suggested that we might expect a more frequent association of this disease with KS in the same patient than the two cases reported to date. PMID- 3965525 TI - Skin refrigerants. PMID- 3965526 TI - 14th Bethesda Conference. Noninvasive diagnostic instrumentation in the assessment of cardiovascular disease in the young. September 12-13, 1983. Bethesda, Maryland. PMID- 3965527 TI - Assessment of hemodynamic function with pulsed Doppler ultrasound. AB - Recent refinements in pulsed Doppler technology have made possible the noninvasive assessment of hemodynamic function. The application of the Doppler frequency shift principle to study discrete velocity events at a measured distance from the transducer is discussed. The accuracy and limitations of Doppler techniques in determining ascending aortic and peripheral blood flow velocities in infants with various cardiac lesions are examined. Noninvasive assessment of myocardial contractility is also described. Most studies performed to date suggest that pulsed Doppler techniques provide a sensitive approach to the measurement of flow velocity and acceleration in appropriate selected circumstances. However, distinctions between volume flow and flow velocity must be considered in the interpretation of data. PMID- 3965528 TI - Assessment of aortic blood flow velocities with continuous wave Doppler ultrasound in the neonate and young child. AB - Aortic flow velocities can be recorded with pulsed or continuous wave Doppler ultrasound. In the absence of obstruction or regurgitation, changes in flow can be assessed and stroke volume obtained. Continuous wave Doppler ultrasound has the advantage that there is no limit to the velocities that can be recorded. In left ventricular outflow obstruction and coarctation, the pressure drop across these can be calculated from increases in maximal velocity using a modification of the Bernoulli equation. Other systolic high velocity jets such as mitral regurgitation or ventricular septal defect may also be recorded with continuous wave Doppler ultrasound from the suprasternal notch, but they can be distinguished from aortic flow velocities by their timing and duration when the flow signals are recorded together with the electrocardiogram and phonocardiogram. In aortic regurgitation, reversal of flow across the aortic valve in diastole can be shown and with high velocity in the regurgitant jet. PMID- 3965529 TI - Resolution and display requirements for ultrasound Doppler/evaluation of the heart in children, infants and the unborn human fetus. AB - Technical considerations and the instrumentation used for pediatric two dimensional echocardiography and Doppler examination are reviewed. The configurations of sector scanners, the function of the mechanical versus phased array systems and considerations related to lateral, axial and azimuthal resolution requirements are discussed. The performance and requirements for echocardiographic cardiographic scan converters and the requirements for pediatric display are reviewed. Methods of performing quantitative Doppler echocardiography are discussed because this technique provides new and important types of information for the evaluation of congenital heart disease. Considerations of Doppler velocity, Doppler spatial resolution and Doppler display requirements are presented. Characteristics of ultrasonic imaging devices for use in fetal echocardiography and fetal Doppler study are reviewed, and a brief overview of techniques for the extraction of information about the nature of ultrasound scatterers (that is, tissue signature) is presented. It is the purpose of this technically oriented discussion to present the capabilities, trade-offs and needs for future development relevant to pediatric echocardiography in 1983. PMID- 3965530 TI - Assessment of cardiovascular function by digital angiocardiography. AB - A methodology for computerized digital videoangiocardiography is briefly described. Single or biplane projection image series from the cardiovascular system are combined with the corresponding physiologic (electrocardiogram, blood pressure, etc.) reference data, digitized and stored as a block of simultaneously available information representing anatomic and functional aspects of the cardiovascular system. Simple mask mode and more complex modes of digital subtraction, image combination and manipulation techniques, as developed during the last decade, are mentioned. These techniques are primarily useful to separate the contrast bolus from the background, thereby allowing contrast enhancement with less contrast medium injected selectively, or so-called noninvasive intravenous angiocardiography. Ventricular function can be assessed by these simple digital image processing techniques. This has been proved for determining right ventricular volumes and ejection fraction with respect to reproducibility and accuracy using conventional biplane angiocardiography as reference. More complex techniques for the assessment of function, in particular blood flow distributions in the systemic circulation, are described using information from the whole digitized angiocardiographic image series by extracting time and volume parameters from the complete matrix of pixel densograms. Various modes of extraction and display of time parameters allow a generation of parametric images that display heretofore unavailable flow patterns reflecting the progress of the contrast bolus within the arterial tree. Based on an adequate temporal segmentation (for example, time segments of one cardiac cycle) and simultaneous volume determination of the circulatory structure from the area of the densogram, relative and absolute flow as well as regional flow distribution in a branching arterial system can be determined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965531 TI - Two-dimensional echocardiography in the older child. AB - The role of two-dimensional echocardiography in the management of any congenital cardiovascular anomaly depends on the lesion's natural history and surgical alternatives. Diagnostic assessment of subaortic stenosis and postoperative follow-up of Fontan and Mustard/Senning procedures and tetralogy of Fallot reconstruction illustrate the application of two-dimensional echocardiography to the management of these problems in the older child. Two-dimensional echocardiography displays the static anatomic as well as dynamic functional sequels of left ventricular outflow obstruction. Detailed anatomic display of Fontan reconstruction is compromised by its somewhat unpredictable spatial organization. Combining two-dimensional imaging with gated pulsed Doppler techniques, however, supplements limited anatomic definition with flow profile data specific to the varied surgical interpretations of the Fontan principle. In a similar manner, combined imaging after Senning/Mustard procedures permits detailed anatomic and hemodynamic interrogation of pulmonary and systemic venous return to the neo-left and neo-right atria. The limitations of cardiac ultrasound imaging of the older child after tetralogy of Fallot reconstruction offer some insight into the future directions that are necessary in the application of this imaging technique. Imaging of these patients is compromised by the prosthetic material, which compromises the assessment of right ventricular outflow pulmonary artery reconstruction and ventricular septal closure. Although gated pulsed Doppler echocardiography overcomes some of these limitations, better tissue characterization in the presence of bioprosthetic material is necessary. PMID- 3965532 TI - Noninvasive assessment of cardiovascular disease in the young: a clinical overview. PMID- 3965533 TI - Assessing cardiac anatomy with digital subtraction angiography. AB - The use of intravenous digital subtraction angiography in the assessment of patients with congenital heart disease is described. Intravenous digital subtraction angiographic techniques are particularly helpful in visually assessing left to right shunts in patients with atrial and ventricular septal defects and anomalies of pulmonary venous return. Digital subtraction angiographic techniques have also been used to quantitate the magnitude of left to right shunts and have been compared with radionuclide-determined pulmonary flow/systemic flow ratios (r = 0.89, p less than 0.0001). Digital subtraction angiographic techniques are particularly helpful in evaluating the right atrium, right ventricle and pulmonary arteries as well as the aorta and aortic arch. We have used digital subtraction angiographic techniques in the immediate and long term postoperative evaluations of patients after congenital heart surgery. The safety of digital subtraction angiography lends itself to pediatric patients and can be performed on an out patient basis. Digital subtraction angiography provides significant anatomic information that has modified our traditional approach to patients with congenital heart disease. PMID- 3965534 TI - Computed tomography of the heart: evaluation of anatomy and function. AB - Diseases of the heart and blood vessels represent one of the most challenging problems for advanced diagnostic imaging systems. Computed tomographic scanning is potentially an ideal cardiac imaging modality since it is a cross-sectional imaging method with very high resolution. Currently available computed tomographic scanners have exposure speeds of 1 to 5 seconds, which are inadequate for the majority of cardiovascular imaging applications. Nevertheless, a variety of limited computed tomographic scanning techniques have been successfully performed in selected patient subgroups. These methods require the administration of contrast medium injected or infused into a peripheral vein, combined with either dynamic computed tomographic scanning or some form of electrocardiographic gated computed tomography. The newer conventional computed tomographic scanners can display anatomic structures in the heart and great vessels with considerable fidelity and provide not only cross-sectional displays but also, by means of computer manipulation, any selected reconstructed images in oblique, coronal or sagittal projections. Feasibility studies indicate improved accuracy of computed tomographic measurements of cardiac chamber volumes. Physiologic measurements include estimation of shunt flows and cardiac output and analysis of myocardial wall thickening. The full potential of computed tomography should be reached once fast, multiple slice, computed tomographic scanners using scanning electron beam techniques become available. The prototype CVCT (cine computed tomographic C-100 scanner) designed at the University of California, San Francisco, is now undergoing evaluation. This instrument images up to eight contiguous slices at the rate of 16 to 24 images/s. The computed tomographic scanner specifically designed for cardiac imaging should extend the utility of computed tomography in the evaluation of cardiac diseases and the study of cardiovascular physiology. PMID- 3965535 TI - Anatomy and function of the heart and intrathoracic vessels in congenital heart disease: evaluation with the Dynamic Spatial Reconstructor. AB - The Dynamic Spatial Reconstructor is a unique high speed volume imaging X-ray scanner based on computed tomographic principles. It has several potential advantages over conventional angiographic methods, including reduced invasion, reduced rate of false negative results and increased accuracy of measurements of structure and function. To evaluate the utility of the Dynamic Spatial Reconstructor in the investigation of congenital heart disease, scanning was performed in several pediatric patients with pulmonary valve atresia. Early results show that three-dimensional images of the cardiac chambers and intrathoracic vessels can be acquired and displayed with the system. All the information necessary for quantitative analysis of the pulmonary arteries can be obtained with a single scan involving injection of 0.6 to 2.0 cc/kg of contrast agent and radiation exposure of 0.54 to 0.95 rad/s over 5 to 8 seconds. PMID- 3965537 TI - Specific techniques for assessing function: introduction. PMID- 3965536 TI - Assessment of cardiac anatomy using nuclear magnetic resonance imaging. AB - Nuclear magnetic resonance imaging has emerged in the past few years as a completely noninvasive method for medical imaging of internal organs. Because of the loss of signal intensity by motional nuclei (hydrogen) using most proton imaging techniques, flowing blood within the cardiovascular system generates little or no signal and consequently there is high natural contrast between blood and the walls of blood vessels or cardiac chambers. However, motion during imaging also complicates cardiac imaging because signal is lost from the nuclei in the moving cardiac structures. Consequently electrocardiographic gating of data acquisition is required for nuclear magnetic resonance imaging of the heart. Distinct advantages of nuclear magnetic resonance imaging in relation to other imaging modalities are good contrast between soft tissues and the capability for characterization of specific tissues by estimation of magnetic relaxation times. Early in vitro studies measuring relaxation times of myocardial tissue samples of excised hearts indicate that nuclear magnetic resonance imaging will be capable of discriminating infarcted from normal myocardium. Recent studies using electrocardiographically gated nuclear magnetic resonance imaging of dogs with acute infarction showed the infarct as a region of high intensity on spin-echo images. Initial clinical experience with electrocardiographically gated nuclear magnetic resonance imaging (0.35 tesla) in patients has clearly defined internal cardiac anatomy without the use of contrast media. This technique has demonstrated the consequence of previous myocardial infarction such as regional wall thinning, aneurysm, thrombus and contractile dysfunction, a number of pericardial abnormalities and the morphology of hypertrophic and congestive cardiomyopathies. PMID- 3965539 TI - Abstracts of papers to be presented at the 34th Annual Scientific Session of the American College of Cardiology, Anaheim, California, March 10-14, 1985. PMID- 3965538 TI - Echocardiographic assessment of cardiac function in infants and children. AB - Echocardiography has become an established technique for the assessment of cardiac function in infants and children. M-mode echocardiography provides measurements of left ventricular diameter and wall thickness and allows calculation of their rate of change during the cardiac cycle. Left and right ventricular systolic time intervals may be determined from recordings of aortic and pulmonary valve motion. Two-dimensional echocardiographic images may be utilized for the determination of left and right ventricular volume and ejection fraction. Compared with other noninvasive imaging methods, echocardiography is a rapid, safe and inexpensive technique. Moreover, future developments are likely to include improved image processing and computer analysis of two-dimensional images. PMID- 3965540 TI - The American Academy of Allergy and Immunology. Forty-first annual meeting. New York, N.Y., March 16-20, 1985. Abstracts. PMID- 3965541 TI - Vitamin B-6 status of southern adolescent girls. AB - The vitamin B-6 status of 583 white and black adolescent girls living in Alabama, Arkansas, North Carolina, Oklahoma, and Virginia was assessed using the parameters coenzyme stimulation of erythrocyte alanine aminotransferase activities and dietary intakes of the vitamin. The sample included 382 white and 201 black girls who were 12, 14, or 16 years of age; the sample was also divided into low, medium, and high per capita income groups. The height and weight measurements of the subjects were within normal ranges. The mean estimated daily vitamin B-6 intake of the girls from food sources was 1.20 mg daily, as indicated by evaluation of data obtained via two nonsequential 24-hour food recalls; about half of the subjects reported consuming less than 66% of the Recommended Dietary Allowance for the vitamin. Approximately 20% of the girls had marginal vitamin B 6 status and 13%, deficient status, as indicated by coenzyme stimulation values. Coenzyme stimulation and dietary values of the race, age, and income groups were similar. Vitamin B-6 inadequacy appears to be fairly prevalent among white and black southern adolescent girls. PMID- 3965542 TI - Supplement use: vitamin intakes and biochemical indexes in 40- to 108-month-old children. AB - Intakes and related biochemical indexes of ascorbic acid, thiamin, riboflavin, pyridoxine, vitamin B-12, and folic acid were examined for adequacy in 30 normal children aged 40 to 108 months. Comparisons were made between intake and biochemical index values of children who reported regular use of vitamin supplements and those who reported none. Three-day food records provided nutrient intake data; blood samples, drawn following an overnight fast, were analyzed for biochemical indexes. Student's t-test and the Pearson r were used for comparisons. Mean intakes of most nutrients differed significantly between the supplemented and nonsupplemented groups only when supplements were considered. Mean biochemical indexes differed significantly for riboflavin (p less than .005). Correlations between intakes and respective biochemical indexes were significant for riboflavin (p less than .01) and vitamin B-12 (p less than .01) in the supplemented group and for folate with RBC folate (p less than .005) in the nonsupplemented group. No deficiencies in either group were evident from biochemical indexes; improvement in indexes with supplement use was interpreted as being only relative and not suggestive that such use is beneficial. PMID- 3965543 TI - Analysis of the Journal of The American Dietetic Association, 1967 to 1983. AB - Analysis of the Journal of The American Dietetic Association was undertaken for 1967 to 1983 to determine whether there were changes that might have resulted from the report of the 1972 Study Commission on Dietetics. The study analyzed such factors as the number of original articles, educational background of authors and Journal advisory board members, abstracting of other Journal articles, indexing, citation analysis, and impact factor of the Journal. Study results show increased educational qualifications of authors and advisory board members, more original articles, more efficient indexing, and greater citation frequency. PMID- 3965544 TI - Nutritional assessment indications of postburn complications. AB - This study evaluates the use of nutritional assessment indexes measured on the fifth day after injury to predict subsequent wound infections, episodes of septicemia, and other infectious complications in burned patients. Nutritional assessment data collected included anthropometric measurements (weight, height, triceps skinfold, and upper-arm circumference); biochemical testing (serum albumin concentration, serum transferrin concentration, total lymphocyte count, creatinine/height index, and nitrogen balance); and recall skin antigen testing. Seventy-four adult patients (mean age of 35 years) who had burn injuries ranging from 10% to 96% total body surface were studied. Indexes predictive of imminent wound infection include serum transferrin concentrations less than 150 mg/dl (p = .0006) and anergy to the skin test battery (p = .01). Those indexes were also prognostic of the development of septicemia (p = .0002 and p = .0001, respectively). Although statistically insignificant, total lymphocyte count also showed a similar trend toward predicting complications. Serum albumin concentration (less than 3.0 gm/dl), creatinine/height index (less than 60% standard), percent ideal body weight (less than 80%), percent weight change, and nitrogen balance did not contribute to group discrimination. Severe depletion of the visceral protein compartment was documented in a large percentage of patients on the fifth postburn day. Serum transferrin concentration and recall skin antigen testing can be helpful in identifying thermally injured patients who are at high risk of infectious complications. PMID- 3965545 TI - Process guides for nutrition care in community health. AB - The process of nutrition care is central to the clinical management of the public health client. However, this care is not often provided by the public health nurse. Thus, process guides that describe the techniques and strategies for providing nutrition care are important components of continuing education for those health professionals. This article presents one format for the development and presentation of such guides. Procedures for implementing the guides in public health practice are also described. PMID- 3965546 TI - Primiparas' beliefs about breast feeding. PMID- 3965547 TI - Opinions of physicians and hospitals of current breast-feeding recommendations. PMID- 3965548 TI - University wellness commitment initiates nutrition clinic. PMID- 3965549 TI - NIH diagnostic criteria for Alzheimer's disease. PMID- 3965550 TI - Update on some epidemiologic features of intermittent claudication: the Framingham Study. AB - During 26 years of surveillance of the Framingham Study Cohort of 5,209 subjects, 176 men and 119 women developed occlusive peripheral arterial disease manifested as intermittent claudication (IC). The incidence increased sharply with age until the age of 75, with about a twofold male predominance at all ages. An incidence of IC comparable to that of angina pectoris was obtained ten years later in life than for angina pectoris. Cigarette smoking, impaired glucose tolerance, and hypertension were powerful predisposing factors. Impaired glucose tolerance was a greater risk in women than in men, and glycosuria carried a greater risk than other indicators of impaired glucose tolerance. Cigarette smoking had about the same impact in men and women, approximately doubling the risk, and the impact was discernible into advanced age. Hypertension increased risk 2.5- to fourfold, respectively, in men and women. A low vital capacity was associated with a substantial excess risk. Electrocardiographic evidence of left ventricular hypertrophy predicted IC in both sexes. Serum cholesterol, relative weight, and hematocrit were weak risk factors. A risk profile made up of the major cardiovascular risk factors was better for predicting IC than for predicting coronary heart disease. Mortality was increased two- to fourfold in men and women, respectively, mainly because of coexistent cardiovascular disease. PMID- 3965551 TI - The effect of age on blood pressure in hyperthyroidism. AB - To better define the effect of age on blood pressure in patients with hyperthyroidism, the blood pressures of 321 patients with hyperthyroidism were compared with those of 324 euthyroid controls. Subjects were divided into four age groups by decade from 20 to 59 years. The systolic, but not diastolic, blood pressure in the patients with hyperthyroidism was significantly higher in all age groups. Among the euthyroid controls, the systolic blood pressure increased with age. However, no age-related increase was apparent among the hyperthyroid patients because of the relatively high systolic blood pressure in young patients. Effective antithyroid treatment reduced the systolic blood pressure significantly in hyperthyroid patients. The reduction of systolic blood pressure was greater in the younger hyperthyroid patients than that in the older ones, so that an age-related increase in systolic blood pressure was present after a euthyroid state had been achieved. These results provide evidence against the report that in hyperthyroidism, hypertension tends to occur in older patients, and suggest that the effect of excessive thyroid hormone on the systolic blood pressure may differ according to age. PMID- 3965552 TI - Criteria for the clinical diagnosis of Alzheimer's disease. Excerpts from the NINCDS-ADRDA Work Group report. PMID- 3965553 TI - Some basic principles of working with older patients. PMID- 3965554 TI - Psychiatric assessment of elderly patients in the home: a survey of 176 cases. AB - One hundred and seventy-six homebound elderly patients referred for psychiatric evaluation by family, physician, or community agency were assessed in the home by a geriatrician psychiatrist, accompanied by those involved with the patient's care, whenever possible. Careful attention was paid to the interaction between psychiatric, medical, and social parameters and their collective effect on the aging patient. The most common discrete psychiatric diagnoses were dementia, with or without secondary symptoms; major depression; and paranoid states without dementia. Assessment resulted in home treatment and maintenance through a variety of supportive interventions frequently accompanied by chemotherapy, emergency psychiatric and medical hospitalization, and placement, as well as education of family and community workers. PMID- 3965555 TI - Socialization and aging group consciousness: the effect of neighborhood age concentration. AB - In order to test hypotheses regarding effects of age concentration upon socialization and aging group consciousness, 1,185 persons 60 years of age and over living in areas representing low, average, and high concentrations of older persons were interviewed. Results indicated that age concentration was associated with knowledge of services and with age of persons in formal and informal neighborhood networks but was not related to attitude toward older persons in the abstract, to own age identification, to associational preference, or to taking political action. It appears that age concentration influences access to, more than choice of age peers. Both socialization and aging group consciousness are associated with age, health and socioeconomic status. It may be concluded that the ecological variable of age concentration in the range encountered by most older persons has only limited effects. PMID- 3965556 TI - Socioeconomic comparisons and life satisfaction of elderly adults. AB - The hypothesis that overall satisfaction with life is influenced by one's financial situation vis-a-vis significant others was tested. Respondents compared themselves financially to the relative, friend, and neighbor to whom they felt closest. Data from a 1980 community survey of persons 60 years of age and older showed that the better off financially respondents perceived themselves to be compared with the relative to whom they felt closest, the greater the life satisfaction. This effect was independent of functional health, age, sex, race, marital status, education, income, household size, and social participation. These findings suggest that life satisfaction reflects not only one's location in the broader stratification system but also one's location in a rather limited network of significant others. PMID- 3965557 TI - Fever and survival in aged mice after endotoxin challenge. AB - Male C57BL/6 mice of 12, 19, and 24 months of age received injections of low (25 micrograms 100 g-1 body weight) or high (50 micrograms 100 g-1 body weight) doses of Salmonella typhosa endotoxin and were exposed to ambient temperatures below (24 degrees C) or within (30 degrees C) the thermoneutral zone. Old mice (19 and 24 months) developed initial fevers followed by hypothermia in response to endotoxin challenge at 24 degrees C, irrespective of dose; 12-month-old-mice became hypothermic at 24 degrees C following injection of the high dose of endotoxin only. At 30 degrees C, 12- and 19-month-old mice developed and maintained fever over 4 hr in response to endotoxin compared with the 24-month old mice who were unable to maintain fevers. Logistic regression analysis showed that age, ambient temperature, and body temperature responses were significant predictors of survival outcome in endotoxin-treated mice; of these, age and ambient temperature had the strongest effects. PMID- 3965558 TI - Platelet monoamine oxidase activity: demographic characteristics contribute to enzyme activity variability. AB - In a large (n = 459) sample of adults free of psychiatric, neurologic, and endocrinologic disease, platelet monoamine oxidase activity was analyzed by multiple regression of the demographic variables age, race, and gender on enzyme activity. Reported here are variations for all three demographic variables such that significantly greater enzyme activity is seen in female, older, and white subjects relative to male, younger, and black subjects. For each demographic group the data demonstrated a curvilinear relationship of age and enzyme activity with a nadir of activity at age 30. For this sample enzyme activity nearly doubled between subjects at age 30 and at age 80. We believe this study to be the first to report racial differences in this enzyme activity and to analyze normative data for this enzyme by multiple regression techniques. PMID- 3965559 TI - Relationship of patient age to clinical features and outcome for in-hospital treatment of pneumonia. AB - Medical records of 166 patients hospitalized for pneumonia were analyzed to determine the relationship between patient age and the clinical features and outcome. Fifty-seven patients were older than 79 years, 55 were 60 to 79 years, and 54 were younger than 60 years. The three groups had similar heart rates, respiratory rates, arterial/alveolar oxygen tension ratios, leukocyte counts, body temperatures, frequency of multilobe pneumonias, and incidence and types of bacterial pathogens. Mortality was 0, 6, and 11% in decades 5 through 7 and rose gradually with age, being 11, 13, and 17% in decades 8 through 10. Hospital stay was 5.7 days in those less than 60 years of age, 9.8 days in those aged 60 to 79, and 11.3 days in those older than 79 years. Although elderly adults are hospitalized frequently for treatment of pneumonia, an individual episode of pneumonia requiring hospitalization in the elderly patient is of equivalent severity to that in younger patients and has similar clinical features and outcome. PMID- 3965560 TI - Cognitive and chemosensory influences on age-related changes in the ability to identify blended foods. AB - Two experiments explored the effects of age, sex, and chemosensory function on the ability of blindfolded participants to identify a series of 12 blended foods. In the first experiment 40 persons aged 18 to 26 and 40 persons over 65 years of age attempted to identify the pureed foods using both taste and odor cues. Half the participants in each group were female, half were male. The average percentage correct on first attempt to identify was significantly higher in young than in old individuals. An Age X Sex interaction revealed a female superiority over men in the elderly group only. With feedback and practice, participants improved, but the age effect remained significant. In the second experiment, 20 young and 17 elderly women who had their nostrils occluded attempted the same identification task. When deprived of olfaction, the performance of young women fell to the same level as that of the old women on first exposure. The relative contributions of cognitive, gustatory, and olfactory/trigeminal factors to the age-related decline in chemosensory function are discussed. PMID- 3965561 TI - Age differences in cerebral blood flow during rest and during mental activation measurements with and without monetary incentive. AB - This experiment compared the diffuse and regional cerebral blood flow (CBF) during rest and during cognitive activation with and without incentive-induced arousal in young, middle-aged, and older adults. Two normal rest CBF measurements were followed by two mental mathematics activation CBF measurements. For the first activation measurement, half the participants in each age group were offered monetary incentive for correct performance and half the participants received no monetary incentive. All participants were offered monetary incentive on the final activation measurement. Older participants had lower resting blood flow at all detectors, but age-related reductions in blood flow were statistically significant only in anterior and inferior rolandic regions. The effect of monetary incentive was to increase blood flow at the inferior rolandic detector in both hemispheres. The CBF response to cognitive activation and monetary incentive did not differ in the three age groups. PMID- 3965562 TI - Age-related effects of temporal contingencies on response speed and memory: an operant analysis. AB - Single-subject methods were used to study influences of extended training and temporal contingencies. Five younger (18 to 21 years) and five older (65 to 74 years) healthy men responded to a series of matching-to-sample discriminations with sample-choice intervals of 0, 5, 10, and 15 s. During baseline sessions, there was no time limit placed on the response to the choice stimuli. Subsequently, correct responses were reinforced only if they occurred within a specified limit. Men of both ages responded faster to the choice stimuli as increasingly stringent limits were imposed, and speeds exceeded those under the baseline condition when the men had been instructed to be accurate and prompt. When the limits subsequently were removed, response speeds decreased somewhat but still were above earlier baseline performances. Under both baseline and time limit conditions, responding was slower when the choice stimuli were delayed, indicating that the procedure tapped short-term memory processes as well as psychomotor speed. Responding also was slower when the stimulus pool involved eight rather than two stimuli. Although performances of the older men improved substantially during the course of training, the younger men improved to the same extent so that age differences were not appreciably reduced. PMID- 3965563 TI - Aging and retrieval of words in semantic memory. AB - Twenty-four young and 24 old adults participated in a lexical decision task (Study 1) in which they judged whether letter strings were words. No age differences were found in either accuracy or response latency. In Study 2 18 young and 18 old adults participated in a word retrieval study in which the stimulus was the definition of a target word and the task was to name the word that was defined. Younger adults were superior in word retrieval as measured by both number of successful retrievals and response latency. The discrepancy between the two sets of results is attributed to differences in retrieval requirements, which are interpreted within the framework of a two-component model of semantic memory. It is suggested that older adults have a specific deficit in accessing word-name information in an orthographically organized lexical network given stimulus information that is conceptual rather than orthographic. PMID- 3965565 TI - A longitudinal study of tolerance to cold stress among C57BL/6J mice. AB - C57BL/6J male mice of different ages were movement-restricted and exposed to 10 degrees C for 3-hr periods every other week while colonic temperature was measured. A longitudinal trend in cold tolerance related to age and to initial colonic temperature was demonstrated. Adaptative thermoregulatory changes during cold exposure occurred during the first two tests. These were similar for all age groups except 30-month-old mice. There was no adaptation of colonic temperature during cold exposure among aged mice with repeated testing; however, their baseline colonic temperatures prior to testing increased after the first two tests. This finding suggests that old animals adjust to repeated cold stress differently than do younger mice. Specifically, younger animals are capable of adjusting their thermoregulatory response during cold stress with no change in baseline (pre-stress) temperature. Old animals do not modify the responses emitted during the stress; however, they do adapt by raising their baseline temperatures. Repeated cold exposure started later in life increased mortality among old animals but did not affect maximum lifespan. PMID- 3965564 TI - The black/white mortality crossover: investigation in a community-based study. AB - The black/white mortality crossover at about age 75, a result of lower white mortality rates at younger ages and lower black rates at the oldest ages, has been observed in U.S. vital statistics since 1900. Though a persistant observation in such data, its validity has been challenged by questions about census enumeration and age reporting on death certificates. Analyses of 20 years experience of all-cause mortality in the community-based Evans County Study using a Weibull model of age specific mortality rates showed a statistically significant black/white mortality crossover for both men (at age 73) and women (at age 85). The finding of a crossover in this longitudinally followed population is significant because the age reporting for both survivors and age at death for nonsurvivors were obtained in the study protocol and did not rely on age reporting either in census data or on the death certificate. Differences in the age and sex patterns of mortality between two populations living in the same geographic region are relevant to questions about the etiology of the major age related chronic diseases as well as to topics of current interest in health care policy. PMID- 3965566 TI - Determinants and consequences of retirement among men of different races and economic levels. AB - Data from two national longitudinal studies of older workers were examined in order to compare the determinants and consequences of retirement for white and black men, and for poverty, marginal, and upper economic level men. The number of categories important in determining retirement was greater for white men than for black men and increased with increase in economic level. Retirement was found to have few consequences, being important mainly with respect to health and economic matters. Blacks and poverty level men were minimally affected by retirement, the impact of retirement probably being somewhat ameliorated by age-determined income maintenance programs and subsidies. Men at the marginal economic level were affected most adversely. PMID- 3965567 TI - Detection of plasma membrane cholesterol by filipin during microvillogenesis and ciliogenesis in quail oviduct. AB - Using filipin as a probe for the presence of membrane cholesterol, the evolution of cholesterol distribution in the apical plasma membrane was studied during estrogen-induced ciliogenesis in quail oviduct and compared with the distribution of intramembrane particles (IMPs). Ciliary growth is preceded by the first step of microvillus differentiation. Microvilli emerge in membrane domains rich in IMPs and devoid of filipin-cholesterol (f-c) complexes. However growing microvillus membrane shows f-c complexes. During ciliary growth, microvilli lengthen from 0.5 to 2 microns, indicating that the microvillar membrane is not a membrane reservoir for ciliogenesis. During ciliary growth, the characteristic ciliary necklace IMP rows appear progressively at the base of cilia. The first IMP row is organized in a membrane circlet lacking of f-c complexes, whereas the new shaft membrane in the middle of the circlet exhibits numerous complexes. These two different domains of the cilia keep their specificity during ciliary growth. Only the ciliary tip shows fewer complexes than the shaft membrane. The apical membrane of differentiated ciliated cells is thus composed of various domains, the ciliary shaft full of f-c complexes and poor in IMPs, the ciliary necklace is devoid of f-c complexes and rich in IMPs, the microvilli membrane is rich in both IMPs and f-c complexes, and the interciliary membrane is poor in both f-c complexes and IMPs, whereas the undifferentiated cells exhibit an apical membrane in which f-c complexes and IMPs are distributed homogeneously. PMID- 3965568 TI - Localization of the conglutinin binding site on the third component of human complement. AB - The binding site on the human third complement component for bovine conglutinin has been located. C3 fragments were purified to homogeneity by preparative SDS polyacrylamide-gel electrophoresis. Only the N-terminal 27,000 dalton (Da) fragment of the alpha'-chain and the beta-chain were found to be glycosylated, and the carbohydrate was susceptible to endo-beta-N-acetylglucosaminidase H. This finding indicates that only high mannose or hybrid-type oligosaccharide chains are present on the C3 molecule. Binding to conglutinin was determined by an enzyme-linked immunosorbent assay and occurred with C3b, iC3b, C3c, the alpha chain, and the 27,000 Da fragment of the alpha'-chain, but not with C3d or the C terminal 40,000 Da fragment of the alpha'-chain. The beta-chain displayed very weak interaction. Binding to conglutinin could be inhibited by EDTA, N acetylglucosamine, and to a lesser degree by mannose. Enzymatic removal of the carbohydrate from the C3 molecule abolished binding to conglutinin. It is concluded that bovine conglutinin binds to the carbohydrate moiety located on the N-terminal 27,000 Da polypeptide of the alpha-chain. PMID- 3965569 TI - Complement-mediated hemolytic activity of succinylated concanavalin A: preparation and activity of cell intermediates. AB - Succinylated concanavalin A (SCon A) lyses sheep erythrocytes (E) in the presence of complement, whereas the native tetravalent lectin, Con A, is inactive. We have studied the ability of E-SCon A (ES) to interact with early acting guinea pig (gp) or human (hu) complement components (C1, C2, C4) and found that cell intermediates ESC1, ESC4, ESC14, and ESC142 can be generated that are analogous to intermediates conventionally prepared with E and rabbit IgM (pentameric) anti Forssman antibody. Titration of gp or hu C1, C4, and C2, and quantification of the number of activated C1 molecules bound to ESC4 by the C1 fixation and transfer test showed in each case that an average of one effective site per cell was sufficient to cause cell lysis. Determination of tmax for optimal formation of ESC142 sites depended on the species combination of components used to make the intermediates, and the decay of ESC142 and EAC142 sites or sites generated with ESC4, EAC4, and trypsin-activated C2 were similar. The sugar alpha-D methylglucopyranoside (alpha-MGP) inhibited binding of SCon A to E and eluted the lectin from ES, whereas galactose was nearly inactive, consistent with lectin sugar-binding selectivity. In contrast, both sugars were ineffective in eluting SCon A or C4hu from ESC4hu, indicating that C4hu blocked the interaction between lectin and alpha-MGP, perhaps by steric hindrance. SCon A is a divalent functional analogue of IgM anti-Forssman antibody that may be a uniquely suited reagent specific for cell membrane glycoconjugates for studying the mechanism of binding and activation of complement components. PMID- 3965570 TI - Immunoprecipitation analysis of radiolabelled protein antigens biosynthesized in vitro by S. mansoni. I. Identification of antigens uniquely recognized by protective antibodies. AB - Protein antigens from 4-wk worms were metabolically radiolabelled with [3H]leucine or [35S]methionine. Three freeze-thaw cycles released a large proportion (50% to 60%) of the TCA-precipitable radioactivity from the worms. Immune serum from twice-infected Fischer rats (F-2x), which was shown to confer resistance in a passive immunization assay, and immune serum from twice-infected Wistar Furth rats (W-2x), which does not confer resistance, were used for analyzing antigens in this worm fraction. Antibodies in these antisera differed in their titers to the freeze-thaw released antigens (W-2x greater than F-2x) and in their relative affinities for these antigens (F-2x greater than W-2x). Gradient slab gel electrophoresis of immunoprecipitates of radiolabelled antigens under denaturing conditions revealed many components, which could be categorized into two main types: unique antigens, recognized only by F-2x antibodies, and nonunique antigens, recognized by both F-2x and W-2x antibodies. The potential relevance of these antigens in resistance was further examined by antibody absorption experiments in which 4-wk worms were used as an immunoabsorbent to remove 90% to 95% of the immunoprecipitating activity and 65% to 70% (p less than 0.005) of the capacity to confer resistance in a passive immunization assay. It was concluded that loss of both anti-schistosome activities was specific since antigen released by worms during absorption could account for only 16% of the reduction in antigen-binding capacity and the titer of antibodies directed against beta-galactosidase did not significantly change during absorption. Antigens recognized uniquely by F-2x antibodies are therefore candidates for immunization studies examining induction of resistance against Schistosoma mansoni. PMID- 3965571 TI - Imbalanced accumulation of ribosomal RNA in macrophages activated in vivo or in vitro to a cytolytic stage. AB - Previous studies have shown that peritoneal murine macrophages activated in vivo and in vitro to a tumoricidal stage have a depressed rate of RNA synthesis. In attempting to clarify the differences in RNA metabolism between noncytotoxic and tumoricidal macrophages, we have studied the relative accumulation of various species of RNA in macrophages activated in vivo and in vitro with the use of agarose gel electrophoresis. Macrophages activated in vitro to a cytotoxic stage with supernatants containing lymphokines (LK) and traces of lipopolysaccharide (LPS) have an imbalanced accumulation of mature ribosomal RNA (rRNA), with a decreased accumulation of 28S rRNA compared to 18S rRNA. In contrast, macrophages primed in vitro with LK free of detectable endotoxins that exhibit suppressive rather than tumoricidal activity do not manifest a decreased 28S:18S rRNA ratio. The conclusion that the decreased 28S:18S rRNA ratio was associated with the activation of macrophages to a cytolytic stage was supported by the finding that cytotoxic macrophages activated in vivo by i.p. injection of Propionibacterium acnes (formerly designated C. parvum) also demonstrated a decreased accumulation of 28S comparable with that observed in in vitro-activated macrophages. Moreover, activated macrophages that lost their cytolytic activity upon prolonged in vitro culture had an augmented accumulation of 28S rRNA. These results provide the first direct evidence that the expression of cytolytic activity is associated with modulation of a specific class of RNA. The unbalanced accumulation of rRNA appears to be a late molecular event in the activation process occurring during the transition from primed to cytotoxic macrophages, because inflammatory and primed macrophages had normal rRNA accumulation. A model of macrophage activation accounting for these results is proposed. PMID- 3965572 TI - Inhibition of human tumor growth by IgG2A monoclonal antibodies correlates with antibody density on tumor cells. AB - Eight monoclonal antibodies (MAb) of IgG2a isotype that were produced against human melanomas were tested for tumor growth-inhibiting properties in nude mice injected with human melanoma cells of various origins. Four of the eight MAb inhibited growth of these tumors, and all four of these antibodies reacted in antibody-dependent macrophage-mediated cytotoxicity (ADMC) assays in vitro. The MAb that were inactive in vivo also did not react in these assays in vitro. The number of antibody-binding sites per cell on the tumor cell surface was significantly higher for tumoricidal MAb as compared to unreactive MAb. On the other hand, the percentage of tumor cells binding the MAb and the binding affinity to these cells were the same for the two groups of MAb. Also, tumoricidal and nontumoricidal MAb bound with similar affinity and antibody density to Fc receptors on macrophages. The importance of the number of antibody sites on the tumor cell surface for tumor destruction by MAb was confirmed by the demonstration of tumoricidal effects of mixtures of MAb that were by themselves not tumoricidal. MAb binding to different molecules on melanoma cells were complementary in ADMC, whereas MAb directed to the same molecule but to different epitopes were not. PMID- 3965573 TI - Evidence for the role of class I and class II HLA antigens in the lytic function of a cloned line of human natural killer cells. AB - Monoclonal antibodies with specificity for HLA class I and class II antigens were generated which either inhibit or enhance the lytic activity of a cloned line of human NK cells. These antibodies were obtained from a fusion with spleen cells from mice immunized with NK clone 3.3. They affect the lytic function of that clone at the level of the killer cell; additional evidence suggests that the effect takes place during an early stage of lysis. Immunoprecipitation and cross clearing experiments using MHC antibodies of known specificity demonstrate the reactivity of mAbs 131 and 164 with HLA class I antigens and mAbs 210 and 273 with HLA class II antigens. Binding studies indicate that these antibodies are probably recognizing nonpolymorphic MHC determinants. Although these antibodies bind to other NK effector cells tested, they have no effect on the lytic function of these bulk NK populations. Preliminary studies, however, indicate that they do affect the NK activity of a proportion of the clones within these bulk populations. To further assess the potential role of HLA gene products in the lytic function of NK3.3, several well-defined anti-MHC antibodies were tested for their effects on NK3.3 function. The anti-HLA class I and class II antibodies could each be grouped into functional categories based on their ability to enhance, inhibit, or not affect the lysis of NK-sensitive targets K562 and MOLT-4 by NK clone 3.3. These results demonstrate, for the first time, a potential involvement of MHC molecules with NK function. PMID- 3965574 TI - Modulation of human natural killer cell function by L-leucine methyl ester: monocyte-dependent depletion from human peripheral blood mononuclear cells. AB - L-leucine methyl ester (Leu-OMe) causes lysosomal disruption and death of human monocytes (M phi). In addition, Leu-OMe removed natural killer cell (NK) activity from human peripheral mononuclear cells (PBM). Thus, a brief preincubation of PBM with Leu-OMe (greater than 1 mM) caused irreversible loss of NK function as assessed by the lysis of K562 targets. By contrast, a variety of other amino acid methyl esters, including L-glutamic dimethyl ester, L-valine methyl ester, and L isoleucine methyl ester caused reversible inhibition of NK activity in a manner that was similar to other lysosomotropic agents such as chloroquine and ammonium chloride, but did not cause irreversible loss of all NK function. Leu-OMe appeared to cause actual removal of NK effector cells from PBM, because K562 target binding cells, Leu-11b+ lymphocytes, and OKM1+ lymphocytes were depleted. If M phi were removed from PBM before the incubation, Leu-OMe caused only reversible inhibition of NK function in a manner similar to that observed with other amino acid methyl esters. Upon the addition of freshly isolated M phi, polymorphonuclear leukocytes, or sonicates of these cells to M phi-depleted lymphocyte populations, irreversible ablation of NK function was again observed as a result of Leu-OMe exposure. After in vitro culture, M phi lost their susceptibility to Leu-OMe toxicity and the ability to mediate the irreversible deletion of NK cells resulting from Leu-OMe incubation. These results indicate that in the absence of M phi, Leu-OMe and a variety of other amino acid methyl esters are reversible inhibitors of NK function. However, Leu-OMe is unique in that it can interact with M phi or granulocytes to effect an irreversible loss of NK activity from human peripheral blood lymphocytes. PMID- 3965575 TI - Ultrastructural demonstration of anionic sites in basement membrane zone by cationic probes. AB - Anionic sites were demonstrated ultrastructurally in both the dermal and epidermal edges of the lamina densa using strongly cationized polyethyleneimine as a tracer. Enzyme digestion with heparitinase and pronase removed the anionic binding sites, indicating that the sites consisted largely of heparan sulfate proteoglycan. PMID- 3965576 TI - Induction and suppression of contact sensitivity by liposomes carrying molecules from haptenated epidermal cells. AB - Liposomes carrying molecules from trinitrophenylated epidermal cells (TNP-EC) liposomes stimulated the hapten-specific proliferation of lymphocytes in vitro in our previous study. In order to analyze the role of TNP-EC liposomes in vivo, they were injected into naive mice. TNP-EC liposomes induced contact sensitivity effectively when injected either s.c. or i.p. Contact sensitivity induced by TNP EC liposomes was a long-lived T cell-mediated reaction. A s.c. injection of liposomes with molecules from TNP-Ia antigen-depleted epidermal cells [TNP-EC (Ia ) liposomes] failed to induce contact sensitivity and developed unresponsiveness. This unresponsiveness was transferred by T cells, i.e., suppressor T cells. Therefore, it is suggested that Ia antigens in epidermal cells play a critical role for induction and suppression of contact sensitivity. PMID- 3965577 TI - Experimentally induced pemphigus vulgaris in neonatal BALB/c mice: a time-course study of clinical, immunologic, ultrastructural, and cytochemical changes. AB - Pemphigus vulgaris autoantibodies (PV IgG) promote cell detachment in epidermal cell cultures and acantholysis in the epidermis of neonatal BALB/c mice in vivo. We have studied the evolution of the immunologic and ultrastructural changes in the epidermis of BALB/c mice that receive parenteral injections of PV IgG. Neonatal BALB/c mice received a single i.p. injection of PV IgG (10 mg/g body weight) or control IgG from normal humans. The skin and serum of these animals was obtained at 0, 1, 3, 6, 12, 18, and 24 h post injection, and examined by immunofluorescence (IF), electron microscopy (EM), and immunoelectron microscopy (IEM). PV IgG was detected in the mouse serum and bound to the epidermal cells as soon as 1 h after injection by IF and IEM. The intensity of the binding in the skin (by IF) increased sharply between 3 and 6 h, and remained positive at 24 h. Early epidermal cell detachment was demonstrable by EM at 1 h as widening of the epidermal intercellular spaces (ICS), and by 6 h the ICS between desmosomes had detached completely. Desmosomal junctions are the last to separate, occurring at 12-18 h. At this point, complete cell detachment occurred in the suprabasilar layers of the epidermis. Basal cells remain attached to the underlying dermis (tombstone row). Coincident with cell detachment, intracellular tonofilaments retracted from the cell periphery and clustered in a perinuclear position. IEM confirmed the binding of PV antibodies to the surface of epidermal cells in early and established lesions. This study demonstrates that the early immunologic and ultrastructural changes that occur in human pemphigus vulgaris are reproduced in this mouse model of the disease. PMID- 3965578 TI - Measurement of sebum secretion rates in young children. AB - Sustainable rates of lipid secretion were measured on the foreheads of 24 children, ages 6-8. The method of measurement involved absorption of skin surface lipid into bentonite clay and subsequent separation and measurement of the various lipid classes by quantitative thin-layer chromatography. In 9 of the children, sebum secretion appeared to be virtually nonexistent, judging by the low amounts of lipid recovered and the low percentages of wax esters and squalene, which are purely sebaceous lipid classes. An effect of age on sebum secretion rates was observed with median rates of wax ester secretion, being 7, 28, and 48 micrograms/10 cm2/3 h for 6-, 7-, and 8-year-olds, respectively. These values are well below those of most young adults. The relation between wax ester secretion rate and skin surface lipid composition on the forehead was investigated and found to conform to the formula: microgram wax esters/10 cm2/3 h = 28 X wax esters/(cholesterol + cholesterol esters), with a correlation coefficient (r) of 0.94. PMID- 3965579 TI - Androgen receptor characteristics in skin fibroblasts from hirsute women. AB - Hormonal measurements in some women with hirsutism often reveal little or no elevation in androgen levels to explain the disorder. Thus, it has been postulated that increased sensitivity of the hair follicle to androgen may contribute to the development of hirsutism in such patients. We, therefore, sought androgen receptor abnormalities in skin fibroblasts cultured from 10 hirsute women (ages 17-43) and normal or mildly elevated plasma testosterone levels (28-82 ng/dl). Androgen receptor content (Ro) and binding affinity (Kd) in cultured pubic skin fibroblasts were measured using a dispersed, whole cell assay. Ten such cell lines from these women were compared with 19 pubic skin cell lines from 9 normal volunteers (6 males and 3 females) and from 10 other subjects (males with gynecomastia or hypospadias). There was no statistically significant difference in the mean androgen receptor content (11,600 +/- 2700 (SE) sites/cell fibroblasts vs 7900 +/- 700 sites/cell or binding affinity (2.0 +/- 0.3 (SE) X 10(-9) M vs 1.5 +/- 0.2 X 10(-9) M, respectively) between the patients' fibroblasts and those of the controls. We conclude that hirsutism cannot be explained by abnormalities in fibroblast androgen receptor number or affinity. These observations do not exclude the possibility that other mechanisms might lead to increased peripheral androgen sensitivity in such patients. PMID- 3965580 TI - The measurement of the stratum corneum reservoir. A predictive method for in vivo percutaneous absorption studies: influence of application time. AB - The relation existing in vivo between the reservoir function of the stratum corneum following a 30-min application time and the total percutaneous absorption of molecules applied for a longer time was studied on hairless rats. One thousand nanomoles of 4 radiolabeled molecules (theophylline, nicotinic acid, acetyl salicylic acid, benzoic acid) were applied on 1 cm2 of back skin for 0.5, 2, 4, and 6 h. The total recovery in excreta and the whole animal body were measured 4 days later in order to determine the level of absorption. A direct proportionality (r = 0.99) between the total percutaneous absorption of these compounds and the duration of their application was observed. This suggests that a constant flux of penetration does exist in vivo. The reservoir function of the stratum corneum was measured by successive stripping of the treated area. Following a 30-min application, a strict correlation (r = 0.99) between the total amounts of molecules penetrated in 4 days and the amounts found in the reservoir of the horny layer was demonstrated. All together these findings show that the simple knowledge of the reservoir effect of the stratum corneum for a molecule applied for 30 min allows the predictive assessment of its total penetration resulting from various times of application. PMID- 3965581 TI - Stimulus-dependent increased generation of oxygen intermediates in monocytes and polymorphonuclear leukocytes in psoriasis. AB - Based on recent findings indicating increased respiratory burst activity of monocytes (M phi) and polymorphonuclear leukocytes (PMN) in psoriasis upon stimulation with zymosan particles, we examined the question of whether incubation with various stimuli always results in augmented oxidative metabolism in psoriatic phagocytes. We compared M phi and PMN isolated from the peripheral blood of 12 patients with psoriasis and 12 control individuals. We measured the generation of oxygen intermediates of resting and stimulated M phi and PMN by luminol-enhanced chemiluminescence. The stimulants applied were: (1) aggregated immunoglobulin (aggIg), (2) zymosan, (3) zymosan opsonized with autologous serum, (4) phorbol myristate acetate (PMA), and (5) concanavalin A (ConA). We found no difference between patients and controls in the generation of oxygen intermediates by resting M phi and PMN. Stimulation by aggIg and zymosan yielded an increased chemiluminescent response in psoriatic M phi and PMN. Serum-treated zymosan effected increased light generation in M phi but not in PMN of patients. By contrast, PMA, and in particular ConA, brought about markedly increased generation of oxygen intermediates in PMN only of patients with psoriasis. Our results indicate control of the increased generation of oxygen intermediates of M phi and PMN by different stimuli. The metabolic events underlying the augmented phagocytic response may be similar to abnormalities found in involved psoriatic skin. PMID- 3965582 TI - Variable radiosensitivity in fibroblasts from patients with tuberous sclerosis. AB - It has been reported that some of the cultured cell strains derived from patients with tuberous sclerosis (TS) showed hypersensitivity to gamma-rays or a radiomimetic chemical. Thirteen fibroblast cell strains from 11 patients with TS were examined for their sensitivity to x-rays as determined from their colony forming ability. All strains derived from normal-appearing skin of patients, either sporadic or familial cases, showed sensitivity within the normal control range. Five cell strains originating from tumorous skin of 3 patients did not show hypersensitivity. It was concluded that the sensitivity to x-rays of cultured cells of TS is essentially normal. However, the mean D0 or D10 values of the strains from tumorous skin tended to be lower compared to those for normal skin of patients. In addition, we could confirm the hypersensitivity to x-rays in the cell strains of TS which had been shown to be hypersensitive to gamma-rays. These results appear to indicate that at least some of the cells of TS are liable to change to exhibit a hypersensitive trait in unknown acquired conditions. PMID- 3965583 TI - Mechanical analysis of hypertrophic scar tissue: structural basis for apparent increased rigidity. AB - The mechanical behavior of normal human skin and hypertrophic scar tissue (HST) is compared using constant-strain-rate and successive stress-relaxation uniaxial loading programs in vitro. HST is less extensible, requires more energy to be stretched in the physiologic range, and stores strain energy less efficiently than normal skin. The explanations for the differences observed between the mechanical behavior of normal skin and HST are based on the differences in their composition and structure. We suggest that the collagen fiber network is partially "prealigned" in a crimped tendon-like organization in HST, which reduces its extensibility and raises the strain energy required to stretch it. It is further hypothesized that an incomplete elastic fiber network, an abnormal glycosaminoglycan content, and/or abnormal collagen fiber slippage are responsible for the reduced capacity to return strain energy in the hypertrophic scar tissue. The results of these studies indicate that although HST has been described as stiffer than normal skin, the maximum stiffness of skin and HST are similar. The "apparent" increased rigidity of HST is a result of reduced extensibility rather than a change in its stiffness. This inexensibility may manifest itself by limiting joint mobility in the patient with HST. PMID- 3965584 TI - Campylobacter cinaedi (sp. nov.) and Campylobacter fennelliae (sp. nov.): two new Campylobacter species associated with enteric disease in homosexual men. AB - In a recent study in Seattle, we isolated Campylobacter-like organisms (CLOs) significantly more often from homosexual men with intestinal symptoms than from asymptomatic heterosexual and homosexual control subjects. Biochemical tests, morphology, and guanine-plus-cytosine content of whole-cell DNA showed that these organisms were similar to, but distinguishable from, other species in the genus Campylobacter. DNA homology tests showed that the Campylobacter-like organisms belong to four unique genetic groups, two of which were phenotypically identical. We developed a rapid screening test to genetically group these organisms and to assess the correlation of each genotype with enteric disease in homosexual men. Three of the four CLO groups were isolated only from men with proctitis, proctocolitis, and/or enteritis. The remaining group, isolated from both symptomatic and asymptomatic homosexual men, was significantly correlated with the presence of polymorphonuclear leukocytes in the rectal secretions of asymptomatic men, a finding that suggests subclinical disease. We have tentatively classified two of the CLO groups into species, Campylobacter cinaedi sp. nov. and Campylobacter fennelliae sp. nov. PMID- 3965585 TI - Capnocytophaga species: infections in nonimmunocompromised and immunocompromised hosts. AB - Retrospective review of isolates of Capnocytophaga, a genus of capnophilic gram negative bacilli, referred to the Massachusetts State Laboratory Institute in Boston revealed 31 patients with infection due to Capnocytophaga, 16 in nonimmunocompromised hosts. These infections included empyema (three patients), lung abscess (one), sinusitis (one), conjunctivitis (three), subphrenic abscess (one), wound (three), osteomyelitis (one), and bacteremia (three). Two of the wound infections were closed-fist injuries involving bone or soft tissue. Capnocytophaga was frequently isolated as part of a polymicrobial infection with other oral flora. There was only one death in the nonimmunocompromised group. In contrast, of 15 immunocompromised patients with 16 episodes of bacteremia due to Capnocytophaga, 87% had leukopenia and 73% had significant oral pathology such as gingivitis, mucositis, or ulceration. Five immunocompromised patients died. Thus, Capnocytophaga species may cause disease in both nonimmunocompromised and immunocompromised hosts. Isolation of this organism should suggest an oral source for infection. PMID- 3965586 TI - Detection of gram-negative bacteremia by limulus amebocyte lysate assay: evaluation in a rat model of peritonitis. AB - A spectrophotometric Limulus amebocyte lysate assay using lysis filtration and centrifugation has been developed for the detection of gram-negative bacteria in blood. The assay is directed at detection of endotoxin in viable and nonviable bacteria present in the blood-stream and not detection of free endotoxin in plasma. The assay was evaluated in a model of peritonitis in which rats were challenged with an inoculum consisting of sterilized human feces, barium sulfate, and one of eight species of bacteria. This assay was able to detect gram-negative bacteremia due to Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens, Proteus mirabilis, and Klebsiella pneumoniae in the rat model when compared with sham-inoculated uninfected rats. The assay failed to detect bacteremia due to Bacteroides fragilis or Staphylococcus aureus, nor was there a significant rise in absorbance when a pellet containing sterilized feces was implanted in the rat. PMID- 3965587 TI - Effects of exopolysaccharide production by viridans streptococci on penicillin therapy of experimental endocarditis. AB - The influence of exopolysaccharide production by viridans streptococci on penicillin therapy of endocarditis was studied in rabbits with experimental aortic-valve endocarditis. Animals were first infected with penicillin susceptible streptococci known to produce varying amounts of exopolysaccharide in cardiac vegetations. Treatment with procaine penicillin, 300,000 U every 12 hr, was begun one to two days after infection. After five days of therapy, animals infected with Streptococcus sanguis II and Streptococcus morbillorum, both vigorous exopolysaccharide producers, continued to have infected vegetations, while animals infected with Streptococcus salivarius and a different Streptococcus sanguis II, both deficient in exopolysaccharide production, had sterile vegetations. These findings indicate that failure to eradicate streptococci from vegetations correlates with exopolysaccharide production and that this property may be important in determining outcome of therapy. PMID- 3965588 TI - Efficacy of vancomycin plus rifampin in experimental aortic-valve endocarditis due to methicillin-resistant Staphylococcus aureus: in vitro-in vivo correlations. AB - Studies of in vitro and in vivo bactericidal interactions of vancomycin plus rifampin against Staphylococcus aureus have yielded conflicting results. In this study the efficacy of this drug combination in experimental endocarditis due to a methicillin-resistant strain of S. aureus was investigated. Left-sided endocarditis was induced in 84 rabbits by an infecting strain that had been found to be synergistically killed by vancomycin plus rifampin in vitro when tested by the timed-kill curve technique; in contrast, the checkerboard technique had indicated that the two drugs were antagonistic against this strain. Infected animals received no therapy, vancomycin alone (30 mg/kg per day), rifampin alone (20 mg/kg per day), or both drugs (in the same doses). The combination was significantly more effective than the single-drug regimens in terms of (1) reduction of mean methicillin-resistant S. aureus vegetation titers (P less than .05-.0005), (2) rate and incidence of sterilization of vegetations (P less than .0005), and (3) rate of "radical" cure of endocarditis (P less than .005). Vancomycin alone and vancomycin plus rifampin were equally effective in reducing mortality and sterilizing renal abscesses. The use of vancomycin prevented the in vivo development of resistance to rifampin. No evidence that rifampin exerted an antagonistic effect on the in vivo bactericidal activity of vancomycin was found. PMID- 3965590 TI - Mycobacterium avium-Mycobacterium intracellulare from the intestinal tracts of patients with the acquired immunodeficiency syndrome: concepts regarding acquisition and pathogenesis. PMID- 3965589 TI - Cross-reactivity of antigens from the cytoplasm and cell walls of some corynebacteria and mycobacteria. AB - Leprosy-derived corynebacteria (LDC) are non-acid-fast organisms isolated from leprosy lesions in humans. In this study 20 antigens of native LDC cytoplasm were identified by immunoelectrophoresis, and autoclaving yielded the M1 component, which strongly cross-reacted with antigen 60 of Mycobacterium bovis BCG (bacille Calmette-Guerin) and antigen 7 of Mycobacterium leprae. The polysaccharide moiety of M1 was immunologically related to the LDC cell wall polysaccharide previously characterized as arabinogalactomannan. The latter polysaccharide competitively inhibited the formation of immune complexes by labeled M1 and antisera to the LDC cell wall; cytoplasm and wall polysaccharides from other bacteria produced lower level inhibition. In a radioimmunoassay with 125I-labeled antigen 7 of M. leprae, sera from patients with leprosy and antisera to the LDC cell wall yielded overlapping curves. Sera from patients with tuberculoid leprosy and those from patients with lepromatous leprosy afforded different levels of inhibition in this radioimmunoassay; this result indicated a difference in antibody specificity in the two forms of leprosy. In conclusion, the cell wall polysaccharide of LDC corresponds to the main thermostable cytoplasmic antigen M1, which strongly crossreacts with sera from patients with leprosy and, more specifically, with antigen 7 of M. leprae. PMID- 3965591 TI - Prevalence of hepatitis B-associated delta agent among mentally retarded carriers of HBsAg. PMID- 3965592 TI - Ionic, hydrophobic, and hemagglutinating properties of Shigella species. PMID- 3965593 TI - Effects of maternal protein deprivation on the nutritional status and neutrophil function of suckling neonatal rats. AB - An animal model of neonatal protein deprivation was developed to examine the effects of maternal malnutrition on growth and development and on the host defense system of the suckling offspring. Adult rats were fed either a protein deficient (3% casein) or normal (25% casein) diet beginning one day after parturition. Offspring of the protein-deprived animals showed biochemical signs of nutritional imbalance such as changes in serum acid hydrolase levels as early as the second day of life; growth retardation and hypoproteinemia developed by day 4. When malnourished and control sucklings were infected at 12 days of age with Staphylococcus aureus, it was noted that protein deprivation did not influence neutrophil mobilization. However, malnourished animals responded to infection with larger perturbations in neutrophil counts than did the controls, were unable to control the infection, and ultimately showed neutrophil depletion. These studies suggest that protein deprivation affects the quantity and quality of milk and that the offspring of a protein-deficient animal are not only growth retarded but are also compromised in their ability to deal with infection. PMID- 3965594 TI - Intracellular growth and phagocytosis of Blastomyces dermatitidis by monocyte derived macrophages from previously infected and normal subjects. AB - Blastomyces dermatitidis evokes responses of human cellular immunity typical of other intracellular fungal pathogens. Differences in growth rates of intracellular Blastomyces yeast and the differences in amounts of yeast phagocytized by macrophages were determined for macrophages derived from peripheral blood monocytes from 11 persons with treated blastomycosis and 11 normal, healthy persons. Cellular immunity was examined by lymphocyte uptake of [3H]thymidine in response to a specific antigen of Blastomyces yeast. Yeast were more readily phagocytized by macrophages from the previously treated donors when compared with those from the normal donors; the yeast were confirmed to be intracellular by transmission electron microscopy. Likewise, a decrease in growth rates of yeast was demonstrable in cultures of macrophages from previously treated donors as compared with normal donors. This greater efficiency of phagocytosis and growth inhibition of B. dermatitidis reflects another mechanism of human cellular immunity to this fungal infection. PMID- 3965595 TI - Comparison of infection rats and severity of illness for influenza A subtypes H1N1 and H3N2. AB - In the Houston Family Study, overall rates of infection for the three major outbreaks of influenza A from 1977 to 1981 were higher for subtype H3N2 than for H1N1. Rates in school children were almost identical, but rates of infection with H1N1 were lower in adults and in preschool children, especially those younger than two years of age. However, rates for the two subtypes were similar in young children within families that experienced influenza A infections. In the total population overall illness rates among infected persons were identical, and diagnoses were similar. Among 145 identified primary infections (1977-1982), more H3N2 infections resulted in systemic (febrile) illness or lower-respiratory-tract disease, but a detailed comparison of illness features of 54 primary infections in children aged two to five years showed no significant differences. Epidemiological differences appear to be more important than pathogenic potential in determining the community impact of these two subtypes of type A influenza virus. PMID- 3965596 TI - Cross-subtype protection in humans during sequential, overlapping, and/or concurrent epidemics caused by H3N2 and H1N1 influenza viruses. AB - A total of 663 pupils at four schools were studied serologically and clinically during a period of large sequential and/or mixed epidemics of infection with two subtypes of influenza A virus, H3N2 and H1N1. Of 91 middle-school pupils infected with H3N2 virus shortly before and 82 pupils not previously infected with this subtype, 59% and 91% became infected with H1N1 virus, respectively; this difference was significant. Similar results were obtained at the two primary schools studied. At a high school where epidemics due to the H3N2 and H1N1 subtypes occurred concurrently, the rate of infection of individual pupils with both viruses (2%) was significantly lower than those at the other three schools (21%, 23%, and 31%, respectively), where an epidemic caused by the H3N2 subtype appeared first and was then partially overlapped and succeeded by an epidemic caused by the H1N1 subtype. These findings suggest the existence of cross-subtype protection in humans during sequential and/or concurrent epidemics caused by two viral subtypes. PMID- 3965597 TI - Development and persistence of class-specific antibodies in the serum and nasopharyngeal washings of rubella vaccinees. AB - Serial samples of serum and nasopharyngeal washings were obtained from 43 volunteers given one of four rubella vaccines (HPV77.DE5, RA27/3, To-336, and Cendehill) and from nine naturally infected volunteers. Rubella-specific serum IgG was detected by radioimmunoassay for up to 12 years in all but one vaccinee, and booster responses occurred in 23.3% of vaccinees. Rubella-specific serum IgA was detected in 37 (90.2%) of 41 vaccinees one year after vaccination but in only five (45.5%) of 11 vaccinees tested 10-12 years after vaccination. Low levels of rubella-specific IgM detected by M-antibody capture radioimmunoassay persisted in seven volunteers--four of them HPV77.DE5 vaccinees--four more than one year after vaccination. Rubella-specific nasopharyngeal IgA was detected for up to five years after natural infection or vaccination with RA27/3 but for no longer than three years among Cendehill, HPV77.DE5, and To-336 vaccinees. Nasopharyngeal IgG antibodies were detected less frequently and at lower levels. PMID- 3965598 TI - International renaissance of primary care and family practice. PMID- 3965599 TI - Differentiation of iron deficiency and the anemia of chronic disease. AB - The predictive value positive of serum iron studies and erythrocyte indices in differentiating between iron deficiency anemia and the anemia of chronic disease (ACD) were determined in 82 hospitalized patients with an iron-binding saturation of 15 percent or less. Iron deficiency, determined by serum ferritin of 20 ng/mL or less, was present in only 31 percent of patients with a serum iron level of 10 micrograms/dL or less; 39 percent of patients with a transferrin saturation of 5 percent or less, and 54 percent of patients with a total iron-binding capacity (TIBC) of 350 micrograms/dL or greater; conversely, iron deficiency was present in only 3 percent of patients with a TIBC of 250 micrograms/dL or less. Iron deficiency was present in 83 percent of patients with a mean corpuscular volume (MCV) of 75 microns3 or less, but only 2 percent of patients with an MCV of 86 microns3 or greater. It is concluded that the MCV has strong predictive value positive (and negative) when below (or above) the values just cited, but that serum iron studies do not have sufficient predictive value to justify their use in the routine differentiation between iron deficiency anemia and the ACD in hospitalized patients when no other cause for anemia is likely. PMID- 3965600 TI - Drug and environmental exposure histories in selective patient populations. AB - Drug histories and environmental exposures are an important part of all medical histories and are particularly significant in specific at-risk primary care patient populations such as obstetrical patients, primary care genetic referrals, and pediatric patients being evaluated in developmental centers. A review of genetic referrals made by primary care physicians to a satellite genetics clinic over a one-year period showed that 29 percent of all referrals had a significant history of single drug exposure, single environmental exposure, or multiple environmental and drug exposures. Drug and environmental exposures must be an important consideration in all at-risk groups. PMID- 3965601 TI - Urticaria in a family practice. AB - A review of the charts of 79 patients with urticaria was conducted in a residency based family practice center. All patients seen with urticaria in 7 years who were identified by the practice-data retrieval system were included in the review. The annual incidence of urticaria was 0.27 percent. Female patients predominated (76 percent), and 70 percent of the cases lasted less than 6 weeks. A personal history of atopy was more common in acute urticaria than in urticaria lasting longer than 6 weeks (P less than .05). No causes were identified in 54 percent of the cases. Association with zomepirac and symptomatic dermographism were each noted in three cases. Diagnostic tests were performed in 17 percent of cases, and consultation or referral occurred in 15 percent. Treatment usually included antihistamines (89 percent). The coded diagnosis was judged by the chart reviewers to be incorrect or inadequately supported in 28 of the 108 charts (26 percent) coded urticaria. In 25 charts coded for other skin disorders, three cases (12 percent) of urticaria were noted by the chart reviewers. Coding errors involving digit transposition were noted in three of 1,044 cases. Diagnostic error, incorrect coding by nonphysicians or by physicians not familiar with the coding system, or even clerical error may be a significant problem in this type of study. PMID- 3965602 TI - Therapeutic homework: the use of behavioral assignments in office counseling. AB - Office counseling provides an intensive, short-term opportunity for patients to learn new response patterns and coping skills. Progress is enhanced to the extent that patients experiment with and practice new approaches in real-life situations outside the physician's office. Particularly in a family medicine context, with its associated time constraints, it is important for patients' between-session experience to be orchestrated carefully to solidify or act upon learning from brief counseling sessions. Behavioral assignments and other therapeutic homework are essential tools for the family physician to take advantage of between-session opportunities for patients to learn and change. Examples of therapeutic homework include self-monitoring, lists, narrative accounts, questionnaires, action assignments, and published patient education material. This paper provides theoretical background about therapeutic homework and presents guidelines that should increase the likelihood that behavioral assignments will be understood and carried out in an effective way. PMID- 3965603 TI - Reversal of theophylline toxicity using oral activated charcoal. PMID- 3965604 TI - Use of a health planning conference in a family practice. PMID- 3965605 TI - Listeria pleural effusion in a noncompromised host. PMID- 3965606 TI - Reserpine: the maligned antihypertensive drug. PMID- 3965607 TI - Defensive projection. An investigation of its role in paranoid conditions. AB - This paper reports two studies bearing upon the role of defensive projection in paranoid conditions. The first study considered a proposal explaining the mechanics of projection. People who use their social environment for standards of comparison in making self-evaluations may distort the social comparison process in the case of a threatening characteristic. False attribution or selective perception may allow a social standard to be shifted toward the negative attribute. Given the modified standard, the characteristic can be minimized or denied. Evidence supporting this hypothesis was found when high projectors (among normals) reported greater use of social comparison in reaching self-evaluation judgments concerning negative qualities. The second study considered the clinical implications of the proposition that defensive projection, defined this way, would be found among those who are more heavily invested in their social environment. It was predicted that reactive paranoid schizophrenics, identified by greater premorbid commitment to their social environment, would use projection; process paranoid schizophrenics, having a greater premorbid history of social withdrawal, would not. This prediction was confirmed. Process paranoids demonstrated the most idiosyncratic free associations to verbal cues, suggesting the autistic (self-preoccupied) quality of their thinking and delusions. PMID- 3965608 TI - Information processing in borderline patients. AB - An experiment was conducted to determine whether depressed borderline patients could be distinguished from normal controls and psychotic patients on the basis of a visual backward masking task that measures speed of information processing. Results showed that a) borderline patients could not be distinguished from normal controls on the information-processing task; b) both the borderline patients and the normal controls were superior to psychotic patients with diagnoses of major depressive, schizoaffective, and manic disorders; and c) among the three psychotic groups, the schizoaffective subjects were the most impaired. The data support the idea that borderline patients have normal-range information processing functions. In distinction, all three psychotic groups showed disruption of this fundamental ego function by which information is processed. The results of related experiments indicate that schizotypal patients (in distinction to borderline patients) are abnormal information processors. Taken together, these findings support the contention that the schizotypal/borderline distinction is valid. PMID- 3965609 TI - Borderline diagnosis from hospital records. Reliability and validity of Gunderson's Diagnostic Interview for Borderlines (DIB). AB - Two trained and experienced clinical psychologists and two nontrained students rated the sections in Gunderson's Diagnostic Interview for Borderlines (DIB) on the basis of hospital records for 16 patients (DIB-R). The results showed that both reliability and validity, i.e., correlations with an actual interview, were unexpectedly high, around .80 for the trained judges and around .55 for the nontrained judges. The conclusion is that the DIB may be used for retrospective diagnosis of borderline patients from hospital records. PMID- 3965610 TI - Thought disorder. A function of schizophrenia, mania, or psychosis? AB - Does thought disorder emerge solely as a function of psychosis, or is it a function of diagnosis? The present research investigated whether thought disorder is more frequent in specific diagnostic groups, such as schizophrenia and mania, than in other types of psychotic disorders. The frequency and severity of positive thought disorder was assessed in 324 Research Diagnostic Criteria and DSM-III schizophrenics, manics, other psychotic patients, and nonpsychotic patients, and a normal comparison group. Fifty-seven percent of the sample were first hospital admissions. Patients were tested at the acute phase of their disorder, within the first 2 weeks of hospitalization, with three cognitive tests. Scores from these three tests were scaled to obtain a composite index of the severity of positive thought disorder. Diagnostic factors were more salient to the severity of disordered thinking than was psychosis. Thought disorder was significantly more frequent in schizophrenia and mania than in other psychotic disorders (p less than .05). The frequency of patients with severe thought disorder was reduced as one moved down the hierarchy of manic, schizophrenic, schizoaffective, and depressed psychotic disturbances (p less than .001). Rather surprisingly, the current research suggests that nonpsychotic manic patients may be as thought disordered as psychotic manic patients at acute phases of disturbance. This would indicate that the presence of positive thought disorder in mania is not primarily a function of most of these patients' being psychotic at the acute phase of disturbance. Thought disorder was not simply a function of psychosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965612 TI - Homocystinuria and schizophrenia. Literature review and case report. AB - The autosomal recessive disorder homocystinuria involves, in all its subgroups, an abnormality of methionine metabolism. The metabolism of methionine has been a central focus of interest for those who propose the transmethylation hypothesis of schizophrenia. The "methionine effect," as described in the research literature, is thus a theoretical link between these two disorders. The authors review the literature and describe those cases where both have occurred in the same patient. They indicate that whereas many patients with homocystinuria have been psychotic, few have been actually labeled schizophrenic. A patient with homocystinuria, mental retardation, and episodic psychosis is described and this case is used to point to the difficulties in making a definite psychiatric diagnosis in these patients. A relationship between the two syndromes is suggested. PMID- 3965611 TI - Symptomatic, familial, perinatal, and social correlates of computerized axial tomography (CAT) changes in schizophrenics and bipolars. AB - Computerized axial tomography (CAT) scans were blindly examined, and lateral ventricular-to-brain ratios calculated in 19 schizophrenic and 27 bipolar patients, and in an equal number of individually matched normal controls. Family history, early development, past psychiatric history, and current functioning and symptomatology were analyzed for all patients. Lateral ventricular enlargement on CAT was found in a significant proportion of both patient groups. Patients with such enlargement tended to have greater numbers of negative symptoms and poorer premorbid adjustment, but did not differ regarding family history of psychiatric illness. A subgroup of schizophrenics with presumed early brain damage was identified. This group had more marked ventricular enlargement, a greater number of negative symptoms, and an earlier onset of illness. PMID- 3965613 TI - Women of polygamous marriages in an inpatient psychiatric service in Kuwait. AB - The practice of polygamy, although varying from culture to culture, is widespread in many areas of the world. In Kuwait, for example, 8 to 12.5% of all marriages contracted are polygamous. Although sociologists and anthropologists, as well as common sense, have suggested that a polygamous marriage may have a negative effect on the wives involved, an extensive literature search failed to uncover any psychiatric research that attempts to examine this situation or objectively delineates possible psychiatric sequelae. The present study was a pilot effort to determine whether Kuwaiti wives of polygamous marriages were disproportionately represented in the inpatient psychiatric as opposed to the general population. A second purpose was to determine the extent of the relationship between psychiatric disorder and marital situation. Preliminary data indicated that the percentage of wives of polygamous marriages was significantly greater in the inpatient psychiatric population than in the general population of Kuwait, as reflected in the 1975 census. In addition, the results suggested a relationship between the nature of psychiatric disorder and the marital situation. Alternate explanations of the data are advanced, and the need for controlled future studies outlined. PMID- 3965614 TI - Effects of ethanol in vitro and in vivo on the release of endogenous catecholamines from specific regions of rat brain. AB - Blocks of tissue from the hypothalamus, olfactory bulb, or striatum of rats were incubated in vitro to study the basal and potassium-stimulated release of endogenous catecholamines. When ethanol (100-250 mM) was added to these preparations in vitro no changes in release were observed. When ethanol (3.0 g X kg-1) was injected intraperitoneally in vivo, however, and 3,4 dihydroxyphenylethylamine (DA, dopamine) release was measured in vitro at various times after drug administration, significant increases in the basal release and decreases in the potassium-stimulated release were observed in striatum and olfactory bulb. In striatum, these changes showed a more rapid onset and a longer duration than in olfactory bulb. In both brain regions, DA release did not differ from controls at 4-6 h after the ethanol injection, although blood ethanol concentrations remained elevated. This may imply the tissue's acquisition of acute functional tolerance to the drug. Similar increases and decreases in the basal and the potassium-induced release of DA from striatal tissues were also found at 1 h after injection of a lower dose of ethanol (1.0 g X kg-1). In terms of behavior, this lower dose of ethanol produced only mild intoxication and ataxia, in contrast to the loss of righting reflex following the higher dose. PMID- 3965615 TI - Effects of short- and long-term protriptyline treatment on phospholipid metabolism in rat brain. AB - Wistar rats were injected intraperitoneally with 10 mg/kg of protriptyline according to one of the following schedules: a single dose or daily for 4 days (short-term), or daily for 2 or 13 weeks (long-term). Total lipid, total phospholipid, and individual phospholipid contents in the brain were determined. Further, the incorporation of 32P into individual phospholipids in vivo and the fatty acid composition of phosphatidylethanolamine in the brains of rats treated with protriptyline for 13 weeks were studied. Three alternative phases of changes of total and individual phospholipid contents in the brain during 13 weeks of experimentation were distinguished. An increase of phospholipid contents after 4 days, a decrease after 2 weeks, and a further increase after 13 weeks of protriptyline administration were found. However, phosphatidylinositol and phosphatidic acid levels after 13 weeks of protriptyline administration were diminished. The decrease of specific radioactivity of phosphatidylethanolamine, phosphatidylcholine, and phosphatidylserine and the increase of phosphatidylinositol, phosphatidic acid, and sphingomyelin in rats treated with the drug for a longer period of time were noted. No greater differences in fatty acid composition of phosphatidylethanolamine in the brains of the same group of rats were observed as compared to control. These results indicate that during long-term treatment with protriptyline the contents of lipids and phospholipids in rat brain are altered. The modification of the biological function of phospholipids in brain cell membranes is suggested. PMID- 3965616 TI - Impaired development of rat cerebellum induced by neonatal injection of the glycoprotein synthesis inhibitor, tunicamycin. AB - The effects of the protein glycosylation inhibitor tunicamycin on the postnatal development of the rat cerebellum were examined in vivo. Tunicamycin (0.2 micrograms) was injected intracranially into 1-day-old rats. Inhibition of glycosylation of the macromolecules in the cerebellum by tunicamycin treatment was suggested by a reduced incorporation of [3H]glucosamine into the trichloroacetic acid (TCA)-insoluble fraction. The tunicamycin treatment did not affect gain in body weight significantly. However the cerebellar weight was significantly reduced by 30-40% compared with that of the controls. Development of GABAergic and cholinergic innervations in the hypoplastic cerebellum was examined by measuring the activities of glutamate decarboxylase (GAD) and choline acetyltransferase (ChAT). The specific activity and the total activity of GAD were significantly reduced in the tunicamycin-treated cerebellum. In contrast the specific activity of ChAT was significantly increased, whereas the total activity of ChAT per cerebellum was identical with that of the controls. These results suggest that the intracranial injection of tunicamycin affects the postnatal development of rat cerebellum, such as GABAergic and cholinergic innervations. PMID- 3965617 TI - Dopamine-beta-hydroxylase: structural comparisons of membrane-bound versus soluble forms from adrenal medulla and pheochromocytoma. AB - Dopamine-beta-hydroxylase (DBH) in membrane-bound (mDBH) and water-soluble (sDBH) forms was isolated from chromaffin granules of bovine adrenal medullae and a human pheochromocytoma tumor. sDBH was purified by concanavalin A-agarose column chromatography followed by DEAE-Sepharose column chromatography. The final bovine preparation had a specific activity of 16.27 IU/mg; the human preparation had a specific activity of 9.16 IU/mg. mDBH was isolated in enzymatically inactive form by preparative polyacrylamide gel electrophoresis. The proteins were subjected to amino acid analysis, as well as digestion with trypsin, followed by separation of the resulting peptides by two-dimensional TLC/electrophoresis. No intraspecies differences between sDBH and mDBH were found from comparisons of amino acid composition or peptide maps. Thus the basis of the difference between sDBH and mDBH cannot easily be explained by differences in primary structure, within the resolution of these techniques. PMID- 3965618 TI - Comparison of protein synthesis in mitochondria, synaptosomes, and intact brain cells. AB - Qualitative aspects of protein synthesis in organelles and intact cultured cells of brain origin were compared to clarify the distinction between synaptosomal and mitochondrial protein synthesis. Brain mitochondria and synaptosomes were isolated either on a traditional Ficoll-sucrose gradient or by a new Percoll gradient procedure, and were incubated in an amino acid incorporation system containing [35S]methionine, then electrophoresed on gradient slab gels. Autoradiography of the gels revealed that in the presence of cycloheximide both mitochondria and synaptosomes synthesized at least 17 proteins in the 6,000 50,000 MW range, and that incubation with chloramphenicol reduced or eliminated these bands. With minor variation these patterns in the low-molecular-weight region also resembled patterns obtained from cycloheximide-inhibited rat liver mitochondria and intact brain cells (cultured glia, glioma, and neuroblastoma). In the higher molecular weight region of the gels (greater than 50,000) banding patterns were more complex and tended to differ between organelles and intact cells. These polypeptides probably reflect nonmitochondrial protein synthesis, and their variable response to inhibitors may account for confusion in the literature with regard to the effects of inhibitors of protein synthesis in brain mitochondria and synaptosomes. PMID- 3965619 TI - Rate equations and kinetics of uptake of alpha-aminoisobutyric acid and gamma aminobutyric acid by mouse cerebrum slices incubated in media containing L(+) lactate or a mixture of succinate, L-malate, and pyruvate as the energy source. AB - Influx of alpha-aminoisobutyric acid (AIB) and gamma-aminobutyric acid (GABA) by mouse cerebrum slices incubated with L-lactate or a mixture of succinate, L malate, and pyruvate (SMP) as the energy source follows the phenomenological rate equation for influx from pyruvate and glucose media: v = Vmax/(1 + Kt/S) + kuS, where v is rate and S is concentration of amino acid. There are two kinetically distinct, parallel components for concentrative uptake, one saturable, and one unsaturable. Rates are less with lactate than with pyruvate and still less with SMP (only GABA was studied), disproving the hypotheses that lower rates with pyruvate compared to glucose are due to an abnormal redox state in the tissue or to a Krebs cycle unbalanced by input at only one point. The carriers for AIB and GABA are qualitatively different. In lactate medium the capacity of each AIB carrier is unchanged but its affinity is reduced to one-third. In lactate and SMP media, the capacity of the saturable GABA carrier is diminished although its affinity is increased. Rates from these media with added glucose or a glucose analog confirm that amino acid and glucose fluxes are not coupled. PMID- 3965620 TI - Changes in brain energy metabolism and protein synthesis following transient bilateral ischemia in the gerbil. AB - The time course of the reduction in brain protein synthesis following transient bilateral ischemia in the gerbil was characterized and compared with changes in a number of metabolites related to brain energy metabolism. The recovery of brain protein synthesis was similar following ischemic periods of 5, 10, or 20 min; in vitro incorporation activity of brain supernatants was reduced to approximately 10% of control at 10 or 30 min recirculation, showed slight recovery at 60 min, and returned to 60% of control activity by 4 h. Protein synthesis activity was indistinguishable from control at 24 h. One minute of ischemia produced no detectable effect on protein synthesis measured after 30 min reperfusion; longer periods of ischemia resulted in progressive inhibition, with 5 min producing the maximal effect. Pentobarbital (50 mg/kg) increased by 1-2 min the threshold ischemic duration required to produce a given effect. Whereas most metabolites recovered quickly following 5 min ischemia, glycogen showed a delayed recovery comparable to that seen for protein synthesis. These results are discussed in relation to possible mechanisms for the coordinate regulation of brain energy metabolism and protein synthesis. An improved method for the fluorimetric measurement of guanine nucleotides is described. PMID- 3965621 TI - Human brain 6-phosphogluconate dehydrogenase: purification and kinetic properties. AB - 6-Phosphogluconate dehydrogenase has been purified from human brain to a specific activity of 22.8 U/mg protein. The molecular weight was 90,000. At low ionic strengths enzyme activity increased, due to an increase in Vmax and a decrease in Km for 6-phosphogluconate, and activity subsequently decreased as the ionic strength was increased (above 0.12). Both 6-phosphogluconate and NADP+ provided good protection against thermal inactivation, with 6-phosphogluconate also providing considerable protection against loss of activity caused by p chloromercuribenzoate and iodoacetamide. Initial velocity studies indicated the enzyme mechanism was sequential. NADPH was a competitive inhibitor with respect to NADP+, and the Ki values for this inhibition were dependent on the concentration of 6-phosphogluconate. Product inhibition by NADPH was noncompetitive when 6-phosphogluconate was the variable substrate, whereas inhibition by the products CO2 and ribulose 5-phosphogluconate and NADP+ were varied. In totality these data suggest that binding of substrates to the enzyme is random. CO2 and ribulose 5-phosphate are released from the enzyme in random order with NADPH as the last product released. PMID- 3965622 TI - Metabolic fluxes between [14C]2-deoxy-D-glucose and [14C]2-deoxy-D-glucose-6 phosphate in brain in vivo. AB - The rates of the phosphorylation and dephosphorylation of 2-deoxyglucose were measured in rat brain in vivo using tracer kinetic techniques. The rate constant for each reaction was estimated from two separate experiments with different protocols for tracer administration. Tracer amounts of [1-14C]2-deoxyglucose (1 microCi) were injected through the internal carotid artery (intraarterial experiment), or through the atrium (intravenous experiment). Brains were sampled by freeze-blowing at various times after the injection. In the intraarterial experiment, the rate constant for the forward reaction from 2-deoxyglucose to 2 deoxyglucose phosphate was calculated by dividing the initial rate of 2 deoxyglucose phosphate production by the 2-deoxyglucose content in brain. The rate constant for the reverse reaction from 2-deoxyglucose phosphate to 2 deoxyglucose was calculated from the decay constant of 2-deoxyglucose phosphate. The rate constants estimated were 10.1 +/- 1.4%/min (SD) and 3.00 +/- 0.01%/min (SD), respectively, for the forward and reverse reactions. In the intravenous experiment, rate constants for both reactions were estimated by compartmental analysis. By fitting data to program SAAM-27, the rate constants for the forward and reverse reactions were estimated as 11.4 +/- 0.4%/min (SD) and 5.1 +/- 0.4%/min (SD), respectively. The rate constants determined were compared to those for the reactions between glucose and glucose-6-phosphate, estimated previously from labeled glucoses. It is concluded that the rate of glucose utilization measured by the 2-deoxyglucose method reflects the rate of the hexokinase reaction and not the rate of glucose utilization or brain energy utilization. PMID- 3965623 TI - Isolation of diosgenin[(25R)-spirost-5-en-3 beta-ol] from a lysate of a new hypotensive phospholipid occurring in bovine brain. AB - Diosgenin[(25R)-spirost-5-en-3 beta-ol] and cholesterol were detected as trimethylsilyl derivatives by gas chromatography-mass spectrometry in an alkaline lysate of a new hypotensive phospholipid from the lipid fraction of bovine brain. These steroids seemed to be present in the hypotensive phospholipid fraction in some bound forms. PMID- 3965624 TI - Immunohistochemical diagnosis of olfactory neuroblastoma. AB - Olfactory neuroblastoma (OLF NB) is an uncommon neurogenic tumor arising in the nasal cavity. To identify the immunohistochemical reactivity of OLF NB, we examined specimens from ten patients for the presence of neuron-specific enolase (NSE), S-100 protein (S-100) and glial fibrillary acidic protein (GFAP). Formalin fixed paraffin sections were treated with rabbit antisera using the peroxidase antiperoxidase (PAP) and avidin-biotin immunofluorescence methods. Results were compared with those observed in four neuroblastomas (two central and two peripheral sites), 17 medulloblastomas, four pheochromocytomas and five paragangliomas. All OLF NB were positive for NSE and S-100. NSE was uniformly distributed throughout clusters of tumor cells within tumor nodules. The S-100 reactivity was distributed in neoplastic cell nuclei and long cytoplasmic processes of cells which interconnected to form a network at the periphery of tumor cell nests. GFAP was observed only in astrocyte-like cells in one tumor. Although the S-100-positive cells in OLF NB resembled S-100-positive sustentacular cells of paraganglioma and pheochromocytoma, the network pattern was distinctive in OLF NB. The immunodiagnostic pattern of OLF NB includes the following: (a) NSE present in irregular clusters of tumor cells, (b) S-100 present in peripheral cells which form a marginal network, (c) and GFAP rarely present. PMID- 3965625 TI - A new approach toward analyzing peripheral nerve fiber populations. I. Variance in sheath thickness corresponds to different geometric proportions of the internodes. AB - The thickness of the myelin sheath is known to increase with axon caliber, but there is also a superimposed, slight variation in sheath thickness depending on whether a fiber of a given caliber has very long or very short internodes. This relationship between myelin sheath thickness and the geometric proportion of the internode has been shown in subserial sections of isolated nerve fibers. It allows a prediction of sheath thickness from the quotient internode length/axon caliber, or conversely, a prediction of internode foreshortening from sheath thickness. We applied this new approach to the analysis of sciatic fiber populations of frogs, mice, rats and cats. The geometric proportions of these fibers were defined by the quotient internode length/fiber caliber. This quotient was compared with minor variation in sheath thickness as determined with a computer-assisted technique measuring large numbers of fibers in low-power electron micrographs. The method also calculated fiber shrinkage and recalculated all data for circular fiber profiles. The data obtained confirmed previous electron microscopic measurements showing that there is a slight reduction in sheath thickness when a fiber of a given caliber has relatively short internodes, and vice versa. A population of very thin, thinly myelinated fibers was also revealed. Sheath thickness and the geometric proportions of internodes in frogs differed markedly from those in mammals. PMID- 3965626 TI - A new approach toward analyzing peripheral nerve fiber populations. II. Foreshortening of regenerated internodes corresponds to reduced sheath thickness. AB - The new approach used in this study is based on the concept that axon caliber is not the only factor affecting the thickness of the myelin sheath. It is necessary to consider the entire geometric proportions of the internode, since sheath thickness corresponds to the relationship between axon caliber and the length of the internode. This type of analysis was applied to the regenerated internodes in rat sciatic nerves. Survival periods of 4, 9, 18 and 36 weeks were studied after lesions had been placed in young adult rats. The data show significantly thinner sheaths for regenerated fibers as compared with normal nerves, consistent with previous observations. This reduction in sheath thickness, however, corresponded quantitatively to the degree of foreshortening of internodes in the regenerated nerves. An average reduction of 10 in the quotient internode length/fiber caliber corresponded to a reduction of about 0.015 in the relative thickness of the sheath (quotient axon diameter/fiber diameter). This means that regenerated myelin sheaths are not truly hypoplastic; rather, they are adapted to the reduced internode length, and have the same relationship found for normal fibers. In partially damaged nerves there was a clear distinction in terms of sheath thickness between regenerated fibers and undamaged fibers. Demonstration of this phenomenon by scatter diagrams opens new possibilities for the quantitative assessment of neuropathies. PMID- 3965627 TI - Report of Children's Cancer Study Group. PMID- 3965628 TI - A controlled trial of the effect of 4-hydroxypyrazolopyrimidine (allopurinol) on the toxicity of a single bolus dose of 5-fluorouracil. AB - We have evaluated, in a controlled study, the modification of the toxicity of a single bolus dose of 5-fluorouracil (5-FU) by allopurinol. Patients first received a single dose of 5-FU and were monitored for toxicity. If a measurable nadir in WBC or platelet count occurred, then the same dose of 5-FU was repeated with concurrent allopurinol, given for four consecutive days at an initial dose of 300 mg twice daily, starting the day before the administration of 5-FU. With this schedule, each evaluable patient received courses of 5-FU with and without allopurinol that could be compared for toxicity. Twenty patients received initial 5-FU doses of either 1,200 mg/m2 or 1,500 mg/m2 and later had the same dose repeated with allopurinol. Nineteen of these patients had a higher WBC count with allopurinol than without it. In several patients who received a further course of 5-FU with 900-mg/d allopurinol, the WBC count was yet higher than with 600-mg/d allopurinol. The myelosuppression produced by 5-FU was characterized by a decrease in granulocyte levels that was much greater than the decrease in lymphocyte levels, and the result of allopurinol treatment was to attenuate this effort on granulocytes. In a second part of the trial, the goal was to establish the maximum tolerated dose of 5-FU given with concurrent allopurinol. In this part of the study, all patients entered were given 5-FU, usually 1,200 mg/m2, with allopurinol, usually 600 mg/d for four days. Escalations of one or the other drugs were made on subsequent treatments. The data for 22 patients showed that 1,800 mg/m2 of 5-FU was well tolerated if given with 600 to 1,200 mg of allopurinol per day, and that the WBC count nadirs were no more severe than those of 1,200-mg/m2 5-FU without allopurinol. Neurotoxicity became limiting in some patients treated at these higher doses. We conclude that allopurinol given in the proper dose and schedule can diminish the granulocytopenia produced by bolus doses of 5-FU, thereby allowing a 50% increase in the maximal tolerated dose of 5 FU. PMID- 3965630 TI - Prognostic value of blood glucose in Hodgkin's disease. PMID- 3965629 TI - Phase I trial of misonidazole (NSC#261037) plus cyclophosphamide in solid tumors. AB - Misonidazole, a hypoxic cell sensitizer, enhances the antitumor effects of cyclophosphamide in preclinical studies. Several studies also showed increased cytotoxicity for normal tissues. We undertook a phase I study of this combination. The regimen consisted of oral administration of misonidazole at one of two dose levels, 1 g/m2 and 2 g/m2, followed by an intravenous (IV) injection of cyclophosphamide four hours later. The cycle was repeated every twenty-one days. The dose of misonidazole remained constant for each regimen, but the dose of cyclophosphamide ranged from 0.4 g/m2 to 1.3 g/m2. Thirty-eight trials in 35 patients with advanced solid tumors were considered evaluable. Dose-limiting toxicity was granulocytopenia at 1 g/m2 of cyclophosphamide without significant thrombocytopenia or anemia. Peripheral neuropathy was negligible. Two patients received cumulative doses of 8 and 16 g/m2 of misonidazole without neurotoxicity. One patient developed hemorrhagic cystitis. Nausea and vomiting was mild to moderate. Possible evidence of tumor stabilization was seen in three patients, and one patient had a mixed response. The mean serum half-life for misonidazole was 11.3 hours (range, 8.4 to 20.0) and for cyclophosphamide 8.3 hours (range, 3.2 to 15.5), both within the previously reported ranges. In conclusion, it appears that this combination is well tolerated and that misonidazole does not significantly potentiate myelotoxicity caused by cyclophosphamide or alter its pharmacokinetics. The recommended starting doses for misonidazole and cyclophosphamide in phase II trials using this schedule of administration should be 2 g/m2 and 1 g/m2, respectively, with escalation for cyclophosphamide to individual tolerance. PMID- 3965631 TI - Morphological subclassification of follicular lymphoma: variability of diagnoses among hematopathologists, a collaborative study between the Repository Center and Pathology Panel for Lymphoma Clinical Studies. AB - A collaborative study between the Repository Center for Lymphoma Clinical Studies and the members of the lymphoma pathology subcommittee of the major cooperative oncology groups was undertaken in an effort to ascertain the reproducibility and the interobserver agreement for the cytologic diagnosis of follicular lymphomas. A group of 105 patients with follicular lymphomas were subclassified by seven hematopathologists according to two methods. In the first method, cases were subclassified according to the Rappaport, Lukes, and Collins, and Working Formulation systems. In these systems, follicular lymphomas are subclassified by estimation of the different cell populations without the actual counting of cells. With this method, great variability in diagnosis was noted. For example: (1) The consensus diagnosis was that of poorly differentiated lymphocytic lymphoma (PDL) in 39 cases, but among the individual pathologists the number of cases thus diagnosed ranged from 24 to 65; (2) In 40 cases, the consensus diagnosis was follicular lymphoma, mixed-cell type; however, all seven pathologists independently agreed on this subtype in only one case; (3) A major disagreement was noted in 39 cases (37%), in which both diagnostic extremes (small cleaved and large noncleaved) were expressed. In the second method, only precise counts of different cells were made, according to a modification of the method recommended by Berard. With this counting method, diagnoses were independently derived based on the counts provided by the seven pathologists for large cleaved, small noncleaved, and large noncleaved cells. The variability in the results was wide also with this second method. For example, the average number of large cells found by each pathologist was ascertained, and the ranges were determined. The average range was 28 cells, which was considered high. The same determinations were performed only for large noncleaved cells, and the range was found to be 15 cells, which was also considered high. When the diagnoses derived from counts of only large noncleaved cells were compared with the traditional, more subjective diagnoses, fairly close agreement was obtained. In summary, the great variability in diagnoses of follicular lymphomas among pathologists may be attributed to the difficulties inherent in accurate determination of cell size and of the precise percentages of different cells. Until solutions to these problems are developed, one can subclassify follicular lymphomas according to the Berard method or the estimation method. PMID- 3965632 TI - Correlation of chromosome abnormalities with patient characteristics, histologic subtype, and induction success in children with acute nonlymphocytic leukemia. AB - Cytogenetic analyses of bone marrow cells were performed in 195 children with acute nonlymphocytic leukemia (ANLL) at diagnosis, as part of Childrens Cancer Study Group Study No. 251. Ninety-six patients (49%) exhibited clonal abnormalities, including trisomy 8 in 18 patients, t(8;21) in 11, t(15;17) in seven, loss of a sex chromosome in seven, monosomy 7 in seven, and the Philadelphia chromosome in four. Clonal abnormalities were found significantly more often in younger patients. Furthermore, recurring cytogenetic abnormalities tended to correlate with specific ages. For example, t(8;21) was associated significantly with children over four years of age, while -7 associated with overall loss of genetic material from the long arm of chromosome 7 (7q) and 11q- were associated significantly with younger children. Recurring chromosome abnormalities also correlated with specific ANLL histologic subtypes, such as t(8;21) with acute myelogenous leukemia and t(15;17) with acute promyelocytic leukemia. Presence or absence of cytogenetic abnormalities was compared with the ability of patients to achieve remission. Individuals exhibiting clonal abnormalities in bone marrow cells had an equally likely chance of achieving remission (74%) as those individuals with normal karyotypes (75%). Nonrandom chromosome abnormalities associated with a high induction success rate included +8 with a 94% induction success rate (P = .13) and t(8;21) with a 91% success rate (P = .46). Patients exhibiting the -7 abnormality associated with overall loss of 7q had a significantly less successful induction outcome, with only 28% achieving remission (P = .02); three of seven patients with t(15;17) died during induction therapy. PMID- 3965633 TI - Stage IV diffuse large-cell lymphoma: a long-term analysis. AB - A long-term analysis of the clinical outcome of previously untreated adult patients who presented with stage IV diffuse large-cell lymphoma at diagnosis was performed to identify possible prognostic factors. Sixty-one patients were seen between 1974 and 1981; all were treated with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin followed by cyclophosphamide, vincristine, prednisone, and bleomycin for a total of one year. Overall five-year survival was 48.5%, with a median follow-up of 53 months. Of the 56 patients evaluable for remission status, 41 achieved a complete remission, and 27 are alive and disease free. Clinical factors of prognostic importance for survival included age, constitutional symptoms, lactate dehydrogenase (LDH) level, presence of mediastinal disease, large-cell infiltration of bone marrow, and number of extranodal sites of disease. The proportional hazards model then identified age, number of extranodal sites, and, to a lesser extent, serum LDH level as independent risk factors for survival. Four distinct patient risk groups were identified using these three factors. Younger patients with only one extranodal site of disease and normal LDH levels responded well on this therapy, with 100% alive at five years. In contrast, survival was less than 30% at five years for patients in the lowest risk group. There were 11 relapses; LDH level, constitutional symptoms, and mediastinal disease predicted for relapse. Knowledge of these risk factors permits individualization of treatment planning and allows more meaningful comparisons with the results of treatment studies using other intensive regimens. PMID- 3965634 TI - The human tumor clonogenic assay in human breast cancer. AB - The human tumor clonogenic assay (HTCA) was evaluated in 407 fresh samples of breast cancer from 288 patients. Seventy samples were inadequate for testing. Adequate in vitro growth for drug testing (greater than 30 colonies/plate) was obtained in 91 (27%) of the 337 viable samples, inadequate growth for drug evaluation (5 to 30 colonies/plate) in 17%, and no colony formation (less than 5 colonies/plate) in 56%. Operationally defining a greater than or equal to 50% inhibition of colony formation as in vitro drug sensitivity, the in vitro response rates to 12 anticancer drugs tested against ten to 36 different cancers (arranged in decreasing order according to the number of tests performed) were as follows: doxorubicin (14%), bisantrene (54%), vinblastine (33%), mitomycin (36%), interferon clone A (23%), 5-fluorouracil (20%), methotrexate (17%), leukocyte interferon (33%), mitoxantrone (42%), cyclophosphamide (25%), m-AMSA (16%), and melphalan (10%). Among 25 patients receiving single-agent therapy, there were ten (59%) of 17 with in vitro sensitivity who responded; resistance was correctly predicted in nine patients (100%), P = .01. Among 34 patients treated with combination chemotherapy, seven (50%) of 14 with in vitro sensitivity responded, and resistance was predicted in 13 (65%) of 20 patients. Difficulties in using the HTCA in breast cancer (including small specimen size, difficulties in disaggregation, and inadequacy of growth) will require additional research. Nonetheless, the assay appears to detect in vitro activity as well as resistance of a variety of anticancer agents and appears to predict clinical responsiveness to standard as well as some investigational single agents. PMID- 3965635 TI - Identification of excitatory and inhibitory motoneurons in the nematode Ascaris by electrophysiological techniques. AB - A physiological preparation in which it is possible to record responses in muscle to stimulation of single motoneurons of the nematode Ascaris lumbricoides is described. With this preparation we have determined the physiological sign (E or I; excitatory or inhibitory) of the neuromuscular synapses of 21 identified motoneurons--12 are excitatory and 9 inhibitory. Ascaris motoneurons had previously been classified by morphological criteria into seven classes (Stretton, A. O. W., R. M. Fishpool, E. Southgate, J. E. Donmoyer, J. P. Walrond, J. E. R. Moses, and I. S. Kass (1978) Proc. Natl. Acad. Sci. U. S. A. 75: 3493 3497). Physiological studies were performed on members of five of these classes. Three classes of neurons (DE1, DE2, and DE3) are excitatory to dorsal muscle cells. Two classes (DI and VI) are inhibitory neurons which innervate the dorsal and ventral muscle cells, respectively. The motoneurons in Caenorhabditis elegans (White, J. E., E. Southgate, J. N. Thomson, and S. Brenner (1976) Philos. Trans. R. Soc. Lond. (Biol.) 275: 327-348) can be divided into seven morphological classes which are very similar to those in Ascaris. Based upon the structure function correlation in Ascaris, we have predicted which motoneurons are excitatory and which are inhibitory in C. elegans. PMID- 3965636 TI - Embryonic development of glial cells and their junctions in the locust central nervous system. AB - The embryonic development of the specialized glial cells that form the perineurial blood-brain barrier in the locust CNS has been studied by freeze fracture and tracer uptake. These cells migrate to form bracelet cell arrangements around the nervous tissues between day 4 to day 10 of embryonic differentiation which lasts 14 days in toto. A number of different kinds of intercellular junction form between the bracelet cells from day 8 to day 13 of development. These include gap junctions with features characteristic of arthropods, which seem to assemble by lateral migration of 13-nm E face intramembranous particles (IMPs), which ultimately cluster to form a large number of mature plaques of varying diameters. Less numerous are tight junctions which serve to restrict entry of exogenous molecules, including lanthanum and cationic ferritin, thereby forming the blood-brain barrier; these appear to assemble by migration of individual 8- to 10-nm P face IMPs into ridges which are found between the overlapping fingers of the perineurial bracelet cell processes. Septate junctions also mature at this stage in embryonic development by apparent assembly of IMPs into characteristic aligned rows; these may serve to slow down the entry of positively charged molecules as well as being adhesive, although anionic ferritin may leak into the CNS even after septate and tight junction formation. The observed changes in cellular associations and the formation of the blood-brain barrier coincide with the onset of mature neuronal electrical properties and spontaneous synaptic input. PMID- 3965637 TI - Electrophysiological properties of identified cells in the in vitro olfactory epithelium of the tiger salamander. AB - An in vitro preparation of the salamander olfactory epithelium has been developed for electrophysiological analysis. Intracellular measurements of membrane properties of the main epithelial cell types have been carried out, combined with Lucifer Yellow injections. The most prevalent type of cell had a high resting membrane potential and relatively low input resistance. This cell never discharged impulses, either spontaneously or to injected current. Lucifer Yellow injections identified this cell type as a supporting cell. A less frequent type had a medium resting potential and a very high input resistance. This type always discharged impulses in response to injected depolarizing current. Lucifer Yellow injections identified this cell type as an olfactory receptor neuron. The least frequent type had a medium resting potential and a high input resistance. It never generated action potentials. This nonspiking type was tentatively identified as an immature receptor neuron in the process of differentiating from basal stem cells in the epithelium. These are the first results to document physiological properties for the main cell types and morphological identification of two of the types in the same preparation of the olfactory epithelium. Our results support previous suggestions regarding the glial-like properties of the supporting cells. The membrane properties of the receptor neurons appear to be well suited for mediating the olfactory sensory response of these cells. PMID- 3965638 TI - Changes in the electrical properties of olfactory epithelial cells in the tiger salamander after olfactory nerve transection. AB - Transection of olfactory nerves causes degeneration of receptor neurons in the olfactory epithelium, followed by generation of new receptor neurons. We have carried out intracellular recordings to document changes in epithelial cell populations during receptor neuron degeneration and regrowth at 1, 2, and 4 weeks following olfactory nerve transection in the salamander. Receptor neurons were greatly reduced in numbers at 1 week, and gradually returned to the normal percentage of intracellular penetrations by 4 weeks. They had a resting membrane potential between -30 and -50 mV and high input resistance, 100 to 600 megohms, characteristically seen in normal epithelium. However, at 1 week, the receptor neurons were able to generate only a single spike in response to injected current, and did not re-acquire their ability to respond repetitively until 4 weeks. Cells with the properties of immature receptor neurons (resting membrane potential between -30 and -50 mV and high input resistance, 100 to 600 megohms, but unable to generate spikes) increased significantly in number in the post transection period. This correlates with the burst of mitotic activity giving rise to new receptor neurons after nerve transection. Supporting cells changed their properties in the aftermath of transection. One type (A) showed a decrease in resting membrane potential and a small increase in input resistance. A second type (B) showed a very large increase in input resistance. These results imply that the degenerating receptor neurons transmit a signal that leads to changes in the functional properties of the glial-like supporting cells. These may involve changes in the membrane properties or in electrical coupling between cells. PMID- 3965639 TI - Rapid recovery of pineal function after partial denervation: a possible role for heteroneuronal uptake of transmitter in modulating synaptic efficacy. AB - The pineal gland is innervated by sympathetic neurons whose cell bodies are located in the two superior cervical ganglia and whose axons reach the gland via the two internal carotid nerves (ICNs). Bilateral decentralization of the superior cervical ganglia, produced by lesioning both cervical sympathetic trunks (CSTs), abolishes the circadian rhythm in the activity of the pineal enzyme serotonin N-acetyltransferase (NAT). We have examined the effects on NAT activity of unilaterally cutting the ICN or the CST. During the first night after either operation, nocturnal NAT activity was reduced by 75% compared to controls. However, during the second night after unilaterally cutting the ICN, NAT activity was restored to control values, and normal enzyme activity was seen in these lesioned animals for up to 1 month after this operation. On the other hand, following unilateral decentralization of one superior cervical ganglion, enzyme activity was reduced for at least 5 months. The high enzyme activity in animals with one ICN cut was abolished by cutting the contralateral CST, indicating that the recovery of NAT activity depended on the remaining intact sympathetic neurons. Electrical stimulation of the intact ICN during the daytime in animals in which the contralateral ICN was cut produced an increase in pineal NAT activity which was greater than the increase seen when similar stimulation was performed in sham-operated animals or in animals in which the contralateral superior cervical ganglion had been decentralized. The time course of the recovery of nocturnal NAT activity after unilateral denervation of the pineal gland was similar to the time course of the decrease in norepinephrine uptake sites in the gland.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965640 TI - Excitatory and inhibitory activity in the dorsal musculature of the nematode Ascaris evoked by single dorsal excitatory motonerons. AB - A physiological preparation, in which identified motoneurons of the nematode Ascaris lumbricoides can be individually stimulated, was used to map the response evoked by single dorsal excitatory (DE) motoneurons in muscle cells innervated along the length of the dorsal nerve cord. As previously reported (Walrond, J. P., I. S. Kaas, A. O. W. Stretton, and J. E. Donmoyer (1985) J. Neurosci. 5: 1 8), stimulation of a DE cell produces excitatory responses in muscle cells which it directly innervates. Excitatory activity propagates along the most strongly activated region of muscle at a velocity of approximately 28 cm/sec, then relaxes into a slower velocity of approximately 12 cm/sec. When either the DE1 or DE3 neurons were stimulated, excitatory responses were also observed in muscle cells not directly innervated by the neuron. These signals propagate in the opposite direction from the fast-propagating activity at a velocity of approximately 13 cm/sec. Injection of hyperpolarizing current into muscle cells blocks this slower propagation but fails to block the faster conduction. We conclude that the fast conducting responses result from signals propagating in the motor axon, whereas the slow responses are conducted through gap junctions which connect Ascaris muscle cells. Stimulating a single DE motoneuron also evokes hyperpolarizing muscle responses in regions adjacent to the zones of fast and slow excitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965641 TI - Noradrenergic responses of spinal neurons in locus coeruleus-spinal cord co cultures. AB - Locus coeruleus (LC) explants were co-cultured with dissociated spinal neurons of mice. Nerve fibers exhibiting catecholamine fluorescence radiated from the explants and frequently invested spinal cord (SC) neurons close to the explants. Electrical stimulation of the explant and iontophoretic application of norepinephrine evoked a spectrum of slow depolarizing, hyperpolarizing, and biphasic responses in the SC cells. The responses to LC stimulation and to application of norepinephrine were usually similar in a given cell. The depolarizing responses were associated with an increase in apparent input resistance and pharmacologic tests indicated that the responses were mediated by alpha-receptors. Neurons in regions innervated by catecholamine-containing fibers usually gave depolarizing responses to LC stimulation and such neurons had a very high probability of exhibiting depolarizing responses to applied norepinephrine. It would appear that either locus coeruleus explants favored the survival of cells with alpha-receptors or expression of these receptors in SC neurons was induced by innervation of the neurons by locus coeruleus axons. PMID- 3965642 TI - Conditioned modification of phototactic behavior in Hermissenda. I. Analysis of light intensity. AB - Psychophysical experiments examined the control of phototactic behavior by light intensity in the nudibranch mollusk Hermissenda by measuring the time that Hermissenda remained in an illuminated area. This measure of phototactic behavior exhibits a closer correspondence to changes in test light intensity than other previously examined measures of phototaxis. Changing the intensity of a test light in a series of increasing steps resulted in a graded increase in positive phototactic behavior. Behavioral responses to different light intensities were examined in conditioned and control animals. Conditioning resulted in a significant suppression of phototactic behavior at all light intensities examined. Random control procedures did not produce suppression of phototactic responding. These behavioral results provide a data base to examine how well neural correlates produced during conditioning fit the behavior. PMID- 3965643 TI - Conditioned modification of phototactic behavior in Hermissenda. II. Differential adaptation of B-photoreceptors. AB - Changes in the response of B-type photoreceptors to illumination were examined in the isolated nervous systems of Hermissenda following the conditioning procedures described in the preceding paper. Analysis of the transient peak amplitude of the depolarizing generator potential at the onset of two of the three light intensities used in the behavioral studies did not reveal an enhanced photoresponse to the light. However, when the activity of the same B photoreceptors was examined after 5 min of continuous light, there was a significant decrease in the light-adapted discharge rate and a decreased generator potential amplitude in conditioned animals as compared to the random controls. An examination of the light adapted photoresponse in preparations where spike generation and synaptic interactions were eliminated showed that the decreased photoresponse of conditioned animals was due to factors that are intrinsic to the B-photoreceptors. These results are consistent with previous work suggesting that conditioning produces substantial adaptation effects in B photoreceptors (Crow, T. (1982) Soc. Neurosci. Abstr. 8: 824). Since the cellular changes qualitatively follow the behavioral changes and are observed at times and light intensities that are similar to those where the suppression of phototactic behavior is expressed, phototactic suppression may be directly related to the changes in the B-photoreceptors and may not require the previously proposed complex network interactions within the eyes of Hermissenda. PMID- 3965644 TI - Sexually dimorphic regions in the medial preoptic area and the bed nucleus of the stria terminalis of the guinea pig brain: a description and an investigation of their relationship to gonadal steroids in adulthood. AB - Sexually dimorphic regions are described in two areas of the guinea pig brain: the medial preoptic area (MPOA) and the bed nucleus of the stria terminalis (BNST). The volume of a darkly staining portion of the MPOA is approximately 4 fold larger in male than in female guinea pigs, and the volume of a darkly staining portion of the BNST is approximately 36% larger in male than in female animals. The sex differences in both of these areas are present in animals that have been gonadectomized as adults as well as in intact animals, suggesting that they result from differences between the sexes in the hormonal environment during early development. Both the MPOA and the BNST bind high levels of gonadal steroids early in life, during the period when functional differentiation occurs. It is possible that dramatic morphological sex differences characterize such steroid-binding areas. Furthermore, these sexually dimorphic areas may form an anatomically and functionally interrelated system. Attention to these possibilities may help elucidate more precisely the neural basis for sexually dimorphic functions, as well as the basic mechanisms underlying sexual differentiation of behavior and the brain. PMID- 3965645 TI - Neural mechanisms of motor program switching in the mollusc Pleurobranchaea. I. Central motor programs underlying ingestion, egestion, and the "neutral" rhythm(s). AB - The buccal musculature of the carnivorous gastropod Pleurobranchaea is used in three cyclic patterns of coordination underlying, respectively, ingestion, egestion, and a third, unknown behavior(s) (Croll, R. P., and W. J. Davis (1981) J. Comp. Physiol. 145: 277-287; Croll, R. P., and W. J. Davis (1982) J. Comp. Physiol. 147: 143-154). The corresponding three motor programs can be identified and distinguished in the intact animal (Croll, R. P., and W. J. Davis (1981) J. Comp. Physiol. 145: 277-287), the reduced preparation (Croll, R. P., and W. J. Davis (1982) J. Comp. Physiol. 147: 143-154, and the present paper), and the isolated CNS (present paper), on the basis of several qualitative and quantitative criteria. Distinguishing parameters developed here include: the activity of the salivary duct, which bursts in phase with protraction during ingestion, is silent during egestion, and usually bursts biphasically and in antiphase with protraction during the third ("neutral") rhythm(s); and the protractor duty cycle, which is generally 33 to 50% during ingestion, greater than 50% during egestion, and less than 33% during the neutral rhythm(s). Retractor duty cycles did not differ significantly between the three motor programs. The neutral rhythm(s) may be a low-intensity version of the ingestion motor program, with which it shares most features. The three buccal motor programs can be elicited in the reduced preparation (sensory feedback intact) and in the isolated, deafferented CNS. Therefore, multiple motor programs in this metastable motor system are each endogenous to the CNS; i.e., they can each be generated by a central pattern generator(s) in the absence of sensory feedback.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965646 TI - Neural mechanisms of motor program switching in the mollusc Pleurobranchaea. II. Role of the ventral white cell, anterior ventral, and B3 buccal neurons. AB - Identified buccal neurons in the mollusc Pleurobranchaea were stimulated and recorded intracellularly while recording the resultant identified motor program from buccal muscles (reduced preparation) or nerves (isolated central nervous system). Neurons studied included the ventral white cell (VWC), members of the anterior ventral (AV) population, and interneuron B3. Each of these neurons elicited the egestion motor program or its characteristic components when stimulated intracellularly. The characteristic prolonged plateau potential of the VWC was frequently associated with the egestion motor program but never with the ingestion motor program or its characteristic components. Intracellular recordings from these same neurons during spontaneous or induced buccal motor programs were consistent with the view that these neurons participate in production of the egestion motor program. The VWC discharged also during the neutral buccal rhythm, although in a different pattern from that seen during the egestion motor program, suggesting that it is multifunctional. Synaptic targets of the VWC are unknown, but synaptic influences of the AV and B3 neurons were found and are appropriate to their proposed role in egestion. This study therefore indicates that an interrelated cluster of buccal neurons is specialized to command the egestion motor program. PMID- 3965647 TI - Neural mechanisms of motor program switching in the mollusc Pleurobranchaea. III. Role fo the paracerebral neurons and other identified brain neurons. AB - Identified neurons in the cerebropleural ganglion (brain) of the mollusc Pleurobranchaea were stimulated and recorded from intracellularly while recording the identified motor program from buccal muscles (reduced preparation) or nerves (isolated central nervous system). Neurons studied included the metacerebral giant neurons (MCGs), phasic paracerebral neurons (PCp's), polysynaptic excitors of the PCp's (PSEs), type II electrotonic neurons (ETII's), type I electrotonic neurons (ETI's) and several other identified neurons or neuronal classes. Intracellular stimulation of the above identified neurons generally elicited the ingestion motor program or its characteristic components, but never the egestion motor program and seldom its characteristic components. Intracellular recordings from these neurons in the isolated central nervous system preparation while eliciting the ingestion and egestion motor program generally showed cyclic membrane potential oscillations in phase with both motor programs, indicating that these neurons receive synaptic feedback from the ingestion and egestion central pattern generator(s). This study is therefore consistent with the view that an interrelated cluster of brain neurons is specialized to command the ingestion motor program. A neural model of motor program switching in the buccal motor system is formulated, comprising separate command pathways for ingestion and egestion that converge on a common central pattern generator(s). PMID- 3965648 TI - Reciprocal inhibition in the motor nervous system of the nematode Ascaris: direct control of ventral inhibitory motoneurons by dorsal excitatory motoneurons. AB - In previous physiological experiments (Stretton, A. O. W., R. M. Fishpool, E. Southgate, J. E. Donmoyer, J. P. Walrond, J. E. R. Moses, and I. S. Kass (1978) Proc. Natl. Acad. Sci. U. S. A. 75: 3493-3497), we have shown that the dorsal cord of the nematode Ascaris lumbricoides includes the processes of three types of dorsal excitatory (DE) motoneurons and one type of ventral inhibitory (VI) motoneuron. Ultrastructural studies have revealed that the axons of the DE motoneurons make monosynaptic contacts with the dorsal processes of VI motoneurons. In this paper, we describe a physiological preparation with which to investigate the properties of these synapses. We show that activation of a DE neuron can excite a VI neuron producing inhibition in ventral muscle cells shortly after dorsal muscle cells are excited, thus mediating reciprocity between dorsal and ventral muscles. Each VI dendrite receives input from four or five DE neurons; activation of any one of these DE neurons is sufficient to activate the VI neuron. PMID- 3965649 TI - Assessment of the site of ventricular activation by Fourier analysis of gated blood-pool studies. AB - We studied the use of first-harmonic Fourier analysis of gated blood-pool images to assess the site of ventricular activation in a group of 12 patients undergoing electrophysiologic pacing studies. We acquired gated blood-pool studies during pacing at up to four sites at each of two different rates. A total of 50 studies were made. At a pacing rate of 100 beats/min, when the pacing electrode was at the right-ventricular apex, 9/13 times the Fourier activation site agreed; at the right-ventricular outflow tract, 7/8; at the anterolateral left-ventricular wall, 4/4. When the Fourier activation site was at the right-ventricular apex, 9/9 times the pacing electrode was there; at the right-ventricular outflow tract, 7/10; in the left ventricle, 4/4. Fourier analysis of gated blood-pool studies can help identify the site of ventricular activation but is not sufficiently accurate to fully replace endocardial mapping. PMID- 3965650 TI - Krypton-81m imaging of the right ventricle. AB - We report the development of a method for obtaining right-ventricular radionuclide angiograms using continuous peripheral intravenous infusion of the ultra-short-lived nuclide krypton-81m. This tracer has a half-life of 13 sec, emits a single 190-keV photon, and is extremely insoluble. During infusion into a peripheral vein, Kr-81m achieves stable count rates over the right heart, and it is essentially completely cleared by the lungs during its initial pulmonary transit. Thus no interfering activity is present in the systemic circulation. Initial studies provide excellent data on right-heart anatomy and function. PMID- 3965651 TI - Vocal cord paralysis following I-131 ablation of a postthyroidectomy remnant. AB - Vocal cord paralysis has been reported following I-131 therapy of thyrotoxicosis and following ablation of the whole thyroid. However, this rare complication has not previously been described following I-131 ablation of a postthyroidectomy remnant. We report a patient who required tracheostomy for bilateral vocal cord paralysis following I-131 ablation after near-total thyroidectomy for papillary thyroid carcinoma. PMID- 3965652 TI - Accuracy of proton T1 calculated by approximations from image signals. AB - In proton magnetic resonance imaging, T1 calculation from two measurements is simplified by using an approximation algorithm that assumes equilibrium recovery of longitudinal magnetizations or one that ignores refocusing 180 degrees pulses used. Errors in calculated T1 arising from either approximation are evaluated using signal expressions that presume neither approximation. The approximation error depends on T1, sequence parameters, and the simplifying algorithm. The computed relation can be used to correct for the approximation error. The correction reduces calculated-T1 errors, but does not eliminate them, since other significant or potentially significant sources of the error are unaccounted for. These sources relate to ever-present stochastic noises, proper signal expressions, various instrumental factors, exponential compared with nonexponential nature of tissue proton relaxations, and tissue movements. The problem of quantitative T1 measurement from image signals is briefly discussed. PMID- 3965653 TI - Intracellular distribution and radiotoxicity of chromium-51 in mammalian cells: Auger-electron dosimetry. AB - The kinetics of uptake and of radiotoxicity of chromium-51, an Auger-electron emitter, have been studied in V79 lung fibroblasts of the Chinese hamster. Intracellular radioactivity was directly proportional to the incubation period and to the extracellular concentration of the Cr-51. About 14% of the cellular activity was associated with the nucleus, whereas approximately 2% was guanidine precipitable and therefore bound to DNA. The growth rate of V79 cells was slowed following intracellular incorporation of Cr-51. The cell-survival curve, in terms of colony-forming ability, was of the low-LET type, with a D37 of 6.2 pCi/cell. Theoretical dosimetric estimates indicate that, under the given experimental conditions, the mean lethal dose to the cell nucleus was 870 rad. Although this value is somewhat larger than the x-ray D37 dose of 580 rad for this cell line, it is more realistic than the gross underestimate obtained by classical MIRD calculations (2-3 rad/cell). PMID- 3965654 TI - Technetium-99m labeling of polymorphonuclear leukocytes: preparation with two different stannous agents. AB - A technique for in vitro labeling of human polymorphonuclear leukocytes with Tc 99m is described. Titration of stannous fluoride and stannous pyrophosphate concentrations for pretinning was performed, and optimal amounts of the stannous agents were added to polymorphonuclear leukocytes efficiently isolated from 100 ml of blood. Labeling with 10-15 mCi Tc-99m resulted, after three washings of cell suspensions, in yields of 1.6-4.8 mCi, corresponding to 20.5-33.5% of added tracer. Cell-bound activity in the final cell suspensions was 92.3% +/- 1.9 of the added dose. Cell function was not impaired by the labeling technique. Sterility and exclusion of bacterial endotoxins in the final cell suspensions were demonstrated. The method may prove of diagnostic value in the isolation, labeling, and reinjection of autologous leukocytes for scintigraphic imaging of acute inflammatory lesions. PMID- 3965655 TI - Blood volume in the rat. AB - The organ distribution of radiopharmaceuticals in the rat is usually estimated using 7% of body weight (BW) for blood volume (BV). In spite of its important impact on the evaluation of new agents, this value has not been validated adequately. We therefore studied blood volume in 70 awake Wistar rats (100 to 400 g BW) in which red blood cell volume (RBCV) and plasma volume (PV) were measured simultaneously. Red blood cell volume was measured by in vitro RBC-tagging with Tc-99m in Sn-pyrophosphate, 0.05 microgram per ml of blood; plasma volume was measured with I-125 human serum albumin (HSA). Ten minutes after injection of the dose, 0.5 ml of blood was withdrawn from the carotid or femoral artery and duplicate samples of 0.025 ml of blood were counted after separating RBCs from plasma. Total blood volume was calculated by adding RBC volume and plasma volume. The relationship for the entire group was: BV (ml) = 0.06 X BW + 0.77 (r = 0.99, n = 70, p less than 0.001). The difference between male and female rats was not statistically significant. The use of an arbitrary value of 7% for estimation of blood volume can lead to significant errors in calculating radiopharmaceutical distribution. The use of the general formula for the blood-volume calculation described here should improve the accuracy and reliability of estimates of radiopharmaceutical distribution. PMID- 3965656 TI - Multiple-hospital survey of ejection-fraction variability using a cardiac phantom. AB - A dynamic cardiac phantom was used to provide identical input data at 11 different nuclear medicine laboratories throughout the Philadelphia area, and the variability in the resulting calculations of ejection fraction (EF) was assessed. The variability observed between different operators using the same computer system averaged 3 EF units, which was similar to that between different observers using different types of computers. In the range of low ejection fractions, however, there was a suggestion that EFs calculated with an MDS computer were slightly lower than those from a DEC computer. PMID- 3965657 TI - Data acquisition using a scintillation detector interfaced to a personal microcomputer. AB - A method is described for interfacing a cadmium telluride semiconductor nonimaging detector to a personal microcomputer in order to store and display nuclear medicine data. There was virtual identity between the count rates stored in the computer and those recorded from the detector's display, demonstrating that the computer accurately acquired data from the probe without erroneous loss or addition of data. Interfacing a nonimaging detector to a microcomputer may provide an extremely versatile method of acquiring, storing, and displaying nuclear medicine data. PMID- 3965658 TI - Regional quantitative noninvasive assessment of cerebral perfusion and function with N-isopropyl-[123I]p-iodoamphetamine. AB - Although several reports on the clinical usefulness of N-isopropyl-[123]p iodoamphetamine (IMP) in the diagnosis of cerebral disease have appeared in the literature, quantitative, noninvasive measurements of regional cerebral blood flow with this method pose difficulties because cerebral IMP uptake not only depends on cerebral perfusion but also on cerebral function. Rather than trying to develop a method to measure cerebral perfusion with IMP, we have chosen to test a method to quantitatively evaluate planar and emission computed tomographic (ECT) studies by comparing the data obtained in patients with established pathology (n = 51, number of scans = 54) with the data obtained in a group of normal individuals (n = 10, number of scans = 11). Using this method, absolute cerebral IMP uptake (counts/pixel/mCi/min) and planar anterior right-left ratios were obtained. Also measured were right-left ratios obtained from 12 paired regions in three ECT slices. In the control group, we found an IMP uptake of 35.6 +/- 4.3 cts/pixel/mCi/min and right-left ratios around 1.00 (s.d. less than 2%). The evaluation of the patients cerebral IMP uptake asymmetries relative to the normal standard values is a useful adjunct to qualitative image analysis in assessing the presence and severity of disease, as qualitative analysis is prone to false-positive and negative results. Cerebral IMP uptake as measured in cts/pixel/mCi/min is abnormal only in severe cerebral disease and therefore generally a less helpful parameter. PMID- 3965659 TI - Use of NEMA protocols for routine quality assurance. PMID- 3965660 TI - Radionuclide imaging in pulmonary edema. PMID- 3965661 TI - Brain tumor imaging using C-11-labeled L-methionine and D-methionine. PMID- 3965662 TI - Effect on the interaction of dietary carbohydrate and fat on the responses of rats to starvation-refeeding. AB - The interacting effects of sucrose or starch with corn or coconut oil on the lipogenic responses of rats to starvation-refeeding was studied. Rats were either ad libitum-fed or starved for 48 h and refed for 48 h. Four different diets were used: 65% starch-5% corn oil, 65% starch-5% coconut oil, 65% sucrose-5% corn oil, 65% sucrose-5% coconut oil. Lipogenesis was assessed in two ways: glucose-6 phosphate dehydrogenase (G6PD) activity, malic enzyme (ME) activity and percent liver lipid (expt 1) and tritium (3HOH) incorporation into fatty acids (expt 2). Starved-refed rats had more liver lipid, greater enzyme activity and greater 3H incorporation into fatty acids than ad libitum-fed rats. Sucrose-fed rats had more lipogenic activity than starch-fed rats. Rats fed coconut oil were more lipogenic than rats fed corn oil. There were highly significant correlation coefficients between the enzyme activities (G6PD and ME) and the percent liver lipid and between the enzyme activities and 3H incorporation into fatty acid. Analysis of variance of these data revealed significant dietary effects on these lipogenic responses to starvation-refeeding. We conclude that both dietary carbohydrate and lipid play a significant role in the determination of the magnitude of the lipogenic response to starvation-refeeding. PMID- 3965663 TI - Dual-isotope method for determination of human zinc absorption: the use of a test meal of turkey meat. AB - The percentage of 65Zn taken up (absorbed) from extrinsically labeled turkey meat was calculated from the amounts of 65Zn and a nonabsorbed 51Cr marker present in the body or in a single stool specimen after 1-2 d. 51CrCl3 proved to be a suitable marker for unabsorbed 65Zn and so the early determination of 65Zn absorption was possible. With stool counting, 65Zn absorption data from first stool samples after 1-2 d were accurate as judged by correlation with the amount of 65Zn in the body 7-10 d later (retention); results from subsequent stools gave lower absorption values due to the early excretion of some absorbed 65Zn. The dual-isotope method gave reproducible results when four successive tests of zinc absorption were carried out in a group of six subjects. The average (mean +/- SD) 65Zn absorption from turkey meals containing 31 mumol (2 mg) and 46 mumol (3 mg) of zinc was 39 +/- 8% and 29 +/- 6%, respectively, measured by stool counting; 65Zn absorption and retention correlated well in both studies. A series of different beverages was given in place of water with the turkey meal. Orange juice significantly reduced 65Zn absorption and milk also showed this tendency, but tea, whiskey, wine or beer had no significant effect on the absorption of 65Zn from the turkey meal. In groups of subjects the mean ratio of 65Zn absorption from extrinsically labeled turkey meat on two occasions (1.06) was not significantly different from that of the absorption of extrinsic to intrinsic 65Zn labels (1.16). The dual-isotope technique with either stool or body counting is suitable for the rapid determination of 65Zn absorption from extrinsically labeled turkey within 2 d. PMID- 3965664 TI - Elevated levels of dietary ascorbic acid increase immune responses in channel catfish. AB - Channel catfish fingerlings were fed purified diets containing 0 to 3000 mg/kg of ascorbic acid until external signs of scurvy were seen in the fish fed the ascorbic acid-deficient diet. At this time, resistance to bacterial infection, antibody production, complement activity and phagocytic activity were assessed for fish from the various dietary treatments. Mortality rates of fish experimentally infected with Edwardsiella ictaluri, the bacterium causing enteric septicemia in channel catfish, decreased with increases in dietary ascorbic acid doses, ranging from 100% for fish fed the ascorbic acid-deficient diet to 15% for fish fed 300 mg ascorbic acid per kilogram diet and 0 for fish fed 3000 mg ascorbic acid per kilogram diet. Antibody response to E. ictaluri antigen, hemolysis of sensitized sheep erythrocytes by complement activity and phagocytic engulfment of E. ictaluri by peripheral phagocytes were each impaired in fish fed the diet without supplemental ascorbic acid; intracellular bactericidal activity of the phagocytes was not affected by ascorbic acid deficiency. There were no differences in antibody production, complement activity, or phagocytic activities among fish fed diets containing 30-300 mg ascorbic acid/kg of diet. However, the dose level of 3000 mg ascorbic acid/kg significantly enhanced antibody production and complement activity. PMID- 3965665 TI - Carnitine levels in iron-deficient rat pups. AB - Hypertriglyceridemia and fatty livers have been observed in pups of Fe-deficient rats. Lowered tissue carnitine level is proposed as a mechanism responsible for altered lipid metabolism. Two hydroxylases involved in carnitine synthesis have been shown to require Fe in vitro. To determine if dietary Fe deficiency reduces tissue carnitine levels, two groups of 12 rats were fed 6 ppm Fe (-Fe) or 250 ppm Fe (+Fe) ad libitum from d 1 gestation to d 16 lactation. Feeding -Fe diets to dams resulted in 15% lower hemoglobin levels in pups on d 2 (P less than 0.02) and 50% lower levels on d 16 (P less than 0.001). Total carnitine level (nanomoles/milligram noncollagen protein) and triacylglycerol were assayed in pup tissues on d 2 and 16. While tissue carnitine and triacyglycerol was similar on d 2, d 16 liver carnitine was lower (P less than 0.001), triacylglycerol was eightfold higher in -Fe pups than in controls. Fe deficiency did not alter either carnitine concentration in milk on d 2 or 16 or the concentration of amino acid precursors of carnitine in milk on d 16. Decreased carnitine levels in the -Fe rat pup are contribute to triacylglycerol accumulation in liver. PMID- 3965666 TI - Deficiency of pyrroline-5-carboxylate synthase in the intestinal mucosa of the cat. AB - Pyrroline-5-carboxylate synthase activity of the intestinal mucosa of cats was compared to that of rats and found to be only 18% as high per gram of mucosa and only 5% as high per kilogram body weight. This severe limitation in the first step in the de novo synthesis of ornithine may be the metabolic basis for the severe hyperammonemia found in cats fed an arginine-deficient diet. This lack of ornithine synthesis makes the cat completely dependent on dietary arginine for the ornithine required for the removal of ammonia via urea synthesis in the liver. PMID- 3965667 TI - Simulation of normal protein accretion in rats. AB - A dynamic model of growth in rats has been developed based on the application to whole-body protein of terms previously identified in relationship to hyperplasia and hypertrophy of individual mammalian tissues and organs. Differential equations determined to be the simplest adequate to simulate postweaning growth patterns describe DNA accretion, protein synthesis and protein degradation. Maximum cell number (DNAMX) and cell size (protein/DNA) are implicit in the equations as genetically specified regulators of growth. Effects of differences in mature size on patterns of growth are accommodated by adjusting rate constants such that at equal maturity, rates are proportional to mature size to the 0.73 power. The sensitivity of the model was tested for independently derived parameter values and all deduced parameters. Model behavior is sensitive to the definition of DNAMX but is relatively insensitive to other parameter values. In particular, protein synthesis and degradation rates are highly correlated so that an independent estimate of one or the other is required to define the model. Rate constants optimized with respect to data on DNA and protein accretion in male Sherman rats (DNAMX = 429 mg) were used to simulate growth of male Sprague-Dawley rats (DNAMX = 150 mg). Good agreement was obtained between observed and predicted values with no systematic error of prediction. PMID- 3965668 TI - Response surfaces of body protein and energy gains in growing chicks fed diets over the entire range of compositions of protein, fat and carbohydrate. AB - Responses of metabolized energy, body protein gain and body energy gain of growing chicks to dietary composition of energy-yielding nutrients were studied. Twenty-seven groups of White Leghorn male chicks were force-fed purified isocaloric diets that covered the entire range of composition on a gross energy basis (0 to 100%) of protein, fat and carbohydrate for 10 d. Prediction equations of response surfaces of metabolized energy, body protein gain and energy gain were formulated by multiple regression techniques. The response surface of metabolized energy had a convex configuration and showed that the contribution rate of each energy-yielding nutrient to energy metabolizability varied with the levels of the three nutrients in the diet. Feeding protein-free diets especially diminished the metabolizability of carbohydrate and fat. The response surface of body energy gain was roughly parallel to that of metabolized energy, but the former was highly dependent on the caloric ratio of dietary carbohydrate to fat and reached a plateau at about 20% protein gross energy. Body protein gain increased almost linearly with an increase in protein in a low protein field, reaching a plateau at about 55% protein gross energy and was not very much affected by the calorie ratio of dietary carbohydrate to fat. In terms of energy yielding nutrients, these results have provided an insight into the "balanced ration" for maximal body energy gain and body protein gain. PMID- 3965669 TI - Changes in response to ascorbic acid administered orally to rat pups: lung collagen, elastin and protein synthesis. AB - Rat pups were supplemented orally with high doses of L-ascorbic acid (AA) or D isoascorbic acid (IA) throughout suckling. The regulation of AA in the lung and its relationship to collagen and elastin deposition were examined. Based on known responses of smooth muscle cells and fibroblasts in culture to high concentrations of AA, it was hypothesized that a markedly elevated intake of AA should increase net collagen deposition, but decrease net elastin deposition in the neonatal rat lung. In two experiments, groups of rat pups were gavaged daily with AA (in saline), in amounts corresponding to 0.1, 1 or 2% of the total consumed milk solids. As controls, pups were gavaged with IA (2% of the milk solids) or saline. The treatments were initiated 2 d postpartum and continued for 19 or 23 d. Compared to the saline-gavaged pups. AA and IA were elevated (twofold) in serum and lung at d 11, but not at d 25. Urinary excretion represented a major route for elimination of excess AA and IA. With respect to collagen and elastin accumulation, only elastin consistently was altered (10-20% decrease) in groups supplemented with AA or IA at the termination of experiments. The rodent appears to defend against elevation of AA concentration in the lung. Consequently, the putative effects of AA on the net deposition of lung collagen and elastin in vivo are less obvious than effects reported by others from in vitro studies. PMID- 3965670 TI - Nomenclature policy: generic descriptors and trivial names for vitamins and related compounds. PMID- 3965671 TI - Determinants of weight and adiposity in the first year of life. AB - To overcome methodologic defects (failure to control for confounding factors, univariate statistical analyses) in previous studies of etiologic determinants of childhood adiposity, we carried out a prospective cohort study of 462 healthy, full-term infants observed from birth to 12 months. Postpartum, we obtained sociodemographic data and administered two recently validated scales of maternal attitudes toward feeding and infant body habitus. Parental heights and weights and infant feeding variables were determined by interview, and at 6 and 12 months we measured height and weight and triceps, subscapular, and suprailiac skinfolds. Multiple regression analysis was used to determine independently predictive factors for weight, body mass index (BMI = weight/height), and the sum of the three skinfold measurements. Birth weight, sex, age at introduction of solid, and duration of breast-feeding were all significant predictors of weight at 12 months (r2 = 0.296, P less than 0.0001). Significant determinants for BMI included birth weight, duration of breast-feeding, sex, and IBH (r2 = 0.125, P less than 0.0001); those for total skinfold were age at introduction of solid foods and birth weight (r2 = 0.038, P = 0.002). Similar results were obtained at 6 months, although slightly less of the variance was explained. We conclude that the ability to predict which babies will be heavy or obese during the first year is limited. Breast-feeding and delayed introduction of solid foods do offer some protective effect, however, and thus efforts to encourage these practices may be reaping some benefit. PMID- 3965672 TI - Influence of gestational age on cord serum bilirubin binding studies. AB - The effect of gestational age on bilirubin binding was studied using cord serum from 22 preterm infants and 13 term infants and serum from 17 adults. Using the peroxidase oxidation method, a bilirubin titration curve was obtained by adding bilirubin to serum and measuring the apparent unbound bilirubin concentration. The resultant curve was analyzed using the least-squares fit of the empiric equation Y = aXb. After correction for albumin concentration by plotting the apparent unbound bilirubin concentration against the molar ratio of total bilirubin/albumin, term and preterm infants had identical titration curves, which remained inferior to that of adults. In addition, the apparent primary bilirubin association constant Ka'1 was similar for all infants but was two to three times less than that for adults. We conclude that bilirubin binding by cord serum is equivalent regardless of gestational age. However, adult serum binds bilirubin qualitatively better than does serum from infants of all gestational ages. We suggest that the adverse effect of prematurity on bilirubin binding noted in previous studies may have reflected postnatal complications rather than gestational age as such. PMID- 3965673 TI - Cardiorespiratory status in relation to mild deformity in adolescent idiopathic scoliosis. AB - We assessed the cardiorespiratory function in young persons with adolescent idiopathic scoliosis as they entered adult life; the condition had been detected and managed through a Montreal area school screening program in the years 1975 to 1979, and all patients had been discharged with stable condition. Thirty-two youths (average age 17.7 years) with Cobb angle from 3 to 32 degrees and 93 girls (average age 17.3 years) with Cobb angle from 3 to 46 degrees did not differ from their unaffected school friends in smoking habit, respiratory symptoms, lung volumes, expiratory flow rates, diffusing capacity, maximal respiratory pressures, or submaximal exercise results. When expressed as percent predicted, pulmonary functions were within the normal range in all but one patient. Normal results were also recorded in a subsample of 20 girls undergoing a more detailed progressive maximal exercise test. This information is pertinent for counseling the adolescent with scoliosis but needs to be supplemented by prospective measurements to determine the natural history of mild scoliosis in later adult life. PMID- 3965674 TI - Accuracy of the Welch Allyn AudioScope and traditional hearing screening for children with known hearing loss. AB - The Welch Allyn AudioScope is a new screening instrument that allows both audiometric testing at 500, 1000, 2000, and 4000 Hz at 25 dB hearing level and otoscopic examination. Sixty-eight patients between 3 and 9 years of age with normal hearing or a variety of hearing losses comprised the study population. Immediately after receiving an audiologic evaluation the subjects were screened with a traditional screening audiometer and two examinations with the AudioScope, performed in a clinic examining room by pediatricians and nurse practitioners unaware of the children's hearing status. The AudioScope was as accurate as traditional hearing screening in identifying children with normal hearing and those with hearing loss. Log-linear modeling demonstrated that the results of AudioScope testing were similar to those of traditional hearing screening. However, the false positive rate was higher at 500 Hz for the first AudioScope examination, suggesting the need for two AudioScope tests. The AudioScope was quick and easy to use, nonthreatening to the subjects, less expensive than a pure tone screening audiometer, and does not require a sound-treated room. PMID- 3965675 TI - Growth and sexual maturation in thalassemia major. AB - Growth and sexual development were evaluated in 250 adolescents with beta thalassemia major. Before transfusion hemoglobin concentration had not been less than 9.5 gm/dl in the last 5 years; desferrioxamine had been administered for 7 to 10 years, including by the subcutaneous route for 3 years. Thirty-seven percent of patients were found to be 2 SD below the mean for normal height; after age 14 years the percentage was 62% for males and 35% for females. Eighty-three percent of males and 75% of females had delayed skeletal maturation. Complete lack of pubescent changes was present in 38% of females and 67% of males aged 12 to 18 years. Only 19% of females had experienced menarche; secondary amenorrhea intervened in a third of them. A multiple regression analysis of indicators of pubertal development with age, age at first transfusion, age at splenectomy, number of transfusions, serum transaminase and ferritin, and duration and intensity of chelation therapy failed to identify the factors responsible for the variation observed in sexual maturation among patients with thalassemia. PMID- 3965676 TI - Behavior problems and social competence in girls with true precocious puberty. AB - We report a controlled standardized behavioral assessment of 33 girls with true precocious puberty using the Child Behavior Checklist. Although a majority of the girls were reported not to have behavior problems, many were reported to have a dysphoric adjustment to their condition. Twenty-seven percent of the girls with true precocious puberty scored greater than 2 SD above the mean on the Total Behavior Problem scale 10 times the expected prevalence rate. They also scored significantly higher (P less than 0.01) than matched controls on both the internalizing or "overcontrolled symptom" and externalizing or "undercontrolled symptom" scales. Forty-eight percent scored greater than 2 SD above the mean on the Social Withdrawal scale. The high prevalence of reported problem behaviors in this sample may be related directly or indirectly to the precocious maturation mediated by biologic, psychologic, social, and environmental variables. Although elevated levels of sex steroids may directly contribute to increased aggressive and hyperactive behaviors, they may also be modified by social and environmental factors. PMID- 3965677 TI - Chlamydia trachomatis causing pleural effusion. PMID- 3965678 TI - Asymptomatic autosomal dominant hypoparathyroidism in six family members of a symptomatic infant. PMID- 3965679 TI - Calcification following heel sticks. PMID- 3965680 TI - Midarm muscle circumference as indicator of muscle mass. PMID- 3965681 TI - Recurrent severe infections in a girl with apparently variable expression of mosaicism for chronic granulomatous disease. AB - A carrier of chronic granulomatous disease (CGD) has had recurrent severe purulent infections like those characteristic of CGD. The carrier state was demonstrated by the presence of both normal and CGD granulocytes in her blood; the percentage of normal granulocytes varied from 4% to 44% over 4 years. In addition, her granulocytes were partially defective in killing Escherichia coli and staphylococci and in the release of superoxide anion during stimulation. Extensive evaluation of her immune system and phagocyte function failed to reveal a second abnormality. The course in this child indicates that the carrier state for X-linked CGD cannot be considered a benign condition and might be more properly conceptualized as a continuum in expression of the full disease. Screening assays for CGD should possess the capacity to diagnose carriers of the X-linked form of the disease. PMID- 3965682 TI - Suppression of granulopoietic progenitor cell proliferation by metabolites of the branched-chain amino acids. AB - The effects of branched-chain amino acid metabolites on granulocyte-macrophage progenitor cell proliferation in marrow culture are reported. Isovalerate and propionate profoundly suppress granulopoiesis at both 3.2 and 6.4 mM concentrations, whereas methylmalonate and other metabolites suppress to a lesser degree. The parent branched-chain amino acids leucine, isoleucine, and valine do not suppress in vitro granulopoiesis at similar concentrations. Because the concentrations of the organic acids tested fall within the pathophysiologic ranges observed in patients with isovaleric, propionic, and methylmalonic acidemias, we suggest that elevated in vivo levels of isovalerate, propionate, and to a lesser degree methylmalonate are responsible for the neutropenia observed in these disorders. PMID- 3965683 TI - Reappraisal of digitalis in infants with left-to-right shunts and heart failure. PMID- 3965684 TI - Tooth exfoliation and osteonecrosis of the maxilla after trigeminal herpes zoster. PMID- 3965685 TI - Coronary arterial thrombi in Kawasaki disease. PMID- 3965686 TI - Cause of hearing loss in the high-risk premature infant. AB - Bilateral hearing loss occurred in 9.7% of infants who survived despite very low birth weight (less than or equal to 1500 gm), 16.7% of infants who survived neonatal seizures, and 28.6% of infants who survived both low birth weight and neonatal seizures. All neonates received treatment in a single neonatal intensive care unit between 1976 and 1980. Twenty-two of 36 hearing-impaired children were normal physically and mentally, with IQ scores of greater than or equal to 85. Significant neonatal predictors of hearing loss in high-risk premature infants (less than or equal to 36 weeks gestation), as determined by multivariable testing, were prolonged respirator care, high serum bilirubin concentration, and hyponatremia. Exchange transfusions were associated with a decreased risk of hearing loss. PMID- 3965687 TI - Amrinone effects on electromechanical coupling and depolarization-induced automaticity in ventricular muscle of guinea pigs and ferrets. AB - The effects of the cardiotonic agent, amrinone (0.05-4 mM), on electrical and mechanical activities of ferret and guinea-pig papillary muscles were studied using current and voltage clamp (single sucrose gap) techniques. In current clamp studies, amrinone increased, in a dose-dependent manner, contractile force elicited by action potential in both species. Depolarization-induced automaticity was facilitated in ferret muscles at all maximum diastolic potentials between -70 and -15 mV. Facilitation of automaticity in guinea-pig muscles occurred only at potentials more negative than -35 mV and was suppressed at more positive potentials. Cimetidine (10 microM) partially reversed the effects of amrinone on automaticity in both species. In voltage clamp studies, amrinone increased the slow inward current. Steady-state outward current was increased in guinea-pig but not in ferret muscles. A dual effect of amrinone on tension was observed. Amrinone was found to increase phasic tension of ferret papillary muscles only for depolarizations lasting less than 250 to 300 msec. For longer depolarizations, amrinone decreased the phasic tension (in a dose-dependent manner), whereas the tonic tension was not modified. The decrease as well as the increase in tension was associated with an increase of the slow inward current. The results suggest that amrinone may be arrhythmogenic and may have an intracellular action at the sarcoplasmic reticulum level (partial inhibition) in addition to its action on the calcium current. PMID- 3965688 TI - Antidiuretic hormone antagonists and aquaresis in dogs: different vasopressin sensitivity and antagonist potency in renal cortex and papilla. AB - To understand the molecular mechanism of action of the novel class of diuretic agents, the antidiuretic hormone antagonists ["aquaretics" (specific water-losing activity as caused by vasopressin antagonists, as distinguished from the saluresis of conventional diuretics)], in the dog studies were made of the properties of the vasopressin-responsive adenylate cyclase system and the antagonist potencies of the vasopressin analogs [1-(beta-mercapto-beta, beta cyclopentamethylenepropionic acid), 2-(O-ethyl)tyrosine,4-valine,8 arginine]vasopressin; [1-(beta-mercapto-beta-mercapto-beta, beta cyclopentamethylenepropionic acid), 2-D-phenylalanine,4-valine,8 arginine]vasopressin; and [1-(beta-mercapto-beta, beta-cyclopenta methylenepropionic acid), 2-D-(O-ethyl)tyrosine,4-valine,8-arginine]vasopressin (SK&F 100398, 101071 and 101498, respectively) using plasma membranes prepared from cortex, medulla and papilla of dog kidney. It was observed that the greatest sensitivity for vasopressin was in the papilla (concentration of 8-arginine vasopressin required for 50% activation of adenylate cyclase [Kact] was 2.0 X 10( 9)M, 1.1 X 10(-9)M and 5.1 X 10(-10) M in the cortex, medulla and papilla, respectively). The addition of 10(-5)M GTP did not alter the Kact of the cortex but enhanced 10-fold the vasopressin sensitivity of the papilla to 5.2 X 10(-11) M. The vasopressin analogs were competitive antagonists of vasopressin-stimulated adenylate cyclase of cortex and papilla with the greatest potency for the papillary enzyme (Ki in papilla was 3.6 X 10(-9)M, 4.6 X 10(-9)M and 1.0 X 10( 9)M for SK&F 100398, 101071 and 101498, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965689 TI - Clinical pharmacology of tomoxetine, a potential antidepressant. AB - Tomoxetine (LY139603) selectively inhibits norepinephrine uptake in animals and has activity in animal models of depression. Tomoxetine was administered in single oral doses up to 90 mg to healthy normal volunteers. In addition, normal human subjects received either 20 or 40 mg of tomoxetine b.i.d. for 1 week to evaluate the safety and pharmacologic activity of the compound in humans. At these doses, no serious drug-related adverse effects were encountered. Activity of the compound at the lower dose (20 mg b.i.d.) was evaluated by examining changes in the pressor responses to infused norepinephrine and tyramine and by determining [3H]serotonin uptake in platelets harvested from subjects receiving the compound. Pressor sensitivity to norepinephrine was increased by 261 +/- 69% of control, and pressor sensitivity to tyramine was decreased by 51 +/- 6% of control during treatment. Changes in the pressor sensitivity to norepinephrine in individual subjects were positively correlated with drug levels. There were no statistically significant changes in platelet [3H]serotonin uptake. These results indicate that tomoxetine selectively inhibits norepinephrine uptake in humans at doses which are clinically well tolerated and suggest that tomoxetine has potential clinical use as an antidepressant. PMID- 3965690 TI - Imipramine and desipramine disposition in the elderly. AB - Forty-six healthy male and female volunteers aged 21 to 88 received single 12.5 mg i.v. doses of imipramine, and 35 of these people received single 50-mg p.o. imipramine doses on a different occasion. Thirty-five similar volunteers received single 50-mg p.o. desipramine doses. Among these subjects 25 participated in studies of both imipramine and desipramine. Kinetic variables for the respective drugs were determined from multiple plasma drug concentrations from samples obtained during 96 hr after the dosage. Imipramine half-life was markedly prolonged in elderly vs. young males (28.6 vs. 16.5 hr; P less than .001) and females (30.2 vs. 17.8 hr; P less than .01) due to decreased clearance (males: 567 vs. 945 ml/min, P less than .01; females: 599 vs. 975 ml/min, P less than .005) with no change in volume of distribution. After p.o. imipramine doses time to peak imipramine concentration was shorter in elderly females (2.1 vs. 4.8 hr; P less than .005) but no different in males. Peak concentration achieved was greater in the elderly of both sexes (males: 40.2 vs. 19.5 ng/ml, P less than .005; females: 44.7 vs. 10.4 ng/ml, P less than .01). Comparison of p.o. and i.v. imipramine doses indicated no difference in absolute bioavailability between the elderly and young of either sex. In contrast, after p.o. desipramine more limited age-related changes were noted. Desipramine half-life was slightly prolonged in elderly males (30.8 vs. 21.2 hr; P less than .05) apparently related to a nonsignificant decrease in p.o. clearance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965691 TI - Changes in histidine uptake and histamine synthesis during the growth cycle of rat basophilic leukemia (2H3) cells. AB - Rat basophil leukemia (2H3) cells, like normal rat peritoneal mast cells, were shown to take up and decarboxylate histidine. Uptake was mediated by a temperature-dependent system with high affinity (apparent Km 24 +/- 4 microM) for histidine. Newly formed histamine was incorporated into the intracellular pool of histamine. In confluent cultures, substantial amounts of histamine were lost to the medium while intracellular histamine levels remained constant. As calculated from the rate of appearance of histamine in the medium, the maximum turnover time for the intracellular histamine pool (2-7 nmol/10(6) cells) was about 12 hr. Variation in histamine content, histidine uptake and histidine decarboxylation was noted with different passages of 2H3 cells, but with all passages there were characteristic changes in these parameters during growth and division of the cells. Separation of cells into fractions of different size by elutriation indicated low rates of histidine uptake and decarboxylation in the smallest 2H3 cells, a progressive increase in ability to take up and decarboxylate histidine as the cells approached the S phase of growth and marked decline in this ability in fractions containing the larger cells. The changes in kinetic constants suggested that fluctuation in histidine uptake during the life cycle of the 2H3 cell was due to changes in the number of active carriers or sites of histidine transport and that during cell division all components associated with histamine synthesis (i.e., histidine uptake and decarboxylation) were diminished. PMID- 3965692 TI - Acute effects of marihuana smoking on prolactin levels in human females. AB - Plasma prolactin levels were determined in 16 healthy adult females before and after marihuana cigarette (1.83% delta 9-tetrahydrocannabinol) and placebo cigarette smoking. All subjects served as their own controls in double blind studies which were carried out on a residential research ward facility. Eight women were studied during the follicular phase and eight women were studied during the luteal phase of the menstrual cycle. Marihuana smoking did not produce any significant changes in plasma prolactin levels during the follicular phase of the menstrual cycle. However, plasma prolactin levels were significantly lower at 60 to 120 min (P less than .01) and 150 to 180 min (P less than .05) after marihuana smoking during the luteal phase of the menstrual cycle. Marihuana induced suppression of plasma prolactin levels occurs in women but has not been observed in studies with human males. PMID- 3965693 TI - Neuropharmacological characterization of fragment B from tetanus toxin. AB - Tetanus toxin and Fragment B from tetanus toxin were assayed for activity on the mouse phrenic nerve-hemidiaphragm preparation. Both molecules produced blockade of neuromuscular transmission, but the parent molecule was at least two orders of magnitude more potent than the fragment. Experiments were done to determine whether the toxicity attributed to Fragment B was authentic or due to contamination with the parent molecule. Analysis of the fragment by high performance liquid chromatography and by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate revealed trace contamination. Removal of the major contaminant (1-2%) did not abolish toxicity of the material. However, in pharmacological experiments with native toxin and its fragment, the latter behaved indistinguishably from the former. At equiactive concentrations, both were antagonized by Fragment C and both were antagonized by lysosomotropic agents (ammonium chloride and methylamine hydrochloride). In addition, monoclonal antibodies directed against epitopes in Fragment C neutralized both native toxin and the material presumed to be Fragment B. The studies with antagonists and antibodies suggest that the toxicity apparently associated with Fragment B was in fact due to trace contamination with the parent molecule. In experiments on planar lipid bilayers, Fragment B formed pH-dependent channels. This activity was not abolished by monoclonal antibodies directed against epitopes in Fragment C. The data indicate that Fragment B retains the ability to form channels in membranes, but in the absence of Fragment C it retains little ability to paralyze neuromuscular transmission. PMID- 3965694 TI - Suppression of repetitive firing of neurons by diphenylbarbituric acid. AB - A slow outward current has been demonstrated in Aplysia giant neurons which serves to suppress repetitive firing. The barbiturates phenobarbital and pentobarbital enhance the slow outward current and the suppression of repetitive firing. In this study, the effects of diphenylbarbituric acid, which shows anticonvulsant activity in mice and rats but possesses minimal sedative properties, were tested on slow outward current and firing behavior. Diphenylbarbituric acid enhances slow outward current and suppresses repetitive firing at lower concentrations than phenobarbital and pentobarbital. Because diphenylbarbituric acid is effective at enhancing slow outward current but does not produce sedation, this property of barbiturates is apparently not associated with the sedative properties of these drugs, but rather is important for the anticonvulsant effects. PMID- 3965695 TI - Gentamicin or chlorphentermine induction of phospholipidosis in the developing organism: role of tissue and species in manifestation of toxicity. AB - Daily, s.c. injection of gentamicin (100 mg/kg) for 2 days produced a significant increase in total phospholipid content of newborn rat kidney. Separation of individual phospholipid components revealed a significant rise in renal phosphatidylserine, phosphatidylinositol and phosphatidylcholine, whereas no marked change was noted in sphingomyelin, phosphatidylethanolamine or phosphatidylglycerol. Gentamicin did not significantly alter individual phospholipid classes and total phospholipid content in newborn rat liver and lung. Daily, oral chlorphentermine (60 mg/kg) administration also elevated total renal phospholipid levels and all individual phospholipid classes except sphingomyelin. In addition, a significant rise in all phospholipid components and total phospholipid content was noted in lungs of chlorphentermine-treated newborns. In the case of rat kidney, both gentamicin and chlorphentermine produced the greatest percentage of increase in phosphatidylinositol, whereas in lung phosphatidylcholine exhibited the highest percentage of elevation in response to chlorphentermine. In newborn rat liver, chlorphentermine did not induce alterations in individual and total phospholipid content. Gentamicin or chlorphentermine (1 mg/egg) failed to induce a phospholipidosis in chick embryo kidney and liver. Evidence suggests that drug-induced phospholipidosis is both species- and tissue-dependent and that this metabolic phenomenon is associated with inhibition of lysosomal phospholipases. PMID- 3965696 TI - Influence of fraction unbound upon the renal clearance of furosemide in the isolated perfused rat kidney. AB - The influence of fraction furosemide unbound (varied over a 28-fold range) upon its renal clearance was studied in an isolated perfused rat kidney, while renal function was maintained. Renal clearance and unbound fraction of furosemide were found to be related linearly, the average unbound renal clearance being 3.3 ml min-1. Urine pH and urine flow rate did not influence furosemide renal clearance in the ranges experienced in this study. Our results are consistent with those predicted from a consideration of the kinetics of renal excretion. PMID- 3965697 TI - Inhibitory effect of quinacrine on myocardial reactive hyperemia in the dog. AB - We investigated the effect of quinacrine, a phospholipase A2 inhibitor, on myocardial reactive hyperemic response after 5-, 10- and 20-sec coronary occlusions and adenosine-induced coronary vasodilatation in perfused dog hearts in situ. Continuous infusions of quinacrine (30-300 micrograms/min) into the left coronary artery significantly reduced both reactive hyperemic response and increase in coronary blood flow produced by intracoronary injections of adenosine (1-30 micrograms) without significant effect on basal coronary blood flow, perfusion pressure and heart rate. Neither acetylcholine- nor verapamil-induced increases in coronary blood flow were modified by quinacrine. The reactive hyperemic response and the vasodilatory effect of adenosine were both reduced by intracoronary infusions of theophylline (100-1000 micrograms/min). The inhibitory effect of theophylline on the reactive hyperemic response was less prominent than that of quinacrine, whereas the vasodilatory effect of adenosine was reduced to the same extent by both drugs. Intracoronary infusions of indomethacin (a cyclooxygenase inhibitor), phenidone (an inhibitor of both cyclooxygenase and lipoxygenase) and nordihydroguaiaretic acid (a lipoxygenase inhibitor) did not affect the reactive hyperemic response. The present results support the hypothesis that adenosine may be a mediator of myocardial reactive hyperemia and suggest that other factors, possibly phospholipase products, may also contribute to this phenomenon. We were unable to define the mechanism involved; however, it can be excluded that cyclooxygenase and lipoxygenase products of arachidonic acid contribute to myocardial reactive hyperemia. PMID- 3965699 TI - Discriminative stimuli produced by clonidine in spontaneously hypertensive rats: generalization to antihypertensive drugs with different mechanisms of action. AB - Spontaneously hypertensive rats were food deprived and trained to lever press on a fixed-ratio 10 schedule of food reinforcement in a paradigm in which responding was reinforced on one lever after an injection of clonidine (0.02 mg/kg) and on an alternate lever after an injection of saline. The spontaneously hypertensive rats learned the clonidine-saline discrimination to a criterion of correct lever selection on 10 consecutive days in an average of 39 training sessions. In subsequent tests, emission of clonidine discrimination responses was found to be both time dependent and dose dependent (ED50, 0.009 mg/kg). The antihypertensive drugs lofexidine (ED50, 0.03 mg/kg), guanabenz (ED50, 0.019 mg/kg), p aminoclonidine (ED50, 0.23 mg/kg), methyldopa (ED50, 21.8 mg/kg), hydralazine (ED50, 0.98 mg/kg), prazosin (ED50, 0.72 mg/kg), minoxidil (ED50, 12.4 mg/kg) and pergolide (ED50, 0.021 mg/kg) were generalized to clonidine in a dose-dependent manner. Yohimbine antagonized both the antihypertensive action and the discriminative stimulus properties of clonidine in parallel without antagonizing those actions of hydralazine. Similarly, the discriminative stimulus properties and antihypertensive action of pergolide were antagonized by sulpiride in parallel without antagonizing any of those effects when produced by clonidine or hydralazine. Although the stimulus properties and response-suppressive actions of the antihypertensive or other drugs were not related, the ED50 values for generalization of the drugs to the clonidine stimulus and for their antihypertensive action were highly correlated (r = 0.99). These data suggest that clonidine produces an interoceptive discriminative stimulus that is based upon its antihypertensive action in spontaneously hypertensive rats. PMID- 3965698 TI - Description and analysis of the myotonolytic effects of phenytoin in the decerebrate cat: implications for potential utility of phenytoin in spastic disorders. AB - Phenytoin (DPH) was evaluated for its capacity to reduce several motor manifestations of decerebrate rigidity in the cat. In doses of the order of 40 to 50 mg/kg i.v., DPH diminished the force necessary to collapse the hyperextended limbs; at about half this dose range, the drug reduced gamma-motoneuron discharges; at still lower doses the drug profoundly depressed mechanical and electromyographic responses evoked by stretch from both forelimb and hindlimb extensor muscles. Serum levels of DPH associated with substantial reduction in electrical and mechanical manifestations of the extensor hypertonus were of the same order conventionally encountered when the drug is administered to humans for acute seizure management. The data are supportive of a centrally and peripherally mediated muscle relaxing effect of the drug in states where muscle spindle involvement is a contributing factor, and may help to explain further the utility of DPH in the treatment of spasticity. PMID- 3965700 TI - Assay of dopamine receptors with [alpha-3H]flupenthixol. AB - Two major classes of dopamine receptors, called D-1 receptors and D-2 receptors, have been identified. [alpha-3H]Flupenthixol has been used as a radioligand for the study of D-1 receptors, which are thought to act through stimulation of adenylate cyclase activity. Previous studies in our laboratory have shown that the D-2 receptors in rat caudate labeled by [3H]spiroperidol also have a high affinity for alpha-flupenthixol. The present experiments show that although Scatchard analysis of the binding of [alpha-3H]flupenthixol is consistent with the presence of a homogeneous population of receptors, subpopulations of these sites can be distinguished by their differing affinities for spiroperidol, which has a Kd for D-1 receptors of about 0.3 microM and a Kd for D-2 receptors of approximately 50 pM. The number of D-1 receptors in rat striatum is approximately 4 times the number of D-2 receptors. D-1 receptors can be studied by including 10 nM spiroperidol in assays carried out with [alpha-3H]flupenthixol, thus blocking the binding of [alpha-3H]flupenthixol to D-2 receptors. The affinity of these receptors for dopamine is decreased by GTP, as has been observed in studies of other receptors whose effects are mediated through changes in adenylate cyclase activity. In the presence of spiroperidol, the Hill coefficients determined from dose-response curves of the inhibition of the binding of [alpha-3H]flupenthixol by antagonists or by agonists in the presence of GTP suggest that the binding reaction obeys simple Michaelis-Menten kinetics for a single class of binding sites. PMID- 3965701 TI - Structural requirements for muscarinic receptor occupation and receptor activation by oxotremorine analogs in the guinea-pig ileum. AB - The muscarinic activities in the isolated guinea-pig ileum of nine analogs of oxotremorine, modified only in the amino group, were resolved into affinity and efficacy components. The method used involved analysis of dose-response data before and after fractional inactivation of receptors with propylbenzilylcholine mustard. The dissociation constants (KA) thus obtained for oxotremorine (6.79 X 10(-7) M), oxotremorine methiodide (6.74 X 10(-6) M) and oxotremorine-M (2.92 X 10(-6) M) agreed well with their reported low-affinity dissociation constants (KL) determined in receptor binding studies. There was no correlation between relative affinities and efficacies of the nine agonists studied, suggesting different structural requirements for occupation and activation of muscarinic receptors in the guinea-pig ileum. Although oxotremorine had higher affinity than its analogs, some of the latter had substantially greater efficacy than oxotremorine. Thus, replacement of the pyrrolidine ring of oxotremorine by azetidino, dimethylamino or trimethylammonium groups was accompanied by a 4- to 7 fold increase in efficacy. A diethylamino group in place of pyrrolidine gave an 18-fold decrease in efficacy and a triethylammonium group abolished efficacy. The relative efficacies of the nine agonists were inversely correlated with the size of the amino or ammonium group. No significant correlation was observed between relative affinities for the receptor and size of the cationic head. PMID- 3965702 TI - N-2,3-Butadienyl-1,4-butanediamine derivatives: potent irreversible inactivators of mammalian polyamine oxidase. PMID- 3965703 TI - gamma-Aminobutyric acid esters. 2. Synthesis, brain uptake, and pharmacological properties of lipid esters of gamma-aminobutyric acid. AB - Two lipid esters of U-14C-labeled and unlabeled gamma-aminobutyric acid (GABA) were synthesized to test the possibility that natural lipid analogues, which resemble normal components of lipid bilayer membranes, can penetrate the blood brain barrier and transport exogenous GABA to the brain. The uptake of 1 linolenoyl-2,3-bis(4-aminobutyryl)propane-1,2,3-triol and 1,2-dilinolenoyl-3-(4 aminobutyryl)propane-1,2,3-triol into mouse brain relative to liver was found to be, respectively, 75- and 127-fold greater than that of free GABA. The results indicate that there is little or no blood-brain barrier for the GABA ester molecules at doses up to 0.36 mmol/kg. Both ester compounds, but neither free GABA nor the lipid components delivered systemically, demonstrated central nervous system depressant properties by inhibiting the general motor activity of mice. Brain tissue has esterase activity which can release GABA from these compounds. This suggests that these compounds function as "prodrugs" to release GABA in the CNS. PMID- 3965704 TI - Synthesis of some quaternary ammonium alkylating agents and their effects on soman-inhibited acetylcholinesterase. AB - A number of compounds were synthesized and tested for their ability to realkylate the phosphonate anion of "aged", soman-inhibited acetylcholinesterase. None were found able to do so, but two of the compounds in particular, [2-(4 pyridyl)ethyl]diethylmethylammonium iodide (6) and its 2-isomer 7, proved able to slow the rate of aging significantly. PMID- 3965706 TI - Potentiation of fasciolicidal agents by benzoyl side chains. Synthesis of benzoylsalicylanilides. AB - The synthesis and potent fasciolicidal activity of novel salicylanilides, with benzoyl substituents in the salicyl ring, is described. Several compounds surpassed the activity of commercially used flukicides against Fasciola hepatica infections in rats. Compounds 10, 11, and 15 were poorly active against the parasite in sheep and inactive in infected calves. It is concluded that the benzoyl substituents potentiate antiparasitic action by virtue of their electron withdrawing properties rather than by advantageous protein binding at parasite receptor sites. Poor activity in sheep is ascribed to in vivo reduction of the carbonyl in the benzoyl group of the anilides. PMID- 3965705 TI - 2-(beta-Arylethylamino)- and 4-(beta-arylethylamino)quinazolines as phosphodiesterase inhibitors. AB - The existence of several forms of cAMP phosphodiesterase having differing kinetic characteristics suggests the feasibility of developing tissue-selective inhibitors of this enzyme. This observation is of particular importance in the development of therapeutic agents for the management of reversible obstructive airways disorders. The present report describes the design, synthesis and pharmacological characterization of a series of 6,7-dimethoxyquinazoline derivatives having beta-arylethylamine substituents at the 2- or 4-positions. The quinazoline nucleus is intended to confer a high degree of inhibitory activity for phosphodiesterase while the beta-aryethylamine moieties are designed to provide selectivity for adrenergically innervated tissue. The target compounds of this study, 6 and 7, were prepared via beta-arylethylamine displacement of chloride from an appropriate chloroquinazoline intermediate. The resulting products were evaluated for their ability to relax guinea pig tracheal smooth muscle and as inhibitors of phosphodiesterase. PMID- 3965707 TI - Reactivators of organophosphorus-inhibited acetylcholinesterase. 1. Imidazole oxime derivatives. AB - 4-[(Hydroxyimino)methyl]-3-methylimidazolium iodides were prepared and tested for their reactivating potency on acetylcholinesterase inhibited by tetraethyl pyrophosphate (TEPP). The in vitro testing revealed that the new compounds are weak reactivators of the phosphorylated electrophorus acetylcholinesterase. PMID- 3965708 TI - Relationship between structure and antineoplastic activity of (arylsulfonyl)hydrazones of 4-pyridinecarboxaldehyde. AB - The effects of various structural modifications on the antineoplastic activity of (arylsulfonyl)hydrazones of 4-pyridinecarboxaldehyde were examined in mice bearing either Sarcoma 180 or P388 leukemia. The introduction of different functional groups into the phenyl ring of the benzenesulfonyl moiety did not alter tumor inhibitory activity appreciably, and the pyridine ring could be replaced by 4-nitrobenzene without loss of antineoplastic activity. However, the aldehyde proton and the hydrazone proton alpha to the sulfonyl group were essential, and their substitution resulted in inactive anticancer agents. PMID- 3965709 TI - Mechanism-based inactivation of N-arylhydroxamic acid N,O-acyltransferase by 7 substituted-N-hydroxy-2-acetamidofluorenes. AB - N-Arylhydroxamic acid N,O-acyltransferase (AHAT) catalyzes the transfer of the N acetyl group from N-arylhydroxamic acids to arylamines. In the absence of an arylamine acceptor, AHAT catalyzes the conversion of N-arylhydroxamic acids to reactive electrophilic intermediates that become irreversibly bound to cellular nucleophiles, including those present on AHAT itself. As part of an investigation of the AHAT-catalyzed bioactivation process, a series of 7-substituted analogues of N-hydroxy-2-acetamidofluorene (1) was synthesized and evaluated in vitro as substrates and inactivators of a partially purified hamster hepatic AHAT preparation. All of the compounds functioned as acetyl donors in the AHAT catalyzed transacetylation of 4-aminoazobenzene (AAB) and all of them were inactivators of AHAT. The inactivation process exhibited apparent first-order kinetics, and the 7-methoxy compound exhibited the largest inactivation rate constant. Quantitative structure-activity analysis provided support for the concept that positively charged species are involved in the inactivation of AHAT by this series of compounds. Results of experiments in which nucleophilic trapping agents such as glutathione, cysteine, methionine, guanosine phosphate, and tRNA were included in incubation mixtures with AHAT and the N-arylhydroxamic acids indicated that electrophiles which diffuse away from the enzyme active site participate in the inactivation process. PMID- 3965710 TI - Sleep-inducing N-alkyl-5-[m-(trifluoromethyl)phenyl]-5-hydroxy-2-pyrrolidinones and N-alkyl-3-(trifluoromethyl)cinnamamides. AB - A series of N-alkyl-3-[m-(trifluoromethyl)phenyl]-5-hydroxy-2-pyrrolidinones and N-alkyl-3-(trifluoromethyl)-cinnamamides were prepared and screened in a series of tests designed to detect potential sleep inducers. The more active members of the series were evaluated for their ability to induce sleep in Cebus monkeys. The most active compound, N-methyl-5-[m-(trifluoromethyl)phenyl]-5-hydroxy-2 pyrrolidinone, was equal to methaqualone. PMID- 3965711 TI - 1H-2-Benzopyran-1-one derivatives, microbial products with pharmacological activity. Conversion into orally active derivatives with antiinflammatory and antiulcer activities. AB - A novel gastroprotective substance, 6-[[1(S)-[3(S),4-dihydro-8-hydroxy-1-oxo-1H-2 benzopyran-3-yl] -3-methylbutyl]amino]-4(S),5(S)-dihydroxy-6-oxo-3(S) ammoniohexanoate (AI-77-B, 1), isolated from a culture broth of Bacillus pumilus AI-77, was chemically modified to prodrugs that are active by oral dosing. Compound 1 was lactonized and then monoalkylated at the primary amine position. Six N-alkylated gamma-lactone derivatives of 1 (with alkyl chains being methyl 5a, ethyl 5b, n-propyl 5c, n-butyl 5d, n-pentyl 5e, or n-hexyl 5f) were synthesized and eight compounds including 1 and gamma-lactone derivative 2 were compared for their gastroprotective activities and blood levels after oral administration in rats. Further, chloroform-water partition coefficients of 5a-f were also compared as a measure of lipid solubility. The protective effects of these compounds on stress ulcers were mutually related to blood levels of dealkylated compounds (1 and 2). Parent compound 1 was detected in blood at 1 h after each of 5a-d was administered. When 5b or 5c was administered, high activity and high blood levels of 1 were observed in comparison with those levels obtained with 5a or 5d. Neither 5e nor 5f were detected in any amount in blood by oral administration without special formulation due to extremely low solubilities and agglutinative properties in intestinal fluid. Interestingly, 5b and 5c were found to have antiinflammatory activities in addition to potent antiulcerogenicity action. PMID- 3965712 TI - Lack of influence of the carbamoyl group on the stereochemistry of the acid catalyzed opening of the aziridine ring of the mitomycins and of congeners. AB - The acid-catalyzed opening of the aziridine ring of mitomycins A and C is known to occur predominantly with cis stereochemistry. We have observed that the presence or absence of a carbamoyl group at C-10 of mitomycin C and in certain of its analogues does not have a significant influence on the stereochemistry of the opening of this ring. The trans product obtained from mitomycin C was shown to be stable when treated with acid under the conditions of its formation. Mitomycin B was also shown to yield predominantly the cis product when it was subjected to acid-catalyzed opening of its aziridine ring. The 1H NMR spectra of acetate derivatives prepared from mitomycin B show two sets of signals that are due to two populations of rotamers. The analysis of these spectra has substantiated several previous spectral assignments. This paper also presents some thoughts on acid-catalyzed bifunctional DNA alkylation by mitomycins and 10-decarbamoyloxy-9 dehydromitomycins. PMID- 3965713 TI - Metabolism of phencyclidine. The role of the carbinolamine intermediate in the formation of lactam and amino acid metabolites of nitrogen heterocycles. AB - The transformation of phencyclidine in a mouse liver microsome preparation to several oxidative metabolites was studied. With use of GLC and HPLC methods with internal standards, phencyclidine and six metabolites were quantitated and the amino acid 12, resulting from the alpha-oxidation of the piperidine ring, was produced in 10-50 times greater amounts than the other metabolites. While most piperidines and pyrrolidines produce an amino acid and a corresponding lactam, it was found that phencyclidine was not converted to the lactam 11. PMID- 3965714 TI - Drug glycosides: potential prodrugs for colon-specific drug delivery. AB - The influence of prodrug structure on specificity of glycoside/glycosidase based colon-specific drug delivery was studied by preparing nine steroid glycosides, measuring their relative lipophilicities, and hydrolyzing them with bacterial glycosidases from rat intestines. The 21-yl beta-D-glucosides and galactosides of dexamethasone, prednisolone, hydrocortisone, and fludrocortisone and the 21-yl beta-D-cellobioside of prednisolone were prepared by a modified Koenigs-Knorr reaction. The deacetylated glycoside prodrugs, along with the P-nitrophenyl derivatives of beta-D-glucoside, galactoside, and cellobioside, were subjected to hydrolysis by the contents of the rat stomach, proximal small intestine (PSI), distal small intestine (DSI), and cecum. All the prodrugs were hydrolyzed slowly by PSI and stomach contents, more rapidly by contents of the DSI, and most rapidly by cecal contents. This is the basis of the site-specific drug delivery reported earlier (Friend, D. R.; Chang, G. W. J. Med. Chem. 1984, 27, 261). Furthermore, the prodrugs themselves had very different susceptibilities to hydrolysis. Hydrolysis rates catalyzed by DSI contents decreased in the following order: prednisolon-21-yl beta-D-galactoside (10) greater than prednisolon-21-yl beta-D-glucoside (2) greater than prednisolon-21-yl beta-D-cellobioside (13) greater than dexamethason-21-yl beta-D-galactoside (9) greater than dexamethason 21-yl beta-D-glucoside (1). Hydrolysis of cellobioside 13 was only half that of glucoside 2 and one-fourth that of galactoside 10. Hydrolysis of all the prodrugs in cecal contents was rapid, with the exceptions of hydrocortison-21-yl beta-D glucoside (5) and fludrocortison-21-yl beta-D-glucoside (7), which were hydrolyzed more slowly than the other glucoside prodrugs. Eadie-Hofstee plots for hydrolysis of the glucoside compounds suggested that bacterial beta-D-glucosidase activity in the colon may be more heterogeneous in nature than beta-D galactosidase activity. Relative lipophilicities of the prodrugs and free steroids were compared by measuring their octanol-buffer partition coefficients (P). The logarithm of the P of cellobioside 13 (-0.56) was considerably lower than that of the other prodrugs, which ranged from 0.11 to 0.84. Log P of the free steroids ranged from 1.54 to 1.73. These relative rates of hydrolysis and relative lipophilicities, along with previously reported animal experiments, enable one to estimate the site specificity of glycoside prodrugs prior to extensive animal studies. PMID- 3965715 TI - 3-(1-Indolinyl)benzylamines: a new class of analgesic agents. AB - An extensive series of 3-(1-indolinyl)benzylamines and related compounds was synthesized and tested for analgesic activity. After a detailed study of structure-activity relationships, 3-(1-indolinyl)benzylamine (2b) was selected for further investigation as the most interesting member of this novel class of compounds. It was active in both the phenylquinone writhing and tail-flick assays for analgesic activity. No motor deficits were observed in the rotorod test, and 2b was found to be free of any other effects on the central nervous system. The compound did not bind to opiate receptors, since it was inactive in inhibiting the stereospecific binding of [3H]naloxone in rat brain homogenates. Thus, 3-(1 indolinyl)benzylamine represents a novel analgesic with an unusual chemical structure and biological profile. PMID- 3965716 TI - [(Aminomethyl)arloxy]acetic acid esters. A new class of high-ceiling diuretics. 3. Variation in the bridge between the aromatic rings to complete mapping of the receptor. AB - Continued structural evaluation of the [(aminomethyl)aryloxy]acetic ester diuretics has produced a series of compounds in which the functional group that bridges the two aromatic rings has been varied. Diuretic screening of these analogues in rats indicates that the keto group can be effectively replaced with an ether or thio ether function with a slight increase in potency, whereas the methylene and sulfoxide linking groups lead to diminished saluretic potency. Replacement with either -SO2-, -COCO-, -CH2O-, -CONH- or direct bond results in a loss of activity. Although the series was designed according to QSAR criteria, the traditional linear free-energy properties of these compounds do not correlate with diuretic potency. However, conformational analysis of the series by potential energy calculations indicates that all active compounds have an accessible conformation that matches the bridge atom-carboxylate distance of the very potent dihydrobenzofuran analogue 56. Conformational calculations of several compounds in which the aminomethyl group was varied suggests that the active conformation is probably a low-energy conformation. Consideration of rotation about the bridge could not distinguish between two possible orientations of the aminomethyl ring in the active conformation. However, there is a quantitative negative linear correlation between diuretic potency and the protrusion into space of the group that bridges the two aromatic rings. PMID- 3965717 TI - Comparison of the hypolipidemic activity of cyclic vs. acyclic imides. AB - Two series of nitrogen-substituted cyclic and acyclic imides were examined for hypolipidemic activity in mice after dosing for 16 days at a dose of 20 mg/kg per day. The hypolipidemic activity of the unsubstituted, N-butyl, N-3-oxobutyl, and N-2-carboxyethyl derivatives of diacetimide and succinimide were compared as well as the unsubstituted and N-substituted dibenzimide and diphenimide. It was shown that an imide functionality incorporated into a ring was not necessary for hypocholesterolemic activity. Good hypocholesterolemic activity was observed in both series of acyclic and cyclic imides. However, a cyclic imido structure was a necessary requirement for good hypotriglyceridemic activity. A decrease in hypotriglyceridemic activity was noted when comparing the cyclic imides to their respective acyclic congeners. PMID- 3965718 TI - Diterpenoid sweeteners. Synthesis and sensory evaluation of stevioside analogues with improved organoleptic properties. AB - Congeneric series of stevioside (1) and rebaudioside A (3) analogues have been prepared. It was found that the bitter-taste component endogenous in the natural compounds 1 and 3 may be eliminated by increase in molecular hydrophilic character. Through the series of compounds prepared, bitter-taste character was correlated with k', a chromatographic indicator of gross hydrophilicity. An analogue (11) of stevioside, shown chromatographically to be of increased hydrophilicity, was prepared and found to exhibit no bitter-taste character. Similarly an analogue (13) of rebaudioside A, having increased polarity, was prepared and found not to exhibit any bitter taste. The rebaudioside A analogue 13 was determined to have higher potency than 11 is suggested as a potential non nutritive sweetener for food applications. PMID- 3965719 TI - Dentistry in medical education: results of a comprehensive survey. AB - A survey of all U.S. and Canadian medical schools was undertaken to assess the current extent and nature of instruction in dental topics for medical students. The perceived importance of including such instruction in the undergraduate medical curriculum was ascertained, and barriers to teaching dental topics to medical students were identified. PMID- 3965720 TI - Self-evaluation in undergraduate medical education: a longitudinal perspective. AB - Although self-evaluation is crucial in the practice of medicine, few educators have formally introduced self-assessment into the undergraduate medical curriculum. However, students in the baccalaureate-M.D. degree program at the University of Missouri, Kansas City, must complete a self-evaluation at the close of every medical school course and rotation during the last four years of a six year curriculum. In this paper, the authors examine the self-ratings of 211 of these students as they progressed through the program in order to discover trends in and correlates of the self-assessments. Although the students' self evaluations and faculty members' ratings of these students' performances rose year by year, the relationship between the students' and the faculty's ratings decreased through time. Yet, results suggest that self-evaluation has educational merit as a measure of noncognitive abilities associated with clinical performance and as a stimulus to further learning and professional development. PMID- 3965721 TI - Comparison of intraining evaluation with tests of clinical ability in medical students. AB - Seventy-two medical students were studied regarding the predictive value of a number of evaluation procedures as they rotated through the Department of Medicine during their four-year undergraduate medical program at Queen's University in Kingston, Ontario, Canada. Scores obtained in two subjective evaluation procedures--one compiled at the completion of the second-year clinical skills course and the other at the end of the fourth-year clerkship--were compared with each other and with scores obtained on an objective structured clinical examination, two multiple-choice examinations, and two oral examinations. Even in this fairly homogeneous group of teachers and students, correlation between the different evaluation procedures was absent or slight. PMID- 3965722 TI - Factors predictive of physician location. AB - The results of a survey of 182 graduates from the University of South Dakota School of Medicine between 1969 and 1973 are reported and discussed. The study was designed to determine which factors are predictive of practice location. Individual factors found to be related significantly to physician location were size of community where the physician grew up, size of community where the physician's spouse was raised, size of the physician's high school graduating class, number of contacts with other physicians, importance to the physician of continuing medical education opportunities, importance to the physician of professional growth opportunities, and importance of the availability of medical facilities. In addition, a multiple regression procedure was used to determine the viability of a number of independent variables in predicting physician location. From a total of 29 independent variables obtained from the survey instrument, nine factors were found to contribute significantly to the overall prediction of practice location. PMID- 3965724 TI - Relationship of old and new MCAT scores to performance on the Part III examination of the NBME. PMID- 3965723 TI - Integrating cost awareness with ethics in the undergraduate medical curriculum. AB - The challenge to train medical students in cost awareness regarding medical care led to a program at the Oregon Health Sciences University that integrates concern for costs with medical ethics. Cost awareness is a perspective that balances the physician's ethical obligations toward individual patients with their duties toward society whose pooled resources pay for medical services. The program integrates the subject of cost awareness into major required courses spanning the four-year curriculum. First-year students see costs in the context of an overview of social aspects of medical care. For second-year students, cost awareness is incorporated into training in basic clinical skills. Third- and fourth-year students are shown the bill for one of their patients and analyze their ward experiences from the perspective of resource utilization. Junior and senior students examine the impact of the legal system and professional ethics on health care costs. Elective course work on cost awareness is also available. PMID- 3965725 TI - Students' attitudes toward career choice: a family practice perspective. PMID- 3965726 TI - Reactions of medical students to dissection. PMID- 3965727 TI - The role of the faculty adviser in a family medicine residency. PMID- 3965728 TI - The patient as teacher. PMID- 3965729 TI - Preliminary study at the Medical University of Southern Africa on student self assessment as a means of evaluation. PMID- 3965730 TI - Evaluation of clinical competence. PMID- 3965731 TI - Inflation and medical school faculty salaries. PMID- 3965732 TI - Impact of board certification on physician practice characteristics. AB - In the study reported here, the authors, using data from two American Medical Association surveys, examine the impact of board certification on selected physician practice characteristics. The results indicate that board certification is more prevalent for certain specialties, ages, types of practice, and locations of practice. Board certification has a substantial impact on the gross income of most major specialties, but these differences decline significantly for net incomes. Finally, comparisons of the hours worked per week and weeks worked per year show only small differences between board-certified and nonboard-certified physicians. PMID- 3965733 TI - Predicting energy expenditures in burned patients. AB - Daily caloric requirements in patients with major burns are frequently estimated using the Curreri formula (25 X body weight (kg) + 40 X % BSA burned). In nonburned patients modifications of the Harris-Benedict formulas have been used to estimate energy requirements. These equations have not been validated against measured energy expenditures in burned patients. Thirty-five patients with second and third-degree burns covering from 10 to 75% of the body surface area underwent assessments of energy expenditures by indirect calorimetry and by the Curreri and Harris-Benedict formulas. The mean energy expenditure calculated from the Harris-Benedict formulas (BEE) underestimated the mean measured energy expenditure (MEE) by 23% (p less than 0.001), while the mean energy expenditure calculated from the Curreri formula (CEE) overestimated the mean MEE by 58% (p less than 0.001). There were significant correlations between the MEE, BEE, and CEE. In patients with burns greater than 20% of the body surface area, the correlation between MEE and BEE was higher than that found with the Curreri formula. PMID- 3965734 TI - Cataracts: a long-term complication of electrical injury. AB - The development of cataracts, a well-known complication of electrical injury, remains poorly understood. We reviewed 113 patients suffering major electrical injuries and identified seven patients who suffered 13 cataracts, an incidence of 6.2%. Six of the seven patients were injured with high (greater than 1,000-v) voltage current, while one man was injured by a 440-v source. All patients suffered true 'entrance and exit' wounds, but only three such injuries involved the head or neck. Cataracts first presented as decreased visual acuity 1 to 12 months postinjury. Ten of the 13 cataracts progressed to a point where surgery was required, from 3 to 27 months postinjury. Surgical therapy resulted in excellent return of vision in every case, although one patient was lost to followup and developed a late retinal detachment. Electrical cataracts remain a serious potential complication of electrical injury. Awareness by burn team members is essential in providing optimal treatment to victims of electrical injury. PMID- 3965735 TI - Hypertonic lactated saline resuscitation of severely burned patients over 60 years of age. AB - Twenty-six adults more than 60 years old with burns greater than or equal to 30% of the body surface area were resuscitated using hypertonic lactated saline (HLS). Hemodynamic parameters of resuscitation were measured in ten of the patients using a Swan-Ganz catheter. In spite of signs of hemodynamic stability, these patients demonstrated mean cardiac indices (CI) below their age-corrected norms and pulmonary capillary wedge pressures (PCWP) below 5 mm Hg through 24 hours, yet 92% of the patients produced normal or super-normal volumes of urine. Hemodynamic monitoring may be helpful for precise fluid replacement in extensively burned elderly patients; however, a normal CI and PCWP may not be the appropriate endpoint for resuscitation of the elderly when using HLS. This review supports the concept that HLS resuscitation of critically burned older patients is both safe and efficacious, leading to an 81% survival of this severely compromised group well past the resuscitation phase of injury. PMID- 3965736 TI - Use of indirect calorimetry in the nutritional management of burned patients. AB - The use of indirect calorimetry in assessing and monitoring nutritional support in burn patients is reported. Twenty-nine patients with a mean burn size of 35% TBSA were monitored with 228 measurements of resting energy expenditure (REE), calculations of respiratory quotient (RQ), and substrate metabolism. Daily weights, nitrogen balance determinations, and routine laboratory tests were also obtained. Oxygen consumption (VO2) was 186 +/- 39 ml/min/M2, corresponding to REE of 2,506 +/- 543 kcal/day. REE varied during the course of wound healing, demonstrating a biphasic course. Metabolic rate was also significantly increased with the performance of routine procedures such as dressings and surgery. Measurements of REE were a mean 76% of predictions based on the Curreri formula, and 1.47 times basal energy expenditure (BEE) calculated by the Harris-Benedict equation. Neither formula provided for the great variations observed in daily, and individual, measurements of REE. During the study, patients consumed 2,900 +/ 811 kcal/day, which exceeded REE by 1.14. This was associated with mean weight loss of 3.2% (range, -16 to 9%). RQ was less than 0.85 in 9% of determinations, but exceeded 1.0 24% of the time. Protein accounted for 17 +/- 3% of total metabolism, corresponding to a calorie:nitrogen ratio of 128:1. Practically, however, provision of this much protein proved difficult. Routine use of indirect calorimetry permits tailoring of nutritional support for burn patients, and is valuable in the early detection of significant under- or overnutrition. PMID- 3965737 TI - Abbreviated Injury Scale and Injury Severity Score: a scoring chart. AB - The Abbreviated Injury Scale and the Injury Severity Score are important tools for grading the severity of injury to trauma patients. The Trauma Chart provided is a simple and concise guide for scoring and recording this useful information. The chart is useful in both a large wall-mounted form and in the reduced two-page form included in this article. PMID- 3965738 TI - Prehospital stabilization of critically injured patients: a failed concept. AB - Prehospital resuscitation and stabilization of major trauma victims is increasingly employed. To evaluate the benefits of one such maneuver, fluid administration, we reviewed 52 consecutive trauma cases in which patients had a blood pressure of less than 100 mm Hg either at the scene or on arrival to hospital. In all cases, transport time to hospital was less than IV establishment time. Fluid volume infused had little influence on final outcomes. A percentage of patients with correctable surgical lesions might have been salvaged had prompt transport been instituted. Field maneuvers in critically injured patients should be minimized to decrease ultimate mortality. PMID- 3965739 TI - Five-year experience with PTFE grafts in vascular wounds. AB - From 1978 through 1983, 206 patients had 236 polytetrafluoroethylene (PTFE) grafts inserted in vascular wounds. More than 85% of injuries were due to gunshot wounds, shotgun wounds, or stab wounds. Arterial grafts were inserted into vessels of the upper extremity (38.8%), lower extremity (46.1%), neck and chest (8.8%), and abdomen (6.3%). Grafts were most commonly placed in the brachial or superficial femoral arteries. Venous grafts were more commonly inserted into vessels of the extremities (96.7%), with the majority located in the superficial femoral vein. PTFE was found to be an acceptable prosthesis for interposition grafting in arterial wounds, but long-term patency was less than that seen when interposed saphenous vein grafts are used. Early and late occlusions were a significant problem with 4-mm PTFE grafts in the brachial artery, and this size is not recommended in this location. Peripheral PTFE graft infection did not occur in the absence of exposure of the graft or of osteomyelitis. Exposed grafts did not fare well and early coverage is recommended, even with extensive soft tissue wounds around the graft. PTFE grafts inserted in proximal extremity veins are excellent temporary conduits which decrease hemorrhage in blast cavities and fasciotomy sites, but all grafts studied by venography at 7 to 14 days were either narrowed or occluded. PMID- 3965740 TI - Facial injuries associated with cervical fractures: recognition, patterns, and management. AB - Publications in both the orthopedic and maxillofacial literature have noted the association of cervical spine and facial injuries. However, because the incidence of spinal injury is low, we found no study which documented the relationship between maxillofacial and cervical spine injuries. The present study reviewed 982 cervical spine injuries in two major trauma centers, finding a 19.3% incidence of facial injury. Fourteen per cent of patients had soft-tissue injuries and 8.6%, facial fractures. Important relationships were noted between fractures of the mandible and upper cervical spine, and soft-tissue injuries of the upper face and fractures of the lower cervical spine. Methods of care adapted to the combined injuries are described. The study concludes that examination of the face for soft tissue and bony injuries may give important clues on the direction and intensity of the force injuring the cervical spine. PMID- 3965741 TI - Penetrating cardiac trauma. PMID- 3965742 TI - A field evaluation of the esophageal obturator airway. PMID- 3965744 TI - Transfection of REP- mycoplasmas with viral single-stranded DNA. AB - Double-stranded DNA from mycoplasma virus L2 can transfect Acholeplasma laidlawii cells in the presence of polyethylene glycol (T. L. Sladek and J. Maniloff, J. Bacteriol. 155:734-741, 1983). We report here that both single-stranded DNA and double-stranded replicative form DNA, from the single-stranded DNA mycoplasma virus L51, are also infectious in this system. For both DNAs transfection frequencies were in the range of 10(-8) transfectants per DNA molecule and 10(-3) transfectants per CFU. An unexpected finding was that both DNAs could transfect A. laidlawii strain REP-, a variant which is a nonpermissive host for single stranded DNA mycoplasma viruses due to a block in viral DNA replication (Nowak et al., J. Bacteriol. 127:832-836, 1976). The number of viruses produced by transfected REP- cells was comparable to the number produced by both transfected and infected wild-type cells. Therefore, transfected L51 DNAs are able to bypass the replication block in REP- cells that occurs when these cells are infected by L51 virions. PMID- 3965743 TI - Detection of immunologically cross-reacting capsid protein of alphaviruses on the surfaces of infected L929 cells. AB - Hyperimmune, but not normal immune, monospecific antiserum made to capsid protein of Sindbis virus (SIN) was found to cause cytolysis equally well of both SIN- and Semliki Forest virus-infected L929 cells in antibody-dependent, complement mediated cytotoxicity assays. The cell surface reactivity of the hyperimmune antiserum was also demonstrated by solid-phase radioimmune assays with unfixed infected cells or infected cells fixed with low concentrations of glutaraldehyde (0.025%) before reactivity with antisera. Higher concentrations of glutaraldehyde lowered the sensitivity of detection. Purified SIN capsid protein specifically inhibited antibody-dependent, complement-mediated cytotoxicity by the monospecific anti-capsid protein serum on SIN- and Semliki Forest virus-infected target cells. That hyperimmune anti-SIN serum also cross-reacts with capsid protein on the surface of Semliki Forest virus-infected cells was suggested by the fact that capsid protein inhibited cross-cytolysis in the antibody-dependent, complement-mediated cytotoxicity assay. The latter antiserum was collected after repeated injections of purified virions over a 9-month period. The results suggest that hyperimmune monospecific antisera made to SIN capsid protein or hyperimmune antisera to SIN or Semliki Forest virions detect homologous and cross reacting capsid protein determinants on the surface of infected cells. PMID- 3965745 TI - Cardiovascular surgery--the rocket and its stars: presidential address. PMID- 3965746 TI - The occluded renal artery: durability of revascularization. AB - Between 1970 and 1982, 50 patients (38 male and 12 female) underwent revascularization of 51 occluded renal arteries. Ages ranged from 8 to 71 years (mean 54.6 years). Occlusion was caused by atherosclerosis in 43 patients, fibromuscular dysplasia in three, chronic dissection in two, abdominal aortic coarctation in one, and neurofibromatosis in one. Contralateral renal artery occlusive disease occurred in 22 patients. Extrarenal atherosclerosis occurred in 44 patients. Mean preoperative serum creatinine level ranged from 0.5 to 8.4 mg/dl (mean 1.9 mg/dl). No patient required preoperative dialysis. Length of the involved kidney ranged from 8.4 to 14.5 cm (mean 11.5 cm). Indication for renal revascularization was hypertension in 49 patients and preservation of renal function in one. Renal artery bypass was performed in 36 patients, renal artery endarterectomy in six, transaortic endarterectomy in five, and reimplantation of the renal artery in three. Simultaneous revascularization of the contralateral renal artery was performed in 20 patients. There were three operative deaths. At hospital dismissal, hypertension had improved in 45 of 46 patients. Follow-up periods ranged from 4 months to 12 years (mean 50.2 months). Thirty-four patients remained normotensive, five still had less hypertension, and seven became worse. These data demonstrate that revascularization of an occluded renal artery can be effective in controlling hypertension and that this effect is durable in the majority of patients. PMID- 3965747 TI - Reoperation for complications of renal artery reconstructive surgery undertaken for treatment of renovascular hypertension. AB - Seventy-two secondary operations for complications of prior renal artery reconstructive surgery were undertaken in 58 patients. This experience evolved from the management of 373 patients who underwent 425 primary operations for renovascular hypertension. Secondary operations were performed 10 times in pediatric patients following 42 primary procedures (24%); 44 times in adult fibrodysplastic patients following 199 initial operations (22%); and 18 times in atherosclerotic patients after 184 primary operations (10%). The overall reoperation rate was 15.5% (58 of 373 patients). Reoperation typically followed persistent or recurrent hypertension caused by graft thromboses, perianastomotic graft narrowing, or progressive nonanastomotic graft stenoses. Aneurysmal deterioration of vein grafts was an uncommon reason for reoperation. Secondary reconstructions included nephrectomy (31), bypass with vein grafts (15) or prosthetic grafts (8), angioplasty or reimplantation (12), thrombectomy (4), and operative dilation (2). Benefits regarding hypertension control were afforded 91% of these patients. One death occurred among the 72 reoperations, representing a 1.4% operative mortality rate. Reoperative renal artery reconstructive surgery for complications of renal revascularization may present formidable technical problems. Early diagnosis and prompt reoperation with exacting vascular surgical techniques are most likely to provide optimal results. PMID- 3965748 TI - What determines the symptoms associated with subclavian artery occlusive disease? AB - Symptoms associated with subclavian artery stenosis are related to reduced cerebral or arm blood flow. A large difference in blood pressure between the two arms is associated with symptoms of arm ischemia alone and is usually caused by an anatomic variant. The presence or absence of a radiologic steal alone did not seem to determine the type or presence of symptoms. The type of cerebral symptoms seems to be determined by the location of other extracranial vascular stenosis. In patients with hemispheric symptoms there was a higher incidence of anterior circulation insufficiency and a greater reduction in the overall cerebral blood flow. In patients with nonhemispheric symptoms a higher incidence of posterior circulation insufficiency occurred. There may be a small group with nonhemispheric symptoms and a subclavian artery stenosis in whom reversed vertebral artery blood flow is the sole determinant. Perhaps more accurate delineation of other extracranial vascular stenosis would help determine what stenosis in addition to the subclavian artery occlusive disease determines the presenting symptoms. Surgical repair of these lesions may lead to an improved cure rate in this group of patients. PMID- 3965749 TI - Management of patients with symptomatic extracranial carotid artery disease and incidental intracranial berry aneurysm. AB - Perioperative fluctuation of blood pressure and the use of anticoagulants during carotid endarterectomy may potentiate lethal aneurysm rupture in patients who have symptomatic extracranial carotid artery occlusive disease with incidental, asymptomatic, intracranial berry aneurysms. Ten patients having this combination are described in the present study. Of five men and five women whose mean age was 63 years, nine had symptomatic carotid bifurcation atherosclerosis, one had internal carotid fibromuscular dysplasia, and all had intracranial berry aneurysms ranging from 2 to 13 mm in diameter (mean diameter 6.6 mm). In seven patients, aneurysms were greater than or equal to 6 mm in diameter. Hypertension was present in seven patients and moderately severe in five. Three of the aneurysms were located in the intracranial internal carotid artery, five in the middle cerebral artery, three in the posterior communicating artery, one in the anterior cerebral artery, and one in the superior cerebellar artery. Twelve carotid reconstructive procedures were performed without morbidity related to aneurysm rupture. These included 10 carotid endarterectomies, one of which was combined with Dacron patch angioplasty and one of which was combined with a simultaneous coronary artery bypass; one carotid artery dilatation for fibromuscular disease; and one reoperative carotid endarterectomy with patch angioplasty. Three patients had correction of hemodynamically significant lesions, two of which were proximal to ipsilateral anterior circulation aneurysms. An intraluminal shunt and heparin anticoagulation therapy were used in all patients. Despite a concerted effort to control blood pressure, the patients' perioperative blood pressures ranged from 60/30 to 240/110 mm Hg. Three patients had subsequent elective clipping of intracranial aneurysms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965751 TI - Early operative intervention after thrombolytic therapy for acute myocardial infarction. AB - Thrombolytic therapy effectively interrupts acute myocardial infarction but does not correct the underlying plaque causing acute thrombosis. Early operation and treatment of the residual coronary artery disease has therefore been evaluated. Over 29 months, 184 patients with acute myocardial infarction of less than 6 hours duration were treated with intracoronary (IC) or intravenous (IV) streptokinase (SK). Angiography was performed early and thrombolysis found to be successful in 70% of the IC-SK group and 82% of the IV-SK group. One hundred six patients with successful thrombolysis had early revascularization surgery performed 3.3 +/- 2.1 days following SK treatment (range 0 to 11 days). These patients were compared with 110 consecutive patients who underwent coronary artery bypass grafting for standard indications. The SK group had an average of 3.0 +/- 1.4 grafts, 4.3 +/- 3.1 units of blood, and 10.8 +/- 5.3 days in the hospital postoperatively per patient and had an operative mortality rate of 2.7%. The control group averaged 3.6 +/- 1.3 grafts, 4.0 +/- 2.4 units of blood, and 9.6 +/- 3.5 days in the hospital postoperatively per patient with an operative mortality rate of 2.7%. This experience indicates that early operation following SK therapy can be performed with low operative risk and without prolonged hospitalization. PMID- 3965750 TI - Results of revascularization and amputation in severe lower extremity ischemia: a five-year clinical experience. AB - Aggressive revascularization of the ischemic lower extremity in atherosclerotic occlusive disease by femoropopliteal (FP) and femorotibial (FT) bypass or profundaplasty (P), as indicated, has been advocated by some authors for all patients. Others have recommended primary amputation, particularly for tibial occlusive disease. To clarify this clinical dilemma, we reviewed the results of 547 procedures performed during the last 5 years: revascularization in 375 (69%) instances and below-knee amputation (BKA) in 172 (31%) cases. Bypass procedures were used in 246 cases: FP in 155 (64%) and FT in 91 (37%). Reversed autogenous saphenous vein (ASV) was used preferentially in 125 (51%) cases, whereas polytetrafluoroethylene (PTFE) was used in 121 (49%) cases. P was performed in 129 instances accompanied by inflow procedures in 92 (71%) of these cases. Cumulative limb salvage (LS) exceeded bypass patency in all categories and resulted in 2- and 5-year LS rates of 83% and 81% for FP with the use of ASV and 52% and 35% for PTFE. The LS rate for FT was 53% and 47%, respectively, for ASV and 20% and 15% for PTFE. Rest pain was successfully relieved by P in 99 cases (77%), whereas healing occurred in only 51% of cases with tissue loss. The perioperative mortality rate for revascularization was 3%; 42% of the group died during follow-up, death usually resulting from complications of atherosclerosis. Of the 172 BKAs, primary healing occurred in 80%, but the perioperative mortality rate was 13%. FP and FT bypasses are preferred procedures if ASV is available, whereas use of PTFE should be limited to FP bypasses only. Rest pain is relieved by P but tissue loss should prompt consideration for bypass. BKA should be considered in cases of severe tibial disease only in the absence of a suitable ASV, as the perioperative mortality rate is high and ultimate rehabilitation (64%) is limited. PMID- 3965752 TI - Valve failure with the Ionescu-Shiley bovine pericardial bioprosthesis: analysis of 2680 patients. AB - Early reports on the excellent hemodynamic function and low thromboembolic rates of the Ionescu-Shiley bovine pericardial bioprosthetic valve (BPV) encouraged us to use it as our choice for valve replacement in 2680 patients from 1978 through 1983. Analysis of these patients at 5-year follow-up (mean 21.6 months) demonstrated the following important trends. Despite anticoagulation therapy in 48%, thromboembolism occurred in 88 patients for a linearized rate of 1.87% emboli per patient-year and was not time-related. The highest incidence of thromboembolism was in mitral valve replacement (MVR) (2.76% per patient-year). The actuarial freedom from reoperation resulting from valve failure at 5 years was 82% in aortic valve replacement (AVR), 87.1% in MVR, and 92.6% in AVR/MVR. The most distressing causes for reoperation were valve calcification (33 patients, 0.68% per patient-year) and leaflet disruption (11 patients, 0.23% per patient-year). Valve calcification was related to age, small valve size, and AVR position and increased with time, especially at the 4- to 5-year intervals. In patients under 30 years of age, calcification occurred in 18.7% at a mean time of 40.8 months in AVR and in 8.2% at 44 months in MVR, for an overall rate of 11.6%. Over the age of 30 years, it occurred in 14 patients (0.6%) at a mean time of 44 months. Leaflet disruption was not related to age and occurred later in AVR (50 to 58 months) than MVR (1.5 to 61 months). Events increased with time (mean range 37 to 58 months). Because of calcification and leaflet disruption, valve failure causing reoperation has increased significantly at the 4- to 5-year intervals even when valve replacement in patients under 30 years of age is excluded. If this trend continues, the valve failure rate will be exceedingly high on further follow-up. Thus we have limited the use of the BPV to a selected group of patients in whom valve longevity is less important than effective orifice size, thromboembolic rate, and freedom from anticoagulation. PMID- 3965753 TI - Failure of antiplatelet therapy with ibuprofen (Motrin) to prevent neointimal fibrous hyperplasia. AB - To evaluate the effect of ibuprofen (Motrin) on the development of neointimal fibrous hyperplasia (NFH), 4 cm segments of expanded polytetrafluoroethylene (ePTFE) grafts with an internal diameter of 4 mm were implanted in the femoral arteries of 28 dogs. Three dogs served as controls and these grafts were removed at 7 to 14 days. The remaining 25 dogs were medicated with either intravenous (IV) or oral (PO) ibuprofen. The medicated dogs were grouped according to whether the ibuprofen was administered prior to or after graft implantation. The orally medicated dogs were also grouped according to whether the grafts were removed from 30 to 60 days after graft implantation. The grafts were analyzed for the amount of anastomotic initimal hyperplasia, pannus extension, thrombus deposition, and patency. Analysis of the data demonstrated no statistically significant differences among any of the treatment groups or the control group for the variables analyzed. We conclude that ibuprofen neither prevents nor retards the development of NFH. There was a trend toward less thrombus deposition in the animals that received oral ibuprofen preoperatively. There was also a trend toward higher patency in the animals that received ibuprofen prior to graft implantation, which most likely resulted from decreased thrombus and fibrin deposition. PMID- 3965754 TI - Carotid endarterectomy in the stroke patient: computerized axial tomography to determine timing. AB - Historically, patients with mild to moderate neurologic deficits lasting longer than 24 hours were believed to have sustained a completed stroke. They were followed up for 4 to 6 weeks and cerebral angiography was performed if indicated. CT scanning has identified a subset of these patients who have sustained a reversible ischemic neurologic deficit (RIND) rather than a completed stroke. The timing for angiography and surgery for this group has not been established. In an earlier study we found that 21% (4 of 19 patients) suffered a second stroke during the 4- to 6-week waiting period. To avoid this high rate of recurrence, we instituted an aggressive program of CT scan evaluation and surgical therapy for all "stroke patients" with negative CT scans. Two hundred forty-five patients were seen with a persistent neurologic deficit between July 1980 and December 1983. These patients underwent CT scans 1 and 5 days after the initial event. Of these 245 patients, 171 patients (70%) were found to have negative CT scans. Appropriate carotid lesions were found by arteriography in 110 (64%) of the negative CT scan group. There were 61 (55%) men and 49 (45%) women in this group. Eighty-five patients (77%) had previous neurologic symptoms or a cerebrovascular accident. Hypertension was present in 52% and diabetes mellitus in 30%. All 110 patients underwent carotid endarterectomy within 14 days (mean 10 days) of the initial onset of their neurologic deficit; these were all done with shunt protection. No patient suffered another neurologic deficit in the same territory within 30 days after surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3965756 TI - Revascularization of the external carotid artery. PMID- 3965755 TI - Oxygen inhalation--induced transcutaneous PO2 changes as a predictor of amputation level. AB - Noninvasive transcutaneous PO2 (TcpO2) determinations have been developed to study peripheral arterial occlusive disease. To evaluate this technique as a predictor of amputation outcome, a blind, prospective study of 101 patients undergoing 119 amputations (23 above-knee [AK], 57 below-knee [BK], and 39 forefoot) was performed. TcpO2 measurements were obtained from the dorsum of the foot and 10 cm distal to the patella, both prior to and 10 minutes after inhalation of 100% oxygen. On the basis of preliminary results, initial TcpO2 values greater than 10 mm Hg or an increase greater than 10 mm Hg after oxygen inhalation were considered to predict a successful outcome, whereas failure was predicted when the initial TcpO2 value was less than 10 mm Hg and the increase after oxygen inhalation did not exceed the 10 mm Hg level. In the BK amputation group the test was 95% sensitive, 100% specific, and 95% accurate. Retrospective utilization of the above criteria in patients who had undergone both oxygen inhalation testing and AK amputation suggested that 9 of 17 limbs (53%) might have undergone a more distal BK amputation successfully. These results document the effectiveness of an initial TcpO2 determination coupled with the response to 100% oxygen inhalation as an excellent predictor of the outcome of lower extremity amputations. PMID- 3965757 TI - Extracranial-intracranial bypasses. PMID- 3965758 TI - The contrary position to the nonresective treatment for abdominal aortic aneurysm. AB - The operative mortality rate for abdominal aortic aneurysm resection remains high (20% to 66%) for high-risk patients. The high-risk factors are severe cardiac, respiratory, and renal insufficiency and morbid obesity. Those advocating the alternative nonresective treatment of aneurysm thrombosis and axillofemoral bypass grafts have reduced the operative mortality rate to between 0% and 7%. However, in a collective series of 87 patients, there was a mortality rate of 10.3% in the patients with aortic aneurysms treated by the nonresective method and an incidence of reoperation for complications of axillofemoral graft of 31.0%. Many of these patients had subsequent operations and/or radiologic procedures to complete the process of aneurysm thrombosis (23.0%). Because there is an increasing trend toward this method of treatment, we reviewed our experience with the conventional aneurysm resection in a similar group of patients. Of 105 consecutive patients, 19 qualified as high risk. One patient died, resulting in an operative mortality rate of 5.2%. Cerebral, cardiac, and renal morbidity was transient and subsequent operations were not required. Eighteen patients were discharged as well. In the remaining 86 patients, one died, resulting in an operative mortality rate of 1.2%. The mortality rate for the entire series was 1.9%. Indications for the nonresective treatment appear to be increasing by the addition of other risk factors. This trend is of concern. We believe that there are limited indications for the treatment of aortic aneurysms without resection. However, the procedure should not be offered lightly as an alternative form of treatment. PMID- 3965759 TI - Protection of the kidney after temporary ischemia: free radical scavengers. AB - Free radicals have been implicated in the damage caused by tissue ischemia and reperfusion. Canine kidneys were subjected to a 60-minute period of normothermic ischemia. One group of animals received intra-arterial superoxide dismutase (SOD, 17.6 mg/50 ml, 50,000 units) at the end of the ischemic period, whereas a second group received albumin (17.6 mg/50 ml). The kidneys treated with SOD demonstrated significantly less edema formation (1.0 +/- 0.3% wet weight vs. 1.8 +/- 0.2%, mean +/- SEM, p less than 0.05) and lower renovascular resistance (44.0 +/- 5.6 dynes-sec/cm5 vs. 64.0 +/- 12.0, p less than 0.05). The SOD group displayed greater preservation of both glomerular filtration rate (45.9 +/- 6.1% of baseline vs. 23.7 +/- 5.8%, p less than 0.05) and urine flow (1.3 +/- 0.4 ml/min vs. 0.3 +/- 0.1, p less than 0.05). We conclude that the free radical scavenger SOD provides significant protection of the kidney during ischemia and reperfusion. PMID- 3965760 TI - Thrombolytic therapy for acute arterial occlusion. AB - To evaluate the role of selective intra-arterial low-dose thrombolytic therapy (SILDT) as an alternative to the surgical management of acute arterial occlusion, the hospital records of 40 patients who underwent 43 SILDT treatments with either streptokinase (36) or urokinase (7) between December 1979 and March 1984 were reviewed. Twenty-eight patients underwent 30 treatments (group 1) for native arterial occlusion and 12 patients underwent 13 treatments (group 2) for prosthetic or autogenous graft occlusions. Therapy was deemed successful if subsequent surgical therapy was obviated. In group 1, SILDT was successful in 13 of 28 (45%) patients with 12 of 25 lower extremity occlusions and one of three upper extremity occlusions. Successful lysis in the native artery occlusion group fell into three categories: five patients were successfully treated for arterial thrombosis complicating percutaneous transluminal angioplasty (PTA); four patients required PTA after complete lysis revealed an underlying arterial stenosis; and only three required no further therapy after SILDT. SILDT failed in all three patients with the aortoiliac occlusions. Eleven patients with femoral artery occlusions and unsuccessful SILDT required six bypass procedures, three amputations, one embolectomy, and one PTA. In group 2 only 3 of 14 treatments (21%) were successful. Bypass revision was not possible in 11 patients and all required amputation. Systemic fibrinolysis was seen in 20 (59%) of 34 patients with available data. Neither fibrinogen levels nor fibrin degradation products predicted the occurrence of complications. Minor complications occurred in 18 of 43 (43%) treatments; small hematomas at the catheter entry site were most common. Minor complications occurred in 20 of 43 treatments (44%) and included severe local hemorrhage (four), distant bleeding (three), pulmonary embolism (four), myocardial infarction (three), unmasking of an aortoduodenal fistula (one), and clot migration requiring emergency thrombectomy (four). SILDT is most effective in acute arterial thrombosis complicating arteriography or percutaneous angioplasty. It may play a role in the patient in whom thrombolysis can reveal an underlying stenosis amenable to percutaneous angioplasty. This experience shows SILDT to be of limited value in the management of prosthetic autogenous graft occlusions. Finally, thrombolytic therapy is associated with significant morbidity and mortality rates and requires cautious monitoring to detect arterial thrombus migration, worsening tissue ischemia, venous thromboembolism, intracerebral hemorrhage, and local or systemic bleeding. PMID- 3965761 TI - Carotid endarterectomy after a completed stroke: reduction in long-term neurologic deterioration. AB - The merit of carotid endarterectomy for patients who previously have sustained a completed stroke remains controversial. Between January 1976 and December 1983, 118 stroke patients with mild to severe permanent neurologic deficits were evaluated. Fifty-nine patients were managed nonoperatively and 59 operatively. Both cohorts were similar in age and sex distribution, incidence of hypertension (69%), diabetes mellitus (25%), and cardiac disease (39%). In the long-term follow-up (medical cohort average was 44.1 +/- 5.0 months; surgical cohort average, 41.8 +/- 3.7 months) the overall survival rate was comparable, that is, there were nine medical deaths and eight surgical deaths. However, there was a significant difference in the development of new neurologic deficits. Twelve of the 59 unoperated patients had new neurologic deficits and three patients died at 12, 36, and 48 months as a result of a recurrent stroke. New neurologic deficits developed in only two of the 59 surgical patients and there were no stroke related deaths. When the cumulative probability of remaining free from recurrent deficits was examined in the surviving patients at 6 years, all of the patients in the operated group remained free from recurrent deficits, whereas only 58% of the patients in the unoperated group were free of new neurologic deficits (p = 0.02). These data suggest that stroke patients with fixed mild to moderate neurologic deficits and with carotid lesions may be protected from recurrent neurologic complications by carotid endarterectomy. PMID- 3965762 TI - Late results following operative repair for celiac artery compression syndrome. AB - The clinical significance of celiac artery compression by the median arcuate ligament of the diaphragm remains unsettled. The controversy stems from an undefined pathophysiologic mechanism and the existence of celiac compression in asymptomatic patients. This study was therefore conducted to evaluate the late results of operative therapy among our patients and possibly to identify parameters that might correlate with sustained symptom relief. Among 51 patients (12 men and 39 women) (mean age 47 years) who underwent operative treatment for symptomatic celiac artery compression, 44 (86%) were available for late follow up. Their clinical status was determined between 1 and 18 years postoperatively (mean 9.0 years) by patient interview (36) or chart review (7). Operative treatment consisted of celiac axis decompression only (16 patients), celiac decompression and dilatation (17 patients), or celiac decompression and reconstruction by primary reanastomosis or interposition grafting (18 patients). Sustained symptom relief occurred more often with a postprandial pain pattern (81% cure), age between 40 and 60 years (77%), and weight loss of 20 pounds or more (67%). A negative correlation with clinical improvement was demonstrated for an atypical pain pattern with periods of remission (43% cure), a history of psychiatric disorder or alcohol abuse (40%), age greater than 60 years (40%), and weight loss of less than 20 pounds (53%). Eight of 15 patients (53%) treated by celiac decompression alone remained asymptomatic at late follow-up in contrast to 22 of 29 patients (76%) treated by celiac decompression plus some form of celiac revascularization. Late follow-up arteriograms (18 studies) showed a widely patent celiac artery in 70% of asymptomatic patients but a stenosed or occluded celiac axis in 75% of symptomatic patients. These findings suggest that persistent clinical improvement in patients with symptomatic celiac axis compression can be achieved by an operative technique that ensures celiac axis patency. Although some clinical features are identified that correlate with long term benefit, reliable diagnosis of the symptomatic patient awaits definition of the pathophysiologic mechanisms involved in this syndrome. PMID- 3965763 TI - Leads from the MMWR. Toy safety--United States, 1983. PMID- 3965764 TI - Leads from the MMWR. Temporal patterns of motor-vehicle-related fatalities associated with young drinking drivers--United States, 1983. PMID- 3965765 TI - Boxing. PMID- 3965766 TI - The ultimate audit. PMID- 3965767 TI - Incidence of neonatal herpes simplex infections. PMID- 3965769 TI - Cataract surgery in patient who sneezes. PMID- 3965768 TI - Toxic epidermal necrolysis associated with maternal use of heparin. PMID- 3965770 TI - Genetic counseling. PMID- 3965771 TI - Neurological deficits following the hot bath test in multiple sclerosis. PMID- 3965772 TI - The incidence rate of acquired immunodeficiency syndrome in selected populations. AB - Population figures were obtained, and incidence rates of acquired immunodeficiency syndrome (AIDS) for the 12 months from June 1, 1983, to May 31, 1984, were estimated for single (never-married) men aged 15 years or older, intravenous (IV) drug users, Haitians living in the United States, persons with hemophilia A and B, female sexual contacts of male IV drug users, and blood transfusion recipients. Single men in San Francisco and Manhattan, IV drug users in New York City and New Jersey, hemophilia A patients, and recent Haitian entrants had the highest rates of disease (82.0 to 268.9 per 100,000). Male IV drug users and male Haitians were two to four times as likely to experience development of AIDS as were females in each group. Persons with hemophilia A had six times the incidence rate of AIDS as did those with hemophilia B. Persons with severe hemophilia A had three times the rate of those with moderate and seven times the rate of those with mild clotting factor deficiency. Although blood transfusion recipients and female sexual contacts of male IV drug users had much lower average yearly rates than did persons in the four other groups (0.4 to 9.4 per 100,000), they still had a higher incidence rate of AIDS than did persons not belonging to any of these groups (0.1 per 100,000). PMID- 3965773 TI - Factors influencing return to work following cerebral infarction. AB - A study of 379 patients, employed before cerebral infarction and living one year afterward, was undertaken to determine what factors had influenced their returning to work. We found age, occupation, degree of disability, race, and hemisphere infarcted to be significant. Younger patients with less disability were more likely to return to work. Patients employed in professional-managerial positions were more likely to return to work than patients in blue-collar or farming positions. Although there were no racial differences following a left hemisphere infarct, white patients were more likely to return to work following a right-hemisphere infarct. Sex, blood pressure, severity of stroke, educational level, consciousness level at admission, maximum weakness in extremities, first v repeated stroke, care by a specially trained stroke team, rehabilitation therapy, and speech did not additionally influence the probability of returning to work. PMID- 3965774 TI - Transdermal clonidine therapy in hypertensive patients. Effects on office and ambulatory recorded blood pressure values. AB - The antihypertensive effect of clonidine hydrochloride delivered at a constant rate for seven days by transdermal disks was evaluated in seven patients with essential hypertension. Blood pressure values measured at the physician's office were not significantly decreased by one month of treatment with one (n = 2) or two (n = 5) once-weekly applied clonidine transdermal disks. In contrast, blood pressure values recorded during patients' customary daily activities by means of a portable blood pressure recorder were considerably reduced, from 159/97 +/- 2/2 to 136/76 +/- 7/5 mm Hg. Plasma drug concentration at the end of the fourth week averaged 1.22 +/- 0.24 ng/mL. Plasma renin, vasopressin, and epinephrine levels were not modified by clonidine, whereas plasma norepinephrine level was significantly reduced. Local skin erythema developed in three patients and dry mouth in six. These findings suggest that clonidine transdermal disks lower blood pressure in hypertensive patients, but produce local skin lesions and general side effects. PMID- 3965775 TI - Postexercise proteinuria in humans. Facts and mechanisms. AB - Strenuous exercise induces profound changes in renal hemodynamics and the protein content of urine. Postexercise proteinuria seems to be directly related to the intensity of exercise, rather than to its duration. The pattern of proteins identified in urine collected after exercise is different from normal physiological proteinuria. Immunochemical techniques demonstrate that postexercise proteinuria is of mixed glomerular-tubular type when heavy exercise is involved. The origin of proteinuria after light exercise seems to be preponderantly of glomerular type. Clearance of individual plasma proteins suggests an increased glomerular permeability and a partial tubular-reabsorption inhibition of macromolecules. PMID- 3965776 TI - Tularemia and rhabdomyolysis. AB - Rhabdomyolysis as a complication of tularemia occurred in four patients in Tennessee over a four-year period. All patients were severely ill and had renal failure. Tularemia was not suspected initially in any of these patients. One patient died of complications of rhabdomyolysis. At autopsy, multiple abscesses were present within skeletal muscle, suggesting that rhabdomyolysis resulted from direct muscle involvement with Francisella tularensis. Tularemia should be considered in the differential diagnosis of patients with an acute febrile illness and rhabdomyolysis. Conversely, in patients with acute tularemia, the possibility of rhabdomyolysis should be entertained early, especially in those with evidence of myoglobinuria and/or impaired renal function. PMID- 3965777 TI - Return to work after stroke. PMID- 3965778 TI - Flexibility emphasized in medical preparations for possible disasters. PMID- 3965779 TI - Disaster plan launches training, site selection. PMID- 3965780 TI - Leads from the MMWR. Acute convulsions associated with endrin poisoning- Pakistan. PMID- 3965781 TI - Leads from the MMWR. Human Salmonella isolates--United States, 1983. PMID- 3965782 TI - Leads from the MMWR. Influenza activity--United States. PMID- 3965783 TI - Hypomagnesemia causes coronary artery spasm. PMID- 3965784 TI - Nursing home patients underserved. PMID- 3965786 TI - Treating myocardial infarction at home. PMID- 3965785 TI - Treatment of status asthmaticus. PMID- 3965787 TI - Treatment of traumatic hyphema. PMID- 3965788 TI - Childhood cancer mortality. PMID- 3965789 TI - Mothers of infants with the acquired immunodeficiency syndrome. Evidence for both symptomatic and asymptomatic carriers. AB - Sixteen mothers of 22 infants with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex were followed up for evidence of clinical and immunologic abnormalities. With one exception, all mothers were clinically well at delivery but had evidence of immune dysfunction, with T-cell abnormalities and inverted T4/T8 ratios and/or elevation of serum immunoglobulin levels, particularly of IgG. During a follow-up period that averaged 30 months, AIDS developed in five of the mothers and AIDS-related complex in seven. Twelve subsequent pregnancies in 11 mothers produced four affected infants, suggesting that mothers can be persistently infected. Six mothers were delivered of subsequent infants who remain unaffected. These results suggest that the mothers are the likely source of infection in non-transfusion-associated cases of AIDS or AIDS-related complex in infants, that mothers have persistent immunologic abnormalities, and that they are at increased risk of developing AIDS or AIDS-related complex. PMID- 3965790 TI - Cyanide intoxication among silver-reclaiming workers. AB - Thirty-six former workers in a silver-reclaiming facility who had been exposed over a long-term to excessive levels of cyanide were studied to determine acute and residual toxic reactions. The study involved physical examinations, laboratory studies, and a questionnaire to determine levels of exposure, symptoms during employment, and current symptoms. Questionnaire data showed that during the time of active employment there was a high prevalence of symptoms that are consistent with acute cyanide toxic reactions. A significant positive trend for prevalence of cyanide-related symptoms measured against levels of exposure was demonstrated, supporting a dose-response effect. Some symptoms occurring seven or more months after exposure had ceased also exhibited a dose-response trend. Mild abnormalities of vitamin B12, folate, and thyroid function were detected and suggest long-term cyanide effects. PMID- 3965791 TI - Reducing black neonatal mortality. Will improvement in birth weight be enough? AB - To study some of the factors contributing to the higher rate of black neonatal mortality in the United States, we used matched cohort records for California between 1980 and 1981 and for Georgia between 1979 and 1981. We found that at any combination of birth weight and gestational age, black neonates weighing less than 3,000 g had lower mortality rates than whites, but this survival advantage was outweighed by considerably higher rates of low birth weight among blacks. At 3,000 g or more, whites had the survival advantage; even at optimal survival weight, the black mortality rate was nearly twice that for whites. If a reduction in the black mortality rate is to occur, improvements are needed both in the black birth-weight distribution and in birth-weight-specific mortality rates, particularly in the normal birth-weight ranges. PMID- 3965792 TI - Where have all the students gone? An epidemiologic study of US nationals applying for certification by the Educational Commission for Foreign Medical Graduates, 1969 through 1982. AB - Larger and larger numbers of US nationals are studying medicine abroad and they now comprise the foremost national group of foreign medical graduates (FMGs) seeking to enter the US health care system. The Educational Commission for Foreign Medical Graduates (ECFMG) is currently conducting a comprehensive study of 205,542 graduates of foreign medical schools who, during a 14-year study period, 1969 through 1982, have sought its certification, an established prerequisite for FMGs applying for training in an accredited hospital residency program and/or licensure within the United States. This report summarizes preliminary data on the 17,642 US citizens included in the study who attended 431 different medical schools in 79 foreign countries. Particular attention is given to their performance on the combined medical knowledge-English language competence examinations requisite to the awarding of ECFMG certification. PMID- 3965794 TI - Abolition not reform. PMID- 3965793 TI - Chronic supraventricular tachycardia. A curable cause of congestive cardiomyopathy. AB - Two cases of congestive cardiomyopathy were proved to be due to chronic atrial automatic-focus tachycardia. Surgical elimination of the tachycardia resulted in normalization of cardiac function in both cases. We suggest that patients with congestive cardiomyopathy be carefully screened for supraventricular tachycardia. Patients with chronic supraventricular tachycardia should be treated aggressively to prevent myocardial dysfunction. PMID- 3965795 TI - Welcome to the physicians of Southeast Asia. PMID- 3965796 TI - Realities not myths. PMID- 3965797 TI - Cost-effective cardiology: the new challenge. PMID- 3965798 TI - Proliferation and response of oligodendrocytes. PMID- 3965799 TI - Hilar biliary plexus in human liver. A comparative study of the intrahepatic bile ducts in man and animals. AB - A comparative study of the hepatic bile ducts of man and laboratory animals was made by means of scanning electron microscopy of biliary tract casts. In man, the large intrahepatic bile ducts at the hilum have many irregular side branches and pouches which are all situated in one plane corresponding anatomically to the transverse fissure (porta hepatis). At the bifurcation, some of the side branches from two or three bile ducts communicate with each other. The anastomosing plexus so formed provides communications between the main bile ducts. Bile ducts of the rhesus monkey show a similar but less well developed structure. In the pig, many pouches are observed around not only large but also small bile ducts. No such structures are observed in dog, guinea pig, or rabbit bile ducts. These irregular side branches and pouches correspond to the "vasa aberrantia" and "parietal sacculi" described by L. S. Beale (The Liver. Lecture on the Principles and Practice of Medicine, p 47. London, Churchill, 1889), and they may store and modify bile. The plexus described in man in this report may provide an anatomical basis for incomplete biliary obstruction without cholestasis. A role in biliary atresia and in Caroli's disease is also raised. PMID- 3965801 TI - Direct toxic effects of paraquat and oxygen on cultured endothelial cells. AB - Paraquat (PQ) is a herbicide known to generate O2 radicals and to injure lung epithelial cells, leading eventually to pulmonary fibrosis. To test for the possible existence of a direct cytotoxic action of PQ on endothelial cells, we have studied, for up to 5 days, the action of 10(-6) to 10(-4) M PQ on primary cultures of pig aortic endothelial cells and compared these effects to those obtained with exposure to 95% O2-5% CO2. The decrease in DNA and protein content of Petri dishes and the increase in lactate dehydrogenase release were found to depend on PQ concentration and the duration of exposure to PQ. The toxic effects of hyperoxia were intermediate, ranging between those obtained with 10(-5) and 10(-4) M PQ. Hyperoxia and 10(-4) M PQ produced a similar marked inhibition of DNA synthesis after a 1-day period of exposure. Combined exposure to both PQ and hyperoxia resulted in changes comparable to those obtained with hyperoxia alone (decrease in protein and DNA content) or PQ alone (lactate dehydrogenase release). Additive effects were seen only for the inhibition of DNA synthesis. The selenomethionine-related increase in glutathione peroxidase activity had a protective effect against hyperoxia-induced lactate dehydrogenase release but not against PQ induced cytolysis. Finally, shorter exposures to O2 and PQ revealed the existence of a trend toward recovery only for cells exposed to hyperoxia. The prolonged toxic action of PQ could not be related to PQ accumulation and storage by endothelial cells. These studies indicate that PQ can exert a direct, dose dependent, and prolonged cytotoxic effect on cultured endothelial cells. PMID- 3965800 TI - Histopathologic features of phorbol myristate acetate-induced lung injury. AB - Rabbits given daily intravenous injections of phorbol myristate acetate (PMA) develop acute and chronic pulmonary disease. We distinguished three phases in the histologic progression of the lung injury. An acute phase (occurring within 1.5 hours of the first injection) involved hemorrhagic pneumonitis, increased lung weight, and increased numbers of neutrophils as well as erythrocytes in alveolar fluid. The intermediate phase (occurring 1 to 7 days after the initial injection) involved interstitial pneumonitis: neutrophils and macrophages infiltrated into lung interstitium and alveolar fluid. The relative number of type II alveolar epithelial cells increased dramatically and lung weight became maximal during this phase. In the chronic phase (occurring within 14 days and lasting greater than 77 days) diffuse interstitial fibrosis progressed, whereas inflammatory changes abated. Animals treated daily with PMA developed a linear increase in lung hydroxyproline content beginning on the 7th day of treatment. Values increased to three to four times above controls by day 77. Animals treated with PMA for only 14 days and sacrificed up to 63 days thereafter had lung hydroxyproline values that were intermediate between controls and animals injected daily for 77 days. Their fibrosis neither progressed nor reversed when PMA treatment was stopped. In contrast, animals receiving a single dose of PMA developed only the acute and intermediate phases of injury; no detectable fibrosis occurred, and their lung reactions resolved completely. Finally, animals made neutropenic with nitrogen mustard did not respond to PMA with increased lung weight or changes in alveolar lavage fluid cellularity during the early or intermediate phases of the disease. They did, however, exhibit increased interstitial cellularity. Thus, PMA produces abrupt pneumonitis that progresses to fibrosis. The acute and intermediate phases of injury are neutrophil dependent and reversible, whereas the chronic fibrotic phase is irreversible and requires continued PMA injections for progression. PMID- 3965802 TI - Effect of gentamicin on isolated glomeruli and proximal tubules of the rabbit. AB - Alterations in both glomerular filtration rate and tubular transport occur in clinical gentamicin nephrotoxicity. We have studied the function of isolated tubules and glomeruli from rabbits treated with gentamicin. Gentamicin was administered subcutaneously to sexually immature (1400 to 1800 gm) or sexually mature (3800 to 4600 gm) New Zealand White rabbits in a dose of 15 mg/kg twice a day. Immature rabbits were treated for 28 to 31 days and developed only minimal renal insufficiency. About one-half of the mature rabbits developed azotemia. The mature rabbits that did not become azotemic were sacrificed after 28 to 30 days, and those that became azotemic were killed when their serum creatinine reached 2.5 mg/dl or higher (10 to 24 days). Animals were anesthetized and kidneys were removed for histologic examination and isolation of tubules and glomeruli. The ratio of p-aminohippuric acid (PAH) concentration in isolated tubule cells to that in medium after incubation in 3H-PAH (1 microM) at 37 degrees C for 30 minutes (T/M PAH) was used as an indicator of transport capacity of tubules. T/M PAH ratios averaged 196 +/- 18 and 111 +/- 21 for control immature and mature rabbits, respectively, and 135 +/- 22, 80 +/- 16, and 9 +/- 2 for gentamicin treated immature and mature nonazotemic and mature azotemic rabbits, respectively. Glomeruli were isolated and filtration induced in vitro by a transcapillary oncotic gradient. Ultrafiltration coefficient, Kf, of glomeruli of immature and mature control rabbits averaged 3.78 +/- 0.29 and 5.84 +/- 0.51 nl/minute X mm Hg. Kf from gentamicin-treated immature rabbits averaged 2.82 +/- 0.20 and from mature azotemic rabbits 3.14 +/- 0.44 nl/minute X mm Hg. Kf of both mature and immature rabbits were decreased compared with controls (p less than 0.01). When all animals were considered, relative glomerular filtration rate, estimated from 1/serum creatinine, was positively correlated with the T/M PAH and Kf. When only experimental animals were studied, 1/serum creatinine and T/M PAH were also correlated. Decreased glomerular filtration rate and dysfunction of proximal tubules were also correlated with abnormal tubule histology. We suggest that injury to glomeruli and tubules may represent independent manifestations of gentamicin toxicity. Dysfunction may be present even when there are only mild histologic changes and glomerular filtration rate is near normal. Kf does not appear to limit glomerular filtration rate after treatment with gentamicin; rather, some direct or indirect effect of tubular injury may determine the decrement in glomerular filtration rate. PMID- 3965803 TI - Carbohydrate metabolism and the hemodynamic response to shock. AB - To investigate the temporal relationship of changes in carbohydrate metabolism to changes in the hemodynamic stability of the dog in protracted hemorrhagic shock, 30 animals were studied. Blood pressure was maintained at 60 mm Hg for 12 hr during which hemodynamic and metabolic parameters were studied. In early shock cardiac output was decreased and peripheral resistance increased. After 2 hr cardiac output began to increase and peripheral resistance began a progressive decline despite the continuing hypotensive state. Hemodynamic decompensation was essentially complete at 5 hr. There was early and marked mobilization of carbohydrate stores. Muscle glycogen was rapidly mobilized over a 5-hr period. Serum glucose and blood lactate levels rose and remained elevated for 8 hr. Amino acid degradation remained at high levels throughout the experimental period. Hemodynamic decompensation began well before significant depletion of carbohydrate stores and was complete well before the relative exhaustion of the available reserves. PMID- 3965804 TI - The effect of truncal vagotomy on serotonin distribution in the rat gastrointestinal tract. AB - The 5-HT levels in biopsies from the rat gastrointestinal tract were measured by a sensitive liquid chromatography method with electrochemical detection. The highest levels were found in the gastroduodenal and cecal regions. Sham-operated controls were compared with rats subjected to combined truncal vagotomy and pyloroplasty or pyloroplasty alone 5 weeks after surgery. Significantly decreased 5-HT levels were demonstrated in animals subjected to vagotomy + pyloroplasty or to pyloroplasty alone, compared with sham-operated controls. In the upper gastrointestinal tract of vagotomized animals significantly decreased 5-HT levels were found when compared with animals subjected to pyloroplasty alone. However, anesthesia and surgery (sham operation) per se markedly increased 5-HT levels of the gut even 5 weeks postoperatively, when compared with acutely killed rats. The underlying mechanism is still obscure. However, vagotomy largely prevented this increase. Therefore, the importance of correct controls is emphasized, since previous investigations claim to have demonstrated increased 5-HT levels in vagotomized animals, when compared with nonoperated controls. PMID- 3965805 TI - A method for improved yield and purity in extracting lymphocytes from lung tumors. AB - Tumor-infiltrating lymphocytes (TIL) from human pulmonary tumors have been studied as a model for local depression of cell-mediated immunity at the tumor site. To better characterize these lymphoid infiltrates, a new method of lymphocyte extraction of high yield and purity was developed. The TIL from 11 human lung tumors of varying histologic types were prepared. After mechanical disaggregation to a single cell suspension, the TIL, contaminated with tumor cells and macrophages, were incubated with carbonyl iron to deplete macrophages. Further purification was performed in a unit gravity sedimentation apparatus utilizing a continuous 2-4% Ficoll gradient. Usable TIL recovery was 41.2 +/- 7.7% of input cells and was minimally contaminated by tumor cells and macrophage/monocytes. The high yield and purity of TIL preparations have resulted in a higher proportion of tumors suitable for immunological analysis. An example of the type of experiments possible with such preparations is shown. PMID- 3965806 TI - Growth of pulmonary metastases of B16 melanoma in mast cell-free mice. AB - The relationship of mast cells to tumor growth has been debated but not elucidated. The existence of a mast cell-free animal, the W/Wv mouse, provides a model in which tumor metastasis can be studied with special reference to host tissues and their mast cell content rather than to the adhesiveness of the tumor cell itself. Both hind footpads of 30 W/Wv mice and 30 control mice (+/+) were injected with 2 X 10(5) cells of B16-F10 melanoma cells. The left paw received 1000 rads orthovoltage radiation 12 hr before tumor inoculation. Growth of tumors in both paws was recorded. Ten animals from each group were killed on Day 31 after tumor inoculation, and the remaining animals were kept until they died. Autopsy was performed in all animals, and patterns of metastasis were recorded. Results showed that (1) preinoculation radiation significantly slowed tumor growth in the left paw (P = 0.0009), and (2) lung metastases were present in 4 of 10 W/Wv mice, but in none of 10 +/+ mice killed after 31 days (P = 0.05). Overall, 17 of 25 W/Wv mice and 8 of 26 +/+ mice had lung metastases (P = 0.008). PMID- 3965807 TI - Postoperative immunization with peanut agglutinin-binding glycoprotein from Lewis lung carcinoma in mice. AB - The effects of postoperative immunization with purified tumor-associated antigens on the development of lung metastases following excision of the Lewis lung carcinoma (3LL) were investigated. Soluble tumor-associated antigens were isolated from 3LL cells by detergent solubilization and purified by affinity chromatography on peanut agglutinin (PNA)-agarose. The immunization with subcutaneous injections of PNA-binding glycoproteins (PNA receptors) at the early phase following excision of primary footpad tumors of 3LL resulted in a significant decrease in incidence and size of lung metastases. The delayed immunization, however, failed to suppress the development and growth of metastatic lung tumors after surgery. The suppression in postoperative development of lung metastases was found to depend on the scheduling of immunization following local tumor excision. Splenectomy performed simultaneously with amputation of the tumor-bearing leg completely abolished the decrease in the development and growth of postoperative lung metastases in immunized mice. The involvement of the lymphoid system in the control of metastatic tumor growth was also confirmed in an in vivo tumor neutralization assay utilizing the spleen cells. PMID- 3965808 TI - The "divided stomach"--a model for separate acid and alkali collection in the pig. AB - Bile duct ligation (BDL) in the pig results uniformly in fatal oesophago-gastric ulceration which appears to be related to hypersecretion of acid. The presence of bile in normal porcine gastric juice may interfere with studies of acid secretion. The present studies were conducted in pigs with the stomach divided into two separate pouches (proximal and antral) which allowed individual collection of acid or alkali secretion. In normal pigs, division of the stomach resulted in a 30-50% decrease in secretion, rather than any increase in measureable acid. In BDL pigs, there was an 8- to 15-fold increase in alkali collection by antral pouches which may have been in response to acid hypersecretion, or merely duodenal or pancreatic juice reflux. No normal pigs with divided stomachs developed significant ulceration suggesting that such ulcers were not related to exclusion of bile from the stomach. It is proposed that a total gastric fistula may be used in the pig for studies of acid secretion, and that the model with divided stomach may be used for assessment of the effects of secretagogues or hormones upon individual acid or alkali secretion. PMID- 3965809 TI - Coarctation of the aorta in patients younger than three months. A critique of the subclavian flap operation. AB - Unexpected and disappointing late results with the subclavian flap operation prompted this analysis of repair of coarctation in infants under 3 months of age. A total of 134 such patients underwent surgical repair since 1960 with 55 end-to end anastomoses performed earlier in our experience (mean follow-up 5.0 years) and 67 subclavian flap angioplasty operations performed more recently (mean follow-up 2.0 years). The operative mortality was not significantly different (p = 0.3) between end-to-end anastomosis (29%) and subclavian flap angioplasty (19%), but it was significantly higher (p less than 0.01) in the first week of life (56%). Recurrent coarctation occurred in 16 cases, necessitating reoperation. The reoperation-free rates (with standard error) at 5 years for end to-end anastomosis and subclavian flap angioplasty were 92% +/- 5% and 75% +/- 7%, respectively (p = 0.01). Eight of 10 patients who had reoperation after angioplasty had early recurrence with continued involution of the periductal tissues and growth of the posterior aortic ridge. Six patients who had recurrence after anastomosis demonstrated late anastomotic growth failure. The most common reoperation technique was patch aortoplasty (10 patients). The high incidence of early recurrence with subclavian flap angioplasty in infants under 3 months of age suggests end-to-end anastomosis as the procedure of choice when applicable. PMID- 3965810 TI - The exposed cardiac pacemaker. Treatment by subfascial pocket relocation. AB - Ten patients were treated for skin erosion and exposure of chronically implanted pacemakers. The pulse generators had been implanted either subcutaneously or in the subpectoral, submammary location. All patients were treated either by primary or secondary relocation of the pulse generator to deeper subfascial planes. Pacemakers relocated primarily to subfacial planes healed without resurfacing. Those pacemakers relocated to other superficial planes resurfaced but healed in a second subfascial translocation. Bacteriologic studies on these patients revealed that the organisms cultured or antibiotics utilized did not influence the fate of the relocated pulse generator. The subfascial location was the only determinant of the ultimate healing of the exposed pacemaker. We conclude that subfascial relocation of well-functioning pacemaker generators should be considered as an alternative to complete replacement of the unit. PMID- 3965811 TI - Technique for the surgical extraction of permanent pacing leads and electrodes. AB - When a pacing lead becomes infected, the most expedient and successful therapy is its removal. A new surgical extraction technique, combining the use of fluoroscopy and a limited surgical dissection of the right atrium, is presented for the removal of a lead entrapped in the heart or venous system. PMID- 3965812 TI - Transthoracic approach to the left subclavian and vertebral arteries. AB - The method of simultaneous transthoracic repair of stenosis of the left subclavian artery and stricture of the origin of the left vertebral artery is presented. PMID- 3965813 TI - The surgical anatomy of hypoplasia of aortic tract complex. PMID- 3965814 TI - Noncardioplegic myocardial preservation for coronary revascularization. PMID- 3965815 TI - Encircling endocardial resection with complete removal of endocardial scar without intraoperative mapping for the ablation of drug-resistant ventricular tachycardia. AB - Encircling endocardial resection, with complete removal of endocardial scar unguided by intraoperative mapping, was employed in 10 patients with drug resistant sustained ventricular tachycardia. Reproducible sustained ventricular tachycardia was induced in all patients preoperatively with programmed electrical stimulation. A trial of conventional antiarrhythmics had failed in all 10 patients; seven patients required frequent cardioversion, and three patients required overdrive suppression with temporary transvenous pacing. Encircling endocardial resection was performed in all patients, with complete removal of endocardial scar; partial reimplantation of the mitral apparatus was required in nine patients. Eight patients underwent aneurysmectomy, and the nine patients who required concomitant aorta-coronary bypass received a total of 13 grafts (mean 1.3 grafts per patient). There were no spontaneous postoperative arrhythmias. One patient without postoperative clinical arrhythmias, who had required daily preoperative cardioversion, had inducible ventricular tachycardia with postoperative programmed electrical stimulation, but not after loading with procainamide. Mean follow-up was 17.3 months. Eight patients are alive and well. There were two late deaths. One patient died with recurrent ventricular septal defects 2.5 months following extensive septal encircling endocardial resection, and one patient was readmitted after 4 months with massive pulmonary embolus and right-sided heart failure. This early experience suggests that this procedure, with complete removal of endocardial scar, successfully ablates reentrant ventricular tachycardia. We believe that the procedure will prove to be more effective than localized endocardial resection because the encircling procedure removes all ventricular sites that have the potential to generate reentrant ventricular tachycardia. PMID- 3965816 TI - Aneurysm of the thoracic aorta. Review of 260 cases. AB - In a 1980 review of the natural history and treatment of 176 thoracic aortic aneurysms, we noted the high incidence of rupture (47% overall) in 135 patients not treated surgically. Since that original study we have added another 84 patients to our series and have noted a complete change in management such that most patients are now treated surgically. We now have 260 patients in our series, 126 of whom were treated surgically. Sixty-seven were emergency operations and 59 were elective. Surgical mortality was 8% for elective resection and 33% for emergency operation. Over the past 5 years these figures have improved to 5% surgical mortality for elective resection and 16% surgical mortality for emergency resection. The 5 year survival rates for the entire series were 50% for patients treated with elective operation, 30% for combined emergency and elective operation groups, and 21% for nonsurgically treated patients. Abdominal aortic aneurysm was present in 74 patients (28%) and 23 of these patients had undergone a prior resection of an abdominal aortic aneurysm. This series documents the improved survival of patients with aneurysms of the thoracic aorta who are treated with prompt surgical intervention. It also further substantiates earlier findings of a high incidence of aneurysms of the abdominal aorta in this patient population. PMID- 3965817 TI - Cardiovascular effects of protamine sulfate are dependent on the presence and type of circulating heparin. AB - Man's response to clinical doses of protamine is highly variable. We investigated the influence of circulating heparin in nine swine (mean age 6 weeks, weight 10 kg). Through a sternotomy we implanted an electromagnetic flow probe around the pulmonary artery for cardiac output determination and catheters into the ascending aorta, pulmonary artery, right atrium, and left atrium for pressure monitoring. Each animal was allowed to recover and was studied awake on 3 consecutive days. Protamine, 3 mg/kg, beef lung heparin, 300 U/kg, and pork mucosal heparin, 300 U/kg, followed by protamine, were given in rotation by intravenous bolus. Protamine alone had no effect. Beef lung heparin followed by protamine induced a marked increase in pulmonary artery pressure (mean 38 +/- 3 to 51 +/- 5 mm Hg in 3 minutes). Pulmonary vascular resistance doubled (mean 0.12 +/- 0.01 to 0.23 +/- 0.04 R within 4 minutes), returning to normal within 15 minutes. Cardiac index and aortic pressure changed minimally. Pork mucosal heparin followed by protamine induced a similar but greater increase in mean pulmonary arterial pressure; however, cardiac index fell significantly (p less than 0.05, 207 +/- 16 to 117 +/- 16 ml/kg/min-1 at 1 minute) despite a regular rhythm and adequate left atrial filling pressure. Thus cardiac contractility was depressed. Systemic hypotension occurred in three of nine pigs. Both mean pulmonary vascular resistance and systemic vascular resistance increased (0.12 +/ 0.01 to 0.67 +/- 0.25 R and 0.40 +/- 0.04 to 1.09 +/- 0.25 R, respectively), significantly (p less than 0.05) more with pork than beef heparin. These data demonstrate that cardiovascular response to protamine neutralization varies significantly in regard to the type of heparin used. Furthermore, circulating heparin is required to produce those effects previously attributed to protamine alone. PMID- 3965818 TI - Resectional operations and long-term results in carcinoma of the esophagus. AB - The 5 year survival rate after resectional operations for carcinoma of the esophagus is still very low. Many factors have been identified as contributing to these poor long-term results. The main factor found in this study, comprising 102 patients undergoing resection out of 125 patients operated upon during a 10 year period, was nonradical resection. The main cause of nonradical resection was invasion of the tumor into the mediastinum, which was observed in 80% of the patients. In 43 of the 102 patients undergoing resection, the penetration of the carcinoma into the tissue surrounding the esophagus was observed only histologically. Thirty-three of the 38 hospital survivors in this group died within 2 years of the operation of recurrence of carcinoma. Fourteen of 17 survivors after resectional operations in whom the tumor growth was still limited to the esophagus were alive from 2 to 9 years (mean 6 years) after the operation, without evidence of recurrence. PMID- 3965819 TI - Esophagopleural fistula after pneumonectomy for inflammatory disease. AB - The development of an esophagopleural fistula after pneumonectomy is one of the less common complications of pneumonectomy. Herein reported are seven cases over a period of 14 years, five from a series of 896 pneumonectomies performed for malignant or inflammatory disease in the Department of Thoracic Surgery and two referred after pneumonectomy elsewhere. The fistula was demonstrated by the escape of radiographic contrast material, methylene blue, or food particles into the pleural space or was observed at esophagoscopy. In all, the associated empyema was first treated by drainage, and surgical repair of the fistula was attempted in only three cases. In six cases the fistula had closed before the patient left hospital. In the seventh, the patient insisted on leaving the hospital while under treatment and before closure had occurred. One patient died of cor pulmonale 2 years after closure of the fistula. There has been no recurrence of the fistula in any of the patients observed. Conservative management is at variance with that of many authors. PMID- 3965820 TI - Efficacy of crystalloid cardioplegic solutions in patients undergoing myocardial revascularization. Effect of infusion route and regional wall motion on preservation of adenine nucleotide stores. AB - The effect of varying the mode of cardioplegic delivery and the presence of regional wall motion abnormalities on myocardial protection by crystalloid cardioplegic solutions was assessed in 68 patients undergoing coronary artery bypass grafting. Serial transmural biopsy specimens from the left ventricular apex were assayed for adenosine triphosphate. All patients had more than 75% stenosis of the left anterior descending coronary artery. They were prospectively randomized into Groups I and II to receive (I) all cardioplegic solution infused via the aortic root or (II) reinfusions of cardioplegic solution given both centrally and through the completed distal left anterior descending anastomosis. Patients were also stratified as to the presence of normal (N) or impaired (Ab) apicoanterior regional wall motion. Inadequate delivery of cardioplegia during ischemia in Group I was manifested by a 41% (p less than 0.01) depletion of adenosine triphosphate stores in abnormally contracting myocardium distal to the left anterior descending stenosis that was not repleted after restoration of coronary flow and a 27% (p less than 0.05) decline in ATP stores during reperfusion in myocardium with normal preoperative wall motion. In contrast, nucleotide stores were preserved at preischemic levels throughout ischemia and reperfusion in Group II regardless of preoperative wall motion. Preservation of ATP did not correlate with duration of ischemia, highest recorded septal temperature, or volume of cardioplegic solution infused. Two patients in each group had a new perioperative infarction. However, 38% of patients in Group IAb required transient inotropic support versus 5% in Group IIAb (p less than 0.05). These data emphasize that reinfusion of cardioplegic solutions distal to coronary obstructions is mandatory for optimal myocardial protection during coronary revascularization. PMID- 3965821 TI - Primary pulmonary hypertension: a histopathologic study of 80 cases. AB - Among 80 cases with a clinical diagnosis of primary (unexplained) pulmonary hypertension, 45 (56%) had thromboembolic disease and 22 (28%) had plexogenic arteriopathy; the remaining 13 (16%) had pulmonary veno-occlusive disease, primary medial hypertrophy, primary pulmonary arteritis, or changes consistent with pulmonary venous hypertension. The mean age was 16 years for primary pulmonary arteritis, 21 to 34 years for plexogenic pulmonary arteriopathy, primary medial hypertrophy, and pulmonary veno-occlusive disease, and 41 and 45 years for thromboembolic disease and pulmonary venous hypertension, respectively. In all forms except pulmonary veno-occlusive disease and apparent pulmonary venous hypertension, female patients were involved twice as often as male patients. With the exception of apparent pulmonary venous hypertension, patients with plexogenic pulmonary arteriopathy had the longest survival (63 months). Sudden death, however, occurred most frequently in patients with plexogenic disease (45%) and occurred 2.5 times as often in this group as in patients with thromboembolic disease. Among our 80 cases, the most frequent histopathologic lesions were medial hypertrophy, intimal proliferation and fibrosis, fibrinoid degeneration and necrosis, and thrombosis. Thrombi were commonly observed and may have developed in situ or by embolization; they were often rich in platelets when they occurred in small pulmonary vessels. These histologic features may form the morphologic substrate for elevated pulmonary vascular resistance, and their recognition may provide the rationale for possible intervention with pulmonary vasodilators, anticoagulants, or platelet inhibitors. PMID- 3965822 TI - Anaplastic carcinoma of the thyroid: a clinicopathologic study of 82 cases. AB - Anaplastic carcinoma of the thyroid accounts for about 10% to 15% of all thyroid carcinomas in the United States. Its lethality is evidenced by a 5-year survival rate of 3.6% and a median survival of 4 months. Rapid growth of a thyroid mass, frequently in a preexisting goiter, is the most common manifestation; the diagnosis should be considered and expeditiously pursued in all patients who present with this finding. Relatively favorable prognostic features seem to be unilateral tumors, a tumor diameter of less than 5 cm, no invasion of adjacent tissue, and absence of nodal involvement. For resectable lesions, thyroid lobectomy with wide margins of adjacent soft tissue on the side of the tumor seems to constitute a safe, appropriately aggressive surgical approach. Total thyroidectomy and radical neck dissection results in an increased complication rate and has no advantage over a more conservative approach. Radiotherapy, chemotherapy, immunotherapy, and combination radiotherapy and chemotherapy need further evaluation. PMID- 3965823 TI - Classification of facial nerve disorders. PMID- 3965825 TI - Soft tissue surgery of mastoidotympanoplasty. PMID- 3965824 TI - Flow-regulated continuous spinal drainage in the management of cerebrospinal fluid fistulas. PMID- 3965826 TI - External septorhinoplasty in children. AB - External septorhinoplasty was performed on 15 patients over a 12-year period in a general pediatric otolaryngology practice. It is the operation of first choice when there is significant dorsal nasoseptal pathology. Good cosmetic and functional results are obtained by full dissection of the nasoseptal pathology, judicious resection of thickened deformed cartilaginous and osseous tissues, and repositioning of a suitable nasoseptal fragment anteriorly in the midline. PMID- 3965827 TI - Inverted papilloma of the nose and paranasal sinuses in childhood and adolescence. AB - Inverted papilloma of the nose and paranasal sinuses is a tumor not usually associated with childhood. These five cases from the Massachusetts Eye and Ear Infirmary provide the only series in the literature. The patients ranged in age from 6 to 20 years. One case involved the septum exclusively; the patient experienced a recurrence. The other four cases were of sinus origin. One of these patients also experienced recurrences before definitive surgery. Another presented with a simultaneous squamous cell carcinoma. Evaluation of these cases demonstrates that the same successful, comprehensive surgical management advised for adults is justifiable in this younger age group. PMID- 3965828 TI - Laryngotracheal stenosis in spondyloepiphyseal dysplasia. AB - Laryngotracheal stenosis has not been reported previously as a manifestation of spondyloepiphyseal dysplasia. Two recent cases are reported detailing the upper airway pathology encountered. The clinical features of spondyloepiphyseal dysplasia are reviewed in an attempt to develop a treatment protocol for such patients with laryngotracheal stenosis. The ultrastructural abnormalities found in these patients' cartilages are emphasized. Caution is advised before attempting laryngotracheoplasty. PMID- 3965829 TI - Vocal cord paralysis and recovery with thyroid lymphoma. AB - Vocal cord paralysis has been reported in 33 patients with thyroid lymphoma for an estimated overall incidence of 17%. There is little expectation of vocal cord function recovery, both because neoplastic invasion is believed irreversible and since surgery often necessitates sacrifice of the recurrent laryngeal nerve. Unlike in most well differentiated thyroid malignancies, external radiation therapy plays a vital role in the treatment of thyroid lymphoma. The patient presented here had complete recovery of vocal cord function following radiation therapy for a large thyroid lymphoma associated with vocal cord paralysis. This is the first reported case of such recovery following treatment for a thyroid neoplasm. The rather rapid and complete recovery of neural function suggests that, at least in some, paralysis is caused by reversible compression rather than by neural invasion or tumor-induced neurolysis. PMID- 3965830 TI - Intratracheal thyroid--familial occurrence. AB - The presence of thyroid tissue within the tracheal lumen is an unusual cause of upper respiratory obstruction. Thyroid tissue in this location may represent true ectopic thyroid or may be caused by invasion of the trachea by a malignant process. This paper presents two patients from the same family who were found to have thyroid tissue in the trachea. The first illustrates the clinical course of a thyroid malignancy within the trachea, and the second had a true ectopic intratracheal thyroid mass. The embryology, diagnosis, and management of ectopic intratracheal thyroid are outlined. PMID- 3965831 TI - Tracheal reconstruction with pedicled thyroid cartilage. AB - Limited areas of tracheal stenosis have been repaired with a variety of techniques. More extensive upper tracheal defects present a greater challenge with less predictable success. The following is the description of yet another technique for reconstruction of extensive upper tracheal defects. We report on the use of a muscle-pedicled thyroid alar graft which carries its own blood supply and perichondrial covering, supplies a large, conveniently shaped graft, requires one operative site and one operative sitting, and has proven advantageous even in the comprised patient. PMID- 3965832 TI - Transient hearing loss with metrizamide. AB - Two case studies are reported in which transient low frequency sensorineural hearing loss was experienced following myelography and CT scanning with metrizamide. Low frequency sensorineural hearing loss is considered to be the result of increased stiffness of one or both of the inner ear membranes. A review of the literature regarding an osmotic relationship between blood, cerebrospinal fluid, and the inner ear fluids attempts to explain how this phenomenon may have occurred with metrizamide. The transient sensorineural loss observed in the case studies presented is compared to the pathophysiology attributed to the formation of endolymphatic hydrops. PMID- 3965833 TI - Evaluation of the effectiveness of uvulopalatopharyngoplasty. AB - A new surgical procedure to treat obstructive sleep apnea by uvulopalatopharyngoplasty (UPPP) was evaluated in 66 patients, 63 men and 3 women, with objectively documented sleep apnea syndrome. Removal of redundant tissue in the oropharynx (UPPP) significantly improved excessive daytime sleepiness, reduced by half the frequency of apneas and hypoxia occurring during sleep, and improved the quality of sleep. Closer analysis indicated that all 66 patients did not benefit to the same degree. Among patients classified as responders, the frequency of apnea was reduced to a level seen in healthy adults of the same age, measures of sleep approached normal, and excessive daytime sleepiness was eliminated. In nonresponders, frequency of apnea and consequent disruption of sleep was not reduced, but nocturnal hypoxia was improved. PMID- 3965834 TI - Clinical experience with a short-acting caloric test. AB - The prolonged labyrinthine stimulation produced by the conventional caloric irrigation is uncomfortable and fatiguing to patients and necessitates an undesirable waiting period between applications of the test. The present report describes the use of a short-acting caloric test, and an analysis of all available data on 100 consecutive patients evaluated with this procedure. Because the labyrinthine stimulus produced by the new method is short-acting and because the stimulus was applied at reduced intensity in patients who were more sensitive, the new procedure was well tolerated even when five or more irrigations were used. It was found convenient to repeat irrigations when results were uncertain, thereby ensuring a more reliable assessment of vestibular function. PMID- 3965835 TI - Osteomyelitis of the head and neck: sequential radionuclide scanning in diagnosis and therapy. AB - Sequential technetium and gallium scans of the head and neck were used to confirm the diagnosis of osteomyelitis and as an important therapeutic aid to delineate the transformation of active osteomyelitis to inactive osteomyelitis in 11 cases involving sites in the head and neck. Illustrative cases are presented of frontal sinus and cervical spine osteomyelitis and laryngeal osteochondritis. PMID- 3965836 TI - Cervical thymic cyst: case report and review of literature. AB - An unusual case of a cervical thymic cyst in a 4-year-old boy is presented. The embryology, histopathology, and clinical presentation is discussed. This entity should be included in the differential diagnosis of cystic neck masses in the pediatric age group. PMID- 3965837 TI - Bacterial tracheitis--two-year experience. AB - Inflammatory illnesses of the pediatric airway cause significant morbidity and mortality. Bacterial tracheitis is a distinct entity with features common to both croup and epiglottitis. Ten patients between the ages of 3 months and 12 years were treated at Children's Hospital, Boston, MA., for bacterial tracheitis. The clinical presentation and medical management is discussed. Seven of the patients required both direct laryngoscopy and bronchoscopy; one patient required urgent intubation; and one patient required indirect laryngoscopy. In one patient the diagnosis was based on clinical and radiographic findings in conjunction with tracheal aspirates. Seven of the 10 patients did well with aggressive medical management. Three patients required endotracheal intubation. No patient required tracheotomy, and there were no cardiopulmonary arrests. It is of particular interest that although the patients in this series presented in a manner similar to that of patients in other published series, the management is significantly different and the overall outcome is significantly better. PMID- 3965838 TI - Cholesteatoma surgery: the influence of the canal wall. AB - Although there is an increasing awareness of the risks of complications following intact canal wall tympanoplasty (ICWT) for cholesteatoma, long-term evidence to support a preference for alternative techniques in which the canal wall having been removed, the resultant cavity is obliterated, is comparatively scarce. In order to clarify this uncertainty, long-term results with both operations have been analyzed to determine incidence rates for postoperative complications and functional results. Recurrent cholesteatoma (retraction pocket) has occurred in 14% of ICWT ears and 1% of ears with mastoid obliteration and tympanic reconstruction. The incidence of clinically detected residual disease with both operations has been extremely low so far, in spite of greater than 20% incidence of epithelial pearls at the second stage of separate planned two-stage procedures with each technique. It is concluded that reduction to the greatest degree possible of cholesteatomatous complications from tympanoplasty necessitates removal of the canal wall. PMID- 3965839 TI - Uterine carcinoma metastatic to the larynx. AB - Involvement of the larynx with metastatic disease is a rare occurrence. Batson's plexus was first proposed to explain metastatic disease to the head and neck from distant primaries, but more recent studies suggest that tumor cells in the thoracic duct may spread to the cervical region by way of retrograde flow through afferent cervical lymphatic vessels. PMID- 3965840 TI - Combine Marocel and Gelfilm as a nasal pack. PMID- 3965841 TI - Amodiaquine as a prodrug: importance of metabolite(s) in the antimalarial effect of amodiaquine in humans. AB - Existing analytical methods for assaying the 4-aminoquinoline antimalarial amodiaquine in body fluids are nonspecific and obscure the fact that little or no amodiaquine is present in the blood of dosed persons. We have isolated four metabolites of amodiaquine. The two major metabolites have been identified; one is desethylamodiaquine, and the other has been tentatively identified on the basis of proton nuclear magnetic resonance spectroscopy as 2 hydroxydesethylamodiaquine. We developed a reverse-phase high-performance liquid chromatographic (HPLC) method that separates the two major metabolites from each other and from amodiaquine, allowing separate quantification. The impact of these findings on in vitro sensitivity testing and blood analysis of persons dosed with amodiaquine is discussed. PMID- 3965842 TI - Does aging affect the intestinal transport of riboflavin? AB - Riboflavin deficiency has been reported in older individuals. The cause of this deficiency is not know but could include a decrease in the intestinal absorptive capacity for riboflavin. Therefore, we examined the intestinal absorption of riboflavin in young (3 month) and old (26 month) rats. We used in vitro jejunal everted sacs. The kinetic parameters of riboflavin absorption disclosed apparent Km of 0.37 and 0.43 microM and Vmax of 37 and 38 pmole/g initial tissue wet wt/20 min in young and old rats, respectively. These data do not demonstrate an aging associated change in the intestinal transport capacity for riboflavin. If these results are extrapolated to man, it would mean that the deficiency of riboflavin found in the elderly is not due to its intestinal malabsorption. Therefore, other mechanisms must be sought to account for the deficiency of riboflavin seen in the elderly. PMID- 3965843 TI - Facilitation of isoproterenol induced airway smooth muscle relaxation by nifedipine. AB - The facilitating effect of nifedipine on isoproterenol induced airway smooth muscle relaxation was studied in guinea pig tracheas. For isometric force measurement, 4 mm tracheal cylinders were suspended in incubation chambers in oxygenated physiologic medium. After 90 minutes of equilibration under 2 grams resting tension, at a temperature of 37 degrees C and pH of 7.4, concentration response curves for isoproterenol were performed with and without the addition of a 1 X 10(-5)M nifedipine dose. The experiments were then repeated using tissues precontracted with histamine. Our data show that in the nifedipine pretreated tissues, the EC50 of isoproterenol is shifted to the left (p less than 0.05) probably due to further reduction in cytosolic calcium by nifedipine. Our findings suggest that nifedipine might have a role in the treatment of asthma and obstructive airway disease. PMID- 3965844 TI - Relationship between coronary flow and adenosine release in reactive hyperemia. AB - A linear relationship was found between coronary flow and adenosine release during the course of reactive hyperemia. Isolated guinea pig heart was perfused with a modified Krebs Ringer bicarbonate buffer containing 2.0 mM pyruvate. Hyperemia was induced with 30, 60 and 90-second coronary occlusions. The hyperemic response was divided into three consecutive 13-second intervals (I, II and III), and perfusate efflux from coronary circulation was collected during the last 10 seconds of each interval for adenosine assay using the HPLC. The data show a control flow of 3.13 +/- 0.4 ml/min/g and adenosine release of 66 +/- 4 pmoles/min/g. Flow increased by 99, 38 and 23% at I, II and III, respectively following 30-second occlusion, whereas adenosine release increased by 241, 132 and 91% for I, II and III. A 60-second occlusion increased the flow by 125, 64 and 34% with a simultaneous increase in the release of adenosine by 464, 155 and 133%, respectively, for I, II and III. Marked elevations in flow (165, 92 and 59%) and in adenosine release (659, 194 and 176%) for I, II and III were observed following 90-second occlusion. The linear relationship between coronary flow and adenosine release had r values of 0.84, 0.74 and 0.88 for 30, 60 and 90-second occlusions, respectively. This study quantifies the relationship between coronary flow and adenosine release during the course of reactive hyperemia. It also suggests that on a percent basis, adenosine contributes equally to the hyperemia at I, II and III. PMID- 3965845 TI - Relationship between red blood cell uptake and methemoglobin production by nitrobenzene and dinitrobenzene in vitro. AB - Nitrobenzene increases methemoglobin formation when incubated with native hemoglobin but not when incubated with red blood cell suspensions. These experiments were designed to determine if transport of nitrobenzene across the red blood cell membrane is a limiting factor for methemoglobin production by red blood cell suspensions. Incubation of [14C]-m-, o- or p-dinitrobenzene, but not mononitrobenzene, with red blood cell suspensions caused a time-dependent increase in methemoglobin. All three dinitrobenzenes and mononitrobenzene crossed the red blood cell membrane and accumulated in the erythrocytes after only 1 min of incubation. Incubation of mononitrobenzene with hemolysates did not result in methemoglobin production. Incubation of red blood cells with the dinitrobenzenes or mononitrobenzene for 1 and 10 min at 4 degrees C did not influence red blood cell uptake of the nitrobenzenes, suggesting that these compounds do not enter the red blood cell by an active process. Dinitrobenzene-induced methemoglobin production was markedly inhibited at 4 degrees C, and may be a result of decreased interaction with hemoglobin and/or decreased metabolism to reactive intermediates which mediate methemoglobin production. These data indicate that red blood cell transport of nitrobenzene is not the limiting factor in methemoglobin production in vitro. PMID- 3965846 TI - Selective effects of adenosine receptor agonists upon coronary resistance and heart rate in isolated working rabbit hearts. AB - Dose dependent changes in heart rate (HR) and coronary resistance (CR) were determined for adenosine, 5'-N-ethylcarboxamide adenosine (NECA) and l-N6 phenylisopropyladenosine (l-PIA) over a dose range of 1 X 10(-9) to 1 x 10(-5) M. Changes in CR were determined under controlled metabolic demand conditions (constant mean aortic pressure, constant mean left atrial pressure, and constant HR). Decreases in HR were determined by allowing the paced hearts to beat spontaneously between doses for 15 seconds. Adenosine significantly decreased CR and HR at greater than or equal to 1 X 10(-5) M. NECA significantly decreased both CR and HR at greater than or equal to 3 X 10(-8) M. l-PIA significantly decreased HR at greater than or equal to 3 X 10(-8) M; however a dose at greater than or equal to 3 X 10(-6) M was required to significantly decrease CR. These results provide evidence that the coronary vasodilator action of adenosine may primarily be mediated by A2 receptors. Furthermore, the data are in support of previous observations that the bradycardic action of adenosine is principally mediated via A1 receptors. PMID- 3965847 TI - Heparin effects during hyperbaric oxygenation in rats. AB - The effects of heparin were studied concurrently with development of neurological and respiratory signs of oxygen toxicity in awake unrestrained rats exposed to 3 atmosphere absolute (ATA) oxygen. The modification of the early electrophysiological manifestations of CNS oxygen toxicity by heparin in the absence of obvious signs of pulmonary oxygen toxicity was also determined at 5 ATA oxygen by electrocorticographic recording. The femoral artery of all rats was cannulated two days before the exposures to hyperbaric oxygenation (HBO), and the effect of intraarterial injection of 10 U/100g/3h heparin or an equivalent volume of saline was studied in experimental and control rats, respectively. In rats exposed to 3 ATA oxygen, the latency of the onset of the first oxygen-induced convulsions, the time interval between the first convulsion and death, and the survival time were measured. Exposure to 5 ATA oxygen was continued until the onset of the first preconvulsive paroxysmal electrical discharges (FED), considered to be an early electrophysiological indicator of CNS oxygen toxicity. The onset of convulsions was slightly delayed in heparin-treated rats exposed to 3 ATA oxygen, and the time interval between the first convulsions and death was significantly reduced in heparinized rats. No difference in survival time between heparin- and saline-treated rats was observed. Heparin significantly delayed the time of onset of the FED during exposure to 5 ATA oxygen. Gross postmortem examination of the lungs and internal organs revealed only a bloody froth in the trachea of the heparin-treated rats exposed to 3 ATA oxygen. It is concluded that the heparin-hyperoxic interaction during development of pulmonary and CNS oxygen toxicity may be related to the anticoagulant effect of heparin and hyperoxic induced pulmonary lesions. PMID- 3965848 TI - Prolactin inhibits the development of stress-induced ulcers in the rat. AB - Hyperprolactinaemia, as induced by pituitary homografts under the kidney capsule, was accompanied by an inhibition of development of gastric ulcers following the application of cold-plus-restraint stress in male rats. This effect was mimicked by intracisternal administration of a low dose of the hormone. Peripheral injection of the dopamine receptor antagonist, domperidone, also inhibited the development of stress-induced ulcers. However, no effect was found after peripheral injection of another dopamine receptor antagonist, haloperidol. This latter drug appeared to antagonize the cytoprotective effect of prolactin (PRL) on stress-induced ulcers. Furthermore, peripheral injection of the prostaglandin synthesis inhibitor, indomethacin, increased the incidence of gastric ulcers in hyperprolactinaemic rats subjected to cold -plus-restraint stress. These data suggest that the cytoprotective effect of PRL on development of gastric ulcers in stressed animals may involve both central (i.e. dopamine transmission) and peripheral (i.e. prostaglandin synthesis) mechanisms. PMID- 3965849 TI - Nitrobenzylthioinosine binding in brain: an interspecies study. AB - The binding of the potent adenosine uptake inhibitor [3H]nitrobenzylthioinosine ( [3H]NBI) to cerebral cortical membrane preparations from human, dog, guinea pig, rat, and mouse was investigated. Reversible, specific, saturable, high affinity binding was found in all five species with similar kinetic parameters. (Kd = 0.16 0.44 nM; Bmax = 128-196 fmol/mg prot.). Dilazep, hexobendine, and dipyridamole were all high potency inhibitors of [3H]NBI binding in human, dog, guinea pig and mouse preparations but not in rat. These compounds showed a competitive inhibition of [3H]NBI binding indicating that they are acting at the same site. Discrepancies seen in the rat appear to be a unique, species related anomaly. The dihydropyridine calcium antagonists also inhibited binding with lower potency than the adenosine uptake blockers. This inhibition was most potent in dog and human and suggests a relationship between the calcium channel and the adenosine uptake site. PMID- 3965850 TI - Effects of subconvulsive and repeated electroconvulsive shock on thyrotropin releasing hormone in rat brain. AB - Male Sprague-Dawley rats were given a single electroconvulsive shock (ECS) on alternate days and sacrificed 48 hrs after 1, 3, or 5 seizures. The content of TRH in hippocampus, pyriform cortex and amygdala was increased 2.5-fold, 5.4-fold and 4.3-fold respectively, 48 hrs. after 3 alternate-day electroconvulsive shocks (ECS) and remained unchanged after 2 additional shocks. Pyriform cortex exhibited a significant intermediate increase (1.7-fold) after only 1 ECS. In a second study, rats were sacrificed 48 hrs after a series of 5 alternate-day ECS vs. subconvulsive shocks (SCS). SCS had no significant effect in these same regions, but was seen to alter TRH in striatum. These results provide an interesting parallel to several aspects of clinical electroconvulsive treatment (ECT) of depression. Together with other findings, these data suggest also, that endogenous TRH may play a role in the modulation of convulsive seizures. PMID- 3965851 TI - Verapamil is a competitive inhibitor of gamma-aminobutyric acid and calcium uptakes by mouse brain subcellular particles. AB - We found that verapamil and its methoxy analogue, D600, were relatively potent (micromolar) inhibitors of Na+-dependent GABA uptake by a mouse brain microsomal subfraction (P3). Verapamil was competitive with GABA and uncompetitive with Na+ in the uptake assay with the P3 fraction. These substances were much less effective in inhibiting GABA binding in a receptor-related assay system with synaptosomal membranes. Inhibition by verapamil of Na+-dependent 45Ca++ uptake by the P3 particles was competitive with Ca++. A consideration of our results with those in the literature led to the suggestion that the interaction of verapamil and related substances with GABA and 45Ca uptake processes by the P3 fraction, as well as with many other membrane activities, may be allosteric in nature rather than directly competitive with specific ligands at their binding sites. PMID- 3965852 TI - Place conditioning with morphine and phencyclidine: dose dependent effects. AB - In a place conditioning paradigm, rats were exposed to one of two distinctive environments following injection of drug or vehicle. Preference was measured under drug free conditions by allowing subjects free access to both settings and measuring where they spent more time. Comparisons were made between morphine and saline; PCP and saline; and one of several doses of morphine and a standard dose. Morphine was preferred over saline and, when compared to the reference dose, lower doses of morphine were less preferred and higher doses more preferred. PCP was never preferred over saline and under some conditions produced a conditioned place aversion. The ability to generate dose dependent effects with morphine should allow more sophisticated studies in which shifts in dose response curves are required. PMID- 3965853 TI - Gastrin/cholecystokinin-like immunoreactivity in human blood cells. AB - In the gastrin and/or cholecystokinin-like immunoreactivity (G/CCK-LI) elution patterns of blood cells in human adults, erythrocyte (RBC) elution pattern has three peaks which are coeluted with gastrin-34 (G34), gastrin-17 (G17) and Vt, and polymorphonuclear leukocyte (PMN) and mononuclear cell (MNC) elution patterns have four peaks which are coeluted with Vo, G34, G17 and Vt. The content of G/CCK LI in RBC is 1.20 +/- 0.54 f mole/10(8) cells (mean +/- SD). That in PMN and MNC is 1.44 +/- 0.67 p mole/10(8) cells and 1.67 +/- 0.76 p mole/10(8) cells, respectively. PMID- 3965854 TI - The distribution of acetylcholine and choline in guinea pig heart. AB - The regional distributions of acetylcholine (ACh) and choline (Ch) in the guinea pig heart were investigated with a pyrolysis-mass fragmentography technique. Using ACh as a marker for cholinergic neurons, we have described a pattern of parasympathetic innervation in the guinea pig heart. This distribution is very similar to that suggested by studies using several different cholinergic indicators in various species. Atrial areas receive richer parasympathetic innervation than ventricular areas, with the right portions receiving more than the left. The nodal areas were the most abundantly innervated regions examined. Ch content is not a good indicator for cholinergic innervation as the regional distribution of ACh and Ch throughout the guinea pig heart are not strongly associated. PMID- 3965855 TI - Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies. AB - Nodules were found in 1108 subjects who received childhood radiation for benign conditions of the cervical area at our institution. This is 37.5% of 2958 subjects, out of a total of 5379, for whom there is follow-up information. Of the 848 subjects who have had thyroidectomies, 297 (35.0%) had thyroid cancer. In addition to thyroid tumors, salivary, neural, and probably parathyroid tumors also occurred as a late consequence of childhood radiation. Prospective studies of the subjects indicate that thyroid nodules are continuing to occur at a constant rate. The measurement of serum thyroglobulin is helpful in identifying individuals for whom the risk of developing a nodule is increased. Follow-up of patients with nonsurgically-treated nodules indicates that some of their nodules are progressive. At the present time there is no indication that radiation induced cancers behave differently than ones in other settings. However, some of their characteristics, especially their multicentricity and occurrence in younger individuals, indicate that continued follow-up is necessary. On the basis of the data generated by the follow-up program at our institution and programs elsewhere, recommendations for screening, treatment, and follow-up are made. The recommendations stress the importance of estimating risk based on radiation dose, previous tumors, and serum thyroglobulin, in arriving at clinical decisions for these subjects. PMID- 3965856 TI - Cerebrovascular complications in patients with cancer. AB - In an autopsy study of patients with cancer, 14.6% had pathologic evidence of cerebrovascular disease (CVD), and in 7.4% clinical symptoms of CVD had been present in life. The usual risk factors for CVD were overshadowed by pathophysiologic abnormalities related to the neoplasm, including direct effects of the tumor, coagulation disorders, infections and diagnostic or therapeutic procedures. In patients with leukemia, hemorrhages (72.4%) were much more common than ischemic infarcts. In lymphoma patients, the incidence of cerebral bleeding was lower (36.3%). In both groups, the leading causes of ischemic infarction were septic thrombi and intravascular coagulation. In patients with carcinoma, cerebral infarctions (54.1%) were more frequent than hemorrhages. NBTE (18.5%) and intravascular coagulation (9.6%) were the most common etiologies. Hemorrhages other than intratumoral bleeding in patients with melanoma or germ cell tumors were unusual. The clinical presentation of CVD in patients with cancer is more often a diffuse encephalopathy, with or without localizing signs, than the typical acute onset of a focal deficit. This was particularly true with intravascular coagulation, septic infarction and subdural hematoma. Our study suggests that by knowing the clinical setting, neurologic features and laboratory findings, one can, in many instances, make an accurate clinical diagnosis that, in some cases, leads to effective treatment. PMID- 3965857 TI - Abnormal cell-interactive properties of low-density lipoproteins isolated from patients with chronic renal failure. AB - Patients with renal failure on maintenance hemodialysis have accelerated rate of atherosclerosis. This, and the fact that chemically modified low-density lipoproteins (LDL) have a better capacity than native LDL to stimulate cholesteryl ester accumulation within macrophages in the vessel wall, led us to examine the possibility that some alteration in apo-LDL may take place in chronically uremic patients. We isolated LDL (d = 1.019 - 1.063 g/mL) from 18 patients with chronic renal failure and from 13 normolipidemic controls and compared the interactive properties of the different LDL preparations with cultured fibroblasts. Our results show that "uremic" LDL associates less, is degraded less, and has diminished ability to stimulate cholesteryl ester formation in fibroblasts when compared to normal LDL. LDL carbamylated in vitro showed interactive properties with fibroblasts similar to those of uremic LDL. Uremic LDL was not taken up by scavenger receptors present on rat peritoneal macrophages, similarly to normal LDL. However, the decrease in uptake by fibroblasts of uremic LDL may increase the residence time of these particles within the subendothelial region of the vessel wall, ultimately resulting in increased atherogenicity. Carbamylation of lysine residues of apoB in vivo, abnormal catabolism of LDL due to the absence of functional renal tissue, or triglyceride enrichment of LDL are among the possible explanations for the abnormal properties of uremic LDL. PMID- 3965858 TI - Serum cholesterol, lecithin-cholesterol acyltransferase, and hepatic hydroxymethylglutaryl coenzyme A reductase activities of lean and obese Zucker rats. AB - Serum cholesterol concentrations, lecithin-cholesterol acyltransferase (LCAT), and hepatic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activities of lean and obese Zucker rats were compared. The excess serum cholesterol of the female obese rat is found to be mainly free cholesterol associated with very low density lipoproteins, whereas that of the male obese rat is carried as cholesterol esters associated with high-density lipoproteins. The high level of serum free cholesterol in the female obese rat is not due to a deficiency in lecithin-cholesterol acyltransferase activity. This enzyme activity is found to be elevated in the male obese rat. Hepatic HMG-CoA reductase activity declines as rats mature; this observation is most apparent in obese male rats. Lean rats exhibit the normal diurnal rhythm, but mature obese rats show little diurnal variation in HMG-CoA reductase activity. Obese female rats maintain high reductase activities, but the activities of obese male rats remain low at all times. Starvation suppresses liver HMG-CoA reductase and serum cholesterol in both lean and obese female rats. Thus, an increase in hepatic cholesterol synthesis may contribute to hypercholesterolemia in the obese female Zucker rat. On the other hand, factors such as nonhepatic synthesis or a decreased cholesterol catabolism may play more important roles in maintaining high serum cholesterol in the obese male Zucker rat. PMID- 3965859 TI - Pancreatic polypeptide in Pima Indians: the influence of obesity and diabetes. AB - The influence of obesity and diabetes on circulating pancreatic polypeptide (PP) levels was studied in 62 Pima Indians and 22 caucasians. Plasma PP was determined in the fasting state and after a standardized test meal. Fasting and the postprandial PP responses were not significantly different among the Pima Indians whether nonobese, obese, or diabetic. However, their concentrations were significantly higher both fasting and postprandially compared to those of caucasians. In both groups the postprandial PP response was positively correlated with the fasting level. Fasting and postprandial PP levels positively correlated with age in Pimas. PMID- 3965860 TI - Effect of desialylation of very low-density lipoproteins on their catabolism by lipoprotein lipase. AB - Very low-density lipoproteins (VLDL) contain sialylated apolipoproteins (apo) (eg, apo CIII1-3) that inhibit apo CII activation of lipoprotein lipase (LPL) and also uptake of triglyceride (TG)-rich lipoproteins by the liver. Hypertriglyceridemic patients can have an excess of sialylated apo CIII (apo CIII1 or apo CIII2) in VLDL. These observations have prompted the notion that sialic acid in VLDL may impede LPL or receptor-mediated clearance of VLDL and thus result in hypertriglyceridemia. The aim of this study was to determine whether desialylation of VLDL altered their property as a substrate for LPL. VLDL isolated from five hypertriglyceridemic patients was desialylated with neuraminidase, labeled with a fluorescent probe, dansyl phosphatidylethanolamine and 600 micrograms of labeled VLDL TG were incubated with a constant amount of purified bovine LPL. The change in fluorescence against time was monitored on a recorder to yield curves representing continuous lipolysis of VLDL by LPL. Mean initial velocity of reaction (Vi) and extent of lipolysis measured as total increase in fluorescence over baseline at 30 minutes (F30/FO) were similar (Vi = 10.2 +/- 0.37 control v 10.2 +/- 0.42 u/min desialylated VLDL; F30/FO = 4.1 +/- 0.15, control v 4.1 +/- 0.07 desialylated VLDL; n = 5). Thus, sialic acid does not influence VLDL catabolism by LPL. Our study does not exclude a possible role of the sialic acid in receptor mediated uptake of remnants produced by initial catabolism of VLDL by LPL. PMID- 3965861 TI - Direct synthesis of low-density lipoprotein apoprotein B in the miniature pig. AB - The metabolism of apoprotein B (apo B) was investigated in five miniature pigs following the injection of radiolabeled, very low-density lipoproteins (VLDL). The fractional catabolic rate (FCR) for VLDL apoprotein B was 0.71 +/- 0.10 h-1 (mean +/- SE), the rate of flux was 0.77 +/- 0.05 mg h-1 kg-1, and the pool size of apoprotein B averaged 1.26 +/- 0.20 mg kg-1. Examination of precursor-product relationships between VLDL and low-density lipoprotein (LDL) apoprotein B illustrated that a significant proportion (greater than 80%) of LDL apo B was derived from some source other than VLDL catabolism. In further experiments (n = 4), 125I-VLDL and 131I-LDL were simultaneously injected into miniature pigs. The fractional catabolic rate of LDL apo B averaged 0.055 +/- 0.008 h-1 and the flux rate 0.73 +/- 0.07 mg h-1 kg-1. These dual-label studies allowed us to calculate that an average of 16% of VLDL apoprotein B was converted to LDL and thus the remainder was cleared directly from the circulation. Simultaneous injection of radiolabeled homologous and human VLDL indicated that the catabolism of the two tracers was qualitatively similar. However, human VLDL apo B exhibited a slower fractional catabolic rate (0.42 v 0.71 h-1 P less than 0.05) and reduced rate of conversion to LDL. Therefore, low-density lipoproteins in the pig are largely produced by direct secretion into the circulation, independent of VLDL catabolism. Apo B metabolism in miniature pigs is similar to that of cynomologous and squirrel monkeys, and rats, but differs from normal humans in whom all LDL apo B is derived from VLDL catabolism. PMID- 3965862 TI - Serum branched chain amino and keto acid response to fasting in humans. AB - Eight healthy individuals were fasted for 72 hours. The concentrations of the branched chain keto acids (BCKA), branched chain amino acids (BCAA), C peptide, and glucagon were determined in peripheral venous blood. alpha-ketoisocaproic acid, alpha-keto-beta-methyl-n-valeric acid, and alpha-ketoisovaleric acid increased significantly within 36 hours along with the corresponding amino acids. After 60 hours of starvation, the concentrations of BCKA and BCAA declined despite the fact that the subjects were still in the fasting state. These changes were accompanied by a decrease in the concentrations of C peptide and an increase in glucagon levels. It is suggested that in starving man insulinopenia may contribute to the rise in BCKA concentrations and that the increase in BCKA may be a mechanism to reduce proteolysis. PMID- 3965863 TI - Influence of polyunsaturated fats and fat restriction on serum lipoproteins in humans. AB - This study was designed to determine the effects of polyunsaturated fats and of reducing intake of total fat on serum lipids, lipoproteins, and apolipoproteins. Twenty-two normolipidemic women living in a nunnery were given a reference diet (fat/carbohydrate 42/46% of energy, P/S ratio 0.16), a polyunsaturated diet (42/46%, P/S 1,0), and a low-fat, polyunsaturated diet (32/56%, P/S 1.0) for 6 weeks each. Serum and lipoprotein lipids were determined by standard procedures, apolipoproteins either by laser immunonephelometry or by rocket immunoelectrophoresis. Consumption of the polyunsaturated diet decreased cholesterol and apolipoprotein B levels in VLDL (-33.1% and -23.8%) and in LDL ( 13.5% and -8.8%) without affecting HDL. Consumption of the low-fat, polyunsaturated diet resulted in a reincrease of VLDL triglycerides, but not of VLDL cholesterol. Concentration of VLDL apolipoprotein B further fell (-41.6%) and that of apolipoprotein E decreased (-25.9%), resulting in an increased VLDL lipid/apolipoprotein mass ratio. This study indicates that responses to therapeutic polyunsaturated diet are lowered levels of VLDL and LDL, but unchanged levels of HDL. Additional restriction of dietary fat intake alters the VLDL composition with a decrement in apolipoprotein E enriched VLDL particles. PMID- 3965864 TI - Carotenoids and vitamin A: the effect of hypocholesterolemic agents on serum levels. AB - Serum total carotenoid (STC) and vitamin A levels were done as part of the biochemical screening in comparative studies of lipid lowering agents in type Ila hyperlipoproteinemic patients. STC levels were reduced following bile acid sequestering agent administration (colestipol 30 g/d) by 30% (P less than 0.01). Clofibrate and avicel placebo had inconsistent and nonsignificant effects on the STC levels. Serum vitamin A levels were not significantly altered by any of the test agents. The STC level changes were not correlated with concomitant changes in low-density lipoprotein-cholesterol (LDL-C) during any of the treatment regimens. It is suggested that STC level changes are related to alterations in the absorption of carotenoids during bile acid sequestrant administration. PMID- 3965865 TI - Mortality from bleeding peptic ulcer. Alfred Hospital, Melbourne, 1976-1980. AB - Of 682 patients (755 admissions) who were admitted to hospital with bleeding peptic ulcers or erosive gastritis-duodenitis during a five-year period, 92 died (12% of admissions). In 70% of admissions to hospital, the patients were aged 50 years or older. The overall mortality rates were 13% in patients with bleeding gastric ulcers; 12% in those with duodenal ulcers; and 11% in those with gastritis-duodenitis. Fourteen per cent of patients with bleeding gastric ulcers, 21% of those with duodenal ulcers, and 4% of those with erosive gastritis duodenitis had undergone surgery. Ten of 92 deaths (11%) occurred after the operation; of these, only one patient who died was aged less than 50 years. The postoperative mortality rates were 8% in patients with bleeding gastric ulcers, and 12% in those with duodenal ulcers; there were no deaths after operation for gastritis-duodenitis. Whereas the 13% overall mortality rate in patients with bleeding gastric ulcers closely resembled that found in other series, the 12% overall mortality rate in patients with bleeding duodenal ulcers was about twice that reported in recent British and Australian series. PMID- 3965866 TI - Mortality from influenza and allied infections in South Australia during 1968 1981. AB - Numbers of deaths from pneumonia and influenza and other causes were analysed for successive four-week periods in South Australia during 1968-1981. An overall excess in deaths from pneumonia or influenza of 74% was evident during the winter months and early spring, compared with summer and early autumn. An accompanying excess of 18% occurred for deaths assigned to other causes. There was a strong association between numbers of deaths from pneumonia and influenza and other deaths, suggesting that influenza may have a broad impact on mortality. This mostly applied to individuals aged 60 years and over. There is the need for medical practitioners to provide prophylactic care to protect aged patients against the effects of influenza. This should be done in autumn, and special attention should be given to individuals with underlying conditions. PMID- 3965867 TI - Nuclear magnetic resonance imaging. Applications in the diagnosis of cerebrospinal diseases. AB - The applications of the important new diagnostic modality, nuclear magnetic resonance (NMR) imaging (or MRI), to the diagnosis of diseases of the central nervous system (CNS) are discussed. Specific examples of NMR imaging of cerebral and spinal tumours, infarction, demyelination and subdural haematomas are illustrated and compared with corresponding CT scans. The greater sensitivity of NMR, together with its ability to image in axial, coronal and sagittal planes, suggests that NMR will replace CT for many diagnostic investigations of the CNS. PMID- 3965868 TI - The trained nurse in general practice. AB - A trained nurse is employed in a suburban general practice in South Australia to provide additional care for elderly patients at home. This nurse's observations, her assessments, the problems she encountered and the courses of action she took during 426 consecutive visits are reported and discussed. The cost of the visits is estimated. PMID- 3965869 TI - Advances in imaging technology and their implications. PMID- 3965870 TI - Medical consultation--contract versus tort? AB - A surgeon was sued for breach of contract for a failed sterilization, resulting in an unwanted pregnancy. It was conceded that the operation was carried out skillfully and with due care. The major ground relied on was that, whilst there may be no common law duty to warn of the small risk of spontaneous recanalization, the contract in the present case was for the male plaintiff to be sterilized, so that the failure to achieve this result constituted a breach of contract. PMID- 3965871 TI - The citadel within. The teacher in the student-teacher relationship. PMID- 3965872 TI - The tyranny of testing. PMID- 3965873 TI - Nuclear magnetic resonance becomes established. PMID- 3965874 TI - Hepatic reactions to nifedipine. AB - Two cases in which abnormal liver function tests were associated with the use of nifedipine are reported. In both cases, liver function returned to normal after withdrawal of the drug. Evidence suggests that the toxic effect of nifedipine on the liver is due to hypersensitivity. PMID- 3965875 TI - Aggravation of myocardial ischaemia by nifedipine. AB - Three cases in which myocardial ischaemia was possibly precipitated by the administration of nifedipine are reported. It is suggested that the initial administration of nifedipine should be undertaken with caution in patients with unstable ischaemic heart disease. PMID- 3965876 TI - Stress, type-A behaviour and infarction. PMID- 3965878 TI - The role of the nurse in Australia. PMID- 3965877 TI - Intrahepatic gallbladder and obstructive jaundice. AB - A case of intrahepatic gallbladder--a rare anomaly of the biliary tree which predisposes towards the formation of calculi--is reported. The special difficulties which may be encountered in the management of the complications of cholelithiasis in these circumstances are described. PMID- 3965879 TI - A statement on breast health and mammography. PMID- 3965880 TI - Breast screening. PMID- 3965881 TI - Magnetic resonance imaging (MRI) in Australia. PMID- 3965883 TI - Doctors versus governments. PMID- 3965882 TI - Malaria prophylaxis for travellers. PMID- 3965884 TI - Latrodectism as mimic. PMID- 3965885 TI - Circumcision and hygiene. PMID- 3965886 TI - RSI and Space Invaders. PMID- 3965887 TI - Orthomolecular psychiatry/medicine. PMID- 3965889 TI - Hepatitis in dermatologists. PMID- 3965888 TI - Cimetidine for herpes zoster. PMID- 3965890 TI - Toxoplasma antibody in WA. PMID- 3965892 TI - Diabetes in the Pacific. PMID- 3965891 TI - Squamous-cell carcinoma treatment. PMID- 3965893 TI - The fractured prosthetic component. PMID- 3965894 TI - Promotion of breast self-examination in South Australia. A short-term evaluation. AB - In early October 1982, a campaign was launched in South Australia to encourage women to practice breast self-examination. A study of data from the State Cancer Registry was conducted to determine the impact of the campaign on the detection rate, the patient-survival rate and the extent of the tumour at the time of diagnosis. In the three months after the launch, 30% more cancer cases were detected than expected from the numbers presenting during similar periods in previous years. The increase was 53% for women under 50 years of age and 21% for older subjects. There is an indication that tumours diagnosed in the three months after the launch of the campaign were diagnosed earlier than those presenting in corresponding periods in earlier years. The proportion of cases with four or more affected nodes at diagnosis was substantially reduced. The slight differences in tumour diameter and one-year patient survival were also consistent with earlier diagnosis. PMID- 3965895 TI - Acetazolamide-induced anaemia. PMID- 3965896 TI - Diet, nutrition and disease. Contemporary Australian epidemiology. PMID- 3965897 TI - Epidemiology of cancer in Australia. PMID- 3965898 TI - Epidemiological research in cardiovascular disease in Australia: 1984. PMID- 3965899 TI - Epidemiology in occupational health. PMID- 3965900 TI - Hospital outbreak of multiresistant Staphylococcus aureus in Victoria, 1979-1984. AB - The outbreak of nosocomial infection caused by multiresistant Staphylococcus aureus (MRSA) strains in Victoria has been monitored by a continuing programme of collecting monthly statistics from all hospitals on new patients who have been either colonized or infected by these strains. Data collected during the period from November 1980 to September 1984 have been plotted on graphs. Whereas the prevalence of MRSA strains has remained virtually unchanged, the number of infections attributed to them appears to have gradually decreased since November 1982. PMID- 3965901 TI - Ophthalmic manifestations of pituitary apoplexy. AB - A case of pituitary apoplexy which occurred in a patient with prolactinoma is reported. The signs and symptoms on presentation were headache, loss of vision, sixth-nerve palsy, subarachnoid haemorrhage and fever. Physicians are alerted to the necessity of prompt and accurate diagnosis in this condition to allow urgent decompression of the anterior visual pathways. PMID- 3965902 TI - Health--a shrinking constituency? PMID- 3965903 TI - Modification of the "ten-day rule" on radiological examination of women. PMID- 3965904 TI - Conjugative plasmids in MRSA. PMID- 3965905 TI - MRSA in a major teaching hospital. PMID- 3965906 TI - Hyperbaric oxygen and retinal vascular changes. PMID- 3965907 TI - AIDS and surgery. PMID- 3965909 TI - Perennial rhinitis in children. PMID- 3965908 TI - Multiple fractures associated with myocardial infarction. PMID- 3965910 TI - Nuclear war and health. PMID- 3965911 TI - Circumcision and hygiene. PMID- 3965912 TI - Physiotherapy and ill-effects. PMID- 3965913 TI - Medic Alert bracelets. PMID- 3965914 TI - The uses of epidemiology. PMID- 3965915 TI - Epidemiology comes of age. PMID- 3965916 TI - Epidemiology, influenza, and research in general practice. PMID- 3965917 TI - Primary liver cell carcinoma. Clinical features. AB - The clinical features of 77 patients with primary liver cell carcinoma seen over a nine-year period were examined. Eighty per cent of the patients had underlying cirrhosis, of alcoholic origin in most cases. In nine of the patients hepatitis B surface antigen was found in the serum; all nine patients were born in areas where hepatitis B virus infection is endemic. Abdominal pain and ascites were the most common presenting symptoms; they are due mainly to the locally invasive nature of the tumour. A confirmatory laboratory finding in the diagnosis is the observation of raised alkaline phosphatase levels and the presence of alpha fetoprotein in the serum. The diagnosis should be established without performing a laparotomy and should seriously be considered in a previously stable patient with cirrhosis who deteriorates clinically without obvious cause. PMID- 3965918 TI - Naturally acquired immunity to influenza type A. Lessons from two coexisting subtypes. AB - When the H1N1 subtype of influenza reappeared in the Northern Hemisphere during 1977, after a 20-year absence, it behaved very differently from the H3N2 subtype still in circulation. In Sydney, we studied the incidence of both subtypes of laboratory-proven influenza type A in 287 unvaccinated volunteers whose serum antibody titres were measured before and after each winter, to facilitate the detection of subclinical as well as clinical infection. During a 1977 epidemic, the A/Victoria/3/75 strain of the H3N2 subtype attacked participants of all age groups, whereas during epidemics of 1979 and 1981, the A/USSR/90/77 and A/Brazil/11/78 strains of the H1N1 subtype attacked only subjects born after 1950. The older participants apparently possessed homologous protection, acquired as a result of exposure to H1N1 more than 20 years earlier and not dependent upon strain-specific haemagglutination inhibition antibody. PMID- 3965919 TI - Effect of influenza epidemics on Australian mortality. AB - The effect of influenza epidemics on all major causes of death has been examined. The results showed an increase in total mortality, and a fall in life expectancy, during epidemic years. Using the 1974 epidemic as an example, an increase in mortality was found in all age groups, with the greatest percentage in increases occurring in the very young and the very old. For all ages combined, the greatest percentage increases in mortality were for respiratory diseases, while the greatest absolute increases in mortality were for cardiovascular diseases, especially ischaemic heart disease. A thrombotic mechanism is suggested to explain the increase in mortality from cardiovascular diseases. PMID- 3965920 TI - Diet and coronary heart disease. PMID- 3965921 TI - Oral erythromycins. PMID- 3965922 TI - A study of structure-activity relationships in 4-deoxypyrido[1',2' 1,2]imidazo[5,4-c]rifamycin SV derivatives by electron spectroscopy for chemical analysis and 1H NMR. AB - A new class of rifamycins, 4-deoxypyrido[1',2'-1,2]imidazo[5,4-c]rifamycin SV derivatives, has been synthesized. They are potent antibacterial agents and are not absorbed at the gastrointestinal level and can therefore probably be used as antibacterial intestinal disinfectants. From the present X-ray, electron spectroscopy for chemical analysis, and 1H NMR study, it appears that this peculiar pharmacokinetic behavior is mainly to be attributed to the fact that the pyridoimidazo system exists in these compounds in a mesomeric betaine form, bearing one positively and one negatively charged nitrogen. If it is assumed that rifamycins are generally absorbed by passive diffusion, the presence of the two oppositely charged nitrogens, together with the presence of the phenolic hydroxyls, means that these molecules are ionized at all pH values encountered along the gastrointestinal tract, which thus prevents their absorption. These molecules also display a strong tendency to self-associate both in solution and in the solid state, and the increase in molecular size may also play a role in preventing their absorption. PMID- 3965923 TI - Role of hepatic monooxygenases in generating estrogenic metabolites from methoxychlor and from its identified contaminants. AB - Previous investigations demonstrated that methoxychlor [1,1,1-trichloro-2,2-bis(4 methoxyphenyl)ethane] contains estrogenic contaminants and that methoxychlor per se is not an estrogen but is a proestrogen being metabolized in vivo into estrogenic products. The present study examined structurally identified methoxychlor contaminants as to their estrogenic or proestrogenic properties. Also, the estrogenic activity of demethylated metabolites of methoxychlor and of one contaminant was determined. To examine these properties, we utilized an assay developed by us that monitors whether a given compound, incubated with isolated rat uteri, can diminish the uterine cytosolic estrogen receptor and elevate the nuclear estrogen receptor and whether metabolic intervention by hepatic microsomal monooxygenase(s) is required by the respective compound for this cellular redistribution of the receptor. Of the 15 compounds examined which constitute with methoxychlor 99.5% of total technical grade methoxychlor, two compounds, 1,1-dichloro-2-(4-hydroxyphenyl)-2-(4-methoxyphenyl)ethene (mono-OH MDDE) and 1,1,1-trichloro-2-(4-hydroxyphenyl)-2-(4-methoxyphenyl)ethane (mono-OH methoxychlor), were active per se and two compounds, 1,1-dichloro-2,2-bis(4 methoxyphenyl)ethene (MDDE) and methoxychlor, required metabolic transformation for estrogenic activity to be manifested. Subsequently, it was shown that the mono- and bis-OH metabolites of MDDE and of methoxychlor were active estrogens and that the order of activity, either by the above procedure or in terms of relative binding affinity to rat uterine cytosolic receptor, was as follows: bis OH-MDDE much greater than bis-OH-methoxychlor greater than mono-OH-MDDE greater than mono-OH-methoxychlor. Following the in vitro observations, the activity of MDDE and bis-OH-MDDE was determined in vivo in immature rats. It appears that both compounds are estrogenic, yielding marked elevation in ornithine decarboxylase (EC 4.1.1.17) levels and moderate increase in uterine weight. A comparison with methoxychlor and bis-OH-methoxychlor [1,1,1-trichloro-2,2-bis(p hydroxyphenyl)ethane] demonstrates that the order of potencies is similar to that observed in the in vitro determinations. These studies demonstrate the usefulness of the in vitro assay for determining the estrogenic and proestrogenic properties of compounds of which limited quantities are available, often insufficient for in vivo determination. Also, whereas the in vitro assay is simple and rapid, a lengthy investigation might be required to determine in vivo whether a given compound is an estrogen or a proestrogen.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3965924 TI - Changes in the concentration of seven forms of cytochrome P-450 in primary cultures of adult rat hepatocytes. AB - We prepared primary monolayer cultures of adult rat hepatocytes and measured the losses of cytochromes P-450 with the use of specific antibodies directed against purified forms of hepatic cytochrome P-450 which predominate in untreated rats (P 450UT-A, P-450UT-F) or in rats treated with phenobarbital (P-450PB-B/D, P-450PB C, P-450PB/PCN-E) or with 3-methylcholanthrene (P-450 beta NF-B, P-450 beta NF/ISF-G). In hepatocytes prepared from an untreated rat and incubated in control medium, total cytochrome P-450, measured spectrally as CO-binding hemoprotein, declined 68% during the first 72 hr in culture. However, the sum of the immunoreactive cytochromes P-450 declined only 24%, indicating that loss of heme rather than of protein accounts for much of the well-known loss of cytochromes P 450 in hepatocyte cultures. In cultures prepared from untreated rats or from rats treated with phenobarbital or with 3-methylcholanthrene, individual forms of cytochrome P-450 declined at markedly differing rates. Incubation of cultures in three different media previously reported to maintain levels of total cytochrome P-450 failed to prevent the decline in total cytochrome P-450 during the first 24 to 72 hr in culture. However, in cultures incubated in medium containing metyrapone, the level of holocytochrome P-450 was maintained at the initial value during the first 72 hr, apparently by preventing the net loss of cytochrome P-450 heme and by increasing the concentrations of immunoreactive P-450PB/PCN-E and P 450 beta NF-B. Medium containing nicotinamide increased the proportion of P-450 beta NF-B relative to the other forms of cytochrome P-450, whereas cysteine-free medium increased P-450UT-F. We conclude that loss of cytochrome P-450 in cultured hepatocytes involves loss of its heme moiety coupled with changes in the concentrations of the individual forms. Recognition of these changes as influenced by specific components of the culture medium is important when using primary hepatocyte cultures for study of xenobiotic metabolism and toxicity in the liver. PMID- 3965925 TI - Fetal thymus organ culture as an in vitro model for the toxicity of 2,3,7,8 tetrachlorodibenzo-p-dioxin and its congeners. AB - Fetal thymuses from C57BL/6 (B6) and DBA/2J (D2) mice from gestation day 14 or 15 were explanted and grown for 2 and 6 days in culture in the presence of 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) and a number of its congeners, known ligands of the Ah receptor (Ah, designating genetic locus for aryl hydrocarbon responsiveness). TCDD and 2,3,7,8-tetrachlorodibenzofuran (TCDBF) showed the same toxicity to B6 thymuses with a 50% inhibition of lymphoid development (EC50) at 10(-10) M concentration. 3,3',4,4'-Tetrachloroazoxybenzene (TCAOB) was only 2-10 times less effective, while the EC50 of 3,3',4,4'-tetrachlorobiphenyl (TCB) was around 10(-8) M (100 times higher than that of TCDD). TCBs with chlorine atoms in the position close to the biphenyl bridge were nontoxic even at 10(-5) M concentration. Thymuses exposed to TCDD, TCDBF, and TCAOB in vivo at teratogenic doses given to the mothers and explanted 24-48 hr later were smaller and inhibited in their early in vitro growth, but recovered slowly (less rapid for TCDD) as judged by lymphoid cell counts and [3H]thymidine incorporation. These results indicate a good correlation for this group of compounds between their activity as ligands of the Ah receptor and toxicity in vitro. Other ligands of the Ah receptor, namely 3-methylcholanthrene and beta-naphthoflavone, were inactive at the highest concentrations tested (10(-6) M). Thymuses from D2 mice, considered Ah receptor-defective, were nonsensitive to TCDD at the concentrations used (up to 3 X 10(-8) M) after 2 days in culture, indicating more than 100 times lower sensitivity as compared to B6 thymuses. After 6 days in culture, their sensitivity was however only 1 order of magnitude lower than that of B6 thymuses. Therefore "low sensitivity" of D2 thymuses may be at least partially overcome by prolonged exposure to TCDD in vitro. PMID- 3965927 TI - A quantum mechanical approach to the theory of cancer from polynuclear compounds. Metabolic activation and carcinogenicity of extended anilines and aminoazo compounds. AB - Calculations have been carried out of the electronic structure and molecular properties in relation to metabolic activation and carcinogenic activities of polycyclic aromatic amines (PAAs). Quantum mechanical molecular orbital method MINDO/3 is employed in the calculations mainly on anilines, extended anilines, and aminoazo and other azo compounds. The calculations, in agreement with findings of Arcos and Argus, indicate that for the highest level of carcinogenic activity obtainable with the dicyclic aromatic amines, the amino substituent must be introduced at the terminal carbon atom of the longest conjugate chain. In the case of monocyclic compounds, in particular, charge distribution of the amino substitution aids in identifying the carcinogenic character of the PAAs. Our results demonstrate that ring hydroxylation leads to detoxification of the compounds. However, the major pathway leading to carcinogenic activity involves transformation to hydroxylamines and subsequently to electrophilic arylnitrenium ions (ANIs). These are in line with findings from experiments. Calculations of certain electronic parameters give expected relative carcinogenic potencies. In all cases the ANIs function as ambient electrophiles which can undergo both electrostatic and covalent binding with nucleophilic centers of proteins and DNA bases. PMID- 3965926 TI - Regiospecific gamma-conjugation of methotrexate to poly(L-lysine). Chemical and biological studies. AB - Regiospecific syntheses of gamma- and alpha-conjugates of methotrexate and poly(L lysine) are described. The alpha- and gamma-t-butyl esters, respectively, of methotrexate were coupled to poly(L-lysine) with diphenylphosphoryl azide in N,N dimethylformamide, the ester-protecting group was cleaved with 15% hydrogen bromide in acetic acid, and small molecules were removed by dialysis. Poly(L lysine) of Mr = 1,500-8,000 and 8,000-30,000 was used to prepare six different conjugates, which were characterized by ultraviolet absorbance measurement and quantitative amino acid analysis. The degree of substitution varied from one methotrexate per 4.7 lysines to one methotrexate per 10.2 lysines. Dihydrofolate reductase inhibition in a cell-free assay was observed with alpha- and gamma conjugates, but the latter had the greater affinity (only 3-fold less than that of methotrexate itself). The binding of the conjugates exhibited a slight pH dependence, with affinity being greater at pH 7.2 than at pH 8.5 for both alpha- and gamma-conjugates. Toxicity to cultured rat hepatoma cells (H35) was also greater for the gamma-conjugates, and showed some dependence on the chain-length and degree of substitution of the poly(L-lysine) carrier. Cells resistant to methotrexate by virtue of a transport defect (H35R0.3 line) retained their sensitivity to the gamma-conjugate, but less so to the alpha-conjugate. There was also some retention of sensitivity in a more highly resistant cell line (H35R10) with impaired methotrexate transport and a concomitant increase in dihydrofolate reductase activity. gamma-Conjugation was likewise more favorable in cytotoxicity assays against L1210 murine leukemia cells, and there was partial retention of activity against highly methotrexate-resistant lines (L1210/R71 and L1210/R81) with a transport defect and/or an elevation of dihydrofolate reductase content. In antitumor assays against intraperitoneal L1210 leukemia in mice, a gamma conjugate with Mr = 8,000-30,000 and one methotrexate per 5.5 lysines produced a 35-75% increase in lifespan when administered intraperitoneally at single doses equivalent to 10-20 mg/kg of methotrexate. A similar increase in lifespan with methotrexate alone on the single-dose regimen required 50-150 mg/kg. An alpha conjugate of similar Mr and degree of substitution was inactive at nontoxic doses, as were other gamma-conjugates of lower Mr and/or degree of substitution.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3965928 TI - A method for assessing damage to mitochondrial DNA caused by radiation and epichlorohydrin. AB - This paper describes a rapid and reliable method for quantification of damage to mitochondrial DNA (mtDNA), especially strand breaks. The degree of damage to mtDNA is assessed by the proportion of physical forms (i.e., supercoiled versus open-circular and linear forms) upon agarose gel electrophoresis, blotting, and visualization by hybridization with [32P]mtDNA probes. The use of a radiolabeled probe is a crucial step in the procedure because it provides both a means to quantify by radioautography and to obtain the mtDNA specificity required to eliminate misinterpretation due to nuclear DNA contamination. To demonstrate the utility of this technique, X-irradiation and epichlorohydrin are shown to damage both isolated mtDNA and mtDNA in whole cells in a dose-dependent fashion. PMID- 3965929 TI - Muscarinic receptor heterogeneity revealed by interaction with bretylium tosylate. Different ligand-receptor conformations versus different receptor subclasses. AB - The interaction of the antiarrhythmic drug, bretylium tosylate, with the muscarinic receptor in tissue homogenates from regions of rat brain and heart and from submandibular gland and ileal wall was investigated. Competition binding experiments were carried out using the highly specific tritiated antagonist N methyl-4-piperidyl benzilate. Bretylium displayed heterogeneous binding characteristics. The binding of the drug to neural and glandular preparations was found to be best fitted by a one-site model in each case. On the other hand, in the case of muscle preparations (heart and ileum), a two-site model yielded a significantly better fit for the binding data than that given by a single site model. High affinity sites for the drug were detected in the muscle tissue only, with equilibrium binding constants of 0.24 +/- 0.12, 0.97 +/- 0.27, and 0.57 +/- 0.41 microM for the atrium, ventricle, and ileum, respectively. The low affinity binding constants in the muscle tissues were similar (approximately 10 microM) to those in the neural and glandular tissues examined, namely, the cortex, the hippocampus, the medulla pons, and the submandibular gland. The drug had no effect on agonist-binding characteristics. The heterogeneous binding of bretylium is compared to that of another nonclassical antagonist, pirenzepine. The results are discussed in relation to two alternative hypotheses put forward to account for antagonist heterogeneity in binding, the one involving ligand-receptor conformations and the other receptor subclasses. PMID- 3965930 TI - Characterization of specific binding sites for [3H](d)-N-allylnormetazocine in rat brain membranes. AB - Binding of [3H](d)-N-allylnormetazocine ([3H](d)-NANM) to rat brain membranes is stereospecific, reversible, and saturable (Bmax = 260 fmol/mg of protein) and manifests moderately high affinity (Kd = 20 nM). The rank order of potency among opioidbenzomorphans and phencyclidine (PCP) analogs for competition for [3H](d) NANM-binding sites is as follows: (d)-NANM = PCP-3-OH greater than (d) cyclazocine greater than N-ethylphenylcyclohexylamine greater than PCP greater than (l)-cyclazocine = dextrorphan greater than (d/l)-ethylketocyclazocine greater than (d/l)-bremazocine greater than (1)-NANM greater than 1 phenylcyclohexylamine greater than levorphanol. Other opioid ligands, relatively selective for each of the types of opioid binding sites other than sigma, such as morphine (mu), H-Tyr-D-Ala(Me)Phe-NH-CH2-OH (mu), D-Ala2-D-Leu5-enkephalin (delta), tifluadom (kappa), and U 50488 (kappa) as well as etorphine and naloxone were all unable to compete with [3H](d)-NANM for specific binding even at a concentration of 1 microM. Regional distribution studies of [3H](d)-NANM-binding sites show high density in the hippocampus, thalamus, hypothalamus, and amygdala and low density in cerebellum and nonfrontal neocortex membranes of the rat brain. These binding sites are very sensitive to protein-modifying enzymes and reagents such as trypsin and N-ethylmaleimide and to heat denaturation. These results provide direct biochemical evidence for the existence of distinct (d) NANM-binding sites in rat brain. In addition, this study supports the view that PCP and several of its analogues and the dextrorotatory isomers of psychotomimetic benzomorphans may act at a common recognition site in rat central nervous system. PMID- 3965931 TI - Structure-function studies with derivatives of 6-benzyl-1,3-benzodioxole, a new class of synthetic compounds which inhibit tubulin polymerization and mitosis. AB - A new class of synthetic antineoplastic compounds, derivatives of 6-benzyl-1,3 benzodioxole, has significant antimitotic activity. These compounds inhibit microtubule assembly and are competitive inhibitors of the binding of colchicine to tubulin. Both their structure and their partial inhibition of tubulin dependent GTP hydrolysis indicate that they are most comparable to podophyllotoxin of all known antimitotic drugs. Maximum activity required an intact dioxole ring, a methoxy or ethoxy substituent at position 5, and, on the benzyl moiety at position 6, a para-methoxy group. Additional methoxy groups on the benzyl substituent, to increase the apparent structural similarity to podophyllotoxin, resulted in major reduction of the antitubulin activity of these drugs. PMID- 3965932 TI - Risk factors for breast cancer in women with proliferative breast disease. AB - To assess the importance of various risk factors for breast cancer in women with benign proliferative breast lesions, we reevaluated 10,366 consecutive breast biopsies performed in women who had presented at three Nashville hospitals. The median duration of follow-up was 17 years for 3303 women, 1925 of whom had proliferative disease. This sample contained 84.4 per cent of the patients originally selected for follow-up. Women having proliferative disease without atypical hyperplasia had a risk of cancer that was 1.9 times the risk in women with nonproliferative lesions (95 per cent confidence interval, 1.2 to 2.9). The risk in women with atypical hyperplasia (atypia) was 5.3 times that in women with nonproliferative lesions (95 per cent confidence interval, 3.1 to 8.8). A family history of breast cancer had little effect on the risk in women with nonproliferative lesions. However, the risk in women with atypia and a family history of breast cancer was 11 times that in women who had nonproliferative lesions without a family history (95 per cent confidence interval, 5.5 to 24). Calcification elevated the cancer risk in patients with proliferative disease. Although cysts alone did not substantially elevate the risk, women with both cysts and a family history of breast cancer had a risk 2.7 times higher than that for women without either of these risk factors (95 per cent confidence interval, 1.5 to 4.6). This study demonstrates that the majority of women (70 per cent) who undergo breast biopsy for benign disease are not at increased risk of cancer. However, patients with a clinically meaningful elevation in cancer risk can be identified on the basis of atypical hyperplasia and a family history of breast cancer. PMID- 3965933 TI - Bronchiolitis obliterans organizing pneumonia. AB - In 50 of 94 patients with bronchiolitis obliterans we found no apparent cause or associated disease, and the bronchiolitis obliterans occurred with patchy organizing pneumonia. Histologic characteristics included polypoid masses of granulation tissue in lumens of small airways, alveolar ducts, and some alveoli. The fibrosis was uniform in age, suggesting that all repair had begun at the same time. The distribution was patchy, with preservation of background architecture. Clinically, there was cough or flu-like illness for 4 to 10 weeks, and crackles were heard in the lungs of 68 per cent of the patients. Radiographs showed an unusual pattern of patchy densities with a "ground glass" appearance in 81 per cent. Physiologically, there was restriction in 72 per cent of the patients, and 86 per cent had impaired diffusing capacity. Obstruction was limited to smokers. The mean follow-up period was four years. With corticosteroids, there was complete clinical and physiologic recovery in 65 per cent of the subjects; two died from progressive disease. This disorder differs from bronchiolitis obliterans with irreversible obstruction. It was confused most often with idiopathic pulmonary fibrosis. In view of the benign course and therapeutic response, a histologic distinction is important. PMID- 3965934 TI - Dangers for pregnant women in the work place. PMID- 3965935 TI - Inadvertent aluminum administration during plasma exchange due to aluminum contamination of albumin-replacement solutions. PMID- 3965936 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1985. A 33-year-old man with progressive right facial paresis and ophthalmoplegia without ptosis. PMID- 3965937 TI - Vitamin C and cancer. PMID- 3965938 TI - Goodbye to "fibrocystic disease". PMID- 3965939 TI - Public perceptions of medicine. PMID- 3965940 TI - Exercise and sudden cardiac death. PMID- 3965941 TI - Clonazepam and sexual precocity. PMID- 3965942 TI - Sex differences in diabetes. PMID- 3965943 TI - Break-dancing neck. PMID- 3965944 TI - Comprehensive treatment of panic disorders. PMID- 3965946 TI - Ethicists in the hospital. PMID- 3965945 TI - Stress fractures as a cause of knee pain. PMID- 3965947 TI - The impact of routine admission chest x-ray films on patient care. AB - We evaluated the impact of routine chest x-ray films, obtained on admission, on the treatment of patients on internal medicine wards of the Veterans Administration Medical Center, Long Beach, California--a population known to have a high prevalence of cardiopulmonary disease. The reasons for ordering chest films were determined prospectively, and three Department of Medicine faculty members reviewed the charts of admitted patients to determine the impact of chest film results on patient care. Routine chest x-ray films were ordered for 294 (60 per cent) of the 491 patients studied. Abnormalities were noted in 106 (36 per cent) of these 294 patients. The findings were previously known, chronic, and stable in 86 patients; they were new in only 20. Treatment was changed because of chest-film results in only 12 (4 per cent) of the patients. In only one of these patients would appropriate treatment probably have been omitted if a chest film had not been obtained, and the patient's outcome was not improved by the treatment instituted. We conclude that the impact of routine admission chest x ray films on patient care is very small, even in a population with a high prevalence of cardiopulmonary disease. We recommend that such films not be ordered solely because of admission. PMID- 3965948 TI - Pituitary dwarfism in a patient with circulating abnormal growth hormone polymers. PMID- 3965949 TI - Rapid dissolution of gallstones by methyl tert-butyl ether. Preliminary observations. PMID- 3965950 TI - Sinus arrest during REM sleep. PMID- 3965951 TI - Monitoring oxygen transcutaneously in critically ill patients. PMID- 3965952 TI - Procainamide: autoimmune phenomena and acetylator phenotype. PMID- 3965953 TI - Hypothermia in Hodgkin's disease. PMID- 3965954 TI - Iatrogenic Horner's syndrome: a complication of thoracostomy-tube replacement. PMID- 3965955 TI - Clearing of psoriatic lesions after the application of tape. PMID- 3965956 TI - Thirst in the elderly. PMID- 3965957 TI - Availability of durable power of attorney for health care. PMID- 3965958 TI - 28-year survival after myocardial infarction with ventricular fibrillation treated by electrical countershock. PMID- 3965959 TI - Hospital practice in Nepal. PMID- 3965960 TI - Basic curricular goals in medical ethics. PMID- 3965961 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 5-1985. A 33-year-old woman with pituitary dysfunction and diabetes mellitus. PMID- 3965962 TI - Ventricular aneurysm formation after infarction. PMID- 3965963 TI - Strut fractures with the Bjork-Shiley valve. PMID- 3965964 TI - Chromosome 10 deletion in carcinoma of the prostate. PMID- 3965965 TI - Cigarette smoking and neoplasia of the uterine cervix: smoke constituents in cervical mucus. PMID- 3965966 TI - High-dose methylprednisolone in acute immune cold hemolysis. PMID- 3965967 TI - Toward greater donor organ availability for transplantation. PMID- 3965968 TI - Financing child health care. PMID- 3965969 TI - Sigma factors in multitude. PMID- 3965970 TI - Rhodopsin-like sensitivity of extra-retinal photoreceptors mediating the photoperiodic response in quail. AB - It has been known for some 50 years that birds use photoreceptors in or near the hypothalamus to mediate the photoperiodic responses that control seasonal breeding. So far, however, attempts to identify the photopigment by determining an action spectrum have failed. The problems stem from the selective filtering of light by the tissues surrounding the photoreceptors and the need to deliver defined amounts of light over the days or weeks required to induce a quantitative measure of photostimulation. Here we have developed a technique which produces a quantitative action spectrum for the photoperiodic response in the Japanese quail; the results indicate the presence of a rhodopsin photopigment with a peak sensitivity of approximately 492 nm. The photoreceptors exhibit a level of sensitivity comparable with that of vertebrate visual pigments. We conclude that the brain photoreceptors of birds are based on a rhodopsin/rhodopsin-like photopigment. PMID- 3965971 TI - The apical surface of canine chief cell monolayers resists H+ back-diffusion. AB - The resistance of the gastric mucosa to acid and peptic injury is reflected by a resistance to the back-diffusion of H+ from gastric lumen to blood. The nature of this 'barrier', however, remains undefined. Using Ussing chambers, we have now studied the acid-barrier function of monolayers prepared from dispersed canine fundic chief cells. These monolayers secrete pepsinogen in response to stimulation. We found that, on acidification of the apical solution to pH 2, transepithelial resistance (R) increased 2.6-fold and the monolayers maintained this 1:100,000 H+ concentration gradient for more than 4 h. The addition of aspirin to the acidified apical solution caused a rapid decay in R, as did acidification of the basolateral solution to a pH less than 5.5. Ouabain-treated monolayers displayed the rise in R expected with apical acidification, while potential difference (V) and short-circuit current (Isc) decreased essentially to zero, indicating impermeability to H+. However, if the integrity of the ouabain treated monolayers was disrupted by low apical pH, H+ permeation occurred, reflected by an Isc that was dependent on the H+ gradient across monolayers. These data indicate that the apical surface of chief cells is a very tight barrier to H+ diffusion and may be an important element resisting acid-peptic injury. PMID- 3965972 TI - Isolation and structure of a novel C-terminally amidated opioid peptide, amidorphin, from bovine adrenal medulla. AB - Biologically active peptide hormones and neurotransmitters have been shown to be enzymatically liberated from larger, inactive precursor molecules by tissue specific post-translational processing, particularly at the typical cleavage signals of paired basic residues. Subsequent N-terminal or C-terminal modifications may be of importance in regulating the biological activities of these peptides. C-terminal alpha-amidation is considered to be essential for the biological function of several non-opioid peptides. Here we present the isolation and structure of a novel C-terminally amidated opioid peptide, amidorphin, from bovine adrenal medulla. Amidorphin and the recently isolated octapeptide metorphamide (adrenorphin) are the only endogenous opioid peptides in mammals known to possess a C-terminal amide group. The amino acid sequence of amidorphin corresponds to the sequence 104-129 of bovine proenkephalin A. Very high concentrations of amidorphin were detected in bovine adrenal medulla and in a further endocrinological system, the hypothalamic-neurohypophyseal axis. Amidorphin may therefore be considered to be a major gene product of the opioid peptide precursor proenkephalin A in these endocrine tissues. PMID- 3965973 TI - Polypeptide ligation occurs during post-translational modification of concanavalin A. AB - Lectins are proteins with multivalent carbohydrate-binding sites, which confer the ability to agglutinate. The seeds of legumes are particularly rich in lectins, for example, concanavalin A (Con A) comprises up to 15% of the protein in the cotyledons of jack bean (Canavalia ensiformis) seeds. The amino acid sequences of Con A and several other legume lectins have been partially or fully determined, and comparison of these sequences from different species reveals a circular homology (Fig. 1A); rearrangements within the genome have been suggested to explain this. We report here that the circular homology displayed by Con A is due to a post-translational transposition and ligation within the initial polypeptide. This type of modification has not been reported previously for eukaryotes, although it has been suggested to occur in bacteriophage lambda. PMID- 3965974 TI - Fetal occipital cortical neurones transplanted to the rostral cortex can extend and maintain a pyramidal tract axon. AB - In adult rats, cortical neurones that send axons through the pyramidal tract are confined to layer V, over the rostral two-thirds of the cerebral hemisphere. However, during the first postnatal week, many neurones in layer V in the occipital cortex (including the visual cortex) also extend axon collaterals through the pyramidal tract and into the spinal cord. These occipital corticospinal collaterals are completely eliminated over the subsequent 2 weeks, although their cells of origin do not die. We now report that when portions of the occipital cortex from fetal rats are transplanted to more rostral cortical regions of newborn rats, some of the transplanted neurones not only extend axons through the pyramidal tract, but also maintain these axons beyond the stage at which they are normally eliminated. These results suggest that normally eliminated cortical axons can be 'rescued' and, in the case of pyramidal tract neurones, the position of the neurones within the tangential plane of the cortex is a critical factor in determining which neurones retain and which lose their pyramidal tract collaterals. PMID- 3965975 TI - Transmission distortion of t-haplotypes is due to interactions between meiotic partners. AB - The T/t-complex of the mouse includes a series of recessive lethal and semi lethal mutations but, despite such lethalities, mutant t-haplotypes are found in high frequency in wild mouse populations. This polymorphism is apparently maintained because heterozygous males preferentially transmit the t-bearing chromosome to their offspring. Despite many attempts to define the basis of the transmission ratio distortion, it has been unclear whether this is because t bearing sperm have better than average fertilizing ability or whether +-bearing sperm in heterozygous males are rendered defective. To examine this point, we constructed male (XY in equilibrium XY) chimaeras containing +/+ and +/tw73 genotypes, marked respectively by albino and pigmented coat colours, and two isozyme variants. Such males produce a mixture of three different sperm types: + bearing sperm from the +/+ genotype, +-bearing sperm from the +/t genotype, and t bearing sperm from the +/t genotype. Appropriate matings can distinguish between these three types, and our data, reported here, show that t-bearing sperm in chimaeric mice maintain their advantage over their 'meiotic partners' but do not have any advantage over sperm from the +/+ genotype. PMID- 3965976 TI - Three-dimensional structure of an antigen-antibody complex at 6 A resolution. AB - Present understanding of the three-dimensional structure of antibody combining sites is based on X-ray diffraction studies of myeloma immunoglobulins. The structures of the antigen-binding fragment (Fab) complexes of two of these immunoglobulins with small ligands have also been determined. However, there is no crystallographic information concerning the interactions of an antibody with an antigen, nor do we know the precise structure of antigenic determinants on protein molecules. We now report the first structure determination of an antigen antibody complex at 6 A resolution. The structure of the complex between hen egg white lysozyme and the Fab of a monoclonal anti-lysozyme antibody (D1.3) shows that the combining site of antibodies is not merely a cleft delineated by the complementarity-determining regions of the variable regions of the light and heavy chains, but is a larger area extending beyond it. A correspondingly large area of the antigen makes close contacts with the antibody, in agreement with the notion of a 'topographical' rather than 'sequential' antigenic determinant. The structural basis of cross-reactivities of an antibody with heterologous antigens and the effect of a single amino acid substitution on antigenic specificity can thus be visualized in the structural model presented here. PMID- 3965977 TI - Mediation of slow-inhibitory postsynaptic potentials. PMID- 3965978 TI - Surrogacy falsely in the dock. PMID- 3965979 TI - Subtleties of actin assembly. PMID- 3965980 TI - Persistent rheumatic chorea. AB - A 79-year-old woman had rheumatic chorea that persisted after age 5 years and increased in severity at age 73. The continued chorea and late decompensation could have been due to incomplete functional resolution in the basal ganglia and decreasing reserve of striatal neurons with age. Sydenham's chorea persisting into late life has not been reported previously. PMID- 3965981 TI - Spinal cord degeneration in AIDS. AB - Ten months before his death, a 36-year-old homosexual man with AIDS developed progressive symmetric paraparesis with muscle wasting, paresthesias, reflex uninhibited bladder function, and bowel incontinence. Neuropathologic postmortem examination revealed a symmetric degeneration of the lateral and anterior pyramidal tracts as well as the posterior columns. Scattered microglial nodules were present in the brain and spinal cord. The cause of this spinal cord complication remains uncertain. Possible etiologies of the demyelinating process include infectious, parainfectious, nutritional, paraneoplastic, and toxic causes. PMID- 3965982 TI - Long-acting propranolol in essential tremor. AB - Long-acting propranolol (propranolol-LA) was compared with propranolol in divided doses in 18 patients with essential tremor. Three patients were unresponsive to both preparations. Propranolol-LA was preferred by 87% of patients for ease of administration and by 67% for tremor control. Propranolol-LA provided similar (53%), and in some patients greater (47%), reduction of tremor amplitude than divided dosing. Propranolol-LA should be a useful drug in essential tremor. PMID- 3965983 TI - Staphylococcal meningitis: a complication of psoas abscess. AB - A previously healthy 59-year-old woman presented with fever, neck stiffness, and localized back tenderness. Spinal fluid and blood cultures grew Staphylococcus aureus. A diagnosis of pyogenic meningitis was made, but further investigation revealed that the meningitis arose from a clinically occult psoas abscess. PMID- 3965984 TI - Migrainous ischemic optic neuropathy. AB - Anterior ischemic optic neuropathy (AION) is a stroke syndrome of the eye seen in isolation or as a manifestation of underlying disease. A case of migrainous AION is reported, and the implications of anterior visual pathway migraine discussed. PMID- 3965985 TI - Patients with pseudoseizures: intellectual and cognitive performance. AB - We compared cognitive and intellectual performance of patients with pseudoseizures (pseudoseizure-only group), pseudoseizures and epilepsy (mixed seizure group), and generalized epileptic seizures (generalized seizure group). The pseudoseizure-only group performed significantly better on all measures except those of simple motor function. There were no significant differences between those with mixed and generalized seizures. Therefore, cognitive and intellectual performances of patients with pseudoseizures are influenced by the presence or absence of concomitant epilepsy, and suggest that it is necessary to distinguish patients with and without epilepsy in studies of pseudoseizures. PMID- 3965986 TI - Compression-induced brain edema in rats: effect of dietary vitamin E on membrane damage in the brain. AB - Vasogenic edema was produced by focal epidural brain compression followed by sudden decompression in rats raised on diets that varied in content of vitamin E. Cerebral content of total fatty acids and vitamin E was assayed at 24 hours postdecompression after a 24-hour period of compression. Levels of all individual fatty acids in the previously compressed brain region were less by 19 to 22% in the vitamin E-deficient group than in sham-operated controls (p less than 0.05); by 4 to 13% in the vitamin E-normal group; and by 0 to 7% in the vitamin E supplemented group. Brain levels of vitamin E were not altered by compression in any group. By physicochemical interaction with phospholipids, vitamin E may serve to stabilize membranes after this type of brain injury. PMID- 3965987 TI - Familial restless legs with periodic movements in sleep: electrophysiologic, biochemical, and pharmacologic study. AB - Restless legs syndrome was present in nine members of a family over a span of five generations. In three subjects, the diagnosis was confirmed by all-night sleep recordings and concomitant EMG. Two of these three subjects also had periodic movements in sleep. The frequency of leg movements decreased from wakefulness to stages 1 and 2 non-REM sleep. There was an increase of free dopamine and homovanillic acid in CSF of the propositus. Clonazepam effectively controlled restless legs in the propositus and his mother. PMID- 3965988 TI - Ocular dipping. PMID- 3965989 TI - Reye's syndrome and short-chain fatty acids. PMID- 3965990 TI - Adult-onset focal dystonia. PMID- 3965991 TI - Traumatic birth and syringomyelia. PMID- 3965992 TI - Familial Meige syndrome and thyroid dysfunction. PMID- 3965994 TI - SEP correlation with somatosensory perception. PMID- 3965993 TI - Nomifensine exacerbates narcolepsy. PMID- 3965995 TI - Caveat: hyperventilation with sickle cell disease. PMID- 3965996 TI - Acute subdural hematomas may appear isodense in anemia. PMID- 3965997 TI - Dermatomyositis spares extraocular muscles. PMID- 3965998 TI - Permanent visual loss after shunt malfunction. AB - Fourteen (1.8%) of more than 800 children evaluated in a Visually Impaired Program over 10 years became permanently blind during an episode of raised intracranial pressure secondary to shunt malfunction. Visual symptoms and papilledema were recognized in only three children at the onset of blindness. Clinical and radiologic findings suggested that the loss of sight was caused by a lesion in the pregeniculate pathway in nine patients, probably due to ischemia; five children in the postgeniculate group sustained infarcts of the occipital lobes. These cases highlight the importance of parent education and prompt treatment of raised intracranial pressure due to shunt malfunction. PMID- 3965999 TI - Prolactin changes after seizures classified by EEG monitoring. AB - We examined the postictal hyperprolactinemia after seizures classified by EEG and video telemetry. Prolactin did rise after complex partial seizures that involved motor behaviors and was not further increased by secondary generalization. Nontemporal partial seizures or pseudoseizures did not demonstrate this increase. There was no difference in prolactin elevation after generalized tonic-clonic seizures, whether secondarily generalized or generalized from onset. A discriminant function accurately classified 94% of patients with pseudoseizures and 66% of patients with true cerebral seizures for an overall classification accuracy of 72%. PMID- 3966000 TI - Cerebral dysfunction after chronic hypoxia in children. AB - Although the long-term effects of acute anoxia have been studied, the effects of chronic hypoxia on the developing human brain have received little attention. We studied children with a cyanotic congenital heart defect to assess the impact of chronic hypoxia by eight measures: neurologic examination, visual evoked response, EEG, behavioral adjustment, cognitive, perceptual-motor, and attentional functioning, and school performance. On outcome evaluation, these children evidenced diverse neurophysiologic dysfunction. Chronic hypoxia was associated with impaired motor function, inability to sustain attention, and low academic achievement. PMID- 3966001 TI - The triad of neurologic manifestations of Lyme disease: meningitis, cranial neuritis, and radiculoneuritis. AB - We studied 38 patients with Lyme meningitis, a newly recognized spirochetal infection. The patients characteristically had intermittent attacks of severe headache, mild meningismus, and a predominantly lymphocytic pleocytosis. In addition to meningitis, 11 patients experienced subtle encephalitic signs, 19 had cranial neuritis, most commonly unilateral or bilateral facial palsy, and 12 developed peripheral radiculoneuritis, plexitis, or mononeuritis multiplex. Without antibiotic therapy, the duration of neurologic involvement was 3 to 18 months. Although sometimes incomplete, the triad of neurologic manifestations of Lyme disease--meningitis, cranial neuritis, and radiculoneuritis--presents a unique clinical picture. PMID- 3966002 TI - Dorsal midbrain syndrome: clinical and oculographic findings. AB - We report clinical and oculographic findings in seven patients with the dorsal midbrain syndrome (Parinaud's syndrome). All presented with limited upward voluntary gaze and convergence nystagmus with attempted upward voluntary gaze. Quantitative analysis of vertical eye movements documented characteristic abnormalities of saccades with relative preservation of reflex eye movements (ie, vestibular, optokinetic, and visual-vestibular). Vertical saccade velocity was only slightly decreased in five patients with tumors, indicating that the vertical burst neurons in the mesencephalic reticular formation and their efferent pathways to the oculomotor neurons were minimally damaged. On the other hand, two patients with probable brainstem encephalitis exhibited marked slowing of vertical saccades, indicating that the burst neurons, or their efferent pathways to the oculomotor neurons, were severely damaged. PMID- 3966003 TI - Autosomal dominant syndrome of lipid neuromyopathy with normal carnitine: successful treatment with long-chain fatty-acid-free diet. AB - A family (mother and two sons) have had lifelong muscle weakness and intolerance to fatty food. Histochemistry of muscle biopsies of all three patients demonstrated increased lipids in type I muscle fibers and type II muscle fiber atrophy and paucity. Electronmicroscopy of muscle revealed increased lipids, abnormal mitochondria, and increased lipofuscin granules. Electronmicroscopy of sural nerve showed inclusions in most of the Schwann cell cytoplasm, with lipid droplets, zebra bodies, lipofuscin granules, and abnormal mitochondria. Carnitine and CPT I and II levels were normal in serum and muscle. Treatment with long chain fatty-acid-free diet resulted in remarkable clinical improvement and in decrease of lipid droplets in the muscle. This dietary program may be useful in other forms of lipid myopathy. PMID- 3966004 TI - Validity and reliability of a rating scale for the primary torsion dystonias. AB - For quantitative assessment of the primary torsion dystonias, a rating scale is proposed that has two sections--a Movement Scale, based on examination, and a Disability Scale, based on the patient's statements about seven activities of daily living. We assessed the validity of the Movement Scale by comparing scores with a ranking of patients according to dystonia severity and with ratings of the patients on the Disability Scale. In addition, we assessed the inter-and intra rater reliability of the scale by comparing independent scorings of patients by four examiners and by comparing scorings by the same examiners performed at different times. We found that the Movement Scale was a valid and reliable indicator of the severity of primary torsion dystonia. PMID- 3966005 TI - Release of antidiuretic hormone in quadriplegic subjects in response to head-up tilt. AB - Plasma antidiuretic hormone (ADH) levels during head-up tilt were measured in quadriplegic patients and normal healthy subjects. In normal subjects, neither rapid tilt (from horizontal to 70 degrees head-up in 20 seconds and remaining head-up for 5 minutes) nor gradual tilt (from horizontal to 70 degrees head-up over 15 minutes) significantly changed the plasma ADH level. In contrast, rapid tilt elevated plasma ADH levels approximately fourfold in quadriplegic subjects. A less dramatic elevation in plasma ADH levels followed gradual tilt in quadriplegic subjects. These data, along with the possibility that the pressor potency of ADH is enhanced in quadriplegic subjects, suggest that ADH is involved in the maintenance of blood pressure in quadriplegics in a head-up position. PMID- 3966006 TI - Initial treatment of parkinsonism with 8-alpha-amino-ergoline. AB - We treated 12 patients with Parkinson's disease with an 8-alpha-amino-ergoline derivative, CU 32-085. The daily dosage was increased slowly to 7 mg over 9 weeks, held constant for 8 weeks, then replaced by placebo for 4 weeks. We found statistically significant benefit over placebo or pretreatment disability. The effect was seen at daily dosages of 3 mg or more. Its magnitude was dose related. There was no further improvement on prolonged treatment with 7 mg daily. Side effects were mild and did not require interruption of treatment. PMID- 3966007 TI - Defective [U-14 C] palmitic acid oxidation in Duchenne muscular dystrophy. AB - Compared with normal skeletal muscle, muscle from patients with Duchenne dystrophy had decreased [U-14 C] palmitic acid oxidation. [1-14 C] palmitic acid oxidation was normal. These results may indicate a defect in intramitochondrial fatty acid oxidation. PMID- 3966008 TI - Delayed choreoathetosis following acute carbon monoxide poisoning. AB - Ten days after accidental exposure to carbon monoxide, a 17-year-old youth developed transitory choreoathetosis of both arms, face, and neck, with moderate dysarthria. CT revealed symmetric bilateral infarction in the head of the caudate nucleus, the putamen, and the small parts of the anterolateral globus pallidus. PMID- 3966009 TI - Wernicke's encephalopathy after gastroplasty for morbid obesity. AB - A young woman developed Wernicke's encephalopathy after gastroplasty for morbid obesity. Her clinical presentation of nystagmus and ocular gaze palsies, ataxia, and a sensorimotor neuropathy is described. A small number of previously described patients are compared with respect to clinical features, response to treatment, and investigative procedures. PMID- 3966010 TI - To have or not to have a pregnancy. PMID- 3966011 TI - A platelet function defect in preeclampsia. AB - A prospective study was performed on 26 preeclamptic patients and 17 pregnant control subjects relating the platelet count to in vivo platelet function as assessed by the bleeding time and in vitro platelet function as assessed by collagen-stimulated thromboxane B2 biosynthesis. The results of these tests were normal in all control subjects. Nine of the 26 preeclamptic patients (34%) showed thrombocytopenia, and five of these patients had a prolonged bleeding time. Four of the 16 nonthrombocytopenic patients also had a prolonged bleeding time. Eleven patients had impaired thromboxane B2 biosynthesis, and seven of these had a prolonged bleeding time. In all patients, the bleeding time returned to normal, and in most the platelet count returned to normal within five days or after delivery. A significant proportion of patients with preeclampsia develop an acquired defect of platelet function that could contribute to bleeding. PMID- 3966012 TI - The association of chorioamnionitis with preterm delivery. AB - To ascertain what proportion of preterm deliveries are attributable to the association with chorioamnionitis, the authors examined prospectively the placentas from all 2774 women who delivered at the Johns Hopkins Hospital during 1980. The incidence of preterm delivery was 5.4% (110 of 2027) when neither chorioamnionitis nor premature rupture of membranes (PROM) was present, 11.9% (29 of 243) when chorioamnionitis was present without PROM, and 56.7% (51 of 90) when both chorioamnionitis and PROM were present (P less than .05). Only 27 of 333 cases of histopathologic chorioamnionitis or 8.1% had maternal antepartum fever, and only 11 of 333 or 3.3% had neonatal sepsis. Using logistic regression analysis to control for confounding variables, approximately 25% of the preterm deliveries were statistically attributable to histopathologic chorioamnionitis, occurring either alone or in association with PROM. In light of the infrequency with which histopathologic chorioamnionitis is clinically evident, the strong relationship between histopathologic chorioamnionitis and preterm delivery suggests that occult antepartum infection of the genital tract is an important cause of preterm delivery. PMID- 3966013 TI - Intrapartum management of twin gestation. AB - Neonatal mortality and morbidity were analyzed in 362 pairs of twins delivered at Yale-New Haven Medical Center during a five-year period. Of the 154 (42.5%) pairs in vertex-vertex presentations, 125 (81.2%) were delivered vaginally. No difference in the occurrence of low five-minute Apgar scores was found in relation to the length of time interval between delivery of the twins. Of the 139 (38.4%) twins in vertex-nonvertex presentations, 99 (71.2%) were delivered vaginally. In the entire series, there was one case of significant birth trauma related to vaginal delivery of a nonvertex second twin. The one instance of neonatal death clearly related to birth asphyxia resulted after cesarean section. A protocol for the intrapartum management of twin gestations is presented based upon intrapartum fetal presentation and sonographically determined estimated fetal weight. PMID- 3966014 TI - Fixed fetal heart rate pattern after intrauterine accidental decerebration. AB - A fixed fetal heart rate (FHR) pattern, with a normal frequency without accelerations and decelerations can be observed in early pregnancy during the inactive episodes of the rest-activity cycle, in association with certain drugs administered to the mother and in some cases of anencephaly. In the present case report a fetus is described in which a persistent fixed FHR pattern was indicative of decerebration in utero. The latter occurred after a serious maternal respiratory and cardiovascular collapse. The discrepancy between maternal and fetal outcome and the pathophysiologic backgrounds underlying the FHR changes are discussed. PMID- 3966015 TI - Effect of danazol on vocal pitch: a case study. AB - Acoustic analysis was used to measure fundamental frequency (vocal pitch in cycles per second) in a woman before, during, and after danazol therapy for endometriosis. A moderate lowering of fundamental frequency occurred within the three months of therapy and progressively lowered throughout the 5.5-month course. There was some action toward pretreatment levels, but 12 months after therapy, lowering of fundamental frequency persisted. The acceptability of this side effect and the need for further research are discussed. PMID- 3966016 TI - Myocardial infarction during pregnancy: a review. AB - In the present review the world literature on pregnancy complicated by myocardial infarction is summarized, and two additional cases are presented. It is apparent that the majority of pregnant women who have died after myocardial infarction did so at the time of initial infarction, and maternal mortality was greatest if the infarction was late in pregnancy. Moreover, delivery within two weeks of infarction was associated with increased mortality as was reinfarction during labor. These results suggest that the increasing cardiovascular stresses of late pregnancy, especially when intensified by parturition, seriously compromise women with ischemic heart disease. Efforts should therefore be made to limit myocardial oxygen demand/consumption throughout pregnancy, and particularly during parturition. Although principles of management can be generalized, these high risk patients require individualization of care by a multidisciplinary team of cardiologists, anesthesiologists, and obstetricians. PMID- 3966018 TI - Multiple gestation. PMID- 3966017 TI - Trends in obstetric-gynecologic academic manpower--1983. AB - Since 1980 medical school faculty growth has essentially ceased, in comparison to earlier substantial increases. Women are represented in full-time faculty positions in a larger proportion than among practicing obstetrician gynecologists. Subspecialist numbers on faculties have increased, with a small decline in generalist obstetrician-gynecologists. Despite the current plateau, medical school departments project a 36% increase in faculty members during the next five years, and an even larger increase in faculty involved in research. PMID- 3966019 TI - Premature rupture of membranes. PMID- 3966020 TI - Altered prolactin bioactivity in amniotic fluid of hypertensive pregnancy. AB - The high concentrations of prolactin (hPRL) in human amniotic fluid appear to be derived principally from maternal decidua. The present study evaluated both the biologic and immunologic activity of amniotic fluid hPRL obtained from normal and selected complicated pregnancies. Biologic and immunologic activities of amniotic fluid hPRL were also compared with lecithin:sphingomyelin ratios and phosphatidylglycerol content. No significant correlation existed between amniotic fluid hPRL activities and fetal lung maturation. However, a significant increase in amniotic fluid hPRL concentration as well as specific biologic activity of the hormone was found in pregnancies complicated by hypertension. These findings suggest alterations in the synthesis of decidual hPRL and/or its transport to the amniotic fluid that may influence pregnancy-induced hypertension. PMID- 3966021 TI - Effect of nicardipine HCl on prematurely induced uterine activity in the pregnant rabbit. AB - The tocolytic and cardiovascular effects of intravenous nicardipine HCl, a calcium entry blocker, were studied in 20 pregnant rabbits. Premature uterine activity was induced by extraovular infusion of prostaglandin F2-alpha and three different nicardipine HCl dose schedules were tested. Significant dose-related inhibition of both electrical and mechanical uterine activity was observed. Treatment was also accompanied by a significant rise in pulse rate and a decrease in both diastolic and systolic blood pressure. It is concluded that nicardipine HCl is a potent tocolytic agent that deserves further evaluation for possible clinical use. PMID- 3966022 TI - Adenocarcinoma of the uterine cervix: histologic variables associated with lymph node metastasis and survival. AB - One hundred and two patients were treated for primary adenocarcinoma of the uterine cervix over a ten-year period from 1973 to 1982. Of these, 51 patients underwent initial surgical management that included a pelvic and para-aortic lymphadenectomy with a radical hysterectomy or a surgical staging operation. Clinical lesion size, grade, and depth of stromal invasion were correlated with lymph node metastasis and survival. The incidence of positive lymph nodes was 14.6% for stage I and 40.0% for stage II. Positive lymph nodes were documented in none of 15 patients with lesions smaller than 2 cm, 16.7% (five of 30) with 2 to 4 cm, and 82.3% (five of six) with larger than 4 cm; 5.3% of grade 1 tumors, 11.1% of grade 2, and 50.0% of grade 3. There were no lymph node metastases (zero of six) in patients with a tumor that had a depth invasion of less than 2 mm, whereas positive nodes were found in 11.1% (two of 18) patients with 2 to 5 mm of invasion, 28.6% (two of seven) with 5 to 10 mm, and 57.1% (four of seven) with greater than 10 mm of invasion. Five-year survival was 82.9% for stage I and 42.9% for stage II patients; 91.7% with negative lymph nodes, and 10% with positive nodes (P less than .0001). The size of the primary tumor (P less than .0001), tumor grade (P less than .05), and depth of invasion (P less than .05) correlated with patient survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966023 TI - Influence of chorioamnionitis on long-term prognosis in low birth weight infants. AB - The contribution of obstetric management to quality of life of surviving low birth weight infants is unclear. A possible association between maternal chorioamnionitis and development outcome was evaluated. One hundred twenty-seven mother/infant pairs with infant birth weight less than 2000 g were studied. The antenatal course was complicated by chorioamnionitis, premature rupture of membranes without chorioamnionitis, premature labor, or abruptio placenta. Analysis of variance was performed using these four diagnosis groups. After potentially confounding variables were taken into account, the overall difference in the four groups in Mental Development Index (Bayley Scales) was borderline (P = .138). However, significant differences remained between the group with chorioamnionitis and the group with premature rupture of membranes without chorioamnionitis (P = .017). The potential advantage of leaving infants in utero after premature rupture of membranes may be offset by disadvantage of chorioamnionitis with respect to future development in surviving infants. PMID- 3966024 TI - Whole abdominal radiation as salvage therapy for epithelial ovarian cancer. AB - Thirty patients found to have residual epithelial ovarian cancer at second-look laparotomy were treated with whole abdominal radiation as salvage therapy. Dosage fractions were 120 rad per day until 3000 rad were delivered, then the pelvis was boosted to 5000 rad at 180 rad per day. Fourteen patients (47%) completed therapy without interruption and seven (23%) completed therapy with interruptions due to myelosuppression ranging from one to four weeks. Therapy was not completed in nine patients (30%). Four of 16 patients (25%) with microscopic residual disease before radiation remain alive and free of disease at 22 to 41 months. Two of six (33%) patients with minimal (less than or equal to 5 mm) residual disease remain alive and free of disease 19 to 40 months after radiation treatment. Patients with residual nodules greater than 5 mm uniformly did poorly. Patients who progressed on primary chemotherapy had a median survival of seven months, compared with more than 38 months for chemotherapy responders. Chronic bowel morbidity was a significant problem, with 30% of patients surviving at least four months from completion of radiation requiring laparotomy for small bowel obstruction. These preliminary results suggest that whole abdominal radiation may be useful in the management of patients who have responded to primary chemotherapy, but the benefit is confined to those patients who have minimal or microscopic disease at second-look laparotomy. PMID- 3966025 TI - Fine-needle aspiration in gynecology: evaluation of extrapelvic lesions in patients with gynecologic malignancy. AB - Fine-needle aspiration for suspicious extrapelvic lesions is documented in 82 specimens from patients with known pelvic malignancy. Specimens were obtained from lung (39%), supraclavicular lymph nodes (24%), paraaortic lymph nodes (11%), liver (7%), and other sites. Three of 32 (9.4%) patients with transthoracic aspirates experienced pneumothoraces requiring chest tube placement, and three others had smaller pneumothoraces that resolved spontaneously. Fifty-nine (72%) specimens were positive for malignancy. There were no known false positives. Of six negative aspirates that had follow-up histology, there were two false negatives. When the subsequent course was used as an indication of accuracy, specificity was 100%, and sensitivity was 91%. Fifty-eight (71%) patients had therapeutic alterations as a direct result of aspiration diagnosis. Thirty-nine major operative procedures and 28 open biopsies were spared. Fine-needle aspiration is a reliable and cost-effective diagnostic method that should become an increasingly routine component of the diagnostic armamentarium and may have broader roles defined through continuing study. PMID- 3966027 TI - Cervical intraepithelial neoplasia after conization: a study of 522 consecutive cervical cones. AB - The relationship between involvement of the cervical cone margins by cervical intraepithelial neoplasia (CIN) and the presence or absence of CIN as determined by subsequent hysterectomy or cytology follow-up was studied in 522 cervical cones. Hysterectomy was performed in 161 patients, 54% of which were done within six weeks after conization. The remaining patients were followed up with cytology. In 136 women, cone margins were involved by CIN. Twelve of these patients were lost to follow-up. Forty of the 73 (54.8%) patients who underwent hysterectomy had CIN in the uterus. One of 51 (1.9%) patients followed up with cytology developed cytologic evidence of CIN. In 60% of the patients with CIN III and involved margins, in whom hysterectomy was delayed for more than six weeks, there was at least one interval of cytology positive for CIN. All these patients had CIN at the time of hysterectomy. In contrast, CIN was not present in patients with negative follow-up cytology. None of the 107 patients with CIN III and free margins had CIN at hysterectomy or during follow-up. However, of the 249 women with CIN I to II and free margins, six had CIN at hysterectomy. In none of the cases was the residual disease worse than CIN. Although it is impossible to predict the presence or absence of residual CIN based on the appearance of the cone margins, it is important to report the status of the margins. Free margins indicate removal of the CIN in a majority of cases, or reassures that invasive cancer is not present.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966026 TI - Computed tomography in evaluation of extrapelvic lymphadenopathy in carcinoma of the cervix. AB - The diagnostic value of computed tomography for detecting metastatic tumor in common iliac and/or paraaortic lymph nodes among 44 patients with cervical carcinoma was analyzed. Pathologic confirmation of nodal status was obtained in 33 patients with primary disease and 11 patients with recurrent disease, either by staging laparotomy (82%) or fine needle aspiration (18%). Nodal metastases were detected in 12 patients. Fine needle aspiration of nodes 1.5 cm or greater in size detected 67% of metastatic nodes. The sensitivity of computed tomography for detection of metastatic nodes was 75%, specificity 91%, negative predictive value 91%, and positive predictive value 75%. There appears to be a role for computed tomography and fine needle aspiration of enlarged nodes in patients with advanced or recurrent cervical carcinoma. PMID- 3966028 TI - Adenocarcinoma of the uterine cervix: a study of 73 cases. AB - Seventy-three patients with adenocarcinoma of the cervix were seen between 1969 and 1983. This represented 8.1% of all carcinoma of cervix seen during that period. Survival rates in stage Ib were significantly worse for those with poorly differentiated lesions and for those with involved pelvic lymph nodes. Age at presentation appeared to decline over the period of the study. When the patients with stage Ib lesions were compared with a group of stage Ib squamous carcinomas treated in the same unit, there was no difference in age at presentation, node metastasis rates, or survival. Four patients had cervical intraepithelial neoplasia (CIN) in addition to adenocarcinoma. PMID- 3966029 TI - Treatment of stage I adenocarcinoma of the endometrium by hysterectomy and irradiation: analysis of complications. AB - Twelve of 304 patients (4%) treated with surgery and adjuvant irradiation for endometrial carcinoma experienced a serious complication. The complication rate for patients whose irradiation consisted of an implant alone was only 1% (two of 199), if the implant was preoperative, but was 12% (three of 26) if the implant was postoperative. For patients who received external pelvic irradiation as part of their adjuvant therapy, the incidence of complications was 8.8% (seven of 79) and the timing (preoperative versus postoperative) had no effect. There was, however, a significant correlation of the complication rate with an increasing dose of external irradiation to the whole pelvis: For doses of 3000 rad or less, it was 2% (five of 264) but was 18% (seven of 40) for doses in excess of 3000 rad. These data suggest that the safest form of adjuvant irradiation for adenocarcinoma of the endometrium is a preoperative implant, and that adding external pelvic irradiation to the preoperative implant will significantly increase the complication rate if the external dose to the central pelvis exceeds 3000 rad. PMID- 3966030 TI - The pathologic spectrum of uterotubal junction obstruction. AB - Excised tubal segments from 42 women with uterotubal junction obstruction were studied histologically to evaluate the pathologic spectrum of disease and correlate this with clinical data. The most frequent lesion encountered was obliterative fibrosis (38.1%), confirmed by connective tissue stains, which was not associated with cornual nodularity. Other pathologic entities included salpingitis isthmica nodosa (23.8%), intramucosal endometriosis (14.3%), and chronic tubal inflammation (21.4%). Intramucosal endometriosis was distinguishable from salpingitis isthmica nodosa by virtue of its unique stroma confirmed by connective tissue staining. Women with previous pregnancies were included in all the groups. In all instances, the obstruction was present in the transmural portion of the tube and extended a variable distance into the isthmic segment. These observations on uterotubal junction obstruction demonstrate that: 1) There are multiple distinct histologic patterns, 2) Intraabdominal findings do not predict the histology of the uterotubal junction pathology, 3) Any histologic pattern can be associated with a previous intrauterine or ectopic pregnancy, and 4) The obstruction begins within the transmural portion of the oviduct, extends a variable distance into the isthmic segment, but does not obstruct the ampullary segment. These data suggest that the initiating process originates within the uterus and that fibrosis may represent a nonspecific response to chronic injury of the transmural and isthmic segments of the oviduct. PMID- 3966031 TI - Follow-up studies on children with severe dietary chloride deficiency during infancy. AB - Ten children who had severe dietary chloride deficiency during early infancy have grown normally during their first 4 to 5 years. With the exception of one child who did not get into the sitting position alone until he was 9 1/2 months of age, the patients reached the usual developmental milestones of the first 2 years during the expected age intervals. Developmental and psychological testing indicates that all of the children have at least average ability. However, three children have shown behavior patterns that may interfere with successful school performance. Serum creatinine and urea nitrogen concentrations appear to be normal as does renal concentrating capacity. During a 4-year follow-up, one child has shown persistent and a second intermittent microscopic hematuria. PMID- 3966032 TI - Impact of the WIC program on the iron status of infants. AB - The WIC Program (Special Supplemental Food Program for Women, Infants and Children) was initiated in the early 1970s to improve the nutritional status of pregnant women, lactating women, and children from birth to 5 years of age who were at risk for nutritionally related health problems. Better hematologic status of a group of preschool-aged infants who were enrolled in the WIC Program from birth, as compared with another group of similar age and socioeconomic status from the pre-WIC Program era, suggests that participation in the WIC Program will help limit the development of iron depletion or iron deficiency anemia in young children, an important consideration in view of the deleterious hematologic and nonhematologic effects that have been attributed to those conditions. PMID- 3966033 TI - Acute pulmonary edema complicating tonsillectomy and adenoidectomy. AB - In summary, we have presented two cases to illustrate the problem of postoperative pulmonary edema following tonsillectomy and adenoidectomy. Furthermore, we have discussed the difficulty in predicting those patients who will develop this complication. Because of the potential seriousness and unpredictability of acute pulmonary edema following tonsillectomy for chronic obstruction, it is important that medical personnel, including pediatricians caring for patients after tonsillectomy, be able to readily recognize this phenomenon of acute onset of congestive heart failure and treat it rapidly with diuretics, continuous positive airway pressure, and respiratory support as needed. PMID- 3966034 TI - Group C streptococcal endocarditis. PMID- 3966035 TI - Intellectual functioning and ectodermal dysplasia. PMID- 3966036 TI - Clinical estimation of liver size in newborn infants. PMID- 3966037 TI - Zinc deficiency: cause of hypoproteinemia or its result? PMID- 3966038 TI - Levothyroxine poisoning. PMID- 3966039 TI - The face in otitis media. PMID- 3966040 TI - A successful city-wide smoke detector giveaway program. AB - Each year, 5,000 Americans die and 300,000 are hospitalized as a result of 2.8 million residential fires. Almost all house fires allow time for safe exit if an early warning is given. Smoke detectors are an effective, reliable, and inexpensive method of providing such warning. After an upsurge of deaths related to fires in 1982, Baltimore City gave away 3,720 smoke detectors to households that requested them. This study addressed two questions: (1) Did the households that received the smoke detectors install them? (2) Was the population reached by this giveaway program a population at high risk from fire? A survey of 231 randomly selected households among those requesting smoke detectors was conducted 8 to 10 months after the giveaway program. At that time, smoke detectors were installed in 92% (212/231) of the homes and 88% (187/212) of the installed smoke detectors were operational. Households requesting smoke detectors were in census tracts at higher risk from fire. The correlation coefficient between the rate of requesting a smoke detector and the risk of death or injury related to fires was r = .90, P less than .001. The 231 surveyed households had more personal fire risk factors than the general population. The success of this smoke detector giveaway program is notable in that it required the active participation of a high-risk population. PMID- 3966041 TI - Stressful life events and somatic complaints in adolescents. AB - Although life stress has often been associated with recurrent pain in children and adolescents, level of stress has not previously been found useful in differentiating patients with functional pain from those in whom other conditions are diagnosed. In this study, a standard measure of stressful life events was systematically administered to 172 adolescents seen for the first time at an outpatient adolescent clinic. Patients with recurrent pain for which no organic etiology could be identified reported significantly higher life stress than patients being seen for routine checkup, acute minor illness, stable chronic illness, or pain with clinically diagnosed organic cause. Furthermore, patients referred for behavior problems indicated significantly higher life stress than all other patient groups. It is suggested that a measure of stressful life events may be a useful adjunct to the clinical interview and is of particular value in identifying specific stressors and planning treatment to address them. PMID- 3966042 TI - Determinants of mother-infant interaction in adolescent mothers. AB - Mother-infant interactions of adolescent and nonadolescent mothers are compared, and the impact of maternal age, ego development, education, and child care support on these interactions is examined. Thirty primiparous, white, lower- to middle-class mothers (half less than or equal to 17 years) and their healthy full term infants (8 months) were studied. Interactions were videotaped during face-to face interactions and teaching sessions. Child care support and ego development were assessed. During face-to-face interactions, only one difference was found between adolescent and nonadolescent mothers: nonadolescent mothers showed more positive affect toward infants. During teaching, nonadolescent mothers talked more, showed more positive affect toward infants, and demonstrated tasks more often. Individual differences during face-to-face interactions were more related to mothers' ego development and support whereas teaching interactions were mostly associated with maternal age. Thus, maternal age was a stronger predictor of interactive style during teaching. This may partially explain noted cognitive deficits in infants of teenage mothers. However, individual differences among all mothers in ego development, education, and support were significantly related to interactions. Thus, teenage mothers with less education and support and lower ego development may represent a higher risk subgroup of adolescent mothers providing less optimal care-giving environments for their infants. PMID- 3966043 TI - Family life events, maternal depression, and maternal and teacher descriptions of child behavior. AB - The relationship between family life events, maternal depression, and teacher and maternal ratings of child behavior was studied in a birth cohort of New Zealand children. Analysis of variance and multiple regression analysis showed that for maternal ratings of child behavior, both maternal depression and family life events made significant independent contributions. For teacher ratings of child behavior, the only significant predictor was family life events. These results persisted when appropriate controls for family social, economic, and demographic characteristics were taken into account. The theoretical implications of these findings are discussed. PMID- 3966044 TI - Long-term effects of nonorganic failure to thrive. AB - Fourteen children admitted to the hospital at an average age of 12.5 years previously were reviewed in comparison with a group of children matched for age, sex, social class, and ethnic group. The children in the study group were smaller in height and weight, than children in the comparison group. They had lower scores on the verbal intelligence scale of the Wechsler Intelligence Scale for Children--Revised, poorer language development, and less well-developed reading skills. They had lower social maturity and a higher incidence of behavioral disturbances. There were no differences between the study and comparison groups in family size, maternal age, family health, social isolation, and mothers' childhood experiences. The study group mothers had less knowledge about their children's education, were more anxious, and had a tendency toward concrete thinking. To prevent the long-term adverse effects of nonorganic failure to thrive, a more active, practical, and long-term program, begun at the time of presentation, is recommended. PMID- 3966046 TI - Neonatal mortality: effects of selective pediatric interventions. AB - A previous prospective study of neonatal mortality in babies receiving special care at the University College Hospital, Ibadan, revealed that respiratory failure associated with prematurity, perinatal asphyxia, sepsis, and congenital malformations were the major causes of high neonatal mortality. To improve survival, selective measures were taken to improve care of low-birth-weight infants and prevent or treat intrapartum and postnatal hypoxia, metabolic acidosis, hypoglycemia, and hypothermia. A change in the initial antibiotic management of suspected septicemia to the use of cloxacillin and an aminoglycoside was also introduced, based on the current knowledge of etiologic agents and their antimicrobial sensitivities. In the 5-year period (1976 to 1980), the neonatal mortality in babies weighing 2,500 g and more at birth dropped significantly from 1.2% to 0.7% (P less than .02). The case fatality rates from birth asphyxia and neonatal sepsis dropped by 48% and 32%, respectively. Despite therapeutic interventions, however, the neonatal mortality in babies with birth weight of 1,000 g or less, 1,001 to 1,500 g, 1,501 to 2,000 g, and 2,001 to 2,499 g remained unchanged at about 82%, 25%, 9%, and 3%, respectively. These results suggest that early identification of infants at risk of developing birth asphyxia or neonatal septicemia and institution of prompt and appropriate management could produce a significant reduction in mortality in infants of normal birth weight. Survival of low-birth-weight infants requires additional high technical, financial, and manpower resources, which most centers in developing countries cannot afford at the present time. Therefore, efforts are probably better concentrated on decreasing the incidence of low birth weight. PMID- 3966045 TI - Childhood death and poverty: a study of all childhood deaths in Maine, 1976 to 1980. AB - All child deaths occurring from 1976 to 1980 in Maine were studied. All children who were participating in social welfare programs (Medicaid, Food Stamps, or Aid to Families with Dependent Children [AFDC]) at the time of death were categorized as children from "low-income" families. This group of children had an overall death rate 3.1 times greater than children who were not on a social welfare program at the time of death. Children from low-income families were at higher risk for disease-related deaths (3.5:1), accidental deaths (2.6:1), and homicide deaths (5.0:1), but not for suicides. These data suggest that excess mortality is occurring among infants and children from low-income families in spite of Medicaid and other poverty programs and that this excess mortality has important public health and social policy implications. Pediatricians and others interested in the well-being of children should support improvement of current health care delivery and social welfare programs, because the current system is failing to provide an optimal health outlook for every child. PMID- 3966047 TI - Wrongful life and wrongful birth: new concepts for the pediatrician. AB - Over the past two decades, numerous suits for damages have been brought against physicians for the injury of wrongful life, or wrongful birth. Within the past 5 years, several precedents have been set that broaden the physician's legal obligation to recognize and act upon foreseeable or potentially recurrent genetic, teratogenic, or chromosomal disorders. These precedents may be expected to affect all physicians, but particularly pediatricians, because of the increased frequency of such disorders in the pediatric population. PMID- 3966048 TI - Ventilatory chemosensitivity in subjects with a history of childhood cyanotic breath-holding spells. AB - The ability of children with cyanotic breath-holding spells to respond to anger or frustration by voluntary breath-holding for prolonged periods (often to the point of precipitating hypoxic seizure activity) suggested the hypothesis that such children may have a less powerful urge to breathe in the presence of hypoxia and/or hypercapnia than children who do not have breath-holding spells. Because ventilatory chemosensitivity is difficult to measure in infants and young children, this hypothesis was tested indirectly by measuring the ventilatory responses to hyperoxic progressive hypercapnia and to isocapnic progressive hypoxia of seven individuals who had a history of cyanotic breath-holding spells in infancy and 17 control subjects. The mean values for sensitivity to hypoxia and to hypercapnia were not significantly different between the two groups, and the responses of the majority of the subjects with cyanotic breath-holding spells were clearly within the normal range. There were fewer individuals with high normal ventilatory responses among the subjects with cyanotic breath-holding spells. Although children with cyanotic breath-holding spells may have decreased ventilatory chemosensitivity transiently during infancy or may differ from other children in some other aspect of the control of breathing, the pathogenesis of infantile cyanotic breath-holding spells does not involve a permanently blunted sensitivity to hypercapnia or hypoxia. PMID- 3966049 TI - Lipid digestion and absorption. AB - The importance of nutrient lipids to the developing preterm and term infant has served to focus investigations upon the mechanisms of fat digestion and absorption. The unique physical-chemical properties of the human milk fat globule have been reviewed. Emphasis is placed on the newer understandings that have emerged concerning the intraluminal phase of triglycerides hydrolysis and solubilization of the lipolytic products. The mechanisms of action of the pancreatic lipase, colipase, and phospholipase A2 system, and the importance of intragastric lipolysis for initiating the lipid digestion are explored. Lastly, aspects of bile acid micelle formation and its role on nutrient lipid solubilization and absorption are examined in view of the postnatal adaptations that occur with weaning and the introduction of alternative nutrient sources to the older infant. PMID- 3966050 TI - Absorption of protein and protein fragments in the developing intestine: role in immunologic/allergic reactions. AB - An important adaptation of the gastrointestinal tract to the extrauterine environment is its development of a mucosal barrier against the penetration of proteins and protein fragments. To combat the potential danger of invasion across the mucosal barrier the newborn infant must develop within the lumen and on the luminal mucosal surface an elaborate system of defense mechanisms which act to control and maintain the epithelium as an impermeable barrier to the uptake of macromolecular antigens. As a result of a delay in the maturation of the mucosal barrier, newborn infants are particularly vulnerable to pathologic penetration by harmful intraluminal substances. The consequences of altered defense are susceptibility to infection and the potential for hypersensitivity reactions and the formation of immune complexes. With these reactions comes the potential for developing life-threatening diseases such as necrotizing enterocolitis, sepsis, and hepatitis. Fortunately, "nature" has provided a means for passively protecting the "vulnerable" newborn against the dangers of a deficient intestinal defense system, namely human milk. It is now increasingly apparent that human milk contains not only antibodies and viable leukocytes but many other substances that can interfere with bacterial colonization and prevent antigen penetration. PMID- 3966051 TI - Weaning practices in deprived environments: the weaning dilemma. AB - The weaning process varies widely among different cultures as to when the practice is initiated and terminated; in the variety, quality, and quantity of the weaning foods; and in the manner in which the endogenous food is provided. The variations in practices range from providing a food source even before the first breast-feeding to feeding nothing but breast milk for as long as 9 to 12 months, and include feeding from a cupped hand to use of a modern feeding bottle. The advice often given healthy mothers is to breast-feed for as long as possible and compatible with life-style. Most often, when breast-feeding is prolonged, the practice is to provide some complementary food from the early postpartum months onward. However, among some poor traditional societies and in deprived environments, this food may be limited and monotonous in flavor and texture. The monotony of the diet may act synergistically with the consequences of repeated infectious morbidity, and result in chronically depressed appetite and limited acceptance of additional food in quantity and variety at the time when this becomes critical for meeting the nutritional needs of the growing infant. The serious malnutrition prevalent in the 1 to 3 year olds in many deprived environments may have its antecedent etiology in the complementary feeding practices established in the first year of life. Effective interventions to reverse growth faltering of infants reared in deprived environments where breast feeding is prolonged may require increased attention to providing variety in the weaning diet from at least 4 months onward. PMID- 3966052 TI - Response of the gastrointestinal tract to premature weaning in experimental animals. AB - Weaning is an important period in the life of all mammals including the human. During this time the external and internal environment exhibits substantial changes that are in concert under normal conditions. Premature weaning interferes with the development of various functions. Studies demonstrate that premature weaning has immediate and delayed effects. The analysis of the delayed (late) effects of the premature weaning has considerable significance in the advancement of effective preventive medicine. PMID- 3966053 TI - Skin diseases of the external genitalia. Recognition and treatment. AB - Dermatologic diseases of the genitalia are of several types: congenital diseases, acquired diseases (those caused by viruses, bacteria, fungi, or physical or chemical toxins), tumors, and atrophic dermatoses. The methods available to diagnose these diseases vary. Some conditions may be recognized by appearance alone, whereas others require histopathologic examination of involved skin for correct diagnosis. Some do not need treatment, while others call for an aggressive approach. Some types of genital dermatologic diseases, such as herpes infections and condylomata acuminata, appear to be associated with genital carcinogenesis. Patients with these diseases should be carefully examined. PMID- 3966054 TI - Malaria. Prevention is the key. PMID- 3966055 TI - Entrapment neuropathies. Differential diagnosis and management. AB - Entrapment neuropathies are a common cause of pain and disability in both the upper and lower extremities. Diagnosis is based on clinical presentation and electrodiagnostic evaluation. Treatment consists of conservative measures to relieve pressure and pain and in some cases surgical freeing of the nerve. PMID- 3966057 TI - The thoracic outlet syndrome. Meeting the diagnostic challenge. AB - Although arm and hand pain, paresthesias, and weakness are common complaints in thoracic outlet syndrome, only a small minority of patients presenting with these symptoms will be found to actually have this condition. Thus, the clinician should be familiar with the symptoms and signs of this syndrome and also be aware of the difficulties of objectively confirming the diagnosis. After a thorough history and physical examination, cervical spine radiographic and electromyographic study may be the most helpful first tests for exclusion of other common conditions causing similar symptoms, such as cervical degenerative arthritis and carpal tunnel syndrome. Arteriography may well be considered next if the patient does not respond to conservative treatment. Only when other, more common illnesses are excluded should the thoracic outlet be surgically explored. Results of surgical therapy should be good, especially if true pathologic compression of the neurovascular structure is present. PMID- 3966056 TI - Carpal tunnel syndrome. Avoiding poor treatment results. AB - Carpal tunnel syndrome is one of the most common causes of paresthesias, pain, and weakness of the hands. All physicians should be aware of the typical presentation of the syndrome, its differential diagnosis, and the various options for treatment. The prognosis with surgical treatment is excellent if significant muscle atrophy has not occurred. PMID- 3966058 TI - Ulnar nerve entrapment at the elbow. Tailoring the treatment to the cause. AB - Ulnar nerve entrapment at the elbow is a common cause of arm and hand pain, paresthesias, and weakness. Its characteristics and the appropriate diagnostic tests should be known to all primary care physicians. An understanding of the surgical treatment of this common disorder is helpful in providing informed medical care. PMID- 3966059 TI - Exercise prescription. Not just for cardiac patients. AB - Exercise can be prescribed for many patients depending on the type, frequency, duration, and intensity of the activity. The patient's interests and goals must be balanced with the fitness profile. For maximum benefit, exercise should be performed regularly--three times per week on an every-other-day basis, with each training session lasting 35 to 45 minutes. Contraindications to exercise depend on the type of activity and the health status of the participant. PMID- 3966060 TI - Measles in young adults. The case for vigorous pursuit of immunization. AB - Although the incidence of measles has reached record low levels in the United States, measles continues to occur in young adults. No single public health measure can ensure immunity for young adults, as school immunization laws do for young children. Therefore, to eliminate measles in this age-group, clinicians must take the initiative to vaccinate or revaccinate patients. To facilitate containment of outbreaks of measles, clinicians should include measles in the differential diagnosis of any illness characterized by fever and a generalized rash and should promptly report these cases as suspected measles to local health departments, without waiting for laboratory confirmation. If the suspected case is indeed measles, a significant outbreak could be avoided long before the first laboratory results are known. PMID- 3966062 TI - Building a pathway to better health. The primary care physician's role. PMID- 3966061 TI - Calcium metabolism without anguish. Understanding the body's homeostatic 'black box'. PMID- 3966063 TI - Practical information on aortoiliac disease. PMID- 3966064 TI - Normal and reference ranges: the myth of equality. PMID- 3966065 TI - Rare complication of subclavian vein catheterization. PMID- 3966066 TI - Pruritus ani. What to do, what not to do to control this infernal itch. AB - The essentials of the treatment of pruritus ani consist of keeping the perianal skin scrupulously clean and dry. The most important damaging factors are fecal residue, moisture, scratching, steroids, and local anesthetics. PMID- 3966067 TI - Physician and staff. A new look at an old relationship. PMID- 3966068 TI - Anaerobic bacterial pneumonia in an otherwise healthy young adult. PMID- 3966069 TI - Hemodialysis. Basic principles and practice. AB - Hemodialysis removes uremic toxins and excess fluid from the blood by diffusion dialysis and ultrafiltration. The efficiency of this process depends on the size, shape, and type of semipermeable membrane used in the hemodialyzer. Although the hollow-fiber kidney remains popular, the parallel-plate hemodialyzer is reestablishing itself, partly because it can use newer types of membranes. With newer membranes, ultrafiltration can be performed without diffusion dialysis, which appears to have important clinical advantages. The dialysate bath used in the hemodialyzer resembles plasma water in composition, with electrolytes added to compensate for abnormalities of end-stage renal disease. Although the technical problems of hemodialysis have been largely overcome, an accurate, easy to-use method of evaluating the adequacy of the hemodialysis prescription has yet to be devised. PMID- 3966070 TI - Effects of aminoglutethimide on cervical dilatability and serum immunoreactive relaxin in pregnant rats. AB - Administration of aminoglutethimide (AG) at a daily sc dose of 20 mg/kg to rats from the 10th to 20th days of pregnancy resulted in fetal wastage, increased placental weights, and decreased placental alkaline phosphatase. In an effort to determine the endocrine problems relating to these abnormalities, serum relaxin (R) and progesterone (P) levels were determined by RIA and cervical distensibility was measured: All three parameters were subnormal in AG-treated rats. Therapy with estrogen (E) or (P) failed to correct any of the physiological problems associated with AG treatment, but a combination of these steroids increased fetal survival to control levels. However, cervical dilation in preparation for parturition failed to occur. Relaxin therapy alone increased cervical dilation but did not enhance fetal survival. A combination of E, P, and R maintained a normal complement of fetuses and provided normal cervical dilation. None of the treatments prevented placental enlargement but P treatment tended to maintain normal placental alkaline phosphatase. PMID- 3966071 TI - Physiological peripubertal activation of the ovary is not reproduced by pregnant mare serum gonadotropin (PMSG) administration. AB - During the days preceding the first ovulation the ovary of the rat exhibits a remarkable increase in estradiol (E2) and progesterone (P) release in response to gonadotropins. No such increase is observed in the case of androgens (A, testosterone + dihydrotestosterone). The present experiments were undertaken to examine the possibility of reproducing these developmental events by stimulating the ovary with a gonadotropin that has substantial FSH-like activity. In vivo administration of pregnant mare serum gonadotropin (PMSG) to juvenile 29-day-old rats greatly increased the in vitro E2 and A response to human chorionic gonadotropin (hCG) measured 2 days later in the morning. The magnitude of the A response was significantly larger than that of ovaries from juvenile animals or rats in first proestrus. The E2 response was much greater than that of juvenile ovaries but similar to that of ovaries from late proestrous rats. In contrast, the P response to hCG was not enhanced by PMSG. In fact the response was similar to that of juvenile ovaries and markedly less than that of first proestrous rats. This decreased P response was not due to a greater conversion of P to its less active metabolite 20 alpha-hydroxy-4-pregnen-3-one (20 alpha-OH-P). The results suggest that PMSG enhances the E2 and A response of immature ovaries to hCG at the expense of that of P. Treatment of immature rats with PMSG may represent a useful model to study E2 release from preovulatory ovaries, but it cannot be used to reproduce in its entirety the developmental changes in steroidal response to gonadotropins associated with normal puberty. PMID- 3966073 TI - Comparison of hyposmolar and hyperosmolar effects on in vitro luteinizing hormone secretion by anterior pituitary cells. AB - It has previously been described that perifusion of acutely dispersed adenohypophyseal cells with hypotonic medium causes an immediate high-amplitude "on" burst of luteinizing hormone (LH) secretion. In the present report the converse study with hyperosmolar solutions has been made. Perifusion with hypertonic medium depressed LH secretion; return to isotonicity caused an immediate high-amplitude "off" burst of LH secretion closely resembling that induced by hypotonic perifusion. The data give further support to the theory that exocytotic secretion may involve expansion of the outer cell membrane, thus drawing secretory granules to the cell surface where their contents are extruded. PMID- 3966072 TI - Pure human pancreatic juice directly enhances uptake of cobalamin by guinea pig ileum in vivo. AB - Although pancreatic enzymes clearly degrade R binder, a nonintrinsic factor binder, the full scope of the pancreatic role in cobalamin absorption remains the subject of debate. Therefore the direct effect of pure human pancreatic juice (PPJ) on ileal cobalamin absorption in the absence of intrinsic factor was studied. PPJ significantly enhanced cobalamin uptake in guinea pig ileal loop perfused in vivo. It did not do so in the jejunum. This PPJ activity in the ileum was further stimulated by enteropeptidase and inhibited by aprotinin. The intestinal mucosa remained intact during our study by morphologic and inulin clearance criteria and behaved normally with respect to intrinsic factor and nonintrinsic factor binders. Since no intrinsic factor was present in the perfusate, PPJ must directly enhance cobalamin uptake by the ileum, perhaps promoting cobalamin attachment to receptor sites for subsequent transport by intrinsic factor. PPJ thus seems to affect cobalamin absorption at several levels. Previous studies have established its interaction with luminal R binders and with bile. The findings now indicate that pancreatic juice may have an additional, more direct role in promoting cobalamin absorption in the ileum. PMID- 3966074 TI - Dexamethasone-induced phospholipase A2-inhibitory proteins (PLIP) influenced by the H-2 histocompatibility region. AB - Recent work has indicated that the H-2 histocompatibility complex on chromosome 17 influences the degree of glucocorticoid-induced teratogenicity and anti inflammatory response. Since both of these hormonal actions appear to be mediated by the induction of phospholipase A2-inhibitory proteins (PLIP), the influence of the H-2 complex on the induction of PLIP by glucocorticoids in thymocytes and embryonic palates has been investigated. Analysis of dexamethasone-induced PLIP by Sephadex G-100 revealed four peaks of mol wt 55,000, 40,000, 28,000 and 15,000 in mouse thymocytes and from one to three of these PLIPs in mouse embryonic palates. The 55,000 mol wt PLIP comprised 50-60% of the total activity. The total amount of dexamethasone-induced PLIP is significantly higher in B10.A (H-2a) thymocytes than that in thymocytes of their congenic resistant partners, B10 (H 2b). The induced level of PLIP in the embryonic palates treated with dexamethasone is also significantly higher in the H-2a congenic strains with either the A or B background (AWy or B10.A) than that in their resistant partners (A.BY or B10). Thus, both susceptibility to glucocorticoid-induced cleft palate and the production of PLIP by this hormone are influenced by the H-2 complex. PMID- 3966075 TI - Factors influencing calcium influx in endotoxin-challenged fibroblasts. AB - The role of cell density and pH on calcium influx was studied in normal and endotoxin-challenged cultured 3T6 fibroblasts. In normal fibroblasts, at low cell densities, there was no marked difference in calcium influx at pH 6.6, 7.4, and 7.8, whereas at high cell densities, the calcium influx was markedly higher at pH 6.6 as compared to that at pH 7.8. Endotoxin treatment for 4 hr at low cell density and in alkaline pH (7.4-7.8) increased calcium influx in a dose-dependent manner. In contrast, at high cell density and low pH (6.6), endotoxin treatment markedly decreased calcium influx in a dose- and time-dependent manner. These endotoxin-induced changes in calcium influx were not fully compensated by altered calcium efflux because total calcium content of the cells was found to be altered. The efficacy of the endotoxin varied depending on the bacterial source of the endotoxin and the method of purification. There was a relationship between the effect of different endotoxins on the increase in calcium influx and the inhibition of cell proliferation. Endotoxin did not decrease, but slightly increased cell proliferation when added to high cell density cultures even at a concentration of 200 micrograms/ml. PMID- 3966076 TI - Choleretic effects of differently structured bile acids in the guinea pig. AB - The effects of 10 differently structured bile acids on bile flow and composition were studied in anesthetized, bile duct-cannulated guinea pigs. At the infusion rates of 2 and 4 mumole/min/kg, all bile acids produced choleresis. The most potent was chenodeoxycholate, which increased bile flow by an average of 31.25 microliters/mumole of bile acids excreted in bile. The weakest choleretic was tauroursodeoxycholate (11.02 mu/mumole). When the choleretic activity was plotted against bile acid hydrophobicity (high-performance liquid chromatography retention factor, obtained from the literature), linearity was observed with similarly conjugated bile acids. The order of potency was deoxycholate greater than chenodeoxycholate greater than cholate greater than ursodeoxycholate, both for the glycine and taurine conjugates, and for the unconjugated bile acids as well. Conjugation was also important, and the rank ordering for the choleretic activity (unconjugated bile acids greater than glycine-conjugates greater than taurine-conjugates) was the same as that for the hydrophobicity. When the choleretic activity was plotted against bile acid micellar aggregation number (in 0.15 M NaCl at 36 degrees C, obtained from the literature), a linear, direct relationship was observed. All bile acids produced similar effects on bile electrolyte concentrations: both bicarbonate and chloride slightly declined during choleresis, whereas bile acid concentrations increased. These studies suggest that, in the guinea pig the differing choleretic activities of differently structured bile acids are not due to their forming micelles in bile of different sizes; either the more hydrophobic bile acids form vesicles, whereas the more hydrophilic form micelles; or bile acids produce choleresis, in part or exclusively, by stimulating an additional secretory mechanism, possibly an inorganic ion pump; or both. PMID- 3966078 TI - Differentiated pressor and sympathetic responses to dual brain stimulation: ventromedial hypothalamus versus locus coeruleus. AB - Sensitivity of the ventromedial hypothalamus (VMH) to electrical stimulation was compared with that of the locus coeruleus (LC) in urethane-anesthetized rats. Based not only on current strengths required to elicit threshold effects, but also on magnitude of pressor responses to suprathreshold stimulation, the LC was consistently more sensitive than the VMH. Despite this greater pressor sensitivity, splanchnic nerve firing increased almost equally upon stimulation of either brain area. Similar comparisons made in other rats following bilateral adrenalectomy or pretreatment with a vasopressin antagonist showed no significant alteration of pressor and sympathetic responsiveness to stimulation of either the LC or the VMH. When frequency of neural firing was recorded from a lumbar sympathetic trunk instead of the splanchnic nerve, increases in sympathetic nerve activity produced by LC stimulation were significantly larger than those produced from the VMH. The results suggest that greater pressor sensitivity of the LC is due, at least in part, to stronger constriction in vascular beds innervated by the lumbar sympathetic chains. PMID- 3966077 TI - Differential binding of folates by rat renal cortex brush border and basolateral membrane preparations. AB - The binding of radioactive 5-methyltetrahydrofolate and folic acid was found to be greater in brush border than in basolateral membrane preparations of rat renal cortex. This appeared to be due to an increased amount of a specific folate binding protein in the brush border membrane preparations as compared to those of the basolateral membrane. The binding was saturable and inhibited by nonradioactive folic acid and, therefore, a specific, rather than nonspecific process. The Km's for folic acid binding in brush border and basolateral membrane preparations were similar and involved a single high-affinity binding site. In contrast, methotrexate was found to bind equally well to both brush border and basolateral membrane preparations. Moreover, folic acid binding was not inhibited by an equimolar amount of methotrexate. A folate binding protein could be extracted from either membrane preparation with 1% Triton X-100 and, to a lesser extent, with 0.6 M NaCl. These different extraction procedures resulted in different apparent molecular weights for folate binding protein (greater than 160,000 for Triton X-100-extracted samples and 40,000 for NaCl-extracted samples). The membrane preparation pellets remaining after NaCl extraction were able to rebind tritiated folic acid and also the 40,000-Da folate binding protein. On the other hand, membrane preparations extracted with Triton X-100 lost the ability to bind folic acid or the 40,000-Da folate binding protein. These differences in molecular weight and rebinding capacity may be explained by the existence of a receptor for folate binding protein which was extracted by Triton X-100, but not by NaCl. The greater concentration of folate binding protein in the renal tubule cell brush border membrane preparations as compared to those from basolateral membranes ascribes, for the first time, a functional role for folate binding protein in the renal reabsorption of folates which is required to prevent loss of folate in the urine and perhaps in the membrane transport of folates in general. PMID- 3966079 TI - Enhancement of two motor functions of the lower extremity in a child with spastic quadriplegia. AB - This single-subject experimental design examined the immediate effects of four neurodevelopmental treatment (NDT) activities on two dependent variables: dorsiflexor muscle activity during an equilibrium response and frequency of heel contact during movement to a standing position. The subject was a 2.5-year-old boy with spastic quadriplegia. During the seven days of Baseline 1 Phase, the nine days of Treatment Phase, and the seven days of Baseline 2 Phase, dorsiflexor muscle activity was examined using an EMG instrument with surface electrodes. Frequency of heel contact was recorded as the number of times in seven trials that the child came to a standing position with his heel contacting the floor. Conditions were identical across all three phases except that four NDT activities were introduced during the Treatment Phase and were withdrawn during the Baseline 2 Phase. The results demonstrated that these NDT activities increased dorsiflexor muscle activity during a posterior equilibrium reaction and increased the frequency of heel contact when the child came to a standing position. This study contributes to the growing body of literature in NDT. PMID- 3966080 TI - Gait cycle duration in 3-year-old children. AB - The gait cycle duration of 11 children who were 3 years old was recorded using cinematography. The variation of cycle duration from cycle to cycle during free walking with each child and the variation of mean cycle duration among the children are reported. I analyzed individual subject characteristics including sex, height, weight, leg length, and age at onset of independent walking for strength of relationship to recorded cycle duration. Results suggest that cycle duration in 3-year-old children during free walking is shorter than that expected for adults. A minimum of variability exists in average cycle duration across subjects at 3 years of age; however, considerable variation of cycle duration from cycle to cycle within individual subjects is not uncommon. I identified no significant relationships between subject characteristics and gait cycle duration. The data reported are consistent with the results of other studies showing a trend of gradually increasing cycle duration and decreasing variability with increasing age in early childhood. PMID- 3966081 TI - Rising from a chair. Influence of age and chair design. AB - We studied the effect of age on the act of rising from a standard armchair in a younger (means = 24 years) and an older (means = 75 years) group of healthy adult women. Rising from a standard armchair and an armchair specially designed for comfort in sitting of the elderly was studied in the older group to determine the influence of the special chair. We used electrogoniometry, EMG, and videotape analysis to record the activity for both groups. The older group placed their feet farther back and showed greater vastus lateralis muscle activity than did the younger group to rise from the standard chair. These results suggest that rising from the standard chair was more difficult for the older than for the younger group. In the special chair, the older subjects showed even more vastus lateralis muscle activity, greater knee flexion, and greater trunk forward lean. Rising from the special chair, therefore, appeared to be more difficult than rising from a standard chair; this finding suggests that both comfort and function must be considered in chair selection for certain groups. PMID- 3966082 TI - Assessment of resident physicians' knowledge of physical therapy. AB - Half of all US medical schools offer courses in rehabilitation medicine; however, 46 states require physician referrals for physical therapy services. The purpose of this study was to identify areas of deficit in resident physicians' knowledge of selected physical therapy modalities and evaluative procedures and to determine if resident physicians perceived themselves to have adequate background to refer patients to physical therapy effectively. We mailed a questionnaire to 345 resident physicians chosen from area hospitals and obtained a response rate of 32 percent. The demographic portion of the questionnaire was analyzed by the use of descriptive and chi-square statistics. We tested knowledge of modalities and evaluative procedures through matching of treatment referrals with specific patient diagnoses and analyzed the data in terms of chi-square, frequencies, and correlated statistics. The results indicated that the majority of respondents refer patients to physical therapy (98%) and feel adequately informed to do so (54%). Test results, however, ranged from 1 to 73 percent correct, with only one score above 70 percent correct. This finding indicated a deficit in resident physicians' knowledge of physical therapy. We also identified a need for physical therapists to educate physicians about treatment modalities and evaluative procedures through continuing education programs. PMID- 3966083 TI - Usefulness of footprint-sequence analysis in lower-limb amputees. AB - Clinicians evaluated the usefulness of footprint-sequence analysis in 25 lower limb amputees who were all prostheses wearers. The patients walked at a comfortable speed with their usual walking aids along a 2.24-m footprint recording strip. Each patient's physical therapist and physician indicated on visual-analogue scales how useful they judged both raw and derived data to be in problem solving and as documentation for future comparison. Both groups of clinicians found this type of analysis moderately useful. We found no significant difference, but moderate correlation (r = .61, p less than .01), between their estimates of usefulness for problem solving and for future documentation. They considered the derived data slightly, but significantly, more useful than the raw data (t = 4.20, p less than .001). We found no significant difference or correlation between the estimates of physical therapists and those of physicians. The clinicians ranked pressure distribution, stride width, step length, foot angle, and stride length in order of perceived usefulness. Footprint-sequence analysis appears to be a moderately useful adjunct to the evaluation and documentation of the walking problems of lower-limb amputees. Both raw and derived data should be made available to the physical therapists and physicians caring for these patients. PMID- 3966084 TI - Cybex II isokinetic dynamometer for the documentation of spasticity. Suggestion from the field. PMID- 3966085 TI - Acceptance of physical therapist assistant course work by programs preparing physical therapists. AB - I developed and sent a questionnaire to the directors of entry-level physical therapy programs to determine if course work taken in an associate degree program could be credited toward requirements leading to a higher degree or certificate in physical therapy. I sent 86 questionnaires; 45 were returned. Results of the survey revealed that basic science courses taken by the physical therapist assistant (PTA) students are more likely to be credited (up to half of the respondents replied positively) toward a higher degree or certificate than are technical courses like therapeutic exercise, fundamentals of physical therapy, or physical modalities. Moreover, as many as 79 percent of the respondents reported that PTAs would not be granted transfer credit for their technical courses. Of those respondents whose programs do give credit for the technical courses, the courses are usually considered as elective hours. Although the concept of upward mobility appears to remain viable in the educational philosophy of the American Physical Therapy Association, students who view the associate degree program as an entry point into a physical therapy program must be aware of the problems of acceptance of PTA credits in an entry-level physical therapy program. PMID- 3966086 TI - Obstetrics in the physical therapy curriculum. AB - We report the status of obstetric education in physical therapy curricula. A questionnaire was sent to 83 accredited physical therapy education programs. Of the respondents from 69 programs, 47 (68%) included a specific unit or information on obstetrics in their program. The reporting programs averaged 7.5 hours for obstetric education. The unit was required in 45 of the 47 programs. Topics covered included anatomy and physiology, psychology, labor and delivery sequence, relaxation techniques, breathing techniques, prenatal and postpartum exercises, body mechanics, nutrition, fetal development, and birthing alternatives. Fifty-three percent of the units were taught by a physical therapist and combination of other professionals including a nurse, physician, nutritionist, psychiatric social worker, physiologist, or anatomist. We present behavioral objectives, required readings, and audiovisual aids used in the units. PMID- 3966087 TI - Lateral canthoplasty to change the eye slant. AB - A technique is described to modify eyelid slanting and correct excessive scleral show. The anatomic relations of the canthal ligament with the fibrous supporting structures of the eyelid are discussed. The procedure is indicated in aesthetic surgery, in congenital anomalies, and in sequelae of trauma. PMID- 3966088 TI - Cervicofacial rhytidoplasty in Ehlers-Danlos syndrome: hazards on healing. AB - Ehlers-Danlos syndrome is an uncommon autosomal-dominantly inherited connective tissue disorder marked by excessive skin and joint laxity and easy bruising and ecchymotic tendency that poses a formidable threat to achieving face lift surgery in its normal perspective. Since this surgery is often sought by these patients as a result of premature excessive skin wrinkling of the face, one has to be aware of its possibility during the preoperative examination of the patient. All the possible complications and their management are described to the patient with a case history actually presenting these complications. PMID- 3966089 TI - Xeroderma pigmentosum: oldest living survivor? AB - Xeroderma pigmentosum is an infrequently occurring disease characterized by premature solar skin degeneration owing to an inherent deficiency in the enzymatic process of excision repair of x-ray-induced DNA alterations. Currently, there are six known genetic forms of this disease. The presence or absence of central nervous system involvement is a manifestation of the heterogeneity of the disease. Survival beyond the third decade of life is unusual. The authors present a 46-year-old patient with proven xeroderma pigmentosum who manifests many characteristic features of this affliction and may be one of the oldest, if not the oldest, living survivor of this unusual disease. PMID- 3966090 TI - Salvage of seeing eyes after avulsion of upper and lower lids. AB - It is often stated that any injury severe enough to avulse both lids will inevitably destroy the globe. Two cases are presented in which the globe was uninjured but exposed, requiring immediate coverage. Local skin flaps placed over mobilized conjunctiva were used for emergency cover. One was eventually made into functioning eyelids; the other remains dormant. First-line options for local flaps may not be available because of regional trauma. The reconstructive surgeon caring for acute trauma patients should be familiar with all available options, including recently described island and myocutaneous flaps. PMID- 3966092 TI - Scapular free-flap dissection made easier. AB - An improved technique for the dissection of the scapular free flap is presented. It includes identification of the triangular space by palpation and delivery and deep dissection of the proximal flap pedicle by means of a counterincision in the axilla. This technique allows for a rapid, safe, and easy dissection of the transverse scapular flap. PMID- 3966091 TI - Reconstruction of a socket using a retroauricular temporal flap. AB - The reconstruction of a continent socket with a skin graft may be difficult because of varying degrees of contracture. In an effort to solve this problem, a retroauricular temporal flap was successfully transposed in a two-stage procedure. The one-stage transposition of a retroauricular island flap based on a temporal pedicle was a partial failure. PMID- 3966093 TI - A new method of end-to-end microvascular anastomosis: the Y-shape. PMID- 3966094 TI - Transfusing plastic surgical patients. PMID- 3966095 TI - Precise terminology for suction lipectomy. PMID- 3966096 TI - Liposuction: the downside. PMID- 3966097 TI - A less expensive interference filter for fluorescence photography. PMID- 3966098 TI - Abnormal transaminase levels in burned patients. PMID- 3966099 TI - Management of ganglia in blacks. PMID- 3966100 TI - Centrocentral nerve union with autologous transplantation. PMID- 3966101 TI - Reply to suction lipectomy. PMID- 3966102 TI - Hair-bearing neck flap for upper lip reconstruction. PMID- 3966103 TI - A portable photographic backdrop. PMID- 3966104 TI - Experimental and clinical results of new advances in the treatment of facial trauma. AB - Theoretical considerations and photoelastic and mechanical experiments showed us the progression from metal wires to metal plates in different systems. In the midface there is no question about stabilization by miniplate systems. For mandibular fracture treatment, there is a discussion going on at present about the use of stable maxisystems versus less stable minisystems. Our clinical experience of 15 years indicates that there is no further demand for strict stable fixation of mandibular fractures, and we were encouraged to use less stable systems with similar good results, as our follow-up and statistical evaluation showed. To continue the simplification of osteosynthesis methods we are performing experiments with resorbable materials. Early results show fracture healing comparable with that found with plate-and-screw systems. Our clinical experience has shown that there is no longer any question about the ability of stable fracture treatment by means of osteosynthesis. However, there still is the question of how functional such fracture treatment might be. PMID- 3966105 TI - Comparison of the diagnostic methods used in maxillofacial trauma. AB - A prospective study was performed to evaluate the diagnostic methods used in acute maxillofacial trauma. Clinical examination, routine facial x-rays with linear tomography, and computer tomography were compared in 49 patients. Computer tomography was found to be the most accurate test in the diagnosis of facial bone injury, especially complex fractures. Computer tomography also provided valuable information regarding soft-tissue injury of the face. The radiation doses of linear tomography and computer tomography were calculated to be below the level known to cause cataract formation. Computer tomography is a safe, reliable adjunct in the diagnosis of acute maxillofacial trauma and should be strongly considered after initial screening measures are completed. PMID- 3966106 TI - The benefit of chilling in argon-laser treatment of port-wine stains. AB - The authors compare results obtained in argon laser treatment of port-wine stains with and without preliminary chilling, noting that the success rate is considerably greater with the former procedure (68.6 percent) than with the latter (37.5 percent) (X2 = 4.37 p less than 0.05). The effect of chilling has been studied with special reference to the vitropressure test. Different hypotheses are presented to account for the difference and possible complications of the treatment are considered. PMID- 3966107 TI - External oblique fasciocutaneous flap for elbow coverage. AB - The external oblique fasciocutaneous pedicle flap can be used for reconstruction of soft-tissue defects of the elbow. This flap has been used in five patients, and results have been good. The technique is appropriate in patients with recurrent defects of the elbow in whom local tissue has been previously used and is no longer available. With the development of local fasciocutaneous units, this method may have limited application. However, because of the relationship of this flap to the elbow, the procedure can be done easily and rapidly with minimal immobilization. It is a clinical impression that blood supply to the skin is enhanced by elevation of its underlying fascia. Anatomic dissections have demonstrated that there is an axial-pattern blood supply to this flap arising from the lateral border of the external oblique muscle. PMID- 3966108 TI - A double-split gluteus maximus muscle flap for reconstruction of the rectal sphincter. AB - A double-split gluteus maximus muscle flap has been described as a method for reconstructing difficult cases of rectal sphincter disruption secondary to trauma. Anatomic considerations and three case reports are documented. All three patients have derived nearly complete rectal continence after this procedure. The use of the inferior portion of only one gluteus maximus muscle preserves posterior hip stability and the proximal neurovascular supply to the portion of muscle that surrounds the anus. This procedure could potentially be used for rectal sphincter reconstruction in selected cases after ablative surgery in the anal region. PMID- 3966109 TI - Microvascular free transfer of iliac bone based on the deep superior branches of the superior gluteal vessels. AB - The findings from dissection, injection studies, corrosion specimens, and angiograms in 300 specimens of the iliogluteal region taken from 150 cadavers are reported. These findings suggest that the deep superior branches of the superior gluteal vessels may serve a nutritive pedicle in microvascular free transfer of iliac bone. Therefore, the operative technique has been developed and applied clinically with good results. The selection of different vessels as a nutritive pedicle for the free transfer of iliac bone is discussed. PMID- 3966111 TI - Anatomic observations of the carpal tunnel in cadavers with a report of unusual thickening of the perineurium of the median nerve. AB - The carpal tunnel of 50 cadavers (100 hands) was dissected. Macroscopic finding included 14 median nerves with pressure signs (in 4 cadavers, unilaterally and 5 bilaterally). In three cadavers, marked synovitis was seen around the tendons and the nerve; in one, lipoma was evident; and in the rest, thickening of the volar carpal ligament was seen. Microscopic examination of the compressed nerves showed concentric thickening of the perineurium, thrombosis of veins, and intrafascicular fibrosis. In one nerve, the thickening of the perineurium was not concentric, but only at that part of the fascicle adjacent to the volar carpal ligament in an "onion peel" form. PMID- 3966110 TI - Comparison of early passive motion and immobilization after flexor tendon repairs. AB - Thirty-one flexor tendon repairs in 30 patients managed by early passive motion were retrospectively compared with 31 flexor tendon repairs in 30 patients managed by 3 weeks of postoperative immobilization. Repairs were performed by several surgeons, including plastic surgical residents. There were no statistically significant differences between the two groups comparing age, zone of injury, number of tendons repaired, nature of injury, or associated injuries. No statistically significant difference was found between the two groups when total active and total passive range of motion were compared for repairs in zone I, zone II, zones III and IV, and all zones combined. In the early passive motion group in zone II, there were 12 percent excellent results, 15 percent good results, 23 percent fair results, and 50 percent poor results. In the immobilization group, there were 18 percent excellent results, 8 percent good results, 23 percent fair results, and 53 percent poor results. There was no significant difference between the two groups (p less than 0.05). PMID- 3966112 TI - Calf augmentation: a new calf prosthesis. AB - This paper describes a method of calf augmentation by using gel-filled implants to correct thin or asymmetrical legs. The implants are placed over both heads of the gastrocnemius muscle beneath the fascia cruris superficialis. In order to simplify Glitzenstein's procedure, modified implants were developed by the author. In over 25 cases, this technique gave encouraging results. PMID- 3966114 TI - Graduate education in plastic surgery: time for a change. PMID- 3966113 TI - Experimental studies in the survival of venous island flaps without arterial inflow. AB - The authors have studied the effects of various circulatory settings on flap survival. The dog model was used to study the survival of venous flaps without arterial inflow both as island and free flaps. Venous flaps were compared with arterial flaps without venous outflow and standard island flaps with arterial inflow and venous outflow. Attempts were made to study their vascular morphology and blood gas changes. The venous flaps without arterial inflow survived with normal hair growth and wound healing, as did the standard island flaps. These observations suggest that capillary diffusion can occur without the continuous flow of blood through a capillary. Several possible mechanisms to explain survival of the venous flaps without arterial inflow were discussed. These observations could be important in providing an animal model to study microcirculation and a possible new area for microsurgical transfer of a skin flap. PMID- 3966115 TI - Continuing medical education: more of an opportunity than a nuisance. PMID- 3966116 TI - Esophagogastric polyps: radiographic and endoscopic findings. AB - Radiographic, endoscopic, and pathological findings were correlated in 20 patients with polypoid esophagogastric lesions. In 16 patients, pathological examination showed chronic inflammatory change and epithelial hyperplasia; the polyp was located on the gastric side of the squamocolumnar junction, usually in association with a prominent gastric fold, and probably represented a localized form of gastritis. In the other 4 patients, the lesion was adenocarcinoma. An inflammatory esophagogastric polyp may be differentiated from polypoid carcinoma when adequate radiographs are available and specific diagnostic criteria are followed. Endoscopic biopsy is recommended if the lesion does not fulfill the criteria of an inflammatory esophagogastric polyp. PMID- 3966117 TI - Crohn disease of the small intestine: diffuse mucosal granularity. AB - A diffuse granular mucosal pattern, produced by a reticular network of radiolucent foci 0.5 to 1 mm in diameter, was identified in 39 out of 46 consecutive patients with Crohn disease of the small intestine. Resected specimens demonstrated that this pattern represented wide, blunted villi with lymphocytic infiltration. Such a pattern was the only evidence of small bowel involvement in 17 cases. In 3 patients with the commonly recognized lesions, separate regions of diffuse granularity were seen. No such pattern was detected in normal patients. Demonstration of diffuse granularity may contribute to the diagnosis and management of Crohn disease. PMID- 3966118 TI - Clinical application of in vitro studies for barium-enema examination following colorectal biopsy. AB - A total of 150 colorectal biopsies were performed in 71 patients and correlated with the barium-enema examination (BE). The investigation was divided into two parts. In the first part, involving 19 patients, the depth of each biopsy specimen was determined histologically prior to BE and potential complications related to the biopsy-BE sequence were evaluated. In the second part, involving all 71 patients, the depth of biopsy specimens taken from various colon lesions was determined histologically without regard to the timing of BE. The results confirm previous in vitro findings in pigs and dogs, namely: (a) BE may be performed without delay following a superficial biopsy, but should not be performed until at least 6 days after a deep biopsy; (b) transcolonoscopic biopsies are likely to be superficial, while transproctoscopic biopsies have the potential to be deep; and (c) BE should be delayed at least 6 days following polypectomy or polyp biopsy performed with electrosurgery. PMID- 3966119 TI - Intrahepatic venous collaterals forming via the inferior right hepatic vein in 3 patients with obstruction of the inferior vena cava. AB - When the inferior vena cava is obstructed, collateral veins enlarge, connecting with the inferior (accessory) right hepatic vein (IRHV) and thence through various hepatic veins to the right atrium. Three such cases are described. In one patient, most contrast material flowed into the IRHV and from there to the left hepatic vein. The second patient had several large collaterals arising from the IRHV and flowing into the right and middle hepatic veins, while the third patient demonstrated anastomoses between the IRHV and the middle hepatic vein. All of these hepatic venous shunts eventually drained into the right atrium. There were no clinical manifestations such as ascites, edema, or dilatation of the abdominal veins. Cavography alone or combined with computed tomography proved to be diagnostic in the assessment of these intrahepatic collaterals. PMID- 3966120 TI - Shoulder arthrography: comparison of morbidity after use of various contrast media. AB - This prospective study compares immediate and delayed patient discomfort in 177 patients following shoulder arthrography using intraarticular combinations of metrizamide, meglumine/sodium diatrizoate, meglumine diatrizoate, lidocaine, epinephrine, and air. Patients receiving conventional ionic monomeric positive contrast media had a 60% (90/150) incidence of moderate or severe delayed exacerbation of their baseline symptoms; only 14% (3/21) of patients receiving metrizamide, a nonionic contrast medium, had similar levels of postprocedural discomfort. Morbidity was somewhat diminished with the use of double-contrast (45%, 34/75) rather than single-contrast (75%, 56/75) examinations, and with avoidance of sodium-containing contrast agents or epinephrine. Nonionic or monovalent polymeric contrast media, despite their present high cost, may be the agents of choice if single-contrast arthrography is performed in joints (such as the shoulder, hip, and temporomandibular) associated with a high incidence of post-procedural pain. PMID- 3966121 TI - Acro-osteolysis associated with hypertrophic pulmonary osteoarthropathy and pachydermoperiostosis. AB - The authors report two cases of marked acro-osteolysis. One patient, a 16-year old boy, had hypertrophic pulmonary osteoarthropathy associated with bronchiectasis, clubbing of the digits, synovitis, and osseous changes. The other patient, a 55-year-old man, had pachydermoperiostosis as well as synovial hypertrophy, clubbing of the digits, blepharitis, and a cataract. While the association of acro-osteolysis and pachydermoperiostosis has been reported before, this appears to be the first verified case of acro-osteolysis combined with hypertrophic pulmonary osteoarthropathy. PMID- 3966122 TI - Failed hemodialysis shunts. One year of experience with aggressive treatment. AB - Thirty-three failed hemodialysis access shunts in 26 patients were treated by streptokinase declotting and/or transluminal angioplasty over a period of one year. Seventeen (52%) were restored to function without surgical intervention; 7 (21%) had restoration of flow but required surgical correction of an underlying problem such as a pseudoaneurysm or vascular stenosis which resisted angioplasty; and 9 (27%) showed no improvement. The authors discuss their technique as well as causes of shunt failure, those lesions likely to be improved by declotting and/or angioplasty, and reasons for treatment failure and recurrent thrombosis. PMID- 3966123 TI - Absolute ethanol injection of the adrenal artery: hypertensive reaction. AB - Transcatheter injection of 0.4 ml of absolute ethanol into the adrenal artery was performed in three Rhesus monkeys. The injection produced a mean increase of 60 mmHg in systolic blood pressure and 50 mmHg in diastolic blood pressure within two minutes. Hypertension was accompanied by cardiac arrhythmias (two monkeys) and sinus tachycardia (one monkey). These changes were probably related to an acute catecholamine release. Embolization of the inferior phrenic artery with Gelfoam powder produced only a mild blood pressure elevation in three monkeys (6 mmHg systolic pressure and 10 mmHg diastolic pressure). PMID- 3966124 TI - Interventional radiology in infants and children: clinical and technical aspects. AB - The authors performed 53 extravascular interventional procedures in 47 pediatric patients between July 1981 and September 1983. Except for transhepatic cholangiography in patients without intrahepatic biliary dilatation, the success rate was high. There were few complications, and none that were life-threatening or required surgery. More than 90% of procedures were performed without general anesthesia. Factors essential to safe and successful intervention in infants, children, and adolescents, in the authors' opinion, include (a) active involvement by the radiologist, (b) guidance by real-time imaging, (c) careful matching of needles, catheters, and guide wires to patient size, and (d) adequate sedation and analgesia. PMID- 3966125 TI - Magnetic resonance imaging of the brainstem: normal structure and basic functional anatomy. AB - Normal structure and basic functional anatomy of the brainstem were studied using anatomic sections obtained with a cryomicrotome whole-organ sectioning technique. Major tracts and nuclei were identified and their function summarized. Magnetic resonance imaging of the brainstem was performed on 10 normal volunteers. By comparing these images with the corresponding anatomic sections, normal structures, including major tracts and nuclei, were identified. Knowledge of location and function of clinically important brainstem nuclei and tracts is necessary for optimal magnetic resonance image interpretation. PMID- 3966126 TI - Extracranial tumor vascularity: determination by dynamic CT scanning. Part I: Concepts and signature curves. AB - Combined conventional drip infusion-dynamic CT scanning was performed on 28 patients with clinically discovered neck or parapharyngeal space masses. Seventeen of these also had digital venous study or angiographic studies either to confirm the CT diagnosis or as part of an embolization procedure. The studies indicate that the initial portion of the dynamic scan curve can be characteristically classified as either an arterial, venous, or hypovascular signature curve. The current ideas of how these curves are generated, the specific appearance of these signature curves, and the types of pathologic conditions that correlate with each curve are discussed. PMID- 3966127 TI - Dynamic computed tomography of the head and neck: differential diagnostic value. AB - A retrospective review of the dynamic CT studies performed in our institution on head and neck lesions, excluding the brain, was carried out. Five basic types of density vs. time curves were obtained. Dynamic CT scanning is valuable in the differential diagnosis, management, and followup of such cases; its usefulness as an imaging modality in diagnosis and followup of hemangiomas is stressed. PMID- 3966128 TI - Obstetrical magnetic resonance imaging: maternal anatomy. AB - Eleven patients whose pregnancies were at 34-36 weeks of gestational development underwent magnetic resonance (MR) imaging. Images of the maternal pelvis were assessed for anatomical changes of pregnancy in comparison with MR images of five non-pregnant volunteers. The relationship of the fetal presenting part to the internal os of the cervix was seen in all patients. Effacement of the cervix was identified when present. The maternal spine demonstrated disk abnormalities in nine patients. Changes in venous flow patterns were readily identified in all patients. The inferior vena cava was flattened or obliterated, a high signal was present in the iliac vessels (TE 56), and large collateral vessels were present. PMID- 3966129 TI - Obstetrical magnetic resonance imaging: fetal anatomy. AB - Nine patients who were 34-36 weeks pregnant underwent magnetic resonance (MR) imaging. Sagittal images using spin echo technique (TR 2.0 sec, TE 28 msec) were optimal for delineating fetal anatomy. The fetal cardiovascular, pulmonary, and central nervous systems were depicted in all cases. The heart and major vessels were readily seen due to the natural contrast of flowing blood. The intensity of the fluid-filled lungs greatly increased with a longer TR or TE, delimiting thorax from liver. The brain was relatively featureless due to the lack of gray white matter differentiation. The umbilical cord within the amniotic fluid and its insertion into the placenta and fetus was identified in all cases. MR is a new modality for fetal imaging that offers tissue-characterization information that complements the superior anatomic detail of ultrasound scanning. PMID- 3966130 TI - Verification and evaluation of internal flow and motion. True magnetic resonance imaging by the phase gradient modulation method. AB - We report qualitative and quantitative evaluation and verification studies of the bipolar phase gradient modulation method for true MR imaging of internal flow and motion velocities. Velocity encoding modulations provide speed-of-motion and direction-sensitive images using special phase-sensitive reconstructions. True motion MR imaging does not depend upon subject parameters, T1 or T2, nor upon selective active-volume time-of-flight calculations, nor is it limited strictly to fluid-flow velocities. Conventional MR sequences often induce strong accidental phase gradient modulations that can cause severe artifacts in conventional MR scans and limit the useful sensitivities of true motion MR. Multiple steps of velocity encoding allow resolution of separate elements of the velocity spectrum, and enable suppression of all such phase-artifact difficulties. Some view-to-view phase inconsistencies are intrinsic to the subject being scanned, e.g., strong motion variations during the heart cycle; limitations due to such effects require external modifications in the scanning, such as cardiac gating. Since conventional density information remains in the data, independent of velocity encoding modulations, we suggest a multiple encoding sequence and saving the MR raw data. These evaluations and verifications demonstrate exciting potential in clinical application for the phase gradient modulation method of true flow and motion MR imaging. PMID- 3966131 TI - Blood flow: magnetic resonance imaging. AB - The appearance of flowing fluid has been evaluated in several clinical situations using a flow phantom, computer simulation, and clinical magnetic resonance (MR) images. Unsaturated protons just entering the imaging volume can emit a strong signal relative to the partially saturated adjacent tissue ("flow-related enhancement"). Slow laminar flow in veins can be distinguished on the basis of a stronger second echo due to rephasing effects ("even echo rephasing"). Synchronization of the cardiac cycle and the MR pulsing sequence produces increased signal in sections acquired during diastole ("diastolic pseudogating"). Intraluminal signal is shown to decrease as velocity is increased ("high velocity signal loss"). Onset of turbulence causes further loss of signal. Direction of flow oblique to the imaging plane can be predicted on the basis of decreased upstream and increased downstream signal. PMID- 3966132 TI - Prototype coil for magnetic resonance imaging of the female breast. Work in progress. AB - Magnetic resonance imaging (MRI) of the breast was performed in 35 women using a prototype breast coil at 0.15 T. The distribution of fibroglandular and fatty tissues was demonstrated sufficiently well to permit correlation with the mammographic patterns of Wolfe, and it was possible to identify 1-cm cysts. The signal intensity of the cysts varied from low to high as repetition time (TR) and echo time (TE) using the spin echo technique (TR/TE) were prolonged from 250/30 to 1,000/120. In two women, fibroadenomas were seen as low-intensity, smoothly marginated lesions surrounded by fat. A range of in vivo observed T1 values is summarized for normal and pathologic tissues. It is concluded that MRI of the female breast, currently in the developmental phase, is feasible and further evaluation is indicated. PMID- 3966133 TI - Thin-section definition in magnetic resonance imaging. Technical concepts and their implementation. AB - In multisection magnetic resonance imaging, gradient strength and earliest desired echo time (TE) set a limit to the thinnest section achievable. Offset radio-frequency irradiation techniques and phase encoding within a thick section make possible the production of thin sections of clinically useful quality in practical imaging times. PMID- 3966135 TI - Hemodynamics of portal blood flow shown by CT portography. Work in progress. AB - Computed tomography and arterial portography were combined in 12 patients for studies of the anatomy and hemodynamics of the portal venous system. This technique was found to be more sensitive than conventional venous-phase angiograms of the superior mesenteric and splenic arteries for evaluation of the anatomy of the portal venous system and extent of thrombosis in patients with cavernous transformation and also facilitated recognition of subtle evidence of hepatofugal flow and portosystemic shunts. CT portography can be employed when conventional angiograms fail to show the portal vein adequately. PMID- 3966134 TI - Proton chemical shift imaging: an evaluation of its clinical potential using an in vivo fatty liver model. AB - The potential laboratory and clinical utility of proton chemical shift imaging (PCSI) was evaluated by studying fatty liver change in rats, which offered a simple animal model for tissue lipid buildup. There was excellent correlation between lipid group signal intensities from in vivo PCSI studies and liver triglyceride levels obtained from in vitro measurements (R = 0.97). The in vivo T1 relaxation time measurements in fatty liver tissue demonstrated two distinct populations of nonexchanging protons. We explain the reason for the lack of sensitivity in conventional magnetic resonance (MR) imaging studies of fatty liver change and discuss the implications of our findings for MR imaging studies of other tissues. PCSI promises improved diagnostic sensitivity and specificity in studying a wide range of human pathologic conditions. PMID- 3966136 TI - High-density renal cysts in autosomal dominant polycystic kidney disease demonstrated by CT. AB - Unenhanced abdominal CT scans of 35 patients with autosomal dominant polycystic kidney disease (ADPKD) showed multiple high-density (58-84 HU) renal cysts in 42.9% of patients, occasional high-density cysts in 25.7%, and no high-density cysts in 31.4%. These high-density cysts were usually subcapsular and were more frequent in patients with markedly enlarged kidneys and flank pain at the time of CT. Several were found to contain altered blood on pathological analysis. Follow up CT often showed a reduction in cyst densities, although some cysts developed mural calcification and calcification of their contents. High-density cysts are probably produced by cyst hemorrhage. This may occur randomly as part of the natural history of the disease or may result from minor trauma to the enlarged kidneys. Renal carcinomas occur rarely in ADPKD and may occasionally be hyperdense. However, high-density cysts may usually be distinguished from carcinomas on CT by their smooth contours, sharp interfaces with renal parenchyma, homogeneity, and lack of contrast enhancement. PMID- 3966137 TI - Multiple myeloma: evaluation by CT. AB - Although patients who have multiple myeloma usually have straightforward clinical symptoms and corroborative radiographs, in some instances, these patients will present atypically, with symptoms suggesting active disease but radiographs that are normal or nonspecific. We reviewed the records of 32 patients who had documented multiple myeloma and had undergone CT examinations, assessing the value of those examinations. Although CT is not indicated in all patients who have multiple myeloma, it is especially useful in patients who have bone pain and normal or nonspecific radiographs. CT provided confirmatory information in all cases in which lesions were seen on radiographs. CT also frequently demonstrated a greater extent of disease than could be appreciated on the radiographs. PMID- 3966138 TI - Test pattern for video displays and hard-copy cameras. AB - Members of a Subcommittee of the Society of Motion Picture and Television Engineers, with the cooperation of other professional societies, have developed specifications for an operational test pattern for evaluation of television monitors and film recording cameras used in medical diagnostic imaging. The purpose of this test pattern and the associated recommended practice is to provide the users of the medical diagnostic display systems with a comprehensive test for set-up, acceptance testing, and day-to-day operational checks. Details of the test pattern, examples of the system problems diagnosed by use of the pattern, and methods for optimizing display devices with the pattern are presented. PMID- 3966139 TI - Pseudoaneurysm: a complication of faulty technique in femoral arterial puncture. AB - Pseudoaneurysm is a well-documented but rare complication of retrograde femoral arterial puncture. We present six patients in whom pseudoaneurysm complicated this procedure. The pseudoaneurysm arose from the superficial femoral artery in five patients and from the profunda femoris artery in one. An arteriovenous fistula also arose from the superficial femoral artery in one patient. In no patient did the pseudoaneurysm arise from the common femoral artery. Two mechanisms are postulated as to why pseudoaneurysms rarely complicate puncture of the common femoral artery. PMID- 3966140 TI - Aspiration and drainage procedures in the intensive care unit: percutaneous sonographic guidance. AB - Ultrasound guidance was used in 10 aspiration and six drainage procedures in the intensive care unit. Sonography offered a safe and effective method for guidance of diagnostic aspiration in the ICU setting. Additionally, cholecystostomy, nephrostomy, abscess drainage, and empyema drainage were performed at bedside as lifesaving procedures in six critically ill patients using US guidance. PMID- 3966141 TI - Silicone biliary stents for percutaneous management of biliary obstruction. AB - Silicone tubes in 2-F increments from 12 to 20 F were developed for long term external-internal drainage of benign and malignant biliary obstructions. Passed coaxially over Teflon catheters and a guidewire, the silicone stents were softer and had larger sideholes than conventional drainage tubes. Once the acute track had matured (two weeks or longer), a silicone stent, 2 F larger than the preceding one, could be placed at each succeeding tube change. We have placed these tubes in 50 patients, 24 of whom had initially placed percutaneous catheters and 26 of whom had surgically placed stents. These tubes remain patent at least as long as conventional catheters and all patients have reported increased comfort using these catheters compared with standard ones. PMID- 3966142 TI - A light-guidance system to be used for CT-guided biopsy. AB - We describe a light-guidance system that uses intersecting helium-neon laser beams to provide precise guidance for biopsy approaches from any direction (including compound angles) during CT-guided biopsy of the chest and abdomen. Interactive software provides visualization of the proposed path, indicates the segment of that path that will pass through each section, and displays the settings for the apparatus. PMID- 3966143 TI - Patient motion artifacts on scintigraphic gastric emptying studies. AB - Patient motion during scintigraphic gastric emptying studies can result in the false diagnosis of gastroesophageal reflux or of accelerated gastric emptying. A simple means of detecting patient motion, by generating a time-activity curve from a region of interest drawn about a Tc-99m marker, is described. PMID- 3966144 TI - Inpatient management: a new role for interventional radiologists. AB - A new role for interventional radiologists, which allows them greater control over patient management, is discussed. The development of interventional radiology services that provide inpatient and outpatient care will establish interventional radiology as an important primary service and improve patient care. PMID- 3966145 TI - The radiologist as an attending physician: routine or special procedure? AB - The role of the interventional radiologist as an attending physician is discussed, and the disadvantages considered. It is the author's opinion that the disadvantages outweigh the advantages, and that a system in which interventional radiologists function as attending physicians will have limited applicability in most practices. PMID- 3966146 TI - Re: A simple, reliable method for fixation of percutaneous drainage catheters. PMID- 3966147 TI - Re: Adam's lobe. PMID- 3966148 TI - Re: The anterior subcostal vs. lateral intracostal approach to biliary drainage procedures. PMID- 3966149 TI - ADAMHA funding pressed. PMID- 3966150 TI - New curriculum at Harvard Medical School. PMID- 3966151 TI - Targeted modulation of acute inflammation. AB - Localized inflammation of the lungs was induced with the neutrophil chemoattractant, N-formylmethionylleucylphenylalanine (FMLP) in combination with magnetically responsive albumin microspheres, a drug carrier that provides efficient, extremely rapid localization in tissue. Intravenous targeting to rat lungs was accomplished by means of an external thoracic magnet. This caused progressive local accumulation of neutrophils, extravascular cell migration, and acute tissue injury. Microscopic findings favored chemotaxis as the principal mechanism of cell accumulation. This system provides a new experimental model for acute alveolar damage, a rapid in vivo assay for drugs that modulate neutrophil chemotaxis, and a new therapeutic approach to focusing inflammation in patients with chemotactic defects. PMID- 3966152 TI - Coupling of action potential activity between unmyelinated fibers in the peripheral nerve of monkey. AB - Bidirectional coupling of action potential activity occurs between unmyelinated fibers in the normal peripheral nerve of monkey. The site of coupling is near the cutaneous nociceptive receptor associated with one of the fibers. This coupling could be due to an electrical synapse and could provide the basis for the flare associated with the axon reflex. PMID- 3966153 TI - Evoked mechanical responses of isolated cochlear outer hair cells. AB - Intracellular current administration evokes rapid, graded, and bidirectional mechanical responses of isolated outer hair cells from the mammalian inner ear. The cells become shorter in response to depolarizing and longer in response to hyperpolarizing currents in the synaptic end of the cell. The cells respond with either an increase or decrease in length to transcellular alternating current stimulation. The direction of the movement with transcellular stimuli appears to be frequency dependent. Iontophoretic application of acetylcholine to the synaptic end of the cell decreases its length. The microarchitecture of the organ of Corti permits length changes of outer hair cells in a manner that could significantly influence the mechanics of the cochlear partition and thereby contribute to the exquisite sensitivity of mammalian hearing. PMID- 3966154 TI - Avoiding the schistosome's tricks. PMID- 3966155 TI - Study of Reye's-aspirin link raises concerns. PMID- 3966156 TI - Agency scraps plan to limit ethylene oxide. PMID- 3966158 TI - OMB directive will cost NIH loss of 1500 grants. PMID- 3966157 TI - Government policies and the cost of doing research. AB - The changes in the political economy of science are the natural outcome of two trends: science itself has become a more capital-intensive activity at the same time that federal support for research programs has slowed its growth. The results of the accumulating shortfall in the capital base for university research -increased seeking of support from private industry, efforts to circumvent peer review and competitive allocation, and a falling-out between institutions and investigators over how to divide up available resources--threaten to unravel what has been an extraordinary way of doing science. PMID- 3966159 TI - Histological demonstration of mosaicism in a series of chimeric rats produced between congenic strains. AB - Experimental chimeras were produced by aggregating morulae from congenic strains of PVG rats differing in the major histocompatibility complex (RTI). Monoclonal antibodies against variant class I antigens of the two strains were directly conjugated to iodine-125 and applied to tissue sections. Autoradiograms allowed examination of most internal tissues. The proportion of PVG-RTIa cells in the erythrocyte populations of the chimeras varied from 8 to 70 percent, as determined with fluorescence-activated flow cytometry. Digital analysis of autoradiograms demonstrated that the contribution of PVG-RTIa cells to the livers of the chimeras ranged from 34 to 86 percent. Patches of cells of each genotype in the liver were geometrically complex, with large variations in size. The thymus, but not the spleen, showed evidence of oligoclonal development. The adrenal cortex revealed a radially striped pattern, suggestive of clonal expansion of stem cells. With this approach it is possible to measure cell distribution in chimeras through direct histological visualization, which may prove useful in the study of rat organogenesis. PMID- 3966160 TI - Microorganism mediated reproductive isolation in flour beetles (genus Tribolium). AB - Reproductive isolation is induced by microorganisms in diverse geographic strains of the flour beetle Tribolium confusum (Coleoptera:Tenebrionidae). The incompatibility between populations is due to nongenetic cytoplasmically inherited factors. Males of infected strains produce no progeny when crossed with females of noninfected strains; however, they produce "normal" numbers of progeny when crossed with infected females. Males from noninfected strains show no reproductive isolation. Infected strains of T. confusum can be cured when tetracycline or other antibiotics are added to the flour medium. "Cured" strains become partially reproductively isolated from all noncured strains including the source strain PMID- 3966161 TI - Vaccination against Schistosoma mansoni with purified surface antigens. AB - Two surface antigens were isolated from young or adult schistosomes by affinity chromatography with monoclonal antibodies. Vaccination with an antigen having a molecular weight of 155,000 gave partial protection against challenge in some batches of mice and in a group of cynomolgus monkeys. Vaccination with an antigen having a molecular weight of 53,000 gave similar levels of protection in mice. The results demonstrate that protection can be obtained with single antigens, but the precise requirements for reproducible vaccination are as yet unknown. PMID- 3966162 TI - Transovarial transmission of murine typhus rickettsiae in Xenopsylla cheopis fleas. AB - It has been generally accepted that infected fleas do not pass on Rickettsia mooseri, or indeed any other known pathogen, to their progeny. It is reported here that such transovarial transmission does occur in laboratory-infected Xenopsylla cheopis fleas. By means of the direct fluorescent antibody test, Rickettsia mooseri was observed in cells of the hemolymph of infected fleas. As many as 11 percent of the adults and 2.9 percent of the larvae of the generation reared therefrom, had demonstrable rickettsiae. Moreover, batches of the F1 fleas were capable of transmitting the infection to more than 18 percent of the rats they infested. The data support the contention that Xenopsylla cheopis fleas play an important role in the maintenance of murine typhus in rats in nature. PMID- 3966164 TI - Learning medical fallibility. PMID- 3966163 TI - Multiple organ carcinogenicity of 1,3-butadiene in B6C3F1 mice after 60 weeks of inhalation exposure. AB - Groups of 50 male and 50 female B6C3F1 mice were exposed 6 hours per day, 5 days per week, for 60 to 61 weeks to air containing 0, 625, or 1250 parts per million 1,3-butadiene. These concentrations are somewhat below and slightly above the Occupational Safety and Health Administration standard of 1000 parts per million for butadiene. The study was designed for 104-week exposures but had to be ended early due to cancer-related mortality in both sexes at both exposure concentrations. There were early induction and significantly increased incidences of hemangiosarcomas of the heart, malignant lymphomas, alveolar-bronchiolar neoplasms, squamous cell neoplasms of the forestomach in males and females and acinar cell carcinomas of the mammary gland, granulosa cell neoplasms of the ovary, and hepatocellular neoplasms in females. Current workplace standards for exposure to butadiene should be reexamined in view of these findings. PMID- 3966165 TI - Cheyne-Stokes breathing during sleep in patients with left ventricular heart failure. AB - Fifteen patients with left ventricular heart failure (LVF) without known breathing disorders during sleep had full-night recordings of sleep and breathing to study the incidence and impact of the apnea of Cheyne-Stokes breathing. This group showed a marked degree of sleep-related breathing abnormalities, 40% demonstrating Cheyne-Stokes breathing with five or more central apneas per hour of sleep. Cheyne-Stokes breathing during sleep in patients with LVF predicted an increased short-term mortality rate. All six patients with LVF and Cheyne-Stokes breathing with more than five apneas per hour of sleep were dead within six months, while only three of nine patients without recurrent apnea died within six months, a significant difference (P less than .05) even in this small group. Among seven patients with LVF studied with the polysomnogram, there were statistically significant differences between the Cheyne-Stokes and non-apnea groups in total sleep time, awakening per hour, and the number of arterial desaturations. Although sleep disturbances have been anecdotally described in patients with LVF, no previous investigation has determined the incidence and impact of Cheyne-Stokes breathing during sleep in LVF. Our findings that Cheyne Stokes breathing predicts an adverse short-term mortality rate confirm the clinical impression that Cheyne-Stokes breathing is a poor prognostic sign in LVF. PMID- 3966166 TI - Diagnostic limitations of the dexamethasone suppression test in screening for depression. AB - Research advancements in the use of laboratory testing to diagnose psychiatric conditions have recently led to certain misconceptions about the diagnostic accuracy of these tests. One such test, the dexamethasone suppression test (DST), was introduced as a laboratory test for melancholia (or "endogenous" depression). Because depressed patients are frequently first seen as outpatients by primary care physicians, there has been interest in using the DST as a screening test for depression. This paper lists the variables that contribute to abnormal (false positive?) DST results and points out the diagnostic limitations of this laboratory test in outpatients. Several guidelines are proposed for diagnosing depression without the DST. PMID- 3966167 TI - Classical heatstroke: clinical and laboratory assessment. AB - We reviewed the clinical and laboratory characteristics of 34 patients who had classical heatstroke during the Kansas City heat wave of 1980. The patients were elderly, predominantly black, and of low socioeconomic class. Overall mortality was 18%, with 9% of patients exhibiting severe residual neurologic deficit; 73% had full recovery. Patients with coma, temperature greater than or equal to 108 F (42.2 C), severe hypotension, coagulopathy, and need for respiratory assistance were at highest risk of death. Associated disease was common (67%), with hypertension (32%), diabetes (21%), and alcoholism (21%) being most frequent. Medications known to predispose to heatstroke were used by 56% of patients. Hematologic abnormalities were nonspecific, and clinical evidence of renal or hepatic failure was rare. Hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia, and elevated levels of creatine phosphokinase and glucose were frequent but did not correlate with outcome. The predominant arterial blood gas abnormality was metabolic acidosis or a combined metabolic acidosis and respiratory alkalosis. PMID- 3966168 TI - Correlates of infant death from infectious diarrhea in the southeastern United States. AB - Infectious diarrhea (ID) caused 242 infant deaths in South Carolina between 1970 and 1978, and is still a significant cause of death in the southeastern United States. Therefore, using South Carolina death certificates from 1970 to 1978 and the state's linked birth/death certificate file, we sought prenatal and postnatal characteristics that might predict death from gastroenteritis in the first year of life. Accuracy of diagnoses was verified from the original death certificates and in a sample of hospital charts. Most deaths caused by ID occurred after the first 28 days of life and were significantly concentrated in the winter. Low birth weight (odds ratio 7.09), nonwhite race (7.00), inadequate prenatal care (4.35), small size of hospital (0.31), and illegitimate birth (2.35) were all significantly associated with postneonatal death. Infants with all of the three strongest predictor characteristics were 14 times as likely to die of ID, but the "predictive value" of this combination for ID death was only 0.54%. Although mothers of these high-risk infants should be given special education about prevention of dehydration, and the families would be logical candidates for a rotavirus vaccine trial, more expensive interventions should not be instituted without a cost-benefit analysis. PMID- 3966169 TI - Reproductive performance of patients treated with clomiphene citrate. AB - From 1967-1980, 488 infertile women underwent induction of ovulation with clomiphene citrate at the University of Virginia Hospital. Conception occurred during treatment cycles in 209 women (group 1), but 279 women (group 2) failed to conceive. The outcome of pregnancy was defined in group 1, and the pregnancies that occurred in both groups after treatment was discontinued were analyzed. Early pregnancy wastage (spontaneous abortion and ectopic pregnancy) in these groups was compared with the accepted incidence in the general population. Although the rates of adverse pregnancy outcome were higher in our study populations, there was no statistical difference when compared to the general population. PMID- 3966170 TI - Does preamputation pain influence phantom limb pain in cancer patients? AB - Phantom sensation and phantom limb pain are two recognized sequelae of limb amputation. In most previous surveys, amputations were done for arteriosclerotic or trauma related conditions. We studied 25 patients who had lower extremity amputation for neoplasia. In studying the features of pain before and after amputation, we found phantom limb pain in cancer patients similar in presentation and description to that in noncancer amputees. There appeared to be no correlation between the severity of each episode of phantom pain and the overall effect of the pain on the patient's life. The quality and location of the phantom pain did not resemble the preamputation pain. We recommend a multidisciplinary approach to treatment. PMID- 3966171 TI - The arm as an alternative site for vascular access for dialysis in patients with recurrent access failure. AB - Patients with chronic renal failure requiring dialysis and in whom multiple attempts at vascular access have previously failed represent a challenge to vascular surgeons. In these difficult patients the arm offers an excellent site for either an autogenous fistula or a prosthetic shunt because of the relatively unharmed portion of the upper cephalic vein or the protected location of the brachial vein in most individuals. (The anatomic region of the arm by definition is the area between the shoulder and the elbow.) Over the last two years we have studied 15 patients with a mean of 2.5 previously failed shunts or fistulas who subsequently had vascular access procedures in the arm, with the brachial artery as the inflow and the cephalic vein or brachial vein as the outflow. The first choice was the cephalic vein transposition to the brachial artery because it involved only one anastomosis and is autogenous vein. The alternative was a prosthetic graft of polytetrafluoroethylene (PTEE) between the brachial artery and the cephalic vein or brachial vein in the arm. The patency rate of these arm access procedures has been 75%. None of these patients had had congestive heart failure, distal ischemia, or excessive hematoma formation. The arm represents an excellent source for fistula or shunt construction in those difficult patients in whom previous vascular access sites have already failed. PMID- 3966172 TI - Sequential bypass grafting for salvage of lower extremities. AB - Since 1978, 12 patients at our institution have had distal sequential bypass grafting for limb salvage with either polytetrafluoroethylene (PTFE) or reversed saphenous vein and anastomoses to two different distal vessels. Seven patients had had previous vascular operations. One patient died of a stoke in the early postoperative period; a second patient, who was lost to follow-up several months after operation, was presumed to have died. Follow-up is otherwise complete (range seven to 48 months), without early or late limb loss. Results are encouraging and suggest that the sequential anastomotic technique may offer improved results in appropriate limb salvage cases with poor distal runoff. PMID- 3966173 TI - Race, age, and pernicious anemia. AB - We have described a 22-year-old black man with pernicious anemia, classically considered a disease of middle-aged and elderly Northern Europeans. It is considered rare in non-caucasians and children. The majority of very young patients have been considered to have the congenital form of pernicious and anemia, characterized by absence of intrinsic factor with normal gastric mucosa and acid production. We have seen no patients with this type of the disease. Furthermore, all five patients under 25 years of age and eight of nine under 35 were black. We found no racial difference in the incidence of pernicious anemia, but we believe it may occur at a younger age in black patients. PMID- 3966174 TI - Ventricular premature complexes in the early diagnosis of acute myocardial infarction. AB - The morphology of ventricular premature complexes (VPCs) is useful in detecting old or recent myocardial infarction. Rarely, however, have VPCs provided the first objective evidence of transmural myocardial infarction. In two patients with chest pain, VPCs early in the hospital course revealed myocardial infarction, while normally conducted sinus beats showed no evidence of acute transmural infarction. Transmural infarction with total occlusion of a large coronary artery was confirmed angiographically. We conclude that acute transmural myocardial infarction may be diagnosed early and accurately from VPC morphology before the appearance of other evidence of infarction. PMID- 3966175 TI - Hypertension clinics. PMID- 3966176 TI - Imipramine: withdrawal and urticaria. PMID- 3966177 TI - The Guillain-Barre syndrome. A review of admissions to an intensive care unit over 8 years. AB - Forty-four patients with a diagnosis of Guillain-Barre syndrome were admitted to the Intensive Care Unit at Baragwanath Hospital, Johannesburg, between January 1975 and December 1982. Of these patients 7 were found to have other diseases with similar features, and they were excluded from the study, leaving 37 patients; 2 patients were admitted twice. An unexpected finding was that 21 patients (56,8%) were less than 10 years of age. Respiratory failure was present on admission in 15 cases (38,5% of the 39 admissions). Treatment was mostly supportive in nature and included assisted ventilation. Most morbidity involved the respiratory system. The high mortality (8 patients (21,6%) died) was probably due to the severe nature of the disease in these cases. PMID- 3966178 TI - Granuloma inguinale in the eastern Transvaal. AB - Granuloma inguinale, considered to be a venereal disease, has a world-wide distribution but is more prevalent in tropical and subtropical regions. A number of patients presenting with typical features of this disease, characterized in particular by a beefy-red exuberant appearance of the lesions, have been treated at Shongwe Hospital in Kangwane in the Eastern Transvaal. In 43 of these patients (27 male and 16 female), nearly all in the sexually active age group of 18-41 years, the diagnosis was confirmed by demonstration of typical Donovan bodies. These patients responded well to treatment with tetracycline, but in some the lesions recurred and required further treatment. The chronicity of the lesions should alert the clinician to the possibility of granuloma inguinale, a condition which appears to be more prevalent in this region than previously recognized. PMID- 3966179 TI - Cerebrospinal fluid lactate and lactate dehydrogenase levels as diagnostic aids in tuberculous meningitis. AB - The value of cerebrospinal fluid (CSF) lactate and lactate dehydrogenase (LD) values as aids in differentiating tuberculous meningitis (TBM) from aseptic meningitis has been investigated. Using an upper limit of normal for CSF lactate levels of 2,75 mmol/l resulted in detection of 24 out of 26 cases of TBM (a sensitivity of 92%). If, however, a level of 3,85 mmol/l was taken as the upper limit of normal, then 18 out of 26 cases were detected (a sensitivity of 69%). Using 40 U/l as the upper limit of normal for LD levels detected 21 out of 38 cases of TBM (a sensitivity of 55%). Both tests may give normal values in the presence of TBM, but this should not cause specific antituberculosis therapy to be withheld. Neither test appears to hold marked advantages over conventional chemical analysis of CSF in differentiating TBM from aseptic meningitis. PMID- 3966180 TI - Acquired methaemoglobinaemia in pregnancy. A case report. AB - The first report of transient, presumably drug-induced, acquired methaemoglobinaemia in pregnancy is presented. The patient required no treatment and there was no fetal distress or intra-uterine growth retardation. A normal, full-term, female infant was born by normal vaginal delivery. PMID- 3966181 TI - Anaesthesia in myositis ossificans progressiva. A case report and clinical review. AB - An 18-year-old black youth with myositis ossificans progressiva recently underwent eye surgery. The clinical, laboratory and radiological findings are described. The problems associated with anaesthesia are presented and their management is discussed. The condition is briefly reviewed. PMID- 3966182 TI - The treatment of resistant hypotension with ornipressin. A case report. AB - A 50-year-old man underwent emergency aortic valve replacement. He had been treated with five antihypertensive agents before the procedure; this contributed to the development of profound hypotension after induction of anaesthesia. The hypotension did not respond to conventional treatment with an incremental intravenous infusion of phenylephrine HCl, probably due to the direct vasodilator action of the hydralazine group of drugs which renders the peripheral vascular smooth muscle unresponsive to sympathomimetic stimulation. The hypotension did, however, respond rapidly to low-dose infusion of a synthetic vasopressor, ornipressin (POR 8; Sandoz), a drug with a direct action on vascular smooth muscle, especially the capacitance vessels. Ornipressin thus restores vascular smooth-muscle tone even when the integrity of the adrenergic pathways is no longer intact. PMID- 3966183 TI - Advanced osteitis fibrosa cystica in the absence of phalangeal subperiosteal resorption. A case report and review of the literature. AB - A case of primary hyperparathyroidism with advanced osteitis fibrosa cystica but without any subperiosteal phalangeal bone resorption is described. A review of this unusual radiological feature is presented. High-detail magnification radiography (microradiography) is advocated for the early diagnosis of bony defects in hyperparathyroidism. PMID- 3966184 TI - Thrombocytopenia followed by rebound thrombocytosis. PMID- 3966185 TI - Meningococcal arthritis. AB - Meningococcal infection (MI) remains endemic in the Western Cape. A review of 2216 cases in which the condition was diagnosed and notified to the relevant authorities between January 1977 and March 1982 is presented. In 121 patients the disease was complicated by meningococcal arthritis (MA). MI and MA occurred most commonly in the Coloured population; over 50% of patients with MI were less than 2 years of age; and patients with MA were slightly older than the sample mean. The onset of arthritis showed a biphasic pattern with an early peak at 1-2 days and a later peak, heralded by typical recrudescence of fever, at 5-10 days which usually lasted 5-7 days. It was most often monarticular, the knee being the joint most frequently affected. Four cases of isolated MA were also encountered. PMID- 3966186 TI - Immunological abnormalities in South African homosexuals--a non-infectious co factor? PMID- 3966187 TI - Medical applications of nuclear magnetic resonance. PMID- 3966188 TI - Uterine contraction patterns in abruptio placentae. AB - Tocographic monitoring of 21 patients with grade III abruptio placentae revealed the following: the tocographic pattern can be of diagnostic aid; the tocograph is of no value in measuring progress, because there is no significant change in uterine tone and contraction frequency and amplitude from the time the membranes are ruptured until the delivery of the fetus; and the tocographic patterns in abruptio placentae are probably of diagnostic value as regards the coagulation defect, but further proof of this is necessary. PMID- 3966189 TI - Mseleni joint disease. Part I. An animal model? AB - Rats fed maize-based diets approximating to that eaten by blacks at risk of Mseleni joint disease developed fibrous osteodystrophy and nutritional secondary hyperparathyroidism, thought to be due to dietary calcium deficiency. This suggests that a dietary cause for this disease needs to be investigated further. PMID- 3966190 TI - Attitudes to the provision of primary health care at the day hospitals in Cape Town. AB - Day hospitals in Cape Town are examined against the criteria in the definition of primary health care of the World Health Organization's Declaration of Alma Ata. A survey of patients attending a day hospital was undertaken to ascertain the consumer perspective regarding access to and quality of the service offered. The provider's perspective was obtained from secondary sources and in-depth interviews. It was found that the services are generally acceptable to the users, but that factors such as waiting time and transport create problems for patients. Community participation is also very limited. The separation of preventive and curative services also places limitations on the day hospitals--they provide only curative health care. The most important reason given by patients for using the day hospitals is the low cost. PMID- 3966191 TI - Sigmoid volvulus in advanced pregnancy. Report of 2 cases. AB - Two cases of sigmoid volvulus complicating pregnancy at 33 and 26 weeks' gestation are reported. The clinical presentations were strikingly similar, although the second patient presented later in the evolution of the condition and died 6 hours after surgery. Both fetuses died in utero. The reasons for suspecting sigmoid volvulus as a cause of intestinal obstruction (especially in pregnant black women) and its management are outlined. PMID- 3966192 TI - Intrahepatic gallstones. A case report. AB - A Coloured woman was admitted to hospital with a 3-day history of acute right upper abdominal pain, nausea and vomiting. Acute cholecystitis was confirmed by biliary imaging using technetium-99m. An acutely inflamed gallbladder and two pigment stones in the common bile duct were removed. There were numerous retained gallstones in biliary radicles of the right hepatic duct; attempts to dislodge these by saline flushing failed. An extended choledochotomy with further exploration of the intrahepatic radicles also failed to remove the incarcerated stones. Biliary enteric drainage was achieved by choledochoduodenostomy and short term postoperative progress was uneventful. PMID- 3966193 TI - Malignant melanoma of the anal canal. A case report and review. AB - Primary malignant melanoma of the anal canal is a fairly uncommon but highly malignant disease. At the time of diagnosis it is usually far advanced and therefore incurable. Confusion with benign conditions and ignorance regarding the disease entity result in delayed diagnosis in a high percentage of cases. Improvement in the survival rate depends on acute surgical awareness, early diagnosis and aggressive surgical intervention. PMID- 3966194 TI - Paraplegia in Paget's disease of the vertebral column. A case report. AB - A case of Paget's disease of the lumbar and thoracic vertebrae together with gradual-onset paraplegia is reported. The need for early recognition of the disease and early institution of medical treatment is highlighted. PMID- 3966195 TI - Aneurysmal bone cysts of the patella secondary to chondroblastoma. Case reports. AB - Three cases of aneurysmal bone cysts secondary to chondroblastoma of the patella are described. This association is not particularly uncommon, but its occurrence in the patella is unusual. Treatment consists of curettage and bone grafting; however, if the patella is grossly enlarged or distorted, patellectomy is preferable. PMID- 3966196 TI - Apnoea in an infant due to proprietary medicines. PMID- 3966197 TI - Subdermal contraceptive implants. PMID- 3966199 TI - An information service in a geriatric unit. AB - A major deficiency during the initial stages of development of a geriatric unit was a lack of easily available information concerning facilities and services already existing in the community. A postal survey undertaken in conjunction with the Cape Peninsula Organization for the Aged resulted in the production of an information manual of services available to the elderly in the Cape Peninsula. In the introduction to this manual an invitation was extended to readers to direct requests for information to the Geriatric Unit at the Medical School of the University of Cape Town. This paper reports on the first 50 enquiries received, as a result of which 73 items of advice or information were given. Unmet community needs were revealed in 9 instances. Useful assistance was known to have resulted on 30 occasions, consisting, in the main, of arrangements initiated for appropriate residential placement, for geriatric and psychogeriatric assessments and for domiciliary assessments by community nursing sisters or social workers, sometimes assisted by an occupational therapist or physiotherapist. Those who care for the aged at home need to be put in touch with correct sources of relevant information, and this appears to have constituted an additional and useful function of our information service. PMID- 3966198 TI - Evidence of hyperinsulinaemia and hypoxaemia in the cord blood of neonates born to mothers with gestational diabetes. AB - Increased cord blood C-peptide levels in neonates born to mothers with gestational diabetes (GD) were directly correlated with the increased relative birth weight ratio (BWR) of these neonates. In addition, the percentage oxygen saturation of the cord blood was inversely correlated with cord blood C-peptide levels and with the relative BWR. These correlations were absent in neonates delivered to normal mothers. The results indicate the presence of both hyperinsulinaemia and mild hypoxaemia in neonates of mothers with GD. In poorly controlled diabetic pregnancy this hypoxaemia may constitute an important fetal risk factor. PMID- 3966200 TI - [Positive serological tests for syphilis in black primary school children in Bloemfontein: a pilot study]. AB - Sera from 1575 black primary school children in Bloemfontein were subjected to serological screening tests for syphilis. Forty-six (2,92%) were found to be seropositive on screening; 32 (2,03%) of these were confirmed as true-positive reactions and 10 (0,64%) manifested only biological false-positive reactions. Four sera were insufficient for confirmatory tests. From published reports covering a period of over 60 years, it is evident that syphilis is widespread in South Africa, especially in black communities. There is no evidence of a decline in the prevalence of the disease but rather of an increase, including endemic syphilis affecting children. A nationwide survey is recommended to determine the magnitude of the problem and the need for a sustained treatment campaign. PMID- 3966201 TI - Clinical competence of paediatric primary health care nurses in Soweto. AB - Primary health care (PHC) nurses provide care at polyclinics in Soweto. Our study assessed nurse competence in the clinical detection of important respiratory signs in 337 consecutive paediatric patients with respiratory complaints. The patients were then independently re-examined by two paediatricians, one of whom was arbitrarily chosen as a 'standard doctor'. The standard doctor found 95 patients with important respiratory signs; nurses detected the same signs in 45 and the other doctor in 44 patients. Therefore nurses detected important signs as well as could be expected, considering the inter-observer variation between doctors. The nurses did, however, significantly overdiagnose one condition, follicular tonsillitis. Our results suggest that the Soweto paediatric PHC nurses detect clinical signs with as much accuracy as doctors. This study adds to the available evidence that adequately trained and supervised nurse practitioners can provide high-quality health care. PMID- 3966202 TI - Micrognathia, obstructive sleep apnoea and cor pulmonale--a case for tracheostomy. AB - A patient with congenital micrognathia, hypersomnia and severe pulmonary hypertension which resulted in sudden death during sleep is described. Hypersomnolence is a well-recognized manifestation of the pickwickian syndrome. A less recognized but similar disorder may affect patients with congenital or acquired micrognathia. The pathogenesis of this syndrome and obstructive sleep apnoea are reviewed. Tracheostomy timeously performed may be life-saving and the value of early resort to this apparently drastic procedure in a high-risk patient is emphasized. PMID- 3966203 TI - The operative stabilization and grafting of thoracic and lumbar spinal fractures. AB - In this paper several concepts of surgical treatment of thoracic and lumbar fractures are reviewed. Most classifications of these fractures are primarily radiologic, but pathomechanical aspects are very important as these guide the insight into and the rationale of the different modes of treatment. The segment of movement can be considered biomechanically as a three-dimensional system, built up from two rings, linked together at five functional points of support. Our principal mode of surgical therapy after closed reduction by halo-femoral traction is anterolateral decompression, stabilization and grafting to induce fusion. In suitable cases, a dorsal or posterolateral approach and instrumentation can be combined with ventral methods. By using the primary anterolateral approach, one can reduce malalignment at the site where it is needed. Decompression can be carried out where it is truly necessary. One can give support within the segment of movement at the logical place from a biomechanical point of view: the weight bearing part, i.e., the anterior ring. By excision of the injured bony and ligamentous tissue, motion in the damaged segment of movement is eliminated, the original height is restored by grafting, and at the same time the load-bearing capacity of the fractured area is repaired. By applying Zielke instrumentation one can compress the grafts in accordance with modern views on fracture treatment. This "philosophy" is illustrated with case histories and a decision making flow chart. PMID- 3966204 TI - Pathogenesis of normal-pressure hydrocephalus--preliminary observations. AB - Eight cases with well-documented normal-pressure hydrocephalus were studied prospectively for 6 months by history, neurological examinations, Mini-Mental Status tests, xenon-contrast computed tomography measurements of local cerebral blood flow, and cerebral xenon solubility expressed as partition coefficients. Local cerebral blood flow and local partition coefficients were reduced throughout frontal and temporal lobes, basal ganglia, and thalamus. Cerebrospinal fluid shunting procedures were carried out in seven cases. As a result, local cerebral blood flow and local partition coefficients increased toward normal, particularly in frontal white matter, frontotemporal cortex, and basal ganglia. Ventricular size became reduced and mental status improved. Local partition coefficient values were reduced by increased tissue water because low values confirmed cerebrospinal fluid diffusion into white matter, which resolved after shunting. Patients likely to benefit from shunting, including shunt failures requiring revision, were detected. PMID- 3966205 TI - Pineal astrocytoma. PMID- 3966206 TI - Injuries of the cervical spine in high school wrestling. AB - Severe injuries to the cervical spine and spinal cord have been widely reported from many causes: automobile accidents, diving mishaps, falls, and contact sports. This paper concerns three young men who sustained severe trauma to the cervical spine and spinal cord during high school wrestling. Certain head-holds are prone to cause such injuries. Their tetraparesis and tetraplegia were reversed by reducing the fracture-dislocation and internal stabilization, in one case by decompressive laminectomy when no bony disruption was encountered. Their recoveries were satisfactory, but prevention of these cervical injuries may be accomplished by elimination of the more dangerous holds in wrestling. PMID- 3966207 TI - Giant cell tumor in cervical spine. AB - A giant cell tumor in the cervical spine of a 67-year-old man complaining of pain in the neck and occipital area is reported. Cervical x-ray films revealed a round destructive lesion in the vertebral body of the fourth cervical vertebra. On the plain cervical computed tomography scan, the most impressive finding was a soap bubble appearance, which showed a linear high-density area in the mass lesion with destruction of the vertebral body. After embolizing one branch of the artery feeding the tumor, a radical operation was carried out via the anterior approach. The role of cervical computed tomography scanning and computed tomographic myelography in diagnosing and showing the extension of the giant cell tumor is discussed. PMID- 3966208 TI - Idiopathic spinal extradural lipomas: three cases and review of the literature. AB - Three cases of extradural spinal lipomas in adults are described in which there was no association with steroids. In all three cases the tumors were situated in the lumbar region and the patients were muscular, nonobese males. Two of the three cases had long histories contrary to those previously reported. Preceding transient neurological symptoms were noted in two of the three cases. The etiology of this phenomenon is discussed. It is possible that these lipomas, which are not associated with steroids, may represent a different spectrum of disease. PMID- 3966209 TI - Reversible arterial hypotension after acute aneurysmal subarachnoid hemorrhage. AB - The authors report five patients who developed transient arterial hypotension immediately after the rupture of cerebral aneurysms. They manifested deep coma (three cases), abnormal electrocardiogram (four cases), and remarkable pulmonary edema (two cases). The level of consciousness in all three patients who were in deep coma improved with the normalization of blood pressure. Although two patients died of recurrent hemorrhage, the other three patients were discharged in satisfactory condition. Serious clinical conditions that are not terminal and are caused by arterial hypotension immediately after the rupture of cerebral aneurysms are sometimes reversible with adequate treatment. PMID- 3966210 TI - Intradural cyst with compression of the cauda equina in ankylosing spondylitis. AB - A cauda equina syndrome complicating long-standing ankylosing spondylitis was found to be due to a large multiloculated cyst. This differed from posterior dural diverticula identified in similar cases in that the cyst filled the lumbar canal with erosion of the upper lumbar vertebral bodies and chronic inflammatory changes were evident in the cyst wall. Cauda equina compromise in ankylosing spondylitis has several possible mechanisms including fibrosis following arachnoiditis, root damage by dural diverticula, and direct compression by arachnoid cyst. PMID- 3966211 TI - Sudden quadriplegia after a minor trauma. The role of preexisting spinal stenosis. AB - Three patients are described who became quadriplegic after a minor trauma to the spine without suffering a spinal fracture dislocation. Radiologic investigation revealed marked stenosis of the spinal canal, due to developmental stenosis with superimposed degenerative changes in two patients, and calcification of posterior longitudinal ligament of the spine in one. Two patients recovered almost completely with conservative measures. The spinal cord may be able to tolerate slowly increasing mechanical pressure for many years and conform to the shape of the spinal canal without causing any neurological symptoms. However, when stenosis is severe, any additional pressure, for example, swelling and edema from trauma, may cause a neurologic catastrophe. PMID- 3966212 TI - Severe thrombocytopenia associated with phenytoin and cimetidine therapy. AB - A 67-year-old man developed a sudden onset of severe isolated thrombocytopenia (platelet count, 1000/mm3) after 10 days of phenytoin administration as a prophylactic measure prior to craniotomy. The patient had also been taking cimetidine for 2 months prior to admission. No other hematological complications were noted, and an extensive hematologic investigation was otherwise unremarkable. Rapid resolution of the thrombocytopenia upon discontinuation of phenytoin and cimetidine strongly suggests a drug-induced adverse reaction. PMID- 3966213 TI - Intrasellar chordoma and hyperprolactinemia. AB - An intrasellar chordoma in a patient with diplopia and hyperprolactinemia is presented. A brief review of the literature on intrasellar chordomas and the potential etiology for the hyperprolactinemia in this patient are discussed. PMID- 3966214 TI - Paroxysmal tinnitus and nystagmus accompanied by facial spasm. AB - A case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, in which neurovascular decompression was performed, is reported. The paroxysmal tinnitus and nystagmus were synchronous with each other. Horizontal nystagmus with a rotary component was found to be counterclockwise during the brief attack of tinnitus, whereas its direction became clockwise while free of tinnitus. The patient has been postoperatively relieved not only of the facial spasm, but also of the tinnitus and nystagmus. The mechanism of the occurrence of the syndrome and the significance of the neurootologic examination are discussed. PMID- 3966215 TI - Neurilemomas of the cauda equina presenting as prolapsed lumbar intervertebral disks. AB - Neurilemomas of the cauda equina can present with a clinical syndrome indistinguishable from an acute prolapsed lumbar intervertebral disk. There is backache and sciatica, occasionally after trauma, and straight leg raising is usually limited with signs of L-5 or S-1 root compression. The only distinguishing clinical characteristic is that the pain is worse on recumbency and relieved by sitting or walking. There may be no plain x-ray changes for many years and the tumor is usually at the level of L-2 or L-3 vertebral body. Seven such cases are described in this report. PMID- 3966216 TI - Aneurysmal bone cysts in the cranial vault and base of skull. AB - Three cases of aneurysmal bone cyst of the skull are reported. The localization in the base of the skull (two cases) is extremely rare and simulates a space occupying intracerebral lesion. The clinical and microscopic findings, and their significance for the differential diagnosis from malignant brain tumors, are described. PMID- 3966217 TI - Timid neurosurgeons. PMID- 3966218 TI - Giant aneurysms of the cavernous carotid artery. PMID- 3966219 TI - Dermoid cysts. PMID- 3966220 TI - Moyamoya disease and subarachnoid hemorrhage. PMID- 3966221 TI - Cerebral hemorrhage. PMID- 3966222 TI - Rerupture of intracranial aneurysms. PMID- 3966223 TI - Anterior interhemispheric approach to aneurysms of the anterior communicating artery. AB - A modified anterior interhemispheric approach for clipping aneurysms of the anterior communicating artery is described. This approach is preferred on anatomical grounds because the anterior circle of Willis can be fully visualized with minimal manipulation of the frontal lobes and anterior cerebral arteries. The advantages of this approach are minimal traction, reduced operative time, and preservation of the olfactory nerve. PMID- 3966225 TI - Survival and causes of death after adrenalectomy for Cushing's disease. AB - A consecutive series of 79 patients with Cushing's disease, treated by bilateral adrenalectomy (subtotal, total initially, or total finally) between 1953 and 1980, were studied to determine the survival and mortality rates and causes of death as long as 28 years after surgery. There were three early postoperative deaths, the last in 1974, caused by coma of unknown cause, severe diarrhea, and pulmonary embolism, respectively. The actuarial survival rates at intervals of 1, 2, 3, 5, 10, 15, and 20 years after surgery were approximately 87%, 83%, 82%, 79%, 72%, 68%, and 62%, respectively. These are significantly less than the rates for the general population (p less than 0.001). There were no differences between the sexes or between the types of operation (p greater than 0.05). The commonest causes of death were cardiac or vascular lesions (11 patients) and the local effects of pituitary tumors (four patients). These long-term results of an established method of treatment provide a standard by which other, especially newer, methods may be compared. PMID- 3966224 TI - A new technique for ileoanal and coloanal anastomosis. AB - The following report includes a description of the technical details of a new surgical method for the total removal of the rectum while preserving the anal sphincter function. Seventeen patients including 11 patients with rectal carcinoma, two with diffuse polyposis involving the rectum, three with ulcerative colitis, and one with Crohn's disease of the colon and rectum have undergone operation by this method in the last 4 years. Clinical follow-up (mean 22 months) of these patients has demonstrated normal and continence for feces and gas. Postoperative manometric and electromyographic studies have also shown adequate sphincteric function. This method could be carried out either on patients in whom the total removal of the rectum is indicated or in patients with previous ileostomy or colostomy and a remaining rectal stump unsuitable for direct anastomosis. PMID- 3966227 TI - Anatomy of the choledochopancreatic duct junction in primary sclerosing cholangitis. AB - Primary sclerosing cholangitis (PSC) is a rare disease for which the etiology is unknown. Because abnormalities of the choledochopancreatic duct junction (CDPDJ) have been implicated in the pathogenesis of other rare biliary problems such as choledochal cysts and biliary atresia, we reviewed the cholangiographic anatomy of the CDPDJ in our patients with PSC. From 1955 through July 1983, 46 patients with PSC were seen at the University of California at Los Angeles Medical Center. In 20 of these 46 patients anatomy of the CDPDJ could be evaluated by review of endoscopic retrograde cholangiopancreatography (11 patients) or by reflux into the pancreatic duct during transhepatic, operative, or postoperative tube cholangiography (nine patients). Roentgenograms were evaluated for the length of common channel of the biliary and pancreatic ducts and the degree of reflux into and anatomic abnormalities of the pancreatic duct. All bile ducts were abnormal, and pancreatic duct reflux occurred in 14 of 42 patients (33%) who underwent transhepatic or tube cholangiography. An abnormally long (greater than 15 mm) common channel was present in two of 20 patients (10%), pancreatic duct reflux of more than 100 mm occurred in six of 14 patients (43%), and pancreatic duct abnormalities were seen in nine of 18 patients (50%). These data suggest that in patients with PSC abnormal pancreatic duct reflux and anatomy are common but variations in the anatomy of the CDPDJ are rare. However, altered function of the CDPDJ may contribute to excessive reflux into and anatomic changes of the pancreatic ducts and the moderate incidence of pancreatitis observed in patients with PSC. PMID- 3966226 TI - Is paraplegia after repair of coarctation of the aorta due principally to distal hypotension during aortic cross-clamping? AB - The hypothesis is presented that paraplegia after coarctation of the aorta is principally due to hypotension of sufficient severity and duration. In a group of 103 patients who underwent surgery during a 10-year period, the distal aortic pressure was maintained above 60 mm Hg while the aorta was cross-clamped or the period of cross-clamping was limited to less than 20 minutes. No neurologic problems occurred. In 17 of the 103 cases aortic pressure decreased below 60 mm Hg, occurring in 8% of patients with the aorta occluded below the left subclavian artery but in 30% of those occluded above. Therapeutic measures used in the 17 patients included infusion of metaraminol in five and limiting cross-clamp time to less than 20 minutes in 11. The theory is proposed that ligation of intercostal arteries in a patient with coarctation cannot injure the spinal cord because the normal direction of blood flow is reversed. Certainly, in patients without a coarctation, such as thoracic aneurysms, ligation of a critical intercostal artery may injure the spinal cord. However, in patients with coarctation the direction of blood flow is reversed, blood flowing from the intercostals into the distal aorta. The vague relationship long noted between development of collateral circulation, including rib notching, and the frequency of paraplegia probably depends not on the presence of enlarged intercostal arteries but on whether their temporary occlusion at the time of aortic cross clamping results in distal hypotension. Data with somatosensory-evoked potentials measured during operations on the thoracic aorta in 25 patients found no changes in sensory potentials as long as the distal aortic pressure remained above 60 mm Hg, but a gradual disappearance was found at lower pressures. In five of six patients with large thoracicoabdominal aneurysms in whom sensory potentials were absent for longer than 30 minutes, paraplegia resulted. Use of somatosensory potentials provides a significant method for evaluating methods to protect from paraplegia. This method should be far more productive than are simple clinical experiences because the fortunate rare occurrence of paraplegia, one in 200, greatly limits available data. PMID- 3966228 TI - Vascular malformations. AB - Fourteen patients with hemangiomas or arteriovenous malformations treated with operative management are described. Particular emphasis is placed on the definition of terms and the methods of differentiating arteriovenous fistulas, hemangiomas, and arteriovenous malformations. Arteriovenous fistulas are acquired lesions consisting of a single communication. Hemangiomas are congential lesions that rarely pulsate or have an associated bruit; moreover by angiography they have multiple small feeding arterial vessels and histologically are composed of numerous thin-walled, but normal-appearing, blood vessels. Arteriovenous malformations are also congenital but they pulsate and have associated bruits; furthermore on angiography they have a number of larger arterial feeding vessels and histologically are composed of abnormal dysplastic vessels. Operative management of all lesions should be carefully planned and executed. Arteriovenous malformations and skeletal muscle hemangiomas will have a tendency to recur if not completely excised. PMID- 3966229 TI - Surgical management of the gastroesophageal reflux syndrome in childhood. AB - Gastroesophageal reflux (GER) is a common cause of repeated emesis, failure to thrive, repeated pulmonary infection, and asthma in infants and children. During a 14-year period 270 children underwent gastroesophageal fundoplication for symptomatic reflux. The 24-hour esophageal pH monitoring is the most accurate test available to verify the presence of GER and is also helpful in evaluating the results of fundoplication. Transabdominal fundoplication may be performed with a low risk of complications. The most frequent complication requiring reoperation is paraesophageal hiatus hernia (6/270 patients), which should be repaired in almost all instances when symptoms develop. Closure of the crura posterior to the esophagus greatly reduces the incidence of this problem. Esophageal motility disorders occur in more than 35% of patients with symptomatic reflux and militate against performing a tight antireflux operation. Approximately 50% of patients with symptomatic reflux have associated gastric motility disorders. Radionuclide studies with 99mTC sulfur colloid in semisolid feedings have determined the magnitude of gastric retention after a feeding and have been helpful in identifying children who require a pyloroplasty with or without fundoplication. Pyloroplasty is performed simultaneously with fundoplication in approximately 10% of patients with symptomatic reflux when the lower esophageal sphincter pressure is low and the esophageal pH monitor shows reflux. The excellent clinical results achieved by fundoplication with or without pyloroplasty and the low morbidity and mortality rates indicate that these procedures should be used early in the management of infants and children who suffer symptomatic GER. PMID- 3966230 TI - The evaluation of mesoatrial shunt patency with computed tomography. AB - The mesoatrial shunt is performed in patients with the Budd-Chiari syndrome when the inferior vena cava is occluded and not available for a conventional portosystemic shunt. Computed tomography (CT), with injection of contrast media, was used to evaluate mesoatrial shunt patency with five examinations in four patients. Shunt patency was demonstrated by CT and confirmed by angiography in two studies. Total shunt occlusion diagnosed by CT in two additional cases was confirmed by angiography or operation. Partial graft occlusion diagnosed by CT in a fifth study was verified by both angiography and operation. CT is recommended instead of angiography in the evaluation of mesoatrial shunts because it is less invasive, it may be performed on an outpatient basis, and it yields additional useful information related to shunt patency, such as the volume of ascites, collateral vascularity, and the size of the spleen. PMID- 3966231 TI - Normalization of local blood flow regulation in the ischemic forefoot after arterial reconstruction. AB - Two local blood flow regulating mechanisms were studied before and after arterial reconstruction in 30 limbs suffering from occlusive arterial disease. Changes in forefoot blood flow were measured from the washout of a subcutaneous 133xenon depot. Arterial and venous pressures were changed by passive lowering and elevation of the foot. In 14 limbs suffering from severe ischemia, the local vasoconstrictor response to increased venous pressure was abolished as blood flow increased 37% when the limbs were lowered 40 cm. Autoregulation of blood flow was abolished also as flow decreased 51% when the limbs were elevated 20 cm. The estimated vascular resistance was constant during lowering and elevation, indicating paralysis of the arterioles. The vasoconstrictor response had returned at the tenth postoperative day as blood flow decreased 32% during lowering. Autoregulation had also returned as blood flow remained almost constant during elevation to 40 cm. In 16 limbs with less severe ischemia, vasoconstrictor response as well as autoregulation was preserved before operation, and no disturbances occurred after operation. Despite the early normalization of local blood flow regulation, postoperative hyperemia developed in most limbs. Post reconstruction edema developed after all but one of the 13 femorodistal bypass operations and after only one of the 17 aortoiliac reconstructions. This suggests that post-reconstruction hyperemia and post-reconstruction edema are not caused by arteriolar insufficiency. PMID- 3966232 TI - The iliac-origin arterial graft: a useful alternative for iliac occlusive disease. AB - The results of ilioiliac and iliofemoral bypass grafts were compared with those for aortic-origin grafts in 205 patients and 332 legs operated upon for aortoiliac occlusive disease since 1972. Poor-risk patients who had a patent distal aorta and at least one functionally patent proximal iliac artery were considered for reconstruction with the iliac artery used for the proximal anastomosis. The procedure, performed through a retroperitoneal approach, has several technical advantages and is especially satisfactory for patients who would otherwise have an axillofemoral graft. The data indicate that these iliac origin reconstructions compare favorably in patency with aortic-origin reconstructions or with other "extra-anatomic" arterial reconstructions, enabling extremely low morbidity and mortality rates even in high-risk patients. PMID- 3966233 TI - Absorption dynamics of organic chemical transport across trout gills as related to octanol-water partition coefficient. AB - An in vivo fish preparation was used that allowed a direct measure of the transport rates of 14 different organic chemicals across the gills of rainbow trout (Salmo gairdneri). The chemicals, all C14 labeled, were selected from five classes, encompassing a range of octanol-water partition coefficient (log P) values, from 0.23 (ethyl formate) to 7.5 (mirex). The uptake efficiency (extraction efficiency) of each chemical was determined by monitoring the inspired and expired water of trout exposed to each chemical over an exposure period of 1 to 6 hr. The mean gill extraction efficiency for all chemicals tested varied from a low of 7% to a high of 60%, extracted in a single pall of the chemical across the gills. The extraction efficiency of chemicals with log P or 1 or less were low and showed no relationship to log P. These low extraction efficiencies seen at log P of 1 and below with molecular weights below 100 were indicative of aqueous pore transport. The mean extraction efficiency for chemicals with log P values of 1 to 3 seemed to vary directly with log P, to a maximum of slightly greater than 60%, suggesting that uptake was controlled by the lipid membrane. The mean extraction efficiency for chemicals with log P of 3 to 6 was independent of log P and remained at 60%, which suggested that gill uptake was controlled by aqueous diffusion rates rather than gill membrane permeability. The mean extraction efficiency with mirex (log P = 7.5) decreased to 20%. This behavior was consistent with previous physical models which predict that high log P and melting point (low water solubility) may substantially reduce the rate of accumulation in fish. These studies support the passive diffusion model for the uptake of organics at the gill-water interface. PMID- 3966234 TI - In vitro covalent binding of cismethrin, bioresmethrin, and their common alcohol to hepatic proteins. AB - When [14C]Alcohol-labeled cismethrin, bioresmethrin, and 5-benzyl-3-furylmethyl alcohol (BFA) were incubated with rat liver S 9 homogenates or microsomes, a proportion of the radioactive compounds was covalently bound to proteins. The covalent binding was greater with phenobarbital-pretreated rats, and dependent on a NADPH-generating system. When a S 9 homogenate was used, the bound compounds were twofold higher for cismethrin than for bioresmethrin and BFA. Inversely, when microsomes were used more covalent binding occurred with bioresmethrin and BFA than with cismethrin. The inhibition of esterases by tetraethyl pyrophosphate (TEPP) in a S 9 homogenate did not alter the amount of covalent binding to the three compounds whereas malathion inhibited this binding. Treatment of a S 9 homogenate with piperonyl butoxide, however, greatly reduced covalent binding. Covalent binding was inhibited when the microsomes were incubated with carbon monoxide or modified by thermal denaturation. It is suggested that oxidative metabolism was responsible for the covalent binding. PMID- 3966235 TI - Comparison of the short-term effects of di(2-ethylhexyl) phthalate, di(n-hexyl) phthalate, and di(n-octyl) phthalate in rats. AB - This study compares changes in the livers of rats treated with di(2-ethylhexyl) phthalate (DEHP) and its straight-chain analogs di(n-hexyl) phthalate (DnHP) and di(n-octyl phthalate (DnOP). Groups of rats were fed diets containing 20,000 ppm of one of these compounds. Subgroups were killed after 3, 10, and 21 days, and the livers were examined by histological, cytological, and biochemical methods. The results show considerable differences between the effects of the branched chain phthalate ester DEHP and its straight-chain analogs. The major effects on the liver following administration of diets containing DEHP were midzonal and periportal accumulation of small droplets of lipid, hepatomegaly accompanied by an initial burst of mitosis, proliferation of hepatic peroxisomes and of smooth endoplasmic reticulum accompanied by induction of peroxisomal fatty acid oxidation, damage to the peroxisomal membranes as evidenced by increased leakage of catalase to the cytosol, and centrilobular loss of glycogen and falls in glucose-6-phosphatase activity and in low-molecular-weight reducing agents. In contrast, diets containing DnHP or DnOP induced accumulation of large droplets of fat around central veins leading, by 10 days, to mild centrilobular necrosis and a very slight induction of one peroxisomal enzyme and an increase in liver weight, but no significant changes in any other parameters which were affected by DEHP. PMID- 3966236 TI - Reproductive effects of inhaled methyl chloride in the male Fischer 344 rat. I. Mating performance and dominant lethal assay. AB - Methyl chloride (MeCl) is a direct-acting mutagen in bacteria, induces renal adenocarcinomas in male mice, and is a potent reproductive toxicant in the male Fischer 344 (F-344) rat. A dominant lethal assay was performed to examine the possibility that MeCl may be a germ cell mutagen in the F-344 male rat. Groups of 40 rats each were exposed to 0, 1000, or 3000 ppm MeCl 6 hr/day for 5 consecutive days, or received a single ip injection of 0.2 mg triethylenemelamine (TEM)/kg as a positive control. Each male was bred to a single female weekly for 8 weeks, and the standard criteria of dominant lethal tests were recorded. Exposure to 1000 ppm MeCl caused no consistent change in any parameter relative to control values. TEM caused increases in pre- and postimplantation loss indices in Weeks 1 to 5 postexposure, corresponding to sperm exposed in the epididymis and as early to late stage spermatids in the testis. Exposure to 3000 ppm MeCl caused a slight increase in postimplantation loss at Week 1 postexposure only, i.e., in sperm exposed in the epididymis or vas deferens, and increases in preimplantation loss throughout the 8 weeks postexposure. Fertility of the 3000 ppm MeCl-exposed males was significantly decreased by Week 2 after exposure, and never recovered to control values during the period of observation. It is suggested that the increased preimplantation losses are due, at least in part, to cytotoxic rather than genotoxic effects. High concentrations of inhaled MeCl, however, do induce dominant lethal mutations (reflected as an increased level of postimplantation fetal deaths) in sperm located within the vas deferens and epididymis at the time of exposure. PMID- 3966237 TI - Reproductive effects of inhaled methyl chloride in the male Fischer 344 rat. II. Spermatogonial toxicity and sperm quality. AB - Studies were performed to assess the effects of inhaled methyl chloride (MeCl) on sperm quality and testicular histopathology in the Fischer 344 rat. Adult male F 344 rats were exposed to 1000 or 3000 ppm MeCl 6 hr/day for 5 days, or received an ip injection of 0.2 mg triethylenemelamine (TEM)/kg on the afternoon of Day 5. Five males from a control group and each of the three treatment groups were killed weekly for 8 weeks, and five more from the control and 3000 ppm groups at Week 16 postexposure. Male rats from the 1000 ppm MeCl- and TEM-exposed groups exhibited no consistent difference from control males in any parameter measured. In the 3000 ppm MeCl group, over 50% of the males had uni- or bilateral sperm granulomas in the cauda epididymis. Testes weights were significantly depressed in these males by 3 weeks postexposure, and remained depressed as late as 8 weeks after treatment. Testicular spermatid head counts were significantly lower by 2 weeks postexposure, and the testes showed a characteristic cytotoxic response to MeCl exposure, including a delay in spermiation, chromatin margination in round spermatids, epithelial vacuolation, luminal exfoliation of spermatogenic cells, and multinucleated giant cells. Counts of repopulating seminiferous tubule cross sections and of testicular sperm heads at 7 weeks postexposure indicated that 60 to 70% of the spermatogonial stem cells had been killed by MeCl exposure. Sperm isolated from the vasa deferentia had significantly depressed numbers and an elevated frequency of abnormal sperm head morphology by Week 1 postexposure, and significantly depressed sperm motility and an elevated frequency of headless tails by Week 3 postexposure. All parameters measured in the testes and in vasa deferentia sperm showed varying degrees of recovery, and all were near the normal range by Week 16 postexposure except sperm count. These data suggest that the previously reported high preimplantation loss caused by methyl chloride exposure may be primarily due to cytotoxic effects on the testis and epididymal epithelium, rather than to direct genotoxic effects on the sperm. PMID- 3966238 TI - The renal handling of terephthalic acid. AB - By use of the Sperber in vivo chicken preparation method (1948, Ann. R. Agric. Coll. Swed. 15, 317-349), infusion of radiolabeled terephthalic acid ([14C]TPA) into the renal portal circulation revealed a first-pass excretion of the unchanged compound into the urine. This model was utilized further to characterize the excretory transport of [14C]TPA and provide information on the structural specificity in the secretion of dicarboxylic acids. At an infusion rate of 0.4 nmol/min. 60% of the [14C]TPA which reached the kidney was directly excreted. An infusion rate of 3 or 6 mumol/min resulted in complete removal of [14C]TPA by the kidney. These results indicate that TPA is both actively secreted and actively reabsorbed when infused at 0.4 nmol/min and that active reabsorption is saturated with the infusion of TPA at higher concentrations. The secretory process was saturated with the infusion of TPA at 40 mumol/mn. The excretory transport of TPA was inhibited by the infusion of probenecid, salicylate, and m hydroxybenzoic acid, indicating that these organic acids share the same organic anion excretory transport process. m-Hydroxybenzoic acid did not alter the simultaneously measured excretory transport of p-aminohippuric acid (PAH), suggesting that there are different systems involved in the secretion of TPA and PAH. The structural specificity for renal secretion of dicarboxylic acids was revealed by the use of o-phthalic acid and m-phthalic acid as possible inhibitors of TPA secretion. m-Phthalate, but not o-phthalate, inhibited TPA excretory transport, indicating that there is some specificity in the renal secretion of carboxy-substituted benzoic acids. TPA was actively accumulated by rat and human cadaver renal cortical slices. PMID- 3966239 TI - Neurotoxic esterase in rooster testis. AB - Neurotoxic esterase (NTE) is the putative target protein in the nervous system for the initiation of organophosphorus-induced delayed neuropathy. Here it is reported that NTE activity is present in rooster testis. Complete titration of rooster testis phenyl valerate esterases with paraoxon shows that about 15% of the enzymic activity is resistant to paraoxon. NTE activity after complete mipafox titration accounts for 30% of paraoxon-resistant phenyl valerate esterases and corresponds to 7.93 +/- 0.39 nmol/min/mg of protein (mean +/- SD, n = 7). Testis NTE is inhibited in vitro similarly to brain NTE by several organophosphorus compounds. Subcellular fractionation studies of the testis indicate that most NTE activity is particle bound. Testis NTE is also inhibited in vivo by several organophosphorus esters but to a lesser extent than brain NTE. Birds doses with organophosphorus compounds, causing delayed neuropathy, became grossly ataxic, but no testicular pathology was noted by light microscopy in roosters killed 15 days after administration. Serum testosterone levels also measured 15 days after dosing were not different from those of a control group. Recovery of NTE activity was faster in testis than in brain (4 days vs 6 days to recover to 50% of initial activity) in animals that received a high dose of an organophosphorus ester which cause delayed neuropathy. PMID- 3966240 TI - Degenerative processes in skeletal muscle of Cd2+-treated rats and Cd2+ inhibition of mitochondrial Ca2+ transport. AB - In rat skeletal muscle, chronic exposure to 50 ppm Cd2+ in drinking water produced both ultrastructural and functional damage, which took place successively and increased gradually with duration of treatment. Ultrastructurally, the first effect was a regression of the sarcoplasmic reticulum, mitochondrial cristae, and glycogen granules. Then, the number of mitochondria diminished and a degeneration of myofilaments appeared. During the 9 month course of treatment, however, the terminal cisternae and the lateral saccules of sarcoplasmic reticulum remained, and the Z lines maintained their tight and rigorously parallel appearance. Functionally, the activities of two cytosolic Ca2+-sensitive enzymes (lactate dehydrogenase and malate dehydrogenase) decreased. Their partial restoration by EGTA and EDTA suggested the presence of inhibitory divalent cations in the cytosol of treated rats. Cd2+ also inhibited Ca2+ transport in mitochondria through the uncoupling of oxidative phosphorylation. Hence, an increase of Ca2+ concentration of the cytosol of Cd2+ treated rats, activating degradative enzymes such as phospholipases, proteases and phosphorylase b kinase, can be incriminated. A direct inhibitory action of Cd2+ on the activities of lactate dehydrogenase and malate dehydrogenase also occurred. Direct action of Cd2+ on certain other Ca2+-sensitive enzymes, thereby aggravating the indirect damage induced through increasing the Ca2+ concentration in cytosol, is hypothesized. In mitochondria, a Cd2+ activation of phospholipase A2 and/or a Ca2+-sensitive protease is a unique possibility, since Ca2+ accumulation was prevented by cytosolic Cd2+. PMID- 3966241 TI - An investigation of the role of microsomal oxidative metabolism in the in vivo genotoxicity of 1,2-dichloroethane. AB - In vitro studies have demonstrated that two different metabolic pathways, glutathione conjugation mediated by the glutathione S-transferases and microsomal oxidation, may be involved in the genotoxicity and carcinogenicity of 1,2 dichloroethane (DCE). To evaluate the importance of microsomal oxidative metabolism in the bioactivation of DCE in vivo, male B6C3F1 mice were pretreated with piperonyl butoxide (PIB), an inhibitor of microsomal oxidative metabolism, and the effect of this pretreatment on the extent of hepatic DNA damage produced by DCE was determined 4 hr after DCE administration. The in vivo genotoxicity of 2-chloroethanol, a product of the microsomal oxidative metabolism of DCE, was also investigated. Hepatic DNA damage was measured with a sensitive, alkaline DNA unwinding assay for the presence of single-strand breaks and alkali-labile lesions in DNA. Pretreatment of mice with PIB to inhibit microsomal oxidative metabolism significantly potentiated the hepatic DNA damage observed 4 hr after a single, 200-mg/kg, ip dose of DCE. Treatment of mice with single, ip doses of 2 chloroethanol as high as 1.2 mmol/kg failed to produce any evidence of single strand breaks and/or alkali-labile lesions in hepatic DNA. When diethyl maleate (DEM) was used to deplete hepatic glutathione levels prior to administration of 2 chloroethanol, the acute hepatotoxicity of 2-chloroethanol was potentiated but again there was no evidence of hepatic damage. These results indicate that microsomal, oxidative metabolism of DCE to 2-chloroethanol and/or 2 chloroacetaldehyde is not responsible for the hepatic DNA damage observed in these studies after DCE administration. PMID- 3966242 TI - The role of high density lipoproteins in the biodistribution of two radioiodinated probes in the rat. AB - Two radioiodinated probes, 125I-cholesteryl oleate (125I-CO), a derivative of a natural constituent of lipoproteins, and 1-(2-chlorophenyl)-1-(4[125I]iodophenyl) 2,2-dichlorethane (125I-DDD), an analog of the adrenolytic drug o,p'-DDD (mitotane), were selected to study the role of lipoproteins in drug disposition and to examine the ability of these vehicles to direct foreign molecules to specific tissues. In vivo and in vitro techniques were utilized to associate these probes with rat high density lipoproteins (HDL). Tissue distribution studies indicated that prior incorporation of 125I-CO into rat HDL increased the uptake of 125I-CO by rat adrenal, which was dramatically enhanced when this preparation was administered to animals made hypolipidemic with 4 aminopyrazolo(3,4-d)-pyrimidine (4-APP). Acetylation of HDL labeled with 125I-CO provided evidence that the observed uptake into the adrenal was via a receptor mediated process. In contrast with these results, prior association of 125I-DDD with rat HDL failed to alter the ability of this compound to accumulate in adrenal tissue of normal or hypolipidemic animals. Polyacrylamide gel electrophoresis (PAGE) was utilized to examine the stability of the association of 125I-CO and 125I-DDD with rat HDL. These results suggested that 125I-CO was associated with the lipophilic core of HDL, whereas 125I-DDD appeared to be partially associated with the surface components of HDL. Saturation of surface components with stable o,p'-DDD offered data to suggest that this binding to apoproteins may disrupt the normal receptor-mediated uptake process. These studies indicate that lipoproteins may effect the distribution and tissue uptake of lipophilic compounds and, conversely, lipophilic molecules can effect the metabolic fate of lipoproteins. The overall result is dependent upon the nature of the association of these lipophilic compounds with lipoproteins which is difficult to predict on the basis of molecular structure alone. PMID- 3966243 TI - In vivo regulation of delta-aminolevulinate dehydratase activity. AB - The interrelationships among purified delta-aminolevulinate dehydratase (ALA-D; EC 4.2.1.24) activity, Pb, and ALA-D concentrations were studied in vitro. The ratio of Pb to the ALA-D subunit, but not the Pb concentration, determined the relative activity of ALA-D, indicating the significance of the amount of ALA-D in studying the mechanism of enzyme inhibition by Pb. To elucidate the in vivo mechanisms of ALA-D regulation, male Wistar rats, 6 months old, were treated with Pb, Zn, and glutathione (GSH) separately or in combination for 130 days. After Pb administration, the amount of ALA-D, as determined by radioimmunoassay, increased in the presence and in the absence of the Zn-GSH pretreatment, even if the enzyme activity were higher (the Zn-GSH-Pb-treated rats) than that of the control. Zn and GSH restored the enzyme activity in vivo synergistically. Since immunochemical study showed the identity of the liver ALA-D with the erythroid ALA-D, the liver and erythroid data were pooled to quantify the interrelationship among ALA-D activity, and Pb, Zn, SH, and the enzyme concentrations. The equation was the relative activity of ALA-D (%) = 0.256.[Pb/ALA-D subunit]2 - 9.56.[Pb/ALA D subunit] - 0.000281.[square root Zn.SH/ALA-D subunit]2 + 0.0898..[square root Zn.SH/ALA-D subunit] + 33.6 (multiple correlation coefficient = 0.909, n = 108, p less than 0.01). The result indicated that 83% of the in vivo regulation of ALA-D activity is explained when the four factors, Pb, Zn, SH, and ALA-D concentrations, are considered in combination. PMID- 3966245 TI - Potentiation of the teratogenic effects and altered disposition of diphenylhydantoin in mice fed a purified diet. AB - The effect of a standardized purified diet (AIN-76) on the teratogenic response to diphenylhydantoin (DPH) was studied in mice. Mice were fed either the purified diet or Purina Rodent Laboratory Chow for 2-4 weeks prior to mating, and were treated with either saline or 50 mg/kg of DPH on Days 12, 13, and 14 of gestation (copulatory plug = Day 0). The teratogenic response to DPH was found to be markedly potentiated in mice fed the purified diet (75% cleft palate) as compared to mice fed rodent chow (21% cleft palate). The potentiated teratogenic response to DPH correlated with markedly higher plasma DPH levels in pregnant mice fed the purified diet, indicating that the disposition of DPH was impaired. These effects were attributed to a decreased basal level of drug-metabolizing enzymes in mice fed the purified diet, as indicated by markedly prolonged hexobarbital sleeping times. Modifications of the purified diet, which included the replacement of soluble carbohydrate (50% sucrose) in the purified diet with either cornstarch or casein, did not alter the high incidence of cleft palate. A reduction in the incidence of cleft palate was observed, however, when corn oil in the purified diet was replaced with linseed oil. The replacement of corn oil with linseed oil in the purified diet also restored the hexobarbital sleeping times to those observed in mice fed rodent chow. It is concluded that mice fed purified diets have decreased basal levels of drug-metabolizing activity that alter the disposition of DPH and, as a consequence, potentiate its teratogenic effects. PMID- 3966244 TI - Absence of a promoting or sequential syncarcinogenic effect in rat liver by the carcinogenic hypolipidemic drug nafenopin given after N-2-fluorenylacetamide. AB - The hypolipidemic agent nafenopin, (NF), has been reported to be carcinogenic to rat liver. To determine whether nafenopin exerts a promoting or syncarcinogenic effect in rat liver, its effect on liver carcinogenesis induced by N-2 fluorenylacetamide (FAA) was studied. In two separate experiments, male F344 rats were fed 0.02% FAA for either 10 or 8 weeks to induce preneoplastic liver lesions. Following a recovery period of 1 week, rats were given 0.01 or 0.02% NF in the diet for 23 weeks in one experiment and 0.05 or 0.1% for 24 weeks in the other. The final incidence of neoplasms, and their numbers, size distribution, and degrees of differentiation were not significantly different in groups given NF after FAA compared to those maintained on a basal diet after FAA. In the group treated with the highest dose level of NF following FAA, however, there was a decrease in the number of grossly visible small neoplasms. In contrast, the liver neoplasm promoter phenobarbital increased the multiplicity, although not the incidence, of liver neoplasms when given after FAA. Thus, four different dose levels of NF showed no promoting or syncarcinogenic effect on FAA-induced hepatocarcinogenesis. PMID- 3966247 TI - [Hypotheses on radiation protection]. PMID- 3966248 TI - [Pathophysiology of chronic radiation exposure of the body]. PMID- 3966246 TI - Toxicity of the mycotoxin, cyclopiazonic acid, to Sprague-Dawley rats. AB - Groups of male Sprague-Dawley rats received po doses of cyclopiazonic acid (CPA) on four consecutive days at 0.0, 0.2, 2.0, 4.0, or 8.0 mg kg-1 days-1. Clinical signs of toxicity were observed only in the two highest dose groups. Rats in the highest dose group exhibited abnormal behavior, diarrhea, and other signs of toxicity after several days of dosing, and most were moribund before the last scheduled dose was administered. Liver and spleen were more severely affected than other organs in the two highest dose groups. Livers contained diffuse pycnotic nuclei and, in some high-dose rats, focal areas of coagulative necrosis. In the high-dose group aspartate and alanine aminotransferase activities were elevated, cytochrome P-450 concentration was decreased, and glutathione S transferase activity was unchanged. Spleens were hemorrhagic and white pulp contained necrotic lymphocytes. White cell counts were decreased in a dose related manner in the two highest dose groups. The gastrointestinal tract of high dose rats contained pycnotic nuclei, and sites of necrosis were observed in stomach, but these lesions were limited to several animals, and were generally mild. Pathologic changes in conjunction with decreased feed and water intake probably contributed to the general deterioration of high-dose rats that resulted in death. PMID- 3966249 TI - [The new dose estimates for Hiroshima and Nagasaki and the consequences for those survivors exposed to low doses]. PMID- 3966250 TI - [Results of the German Thorotrast Study]. PMID- 3966251 TI - Increased excretion of immunoreactive thromboxane B2 in cerebral ischemia. AB - Thromboxane B2 (TXB2) is the stable metabolite of thromboxane A2 (TXA2), a potent vasoconstrictor which induces irreversible platelet aggregation. The inhibition of TXA2 by aspirin and other agents has been associated with improved outcome following cerebral ischemia in clinical and laboratory studies. To investigate the relation of TXA2 production to cerebral ischemia, we measured the urinary excretion of TXA2 metabolites in 30 patients with acute cerebral ischemia. Urinary immunoreactive TXB2 for this group of ischemic patients was elevated compared to normals, 1818 +/- 344 pg/mg Cr (mean +/- SE) vs 880 +/- 122 pg/mg Cr (p less than .05). Among various subsets of the ischemic patients, those with severe stroke (2108 +/- 536 pg/mg Cr), large vessel disease (1646 +/- 335 pg/mg Cr), and cardiogenic stroke (2712 +/- 1045 pg/mg Cr) were all significantly elevated. Of the stroke patients, only the males demonstrated this significant elevation. These elevations of urinary immunoreactive TXB2 are consistent with a role for increased platelet activation in the pathogenesis of some forms of cerebral ischemia and suggest that gender differences in arachidonate metabolism may exist for stroke patients. PMID- 3966252 TI - Ischemic brain edema following occlusion of the middle cerebral artery in the rat. I: The time courses of the brain water, sodium and potassium contents and blood-brain barrier permeability to 125I-albumin. AB - The present study was undertaken to analyze the roles of brain cations and of the blood-brain barrier (BBB) to albumin in the development of ischemic brain edema. Using the rat middle cerebral artery (MCA) occlusion model, changes in the brain water, sodium, and potassium contents were followed for a period of seven days. The permeability of the BBB to proteins was also followed by 125I-albumin transfer from the blood into the brain. A significant edema developed as early as three hours after MCA occlusion. This progressed rapidly to reach a maximum on the third day, gradually regressing thereafter. The increase in the brain water contents showed a parallel time course to the increase in the sodium and decrease in the potassium contents. A significant increase in the BBB permeability to albumin occurred 72 hours after MCA occlusion. However, there was no correlation between the brain water content and BBB permeability to albumin in the hemispheres studied 72 hours after MCA occlusion. The correlation between the brain water and sodium contents was not clear during the first six hours, but became highly significant thereafter. The data suggest that an increase in the BBB permeability to sodium occurred 12-48 hours after MCA occlusion, which, together with an antecedent intracellular shift of sodium, resulted in a massive influx of water and sodium into the brain. The BBB permeability change to sodium, not to proteins, seems to play a predominant role in the pathogenesis underlying ischemic brain edema. PMID- 3966253 TI - Ischemic brain edema following occlusion of the middle cerebral artery in the rat. II: Alteration of the eicosanoid synthesis profile of brain microvessels. AB - Using the rat middle cerebral artery occlusion model, alterations in the eicosanoid synthetic capacity of brain microvessels following ischemia were studied by radiochromatography. Brain microvessels of normal rats predominantly produced hydroxyacids with relatively small amounts of PGD2 and PGE2 from exogenous arachidonic acid. Confirmation that hydroxyacids and prostaglandins were products respectively of lipoxygenase(s) and cyclooxygenase was obtained by experiments using indomethacin and eicosatetraynoic acid. The eicosanoid synthetic capacity of the brain microvessel, especially of hydroxyacids, was significantly enhanced 24 and 72 hours after the onset of ischemia. Because this is the phase of maximum edema in the present model, enhanced eicosanoid production in the brain microvessel may be involved in the mechanisms that underly ischemic brain edema. PMID- 3966254 TI - No intracerebral steal phenomenon in the ischemic brain following papaverine administration. AB - The steal phenomenon due to a vasodilator was investigated in 6 cats in which cerebral ischemia had been produced by left middle cerebral artery (MCA) occlusion. The photoelectric method was employed for continuous recording of the cerebral blood volume together with frequent determinations of the cerebral blood flow (CBF) through the ischemic cerebral tissue at the following four stages: before MCA occlusion, 2 hours after MCA occlusion before the injection of papaverine, after the injection of papaverine, and when the systemic arterial blood pressure (SABP) was adjusted non-pharmacologically to the control level using a "vasculator". The administration of the vasodilator produced conflicting results for the CBF changes in the ischemic area with a decrease in SABP as reported previously in the literature. However, when the SABP was corrected to the control level, the CBF in the ischemic region became increased in all 6 cases to above the control ischemic flow values. It is concluded that the decreased CBF in the ischemic tissue after vasodilator administration was not due to the steal phenomenon, but simply to a fall in SABP. PMID- 3966255 TI - Frequency of echocardiographic abnormalities in patients with ischemia of the carotid territory--a preliminary report. AB - Eighty-eight consecutive patients referred to a neurosurgical Department (63 men and 25 women) aged from 14 to 68 years, with cerebral ischemia in the carotid territory were subjected to M-mode and two-dimensional echocardiography, carotid angiography and assessment of risk factors. There were 27 patients (average age 54 years) in whom carotid angiography demonstrated a probable source for the ischemia. Carotid angiography was normal in 51 of the remaining 61 (average age 39 years) while 10 revealed distant emboli. Although the incidence of "abnormal echocardiograms" was similar in the two groups (56% and 54% respectively) the spectrum of abnormalities were different. Only 5 (18%) of the 27 patients with abnormal angiograms had a potential cardiac source of emboli while 24 (39%) out of the remaining 61 patients had a potential cardiac source demonstrated at echocardiography. There was a high incidence of mitral valve prolapse (34%) in this latter group of patients. Mitral valve prolapse was not seen in the present series in patients with a probable carotid source on angiography. PMID- 3966256 TI - Reactions of granular pericytes in a rabbit cerebrovascular ischemia model. AB - This study was undertaken to examine some of the quantitative and qualitative changes which might occur in the cerebral granular pericyte population when comparing control and embolically stressed animals. Eight animals, male NZW 2-2.5 kg rabbits, were given intracarotid sublethal injections of human atheroma concentrated at 125 mg/ml. Eight others received 1 cc of sterile saline. Two hours after injection the brains were fixed with either neutral buffered formalin or 3% buffered glutaraldehyde by cardiac perfusion at 110 mmHg pressure. The brains were removed and sliced, anteroposteriorly, in 3 mm slices. Each slice from five brains for each condition was then processed for paraffin sectioning and staining with Hematoxylin and PAS. Two animals for each condition underwent the same treatments and were processed for frozen sectioning and staining with Oil Red O. One animal for each condition had each brain slice sectioned by vibratome (40 micrometers) and was processed appropriately and examined by either fluorescence microscopy, standard electron microscopy or acid phosphatase electron microscopy. In the groups stained with Hematoxylin and PAS, granular pericytes were counted for each of the first five levels of each brain for both the control and experimental conditions. The results of this study reconfirmed that these cells were granular pericytes; that is, they were autofluorescent and PAS positive; were surrounded by a basement membrane, were acid phosphatase positive and contained a heterogenous granular cytoplasmic inclusion population. Further, after ischemic insult, the number of granular pericytes increased significantly at two hours. It was also shown that these cells appeared capable of accumulating lipid components of the injected atheroma from the vessel lumen. PMID- 3966257 TI - Spontaneous dissecting aneurysms of the internal carotid and vertebral arteries- two case reports. AB - Two patients had acute spontaneous dissection of both internal carotid arteries and of one or both vertebral arteries. One had angiographic signs suggestive of fibro-muscular dysplasia and both were on oral contraceptives. They were treated with high dose heparin and made a good clinical recovery. A digital intravenous angiography performed two to three months later showed a complete recanalization of arteries involved. These patients are similar to those reported as "idiopathic regressing arteriopathy" and "reversible angiopathy" which probably correspond to the same entity. PMID- 3966258 TI - Hypertensive putaminal hemorrhage presenting with hemichorea. AB - A progressive motor deficit primarily manifested by hemichorea developed in a 42 year-old hypertensive man. CT scan demonstrated contralateral putaminal hemorrhage. The patient's course was benign. Previous cases of acute hemichorea familiar to use and documented by CT scans have involved nonhemorrhagic lesions of either the putamen or caudate. PMID- 3966259 TI - Cardiac radionuclide angiography in patient with cerebrovascular disease. PMID- 3966260 TI - Transient global ischemia. PMID- 3966261 TI - Acute ethanol ingestion increases platelet reactivity: is there a relationship to stroke? AB - The effects of ethanol ingestion on ADP-induced platelet aggregation and associated thromboxane formation were studied in the platelet-rich plasma of 10 healthy male volunteers, each serving as his own control. Ethanol caused a transient decrease in threshold concentration of ADP to produce irreversible aggregation. Over a wide range of ADP total platelet aggregation was increased. In the presence of irreversible aggregation, formation of thromboxane B2 rose from 303 +/- 56 to 950 +/- 212 fmol per 10(7) platelets (p less than 0.01). The effects lasted as long as ethanol was present in blood, did not significantly correlate to blood ethanol levels and exhibited great individual variation. It remains to be proved, whether these observations could contribute to the increased risk of ischemic brain infarction associated with acute ethanol ingestion. PMID- 3966262 TI - Serum HDL/total cholesterol ratio and blood pressure in asymptomatic atherosclerotic lesions of the cervical carotid arteries in men. AB - One hundred neurologically asymptomatic male subjects (aged 50-69 years), randomly selected through population registers, were screened for atherosclerotic lesions of the cervical carotid arteries, using a high resolution multi-gate pulsed Doppler system. In 93 subjects serum was assayed for total and HDL cholesterol. Besides, cuff arterial blood pressure measurements were made. Twenty three of these subjects (Group III) were classified as abnormal according to the Doppler investigation (degree of narrowing less than 50% in 78% of the cases). Seven of these 23 subjects also had a history of ischemic heart disease or intermittent claudication. Of the 70 subjects with a normal Doppler examination 16 had a history of ischemic heart disease and/or intermittent claudication (Group II). The remaining 54 subjects served as controls (Group I). The frequency of asymptomatic atherosclerotic lesions of the cervical carotid arteries in the population under investigation was 23%. The HDL/total cholesterol ratio was lower and the frequency of high blood pressure higher in the Groups II and III than in Group I. The findings in this study support the idea that a low serum HDL/total cholesterol ratio and high blood pressure have a high degree of association with atherosclerotic lesions of the cervical carotid arteries. This association is already apparent at an early stage of the disease, i.e. in asymptomatic subjects with a slight to moderate degree of carotid artery narrowing. PMID- 3966263 TI - Modification of cerebral ischemia with Fluosol. AB - Fluosol-DA (Perfluorochemical Blood Substitute) was investigated in a previous study and found to provide some protection from ischemia and possible usefulness in limiting the size of infarction. In the present study, larger doses over longer periods of acute focal cerebral ischemia were used. Twenty four cats had transorbital ligation of the middle cerebral artery (MCA). The 12 experimental animals were given 20% Fluosol-DA. The control group of 12 received isotonic saline solution. Twenty-four hours after the MCA occlusion, the cats were perfused with saline and phosphate-buffered formalin. The brains were removed and immersed in 10% formalin for 2 weeks. The results of macroscopic and histological examination suggested that, although Fluosol-DA did not provide complete protection from ischemic injury to the brains of the cats treated, it may have helped to slow the development of the pathological changes. PMID- 3966264 TI - Changes in ambulation and drinking behavior related to stroke in stroke-prone spontaneously hypertensive rats. AB - In order to elucidate the behavioral changes related to stroke, ambulatory activity and water drinking were observed in stroke-prone spontaneously hypertensive rats (SHRSP). Age matched male SHRSP and Wistar Kyoto rats (WKY) were subjected to a 12 hour light and dark alternation cycle. Ambulation and drinking activity counts were determined simultaneously with an Ambulo Drinkometer. Before stroke, ambulation and drinking activity counts in the dark phase (82%) were higher than those in the light phase (18%). Both parameters were well synchronized with the light and dark alternation cycle. With aging, daily ambulation decreased while daily drinking activity increased in SHRSP and WKY. Daily ambulation and drinking activity in 15 and 30 week old SHRSP were greater than those of WKY. It was demonstrated with an Ambulo-Drinkometer that SHRSP undergo specific behavioral changes before the onset of stroke. For instance, the 40-60 week old SHRSP showed significant individual variation in both ambulation and drinking activity. This desynchronization with the light and dark alternation cycle was followed by stroke. Twenty seven autopsies showed 11 cerebral infarctions, 10 cerebral hemorrhage and 6 cerebral hemorrhage with infarctions to be the causes of death. PMID- 3966265 TI - Nationwide co-operative study of intracranial aneurysm surgery in Japan. AB - A cooperative study was made of 4750 intracranial aneurysm cases collected from 133 neurosurgical clinics in Japan by letter inquiry for the period of 2 years from January 1974 to December 1975. Among them, 4124 cases (87%) had a single aneurysm, and 626 cases (13%) had multiple ones. Direct radical surgery was done in 78% of all cases, carotid ligation in 2% and non-surgical treatment in 17%. Direct surgery in a mortality rate of 15% for ruptured aneurysm cases and 7% for nonruptured cases. Radical surgery within 24 hours after rupture had a mortality of 51%, while those within 1 week and 2 weeks were 39% and 30% respectively; grade I or II patients, however, showed much better surgical results even in early operations. The neurosurgical clinics included in this study were spread throughout most of Japan. Micro-surgical technic was already in use of aneurysm surgery at the time of this study in Japan. PMID- 3966266 TI - Effects of low dose aspirin on platelet function in patients with recent cerebral ischemia. AB - We tested the antiplatelet effects of low-dose aspirin in patients with occlusive cerebrovascular disease, because conventional dosage aspirin inhibits vascular synthesis of prostacyclin at the same time that it inhibits platelets. The effects on platelet function and thromboxane A2 synthesis of 40 mg of aspirin daily or 40 mg aspirin plus dipyridamole were measured in 23 patients starting within a week after the onset of cerebral ischemia. All patients had normal baseline platelet aggregation responses to four stimuli: arachidonate, epinephrine, adenosine diphosphate and collagen. The generation of thromboxane A2 by platelets, measured as serum thromboxane B2, was also normal. After 3 to 7 days of low dose aspirin therapy, platelet aggregation responses were suppressed to the extent observed with higher dosage aspirin. Serotonin release during platelet aggregation was inhibited by more than 95% and thromboxane B2 levels in clotted blood fell by more than 95%. Responses to aspirin treatment were similar in patients with transient ischemic attacks and in those with stroke and were also similar in both sexes. No differences in platelet responses were observed between patients receiving aspirin alone and aspirin plus dipyridamole. Thus 40 mg aspirin daily inhibited platelet responses as effectively as higher doses of aspirin in patients who had recent cerebral ischemia and showed a cumulative antiplatelet effect. PMID- 3966267 TI - Decrease in cerebral blood flow in rats after experimental subarachnoid hemorrhage: a new animal model. AB - There continues to be a need for good animal models of experimental subarachnoid hemorrhage (SAH). The rat would be an ideal subject in which to study SAH since it is inexpensive and easier to use than the larger laboratory animals. The present study was undertaken to determine if alterations of cerebral blood flow could be produced in the rat after experimental SAH, and thereby justify using the rat as a model for further study of SAH. Rats weighing between 450 and 500 grams underwent insertion of a cannula into the cisterna magna at least 5 days prior to physiological testing. One group of rats then received a 0.3 cc injection of fresh autologous arterial blood into the cisterna magna to simulate a SAH. Another group of rats received injection of an equal volume of mock CSF (buffered saline) into the cisterna magna. A third group of rats had no subarachnoid injections. In all three groups, blood flow to the cerebral hemispheres was measured with the labeled microsphere technique. Rats with experimental SAH showed a 40% decrease of cerebral blood flow, whereas rats with saline injections showed only a 15% decrease. Control rats had no changes of cerebral blood flow. These studies demonstrate that the rat is a potential experimental model for investigations into SAH. PMID- 3966268 TI - Effect of small deep hemispheric infarction on the ipsilateral cortical blood flow in man. AB - The effect of small, deep ischemic lesions on the ipsilateral cortical circulation was investigated in 10 patients with persistent mild or moderate neurological deficits due to infarcts in the internal capsule. rCBF studies by the 133Xe intracarotid injection method were performed 14-180 days after the onset of the infarction. The rCBF functional image was made up from the data of 133Xe dynamic images measured by an Anger-type gamma camera and the rCBF values were calculated by the initial slope method. The average value of mean rCBFs (mCBF) in 10 patients was 44.9 +/- 7.1 ml/100g/min (average PaCO2; 39.9 +/- 4.3 mm Hg). In the rCBF functional images, a focal hypoperfusion area was observed in all cases and localized around the central sulcus, especially in the precentral and central areas. Significant decreases of mCBF and the tendency to decrease of the rCBFs in the hypoperfusion focus were noted in the patients with the larger infarcts in comparison with those with the smaller ones. These results suggest that a small, deep ischemic lesion such as a capsular infarct may have remote effects on the ipsilateral cortical circulation, due probably to the damage of a number of fibers passing through the lesion. PMID- 3966269 TI - Hemispheric blood flow in the rat after unilateral common carotid occlusion: evolution with time. AB - Acute occlusion of one common carotid artery in the anesthetized normocapnic rat results in a moderate cerebral blood flow (CBF) decrease in both cerebral hemispheres. No asymmetrical perfusion is observed when the overall flow in each hemisphere is considered. The increase in blood flow which normally occurs in hypercapnia is strongly impaired in the cerebral hemisphere on the occluded side resulting in an important asymmetrical hemispheric perfusion. The days (1, 5, 15, 30) following unilateral carotid occlusion normal control CBF values are found in both hemispheres in normocapnic conditions. Hemispheric perfusion asymmetry in hypercapnia also becomes progressively less pronounced with time but a slight asymmetry still persists one month after unilateral carotid occlusion. PMID- 3966270 TI - Sympathetic nerve activity: a link to stroke? AB - Spontaneously hypertensive rats (SHR) have been shown to have an increased capacity for superior cervical sympathetic nerve activity which may protect against stroke (Mueller et al: Stroke 13: 115, 1982). Sympathetic nerve activity has never been examined in the stroke-prone substrain of SHR (SP). In this study we measured superior cervical sympathetic nerve activity during rest and during a maximal sympathetic response in SHR, SP, and their normotensive controls, Wistar Kyoto (WKY). The resting superior cervical sympathetic nerve activity of SP was significantly less than SHR (p less than 0.02) but not different from WKY. During central ischemia, used to induce maximal sympathetic response, the increase in SP sympathetic nerve activity was significantly less than SHR (p less than 0.001) but was not different from WKY. This diminished capacity for elevated superior cervical sympathetic nerve activity in stroke-prone SHR may relate to their increased predisposition to stroke because sympathetic hyperactivity cannot protect cerebral vessels during acute hypertension. PMID- 3966271 TI - Cerebral infarction in rats using homologous blood emboli: development of a new experimental model. AB - A reproducible model of thromboembolism in the rat was developed and the temporal relationship between hydrogen clearance, regional cerebral blood flow (rCBF) and power spectral-analyzed electroencephalographic (EEG) activity explored for up to four hours postinsult. Sixteen rats were subjected to right internal carotid artery homologous blood embolization after electrocautery of the pterygopalatine artery. Four rats were subjected to sham operation. Cerebral angiography before and for up to four hours postinsult was used to verify the distal migration and fragmentation of the emboli. Preembolic mean rCBF was 62 +/- 9 ml . 100g-1 . min 1 and 65 +/- 12 ml . 100g-1 . min-1 in the embolized and contralateral sides, respectively. Based upon the distribution of the emboli at sacrifice, the experimental group of 12 rats fell into three subgroups: unilateral proximal embolism, n = 8; unilateral peripheral embolism, n = 3; and bilateral proximal embolism, n = 1. In unilateral proximal embolism the mean rCBF in the embolized hemisphere ranged between 10 and 20 ml . 100g-1 . min-1 and correlated well with changes in EEG power spectra. In unilateral peripheral embolism, the mean rCBF in the embolized hemisphere fell significantly 30 min postembolism. It returned progressively towards preembolic values as the embolic clots migrated distally and fragmented. Despite the restoration of rCBF, recovery of EEG activity appeared to be delayed. Our results did not show luxury perfusion after embolic insults. The time course for the reopening of the embolized artery and the delay in recovery of neuronal function (i.e., EEG activity) relative to the restoration of rCBF are discussed. PMID- 3966272 TI - Long-term assessment of cerebral perfusion following STA-MCA by-pass in patients. AB - A prospective study of mean hemispheric cerebral blood flow (CBF) correlated with clinical status has now been completed for the past 54 months. Thirty-eight patients underwent superficial temporal to middle cerebral artery (STA-MCA) by pass. They were compared with 22 patients with similar arteriographic lesions and clinical symptoms, treated medically throughout the same interval of time. Assignment to either treatment group was not randomized but depended solely on choice of patient or treating physician. Both groups were matched for age, clinical symptoms, angiographic abnormalities, and CBF values. All patients had proximal occlusion of one internal carotid artery or intracranial occlusive disease of the internal carotid or middle cerebral arteries. CBF measurements and clinical evaluations were repeated at regular intervals up to 54 months following surgery or institution of medical treatment. Mean follow up interval after STA MCA by-pass was 28.7 months and for medical treatment was 29.7 months. Mean hemispheric CBF values for STA-MCA patients became significantly increased 2 weeks after operation. After that, CBF flow values decreased. At 24 months after surgery, flow values for surgically treated patients were significantly higher than among those treated medically, although there were no differences in flow values between the two groups at 3, 6, 12, 36 and 48 months. Prospective clinical evaluations after STA-MCA by-pass were as follows: 12 (32%) improved with cessation of TIAs and/or neurological improvement, 16 (42%) remained unchanged, 7 (18%) deteriorated (due to new or recurrent strokes) and 3 (8%) expired. Clinical results were the same for medical treatment: 6 (27%) improved, 10 (46%) unchanged, 4 (18%) deteriorated due to new or recurrent stroke, and 2 (9%) expired. PMID- 3966273 TI - Correlation between cellular ATP level and bile excretion in the rat liver. AB - The influence of the cellular level of adenosine triphosphate (ATP) in the liver on bile excretion was studied in rats. In ischemia, the cellular ATP level decreased rapidly--and, concomitantly, bile flow stopped within 5 min. Administration of L-ethionine i.p. to rats reduced the bile flow rate with decrease in the cellular ATP level. The correlation between the bile flow rate and the cellular ATP level was confirmed in a liver perfusion system. On anoxic perfusion, the ATP level and bile flow rate changed in the same manner as in ischemia. The recovery rates of both on reoxygenation decreased with increase in the anoxic perfusion period. During perfusion under oxygenated conditions, decrease in cellular ATP to various levels by infusion of various concentrations of potassium cyanide, an inhibitor of respiration, resulted in corresponding and concomitant suppression of bile excretion. Kinetic analysis of the bile flow rate revealed a Michaelis-Menten-type curve for the cellular ATP level. The apparent Kms for ATP of bile flow rate in L-ethionine-treated rat liver and liver perfused with potassium cyanide were 1.0 and 1.6 mM, and their Vmax values were 4.1 and 2.5 microliter/min/g liver, respectively. The concentrations of main bile components, such as phospholipids, cholesterol, and taurocholate increased, but their total outputs decreased with decrease in the ATP level, and returned to the normal range with recovery of the ATP level. Thus, it was shown experimentally that the extent of hepatic injury can be assessed simply by monitoring the bile flow rate, which reflects the cellular level of ATP. PMID- 3966274 TI - Adrenal "incidentalomas". Need for surgery. AB - A series of eleven adrenal tumors is presented. Only one of the adrenal tumors showed evidence of endocrine function while eight tumors were incidentally discovered during radiologic evaluations. Surgical exploration was performed in all cases as the final diagnostic measure. There were four malignancies, three nonfunctioning carcinomas, and one neuroblastoma. Two of the four malignancies were discovered incidentally on radiologic evaluation and were considered preoperatively to be benign cystic lesions by radiographic criteria. One benign adrenal hamartoma was diagnosed preoperatively as an adrenal carcinoma. In view of the questionable accuracy of radiologic diagnosis of adrenal masses and the well-documented difficulty in differentiating adrenal adenomas from carcinomas on histologic grounds, consideration should be given to the surgical exploration and excision of all adrenal masses discovered incidentally. PMID- 3966275 TI - Renal arteriovenous fistula following nephrectomy. AB - Three cases of postnephrectomy renal arteriovenous fistula are described. A review of the literature shows the rarity of this complication since only 62 cases (including the author's cases) are known. Reported cases have been recognized after intervals up to forty years. The major complication is cardiac failure. Surgical treatment gives satisfactory results, but nonsurgical closure has now become possible. Early diagnosis is easy by auscultation of the loin which constantly reveals a continuous bruit. PMID- 3966276 TI - Spontaneous rupture of hydronephrotic renal pelvis with massive hemorrhage. AB - Spontaneous rupture of a hydronephrotic renal pelvis with massive hemorrhage presents as a perplexing diagnostic challenge to the urologist. The preoperative distinction between this condition and spontaneous rupture of the kidney (Wunderlich disease) may prove uncertain or equivocal despite the application of exhaustive diagnostic modalities. Surgical intervention should follow initial stabilization, and nephrectomy has been the procedure of choice. PMID- 3966277 TI - Results of urometabolic evaluation in 127 patients with renal calculous disease. AB - One hundred twenty-seven selected stone formers were evaluated. With the simple ambulatory tests proposed by Pak for metabolic screening and a complete urologic evaluation an anomaly was found in more than 90 per cent of the cases. The patients were divided into three groups: (1) patients operated on for staghorn stones; (2) patients with episodes of spontaneous stone eliminations or young people with only one stone episode; and (3) patients operated on for stone disease. No significant differences were noted except for the occurrence of urinary tract infection and for struvite and calcium oxalate occurrence in the different groups. Urinary tract infection combined with a metabolic disorder appear to make the evolution from small kidney stone to staghorn stone a reality. PMID- 3966278 TI - Augmentation ileocystoplasty in neuropathic bladder. AB - Augmentation cystoplasty is a viable treatment modality in patients with neuropathic bladder. Indications include incontinence despite pharmacologic manipulation, persistent hydroureteronephrosis, vesicoureteral reflux, and propantheline bromide intolerance. Eight patients have had augmentation cystoplasties, with all obtaining normal bladder capacity, intravesical pressure, and voiding frequency. Reflux and hydronephrosis have been eliminated or significantly reduced in those patients who had experienced those problems prior to augmentation. Four cases are presented. PMID- 3966279 TI - Complications from external (condom) urinary drainage devices. AB - External urinary drainage devices are usually considered safe and are in wide clinical use. There are only a few reports of complications arising from their improper use. We present 6 patients who suffered major complications from external condom drainage at home. The etiology and preventive measures are discussed. PMID- 3966280 TI - Acid phosphatase levels of irrigant solution during transurethral prostatectomy. AB - The acid phosphatase level of irrigant solution used during transurethral prostate resections was measured in 20 patients. The mean acid phosphatase of the irrigant solution was 45.3 IU/L (S.D. 50.7). The degree of elevation of irrigant acid phosphatase was related to the weight of tissue resected, the duration of the resection, and the total volume of irrigant used. A transient elevation of serum acid phosphatase occurred postoperatively which was associated with the level of urinary acid phosphatase elevation and the amount of absorbed irrigant solution based on changes in serum sodium. PMID- 3966281 TI - Vacuum cleaner injury to penis: a common urologic problem? AB - Erotic stimulation by the use of vacuum cleaners or electric brooms appears to be a common form of masturbation. Unfortunately, and contrary to apparent public appreciation, injury due to this form of autostimulation may not be unusual. Five cases of significant penile trauma resulting from this form of masturbation are presented, with a spectrum of severe injuries, including loss of the glans penis. PMID- 3966282 TI - Intubated cutaneous ureterostomy: option for high-risk patients needing supravesical urinary diversion. AB - Failure of primary healing between ureter and skin has led to numerous complications and the virtual abandonment of cutaneous ureterostomy. When an indwelling double-J stent can be maintained, primary healing occurs and good ureterocutaneous anastomoses result. Ostomy training is only slightly more difficult than in patients with an ileal conduit urinary diversion and has presented no major problems. We now favor cutaneous ureterostomy in selected high risk patients because of the lesser magnitude of this form of supravesical urinary diversion and, especially, because intubation has overcome most of the complications of this procedure. PMID- 3966283 TI - Nonhormonal mechanism of sexual inadequacy in patients with varicocele. AB - Ten normal men and 45 patients with varicocele (with or without sexual complaints) had evaluation of plasma androgen levels. Except for those with reduced libido, no differences were observed among the groups. These findings suggest a nonhormonal mechanism responsible for the erectile disturbances observed in some patients with varicocele. PMID- 3966284 TI - Unilateral ureteral obstruction secondary to sarcoidosis. AB - An episode of unilateral ureteral obstruction secondary to sarcoidosis is described. Corticosteroid treatment resulted in prompt and complete resolution of the obstruction and associated lymphadenopathy. We believe this represents the first reported case of ureteral obstruction secondary to sarcoidosis. PMID- 3966285 TI - Adenocarcinoma of gallbladder presenting as ureteral obstruction. AB - A fifty-five-year-old man presenting with unilateral renal colic and ureteral obstruction was found to have ureteral metastasis from a primary gallbladder carcinoma. This appears to be the second report of such a case in the English literature. PMID- 3966287 TI - Management of vesicouterine fistula following cesarean section. AB - Contrary to belief, urinary incontinence in vesicouterine fistulas following cesarean section is as common as cyclic hematuria with apparent amenorrhea. Review of the English literature revealed 21 cases and herein is added a new case. The presentations and management of such cases are discussed. PMID- 3966286 TI - Squamous cell carcinoma of scrotum. AB - Squamous cell carcinoma of the scrotum is a rare malignancy in the United States. This series includes the eighth reported case of this lesion in a black American. Surgery still remains the only effective therapeutic modality. The use of sentinel and superficial inguinal node biopsies was important in determining whether or not radical ilioinguinal lymphadenectomy was needed in 2 patients. PMID- 3966289 TI - Rupture of prostatic urethral valves via vesicostomy. PMID- 3966288 TI - Ureterocutaneous fistulas secondary to urinary calculous disease. AB - Fistulas of the ureter are uncommon and are usually secondary to trauma or iatrogenic in nature. Spontaneous rupture of the ureter is rare, usually ending in a periureteral abscess. Two cases of spontaneous rupture of the ureter secondary to calculous disease resulting in ureterocutaneous fistulas are described. PMID- 3966290 TI - Simple method for reduction of paraphimosis. PMID- 3966291 TI - Placement of Foley catheter for perineal urethrostomy by Seldinger technique. PMID- 3966292 TI - A new device for measuring penile rigidity. PMID- 3966293 TI - Coccidioidomycosis of prostate. AB - A rare case of coccidioidomycosis of the prostate is described. This case appears to be the ninth case of clinically diagnosed prostate coccidioidomycosis in the literature. The presence of extragenital site involvement was associated with a high rate of mortality. PMID- 3966294 TI - Further studies on specificity of red cell adherence test: nonmalignant bladder lesions. AB - Specific red cell adherence test for blood group antigens was utilized in 32 nonmalignant bladder lesions, none of which was associated with bladder cancer, to determine the specificity of this test. All of the 14 lesions of cystitis cystica, cystitis glandularis, and chronic cystitis retained their antigens. Of the 18 lesions of squamous metaplasia, 13 (72%) were antigen positive. Testing for blood group antigens showed an overall 84 per cent specific rate in 27 of the 32 nonmalignant bladder lesions. PMID- 3966295 TI - Value of scrotal scanning. Report of 62 cases. AB - A review of sixty-two technetium scrotal scans performed over a one-year period has led to a classification of pathologic states based on the degree of uptake of the radioactive isotope. Absent uptake, or a "cold" scan, is present only with testicular torsion, and rarely with avascular tumors. Increased uptake, or a "hot" scan, is most commonly seen with inflammatory conditions such as acute epididymitis and orchitis, and less commonly with tumor. "Mixed" scans can be associated with abscess, tumor with necrosis, trauma, and late torsion. PMID- 3966296 TI - Concept of vesicoureteral reflux. PMID- 3966297 TI - Antigenic variants of CVS rabies virus with altered glycosylation sites. AB - The virion-associated glycoprotein of the CVS-11 strain of rabies virus exists in two forms, GI and GII, which differ in their carbohydrate content. The structural relationship between GI and GII is investigated in order to account for the difference in glycosylation. Partial sequence analysis and mapping of tryptic glycopeptides isolated from the parent CVS-11 GI and GII glycoprotein forms revealed that two of the three predicted glycosylation sites (at Asn-204 and Asn 319) were utilized in the GI form whereas only one of these two sites (at Asn 319) was utilized in the GII form. One predicted glycosylation site (at Asn-37) was not utilized in either species. In the variant virus, RV231-22, a single glycoprotein species was detected which corresponded in electrophoretic mobility to the GI form of the parent virus. Nucleotide sequence analysis of the variant glycoprotein gene revealed a base mutation which specifies an amino acid change six residues upstream from the predicted glycosylation site at Asn-204. This single amino acid substitution apparently results in utilization of the signal at Asn-204 in the GII form of RV231-22 virus. The amino acid substitution is discussed in relation to altered conformation. In the variant virus RV194-2 (F3), both GI and GII glycoprotein forms were present, but each revealed slower electrophoretic mobilities compared with the corresponding parent glycoprotein forms in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). An extra glycosylation site was identified in both glycoprotein forms of this variant virus. PMID- 3966298 TI - Cell surface receptors for murine leukemia viruses: two assays and their implications. AB - Two assays were developed for identifying individual cells which bear murine leukemia virus receptors: an erythrocyte rosette assay for ecotropic receptors, and an efficient immune cytotoxic assay for cells with ecotropic or amphotropic receptors. Both assays indicate that ecotropic MuLV adsorbed to its cell surface receptor only slowly becomes internalized. Furthermore, attempts to isolate murine fibroblast variants lacking these ecotropic MuLV receptors were unsuccessful, suggesting either that mutations in the receptor gene are rare (less than 10(-7) per generation) or that the receptor is required for cell viability. These assays are rapid and can be used to identify receptor-bearing cells in mixed populations, a prerequisite for molecular genetic studies. PMID- 3966299 TI - Mapping the 5' ends, 3' ends, and splice sites of mRNAs from the early E3 transcription unit of adenovirus 5. AB - Using nuclease gel analyses, the sites in the approximately 4000 nucleotide (nt) E3 transcription unit of adenovirus 5 (Ad5) that encode the 5' ends, 3' ends, and 5' and 3' splice sites of the approximately 10 E3 mRNAs were determined. Transcription initiation of all mRNAs occurs at two major (nt 1 and 8) and approximately two minor sites, situated 20-30 nt 3' to a TATA box. There are two major 3' end sites (nt 2227 and 3308), located approximately 20 nt downstream from ATTAAA and an AATAAA sequences, respectively. Thus, ATTAAA, as well as the usual AATAAA, apparently can function as a 3' end signal. There are two 5' splice sites (nt 372 and 923), both with GT at the intron boundary. There are four 3' splice sites (nt 766, 1817, 2201, and 2880), all with AG at the intron boundary. The nt 1817, 2201, and 2880 3' splice sites are located immediately upstream from open reading frames, such that splicing at the different sites allows synthesis of completely different proteins. PMID- 3966300 TI - Urinalysis: the physician's responsibility. AB - Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract disease is absent, at least within the limitations of the examination. Performing a urinalysis takes no more than 10 minutes, is relatively inexpensive and requires minimal training in proper techniques. PMID- 3966302 TI - Pulmonary interstitial emphysema. PMID- 3966301 TI - Entrapment neuropathies of the upper extremity. AB - Entrapment neuropathies occur in a number of different but predictable locations in the upper extremity. These neuropathies can produce a spectrum of sensory and motor deficits in the hand and upper extremity. A careful clinical examination in conjunction with electromyography and nerve conduction velocity studies can usually delineate peripheral nerve dysfunction. Prognosis depends on the degree of nerve injury, which is related to both the cause and the duration of the entrapment. PMID- 3966303 TI - Salpingitis and pelvic inflammatory disease. AB - Chlamydia trachomatis is becoming an increasingly important etiologic agent. The physician must also be aware of other nongonococcal causes of pelvic inflammatory disease, such as Mycoplasma, Ureaplasma, coliforms and anaerobes. Epidemiologic characteristics of the various microorganisms differ, with the frequency of nongonococcal disease higher in older women. Intrauterine devices increase the potential for pelvic inflammatory disease. The rising incidence of nongonococcal and dual infections has led to therapeutic and preventive techniques aimed at multiple etiologies. PMID- 3966304 TI - Sexuality in cancer patients. AB - The sexual concerns of patients with cancer may be overlooked during the acute stage of illness. Both the general stress of hospitalization and the specific threat of surgery can affect sexuality. Breast cancer and cancer of the reproductive organs cause the most concern, although other tumors can be as devastating. "Ostomies" and limb amputations raise special questions, and radiation therapy affects sexual and reproductive function. Underlying depression has a profound effect. PMID- 3966305 TI - Home and nursing home care of the dependent elderly patient. AB - The factors that make an elderly person at risk for increased dependency and institutionalization are becoming more clearly defined. Family physicians should be familiar with the potential sources of support that can maintain increasingly dependent older persons in their own homes. A nursing home placement requires careful consideration to ensure appropriate placement and continuing family involvement in the life of the nursing home resident. PMID- 3966306 TI - Medical psychotherapy. AB - Medical psychotherapy is often practiced by family physicians unknowingly. It shares certain features with all other forms of psychotherapy, but it also possesses its own unique qualities. Medical psychotherapy represents combinations of techniques, learned largely by experience, that are useful in treating the patient in crisis, as well as the patient with chronic psychiatric or physical illness. It contributes to higher quality medical care. PMID- 3966307 TI - Congenital complete heart block. AB - Recent studies have demonstrated immunologic abnormalities in the mothers of infants with congenital complete heart block. The disorder should be suspected when a slow pulse rate is detected before or after birth. The block most often occurs in the AV node. There are several specific indications for pacemaker therapy. Most patients who survive beyond infancy are able to lead relatively normal lives. PMID- 3966308 TI - Irritable bowel syndrome: treatment update. AB - Patients with irritable bowel syndrome may be classified as "psychologic reactors," "food reactors" or "mixed reactors." The management approach is tailored to the reactive pattern. Education and reassurance are paramount in the management of irritable bowel syndrome. Psychologic reactors may benefit from antidepressant therapy, psychotherapy, relaxation training and biofeedback. Eliminating offending foods from the diet may provide relief in food reactors. Regular exercise may be especially salutary in patients with constipation. PMID- 3966309 TI - The value of biopsy in inflammatory skin diseases. PMID- 3966310 TI - Nitrous oxide analgesia for outpatient procedures. AB - Nitrous oxide analgesia is a safe alternative to parenteral narcotics for outpatient surgical procedures. This type of analgesia is effective, well tolerated by most age groups, easily administered, rapidly reversible and associated with a low incidence of serious side effects. Hypoxia can be prevented by using fail-safe equipment, by observing prescribed limitations on nitrous oxide concentrations and by administering 100 percent oxygen on termination of nitrous oxide administration. PMID- 3966311 TI - Ocular toxicity of systemic drugs. PMID- 3966312 TI - Correlations of systolic time intervals and radionuclide angiography at rest and during exercise. AB - Systolic time intervals (STI) were correlated with radionuclide angiography studies (RAS) in 57 patients at rest, during maximal semisitting bicycle exercise, and at 4 minutes following the cessation of exercise. Eleven were judged as being free of coronary artery disease (group 1), while 14 had coronary artery disease without (group 2A), and 27 (group 2B) with a previous transmural myocardial infarction. For RAS, resting radionuclide ejection fraction (REF), the changes in REF and end-systolic volume, and the development of a wall motion abnormality at peak exercise were each highly correlated with the presence of coronary disease (p less than 0.001). The accuracy of STI parameters in predicting the presence of coronary disease was poor (less than 60%). Changes in end-diastolic volume (EDV) correlated significantly with PEP/LVET and LVET1 changes following exercise. Moreover, patients with an abnormal (greater than 25%) increase in EDV at peak exercise had a greater increase in LVET1 in the postexercise period (p less than 0.01). We conclude that STI is not accurate enough a predictor of coronary disease or left ventricular function to serve as a useful screening test. Changes in STI parameters appear to be more related to changes in ventricular volume than to ventricular function. PMID- 3966313 TI - Cardiac pacing in children: a 15-year experience. PMID- 3966314 TI - Paroxysmal nonreentrant tachycardia due to simultaneous conduction via dual atrioventricular nodal pathways. PMID- 3966315 TI - Junctional ectopic tachycardia in an infant: electrophysiologic evaluation. PMID- 3966316 TI - Successful surgical treatment of left atrial tachycardia. PMID- 3966317 TI - Sinus arrest and hypotension with combined amiodarone-diltiazem therapy. PMID- 3966318 TI - Torsade de pointes and magnesium deficiency. PMID- 3966319 TI - Torsade de pointes: a maximal vulnerability arrhythmia. PMID- 3966320 TI - Two-dimensional echocardiographic appearance of pseudo-dehiscence of Hancock aortic prosthesis. PMID- 3966321 TI - Aortic valve ring abscess: two-dimensional echocardiographic features leading to valve replacement. PMID- 3966322 TI - Noninvasive diagnosis of mirror-image dextrocardia with thoracic-abdominal discordance. PMID- 3966323 TI - Successful surgical repair of absent pulmonary valve syndrome in infancy. PMID- 3966324 TI - Congenital right-sided diaphragmatic hernia and hypoplastic left heart syndrome. PMID- 3966325 TI - Persistent intracardiac thrombi and systemic embolization despite anticoagulant therapy. PMID- 3966327 TI - A new device for detection of postural ST-T changes in ambulatory electrocardiography. PMID- 3966326 TI - The importance of two-dimensional echocardiography in identification and assessment of the left atrium. PMID- 3966328 TI - Early angiography after myocardial infarction: what have we learned? PMID- 3966329 TI - Treatment with oral lorcainide in patients with sustained ventricular tachycardia and fibrillation. AB - Fifty patients with drug-refractory (failed 7 +/- 2 other drug trials) sustained ventricular tachycardia or fibrillation were treated with oral lorcainide. Twenty three patients underwent programmed stimulation both before and after oral lorcainide, and all 23 remained inducible, although ventricular tachycardia cycle length was prolonged and mean arterial pressure was higher. Lorcainide was discontinued in 23 patients prior to hospital discharge because of death in four patients, side effects in five patients, spontaneous clinical arrhythmia recurrence in six patients, and ventricular tachyarrhythmias induced at electrophysiologic study in eight patients. Twenty-seven patients were discharged on an average dose of 169 +/- 56 mg twice a day, including 15 in whom ventricular tachycardia remained inducible. During long-term follow-up the drug was discontinued in 15 patients; three because of side effects, three because of clinical nonfatal arrhythmia recurrence, two who selected other alternative therapy, and seven patients who died suddenly due to ventricular tachyarrhythmias. Twelve patients remain on long-term lorcainide. The actuarial 1 year chance of being arrhythmia free was 38.9%, and 1-year cardiovascular and arrhythmia survival rates were 56.8% and 60.4%, respectively. Based on our data we conclude that: In this extremely drug-resistant patient population the clinical efficacy of lorcainide is low; lorcainide should not be used empirically in such highly drug-resistant patients; persistent ventricular tachyarrhythmia inducibility at electrophysiologic study implies a poor prognosis in patients treated with oral lorcainide; the incidence of becoming noninducible during oral lorcainide therapy in highly drug-resistant patients appears low; and for patients in whom the drug seems partially beneficial it could be used in conjunction with a backup automatic implantable cardioverter/defibrillator. PMID- 3966330 TI - Long-term lorcainide therapy in patients with ventricular tachycardia. AB - One hundred patients inducible at electrophysiologic studies underwent serial drug testing with procainamide, lidocaine, and lorcainide to determine comparative efficacy. Acute intravenous administration was followed by repeat programmed electrical stimulation (PES) studies on separate days for each antiarrhythmic drug. Lorcainide prevented ventricular tachycardia (VT) induction in 69% of the 100 patients studied, procainamide was effective in 50% of the 75 patients studied, and lidocaine prevented VT induction in 30% of 53 patients. Following PES and serial drug testing, 46 patients were started on lorcainide, nine patients on procainamide, and 45 patients were started on other antiarrhythmic drug regimens. Seventy percent of the patients have remained on lorcainide therapy, while 47% have continued on other drug therapies started over a 20.5 +/- 3.2-month mean follow-up period. Despite sleep-wake disturbances and a need for sedation at night, lorcainide therapy was tolerated well in this population and remained an effective antiarrhythmic with prolonged administration. PMID- 3966332 TI - Electrophysiologic effects of unilateral right and left stellate ganglion block on the human heart. AB - To determine the electrophysiologic effects of stellate ganglion (SG) block on the human heart, the two SGs were anesthetized separately, with a 24-hour interval between the two procedures, in 13 patients with episodes of supraventricular tachycardia (six had Kent bundles). Left SG block caused: (1) a lengthening of the AH interval, measured at fixed atrial rates of 10 +/- 12 msec (p less than 0.01); (2) a marked depression of the VA conduction in six of the seven patients with measurable VA interval (in two patients it produced complete VA block); (3) a slowing of 20 to 40 msec of the cycle of an electrically induced reciprocating tachycardia; and (4) failure to modify the QT interval duration. In contrast, right SG block produced asymmetric or opposite changes and prolonged the QT interval (7.6 +/- 8.8 msec, p less than 0.05). Atrial and ventricular refractoriness was not significantly altered by SG block. Retrograde effective refractory period of the Kent bundle changed 20 to 60 msec after unilateral SG blockade. Thus, this study suggests that the human conduction system and the Kent bundles receive an appreciable sympathetic influence from the SG. Like experimental studies, we also found an asymmetric response to unilateral SG block and a dominance, in most of our patients, of the left SG. The influence on myocardial refractoriness was less apparent. PMID- 3966331 TI - Hemodynamic effects of intravenous flecainide relative to the level of ventricular function in patients with coronary artery disease. AB - Flecainide, a new antiarrhythmic agent with poorly defined hemodynamic actions, was studied in 22 patients with coronary artery disease. Intravenous infusions of 1 mg/kg and 2 mg/kg resulted in respective increases in right atrial pressure (12%, p less than 0.05; 15%, p less than 0.01), mean pulmonary artery pressure (27%, p less than 0.01; 28%, p less than 0.01), and pulmonary capillary wedge pressure (44%, p less than 0.05; 33%, p less than 0.01). Cardiac index decreased 8% (p less than 0.05) after 1 mg/kg flecainide and 12% (p less than 0.05) after the 2 mg/kg dose. The mean left ventricular ejection fraction decreased by 15% (p less than 0.01) and 16% (p less than 0.01), respectively, 10 minutes after 1 mg/kg and 2 mg/kg of flecainide. Minimal increases in the heart rate (less than 5%) and no significant change in arterial pressure occurred 5 to 10 minutes after flecainide and were associated with borderline and variable increases in pulmonary and systemic vascular resistances. Flecainide diluent did not induce changes in pulmonary capillary wedge pressure or left ventricular ejection fraction. Thus, flecainide exerts a moderate but significant negative inotropic effect which may be clinically significant in patients with severely compromised ventricular function. PMID- 3966333 TI - Effects of nifedipine on baroreflex modulation of vascular resistance in man. AB - Studies in animals have demonstrated that, in addition to their vascular effects, calcium channel blockers have important effects on baroreceptor function. We performed a series of experiments to determine if nifedipine, in doses employed clinically, alters baroreflex control of vascular resistance in normal humans. Forearm vasoconstrictor responses of 14 normal subjects to unloading of baroreceptors with lower body negative pressure (LBNP), to a cold pressor test and during intra-arterial infusions of norepinephrine were studied in the control state and following administration of nifedipine. Nifedipine had no effect on baseline mean arterial pressure or central venous pressure. Heart rate and forearm blood flow (FBF) increased significantly following nifedipine: heart rate = 59.7 +/- 2.4 bpm before and 72.6 +/- 4.4 bpm after nifedipine (mean +/- SE, p less than 0.001, n = 14); FBF = 4.6 +/- 0.4 ml X min-1 X 100 ml-1 before and 6.7 +/- 1.0 ml X min1 X 100 ml-1 after nifedipine (p less than 0.02, n = 14). Forearm vascular resistance (FVR) tended to decrease following nifedipine but the difference was not significant: FVR = 21.1 +/- 1.4 units before and 17.8 +/- 2.3 units after nifedipine (p = 0.07, n = 14). Nifedipine attenuated forearm vasoconstrictor responses to cold pressor stimulus: delta FVR during cold pressor test = +10.3 +/- 2.4 units before and +4.7 +/- 1.4 units after nifedipine (p less than 0.02, n = 14). Likewise, nifedipine depressed vasoconstrictor responses to intra-arterial infusion of norepinephrine: delta FVR during norepinephrine = +15.5 +/- 3.4 units before and +10.2 +/- 2.9 units after nifedipine (p less than 0.05, n = 7).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966334 TI - Transient myocardial ischemia with minimal electrocardiographic changes: an echocardiographic study in patients with Prinzmetal's angina. AB - Kn patients with Prinzmetal's angina, episodes of transient T wave abnormalities (T abn) are often documented in addition to the typical episodes of ST segment elevation (ST). As the interpretation of these minor ECG changes is still uncertain, we investigated if transient T abn are associated with reversible ventricular asynergies, similar to episodes with ST. For this purpose an ECG lead and a two-dimensional echocardiographic projection, which showed clear-cut changes during previous episodes of ST, were simultaneously monitored in five patients with Prinzmetal's angina for a total of 13 hours and 20 minutes. In all patients, the 30 episodes of ST recorded were all accompanied by reversible ventricular asynergies. Furthermore, in four of these patients, 14 episodes of T abn (peaking, flattening, or the appearance of a diphasic T wave) were recorded. All T abn were associated with reversible asynergies, as detected by three independent observers. The mechanical impairment occurred in the same ventricular wall both during ST and during T abn. During T abn the degree of mechanical impairment appeared less severe (hypokinesia in 12 and akinesia in two episodes) than during ST (hypokinesia in one, akinesia in 25, and dyskinesia in four episodes) (p less than 0.001). The duration of asynergies was less during T abn (107 +/- 76 seconds) than during ST (169 +/- 83 seconds) (p less than 0.05). Chest pain was reported in 5 of 14 episodes of T abn (36%) and in 20 of 30 (66%) episodes of ST (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966335 TI - Postinfarction sudden death: significance of inducible ventricular tachycardia and infarct size in a conscious canine model. AB - The relationship between inducible ventricular tachycardia in the convalescent phase of myocardial infarction and subsequent spontaneous ventricular fibrillation is uncertain. Thirty conscious instrumented dogs underwent programmed ventricular stimulation 5 days after anterior infarction; 15 had inducible ventricular tachycardia and 15 were noninducible. Following programmed ventricular stimulation, the application of a 150 uA current to the intima of the proximal circumflex artery initiated intimal damage, thrombosis, and acute ischemia of the posterolateral wall. After 20 minutes of ischemia, 73% inducible and 15% noninducible animals developed ventricular fibrillation (p less than 0.005) without previous hypotension. At 24 hours, 7% inducible and 85% noninducible animals survived (p less than 0.001). Anterior infarct size (percentage of left ventricular mass) was much larger in inducible (24.7 +/- 1.7%) than in noninducible (5.3 +/- 1.1%) (p less than 0.001) animals. Inducible ventricular tachycardia following infarction was highly predictive of spontaneous ventricular fibrillation during a later ischemic episode in this model. The mass of previously injured myocardium was a critical determinant of both. PMID- 3966337 TI - Value of two-dimensional echocardiographic detection of incomplete mitral leaflet closure. AB - The echocardiographic pattern of incomplete mitral leaflet closure (IMLC) is reported to be present in about 90% of patients with acute myocardial infarction and new onset of mitral regurgitation. To determine the significance of this echocardiographic sign, we retrieved all echocardiograms containing this abnormality from a file of 1200 consecutive echocardiograms. Seventy-three echocardiograms manifested IMLC. We also studied a control group consisting of 52 patients without IMLC, but who were matched with the IMLC group with respect to a range of left ventricular (LV) diameters at end diastole and fractional shortening. The following was found in the control group: fewer wall motion abnormalities per patient, less frequent mitral "B bumps," and a smaller LV end diastolic dimension (LVEDD) (p less than 0.05 for each comparison). By logistic regression, the variable most important to the probability of having IMLC was the presence of mitral valve "B bumps." We conclude that: (1) elevated left ventricular filling pressure is associated with IMLC and (2) IMLC is not specific for the subset of patients with papillary muscle dysfunction due to acute myocardial infarction. Rather, IMLC is commonly seen in association with dilated, usually ischemic cardiomyopathy. PMID- 3966336 TI - Evaluation of the association of mitral valve prolapse in patients with Wolff Parkinson-White type ECG and its relationship to the ventricular activation pattern. AB - The association of mitral valve prolapse (MVP) and Wolff-Parkinson-White (WPW) syndrome was examined using simultaneous two-dimensional and M-mode echocardiography. Twelve-lead electrocardiograms (ECGs) and two-dimensional echocardiograms (2DEs) were recorded in 24 patients with WPW. The location of the accessory pathway was predicted from the ECG as being in one of 10 possible sites correlating the delta wave polarity with epicardial mapping. Nineteen of the 24 patients had conduction via the accessory pathway and five were conducting normally during the recording of the echocardiogram. Mitral valve prolapse was found in 13 of 19 patients conducting via the accessory pathway. The only WPW patient with mitral valve prolapse during normal conduction had a chest deformity which has an independent association with mitral prolapse. No association was found between the prediction of the accessory pathway and the presence of mitral prolapse. We concluded that consideration should be given to the possibility that some patients demonstrating MVP do so as the result of the altered sequence of ventricular activation, rather than as the result of a structural abnormality. PMID- 3966338 TI - Myocardial catecholamine balance during angina: effects of calcium entry blockers, verapamil and nifedipine. AB - To evaluate the effects of calcium entry blocking agents on cardiac sympathetic tone during angina pectoris, arterial and coronary sinus (CS) norepinephrine (NE) and epinephrine (E) concentrations and CS blood flow were determined at rest and during pacing-induced angina, both before and after verapamil in nine patients and after nifedipine in nine patients, all of whom had fixed obstructive coronary artery disease. Resting arterial NE and E concentrations and myocardial NE release and E uptake remained unchanged during angina before verapamil and nifedipine, suggesting unaltered systemic and cardiac sympathetic tone and myocardial E handling. Following verapamil and nifedipine, arterial NE and E concentrations remained unchanged. After verapamil, net myocardial NE release increased from 16,072 +/- 18,881 to 35,520 +/- 30,595 at preverapamil angina rate (p less than 0.01) and to 39,643 +/- 29,728 pg/min at postverapamil angina rate (p less than 0.01). NE release after nifedipine increased from -4207 +/- 8898 to 10,988 +/- 30,711 (p less than 0.05) at prenifedipine angina rate and to 19,942 +/- 26,644 pg/min (p less than 0.05) at postnifedipine angina rate. NE release was independent of changes in CS flow after verapamil or nifedipine. E uptake after verapamil and nifedipine remained unchanged. Although the precise mechanism is not known, myocardial alpha-adrenergic receptor blockage with verapamil and nifedipine remains a possible explanation for increased myocardial NE release. PMID- 3966339 TI - The effect of dextro-, levo-, and racemic verapamil on atrioventricular conduction in humans. AB - To study the dromotropic effects of dextro(D)- and levo(L)-verapamil on atrioventricular (AV) conduction in humans, we investigated the prolongation of the PR interval following intravenous administrations of each isomer and racemic preparation (D, 5, 25, and 50 mg; L, 5, 7.5, and 10 mg; racemic, 10 mg). The plasma drug concentration-effect relationship was analyzed by log-linear regression and the sigmoidal Emax model. The sigmoidal Emax model provided a significantly better fit for the data than log-linear regression (p less than 0.01). Maximum drug effect (Emax) and plasma drug concentration associated with 50% Emax (EC50) were calculated by means of the Emax model. The dromotropic potency of each isomer was assessed in terms of EC50 and the drug concentration associated with a 10% PR prolongation from the basal level calculated by the Emax model. The results demonstrated that L-verapamil was 10 and 18 times more potent than D-verapamil in terms of EC50 (D, 188.9 +/- 108.4 ng/ml; L, 17.7 +/- 11.3 ng/ml; p less than 0.05) and drug concentration associated with 10% PR prolongation (D, 166.6 +/- 48.1 ng/ml; L, 9.1 +/- 2.8 ng/ml; p less than 0.01), respectively. A stereospecific difference in plasma protein binding was observed (D, 93.7 +/- 2.2%; L, 88.5 +/- 1.6%; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966340 TI - Ischemia at rest is independent of the extent of ventricular dysfunction and arrhythmias in patients with coronary artery disease. AB - To assess the relation between myocardial ischemia, ventricular arrhythmias (VA), and left ventricular (LV) dysfunction, we evaluated 74 patients with coronary artery disease (CAD) using radionuclide angiography (to determine the resting ejection fraction [EF]), resting thallium-201 scintigraphy (to ascertain the extent of resting ischemia), and 24-hour Holter monitoring (to assess VA). Thirty patients had resting ischemia, 26 had resting EF less than 30%, and 27 had repetitive VA. Patients with and without ischemia had similar EFs (36 +/- 14 vs 38 +/- 14, p = NS). Further, patients with and without repetitive forms of VA had a similar number of resting ischemic segments (1.1 +/- 1.7 vs 1.1 +/- 2.2, p = NS). Patients with EFs less than 30 had more VA than patients with EFs greater than or equal to 30 (Holter class 4.3 +/- 2.3 vs 3.0 +/- 1.8, p less than 0.01) but a similar extent of ischemia (1.4 +/- 2.2 vs 1.0 +/- 1.7, p = NS). Thus, while patients with lower EFs have more repetitive forms of VA, ischemia at rest is independent of VA and EF. These data suggest that prognostic stratification of patients with CAD for intervention studies should include a separate consideration of ischemia. PMID- 3966341 TI - Spontaneous ventricular tachycardia associated with isolated right ventricular infarction, one day after right coronary artery occlusion in the dog: studies on the site of origin and mechanism. AB - The electrophysiologic and arrhythmic properties of isolated infarcted right ventricle (RV) were studied in 17 dogs during the first 24 hours after complete occlusion of the right coronary artery (RCA). During the 16-to-20-hour post occlusion period, spontaneously occurring sustained monomorphic ventricular tachycardia (VT) was present in all 17 dogs. Overdrive ventricular pacing (cycle lengths 200 to 250 msec) caused significant suppression of the VT when the rate of the VT was slower than 150 bpm (range 120 to 145 bpm) (n = 9), but had negligible effect when VT rate was higher than 150 bpm (range 160 to 245 bpm (n = 8). Overdrive pacing could not terminate either the slow or the fast type of VT. Bipolar intramural electrograms have showed electrical activity in the infarcted RV zone to precede Q wave of the VT by 15.4 +/- 5.8 msec regardless of VT rate. Microelectrode studies on isolated RV endocardial infarcted tissues 24 hours after RCA occlusions have shown the presence of spontaneous repetitive activity at a rate of 87 +/- 47 bpm, which was overdrive suppressed in dogs with slow VT, and spontaneous activity at a rate of 115.2 +/- 36 bpm (p less than 0.05) which was not overdrive suppressed in dogs with fast VT. Maximum diastolic potential, action potential amplitude, and Vmax of surviving subendocardial Purkinje fibers (SEPF) in the infarct zone were slightly but significantly depressed (p less than 0.05), and they manifested enhanced phase 4 depolarization, giving rise to automatic impulse initiation. Although action potential duration of these fibers was somewhat prolonged (p less than 0.05), no conduction delay occurred. Histopathologic examinations have shown necrosis of the basal two thirds of the RV, with no left ventricular involvement. Electron microscopy revealed lipid accumulation in the surviving SEPF as the sole abnormality. We conclude (1) that occlusion of the RCA in the dog is associated with high survival rate despite extensive necrosis involving exclusively the RV and (2) that VT seen during the 20 to 24 hours after occlusion arise in the infarcted zone of the RV, by an enhanced automatic mechanism in the surviving SEPF, possibly caused by cytoplasmic lipid accumulation. This model, by virtue of its high survival rate and frequency of late VTs, should be useful in providing clues to determine factors involved in the genesis of early VT/VF and for the evaluation of new pharmacologic agents during the 20- to 24-hour VT period. PMID- 3966342 TI - Positive treadmill stress tests post myocardial infarction in patients with single-vessel coronary disease. AB - To investigate the possibility that patients with single-vessel coronary artery disease (CAD) and recent myocardial infarction (MI) can have ST segment depression on post infarction treadmill testing due to ischemia, we studied 16 such patients who underwent cardiac catheterization and exercise testing after MI. Of the 11 patients with ST segment depression on treadmill testing, 10 failed to increase their ejection fraction and nine had a focal worsening of wall motion during exercise radionuclide ventriculography. Seven of these 11 patients had hypokinesis or normokinesis in the suspected area of infarction. In contrast, four of the five patients without ST segment depression on treadmill stress testing had an increase in ejection fraction with stress which was significantly greater than that seen in patients with ST depression (7.2% vs 0%, p less than 0.05). Short-term follow-up (1.1 years) revealed continued post infarction angina in 10 of the 11 patients with positive treadmill stress tests. Four of these patients underwent either percutaneous transluminal angioplasty or surgery. We conclude that positive post infarction treadmill tests due to exercise-induced ischemia may occur in patients with single-vessel CAD and may be associated with continued angina that requires surgical intervention. PMID- 3966343 TI - The effects of Valsalva maneuver on global and segmental left ventricular function in presence and absence of coronary artery disease. AB - To determine the effects of the Valsalva maneuver on global and regional left ventricular function, single-plane left ventriculograms were performed in the 30 degree right anterior oblique projection in 50 patients during normal breath holding and during the late strain phase of the Valsalva maneuver. Thirty-one patients had significant coronary artery disease (greater than 70% luminal narrowing in a major coronary artery). Ventriculograms were analyzed for determination of ejection fraction, end-diastolic, and end-systolic volumes. Regional wall motion was analyzed by a chord method of calculating segmental fractional shortening. Ejection fraction increased significantly in the entire group of patients (62 +/- 16% to 70 +/- 19%, p less than 0.0001), while both end diastolic (105 +/- 33 cc to 88 +/- 34 cc, p less than 0.0001) and end-systolic volumes (43 +/- 29 cc to 30 +/- 29 cc, p less than 0.0001) showed striking reductions with Valsalva maneuver. Patients without significant coronary disease usually exhibited global augmentation in left ventricular function, while those with coronary disease often exhibited only segmental improvement. This augmentation appeared to be dependent on the patency of the supplying coronary vessel. PMID- 3966344 TI - Ventricular fibrillation during coronary angiography: an analysis of mechanisms. AB - To investigate the mechanisms of ventricular fibrillation (VF) during coronary angiography, we assessed ventricular automaticity, local QT intervals, local conduction characteristics, and the ability to induce arrhythmias with premature ventricular stimulation in 30 dogs after intracoronary injections of 4 to 6 cc of Renografin 76 (RG 76). Ventricular automaticity was measured in six dogs as the idioventricular escape rate following intense vagal stimulation and was unchanged (51 +/- 6 vs 52 +/- 6 bpm, p greater than 0.05) with 6 cc of RG 76. In addition, 8 of 10 injections of 6 cc of RG 76 produced VF at a heart rate of 200 bpm compared to only 2 of 10 injections at a heart rate of 80 bpm (p less than 0.05). Composite and bipolar plunge electrodes were placed in the region perfused by the left anterior descending coronary artery (LAD) and circumflex coronary artery to assess QT intervals and conduction characteristics. RG 76, 4cc, produced a 116 +/ 18 msec increase in the QT intervals recorded from the region perfused by the LAD, resulting in a marked dispersion in repolarization. Both local bipolar and composite electrograms showed minimal conduction delay, which rarely extended beyond the QRS of a lead II ECG during atrial paced rhythm. As premature beats (spontaneous or induced) conducted through the region of QT prolongation, marked conduction delay was recorded from bipolar electrograms, while composite electrograms recorded continuous fractionated electrical activity spanning the diastolic interval at the onset of VF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966345 TI - In vivo effects of acute changes in osmolality and sodium concentration on myocardial contractility. AB - Effects of acute changes in osmolality and sodium concentration (Na) on myocardial contractility (MC) were examined in anesthetized dogs. Using a carotid to left anterior descending bypass, 4 cc of NaCl and/or dextrose of varying osmolality as injected and the percentage of change in MC measured. At Na = O mEq/L, a positive inotropic response occurred, which varied inversely as osmolality increased from 300 (MC = 100 +/- 23%) to 700 mOsm/L (MC = 39 +/- 10%, p less than 0.01). Similar ranges of positive responses of lesser magnitude were noted at Na = 75 mEq/L. At Na = 150, 190, or 350 mEq/L, similar increments in osmolality caused an increasingly negative inotropic response. An inverse relationship between Na and MC was noted with osmolality held constant. Injections of the nonionic contrast agent, P297, in 5% dextrose or 0.9% NaCl, resulted in 28 +/- 3% or -17 +/- 4% (p less than 0.01) change in MC, respectively. Sodium concentration and osmolality have independent effects on MC. Hyperosmolality/hypernatremia causes a negative inotropic response while hyponatremia causes a positive one. PMID- 3966347 TI - Occult arrhythmias as the etiology of unexplained syncope in children with structurally normal hearts. AB - We evaluated six children for syncope of unknown etiology between March, 1983, and March, 1984. All had undergone previous neurologic evaluation which was normal. Cardiac examination, chest roentgenograms, and two-dimensional echocardiograms were also normal in all of the patients. Abnormal noninvasive findings in five patients included Mobitz type II atrioventricular (AV) block (one patient), sinus bradycardia (three patients), and supraventricular tachycardia (one patient). Four patients had one or more abnormal findings at invasive electrophysiologic study including evidence of sinus node dysfunction (three patients), AV node dysfunction (three patients), and distal His-Purkinje system disease (two patients). All children had a normal right heart hemodynamic catheterization. We conclude that arrhythmias are an important cause of syncope in some children with an otherwise normal heart when neurologic causes have been excluded. PMID- 3966346 TI - Coronary vasoconstriction and catecholamine cardiomyopathy. AB - Norepinephrine (NE) causes extensive myocardial injury in the rabbit. To investigate a potential mechanism we measured coronary blood flow with radioactive microspheres. Coronary resistance and oxygen demand (heart rate-blood pressure double product) were calculated. Severity of injury was determined by semiquantitative histologic evaluation. Changes resulting from NE infusion were determined in animals with or without alpha-receptor blockade with phentolamine (10 mg). In all animals oxygen demand remained constant. Coronary blood flow (ml/gm/min) was 2.66 at the beginning of the experiment, rose to 3.46 after 3 minutes of NE infusion (p less than 0.05), then declined to baseline values (2.33) after 10 minutes. However, coronary blood flow was sharply lower than baseline (1.51; p less than 0.05) after 40 minutes of infusion. Coronary resistance rose progressively from baseline values of 40.9 (units) to 74.8 at 40 minutes (p less than 0.05). Animals given phentolamine manifested none of these changes. Control subjects infused with saline solution showed no significant changes in coronary blood flow or coronary resistance. Animals pretreated with phentolamine had minimal histologic damage at 48 hours compared with NE alone (p less than 0.01). We conclude that NE induces sustained coronary vasoconstriction in the rabbit and that reduced coronary blood flow may contribute to the pathogenesis of NE cardiomyopathy in this species. PMID- 3966349 TI - The effects of sampling site on the two-dimensional echo-Doppler determination of cardiac output. AB - Cardiac output was measured by two-dimensional echocardiographic Doppler technique in 55 adult patients in the intensive care unit. Doppler cardiac output determinations were measured from four sites (suprasternal long axis of the ascending aorta, suprasternal long axis of the descending aortic, apical left ventricular outflow tract, and parasternal long axis of the main pulmonary artery) and were compared to cardiac output determined by thermodilution for a total of 101 observations (r = 0.84). Mean cardiac output was 5.3 L/min (range 1.8 to 9.5 L/min) by Doppler technique and 5.1 L/min (range 1.6 to 8.9 L/min) as measured by thermodilution. Correlation of Doppler cardiac output with thermodilution cardiac output gave r values of 0.85, 0.83, 0.90, and 0.81 from the ascending aorta, descending aorta, left ventricular outflow tract, and pulmonary artery, respectively. Averaging of data in patients in whom more than one determination was possible resulted in improved correlation (r = 0.94). Thus, cardiac output can be measured with reasonable accuracy by Doppler from a variety of sampling sites and averaging of data from more than one site may improve these results. PMID- 3966348 TI - Comparative angiographic right and left ventricular volumes. AB - Comparative angiographic right and left ventricular volumes and right and left ventricular ejection fractions have been reported in the same normal infants and children. This relationship was assessed in adult patients to determine if these pediatric observations persist in later life. Seventeen adults, who had both right and left ventricular angiograms and who had no demonstrable organic heart disease, were studied. Right ventricular end-diastolic volume ranged from 54 to 98 (76 +/- 14, mean +/- SD) cc/m2 and left ventricular end-diastolic volume ranged from 48 to 90 (70 +/- 12) cc/m2; p less than 0.03. Right ventricular end systolic volume ranged from 22 to 47 (33 +/- 8.0) cc/m2 and left ventricular end systolic volume ranged from 13 to 34 (22 +/- 5.3) cc/m2; p less than 0.00005. Calculated right ventricular stroke volume ranged from 31 to 60 (43 +/- 8.3) cc/m2 and left ventricular stroke volume ranged from 29 to 70 (48 +/- 11) cc/m2; p = NS. Calculated right ventricular ejection fraction ranged from 0.48 to 0.62 (0.57 +/- 0.04) and the left ventricular ejection fraction ranged from 0.57 to 0.84 (0.68 +/- 0.07; p less than 0.00005. Both right ventricular end-systolic and end-diastolic volumes were greater than left ventricular end-systolic and end diastolic volumes. This resulted in decreased right ventricular ejection fraction compared to left ventricular ejection fraction. The difference between the two ventricles may be due to compliance, muscle mass, and anatomic configuration with a net result of one chamber more completely emptying than the other. Thus it appears that the relationships between right and left ventricular volumes noted in infancy and childhood persist in adult life. PMID- 3966350 TI - Transseptal left heart catheterization with a Swan-Ganz flow-directed catheter: review of 173 studies. AB - Of 178 transseptal left heart catheterizations performed, 173 successful cases are reported, with the use of a Swan-Ganz, flow-directed, balloon-tipped catheter. By means of a modified Brockenbrough technique, which is described in detail, a 10F Teflon tube (3.3 mm outside diameter) was inserted into the left atrium. Through the tube, which was continuously flushed with saline solution, a 5F Swan-Ganz catheter was introduced into the left atrium. In all cases where left atrial puncture was possible (n = 173), the left ventricle was easily entered, even in the presence of mitral stenosis. Two major complications with signs of cerebral embolism occurred in this series. The method is technically reliable and acceptably safe in cases where the transseptal route of left heart catheterization is required. PMID- 3966351 TI - Clinical predictability of left ventricular function post myocardial infarction from the electrocardiogram. PMID- 3966352 TI - The role of echocardiography and computed tomography in the evaluation of constrictive pericarditis. PMID- 3966353 TI - Esophageal echocardiographic analysis of atrial dynamics. PMID- 3966354 TI - Echocardiographic diagnosis of unruptured aneurysm of right sinus of Valsalva: an unusual cause of right ventricular outflow obstruction. PMID- 3966355 TI - Ruptured sinus of Valsalva: demonstration by contrast echocardiography during cardiac catheterization. PMID- 3966356 TI - Echocardiographic recognition of pulmonary artery endarteritis in patent ductus arteriosus. PMID- 3966357 TI - Antemortem echocardiographic identification of right atrial thromboembolus. PMID- 3966358 TI - Myocarditis with transient left ventricular apical dyskinesis. PMID- 3966359 TI - Constrictive pericarditis secondary to primary chylopericardium. PMID- 3966360 TI - Unusual ventricular depolarizations associated with torsade de pointes. PMID- 3966361 TI - Acute myocardial infarction following asymptomatic ST elevation despite diltiazem therapy. PMID- 3966362 TI - Sustained benefit of verapamil in pulmonary hypertension with progressive systemic sclerosis. PMID- 3966363 TI - Intermittent spontaneous disc escape and reseating of Bjork-Shiley mitral valve prosthesis. PMID- 3966364 TI - Splenic infarction: complication of intra-aortic balloon counterpulsation. PMID- 3966365 TI - Emergency transvenous pacing in infants. PMID- 3966366 TI - Neural circulatory control in the hyperdynamic circulatory state syndrome. PMID- 3966367 TI - Evaluation of patients with acute myocardial infarction: which test, for whom and why? PMID- 3966368 TI - Prolonged repolarization: a historical perspective. AB - This symposium will more fully discuss QT prolongation--an area of controversy- prolonged QT syndromes, and new groups of agents that prolong repolarization and the QT interval (calcium blockers and antiarrhythmic agents). This is an important evolving field with old biases confronting a new and more thorough understanding of the phenomenon of prolonged repolarization. PMID- 3966369 TI - Idiopathic long QT syndrome: progress and questions. PMID- 3966370 TI - Serial measurements of systolic time intervals during treatment with hydrochlorothiazide alone and combined with other antihypertensive agents. AB - As part of the Veterans Administration cooperative studies on antihypertensive agents, systolic time intervals (STIs) were recorded before and after 2 or 4 weeks of treatment with hydrochlorothiazide (HCTZ) alone in 320 asymptomatic patients with mild to moderate hypertension. After treatment with HCTZ, left ventricular ejection time corrected for heart rate (delta LVET) was significantly reduced. This decrease is consistent with other hemodynamic observations indicating a reduced preload and stroke volume after administration of thiazides. Electromechanical systole corrected for heart rate (delta QS2) decreased, while the ratio of preejection period to LVET (PEP/LVET) increased, reflecting reduced left ventricular function. PEP did not change. Four step 2 drugs--hydralazine, prazosin, oxprenolol and propranolol--were then added randomly to HCTZ and further recordings of STIs were taken at 1 and 6 months after administration of these drugs. The delta LVET and delta QS2 increased and PEP/LVET decreased, suggesting improved left ventricular function after administration of all 4 agents. These changes may have been due to the added agents or to the recovery of cardiac output that occurs independently during long-term treatment with thiazide diuretic drugs alone. PEP decreased slightly after hydralazine and prazosin and increased slightly after treatment with the beta-blocking drugs, although none of these changes were significant except those during hydralazine treatment. Processing of the STIs was greatly facilitated by the automated system for recording and analyzing the measurements. PMID- 3966371 TI - Role of prostaglandins in the renal handling of a salt load in essential hypertension. AB - Renal function and systemic hemodynamics were assessed in 10 hypertensive patients and in 10 age-matched normotensive subjects during control conditions (80 mEq of sodium/day) and after a salt load, either alone (480 mEq/day) or combined with indomethacin or sulindac. Indomethacin was used to induce ubiquitous inhibition of prostaglandin synthesis and sulindac to inhibit prostaglandin synthesis in all tissues except the kidney. Under control conditions there was no significant difference between the 2 groups in any measurement except blood pressure and total peripheral resistance. Also, the changes induced by salt load in the 2 groups were comparable. However, after indomethacin administration, only hypertensive patients showed a significant reduction in the 24-hour sodium excretion (from 417 +/- 61 to 317 +/- 49 mEq, p less than 0.05), so that the difference between this value and the corresponding value of normotensive subjects (453 +/- 79 mEq) became significant (p less than 0.05). The changes in sodium excretion in hypertensive patients were significantly correlated with the changes in renal plasma flow (r = 0.803, p less than 0.01). However, cardiac output and renal blood flow showed a similar pattern in normal and hypertensive persons. Finally, after the addition of sulindac to salt load, the differences in the 24-hour sodium excretion vanished. These results were also confirmed in an ancillary study performed, using the same protocol, in 10 other hypertensive patients using ibuprofen rather than indomethacin. Our data suggest that renal prostaglandins participate in renal disposal of chronic salt load in hypertensive patients but not in normal persons. PMID- 3966372 TI - Frequency of mitral valve dysfunction from mitral anular calcium as detected by Doppler echocardiography. AB - Doppler echocardiography is useful for detecting and quantifying mitral regurgitation (MR) and mitral stenosis (MS). To determine the prevalence of these abnormalities in patients with mitral anular calcium (MAC), 51 consecutive patients who had an echocardiographic diagnosis of MAC were examined by Doppler ultrasound. Transmitral flow was evaluated to determine the presence of MR or left ventricular inflow obstruction (MS) by continuous and pulsed-wave Doppler echocardiography. The severity of these hemodynamic abnormalities was quantitated by previously described techniques. Eleven patients (22%) had mild MR, 17 (33%) had moderate to severe MR and 4 (8%) had significant MS. Clinical findings such as a systolic murmur, evidence of congestive heart failure, and dyspnea on exertion were not helpful in distinguishing patients with no or mild MR from those who had moderate to severe MR. M-mode measured left atrial size was significantly larger (p less than 0.05) in patients with moderate to severe MR. This study suggests that MR is often associated with MAC, that MS is not a rare finding with MAC, and that Doppler echocardiography can quantitate these lesions in the elderly when symptoms are not specific and physical findings are inconclusive or absent. PMID- 3966373 TI - Mitral valve prolapse and ruptured chordae tendineae. AB - To determine the causes of ruptured chordae tendineae and a suspected etiologic role for mitral valve prolapse (MVP), the mitral valve in 25 consecutive and surgically proved cases of chordal rupture were examined. The diagnosis of MVP was made on the basis of redundancy and marked hooding of the mitral leaflets and on histologic changes. MVP was the underlying morphologic abnormality in 23 patients, only 1 of whom had infective endocarditis that was responsible for the rupture. Thus MVP was the only underlying morphologic abnormality in 22 of 25 patients (88%). Another finding in this study was the demonstration of auscultatory and angiographic or echocardiographic evidence of MVP in 4 patients, aged 4 to 11 years (mean 7), before chordal rupture; no patient had had endocarditis. The morphologic and historical evidence would indicate that MVP is probably the most common cause of so-called spontaneous chordal rupture. PMID- 3966374 TI - Findings on endomyocardial biopsy in infants and children with dilated cardiomyopathy. AB - Fifteen infants and children with dilated cardiomyopathy underwent transvascular endomyocardial biopsy. The light and electron microscopic findings were reviewed to evaluate the presence of lymphocytes as an indicator of active myocarditis. Both ventricles were biopsied in 13 patients, and the right ventricle only was biopsied in 2. None of the endomyocardial specimens obtained by biopsy revealed an inflammatory process. Interstitial fibrosis, myofiber hypertrophy, degeneration and necrosis were found. Ultrastructural abnormalities of the mitochondria, T tubules or Z bands were noted in approximately one-third of patients. Persistent, active myocarditis is an uncommon cause of dilated cardiomyopathy in children. Immunosuppressive therapy, which may be harmful, should be considered only after myocardial inflammation has been documented by endomyocardial biopsy. PMID- 3966375 TI - Magnitude and implications of spontaneous hemodynamic variability in primary pulmonary hypertension. AB - The pulmonary artery (PA) pressure and pulmonary resistance at rest have been noted to vary spontaneously in patients with primary pulmonary hypertension. To evaluate this variation, in 12 patients (8 women, 4 men, aged 43 +/- 13 years), hourly measurements were made for 6 consecutive hours of heart rate, systemic and PA pressures, cardiac output, systemic and pulmonary resistance. After these baseline measurements the patients were tested with hydralazine and nifedipine therapy. Spontaneous variability in pulmonary pressures and resistances occurred in each patient, with the amount of variation (coefficient of variation) in PA pressure averaging 8% and in total pulmonary resistance 13% over the 6 hours. The patients with the most variability in mean PA pressure also had the most variability in cardiac output (r = 0.69, p = 0.02). Variability also correlated with the severity of the disease, as the patients with the highest total pulmonary resistances also had the most variation for that factor (r = 0.91, p less than 0.01). The amount of variability did not correlate, however, with the acute response to either hydralazine or nifedipine administration. Based on the average coefficients of variation in these 12 patients, estimates were obtained of the percent change needed for an observed change to be attributed to a drug effect with 95% confidence. From these estimates, it was projected that for a single patient, a mean change in pulmonary resistance of 36% or a mean change in PA pressure of 22% would be required in order to attribute the changes to a drug effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966377 TI - Diastolic time during recovery from upright exercise in persons without heart disease. AB - To assess the relation between heart rate and diastolic time (cardiac cycle minus electromechanical systole) during the recovery period from upright exercise, 12 normal volunteers were studied immediately after and 2 and 5 minutes after exercise in the upright position. Although heart rate was significantly lower at 5 minutes compared with 2 minutes after exercise (106 vs 116 beats/min), there was significant shortening of diastolic time (from 251 to 230 ms) and total diastole per minute (from 28,634 to 24,220 ms/min). The explanation of this phenomenon appears to be disproportionate lengthening of diastolic time at 2 minutes after exercise, which must represent physiologic response due to increased left ventricular filling as well as continuing adrenergic effects, which would be diminished at 5 minutes. This lengthening of diastolic time also would maintain decreased subendocardial blood flow caused by increased end diastolic volume. PMID- 3966376 TI - Acute effects of alcohol on left ventricular function in healthy subjects at rest and during upright exercise. AB - Six healthy men, aged 23 to 30 years, were studied by radionuclide angiocardiography at rest and at 2 submaximal exercise levels in the upright position during increasing alcohol intoxication. At light intoxication (serum ethanol 23 mmol/liter), the median value of left ventricular (LV) ejection fraction (EF) at rest decreased by 5%. At heavy intoxication (serum ethanol 45 mmol/liter), the median LVEF decreased at rest by 11% and during 75% submaximal exercise by 6%, heart rate at rest increased (median 81 vs 62 beats/min), and systolic blood pressure decreased during 50% submaximal exercise (median 145 vs 163 mm Hg). No significant changes of plasma epinephrine concentrations were recorded, whereas plasma norepinephrine concentrations were increased by 24% at rest during light intoxication and by 30 to 38% during heavy intoxication. No changes of LVEF and plasma catecholamine levels were recorded after ingestion of isovolumic, isocaloric drinks as compared with values obtained before intake. Thus, influences of ingestion per se and repeated investigations of LV function were excluded. These findings suggest that in healthy subjects alcohol intoxication causes a dose-dependent impairment of cardiac contractility. Compensatory mechanisms may account for a reduced influence during exercise. PMID- 3966378 TI - Radiation exposure and protection in cardiac catheterization laboratories. AB - Cardiac catheterization with angiography can deliver the greatest dose of x radiation of any diagnostic medical examination. The physicians and technologists in the angiography room receive low-level scattered radiation over a period of months to decades. Although the radiobiology is complex, the physicians who perform cardiac catheterization should be familiar with the potential genetic and somatic effects of radiation and with the methods to reduce or eliminate x-ray exposure. The aim of radiation protection criteria is to reduce the risk of cancer death to less than the fatality risk for other occupations regarded as safe. This report is a review of the literature relating to radiation exposure and protection in cardiac catheterization laboratories. Catheterization personnel have control over the time duration of exposure, placement of technologists, shielding, location of equipment and monitoring of dose received. PMID- 3966379 TI - Accuracy of left ventricular ejection fraction using the nuclear stethoscope in left ventricular aneurysm. AB - Although the nuclear stethoscope, a nonimaging probe, accurately determines left ventricular (LV) ejection fraction (EF), its reliability in patients with LV aneurysm has not been established. Accordingly, LVEF was determined using the nuclear stethoscope and compared with that determined by equilibrium gated blood pool scanning in 29 patients, 1 studied on 2 separate occasions, for a total of 30 patient studies. Patient studies were separated into 2 groups. Patients in group I (n = 20) had no gated blood pool evidence for aneurysm, and those in group II (n = 10) had discrete focal akinesia or dyskinesia. Nineteen patients (13 in group I and 6 in group II) had 2 separate nuclear stethoscope acquisitions. In group I, EF determined by gated blood pool scanning (53 +/- 4%, mean +/- standard error) did not differ from that determined by nuclear stethoscope (51 +/- 4%). EF determined using either gated blood pool scanning (32 +/- 6%) or nuclear stethoscope (35 +/- 5%) was significantly lower in group II than in group I, although nuclear stethoscope and gated blood pool scanning did not differ. Reproducibility was excellent (r = 0.96). Overall, nuclear stethoscope and gated blood pool EFs correlated closely (r = 0.93), and the correlation coefficients were similar in groups I (r = 0.92) and II (r = 0.92). The slopes of the regression curves for group I (0.97) and group II (0.92) were not statistically different. These results confirm the accuracy and reproducibility of LVEF determination by nuclear stethoscope and specifically demonstrate its reliability in patients with LV aneurysm. PMID- 3966380 TI - Electrophysiologic and anatomic changes in the atrioventricular junction of dogs after direct-current shocks through tissue fixation catheters. AB - Barb-tipped fixation electrode catheters were inserted under fluoroscopic control in the region of the atrioventricular (AV) node in 6 dogs. A series of direct current shocks (20 to 240 J) were delivered from the electrode catheter to a back plate. Serial electrophysiologic studies were performed before and 2 to 3 weeks after delivery of the shocks. In general, low-energy shocks--20 to 180 J- resulted in predominant damage to the approaches to the AV node, the AV node and common bundle, whereas larger shocks created diffuse damage involving the His bundle and bundle branches. Despite histologic damage to the AV junction, only minimal changes in AV conduction were observed. Thus, there is a large safety margin for AV conduction. PMID- 3966381 TI - Mechanical "cough" cardiopulmonary resuscitation during cardiac arrest in dogs. AB - Hemodynamic findings during ventricular fibrillation (VF) and closed-chest cardiopulmonary resuscitation (CPR) are similar to those described during VF and vigorous coughing. Interventions during CPR that mimic the physiologic events of coughing (high intrathoracic pressure and high intraabdominal pressure) improve perfusion during VF and CPR. An external circulatory assist apparatus was devised to emulate cough physiology, i.e., simultaneous pulsatile increases in intrathoracic pressure (pneumatic vest), intraabdominal pressure (abdominal binder) and airway pressure (high-pressure airway inflation). In this study, vest/binder CPR was compared with conventional CPR during 30 minutes of VF and artificial support in 18 randomized dogs. Defibrillation and long-term (more than 24 hours) survival were chosen as end points. During VF and artificial support, aortic and right atrial (RA) pressures, the instantaneous aortic-RA pressure difference (coronary perfusion pressure) and blood gas levels were measured. After 30 minutes of VF and administration of 1 mg of epinephrine, countershock was attempted. Systolic aortic and RA pressures, mean aortic-RA pressure difference and blood gas levels were not significantly different between dogs that were successfully resuscitated and those that were not. However, peak diastolic coronary perfusion pressure (peak diastolic aortic-RA pressure) for survivors averaged 23 +/- 6 mm Hg, but only 6 +/- 10 mm Hg for nonsurvivors (p less than 0.001). A peak diastolic coronary perfusion pressure 16 mm Hg or greater had a positive and negative predictive value for a successful outcome of 1.00. Only 1 of 9 conventional CPR dogs survived 24 hours; 7 of 9 dogs supported with the vest/binder device were alive and neurologically normal at 24 hours (p = 0.007).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966383 TI - On pulmonary vascular resistance: the need for more precise definition. PMID- 3966382 TI - Influence of the aortic component of the second heart sound on left ventricular maximal negative dP/dt in the dog. AB - Maximal negative left ventricular dP/dt is widely used as a measure of isovolumic muscular relaxation of the left ventricle. In the course of canine experiments designed to elucidate the hemodynamic events responsible for the aortic component of the second heart sound, high-fidelity left ventricular pressure and dP/dt signals were recorded and accelerations detected on the root of the aorta and epicardium at the cardiac apex. The second heart sound was coincident with maximal negative dP/dt and affected its magnitude to a variable and unpredictable extent. This may account for some of the unexpected variations in magnitude of maximal negative dP/dt that have been described in various disease states and in laboratory experiments where the effects of physiologic and pharmacologic interventions have been studied. PMID- 3966384 TI - Systemic hypertension, diuretic drugs, arrhythmias and death. PMID- 3966385 TI - Coronary artery spasm in hypothyroidism. PMID- 3966386 TI - Thallium-201 exercise scintigraphy and left bundle branch block. PMID- 3966387 TI - Effects of noncaptured stimuli during rapid right ventricular pacing: does concealed conduction occur in the human ventricle? PMID- 3966388 TI - Prosthetic mitral regurgitation detected by Doppler echocardiography. PMID- 3966389 TI - Origin of the right coronary artery from the pulmonary trunk: diagnosis by two dimensional echocardiography. PMID- 3966390 TI - Aortic dissection in more than one family member. PMID- 3966391 TI - Some unanswered problems with probability analysis: possible impact on exercise thallium test use. PMID- 3966392 TI - Detection of atrial myxoma by magnetic resonance imaging. PMID- 3966393 TI - Ventricular fibrillation during coronary arteriography. PMID- 3966394 TI - Characterization of ventricular fibrillation during coronary angiography. PMID- 3966395 TI - Chest thump acceleration of ventricular tachycardia. PMID- 3966396 TI - Coronary hemodynamic and metabolic effects of nifedipine in patients with coronary artery disease treated with beta-blocking drugs. AB - In humans, reflex sympathetic nerve activation modulates the direct cardiac action of nifedipine after systemic administration and results in a positive chronotropic and inotropic response. The coronary hemodynamic and metabolic effects of nifedipine were evaluated after propranolol-induced acute beta receptor blockade in 12 patients with angiographically documented coronary artery disease. The intravenous injection of propranolol led to a decrease in heart rate, coronary blood flow and myocardial oxygen consumption and an increase in coronary vascular resistance and the coronary arteriovenous oxygen difference. Mean aortic pressure did not change. The subsequent intravenous administration of nifedipine resulted in a transient increase in coronary blood flow and a reduction in coronary vascular resistance and the coronary arteriovenous oxygen difference and a sustained decrease in mean aortic pressure and myocardial oxygen consumption without significant changes in heart rate. Thus, in the presence of beta-receptor blockade, the positive chronotropic response to nifedipine is attenuated and nifedipine reduces myocardial oxygen consumption significantly. The vasodilatory effect of nifedipine is maintained and a potential propranolol related inappropriate vasoconstriction may be reversed. The combination of nifedipine and beta-receptor blocking agents may be useful in the treatment of patients with both effort-induced angina and angina related to changes in coronary vasomotor tone. PMID- 3966397 TI - Value of arm exercise testing in detecting coronary artery disease. AB - Alternative methods of exercise testing are needed for patients with vascular, orthopedic or neurologic conditions who cannot perform leg exercise. To determine the sensitivity of arm exercise in detecting coronary artery disease (CAD), 30 patients with angina pectoris performed both arm ergometry and treadmill testing before coronary angiography. All patients had at least 70% diameter reduction in 1 or more major coronary arteries. Ischemic ST depression (greater than or equal to 1 mm) or angina occurred more frequently (86%, 26 patients) with leg exercise than with arm exercise (40%, 12 patients). There was no significant difference in peak rate-pressure product achieved with either test, although the peak oxygen consumption was greater during leg exercise than during arm exercise (18 vs 13 ml/kg/min, respectively, p less than 0.001). For concordantly positive tests, the oxygen consumption at onset of ischemia was significantly lower during arm testing than during leg testing (12 vs 17 ml/kg/min, respectively, p less than 0.001). There was no significant difference in heart rate during either test at onset ischemia. Thus, arm exercise testing is a reasonable, but not equivalent, alternative to leg exercise testing in patients who cannot perform leg exercise. PMID- 3966398 TI - Coronary risk factors and their pathway of action through coronary raised lesions, coronary stenoses and coronary death. Multivariate statistical analysis of an autopsy series: the Oslo Study. AB - From 1972 to 1973, 16,202 Oslo men, aged 40 to 49 years, were examined for cardiovascular disease and coronary heart disease (CHD) risk factors. This report describes the results of autopsy examinations from 204 of 471 men who died in this cohort with regard to associations between selected risk factors and (1) raised coronary atherosclerotic lesions (RL), (2) coronary artery stenosis, and (3) CHD death. Total serum cholesterol and blood pressure levels were positively associated with all 3 measures of coronary atherosclerosis and its complications, both in univariate and multivariate analyses, whereas high-density lipoprotein (HDL) cholesterol was highly and inversely related. Triglyceride levels, cigarette smoking, social class and physical activity at work and at leisure were not significantly associated with either of the 3 measures. When RL was added to the model with stenosis as the dependent variable, the risk factors no longer appeared as independent; this is consistent with the hypothesis that these factors, when significant, work through the development of RL to produce stenosis. HDL cholesterol was the only risk factor independently and significantly associated with CHD death when RL or stenosis or both were put into the model for CHD. This points to the possibility of HDL cholesterol also working through mechanisms other than the prevention of RL and stenosis toward CHD death. PMID- 3966400 TI - Collateral circulation in coronary artery disease. AB - The coronary arteriograms and left ventriculograms of 202 consecutive patients were reviewed. All had at least 75% diameter reduction of 1 or more major coronary arteries. In 127 patients (63%), at least 1 major branch was totally occluded. Collateral circulation was seen in 125 of these 127 patients (190 of 192 totally occluded arteries). Of the 75 patients without total occlusion, only 2 with 99% (or near-total) occlusion had demonstrable collateral circulation (2 of 208 arteries). In no patient with 75 to 98% diameter narrowing was collateral circulation demonstrated (0 of 164 arteries). An analysis was made of the relation between left ventricular (LV) segmental wall motion and the quality of collateral circulation in 190 totally occluded arteries among 125 patients. Of 126 arteries with good collateral circulation, LV contraction was normal in 21%, hypokinetic in 48% and akinetic/dyskinetic in 29%. Of 64 arteries with poor collateral circulation, LV contraction was normal in 23%, hypokinetic in 55% and akinetic/dyskinetic in 20%. There was no statistically significant difference between the effect of good or poor collateral circulation on LV function. These data indicate that collateral circulation cannot be seen angiographically unless there is total or near-total occlusion, and that the presence of collateral circulation does not correlate with LV wall motion abnormalities, i.e., akinetic area, despite good collateral flow or normal wall motion despite absent or poor collateral flow. PMID- 3966399 TI - Positive exercise thallium-201 test responses in patients with less than 50% maximal coronary stenosis: angiographic and clinical predictors. AB - The incidence and causes of abnormal thallium-201 (TI-201) myocardial perfusion studies in the absence of significant coronary artery disease were examined. The study group consisted of 100 consecutive patients undergoing exercise TI-201 testing and coronary angiography who were found to have maximal coronary artery diameter narrowing of less than 50%. Maximal coronary stenosis ranged from 0 to 40%. The independent and relative influences of patient clinical, exercise and angiographic data were assessed by logistic regression analysis. Significant predictors of a positive stress TI-201 test result were: (1) percent maximal coronary stenosis (p less than 0.0005), (2) propranolol use (p less than 0.01), (3) interaction of propranolol use and percent maximal stenosis (p less than 0.005), and (4) stress-induced chest pain (p = 0.05). No other patient variable had a significant influence. Positive TI-201 test results were more common in patients with 21 to 40% maximal stenosis (59%) than in patients with 0 to 20% maximal stenosis (27%) (p less than 0.01). Among patients with 21 to 40% stenosis, a positive test response was more common when 85% of maximal predicted heart rate was achieved (75%) than when it was not (40%) (p less than 0.05). Of 16 nonapical perfusion defects seen in patients with 21 to 40% maximal stenosis, 14 were in the territory that corresponded with such a coronary stenosis. Patients taking propranolol were more likely to have a positive TI-201 test result (45%) than patients not taking propranolol (22%) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966401 TI - Flecainide: long-term treatment using a reduced dosing schedule. AB - Flecainide was initially prescribed at a dose of 200 mg twice daily, but after early toxicity in patients with ventricular tachycardia (VT), the dosage was reduced to 100 mg twice daily. The effects of flecainide were studied in 40 patients (29 men and 11 women, mean age 62 +/- 2 years, ejection fraction 45 +/- 3%) who underwent programmed electrical stimulation to determine the efficacy of flecainide in preventing VT chronically at the reduced dose. Sustained VT was induced in 21 patients and nonsustained VT in 19. Flecainide prevented VT induction in 26 patients (65%). At a mean dose of 1.5 +/- 0.1 mg/kg, prolongation occurred in the effective refractory period of the first (280 +/- 5 vs 249 +/- 5 ms) and second (254 +/- 6 vs 209 +/- 9 ms) extrastimuli (p less than 0.01). In the patients protected by flecainide, the effective refractory periods increased by a 17 +/- 2% and 21 +/- 3%, in contrast to only a 7 +/- 3% and 6 +/- 4% increase in the nonprotected group (p less than 0.05), despite a higher mean dose (1.9 +/- 0.1 vs 1.35 +/- 0.1 mg/kg). Twenty-one patients were discharged on flecainide therapy, 100 mg twice daily, and were followed for a mean of 11 months. Sixteen patients are alive and well, 1 died suddenly, 1 died from a noncardiac cause and 1 had a "breakthrough" arrhythmia. Two were switched to quinidine therapy by their referring physicians, but were without problems while receiving flecainide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966402 TI - Effect of electrical activation site on left ventricular performance in ventricular tachycardia patients with coronary heart disease. AB - Some patients with ventricular tachycardia (VT) remain virtually asymptomatic, whereas others have syncope despite similar VT rates. The role of ventricular activation site on left ventricular (LV) function was examined in 10 patients undergoing electrophysiologic evaluation for recurrent ventricular arrhythmias. Radionuclide ventriculograms were acquired to calculate LV volumes and aortic or LV pressure was measured during right atrial and right ventricular (RV) pacing. RV apical pacing resulted in end-diastolic volumes similar to those achieved with right atrial pacing (171 +/- 27 vs 175 +/- 19 ml), whereas RV outflow tract pacing showed a trend toward lower volumes (168 +/- 32 vs 177 +/- 33 ml). Comparison between RV apical and RV outflow tract pacing showed that apical activation resulted in higher end-diastolic volumes (216 +/- 26 vs 194 +/- 22 ml, p = 0.020), end-systolic volumes (175 +/- 25 vs 158 +/- 20 ml, p = 0.041), stroke volumes (42 +/- 4 vs 36 +/- 6 ml, p = 0.046), peak rates of LV ejection (309 +/- 57 vs 245 +/- 40 ml/s, p = 0.034) and peak rates normalized for differences in end-diastolic volume (1.5 +/- 0.3 vs 1.3 +/- 0.3; p = 0.047) without a significant increase in peak pressures (131 +/- 12 vs 127 +/- 14 mm Hg, p greater than 0.30) or ejection fractions (24 +/- 5 vs 22 +/- 4%, p = 0.187). These changes were accompanied by an increase in LV/RV stroke count ratios during RV apical vs RV outflow tract pacing (1.6 +/- 0.2 vs 1.2 +/- 0.2, p = 0.030), suggesting the development of mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966403 TI - Intravenous and oral loading versus oral loading alone with amiodarone for chronic refractory ventricular arrhythmias. AB - To determine whether combined intravenous (i.v.) and oral loading with amiodarone can shorten its onset of action, a comparative study was conducted. Twenty patients with refractory ventricular arrhythmias were treated with amiodarone. All patients had frequent (greater than or equal to 30/hour) and complex (repetitive) ventricular premature beats on a 48-hour baseline Holter recording. Ten patients (group A) received oral loading alone: 800 mg/day for 7 days, 600 mg/day for 3 days, then a maintenance dose 200 to 400 mg/day. Ten patients (group B) received i.v. and oral loading: 5 mg/kg i.v., and then the same regimen as for group A. Follow-up 24-hour Holter recordings were obtained daily for 7 days, weekly for 1 month, and then monthly. Arrhythmia control was defined as at least a 70% reduction in ventricular premature beats, a 90% or greater reduction in couplets and abolition of ventricular tachycardia. The time to optimal ventricular arrhythmia control was shorter for group B (20 +/- 18 vs 105 +/- 83 days, p less than 0.05) and the cumulative amiodarone dose at the time of control was smaller for group B (10 +/- 8 vs 48 +/- 39 g, p less than 0.05). No complications were encountered with i.v. amiodarone. Thus, initial loading with i.v. amiodarone can shorten the time to optimal ventricular arrhythmia control and lower the cumulative dose required. PMID- 3966404 TI - Intravenous quinidine: relations among concentration, tachyarrhythmia suppression and electrophysiologic actions with inducible sustained ventricular tachycardia. AB - A computer simulation was used to devise quinidine sulfate infusions to produce pseudo-steady-state concentrations in the low (8 microM/liter) and high (14 microM/liter) therapeutic ranges, avoiding high peak concentrations. Using this infusion, efficacy and electrophysiologic actions of quinidine sulfate were assessed in 21 patients with sustained inducible ventricular tachycardia (VT) when concentrations were 12.6 +/- 11 microM/liter (mean +/- standard deviation) and 18 +/- 9 microM/liter. Although mean concentrations approximated target levels, there was substantial individual variation. A reciprocal linear relation (r = 0.8, p less than 0.01) was noted between resultant serum concentrations and drug-free ejection fraction (EF). Transient hypotension occurred early in 3 patients, 2 of whom had a normal left ventricular (LV) EF. No hemodynamic compromise was seen in patients with LVEFs of less than 30%. Induced VT was suppressed in 5 patients at low concentrations and in an additional 4 at high concentrations (total 9 of 21, 42%). Concentration-dependent changes in the ventricular effective refractory period of the beat induced by S3 paralleled antiarrhythmic efficacy. Independent of response or lack of response to intravenous quinidine, 17 patients received gradually increasing oral quinidine dosages adjusted to reproduce plasma levels that had been effective during intravenous administration, or to maximal well-tolerated dosage (if side effects occurred). VT was still inducible during oral treatment in 4 of 5 patients in whom VT had been suppressed during the intravenous infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966405 TI - Effect of the calcium antagonist diltiazem on atrioventricular conduction in chronic atrial fibrillation. AB - The effect of oral diltiazem treatment on the mean ventricular rate was studied in 10 patients with stable atrial fibrillation (AF). The profile of mean ventricular rate was analyzed by means of 24-hour electrocardiographic recordings. Both single-dose (120 mg) and maintenance therapy (80 mg 3 times daily) reduced the mean ventricular rate significantly. After the single dose, the effect set in after 120 +/- 40 minutes (mean +/- standard deviation) and persisted for 347 +/- 84 minutes. Histograms of RR intervals were plotted and their changes after diltiazem therapy were also analyzed. The shortest and longest atrioventricular (AV) conduction times were defined as 5% and 95% values of the cumulative frequency curve, respectively. There were 2 distinct types of the RR-interval histographic changes: In 50% of the patients, the longest and shortest RR intervals prolonged proportionately; in the other 50%, the longest intervals increased disproportionately. Results indicate that oral diltiazem treatment can significantly decrease the mean ventricular rate in patients with AF by influencing the concealed conduction in the AV node. The changes of the RR interval histograms suggest that in 50% of the patients, the increase of the concealed conduction was probably caused primarily by the increase of AF rate, and in 50% both increased AF rate and prolonged refractory period in the AV node contributed to the increase of concealed conduction. PMID- 3966406 TI - New concepts in the mechanisms and treatment of congestive heart failure. Introduction. PMID- 3966407 TI - Cardiopulmonary exercise testing for evaluation of chronic cardiac failure. AB - The heart, lungs and hemoglobin form the body's gas transport system, which links the atmosphere and its supply of O2 with tissue, while simultaneously providing for the elimination of the metabolic end-product, CO2, into the atmosphere. The transport of these respiratory gases must be in accordance with metabolic need. This is particularly evident during the physiologic stress of isotonic exercise, when the O2 requirements and CO2 production of skeletal muscle are increased. The monitoring of these respiratory gases during exercise, referred to as cardiopulmonary exercise testing (CAR-PET), can be used to assess heart and lung function in patients with cardiovascular or lung disease or both. Chronic cardiac failure (CCF) may be defined in physiologic terms as that circumstance in which the heart fails to provide tissue with O2 at a rate commensurate with aerobic requirements. In patients with CCF, CAR-PET represents a noninvasive means to determine aerobic capacity (that is, maximal O2 uptake) and anaerobic threshold during incremental treadmill exercise. It can also provide an objective measure of the severity of failure, the functional status of the patient and the heart's pump reserve. By using additional measurements of ventilation, arterial O2 saturation and, in selected cases, hemodynamic monitoring, the nature and severity of cardiovascular and pulmonary disease may be evaluated. PMID- 3966408 TI - Epidemiology of congestive heart failure. AB - Despite the paucity of epidemiologic work on congestive heart failure (CHF), the salient features of the natural course of cardiac failure are understood. The estimated 1983 incidence of CHF in the United States was 214,000 men and 184,000 women. The estimate of prevalence was 2.3 million persons, with a remarkable increase with advancing age and higher rates in men than women at all ages. Overt heart disease plus age are the principal determinants of the incidence of CHF. Nearly 90% of patients with CHF have systemic hypertension or coronary heart disease, or both, as the antecedent underlying condition. Diabetes mellitus increases the risk of CHF at all ages, particularly in women and those treated with insulin. The prognosis after diagnosis of CHF is grim and is related to the degree of myocardial dysfunction. The challenge is to develop more effective drugs not only for the management of overt CHF, but also for the prevention of its progression. PMID- 3966410 TI - Pathophysiology of congestive heart failure. AB - Over the past several years, additional information has been accumulated on the pathophysiology of congestive heart failure. The primary cardiac defect is a decrease in intrinsic contractility of the myocardium, usually brought on by prolonged pressure or volume overload. Several associated biochemical changes have been described, although no precise cause-and-effect relation has been determined. A number of neurohumoral changes occur, which increase systemic vascular resistance. This increased resistance contributes further to a decrease in cardiac output. In fact, many such "compensatory mechanisms" that are initially beneficial may overshoot and produce deleterious hemodynamic effects. Therapeutic interventions such as diuretics, inotropic drugs and vasodilators are frequently helpful by correcting compensatory mechanisms that overshoot. PMID- 3966409 TI - Potential for altering the natural history of congestive heart failure: need for large clinical trials. AB - Congestive heart failure (CHF) is a major clinical and public health problem; moreover, its incidence is increasing. Once this syndrome is manifest, the mortality rate is very high. To date, none of the drugs available for its treatment has been shown to reduce mortality. It is theoretically possible that in patients with overt CHF, drug treatment may not alter prognosis. This hypothesis suggests that patients at high risk of heart failure should be treated before CHF becomes manifest. Alternatively, the trials of patients with manifest CHF may have been unpromising, simply because they were too small. These considerations indicate an urgent need for very large studies of both categories of patients--a "prevention" trial in those without overt CHF and a "treatment" trial in those with overt CHF. PMID- 3966411 TI - The substitution of sucrose polyester for dietary fat in obese, hypercholesterolemic outpatients. AB - Our aim was to determine the effects of the substitution of sucrose polyester (SPE) for dietary fat in a 16-week outpatient study in 36 obese subjects with primary hypercholesterolemia. The subjects were randomized into three groups who followed a 16-week treatment period where all subjects received hypocaloric diets which provided approximately 7 kcal/lb body weight, a polyunsaturated/saturated (P/S) fat ratio of 0.9, and 180 mg cholesterol/day. The percentages of calories as fat in the 3 groups were as follows: a low fat diet group (n = 12) received 27% of dietary calories as fat, a low fat plus SPE group (n = 13) received 25% of calories as fat plus 27 g SPE/day as a bread spread and salad dressing, and a third group (placebo, n = 11) received 37% of calories as fat with a 27 g/day conventional fat placebo (bread spread and salad dressing). Mean weight loss from baseline in the 16 week treatment period was 2.6, 3.9, and 3.4% respectively in the placebo, diet, and SPE groups, p less than .05 for each group, without significant differences between the groups. There was a mean reduction of low density lipoprotein cholesterol (LDL-C) of 16% in the SPE group (p less than .05), more than twice the reductions in the placebo and diet groups, 5% and 6%, respectively. There was a mean 20% reduction in the SPE group in triglyceride and very low density lipoprotein cholesterol (p less than .05), compared to 7 and 10% reductions in the placebo and diet groups respectively. The degree of weight loss was correlated with the degree of reduction in LDL-C in the low fat diet group, and in the low fat diet group plus SPE (r = 0.59 for both groups). Without confounding by different levels of dietary cholesterol or P/S, SPE induced significant reductions in LDL-C in hypercholesterolemic obese subjects beyond the effects of weight loss alone. The effects of SPE were significantly greater than those achieved by the use of a diet which severely limited conventional dietary fat intake (to 40 g/day). SPE in the form of a bread spread and a salad dressing is a practical formulation for outpatient hypocholesterolemic low fat diets and provides the lubricity and organoleptic benefits of authentic foods without the dense caloric content of digestible fats. PMID- 3966412 TI - Hypovitaminosis D and elevated serum alkaline phosphatase in elderly Irish people. AB - The vitamin D status of 181 elderly Irish community-dwelling and institutionalized subjects was studied during Winter-Spring. The mean serum 25 hydroxyvitamin D level was 10 nmol/L (95% range less than 5.0-59 nmol/L); values were below 25 nmol/L in 79 percent of subjects. A significant seasonal variation of serum 25-hydroxyvitamin D levels was noted in elderly community-dwelling subjects. The previously documented age-related increase in serum alkaline phosphatase activity was significantly less in vitamin D replete subjects than in vitamin D deplete subjects in this study (P less than 0.005). The higher serum alkaline phosphatase values found in the vitamin D deplete subjects may represent mild secondary hyperparathyroidism or osteomalacia. The relationship of vitamin D status to both dietary intake and effective sunlight (latitude) is examined. PMID- 3966413 TI - Biopterin and neopterin in various milks and infant formulas. AB - Biopterin and neopterin concentrations were measured by reverse-phase high pressure liquid chromatography in milks of man, cow, rabbit, cat, and rat and in commercial formulas widely used in North America. There was wide variation of concentration among species. Higher concentrations of biopterin were present in human milk (392.0 +/- 158.6 pmol/ml) than were present in all milk formulas analyzed (2.6-50.6 pmol/ml). PMID- 3966414 TI - Casein content of human milk. AB - Three methods for estimating the casein content of human milk were tested; isoelectric precipitation with washing and correction for co-precipitating proteins, sedimentation by ultracentrifugation, and indirect analysis (ie analyzing for the content of the major whey proteins and subtracting these from the total protein content). Gel electrophoresis and amino acid analysis were used to confirm some of the results. The casein content (mg/ml) of mature human milk (n = 9) was 2.33 +/- 1.69 by isoelectric precipitation, 1.80 +/- 0.48 by sedimentation and 2.96 +/- 1.08 by the indirect approach. A probable partition of nitrogen in breast milk would be casein N: whey protein N: non-protein N of 20:50:30; ie the correct ratio of casein nitrogen: whey nitrogen is approximately 20:80. Analysis of trace elements and minerals demonstrates that of total Ca 10%, Mg 5%, Zn 28%, Cu 17%, and Fe 27% is bound to casein when prepared by ultracentrifugation while isoelectric precipitation causes a redistribution of some of these elements. Since the protein ratio of human milk is considered a guideline when manufacturing infant formulas, these findings should be considered with regard to infant nutrition. PMID- 3966415 TI - Milk and plasma lipid composition in a lactating patient with type I hyperlipoproteinemia. AB - This report describes studies on the plasma and milk lipid composition of a patient with primary Type I hyperlipoproteinemia who had been followed through her second pregnancy. Post-partum she lactated, supplying milk for assay. It was abnormal in the low content of its total lipid and in the bizarre composition of its fatty acids. The proportion of long chain fatty acids was unusually low, and that of medium chain fatty acids unusually high. Furthermore, the fatty acids of the patient's milk differed greatly from those of her plasma triglycerides. This was in marked contrast to normal nursing mothers' milk, in which the fatty acid composition is comparable to that of plasma triglycerides. The patient's milk fatty acids were shorter in chain length and deficient in essential fatty acids. During the time of lactation, the patient remained hyperlipidemic and her post heparin plasma had no lipolytic activity. These data and the differences between the plasma and milk fatty acids suggested that in the patient the circulating triglyceride fatty acids did not enter the mammary gland. Without preformed fatty acids entering it from plasma or adipose tissue, the lactating breast apparently synthesized fatty acids de novo. These newly synthesized fatty acids were of medium, rather than long chain length. This accounted for the abundance of medium chain length triglycerides in the patient's milk. The studies suggested that the deficit of lipoprotein lipase in Type I hyperlipoproteinemia extended to the mammary gland. PMID- 3966416 TI - Evolving scientific bases for the Recommended Dietary Allowances--a critical look at methodologies. PMID- 3966417 TI - Uses and limits of the use of the Recommended Dietary Allowances for evaluating dietary intake data. PMID- 3966418 TI - Status of the 10th edition of the Recommended Dietary Allowances--prospects for the future. PMID- 3966419 TI - The hazards of very-low-calorie dieting. PMID- 3966420 TI - Absorption of calcium salts. PMID- 3966421 TI - Effects of different levels of vitamin B-6 supplementation on vitamin B-6 concentrations in human milk and vitamin B-6 intakes of breastfed infants. AB - Vitamin B-6 has been reported to vary in concentration in human milk in response to changes in maternal intake of the vitamin. This study examined the effects of such changes on the breastfed infants' intake of vitamin B-6. Lactating mothers received 0, 2.5, 10.0 or 20.0 mg pyridoxine X HCl (PN X HCl) for 3 consecutive days in addition to dietary sources. Dietary intakes of vitamin B-6 (mean = 1.8 +/- 0.2 mg/day) were similar among the four groups. Vitamin B-6 was determined in milk samples from each feeding and milk intakes of infants were estimated by test weighing. Nonsupplemented mothers had lower vitamin B-6 in their milk (93 +/- 8 micrograms/L) and vitamin B-6 intake of their infants was lower (0.06 +/- 0.01 mg/day) compared to other groups. Maternal supplementation with 2.5, 10.0 or 20.0 mg PN X HCl was paralleled by vitamin B-6 levels in milk of 192 +/- 16, 247 +/- 25 and 413 +/- 45 micrograms/L, respectively, and by vitamin B-6 intakes of breastfed infants of 0.12 +/- 0.02, 0.22 +/- 0.02 and 0.28 +/- 0.03 mg/day, respectively. When maternal intakes of vitamin B-6 approximated 20.0 mg/day, breastfed infants were unlikely to receive the current RDA of 0.3 mg vitamin B 6/day. PMID- 3966422 TI - Increased green and yellow vegetable intake and lowered cancer deaths in an elderly population. AB - In a prospective cohort study of 1271 Massachusetts residents 66 years of age or older, we examined the association between consumption of carotene-containing vegetables and subsequent five year mortality. Dietary information was obtained by food frequency questionnaire in 1976. The relative risk of cancer mortality was examined within quintiles of green and yellow vegetable score (calculated from intake of carrots or squash, tomatoes, salads or leafy vegetables, dried fruits, fresh strawberries or fresh melon, and broccoli or brussel sprouts). After controlling for age and smoking behavior, those in the highest quintile of intake of these carotene-containing vegetables had a risk of cancer mortality which was 0.3 (95% confidence limits 0.10-0.96) that of those in the lowest quintile. The trend of decreased cancer risk with increasing intake of carotene containing vegetables was significant (p = .026). This relationship is consistent with the hypothesis that carotene may act as an inhibitor of carcinogenesis. PMID- 3966423 TI - Does the oral zinc tolerance test measure zinc absorption? AB - Increases in plasma zinc concentration were compared with radiozinc absorption after oral test doses. Ten healthy, fasting subjects were each given 385 mumol zinc chloride (25 mg Zn) labelled with 0.5 muCi 65ZnCl2 and a non-absorbed marker, 51CrCl3, dissolved in 100 ml of water; another 10 persons were given 354 mumol zinc chloride and 125 g of minced turkey containing 31 mumol zinc also labelled with 65Zn and 51Cr. Measurements were made of plasma zinc concentration at hourly intervals for 5 hours, radiozinc absorption by stool counting of unabsorbed radioactivity 12-36 hours later, and radiozinc retention by whole body counting at 7 days. The mean percentage of radiozinc absorbed and retained in the body from the two test meals was found to be identical (42%). In contrast the increased area under the plasma zinc curve up to 5 hours after the turkey meal, 28 +/- 9 mumol/L (mean +/- SD) was significantly less than that for zinc chloride alone, 47 +/- 15 mumol/L, p less than 0.005. Despite this difference, a good correlation was found between the area under the plasma zinc curve and 65Zn absorption in individual subjects after each meal. The discrepancy between the results of zinc absorption derived from the plasma zinc curve and 65Zn absorption for the liquid and solid test meals was most likely explained by binding of zinc to food and delayed gastric emptying of the solid meal. With a test meal of turkey meat at least this dampened the plasma appearance of zinc but did not affect its overall absorption. PMID- 3966424 TI - Zinc and acute tropical ulcers in Gambian children and adolescents. AB - 28 Gambian children and adolescents with acute tropical leg ulcers entered a double blind trial of oral zinc supplements as an adjunct to standard treatment. Analysis of the area healing of the ulcers resulted in a mathematical expression which showed that for each subject re-epithelialization reduced the ulcer radius at a constant healing rate (k). k was derived from the equation At = pi X (r - k X t)2, where At = residual ulcer area at time "t", r = initial ulcer radius and t = time from start of treatment. In the zinc treated group k was 0.55 +/- 0.39 mm/day, and 0.51 +/- 0.25 mm/day in the placebo group. The initial low plasma zinc of 6.5 +/- 1.9 mumol/L in the ulcerated subjects was not significantly lower than that of 7.5 +/- 3.6 mumol/L in the nonulcerated controls. Oral zinc supplements significantly elevated plasma zinc concentrations by 5.8 +/- 4.8 mumol/L compared to the placebo group's change of 0.4 +/- 2.0 mumol/L (p less than 0.001). Plasma alkaline phosphatase activities and fatty acid profiles did not change with zinc supplementation. Thus unequivocal clinical and biochemical evidence of zinc deficiency in these ulcerated subjects was not established, despite changes in plasma zinc. This study does not indicate any role for zinc supplementation in the management of acute tropical ulcers. PMID- 3966425 TI - The effect of dietary sodium on urinary calcium and potassium excretion in normotensive men with different calcium intakes. AB - On the basis of their usual calcium intake, 12 healthy normotensive male students were divided into a low and a high calcium group. Both groups were provided with complete diets containing the same calculated quantities, expressed per MJ, of protein, fat, carbohydrate, sodium, potassium, phosphorus, and calcium. After an initial period of two weeks during which all participants received an additional 100 mmol sodium daily, 6 participants received an additional 22 mmol sodium/day (low sodium), the other 6 participants 178 mmol sodium/day (high sodium). After two weeks the sodium regimes were crossed over for a subsequent two-week period. When the second week of the low sodium period is compared with the second week of the high sodium period, the increase in the calcium/creatinine ratio, expressed on molar basis, was 0.059 for the low and 0.053 for the high calcium group (p less than 0.05). The increase in the molar potassium/creatinine ratio was 0.65 for the low and 0.03 for the high calcium group (p less than 0.025). However, after correcting for the calcium intake the effect in the low calcium group was found to be greater (p less than 0.05). Sodium supplementation was found to have no effect on blood pressure, but mean systolic (p less than 0.10) and diastolic in the high calcium group were lower. This suggests that calcium may well play a role in the regulation of blood pressure. PMID- 3966426 TI - Vitamin E deficiency in adults with chronic liver disease. AB - In order to determine the frequency of vitamin E deficiency in adults with chronic liver disease, we measured serum vitamin E concentrations and calculated the ratio of serum vitamin E to total serum lipids (E/lipids) in forty-two patients with primary biliary cirrhosis (PBC) (Group A), fifteen patients with other forms of chronic liver disease (Group B), and twenty-five healthy adult control subjects (Group C). Although the mean serum vitamin E concentration did not differ significantly among the three groups, the ratio of serum vitamin E/lipids was significantly lower in Group A than Groups B and C. Vitamin E deficiency, as defined by the ratio of serum vitamin E/lipids below 0.8 mg/gm, was present in seven (17%) Group A and one (7%) Group B patients. Serum cholylglycine, sulfated lithocholate conjugates, and bilirubin were significantly higher and the mean duration of symptomatic primary biliary cirrhosis was significantly longer (6.6 vs 2.3 years) in the vitamin E-deficient compared to the vitamin E-sufficient Group A patients. Our study demonstrates that vitamin E deficiency may occur in adults with severe, prolonged cholestatic liver disease. PMID- 3966427 TI - The effect of a phenylalanine and tyrosine restricted diet on elemental balance studies and plasma aminograms of patients with disseminated malignant melanoma. AB - Previous studies indicate dietary phenylalanine and tyrosine restriction may be of value in managing advanced cancer patients. To further evaluate this approach, we performed a 60-day study in which four patients with advanced malignant melanoma received formula diets via nasogastric tube containing only 8 mg total phenylalanine and tyrosine per kg lean body mass per day. Two of three patients completing elemental balance studies were in negative nitrogen, potassium, and phosphorus balance, suggesting an essential nutrient deficiency. Three patients tolerated the diet well, but one was non-compliant. Although no serious toxicity developed, serum albumin, total iron binding capacity and cholesterol significantly decreased (p less than 0.01) in the three complaint patients. Fasting plasma phenylalanine and tyrosine values did not significantly change during the study, but two-hour postprandial plasma phenylalanine and tyrosine concentrations fell below normal and were significantly lower than preprandial levels (p less than 0.01). There were no tumor responses. PMID- 3966428 TI - First national in-service examination for pathology residents. AB - To fulfill an identified need in pathology residency program training, in 1983 the American Society of Clinical Pathologists introduced the first national in service examination for pathology residents. This 175-item objective examination structured with seven subtest categories for various clinical rotations was administered to 1,200 residents-in-training representing 145 training programs, 40 states, and the District of Columbia. Individual norm-referenced results reports returned to each examinee, and program reports to each residency program director, indicated rank of individual examinee performance in each category and in all categories as well as with defined peer groups. Anonymity of individual results was optional to program directors. The data indicate that although performance improves with each subsequent year of residency training, the improvement is not so great as expected and that the level of performance of residents entering training was higher than anticipated. Postexamination evaluation indicated the need for this effort to continue. PMID- 3966429 TI - Atypical ovarian hyperthecosis in a virilized postmenopausal woman. AB - Ovarian venous concentrations of testosterone (18.7 ng/mL and 8.2 ng/mL) were three to six times higher than the peripheral concentrations (2.8 ng/mL) in a hirsute postmenopausal woman. She had cystic hyperplasia of the endometrium and atypical hyperthecosis of the ovary. Postoperatively, the testosterone levels returned to normal. From the results of the immunoperoxidase reaction, the luteinized stromal cells of the ovaries were the site of increased production of the testosterone and estradiol. By the same technic, these cells were negative for LH but strongly positive for FSH. From these data, the authors conclude that the luteinized cells were the primary source of the excessive testosterone, that the same cells were the direct and indirect (by peripheral testosterone conversion) source of estradiol, that LH was very likely not involved in the process of steroid hormone production, and that FSH may be the trophic stimulus responsible for the functional activity of the luteinized stromal cells in this virilized postmenopausal woman. PMID- 3966430 TI - Adamantinoma of the pretibial soft tissue. Clinicopathologic features, differential diagnosis, and possible relationship to intraosseous disease. AB - The authors illustrate two neoplasms arising in the pretibial soft tissue that are histologically identical to adamantinoma of the long bones. The tumors developed in a 24-year-old woman and a 31-year-old man. Both were treated by local excision. Histologically, one tumor had a tubular pattern and one was composed of spindled, basaloid cells. One patient is free of disease after 14 months and one developed two recurrences after three and eight years, with the second recurrence invading the underlying tibia. Soft tissue adamantinoma may be confused with a wide range of neoplasms, including synovial sarcoma, cutaneous mixed tumor, histiocytoid hemangioma, angiosarcoma, metastatic adenocarcinoma, basal cell carcinoma, and sweat gland carcinoma. Histologic features allowing distinction from these entities and the possible relationship of soft tissue adamantinoma to its osseous counterpart are discussed. PMID- 3966431 TI - A simplified radioimmunoassay for antibodies causing immune cytopenia. AB - A two-step, solid-phase radioimmunoassay for the measurement of antibodies directed against platelets, neutrophils, and red blood cells is described. Cells to be tested or standard solutions of human IgG (HIgG) first are incubated with excess 125I goat anti-human IgG. Unbound 125I anti-IgG is adsorbed in a second step to polystyrene balls (PB) coated with excess human IgG. Inhibition of binding in this second step is related directly to the level of cell associated IgG. The amount of cell bound IgG is determined by comparison to a inhibition curve for standard IgG solution. The method was evaluated by quantitating antibody levels in patients with clinical evidence of immune cytopenias. PMID- 3966432 TI - Pseudo-Chediak-Higashi anomaly. AB - Pseudo-Chediak-Higashi (PCH) anomaly was seen in a patient with a myelodysplastic syndrome evolving from pancytopenia with normocellular marrow to a myeloblastic leukemia over a period of 72 months. This case is reported. PMID- 3966433 TI - False localization of site of endocarditis by cardiac catheterization with quantitative cultures. AB - The authors present a patient with relapsing Pseudomonas aeruginosa endocarditis in whom cardiac catheterization with quantitative cultures falsely localized the infection to the tricuspid valve, probably because the patient was having intermittent rather than continuous bacteremia. After catheterization the patient developed mitral insufficiency and congestive heart failure. This experience suggests that quantitative cultures during cardiac catheterization may give misleading results and that the procedure may have significant complications. PMID- 3966434 TI - Autofluorescence of Rhinosporidium seeberii. PMID- 3966435 TI - Change of heart? PMID- 3966436 TI - Autofluorescence of lipofuscin granules? PMID- 3966437 TI - An intralaboratory evaluation of the Coulter S+II lymphocyte percent (CLy%) as indicative of actual lymphocyte numbers in blood. AB - A field trial of the medical significance and possible error rate associated with the Coulter S+II lymphocyte percent was performed by comparing 1,500 sequential differentials performed on Geometric Data Hematrak instruments to the results of Coulter volume displacement enumeration of lymphocytes on three S+II instruments. The results of this study indicate that a statistically significant but medically insignificant bias is present between lymphocyte counting technics, that the statistical imprecision of the determination of lymphocytes by the Coulter lymph percent (CLy%) falls within the expected range for statistical inaccuracy of determination of lymphocytes by manual differential technics and that in virtually all cases no medically significant errors would result from accepting the CLy% as indicating the actual numbers of lymphocytes present, as all blood specimens with medically significant abnormalities would have had manual differential and slide review triggered by other abnormalities in the blood count results. The Coulter lymph percent is a useful addition to the other complete blood count parameters. PMID- 3966438 TI - Evaluation of the S-Plus IV. AB - An evaluation of a Coulter Counter Model S-Plus IV hematology analyzer was undertaken at Memorial Sloan-Kettering Cancer Center to assess performance characteristics and to determine accuracy in analyzing both normal and clinical specimens. Special emphasis was placed on the platelet parameter. Precision, linearity, and carryover were found to be well within the manufacturer's specifications. A total of 222 patient samples were analyzed in the routine laboratory and on the Model S-Plus IV. Coefficients of correlation of 0.99 or higher were obtained for white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hgb), platelets (Plt), except mean cell volume (MCV) (r = 0.93). Results from 99 selected normal samples were compared with those from manual reference methods. Coefficients of correlation of 0.98 or higher were obtained for WBC, RBC, and Hgb. For MCV, the correlation coefficient was 0.85 and for Plt, 0.89 was obtained. The lower coefficient of correlation for these two parameters may be a function of the imprecision of the manual reference methods. In a previous study with an original Model S-Plus, the Plt parameter occasionally exhibited spuriously high counts. With the advent of third-generation S-Plus instruments, represented by the Model S-Plus IV, the possibility of reporting aberrant Plt values virtually has been eliminated. Data from the current study verify this. However, 93% of the flagged Plt results proved to be accurate, checking slides on these introduced inefficiencies in the laboratory. PMID- 3966439 TI - Histochemical characteristics of fat-storing cells in alcoholic liver disease: a study by the gold chloride method using needle biopsy specimens of the liver. AB - To evaluate the relationship between fat-storing cells and fibrosis of the liver in alcoholic liver disease, the characteristics of fat-storing cells were studied by light microscopy with a modification of Kupffer's gold chloride method. Liver biopsy specimens were obtained at laparoscopy with a Trucut needle from 59 patients with alcoholic liver disease, 10 with no hepatic fibrosis, 18 with mild fibrosis, 18 with moderate fibrosis, and 13 with liver cirrhosis. These specimens were divided into three classes (weak, moderate, and strong) with respect to the response of fat-storing cells to the gold chloride reaction, which indicates the amount of vitamin A contained in fat-storing cells. It was found that in alcoholic liver disease the gold chloride reaction became weaker as hepatic fibrosis progressed (P less than 0.001). By contrast, no significant association was observed between the gold chloride reaction and the degree of hepatic fibrosis in 74 specimens from patients with nonalcoholic liver disease. These results show that in alcoholic liver disease hepatic fibrosis is characterized histochemically by the reduced response of fat-storing cells to the gold chloride reaction. The role of the change in fat-storing cells in alcoholic liver disease remains to be elucidated. PMID- 3966440 TI - Catenoidal shape of the interventricular septum acquired secondary to myocardial infarction. AB - A catenoidal, or saddle-shaped, configuration of the interventricular septum, concave toward the left ventricular cavity in the transverse plane, but convex toward the left ventricular cavity in the apex to base plane, occurs in idiopathic hypertrophic subaortic stenosis and possibly may lead to septal hypertrophy and immobility. The authors also have observed catenoidal shape of the interventricular septum in hearts with myocardial infarcts. They reviewed 1,415 hearts examined after postmortem arteriography and fixation in distention from patients autopsied at The Johns Hopkins Hospital. Among 586 hearts with myocardial infarcts, there were 54 (9%) with a catenoidal shape of the interventricular septum. The infarcts, 45 anterior septal and 9 inferior and lateral, appeared to account for the reversal of normal apex to base curvature, although coexistent idiopathic hypertrophic subaortic stenosis could not be excluded in 3 patients. There was moderate or marked infarct expansion in 25/54 (46%) and septal or free wall rupture in 8 (15%) hearts. Reduced average net septal curvature in the 54 hearts, highly significant compared with that in 80 hearts without infarcts (P less than 0.001), would reduce the septum's contribution to left ventricular function and may contribute to the observed postinfarct congestive failure, 30/54 (56%), and hypoperfusion, 7/54 (13%). The results suggest that some myocardial infarcts may produce a catenoidal shape of the interventricular septum that could reduce the functional activity of the surviving uninfarcted basilar portion of the septum and thereby contribute to postinfarction cardiac dysfunction. PMID- 3966441 TI - Microwave technology for the rapid thawing of frozen blood components. AB - Based on a continuing need to provide a more rapid response to requests for thawed fresh frozen plasma, the authors evaluated plasma thawing with the use of a microwave oven and compared it with conventional 37 degrees C waterbath thawing methods. Their results indicate that microwave-thawed plasma contains precipitated denatured protein (mainly albumin and fibrinogen) and that there is a significant reduction of coagulation Factors IX, X, XI, and fibrinogen compared with fresh plasma. They also measured levels of di-ethyl hexyl phthalate after microwave thawing and found its rate of accumulation similar to that of the 37 degrees C waterbath. More importantly, fundamental principles of microwave heating preclude uniform temperatures being maintained throughout the thawing of plasma; hence, the denaturation of plasma proteins is expected to occur under even low heating conditions. PMID- 3966442 TI - Compartmentalization of iron in sickle cell anemia--an autopsy study. AB - In autopsy studies of two sickle cell anemia (SCA) patients, iron was totally absent from all organs in one case in which the serum ferritin had been low, while the other patient demonstrated hepatic, splenic, and renal siderosis but no iron stores in the bone marrow. Serum ferritin had been very high in this case. These findings suggest that in SCA bone marrow biopsy may be an unreliable means to determine iron stores, but rather the ferritin level should be used. PMID- 3966444 TI - Leukocyte esterase activity and nitrite test as a rapid screen for significant bacteriuria. AB - The results of a simple, inexpensive reagent strip test for the detection of leukocyte esterase and nitrite in 252 urine specimens were compared with semiquantitative urine cultures. Negative reagent strip results predicted correctly all urine culture results with less than 10(5) CFU/mL. Screening of urine specimens with the Chemstrip L/N could aid in reducing the cost of laboratory testing. PMID- 3966443 TI - The unwarranted use of replicate analysis in routine coagulation studies. AB - The need to assure the validity of semiautomated coagulation procedures by performing replicate determinations is assessed. Prothrombin times (PT) and activated partial thromboplastin times (aPTT) were run as duplicate assays using two different photo-optical detection systems. Sixty specimens with a broad range of PT and aPTT results were studied as aliquots of 80, 100, and 140 microL of plasma. A total of 1,440 studies were performed. No statistically significant differences were found among the data for complementary groups of assays. It is concluded that replicate analyses do not enhance the precision nor the accuracy of these coagulation studies. These factors are more controlled adequately by quality assurance procedures, including frequent calibration checks, the use of internal standards, and multilevel commercial controls. PMID- 3966445 TI - The spot indole test for identification of swarming Proteus. AB - The authors evaluated the use of the spot indole test for rapid speciation of swarming Proteus from the primary isolation plate. One hundred seventy-two consecutive isolates of swarming Proteus were studied, 163 Proteus mirabilis and nine Proteus vulgaris. One hundred fifty-six isolates (95.7%) of Proteus mirabilis gave a negative spot indole. Seven (4.3%) gave a positive spot indole test, but all seven isolates were from cultures in which other indole-producing organisms also were present. If only isolates representing single gram-negative strains in the specimens were tested, the predictive value was greater than 99%. Eight of the nine (88.9%) Proteus vulgaris isolates gave a positive spot indole test; one (11.1%) gave a negative result. This isolate also failed to produce indole by conventional methods but was ornithine decarboxylase negative, and additional biochemical testing was consistent with the Proteus vulgaris identification. All Proteus vulgaris isolates were resistant to ampicillin, and 94.2% of the Proteus mirabilis tested were ampicillin susceptible. The spot indole test is a rapid, accurate, simple, and cost-effective means of speciating swarming Proteus strains isolated as the only gram-negative bacilli in a specimen. The spot indole test should be used in conjunction with an ampicillin susceptibility test result or other confirmatory test information if other gram negative bacilli are present in the culture. PMID- 3966446 TI - Lea blood group antigen on human platelets. AB - One- and two-stage radioligand assays were used to determine if human platelets possess the Lea antigen. Goat IgG anti-Lea antibody was purified by multiple adsorptions with Le(a-b-) human red blood cells, followed by affinity chromatography with synthetic Lea substance and labeling with 125I. Human IgG anti-Lea antibody was used either in a two stage radioassay with 125I-labeled mouse monoclonal IgG anti-human IgG as the second antibody or, alternatively, purified by Staph protein A chromatography, labeled with 125I, and used in a one stage radioassay. Platelets from donors of appropriate red blood cell phenotypes were incubated with the antisera, centrifuged through phthalate esters, and assayed in a gamma scintillation counter. Dose response and saturation curve analysis demonstrate the presence of Lewis a antigen on platelets from Lea+ donors. Furthermore, platelets from an Le(a-b-) donor incubated in Le (a+b-) plasma adsorb Lea antigen in a similar manner to red blood cells. The clinical significance of these antigens in platelet transfusion remains undefined. PMID- 3966447 TI - Carcinoma of the pancreas with endocrine component in childhood. A case report. AB - A case of pancreatic tumor in a six-year-old girl is presented. The tumor had histologic characteristics of acinar cell carcinoma with endocrine component. Grossly, it was encapsulated and attached to the tail of the pancreas, measuring 8 cm in the greatest diameter. Histologically, the tumor was composed of medium sized tumor cells, with mild pleomorphism showing mainly acinar structures. Many of these tumor cell contained fine granules that were periodic acid-Schiff positive, diastase resistant, and positive with dimethylaminobenzaldehyde nitrite strain for tryptophan, and some contained granules that were positive with Grimelius stain and positive with peroxidase-antiperoxidase technic for gastrin. Electron microscopy revealed two types of membrane-bound granules in the tumor cells. The larger granules measured 400-700 nm in diameter and appeared to be zymogen granules, while the smaller ones measured 100-200 nm in diameter and appeared to be neuroendocrine granules. Some cells contained both granules. The postoperative course of the patient was excellent, and she was alive and well 13 years after operation. This may be the second reported case of acinar-endocrine cell tumor of the pancreas. PMID- 3966448 TI - Perforation of the ileum in Yersinia enterocolitica infection. AB - A 69-year-old woman with a 5-wk history of diarrhea and abdominal pain was found to have multiple perforations of the terminal ileum. Blood cultures and cultures of the fistulae and mesenteric lymph nodes were positive for Yersinia enterocolitica infection. This is believed to be the first documented case of perforation of the intestinal tract with this disease. PMID- 3966449 TI - Small intestinal lymphoma in three patients with acquired immune deficiency syndrome. AB - Three cases of small bowel lymphoma in young homosexual men are presented. All three had acquired immune deficiency syndrome as demonstrated by demography, sexual history, cachexia, opportunistic infections by Cytomegalovirus, Pneumocystis carinii, atypical Mycobacterium, Candida, and/or evidence of immune deficiency, such as skin test anergy, lymphopenia, inversion of T-helper/T suppressor ratio, and diminished lymphocyte response to either phytohemmaglutinin or pokeweed mitogen. All had peripheral and/or abdominal lymphadenopathy, and gastrointestinal symptoms, e.g., diarrhea, spasms, constipation, and oral candidiasis. The diagnosis of lymphoma was made at laparotomy in all cases. All three had complete removal of localized tumor (stage Ie or IIe), yet died within 6 months of surgery and/or chemotherapy. Thus gastrointestinal complaints may not always be related to "gay bowel" syndrome, or other infectious diseases in patients with acquired immune deficiency syndrome. Small intestinal lymphoma should be added to the list of neoplasms to which this group is susceptible. PMID- 3966450 TI - Celiac disease: does hyposplenism predispose to the development of malignant disease? AB - Splenic size and function was assessed in eight patients with celiac disease and coexisting malignancy (six had small bowel lymphoma and two gastric adenocarcinoma). The size of the spleen was reduced in four of seven patients as seen at autopsy or radionucleotide scanning. Splenic function was studied using "pitted" erythrocyte counts, platelet counts, and Howell-Jolly bodies and was impaired in five of eight patients. Malignant disease developed in some celiacs with normal splenic size and function. Splenic function as measured by pitted erythrocyte counts was similar in the celiac patients with malignancy and appropriately matched nonmalignant celiacs. We conclude that hyposplenism in celiac disease does not influence the development of malignant disease. PMID- 3966451 TI - Clinical, histological, and electron microscopic study of mast cell disease of the small bowel. AB - A patient with mast cell disease of the small bowel is described in whom clinical, histological, and ultrastructural studies served to delineate the characteristic features of the disease. Urticaria pigmentosa, steatorrhea, eosinophilia, absence of antireticulin antibodies, and submucosal nodularity seen on radiographic study of the duodenum were the clinical characteristics. The endoscopic appearance was that of severe exudative duodenitis. The histology of the small intestinal mucosa showed crypt cell destruction and villous atrophy. Marked infiltration of the lamina propria with mast cells, eosinophils, and neutrophils was also distinctive. The enterocytes retained their columnar epithelium, confirmed on electron microscopy. The fine structural abnormalities of the mast cells are demonstrated for the first time. Degranulated mast cells predominated within the lamina propria and none was seen among the epithelial layers. The mast cell nuclei were irregular, often binuclear, and showed loss of their normal heterochromatin pattern. In their cytoplasm only few granulated bodies were seen and even more rarely inclusions with whorls and scrolls. We conclude that the clinical, histopathological, and ultrastructural appearances in mast cell disease of the small bowel are distinctive and should be used as criteria for diagnosis. Care should be taken in the evaluation of the number of mast cells since the demonstration of these cells may be affected by various fixing and staining techniques. PMID- 3966452 TI - Natural history of repaired umbilical hernias in patients with and without ascites. AB - A retrospective chart review was undertaken to determine the natural history of repaired umbilical hernias in patients with and without a history of ascites. Eighty-five patients underwent umbilical herniorrhaphy during the interval from January 1973 to March 1983. The length of hospital stay was significantly longer for the 22 patients who had a history of ascites; however, the complication rate of elective repair of umbilical hernias that were caused by ascites was not different from that of the 63 patients without a history of ascites. There was no operative mortality in either group. Sixty-eight patients were reevaluated at least 1 month postoperatively. Of the 51 patients who had never had ascites, six (12%) developed a recurrent hernia. Of the 17 patients whose hernias were caused by ascites, eight (47%) developed recurrences. Of the 11 herniorrhaphies performed when ascitic fluid was present, eight (73%) resulted in a recurrence, whereas only one (17%) patient had a recurrence among the group of seven patients who underwent herniorrhaphy at a time when the ascitic fluid was no longer present. Umbilical hernias caused by ascites can be repaired with acceptable morbidity and probably should be repaired after the fluid has been medically removed. PMID- 3966453 TI - The association of Streptococcus bovis fecal carriage and colon neoplasia: possible relationship with polyps and their premalignant potential. AB - We designed a study to evaluate the fecal carrier rate of Streptococcus bovis in patients with endoscopically proven colonic polyps. Benign polyps (n = 63), i.e., hyperplastic, inflammatory, and juvenile, had a similar fecal carrier rate as the normal control colons. Colons with polyps that are at increased risk for malignant degeneration (n = 62), i.e., tubulovillous and villous adenomas, and colons with carcinoma (n = 18), had a statistically significant increase (p less than 0.05) in the fecal carrier rate for S. bovis over the benign colon group. Overall, the incidence of S. bovis carriage in all colons with polyps was intermediary between normal colons and colons with carcinoma although the numbers did not achieve statistical significance. PMID- 3966454 TI - Evaluation of colonic neoplasia by flow cytometry of endoscopic biopsies. AB - Colonoscopy is a valuable and frequently used method in the evaluation of colonic neoplasia. Flow cytometry is a technique that can be used to diagnose malignancy. In this study, flow cytometry was used to evaluate colonoscopic biopsies taken from patients with suspected colonic neoplasia. Nineteen colonic biopsies were obtained and evaluated by this technique. Aneuploidy was demonstrated in six patients with carcinoma of the colon. In addition, abnormal DNA histograms were noted in two premalignant conditions (colonic adenoma and inflammatory bowel disease). The results show that flow cytometry can be applied to colonic biopsies and suggest that it may be of use in the diagnosis of malignant and premalignant conditions of the colon. PMID- 3966455 TI - Effects of age and sex on anorectal manometry. AB - We studied rectal and anal function in 18 healthy elderly and 18 healthy young adults using intraluminal pressure transducers and a rectal balloon. Both age groups consisted of nine females and nine males. Age did not affect anal length, highest anal resting tone, anal pullthrough pressures obtained during rest and voluntary squeeze, threshold of the rectosphincteric reflex (RSR), amplitude of RSR with 60 ml rectal distension, threshold of sensation, critical volume, and rectal wall elasticity. Sex did not affect anal length, threshold of RSR, amplitude of RSR with 60 ml rectal distension, the critical volume and rectal wall elasticity. But the highest anal resting tone, anal pullthrough pressures obtained during rest and voluntary squeeze, and threshold of rectal sensation were significantly higher in the males than in the females. While aging did not affect anal and rectal function, sex did. Males achieved higher anal canal pressures. Therefore, statistical comparison between different groups of subjects is valid only if the groups are matched for sex. PMID- 3966456 TI - Differential determination of serum isoamylase using an amylase inhibitor and its clinical application. AB - Diagnostic significance of a simple and rapid screening procedure for determining the relative amounts of pancreatic and salivary isoamylase using an amylase inhibitor was evaluated in 242 subjects (controls 84, acute pancreatitis nine, chronic pancreatitis 28, pancreatic cancer 14, peptic ulcer 25, liver cirrhosis 15, cholelithiasis 24, irritable colon syndrome 13, diabetes mellitus 13, mumps seven, and chronic renal failure 10). Electrophoretically separated isoamylases of saliva and pure pancreatic juice were all inhibited at similar degrees to the corresponding unfractionated amylases. Total amylase and pancreatic isoamylase were elevated in all nine patients with acute pancreatitis. Pancreatic isoamylase was decreased in 12 of 28 patients (43%) with chronic pancreatitis and increased in nine of 14 patients (64%) with pancreatic cancer. The mean pancreatic isoamylase activity in the patients with acute pancreatitis was significantly higher (p less than 0.01), while that of chronic pancreatitis was significantly lower (p less than 0.05) when compared with controls. The inhibition method offers simple, rapid, and specific analysis of serum isoamylase for the differential diagnosis of hyperamylasemia in cases of emergency. PMID- 3966457 TI - "Bull's eye" or "target" lesions of the stomach secondary to carcinoma of the lung. AB - Three patients with radiographically demonstrated "bulls eye" or "target" lesions of the stomach were found to have gastric metastases from carcinoma of the lung. In two of the three patients, upper gastrointestinal radiography was performed because of gastrointestinal bleeding. Awareness of this association may facilitate earlier recognition of the primary site or earlier recognition of metastatic disease in similar cases. The radiographic appearance of the lesions in these patients is presented, along with a discussion of the pathogenesis of these lesions. PMID- 3966458 TI - Gastroenterology and the law. PMID- 3966459 TI - Comparison of the measurement of surface or total platelet-associated IgG in the diagnosis of immune thrombocytopenia. AB - Platelet-associated IgG (PAIgG) can be measured on intact platelets or following platelet lysis. Measurement of PAIgG following platelet lysis may provide different or additional information compared to PAIgG measured on intact platelets. The PAIgG of lysed platelets represents "total" PAIgG, ie, IgG on the surface of platelets plus any IgG that was inside the platelet. To investigate the clinical relevance of the two types of PAIgG assay we performed a prospective study on washed platelets collected from 47 patients with idiopathic thrombocytopenic purpura (ITP). The PAIgG was measured on intact and lysed platelets using an immunoradiometric assay. Platelet-associated IgG was 2-3 times higher when measured on lysed platelets from healthy controls or patients with ITP compared to PAIgG measured on the same intact platelets. The higher level of PAIgG observed following platelet lysis was not due to the reactions not achieving equilibrium. Using lysed platelets, PAIgG was elevated on 29 of 47 samples from different ITP patients and elevated in 31 samples when measured on intact platelets. The PAIgG is invariably higher when measured following platelet lysis compared measurements made on intact platelets. Neither technique offers a diagnostic advantage over the other. PMID- 3966460 TI - The relation of megakaryocyte ploidy to platelet volume. PMID- 3966461 TI - Erythrocyte membrane phosphorylation in aging rats. AB - By sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), the protein profile and autophosphorylation of plasma membranes of red cells from 3-, 9-, 18-, and 30-month-old rats was examined. No major changes in SDS-PAGE protein profiles were noticeable. However, endogenous (auto) and exogenous phosphorylation in the presence of (gamma-32P)ATP showed an age-dependent increase in 32P uptake. pH optimum was between 8.0 and 9.0 for all age groups. Cyclic AMP was without effect on either endogenous or exogenous phosphorylation. Further analysis of the autophosphorylation reaction by quantification of autoradiograms obtained from SDS-PAGE gels displayed an age-dependent increase in phosphorylation of bands 2, 3, 4.1, and 4.5 [nomenclature of Fairbanks et al. Biochemistry 10:2606, 1971] and of several other minor bands. The data imply that alteration in red cell membranes may occur during aging of rats causing an enhancement in endogenous kinase activity and possibly in the number of phosphate acceptor sites as well. PMID- 3966462 TI - Use of 75Se-labeled methionine to study the sequestration of senescent red blood cells. AB - Labeling red blood cells with Na251CrO4 enabled us to study certain aspects of red cell survival and sequestration from the circulation. As a random labeling procedure, however, the 51Cr method has certain limitations. Therefore, we developed a cohort labeling method using 75Se-methionine as a two-rat procedure. This gives us a clear pulse-labeled population of rat red cells to study the dynamics of sequestration. With this labeling procedure, it was possible to demonstrate that 1) there is an increase in the density of red cells with age, 2) a significant sequestration of red cells from the circulation is apparent at the end of 48 days and essentially is complete at the end of 60 days, 3) there is a corresponding uptake of senescent red cells in the spleen, which peaks at 55 days, and 4) the 60-day end point is sharper and is more definitive when the "specific activity" (cpm per red blood cell) of the labeled red cells in the spleen is compared to that of the red cells still in the circulation. Asialo red cells, obtained by removal of sialic acid with sialidase, frequently have been used as a model for the study of sequestration of senescent red cells. With the technique herein described, it was possible to show that while asialo red cells will inhibit the uptake of labeled asialo red cells, they have no effect on the sequestration of senescent red cells. Presumably, different sites and mechanisms of sequestration are involved. PMID- 3966463 TI - Severe congenital neutropenia with unique features of dysgranulopoiesis. AB - Congenital dysgranulopietic neutropenia (CDN) is a recently proposed entity that describes a small subgroup of children with clinically severe neutropenia. We followed and studied a 3-year-old girl with neutropenia (less than 500/mm3) and recurrent severe infections in whom repeated marrow evaluations revealed large (30-50 microns) multinucleated promyelocytes to polymorphonuclear cells with as many as 4 to 16 nuclei or nuclear lobes, respectively. In addition to the nuclear endoreduplication, ultrastructural and cytochemical evaluation of these cells demonstrated abnormalities in granule genesis and centriole structure. Concomitantly, immunoperoxidase staining indicated that many of the granules were devoid of lactoferrin but not lysozyme. In vitro proliferation studies revealed normal to increased thymidine labeling, normal numbers of colony-forming cells, and normal colony-stimulating activity from blood and marrow mononuclear cells, findings consistent with ineffective myelopoiesis. However, serum folate, B12, and lysozyme levels were normal. The nuclear and cytoplasmic abnormalities in this patient result in an extreme example of CDN, distinct from previously described cases. PMID- 3966464 TI - Monitoring of intensive phlebotomy therapy in iron overload by serum ferritin assay. AB - Four patients with idiopathic hemochromatosis were treated with intensive phlebotomy therapy. In 1 to 2 years, 8.8-16.7 g iron was removed. In three out of four patients hemoglobin levels fell at the end of therapy. Serum ferritin was continuously measured during therapy. The greatly elevated serum ferritin levels normalized or decreased to subnormal levels in all patients after therapy. Despite some fluctuations in the first phase of therapy, the fall in serum ferritin was regular with halving of the ferritin levels after about 50% of the excess iron was removed. The normalization of serum ferritin occurred in advance of the hemoglobin decrease at the end of therapy, indicating that in the later stages of therapy the normal iron stores are also depleted. It is emphasized that serum ferritin measurements are useful for monitoring of intensive phlebotomy therapy, and in particular to indicate the end of therapy before anemia develops. PMID- 3966465 TI - Geographic access to health care services: the case of maintenance hemodialysis. AB - A longitudinal study of the system for delivering maintenance hemodialysis services in St Louis, Missouri was conducted to determine the significance of geographic access in the selection and continued utilization of a treatment facility. Historically, center hemodialysis patients in this metropolitan area received care at four centrally located facilities. In 1981, two new, independent facilities were constructed; a satellite of an existing unit was opened in 1983. The data obtained in this study demonstrated that end-stage renal disease (ESRD) patients generally did not change their mode of maintenance therapy, their treatment facility, or the location of their personal residence. When such changes occurred, they were rarely precipitated by a desire to reduce travel time to treatment. Furthermore, the opportunity to improve geographic access by transferring to a closer unit was perceived by patients to be viable only if they could retain their physician. It was concluded, therefore, that travel time to treatment is a relatively unimportant aspect of the chronic care of center hemodialysis patients in a metropolitan area. PMID- 3966466 TI - Does social support determine the treatment setting for hemodialysis patients? AB - The availability of an adequate system of social support has been suggested to be significant in determining whether an end-stage renal disease (ESRD) patient is dialyzed in a center or at home. To evaluate this hypothesis more completely, we conducted a study of social support among 257 home and center hemodialysis patients receiving maintenance therapy at four facilities in a midwestern, metropolitan area. A statistically significant difference, chi 2(3) = 14.031, P = 0.0029, was observed in the percentage of patients with social support available to them across the four facilities. The distribution of patients between home and center hemodialysis at the facilities also differed significantly, chi 2(3) = 14.919, P = 0.0019. An adequate social support system was present among 96.4% of the 55 home hemodialysis patients and 85.6% of the 202 center hemodialysis patients, a difference that was statistically significant, chi 2(1) = 4.684, P = 0.0305. However, a more detailed analysis of these findings revealed that the presence of social support was not significant, chi 2(1) = 1.080, P = 0.2995, in determining whether and ESRD patient was dialyzed at home or in a center after accounting for the facility differences. The facility differences remained significant in determining the setting of hemodialysis even after correcting for social support, chi 2(3) = 10.740, P = 0.0132. We concluded, therefore, that the attitudes of clinical staff toward home and center hemodialysis and the willingness of staff to develop those resources that facilitate a specific treatment setting are the principal elements in the therapy selection process. PMID- 3966467 TI - The changing spectrum of heroin-associated nephropathy. AB - Thirty-five renal biopsies were performed on heroin abusers at our institution between January 1977 and June 1983 as part of the evaluation of unexplained heavy proteinuria. Twenty-eight patients (80%) had histopathologic diagnoses of either focal segmental glomerulosclerosis or renal amyloidosis. Patients having a diagnosis of renal amyloidosis were older (P = 0.025), had a longer history of heroin abuse (P = 0.05), and 13/14 demonstrated clear evidence of chronic subcutaneous suppurative lesions. The remaining seven patients demonstrated a spectrum of disease similar to that seen in the nonaddicted population. We compared the clinical and biopsy characteristics of patients evaluated between 1977 and 1980 with those seen between 1981 and 1983. The relative incidences of renal amyloidosis and focal glomerulosclerosis changed significantly (P = 0.025). Whereas 29% of patients in the early series had renal amyloidosis and 57% had focal glomerulosclerosis, the relative incidences in the later series were 48% and 29%, respectively. The development of renal amyloidosis in our patients appears to be related to a longer duration of heroin abuse with increased incidence of subcutaneous injection of the narcotic. Chronic, suppurative skin ulcerations tend to occur at the site of injection, resulting in a persistent acute-phase inflammatory state important for the initiation and potentiation of secondary amyloidosis. PMID- 3966468 TI - "Malignant" IgA nephropathy. AB - Most patients with mesangial IgA nephropathy who run a progressive course usually do so over a period of 10 to 20 years. This paper describes the course of three young men with similar presenting features and biopsy findings who progressed to end-stage renal failure in less than 4 years from presentation, even though initially all had serum creatinine levels that were in the normal range. They presented with macroscopic hematuria, which has previously been regarded as an indicator of a favorable prognosis, and all three had loin pain, constantly elevated urinary erythrocyte counts, and crescents in renal biopsies. In two cases, treatment appeared to be associated with stabilization of renal function, but deterioration to end-stage renal failure occurred rapidly after treatment was ceased. PMID- 3966469 TI - Lethal hyperkalemia associated with severe hyperglycemia in diabetic patients with renal failure. AB - Two patients with diabetic nephropathy on maintenance hemodialysis developed extreme hyperkalemia (7.9 and 9.3 mmol/L, respectively) in association with severe episodes of hyperglycemia (1,152 and 1,185 mg/dL, respectively). The increase in serum potassium was out of proportion to the degree of metabolic acidosis that both patients had, and no exogenous source of hyperkalemia could be identified. Despite treatment efforts both patients died shortly after arrival as a consequence of cardiac arrest. It is proposed that the hyperosmolality of extracellular fluid produced by severe hyperglycemia drives potassium passively out of the cells, therefore favoring the rapid development of hyperkalemia. Insulin deficiency could also play a role. This situation is particularly dangerous in individuals with impaired renal function. Adequate blood glucose control in diabetic patients on dialysis is important to avoid life-threatening hyperkalemia. PMID- 3966470 TI - Urinary lipid bodies in polycystic kidney disease. AB - Urinary doubly refractile lipid bodies (oval fat bodies) are observed most frequently in patients with heavy proteinuria resulting from glomerular disease. We observed doubly refractile lipid bodies (DRLB) in the urine sediment of 60% of 35 patients with autosomal dominant polycystic kidney disease (ADPKD). All patients had clinical courses typical of ADPKD, and none exhibited the features of a second, unrelated renal disease. DRLB in the urine were correlated with a urine dipstick protein reading exceeding trace. Age, sex, BP, and serum creatinine concentration were not associated with the presence of DRLB in the urine. Examination of cyst fluid obtained from kidneys of six ADPKD patients revealed DRLB in 80% of cyst fluid samples that contained degraded blood (so called chocolate cysts). The DRLB in cyst fluid were morphologically indistinguishable from those observed in urine, and DRLB from both sources were stained with oil red O. We conclude that urinary DRLB are a clinical feature of ADPKD. PMID- 3966472 TI - Sodium chloride pica secondary to iron-deficiency anemia. AB - A young woman was referred for nephrologic evaluation of hypertension and a curious desire for table salt. Suspicion of iron-deficiency anemia arose only after it was determined that sodium balance was achievable during supervised sodium restriction. This salt craving abated within 2 weeks of initiation of iron replacement therapy. Although pica is a common manifestation of iron deficiency, this appears to be the first reported case of salt pica secondary to iron deficiency. PMID- 3966471 TI - Hyperkalemia complicating digoxin toxicity in a patient with renal failure. AB - We describe the occurrence of hyperkalemia in a stable hemodialysis patient who developed digoxin toxicity. The patient had been receiving digoxin for 2 years. His maintenance digoxin dose was increased from 0.125 to 0.25 mg three times a week, which resulted in a toxic serum level of 4.9 ng/mL (therapeutic range is 0.8 to 2.0 ng/mL). As a consequence of the digoxin toxicity, he became hyperkalemic (7.8 mEq/L), and this value returned to normal only after the digoxin level was lowered by a combination of oral charcoal and dialysis. This study shows how readily hyperkalemia can occur in an anephric patient manifesting digoxin toxicity. Thus, potentially lethal hyperkalemia can occur in hemodialysis patients who ingest therapeutic quantities of digoxin. Digoxin toxicity should be added to the differential diagnosis of hyperkalemia in patients with renal failure. This can occur despite the absence of a history of massive ingestion of a cardiac glycoside. PMID- 3966473 TI - Association of hyperestrogenemia and coronary heart disease in men in the Framingham cohort. PMID- 3966474 TI - Severe theophylline toxicity. PMID- 3966475 TI - Effects of patients' socioeconomic status and physicians' training and practice on patient-doctor communication. AB - To determine characteristics of patients and doctors that are associated with effective communication, patient-doctor communication was studied in 100 ambulatory patients who underwent echocardiography to evaluate previously undefined cardiac problems. As a marker for effective communication, this report examined how often the patient and doctor agreed about basic aspects of care, including symptoms, test results, therapy, and prognosis. Communication between the patient and physician was less effective when the patient was of lower socioeconomic status, as determined by occupation or insurance coverage. Characteristics of physician's training and practice were not significantly associated with better communication. Physicians were unable to predict when their responses would or would not agree with those of their patients. These findings suggest that there is the risk of less effective communication between patients of lower socioeconomic status and their physicians, and that physicians may be unaware that less effective communication is occurring. PMID- 3966476 TI - Chronic dyspnea in a 22-year-old woman. PMID- 3966477 TI - Chronic strongyloidiasis in Vietnam veterans. AB - Chronic Strongyloides stercoralis infections can produce intermittent urticarial skin eruptions and gastrointestinal discomfort for years. Three cases of symptomatic infection acquired by United States military personnel in Vietnam are presented as examples of chronic parasitic disease unrecognized by physicians despite clear histories of geographic exposure, classic creeping skin eruptions, and eosinophilia. More attention needs to be paid to the possible long-term sequela from military service in tropical climates by both military and civilian physicians. PMID- 3966478 TI - Fulminant disseminated carcinomatosis arising from squamous cell carcinoma of the tongue. AB - Squamous cell carcinoma of the tongue tends to be an indolent disease. Tumors that present as small, localized lesions of the anterior tongue have a median five-year survival greater than 70 percent whether treated by irradiation or surgery. Distant metastases occur in only 7.5 percent. This report describes a well-differentiated T1N0M0 squamous cell carcinoma of the anterior tongue that progressed from diagnosis to death of the patient in less than nine months. At autopsy, the tumor had disseminated widely, including simultaneous metastases to all layers of the heart. It is concluded that factors other than morphology and anatomic extent at presentation may modify prognosis in squamous cell carcinoma of the tongue. PMID- 3966479 TI - Familial hypocalciuric hypercalcemia. Mild expression of the gene in heterozygotes and severe expression in homozygotes. AB - Autosomal dominant familial hypocalciuric hypercalcemia was found in a kindred with neonatal severe primary hyperparathyroidism, previously judged to be an autosomal recessive trait. Mild hypercalcemia was documented in eight members representing three generations. Mild hypercalcemia was documented at an age as early as one week. In seven adults presumed to be heterozygotes, urinary calcium levels were in the same range as for familial hypocalciuric hypercalcemia. An additional adult member (who previously underwent parathyroidectomy for neonatal severe primary hyperparathyroidism) showed an abnormality in renal clearance of calcium and sodium characteristic of combined familial hypocalciuric hypercalcemia and surgical hypoparathyroidism. Parathyroidectomy in three hypercalcemic members did not cause normocalcemia. Unlike other kindreds with familial hypocalciuric hypercalcemia in whom hypercalcemia is consistent over time and moderate in heterozygotes, this kindred was characterized by heterozygotes showing hypercalcemia that was intermittent and mild. The consanguineous parents of the two previously described severely affected neonates were judged to be heterozygotes for familial hypocalciuric hypercalcemia. In conclusion, (1) a gene presenting as familial hypocalciuric hypercalcemia can be expressed as hypercalcemia that is intermittent and very mild in heterozygotes; (2) such a gene can cause neonatal severe primary hyperparathyroidism in homozygotes. PMID- 3966480 TI - Recurrent prolactinoma and meningioma following irradiation and bromocriptine treatment. AB - This case report describes a 45-year-old man with a massive extrasellar prolactinoma, treated initially with surgery and radiotherapy, who experienced a dramatic reduction of the bulk of his tumor but persistence and subsequent progression of an extrasellar portion while receiving long-term bromocriptine therapy, despite stable, suppressed prolactin levels. Although the residual tumor was thought to be adenomatous tissue unresponsive to bromocriptine, a meningioma was ultimately diagnosed. Because the meningioma may have been radiation-induced, clinicians are reminded to consider a second neoplasm in cases of apparent bromocriptine treatment failures, especially when prolactin levels are stable. PMID- 3966481 TI - Hemophilus aphrophilus meningitis followed by vertebral osteomyelitis and suppurative psoas abscess. AB - Hemophilus aphrophilus is an uncommon pathogen in man. It has rarely been reported as a cause of meningitis, exclusively in boys three years or younger. Osteomyelitis due to this organism is also rare. H. aphrophilus was responsible for meningitis, probable thoracic empyema, and ultimately vertebral osteomyelitis and suppurative psoas abscess formation in a woman following metrizamide myelography. The patient responded well to antibiotic treatment and surgical drainage. The organism was sensitive not only to chloramphenicol but also to newer cephalosporin antibiotics. PMID- 3966482 TI - Horner's syndrome secondary to Swan-Ganz catheterization. AB - A preganglionic Horner's syndrome developed shortly after ipsilateral percutaneous insertion of a Swan-Ganz catheter in the internal jugular vein for management of pulmonary edema. There were no other neurologic findings nor evidence of mass lesions in the neck or pulmonary apex. This is believed to be the first reported case of Horner's syndrome complicating Swan-Ganz catheterization, which may occur more commonly than is generally appreciated. PMID- 3966483 TI - Survival after severe hypernatremia due to salt ingestion by an adult. AB - An 85-year-old woman was brought to the hospital with a serum sodium level of 193 mmol/liter following salt ingestion. She was treated with free water replacement and recovered within 48 hours. She represents the sole survivor of salt ingestion of this severity in the literature. PMID- 3966484 TI - Effects of a high-complex-carbohydrate, low-fat, low-cholesterol diet on levels of serum lipids and estradiol. AB - Recent studies have implicated elevated levels of serum estradiol in males as the major predisposing factor for myocardial infarction, with serum cholesterol playing a secondary role. The purpose of the present study was to investigate the effects of a high-complex-carbohydrate, low-fat, low-cholesterol diet and daily exercise on levels of serum estradiol, testosterone, and lipids in males. Twenty one males participating in the Pritikin Longevity Center 26-day residential program volunteered for the study. During the program, serum estradiol levels were significantly reduced from 47.2 +/- 4.6 to 23.8 +/- 2.5 pg/ml (mean +/- SE) whereas serum testosterone levels were unchanged (5.1 +/- 0.3 versus 5.1 +/- 0.2 ng/ml). Total serum cholesterol levels were reduced from 229 +/- 9 to 181 +/- 7 mg/dl whereas triglyceride levels were reduced from 301 +/- 66 to 151 +/- 13 mg/dl. High-density lipoprotein-cholesterol levels fell from 41 +/- 3 to 35 +/- 1 mg/dl whereas the ratio of total cholesterol to high-density lipoprotein cholesterol was unchanged (5.5 +/- 0.4 versus 5.1 +/- 0.3). PMID- 3966485 TI - Medicine and health care along the Silk Road in China. PMID- 3966486 TI - Continuous high-grade mycobacterium avium-intracellulare bacteremia in patients with the acquired immune deficiency syndrome. AB - Serial quantitative blood cultures were performed before and during treatment in four patients with the acquired immune deficiency syndrome (AIDS) and Mycobacterium avium-intracellulare bacteremia. Initial colony counts were 350 to 28,000 cfu/ml, the counts declined substantially with treatment in two patients, and they declined modestly with treatment but rose when it was stopped in the other two. In one patient who was studied in detail, most of the circulating organisms were within the leukocytes, colony counts in blood subjected to lytic agents were 1.9- to 5.2-fold higher than in unlysed blood, and there were 10(5) to 10(6) times more organisms per gram in several tissue specimens obtained at autopsy than per milliliter of blood. It is concluded that continuous high-grade bacteremia is common in patients with AIDS and severe M. avium-intracellulare infections and that serial quantitative blood cultures provide a potential means for studying treatment in these patients. PMID- 3966487 TI - Depression among Vietnamese refugees in a primary care clinic. AB - Refugees are at high risk for mental disorders and manifest cultural influences in their health behavior. The Vietnamese Depression Scale was administered to Vietnamese patients at a community clinic to assess the underlying prevalence of depression. The rate of accurate diagnosis and the manifestations of depression were also examined. A high prevalence of depression (52 percent) and a high level of underdiagnosis (56 percent) by primary care physicians were found. Ninety-five percent of these patients presented with physical symptoms. Compared with patients who had negative depression scores, those who had positive depression scores were more likely to be older and sought care at the clinic more frequently. These findings underscore the importance of depression as an urgent health problem among Vietnamese refugees in primary care. Accuracy in diagnosis can be improved by using the Vietnamese Depression Scale and constitutes the first step toward effective treatment. PMID- 3966488 TI - Clinical and endoscopic findings in patients early in the course of clostridium difficile-associated pseudomembranous colitis. AB - Endoscopic and clinical features are reported for 39 patients detected early in the course of pseudomembranous colitis. Disease was detected early by virtue of careful surveillance in patients in whom diarrhea developed. Early proctosigmoidoscopic findings in pseudomembranous colitis are illustrated. Clinical presentation includes development of fever, leukocytosis, abdominal pain, and even an ileus picture on radiography in addition to diarrhea. PMID- 3966489 TI - Infectious peritonitis in patients receiving intraperitoneal chemotherapy. AB - A total of 32 episodes of infectious peritonitis developed in 90 patients receiving intraperitoneal chemotherapy. Staphylococcus epidermidis was the organism most commonly cultured, accounting for 65 percent of isolates. Result of initial gram stain was positive in 35 percent of cases. The development of fever and abdominal pain as well as rising peripheral and peritoneal fluid white blood cell counts was helpful in the making of a diagnosis of infectious peritonitis. Seventy-five percent of patients were cured with antibiotic therapy alone whereas one quarter also required removal of the semi-permanent catheter. Patients treated with intraperitoneal chemotherapy delivered by dialysis exchange over several days exhibited significantly more episodes of infection than patients treated by a single-drug instillation each month. Although the development of bacterial peritonitis remains a problem during intracavitary chemotherapy, the use of subcutaneous ports and meticulous sterile technique during catheter manipulation will hopefully decrease the risk of occurrence of this potentially avoidable complication. PMID- 3966490 TI - Course and prognosis of sarcoidosis in a nonreferral setting. Analysis of 86 patients observed for 10 years. AB - Analysis of the course and prognosis of 86 patients with sarcoidosis over a 10 year period of observation in a nonreferral setting (Kaiser-Permanente Medical Care Program), a prepaid health maintenance organization, revealed no deaths or severe disability due to respiratory failure or cor pulmonale among 12 patients in whom pulmonary fibrosis either was present or developed during the period of observation. The prognosis by stage and overall was not influenced by race. Because of the method of disease identification that was chosen, it is believed the favorable outcome observed more closely approximates the course and prognosis of sarcoidosis as it occurs in the population in general than do series emanating from institutional settings. PMID- 3966491 TI - Use of serum bile acids in the identification of vinyl chloride hepatotoxicity. AB - Most previous studies proposing serum bile acids as indicators of hepatic function have been performed in hospitalized patients in whom overt symptomatic liver disease was present. The ability of fasting levels of serum bile acids to identify mild, clinically inapparent chemical liver injury in an occupational setting was compared with that of indocyanine green clearance and routine biochemical liver tests in 67 asymptomatic chemical workers in whom liver biopsies had been performed for medical indications. Histologically, 15 were found to have chemical liver injury, 27 had nonchemical liver disease, and 25 were normal. Two serum bile acids, cholylglycine and conjugates of cholic acid, were determined by radioimmunoassay, using 466 "normal" males from the same worker cohort as a reference range. The geometric mean concentrations of cholylglycine in patients with chemical liver injury, patients with nonchemical liver disease, and normal subjects were 47.9, 19.1, and 20.0 micrograms/dl, respectively (p = 0.036 by analysis of variance). Conjugates of cholic acid showed similar differences (p = 0.027), as did indocyanine green clearance with mean half-life of 4.2, 3.2, and 3.3 minutes in the three biopsy subgroups, respectively (p = 0.043). Such differences were not observed for biochemical liver tests. The fasting level of serum bile acids provided high specificity but lower sensitivity in the detection of all types of liver disease. However, serum bile acids and indocyanine green clearance provided a higher specificity and sensitivity for chemical liver injury than for nonchemical liver disease. An index of average exposure to vinyl chloride was significantly greater in the subgroup with chemical liver injury than in the other two groups, further supporting the association of chemical type injury with impaired anion uptake. These data identify the fasting level of serum bile acids as a clinically usable indicator of early chemical injury in chemically exposed asymptomatic worker populations with liver dysfunction. Further investigation is needed in other occupational hepatotoxic environments to determine if this association is limited to vinyl monomer type injury. PMID- 3966492 TI - Simple method for measurement of lower extremity muscle strength. AB - A simple, rapid, reproducible method for quantification of lower extremity muscle strength was standardized. The time needed to stand 10 times from a standard chair was recorded in 139 healthy subjects, aged 20 to 85 years (77 men, 62 women). Reproducibility was 6.8 percent (+/- 3.4 percent). Neither height nor weight was related to time in either sex. Weight was related to time (p less than 0.05) after adjusting for age, but this effect was slight compared with the effect of age alone. A highly significant (p less than 0.0001) relationship between time and age was found in both sexes. Younger men performed better than younger women, although this difference was lost in the older age groups. The results of this simple test correlated well with published data on the strength of knee flexor and extensor muscles in groups of men and women of various ages. This method was used to evaluate serially six consecutive patients with classic polymyositis or dermatomyositis. Improvement after treatment with prednisone used alone or in combination with azathioprine or methotrexate was found in all cases. PMID- 3966493 TI - Chronic arthropathy in long-term hemodialysis. AB - Acute arthritis and periarthritis are known to develop in patients undergoing long-term hemodialysis; however, the long-term consequences of hemodialysis on joint structure and function have not been thoroughly evaluated in a cohort of patients. All patients (11) undergoing hemodialysis for 10 or more years were evaluated for symptoms, joint function, and radiographic abnormalities. Eight patients had joint symptoms, excluding those from a septic or traumatic process. Only four patients had acute episodes of arthritis. Nine patients had abnormalities on physical examination, including decreased range of motion, joint effusion, crepitance, or deformity. Nine patients had abnormal findings on radiography, including narrowing, erosions, and calcification. Those with more severe disease were younger and had been receiving dialysis treatments longer. It is concluded that prolonged hemodialysis is associated with a progressive deterioration of joint structure and function with or without acute episodes of synovitis. PMID- 3966494 TI - Effect of hypoxemia on sodium and water excretion in chronic obstructive lung disease. AB - To determine the role of hypoxemia in the pathogenesis of impaired sodium and water excretion in advanced chronic obstructive lung disease, 11 clinically stable, hypercapneic patients requiring long-term supplemental oxygen were studied. The renal, hormonal, and cardiovascular responses to sodium and water loading were determined during five-and-a-half-hour studies on a control day (arterial oxygen tension = 80 +/- 6 mm Hg) and on an experimental day under hypoxic conditions (arterial oxygen tension = 39 +/- 2 mm Hg). Hypoxemia produced a significant decrease in urinary sodium excretion but did not affect urinary water excretion. Hypoxemia also resulted in concomitant declines in mean blood pressure, glomerular filtration rate, and filtered sodium load. Renal plasma flow and filtration fraction were unchanged whereas cardiac index rose. On the control day, plasma renin activity and norepinephrine levels were elevated whereas aldosterone and arginine vasopressin levels were normal; none of these four hormones was affected by hypoxemia. Renal tubular function did not appear to be altered by hypoxemia as there was no significant change in fractional reabsorption of sodium. The concurrent decreases in glomerular filtration rate, filtered sodium load, and mean blood pressure at constant renal plasma flow suggest that the reduction in urinary sodium excretion was due to an effect of hypoxemia on glomerular function, possibly related to impaired renovascular autoregulation. PMID- 3966495 TI - Risk factors for postmenopausal osteoporosis. AB - Fifty-eight women with postmenopausal osteoporosis (crush fracture of the spine) were compared with 58 age-matched normal women. The osteoporotic women had lower total-body calcium levels and bone mineral content of the radius, had undergone an earlier menopause, smoked cigarettes more, and had breast-fed less often. They also had lower levels of estrone, estradiol, and testosterone and reduced levels of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D. These findings suggest the presence of changeable risk factors for the development of osteoporosis. Smoking should be discouraged. An adequate intake of calcium and vitamin D should be ensured. It is the opinion of the authors that those women who have had an early menopause or who have a low bone mass at the time of menopause should be given the choice of medically supervised replacement therapy with estrogen and progesterone. PMID- 3966496 TI - Post-tubal sterilization syndrome--a misnomer. AB - Menstrual parameters and gynecologic symptoms of 389 women who underwent laparoscopic tubal banding were studied prospectively and longitudinally. Previous oral contraceptive users exhibited an immediate increase in menstrual flow and dysmenorrhea, which declined slightly with time. No such changes occurred in women who used other methods of temporary contraception. A significant increase in noncyclic pelvic pain, independent of previous contraceptive usage, developed only in women greater than 38 years of age. Menstrual cycles and dyspareunia were not affected. A small control group of women whose husbands underwent vasectomy showed no significant changes in any of these parameters. PMID- 3966498 TI - Use of atropine to differentiate normoxic from hypoxic bradycardia. PMID- 3966497 TI - Characterization and comparison of two forms of human chorionic gonadotropin from hydatidiform moles with low and high immunoreactivity. AB - Two glycoproteins (LM-hCG and HM-hCG) with gonadotropic activity were purified from the chorionic tissue of patients with hydatidiform mole with low and high urinary human chorionic gonadotropin levels and were compared to each other. The immunologic, biologic, and physicochemical properties of the two preparations were very similar. Also, the quantities of LM-hCG and HM-hCG recovered from molar tissue from the two types of patients were similar. However, the molar tissue from patients who excreted high levels of human chorionic gonadotropin immunoreactivity also contained other molecular forms with apparent human chorionic gonadotropin immunoreactivity tissues from patients who excreted low levels did not. These latter molecular forms may account for the differences in the levels of human chorionic gonadotropin immunoreactivity excreted by the two types of patients. PMID- 3966499 TI - The "lytic cocktail" induces recurrence of fits in the treatment of eclampsia. PMID- 3966500 TI - Prognostic significance of adenofibromatous pattern in ovarian epithelial malignancies. PMID- 3966501 TI - Significance of fetal deceleration during antepartum heart rate testing. PMID- 3966502 TI - Autocorrelation techniques in fetal monitoring. AB - Fetal monitors that feature autocorrelation have recently been introduced. This paper discusses autocorrelation and describes how it extracts periodic signals from a noisy background. An example of its performance under clinical conditions demonstrating advantages and limitations is discussed. PMID- 3966503 TI - Low-dose oral contraception and blood pressure in women with a past history of elevated blood pressure. AB - Sixty-one women with a past history of elevated blood pressure (high-risk group) associated with oral contraceptive use (27 patients), unknown etiology (17 patients), or preeclampsia (17 patients) used a low-dose oral contraceptive containing 0.4 mg of norethindrone and 35 micrograms of ethinyl estradiol for 3 to 24 months. The highest blood pressures recorded in the past were 141.0 +/- 14.9 (mean +/- SD) mm Hg systolic and 98.3 +/- 8.0 diastolic. Sixty-one women without a past history of elevated blood pressure (low-risk group), selected from a pool of 616 low-risk patients, were matched with the high-risk group for race, initial age, initial body weight, duration of use, history of smoking, and family history of hypertension. The blood pressures in the high-risk group before and after oral contraceptive therapy were significantly higher than those in the low risk group. Despite these differences, the mean systolic and diastolic blood pressures in these two groups of women using the low-dose oral contraceptive did not rise when compared with their own baseline blood pressures. Five high-risk patients (8.2%) discontinued therapy because of the redevelopment of hypertension; however, blood pressures at discontinuance were comparable to the previous highest blood pressures. PMID- 3966504 TI - Management of preterm prematurely ruptured membranes: a prospective randomized comparison of observation versus use of steroids and timed delivery. AB - The use of hydrocortisone and timed delivery was compared to expectant management of pregnancies complicated by preterm prematurely ruptured membranes in a prospective randomized trial of 73 patients. The incidence of maternal and neonatal complications was compared. There was no significant difference in the incidence of respiratory distress syndrome. Steroid-treated mothers had an increased incidence of postpartum febrile morbidity. We conclude that treatment of women with preterm prematurely ruptured membranes with hydrocortisone and timed delivery offers no advantage over expectant management. PMID- 3966505 TI - Survey of obstetric forceps training in North America in 1981. AB - In April, 1983, a questionnaire was sent to all 144 United States and Canadian members of the Association of Professors of Gynecology and Obstetrics to survey residency training and current use of obstetric forceps in 1981. One hundred five programs (73%), responsible for at least 283,000 births in 1981, were subsequently analyzed. All training programs used outlet forceps and all programs but one used midforceps for delivery. Hospitals with high cesarean birth rates did not perform significantly fewer midforceps operations. Hospitals with high midforceps rates did not also have high outlet forceps rates nor did these high rates closely reflect the personal attitude to obstetric forceps of the director of the obstetric training program. Simpson's forceps were most commonly used for outlet forceps and occipitoanterior midforceps operations, whereas Kielland's forceps were selected by 76% of programs for rotational midcavity deliveries. Staff obstetricians were the primary instructors of forceps technique in the delivery room in only 50% of United States programs; all Canadian respondents reported the staff obstetrician as the principal educator in obstetric residency forceps training. PMID- 3966506 TI - Initial instruction in the pelvic examination in the United States and Canada, 1983. AB - Initial instruction in the pelvic examination in the United States and Canada was reviewed by questionnaire. Seventy-two percent of the 116 responding medical schools taught this material in the second year, two-thirds with a specific course devoted to the subject. Ninety-three percent used "live models" or "teaching associates" in place of, or in addition to, traditional methods such as the examination of clinic patients. The use of teaching associates was uniformly rated as an extremely effective educational method. A continued trend toward use of an educational methodology that emphasizes communication as well as psychomotor skill instruction is identified. PMID- 3966507 TI - Antepartum fetal heart rate testing. XII. The effect of manual manipulation of the fetus on the nonstress test. AB - A prospective study of 790 patients was performed in order to examine the role of manual manipulation of the fetus in the nonstress test. The patients were assigned randomly to two groups based on the last two digits of their hospital number. The odd-numbered patients underwent manual manipulation of the fetus prior to the onset of the nonstress test; the even-numbered patients did not. There was no significant difference between the two groups with respect to the indications for testing and the total number of tests. There was no statistically significant difference between the two groups with respect to the ratio of reactive to nonreactive nonstress tests and the mean duration of testing. Simple manual manipulation of the fetus does not seem to change the outcome in antepartum fetal heart rate testing when the nonstress test is the primary one. PMID- 3966508 TI - Triploidy and chromosomes. AB - In a total sample of 105 triploid spontaneous abortions and live-born and stillborn infants, the parental origin could be determined in 77%. Dispermy was the most common cause of this abnormality. Among the digynic triploids 69% resulted from retention of the second polar body. Parental ages did not differ from those of the general population except for 10 aneuploid triploids with significantly elevated parental ages. In five sibships, simple aneuploidy in another pregnancy was observed, four of them being potentially viable. Two sisters had triploid conceptions. There were four twin pregnancies, a frequency of one in 26. Only two triploids had an XYY sex chromosome complement, one of which was mosaic with loss of an autosome and the other was a chimera. A frequency of almost 50% of mothers exposed to preconception abdominal radiation is suggestive of an association between radiation and triploidy and requires further investigation. PMID- 3966509 TI - The significance of a previous stillbirth. AB - Among 7052 patients studied between 1976 and 1982 in a collaborative project on antepartum fetal heart rate monitoring, 337 patients had a previous stillbirth as a reason for testing. Overall a previous stillbirth history significantly increased the risk of having a positive result on a contraction stress test, primarily among hypertensive patients. Patients with a previous stillbirth also had a significantly higher incidence of respiratory distress syndrome in their neonates attributable to premature intervention for maternal indications (primarily among hypertensive women and patients with clinical intrauterine growth retardation). Low Apgar scores were found to be significantly increased in diabetics with previous stillbirths primarily due to neonates with congenital malformations. Premature intervention by labor induction or cesarean section was more common among patients with a previous stillbirth for both maternal indications and abnormal antepartum fetal heart rate studies. Previous stillbirth would appear therefore to be a significant risk factor primarily when associated with a diagnosis of hypertension or clinical intrauterine growth retardation. PMID- 3966510 TI - Breast aspiration biopsy with multihole needles for histologic and cytologic examination. AB - Multihole needle biopsy has been performed on 166 patients. Commercially available 22-, 20-, 18-, and 16-gauge hypodermic needles (40 to 75 mm in length) are prepared with three sharp-edged holes around the distal part of the needle, allowing aspiration of 3 to 6 ml or more of tissue, for both histologic and cytologic examination. Of patients with carcinoma, fibrocystic disease, fibroadenoma, intraductal proliferation (papillomatosis), and duct ectasia, multihole needle cytologic examination is significantly more accurate (35% to 83%) than single-hole needle examination (11% to 67%). Multihole needle histologic examination, however, is far more accurate, with diagnostic success ranging from 75% to 94% for the disorders described above. The procedure has several uses. For patients with isolated fibrocystic areas, duct ectasia, or papillomatosis, multihole needle biopsy not only is diagnostic but may also be therapeutic by virtue of removal of abnormal tissue by aspiration. Biopsies of areas of microcalcification can be obtained under x-ray control. In patients at high risk of breast cancer (carcinoma in mother and/or sister), breast aspiration is performed when the slightest suspicion arises. In patients with unilateral breast cancer at high risk of bilateral carcinoma (premenopausal breast cancer, lobular carcinoma, tubular carcinoma, family history of breast cancer), random needle biopsy is performed in the contralateral breast for cancer detection. Furthermore, during follow-up of breast cancer patients, biopsies of locoregional changes or suspicious areas in the contralateral breast are obtained with the multihole needle for diagnostic evaluation. Thus multihole needle biopsy represents an improvement over the single-hole needle currently used, with enough tissue provided for adequate initial diagnosis and follow-up diagnostic evaluations in patients with benign and malignant breast disease. PMID- 3966511 TI - Myotonic muscular dystrophy associated with ritodrine tocolysis. AB - A patient thought to be normal was admitted with premature labor at 29+ weeks' gestation. Treatment with the beta-mimetic ritodrine hydrochloride appeared to provoke symptoms of myotonic muscular dystrophy. Neurological history and examination confirmed the presence of previously unsuspected myotonic dystrophy in the patient, her father, and paternal grandfather. Discontinuation of the drug led to improvement in myotonia symptoms but worsening premature labor. Magnesium sulfate did not provoke the same symptoms but was unsuccessful in controlling premature contractions. Long-term management with bed rest, phenytoin, and isoxsuprine hydrochloride resulted in term delivery. Subsequently, maternal symptoms of myotonia disappeared. Congenital myotonia was suspected in the fetus because of the ultrasonic demonstration of polyhydramnios and reduced fetal movements. This was confirmed at delivery. The mechanism by which ritodrine unmasked the myotonia is unclear but may be related to changes in the cell membrane (chloride conductance, the sodium-potassium pump, or membrane polarization). PMID- 3966512 TI - Pseudomembranous colitis following prophylactic antibiotic use in primary cesarean section. AB - A report of a hospital outbreak of pseudomembranous colitis in three patients given prophylactic antibiotic therapy before and after primary cesarean section is presented. All patients shared the same ward and labor and delivery room, and the colitis occurred within an 8-day period. The diagnosis of pseudomembranous colitis was suspected clinically and confirmed by limited colonoscopy and biopsy followed by stool culture and toxin assay for Clostridium difficile. The high carrier rate of Clostridium difficile in the female urogenital tract and altered colonic motility during pregnancy, in addition to antibiotic use, may have contributed to the establishment of this disease. When diarrhea develops postoperatively in patients who have undergone cesarean section, pseudomembranous colitis as a potential serious complication must be kept in mind and necessary precautions taken to impede cross-contamination and development of secondary cases. PMID- 3966513 TI - Ultrasonic estimation of weight in the very low-birth weight fetus: a resident versus staff physician comparison. AB - The estimation of weight in the very low-birth weight fetus (less than 1500 gm) is becoming more important in obstetric management as neonatal nurseries are reporting better outcome in this weight category. It has become clear that assessment of weight can best be accomplished through the use of ultrasound. In many institutions, however, ultrasonography is under the control of other departments and is not readily available. This arrangement prevents rapid access and compromises the benefit of the technique. To evaluate the accuracy of scans performed in very low-birth weight infants by personnel with limited training in ultrasonography, we undertook a systematic study of weight estimates in this select group of patients. To date, 31 ultrasound examinations have been performed by staff physicians and 50 by resident physicians. Comparisons made between ultrasound examinations by staff and resident physicians showed that the absolute error between the ultrasound-predicted weight and the actual weight, though less in the case of staff physician examinations, was not statistically significant. PMID- 3966514 TI - Evaluation of intra-amniotic administration of 120 gm of urea with 5 mg of prostaglandin F2 alpha for midtrimester termination of pregnancy between 20 and 24 weeks' gestation. AB - The occasional finding of signs of life in fetuses delivered following intra amniotic administration of 80 gm of urea and 5 mg of prostaglandin F2 alpha suggested that the dose of 80 gm of urea was inadequate beyond the nineteenth week. Protocol modifications were made, and the metabolic effects of intra amniotic administration of 120 gm of urea used beyond the nineteenth week were compared to those of the 80 gm dose of urea used in patients prior to the twentieth week. The 120 gm urea dose was well tolerated. The peak blood urea nitrogen (at 4 hours after instillation) was higher with 120 gm of urea (36.4 mg/dl) than with 80 gm of urea (24.6 mg/dl) (p less than 0.05). Small decreases in the platelet count (14% of control) and serum fibrinogen (11%), sodium (2%), potassium (7%), and carbon dioxide (11%) levels and a 5% increase in peak serum osmolality were found. Following the change in protocol, fetal heart activity has been absent at 3 hours after instillation in all cases less than 24 weeks from the last menstrual period. PMID- 3966515 TI - Neuroretinal rim area in early glaucoma. AB - The neuroretinal rim area of the optic nerve head was measured in 33 normal individuals, 50 subjects suspected of having glaucoma, and 51 patients with glaucoma. The measurements were corrected for magnification produced by the optical system of the eye. The rim areas were statistically highly significantly different in these clinical groups. Mean neuroretinal rim area in the normal controls was 1.40 +/- 0.186 mm2. Therefore, 95% of the normal subjects had rim areas greater than 1.09 mm2; 30% of the subjects with ocular hypertension and 73% of the patients with glaucoma had rim areas less than 1.09 mm2. PMID- 3966516 TI - Lacrimal surgery in children. AB - Of 142 children who underwent major lacrimal surgery (160 dacryocystorhinostomies, one congenital fistula excision, one dacryocystectomy, and one canaliculostomy), 49 had congenital nasolacrimal duct obstruction (34%). Lacrimal obstruction was also associated with canaliculitis, punctal agenesis, trauma, congenital fistula, dacryocystitis, craniofacial defects, and functional eyelid abnormalities. Although the timing and technique of the surgery varied according to the abnormalities, an overall functional success rate of 90% (144 of 160 procedures) was achieved. PMID- 3966517 TI - A survey of current cataract surgical techniques. AB - A survey of 674 ophthalmologists in the United States confirmed that intraocular implants, along with extracapsular extraction and ambulatory surgery, are emerging as widely practiced surgical techniques. The data were analyzed geographically and statistically significant differences by region were found. More ophthalmic surgeons are likely to use both extracapsular extractions and ambulatory surgery in the future. PMID- 3966518 TI - Fleck retina in Kjellin's syndrome. AB - We examined members of two families with Kjellin's syndrome, an autosomal recessive disorder characterized by spastic paraparesis, dementia, and macular changes. Although the retinal lesions resemble the flecks of fundus flavimaculatus by ophthalmoscopy, they appear distinct from previously reported retinal flecks by fluorescein angiography. PMID- 3966519 TI - Progressive-addition lenses in the treatment of accommodative esotropia. AB - Thirty-two children ranging in age from 18 months to 16 years were treated for accommodative esotropia with variable-focus lenses instead of executive bifocals. The major advantages were the improved appearance of the glasses and the more natural progression of accommodative treatment from distance to near which provided more relaxation of convergence in the intermediate zone. The chief disadvantage was the difficulty fitting small children with lenses that were originally designed for the use of presbyopic adults. The maximum power for the effective control of the deviation for reading is at the bottom of the lens. Keeping this portion of the lens high enough proved to be difficult in small children. None of the patients were willing to return to executive bifocals after having worn progressive-addition lenses. PMID- 3966520 TI - Lack of alternation in patients treated for strabismic amblyopia. AB - Of a series of 57 formerly amblyopic patients who attained equal visual acuities (20/20 or better in each eye), only 29 were able to alternate after treatment. The oldest patient was 5 years old. The pattern visual-evoked response of the previously amblyopic eye in nonalternators showed a reduced amplitude as compared with that of the sound eye. This probably occurred because of a reduced number of cortical cells subserving the formerly amblyopic eye. Lack of alternation may be the result of cortical competition. More cortical cells are connected to the originally normal eye even after successful treatment of the amblyopic eye in the nonalternating patient. PMID- 3966521 TI - Penicillamine-induced ocular myasthenia gravis. AB - Two patients with rheumatoid arthritis (two women, 58 and 62 years old) developed reversible penicillamine-induced ocular myasthenia gravis. Both had the HLA-DR1 antigen, unlike most patients with idiopathic myasthenia gravis who show HLA-DR3, suggesting that penicillamine-induced myasthenia gravis and its idiopathic counterpart occur in patients with different genetic backgrounds. In both cases, cessation of drug treatment led to resolution of the symptoms. PMID- 3966522 TI - Conjunctival biopsy in sarcoidosis. AB - In a prospective study of systemic sarcoidosis, 28 patients underwent 55 conjunctival biopsies. The incidences of positive granulomatous lesions in proven and suspected sarcoidosis cases were 71.4% (ten of 14 patients) and 28.5% (four of 14 patients), respectively. Thus, random, bilateral conjunctival biopsies should be performed as soon as possible in all cases of presumed sarcoidosis. PMID- 3966524 TI - Subconjunctival dislocation of a posterior chamber intraocular lens. PMID- 3966523 TI - Ascorbic acid therapy in a thermal burn model of corneal ulceration in rabbits. AB - We studied the effect of topical and systemic ascorbic acid on a rabbit model of corneal ulceration produced by thermal burn. Central stromal ulceration occurred in 77% to 100% of eyes in all treatment groups. The rate of ulceration was accelerated in animals treated with systemic ascorbic acid. Ulceration began after 5.80 +/- 2.14 days in control eyes and 2.75 +/- 1.26 days in the eyes of rabbits treated with both topical and systemic ascorbic acid (P less than .02). Subconjunctival ascorbic acid alone did not affect the rate of ulceration (average onset, 6 +/- 1 days). Once ulceration occurred in animals treated with both topical and systemic ascorbic acid, the incidence of perforation and descemetocele formation was increased and that of healing was decreased. The time required for healing was not significantly altered by treatment (9.50 +/- 2.28 days for control eyes vs 5.75 +/- 2.78 days for treated eyes) (P greater than .05). PMID- 3966525 TI - An inexpensive irrigating pusher for posterior chamber lens implantation. PMID- 3966527 TI - Intraocular hypertension resulting from pupillary block by silicone oil. PMID- 3966526 TI - Globe stabilization in experimental microsurgery. PMID- 3966528 TI - Adaptor for low-power projection of eye sections. PMID- 3966529 TI - Contact thermal burns of the cornea from electric curling irons. PMID- 3966530 TI - Artifacts introduced by spectacle lenses in the measurement of strabismic deviations. PMID- 3966531 TI - Local ocular hypotensive effect of topically applied acetazolamide. PMID- 3966532 TI - Byssinosis: Release of prostaglandins, thromboxane, and 5-hydroxytryptamine in bronchopulmonary lavage fluid after inhalation of cotton dust extracts. AB - New Zealand White rabbits were exposed intratracheally to aerosolized cotton dust extract (CDE) for 5 minutes of tidal breathing and lavaged 15 minutes 1, 4, and 6 hours after exposure. Bronchoalveolar lavage cells were counted, and the number of macrophages and polymorphonuclear leukocytes (PMNs) was determined. Cell recruitment, which began 1 hour after exposure to CDE and plateaued at 6 hours, consisted of both mononuclear cells and PMNs. Lavage fluid was analyzed for concentrations of prostaglandin F2 alpha (PGF2 alpha), prostaglandin E1 and E2 (PGE), thromboxane B2 (TxB2), and 5-hydroxytryptamine (5-HT). PGF2 alpha, PGE, TxB2, and 5-HT were maximally increased in the lavage 4 hours after exposure to CDE. This is the first study to demonstrate the in vivo release of arachidonic acid metabolites and 5-HT in the lung in response to CDE inhalation. This study also demonstrates that maximum mediator release occurs at 4 hours after exposure to aerosolized CDE. These findings strongly suggest that arachidonic acid metabolites are available to mediate either totally or partially the pathogenic mechanism(s) of bronchoconstriction seen in the acute byssinotic reaction of man. PMID- 3966534 TI - Neonatal biliary atresia. PMID- 3966533 TI - Evolution of foam cells in subcutaneous rabbit carrageenan granulomas: I. Light microscopic and ultrastructural study. AB - With an increasing interest in the role of the monocyte-macrophage in the pathogenesis of atherosclerosis and as a progenitor of plaque intimal foam cells, a model for the study of foam-cell differentiation in an extravascular environment has been developed. Granulomas were induced in 25 normocholesterolemic (NC) and 28 hypercholesterolemic (HC) rabbits by the subcutaneous injection of 15 ml of 1% carrageenan. Granuloma tissue was harvested at 4, 7, 14, and 28 days and studied by light and transmission electron microscopy. Macrophages and foam cells were isolated by enzymic dispersion with collagenase and cultured for further characterization by scanning electron microscopy, nonspecific esterase (NSE), and oil red O (ORO) staining. Granuloma macrophages from NC rabbits were consistently ORO-negative, contrasting with those from HC rabbits which were strongly ORO-positive, even at 4 and 7 days. With an increasing duration of exposure to hypercholesterolemia, macrophages accumulated increasing amounts of stainable lipid, and in the 28-day HC granulomas, large foam cells distended by lipid inclusions accounted for 70% of the cells present. This model has established that NSE-positive macrophages in HC granulomas accumulate lipid and assume the morphologic characteristics of atheromatous intimal foam cells. PMID- 3966535 TI - Lyme arthritis. Spirochetes found in synovial microangiopathic lesions. AB - In 17 patients with Lyme disease, synovial specimens, obtained by synovectomy or needle biopsy, showed nonspecific villous hypertrophy, synovial cell hyperplasia, prominent microvasculature, lymphoplasmacellular infiltration, and sometimes lymphoid follicles. The larger surgically obtained specimens also showed striking deposition of fibrin in synovial stroma and a form of endarteritis obliterans. In 2 patients, spirochetes were seen in and around blood vessels by the Dieterle silver stain. Compared with 55 cases of other synovial disease, obliterative microvascular lesions were seen only in Lyme synovia, but marked stromal deposition of fibrin seemed nonspecific. These findings imply that the Lyme spirochete may survive for years in affected synovium and may be directly responsible for the microvascular injury. PMID- 3966537 TI - Caffeine-induced myocardial injury in calcium-free perfused rat hearts. AB - Hearts depleted of extracellular calcium become susceptible to injury caused by repletion of extracellular calcium (calcium paradox). It has been suggested that calcium-free perfusion causes weakening of intercalated disks and that the physical stress of contracture may cause sarcolemmal membrane rupture and creatine kinase (CK) release. To further investigate this hypothesis, the effects of caffeine on contracture, cellular morphology, and CK release were studied in control and calcium-free perfused isolated rat hearts. Control hearts perfused with 2.5 mM calcium retained normal ultrastructure for long periods of perfusion. Calcium-free hearts perfused for 12 minutes developed separations of fascia adherens portions of intercalated disks but retained intact nexus junctions. Hearts subjected to 5-minute calcium-free perfusion, followed by calcium repletion, developed a massive CK release and extensive contraction band necrosis (calcium paradox). Ten millimolar caffeine, which causes rapid calcium release from sarcoplasmic reticulum (SR), produced contracture, but not CK release, from control hearts perfused with medium containing 2.5 mM calcium. In calcium-free perfused hearts, caffeine caused sudden CK release accompanied by contracture, development of contraction bands, wide separations of cells at intercalated disks, and sarcolemmal membrane injury. Caffeine-induced injury occurred despite 3 mM amobarbital inhibition of mitochondrial respiration. Hearts perfused with caffeine in the presence of calcium relaxed when made calcium-free and did not release CK. Addition of caffeine following calcium-free perfusion at 22 C, which protects the heart from the calcium paradox, produced a rapid, transient contracture. These results are compatible with the hypothesis that myocardial cell injury in calcium-free hearts is not dependent on repletion of extracellular calcium or mitochondrial function, but can result from contracture following caffeine-induced release of intracellular calcium from the SR. PMID- 3966536 TI - Mechanisms of arterial graft failure. 1. Role of cellular proliferation in early healing of PTFE prostheses. AB - Failure of long-term synthetic arterial bypass grafts has been attributed in part to anastomotic stenosis, but the pathologic basis for this has not been determined. Which cells participate in the formation of the stenosis and the relationship between normal healing and the pathologic development of anastomotic narrowing have not been delineated. In this study we have examined early wound healing in 4-mm polytetrafluorethylene arterial bypass grafts placed in baboons. In this primate model, endothelium and smooth muscle cells (SMCs) derived from the cut ends of adjacent artery form the new intima and migrate together along the luminal surface of the graft at approximately 0.2 mm/day. Both cell types proliferate in association with the growing edge. In addition, both endothelium and SMCs located discretely over anastomoses continue to proliferate despite complete endothelial coverage. Intimal cross-sectional area in this region is always greater than over adjacent graft. Fibroblasts are invariably found in graft matrix and adventitia and do not contribute to formation of intima. It is hypothesized that anastomotic narrowing might be due to chronic endothelial injury and turnover associated with continued SMC proliferation and intimal thickening. PMID- 3966538 TI - Pulmonary endothelial and bronchiolar epithelial lesions induced by 4-ipomeanol in mice. AB - The morphogenesis of pulmonary edema and bronchiolar injury induced by the toxic furan, 4-ipomeanol, was studied by combined light and transmission electron microscopy. Weanling male CD-1 mice received 47 mg 4-ipomeanol/kg body weight by intraperitoneal injection and were studied at intervals from 2 to 360 hours after treatment. Interstitial edema associated with damaged endothelial cells was observed as early as 2 hours after treatment. The most severe endothelial damage was observed from 12 to 24 hours after treatment and occurred in association with alveolar edema. Capillary endothelial cell damage was characterized by marked dilation of endoplasmic reticulum and perinuclear envelopes, marked swelling of mitochondria, separation of cytoplasmic processes from other endothelial cells and their basal laminae, and occasional disruptions in the plasmalemma. Endothelial cell lesions in small caliber veins were similar but less pronounced as compared with the alterations observed in capillary endothelium. Minimal changes were present in alveolar epithelial cells. Damage to nonciliated bronchiolar epithelial cells was first observed at 4 hours after injection. The most severe changes in nonciliated cells occurred from 36 to 48 hours after treatment and included swelling of endoplasmic reticulum, necrosis, and sloughing. There was also necrosis and sloughing of ciliated bronchiolar epithelial cells. Endothelial and bronchiolar epithelial repair and resolution of the alveolar edema were complete by 240 hours after treatment. It is concluded that the endothelium lining capillaries and small veins, in addition to the nonciliated bronchiolar epithelial cell, are early targets in the development of 4-ipomeanol toxicity in the mouse and that the endothelial cell injury plays a major role in the development of pulmonary edema in this species. The results further suggest the possibility that pulmonary endothelial cells have the capability of metabolizing xenobiotic compounds such as 4-ipomeanol to form ultimate toxins. PMID- 3966539 TI - Muscle metabolism and performance in perfused rat hindquarter during heavy exercise. AB - An isolated perfused rat hindquarter model was used to examine muscle metabolism and performance during heavy muscular contraction. A one-pass system was used to perfuse the hindquarter for 30 min at rest and 20 min while electrically stimulated at 0.5 Hz with tetanic stimuli (100 Hz). The isometric tension generated by the gastrocnemius-plantaris-soleus muscle group was recorded continuously, and muscle biopsies were taken pre- and postperfusion. Peak tension was 2,648 +/- 55 g, decreasing to 69.3 and 51.6% of peak following 5 and 20 min of stimulation, respectively. Hindquarter O2 uptake increased from 0.56 mumol X min-1 X g perfused muscle-1 to 2.60 mumol X min-1 X g working muscle-1 after 3 min of stimulation and declined slightly thereafter. Lactate release by the hindquarter increased at the onset of stimulation, peaked at 2-4 min (23.4 +/- 1.4 mumol X min-1), and decreased to a constant amount in the final 10 min. Five minutes of stimulation produced large decreases in glycogen, creatine phosphate (CP), and ATP levels and increased lactate concentrations in all muscles sampled except the soleus. An additional 15 min of stimulation further decreased glycogen concentrations while lactate concentrations decreased in all muscles. Calculations based on the measured amounts of O2 and CP consumed and the amount of lactate produced revealed a heavy glycolytic contribution to energy production during the initial 5 min of stimulation (23%) and an aerobic domination during the final 15 min (90%). With this model heavy muscular contraction can be sustained to permit the measurement of uptake and release of substrates and products of the main energy-yielding pathways. PMID- 3966540 TI - Preparation of individual human diploid fibroblasts and study of ion transport. AB - A method for analyzing individual mammalian cells with electron probe microanalysis has been developed using human diploid fibroblasts. Cells were grown on the same support that is used for experimental manipulations and analysis. Steady-state cation and anion concentrations and kinetic processes during experimental perturbations could be measured on populations of less than 1,000 cells. Human diploid fibroblasts in normal tissue culture medium had the following intracellular concentrations (in mM): K, 168; Na, 25.0; Cl, 51.2; P, 84.1; S, 16.5; Ca, 6.04; and Mg, 10.0. The ratios of K to Na were equivalent when measured in the nuclear or cytoplasmic area of the cells. Serum in the incubation medium was found to increase the cellular effective permeability to Na by a factor of 2.5, while leaving the effective permeability to K unchanged. When returned to control medium after 7 h of incubation in K-free medium, the cells recovered normal K/Na in less than 1 h. In some experiments the coupling ratio of the ouabain-inhibitable cellular transport of Na to K was 3:2 and the ratio of Cl to K was 1:2. The sum of intracellular content (Na + K) (an estimate of cellular volume) did not change when the cells were placed in K-free medium and increased by less than 30% after ouabain treatment. After 5-7 h of ouabain treatment or of incubation in K-free medium, long after the intracellular K had been replaced by Na, the cellular chloride content had not changed significantly. PMID- 3966541 TI - Influence of aerobic metabolism on IMP accumulation in fast-twitch muscle. AB - Significant activation of AMP deaminase in fast-twitch muscle leads to a loss of ATP and accumulation of NH4 and IMP. Although this occurs during severe metabolic stress caused by intense contraction conditions, the process is probably influenced by the muscle's capacity for aerobic metabolism. We evaluated this possibility during moderately intense (5 Hz) contraction conditions in situ by following the time course of NH4 and IMP accumulation in fast-twitch, low oxidative white (FTW) and fast-twitch, high-oxidative red (FTR) muscle of the rat. A high rate of IMP formation, resulting in a 50% loss of ATP content, occurred in normal FTW, but not FTR muscle, during contractions when blood flow was intact. Eliminating blood flow prior to contractions, however, removed the distinction between the FTR and FTW muscle. The FTR fiber section now produced a high IMP content and a stoichiometric loss of ATP. Thus the ability of the FTR fiber to sustain this contraction effort without an ATP loss is due to its greater functional capacity for aerobic metabolism. The FTW muscle section of trained animals exhibited a reduced accumulation of IMP and a smaller loss of ATP during the same 5-Hz stimulation. The mitochondrial content and peak blood flow of this FTW fiber section is increased by training. Thus it is probable that the cellular conditions leading to a significant accumulation of IMP in fast-twitch muscle are determined by the metabolic stress established by the contraction effort, relative to the muscle fiber's functional capacity for aerobic metabolism. PMID- 3966542 TI - Influence of acidosis on AMP deaminase activity in contracting fast-twitch muscle. AB - The rate of AMP deamination to IMP and NH4, by the action of AMP deaminase, is increased in vitro by acidosis and elevations in [AMP] and [ADP]. We evaluated the influence of acidosis on the activity of AMP deaminase in contracting muscle (5 Hz) by relating the time course of IMP and NH4 production to lactate-induced acidosis in low-oxidative, fast-twitch white (FTW) and high-oxidative, fast twitch red (FTR) muscle of the rat. Cellular acidosis was modified by controlling lactic acid accumulation by regulating muscle blood flow and using trained animals. A significant activation of AMP deaminase occurred in both muscle types, but only at times when the estimated pH was 6.6 and below (lactate content 20 mu mol/g and above). Cellular acidosis, however, is not absolutely essential, since iodoacetic acid-blocked muscle lost 85-90% of its ATP to IMP during contractions. Thus cellular acidosis seems to be an important, but not the sole, factor activating AMP deaminase during contractions. Further, the influence of acidosis is probably different between fiber types, since the estimated free AMP and ADP contents, calculated from the creatine kinase and myokinase reactions, were different in the two fiber types. Most of the activation of AMP deaminase in FTR muscle could be attributed to a substrate effect of the increased free AMP content. In contrast, most of the activation of AMP deaminase in the FTW muscle was due to factors other than a substrate effect. These results suggest that cellular acidosis during intense contraction conditions is a major factor activating AMP deaminase, especially in the low-oxidative FTW muscle fiber type. PMID- 3966543 TI - Magnesium transport in murine S49 lymphoma cells: pharmacology and divalent cation selectivity. AB - The murine S49 lymphoma cell transports Mg2+ by a system distinct from systems responsible for Ca2+ influx (J. Physiol. London 337: 351-371, 1983). We have now determined the ability of various cations, anions, and drugs to modulate Mg2+ influx. Neither sulfate, nitrate, phosphate, nor bicarbonate altered Mg2+ influx. Among cations only T1+, Ba2+, Zn2+, Mn2+, Sc3+, and La3+ potently inhibited Mg2+ influx without causing obvious cell toxicity. Seventeen other cations were ineffective at maximal nontoxic concentrations. T1+ inhibition (Ki = 300 micron) is noncompetitive and apparently derives from its ability to dissipate membrane potential. The noncompetitive nature of and the rather poor inhibition constants for Ca2+ (Ki approximately equal to 5 mM) and Mn2+ (Ki = 200 micron) indicate that neither cation is an effective physiological antagonist of Mg2+ influx. Only Ba2+ exhibited competitive inhibition of Mg2+ influx (Ki = 1 mM). Cisplatin and Ca2+ channel antagonists also did not inhibit Mg2+ influx. These data further differentiate Mg2+ transport systems from those for Ca2+. In addition, the selectivity series for group IIa cation inhibition of influx (Mg2+ greater than Ba2+ much greater than Ca2+ greater than or equal to Sr2+) has not been observed previously in biological systems and is indicative of a very high anionic field strength at the Mg2+ recognition site. PMID- 3966544 TI - Human erythrocyte membrane proteins of zone 4.5 exist as families of related proteins. AB - An analysis of the polypeptide composition of zone 4.5 of human erythrocyte membranes has been done by immunoautoradiographic and two-dimensional peptide mapping techniques. Results of these studies demonstrated that the Coomassie blue profile was constant, with 14 well-resolved bands present. Zone 4.5 polypeptides existed as at least four families of two or more components with closely related polypeptide backbones. The families could be distinguished on the basis of their extraction characteristics, immunological cross-reactivity, and two-dimensional peptide maps. One family was related to protein 4.1, one family was related to band 3, and two families were independent and not similar to other larger membrane proteins. The data show that all of the visualized bands in zone 4.5 do not have the same protein composition and that several closely related forms of some polypeptides are present. PMID- 3966545 TI - Regulation of plasma lipid levels by plasma viscosity in nephrotic rats. AB - The viscosity of the extracellular medium of cultured hepatocytes has been shown to be a regulator of the secretion and synthesis of very low-density lipoproteins (Yedgar et al., J. Biol. Chem. 257: 2188-2192, 1982). At present, the role of plasma viscosity in regulation of plasma lipoprotein levels was examined in vivo using nephrotic hyperlipidemic rats. Plasma viscosity was increased by injection of macromolecules: simultaneously with induction of nephrosis by aminonucleoside; and after the lipid level had reached its maximum. In experiment 1 the elevation of plasma viscosity (which persisted for at least 2 days) delayed the development of the hyperlipidemia by at least 2 days. In experiment 2 increasing the plasma viscosity reduced plasma triglyceride and cholesterol levels by 70 and 40%, respectively, within 2 days. The hyperlipidemia was accompanied by increased plasma viscosity. The contribution of lipoproteins to plasma viscosity was 27% in the nephrotic-hyperlipidemic rats, compared with 4% in normal rats. It is suggested that plasma viscosity regulates lipoprotein levels in vivo concordant with the observation in cultured hepatocytes. PMID- 3966546 TI - Growth of fetal guinea pig: physical and chemical characteristics. AB - The growth of the fetal guinea pig was studied in 32 fetuses in 12 litters, ranging from 39 days gestation to full term (67 days). The wet weight of the fetus was well approximated by an exponential function of gestational age (GA) in days [fetal weight (g) = 0.993 e(0.068 X GA), r = 0.94]. Dry weight increased more rapidly than wet weight [dry weight (g) = 0.039 e(0.102 X GA); r = 0.97], resulting in an increase in percent dry weight from approximately 10% at 40 days gestation to 30% at term. Fat content increased even more rapidly than dry weight [body fat (g) = 0.00123 e(0.136 X GA), r = 0.97], accounting for 33% of dry weight and 11.7% of wet weight at term. Using bomb calorimetric projections of caloric value of 9.3 kcal X g fat-1 X day-1 and 4.6 kcal X g nonfat dry wt-1 X day-1, we estimate that growth of the fetal guinea pig requires 220 kcal X kg fetal wt-1 X day-1 near term. Carbon and nitrogen contents of the fetus increased at different rates, reflecting the changes in fat and nonfat tissues. Amino acids contributed 80% of total body nitrogen and 41% of total body carbon near term. Cysteine concentrations increased and lysine concentrations decreased with gestational age; the concentrations of the other measured amino acids did not change with gestational age. These studies represent the first systematic study of the chemical growth of the fetus in a nonhuman species. PMID- 3966547 TI - Brown adipose tissue after ventromedial hypothalamic lesions in rats. AB - The interscapular brown adipose tissue (IBAT) from obese rats with lesions of the ventromedial hypothalamus (VMH) was approximately 5 times heavier than those from controls. This hypertrophy of IBAT was associated with a marked enlargement of constituent adipocytes and their apparent transformation from multiloculated structure of lipid droplets into the uniloculated structure. The rate of fatty acid synthesis in IBAT of the obese rats was less than one-tenth of that in control rats and approximated the value in white adipose tissue (WAT) when they were starved for 24 h. When rats were fed, the synthetic rate was increased, but the lipogenic response of IBAT in the obese rats was much greater than that in controls, the extent of the response being comparable to that of WAT. The IBAT temperature rose rapidly on electrical stimulation of the sympathetic nerves to the tissue in control rats, whereas the temperature response was reduced markedly in the obese rats. It was suggested that thermogenesis in BAT was impaired in obese rats with VMH lesions by decreasing triglyceride turnover in BAT, probably due to dysfunction of the sympathetic nervous system and a consequent transformation of BAT into WAT. PMID- 3966548 TI - Effects of ANG II and K+ on Ca efflux and aldosterone production in adrenal glomerulosa cells. AB - A comparison was made of the effects of angiotensin II (ANG II) and K+ on aldosterone secretion and calcium efflux from porcine adrenal glomerulosa cells. In the presence of 1.25 mM Ca2+ in the perifusion medium, both 1 x 10(-9) M ANG II and 12 mM K+ caused a 3-fold increase in rate of aldosterone secretion. ANG II caused a 3.5-fold increase in the fractional efflux ratios of radiocalcium from cells prelabeled with 45Ca, but K+ caused only a 1.5-fold increase. When the perifusate contained no Ca2+ or the Ca2+ was replaced by 0.6 mM Sr2+, the effects of K+ on both 45Ca efflux and aldosterone production were abolished. On the other hand, ANG II still caused approximately the same increase in the fractional efflux ratio of radiocalcium and 25-50% of the normal increase in aldosterone production rate. When the perifusate contained 1.25 mM calcium and 25 microM dantrolene, K+ produced the same 1.5-fold increase in calcium efflux and the same maximal rate of aldosterone production as seen in the absence of dantrolene. In contrast, dantrolene greatly inhibited ANG II-induced increase in the fractional efflux ratio of calcium, 1.5-fold compared with 3.5-fold in the absence of dantrolene. Likewise, dantrolene delayed the onset of the ANG II-induced increase in aldosterone secretion and reduced the maximal rate of secretion to 50%. Cells incubated with both dantrolene and media containing no Ca2+ or containing Sr2+ in place of Ca2+ showed no response to ANG II either in terms of calcium efflux or aldosterone production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966549 TI - Blood glucose homeostasis in rats with a deficiency of liver phosphorylase kinase. AB - The glycogen storage disorder (gsd/gsd) rat has little or no phosphorylase kinase activity in the liver and is unable to break down liver glycogen on fasting. Nevertheless, gsd/gsd rats do not become hypoglycaemic on fasting. Gsd/gsd rats showed a decreased rate of glucose turnover measured with [6-3H]glucose. Perfused livers from gsd/gsd rats showed decreased rates of gluconeogenesis from lactate and alanine when the results were expressed per gram of liver, but the total glucose produced per liver was normal. Measurement of gluconeogenesis in vivo using [14C]-bicarbonate showed that gsd/gsd rats had a decreased rate of glucose production from substrates that enter the gluconeogenic pathway before pyruvate. We conclude that gsd/gsd rats have adapted to unavailability of liver glycogen by decreasing peripheral uptake of glucose and not by increasing gluconeogenesis. PMID- 3966551 TI - Specific binding of serotonin in rat lung. AB - Mammalian lungs have been shown to store and to inactivate serotonin (5-HT) by an active process involving uptake and metabolism. 5-HT has direct action on lung including constrictor effects of pulmonary vascular and tracheobronchial smooth muscle, suggesting the presence of 5-HT receptors in lung. We have identified specific 5-HT binding of high affinity to the different lung portions and have shown that there was a different capacity for this binding. Two different 5-HT binding capacities are present in a purified mitochondrial fraction. Saturation analysis of 5-[3H]HT binding to outer mitochondrial membranes demonstrates a single, temperature-sensitive, high-affinity and high-capacity binding (Kd = 8.3 +/- 1.2 nM, maximum binding capacity = 0.819 +/- 0.046 pmol/mg protein). The dissociation constant of inner mitochondrial membrane demonstrates a low-capacity site (Kd = 25.2 +/- 2.2 nM, maximum binding capacity = 0.453 +/- 0.037 pmol/mg protein). The purified microsomal fraction of lung exhibits a high-capacity binding site for 5-[3H]HT (Kd = 14.8 +/- 1.6 nM, maximum binding capacity = 0.760 +/- 0.03 pmol/mg protein). In addition to the lung being the major site for its inactivation, the presence of several specific 5-HT receptors may be related to some of the known 5-HT actions in lung and may suggest other unknown actions of this amine. PMID- 3966550 TI - Net release or uptake of histidine and carnosine in kidney of dogs. AB - Previous studies are equivocal as to whether the dog kidney produces histidine. Because one possible source of renal histidine is carnosine (beta-alanyl-L histidine), we investigated net renal production (release) or utilization (uptake) (Qmet) of histidine and carnosine in 19 female dogs after they were fed histidine-free (9 dogs) or histidine-containing diets (10 dogs). Diets were fed in short-(2-11 days) or long-term (52-57 days) studies. Dogs were infused with half-normal saline for 120 min followed by an infusion of half-normal saline containing carnosine, 50 mumol/min. Renal Qmet histidine, calculated from either plasma or whole blood values, was positive during infusion of half-normal saline. During carnosine infusion, Qmet histidine increased markedly, and there was net renal uptake of carnosine. The Qmet histidine and carnosine were not different in the dogs fed histidine-free vs. histidine-containing diets. Thus there is net renal release of histidine in female dogs that increases when carnosine is administered. Qmet histidine or carnosine do not change adaptively when dogs are fed histidine-free diets. PMID- 3966552 TI - Effects of prior adrenalectomy on postpneumonectomy lung growth in the rat. AB - The effects of adrenalectomy, with and without subsequent glucocorticoid replacement therapy, on postpneumonectomy compensatory lung growth in the rat were investigated. Male Sprague-Dawley rats (200-230 g) were subjected to no operation (UNOP), left pneumonectomy (PNX), or PNX preceded by bilateral adrenalectomy 5 days earlier (ADX/PNX). At 14 days post-PNX, when compensatory lung growth is normally complete in 200-g rats, right lung (RL) dry weights of PNX (263 +/- 6 mg, n = 26) and ADX/PNX (334 +/- 13 mg, n = 25) rats were increased 58 and 101%, respectively, relative to UNOP controls (166 +/- 5 mg, n = 10). Increases in total DNA, RNA, and protein in the right lungs of PNX and ADX/PNX rats occurred in proportion to RL dry mass. The increase in all parameters examined in PNX and ADX/PNX rats at 7 days post-PNX was half that at 14 days, indicating linear lung growth in both treatment groups. The stimulatory effect of ADX on lung growth was blocked by hydrocortisone acetate (HCA), administered intraperitoneally in daily doses of 5 mg/kg, beginning on the day of PNX. The RL dry weights of HCA-treated ADX/PNX rats (241 +/- 7 mg, n = 10) did not differ significantly from the corresponding value in PNX rats (270 +/- 14 mg, n = 7). The lower RL weights in the HCA-treated rats resulted from an inhibition of cell division, as evidenced by the total RL DNA content, which was similar to that in PNX animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966553 TI - Palatability and postprandial thermogenesis in dogs. AB - The role of palatability on postprandial thermogenesis was determined in six mongrel dogs of approximately 16 kg. Oxygen uptake (VO2) was continuously monitored by indirect calorimetry for 1 h before and 2 h after a standard meal of 1,390 kcal. In the first experiment each dog was given access to the meal, which was ingested within 5 min. In a second experiment the same meal was sham fed and collected into an esophageal pouch. In a third experiment the dogs were tube fed. In the first experiment a biphasic response was found in the postprandial increase in metabolic rate; a first phase lasting approximately 40 min and the other from 40 to 125 min. In the second experiment the increase in VO2 was comparable with that of the first experiment for the first 40 min but almost abolished for the remaining period; the sight and smell of food alone produced a similar effect. In the third experiment tube feeding caused a small increase in VO2, which was four times smaller than that found in both the first and the second experiment during the initial phase. However, during the second phase the increase in VO2 was comparable with that of experiment 1. An initial phase of feeding lasting approximately 40 min is identified with food palatability, whereas the second phase would correspond to a large extent to specific dynamic action of food. PMID- 3966554 TI - Pentobarbital effects on plasma catecholamines: temperature, heart rate, and blood pressure. AB - The effects of intravenous pentobarbital were studied in dogs. Plasma pentobarbital concentrations were inversely related to epinephrine and norepinephrine concentrations. Plasma catecholamines appeared fully suppressed at pentobarbital levels greater than 25-30 micrograms/ml. Furthermore, pentobarbital levels were negatively related to rectal temperature, heart rate, and mean blood pressure. The methods of pentobarbital administration influenced plasma pentobarbital as well as epinephrine and norepinephrine levels, temperature, heart rate, and blood pressure. These observations suggest the possibility that pentobarbital inhibits the sympathetic nervous system, which in turn may affect temperature, heart rate, and blood pressure. Because pentobarbital anesthesia affects plasma catecholamine concentrations, the regimen used in animal models requires consideration when interpreting data potentially influenced by the sympathetic nervous system. PMID- 3966555 TI - Regulation of amiloride-sensitive electrogenic sodium transport in the rat colon by steroid hormones. AB - The role of steroids in the regulation of colonic sodium transport was examined by infusing steroids into adrenalectomized (ADX) rats and evaluating the short circuit current (ISC) in vitro. Amiloride-sensitive ISC was induced by aldosterone and corticosterone with half-maximal doses (ED50) of 2 and 260 micrograms X kg-1 X h-1), respectively. Synthetic glucocorticoids such as methylprednisolone (33 mg/kg) and dexamethasone (ED50 = 30 micrograms X kg-1 X h 1) were also effective. Supramaximal doses of aldosterone (7.5 times ED50) for 24 h increased the total ISC (7-fold), the amiloride-sensitive ISC (366-fold), and the conductance (2-fold), as well as the potassium-stimulated phosphatase activity (2-fold) (reported previously). Compared with aldosterone, supramaximal doses of dexamethasone (4 times ED50) produced greater increases in the total ISC (15-fold) and the amiloride-sensitive ISC (674-fold). In contrast to aldosterone, dexamethasone also increased the amiloride-insensitive ISC (3-fold). Glucocorticoid action was not mediated by insulin since the ISC from diabetic ADX rats was increased by dexamethasone to a similar extent (11-fold) as in nondiabetic rats. Estradiol, progesterone, and testosterone did not stimulate the colonic ISC of ADX rats. The ED50 values of corticosterone and aldosterone, measured in terms of amiloride-sensitive sodium transport, produced serum levels that were slightly above those of unstressed, adrenal-intact animals and thus must be considered physiological. It is concluded that at physiological levels both steroids may mediate amiloride-sensitive sodium transport in the rat colon. However, as judged from changes in serum steroid levels, aldosterone is the physiological regulator of elevated sodium absorption in sodium deficiency. PMID- 3966557 TI - Neurotensin: a central neuromodulator of gastrointestinal motility in the dog. AB - The effects of intracerebroventricular and intravenous injection of neurotensin on gastrointestinal and colonic motility were examined in fasted and fed conscious, intact, and vagotomized dogs. When administered intracerebroventricularly at 20 ng X kg-1 or higher doses in the fasted state, neurotensin reduced the duration of the periods of gastric motility for 3-4 h. During this time the jejunal migrating motor complex was replaced by isolated phases of regular activity occurring at a rhythm of 2-3/h, while colonic motility was unaffected. These effects were abolished after vagotomy and were not observed for 25 times higher doses when administered intravenously. Injected intracerebroventricularly at a dose of 100 ng X kg-1 30 min after a meal, neurotensin significantly reduced (P less than 0.01) the duration of the fed pattern (2.7 +/- 0.7 vs. 8.7 +/- 1.2 h for control); this effect was not observed when neurotensin was administered intracerebroventricularly 20 min before or 120 min after a meal or when injected intravenously. Systemic administration of neurotensin at a dose of 500 ng X kg-1 significantly increased (P less than 0.05) during 2 h the colonic motility indexes in both fasted and fed dogs before and after vagotomy. It is concluded that neurotensin can act i) centrally to control the pattern of antral and jejunal motility in the fasted and fed dogs, these effects being mediated by the vagus; and ii) peripherally to control the pattern of colonic motility, this response being unaffected by vagotomy. PMID- 3966556 TI - Amiloride-sensitive salt and fluid absorption in small intestine of sodium depleted rats. AB - Secondary hyperaldosteronism produced by Na+ depletion was associated with increases in salt and fluid absorption in both the small intestine and the distal colon but not in the cecum and the proximal colon. Because these changes had not been documented for the small intestine, this study focused on the regulation of this tissue. Increased NaCl and water absorption was expressed in vitro by increases in short-circuit current and transepithelial potential and in vivo by increased fluid absorption and a decreased luminal content of Na+ and water. For example, the short-circuit current in the ileum of Na+-depleted rats was 2-fold that of adrenalectomized and 1.3-fold that of adrenal-intact control animals. The short-circuit current was inhibitable 24 +/- 14% by micromolar concentrations of amiloride in Na+-deficient animals compared with 1 +/- 3% in control animals. Similarly, ileal fluid absorption in vivo was 2.3-fold higher in Na+-deficient relative to control animals. The additional fluid absorption was sensitive to 50 microM amiloride, whereas amiloride had no effect in control animals. Furthermore, the Na+ content of the chyme from the ileum of Na+-deficient animals was about half that of controls. These results suggest that mineralocorticoids can induce the amiloride-sensitive Na+ transporter in the small intestine and that this type of epithelial salt transport can become a major pathway for salt retention by the small intestine. PMID- 3966558 TI - Effect of acid-base balance and acetazolamide on ursodeoxycholate-induced biliary bicarbonate secretion. AB - Biliary bicarbonate secretion may play an important role in canalicular bile flow. The aim of this study was to examine the effect of disturbances in acid base balance on ursodeoxycholate (UDCA)-induced choleresis and bicarbonate secretion. Isolated rat livers were perfused with an erythrocyte-free solution in a recirculating system. In the absence of bile acid infusion, bicarbonate concentration in bile varied in parallel with that in the perfusate (15.6-35.1 mM), irrespective of the perfusate pH (7.26-7.55). Bicarbonate concentration in bile was not significantly different from that in the perfusate. Under UDCA infusion (2 mumol/min), bicarbonate concentration in bile and perfusate was correlated (P less than 0.001). Bicarbonate concentration in bile was always higher than that in the perfusate. Perfusate pH changes (7.25-7.56) induced by changes in perfusate carbon dioxide tension had no significant effect on bicarbonate secretion or bile flow. A significant correlation was found between bile flow and bicarbonate secretion both with and without UDCA. Acetazolamide (1 mM) significantly decreased both UDCA-stimulated bile flow (-27.7%) and bicarbonate concentration (-51.8%). These results suggest that canalicular bicarbonate secretion includes an equilibrative component that is possibly linked to diffusion of plasmatic CO2 or HCO3- and a concentrative transport that is stimulated by UDCA, is independent of plasma pH, and involves carbonic anhydrase. PMID- 3966559 TI - Effect of divalent cations on gastrointestinal hormone release and exocrine pancreatic secretion in dogs. AB - The purpose of this study was to examine the effect of three common divalent cations (Ca2+, Mg2+, and Zn2+) on the release of cholecystokinin (CCK-33), pancreatic polypeptide (PP), and gastrin. Five dogs with pancreatic and gastric fistulas were given 1-h intraduodenal infusions of calcium (5 mmol X kg-1 X h-1), magnesium (4 mmol X kg-1 X h-1), or zinc (1 mmol X kg-1h-1). At another time the same dogs were given an intravenous bolus followed immediately by a 1-h infusion of calcium (0.36 mmol/kg [bolus], 0.36 mmol X kg-1 X h-1), magnesium (0.25 mmol/kg [bolus], 0.25 mmol X kg-1 X h-1), or zinc (0.03 mmol/kg [bolus], 0.03 mmol X kg-1 X h-1). Intraduodenal infusions of calcium, magnesium, and zinc significantly stimulated CCK-33, PP, and gastrin release. Intravenous calcium stimulated CCK-33, PP, and gastrin release to 245, 193, and 155% of basal levels, respectively. Intravenous magnesium increased CCK-33 to 123% of basal levels but did not stimulate PP and gastrin levels. Intravenous zinc stimulated release of CCK-33, PP, and gastrin to 126, 185, and 124%, respectively. This study shows that calcium, magnesium, and zinc can stimulate release of CCK-33, PP, and gastrin in much the same manner. We suggest that these cations may have a nonspecific electrical action that results in an alteration of membrane permeability, which leads to release of gastrointestinal hormones. PMID- 3966560 TI - Kinetics of zinc absorption by luminally and vascularly perfused rat intestine. AB - Zinc absorption by intestines of rats fed either zinc-deficient or zinc-adequate diets was measured by simultaneous luminal and vascular perfusion. The rate of absorption increased steadily for the first 30-40 min of perfusion over the entire lumen zinc concentration range examined (8-234 microM). During the last 10 min of perfusion the absorption rate did not change appreciably with time (steady state), and absorption by intestines from the zinc-depleted rats showed evidence of both carrier-mediated (saturable) and nonmediated (nonsaturable) components. The former had a Km of 55 microM and a Jmax of 3.3 nmol X min-1. In contrast, the absorption rate during the last 10 min of the perfusion period was a sigmoidal function of the luminal zinc concentration with intestines from zinc-adequate rats. The cytosol 65Zn concentration increased proportionately with increased luminal 65Zn concentration but was significantly greater in intestines from zinc depleted rats. Both high-molecular-weight species and metallothionein accounted for this increase in cytosolic 65Zn. An increase in the vascular bed zinc concentration increased the amount of zinc transferred to the mucosal cytosol but did not increase the amount transferred to the lumen. These results suggest a second mechanism of absorption may be induced during a dietary zinc depletion that is carrier mediated. Moreover, while zinc is transferred in the vascular-to mucosal direction from the vascular supply, little actually enters the lumen. PMID- 3966561 TI - Relation between pancreatic growth and blood flow. AB - Male rats were treated with daily subcutaneous injections (3 micrograms/kg) of cholecystokinin octapeptide (CCK-OP), a synthetic CCK analogue, for 2, 4, 7, and 14 days, while control rats were injected with saline over the same intervals. Regional blood flows were measured with Sc46-labeled microspheres using the reference-organ method. Pancreatic wet and dry weights were determined in each treatment group. Total pancreatic DNA content was estimated with the diphenylamine reaction. Significant hyperplasia and increases in pancreatic wet weight occurred at 7 and 14 days, although hypertrophy was not evident in any of the treatment groups. No increases in small intestine wet weight or DNA content were evident in any treatment group. CCK-OP treatment induced a significant pancreatic hyperemia at 2 and 4 days of treatment. Pancreatic blood flow at 7 and 14 days was not different from control when expressed per unit tissue weight. The hyperemia seen at 2 and 4 days was not due to either a direct vascular effect of CCK-OP or an increase in pancreatic exocrine secretion. The hyperemia is therefore due to the growth stimulus and may be related to vasodilator metabolite accumulation during pancreatic tissue proliferation. PMID- 3966562 TI - Lipase secretion from dispersed rabbit gastric glands. AB - We have measured gastric lipase activity in dispersed glands of rabbit stomach by quantitating the hydrolysis of tri[3H]olein. Lipase activity in isolated gastric glands was 200-400 nmol [3H]oleic acid released per milligram dry weight per minute. The percentage of lipase activity released during incubation for 30 min at 37 degrees C under basal conditions was 1.5-4.5%. Lipase release was stimulated by secretagogues: 10 nM cholecystokinin octapeptide (CCK-8) and 100 microM carbachol led to four- to sixfold and two- to threefold higher enzyme secretion, respectively, while histamine had no effect. Carbonyl cyanide m chlorophenylhydrazone (30 microM) completely inhibited the CCK-8-induced lipase release, indicating that lipase secretion is dependent on mitochondrial oxidative energy; dibutyryl cGMP (1 mM) inhibited 1 nM CCK-8-stimulated but not 100 microM carbachol-stimulated secretion; atropine (1 microM) had the opposite effect. These studies suggest that secretion of lipase from isolated gastric glands is stimulated by at least two receptor mechanisms. These studies show that a lipase that hydrolyzes long-chain triglyceride is secreted by rabbit stomach mucosa and that the secretion of gastric lipase is stimulated by two different receptor mechanisms. PMID- 3966563 TI - Vasoactive intestinal peptide as a neural mediator of gastric relaxation. AB - Two main candidates, adenosine 5'-triphosphate (ATP) and vasoactive intestinal peptide (VIP), have been proposed as inhibitory transmitters at neuromuscular junctions in the gut. We have used a photoaffinity analogue of ATP, 3'-O-(4 benzoyl)benzoyl ATP or BzATP, that binds covalently to ATP receptors and inactivates them in the presence of light and a specific high-affinity VIP antiserum in order to examine the contributions of ATP and VIP to neurally induced relaxation in circular smooth muscle of the gastric fundus of the guinea pig. VIP and ATP caused dose-dependent relaxation; the effect of ATP was equal to that of its stable isostere, alpha, beta-methylene ATP, and was resistant to degradation by adenosine deaminase, indicating interaction of ATP with purinergic P2-receptors. Relaxation induced by VIP was selectively inhibited by VIP antiserum (final dilution 1:120), while that induced by ATP was selectively inhibited by photoactivated BzATP. Relaxation induced by electrical field (i.e., neural) stimulation was inhibited by VIP antiserum only; photoactivated BzATP had no effect. Inhibition of neurally induced relaxation ranged from 86% (P less than 0.01) at the lowest frequencies to 34% (P less than 0.01) at the highest frequencies. Maximal field stimulation caused an 11-fold increase in VIP release from intramural neurons. The results strongly favor VIP as the neural mediator of gastric relaxation. PMID- 3966565 TI - Transferrin and iron release from rat hepatocytes in culture. AB - The regulation of transferrin and iron release from the liver was studied using adult rat hepatocytes in primary monolayer culture. The cells were prelabeled by incubation with rat transferrin doubly labeled with iodine-125 and iron-59. Approximately 50% of the 125I-transferrin but only 10% of the iron-59 taken up by the cells was released during reincubation for 24 h. Less than 10% of the refluxed transferrin was catabolized as indicated by the protein-free iodine-125 values. These results suggest that at least part of iron uptake by hepatocytes is mediated by the reversible binding of transferrin in a manner comparable with erythroid cells and placenta. However, several iron chelators mobilized hepatic iron, in contrast to erythroid cells. Apotransferrin and desferrioxamine released a maximum of about 20% iron-59 with little effect on transferrin binding. A greater proportion of the iron-59 was available for chelation after shorter uptake times (1-2 h) than longer times. Hence, there are at least three iron compartments in hepatocytes in culture: rapidly refluxing iron that may be transferrin bound, a fixed pool, and a chelatable pool that may represent iron in transit between plasma transferrin and ferritin. PMID- 3966564 TI - Lactoferrin catabolism in the rat liver. AB - The hepatic uptake and degradation of human diferric 125I-lactoferrin by the liver of the intact rat were studied. After intravenous injection, the tracer was rapidly cleared by the liver, probably by adsorptive pinocytosis, as inferred from observations with a 3,470-fold dose range. Endocytosed lactoferrin was transferred, with a delay, from a light-density subcellular particle to an organelle that had a density similar to lysosomes. The loss of protein bound 125I from the liver was very slow (half-life 2.7 h), and its rate matched closely that of human asialotransferrin type 3. Lactoferrin was found to be a poor substrate for lysosomal hydrolases in vitro. Fucoidin effected the release of a portion of lactoferrin from the liver back into the plasma. By using this agent, indirect evidence was obtained suggesting that a fraction of lactoferrin is being repeatedly endo- and exocytosed (diacytosed) by the liver over prolonged periods of time. Fucosylation failed to impart lactoferrinlike properties on human asialotransferrin type 1, although the derivatized protein exhibited a less than or equal to 10-fold increase in affinity for the liver relative to the parent molecule. PMID- 3966566 TI - Consistent reversal of abnormal DSTs after different antidepressant therapies in a patient with dementia. AB - The authors present a longitudinal case study of a 57-year-old man whose initial symptoms consisted of depression and dementia associated with an abnormal dexamethasone suppression test (DST). Antidepressant therapy resulted in consistent reversal of the DST and partial remission of the patient's vegetative signs. Nevertheless, the patient's condition deteriorated over 36 months to end stage dementia. PMID- 3966567 TI - The impact of broadened civil commitment standards on admissions to state mental hospitals. AB - In 1979, the state of Washington broadened its criteria governing the involuntary commitment of the mentally ill. This study examined the impact of the revised law on involuntary and voluntary admissions and on the type of patient admitted to state hospitals in Washington. The short-term effect of the law was an abrupt increase in involuntary commitments, with a concomitant but not offsetting decline in voluntary admissions. Although the law resulted in a substantial change in admissions policy, it does not appear to have altered the type of patient admitted to state mental hospitals in Washington. PMID- 3966568 TI - Association of fragile X syndrome with autism. AB - The fragile X syndrome has been associated with autism. Blood samples from 37 autistic children and a control group were negative for fragile X chromosome. Large numbers of nonrandom autosomal lesions were observed in both the autistic and control groups. PMID- 3966569 TI - Hypnotic change in combat dreams of two veterans with posttraumatic stress disorder. AB - The recurrent nocturnal traumatic dreams of two veterans were dispelled with hypnosis. Dream substitutions were rehearsed in hypnotic trance and subsequently dreamed at night, and afterward the original traumatic dreams ceased. PMID- 3966571 TI - Self-mutilation and contagion: an empirical test. AB - Twenty-five subjects treated at a center for disturbed adolescents were observed over a 1-year period for signs of self-mutilative contagion. Statistical analysis confirmed that self-mutilation occurred in clusters throughout the year, suggesting that subjects imitated one another's behavior. PMID- 3966570 TI - Alcohol and strokes in young adults. AB - Current drinking, alcoholic binges, and a history of alcohol intoxication differentiated young stroke patients from older stroke patients and young medical control subjects. Acute heavy alcohol consumption may be an important element in the development of strokes among young adults. PMID- 3966572 TI - The impact of grief on ventilatory control. AB - The authors studied ventilatory control in four parents grieving over the death of an infant. Abnormalities in respiratory control were common and resembled those previously reported in depressed patients. The results raise questions about the relationship between affective state and ventilatory control. PMID- 3966573 TI - The waking event-dream interval. AB - Through self-observation, the author estimated the interval between waking events and their incorporation into a dream. Most of the events had occurred the day of the dream, but some had occurred 3-4 days earlier. PMID- 3966574 TI - 6-Sulphatoxy melatonin in melancholia. AB - The daytime and nighttime levels of 6-sulphatoxy melatonin, a metabolite of melatonin, were measured in eight melancholic patients. Three patients did not show a marked nocturnal increase in 6-sulphatoxy melatonin excretion. The author discusses the relationship between melatonin and melancholia. PMID- 3966575 TI - The dexamethasone suppression test in newly hospitalized schizophrenic patients. AB - Of 15 unmedicated chronic schizophrenic patients with acute exacerbations and 15 healthy controls given the dexamethasone suppression test (DST), 11 patients and two controls were nonsuppressors. The results add to the evidence that the DST has limited value in psychiatric diagnosis. PMID- 3966576 TI - Case report of lateralized affective states immediately after ECT. AB - Dysphoric states were observed in a patient immediately after right unilateral and bilateral ECT, while euphoric states followed left unilateral ECT, suggesting that disruption of lateralized neural mechanisms may have been involved in the pathophysiology of the affective states. PMID- 3966577 TI - Anorexia nervosa and affective disorders. PMID- 3966578 TI - Neuroleptic malignant syndrome and amantadine withdrawal. PMID- 3966579 TI - Trazodone and priapism. PMID- 3966580 TI - CSF copper concentrations. PMID- 3966581 TI - Handgun control laws, suicide, and homicide. PMID- 3966582 TI - Bitemporal atrophy in a patient with Fregoli syndrome, syndrome of intermetamorphosis, and reduplicative paramnesia. PMID- 3966583 TI - Psychotherapy during radiotherapy: effects on emotional and physical distress. AB - The authors determined the effects of ongoing weekly individual psychotherapy on the symptoms of patients undergoing a 6-week course of radiotherapy for cancer. Forty-eight patients were given weekly psychotherapy sessions for 10 weeks; another 52 patients served as control subjects. A statistically significant reduction was found in both emotional and "physical" manifestations of distress in the patients receiving psychotherapy compared with the control group. This was true regardless of gender, ward or private patient status, or knowledge of diagnosis. Patient gender and knowledge of diagnosis did affect the pattern and magnitude of the response to psychotherapy. PMID- 3966584 TI - Psychological outcome of lumpectomy versus mastectomy in the treatment of breast cancer. AB - Forty-six patients who underwent modified radical mastectomy were compared 14 months after surgery with 21 patients who underwent lumpectomy and radiation; all patients had stage I or II breast cancer. Lumpectomy patients reported less of a loss of feelings of attractiveness and femininity, were less self-conscious about their appearance, received more emotional support from friends, and were more open about their surgery and sexual feelings after surgery. Unlike the mastectomy patients, they saw their spouses' sexuality as enhanced after surgery. Lumpectomy patients were not less anxious or less depressed but showed better overall adaptation to their surgery and less functional change. PMID- 3966586 TI - How primary care physicians treat psychiatric disorders: a national survey of family practitioners. AB - A survey of 350 family practice physicians nationwide showed that 22.6% of their patients had significant psychiatric disorders. Physicians reported treating most psychiatric problems themselves, usually through a combination of psychotropic drugs, advice, and reassurance. The results suggest that anxiolytics are more conservatively used and referrals for mental health care more often made than past studies indicate. Physicians cited patient resistance and time limitations as the most important barriers to primary care mental health treatment, followed by limited third-party payment for mental health services, poor coordination between the primary care and mental health care sectors, and insufficient training to treat psychiatric disorders. PMID- 3966585 TI - The sooner the better: a study of psychological factors in women undergoing immediate versus delayed breast reconstruction. AB - Patients who had reconstructive breast surgery at the time of mastectomy (immediate) or within 1 year (early) had significantly less recalled distress about their mastectomy than those who had it more than 1 year later (delayed). Women who had immediate or delayed reconstructive surgery had similar levels of psychological symptoms, which were slightly lower than those reported by women in the early reconstructive group. The wish to wear a wider range of clothes and the wish to be rid of the external prosthesis were common motivations for reconstructive surgery. The desire to improve sexual relations or one's marital state was less common and should be viewed with caution when presented as the primary motivation for this procedure. PMID- 3966587 TI - Hyperammonemia in Alzheimer's disease. AB - Postprandial blood ammonia levels were significantly higher in 22 patients with Alzheimer's disease than in 37 control subjects. In the Alzheimer group, fasting blood ammonia levels were significantly higher in patients whose EEGs showed triphasic waves than in patients without this change. The direction of change from fasting to postprandial blood ammonia levels was also significantly different between these two groups. PMID- 3966588 TI - Findings in psychiatric consultations with patients with acquired immune deficiency syndrome. AB - Thirteen of 40 patients with acquired immune deficiency syndrome (AIDS) admitted to the wards of a large city hospital were seen by the staff of a psychiatric consultation service. Eleven were gay men and two were bisexual men. "Depression" was the stated reason for referral of 10 patients; of these, two met DSM-III criteria for major depression, one had dysthymic disorder, and seven had adjustment disorder with depressed mood. Recurrent psychological themes of the 13 patients were: dealing with a life-threatening illness, uncertainty about the implications of an AIDS diagnosis, social isolation, and guilt over their previous life style. The role of the primary physician and of the mental health professional in the psychological care of AIDS patients is discussed. PMID- 3966589 TI - Psychiatric diagnoses of Cuban refugees in the United States: findings of medical review boards. AB - To assess the reproducibility of psychiatric diagnoses made in immigration proceedings, the authors examined cases of 109 Cuban refugees who had appealed psychiatric diagnoses that precluded their admission to the United States according to the Immigration and Nationality Act. Medical review boards upheld only 23 (42%) of 55 initial diagnoses of antisocial personality disorder but affirmed exclusionary certifications in 39 (72%) of the 54 other cases. Failure to sustain a high proportion of diagnoses of antisocial personality disorder may reflect interviewer biases, cross-cultural inappropriateness of diagnostic criteria, or other deficiencies in the current system of psychiatric evaluation of potential refugees. PMID- 3966590 TI - Medicolegal pitfalls in the treatment of borderline patients. AB - Patients with the borderline syndrome, although not always the sickest patients, often cause the most difficulty because of their intense and contagious affects, their often impulsive behavior, and the strains they place on the treaters' countertransference. The author explores the hitherto ignored area of medicolegal problems that often arise in treatment of borderline patients. Specifically, he addresses the issues of legal ignorance of the syndrome, the effect of dynamic processes such as splitting and psychotic transference, problems regarding limit setting and related management approaches, and problems arising from countertransference phenomena. He suggests approaches to these problems as well. PMID- 3966591 TI - A diagnostic and family study of posttraumatic stress disorder. AB - A family history study of 36 patients with chronic posttraumatic stress disorder revealed a positive history of familial psychopathology in 66% of the patients. Alcoholism, depression, and anxiety disorders were the disorders most commonly found. The patients also had a higher prevalence of alcoholic siblings than did a retrospectively derived control group of depressed and anxious male patients. With respect to the proportion of familial anxiety to familial depression, the probands with posttraumatic stress disorder more closely resembled probands with generalized anxiety than probands with depression. Every patient had experienced at least one significant psychiatric illness during his lifetime, most commonly alcohol abuse or depression. PMID- 3966592 TI - Oral disease and quality of life. PMID- 3966593 TI - A time for new thinking about teenage pregnancy. PMID- 3966594 TI - Dental health and public policy: the social impact of dental disease. AB - This paper analyzes the potential of using measures of social function as health indicators in dental research. It discusses existing methodologies and presents findings from a cross-section of studies that adopt a social function perspective in the investigation of oral health status. While the literature in this area is small, much of the research concerns disability days associated with dental problems. The United States National Health Interview Survey reported in 1981 that 4.87 million dental conditions caused 17.7 million days of restricted activity, 6.73 million days of bed disability, and 7.05 million days of work loss. Other reports suggest that these data may be underestimates due to the National Health Survey's definition of disability days. Several other studies have found work loss to affect from 15 per cent to 33 per cent of samples studied resulting in many more work loss days than reported by the National Health Survey. Our study concludes that traditional measures of oral health status--such as decayed, missing, and filled teeth and the periodontal index--should be linked to measures of social outcome in order to place dental conditions within the broader context of health status in terms that are relevant to policy makers. PMID- 3966595 TI - The influence of client-provider relationships on teenage women's subsequent use of contraception. AB - This paper describes the relationships of selected dimensions of nurse-client interaction in county health department family planning clinics to the subsequent contraceptive use of the clinic's unmarried teenage clients. The subjects for the study are the clients and professional staff of 78 clinics: 2,900 eligible clients making their first contraceptive visit and 338 clinic staff nurses. Results of interviews demonstrate that client and staff expectations and interactions are significant predictors of adherence to a contraceptive regimen; under circumstances where clients anticipate, and staff employ, authoritative guidance in helping the clients to select a contraceptive method, clinic mean levels of contraceptive use are substantially increased. Overall, 40 per cent of clinic variation in contraceptive compliance is explained by the interaction dimensions and other aspects of clinic organization addressed in this paper. Implications of these results for the structuring of family planning clinic programs directed toward teenage women are briefly considered. PMID- 3966596 TI - Reinstitution of diet therapy in PKU patients from twenty-two US clinics. AB - In a nationwide survey we found 72 PKU (phenylketonuria) patients who had terminated diet but later returned to diet. Sixty-one patients resumed diet due to clinical problems. Age at initial diet discontinuation ranged from three to 20 years. The most prevalent problems reported were poor school performance, and mood and/or behavior changes. Following diet reinstitution, only positive changes were noted for 42 patients, no changes for 19 patients, and 11 had one or more negative changes. Improvements and blood phenylalanine levels were not significantly correlated, but only 11 patients maintained levels less than 10 mg/dl. The number of improvements was significantly correlated with length of time on diet (p less than 0.001). After a median of 10 months on diet, 22 patients had again discontinued due to poor diet control, lack of motivation, poor formula tolerance, lack of apparent benefits and/or changes for the worse. Median time on diet for the 50 second-time continuers was two years nine months. PMID- 3966597 TI - Limitations of provider interventions in hypertension quality assurance. AB - In an institutional quality assurance program in hypertension, performance of tests, control of blood pressure, and follow-up were monitored through a computer program that was developed to audit records in an automated record system. Two types of feedback previously shown to be effective were provided quarterly for a period of one year to experimental providers. For all hypertensives considered together, there were no differences between scores of Experimental and Control providers based on percentage of patients meeting pre-set criteria in testing- 87% vs 87%--, blood pressure control--58% vs 59%--, or follow-up--79% vs 77%. Only small but significant differences occurred in the subgroup of moderate to severe hypertensives. There appear to be limitations to what can be accomplished through hypertension quality assurance interventions directed at providers of care in this institutional setting. Interventions designed to deal directly with patients whose blood pressures are uncontrolled may be more effective. PMID- 3966598 TI - Emergency CPR instruction via telephone. AB - We initiated a program of telephone CPR (cardiopulmonary resuscitation) instruction provided by emergency dispatchers to increase the percentage of bystander-initiated CPR for out-of-hospital cardiac arrest. Cardiac arrests in King County, Washington were studied for 20 months before and after the telephone CPR program began. Bystander-initiated CPR increased from 86 of 191 (45 per cent) cardiac arrests before the program to 143 of 255 (56 per cent) cardiac arrests after the program. During the after period, 58 patients received CPR as a result of telephone instruction, 12 of whom were discharged. We estimate that four lives may have been saved by the program. A review of hospital records revealed no excess morbidity in the group of patients receiving dispatcher-assisted CPR. PMID- 3966599 TI - A simple language-based acculturation scale for Mexican Americans: validation and application to health care research. AB - A simple scale for quantifying English use among Mexican Americans was constructed from four brief questions which proved to have excellent scaling characteristics by Guttman Scalogram Analysis in two independent data sets. Construct validity was established by significant associations of the scale with ethnicity, place of birth, generation within the United States, and type of neighborhood. Highly significant associations were found between scale scores and use of oral contraceptives, parity, "fatalism" regarding health, and attitudes toward folk healers. These associations remained significant (though weak) after controlling for education and family income. The language scale thus appears to be reliable and valid, to be capable of distinguishing meaningful subsets among the Mexican American population, and to be applicable to health care investigation. PMID- 3966600 TI - Child abuse incidence and reporting by hospitals: significance of severity, class, and race. AB - Estimates from the National Study of the Incidence and Severity of Child Abuse and Neglect suggest that hospitals recognized over 77,000 cases of child abuse between May 3, 1979, and April 30, 1980. Compared to other agencies in the sample, hospitals identified children who were younger, Black, lived in urban areas, and had more serious injuries. Hospitals failed to report to child protection agencies almost half of the cases that met the study's definition of abuse. Discriminant analysis revealed that income, mother's role in abuse, emotional abuse, race, maternal employment, and sexual abuse distinguished the reported from the unreported cases. Disproportionate numbers of unreported cases were victims of emotional abuse and came from families of higher income. Their mothers were more often White and more often alleged to be responsible for the injuries. PMID- 3966602 TI - Control definition in case-control studies of ectopic pregnancy. AB - In case-control studies of ectopic pregnancy, the optimal sampling frame for control selection is influenced heavily by the hypothesis being tested. The selection of women completing an intrauterine pregnancy, a common choice for a control group in studies to date, is appropriate only if the hypothesis does not relate to exposures that selectively prevent an intrauterine pregnancy (e.g., use of an intrauterine device (IUD) at the time of conception). Even for other exposures, the selection of such women can yield misleading results if the exposure is related to the likelihood of completion of the intrauterine pregnancy. On the other hand, the selection of nonpregnant women as controls, while permitting a valid evaluation of the risk associated with exposure such as the use of an IUD, can introduce a substantial degree of incomparability between cases and controls with regard to other contraceptive practices and their correlates. Whichever of the two sampling frames that is chosen, an appreciation of these potential biases can lead to ways of tailoring the selection of individual controls to minimize the magnitude of the bias. PMID- 3966601 TI - Delegation of expanded functions to dental assistants and hygienists. AB - One hundred and twenty-six dental offices in Washington State kept a record of each time an expanded function was performed by the dentist, hygienist, or assistant. There were five two-week recording periods starting in February 1979 and ending in February 1981. Consistent with increasing productivity, dentists most frequently delegate tasks to dental assistants rather than dental hygienists and delegate an individual task consistently if it is delegated at all. For tasks that may be delegated to the assistant, a relationship was found between the per cent of dentists delegating an individual task and the amount of the dentist's time that is freed through delegating that task. From the perspective of quality of care, the per cent of dentists who delegate a task was inversely related to the complexity of the task. PMID- 3966603 TI - An analysis of economic costs associated with an outbreak of typhoid fever. AB - We examined the costs of a typhoid fever outbreak caused by exposures to contaminated food over a 47-day period at a restaurant. For the 49 respondents, the patient-related costs (+215,548) were primarily medical expenses (+183,902) and lost income or productivity (+28,603). The estimated patient-related costs for all 80 outbreak-associated cases was +351,920. Had contaminated food continued to be served, the prevention-related costs (+36,500) would have been offset by patient-related costs (+7,488/day) within 5 days. PMID- 3966604 TI - Public opinion on and potential demand for vasectomy in semi-rural Guatemala. AB - In this study of 1,600 men aged 25-50 from semi-rural Guatemala, three-fourths had heard of vasectomy. Among these, 54 per cent approved of it. However, the survey reveals a widespread lack of knowledge regarding the procedure, as well as negative perceptions or doubts about its effect on sexual performance, ability to do hard work, health, and manhood. One-fourth of the respondents who knew of vasectomy and who desired no more children expressed interest in having the operation, a finding which raises questions as to the potential (unrecognized) demand for vasectomy in other developing countries. PMID- 3966605 TI - Contraceptive usage during lactation: analysis of 1973 and 1976 National Survey of Family Growth: I. Age and race. AB - Data from the National Survey of Family Growth are analyzed to estimate the prevalence of contraceptive use during lactation. Approximately 20 per cent of lactating women were sexually active and did not use a method in months two through six, postpartum. Among method users, the largest proportion chose barrier methods but 14 per cent used oral contraceptives in the early postpartum period. Between 1973 and 1976 there was an increase in the percentage of women who utilized a contraceptive method during lactation and a decrease in the per cent using oral contraceptives. PMID- 3966606 TI - The teaching of occupational health in United States medical schools: five-year follow-up of an initial survey. AB - A survey of 111 of the 127 United States medical schools revealed that 73 (66 per cent) specifically taught occupational health during the 1982-83 academic year, compared to 50 per cent in 1977-78. Occupational health was a required part of the curriculum in 54 per cent of the schools compared to 30 per cent in 1977-78. However, the median required curriculum time for occupational health was four hours during both academic years. Increased attention needs to be given to occupational health in medical school curricula. PMID- 3966607 TI - The use of comparability ratios to adjust hospital trend data. AB - Hospital trend data may be affected by changes in diagnostic coding schemes. We studied the change from ICDA-8 (I-8) to ICD-9-CM (I-9) in a sample of roughly 13,600 double-coded Veterans Administration hospital diagnoses. Comparability ratios were computed and used to adjust trend data which overlap the time period when the shift from I-8 to I-9 occurred. With this adjustment for change in diagnostic coding scheme, apparent diagnostic trends are substantially altered. PMID- 3966608 TI - Vehicular carbon monoxide screening: identification in a cross-cultural setting of a substantial public health risk factor. AB - A community program of screening and education for prevention of vehicular carbon monoxide (CO) poisoning among a high-risk population in a cross-cultural setting is presented. The program was developed after two infant deaths in separate incidents of vehicular CO poisoning. The results of the screening show 18.6 per cent of vehicles exceeding the Environmental Protection Agency eight-hour standard for CO exposure, and 2.6 per cent exceeding the one-hour standard. Extension of such programs to other high-risk populations is recommended. PMID- 3966609 TI - Utilization of dental services in the United States and an insured population. AB - Dental service utilization rates among 1.2 million Pennsylvania Blue Shield dental insureds are compared to rates in the US population. Insurance appears to stimulate the utilization of dental services above national norms; children appear to be a major beneficiary of insurance's incentive effect on dental service use. The implications of these findings for health planners and dental insurance providers are discussed. PMID- 3966610 TI - Non-fatal suicidal and life-threatening behavior among 13- to 17-year old adolescents seeking emergency medical care. AB - In suicidal behavior emergency room admissions of 13- to 17-year olds at the Brockton Hospital (Massachusetts), females predominated over males by almost two to one. For subclassification of life-threatening behaviors, frequency was about the same for males and females, but for suicide attempts and suicide gestures, female frequency was two to four times that of males. Repeat episodes of self inflicted injury were more common among females. The type of the initial episode was a powerful predictor of a repeat occurrence. PMID- 3966611 TI - On whirlpool spa maintenance. PMID- 3966612 TI - Two comments on fetal loss and wastewater workers. PMID- 3966613 TI - Regionalization of medical care. PMID- 3966614 TI - Home care for the ill elderly--who benefits? PMID- 3966615 TI - Injury reduction by mandatory child passenger safety laws. PMID- 3966616 TI - The centralization of operations and access to treatment: total hip replacement in Manitoba. AB - The impact of centralized facilities on access to care was tested by studying total hip arthroplasty in the Province of Manitoba, Canada. Data from the Manitoba Health Services Commission, which insures costs of all medical services in the Province, show that the availability of this surgical procedure has increased steadily over the 1973-78 period at a rate similar to that elsewhere in North America. Although Manitoba's population is geographically dispersed, specialized orthopedic services are concentrated in two urban centers. No important difference in access to care for this condition was found between urban center residents and residents distant from the surgical facilities. PMID- 3966617 TI - A randomized controlled study of a home health care team. AB - This report describes the findings of a randomized study of a new team approach to home care for homebound chronically or terminally ill elderly. The team includes a physician, nurse practitioner, and social worker delivering primary health care in the patient's home, including physician house calls. Weekly team conferences assure coordination of patient care. The team is available for emergency consultation through a 24-hour telephone service. The team physician attends to the patient during necessary hospitalizations. This approach was evaluated in a randomized experimental design study measuring its impact on health care utilization, functional changes in patients, and patient and caretaker satisfaction. The team patients had fewer hospitalizations, nursing home admissions, and outpatient visits than the controls. They were more often able to die at home, if this was their wish. As expected, they used more in-home services, measured in weighted cost figures; their overall cost was lower than their controls, but the difference was not statistically significant. Their functional abilities did not change differently from the controls, but they, and especially their informal caretakers in the home, expressed significantly higher satisfaction with the care received. PMID- 3966618 TI - An assessment of the California Child Passenger Restraint Requirement. AB - To evaluate the California Child Passenger Restraint Law requiring children under four years of age to be transported in car seats, we examined monthly injury and fatality levels from January 1978 to December 1983 for children 0-3 and 4-7 years of age using Box-Jenkins time series models. A significant 8.36 per cent reduction in injuries was found for the 0-3 year old age group, but no significant reduction in injuries was found for 4-7 year olds. No significant reduction in fatalities was found for either age group. A similar analysis of injuries and fatalities in Texas, a state without a car seat law, showed no significant reductions in either injuries or fatalities. There was no change in the number of California 0-3 year olds in the years after the law was enacted. PMID- 3966619 TI - Cigarette smoking and lung cancer in 'Hispanic' whites and other whites in New Mexico. AB - A population-based case-control study of lung cancer was performed in New Mexico to explain the differing patterns of lung cancer occurrence in the state's "Hispanic" Whites and other Whites. From 1980 through 1982, interviews were completed with 521 cases and 769 controls. In the male controls, the prevalence of current and previous cigarette usage was similar in the two ethnic groups, but Hispanics smoked fewer cigarettes daily. In the female controls, a lower percentage of Hispanics had ever smoked and their usual consumption was less than that of other White women. Older Hispanic female smokers had used hand-rolled cigarettes for an average of 8.8 years, whereas other White women of the same age had used this type for less than one-half year. Both stratified and multiple logistic analysis showed comparable risks of lung cancer in Hispanic White and other White smokers. There was no evidence of interaction between ethnicity and cigarette smoking. These analyses imply that the differences in lung cancer incidence between New Mexico's Hispanic Whites and other Whites are largely explained by the patterns of cigarette smoking of these two groups. PMID- 3966620 TI - Mortality patterns in the modernized Pacific Island nation of Nauru. AB - Nauru is a small phosphate-rich independent island country situated in the Central Pacific. The population is Micronesian and was estimated to be 4,680 in mid-1981. An analysis of mortality data for the years 1976-81 indicates a high adult male mortality due to accidents, injuries, cardiovascular disease, and diabetes. The life expectancy estimate at birth for men was 49 years, and for women 62 years. The male life expectancy is among the lowest in the region. The considerable adult male mortality appears to be related to the rapidly acquired affluence and the ready availability of motorcycles, cars, imported foods, tobacco, and alcohol. The data suggest that modernization of the economy in Pacific Island nations can lead to new and serious public health problems. PMID- 3966622 TI - A waterborne outbreak of hepatitis A in Meade County, Kentucky. AB - In November 1982, Meade County, Kentucky health officials noted a sudden increase in the incidence of hepatitis A. Using a standardized interview of 73 cases (68 serologically confirmed), and 85 controls (all negative for antibody to hepatitis A virus), the most important risk factor identified was household use of untreated water from a single spring. A dose-response relationship was found for consumption of unboiled spring water. Water samples taken from the spring during the outbreak were contaminated with fecal coliforms. PMID- 3966623 TI - Firearm-related fatalities: an epidemiologic assessment of violent death. AB - This study examines 1970-78 South Carolina firearm fatalities utilizing vital record data. During this period, 5,808 firearm deaths, classified as accident, homicide, suicide, or undetermined, were reported with an average annual fatality rate of 23.35 deaths per 100,000 estimated population. Firearm fatalities in South Carolina were the sixth leading cause of death in 1975 and accounted for 2.9 per cent of all deaths to residents. A significant period decline in the firearm fatality rate was observed and was attributed mainly to decreases in the non-White rate. In 1978, the fatality rate for non-Whites (18.5) fell below the rate for Whites (19.1) for the first time in the years investigated. Firearm deaths represent a major community health problem and, as such, warrant attention and direct involvement by state and local health professionals. PMID- 3966621 TI - Declining perinatal mortality in a region of Finland, 1968-82. AB - Perinatal mortality (PNM) in the catchment area of the University Central Hospital of Turku (UCHT), Finland, was investigated during a 15-year period from 1968 to 1982. During the study period, 82,151 babies were born, there were 531 fetal deaths and 505 cases of early neonatal death. The PNM rate declined during the study period from 17.9 in 1968 to 7.0 in 1982, or from 14.8 to 4.6 when infants weighing less than 1000 grams were excluded. Significant declines occurred in PNM due to maternal illness, placental and umbilical cord complications, other asphyxias and respiratory distress syndrome. We believe the centralization of obstetric and neonatal services for risk cases, the introduction of modern obstetric and neonatal management, and continuing education of personnel at every level of maternity and neonatal care accounted for the decline. PMID- 3966624 TI - Smoking behavior among US Latinos: an emerging challenge for public health. AB - In this paper we review evidence on smoking and lung cancer among Latinos, including findings from several unpublished studies and technical reports. Recent surveys of smoking behavior in California, Texas, and New Mexico indicate a notable sex difference in smoking among Latinos, with Latino males smoking at least as frequently as White males, while Latino females report smoking rates considerably lower than White females. Our analysis of the 1979 and 1980 National Health Interview Surveys corroborates this finding and also indicates that this pattern holds true for subgroups of the Latino population, including country of origin. Taken together, these findings suggest that among Latino males rates of lung cancer and other cigarette-linked diseases may increase in the near future. PMID- 3966625 TI - VMA mass screening program of neuroblastoma for infants in Nagoya City, Japan. AB - In Nagoya City, Japan, VMA mass screening for detection of neuroblastoma has been performed since 1977. Filter paper strips wetted with urine are mailed to a central laboratory. Positive tests are followed up by more definitive testing. Of the 20,053 urine samples of 6-month-old infants tested, January 1977 to March 1983, five asymptomatic infants with neuroblastoma have been discovered. All have been treated and are alive as of January 1984. PMID- 3966626 TI - Pattern of alcohol use associated with self-identified problem drinking. AB - To estimate the pattern and level of alcohol consumption leading to problem drinking, the drinking histories of 70 early stage problem drinkers were examined. An average consumption of four drinks (54 g/ethanol), on an average of three days/week, was the pattern that best separated the phase when patients were problem free from the phase when their drinking led to problems. PMID- 3966627 TI - The prostitute, the playboy, and the poet: rationing schemes for organ transplantation. PMID- 3966628 TI - One-fifth of 1983 US births by cesarean section. PMID- 3966630 TI - Antipyrine elimination in patients with obstructive jaundice: a predictor of outcome. AB - A number of factors are known to be related to increased mortality of surgery in obstructive jaundice, yet precise identification of patients at greatest risk is difficult. We have studied the elimination of the minor analgesic antipyrine as a dynamic measure of hepatic metabolic function in patients with obstructive jaundice undergoing percutaneous transhepatic biliary drainage. Of 46 patients in whom antipyrine clearance was measured, 21 had an antipyrine half-life less than 15 hours and 2 died in the hospital. Of 25 who had an antipyrine half-life greater than 15 hours, 10 died in the hospital, 4 before undergoing surgery. The difference in mortality is significant (p less than 0.05). Of 15 patients who had serial antipyrine tests, only 4 showed an improvement during percutaneous transhepatic biliary drainage. The antipyrine test may be a useful predictor of outcome in obstructive jaundice, and this study suggests that hepatic function does not improve in all patients undergoing preoperative percutaneous transhepatic biliary drainage. PMID- 3966629 TI - Effect of aging on pancreatic secretion in rats. AB - We have characterized the effects of aging on the pancreatic exocrine secretory response to the normal stimulatory hormones, secretin, and cholecystokinin. Young (6 month old) and aged (26 months old) male Sprague-Dawley rats were prepared with pancreatic fistulas and challenged with different doses of secretin (0.03, 0.06, and 0.12 nmol/kg) and cholecystokinin-8 (0.3, 0.6, and 1.2 nmol/kg) intravenously. The pancreatic secretion was measured for volume and bicarbonate and protein outputs. Our results show that in aged rats, the basal pancreatic secretion volume and protein and bicarbonate outputs were significantly reduced, and the pancreatic secretion volume and protein and bicarbonate responses to graded doses of secretin or cholecystokinin-8 were significantly reduced. This study demonstrates that pancreatic exocrine function in rats diminishes with age. PMID- 3966631 TI - The bypassed stomach. AB - Retrograde duodenogastroscopy solves the problem of postoperative evaluation of the gastric bypass patient. The stomach may be bypassed to treat morbid obesity, but it no longer need be inaccessible. Endoscopic gastritis is rare in the proximal gastric pouch but common in the distal gastric segment and may be related to the presence of bile. Although the gastric mucosa is histologically normal in half of the gastric bypass patients, acute and chronic gastritis, regenerative changes, and intestinal metaplasia may develop in either or both segments. The causes and implications of these endoscopic and histologic findings are unknown. PMID- 3966632 TI - Evidence of a noncholecystokinin stimulant of gallbladder contraction: comparison of fasting serum concentrations in healthy subjects and in patients with gallstones. AB - Some investigators have reported that patients with gallstones empty their gallbladders more rapidly than do healthy subjects. This may contribute to the formation of lithogenic bile. To date, cholecystokinin is considered the prime mediator of gallbladder contraction. Evidence exists that cholecystokinin may not be the major hormone accounting for gallbladder emptying. The purpose of this study was to demonstrate the existence of this noncholecystokinin substance in healthy persons and to compare its concentration with that in patients with cholesterol gallstones. Fasting serum levels from 15 healthy human subjects (8 women and 7 men, mean age 32 +/- 8 years) and 10 patients with cholesterol gallstones (5 women and 5 men, mean age 48 +/- 16 years) were studied. Using rabbit in vitro gallbladder bioassay and cholecystokinin-8 as standards, serum bioactivity was measured and expressed as cholecystokinin-8 equivalent bioactivity. The effectiveness of serum to contract the gallbladder was tested before and after removal of cholecystokinin from the serum. Cholecystokinin was removed from the serum samples by affinity chromatography with Sepharose 4B beads coated with cholecystokinin 5135 antibody. Gallbladder contractility from this treated serum thus reflects the action of a noncholecystokinin stimulant. The cholecystokinin-8 bioactivity equivalents in untreated samples from healthy subjects and from patients with gallstones were 2.9 +/- 0.3 and 7.6 +/- 0.7 ng/ml, respectively. The fact that bioactivity of serum persisted after removal of cholecystokinin in both groups of subjects provides evidence that a noncholecystokinin stimulant of gallbladder contraction exists. This substance is found in significantly higher concentrations in the fasting serum of patients with gallstones compared with healthy subjects. This finding may explain, at least in part, the increased gallbladder emptying rate in patients with gallstones and may account for the reduced bile salt pool size and, thus, formation of lithogenic bile. PMID- 3966633 TI - Approach to the spectrum of Budd-Chiari syndrome: which patients require portal decompression? AB - Budd-Chiari syndrome (occlusion of the hepatic veins) represents a spectrum disorder. From 1974 to 1984, 20 patients with the syndrome were managed. Eleven required shunt surgery (Group 1) and 5 were managed with nonshunt therapy (Groups 2 and 3). Results have been good. Retrospective review of the liver biopsy specimens showed that Group 1 patients had a greater degree of zone 3 necrosis than Group 2 and 3 patients. We submit that presence of zone 3 necrosis on an initial liver biopsy specimen may define the failing liver of Budd-Chiari syndrome that requires conversion of the portal vein to an outflow tract by shunting. PMID- 3966634 TI - Effect of obesity on esophageal transit. AB - Esophageal transit time as measured by radionuclide scintigraphy using a swallowed technetium sulfur colloid bolus was measured in obese patients with gastroesophageal reflux, lean patients with reflux, and lean volunteers without reflux. The esophageal transit time was significantly prolonged in the obese group compared with both lean groups (p less than 0.001). Esophageal manometric measurement also confirmed that obese patients have an elevated gastroesophageal pressure gradient, presumably caused by increased intraabdominal pressure resulting from the mechanical burden of excess fat. The esophageal transit time is significantly related to the gastroesophageal pressure gradient. This finding, coupled with those in previous manometric investigations showing that esophageal muscle has a decreased maximum velocity with increasing afterload, explains in part why obese patients have delayed esophageal transit time. Therapy for reflux in obese patients should be aimed at improving esophageal transit. PMID- 3966635 TI - Gastroesophageal reflux in the infant with cystic fibrosis. AB - The association of gastroesophageal reflux and its sequelae in the infant with cystic fibrosis has gone virtually unnoticed. Eight of 40 newly diagnosed infants with cystic fibrosis seen over a 24 month period had significant gastroesophageal reflux, characterized by vomiting (7 infants), recurrent pneumonia (7 infants), and failure to thrive (4 infants). Gastroesophageal reflux was demonstrated by a combination of barium swallow, scintiscan, manometry, and esophagoscopy. Three infants had rapid and permanent alleviation of symptoms after standard medical therapy; in five infants, therapy failed and they required a Nissen fundoplication. Three infants required postoperative ventilatory support for 1, 2, and 5 days. No tracheostomies were required. Postoperative hospital stay averaged 12 days (range 5 to 30 days). There were no complications or perioperative deaths. All children had complete relief of their preoperative symptoms. The group that required surgery presented earlier (mean 7 weeks of age) to the cystic fibrosis center than either the medically treated group (mean 5 months of age) or the group free of gastroesophageal reflux symptoms (5 1/2 months of age). Also, postoperative hospitalization time markedly decreased from 50 percent of 577 combined patient days preoperatively to 4 percent of 1,639 days postoperatively; this 4 percent then paralleled what was seen in the group without gastroesophageal reflux (3 percent of 19,966 combined patient days) and the group controlled medically (5 percent of 1,897 days). The pulmonary manifestations of cystic fibrosis are extremely variable, and evaluation of the effect that any intervention has on the natural history of the disease is difficult. Nonetheless, we believe that even this small series suggests that gastroesophageal reflux and its complications can significantly alter the courses of some children with cystic fibrosis. Gastroesophageal reflux should be managed as aggressively as it is in any child with reflux, and a successful and safe reduction of symptoms can be expected with intensive management. PMID- 3966636 TI - Barrett's esophagus: its prevalence and association with adenocarcinoma in patients with symptoms of gastroesophageal reflux. AB - The pathologic reports of all 1,020 esophageal biopsy specimens obtained between 1975 and 1981 in patients with symptoms of gastroesophageal reflux were reviewed. Barrett's esophagus was identified in 84 patients (8 percent). The 362 patients seen between 1980 and 1981 were reviewed in detail. The symptoms in patients with Barrett's esophagus differed from those of the patients without Barrett's esophagus. Dysphagia was more often present in the former group (34 percent versus 16 percent, p less than 0.05) and epigastric distress was less frequent (11 percent versus 27 percent, p less than 0.05). Objective findings of hiatal hernia, esophageal stricture, and esophageal ulcers occurred more commonly in patients with Barrett's esophagus than in those without Barrett's esophagus (70 percent versus 48 percent, 31 percent versus 4 percent, and 14 percent versus 6 percent, respectively, p less than 0.05). Mid esophageal strictures were associated almost exclusively with Barrett's esophagus (five of six patients). At esophagoscopy, erythema was seen more commonly with Barrett's esophagus. The diagnosis was suspected by the endoscopist in only 34 percent of patients subsequently demonstrated histopathologically to have Barrett's esophagus. There was no significant difference in the prevalence of a positive Bernstein test result or gastroesophageal reflux on upper gastrointestinal series in patients with and without Barrett's esophagus. However, a hypotensive lower esophageal sphincter was found more commonly in patients with Barrett's esophagus (100 percent versus 53 percent, p less than 0.05). Thirteen of the 84 patients with Barrett's esophagus (15 percent) had a coexistent adenocarcinoma arising from Barrett's mucosa. These patients, when compared with the patients with Barrett's esophagus without carcinoma, were more often male (77 percent versus 51 percent, p = 0.1), more often had dysphagia (69 percent versus 34 percent, p less than 0.05), and more frequently had a comparatively short duration of symptoms (67 percent versus 36 percent, p less than 0.05). Our findings suggest that patients with Barrett's esophagus have a high risk of development of carcinoma. Because the entity is often not recognized at endoscopy, routine esophageal biopsy should be performed on all patients undergoing esophagoscopy for symptoms of gastroesophageal reflux. Patients with known Barrett's esophagus should be followed closely with repeated endoscopy and biopsy. PMID- 3966637 TI - Complications and quality of life after ileorectal anastomosis for ulcerative colitis. AB - Ileorectal anastomosis is a safe operation with low mortality and morbidity and offers a good prospect for success in many patients with ulcerative colitis. The functional results are good in the majority of patients, and there is a high level of patient acceptance. There is a low cancer risk with regular surveillance, but there is a relative contraindication for ileorectal anastomosis in patients with colon cancer or dysplasia present at the time of colectomy. For many patients, especially children and adolescents in their formative years and for young adults, it avoids or delays an ileostomy and avoids the risk of postoperative sexual dysfunction, while at the same time still permits the elective use of some other continence-preserving operation at a later date. PMID- 3966638 TI - Mechanisms of rectal continence. Lessons from the ileoanal procedure. AB - To clarify mechanisms of rectal continence, we evaluated 34 patients who had straight or J-pouch ileoanal anastomosis. This evaluation included pressures, anal inhibitory reflex, neorectal capacity, neorectal compliance, and the ability to discriminate stool from gas. Both groups of patients had satisfactory anal sphincter resting pressures and neorectal capacities, and all could discriminate stool from gas despite the absence of any rectal mucosa. We conclude that normal rectal mucosa is not necessary to be able to discriminate stool from gas; a long rectal muscular cuff is not necessary for rectal sensation; essentially normal sphincter function is preserved, and this procedure does not normally fail because of inadequate sphincter function or the absence of the anal inhibitory reflex; and in the presence of normal sphincter function, continence is not dependent on the presence of normal mucosa or the anal inhibitory reflex but correlates with reservoir capacity and compliance as well as with the frequency and strength of intrinsic bowel contractions. PMID- 3966639 TI - Pentagastrin stimulates in vitro growth of normal and malignant human colon epithelial cells. AB - Five normal and four malignant human colon epithelial cultures initiated and maintained in our laboratories as well as the standardized in vitro human adenocarcinoma cell line HT-29 were plated in multiwell plates and incubated at 37 degrees C for 72 hours with either phosphate-buffered saline solution or pentagastrin (5 micrograms/ml). Pentagastrin stimulated normal cells to increase (p less than 0.05) in number by an average of 65 percent compared with saline control cells, whereas malignant cells increased an average of 59 percent compared with control cells. There was no difference in the magnitude of trophic effect between the normal and malignant cells. Further studies are indicated to elucidate the role of gastrin in either initiating, promoting, or both, the growth of carcinoma of the colon. PMID- 3966640 TI - Regulation of gastric acid secretion by secretin and serotonin. AB - We have tested the interaction between serotonin and secretin in pentagastrin induced gastric acid secretion in six dogs prepared with Thomas gastric and duodenal cannulas. We further examined the effect of methysergide, a serotonin antagonist, on gastric acid secretion. The intravenous administration of serotonin or secretin alone significantly inhibited pentagastrin-induced gastric acid secretion. The combined administration of serotonin and secretin inhibited gastric acid secretion to a greater magnitude than either secretagogue alone. The administration of methysergide diminished basal concentrations of secretin on gastric acid secretion. Methysergide also enhanced the stimulatory activity of pentagastrin-induced gastric acid secretion. The inhibitory action of intraduodenal acidification of pentagastrin-induced gastric acid secretion was reversed by methysergide. PMID- 3966641 TI - Periampullary tumors: which ones should be resected? AB - Resection was carried out in 118 patients for periampullary lesions. Ninety-eight of these were adenocarcinomas and were treated by the Whipple operation, total pancreatectomy, or local resection (87 patients, 7 patients, and 4 patients, respectively). Diagnosis of pancreatic head carcinoma before resection was falsely positive in 27 percent of the patients. Mortality for radical resection was 4 percent. Five year survival for ampullary carcinoma was 32 percent, and for pancreatic head carcinoma it was 7 percent. Resection of all periampullary tumors is recommended, with the Whipple operation being the standard in most cases. PMID- 3966642 TI - Focal gastric mucosal blood flow at the site of aspirin-induced ulceration. AB - Focal gastric mucosal blood flow as measured by the hydrogen gas clearance method was compared with total gastric blood flow as determined by venous outflow in an isolated segment of canine stomach before, during, and after exposure to aspirin. Despite an increase in total gastric blood flow from 10.8 +/- 1.6 ml/min per chamber to 17.4 +/- 1.9 ml/min per chamber and mucosal blood flow at nonulcerated sites from 29.5 +/- 4.3 ml/min per 100 g to 83 +/- 14.4 ml/min per 100 g, mucosal blood flow at the site of aspirin-induced ulceration was significantly reduced from 29.5 +/- 4.3 ml/min per 100 g to 12.5 +/- 2.5 ml/min per 100 g. After the removal of aspirin, mucosal blood flow returned to control levels. Such a redistribution of mucosal blood flow in response to aspirin is consistent with the localized nature of acute aspirin-induced injury. The findings also explain the inability of previous methods measuring blood flow of the entire stomach to demonstrate mucosal ischemia during such injury. PMID- 3966643 TI - Secretory effects of intravenous serotonin on the proximal jejunum of the awake dog. AB - The intestinal secretory effects of hyperserotoninemia were studied in conscious dogs with cannulated, exteriorized chronic proximal jejunal segments. A basal absorptive state for water and electrolytes was significantly changed to a secretory state for water, sodium ion, chloride ion, and potassium ion when serotonin was infused intravenously at 30 micrograms/kg per minute. This effect disappeared with the cessation of the infusion. During infusion, whole blood serotonin concentrations were similar to those in patients with the carcinoid syndrome. Diarrhea developed in all animals studied during infusion, and significant hypokalemia also occurred. These results support a primary role for serotonin in the pathogenesis of diarrhea associated with the carcinoid syndrome. PMID- 3966644 TI - The exoendoprosthesis in proximal bilioenteric anastomoses. AB - The exoendoprosthesis is a completely indwelling anastomotic stent with the external end fixed to a reservoir in the subcutaneous tissue. With local anesthesia, cholangiography and tube exchange are possible. The exoendoprosthesis was used in 15 patients with obstruction to the proximal bile duct. The obstructive lesions included cholangiocarcinoma (six patients), pancreatic cancer (two patients), gallbladder cancer (two patients), sclerosing cholangitis (three patients), and benign stricture (two patients). The postoperative course was comparable to similar series with external tubes. In one patient, a persistent bile fistula necessitated early exteriorization of the tube and biliary decompression. If cholangitis or jaundice recurred, the tube was exteriorized and exchanged to be managed conventionally. However 12 months postoperatively, eight patients had indwelling tubes without any incidence of cholangitis or jaundice. The indwelling location of the tube relieved the patients of the burden of tube management and may have reduced the incidence of cholangitis. PMID- 3966645 TI - Intestinal ischemia: reduction of mortality utilizing intraluminal perfluorochemical. AB - This study reports an assessment of a method of intestinal protection by the intraluminal administration of an oxygenated perfluorochemical, perfluorotributylamine, or gaseous oxygen in an attempt to provide oxygen for mucosal cells rendered ischemia. A model of acute arterial or acute arteriovenous ischemia was produced in adult female rats. All control ischemic animals died within 12 hours. To assess intestinal protection, the mortality rates in the experimental groups were compared with the 100 percent control mortality. Gaseous oxygen and oxygenated perfluorochemical administered intraluminally reduced mortality significantly in the acute arterial model but not in rats with arteriovenous occlusion. Electron microscopy demonstrated preservation of villi after 1 and 2 hours of occlusion in the oxygen-treated groups. Light microscopy revealed massive destruction in control animals with preserved architecture in both the gaseous oxygen and oxygenated perfluorochemical groups. These results demonstrate that the intraluminal delivery of oxygen to bowel rendered ischemic by arterial occlusion may significantly decrease anatomic bowel disruption and improve animal survival. Such techniques have a potential clinical application to facilitate salvage of ischemic intestine and to augment intestinal preservation. PMID- 3966646 TI - Effect of dimethyl sulfoxide and glycerol on acute bowel ischemia in the rat. AB - After a 30 minute period of superior mesenteric artery occlusion in adult rats, there was a significant decrease in peritoneal inflammatory reaction, ileus, peritoneal adhesion formation, and histologically proved bowel wall necrosis in animals given intravenous dimethyl sulfoxide at the end of the ischemic period. In contrast, control rats given normal saline solution intravenously demonstrated severe inflammatory reaction, ileus, hemorrhagic peritoneal fluid, extensive adhesion formation, and areas of bowel wall necrosis. Intravenous glycerol did not have the beneficial effect seen with dimethyl sulfoxide. Neither compound was effective when given intraperitoneally. We conclude that intravenous dimethyl sulfoxide has a significant protective effect in rats with acute intestinal ischemia due to the superior mesenteric artery occlusion in the rat. PMID- 3966647 TI - Epidermoid cancer of the anal margin. Pathologic features, treatment, and clinical results. AB - Epidermoid cancer of the anal margin should be distinguished from that in the canal because of its different clinical and pathologic characteristics, the suitability of local excision for its treatment, and its better overall prognosis. In addition, margin cancer rarely metastasises to visceral sites. Forty-eight patients with epidermoid cancer of the anal margin were reviewed. Two refused treatment, 4 had palliative therapy for advanced, inoperable disease, 31 had local excision, and 11 were treated by abdominoperineal resection. Local excision provided satisfactory results with a corrected 5 year survival of 88 percent, although locoregional recurrence developed in 46 percent of these patients during follow-up. A second local excision or inguinal lymphadenectomy provided good results in the patients with recurrence. Abdominoperineal resection did not provide better overall survival figures. PMID- 3966648 TI - Pharmacokinetics and pharmacodynamics of d-tubocurarine and metocurine in the elderly. AB - The effects of age (older than 70 yr) on the pharmacokinetics and pharmacodynamics of d-tubocurarine (dTc) and metocurine (MTc) were evaluated in studies of 21 patients aged 70-87 and 21 patients aged 29-59. There was a significant difference in the pharmacokinetic parameters of all elderly patients compared with younger controls. With both dTc and MTc, the elderly exhibited a decreased plasma clearance, decreased initial volume of distribution, decreased volume of distribution, and a prolonged elimination half-life. After 0.3 mg/kg of dTc, the times for 50% return of twitch and recovery index (25-75% return of twitch response) in the elderly were significantly longer than in the young (P less than 0.02). A similar observation was made for the elderly patients receiving 0.15 mg/kg of MTc. No significant difference was seen in the log plasma concentration-twitch response relationship between 20-80% paralysis in young and in elderly patients receiving dTc. There was a similar lack of significant difference between the log plasma concentration-twitch response lines for elderly and young patients receiving MTc. Because there was no difference between the plasma concentration-response relationships in the elderly and young, altered sensitivity to dTc or MTc cannot explain the longer duration of action seen in the elderly. The most likely explanation for this difference is the altered pharmacokinetics of these two drugs in the elderly. PMID- 3966649 TI - Sodium citrate pretreatment in elective cesarean section patients. AB - Thirty-two healthy term parturients undergoing elective cesarean section randomly received either no antacid (n = 10), 30 ml of 0.3 molar sodium citrate less than 60 min preoperatively (n = 11), or 30 ml of 0.3 molar sodium citrate longer than 60 min preoperatively (n = 11). Immediately after delivery, the stomach was emptied as completely as possible through a #18 Salem Sump tube passed orally. Mean gastric pH in the three groups was 1.8 +/- 2.7 (SD), 5.0 +/- 1.5, and 2.7 +/ 1.2, respectively. Gastric pH was significantly higher in the short interval group than in either the control group or in patients receiving their sodium citrate more than 60 min in advance. Gastric volumes were similar. All control patients had a gastric pH less than 2.5. Nine percent of patients receiving sodium citrate less than 60 min in advance and 50% of patients receiving their sodium citrate longer than 60 min in advance had a pH of less than 2.5. Volumes exceeding 25 ml occurred with equal frequency. No patient in the short interval group had a combination of both pH of less than 2.5 and a volume exceeding 25 ml. This combination occurred with equal frequency in control patients (64%) and in those patients receiving their sodium citrate more than 60 min in advance (50%). We conclude that sodium citrate effectively increases gastric pH when given less than 60 min prior to the induction of anesthesia. PMID- 3966650 TI - Computer-controlled regulation of sodium nitroprusside infusion. AB - We built and tested a combined proportional/derivative and minimum variance adaptive control algorithm for the regulation of blood pressure using sodium nitroprusside (SNP). In ten dogs the pressure was reduced by 30 mm Hg for 1 hr. The blood pressure came to within 5 mm Hg of the desired pressure in 1.7 +/- 4 min and after 3.4 +/- 0.3 min it remained within +/- 5 mm Hg of the desired value. During the nitroprusside infusion, bolus doses of epinephrine and SNP as well as phlebotomy were used to challenge the controller. The controller responded rapidly and effectively so that blood pressure remained stable throughout each challenge. Control was achieved in ten dogs with very different sensitivities to SNP. After 1 hr of SNP infusion, the rate of SNP infusion required to maintain a 30 mm Hg reduction in pressure averaged 112 ml/hr with a standard deviation of 108 ml/hr. Adaptive control met the challenge of large differences in sensitivity and maintained the desired blood pressure. PMID- 3966651 TI - The effects of isoflurane and isoflurane-nitrous oxide anesthesia on brainstem auditory evoked potentials in humans. AB - Monitoring of brainstem auditory evoked potentials (BAEP) during neurological surgery can provide useful information. However, in order to interpret intraoperative BAEP changes, it is necessary to delineate the influence of anesthesia, including inhalation agents. In this study, we examined the influence of isoflurane and isoflurane-nitrous oxide anesthesia on BAEP in ten healthy volunteers during normothermic, normocapnic, and normotensive conditions. Isoflurane significantly increased the latencies of peaks III, IV, and V at all end-tidal concentrations studied (1.0%, 1.5%, and 2.0%). Addition of 50% nitrous oxide did not influence these findings. The increase in latencies with isoflurane anesthesia, however, was nonlinear and appeared to plateau after 1.5%. We suggest that during isoflurane anesthesia, an intraoperative increase in peak V latency beyond 1.0 msec is best explained by factors other than direct effects of isoflurane. PMID- 3966652 TI - Flammable surgical drapes--a patient and personnel hazard. AB - After a surgical drape fire, the New York State Society of Anesthesiologists, Operating Room Safety Committee, investigated the factors contributing to it. Subsequently, eight detailed cases were collected. It found that no voluntary standards or government regulations exist to oversee the flammability of surgical drapes; no agency or bureau collects reports of operating room fires; most professionals are not aware of the hazard because no labelling requirements regarding flammability exist and because most episodes are minor in nature or settled out of court and thus not reported. This relatively new hazard has developed with the more frequent use of high-energy devices designed to provide better therapeutic results. PMID- 3966653 TI - On-line conjunctival oxygen tension as a guide to cerebral oxygenation. PMID- 3966654 TI - Effects of verapamil on uterine blood flow and maternal cardiovascular function in the awake pregnant ewe. AB - Calcium entry blocking drugs may have a role in the treatment of maternal and fetal tachyarrhythmias, as well as for treatment of premature labor. This study was undertaken to assess the hemodynamic effects of verapamil in the awake pregnant ewe. Verapamil, 0.2 mg/kg administered intravenously over 3 min, resulted in the following maternal cardiovascular changes: transient (2 min) but significant decreases in systolic, diastolic, and mean blood pressures, and significant but equally transient increases in central venous pressure and mean pulmonary arterial pressure. Pulmonary capillary wedge pressure increased for 5 min. These results are consistent with the negative inotropic and peripheral vasodilating effects of verapamil. Cardiac output, systemic vascular resistance, and pulmonary vascular resistance were unaffected. Uterine blood flow decreased 25% at 2 min and remained significantly (7-18%) below control levels for 30 min after drug injection. The effects of verapamil on uterine blood flow suggest that it should be used with caution in cases where uteroplacental perfusion is compromised. PMID- 3966655 TI - Fentanyl anesthesia in familial dysautonomia. PMID- 3966656 TI - Halothane or enflurane for inhalation induction? A study of children's preferences. PMID- 3966657 TI - Prolonged myoclonus after etomidate anesthesia. PMID- 3966658 TI - Obstetrical lumbar epidural anesthesia in patients with previous posterior spinal fusion for kyphoscoliosis. PMID- 3966659 TI - Subarachnoid hemorrhage and intraoperative electrocardiographic changes simulating myocardial ischemia--anesthesiologist's dilemma. PMID- 3966660 TI - Transillumination of the trachea with Flexilum. PMID- 3966661 TI - Unusual complication of a central venous catheter. PMID- 3966662 TI - Prolonged anesthesia with isoflurane. PMID- 3966663 TI - Halothane anesthesia does not exacerbate hepatic dysfunction in cirrhotic rats. AB - The authors have refined a model of cirrhosis in the rat and used it to determine whether the administration of halothane anesthesia adversely affects preexisting liver disease. Male Wistar rats were placed on phenobarbital water and were assigned randomly to two groups. Group 1 rats were exposed by inhalation to carbon tetrachloride (CC14) at weekly intervals for 12 exposures while Group 2 rats received only air. All treatment including phenobarbital then was withdrawn for 4 weeks. Rats then were bled for SGOT and SGPT determinations and 24 h later were exposed to 1.8% halothane in oxygen for 3 h (HAL); the remaining rats from each group were exposed to 100% oxygen for 3 h (O2). Twenty-four hours later, rats were killed and blood was obtained for SGOT and SGPT by cardiac puncture. Light microscopic histologic examination was performed blind on liver sections for cirrhosis and scored for superimposed acute focal necrosis. The weekly sublethal CCl4 exposure resulted in histologically demonstrable cirrhosis in all surviving Group 1 animals. The mean (+/- SD) SGOT (128 +/- 32 IU/1) and SGPT (86 +/- 24 IU/1) values for the Group 1 rats were significantly greater (P less than 0.01) than those for Group 2 rats (98 +/- 18 IU/1 and 57 +/- 12 IU/1, respectively). Cirrhotic animals showed neither deterioration in liver function nor acute liver cell necrosis after Hal compared with O2. However, Group 2 rats showed a modest but significant increase in SGOT (P less than 0.05) after HAL, while this change was not noted after O2. Thus, 1.8% halothane anesthesia in oxygen did not result in superimposition of acute liver cell injury in already cirrhotic rats. PMID- 3966664 TI - Increased hepatic microsomal enzyme activity after surgery under halothane or spinal anesthesia. AB - Thirty-two fit patients scheduled for explorative arthrotomy of the knee were allocated randomly to either halothane/oxygen anesthesia or spinal anesthesia with bupivacaine 0.25 mg X kg-1. The day before and 1, 10, and 21 days after surgery, the aminopyrine breath test (ABT) was performed. The day before and 5, 10, and 21 days after surgery, the antipyrine clearance (APcl) was measured by the single sample saliva technique. The ABT as well as the APcl were increased significantly postoperatively (P less than 0.01). The day after surgery the ABT was increased by 13 +/- 21% in the spinal anesthesia group only, whereas a late increase by 14 +/- 31% was found in the halothane group. Five days after surgery, the APcl was increased by 36 +/- 45% in the spinal anesthesia group and by 21 +/- 28% in the halothane group. Both tests returned to base line values within 3 weeks postoperatively. In five volunteers following the same sampling scheme but receiving bupivacaine 0.25 mg X kg-1 im without surgery, no change in the ABT or the APcl was observed. The authors conclude that surgery may cause microsomal enzyme induction regardless of the anesthetic agent or technique used. The mechanism of this induction remains to be elucidated. PMID- 3966665 TI - Mechanism of the effect of droperidol to induce catecholamine efflux from the adrenal medulla. AB - The study was undertaken to determine whether droperidol had an effect to induce catecholamine efflux from the adrenal medulla as a mechanism for the possible pressor effect of droperidol in patients with pheochromocytoma and, if so, to ascertain the site of action of this compound. The efflux of catecholamines from perfused dog adrenals was increased from control level, 0.15 micrograms/min, to 0.66 micrograms/min by the administration of droperidol 6.6 microM. This effect of droperidol was not dependent on extracellular Ca++, in contrast to acetylcholine. The concomitant secretion of catecholamines and dopamine-beta hydroxylase was observed in response to acetylcholine and caffeine. However, droperidol-, histamine-, and reserpine-induced catecholamine efflux was not accompanied by dopamine-beta-hydroxylase release. In additional studies, chromaffin granules were isolated with a Millipore filter technique from the bovine adrenal medulla and were incubated for 10 min in an isotonic medium to examine the direct effects of droperidol. Droperidol did not enhance the efflux of catecholamines from the granules in contrast to histamine. The uptake of 14C norepinephrine into the granules was inhibited by droperidol in a manner comparable to reserpine. The results suggest that droperidol induces catecholamine efflux from adrenal medullary cells and the efflux probably is caused by a nonexocytotic mechanism. A contributing mechanism was an inhibition of catecholamine uptake into chromaffin granules, resulting in an increased diffusion of catecholamines out of the cell. PMID- 3966666 TI - Enflurane enhances postischemic functional recovery in the isolated rat heart. AB - Enflurane is a direct myocardial depressant and may act as a myocardial protective agent during ischemia. The authors studied the effects of enflurane on myocardial high-energy phosphates and tolerance to ischemia in the normothermic, isolated rat heart. After isolation and perfusion with Krebs-Henseleit buffer, the hearts were perfused with either buffer (control) or buffer gassed with 2% enflurane for 10 minutes. Thereafter, hearts were made globally ischemic and elapsed times to initiation of ischemic contracture (IC) were determined. ATP and creatine phosphate (CP) were measured at the conclusion of control and enflurane administration and at IC. Ten hearts per group were reperfused with buffer following IC for 20 min; peak pressure and ATP and CP were determined. Administration of 2% enflurane significantly decreased peak pressure by 20% but did not alter baseline high-energy phosphate levels nor did it prolong time to IC. However, enflurane-treated hearts exhibited significantly greater (P less than 0.01) recovery of function as defined by per cent return of peak pressure (67% +/- 3%) when compared with those hearts not treated with enflurane preischemically (44% +/- 5%). Also, enflurane-treated hearts had significantly higher (P less than 0.01) ATP levels at the conclusion of reperfusion than hearts not perfused with enflurane (12.2 +/- .8 mumol/g dry weight vs. 9.0 +/- 0.8 mumol/g dry weight). These findings suggest that enflurane administered prior to an ischemic interval enhances postischemic myocardial recovery. PMID- 3966667 TI - Cardiovascular effects of ketamine in humans with cervical or lumbar epidural blockade. AB - To examine the effect of sympathectomy induced by epidural blockade on the cardiovascular effects of ketamine anesthesia, the authors compared the changes in arterial blood pressure (AP) and heart rate (HR) following intravenous administration of ketamine in patients who had cervical epidural anesthesia (n = 18), lumbar epidural anesthesia (n = 16), or light general anesthesia alone (n = 16). Ketamine, 2 mg/kg, iv, produced statistically significant increases in both AP and HR in all patients studied. However, the per cent increases in systolic AP in the cervical group were statistically less than those in the lumbar epidural group and control groups (P less than 0.05), which did not significantly differ from each other. The changes in HR following ketamine in the cervical group were significantly less than those in the other two groups (at 3-10 min following ketamine) (P less than 0.05). These results indicate that the cardiovascular stimulatory effects of ketamine are suppressed partially by a high level of epidural anesthesia but not by a low level of epidural blockade. Since patients with cervical epidural anesthesia had an analgesic level extending between C4 and Th8, the above attenuative effects of epidural blockade may be considered to be attributable to cardiac sympathectomy induced by a high level of epidural anesthesia. PMID- 3966668 TI - Verapamil: placental transfer and effects on maternal and fetal hemodynamics and atrioventricular conduction in the pregnant ewe. AB - Verapamil may have application in the field of obstetrics for treatment of maternal and fetal tachyarrhythmias. This study was performed to assess the maternal and fetal hemodynamic effects of this drug, as well as to determine its placental transfer and effects on maternal and fetal atrioventricular conduction in the pregnant ewe. Verapamil, 0.2 mg/kg, administered intravenously over 3 min, resulted in a transient decrease in maternal mean and diastolic blood pressures. There was, however, no significant change in fetal systolic, diastolic, and mean blood pressures. Maternal and fetal heart rates also were unchanged throughout the experiment. Atrioventricular conduction, assessed by measurement of PR intervals, was prolonged in both the ewe (41%) and the fetus (78%). Placental transfer of verapamil was limited, as shown by the umbilical vein to uterine artery drug concentration ratios of 0.35-0.45 throughout most of the experiment. Fetal hepatic extraction of the drug appeared to be substantial, since the drug concentration in the fetal carotid artery was less than that of the umbilical vein at 1, 3, and 5 min after drug injection. PMID- 3966669 TI - Errors in measurement of oxygen uptake due to anesthetic gases. AB - Errors in measurement of exhaled gas volume, mixed expired oxygen and carbon dioxide concentrations, and inspired oxygen concentration and the presence of exhaled anesthetic agents cause errors in on-line calculated oxygen uptake that increase geometrically with increasing inspired oxygen concentration. No one has quantified the decrease in the magnitude of the error that might be realized if directly measured nitrogen concentration were included in the calculation. We used a computer model to evaluate this improvement, assuming an oxygen uptake of 200 ml/min and normal ventilatory parameters. Using a Monte Carlo technique, we generated 100 sets of data points, with random errors averaging 0.5% around the expected gas concentrations, and compared the accuracy of oxygen uptake calculated with and without inclusion of directly measured inspired and expired nitrogen concentrations. When the inspired oxygen fractions were 0.2, 0.5, and 0.8, the calculated oxygen uptakes +/- % standard deviation were 200 +/- 4.3, 200 +/- 12, and 196 +/- 21 when directly measured nitrogen was included versus 200 +/ 3.5, 196 +/- 16, and 205 +/- 71 when it was not. The procedure was repeated, assuming 50 ml/min of anesthetic excretion and the calculated oxygen uptakes were 200 +/- 4.6, 202 +/- 12, and 195 +/- 17 versus 212 +/- 3.8, 251 +/- 17, and 398 +/- 64. Including direct measurement of inhaled and exhaled concentrations of nitrogen or another insoluble inert tracer gas allows accurate measurement of oxygen uptake, even in the presence of exhaled anesthetic gases. It also decreases the error in oxygen uptake determination by a factor of nearly six when the inhaled oxygen fraction is 0.8. PMID- 3966670 TI - Adrenergic vasoconstriction in peripheral nerves of the rabbit. AB - The blood flow in the sciatic nerve of the rabbit was estimated from the wash out of intraneurally injected 133Xe. To avoid diffusion of the tracer into the surrounding muscular tissue, the nerve was covered by a gas-tight plastic film. Using this technique, the basal blood flow in the sciatic nerve was estimated to 35 ml X min-1 X 100 g-1. It was found that intraarterial norepinephrine and electrical stimulation of the lumbar sympathetic chain strongly reduced the wash out of 133Xe, which only can be explained by a pronounced reduction of the blood flow in the nerve itself. The blood flow again increased within 4 min of stopping the infusion of norepinephrine or the sympathetic stimulation. The prolonged effect and higher neurotoxicity of local anesthetics containing adrenaline may be explained by an alpha receptor-mediated vasoconstriction of the microvessels of peripheral nerves. PMID- 3966671 TI - Soda lime adsorption of isoflurane and enflurane. AB - The authors demonstrated that soda lime will adsorb enflurane or isoflurane as a function of the water content of the soda lime. Various volumes of liquid enflurane or isoflurane were placed in an equilibration flask containing fresh (15% water by weight) or dried soda lime and the vapor phase anesthetic concentrations plotted. When dry soda lime was used, the plot of concentration as a function of volume of liquid added was biphasic: initially flat and then rising linearly. This is qualitatively similar to data reported previously for halothane. The authors hypothesize that drying soda lime produces a molecular sieve-like structure, as adsorption is greatest for molecules with small carbon chain lengths and kinetic diameters, or with structural characteristics such as cis/trans isomerism, which effectively reduce molecular size. PMID- 3966672 TI - Bupivacaine blood levels during continuous interscalene block. PMID- 3966673 TI - Misleading mass spectrometer reading caused by an aerosol propellant. PMID- 3966674 TI - Patient monitoring during magnetic resonance imaging. PMID- 3966675 TI - Noninvasive detection of profound arterial desaturations using a pulse oximetry device. PMID- 3966676 TI - Effect of succinylcholine on plasma potassium in children with cerebral palsy. PMID- 3966678 TI - A disposable intravenous pressure infusion device. PMID- 3966677 TI - Tension subcutaneous emphysema. PMID- 3966679 TI - Superficial temporal artery cannulation is not benign. PMID- 3966680 TI - New problem leaks out. PMID- 3966681 TI - Multiple comparison procedures in the analysis of designed experiments. PMID- 3966682 TI - A simple nomogram for determining drug infusion rates. PMID- 3966683 TI - Medical protocol by habit--the avoidance of amide local anesthetics in malignant hyperthermia susceptible patients. PMID- 3966684 TI - Case review: chronic cough in a 59-year-old man. PMID- 3966685 TI - The effect of an aerosolized antihistamine, chlorpheniramine maleate, on exercise induced bronchospasm. AB - We studied the effect on airway function of chlorpheniramine maleate (C), an H1 antagonist, delivered as an aerosol to 12 asthmatic subjects, 40 minutes before submaximal exercise. The study consisted of three protocol days. A first day established that the asthmatic subjects had exercise-induced bronchospasm (EIB). On the remaining two protocol days, 10 mg of C or a saline placebo (P) were administered by aerosol nebulizer in a double-blind randomized fashion over a 5 minute period. Pulmonary function was measured immediately after the aerosol inhalation as well as 10 and 30 minutes later. A 5-7-minute period of exercise was then performed by each subject on a cycloergometer, and lung function was again measured immediately and 5 minutes after exercise. Thirty minutes after the inhalation of C there was a significant increase in lung function parameters (1.80 +/- 0.23 to 2.32 +/- 0.34/sec for MEF40%(P); Mean +/- 1 SE, P less than .05) but not for placebo. MEF40%(P) remained significantly higher on the C day than on the P day following exercise; however, this difference was no greater than the difference seen immediately before exercise. We suggest that C promotes mild bronchodilation of asthmatic airways, and that this effect in EIB may be interpreted as the result of an alteration of baseline airway caliber. PMID- 3966686 TI - Theophylline compliance in asthmatic children. AB - Thirty-nine chronic asthmatic children were enrolled in a 6-month outpatient theophylline compliance study. Seventy-two percent of these patients maintained mean theophylline levels greater than or equal to 5 mcg/ml, the definition of theophylline compliance. Both compliant and noncompliant patients showed significant reduction in wheezing symptoms (P less than .005). Demographic factors including age, race, sex, and number of parents at home were not correlated with drug compliance behavior. Specific behavioral interventions were implemented to promote drug compliance. Behavioral interventions that were most effective in achieving compliance were parental encouragement and increasing parental supervision of medication (compliance, asthma, theophylline, behavioral intervention). PMID- 3966687 TI - Direct and indirect costs associated with the management of childhood asthma. AB - The financial impact of childhood asthma has not been assessed since Vance and Taylor reported their data in Annals of Allergy 13 years ago. The present study updates the financial impact the direct costs (e.g., physician fees) have on families and assesses the indirect expenditures (e.g., income loss) associated with managing a child's asthma. PMID- 3966688 TI - Pulmonary function and bronchial hyperreactivity in asthmatic children with house dust mite allergy during prolonged stay in the Italian Alps (Misurina, 1756 m). AB - The effects of high altitude were evaluated in 14 children with allergic bronchial asthma over an 8-month period. Clinical improvement, as assessed by decreased bronchial lability, was demonstrated by pulmonary function studies. There was a decreased requirement for drugs and steroids were discontinued in our children. The results of this study suggest the use of this approach as a possible adjunct to the management of refractory cases of bronchial asthma. PMID- 3966689 TI - Allergic bronchopulmonary aspergillosis in Indian children with bronchial asthma. AB - Out of 243 children with bronchial asthma, 107 children (44%) were found to have perennial asthma. These children were studied to determine the incidence of allergic bronchopulmonary aspergillosis (ABPA) in Indian children. Clinical and radiologic evaluations, skin testing, and precipitin studies with Aspergillus fumigatus antigen, and total IgE level estimations were done. Fifteen percent of children had four or more of the criteria, and were considered to have ABPA. PMID- 3966690 TI - The effect of cold exposure and exercise upon the nasal mucosal responses in nasal allergy. AB - In subjects with nasal allergy, neither cold exposure nor exercise enhanced the nasal responses induced by nasal antigen challenge but they rather tended to suppress it. Cold exposure caused nasal mucosal swelling but its extent did not differ significantly between the subjects with nasal allergy and the normal controls. PMID- 3966691 TI - Studies of bronchial secretion. The influence of inflammatory response and bacterial infection. AB - Bronchial secretions obtained during bronchoscopic examination of 60 children suffering from respiratory tract infections were studied for the concentration of immunoglobulins, anti-proteolytic factors, lactoferrin, and lysozyme. Eleven children having bronchial asthma without a history of chronic or recurrent infections of the respiratory tract were designated as a control. The results were analysed in relation to clinical diagnosis (chronic bronchitis, bronchitis, bronchiectasis) or to the local status of bronchial mucosa at the time of bronchoscopy (no inflammation, inflammation, inflammation with documented bacterial infection). The statistical analysis of the results revealed a decrease of lactoferrin and locally produced IgA in the group of children suffering from bronchitis and chronic bronchitis. Samples infected with Haemophilus species had significantly higher concentration of lactoferrin than any other group. Similarly, albumin in this group was higher than in the other group except that other bacteria were present. Samples infected with Haemophilus also had increased concentrations of S-IgA, IgG, and anti-proteolytic factors when compared with the group without local inflammation. PMID- 3966693 TI - A standardized skin-test assay of allergen potency and stability. PMID- 3966692 TI - Hypersensitivity pneumonitis in grain farmers due to sensitization to Erwinia herbicola. AB - Two cases of hypersensitivity pneumonitis in grain workers are described. Both cases had evidence of sensitization to the gram-negative bacteria Erwinia herbicola as judged by skin tests, detection of serum precipitins, and inhalation challenge. E. herbicola is frequently found in the microflora of grains. PMID- 3966694 TI - Bronchial asthma, the tough case. PMID- 3966695 TI - Coccidioidomycosis at a university health service. AB - At a single university health service within an endemic area, 172 cases of coccidioidomycosis were retrospectively identified by fungal cultures, serologic studies, or intercurrent skin test conversions. The average annual incidence of symptomatic infection was 0.43% for susceptible students. Peak case rates occurred in November and June (11 cases/10,000 clinic visits) and were 1.5 to 6 times greater than in other months. Although mononucleosis was diagnosed approximately twice as frequently as coccidioidomycosis, coccidioidal infections required 74% more visits per patient and over 3 times longer clinical supervision than did mononucleosis. Although only 2 patients disseminated, diagnosis and management of patients with coccidioidomycosis constituted more than 2% of our clinic's visits, for an estimated annual cost of more than $34,000. Because our patient population is young and otherwise healthy, our estimates of the impact of primary coccidioidal infection may underestimate that on civilian public health as a whole. PMID- 3966696 TI - Experimental polymyxin B-induced interstitial lung disease characterized by an accumulation of cytotoxic eosinophils in the alveolar structures. AB - A variety of lung disorders are associated with the accumulation of eosinophils in the alveolar structures. To help understand the role of eosinophils in these disorders, an animal model of eosinophilic lung disease was developed. Administration of an aerosol of polymyxin B to guinea pigs (3 times per wk for 4 wk) produced diffuse interstitial lung disease with alveolar wall thickening and an alveolitis characterized by marked increases in eosinophils and alveolar macrophages. Bronchoalveolar lavage confirmed the presence of significantly increased numbers of eosinophils and alveolar macrophages in polymyxin-B-treated animals compared with those in control animals. Using density gradient centrifugation, approximately 10(7) eosinophils could be purified from the lungs of a single polymyxin-B-treated animal. Importantly, eosinophils purified from the lungs from polymyxin B-treated animals exhibited significant spontaneous cellular cytotoxicity for human fetal lung fibroblasts. In contrast, neither eosinophils from control animals nor alveolar macrophages from either group of animals were cytotoxic. These findings demonstrate that eosinophils possess effector processes capable of injuring the lung parenchyma and suggest that eosinophils can contribute to the pathogenesis of the interstitial lung disease. PMID- 3966697 TI - Pulmonary cavitation and massive hemoptysis in invasive pulmonary aspergillosis. Influence of bone marrow recovery in patients with acute leukemia. AB - The influence of bone marrow recovery on the clinical and radiographic course of invasive pulmonary aspergillosis in patients with acute leukemia has not been well characterized. We studied 26 patients with acute leukemia and invasive pulmonary aspergillosis, comparing those who recovered from chemotherapy-induced granulocytopenia (Group 1, 15 patients) with those who did not (Group 2, 11 patients). Radiographic evidence of pulmonary cavitation was not seen in any Group 2 patient, but developed in 11 of 15 (73%) Group 1 patients (p less than 0.005). In these patients, cavitation always occurred after marrow recovery, an average of 2.0 days (range: 0 to 6 days) after the granulocyte count exceeded 500/mm3. Eight patients in Group 1 and 2 in Group 2 experienced a total of 38 episodes of hemoptysis. Four of the 26 patients, all in Group 1, developed massive hemoptysis (greater than 150 ml of blood per episode), leading to 1 death. In 3 of these 4 patients, cavitation preceded the episode of massive hemoptysis. At the time of massive bleeding, the granulocyte count was greater than 500/mm3, the platelet count greater than 38,000/mm3, and the other coagulation parameters were normal in all 4 patients. Our findings demonstrate that in patients with acute leukemia undergoing chemotherapy, bone marrow recovery markedly influences the clinical and radiographic course of invasive pulmonary aspergillosis. Development of a granulocyte count greater than 500/mm3 is associated with pulmonary cavitation, and on occasion with massive hemoptysis. PMID- 3966698 TI - The role of bronchial circulation in lung abscess. AB - We studied the anatomy of bronchial circulation in 6 sheep with multiple lung abscesses. After anesthesia, the animals were heparinized and exsanguinated. The bronchial artery, pulmonary artery, and tracheobronchial tree were filled with Batson's solution of varying colors. The cast was dissected and the anatomy was studied with a dissecting microscope as well as a scanning electron-microscope. The bronchial arteries were found to be enlarged and hypertrophied in all infected animals. The abscess cavities were surrounded with a dense vascular plexus that was being supplied exclusively by the bronchial arteries. The pulmonary capillaries were sparse and were filled entirely by the bronchial artery. The pulmonary circulation did not supply the walls of lung abscess cavity. Our findings indicate that the bronchial circulation may be more important than the pulmonary circulation in resolution and repair after certain lung infections. PMID- 3966699 TI - Distribution of secretory component and immunoglobulins in the developing lung. AB - The distribution of secretory component and immunoglobulins, IgA, IgG, and IgM in developing human lungs, ranging in age from 12 gestational weeks to 8 yr, was studied using the indirect peroxidase-labeled antibody method. Secretory component appeared first in the serous bronchial epithelium near the duct openings at the sixteenth gestational week, in goblet cells at the twentieth gestational week, and in bronchiolar epithelium at the twenty-second gestational week. The number of secretory component-positive cells (Y) in bronchial epithelium increased with age in weeks (X) according to the formula Y = 15.328 + 0.094 log X (p less than 0.001). Secretory component was almost absent in bronchiolar epithelium in atelectatic lungs with or without hyaline membrane. Secretory component-positive cells were never observed below the levels of respiratory bronchioles. Immunocompetent cells appeared in the bronchial walls after birth in normal lungs, but they appeared at the thirty-ninth gestational week in cases of pulmonary infection. The IgA- and IgM-containing cells were present around the bronchial glands in normal lungs, whereas IgG-containing cells were not associated with the glands. In normal lungs, IgA-containing cells were most prominent, followed by IgM-containing cells and IgG-containing cells. The apical portions of serous epithelial cells of bronchi and bronchial glands were positive for IgA and IgM. In bacterial and viral pulmonary infections, IgA containing cells increased in number in the bronchial glands. The appearance of secretory component-positive cells long before immunoglobulin-containing cells in fetal lungs suggests that secretory component may play some role in the formation of the mucociliary blanket, instead of selective transport of IgA or IgM. PMID- 3966700 TI - Elevated lung volume and alveolar pressure during jet ventilation of rabbits. AB - We measured lung volume, tidal volume, and pressures at the airway opening, trachea, and alveoli during jet ventilation of rabbits at frequencies from 2 to 15 Hz when inspiratory time was varied from 10 to 50% of the ventilator cycle. Lung volume was determined dynamically and was dependent on tidal volume, expiratory duration, and the expiratory time constant of the respiratory system. Tidal volume decreased with increasing frequency and lung volume, and was greater than estimated dead-space volume over most of the frequency range studied. Pressure at the airway opening was not a good estimate of either mean pressure or pressure swings in the alveoli. Tracheal pressure corresponded fairly well to alveolar pressure. Alveolar pressure swings diminished with increasing frequency and decreasing inspiratory duration. In the clinical setting these results mean that measurement of pressures at the airway opening is not an adequate way to monitor patients during jet ventilation. In addition, the clinician must be aware that substantial increases in functional residual capacity may occur during jet ventilation, thereby placing the patient at risk of pneumothorax. PMID- 3966701 TI - Small airways disease and mineral dust exposure. Prevalence, structure, and function. AB - Previously we described a lesion of the small airways that appears related to mineral dust exposure and is found in asbestos and nonasbestos dust-exposed populations. To determine the usefulness of this lesion as a marker for mineral dust exposure, and to determine whether it produces functional consequences, we examined a group of 53 workers who had been either hard rock miners or in the asbestos, construction, and shipyard industries. The specific lesion (mineral dust airways disease (MDAD] consists of marked fibrosis and pigmentation of the respiratory bronchioles and was found in 13 of 53 workers with dust exposure, but only in 1 of 121 without dust exposure. Compared with age and smoking-matched dust-exposed control subjects, patients with this lesion had significant abnormalities of forced expiratory volume in one second (FEV1), forced expiratory flow during the middle half of the forced vital capacity (FEF25-75), vital capacity (VC), and nitrogen washout. In addition to fibrosis in the walls of respiratory bronchioles, these patients also had significant increases of fibrosis in the walls of membranous bronchioles, indicating that changes in the small airways are widespread in this subset of workers. We conclude that markedly abnormal small airways are present in some workers with mineral dust exposure; pathologic observation of this lesion is a good indicator of dust exposure, and its presence is associated with abnormalities of air flow greater than those induced by smoking alone. The presence of this lesion in only a portion of dust exposed workers may account for contradictory results in past studies that attempted to demonstrate air flow abnormalities associated with mineral dust exposure. PMID- 3966702 TI - Characterization of the bronchoalveolar cellular response in experimental asbestosis. Different reactions depending on the fibrogenic potential. AB - Analysis of bronchoalveolar cell types and structure was performed during the development of asbestos-induced lung injury in the rat. Animals received single intratracheal injections of one of the following: saline (control), UICC chrysotile B asbestos (5 mg), or very short 4T30 chrysotile fibers (5 mg). Bronchoalveolar lavage (BAL) was performed at various intervals after instillation. Analysis of BAL fluid showed significant increase in inflammatory cells in response to asbestos, which persisted longer in animals treated with chrysotile B. Presence of numerous mitotic figures in BAL fluid of treated animals suggests that macrophage replication may contribute in part to this response. Differential cellular analysis indicated that after injection of long chrysotile fibers, which causes fibrotic lesions within 7 days, polymorphonuclear leukocytes (PMN) appear as early as Day 1 in significant concentration (40%) in the bronchoalveolar compartment and persist through Day 7 after treatment. From Day 7 to Day 21, multinucleated cells (MGC) were found in lavage fluid (5 to 8%). Most of these cells were binucleated, and none had more than 3 nuclei. By contrast, exposure to very short chrysotile fibers caused only a very transient influx of PMN on Day 1. By Day 7, there was a significant increase in MGC, which persisted through Day 21, at which time no fibrosis was apparent. Although most of these cells were binucleated, many cells had 3 or more nuclei. The giant cells were predominantly of the foreign body type, with MGC of the Langhans type also present.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966703 TI - Motheaten mice--an animal model with an inherited form of interstitial lung disease. AB - The motheaten gene represents a single recessive mutation that occurs in mice and is associated with systemic immune abnormalities. Although they have abnormalities in several organs, homozygote animals (me/me) die by 8 wk of age from a diffuse, noninfectious lung disease. To evaluate this genetically determined model of interstitial lung disease, the lungs of these animals were studied by light and transmission electron microscopy and by bronchoalveolar lavage. Two control groups of mice were evaluated: (1) littermate normal mice, including mice without the motheaten gene (+/+) and mice heterozygous (me/+) the motheaten gene, and (2) nonlittermate normal mice (+/+). While the lungs of both control groups were normal morphologically, the lung disease in the homozygous motheaten mice progressed through 3 stages: (1) focal intra-alveolar hemorrhage with accumulations of alveolar macrophages and neutrophils in the lower respiratory tract; (2) persistent alveolitis and hemorrhage, and reparative processes including frequent mitoses of fibroblasts and type II alveolar epithelial cells; and (3) consolidation of the alveolar structures by massive accumulation of macrophages and marked derangement and fibrosis of the alveolar walls. Consistent with the morphologic findings, evaluation of mid-stage lung disease by lavage demonstrated that the alveolitis was characterized by a marked expansion of the total number of effector cells, an accumulation of neutrophils, and a marked expansion of the total numbers of T-lymphocytes and B-lymphocytes. Thus, the motheaten mouse can be regarded as a genetically determined model of interstitial lung disease characterized by alveolar hemorrhage, derangement of parenchymal cells, fibrosis, and an alveolitis with distinctive features.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966704 TI - Influence of the respiratory route on the resting breathing pattern in humans. AB - It has been shown that the pattern of breathing is modified when breathing through a mouthpiece (MP) with a noseclip (NC), although the reasons for this are not clear. We studied 14 healthy naive subjects during unrestrained breathing, while connected to a spirometer without NC, and while connected to a spirometer with NC. Breathing pattern, studied with an inductive plethysmograph (Respitrace), was recorded during 4 min in each case, once a steady state was attained. During unrestrained breathing, all subjects breathed exclusively through the nose. During spirometric testing without NC, 9 of 14 subjects still breathed through the nose only (since the oropharynx is closed by the soft palate and the tongue, and flow proceeds through the nose). Tidal volume (VT), frequency (f), minute ventilation (VE), inspiratory time, mean inspiratory flow, and duty cycle (Tl/Ttot) were not different during the first 2 procedures (p greater than 0.1 by analysis of variance). By contrast, during spirometric testing with NC, mean VT increased from 530 (during unrestrained breathing) to 700 ml (p less than 0.02), whereas f decreased from 14.9 to 13.6 breaths X min-1 (p greater than 0.05), VE did not change, and Tl/Tot increased from 37 to 41% (p less than 0.05). These data suggest that the change in the pattern of breathing depends on the breathing route. To further confirm this, we asked 8 separate subjects to simply breathe through either the nose or the mouth (half of them starting with mouth breathing, half with nose breathing) while respiration was monitored with the Respitrace without any connection to the airways.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966705 TI - Pulmonary function in subjects at the extremes of stature. AB - Normal indexes of pulmonary function are based on data from large numbers of persons, using sex, size, and age as independent determinants. The influence of aging has been well examined, but few subjects at the extremes of stature have been included in previous studies. The predicted normal values are extrapolated from data acquired in studies of persons of average height. To evaluate these predictions at the extremes of stature, we performed full pulmonary function testing in 49 healthy, nonsmoking Caucasian subjects (28 men, 21 women) who were either above the 99th or below the 5th percentile for height. Nineteen subjects of average height (9 men, 10 women) performed spirometric testing. The techniques and equipment used met the American Thoracic Society's recommendations. We demonstrated that predicted values of pulmonary function testing can be extended to include those persons at the extremes of stature. PMID- 3966706 TI - Respiratory consequences of abdominal hernia in a patient with severe chronic obstructive pulmonary disease. AB - The diaphragm is the most important muscle of respiration. It is believed that the abdominal contents affect diaphragmatic contraction by helping determine its length tension state and by acting as a fulcrum for this muscle to lift the rib cage and thereby increase lung volume. In support of these concepts we describe a patient with severe chronic obstructive pulmonary disease and a large midline hernia of the abdomen who, when standing, had a gastric pressure (Pg) of 4 cm H2O and a maximal transdiaphragmatic pressure (Pdimax) of 14 cm H2O. This was associated with an O2 saturation of 82%, lower thoracic and upper abdominal paradoxical breathing, and severe dyspnea. Once the hernia was reduced there was a rise in Pg to 12 cm H2O, of Pdimax to 27 cm H2O, and of O2 saturation to 89%. There was normalization of the breathing pattern and a decrease in dyspnea. Reduction of this patient's abdominal hernia resulted in an increase in her exercise tolerance. PMID- 3966707 TI - Physiologic closure of a symptomatic patent foramen ovale with oxygen therapy. AB - Surgery is required for correction of a physiologically significant patent foramen ovale. We report a patient with poliomyelitis and respiratory failure in whom a patent foramen ovale became symptomatic because of hypoxemia-induced pulmonary hypertension. Oxygen therapy and mechanical ventilation reversed the pulmonary hypertension, resulting in physiologic termination of the patent foramen ovale without surgery. PMID- 3966708 TI - Dependence of oxygen uptake on oxygen transport in patients with chronic obstructive pulmonary disease. PMID- 3966709 TI - Sustained-release theophylline reduces dyspnea in nonreversible obstructive airway disease. AB - Although orally administered theophylline has been prescribed widely in patients with nonreversible airway obstruction, symptomatic benefit has not been established. To assess the effects of orally administered theophylline on dyspnea, we performed a randomized, double-bind, crossover, placebo-theophylline clinical trial in 12 ambulatory male patients with moderate to severe nonreversible airway obstruction. Dyspnea was rated using 2 clinical indexes based on 3 components affecting breathlessness: functional impairment, magnitude of task that evokes dyspnea, and the associated magnitude of effort. Dyspnea and physiologic parameters were measured on 4 occasions: at baseline, 4 wk after initial treatment, a second baseline after a 2-wk washout period, and 4 wk after the second medication. For the 12 patients, mean age (+/- SD) was 60 +/- 7 yr, forced expiratory volume in one second was 1.36 +/- 0.67 L (mean, 40% of predicted), and arterial oxygen tension was 71 +/- 10 mmHg. During the treatment phase, all patients had a therapeutic theophylline blood level (range, 12 to 19 micrograms/ml). Theophylline significantly decreased the components of functional impairment (p = 0.02) and magnitude of task (p = 0.02) relating to dyspnea, as well as the overall dyspnea rating (p = 0.01). There were no significant differences between placebo and theophylline therapy for spirometry, arterial blood gas tensions, and the 12-min walking distance. Thus, sustained-release theophylline significantly reduced dyspnea in these ambulatory patients with moderate to severe nonreversible airway obstruction without altering lung function, gas exchange, or exercise performance. PMID- 3966711 TI - Variability of airway responsiveness to histamine aerosol in normal subjects. Role of deposition. AB - The purpose of this investigation was to determine if the variability of bronchial responsiveness to inhaled histamine in normal subjects is related to the total dose of histamine deposited in the airways. To test this possibility, we used a new method of histamine challenge that permits calculating the histamine mass deposited in the airways in an attempt to correlate it with the magnitude of the response. Using a standardized breath-holding maneuver, 10 healthy nonsmokers and 10 healthy smokers with normal spirometry inhaled an aerosol generated from a solution containing a fixed ratio of histamine and a small quantity of hematoporphyrin serving as a fluorescent tracer. The mass of histamine deposited was calculated from the measured fluorescence of the inspired and expired aerosol. Forced expiratory volume in one second (FEV1) was measured before and 10 min after inhalation challenge. There was a negative correlation between percent decrease in FEV1 (delta FEV1) and histamine mass deposited in the nonsmokers (r = -0.83, p less than 0.005) and smokers (r = -0.82, p less than 0.005) without a difference between the 2 slopes. The range of delta FEV1 was 7 to 33% and of histamine mass deposited, 0.02 to 0.18 mg in the nonsmokers. The respective values in the smokers were 2 to 30% and 0.02 to 0.17 mg. In 6 subjects in whom dose-response curves were obtained, the mean deposited histamine mass required to decrease the FEV1 by 10% was 0.11 mg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966710 TI - Relaxation of lower esophageal sphincter and stimulation of gastric secretion and diuresis by antiasthmatic xanthines. Role of adenosine antagonism. AB - The study was designed to obtain information on selected extrapulmonary effects of enprofylline, an adenosine-non-blocking alkylxanthine that is about 5 times more potent as a bronchodilator than the adenosine receptor antagonist theophylline. Effects of theophylline (5.0 mg/kg) on lower esophageal sphincter pressure (LESP), gastric secretion, and diuresis and of enprofylline (1.5 mg/kg intravenously producing about 2 micrograms/ml plasma) were examined in 8 healthy volunteers. Enprofylline and theophylline decreased LESP (by 5.0 +/- 2.6 mm Hg, mean +/- SD, p less than 0.001, and by 5.8 +/- 2.7 mmHg, p less than 0.001, respectively), but only theophylline stimulated gastric secretion (volume p less than 0.01 and acidity p less than 0.01) and urine production (volume p less than 0.01 and sodium chloride excretion p less than 0.01). Neither xanthine affected plasma gastrin. Enprofylline and theophylline can be expected to have a similar ability to reduce the barrier to gastroesophageal reflux, but only the latter would have additional stimulant effects on gastric secretion and diuresis. These findings may have clinical significance and suggest a role for adenosine in regulating gastric secretion (and diuresis) but not LESP. PMID- 3966712 TI - Reproducibility of individual responses to ozone exposure. AB - Because large intersubject differences in the magnitudes of response to a single ozone (O3) exposure have been observed, we undertook to determine if this variability were due to differences in intrinsic responsiveness to O3 or to other factors. Thirty-two subjects were exposed to 1 of 5 O3 concentrations (0.12, 0.18, 0.24, 0.30, or 0.40 ppm), and each underwent one or more repeat exposures separated by from 3 wk to 14 months. Magnitudes of change for pulmonary function variables, respiratory rate and tidal volume, and for reported symptoms were compared for the repeated exposures. Changes induced in forced expiratory spirometric measurements were highly reproducible for as long as 10 months and for all tested O3 concentrations of 0.18 ppm or greater. This high degree of reproducibility indicates that the magnitude of response to a single exposure is a precise estimate of that subject's intrinsic O3 responsiveness. We conclude that the previously observed intersubject variability in magnitude of O3-induced effects is the result of large differences in intrinsic responsiveness to O3. PMID- 3966713 TI - Differential elevation by protriptyline and depression by diazepam of upper airway respiratory motor activity. AB - Effects of systemically administered protriptyline and diazepam on the respiratory activity of the phrenic, hypoglossal, and recurrent laryngeal nerves were investigated in vagotomized, decerebrate cats. Both hypoglossal and recurrent laryngeal nerve activities were consistently increased after protriptyline administration, whereas the phrenic nerve discharge was not systematically altered. Similar changes were observed in cats with bilateral carotid sinus nerve sections. Diazepam induced a reduction of hypoglossal and recurrent laryngeal nerve activities at doses that did not alter phrenic nerve discharge. These results with diazepam were the same in carotid chemodenervated cats. We conclude that neural mechanisms controlling upper airway muscles are much more sensitive to protriptyline and diazepam than are those of the bulbospinal-phrenic system. The selective augmentation of hypoglossal and recurrent laryngeal discharges by protriptyline could account for the reported decrease in the frequency of obstructive sleep apneas in patients receiving this antidepressant. In contrast, diazepam, by depressing motor activity to upper airway muscles, may exacerbate oropharyngeal obstruction during sleep. PMID- 3966714 TI - Increased vascular responsiveness in lungs of rats with pulmonary hypertension induced by monocrotaline pyrrole. AB - Monocrotaline (MCT) is a natural product that causes pulmonary hypertension in rats after metabolic activation to a pyrrole form (MCTP). To examine the vascular reactivity of the pulmonary bed, blood-perfused isolated lungs from MCTP- or vehicle-treated rats were challenged with angiotensin II (AII) and 5 hydroxytryptamine (5HT), and the resultant increases in perfusion pressure were measured. Fourteen days after a single exposure, the pressor responses to AII (0 25 or 0.50 microgram) and 5 HT (12.5 to 50 microgram) were approximately 3 times as great in isolated lungs of MCTP-treated rats as in those of control rats. When examined 7 days after exposure, the response to 25 micrograms 5HT but not to 0.25 microgram AII was enhanced by MCTP; MCT is known to decrease 5HT uptake by pulmonary capillary endothelial cells. Imipramine, a 5HT uptake inhibitor, did not alter the vascular responses to 25 micrograms 5HT in lungs from either control or MCTP-treated rats. The increased responsiveness of the pulmonary vasculature to AII and 5HT after MCTP exposure could play a role in the development and/or maintenance of pulmonary hypertension in this rat model. PMID- 3966715 TI - Interference of cardiovascular sounds with phonopneumography in children. AB - We have used fast Fourier transform and power spectra analysis to determine possible interference of cardiovascular sounds with the analysis of breath sounds in children. Ten normal children, 8 to 13 yr of age, were studied with sound transducer over midprecordium, right upper lobe, and right lower lobe along with simultaneously recorded ECG and air flow. Detection of R-waves facilitated sampling of sound segments at defined flow rates, with inclusion or exclusion of heart sounds. Measurements during breath-holding and without heart sounds served as baseline values. Heart sounds were only slightly attenuated over the right upper lobe. There was a considerable overlap in the power spectra of heart and breath sounds, mainly in frequencies below 100 Hz. Analysis of low-frequency components of normal breath sounds requires sampling during parts of the cardiac cycle that are free of cardiovascular sounds. PMID- 3966716 TI - Indomethacin enhances response of human bronchus to antigen. AB - We studied the effect of indomethacin, an inhibitor of the cyclooxygenase pathway of arachidonic acid metabolism, on antigen-induced contraction of passively sensitized human bronchus in vitro. Incubation with indomethacin (3 microM) prior to antigen challenge produced significant enhancement of both the early (histamine-dependent) and late (SRS-A-dependent) phases of the contraction. Indomethacin potentiated anaphylactic histamine release from the bronchial tissue by approximately twofold but had no significant effect on basal tone or responsiveness to exogenous histamine. These data suggest that inhibition of the cyclooxygenase pathway results in potentiation of antigen-induced constriction of human bronchus principally through enhanced release of anaphylactic mediators from airway mast cells. PMID- 3966718 TI - Subtotal parathyroidectomy versus total parathyroidectomy with autotransplantation for secondary hyperparathyroidism. AB - A retrospective review of patients treated for secondary hyperparathyroidism by total parathyroidectomy with parathyroid autotransplantation (tPTX) and subtotal parathyroidectomy (sPTX) is presented. Ten patients underwent tPTX, and 22 patients underwent sPTX between 1977 and 1982. Hypocalcemia and complications of its treatment were a problem in the tPTX patients. One patient in the tPTX group and no patients in the sPTX group have required reoperation for recurrence. Both procedures were highly successful in relieving symptoms of secondary hyperparathyroidism and in reversing renal osteodystrophy. The authors believe that sPTX is a proven, effective operation and the operative treatment of choice for secondary hyperparathyroidism. PMID- 3966717 TI - Human alveolar macrophage inhibition of lung fibroblast growth. A prostaglandin dependent process. AB - The processes controlling fibrosis in the human lung are poorly understood. Mononuclear cells may be important regulators of fibroblast function, and the alveolar macrophage (AM) is the major mononuclear phagocyte of the human lung. To further understand AM-fibroblast interactions in the lung, supernatants from unstimulated and stimulated adherent human AM were obtained and their effect on the log phase growth of human lung fibroblasts was characterized. Alveolar macrophage supernatants inhibited fibroblast growth in a dose-dependent fashion. This inhibition was the result of a heat-stable (56 degrees C, 1 h), nondialyzable (molecular weight cutoff, 12,000 daltons), soluble factor(s), which was preferentially elaborated by smaller and denser macrophage subpopulations. The inhibitory capacity of an AM supernatant was directly related to its capacity to stimulate fibroblast prostaglandin production. Blocking fibroblast prostaglandin production reversed the inhibition of fibroblast growth caused by AM supernatants. Thus, AM inhibition of fibroblast growth may be mediated in part by fibroblast prostaglandin production. Alveolar macrophage inhibition of fibroblast growth may be important in preventing fibrosis in normal persons and/or in inhibiting the fibrotic response seen with pulmonary inflammation. PMID- 3966719 TI - Changing attitudes toward management of cancer of the colon and rectum. AB - Changes in the attitudes of surgeons toward the management of cancer of the colon and rectum over a 5-year period were assessed by analysis of responses of general surgeons to a 21-item questionnaire on colon cancer from 1978 and 1983. Comparisons of the responses revealed that the use of routine preoperative liver scans has decreased from 57 to 45 per cent. Transanal resection of villous adenoma of the rectum is used more often (44% in 1983 versus 34% in 1978). For obstructing carcinoma of the colon, a two-stage procedure is used more often, with 46 per cent of the respondents in favor of this approach in 1983 compared with 29 per cent in 1978. The use of staplers for colon anastomoses following resection has also increased with 44 per cent surgeons in 1983 using this technique always or frequently compared with 21 per cent in 1978. Following anterior resection, 66 per cent of respondents in 1983 seldom or never use a transverse colostomy (54% in 1978). The number of surgeons closing the perineal wound over suction drains following an abdominoperineal resection has increased from 46 per cent (1978) to 63 per cent in 1983. Sphincter-saving procedures for carcinoma of the rectum are used by a large number of surgeons in 1983 (29% versus 9% in 1978). An increase is noted in the use of preoperative radiation therapy for selected cases of rectal cancer (53% in 1978 to 68% in 1983).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966720 TI - Primary small bowel malignancies. AB - Fifty-five patients with primary small bowel malignancies were evaluated from 1955 to 1983. Twenty-seven patients (49%) had carcinoid tumors, 16 (29%) had adenocarcinomas, and 12 (22%) had leiomyosarcomas. The average age at presentation was 68 years (range: carcinoids, 27-82; leiomyosarcomas, 36-75; adenocarcinomas, 40-83). Carcinoids and leiomyosarcomas were 1.7 and 2.0 times, respectively, more common in men; adenocarcinomas showed no sex predominance. Eighty-nine per cent of all patients had symptoms: abdominal pain in 65 per cent, obstruction in 23 per cent, bleeding in 8 per cent, and palpable mass in 5 per cent. Although 27 per cent of carcinoid patients were asymptomatic, 40 per cent exhibited the carcinoid syndrome. Symptoms were longstanding in the majority of cases, and, at the time of diagnosis, 49 per cent of the carcinomas were metastatic. Fifty-five per cent of the tumors were in the ileum, 24 per cent in the jejunum, and 21 per cent in the duodenum. Fifty-five patients (89%) underwent resection for palliation or cure. Five adenocarcinoma patients (32%) survived 1 year, and one (6%) lived 10 years. Twenty-five per cent of leiomyosarcoma patients survived for 10 years. Eighty-seven per cent of patients with carcinoids survived for 1 year, 39 per cent for 5 years, and 22 per cent for 10 years. Previous reports have documented the difficulty of diagnosing these lesions, as does the present study. A higher degree of physician awareness and a more aggressive investigation of referable symptoms should lead to earlier treatment and better long-term results. PMID- 3966721 TI - Carcinoid tumors of the gastrointestinal tract. AB - Carcinoid tumors continue to be of specific clinical interest because of their diverse presentation, hormonal secretion, and malignant potential. One hundred ninety-two patients with carcinoid tumors were treated at the University of Iowa Hospitals and Clinics between 1938 and 1982. The most common location of these tumors was the appendix (30%), followed by the ileum (23%) and rectum (9%). Metastatic disease occurred in 29 per cent of all patients, with colonic and ileal tumors being the most likely to metastasize (40% and 35%, respectively). Surgical excision continues to be the treatment of choice in resectable tumors. Appendectomy alone proved effective in the treatment of appendiceal tumors less than 2 cm in diameter and without lymph node metastases. Local excision was also sufficient for the treatment of rectal tumors less than 2 cm in diameter and without invasion of the muscularis propria. Ileal, colonic, and locally advanced appendiceal and rectal tumors should be treated with radical excision including resection of the regional lymph nodes. The overall 5-year survival rate was 47%. Patients with metastatic disease had a lower survival rate (25%) compared with patients without metastases (64%). PMID- 3966722 TI - Can survival in pancreatic adenocarcinoma be predicted by primary size or stage? AB - Evaluation of diagnosis and treatment modalities in pancreas cancer is hampered by the lack of a suitable staging system. The current staging protocol of the American Joint Committee is arranged as follows: intrapancreatic disease (stage I), localized invasion (stage II), positive regional lymph nodes (stage III), and distant metastases (stage IV). Primary size is not taken into account and may represent an important determinant of survival, as it does in other malignancies. Primary size as a criterion of operability may assume increasing importance, given the demonstrated accuracy of sonography and computed tomography. Chart review was undertaken of the 119 consecutive patients with pancreas cancer presenting at Grady Hospital between 1976 and 1981. Ninety-one per cent were histologically confirmed. The presence or absence of metastases continues to be the most important factor predicting survival (P less than 0.001). It was demonstrated, however, that patients with primary lesions less than 5 cm lived significantly longer than those with primaries greater than or equal to 5 cm (P less than 0.02). Using the currently recommended American Joint Committee protocol, there was no difference in survival curves among stages, I, II, and III. The median survival times were 7.5 months, 5 months, and 5 months, respectively. Between combined stages I, II, and III and stage IV (median survival, 1.0 month), there was a significant difference (P less than 0.001) in survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966723 TI - Male breast carcinoma. AB - Fifty men with primary breast carcinoma were seen between the years 1938 and 1983 at the University of Iowa Hospitals and Clinics. In most patients, there was a significant delay between the onset of symptoms and seeking medical advice (mean, 21 months; range, 1-156). The vast majority of patients were treated by simple, modified radical, or radical mastectomy. Ten patients underwent incisional or excisional biopsy with or without radiation because of locally advanced disease or distant metastases. Survival was comparable in the groups of patients treated with simple mastectomy (mean, 70 months), modified radical mastectomy (mean, 61 months), and radical mastectomy (mean, 78 months). Local recurrence occurred in 25 per cent of all patients, and this rate was not dependent on the operation performed. The data suggest that modified radical mastectomy is adequate therapy for local control and staging of the disease without reducing survival from that observed after radical mastectomy. PMID- 3966724 TI - Specimen xeroradiography after needle localization and biopsy of noncalcified, nonpalpable breast lesions. AB - Xeroradiography was used to detect and aid in needle localization of 63 nonpalpable breast lesions over an 8-year period. In 28 patients (44%), no microcalcifications were present in the lesion biopsied. Xeroradiographs of these noncalcified lesions after their submersion in water carried a clean and close resemblance to their in vivo appearance and aided the pathologist in localizing the abnormality within the biopsy specimen. This simple method improved the accuracy of the needle-guided biopsy while allowing excision of minimal breast tissue. A total of 17 (27%) lesions revealed malignancy. At the time of mastectomy, all carcinomas were at an early stage with no nodal involvement. No recurrence has been detected to date with a mean follow-up period of 24 months. This procedure requires close cooperation between the surgeon, radiologist, and pathologist. PMID- 3966725 TI - The role of routine biopsy of all parathyroid glands in primary hyperparathyroidism. AB - Since 1974, a concerted effort has been made to identify and biopsy all parathyroid glands in patients presenting with primary hyperparathyroidism. From 1974 until July 1982, 247 patients had initial cervical exploration for primary hyperparathyroidism. The percentage of patients in whom four or more glands were identified rose from 53 per cent in 1974 to as high as 88 per cent, with a mean of 80 per cent during the 8.5-year period. Ectopic location, prior thyroid surgery, and detrimental effects of prolonging surgery in some patients are reasons precluding localization of all glands in every patient. The percentage of biopsies positive for parathyroid tissue rose from 78 per cent in 1974 to 94 per cent in 1982. Routine biopsy of all glands provided the following results of classification in the 247 cases: adenoma, 56 per cent; diffuse hyperplasia, 18 per cent; nodular hyperplasia, 24 per cent; carcinoma, 0.8 per cent; and in three cases, four normal glands were identified. The one major complication was a case of temporary bilateral recurrent laryngeal nerve palsy. Mean follow-up period is 3 years. There was no case of permanent hypocalcemia and no operative deaths. Persistence and recurrence rates are 4.9 per cent and 0.4 per cent, respectively. Four of the patients with persistence and the one patient with recurrence have required reexploration. All but one of these was considered cured by reoperation. Eight of the 12 patients with initial persistent hypercalcemia postoperatively have been managed conservatively. These results suggest routine attempts to identify and biopsy all glands can be performed with minimal risk and complications and without permanent hypocalcemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966727 TI - Caution: very-low-calorie diets can be deadly. PMID- 3966728 TI - House staff pregnancy in internal medicine residencies. PMID- 3966726 TI - Performance of women candidates on the American Board of Internal Medicine Certifying Examination, 1973-1982. AB - Trends in the performances of female and male candidates taking the American Board of Internal Medicine Certifying Examination from 1973 through 1982 were examined. The mean scores of female candidates who graduated from medical schools in the United States or Canada and who were taking the examination for the first time improved from 428 to 470, and the percentage of those passing improved from 59% to 76%. The number of women taking the examination also increased markedly, by over 500%. Performance of female candidates remained slightly lower than that of male candidates, regardless of the quality of the residency training program or the medical school from which a candidate had graduated or the rating given a candidate by the director of the candidate's residency program. Except for the oldest candidates, age followed this pattern as well. Our findings suggest that the gender gap in scores on the Certifying Examination in Internal Medicine is narrowing. PMID- 3966729 TI - The second-generation sulfonylureas: change or progress? PMID- 3966730 TI - Pentoxifylline and intermittent claudication. PMID- 3966731 TI - Registry for angiofollicular lymph node hyperplasia. PMID- 3966732 TI - Bilateral breast cancer and radiotherapy for asthma. PMID- 3966733 TI - Abortion and the ethics manual. PMID- 3966734 TI - Minoxidil in breast milk. PMID- 3966735 TI - Dysosmia, dysgeusia, and nifedipine. PMID- 3966736 TI - Sarcoid meningoencephalitis treated with high-dosage steroids and radiation. PMID- 3966737 TI - Transmission of infection during training for cardiopulmonary resuscitation. PMID- 3966738 TI - Levamisole, immunostimulation, and the acquired immunodeficiency syndrome. PMID- 3966739 TI - Fungal peritonitis and peritoneal catheters. PMID- 3966740 TI - Dapsone and aplastic anemia. PMID- 3966741 TI - Vitamin B12 deficiency after gastric surgery. PMID- 3966742 TI - Hemodynamic response to oxygen therapy in chronic obstructive pulmonary disease. AB - At six centers, 203 patients with stabilized hypoxemic chronic obstructive pulmonary disease were evaluated hemodynamically during a continuous or 12-hour oxygen therapy program. Neither oxygen therapy program resulted in correction or near-correction of the baseline hemodynamic abnormalities. The continuous oxygen therapy group did show improvement in pulmonary vascular resistance, pulmonary arterial pressure, and stroke volume index. The improvement in pulmonary vascular resistance was associated with improved cardiac function, as evidenced by an increase in baseline and exercise stroke volume index. The nocturnal oxygen therapy group showed stable hemodynamic variables. For both groups, changes in mean pulmonary artery pressure during the first 6 months were associated with subsequent survival after adjustment for association with the baseline mean pulmonary artery pressure. Continuous oxygen therapy can improve the hemodynamic abnormalities of patients with hypoxic chronic obstructive pulmonary disease. The hemodynamic response to this treatment is predictive of survival. PMID- 3966743 TI - Cutaneous malignant melanoma after Hodgkin's disease. AB - Eight cutaneous malignant melanomas occurred in 6 of 1405 patients with Hodgkin's disease, although the expected incidence rate was 0.77 (relative risk, 8; 95% confidence interval, 3 to 17). One melanoma was a thin, level II lesion less than 0.76 mm thick; the rest were mostly bulky, deeply invasive lesions despite close clinical surveillance. The melanomas spread aggressively; 3 of 6 patients died within 1 to 3 years. Two of the six patients developed a second primary malignant melanoma 1 year after the first. Two of six patients had biopsy-proven dysplastic nevus syndrome, a known precursor to cutaneous malignant melanoma, and an additional 3 patients had clinical evidence of dysplastic nevus syndrome. Histologically, the malignant melanomas showed a sparse inflammatory infiltrate, an abnormal host response seen previously in cutaneous melanomas developing in immunosuppressed patients. Dysplastic nevi may identify patients at highest risk who require modified medical management. PMID- 3966744 TI - Clonidine suppression testing in essential hypertension. AB - To assess the contribution of sympathetic outflow to blood pressure in patients with essential hypertension, we measured blood pressure and plasma norepinephrine responses to clonidine, an antihypertensive agent that decreases central sympathetic outflow, in 44 patients and in 41 normotensive control subjects of similar age. Among the hypertensive patients, the resting level of plasma norepinephrine was significantly related to the decrease in mean arterial pressure 3 hours after a single oral dose of clonidine 300 micrograms (r = 0.62, p less than 0.001). The magnitude of the depressor response in the patients also was correlated significantly with the decrease in plasma norepinephrine after clonidine (r = 0.60, p less than 0.001). These results suggest that increased sympathetic outflow plays a pathophysiologic role in some patients with essential hypertension. PMID- 3966745 TI - Anorexia nervosa and sudden death. AB - Necropsy findings and electrocardiograms from three women with anorexia nervosa were reviewed. Necropsy examination failed to establish an anatomic cause of death. Electrocardiograms recorded days or less before death showed various degrees of Q-T interval prolongation: Q-T intervals corrected for heart rate measured 0.61 s, 0.47 s, and 0.46 s, respectively. Terminal ventricular tachyarrhythmias were documented in two patients, including torsade de pointes in one. The necropsy and clinical findings in these three cases provide evidence that sudden death in anorexia nervosa, like sudden death in liquid-protein dieting, may result from ventricular tachyarrhythmias related to Q-T interval prolongation. For such patients, electrocardiographic monitoring should be routine. PMID- 3966746 TI - Amplitude of ventricular fibrillation waveform and outcome after cardiac arrest. AB - The amplitude of ventricular fibrillation found initially in 394 patients was compared to clinical and logistical findings at the time of cardiac arrest. Peak to-peak amplitude averaged 0.55 +/- 0.25 mV; a very low amplitude (0.2 mV or less) or "fine" fibrillation was present in 66 patients (17%). The amplitude was not found to be related to clinical histories, but depended on the length of the period from collapse until start of basic life support (p = 0.004) and the delay until assessment by paramedics (p = 0.001). Survival rates were strongly associated with amplitude: only 4 patients (6%) with fine ventricular fibrillation survived, compared to 117 or 328 patients (36%) in whom the initial amplitude was higher (p less than 0.001). Patient outcome related to amplitude even after adjusting for clinical history and logistical delays (p less than 0.005). We conclude that fine ventricular fibrillation is in part the result of delay in initiation of treatment, and that fibrillation amplitude is a powerful indicator of outcome after cardiac arrest. PMID- 3966747 TI - Fatal disseminated candidiasis due to amphotericin-B-resistant Candida guilliermondii. PMID- 3966749 TI - Serum amyloid A protein in familial Mediterranean fever. PMID- 3966748 TI - Hodgkin's disease in homosexual men with generalized lymphadenopathy. PMID- 3966750 TI - Ambulatory Holter electrocardiography: choice of technologies and clinical uses. AB - Rapid growth in the use and complexity of Holter monitoring technologies has resulted in the diverse recorders and analysis devices that are compared in this review. Holter recording modes include continuous recording, which makes all electrocardiographic (ECG) data available for analysis; patient-activated recording, which is useful for capturing infrequent symptomatic arrhythmias; and event recording, which provides data on ECG events detected by the recorder, but whose reliability is limited. Various sophisticated, computer-based analysis systems exist, with varying prices and degrees of accuracy and reliability. Quantitative data are essential in the use of Holter monitoring to define the response of ventricular arrhythmias to therapeutic interventions, but the physician must be wary of quantitative data unless a quality-control program has been established and validated. Although Holter monitoring is safe, problems in recording and in differentiating artifacts from true cardiac rhythm disturbances may result in false clinical diagnoses unless these problems are recognized. PMID- 3966751 TI - Hemodynamic characteristics of patients with hypothermia due to occult infection and other causes. AB - Eighty-five consecutive patients with hypothermia were prospectively evaluated to assess clinical and laboratory data that would differentiate those patients with hypothermia caused by severe infection and bacteremia and those with hypothermia of other causes. Thirty-two patients had hemodynamic monitoring, allowing us to assess hemodynamic differences between the two groups. Clinical characteristics, including admission temperature, leukocyte count, mean arterial pressure, pulse rate, respiratory rate, arterial pH, and pulmonary capillary wedge pressure, did not distinguish between the two groups. However, patients with infection with bacteremia had lower calculated systemic vascular resistances (486.0 +/- 125.0 compared with 1759.9 +/- 331.0 dynes.s.cm-5; p = 0.001) and higher cardiac indices (7.1 +/- 1.9 compared with 2.8 +/- 0.7 L/min X M2; p = 0.006) than patients without severe infections. Thus, our data suggest that hemodynamic characteristics are different in patients with infection-related hypothermia and patients with hypothermia associated with other causes, and appear to depend on the underlying disease. PMID- 3966752 TI - Menstrual function and bone mass in elite women distance runners. Endocrine and metabolic features. AB - Bone mass and metabolic features were studied in 17 women distance runners. Eleven of the women had secondary amenorrhea for 1 to 7 years. Six women have maintained regular menses since menarche. Both groups were matched for aerobic capacity, body fat, exercise intensity, and age of menarche. Mineral density of lumbar spine in the amenorrheic runners was lower than that in the cyclic women and age-matched controls, but higher than that in runners with secondary amenorrhea who are less physically active. Mineral density of the radius was normal in both groups. Running-related fractures were more frequent in amenorrheic women. Metabolic assessment showed no differences between groups, except that serum triiodothyronine was lower in the amenorrheic group, perhaps reflecting low calorie intake. Intense exercise may reduce the impact of amenorrhea on bone mass; however, amenorrheic runners remain at high risk for exercise-related fractures. PMID- 3966753 TI - Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. AB - We prospectively evaluated the frequency, cause, and outcome of hyponatremia (plasma sodium concentration, less than 130 meq/L), as well as the hormonal response to this condition, in hospitalized patients. Daily incidence and prevalence of hyponatremia averaged 0.97% and 2.48%, respectively. Two thirds of all hyponatremia was hospital acquired. Normovolemic states (so-called syndrome of inappropriate secretion of antidiuretic hormone) were the most commonly seen clinical setting of hyponatremia. The fatality rate for hyponatremic patients was 60-fold that for patients without documented hyponatremia. Nonosmotic secretion of vasopressin was present in 97% of hyponatremic patients in whom it was sought. In edematous and hypovolemic patients, plasma hormonal responses (increases in plasma renin activity and aldosterone and norepinephrine levels) were compatible with baroreceptor-mediated release of vasopressin. Hyponatremia is a common hospital-acquired electrolyte disturbance that is an indicator of poor prognosis. Nonosmotic secretion of arginine vasopressin is a major pathogenetic factor in this electrolyte disturbance. PMID- 3966754 TI - Leukemia of large granular lymphocytes: association with clonal chromosomal abnormalities and autoimmune neutropenia, thrombocytopenia, and hemolytic anemia. AB - Three patients had leukocytosis of large granular lymphocytes and chronic neutropenia. Clonal chromosomal abnormalities (trisomy 8 and trisomy 14) and lymphocytic infiltration of splenic red pulp, hepatic sinusoids, and bone marrow indicated the neoplastic nature of the large granular lymphocytes. Demonstration of a T3+, T8+, HNK-1 + phenotype and low natural killer cell activity that was augmented by interferon treatment showed the leukemic cells to be immature natural killer cells. Multiple autoantibodies were present and included rheumatoid factor and antinuclear, antineutrophil, antiplatelet, and antierythrocyte antibodies, suggesting a defect of B-cell immunoregulation. In addition, in-vitro studies showed impaired suppression of immunoglobulin biosynthesis by abnormal cells from one patient. Antineutrophil antibodies and absence of direct cell-mediated inhibition of granulocyte-macrophage colony formation supported a humoral immune mechanism for the neutropenia. In these patients the syndrome of splenomegaly, multiple autoantibodies with neutropenia, and lymphocytosis of large granular lymphocytes is due to a neoplastic proliferation of immature natural killer cells. PMID- 3966755 TI - Lupus nephritis and other autoimmune features in patients with diabetes mellitus due to autoantibody to insulin receptors. AB - The frequency of various autoimmune features in 14 patients with insulin resistant diabetes mellitus (type B) was reviewed. Twelve patients had leukopenia, high titers of antinuclear antibodies (speckled pattern), and hypoalbuminemia; 11 had elevated serum levels of IgG and high erythrocyte sedimentation rates; 7 had proteinuria and high serum levels of antibodies to DNA; and 5 had alopecia and elevated serum levels of IgA. Lupus erythematosus preparations were negative in all patients. Eight patients met the conventional criteria for the diagnosis of systemic lupus erythematosus. Three patients developed renal involvement while under care at the National Institutes of Health. Kidney tissue samples showed proliferative and membranous glomerulonephritis, tubulointerstitial nephritis, and electron-dense deposits similar to those of lupus nephritis. The lupus nephritis in these 3 patients appeared to be independent of the level of insulin-receptor antibody and glucose dysmetabolism. This study documents the presence of systemic lupus erythematosus in a large proportion of patients with insulin resistance due to autoantibodies to insulin receptors and emphasizes that careful monitoring of such patients for major complications of lupus nephritis is warranted. PMID- 3966756 TI - Increased dermal mast cell populations in progressive systemic sclerosis: a link in chronic fibrosis? AB - Dermal collagen deposition is the hallmark of the early indurative phase of progressive systemic sclerosis (scleroderma). This process, however, tends to remit in late stages of the disease. Because mast cells are believed to participate in the development of fibrotic processes, we measured the density of the cutaneous mast cell population in clinically involved and uninvolved skin of a group of patients with scleroderma. Mast cell counts in clinically involved skin of patients with early stages of scleroderma (111 +/- 28 [SD] cells/mm2) were significantly greater than those in clinically uninvolved skin of the same patients (58 +/- 26 cells/mm2) and also greater than those of normal controls (50 +/- 14 cells/mm2). Mast cell counts in clinically involved and uninvolved skin of patients with late scleroderma were normal. When mast cell density was analyzed by depth of dermis, an 85% increase was noted in involved papillary dermis and a 152% increase in involved reticular dermis in patients with early scleroderma when compared with densities in controls. These results suggest that mast cells may be important in the pathogenesis of the early cutaneous lesions of progressive systemic sclerosis, perhaps by promoting fibrosis. PMID- 3966757 TI - Thyroid abnormalities in dermatitis herpetiformis. Prevalence of clinical thyroid disease and thyroid autoantibodies. AB - We studied thyroid abnormalities in 50 patients with dermatitis herpetiformis. Two patients had a history of hyperthyroidism, and 5 had hypothyroidism and were on thyroid replacement therapy. Three patients had had thyroidectomies for nodules, and 5 had asymptomatic goiter. Two patients were clinically euthyroid with elevated thyrotrophin and low normal thyroxine levels, indicating early thyroid insufficiency. Thyroid microsomal antibodies were seen in 38% of patients with dermatitis herpetiformis compared to 12% of controls. The presence of clinical or serologic thyroid abnormalities in 26 of 50 patients shows a significant but unexplained association between dermatitis herpetiformis and thyroid disease. PMID- 3966759 TI - Aspartame-induced granulomatous panniculitis. PMID- 3966758 TI - Treatment of diabetic diarrhea with clonidine. AB - Stimulation of alpha 2-adrenergic receptors on enterocytes promotes fluid and electrolyte absorption and inhibits anion secretion. Loss of adrenergic innervation may play a role in impaired intestinal fluid and electrolyte absorption in diabetic patients with autonomic neuropathy. Clonidine, an alpha 2 adrenergic agonist, was used to treat three patients with "idiopathic" diabetic diarrhea after other treatments had failed: The volume of diarrhea declined significantly (p less than 0.01). Diarrhea recurred when the drug was withdrawn, but the patient's condition improved again when clonidine treatment was reintroduced. Hypotension did not occur as a side effect presumably because of the autonomic neuropathy of these patients. PMID- 3966760 TI - Granulomatous angiitis presenting with polymyalgia rheumatica and abnormal pituitary function. PMID- 3966763 TI - Chemotherapy and chemoprophylaxis of travelers' diarrhea. PMID- 3966761 TI - General medical care and the education of internists in university hospitals. An evaluation of the teaching hospital general medicine group practice program. AB - Fifteen general internal medicine group practices in university teaching hospitals were studied to evaluate their primary care services and education. Data were collected over 9 months from physicians, patients, and medical records, and by observation. All institutions had closed their general medical clinics. Many patients being treated in group practices were very sick; 57% had hypertension; 21% were diabetic; and 45% could not work. Most were satisfied with their care. Care for acute problems from a health care provider in the practice was available quickly; regular physicians were harder to see. House staff and faculty spent little time in the practices. Few practices used teams; most used traditional attending and house staff models. Practice physicians could not easily determine when patients were seen in the institution's emergency department or were hospitalized. Quality of care standards were not uniformly met. Finally, the structure of academic centers appeared to inhibit the practices' performance, suggesting a need for further appraisal of relationships between university hospitals and their ambulatory care units. PMID- 3966762 TI - Athletic women, amenorrhea, and skeletal integrity. PMID- 3966764 TI - The academic future of general internal medicine. PMID- 3966765 TI - Responsibilities of the primary care internist in the care of the allergic patient. PMID- 3966766 TI - Better reporting of adverse drug reactions. PMID- 3966767 TI - The humanities in medicine. PMID- 3966768 TI - Barium meals and endoscopy. PMID- 3966769 TI - Ranitidine and the liver. PMID- 3966770 TI - Renal disease and the acquired immunodeficiency syndrome. PMID- 3966771 TI - Aminoglycoside nephrotoxicity and age. PMID- 3966772 TI - Cefotaxime and nafcillin-tobramycin. PMID- 3966773 TI - Marrow fat and estimates of bone loss. PMID- 3966774 TI - Assessing nutritional status. PMID- 3966775 TI - Pregnancy and sinus histiocytosis with massive lymphadenopathy. PMID- 3966776 TI - The use of a volumetric infusion pump for the intra-arterial infusion of drugs. AB - Volumetric infusion pumps are widely used for intravenous infusions. We have extended their use to the intra-arterial infusion of drugs. An in vitro evaluation of the performance of such devices, under experimental conditions comparable to an intra-arterial infusion, was carried out. The results obtained confirmed the accuracy of volumetric infusion pumps for intra-arterial infusions. The system was found to be safe, reliable and simple in clinical practice. PMID- 3966777 TI - Pain control after surgery: a survey of current practice. AB - A questionnaire was sent to 302 qualified nurses in an attempt to elicit their current practice of administering postoperative analgesics, knowledge of the drugs, opinions regarding prescribing habits and comments on how pain control could be improved; 211 nurses replied (70% response). Knowledge was good but practice poor in that 56% give less than six doses postoperatively and the majority of nurses do not give analgesics until the patient is in pain; 66% thought the amount of analgesic given was a poor indication of pain experienced; 62% felt that prescribing by doctors was inconsistent and 90% thought it could be improved. Deficiencies in communication between anaesthetists, nurses and patients were highlighted. The nurses wished for more involvement in pain management and for more education of patients preoperatively. A selection of comments is included and possible simple methods for improving pain control are discussed. PMID- 3966778 TI - Ovarian cysts and tumours in infancy and childhood. AB - Cysts and tumours of the ovary are not uncommon in childhood. In 33 years between 1950 and 1982 106 patients were operated on at Alder Hey Children's Hospital and the Royal Liverpool Children's Hospital. Of these 71 were pre-menarchal. The mode of presentation, pathology and diagnostic difficulties of the pre-menarchal lesions are reviewed. The value of ultrasound scanning has become apparent in recent years. Most cysts and tumours are benign, but dysgerminomas are the most common malignant tumours encountered. Even when there is evidence of spread of the tumour the prognosis in these remains reasonably good. PMID- 3966779 TI - Use of a snugging ligature for securing a cholangiogram catheter into the cystic duct. PMID- 3966780 TI - The fate of the EEA stapled anastomosis: a clinico-radiological study of 38 patients. AB - Despite the widespread use of the EEA stapling device, little is known about the eventual fate of the stapled anastomosis. In a study of 38 stapled colonic anastomoses the staples were found to have passed out rectally in 11 patients (29%) within 6 months of surgery. Staple loss occurred only when the small or medium sized cartridges were used (P less than 0.02). Anastomotic stenosis developed in 5 patients (13.2%) and was also related to the use of the smaller size cartridges. In order to minimise these problems every effort should be made to use the large EEA cartridge. PMID- 3966781 TI - Conservative management of appendix mass in children. AB - Of 834 children who had appendicectomy for appendicitis 77 (9.2%) had developed an appendix mass when first seen. Under 6 years of age 25% of appendicitis patients had an appendix mass at presentation and almost 60% of the masses seen were in patients under six years of age. Forty three of the 77 masses (55%) were palpable only under anaesthesia. The masses were all initially managed conservatively by bed rest, intravenous fluids and intravenous antibiotics. All but eight (10%) of the 77 patients responded to this form of treatment. Interval appendicectomy was planned for a date 4 weeks following discharge. The overall total average bed stay including interval appendicectomy was 16 days. There were no late complications or relaparotomies. PMID- 3966782 TI - Recent experience with arterial embolism of the limbs in a vascular unit. AB - A 5 1/2-year experience of 147 patients with arterial embolism of the limbs is reported. The mean age was 66.9 years, range 24-90 years and the male to female ratio was 1.07 to 1. Two distinct types of embolic episode with very different clinical consequences were recognised. Type I (64%) in which large emboli occluded the proximal arteries of the lower limb. They were usually treated by embolectomy and were followed by death or permanent disability in 63% of patients. Type II (36%) in which small emboli occluded the arterial supply of the upper limb or the arteries of the distal lower limb. Embolectomy was performed in only 60% of cases. Death was unusual and disability occurred largely as a consequence of non-surgical management. After occlusion of the aorta, iliac or femoral arteries embolectomy is necessary to save both life and limb while after embolism of the arm or distal lower limb it is essential for the preservation of function. PMID- 3966783 TI - Anaesthetic management of vitrectomy. AB - The problems and anaesthetic management of patients undergoing vitrectomy are discussed in a series of 111 patients who underwent 129 operations. PMID- 3966784 TI - Analysis of a hospital-based stomatherapy service. AB - We have analysed the activities of a hospital-based stomatherapy service between 1980 and 1983. The average numbers of patients seen per annum included 395 out patients, 307 in-patients and 116 home visits. Of the 276 in-patients with colostomies, 72% had underlying malignant disease; 17% were performed as emergencies and 51% were temporary stomas. Hospital mortality for patients with a temporary stoma was 19% and only 59% had their temporary stoma reversed. Only 45% of colostomy patients received preoperative counselling and 11% had no regular follow-up. Complications were recorded at some stage after colostomy in 25% but only 10% required surgical refashioning. Of the 184 in-patients with ileostomies, 52% had ulcerative colitis and 41% had Crohn's disease. Only 13% of ileostomies were performed as emergencies, and only 11% were temporary. In contrast to colostomy, 83% of ileostomy patients received preoperative counselling and adequate follow-up was provided for 98% of patients. Complications were recorded in 57% of patients after ileostomy but surgical reconstruction was needed in only 18%. PMID- 3966785 TI - Management of penetrating injuries of the internal carotid artery. AB - Penetrating injury of the extracranial carotid arteries has until recently remained relatively uncommon, with some 250 cases being reported in the past 10 years. Internal carotid trauma represents approximately 20% of this total, and the management of these injuries high in the neck is controversial. Use of the Fogarty balloon catheter for control of distal retrograde bleeding is recommended. PMID- 3966787 TI - Prolonged release extradural morphine. AB - The effects of extradural administration of a microcrystalline preparation of morphine (Duromorph) were studied in 5 patients with postoperative or malignant pain. As assessed by pain scores on a visual analogue scale, the effects of the analgesic were extremely variable; the best results were obtained in patients with postoperative pain. Two patients with chronic pain due to malignant disease developed slow respiratory rates. The plasma concentration of morphine usually followed a biphasic pattern; an initial peak between 0.5 and 1.5 hours was succeeded by a second, large peak between 6 and 12 hours. There was little or no apparent relation between the plasma concentration of morphine and the relief of pain, suggesting that Duromorph may have a local effect on the spinal cord. PMID- 3966786 TI - Radical neck dissection for squamous cell carcinoma of the head and neck: early and long-term results of treatment. AB - An account is given of the use of radical neck dissection in a consecutive series of 147 patients treated during the years 1967-76 in the Head and Neck Unit of the Royal Marsden Hospital. The majority had received previous treatment principally by irradiation to full dosage, some by previous surgery, and a minority by induction cytotoxic chemotherapy. The 5-year determinate survival results for surgical salvage are 28.03%, and 20.5% at 10 years. Prevention of recurrent cancer in the neck was achieved in 70% of all those who later succumbed to their disease. PMID- 3966788 TI - The pentose phosphate cycle is regulated by NADPH/NADP ratio in rat liver. AB - The changes in the activity of the pentose phosphate cycle produced by the activation or inhibition of different NADPH-consuming pathways have been studied. The inhibition of fatty acid synthesis by kynurenate produced to the same extent, inhibition of the pentose phosphate cycle activity and an increase (about twofold) in the NADPH/NADP ratio. The addition of ter-butyl-hydroperoxide or paraquat, which is metabolized via NADPH-consuming pathways, produced the activation of the pentose phosphate cycle and a decrease in the NADPH/NADP ratio (about threefold). The plot of the NADPH/NADP ratio versus the pentose phosphate cycle activity gave a straight line with a regression index of 0.999. The regulation of the pentose phosphate cycle mainly by the intracellular NADPH/NADP ratio is discussed. PMID- 3966789 TI - Characterization of monoclonal antibodies to oat phytochrome by competitive radioimmunoassays and comparative immunoblots of phytochrome peptides. AB - A library of 50 hybridomas which make antibodies to oat phytochrome was produced from the fusion of spleen cells from immunized Balb/c mice with P3x63Ag8 myeloma cells. Hybridomas were selected in a medium containing hypoxanthine, aminopterin, and thymidine, and specific hybridomas were screened for production of antibodies to phytochrome using a solid-phase enzyme-linked immunoadsorbent assay which was antigen specific. Positive cultures were cloned three times by limit dilution to assure monoclonal growth and stability. Specificity toward phytochrome was established by Western blot analysis and immunoprecipitation. Epitope specificity of nine monoclonal antibodies was determined by competitive inhibition radioimmunoassays and/or comparative immunoblots of tryptic peptides of phytochrome. PMID- 3966790 TI - Interrelation between salvage of purine nucleotides and protein synthesis in rat heart cells. AB - The effect of transition from a respiring to a respiration-inhibited state on the rate of protein synthesis was investigated in glycolyzing, cultured rat heart cells. The rate was found to be significantly lower after blocking respiration, and it was further decreased by L-lactate. In contrast, pyruvate or phenazine methosulfate prevented the drop in the rate caused by lack of respiration. The changes in the respiratory state also affected the steady-state concentration of ATP, which varied in the same sense as the rate of protein synthesis. Pyruvate or phenazine methosulfate induced an increment in the concentration of ATP of respiration-inhibited cells. This increment could not be accounted for by more extensive phosphorylation of the available purine nucleotides, but required repletion of the pool by synthesis of purine nucleotides through the salvage pathway. Pyruvate and phenazine methosulfate were found to stimulate incorporation of labeled hypoxanthine into the purine nucleotide fraction in general, and into the nucleotide triphosphates in particular. Under similar incubation conditions an increase in the ATP/ADP ratio was also noted. The stimulatory effect of pyruvate on protein synthesis and on the cellular level of ATP was also observed in respiration-inhibited 3T6 cells and in human fibroblasts, but not in human fibroblasts deficient in the salvage enzyme, hypoxanthine-guanine-phosphoribosyltransferase. Based on the demonstrated influence of L-lactate, pyruvate, and phenazine methosulfate on the salvage synthesis of purine nucleotides [K. Ravid, P. Diamant, and Y. Avi-Dor, (1984) Arch. Biochem. Biophys. 229, 632-639] and on the present findings, the connection between protein synthesis and the salvage activity is discussed. PMID- 3966791 TI - Acidic phospholipids may inhibit rat brain hexokinase by interaction at the nucleotide binding site. AB - Rat brain hexokinase (ATP:D-hexose 6-phosphotransferase; EC 2.7.1.1) is inhibited by acidic phospholipids such as phosphatidylinositol, phosphatidylserine, and cardiolipin. Several aspects of this inhibition are atypical when compared to inhibition by established reversible inhibitors of this enzyme such as the product, Glc-6-P. Maximal inhibition is attained rather slowly (approximately 30 min at 22 degrees C), and is not reversed by simple dilution of the enzyme-lipid mixture. Ligands such as ATP or Glc-6-P can protect the enzyme against inhibition by acidic phospholipids; addition of protective ligands after mixing of enzyme and lipids does not, however, reverse inhibition that occurred prior to ligand addition. Inhibition can be prevented but not reversed by elevated (0.1-0.2 M) [NaCl], indicating a probable role for electrostatic forces in the interaction of lipid with enzyme. Greater inhibition is seen at 22 degrees C than at 3-4 degrees C, suggesting that hydrophobic interactions may also be involved. It is suggested that acidic phospholipids inhibit brain hexokinase by binding at the nucleotide binding site of the enzyme. The effectiveness of ATP (or the ATP analog, Cibacron Blue) in protecting against inhibition by acidic phospholipids is attributed to direct competition between ATP and the phospholipid for a common binding site. The effectiveness of Glc-6-P (or analogs) in preventing the inhibition is attributed to a conformational change, induced by the binding of this ligand, which prevents binding of ATP or acidic phospholipids to the enzyme. The pH dependency of the inhibition has suggested involvement of the protonated form of a dissociable group (pK approximately 7) on the enzyme in the interaction with acidic phospholipids; this may be the histidyl residue implicated by Solheim and Fromm [Biochemistry 19, 6074-6080 (1984)] in the binding of ATP to brain hexokinase. Structural similarities in the nucleotide-binding sites of several nucleotide-binding enzymes suggest that similar inhibition by acidic phospholipids may be seen with other enzymes of this type; there are already some reports to this effect. PMID- 3966792 TI - Hepatic microsomal short-chain beta-hydroxyacyl-CoA dehydrase distinct from the fatty acid elongation component: substrate specificity of the membrane-extracted enzyme. AB - The ability of 0.4 M KCl to extract over 80% of a short-chain beta-hydroxyacyl CoA dehydrase from rat hepatic endoplasmic reticulum, while more than 80% of the long-chain beta-hydroxyacyl-CoA dehydrase component of the fatty acid chain elongation system remains intact, confirms the existence of more than one hepatic microsomal dehydrase. Following extraction from the microsomal membrane, the short-chain dehydrase undergoes, at least, a two-fold activation. Employing even numbered trans-2-enoyl-CoA substrates ranging in carbon chain length from 4 to 16, the highest dehydrase specific activity of 16 mumol min-1 mg protein-1 was obtained with trans-2-hexenoyl-CoA; crotonyl-CoA was the second most active substrate, followed by 8 greater than 10 greater than 12 greater than 14 greater than 16. The specific activity of the short-chain dehydrase with trans-2 hexadecenoyl-CoA (C-16) was only 3% of that observed with the trans-2-hexenoyl CoA. With crotonyl-CoA or beta-hydroxybutyryl-CoA as substrates, HPLC was employed to identify the products, beta-hydroxybutyryl-CoA, of the hydration reaction, or crotonyl-CoA, of the reverse dehydration reaction. It was also observed that the short-chain dehydrase catalyzed the formation of both D(-) and L(+) stereoisomers of beta-hydroxybutyryl-CoA. The equilibrium constant for the dehydrase-catalyzed reaction determined at pH 7.4 and 35 degrees C, was calculated to be 6.38 X 10(-2) M-1, while the standard free energy change was 775 cal/mol, results similar to those obtained with crystalline crotonase. Finally, based on membrane fraction marker enzymes, substrate specificity, and heat lability of the dehydrase, it was concluded that the microsomal membrane contains a short-chain beta-hydroxyacyl-CoA dehydrase which is separate from the mitochondrial crotonase. PMID- 3966793 TI - Effect of inhibition of DNA synthesis on histone synthesis, turnover, and deposition in the rat testis. AB - In testicular seminiferous epithelial cells (SEC) of normal and hypophysectomized rats, 1-beta-D-arabinofuranosylcytosine and hydroxyurea (at concentrations which inhibited DNA synthesis nearly completely) inhibited histone synthesis only partially, and to a different extent for each histone fraction. In the presence of the inhibitors, the extent of synthesis relative to the corresponding control was TH1-x greater than H1 greater than TH2B-x = X2 = H2A greater than H2B = H3 greater than H4, in which synthesis of the H4 fraction was about 50% of control and that of TH1-x was 90-95% of control. The extent of inhibition of synthesis of each histone fraction was similar after hypophysectomy and, therefore, the changing of the relative populations of heterogeneous cells in the SEC did not influence the relative effects of the inhibitors of DNA synthesis on the synthesis of the various histone fractions. After [3H]leucine injection, the molar proportions of labeled histones relative to H4 decreased markedly between 1.5 h and 6-15 days; this finding indicated that there was rapid removal of histones compared to the H4 fraction during this period. When [14C]thymidine was injected 24 h prior to hydroxyurea treatment and [3H]leucine injection, the ratios of specific activities of histone H4 to DNA did not change significantly over an 11-day period. It appears that newly synthesized histone H4 and other somatic histones are associated with existing DNA in the presence of DNA inhibitors. PMID- 3966794 TI - Isolation and characterization of human liver guanine deaminase. AB - Guanine deaminase (EC 3.5.4.3, guanine aminohydrolase [GAH]) was purified 3248 fold from human liver to homogeneity with a specific activity of 21.5. A combination of ammonium sulfate fractionation, and DEAE-cellulose, hydroxylapatite, and affinity chromatography with guanine triphosphate ligand were used to purify the enzyme. The enzyme was a dimer protein of a molecular weight of 120,000 with each subunit of 59,000 as determined by gel filtration and sodium dodecyl sulfate-gel electrophoresis. Isoelectric focusing gave a pI of 4.76. It was found to be an acidic protein, as evidenced by the amino acid analysis, enriched with glutamate, aspartate, alanine and glycine. It showed a sharp pH optimum of 8.0. The apparent Km for guanine was determined to be 1.53 X 10(-5) M at pH 6.0 and 2 X 10(-4) M for 8-azaguanine as a substrate at pH 6.0. The enzyme was found to be sensitive to p-hydroxymercuribenzoate inhibition with a Ki of 1.53 X 10(-5) M and a Ki of 5 X 10(-5) M with 5-aminoimidazole-4 carboxamide as an inhibitor. The inhibition with iodoacetic acid showed only a 7% loss in the activity at 1 X 10(-4) M and a 24% loss at 1 X 10(-3) M after 30 min of incubation, whereas p-hydroxymercuribenzoate incubation for 30 min resulted in a 91% loss of activity at a concentration of 1 X 10(-4) M. Guanine was the substrate for all of the inhibition studies. The enzyme was observed to be stable up to 40 degrees C, with a loss of almost all activity at 65 degrees C with 30 min incubation. Two pKa values were obtained at 5.85 and 8.0. Analysis of the N terminal amino acid proved to be valine while the C-terminal residue was identified as alanine. PMID- 3966795 TI - Association of M13 I-forms and spheroids with lipid vesicles. AB - Electron microscopy and density gradient centrifugation were used to demonstrate that the coat protein of M13 I-forms and spheroids, but not of filaments, can form some type of association with lipid vesicles in vitro. The association was detected only when the phage particles were incubated with dilauroylphosphatidylcholine (DLPC) or dimyristoylphosphatidylcholine (DMPC) small unilamellar vesicles (SUV) above the phase transition temperature of the lipid. Under these conditions the I-form coat protein was resistant to proteolytic digestion, and the viral DNA was also associated with the vesicles. PMID- 3966796 TI - Stabilization of hepatic colchicine-binding activity by organic acids. AB - Previous work has shown that the total hepatic tubulin pool and the hepatic microtubule-derived tubulin pool do not have identical [3H]colchicine binding properties. Rapid loss of colchicine-binding activity was noted in the microtubule-derived fractions of liver tubulin. Furthermore, quantitative determination of the total and polymerized tubulin in the liver by the [3H]colchicine-binding assay was hampered by rapid and unequal loss of binding sites under assay conditions. The organic acids, glutamate and glucose 1 phosphate, have been shown to stabilize calf brain tubulin against loss of colchicine-binding sites. Therefore, these compounds were tested as possible protecting agents against loss of colchicine binding activity of liver tubulin. It was found that these agents stabilized liver tubulin under [3H]colchicine binding conditions. Additional experiments showed that these agents also prevented the rapid loss of colchicine-binding activity that occurred when purified brain tubulin was exposed to liver supernates. These results suggest that the inclusion of the organic acids, glutamate and glucose 1-phosphate, may modify the time decay properties of liver tubulin in solution. Further, these data suggest that these protecting agents may be of analytical value in [3H]colchicine-binding assay systems for liver tubulin. PMID- 3966797 TI - Pyridoxal phosphate protects against an irreversible temperature-dependent inactivation of hepatic delta-aminolevulinic acid synthase. AB - The stability of hepatic delta-aminolevulinic acid synthase (ALAS), the first and rate-limiting enzyme of the heme biosynthetic pathway, was investigated. Incubation of the mitochondrial matrix fraction obtained from either control or allylisopropylacetamide-induced rats at 37 degrees C in Tris-Cl, pH 7.4, EDTA, and dithiothreitol resulted in a rapid decrease in ALAS activity such that 50-70% of the activity was lost after 30 min. Similar decreases in ALAS activity were observed when a cytosolic fraction from the induced animals was incubated at 37 degrees C. Addition of 0.1 mM pyridoxal-P, the cofactor of ALAS, to the preincubation medium completely prevented the observed loss of activity; however, dialysis of the inactive matrix fraction against several changes of buffer containing pyridoxal-P did not restore activity, suggesting that the inactivation was irreversible. These decreases in ALAS activity in the absence of pyridoxal-P were temperature dependent, as a 55% loss of ALAS activity was observed after a 60-min incubation at 30 degrees C, while the enzyme was completely stable when preincubated at 22 degrees C for 60 min. This inactivation of ALAS does not appear to involve proteolytic digestion, as addition of a wide spectrum of protease inhibitors to the preincubation medium in the absence of pyridoxal-P did not protect against the inactivation. The suggestion is made that the cofactor, pyridoxal-P, may dissociate from the enzyme during the preincubation and, consequently, the apoenzyme may be irreversibly inactivated at temperatures above 22 degrees C. PMID- 3966798 TI - A macromolecular shape function based on sedimentation velocity parameters. AB - A volume-independent shape function, experimentally determinable from sedimentation velocity experiments, was formulated explicitly in terms of the axial ratio of a macromolecule considered as an ellipsoid of revolution. Use of this function offers a simple first approach to the elucidation of macromolecular geometry as illustrated by calculations for ovalbumin, bovine serum albumin, and myosin. PMID- 3966799 TI - Far-ultraviolet circular dichroism and uronic acid components of anticoagulant deca-, dodeca-, tetradeca-, and octadecasaccharide heparin fractions. AB - The therapeutic anticoagulant action of heparin is mediated by the ability of a multifunctional octadecasaccharide region of the molecule to bind to and differentially alter the conformational integrity of antithrombin, and the sugar sequence of the primary binding domain is known. Low ultraviolet circular dichroism spectroscopy of heparin-derived anticoagulant octa-, deca-, dodeca-, tetradeca-, and octadecasaccharides has been useful in elucidating the nature of the sugars that are contained within the second functional domain of the octadecasaccharide. The difference between the spectra of the molar ellipticity of the above sequential oligosaccharides was taken to be the CD spectrum of the corresponding additional disaccharide unit(s). Optical models of the component disaccharides of heparin were derived from CD spectra of heparins having a high degree of sulfation, synthetic glycosides of N-acetylglucosamine, and glycosides of component uronic acids. These were sufficiently distinct in magnitude and spectral position to warrant interpretation of the experimental difference CD spectra. The uronic acids of the disaccharides between deca- and octamer, dodeca- and decamer, and tetradeca- and dodecamer were thereby ascribed to sulfated iduronate, unsulfated iduronate, and glucuronate residues, respectively, while those of the tetrasaccharide between the octadeca- and tetradecasaccharide were tentatively assigned to sulfated iduronate moieties. Interpretation of the difference CD spectra on the basis of the optical models was less certain in regard to the amino sugar components. It appears that the amino sugar derivative between the dodeca- and decamer was N-acetylglucosamine, while the other disaccharides of the octa- to octadecasaccharide probably contained the N sulfated derivative. A speculative disaccharide sequence drawn from these data indicates that relatively less strongly anionic disaccharides, having nonsulfated uronic acid moieties and N-acetylglucosamine, were flanked by trisulfated disaccharide units, constituting a structural element similar to that which contains the primary binding domain of the anticoagulant. PMID- 3966801 TI - Nanosecond motions of the single tryptophan residues in apolipoproteins C-I and C II: a study by oxygen quenching and fluorescence depolarization. AB - Rotational freedom of the single tryptophan residue in human plasma apolipoproteins C-I (apo C-I) and C-II (apo C-II) was investigated by oxygen quenching and lifetime-resolved anisotropies. The tryptophan in both apo C-I and C-II was highly accessible to oxygen quenching. The tryptophan residue in both apo C-I and C-II and their sodium dodecyl sulfate (SDS) or dimyristoylphosphatidylcholine (DMPC) complexes displayed significant motional freedom on the nanosecond time scale. Lifetime-resolved anisotropies of tryptophan residues under conditions of oxygen quenching revealed an increase in the amplitude of the segmental motions at 40 degrees C as compared to that at 5 degrees C. It was concluded from these studies that both the apoprotein C-I and C II are highly flexible molecules, and that the nanosecond motions of the tryptophan residue are sensitive to the fluidity of its environment in both SDS and DMPC complexes. PMID- 3966800 TI - Aldehyde dehydrogenase activity as the rate-limiting factor for acetaldehyde metabolism in rat liver. AB - The velocity of acetaldehyde metabolism in rat liver may be governed either by the rate of regeneration of NAD from NADH through the electron transport system or by the activity of aldehyde dehydrogenase (ALDH). Measurements of oxygen consumption revealed that the electron transport system was capable of reoxidizing ALDH-generated NADH much faster than it was produced and hence was not rate-limiting for aldehyde metabolism. To confirm that ALDH activity was the rate-limiting factor, low-Km ALDH in slices or intact mitochondria was partially inhibited by treatment with cyanamide and the rate of acetaldehyde metabolism measured. Any inhibition of low-Km ALDH resulted in a decreased rate of acetaldehyde metabolism, indicating that no excess of low-Km ALDH existed. Approximately 40% of the metabolism of 200 microM acetaldehyde in slices was not catalyzed by low-Km ALDH. Fifteen of this 40% was catalyzed by high-Km ALDH. A possible contribution by aldehyde oxidase was ruled out through the use of a competitive inhibitor, quinacrine. Acetaldehyde binding to cytosolic proteins may account for the remainder. By measuring acetaldehyde accumulation during ethanol metabolism, it was also established that low-Km ALDH activity was rate-limiting for acetaldehyde oxidation during concomitant ethanol oxidation. PMID- 3966802 TI - Arachidonic acid-related elicitors of the hypersensitive response in potato and enhancement of their activities by glucans from Phytophthora infestans (Mont.) deBary. AB - The dose response for elicitation of the hypersensitive reaction in potato tuber discs by arachidonic acid (AA) suggested saturation at higher concentrations. Glucans from Phytophthora infestans, inactive themselves as elicitors of the hypersensitive reaction, enhanced sesquiterpene accumulation and hypersensitive browning elicited by AA. Significant activity (seven times control values) was observed with 33 pmol AA/3.0-cm potato disc in the presence of glucans. Glucans did not affect accumulation of steroid glycoalkaloids, influence the timing or relative amounts of sesquiterpenes which accumulate, or affect recovery of AA added to potato discs. Glucans enhanced activity whether added to potato discs 18 h prior to AA, at the same time as AA, or 18 h after AA. Elicitor activity in the presence of glucans was evident with 20-carbon unsaturated fatty acids that had little or no elicitor activity in the absence of glucans. The position of double bonds had considerable influence on the specific activity of unsaturated fatty acids. The most active had a minimum of three double bonds in a methylene interrupted series beginning with delta 5, e.g., delta 5,8,11. A delta 5 double bond conferred significant activity even if it was not part of a methylene interrupted series. The 20-carbon chain length appeared optimal for elicitor activity. The 22-carbon chain acids had low activity, and 16- and 18-carbon acids were inactive. A free carboxyl group or easily transesterified group appeared necessary for activity. Arachidonyl alcohol had very low activity and arachidonyl cyanide was inactive. AA-containing phosphatidylcholine, lysophosphatidylcholine and monoacylglycerol were at least as active as free AA, AA-containing diacylglycerols were slightly less active than free AA, and triarachidonyl glycerol was inactive. PMID- 3966803 TI - Comparison of the entropy-driven polymerization reactions of E66 and vulgare tobacco mosaic virus proteins. AB - The effects of temperature (T), ionic strength (mu), and pH on the polymerization of the coat protein of the E66 strain of tobacco mosaic virus (TMV) from the 4 S form (A), a trimer of the polypeptide chain, to the 20 S form (D) were investigated by the method of sedimentation velocity. Interpretations of thermodynamic parameters were based on only those data obtained in experiments for which reversibility could be demonstrated both by lowering temperature and by lowering concentration. E66 protein differed from vulgare TMV in that, in position 140, lysine replaced asparagine. Thus, E66 protein should be less hydrophobic than vulgare protein and K's, the salting-out constant, should be less. The charge on unpolymerized E66 protein was -3 proton units per polypeptide chain, compared to -4 for vulgare protein. The electrical work contribution, delta W*el, for E66 protein should be (-3/-4)2, or 0.5625 that for vulgare. The results were that delta W*el at pH 6.7, 15 degrees C, and mu = 0.1 was 0.700 kcal/mol for E66 protein compared to 1.22 for vulgare. The experimental ratio was 0.574; K's = 2.16 for E66 compared to 4.93 for vulgare. Hydrogen ions (1.5) were bound per A unit, or 0.5 per polypeptide chain, in the formation of D from A. delta H*, the enthalpy change per mole of A, was 33 kcal at pH 6.7 and 36 at pH 6.9, compared to 30 at both pH values for vulgare protein. delta S*, the entropy change per mole of A, was +132.1 e.u. for E66 compared to 127.4 for vulgare. Entropy-driven processes are found in dynamic biological situations. Ready reversibility at biological temperatures is a requirement, yet the polymer structures must be strong and well ordered. This is achieved through a large number of weak bonds between subunits, combined with ready reversibility under slightly changed conditions. The significant role of water is to facilitate depolymerization by binding to subunits. PMID- 3966804 TI - Rat liver 4-hydroxy-2-ketoglutarate aldolase: purification and kinetic characterization. AB - The enzyme 4-hydroxy-2-ketoglutarate aldolase (4HKG aldolase), which catalyzes the reversible cleavage of 4-hydroxy-2-ketoglutarate to form pyruvate and glyoxylate, was isolated from rat liver. The purification scheme as well as a study of several of the physical and kinetic properties of the enzyme are presented. The effects of anions, various buffers, and possible physiologically relevant effectors on the kinetic parameters of the aldolase were also investigated. It was found that pyruvate analogs inhibited the aldolase. Oxaloacetate was a competitive inhibitor of the aldolase, and in addition caused synergistic inhibition with respect to pyruvate analogs at low substrate concentration. These results are discussed in terms of possible regulation of the aldolase. PMID- 3966805 TI - Further studies on the activation of glucocerebrosidase by a heat-stable factor from Gaucher spleen. AB - Using Sephadex G-75 and DEAE-cellulose column chromatography, an 8270-Da glycopeptide (designated Fragment II) has been isolated from a cyanogen bromide formic acid digest of a heat-stable factor from Gaucher spleen which activates a lipid-depleted preparation of lysosomal glucocerebrosidase from human liver. Fragment II contains all of the activity present in the native heat-stable factor. Compared with the parent factor, Fragment II contains four fewer cysteine and methionine residues and one less of each of the following: aspartic acid, threonine, serine, valine, isoleucine, and leucine. Nearly all of the monosaccharides present in the parent heat-stable factor can be accounted for in Fragment II, including three glucosamine, three mannose, one sialic acid, and one fucose. By itself, Fragment II has little or no stimulatory activity; its major effect is to markedly increase the sensitivity of glucocerebrosidase to activation by phosphatidylserine. A mixture of 1 microgram phosphatidylserine and 2 micrograms of the cyanogen bromide fragment activates the lipid-depleted preparation of glucocerebrosidase 50% more than 30 micrograms phosphatidylserine alone. Analysis of the Km and Vmax of glucocerebrosidase at various hydrogen ion concentrations revealed that the heat-stable factor and phosphatidylserine together dramatically increase the catalytic efficiency (Vmax/Km) of glucocerebrosidase while making apparent three ionizable groups that participate in the catalysis. Phosphatidylserine alone recruits two ionizable groups, but catalytic efficiency is lower than when heat-stable factor is also present. Heat stable factor alone has no discernable effect on the ionization of functional groups on the enzyme or on catalytic efficiency. By sucrose density gradient ultracentrifugation, it was shown that preincubation of rat liver glucocerebrosidase with phosphatidylserine and heat-stable factor shifted the enzyme completely from a 56,600-Da form to a 188,100-Da form. The activity of the slower sedimenting form of glucocerebrosidase was totally dependent upon exogenous bile salt activator, whereas the faster sedimenting form exhibited the same activity in the presence or absence of sodium taurocholate. It appears that the heat-stable factor promotes the transfer of phosphatidylserine to glucocerebrosidase, which, in turn, results in an increase in both the catalytic efficiency and size of the enzyme. PMID- 3966806 TI - [Phase I trial of 4'-O-tetrahydropyranyl-doxorubicin (THP)--a multi-institutional cooperative study]. AB - A phase I trial of a new anthracycline derivative, 4'-O tetrahydropyranyldoxorubicin (THP), was conducted in 54 patients with various advanced solid tumors and malignant lymphomas. Starting dose was 5 mg/m2 i.v. and dose escalations were made by a modified Fibonacci search scheme. There were 40 evaluable courses. The dose-limiting toxic effect was leukopenia which was dose related and reversible. The maximum tolerated dose for a single i.v. injection was estimated to be 55 mg/m2. The median nadir day for leukopenia was day 12 with recovery occurring 13 days (median) after reaching the nadir. Thrombocytopenia was less commonly observed than leukopenia. Other toxic effects were mild gastrointestinal disturbances, fever and general malaise. Ventricular extrasystole was observed in a case of pancreatic cancer who received 5 mg/m2 of the drug. There were no cases with alopecia, or with hepatic or renal dysfunction. With regard to objective tumor response, CR was observed in 2 cases with NHL, and MR in 2 cases with lung cancer, and 1 case each with breast cancer and NHL. Response occurred at a dose of more than 35 mg/m2. The recommended dose schedule for phase II trial is 35-45 mg/m2 by single i.v. injection at 3-4-week intervals. PMID- 3966807 TI - [Antitumor activity of recombinant human tumor necrosis factor (TNF)]. PMID- 3966808 TI - [Changes of immunosuppressive acidic protein (IAP) in patients treated with total body hyperthermia]. PMID- 3966809 TI - [Experimental animal information file: Millardia meltada]. PMID- 3966810 TI - [Therapeutic effect of sequential doses of methotrexate (MTX) and 5-fluorouracil (5-FU) in advanced gastric cancer: comparison of intermediate-dose MTX with high dose MTX]. AB - Twenty-one patients were treated with sequential doses of MTX and 5-FU so as to be classified by MTX dosage into an intermediate MTX-dose group and a high MTX dose group. In the intermediate-dose MTX group, the drug was given at a dosage of 100 mg/m2 intravenously (i.v.) and followed 1 hour later by 5-FU at 800 mg/m2 i.v. (dripping for 1 hour); the drugs were recycled every 1 week. In the high dose MTX group, the drug was administered at a dose of 1.5 g/m2 i.v. (dripping for 2 hours) and followed 1 hour later by 5-FU at 1.5 g/m2 i.v. (dripping for 2 hours); the drugs were recycled every 2-3 weeks. Average MTX concentrations in serum at the start of 5-FU administration were 1.69 X 10(-5) and 1.33 X 10(-4) mol/l/h in the intermediate and high-dose MTX groups, respectively. Six (50%) of 12 patients adequately treated with intermediate-dose MTX had a partial response (PR), and one (14.3%) of 7 evaluable patients treated with high-dose MTX had a PR. Major toxicity included diarrhea (33.3%) in the intermediate-dose MTX group and hair loss (71.4%) in the high-dose MTX group. Hematological toxicity was mild in MTX group: six (50%) of 12 patients had a granulocyte count nadir less than 1,000/microliters and one (8.3%) of 12 patients had a platelet count nadir less than 10(5)/microliters in the intermediate-dose MTX group. Five (71.4%) of 7 patients had a granulocyte nadir less than 1,000/microliters and two (28.6%) of 7 patients had a platelet count nadir less than 10(5)/microliters in the high-dose MTX group. PMID- 3966811 TI - Ochronosislike pigmentation from hydroquinone bleaching creams in American blacks. AB - Two patients had pitch-black pigmentation and colloid milium formation following the use of 2% hydroquinone-containing bleaching creams. These are among the first known cases in American blacks, although this phenomenon has been recognized previously in African blacks. Ultrastructural studies indicated that the pigment was due to the formation of elastotic fibers. These fibers attained an enormous size and disintegrated, leaving irregular fibers and fragments dispersed in the dermis. It is important that this clinical picture be recognized, since the use of these bleaching creams is widespread. PMID- 3966812 TI - Congenital bullous urticaria pigmentosa. Treatment with concomitant use of H1- and H2-receptor antagonists. PMID- 3966813 TI - Vitiligo. PMID- 3966814 TI - Wattle: an unusual congenital anomaly. PMID- 3966815 TI - Perinatal gangrene of the buttock: a spontaneous condition. PMID- 3966816 TI - Squamous cell carcinoma arising in long-standing necrobiosis lipoidica. PMID- 3966817 TI - Dapsone and Heinz bodies. PMID- 3966818 TI - Trichomycosis of the scrotal hair. PMID- 3966819 TI - Topical fluorouracil in vitiligo. PMID- 3966820 TI - Linear hypopigmentation. PMID- 3966821 TI - Systemic lupus erythematosus with pemphigus vulgaris. PMID- 3966822 TI - Topical antiandrogens. What use in dermatology? PMID- 3966823 TI - Irritant and allergic responses as influenced by triamcinolone in patch test materials. AB - While the prior application of triamcinolone acetonide to skin does not strongly influence patch test reactions, the presence of triamcinolone in the materials used for patch testing has a profound effect. Both irritant and allergic reactions to thimerosal are consistently negated when triamcinolone acetonide is present in concentrations of 0.1% and 0.025%. PMID- 3966824 TI - Pyostomatitis vegetans. A reactive mucosal marker for inflammatory disease of the gut. AB - Pyostomatitis vegetans is a rarely occurring disorder of the oral mucosa, which has a dramatic clinical picture and a striking histopathologic pattern. Moreover, the condition is a highly specific oral mucosal marker for inflammatory bowel disease, particularly ulcerative colitis. Our findings in two cases and a review of the literature emphasize the relationship of pyostomatitis vegetans to inflammatory bowel disease and the vegetating dermatoses. PMID- 3966825 TI - Arteriovenous malformation simulating Kaposi's sarcoma (pseudo-Kaposi's sarcoma). AB - A patient whose condition was initially misdiagnosed as Kaposi's sarcoma involving the left foot received radiation therapy for that disorder. Subsequent examination yielded a correct diagnosis of arteriovenous (AV) malformation. Such cases of AV malformations with skin changes resembling Kaposi's sarcoma have been called pseudo-Kaposi's sarcoma. The clinicopathologic distinctions between Kaposi's sarcoma and pseudo-Kaposi's lesions are discussed. All patients suspected of having Kaposi's sarcoma, especially those younger than 30 years of age, should have careful evaluation for an unsuspected AV malformation. PMID- 3966826 TI - Prognosis of patients with pathologic stage II cutaneous malignant melanoma. AB - The prognostic relevance of the extent of nodal metastases, lesion thickness, level of invasion, site of lesion, satellitosis, age, sex, and year of diagnosis and treatment were assessed in 213 consecutive patients with pathologic Stage II malignant melanoma (157 with clinical Stage I disease and 56 with clinical Stage II disease). Of these factors, only three were significant: 1) clinical status of the lymph nodes (p less than 0.0001); 2) thickness of the primary lesion in the ranges of less than 2.0 mm, 2.0 to 4.9 mm, and 5.0 mm or greater (p = 0.002); and 3) level of invasion (p = 0.0002). The extent of nodal metastases in those patients with clinical Stage I disease was not significant. The difference in survival between patients with clinically negative/histologically positive nodes (clinical Stage I) and clinically positive/histologically positive nodes (clinical Stage II) was apparent throughout the follow-up period. The 5- and 10 year survival rates for the clinical Stage I patients were 44% and 28%, respectively, and for the clinical Stage II patients 21% and 12%, respectively (p less than 0.0001). A 5-year cumulative survival rate of 65% was achieved for clinical Stage I patients having primary lesions of less than 2.0 mm in thickness, while it was 19% for patients having primary lesions of 5.0 mm or more in thickness. For pathologic Stage II malignant melanoma patients, prognosis is most dependent on the clinical status of the lymph nodes, not on the number of lymph nodes with micrometastases. PMID- 3966827 TI - Surgical management of chronic pulmonary embolism. AB - Recurrent pulmonary emboli ultimately may produce respiratory insufficiency, severe hypoxemia, and progressive pulmonary hypertension. In many patients this syndrome is silent in its initial phases, and when thrombophlebitis is present it is often unresponsive to anticoagulant therapy. Unless pulmonary embolectomy is undertaken, most of these patients characteristically succumb with severe respiratory insufficiency. Twenty-five patients with this syndrome have been evaluated at the Duke University Medical Center, and 14 were selected for elective pulmonary embolectomy for relief of severe and incapacitating pulmonary insufficiency. In each patient preoperative pulmonary scans and arteriography demonstrated a high degree of vascular occlusion. The obstructing lesions affected both lungs in the majority of patients. Bronchial arteriography was found to be a very valuable method for demonstrating patency of the pulmonary arteries distal to occluding lesions by retrograde filling through collateral vessels joining the bronchial and pulmonary circulations. Preoperatively radionuclide angiocardiography revealed severe right ventricular dysfunction with significantly depressed ejection fractions at rest and during exercise. Retrograde pulmonary arterial flow as shown by selective bronchial arteriography was excellent in ten patients, fair in three, and absent in one. Long term follow up indicated a clear relationship between the magnitude of arterial backflow at the time of embolectomy and the degree of clinical improvement. There were two perioperative deaths, one from massive reperfusion pulmonary hemorrhage and another from intractable right ventricular failure. Eleven patients with this syndrome were unsuitable candidates for embolectomy and of these, nine had severe distal emboli diffusely spread in the small pulmonary arteries and not amenable to direct removal. One patient had severe right ventricular failure with extreme pulmonary hypertension (145/45 mmHg) and another was massively obese with severe congestive heart failure and expired in the hospital a week later. In this group of 11 patients, three succumbed and most of the others are currently totally debilitated at rest (NYHA Class IV). Long-term follow-up of the surgically managed patients (1 to 15 years) shows that ten patients improved from NYHA functional Class IV to either I or II, another patient from Class III to Class I, and a final patient was only minimally improved.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3966829 TI - Outpatient biopsy of breast cancer. Influence on survival. AB - From 1948 to 1975, at the Istituto Nazionale Tumori of Milan, 209 patients underwent extended radical mastectomy (ERM) for breast cancer classified as T1 NO 1 MO. In 57 patients (27.3%), the ERM was preceded by an excisional biopsy performed in the outpatient clinic (Group A), of which 75% were performed within 30 days of admission and 25% after 30 days (average, 25 days; range 5-99). The remaining 152 patients (Group B) underwent an extemporaneous frozen biopsy. There was no difference in the distribution of the histologic types in the two groups. The axillary lymph nodes (N) and the internal mammary chain (MI) were free of neoplastic invasion (N-, MI-) in 156 patients (74.6%), 44 in Group A (77.2%) and 112 in Group B (73.7%). Actuarial 10-year survival of the patients was 79.9% in Group A and 77.7% in Group B (p = NS). It was 90% in N- MI- patients of Group A and 81.9% in those of Group B (p = NS). Instead, for N+ patients, actuarial survival at 10 years was 50% in Group A and 67% in Group B (p = NS), and for MI+ patients it was 50% and 49.8%, respectively. These present data do not support the hypothesis that a delay between biopsy and radical surgery of breast cancer is an important prognostic factor. PMID- 3966828 TI - Differentiation between Crohn's disease and other inflammatory conditions by electron microscopy. AB - The authors previously have demonstrated axonal necrosis of autonomic nerves in the surgically resected ilea of patients with Crohn's disease both in grossly normal ileal resection margins and in diseased areas. The present study of ileal stomal biopsies was carried out to obviate the possibility that the observed axonal damage might be related to the prolonged surgical manipulations required for ileal resection. The authors present studies of biopsies of ileal stomas and of small bowel from patients with Crohn's disease and various control disorders, including ulcerative colitis. Stomal biopsies were fixed immediately after they were obtained. Widespread, severe axonal necrosis of autonomic nerves was present in all Crohn's disease specimens, regardless of the patient's clinical status or the gross or routine microscopic evaluation of the same specimen. Controls either had no necrosis or displayed a minor degree of focal necrosis involving single axons. The authors conclude that Crohn's disease is accompanied by a severe and extensive necrosis of gut axons, and that such electron microscopic findings may serve to differentiate Crohn's disease from other inflammatory disorders. PMID- 3966830 TI - Multiple systems organ failure. Modulation of hepatocyte protein synthesis by endotoxin activated Kupffer cells. AB - The etiology of hepatic insufficiency associated with the multiple systems organ failure (MSOF) syndrome is unclear. The authors have investigated the possibility that a macrophage/Kupffer cell mediated modulation of hepatocyte function may play a role in this phenomenon. Isolated rat hepatocytes were cultured, and their rate of protein synthesis was measured by cpm of 3H leucine incorporation into protein. Nonparenchymal rat liver cells (NPC) comprised of 35-40% Kupffer cells were added to hepatocytes to establish a co-culture with or without endotoxin. Neither NPC alone nor endotoxin alone affected hepatocyte protein synthesis. However, in the presence of endotoxin, NPC caused a marked diminution of hepatocyte protein synthesis (4,396 +/- 449 cpm) compared with control hepatocytes (10,943 +/- 623 cpm). No change in microscopic morphology or ability to exclude trypan blue occurred. This modulation of hepatocyte function by an endotoxin stimulated Kupffer cell preparation may, in part, represent the mechanism of hepatic insufficiency associated with the MSOF syndrome. PMID- 3966831 TI - Clinical risk factors for prolonged PT/PTT in abdominal sepsis patients treated with moxalactam or tobramycin plus clindamycin. AB - Factors associated with prolongation of the prothrombin time were analyzed in 94 patients with intra-abdominal sepsis. Patients were randomized prospectively to receive either the combination of tobramycin and clindamycin (TM/C) or moxalactam (MOX). This paper presents a retrospective review designed to compare the frequency of prolonged clotting times and to analyze predisposing factors. Prothrombin time (PT) prolongation occurred more frequently in patients given moxalactam (19 of 47 patients) than in patients given the combination of tobramycin and clindamycin (9 of 47 patients) (p less than 0.05). Prolongation of the partial thromboplastin time (PTT) occurred in all patients with a prolonged PT. Liver disease, upper gastrointestinal surgery, and use of cimetidine were more frequent in those patients with abnormal PT/PTT values (p less than 0.05). Two moxalactam-treated patients with subsequent PT/PTT prolongation had individual clotting factors assayed before moxalactam treatment and at the time of detection of the abnormal PT. The activity of clotting factors II, VII, VIII, IX, X, and XII was reduced during MOX therapy. Treatment with vitamin K reversed the abnormality. In view of underlying abnormalities and rapid response to parenteral vitamin K, the mechanism is probably an acute vitamin K deficiency superimposed upon chronic vitamin K deficiency. In patients with intra-abdominal infection, those treated with MOX are more likely to develop abnormal PT than those treated with TM/C. Since abnormal PT/PTT was common even in TM/C patients, supplemental vitamin K should be considered for all seriously ill, older patients with abdominal infections. PMID- 3966832 TI - The importance of biventricular failure in patients with postoperative cardiogenic shock. AB - To evaluate the importance of severe biventricular failure in patients with postcardiotomy ventricular failure, we analyzed the data from 30 patients treated with ventricular assist devices (VADs) over a five-year period. All patients had profound postoperative ventricular failure refractory to drugs and an intraaortic balloon (IAB). Evaluation of preoperative ventricular function did not allow prediction of which patients would require VADs. However, the development of perioperative myocardial infarction was an important determinant of the need for postoperative support with a VAD. Twenty patients received only a left VAD (LVAD). Four of them had isolated left ventricular failure; 3 were weaned, and 2 survived. None of the 16 patients with biventricular failure who received only an LVAD were weaned. Ten other patients with biventricular failure received biventricular support, either with a right VAD and IAB, or with two VADs. Of these 10 patients, 5 were weaned and 3 survived. Considering all 26 patients with biventricular failure, those receiving biventricular mechanical support (10) had a better chance (p less than 0.025) of being weaned (5/10) and surviving (3/10) than those who received only an LVAD (0/16). We conclude that biventricular failure is common in patients with postcardiotomy ventricular failure and is often the result of perioperative infarction. While patients with isolated left ventricular failure did well with an LVAD only, those with biventricular failure required biventricular mechanical support for survival. PMID- 3966833 TI - Effective clinical application of ventricular bypass. PMID- 3966834 TI - Effects of coenzyme Q10 added to a potassium cardioplegic solution for myocardial protection during ischemic cardiac arrest. AB - To evaluate effects of coenzyme Q10 added to a potassium cardioplegic solution for myocardial protection, 17 mongrel dogs underwent 60 minutes of ischemic cardiac arrest under cardiopulmonary bypass. Cardiac arrest was induced by infusing the cardioplegic solution into the aortic root every 20 minutes. Experimental animals were divided into three groups according to the cardioplegic solution used. In Group 1, we used our clinical potassium cardioplegic solution (K+, 22.31 mEq/L); in Group 2, potassium cardioplegic solution with coenzyme Q10 added (coenzyme Q10, 30 mg/500 ml of solution); and in Group 3, cardioplegic solution with coenzyme Q10 solvent. Exogenous coenzyme Q10 in the cardioplegic solution provided significantly high myocardial stores of adenosine triphosphate and creatine phosphate and a low level of lactate during induced ischemia and reperfusion. Furthermore, percent recovery of the aortic flow in Group 2 was significantly higher than that in the other two groups. Ultrastructures of the ischemic myocardium in Group 2 were better preserved than those in Group 1. Addition of coenzyme Q10 to potassium cardioplegia resulted in improved myocardial oxygen utilization and accelerated recovery of myocardial energy metabolism after reestablishment of circulation. PMID- 3966835 TI - Surgical experience in descending thoracic aneurysmectomy with and without adjuncts to avoid ischemia. AB - Over the past twelve years, surgical treatment of descending thoracic aneurysms has been performed in 360 patients. Three different operative strategies were employed during resection to provide distal aortic perfusion by temporary bypass (Group 1, 75 patients) or shunt (Group 2, 22 patients) or to simplify the operative procedure with aortic cross-clamping alone (Group 3, 263 patients). The surgical results were determined primarily by patient-related and disease-related variables. Advanced age (older than 70 years), atherosclerotic cause, and emergency operation significantly increased the risks of early mortality and morbidity. The incidence of death (11.7%), paraplegia (6.5%), or renal failure (6%) was not reduced by the use of adjunctive perfusion, and bleeding complications increased significantly in Groups 1 and 2. Spinal cord injury was increased significantly by emergency operations, cross-clamp times exceeding 30 minutes, and extensive aneurysms (p less than 0.05). The risk of renal failure was increased by advanced age and atherosclerotic cause (p less than 0.05). With an experienced surgical team, the primary risks of descending thoracic aneurysmectomy are not influenced by the method of adjunctive perfusion, but are determined by patient factors such as the nature and extent of the aneurysm. PMID- 3966836 TI - Primary chest wall tumors. AB - A retrospective study of 53 primary chest wall tumors, 26 benign and 27 malignant, was carried out to review their clinical radiological and pathological features. Forty-nine of the 53 lesions presented in the ribs and the remaining 4, in the sternum. The overall 5-year survival for patients with primary malignant neoplasms of the chest wall was 33.3%, and the 10-year survival was 18.5%. All of the deaths were disease related. All of the patients with benign tumors were treated by excision without recurrence or death. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissues were visualized. On the basis of our analysis, we believe that all tumors of the chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain an adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions. PMID- 3966837 TI - Rigid intraluminal prosthesis for replacement of thoracic and abdominal aorta. AB - During the past seven years, 80 patients have undergone aortic substitution using a rigid intraluminal prosthesis. There were 9 early deaths. The procedures involved 32 dissecting aneurysms (18 ascending and 14 descending), 16 atherosclerotic aneurysms of the ascending aorta and 13 atherosclerotic aneurysms of the descending aorta, 3 thoracoabdominal aneurysms, 2 arch aneurysms, and 14 abdominal aortic aneurysms. There was one early dislodgment of the rings necessitating reoperation, but no other early complications related to the procedure. In the follow-up period (mean, 25 months) there were 6 late deaths. One occurred 6 months after operation in a patient with empyema. There were no late complications of thrombosis, erosion, pseudoaneurysm formation, or hemorrhage. The follow-up data are extremely encouraging. We now are using this device whenever possible in all substitutions of the aorta, although in approximately 40% of patients, it is necessary to remove one of the spools and suture either the proximal or distal end of the graft owing to the close proximity of the aneurysm to the coronary ostia or the origin of the subclavian artery. Important techniques of insertion and postoperative angiograms are presented. PMID- 3966838 TI - Postoperative phrenic nerve palsy in patients with open-heart surgery. AB - We prospectively studied patients undergoing open-heart surgical procedures to evaluate the role of phrenic nerve palsy in the causation of the high incidence of pulmonary complications reported in these patients. Although atelectasis, or infiltrates, or both developed in the left lower lobe of 98% of the patients (43 of 44) with or without similar changes on the right side, only 5 (11%) of the 44 patients had diaphragmatic dysfunction following operation. In 1, the left phrenic nerve became inexcitable; 2 had paresis of the left hemidiaphragm, and 2 had paresis of the right hemidiaphragm. Although damage to the phrenic nerve can occur during open-heart operations, a relatively low incidence of this complication does not support it as the major cause of postoperative pulmonary complications. PMID- 3966839 TI - Total fundoplication gastroplasty (Nissen gastroplasty): five-year review. AB - Gastroplasty was introduced by Collis in 1961 and has undergone several modifications. The combination of total fundoplication with gastroplasty was reported in 1977 and referred to as total fundoplication gastroplasty; however, the term Nissen gastroplasty also is commonly used. This article is an extension of the original 1977 report and, to our knowledge, represents the first 5-year review of total fundoplication gastroplasty. Three hundred fifty-one consecutive patients with intractable reflux were preoperatively evaluated by history, radiographic studies, manometric studies with determination of pH, and esophagogastroduodenoscopy prior to surgical management by total fundoplication gastroplasty. There were no operative deaths. Follow-up averaged 6.5 years with an effective clinical review available for 95.4% of the patients, radiographic studies for 92.3%, and manometric studies with pH evaluation for 70.7%. Among the 335 patients with 5 or more years of follow-up, 93.1% had excellent results with normal eating and no investigative evidence of recurrence of reflux, 4.0% had mild residual symptoms, and 2.9% had persistent or recurrent symptoms. With this technique, the problems of overcompetence and dysphagia are substantially reduced because the completion fundoplication is tailored to a length of 1 cm while anatomical stability is maintained with a long intraabdominal segment. PMID- 3966840 TI - Repair of anomalous origin of the right pulmonary artery from the ascending aorta associated with subtotal left cor triatriatum. AB - A unique case of anomalous origin of the right pulmonary artery from the ascending aorta associated with subtotal left cor triatriatum and severe pulmonary hypertension in a 4-month-old infant was successfully repaired using cardiopulmonary bypass and circulatory arrest. PMID- 3966841 TI - Truncus arteriosus with interrupted aortic arch: report of a successful surgical repair. AB - The association of truncus arteriosus with interrupted aortic arch represents a formidable surgical challenge. Two successful repairs have been reported, but none for the past ten years. This report presents a third successful repair using a technique that allows the widely patent ductus arteriosus to maintain continuity between the truncus (with pulmonary arteries detached) and the descending aorta. Right ventricle-pulmonary artery continuity is established in the usual way with a porcine-valved conduit. While long-term potential difficulties with this approach are recognized, it appears to give satisfactory initial palliation and to be an acceptable method of treatment for this combination of defects. The embryology and the anatomy of the lesion are briefly discussed. PMID- 3966842 TI - The management of chylothorax. AB - A series of 15 patients was treated for chylothorax over a 20-year period. The anatomy, physiology, and diseases of the thoracic duct are described, and a plan for the management of chylothorax is presented. If conservative therapy (e.g., aspiration or drainage with restriction of oral intake and intravenous replacement) is not successful after two to three weeks, surgical treatment is necessary and efficacious. The thoracic duct is explored by a full thoracotomy on the side of the effusion. It is readily seen if 6 to 8 oz of a mixture of milk and cream is given to the patient a few hours before operation. The milky fluid drips from the open duct, which is easily oversewn. PMID- 3966843 TI - Pancoast's tumor. PMID- 3966844 TI - Operative closure of patent ductus. PMID- 3966845 TI - Hemorrhage during redo sternotomy. PMID- 3966846 TI - Tricuspid valve replacement. PMID- 3966848 TI - Birth seasonality and schizophrenia. PMID- 3966847 TI - Winter births and seasonal affective disorder. PMID- 3966849 TI - Diagnosis and prognosis in schizophrenia. AB - We showed that schizophrenia was a discrete disorder by using a quantitative clinical scale that discriminated schizophrenics from other subjects in a prospective follow-up and family study of 500 psychiatric outpatients. Four symptoms tended to occur together as a stable syndrome throughout the six- to 12 year follow-up: persecutory delusions, delusions of control, firmly fixed mood incongruent delusions, and auditory hallucinations. Scale scores were computed as the number of these four symptoms that was present less one if there was a history of spending sprees with marked elation. More than 68% of the schizophrenics and fewer than 2% of nonschizophrenics had scores of +2 or greater. The distribution of scores was bimodal: persons with scores of +1 were relatively rare. Also, there was familial resemblance for the presence or absence of schizophrenia, but no additional resemblance for the number of schizophrenic symptoms. Despite this relative discreteness, scale scores were valuable for quantifying the certainty of diagnosis and predicting outcome. PMID- 3966850 TI - Language and thinking in psychosis. Is there an input abnormality? AB - We studied "formal thought disorder" in schizophrenics, schizoaffectives, and manics by examining syntax processing and perception of meaning, using the "embedded click" and "memory for gist tasks," two paradigms that were developed by psycholinguists. To control for generalized performance deficits, a matched task design was used. Contrary to expectation, patients did worse on a matched memory for digits task than on sentence processing. At a six-month follow-up examination, schizophrenics' performance did not improve while other patients' did. We concluded that psychotic patients have no specific language perception deficit but do have a short-term memory deficit. This deficit tends to remit for manics and schizoaffectives, but not for schizophrenics. PMID- 3966851 TI - Parental affective style and the treatment of schizophrenia. Predicting course of illness and social functioning. AB - In a randomized controlled study, the affective style (AS) of parents of schizophrenics in clinic-based individual treatment groups and home-based family treatment groups was compared prior to treatment and again three months after treatment had begun. Affective style is an index reflecting the quality of the family emotional climate, measured from face-to-face discussion. Pretherapy and posttherapy measures of negative AS were significantly predictive of relapse within the nine-month treatment period for patients in individual treatment. In addition, for both treatment groups, a negative AS pattern at the posttherapy reassessment was significantly associated with decreased patient social functioning, reduced ability of the family to absorb the family intervention, and lower capacity of the family to cope with everyday family stresses. The results suggest that AS is an important intrafamilial attribute, with implications for treatment strategy and planning. PMID- 3966852 TI - Mortality in a follow-up of 500 psychiatric outpatients. I. Total mortality. AB - Total or all-cause mortality data were determined from a prospective study of 500 randomly selected psychiatric outpatients during a mean follow-up period of seven years. With the use of age-, sex-, and race-adjusted methods, a mortality nearly twice that expected from reference population rates was observed. Mortality was excessive among younger, but not older, patients; and among white men and women and black men, but not among black women. Certain psychiatric diagnoses (based on structured personal interviews performed at index and using explicit criteria) were associated with excess mortality: alcoholism, antisocial personality, drug addiction, homosexuality, organic brain syndrome, and schizophrenia. Excess mortality was not observed among patients with primary affective disorders, ie, disorders not antedated by nonaffective psychiatric illness. PMID- 3966853 TI - Mortality in a follow-up of 500 psychiatric outpatients. II. Cause-specific mortality. AB - In a six- to 12-year follow-up study of 500 psychiatric outpatients, death from natural causes occurred 11/2 times the expected rate, although the excess was not significant. Death from unnatural causes occurred 31/2 times the expected rate, a significant elevation. Suicide and homicide rates were particularly excessive. Unnatural mortality was excessive among younger, but not older, patients, and among all sex-race groups except black women, none of whom died unnaturally. Initial psychiatric diagnoses highly predictive of unnatural death included alcoholism, antisocial personality, drug addiction, and homosexuality. Secondary affective disorder was predictive of excess unnatural mortality, but in all cases of such death one of the four disorders associated with excess mortality antedated the affective disturbance. No patient with an index diagnosis of primary affective disorder died of an unnatural cause. Despite a frequent history of suicide attempts, hysteria was not associated with excess unnatural mortality. PMID- 3966854 TI - The Iowa record-linkage study. I. Suicides and accidental deaths among psychiatric patients. AB - In a prospective investigation of 5,412 formerly hospitalized psychiatric patients, 68 committed suicide and 38 died from accidental causes. Both figures are significantly in excess of expectations based on a relevant control population. Those at significant risk included men and women of all ages, except those older than 69 years. Comparison of standardized mortality ratios suggests relatively greater risk for women and young persons. Risk for suicide was significant for patients of both sexes with acute schizophrenia, schizophrenia, affective disorders, and alcohol and other drug abuse, for men with neuroses, and for women with depressive neuroses. Risk for accidental death was greatest for those aged from 30 to 49 years and for those with personality disorders. PMID- 3966855 TI - The Iowa record-linkage study. II. Excess mortality among patients with organic mental disorders. AB - Of 543 patients with organic mental disorders hospitalized at the University of Iowa Psychiatric Hospital, Iowa City, during a ten-year period, 87 died. This mortality was significant based on a control population. Patients of all ages were at risk for early death, especially those younger than 40 years. Risk was greatest during the first two years of follow-up; thereafter the observed death rate approached the expected rate. Patients were at special risk for death from "natural" causes, particularly cancer and heart disease among women, and influenza or pneumonia or "other" natural causes among men. During the first two years of follow-up, men were also at risk for death from accidents or suicide. Women with alcohol- and drug-related psychoses were at risk for death early in follow-up, but the diagnosis was not associated with risk from "unnatural death" in either sex. PMID- 3966856 TI - The Iowa record-linkage study. III. Excess mortality among patients with 'functional' disorders. AB - Our investigation of the pattern of mortality among former inpatients in nine diagnostic groups was based on deaths found among 4,869 former inpatients of the University of Iowa Psychiatric Hospital, Iowa City, during a ten-year period. Comparisons were made with expected values based on a relevant Iowa control population. The first two years of follow-up was a period of great risk but not after. Excessive mortality from "unnatural" causes was found among patients of either sex with an affective disorder, schizophrenia, alcohol or other drug abuse, and personality disorders, among men with acute schizophrenia or neuroses, and among women with depressive neuroses. Women with acute schizophrenia or a psychophysiologic disorder or special symptom were at risk for a "natural" death. These findings confirm the risk of reduced life span that patients in all nine categories share. PMID- 3966857 TI - The hidden mental health network. Treatment of mental illness by nonpsychiatrist physicians. AB - Building on a previous study, this report explores in more detail one aspect of the "de facto mental health services system," the treatment of mental disorders by nonpsychiatrist physicians in office-based practice. Data from the 1980 and 1981 National Ambulatory Medical Care surveys indicate that almost one half of all office visits to a physician resulting in a mental disorder diagnosis are to nonpsychiatrists, mostly in primary care. Nonpsychiatrists' mentally ill patients tend to be less seriously ill than patients of psychiatrists, and are more likely to come in with physical problems. They are also significantly more likely to be female, to be nonwhite, and to be elderly. Physicians treating these patients appear to be providing a different product than psychiatrists are, spending less time with patients, but using a wider range of diagnostic and therapeutic services during each office visit. PMID- 3966859 TI - Educational goals and objectives in physical medicine and rehabilitation for the medical school graduate. PMID- 3966858 TI - Mortality studies in psychiatry. Should they stop or proceed? AB - Psychiatry as a medical discipline has a special concern for preventing premature deaths in psychiatric patients. Such patients continue to be at excess mortality risk despite changing patterns of causes of death and improvements in the treatment of some diagnostic groups. In this overview of current findings and research trends, we find a continuing need for mortality studies and increased opportunities for integrating these investigations with other longitudinal studies of psychiatric populations. PMID- 3966861 TI - Ulnar nerve conduction study of the first dorsal interosseous muscle. AB - Ulnar neuropathy at or distal to the wrist is difficult to diagnose. Sensation is normal in the majority of cases, and the interosseous muscles are usually more severely involved than are the hypothenar muscles. A technique for ulnar nerve conduction study of the first dorsal interosseous muscle is described, and normal values based upon 373 studies are presented. Using this technique the upper limit for distal motor latency (DML) to the first dorsal interosseous (FDI) muscle is 4.5 ms. More precisely, DML to the FDI should not exceed DML to the contralateral FDI by more than 1.3 ms, nor should this value exceed the DML to the ipsilateral abductor digiti minimi by more than 2.0 ms. The lower limit for amplitude of the compound muscle action potential recorded over FDI is 6mV. If motor conduction study of the first dorsal interosseous muscle is more routinely performed, earlier and more frequent recognition could be followed by improved surgical remediation of this compression neuropathy. PMID- 3966860 TI - Lumbar spinal stenosis: analysis of pre- and postoperative somatosensory evoked potentials. AB - Cortical somatosensory evoked potential (CSEP) examinations were performed of 20 patients with lumbar spinal stenosis a day prior to surgery and 10 to 12 days after spinal decompression and bilateral lateral fusion. CSEPs were recorded to Cz-Fz (10-20 international EEG system) following stimulation of 32 tibial, peroneal and sural nerves and 16 saphenous nerves. A total of 110 nerves were examined. Using CSEP P1 latency as criteria for inclusion in the study, 21 tibial, 20 peroneal and 17 sural nerves were subjected to paired two-tailed t tests to determine whether the CSEP changes that occurred postoperatively were statistically significant (p less than 0.05). Postoperative P1 latencies of tibial, peroneal, and sural nerves changed significantly as well as N1 latencies and P1-N1 amplitudes of tibial and peroneal nerves. Nineteen patients improved clinically. It is postulated that pathologic narrowing of the spinal canal in spinal stenosis leads to nerve root compression and ischemia with resultant dysfunction primarily affecting large diameter myelinated fibers and that decompression procedure may adequately relieve the underlying pathologic processes. Improvement in CSEPs may be from increase in available numbers of functioning large diameter myelinated fibers, conversion to normal from a conduction block, and, perhaps, improved axoplasmic flow. PMID- 3966862 TI - H-reflex changes following spinal cord injury. AB - Changes in both central synaptic excitability (CSE) and peripheral sensitivity of muscle spindle stretch receptors have been hypothesized to contribute to hyperactive stretch reflexes of spasticity. To assess CSE, the monosynaptic H reflex to the triceps surae muscles was tested serially over the first six months after traumatic spinal cord injury (SCI). Six clinically complete SCI patients were compared to age-matched control subjects. As a measure of H-reflex excitability, H/M ratios were calculated by dividing maximum H-reflex by maximum M-response amplitude. Analysis of variance over the testing trials showed significant change in H/M ratios for SCI patients (p less than 0.01). T-tests comparing mean H/M ratios at different time periods after SCI revealed a significant increment after three months (p less than 0.01). H-reflex amplitude also increased significantly over this time period (p less than 0.04), but M response amplitude did not change significantly. These increases in H/M ratio and H-reflex amplitude suggest that an increase in CSE may contribute to the appearance of hyperreflexia after SCI. PMID- 3966863 TI - Accessory nerve latency to the middle and lower trapezius. AB - Trapezius muscle dysfunction occurs following injury to the spinal accessory nerve from a variety of causes. The trapezius consists of three distinct segments: upper, middle, and lower. Since previous studies of accessory nerve latency measure conduction to the upper trapezius segment only, this present study describes a standardized technique for determining accessory nerve latency to the middle and lower trapezius, a particularly important measurement for accurate examination for those who are in pain or unable to cooperate. Mean normal latency in 21 nerves to the middle trapezius is 3.0 +/- 0.2 msec and to the lower trapezius is 4.6 +/- 0.3 msec. Accessory nerve latency measurement of the middle and lower trapezius segments is valuable in a case of surgical injury in the posterior cervical triangle, especially during recovery from accessory nerve injury when reinnervation of the upper segment precedes the middle and lower segments. PMID- 3966864 TI - Dynamic approach in the diagnosis of thoracic outlet syndrome using somatosensory evoked responses. AB - The clinical diagnosis of thoracic outlet syndrome (TOS) is controversial. Objective documentation of this disorder is often unobtainable, even with electrodiagnostic techniques. This preliminary report describes an objective diagnostic method of evaluating TOS using somatosensory evoked potential testing (SEP) and dynamic arm positioning. Evoked potentials were recorded over the brachial plexus (N9) and C7 cervical vertebra (N13) after distal stimulation of the median and/or ulnar nerves. This was performed with the arm both at the side (anatomic position), and then positioned in abduction and external rotation. Absolute and interpeak latencies were measured in both positions. Of 14 patients clinically suspected of having TOS, six showed normal N13 evoked responses in the anatomic position despite a disappearance of this potential when tested with the symptomatic arm in the dynamic position of abduction and external rotation. Fourteen control subjects had normal responses with the arm tested in both positions. The SEP coupled with the dynamic stress of the nerves coursing through the thoracic outlet may be helpful as a new objective aid in the diagnosis of TOS. PMID- 3966865 TI - Agitation in closed head injury: haloperidol effects on rehabilitation outcome. AB - The role of agitation as a prognostic indicator of outcome in 26 patients with severe traumatic closed head injury was studied to explore haloperidol effects on the outcome of rehabilitation treatment. The incidence and degree of agitation and post-traumatic amnesia (PTA) in brain-injured patients undergoing comprehensive inpatient rehabilitation were also studied. Variables measured included length of coma, PTA, rehabilitation admission and discharge functional status, and CT scan results. Of the 26 patients, 25 were agitated after emerging from coma and 11 required intervention with haloperidol. Treated and nontreated patients were compared statistically. No differences were found between groups as to demographics, length of coma, and most importantly, in success of rehabilitation outcome. The duration of PTA was significantly longer in the treated group. PMID- 3966866 TI - Glasgow Outcome Scale and Disability Rating Scale: comparative usefulness in following recovery in traumatic head injury. AB - Clinical experience and analysis of use of the Disability Rating Scale (DRS) and the Glasgow Outcome Scale (GOS) are reported in 70 patients up to two years after head injury. Statistical analysis shows significant change demonstrated by the DRS across the intervals from two to four, two to six, and six to 12 months after injury. The DRS more sensitively reflects improvement during inhospital rehabilitation than the GOS, 71% to 33%, respectively. Significant improvement is shown up to one year after injury. Trend data on seven patients for whom two-year data were available showed continued improvement, although the data were not statistically significant. The DRS has shown itself to be a sensitive, functional, reliable, and quantitative means of monitoring patients with traumatic head injury during the course of their recovery. PMID- 3966867 TI - Closed head injury in spinal cord injured patients: retrospective study of loss of consciousness and post-traumatic amnesia. AB - Previous studies of trauma-related spinal cord injured patients suggest that 25% to 50% of these patients sustain a concomitant cranio-cerebral trauma. A loss of consciousness (LOC) of 20 minutes' duration or a post-traumatic amnesia (PTA) lasting 24 hours has been associated with deficits in concentration, attention, memory, and higher-level cognitive functions. These may present as significant factors influencing learning and adaptation during and after the formal rehabilitation process. A systematic review was performed of the medical records of 101 trauma-related spinal cord injured patients who were admitted to Northwestern Memorial Hospital and the Rehabilitation Institute of Chicago within seven days of injury. The reported incidence of LOC and PTA in spinal cord injured patients was evaluated, and these data were compared with the level and etiology of injury, and with radiographic work-up, if any, for head injury. Eighty-seven percent of all emergency room admissions and 67% of all rehabilitation admissions were assessed for LOC. Fewer than 25% of all patients in both settings were assessed for PTA. Forty-two percent of all patients reported LOC, PTA, or both occurring simultaneously with the spinal cord injury. Assessment and incidence were unrelated to level of injury but were influenced by etiology. One-third of the patients who reported LOC, PTA, or both underwent further evaluation with computed tomographic (CT) scan or radiography of the skull. Assessment of LOC is conducted more consistently in the ER than in the rehabilitation setting. Assessment of PTA is performed infrequently despite its relevance to the rehabilitation process. Head injury may frequently be associated with traumatic spinal cord injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966868 TI - Anterior hypopituitarism: a consequence of head injury. AB - Anterior pituitary insufficiency in patients with traumatic brain injury is rare. Only sporadic cases have been reported in the literature. The authors report a case of panhypopituitarism that developed in a 19-year-old man and was diagnosed six months after the patient sustained severe craniocerebral trauma in a motor vehicle accident. After an initial slow improvement in neurologic function he very gradually retrogressed in physical and mental capacities. An acute adrenal crisis led to the diagnosis of hypopituitarism. Institution of appropriate hormone therapy resulted in steady improvement in motor and cognitive functioning. The authors reviewed the literature and discuss the possible pathophysiology. They exhort physiatrists to be aware of this rare but potentially fatal consequence of craniocerebral trauma. PMID- 3966869 TI - Single fiber electromyography with a standard monopolar electrode. AB - A technique of obtaining qualitative single fiber electromyography information with standard monopolar electrodes is described. The technique requires an electromyograph equipped with a trigger and delay line. Single fiber electromyography is an effective tool in dealing with disorders that affect neuromuscular transmission and for observing the recovery of nerve injuries. Since most problems encountered in clinical practice deal with the diagnosis and follow-up of radiculopathies and peripheral nerve compromise, the use of single fiber electromyography in these conditions is of great clinical importance. PMID- 3966870 TI - Tibial nerve entrapment by a Baker cyst: case report. AB - We report a rare case of degenerative joint disease of both knees, complicated by a Baker cyst. Our emphasis is on the role of electromyography and electrodiagnosis in the localization of this nerve entrapment syndrome. The patient presented with pain and swelling; venography revealed deep venous thrombosis of the right calf, including the popliteal and proximal superficial femoral vessels. The patient responded well to bed rest, analgesics, intravenous heparin and subsequent Coumadin anticoagulation, and was discharged two weeks later. Five weeks after onset of these acute problems, nerve conduction studies were done, leading to a diagnosis of Baker cyst with nerve entrapment. He responded well to knee joint aspiration and intraarticular prednisolone injection. Some evidence of improvement in the flexor hallicus longus muscle was detected at three-month follow-up. PMID- 3966871 TI - Recognizing the challenges of prevention in rehabilitation. PMID- 3966872 TI - Reliability of criteria for predicting persistent or recurrent sepsis. AB - We reviewed the charts of 2,567 patients from 11 prospective clinical trials of antibiotic therapy for surgical infection to identify reliable predictors of sepsis eradication. Particular attention was paid to temperature, blood cell counts, renal and hepatic function tests, arterial gases, and clotting factors, both at the termination of parenteral antibiotic administration as well as at patient discharge from the hospital. On the discontinuation of antibiotic therapy, sepsis recurred in 19% of the patients who had a normal rectal temperature, in 3% of the patients if the rectal temperature and WBC count were normal, but in no patient when both the temperature and WBC count were normal and the differential blood smear contained less than 73% granulocytes and less than 3% immature forms. Rates for recurrent sepsis, once antibiotic therapy was discontinued for more than 48 hours, were 8%, 2%, and 0%, respectively, for the same criteria at hospital discharge. PMID- 3966873 TI - Surgical infection stratification system for intra-abdominal infection. Multicenter trial. AB - One hundred eighty-seven patients treated for established intra-abdominal infection in five medical centers were studied using the surgical infection stratification system. This system combines an anatomic category with a numerical estimate (acute physiology score [APS]) of deviation from normal of 33 routine laboratory tests or physical findings. Overall mortality was 24% and the rate of treatment "success" with a single operation and single course of antibiotics was 48%. Eighty percent of deaths occurred with infection present. Multivariate analysis disclosed that APS, malnutrition, and age were most noteworthy for predicting survival or death. Intra-abdominal infection carries substantial mortality and morbidity despite advances in understanding the underlying pathophysiologic condition. Additional clinical studies are needed. Uniform reporting criteria, including the use of an objective severity scoring system, are suggested for future reports concerning intra-abdominal infection. PMID- 3966874 TI - Enterococcal bacteremia in surgical patients. AB - In 73 surgical patients enterococcal bacteremia was preceded by antibiotic administration (n = 58), central venous catheters (n = 52), other-organism bacteremia (n = 44), and gastrointestinal tract operations (n = 41). Surgical wounds and urinary tract infections were the most frequent portal of entry. The overall mortality was 42%. The mortality risk was significantly greater in patients with preceding or concomitant gram-positive bacteremia and four or more days of cephalosporin administration prior to enterococcemia. In 21 patients who had been given cephalosporins and who had gram-positive bacteremia, specific antienterococcal therapy resulted in survival in five of nine patients, compared with three of 12 who survived without therapy. Enterococcal bacteremia in surgical patients follows antibiotic administration, central venous catheter use, other-organism bacteremia, and intra-abdominal operations. Preceding or concomitant gram-positive bacteremia defines a subgroup of patients with high mortality who seem to respond to antienterococcal therapy. PMID- 3966875 TI - Serum level monitoring of aminoglycoside antibiotics. Limitations in intensive care unit-related bacterial pneumonia. AB - Serum aminoglycoside assays have been accepted as useful methods of enhancing therapeutic efficacy in the treatment of intensive care unit-acquired pneumonia and in avoiding aminoglycoside nephrotoxicity. We prospectively studied 68 surgical patients with normal renal function and gram-negative bacterial pneumonia who were treated with aminoglycosides. Serum levels indicated subtherapeutic levels in 47 patients and verified optimum levels in 13 patients. Toxic trough levels developed in six patients and, despite immediate dosage adjustment, five patients suffered nephrotoxicity. Six additional patients also had nephrotoxicity. Five of these patients never had toxic peak or trough levels and rising trough levels developed in one patient after serum creatinine levels began to rise. We conclude that routine monitoring of serum levels effectively detects subtherapeutic antibiotic levels. This modality is useful for optimizing dosage schedules, but does not serve to predict or avoid nephrotoxicity in critically ill surgical patients. PMID- 3966876 TI - Abscence of CNS lesion in autopsied patients with Miller-Fisher syndrome. PMID- 3966877 TI - Effects of propranolol and ataxic syndromes. PMID- 3966879 TI - Autonomic function in myotonic dystrophy. PMID- 3966878 TI - Linolenic acid deficiency. PMID- 3966880 TI - Neurotoxicity of metrizamide. PMID- 3966881 TI - Computed tomography in chronic seizure disorder caused by glioma. AB - Since the introduction of computed tomography (CT) in 1974, 137 patients underwent cortical resection for intractable epilepsy. The CT scans of 32 of these patients demonstrated an isolated calcified or hypodense lesion of unknown origin. The mean interval from onset of the seizure disorder to surgery was 11 years. The referring physicians frequently considered these lesions to be of nonneoplastic origin, which usually delayed surgical management. Twenty-six of the 32 patients, however, proved to have a cerebral glioma, seven showing anaplastic changes. Because the majority of these patients were found to have a neoplasm and especially because the CT scan could not distinguish between a well differentiated glioma and those with anaplastic changes, we recommend early surgical treatment in patients with chronic seizure disorders who are found to have an isolated lesion of unknown origin on CT scan. PMID- 3966882 TI - Early cortical median nerve somatosensory evoked potentials. Prognostic value in anoxic coma. AB - Subcortical and early cortical median nerve somatosensory evoked potentials (SEPs) were examined in 26 patients in hypoxic coma. The amplitude ratio between the negative slope of the scalp response and the following positive trough was determined. The latency difference between the major negative component recorded from the upper neck, N14, and the initial negative potential from the scalp, N20, was also measured. The mean of these parameters in both hemispheres was referred to as mean central conduction time (MCCT) and mean amplitude ratio (MAR). There was a significant difference in MAR in patients with a bilaterally recordable scalp response between those with a good and those with a bad outcome, but no difference in MCCT. Comparison of SEP findings with postmortem examinations suggests that a reduced MAR may yield an estimate of cortical damage in hypoxic coma. PMID- 3966883 TI - Aphasia following pluridirectional tomography with metrizamide. The effect of patient position. AB - Eight of 67 patients became transiently aphasic after myelography or cisternography with metrizamide. All eight patients had been placed in the left lateral decubitus position for pluridirectional tomography. Immediate EEGs revealed focal left-sided abnormalities in two patients. In one other patient, a computed tomographic scan showed contrast mainly over the left hemisphere. All of the symptoms resolved within 48 hours. In 34 patients who were placed on the right side, no language disturbance was noted. Aphasia after pluridirectional tomography with metrizamide may be due to local irritation of the perisylvian language centers of the dominant hemisphere. The phenomenon is distinct from syndromes of generalized confusion. The complication may be avoided by placing patients in a right lateral decubitus position for pluridirectional tomography. PMID- 3966884 TI - Propranolol plasma levels and relief of migraine. Relationship between plasma propranolol and 4-hydroxypropranolol concentrations and clinical effects. AB - The relationship between propranolol and 4-hydroxypropranolol plasma concentrations and relief of migraine was assessed in 17 patients during treatment with oral racemic propranolol hydrochloride in doses of 40 to 240 mg/day. Propranolol decreased the migraine index more than 70% in 13 patients: five patients at a dosage of 40 mg/day, five patients at a dosage of 120 mg/day, and three patients at a dosage of 240 mg/day. Three patients did not achieve a good improvement of migraine at any of the doses used. The relief of migraine was not directly related to the propranolol and 4-hydroxypropranolol plasma concentrations. PMID- 3966885 TI - Fingerprint patterns in Alzheimer's disease. AB - Fingerprint dermatoglyphic patterns in 50 patients with presumed senile dementia of the Alzheimer type (SDAT) were compared with a control group of 50 patients with other neurologic diseases and with population norms. Patients with SDAT showed a significantly increased frequency of ulnar loops on their fingertips and a concomitantly decreased frequency of whorls and arches. A pattern of eight or more ulnar loops was found significantly more often in patients with SDAT (72%) than in the control group (26%). Fourteen patients with SDAT had ulnar loops on all ten fingers; this occurred in four patients in the control group. Radial loops on the fourth and fifth digits were more prevalent in patients with SDAT. The fingerprint patterns observed in patients with SDAT are congruent with patterns repeatedly found in Down's syndrome, and support the known associations between these two diseases at a further level. PMID- 3966886 TI - Vertebrobasilar transient ischemic attacks in internal carotid artery occlusion or tight stenosis. AB - We studied 12 patients with internal carotid artery (ICA) occlusion or tight stenosis but without vertebrobasilar and subclavian atherosclerosis who suffered vertebrobasilar insufficiency (VBI). The patients with ICA occlusion were compared with a sex- and age-matched control group that had ICA occlusion but no VBI. Visible infarct on computed tomographic scan, greater size of visible infarct, weak collateral circulation, and bilateral atherosclerosis of the ICA significantly correlated with the occurrence of VBI. No significant difference was demonstrated for emboligenic lesions, but posterior to anterior flow through the posterior communicating arteries was demonstrated only in the patients with VBI. These facts suggested hemodynamic disturbances with "steal VBI." In ICA tight stenosis, VBI symptoms disappeared after endarterectomy but persisted in patients with more than 50% stenosis; this was also suggestive of hemodynamic VBI. Vertebrobasilar insufficiency had a prognostic significance, being associated with an increased occurrence of delayed stroke. PMID- 3966887 TI - Methylphenidate therapy for aggression in a man with ring 22 chromosome. Report and literature review. AB - A 28-year-old mentally retarded man with ring 22 chromosome [r(22)] had deterioration of mood and behavior, decreased speech, bradykinesia, and decline of fine motor skills over a three-year period, which were further exacerbated by treatment with phenothiazines. A trial of methylphenidate hydrochloride resulted in rapid improvement of mood, behavior, and to a small extent, motor function. This finding suggests that dopamine depletion may play a role in the behavioral deterioration seen in this disorder. The possibility that genes that control dopamine metabolism may be present on chromosome 22 is raised. The phenotype of this patient is compared with the 25 reported cases of r(22). PMID- 3966888 TI - Evoked responses. Overused, underused, or misused? PMID- 3966890 TI - California encephalitis virus causes subacute encephalomyelitis in an adult. AB - A 24-year-old man from rural Mississippi had a case of California encephalitis (CE) that evolved as a subacute encephalomyelitis. The incidence of CE in adults is low, especially in the southeastern United States, and to our knowledge the clinical profile of symptomatic disease in adults has not been established. The characteristics of CE and St Louis encephalitis, the usual cause of arboviral illness affecting adults in the Southeast, differ. PMID- 3966889 TI - Return to alertness after brain-stem hemorrhage. A case with evoked potential and roentgenographic evidence of bilateral tegmental damage. AB - After a 65-year-old man had received anticoagulation therapy for brain-stem ischemia, a large, bilateral pontomesencephalic hemorrhage developed in the ischemic region. He survived a period of being "locked in" to attain a limited functional recovery. When he first became alert, brain-stem auditory evoked potentials and short-latency somatosensory evoked potentials (SEPs) demonstrated bilateral brain-stem damage; computed tomography revealed a bilateral tegmental hematoma. Results of repeated studies changed little as clinical improvement occurred. Recovery from brain-stem hemorrhage is rare, and return of consciousness with bilateral tegmental involvement is even more rare. The short latency SEPs are useful in defining the extent of brain-stem damage, but they evaluate structures distinct from those regulating consciousness and cannot predict a return to alertness. PMID- 3966891 TI - Bilateral pontine gaze palsy. Nuclear magnetic resonance findings in presumed multiple sclerosis. PMID- 3966892 TI - Changing concepts of acoustic neuroma diagnosis. AB - Three hundred five acoustic neuromas were reviewed to determine the sensitivity of combining the auditory brainstem response (ABR) and the intravenous contrast enhanced computed tomogram (CT) as screening tests for acoustic neuroma diagnosis. The ABR detected 98% of the tumors. The enhanced CT demonstrated 97% of tumors larger than 1.5 cm, but only 48% of neuromas 1.5 cm or smaller. The combination of both ABR and enhanced CT, used as the initial screening tests, identified 99% of the neuromas. We conclude that ABR, with enhanced CT as needed, is an accurate screening protocol. This method can be used as an alternative to the traditional ABR, electronystagmography, and internal auditory canal tomograms. PMID- 3966893 TI - Auditory evoked responses in multiple sclerosis. Wave I abnormality. AB - Far-field short latency auditory evoked potentials (AEPs) were obtained in 40 patients with definite multiple sclerosis (MS) and 20 normal control subjects. Nine of 40 patients had abnormal wave I and normal hearing as established by pure tone audiometry. It is concluded that, in the population of patients with MS tested, slightly more than one fifth had AEP evidence of subclinical involvement of the auditory portion of the eighth cranial nerve. PMID- 3966894 TI - Surgical anatomy of septorhinoplasty. AB - Anatomic studies of the nose were done in 60 cadavers, both fresh and embalmed, allowing correlation of surgical anatomy and operative techniques. All septorhinoplasties were performed on fresh cadavers, using a clinical instrument set and head lamp. In addition, the alar cartilages were assessed in 25 patients undergoing external rhinoplasty. This multifaceted study provided an integrated approach to nasal anatomy. PMID- 3966895 TI - DNA flow cytometry of thyroid neoplasms. AB - Mechanically dispersed cell suspensions from 23 thyroid lesions were studied by acridine orange flow cytometry. Eight of 14 carcinomas (three papillary, two medullary, two Hurthle cell, and one follicular) manifested abnormal DNA indices ranging from 0.6 to 2.0. Six carcinomas (four papillary and two medullary) were diploid. Four patients having papillary carcinomas with diploid DNA content were young women whose clinical course of disease was indolent. Three papillary carcinomas with abnormal DNA content were found in older men with clinically aggressive disease. One benign adenomatoid nodule displayed a small population with a low-degree hyperdiploid stemline (DNA index = 1.1) with low proliferative activity. Differentiation between clinically indolent and aggressive carcinomas may be possible by nuclear DNA determination, but further work is needed to determine the importance of proliferative activity in thyroid carcinoma. PMID- 3966896 TI - Neoglottic reconstruction following total laryngectomy. AB - Aspiration of saliva and food and postoperative stenosis of the shunt are not infrequent among laryngectomized patients who have undergone surgery for voice rehabilitation. A new technique for neoglottic reconstruction has been developed to overcome these complications. A neoglottis was created from the upper-tracheal rings to prevent postoperative stenosis and was also made to protrude into the esophagus, in order to prevent aspiration. This procedure has been performed on eight patients, seven of whom are speaking well and have no aspiration. Their speech is superior to esophageal speech when judged on the basis of duration and intelligibility. In one case, however, the neoglottis had to be closed because of aspiration. PMID- 3966897 TI - Survival of myocutaneous flaps. Experimental evaluation by intra-arterial injection of a dye. AB - Ninety-four myocutaneous island flaps of the pectoralis major were studied in the rabbit using sulfan blue (Disulphine-blue). In 13 cases, the dye was injected intra-arterially in the acromiothoracic artery before the flap was lifted, and 47 more were injected after the lifting of the flap. In 34 further cases, sulfan blue was injected intravenously once the flap had been lifted. In another 16 flaps, vascularization was studied by means of "diaphanization" (ie, making the tissue transparent or diaphenous in nature). In all groups, the surviving length of flap was observed to be greater than the stained length. Intra-arterial administration of sulfan blue was associated with reduced flap survival. Viable flap length was not related to the anatomy of the vascular base. PMID- 3966898 TI - Lyme disease. A cause of bilateral facial paralysis. AB - Recently we had the opportunity of treating a boy from the northeastern region of the United States in whom bilateral facial palsies developed. After obtaining a detailed history and performing a thorough physical examination, the findings suggested Lyme disease. We herein discuss our evaluation and treatment of this child as well as review the otolaryngologic manifestations of this rare disease. PMID- 3966900 TI - Lateral sinus thrombosis. Medical or surgical treatment? AB - Although it is rarely seen now, lateral sinus thrombosis may occur in either its septic or aseptic form. Septic lateral sinus thrombosis is a potentially fatal condition in which early diagnosis may be difficult because of previous antibiotic therapy. Once diagnosis is made, combined antibiotic and surgical treatment is necessary to keep the mortality rate at 25%. Aseptic lateral sinus thrombosis is a condition that is rarely fatal but that leads to symptoms of severe headache and visual impairment. The increased intracranial pressure is associated with a blockage of the dominant sinus (usually the right one). The decision to use medical treatment alone or to combine it with surgical treatment must depend on the clinical features of each case. PMID- 3966899 TI - Medial orbital blow-out fracture with entrapment. AB - Blow-out fracture of the medial orbital wall, concomitant with tissue entrapment, is a rare condition occurring in those sustaining blunt trauma. Clinical signs of swelling, ecchymosis, enophthalmos, or diplopia during medial or lateral gaze is suggestive of the condition. Diagnostic confirmation is obtained by forced duction testing and computed tomography. Treatment with medial orbital decompression and limited ethmoidectomy is recommended in order to obtain optimum return of function with minimal risk. PMID- 3966902 TI - Injectable liquid silicone. PMID- 3966901 TI - Difficulty in high-pitched phonation by laryngeal trauma. AB - We treated a case of laryngeal trauma in which difficulty in high-pitched phonation was the main feature of a voice problem. We emphasize the importance of phonatory function tests in determining the mechanism of voice disorders and in monitoring the effects of treatment. Physical examination, phonatory function tests, computed tomographic scan, and electromyogram disclosed that the voice problem was caused by a fracture of the thyroid cartilage and its fixation against the cricoid cartilage. An open reduction yielded recovery of the phonatory function. PMID- 3966903 TI - Arterial dermatan sulfate proteoglycan structure in pigeons susceptible to atherosclerosis. AB - Arterial dermatan sulfate proteoglycans (DS-PG) were isolated from randomly bred White Carneau (RBWC) pigeons and a line of White Carneau pigeons (WC-2) genetically selected for increased atherosclerosis susceptibility. To characterize the basic proteoglycan (PG) structure and to identify structural differences that may relate to a specific arterial phenotype, embryos were labeled with radioactive sulfate in ovo and PG were isolated from aortas with 4.0 M GdnHCl. DS-PG were separated from chondroitin sulfate PG by gel chromatography and further purified by CsCl buoyant density ultracentrifugation and ion-exchange of chromatography. The DS-PG monomers from the two genetic lines of pigeons eluted at different positions on two high pressure liquid chromatography (HPLC) gel permeation systems, which suggested a structural difference between the two monomers. Analysis of the monomer components showed a similar protein core molecular weight of 50,000 for each and a similar amino acid composition. Glycosaminoglycans (GAG) molecular weights were estimated to be 15,000 for WC-2 and 18,000 for RBWC. The findings suggest a basic difference in post translational processing of PG in the two pigeon types which may reflect distinct functional properties associated with resistance or susceptibility to atherosclerosis. PMID- 3966905 TI - Measuring psychosocial variables in epidemiological studies of cardiovascular disease. PMID- 3966904 TI - Smooth muscle cells produce an inhibitor of endothelial cell growth. AB - A potent inhibitor of endothelial cell growth and neovascularization has previously been isolated from both bovine and human aorta. In an attempt to determine if the major cellular component of that tissue, smooth muscle cells, synthesized molecules with this activity, we studied the effects of serum-free conditioned medium from bovine aortic smooth muscle on the growth of cultured endothelial cells from bovine aorta. The smooth muscle conditioned medium was found to contain both growth inhibitory and stimulating activities that could be distinguished by their heat stability. The inhibitor is precipitable by ammonium sulfate, heat stable (80 degrees C), and inactivated by dithiothreitol, trypsin, and 2-mercaptoethanol. It has an estimated molecular weight of approximately 35,000 to 40,000 daltons (by column chromatography). It therefore appears that smooth muscle cells produce an inhibitor of endothelial cell growth that belongs to a class of natural endothelial cell growth inhibitors derived from avascular tissues we tentatively term "avasculins." Proof of its identity with the inhibitor isolated from intact aorta (or other tissues) must await purification. PMID- 3966906 TI - Transmural organization of the arterial media. The lamellar unit revisited. AB - When scanning electron micrographs of orthogonal transmural fracture surfaces of distended aortas were compared with appearances on corresponding semithin light microscopic and ultrathin transmission electron microscopic sections, medial lamellar units could be resolved into composites of overlapping, musculo-elastic fascicles lying parallel to tangential planes of section. Each fascicle consisted of a group of commonly oriented, elongated smooth muscle cells and an encompassing array of branching, similarly oriented elastic fibers. On longitudinal sections of straight segments of the aorta, fascicles appeared as closely packed, transversely transected smooth muscle cell groups within compartments formed by similarly transected elastic fibers. On transverse sections, fascicles appeared as groups of cells within cell strips or layers, each of which was bracketed on both its luminal and abluminal sides by straight elastic fibers. Fascicles were increasingly evident during growth as commonly oriented groups of cells within the already present concentric cell layers became demarcated by enlarging elastic fibers. Wavy collagen fiber bundles, distinct from the interlaced fibrils of the immediate pericellular matrix, were interposed mainly between the facing elastin systems within the fibrous regions between cell layers. Thus, the radial transmural disposition of cells and matrix fibers on transverse sections of the media in well developed aortas proved to be: elastin cells-elastin--collagen bundles--elastin-cells-elastin--collagen bundles, etc. Medias of major branch arteries were also composed of musculo-elastic fascicles, but their encompassing elastic fiber systems were less prominent than in the aorta. In straight segments of aortas and arteries, fascicles were uniform in size at any given transmural level and oriented mainly circumferentially. At bends and branch points fascicles were smaller and less uniform in size and orientation. In relation to changes in vessel wall curvature, alignment of the fascicles was usually in the direction of presumed resultant tensile stress. The findings suggest that these subunits of medial organization correspond to the distribution and magnitude of tensile stresses. PMID- 3966907 TI - Verapamil enhances receptor-mediated endocytosis of low density lipoproteins by aortic cells in culture. AB - Bovine aortic endothelial and smooth muscle cells (SMC) and human skin fibroblasts (HSF) were used to study the effect of verapamil on cellular interactions with human low density lipoprotein (LDL). Verapamil, 10 to 50 microM, increased 125I-LDL uptake and degradation by 70% to 200% in the various cells after 24 to 48 hours of incubation. The increase in the total amount of LDL endocytosed, labeled with 3H-cholesteryl linoleate (3H-CL), was comparable to that determined with 125I-LDL. In HSF and SMC, a delay in 125I-LDL degradation and hydrolysis of 3H-CL was seen in cells treated for 3 to 24 hours with verapamil. Pretreatment of HSF with 50 microM verapamil for 24 hours and incubation with 2 to 50 micrograms 125I-LDL protein/ml for 1 hour resulted in a 50% to 200% increase in heparin releasable and in a 40% to 130% increase in cellular 125I-LDL. Thus, the increase in 125I-LDL binding and uptake in verapamil treated cells was apparently due to an increase in receptor number, rather than in receptor affinity. The effect of verapamil on LDL uptake and degradation was also seen in cells that were pretreated for 24 hours and incubated with 125I-LDL in the absence of verapamil. The effect of verapamil was not apparent in LDL receptor-negative cells. Cycloheximide blocked the verapamil effect. The Na+ channel blocker, tetrodotoxin x 10(-6) M, caused a 30% to 50% increase in the total amount of LDL endocytosed, but no delay in LDL degradation; amiloride 2 x 10(-3) M was not effective. If the presently described effect of verapamil also occurs in vivo, this might contribute to the reported beneficial effects of Ca++ channel blockers in experimental atherosclerosis by promoting transfer of LDL cholesteryl ester from the aortic interstitium to a catabolic compartment. PMID- 3966908 TI - Control of monocyte recruitment by chemotactic factor(s) in lesion-prone areas of swine aorta. AB - Aortic areas predisposed to early atherosclerosis in swine demarcated by Evans blue uptake (blue areas) show preferential intimal penetration by blood monocytes before and during lesion formation. These cells are thought to be the major source of foam cells in these early lesions. To examine mechanisms controlling monocyte migration into these areas, extracts of aortic tissue from both blue and white areas of hypercholesterolemic (H) and normal (N) swine were tested for chemotactic activity against monocytes from N and H swine and neutrophils from H swine. The data indicate that extracts of blue areas from H swine contained at least one, and possibly two, factors chemotactic only for monocytes from H swine, but not N swine. These factors were not present in similar extracts from white areas of H swine, or either blue or white area extracts from N swine. Gel filtration chromatography of crude blue area extracts separated two chemotactically active fractions of molecular weights 68,000 and 5000 that were not present in white area extracts and that elicited a positive chemotactic effect only for H swine monocytes. These findings provide a mechanism explaining our previous findings of preferential monocyte adhesion and intimal penetration in lesion-prone areas, and indicate that control of monocyte recruitment into the artery involves not only alteration of the arterial wall, but also functional changes in the circulating monocyte. PMID- 3966909 TI - Lesion regression and protein synthesis in rabbits after removal of dietary cholesterol. AB - This study was conducted to determine whether atherosclerotic lesions regressed in rabbits that were placed on a normal, low cholesterol diet. Rabbits (n = 16) were fed a 2% cholesterol diet for 90 days; nine rabbits were killed, and the remaining seven rabbits were fed a low cholesterol diet for 7 months.. Appropriate noncholesterol-fed controls were used with each group. After 90 days of cholesterol feeding, the rabbits' thoracic aortas showed severe lesions, accompanied by significantly elevated rates of collagen and noncollagen protein synthesis and significantly increased amounts of cholesterol and soluble collagen. Cholesterol-fed rabbits that were fed a normal diet for 7 months had normal serum cholesterol levels, but exhibited extensive aortic lesions with elevated cholesterol content. Biochemically, the rate of aortic collagen synthesis remained significantly elevated above control values; however, the collagen content was not different from controls. This lack of collagen accumulation in the presence of a prolonged increase in synthetic rate was surprising. One possible explanation is that in the diseased aorta there is a rapid turnover of collagen, resulting in a redistribution or remodeling of the connective tissue, rather than an increased accumulation. PMID- 3966911 TI - Apoprotein B-48 is a constant finding in very low density lipoproteins of humans. AB - The results of this study indicate that very low density lipoprotein (VLDL) from the plasma of fasting normolipidemic or slightly hypertriglyceridemic subjects contains two apo B species. In SDS gel electrophoresis, the VLDL shows the presence of a major band corresponding to low density lipoprotein (LDL) apo B (apo B-100) and a minor band with the appropriate mobility of the lymph chylomicron apo B (apo B-48). The reactivity of monoclonal antibodies directed against opportunely selected human apo B suggests that the protein with the lower molecular weight corresponds to apo B-48. This finding was confirmed by using immunoadsorbants and affinity chromatography with monoclonal antibodies that react only with apo B-100. Through this method, VLDL were separated into two fractions: one that had only apo B-100 and one with both apo B-100 and apo B-48. Hepatic and intestinal VLDL may constitute different particles. The ratio of apo B-100 to apo B-48 in VLDL decreased as the mass of fasting plasma VLDL increased. This may improve our understanding of the metabolism of triglyceride-rich lipoproteins. The investigation of the new subspecies of apo B may be relevant in understanding the atherogenetic process and better defining the hyperlipidemic states. PMID- 3966910 TI - Regional compliance of brachial artery and saline infusion in patients with arteriosclerosis obliterans. AB - Simultaneous brachial artery pressure and blood flow measurements were made in 15 patients with arteriosclerosis of the lower limbs (AOLL) and in controls of the same age and sex. Blood flow was evaluated by a pulsed Doppler device with a double-transducer probe. From analysis of the pressure-flow curves during diastole, regional arterial compliance (RAC) was determined by using as a model of the forearm arterial tree a system of tubes, each with a storage capacity, in series with the arteriolar resistance vessels. In AOLL patients, RAC was significantly reduced (102 +/- 13 vs 173 +/- 14.10(-4) ml/mm Hg, p less than 0.01), and systolic pressure was significantly increased. After saline infusion, systolic pressure continued to increase and arterial compliance, to decrease; brachial blood flow did not change. Study of the baroreflex sensitivity in AOLL patients under basal conditions indicated that a higher pulse pressure was required to obtain the same heart rate as in the controls. The study provided evidence that in AOLL patients: 1) compliance was reduced in the brachial artery (a regional circulation with no clinical evidence of arterial occlusion); 2) an increase in systolic pressure resulted from the decreased arterial compliance; and 3) saline infusion exaggerated the observed reduction in arterial compliance and increase in systolic pressure. PMID- 3966912 TI - Serum lipoprotein and lipoprotein lipase in overweight, type II diabetics during and after supplemented fasting. AB - Poorly controlled, obese, Type II diabetics were studied before, during, and 3 months after a weight reduction program that used supplemented fasting (200 kcal or 0.9 MJ/day). During fasting, the very low density lipoprotein (VLDL) triglycerides (TG) decreased, as did the adipose tissue lipoprotein lipase (AT LPLA) and skeletal muscle lipoprotein lipase (SM-LPLA) activities. Three months later VLDL TG remained low (-59%), while high density lipoprotein cholesterol was higher (+11%) and blood glucose control improved compared with values on admission. The fractional removal rate (K2) at the i.v. fat tolerance test (IVFTT) and the SM-LPLA were unchanged, while AT-LPLA (expressed per gram of wet weight, but not as whole-body AT-LPLA) increased by 25%. There were no significant correlations between AT-LPLA and the lipoprotein TG concentrations or K2-IVFTT, although there were significant positive correlations between SM-LPLA and K2-IVFtt, both on admission and after body weight stabilization. This may indicate that SM-LPLA is more directly related to the capacity to remove lipoprotein TG, at least in obese diabetic patients. K2-IVFTT was inversely correlated to the VLDL TG and cholesterol concentrations both before and 3 months after fasting. Because both SM-LPLA and K2-IVFTT were unchanged after body weight reduction, the change in VLDL TG may be mainly due to a reduced rate of lipoprotein synthesis. PMID- 3966913 TI - Salvage of uridine in the mouse. Effect of uridine phosphorylase pretreatment. AB - Salvage of circulating nucleosides provides an alternative to de novo synthesis of nucleotides and may modify response to antimetabolites. We have investigated treatment with uridine phosphorylase as a means of inhibiting salvage of uridine in vivo. Examination of the metabolism of intravenous [3H] uridine in mice revealed that 30-40% was salvaged by conversion to uracil nucleotides and the remainder was catabolized. In contrast, less than 0.3% of intravenous [3H]uracil was salvaged. Addition of partially purified bacterial uridine phosphorylase to plasma produced a rapid phosphorolysis of uridine. In vivo, 1.5 hr after intravenous injection of 9 units of uridine phosphorylase, plasma activity (1.3 units/ml) was 65-fold greater than that of control mice. Pretreatment with uridine phosphorylase prior to administration of [3H]uridine produced a marked (65-92%) but incomplete inhibition of salvage of uridine in all tissues examined. The dose required to produce 50% inhibition of uridine salvage at 1 hr was 2 to 2.5 units/mouse. The inhibition of nucleoside salvage by this approach may permit an evaluation of the role of nucleoside salvage in the supply of cellular nucleotides and the effects of concurrent inhibition of de novo and salvage pathways for nucleotide synthesis. PMID- 3966914 TI - Evaluation of the stoichiometry and strength of chloroquine-porphyrin interactions by difference spectroscopy. PMID- 3966915 TI - Aging and stereospecific reactivation of mouse erythrocyte and brain acetylcholinesterases inhibited by soman. PMID- 3966916 TI - Genetic polymorphism in drug oxidation: in vitro studies of human debrisoquine 4 hydroxylase and bufuralol 1'-hydroxylase activities. AB - A sensitive, specific assay utilizing fluorescence-HPLC has been developed for determining the 1'-hydroxylation of bufuralol by human liver. The 1' hydroxylation of the isomers of bufuralol varied threefold, both the Vmax and the Km for the (+) isomer being greater than the corresponding values for the (-) isomer. Debrisoquine was a competitive inhibitor of the 1'-hydroxylation of both isomers and of the racemate of bufuralol. Both isomers and the racemate of bufuralol were competitive inhibitors of debrisoquine 4-hydroxylase activity. The competitive inhibition of debrisoquine and bufuralol of each other's metabolism, together with the similarity in the values for Km and Ki, support the conclusion that the same form of cytochrome P-450 catalyses these two reactions. PMID- 3966917 TI - Transport of cefadroxil, an aminocephalosporin antibiotic, across the small intestinal brush border membrane. AB - The transport characteristics of cefadroxil, an aminocephalosporin antibiotic, across the brush border membrane of rat small intestine were investigated by a rapid filtration technique. The uptake of cefadroxil was not affected by Na+ gradient, suggesting the absence of a cotransport system between cefadroxil and Na+ in the brush border membrane. The uptake was slightly inhibited by HgCl2 pretreatment and stimulated by the countertransport effect, where cyclacillin played a role as an elicitor. These results suggest the existence of a carrier mediated transport system for cefadroxil in the brush border membrane, which is shared with cyclacillin. Papain treatment increased the specific transport activities for the antibiotic. This may be the first step of purification of the cefadroxil transport carrier. PMID- 3966918 TI - Induction of liver cytochrome P-450 in mice by warfarin. Comparison of warfarin-, phenobarbitone-, and cobalt-induced hepatic microsomal protein patterns by PAGE after partial purification on octyl-sepharose CL-4B. AB - A rapid method is presented to separate mouse liver cytochrome P-450 from other components of the microsomal monooxygenase system and to increase specific activity by hydrophobic interaction chromatography on Octyl-Sepharose CL-4B by a factor of between 3.8 and 5.3. In addition it is shown that varieties of cytochrome P-450 can be separated from each other by Octyl-Sepharose CL-4B. After oral applications of 120 mg/kg warfarin once daily for three days SDS-PAGE analysis of the partially purified cytochrome P-450 fraction revealed a protein pattern in the 50 Kd region that is practically indistinguishable from that after conventional phenobarbitone pretreatment. On the other hand, cobalt pretreatment results in a different pattern that is distinguished from that of normals as well as from that of phenobarbitone- and warfarin-pretreated mice. From these results in conjunction with the previous finding of increased drug metabolic activity after warfarin pretreatment it is concluded that warfarin elicits phenobarbitone like induction of the hepatic monooxygenases in mice. PMID- 3966919 TI - Inhibition by chlorpromazine of thyroxine modulation of flavin metabolism in liver, cerebrum and cerebellum. AB - In livers of adult rats that have been treated with thyroxine, the rate of incorporation of radiolabeled riboflavin into both flavin adenine dinucleotide (FAD) and FAD covalently attached to specific apoflavoenzymes was enhanced markedly. By contrast, thyroxine diminished riboflavin incorporation into FAD in cerebrum and cerebellum but continued to enhance incorporation into the covalently bound fraction of FAD. Diminished net incorporation of riboflavin into FAD in brains of adult rats may reflect increased utilization of this fraction for covalent attachment into specific apoflavoenzymes rather than down regulation of the FAD biosynthetic enzymes, flavokinase and FAD pyrophosphorylase, inasmuch as covalent attachment of FAD occurs subsequent to the formation of FAD. The psychotropic drug, chlorpromazine, over a wide dose range, exerted an inhibitory effect on both incorporation of riboflavin into FAD and the utilization of FAD for incorporation into covalently bound flavoenzymes in liver, cerebrum, and cerebellum. Thus, chlorpromazine inhibition of FAD metabolism occurred regardless of the direction of the thyroxine effect and was compatible with an observed inhibitory effect by this drug upon the flavin biosynthetic enzymes. PMID- 3966920 TI - Inactivation by acivicin of carbamoyl-phosphate synthetase II of human colon carcinoma. AB - The effect of the anti-tumor, anti-glutamine drug acivicin, L-(alpha S,5S)-alpha amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid, was determined on the activity of the rate-limiting enzyme of de novo pyrimidine biosynthesis, carbamoyl phosphate synthetase II (glutamine-hydrolyzing) (EC 6.3.5.5), in human colon carcinoma. The synthetase II activity in human colon carcinoma was elevated 2- to 3-fold over values of the normal colon mucosa, and the substrate kinetic constants were similar for the enzyme in normal and neoplastic colon. The Km for glutamine was 17 microM (colon carcinoma) and 23 microM (normal mucosa), whereas the Km for ATP was 2.1 and 1.7 mM in tumor and mucosa respectively. The synthetase II activity in colon carcinoma was inhibited to a similar extent by UMP, UDP and UTP (36-41%). The three uracil nucleotides were also equally effective in inhibiting the enzyme from normal mucosa (39-46%). Both enzymes were activated by PRPP (63 and 57%) in mucosa and carcinoma respectively. Acivicin in vitro selectively inactivated the glutamine-dependent synthetase II from human colon carcinoma, and it did not affect the ammonia-dependent activity. The acivicin inactivation constant (Kinact) was 100 microM, and the minimum inactivation half-time (T) was 0.7 min. Acivicin most likely exerts its effect against human colon synthetase II by acting as an active site directed affinity analogue of L-glutamine. PMID- 3966921 TI - The involvement of iron and lipid peroxidation in the pathogenesis of HCB induced porphyria. AB - Hexachlorobenzene (HCB) induces a porphyria characterized by a diminished activity of the enzyme uroporphyrinogen decarboxylase (URO-D), presumably due to inactivation by reactive metabolites of HCB. We studied the effect of iron on HCB porphyria in female rats, to determine whether the iron dependent process of lipid peroxidation was involved in the pathogenesis of porphyria. We showed that malondialdehyde formation is increased in rat liver tissue of porphyric rats and that high molecular weight proteins due to cross-linking are formed. We also showed that the induction of porphyria by HCB is dependent on the presence of iron. Our findings suggest that lipid peroxidation is involved in the toxicity of HCB and that the aggravating effects of iron on HCB are mediated by lipid peroxidation. PMID- 3966922 TI - Studies on the intracerebral metabolism of anticonvulsant drugs--II. Disposition of carbamazepine in the isolated perfused rat brain. AB - Carbamazepine (CBZ) was perfused (85 nmoles/ml) through the isolated brains of rats. After 2 hr the mean regional concentrations of the drug were between 170 and 234 nmoles/g wet weight. The total brain content of CBZ was 390 nmoles. During perfusion 82 nmoles epoxycarbamazepine (E-CBZ) were formed, most of which were found in perfusion medium. Tissue levels of E-CBZ were between 0.3 and 2.8 nmoles/g wet weight. No dihydroxycarbamazepine (DH-CBZ) could be found. Pretreatment of the rats with phenobarbital neither influenced the uptake of CBZ into the brains nor increased the formation of E-CBZ significantly. PMID- 3966923 TI - Antitumour imidazotetrazines--VIII. Uptake and decomposition of a novel antitumour agent mitozolomide (CCRG 81010; M and B 39565; NSC 353451) in TLX5 mouse lymphoma in vitro. AB - The uptake and incorporation of 8-carbamoyl-3-(2-chloroethyl)(6-14C-imidazo)[5,1 d]-1,2,3,5-tetrazin+ ++-4-(3H)- one (Mitozolomide) into TLX5 mouse lymphoma cells has been studied in vitro. Uptake was rapid, reaching a cell/medium distribution of approximately unity in 1 min at 37 degrees and 10 min at 4 degrees, directly proportional to drug concentration and was unaffected by metabolic inhibitors. These results are consistent with a simple diffusion mechanism. No difference in uptake was observed between drug sensitive and resistant TLX5 lymphoma cells. Cellular radioactivity was found to be progressively accumulated into acid insoluble material. Acid hydrolysis of this precipitate followed by hplc analysis of the DNA and RNA bases showed that the radioactivity was associated solely with adenine and guanine bases. Mitozolomide was unstable in tissue culture medium and over a 24 hr period about 80% of the drug was converted into 5-aminoimidazole-4 carboxamide (AIC). Non-radioactive AIC suppressed the incorporation of radioactivity into nucleic acids, but had no effects on the initial rate of uptake of mitozolomide into the cell. These results suggest that the radioactivity in nucleic acids arises as a result of salvage of AIC, formed by intracellular decomposition of mitozolomide. PMID- 3966924 TI - Inhibition by dihydropyridine class calcium channel blockers of tumor cell platelet-endothelial cell interactions in vitro and metastasis in vivo. AB - Three calcium channel blockers of the dihydropyridine class were tested in vitro for their effects on tumor cell-platelet-endothelial cell interactions and in vivo for antimetastatic properties. Felodipine, nimodipine and nifedipine inhibited tumor cell-induced platelet aggregation in vitro in a dose-dependent manner. These compounds also inhibited platelet-enhanced tumor cell adhesion to endothelial cells in vitro. Lung colony formation ("experimental" metastasis) and spontaneous pulmonary metastasis were inhibited by felodipine, nimodipine and nifedipine. From the present studies on three calcium channel blockers of the dihydropyridine class we hypothesize that calcium channel blockers may represent a new generic class of antimetastatic agents. PMID- 3966925 TI - In vivo inactivation of formylglycinamidine ribonucleotide synthetase in rat hepatoma. AB - The antitumor drug acivicin, L-(alpha S,5S)-alpha-amino-3-chloro-4,5-dihydro-5 isoxazoleacetic acid, irreversibly inactivated in vivo formylglycinamidine ribonucleotide synthetase (FGAM synthetase, EC 6.3.5.3) in transplantable rat hepatoma 3924A while the activity in host liver remained unchanged. At acivicin doses of 1.0 and 5.0 mg/kg body weight, enzyme activity in the hepatoma decreased to 26 and 5%, respectively, after 2 hr. The activity of the in vivo inactivated hepatoma 3924A enzyme could not be restored by gel filtration or 40 hr of dialysis. In the absence of L-glutamine, acivicin in vitro inactivated both liver and hepatoma FGAM synthetase in a time-dependent fashion, with an inactivation constant Kinact = 66 microM and a minimum inactivation half-time T = 1.0 min. In the presence of L-glutamine, competitive inhibition was observed with a Ki = 5 microM. Protection against in vitro inactivation was observed in the presence of 1 mM L-glutamine, suggesting that L-glutamine concentrations are important in the selective toxicity of acivicin on hepatoma cells in vivo. Irreversible inhibition of FGAM synthetase by acivicin is consistent with the view that this antibiotic is an active site-directed affinity analog of L-glutamine and indicates that this enzyme is a sensitive target of acivicin action. PMID- 3966926 TI - Chloroform-induced alteration of glutathione S-transferase activity. AB - The effect of chloroform treatment on the hepatic glutathione S-transferases was studied in phenobarbital-treated rats. The apparent isozymic composition of glutathione S-transferases in hepatic cytosol was changed after chloroform treatment. Glutathione S-transferases AA, A, B, C, and D + E were observed in hepatic cytosol from untreated rats; in contrast, the catalytic activity associated with basic glutathione S-transferases, such as AA, A, B, and C, decreased with time after chloroform treatment. Glutathione S-transferase B was not detectable 2 hr after chloroform treatment, and glutathione S-transferases AA and C were scarcely detectable after 5 hr. Twenty-four hours after chloroform treatment, glutathione S-transferases A and C were clearly detectable as was D + E and a small amount of B. Hepatic cytosolic glutathione S-transferase activity was decreased by chloroform treatment, and reached a minimum at 5 hr after treatment. Corresponding to the decrease of hepatic cytosol glutathione S transferase activity, serum glutathione S-transferase activity was elevated maximally 5 hr after chloroform treatment and returned to almost normal by 24 hr. Treatment of rats with SKF 525-A or cysteine inhibited the chloroform-induced elevation of serum glutathione S-transferase activity. The chromatographic properties of the glutathione S-transferases present in serum were similar to glutathione S-transferase D + E. Furthermore, after incubation of partially purified cytosolic glutathione S-transferases with chloroform in the presence of hepatic microsomes and NADPH, only transferase D + E was detected. The addition of bilirubin to partially purified cytosolic glutathione S-transferase decreased the basic character of glutathione S-transferases B and C. In conclusion, chloroform caused a release of hepatic cytosolic glutathione S-transferases into serum. Both the active metabolite of chloroform, which was produced by the microsomal cytochrome P-450 system, and bilirubin, which was increased by chloroform treatment, played roles in altering the properties of the glutathione S-transferases. PMID- 3966927 TI - Therapeutic efficacy of asparaginase encapsulated in intact erythrocytes. AB - Asparaginase has been encapsulated in intact erythrocytes by a gentle loading technique. The loaded cells were found to survive removal by the recticuloendothelial system when returned to the circulation of mice. In addition the enzyme removed all detectable asparagine from the plasma in vivo for at least two weeks after the injection of the loaded cells. In vitro evidence suggested that the asparagine entered the cell and was metabolised by the loaded enzyme in situ. No evidence was found to suggest that the enzyme left the cell. When the encapsulated asparaginase was tested against the 6C3HED tumour in C3H mice the encapsulated preparation was superior to the free enzyme in treating the tumour and was the only treatment to produce 'cured' mice. Encapsulated asparaginase also lowered glutamine levels both in vivo and in vitro. The possibility that LDH virus was responsible for the excellent results obtained with the encapsulated enzyme was investigated and eliminated. PMID- 3966928 TI - The development of tolerance to antilipolytic agents in rats. AB - The development of tolerance to the action of certain antilipolytic agents has been investigated in vivo in rats. Tolerance to oral nicotinic acid developed during twice daily dosing for 4 days at 100 and 250 mg/kg but not at 10, 25 or 50 mg/kg. Tolerance induced by high doses of nicotinic acid was no longer detectable after a further week without treatment. Tolerance developed to a dose of 10 mg/kg nicotinic acid when dosing was repeated at hourly intervals for up to 6 hr. Rats made tolerant to nicotinic acid also became tolerant to both 5-methylpyrazole-3 carboxylic acid and to pyridyl-3-tetrazole and rats made tolerant to these antilipolytic agents were also tolerant to nicotinic acid. Rats made tolerant to nicotinic acid still responded to the antilipolytic activity of the prostaglandin analogue, sulprostone. These results suggest that nicotinic acid, pyridyl-3 tetrazole and 5-methylpyrazole-3-carboxylic acid act through a common mechanism or receptor and that the development of tolerance is associated with this receptor or the mechanism by which it is linked to adenylate cyclase. PMID- 3966929 TI - The development of tolerance to antilipolytic agents by isolated rat adipocytes. AB - Using an isolated rat epididymal adipocyte system we have studied the development of tolerance to and cross-tolerance between nicotinic acid, 5-methylpyrazole-3 carboxylic acid and pyridyl-3-tetrazole. Preincubating isolated adipocytes with any one of these compounds results in a reduction of the antilipolytic activity of that compound when the cells are exposed to a subsequent challenge dose. Furthermore, preincubation with nicotinic acid, 5-methylpyrazole-3-carboxylic acid or pyridyl-3-tetrazole results in a reduction of the antilipolytic response to challenge with either of the other two compounds. Preincubation of isolated adipocytes with nicotinic acid does not affect the subsequent antilipolytic activity of the PGE2 analogue, sulprostone. Preincubation with sulprostone does not lead to the development of tolerance to its own antilipolytic actions. The results obtained from these studies suggest that nicotinic acid, 5-methylpyrazole 3-carboxylic acid and pyridyl-3-tetrazole exert their antilipolytic activity via a common biochemical pathway which is distinct from that mediating the antilipolytic activity of prostaglandins. These findings also indicate that the development of tolerance occurs prior to the involvement of adenylate cyclase in lipolysis. PMID- 3966930 TI - Stereospecific in vitro N-methylation of nicotine in guinea pig tissues by an S adenosylmethionine-dependent N-methyltransferase. PMID- 3966931 TI - Dopamine microinjection into the nucleus accumbens: correlation between metabolism and behavior. PMID- 3966932 TI - Different effects of acute and chronic diabetes mellitus on hepatic drug metabolism in the rat. PMID- 3966933 TI - Ibuprofen may induce meningitis in (NZB X NZW)F1 mice. PMID- 3966934 TI - Evaluation of an educational program for primary care practitioners, on the management of osteoarthritis. PMID- 3966935 TI - In vitro synthesis of low molecular weight IgM in rheumatoid arthritis. PMID- 3966936 TI - Synovial fluid lymphocyte subpopulations in the polyarthritis of immunoblastic lymphadenopathy. PMID- 3966937 TI - Reproducibility of multiple-observer scoring of radiologic abnormalities in the hands and wrists of patients with rheumatoid arthritis. AB - Forty-one coded radiographic films from 16 patients with rheumatoid arthritis were read by 13 observers, using 4 different methods for scoring abnormalities. Although absolute scores differed widely among individual observers, correlation coefficients were greater than 0.850 for approximately 2 of 3 comparisons. When films were ranked, using the median rank of all readers, 72% of individual ranks were within 10% of the median ranks. Among serial films on individual patients, 92% of comparisons between early and late films were interpreted as demonstrating progression of abnormalities when mean standardized scores showed an increase in scores of 15 units or greater. Films with lesser changes were interpreted inconsistently. This study shows good general agreement among readers in scoring radiologic abnormalities of hands and wrists, when applied to a film set showing a broad spectrum of severity, and defines the sensitivity of radiologic detection of disease progression. PMID- 3966938 TI - Quantitative histologic studies on the pathogenesis of periarticular osteoporosis in rheumatoid arthritis. AB - The pathogenesis of periarticular osteopenia in rheumatoid arthritis (RA) was investigated by histomorphometry on juxtaarticular bone removed during joint surgery. Twenty areas from 12 RA patients were compared with 14 areas from 6 osteoarthritis (OA) patients. There was no difference between the 2 groups in the percent of total bone volume. However, increased bone formation was suggested by an increase in the percent of active osteoid surface in RA compared with that in OA. Bone resorption was also increased in RA, as evidenced by increases versus OA in percent total resorptive surface, percent active resorptive surface, and number of osteoclasts. These results demonstrate increased turnover of bone in RA, especially in the resorptive phase of the periarticular trabecular bone. It is proposed that soluble factor(s) synthesized in the contiguous rheumatoid synovium may be transferred to the periarticular bone space, stimulating osteoclasts to resorb bone. PMID- 3966939 TI - Therapeutic value of graded aerobic exercise training in rheumatoid arthritis. AB - Women with rheumatoid arthritis performed 1 of 3 low intensity aerobic exercise protocols (15, 25, and 35 minutes) 3 times per week for 12 weeks. A nontraining group served as controls. All exercise groups improved their aerobic capacity, exercise time, and joint counts. Subjects described improvement in activities of daily living and reduced joint pain and fatigue. Exercise duration up to 35 minutes can be therapeutic, and as little as 15 minutes of exercise 3 times/week is sufficient to improve aerobic capacity in rheumatoid arthritis patients with severe limitations. PMID- 3966940 TI - The incidence of systemic lupus erythematosus in Baltimore, Maryland, 1970-1977. AB - The incidence of systemic lupus erythematosus, based on first hospital discharge diagnosis, in Baltimore, Maryland for the years 1970 through 1977 was determined for individual sex-race groups and the total population. Age-specific incidence rates were consistently highest among black females and lowest among white males: rates for white females exceeded those for black males through age 54, but then declined for ages greater than or equal to 55. Mean age at diagnosis was significantly lower for black females versus white females (35.5 versus 41.7 years, P = 0.005) and for all females versus all males (37.2 versus 44.2 years, P = 0.012). There were no temporal trends noted in yearly age-adjusted incidence rates during the 8-year study period. The overall population incidence of systemic lupus erythematosus was 4.6 per 100,000 per year, representing a twofold increase over a comparable study done in New York City 15 years ago. PMID- 3966941 TI - Beneficial effect of intravenous cyclophosphamide and oral prednisone on D penicillamine-associated bronchiolitis obliterans. PMID- 3966942 TI - Isolation of echovirus type 11 from synovial fluid in acute monocytic arthritis. PMID- 3966943 TI - A survey of audiological services within the school system. PMID- 3966944 TI - Institutionalized people: can we do a better job? PMID- 3966946 TI - Computed tomographic appearances of cardiac amyloidosis. PMID- 3966945 TI - Management of primary pulmonary hypertension. PMID- 3966947 TI - Prognostic significance of left ventricular ejection fraction after acute myocardial infarction. A bedside radionuclide study. AB - The prognostic significance of left ventricular ejection fraction measurements obtained at the bedside was assessed in 171 patients as soon as possible after acute myocardial infarction. Ejection fraction was measured with a radionuclide first pass portable probe method within a mean of 24 hours of the onset of major symptoms. The results were related prospectively to the subsequent incidence of ventricular fibrillation in hospital, and to hospital and postdischarge deaths in a mean follow up period of 15 (range 9-21) months. All eight episodes of primary ventricular fibrillation, all 12 deaths due to pump failure in hospital, and also 12 out of 13 postdischarge deaths occurred in that minority of 81 patients whose initial postinfarction left ventricular ejection fraction was less than 0.35. Multivariate correlation with clinical, enzymatic, and electrocardiographic indicators of myocardial infarction showed that the prognostic significance of these indicators could largely be explained by their association with low left ventricular ejection fractions. Left ventricular ejection fraction measured within the initial 24 hours after acute myocardial infarction predicts prognosis throughout the subsequent year. PMID- 3966948 TI - Myocarditis confirmed by biopsy presenting as acute myocardial infarction. AB - Two cases of acute myocardial infarction occurred in association with myocarditis, which was confirmed by biopsy. The first patient suffered an anteroseptal and the second patient an inferior wall myocardial infarction shortly after an acute viral illness. In both patients, coronary angiography showed normal coronary arteries, and right ventricular endomyocardial biopsy confirmed myocarditis. Histological abnormalities attributable to ischaemic heart disease were absent. The first patient's condition became stable after immunosuppressive treatment. Myocarditis resolved spontaneously within three months in the second patient. Coronary artery spasm and myocardial involvement with a systemic disease were unlikely. Endomyocardial biopsy in patients with acute myocardial infarction and normal coronary arteries may be useful in identifying myocarditis associated with myocardial necrosis. Myocarditis in acute myocardial infarction in the absence of coronary artery obstruction has not previously been documented during life. PMID- 3966949 TI - Is there an indication for coronary angiography in patients under 60 years of age with no or minimal angina pectoris after a first myocardial infarction? AB - Coronary angiography and exercise stress tests were performed in 91 consecutive patients under 60 years of age having either no or only mild angina pectoris with or without medication after a first myocardial infarction. Nine (10%) patients had angiographic high risk coronary artery disease defined as three vessel disease, left main stenosis, or proximal stenosis of the left anterior descending artery. Eighteen patients had a positive electrocardiographic exercise stress test including eight of the nine patients with angiographic high risk coronary artery disease. It may be concluded therefore that coronary angiography to detect high risk coronary artery disease in this group can be restricted to patients with a positive exercise stress test. This policy would obviate the need for about 80% of coronary angiograms performed in this age group. PMID- 3966950 TI - Comparative recognition of left ventricular thrombi by echocardiography and cineangiography. AB - Studies performed in 47 patients, 11 of whom underwent surgery for aneurysmectomy and 36 of whom underwent cardiac transplantation, were reviewed to assess the diagnostic accuracies of cross sectional echocardiography and cineangiography in detecting left ventricular mural thrombi and the effect of anticoagulation treatment on the incidence of such thrombi. Cross sectional echocardiography in 37 patients and cineangiography in 26 (16 patients were examined by both methods) were analysed independently by sets of two observers experienced in the respective methods. All four observers were blinded to the pathological or surgical findings regarding mural thrombus. Mural thrombus was confirmed by pathological investigation in 14 of 47 (30%) cases; 11 of these 14 patients had intra-aneurysmal thrombi. The negative predictive value was quite good for both methods, but cross sectional echocardiography had a superior positive predictive value. This was due both to detailed soft tissue resolution by cross sectional echocardiography and to overdetection of mural thrombi by cineangiography in cases of aneurysms without mural thrombi. Mural thrombi were present in three of 20 patients with preceding anticoagulation and in 10 of 19 patients without anticoagulation. The results emphasise that cross sectional echocardiography is more reliable than cineangiography in recognising thrombi. PMID- 3966951 TI - Reduction of infarct size. An attractive concept: useful--or possible--in humans? PMID- 3966952 TI - Transposition of the great arteries and narrowing of the aortic arch. Emphasis on right ventricular characteristics. AB - Of 279 patients with transposition of the great arteries, 14(5%) had narrowing of the aorta, including local coarctation (6), isthmus hypoplasia (6), isthmus atresia (1), and kinking of the aorta (1). There were six deaths in 10 surgically treated patients; in addition four patients died before operation. Two of the four survivors had a subpulmonary malalignment ventricular septal defect with angiocardiographic narrowing of the right ventricular outflow tract, two had evidence of redundant muscle tissue obstructing the right ventricular outflow tract. Necropsy showed the presence of anatomical right ventricular outflow tract or inflow tract obstruction or both in all 10 cases. Outflow tract obstruction was represented by anterior displacement of the infundibular septum and ventriculoinfundibular fold (in hearts with a subpulmonary malalignment ventricular septal defect) or by redundant muscle tissue; inflow tract obstruction was represented by hypoplasia of the tricuspid valve. It is concluded that the combination of transposition of the great arteries and narrowing of the aorta is always accompanied by right ventricular outflow or inflow tract obstruction or both; the right ventricular abnormalities are probably responsible for the presence of the aortic arch anomalies by reducing aortic flow during morphogenesis. Successful surgical treatment of this complex anomaly is feasible in selected cases. PMID- 3966953 TI - Aneurysmal dilatation of left atrial appendage diagnosed by cross sectional echocardiography and surgically removed. AB - An isolated aneurysmal dilatation of the left atrial appendage was found in an 18 year old girl who presented with atrial fibrillation and an unusual cardiac shadow on routine chest radiographs. The diagnosis was made by cross sectional echocardiography. The giant appendage was excised to remove the risk of systemic embolism and the need for life long anticoagulation. PMID- 3966954 TI - Proceedings of the British Cardiac Society. Abstracts. PMID- 3966955 TI - Quantitative influence of serum creatine kinase isoenzyme MB estimated infarct size and other prognostic variables on one year mortality after acute myocardial infarction. AB - The aim of the present study was to determine the strength of the relation between serum creatine kinase isoenzyme MB estimated infarct size, other prognostic variables, and mortality after acute myocardial infarction. Serum creatine kinase MB estimated infarct size and 11 other prognostic variables were obtained in 317 patients. By Cox regression analysis the prognostic variables significantly related to mortality were identified: congestive heart failure, estimated infarct size, New York Heart Association class, number of previous infarcts, and age. Congestive heart failure and estimated infarct size were most strongly related to mortality. The relation between the prognostic variables and mortality was non-linear, and the variables influenced each others' relation to mortality. A prognostic index based on all five prognostic variables provided the best means of estimating the probability of survival after acute myocardial infarct. Neither serum creatine kinase MB estimated infarct size nor any of the other prognostic variables had a significant independent influence on mortality, and the probability of survival was high in the absence of any of the prognostic variables in combination. PMID- 3966956 TI - Doppler echocardiographic measurement of cardiac output using the mitral orifice method. AB - Cardiac output was determined in 20 patients with various cardiac conditions by measuring the cross sectional area of the mitral orifice by echocardiography and the transmitral flow by the Doppler technique. Cardiac output was calculated by multiplying the corrected mitral orifice area by the maximum diastolic velocity integral recorded by the pulsed mode. The results were compared with that obtained by the Fick method. The correlation for cardiac output by the two techniques was high in the whole group, particularly in patients without mitral regurgitation. There was also a good correlation for stroke volume determined by the two methods. Cardiac output was significantly overestimated by the continuous mode and in patients with mitral regurgitation. These results show that the mitral orifice method provides a new and reliable approach to the non-invasive measurement of cardiac output. PMID- 3966957 TI - Successful treatment of atrial tachycardias with flecainide acetate. AB - Intravenous flecainide successfully terminated atrial tachycardia in three patients. Maintenance treatment with oral flecainide prevented the recurrence of tachycardia for up to three years. These results suggest an additional use for flecainide which should be further explored. PMID- 3966958 TI - Tetralogy of Fallot with major aortopulmonary collateral arteries. AB - The clinical features of eight patients with tetralogy of Fallot and major aortopulmonary collateral arteries were determined and found to be usually unhelpful in differentiating such patients from those with pulmonary atresia with ventricular septal defect. The point of connection between the pulmonary and collateral arteries could usually be demonstrated at cineangiography by observing washin and washout between the two systems. The central pulmonary arteries connected with the entire pulmonary vascular bed in the five patients in whom the anatomy of the pulmonary circulation was clearly demonstrated and were thought to do so in the remaining three patients also. In six out of eight patients only one collateral artery connected with each hilar pulmonary artery. These findings suggest that the anatomy of the pulmonary circulation in patients with tetralogy of Fallot and major aortopulmonary collateral arteries is usually less complex than in pulmonary atresia with ventricular septal defect, making the outlook for complete repair more hopeful. The major determinant of successful complete repair appears to be pulmonary arterial size. Early palliative surgery to increase pulmonary blood flow is recommended to encourage normal growth of the central and intrapulmonary arteries. PMID- 3966959 TI - Submaximal exercise testing early after myocardial infarction. Difficulty of predicting coronary anatomy and left ventricular performance. AB - Impaired left ventricular function and extensive coronary artery disease are important determinants of prognosis after acute myocardial infarction. The ability of clinical and predischarge submaximal exercise test variables to predict multivessel coronary artery disease and impaired left ventricular function was assessed in 62 survivors of acute myocardial infarction. Abnormal exercise blood pressure response and short exercise performance were predictors of multivessel disease, but exercise induced ST segment changes and clinical variables were not. Q wave infarction, high grade Killip classification, and exercise induced ST segment elevation predicted statistically significant impairment of resting left ventricular function, whereas other clinical and exercise test variables did not. Exercise induced ST segment changes were therefore of little value in detecting extensive coronary disease, although exercise induced ST elevation was an indicator of poor resting left ventricular function. Although abnormal exercise haemodynamics may detect extensive coronary artery disease, other physiological markers of reversible myocardial ischaemia are probably necessary to plan optimal management in these patients. PMID- 3966961 TI - Unruptured right coronary sinus to left ventricle aneurysm diagnosed by cross sectional echocardiography. AB - A 37 year old Chinese man presenting with features of chest infection was diagnosed as having severe aortic regurgitation. Cross sectional echocardiography showed an intact right coronary sinus of Valsalva aneurysm, which protruded into the left ventricle. The changes in appearance of the aneurysm during the cardiac cycle were recorded by cross sectional echocardiography. The opening of the aneurysm was successfully closed and the aortic valve replaced with a mechanical prosthesis. PMID- 3966960 TI - Morphology of ambulatory ST segment changes in patients with varying severity of coronary artery disease. Investigation of the frequency of nocturnal ischaemia and coronary spasm. AB - The frequency and magnitude of objectively determined myocardial ischaemia during normal daily activities of patients with varying severity of coronary artery disease are unknown. Furthermore, the incidence of nocturnal resting myocardial ischaemia and frequency of coronary spasm in patients with normal coronary arteries and chest pain are also not known. One hundred consecutive patients with chest pain referred for coronary angiography were therefore investigated with exercise testing and ambulatory ST segment monitoring. Fifty two of 74 patients with significant coronary artery disease and six of 26 with no significant coronary narrowing had episodes of ST segment change during 48 hours of ambulatory monitoring. Two patients, one with normal coronary arteries and localised spasm and one with three vessel disease, had episodes of ST segment elevation, whereas all other patients had episodes of ST segment depression. The frequency, duration, and magnitude of ST segment changes were greater in patients with more severe types of coronary artery disease. Thus more than six episodes of ST segment change per day occurred in patients with two or three vessel disease or left main stem stenosis and in the only patient with coronary spasm and normal coronary arteries. Nocturnal ischaemia occurred in 15% of patients with coronary artery disease and was almost an invariable indicator of two or three vessel coronary artery disease or left main stem stenosis. Episodes of ST segment change occurred most commonly during the morning hours and least commonly during the night, in parallel with changes in basal hourly heart rates. The heart rate at the onset of ST segment change tended to be lower in patients with coronary artery disease than in those with normal coronary arteries. The duration of exercise to ST segment depression tended to be shorter in patients with more severe disease, but it could not predict patients with nocturnal myocardial ischaemia, left main stem stenosis, or coronary spasm, whereas ambulatory ST segment monitoring was able to identify most of these patients. PMID- 3966962 TI - Myocardial infarction with normal coronary arteries and factor XII deficiency. AB - A 17 year old girl had a myocardial infarction. Three days later coronary angiography showed an occlusive thrombus in the circumflex and anterior descending arteries. The coronary arteries themselves appeared to be normal, and this was confirmed at repeat angiography three months later. Tests of haemostasis showed a deficiency of factor XII. PMID- 3966963 TI - Ischaemic brain damage: the role of excitatory activity and of calcium entry. PMID- 3966964 TI - Pancreatic carcinogenesis-enhancement by cholecystokinin in the hamster nitrosamine model. AB - The role of the pancreaticotrophic hormone cholecystokinin (CCK) in modifying the pancreatic response to carcinogen has been examined in the hamster-nitrosamine pancreatic cancer model. Exogenous CCK, 30 IDU kg-1, stimulated a maximal pancreatic secretory response when given intravenously and caused hypertrophy and hyperplasia of the pancreas when given subcutaneously over a period of 6 weeks (pancreatic wet weight, mg per 100 g body weight, controls 295.6 +/- 61; CCK treated 466.4 +/- 77, P less than 0.001). When the same dose of CCK was given to animals receiving N-nitrosobis (2-oxopropyl)amine (BOP; 5 mg kg-1 weekly) there was a reduction in latency period and increase in induction rate of tumour development (CCK + BOP vs. BOP alone, 12 animals with tumours vs. 2 at 15 weeks; P less than 0.02). These effects are consistent with CCK acting as a co carcinogen or promoter of pancreatic carcinogenesis in this model. PMID- 3966965 TI - Male breast carcinoma--a review of 301 cases from the Christie Hospital & Holt Radium Institute, Manchester. AB - A series of 301 cases of male breast carcinoma has been analysed; of these, 292 have been treated at The Christie Hospital, Manchester and followed-up for a maximum of 15 years. The mean age was 63 years. The corrected survival was 52%, 38% and 36% at 5, 10 and 15 years respectively. For clinical Stage I, the 15 year survival was 61%. Since 1976, adjuvant Tamoxifen for one year has been administered to patients with operable Stage II (path) and Stage III disease following surgery and radiotherapy. Twenty-three patients so treated have a corrected survival of 55% at 5 years compared to 28% previously. Of 22 tumours assayed for oestrogen and progesterone receptors, 86% showed a positive result. For recurrent/metastatic disease, the drug Tamoxifen is recommended as the treatment of choice. PMID- 3966966 TI - Mesothelioma of the peritoneum during 1967-82 in England and Wales. AB - The time-trend and geographical distribution of mesothelioma of the peritoneum during the years 1967-82 in England and Wales have been studied from the Mesothelioma Register held by the Medical Division of the Health and Safety Executive. Over the 16-year period the annual number of cases registered rose from about 15-20 to about 30-50. Although the number occurring in men was double that in women, the trend was similar for both sexes. There is likely to be some further increase before any improvement due to the recent diminished usage of asbestos is seen. Local Authority areas with raised rates have been identified, and the geographical pattern is similar to that of the distribution of the asbestos-using industry in the past. In both sexes there are high registration rates on the east side of London but, in contrast to mesothelioma of the pleura, a concentration of cases among men in the major ports where shipbuilding and ship repairing were carried out is not so apparent. PMID- 3966967 TI - Free radical detoxifying systems in human colorectal cancer. PMID- 3966968 TI - Selective killing of contaminating human fibroblasts in epithelial cultures derived from colorectal tumours using an anti Thy-1 antibody-ricin conjugate. PMID- 3966969 TI - Cigarette smoking and cancer of the uterine cervix. PMID- 3966970 TI - The validity of the labelling index in tumour studies. AB - The distribution of labelled cells through 5 different mouse tumours was measured after a single injection of [3H]-thymidine [( 3H]-TdR) or [3H]-deoxyuridine [( 3H]-UdR). All the tumours had areas where the percentage of labelled cells (the labelling index, LI) was high and areas where the LI was very low. The total area with a low LI was greater after [3H]-TdR than after [3H]-UdR injection in all 5 tumours. In one of the tumours, carcinoma NT, repeated injections of [3H]-UdR at 2 h intervals caused the areas of high LI to spread, eliminating all areas of low LI in many specimens. When 5-fluorodeoxyuridine (FUdR) was injected, to block de novo DNA synthesis in carcinoma NT, [3H]-TdR was incorporated by many more cells. The LI was increased throughout the tumour and no area had a LI below 20% after FUdR plus [3H]-TdR. After flash-labelling with [3H]-TdR alone, nearly half the tumour had a LI below 20%. We conclude that the labelling seen after FUdR plus [3H]-TdR represented the true distribution of S phase cells in carcinoma NT. Routine flash-labelling with [3H]-TdR or [3H]-UdR left nearly half the S phase cells unlabelled and gave an erroneously low value for the proportion of DNA synthesising cells in the tumour. The results suggest that many tumour cells have very large endogenous nucleotide pools which cannot be flooded by a single injection, even of [3H]-UdR. PMID- 3966971 TI - The cytostatic activity of cultured Kupffer cells. AB - The cytostatic activity of a population of cultured syngeneic and allogeneic Kupffer cells against the K31 tumour cell line has been studied in vitro. The addition of purified populations if Kupffer cells to the tumour cell line resulted in a reduction in the uptake of 125IUdR by the tumour cells. This cytostatic activity was not due to a non-labile supernatant effect. There was a progressive loss of the cytostatic activity of the Kupffer cells as their time in culture increased. The experiments show that Kupffer cells, like other macrophages, possess cytostatic activity in vitro which is not genetically restricted. PMID- 3966972 TI - Effects of the induction of hepatic microsomal metabolism on the toxicity of cyclophosphamide. AB - Cyclophosphamide (CP) administration to rats in a single i.p. dose (200 mg kg-1), while producing urinary bladder toxicity and 30-40% depression of the hepatic microsomal mixed function oxidase (MFO), failed to produce any depression of MFO activities in extrahepatic tissues such as lung, kidney and intestine. Phenobarbital pretreatment of the rats, which is known to enhance hepatic microsomal activation of CP, protected against CP-induced urinary bladder toxicity and the depression of hepatic MFO activities. This protection appears to be, at least in part, related to phenobarbital induction of hepatic cytochrome P 450 isozyme(s) that metabolizes CP to a new metabolite tentatively identified as didechlorodihydroxycyclophosphamide. PMID- 3966973 TI - The effect of systemic hyperthermia on melphalan pharmacokinetics in mice. AB - The effect of 45 min systemic heating at 41 degrees C on plasma and RIF-1 tumour pharmacokinetics of intraperitoneally administered melphalan (MEL) was studied in C3H mice. This heat dose causes greater potentiation of MEL in tumour than in marrow cells, resulting in a therapeutic gain for the combined therapy (Honess & Bleehen, 1985). MEL (7.5 mg kg-1) was administered at the start of heating and concentrations assayed from 20-90 min by high-performance liquid chromatography (HPLC). With or without heat peak concentrations were achieved by 20 min and were 3 to 4 micrograms ml-1 in plasma and 1-3 micrograms g-1 in tumour. Higher MEL concentrations in both plasma and tumour were found in heated animals at times after 20 min from injection, but the effect was greater in plasma (2.5-4 fold) than in tumour (1.5-2 fold) where differences were not always significant. At 40 min after a dose of 7.5 mg kg-1, plasma and tumour concentrations in heated animals were equivalent to those after 12.5 mg kg-1 and 8.5 mg kg-1, respectively, without heating. Tumour/plasma ratios were usually lower in heated than in unheated animals where they often exceeded 100%. The apparent plasma elimination half-life (t1/2) was 17.5-25 min in unheated and 24-44 min in heated animals. The area under the curve (AUC) was increased by a factor of 1.2-1.5 in heated animals, at least partly due to a decrease in volume of distribution. The heat induced increase in MEL exposure may be involved in the enhanced response to the drug, but does not appear to explain the therapeutic gain compaired to MEL alone. PMID- 3966974 TI - Misonidazole protects mouse tumour and normal tissues from the toxicity of oral CCNU. AB - Because the nitrosourea CCNU is given exclusively by the oral route in man, we have carried out studies in mice on the antitumour activity, acute toxicity and pharmacokinetics of oral CCNU, either alone or in combination with the chemosensitizer misonidazole. In both plasma and KHT tumour the peak concentration and "early" AUC for total nitrosoureas were about 1.4-1.5 fold greater for the oral compared to the i.p. route. These differences were reflected in the roughly twofold greater antitumour activity for the oral route. In contrast, acute toxicity tests showed that oral CCNU was 1.45 times less toxic to normal tissue, although the dose-limiting organ may be different for the two routes. Misonidazole reduced the antitumour activity of oral CCNU by dose modifying factors (DMF) of 0.58-0.71. Similarly, the acute toxicity was also diminished by a DMF of 0.74. Misonidazole has a complex effect on oral CCNU pharmacokinetics. The plasma and tumour total nitrosourea peak concentrations were reduced by 1.5 and 1.7 fold respectively. Misonidazole also reduced the "early" nitrosourea AUC, with the extent of the reduction depending on the minimum effective concentration (MEC) chosen. For example, the plasma nitrosourea AUC was reduced by factors of 1.05 and 9.6 for MEC values of 1 and 2 micrograms ml-1 respectively. We propose these pharmacokinetic changes to be the underlying mechanism for the reduction of oral CCNU cytotoxicity by misonidazole. Clinical trials of such combinations should be accompanied by detailed pharmacokinetic evaluation. PMID- 3966975 TI - Disaggregation of human solid tumours by combined mechanical and enzymatic methods. AB - Two combined mechanical and enzymatic disaggregation techniques and a simple mechanical disaggregation procedure were compared. The combined procedures involved a mechanical comminution of the tumour tissue followed by incubation in trypsin. In one method, the tissue was subjected to long-term trypsinization at 4 degrees C, and in the other procedure, repeated short-term trypsinization at 37 degrees C was applied. The results were compared in terms of the yield of viable cells, plating efficiency, the ability to produce tumours in nude mice, and DNA distribution as measured by flow cytometry. The combined techniques provided reproducible cell yields of 2-10 X 10(7) viable cells g-1 of tissue, whereas only a small number of tumour cells was produced by the mechanical method. DNA analysis demonstrated that only the long-term trypsinization procedure resulted in a representative cell yield from all the tumours tested. PMID- 3966976 TI - The effect of passage in vitro and in vivo on the properties of murine fibrosarcomas I. Tumorigenicity and immunogenicity. AB - Cloned cell lines of chemically-induced murine fibrosarcomas maintained in tissue culture usually fail to grow when transplanted to normal syngeneic mice. They grow, however, in various categories of T cell deficient mice and after such passage grow readily in normal mice. Both cultured and mouse-passaged lines possess strong TATA. Three alternative explanations are suggested which might account for these findings. Emergence during the initial passage of a population of tumour cells resistant to NC cells. Acquisition during the initial passage of a protective surface molecule that interferes with the efferent side of the immune response when the tumour cells are subsequently transplanted to a normal host. Loss during the initial passage of a Class I MHC molecule which prevents dual recognition of the tumour cells by T cells when they are transplanted to a normal host. New experiments are proposed to distinguish between these possibilities. PMID- 3966977 TI - Tumour growth delay following single dose irradiation of human melanoma xenografts. Correlations with tumour growth parameters, vascular structure and cellular radiosensitivity. AB - The radiation response of 5 different lines of human melanoma xenografts was studied. Tumours grown s.c. in the flanks of athymic mice were exposed to single doses of 5-25 Gy and subsequently analysed with respect to specific growth delay. The variation in radiation response among these melanoma lines was almost as large as that reported for human tumour xenografts differing in histological type. The most radioresistant melanomas showed longer volume-doubling times, lower growth fractions, higher cell loss factors and lower vascular density than the most radiosensitive ones. The radiation response was not correlated to the fraction of cells in S-phase or the DNA content of the tumour cells. Cell suspensions prepared from the different melanomas, irradiated under aerobic conditions and assayed in soft agar, also showed large variability in radiation response. Specific growth delay after 15 Gy was found to be correlated to the surviving fraction measured in vitro after 6 Gy, but not clearly to the Do value. It is suggested that tumour growth characteristics in vivo as well as radiation response in vitro may be of prognostic value for prediction of radioresponsiveness of melanomas. PMID- 3966978 TI - The response to cytotoxic drugs of EMT6 cells treated either as intact or disaggregated spheroids. AB - We have compared the response to a number of cytotoxic drugs of cells treated either within intact multicellular spheroids or as isolated cells following spheroid disaggregation. The cells used were of the EMT6/Ca/VJAC mouse tumour line and spheroids were treated or disaggregated at a mean diameter of 250 micron. The response of cell to nitrogen mustard (HN2) or CCNU was similar under the two exposure conditions and we conclude that factors related to spheroid structure (i.e. drug penetrability, intercellular contact effect and microenvironment within the spheroid) do not influence the initial response to these agents. Recovery of potentially lethal damage occurring over 24 h, however, greatly modifies the level of cell killing in intact spheroids. EMT6 cells were found to be extremely resistant to vincristine under all exposure conditions. For adriamycin (ADM), cells were always initially more sensitive when exposed to the drug in suspension rather than in intact spheroids. When ADM exposure was prolonged beyond 1 h, however, delaying spheroid disaggregation for 24 h led to increased cell kill and reduced differential between the two conditions of exposure. The data suggest that both drug penetration problems and other factors related to spheroid structure are involved in determining the response of cells in small spheroids to ADM. PMID- 3966979 TI - Factors influencing the chemosensitization of melphalan by misonidazole. AB - The effect of melphalan alone or combined with various schedules of misonidazole (MISO) has been tested on a murine fibrosarcoma. The tumoricidal effect has been determined using the growth delay assay. Large single doses (500-1000 mgkg-1) of MISO enhanced the anti-tumour effect of melphalan, especially at high melphalan doses. This was accompanied by a drop in body and tumour temperature and an increase in the melphalan half-life. The MISO-induced hypothermia was prevented in one experiment by keeping the mice in an ambient temperature of 35 degrees C for 3 h. This reduced the exposure to melphalan but did not diminish the cytotoxic effect of the drug combination. Chronic administration of MISO for an 8 h period gave no enhancement of melphalan damage, whether melphalan was given half-way through or at the end of the period of dosing. It seems that a threshold tumour concentration of MISO, in excess of 70 micrograms g-1, is needed for enhancement of melphalan cytotoxicity; prolonged exposures to very low doses are ineffective. PMID- 3966980 TI - Binding of misonidazole to hypoxic cells in monolayer and spheroid culture: evidence that a side-chain label is bound as efficiently as a ring label. AB - The binding of ring-labelled and side-chain labelled misonidazole to hypoxic cells in monolayer and spheroid cultures of mammalian cells has been compared. The kinetics and patterns of binding for the two labelled compounds are indistinguishable. This finding has implications for the mechanism of binding and for the design of misonidazole analogues which might be used to identify hypoxic zones in tumours. PMID- 3966981 TI - Chromosomal analysis of neuroblastoma. AB - Ten children with abdominal neuroblastoma were included in the study. Biopsies from the neuroblastomas were taken during surgical operations, nine from the primary tumours and one from a metastasis. Histopathology was done for diagnosis. Chromosomal cultures of neuroblastoma cells and peripheral blood lymphocytes were performed. The peripheral blood lymphocytes revealed normal chromosomal complements. The 10 tumours were in the peridiploid range with random gains or losses of chromosomes. Deletion of the short arm of chromosome number 1 distal to band p31 occurred in 6 tumours. Other structural changes and giant markers were found. It was concluded that a regulatory gene controlling the transformation gene of neuroblastoma, is present at or distal to lp31. PMID- 3966982 TI - The effect of oestrogen and progesterone receptors on recurrence and survival in patients with carcinoma of the breast. AB - Recurrence and survival rates were studied in 175 women with breast cancer who, until the development of recurrent disease, received no treatment other than a modified radical (Patey) mastectomy, and in whom the oestrogen (REc) and progesterone (RPc) receptor content of the primary tumour was measured. At the time of first relapse most patients received endocrine therapy. At a minimum follow-up of 58 months post menopausal patients who possessed REc had an increased relapse-free survival (RFS) (P = 0.02). When examined by node status patients with 1-3 axillary nodes containing tumour also had an improvement in RFS (P = 0.02). There was no benefit for node-negative or premenopausal patients. In 163 patients in whom RPc was measured, RFS was unaffected by the possession of this receptor regardless of the degree of node involvement or menopausal status. Patients with REc had a significantly longer survival following mastectomy than patients without it (P = 0.006). This was most marked in post-menopausal (P = 0.003) and node-positive (P = 0.03) patients. Survival following mastectomy was also increased in patients possessing RPc (P = 0.04) and again was most marked for post-menopausal patients (P = 0.01), although no difference could be identified within node subgroups. There were significant differences in the post relapse survival of REc and RPc positive and negative patients (REc P = 0.03, RPc P = 0.001). Patients with both receptors survived approximately 37 months longer than their receptor-negative counterparts. This study failed to confirm that the measurement of REc and RPc can reliably predict early relapse in breast cancer. The greater overall survival of receptor-positive patients is mainly due to an increase in survival following relapse. This may reflect the response of receptor positive tumours to endocrine therapy given for recurrent disease. PMID- 3966984 TI - A perfused biological phantom and tumour model. PMID- 3966983 TI - Frequency of benign and malignant breast lesions in 207 consecutive autopsies in Australian women. AB - A histopathological study was undertaken on breast tissue dissected during the course of 207 consecutive forensic post-mortems on women over the age of 15 years in order to define the frequency and types of lesions found in Australian women. At least 10 blocks were obtained from each breast and a total of 4,738 blocks were examined. A particularly high frequency of atypical hyperplasia (12.6%), carcinoma in situ (13.0%), focal secretory change (24.1%) and perilobular haemangiomas (11.2%) was found. The radial scar, considered by some to be a precursor of infiltrating ductal carcinoma was found in 7.7% of the women. PMID- 3966986 TI - Normal maternity care: whose responsibility? PMID- 3966987 TI - Failure of post-coital contraception after insertion of an intrauterine device. Case report. PMID- 3966985 TI - A preliminary study utilizing viable HLA mismatched cultured glioma cells as adjuvant therapy for patients with malignant gliomas. PMID- 3966988 TI - Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation. AB - Placental microvascular anatomy was correlated with antenatal assessment of the umbilical circulation in 106 patients to further validate the measurement of the A/B ratio (the ratio of peak systolic to least diastolic flow velocity) of the umbilical artery flow velocity time waveforms as an index of blood flow resistance. Three groups of patients were studied: a normal group of 38 uncomplicated pregnancies, a control group of 33 potentially 'at risk' pregnancies with a normal A/B ratio matched by risk factors and gestation with the third group of 35 pregnancies with a high A/B ratio. Placental arterial resistance was quantitated by counting the number of small muscular arteries (less than 90 micron diameter) in the tertiary stem villi in a standard microscopic field (mean 18.5 fields/placenta). The modal small arterial vessel count was shown to be significantly less in the group with a high fetal risk and a high A/B ratio (1-2 arteries/field) than in both the normal and control groups (7-8 arteries/field). The tertiary villus count did not vary between groups. Antenatal studies of umbilical artery flow velocity waveforms with Doppler ultrasound identify a specific microvascular lesion in the placenta characterized by obliteration of small muscular arteries in the tertiary stem villi. PMID- 3966989 TI - Uteroplacental blood flow velocity-time waveforms in normal and complicated pregnancy. AB - A simple continuous wave Doppler ultrasound system for recording arterial flow velocity waveforms in branches of the uterine artery in the placental bed is described. Twelve normal pregnancies were studied serially from 20 weeks to delivery. The diastolic flow velocity expressed as a percentage of the systolic provides an index of downstream vascular bed resistance and perfusion. This always exceeded 50% in normal pregnancy and there was a small increase with gestational age indicative of a decreasing flow resistance. Of the 91 complicated pregnancies, studied because of potential uteroplacental insufficiency and fetal risk, 25 resulted in the birth of an infant small-for-gestational-age. In 15 the uterine artery flow velocity waveform revealed a pattern of low diastolic flow velocity. It is postulated that these represent a subgroup of growth-retarded fetuses in whom there is reduced uterine artery perfusion. Reduced uterine artery diastolic flow velocity in these patients was associated with reduced umbilical artery diastolic flow velocity on the fetal side of the placenta. In contrast the 10 small-for-gestation infants associated with normal uterine artery waveforms suggest a primary fetal cause. Twelve patients with severe hypertensive disease of pregnancy were studied. Nine were associated with reduced uterine artery diastolic flow velocity (reduced uterine artery perfusion) consistent with vasospasm in the branches of the uterine artery in the placental bed. PMID- 3966990 TI - Premalignant lesions and microinvasive carcinoma of the cervix in Jewish women: an epidemiological study. AB - During the years 1979-1982 cervical smears were taken from 3974 women at the cervical pathology unit at the Serlin Maternity Hospital, Tel Aviv Medical Center, Tel Aviv. There were 69 patients with positive cytology who had colposcopic directed biopsies which revealed cervical intraepithelial neoplasia (CIN) or a microinvasive lesion; a prevalence rate of 17 per 1000. Epidemiological characteristics of the 69 patients with CIN and microinvasion revealed that these women were younger than those with negative cytology, had more sexual partners and pregnancies, started their sexual activities earlier, and only half of them were married. In the whole series 57% of the women were of Ashkenazi origin and 43% were of Eastern and Sephardic origin, whereas in the group with positive cytology the proportion of women of Eastern and Sephardic origin was twice that of Ashkenazi origin, 64 and 36%, respectively. Only 4.5% of women in the CIN group declared themselves as religiously observant compared with 9.8% in the control group. PMID- 3966991 TI - Growth of total intrauterine, intra-amniotic and placental volume in normal singleton pregnancy measured by ultrasound. AB - The growth of total intrauterine, intra-amniotic and placental volume during the latter half of pregnancy was studied longitudinally with ultrasound in 115 healthy women with normal singleton pregnancies. A parallel planimetric area method was used. The range and distribution of normal values between 20 and 40 weeks was determined for a main study group of 103 primiparous women with which values from 12 parous women were compared. Total intrauterine volume increased from a median of 1006 ml to 4420 ml, intra-amniotic volume from 716 ml to 3406 ml and placental volume, calculated as the difference between total intrauterine and intra-amniotic volume, increased from 259 ml to 801 ml. Variation between individuals was wide at all stages of pregnancy. No significant difference was found between primiparous and parous women. Between successive 5-week periods from 20 to 40 weeks there was evidence that women tended to maintain their initial volume ranking. During the 30-35 week period, rate of growth of total intrauterine and intra-amniotic volume was somewhat faster than the near constant mean rate at other times, while the rate of growth of placental volume decreased after 30 weeks towards term. PMID- 3966992 TI - Baseline fetal heart rates from 15 to 38 weeks gestation in normotensive and hypertensive pregnancies. AB - To determine whether the fetal heart behaves differently in normotensive and hypertensive pregnancies, the changes in baseline fetal heart rate were investigated prospectively from 15 to 38 weeks gestation in 16 women who were normotensive at the time of booking in the antenatal clinic. Fetal heart rate recordings were made ultrasonically, and were computer-processed by the programs TELEPLOT and BASELINE. Those women who remained normotensive exhibited a decrease of fetal heart rate with advancing gestational age, but this did not occur in the six women who eventually developed hypertension. PMID- 3966993 TI - Progesterone, cortisol and oestradiol-17 beta in the initiation of human parturition: partitioning between free and bound hormone in plasma. AB - The concentrations of total and free progesterone, oestradiol-17 beta, and cortisol were measured in the plasma of 24 pregnant women from 10-17 days prepartum, during labour, and for 2-3 days postpartum. All the women were delivered vaginally, and their hormonal profiles were similar, whether they initiated labour spontaneously (n = 11) or were induced by rupture of the fetal membranes (n = 13). Before labour, the plasma concentrations of total radioimmunoassayable progesterone, oestradiol-17 beta and cortisol were 557.3 (SEM 70.3) nmol/l and 590.0 (SEM 76.7) nmol/l, 94.3 (SEM 18.7) nmol/l and 111.6 (SEM 19.8) nmol/l, and 1087.2 (SEM 103.7) nmol/l and 1020.7 (SEM 100.7) nmol/l, for the spontaneous and induced groups, respectively. During labour progesterone and oestradiol-17 beta declined in maternal plasma to around 130 nmol/l and 30 nmol/l in both groups by the end of the third stage. The free fractions of progesterone and oestradiol-17 beta remained constant throughout labour and over the entire study period at 2-3% and 1-2%, respectively. Total plasma cortisol rose to 1243.7 (SEM 83.3) nmol/l (P less than 0.02, spontaneous group) and 1247.5 (SEM 97.4) nmol/l (P less than 0.001, induced group) by the end of the first stage of labour. Concomitantly, free cortisol increased from 4.5-5.5% to 7.2-8.2% over this period so that its concentration increased by approximately 2.5-fold in both groups of women during labour. We conclude that the total and physiologically-active free concentrations of progesterone and oestradiol-17 beta in maternal plasma do not change immediately before the onset of labour.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3966995 TI - The 'birth plan' experience. AB - All antenatal patients booked for hospital confinement in Huddersfield have been offered a 'birth plan' on which to indicate their wishes regarding labour ward procedures. The first 100 plans have been analysed and the information supplemented by a questionnaire answered by the women in the puerperium. PMID- 3966994 TI - A routine system for monitoring perinatal deaths in Scotland. AB - Since 1983 the monitoring of perinatal deaths in Scotland has been incorporated into the established data collection system which monitors maternal and child health in Scotland. This paper describes the transition from a research project to the routine system and the extension of the data collection to include paediatric and pathological findings. This information is provided by local co ordinators in active clinical practice. Baseline data are obtained from the routine maternity discharge document (SMR 2). A summary of the findings for the first 4 years of the study, 1977, 1979, 1980 and 1981 is presented, including information about birthweight and gestation-specific perinatal mortality rates; perinatal mortality rates by time of death in relation to labour and singleton and multiple perinatal mortality rates by the obstetric complication preceding the death. PMID- 3966996 TI - Anterior chamber angle in the exfoliation syndrome. AB - The gonioscopic findings of 76 patients with the exfoliation syndrome were reviewed. A high frequency of narrowness of the anterior chamber (AC) angle was found (32%). 18% had angles considered occludable, and 14% had obvious angle closure glaucoma as shown by the presence of peripheral anterior synechias (PAS). Increased pigmentation of the posterior trabecular meshwork (PTM) was noted in all cases. When this pigmentation was markedly asymmetrical, unilateral exfoliation with glaucoma was common in the more pigmented eye. In addition heavy angle pigmentation in the absence of exfoliation was noted in the fellow eye of patients with characteristic exfoliated material in the other eye. Increased pigmentation of the PTM may be the earliest detectable sign of the exfoliation syndrome (ES). The clinical significance of our estimating PTM pigmentation at the 12 o'clock position is discussed. In view of the accelerated optic nerve damage associated with the development of glaucoma secondary to ES, routine estimation of the pigmentation of the PTM at 12 o'clock is recommended in the hope of early detection of cases of otherwise inapparent ES. PMID- 3966997 TI - A randomised prospective study on treatment of central retinal vein occlusion by isovolaemic haemodilution and photocoagulation. AB - Thirty eight patients with ischaemic and non-ischaemic central retinal vein occlusion were evaluated for the effect of isovolaemic haemodilution. They were allocated at random to a haemodilution group (19 patients, panretinal photocoagulation and isovolaemic haemodilution) and a control group (19 patients, panretinal photocoagulation). Haematocrit was lowered in steps to 30 to 35% in the haemodilution group by repeated exchanges of whole blood for plasma and dextran (MW 40 000) and kept at this level for a period of six weeks. The haemodilution did not lead to serious complications. Three months after starting the treatment eight of 19 patients with haemodilution showed a better visual acuity, whereas only one of 19 control patients had improved. Seven of 17 patients with haemodilution, but only one of 17 control patients, retained a better visual acuity after one year. In the haemodilution group there were fewer patients with macular fibrosis and more with only minor foveal changes. The haemodilution seems to be more effective in patients with ischaemic than with non ischaemic central retinal vein occlusion. It is concluded that isovolaemic haemodilution improves the visual outcome of patients with central retinal vein occlusion, probably mediated by enhanced retinal blood flow. PMID- 3966998 TI - Ocular hypotensive effect of late pregnancy with and without high blood pressure. AB - The mean ocular tension of third trimester hypertensive pregnant women did not differ significantly from that of third trimester non-hypertensives, in contrast to the tendency for open-angle glaucoma to be associated with vascular hypertension. Presumably there are different causes for the two types of vascular hypertension. The ocular hypotensive effect of late pregnancy (third trimester) was confirmed. PMID- 3966999 TI - Studies on retinitis pigmentosa in man. II. Erythrocyte osmotic fragility. AB - The osmotic fragility of erythrocytes from patients with genetically classified forms of retinitis pigmentosa (RP) has been studied. The mean fragility was increased in autosomal dominantly inherited RP, where the dystrophy was expressed regionally in the retina, with both rods and cones affected. In contrast it was normal in patients with the dominantly inherited disease, which leads to a diffusely distributed dystrophy of, predominantly, rod photoreceptor cells. Raised osmotic fragility of erythrocytes has also been observed in female patients with multiplex (recessive) RP and in female carriers of the X-linked form of the disease. PMID- 3967001 TI - Impaired contrast sensitivity in diabetic patients with and without retinopathy: a new technique for rapid assessment. AB - A simple technique is described for assessing the sensitivity of the human visual system to gratings at threshold contrast. The technique has advantages for clinical use in that it is (1) inexpensive, (2) quick to administer, (3) portable, and (4) relatively free from bias. Forty-two diabetic patients and 84 normal controls have been tested. Fifteen diabetic patients (6/20 with retinopathy and 9/22 without) had test scores more than two standard deviations below the norm for age-matched controls. PMID- 3967000 TI - Contrast attenuation characteristics of iris clipped intraocular lens implants in situ. AB - In this study contrast thresholds were monitored over a wide range of spatial frequencies for patients with iris clipped implants or Fyodorov and Binkhorst types. These results were compared with those of an age matched normal group and attenuation characteristics derived for the implants and media environment alone. These results show that lenticular implants of this type can produce large reductions in contrast with a wide variety of transfer functions, for example, low pass, band reject, and band pass. These findings highlight the potential inadequacies of the assessment of the visual capabilities of these devices by acuity measures alone. We suggest that a more realistic and abbreviated approach should be based upon supplementing acuity assessment with monitoring of threshold sensitivity for a low, medium, and high spatial frequency sinewave grating. PMID- 3967002 TI - Gas gangrene infection of the eyes and orbits. AB - The literature on Clostridium perfringens infections is reviewed up to 1983. An additional case is reported with bilateral clostridial infections of the eye and orbit. One eye followed the classical course of relentless panophthalmitis, amaurosis, and orbital cellulitis ending in enucleation. The second eye contained intracameral mud and gas bubbles that were removed by vitrectomy instrumentation. Subsequent removal of the toxic cataract resulted in a final aided visual acuity of 6/18, N8. This is the third report of a retained globe, and we believe the only known case where the patient was left with useful vision. PMID- 3967003 TI - Giant retinal tears after central vitrectomy. AB - Giant retinal breaks developed in four eyes within two months of pars plana vitrectomy. The pathogenesis and implications of this serious complication are discussed. PMID- 3967004 TI - Glaucoma triple procedure of extracapsular cataract extraction, posterior chamber lens implantation, and trabeculectomy. AB - Thirty-four consecutive glaucoma triple procedures with a minimum follow up of six months have been shown to be effective and safe. Satisfactory control of the glaucoma was achieved in each case, and 91% of eyes were returned to an acuity of 6/12 or better. 1% sodium hyaluronate was found to be beneficial by preventing scleral or corneal collapse during surgery and ensuring an even filtration postoperatively without hypotony. PMID- 3967006 TI - Redox study of electron donation to P-680 in Photosystem II. AB - Flash-induced absorption changes at 820 nm were studied as a function of redox potential in Tris-extracted Photosystem II oxygen-evolving particles and Triton subchloroplast fraction II particles. The rereduction kinetics of P-680+ in both preparations showed biphasic recovery phases with half-times of 42 and 625 microseconds at pH 4.5. The magnitude of the 42 microseconds phase of P-680+ rereduction was strongly dependent on the redox potential of the medium. This absorption transient, attributed to electron donation from D1 (the secondary electron donor in oxygen-inhibited chloroplasts), titrated as a single redox component with a midpoint potential of +240 +/- 35 mV. The experimentally determined midpoint potential was found to be independent of pH over the tested range 4.5-6.0. In contrast, the magnitude of the 625 microseconds phase of P-680+ rereduction was independent of redox potential between +350 and +100 mV. These results are interpreted in terms of a model in which an alternate electron donor with Em approximately equal to 240 mV, termed D0, serves as a rapid donor (t 1/2 less than or equal to 2 microseconds) to P-680+ in Tris-extracted and Triton treated Photosystem-II preparations. According to this model, the slower electron donor, D1, is functional only when D0 becomes oxidized. PMID- 3967005 TI - Functional studies on in situ-like mitochondria isolated in the presence of polyvinyl pyrrolidone. AB - Mitochondria isolated and maintained in sucrose mannitol medium show a large intermembrane space and a condensed matrix unlike the appearance of in situ mitochondria. Mitochondria resembling in situ organelles are obtained when the isolation medium is supplemented with certain macromolecules such as polyvinyl pyrrolidone. We found that the in situ appearance was acquired also by the conventionally isolated mitochondria when they were exposed to 2% polyvinyl pyrrolidone supplemented medium. Paradoxically, however, these in situ looking mitochondria proved functionally inferior in that their brief incubation without substrates led to a marked loss of their ability to respire with subsequently added substrates such as pyruvate, acylcarnitines or glutamate. The oxidation of succinate was, however, not so affected. This phenomenon was shared by heart and skeletal muscle mitochondria of different animal species but not by rat liver mitochondria. The inhibition of respiration could not be related to the failure to oxidize NADH, to the tieing up of mitochondrial free CoASH, or to the increased matrix space of mitochondria that was observed in the presence of polyvinyl pyrrolidone. The polyvinyl pyrrolidone-exposed mitochondria regained their respiratory ability on being freed from polyvinyl pyrrolidone. The same phenomenon was seen also when the medium contained 2% albumin or 20% Ficoll. PMID- 3967008 TI - Oxidative metabolism of Polytron versus Nagarse mitochondria in hearts of genetically diabetic mice. AB - We have shown previously that heart mitochondria obtained by the Nagarse method from genetically diabetic mice (C57BL/KsJ db/db) exhibit a defect in oxidizing NAD+-linked substrates (Kuo, T.H., Moore, K.H., Giacomelli, F. and Wiener, J. (1983) Diabetes 32, 781-787). In this study, the oxidative phosphorylation characteristics of cardiac mitochondria isolated by the Polytron method were compared with that of Nagarse mitochondria. Evidence is presented here that in the diabetic heart both Nagarse and Polytron mitochondria have defective pyruvate oxidation, whereas only the former exhibit impaired fatty acid oxidation. Assay of two rate-limiting beta-oxidation enzymes, namely beta-hydroxyacyl-CoA dehydrogenase and beta-ketothiolase, indicates no alteration in specific activities from diabetic mice vs. controls. The data suggest that two populations of mitochondria are present in myocardium and that the defective oxidative metabolism in the cardiac mitochondria of db/db mice may be linked to deficiencies in total NAD + NADH content. PMID- 3967007 TI - Fast cold-induced activation of the external pathway of NADH oxidation in liver mitochondria of hyperthyroid rats. AB - The exposure of a cold-adapted rat for 15 min at 4 degrees C results in the appearance of measurable oxidation of added NADH via the external amytal- and antimycin-A-resistant pathway in liver mitochondria. This effect increases if the animal has been treated with thyroid gland preparation for 4-5 days. In vitro, the addition of Mg2+ or increase in the tonicity of incubation mixture suppresses external NADH oxidation. Addition of 70 mg X ml-1 serum albumin or 70 mg X ml-1 polyvinylpyrrolidone in the presence of Mg2+ and addition of 20 microM palmitic or 20 microM oleic acids induces to some extent external NADH oxidation in the mitochondria of control (nontreated) and of cold-adapted, thyroidgland preparation-treated rats. It is concluded that hyperthyroid rats can be used as a model of cold-induced initiation of the external pathway of NADH oxidation. A relation between the increase of exogenous NADH oxidation and phospholipase A2 activity in liver mitochondria is discussed. PMID- 3967009 TI - Preparation and characterization of heat-sensitive immunoliposomes. AB - Immunoliposomes able to bind specifically to target cells and to release their encapsulated contents upon brief heating were prepared. Monoclonal anti-H2Kk was covalently derivatized with palmitic acid by the method of Huang, A. et al. (Huang, A., Tsao, Y.S., Kennel, S.J. and Huang, L. (1982) Biochim. Biophys. Acta 716, 140-150). The palmitoyl antibody was injected at a controlled rate into a suspension of fused unilamellar dipalmitoylphosphatidylcholine liposomes maintained at a constant temperature. The final protein-to-lipid ratio of the resultant liposomes with incorporated antibody (immunoliposomes) was dependent upon the rate of antibody injection and the lipid concentration. Injection of palmitoyl antibody into a liposome suspension containing 50 mM carboxyfluorescein at 41 degrees C resulted in simultaneous antibody incorporation and entrapment of dye. Immunoliposomes were able to release the entrapped carboxyfluorescein upon heating. The release of dye at temperatures between the pre- and main-transition temperatures of DPPC was abolished by the addition of calf serum (5%). Furthermore, the presence of serum resulted in an increase in the temperature of the maximal release rate and also in the rate of release at that temperature. Retention of antigen-binding capacity was demonstrated by the ability of the immunoliposomes to bind specifically to the target cells. Rapid release of entrapped carboxyfluorescein from immunoliposomes bound to target cells at 4 degrees C was achieved upon brief exposure (less than 3 min) at 41 degrees C. These heat-sensitive immunoliposomes may be useful in enhancing drug delivery to target cells. PMID- 3967010 TI - Divalent cation-induced phosphatidic acid membrane fusion. Effect of ion binding and membrane surface tension. AB - A study was made on the correlation between the degree of membrane fusion and surface tension increase of phosphatidic acid membranes caused by divalent cations. Membrane fusion was followed by the Tb3+/dipicolinic acid assay, monitoring the fluorescent intensity for mixing of the internal aqueous contents of small unilamellar lipid vesicles. The surface tension and surface potential of monolayers made of the same lipids as used in the fusion experiments were measured as a function of divalent cation concentration. It was found that the 'threshold' concentration to induce massive vesicle membrane fusion was the same for Ca2+ and Mg2+, and that the surface tension increase in the monolayer, induced by changing divalent cation concentration from zero to a concentration which corresponds to its threshold value, inducing vesicle membrane fusion, was approximately the same: 6.3 dyn/cm for both Ca2+ and Mg2+. Both the divalent cation's threshold concentrations as well as the surface tension change corresponding to the threshold concentration for the phosphatidic acid membrane were smaller than those for the phosphatidylserine membrane. The different fusion capability of these divalent cations for phosphatidic acid and phosphatidylserine membranes is discussed in terms of the different ion binding capabilities of these ions to the membranes. PMID- 3967011 TI - The kinetics of colloid osmotic hemolysis. I. Nystatin-induced lysis. AB - A kinetic model of colloid osmotic hemolysis for cation-permeable cells has been developed. The model consists of three essential components. The first is a set of flux equations, under the assumption that the membrane potential is equal to the chloride equilibrium potential and that cation fluxes are described by the Goldman flux equation. The second is the osmotic equilibrium model of Freedman and Hoffman that takes into account the non-ideal osmotic behavior of erythrocytes. The third is an empirical relation between hemolysis and cell volume, developed from the lysis behavior in hypoosmotic media. Model simulations are compared with lysis experiments using the antibiotic nystatin to raise cation permeability. The form of the kinetics and inhibition of lysis by sucrose are described well by the model. In additional lysis experiments at different external pH the small pH dependence is accounted for by the model. PMID- 3967012 TI - The kinetics of colloid osmotic hemolysis. II. Photohemolysis. AB - Many of the known features of photohemolysis have been organized in a kinetic model that simulates the lytic time-course in a variety of conditions. The model combines Nernst-Planck flux principles, the osmotic equilibrium model of Freedman and Hoffman, equations relating illumination parameters to ion permeability, and an empirical relation between cell volume and lysis. Model simulations are compared with experiments showing the dependence of lysis kinetics on sensitizer concentration and on the osmotic content of the reaction medium. Additional experiments demonstrate that the inherent osmotic fragility of erythrocytes is not altered by illumination conditions that cause major delayed lysis 23 h later. The successful simulations support the hypothesis that photohemolysis is a colloid osmotic lysis occurring in cells behaving as imperfect osmometers. PMID- 3967013 TI - Rapid isolation of neuroblastoma plasma membranes on Percoll gradients. Characterization and lipid composition. AB - A purified plasma membrane fraction was isolated from cultured neuroblastoma (N1E 115) cells on a discontinuous gradient of 5, 25 and 35% Percoll within 1 h of cell disruption by nitrogen cavitation. Yield of plasma membrane, banding in the 25% Percoll (d = 1.051), was high as judged by the recoveries of the marker enzymes, 5'-nucleotidase (58.0 +/- 5.4%, n = 5), alkaline phosphatase (46.0 +/- 3.0%, n = 4) and Mg2+-stimulated neutral sphingomyelinase (48.0 +/- 4.2%, n = 3); enrichment of specific activities of these enzymes relative to total cell homogenate (lysate) were 10.9 +/- 1.0-, 9.1 +/- 1.0- and 9.6 +/- 0.4-fold, respectively. Levels of marker enzymes for other organelles were less than 3% of total activity, except for microsomes (less than 9%). The plasma membrane fraction was further characterized by 2-, 5- and 6-fold higher content (nmol/mg protein) of total phospholipids, free cholesterol and sphingomyelin, respectively, compared to lysate. Ratios of free cholesterol to phospholipids and of sphingomyelin to phosphatidylcholine in the plasma membrane fraction were about 2-fold greater than that of lysate. The cholesterol ester content of plasma membrane (36 +/- 8 nmol/mg protein) was 2-3-fold higher than that of lysate. Sphingomyelin of the plasma membrane fraction had a higher concentration of long chain fatty acids (more than 18 carbon atoms) relative to lysate or microsomes. Significant differences also were observed in the fatty acyl composition of diphosphatidylglycerol, cholesterol esters and triacylglycerol of plasma membrane. Thus, we have devised a rapid and reliable method for isolation of highly purified plasma membranes of cultured neuroblastoma cells that is suitable for comparison of metabolic relationships between the plasma membrane and other cellular organelles. PMID- 3967014 TI - Concurrent disappearance of N-acylethanolamine glycerophospholipids and phagolysosomes enriched in N-acylethanolamine glycerophospholipids as Dictyostelium discoideum cells aggregate. AB - As the cellular slime mold, Dictyostelium discoideum, undergoes development, a phospholipid fraction containing 80% N-acylethanolamine glycerophospholipids (NAEGPs) and 20% acylphosphatidylglycerol (APG) disappears during the aggregation stage. In this study, the subcellular distribution of that NAEGP phospholipid fraction and the precise time period of disappearance of the fraction were determined. The content of the NAEGP fraction was determined in aggregating cells at 2-h intervals from the beginning of the developmental phase through 14 h, when the cells were completely aggregated. The NAEGP fraction comprised about 8% of the phospholipids in amoebae just starting the development cycle and about 12% in cells between 2 and 6 h of development; then its level decreased until it could not be detected at 12 and 14 h of development. The mole percentage of the total lipid phosphate in the NAEGP fraction was determined in isolated subcellular organelles. The phagolysosomes were enriched in the NAEGP fraction 1.7-2-fold over the level found in the amoebae and about 8-fold over the level in fractions highly enriched in the plasma membrane, mitochondria or peroxisomes. The content of phagolysosomes was determined by electron microscopy of aggregating cells. The amoebae contained large amounts of phagolysosomes up to 6 h of development, and then they gradually disappeared between 6 and 12 h of development. This combination of quantitative phospholipid analysis, subcellular organelle isolation and electron microscopy has revealed that in D. discoideum amoebae, the phagolysosomes were selectively enriched in the NAEGP fraction and both the NAEGP enriched phagolysosomes and the NAEGPs disappeared concurrently between 6 and 12 h of development. PMID- 3967015 TI - Transmembrane ferricyanide reduction in carrot cells. AB - Carrot cells (Daucus carota) grown in tissue culture are capable of reducing the non-permeable electron acceptor, ferricyanide, with concomitant proton extrusion from the cell. Optimum conditions for transmembrane ferricyanide reduction include a pH of 7.0-7.5 in a medium containing 10 mM each KCl, NaCl and CaCl2. Data are shown to prove that transmembrane ferricyanide reduction is an enzymatic process. It does not depend on the secretion of phenolics from the cell within the time limits of the assay (10 min). The presence of broken cells and cell fragments are excluded on the basis of stimulation or only slight inhibition by mitochondrial inhibitors. However, transmembrane ferricyanide reduction by carrot cells is inhibited about 50% by various glycolysis inhibitors, which are presumed to reduce the internal levels of NADH. Treatment of cells with p diazoniumbenzenesulfonic acid, a non-permeant membrane modifying agent, also inhibits transmembrane ferricyanide reduction more than 90%. The data presented support the existence of a transplasma membrane redox system in carrot cells. PMID- 3967016 TI - The effect of ionic strength on the lipid peroxidation of porcine intestinal brush-border membrane vesicles. AB - The effects of salt concentration gradient (inside to outside) on the lipid peroxidation of porcine intestinal brush-border membrane vesicles have been studied and several interesting features of the peroxidation have been elucidated. The addition of dithiothreitol and Fe2+ is far more effective in induction of the lipid peroxidation than any of the other metal ion species tested (Fe3+, Cu2+, Ni2+, Zn2+ and Cr3+). The peroxidation rate of the membrane vesicles induced by dithiothreitol plus Fe2+ was sensitive for the incubation temperature and was increased with increase of the temperature. Imposition of an inward salt concentration gradient on the membrane vesicles preloaded with 300 mM mannitol by addition of 100 mM chloride of K+, Na+, Li+, Rb+, NH4+ or choline to medium produces a very large reduction of the lipid peroxidation induced by dithiothreitol plus Fe2+. The membrane peroxidation is depressed more with the mannitol (300 mM)-preloaded vesicles than with the K2SO4 (100 mM)-preloaded vesicles when they are incubated in medium containing 20-100 mM of K2SO4. Addition of membrane-permeant anions such as SCN- and I-, but not addition of NO3 , to incubation medium has been found to decrease markedly the lipid peroxidation of the mannitol-preloaded vesicles. From these results it is suggested that the lipid peroxidation of the brush-border membranes by addition of dithiothreitol plus Fe2+ is sensitively changed with change in ionic strength. PMID- 3967017 TI - Putrescine transport in human platelets. AB - Putrescine transport has been studied in human platelets. The uptake of putrescine is saturable and appears to be an energy-dependent process, since it is inhibited by the uncoupler 2,4-dinitrophenol and low temperature. The evidence presented suggests that the uptake process is complex and may be dependent upon pH gradient, membrane potential, and other unidentified factors. Putrescine transport is not inhibited by amino acids and is only slightly inhibited by spermidine and spermine. A membrane protein involved in putrescine transport has been identified and partially purified. Differential labeling with N ethylmaleimide identified proteins with apparent molecular weights of 65000 and 23000 as determined by SDS-polyacrylamide gel electrophoresis. Column chromatographic purification on a putrescine affinity column revealed a Mr 55000 protein which copurified with the Mr 65000 protein. Additional evidence supporting the involvement of these proteins in putrescine transport was seen in putrescine protection against N-ethylmaleimide inhibition of putrescine uptake. Putrescine uptake may occur via the serotonin transport system, since imipramine inhibits transport and because of the similarities in the molecular weights of the proteins implicated in transport. PMID- 3967018 TI - Interactions of pyrethroids with phosphatidylcholine liposomal membranes. AB - Interactions of several pyrethroids with membrane lipids in the form of dipalmitoylphosphatidylcholine (DPPC) liposomes have been studied using fluorescent membrane probes. Fluorescence anisotropy values and lifetimes (determined by phase-shift and demodulation techniques) of the fluorescent probe, 1,6-diphenyl-1,3,5-hexatriene, were decreased in gel phase liposomes by pyrethroids at concentrations on the order of 10 microM. The pyrethroids containing a cyano substituent were also observed to cause collisional quenching of diphenylhexatriene fluorescence. Pyrethroids differed in their effectiveness at lowering the phase transition temperature of DPPC, and in their ability to broaden the temperature range of this transition. The fluorescence intensity of DPPC-incorporated chlorophyll a was used to monitor the pretransition of DPPC and the lateral diffusion of a membrane component located in the polar headgroup region. Permethrin did not affect chlorophyll a fluorescence intensity at any temperature. It may be concluded from these results that pyrethroids are preferentially located in the interior hydrophobic regions of the lipid bilayer, and that these compounds can disorder hydrocarbon packing in the bilayer core. However, polar headgroups were not disordered, and diffusion of membrane components in the polar headgroup region was not altered. PMID- 3967019 TI - Stopped-flow study of anesthetic effect on water-transport kinetics through phospholipid membranes. Interfacial versus lipid core ligands. AB - We have compared ligand effects between polar and apolar anesthetic molecules upon water transport across phospholipid membranes by kinetic analysis of the osmotic swelling rate, using a stopped-flow technique. Chloroform and 1-hexanol were used as interfacial ligands, and carbon tetrachloride and n-hexane were used as their counterparts, representing lipid core action. Because anesthetics transform the solid-gel membrane into a liquid-crystalline state, and because phospholipid membranes display an anomaly in permeability at the phase transition, dimyristoylphosphatidylcholine vesicles were studied at temperatures above the main phase transition to avoid this anomaly. All these molecules increased the osmotic swelling rate. However, a significant difference was observed in the activation energy, delta Ep, between polar and apolar molecules; delta Ep was almost unaltered by the addition of polar molecules (chloroform and 1-hexanol), whereas it was decreased by apolar molecules (carbon tetrachloride and n-hexane). The obtained results were analyzed in terms of the dissolution diffusion mechanism for water permeation across the lipid membrane. It is suggested that polar molecules affect water permeability by altering the partition of water between the membrane interior and water phase, and apolar molecules affect it by altering both the partition and the diffusion of water within the membrane interior. PMID- 3967020 TI - Mg2+-ATP-dependent sodium transport in inside-out basolateral plasma membrane vesicles from guinea-pig small intestinal epithelial cells. AB - The transport of sodium into inside-out basolateral plasma membrane vesicles from small intestinal epithelial cells has been examined. It was found, under equilibrium conditions, that binding of 22Na represents approx. 55% of the total uptake during an equilibration period of 30 min; 45% of the total uptake correspond to passive sodium entry in the vesicle space. In addition to binding and to passive Na+ entry, two distinct mechanisms capable of accumulating sodium in the intravesicular space can be demonstrated when ATP is added to the incubation medium. One transports sodium actively in the absence of potassium, whereas the other requires the presence of potassium in the interior of the vesicles. The two mechanisms can also be differentiated by their affinities for sodium, their optimal pH and by their behaviour towards different inhibitors. Thus, the mechanism that transports sodium in the absence of potassium is refractory to ouabain, but is inhibited by ethacrynic acid and furosemide, whilst the mechanism that accumulates sodium inside the vesicles in the presence of internal potassium is strongly inhibited by ouabain, is weakly inhibited by ethacrynic acid and is insensitive of furosemide. ATP is a specific stimulator of both processes, and the requirement for magnesium is absolute in both cases. PMID- 3967021 TI - Na+-dependent transport of alpha-aminoisobutyrate in isolated basolateral membrane vesicles from rat parotid glands. AB - Basolateral plasma membranes were prepared from rat parotid gland after centrifugation in a self-orienting Percoll gradient. K+-dependent phosphatase [Na+ + K+)-ATPase), a marker enzyme for basolateral membranes, was enriched 10 fold from tissue homogenates. Using this preparation, the transport of alpha aminoisobutyrate was studied. The uptake of alpha-aminoisobutyrate was Na+ dependent, osmotically sensitive, and temperature-dependent. In the presence of a Na+ gradient between the extra- and intravesicular solutions, vesicles showed an 'overshoot' accumulation of alpha-aminoisobutyrate. Sodium-dependent alpha aminoisobutyrate uptake was saturable, exhibiting an apparent Km of 1.28 +/- 0.35 mM and Vmax of 780 +/- 170 pmol/min per mg protein. alpha-Aminoisobutyrate transport was inhibited considerably by monensin, but incubating with ouabain was without effect. These results suggest that basolateral membrane vesicles, which possess an active amino acid transport system (system A), can be prepared from the rat parotid gland. PMID- 3967022 TI - Variations in dietary triacylglycerol saturation alter the lipid composition and fluidity of rat intestinal plasma membranes. AB - Rats were maintained on nutritionally complete diets enriched in unsaturated (corn oil) or saturated (butter fat) triacylglycerols. After 6 weeks, significant differences in the lipid composition and fluidity of a number of intestinal membranes were observed. The corn oil diet (enriched mainly in linoleic acid) increased the overall unsaturation of the acyl chains and enhanced the lipid fluidity, as assessed by the fluorescence anisotropy of 1,6-diphenyl-1,3,5 hexatriene, of enterocyte microvillus and basolateral membranes and of colonocyte basolateral membranes. Concomitantly, the cholesterol content and the cholesterol/phospholipid molar ratio were increased in the microvillus but not in the basolateral membranes. The increased cholesterol in ileal microvillus membranes can result from enhanced cellular biosynthesis, since ileal slices from rats fed the unsaturated diet incorporated [14C]octanoate more rapidly into digitonin-precipitable sterol. Increased fluidity of the enterocyte microvillus and basolateral membranes, respectively, enhanced the enzyme specific activities of p-nitrophenylphosphatase and (Na+ + K+)-dependent adenosine triphosphatase. The results indicate that the lipid composition, fluidity and enzyme activities of intestinal plasma membranes can be altered by dietary means. Moreover, rat enterocytes possess regulatory mechanisms which modulate the cholesterol content of the microvillus membranes so as to mitigate changes in lipid fluidity. PMID- 3967023 TI - Role of the membrane concanavalin A binding site in platelet-fibrin interactions. AB - Concanavalin A was employed to study the role of platelet membrane glycoproteins in platelet-fibrin interactions during clot formation. A rheological technique was used to study the interactions, measuring the clot rigidity and platelet contractile force simultaneously during the formation of network structure. Concanavalin A lowered the clot rigidity and contractile force of a platelet-rich plasma clot by a small extent. Plasma glycoproteins probably compete with platelet membranes for concanavalin A binding in platelet-rich plasma. Both native concanavalin A (tetrameric) and succinyl concanavalin A (dimeric) lowered the clot rigidity and contractile force of a washed platelet-fibrin clot dramatically, almost down to those values found for fibrin clots. Inhibition studies with alpha-methyl-D-mannoside indicated that the concanavalin A effects were specific for the concanavalin A binding capacity to platelets. The effects of native concanavalin A on platelet-fibrin clots were only partially reversible, while the succinyl concanavalin A effects were completely reversible. The observed concanavalin A effects are probably mainly due to concanavalin A binding to platelet membrane glycoproteins. The concanavalin A binding site appears to play an important role in the fibrin binding to platelets. PMID- 3967024 TI - Tetanus toxin interaction with human erythrocytes. I. Properties of polysialoganglioside association with the cell surface. AB - Human erythrocytes in suspension acquire gangliosides containing di- and trisialosyl residues added to the maintenance medium. This is reflected in the increased cell-associated sialic acid content and ability to bind 125I-labeled tetanus toxin. A salt-sensitive and a salt-insensitive ganglioside-mediated toxin cell surface association is detected which is reduced after sialidase treatment of ganglioside-supplemented cells. The salt-insensitive ganglioside-cell association is saturable after 2 h incubation in 0.3 M mannitol buffer and has an optimum at pH 5. The association process is higher at 37 degrees C than at 4 degrees C, depends on cell density, and is considerably higher in metabolically active cells compared to lysed cells. Pretreatment of cells with trypsin decreases the salt-resistant toxin association with ganglioside-supplemented cells. In contrast, glutaraldehyde-fixed cells treated with trypsin and supplemented with gangliosides bind more toxin which is insensitive to salt. Ganglioside-mediated tetanus toxin binding to the intact erythrocyte membrane can be utilized as a model system for studying the role of glycolipids in membrane function. PMID- 3967025 TI - Tetanus toxin interaction with human erythrocytes. II. Kinetic properties of toxin association and evidence for a ganglioside-toxin macromolecular complex formation. AB - The properties of tetanus toxin interaction with human erythrocytes supplemented with disialo- and trisialo-gangliosides have been investigated. Binding of toxin is linear with time for 1 h and is 3-4-fold higher at 37 degrees C than at 4 degrees C during incubation of long duration. It exhibits saturation at toxin concentrations between 0.1 and 1 microgram/ml; however, it is nonsaturable between 1 and up to 50 micrograms/ml. It is effectively prevented by free gangliosides and antibodies or by pretreatment with sialidase but is unaffected by a number of closely related ligands including toxoid and toxin fragments. NaCl (1 M) removes a great portion (86%) of cell-associated toxin while Triton X-100 extracts an additional fraction (30%) of the salt-resistant cell-bound toxin. The residual sequestred toxin after detergent extraction is sensitive to proteolytic degradation. The trypsin-stable fraction (1.5%) is biotoxic and may be indicative of internalization of toxin. A macromolecular complex of about 700 kDa containing toxin and gangliosides has been isolated and characterized by Sephacryl S-300 gel permeation chromatography, SDS-gel electrophoresis, immunoprecipitability and biotoxicity. This complex is obtained only in ganglioside-supplemented cells and not when free 3H-labeled GD1b is reacted with 125I-labeled toxin in solution in the absence of cells. The hydrophobicity properties acquired as a result of ganglioside-toxin interaction, presumably at the cell surface, suggest a conformational change of the toxin which may enable its penetration into the bilayer. PMID- 3967026 TI - Evidence for the presence of an ATP transport system in brush-border membrane vesicles isolated from the kidney cortex. AB - Results of 31P-NMR studies and transport experiments using the radioactive tracer technique are presented. They point to the conclusion that ATP is taken up into isolated renal brush-border membrane vesicles, possibly by a carrier-mediated mechanism. PMID- 3967027 TI - The influence of glucocorticoid on albumin synthesis and its messenger RNA in rat in vivo and in hepatocyte suspension culture. AB - Corticosteroids are known to stimulate the synthesis of a number of liver specific proteins. The reports regarding the effect of glucocorticoid on albumin synthesis in vivo and in vitro are controversial. In an attempt to determine the mechanism by which glucocorticoid exerts its influence on hepatic albumin synthesis and to find an explanation for the conflicting data, we have studied the effect of dexamethasone disodium phosphate on albumin synthesis and albumin messenger RNA as determined by the molecular hybridization technique in hepatocytes in rat in vivo and in suspension culture. In hepatocyte suspension culture, addition of 0.48 microM dexamethasone in medium at zero time led to a significant increase (20%) in incorporation of labeled precursor into albumin as compared to control experiments; this was accompanied by a maintainance of the initial level of full-length albumin mRNA for a 9 h period. In hepatocytes cultured without dexamethasone in the medium there was a progressive loss of albumin mRNA content. Despite this finding, dexamethasone was not able to increase the albumin mRNA content in hepatocyte to a level higher than the initial value. Moreover, administration of this hormone either intraperitoneally or intravenously into rats did not lead to enhanced cell-free albumin synthesis or to an increased level of albumin mRNA. These findings suggest that glucocorticoid does not play an essential role in the regulation of albumin synthesis in vivo. In vitro, however, glucocorticoid leads to a preservation of the initial level of albumin mRNA and thus plays a role in the control of spontaneous dedifferentiation of liver cells in culture. PMID- 3967028 TI - Inhibition of DNA repair by trifluoperazine. AB - We examined the possible role of calmodulin in the excision repair of ultraviolet light-induced pyrimidine dimers in damaged DNA by means of specialized assay systems. These assays included bromodeoxyuridine photolysis, dimer chromatography and cytosine arabinoside incorporation in conjunction with hydroxyurea. The calmodulin antagonist, trifluoperazine, and the calcium-chelating agent, EGTA, were employed to ascertain what affect calmodulin played in the repair process. Normal human fibroblast cells were used in all studies described in this report. After exposure to 10 J/m2 of 254 nm light, we observed a decrease of about 30% in the number of single-strand breaks produced in the presence of 25 microM trifluoperazine (1.9 vs. 3.3) in controls although the numbers of bases re inserted in the repaired regions were similar (64 vs. 72). Measurement of thymine containing dimers remaining throughout a 24 h time period indicated a 30% difference in the excision of dimers when tested with either EGTA or trifluoperazine. We also observed a significant decrease in the number of cytosine arabinoside arrested repair sites in the presence of either EGTA or trifluoperazine. The results are discussed with relation to the possibility of calmodulin altering the initial incision by repair endonuclease. PMID- 3967029 TI - The complete amino acid sequence of diphtheria toxin fragment B. Correlation with its lipid-binding properties. AB - The complete amino acid sequence of fragment B from diphtheria toxin has been determined. The polypeptide chain was split with cyanogen bromide, o iodosobenzoic acid, clostripain and trypsin; all amino acid sequence analyses were made by automated Edman degradation. Fragment B, which corresponds to the carboxy terminus of the toxin molecule, contains 342 amino acids and has an Mr of 37240. The proposed amino acid sequence fully confirms the structure recently deduced from the nucleotide sequence of the structural gene. The complete sequence is analyzed in relationship with the role of fragment B in the transfer of diphtheria toxin fragment A from the extracellular medium into the cell cytoplasm. PMID- 3967030 TI - Purification and properties of extracellular poly(3-hydroxybutyrate) depolymerases from Pseudomonas lemoignei. AB - Extracellular poly(3-hydroxybutyrate) depolymerase was purified from the culture medium of Peudomonas lemoignei and separated into four isozymes (A1, A2, B1 and B2) by CM-Sepharose CL-6B chromatography. The molecular weights of A1 and A2 and those of B1 and B2 were estimated to be 54 000 and 58 000, respectively, by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The isoelectric points of A1, A2, B1 and B2 were found to be approximately pH 9.7, 10.0, 10.0 and 10.6, respectively, by isoelectric focusing. All four enzymes hydrolyzed poly(3-hydroxybutyrate) and oligomeric esters of D-(-)-3 hydroxybutyrate, but showed no activity toward the dimeric ester. Analysis of hydrolytic products of the oligomeric esters with A1 and B2 suggested that the enzymes hydrolyzed mainly the second and third ester bonds from the free hydroxy terminus at different frequencies, depending upon the chain length of the substrates. PMID- 3967031 TI - Interaction with troponin T from white skeletal muscle restores in white skeletal muscle AMP deaminase those allosteric properties removed by limited proteolysis. AB - Limited proteolysis of rabbit skeletal muscle AMP deaminase (AMP aminohydrolase, EC 3.5.4.6) with trypsin results in conversion of the enzyme to a form which is no longer inhibited by ATP and exhibits hyperbolic kinetics even at low K+ concentration and in the absence of ADP. The interaction with troponin T from white skeletal muscle or with the phosphorylated 42-residue N-terminal peptide of troponin T restores in the trypsin-treated AMP deaminase the sensitivity to adenine nucleotides and increases the KA for K+ activation of the enzyme from 1 mM to 12 mM, this effect being diametrically opposite to that exerted by limited proteolysis on the native enzyme. Treatment of the N-terminal peptide of troponin T with alkaline phosphatase abolishes the modulating properties of the peptide, suggesting that phosphorylation-dephosphorylation processes may be involved in the regulation of the enzyme. PMID- 3967032 TI - Purification and structural comparisons of the cytosolic and mitochondrial isoenzymes of fumarase from pig liver. AB - A method has been developed for the purification of cytosolic and mitochondrial isoenzymes of fumarase from total homogenates of pig liver. Separation of the isoenzymes from one another was achieved using chromatofocusing. The isoenzymes were pure as judged by production of single bands on electrophoresis in the presence of sodium dodecyl sulphate; they appeared to have identical or very similar subunit molecular weights. The isoenzymes differed in electrophoretic properties under nondenaturing conditions. One-dimensional peptide maps of fragments produced from the two isoenzymes by chemical cleavage at cysteine residues were identical; maps obtained after digestion with the V8 proteinase from Staphylococcus aureus showed small differences at short times of digestion which could have reflected variations in rates of hydrolysis rather than structural differences. However, two-dimensional peptide maps of digests obtained by treatment of the isoenzymes with trypsin followed by chymotrypsin had 58 peptides in common, but showed two peptides unique to the mitochondrial isoenzyme and five peptides unique to the cytosolic form. Using the dansylation procedure, the mitochondrial isoenzyme was shown to have N-terminal alanine and the cytosolic form to have N-terminal glutamic acid or glutamine. We conclude that the isoenzymes of fumarase are identical over nearly all of their amino acid sequences but differ at their N-termini; the extent of these differences is yet to be established. These results are consistent with the claim (Edwards, Y.H. and Hopkinson,D.A. (1979) Ann. Human Genet. Lond. 42, 303-313) that the isoenzymes are determined at the same genetic locus, but they raise interesting questions about the biosynthesis of the isoenzymes. PMID- 3967033 TI - Human seminal ribonuclease. A tool to check the role of basic charges and glycosylation of a ribonuclease in the action of the enzyme on double-stranded RNA. AB - Human seminal ribonuclease (a basic protein occurring in a glycosylated and in a non-glycosylated form) is very active against double-stranded RNAs (De Prisco, R., Sorrentino, S., Leone, E. and Libonati, M. (1984) Biochim. Biophys. Acta 788, 356-363). The action of the two enzyme forms on single-stranded and double stranded substrates was studied as a function of pH and ionic strength. Results indicate (1) that glycosylation of the RNAase molecule does not affect enzyme action on single-stranded RNAs, while (2) degradation of double-stranded RNAs is moderately increased by the presence of carbohydrates in the enzyme molecule. Human seminal RNAase shows a marked helix-destabilizing activity on poly(dA-dT) X poly(dA-dT). Under various conditions, this action (1) is definitely stronger than that of bovine RNAase A, and (2) seems to be less dependent on the glycosylation than on the basicity of the enzyme protein. The remarkable activity of human seminal RNAase on double-stranded RNA may, at least partly, be related to the enzyme properties mentioned above. PMID- 3967034 TI - Glycylglycyl-L-cysteine as a substrate for renal sulfhydryl oxidase (glutathione oxidase). AB - Covalent chromatographically isolated bovine kidney sulfhydryl oxidase was found to catalyze the oxidation of cysteine and cysteine-containing substrates as determined by assaying with 5,5'-dithiobis(2-nitrobenzoate). Monitoring the time course of substrate disappearance and product formation by means of high-pressure liquid chromatography revealed that such partially purified renal sulfhydryl oxidase preparations catalyze the direct oxidation of glycylglycyl-L-cysteine to its disulfide form with no other detectable metabolic products. Accordingly, Gly Gly-Cys appears to be better suited for routine assays of sulfhydryl oxidase activity than is the traditionally employed substrate, glutathione, whose oxidation can be initiated by gamma-glutamyltransferase-catalyzed cleavage of the gamma-peptide bond, leading to falsely 'positive' assays in the absence of sulfhydryl oxidase per se. PMID- 3967035 TI - Spin-state equilibrium in the model complexes of azide hemoprotein. AB - Addition of NaN3 to ferric protohemin biscoordinated with 1-methylimidazole (1 MeIm) or 2-methylimidazole (2-MeIm) in (CH3)2SO resulted in sizeable visible absorption changes, corresponding to the formation of the mixed ligand complexes, hemin X N-3 X 1-MeIm and hemin X N-3 X 2-MeIm. The visible absorption spectrum of the 1-MeIm complex was closely similar to those of azide hemoproteins, while the 2-MeIm derivative exhibited intensified 500 and 625 nm bands and depressed 540 and 570 nm peaks. The iron-bound N-3 of the model complexes exhibited two infrared stretching bands, which were assigned to the high- and low-spin peaks. The intensity of the high-spin infrared peaks increased at higher temperature. From the analyses of the infrared spectral changes, the thermodynamic values of the thermal spin equilibria were determined to be delta H = -3920 cal/mol and delta S = -11.1 e.u. for hemin X N-3 X 1-MeIm and delta H = -2150 cal/mol and delta S = 7.9 e.u. for hemin X N-3 X 2-MeIm. The thermodynamic values of the 1 MeIm complex are similar to the reported values for azide metmyoglobin, suggesting that the contribution from the nonbonded porphyrin-globin contacts to the spin equilibrium is small in azide metmyoglobin. Comparison of the delta H and delta S values among model systems indicates that delta H and delta S compensation similar to that observed in hemoprotein also holds in the models. This may suggest an underlying common denominator for the spin-equilibrium mechanisms in hemins and hemoproteins. PMID- 3967036 TI - The quaternary structure and activity of newly purified fatty acid synthetase from the Harderian gland of guinea-pig. AB - Fatty acid synthetase was isolated from the Harderian gland of guinea-pig. The fatty acids synthesized by the purified enzyme were analyzed by mass fragmentography. The purified enzyme had an inherent capacity to utilize methylmalonyl-CoA and synthesize methyl-branched fatty acids. Physicochemical studies indicated that an active enzyme was a dimer, consisted of two subunits of Mr = 2.5 X 10(5). The negatively stained enzyme had an electron micrographic image of an ellipsoidal contour with a continuous middle cleft along the major axis. The major and minor axes were approximately equal to 220 and 150 A, respectively. In a dimer, the subunit had a rod-like structure about 220 A long and 50 A wide. The enzyme was inactivated and dissociated into subunits by incubation at 0 degree C. The inactivated enzyme was fully reactivated by raising the temperature of the solution. The relationship between the quaternary structure of the enzyme and the occurrence of enzymatic activity was studied by high-performance liquid chromatography. Neither active monomers nor inactive dimers were found in inactivation and reactivation processes. The initial velocity of reactivation was proportional to the enzyme concentration over a concentration range of 160-800 micrograms/ml, indicating that the rate determining step in the reactivation reaction was unimolecular. PMID- 3967037 TI - 1-O-alkyl-2-acyl-sn-glycero-3-phosphorylcholine is the precursor of platelet activating factor in stimulated rabbit platelets. Evidence for an alkylacetyl glycerophosphorylcholine cycle. AB - The metabolism of [3H]PAF-acether ([1',2'-3H]alkyl-2-acetyl-sn-glycero-3 phosphorylcholine ([3H]alkylacetyl-GPC)) by rabbit platelets was investigated using thin-layer chromatography and high-performance liquid chromatography followed by radioactivity detection. After 2 h of incubation at 37 degrees C, 90 +/- 5.3% of [3H]PAF-acether taken up by the platelets were converted into a product identified as sn-2 long-chain acyl analogue ([3H]alkylacyl-GPC) which was incorporated in the membranes. This conversion was independent from extracellular calcium and was completely inhibited by platelet pre-exposure to 2 mM phenylmethylsulfonyl fluoride, a serine hydrolase inhibitor, which failed to inhibit the uptake of [3H]PAF-acether by the cells. The 2-deacetylated derivative, lyso-[3H]PAF-acether was found to be an intermediate of the conversion of [3H]PAF-acether into [3H]alkylacyl-GPC in platelet homogenates. Platelet stimulation with 2.5 U/ml of thrombin induced a reduction (16.5 +/- 2.2%) of its content of [3H]alkylacyl-GPC, accompanied by the release of [3H]PAF acether and lyso-[3H]PAF-acether to the medium. These effects were suppressed by the phospholipase A2 inhibitor, p-bromophenacyl bromide. Our results demonstrate that intact platelets convert exogenous PAF-acether into alkylacyl-GPC, which can serve as the precursor of PAF-acether released during stimulation. The existence of a metabolic cycle for the uptake, the release and the inactivation of PAF acether by platelets is suggested. PMID- 3967038 TI - The cerebro-hepato-renal (Zellweger) syndrome. Impaired de novo biosynthesis of plasmalogens in cultured skin fibroblasts. AB - In tissues of patients with the cerebro-hepato-renal (Zellweger) syndrome the plasmalogen content is very low. In order to study the biosynthesis of plasmalogens, skin fibroblasts of Zellweger patients, controls and heterozygotes, and amniotic fluid cells of controls were cultured in a medium supplemented with [1-14 C]hexadecanol or 1-O-[9,10-3H2]octadecylglycerol. The incorporation of 14C label into the alkenyl moiety of plasmalogens was strongly reduced in Zellweger patients as compared to controls. The low concentration of 14C-labeled plasmalogens was not compensated for by an elevated levels of 14C-labeled alkyl phospholipids. Hexadecanol was partly oxidized to fatty acid in all cell lines and the incorporation of 14C-labeled fatty acid into phospholipids was comparable for patients and controls. [3H]Alkylglycerol was incorporated into plasmalogens with the same efficiency in Zellweger patients as in controls. These results indicate that only the reaction(s) involved in the introduction of the ether bond in the process of plasmalogen synthesis are deficient in Zellweger patients. The results also suggest that the hexadecanol incorporation patterns can be used for the (prenatal) diagnosis of the Zellweger syndrome. PMID- 3967039 TI - Microsomal fatty acid desaturase activities in vitamin A-deficient rat liver. AB - The activity of microsomal fatty acid delta 9-desaturase was significantly higher in liver microsomes of vitamin A-deficient rats as compared with their controls. Feeding of vitamin A-supplemented control diet to the deficient rats restored the delta 9-desaturase activity to the control values. The activity of delta 6 desaturase was not affected by vitamin A deficiency. PMID- 3967041 TI - Interactions of pig brain cytosolic sialidase with gangliosides. Formation of catalytically inactive enzyme-ganglioside complexes. AB - Cytosolic sialidase A was extracted from pig brain and purified about 2000-fold with respect to the starting homogenate (about 550-fold relative to the cytosolic fraction). The enzyme preparation provided a single peak on Ultrogel AcA-34 column chromatography and had an apparent molecular weight of 4 x 10(4). On incubation with micellar ganglioside GT1b, (molecular weight of the micelle, 3.5 x 10(5)) under the conditions used for the enzyme assay, brain cytosolic sialidase A formed two ganglioside-enzyme complexes, I and II, which were isolated and characterized. Complex II had a molecular weight of 4.2 X 10(5), and a ganglioside/protein ratio (w/w) of 4:1. This is consistent with a stoichiometric combination of one ganglioside micelle and two enzyme molecules. Complex I was probably a dimer of complex II. In both complexes I and II cytosolic sialidase was completely inactive. Inactivation of cytosolic sialidase by formation of the corresponding complexes was also obtained with gangliosides GD1a and GD1b, which, like GT1b, are potential substrates for the enzyme and GM1, which is resistant to the enzyme action. Therefore, the enzyme becomes inactive after interacting with ganglioside micelles. GT1b-sialidase complexes acted as excellent substrates for free cytosolic sialidase, as did the complexes with GD1a and GD1b. PMID- 3967040 TI - Intestinal mucins and cholesterol uptake in vitro. AB - A mucus material, secreted by intestinal segments, with a high affinity for cholesterol, has been isolated and chemically characterized. The mucin contained 11% carbohydrate, largely as glucosamine, galactose and N-acetylneuraminic acid, and 19% lipid, of which 86% was unesterified fatty acid. The isolated material readily bound cholesterol in a stoichiometric manner. Conditions known to enhance cholesterol absorption in vivo also decreased mucin complexing to cholesterol in vitro. This association of cholesterol and intestinal surface mucin also occurred during incubations of intestinal segments with dispersed cholesterol, resulting in a high level of intestinal adsorption, with little or no cellular absorption of the sterol. However, when cholesterol was solubilized in simple or complex micelles containing bile salts, surface adsorption of cholesterol was reduced and net absorption was increased. The results suggest that surface mucin binding of cholesterol may represent at least one major diffusion limitation to cholesterol absorption in the intestine. PMID- 3967042 TI - Carnitine palmitoyltransferase. Activation by palmitoyl-CoA and inactivation by malonyl-CoA. AB - Extraction of rat liver mitochondria twice with 0.5% Triton X-100 in a salt-free medium leaves less than 10% of the carnitine palmitoyltransferase membrane bound. The remaining membrane-bound enzyme is inhibited virtually completely by 10 microM malonyl-CoA. Preincubation of the extracted membranes with palmitoyl-CoA and salts (KCI) for several minutes activates the enzyme and makes it increasingly insensitive to malonyl-CoA. Addition of malonyl-CoA to the preincubation reverses this desensitization. In albumin-containing media salts also decrease the binding of palmitoyl-CoA to albumin and stimulate carnitine palmitoyltransferase by increasing substrate availability in free solution. The reverse reaction shows accelerated desensitization by palmitoylcarnitine and resensitization by malonyl-CoA. PMID- 3967043 TI - Impairment of citrulline synthesis during late pregnancy and lactation in rats. AB - Synthesis of citrulline by rat liver mitochondria was investigated during late pregnancy and early lactation. It was strongly decreased over all the period studied except during delivery, where a sudden rise was observed. The mitochondrial enzymes carbamoylphosphate synthetase I (ammonia) (EC 6.3.4.16) and ornithine carbamoyltransferase (EC 2.1.3.3) did not fall significantly during this period, although carbamoylphosphate synthetase I (ammonia) was slightly decreased antepartum. Citrulline synthesis was found significantly correlated to N-acetylglutamate concentration in mitochondria throughout the period considered. On the other hand, low levels of N-acetylglutamate could be explained by low activity of N-acetylglutamate synthase (EC 2.3.1.1). PMID- 3967044 TI - Glycosaminoglycan content of glomerular and tubular basement membranes of various mammalian species. AB - A spectrophotometric assay was applied for quantitation of sulfated glycosaminoglycans in digested renal basement membranes of six mammalian species. The conditions of digestion and the accuracy of the assay were evaluated. Papain digestion and alkaline treatment appeared to be most effective for solubilization. Basement membrane preparations obtained by sonication contained more glycosaminoglycans than those isolated by detergent treatment. Glomerular basement membranes had generally a higher glycosaminoglycan content than tubular basement membranes. PMID- 3967045 TI - The metallochromic indicator dye Arsenazo III forms 1:1 complexes with caffeine. AB - The metallochromic indicator dye, Arsenazo III, forms a 1:1 complex with caffeine, a methylxanthine. Binding is accompanied by a wavelength-dependent shift in the absorption spectrum of the dye. The magnitude of the absorption change is significant at wavelengths typically used to monitor intracellular calcium ion. The equilibrium constant for the caffeine-dye reaction is approx. 20 mM. The complex has a differential molar extinction coefficient of -5.05 X 10(3) M-1 X cm-1 at 630 nm. PMID- 3967046 TI - The influence of adenosine triphosphate, adenosine diphosphate and cytochalasin B on nucleotide exchange of F-actin. Evidence that treadmilling is not involved. AB - [14C]ATP-containing G-actin was polymerized to [14C]ADP-containing F-actin. The exchange of the filament-bound nucleotide with nucleotides of the medium was investigated by measuring the loss of radioactivity from the filaments under various conditions. Nucleotide exchange was faster in the presence of ATP than of ADP (this could be observed in the presence of Mg2+ as well as in the presence of Ca2+). Cytochalasin B had a small accelerating effect in the presence of ATP but had no effect in the presence of ADP. The kinetics of exchange remained unchanged when the filaments contained a 'cap' of actin with non-radioactive nucleotides, suggesting that nucleotide exchange was not a property of the filament ends. PMID- 3967047 TI - Electrochemical and glucose oxidase coenzyme activity of flavin adenine dinucleotide covalently attached to glassy carbon at the adenine amino group. AB - Flavin adenine dinucleotide (FAD) was covalently attached to an electron conducting support, i.e., glassy carbon. The support was activated by oxidation to create surface carboxylic acid groups, followed by reaction with a water soluble carbodiimide. FAD was then attached to the activated support by three different methods: (1) directly; (2) through 6-aminocaproic acid as a spacer; and (3) through ethylenediamine glutaraldehyde as a spacer. Coupling occurred at the FAD adenine amino group, or possibly at a ribityl OH group. Cyclic voltammetry was used to determine Eo' values and FAD loadings. The immobilized FAD also acted as a catalyst for the oxidation of reduced nicotinamide adenine dinucleotide (NADH) in that it reduced overpotential by about 195 mV. When the apoenzyme of glucose oxidase was added to the glassy carbon-FAD or glassy carbon-spacer-FAD preparations, no reconstitution of enzyme activity could be observed. This suggests strongly that the adenine amino group of FAD cannot be modified by attachment of something as large as easily visible solid particles. However, it leaves unanswered the question of larger molecular weight material can be accommodated in the FAD-apoenzyme cleft and retain glucose oxidase activity. PMID- 3967048 TI - Specific inhibition of polyamine oxidase in vivo is a method for the elucidation of its physiological role. AB - N1-Methyl-N2-(2,3-butadienyl)-1,4-butanediamine (MDL 72521) and N1,N2-bis(2,3 butadienyl)-1,4-butanediamine (MDL 72527) are specific, potent, enzyme-activated, irreversible inhibitors of polyamine oxidase in vitro. These compounds are also capable of completely inhibiting polyamine oxidase in mouse tissues at intraperitoneal doses greater than 20 mg/kg. Enzyme activity reappears in the various organs within 2-3 days to 50% of the control values. Irreversible inhibition of polyamine oxidase in mice led to decreased putrescine (30-40%) and spermidine (10-20%) levels in liver and some other organs. At the same time N1 acetylspermidine and, to a lesser extent, N1-acetylspermine were accumulating at rates which are assumed to be related to the rates of polyamine degradation. Even after treatment with polyamine oxidase inhibitors over a period of 6 weeks at doses which produced complete inhibition of polyamine oxidase in all organs, including the brain, neither toxic effects nor changes in body weight or behaviour were observed. PMID- 3967049 TI - Oxidative metabolism of cultured human skeletal muscle cells in comparison with biopsy material. AB - Human muscle cell cultures were examined for capacities to oxidize several substrates, and for activities of some enzymes related to intermediate metabolism. The results indicate that mitochondrial activities attained appreciable degrees of maturity. The specific activity of creatine kinase increased during myoblast fusion. In contrast, parameters of oxidative metabolism (palmitate and pyruvate oxidation, and cytochrome c oxidase and citrate synthase) did not significantly change throughout myogenesis and thereafter. In differentiated cells (myotubes) the oxidation capacities were pyruvate greater than 2-oxoglutarate greater than malate (+ acetylcarnitine) greater than malate (+ pyruvate), as in muscle biopsies. With regard to protein the cultured human muscle cells showed higher activities than the original biopsies (= 100%) with respect to citrate synthase (179%), but lower values for cytochrome c oxidase (50%) and creatine kinase (7%). Palmitate oxidation capacities were the same in both systems. The presence of antimycin and rotenon inhibited to a comparable extent the palmitate oxidation in cultured muscle and biopsies. PMID- 3967050 TI - Increased biosynthesis of pyruvate kinase under hypoxic conditions in mammalian cells. AB - The rate of biosynthesis of pyruvate kinase (ATP:pyruvate 2-O-phosphotransferase, EC 2.7.1.40) was compared in cells maintained under normoxic or hypoxic conditions. L8 cells (a myoblast cell line) were pulse-labeled with [3H]leucine and incorporation of radioactivity into pyruvate kinase was measured after quantitative affinity separation with anti-pyruvate kinase monoclonal antibody. During chronic hypoxia there is an increased rate of biosynthesis of pyruvate kinase leading to an increase in enzyme content and augmented glycolytic capacity. An inhibitor of the electron transport chain, antimycin A, was used to determine whether changes in pyruvate kinase content occurring during hypoxia are a result of reduction in molecular oxygen directly or an indirect consequence of oxygen depletion. Pyruvate kinase activity increased during chronic antimycin A exposure under normoxic conditions. The increase was quantitatively accounted for by an increase in cellular pyruvate kinase enzyme content. This suggested that decreases in the levels of molecular O2 are not the direct stimulus for the increased content of pyruvate kinase. It is more likely that the increased pyruvate kinase content results from depressed rates of electron transport through the mitochondrial electron transport chain. PMID- 3967052 TI - Post-receptor actions of somatomedin on chondrocyte collagen biosynthesis. AB - The anabolic effects of human somatomedin C on freshly isolated Swarm chondrosarcoma chondrocytes were studied. Physiological concentrations (2-34 nM) of somatomedin, but not growth hormone, stimulated the incorporation of radiolabeled precursors into collagen and non-collagen proteins, RNA and proteoglycans. The 120% increase in radiolabeling of collagen with [3H]proline by 10 nM somatomedin C was not due to changes in the rate of [3H]proline uptake. Similarly, the specific activity of newly synthesized [3H]proline-labeled collagen was not increased by 10 nM somatomedin C, indicating that changes in proline pool size or compartmentalization of [3H]proline were not involved. Somatomedin C had no effect on the rate of [3H]collagen degradation. The ability of somatomedin C to stimulate collagen synthesis was unaffected by concentrations of actinomycin D which inhibited chondrocyte RNA synthesis 90% or more. These results demonstrate that somatomedin exerts a general anabolic effect on chondrosarcoma chondrocyte metabolism. The fact that somatomedin C stimulates chondrocyte collagen synthesis in the absence of RNA synthesis suggests that this effect may be at the post-transcriptional level. PMID- 3967051 TI - Protein mixed-disulfides in cardiac cells. S-thiolation of soluble proteins in response to diamide. AB - Protein mixed-disulfides in cultured rat heart cells were analyzed by gel electrophoresis under conditions that eliminated artifactual formation of these protein derivatives. Protein S-thiolation (protein mixed-disulfide formation) was detectable under normal culture conditions. Diamide oxidized intracellular glutathione in these cells and produced extensive protein S-thiolation. The specificity of this protein modification indicates a role in the regulation of cardiac metabolism. PMID- 3967053 TI - Effects of different ways of covering the eyes on behavior of jaundiced infants treated with phototherapy. AB - This study was performed to determine whether covering the eyes with an opaque screen over the head end of the bassinet instead of the normal patch would improve the behavioral organization of jaundiced, but otherwise healthy, term infants treated with phototherapy. 38 matched infants were randomly assigned to have a patch or a screen. Serum bilirubin at the time of observation was 11.2 17.5 mg/100 ml (mean = 13.7, patch) and 9.4-16.4 mg/100 ml (mean = 13.4, screen). 19 infants, of whom 11 were jaundiced (6.2-14.3 mg/100 ml, mean = 10.3), served as control subjects. The infants were examined with the Brazelton scale on the 3rd day after birth, when the patch subjects had been under blue light from 6 to 45 h (mean = 23.9), and the screen subjects from 6 to 61.5 h (mean = 22.6). The control subjects scored better (all differences, p less than 0.05) than the patch subjects on inanimate visual, animate visual, visual and auditory, alertness. The control subjects also did better than the screen subjects on inanimate visual, animate visual, animate auditory, visual and auditory, alertness, but poorer on motor maturity and consolability. The screen subjects did poorer than the patch subjects only on skin color lability. At 1 month of age, 9 sets of matched infants were examined. The only difference was that the control subjects did better than the patch subjects on animate visual and lability of state. Our data confirm the poorer short-term orientation performance of jaundiced infants treated with phototherapy but do not indicate that covering the eyes with an opaque screen improves behavioral organization. PMID- 3967054 TI - The metabolic and endocrine milieu of the human fetus at 18-21 weeks of gestation. II. Blood glucose, lactate, pyruvate and ketone body concentrations. AB - Blood levels of glucose, lactate, pyruvate and total ketone bodies were measured in 16 conscious mothers and their minimally stressed fetuses at 18-21 weeks gestation. Blood samples were taken from the maternal antecubital vein and from the fetal umbilical vein and artery during fetoscopy prior to termination of pregnancy. The mean concentrations of blood glucose, lactate and pyruvate were similar in maternal and fetal venous blood; no significant difference was found between the fetal umbilical artery and vein concentrations. Maternal total blood ketone body levels were significantly higher than fetal levels with no detectable umbilical venous arterial concentration difference. There was a significant inverse relationship between the umbilical artery levels and the umbilical venous arterial concentration differences for blood glucose and lactate. PMID- 3967055 TI - Bile acid metabolism during development: metabolism of taurodeoxycholic acid in human fetal liver. AB - The metabolism of tauro-[24-14C]deoxycholic acid was studied in microsomal preparations from fetal liver. The livers were obtained at legal abortions performed between week 13 and 24. Taurodeoxycholic acid was efficiently hydroxylated in the 1 beta- and 7 alpha-positions. The hydroxylase activities did not increase with gestational age. A marked variation in extent of hydroxylation was noted between different preparations. The results are discussed in relation to earlier knowledge of fetal and neonatal bile acid metabolism. PMID- 3967056 TI - Effects of fetal decapitation upon porcine placental metabolism. Evidence for a fetal influence in placental metabolism. AB - This experiment was performed to determine if the fetus can influence its placental metabolism. Fetal pigs were decapitated at 45 days of gestation and their placentas compared at 110 days to within litter controls. No histological or histochemical differences were observed. Glycogen levels were elevated in the fetal placenta of decapitated pigs by 107%. Fatty acid synthesis was increased in the fetal placenta of decapitated animals (12.9 +/- 1.5 vs. 3.4 +/- 0.7 nmol acetate units/100 mg/2 h). Fetal decapitation increased fetal placental fatty acid esterification by 43% and oxidation by 125%. The altered lipid metabolism of the fetal placenta was reflected in enzymes associated with substrate utilization (pyruvate kinase and lactate dehydrogenase). Maternal placenta lipogenesis was also altered by fetal manipulation. Leucine conversion to its alpha ketoacid was increased in the fetal placenta of the decapitated pigs (14.8 +/- 1.7 vs. 8.6 +/- 1.4 nmol/100 mg/2 h) indicating amino acid metabolism was affected by this treatment. The ability of an altered fetal endocrinology and metabolism to affect the placental metabolism supports the concept of a fetal influence on placental metabolism. PMID- 3967057 TI - Lipolytic activity of renal cortex during ontogenetic development in rats. AB - The lipolytic activity of rat kidney cortex was investigated in newborn and adult rats. Two peaks of lipolytic activity could be detected at pH 5.0 and 8.4, respectively. Lipase activity at pH 5.0 is completely inhibited by 0.2 M sodium fluoride and can be stimulated by norepinephrine (10 micrograms/ml). Full activity is already present in 5-day-old rats. The response to sodium fluoride and norepinephrine is identical in newborn and adult animals. Lipase activity at pH 8.4 is inhibited up to 85% by 0.6 M sodium chloride. Activity is very low in 5 day-old rats and increases during maturation. This lipase can be stimulated by heparin (100 micrograms/ml) by about 10-25% in newborn and adult animals. PMID- 3967058 TI - Coagulation factors in the premature infant born after about 32 weeks of gestation. AB - In plasma samples from 10 premature infants born after about 32 weeks of gestation, a number of coagulation factors have been determined. For 9 infants, who were healthy, mean values are given: fibrinogen-antigen, 311 mg/dl; factor II, +/- 0.46 U/ml; factor V, 0.80 U/ml; factor VII, 0.59 U/ml; factor VIII coagulant activity, 0.93 U/ml; factor VIII-related antigen, 1.66 U/ml; procoagulant factor VIII antigen, 1.15 U/ml; factor IX coagulant activity, 0.41 U/ml; factor IX antigen, 0.42 U/ml; factor X coagulant activity, 0.52 U/ml; factor X antigen, 0.61 U/ml, and antithrombin III-antigen (AT-III), 0.43 U/ml. In 5 infants a second sample was taken a week after the first one; for most values there was no significant rise, except for factor II and AT-III. The values we found in this group of premature infants are within the range of those reported in earlier literature. They are higher than the ones we found in early fetal samples and most of them are similar to those we found in early fetal samples and most of them are similar to those we found in the cord blood of full-term newborns. PMID- 3967059 TI - [Systemic hemodynamic changes during the development of DOCA-salt hypertension. The effect of neonatal sympathectomy]. AB - The elevation of the cardiac index was discovered at the initial stage of DOCA salt hypertension in rats. The blood pressure rise at the stage of stable hypertension was caused by an increase in the total peripheral vascular resistance. Neonatal sympathectomy prevented the development of DOCA-salt hypertension and elevation of the cardiac index revealed in control sympathectomized rats. PMID- 3967060 TI - [Structural organization of the compensation process in the lymph nodes in venous stasis]. AB - Transmission and scanning electron microscopy was used to study the structural organization of the lymph nodes during venous congestion. At the early period (1 h of venous congestion) one could see an increased number of the fenestrated cells in the venous part of the capillary whereas at the later period (after 6 h to 3 days) a rise of the microvesicular transport via endotheliocytes of the arterial part of the capillary and via fenestras of the venous part. Within 7 to 14 days one could see activation of the microvesicular transport via the indicated parts of the capillary. At all the stages of venous congestion the fluid contained by the parenchyma of the lymph node penetrates via fenestras and intercellular fissures to the marginal sinus, while only via fenestra to the cerebral sinuses. PMID- 3967061 TI - [Effectiveness of protecting the myocardium against ischemia with a normothermic cardioplegic solution and creatine phosphate]. AB - The protective effects of cardioplegic solutions (CS) containing creatine phosphate (CP) were studied in a rat heart model of cardiopulmonary bypass and ischemic cardiac arrest. Isolated rat hearts were subjected to a 3-minute coronary infusion with CS containing CP in normothermic (37 degrees C) and hypothermic (4-6 degrees C) regimes. In the normothermia group, the postischemic functional recovery was 70-75% of the preischemic control value, while the cellular ATP and CP content was reduced but insignificantly. By contrast, in the hypothermia group, the postischemic functional recovery was markedly depressed, with the tissue high-energy phosphate content being appreciably lowered. The data obtained confirm high efficacy of CP-containing cardioplegic solutions administered under normothermia conditions. PMID- 3967062 TI - [Immunosedimentation analysis of proteins]. AB - After performing experiments with protein sedimentation the ultracentrifuge test tube was attached to the inferior opening of the channel in the agar block with a vertical gradient of saccharose concentration. The liquid with protein zones was removed from the test-tube to the channel, forcing a 60% solution of saccharose beneath the lower layers in the test-tube. Horizontal electrophoresis was performed so that the protein zones penetrated the width of the channel walls. A piece of agar gel was cut out from the walls along the whole height of the channel. That piece was placed on the slide and embedded with a mixture of agar and antiserum. Immunoelectrophoresis was made according to Lowrell. The method permits obtaining for the first time continuous sedimentograms during immunodevelopment of the protein zones derived on ultracentrifugation. PMID- 3967063 TI - [Distortions of respiratory indices during muscle work in research procedures using masks]. AB - Maskless telemetry of respiration (dynamic radiorheopneumography) developed by one of the authors was employed in observations over 66 persons during laboratory running and over 13 athletes in the course of routine training. It was shown that conventional research methods for pulmonary ventilation produce significant disturbances in the respiratory parameters: the respiratory rate diminishes, the respiratory volume increases. The disturbances are more pronounced in men, rising with increase in exercise intensity up to 20-30% and more. Transition from restrained to free respiration is accompanied by more remarkable changes in the respiratory parameters as compared to reverse transition. PMID- 3967064 TI - [Phenomenon of indirect isoserological incompatibility in experimental transfusion research and its clinical significance]. AB - It has been established in experiments on dogs exposed to blood transfusions that if the animals are screened according to the cross-matching testing system and show as a result the lack of red blood cell agglutination, this does not provide evidence in favour of their complete isoserological compatibility. To confirm whether the animals are compatible, it is required to carry out 7 to 8 tests with other species. If the tests reveal red blood cell agglutination, blood transfusion is characterized by demonstrable isoserological incompatibility and the recipient dies. If the cross-matching with the other animals of the group is accompanied by red blood cell agglutination but the latter is absent in the testing of a particular animal pair, such a condition is designated as "indirect" incompatibility, since hemotransfusion in this animal pair is characterized by the manifestations of incompatibility. However, it is not so pronounced and the recipient can be saved by intensive care. The authors conclude that isoserological incompatibility has different grades of intensity and offer methods for the screening of animals for simulation of graver and facilitated grades of incompatibility. It is assumed that the clinical transfusiology also has grades of the severity of hemotransfusion-induced conflicts, particularly in cardiosurgery. The use of large amounts of donor's blood for extracorporeal circulation and making for large blood losses is very likely to entail isoserological incompatibility cases which may remain unrecognized because of the gravity of surgical intervention, provoking at the same time the postoperative acute heart failure. PMID- 3967065 TI - [Role of K+, Na+, and Ca2+ ions in the cardiodepressive action of blood plasma in burn shock and the crush syndrome]. AB - Ion-selective electrodes were employed to measure the concentration of K+, Na+ and Ca2+ in blood plasma of rabbits with burn shock or crush syndrome (CS). No significant changes in the plasma concentration of Na+, and Ca2+ were found under both pathological conditions. The plasma concentration of K+ in burn shock significantly increased from 3.06 +/- 0.73 (control) to 5.28 +/- 2.65 mM (n = 10), whereas in CS from 3.42 +/- 1.03 to 4.92 +/- 1,29 mM (n = 8). The rise of K+ concentration in the control plasma to the maximal values seen in the "burn" and "syndrome" plasma led to an increase in the duration of intracellular action potentials (AP) but did not substantially change the amplitude of isometric contractions of the papillary muscles of rabbit heart. Meanwhile the similar rise of the duration of intracellular AP during perfusion of the papillary muscles with the "burn" and "syndrome" plasma was accompanied by an appreciable drop of the amplitude of isometric contractions. It is suggested that elevation of K+ concentration in blood plasma, inducing an increase in the duration of intracellular AP of cardiocytes may be responsible for changes in the ECG in burn and CS. At the same time inhibition of myocardial contractility in burn shock and CS is virtually not linked with hyperkalemia. PMID- 3967066 TI - [Quantitative changes in liver dehydrogenase activity during temporary ischemia of the extremities and in the postischemic period]. AB - Experimental temporary occlusion of the dog hind limbs was produced. Histoenzymological changes in the liver induced by the temporary ischemia of the limbs and by ischemia with a 2-hour revascularization were subjected to comparative histophotometric examination. The data obtained indicate an appreciable rise in the enzymatic activity of hepatocytes at the early stages of experiments and increasing reduction in metabolic processes at the later stages. A substantial decrease was noted in the activity of the liver enzymes under study, with that decrease being especially pronounced at the later times in experiments with limb revascularization, which is accounted for by a far greater release to the bloodstream of metabolic products from the ischemized limbs. PMID- 3967067 TI - [Importance of the functional activity of thrombocytes and the antiaggregation activity of the vascular walls in regulating blood aggregation]. AB - It was established in dog experiments that aggregation activity of platelets and the rate of aggregation were higher in arterial than in venous blood, with the platelet content being identical. Antiaggregation activity of vascular walls of the arterial system. The data obtained indicate the presence of the arteriovenous difference of the function of the vascular-platelet hemostasis, which is of a role in the processes of regulating the state of blood aggregation in the body. PMID- 3967068 TI - [Microchromatographic study of proteins in hippocampal field CA3 during prolonged posttetanic potentiation in surviving sections]. AB - A study was made of 3H-leucine incorporation into water- and tween-soluble proteins of the hippocampal CA3 field under the development of prolonged post tetanic potentiation (PPTP) because of stimulation of mossy fibers. The mixture of supernatant proteins was assayed by ion-exchange microchromatography while each fraction was evaluated for the radioactive label incorporation. In the course of the assay of the chromatograms obtained, no significant alterations in the protein spectrum were found during the development of the PPTP. Substantial changes were identified in the rate of the labeled leucine incorporation in the acid part of the spectrum represented by acid proteins and polypeptides including brain specific ones. It is assumed that the development of the PPTP in the hippocampal pyramids is associated with activation of the proteins under consideration. PMID- 3967069 TI - [Fatty acid composition of mitochondrial phospholipids of the ischemic heart]. AB - Gas liquid chromatography was used to study fatty acid (FA) composition of lysophosphatidylcholine (lyso-PC) and phosphatidylcholine in isolated rabbit heart mitochondria. In control, lyso-PC and PC were found to contain 95 and 66% of unsaturated FA, respectively. At 1 hour of ischemia (autolysis at 37 degrees C) the percentage of saturated FA in lyso-PC noticeably increased whereas FA composition remained unchanged. It is concluded that changes in FA composition of lyso-PC are caused by phospholipase A2 action. PMID- 3967070 TI - [Effect of brain antibodies on the lipid peroxidation process in the brain]. AB - The authors studies the effects of blood serum and IgG fraction from dogs immunized with brain and blood sera from patients with multiple sclerosis and schizophrenia on lipid peroxidation in rat brain homogenates. Measured the content of diene conjugates (DC) and malonic dialdehyde (MDA) in the rat brain after administering the IgG fraction. It was established that antioxidant activity of blood sera and IgG fraction from control animals and donors was significantly higher as compared to experimental. Administration of the IgG fraction brought about an increase in the content of DC and MDA in the brain of experimental animals. It is concluded that complement-dependent brain antibodies present in the blood serum of patients with schizophrenia and multiple sclerosis potentiate lipid peroxidation in the cerebral tissue and that the unsophisticated and informative method for antibody determination may be used in clinical practice. PMID- 3967071 TI - [Effect of desglycine-arginine vasopressin on the excitability of the command neurons of the defensive reflex in the edible snail]. AB - Perfusion of the snail (Helix lucorum L.) CNS with DG-AVP (concentration 10(-6) M) in the course of low frequency intracellular stimulation (2-4-minute interval) of the defensive reflex command neurons led to an increase in the excitability. It was expressed both in the reduction of the spike generation latency, in the increased number of spikes in response to fixed stimuli, and in the activation of pacemaker potentials. If DG-AVP was added to the medium during endoneuronal habituation, there was no increase in the excitability. It is supposed that modification of the neuronal excitability may be caused by the DG-AVP effect on the pacemaker mechanism. PMID- 3967072 TI - [Activation of the caffeine center of the sarcoplasmic reticulum at a reduced concentration of magnesium ions]. AB - The action of caffeine and Mg2+ on the efficacy of Ca2+ transport by terminal cisterns and longitudinal tubules of rabbit skeletal muscle sarcoplasmic reticulum (SR) was studied and compared. Addition of 5 to 10 mM caffeine to the incubation medium or a decrease in Mg2+ concentration from 4 to 0.1 mM led to a 3 fold diminution of the Ca/ATP ratio for the terminal cistern fraction. In longitudinal tubules, that effect was far less pronounced. The effects of caffeine and decreases in Mg2+ concentration were blocked by ruthenium red, tetracaine and dimethylsulfoxide. It is assumed that the decrease in Mg2+ concentration is accompanied by activation of the caffeine site of the SR, induced by the intravesicular caffeine-like factor. PMID- 3967073 TI - [Protein-synthesizing function of the liver of rabbits in experimental myocardial infarct]. AB - The content of serum albumin in rabbit blood was found to be lowered within the first day after reproduction of experimental myocardial infarction. The rate and the level of translation of endogenous mRNA were studied in cell-free systems from normal rabbit liver and 6-12-24 h after experimental myocardial infarction. The decrease of the total protein synthesis in the crude cell-free system from the liver of experimental animals was shown to depend on the lack of energy supply rather than on the reduced activity of the protein-synthesizing apparatus. The relative drop of protein synthesis in the cell-free system with saturating concentration of ATP, GTP and creatine phosphate is likely to be connected with a decrease in the proportion of membrane-bound polysomes. PMID- 3967074 TI - [Anticoagulant and nonenzymatic fibrinolytic activity of plasma in animals after intravenous injection of a heparin-antithrombin III complex]. AB - The heparin-antithrombin III complex with a weight ratio 1:3 had a powerful anticoagulant and non-enzymatic fibrinolytic activity in vitro. Seven and 30 min after intravenous injection of the complex the animal blood plasma showed a considerable prolongation of the thrombin time and an increase in non-enzymatic fibrinolytic activity. The effect of heparin injected in a dose equivalent to its content in the complex on the parameters under study was appreciably less and disappeared by the 30th minute of the observation period. PMID- 3967075 TI - [Mechanism of the cerebrovascular effect of piracetam]. AB - Piracetam produces a more pronounced effect on cerebral circulation disturbed by hemorrhagic shock as compared with intact animals. Piracetam has a depressant effect on the nervous regulation of cerebral circulation by suppressing the reflex constriction of the vessels in both arterial systems of the brain. The cerebrovascular effects of piracetam are not mediated through the GABAergic bicuculline-sensitive mechanisms, which is supported by experiments where the drug exhibits its effects under the blockade of GABA receptors. PMID- 3967077 TI - [Corticosterone reception by alveolar macrophages when their functional activity has changed]. AB - The binding of 3H-corticosterone by rat alveolar macrophages was studied before and after stimulation with zymosan in vivo. Thirty min after incubation of the macrophagal monolayer from intact animals with 3H-corticosterone accumulation of the hormone by the cells came to an end. As the concentration of 3H corticosterone in the incubation medium was raised, the binding of the hormone with the saturated (receptor) system of alveolar macrophages terminated upon absorption of 10.6 fmol per 10(6) cells. Further raising of the level of the bound hormone was effected by the unsaturated (lipid) system. Stimulation with zymosan led not only to an increase in the number of the cells of the bronchoalveolar tract but also to an elevation of the intensity of 3H corticosterone engulfment by alveolar macrophages. The number of binding sites per cell in the zymosan-activated macrophages increased 1.5-fold. This may be an important moment determining the development and liquidation of mononuclear infiltrations in the lung. PMID- 3967076 TI - [Kinetics of 3H-remantadine accumulation and excretion in the tissues of pregnant mice and their fetuses]. AB - The authors studied the pharmacodynamics of remantadin in fetuses, liver, kidneys and spleen of pregnant mice after a single oral administration of 3H-remantadin in a dose of 2.8 mg/kg. Thirty to 60 min after the drug administration the fetuses and tissues showed the maximal amount of the drug penetrating an organ. The greatest amount of remantadin was detected in the liver, the least amount in the kidneys and fetuses. The drug half-life in organs and fetuses did not exceed 2 hours. Twelve hours after the drug administration the kidneys and spleen demonstrated remantadin traces (less than 0.1%), the fetuses showed 0.2% and the liver about 0.7% of the drug. It is concluded that remantadin is marked by good placenta permeability and that it is completely eliminated from the fetus. PMID- 3967078 TI - [Effect of adrenalectomy of the recipients of allogeneic lymphocytes on the inactivation of endogenous colony-forming cells in mice]. AB - Intravenous injection of lymph node cells from the parental C57BL/6 mouse line in doses of 2 X 10(6) or 5 X 10(6) into sublethally irradiated (CBA X C57BL/6) F1 hybrids produced more demonstrable suppression of endogenous colony-formation in adrenalectomized recipients as compared with that seen in sham-operated on ones (P less than 0.01). The recipients' adrenalectomy itself was accompanied by an over 2-fold increase in the number of the endogenous colony-forming cells in the spleen as compared with sham-operated on mice. Possible mechanisms, by which the killer action of lymphocytes on the endogenous colony-forming cells is potentiated, are under discussion. PMID- 3967079 TI - [Induction of drug resistance to sarcolysine in plasmacytoma line MORC/406]. AB - A sarcolysine-resistant strain of mouse plasmacytoma MOPC/406 was obtained in experiments on 250 BALB/c mice. The initial plasmacytoma strain is highly sensitive to sarcolysine. When administered in doses of 10 and 5 mg/kg it increases the lifespan up to 50 days (the observation period). In the course of resistance induction by incremental doses of sarcolysine, a highly resistant plasmacytoma strain was obtained. In the 20th generation of inoculations with the use of sarcolysine administration of 10 mg/kg (intraperitoneally) provided only a 18% increase in the lifespan, whereas the dose 5 mg/kg stimulated the growth of plasmacytoma. The strain obtained preserves its resistance under cryoconservation in liquid nitrogen, being a model that permits one to study resistance, cross resistance and approaches to its overcoming. PMID- 3967080 TI - [Amino acid composition of the lymph and blood in allergic transformations of the body]. AB - The time-course of changes in the content of free amino acids and total protein in lymph of the thoracic duct and peripheral blood was studied in dogs during sensitization and anaphylactic shock (AS). Allergic rearrangement of the body during AS was accompanied by considerable disorders in redistribution of free amino acids in body fluids (blood, interstitial fluid and lymph). It is assumed that changes in the quantitative ratios occurring between individual amino acids during metabolic processes under sensitization are likely to cause protein biosynthesis disorders in the body experiencing allergic rearrangement. PMID- 3967081 TI - [Morphogenetic characteristics of the aggregates formed in epithelial and mesenchymal recombinations of the lungs from intact and urethane-exposed mouse embryos]. AB - A study was made of the morphogenesis of organotypic aggregates obtained by epithelial mesenchymal recombinations from the lungs of embryonic mice, intact and treated with urethane. Normal growth and differentiation of organotypic structures were observed in long-term cultures of aggregates obtained by recombinations of the lung epithelium (E) and mesenchyma (M) from intact (i) embryonic mice (EiMi). Hyperplasia and squamous-cell metaplasia (with or without keratinization) of the epithelium were found in aggregates obtained from E and M of the treated mouse embryos (EtMt) and in aggregates obtained by recombinations of lung E and M from intact and treated embryos (EtMi, EiMt). The data obtained suggest that the alterations in epithelial mesenchymal interactions are of great significance for transplacental lung blastomogenesis and that the mesenchymal lung cells play an important part in mediation of the transplacental carcinogenous effects on epithelial target cells via subsequent epithelial mesenchymal tissue interactions. PMID- 3967082 TI - Age-related changes in deformability of human erythrocytes. AB - The present study was designed to further the characterization of age-related changes in the deformability of human erythrocytes. The top (approximately young) and bottom (approximately old) 10% fractions of density-separated red cells from ten normal donors were subjected to graded levels of shear stress in a rheoscope. Measurements were made of steady-state elongation (cells tank treading in a state of dynamic equilibrium) and the time course of shape recovery following abrupt cessation of shear. In parallel with the rheologic experiments, several physical and chemical properties were assayed to determine correlates of mechanical properties. These included mean cell volume, mean corpuscular hemoglobin concentration, type A1 hemoglobin, glucosylation of membrane proteins, and membrane phospholipid and protein concentration. The microrheologic observations revealed that only about 90% of the old cells retained their capacity to tank tread. However, the tank-treading cells elongated less than their younger counterparts at corresponding levels of shear stress, thus demonstrating a reduced level of deformability. Further analysis of the data indicates that increases in membrane viscosity and elastic modulus along with a significant loss in excess surface area contribute to the limitation of the ability of the older cells to change shape. PMID- 3967083 TI - Microrheologic investigation of erythrocyte deformability in diabetes mellitus. AB - This study was undertaken to determine whether diabetes alters the viscoelastic properties of erythrocytes. The oldest and youngest 10% fractions of circulating red cells were separated by centrifugation of freshly drawn blood obtained from ten diabetics with disease of one to 20 years' duration and from an equal number of age- and sex-matched control subjects. Cells from each fraction were suspended in phosphate-buffered saline, and their rheologic behavior was examined in a rheoscope. The elongation of cells, the percentage of cells that tank-treaded in response to shear stress, tank-treading frequency, and the rate of recovery of cell shape upon cessation of shear stress were determined in the oldest and youngest 10% of cells for diabetics as well as for controls. All four parameters were virtually identical for diabetics and controls. Additional aliquots of cells were taken for assessment of nonenzymatic glucosylation of hemoglobin and cell membrane protein. The absence of any measurable difference in rheologic behavior of cells from diabetic and control subjects, despite substantial differences in nonenzymatic glucosylation of hemoglobin and cell membrane proteins, suggests that the magnitude of glucosylation observed in these cellular constituents does not alter the viscoelastic properties of the cells. The implication of these observations is that microvascular complications of diabetes are not attributable to altered deformability of red cells. PMID- 3967084 TI - Multiple myeloma: significance of plasmablastic subtype in morphological classification. AB - We classified 100 cases of myeloma before chemotherapy as mature (28), intermediate (38), immature (19), or plasmablastic (15). The plasmablastic group had an estimated median survival (Kaplan-Meier method) of ten months, compared to 35 months for the other types (P less than .05). Decreased survival in the plasmablastic group was due to more frequent deaths in the first six months. There were no significant differences in survival among the mature, intermediate, and immature groups or among patients with different morphological grade or asynchrony scores. The plasmablastic myeloma group had more frequent renal insufficiency and higher plasma cell labeling indices, which may have contributed to the shorter survival. PMID- 3967085 TI - The role of activated human platelets in prothrombin and factor X activation. AB - The effect of activated human platelets in intrinsic factor X activation was compared with their effect in prothrombin activation. Compared with unstimulated platelets, platelets triggered by the combined action of collagen plus thrombin showed a tenfold activity increase in prothrombin activation, and a 20-fold rate enhancement in factor X activation. Treatment of collagen plus thrombin stimulated platelets with N.naja phospholipase A2 almost completely abolished their activity in prothrombin and factor X activation. Since no significant cell lysis occurs during phospholipase treatment, this indicates that platelet phospholipids, exposed at the membrane exterior, play an essential role in the interaction of platelets with the proteins of the prothrombin and factor X activating complexes. The time course of generation of the procoagulant platelet surface was different when the amount of coagulation factors present in the assay systems was varied. At suboptimal concentrations of coagulation factors, maximum platelet activity was reached after a shorter time period than at saturating concentrations. When measured at suboptimal amounts of coagulation factors, the platelet activity in prothrombin and factor X activation is also more sensitive to phospholipase treatment. Experiments with synthetic phospholipid mixtures show that prothrombin and factor X activation are optimal at low mol% phosphatidylserine when high concentrations of factor Va and factor VIIIa are employed. The optimal mol% phosphatidylserine increases when the concentrations of nonenzymatic protein cofactors are lowered. These findings are discussed in relation to a model in which phosphatidylserine, exposed at the outer surface of activated platelets, plays an essential role in prothrombin and factor X activation. It is proposed that this phosphatidylserine is not homogeneously distributed in the platelet outer membrane, but that areas with different phosphatidylserine density participate in coagulation factor activation. PMID- 3967086 TI - A monoclonal anti-human platelet antibody: a new platelet aggregating substance. AB - A monoclonal anti-human platelet antibody, TP82, is described, which caused irreversible aggregation of platelets in association with the release of adenosine triphosphate or [14C] serotonin, and which inhibited ristocetin-induced agglutination. Immunofluorescence assay showed that the antibody binds to platelets, megakaryocytes, and common acute lymphoblastic leukemia cells. The antibody (IgG1) immunoprecipitated a polypeptide of 23,000 daltons with an isoelectric point of about 7.0. The aggregation induced by the purified antibody and/or F(ab')2 fragments occurred in platelet-rich plasma and with washed platelets, but not with formalin-fixed washed platelets. TP82-induced aggregation was completely inhibited by disodium ethylendiaminotetraacetate, diltiazem, W-7, PGE1, and several metabolic inhibitors. At a concentration of apyrase or CP/CPK, which inhibited adenosine 5-diphosphate-induced aggregation. TP82-induced aggregation was only partially affected. Thrombin was not required for the antibody-mediated effects, since two thrombin inhibitors failed to block the reaction. The antibody, at least at a high concentration, induced platelet aggregation by a mechanism almost independent of thromboxane A2 formation, since cyclooxygenase inhibitors had little inhibitory effect on aggregation. TP82 monoclonal antibody is a new platelet-aggregating substance that interacts with a low-molecular-weight binding site on the platelet membrane. PMID- 3967087 TI - Rapid method for isolation of normal human peripheral blood eosinophils on discontinuous Percoll gradients and comparison with neutrophils. AB - Previous studies on human eosinophils often have used cells from patients with hypereosinophilia syndrome or parasitosis owing to the difficulty in isolating pure populations of eosinophils from normal individuals. In the present study, human eosinophils were isolated with a purity of 97%, with 70% recovery from normal individuals with blood eosinophil counts of less than 3%. Human eosinophils are denser than neutrophils, but the range of densities of the two cell types overlap, making purification of eosinophils by density-gradient centrifugation difficult. However, if neutrophils were exposed to the chemotactic peptide (f-Met-Leu-Phe), which did not stimulate eosinophils, the neutrophils' density decreased, shifting them away from the density of eosinophils. Whole normal blood anticoagulated with EDTA was incubated at 37 degrees C for 15 minutes with 10(-6) mol/L f-Met-Leu-Phe and then layered over a discontinuous Percoll gradient (65% and 75% in diluted phosphate-buffered saline) and centrifuged at 400 g for 25 minutes at 22 degrees C. The cell layer between the 65% and 75% Percoll was collected and washed, and hypotonic lysis was used to remove erythrocytes. This cell layer contained 97.3 +/- 0.7% eosinophils (N = 8) with a yield of 4.9 X 10(4) eosinophils per milliliter of whole blood, or 70% of the total eosinophil count. The isolated eosinophils were in a quiescent state but responded to Escherichia coli endotoxin-activated serum with shape change and chemotaxis, membrane depolarization, and reduced nitroblue tetrazolium (96.0 +/- 1.0%), when stimulated with phorbol myristate acetate. In phagocytic assays, 89.3 +/- 1.3% of the eosinophils ingested Candida albicans v 96.0% +/- 1.0% of neutrophils. In contrast, the eosinophils did not respond chemotactically, alter membrane potential, or reduce nitroblue tetrazolium when treated with f-Met-Leu Phe, and studies with f-Met-Leu-[3H]Phe showed that normal eosinophils lacked expression of receptors for f-Met-Leu-Phe. In control studies, normal eosinophils that were not exposed to f-Met-Leu-Phe during purification also failed to respond to f-Met-Leu-Phe, indicating intrinsic differences between normal eosinophils and neutrophils. Thus, exposure of whole blood to f-Met-Leu-Phe, followed by separation on Percoll is a simple method for rapid isolation of normal human eosinophils. PMID- 3967088 TI - Adherence of human polymorphonuclear leukocytes to endothelial monolayers: effects of temperature, divalent cations, and chemotactic factors on the strength of adherence measured with a new centrifugation assay. AB - Polymorphonuclear leukocytes (PMNs) adhere to endothelial cells at sites of acute inflammation. To examine this phenomenon in vitro, we have developed a new assay to measure adherence of PMNs to cultured endothelial cells. Human PMNs were labeled with 111indium-oxine and incubated in microtiter wells with monolayers of either human umbilical vein or bovine aortic endothelial cells. Following incubation, the wells were sealed, inverted, and centrifuged at varying speeds. Results are expressed as the percentage of PMNs added initially that remained attached to the monolayers after being subjected to dislodgment forces (ie, relative centrifugal forces) ranging from 1 to 1,200 g. Adherence of PMNs to endothelial monolayers was temperature dependent, dependent on the concentration of extracellular Mg2+ (but not Ca2+), and enhanced significantly by the chemotactic peptides, N-formyl-methionyl-leucyl-phenylalanine (fMLP) and human C5a. It was found that fMLP and C5a not only increased the number of PMNs that adhered to endothelial cells, but also increased the strength of adherence. PMID- 3967090 TI - Antithrombin Milano: a new variant with monomeric and dimeric inactive antithrombin III. AB - A qualitative defect of antithrombin III (AT III) has been demonstrated over three generations in eight members of an Italian family by the discrepancy between a normal amount of antigen and decreased antithrombin and anti-Xa activity in the presence or in the absence of heparin. By two-dimensional immunoelectrophoresis in the absence of heparin, two peaks of AT III were present in all patients' plasma. AT III was purified from normal and propositus plasma by sulfate dextran precipitation followed by heparin affinity chromatography. The elution profile of the patient's AT III was abnormal and allowed the separation of two populations of AT III, normal and abnormal. The first fraction (normal AT III) contained AT III activity, migrated as a single peak by two-dimensional immunoelectrophoresis and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), demonstrated a single band with a molecular weight (mol wt) identical to that of normal AT III (60,000). Conversely, the last fraction, devoid of AT III activity, migrated as a single abnormal peak by two dimensional immunoelectrophoresis in the absence of heparin. By SDS-PAGE, two bands were observed: one with a mol wt of 60,000 and a second one with a mol wt of 120,000. Western blots clearly demonstrated cross-reactivity of the 120,000 and 60,000 mol wt bands with monospecific antisera to human AT III. Reduction of the 120,000 mol wt band converted it to a single 60,000 mol wt band, suggesting the presence of an abnormal dimeric form of AT III. The name AT III Milano is proposed for this new variant. PMID- 3967089 TI - Glycolate kinase activity in human red cells. AB - Human red cells manifest glycolate kinase activity. This activity copurifies with pyruvate kinase and is decreased in the red cells of subjects with hereditary pyruvate kinase deficiency. Glycolate kinase activity was detected in the presence of FDP or glucose-1,6-P2. In the presence of 1 mmol/L FDP, the Km for adenosine triphosphate (ATP) was 0.28 mmol/L and a half maximum velocity for glycolate was obtained at 40 mmol/L. The pH optimum of the reaction was over 10.5 With 10 mumol/L FDP, 500 mumol/L glucose-1,6-P2, 2 mmol/L ATP, 5 mmol/L MgCl2, and 50 mmol/L glycolate at pH 7.5, glycolate kinase activity was calculated to be approximately 0.0013 U/mL RBC. In view of this low activity even in the presence of massive amounts of glycolate, the glycolate kinase reaction cannot account for the maintenance of the reported phosphoglycolate level in human red cells. PMID- 3967091 TI - Fibrinogen biosynthesis in isolated guinea pig megakaryocytes. AB - Fibrinogen synthesis was investigated in guinea pig megakaryocytes. Purified megakaryocytes were incubated with 35S-methionine in methionine-free incubation medium for 18 hours. Newly synthesized fibrinogen in megakaryocyte lysates enriched with purified carrier guinea pig fibrinogen was immunoprecipitated with a specific anti-guinea pig fibrinogen antiserum produced in rabbits. Proteins in the immunoprecipitates were analyzed with a 3.5% to 10.0% gradient polyacrylamide slab gel electrophoresis and auto-radiography. Radioactivity was detected in a protein band of 340,000 daltons. In order to verify fibrinogen synthesis, immunoprecipitate was analyzed by two-dimensional slab gel electrophoresis: (1) the first dimension separated unreduced fibrinogen using a 3.5% to 10.0% gradient gel; (2) following reduction by 2-beta-mercaptoethanol, fibrinogen chains were separated in the second dimension using a 10% gel. Alpha, beta, and gamma fibrinogen chains, which represented carrier guinea pig plasma fibrinogen, were visualized by Coomassie brilliant blue. Autoradiography identified the incorporation of radioactivity into the three fibrinogen chains. In control experiments, immunoprecipitates, produced by exposing megakaryocyte lysates to preimmune rabbit serum and goat anti-rabbit IgG, were also analyzed by the two dimensional gel system. Radioactivity was not detected in sites corresponding to the migration of fibrinogen subunits. The study demonstrates that isolated guinea pig megakaryocytes can synthesize fibrinogen. The electrophoretic mobility of newly synthesized fibrinogen and subunits is similar to that of guinea pig plasma fibrinogen. PMID- 3967092 TI - Antithrombin III levels in acute leukemia. PMID- 3967093 TI - Megakaryocyte enrichment procedures. PMID- 3967094 TI - Translocation (1,3) in myelodysplastic disorders. PMID- 3967095 TI - Normal plasma levels of B12 binding proteins in hypereosinophilic syndrome and secondary hypereosinophilia. PMID- 3967096 TI - Efficiency of canine renal blood flow autoregulation in kidneys with or without glomerular filtration. AB - In order to evaluate vascular (myogenic) and tubular (tubuloglomerular feedback) mechanisms involved in renal blood flow (RBF) autoregulation, canine kidneys with filtration (normal) and without filtration (nonfiltering, NFK; ureteral obstructed, UO) were studied. RBF was monitored in response to stepwise reductions in renal perfusion pressure of -20, -40, and -60 mm Hg from control pressure. None of the three groups demonstrated significant changes in RBF from their respective control values (normal, 380 ml/min/100 g; NFK, 179 ml/min/100 g; UO, 153 ml/min/100 g) until the lowest pressure (-60 mm Hg from control pressure). All three groups responded to the pressure reductions with significant decreases in renal vascular resistance. However, the calculated efficiency of the autoregulatory response for the NFK and UO groups was significantly less than for the normal group. Elimination of tubuloglomerular feedback (NFK and UO) did not necessarily eliminate renal vascular autoregulation, but did reduce the efficiency of autoregulation. It is suggested that both vascular (myogenic) and tubular (tubuloglomerular) mechanisms may coexist to efficiently autoregulate blood flow in normal filtering kidneys. However, a reduction in metabolic activity as a contributor to the reduced ability to autoregulate in these kidneys could be an additional possibility. PMID- 3967097 TI - Accumulation of 3H-adrenaline by rabbit aorta. AB - The accumulation of (-)-3H-adrenaline (3H-A) by rabbit isolated aorta was studied. In all experiments, monoamine oxidase and catechol-O-methyltransferase were inhibited by treatment with pargyline and 3',4'-dihydroxy-2-methyl propiophenone (U-0521), respectively. The relationship between the accumulation of 3H derived from 3H-A (10(-8) M) and the duration of incubation (0-3 h) was linear. The 3H-accumulation after 3 h incubation was 22.5 ml X g-1. In reserpine treated tissue, the 3H-accumulation levelled off after 30 min and was 8.5 ml X g 1 after 3 h. The concentration of 3H-A or (-)-3H-noradrenaline (3H-NA) and the 3H accumulation (ml X g-1) were inversely related. At 10(-8) M, the 1-hour accumulation of 3H derived from 3H-A and 3H-NA was 7.8 and 15.2 ml X g-1, respectively. With increasing concentrations (3 X 10(-8)-10(-4) M), the accumulation values approached each other. At 10(-4) M, the accumulation was 2.3 and 2.8 ml X g-1 for 3H-A and 3H-NA, respectively. The accumulation of 3H derived from 3H-A (10(-8)-10(-4) M) by reserpine-treated tissue also showed an inverse relationship with concentration: 5.4 ml X g-1 (10(-8) M) and 2.6 ml X g-1 (10(-4) M). The accumulation of 3H derived from 3H-A (10(-8) M; 1 h) was dependent on the bath temperature (1-37 degrees C). The accumulation increased continuously from 1.1 ml X g-1 (1 degree C) to 11.1 ml X g-1 (37 degrees C). Storage of tissue (0-5 days in salt solution without equilibration with 95% O2/5% CO2; 4 degrees C) did not affect the accumulation of 3H derived from 3H-A (10(-8) M; 1 h). Thereafter (7-14 days), the accumulation decreased. The inhibitory potency (IC50;-log M) of desimipramine, cocaine, (-)-propranolol, (-)-isoprenaline, and (+/-) normetanephrine on accumulation of 3H derived from 3H-A (10(-8) M; 1 h) was found to be 8.26; 6.50; 5.48, 4.88, and 4.02, respectively. The maximal degree of inhibition was almost the same for these drugs, while that of clonidine and corticosterone was 50 and 20%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3967098 TI - In-vitro induction of some features of hairy cell leukemia in chronic lymphocytic leukemia and immunocytoma cells. AB - In an attempt to induce in vitro differentiation we exposed cells from patients with chronic lymphocytic leukemia (CLL) and with immunocytoma (IC) to 12-0-tetra decanoylphorbol-13-acetate (TPA) at 160 nM. After 3 to 5 days of culture cells became enlarged and the CLL cells developed a basophilic cytoplasm with an excentric nucleus. In some instances cells with many fine projections were seen. We then employed the monoclonal antibody (MAB) HD 6, which was generated against hairy cell leukemia (HCL) cells and reacts most strongly with such cells but is unreactive with plasmocytoma cells and with most CLL cells. TPA treatment induced a greatly enhanced HD 6 binding in CLL and IC cells compared to controls as demonstrated by indirect immunofluorescence. Cytochemical studies revealed that at the same time an acid phosphatase was induced, which was found to be tartrate resistant in every instance tested. Thus, several features of HCL can be induced in CLL and IC demonstrating the close relatedness of these entities. PMID- 3967099 TI - Toxicity and bone marrow response of patients with hairy cell leukemia treated with biosynthetic (recombinant) alpha-2-interferon. PMID- 3967100 TI - Influence of chronic arsenic poisoning on bone marrow morphology. A case report. AB - Arsenic is widely used for the production of insecticides, paints, ceramics and for the preparation of textiles, leather and furs. Nevertheless hematologists are almost unaware of the influence of arsenic on bone marrow morphology. In the case described here we have found slight megaloblastic hemopoiesis, typical karyorrhexis in erythropoietic accompanied by basophilic stippling and impairment of mitoses in megakaryocytes and granulopoietic cells. PMID- 3967101 TI - Lactoferrin (LF), prostaglandin E (PGE) and neutrophils in children with sickle cell disease (SCD) PMID- 3967102 TI - Thromboxane production by perturbed bovine aortic endothelial cells in culture. AB - Bovine aortic endothelial cells in culture were incubated with endotoxin. The amount of thromboxane A2 synthesized was then determined by a specific radioimmunoassay for thromboxane B2. After a lag of several hours the cells changed their shape and parallel to the change in cell shape release of thromboxane B2 occurred. At 24 h the amount of thromboxane B2 generated in response to endotoxin was 200-fold above baseline. Thromboxane B2 generation could be blocked by aspirin and the specific thromboxane synthetase inhibitor UK 37248. The endotoxin effect was dependent on protein and RNA synthesis as evidenced by the inhibitory action of cycloheximide (1.5 microM) and actinomycin D (2 micron). PMID- 3967103 TI - The distribution of lymph nodes in and around the parotid gland: an anatomical study. AB - The numbers of lymph nodes in and around the parotid salivary gland and their sites in relation to the facial nerve within that gland have been established in the 20 glands of 10 individuals whose age distribution approximated to that of patients most likely to suffer metastatic disease to these nodes. Virtually all the nodes were found to be superficial to the facial nerve. PMID- 3967104 TI - The degloved hand: immediate complete restoration of skin cover with a contralateral forearm free flap. AB - This paper describes a method of repair of a serious injury with major skin loss on both the volar and dorsal aspects of the hand and wrist using a free "forearm flap" from the opposite limb. The technique is a one-stage procedure, provides a completely variable amount of skin, the freedom to elevate the repaired hand and the opportunity to revascularise the most distal structures using the vessels incorporated in the flap. PMID- 3967106 TI - Malignant melanoma, evaluation of clinical follow up by questionnaire survey. AB - A retrospective questionnaire study, by post, revealed that 69% of patients, still living following first tumour recurrence, had detected the recurrence themselves prior to routine clinic appointments. Nearly 90% developed their first recurrence in the first 5 years following primary surgical treatment. Not only could the length of routine clinic follow-up after primary melanoma treatment be shortened, but with further education of the patient and involvement of the general practitioner it seems likely that patients can be trusted to detect their own recurrences and seek appropriate advice. PMID- 3967105 TI - Some observations on the radial artery island flap. AB - The venous drainage of proximal-paddle and distal-paddle radial artery island flaps has been investigated using X-ray injection techniques. PMID- 3967107 TI - A retrospective study of treatment of orbital floor fractures with the maxillary sinus approach. AB - The Cook County Hospital, Chicago, Illinois, protocol for the management of orbital fractures is presented. Diplopia which fails to resolve in 1 week or appears after oedema subsides, enophthalmos or radiographic depression of the orbital floor, associated tripod fracture deformity, or purulent maxillary sinusitis are indications for surgery. The surgical procedure is a modification of the maxillary sinus approach, which includes the use of iodoform gauze packing, nasal antrostomy, a double layer oral closure and prophylactic antibiotics. A review of 102 patients treated surgically over a 6-year period is presented. Post-operative diplopia was 9% and there were minor complications in 3%, which were significantly lower than previously reported series of orbital fractures treated either non-operatively, or through an orbital exploration approach. No patient treated non-operatively required surgery in the future. The protocol presented can eliminate unnecessary exploration and yields excellent results with a simple surgical procedure. PMID- 3967108 TI - The pattern and incidence of nasolacrimal injury in naso-orbital-ethmoid fractures: the role of delayed assessment and dacryocystorhinostomy. AB - A detailed review of forty-six patients with severe naso-orbital-ethmoid injury confirms that naso-lacrimal system injury is less common than originally suspected. Post-operative epiphora is more frequently due to eyelid malposition than naso-lacrimal obstruction. Eight patients (17.4%) required eventual dacryocystorhinostomy. Three out of five patients (60%), treated with closed reduction and external splint fixation, needed dacryocystorhinostomy. This treatment predisposes to external compression of the naso-lacrimal system by malpositioned bone fragments and segments. Open reduction and internal fixation of all fractures provides optimal repair and minimizes the incidence of post operative epiphora. During fracture repair, the naso-lacrimal sac should be identified, but not probed or intubated unless obviously lacerated. The upper lacrimal pathway is protected by the medial canthal ligament. Obstruction usually occurs in the bony naso-lacrimal canal. Telecanthus invariably accompanies severe naso-orbital-ethmoid injuries and subsequent naso-lacrimal obstruction. Dacryocystography is useful in the investigation of naso-lacrimal function. When dacryocystorhinostomy is necessary, it should be performed at least 3 months after the primary repair. PMID- 3967109 TI - A new compound osteo-myocutaneous free flap: the posterior iliac artery flap. AB - A hitherto undescribed osteo-myocutaneous free flap is presented. It is based on a branch of the superficial branch of the superior gluteal artery and includes the posterior iliac crest, the posterior part of the gluteus maximus and medius muscles and the overlying skin. This type of flap has allowed us to reconstruct a bony defect of up to 8 cm in the tibia. PMID- 3967110 TI - Continuous subcutaneous tissue pH measurement as a monitor of blood flow in skin flaps: an experimental study. AB - A miniaturised glass pH probe that makes possible the continuous measurement of subcutaneous tissue pH is described. This instrument has been evaluated as a monitor of blood flow in experimental skin flaps. A rapid fall in tissue pH in response to either arterial or venous occlusion was observed. The results suggest that this technique may be a useful method of monitoring microvascular free flaps. PMID- 3967111 TI - Tumour spread in a delto-pectoral pedicle flap used in reconstruction of the lower jaw: case report. AB - A number of well-established pedicled flaps, including for example the delto pectoral and pectoralis major flaps, are used in reconstructive work following excision of head and neck tumours. The most commonly encountered tumours of the head and neck spread predominantly via the lymphatic system and during the time between the insetting of a flap and the division of its pedicle some micro lymphatic continuity of flow must develop from the site of insertion down the flap to its pedicle. This may form a route for spread of tumour when the primary lesion has been inadequately excised. A case report is presented. PMID- 3967112 TI - A supero-medial thigh flap for urethral reconstruction in epispadias and hypospadias. AB - A reliable axial flap from the adductor region has been used for many years to repair a series of urethral defects formerly regarded as difficult problems. In particular the flap has proved invaluable in the treatment of epispadias "cripples". Suggestions are also made for correcting the reverse chordee deformity due to the shortage of skin on the dorsum which, if untreated, spoils the functional result. The use of a supero-medial thigh flap was reported by Hirshowitz et al. (1980, 1982) for repair of the scrotum and vulva. The same flap had been discovered independently in 1978 in this department and used for the repair of epispadias and hypospadias "cripples". Its reliability was soon recognised and the presence of axial vessels from the medial femoral circumflex artery and vein were demonstrated by transillumination at the time of surgery and by study in the post-mortem room. Some patients with epispadias are referred at puberty with an unrepaired scarred penis and a reverse chordee deformity. The defect cannot be repaired with local tissue alone and the same difficulty is encountered with some hypospadias "cripples". Occasionally untreated cases of perineal hypospadias are seen with a marked shortage of local tissue. In our experience scrotal flaps may fail to heal and orthodox groin flaps may have difficulty in reaching the target. Although the superomedial thigh flap will require at least two stages it is a reliable technique and it provides a generous amount of tissue with which to solve what may at first sight seem to be an insuperable problem.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967113 TI - The uses of external nipple-areola prostheses following reconstruction of a breast mound after mastectomy. AB - Following reconstruction of the breast after mastectomy it is common practice to allow a "settling" period before grafting the nipple-areola complex. A selection of external nipple-areola prostheses are described which can be used until surgical reconstruction can be carried out and which are helpful in determining the correct position of the nipple-areola grafts. It has been found that some patients actually prefer to use the prostheses permanently for dress purposes rather than undergo an additional operation. PMID- 3967114 TI - Metastatic patterns of squamous carcinoma in the parotid lymph nodes. AB - The clinical and pathological patterns of squamous carcinoma of the skin metastasising to the parotid lymph nodes have been analysed in 28 patients in whom such metastasis occurred over the period 1972 to 1981. Prognosis appears to be closely related to whether tumour has spread out with the nodes into the parenchyma of the parotid gland or is still confined within the nodes. PMID- 3967115 TI - Sagittal genioplasty: a new technique of genioplasty. AB - A new technique for performing genioplasties is described. Antero-posterior and vertical deformities of the chin can be corrected and because a large surface area of bone remains in contact under compression following the osteotomy, a stable osteosynthesis is achieved. Access for fixation, using either wires or leg screws, is good and this feature, combined with the mechanical advantage obtained from the osteotomy cuts, contributes to great stability. The technique is safe, since there is minimal periosteal stripping; the bone cuts avoid the mental nerves and the mobilised bony chin retains a vascularised muscle pedicle. PMID- 3967116 TI - The use of morphanalysis in orthognathic surgery. AB - A method of analysing and planning orthognathic surgery is described using morphanalysis in conjunction with standard photographic techniques, cephalometry and dental study models. PMID- 3967117 TI - First steps of a consultant in plastic surgery: personal experience. PMID- 3967118 TI - Primary columella lengthening and lip adhesion. PMID- 3967119 TI - The surgical correction of residual facial disfigurement produced by rhinophycomycosis entomophthorae: a case report. AB - Rhinophycomycosis entomophthorae is a rare tropical granulomatous infection caused by the fungal organism Entomophthora coronata. The disease arises as a submucosal granuloma, usually in the region of the inferior turbinate, spreads centrifugally to involve the nasal sinuses, alae nasae, upper lip, forehead and cheeks and may produce extensive facial deformity. The response to medical treatment with potassium iodide or co-trimoxazole is variable. We wish to report a case in which staged surgical correction of the sequelae of the disease produced a significant improvement in the facial appearance. PMID- 3967120 TI - An unusual acid antrum. PMID- 3967121 TI - Candidial obstruction of the common bile duct. PMID- 3967122 TI - Survival following local skin recurrence after mastectomy. AB - Seventy-three patients with breast cancer, treated by radical mastectomy, who subsequently developed a local skin recurrence without clinical evidence of disseminated disease, have been reviewed. There were significant differences between the survival of patients with single and multiple recurrences. Only 10 per cent of those with multiple lesions survived 5 years, and none was alive at 10 years, whereas 42 per cent of those with single lesions survived 5 years and 22 per cent were alive and well at 10 years' postrecurrence. Adequate local treatment of a single skin nodule may enable a subset of patients to survive without subsequent development of breast cancer metastases. PMID- 3967123 TI - Benign breast disease in a West Indian population. AB - A review of 1726 breast lesions in West Indian women from Trinidad showed that the pattern of disease is significantly different from that reported in whites but similar to reports from India and Africa. This difference is mainly due to the high frequency of fibro-adenoma in our adolescent women. Fibro-adenoma was the commonest lesion (39.3 per cent), followed by mammary dysplasia (32 per cent) and carcinoma (21 per cent). Although carcinoma comprised only 21 per cent of all breast lesions, nearly 40 per cent of true neoplasms were malignant. We believe all suspicious breast lumps in black women need biopsy and further analysis of morphological components of benign breast lesions is necessary to evaluate precursors to cancer of the breast. PMID- 3967124 TI - Ulcerative colitis complicated by lymphoma and adenocarcinoma. PMID- 3967125 TI - Villous adenomas in the duodenum. AB - Five patients with villous adenomas in the duodenum are described. In one patient malignant degeneration had occurred at the time of diagnosis. This patient was treated with a pancreaticoduodenal resection and is doing well 2 years postoperatively. The other four patients all had a duodenotomy and a local excision of the tumour. One patient had a recurrence with malignant degeneration within 1 year. The other three patients are doing well without signs of recurrence 1-4 years postoperatively. It is concluded that duodenal villous adenomas are potentially malignant. The strategy of surgical treatment is discussed. PMID- 3967126 TI - Evaluation of surgical treatment of carcinoma of the oesophagus in the elderly: 20 years' experience. AB - The results of 231 oesophageal resections and reconstruction in 395 patients with thoracic oesophageal carcinoma presenting in the last 20 years are reported. In patients over 70, the incidence of multiple pathology and postoperative complication was high. The most frequent causes of death after surgery were pulmonary complications, and anastomotic leakage. As the mortality rate in the aged group exceeded that of the younger groups, careful pre-operative assessment, the indication for surgery and postoperative care should be carefully considered, even though only surgery offers a hope of cure for patients with oesophageal carcinoma. If the elderly can tolerate the surgical procedures, the 5 year survival rate equals that of the younger patients. PMID- 3967127 TI - Quality of life after restorative proctocolectomy with pelvic ileal reservoir. AB - Fifty-five patients who had undergone restorative proctocolectomy with a pelvic ileal reservoir between 3 and 82 months previously were sent a detailed questionnaire to assess their quality of life. All patients had experienced an ileostomy at some time. Fifty-one (94 per cent) returned completed questionnaires. The average frequency of evacuation from the reservoir was four times per 24 hours. Antidiarrhoeal medication was required by 14 (27.4 per cent). Continence was normal in 32 (62.7 per cent) and only 3 (5.9 per cent) had troublesome faecal leakage. Twenty-two (43.1 per cent) evacuated stool spontaneously, while 24 (47.1 per cent) needed to catheterize the reservoir for each evacuation. Four patients who had had the reservoir removed were added to the 51 responders to give a total number of 55 whose quality of life was considered in this study. The reservoir was preferred to an ileostomy with regard to confidence (87 per cent), cleanliness (89 per cent), sexual self-image (87 per cent), social (85 per cent) and sport activity (87 per cent), and ease of carrying out work (84 per cent). The overall preference was 87 per cent. Thirty four (66.7 per cent) felt there was no significant disadvantage associated with the reservoir, while 10 (19.6 per cent) saw the long convalescent period and 9 (17.6 per cent) the requirement for catheterization as drawbacks. PMID- 3967128 TI - Local recurrence after potentially curative resection for rectal cancer in a series of 1008 patients. AB - Local recurrence and its related mortality after potentially curative resection for rectal cancer have been analysed in a series of 1008 patients managed by one of the authors. Nine hundred and thirty-four were available for analysis of recurrence. One hundred and seven (11 per cent) patients developed local recurrence without evidence of systemic spread and 84 (9 per cent) both local and systemic recurrence. Local recurrence was less common (14 per cent) after resection of tumours of the upper third of the rectum compared with the middle (21 per cent) (P = 0.02) or lower thirds (26 per cent) (P less than 0.001). Local recurrence was related to both tumour stage and differentiation (P less than 0.001). There was no significant relationship between local recurrence and tumour size or the type of curative resection performed, restorative or non-restorative. The distal margin of clearance after restorative resection did not influence the local recurrence rate. Of patients who developed metastases recurrence was evident within 2 years in 60 per cent. Three hundred and thirty-two patients died from recurrence, 91 (27 per cent) with evidence of local recurrence only, 80 (24 per cent) with combined local and systemic recurrence and 161 (48 per cent) with evidence of systemic spread only. The corresponding median survivals were 35, 34 and 39 months. PMID- 3967129 TI - Conservative management of post-traumatic parotid fistulae and sialoceles: a prospective study. AB - A prospective study of 14 consecutive patients with parotid injuries treated over a 4-month period, is presented. Three patients underwent emergency duct repair and 11 patients, presenting with delayed fistulae or subcutaneous collections of saliva (sialoceles), were treated conservatively with uniform success. Glandular injury closed within an average of 5 days of treatment and ductal leaks within approximately 14 days. PMID- 3967130 TI - Lugol's iodine: its effect on thyroid blood flow in patients with thyrotoxicosis. AB - It has been established practice for 60 years to prepare thyrotoxic patients undergoing thyroidectomy with Lugol's iodine. However, evidence in support of its claimed benefits, namely a reduction in the vascularity and friability of the toxic thyroid gland, is scanty. We have therefore determined the effect of Lugol's iodine on thyroid blood flow, as measured by thyroid uptake of thallium 201, in nine patients with Graves' disease and one euthyroid patient. Thallium 201 uptake, as well as serum thyroxine and triiodothyronine, fell significantly after treatment with iodine. Although not correlated with thyroid function tests, thallium-201 uptake was significantly correlated with thyroid weight. These results support the contention that thyroid blood flow is reduced in thyrotoxic patients treated with Lugol's iodine. PMID- 3967131 TI - The establishment of a microcomputer-based diagnosis and operations index in the Department of Surgery of a district general hospital. AB - The development and running of a microcomputer-based index of diagnoses and operations in the surgical department of a district general hospital is described. Many major problems have occurred, leading to malfunction or failure of the system, but it appears that these difficulties have now been resolved. In one year 4360 records have been fully processed with 4775 diagnoses, and 3968 operation codes have been permanently recorded. A further 560 patient records have been entered and await admission. The day-to-day running of the computer has been achieved by established secretarial staff without increase in number. The advantages and disadvantages of this system are outlined. PMID- 3967132 TI - A study of rat intestinal wound healing in the presence of radiation injury. AB - Anastomotic dehiscence is a common complication following the resection of intestine with late radiation damage, and can occur even after wide resection of obviously compromised tissue. In this study using male rats, exteriorized segments of terminal ileum and/or the fatty appendages of the testes were exposed to single doses of irradiation (10, 15 and 20 Gy) producing early and late damage of varying severity. Wounds made at intervals from 2-24 weeks after irradiation in normal or irradiated ileum were repaired immediately and wrapped in normal or irradiated appendages. Post mortem examination of the wounds 4-7 days later showed that, in general, control wounds made in unirradiated tissues healed soundly. The incidence of wound breakdown in irradiated tissues was dose dependent. After irradiation of the ileum alone, the frequency of suture line dehiscence increased with the interval between irradiation and wounding. When the ileum and appendages or appendages alone had been irradiated, the frequency of dehiscence was increased from 2 weeks post-irradiation onwards. This study emphasizes the important role played by adhesions in rat intestinal wound healing and shows that dehiscence may occur if irradiated tissues are positioned next to a suture line made in normal rat intestine. The findings suggest that, in clinical practice, it may be advisable to ensure that anastomoses at risk from radiation damage area wrapped in unirradiated tissue such as omentum. PMID- 3967134 TI - Influence of pre- and intra- operative factors on the occurrence of postoperative fatigue. AB - Subjective feeling of fatigue was assessed before and 10, 20 and 30 days after uncomplicated abdominal surgery in 52 patients and after minor otological surgery in 15 patients. In major surgery fatigue increased from 3.0 +/- 0.2 (mean +/- s.e.m.) arbitrary units pre-operatively to 6.1 +/- 0.3, 5.3 +/- 0.3 and 4.1 +/- 0.3 on day 10, 20 and 30, respectively (P less than 0.001). In contrast, after minor surgery fatigue did not change from before surgery (2.1 +/- 0.3) to day 7 (2.9 +/- 0.5) (P greater than 0.05), day 20 (2.3 +/- 0.4) (P greater than 0.4), or day 30 after surgery (2.1 +/- 0.3) (P greater than 0.9). Differences in fatigue between groups were significant postoperatively (P less than 0.001), but not preoperatively (P greater than 0.05). Mean duration of surgery was similar in the two groups. In the abdominal group an increase in postoperative fatigue did not correlate with age, sex, pre-operative degree of fatigue, actual body weight, triceps skinfold thickness (TSF), arm muscle circumference (AMC), anthropometric index (body weight X TSF X AMC) or serum-transferrin, but did slightly with pre operative body weight related to ideal body weight (r = -0.3, P less than 0.05). Thus, the magnitude of the trauma and not the duration of anaesthesia may be important for occurrence of postoperative fatigue. Furthermore, fatigue after elective abdominal surgery seems to be unpredictable from the pre-operative status of the patient. PMID- 3967133 TI - Fibronectin, complement and immunoglobulins in serum after surgery. AB - In recent years it has been suggested that fibronectin is a non-specific opsonic protein of significance in host resistance against septic complications following trauma and surgery. The aim of the present study was to investigate the fluctuations in serum levels of fibronectin, immunoglobulins IgG and IgM, and complement factors C3 and C4 postoperatively. Serum samples were obtained pre operatively and at different intervals postoperatively in 72 patients admitted for elective surgical procedures on the alimentary tract, the heart and the hip joint. The mean pre-operative fibronectin values were 257 +/- 79 micrograms/ml. The lowest values (166 +/- 65 micrograms/ml) were found immediately after the operation, followed by an increase which did not reach pre-operative levels within 120 h. Five patients who developed postoperative complications and 14 patients with malignant disease did not differ significantly either in their pre- or postoperative fibronectin levels, compared with the whole group. The lowest fibronectin levels seen were also significantly above the concentrations necessary to promote binding of gelatinized test particles to macrophages and monocytes in vitro. There was a significant decrease in C3, C4 and IgG levels postoperatively whereas IgM levels were unaltered. The observed reduction did not extend below the lower normal levels for these proteins. The probable mechanism behind the reduction in serum levels seems to be a sequestration at the site of tissue injury. The postoperative reduction in circulating fibronectin levels has probably no implications for host resistance against septic complications. When sequestered into the site of injury, it may, however, be of significance for normal wound healing, due to its cell-matrix interactions. PMID- 3967135 TI - Pain and mobility after inguinal herniorrhaphy: ineffectiveness of subcutaneous bupivacaine. AB - We studied pain and mobility in 101 men undergoing elective unilateral inguinal herniorrhaphy. Subcutaneous infusion of 0.5 per cent bupivacaine via a fine catheter was used as an adjunct to conventional analgesia in half of the patients. This had no effect on the perception of pain measured at 8 and 24 h by visual linear analogue, nor on the analgesics requested by the patients. The walking ability of all patients was significantly impaired 24 h postoperatively, but again bupivacaine conferred no benefit. Organisms were cultured from 12.5 per cent of the catheters. PMID- 3967136 TI - Prediction of recurrence after mastectomy for operable breast cancer. AB - A patient's risk of early recurrence after mastectomy for breast cancer has been estimated by using a combination of four prognostic factors. A computer program, designed to calculate the exact probability of recurrence within 2 years of mastectomy, was accurate when tested on 240 patients. A simple scoring system could identify patients at lower and greater risk than any single factor alone. PMID- 3967137 TI - The diagnosis of aortic graft-enteric fistulae by computed tomography. AB - A number of techniques have been used to diagnose aortic graft-enteric fistulae. These are reviewed and their value assessed. Three patients are described in whom the diagnosis was correctly made from characteristic appearances seen on a computed tomography (CT) scan. Further experience may show that CT scanning has an important role in the detection of this condition. PMID- 3967138 TI - Pancreatic duct haemorrhage. PMID- 3967139 TI - Perforation on cimetidine. PMID- 3967140 TI - Early aneurysmal degeneration of umbilical vein bypass grafts. PMID- 3967141 TI - Hypocalcemia after subtotal thyroidectomy for thyrotoxicosis. PMID- 3967142 TI - Prevention of heel pressure sores with a simple pneumatic device. PMID- 3967143 TI - [The effect of smoking on the cytochrome and oxidase system of the cardiac muscle]. PMID- 3967144 TI - [Hypersplenism]. PMID- 3967145 TI - [Clinical significance of steatosis of the liver]. PMID- 3967146 TI - [Changes in metabolic function of the liver in patients with chronic hepatic diseases]. PMID- 3967147 TI - [Colonoscopic polypectomy in the diagnosis of potentially malignant tumors of the large intestine]. PMID- 3967148 TI - [Clinicopharmacologic aspects of the effects of serotonin and its blockade]. PMID- 3967149 TI - [Experimental cough induced by a chemical stimulus in rabbits with pulmonary edema]. PMID- 3967150 TI - [Observation--experimentation--requirements of research]. PMID- 3967151 TI - [Computer-assisted ergometric study in cardiopulmonary diagnosis]. PMID- 3967152 TI - [Levels of eosinophils in the peripheral blood in intestinal parasitic diseases before antiparasitic treatment and after antiparasitic treatment]. PMID- 3967153 TI - [The importance of apolipoprotein B determination in familial hyperlipoproteinemia]. PMID- 3967154 TI - [Objective characterization of the effects of manipulation and positional relaxation using quantitative thermography]. PMID- 3967155 TI - How books and journals will survive the electronic revolution. PMID- 3967156 TI - The balance between research and medical education. PMID- 3967157 TI - Prescription drug abuse. PMID- 3967158 TI - Psychiatric and nonpsychiatric facilities in the care of psychogeriatric patients. AB - The care of elderly patients who are mentally impaired requires reorganization in the delivery of mental health services to these patients. In this paper recommendations are made for the improvement of such services. These include the development of comprehensive psychogeriatric assessment services, which should be based mainly in general hospitals, the rationalization of the roles of facilities that provide nonpsychiatric long-term care, the development of specialized facilities for demented elderly patients, and a focus on education in psychogeriatrics for both undergraduate and postgraduate students in medicine and in other health care professions. PMID- 3967159 TI - Duration of chest pain associated with acute myocardial infarction: a predictor of long-term prognosis. AB - This paper describes 109 patients who had their first myocardial infarction and were then followed up for 3 to 8 years. The following data were collected at the time of the infarction: duration and severity of chest pain, type of infarction and peak SGOT (serum glutamic oxaloacetic transaminase) level. The duration of chest pain has previously been shown to correlate with infarct size. Duration of chest pain, age and peak SGOT level were found to be the most important predictors of survival. None of the other independent variables contributed further to survival when the effects of duration of pain, age and SGOT level were taken into account. However, there was a significant association between pain duration and functional status. These data suggest that the duration of chest pain during first myocardial infarctions is a predictor of long-term prognosis and probably of functional status. PMID- 3967160 TI - Explaining variations in cesarean section rates: patients, facilities or policies? AB - Using overall rates of cesarean section and either rates of diagnosis or rates of cesarean section for the four main indications for this procedure, we analysed the variations among teaching and community hospitals in four of Ontario's six regions. The rates varied substantially in both 1979 and 1982, with the overall rate for cesarean section in 1982 being 17.1 to 21.0 per 100 deliveries in the teaching hospitals and 16.5 to 19.7 in the community hospitals. The rate of diagnosis of dystocia varied up to threefold in the teaching hospitals and up to twofold in the community hospitals. Fetal distress was diagnosed at even more variables rates. The rate of repeat cesarean section varied most in the teaching hospitals, whereas the rate of cesarean section for breech presentation varied significantly in the community and the teaching hospitals in 1982 but only in the community hospitals in 1979. Nearly all the rates increased between 1979 and 1982. Differences in patient characteristics and in availability of resources appeared less important in explaining these rate variations than differences in clinical policy. PMID- 3967161 TI - Antiparasitic drugs: availability and regulatory requirements for "emergency" supply. PMID- 3967162 TI - Nova Scotia: risking rights to the political process. PMID- 3967163 TI - The Reagan administration: what lies ahead? PMID- 3967164 TI - Where's the credibility in hospital administrators? PMID- 3967165 TI - Is there a virologist in the house? PMID- 3967166 TI - Dosimetry of cytostatics in hyperthermic regional isolated perfusion. AB - During the period from February to October 1983, 21 patients with malignant melanoma of the extremities were treated by hyperthermic regional isolated perfusion with L-phenylalanine mustard (melphalan). The melphalan dose for each patient was determined by the tissue volume of the perfused region, using a dose of 10 mg/l perfused tissue. Despite an average increase of melphalan dosage of 18% above the maximum for iliac perfusions recommended in the literature, no increase in toxic tissue reactions was observed after hyperthermic iliac perfusions. The same dose of 10 mg/l perfused tissue was used in hyperthermic axillary perfusions, resulting in an average decrease of melphalan dosage of 14% below the minimum recommended in the literature. By applying a constant dose per unit tissue volume, a standardization of treatment is achieved. This excludes variations like body weight, age, type of complexion, and hair color, which so far have determined dosimetry. PMID- 3967167 TI - A randomized trial of adjuvant chemotherapy and immunotherapy in Stage I and Stage II cutaneous melanoma. An interim report. AB - Seventy patients with Stage I and II malignant melanoma were randomized to treatment with either intravenous dacarbazine alone or intravenous dacarbazine plus intradermal injection of the methanol-extracted residue of bacillus Calmette Guerin (BCG). Analysis of treatment failed to reveal a statistically significant difference between these two forms of treatment in Stage I and II patients. It is possible that chemoimmunotherapy may increase survival in Stage II patients, but this possibility should be interpreted with caution. PMID- 3967168 TI - Distribution and organelle specificity of melanoma-associated antigens identified by Mo 465.12 in human malignant melanoma. AB - Mo 465.12 (Mo 465) is a unique monoclonal antibody that detects cytoplasmic antigens highly restricted to the cells of human malignant melanoma (MM). As yet, it is not known which cytoplasmic components are reactive with Mo 465 within MM cells. This study, using the enzyme-linked immunosorbent assay (ELISA) technique, examines the distribution and specificity of Mo 465-reactive proteins in MM tissues that were isolated by cell fractionation and solubilized by a nonionic detergent (Brij 35). Light microscopically, Mo 465 bound strongly to the cytoplasm of MM cells, being localized as patchy or microgranular, but not to the normal epidermal melanocytes. When the cultured MM cells were fractionated, Mo 465 reacted with both soluble and membrane fractions and with the spent culture medium. To further identify the organelle specificity of Mo 465-reactive proteins, metastatic human MM and normal human liver tissues were separated into the fractions of large granules, small granules, Golgi apparatus, mitochondria, rough endoplasmic reticulum (ER), smooth ER, microsomes, and melanosomes. Mo 465 reactive proteins were detected in the fractions of crude homogenate, microsomes, and rough ER of MM tissue, and their reactivities were in parallel to the concentration of solubilized protein. the findings indicate that Mo 465-reactive proteins are localized in rough ER, that they are released into the cytoplasm, and that in the in vitro condition they are shed into the culture medium. PMID- 3967169 TI - Endometrioid differentiation in ovarian sex cord tumor with annular tubules accompanied by gestagenic effect. AB - A case of ovarian sex cord tumor with annular tubules (SCTAT) without Peutz Jeghers syndrome is presented in which portions of the neoplasm showed endometrioid differentiation. In addition, histologic examination of endometrium obtained from curettings and hysterectomy specimen revealed atrophic glands and a decidual type stroma, indicating a possible gestagenic effect of the ovarian tumor. The latter has so far been only briefly alluded to in the literature, whereas to the best of the authors' knowledge, endometrioid differentiation has not yet been reported to occur in SCTAT. PMID- 3967170 TI - The fine structure of astroblastoma. AB - An astroblastoma in the cerebrum was investigated with the electron microscope. A distinctive feature of the tumor was the radial arrangement of astrocytic cells around the blood vessels. The blood vessels in the tumor commonly exhibited fenestrated endothelial cells. The endothelium was generally surrounded by lamellated basal laminae that were compactly invested in the neoplastic cells. The most remarkable feature of the tumor cells was the frequent presence of coated vesicles. The cytoplasm of some tumor cells was filled by delicate glial fibrils and microtubules, whereas that of others contained a moderate amount of rough-surfaced endoplasmic reticulum, free ribosomes, and mitochondria, but only scanty glial fibrils and microtubules. The former usually possessed long, thin cell processes, whereas the latter had poor development of cell processes and commonly showed multiple or giant nuclei containing several nuclear bodies and prominent nucleoli. In summary, this ultrastructural study of astroblastoma revealed the coexistence of varied maturity astrocytic cells and their compact arrangement around fenestrated blood vessels. PMID- 3967172 TI - Morphologic characteristics of benign and malignant adrenocortical tumors. AB - Differentiation between benign and malignant tumors of the adrenal cortex was studied by means of seven histologic parameters. Each separate criterion was significantly different in two groups, one consisting of patients without metastases within 10 years after operation and one of patients with metastatic tumors. Discrimination on the basis of single parameters in individual patients, however, was of little value. When a histologic index was calculated using the same parameters but after "weighing," a much better discrimination was obtained. The histologic index and, to a lesser degree, the mitotic activity seems to be related to the survival time of the patients with adrenal cortical carcinoma. The authors conclude that the calculation of a histologic index based on a summation of different parameters makes it possible to differentiate between malignant and benign adrenal cortical tumors. As single parameters, tumor weight and mitotic activity have the highest discriminating value. PMID- 3967171 TI - Modification of immunogenic tumor growth by adrenalectomy in a syngeneic murine system. AB - The immunosuppressive action of adrenal glucocorticosteroids is well-known, and depressed cell-mediated immunity and adrenal cortical hyperplasia have been described in tumor-bearing animals. This study was designed to evaluate the effect of removing the source of lympholytic steroids by adrenalectomy upon tumor growth rate, thymus weight, and thymocyte incorporation of iodine 125 (125I) deoxyuridine into DNA. Newly derived methylcholanthrene-induced immunogenic fibrosarcomas were used in male syngeneic mice. Log dosages of 10(4), 10(5), and 10(6) viable tumor cells as single cell suspension were injected subcutaneously into the popliteal space of adrenalectomized and control mice. Tumor size was followed serially with caliper measurements, and the animals were killed 4 weeks after inoculation. Adrenalectomized mice inoculated with 10(4) cells had smaller tumors (P less than 0.02), heavier thymi (P less than 0.01), and more thymic DNA synthesis (P less than 0.05) than their tumor-bearing controls. No differences were seen between populations receiving 10(5) or 10(6) tumor cell inoculations. A second experiment was carried out in which intact controls, adrenalectomized animals, and sham adrenalectomy animals were inoculated with 10(4) tumor cells and killed 28 days later. Tumor growth rate and volume were significantly decreased for the adrenalectomized mice, which had higher thymus weights and DNA synthesis. These findings suggest that pretreatment adrenalectomy slows the growth of antigenic tumor cells and prevents thymic involution after tumor growth in a syngeneic murine system. PMID- 3967173 TI - Correlation of erythrocyte and plasma levels of zinc, copper, and iron with evidence of metastatic spread in cancer patients. AB - The level of plasma copper (Cu-Pl) and zinc (Zn-Pl) and the level of erythrocyte iron (Fe-RBC), copper (Cu-RBC), and zinc (Zn-RBC) were determined in the blood of 70 normal donors and 138 patients with various solid tumors by diagnostic x-ray spectrometry (DXS), a technique based on x-ray fluorescence spectrometry analysis. There were no significant changes in the mean values of Zn-Pl, Fe-RBC, and Cu-RBC in the patients when compared with those of normal donors. The mean level of Cu-Pl in the normal donors was 1.34 +/- 0.37 micrograms/ml; it was significantly increased in the patients, ranging between 1.47 +/- 0.34 micrograms/ml for patients without evidence of active cancer (NED) and 1.91 +/- 0.76 micrograms/ml for patients with hepatic metastases. The most significant change observed was an increase in the Zn-RBC found in the patients with clinical evidence of metastatic spread. Whereas the Zn-RBC level in the normal donors was 9.85 +/- 1.47 micrograms/g wet weight, and not significantly elevated in the NED patients, it was elevated to values of 11.37 +/- 1.55 micrograms/g (P less than 0.004) for patients with soft tissue and hepatic metastases and was 12.34 +/- 1.65 micrograms/g (P less than 0.001) for patients with bone metastases. The data suggest a clear correlation between Zn-RBC and metastatic spread in nonlymphomatous human cancer. PMID- 3967174 TI - Long-term results and prognostic factors in patients with differentiated thyroid carcinoma. AB - A multivariate analysis of the prognostic factors was carried out on a series of 546 differentiated thyroid cancers followed for 8 to 40 years. For survival, the highest risk factor was associated with age; tumors diagnosed in patients younger than 45 years had higher relapse-free survival (RFS) and total survival (TS) rates and a slower growth rate. In children, although the RFS and TS at 15 years were high, they decreased later. The second independent prognostic factor was histology. There was no difference between papillary and follicular well differentiated (FWD) tumors, but follicular moderately differentiated (FMD) had lower TS and RFS. Among FMD cancers, relapses occurred earlier and the interval between relapse and death was shorter. The third factor was sex. Tumors tended to disseminate more in male than in female patients. The survival rate after relapse was the same, however, suggesting that the growth rates are not different. The presence of palpable lymph nodes also had a significant independent impact on both TS and RFS. Patients treated after 1960 have a better outcome than patients treated earlier, although they did not differ in age distribution, histologic characteristics, sex ratio, or incidence of palpable lymph nodes. The distribution of time intervals between treatment and relapse was not compatible with an exponential failure time model but fit with a log-logistic model. Relapses can occur as late as 30 years or more after initial treatment. Elevated levels of circulating thyroglobulin have been observed in about 12% of the patients who had been in complete remission for longer than 20 years. PMID- 3967175 TI - Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy. AB - A clinicopathologic study of 241 cases of papillary thyroid carcinoma treated at the University of Florence Medical School, Florence, Italy is presented. The features of greatest prognostic value were patient's age at presentation, small tumor size, total encapsulation, extrathyroid extension, multicentricity, and presence of distant metastases. The prognosis of the disease was not influenced by the pattern of tumor growth, presence of solid areas, initial presence or subsequent development of cervical lymph node metastases, type of initial thyroid operation, performance of neck dissection, or prophylactic administration of radioactive iodine. It is concluded that conservative thyroid surgery in the form of lobectomy, without neck dissection or prophylactic administration of iodine 131 (131I), constitutes adequate therapy for most cases of papillary thyroid carcinoma. More extensive therapy should be considered for older patients and for those in whom the tumor exhibits extrathyroid extension or easily detectable multicentricity. PMID- 3967176 TI - Multiple chondrosarcomas in dyschondroplasia (Ollier's disease). AB - The relationship between dyschondroplasia (Ollier's Disease) and the possibility of malignant change is well known. The authors describe a patient who developed four primary chondrosarcomas over 11 years. These were treated by local wide excision and, in two sites, prosthetic replacement to preserve the limb. To the authors' knowledge, no patient with more than two primary chondrosarcomas has previously been described. PMID- 3967177 TI - Adrenal myelolipoma diagnosis by computed-tomography-guided fine-needle aspiration. A case report. AB - A case of adrenal myelolipoma, to the authors' knowledge, the first diagnosed by fine-needle aspiration, is reported. Adrenal myelolipoma is an unusual, benign lesion with a distinctive cytologic appearance. Computed tomography (CT)-guided fine-needle aspiration of the adrenal gland involves minimal morbidity and provides rapid, reliable differentiation of this entity from a malignant neoplasm. PMID- 3967178 TI - Adenocarcinoma of unknown primary site. The Brooke Army Medical Center experience. AB - A retrospective analysis of 56 tumor board records carrying the diagnosis of adenocarcinoma of unknown primary site (ACUPS) was completed. The cohort represents 1.7% of the registrations during the period from 1971-1981. The liver was the most common site from which a biopsy specimen was taken for diagnosis. The lung and pancreas were the most frequent proven primary sites. Eighteen cases went to autopsy. Primaries remained undetected in five (27%). Three of 37 patients treated with chemotherapy responded (8%). All cases to survive for longer than 24 months were well-differentiated adenocarcinomas (median survival, 6 months). The median survival of the entire cohort was 4 months. The survival difference between well-differentiated histology and less-differentiated histology was not significant (P = 0.076). The search for the primary includes investigation of the patients' signs and symptoms and limited screening tests. Treatment has not been proven to alter the natural history of ACUPS and must be weighed against toxicity. PMID- 3967179 TI - Brain mass as a manifestation of very late relapse in nonendemic Burkitt's lymphoma. AB - A 4-year-old boy was diagnosed as suffering from Burkitt's lymphoma with abdominal and maxillary involvement. The child was from a nonendemic area for Burkitt's lymphoma, and no association with Epstein-Barr virus was found. Two years after the completion of therapy, (3.25 years later) the child developed a solitary brain tumor, which was completely excised and was diagnosed as Burkitt's lymphoma. No meningeal involvement was found. Very late relapse in nonendemic Burkitt's lymphoma is very rare, and its presentation as a solid brain mass without meningeal involvement has not been reported before. PMID- 3967180 TI - Concomitant conjugal gliomas with similar histologic features. AB - Conjugal tumors are rarely reported; but nevertheless, raise important questions of possible etiologic factors. In this report, the presentation of grade 2 gemistocytic astrocytomas in an unrelated married couple in their early thirties within 18 months of each other is described. In both cases the left frontal region of the brain was involved and histologically the tumors were very similar. Although there are no accurate figures on the true incidence of gliomas, an estimate can be derived from reliable epidemiologic studies of primary brain tumors as a whole. Using such data, it is calculated that the risk of two designated persons developing a grade 1 to 2 astrocytoma while in the fourth decade within the same year is approximately 1 in 30 billion (10(9)) and, for this couple, over a period of 15 years, at least 1 in 185 million. No specific causative environmental factors were identified in the patients, and results of conventional tests for viral and other infections were negative. It is postulated that apart from remote chance, such conjugal lesions implicate the action of an environmental agent. In the absence of other factors, involvement of a slow, unconventional virus is a possibility that must be strongly considered. PMID- 3967181 TI - Carcinoma of the vagina. Factors influencing treatment outcome. AB - A 33-year review from the University of Michigan Medical Center of 86 cases of primary carcinoma of the vagina included 68 squamous carcinomas, 13 adenocarcinomas, and 5 small cell carcinomas. There was a 26% incidence of prior cervical carcinoma and a 21% incidence of prior pelvic radiation therapy. The median interval between the diagnosis of invasive cervical and vaginal carcinoma was 20 years. Survival was strongly correlated with stage. There was no association between survival and involvement of a particular vaginal segment or the amount of vaginal surface area involved with tumor. Irradiation was the most frequently employed primary therapy for vaginal carcinoma. Local control was correlated with the mid-tumor irradiation dose, with predictable control obtained only with doses above 7500 rad. The use of interstitial therapy should facilitate local control without increasing the complication rate. PMID- 3967182 TI - Hypercalcemia, renal failure, and relapse in multiple myeloma. AB - Forty-two patients with multiple myeloma that responded to initial treatment were observed for at least 6 months during a 2-year period. Eleven deaths occurred, seven of these being associated with hypercalcemia. None of these patients developed renal insufficiency before the serum calcium level rose, although kidney function deteriorated later in five of them. In those patients who are susceptible, hypercalcemia appears to be a good early indicator of relapse in multiple myeloma. PMID- 3967183 TI - Bladder cancer risk and pipes, cigars, and smokeless tobacco. AB - Interview data from 2982 patients with bladder cancer and 5782 controls selected from the general population were used to assess the effects of non-cigarette tobacco use on bladder cancer risk. Compared to men who had never smoked, those who had smoked pipes but not cigars or cigarettes had a relative risk estimated at 1.23 (95% confidence interval [CI] = 0.75-2.00). Those who smoked cigars but not pipes or cigarettes were estimated to have a relative risk of 1.33 (95% CI = 0.92-1.94). Little evidence of dose response was observed. The excess relative risk to pipe smokers was limited to those who inhaled deeply. PMID- 3967184 TI - Risk factors of squamous cell carcinoma of the skin. A case-control study in the Montreal region. AB - A matched case-control study was undertaken to assess the relative risk associated with known and suspected risk factors of squamous cell carcinoma of the skin among patients in the Montreal region. Three hundred eleven cases histologically diagnosed in 1977 and 1978 in 12 hospitals and meeting strict definition criteria were identified. With the exception of six cases, two controls were matched to each case for sex, age, and hospital of diagnosis. A logistic regression analysis was done. The known host risk factors (eye and hair color, complexion, descent) and nonoccupational sunlight exposure were found to be operative in the Montreal region. After adjusting for these factors, occupational sunlight exposure appeared to be a risk factor. An association was then observed between the risk of squamous cell carcinoma of the skin and tobacco smoking and the use of a sunlamp. Relative risks associated with the above mentioned factors were estimated. PMID- 3967185 TI - Alveolar soft-part sarcoma. A study of 13 typical examples and one with a histologically atypical component. AB - Thirteen cases of typical alveolar soft-part sarcoma and one in which the tumor had a histologically atypical component are presented. The atypical zone in the latter case was characterized by increased nuclear hyperchromatism and pleomorphism, increased nuclear-cytoplasmic ratio, decreased cytoplasmic eosinophilia and granularity, a less distinct "nesting" pattern, and more numerous mitotic figures. The tumors occurred almost entirely in the younger decades and involved a variety of soft tissue sites. Sex distribution was 1:1, and there was a slight left-sided predominance in tumor location. Median survival of the patients with typical alveolar soft-part sarcoma was 79 months (the patient with the atypical neoplasm died at 36 months). The major factor related to both survival and the likelihood of metastasis was tumor size. PMID- 3967186 TI - Large glucagon-like immunoreactivity in a primary ovarian carcinoid. AB - A primary ovarian carcinoid composed of both trabecular and strumal types was studied by histochemical, immunocytochemical, and biochemical techniques. High contents of glucagon, secretin, and calcitonin were demonstrated in the tumor homogenate. All of the tumor cells, irrespective of histologic type, showed properties of argyrophilia and neurosecretory granules on electron microscopy. Glucagon-producing cells were positive in trabecular carcinoid by immunoperoxidase techniques. Bio-Gel P10 gel filtration showed that the molecular weight of major immunoreactive glucagon in tumor was 20,000. It migrated faster than true glucagon after polyacrylamide gel electrophoresis. No clinical symptoms of glucagonoma developed. PMID- 3967187 TI - In vitro cellular cytotoxicity for a human colon cancer cell line by mucosal mononuclear cells of patients with colon cancer and other disorders. AB - In vitro cellular cytotoxicity of mononuclear cells of intestinal mucosa and peripheral blood for a colon cancer cell target was measured in patients with colon cancer and other disorders requiring resection. Four- and 24-hour cytotoxicity assays were conducted using selenium 75 (75Se)-labeled RPMI-4788 human colon cancer target cells grown in culture. In the cancer group mean cytotoxicity was 30.4% at 24 hours for peripheral blood effectors and 8.0% for effectors from normal mucosa. Values in patients with Crohn's disease were 10.4% for blood and 17.2% for effectors from normal mucosa, and 13.6% and 18.5%, respectively, for blood and abnormal mucosa. Values in patients with other diseases were 25% for blood and 14.7% for mucosa. Mean cytotoxicity at 4 hours did not exceed 6.4% for any group, and assays in autologous serum gave results similar to tests in calf serum. In additional studies, K 562 chronic leukemia cells were somewhat more sensitive to lysis than RPMI-4788 by blood mononuclear cells, but there was no lysis of K 562 by mucosal populations that were cytotoxic for RPMI-4788. There was no competitive inhibition by either target cell for the other. It was concluded that 75Se RPMI-4788 colon cancer cells are suitable targets for evaluating in vitro cytotoxicity by intestinal mucosal cells and that mucosal cytotoxicity in patients with colon cancer is depressed compared to cytotoxicity by peripheral blood effectors. PMID- 3967188 TI - Influence of treatment with APD-bisphosphonate on the bone lesions in the mouse 5T2 multiple myeloma. AB - The effects of the treatment of multiple myeloma (MM) with APD-bisphosphonate on bone destruction, the dissemination pattern of the MM, and toxicity for normal and malignant cells were investigated in an animal model, the 5T2 MM. This mouse MM very closely resembles the human disease, including the typical bone lesions. It was demonstrated by radiography, microradiography, and histologic investigation that the treatment of the 5T2 MM with APD-bisphosphonate protected the mice against a loss of bone to a significant extent. It seemed that the treatment with APD not only diminished the bone destruction by the MM but also led to the formation of new bone in already-affected bone tissue. The growth pattern of the MM was not substantially influenced by the treatment, even though there was an indication that APD exerts some cytotoxic effect on the MM cells. PMID- 3967189 TI - Malignant thyroid tumors at autopsy in a Swedish goitrous population. AB - In a series of 500 consecutive autopsies in a Swedish population with a high rate of goiter (29%) the incidence of malignant thyroid tumors was 6.0%. There were 25 papillary, 2 follicular, and 2 medullary carcinomas and 1 non-Hodgkin's lymphoma immunocytoma. No significant differences in tumor incidence was found between goiter patients and those with normal glands. Notably the tumors occurred more often in men than in women (ratio, 1.5). PMID- 3967190 TI - Significance of urinary neopterin in patients with malignant tumors of the genitourinary tract. AB - The urinary neopterin excretion was measured by high-performance liquid chromatography in 417 healthy subjects and in 76 patients with clinically and pathohistologically verified neoplasias of the urinary tract (bladder tumor, carcinoma of the prostate, and renal cell carcinoma). The patients with early tumor stages both with bladder tumor and carcinoma of the prostate had normal urinary neopterin levels, except one patient with bladder tumor who had a value at the upper confidence limit. Of 40 patients with higher stages of bladder tumor and carcinoma of the prostate, 35 had elevated urinary neopterin levels. Two of 10 patients with bladder tumor in stage T3, 1 of 4 patients with carcinoma of the prostate Stage C, and 2 of 15 patients with prostatic cancer Stage D showed normal neopterin levels. The patients with renal cell carcinoma did not demonstrate any definite correlation between tumor stage and urinary neopterin excretion. The current study suggests that the neopterin assay may supplement laboratory measurements in tumors of the urinary tract, providing helpful information regarding case selection for the most convenient therapeutic management and postoperative follow-up. PMID- 3967191 TI - Association of lymphocytic neoplasia and mesothelioma. AB - Two lymphocytic neoplasms, chronic lymphocytic leukemia and poorly differentiated lymphoma, were detected in two patients who had nonoccupational exposure to asbestos. Both had a pleural mesothelioma subsequent to their initial presentation with lymphocytic neoplasm. Recent reports have suggested a possible association between asbestos exposure and lymphoproliferative neoplasms. Chronic antigenic stimulation by asbestos could predispose one to the immunoproliferative disorders seen in these patients. The possible significance of this relationship is discussed for future consideration. PMID- 3967192 TI - Thymoma. A comparative study of clinical stages, histologic features, and survival in 200 cases. AB - Two hundred thymomas, surgically treated between 1955 and 1982 at the Marie Lannelongue Surgical Center, were subjected to statistical analysis, comparing clinical stages and histologic types and relating them to survival. Clinical stages were defined as follows. Stage I: no invasiveness, total excision; Stage II: localized invasiveness (no more than two mediastinal structures); Stage III: largely invasive, with or without distant tumorous grafts, lymph node deposits, or metastases. Four histologic types were retained: (1) spindle or oval cell type thymoma, (2) lymphocyte-rich thymoma, (3) differentiated epithelial thymoma, and (4) undifferentiated epithelial thymoma. Invasiveness remained a major prognostic factor, but the degree of invasion did not affect the survival rate or always justify radical surgery. Thus, the survival rate dropped from 85% at 5 years and 80% at 10 years in noninvasive tumors to 50% and 35%, respectively, in invasive tumors, but without significant difference between moderately invasive Stage II and largely invasive Stage III tumors. Histologic typing indicated a good correlation between the degree of differentiation of the tumors and prognosis. The survival rates were 80% at 5 years and 75% at 10 years for spindle cell type 1 and lymphocyte-rich type 2 thymomas, 75% at 5 years and 50% at 10 years for differentiated epithelial type 3, and nil at 5 years for undifferentiated type 4 thymomas. Although invasiveness often paralleled histologic typing, they appeared as two distinct parameters with separate prognostic significance, particularly in differentiated and undifferentiated epithelial tumors. One hundred five patients had myasthenia gravis and 14 had another autoimmune disease. The associated syndromes were no longer an adverse factor in the prognosis of thymoma. PMID- 3967193 TI - Retiform differentiation in ovarian Sertoli-Leydig cell tumors. A clinicopathologic study of six cases from a Gynecologic Oncology Group study. AB - This report analyzes six ovarian Sertoli-Leydig cell tumors that showed retiform differentiation. The patients were young (6-29 years; average age, 17). The tumors were all limited to one ovary, and the patients have remained disease free, with one exception, a patient who died of recurrent neoplasm 3.5 years after operation. On microscopic examination, the retiform areas were predominant in three cases and focal in the other three. The retiform areas consisted of an irregular anastomosing network of spaces lined by cuboidal cells, often with papillary formations and sometimes with tubules compressed to form slit-like spaces. In three cases the retiform areas appeared mature, and in three they were less differentiated. All tumors also had areas of typical Sertoli-Leydig cell tumor of either poor or intermediate differentiation. In the patient with metastatic disease, the metastases had a pure sarcomatoid pattern without any retiform areas. PMID- 3967194 TI - Comparison of prognostic factors for survival and recurrence in malignant melanoma of the skin, clinical Stage I. AB - Potential prognostic factors for survival time, 5-year survival rate, recurrence free time, and 5-year recurrence-free rate were explored for 262 patients with malignant melanoma of the skin, Stage I, using the long-rank test, proportional hazards (Cox) regression, and linear logistic regression. Breslow's thickness was the most important variable in each analysis. A thinner Breslow's thickness was associated with a better prognosis. After adjusting for Breslow's thickness, sex was the next most important variable in each analysis. Women had a better prognosis than men. After adjusting for Breslow's thickness and sex, there were no additional significant prognostic factors for survival time; Clark's level was significant for 5-year survival rate; the number of mitoses, evidence of regression, and presence of vascular invasion were significant for recurrence free time; and the presence of vascular invasion and number of mitoses were significant for 5-year recurrence-free rate. It is recommended that in future prospective studies of adjuvant therapy of Stage I melanoma, patients be stratified into treatment groups on the basis of Breslow's thickness and sex. PMID- 3967195 TI - Cutaneous involvement in Hodgkin's disease. AB - Among 465 patients with Hodgkin's disease seen from 1951 through 1980, there were 16 (3.4%) who had histologically verified "specific" cutaneous involvement with Hodgkin's disease. The most common clinical presentation was of single or multiple dermal or subcutaneous nodules. Three patients had skin lesions at first presentation. In all instances, it was possible to classify the cutaneous histologic pattern using the Rye Classification. In addition, one patient was seen in whom disease was confined to a localized area of skin and subcutaneous tissue. This case was difficult to classify, although there were some histologic features suggestive of lymphocyte-depletion Hodgkin's disease. The findings indicate three mechanisms of cutaneous involvement: (1) retrograde lymphatic spread, distal to involved lymph nodes (11 patients); (2) direct extension from an underlying nodal focus (3 patients); and (3) hematogenous dissemination (2 patients). Cutaneous involvement usually represents, or accompanies, Stage IV disease, and carries an ominous prognosis. The problems inherent in the diagnosis of primary cutaneous Hodgkin's disease are discussed. PMID- 3967196 TI - Kaposi's sarcoma in heterosexual intravenous drug users. AB - Kaposi's sarcoma is a feature of the acquired immunodeficiency syndrome (AIDS) in male homosexuals and Haitians. In this report the authors describe six heterosexual intravenous drug users who developed Kaposi's sarcoma. They had other characteristics of AIDS including opportunistic infections (oral candidiasis, six patients; Pneumocystis carinii pneumonia, two patients; genital herpes simplex, two patients; disseminated cytomegalovirus, one patient; Mycobacterium avium, one patient) and inversion of the normal ratio of helper suppressor T-cell subsets in peripheral blood lymphocytes in the two patients in whom it was determined. These observations indicate that intravenous drug users as well as Haitians and homosexual men are at risk for developing Kaposi's sarcoma as part of the acquired immunodeficiency syndrome. PMID- 3967197 TI - Cancer in Indian Moslems. AB - Moslems are the followers of Islam who, during the time of the Ghaznavid dynasty of Afghanistan, invaded India for the first time. Islam attaches equal importance to material and spiritual aspects of human life. Men and women have equal cultural rights. Marriage is positively enjoined and vigorously encouraged. Circumcision is compulsory before boys attain the age of 7. More than one wife (up to four) is permitted in Islamic Society. Differences in the habits, customs, and ethnic characteristics have all provided important leads for the study of cancer in this community. It is a sign of the times that some of the religious and social customs that were rigidly upheld by the older generations are rapidly giving way to "Modernism." Hence an attempt has been made to examine the differences found in the site-specific cancer risks in the Moslem community in Bombay. Analysis of the data was undertaken by sex- and age-adjusted and age specific incidence rates. The common sites of cancer were found to vary greatly between the Moslem and non-Moslem populations of Greater Bombay. In Moslem men, the lung appears to be at highest risk, followed by the larynx, esophagus, tongue, and hypopharynx, whereas in non-Moslem men, the esophagus is the commonest site, followed by the lung, larynx, and tongue. In women, breast and cervix cancers, which rank first and second, respectively, in frequency in Moslems, reverse their positions in non-Moslem women. PMID- 3967198 TI - Evaluation of the American Cancer Society's Reach to Recovery Program. PMID- 3967199 TI - The value of radiation therapy in addition to surgery for astrocytomas of the adult cerebrum. AB - A retrospective review of 86 adults (age 15 years or older) treated from 1950 to 1979 for well-differentiated astrocytoma or anaplastic astrocytoma of the cerebrum at Washington University Medical Center-Barnes Hospital was undertaken to determine the influence of postoperative radiation therapy on survival and neurologic function. Analysis was facilitated by a temporal change in treatment approach, with reliance on surgery alone before 1960 and routine use of postoperative irradiation after 1970. Six patients had astrocytomas with a juvenile pilocytic histologic pattern. Outcome was uniformly favorable in these cases regardless of therapy (100% survival; median follow-up, 14 years). Actuarial survival for the 80 patients with diffusely infiltrating astrocytoma was significantly better with the addition of postoperative irradiation than with surgery alone (median survival, 5 versus 2.2 years, respectively; 5-year survival, 50% versus 21%, respectively). Posttreatment neurologic function was also superior in the group managed with surgery and postoperative irradiation. The relationship to survival of age, degree of histologic anaplasia, extent of surgical resection, tumor size, and radiation dose was also investigated. PMID- 3967200 TI - Anaplastic astrocytoma of the adult cerebrum. Prognostic value of histologic features. AB - Initial biopsy and resection specimens from 78 cerebral astrocytomas with anaplastic foci occurring in adults were examined for the presence of five specific histologic features traditionally considered indicative of anaplasia. Anaplastic astrocytomas with foci of tumor necrosis had been classified as glioblastoma multiforme and excluded from this analysis. Median actuarial survival was shorter for patients whose tumors contained vascular endothelial proliferation (3.5 years versus 5.5 years) or greater than 1 mitosis per 10 high power microscopic fields (1 year versus 5.5 years). No correlation with survival was found for estimation of nuclear pleomorphism and cell density or the presence of secondary structures. Vascular endothelial proliferation and increased mitotic activity may serve as prognostically significant histologic markers in cerebral astrocytomas of intermediate malignancy. PMID- 3967201 TI - 192Ir pharyngoepiglottic fold interstitial implants. The key to successful treatment of base tongue carcinoma by radiation therapy. AB - Twenty-eight patients with squamous carcinomas of the base tongue were seen and evaluated in a conjoint Head and Neck Tumor Board at Stanford between 1976 and 1982. Fourteen patients were treated by combined external beam and interstitial irradiation, 11 of whom had Stage III and IV carcinomas (American Joint Committee). An initial dose of 5000 to 5500 rad was first delivered by external beam irradiation in 5 to 5.5 weeks, followed approximately 3 weeks later by an iridium 192 (192Ir) interstitial implant boost by the trocar and loop technique. The key to successful treatment of these neoplasms was found to be the use of a lateral percutaneous cervical technique, which placed horizontal loops through the oropharyngeal wall above and below the hyoid bone; the superior loop included the pharyngoepiglottic fold and the tonsilloglossal groove. Standard multiple loop implants (submentally inserted) of the base tongue from the vallecula anteriorly to the circumvallate papillae were also used routinely. This approach has been successful, since 10 of the 14 patients (71%) remain without evidence of disease (mean follow-up, 32 months). There have been only two local recurrences, both on the pharyngoepiglottic fold in patients who did not receive the now standard pharyngoepiglottic fold/lateral pharyngeal wall implants. No patients have relapsed after 18 months. The other 14 patients were treated prospectively during the same period by combining initial resection, radical neck dissection, and postoperative irradiation. In this group, there were more locoregional failures compared to the group treated with radiation therapy alone (5 tongue recurrences and 7 neck relapses); in addition, more severe complications were noted in these 14 patients who received surgery and postoperative irradiation. The authors believe that combined external beam and interstitial irradiation is effective treatment for base tongue carcinomas, especially when the high-dose distribution includes the adjacent tonsilloglossal groove, pharyngoepiglottic fold, and oropharyngeal wall to and below the level of the hyoid bone, in addition to treating an adequate base tongue volume. PMID- 3967202 TI - Outcome of different treatment modalities in cervix carcinoma Stage IB and IIA. Observations in a well-defined Swedish population. AB - Stage IB or IIA carcinoma of the cervix in a nonselected series of 263 young (less than or equal to 40 years) women was managed with radiotherapy alone or in combination with radical surgery. When the tumor was detected in Stage IB, the 5 year survival rate was 81% in the radiotherapy group and 96% in the combined therapy group. The corresponding figures for Stage IIA were 74% and 66%, respectively. When lymph node metastases were present at operation, the 5-year survival rate was reduced. The reduction was relatively small in Stage IB, but was decreased from 83% to 27% in Stage IIA. The size of the tumor had prognostic impact on the survival rate. Residual tumor in the surgical specimens was likewise associated with poorer prognosis in Stage IIA. The prediagnostic duration of symptoms indicates that the longer the pretreatment time and higher the stage at diagnosis, the greater the likelihood of metastatic spread. Adenocarcinomas comprised 13% of the tumors in the series. Complications of treatment were few. PMID- 3967203 TI - Analysis of results of radiation therapy for Stage II carcinoma of the cervix. AB - From April 1969 through December 1980, 251 patients with invasive, epidermoid carcinoma of the cervix received radical radiation therapy consisting of a combination of external beam and intracavitary therapy designed to deliver 7000 to 8000 rad to Point A and 6000 to 6500 rad to the pelvic lymph nodes. The disease-free survival at 2, 5, and 10 years for patients with Stage IIA disease was 90%, 76%, and 76%, respectively, whereas for patients with Stage IIB disease it was 77%, 62%, and 59%, respectively. The survival for the entire group at 2, 5, and 10 years was 80%, 65%, and 62%, respectively. Sixty-eight patients had a recurrence within the irradiated volume, for a locoregional recurrence rate of 27% (68/251). In 49 patients complications developed for an overall complication rate of 19.5% (49/251). An analysis of the complications and their degree of severity revealed a correlation with the dose of intracavitary plus external beam therapy given to Point A and to the rectum. The mean dose to Point A for patients with and without complications were 7877 rad (standard error [SE] +/- 95) and 7593 rad (SE +/- 67), respectively. The mean rectal dose for patients with and without intestinal complications were 6767 rad (SE +/- 157) and 6426 rad (SE +/- 78), respectively. The dose difference between patients with and without complications was statistically significant for Point A (P = to 0.0163) but not for the rectal dose (P = to 0.0887). There was no correlation between the bladder dose and urinary complications. Other treatment methods as well as patient and tumor parameters, are being currently analyzed to identify which factors, singly or in combination, may contribute to the development of treatment failures or complications. PMID- 3967204 TI - Combined preoperative and postoperative radiation for bladder cancer. Results of RTOG/Jefferson Study. AB - Ninety-two patients with bladder cancer have been treated with combined pre- and postoperative radiation in a Radiation Oncology Study Group (RTOG) Phase I-II study and at Thomas Jefferson University Hospital. Patients with invasive bladder cancer were entered into the study and given low-dose preoperative radiation (500 rad) to the whole pelvis, either on the day of or the day before cystectomy. Following surgery, patients were pathologically staged. Patients with stage B1 (T2) (grade 3 or 4), stage B2 and C (T3) tumors were given 4500 rad in 5 weeks postoperative radiation. Follow-up in the study ranges from a minimum of 24 months to 5 years, with a median of 36 months. Incidence of complications was 15% (14/92). The 4-year actuarial survival (Kaplan-Meier) by stage of disease is 68% for stage B1 (T2) (grade 3 or 4), 78% for stage B2, and 57% for stage C. These survival results appear to be better than those obtained with other approaches of adjuvant therapy and/or surgery in comparable histopathologically staged patients. PMID- 3967205 TI - Survival following moderate-dose preoperative radiation therapy for carcinoma of the rectum. AB - We performed a retrospective study of patients with carcinoma of the rectum or rectosigmoid undergoing surgical resection. Forty-two patients received adjuvant preoperative radiation therapy (4000-4500 rad). One hundred twenty patients underwent surgical resection alone. Survival of radiation patients was significantly improved over that of Surgery Only patients, even after adjusting for nontreatment factors using Cox regression. Crude 5-year survival was 63% for radiation patients (74% adjusted) compared to 46% for surgery-only patients (48% adjusted) (P less than 0.025). Radiation patients also had longer disease-free survival than surgery-only patients (P less than 0.05) and fewer recurrences (14% versus 37%; P less than 0.025). Fewer radiation patients had lymph nodes involved with tumor than surgery-only patients (20% versus 35%; P = 0.07). Although 71% of radiation patients experienced radiation reactions, these were primarily mild and transitory. We believe that preoperative radiation is an effective and safe adjunct to surgery in the treatment of rectal cancer and that its use can lead to improved survival rates. PMID- 3967206 TI - Nonreciprocal chromosome translocation t(5;14) in cancers of the kidney: adenocarcinoma of the renal parenchyma and transitional cell carcinoma of the kidney pelvis. AB - Chromosome studies were done on an adenocarcinoma of the kidney and a transitional cell carcinoma of the kidney. The adenocarcinoma was in the renal parenchyma, whereas the transitional cell carcinoma was in the kidney pelvis. The adenocarcinoma was moderately well differentiated, and the transitional cell tumor was poorly differentiated. The adenocarcinoma was hypotetraploid, with 69 75 chromosomes per cell, and the transitional cell carcinoma was pseudodiploid, with 46 chromosomes. Both tumors showed a nonreciprocal t(5;14) translocation that resulted in a 5q- and a 14q+ chromosome with loss of 14q material. The breakpoints were in bands 5q13 and 14q22. Both tumors also contained an extra 5q- chromosome. The oncogene c-fms is normally situated in band 5q34 and so may have been translocated onto 14q, although whether it has been activated is conjectural. The t(5;14) translocation may be another tissue-specific cancer chromosome change. PMID- 3967207 TI - Myxoid chondrosarcoma with a translocation involving chromosomes 9 and 22. AB - Myxoid chondrosarcoma is an uncommon neoplasm thought to be derived from mesenchymal chondrocytic cells. Although cytogenetic abnormalities have been reported in sarcomas, too few cases have been studied to determine the frequency of nonrandom chromosomal changes in mesenchymal tumors. In this article, we describe a chondrosarcoma with a nonrandom reciprocal translocation t(9;22)(q22;q11). The cellular homologue to the retrovirus transforming gene of simian sarcoma virus is located on chromosome #22, and its possible significance in this case is discussed. PMID- 3967208 TI - An evaluation of high resolution chromosome banding of hematologic cells by methotrexate synchronization and thymidine release. AB - Methotrexate-thymidine synchronization increased mitotic yield and the numbers of cells with longer chromosomes when compared with direct and day culture (24 hr) techniques. The longer chromosomes overlapped more than shorter ones, but this adverse effect of cell synchronization was outweighed by the substantial gains from increased band number of metaphase cells. A critical feature of the synchronization technique that determines chromosome length is the period of cell culture following thymidine release. This will depend on cell cycle time. Variable results obtained with the synchronization technique probably occur because the cell cycle time of leukemic cells differs from that of normal hematologic cells and normal lymphocytes. It may also differ between patients and between acute and chronic forms of leukemia. PMID- 3967209 TI - In vitro evidence of heterogeneity within pancreatic cancer. AB - The relative importance of the genome and environmental factors has not been established in pancreatic carcinogenesis. The identification of in vitro expressions of cancer genes should enhance such clarification. Hyperdiploidy, with the exception of a low incidence (0%-7%) of tetraploidy, has rarely been observed in dermal monolayer cultures from normal individuals without a family history of solid tumors. Hyperdiploidy (incidence over 1% in a culture) was not observed in dermal fibroblast monolayer cultures derived from 143 clinical normals (ages 18-80 years). In vitro hyperdiploidy (7%-14%), with a normal occurrence of tetraploidy (0%-3%), was observed in 6 of 28 patients with acinar adenocarcinoma of the body of the pancreas. No in vitro hyperdiploidy was observed in the remaining pancreatic cancer patients or in the 25 spouses with negative family cancer histories studied. As hyperdiploidy with a normal occurrence of tetraploidy has been previously reported [1] in a familial pancreatic cancer cluster, this chromosomal alteration was considered to be an in vitro expression of genetic predisposition for pancreatic cancer in approximately 20% of this small (28 patients) sample. In vitro studies on a significantly larger patient sample will be required to determine its incidence in a patient group with acinar adenocarcinoma of the body of the pancreas. PMID- 3967210 TI - Cytogenetic study in six Spanish patients with Burkitt's lymphoma. AB - A cytogenetic study carried out on affected tissues of six children with Burkitt's lymphoma revealed five cases with a typical translocation (8q-; 14q+) and one with a variant t(2p-; 8q+). Additional cytogenetic variations were present in three cases. One had two acrocentric marker chromosomes comprised of material from chromosome #1 (1q21----q44) translocated to the Y gonosome. The other two cases had a cytogenetic alteration of chromosome #12. Cytogenetic studies carried out systematically in Burkitt's lymphoma could be a great help in possibly establishing differences in the biologic and clinical aspects of cases presenting with the t(8;14) versus cases with variant translocations, as this would allow for classification of these patients into groups which, at present, cannot be differentiated using other diagnostic methods. PMID- 3967211 TI - Chromosome 16q, eosinophilia, and leukemia. PMID- 3967212 TI - C-banding studies in lymphocytes from patients with tumors of the nervous system. AB - C-banding studies were performed on cultured peripheral blood lymphocytes from 100 patients with tumors of the nervous system and 30 controls. The classification of Patil and Lubs and the heterochromatic index (HI) of Neeley were used to evaluate the heteromorphism. No overall significant differences were found in the frequency of C-band variants when the findings in both tumoral populations and controls were compared, but we did find an excess of 9qh inversions in some groups of tumor patients. An increase in the amount of heterochromatin in patients with pituitary adenomas and high malignancy grade astrocytomas was noted. PMID- 3967213 TI - A 2p;11q chromosome translocation in dysmyelopoietic preleukemia. AB - Three patients with dysmyelopoietic preleukemia had a marrow clone with translocation t(2;11)(p21;q23) as the only chromosome change. In one patient, the cytogenetically altered cells disappeared following treatment with 13-cis retinoic acid. Although these patients did not constitute a homogeneous clinical subgroup, the 2p;11q translocation should probably be added to the short list of nonrandom karyotypic alterations involving 11q23 that have been described in various hematopoietic disorders. PMID- 3967214 TI - Increased sister chromatid exchange frequency in bone marrow cells of myelodysplastic syndromes. AB - The frequency and distribution of sister chromatid exchange (SCE) was determined in bone marrow and peripheral lymphocytes of patients with preleukemic myelodysplastic syndromes. Patients with refractory anemia (RA), RA with excess of blasts (REAB), RA with ring sideroblasts, and RA in transformation presented a 2-3-fold increase in SCE frequency in the bone marrow cells. In contrast, lymphocytes from these patients showed only a marginal increase in SCE. Analysis of interchromosomal distribution of SCE indicated a preferential involvement of chromosomes in group C in patients with RA with excess of blasts. Furthermore, the SCE in patients was not found to be influenced by the karyotype status. PMID- 3967215 TI - Two Burkitt's lymphomas with chromosome 6 long arm deletions. AB - Two new European Burkitt's lymphoma (BL) cases are reported. Their karyotypic abnormalities were unusual, without involvement of chromosomes #8, #14, #2, or #22. However, in both tumors, a 6q- chromosome was, present. These findings raise questions about the definition of BL and the involvement of various different DNA sequences in the mechanisms of BL genesis. PMID- 3967216 TI - Scanning electron microscopy of marker chromosomes in a human malignancy. PMID- 3967217 TI - Familial mesothelioma: review and family study. AB - To date, with few exceptions, primary attention to the etiology of malignant mesothelioma has been focused on environmental factors. However, several reports of familial aggregations of mesothelioma strongly support the supposition that host factors, in concert with environmental exposure, particularly asbestos, may contribute etiologically to an as yet unknown fraction of occurrences of this disease. However, in evaluation of familial mesothelioma, it is important to consider the possibility of household exposure to asbestos. We report a family in which two brothers with prolonged occupational asbestos exposure manifested malignant pleural mesotheliomas of similar histology. PMID- 3967218 TI - Sister chromatid exchange and proliferation pattern in stimulated lymphocytes of cutaneous malignant melanoma patients. AB - Sister chromatid exchange (SCE) and the proliferative pattern of phytohemagglutinin-stimulated lymphocytes were examined in 36 nonfamilial cutaneous malignant melanoma (CMM) patients. One close relative of each of 27 CMM patients was also examined. All the patients had undergone surgical treatment for the neoplasm, but had received no chemotherapy or radiotherapy. The SCE rates were found to be higher and more variable in a significant fraction of CMM patients, and in relatively fewer unaffected relatives, which is in contrast to findings in unrelated subjects taken as controls. Also, variable and higher proportions of cells in metaphase of the first cell cycle (M1), after 72-hr culture in the presence of bromodeoxyuridine, were more often found among the CMM patients than in the controls; however, no effect of clinical progression of the neoplastic disease on SCE rates or on the lymphoproliferative pattern was observed. The present study indicates heterogeneity among subjects who develop CMM and suggests that the peculiarities of SCE rates and of the lymphoproliferative patterns observed in some of the CMM patients and in a few of their close relatives may be connected with the mechanism of onset of the neoplasm. PMID- 3967219 TI - Clonal chromosome abnormalities in prison-acquired lymphoproliferative syndrome. AB - Lymph nodes from five male patients with prison-acquired lymphoproliferative syndrome (PALS), which seems to be a prodrome of acquired immune deficiency syndrome (AIDS), were examined cytogenetically. Two had clonal chromosome abnormalities, i.e., 11q- and -11, and another had multiple nonclonal chromosome changes, including t(2p-;3q+),6q-,+12,14q+. These chromosome changes are also common in malignant lymphoma and suggest that the patients with PALS may be predisposed to develop malignant lymphoma. PMID- 3967220 TI - "Unusual SCD" explained by differences in BrdU incorporation during subsequent cell cycles. AB - In the course of three consecutive cell cycles, V79 cells were labeled with BrdU by different labeling protocols. Cells treated for three cycles with bromodeoxyuridine (BrdU) showed third division metaphases, with the typical appearance after fluorescent plus Giemsa (FPG) staining (i.e., 75% of the chromatids showed light staining, 25% showed dark staining). The same staining pattern is achieved by the second labeling protocol, during which the cells have replicated for two cycles in the presence of BrdU and, during the last cycle, in the absence of BrdU. Cells that have replicated only for one cell cycle in BrdU containing medium, and the following two cycles in normal medium, depict just the opposite staining pattern (i.e., 75% dark, 25% light). These experiments explain how the variation of BrdU substitution in the DNA leads to altered FPG staining. Unexpected staining patterns ("unusual SCD") are also observed after seemingly permanent BrdU substitution. This phenomenon, which has been found in cancer cells, is due to the decrease in BrdU concentration and not to a peculiarity of the cells investigated. PMID- 3967221 TI - Preleukemia and leukemia with 12p- and 19q+ chromosome alterations following Alkeran therapy. AB - Among 20 patients with acute nonlymphocytic leukemia or dysmyelopoietic preleukemia secondary to Alkeran therapy for another tumor, four had a del(12)(p11-p12) and four had a translocation to 19q13 among multiple karyotypic alterations in their neoplastic hematopoetic clones. It is suggested that these two cytogenetic abnormalities may occur nonrandomly in such hemic disorders and may play a limited role in their pathogenesis. PMID- 3967222 TI - Identical chromosome translocations involving the region of the c-myb oncogene in four metastases of a mediastinal teratocarcinoma. AB - A 39-year-old white male presented with a disseminated mediastinal teratocarcinoma. Karyotyping was performed on two mature residual metastatic lesions in the lungs immediately following chemotherapy, on a recurring lung lesion after 5 months, and on a metastasis in the right thigh 5 months after salvage chemotherapy. All four lesions were pseudoeuploid and showed identical chromosomal abnormalities: a translocation with the two chromosomes #6 and one chromosome #11 involved, resulting in 46, XY, t (6;6;11) (q21;q23;q13). The breakpoint in chromosome #6 is in the region to which the oncogene c-myb has been localized, and the breakpoint in chromosome #11 is at a known fragile and possibly oncogenic site, suggesting that the translocations in this case may have played a crucial role in the development of the malignancy. PMID- 3967223 TI - Use of high-resolution 31P-labeled topical magnetic resonance spectroscopy to monitor in vivo tumor metabolism in rats. AB - A probe using a single-tuned solenoid coil has been constructed to study in vivo metabolism of rats in a wide-bore Bruker nuclear magnetic resonance spectrometer. Transplantable rat mammary adenocarcinomas (estrogen receptor negative) were implanted into the hind leg muscle of 8-week-old rats. The other leg without tumor was used as a control. Tumor metabolism could be distinguished from that of surrounding muscle by the appearance of inorganic phosphate and sugar phosphate resonances, reflecting tissue necrosis, and increased glycolysis. Tumor growth was accompanied by an increase in the size of these peaks, and the chemical shifts of the inorganic phosphate peak indicated that the intracellular pH became more acidic. Administration of methotrexate (i.v.) reversed these patterns and decreased tumor volume. Changes in the phosphocreatine peaks indicated changes in tumor volume rather than in tumor metabolism. These studies show that topical magnetic resonance not only can monitor the growth of tumors in vivo but can be also used to evaluate the efficacy of chemotherapeutic drugs. PMID- 3967224 TI - Elimination of malignant clonogenic cells from human bone marrow using multiple monoclonal antibodies and complement. AB - A clonogenic assay has been developed that utilizes Burkitt's lymphoma tumor cell lines to detect elimination of up to 5 logs of tumor cell contamination within human bone marrow. Different Burkitt's lymphoma lines bear one or more of a group of markers, including common acute lymphoblastic leukemia antigen gp26 (glycoprotein with a molecular weight of 26,000), B1, surface membrane immunoglobulin, HLA, beta 2-microglobulin, and Ia. Burkitt's tumor cells of the Namalwa line have been mixed with a 20-fold excess of irradiated human bone marrow cells. After treatment with one or more monoclonal antibodies and rabbit complement (RC), mixtures have been grown on a monolayer of irradiated human bone marrow cells and tumor cells enumerated by limiting dilution. Multiple treatments with antibody and RC were more effective than a single treatment in destroying clonogenic tumor cells which bore relevant determinants. Human serum components inhibited the lytic activity of RC in the presence of murine monoclonal antibodies. The total concentration of bone marrow cells proved critical in determining the complete elimination of tumor. Incubation of the Namalwa tumor cell line with RC and the J2 anti-gp26 eliminated more than 3 logs of malignant cells from a 20-fold excess of human bone marrow. Combinations of two monoclonal antibodies were more effective than any single antibody in eliminating Namalwa cells. A combination of three monoclonal reagents was no more effective than a combination of J2 and B1 or J2 and J5 in eliminating Namalwa cells. Treatment of human bone marrow with three antibodies and RC did not, however, produce a selective loss of nonmalignant GM-CFU-C, CFU-E, or BFU-E. PMID- 3967225 TI - Decreased intracellular glutathione concentration and increased hyperthermic cytotoxicity in an acid environment. AB - Chinese hamster ovary (CHO) cells were heated at either pH 7.2 to 7.4 or 6.7 to 6.8 in order to determine if conditions which suppress the development of thermotolerance (pH 6.7 to 6.8) reduce intracellular levels of glutathione (GSH). When the pH of the growth medium was reduced from 7.2 to 6.7, a 25 to 30% reduction in GSH was observed in cells maintained at 37 degrees. Cells heated at 42 degrees in medium adjusted to pH 6.7 had lower levels of GSH compared to cells heated at pH 7.2. Cells were also heated for 1 hr at 43 degrees and then incubated at 37 degrees for up to 9.5 hr prior to GSH measurement. The GSH levels of cells treated at pH 7.3 increased approximately 20% above control, whereas treatment at pH 6.7 resulted in a 20% reduction compared to control. Chinese hamster ovary cells were exposed to 5 mM buthionine sulfoximine (BSO) prior to and during 42 degrees heat treatment. BSO exposure at either pH 7.3 or 6.8 reduced the GSH concentration to approximately 65% of control and increased thermal cytotoxicity. The thermal sensitivity of cells incubated at 42 degrees and pH 7.3 was compared to that of cells incubated at pH 6.8. Decreasing the pH from 7.3 to 6.8 increased sensitivity by a factor of 1.87 in the absence of BSO, whereas decreasing the pH in the presence of BSO increased sensitivity by only 1.50. In summary, these results suggest that the increase in thermal sensitivity observed when Chinese hamster ovary cells are heated in acid medium is due partly to the depletion of GSH. PMID- 3967226 TI - Use of a new citrulline incorporation assay to investigate inhibition of intercellular communication by 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane in human fibroblasts. AB - A citrulline incorporation assay has been developed to measure intercellular communication between argininosuccinate synthetase-deficient and argininosuccinate lyase-deficient human fibroblasts (J. S. Davidson, I. M. Baumgarten, and E. H. Harley, Exp. Cell Res., 150: 367-378, 1984). This method was used to investigate the effects of 1,1,1-trichloro-2,2-bis(p chlorophenyl)ethane (DDT) on intercellular junctional communication. DDT at a concentration of 20 micrograms/ml inhibited metabolic cooperation by 90 to 98%. This inhibition was of rapid onset and was rapidly reversed by washing the cells. Inhibition of metabolic cooperation by DDT was not dependent on the presence of extracellular free calcium, indicating that DDT does not act by increasing net calcium influx into cells. This system should prove useful in elucidating the relationship between tumor promotion and intercellular communication. PMID- 3967227 TI - Mechanism of antitumor action of pyrimidinones in the treatment of B16 melanoma and P388 leukemia. AB - This study was undertaken in an attempt to understand the mechanism of antitumor action of pyrimidinones alone and in combination with cyclophosphamide (CY). Pyrimidinones such as 2-amino-5-bromo-6-(3-fluorophenyl)-4(3H)pyrimidinone (ABMFPP) were relatively nontoxic toward murine L1210 leukemia cell growth in vitro with the concentration of drug required for a 50% inhibition of cell growth being greater than 50 micrograms/ml. In contrast, ABMFPP showed anti-B16 melanoma activity in vivo which was sensitive to X-irradiation of the hosts. These results collectively suggest that pyrimidinones may act differently from conventional cytotoxic antitumor agents. Multiple i.p. injections of ABMFPP (125 mg/kg/injection) significantly augmented the cytotoxicity of both natural killer cells and macrophages in peritoneal exudates. The augmentation of both effector cell populations was delayed, but was more pronounced when animals received a dose of CY (100 mg/kg) prior to ABMFPP injections. The combination of CY and ABMFPP also showed a synergistic anti-P388 leukemia effect which appeared to be related to the initial reduction of the tumor burden by CY and the marked augmentation of the cytotoxicity of both natural killer cells and macrophages by ABMFPP. The antitumor activity of ABMFPP against B16 melanoma was almost completely eliminated when animals received a dose of 400 rads X-irradiation 5 days prior to tumor inoculation or a dose of 200 rads X-irradiation followed by several injections of anti-asialo monosialoganglioside antibody. The administration of anti-asialo monosialoganglioside alone also markedly reduced the anti-B16 melanoma activity of ABMFPP. The magnitude of reduction of the antitumor effect of ABMFPP by radiation and/or anti-asialo monosialoganglioside antibody directly correlated with the inhibition of the ABMFPP-mediated augmentation of immune responses. These results strongly suggest that the antitumor effect of ABMFPP alone or in combination with CY is at least in part mediated through its augmentation of natural killer cell and/or macrophage activities. PMID- 3967228 TI - Hormonal therapy of human endometrial adenocarcinoma in a nude mouse model. AB - The hypothesis that 17 beta-estradiol or tamoxifen (TAM) can potentiate clinical response of endometrial cancer treated with progestin was tested in an ovariectomized nude mouse system, using a sex steroid receptor-positive and a receptor-negative human endometrial carcinoma. Animals were divided into three groups: control; 17 beta-estradiol-treated; and TAM-treated. When tumors of a group reached about 1 cm in diameter, subgroups were given either 0.9% NaCl solution (saline) or medroxyprogesterone acetate (MPA). The receptor-negative tumor grew rapidly in all three groups, and several animals were dead before or during progestin treatment. The growth rate of receptor-containing carcinoma was significantly increased in TAM-treated mice compared to controls (p less than 0.02) but significantly less than that in 17 beta-estradiol-treated animals (p less than 0.01). Endometrial carcinoma in 17 beta-estradiol-saline-treated animals continued to grow rapidly, and all animals were dead by 11 weeks. The growth of tumors in the 17 beta-estradiol-progestin group was suppressed at 11 weeks, and some of these animals lived 20 weeks. Administration of progestin to TAM-exposed animals resulted in a remarkable regression of the tumor compared to TAM-saline-treated group. The growth rate of tumors in control animals (no implants) was unaffected by progestin treatment. We conclude that, in this nude mouse model, treatment with TAM and MPA is superior to MPA alone, or 17 beta estradiol plus MPA for sex steroid receptor-positive endometrial carcinoma. PMID- 3967229 TI - Carcinogenic effect of nitrosoalkylureas and nitrosoalkylcarbamates in Syrian hamsters. AB - Three nitrosoalkylureas, two nitrosotrialkylureas, and three nitrosoalkylcarbamates were given to Syrian golden hamsters by gavage at approximately equimolar doses. Measured by the time to death with tumors as an index, nitrosoethylurea was the most potent carcinogen, followed by nitroso-2 hydroxyethylurea, which was less effective in males than in females. The least effective compounds, by this measure, were nitrosooxazolidone and nitroso-5 methyloxazolidone. The remaining compounds, nitroso-N-ethylurethan, nitroso-2 hydroxypropylurea, nitrosomethyldiethylurea, and nitrosotriethylurea appeared to be of similar potency. All of the compounds induced papillomas or carcinomas of the nonglandular stomach in high incidence, except in the groups given nitrosohydroxyethylurea or nitrosooxazolidone; exceptionally, only 35% of the latter group had tumors, compared with 70% or more in the other groups. All of the nitrosoalkylureas induced a high incidence of hemangiosarcomas of the spleen, but the nitrosoalkylcarbamates did not. The quite uniform response of the hamster to these compounds contrasts with the great variety of organs and cell types in which they induce tumors in the rat. PMID- 3967230 TI - Effect of cyclophosphamide on Friend virus leukemogenesis in virus-sensitive and virus-resistant mice. AB - The influence of cyclophosphamide (CY) on Friend virus leukemogenesis was studied in SJL/J, C57BL/10J, and C57BL/10J X SJL/J F1 (hereafter called B10SJF1) mice. All three differ in their susceptibility to the viral oncogenic effect. Immunosuppressive doses of CY, which by themselves produced no cancer, were followed 2 days later by injection of Friend leukemia virus. The virus doses were the same as used previously. Although in other experiments preinjection of various chemical carcinogens augmented leukemogenesis by Friend leukemia virus in SJL/J mice, in the present study, pretreatment by CY had no such effect. In contrast, CY increased Friend erythroleukemia incidence from 15 to 100% in B10SJF1 mice and from 0 to 85% in C57BL/10J mice. The disease in C57BL/10J mice had a 190-day incubation period, which is approximately 5 times that in the SJL/J and B10SJF1 mice. During this latent period, the C57BL/10J mice harbored infectious Friend leukemia virus in their plasma. PMID- 3967231 TI - Effects of dietary fats and butylated hydroxytoluene on mutagen activation in rats. AB - The effects of hydrogenated fats and butylated hydroxytoluene (BHT) in the diets of rats on the hepatic activation of benzo(a)pyrene, 2-acetylaminofluorene (AAF), and 2-aminofluorene by liver homogenates (S-9 fraction) were evaluated. The Salmonella/microsomal mutagenicity assay (Strain TA 98) was utilized to determine the mutagenic potential of the activated compounds. The S-9 fraction was obtained from animals fed a 15% fat diet consisting of hydrogenated fats (43% trans-fatty acids) or unsaturated fats (0% trans-fatty acids). BHT was administered orally (0.5%) 6 days prior to sacrifice in both groups. The incorporation of BHT in the diet of rats enhanced the mutagenic potential of AAF and 2-aminofluorene but not of benzo(a)pyrene. This effect was independent of the lipid composition of the diet. The most significant increment in the production of mutagenic metabolites was observed with AAF when BHT and hydrogenated fats were included in the diet of rats. Dietary hydrogenated fats appeared to potentiate the effects of BHT on AAF mutagenicity. Further studies to elucidate the mechanisms by which BHT and hydrogenated fats enhance AAF mutagenicity are warranted. PMID- 3967232 TI - Tumor destruction and kinetics of tumor cell death in two experimental mouse tumors following photodynamic therapy. AB - The effect of photodynamic therapy (PDT) on tumor growth as well as on tumor cell survival in vitro and in vivo was studied in the EMT-6 and RIF experimental mouse tumor systems. In vitro, RIF cells were more sensitive towards PDT than were EMT 6 cells when incubated with porphyrin (25 micrograms/ml, dihematoporphyrin ether) and subsequently given graded doses of light. In vivo, both tumor types responded to PDT (EMT-6, dihematoporphyrin ether, 7.5 mg/kg; RIF, dihematoporphyrin ether, 10 mg/kg; both followed 24 hr later by 135 J of light at 630 nm/sq cm) with severe vascular disruption and subsequent disappearance of tumor bulk. However, whereas the cure rate for EMT-6 tumors was 90%, it was 0% for RIF tumors. Raising the light dose to 200 J/sq cm resulted in 100% cures for EMT-6 tumors accompanied by damage to the surrounding tissues and 13% cures for RIF tumors. Tumor cell clonogenicity following PDT in vivo was assessed using the in vitro colony formation assay. In both tumors, it was found to be nearly unaffected by PDT if the tumor tissue was excised and explanted immediately following completion of treatment. This indicates that the effect of PDT on tumor cells directly was not sufficient to decrease tumor clonogenicity even at doses which led to total macroscopic tumor destruction. Where the tumors remained in situ following PDT and explantation was delayed for varying lengths of time (1 to 24 hr), tumor cell death occurred rapidly and progressively, indicating that tumor cell damage was expressed only if the cells remained exposed to the in situ environment after treatment. The kinetics and extent of tumor cell death were very similar for both tumor types despite their difference in cure rates. The reduction in tumor clonogenicity at 4 hr post-PDT closely matched that of tumor deprived of oxygen for the same period of time, implying that one of the major factors contributing to tumor destruction may be damage of the tumor circulation and the consequences of treatment-induced changes in tumor physiology. PMID- 3967233 TI - Beta- to omega-hydroxylation of the esophageal carcinogen methyl-n amylnitrosamine by the rat esophagus and related tissues. AB - When the esophageal carcinogen methyl-n-amylnitrosamine (MNAN; concentration, 3 mg/liter) was incubated in vitro with rat esophagi for 3 hr, five principal neutral metabolites (Metabolites 2 to 6; total yield, 3.0% of the MNAN per 100 mg tissue) were separated by gas chromatography, with detection by a thermal energy analyzer. Rat liver produced similar metabolites (total yield, 2.1% of the MNAN per 100 mg tissue). Metabolites 4 to 6 and a minor product, Metabolite 7, were tentatively identified as 2-, 3-, 4-, and 5-hydroxy-MNAN (HO-MNAN), respectively, from a comparison of their gas chromatography retention times with those of the synthesized compounds. Rat esophagus produced similar amounts of 3- and 4-HO-MNAN and lesser amounts of 2-HO-MNAN, whereas rat liver produced mainly 4-HO-MNAN. Rat nasal tissue metabolized 8.0% of the MNAN per 100 mg tissue, with a metabolite pattern like that of the esophagus. Rat lungs produced mostly 5-HO-MNAN. A comparison of yields from tissues of rats, hamsters, guinea pigs, and mice supported the view that the total production of neutral MNAN metabolites indicated the sensitivity of MNAN carcinogenesis, with some exceptions. MNAN injected i.p. was less carcinogenic for the esophagus and nasal cavity in Sprague Dawley than in MRC-Wistar rats, perhaps because the livers of Sprague-Dawley rats metabolized more of the MNAN. The urine of MNAN-treated MRC-Wistar rats contained MNAN and metabolites provisionally identified as 2-, 3-, and (as the major product) 4-HO-MNAN. The identity of the urinary 4-HO-MNAN was confirmed by gas chromatography-mass spectrometry. We speculate that tissues like the esophagus, which (unlike the liver) produce significant proportions of 2- and 3-HO-MNAN, also produce significant amounts of the most likely proximal carcinogen, 1-HO MNAN. PMID- 3967234 TI - Effect of estrogens and antiestrogens on growth of human breast cancer cells in athymic nude mice. AB - Endocrine therapy with estrogen deprivation or with antiestrogens results in tumor regression in a subset of patients with advanced breast cancer. To better understand the mechanisms by which estrogens and antiestrogens modulate breast cancer growth in vivo, we have studied the effects of endocrine manipulation on the development and growth of tumors derived from cultured human breast cancer cells in the athymic nude mouse. MCF-7 breast cancer cells were inoculated into 6 week-old female BALB/c athymic nude mice. Tumor growth did not occur in ovariectomized mice. Cells remained viable, however, since estrogen supplementation more than 30 days later resulted in tumor formation. Minimal tumor growth was observed in intact female nude mice which have low circulating estrogen levels. Tumor development and growth in ovariectomized or intact mice supplemented with 17 beta-estradiol in the form of a s.c. pellet were dose dependent; growth rates increased with estrogen doses ranging from 0.01 to 0.5 mg. Antiestrogen treatment with either tamoxifen or LY156758 caused transient stimulation of tumor growth, followed by a prolonged stationary phase. Growth resumed with estrogen supplementation. Treatment of mice bearing established MCF 7 tumors with estrogen withdrawal (removal of estrogen pellet) resulted in cessation of tumor growth, but not in tumor regression. Growth inhibition was also observed with antiestrogens and was dose dependent. However, tumor regression did not occur, even in mice treated with high doses of tamoxifen (serum concentration of 1.0 microM) for as long as 60 days. Tumor growth was restored in these mice with estrogen replenishment. Tumor cells also remained viable histologically despite prolonged (1 month) estrogen deprivation or antiestrogen therapy, although the mitotic index was markedly reduced. Similar observations were made with mice inoculated with the hormone-responsive ZR75-1 human breast cancer cells, but not with hormone-independent MDA-231 cells which were not influenced by estrogen or antiestrogen treatment. In summary, development and growth of MCF-7 and ZR75-1 tumors in nude mice are estrogen dependent. Endocrine therapy by estrogen deprivation or antiestrogen treatment inhibits tumor cell proliferation in nude mice, but does not cause tumor regression or loss of cell viability. PMID- 3967235 TI - Protective effects of trifluralin on benzo(a)pyrene-induced tumors in A/J mice. AB - Trifluralin, a widely used herbicide, added to the diet before the p.o. administration of benzo(a)pyrene (BP) and fed continuously, significantly inhibited the induction of lung and forestomach tumors in female A/J mice. Dietary intake of trifluralin before the administration of BP resulted in a significant increase in glutathione in lung and forestomach but not in liver and glandular stomach. Trifluralin treatment also inhibited the binding of [3H]BP to liver and lung DNA, as well as to protein in the liver. Under these conditions, the protection against BP-induced lung tumors and perhaps forestomach tumors may be due to an elevation of tissue glutathione, resulting in a decreased binding of reactive metabolites of BP to macromolecules at these sites. The results indicate that trifluralin has a "blocking" effect in its inhibition of BP-induced tumors. Our studies show that trifluralin also inhibits chemical carcinogenesis in lung and forestomach when started in the diet 1 day after the administration of BP and fed continuously thereafter. In the case of lung, although maximum inhibition of tumors occurred when trifluralin was started 1 day after BP, there was significant protection at all time intervals (0 to 7 days) against lung tumors. The finding that trifluralin protects against BP tumorigenesis when started in the diet after the administration of the carcinogen clearly demonstrates that trifluralin also has a "suppressive" effect against BP-induced tumors. PMID- 3967236 TI - New assay for the O-alkyl cleavage enzyme with alkyl-lysophospholipids as substrates. AB - The O-alkyl cleavage enzyme is important for the metabolism of cytotoxic alkyl lysophospholipids. We have developed a simple new method for the determination of the enzyme activity which is based on the formation of water-soluble phosphate during the enzyme reaction. This is the first assay which avoids the use of radiolabeled substrates. PMID- 3967237 TI - Metabolism of N-nitroso-2,6-dimethylmorpholine by isozymes of rabbit liver microsomal cytochrome P-450. AB - The cis isomer of N-nitroso-2,6-dimethylmorpholine (NNDM), a pancreatic carcinogen for the Syrian golden hamster, is metabolized by hamster liver microsomes to yield N-nitroso(2-hydroxypropyl)(2-oxopropyl)amine (HPOP) as the major product. Rabbit liver microsomes catalyze the metabolism of cis-NNDM to HPOP at a rate slower than that observed with hamster microsomes, but significantly faster than that obtained with rat microsomes. Pretreatment of rabbits with phenobarbital results in a 6-fold increase in the cis-NNDM hydroxylase activity of the rabbit microsomes to levels equal to that observed with the hamster; pretreatment of rabbits with other xenobiotics had no effect on the hydroxylation of cis-NNDM. The role of rabbit liver microsomal cytochrome P 450 in the metabolism of the cis isomer of NNDM was studied in the reconstituted system consisting of NADPH:cytochrome P-450 reductase, phospholipid, and cytochrome P-450. Cytochrome P-450LM2, which is induced by pretreatment with phenobarbital, exhibited the highest activity for the metabolism of cis-NNDM. The Vmax for the formation of HPOP was 1.78 nmol/min/nmol cytochrome P-450LM2, and the apparent Km was 360 microM. Cytochrome P-450LM3a also catalyzed the metabolism of NNDM to HPOP at a significant rate (0.25 nmol/min/nmol cytochrome P 450). Of the four other isozymes of cytochrome P-450 (forms 3b, 3c, 4, and 6) tested in the reconstituted system, only forms 3b and 3c exhibited measurable activities (approximately 0.04 nmol of HPOP formed/min/nmol cytochrome P-450). The addition of antibodies to isozyme 2 to microsomes from phenobarbital-treated rabbits resulted in approximately 95% inhibition of the metabolism of NNDM, while the addition of antibodies to LM3a inhibited NNDM metabolism by only 7%. In microsomes from untreated rabbits, inhibition by anti-LM2 and anti-LM3a antibodies was 50 and 64%, respectively. The addition of antibodies to isozyme 3a to microsomes isolated from ethanol-treated rabbits caused approximately 90% inhibition of the metabolism of NNDM. These data conclusively demonstrate that several forms of cytochrome P-450 can catalyze the metabolism of cis-NNDM and that isozymes 2 and 3a play important roles in the rabbit hepatic metabolism of NNDM to HPOP, the proximate carcinogenic metabolite. PMID- 3967238 TI - Collateral sensitivity to cross-linking agents exhibited by cultured L1210 cells resistant to oxazaphosphorines. AB - The sensitivity of cultured L1210 and P388 cells, sensitive (L1210/0, P388/0) and resistant (L1210/CPA, P388/CPA) to cyclophosphamide in vivo, to five oxazaphosphorine and eight nonoxazaphosphorine cross-linking agents was determined. Each of the resistant sublines was cross-resistant to all of the oxazaphosphorines tested. The P388/CPA cell line was also cross-resistant to all of the nonoxazaphosphorines but, in most cases, not nearly to the same extent. The L1210/CPA cell line was collaterally sensitive to all but one of the nonoxazaphosphorines, in which case it was equisensitive. Changes in sensitivity could not be accounted for by changes in intracellular pH values, or by changes in intracellular inorganic phosphate or acid-soluble organic phosphate concentrations. Inasmuch as the L1210/CPA cell line was specifically resistant to the oxazaphosphorines, identification of the phenotypic basis for this resistance should serve to identify a potentially important determinant with regard to the basis for the oncotoxic specificity of this group of agents. PMID- 3967239 TI - Intercellular communication capacity as a possible determinant of transformation sensitivity of BALB/c 3T3 clonal cells. AB - While clonal cell variants of BALB/c 3T3 with high and low susceptibilities to ultraviolet radiation- and benzo(a)pyrene-induced transformation show similar intercellular communication capacities when they are in the growing phase, a significant loss in communication occurs at confluence only in transformation sensitive clonal variant cells. A potent tumor promoter, 12-O tetradecanoylphorbol-13-acetate, which also enhances BALB/c 3T3 cell transformation induced by methylcholanthrene, inhibited intercellular communication of these variants to a similar extent. These results suggest that intrinsic differences in the control of intercellular communication may be a determinant of the susceptibility of these variants to the induction of transformation. PMID- 3967240 TI - DNA amplification and tumorigenicity of the human melanoma cell line MeWo. AB - Homogeneously staining regions (HSRs) were found in hypodiploid cells (40%) of a subline of the human melanoma cell line, MeWo, (MeWo-C) but were absent from the hypotetraploid cells (60%). Another subline (MeWo-B) was also shown to contain two populations of cells, 70% hypodiploid and 30% hypotetraploid. None of the MeWo-B cells contained HSRs, but all four cell types from both sublines shared marker chromosomes indicating their common origin. The hypodiploid MeWo-B cells were karyotypically similar to the hypodiploid MeWo-C cells except for the presence of the HSRs in the latter. Both MeWo-C and MeWo-B sublines were injected into BALB/c nude mice. The MeWo-C cells were markedly more tumorigenic than MeWo B cells as judged by tumor incidence, latency, average tumor size, and tumor take values. Cytogenetic and flow cytofluorometric analyses of the tumors induced by MeWo-C cells revealed a shift in the tumor cell population from 40% to greater than 90% HSR-containing hypodiploid cells during tumor growth. Hybridization of tumor DNA to a probe (D15Z1), the sequence of which is amplified in the HSRs, also indicated an increase in the proportion of HSR-bearing cells during tumor growth. No such selective advantage was found with the hypodiploid, HSR-lacking MeWo-B cells. The results suggest that HSRs found in the human melanoma line MeWo may confer enhanced tumorigenicity to the cells containing them. PMID- 3967241 TI - Morphological observations during developing concomitant immunity against a C3H/He mammary tumor. AB - During the developing phase of concomitant immunity against primary s.c. implants of the mammary carcinoma MC2, responder cells identified as Lyt 1 and Lyt 2 T cell subsets and B-cells showed little tendency to infiltrate among the cells of the implants and did not appear to have any direct cytotoxic effect. Macrophages were also not cytotoxic at this time, but they were closely associated with the formation of a fibrous cellular capsule, always found around tumors in arrested growth or in regression. After a period of growth, about 20% of the MC2 implants regressed spontaneously. Surgical disruption of the capsules formed around 5-week old primary tumor implants did lead to more frequent regressions, showing that a capsule that could destroy a tumor slowly also shielded the tumor against highly activated and effective systemic rejection mechanisms. In mice less than fully immunized with 3-week-old primary implants, the accumulation of responder cells at a second implant was rapid, and the development of a capsule was accelerated. Only the macrophages had developed a tendency to infiltrate among the tumor cells. Implants in partially immune mice had a lower mitotic index than did implants in normal mice. Of the second implants, 30% did not reach palpable size, and 42% regressed after a period of growth. Only after at least 5 weeks of immunization did a rapid destruction of second implants become evident. The tumor destructive process was associated with infiltration by activated macrophages and was completed in 3 to 6 days. PMID- 3967242 TI - Specific stimulation by phorbol esters of the phosphorylation of histones H2B and H4 in murine lymphocytes. AB - The effect of phorbol diesters on histone phosphorylation in BALB/c mouse lymphocytes, cells which do not respond to these agents with cell division, but with other biochemical and biological changes, was investigated. A technique for fractionating the proteins was used which was more powerful than those used previously in similar studies of phorbol diester effects on the metabolism of these proteins. Exposure of lymphocytes to tumor-promoting phorbol esters resulted in a rapid and specific increase in phosphorylation of the nuclear histone proteins H2B and H4. Within 2 hr, the phosphorylation of these two proteins rose to levels 6- to 8- and 2- to 4-fold greater, respectively, than those in control cells, when lymphocytes were exposed to 800 nM 12-O tetradecanoylphorbol-13-acetate. Lower levels were observed with other phorbol analogues commensurate with their relative tumor-promoting abilities. Lymphocyte mitogens did not increase phosphorylation under the conditions used. The potential ability of the cell system used for defining early in vivo and in vitro phorbol diester effects, and those which are independent of cell division, is discussed. PMID- 3967243 TI - Variability of androgen-related phenotypes in the Shionogi mammary carcinoma during growth, involution, recurrence, and progression to hormonal independence. AB - Several parameters of androgen action were measured in hormone-dependent Shionogi carcinoma cells during phases of growth, regression, and recurrence. In the parental C1 line under steady state conditions, dihydrotestosterone is localized exclusively in the nucleus while testosterone is confined almost entirely to the cytoplasm. After castration, the concentration of testosterone declines more rapidly than that of dihydrotestosterone. Spontaneous recurrent growth is not accompanied by significant elevation of the whole-tissue concentration of either androgen. Neither are changes observed in the concentration of cytoplasmic receptor or in the rate of uptake of androgens into the nucleus. However, relapse is associated with the appearance of a glucose-6-phosphate dehydrogenase double enzyme phenotype and a loss of responsiveness to androgen withdrawal. The autonomous C3 variant line which is devoid of androgen-related markers is characterized by a deficiency of androgen retention by whole tissue and possibly a permeability defect of the plasma membrane. This variant tends to express a glucose-6-phosphate dehydrogenase double-enzyme phenotype. In contrast, the autonomous C4 variant line retains the ability to concentrate modest levels of testosterone in whole tissue and high levels of dihydrotestosterone in the nucleus. Although the number of nuclear binding sites is the same as that observed in the parental C1 line, the concentration of cytoplasmic receptor and the rate of nuclear uptake of androgens are relatively decreased. Expression of a glucose-6-phosphate dehydrogenase double-enzyme phenotype is less frequent than in the autonomous C3 variant line. The above results suggest that a recurrent tumor may contain hormone-sensitive cells which resume growth in an androgen depleted environment. They also imply that progression from the androgen dependent to the autonomous condition involves the selection and outgrowth of hormone-insensitive cells of variable phenotype. PMID- 3967244 TI - Effects of tubulozole on the microtubule system of cells in culture and in vivo. AB - Light and electron microscopic investigations on mammalian cells in vitro and in vivo showed that tubulozole-C (R 46 846), the cis-isomer of tubulozole, a new synthetic anticancer drug, interfered with the structure and function of microtubules in both interphase and mitotic cells. The activity of this compound in experimental tumor systems can thus be explained partly by a direct antimitotic effect and partly by the disintegration of the normal subcellular organization of the nondividing cells. At concentrations which affect the microtubule system, tubulozole-C arrested directional migration of transformed cells and malignant invasion in a three-dimensional organ culture system. Investigations in vivo show that malignant L1210 leukemia cells are more susceptible to the antimicrotubular effect of tubulozole-C than are the normal leukocytes of the host. The trans-isomer of tubulozole (tubulozole-T, R 48 265), which has no antitumor activity in vivo, did not affect the microtubule system of cells in vitro or their capacity for directional migration or for malignant invasion. PMID- 3967245 TI - Selective protein phosphorylation in heterogeneous subpopulations of human colon carcinoma cells. AB - Endogenous membrane and cytosolic and nuclear protein phosphorylations were compared among three well-characterized subpopulations of human colonic carcinoma cells that were originally isolated from a single human primary colon tumor. These intratumoral subpopulations of cells were found to differ significantly in their biological properties. Analysis of phosphoproteins by two-dimensional electrophoresis following 32P phosphorylation of subcellular fractions in a cell free system or labeling intact cells in vivo revealed significant differences in the selective phosphorylation of membrane, cytosol, and nuclear proteins. The two dimensional membrane, cytosol, and nuclear phosphoprotein profiles distinguished the three subpopulations of colonic carcinoma cells from each other. Silver staining proteins from the three subpopulations were also compared. The two dimensional, silver-stained electrophoretic profiles of nuclear proteins were essentially the same for all three subpopulations. The silver-stained electrophoretic profile of membrane and cytosolic proteins revealed only minor differences in the expression of polypeptides. Nevertheless, these changes could also distinguish the three subpopulations. The results of this study suggest that minor differences in the expression of cytosolic and membrane proteins exist in intratumoral subpopulations of colonic cells. However, a significantly greater degree of heterogeneity was found to be associated with post-translational modification of proteins by phosphorylation and/or dephosphorylation. These modifications could play an important role in determining the expression of different biological properties among subpopulations of malignant cells. PMID- 3967246 TI - Effects of monoclonal antibody and complement treatment of human marrow on hematopoiesis in continuous bone marrow culture. AB - Long-term bone marrow cultures were established from single-cell suspensions of human bone marrow that had been treated with monoclonal antibodies and complement. Each treated cell suspension was evaluated for production of hematopoietic stem cells over 20 weeks. Treatment with antibody to HLA-DR (Ia), B1, J2, or J5 did not remove adherent cells including those differentiating to adipocytes in 17-hydroxycorticosteroid. In contrast, treatment with monoclonal antibody directed against human beta 2-microglobulin reduced adipocyte numbers by 100-fold and reduced the total adherent cell density over 70%. Cumulative total nonadherent cell and granulocyte-macrophage colony-forming units (GM-CFUc) production over 20 weeks was not significantly altered by one cycle of anti-Ia plus complement or up to three cycles of treatment with complement and anti-J2, J5, or -B1. However, one cycle of treatment with anti-beta 2-micro-globulin depressed production of both GM-CFUc and nonadherent cells by over 100-fold compared to other treatment groups. While one cycle of treatment of anti-Ia and complement killed all detectable cells forming CFU-erythroid-granulocyte megakaryocyte-macrophage, blast-forming units (erythroid), and GM-CFUc, GM cluster-forming cells survived. Treatment of marrow with three cycles of anti-Ia and complement removed all detectable GM colony- and GM cluster-forming cells; however, this marrow produced fewer cumulative Ia-positive GM-CFUc. Long-term bone marrow cultures may prove to be an interesting system for in vitro analysis of the effects of new immunotherapeutic agents including other monoclonal antibodies prior to clinical use. PMID- 3967247 TI - Pharmacological, toxicological, and therapeutic evaluation in mice of doxorubicin entrapped in cardiolipin liposomes. AB - Doxorubicin possesses high affinity for binding to cardiolipin. We have utilized these properties in preparing stable liposomes of doxorubicin and cardiolipin with a net positive charge. Doxorubicin liposomes were formed by using 11.2 mumol of drug, 5.6 mumol of cardiolipin, 28.5 mumol of phosphatidylcholine, 19.5 mumol of cholesterol, and 11.1 mumol of stearylamine. These liposomes were sonicated for 90 min at 37 degrees followed by extensive dialysis against buffer. The pharmacological, toxicological, and therapeutic effects of doxorubicin entrapped in cardiolipin liposomes were compared with those of free doxorubicin in mice. At a dose of 4 mg/kg i.v., the peak cardiac concentration was achieved in 30 min following free doxorubicin administration, the value being 8.1 micrograms/g. The peak cardiac concentration with doxorubicin in cardiolipin liposomes was obtained at 5 min with a value of 2.8 micrograms/g of tissue. The cardiac concentration X time values for free doxorubicin for the 24-hr period of observation were 55.1 micrograms X hr/g, whereas it was only 7.8 micrograms X hr/g with the drug entrapped in cardiolipin liposomes. Compared to free drug, the liposomal entrapped doxorubicin significantly reduced the histopathological lesions in cardiac tissue of mice at a dose of 15 mg/kg as determined by electron microscopy. The nadir of peripheral white blood cell counts in mice with free drug, 6 mg/kg, was observed on Day 3 which was 50% of control, whereas with liposomal encapsulated drug it was reduced only 23% on Day 7. Doxorubicin in cardiolipin liposomes demonstrated enhanced chemotherapeutic potential against murine ascitic P388 leukemia with a 144% increased life span compared to 55% increased life span with free drug at a dose of 7.5 mg/kg on Days 1, 3, and 7. We conclude that doxorubicin liposomes developed in these studies possess improved therapeutic action as demonstrated by their ability to reduce the toxicity of the drug substantially. PMID- 3967248 TI - Augmented immunity in cancer patients treated with alpha-interferon. AB - Thirty patients with metastatic colon or breast cancer were treated with recombinant alpha-interferon, clone A, 9 to 50 X 10(6) units/sq m, i.m., 3 times weekly for up to 4 months. Immunological parameters including natural killer activity, antibody-dependent cellular cytotoxicity, an assay of inhibition of tumor cell growth in culture, and quantification of leukocyte subsets were monitored serially. Statistically significant increases in the inhibition of tumor growth and in the proportion of peripheral blood mononuclear cells bearing the T10 marker were observed both early and late in the treatment course in the population as a whole (p less than 0.03 and p less than 0.0001, respectively). The true maximum effect in the assay of inhibition of tumor growth was probably higher, since the monitoring was not performed at peak activity for this assay. Other immune parameters, including natural killing, could not be shown to change consistently in the population as a whole, although interferon effects could be discerned easily in the activity profiles of some individual patients. The two patients with tumor response showed increased putative tumor immunity by these measures. These data confirm results previously published supporting the responsiveness of these parameters to interferon as administered clinically and may provide the basis for optimization of interferon dose and scheduling. PMID- 3967249 TI - Human placental alkaline phosphatase in benign and malignant ovarian neoplasia. AB - In benign and malignant ovarian tumor patients, human placental alkaline phosphatase (HPLAP) was determined in serum and extracts from surgical tumor biopsies using a highly specific enzyme-antigen immunoassay based on a mouse monoclonal antibody (E6) to HPLAP. Serum HPLAP levels greater than or equal to 0.1 unit/liter were found in 58% of ovarian cancer patients. Serum carcinoembryonic antigen levels were positive (greater than 5.4 ng/ml) in 17% of these patients. HPLAP was detected in extracts from 13 of the 14 tumors investigated (range, 2.4 to 557 milliunits/g). Only the mixed heterologous Mullerian sarcoma was negative. The highest HPLAP content of normal ovarian tissue was 1.1 milliunits/g. The amount of heat-stable and L-p-bromotetramisole insensitive alkaline phosphatase was in all cases much higher than the fraction recognized by E6. The neoplastic origin of HPLAP was confirmed immunohistochemically on paraffin sections by an indirect avidin-biotin peroxidase staining procedure using E6. The staining pattern was compared to the histochemical distribution of total alkaline phosphatase on adjacent sections. A consistency was found between the amount of HPLAP in tissue extracts and its immunohistochemical distribution. In all the tumors, staining for HPLAP was observed mainly on the plasma membranes of carcinoma cells. In 9 of the 10 carcinomas, the histological distribution of HPLAP and also of total alkaline phosphatase was heterogeneous. HPLAP staining, present in one of five normal ovaries, was restricted to germinal inclusion cysts. The present results support the hypothesis that serous ovarian tumors originate from these cysts. PMID- 3967250 TI - Kinetics of diethylnitrosamine hepatocarcinogenesis in the infant mouse. PMID- 3967251 TI - Chemical carcinogenesis and the oncogenes--a Chemical Pathology Study Section Workshop. PMID- 3967252 TI - Methodologic guidelines for reports of clinical trials. PMID- 3967253 TI - Tamoxifen therapy and colorectal adenocarcinoma: a Southwest Oncology Group study. PMID- 3967254 TI - Adjuvant intrahepatic chemotherapy with mitomycin and 5-FU combined with hepatic irradiation in high-risk patients with carcinoma of the colon: a Southwest Oncology Group phase II pilot study. AB - The Southwest Oncology Group conducted a pilot study in patients who had had total clinical resection of cancer of the colon and had a high risk of recurrence (Duke's C); the purpose of the study was to determine the toxic effects of intra arterial chemotherapy combined with hepatic radiotherapy, in anticipation of their potential use in an adjuvant groupwide protocol. The treatment plan included intra-arterial chemotherapy with mitomycin (3 mg/m2) on Days 1, 4, 35, and 38 by slow intra-arterial push and 5-FU (1000 mg/m2) on Days 1-4 and 35-38 by continuous 96-hour infusion. Radiation therapy was begun on Day 8 of therapy and consisted of 1950 rads in 13 fractions over 2 1/2 weeks. Nineteen patients have been studied. Of 13 fully evaluable patients, two have relapsed in the liver. Eleven patients have developed significant, persistent liver enzyme elevations, and one patient has died from therapy-related liver failure. Combined radiotherapy and intra-arterial chemotherapy may result in significant chronic liver damage, and caution should be exercised in future adjuvant trials. PMID- 3967255 TI - Altered plasma kinetics of 5-FU at high dosage in rat and man. AB - To provide a model for pharmacokinetic studies in patients administered high iv doses of 5-FU after allopurinol or other modifiers of toxicity, rats were given radioactive 5-FU as an iv bolus. At a dose of 50 mg/m2 only 16% of circulating radioactivity was identified as 5-FU after 30 minutes, whereas greater than 90% of radioactivity was 5-FU when rats were given a 1800-mg/m2 dose. This 36-fold increase in 5-FU dose was associated with a greater than 150-fold increase in the 30-minute plasma concentration of 5-FU (0.02-3.3 mM). In patients, it was possible to increase the maximum tolerated dose of 5-FU given as a weekly rapid iv bolus from 800 to 1700 mg/m2 when a 3-day course of allopurinol (900 mg/day orally) preceded 5-FU administration. A dose-dependent increase in the apparent half-life of 5-FU in the plasma was observed and plasma concentrations at 30 minutes were as high as 500 microM after a 1600-mg/m2 dose of the drug. PMID- 3967256 TI - Phase II study of thymosin fraction 5 in the treatment of metastatic renal cell carcinoma. PMID- 3967257 TI - Continuous-infusion spirogermanium for the treatment of refractory carcinoma of the ovary: a phase II trial. PMID- 3967258 TI - Phase II trial of diaziquone in advanced upper aerodigestive cancer. PMID- 3967259 TI - Single-dose dacarbazine and dactinomycin in advanced malignant melanoma. AB - Twenty-one patients with advanced malignant melanoma were treated with dacarbazine at a dose of 800 mg/m2 as a single infusion and dactinomycin at a dose of 1.2 mg/m2 every 3 weeks. Hematologic toxicity was mild and gastrointestinal toxicity was tolerable. The response rate for evaluable patients was 22%, which included both men and women with visceral disease. Three of the four responses were complete. Durations of response were 4, 6, 9, and 48+ months. We conclude that dacarbazine can be safely and effectively given as a single dose along with dactinomycin. The possibility that this combination may be more effective than single agents in obtaining complete responses in patients with visceral disease must be explored further. PMID- 3967260 TI - Phase II study of mitolactol in metastatic malignant melanoma. AB - The Central Pennsylvania Oncology Group conducted a phase II study of mitolactol in advanced metastatic melanoma to determine the overall survival rate and duration of response to this agent. The starting dose was 100 mg/m2/day orally. If no hematologic toxicity was noted on weekly blood cell counts, the dose was increased to 130 mg/m2/day on Day 35, and, if still tolerated, to 160 mg/m2/day on Day 70. Six of 25 evaluable patients (24%) had objective partial response. The median duration of response was 20 weeks, with a range of 10-66 weeks. Six of 25 patients (24%) had stable measurable disease, with a median duration of 9 weeks. The median survival from date of entry in this study was 21 weeks in responding or stable patients compared to 7 weeks in nonresponders. Hematologic toxicity was the dose-limiting factor. This study shows that mitolactol has moderate activity against advanced melanoma, and the drug deserves further study in combination with nonmyelotoxic drugs. PMID- 3967261 TI - Pharmacokinetics of teniposide in patients with ovarian cancer. AB - Pharmacokinetics of teniposide (VM26) after each of three doses were investigated by high-performance liquid chromatographic assay in eight patients with ovarian cancer with normal liver and renal functions. Treatment consisted of a first dose of 100 mg/m2 iv as a 1-hour infusion (Day 1), a second dose of 150 mg/m2 iv as a 1-hour infusion (Day 8), and a third dose of 150 mg/m2 as an approximately 1-day infusion (Day 22). Disappearance of VM26 from plasma followed a biexponential decay pattern. The mean terminal half-life (+/- SE) was 6.9 +/- 0.9 hours after the first dose, 6.1 +/- 0.7 hours after the second dose, and 9.7 +/- 1.4 hours after the third dose. VM26 levels in ascites were lower than those in plasma in the first hours after drug administration, but by 24 hours they were similar or slightly higher. Urinary elimination of VM26 as unchanged drug amounted to less than 10% of the dose. PMID- 3967262 TI - Melphalan: a potential new agent in the treatment of childhood rhabdomyosarcoma. AB - Melphalan has been evaluated against a series of seven childhood rhabdomyosarcomas, each derived from a different patient and maintained in vivo as xenografts in immune-deprived mice. Six lines were derived from untreated tumors and one from a patient refractory to conventional therapy. At the maximum tolerated dose (LD10) a single administration of melphalan caused complete regressions of advanced tumor in six of seven lines, including xenografts derived from the refractory patient. This agent demonstrated activity over a broad range of doses, and was considerably more active than vincristine, cyclophosphamide, doxorubicin, and dactinomycin in the model. PMID- 3967265 TI - [The philosophic categories of necessity and coincidence in medical practice]. PMID- 3967264 TI - [Clinical effectiveness of a new thrombolytic preparation, Streptodecase]. PMID- 3967263 TI - [Study of organ function in patients with acute respiratory failure after shock]. PMID- 3967266 TI - [Suicidal behavior in normal persons]. PMID- 3967267 TI - [Suicide throughout the world 1900-1982]. PMID- 3967268 TI - [Psychopharmaceuticals and pharmaceuticals as suicide agents]. PMID- 3967269 TI - [Psychological aspects of chronic smoking]. PMID- 3967270 TI - [Personal experience in the treatment of acute neurologic insults using hyperbaroxia]. PMID- 3967271 TI - [Per venam subclaviam...]. PMID- 3967272 TI - [A mathematical model of influenza epidemics]. PMID- 3967273 TI - [Quantitative analysis of the microscopic image]. PMID- 3967274 TI - [Microcomputers and improving the level of health care in developing countries]. PMID- 3967275 TI - [Notes from clinical pharmacology facilities in Berlin]. PMID- 3967276 TI - Vascular permeability to lanthanum in the rat incisor pulp. Comparison with endoneurial vessels in the inferior alveolar nerve. AB - Experiments were performed to compare the permeability of capillaries supplying the endoneurial environment, which is invested by perineurium, with vascular permeability in the pulp where perineurium is absent. Anaesthetised rats were perfused through the aorta with physiological solutions containing lanthanum nitrate at 37 degrees C. Pieces of inferior alveolar nerve and segments of mandibular incisors were immersion-fixed and transverse sections were examined electron microscopically for the distribution of lanthanum. In the pulp the nerve fibres pass between lanthanum-impermeable arterioles and venules en route to the incisal end. In the peripheral pulp a few capillaries were permeable but the most permeable capillaries lay between the odontoblasts. Pulpal capillary permeability was attributed to the fenestrated endothelium and contrasted with the unfenestrated endoneurial capillaries which were impermeable to lanthanum. Whereas the tight junctions of endoneurial capillaries are known to prevent certain blood-borne substances from entering the endoneurium, it was not clear whether the permeability of the pulpal capillaries, which are distant from the nerve fibres, could affect the nerve fibre environment. No extravasated lanthanum reached the pulpal nerve fibres suggesting that they are not affected. Technically it was not possible to examine the incisal third of the tooth where the situation could be different because the volume of the pulp decreases and capillaries lie closer to the nerve fibres. PMID- 3967277 TI - Evidence for tight junctions between odontoblasts in the rat incisor. AB - Odontoblasts are known to be involved in the process of dentinogenesis but it is not clear whether substances may also be deposited in predentine and dentine by passing between these cells. Although tight junctions have been described, it is not clear if they are macular or "leaky" as opposed to continuous or "tight". In this study use has been made of the permeability of fenestrated capillaries amongst the odontoblasts to deposit the penetrative tracer lanthanum in the interodontoblastic space. This was done by perfusion of anaesthetized rats with physiological solutions containing lanthanum nitrate at 37 degrees C. Immersion fixation of transverse segments of mandibular incisors and examination with an electron microscope showed that lanthanum could permeate 40-50 microns between the odontoblasts to reach the peripheral pulp. Towards the predentine, often less than 10 microns from the capillaries, its progress was abruptly and completely halted by the junctions at the apical ends of the odontoblast cell bodies. Lanthanum was not found in the predentine. The mature secretory odontoblasts in the rat incisor have therefore been shown to be joined by continuous tight junctions. In the process of dentinogenesis this means that all substances deposited in predentine and dentine must arrive by passing through the odontoblasts. PMID- 3967278 TI - Non-lymphoid cells of bronchus-associated lymphoid tissue of the rat in situ and in suspension. With special reference to interdigitating and follicular dendritic cells. AB - Immunohistochemical, enzyme-histochemical and electron-microscopical methods were used to study non-lymphoid cells of control and stimulated rat bronchus associated lymphoid tissue (BALT) in situ and in suspensions. Particular attention was paid to the so-called antigen-handling cells, i.e., the interdigitating cells (IDC), which are situated in the T-cell areas, the follicular dendritic cells (FDC), which appear to be restricted to germinal centers, and macrophages, present both in T-cell and B-cell areas. The interdigitating cells were distinguished by being Ia-positive and by the presence of acid phosphatase and non-specific esterase activity in an area near the nucleus. Follicular dendritic cells could be observed in situ by using a monoclonal antibody and by the in vitro trapping of HRP-anti-HRP complexes. Several types of macrophages were found. At the electron-microscopical level no well-developed IDC and FDC could be detected in control BALT. However, in BALT of lipopolysaccharide-stimulated and mycoplasma-infected rats, well-developed IDC and FDC were found. It can be concluded that IDC's and FDC's can be found in BALT. PMID- 3967279 TI - Fenestrations of the basal lamina of intestinal villi of the rat. Scanning and transmission electron microscopy. AB - Fenestrations of the basal lamina of rat intestinal villi were revealed by scanning electron microscopy after removal of the overlying epithelial cells by osmic acid maceration. These fenestrations are circular to oval in shape and are 0.5 micron to 5 microns in diameter. They are richly distributed at a density of 1-2 X 10(4)/mm2 in the upper two thirds of the villi, except at the very tips. Roughly 500 fenestrations are found on each side of an average sized tongue shaped villus. Transmission electron-microscopic observations showed that these fenestrations were passages for migrating cells of the immune system such as lymphocytes, eosinophils and macrophages. Protrusions from the basal parts of epithelial cells were also observed passing through these fenestrations. These findings are discussed with respect to their immunological implications and to the passage of nutrients. PMID- 3967280 TI - Autophagy of mitochondria in rat bone marrow erythroid cells. Relation to nuclear extrusion. AB - Late erythroblasts and reticulocytes from bone marrow of male Wistar rats were studied by electron-microscopic stereology. Late erythroblasts with morphological signs of nuclear extrusion (EN + erythroblasts) and late erythroblasts without these signs (EN-erythroblasts) were analysed separately. The volumes of mitochondria, autophagosomes, autophagocytosed mitochondria, autophagocytosed cytoplasm and degraded material inside autophagosomes were calculated per unit volume of cytoplasm. The results demonstrate that (1) the volume density of mitochondria in the cytoplasm decreases by 34% during maturation from (EN-)- to (EN +)-erythroblasts (P less than 0.001) and by 60% during differentiation from (EN +)-erythroblasts to reticulocytes (P less than 0.001), (2) a fivefold increase in the volume density of autophagosomes in the cytoplasm is noted during maturation from (EN-)- to (EN +)-erythroblasts (P less than 0.01), whereas the value of this parameter remains essentially unchanged during the subsequent differentiation to reticulocytes, (3) no mitochondria are found inside autophagosomes of (EN-)-erythroblasts, whereas mitochondria occupy 26% and 35%, respectively, of the autophagosomal volume in (EN +)-erythroblasts and in reticulocytes. Our results show that autophagocytosis of mitochondria starts at the moment of nuclear extrusion and continues in the bone marrow reticulocytes. PMID- 3967281 TI - Ultrastructural localization of acid phosphatase in nonhuman primate vaginal epithelium. AB - The vagina of the rhesus monkey is lined by a stratified squamous epithelium. However, little is known regarding the cytochemical composition of its cell organelles and the substances found in the intercellular spaces. In this study we have examined the ultrastructural distribution of acid phosphatase in the vaginal epithelium. In basal and parabasal cells reaction product was found in some Golgi cisternae and vesicles and in a variety of cytoplasmic granules. Reaction product was also found in some, but not all, membrane-coating granules. In the upper layers of the epithelium, the membrane-coating granules extruded their contents and acid phosphatase was localized in the intercellular spaces. The possible roles of acid phosphatase in keratinization, desquamation, or modification of substances in the intercellular compartment are discussed. PMID- 3967282 TI - Distribution pattern of drained antigens and antibodies in the subcapsular sinus of the lymph node of the rat. AB - A recent study of lymph nodes of the rat showed that they are morphologically and physiologically compartmentalized. A compartment of a node includes a portion of subcapsular sinus into which the lymph, entering via the related afferent lymphatic opening, is filtered. The study also showed that colloidal carbon injected locally in a small dose becomes predominantly associated with the areas of the inner wall of the subcapsular sinus that cover the extra-follicular zone of the peripheral cortex. Little carbon is seen over the folliculo-nodules (follicles with a nodule or germinal center). The question arose as to whether drained natural substances, as antigens and antibodies, follow the same pattern of distribution in the subcapsular sinus as the carbon. Therefore, small doses of fluorescein isothyocyanate (FITC)-conjugated antigens were injected locally into normal rats whose own antibodies in the nodes were stained by immunofluorescence. The pattern of distribution of the antigens in the draining nodes was found to be the same as that of the carbon. Furthermore, the lymph-carried antibodies of the rats were found to follow the same pattern. The morphological basis for such a pattern is explained. The results are further discussed with regard to the probable normal entry route of lymph-carried antigens in the parenchyma of nodes. PMID- 3967283 TI - Evidence for the existence of a subsinus layer of the peripheral cortex in the lymph node of the rat. AB - The peripheral cortex of a lymph node consists of folliculo-nodules (follicles with a nodule or germinal center) and an extrafollicular zone. In the course of an analysis of the nodes in rats under various experimental or abnormal conditions, our attention became focused on the particularities of a thin layer of peripheral cortex underlying the subcapsular sinus. The present paper reports on observations which led to the identification of the "subsinus layer" of the peripheral cortex. The observations suggest that this layer complements the activity of the inner wall of the subcapsular sinus. The layer probably contributes to the selection of certain elements from the afferent lymph and guides them towards the node area where they can join the cell population involved in the immunological activity in which they are to participate. PMID- 3967284 TI - Immuno-electron-microscopic localization of a centriole-related antigen in ciliated cells. AB - An antigen common to purported centriolar and basal body regions of a variety of cell types was previously visualized by immuno-fluorescence microscopy. The present study demonstrates the localization of the antigen relative to the defined basal body structures of ciliated tracheal cells at the electron microscopic level. After ethyldimethylaminopropyl carbodiimide-glutaraldehyde saponin (EGS) fixation and permeabilization, immunoferritin labeling is consistently found associated with amorphous electron-opaque material in proximity to basal bodies and their ciliary rootlets, but not with basal body microtubules themselves. This distribution pattern is distinct from that of other proteins found in the apical region of ciliated cells, such as calmodulin. It is proposed that the dense material may be analogous to pericentriolar material of centrosomes. PMID- 3967285 TI - The fine structure of the ganglia of the guinea-pig trachea. AB - The parasympathetic ganglia of the guinea-pig trachea have been investigated by scanning and transmission electron microscopy. They are covered by a continuous perineurium and connective tissue is found between the neural elements. Blood vessels inside the ganglia have continuous endothelia and are sometimes accompanied by pericytes and a sheath of perineurial cells. Individual neuronal cell bodies and large processes are almost completely covered by a thin layer of satellite cells, except for very small areas that directly face the basal lamina and connective tissue space. Nerve fibres are also completely and individually ensheathed by Schwann cell processes; naked fibres are not found. In some regions of the nerve cell body, there are complex interdigitations between short neuronal processes and satellite cells. Large differences in the size of neurons may indicate the presence of different neuronal populations. Nerve endings containing mainly small clear vesicles are the most common type, and these form synapses on dendrites, but some profiles have many large granular vesicles. These ganglia resemble other parasympathetic, sympathetic and sensory ganglia and not the enteric ganglia. However, an unusual feature of the cytoplasm of the satellite and Schwann cells is the abundance of 10 nm intermediate filaments. PMID- 3967286 TI - Characterization of an oxygen-tolerant cell line derived from Chinese hamster ovary. Antioxygenic enzyme levels and ultrastructural morphometry of peroxisomes and mitochondria. AB - To study the cellular defense mechanism against oxygen toxicity, an oxygen tolerant cell line from Chinese hamster ovary (CHO) was obtained by multistep adaptation to increased O2 levels. The hyperoxia-adapted (HA) cells were able to proliferate under an atmosphere of 99% O2/1% CO2, an O2 tension lethal to the parental (control) cells. When grown under normoxic conditions (20% O2/1% CO2/79% N2) the cells remained tolerant for at least 8 weeks, suggesting a genetic basis for the oxygen tolerance. Compared to the parental cells, the HA cells were irregularly shaped, had larger mitochondria, contained more lipid droplets and showed a reduced growth rate. Ultrastructural morphometry revealed a 1.8-fold (p less than 0.001) increase of the mitochondrial volume fraction in the HA cells, resulting from an increase in both number and average volume of the mitochondria. The volume fraction of peroxisomes was increased over two-fold in the HA cells, as appeared from a approximately 1.9-fold (p less than 0.001) increase in number and a 1.2-fold (p less than 0.025) increase in size. There was no evidence for ultrastructural damage in the HA cells. Specific activities of antioxygenic enzymes were considerably higher in the HA cells compared to controls: CuZn superoxide dismutase, X 2.5; Mn-superoxide dismutase, X 2.1; catalase, X 4.0; glutathione peroxidase, X 1.9. Oxygen tolerance in CHO cells is therefore associated with increased levels of antioxygenic enzymes, confirming the proposed important role of these enzymes in the defense against oxygen toxicity. PMID- 3967287 TI - Adult human arterial smooth muscle cells in primary culture. Modulation from contractile to synthetic phenotype. AB - Smooth muscle cells were isolated enzymatically from adult human arteries, grown in primary culture in medium containing 10% whole blood serum, and studied by transmission electron microscopy and [3H]thymidine autoradiography. In the intact arterial wall and directly after isolation, each smooth muscle cell had a nucleus with a wide peripheral zone of condensed chromatin and a cytoplasm dominated by myofilament bundles with associated dense bodies. After 1-2 days of culture, the cells had attached to the substrate and started to spread out. At the same time, a characteristic fine-structural modification took place. It included nuclear enlargement, dispersion of the chromatin and formation of large nucleoli. Moreover, myofilament bundles disappeared and an extensive rough endoplasmic reticulum and a large Golgi complex were organized in the cytoplasm. This morphological transformation of the cells was completed in 3-4 days. It was accompanied by initiation of DNA replication and mitosis. The observations demonstrate that adult human arterial smooth muscle cells, when cultivated in vitro, pass through a phenotypic modulation of the same type as arterial smooth muscle cells from experimental animals. This modulation gives the cells morphological and functional properties resembling those of the modified smooth muscle cells found in fibroproliferative lesions of atherosclerosis. Further studies of the regulation of smooth muscle phenotype and growth may provide important clues for a better understanding of the pathogenesis of atherosclerosis. PMID- 3967288 TI - Immunocytochemical demonstration of retinal S-antigen in the pineal organ of four mammalian species. AB - By means of immunocytochemistry retinal S-antigen is selectively demonstrated in retinal photoreceptor cells of the rat and in pinealocytes of the hedgehog, rat, gerbil and cat. Brain areas surrounding the pineal organ are immunonegative. The immunoreactive material is evenly distributed in the perikarya of the cells. Occasionally, inner segments of retinal photoreceptors and processes of pinealocytes are also stained. The outer segments of retinal photoreceptors display a strong immunoreaction. In both pinealocytes and retinal photoreceptors the intensity of the immunoreaction varied considerably among individual cells. The immunocytochemical demonstration of retinal S-antigen in mammalian pinealocytes indicates that these cells still bear characteristics of photoreceptors. This finding is in accord with the concept that mammalian pinealocytes are derived from pineal photoreceptor cells of poikilothermic vertebrates. PMID- 3967289 TI - Thinking in one dimension: the impact of molecular biology on development. PMID- 3967290 TI - Formation of a rate-limiting intermediate in 5S RNA gene transcription. AB - We have performed in vitro kinetic analyses of transcription from the 5S gene promoter in order to resolve the rate-limiting events which lead to accurate transcription of the 5S RNA gene. We demonstrate that a rate-limiting intermediate can be formed during an extended incubation prior to initiation of transcription. Formation of such a complex is temperature-dependent, requires magnesium and ATP, consists of stoichiometric amounts of the known class III transcription factors and RNA polymerase III on 5S DNA, and eliminates the normal lag in attainment of a steady-state rate of transcription. This complex is therefore different from the "stable complex" minimally required for template commitment. Further analyses demonstrate that TFIIIB, like TFIIIA and TFIIIC, can be stably sequestered on the 5S gene and also allow us to formulate the following order of factor interactions on the 5S gene: TFIIIA, TFIIIC, TFIIIB, RNA polymerase III. PMID- 3967292 TI - The homeo box: a key to the understanding of development? PMID- 3967291 TI - Left-handed DNA and the synaptic pairing reaction promoted by Ustilago rec1 protein. AB - Left-handed Z-DNA binds tightly to Ustilago rec1 protein. The binding reaction is strongly dependent on ATP, but complexes formed are rapidly dissociated by ADP. The parallel between the kinetics of Z-DNA binding and the synaptic pairing reaction leading to paranemic joint molecules suggests that formation of nascent heteroduplex structures in recombination is coupled with formation of left-handed Z-like DNA on the protein. Equilibrium and kinetic studies show that rec1 protein appears to have a strong Z-DNA binding site that binds Z-DNA 75 times tighter than the B form of the DNA. We propose that DNA with a structure approximated best by a left-handed Z-DNA conformation is a key intermediate in homologous pairing promoted by rec1 protein. PMID- 3967293 TI - mRNA cap binding proteins: essential factors for initiating translation. PMID- 3967294 TI - Menkes' disease: abnormal metallothionein gene regulation in response to copper. AB - Menkes' disease, an inherited disorder of copper metabolism, is characterized by the accumulation of excess copper-metallothionein in certain tissues and cell types. Using cultured fibroblasts, we show that this is due to the ability of low concentrations of copper to induce metallothionein mRNA synthesis in Menkes' but not normal cells. We also show that copper, which is unusually toxic to Menkes' cells, induces the synthesis of 84 kd and 68 kd polypeptides tentatively identified as heat shock proteins. Transfection experiments with a cloned metallothionein fusion gene show that this is due to a defect in a diffusible factor involved in either metallothionein gene transcriptional regulation or copper metabolism. PMID- 3967295 TI - Effects of temperature and single-stranded DNA on the interaction of an RNA polymerase III transcription factor with a tRNA gene. AB - It has previously been shown that a yeast RNA polymerase III transcription factor binds stably to tRNA genes. The principal protein-DNA contacts have now been mapped, by dimethylsulfate footprinting, to the vicinity of the A and B block promoter regions of the S. cerevisiae tRNALeu3 gene. Single-stranded DNA preferentially interferes with the binding of the transcription factor to one of the promoter regions. The effect of temperature on the formation of the transcription factor-DNA complex has been examined: the complex has the kind of "opening" property that has been previously associated with prokaryotic RNA polymerase-promoter complexes, with stability increasing as the temperature is raised. PMID- 3967296 TI - Mitotic stability of yeast chromosomes: a colony color assay that measures nondisjunction and chromosome loss. AB - A colony color assay that measures chromosome stability is described and is used to study several parameters affecting the mitotic maintenance of yeast chromosomes, including ARS function, CEN function, and chromosome size. A cloned ochre-suppressing form of a tRNA gene, SUP11, serves as a marker on natural and in vitro-constructed chromosomes. In diploid strains homozygous for an ochre mutation in ade2, cells carrying no copies of the SUP11 gene are red, those carrying one copy are pink, and those carrying two or more copies are white. Thus, the degree of red sectoring in colonies reflects the frequency of mitotic chromosome loss. The assay also distinguishes between chromosome loss (1:0 segregation) and nondisjunction (2:0 segregation). The most dramatic effect on improving mitotic stability is caused by increasing chromosome size. Circular chromosomes increase in stability through a size range up to approximately 100 kb, but do not continue to be stabilized above this value. However, linear chromosomes continue to increase in mitotic stability throughout the size range tested (up to 137 kb). It is possible that the mitotic stability of linear chromosomes is proportional to chromosome length, up to a plateau value that has not yet been reached in our synthetic constructions. PMID- 3967297 TI - Phenotypic analysis of temperature-sensitive yeast actin mutants. AB - The consequences of two different mutations in the single essential actin structural gene of yeast (Saccharomyces cerevisiae) were studied. Both conditional-lethal actin mutants exhibit six phenotypes at the restrictive temperature: disruption of the asymmetric staining pattern of actin assembly; delocalized deposition of chitin on the cell surface; partial inhibition of secretion of the periplasmic protein, invertase; an intracellular accumulation of secretory vesicles; death of cells in the budded portion of the cell cycle upon prolonged incubation at the restrictive condition; and osmotic sensitivity. These results implicate actin in the organization and polarized growth of the yeast cell surface. PMID- 3967298 TI - Cell migration pathway in the intestinal epithelium: an in situ marker system using mouse aggregation chimeras. AB - The cell migration pathway in the intestinal epithelium of DDK in equilibrium C57BL/6JLac mouse chimeras is demonstrated using Dolichos biflorus agglutinin peroxidase as strain-specific marker. Cell sheets of one genotype extend in relatively straight lines from crypt to villus apex. Narrow sheets are mostly interrupted in the distal two-thirds of duodenal but not ileal villi, suggesting that in the duodenum cell loss occurs below the apical extrusion zone. These differences between duodenum and ileum correspond to differences in villus shape. The pattern of cell migration in Peyer's patch epithelium is consistent with that of the duodenum. In chimeric colon, sharply demarcated territories of crypts with a narrow cuff of surface epithelium represent the counterpart of the villus/crypt unit of the small intestine. PMID- 3967299 TI - Fusion mutants of the influenza virus hemagglutinin glycoprotein. AB - The influenza virus hemagglutinin (HA) mediates viral entry into cells by a low pH induced membrane-fusion event in endosomal vesicles. Mutant viruses with altered pH dependence for both hemolysis and the HA conformational change required for fusion were selected for their ability to grow in cells treated with amantadine hydrochloride, which raises the endosomal pH. The amino acid sequence and three-dimensional location of 19 substitutions on the HA are reported. The mutations fall into two groups, one that results in the destabilization of the pH 7.0 location of the hydrophobic N-terminal HA2 peptide, and a second that results in the alteration of intersubunit contacts, suggesting a large distortion or disruption of these contacts in the "fusion-active" conformation. PMID- 3967300 TI - Effect of in vivo administration of different adjuvants on the in vitro candidacidal activity of mouse peritoneal cells. AB - The candidacidal activity (CA) of peritoneal cells (PC) in vitro was used as a measure of nonspecific microbicidal activity of phagocytes after intraperitoneal injection of mice with different adjuvants. Dilutions of PC were incubated with constant numbers of C. parapsilosis in a 96-well culture plate. The PC number causing 50% reduction of yeast colonies formed after 48 hr at 37 degrees C was called 1 CA50 unit. CA was expressed in CA50 units per 10(6) PC. Optimal reduction of the number of viable candida cells in vitro was established within 1.5 hr while 50% reduction was reached after 0.5 hr. In this test CA was, within limits, independent of the number of viable candida cells added per well (22 to 152 yeast cells), of the concentration of fetal calf serum (1-20%) and of the presence of heat-labile serum components. The CA of PC of individual mice was measured 6, 24, and 96 hr after injection of an adjuvant. In most instances optimal CA was observed 6 hr after administration of adjuvant and varied from 3.7 (methylamine) to 50 (Corynebacterium parvum strain 4982) units. With respect to the titer and duration of CA, the adjuvants were arranged in the following order of increasing efficacy: methylamine, heparin, polyol L 121, suramin, dextran sulfate, polyol L 101, dimethyldioctadecylammonium bromide, Liquoid, heat-killed Listeria monocytogenes, formalin-killed C. parvum strain 10387, and strain 4982. The CA induced by the latter strain persisted at least till 96 hr after injection. The induction of CA was accompanied by recruitment of polymorphonuclear cells. The contribution of distinct phagocytic effector cells to CA and the correlation between modulation of the specific and nonspecific immunity are discussed. PMID- 3967301 TI - Abrogation of macrophage-mediated suppression of T-lymphocyte proliferation with hemoglobin and hemin is a function of iron content. AB - Hemoglobin, hemin, and ferric ion (Fe) were shown to reverse peritoneal exudate cell (PEC)-mediated suppression of concanavalin A-elicited murine spleen cell activation. Titration of hemoglobin and hemin relative to Fe showed a direct relationship between Fe content and reversal of PEC suppression. Indomethacin enhanced the capacity of all three compounds to abrogate PEC suppression on the order of five- to eight-fold. The capacity of endogenous Fe-containing substances as hemoglobin and its catabolites, e.g., hemin, to modulate macrophage expression may be of special significance at sites of inflammation. PMID- 3967303 TI - Morphological, cytochemical, functional, and proliferative characteristics of four murine macrophage-like cell lines. AB - The aim of the present study was to obtain objective data on the morphology and quantitative information about other characteristics of murine macrophage-like cell lines J774.1, PU5-1.8, WEHI-3, and P388-D1, and to compare the findings with those in resident and exudate macrophages collected directly from mice. Fetal fibroblasts were included to serve as controls. Evaluation of the morphological data showed that the cell lines J774.1 and WEHI-3 are almost identical in most respects, that the cells of P388-D1 differ widely from both of the former lines, and that the morphometric parameters of cell line PU5-1.8 occupy an intermediate position. The cells of the P388-D1 line show the most similarity to resident and exudate macrophages, and cell lines J774.1 and WEHI-3 the least. Fetal fibroblasts had divergent values for all morphometric parameters. Good correspondence was found when the quantitative data obtained by morphometric analysis of the cells in question were compared with the morphological pictures. No gross differences as to cytochemical characteristics were found between the cells of the four cell lines, except for 5'-nucleotidase activity. The occurrence of IgG receptors and the ingestion of EIgG were also similar, but the percentage of cells with C3b receptors was much lower in two of the cell lines (WEHI-3 and P388-D1) and the level of EIgMC ingestion was very much higher in one (J774.1) compared with both the other cell lines and the resident and exudate macrophages. The ingestion of opsonized bacteria and latex varied widely within and between the cell lines. Quantitative data on the binding of monoclonal antibodies by the cells of the macrophage cell lines and the resident and exudate macrophages showed a wide variation. The doubling time of the cell lines is on average 1 day; distinct differences were found between these lines with respect to the lag-time of proliferation after replating. Cluster analysis and statistical analysis of morphological and other characteristics gave insight into the degree of resemblance between the cells of the four cell lines on the one hand and the resident and exudate macrophages on the other. PMID- 3967302 TI - Binding and processing of immunostimulatory Fc gamma 1 fragments by the murine macrophage cell line P388D1. AB - Previous data from this laboratory indicated that human Fc gamma fragments induce murine B cells to proliferate and that the induction is macrophage-dependent. To further investigate the role of macrophages in this phenomenon, biologically active Fc gamma fragments from a human IgG1 myeloma protein and the murine macrophage-like cell line P388D1 were utilized. Fc gamma 1 fragments bound specifically and to a single class of receptor on P388D1 cells with a Ka value of 4 X 10(6) M-1 and to approximately 2.4 X 10(5) binding sites/cell. The binding was not effectively inhibited by two immunostimulatory Fc gamma 1 subfragments that were macrophage independent, i.e., pFc' fragments approximating the C gamma 3 domain of IgG1 and synthetic peptides representing residues 335-357 in IgG1. P388D1 cells were able to process Fc gamma 1 fragments but not intact IgG1 into subfragments that were able to induce lymphocyte proliferation in the absence of macrophages. The processing was rapid and resulted in active subfragments of several size classes. These findings not only further document the molecular and cellular events in these systems but underscore the usefulness of the P388D1 cell line in future studies on Fc fragment-induced lymphocyte regulation. PMID- 3967305 TI - Reactivation of allergic encephalomyelitis by means of allogeneic confrontation. AB - Lewis rats recovered from experimental allergic encephalomyelitis (EAE) are resistant to active reinduction of disease. (DA X Lewis)F1 hybrids behave in an identical fashion. The induction of a graft versus host (GVH) reaction in EAE convalescent (DA X Lewis)F1 rats, by injection of normal parental (Lewis) lymphocytes, precipitates a second episode of EAE in a proportion of rats. This secondary episode of EAE can be induced by injection of parental cells either systemically (intravenously) or locally (subcutaneously in the foot). A host versus graft (HVG) reaction does not reactivate EAE in the convalescent host. The observed effect is probably due to reactivation of EAE effector cells following the extensive nonspecific proliferation of host lymphoid cells which is a feature of GVH reactivity. PMID- 3967304 TI - Idiotype-restricted antibody response to specific immune complexes. AB - In this report, we compared the immunogenicity of specific antigen/antibody complexes with that of free antigen. The complexes were prepared in antigen excess using the TEPC-15 myeloma protein and a phosphorylcholine-containing polysaccharide antigen (PnC), and the PnC-specific antibody response was measured using a hemolytic plaque assay 5 days after immunization. The results showed that the complexes were as immunogenic as the free antigen; however, the PnC-specific antibody response induced with the complexes was completely dominated by one particular idiotope (defined by plaque inhibition with the AB1-2 monoclonal antibody). On the other hand, the response of mice immunized with free antigen (PnC) was dominated to a lesser degree by the AB1-2 idiotope, and there was a great degree of variability in idiotope expression among individual mice. The results suggest that immunization with antigen/antibody complexes restricts the response to the expression of idiotopes that are present in the immune complex. PMID- 3967306 TI - Gymnastics safety for the physician. AB - For purposes of referral, it would be wise for the physician who frequently sees gymnasts as patients to own a copy of the U.S.G.S.A. Safety Manual. All safety standards are thoroughly explained and diagrammed. Through the employment of the physician's expertise and the coaches' and gymnasts' cooperation, a reduction in both the frequency and the severity of gymnastics injuries will occur. I firmly believe that gymnastics is already a safe sport. The injury survey previously referred to verifies this. I have, however, learned that through the ongoing support and cooperation of a sports medicine practitioner who has taken the time to acquaint himself with gymnastics, gymnasts will benefit in immeasurable ways. PMID- 3967307 TI - Physiologic aspects of gymnastics. AB - It should be evident from this discussion that there has been little research on gymnastics specifically. A great deal of applied work on the physiology of gymnastics needs to be explored. The bulk of research recently has been related to skill performance (biomechanics). The limited data indicated that the gymnast has the expected low aerobic capacity, due to the short time factor in competition. They are quite lean and muscular and extremely flexible about the hip and shoulders. Training for gymnastics should emphasize activities specifically related to the routine. Various methods can be used to reduce the fatigue that develops throughout the routine and improve performance of the activity. Supplemental strength training should be emphasized using multiple joint exercises. PMID- 3967308 TI - Nutritional and medical aspects of gymnastics. AB - Though gymnastics is not considered to be an endurance sport, female gymnasts appear to be prone to a variety of medical complications, among them nutritional deficiencies and menstrual dysfunction. PMID- 3967309 TI - Symposium on gymnastics. PMID- 3967310 TI - Introduction and history of gymnastics. AB - All ancient societies have been documented as having various aspects of gymnastics in their overall pattern of health and conditioning. In 700 BC the Athenians added gymnastics to Olympic competition; television coverage of gymnastics in the modern Olympics, combined with a heightened interest in physical fitness in general, has led to a resurgence of interest in this sport. PMID- 3967311 TI - A review of women's collegiate gymnastics. AB - A brief review of the injuries in women's collegiate gymnastics is presented, together with a brief analysis of the mechanisms of injury and relative frequency thereof in the different events. PMID- 3967312 TI - Club gymnastics. AB - In summary, we came to the conclusion that gymnastics as performed at the club level has an injury rate that is compatible with other athletic endeavors and follows logical expectations. As these data are augmented in the future, and further refined and analyzed, we hope to be able to offer meaningful suggestions for avoiding injuries. Probably the most important single piece of information that we have gleaned so far is the major discrepancy between the injury rate in those students being spotted during a trick versus those not being spotted. Our data show that there is a definite value in spotting, and we highly recommend a student-to-instructor ratio that allows spotting for the vast majority of tricks. That recommendation holds regardless of the degree of difficulty or the level of experience that the individual has with each maneuver. PMID- 3967313 TI - Problems of the upper extremity in gymnastics. AB - The majority of upper extremity problems experienced by gymnasts are not considered injuries but are regarded as consequences of the sport. Treatment of these problems should include treatment of not only the injury but also the cause. This requires the cooperation of the gymnast, his or her coach, and a physician familiar with the demands placed upon the upper extremity in gymnastics. The level of a gymnast's capabilities must be recognized. Improper techniques must be corrected. Emphasis must be placed on rehabilitation for shoulder problems and strengthening exercises for the elbow and wrist in attempt to decrease the symptoms from repeated forced extension. In the words of Peter Kormann, an Olympic medalist in gymnastics, "All gymnasts work out and compete with ongoing problems in their upper extremities. These problems are only considered serious injuries when the gymnast can no longer compete." PMID- 3967314 TI - Elbow injuries in gymnastics. AB - The medical literature contains little about elbow injuries in gymnastics. However, 30 females with 32 elbow injuries from gymnastics were found and studied. Two had Panner's disease (osteochondritis of the humeral capitellum), and all the others had fractures or dislocations. The majority required open or closed procedures. Recommendations to help reduce elbow injuries would include the use of experienced spotters, thicker pads whenever possible, and education of gymnasts in techniques of falling. After injury has occurred immobilization of the elbow for as short a period as necessary and follow-up therapy in a sports oriented setting are recommended. PMID- 3967316 TI - [General observations on prevention]. PMID- 3967315 TI - Pars interarticularis stress reaction, spondylolysis, and spondylolisthesis in gymnasts. AB - The spectrum of posterior element, vertebral injury in the young gymnast ranges from stress reaction to spondylolisthesis. Hyperextension and repetitive microtrauma lead to such injuries in young athletes. Early recognition may lead to a more favorable clinical outcome. PMID- 3967317 TI - [Significance of autoradiography in middle ear inflammations in childhood]. PMID- 3967318 TI - [Rapid glycerol infusion in the therapy of endolymphatic hydrops]. PMID- 3967319 TI - [Color hearing]. PMID- 3967320 TI - [Symptomatology of foreign bodies in the trachea]. PMID- 3967321 TI - [Perceptual hearing loss of the apicocochlear type]. PMID- 3967322 TI - [The elongated styloid process syndrome]. PMID- 3967323 TI - [Extra-salivary sialomas]. PMID- 3967324 TI - [Incidence of voice and speech disorders in children from selected kindergartens in Bratislava]. PMID- 3967325 TI - [Endoscopy and photodocumentation of the nasopharynx and larynx in children]. PMID- 3967326 TI - [Revision of stapes operations in otosclerosis]. PMID- 3967327 TI - Study of the carcinogenic mechanism for polycyclic aromatic hydrocarbons- extended bay region theory and its quantitative model. AB - With the help of results on the metabolism and the carcinogenic activities of polycyclic aromatic hydrocarbons (PAH), the comprehensive metabolic process in vivo is discussed. It is thought that the carcinogenic activity exhibited by a PAH is determined by the competition between the carcinogenesis and detoxification in which it participates. It is suggested that the essential agent of carcinogenesis should be, as a rule, the highest delocalization energy (beta unit) of the carbonium ion at the aromatic angular ring (A region), which is obtained by the pertubational molecular orbit (PMO) method. Since there are no essential distinctions in the molecular geometry and delocalization energy states between two carbonium ions of the aromatic angular ring and of the bay region, the A region can be looked upon as the extended bay region. On the basis of discussion of the overall metabolism, evaluation of the detoxification efficacy of each kind of the competing carcinogenic factors, including the biological factor B and three structural factors of the PAH molecule: K, A and L, was made. After making necessary approximation, K = 0.228, A = 0.5, L = 1.22 and B = 0.7 are obtained. It can be seen from these values that the L region plays the most important role in detoxification processes, and the K region plays the least important role. The effect of biological factor B is approximately the sum of the K region and the A region. This paper suggests the concept of a carcinogenic constant. For the PAHs with the same number of aromatic rings (N), C is a constant. The curve of function C = f(N), including the extensional line, is an isosceles triangle. The author suggests that it should be called the 'Pyramid Rule'. The final form of the quantitative equation is log R = C[delta E3deloc/(0.7 + 0.228nk + 0.5na + 1.22n1)]. The values for 50 PAHs which had been tested by animal experiments were calculated. Of these, 92% of the PAHs are in agreement with experiments on carcinogenic activities. PMID- 3967328 TI - The role of DNA-repair processes in N-nitrosopyrrolidine-induced mutagenesis. AB - The cytotoxic and mutagenic effects of increasing concentrations of N nitrosopyrrolidine (NPYR) were studied using various DNA repair mutants of Escherichia coli together with rat-liver S9 activation system. Irrespective of which strain was used, the cytotoxic effects of NPYR were similar to those observed in the parent strain. Mutagenicity studies revealed that the uvrA- derivative was more mutable than its repair proficient parent. These observations suggest that NPYR reacts with DNA to generate bulky lesions, which although potentially mutagenic, do not contribute significantly to cell-killing. Subsequent experiments with the metabolic inhibitor SKF 525A revealed that this compound only partially inhibited the mutagenic activity of NPYR, suggesting that although hepatic mixed function oxidase enzymes may participate in NPYR activation other pathways of metabolism are also involved. PMID- 3967330 TI - Metabolism of 2-acetylaminofluorene by eight different forms of cytochrome P-450 isolated from rat liver. AB - Eight different forms of cytochrome P-450 have been isolated from the liver microsomes of male Sprague-Dawley rats and compared with previously characterized forms on the basis of chromatographic behavior, absorption maximum of the carbon monooxide complex, apparent molecular weight upon SDS-disc gel electrophoresis, and substrate specificity. With respect to 2-acetylaminofluorene metabolism in a reconstituted system involving these cytochromes P-450, form c was approximately 16 times as active as form d, which was in turn at least 30 times as active as any of the other forms. The patterns of metabolites obtained with all of the cytochromes P-450 were determined by h.p.l.c. and were all unique. Form d was as active as form c in producing N-hydroxy-2-acetylaminofluorene. This metabolite was observed with only one other form of the cytochrome, i.e., from PB/PCN-E, which gave rise to it at a very low rate. PMID- 3967329 TI - Induction of sarcomas in rats by subcutaneous injection of 7-methoxy-2-nitro naphtho[2,1-b]furan (R 7000). AB - Among the nitro-naphthofurans, 7-methoxy-2-nitro-naphtho[2,1-b]furan (R 7000) has been proved to be a very potent mutagen. The purpose of this study was to demonstrate the carcinogenicity of a R 7000 to male Wistar rats initially 6 weeks old. R 7000 was dissolved in olive oil at a concentration of 1 mg/ml for injection. A S.C. injection of 0.5 ml containing 0.5 mg of R 7000 was given once a week in the neck of each animal tested. Ten control animals were not injected and 10 animals received a 0.5 ml injection of olive oil every week to serve as control. The remaining 70 animals were divided into five groups. Four groups of 10 animals received a total of either 2.5 mg, 5 mg, 7.5 mg or 10 mg of R 7000; the fifth group of 30 animals received 12.5 mg of R 7000. In animals which did not receive R 7000, no malignant tumor was observed. In those to whom R 7000 was administered tumors began to appear at the site of the injection after the third month. At the sixth month of the experiment, most of the animals injected had a tumor at the injection site. The number of tumor-bearing animals and the time between the first injection and the tumor appearance were closely related to the dose of R 7000 injected. These tumors were high grade fibrosarcomas, one animal developed a salivary fibrosarcoma. No other tumors or metastases were found in the autopsied animals. The high carcinogenicity of R 7000 in vivo is analogous to that of methylcholanthrene. The exact mechanism of action of 2-nitro naphthofurans as carcinogens remains to be explained. PMID- 3967331 TI - Reaction mechanisms of trans-1,2-dihydroxy-anti-3,4-epoxy-1,2,3,4-tetrahydro-5 methylchrysene with DNA in aqueous solutions. AB - Reactions of trans-1,2-dihydroxy-anti-3,4-epoxy-1,2,3,4-tetrahydro-5 methylchrysene (anti-5-MeCDE) with DNA and the effects of ionic strength on the reaction were studied in aqueous buffer solution (5 mM sodium phosphate, pH 7) by means of absorption and fluorescence spectroscopy. The results are compared with those obtained with the widely studied metabolite model compound trans-7,8 dihydroxy-anti-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene (BaPDE). The rate constant of hydrolysis of 5-MeCDE is k = 1.0 X 10(4)/S, which is approximately 35 times smaller than the value of k for BaPDE under similar conditions. As in the case of BaPDE, the rate of reaction of 5-MeCDE is accelerated in the presence of DNA. This effect is attributed to the rapid formation of physical association complexes (binding constant K) and the subsequent slower formation (rate constant k3) of carbocations at DNA binding sites, which in turn decay rapidly via hydrolysis to tetraols (1,2,3,4-tetrahydroxytetrahydro-5-methylchrysene, 5-MeCT) and to covalent adducts. The values of K and k3 are 2800 +/- 300/M and 8.7 X 10( 3)/S respectively, and are reduced to 450 +/- 100/M and 1.8 X 10(-3)/S in the presence of 0.1 M NaCl. The fraction of 5-MeCDE molecules which bind covalently to DNA is, on the other hand, constant under these conditions and lies in the range of 5-8%. Similar values for the covalent binding are observed for BaPDE, even though the physical association constant K is approximately 10 times larger than for 5-MeCDE under similar conditions. This difference in the values of K are attributed to the larger aromatic ring system in BaPDE which allows for a higher interaction of this molecule with the bases of DNA. Finally, the tetraol derived from the hydrolysis of 5-MeCDE also binds non-covalently to DNA, but the value of K is approximately 3 times smaller than for the diol epoxide. PMID- 3967332 TI - Identification of phorbol ester binding activity in the particulate and soluble fractions of human fetal tissues. AB - The presence of specific binding sites for phorbol esters was demonstrated in various human fetal tissues by binding assays of [3H]12-O-tetradecanoylphorbol-13 acetate (TPA) to particulate and cytosol fractions. Maximal binding activity of the soluble receptor is dependent on calcium and phosphatidylserine. Marked differences in receptor levels were found in various human fetal tissues. However, all the tissues tested contained binding sites for TPA. Particulate receptor concentration was highest in the brain, while the cytosolic receptor concentration was high in brain, stomach and liver. Human fetal tissues bound TPA with a Kd between 10 and 30 nM. PMID- 3967333 TI - Syntheses of 5-phenyl-2-pyridinamine, a possibly carcinogenic pyrolysis product of phenylalanine, and some of its putative metabolites. AB - 5-Phenyl-2-pyridinamine (PPA) is a pyrolysis product of phenylalanine, the presence of which has been demonstrated in broiled sardines. Since PPA is mutagenic in the Ames test and is structurally related to the aminobiphenyls, it has to be considered as potentially carcinogenic. In this study procedures for the synthesis of PPA and its possible metabolites were developed to make them available for biological studies. PPA was synthesized in one step from 2,5 pyridinediamine. However, this method is only suitable for the preparation of small amounts. Larger quantities were synthesized starting from 5-nitro-2 pyridinamine in four steps. PPA was also prepared via a six-step synthesis, starting from 6-amino-3-pyridinecarboxamide. This route was also used for the synthesis of tritiated PPA [( 3H]PPA) and 2-nitro-5-phenylpyridine, the latter being the precursor of the two putative proximate carcinogenic metabolites, viz. the hydroxylamine and the hydroxamic acid of PPA. In the course of these multi step syntheses a new method for the preparation of unsymmetrical biaryls was worked out. The following possible metabolites were also synthesized: N-(5-phenyl 2-pyridinyl)acetamide in the course of the synthesis of PPA starting from 5-nitro 2-pyridinamine, and both 5-(4-hydroxyphenyl)-2-pyridinamine (4'-OH-PPA) and N-[5 (4-hydroxyphenyl)-2-pyridinyl]acetamide starting from 5-(4-aminophenyl)-2 pyridinamine. After incubation of PPA in suspensions of freshly isolated hepatocytes from rats pretreated with polychlorinated biphenyls (Aroclor 1254) or PPA itself, the presence of 4'-OH-PPA was demonstrated. PMID- 3967335 TI - Base displacement in AAF-modified Z-DNA. AB - A new model is presented for acetylaminofluorene (AAF)-modified Z-DNA, in which the carcinogen is in a base-displaced position, inserted into the helix interior and parallel with an adjacent base. PMID- 3967334 TI - The formation of 9-hydroxychrysene-1,2-diol as an intermediate in the metabolic activation of chrysene. AB - 9-Hydroxy-trans-1,2-dihydro-1,2-dihydroxychrysene (9-hydroxychrysene-1,2-diol), which may be the triol involved in the formation of a chrysene triol-epoxide-DNA adduct in mouse skin, was not detected when chrysene was incubated with rat-liver microsomal preparations. In separate experiments an excess of synthetic 9 hydroxychrysene-1,2-diol was added during the incubation of 3H-labelled chrysene with rat-liver microsomes and was then re-isolated. The triol was found to contain a radioactive product that had chromatographic properties identical to those of 9-hydroxychrysene-1,2-diol when examined by reverse-phase h.p.l.c., both before and after acetylation, by normal-phase h.p.l.c. and by t.l.c. both before and after oxidation. When treated with m-chloroperoxybenzoic acid, the synthetic 9-hydroxychrysene-1,2-diol formed products that possessed alkylating activity and that reacted with DNA in vitro. Examination of the triol-epoxides produced by oxidation of a mixture of synthetic and metabolic 9-hydroxychrysene-1,2-diol by t.l.c. suggested that the anti-isomer was formed. PMID- 3967336 TI - Identification of the N-acetylcysteine conjugate of benzidine formed in the peroxidase activation system. AB - Benzidine is oxidized by the peroxidase/H2O2 system, yielding reactive intermediates. In the presence of thiols, covalent adducts are formed. We used h.p.l.c. to separate the products of the reaction of benzidine with N acetylcysteine. The major product was identified by n.m.r. spectroscopy (1H n.m.r.) as 3-(N-acetylcystein-S-yl)-benzidine. PMID- 3967337 TI - Studies on the mechanisms of altered exocrine acinar cell differentiation and ductal metaplasia following nitrosamine exposure using hamster pancreatic explant organ culture. AB - Syrian golden hamster pancreatic organ explants were treated with either methylnitrosourea (MNU) or N-methyl-N-nitroso-N'-nitroguanidine (MNNG). In control explants treated with only dimethylsulfoxide, there was evidence of autophagy and crinophagy in acinar cells. Carcinogen-exposed explants showed increased numbers of autophagic and crinophagic vacuoles. In long-term cultured explants there was an increase in the number of ducts over zero time control tissues. Eosinophilic cells similar to hepatocyte-like cells were seen in 90% of the carcinogen-treated explant experiments and in 45% of the controls. Nitrosamine exposure did not induce an increase in the overall amount of necrosis measured morphometrically. Nitrosamine exposure in vitro appears to lead to a sequence of events that follow carcinogen metabolism by the acinar cells. The changes that follow include altered cell morphology and toxic cell injury evidenced by autophagic and crinophagic processes, regeneration of ductal appearing cells, the appearance of hepatocyte-like cells and an overall increase in the amount of ductal metaplasia. Within some of these ductal foci, several ductules show atypical features. PMID- 3967338 TI - Metabolism of 2-aminoanthracene by BALB/c and C57BL mammary epithelium in vitro. AB - Aromatic primary amines, activated by P-450-dependent mixed-function oxidases have been shown to be mutagenic and carcinogenic in mammary gland of rodents. In this study, we compared 2-aminoanthracene (2AA) metabolism and inhibition in primary mammary gland cultures of BALB/c and C57BL mice. We sought to establish whether the rate or extent of metabolism was strain dependent as observed with polycyclic aromatic hydrocarbons even though the metabolic process would be different. Cells from either strain of mouse were uninjured by doses of 2AA up to 20 microM but produced polar metabolites of 2AA, some of which apparently formed covalent bonds with cellular macromolecules. In each case, covalent binding was inhibited by alpha-napthoflavone (alpha-NF), a mixed-function oxidase inhibitor. Any notable strain differences in 2AA metabolism and disposition was not observed. Results indicate that mouse mammary epithelial cells are capable of producing reactive metabolites of 2AA, probably via mixed-function oxidation. Thus, metabolic activation of 2AA in breast tissue may induce mutagenesis in mammary epithelium. The inhibitory effects of alpha-NF suggest that this compound may be of interest as a potential anti-carcinogen for the mammary gland. PMID- 3967339 TI - Release of fibronectin is linked to tumor promotion: response of promotable and non-promotable clones of a mouse epidermal cell line. AB - By use of indirect immunofluorescence technique and enzyme-linked immunosorbent assay we show that JB 6 mouse epidermal cells have cell surface fibronectin (FN) and release FN into the culture medium. The addition of 10(-8) M 12-O tetradecanoylphorbol-13-acetate (TPA) to promotable clones caused a 2-fold enhancement of the FN release over solvent control. On the other hand, in non promotable clones, TPA in concentrations of 10(-8) M or 10(-7) M did not cause increased FN release. Mezerein, a non-phorbol diterpene and second-stage tumor promoter was also found to be active in causing enhanced FN release in promotable but not in non-promotable clones. The vitamin A derivative retinoic acid (RA) antagonized the TPA-caused FN-release in promotable clones. RA had, however, no effect on the basic release patterns, when given alone or given to non-promotable clones together with TPA. These results suggest that the increased release of FN may be a required event for promotion to transformation. Our view is derived from the observation that promotable clones of the JB 6 cell line release increased amounts of FN into their medium upon promoter exposure while non-promotable clones are unaffected. PMID- 3967340 TI - Induction of ornithine decarboxylase and DNA synthesis in rat stomach mucosa by methylglyoxal. AB - Administration of methylglyoxal at doses of 300-600 mg/kg body weight by gastric tube to male F344 rats induced 100-fold increase in ornithine decarboxylase activity (formation of 682 pmol CO2/30 min/mg protein) within 7 h, 26-fold increase in DNA synthesis (incorporation of 17 800 d.p.m. of [3H]thymidine/microgram DNA) within 16 h, 16-fold increase in the labeling index of S-phase cells (increase from 1.7 to 26.5) within 16 h, and apparent unscheduled DNA synthesis within 2 h in the glandular stomach mucosa. These results suggest that methylglyoxal has potential promoter activity and may also have initiating activity in carcinogenesis in the glandular stomach. PMID- 3967341 TI - Microsomal metabolism of the carcinogen, N-2-fluorenylacetamide, by the mammary gland and liver of female rats. I. Ring- and N-hydroxylations of N-2 fluorenylacetamide. AB - We determined ring- and N-hydroxylations of a systemic mammary gland carcinogen, N-2-fluorenylacetamide (2-FAA), by microsomal fractions of liver and mammary gland of female rats and the effects of in vivo and/or in vitro modifiers of these oxidations. Pretreatment of lactating rats with 3-methylcholanthrene (3-MC) or beta-naphthoflavone (beta-NF) and non-lactating (50-day old virgin) rats with beta-NF showed similar effects in that the formation of 3-, 5-, 7-, 9- and N hydroxy-2-FAA by hepatic microsomes was increased manyfold and the formation of 1 hydroxy-2-FAA was induced. In mammary gland microsomes, the formation of 3-, 5- and 7-hydroxy-2-FAA was likewise increased, but of 9-hydroxy-2-FAA was unaffected. Only mammary microsomes of lactating rats had capacity for N hydroxylation which was increased approximately 3 times by pretreatment of rats with 3-MC or beta-NF. All of the induced increases of metabolites of 2-FAA in hepatic and mammary microsomes were inhibited by 0.1 mM alpha-naphthoflavone (alpha-NF) in vitro. Pretreatment of non-lactating rats with phenobarbital increased only the formation of 7-hydroxy-2-FAA in hepatic microsomes which was further stimulated by alpha-NF in vitro. The latter also stimulated the formation of 7- and 9- hydroxy-2-FAA by hepatic microsomes of the uninduced rats, but had no effects in mammary microsomes, in which 9-hydroxy-2-FAA was a major metabolite. Hence, the data showed qualitative and quantitative differences between lactating and non-lactating rats in metabolism of 2-FAA by mammary microsomes which may result from differences in the levels (e.g., of cytochrome P 450) and activities of microsomal enzymes determined herein. In hepatic microsomes of these rats, differences in quantities of metabolites of 2-FAA (3-, 7-, 9- and N-hydroxy-2-FAA) were found in corn oil-treated rats only. The solvent (methanol or acetone) used for addition of 2-FAA to the incubation mixtures altered quantitatively the metabolite profiles in hepatic and mammary microsomes of 3-MC or beta-NF treated rats. The formations of 1- and 3- or 5- and 7-hydroxy 2-FAA were greater in the presence of acetone or methanol, respectively. The results of this study suggest that the formation of phenolic and N-hydroxy metabolites of 2-FAA in both hepatic and mammary microsomes of lactating rats is catalyzed by similar form(s) of cytochrome P-450 induced by pretreatment with 3 MC or beta-NF.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3967343 TI - Significance of quiescent smooth muscle migration in the injured rat carotid artery. AB - Cellular accumulation in the intima of injured artery has generally been attributed to smooth muscle cell proliferation. Since smooth muscle cells in normal artery are found mainly in the media, migration of smooth muscle cells into the intima has been considered a necessary prerequisite for subsequent myointimal thickening. The nondividing medial cells would appear to have no role in the reparative process. We have investigated in the rat ballooned carotid the possibility that nondividing cells might also contribute to injury-induced intimal thickening. All proliferating smooth muscle cells were labeled by 3H thymidine given by continuous intraperitoneal infusion. The amounts of 3H thymidine used were not toxic and did not inhibit smooth muscle cell proliferation. Autoradiograms performed on histological cross-sections showed a progressive decrease in the fraction of unlabeled cells at 3, 7, and 14 days after carotid injury. However, the actual number of nondividing cells remained constant. The calculated growth fraction for the 14-day period was 40%. A substantial number of unlabeled cells was observed in the intima. These data have led us to conclude that only a small fraction of smooth muscle cells in an artery proliferate in response to the injury stimulus, and do so shortly after injury, or not at all. Furthermore, nondividing, as well as proliferating smooth muscle cells, can migrate and contribute, in a substantial way, to the increase in intimal smooth muscle cell number. PMID- 3967342 TI - Effects of pressure gradients between branches of the left coronary artery on the pressure axis intercept and the shape of steady state circumflex pressure-flow relations in dogs. AB - When steady state pressure-flow relations are studied in the circumflex coronary artery, pressure gradients develop between it and other branches of the left coronary artery. To assess the effects of these pressure gradients, we compared the pressure axis intercept and shape of steady state circumflex pressure-flow relations in the presence and absence of gradients after autoregulation was abolished, both in the beating heart and during long diastoles in dogs. We used peripheral coronary pressures and radionuclide-labeled microspheres to assess arterial collateral flow. In the beating heart, interarterial pressure gradients reduced the curvature at low circumflex pressures, and overestimated the mean pressure axis intercept by 7.8 mm Hg (P less than 0.05). The results were similar for the pressure-flow relations derived during long diastoles. This overestimation exaggerates the difference between the pressure axis intercept and coronary sinus pressure. The peripheral coronary pressure and microsphere results indicate that these effects are mediated largely by arterial collateral flow. PMID- 3967344 TI - Phospholipase D produces increased contractile force in rabbit ventricular muscle. AB - Inclusion of phospholipase D (Streptomyces chromofuscus, 5 U/ml) in the medium perfusing rabbit papillary muscles increased peak force development by 78% and peak dF/dt by 89%. The maximal contractile response occurred 40-50 minutes after addition of the enzyme to the perfusate. As peak contractile response developed, aftercontractions appeared in most muscles. The inotropic response was slowly reversible, with disappearance of aftercontractions, upon discontinuation of the enzyme. Phospholipase D produces a specific increase of phosphatidic acid in the sarcolemma and, therefore, an increase in net anionic charge on the membrane. It has been shown previously that phospholipase D induces a large increase in sarcolemmal calcium binding. We propose, on the basis of the present study, that phospholipid-bound calcium may play a significant role in the control of contractile force in mammalian myocardium. PMID- 3967345 TI - Transmission of intrathoracic pressure to the intracranial space during cardiopulmonary resuscitation in dogs. AB - Elevation of intrathoracic pressure during cardiopulmonary resuscitation generates carotid pressure and flow, but also increases intracranial pressure. This increase in intracranial pressure may limit cerebral blood flow. Therefore, we performed studies designed to quantify the extent of this transmission and to identify the mechanism of transmission of intrathoracic pressure to the intracranial space during cardiopulmonary resuscitation in dogs. Intracranial pressure increased during the chest compression phase of all modes of cardiopulmonary resuscitation tested. During simultaneous compression-ventilation cardiopulmonary resuscitation, change in intracranial pressure (mm Hg) = 0.33 change in intrathoracic pressure (mm Hg) + 2.02 (r = 0.86) and was not significantly different from the relationship observed during conventional cardiopulmonary resuscitation. The magnitude of transmission of intrathoracic pressure to the intracranial space was increased by binding the abdomen and by raising the baseline intracranial pressure. No single route accounted for transmission of intrathoracic pressure to the intracranial space during cardiopulmonary resuscitation. Intracranial pressure fluctuations were unrelated to either carotid arterial or jugular venous pressure, and were found instead to be the result of pressure transmission by blood in non-valved veins and by cerebrospinal fluid. This was determined by three maneuvers. First, obstruction of cerebrospinal fluid flow by ligation of the cervical spinal cord reduced intracranial pressure (P less than 0.001) and made the change in intracranial pressure equivalent to pressure changes at the confluence of the intracranial venous sinuses, without affecting pressure changes at the confluence of the intracranial venous sinuses. Second, ligation of the cervical spinal cord and one of the two longitudinal vertebral veins adjacent to the cervical cord reduced the pressure changes in the intracranial space and at the confluence of the intracranial venous sinuses to about 60% of the levels observed when the cervical cord alone was ligated. Thus, the non-valved longitudinal vertebral veins appear to be the vascular channels of critical importance to pressure transmission. Finally, pressure changes in the thoracic cerebrospinal fluid were increased (P less than 0.05) by cord ligation, even after exsanguination minimized pressure transmission via blood-filled channels, indicating direct transmission of intrathoracic pressure through intervertebral foramina to the cerebrospinal fluid.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3967346 TI - Relationship between myocardial fiber direction and segment shortening in the midwall of the canine left ventricle. AB - Myocardial fiber orientation undergoes an orderly transition from the epicardium to the endocardium in the left ventricle, with circumferential fibers predominating in the middle one-third of the heart wall. How fibers lying at different depths in the myocardium, running in different directions, interact to produce local deformation is not known. To define the relationship between the orientation of uniaxial myocardial fibers and local wall motion, we placed three sets of ultrasonic dimension gauges in the middle one-third of the apex-to-base distance of the left ventricle of nine dogs. One pair was placed in line and two intentionally out of line with the presumed local fiber direction. The relative angle between the gauge and the local myofibers was determined by the use of postmortem radiography and histological techniques. Our results show that in the midwall of the left ventricle, myocardial segment shortening is maximal in the direction of local fibers; the shortening measured by gauges placed out of line with the local fiber axis by more than 30 degrees was significantly less than the actual in-line fiber shortening which occurred. This suggests that functional tethering between midwall fibers and endocardial or epicardial fibers does not play a major role in the pattern of midwall deformation. We also documented that an external reference line can be used to predict midwall myofiber direction. Using this line as a guide, ultrasonic dimension gauges could be placed within an average of 12 degrees (range: 0.5 to 18.5 degrees) from the local fiber axis. PMID- 3967347 TI - Effects of temperature on measurement of alkaline phosphatase activity. AB - We examined the effects of temperature on the activity and steady-state kinetic properties of alkaline phosphatase (EC 3.1.3.1). Purified isoenzymes from human liver, intestine, and placenta were used, as was human serum, and the enzyme from porcine kidney. Phosphatase activity was estimated by two different assay techniques. For all isoenzymes, apparent Michaelis constants for the substrate 4 nitrophenyl phosphate decreased with increased temperature; Km at 37 degrees C was typically half that determined at 25 degrees C. All enzymes of human origin exhibited similar linear Arrhenius relationships over the range examined, 20-37 degrees C (Ea of 30-36 kJ X mol-1). The porcine kidney enzyme obeyed an Arrhenius relationship that was slightly, but significantly, different from the isoenzymes of human origin. Temperature relationships based upon Arrhenius behavior and individual activity measurements are presented. For human alkaline phosphatases, they differed by no more than 10%. PMID- 3967348 TI - A more specific, simpler radioimmunoassay for carcinoembryonic antigen, with use of monoclonal antibodies. AB - A solid-phase, two-site monoclonal antibody radioimmunoassay for carcinoembryonic antigen in serum or plasma has been developed. Two monoclonal antibodies are used: 3d6, which is immobilized on polystyrene beads, reacts with high-molecular mass CEA; the other, C4, with apparently restricted reactivity toward gastrointestinal tract and mammary carcinomas, is labeled with 125I. The assay consists of incubating 0.2 mL of serum both with 3d6-coated beads and 125I labeled C4 at room temperature for 18 h. The CEA standard is calibrated against WHO international standard (73/601). Advantages of this assay include: (a) no heat or acid pre-treatment of samples; (b) linear response over a wider functional range, 0 to 150 micrograms/L, requiring fewer calibration points; and (c) no interference by glycosaminoglycans. Average inter- and intra-assay reproducibilities (CVs) are less than 10%; analytical recovery of CEA was 94 to 107%. CEA of less than 0.5 micrograms/L can be detected. The mean concentration of CEA in serum from healthy individuals is 0.97 (SD 1.18) micrograms/L; only 3% of the sera tested had concentrations greater than 3.0 micrograms/L. On comparing this assay with a polyclonal RIA, we found similar assay sensitivity for colorectal carcinoma but fewer false-positive results for sera from patients with benign liver and bowel diseases. PMID- 3967349 TI - Improved liquid-chromatographic determination of cyclosporine, with concomitant detection of a cell-bound metabolite. AB - This unique extraction and isocratic "high-performance" liquid chromatographic method for measuring cyclosporine (CsA) in blood involves a Zorbax cyanopropyl analytical column maintained at 58 degrees C, with detection at 214 nm, and recycling of the water:acetonitrile mobile phase for improved long-term column stability and efficiency. Routinely, 1.0 mL of serum, plasma, or whole blood is diluted with water:acetonitrile (70:30) and applied to a disposable solid-phase cyanopropyl column to rapidly extract the drug and the internal standard cyclosporin D (CsD). Analytical recovery for this step averages 90% with whole blood and 98% with serum and plasma. Between-run CVs were 6.5 and 2.6% for means of 104 and 1128 micrograms/L, respectively. The standard curve is linear up to 1600 micrograms/L. The minimum detection limit is 10 to 15 micrograms/L. No interferences from endogenous substances or other drugs were found. In addition, a compound cross reacting with the Sandoz radioimmunoassay antibody was isolated from patients' samples with the present procedure and was tentatively identified as a CsA metabolite(s). It appears to be highly partitioned on blood cells, very little being detected in the serum or plasma. In a comparison with RIA, correlation coefficients were 0.828 and 0.652 for serum and whole blood, respectively. Results from a 12-h pharmacokinetic study in which different sample types were analyzed by RIA and liquid chromatography further exemplified major discrepancies between types of CsA determinations. PMID- 3967350 TI - Computer evaluation of statistical procedures, and a new quality-control statistical procedure. AB - I describe a program for definitive comparison of different quality-control statistical procedures. A microcomputer simulates quality-control results generated by repetitive analytical runs. It applies various statistical rules to each result, tabulating rule breaks to evaluate rules as routinely applied by the analyst. The process repeats with increasing amounts of random and systematic error. Rate of false rejection and true error detection for currently popular statistical procedures were comparatively evaluated together with a new multirule procedure described here. The nature of the analyst's response to out-of-control signals was also evaluated. A single-rule protocol that is as effective as the multirule protocol of Westgard et al. (Clin Chem 27:493, 1981) is reported. PMID- 3967351 TI - Measurement of glycosylated whole-blood protein for assessing glucose control in diabetes: collection and storage of capillary blood on filter paper. AB - We present data on the use of filter-paper blood collection for measurement of glycosylated whole-blood proteins (gWB) (hemoglobin and plasma proteins). A capillary blood sample, obtained by fingerprick, is spotted directly onto filter paper (Schleicher & Schuell 903). The blood spot is washed briefly with alcohol (ethanol or isopropanol) to remove free glucose and dried before shipment to the laboratory. In the laboratory, the blood is eluted from the paper and analyzed for gWB by a colorimetric method. The gWB is primarily a measure of glycosylated hemoglobin (gHb) with a small contribution from glycosylated plasma protein. Concentrations of gWB and gHb are highly correlated (r = 0.91). The filter-paper method offers advantages over currently available methods for quantifying gHb and may be particularly useful in screening for diabetes and for assessing glycemic control in patients from remote areas. PMID- 3967352 TI - Aminophenylboronic acid affinity chromatography and thiobarbituric acid colorimetry compared for measuring glycated albumin. AB - Two techniques originally developed for measurement of glycated ("glycosylated") hemoglobin but also applicable to determination of glycated albumin are the thiobarbituric acid colorimetric technique (I) and the aminophenylboronic acid affinity chromatographic procedure (II). The latter reliably distinguishes diabetics from nondiabetics, and concentrations of glycated hemoglobin and glycated albumin are linearly correlated. I is nonspecific; it neither correlates with diabetic status nor with values derived via the affinity technique. Most of the chromogenic material is present in the fraction of albumin that does not bind to aminophenylboronic acid. Glucose interferes significantly with I but only slightly with II. Prolonged incubation of plasma with glucose dramatically increases the II-determined glycated albumin. Reactivity with thiobarbituric acid increases much less, and mainly in the II-bound fraction. This fraction contains a high proportion of nonspecifically reactive material. The percentage of glycated albumin determined in crude plasma samples by II differs only slightly from the value determined by purifying the albumin from the plasma. This technique appears more promising than I for eventual clinical applications. PMID- 3967353 TI - Phenylalanine analyses of blood-spot control materials: preparation of samples and evaluation of interlaboratory performance. AB - Aliquots (0.1 mL) of whole-blood pools prepared to contain various concentrations of phenylalanine were applied to filter-paper collection cards, dried, and stored in sealed bags. We measured the phenylalanine content of the dried blood spots by bioassay, fluorometry, and "high-performance" liquid chromatography, and found that the concentrations remained constant for two years when samples were kept at -20 degrees C or lower. Intra- and interlaboratory studies showed that results for phenylalanine were greater for laboratories using bioassay procedures than for those using fluorometric procedures. Further, CVs (both among- and within laboratory) obtained with fluorometric procedures were nearly half as great as the CVs obtained by laboratories using bioassay techniques. PMID- 3967354 TI - Mitochondrial enzymes in human serum: comparative determinations of glutamate dehydrogenase and mitochondrial aspartate aminotransferase in healthy persons and patients with chronic liver diseases. AB - We measured the activities of two mitochondrial enzymes, the mitochondrial form of aspartate aminotransferase (EC 2.6.1.1) and glutamate dehydrogenase (EC 1.4.1.2), in the serum of apparently healthy persons (n = 84) and patients suffering from chronic liver diseases (n = 43). The distribution of activities for glutamate dehydrogenase, but not mitochondrial aspartate aminotransferase, was sex-dependent. The upper limits of the reference intervals (99th percentile) at 37 degrees C were 3.2 U/L for mitochondrial aspartate aminotransferase, 6.4 U/L for glutamate dehydrogenase (women), and 11.0 U/L for glutamate dehydrogenase (men); there was a weak correlation between the activities of both mitochondrial enzymes (r = 0.439). In patients with chronic liver diseases we found a greater increase in the activity of glutamate dehydrogenase than of mitochondrial aspartate aminotransferase and the correlation between the two mitochondrial enzymes was stronger. The diagnostic sensitivity and specificity of either mitochondrial enzyme was less than that of total aspartate aminotransferase, alanine aminotransferase (EC 2.6.1.2), or gamma-glutamyltransferase (EC 2.3.2.2). PMID- 3967355 TI - Relationships between magnesium and protein concentrations in serum. AB - We determined concentrations of magnesium, total protein, albumin, and globulin in more than 74 000 serum specimens from patients and noted a direct linear relationship between the concentration of magnesium in serum and the concentrations of total protein, albumin, and globulin in serum. Albumin and magnesium concentrations are linearly related at high and low albumin concentrations; within the reference interval, however, the magnesium concentration is independent of the albumin concentration. Linear regression analysis suggests that 25% of the total serum magnesium is bound to albumin and 8% to globulins. PMID- 3967356 TI - Cholesterol determination in serum after fractionation of lipoproteins by immunoprecipitation. AB - We investigated the immunoprecipitation of apolipoprotein B-binding lipoproteins, or of apo A-I- and apo C-binding lipoproteins, by delipidated antiserum for measuring cholesterol in the nonprecipitated lipoprotein fractions. After immunoprecipitation of serum with delipidated anti-apo B, we determined by immunoelectrophoresis that no beta- or pre-beta lipoproteins were present, whereas alpha-lipoproteins remained in the supernate. Conversely, after immunoprecipitation with an antiserum against apo A-I + apo C, only lipoproteins with beta-mobility were detected and no apo B from beta-lipoproteins was in the precipitate. The concentration of cholesterol in the supernate after immunoprecipitation with anti-apo B correlated highly (r = 0.93, n = 118) with cholesterol measured after precipitation with phosphotungstic acid/MgCl2. The cholesterol concentration after immunoprecipitation with anti-apo AI and anti-apo C correlated similarly well (r = 0.94, n = 145) with the LDL-cholesterol calculated by Friedewald's formula in serum specimens reflecting moderate hyperlipoproteinemia. PMID- 3967357 TI - Measurement of lipase activity by a differential pH technique. AB - This is a new electrochemical method for determination of lipase activity in biological fluids, including serum, plasma, and duodenal juice. Advantages of turbidimetric methods--short reaction time, and small sample and reagent volumes- are combined with those of titrimetric methods: measurement of absolute activity (i.e., no standardization required), saturated substrate conditions, and direct measurement of reaction products. The proposed method is easy, inexpensive, and takes only 3 min. Precision is good: CV = 3.74% within day and 7.3% between days at the clinical-decision concentration, CV = 1.86% within day and 4.65% between days for above-normal lipase activities. The standard curve is linear up to 4500 U/L. Results (y) correlate well with those by turbidimetry (x): y = 0.9287x - 65.3 (r = 0.9719). Reference values are between 0 and 130 U/L. PMID- 3967358 TI - Quality control of lipid measurements in epidemiological studies: the U.S. Air Force HEART program. AB - A special standardization and quality assurance program, similar to that created for the Lipid Research Clinics Program (LRC), was developed for the American Health Foundation Laboratory by the Centers for Disease Control (CDC) to assure the quality of lipid measurements in the U.S. Air Force Health Evaluation and Risk Tabulation (HEART) Program. This study was designed to test the feasibility of reducing the incidence of heart disease in active-duty U.S. Air Force personnel through life-study intervention. During the 18-month study, CDC provided serum calibrators and reference materials for internal control and an external surveillance program for measurements of total cholesterol (TC) and high density-lipoprotein cholesterol (HDLC). The Laboratory, using an automated enzymic method to measure cholesterol, achieved an overall goal for accuracy of less than 2% error (av systematic error, -30.6 mg/L) for TC, as measured on nine reference pools for which values were assigned by CDC. The average bias of measurements of HDLC with heparin-manganese to separate the lipoproteins in five CDC reference pools was -4.6 mg/L. Bias was estimated relative to the values assigned to the reference materials by the CDC reference methods for TC and HDLC. The average CV for TC was 0.89%, for HDLC 2.66%. Accuracy of cholesterol measurements can be assured over time with a standardization and quality assurance program that incorporates accurately labeled reference materials for calibration, internal quality control, and external surveillance. PMID- 3967359 TI - Facilitated determination of ionized calcium. AB - Using a calcium-containing heparin preparation for anticoagulation, we determined [Ca2+], the mean concentration of ionized calcium, in whole blood of 120 healthy blood-donors to be 1.23 (SD 0.04) mmol/L. Similarly, for 50 intensive-care patients selected without conscious bias, the correlation between [Ca2+] in serum (mean 1.15, SD 0.10 mmol/L) and in whole-blood samples anticoagulated with the same heparin preparation (mean 1.15, SD 0.09 mmol/L) was very good (r = 0.95). Storing samples anaerobically on ice for as long as 2 h did not alter whole-blood [Ca2+]. On the other hand, various concentrations of calcium-free heparin preparations all induced a significant decrease in measured [Ca2+]. By using whole-blood samples, rather than plasma or serum, for [Ca2+] determination with a calcium-selective electrode, repetitive measurements can be made with simple handling procedures, facilitating rapid implementation of appropriate therapeutic measures for critically ill patients. PMID- 3967360 TI - Apparent binding of ionized calcium by various buffers. AB - Using different substance concentrations in an aqueous 1.25 mmol/L solution of CaCl2 plus NaCl to a final solution ionic strength of 160 mmol/L, we tested six buffers for their effect on measurements of ionized calcium (Ca2+). Measured Ca2+ decreased with increasing ionic strength and pH. Increasing concentrations of Tris caused a positive Ca2+ electrode bias; the other five buffers caused a negative Ca2+ electrode bias with increasing concentration. 4-(2-Hydroxyethyl)-1 piperazineethanesulfonic acid ("HEPES") at 10 mmol/L maintained pH 7.39 in the aqueous reference solutions containing 0.75 to 2.50 mmol of CaCl2 per liter, and showed a linear Ca2+ response among three different suppliers of Ca2+ instruments; it is thus a suitable buffer for a reference solution. PMID- 3967361 TI - Two automated methods for measuring plasma thiocyanate compared. AB - In an interlaboratory comparison of two continuous-flow analytical procedures for measuring thiocyanate, we used ferric nitrate (y) and p-phenylenediamine/pyridine (x) as colorimetric reagents to measure its concentrations in plasma of 100 consecutive patients attending a peripheral vascular disease clinic. The results correlated well (r = 0.987, p less than 0.001; y = 0.938x + 1.2 mumol/L). However, there were small, systematic, positive differences between the phenylenediamine values and the corresponding ferric nitrate values (paired t = 5.4, p less than 0.001). These differences were linearly related to the means of the pairs of results (r = 0.42, p less than 0.001; y = 0.0739x - 2). Nevertheless, when we used previously determined cutoff points the two sets of SCN concentrations concurred completely in classifying the 100 patients as smokers or nonsmokers. On the basis of self-classification by 71 of these subjects, the measurement techniques had a sensitivity of 91% and a specificity of 75%; when five patients claiming to be nonsmokers but found to have abnormally high values for carboxyhemoglobin (2.7 - 6.9%) were reclassified as smokers, specificity increased to 89%. PMID- 3967362 TI - A sensitive high-temperature electrothermal atomic absorption analysis for Rb+ in erythrocytes and plasma of normal and hypertensive persons. AB - This method for determination of Rb+ in human plasma and erythrocytes by graphite furnace atomic absorption spectrophotometry has a sensitivity of 29 nmol/L for plasma, 12 nmol/L for erythrocytes. The detection limit is 24 nmol/L for plasma, 4.8 nmol/L for erythrocytes. This assay is approximately 30-fold more sensitive than previously reported techniques involving atomic absorption spectrophotometry, enabling use of smaller samples. The rubidium signal is linear with concentration up to 1.2 mumol/L, and addition of other cations to the matrix produces only minor alterations in the Rb+ signal. We measured plasma and erythrocytic Rb+ concentrations in healthy subjects and in patients with untreated essential hypertension. In both, our values are similar to those previously reported for healthy individuals. PMID- 3967363 TI - Stability of bombesin in serum, plasma, urine, and culture media. AB - Using a radioimmunoassay, we studied the stability of bombesin added to pooled human serum, plasma, urine, and two culture media (RPMI-1640 and M199). Bombesin was stable in serum for 5 h at 4 degrees C and 2 h at 21 degrees C. However, in plasma, about half was no longer detected by 5 h at 4 degrees C, and this decline was unaffected by added aprotinin. Bombesin was stable in urine for 24 h at 4 degrees C and for 2 h at 21 degrees C. When incubated in the culture media at 37 degrees C for 60 min, no loss was detected. Bombesin-like immunoreactivity was detectable in the serum of 22 mice bearing tumors established from biopsied small cell lung carcinomas, two of 12 mice bearing tumors established from other malignancies and zero of nine control mice. In contrast, immunoreactivity to this analyte was detected in urine specimens from all mice except for one bearing a non-small-cell tumor. The concentrations detected in serum and urine were uncorrelated. PMID- 3967364 TI - Carboxyhemoglobin determination by second-derivative spectroscopy. AB - In this procedure hemoglobin is converted to its reduced form and the magnitude of the zero-order spectral shift of the reduced hemoglobin peak at 430 nm to the carboxyhemoglobin peak at 418 nm is determined by second-derivative spectrum analysis. The method is simple, straightforward to set up, and rapid. A result may be obtained within 15 min of receiving the sample. It is sufficiently sensitive to differentiate carboxyhemoglobin concentration in the blood of smokers and nonsmokers. PMID- 3967365 TI - An evaluation of the Du Pont aca IV: does it meet medical needs? AB - A new bench-top analyzer from Du Pont, the "aca IV," was evaluated. To do so, we performed 10 different tests during an eight-week test period. The instrument is very precise (CVs less than 2%), results agree well with those obtained with the older acas (II and III), linearity is good in the clinically important ranges, and there is very little drift or carryover. From a medical-needs viewpoint, we found the analyzer satisfactory for all tests except possibly for calcium, for which the medical-needs criteria are so strict that few laboratories can meet them. We reached the latter conclusions by using a statistical model, described here, and from the predictive value of an abnormal test for populations with various prevalences of disease. PMID- 3967366 TI - Effect of storage on measurement of ionized calcium in serum of uremic patients. AB - We studied, in 70 acidotic and non-acidotic uremic patients, the analytical variance in serum ionized calcium as related to duration and temperature of storage. Storage of serum or whole blood at 4 degrees C for as long as 6 h did not significantly alter the measured concentration of ionized calcium in the serum. Storage at room temperature for 6 h, or longer at 4 degrees C or -20 degrees C, resulted in inaccuracies in 39 to 79% of the samples of serum and in 38 to 92% of the samples of whole blood. These errors were not negated by correcting the values for ionized calcium to a pH of 7.40. Indeed, corrected values for calcium were even more unreliable in acidotic patients. We conclude that samples from uremic patients should be analyzed for ionized calcium within 2 h, or within 6 h if stored at 4 degrees C. PMID- 3967368 TI - The upper limit of normal for thyrotropin is 3 or 4 milli-int. units/L. AB - Recently Musto et al. (Clin Chem 30: 329-330, 1984) noted that, despite the clinical importance of accurate measurement of thyrotropin at low concentrations, the upper limit of normal is well below the stated upper limit of normal of most commercial tests. Here I amplify their statement. PMID- 3967367 TI - Factors influencing normal reference intervals for creatinine, urea, and electrolytes in plasma, as measured with a Beckman Astra 8 Analyzer. AB - In a study of 514 healthy adults, we used a Beckman Astra 8 Analyzer to establish normal reference intervals for plasma creatinine, urea, and electrolytes. For potassium and chloride these were considerably lower and higher, respectively, than previously reported ranges. All of these analytes showed significant sex related differences; all except chloride showed age-related changes. The relationship of these biochemical indices to fasting, cigarette smoking, alcohol intake, regular exercise, and the contraceptive pill--independent of these age- and sex-related differences--was assessed by multiple linear regression. The effect was significant in each case. Our results underline the importance of regular review of reference values. PMID- 3967369 TI - Preparation of urine samples for liquid-chromatographic determination of catecholamines: bonded-phase phenylboronic acid, cation-exchange resin, and alumina adsorbents compared. AB - We compared results for the liquid-chromatographic determination of free norepinephrine and epinephrine in urine after purifying the catechols by the following methods: (a) acid-washed alumina, (b) weak cation-exchange resin (WCX), (c) a combination of weak cation-exchange resin followed by alumina (WCX alumina), and (d) commercially available phenylboronic acid adsorbent. We evaluated analytical specificity, sensitivity, recovery, and turnaround time. The WCX-alumina combination produced the most sensitive and specific chromatograms for urinary catecholamines; the other methods took less processing time. Neither WCX nor alumina alone was suitable for routine work because of chromatographic interferences in a significant proportion of urines. The phenylboronic acid method is adequately sensitive and specific for norepinephrine and epinephrine, and samples can be assayed faster. Thus it provides a compromise between the high analytical performance of the WCX-alumina method and the speed of the WCX and alumina methods. PMID- 3967370 TI - Laboratory evaluation of the Greiner G-400 discrete selective multichannel analyzer. AB - We evaluated the new Greiner G-400 selective multichannel analyzer. Thirty different tests can be run in combination profile and single-test mode at a rate between 150 and 300 tests per hour. The new photometer allows kinetic and equilibrium (endpoint) measurements. The G-400 analyzer demonstrated excellent precision, linearity, accuracy, ease of operation, and no carryover. Results for 16 different analytes as determined with the Hitachi 705, GSA II, and Corning 940 correlated favorably with those obtained with the G-400. The G-400 analyzer is suitable for both emergency and routine use. PMID- 3967371 TI - How certain drugs interfere negatively with the Jaffe reaction for creatinine. AB - Phenacemide and cephalothin may interfere either positively or negatively with the determination of creatinine by the Jaffe reaction, depending on the analytical system. The drug-picrate chromophores maximally absorb within the first minute of reaction (21 s for phenacemide, 45 s for cephalothin), after which the absorbances decrease. Thus, these drugs negatively interfere in analytical systems involving kinetic measurements when the time interval of measurement includes the period of decreasing absorbance. PMID- 3967372 TI - Normal "anion gap" (hyperchloremic) acidosis. AB - Hyperchloremic metabolic acidosis in which the anion gap is within normal limits is a common condition in the hospital population, and often presents a difficult diagnostic problem. We describe nine typical cases of this disorder and suggest a logical approach to its evaluation. PMID- 3967373 TI - Rhabdomyolysis: two pediatric case reports. AB - We report two pediatric cases of rhabdomyolysis. This disease involves the destruction of skeletal muscle, which can present with myalgia and a brown pigmented urine. The first patient presented with acute renal failure, hypertension, and hyponatremia. The second patient was pyrexic, hypernatremic, and hypokalemic, and later developed hypertension. Evidence of rhabdomyolysis in both patients included dark, o-tolidine-positive urine, granular casts in the urinary sediment, and grossly increased activities of creatine kinase (greater than 60 000 U/L) in serum. An uncommonly recognized entity in the pediatric age group, rhabdomyolysis often presents as an acute disease with severe onset but can be diagnosed with relatively simple laboratory tests. PMID- 3967374 TI - Abnormal lactate dehydrogenase isoenzyme in serum and tumor tissue of a patient with neuroblastoma. AB - Serum and tumor tissue of a patient with neuroblastoma contained an abnormal isoenzyme of lactate dehydrogenase (LDH; EC 1.1.1.27), which, on agarose gel electrophoresis, migrated between LDH-2 and LDH-3 with a mobility the same as that of the extra LDH isoenzyme found in normal human erythrocytes. On surgical removal of the tumor, the high total LDH activity (775 U/L) in the serum of the patient rapidly decreased to normal (70-220 U/L), and the abnormal LDH isoenzyme was no longer detected. The total LDH activity of the abnormal LDH isoenzyme per gram of hemoglobin in the tumor tissue was 26 times that of erythrocytes, suggesting that the abnormal isoenzyme originated mainly from the tumor cells themselves rather than the erythrocytes contained in the tumor tissue. This first report on the appearance of the abnormal LDH isoenzyme in a patient with neuroblastoma suggests that this abnormal LDH isoenzyme may have some significance as a marker enzyme for neurogenic tumors. PMID- 3967375 TI - Pharmacokinetic analysis of a case of isopropanol intoxication. AB - A comatose 46-year-old woman, admitted to the emergency room, had isopropanol and acetone concentrations of 2000 and 120 mg/L, respectively, in her serum. She had no known history of acute isopropanol intoxication and was otherwise physically healthy. Pharmacokinetic analysis showed that the elimination of both isopropanol and its major metabolite acetone obeyed apparent first-order kinetics with half lives of 6.4 and 22.4 h, respectively. These data contrast with the commonly held view that isopropanol is slowly metabolized. Concentrations of these analytes in cerebrospinal fluid 6 h after admission were similar to those in serum. This is the first report of the pharmacokinetics of both agents in a nonalcoholic person, and it gives the first data on concentrations of these substances in cerebrospinal fluid. PMID- 3967376 TI - Clinical utility of thyrotropin assays: the responsibility of the clinical chemist. PMID- 3967377 TI - Low neutrophil alkaline phosphatase in renal tubular acidosis with hypophosphatemia after toluene sniffing. PMID- 3967378 TI - Modified liquid-chromatographic method for creatinine determinations. PMID- 3967379 TI - Effects of platelets on collection of specimens for assay of ammonia in plasma. PMID- 3967380 TI - Plasma chromium and chromium excretion in diabetes. PMID- 3967381 TI - In vitro oxalogenesis, and measurement of oxalate in serum. PMID- 3967382 TI - Dye-binding and electrophoretic techniques compared for albumin assay in hypoalbuminemic sera. PMID- 3967383 TI - Detecting iron deficiency by serum tests. PMID- 3967384 TI - Evidence for nonenzymic glycation of antithrombin III in diabetic patients. PMID- 3967385 TI - Temperature control better than calibrators for precision in the microcolumn method for hemoglobin A1c. PMID- 3967386 TI - Will implementation of ICES delay method standardization in clinical enzymology? Scandinavian Committee on Enzymes. PMID- 3967387 TI - Significance of C-reactive protein in spinal fluid. PMID- 3967388 TI - Steroid binding in human saliva. PMID- 3967390 TI - Evaporation effect of Ektachem pierceable caps. PMID- 3967389 TI - Simultaneous liquid-chromatographic determination of five nonsteroidal anti inflammatory drugs in plasma or blood. PMID- 3967391 TI - Interference in a two-site immunoradiometric assay for thyrotropin in a child. PMID- 3967392 TI - Atypical CK isoenzyme bands in serum after cardiac surgery. PMID- 3967393 TI - Serum creatine kinase MB in polymyositis. PMID- 3967394 TI - Determination of glutathione in human platelets. PMID- 3967395 TI - Serum copper concentration no help in diagnosis of colorectal cancer? PMID- 3967396 TI - Urinary ascorbate measurement by rate analysis in a centrifugal analyzer. PMID- 3967397 TI - Analyses of the specificity of mouse monoclonal antibodies to syngeneic and allogeneic thyroglobulins. AB - Fourteen mouse monoclonal antibodies (mAbs) to syngeneic and allogeneic thyroglobulins (Tgs) were prepared to study antigenic determinants, their variation among mouse Tgs, and cross-reactivity with various species Tgs. The binding pattern to the Tg panel classified mAbs into three groups but the clustering by competitive-binding inhibition with unlabeled mAbs suggested that at least five antigenic regions existed on the Tg molecule. Mouse Tgs showed no antigenic variation to our mAbs. The cross-reaction with other species Tgs was strictly limited to rat Tgs, excluding one mAb (8.1.1) which reacted with rat and human Tgs. The competitive-binding inhibition by various doses of Tgs substantiated the binding pattern to the Tg panel and furthermore demonstrated that both complete and partial cross-reactions existed. PMID- 3967398 TI - Analysis of immune complexes by two-dimensional gel electrophoresis. AB - High resolution two-dimensional (2D) gel electrophoresis is useful for analysis of constituents of immune complexes (IC) in serum, provided that the samples for the analysis are prepared by a standardized and effective purification protocol. The details of the protocol, which involve gel permeation chromatography and adsorption with protein A-Sepharose, were worked out with a model system of radiolabeled antigen bound to antibody. With this protocol one can attain an over 50% recovery of the antigen, in a protein preparation purified over 1000-fold with respect to starting amounts in an initial 0.5 ml serum. With silver staining of the 2D gel, the model antigen was detectable at levels of 100 ng initial input. The analysis of eight normal sera and eight sera of patients with systemic lupus erythematosus (SLE) showed no clearly demonstrable differences, suggesting that the latter sera did not contain homogeneous antigens exceeding 100 ng within IC. In addition to IgG, albumin was seen in all preparations, probably due to complexing with immunoglobulin. Trace amounts of other constituents of the samples appeared in some gels, and the presence of C3 related material was detectable only by Western blotting. PMID- 3967399 TI - Lytic effects of serum and mononuclear leukocytes on oral epithelial cells in recurrent aphthous stomatitis. AB - A radioisotope-release assay, utilizing 51Cr-labeled epithelial cells derived from non-keratinizing oral mucosa, was developed to investigate in vitro cytolytic reactions correlating with recurrent aphthous stomatitis (RAS). The cytolytic effects of sera and mononuclear leukocytes from patients in the early stage of ulceration were compared with those from matched RAS-negative control subjects. RAS sera induced significantly more cytolysis than did matched control sera. Heating the RAS or control sera for 30 min at 56 degrees C abrogated their cytotoxic activity. RAS mononuclear leukocytes, like their matched controls, showed no significant direct cytotoxicity. Heat-inactivated RAS or control sera acting in concert with RAS or control mononuclear leukocytes showed no consistent cytolytic effects. However, the heat-inactivated sera of some RAS patients, when combined with autologous mononuclear leukocytes, induced significantly more cytolysis than did either component acting alone. Thus heat-labile humoral factors and, in some cases, mononuclear leukocytes acting in concert with heat stable serum factors are implicated in RAS-associated in vitro cytolytic reactions. These findings suggest that the effector mechanisms of such reactions include both complement-mediated and antibody-dependent cell-mediated cytotoxicity. PMID- 3967400 TI - Two-dimensional and M-mode echocardiographic evaluation of fetal arrhythmia. AB - Cardiac anatomy and rhythm were evaluated in the fetuses of 18 pregnant women (between 20 and 42 weeks of gestation) referred because of abnormal fetal heart rate or rhythm. Utilizing a 3 MHz two-dimensional scan head with M-mode capability, M-mode recordings were obtained at paper speeds of 50 and 100 mm/s from 16 fetuses. The arrhythmia of two fetuses was diagnosed using two dimensional echo alone. Semilunar and atrioventricular valve opening and closing points, A waves, plus ventricular wall motion were used for timing purposes; and heart rate and rhythm were determined. Diagnoses made were atrial premature beats n = 3, ventricular premature beats n = 3, congenital heart block n = 4, supraventricular tachycardia n = 3, sinus bradycardia n = 1, and blocked atrial beats n = 1. In three fetuses no arrhythmia was identified. Cardiac anatomy was normal in 16 fetuses, with two (congenital heart block) felt to have univentricular hearts. Fourteen pregnancies went to term, two were delivered prematurely, and two fetuses with congenital heart block were stillborn. In three fetuses arrhythmia was confirmed during labor by fetal scalp electrode. Arrhythmia was absent after birth in 11 of 16 infants, with congenital heart block persistent in two infants, and supraventricular tachycardia, atrial premature beats, and blocked atrial premature beats remaining in one each. Intervention with medical management was attempted in four pregnancies, with successful termination of arrhythmia supraventricular tachycardia) in two fetuses. We conclude that combined two-dimensional M-mode capability is useful in the diagnosis of fetal rhythm disturbances, and perhaps in the selection of timing, and mode of intervention. PMID- 3967401 TI - Noninvasive recording of His bundle electrograms using vectorial leads system. AB - His bundle electrograms were recorded in 8 rats by a signal averaging technique using the Takayasu vectorial lead system. Animals were anesthetized and placed in the prone position. The polarity of three orthogonal leads were: the X axis, from right to left; the Y axis, from top to bottom; the Z axis, from back to front. Potentials from the X, Y, and Z leads were amplified by 20,000 with high-pass 12 dB/octave filtering at 80 Hz, and signal averaging of 2000 beats was performed at a sampling interval of 100 microseconds. The His bundle potential could be clearly defined in all 8 rats. The mean amplitude of the His potential was larger in the X-axis (23.6 +/- 9.2 mu V) or the Y-axis (28.4 +/- 14.5 mu V) than the Z axis lead (11.5 +/- 8.6 mu V). Directions of the His potential vectors were to the left in 5 of 8 rats (62.5%), to the caudal in 4 of 6 rats (66.7%), and to the dorsal site in 6 of 8 rats (75.0%). This vectorial lead system, devised in accordance with McFee and Johnston's theory on lead field, was useful for recording His bundle electrograms. PMID- 3967402 TI - The apical impulse in coronary heart disease. AB - Forty patients (36 with coronary artery disease), who had angiographic assessment of left ventricular function were studied using apexcardiography with a new method of standardization, the objective being to define the parameters of the apical impulse which reflect changes in the left ventricular function and correlate them with clinical assessment of the apical impulse. Based on measurements from patients with normal left ventricular function, abnormalities in apexcardiograms were identified. An increase in amplitude of percent A wave alone (greater than 13.3%) (palpable as an atrial kick in approximately half of these patients) was not associated with significant left ventricular dysfunction. An isolated abnormality in isovolumic slopes, although associated with mild left ventricular dysfunction, could not be detected clinically. Moderate to severe left ventricular dysfunction was always associated with abnormal ejection phase slopes and all had sustained apical impulses. The additional presence of a palpable atrial kick or an increased percent A wave on the apexcardiogram was more indicative of moderate rather than severe dysfunction. Thus this study clearly establishes that left ventricular function does in fact affect the nature of the apical impulse in patients with coronary artery disease and these can be easily defined. PMID- 3967403 TI - The lowering of daytime blood pressures with a single daily dose of acebutolol in ambulant hypertensives. AB - Intra-arterial blood pressure recordings were studied in 10 ambulant subjects with essential hypertension to evaluate the effect of a single daily dose of acebutolol. Blood pressures and heart rates, measured on a beat-to-beat basis were averaged over every hour, for the daytime, night-time, and for the total 24 hours. Acebutolol significantly lowered the average daytime systolic pressure (160 to 142 mmHg, p = less than 0.01), diastolic pressure (78 to 66 mmHg, p = less than 0.01), and the heart rate (92 to 77 beats/min, p = less than 0.001). Significantly lower pressures were demonstrated up to 11 hours after the last dose of acebutolol. The effect on heart rate lasted up to 13 hours. The observed lowering of pressures and heart rate during the remaining 11 hours did not reach statistical significance. PMID- 3967404 TI - Significance of the Q wave in acute myocardial infarction. AB - Acute myocardial infarction may be associated with the development of Q waves on the electrocardiogram (ECG), or with changes limited to the ST segment or T wave. The ECG changes do not accurately differentiate transmural from nontransmural infarction. However, the presence or absence of a Q wave does correlate with some aspects of the clinical course of patients after myocardial infarction, and is therefore of prognostic value. Q-wave infarctions are more likely to be complicated by congestive heart failure during hospitalization. The in-hospital mortality is also higher after a Q-wave infarction than after a non-Q infarction. Both of these findings are probably due to the association of a Q wave with a larger mass of infarcted myocardium. The long-term mortality, however, is the same for Q-wave and non-Q-wave infarctions. This is probably due to an increased late mortality after non-Q infarctions, related in part to a higher rate of reinfarction. The differences between Q-wave and non-Q-wave infarctions are not due to obvious differences in extent and location of coronary artery obstructions. However, there may be differences in the collateral circulation, with more extensive collaterals associated with non-Q infarcts. Appreciation of the prognostic significance of the ECG changes in acute myocardial infarction may help direct the evaluation and management of the patient after myocardial infarction. PMID- 3967405 TI - Wolff-Parkinson-White syndrome type B and left bundle-branch block: electrophysiologic and radionuclide study. AB - Coinciding left bundle-branch block and Wolff-Parkinson-White syndrome type B, a very rare electrocardiographic occurrence, was found in a patient with dilated cardiomyopathy. Electrophysiologic study revealed eccentric retrograde atrial activation during ventricular pacing, suggesting right-sided accessory pathway. At programmed atrial pacing, effective refractory period of the accessory pathway was 310 ms; at shorter pacing coupling intervals, normal atrioventricular conduction with left bundle-branch block was seen. Left bundle-branch block was seen also with His bundle pacing. Radionuclide phase imaging demonstrated right ventricular phase advance and left ventricular phase delay; both right and left ventricular phase images revealed broad phase distribution histograms. Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates. PMID- 3967406 TI - Idiopathic coronary artery dissection: a rare in vivo diagnosis. AB - A 42-year-old white female, who had an acute myocardial infarction, developed postinfarction angina and underwent coronary angiography seven weeks after the event. Coronary angiogram demonstrated a primary dissection of the left anterior descending artery. To our knowledge this is the sixth such report of a patient with primary dissection of a coronary artery demonstrated by angiography and the fourth such patient reported to achieve and maintain asymptomatic status without operative intervention. PMID- 3967407 TI - Mitral valve prolapse related to geometric changes of the heart in cases of progressive muscular dystrophy. PMID- 3967408 TI - The treatment of choice in osteoarthritis of the knee. AB - Up to the present, no prosthesis has functionally matched a normal, living knee. On the contrary, in many instances, well-planned osteotomies have restored degenerative knees to normal function, superseding the use of arthroplasty. The questions are: What are the limits of these procedures and what can be expected from them? PMID- 3967409 TI - Low-velocity gunshot wounds in police officers. AB - One hundred forty-five Philadelphia police officers were injured as a result of gunfire during the period from January 1971 to February 1983. Arrests and arrest attempts were the most common causes of these injuries; on- and off-duty accidents were the second most common causes. Twenty fatalities occurred among the 145 officers. Specific medical and surgical management of gunshot wounds depended largely on the location of the wound and the extent of the damage. Analyses of the location of the wounds in this study revealed that many could have been alleviated through the use of body armor, such as bullet-proof vests and lightweight helmets. Of the treatment records of 100 patients completed for evaluation, average hospitalization time was ten days, time without duty averaged 143 days, and limited duty averaged 70 days. Twenty-two persons received permanent and partial disabilities related either partially or wholly to their wounds. Fourteen individuals expressed anxiety about returning to work as police officers, and two received disability retirements for emotional instability. An officer who is aware of the probability of injury while performing a specific task can decide whether to wear an armored helmet or bullet-proof vest at the appropriate time. In the treatment of low-velocity gunfire injury, the physician could use the guidelines reviewed for specific treatment of the injury and thus anticipate the length of time or probability of the individual returning to work. Early recognition of these factors could help to avoid psychologic trauma. PMID- 3967410 TI - Congenital dislocation of the hip in the American black. AB - Between 1977 and 1982, 19 cases of congenital dislocation of the hip (CDH) were encountered in black infants. Six of these cases were associated with other anomalies (atypical CDH); 13 were typical CDH. The incidence of complete CDH in the white population studied is 1.5/1000; in the black population studied it is 0.46/1000. The increased incidence in comparison to previous studies may possibly reflect genetic heterogeneity in the control population relative to the African black. PMID- 3967411 TI - Prospective analysis of Sheehan total knee arthroplasty. AB - In a prospective study, the clinical results of 64 Sheehan total knee arthroplasties (TKA) were reviewed in 52 patients, with an average follow-up period of five and one-half years. Like most prosthetic designs in use in 1975, the Sheehan prosthesis did not incorporate patellar resurfacing. The initial clinical success achieved without patello-femoral replacement may become less acceptable with longer follow-up periods. Seventy-four percent of the patients in this study had complete relief of pain or mild discomfort not requiring analgesics. With patellar resurfacing as a secondary procedure in three additional cases, the percent successful results increased to 81%. Five knees (12%) required additional surgery, one because of infection, two because of secondary component failure, and two for loosening. The lack of patellofemoral replacement and prospective failure of both tibial and femoral components, possibly due to high stress-loading in a relatively small surface area, have led to the use of other newer TKA designs. PMID- 3967413 TI - Fracture patterns in thalassemia. AB - Of 61 patients with homozygous beta-thalassemia, 30 had fractures; the majority were single fractures. In three thalassemic families, multiple fractures were observed. Although fractures occurred mostly during the growth period, no epiphyseal fractures were found among the patients in the present study. Roentgenograms showed either horizontal or oblique fractures, frequently with compression, or linear fractures without displacement. No delay in fracture healing or residual gross bone deformities were noted, with the exception of fractures of the femoral neck. On the basis of clinical and scintigraphic examinations, four additional adolescent patients, excluded from this study, were suspected of having microfractures around their ankles and knees. In the future, with improvements in diagnostic methods, microfractures may be found often and recognized as a common source of acute pain about the knees and ankles of thalassemic patients. PMID- 3967412 TI - Total knee arthroplasty. AB - The standard prosthesis for most arthritic conditions is a tricompartmental type. Patellar resurfacing should be done in most cases. The question of cruciate preservation or substitution is unresolved, and both types give equivalent clinical results. No advantage has been shown for left or right components. Correction of deformity occurs by soft-tissue release and ligament balancing, rather than by bone resection. Most primary replacements can be performed in this manner, but alignment is critical to the function and survival of a functioning arthroplasty. Most failures can be attributed to incorrect ligament balance or incorrect alignment. Cement fixation of the components has proved effective, and there is no immediate need for alternative methods such as bone ingrowth; new methods will have to prove themselves against the standard already established for cemented prostheses. Patellar complications such as fatigue fracture of the patellar bone now constitute the majority of problems following total knee arthroplasty. PMID- 3967414 TI - Dorsal myelotomy for relief of spasticity in spinal injury patients. AB - Seven male patients, five complete quadriplegic and two complete high thoracic paraplegic, were treated by dorsal longitudinal myelotomy to relieve intractable spasticity of the lower extremities. All had intact neurogenic bladders before surgery. All patients had initial relief of spasticity but had recurrence of spasticity in varying degrees at two to three months postoperation. One patient had repeat myelotomy with similar results. One patient had successful relief of spasticity but lost neurogenic bladder function. Three patients required surgical releases of spastic contractures after surgery. Only one patient was satisfied with the procedure but required additional procedures for relief of spasticity. None of the procedures was considered successful. Dorsal longitudinal myelotomy is not successful in the treatment of spasticity in the spinal-injured patient. PMID- 3967415 TI - Unusual distribution and onset of stress fractures in soldiers. AB - Ninety-four stress fractures were detected in 64 soldiers by scintigraphy during the first 11 weeks of basic training. Unlike past military studies that showed large numbers of stress fractures of the feet, only 2% were in the metatarsals and none were in the calcaneus. Most fractures were in the tibia (71%) and femoral shaft (25%). Contrary to previous reports in the literature, the fractures occurred later in training, with 67% occurring during the fifth to eighth weeks of basic training and 12 percent during the ninth to eleventh weeks. This unusual distribution and onset has possible explanations in (1) new training concepts to fit modern warfare, with more emphasis on runs and marches; (2) new apparel and equipment carried by the soldiers; (3) changes in prearmy lifestyle; and (4) the extensive use of bone scan for diagnosis. PMID- 3967416 TI - The function of the anconeus muscle. AB - The purpose of the present study is to determine whether the anconeus muscle contracts during abduction of the ulna. Abduction of the ulna occurs when pronation takes place around an axis passing through the head of the radius and the second digit. This is in contrast to pronation around an axis passing through the fifth digit, in which the ulna remains relatively stationary. Electromyograms of the anconeus were obtained from five subjects with the elbow supported in 90 degrees of flexion, in full extension, at rest, during supination-pronation around an axis passing through the fifth digit, and during motion around an axis through the second digit. Pronation of the forearm around the axis through the second digit resulted in the greatest amplitude of individual motor unit action potentials and the highest recruitment of additional action potentials. These findings provide evidence substantiating the function of the anconeus muscle as an abductor of the ulna. PMID- 3967417 TI - The closed cryosurgical treatment of giant cell tumor. AB - Twelve patients with giant cell tumor (GCT) treated by the closed method of cryotherapy along with curettage and bone grafting were reviewed retrospectively. Follow-up examinations ranged from two years and two months to 11 years. There was one osseous and one soft-tissue recurrence. There were no thermally related soft-tissue complications. Five patients suffered six postoperative pathologic fractures. Joint function was well preserved in ten of 12 patients, although five patients have varying degrees of joint pain or instability. Closed cryotherapy, curettage, and bone grafting are effective in the treatment of GCT. Special attention to surgical approach, controlled freezing, bone grafting technique, and a supervised rehabilitation program will minimize the incidence of postoperative pathologic fracture and maximize joint function. PMID- 3967418 TI - Injury to articular cartilage joint surfaces. I. Chondral injury produced by patellar shaving: a histopathologic study of human tissue specimens. AB - Five patella specimens from patients who had previously undergone elective shaving procedures for chondromalacia five months to two years prior to patellectomy were examined. There was no significant repair arising from the articular chondrocytes. Fibrous pannus that originated from the subchondral osseous tissue filled the surgical defects. These cases of failed shaving procedures suggest that it is not advisable to assume that all articular defects that are shaved down to bone will be repaired by new cartilage tissue. PMID- 3967419 TI - Multiple stress fractures. A longitudinal study of a soldier with 13 lesions. AB - A highly motivated 18-year-old man continued vigorous military training in spite of the presence of 11 stress fractures and subsequently developed two additional stress fractures. Scintigraphy over 27 weeks illustrated simultaneous regression and progression in his individual multiple foci. When stress fracture foci were not in anatomic locations prone to evolve to gross fractures, healing occurred despite vigorous activities and pain. PMID- 3967420 TI - Variations in treatment of postmenopausal osteoporosis. AB - The purpose of this study was to determine trends and differences between various medical specialties with regard to the treatment of postmenopausal osteoporosis. The method used was a cross-sectional survey, and the authors' sample was composed of 116 physicians. There was an overall lack of consensus on choice of treatment for postmenopausal osteoporosis. Treatment varies with the individual physician without any strict adherence to a formal therapeutic protocol. Calcium was the treatment modality most widely used by all the specialties. Gynecologists and endocrinologists show the greatest usage of estrogens, while orthopedic surgeons show the least. Fluoride was used significantly less than calcium, vitamin D, estrogen, diet, and exercise by all the specialties surveyed. One in three postmenopausal women in the United States has osteoporosis, and one in five will sustain a hip or vertebral fracture. Twelve to twenty percent of elderly patients die within six months of sustaining a hip fracture. There is an obvious need for carefully constructed clinical programs evaluating multiple agents and diagnostic techniques. PMID- 3967421 TI - The Lottes nail in the closed treatment of tibia fractures. AB - The effectiveness of the Lottes nail was evaluated in 63 consecutive cases of tibia fractures treated by closed intramedullary fixation with image intensification. The procedure was offered to all adults except those with Gustillo and Anderson Type III open wounds and with fractures less than 10 cm from the knee or 5 cm from the ankle. The operations were generally performed within a few days in closed fractures and somewhat later in open fractures. Patellar-tendon-bearing casts were applied five to ten days after operation, and weight-bearing to tolerance was emphasized. All fractures united. Bridging callus was generally seen by seven or eight weeks. Complications not necessarily peculiar to the procedure included one each of delayed wound infection, peroneal neurapraxia, compartment syndrome, heel decubitus, and shortening of more than 2 cm. Technical failures included malunion of fracture, loss of fixation by the nail, backing out of the nail, and penetration into the ankle joint. Most of the complications and technical failures could be remedied and did not influence the ultimate result. The authors recommended the Lottes nail and closed intramedullary nail fixation as the preferred method of treatment of diaphyseal fractures of the tibia in adults. PMID- 3967422 TI - Musculoskeletal lesions in yaws. AB - Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures. PMID- 3967423 TI - Radiocarpal dislocation--classification and rationale for management. AB - Radiocarpal dislocation is a rare injury. The authors reviewed seven cases with this injury and identified two groups of patients. Type I involves a dislocation of only the radiocarpal joint, while Type II involves intercarpal dislocation also. Four patients were included in Type I dislocation (3 dorsal and 1 volar). The other three patients had Type II dislocations, all of which were volar dislocations. Two patients had evidence of injury to the median and ulnar nerves at the time of the injury and both recovered completely. Closed reduction was possible with good results in three patients with Type I dislocation. All patients with Type II dislocation required open reduction and all had residual problems. The distinction between Type I and Type II is essential in order to evaluate the full extent of the injury. Closed reduction should always be attempted in Type I dislocation. Type II dislocation should be treated by open reduction and repair of all torn ligaments. PMID- 3967424 TI - Simultaneous dislocation of the five carpometacarpal joints. AB - Two new cases are added to the literature on four previously reported cases of simultaneous dislocation of the five carpometacarpal joints. The priorities of management of other more extensive injuries often delays definitive treatment and in the two cases reported here open reduction and internal fixation was necessary to restore the functional structure of the hand. Restoration of normal grip and pinch strength was obtained in both patients with stable, pain-free carpometacarpal joints. PMID- 3967425 TI - Pathologic fracture risk in rehabilitation of patients with bony metastases. AB - Fifty-four patients with metastatic bone disease were followed prospectively to assess the risk of pathologic fracture during rehabilitation. Sixteen fractures were observed in 12 patients. Only one fracture occurred while the patient was undergoing rehabilitation, and this was a fourth lumbar vertebral compression that did not affect the clinical course of the patient. Patients in the fracture group were generally younger, female, and in a more advanced stage of disease with lytic metastases and a previous occurrence of pathologic fracture. PMID- 3967426 TI - The fatigue resistance of orthopaedic wire. AB - The fatigue resistance of stainless-steel orthopaedic wire was investigated in samples of commercially available (1.2 mm, 16-gauge) stainless-steel wire. The wires were subjected to various types of notching, bending, twisting, and knotting and were then tested on a specially designed wire fatigue testing fixture. The results indicate that a 1% notch is enough to reduce the fatigue resistance of the wire by 63%. Bending, twisting, and knotting of the wire did not appear to seriously affect the fatigue resistance. PMID- 3967427 TI - Total joint arthroplasty of the knee. AB - The total knee experience at a hospital in Baltimore with the Universal Instruments and Total Condylar and Kinematic prostheses in 1978 and 1979, and with the PCA prosthesis with and without cement since 1980, has led to the development of the philosophy that impacts on all aspects of total knee arthroplasty. In most instances, if the patient is a suitable risk for surgery and symptoms are sufficiently disabling to justify knee fusion, the authors would first attempt a total knee arthroplasty regardless of age, weight, or other factors. Technical perfection of alignment and component position are their goals. The vast majority of total knee components can be mechanically fixed rigidly without the addition of methylmethacrylate. In general, clinical examinations (up to four years) suggest that the cementless results were equally as good as the cemented results and did not have a tendency to deteriorate with time. PMID- 3967428 TI - Interobserver variability in interpreting radiographic lucencies about total hip reconstructions. AB - Radiographs are commonly used to identify the loosened total hip reconstruction (THR), to plan revision surgery, and to evaluate long-term follow-up patients for study purposes. Interobserver variability was studied in an attempt to interpret 63 random follow-up films in a group of 93 patients eight to 12 years post-THR. Nine observations were made on the acetabular and femoral sides of the reconstructions on all films for a total of 567 observations. There was considerable disagreement in observations of the acetabular lucencies; a consensus of all three observers was obtained only 46% of the time. There was more uniform agreement among observers (87%) in analyzing the femoral side, although agreement was most frequent when there was no lucency. There was no difference in observer variables when greater lucencies were reported by one or more observers than when there were smaller lucencies. It was concluded that a single observer can reliably record a femoral observation of no lucency and, making allowances for the Mach effect, can reliably distinguish the presence or absence of a lucency. However, a single observer may not be able to make observations of acetabular lucencies with great reliability and, in contrast to femoral lucencies, a single observer may be less reliable in recording acetabular lucencies over 2 mm as compared with those under 2 mm. PMID- 3967429 TI - Posterior stabilization of pelvic fractures by use of threaded compression rods. Case reports and mechanical testing. AB - Threaded compression rods were placed between the posterior-superior spines as a means of posterior stabilization of pelvic fractures. To document the increase in sacroiliac stability afforded by this technique, biomechanical testing was performed. Malgaigne-type fractures with sacroiliac disruptions were created in four cadaver pelvises. The fractures were stabilized with anterior frames of the Slatis or Pittsburgh type and subjected to longitudinal and torsional loading patterns on an Instron machine. The anterior fixation was then augmented with threaded compression rods placed between the posterior-superior spines to compress the disrupted sacroiliac joints, and repeat testing was conducted. Anterior frames alone were found to provide little stabilization of the disrupted sacroiliac joints with either longitudinal or torsional loading. Markedly improved stabilization in both loading modes was achieved with posterior augmentation. Two typical cases are presented to demonstrate that posterior stabilization is as efficacious in clinical practice as in the biomechanics laboratory. PMID- 3967430 TI - Hip fractures: condylocephalic rod versus compression screw. AB - In a series of 70 consecutive patients with nonpathologic intertrochanteric or subtrochanteric hip fractures, the first 35 were treated by a single semi flexible condylocephalic nail. The second 35 patients were treated by a sliding compression screw and side-plate. The groups were comparable regarding age and intercurrent medical illness. The average anesthesia time and blood loss were nearly the same in each group. The incidence of failure of fracture fixation was high in the group treated by the condylocephalic nail, statistically significant at p less than .001. None of the patients treated by the sliding compression screw and side-plate lost fracture fixation. In this series, condylocephalic nails did not provide good fixation of this type of fracture and did not lessen surgical morbidity. PMID- 3967432 TI - Shoulder motion and muscle strength of normal men and women in two age groups. AB - Normal age- and sex-related standards for shoulder range of motion (ROM) and muscle strength are unavailable in the literature. Active range of shoulder motion and maximum isometric strength (torque) of several shoulder muscle groups were measured in normal healthy men and women between 25 and 36 and between 55 and 66 years of age. Values for joint motion were similar for the two age and sex groups. The strength of the women was 45% to 66% of that in men, and strength of the older subjects was 66% to 93% of that in younger subjects. Strength of the second attempt at contraction was greater than that of the first attempt. Arm dominance did not significantly affect strength values. PMID- 3967431 TI - The effect of immobilization devices on the load distribution under the foot. AB - The load distribution under the foot was investigated under various conditions by means of pressure-sensitive transducers. Weight-bearing pressures at the first and third metatarsal heads and at the heel were measured while subjects ambulated barefoot and while wearing numerous immobilization devices. The proportion of body weight imposed on the plantar surface of the foot is dependent on the specific gait pattern displayed during barefoot walking. Maximum reduction of forefoot loads was achieved by means of a short-leg walking cast or an ankle boot cast with a posteriorly placed flat rubber heel. A centrally placed rocker heel leads to increased forefoot loads, especially under the first metatarsal head. Casting devices used in conjunction with cast shoes were not as effective in pressure reduction as the same cast with a posteriorly placed heel, but they were more effective than the rocker heel. The height of the cast and configuration of the sole of the cast shoe had little effect on the observed patterns of force distribution. The wooden-soled post-operative shoe did decrease weight-bearing pressures as compared with barefoot walking and casts with a rocker heel but was less effective than the other devices studied. Peak loads measured at the sole of the foot were dependent on the position of the ankle and subtalar joints at the time of cast application. PMID- 3967433 TI - An improved rabbit restraint for chronic hind limb studies. AB - With the use of an easily fabricated plastic tube restraint system, studies that require avoidance of weight-bearing can be performed on rabbits comfortably maintained with the hind limb immobilized for periods as long as six weeks. PMID- 3967434 TI - Effect of long-term nontraumatic immobilization on metaphyseal spongiosa in young adult and old beagle dogs. AB - A radiographic and histomorphometric change in volume in the metaphyseal spongiosa in response to long-term immobilization was investigated in young adult and old beagle dogs and compared with changes in diaphyseal compacta of the same bones. Sixty weeks of nontraumatic immobilization of young dogs produced a 66% loss of metaphyseal spongiosa in the third metacarpus, a 50% loss in the radius, and a 25% loss in the humerus. In older animals, the loss amounted to 54%, 46%, and 37%, respectively. In both age groups, the loss of the spongiosa exceeded that of the compacta in the same bones, and, as in the compacta, it was greatest in the small peripheral bones. Although maximal loss occurs during the first 24 to 32 weeks, it may continue to a lesser degree up to 60 weeks and perhaps beyond 60 weeks of immobilization. Since bone loss can occur only on bone surfaces, the earlier and greater loss from the spongiosa may be explained in part by the higher endosteal surface-to-volume ratio of spongy bone. Given a similar bone structure and physiology in man and dog, the observations made in this study may apply to man as well. PMID- 3967435 TI - Local administration of antibiotics with an implantable osmotic pump. AB - A totally implantable drug pump was evaluated as a delivery system in the treatment of osteomyelitis. Gentamicin levels in rabbit serum and bone obtained by systemic administration are compared with levels in rabbit serum and bone obtained by local administration via an implantable drug pump. Systemic administration gave mean gentamicin bone levels ranging from less than 1 microgram/gm to 3.6 micrograms/gm, while drug pump administration gave bone levels ranging from 10.8 micrograms/gm to 64.0 micrograms/gm (micrograms = microgram, or 10(-6) gram). To evaluate the drug pump as a mode of therapy, acute staphylococcal osteomyelitis was induced in ten rabbits. Drug pumps filled with amikacin were inserted in five of the infected animals. Three of these were culture-negative at one week. One had a scant growth of Staphylococcus from the pump, and one had scant growth from the pump and the wound. Clinically, none of these five rabbits appeared infected at seven days. The remaining five rabbits were all culture-positive, with heavy growths of staphylococci from their wounds, and clinically, all appeared grossly infected at seven days. These data demonstrate that high local and low systemic levels of antibiotics can be achieved with an implantable drug pump and that this method can sterilize an infected musculoskeletal wound. Therefore, antibiotic administration via an implantable drug pump is an important potential mode of therapy in the treatment of osteomyelitis. PMID- 3967436 TI - Semirigid rod fixation for long-bone fracture. AB - Experiments on 119 New Zealand rabbits were performed to measure healing strength of femurs. Four pairs of normal rabbit femurs were also studied in vitro by use of a four-point bending test to measure bending rigidity. Rabbit-sized octagonal cross-sectioned intramedullary rods with 12%, 20%, 50%, 75%, and 100% of femoral bending rigidity were specially prepared. For each animal, one intramedullary rod was implanted in an osteotomized femur through a standard lateral approach, with the other femur serving as a control. The results from the 12% rigidity rods were widely variable. In the 20% and 50% rigidity groups, the callus diameter was increased over the 75% rigidity group through all phases of healing. The torque ratio in this group increased up to eight weeks and then converged to the ratios of the other rigidities. The 75% rigidity group had shown increase of angular displacement up to eight weeks, while the 20% and 50% rigidity groups continued to improve and reached control strength at 12 weeks of treatment. Furthermore, the 20% and 50% groups absorbed more energy to failure in the later stage of healing than the 75% and 100% rigidity groups. Rods of 20% and 50% rigidity stimulate external callus formation and improve the stability of healing bone. PMID- 3967437 TI - Guidelines for Chiari's osteotomy in the immature skeleton developed from a canine model. AB - Three variations of Chiari's pelvic osteotomy were performed on 18 dysplastic hip joints in young, growing German shepherd dogs and rottweilers. The results of the operations and the reactions of the skeletal tissue were investigated radiologically and histologically after six and 12 months. By use of polyfluorochrome sequential labeling and microangiography, it was demonstrated that neither the formation of new bone nor the blood supply in the vicinity of the rim of the acetabulum (apophysis of the acetabular roof) was seriously impaired by the operation. Conversely, the operative technique was of decisive importance to the result of the operation. Only if the osteotomy was performed through the original acetabular rim, completely covering the femoral head, was the newly formed acetabular roof adequately biomechanically loaded, providing the conditions required for functionally adapted differentiation of skeletal tissue. Chiari's pelvic osteotomy can be performed on canine hips with good chances of success, provided one uses the proper operative technique. Apophyseal bone growth and the blood supply of the newly formed acetabular roof were apparently not disturbed by Chiari's operation. PMID- 3967438 TI - Total knee arthroplasty. AB - Eighty-six nonhinged total knee arthroplasties performed between 1971 and 1981 have been reviewed. Fifty-one were of the geometric type and 35 of the anametric type. The use of both units resulted in a statistically and clinically significant improvement in preoperative pain and an increase in functional activities. Three of 51 geometric units developed loose components that required revision. None of the 35 anametric units has required revision for loosening. Partial radiolucent lines at the tibial bone-cement interface were noted in 43% of the group. Data analysis of age, weight, and sex demonstrated no statistically significant characteristic of this group when compared with the group without radiolucent lines. However, radiolucent lines were more common in those patients with osteoarthritis than in the group with rheumatoid arthritis. In addition, radiolucent lines were noted in 90% of knees in which a metal-backed tibial tray with a central post was used, compared with 36% of knees without metal-backed tibial components. Relief of pain and correction of instability and deformity can be achieved for most patients following nonhinged total knee arthroplasty. PMID- 3967439 TI - Total knee arthroplasty in 1984. AB - In total knee arthroplasty, as little bone as possible should be removed, all intact ligaments should be saved, and fixation by biologic ingrowth, rather than methylmethacrylate, should result in the lowest incidence of loosening. PMID- 3967440 TI - Freeman-Samuelson total arthroplasty of the knee. AB - Experience with cementless fixation over the last six years indicates that the technique offers greater opportunities for bone conservation. Thus, when cement is used, and especially if it is forced into the skeleton under pressure, the amount of bone incorporated into the implant is considerable. Conversely, if no cement is used, grafting techniques to fill defects are becoming increasingly routine, so that today no bone may be removed from the replaced knee or hip--all fragments that are excised are repositioned as grafts in defects. Thus, cementless fixation meets the fundamental orthopedic maxim of the conservation of bone stock. Given that an implant can be fixed with satisfactory clinical results without cement and without bone ingrowth, it becomes difficult to demonstrate a clinical advantage for the latter. Nevertheless, bone ingrowth is possible both experimentally and (with less confidence) in man. Thus, it is clearly a technique that should be evaluated. However, it is not, in the senior author's view, a technique that should as yet be generally used. Hopefully, investigations of this problem will take place in a restrained scientific way rather than by the current method, which is in response to the dictates of fashion and commerce. PMID- 3967441 TI - Essay on total knee arthroplasty. AB - Patient selection in total knee arthroplasty can be a difficult problem for the surgeon. It appears that more young patients are appearing with advanced arthritis of the knee than in the past. Many patients have had previous knee injuries resulting in premature development of degenerative arthritis. The authors believe that in selected cases total knee arthroplasty may be offered to younger patients. Young patients incapacitated by rheumatoid or inflammatory arthritis should not be denied reconstruction by total knee arthroplasty. The problem arises in the more active patient in his forties or fifties who has advanced arthritis of the knee not suitable for treatment by other means. The authors believe that these patients should not be treated by conventional total knee arthroplasty. On an experimental basis, the authors have been performing cementless total knee arthroplasty in younger, more active patients with disabling arthritis. Precision of surgical technique is critical with the newer cementless type of knee replacement. PMID- 3967442 TI - Unicompartmental and total knee arthroplasty. AB - Pain is the main indication for a total knee arthroplasty, and the choice of prosthesis should depend on the arthritic involvement of the joint. There is no substitute for early motion after the operation to regain knee motion. Unicompartmental replacement is valuable to preserve ligament and bony stock in properly selected cases. Excellent results can be expected in even elderly patients with severe arthritis if the operation is well performed. PMID- 3967443 TI - The anatomic total knee resurfacing arthroplasty. AB - The long-term results of total knee arthroplasty are largely dependent on the degree to which the implants and the technique for their insertion duplicate the normal joint anatomy, mechanics, and kinematics. Aberrations in these modalities, occasioned by technical malalignment of the joint or by nonanatomic designing, sizing, or positioning of the implants, are the predominant causes of postoperative limitation of motion and loosening of the implants. Although inadequacies in the bonding effect of cement and in the structural strength of polyethylene have been cited as contributing factors in the incidence of loosening of the tibial component, this complication occurred in less than 2% of 532 cemented Anatomic Total Knee (ATK) replacements that were available for review at a follow-up period of two to 11 years. The long-term follow-up results, based on pain relief, motion, and level of activity, were judged excellent or good in 89% of the knees. Problems related to the patella and loosening of the tibial component were the predominant mechanical complications that required revision. The incidence of loosening was routinely related to technical malalignment of the knee joint or the prosthesis. However, experimental and recent clinical studies indicate that porous-surfaced implants may provide a more durable and long-lasting mode of stabilization. Except for the adaptation of the implants to the porous-coated, noncemented technique, the ATK arthroplasty ensemble has remained essentially unchanged from the original 1972 design. PMID- 3967444 TI - Experiences with three distinct types of total knee joint arthroplasty. AB - Experience with three different designs of total knee systems indicates that generally excellent knee function can be afforded the majority of patients for many years. The identification of patients who presently cannot expect satisfactory long-term function (the young, muscular, or obese, yet otherwise normal, individual, for instance) and their exclusion as candidates is important for long-term success. The importance of postoperative limb alignment and component position is emphasized. Gross instability and great metaphyseal bone loss are identified as the indications for linked, primary, or revision total knee arthroplasty. The role of the dynamic behavior of trabecular bone is hypothesized to be of major importance in long-term prosthetic knee joint function. PMID- 3967445 TI - Cystic fibrosis in Pueblo Indian children. AB - Three Pueblo American Indian children with cystic fibrosis are described. The three cases constitute a higher incidence of cystic fibrosis in Pueblo Indians than would be expected from the known rarity of this disease in American Indian populations. This report discusses the possible genetic implications and emphasizes the need to consider the diagnosis of cystic fibrosis in American Indians with appropriate symptoms. PMID- 3967446 TI - Cystic fibrosis mistaken for idiopathic biliary atresia. AB - Previous reports of prolonged jaundice in cystic fibrosis have not described operative and histopathological findings in the liver and biliary tree. In the two cases reported here, obstructive jaundice in the neonatal period was associated with anatomical evidence of intra- or extrahepatic biliary obstruction. Hepatoportoenterostomy, a surgical procedure that is not without complications, was performed on one of the patients for biliary atresia before the diagnosis of cystic fibrosis was suspected. Prolonged obstructive jaundice may be an early manifestation of cystic fibrosis and may resolve without operative management. A sweat test should be performed on all patients with prolonged obstructive neonatal jaundice to rule out cystic fibrosis. PMID- 3967447 TI - Extrapyramidal movements in a patient with tuberculous meningitis. An early clue to diagnosis. PMID- 3967448 TI - A human umbilical cord with four arteries. AB - An unusual case of a newborn infant with four umbilical arteries is presented. Multiple catheterizations revealed that triplication of the right umbilical artery was responsible. There were no associated malformations, and follow-up at 9 months of age revealed age-appropriate growth and development. This case extends the spectrum of observable umbilical artery anomalies. PMID- 3967449 TI - Management and outcome of necrotizing enterocolitis. AB - A survey of all cases of NEC in the State of Georgia during 1977 and 1978 identified 148 infants with NEC. Fifty-two of these infants were treated surgically, and the survival rate was 48 percent (26/54). The survival rate of medically treated patients was 68 percent (64/94) p less than 0.02. Survival was inversely associated with birthweight, although the survival rate following surgery was similar regardless of size. Age of presentation did not influence frequency of surgery or survival, but if perforation at surgery was present in smaller infants (less than or equal to 1500 g) the survival was less than if operation occurred prior to perforation (78% vs. 39%) p less than 0.05. The type of surgical procedure required also was associated with survival. The survival rate was greatest (90%) if only large bowel was removed and least (27%) if small bowel was resected. These results indicate the influence of birthweight, surgical procedure required, and presence or absence of perforation on survival and particularly surgical survival in NEC. They suggest that reviews of outcome in surgical management must take into account the extent of the surgical procedure that it was necessary to employ. PMID- 3967450 TI - Serum immunoglobulins in the first year of life. AB - Serum IgG, IgM, and IgA were measured in 316 infants younger than 12 months of age. Information including the child's race, sex, age, and past history of infections or atopy was collected. Birth records were also reviewed to ascertain the child's birthweight and gestational age. Serum IgG levels were higher in black infants than in white infants after the age of 4 months. Serum IgM levels were higher in black females than in black males for infants older than 1 month. For infants younger than 4 months of age, those weighing less than 2500 g at birth had lower IgG levels than those weighing more than 2500 g. Infants younger than 1 month whose gestational age had been less than 36 weeks had lower IgG levels than those greater than 36 weeks. Infants aged 1 to 4 months whose gestational age had been less than 36 weeks had lower IgG levels than did those 40 or more weeks. Infants with a positive history for atopy had lower IgG levels than similarly aged infants with a negative history. PMID- 3967451 TI - Spinal bracing and respiratory function in Duchenne muscular dystrophy. PMID- 3967452 TI - Family-focused services for children with rare disorders, exemplified by bladder exstrophy. A Norwegian national health program. AB - Families of children with rare disorders have many experiences in common, as well as special problems related to the specific disorder. This paper presents Frambu Health Centre and the family-focused services offered to patients with bladder exstrophy during the first information and treatment course arranged for this group at the Centre. Main areas of concern as reported by the families are presented. PMID- 3967453 TI - Trimoprostil plasma concentration--gastric acid inhibition relationships: potentiation by food. AB - A single, oral, 1.5-mg dose of trimoprostil was taken before a standard meal and a matching placebo was taken after a standard meal by 10 subjects (group A). A second group of 10 subjects took placebo before a meal and trimoprostil after the meal (group B), while a third group took placebo both before and after the standard meal (group C). Food-stimulated gastric acid production was measured by intragastric titration for 6.5 hr after dosing. Trimoprostil taken after the meal had a greater effect on gastric acid secretion than when taken before the meal: Duration of effect was 5 to 5.5 hr in group B and 2 to 2.5 hr in group A. Blood samples were drawn and assayed for trimoprostil by gas chromatography-mass spectrometry. Mean trimoprostil plasma concentration and mean inhibition of gastric acid secretion data were fit to two models by the Hill equation. The mean plasma concentration associated with 50% inhibition of gastric acid secretion was 1.25 ng/ml. Trimoprostil plasma concentrations between 3 and 4 ng/ml were associated with 70% to 80% gastric acid inhibition. Overall, there appears to be a pharmacokinetic-pharmacologic correlation between trimoprostil plasma concentrations and inhibition of gastric acid secretion. Trimoprostil (1.5 mg) in the presence of food appears to have a therapeutic advantage, in that it decreases acid secretion longer than when taken without food and suffers no loss of bioavailability. PMID- 3967454 TI - Absolute bioavailability of amiodarone in normal subjects. AB - The relative and absolute bioavailability of different oral forms of amiodarone was examined in 12 subjects. The doses were 5 mg/kg iv, two 200-mg commercial tablets by mouth, two 200-mg tablets (new formulation) by mouth, and 400 mg in a drinkable solution. Plasma levels of amiodarone and its N-desethylated metabolite were determined by HPLC. Statistical analysis indicated bioequivalence of the oral forms for all the kinetic parameters examined. After oral dosing, amiodarone was slowly absorbed and the maximum plasma level (0.55 +/- 0.20 mg/l) was reached in 4.5 hr. The absolute bioavailability of oral amiodarone was calculated by comparison of AUCs after oral dosing with those after intravenous injection. A mean oral bioavailability of 65% +/- 22% was indicated. Since the tablets were bioequivalent to the drinkable solution, incomplete absorption seems not be a result of the dissolution characteristics of the commercial formulation but rather of a first-pass effect. PMID- 3967455 TI - Prophylactic amantadine dose and plasma concentration-effect relationships in healthy adults. AB - Amantadine dose, plasma concentration, prophylactic and adverse effect relationships for prevention of influenza A virus infection in healthy young adult subjects were investigated in a double-blind, placebo-controlled study. Seventy-four subjects with hemagglutination inhibition antibody titers less than or equal to 16 against an attenuated influenza A virus AF9/Montreal/3/72 (H3N2) were randomly allocated to groups taking 0 (placebo), 25, 100, or 150 mg amantadine syrup prophylactically twice a day for 31 doses. Eighteen other subjects were randomly allocated to control groups for investigation of drug toxicity (150 mg) or concurrent other virus infection (placebo). Steady-state trough plasma concentrations were 110 +/- 39, 302 +/- 80, and 572 +/- 207 ng/ml (X +/- SD) for the three amantadine doses and increased out of proportion to dose. Prophylaxis groups were challenged intranasally with virus after the fifth dose at steady state; control subjects received saline solution. No subject became ill. Input virus was recovered 48 or 72 hr after challenge from nose or throat swabs of nine of 21 subjects taking placebo, one of 18 subjects taking 100 mg amantadine, three of 18 subjects taking 25 mg amantadine, and six of 17 subjects taking 150 mg amantadine. There were no differences in seroconversion rates or adverse symptoms. Our data do not support a change in the recommended amantadine prophylactic dose for influenza A virus infection in healthy young adults. We defined trough steady-state plasma concentrations associated with the recommended amantadine dose of 100 mg twice a day that should be mimicked in devising dose schedules for populations with differing amantadine kinetics. PMID- 3967456 TI - Amantadine kinetics in healthy elderly men: implications for influenza prevention. AB - Amantadine kinetics were investigated in 10 healthy elderly men 60 to 76 yr old. We calculated a dose that would yield the same trough steady-state plasma amantadine concentration (Cpss; 300 ng/ml) as a 200 mg/day dose taken by young healthy adults; this dose prevents influenza A virus infection and is well tolerated by this population. With a one-compartment open model, kinetic parameters were calculated after a single dose of 25, 50, or 75 mg or the same dose twice a day for 10.5 days. Peak concentration occurred 4.0 to 8.0 hr after dosing, but the calculated AUC was proportional to dose, indicating that relative bioavailability was independent of dose. This was supported by recovery of 88% of the single doses in urine. No change in apparent volume of distribution was found. Log trough Cpss increased with dose. Trough Cpss varied less than 300% for equivalent doses. There was first-order elimination of drug from plasma, with a median t1/2 of 28.9 hr (range 18.5 to 45.0 hr), and elimination was independent of dose and creatinine clearance. The median ratio of renal amantadine clearance to creatinine clearance was 2.07 (range 0.64 to 4.20), suggesting renal tubular secretion. Compared to data from healthy young adults, the t1/2 was doubled and renal drug clearance was diminished in elderly men. To achieve the target trough Cpss of 300 ng/ml, healthy older men must take amantadine at a dose of 1.4 mg/kg/day, and we suggest that this is a rational dose for evaluation of efficacy and safety for influenza A prophylaxis in this population. PMID- 3967457 TI - Reliability of amitriptyline dose prediction based on single-dose plasma levels. AB - To assess prospectively the predictability of therapeutic dosage based on tricyclic antidepressant (TCA) concentrations after a single dose, 30 subjects were given amitriptyline. In the first 11 subjects maintained on a fixed amitriptyline dose regimen, predictive capacities of 18- and 24-hr single-dose levels were assessed and confirmed in relation to steady-state levels. For the other 19 subjects, the dose that would achieve a therapeutic steady-state concentration of 200 ng/ml was predicted from the 18-hr single-dose level and was rapidly instituted. Subjects achieved a mean steady-state TCA level of 204 ng/ml, with approximately 90% of the levels falling within the therapeutic range. There was clinical improvement within 2 wk in 84% of the subjects. Our results suggest that dose prediction based on TCA levels after a single dose is reliable and useful. PMID- 3967458 TI - Effects of nifedipine and diltiazem on plasma levels and renal excretion of beta acetyldigoxin. AB - To determine whether nifedipine or diltiazem affect digoxin kinetics, glycoside plasma concentrations and renal excretion were measured before and during dosing in 23 patients with cardiac insufficiency achieving steady-state conditions. Mean (+/- SD) digoxin plasma concentration was 0.64 +/- 0.22 before and 0.61 +/- 0.21 ng/ml during nifedipine dosing in 11 subjects over a period of 10 to 14 days. Renal digoxin clearance was not influenced by nifedipine, whereas total body clearance and extrarenal clearance of digoxin increased slightly. In contrast, diltiazem resulted in a 24% to 70% (means = 46%) increase in plasma digoxin concentrations in eight of 12 subjects. Renal digoxin clearance was not influenced by diltiazem, whereas total body clearance and extrarenal clearance of digoxin were reduced 28% and 44% in five of the eight subjects in whom renal digoxin excretion was measured. From these data it was concluded that nifedipine has no significant effects on digoxin kinetics, but that digoxin plasma concentrations should be controlled in subjects receiving digoxin with diltiazem until new steady-state digoxin concentrations are established, and that the digoxin dose be reduced if there is evidence of toxicity. PMID- 3967459 TI - Nadolol, propranolol, and thyroid hormones: evidence for a membrane-stabilizing action of propranolol. AB - Ten normal subjects participated in a placebo-controlled, randomized, parallel study to determine the effects on thyroid hormones of chronic (4 wk) propranolol or nadolol, including observation for 2 wk after their discontinuation. Subjects took placebo for 1 wk, then propranolol or nadolol doses increased weekly to 240 mg/day by 3 wk. After 1 wk of placebo, after 2 wk of the highest dose of propranolol or nadolol, and 2, 4, 6, 9, and 13 days after their discontinuation, thyroid hormone levels were measured by radioimmunoassay and heart rate responses to exercise were assessed. Both drugs induced equal and high degrees of exercise tachycardia inhibition. Propranolol decreased 3,3'5-triiodothyronine (T3) levels, increased 3-3'-5'-triiodothyronine (rT3) levels, tended to increase thyroxine levels, but did not increase thyroid-stimulating hormone levels. After discontinuation of propranolol, rT3 levels slowly (day 6) returned to values after placebo, suggesting delayed recovery of 5'-deiodination. There was no evidence of any rebound in T3 levels after withdrawal of propranolol. Nadolol induced no significant changes in the thyroid hormones measured. The data agree with the known effects of propranolol on thyroid hormones in normal man and show that nadolol does not have these effects when given chronically at an equivalent beta-blocking dose. The likely explanation is that the membrane-stabilizing activity of propranolol alters thyroid physiology by interfering with 5' deiodinase. PMID- 3967460 TI - Dose-related cardiac electrophysiologic effects of sulfinpyrazone. AB - To test the hypothesis that sulfinpyrazone exerts cardiac electrophysiologic effects, the drug was intravenously injected into 20 subjects during invasive electrophysiologic testing. Sulfinpyrazone was given intravenously as a bolus and by infusion to achieve two different and stable serum levels. The 20 subjects who were treated with drug were assigned to either a low- (N = 10) or high- (N = 10) dose regimen. The resultant four serum levels of sulfinpyrazone were 102 +/- 45, 199 +/- 75, 278 +/- 57, and 352 +/- 77 X 10(-3) mumol (means +/- SD). Electrophysiologic measurements were made during a baseline electrophysiologic study and at each of the sulfinpyrazone levels and at equivalent times in an untreated control group (N = 11). Two electrophysiologic measurements differed when measured at the highest level of sulfinpyrazone and in control subjects: increased HV interval in sinus rhythm and shortened atrial functional refractory period in sinus rhythm (only for those values below the median). Serum levels of sulfinpyrazone correlated with increased sinoatrial conduction time (only for those values above the median; r = 0.64) and with shortened atrial functional refractory periods (r = 0.37). The latter was stronger (r = 0.67) when only values below the median were included in analysis. Shortening of atrial functional refractory period correlated with serum sulfinpyrazone levels during atrial pacing at fixed cycle lengths of 600 and 500 msec. Serum levels of sulfinpyrazone did not correlate with changes in HV interval. HV intervals did not increase in subjects receiving sulfinpyrazone during atrial pacing and, therefore, the effect on HV interval in sinus rhythm is felt to be spurious.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967461 TI - Liver-specific autoantibodies in chronic hepatitis B virus infection. AB - Anti-liver-specific protein (LSP) antibody and liver membrane autoantibody (LMA) have been evaluated in 88 patients with hepatitis B virus (HBV)-induced chronic liver disease by means of radioimmunoprecipitation and immunofluorescence. Among our patients, 38 presented circulating HBe antigen while 43 had HBe antibody and seven were negative for both. Anti-LSP was mainly found in HBeAg positive chronic active hepatitis (CAH), anti-HBe in positive CAH and in anti-HBe positive chronic persistent hepatitis (CPH). Similar prevalences of LMA (range 13-33%) were detected in the various groups studied. Taking into account the histological diagnosis of disease activity (periportal inflammation and piecemeal necrosis) no significant differences were found between active and inactive patients. Taking into account the HBeAg/anti-HBe status, no significant differences were found between the patients positive for 'e' antigen or 'e' antibody. Humoral autoimmune reactions may also play a role in HBV-induced chronic (active) liver disease irrespective of HBeAg/anti-HBe status and hence of the viral replication activity of the patients. PMID- 3967462 TI - Cholestasis induced by sulphated glycolithocholic acid in the rat: protection by endogenous bile acids. AB - Sulphated glycolithocholic acid (SGLC) causes cholestasis in experimental animals, despite its sulphated form. In the present study, the cholestatic potency and the pharmacokinetics of SGLC were investigated in rats under two conditions: (a) in the presence of an intact circulating bile acid pool and (b) after exhaustion of the bile acid pool by 24 h of bile diversion. Intravenous administration of SGLC (8 mumol/100 g body weight) to rats with an intact bile acid pool did not cause cholestasis. However, biliary phospholipid and cholesterol concentrations were reduced by 40% and 29% respectively during the first hour after administration. When the same dose of the bile acid was injected in rats with a 24 h biliary drainage, a complete cessation of bile production was observed within 1 h. Twelve hours after the onset of cholestasis, bile production gradually increased again, showed a marked overshoot, and reached control levels after 3 days. In the recovery phase, biliary phospholipid and cholesterol concentrations were greatly reduced. The absence of endogenous bile acids did not change the hepatic clearance rate of a tracer dose of radiolabelled SGLC, but markedly decreased its biliary excretion rate. It was concluded that the hepatotoxic effect of SGLC is much more pronounced in rats with an exhausted bile acid pool, possibly due to a slower biliary excretion of the toxic compound. This phenomenon may have clinical implications for patients with a contracted bile acid pool. PMID- 3967463 TI - Potentiation of cardiac vagal action by cold. AB - The effect of cold on vagal action at the heart was studied in sheep, dogs and an isolated guinea pig atrial preparation. During cardiac output measurements in unanaesthetized sheep, by the thermodilution method, bradycardia was evoked on injection of cold indicator in eight of 12 sheep studied. This bradycardia was consistently evoked when blood pressure was increased, but not at normal blood pressure levels. In the guinea pig atrial preparation, which has one vagus nerve attached, bradycardia was evoked by electrical stimulation of the vagus nerve. When the preparation was cooled this bradycardia was potentiated. In anaesthetized dogs, the cut peripheral end of one vagus was stimulated electrically at different frequencies. The linear relationship between pulse interval and vagal frequency was then compared at deep body temperatures of 35, 37, 39 and 41 degrees C. This comparison showed that the vagus prolonged pulse interval more effectively when the animal was cool (35 degrees C) than when it was warm (41 degrees C). PMID- 3967465 TI - Cytoplasmic free [Ca2+] is increased in the platelets of spontaneously hypertensive rats and essential hypertensive patients. AB - The cytoplasmic free calcium concentration [( Ca2+]i) was assessed with the fluorescent dye Quin 2 in platelets and lymphocytes of spontaneously hypertensive rats (SHR), normotensive Wistar-Kyoto rats (WKY), essential hypertensive patients (EHP) and normotensive human control subjects (NCS). [Ca2+]i was significantly higher in the platelets of 8- and 20-week-old SHR in comparison with WKY. However, no difference was evident after weaning. Changes of cellular calcium in hypertensive rats apparently evolved simultaneously with the development of high arterial pressure. [Ca2+]i was significantly higher in platelets of EHP than in NCS. In lymphocytes of SHR, [Ca2+]i was not different from WKY at 4 and 8 weeks, but was increased at 14 weeks and at older ages. In EHP, intralymphocytic [Ca2+] was only modestly higher than in controls. On the whole, the results suggest that control of cytoplasmic calcium in these blood cells is similarly affected in human and animal models of primary hypertension. PMID- 3967466 TI - The contribution of endogenous urea to faecal ammonia in man, determined by 15N labelling of plasma urea. AB - To establish the role of endogenous urea as a source of faecal ammonia, the plasma urea of two healthy men was labelled with 15N at a constant level for several days and its 15N enrichment was compared with that of faecal ammonia and total nitrogen. Faeces collected after one complete gastrointestinal transit from the onset of plasma labelling had ammonia 15N enrichments which were only 8.5 +/- 1.2% and total nitrogen enrichments which were 6.8 +/- 0.7% of the plasma urea 15N enrichment. These results show that endogenous urea is not the main precursor of faecal ammonia, which is probably derived by bacterial deamination from the protein of dietary residues, intestinal secretions and shed epithelial cells. The minor contribution of endogenous urea to faecal ammonia suggests that the lumen of the large bowel is not the main site of endogenous urea hydrolysis. The similar labelling of faecal total nitrogen and ammonia nitrogen supports other evidence that these faecal nitrogen fractions are in a constant state of exchange. PMID- 3967467 TI - Determination of the rate of urea synthesis from serial measurements of plasma urea concentration after an alanine load: theoretical and methodological aspects. AB - A method is described by which the rate of synthesis of urea can be calculated from the change of plasma concentration of urea after an alanine load. The results can be expressed in terms of f, the maximum increase in the rate of urea synthesis, and t, the time at which urea synthesis reaches its maximum. These parameters are calculated by an algebraic curve-fitting technique which is suitable for a desk computer. The method removes the need for isotopic analysis and urine collections. The effect of various errors and experimental conditions on the calculated synthesis parameters is investigated. PMID- 3967464 TI - Pharmacokinetics of synthetic human parathyroid hormone 1-34 in man measured by cytochemical bioassay and radioimmunoassay. AB - Synthetic human parathyroid hormone (hPTH) 1-34 was given by intravenous injection to two healthy men. The time course of its appearance in and disappearance from the plasma was monitored both by cytochemical bioassay and by a specific radioimmunoassay (RIA) system. Immunoreactive N-region parathyroid hormone (iPTH) reached peak concentrations in plasma at 2 min after injection, whereas peak concentrations of biologically active parathyroid hormone (bioPTH) were delayed until 4-6 min. Bioassayable PTH-like activity then disappeared from the plasma (mean transit times 5.8 and 8.6 min), approximately twice as fast as immuno-reactivity. After separate subcutaneous administrations, a calculated 22 37% of administered hPTH 1-34 was subsequently detected in the plasma, by both assay systems. It was not possible to explain fully the non-parallel appearances of bio- and immuno-reactivities in the plasma after intravenous injection nor the non-parallel disappearances after both intravenous and subcutaneous injections on the basis of the present data. It seems likely, however, that in the process of biological degradation the immuno-reactive locus is inactivated by a different reaction from that which destroys bioactivity. To investigate these activity dissociations further will require the application of micro-fractionation procedures in conjunction with both types of assay system. PMID- 3967468 TI - Effect of the calcium antagonist verapamil on human leucocyte sodium transport in vitro. AB - Sodium efflux rate constants and intracellular sodium were measured in leucocytes from healthy volunteers in the presence and absence of the calcium antagonist verapamil hydrochloride. Verapamil stimulated sodium pump activity and this effect was dependent on the presence of external calcium. Verapamil has been reported to reverse the abnormality of sodium transport seen in leucocytes from patients with essential hypertension and the present study demonstrates that sodium pump activity in leucocytes from control subjects is also stimulated by exposure to verapamil in vitro. This direct cellular effect appears to be due to the calcium antagonist properties of the drug. PMID- 3967469 TI - The causative agent in atrial receptor diuresis in the dog is a low molecular weight, lipophilic and weakly acidic substance. AB - Stimulation of atrial receptors by distension of a balloon in the left atrium of anaesthetized dogs results in a reflex diuresis mediated by a humoral agent of unknown identity. In previous investigations, a substance was recovered in a low molecular weight fraction from Bio-Gel P-2 (100-1800 daltons) and shown to be related to the reflex diuresis. In this investigation, the active Bio-Gel P-2 fraction was partitioned with ethyl acetate at pH 11.0, with subsequent partition of the aqueous phase with ethyl acetate at pH 7.4; the activity of the humoral agent was soluble in ethyl acetate at pH 7.4. These investigations suggest that the humoral agent is a low molecular weight, lipophilic and weakly acidic substance. The substance is not antidiuretic hormone (ADH) as vasopressin is insoluble in ethyl acetate at pH 7.4. PMID- 3967471 TI - Evaluation of API SerImm Sure strips for screening and grouping Salmonella isolates. AB - Two new latex agglutination products in which the reagents are dried in macrocupules in plastic strips were evaluated. API SerImm Sure Salmonella Poly for screening and API SerImm Sure Salmonella for grouping (Analytab Products, Plainview, NY) were tested with 63 recent isolates and 72 stock strains of Salmonella groups A-E and 43 stock strains of Salmonella groups F-67. Of the homologous strains, the polyvalent reagent correctly identified 89%, and the grouping reagents 90%. The most commonly occurring serotypes of groups A-E were identified. The major problems were failure to identify Group B 1,4,12,27, and group D29,46 strains, and lack of macrocupules with normal serum-latex controls. The major advantage of the products is convenience, since the SerImm Sure packaging eliminated the need to dilute anti-sera and prepare slides. PMID- 3967470 TI - Medical Research Society communications. London. 3-4 January 1985. Abstracts. PMID- 3967472 TI - Toxicity of amphotericins on chronic administration to mongrel dogs. AB - Conditioned mongrel dogs were given 30 i.v. injections of either AMB (amphotericin B, 0.75 mg/kg body weight), AME (amphotericin B methyl ester, 10 mg/kg body weight), or 5% glucose solution without antimicrobic. Severe loss of body weight and nephrotoxicity occurred with AMB; hepatic dysfunction resulted with AME; astrogliosis and pallor of the myelin were found in dogs given AME and 5% glucose solution. PMID- 3967473 TI - Branhamella catarrhalis bacteraemia and immunosuppression--part of a larger problem? AB - Attention is drawn to the striking association between bacteraemia due to Branhamella catarrhalis and immunosuppression and evidence is cited suggesting a special relationship between this and other Neisseria of intermediate virulence and systemic disease in the immunologically compromised. PMID- 3967474 TI - Candida lusitaniae--an opportunistic pathogen. AB - Candida lusitaniae is a newly recognized opportunistic pathogen amongst immunocompromised patients. The epidemiology and pathology remain largely unknown. This case report describes a 27-year-old female with vasculitis who acquired a fatal C. lusitaniae fungemia. PMID- 3967475 TI - Serological and virological investigations of young children with acute respiratory syndrome associated with respiratory syncytial virus. AB - From January 1979 to March 1979, 341 young children from the metropolitan area of Naples, Italy, were hospitalized with respiratory virus disease. Diagnosis of patients made from virus isolation and seroconversion indicate that the respiratory syncytial virus was a primary cause of this acute respiratory syndrome. PMID- 3967476 TI - In vitro antimicrobial susceptibility testing using 30 microG and 75 microG U63196-E (cefpimizole AC-1370) disks. AB - U63196-E, a new cephalosporin, was evaluated for its antimicrobial spectrum and its application to standardized in vitro susceptibility test methods. The proposed criteria for the 75-micrograms U63196-E disk are greater than or equal to 18 mm (less than or equal to 16 micrograms/ml) = susceptible and less than or equal to 14 mm (greater than 32 micrograms/ml) = resistant. These limits are preferred to the 30 micrograms disk and produce only 4.2% major and very major interpretive errors. Previously published interpretive criteria for the 75 micrograms cefoperazone disk were confirmed. PMID- 3967477 TI - Circulatory responses to exercise. PMID- 3967478 TI - Football injuries to the skeletal system. PMID- 3967479 TI - Anabolic steroids in the training and treatment of athletes. AB - The use of anabolic steroids has become widespread in the athletic population in the hope of developing a competitive edge. The theoretical advantages of increases in lean body mass, body weight, and muscle strength have been difficult to document in the athletic population because of an inability to define a satisfactory placebo or safely test the extremely high doses of steroid purportedly used by the athletic population. Those studies that are available suggest that while some mild weight gain and lean body mass increase may be noted, athletic performance itself is not significantly altered by steroid use. The significant negative side effects that can occur, particularly those that alter liver function and endocrine balance, suggest that there is little to support the use and abuse of these drugs in the treatment and training of athletes. PMID- 3967480 TI - Medication problems in elderly persons. PMID- 3967481 TI - Heat-related illnesses in the athlete. PMID- 3967482 TI - Exercise and the young. PMID- 3967483 TI - Common leg and shoulder conditions in athletes. PMID- 3967484 TI - Characterization of an anionic trypsin from the eel (Anguilla japonica). AB - An enzyme, isolated from the pancreas of the eel Anguilla japonica and designated as anionic trypsin 1, had a molecular weight of 26,000 and an isoelectric point of 5.5. The amino acid composition of the enzyme was similar to that of bovine cationic trypsin as well as anionic trypsins from other species of fish. The enzyme was stable at pH 6 to 9 in the presence of calcium ions. Km and kcat values of the enzyme for N-tosyl-L-arginine methyl ester and N-tosyl-L-lysine methyl ester were quite similar to those of catfish anionic and bovine cationic trypsins. PMID- 3967485 TI - Predominant localization of dihydroxyacetone-phosphate acyltransferase activity in renal peroxisomes of male and female mice. AB - The subcellular localization of DHAPAT activity in male and female albino mouse kidneys was investigated by density gradient centrifugation. DHAPAT has a predominantly peroxisomal distribution in both male and female kidneys; however some activity is also distributed in a less dense region of the gradient, predominantly containing microsomes. Peroxisomal fractions also contain some lactate dehydrogenase activity and approximately 9% of the cellular NAD-dependent alpha-glycerophosphate dehydrogenase activity. PMID- 3967486 TI - Gastric microsomal NADH-cytochrome b5 reductase: characterization and solubilization. AB - NADH-cytochrome b5 reductase from hog gastric microsomes was studied with respect to substrate dependence, optimum pH, thermal denaturation as well as anti cytochrome b5 antibodies and different ions. The reduction of potassium ferricyanide by the enzyme was specific for NADH. Using potassium ferricyanide or trypsin-solubilized liver cytochrome b5 (Tb5) as substrates, enzyme activity was inhibited by ADP and to a lesser extent by ATP. Tb5- (but not ferricyanide-) reductase was activated by ionic strength up to 0.05 ion equivalent per liter and inhibited at higher strengths whatever the ion used (Cl-, Na+, Ca2+, Mg2+). Enzyme solubilization occurred with Triton X100. The solubilization increased the Tb5- (but not the ferricyanide-) reductase activity up to a Triton:protein ratio of 15. We therefore suggest that gastric microsomes contain a Triton soluble membrane-bound NADH cytochrome b5 reductase which is in many respects similar to the liver and red cell enzymes. PMID- 3967487 TI - Kinetics of human and bovine milk lipoprotein lipase and the mechanism of enzyme activation by apolipoprotein C-II. AB - The kinetics of human and bovine milk lipoprotein lipase (HM-LPL and BM-LPL, respectively) were compared by varying apolipoprotein C-II (C-II) or triacylglycerol (TG) concentrations. The apparent Km (TG) and Km (C-II) for HM LPL were 2.2 and 6.7-fold higher than for BM-LPL. Plots of 1/v vs 1/[TG] or 1/[C II] intercepted the respective abscissas at the same points: C-II had no effect on Km (TG) and TG had no effect on Km (C-II). Replots of slope 1/s vs 1/[C-II] gave straight lines which yielded KA values identical to Km (C-II). It is concluded that the HM-LPL system follows a random, bireactant, rapid equilibrium mechanism as shown previously for BM-LPL. PMID- 3967488 TI - Properties and function of malate enzyme from Dicentrarchus labrax L. liver. AB - Malate enzyme (L-malate:NADP+ oxidoreductase (oxaloacetate decarboxylating, EC 1.1.1.40) has been purified from Dicentrarchus labrax liver to 99% homogeneity by gel filtration, anion exchange and affinity chromatographies. The apparent molecular weight was estimated by gel filtration chromatography to be 148,000. Analysis of the enzyme on sodium dodecyl sulphate polyacrylamide disc gel electrophoresis was shown to be a tetrameric protein. The purified enzyme showed a pH optimum 8.5 (Tris-HCl buffer) and required bivalent cations for catalysis. The temperature-activity relationship for the enzyme showed broken Arrhenius plots with inflexions at 15 and 40 degrees C. Kinetic properties and the effects of some metabolites related to L-malate are studied. PMID- 3967489 TI - Lipogenic hepatic enzyme activity of raccoon dogs (Nyctereutes procyonoides) fed various diets. AB - Body weight, obesity and liver weights of male raccoon dogs fed diets of various energy content were higher than those of females. With increasing body weight and obesity the liver weight and glucose-6-phosphate dehydrogenase (G-6-PD) decreased significantly in both sexes. The liver weight correlated very positively with the G-6-PD activity. The alpha-glycerophosphate dehydrogenase (alpha-GPD) correlated with the liver weight only in females. PMID- 3967490 TI - Purification and some properties of two anionic trypsins from the eel (Anguilla japonica). AB - Two anionic enzymes, designated as trypsins 1 and 2, were purified from the pancreas of the eel Anguilla japonica by DEAE-cellulose column chromatography and Sephadex G-75 gel filtration. The final preparation of trypsin 1 was homogeneous but that of trypsin 2 still contained impurities. Both enzymes had similar pH optima of near 8.3 for the hydrolysis of N-tosyl-L-arginine methyl ester. Trypsin 1 was stabilized by calcium ions but the stability of trypsin 2 was not affected by calcium ions. Both enzymes were inhibited by typical trypsin inhibitors including serine proteinase inhibitors. PMID- 3967491 TI - The purification and kinetic characterization of eel white muscle pyruvate kinase. AB - A stable, homogeneous preparation of pyruvate kinase from white muscle of the American eel, Anguilla rostrata with a specific activity of 350 units/mg has been obtained. The enzyme has a pH optimum in the range 6.3-6.5 and requires Mg2+ and K+ for maximum activity. Eel muscle pyruvate kinase exhibits slight co operativity in the binding of the substrate phosphoenol-pyruvate. It is activated by fructose-1,6-bisphosphate in a pH dependent manner and is inhibited by both alanine and phenylalanine. These properties are very similar to the properties of the mammalian M2 isozyme. PMID- 3967492 TI - Investigation of operationalized diagnostic criteria in the diagnosis of schizoaffective and cycloid psychoses. PMID- 3967493 TI - Exemplar prototypes of personality disorder diagnoses. PMID- 3967494 TI - Multiple personality in a case of functional psychosis. PMID- 3967495 TI - Micropenis: gender, erotosexual coping strategy, and behavioral health in nine pediatric cases followed to adulthood. PMID- 3967496 TI - The dissimulating disorders: a single diagnostic entity? PMID- 3967497 TI - The neuroleptic malignant syndrome: review and report of three cases. PMID- 3967498 TI - Coping with precipitating life stress of primarily depressed inpatients. PMID- 3967499 TI - Hemodynamic effects of verapamil in the beta-blocked dog. AB - The use of the calcium channel-blocking agent, verapamil, in beta-blocked patients has been the subject of intense investigation, particularly because both verapamil and the beta-blockers can produce negative inotropic effects. We studied the hemodynamic effects of verapamil in beta-blocked dogs to establish specific measurements that could be used clinically for early identification of combined negative inotropism. Seven anesthetized, mongrel dogs were beta-blocked with propranolol, and then given 2.5-, 5.0-, and 10.0-mg iv boluses of verapamil. The 2.5- and 5.0-mg boluses represent clinical doses, whereas the 10.0-mg bolus is a large pharmacologic dose. Hemodynamic measurements showed that verapamil was well tolerated at clinical doses; increases in stroke volume compensated for decreases in mean arterial pressure. At high doses of verapamil this response was not observed and left ventricular stroke work decreased. Cardiac and stroke indices were not useful indicators of combined drug toxicity in this dog model. PMID- 3967500 TI - Airway humidification with high-frequency jet ventilation. AB - Humidification of inspired gases is indispensible to prevent serious injury to the tracheal mucosa of patients on mechanical ventilation. High-frequency jet ventilation (HFJV), recently introduced for the management of some forms of respiratory failure, presents unusual technical problems of humidification. The present investigation evaluated a technique to humidify jet gases by delivering small droplets of normal saline in front of the injector cannula, and utilizing the jet flow to nebulize the fluids administered. One millicurie of technetium 99m sulfur colloid (Tc-99m) was diluted in 10 ml of saline and infused in the airway of nine patients supported on HFJV. Six patients were orotracheally intubated and three were tracheostomized. A portable gamma camera was used to determine the distribution of radioactive contrast in the airway every 200 sec. When the injector catheter was directed upward, as was the case in tracheostomized patients, contrast material accumulated in the ventilator lines, and visualization of the airway was limited to the trachea. In orotracheally intubated patients, the injector catheter was generally directed downward, and radioactive contrast material extended beyond the major bronchi. The radioactive tracer reached the most distal airway location in patients with the lowest PaCO2 values. Thus, when humidification systems rely on jet-stream nebulization of fluids, the position of the injector cannula should facilitate saline flow by gravity. In the presence of poor alveolar ventilation, the concomitant risk of inadequate humidification should be considered. PMID- 3967501 TI - Use of an acoustic helium analyzer and microprocessor for rapid measurement of absolute lung volume during mechanical ventilation. AB - A technique developed to measure functional residual capacity during mechanical ventilation uses an acoustic helium analyzer and microprocessor to perform open circuit helium washout. The acoustic helium analyzer has acceptable linearity up to a helium concentration of 50% and is stable. The microprocessor combines output from the acoustic analyzer and a ventilator with an expiratory flow signal, to compute lung volume rapidly during mechanical ventilation. In a sample of ten patients with various lung problems, open-circuit helium washout gave results similar to those of a closed-circuit helium-dilution technique during assist control or intermittent mandatory ventilation modes, with or without positive end-expiratory pressure. This open-circuit system has an advantage over other techniques because it is small and portable and can measure lung volume quickly without complicated maneuvers. PMID- 3967502 TI - Bag-valve-mask ventilation; two rescuers are better than one: preliminary report. AB - This study suggests that the bag-valve-mask (BVM) used by a single rescuer with minimal training fails to deliver adequate tidal volumes for resuscitation. When two rescuers use the BVM, tidal volumes are more than recommended and are comparable to those seen with endotracheal intubation. Two-person BVM ventilation should be considered for initial resuscitation in cardiopulmonary arrest. PMID- 3967504 TI - Use of moderate hypothermia and benzodiazepines in cerebral salvage. PMID- 3967505 TI - Pneumoperitoneum: an unusual manifestation of improper oral intubation. PMID- 3967503 TI - Urokinase treatment of pulmonary artery thrombosis complicating the pediatric nephrotic syndrome. AB - Two pediatric patients with severe pulmonary thrombosis complicating a lipoid nephrosis were treated with urokinase administered either as a continuous infusion or in massive bolus doses. Both patients recovered but one died suddenly 2 yr later after recurrence of the nephrotic syndrome and probably new massive pulmonary thrombosis. These patients had severe abnormalities of hemostasis and fibrinolysis, which favored thrombosis and complicated fibrinolytic treatment. PMID- 3967506 TI - Monitoring classifications. PMID- 3967507 TI - Transcutaneous PO2 monitoring during sodium nitroprusside infusion. AB - To determine the effect of vasodilator-induced hypotension on the relationship between transcutaneous PO2 (PtcO2) and PaO2, six mongrel dogs and 20 patients were monitored before and during infusion of sodium nitroprusside (SNP), with PtcO2 sensors heated to 45 degrees C. First, SNP infusion was used to lower the mean arterial pressure (MAP) of anesthetized dogs, in steps of approximately 25%, to 49 +/- 3 (SD) mm Hg. There were no significant changes in cardiac output, oxygen consumption, PtcO2, PaO2, or PtcO2 index (PtcO2/PaO2). Twenty patients were monitored during general anesthesia. Fifteen patients were being treated for acute hypertension with SNP, and in five patients hypotension was induced with SNP to minimize blood loss. There was a significant decrease in MAP, PaO2, and PtcO2, and a significant increase in alveolar-arterial PO2 difference during SNP infusion. PtcO2 index did not change significantly from its preinfusion value in either group. PMID- 3967508 TI - Aerosol delivery in intubated, mechanically ventilated patients. AB - To study the effects of respiratory failure and mechanical ventilation on aerosol delivery to the lungs, we performed nuclear scans after aerosolization of 5 to 9 mCi of Tc-99m diethylenetriamine pentaacetic acid in seven stable, intubated, and mechanically ventilated patients. The radioactivity reaching the lungs was 2.9 +/ .7% (mean +/- SD) of the administered dose, an amount significantly less than that in three healthy nonintubated subjects and also less than what would be expected in nonintubated subjects from other published reports. We then performed a subsequent study in 15 additional mechanically ventilated patients who were receiving aerosolized bronchodilators through their endotracheal tube. In these patients, heart rate and lung mechanical function values before and after treatment were not significantly different. We conclude from these studies that aerosol delivery in mechanically ventilated patients is significantly reduced and that this is probably due to a combination of suboptimal breathing pattern, intrinsic airway disease, and the endotracheal tube functioning as both a site for aerosol deposition through impaction as well as a barrier to gastrointestinal absorption. PMID- 3967509 TI - Hemodynamic and oxygen transport patterns in surviving and nonsurviving postoperative patients. AB - Invasive hemodynamic monitoring was performed on 220 critically ill surgical patients judged by clinical evaluation to have a high likelihood of surgical complications or death. Patients with markedly abnormal preoperative hemodynamic values were excluded from analysis. Data were separated into preoperative, intraoperative and postoperative time intervals and the mean value of each variable for each patient at each time period was computed. In comparison to survivors, the nonsurvivors generally had: (a) reduced myocardial performance as judged by lower cardiac index and left ventricular stroke work in the presence of high right and left ventricular filling pressures, (b) reduced pulmonary function (increased alveolar-arterial oxygen content difference and pulmonary shunt fraction), (c) pulmonary vasoconstriction (increased pulmonary artery pressure and pulmonary vascular resistance), and (d) decreased oxygen delivery despite maintenance of normal arterial blood gases and comparable hemoglobin values. Both survivors and nonsurvivors had vital signs usually within the normal range (until the terminal state of nonsurvivors). PMID- 3967510 TI - Probability of survival as a prognostic and severity of illness score in critically ill surgical patients. AB - A new quantitative method for measuring the prognosis and severity of illness in terms of probability of survival was developed from 224 studies in an index population of 220 critically ill surgical patients. Patients were selected preoperatively to eliminate pre-existing cardiac disease, cirrhosis, nutritional debility, shock or sepsis, in order to evaluate the physiologic relationships of surgical trauma to outcome free of confounding associated medical disorders. The empirically derived numeric severity index was calculated from the probability of survival for each of 28 hemodynamic and oxygen transport variables at each time period after surgery. The score correctly indicated patient outcome in 96% of the index population and 94% of an independent, prospective population. The survivors' score consistently predicted survival within 21.6 +/- 4.4 (SEM) h after the end of surgery. The severity score of those who died consistently predicted nonsurvival within 37 +/- 11 (SEM) h after the end of surgery. We conclude that the score provides a useful, objective, physiologic measure of the severity of illness and prognosis. PMID- 3967512 TI - Reactions to cyanoacrylate adhesives: "instant glue". PMID- 3967513 TI - Wegener's granulomatosis. PMID- 3967511 TI - Pulmonary complications after Fluosol administration to patients with life threatening blood loss. AB - Fluosol-DA 20% (Fluosol), a perfluorochemical emulsion capable of improving oxygen transport, was used to treat three patients with life-threatening hemorrhage. In each case a decreased partial pressure of oxygen, an increased alveolar-arterial oxygen gradient, fever, an increased white blood cell count, and chest x-ray abnormalities occurred at similar time intervals after treatment with Fluosol. In one patient, pulmonary complications were fatal. Similar adverse reactions to treatment with Fluosol have not been previously reported. Possible explanations for these pulmonary complications are the adult respiratory distress syndrome, oxygen toxicity, or direct toxic effects of Fluosol. PMID- 3967514 TI - Toward a rational therapy for psoriasis. PMID- 3967515 TI - Erythema annulare centrifugum as the presenting sign of the hypereosinophilic syndrome: observations on therapy. AB - A 79-year-old man with severe generalized pruritus and erythema annulare centrifugum as manifestations of his idiopathic hypereosinophilic syndrome slowly responded to long-term therapy with ketoconazole and dapsone. The skin lesions cleared within one month but the pruritus and eosinophilia required seven full months of therapy. PMID- 3967516 TI - Hair zinc, scalp hair quantity, and diaper rash in normal infants. AB - Hair zinc concentration was determined by atomic absorption spectrophotometry in 308 normal newborn infants and 199 normal infants aged one to twelve months. Hair zinc concentration declined from 204 micrograms/gm at birth to 112 micrograms/gm at age eight months, and then rose to 144 micrograms/gm at age twelve months. Diaper rash was significantly associated with reduced hair zinc, and infants with the least hair had lower zinc levels than infants with the most hair. The data indicate that hair loss and diaper rash found in normal infants is significantly associated with a reduction in hair zinc concentration. PMID- 3967517 TI - Transient acantholytic dermatosis occurring during pregnancy. AB - A case of transient acantholytic dermatosis (TAD) in pregnancy is reported. The eruption appeared in the third month of the pregnancy and completely resolved two months later. Reports concerning the occurrence of this disorder in young people are rare, and, to the best of our knowledge, this is the first patient in whom onset of the disease has been detected during pregnancy. PMID- 3967519 TI - Replenishing the starved patient. When do lung immune cells recover? PMID- 3967518 TI - Pseudoepitheliomatous, keratotic, and micaceous balanitis. AB - A case of pseudoepitheliomatous, keratotic, and micaceous balanitis in a 69-year old white man is presented. This report supports the notion that this condition is a localized form of verrucous carcinoma which tends to be resistant to treatment and to recur locally. Treatment with topical fluorouracil cream was partially effective but follow-up studies were not available because the patient died of lung cancer. This appears to be only the third reported case of this condition in the English literature. PMID- 3967520 TI - Current treatment modes for tuberculosis. Public policy and implementation. PMID- 3967521 TI - Role of fiberoptic bronchoscopy in patients with hemoptysis and a normal chest roentgenogram. AB - We reviewed the charts of 48 consecutive patients who had fiberoptic bronchoscopy performed in the evaluation of hemoptysis with a normal chest roentgenogram. Fiberoptic bronchoscopy provided a diagnosis other than endobronchial inflammation in only four patients--benign fibromuscular polyp in one patient, Mycobacterium tuberculosis in 1 patient, and carcinoma in two others. A literature review revealed an overall 3 percent incidence of bronchogenic carcinoma in patients with hemoptysis and normal findings on chest roentgenogram. Other than abnormal findings on chest roentgenogram, risk factors for carcinoma in patients with hemoptysis include: (1) age greater than 40; (2) significant smoking history; and (3) duration of hemoptysis for longer than one week. We concluded that in patients with hemoptysis and normal chest x-ray film findings, routine fiberoptic bronchoscopy may not always be indicated to rule out malignancy. PMID- 3967522 TI - Left ventricular function before and after reaching the anaerobic threshold. AB - Simultaneous pulmonary gas exchange analysis and exercise radionuclide angiography were performed in 24 normal patients (14 supine and ten upright). Left ventricular (LV) volumes and ejection fraction (EF) were measured at rest, anaerobic threshold (point of nonlinear increase in ventilation relative to oxygen uptake), and peak exercise. The anaerobic threshold occurred at a similar heart rate for supine vs upright exercise, 78 percent and 77 percent of peak heart rate, respectively. The anaerobic threshold occurred at a similar workload for supine vs upright exercise, 60 percent and 56 percent of peak workload, respectively. The anaerobic threshold also occurred at a similar oxygen uptake for supine vs upright exercise, 69 percent vs 69 percent of peak oxygen uptake, respectively. For both exercise modes, mean LVEF increased (p less than 0.01) by a similar amount (.06 vs .07) from rest to anaerobic threshold, but there was no further increase from anaerobic threshold to peak exercise. The mechanism of the increase was a reduction in end-systolic volume with little or no change in end diastolic volume. This increase was not seen in patients with rest LVEF in the high normal range (greater than 0.68). Therefore, for both supine and upright exercise, the major augmentation in LVEF occurs at earlier stages of exercise, prior to the anaerobic threshold. After the anaerobic threshold, the LVEF response may be highly variable, and a uniform increase is not necessarily expected even in normal subjects. PMID- 3967523 TI - Flow-volume curve abnormalities and obstructive sleep apnea syndrome. AB - Recent reports have suggested that flow volume curve abnormalities may be of interest in the diagnosis of obstructive sleep apnea syndromes by showing either extrathoracic airway obstruction (ratio of expiratory flow to inspiratory flow at 50 percent of forced vital capacity [FEF50/FIF50] exceeding 1) or upper airway fluttering (indicated by a sawtooth aspect on the mid-half of the inspiratory part of the curve) or both. In our study, 57 patients referred for a suspected sleep apnea syndrome (SAS) underwent conventional spirometry, assessment of flow volume curves, ENT examination, and polysomnography. Thirty patients had an obstructive SAS, four patients a central SAS, and 23 patients no SAS. Signs of upper airway fluttering (the sawtooth sign) were present in 61 percent of the patients with obstructive SAS and in 46 percent of the patients without obstructive SAS (central SAS or no SAS). Signs of extrathoracic upper airway obstruction (FEF50/FIF50 greater than 1) were present in 67 percent of the patients with obstructive SAS and in 71 percent of the patients without obstructive SAS. These results suggest that upper airway abnormalities, as reflected by abnormal flow volume curves, are not always associated with obstructive SAS; they favor the hypothesis of a central component in the mechanism of upper airway occlusion during sleep. PMID- 3967524 TI - Respiration during sleep in children with COPD. AB - Seventeen children (mean age, nine years) with chronic obstructive pulmonary disease (COPD) were studied during sleep. Electroencephalography, electrooculography, and electromyography were all recorded. Airflow was measured by nasal and oral thermistors, and abdominal and thoracic anteroposterior diameters by magnetometers. Transcutaneous partial pressure of O2 (tcPO2) and of CO2 (tcPCO2) were monitored. The average total sleep time was 283 min +/- 36 (1 SD). Breathing pauses (BP) five seconds or longer were measured. The mean time of BP expressed as a percentage of TST was 1.3 percent +/- 0.8 (1 SD). The BP occurred most frequently during REM sleep. Forty-six percent of BP were obstructive (OBP). The percentage of OBP was significantly related to the degree of lung resistance during wakefulness. Periodic breathing was observed with a mean frequency of 2.2 times per night (range: 0 to 7). Episodes with paradoxic inward rib cage motion were seen one to 29 times (mean 6.6). Drops in tcPCO2 greater than 5 mm Hg occurred one to eight times and 67 percent were observed during REM sleep. Compared to tcPCO2 during W the mean maximal decrease in tcPCO2 was 14 mm Hg (range 8 to 29). tcPCO2 rose with a mean maximal of 9.1 mm Hg (range 6 to 13). It was concluded that children with COPD had worsened gas exchange during sleep. PMID- 3967525 TI - The early signs of right bundle branch block. AB - Complete right bundle branch block manifests with a rSR' configuration in right orientated leads and a duration of 0.12 sec or longer. Incomplete right bundle branch block is perceived as this classic rSr' configuration and a duration of less than 0.12 sec. This presentation reflects the early development of right bundle branch block which first manifests with a hitherto undescribed sign, namely: a diminution of the S wave amplitude in lead V2. Further progression of the right bundle branch block leads to slurring or notching of the upstroke of the S wave in lead V2 followed by the development of a r' deflection. With further progression, the r' deflection becomes increasingly taller until the advent of complete right bundle branch block which is characterized by a widening of a very tall R' deflection with an apical notch or plateau. PMID- 3967526 TI - Exercise-induced bronchodilation in asthma. AB - Of 34 symptomatic adult asthmatic patients (23 men) aged 51 +/- 13 years (mean +/ 1 SD) with moderately severe airways obstruction who underwent maximal exercise testing at room temperature (22 degrees C) and humidity (44 percent RH) using a bicycle ergometer, we identified seven male patients aged 56 +/- 9 years in whom forced expired volume in one second (FEV1) increased greater than or equal to 20 percent over the baseline pre-exercise value (exercise-induced bronchodilation). At maximal exercise, these patients achieved an O2 consumption of 1.4 +/- 0.4 L/min and a minute ventilation of 56 +/- 9 L/min. Baseline FEV1 was 1.3 +/- 0.5 L (SD) (43 +/- 12 percent predicted) and increased to 2.1 +/- 0.5 L at five minutes after exercise and persisted at least 20 minutes. Exercise was repeated in all seven patients on a separate day one to six months later, and results were similar in six. In these seven patients, three minutes of voluntary isocapnic hyperventilation achieving a minute ventilation comparable to that during maximal exercise led to an increase in FEV1 of 20 +/- 18 percent (range 0 to 54 percent). The Vmax50 was 22 +/- 30 percent before, and 10 +/- 21 percent after maximal exercise and 25 +/- 37 percent before, and 11 +/- 22 percent after isocapnic hyperventilation. Pre-treatment with acetylsalicylic acid (mean serum concentration 120 +/- 64 micrograms/ml) in the six patients with reproducible bronchodilation completely blocked exercise bronchodilation in one patient and blunted it in four others. Findings suggest that a subset of adult patients with symptomatic asthma may develop bronchodilation after six to eight minutes of exercise, that exercise-induced bronchodilation may in part be reproduced with isocapnic hyperventilation, and that it may be blocked completely or partially by acetylsalicylic acid, implying mediation by prostaglandins. PMID- 3967527 TI - Usefulness of skin test in Farmer's lung. AB - The skin test with hay extract or with Micropolyspora faeni (MF), is not commonly used in the diagnosis of Farmer's lung (FL), as it is not considered specific. In our study, we have applied the intracutaneous test with these antigens in 26 patients affected with FL; 18 of them were still in contact with the antigen and the remaining eight had not been in contact with the hay during the previous year. Twenty-five asymptomatic farmers (AF) served as a control group. In the first group and with hay extract, the immediate reading (I) was positive in 15 of 18 (83.3 percent), the late reaction (L) in 18 of 18 (100 percent), and the delayed one (D) in eight of 18 (44.4 percent). In the 25 AF, the results were as follows: I, seven of 85 (28 percent); L, 17 of 25 (68 percent); and D, one of 25 (4 percent). Consequently, the differences between both groups were significant: I, p less than 0.01; L, p less than 0.05; and D, p less than 0.01. Using MF as an antigen, the test is somewhat less effective: p less than 0.02, p less than 0.02, and p less than 0.2, respectively. These results suggest that the intradermal injection with hay extract is an easy, effective test in the diagnosis of FL, and at the same time, a better means of distinguishing FL patients from AF than the precipitation test. PMID- 3967528 TI - Tuberculosis control practices in major metropolitan health departments in the United States. 3. Standard of practice in 1984. AB - Twenty-eight metropolitan health departments in the United States reporting more than 200 cases annually were surveyed to determine the standard of practice in the control of pulmonary tuberculosis. The results were compared to previous surveys done in 1978 and 1980 to determine the impact of policy changes recommended by the American Thoracic Society, American College of Chest Physicians, and Centers for Disease Control and recent reports of innovative chemotherapeutic methods. A high degree of uniformity in chemoprophylaxis practices again was demonstrated. In contrast to our previous survey of 1980, most programs now use rifampin-containing regimens with short (less than 12 month) course chemotherapy as the primary initial treatment regimen for tuberculosis. Mean duration of treatment for tuberculosis decreased from 20.2 +/- 2.1 months in 1980 to 11.7 +/- 1.0 months in 1984. Intermittent chemotherapeutic regimens also were used more frequently in 1984. However, substantial variance from other recommended guidelines still is prevalent among the major metropolitan programs in the United States. PMID- 3967529 TI - Volume of distribution of theophylline in acute exacerbations of reversible airway disease. Effect of body weight. AB - The literature is unclear as to whether theophylline loading doses should be based on total body weight (TBW) or ideal body weight (IBW). The objective of this study was to determine the most appropriate body weight for estimation of volume of distribution (Vd) in calculating theophylline loading dose in patients with acute bronchospasm. Fifty-four adult patients with acute bronchospasm requiring intravenous (IV) theophylline therapy were entered into the study. Patients were randomized into three theophylline loading dose groups based on (1) TBW, (2) IBW, and (3) adjusted body weight (ABW). Initial serum theophylline concentrations were used to determine an IV loading dose to reach a plasma concentration of 12 to 15 micrograms/ml. Percent prediction error was used to determine the appropriateness of each dosing group. Volumes of distribution were also determined for each group. There was a statistically significant difference at p less than 0.01 in the percent prediction error when patients in the TBW group were compared to the IBW and ABW groups. A statistically significant difference in the Vd was observed between the TBW and IBW group (p less than 0.01). We conclude that IBW is more appropriate than TBW or ABW for determining theophylline loading dose in patients with acute bronchospasm. PMID- 3967530 TI - Primary coronary artery dissection. AB - Three patients had angiographic appearance of chronic primary coronary artery dissection with features that differed from other patients with this entity studied at autopsy; they were men, greater than or equal to 40 years of age, had angina pectoris and severe coronary artery disease. The right coronary artery, which was the artery involved with dissection, had only mild atherosclerosis. Further studies are needed to determine the natural history of this angiographic finding. PMID- 3967531 TI - Spontaneous disappearance of a chronic mediastinal mass. PMID- 3967532 TI - Giant pacemaker spikes. An electrocardiographic artifact. AB - The size and orientation of the spikes produced by a pacemaker are often used by clinicians as an index of the pacemaker's function. Following implantation, the pacemaker spikes ordinarily remain constant in size; alterations suggest electrical or mechanical malfunction. We describe a patient in whom giant spikes from a pacemaker were recorded on a digital electrocardiograph shortly after implantation. An electrocardiogram taken the following day, using an analog machine, showed marked diminution in the pacemaker spike. Because of a different type of signal processing, digital electrocardiographs show much larger spikes from pacemakers than do analog machines. PMID- 3967533 TI - Combined bronchoscopy and esophagoscopy using a flexible fiberoptic bronchoscope. AB - A method is described for the performance of combined bronchoscopy and esophagoscopy using a simple modification of the standard flexible fiberoptic bronchoscope. This technique allows safe, simple, and effective examination of the esophagus after the completion of bronchoscopy in patients in whom this examination is indicated. PMID- 3967534 TI - Prolonged respiratory center depression after alcohol and benzodiazepines. AB - A male patient was admitted to the hospital in coma and acute respiratory failure following the oral intake of benzodiazepines and alcohol. On the fourth day after admission, the patient was conscious, results of clinical examination of the respiratory system were normal, and pulmonary ventilation tests and blood gas measurements were within normal limits. However, mouth occlusion pressure and ventilatory response to CO2 were found to be markedly reduced. In the period of weaning the discrepancy between the normal clinical picture and blood gases and the laboratory findings of respiratory depression implies that there is a slowing in recovery of the respiratory center in this type of intoxication. PMID- 3967536 TI - Hypotension and sinus arrest with nifedipine in pulmonary hypertension. AB - An adverse reaction to the acute administration of sublingual nifedipine is reported. Subsequent reversal was by intravenous administration of calcium chloride. PMID- 3967537 TI - Biofeedback and hypnosis in weaning from mechanical ventilators. AB - Weaning patients from mechanical ventilation can be hindered by both physical and psychologic factors. Biofeedback has been used successfully as an adjunct in difficult weaning problems. We have used a combination of hypnosis and biofeedback to wean a patient with neurologic disease who previously failed weaning by standard procedures. A 30-year-old woman with respiratory failure secondary to multiple sclerosis with transverse myelitis was given eight sessions of biofeedback over 12 days in which the movements of her chest wall, as monitored by magnetometers, were displayed on an oscilloscope. The patient was praised for targeted respiratory rate, amplitude, and rhythm. These sessions included hypnosis in which the patient was given suggestions of well-being and that she could breathe as she had five years earlier. In this manner the patient was successfully weaned. Respiratory biofeedback and hypnosis appear to be useful adjuncts in weaning patients from ventilators. PMID- 3967535 TI - Diving and chronic spontaneous pneumothorax. AB - Diving and pneumothorax cannot go together. An air bubble between the visceral and the parietal pleura will change its size according to Boyle's law, and pneumothorax might increase in size during the ascent from a dive. We would like to present the case of a professional diver, who was engaged in active diving for a period of five months during which time he made 80 to 85 dives with pneumothorax. As far as we know, this is the first such case published in the medical literature. We should also like to emphasize the protracted nature of the pneumothorax, which persisted for that time without changing size. This diver had no medical problems with diving, and the deeper he descended, the better he felt. No tension pneumothorax ever occurred and the diagnosis was made by chance. PMID- 3967538 TI - Wire basket removal of a large endobronchial foreign body. PMID- 3967539 TI - Contralateral chylothorax: one more complication of subclavian venous puncture. PMID- 3967540 TI - Early diastolic sound. PMID- 3967541 TI - Prevention from recurrence of summer-type hypersensitivity pneumonitis. PMID- 3967543 TI - Variable tracheal stenosis related to body position. PMID- 3967542 TI - Screening for lung cancer. PMID- 3967544 TI - Multidrug resistance in M fortuitum. PMID- 3967546 TI - National American College of Chest Physicians Consensus Conference on Tuberculosis. PMID- 3967545 TI - Fiberoptic bronchoscopy via endotracheal tube. PMID- 3967547 TI - Non-drug issues related to the treatment of tuberculosis. PMID- 3967548 TI - Preventive treatment of tuberculosis. PMID- 3967549 TI - Public health issues in control of tuberculosis. Surveillance techniques and the role of health care providers. PMID- 3967550 TI - Two-dimensional impedance studies of BSA buoyant density separated human erythrocytes. AB - Combined DC (Coulter Volume) and radio frequency impedance studies were performed on human erythrocytes which had been separated by buoyant density in linear, neutral, isotonic bovine serum albumin gradients. The individual buoyant density fractions showed no reproducible shift in volume with buoyant density but did show a shift with opacity, radio frequency impedance divided by dc impedance. This new electronic parameter of opacity can be related to cell age, since both it and cell age are directly related to buoyant density. This increase in opacity with buoyant density is correlated with a change in shape. PMID- 3967552 TI - Validation of a mathematical procedure for computer analysis of flow cytometric DNA data in human tumors. AB - The determination of tritiated thymidine labeling index and the percentage of cells with S phase DNA content was performed on cell suspensions obtained from 69 patients with non-Hodgkin's lymphoma. The distributions of cells in the cell cycle by computer analysis of flow cytometric data were obtained by two mathematical procedures: the widely adopted Fried model and a new one proposed by Bruni et al. A significant agreement was observed by checking the Spearman index (rs) between the percentages of cells in the different cell cycle phases (G0/1, rs = 0.76; S, rs = 0.60; and G2 + M, rs = 0.43; p less than 0.001) determined by the two procedures. Similarly, a good correlation was observed between the labeling index (LI) and the S phase values obtained by the Fried (rs = 0.45, p less than 0.001) and Bruni (rs = 0.69, p less than 0.001) models, but with a higher agreement for the latter one. The S phase by the Bruni model was also superior in predicting LI: in fact, by employing the S cutoff value of 12%, a better agreement between low LI and low S phase or high LI and high S phase was observed with the Bruni procedure (90%) than with the Fried model (72%). Finally, the analysis of the prognostic significance of the different kinetic variables confirmed the prognostic relevance of LI at any time; the S phase percentage as determined by Bruni et al. was discriminant of survival only at shorter times, and no prognostic significance could be ascribed to S phase according to the Fried procedure. PMID- 3967551 TI - Flow cytometric determination of DNA ploidy level in nuclei isolated from paraffin-embedded tissue. AB - Nuclei, isolated from paraffin-embedded tissue, were stained with propidium iodide (PI) and found suitable for DNA analysis by flow cytometry (FCM). DNA derived fluorescence intensity, however, was always decreased and had a much higher intersample variability as compared to results obtained with fresh material. Using chicken red blood cells (CRBC) as a model system, we found the lower fluorescence intensity to be due to the formalin fixation step in tissue processing. The intersample variability was found to be at least partly caused by variations in the duration of fixation. Overnight trypsinization improved the fluorescence intensity but did not reduce the intersample variability. Under all conditions tested PI binding to CRBC appeared to be saturable. Since fresh diploid or red blood cells could not be used to standardize DNA histograms, an alternative approach was developed in which nuclei from paraffin-embedded normal and tumor tissue of the same specimen were mixed. With this method DNA indices (DI) of 24 colorectal cancers were found to be closely correlated (r = 0.9877, P less than 0.001) with DI obtained with fresh tumor tissue from the same patients. The correlation of the percentages of S-phase nuclei between paraffin-extracted and fresh samples (r = 0.5875, P less than 0.05) was as high as could be expected, taking sampling differences into account. This method is an important tool for the retrospective analysis of FCM-derived DNA parameters in relation to diagnosis and prognosis of neoplasms. PMID- 3967553 TI - Helpful hints in flow cytometry and sorting. AB - Most users of flow cytometers and sorters become proficient in their use through direct operation of the instruments. There are no text books or operation manuals that describe all of the problems that will be encountered and that may not be apparent. We have discovered many of these problems through finding an explanation for unexpected data and in resolving difficulties in achieving and maintaining high resolution and stable operation of the instruments. This paper presents a summary of problems encountered and solutions found at this laboratory and others. PMID- 3967554 TI - A single-parameter analog level discriminator: a cheap and powerful extension of FCM data acquisition. AB - Modern flow cytometers offer the possibility to measure more parameters of individual cells than the normally available data acquisition equipment can store. To enlarge the number of parameters that is taken into account while recording data, an analog level discriminator is described that is easy to build and easy to implement on any existing FCM system. An example of gated data acquisition in light scattering measurements on nucleated human bone marrow cells is given. The level discriminator may give a cheap and yet valuable extension of expensive data acquisition equipment. PMID- 3967555 TI - A convenient on-line device for reagent addition, sample mixing, and temperature control of cell suspensions in flow cytometry. AB - We describe a simple and inexpensive device which permits the addition of up to three different solutions into a cell suspension which is on-line in a flow cytometer. The mixing chamber houses a disposable plastic cuvette stirred with a magnetic stirrer. The sample chamber is attached to a circulating water bath, hence accurate temperature control is achieved. Because the system is prepressurized and the sample line is very short, the delay time-between the point of sample modification and the point of analysis is reduced to a few seconds. Thus reagents may be added rapidly, and kinetic measurements of high temporal resolution are possible. Because the temperature of the sample chamber is regulated, binding can be observed over longer time periods than was previously possible. We demonstrate the usefulness of this device in determining the binding of fluoresceinated hexapeptide to human neutrophils under conditions where the stimulus is infused into the cell suspension while on-line in the cytometer. PMID- 3967556 TI - Light-scattering changes during chemotactic stimulation of human neutrophils: kinetics followed by flow cytometry. AB - The light-scattering properties of human neutrophils were compared on a cell-by cell basis before and after stimulation with chemotactic peptide using flow cytometry. Between 20 and 180 sec after peptide addition, side (90 degrees) scatter declined by up to 4% and forward scatter increased up to 6%. Between 3 and 15 min, side scatter increased up to 15% and forward scatter decreased up to 5%. Association of a fluorescence chemoattractant with neutrophils was most rapid during the initial phase of increasing forward and decreasing side scatter, and association saturated before the maximum increase in side scatter. Evidence is presented that the observed changes in scatter were not a consequence of chemoattractant-induced cell-cell adhesion or neutrophil degranulation. Rather, the early phases of light-scattering changes are interpreted to represent membrane ruffling by the stimulated neutrophil; the later phases polarization of the neutrophil morphology. PMID- 3967557 TI - Low incidence of hepatotoxicity associated with long-term, low-dose oral methotrexate in treatment of refractory psoriasis, psoriatic arthritis, and rheumatoid arthritis. An acceptable risk/benefit ratio. AB - Thirty patients with psoriasis or other nonmalignant diseases had liver biopsies done before treatment with low-dose methotrexate, 15 mg/week, and then at one- to two-year intervals as long as they continued the methotrexate. All patients were symptomatically improved on this regimen. The 15 patients who had normal liver biopsies at the start of the study had normal biopsies after methotrexate. Fifteen others had minor hepatic histologic abnormalities before treatment. Eleven patients had fatty infiltration. Ten showed no significant change after treatment while one had increased fat and portal fibrosis on a fourth liver biopsy done seven years after MTX was begun. This last patient, a former alcohol abuser, continued methotrexate and showed no further worsening at 8 years. The remaining four had portal fibrosis before treatment. One patient had less fibrosis after methotrexate, two patients slightly more fibrosis, and one a marked increase in portal fibrosis. No patient developed cirrhosis or clinical liver disease. Our results suggest that in the absence of alcohol consumption, low-dose weekly methotrexate treatment rarely causes clinically significant liver damage. PMID- 3967558 TI - Nutritional data and etiology of chronic pancreatitis in Mexico. AB - Alcoholism and malnutrition have been implicated commonly in the etiology of chronic pancreatitis (CP). The geographical distribution and clinical and nutritional features differ between the alcoholic and tropical forms of CP. This work presents the etiology and nutritional characteristics of CP in Mexico, a country in which both alcoholism and childhood malnutrition are common. Two well defined groups of patients have been identified: an alcoholic group composed mainly of males with a mean age at clinical onset of 41 years and a high dietary intake of fat, protein, carbohydrates, and calories; and a nonalcoholic group with a female preponderance, a mean age at onset of 23 years, and a higher intake of protein than controls. We conclude that alcoholic chronic pancreatitis in Mexico is similar to that reported in other temperate countries. Although the nonalcoholic group resembles that observed in tropical countries in many ways, our patients are not malnourished, further questioning the role of childhood malnutrition in the pathogenesis of this type of chronic pancreatitis. PMID- 3967560 TI - Development of an improved multi-pressure-sensor probe for recording muscle contraction in human intestine. AB - We have developed an improved semiconductor recording probe for monitoring motility of the upper small intestine in humans. The probe consists of six ultraminiature silicon pressure sensors spaced 10 cm apart and encased in a flexible polyurethane sheath. The probe is small [2.67 mm (8F) diameter], is easily passed transnasally, and is tolerated by patients for prolonged recording periods (24-36 hr) with a minimum of discomfort. The initial semiconductor and catheter material were those designed for use in the cardiovascular system, but they proved to be easily damaged by gastric acid and enzymes. After improvement of this probe, we now have recordings from more than 100 patients for an approximate total of 6000 hr of recording time. The improved probe is a durable recording device that facilitates the investigation of motility of the small intestine in humans in health and disease. PMID- 3967559 TI - Inhibition of pancreatic exocrine secretion and bile entry into the duodenum by isometheptene, a sympathomimetic agent. AB - We have studied the effect of isometheptene, an indirectly acting sympathomimetic with analgesic and antispastic properties, on secretin-cholecystokinin-stimulated pancreatic and biliary outputs. Isometheptene, infused intravenously at a dose of 100 mg in 30 min, significantly inhibited bicarbonate, enzyme, and bilirubin output in eight healthy subjects (compared to control values, the maximum percent inhibition was 34% for bicarbonate, 57% for lipase, 61% for chymotrypsin, and 86% for bilirubin). In four cholecystectomized subjects, the drug inhibited only pancreatic outputs. The inhibitory effect on pancreatic secretion, coupled with the analgesic action, suggest a potential benefit of this drug in acute pancreatic pathology. PMID- 3967561 TI - Chemiluminescent response of neutrophils from patients with inflammatory bowel disease. AB - The activity of inflammatory bowel disease (IBD) is often difficult to monitor by currently available laboratory tests. The oxidative metabolic activity of Ficoll Hypaque separated human neutrophils was determined in a luminol-dependent chemiluminescence assay and compared to the white blood cell (WBC) count and the erythrocyte sedimentation rate (ESR) among 13 subjects with inflammatory bowel disease. Clinical disease activity was assessed with a standardized scoring system and judged to be mild in five subjects and absent (remission) in the other eight subjects. The chemiluminescent response of neutrophils was increased among 12 persons compared to that of healthy subjects. In contrast, the WBC count and ESR were abnormal only among two and four individuals, respectively. The widespread abnormality in neutrophil chemiluminescence, even among subjects classified as being in remission, suggests that chemiluminescence determinations may provide a means to monitor longitudinal changes in disease activity. PMID- 3967562 TI - Absorption of carbohydrate-electrolyte solutions in rat duodenojejunum. Implications for the composition of oral electrolyte solutions in man. AB - Commonly used oral electrolyte solutions are based on glucose, or sucrose, and 90 mM Na+. We had been disappointed with the ability of such solutions to improve Na+ absorption in patients with extensive resection of distal small bowel. Therefore, we tested the effect on net Na+ and water transport of combinations of different carbohydrates (glucose, sucrose, and glucose polymers) and NaCl in the rat duodenojejunum. Absorption was measured under steady-state conditions in unanesthetized animals which were infused with a different combination every hour for up to 5 hr. Of the various combinations, 10 mM glucose polymer (equivalent to 56 mmol of glucose as glucose oligosaccharides), or 60 mM glucose promoted net Na+ absorption from 120 mM NaCl and 20 mM KCl, but the glucose polymer infusate promoted more rapid water absorption than did the infusate containing glucose. The infusate of 10 mM glucose polymer in saline was initially hypotonic (276 mosmol/kg), but it became isotonic (298 mosmol/kg) as the glucose polymer was hydrolyzed during its passage through the duodenojejunum. In contrast, an infusate of 60 mM sucrose with 120 mM NaCl and 20 mM KCl remained hypertonic (320 mosmol/kg), and it did not promote water and Na+ absorption by the duodenojejunum. The efficacy of 10 mM glucose polymer with 120 mM NaCl should be tested in patients with short-bowel syndrome due to distal bowel resection. PMID- 3967563 TI - Healing of cysteamine-induced duodenal ulcers in the rat. AB - The mechanism and time for healing of cysteamine-induced duodenal ulcers in rats were investigated. Cysteamine induces a mixture of erosions, ulcers, and penetrating ulcers. These three stages of ulcerations healed in different ways and in different times. Erosions healed within three days by formation of new mucosa from the epithelium of the remaining parts of the crypts of Lieberkuhn. The mucosa became completely normal within 15 days. Ulcers healed primarily by a contraction of the circular layer of the external muscle coat, thereby approaching the ulcer edges and reestablishing a complete layer of Brunner's glands in the submucosa. Healing was complete within 15 days. Penetrated ulcers healed very slowly by formation of new epithelium and Brunner's glands from the ulcer edges. The newly formed epithelium was desquamated unless protected by underlying Brunner's glands and the regeneration of these therefore determined the healing of the ulcer. Only a few of these ulcers had healed after 50 days. After 100 and 150 days, approximately 50% had healed, and after 200 days still only 64% had healed. Thus the cysteamine ulcer with destroyed muscle coat has a very prolonged healing and thereby represents a model for a chronic duodenal ulcer which may be of value as a model for testing treatments of duodenal ulcers. PMID- 3967564 TI - Appendicolith. Significance in acute appendicitis and demonstration by computed tomography. AB - A case of periappendical abscess is presented in which the diagnosis was made by demonstration of an appendicolith in a large abscess cavity by computed tomography (CT) in conjunction with the clinical signs and symptoms. However, the appendicolith was not detected by plain film radiography. We stress that CT is more sensitive in detection of such small calcified bodies than plain film radiography and that the true incidence of appendicolith in acute appendicitis could be higher than that reported previously. PMID- 3967565 TI - Nutcracker esophagus. PMID- 3967566 TI - Esophageal motility disorders: the specter of the spectrum. PMID- 3967567 TI - Gastric mucosal prolapse or gastroesophageal intussusception. PMID- 3967569 TI - Combination antiemetic therapy in the control of chemotherapy-induced emesis. AB - Severe nausea and vomiting are frequent complications of cancer chemotherapy. Historically, single-agent antiemetic therapy frequently has been less than optimal. Because multiple sites of emetogenic activity may be involved in chemotherapy-induced nausea and vomiting, many investigators are now using combinations of antiemetics in an effort to block multiple receptor sites. Several preliminary studies using combinations of antiemetic agents that have shown encouraging results are summarized. PMID- 3967568 TI - Hepatitis B virus replication in steroid-treated severe HBsAg-positive chronic active hepatitis. AB - To determine the effect of corticosteroids on the replication of hepatitis B virus and to assess the relationship between virus replication and prognosis, the behavior of serum and tissue HBcAg was evaluated in 16 patients with severe HBsAg positive chronic active hepatitis who were treated with prednisone and followed for up to 10 years (mean +/- SEM, 66 +/- 9 months). Hepatitis B virus replication was assessed in serum by a solid-phase radioimmunoassay of Dane particle associated HBcAg and in liver tissue by indirect immunoperoxidase staining for HBcAg. Despite the presence of severe inflammatory activity, only low levels of hepatitis B virus replication were demonstrated. Mean serum HBcAg levels were low at accession and remained essentially unchanged or gradually decreased during corticosteroid therapy. Serum HBcAg appeared in only one patient in whom no virus replication was detected prior to therapy. HBeAg was frequently detected at low titers by radioimmunoassay when serum HBcAg was undetectable. Loss of HBcAg preceded loss of HBeAg by radioimmunoassay, and disappearance of both markers was a prerequisite for sustained histologic remission. In eight patients, inflammation was present despite absence of serum or tissue HBcAg; in three of these, disease activity continued after loss of HBeAg. We conclude that low levels of hepatitis B virus replication may be associated with severe inflammatory activity, and these levels are not increased by long-term corticosteroid therapy. Inflammation can continue despite loss of HBeAg and absence of detectable virus replication. PMID- 3967570 TI - Accidental massive IV administration of cyclosporine in man. AB - A 23-year-old female patient being treated for Hodgkin's disease (pulmonary) received by mistake cyclosporine iv instead of tranexamic acid. We followed the evolution of the clinical signs, which were interpreted as possible signs of acute toxicity, and monitored the plasma concentrations over an 84-hour period. PMID- 3967571 TI - Guanabenz therapy for opiate withdrawal. AB - A 29-year-old man used codeine approximately 1000 mg/d for seven years prior to detoxification. He developed dose-related clonidine side effects of dizziness, sedation, and dysphoria during standard clonidine detoxification; however, opiate withdrawal symptoms persisted. Conversion to guanabenz, a clonidine-like alpha 2 agonist, promptly relieved the opiate withdrawal symptoms without side effect recurrence. Guanabenz shows promise as an opiate withdrawal agent. PMID- 3967572 TI - Enhanced theophylline clearance secondary to phenytoin therapy. AB - This report describes two cases in which theophylline clearance accelerated markedly with concomitant phenytoin administration. Maximum calculated theophylline clearance ranged from 2 1/2 to 3 1/2 times baseline. Onset of the interaction began within five days of beginning concurrent therapy. With combined use, clinicians should be aware, when phenytoin is added, of the potential for reexacerbation of pulmonary symptomatology due to lowered serum theophylline concentrations. PMID- 3967573 TI - Psychotropic drug use by women: demographic, lifestyle, and personality correlates. AB - From initial telephone interviews with a random population of 1187 francophone women, 179 women participated in a further three-hour person-to-person interview focusing on the use of psychotropic medications. Psychotrope users typically were older, in poorer health, and had a lower level of education than abstainers. They showed an increased prevalence of nervousness, anxiety, depression, and restlessness. Initial contact with psychotrope use was through their general practitioners after presentation of vague and ill-defined symptoms. Psychotropic drug use was found among housewives, especially those with children, and among those unemployed but desiring work. Personality profiles of psychotrope users showed that they think of themselves as failures and are more distressed, with significantly greater life changes. Users scored higher on "femininity" subscales, apparently reflecting dependent and nondefensive personality types. In addition, personality measures defined psychotrope users as precise, methodical, cautious, serious, unassertive, and modest. The incompleteness of present unidirectional models of psychotropic drug use are discussed. Suggestions for future research include encompassing the cognitive organization of the psychotrope user within the context of social, affective, and physician influences on this form of coping style. PMID- 3967574 TI - Evaluation of a digoxin pharmacokinetic monitoring service in a community hospital. AB - This study was done to determine the effects of a pharmacokinetic service (PKS) on digoxin concentration monitoring and patient outcomes, including length of stay and toxicity measures. Two-hundred and eighteen consecutive patients with digoxin concentrations outside a target range were studied using a prospective before and after design. Demographic, diagnostic, and digoxin monitoring data were collected. The after group received PKS intervention by a clinical pharmacist. Results showed that the number of digoxin sample obtained was reduced by 22 percent in the after group and plasma concentrations were less often in the toxic range. The after group had significantly shorter lengths of stay (15.3 vs. 11.6 d) and fewer incidences of in-hospital digoxin toxicity (11.1 vs. 2.2 percent). Clinical pharmacist intervention was found to be associated with significant changes in patient outcomes, including length of stay and morbidity. The cost of the PKS was offset by savings resulting from the reduction in digoxin assays alone. PMID- 3967575 TI - Feasibility and cost savings of intravenous administration of aminoglycosides in outpatients with cystic fibrosis. AB - Hospitalization for some patients is often prolonged by days to weeks to complete a course of intravenous antibiotics. This is true with CF patients' who usually receive aminoglycosides throughout their hospital course. This study assesses the practicality and cost effectiveness of intravenous aminoglycoside therapy in outpatients with CF. Fifteen patients were discharged from the hospital a total of 31 times with up to three days of antibiotic, preloaded in syringes, to be administered with a portable syringe pump that delivered a dose over 40 minutes. A total of 242 drug infusions were self-administered in this manner. Flow-rate data indicated that the pumps infused at a rate within +/- 8% of their nominal rate. During the 31 courses of treatment, intravenous catheters had to be replaced on 11 occasions, but four of these episodes occurred in one patient who was treated at home for 36 days. Two malfunctions of the infusion system occurred, as did six catheter site reactions. The cost of preparing drug doses for outpatient use of this system and rental of the pump is not only less than that for in-hospital administration with piggy-back bottles (approximately $20 vs. $30/d, respectively), but totally negates the cost of the hospital room (approximately $200/d). Outpatient administration of aminoglycoside by controlled intravenous infusion is not only convenient and safe, but results in considerable cost savings. PMID- 3967576 TI - Tolmetin in breast milk. PMID- 3967577 TI - Positions held by graduates of postgraduate pharmacy fellowship programs. AB - The Brigham and Women's Hospital Pharmacy Department conducted a survey to determine how recently trained (since 1981) postgraduate pharmacy fellows have been employed. We received responses to mailed survey questionnaires from 40 of 42 institutions or colleges offering a pharmacy fellowship. Survey results showed 117 pharmacists completed fellowships from 1981 through July 1984. Fifty percent (58/117) of all graduates are members of college of pharmacy faculty, 20 percent (24/117) are pharmacy staff specialists, and 12 percent (14/117) have pharmaceutical industry positions. The survey shows that the majority of fellowships completed are in pharmacokinetics, with clinical pharmacology and infectious disease a distant second and third, respectively. Postgraduate pharmacy fellowships are important to prepare pharmacists for faculty positions in clinical or pharmacy practice departments of colleges of pharmacy. PMID- 3967578 TI - Residency training: pharmacy's rate-limiting step to clinical competency. PMID- 3967580 TI - Reading between the lines of clinical trials--I: Design. PMID- 3967579 TI - A third class of drugs: an overview. AB - Drug distribution in the U.S. allows certain products to be used only under the supervision of a physician or dentist. The distribution of other products is underrestricted, such that they may be used by consumers without any supervision. This article discusses the possibility of establishing a third class of drugs that would be available without a prescription but could be purchased only from a pharmacist. The current prescription-to-OTC switch process may provide an excellent opportunity to establish a third class of drugs. However, significant obstacles exist to such a move. For there to be sufficient public policy justification for a third class of drugs, it must be shown that the public will benefit through increased quality of health care and that the economic consequences will not be prohibitive. PMID- 3967581 TI - Reading between the lines of clinical trials--II: Analysis. PMID- 3967582 TI - Testosterone undecanoate--oral therapy for male hypogonadism. PMID- 3967583 TI - [Stroke-like events with negative computer-tomographic findings]. AB - In addition to cardiac and circulatory check-up and sonography of the arteries ascending to the brain, cranial computed tomography is essential for diagnosing strokes, preceding even arteriography. In 917 patients with suspected stroke who had been referred for ambulant computed tomography, catamnestic analyses were performed. Among 662 cases with positive CT findings there were 41 intracerebral hemorrhages and 6 subdural hematomas. In 234 cases, in which the computed tomography initially revealed no circumscribed cerebral infarction, transient ischemic attacks, insults of the cerebral trunk, insults of the cerebrum at an early stage, minor insults in cases of preceding vascular cerebral damage, prolonged reversible neurological deficits (PRIND) as well as vascular or tumorous spinal processes were present (in descending order). In cases of extracranial stenosis of the arteria carotis within the 8-hour interval, primary computed tomography is indicated to exclude hemorrhages or tumors. The sixth or seventh day following an attack is otherwise most suitable to perform secondary computed tomography, since fogging effect may occur later on. PMID- 3967585 TI - [Incidence of psychologic disorders]. PMID- 3967584 TI - [Value of spirometry in the early diagnosis of respiratory system diseases]. AB - During routine use of spirometry in a general medical practice in 31% of a group of 301 patients ventilation disorders were detected, which had not been known before. In 67 patients there was a positive result of a broncholysis test while pulmonary function values were normal (latent obstruction). During detailed interrogation risk factors for a respiratory disease were discovered, although there was no serious discomfort. If spirometry is routinely combined with a broncholysis test, latent respiratory obstruction can be easily recognized. This enables early diagnosis of respiratory diseases in low age groups. PMID- 3967586 TI - [Indications for drug therapy of chronic active hepatitis and posthepatitis liver cirrhosis]. PMID- 3967588 TI - [Warning about considerable pain in diagnostic interventions]. PMID- 3967589 TI - [Bone scan in metastasizing breast cancer]. PMID- 3967587 TI - [Delayed release forms of nitrates--are they obsolete today?]. PMID- 3967590 TI - [Raised creatine kinase]. PMID- 3967591 TI - [Acute pancreatitis caused by codeine preparations?]. PMID- 3967592 TI - [Toxoplasmosis encephalitis in patients with AIDS]. AB - Toxoplasmosis encephalitis developed in three male homosexuals with AIDS. Clinical symptoms of encephalitis began with a nonspecific organic mental syndrome. In two cases there developed late focal symptoms. There were light to moderately severe generalized EEG changes with additional focal signs. CSF findings and toxoplasmosis titres were not diagnostically altered. Computed tomography demonstrated multiple areas of decreased density in cortex and cerebellum. Administration of pyrimethamine and sulfamethoxydiazine to the three patients brought about clinical improvement within a few days and regression of abnormal CT changes within a few weeks of onset of treatment. One patient died after an encephalitis recurrence: autopsy demonstrated toxoplasma pseudocysts in immediate proximity to small necrotic foci in the brain. The possibility of toxoplasma encephalitis should be considered in AIDS patients who develop an organic mental syndrome. Often the diagnosis can only be made after response to a trial of toxoplasmosis treatment. PMID- 3967593 TI - [First examination of neonates. Results of early diagnostic documentation]. AB - There is an annual statistical evaluation of documentation, done since 1971, of an early disease diagnosis programme for children. At first examination of neonates in the years 1977-1981, sex-specific difference was low as regards data on pregnancies at risk, but definite and constant differences were recorded as regards psychic and social stress during pregnancy. Pregnancies at risk without any special features at birth were registered in 12.5%. In 58.4% of newborns no special features with regard to pregnancy or birth were recorded. In contrast to all other markers, final pelvic position was more frequent for girls than boys. The proportion of operative obstetric procedures has slowly fallen from 1977 to 1981. Cesarean section has recently been practised in 12.4%. With regard to birth weight of children, the documentation revealed a difference from the Federal Statistical Office, which showed a higher number of low-birth weight new-borns. Comparing the results with those of other German or foreign statistics, there is a strikingly high frequency of cesarean section in the Federal Republic of Germany. PMID- 3967594 TI - [Normal values for two-dimensional echocardiography]. AB - In 51 normal subjects (26 men, 25 women, age range 15-38 years), normal values for longitudinal axis and diameters of left and right ventricle and left and right atrium were determined by 2-D echocardiography. Both left parasternal longitudinal and cross-sectional cuts were used. Tolerance values to determine normal range were recorded, in addition to mean values and standard deviations. Diastolic and systolic diameters (DD/DS) in the left parasternal longitudinal and cross-sectional cuts gave similar results to those in the 4-chamber view from the apex: DD 2.7 +/- 0.4 (2.3-3.1) cm/m2, DS 1.8 +/- 0.4 (1.4-2.2) cm/m2, and DD 2.7 +/- 0.4 (2.3-3.1) cm/m2, DS 1.7 +/- 0.3 (1.4-2.0) cm/m2, respectively. Sizes of the right ventricle (1.8 +/- 0.4/1.4-2.2 cm/m2) and right atrium (2.4 +/- 0.5/1.9 2.9 cm/m2) could only be obtained in the 4-chamber view. Values for the left atrium (2.3 +/- 0.7/1.6-3.0 cm/m2) were obtained also in the left parasternal cross-section. Correcting for body surface, differences between males and females were reduced to the extent that there was no significant difference between them. These normal values make it possible to standardize the measurement of intracardiac dimensions by 2-D echocardiography and classify individual values. PMID- 3967595 TI - [Poisoning as a method of suicide in children and adolescents]. AB - The number of suicides by children and juveniles has remained similar or even slightly reduced in the last 5 years. This correlates with the constancy or slight reduction in the number of the under-20-years population over this period. Comparison with deaths due to suicide in Prussia (1894-1897) indicates that suicide in children and juveniles is not more common today than it was nearly a hundred years ago. Hanging and suffocation are the most frequent means, followed by poisoning. Less common are jumping from a height, shooting, drowning or stabbing. Cause of the suicide attempt is usually a disturbed relationship to a partner. Acute quarrel with parents dominates. The psychopathological background is abnormal reactions to experience and abnormal reactions to conflict. Neurosis and psychosis or infantile reactions are much less common. PMID- 3967596 TI - [Hyperbaric oxygenation treatment of the after-effects of carbon monoxide poisoning]. AB - Following a symptom-free interval of 2 weeks after acute carbon monoxide poisoning a 38-year-old previously healthy man gradually developed impairment of drive and movement, disturbed memory, disorientation, mutism and abnormal gait. Finally, an apallic syndrome developed. After a total of 40 periods of hyperbaric oxygen administration the patient recovered completely and resumed his work. The EEG improved during the treatment more rapidly than the clinical picture. The electropolysomnograph changed in parallel to the clinical picture. Computed tomography on admission to hospital demonstrated a zone of lower density in the region of the right globus pallidus. This finding was no longer demonstrable after the patient had fully recovered. PMID- 3967597 TI - [Tuberculin diagnosis]. PMID- 3967599 TI - [Recurrent thrombosis of the subclavian vein during estrogen therapy of prostatic cancer]. PMID- 3967598 TI - [Right of the head physician to charge for physico-medical services (Paragraph E of the GOA) during hospital treatment]. PMID- 3967600 TI - [Cyclosporin A treatment in severe endocrine ophthalmopathy]. PMID- 3967601 TI - [Similarities and differences in the psychological performance of schizophrenic patients and their families]. PMID- 3967602 TI - [Continuous ambulatory peritoneal dialysis. 5-year clinical experience]. AB - Continuous ambulatory peritoneal dialysis (CAPD) is, next to conventional home dialysis, a world-wide method of treating chronic renal failure. This is the report of clinical experience of 34 CAPD patients who, from October 1978 to the end of 1983, had undergone 642 treatment months. The incidence of peritonitis after introduction of a new connector system in 1983 was reduced to 1 per 46 CAPD treatment months. In only 7 patients was it necessary to discontinue CAPD for reasons connected with the type of dialysis. No patient requested discontinuance of CAPD. Suitable bag and tube materials, adequate space, and well trained personnel are decisive for a successful CAPD programme, in addition to careful selection of patients. The latter aims at optimal patient motivation for the treatment method which, in principle, is more cost effective than home dialysis. In so far as patients fulfil the requirements for home dialysis they can be excellently rehabilitated. PMID- 3967603 TI - [Diagnosis and therapy control of neuroblastoma using meta-iodo- benzylguanidine]. AB - Meta-iodine-benzylguanidine (MIBG) scanning provides, for the first time, specific radiological means for diagnosis, treatment follow-up and post-treatment care of patients with neuroblastoma. Of 10 such patients studied by MIBG scanning, 7 had histologically confirmed neuroblastoma. In 6 of them there was markedly increased activity in the primary tumor, in 3 metastases were demonstrated. In at least one patient the intensity of increased activity suggested the possibility of selective therapeutic administration. PMID- 3967604 TI - [Incidence of hepatitis B virus infection in the medical personnel of physicians' offices]. AB - Serological examination to determine anti-HBc antibodies in 1487 medical personnel working with practitioners in Essen revealed a hepatitis B virus incidence rate of 12.8%. The incidence rate depended on age, years of service, and nature of duties. Anti-HBc examination of medical personnel is cost-saving in view of high cost of vaccination. It can be omitted only in beginners if certain conditions are fulfilled (anti-HBc rate below 5%). PMID- 3967605 TI - [Unaimed biopsy in gastroscopy]. PMID- 3967606 TI - [Quantitative relation between localized brain lesions and neuropsychological performance in children. Notes on the effect of exercise therapy]. PMID- 3967608 TI - [Dissection of a child's cadaver. 28 September 1982 decision of the County Court of Saarbrucken]. PMID- 3967607 TI - [Chronic diarrhea caused by abuse of laxatives]. PMID- 3967609 TI - [Methylisocyanate]. PMID- 3967610 TI - [Persistence of antibodies against hepatitis B surface antigens after vaccination against hepatitis B]. AB - In 195 patients vaccinated against hepatitis B the course of anti-HBs concentration was followed over 4 years. Persistence of anti-HBs proved to be dependent on the level of anti-HBs concentration after basal immunization: in 14 subjects with a maximal anti-HBs level between 10 and 100 IU/l the level had dropped to less than 10 IU/l (considered to be the lowest prophylactic concentration), while 7 were anti-HBs negative. Of those who had 101-1000 IU/l after initial immunization 49% had anti-HBs levels under 10 IU/l after 4 years, while 18% were negative. Among subjects with concentrations 1001-10 000 IU/l after the third immunization only 7% had values below 10 IU/l after 4 years, 4.2% were negative. All those who, after the third immunization, had had anti-HBs levels above 10 000 IU/l, 4 years later still had anti-HBs levels of more than 100 IU/l (mean 581 IU/l). Quantitative anti-HBs determination after triple vaccination against hepatitis B thus makes it possible to predict the duration of protection and to determine the timing of re-vaccination. PMID- 3967611 TI - [Treatment of deafferentation pain by high-frequency intervention on the dorsal root entry zone]. AB - From August 1980 to May 1981, high-frequency lesions of the dorsal root entry zone of the spinal cord were performed on 35 patients with chronic deafferentiation pains. Among them were 15 patients with traumatic transverse cord lesions, 5 with non-traumatic transverse lesions and 7 with cervical root tears or traumatic brachial plexus lesions, 6 with stump or phantom pain after amputation, and 1 each with sciatic paralysis or spinal arachnopathy. Treatment results were best in complete transverse lesions, cervical root avulsion and brachial plexus lesion, less so for stump or phantom pain of the lower extremities. It failed in patients with sciatic-nerve lesion and arachnopathy. Thus best results are to be expected if the method is limited to genuine deafferentiation pain. PMID- 3967613 TI - [Diagnosis and differential diagnosis of acute chest pain]. PMID- 3967612 TI - [Asthma, eosinophilia and systemic vasculitis: Churg-Strauss syndrome]. AB - In two female patients asthma, marked eosinophilia and symptoms of systemic vasculitis could be classified clinically or histologically as allergic angiitis and granulomatosis (Churg-Strauss syndrome). The course in one patient went back over 20 years, characterized by an asymptomatic interval of 16 years. It is to be assumed that the disease is more frequent than it is diagnosed. It has to be thought of when, in addition to asthma and eosinophilia, there is evidence of involvement of other organs. PMID- 3967614 TI - [Recommendations for the execution of pulmonary function tests in general practice]. PMID- 3967615 TI - [Arrhythmias in athletes]. PMID- 3967616 TI - [The variable functions of the periodical Duodecim]. PMID- 3967617 TI - [Scientific publishing in the future]. PMID- 3967618 TI - [Medical professional skill--broader, thinner or deeper?]. PMID- 3967619 TI - Effect of hypophysectomy and subsequent prolactin administration on hypothalamic 5-hydroxytryptamine synthesis in ovariectomized rats. AB - Increased levels of PRL whether of natural or experimentally induced cause result in an increased turnover of the putative PRL-inhibiting factor dopamine (DA) within tuberoinfundibular neurons, suggesting that PRL can regulate its own release via a short loop feedback mechanism. Although it is known that activation of the hypothalamic 5-hydroxytryptamine (5HT) system stimulates PRL release, the possibility that PRL could alter metabolism or release of this amine within the hypothalamus has not been examined. In the first experiment, bilaterally ovariectomized adult Sprague-Dawley rats were divided into three groups: hypophysectomized rats (HYPOX), HYPOX rats injected sc with 0.5 mg kg-1 ovine PRL (oPRL) at 1000 h and 1800 h on the day before killing the rats (HYPOX + PRL), and rats without further surgical manipulation (controls: NON-HYPOX). Three weeks after surgical manipulation, the rats were injected iv with 100 mg kg-1 NSD-1015 and killed 15 or 30 min later. 5-Hydroxytryptophan accumulation was measured by HPLC with electrochemical detection as an index for the rate of 5HT synthesis. The rate of 5HT synthesis was increased in the median eminence (ME) and mediobasal hypothalamus (MBH) but not anterior hypothalamus of HYPOX rats in comparison to the rate of synthesis of this amine in these areas of control rats. This effect was reversed in the ME and MBH of HYPOX + PRL rats. If 5HT stimulation of PRL release were achieved by 5HT inhibition of the tuberoinfundibular DA system as has been proposed previously, then it is also conceivable that the PRL short loop feedback on hypothalamic 5HT synthesis as suggested by the results of the first experiment is mediated via this DA system. To test this hypothesis in the second experiment, adult Sprague-Dawley rats were injected at 1000 h and 1800 h on the day before their killing with 0.5 mg kg-1 oPRL; 0.5 mg kg-1 oPRL, and 10 mg kg-1 pimozide (PIM) a DA receptor antagonist; 10 mg kg-1 PIM; or, on the day of their killing, with 1 mg kg-1 apomorphine (APO), a DA receptor agonist. An additional group of ovariectomized-HYPOX as well as a group of ovariectomized-NON-HYPOX rats were also included in this experiment. On the day of the experiment the rats were injected iv with 100 mg kg 1 NSD-1015 and killed 30 min later. 5-Hydroxytryptophan accumulation was measured by HPLC with electrochemical detection as an index of the rate of 5HT synthesis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3967620 TI - Age-associated changes in nuclear binding of rat uterine estradiol receptor complexes. AB - Nuclear binding of cytoplasmic estrogen receptors was measured in an in vitro cell-free system, using various mixtures of cytosols and nuclei from uteri of mature (6-9 month old) and senescent (24-25 month old) Wistar rats. Both nuclei and cytoplasmic receptors from senescent uteri were 25-35% less efficient in supporting nuclear binding than those obtained from mature tissues as evidenced by the concentrations of occupiable nuclear acceptor sites. No age differences in association or dissociation constants were observed for the nuclear binding reaction. However, the apparent inability of some aged receptors to bind to the full complement of mature nuclear acceptor sites may indicate a qualitative deficiency in the cytosols of senescent uteri. PMID- 3967621 TI - Hyperinsulinemia suppresses glucose utilization in specific brain regions: in vivo studies using the euglycemic clamp in the rat. AB - It has been suggested that insulin acts centrally by altering brain glucose uptake. Previous studies of the effect of insulin on brain glucose metabolism have been difficult to interpret due to lack of steady state conditions for glucose and/or insulin. To determine whether insulin per se alters brain glucose metabolism, we measured glucose utilization rates, using the deoxyglucose method, in the medial basal hypothalamus, locus coeruleus, and motor cortex of conscious, unrestrained rats undergoing 2-h euglycemic clamps (blood glucose, 4.1 +/- 0.1 mmol/liter) at increasing insulin infusion rates. Plateau insulin levels were 29 +/- 5 mU/liter (controls) and 48 +/- 4, 146 +/- 8, 670 +/- 40, and 7560 +/- 410 mU/liter (clamped). Glucose utilization rates in the medial basal hypothalamus fell significantly from 60 +/- 4 mumol/100 g X min (controls) to 46 +/- 3, 39 +/- 2, 35 +/- 2, and 39 +/- 3 mumol/100 g X min in respective insulin-infused animals (P less than 0.01 vs. controls). Similar falls of up to 39% and 48% were seen in the locus coeruleus and motor cortex, respectively. A significant inverse correlation was found between the glucose utilization rate in each brain region and the log plasma insulin level. The reduction in glucose utilization rate was associated with marked increases in serum corticosterone levels (995 +/- 157 vs. 91 +/- 31 nmol/liter in controls, P less than 0.001). Serum potassium was significantly lower in clamped animals (5.2 +/- 0.3 to 5.9 +/- 0.3 mmol/liter) than in controls (7.0 +/- 0.4 mmol/liter, P less than 0.01). However, the inverse correlation between regional brain glucose utilization and log plasma insulin was independent of changes in serum potassium, while there was no independent correlation with serum potassium. The data reveal reduced glucose utilization in specific brain regions in the presence of insulin levels both equal to and above those found in the postabsorptive state and support a direct effect of insulin in suppressing regional brain glucose utilization. PMID- 3967622 TI - In vitro evidence for an intracellular mechanism limiting the thyroid follicular cell growth response to thyrotropin. AB - The purpose of this study was to further investigate the mechanism that limits thyroid growth in the presence of a sustained elevation of serum TSH. An in vitro thyroid follicle culture was used, thyroid function and growth being assessed by 131I- organification and [3H]thymidine incorporation into DNA, respectively. Normal thyroid follicles incorporated [3H]thymidine in response to added TSH and also organified 131I-. Follicles taken from rats previously given goitrogen for 80 days, however, organified 131I- in response to added TSH but did not incorporate [3H]thymidine. These in vitro results parallel those obtained in in vivo studies despite the disruption of thyroid architecture. We conclude that the growth desensitization seen in vivo during sustained serum TSH elevation is mediated by an intracellular change in the follicular cell (either at the receptor or postreceptor level) rather than by a locally acting chalone. PMID- 3967623 TI - Stimulation of renal deoxyribonucleic acid synthesis by a pituitary-derived renotropin and its inhibition by testosterone and thyroxine. AB - Kidney slices were obtained from castrated-hypophysectomized male rats treated with a single injection of several different gonadotropin preparations (two ovine LH fractions, one bovine LH fraction, and one hCG fraction) or vehicle, then incubated in a buffer containing [3H]thymidine. Only one of the above, an ovine LH preparation, increased [3H]thymidine incorporation into renal DNA, with a peak occurring 8-10 h after injection and therefore termed renotropin. However, in hypophysectomized rats with intact testes, such an effect was not observed. Furthermore, while testosterone propionate alone did not alter basal incorporation in castrated-hypophysectomized rats, it abolished the incorporation that was stimulated by renotropin. These results suggest that androgens, whether of testicular origin or exogenously administered, suppress the increased incorporation of [3H]thymidine stimulated by renotropin. This antagonistic effect of androgen was also observed with T4, but to a lesser degree. Our findings confirm the presence of renotropin, which could not be attributed to other known pituitary hormones, and suggest that there is a complex interaction between this factor and two other renal growth-promoting hormones, testosterone and T4. PMID- 3967624 TI - Inhibition of hormonal activation of hepatic phosphorylase by chlorpropamide: evidence for an intracellular site of drug action. AB - Phosphorylase a activity was measured in hepatocytes from fed rats, some of which received ip chlorpropamide injections for 5 days preceding death (20 mg/100 g BW X day for 5 days). Chlorpropamide treatment significantly depressed basal phosphorylase a activity and lessened the increments in the activity of this enzyme induced by 10(-10) -10(-8) M glucagon and arginine vasopressin. The reductions in phosphorylase a activity after treatment with chlorpropamide were more than sufficient to explain the accompanying decreases in hepatic glucose production. Since glucagon and arginine vasopressin stimulate alternate pathways of phosphorylase activation and since chlorpropamide antagonizes both hormones, it is likely that the drug acts at or distal to the intracellular site (phosphorylase kinase) at which the two activation pathways converge. PMID- 3967625 TI - Sexual dimorphism in the posterior pituitary response to stress in the rat. AB - The posterior pituitary response to immobilization was studied in male and female rats. Plasma levels of arginine vasopressin (AVP) and oxytocin (OT) were measured both in control rats and in rats immobilized in an acrylic restrainer for 1 min. In male rats immobilization did not result in any change in AVP (control: 1.3 +/- 0.2 pmol/liter, mean +/- SEM; immobilized: 2.3 +/- 0.6 pmol/liter), although there was a small but significant increase in OT (control; 4.1 +/- 0.5 pmol/liter; immobilized: 10.2 +/- 2.2 pmol/liter; P less than 0.005). In female rats a marked rise was observed in AVP (control: 1.4 +/- 0.3 pmol/liter; immobilized: 5.5 +/- 1.3 pmol/liter; P less than 0.005), and the rise in OT was considerably greater (P less than 0.01) than that found in males (control: 4.7 +/ 0.8 pmol/liter; immobilized: 26.0 +/- 5.6 pmol/liter; P less than 0.001). Further groups of male and female rats were gonadectomized 2 weeks before immobilization. Basal levels of AVP and OT were unchanged. Orchidectomized males had an increased OT response to immobilization compared with sham-operated males (P less than 0.05) whereas the AVP response was not significantly changed. Ovariectomy did not significantly affect either the AVP or OT responses. Although the neural pathways responsible for the neurohypophyseal response to immobilization are not known, this data demonstrate that the response is dependent on the sex of the rat. PMID- 3967627 TI - The pattern of progesterone secretion in hypophysectomized rats bearing pituitary transplants: effects of hysterectomy, estrogen, and indomethacin. AB - Cyclic rats were hypophysectomized and their pituitaries transplanted beneath the kidney capsule on day 2 (day 1, ovulation); they were then either hysterectomized or sham hysterectomized (uterus intact rats) and injected sc daily with either 1.0 micrograms 17 beta-estradiol (E1) or with the sesame oil vehicle until autopsy on day 105. Blood samples were drawn by jugular venipuncture every 2 to 3 days until day 21 and once weekly thereafter. In these rats the serum progesterone level rose until about day 8 and tended to reach a plateau between days 8 and 14. The regression phase began, in general, after days 8 to 14 and continued, without change in rate, for at least 3 months. In both the uterus intact and the hysterectomized rats, E1 seemed to induce an earlier onset of regression and a brief increase in its rate, but did not otherwise affect the rate of regression. In the hysterectomized rats regression began later than in the uterus-intact rats, but its rate was also not different from the latter. The serum progesterone pattern of rats subjected to pituitary autotransplantation on day 2 was compared with that of pseudopregnant rats which were either subjected to pituitary autotransplantation on day 2, 5, 7, or 9, or were given a pituitary homotransplant on day 2, and then hypophysectomized on day 2, 3, 5, or 7. A group of rats with sham operations served as additional controls. In these rats, the same pattern of serum progesterone already described was seen in those subjected to either pituitary autotransplantation on or before day 5, or to pituitary homotransplantation, and to hypophysectomy on or before day 5. However, when the pituitary was autotransplanted on day 7 or day 9, or when the pituitary homotransplant-bearing rat was hypophysectomized on day 7, regression began earlier and was more rapid than in rats operated on on or before day 5. In fact, in the rats operated on on day 9, regression was as rapid as it was in the intact (sham operation) controls. Another group of rats subjected to pituitary autotransplantation and hysterectomy on day 2 was divided into four subgroups on day 21. In two of these, the rats received indomethacin-containing Silastic capsules inserted into each ovarian bursa; in the other two groups blank capsules were similarly inserted.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3967626 TI - Biosynthesis of calcitonin by human lung cancer cells. AB - The ectopic secretion of calcitonin (CT) by a wide variety of nonthyroidal human tumors has been studied by CT RIA, but little information is available concerning the biosynthesis of CT in these tumors. In the present study, a human lung cancer cell line (BEN), secreting high mol wt forms of CT was investigated to characterize the CT gene products synthesized. When conditioned medium from BEN cells was chromatographed through a Bio-Gel P-30 column, larger species of immunoreactive CT were detected with mol wt of approximately 8,000 and 18,000. Little, if any, CT of 3,500 mol wt was detected. To examine CT gene products produced in BEN cells, poly A+ RNA was isolated from BEN cells and subjected to cell-free translation assays and DNA/RNA hybridization assays. In the wheat germ cell-free translation assay, a single BEN cell product which migrated on sodium dodecyl sulfate-polyacrylamide gels with an apparent mol wt of 17,000 could be specifically immunoprecipitated with CT antisera. A similar sized CT-related translation product is produced in wheat germ assays programmed by mRNA prepared from human medullary thyroid carcinomas. In DNA/RNA hybridization assays, a single BEN cell mRNA species of 1,000 base pairs, identical in size to human thyroidal CT mRNA, hybridized to a radiolabeled CT cDNA probe. Hybridization of the CT cDNA probe with BEN cell mRNA was confirmed by RNA dot blot hybridization and cytoplasmic RNA blotting procedures. These results indicate that larger mol wt forms of CT secreted by BEN cells are derived from a translation product and a mRNA which are of similar, if not identical, size as CT gene products produced in human thyroidal tissues. The inability of lung tumor cells to process the CT precursor to calcitonin of 3,500 mol wt may reflect a lack of specific prohormone processing enzymes in these tumor cells or may be due to structural polymorphism in the CT precursor expressed in the lung cells. PMID- 3967628 TI - Morphological and functional changes during thyroid hyperplasia and involution in C3H mice: effects of iodine and 3,5,3'-triiodothyronine during involution. AB - Involution of thyroid hyperplasia was induced in mice by discontinuing a goitrogenic treatment (low iodine diet plus 0.25% propylthiouracil for 10 days) and returning either to a moderate iodine diet (MID; 1 microgram I/day) alone or associated with T3 administration (1 microgram/day) or to a high iodine diet (HID; 10 micrograms I/day) alone or associated with T3 treatment. Thyroid involution was studied by morphological, stereological, and biochemical methods after 2, 4, 6, and 8 days of involution. Age-paired, HID-fed animals were used as controls. When the involution was induced by MID, the glands resumed a normal morphological aspect. The synthesis and secretion of T3 were highly stimulated on day 2, but decreased thereafter. Plasma T4 levels reached a plateau at 50% of the control value from days 2-8. The administration of T3 together with MID accelerated the involution of hyperplasia and colloid accumulation in the follicular lumina. The synthesis and secretion of T3 and T4 remained lower than those in controls. When the involution was induced by HID, the thyroid weight remained higher than that in controls or in any involuting groups. The number of follicles and epithelial cells as well as the glandular thyroglobulin content were twice the control values. A Wolff-Chaikoff effect was evident on day 4, and hypothyroidism persisted. When HID was supplemented with T3 treatment, glandular weight and morphology were normal, but the Wolff-Chaikoff effect occurred earlier. In conclusion, the iodine dose given after a goitrogenic treatment must be carefully controlled; a high but physiological dose can have deleterious effects, whereas a small dose is beneficial. T3 prevents the deleterious effects of HID, but the thyroid enters a resting state. PMID- 3967629 TI - The development of a male pseudohermaphroditic rat using an inhibitor of the enzyme 5 alpha-reductase. AB - Incomplete masculinization of the external genitalia occurred in male Sprague Dawley rats treated with a potent inhibitor of enzyme 5 alpha-reductase at the critical period of sexual differentiation in utero. The studies were performed using the 5 alpha-reductase inhibitor, 4-methyl-4-aza-5-pregnan-3-one-20[s] carboxylate, one of a series of aza steroids known to competitively inhibit the enzyme 5 alpha-reductase. The degree of inhibition of male external genital development was dependent upon the dose of the inhibitor, and at a dose of 36 mg/kg X day, there was complete feminization of the external genitalia of the male animal with a urogenital sinus and a pseudovagina. These studies provide conclusive evidence for the hypothesis that 5 alpha-reductase activity and dihydrotestosterone (17 beta-hydroxy-5 alpha-androstan-3-one) formation are essential for normal differentiation of male external genitalia. Epididymidis, vasa deferentia, and seminal vesicles were present at all doses of the inhibitor, suggesting testosterone dependency. However, confirmation of the testosterone dependency of Wolffian ductal differentiation awaits further studies, particularly comparison studies with the rabbit and dog, since Wolffian ductal differentiation in the rat, unlike the rabbit and dog, is not abolished with the antiandrogen, cyproterone acetate. The presence of prostatic buds, despite complete external genital feminization, was unexpected and suggests that these structures may have different thresholds of response for dihydrotestosterone. Prostatic differentiation may have a much lower threshold, requiring less dihydrotestosterone for differentiation. PMID- 3967630 TI - Age-correlated and ovary-dependent changes in relationships between plasma estradiol and luteinizing hormone, prolactin, and growth hormone in female C57BL/6J mice. AB - Impairments in the estradiol (E2)-induced surge of LH occur as aging female rodents lose reproductive cycles. These and other impairments can be substantially attenuated by ovariectomy of the young adult. In female rats, plasma PRL tends to increase with age, whereas in male rats, GH tends to decrease; PRL is regulated by E2, whereas GH is probably not. To determine if age correlated neuroendocrine impairments are accompanied by altered neuroendocrine sensitivity to E2, the relationships among plasma E2, LH, PRL, and GH were assessed in 6- and 12-month-old cycling and 18-month-old acyclic female C57BL/6J mice given E2 implants. An additional 18-month-old group, ovariectomized at 6 months of age, was examined to determine if age-correlated changes in sensitivity to E2 are ovary dependent. One week after ovariectomy, mice were given different sized E2 implants which generated a physiological range of plasma E2. Three weeks after implantation, plasma E2 correlated positively with implant size, uterine weight, and PRL, but correlated negatively with LH in each age group; age did not affect plasma E2 levels. The suppression of LH by E2 decreased progressively with age. Conversely, the elevation of PRL by E2 increased with age. These effects of age were largely prevented by ovariectomy at 6 months of age. Plasma GH decreased slightly with age, but was not significantly affected by E2; old mice ovariectomized when young had lower GH levels than previously intact old mice. GH also correlated positively with LH in all age groups. We conclude that neuroendocrine responses to E2 are altered with age even before estrous cycles are lost. Sensitivity to E2 may either increase or decrease, depending on the function. These effects of age can be attenuated by prolonged ovariectomy. Thus, chronic exposure to ovarian E2 during normal reproductive cycles may alter neuroendocrine sensitivity to E2, which may lead to age-correlated impairments in reproductive function. PMID- 3967631 TI - Calcitonin produces hypercalcemia in leopard sharks. AB - Calcitonin was detected by RIA in sera from four marine species, leopard sharks (Triakis semifasciata), horn sharks (Heterodontus francisci), thornback rays (Platyrhinoides triseriata), and kelp bass (Paralabrax clathratus). These animals have levels of calcitonin and calcium higher than freshwater and terrestrial species have. The administration of salmon calcitonin to bass (4 micrograms/kg BW) produced hypocalcemia and hypophosphatemia as has been reported for other bony vertebrates. In marked contrast, calcitonin produced a prompt hypercalcemia in sharks; the average was 9.8% increase in serum calcium in nine animals with no attendant change in phosphorus. These findings demonstrate that calcitonin can increase serum calcium in sharks. Because shark skeleton is composed of cartilage, this hypercalcemic effect of calcitonin does not require a bony skeleton. PMID- 3967633 TI - Testing of 24 food, drug, cosmetic, and fabric dyes in the in vitro and the in vivo/in vitro rat hepatocyte primary culture/DNA repair assays. AB - Twenty-four dyes currently or previously used in the food, drug, cosmetic, and textile industries were tested in the in vitro rat hepatocyte primary culture/DNA repair (HPC/DR) assay and, to a limited extent, in the in vivo/in vitro HPC/DR assay. The positive control, Solvent Yellow 3 (o-aminoazotoluene), and five other dyes (4-dimethylaminobenzeneazo-1-naphthalene, 4-dimethylaminobenzeneazo-2 naphthalene, Direct Blue 53, Acid Blue 9, and 4-dimethylaminostilbene) induced DNA repair in rat hepatocytes both in vitro and in vivo, while 13 of the dyes (Food Red 1, Food Red 5, Food Orange 4, Food Red 7, Acid Red 14, Acid Red 27, Pigment Red 53, Acid Yellow 23, Food Black 1, Food Green 3, Acid Red 51, Acid Blue 74, and Natural Red 4) did not produce any detectable DNA repair in either the in vitro or in vivo/in vitro assays. Direct Blue 14 had weak activity in vitro but none was detected in vivo. In contrast, Solvent Yellow 5 was not active in vitro, but produced a weak positive response in vivo. Negative responses were also obtained for Solvent Yellow 14 and Acid Green 5 in the in vitro assay, whereas the responses produced by these dyes in the in vivo/in vitro assay were judged to be equivocal. An equivocal response was also obtained for Direct Red 28 in the in vivo/in vitro assay as well as in the in vitro assay. These findings provide information about the potential genotoxicity of a number of dyes for which previous genotoxicity data has been inconsistent or inadequate. For some dyes (eg, Solvent Yellow 5), discrepancies between the results obtained in the in vitro and in vivo/in vitro assays may implicate a role for intestinal microflora in their metabolic activation. PMID- 3967632 TI - Development of a standard protocol for in vitro cytogenetic testing with Chinese hamster ovary cells: comparison of results for 22 compounds in two laboratories. AB - A major problem of cytogenetics testing in mammalian cells is lack of agreement of results among laboratories. Our objective was to develop a sensitive in vitro test protocol that was applicable to large-scale chemical screening and yielded comparable results in two laboratories. We used sister chromatid exchange (SCE) and chromosome aberration (CAb) tests in Chinese hamster ovary (CHO) cells. The initial protocol used standard cell densities, medium, batch of rat liver S9 for metabolic activation; positive, negative, and solvent controls; staining and scoring techniques; and fixation times. Treatment without S9 was for 8-12 hr (CAb) or 26 hr (SCE), and with S9 for 2 hr in serum-free medium. Bromodeoxyuridine (BrdUrd) (10 microM) was added to SCE cultures only, 2 hr after addition of the test chemical. Doses were based on the 50% toxicity level in a preliminary test of cell survival 24 hr after treatment. One hundred cells (CAb) or 50 cells (SCE) were scored from each control and from five dose levels. Five clastogens were tested in the first two-laboratory comparison: mitomycin-C, triethylenemelamine, N-methyl-N'-nitro-N-nitrosoguanidine, cyclophosphamide, and benzo(alpha)pyrene. There was quite good agreement between laboratories. Seventeen compounds were then tested "blind" in the two laboratories. As testing proceeded, some discrepancies occurred between the laboratories, and the protocol was modified in attempts to improve the resolution of marginal responses and make dose selection more consistent. The preliminary test for cell survival was omitted. A 10(5) dose range in a half-log series was tested, and cells were scored at the highest dose at which sufficient mitotic cells were obtained, and at the next two lower doses. By delaying fixation times, SCE and CAb were scored at doses that inhibited cell cycle progression. This protocol gave comparable results in the two laboratories in many cases and by testing up to a maximum dose, limited by solubility and/or toxicity, should detect a high proportion of clastogens and SCE inducers. PMID- 3967634 TI - Screening program theory: decision functions and protocols. AB - A screening program is defined to include a set of tests, a decision function, and a protocol. The major characteristics of a screening program are the error rates of the individual tests, the overall error rates of the program, the costs of the individual tests, and the overall program costs. It is shown how to calculate the program error rates for any given decision function. The concept of a screening protocol is developed and a method for enumerating all protocols of a given decision function is given. A given protocol has two calculable costs: the average cost of testing a mutagen and the average cost of calculating a nonmutagen. A method for calculating these costs for any protocol is given. All decision functions utilizing up to five tests are enumerated. PMID- 3967635 TI - Clastogenicity of a male contraceptive, gossypol, in mammalian cell cultures with and without the metabolic activation by S9 mix. AB - The clastogenicity of a potential male contraceptive, gossypol, was examined in cultured Chinese hamster cells with and without the presence of a metabolic activation system (rat liver S9 mix). Gossypol at concentrations of 1, 5, and 10 micrograms/ml did not induce chromosome breakage either in the presence or absence of the S9 mix. The ability of this compound to induce chromosome breakage and polyploidy was further examined in human lymphocyte cultures. Neither increased frequencies of chromosome breakage nor polyploidy was found in lymphocyte cultures from two healthy donors. The present study indicates that gossypol does not cause genetic damage at the chromosomal level. This is consistent with previously reported findings that it does not produce mutations in the Ames test. Gossypol has been under clinical trial in China for years and shown to be effective in 99.9% of over 10,000 men tested with no or mild side effects. If this compound can be further proven to be "safe" and approved for world-wide use as a male contraceptive, it would be for the benefit of all mankind. PMID- 3967636 TI - Effect of 2,5-hexanediol on immunocompetence of mice. AB - A preliminary study on immunotoxicologic evaluation of 2,5-hexanediol (one of the principal metabolites of n-hexane), involving multiple immunological parameters, was carried out in mice. Mice were exposed to 2,5-hexanediol at a 1/5 LD50 dose level for 7 days. Pathotoxicological changes such as marked reduction in absolute and relative lymphoid organ weights, histological abnormalities in thymus, spleen, and adrenal, and reduction in cellularity of lymphoid organs were found. Immune function tests such as delayed hypersensitivity reactions, plaque-forming cell assays, serum antibody titer against SRBC, and resistance to endotoxin shock were also markedly impaired. Results obtained in this study showed that 2,5 hexanediol causes impairment to immunocompetence in mice. PMID- 3967637 TI - Ambient air concentrations of asbestos fibers near the town of Asbestos, Quebec. AB - Ambient air concentrations of asbestos fibers were measured during the period June 20 to August 12, 1980, at three locations; Danville, Asbestos, and Wottenville in the eastern townships of Quebec. Measurements were done with low volume samplers and measurement periods extended from 3 to 13 days. Fiber counts were done by means of electron microscopy. Results indicate that overall fiber concentrations are related to atmospheric stability and to the direction of the prevailing wind with respect to the source of emission. PMID- 3967638 TI - Reversibility of testicular atrophy induced by Di(2-ethylhexyl) phthalate in rats. AB - Previous studies have shown that di(2-ethylhexyl) phthalate (DEHP) results in atrophy of testes and accessory sex organs accompanied by a decreased testicular concentration of zinc in rats. An experiment was performed to determine whether those changes in rat testes are reversible changes. Young Wistar male rats were administered 2.0 g/kg of DEHP for 14 days. At that time, one-half of the rats were killed for determination of zinc and testosterone concentrations in the testis, liver, and serum, and organ weights. The remaining rats were maintained for additional 45 days without further DEHP administration. Testicular weight of rats administered DEHP over the 14-day period was significantly less than that of the control animals, and testicular testosterone content and zinc concentrations were less than those of the control animals. At the end of the 45-day recovery phase, serum testosterone concentration returned to the control level, but testicular zinc concentration and testosterone content were still lower than those of the control animals. In addition, testicular weight of DEHP-treated rats was lower than that of the control animals and histologically, only a small number of seminiferous tubules showed spermatogenesis. These results indicate that, morphologically, DEHP-induced testicular atrophy appears to be of limited reversibility. PMID- 3967639 TI - Projected uptake and toxicity of selenium compounds from the environment. AB - Industrial workers and members of the general public may be exposed to selenium by inhalation of selenium in the workplace or atmosphere or by ingestion of selenium in food. A model has been developed to evaluate the potential uptake of selenium in body tissues by these two exposure routes. Rates were estimated for transport of selenium between five compartments including lung, gastrointestinal tract, blood, liver and other tissues. Results of model simulations were compared to published tissue distribution information obtained from single inhalation exposures of rats and dogs to radiolabeled selenium compounds at concentrations from 20 mg/m3 to 20 micrograms/m3 with initial body burdens of selenium ranging from 28 to 0.09 micrograms Se/kg body wt. The model was then modified to predict equilibrium organ concentrations of selenium in people after continual exposure to selenium in the air or in the diet. Daily intake levels of 100 micrograms/day and a fractional absorption value of 0.8 were used. With an air concentration of 1 ng Se/m3, model predictions indicated that most of the total body selenium in people is likely to come from their diet because selenium in the urban atmosphere contributes a very small part of the total body selenium. However, continual inhalation of selenium at the threshold limit value (TLV; 200 micrograms/m3) could contribute significantly to the total body burden of selenium. Levels of selenium predicted in lung, liver, and blood after inhalation of selenium at the TLV were 22,000, 1200, and 440 ng Se/g tissue. Predicted lung concentrations were near those that produced toxic effects in animals after ingestion of Se. PMID- 3967640 TI - Inhalation studies of Mt. St. Helens volcanic ash in animals: respiratory mechanics, airway reactivity and deposition. AB - Effects of fine volcanic ash aerosol on pulmonary mechanical properties of awake guinea pigs were evaluated during exposure by inhalation. Ash penetration into the lung as well as tissue response to ash were determined by transmission electron microscopy. The reactivity of airway epithelial irritant receptors following ash exposure was assessed using a histamine bronchoprovocation test. Results indicated that breathing 9,4 mg/m3 of ash for 2 hr did not cause a measurable change in pulmonary function of guinea pigs. Electron micrographs showed that ash particles in the lung below the hilus did not seem to produce any acute tissue reaction and were almost all phagocytized by macrophages. Airways of guinea pigs exposed to ash were significantly less responsive to histamine than were the airways of animals exposed only to air. It appears that even though Mt. St. Helens ash was well tolerated by the guinea pig during the exposure, its presence in the inhaled air did change the "histamine sensitivity" of airway epithelial irritant receptors. PMID- 3967641 TI - Kinetics of renal aspartate reabsorption and its inhibition by metals in the intact rat kidney. AB - A modified clearance technique originally developed for the intact rabbit was adapted for use in the intact rat; it permits measurement of maximum tubular capacity (Tm) and half-saturation constant (KM) without the need for high systemic plasma levels and long equilibrating infusions of the solute under study. In this manner, Tm and KM for aspartate reabsorption were determined. Subsequently, we compared these kinetics constants to renal aspartate Tm and KM values in the literature derived from single tubule studies, and analyzed the nephrotoxicity of nickel and cadmium. Aspartate KM and Tm in the intact rat were 6.1 mM and 5.8 mumole/g cortex/min respectively; in contrast, work with single tubules led to KM aspartate of 0.1 mM and Tm aspartate of 20.0 mumole/g cortex/min. The discrepancy between the two sets of results reemphasizes the difficulty in extrapolating from single tubules to intact kidney; presumably tubular heterogeneity accounts for these differences. Aspartate reabsorption was also measured in rats injected intraperitoneally with 20 mumole nickel or cadmium/kg body weight 36 to 40 hr previously. At renal nickel or cadmium concentrations of approximately 10 micrograms/g kidney glomerular filtration rate and aspartate Tm were significantly decreased while aspartate KM was not affected. The effects of the metals resemble a noncompetitive type of inhibition of aspartate reabsorption. PMID- 3967642 TI - Effects of ingestion of hibernia and Prudhoe Bay crude oils on hepatic and renal mixed function oxidase in nestling herring gulls (Larus argentatus). AB - Oral administration of Prudhoe Bay crude or Hibernia crude to nestling herring gulls increased the hepatic cytochrome P-450 content 4-fold. Concomitantly, there was an increase in various mixed-function oxidase and phase II enzyme activities. 7-Ethoxyresorufin O-deethylase was elevated 19-fold, benzo(a)pyrene 3-hydroxylase 6-fold, aniline hydroxylase 3-fold, and aminopyrine N-demethylase and uridine diphosphate glucuronyl transferase 2-fold. There was no change in reduced glutathione S-transferase activity. Renal mixed-function oxidase activities were also elevated. Herring gull livers contained very low levels of DT-diaphorase activity which was inducible 3- to 5-fold by oil administration. PMID- 3967643 TI - Airborne fiber control in buildings during asbestos material removal by amended water methodology. AB - Removal of friable asbestos-containing material can cause high levels of airborne contamination. The potential efficacy of control methods recommended by the Environmental Protection Agency (EPA) was evaluated by examination of 503 air samples obtained in 40 removal projects in a number of locations. The EPA methodology with amended water for fiber emission control was utilized on all of the observed removal projects. The projects were also considered to be well controlled and the study cannot be considered representative of common work practices. The EPA amended water methodology, when effectively utilized and administered, can provide a high degree of contamination control. Mean fiber levels in the work area in this study (1.1 f/cm3) were well below those of dry removal (38.9 f/cm3) and control by application by untreated water (28.6 f/cm3). Airborne contamination was higher during bagging debris (3.8 f/cm3) than during material removal from structural surfaces. The range of fiber levels during removal was 0.0 to 37.0 f/cm3 and fibers were detected from initial barrier construction through final cleaning. Contamination was also occasionally detected outside work area containment barriers. Air sampling produced 0.0 counts in areas of obvious contamination by settled dust and debris. Control methodologies, respiratory protection, and decontamination are discussed. PMID- 3967644 TI - Immunologic effects of nickel. II. Suppression of natural killer cell activity. AB - A single intramuscular injection of nickel chloride (18.3 mg/kg) caused a significant reduction in murine splenic natural killer (NK) cell activity. This reduction in NK activity was not associated with a significant reduction in spleen cellularity nor in the production of suppressor cells. In a 4-hr 51Cr release assay, NK cell activity was suppressed in both CBA/J and C57BL/6J mice. Administration of the nickel dose (i.e., 18.3 mg/kg total) over a 2-week period also caused a significant reduction in NK cell activity. In an in vivo NK assay, the clearance of [125I]iododeoxyuridine-labeled YAC-1 tumor cells from the lungs of nickel-treated mice was significantly reduced compared with saline injected controls. Another in vivo correlate of nickel-induced NK suppression was observed in mice injected with the B16-F10 melanoma. Mice given a single intramuscular injection of NiCl2 (18.3 mg/kg) developed significantly greater numbers of lung tumors than saline controls. The results indicate that NiCl2 is a potent suppressor of NK cell activity. PMID- 3967646 TI - Accumulation and interrelationship of cadmium and zinc in human kidney cortex. AB - Cadmium and zinc have been analyzed in 102 normal human kidney cortex tissues collected from Indian hospitals. Cadmium and zinc were found to accumulate as age increased to 60 years, and had a log-normal distribution. Concentrations of cadmium and zinc in kidney cortex and cadmium/zinc ratios were comparable to those in other studies. The relationship between cadmium and zinc in kidney cortex gave a slope constant of 0.96 (YZn = 0.96XCd + 21.4). PMID- 3967645 TI - Inhalable particles and pulmonary host defense: in vivo and in vitro effects of ambient air and combustion particles. AB - The ability of particulate air pollutants (and possible constituents) to alter pulmonary host defenses was examined using an in vitro alveolar macrophage cytotoxicity assay and an in vivo bacterial infectivity screening test which employed intratracheal injection of the particles. A wide range of response between particles was seen at the 1.0-mg/ml level in vitro and the 0.1-mg/mouse level in vivo. A sample of fluidized-bed coal fly ash, bentonite, asbestos, some ambient air particles, and heavy metal oxides greatly increased susceptibility to pulmonary bacterial infection. Most coal fly ash samples and some air particles caused moderate increases in infectivity, while diesel particulates, volcanic ash, and crystalline silica caused only small increases. Cytotoxic effects on macrophages in vitro were observed with most of the particles. The in vivo and in vitro assays produced a similar ranking of toxicity; however, not all particles that were highly cytotoxic were potent in increasing bacterial infectivity. Increased toxicity measurable by either assay often appeared to be associated with small size or with the presence of metal in the particles. PMID- 3967647 TI - Physicochemical characterization of cryogenically ground, size separated, fibrogenic particles. AB - A method for cryogenically grinding and separating (by size) fibrogenic minerals in the 1-micron size range is described and verified for chrysotile asbestos, quartz, forsterite (an olivine), and tantalum with a battery of analytical tests. Through use of energy dispersive X-ray spectroscopy, neutron activation analysis, X-ray photoelectron spectroscopy, and X-ray diffraction analysis it is shown that the grinding and separation procedure described does not alter the mineral composition, preserves the trace element composition, maintains the surface composition, and preserves the crystalline structure. Further, investigation of electrokinetic properties of these dusts by electrophoretic quasielastic light scattering is described. The small size dispersity of these samples facilitates use of this technique for the determination of the apparent electrokinetic charge and estimations of surface charge density at ionic strengths below physiological. It is suggested that analyses of the type described here be an integral part of studies of the fibrogenic, immunologic, or toxicologic properties of such minerals. This work has been performed in conjunction with the authors' studies of the effects of these particulates on macrophage ultrastructure and immunologic function in vitro. PMID- 3967648 TI - Dual function of calmodulin (delta) in phosphorylase kinase. AB - The Ca2+-independent activity of fast skeletal muscle phosphorylase kinase, A0, can be reversibly stimulated by heparin more than 20-fold; concomitantly the Ca2+ dependent A2 activity is abolished completely. Heparin also drastically changes the aggregation state of the enzyme; aggregated species contain significantly less delta and show an about fivefold higher A0 activity than the tetrameric form containing delta stoichiometrically. We interpret this to mean that delta has two functions in the phosphorylase kinase: an inhibitory one with respect to A0 and an activating one with respect to A2. The inhibition of A0 by Ca2+-free delta is released, i.e. A0 increases when this subunit dissociates from the holoenzyme. The maximally heparin-stimulated A0 activity, A0,hep, is enriched from a crude extract to the same degree and approximately with the same yield as the major activity, A2. The phosphorylase kinase is not eluted from DEAE-cellulose as a symmetrical bell-shaped protein peak. The peak fraction contains the activities A2 and A0,hep superimposed and yields a nearly homogeneous sedimentation boundary with an S20,w value of 25.5 S. The A0 yields a much broader eluation profile showing a distinct maximum from the A2 activity which contains slower sedimenting species of 12.1 S, some tetrameric enzyme of 22.7 S and higher aggregated material. Over the whole profile the activity ratio A2/A0 decreases about sevenfold whereas the ratio A2/A0,hep is constant on average. This shows that A0 is an intrinsic activity of phosphorylase kinase. The heparin-activated A0 activity or A0 itself in the presence of the phosphorylase phosphatase inhibitor, fluoride, can trigger a Ca2+-independent flash activation of phosphorylase in a protein-glycogen complex. Thus, A0 could be responsible for the conversion of phosphorylase b to a at 20 nM free Ca2+ in resting, hormone-stimulated, muscle. PMID- 3967649 TI - Structure determination of oligosaccharides isolated from Cad erythrocyte membranes by permethylation analysis and 500-MHz 1H-NMR spectroscopy. AB - Alkaline borohydride reductive cleavage (beta-elimination) of glycophorin A isolated from one individual of the rare blood group Cad, resulted in the release of six acidic oligosaccharide-alditols which were separated by high-performance liquid chromatography (HPLC) on an alkyl amine silicagel column. The structure of four of them has been determined by the application of methanolysis, methylation analysis and 1H-NMR spectroscopy at 500 MHz. The structures and relative amounts were as follows: oligosaccharide 1: NeuAc(alpha 2-3)Gal(beta 1-3)GalNAc-ol (3.5%); oligosaccharide 3: GalNAc(beta 1-4)[NeuAc(alpha 2-3)]Gal(beta 1-3)GalNAc ol (10.5%); oligosaccharide 5: NeuAc(alpha 2-3)Gal(beta 1-3)[NeuAc(alpha 2 6)]GalNAc-ol (10.4%); oligosaccharide 6: GalNAc(beta 1-4)[NeuAc(alpha 2 3)]Gal(beta 1-3)[NeuAc(alpha 2-6)]GalNAc-ol (71.2%). The two other oligosaccharides (2 and 4) were obtained in very low amount. The major pentasaccharide (oligosaccharide 6) carries the blood group Cad determinant and is a potent inhibitor of human anti-Sda antibody. PMID- 3967650 TI - Fusion of erythrocyte ghosts induced by calcium phosphate. Kinetic characteristics and the role of Ca2+, phosphate and calcium-phosphate complexes. AB - Using an assay which allows continuous monitoring of the mixing of aqueous contents during membrane fusion, we have investigated the kinetics of calcium phosphate-induced fusion of erythrocyte ghosts. In the presence of 10 mM phosphate, the threshold concentration for Ca2+-induced fusion was 1.25 mM, while the optimal concentration was approx. 1.75 mM Ca2+. Further enhancement of the cation concentration (greater than or equal to 2 mM) inhibited fusion of the ghosts. Initiation of fusion required the addition of phosphate prior to the addition of Ca2+, indicating that the combined interaction of Ca2+ and phosphate in or at the plane of the bilayer was a prerequisite for the induction of fusion. Furthermore, fusion was greatly facilitated upon transformation of calcium phosphate in the bulk medium from an amorphous to a solid, crystalline phase. It is suggested that membrane aggregation, and hence fusion, is facilitated by the formation of crystalline calcium phosphate nucleating on the ghost membrane. La3+, Mg2+ and Mn2+ did not trigger the fusion process, although aggregation of the ghosts did occur. Under conditions where calcium phosphate precipitation was inhibited, lanthanum phosphate precipitates facilitated fusion after prior treatment of ghosts with phosphate and Ca2+. These results indicated that fusion prone conditions were induced prior to calcium phosphate precipitation. It is proposed that prior to calcium phosphate precipitation membrane changes are induced by separate interaction of Ca2+ and phosphate with the ghost membrane. Such an interaction could then render the ghosts susceptible to fusion and as soon as conditions are provided allowing close contact between adjacent membranes, fusion will be observed. PMID- 3967651 TI - Cloning and sequence analysis of human genomic DNA encoding gamma subunit precursor of muscle acetylcholine receptor. AB - Human genomic DNA encoding the gamma subunit precursor of the skeletal muscle acetylcholine receptor has been cloned by screening a gene library with a calf cDNA probe and has been subjected to nucleotide sequence analysis. Comparison of the nucleotide sequence of the cloned human genomic DNA with that of the calf cDNA has revealed that the protein-coding sequence of this gene is divided by 11 introns into 12 exons. Evidence is presented to suggest that the human muscle acetylcholine receptor gamma and delta subunit genes are juxtaposed. The primary structure of the gamma subunit precursor of the human muscle acetylcholine receptor has been deduced from the corresponding gene sequence. This polypeptide is composed of 517 amino acids including a hydrophobic prepeptide of 22 amino acids. The gamma subunit of the human muscle acetylcholine receptor, like the alpha subunit of the same receptor as well as the alpha, beta and gamma subunits of its calf counterpart, shares structural features common to all four subunits of the Torpedo electroplax receptor, such as the putative disulphide bridge corresponding to that in the alpha subunit proposed as being in close proximity to the acetylcholine binding site and the four putative, hydrophobic transmembrane segments M1-M4. Thus, the human gamma subunit molecule apparently exhibits the same transmembrane topology as proposed for the fish receptor subunits. The 12 exons seem to correspond to different structural and functional domains of the gamma subunit precursor molecule. Some exons and the protein regions encoded by them are more highly conserved between the mammalian and Torpedo sequences. The pattern of regional homology observed is consistent with the relatively high conservation of the region encompassing the putative disulphide bridge and of the region containing the putative transmembrane segments M1, M2 and M3. PMID- 3967652 TI - Synthesis and secretion of hemopexin in primary cultures of rat hepatocytes. Demonstration of an intracellular precursor of hemopexin. AB - Secretion of hemopexin (20% carbohydrate) and its dependence on glycosylation was studied in primary rat hepatocyte cultures in comparison to the secretion of transferrin (5% carbohydrate). In pulse-chase experiments with [35S]methionine half of the labeled hemopexin was secreted in 30 min. By contrast, it took approximately 50 min for secretion of half of the transferrin. Tunicamycin treatment of cultures significantly delayed the secretion of hemopexin but not that of transferrin. During the pulse period a prominent intracellular precursor of hemopexin, smaller than the mature protein, was evident. It is concluded that the extent of glycosylation of a secretory protein is not necessarily a determinant of the transit time required for intracellular processing and secretion. In the case of hemopexin the glycosylation apparently facilitates the secretion although it is not an absolute prerequisite for the exocytosis of this protein. PMID- 3967653 TI - Collagen-stimulating factor from embryonic brain has ascorbate-like activity and stimulates prolyl hydroxylation in cultured muscle cells. AB - Embryonic rat-brain extract contains a collagen-stimulating factor which enhances the production of collagen types I, III, IV and V by cultured rat muscle cells. Here we report on the partial characterization and possible mechanism of action of a low-molecular-mass fraction with ascorbate-like activity isolated from embryonic rat brain extracts. This activity eluted very close to ascorbate when filtered through Bio-Gel P-2 and Sephadex G-10. The peak of biological activity showed properties of a reducing agent. Both the biological and reducing activities were lost when the fraction was treated with the enzyme ascorbate oxidase. This factor enhanced in a time-dependent manner, the secretion of procollagen, pulse-labeled with [3H] proline. Incubation of the muscle cultures with the factor increased by 15-fold the ratio of hydroxyproline to proline residues in secreted macromolecules over controls. A fourfold increase in the above ratio was obtained for the cellular proteins. Crude homogenates from control and factor-stimulated cultures were tested for prolyl hydroxylase activity using [3H](Pro-Gly-Pro)n as a substrate. Cultures treated with the collagen-stimulating factor showed a 5-50-fold increase in prolyl hydroxylation activity compared to controls. No effect on prolyl hydroxylation was found when the factor was added in vitro to either control or stimulated enzyme preparations. Our results suggest that the collagen-stimulating factor contains ascorbate-like activity which promotes the secretion of collagenous proteins by increasing hydroxylation of proline residues in their polypeptide backbone. PMID- 3967654 TI - Comments on 'Alterations of oxidative-phosphorylation reactions in mitochondria isolated from hypothyroid-rat liver', by I. Ezawa et al. PMID- 3967655 TI - Conformational changes in actin resulting from Ca2+/Mg2+ exchange as detected by proton NMR spectroscopy. AB - Skeletal muscle actin can be maintained in a monomeric form in very low ionic strength solutions as well as in high concentrations (0.6 M) of MgCl2 or CaCl2. 400-MHz 1H-NMR spectra revealed characteristic changes which show that the conformation of actin alters by exchanging Ca2+ for Mg2+ in the single high affinity cation binding site. When all low-affinity cation binding sites are filled (in the presence of high concentrations of Ca2+ or Mg2+), the spectra show that actin conformation differs from that in low-ionic-strength buffer. A comparison of actin in 0.6 M CaCl2 and 0.6 M MgCl2 revealed that the environment of only a small number of protons is affected by the exchange. A new proposal for the essential steps involved in actin polymerization is presented. PMID- 3967656 TI - Glycosphingolipids in insects. Chemical structures of ceramide monosaccharide, disaccharide, and trisaccharide from pupae of Calliphora vicina (Insecta: Diptera). AB - The presence of glycosphingolipids in the pupae of the blowfly, Calliphora vicina, was established. The thin layer chromatographic pattern of the total neutral glycolipids revealed the presence of more than 13 components, the major one being ceramide monohexoside. By the use of high performance liquid chromatography, the three simplest components were isolated and their chemical structures determined: Glc(beta 1-1)Cer, Man(beta 1-4)-Glc(beta 1-1)Cer [with minor component Gal(beta 1-4)Glc(beta 1-1)Cer] and GlcNAc(beta 1-3)Man(beta 1 4)Glc(beta 1-1)-Cer. The ceramide composition of the parent insect glycosphingolipids is dominated by the 20:0 fatty acid, arachidic acid, and the sphingoid tetradecasphing-4-enine. PMID- 3967657 TI - Direct evidence by carbon-13 NMR spectroscopy for the erythro configuration of the sphingoid moiety in Gaucher cerebroside and other natural sphingolipids. AB - By comparison of carbon-13 NMR data from Gaucher cerebroside and from other natural sphingolipids with those from synthetic L-threo-ceramide, D-glucosyl-L threo-ceramide, D-erythro-ceramide and D-glucosyl-D-erythro-ceramide, we have been able to obtain directly, for the first time, unequivocal evidence for the erythro configuration of the sphingosine moiety in natural sphingolipids. Gaucher cerebroside gave the same data as D-glucosyl-D-erythro-ceramide. In contrast, significant shift differences have been observed for sphingosine C-3 (1.9 ppm) and C-4 (1.2 ppm) when comparing the spectral data of Gaucher cerebroside with those of D-glucosyl-L-threo-ceramide. Similar differences have also been found between the carbon-13 NMR data of synthetic D-erythro-ceramide and those of L threo-ceramide. In addition, we have observed that threo-sphingosine C-5 and C-4 of ceramide and D-glucosyl-ceramide resonate near 129.5 ppm and 133.5 ppm, respectively, with a signal separation of about 4 ppm. On the other hand, these signals from the spectra of synthetic D-erythro-ceramide and D-glucosyl-D-erythro ceramide as well as from those of gangliosides, lactosyl-ceramide, galactosyl ceramide and sphingomyelin are found near 130 ppm and 135 ppm, respectively, thus being apart by about 5 ppm, irrespective of the degree of glycosylation of the ceramide portion. Thus, by carbon-13 NMR spectroscopy the erythro configuration of the sphingoid base in natural sphingolipids is directly demonstrated. PMID- 3967658 TI - Modulation of membrane fluidity in living protoplasts of Nicotiana plumbaginifolia by catalytic hydrogenation. AB - A homogeneous water-soluble Ru catalyst, has been incorporated into mesophyll protoplasts isolated from Nicotiana plumbaginifolia leaves. In the presence of hydrogen gas this complex causes an extensive loss of unsaturated fatty acid bonds and a concomitant increase in microviscosity of the cellular membranes. Although the gradual reduction of the level of unsaturation, per se, is accompanied by considerable cell damage, there is an optimum reaction time where approximately 50% of the protoplasts are still living and about 20% of the double bounds initially present in fatty acyl residues have undergone hydrogenation. The possible mechanism of the self regulatory process competing with the hydrogenation in the early stages of the reaction is also discussed. PMID- 3967659 TI - Inhibition of the aminoacylation of selected tRNA molecules by an estrogen regulated factor on uterine ribosomes. Regulation of aminoacylation of tRNA by estrogens. AB - Administration of estradiol to ovariectomized mature rats for 1 h induces a transient increase in the peptide elongation rate on uterine ribosomes. An inhibitor of the peptide elongation rate, which appears to be regulated by estrogen treatment in vivo, can be extracted from ribosomes of estrogen-deprived rats. The extracted inhibitor or a native inhibitor-ribosome complex affects the rate of the peptide elongation reaction in a uterine cell-free protein synthesis system by inhibiting the ability of selected tRNAs in the assay to be charged with amino acids by their respective aminoacyl-tRNA synthetases. The degree of inhibition of charging of the affected tRNAs ranges from 22% to 78%, the order of inhibition being Pro greater than Val greater than Arg greater than Try greater than Leu greater than Glu greater than Ile greater than Gly greater than His greater than Ser greater than Lys. Inhibition results from a specific dose dependent, and presumably reversible, effect of the inhibitor on tRNA, but not on the aminoacyl-tRNA synthetase. The effect does not result from removal of A-C-C terminal nucleotides from the 3' end of tRNA, but does inhibit the ability of selected tRNAs to bind to the aminoacyl-tRNA synthetases. We propose that regulation of the peptide elongation rate on uterine ribosomes by estradiol occurs through the estradiol-induced inactivation of a ribosome-associated inhibitor, which causes a reversible alteration to selected tRNAs. The modified tRNAs are unable to bind to their respective aminoacyl-tRNA synthetase to become charged with an amino acid thus causing the availability of selected aminoacyl tRNAs to become rate-limiting in the sequential elongation of peptides. PMID- 3967660 TI - Affinity labeling of rabbit muscle fructose-1,6-bisphosphate aldolase with 5'-[p (fluorosulfonyl)benzoyl]-1,N6-ethenoadenosine. AB - Aldolase contains one tight binding site and one weak binding site per subunit for ATP [Kasprzak, A. and Kochman, M. (1980) Eur. J. Biochem. 104, 443-450]. The reaction of the ATP analog 5'-[p-(fluorosulfonyl)benzoyl]-1,N6-ethenoadenosine with rabbit aldolase A results in linear inactivation of enzyme with respect to covalent linkage of fluorescent label. The enzyme is completely protected against modification in the presence of saturating covalent binding (k2 = 0.033 min-1) is preceded by a fast reversible binding step (Ki = 6.8 mM). Chemical modification of aldolase leads to formation of stable N epsilon (4-carboxybenzenesulfonyl lysine (Cbs-Lys) and O-(4-carboxybenzenesulfonyl-tyrosine (Cbs-Tyr) derivatives. Almost all Cbs-Lys was found in the N-terminal CNBr peptide (CN-1), whereas Cbs Tyr was present both in the N-terminal (CN-1) and C-terminal (CN-2) peptide. From carboxypeptidase digestion and tryptic peptide analysis, Cbs-Lys was localized in position 107, a small part of Cbs-Tyr was detected in position 84, and the majority of Cbs-Tyr was found in the C-terminal position Tyr-363. We conclude that the covalent binding of the ATP analog occurs at the mononucleotide tight binding site of aldolase and is associated with modification of Lys-107 and Tyr 363. This conclusion is based on the measurements of enzymatic activity loss as a function of ATP analog incorporation as well as on previous data. It is postulated that Lys-107, which is the C-6 phosphate binding site for fructose-1,6 P2, is in close proximity to the functionally important Tyr-363. The rather small extent of modification of Tyr-84 (0.15 mol/subunit), is due either to nonspecific protein modification or labeling of the weak mononucleotide binding site. PMID- 3967661 TI - Characterization of human glucosylsphingosine glucosyl hydrolase and comparison with glucosylceramidase. AB - Properties of glucosylsphingosine (gluco-psychosine) glucosyl hydrolase were studied in detail in cultured human fibroblasts and placenta and were compared with those of glucosylceramidase. The two activities, that are deficient in tissues of Gaucher patients, showed minor but consistent differences. The pH optima were 4.8 for psychosine hydrolysis and 5.3 for glucosylceramide hydrolysis. In the presence of oleic acid, taurocholate activated glucosylceramidase more than 10-fold, while it activated psychosine hydrolysis only by about 30%. Triton X-100 was stimulatory for glucosylceramidase but was strongly inhibitory for psychosine hydrolysis. Phospholipids, that increase many times glucosylceramidase activity, were moderately inhibitory to enzymatic hydrolysis of psychosine. The psychosine hydrolase activity was slightly more heat-stable than the glucosylceramidase activity. The Km values for the two substrates were similar; 1.7 X 10(-5) M for psychosine and 2.7 X 10(-5) M for glucosylceramide. The V for glucosylceramide was, however, 100-times that for psychosine hydrolysis. Psychosine acted as a potent non-competitive inhibitor (Ki = 1.8 X 10(-5) M), while glucosylceramide was a weak inhibitor against psychosine hydrolysis. Within the limit of glucosylceramide solubility, psychosine hydrolysis could not be inhibited by more than 50%. Furthermore, the Dixon plot of glucosylceramide inhibition showed an anomalous slope. The ratio of the two activities was similar in fibroblasts, in the placenta mitochondria-lysosomal fraction and in a partially purified placental preparation. These findings are best explained by the hypothesis that, although the two substrates are hydrolyzed by a single enzyme, they share an overlapping but not identical catalytic site while binding to hydrophobic sites unique for the respective substrates. PMID- 3967662 TI - Ether glycerolipids: novel substrates for studying specificity of enzymes involved in glycerolipid biosynthesis in higher plants. AB - Ether glycerolipids, predominantly alkylacylglycerols and alkylacylglycerophosphocholines, are synthesized in photomixotrophic rape (Brassica napus) suspension cells from various exogenous monoalkylglycerols. The stereospecific distribution of acyl moieties was studied in these ether glycerolipids with regard to chain-length and degree of unsaturation of alkyl moieties and compared with the distribution of acyl moieties in the corresponding endogenous acyl glycerolipids. The results show the following: (1) Alkylacylglycerophosphocholines replaced up to one-half of the corresponding physiological membrane lipids, i.e. diacylglycerophosphocholines, without changing the total amount of cholineglycerophospholipids as compared to untreated cells. (2) The composition of acyl moieties in total lipids of rape cells was practically unaltered by fatty acids derived via oxidative cleavage from the various alkyl moieties of either glycerolipids. (3) In 1-O-alkyl-2-acylglycerols derived from exogenous alkylglycerols and in endogenous 1,2-diacylglycerols compositions of acyl moieties were found to be different indicating that different pathways were operative in the biosynthesis of these two neutral glycerolipids. (4) Enzymes involved in synthesizing molecular species of 1-O alkyl-2-acylglycerophosphocholines or 2-O-alkyl-1-acylglycerophosphocholines as well as 1,2-diacylglycerophosphocholines showed similar specificities with regard to chain-length and degree of unsaturation of both alkyl and corresponding acyl moieties. Thus, ether glycerolipids formed by plant cells from exogenous alkylglycerols are suitable metabolites for studying the specificity of enzymes involved in the biosynthesis of glyerolipids. PMID- 3967663 TI - Synthesis and intracellular transport of lectin and storage protein precursors in endosperm from castor bean. AB - The biosynthesis of the lectins and the other major storage proteins, the 11S globulins and the 2S albumins, which are found in protein bodies has been studied in developing castor bean endosperm cells. Newly synthesized proteins were radiolabelled by incubating intact endosperm tissue with [35S]methionine. The intracellular distribution of radiolabelled proteins was determined after fractionating endosperm homogenates by sucrose density gradient centrifugation. Pulse-chase experiments revealed that all the major protein body components are initially segregated in precursor form into the lumen of the endoplasmic reticulum. The lectin precursors appeared as a group of 64 000-68 000-Mr glycosylated polypeptides, the 11S globulins as a group of 46 000-55 000-Mr polypeptides and the 2S albumins as a single 32 500-Mr polypeptide. These precursors were transferred from the endoplasmic reticulum to a population of transporting vesicles. The subsequent disappearance of the precursors from this vesicle fraction was accompanied by the accumulation of mature polypeptides in the protein body matrix (lectins and 2S albumins) or in the insoluble protein body crystalloid complexes (11S globulins). The castor bean proteins studied all exist as heterodimers in the protein bodies. After intracellular transport an endoproteolytic step is required to release each subunit of the heterodimer from the appropriate single polypeptide precursor. PMID- 3967664 TI - Precursors of ricin and Ricinus communis agglutinin. Glycosylation and processing during synthesis and intracellular transport. AB - During synthesis in vivo the castor bean lectin precursors initially appear in the endoplasmic reticulum as a group of core glycosylated polypeptides of relative molecular mass 64 000-68 000. Pretreatment of intact castor bean endosperm tissue with tunicamycin partially inhibits the cotranslational core glycosylation step and results in the accumulation of a single sized unglycosylated precursor polypeptide of relative molecular mass 59 000. The glycosylated precursors in the endoplasmic reticulum were enzymically converted to the 59 000-Mr form by incubation with endoglucosaminidase H. Intracellular transport of the glycosylated lectin precursors from the endoplasmic reticulum to a denser vesicle fraction was accompanied by modifications to the oligosaccharide moieties which conferred resistance to the action of endoglucosaminidase H. The post-translational addition of fucose to the carbohydrate chain was identified as one of the oligosaccharide modification steps. Fucose addition was catalysed by a glycosyltransferase associated with a smooth-surfaced membrane fraction which was distinct from the endoplasmic reticulum and which was tentatively identified as the Golgi apparatus. Glycosylation was not essential for intracellular transport of the lectin precursors: unglycosylated precursor synthesized in the presence of tunicamycin gave rise to unglycosylated lectin subunits in the protein bodies. PMID- 3967665 TI - Interaction of the pneumococcal amidase with lipoteichoic acid and choline. AB - The choline-containing lipoteichoic acid (LTA, Forssman Antigen) of Streptococcus pneumoniae suppresses the activity of the pneumococcal autolysin, an N-acetyl muramoyl-L-alanine-amidase (amidase) in aqueous solution [Holtje and Tomasz (1975) Proc. Natl Acad. Sci. USA 72, 1690-1694]. The interaction between LTA and enzyme was used to establish a purification by affinity chromatography on LTA Sepharose. The amidase could be eluted from the column with choline only. This implies that binding of the enzyme to LTA is mediated via the choline residues of the LTA. Upon binding to the LTA-Sepharose, the amidase converted from the applied E-form (an inactive form of the amidase) to the active C-form, a process which up to now was known to be mediated only by the pneumococcal choline containing wall teichoic acid. Similar interactions between LTA and amidase seemed to occur in membrane fractions derived from choline-grown cells: the membrane-associated enzyme was present in the C-form and could be detached completely with choline, suggesting that the amidase is bound to the membrane attached LTA rather than being a membrane protein itself. This was supported by the absence of amidase activity in membrane fractions derived from ethanolamine grown pneumococci, in which choline containing LTA is absent. The LTA-Sepharose associated amidase was not inhibited, but retained its activity. The enzyme was also not inhibited by lipase-digested LTA. Both are conditions where the LTA is not present in micelles, unlike in aqueous solution. Therefore, mere binding to the LTA is probably not responsible for the inhibitory effect, but inhibition is a manifestation of an inaccessibility of the substrate for the amidase when bound to micellar LTA. When the interactions between choline and amidase were investigated, it was found that high choline concentrations (2%) inhibited the enzyme completely. Even in vivo, 2% choline in the culture medium led to phenotypically amidase-deficient pneumococci. Furthermore, in vitro, low choline concentrations (0.1%) suppressed the wall-mediated conversion. On the other hand, with high choline concentrations (2%) conversion took place in the absence of cell walls. Depending on how the amidase has been converted, the apparent Mr of the resulting C-amidase was different: the cell-wall-converted enzyme was of high Mr, whereas the choline-converted and the LTA-Sepharose-eluted enzyme showed an apparent low molecular mass known for the E-form, when analyzed on sucrose gradients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3967666 TI - Characterisation of a Dictyostelium discoideum DNA fragment coding for a putative tRNAValGUU gene. Evidence for a single transcription unit consisting of two overlapping class III genes. AB - A genomic DNA fragment from Dictyostelium discoideum was characterized. This DNA, although 74% d(A + T)-rich, codes for a putative tRNAValGUU. The tRNAVal gene overlaps at its 5' half with another RNA polymerase III transcription unit. This RNA polymerase III transcription unit can be folded into a tRNA-like shape and is comprised of significant amounts of invariant and semi-invariant nucleotides present in all eukaryotic tRNAs. This unit contains the two promoter blocks defined for RNA polymerase III, which are homologous to recently defined promoter elements to the extent of 76-88% (A block) and 86-93% (B block) respectively [Sharp et al. (1981) Proc. Natl Acad. Sci. USA 78, 6657-6661]. Both of the overlapping class III genes are transcribed in germinal vesicle extracts prepared from Xenopus laevis oocytes as a single transcription unit, resulting in an unusually large product compared to primary transcripts of other tRNA genes. The unit is not transcribed in HeLa extracts but it competes very strongly for transcription factor(s) under the conditions of stable transcription complex formation. Although the whole unit is transcribed, it is believed that only one functional product is formed. Therefore we define the tRNA-like structure, coded for on this class III transcription unit, as a putative tRNA 'pseudogene' meaning that, although it is transcribed by RNA polymerase III, it is not likely to mature to a functional tRNA. PMID- 3967667 TI - Isolation and characterization of an iron-containing superoxide dismutase from tomato leaves, Lycopersicon esculentum. AB - A cyanide-insensitive superoxide dismutase was purified from tomato leaves (Lycopersicon esculentum, Mill., var. Venture) to apparent homogeneity. The enzyme had twofold higher specific activity (about 4000 standard units) than ferric superoxide dismutases purified from Brassica campestris [Salin, M. L. and Bridges, S. M. (1980) Arch. Biochem. Biophys. 201, 369-374] and Nuphar luteum [Salin, M.L. and Bridges, S. M. (1982) Plant Physiol. 69, 161-165]. The protein had a relative molecular mass of about 42000 and was composed of two equal subunits noncovalently joined. It was negatively charged (pI = 4.6) and contained about 1.45 mol Fe/mol dimer and negligible amounts of Mn, Cu and Zn. Absorption spectrum and sensitivity to NaN3, H2O2 and temperature are also reminiscent of other ferric superoxide dismutases. Comparison of amino acid composition indicated, however, a closer relationship to the Mn-containing enzymes rather than to other Fe-containing superoxide dismutases. Two possible ways of Fe containing superoxide dismutase acquisition by vascular plants were suggested. PMID- 3967668 TI - Perinatal development of the liver in rat and spiny mouse. Its relation to altricial and precocial timing of birth. AB - Rat (Rattus norvegicus) and spiny mouse (Acomys cahirinus) are closely related murinoid species that mainly differ in the developmental timing of birth. A comparison between the developmental profiles of some characteristic enzymes of the liver of both species was carried out to elucidate the question to what extent are these enzymic profiles and hence the maturation of the liver related to the timing of birth? It was found that these organotypic enzymes first become detectable at the same developmental stage in both species. Likewise, the weaning phase of the enzymic profiles occurs at the same developmental time point in both species. It is argued that both the first appearance and the weaning increase in enzyme activity levels occur at endogenously programmed timepoints with only superimposed effects of hormones. In contrast, the perinatal phase of the enzymic profile is completely dependent on the developmental timing of birth and therefore appears not to be anchored to a particular developmental timepoint, but rather to be dependent on birth-associated (hormonal) adaptation. In accordance with this hypothesis it was found that the morphological development of the liver proceeded independent of the timing of birth. Furthermore, the hormonal regulation of the investigated enzymes was found to be the same in both species. Despite the more advanced state of morphological development of the liver in the spiny mouse at birth, it was found that the inducibility of organotypic gene expression by hormones in spiny mouse fetuses was as limited as in rat fetuses. This observation therefore suggests that the intra-uterine environment is responsible for the limited inducibility of enzymes before birth. PMID- 3967669 TI - Comments on: 'Chemical modification of hydroxynitrile lyase by selective reaction of an essential cysteine-SH group with alpha, beta-unsaturated propriophenones as pseudo-substrates' by L. Jaenicke and J. Preun. PMID- 3967670 TI - Spontaneous pain, hyperpathia and wasting of the hand due to parietal lobe haemorrhage. AB - A woman who had spontaneous pain, hyperpathia and wasting of her left hand due to a subcortical lesion in the right parietal lobe is reported. The presentation and evaluation of this most unusual case are discussed. PMID- 3967671 TI - Posttraumatic neuroma of the median nerve: a cause of carpal tunnel syndrome. AB - A case of carpal tunnel syndrome caused by a posttraumatic neuroma-in-continuity of the median nerve is reported. Such a cause of median nerve compression is rare. PMID- 3967672 TI - Pattern of albumin, immunoglobulins, and glucose in cerebrospinal fluid and serum of patients with disorders of the central nervous system. AB - The data of 772 patients were analyzed for albumin, immunoglobulins, glucose, and cell counts in cerebrospinal fluid and serum in healthy controls and in patients with various neurological disorders. Using laser-nephelometric end-point determination the IgG/albumin index was established for controls; a value smaller than 0.85 was considered normal. This index was used to distinguish between impairment of the blood-brain barrier and thecal synthesis of immunoglobulins. No correlation was observed between glucose concentration and cell counts in cerebrospinal fluid. Together with the IgG/albumin index, determination of IgA and IgM increased the sensitivity to detect multiple sclerosis from 43 to 58%. PMID- 3967673 TI - Chronotopographical potential distribution of some SSEP components in cerebrovascular insufficiency. AB - In 7 patients with symptoms of cerebrovascular diseases a somatosensory evoked potential (SSEP) chronotopogram was constructed after median nerve stimulation of seven different EP components: N20, P25, P45, P100, N140, P200 and P300. We examined only a limited number of patients (and controls) because the methodology is very time-consuming. We analyzed the topography in these patients in order to obtain insight in the effect of this disease on EP distributions and to find arguments in favor of the use of this methodology in clinical examination. These chronotopographical maps were constructed on the basis of the localization of maximal amplitude of the different components and their dipole counterparts (if present). 3 patients showed a delay of the specific components, and in 1 patient most of the non-specific components were delayed. The chronotopographical representation in most patients was abnormal. Relations with clinical state and computer tomography (CT) are described. Focal hypodensity on the CT gives rise to a large extension of the area of the specific component N20, overruling the dipole counterpart P20. Slight cortical atrophy in 4 patients causes abnormalities in the P300/N300 dipole direction. Chronotopograms give new information. Therefore, it seems justified to improve the method and implement it for clinical use in the near future. PMID- 3967674 TI - A multinational comparison of drug treatment in patients with cerebrovascular disease. AB - We have compared the frequency with which various drugs were used in patients with cerebrovascular disease in five countries (UK, Italy, Indonesia, Spain and Yugoslavia). There were very large variations in the use of anti-oedema agents, 'cerebral vasodilators', and vitamins, which were not explained by differences in the populations studied. This variation has probably less to do with any scientific validation for the various treatments, which in most cases does not exist, than with medical 'fashion' and commercial pressures. Large variations in prescribing habits for what is thought to be the same disease are undesirable, and reflect a dearth of facts and adequate clinical trials. PMID- 3967675 TI - Endothelial mitochondrial content of cerebral cortical capillaries in Alzheimer's disease. An ultrastructural quantitative study. AB - The mitochondrial content of endothelial cells of cerebral cortical capillaries in patients with Alzheimer's disease and age-matched controls was calculated using stereologic methods. No morphologic abnormalities or quantitative changes in endothelial mitochondria are reported. Our findings do not support the hypothesis of a blood-brain barrier defect in Alzheimer's disease. PMID- 3967676 TI - Use of testosterone in the treatment of cluster headache. AB - The study was carried out on 15 men suffering from the episodic form (12 patients) and the chronic one (3 patients) of cluster headache. Before treatment the patients did not receive any drugs, and after determining the index of attacks the treatment was commenced. For 7-10 days patients were given testosteronum propionicum (25 mg) once a day intramuscularly, and then for the same period of time testosterone (10 mg). Before treatment the index of attacks was 3.66 (total number of attacks 308). In the 1st week of treatment the index decreased to 1.11 (total number of attacks 94) and to 0.16 in the 2nd week. In 3 patients with the chronic form of cluster headache testosterone was ineffective. PMID- 3967677 TI - Bilateral obstruction of internal carotid artery from giant-cell arteritis and massive infarction limited to the vertebrobasilar area. AB - We have studied a patient with tight narrowing of both internal carotid arteries (ICAs) due to giant-cell arteritis. Although the brain supply through the internal and external carotid arteries pathways was totally inefficient, the patient suffered a progressive extensive infarction limited to the vertebrobasilar/posterior cerebral arteries area, except small lesions in the internal capsules. Both vertebral arteries were patent, although a fresh clot partially filled one of them. Without evidence for distal embolization, intracranial involvement by the arteritis, or generalized hypotension, we suggest that our patient suffered an intracranial steal phenomenon from the vertebrobasilar system towards the carotid circulation. PMID- 3967678 TI - Predictors of long-term outcome of convulsive disorders in the first year of life: clinical usefulness of five risk factors. AB - The clinical usefulness of 5 risk factors (delayed development before the onset of seizures, abnormal EEG, symptomatic etiology, abnormal past histories, nonbrief symmetric generalized tonic and/or clonic convulsions) used to indicate long-term prognosis was investigated in 295 children who had convulsive disorders in the first year of life. All patients were followed up to the age of 6 years or older. Patients without any of these risk factors showed mentally and physically normal development, and 89% became seizure-free. However, only 10% or less of the high-risk group with 3 or more of these factors became mentally and physically normal. The score of these 5 factors was significantly related to the long-term prognosis and was assumed to be a valuable index to prognosis in the early stages. PMID- 3967679 TI - Acute peroneal compartmental syndrome. Report of a case. AB - Among the compartmental syndromes the necrosis of peroneal muscles is unusual. We report a case in which the swelling of peroneal muscle causes a compression of the common peroneal nerve below the peroneal head. A disturbance of both the motility and sensibility of the deep and superficial peroneal nerve is present with different pathogenesis. In fact, EMG suggested a muscular damage of the peroneal compartment and a denervation of the pretibial muscle. Interfascicular neurolysis along the peroneal nerve was performed to decompress the common and the deep peroneal nerve. A recovery in the territory of the tibialis anterior deep peroneal nerve confirmed the different mechanisms of paralysis. PMID- 3967680 TI - The myxomatous mitral valve. A risk factor for ischemic stroke in young patients? AB - 3 out of 24 patients with mitral valve prolapse (MVP), mean age 25.7 +/- 3.1 displayed markedly thickened redundant and shaggy mitral leaflets in the two dimensional echocardiogram. The anterior leaflet appeared in the parasternal long axis plane club-shaped in diastole. These three female patients had a history of ischemic stroke, which could be verified by CT-scanning. Suggestion is made that MVP and thickening of the valve is correlated with a higher risk for cerebral infarction. PMID- 3967681 TI - Genetically determined molecular weight differences in murine complement component C6. AB - Plasma samples from male CBA, BALB/c and DBA/2 mice were subjected to polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. Bands of C6 hemolytic activity in the washed resolving gel were identified by means of an erythrocyte/agarose overlay gel. CBA plasma was found to contain two forms of C6, one with a molecular weight (Mr) of approximately 90 000 (type A) and one with a Mr of 100 000 (type B); CBA mice were thus designated C6: A+B+. BALB/c and DBA/2 plasma on the other hand contained only the low molecular weight type A C6 and were designated C6: A+B-. Flat bed isoelectric focusing followed by functional overlays showed that CBA plasma produced two sets of hemolytic bands (pI 5.25-5.4 and 5.0-5.2) whereas BALB/c and DBA/2 plasma produced only the more cathodal band set. The additional band set in CBA plasma corresponded to the high Mr type B C6. Results of breeding experiments demonstrated that the possession of the high Mr type B C6 was inherited in the manner of an autosomal phenotypically dominant characteristic. PMID- 3967682 TI - Response of cultured rat liver epithelial cell lines to tumour-promoting phorbol esters. AB - The membrane effects of a potent tumour promoter, 12-O-tetradecanoyl phorbol-13 acetate (TPA), were studied in a series of cultured rat liver epithelial cell lines. Treatment with TPA resulted in the formation of strand-like aggregates (ridges) of viable cells over the monolayer of IAR 6-1 cells, but not of three other cell lines tested (IAR 20, IAR 6, IAR 6-7). The morphological response of IAR 6-1 to TPA was investigated by determination of phorbol ester receptors, analysis of cellular fucoproteins, surface galactoproteins and iodinatable surface proteins, and specific immunofluorescence for components of the extracellular matrix (fibronectin, laminin-entactin, procollagen type III). A class of specific, saturable, high-affinity receptors for phorbol esters was demonstrated in all four cell lines employing a conventional [20(-3)H]phorbol 12,13-dibutyrate ([3H]PDBu)-binding assay. The dissociation constants were similar in four lines, but the number of receptors per cell in IAR 6-1 cells was about twice that in other lines. Down-regulation of receptors was demonstrated in IAR 20 and IAR 6-1 cells with similar characteristics. Iodinatable surface proteins and galactose-containing surface glycoproteins did not respond to TPA. The distribution of fibronectin, laminin-entactin and procollagen type III was not affected by TPA. A TPA-responsive cell line, IAR 6-1, contained considerably less laminin-entactin than did the other lines. TPA had no influence on metabolic labelling of [3H]fucose-containing cellular glycoprotein in IAR 6-1 cells. One specific protein, with molecular mass of 78 kD, was more heavily labelled with [3H]fucose in IAR 6-1 cells than in the other cell lines. Taken together, the results of this study show that the responsive cells (IAR 6-1) differed from non responsive ones in having more phorbol ester receptors, increased fucosylation of a specific glycoprotein and decreased deposition of laminin-entactin in the extracellular matrix. These surface properties of IAR 6-1 cells may contribute to their ability to respond to TPA. PMID- 3967683 TI - The induction of chromosome condensation in tsBN2, a temperature-sensitive mutant of BHK21, inhibited by the calmodulin antagonist, W-7. AB - The induction of premature chromosome condensation (PCC) in tsBN2 cells, a temperature-sensitive (ts) mutant of BHK21/13 which shows PCC at the non permissive temperature, was almost completely inhibited by 40 microM W-7, an antagonist of calmodulin. The mitotic phosphorylation of histone H1 and H3 was also inhibited by W-7. W-5, a chlorine-deficient analogue of W-7 and which interacts weakly with calmodulin, did not inhibit the induction of PCC, even at a dose of 80 microM. The content of calmodulin in tsBN2 cells was increased by a temperature shift to 40.5 degrees C. All these results suggested that calmodulin is required for the chromosome condensation. PMID- 3967684 TI - The relationship between genome size and synaptonemal complex length in higher plants. AB - There appears to be only a weak correlation between genome size and the corresponding total length of a complete set of synaptonemal complexes (SCs) based on published evidence for several fungal, plant, and animal species. This result is unexpected, considering the strong positive correlations between genome size (DNA amount) and total chromosome length and volume and between relative lengths of chromosomes and SCs. Because the observed weak correlation was based on limited data, we systematically investigated the relationship between genome size and SC length, using ten higher plant species. Two-dimensional spreads of SCs from primary microsporocytes at pachytene were prepared using a hypotonic bursting technique. The SC spreads were examined either by light or electron microscopy, and the lengths of at least ten complete sets of SCs were measured for each of the ten species. Additionally, the genome size of each species was determined from pollen tetrad protoplasts using flow cytometry. A strong correlation (r = 0.97) between total SC length and genome size was observed for higher plants, indicating a constant amount of DNA is associated with a given length of SC, at least when averaged over the whole genome. PMID- 3967685 TI - Biological and biochemical properties of nerve growth factor synthesized by mouse S-180 cells in culture. AB - Nerve Growth Factor (NGF), a protein involved in the maintenance and differentiation of sensory and sympathetic neuronal cells [1], is synthesized by several different types of cells in culture [2-7]. In this paper, the biochemical and biological properties of NGF synthesized by a mouse S-180 sarcoma cell line were examined. These cells do not appear to produce the 7S-NGF molecule, a form of NGF found in high concentrations in the mouse submandibular gland [8]. The 7S NGF is comprised of three distinct protein subunits named beta-NGF, alpha and gamma [9]. Although the S-180 cells do not produce 7S-NGF, the cells do synthesize one of the component subunits of 7S-NGF, the beta-NGF subunit. Biological, electrophoretic, immunological and molecular weight criteria were used to establish that the beta-NGF synthesized by the S-180 cells is very similar to the submandibular gland beta-NGF. The S-180 beta-NGF was bound to an unidentified binding component(s) which is not immunologically similar to either the alpha- or gamma-subunit. The functional significance of this interaction is not known. PMID- 3967686 TI - Communication compartments in mixed cell cultures. AB - Mixed cultures of epithelial (BRL) cells and fibroblasts (BHK), which sort themselves out into separate domains of each cell type, form communication compartments. Electrical coupling, dye coupling and metabolic coupling measurements have been used to show that small ions and molecules can move freely via intercellular junctions between all the cells in a domain, while their movement across the boundaries between domains is severely restricted. Metabolic coupling is the most sensitive method for detecting trans-boundary communication but the results obtained from all three methods are compatible. The data suggest the reduced transfer across the boundaries is due to fewer channels, resulting from a lower frequency of junction formation between heterologous cells, rather than to channels of smaller diameter. Concentration gradients of small cytoplasmic molecules can be established within these communication compartments which are similar to those predicted to explain pattern formation in developing systems. It is suggested that the cell surface features which cause this sorting out are also responsible for the reduced frequency of heterologous junction formation and hence for compartmentalization. PMID- 3967687 TI - Enhanced proliferation of WI38 cells in the presence of glucocorticoid conditioned medium. AB - The addition of hydrocortisone (HC) or dexamethasone (DEX) to WI38 cells at subcultivation is known to result in increased saturation densities (20-40%). We report that maximal increases in saturation density are, however, only observed if HC is added to the culture shortly after subcultivation. We have found that the proliferative response of WI38 cells to glucocorticoids is mediated by a secondary stimulatory factor(s) present in medium-conditioned by cells in the presence of the hormone. Control cultures refed with medium conditioned in the presence of HC for the first 24 h after seeding (24 h HC-CM) achieve saturation densities 20-40% higher than cultures refed with either medium conditioned in the absence of the hormone (24 h CM) or 24 h CM supplemented with fresh HC. Furthermore, WI38 cultures remain responsive to the stimulatory activity present in 24 h HC-CM throughout the growth cycle. The stimulatory effects of 24 h HC-CM are enhanced by repeatedly refeeding cultures; WI38 cells refed every 2 days with 24 h HC-CM demonstrate an extended period of logarithmic growth and achieve densities 2-3 times higher than controls. A preliminary characterization of this activity shows it to be of low molecular weight (MW) (dialyzable using 12 000 MW cut-off tubing) and heat-stable (75 degrees C). PMID- 3967688 TI - Chromosomal sex and distribution of functional germ cells in a series of chimeric mice. AB - An unselected series of chimeric mice were test mated to determine the parental lineage of their functional gametes. The cytological sex of each animal was established and confirmed in all cases by karyological analysis of peripheral blood lymphocytes. The parental cell lineage for each cytological sex was unequivocally established by the presence or absence of the radiation-induced translocation 15(14) (T6). Eleven animals analysed, 10 of these were chimeric. Among the 10 chimeras, 3 were phenotypically female and 7 were phenotypically male. The cytological sex ratio (XY/XY:XX/XY:XX/XX) was 1:6:2. There were 646 offspring from test matings of these chimeras. The coat color analysis of these offspring demonstrated a concordance of cytological sex of the lineage resulting in functional gametes with the phenotypic sex of the animal. PMID- 3967689 TI - Does capacity of DNA replication change during in vitro ageing? AB - We described elsewhere how a lack of change in the rate of DNA chain elongation occurred during in vitro ageing of human diploid fibroblasts. Here we further examined the rate of actual incorporation of tritiated thymidine, the center-to center distance of replicons and the length of each phase of the cell cycle in order to extend our previous results to the other aspects of DNA replication. The results obtained showed that the rate of net DNA synthesis, the replicon size and the duration of S phase did not change during in vitro ageing. Our findings indicated that the reason why the greater part of the cell population at high population doubling levels becomes incapable of proliferating might not be the gradual decline in the ability of DNA replication. The regulation system(s) of DNA replication may alter during the period of culturing without any change in the capacities of the DNA replication machinery and, consequently, the non cycling cells increase. PMID- 3967690 TI - Characterization of lamina-bound chromatin in the nuclear shell isolated from HeLa cells. AB - The structure and the polypeptide composition of the nuclear shell isolated from interphase HeLa cells have been investigated and compared to those of the intranuclear material. The isolated nuclear shell contains chromatin superstructures (28-32 nm thick fibres) made of tightly packed nucleosomes that resist low ionic strength conditions and that are associated with the three nuclear lamins. Chromatin in the nuclear shell exhibits very simple chemical composition. Especially, non-histone proteins are lacking. The results presented here rule out the possibility that the nuclear shell results from contamination of lamina by intranuclear elements. They suggest that the lamins are directly involved in the specific properties and in the organization of chromatin in the nuclear shell. PMID- 3967691 TI - Commitment in a murine embryonal carcinoma cell line during differentiation induced by retinoic acid. AB - Murine embryonal carcinoma (EC) cells are induced to differentiate when cultured in the presence of retinoic acid (RA). Whereas the EC cells have a high plating efficiency, the differentiated cells have little or no colony-forming ability under the same conditions. We have assumed that the loss of colony-forming ability following exposure of EC cells to RA corresponds to the irreversible commitment of EC cells to differentiate. We found that uncommitted EC cells persist in RA-treated aggregates of EC cells and that the proportion of EC cells stabilizes at a level inversely related to the RA concentration. Both experimental evidence and mathematical modelling results are consistent with the interpretation that there is a dynamic equilibrium achieved by a balance between the processes of EC cell proliferation and differentiation. Since different cell types are induced by different RA concentrations, our results suggest that the commitment to differentiate is not related in any simple way to the developmental program which ensues. PMID- 3967692 TI - DNA-mediated transfer of actinomycin D resistance into cultured mouse cells. AB - The transfer of high molecular weight (HMW) DNA isolated from Syrian hamster actinomycin D-resistant cells (C12TSV5/R) to sensitive A9 mouse cells, resulted in the growth in selective medium of transferent clones A9 ActR C11, C12 and C13). The resistant mouse cells have presumably acquired a gene(s) conferring actinomycin D resistance and express a 140-150 K surface glycoprotein, apparently involved in the drug resistance. PMID- 3967693 TI - Fractionation of micrococcal nuclease-digested chromatin solubilized at physiologic ionic strength. AB - When mouse brain nuclei are optimally digested with micrococcal nuclease, most of the chromatin is soluble in a 180 mM salt/1 mM EDTA buffer [1]. At this ionic concentration, chromatin maintains its native structure [2]. In an attempt to selectively extract different fractions of chromatin from digested nuclei, we have examined the differential solubility of chromatin in the 180 mM salt buffer containing concentrations of MgCl2 ranging from 2 to 0 mM. The results suggest that digested chromatin may be fractionated into specific soluble chromatin fractions which correspond to nuclease-sensitive chromatin, bulk chromatin, and heterochromatin. These soluble fractions have a high molecular weight (up to 20 kbp), and contain a full complement of histones as well as a complex assortment of non-histone proteins. The residual insoluble fraction may be equivalent to a native, nuclear matrix-bound chromatin fraction. PMID- 3967694 TI - Dendritic organization of the anterior speech area. AB - Golgi studies revealed significant differences in dendritic patterns between neurons of the left and right opercular regions of the frontal lobe (Broca's speech area on the dominant side) and between cells of the left and right precentral areas (the orofacial motor zones) just behind. Although total dendritic length of the basilar dendritic array seemed characteristic of an area independent of side, a larger proportion of the length on the left (dominant) side was made up of higher order (4, 5, 6) dendrite branches, and lower order (1, 2, 3) segments predominated on the right. The pattern was partially reversed in non-right-handed patients. These findings can be interpreted as indicating an early preponderance of dendrite growth in the non-speech-gifted hemisphere followed by enhanced dendrite growth in the dominant hemisphere coincident with the beginning of conceptualization and speech function. PMID- 3967695 TI - Synaptic membrane phospholipids: effects of maternal ethanol consumption. AB - The cholesterol and phospholipid content and phospholipid composition were determined in synaptic membranes from the 17- to 31-day-old offspring of rats that were pair-fed either a control or 6.6% (v/v) ethanol liquid diet on a chronic basis prior to parturition. At all ages examined, the major synaptic membrane phospholipid was phosphatidyl choline (greater than 40%). Other prominent synaptic membrane phospholipids included phosphatidyl ethanolamine (approximately 17 to 21%), ethanolamine plasmalogen (approximately 5 to 16%), and phosphatidyl serine (approximately 13%). Smaller proportions of sphingomyelin (4 to 7%), phosphatidyl inositol (approximately 1%), and phosphatidic acid (approximately 1%) were detected. Between 17 and 31 days of age, there was a significant decrease in the proportion of phosphatidyl choline and a significant increase in the proportion of ethanolamine plasmalogen. When the offspring of control and ethanol-treated rats were compared, no significant differences were found in either the yield of synaptic membrane protein, or in the concentration of synaptic membrane cholesterol and total phospholipid. However, the proportion of ethanolamine plasmalogen was significantly decreased in the 24-day-old offspring of ethanol-treated rats, suggestive of a delay in the normal development-related increase of this lipid. In addition, there was a small increase in the proportion of sphingomyelin in the 31-day-old offspring of ethanol-treated rats. PMID- 3967696 TI - A conditioning lesion does not induce axonal regeneration in the optic nerve of the rat. PMID- 3967697 TI - A horseradish peroxidase study of rat lingual motoneurons with axons passing through the cervical nerve. AB - The peripheral course of axons of rat lingual motoneurons was studied by HRP injection into the hypoglossal nerve in combination with transecting of the hypoglossal and/or cervical nerve components of the hypoglossocervical plexus. Furthermore, soma sizes of labeled lingual motoneurons were compared in transverse section with those of labeled geniohyoid and thyrohyoid motoneurons, which are situated adjacent to the lingual motoneurons. We found that axons of the majority of lingual motoneurons lying in the main hypoglossal nucleus passed through the hypoglossal nerve throughout their course to the tongue. In a remaining small number of lingual motoneurons lying in a medial portion of the ventromedial subnucleus in the caudal fourth of the main hypoglossal nucleus, their axons passed through the first cervical nerve to the upper root of the ansa cervicalis to the hypoglossal nerve and then to its medial branch. The labeled lingual motoneurons with axons passing through the cervical nerve were intermingled with those whose axons passed through the hypoglossal nerve. The latter motoneurons, however, diminished in number while being traced caudally, and finally in the most caudal main hypoglossal nucleus the former motoneurons occupied a major part of this nucleus. The lingual motoneurons with axons passing through the cervical nerve were smaller in soma size than those with axons passing through the hypoglossal nerve. These two types of lingual motoneurons were both smaller in soma size than the geniohyoid and thyrohyoid motoneurons, and their soma shape was not as flat as that of the latter types of motoneurons. PMID- 3967698 TI - Effect of muscle tendon vibration on the perception of force. AB - The effect of vibrating the biceps muscle tendon on the perception of forces exerted by the elbow flexor muscles was examined during briefly maintained, submaximal contractions. Subjects were required to estimate the perceived magnitude of isometric forces exerted by the elbow flexor muscles under normal conditions and during vibration of the right biceps tendon. The matching forces produced by the unperturbed left arm provided an estimate of the perceived intensity of the reference arm contraction. Both force and the brachial biceps and triceps EMGs were recorded from each arm. In comparison with the matching forces produced under normal conditions, there was a significant overestimation of the forces exerted by the vibrated biceps muscle. This increase in the perceived intensity of the reference force was associated with an increase in the EMGs of the biceps and triceps muscles of the reference arm. It appeared that during vibration the triceps muscle was cocontracting presumably as a means of controlling the reference force. The overestimation of the forces exerted by the vibrated muscle could therefore reflect either the enhanced excitatory drive required to overcome the antagonist activity, or the concomitant increase in the force generated by the agonist muscle. Previous results suggest that the former is the more probable explanation. PMID- 3967699 TI - Comparison of signal and adaptive sensitivity profiles of the surround mechanism of cat retinal ganglion cells. AB - Signal and adaptive sensitivity profiles of the surrounds of cat retinal ganglion cells were determined by varying the position of concentric annuli whose outside and inside diameters varied but whose total area remained constant. Signal sensitivity profiles were determined by adjusting the luminances of these annuli so as to produce a weak suprathreshold response of constant magnitude and time course. Adaptive sensitivity profiles were determined by varying the luminances of concentric equal-area, unmodulated annuli until the response to a temporally modulated annulus attained a criterion level. The results provided evidence that the retinal region over which the surround mechanism of an X cell pools adaptive information and pools signals are the same, and that the distribution of adaptive and signal sensitivities within these regions is similar. A small number of X cells showed local adaptation effects. The adaptive pooling area appeared to be smaller than the signal pooling area for Y cells. PMID- 3967700 TI - Further evidence for the role of the caudate nucleus in programming motor and nonmotor behavior in Java monkeys. AB - This study describes the short-term effects of intracaudate microinjections of carbachol in temporarily isolated and restrained Java monkeys. The monkeys were found to display a series of motor disturbances including blepharoptosis, facial twitches, tongue protrusions, ear flattening, torticollis, and compulsive alternations of rapid flexions and extensions of the extremities. In general, carbachol was found to produce consistent effects as far as it concerns its ability to elicit motor disturbances. Three of the five tested monkeys had previously received another series of carbachol injections when they were freely moving and living in a stabilized social group. Accordingly, the present study enabled us to compare the effectiveness of threshold doses of carbachol in the same monkey in two distinct situations. We concluded first, that motor disturbances and disturbances in social communication were closely coupled in relation to the involvement of a particular cholinoceptive substrate within the caudate nucleus of Java monkeys. Second, the motor disturbances under study appeared to require a larger degree of dysfunctioning of this substrate than did subtle disturbances in the social communication of these monkeys. And, finally, stress inherent to restraint increased the susceptibility of the cholinoceptive substrate within the caudate nucleus. The clinical impact of our findings is discussed in view of differences between the premorbid and manifest phases of Parkinson's disease. PMID- 3967701 TI - Computer feedback reveals quantal aspects of the Hoffmann reflex. AB - The Hoffmann reflex was studied in 13 normal volunteers, using computer feedback to control stimulus intensity. The intensity of the electrical pulse that evoked the H-reflex was maintained at near threshold values by a computer program, which increased or decreased the intensity on the basis of the amplitude of the recorded response. Stimulus intensity was increased for H-responses less than, and decreased for H-responses greater than, a criterion value of 50 microV peak to-peak. More than 500 responses were recorded from each subject during a 40-min period. The feedback procedure tended to hold the H-reflexes near the criterion value. Slow drifts in the required current indicated waxing and waning of threshold. Examination of response amplitude distributions showed two different types. For the nonquantal type, all possible values were represented in the range zero to 200 microV. Responses in the upper half of that range were less frequent than those in the lower half. For the quantal type, the majority of the responses were clustered near zero and at an amplitude that was characteristic for a given recording configuration; very few responses of intermediate amplitude were observed. The quantal pattern of response was ascribed to the firing of low threshold single motor units. PMID- 3967702 TI - Dorsal hippocampal kindling and transfer in split-brain rats. AB - The rate of kindling of a primary site in the dorsal hippocampus of rats was not altered by various forebrain commissurotomies or midbrain bisection. The positive transfer in the kindling of a secondary site in the homotopic hippocampus, on the other hand, was abolished by extensive forebrain transection, whereas anterior callosal or midbrain bisection alone was ineffective. In addition, there was no evidence of an interference effect when rekindling the original primary site. These results have important implications for interhemispheric mechanisms in kindling. PMID- 3967703 TI - Effects of glucocorticoids on experimental allergic neuritis. AB - Corticosteroids were administered to rats and guinea pigs with experimental allergic neuritis, from the time of inoculation with antigen or from the onset of signs of disease. No statistically significant effects were observed in guinea pigs. In rats, to which large doses of corticosteroids were administered, disease severity was slightly but significantly reduced in both groups and recovery was more rapid in the animals treated from the time of induction of disease. These results were comparable with those obtained in trials of corticosteroids in acute inflammatory polyneuropathy in man, which have also not demonstrated any striking effects. PMID- 3967704 TI - Interlimb coordination during stepping in the cat: the role of the dorsal spinocerebellar tract. AB - The role of the dorsal spinocerebellar tract (DSCT) in the neural control of normal interlimb coordination during overground stepping in adult cats was investigated using select spinal cord lesions. Previously, it had been shown that lesions of the caudal thoracic dorsal columns (DCs) which might involve the DSCT or its afferent fibers resulted in a marked change in the patterns of forelimb hind limb coupling during locomotion. In the present study, more rostral DC lesions, which probably included the DSCT or its afferent fibers considerably less, resulted in nearly identical changes in the patterns of interlimb coordination during stepping. Lesions of the dorsolateral funniculus (DLF) at similar spinal levels resulted in no significant changes in interlimb coordination. These lesions did destroy the DSCT, since retrograde transport of horseradish peroxidase (HRP) from the anterior cerebellar vermis to the nucleus dorsalis was blocked caudal to the lesion. These results are consistent with the notion that the DSCT plays little if any role in the precise timing of step cycles of the different limbs. PMID- 3967705 TI - Forebrain damage following prenatal exposure to low-dose X-irradiation. AB - Exposure of fetal rats to X-irradiation on gestational day 15 resulted postnatally in dose-related effects on body weight, growth of forebrain structures, and branching of dendrites of caudate neurons. Rats were followed for 4 months postnatally after 125, 75, 50, or 25 R whole-body irradiation to the dam. Significant decreases in body weight were present at birth after the three high doses and continued as long as 4 months after 125 or 75 R. Decreased thickness of the cerebral cortex and decreased area of the caudate nucleus were also seen. Cortical thickness was reduced by 125 R to half the size of the control cortex and the caudate nucleus to two-thirds of the control. Significant decreases were present to 50 R. Dendritic branching was reduced in caudate neurons by 125 R but not in the basilar dendrites of cortical pyramidal cells. No reduction in number of cortical synapses was seen from electron micrographs of cortical layers 1 or 5. The effect on the cerebral cortex was interpreted as a loss of neurons with retention of branching and synaptogenesis of remaining neurons. In contrast, the caudate nucleus, which develops somewhat before the cerebral cortex, showed effects as a consequence either of direct damage to caudate neurons or of reduced neuropil from reduced afferent input. PMID- 3967706 TI - Water and electrolyte content of rabbit brain after opening the blood-brain barrier by acute hypertension. AB - Changes in water and electrolyte content of the brain and edema formation after acute, drug-induced hypertension were studied in albino rabbits. Blood-brain and blood-cerebrospinal fluid (CSF) barriers opened to Evans blue-albumin when systemic blood pressure was elevated abruptly to more than 160 mm Hg by i.v. injection of Aramin. No statistically significant changes in sodium and potassium content of brain, muscle, and CSF were observed. Measurable brain edema did not develop. The results suggest that short-lasting hypertensive barrier opening does not cause brain edema, but may enhance a tendency for brain edema. PMID- 3967707 TI - Tightly bound fatty acids in the erythrocyte membrane proteins in myotonic dystrophy. AB - The composition of "tightly bound fatty acids" and of loosely bound fatty acids in the erythrocyte membrane proteins from patients with myotonic dystrophy were compared with those of sex- and nearly age-matched normal controls. No significant differences could be detected in the composition of tightly bound fatty acids and there was no gross abnormality in the composition of loosely bound fatty acids between myotonic dystrophy patients and normal controls, although small differences were observed. PMID- 3967708 TI - Variability in the characteristics of pontogeniculooccipital spikes during paradoxical sleep. AB - An important criterion for identifying paradoxical sleep is the presence of a peculiar waveform recorded in the pons, lateral geniculate body, and visual cortex during that sleep state. These waveforms, termed PGO waves, have long been viewed as having large and constant amplitudes, an initial negative deflection in the visual cortex, and not being dependent on the levels of background illumination. Waveforms recorded during wakefulness have different characteristics, and these have been used to differentiate the waking state from paradoxical sleep. The present study demonstrated that most PGO waves have highly variable amplitudes during paradoxical sleep and that only a small fraction conform to the stereotypic wave characteristics of constant and large amplitudes and the presence of initial negative deflections. These findings argue against the criteria commonly used to differentiate PGO waves during paradoxical sleep from the eye movement potentials recorded in wakefulness. PMID- 3967709 TI - Dorsal-ventral differences in the midbrain distribution of single neurons with head movement-correlated and locomotion-correlated firing in the golden hamster. AB - Movement-correlated firing was studied in 111 midbrain neurons recorded in freely behaving hamsters. For 42% of these cells, most of which lay in the deeper laminae of the superior colliculus, firing occurred principally or exclusively in association with head movements. In 38% of the neurons, most of which were in subtectal regions, activity was greatest during locomotion, but also occurred in correlation with other types of movement. PMID- 3967711 TI - High-affinity transport of glutamate in rat brain microvessels. AB - The maintenance of low extracellular concentrations of glutamate in the brain is a complex process in which the role of capillary transport is poorly understood. We examined the kinetics and substrate specificity of glutamate uptake by isolated rat brain microvessels. We showed that these microvessels take up glutamate by an energy- and temperature-dependent, concentrative, high-affinity active transport system with Km of about 2 microM. The presence of this active transport system, coupled with the known slow inward transport of glutamate across the blood-brain barrier, allows us to suggest that this capillary transport system may function in vivo in the unidirectional outward transport of glutamate from brain to blood. PMID- 3967710 TI - Incidence of seizures that follow rehydration of hypernatremic rabbits with intravenous glucose or fructose solutions. AB - Hypernatremic dehydration was induced in rabbits during a 3- to 5-day period resulting in mean plasma sodium concentrations of 187 meq/liter. The animals were then rehydrated during a 4-h period by intravenous administration of a 2.5% glucose or fructose solution. The water content of four regions of brain sample showed a significant (P less than 0.05) increase in brain water content above normal in the rehydrated groups. Brain water content was significantly (P less than 0.01) greater in those animals with seizures compared with those without seizures, suggesting the importance of water intoxication in the pathogenesis of seizure activity. Changes in muscle Na, K, Cl, and water content were not similar to those of brain, indicating that muscle content of these substances was not an accurate reflection of the brain content specific time. The incidence of seizures was significantly (P less than 0.05) greater when glucose solution was used for rehydration (49%) compared with the use of fructose solution (25%). The mechanism(s) by which fructose resulted in a lower incidence of seizures is not known. The frequency of seizure activity was directly proportional to the rate of administration of intravenous solutions utilized to correct hypernatremia. In addition, the specific carbohydrate of the solution appeared to play an important role in the pathophysiology of the development of seizures. PMID- 3967712 TI - An anomalous vagorenal reflex pathway in the cat. AB - Although physiological investigations support the view that the innervation to the kidney is primarily sympathetic in origin, there is anatomic evidence suggesting direct vagal projections to the kidney. We examined electrophysiologically the possibility that neural connections exist between the cervical vagus and renal nerves. Electrical stimulation of the peripheral segment of the cut cervical vagus evoked electrical activity in the central segment of cut renal nerve of chloralose-anesthetized, paralyzed cats. The evoked potentials (vagorenal responses) displayed components with peak latencies of about 50, 120, and 500 ms. Another peak at about 175 ms was also seen in some cases. In addition, a period of postexcitatory depression occurred between approximately 180 and 400 ms after delivery of the stimulus. Evoked responses were recorded in the contralateral as well as the ipsilateral renal nerves. In contrast, stimulation of the central cut end of renal nerves did not elicit responses in the cervical vagus. Vagorenal responses were not altered by cutting the subdiaphragmatic vagus indicating that the abdominal vagus was not involved in this response. Electrical activity in renal nerves elicited by vagal stimulation could be eliminated by either ganglionic blockade or by cutting or cooling the splanchnic nerves. Finally, supraspinal ischemia abolished the vagorenal response. These data suggest that a vagorenal reflex pathway exists and that the potentials recorded in renal nerves are due to activation of aberrant sensory fibers traveling from the peripheral segment of the cut cervical vagus to the central nervous system, where they excite a sympathetic efferent pathway to the kidney. PMID- 3967713 TI - Long-term effects of estrogen on rat skeletal muscle. AB - The long-term effects of estrogen on the development of rat extensor digitorum longus (EDL) and soleus (SOL) muscles were examined using physiological and histochemical methods. The rats were in three groups: group 1, ovariectomized; group 2, sham-operated; and group 3, ovariectomized followed by estradiol administration. Isometric twitch and tetanic tensions of both the EDL and SOL obtained from 10-week-old rats were evoked by electrical stimulation. The isometric twitch tensions of the EDL in groups 2 and 3 were significantly lower than in group 1, however, there was no significant differences in isometric twitch tensions of the SOL among the three groups. The isometric tetanic tensions of the EDL in groups 2 and 3 were also significantly lower than in group 1, and the isometric tetanic tension of the SOL in group 3 was significantly lower than in group 1. There were no changes in the total number of muscle fibers or in the ratios of fiber types. But the mean fiber diameter of all fiber types (particularly in types IIA and IIB) was significantly lower in group 3 than in groups 1 and 2. Therefore, the possibility that estrogen may play an inhibitory role in the development of skeletal muscle fibers has to be considered. PMID- 3967714 TI - Electrical stimulation of the substantia nigra does not increase tail-flick latency in the rat. AB - The effect of electrical stimulation at multiple sites in the midbrain was investigated in rats lightly anesthetized with barbiturate. The application of monopolar electrical stimulation to the substantia nigra (SN) or the adjacent cerebral peduncle failed to produce an elevation in tail-flick latency (TFL) in response to the application of noxious radiant heat. However, the same intensity of stimulation when applied to an area dorsal to the SN led to an elevation in TFL. This effect was not due to current spread to dopaminergic neurons in the zona compacta compartment of the SN because administration of cis-flupenthixol failed to block the effect. We conclude that, contrary to previous suggestions, discrete electrical stimulation of the SN itself does not give rise to a state of antinociception. PMID- 3967715 TI - Plasticity in the 904-day-old male rat cerebral cortex. AB - Ten pairs of male Long-Evans rats living in nonenriched environments (3 rats per small cage) were transferred to either enriched environments (10 rats per large cage plus "toys") or nonenriched environments (2 rats per small cage) at 766 days of age. One hundred and thirty-eight days later, at 904 days of age, the cerebral cortical thickness from these animals was measured on projected, 10-micron, thionine-stained, transverse sections. Although the thickness in the enriched rats was greater than in the nonenriched rats in all sections through the frontal, parietal, and occipital cortices, the 4 to 10% differences were statistically significantly different in only the frontal and occipital cortices. Right greater than left cortical thickness differences were not statistically significant in either the enriched or the nonenriched animals by 904 days of age. Neuron and glial counts were made on enlarged photographs of area 18 in the occipital cortex on 6-micron-thick, luxol fast blue-stained sections. No significant differences in cell counts were noted between the enriched and nonenriched animals. No significant differences in neuronal counts were found among 108-, 650- (from previous experiments), and the 904-day-old nonenriched rats. The notable findings were the plasticity of the extremely old, enriched rats' occipital cortex and the lack of the loss of neurons in cerebral cortical area 18, whether or not the environments were enriched. These results showed that the cerebral cortex remained structurally plastic throughout the lifetime of the organism. PMID- 3967716 TI - Avian muscular dystrophy: serum thyroid defect and limited improvement with methimazole and propylthiouracil. AB - Serum concentrations of triiodothyronine (T3) and thyroxine (T4) were determined by radioimmunoassay in normal and genetically related muscular dystrophic chicks at 2 through 42 days ex ovo. There were no significant differences in T4 concentrations, but T3 concentrations were reduced about 35% below normal values in dystrophic birds at 14 to 42 days. The situation was reversed, however, on day 2, with T3 concentrations about 50% greater in dystrophic than in normal serum. Administration of T3 beginning on day 2 ex ovo did not alter phenotypic expression of dystrophic signs. Administration of the thyroid "antagonists," methimazole and propylthiouracil, however, significantly increased righting ability and reduced serum creatine kinase activity in dystrophic chicks. None of the administered substances improved the histopathology of dystrophic pectoralis major muscles. The data indicate that serum T3 concentrations may provide an early "marker" for avian dystrophy, and suggest that lowered serum T3 concentrations in older chicks may represent a compensatory response to the elevated serum T3 in newly hatched dystrophic chicks. PMID- 3967717 TI - Electromyographic evaluation of a novel surgical preparation to enhance nerve muscle specificity that follows mammalian peripheral nerve trunk transection. AB - Previous studies indicated that axons from proximal stumps of transected peripheral nerves "prefer" to grow through Silastic tubes attached to their native (originally associated) rather than foreign (not originally associated) distal stumps. We determined whether or not this specificity is expressed at the level of the neuromuscular junction. Proximal stumps of transected rat sciatic nerves (peroneal and tibial branches) were attached to single inlet ends of 6-mm long, Y-shape Silastic implants. One outlet was attached to the distal peroneal and the other to the distal tibial stump. Ten weeks later, innervation of the anterior tibialis and interosseous muscles (normally innervated predominantly by peroneal and tibial nerve fibers, respectively) was assessed by measuring compound muscle action potential amplitudes and latencies that follow supramaximal peroneal and tibial nerve stimulation. Results showed higher amplitudes in anterior tibialis muscle, induced by "native" peroneal (vs. tibial) stimulation in four of five animals, and higher amplitudes in interosseous muscles after "native" tibial (vs. peroneal) stimulation in all cases examined. Preparations in which bridges between proximal and distal nerve stumps were bridged with unbranched tubes showed random patterns of muscle innervation. The results suggest that if allowed to express "specificity" at the level of nerve trunk transection, regenerating mammalian peripheral axons can grow into, and form functional connection with, native (vs. foreign) muscle groups. This finding has possible clinical significance. PMID- 3967718 TI - Sympathetic preganglionic efferent and afferent neurons mediated by the greater splanchnic nerve in rabbit. AB - Motion sickness, a multisymptom disorder characterized by abnormal gastrointestinal motility and emesis, can be induced by vestibular effects on the sympathetic portion of the autonomic nervous system. However, the vestibular autonomic pathways are unknown. As a first step in the analysis, we identified the locus of preganglionic sympathetic neurons (PSNs) and dorsal root afferent ganglionic neurons (DRGs) which supply sympathetic innervation to major portions of the gastrointestinal tract in the rabbit. Retrograde labeling of neurons was obtained by application of horseradish peroxidase (HRP) to the cut end of the greater splanchnic nerve. Labeled PSNs were found, ipsilaterally, within the T1 to T11 spinal cord segments, with the highest density of neurons in T6. Most PSNs were located within the intermediolateral column (IML), but a significant portion also occurred within the lateral funiculus (LF), the intercalated region (IC) and the central autonomic area (CA). The proportion of labeling between the four regions depended on the spinal cord segment. In the midthoracic levels, the distribution of labeled neurons was denser in the IML and LF, and in the caudal thoracic segments, the majority were localized in the IC and CA. Labeled cells in these four areas varied morphologically from large fusiform neurons in the IC to small fusiform neurons in the LF, small stellate neurons in the CA, and medium size stellate neurons in the IML. The DRGs were labeled in thoracic segments T1 to T12, with the majority between T5 and T11. These labeled DRG somata of the greater splanchnic nerve were smaller in comparison with unlabeled ones. PMID- 3967719 TI - Cell death in the adult rat dorsal root ganglion after hind limb amputation, spinal cord transection, or both operations. AB - Cell death of embryonic neurons which are unable to attain a proper target is well established. A delayed cell death of adult neurons permanently separated from their target tissue has been demonstrated for several cell groups. Cells of the dorsal root ganglia (DRG) are unique in that a single T-shape neurite has a peripheral branch which extends (for root L5) to the hind limb and a central branch extending into the spinal cord. We found a significant loss of L5 DRG neurons 25 weeks after hind limb amputation. This finding is consistent with the hypothesis that neuron survival is dependent on connection with a suitable target. We were unable to detect cell death in the DRG of L5 after complete spinal cord transection at T9. Separation of DRG cells from their central target is unimportant to neuronal survival. PMID- 3967721 TI - Spatial distribution of capillaries in rat nerves: correlation to ischemic damage. AB - Computerized imaging was used to assess the spatial distribution of capillaries (number, density, and intercapillary distance) in normal rat sciatic nerve and its branches, to be able to make inferences about their distribution to central fascicular degeneration typical of ischemic nerve injury. Capillary density was significantly less in the central regions of fascicles than in outer contour areas in sciatic and proximal tibial nerves, the difference being greater in large fascicles. The mean of the minimum intercapillary distance was significantly greater in the central fascicular region of fascicles of the sciatic but not of the tibial and peroneal nerves. These anatomic characteristics may be a factor in ischemic-induced central fascicular degeneration. A decrease in the number of capillaries in a region might lead to impaired oxygen diffusion when blood flow to the region is compromised. PMID- 3967720 TI - Fatiguability and oxidative capacity of forelimb and hind limb muscles of dystrophic mice. AB - Fatigue indices and succinic dehydrogenase (SDH) activities were determined in the extensor digitorum longus (EDL) and soleus muscles of the hind limb and the extensor carpi radialis longus of the forelimb in control and dystrophic mice aged 4 to 26 weeks. A good correlation was found between SDH activities and fatigue indices in muscles from normal mice. In the dystrophic (dy2J) mice, however, this correlation was not present. The EDL muscles from 26-week-old dy2J mice showed a much higher resistance to fatigue than age-matched controls but this was not accompanied by a significant change in SDH. The increased fatigue resistance in dy2J EDL appeared between 8 and 12 weeks of age and was temporally correlated with the onset of fused bursts of spontaneous activity in the hind limb muscles. Nevertheless, there was no conclusive evidence for a link among this spontaneous activity, oxidative enzyme capacity, and fatigue resistance. PMID- 3967722 TI - Maintenance of respiratory modulation by pneumotaxic mechanisms in deep anesthesia. AB - My purpose was to evaluate the hypothesis that the pneumotaxic center should continue to regulate ventilatory activity in deep anesthesia. In decerebrate cats, the respiratory pattern was reversibly altered from eupnea to apneusis by cooling the rostral pons. Such cooling markedly changed phrenic activity even after doses of halothane, pentobarbital, or chloralose-urethane had almost entirely eliminated this activity in eupnea. It is concluded that both pontile and medullary mechanisms control eupneic ventilatory activity in unanesthetized as well as deeply anesthetized preparations. PMID- 3967723 TI - Cellular heterogeneity in the ependymal layer of the chicken's lumbosacral spinal cord. AB - Cytological development in the ventricular zone of the chicken's lumbosacral spinal cord was studied by light and transmission electron microscopy before and after hatching. Two morphologically distinct types of cell were first noted by embryonic stage 41 and were present in the 2-day-old chick. From cell bodies located at the border of the ependymal layer, a lightly stained process extended among the more numerous and typical ependymal cells to reach the central canal. Synapses were observed only on the cell bodies of the lightly stained cells. PMID- 3967724 TI - Dermacentor variabilis: acquired resistance to ticks in BALB/c mice. AB - To assess the ability of Dermacentor variabilis larvae to feed on mice during repeated infestations, known numbers of larvae were confined to the skin of BALB/c mice within plastic capsules, and different skin sites were used in four successive infestations. In secondary infestations larval feeding appeared to be enhanced, but in subsequent infestations the mice expressed acquired tick resistance, manifested by reduction in numbers of engorged larvae and in weights of fed larvae. Resistance, once established, was still demonstrable four weeks after the previous infestation. Histological examination of skin biopsies from BALB/c mice undergoing repeated infestations revealed slight reactions to primary infestations and increasingly severe responses in subsequent infestations. The latter reactions included prominent participation of mast cells and eosinophils, many of which were degranulated close to tick bite sites. It is suggested that these cells might play a role in the expression of murine tick resistance. PMID- 3967725 TI - Tritrichomonas foetus: cytochemical visualization of the endoplasmic reticulum Golgi complex and lipids. AB - The zinc iodide-osmium tetroxide technique was used to analyze the distribution of the endoplasmic reticulum-Golgi complex system of Tritrichomonas foetus. Interconnections between the cisternae of the endoplasmic reticulum as well as between cisternae of the Golgi complex were observed. The nuclear pores, as well as fenestrations in the Golgi complex, were evident. Three to four profiles of the endoplasmic reticulum were seen in the proximal marginal lamellae, related to the attachment of the recurrent flagellum to the protozoan body. No reaction product was seen in the costae, microtubules, glycogen particles, or hydrogenosomes. Imidazole-buffered osmium tetroxide solution was used to visualize lipids. Electron-dense materials were seen either free in the cytoplasm or within membrane-bounded cytoplasmic vesicles. A high contrast of some membranes, mainly of those which enclosed the hydrogenosomes, was observed in unstained sections. PMID- 3967726 TI - Brugia pahangi: comparative susceptibility of the Mongolian jird, Meriones unguiculatus, and the PD4 inbred hamster, Mesocricetus auratus. AB - The susceptibility of Mongolian jirds, Meriones unguiculatus, and PD4 hamsters, Mesocricetus auratus, to Brugia pahangi was compared based on the percentage adult worm recoveries, mean microfilaremia levels, and adult worm lengths. Fourteen male jirds and seventeen male PD4 hamsters were each inoculated subcutaneously in the left inguinal region with 90-100 L3 of B. pahangi and necropsied 130-150 days after inoculation. There were no significant differences between jirds and hamsters in mean adult worm recoveries (24.7 vs 25.4%) and prepatent periods (69.9 vs 77 days after inoculation). In hamsters, 85% of recovered worms were found in the heart and lungs and 15% were found in genital lymphatic vessels. In jirds, distribution of recovered worms was 66% in genital lymphatics, 23% in the heart and lungs, 8% in the peritoneal cavity, and 3% in lymphatic vessels in other sites. The mean microfilaremia level in jirds (16.5/20 microliter) was significantly higher than in hamsters (8.7/20 microliter. Female worms in the genital lymphatics of jirds were significantly longer than female worms in the genital lymphatics of PD4 hamsters (33.5 vs 27.3 mm). Lengths of worms in other locations were similar between the two species. PMID- 3967727 TI - Xenopsylla cheopis: cellular expression of hypersensitivity in guinea pigs. AB - Guinea pigs multiply exposed to Xenopsylla cheopis adult fleas exhibited marked blood basophil responses to challenge infestation with only minor changes in blood eosinophil levels. Dermal responses to flea feeding were marked by dominant neutrophil (52% of the infiltrate) and eosinophil (32%) accumulations 24 hr after primary feeding, with a weak basophil response (11%). However, after challenge feeding 14 days later, eosinophils dominated, representing 59% of the infiltrate with basophils comprising 30% of the cellular response; neutrophils were rare (7%). Mast cells did not exhibit any increases in density during either the primary or secondary infestation, representing 4-7% of the infiltrate. These results demonstrate that flea feeding induces systemic and local basophil responses as demonstrated for all hematophagous arthropods examined so far. Flea feeding success was not adversely affected by feeding on homologously hypersensitized guinea pigs or guinea pigs sensitized by Ornithodoros parkeri feeding. However, basophil responses at flea feeding sites in heterologous (tick) sensitized animals were more basophilic (26 +/- 4 cells/0.03-mm2 area) than feeding sites in homologous (flea) sensitized hosts (9 +/- 6 cells). Furthermore, primary tick feeding sites become erythematous and indurated after flea feeding on the opposite flank, and were marked histologically by strong basophil abscess (276 +/- 56 cells/0.03-mm2 area); primary flea feeding sites were not activated by tick challenge feeding. These cross-generic challenge feeding experiments suggest antigen cross-reactivity, resulting in activation of feeding sites of a heterologous arthropod.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967729 TI - Trypanosoma brucei: immunogenicity of the variant surface coat glycoprotein of virulent and avirulent subspecies. AB - Comparative analyses were made to define the immunogenic role in mice of the variant surface coat glycoprotein (VSG) of African trypanosomes. Less than 10 micrograms of the glycoprotein fixed to trypanosomes or covalently linked to sheep erythrocytes were 100 times more immunogenic than soluble VSG. Therefore, although VSG is present on the parasites and in the blood of infected hosts, the cell-bound form most likely elicits immunity. Intravenous administration of soluble or cell-bound VSG was a better route of immunization than the subcutaneous route. Therefore, although parasites grow at the site of infection, in tissue spaces, and in the blood, control of blood parasitemia is best developed if the antigen is introduced to the vascular bed. Full protection against homologous challenge occurred by 4 days and was maintained through 30 days. Trypanosome-agglutinating antibody titers could be measured at 3 days, peaked at 5 days, and remained high through 14 days after immunization. Therefore, mice immunized with an optimal dosage of VSG, 2 days before challenge, should have had ample time to elicit a protective response. Most of these mice, however, developed patent infections, and one-third died during the first peak of parasitemia at about the same time as untreated control mice. This indicates that active infection inhibits the early phases of induction of immunity. Mice, suboptimally immunized against and challenged with an avirulent isolate of Trypanosoma brucei gambiense, survived at higher rates than mice immunized and challenged with a virulent clone of T. b. rhodesiense. Cell-fixed and soluble VSG from both parasites elicited similar agglutinating-antibody titers, indicating that the two trypanosomes were equally antigenic. Results from neutralization tests, however, revealed that, per unit of immune mouse serum, 400 times more T. b. gambiense became noninfective than T. b. rhodesiense. Apparently, virulence is related to relative sensitivity of the trypanosomes to immunological assault. PMID- 3967728 TI - Caenorhabditis elegans: lectin-mediated modification of chemotaxis. AB - Binding of the lectins concanavalin A (Con A) and limulin to Caenorhabditis elegans wild type resulted in consistent, reproducible, partial inhibition of chemoattraction to sterile filtrates of Escherichia coli. Normal chemotaxis resumed within 8 hr following treatment with these lectins. Competitive displacement of Con A or limulin by flooding with the specific sugars resulted in rapid resumption of normal chemotactic behavior. The experimental protocol for Con A applied to three age groups (newly hatched larvae, young adults, and old adults) showed the same response for all groups tested. Two mutant C. elegans with morphological defects in the cephalic chemosensilla showed the same inhibition of chemotactic response after exposure to Con A, and rapidly resumed normal behavior after competitive displacement of the lectin. Limulin and Con A did not affect nematode growth, development, or longevity, demonstrating that the observed results were not attributable to toxic effects. These results and other experimental evidence support the premise that behavioral modification was caused by functional impairments caused by Con A and limulin to chemoreceptors located on sensory dendrites of the cephalic sensilla. PMID- 3967730 TI - Visualization of the mitochondria of Toxoplasma gondii-infected mouse fibroblasts by the cationic permeant fluorescent dye rhodamine 123. AB - The mitochondria of living mouse fibroblasts infected with Toxoplasma gondii were monitored with the cationic permeant fluorescent dye rhodamine 123. Fluorescence microscopy revealed that host cell mitochondria accumulated at the cytoplasmic surface of parasitophorous vacuoles and increased the dye uptake in the periparasitophorous vacuole as T. gondii multiplied. PMID- 3967731 TI - Comparison of the in vitro development of mouse single blastomeres with and without the zona pellucida. AB - No difference was observed during in vitro development between mouse single blastomeres with and without the zona pellucida, isolated from 2- and 4-cell stage eggs. PMID- 3967732 TI - Neuron numbers in hypothalamic nuclei of young, middle-aged and aged male rats. AB - Morphologic analysis of nine hypothalamic areas revealed significant decreases in the number of neurons per unit area in the ventral medial and arcuate nuclei. These data suggest that altered neuron numbers in the VMW and perhaps the ARC may participate in the well documented reductions in endocrine and neuroendocrine function observed in aging rats. PMID- 3967734 TI - A new simple temperature-controlled membrane oxygenator for the perfusion of isolated rat livers. AB - A new temperature-controlled membrane oxygenator for perfusing isolated rat livers was assembled using a combination of heat-exchangeable rubber tubing and silicon rubber tubing. The apparatus supplied enough oxygen to satisfy the requirements of hemoglobin-free perfused livers. PMID- 3967735 TI - Serum creatine kinase in marathon runners. AB - Serum creatine phosphokinase (CK) and CK-MB activity were determined in 21 trained runners participating in a marathon race (42.2 km). Enzyme activities immediately after the race increased two to three times compared with activities before the race. The greatest increases were found in the slowest runners, suggesting greater skeletal muscular trauma in the least trained or fit. As these are likely to include the older athletes who are also more likely to suffer acute myocardial injury during strenuous exercise, our findings assume special import in the interpretation of increased CK and CK-MB serum activities of older athletes. PMID- 3967733 TI - Both thermal and nociceptive afferents influence the unit activity of the neurons in the corpus striatum. AB - Both thermal and nociceptive stimulation in the periphery were shown to influence the neuronal activity recorded in the striatal area. Both the thermal and nociceptive sensitivity of the striatal neurons were closely related. PMID- 3967736 TI - Changes in the cardiac glutathione status after ischemia and reperfusion. AB - In the isolated and perfused rabbit heart ischemia induced a rapid decline of contractility, associated with a reduction of the content of tissue GSH with no significant changes in GSSG. Reperfusion induced a small recovery of contractility, a substantial release of total glutathione and a further decrease in the content of tissue GSH with a significant increase of tissue GSSG. Glutathione reductase and glutathione peroxidase activities were not affected by ischemia and reperfusion. This study suggests a possible role for glutathione in the determination of functional damage induced by myocardial ischemia and reperfusion. PMID- 3967737 TI - Longitudinal continuity of the subrhabdomeric cisternae in the photoreceptors of the compound eye of the drone, Apis mellifera. AB - It is shown that the subrhabdomeric cisternae of the honey bee drone photoreceptor cell constitute a single structure with a continuous lumen, that extends over at least 15 micron and perhaps the whole length of the cell. In this case, the structure of the cisternae might subserve the propagation of light adaptation along the cell. PMID- 3967738 TI - Influence of diet on plasma tryptophan and brain serotonin levels in mice. AB - Groups of mice were maintained for up to 78 weeks on tryptophan restricted, protein restricted and control diets. Plasma tryptophan levels were significantly reduced by both forms of dietary restriction. Brain serotonin levels were significantly reduced only in mice on the tryptophan restricted diet, but not for mice on the protein restricted diet. The protein-restricted diet contains less of the large neutral amino acids which compete with tryptophan to enter the brain. It is known that protein restriction and tryptophan restriction extend lifespan. The results presented here suggest that extension of lifespan and lowering of brain serotonin are not related. PMID- 3967740 TI - Biochemical changes in some acrosomal enzymes of spermatozoa during maturation. AB - Goat spermatozoal hyaluronidase and acrosin show significantly increased activities during transition from caput to cauda epididymis. The activity of alkaline phosphatase decreases during spermatozoal transport through epididymis. PMID- 3967739 TI - Dopamine-beta-hydroxylase activity in adrenal gland and spleen of rats after fasting and cold exposure. AB - Fasting (48 h) results in dopamine-beta-hydroxylase (DBH) release both in adrenal gland and spleen, suggestive of an increase in the activity of these organs. Cold exposure (48 h) produces a dissociation of the sympathoadrenal response. When both stimuli are simultaneously employed, the DBH response suggests the preponderance of the response to fasting. Plasma DBH is decreased in all groups studied, this could be due to its half-life and the splenic DBH depletion. PMID- 3967741 TI - Acute toxicity of folic acid in mice. AB - The toxicity of folic acid (PGA) was studied in different inbred strains of mice. LD50 values of PGA by the i.p. route showed a unique toxicity pattern. In some strains, convulsions, ataxia and weakness were observed. Histopathological study in strains S/RVCri, BDF1, DBA/2 and DBA/2fNCri showed acute renal tubular necrosis. PMID- 3967742 TI - Circling behavior induced by phencyclidine in mice and its inhibition by naloxone. AB - Phencyclidine (PCP), when given to mice, induces general hyperactivity and rapid circling, similar to that caused by morphine. These effects are partially antagonized by naloxone. PMID- 3967743 TI - Sanguinarine: its potential as a liver toxic alkaloid present in the seeds of Argemone mexicana. AB - The alkaloid sanguinarine reported to be responsible for several outbreaks of epidemic dropsy in the tropics was examined for its hepatotoxic potential in rats. The studies showed that a single i.p. dose (10 mg/kg) of sanguinarine not only increased the activity of SGPT and SGOT substantially but also caused a significant loss of microsomal cytochrome P-450 and benzphetamine N-demethylase activity. Furthermore, the treated rats exhibited considerable loss of body and liver weight, peritoneal edema and slightly enlarged livers with fibrinous material. Microscopic examination of the liver tissue showed progressive cellular degeneration and necrosis further substantiating that sanguinarine is a potential hepatotoxic alkaloid. PMID- 3967745 TI - Replication pattern of double minutes derived from an insect cell line. AB - The DNA replication pattern of double minutes derived from an established cell line of Aedes albopictus is described. Although the vast majority of double minutes replicate semiconservatively once during the S phase, some double minutes appear to exhibit different pattern(s). Two theories are suggested as possible explanations of our findings. PMID- 3967744 TI - The effects of acute and chronic morphine on regional distribution of cardiac output in brain. AB - Both acute and chronic administration of morphine resulted in an increase in the percent cardiac output received by brain. However, various brain regions were affected differently by the drug treatments. The greatest increases in percent cardiac output received after chronic administration of morphine occurred in pons and cerebellum, while the greatest increases after acute administration occurred in cortex and midbrain. The changes found are in contrast with earlier studies which suggest that morphine has no effect on cerebral blood flow. PMID- 3967746 TI - Loss of antibody production accompanied by chromosome loss in a cloned hybrid line secreting antibodies to sheep red blood cells. AB - Somatic cell hybrids between Sp2/O-Ag14 mouse myeloma cells and lymphocytes derived from BALB/c mice hyperimmunized with sheep red blood cells (SRBC) were produced. One hybrid producing IgG1 antibody to SRBC was selected, cloned twice and subsequently transferred to BALB/c mice. After a number of transfers it was found that the antibody titer in ascites fluid gradually decreased. Cytogenetic analysis revealed gradual chromosome loss in the hybrid clone, which produced progressively less antibody. PMID- 3967748 TI - Lipids in cells of atherosclerotic and uninvolved human aorta. I. Lipid composition of aortic tissue and enzyme-isolated and cultured cells. AB - Phospholipid, triglyceride, cholesterol, and cholesteryl ester contents were measured in unaffected and atherosclerotic areas of human aorta and in a suspension of enzyme-isolated cells from these segments. Aortic tissue and the cells isolated from it, as well as intimal and medial cells, significantly differ in lipid content. As lipoidosis develops in an atherosclerotic lesion, lipids accumulate unevenly in the tissue and cells. In zones of fatty infiltration, lipids accumulate, apparently, mainly inside cells while in the fatty streak and atherosclerotic plaque they predominate in the extracellular space. In a suspension of cells derived from both an atherosclerotic lesion and the underlying media, cholesteryl esters are the main component of excessive fat. In the primary culture of cells enzyme-isolated from unaffected intima, fatty streak, and plaque, the lipid content and composition are retained until Days 12 to 14 and are similar to those of freshly isolated cells. PMID- 3967747 TI - Endogenous splenic colonies and megakaryopoiesis in methylcellulose treated irradiated mice. AB - Endogenous splenic colonies are increased in methylcellulose-treated irradiated mice, 10 days after sublethal irradiation (450 R). The spleen shows an enhancement of megakaryopoiesis, especially localized around foam-cell foci. This suggests that the macrophage system, activated through phagocytic activity against methylcellulose, affects megakaryopoiesis by a microenvironmental mechanism. PMID- 3967749 TI - The morphology and antihypertensive effect of renomedullary interstitial cells derived from Dahl sensitive and resistant rats. AB - The renomedullary interstitial cell (RIC) has been implicated in the antihypertensive action of the kidney. This cell has been isolated in tissue culture and shown to have an antihypertensive action in several models of experimental hypertension. Morphometric studies of RIC in vivo from Dahl rats sensitive and resistant to the hypertensive effects of high-salt diets indicate major differences between the RICs. These cells were therefore isolated from salt sensitive and salt-resistant strains of rat, grown, and maintained in tissue culture. Major morphologic differences between the two cell lines were noted and persisted for multiple tissue culture passages. The cells from resistant animals were larger and had more lipid granules. These differences were similar to those seen in vivo. In short-term experiments these cells were compared for their antihypertensive effect. The two cell lines were injected subcutaneously into two groups of hypertensive recipient rats, one group of Dahl salt-sensitive rats on a high-salt diet and one group of Wistar rats subjected to the one-kidney, one-clip Goldblatt procedure. In both cases differences were noted between the cell lines. These data support the concept that differences between the Dahl salt-sensitive and salt-resistant rats may be related to variations in their RIC. PMID- 3967750 TI - Mosaicism in female hybrid hares heterozygous for glucose-6-phosphate dehydrogenase. VII. Evidence for selective advantage of one phenotype over the other in ditypic samples from aortas of hares fed cholesterol oxidation products. AB - In a previous study the authors demonstrated monotypic foci, all of timidus type, in the atherosclerotic lesions and normal aortic tissue of glucose-6-phosphate dehydrogenase (G-6-PD) mosaic hares fed 25-hydroxycholesterol or triol in addition to a high-cholesterol diet. Other hares fed the high-cholesterol diet without the cholesterol oxidation product additives did not develop monotypic foci. In the current study the question asked was whether ditypic samples from lesions or aortic mediae of the same hares fed the additives would show a higher percentage of timidus type G-6-PD than the hares fed the cholesterol alone. The results showed a significantly higher percentage of timidus type in both lesions and mediae in the groups fed either 25-hydroxycholesterol or triol than in the group fed cholesterol alone. The observations suggest that the change from ditypism to monotypism reported earlier with these cholesterol oxidation products was the result of progressive elimination of the europaeus type to leave only the timidus G-6-PD. This is consistent with the "selective advantage of one phenotype over the other" hypothesis for explaining the observed monotypism as opposed to the "genetic transformation" hypothesis. PMID- 3967751 TI - Uptake--microautophagy--and degradation of exogenous proteins by isolated rat liver lysosomes. Effects of pH, ATP, and inhibitors of proteolysis. AB - Isolated rat liver lysosomes were incubated with [14C]methemoglobin under various conditions. Optimal pH for the in vitro proteolysis was found to be 4-5. To evaluate whether or not degradation of added proteins could be due to enzyme leakage the integrity of the lysosomes was measured. Isolated lysosomes were found to be stable for up to 10 min of incubation at pH 5.5 and for 30 min at pH 7. The degradation of three different proteins (methemoglobin, ovalbumin, and lysozyme) was analyzed. No correlation was detected between rate of breakdown and physical properties of the proteins. Leupeptin, chloroquine, and propylamine inhibited proteolysis of added proteins by 45-65% in both neutral and acid milieu. Possible energy requirement was tested by the addition of Mg2+ and ATP to the incubation medium. A dose-dependent increase in proteolytic rate was found when ATP was added to the lysosomal suspension, a finding most likely due to acidification of the lysosomes and ensuing increased degradation. GTP and ITP were somewhat less effective. The noncleavable ATP analogue 5' adenylylimidodiphosphate gave no stimulation. The ATP-driven proteolysis was inhibited by ethylmaleimide. Isolated lysosomes were also incubated with ferritin in order to visualize a possible uptake process of a protein in the electron microscope. Following incubation, ferritin particles were seen inside intralysosomal vesicles which appeared to be formed by invagination of the lysosomal membrane, a process designated microautophagy. The results thus support the notion that isolated lysosomes may micropinocytose and degrade exogenously added proteins and that this process is ATP dependent. PMID- 3967752 TI - Purification of arogenate dehydrogenase from Phenylobacterium immobile. AB - Phenylobacterium immobile, a bacterium which is able to degrade the herbicide chloridazon, utilizes for L-tyrosine synthesis arogenate as an obligatory intermediate which is converted in the final biosynthetic step by a dehydrogenase to tyrosine. This enzyme, the arogenate dehydrogenase, has been purified for the first time in a 5-step procedure to homogeneity as confirmed by electrophoresis. The Mr of the enzyme that consists of two identical subunits amounts to 69000 as established by gel electrophoresis after cross-linking the enzyme with dimethylsuberimidate. The Km values were 0.09 mM for arogenate and 0.02 mM for NAD+. The enzyme has a high specificity with respect to its substrate arogenate. PMID- 3967754 TI - Measurement by radioimmunoassay of the mitochondrial uncoupling protein from brown adipose tissue of obese (ob/ob) mice and Zucker (fa/fa) rats at different ages. AB - The concentration of the 'uncoupling protein' in brown adipose tissue mitochondria has been measured in lean and obese (ob/ob) mice and Zucker (fa/fa) rats at different ages using a specific radioimmunoassay. During the suckling period the concentration of the protein was similar in normal and mutant animals of both types, despite the decrease in mitochondrial GDP binding observed in the obese. The concentration of uncoupling protein was, however, decreased in adult ob/ob mice and adult Zucker rats compared with their respective lean siblings, in parallel with the decrease in GDP binding. It is concluded that there is a 'masked', or inactive, form of uncoupling protein in young ob/ob mice and fa/fa rats. PMID- 3967753 TI - Mononuclear cell supernatants inhibit prolyl hydroxylation. AB - The effect of phytohemagglutinin(PHA)-activated human peripheral mononuclear cell supernatant (AS) on collagen production by human fibroblasts was examined. The AS inhibited collagen production in a dose- and time-dependent manner. Labeling and pulse chase experiments showed that it did not block collagen secretion, but a greater proportion of molecules synthesized in its presence accumulated within the cells. Amino acid analysis showed that when labeling was done at 24 degrees C prolyl hydroxylation in fibroblasts exposed to the AS was reduced to two-thirds of the cultures treated with control supernatant (CS), however it was not different at 37 degrees C. These results indicate that the AS inhibits collagen hydroxylation, that the un-(under)hydroxylated collagen molecules are degraded at physiological temperature and that suppression of collagen hydroxylation may be a mechanism by which the AS inhibits collagen production. PMID- 3967755 TI - Measurement of the lateral diffusion coefficients of ubiquinones in lipid vesicles by fluorescence quenching of 12-(9-anthroyl)stearate. AB - The lateral diffusion coefficients of some ubiquinone homologues have been measured in phospholipid vesicles exploiting the fluorescence quenching of the probe 12-(9-anthroyl)stearate by the quinones. Diffusion coefficients higher than 10(-6) cm2 X s-1 have been found at 25 degrees C, compatible with the localization of the ubiquinones in the low-viscosity midplane region of the bilayer. PMID- 3967756 TI - Monoclonal antibodies block the bromelain-mediated release of human placental alkaline phosphatase from cultured cancer cells. AB - Certain monoclonal antibodies (mAbs) to human placental alkaline phosphatase (PLAP) block bromelain cleavage of a 2-kDa segment from each of the two polypeptide chains of PLAP. These mAbs also prevent the release of PLAP from cultured cancer cell surfaces by bromelain. Such proteolysis-blocking mAbs serve as tools to specifically modify the molecular topography of cell surfaces by protease treatment. PMID- 3967757 TI - Identity of the metal ligands in the manganese- and iron-containing superoxide dismutases. AB - Alignment of the amino acid sequence of peptides obtained following digestion of Photobacterium leiognathi iron superoxide dismutase with the known sequence of Bacillus stearothermophilus manganese superoxide dismutase shows that the residues found to form ligands to the manganese are conserved in the iron enzyme. This indicates that the metal ligands in both proteins are identical. PMID- 3967758 TI - Reconstituted high density lipoprotein behaviour is modified by the nature of the lipid vesicle. AB - Apo HDL is a more potent inhibitor of lipoprotein lipase than native HDL. HDL reconstituted from apo HDL and vesicles made from either HDL total lipids or HDL phospholipids inhibits lipoprotein lipase in the same manner as native HDL. HDL reconstituted from apo HDL and vesicles made from phosphatidylcholine and sphingomyelin still behaves like apo HDL. PMID- 3967759 TI - Effect of polyethylene glycol on the kinetic behaviour of pyruvate kinase and other potentially regulatory liver enzymes. AB - Assay in the presence of 10% polyethylene glycol has been systematically used with potentially regulatory liver enzymes as an indirect way to induce aggregation of enzymes corresponding to that which could occur at their physiological concentrations. Pyruvate kinase L was markedly affected by polyethylene glycol, as was muscle phosphorylase a, while pyruvate kinase M as well as glucokinase, fructose-1,6-bisphosphatase and other liver enzymes examined were not affected. PMID- 3967760 TI - Torus-shaped particles formed due to intermolecular condensation of circular DNA upon interaction with synthetic tripeptide. AB - The morphology of complexes between relaxed circular plasmid pBR322 DNA and tripeptide L-Val-L-Val-L-Val-NH-NH-Dns (TVP) at different peptide/DNA ratios was studied by electron microscopy. The results show that interaction of TVP with circular DNA leads to the formation of perfect torus-shaped particles. The torus parameter measurements offer the possibility to conclude that DNA condensation observed is of intermolecular nature. On the basis of the analysis of the structures corresponding to the early stages of DNA compaction the model for intermolecular condensation of circular DNA into torus-shaped particles is proposed. PMID- 3967761 TI - Localization of the amino acid substitution site in a fast migrating variant of human serum albumin. AB - Albumin Mi/Fg is an Italian genetic variant of human serum albumin arising from a Lys----Glu substitution which has been located in a CNBr fragment (CNBr VII) corresponding to the -COOH terminal portion of the molecule [(1984) J. Chromatogr. 298, 336-344]. Tryptic peptides of CNBr VII from normal and Mi/Fg albumin have been purified by reverse-phase high-performance liquid chromatography (RP-HPLC) and submitted to comparative structural studies. The amino acid sequence of the tryptic peptide of Mi/Fg variant that differs from the corresponding fragment of the normal serum albumin shows that the Lys----Glu substitution responsible for this variant is located at position 573. This region of the albumin molecule is involved in the binding of long chain fatty acids. PMID- 3967762 TI - Differential binding of rabbit fast muscle myosin light chain isoenzymes to regulated actin. AB - The direct binding of S1(A1) and S1(A2) to regulated actin has been investigated by centrifugation. Binding was measured in the presence of either Mg X AdoPP[NH]P or Mg X ADP at 24 degrees C at various ionic strengths. At low ionic strength, in either the presence or absence of Ca2+, the binding of S1(A1) to regulated actin was always stronger than for S1(A2). As the ionic strength was increased the differential binding between S1(A1) and S1(A2) was still maintained in the presence of Ca2+ but not in its absence. These data are discussed in terms of a modifying role for the N-terminal region of the A1 light chain in regulation of the contractile process. PMID- 3967763 TI - Isolation of the intermediate filament protein vimentin by chromatofocusing. AB - A novel, simple and relatively rapid method is described for the isolation of the intermediate-sized filament protein vimentin from eye lens tissue. Chromatofocusing is applied as the sole purification step. The apparent isoelectric point of the protein in 6 M urea and at 22 degrees C is 4.9. Electrophoretic mobility on one- and two-dimensional polyacrylamide gels, solubility in 6 M urea and amino acid composition were used for identification. PMID- 3967764 TI - Purification of rabbit tumor necrosis factor. AB - Rabbit tumor necrosis factor (TNF) was purified and shown by SDS-PAGE to be a single protein of 18 kDa. TNF in 355 ml rabbit serum was precipitated with ammonium sulfate, and purified by repeated DEAE-Sephadex and Sephacryl S-200 chromatographies, and the final fractionation on Blue-Sepharose 6B. By this procedure its yield was 22% and its specific activity was 2.4 X 10(7) U/mg protein. The sequence of the N-terminal 20 amino acids was determined. PMID- 3967765 TI - The specificity and kinetic properties of trypsin ethylated at the binding site. AB - Treatment of trypsin with triethyloxonium tetrafluoroborate at pH 8, 25 degrees C, results in abolition of binding to the enzyme of specific cationic substrates and inhibitors. The binding constant of soybean trypsin inhibitor to ethylated trypsin is 10000-fold smaller than to intact trypsin. However, the intrinsic ability of trypsin to recognize and react with nonspecific neutral substrates and inhibitors is not lost, and in several cases even considerably enhanced. Thus ethylated trypsin (Tret) resembles chymotrypsin in its behavior. Trypsin-like enzymes are also affected in a similar manner. PMID- 3967766 TI - Production of peptide leukotrienes in endotoxin shock. AB - Arachidonate metabolites are potent mediators generated in endotoxin shock. Following endotoxin administration (15 mg/kg) into unanesthetized rats, we found a rapid biliary secretion of peptide leukotrienes. Analysis of bile for peptide leukotrienes included organic solvent extractions, reversed phase-HPLC, radioimmunoassay (RIA), and spectrophotometry. The major immunoreactive endogenous leukotriene (LT) from bile was eluted between LTC4 and LTD4 in three chromatographic systems. It corresponded thereby to a biliary metabolite of injected LTC4 and LTD4 which in turn showed the ultraviolet spectrum of a peptide leukotriene. This demonstration of endotoxin-induced generation of peptide LTs in vivo was possible by sequential HPLC and RIA analyses in bile into which peptide LTs are eliminated from blood. PMID- 3967767 TI - Involvement of plastoquinone and lipids in electron transport reactions mediated by the cytochrome b6-f complex isolated from spinach. AB - The isolation of a cytochrome b6-f complex from spinach, which is depleted of plastoquinone (and lipid), is reported. The depleted complex no longer functions as a plastoquinol-plastocyanin oxidoreductase but can be reconstituted with plastoquinone and exogenous lipids. The lipid classes digalactosyldiacylglycerol, phosphatidylglycerol and phosphatidylcholine were active in reconstitution while monogalactosyldiacylglycerol and sulfoquinovosyldiacylglycerol were not. Neither plastoquinone nor lipid alone fully reconstitutes electron transport in the depleted complex. Saturation of plastoquinol-plastocyanin oxidoreductase activity in the depleted complex occurs at 1 plastoquinone per cytochrome f. PMID- 3967768 TI - Modulation of a major 30-kDa skeletal muscle protein by thyroid hormone. AB - Thyroidectomy results in the transformation of type II fibres to type I in rat soleus muscle. In vitro translations containing polyribosomes indicate that the template activity of mRNA coding for a 30-kDa protein is increased in hypothyroid (6 months) rats. The cellular content of this protein is also increased in hypothyroid rats. The in vitro synthesis of the 30-kDa protein is not observed in thyroidectomized (10 weeks) rats that have been treated with triiodothyronine. The synthesis and accumulation of this protein are directly related to the proportion of type I fibres in rat skeletal muscle and appear to be modulated by thyroid hormone. PMID- 3967769 TI - Enkephalins: immunomodulators. AB - Our original studies of the enkephalins were centered on behavioral stress and brain dopaminergic interactions. More recently we discovered the enkephalins to be immunomodulators as evidenced by their enhancement effects on lymphocyte blastogenesis in mice, increases in the sizes of the thymus or spleen in rodents, and prolongation of survival of BDF1 mice inoculated with attentuated L1210 cells. Finally, in studies of human blood samples from both normal volunteers and cancer patients, the enkephalins were demonstrated to stimulate active T cell rosettes and natural killer cell activities (in vitro). These studies support our hypothesis that, in stress, the enkephalins modulate the effects of steroid hormones on the immune system. PMID- 3967770 TI - Metabolism of vasopressin. AB - The clearance of vasopressin (VP) by the kidneys and splanchnic viscera was studied in the anesthetized dog. VP is bound to plasma protein, 10% at basal plasma VP levels and 40% at plasma VP concentrations greater than 20 microU/ml. The urinary clearance of VP is 70-100% of the glomerular filtration rate; the renal organ clearance of the hormone is 20-30% greater than its urinary clearance. There is evidence that the renal organ clearance of VP is affected by changes in both glomerular filtration rate and renal blood flow. The renal clearance of VP is a result of glomerular filtration, degradation, or reabsorption in the proximal nephron, and secretion into the distal nephron. In the short term, the renal clearance of VP is unaffected either by changes in the plasma VP concentration over a broad range or by moderate hemorrhage. The splanchnic clearance of VP is accomplished almost equally by the intestine and the liver. Because the sum of the splanchnic and renal clearances of VP is less than estimates of its metabolic clearance rate, there may be a physiologically significant clearance of VP by organs in addition to the kidneys and splanchnic viscera. PMID- 3967771 TI - Factors influencing urinary vasopressin concentration. AB - Vasopressin (VP) activity has been measured in urine for assessments of long-term changes in hormone release. Most laboratories employ radioimmunoassays (RIAs) and extraction of urine for research. It has been assumed that the specificity of the antiserums used and the extraction procedures would be adequate to safeguard against non-VP substances that would interfere with the RIA. New evidence is presented that this is probably not the case. High-performance liquid chromatography of unextracted urine or CG-50 extracts of urine clearly separates two major immunologically active peaks. One corresponds to native VP and the other migrates with the front. Different antiserums recognize the non-VP peak variably, but the VP peak the same. These activities were not separated by Sephadex G-25 chromatography. In addition to variability arising in the measurement of VP, the VP excreted may be influenced by variable renal clearance of the hormone. There is ample evidence to assume that not all plasma VP is filterable and that the proportions of bound and unbound VP vary. Furthermore, there is tubular metabolism and secretion of VP. The variability of these functions is unknown. PMID- 3967772 TI - Factors influencing the secretion of vasopressin into cerebrospinal fluid. AB - Vasopressin (VP) has been found in the cerebrospinal fluid (CSF) of several species of animals. Although it is known that hemorrhage, hypertonicity of body fluid, hypoxia, and hypercapnia all increase VP in plasma, little is known regarding the stimuli that cause the secretion of VP into the CSF. We therefore performed several studies to examine whether stimuli capable of increasing plasma levels of VP can also increase VP in the CSF of anesthetized dogs. We found that hemorrhage, intracerebroventricular infusion of hypertonic artificial CSF, hypoxia, and hypercapnia all produced increases in the concentration of VP in plasma and in CSF, but the time courses and the magnitude of the increases in the two compartments were different. In addition, an i.v. infusion of hypertonic saline or of hydrochloric acid produced an increase in plasma VP without significantly changing CSF VP. Thus, although the secretion of VP into plasma and CSF may be influenced by the same stimuli, changes in one compartment do not necessarily correlate with changes in the other. Taken together, our results are consistent with the hypothesis that the plasma and CSF VP may derive from different sources. PMID- 3967773 TI - Vascular adrenergic interactions during hemorrhagic shock. AB - The objective of this paper is to review the sequence of vascular events that follows severe hemorrhage. The initial cardiovascular imbalance is a fall in the volume/vascular capacity relationship that leads to reductions in cardiac output and mean arterial pressure (MAP). Peripheral sensors detect the fall in MAP and changes in blood chemistry that cause withdrawal of the normal inhibitory tone from the cardiovascular control centers in the central nervous system. The resulting increased sympathetic activity initiates a series of events that include stimulation of peripheral adrenergic nerves and the adrenal medulla. The magnitude of the compensatory vasoconstriction that follows is the net result of the interaction of the epinephrine (E) from the adrenal medulla and norepinephrine (NE) from the peripheral nerves on the peripheral vascular adrenoreceptors as well as other nonadrenergic mechanisms not discussed here (i.e., angiotensin endogenous opiates). By using pharmacological blocking agents, these adrenoreceptors have been subclassified as: innervated postsynaptic alpha 1; presynaptic alpha 2 (Ps alpha 2); and extrasynaptic alpha 2 (Es alpha 2) adrenoreceptors. The action of E and NE on the alpha 1 and Es alpha 2 receptors initiates the compensatory vasoconstriction, whereas action of these catecholamines on the Ps alpha 2 located on the presynaptic membrane inhibits further release of NE from peripheral nerve terminals, thereby reducing the effect of the innervated alpha 1 receptors. This autoinhibition together with a similar action by prostaglandin E on NE release is thought to be, at least in part, responsible for the vascular decompensation known to occur in the skeletal muscle after hemorrhage. Thus, one of the factors determining survival after hemorrhage may be related to the relative dominance of alpha 1 and Es alpha 2 receptors during the initial compensatory response. PMID- 3967774 TI - Coronary artery reactivity in human vessels: some questions and some answers. AB - Spasm of a conduit coronary artery, converting it into a major resistance vessel impeding myocardial blood flow, may have severe short- or long-term effects on cardiac rhythm and systolic ejection of blood. It is now clear that human coronary arteries in vitro contract to acetylcholine but that relaxation is the only response observed in dog coronary vessels. Acetylcholine is as powerful a constrictor of human coronary arteries, in terms of tension induced, as 5 hydroxytryptamine (5-HT) or histamine and is a substantially more powerful constrictor than norepinephrine. Field stimulation of coronary artery strips caused a vasoconstriction that was partially antagonized by atropine (3.45 X 10( 6) M). An enhanced reactivity of the epicardial arteries of cardiac and older patients to several agonists was also observed and appears to provide a background against which a number of vasoactive agents might induce spasm. Coronary tissue from cardiac patients also contains stores of 5-HT and histamine, and the histamine levels are substantially increased above the values in vessels from noncardiac patients. Coronary artery spasm or contraction probably can be initiated by diverse intrinsic and extrinsic influences, including autonomic discharge from either the parasympathetic or sympathetic nervous system or from histamine or 5-HT, and probably no one agent or entity is causative in all cases. PMID- 3967775 TI - Responses of human peripheral arteries to agonists: similarities and differences. AB - A review of the literature indicates that the effects of many vasoactive substances, and particularly alpha agonists, have been investigated in a variety of human peripheral arterial models, including isolated digital, umbilical, uterine, and mesenteric arteries. The limited comparative data on different human arteries, or on animal vs. human arteries, make definition of inter- and intraspecies differences incomplete at this stage. Examination of recent data from our laboratory using the cystic artery indicates that observed differences in responsiveness of the same artery from different subjects may result from a variety of factors not usually considered in animal models. Hence, age of subjects must be controlled, because factors such as vessel wall thickness, optimal resting tension, and blood pressure vary with age. Even when age is controlled, mildly hypertensive or normotensive females with a family history of hypertension are found to have increased vascular responsiveness to some agonists, which implies the need also to control for sex of the subject. The use of appropriate controls and fastidious laboratory techniques are essential to clearly define inter- and intraspecies similarities and differences. PMID- 3967776 TI - Body composition as affected by physical activity and nutrition. AB - Although exercise and/or training can augment maximum oxygen consumption, muscle strength, and endurance, it has not been shown to markedly increase lean body mass (LBM) or to markedly decrease body fat in humans unless androgens are given. Bed rest likewise leads to very modest changes in body composition. Over nutrition, on the other hand, produces a significant increase in body LBM and fat, and undernutrition a fall in both; hence the evaluation of exercise programs should include assessment of energy intake. PMID- 3967777 TI - Metabolism of substrates: energy substrate metabolism during exercise and as modified by training. AB - The question of what is the source of fuel for oxidation by muscle during exercise has been addressed. A review of experiments spanning more than 60 years supports the concept that the major energy source for the metabolism of exercise is the oxidation of fats and carbohydrates. The relative contribution of these major substrates to the total body metabolism depends on factors such as the intensity and duration of the exercise, the diet consumed on the days before the exercise, and the state of physical training. With light prolonged exercise there is a progressively greater use of fat until it can contribute up to 80% of the total caloric expenditure. However, the relative contribution of fat to the metabolism is less and that of carbohydrate greater as exercise intensity increases. Consumption of a diet rich in fat and protein produces a shift toward a greater use of fat with a concomitant reduction of both the intensity and duration of effort that can be sustained. Conversely, ingestion of a carbohydrate rich diet increases the percentage of carbohydrate used and increases endurance. The concentration of glycogen in muscle is reduced by fat-protein diets and elevated by carbohydrate-rich diets. Endurance training results in a shift of the metabolism toward a greater use of fat during the same absolute and relative exercise loads. This produces a glycogen sparing that is associated with improving endurance capacity. PMID- 3967778 TI - Carbohydrate nutrition before, during, and after exercise. AB - The role of dietary carbohydrates (CHO) in the resynthesis of muscle and liver glycogen after prolonged, exhaustive exercise has been clearly demonstrated. The mechanisms responsible for optimal glycogen storage are linked to the activation of glycogen synthetase by depletion of glycogen and the subsequent intake of CHO. Although diets rich in CHO may increase the muscle glycogen stores and enhance endurance exercise performance when consumed in the days before the activity, they also increase the rate of CHO oxidation and the use of muscle glycogen. When consumed in the last hour before exercise, the insulin stimulated-uptake of glucose from blood often results in hypoglycemia, greater dependence on muscle glycogen, and an earlier onset of exhaustion than when no CHO is fed. Ingesting CHO during exercise appears to be of minimal value to performance except in events lasting 2 h or longer. The form of CHO (i.e., glucose, fructose, sucrose) ingested may produce different blood glucose and insulin responses, but the rate of muscle glycogen resynthesis is about the same regardless of the structure. PMID- 3967779 TI - Federation of American Societies for Experimental Biology. 69th Annual Meeting. Anaheim, California, April 21-26, 1985. Abstracts of papers 1-2720. PMID- 3967780 TI - Artificial insemination of single women. PMID- 3967781 TI - The effects of two doses of spironolactone on serum androgens and anagen hair in hirsute women. AB - Spironolactone (S) has been used successfully for the treatment of hirsutism. We evaluated whether the effects of S on serum androgens and hair growth are dose related and whether S affects secreted androgens to the same degree as peripherally derived androgens. Two groups of 15 hirsute patients, similarly matched, received either 100 or 200 mg S daily for 3 months. Serum total testosterone (T) decreased significantly (P less than 0.05) and to a similar degree with both dosages, whereas unbound T was unaltered. Dehydroepiandrosterone sulfate was unaltered, whereas androstenedione decreased with 200 mg S (P less than 0.05). Peripherally derived serum dihydrotestosterone decreased to a similar degree with 100 and 200 mg S (P less than 0.05), whereas 5 alpha-androstane-3 alpha-17 beta-diol (3 alpha-diol) increased (P less than 0.05) similarly with both dosages. Serum 3 alpha-diol glucuronide (3 alpha-diol-G) increased with both dosages, but not significantly. Anagen hair shaft diameters decreased significantly in both groups by 19% +/- 8% and 30% +/- 4% (P less than 0.05). No correlation was found between hair growth and serum androgens. Because serum unbound T was largely unaltered by S, it is suggested that the antiandrogenic effects of S are primarily related to its peripheral effect. However, there is no good clinical marker for this effect as levels of 3 alpha-diol and 3 alpha-diol-G increase. PMID- 3967782 TI - Two pregnancies and the loss of the 46,XX cell line in a 45,X/46,XX Turner mosaic patient. AB - Two successful pregnancies in a patient with a 45,X karyotype are reported. Twelve pregnancies have been reported in 9 monosomy X patients and 57 pregnancies in 24 patients with both a 45,X and a 46,XX cell line. The patient reported here was diagnosed at 10 years of age as a Turner mosaic (45,X/46,XX), but showed no evidence of a normal cell line in any of the four tissues analyzed 15 years later. The difficulty in detecting mosaicism as well as the stability of autosomal and sex chromosomal mosaicism are discussed. An argument is made for early cytogenetic evaluation, utilizing multiple tissues, and analyzing an adequate number of cells. PMID- 3967783 TI - Factors associated with married women's selection of tubal sterilization and vasectomy. AB - Multivariate analyses of data from 248 married women scheduled for tubal sterilization and 165 wives of men scheduled for vasectomy indicated that male and female sterilization methods were selected for different reasons and under different circumstances. More specifically, the woman who underwent tubal sterilization was more likely to have perceived that she had greater influence than her husband over the sterilization decision, to have had cesarean section or vaginal delivery in association with sterilization, to have chosen tubal ligation because her spouse refused to undergo the alternative procedure or because it was convenient to combine it with delivery or other surgery, and to have had a spouse who was unwilling to be sterilized because of possible side effects associated with vasectomy. The woman whose husband underwent vasectomy was more likely to have been very fearful of surgery in general or especially fearful of reproductive surgery, to have known many men who already had had a vasectomy, to have perceived that her husband was more strongly motivated than herself to terminate childbearing, to have had a spouse who participated in birth control, and to have chosen vasectomy because it was easier or less expensive or because her physician advised against tubal sterilization. PMID- 3967784 TI - Removal of the cumulus oophorus from the human oocyte for in vitro fertilization. AB - Removal of cumulus may increase the chance of fertilization in patients with sperm antibodies, may facilitate fertilization in vitro with a small number of spermatozoa, and is necessary for microsurgical injection procedures in vitro. The aim of this study was to establish whether removal of the cumulus has any detrimental effects on the fertilization rate and embryo viability. Removal of cumulus cells from the human oocyte with bovine testicular hyaluronidase did not interfere with fertilization, early embryonic development, or pregnancy. This suggests that human spermatozoa can spontaneously undergo capacitation and fertilize oocytes in vitro in a chemically defined medium containing 10% preovulatory human serum. In three patients with low-quality semen, removal of the cumulus and the addition of hypotaurine and epinephrine apparently did not improve the motility nor the fertilizing capacity of the spermatozoa. Delayed fertilization and cleavage arrest was observed in one patient when spermatozoa obtained from the body region of the epididymis was used for insemination. PMID- 3967785 TI - Comparison of techniques for selection of motile spermatozoa. AB - Procedures to separate motile sperm with high rates of recovery may have clinical application in in vitro fertilization and intrauterine insemination in increasing the probability of fertilization by a normal sperm and subsequent normal embryonic development. A two-step continuous Percoll gradient was an effective means of separating motile sperm which also had enhanced ability to penetrate zona-free hamster ova. However, the requirement for a high-speed centrifuge and rotor makes the procedure impractical in many cases. A one-step discontinuous Percoll gradient was also effective in separating a population of motile sperm. Comparison of the discontinuous Percoll gradient with other techniques for separation of motile sperm indicated the discontinuous Percoll gradient had advantages in terms of recovery, enhancement of motility, and increased ability to penetrate zona-free hamster ova. The velocity of selected sperm was not significantly different among techniques. The one-step discontinuous Percoll gradient appears to have value both for increasing homogeneity of human sperm populations used for basic research and in clinical practice for male subfertility. PMID- 3967787 TI - Correlation of postcoital evaluation with in vitro sperm cervical mucus determinations and ureaplasma cultures. AB - Fifteen trials were completed in 14 couples during an infertility evaluation. The postcoital test (PCT) was accomplished in a standardized manner. Also, standardized determinations of the sperm-cervical mucus penetration test (SCMPT) with the addition of cross-testing (X-test) utilizing bovine cervical mucus (BCM) and normal donor semen (NDS) were done. Male and female samples were also cultured for Ureaplasma urealyticum using U9-B indicator broth and A-7 agar. The PCT and SCMPT agreed in 87% (13/15) of the cases. Utilizing BCM and NDS, where possible, the causative factor was the cervical mucus in 54% (7/13); semen factor in 15% (2/13); both factors in 8% (1/13); and undetermined in 23% (3/13). U. urealyticum cultures were positive in 40% (6/15) of the cases. Analysis of the results revealed: (1) significant correlation between PCT and SCMPT (P less than 0.01); (2) no significant difference among the PCT, SCMPT, and X-test, indicating that the cervical mucus was the causative factor; and (3) no U. urealyticum correlation with the PCT or the SCMPT. Thus, laboratory SCMPT and X-test correlated with the PCT, providing additional information concerning the causative factor in infertility. The U. urealyticum status in cervical mucus and semen cannot be determined from the PCT nor the SCMPT. PMID- 3967788 TI - Xenogenous and in vitro fertilization of frozen/thawed primate oocytes and blastomere separation of embryos. AB - Little research has been done on the in vitro and xenogenous fertilization of cryopreserved primate oocytes. This study reports the development of freezing and thawing methods for squirrel monkey oocytes with subsequent successful fertilization by these two methods. Preliminary results on techniques for blastomere separation using the hamster and squirrel monkey as models are also given. These studies have important implications relative to the long-term frozen storage of human oocytes, their subsequent thawing, in vitro fertilization and embryo transfer, and the use of the blastomere separation procedure, in conjunction with in vitro fertilization, in the diagnosis of embryonic normality and possible congenital defects prior to implantation. PMID- 3967786 TI - Macrophages and infertility: enhancement of human macrophage-mediated sperm killing by antisperm antibodies. AB - The mechanism by which antisperm antibodies inhibit fertility is not completely understood. Macrophages may play a role in mediating infertility by interacting with sperm and destroying gametes. Experiments were conducted evaluating the effect of antisperm antibody on the phagocytosis and lysis of sperm by human peritoneal macrophages in vitro. Sperm from a fertile man treated with sera from normal men and women or medium alone had 5 to 280 molecules of IgG/sperm, as determined by a 125I-labeled anti-human IgG monoclonal antibody assay. By contrast, sperm treated with sera containing antisperm antibodies had 310 to 1240 molecules of IgG/sperm. Peritoneal macrophages harvested from infertile women with tubal/adhesive problems mediated phagocytosis and lysis of 111In-labeled sperm which was enhanced by treatment of the sperm with sera containing antisperm antibodies (39.0% +/- 1.5% versus 76.3% +/- 3.2% phagocytosis, and 3.3% +/- 0.3% versus 23.3% +/- 2.3% lysis of sperm [control versus antibody-treated]). The likelihood of fertilization in couples with antisperm antibody may be determined not only by the antibody but also by the presence of genital tract macrophages capable of destroying the antibody-coated sperm. PMID- 3967789 TI - Infertility in mice after unilateral vasectomy. AB - The effects of unilateral vasectomy upon fertility and antisperm antibody production were studied using DBA/1J mice. Thirty-six males underwent either unilateral vasectomy, unilateral orchiectomy, or sham surgery. In vivo effects upon fertility were monitored by matings. Antisperm antibody titers were measured monthly. In vitro fertilization was performed in the presence of serum obtained 4 months postoperatively, and serum testosterone levels were also determined. After 3 months, only 1 male in the vasectomy group induced a pregnancy (1 of 12), while all but 1 of the males in the two control groups induced a pregnancy (20 of 21). The geometric mean antisperm antibody titer was 1:169 in the vasectomy group, while the orchiectomy and sham surgery groups had titers of 1:4 and 1:14, respectively (P less than 0.0001). The percentage of eggs fertilized in vitro in the presence of serum from experimental mice fell from 80% in the two control groups to 40% in the unilateral vasectomy group. Unilateral vasectomy induced infertility in DBA/1J mice and an antisperm antibody response. Sera containing these antibodies inhibited in vitro fertilization. This suggests that infertility after unilateral vasectomy may be immunologically mediated by antisperm antibodies. PMID- 3967790 TI - Cytogenetic investigations on human oocytes and early human embryonic stages. AB - The chromosome analysis of undivided oocytes and polyploid embryos within a human in vitro fertilization and embryo replacement program offers a unique opportunity to develop correlations between a successful or unsuccessful fertilization and the maturity of the oocytes or the quality of the sperm. Furthermore, it provides information concerning the origin of chromosomal defects. PMID- 3967791 TI - Persistent trophoblastic tissue following salpingostomy for unruptured ectopic pregnancy. PMID- 3967792 TI - Sperm capacitation in the human female reproductive tract. PMID- 3967793 TI - A nonimmunomodulatory effect of chronic cadmium exposure on lymphocyte transformation response in rhesus monkeys (Macaca mulatta). AB - The immunomodulatory effects of cadmium, an environmental pollutant, were assessed in male rhesus monkeys orally exposed to 5 mg cadmium/kg body weight for a period of 4 months. A lymphocyte transformation test was carried out in peripheral blood lymphocytes using different concentrations of phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM). Cadmium exposure of monkeys resulted in a statistically nonsignificant increase in [3H]thymidine incorporation in PHA- and Con-A-stimulated lymphocytes. However, there was a nonsignificant decrease in [3H]thymidine incorporation in PWM-stimulated lymphocytes. These results suggest that cadmium may not have immunosuppressive effects in primates which are phylogenetically close to man. PMID- 3967794 TI - Growth of tumor cells with different sensitivities for murine natural killer cells in young and adult athymic nude mice. AB - Of four tumor cell lines, the murine YAC lymphoma, the human K562 lymphoma, and the human prostatic carcinomas PC3 and PC93, the susceptibility to murine natural killer (NK) cells as well as the tumorigenicity in young (3.5-4 weeks old) and in adult (8-10 weeks old) nude mice were studied. In young nude mice, which exhibited a lower level of NK cell activity than adult nude mice, the formation of solid tumors after inoculation of tumor cell suspensions occurred more frequently and with a shorter time lag than in adult animals. These effects were observed not only with the NK-sensitive YAC cells, but also with the relatively NK-insensitive PC3 and PC93 cells, indicating that also factors other than NK cell susceptibility may influence the growth of tumor cells in nude mice. Therefore, the use of young nude mice may enhance the rate of success of heterotransplantation of human tumors, regardless of the NK cell susceptibility of the tumor cells. PMID- 3967795 TI - Acquisition and clonal growth of human sternal bone marrow obtained incidental to open-heart surgery. AB - The establishment of a convenient method of acquiring ample human bone marrow and the successful growth of hematopoietic precursor cells in standard methylcellulose assay is described. Human sternal marrow curettings were obtained at open-heart surgery. Growth of colonies derived from CFU-gm, BFU-e, and CFU-e was successful. Comparison of the CFU-gm colony production between this and prior studies indicates a consistent mean and range of growth. These results document this to be an efficient source of normal human marrow. PMID- 3967796 TI - Differentiated epidermal outgrowths in the planarian Dugesia gonocephala: a model for studying cell renewal and patterning in single-layered epithelial tissue. AB - Large deep wounds on the ventral side of a flatworm (Planaria) will not heal. Instead, the damage to the parenchyma in the wound's roof will result in a differentiated swelling in the dorsal epidermis, above the wound which will eventually disappear with the disintegration of the underlying damaged tissue and a ventrodorsal hole appears in place of the wound. The dorsal epidermal outgrowth is formed by a number of excrescences, the development of which involves four successive stages. Their analysis suggests that epidermal cells are continuously produced by their own stem cells which remain unnoticed because their nuclei are hardly stainable. The daughter cells differentiate without information from either the underlying tissues or the basal epithelial membrane. During the first stage of this differentiation the cells become ciliated and motile, with some embryonic features. They then produce rhabdites and take up a columnar shape as they may become attached to the basal membrane. After wound setting the production of epidermal cells increases and the overcrowding of the basal membrane results in (1) detachment of stem cells and motile ciliated cells from the basal tissues, i.e. outgrowths; (2) stretching of columnar cells at the base of the outgrowths. When in the process of tissue disintegration the basal membrane of the epithelium also disappears, the cells remain in a single-layered epithelial configuration and retain their original polarity. These results are at variance with the generally accepted hypothesis that, in planarians, epidermal cells originate from the parenchyma and the epidermis is not an autonomous tissue. PMID- 3967797 TI - A study of the adhesive, locomotory and invasive behaviour of Walker 256 carcinosarcoma cells. AB - We have succeeded in selecting two variant strains of the Walker 256 carcinosarcoma which display markedly different adhesive properties. Both the high (W256A) and the low (W256S) adhesive variants respond chemotactically towards 10(-8) M f-met-leu-phe (FMLP) although there is a significant difference in their locomotory ability. Nevertheless, the fact that the essentially non adherent W256S cells can migrate in vitro argues against any simple relationship between adhesion and locomotion. We suggest that traction is important in locomotion but that it need not arise only from direct adhesive interaction. We have also tested the invasive behaviour of the W256 variants using an in vitro model system in which disruption of a cellular barrier by the invasive cells can be recorded electrophysiologically. Although leucocytes can penetrate such a barrier they do so only under chemotactic stimulation, whereas W256 tumour cells of either variant strain will do so spontaneously. The tumour variants induce cell retraction within the barrier and this may lead ultimately to cell detachment and death. The holes which arise may then be colonized by tumour cells, and in this way the invasive process could be promoted. The molecular mechanisms by which tumour cells achieve destruction of the cellular barrier are not clear, but it is likely that a number of enzymes are involved. PMID- 3967798 TI - Developmental origins of motor coordination: leg movements in human infants. AB - The development of coordination of leg movements of human infants is discussed from the perspective of dynamic motor theory. Even in the newborn period, leg movements have topographical and temporal organization, but it is global and inflexible. During the first year, limb segments become both disassociated from these global synergies and reintegrated into more complex coalitions. Growth related changes in the biodynamic properties of the body segments may be as important as neurological maturation in determining the movement outcomes and may help explain the spurts, regressions, and asymmetries seen in early infancy. PMID- 3967799 TI - Development of visually controlled maternal preferences in Peking ducklings. AB - The interaction between natural visual and auditory stimulation in the control of filial behavior was studied in domestic mallard (Peking) ducklings during the first 3 days of postnatal life. Visual imprinting at 24 hr resulted in a visual preference for the familiar model over an unfamiliar model in each of two choice tests, one at 48 hr and one at 72 hr, but only if both models were silent. If both models emitted a recording of the mallard maternal call, the visual preference was found only in the later (72-hr) test. Visuomotor experience between training and testing was found to be essential for the development of the visual preference at 72 hr, but the required experience was of a very general nature. Either a choice test with silent models or a period of social rearing (between 24 and 72 hr) provided effective experience. Thus, the ability to show a visual preference in the presence of the maternal call at 72 hr depends on experience, but not necessarily on further exposure to the imprinting object or to any specific aspects of the test situation. These results demonstrate the importance of normal visual, motor and/or social experience to the development of the visual control of filial behavior in ducklings. PMID- 3967800 TI - Gustatory determinants of suckling in albino rats 5-20 days of age. AB - Taste reactivity in suckling rat pups was assessed. Five-day-old rats in Experiment I were equipped with tongue cannulae seated 2 mm rostral, 0-3 mm caudal, or 4-6 mm caudal to the intermolar eminence. Either water, 1.4 X 10(-3) QHC1, .50M NH4Cl, or .43M NaCl was delivered in one of three fashions during suckling: (1) continuous: fluid was continuously available from a reservoir connected to the cannula, and could be obtained by exerting suction; (2) discrete: same procedure as above, save that fluid was available for only 30 sec every 3 min of the 30-min test; (3) pulsatile: here, .05 ml fluid was delivered by infusion pump 8-10 sec every 3 min, provided the pups were attached to a nipple. Based on intake, time and behavioral measures, we conclude behavioral reactivity exists especially to NH4Cl and NaCl. As to quinine, Day 5 pups were responsive only when QHCl was delivered in the continuous mode. In Experiment II, rats 10, 15, and 20 days of age received the above solutions by infusions with the cannulae located in one of the three positions. Quinine reactivity developed sequentially in an anterior to posterior direction. NH4Cl disrupted behavior in 5 , 10-, and especially 20-day-old rats. Remarkably, Day 15 rats were not behaviorally reactive to NH4Cl. Sodium chloride, especially in the anterior and middle positions, was treated as an aversive solution during suckling throughout development. Based on existing electrophysiological data, the last finding was unexpected. PMID- 3967801 TI - Impaired somatomedin generation test in children with insulin-dependent diabetes mellitus. AB - Recent studies have suggested a partial block in somatomedin (SM) production or growth hormone (GH) action in IDDM. Twelve well-nourished diabetic children (9 males and 3 females with a mean age of 11.2 +/- 3.3 yr), six with an HbA1c of 7.9 11.2% (group A) and six with an HbA1c of 12.5-15.6% (group B), were studied as follows: the GH response after 100 micrograms of oral clonidine and the SM generation capacity after i.m. administration of 0.2 U/kg/dose of human growth hormone (hGH) for 4 days. Group B diabetic subjects had a significantly higher mean +/- SD GH increase after clonidine than did group A patients (delta of 17.4 +/- 4.9 versus 5.7 +/- 6.0 ng/ml, P less than 0.01); the basal GH of both groups were similar (1.6 +/- 0.7 versus 2.3 +/- 1.4 ng/ml). In contrast, the SM response to hGH was significantly decreased in group B children as compared with those in group A (delta of 0.3 +/- 0.3 versus 1.2 +/- 0.4 U/ml, P less than 0.01). The basal SM levels of both groups were normal for age. GH and SM correlated with HbA1c levels (r = +0.80, P less than 0.01; r = -0.79, P less than 0.01, respectively); there was no correlation with plasma and urine glucose or serum cholesterol, cortisol, and transferrin. Our data indicate a blunted SM response to hGH in group B diabetic subjects; this defect in SM generation is apparently not present in group A subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967803 TI - Pathophysiology and pathogenesis of acute gastric mucosal lesions after hypothermic restraint stress in rats. AB - The interrelationships of core body temperature, blood viscosity, gastric mucosal blood flow, surface pH of the corpus mucosa, and acute gastric mucosal lesions in rats after up to 3 h of hypothermic stress were investigated. Three groups of rats were studied: (a) control rats restrained at room temperature, (b) conscious rats under restraint and varying degrees of hypothermia, and (c) anesthetized rats under hypothermia. Under hypothermic stress both restrained and anesthetized rats manifested a sharp decline in core temperature, a marked increase in blood viscosity with a mirror-image decrease in gastric mucosal blood flow, a significant decline in gastric mucosal surface pH, and similar frequencies and severities of acute gastric mucosal lesions. In the control group, neither mucosal lesions nor changes in physiologic measurements were observed, except for a decline in mucosal surface pH. An increase in blood viscosity identical to that in rats subjected to hypothermia was observed in vitro when blood temperature was lowered in the viscometer. These findings indicate that hypothermia but not restraint led to an increase in blood viscosity, which in turn resulted in a decrease in mucosal blood flow and the development of gastric mucosal lesions. Also, hyperacidity was found to be a permissive factor in the pathogenesis of mucosal lesions. PMID- 3967802 TI - Prostaglandin cytoprotection against ethanol-induced gastric injury in the rat. A histologic and cytologic study. AB - Using macroscopic criteria for injury, prostaglandins have been alleged to possess potent antiulcer properties despite meager histologic evidence for this cytoprotective action. This time-sequence study used light, scanning, and transmission electron microscopy to evaluate the effects of 16,16-dimethyl prostaglandin E2 on gastric mucosal integrity after exposure to 100% ethanol. Macroscopically, virtually complete protection against injury to the glandular mucosa of the in vivo rat stomach was noted in animals receiving 10 micrograms/kg body wt of prostaglandin subcutaneously before oral ethanol administration when killed at 5, 20, and 60 min after ethanol exposure compared with oral ethanol after saline injection. On light microscopy the length of injured epithelium in prostaglandin/ethanol- and saline/ethanol-treated tissues was not significantly different at all time periods studied. Although the depth of injury extended into gastric glands in both groups killed at 5 min, the deep pit surface mucus cells in prostaglandin/ethanol mucosa were less damaged and necrotic lesions were virtually absent when compared with saline/ethanol mucosa. At 20 and 60 min, cellular injury could still be identified in prostaglandin/ethanol-treated mucosa but the depth of injury became even less pronounced over time in contrast to mucosa exposed to ethanol without prostaglandin. Scanning electron microscopy and transmission electron microscopy confirmed these differences. Despite the macroscopic findings, these results indicate that prostaglandin does not prevent superficial surface mucus cell necrosis in ethanol-exposed mucosa even though it does spare cells in the pit base. The reduction in damaged cells over time in prostaglandin/ethanol-treated mucosa, in contrast to saline/ethanol-treated mucosa, supports the hypothesis that the reepithelialization of the lamina propria is initiated by spared deep-lying pit cells. PMID- 3967804 TI - Sustained fasting achlorhydria: a comparison of medical regimens. AB - The effects on fasting gastric pH of eight medical regimens were evaluated during a 10-h period in 8 duodenal ulcer patients. Our goal was to find a regimen that would produce sustained, fasting achlorhydria (pH greater than 7.0) in every patient. The effects of commonly prescribed bolus doses of cimetidine, antacid, or their combination were studied first. Mean gastric pH with cimetidine (300 mg/6 h intravenously), antacid (30 ml/h intragastrically), and their combination was 3.5, 4.6, and 6.8, respectively. Although mean pH with the combination was significantly higher than with either drug alone (p less than 0.05), sustained achlorhydria was not achieved. Next we tested constant-infusion regimens of cimetidine (50 mg/h intravenously), antacid (0.5 ml/min intragastrically), and their combination. Whereas infusions of cimetidine or antacid alone produced mean pH levels of 4.3 and 5.2, respectively, not significantly different from their bolus counterparts, the combination regimen resulted in a mean pH of 7.4. However, sustained achlorhydria was still not produced in each patient. Only when the dose of cimetidine infusion was doubled to 100 mg/h and administered with a constant infusion of antacid was sustained achlorhydria achieved in each patient. PMID- 3967805 TI - Explant culture of human fetal small intestine. AB - Human fetal intestine (10-14 wk gestation) has been cultured as explants in a serum-free Leibovitz L-15 medium for periods up to 9 days. As determined by light microscopy, the overall architecture of the intestinal explant was maintained throughout the culture period. At the ultrastructural level the villus absorptive cells remained tall with well-defined brush border, apical tubular system, and supranuclear and infranuclear accumulations of glycogen. All other epithelial cell types were also preserved. The incorporation of [3H]thymidine and [3H]leucine continued during the culture period, reflecting a sustained synthesis of deoxyribonucleic acid and proteins. The hydrolytic activities of the brush border membrane were established based on data obtained throughout the course of the culture of a large number of intestinal specimens. Sucrase, maltase, glucoamylase, trehalase, lactase, alkaline phosphatase, and gamma-glutamyl transpeptidase activities increased during the 9 days of culture even though different patterns were recorded. These observations clearly established that human fetal small intestine can be maintained in organ culture for at least 9 days in a serum-free medium. PMID- 3967806 TI - Use of horseradish peroxidase to identify hindbrain sites that influence gastric motility in the cat. AB - To identify hindbrain sites that influence gastric motility, we administered multiple injections of horseradish peroxidase into the anterior surface of the antrum near the lesser curvature in 3 cats, and used light microscopy to identify horseradish peroxidase-positive neurons in the hindbrain. Retrogradely labeled neurons were found evenly distributed on both sides in the dorsal motor nucleus of the vagus. Labeling extended from 2.5 mm rostral to 2.0 mm caudal to the obex. Labeled neurons were not localized to a specific region of the dorsal motor nucleus of the vagus: no labeling was observed in the nucleus ambiguus or in the nuclei of the solitary tract. Electrical stimulation of the dorsal motor nucleus of the vagus in the area with the greatest number of labeled cell bodies was performed in 4 cats while monitoring antral motility, arterial pressure, and heart rate. Stimulation elicited pronounced antral contractions but no changes in arterial pressure or heart rate. These data demonstrate that the retrograde neuronal tracing technique permits localization of central nervous system sites that specifically influence gastric function. PMID- 3967807 TI - Heterogeneity of muscarinic receptors in the guinea pig esophageal muscularis mucosae and ileal longitudinal muscle. AB - Pharmacologic characteristics of muscarinic receptors in the muscularis mucosae of the guinea pig esophagus were examined in vitro and compared with those of the longitudinal muscle of the guinea pig ileum. All cholinomimetics tested produced a sustained contraction of the muscularis mucosae, in a concentration-dependent manner, which was associated with a small biphasic change in membrane potential, initially a hyperpolarization followed by a depolarization. The contractile response was hardly modified by verapamil, but was depressed by calcium removal from the bathing medium. Both atropine and pirenzepine antagonized the contractile response in a competitive manner, with higher pA2 values than those in the ileum. These results indicate that the muscarinic receptors of the muscularis mucosae of the guinea pig esophagus mainly link with calcium ion channels which are independent of changes in membrane potential and that their subtype populations are probably pharmacologically distinct from those in the ileal longitudinal muscle. PMID- 3967808 TI - Role of the diaphragm in the genesis of lower esophageal sphincter pressure in the cat. AB - To determine the role of the diaphragm in the genesis of the high-pressure zone at the lower esophageal sphincter (LES) we studied the effect of diaphragmatic contraction on lower esophageal sphincter pressure in 10 anesthetized adult cats. Despite anchoring the pressure recording assembly within the LES to prevent axial movement of the sphincter during respiration relative to the pressure recording ports, there was an average oscillation in LES pressure of 17.4 +/- 5.5 mmHg, the frequency of which was the same as the respiratory rate. Peak LES pressure occurred at end-inspiration corresponding with peak diaphragmatic electromyogram. During periods of central apnea induced by manual hyperventilation there was absence of both diaphragmatic electromyogram and the oscillations in LES pressure. Lower esophageal sphincter pressure during apnea was equal to end expiratory pressure during spontaneous respiration. Following complete neuromuscular blockade with pancuronium, artificial respiration with increasing tidal volumes resulted in increasing oscillations in pressure. However, the magnitude of the pressure oscillation even at tidal volumes four times normal was always significantly below that observed during spontaneous eupnic respiration. Furthermore, progressive augmentation of diaphragmatic electromyogram activity by breathing 5% CO2 in air revealed a linear correlation between the magnitude of the respiratory-induced pressure oscillations of the LES and peak integrated diaphragmatic electromyogram in individual animals. It is concluded, therefore, that (a) intrinsic LES tone is best approximated by end-expiratory pressure during spontaneous respiration, (b) the respiratory-induced oscillations in LES pressure are primarily the result of active diaphragmatic contraction, and (c) the level of diaphragmatic electrical activity directly influences the magnitude of the pressure oscillation. PMID- 3967809 TI - Protection against hepatitis B virus infection by immunization with hepatitis B core antigen. AB - Although antibody to the hepatitis B surface antigen usually provides protection against hepatitis B virus (HBV) infection, recent reports indicate that this is not always the case. To study the possible role of immune responses to hepatitis B core antigen in immunity to HBV infection, chimpanzees were immunized with chimpanzee liver-derived or genetically cloned hepatitis B core antigen and later challenged with known infectious HBV. Two chimpanzees, which received liver derived or cloned hepatitis B core antigen in Freund's adjuvant and developed hepatitis B core antibody and low-titer hepatitis B e antibody, were completely protected against HBV infection following challenge. In contrast, another chimpanzee, which received liver-derived hepatitis B core antigen without adjuvant, developed hepatitis B core antibody only in serum and had a subclinical HBV infection when challenged. These findings demonstrate that protection against HBV infection can be induced by immunization with hepatitis B core antigen in adjuvant and that protection, in this case, is not solely dependent on hepatitis B surface antibody. This fact has important implications in our understanding of the biology of HBV infection and in the design of future hepatitis B vaccines. PMID- 3967810 TI - Abnormal gallbladder emptying in a subgroup of patients with gallstones. AB - Gallbladder stasis has been implicated in gallstone formation. Gallbladder filling and emptying were quantitated by computer-assisted cholescintigraphy in 41 normal subjects versus 26 patients with gallstones. Gallbladder contraction was induced by low-dose (1.2 U/kg . h) cholecystokinin infusion. Gallstone patients exhibited normal gallbladder filling, but emptying was significantly (p less than 0.01) reduced compared with controls. On closer inspection, the patients fell into two subgroups, separated by t1/2, the time to empty 50% of gallbladder contents, 19.1 min (mean + 2 SD of control). Fifteen patients (57.7%) with a normal t1/2 (less than 19.1 min) exhibited both normal filling and normal emptying. The remaining 11 patients (43.3%) with t1/2 greater than 19.1 min had grossly abnormal gallbladder emptying, significantly (p less than 0.001) different from both the previous patient subgroup and the controls. There was no significant difference in age, sex, prevalence of obesity, presence or absence of biliary colic, and gallstone size, number, or calcification between these two subgroups. Thus, defective gallbladder emptying is evident in a subgroup of gallstone patients, and is independent of clinical features, stone size, and number. Impaired emptying should be considered when assessing pathogenesis or medical therapy. PMID- 3967811 TI - Duodenal mucosal protection. PMID- 3967812 TI - Effect of propranolol on renal blood flow in portal hypertensive rats. PMID- 3967813 TI - Diagnostic value of fecal fat concentration. PMID- 3967814 TI - Fluid mechanics and intestinal transit. PMID- 3967815 TI - Management of irritable bowel syndrome. PMID- 3967816 TI - Stable equilibria at two loci in populations with large selfing rates. AB - The equilibrium structure of two-locus, two-allele models with very large selfing rates is found using perturbation techniques. For free recombination, r = 1/2, the following results hold. If the heterozygotes do not have at least an approximate 30% advantage in fitness relative to homozygotes, a stable equilibrium with all alleles present is possible only if all of the homozygote fitnesses differ at most by approximately the outcrossing rate, t, and all stable polymorphic equilibria have disequilibrium values, D, that are at most on the order of the outcrossing rate. Once the heterozygote fitnesses are above the threshold, there are stable equilibria possible with D near its maximum possible value. The results show that the observed disequilibria in highly selfed plant populations are not likely to result from selection leading to an equilibrium. PMID- 3967817 TI - A symmetric two-locus fertility model. AB - A model in which selection is mediated by differential fertilities among the genotypes at two diallelic loci is proposed. Fertility depends only on the number of heterozygous loci participating in the mating. Classes analogous to symmetric equilibria in symmetric viability models are determined explicitly and shown to exhibit stability behavior very different from the viability results. Linkage equilibrium is shown to occur in a relatively asymmetric fashion and to overlap in stability with linkage disequilibrium. In many cases single-locus or two-locus polymorphism is shown to be stable simultaneously with chromosome fixation even under very tight linkage. It is suggested that historical effects may be of great significance in the evolution of systems in which fertility is the primary agent of natural selection. PMID- 3967819 TI - Medical education and modest expectations. PMID- 3967818 TI - Epistatic interactions of radiation-sensitive (rad) mutants of Caenorhabditis elegans. AB - Six double mutants and a quadruple mutant were derived from four UV radiation hypersensitive single mutants (rad-1, rad-2, rad-3 and rad-7). Sensitivities of the 11 strains to UV, gamma-radiation and methyl methanesulfonate (MMS) were compared. Of the six double mutants, only the rad-1;rad-2 and rad-3;rad-7 doubles were no more hypersensitive than the most sensitive single mutant to UV radiation. Thus, rad-1 and rad-2 define one epistasis group, whereas rad-3 and rad-7 define another. Consistent with this model was the observation that rad-1 and rad-2, but not rad-3 and rad-7, were hypersensitive to gamma-radiation. In addition, none of the multiple mutants was more hypersensitive to gamma-radiation than the most sensitive single rad mutant. No synergistic interactions of the rad mutations with respect to MMS sensitivities were observed. PMID- 3967820 TI - Patients with medically unexplained symptoms: DSM-III diagnoses and demographic characteristics. AB - This study reports DSM-III diagnoses and demographic characteristics of 100 patients consecutively referred to a university hospital consultation-liaison service for evaluation of medically unexplained symptoms suggesting physical disorders. Thirty-seven percent of patients received diagnoses of somatoform, dissociative, or factitious disorders, and 14% were felt to have psychologic factors affecting physical conditions. Although black and male patients were less often referred for medically unexplained symptoms, once referred they were more likely than white and female patients to receive diagnoses of somatoform, dissociative, or factitious disorders. Among patients with somatoform disorders, those with conversion disorder and somatization disorder tended to be young women, whereas those with psychogenic pain disorder were older and equally likely to be male or female. PMID- 3967821 TI - A psychiatric unit becomes a psychiatric-medical unit: administrative and clinical implications. AB - Increasing awareness of the frequent concurrence of medical and psychiatric illness has led to a resurgence of interest in psychiatric-medical units. This paper describes the conversion of a 19-bed general hospital psychiatric unit to a psychiatric-medical model. The conversion involved hiring a full-time chief and changing priorities for elective admission, but did not involve major changes in staffing; community-based psychiatrists continued to admit the majority of patients. Arrangements were made for medical house staff coverage of emergent medical problems, while daily medical care remained in the hands of the psychiatrists and their private medical consultants. In the year following the transition numerous patients with combined acute medical and psychiatric illness not treatable in the previous model were accepted and successfully treated. Quantitative study of annual statistics from the pre- and posttransition years revealed the following: The average age of patients increased from 46 to 54 years. The proportion of patients over 65 increased from 19% to 34.9%. The proportion of patients with identified concurrent medical diagnoses increased from 54.7% to 69.1%. Dispositions to nursing homes and chronic care facilities decreased from 10.5% to 8.9%. Length of stay increased from 19.3 to 23.1 days. The average daily hospital bill for psychiatric inpatients rose by 24.6%, compared with a hospital-wide average increase of 16.3%. Although the change in model appeared to offer effective treatment to previously underserved patients, it implied a significant shifting of patients and of costs. Administrative implications are discussed, and a list of preconditions for a successful conversion are suggested. PMID- 3967822 TI - Screening for delirium on a general medical ward: the tachistoscope and a global accessibility rating. AB - With a psychiatrist's standardized clinical diagnosis as the criterion, the "Hand Held Tachistoscope" was 100% sensitive, but only 45% specific in detecting delirium among hospital patients on a general medical ward. For each true positive in this sample of 97 patients, there were almost 5 false positives. The 10 patients with clinically diagnosed delirium could not see the stimulus. This was also true for 24 of the 87 nondelirious patients. Performance on the tachistoscope was related to age and education. This was not true for another method of delirium case detection, the global accessibility rating. This rating was 90% sensitive and 95% specific when compared with the psychiatric diagnosis, and was stable across two days of ratings. The global accessibility rating warrants further evaluation as a simple screening test for delirium. PMID- 3967823 TI - Somatization disorder in men. AB - Somatization disorder is thought to be rare in men. This paper reviews five previously reported cases of somatization disorder in men and reports nine new cases referred from primary care physicians. These men have most of the associated features of the disorder, are of lower socioeconomic status, and have other significant psychiatric diagnoses. Eight of the nine men had a dramatic precipitating event at the onset of their illness. This diagnosis appears to be applicable to men and needs to be considered in men with multiple, recurrent unexplained medical symptoms. PMID- 3967824 TI - Evaluation of depression in a general hospital: utility and limitations of the dexamethasone suppression test. AB - Use of the DST was studied in medically hospitalized, depressed patients. Although complicating medical factors necessarily excluded nearly 60% of referrals, post-dexamethasone plasma cortisol values were significantly higher in 14 major depressives appropriate for the DST as compared to 12 patients with milder, subsyndromal depressive conditions. Using a plasma cortisol criterion of greater than 7 micrograms/dl, the DST identified major depression with 57% sensitivity and 92% specificity in this subsample (p less than 0.005). While limited by a high exclusion rate, the DST may be useful for confirmation of major depression in carefully screened general hospital patients. Implications for research and practice are discussed. PMID- 3967825 TI - Measuring regression in hospitalized medical patients: the BUMP scale. AB - This article describes the construction and initial validation of a brief rating scale designed to measure behavioral regression or upset in hospitalized medical patients (the BUMP scale). The scale consists of 32 items representing various psychologic reactions to illness. Nurses completed questionnaires on 213 hospitalized patients. Corrected item-total score correlation coefficients averaged 0.53. Factor analysis revealed four factors measuring behavioral regression, poor patient--staff relations, depression/anxiety, and passivity/withdrawal. Alpha reliabilities revealed a high degree of internal consistency of scale items for total score and the four factor subscales. Cluster analysis revealed four clinically meaningful patient groups that were discussed in terms of various typologies in the literature. Potential uses of the BUMP scale and the need for further validating studies were discussed. PMID- 3967826 TI - Some methodological issues in consultation-liaison psychiatry research. AB - This is a research methodologic design model that may be useful to consultation liaison psychiatrists. It is intended to facilitate such researchers in setting up and executing carefully controlled studies of the effectiveness (in psychiatric, medical, surgical, functional, cost, or other areas) of consultation liaison interventions. The specific variables discussed are areas of particular interest to the authors, but many other variables may be readily substituted into this basic model. The design may be expanded or contracted relatively easily as would be appropriate for particular projects. The overall purpose of this paper is, hopefully, to serve as a catalyst for consultation-liaison psychiatrists to consider such research in their academic settings and to foster increased discussion and critical thinking regarding such research. The authors consider such research efforts important for the future regarding the scientific basis, proven effectiveness, and funding of consultation-liaison and general hospital psychiatry. PMID- 3967827 TI - Conflicts and complexity in inpatient geropsychiatry. AB - In order to illustrate the principles and practice of inpatient geropsychiatric care, the authors present the case of a 73-year-old woman who developed a paranoid delusional syndrome associated with hypothyroidism. The roots of such care, which lie in the network of biopsychosocial losses of late life, are exemplified in their analysis of this patient's multiple medical, psychiatric and social liabilities. The interrelationships among these problems provide the rationale for integrated multidisciplinary assessment and treatment, which is the central organizational concept for geropsychiatric care. Through effective team leadership, efficient case coordination, firm and flexible interdisciplinary boundaries, and incisive prioritization of limited resources and limited options, the multidisciplinary process is shown to provide the basis for a comprehensive and, ideally, a holistic understanding of the patient's strengths and liabilities. The authors highlight this patient's dramatic benefit from such a comprehensive program of medical, psychiatric, and socioenvironmental interventions in order to indicate the fruitfulness of this complex and gratifying process. PMID- 3967828 TI - Psychotherapeutic intervention in angina: II. Implications for research and practice. AB - The second of a two-part series, this article draws on the clinical and research literature reviewed in the first article to formulate guidelines for research and clinical practice. In future research, the complex heterogeneity of coronary artery disease (CAD) must be recognized in more rigorous descriptive, comparative, and physiologic correlative studies of psychosocial etiology. Pseudoangina is largely unexamined by systematic study and therefore warrants research on several of its aspects. Similarly, systematic research on intervention in anginoid pain is virtually nonexistent and obviously warranted. Clinical guidelines include the emphasis of didactic, supportive approaches, detailed focus on several aspects of the pain, early and extended psychotherapeutic availability, recognition and treatment of underlying specific psychopathology, and somatic interventions aimed at presumed pathophysiologic mechanisms. PMID- 3967829 TI - Functional assessment: a new tool to improve geriatric care. PMID- 3967830 TI - Liver in obesity. AB - We report on clinical, nutritional, and hepatic histological findings in 50 non selected obese subjects (mean overweight +74%; range +21-138%). The pathogenesis of the liver damage was assessed with the help of multidimensional analysis of a number of clinical variables. According to the severity of the hepatic lesions, the patients have been ranged in five groups: O (normal liver) 10%; I (fatty liver) 48%; II (fatty hepatitis) 26%; III (fatty fibrosis) 8%; IV (fatty cirrhosis) 8%. The more severe changes (groups III and IV) were constantly associated with excessive alcohol intake. The multidimensional analysis was unable to find a relationship between obesity and the development of fibrosis and cirrhosis whereas it showed that: (a) there was a highly significant correlation between the daily ethanol intake and the degree of overweight, (b) severe fatty metamorphosis was significantly associated with the degree of overweight, the existence of diabetes mellitus, and the amount of alcohol and fat intake, (c) nutritional factors, in particular deficient protein intake, have only an accessory effect in the development of mild inflammation and fibrosis, (d) the consumption of potentially hepatotoxic drugs, very high in the obese (about five drugs per day) could have a role in the development of cirrhosis. In conclusion in our study, there was no evidence that obesity per se could result in severe liver damage. PMID- 3967831 TI - Cholestasis in amoebic liver abscess. AB - Two hundred and thirty six patients with amoebic liver abscess were investigated for cholestasis, its mechanism and the natural course of the disease. Cholestasis was seen in 29% of cases and it presented with some unusual features: it was frequently seen in young men (mean age 38.6 +/- 6.3 years) (87%) with acute onset (69%) and was associated with signs of peritonism, or peritonitis (28%), splenomegaly (12%) and hepatic encephalopathy (coma 13%). Raised diaphragm was seen only in 37% of cases. Alcoholism may have contributed to the cholestasis in 37% of cases. Multiple (43%) and single (32%) large liver abscesses, especially on the inferior surface of the liver (25%), were common in jaundiced patients with amoebic liver abscess, while size and number of abscesses were directly related to the raised serum bilirubin concentrations. Bromsulphalein excretion (BSP) was found to be significantly reduced (p less than 0.01) in patients with jaundice (60%). Retrograde injection of contrast media into the common bile duct during six necropsies showed compression by amoebic liver abscess on the hepatic ducts. The mortality (43%) and the complications were significantly higher (p less than 0.001) in patients with jaundice. The aspiration/surgical drainage of amoebic liver abscess together with a combination of metronidazole and di iodohydroxyquinoline was more effective than either metronidazole alone, or dehydroemetine with chloroquine. PMID- 3967832 TI - Prognosis in Crohn's disease--based on results from a regional patient group from the county of Copenhagen. AB - All patients in the county of Copenhagen (approximately 500 000 inhabitants) with Crohn's disease, n = 185 were followed regularly between 1960 and 1978. The survival, the course of disease, the frequency of surgery, and the working capacity were estimated for the first 10 years of disease on the basis of the follow up results. The observation time ranged from 1-18 years with a median of 5.5 years for clinical observations, 5.8 years for survival, and 9.5 years for the occurrence of gastrointestinal cancer. The follow up was 100% concerning survival and cancer. The survival did not differ from that of the age- and sex matched background population. Cancer was seen in only one of 185 patients corresponding to an annual risk of 0.06% and a cumulated risk after 10 years of 0.56, 95% confidence limits: 0.1-3.1%. The cancer was localised in the ileum. For all years, about 45% of the patients were without clinical symptoms of their disease, in 30% the clinical disease activity was low, and in 25% moderate to high. Among the patients with active disease, the course within the individual year was continuous in about one third and intermittent in about two thirds. After 10 years, 99% of the patients had experienced at least one relapse. The operation rate was 33% in the year of diagnosis, 13% in the following year, and then about 3% per year independent of whether or not the patient had been treated surgically in the past. After 10 years, 45% of the patients had not been treated surgically, 42% had had only one operation, and 13% had had two or more operations for their Crohn's disease. The working capacity was normal in about 75% of the patients for all years except the year of diagnosis. About 15-20% of the patients who had had the disease for more than five years were disabled as compared with about 4.4% of the background population. These results indicate that some of the patients with Crohn's disease run a more serious course with continuing symptoms despite of medical treatment and frequent surgical interventions. Most patients, however, remained capable for work and were able to lead a normal life. PMID- 3967833 TI - Familial occurrence of complement dysfunction in Crohn's disease: correlation with intestinal symptoms and hypercatabolism of complement. AB - Complement was studied in Crohn's disease probands with early onset and in their first degree relatives. Controls included 24 healthy volunteers and 24 patients with ulcerative colitis or peptic ulcers. Subnormal generation of chemotactic activity by the alternative pathway was shown in eight of 21 probands and in six of 33 relatives, a frequency in both groups significantly different from controls (p less than 0.005), with a strong connection between findings in patients and relatives. As previously shown in patients with Crohn's disease, the subnormal generation was related to decreased utilisation of complement C3 in relatives. Raised levels of circulating complement C3c split products suggested complement involvement in Crohn's disease probands. In contrast, plasma C3c was normal in all relatives, and none of the six cases with complement dysfunction had gastrointestinal symptoms or a history of inflammatory bowel disease. Our data suggest, that complement abnormality seen in Crohn's disease patients does not simply reflect mucosal inflammation or hypercatabolism of complement. PMID- 3967834 TI - Long term prognosis in ulcerative colitis--based on results from a regional patient group from the county of Copenhagen. AB - The prognosis of ulcerative colitis including survival, colectomy rate, activity of disease, and working capacity was estimated from a follow up study of 783 patients with ulcerative colitis comprising all patients from the county of Copenhagen, except for the island of Amager, diagnosed between 1960 and 1978. The period of observation ranged from one to 18 years with a median of 6.7 years for the clinical observations, eight years for survival and 11.6 years for the occurrence of large bowel cancer. The follow up was 100% for both survival and cancer. The survival rate in women did not differ from that in the general population. In men over 40 years of age at diagnosis a slight excess mortality was found, but only in the year of diagnosis (2.1%) and the following year (1.5%). Colonic cancer was seen in only seven out of the 783 patients, corresponding to an annual risk of 0.07% and a cumulative risk after 18 years with ulcerative colitis of 1.4% (95% confidence limits, 0.7-2.8%) independent of the initial extent of disease. The colectomy rate was 9.6% in the year of diagnosis. The cumulative 10- and 18-year colectomy rate was 23% and 31%, respectively. After three years from diagnosis the capacity for work both in those subject to resection and treated conservatively did not differ significantly from that in the background population. At any time about 50% of the patients were without symptoms, in about 30% the disease activity was low and in about 20% moderate or high. Most patients, however, differed in activity from one year to another and almost all patients (97%) experienced at least one relapse during a 10 year time period. PMID- 3967836 TI - Changing patterns of coeliac disease frequency: an analysis of Coeliac Society membership records. AB - Examination of Coeliac Society records from eight areas of England has shown that the number of members rose with birth dates from 1900 to 1972, apart from a decline between 1941 to 1962, and then fell steeply. The steep decline in the number of members with birth dates after 1972 is unexplained, and is unlikely to be accounted for by change in diagnostic practice or registration and may reflect a true fall in disease incidence; but the fall in numbers of members with birth dates from 1941 to 1962 is explainable by a tendency for the disease to remit in adolescence or early adult life. PMID- 3967835 TI - Specific food intolerance: its place as a cause of gastrointestinal symptoms. AB - Thirteen out of 49 patients suspected of having specific food intolerance after withdrawal and reintroduction of specific foods, were further subjected to double blind placebo controlled food challenges. Only three of these subjects were thus shown to have proven specific food intolerance. Of the remaining 10, nine were strong 'placebo reactors'. The study suggests that a small number of patients with gastrointestinal symptoms have verifiable specific food intolerance but that a greater number have symptoms attributable to psychogenic causes. PMID- 3967837 TI - Relation between serum group II pepsinogen concentration and the degree of Brunner's gland hyperplasia in patients with chronic renal failure. AB - Serum concentrations of group I and II pepsinogens (PG I and PG II) were determined in 15 patients with chronic renal failure. Gastroduodenoscopy with biopsy and acid secretion tests were also performed. Five patients had histologically confirmed severe Brunner's gland hyperplasia manifesting as multiple polyps in the duodenal bulb. Five patients had a mild form of Brunner's gland hyperplasia which was evident only by histological analysis. Five had no signs of such alterations. The three groups of patients were comparable in age, sex, mean level of serum creatinine, mean duration of dialysis treatment, distribution of non-dialysed and dialysed patients, and gastric histology. In patients with severe Brunner's gland hyperplasia the mean serum PG II concentration was significantly higher than in the other patients. Both the serum PG I and the serum PG II concentrations decreased after receiving a well functioning renal transplant in the two patients who underwent transplantation. PMID- 3967838 TI - Plastic pH electrodes for the measurement of gastrointestinal pH. AB - Plastic electrodes have been developed for measuring pH in the human gastrointestinal tract. The electrodes have a plastic hydrogen ion sensitive membrane sealed to a length of fluid filled PVC tubing. Two recently developed hydrogen ion sensitive ligands have been examined. Their operational characteristics have been described. These electrodes have an electrical response of 52 to 58 mV/pH unit change in the range pH 4-9, with a diminished response outwith this range. They have a low resistance value and a fast response time of one second to reach 90% of their maximum response. The electrodes can be passed down the biopsy channel of an endoscope to obtain mucosal pH readings under direct vision. Readings obtained in this way using plastic electrodes are comparable to those obtained with glass electrodes. Alternatively, these electrodes can be joined to a Crosby capsule, allowing continuous recording of mucosal pH through to the jejunum during jejunal biopsy procedures. These electrodes can be used repeatedly or may be acceptable as inexpensive disposable items for sterile clinical use. PMID- 3967839 TI - Haemodialysis in 'hepatorenal syndrome': report on two cases. AB - We report two patients with hepatorenal syndrome who recovered from oliguria and renal failure after temporary treatment with haemodialysis. Hepatorenal syndrome developed under diuretic treatment in both patients. Volume expansion, dopamine, and prostaglandin I2 did not improve renal function. In the one patient with alcoholic cirrhosis, renal biopsy showed only minimal alterations of glomeruli, tubuli, and arterial vessels. In the other case, the deterioration and improvement in renal function parallelled changes in acute alcohol-toxic hepatic function. We conclude that haemodialysis should be considered for treatment of hepatorenal syndrome in selected patients where reversal of liver failure can be expected. PMID- 3967841 TI - Endoscopic retrieval of miniature battery. PMID- 3967840 TI - Acute delta hepatitis without circulating HBsAg. AB - Infection with the delta agent can only occur in the context of coexistent hepatitis B virus infection. We describe a patient in whom the clinical features of acute delta hepatitis developed when seroconversion from hepatitis B surface antigen to antibody had already occurred and diagnosis of recent acute hepatitis B was based on high titre IgM antibody to hepatitis B core antigen. We discuss the significance of such a serological profile, not previously described. PMID- 3967842 TI - Demonstration of in vitro actions of growth hormone on isolated rat adipocytes. AB - Previous studies have shown that adipocytes isolated from normal rats possess specific receptors for growth hormone (GH). Thus, we have now investigated the direct effects on such cells of GH added in vitro. The biological actions of GH determined were the stimulation of 14C-glucose oxidation to 14CO2 and conversion to 14C-lipid. As in adipose segments, hGH stimulation of these parameters required a 3-4 hr preincubation period in GH-free medium. The effect of hGH or bGH was dose-dependent with maximal effects at 1-2 micrograms/ml (CO2 55 +/- 13% stimulation above basal n = 9; lipid 33 +/- 4% n = 21, mean +/- SEM). The magnitude of the effect in isolated adipocytes was lower than that seen in adipose segments from similar groups of animals (lipid 67 +/- 26%, n = 4). The induction of responsiveness by preincubation was accompanied by a parallel increase in 125I-hGH binding. These studies have demonstrated that adipocytes from normal rats not only possess specific receptors for GH but also are metabolically responsive to GH added in vitro. These data suggest that the isolated rat adipocyte should be a useful model for further investigation of the relationship between GH receptor and post-receptor events. PMID- 3967843 TI - Biosynthetic human growth hormone: effects on growth of Snell dwarf mice. AB - Bacterially synthesized human growth hormone (bhGH) administered to Snell dwarf mice during 4 weeks, induced an increase in body length and weight to a comparable degree as obtained with pituitary-derived human growth hormone (hGH). At a dose of 150 mU/day both bhGH and hGH induced a significant stimulation over saline-treated controls, of the weight of the submandibular salivary glands, the m. quadriceps femoris and gastrocnemius, the heart, liver, kidneys, thymus and spleen. The weight of the brain and the thickness of the skinfold were not influenced by either of the preparations used. When organ weights were expressed as a function of body weight, the contribution of the kidneys to body weight was significantly higher with hGH than with bhGH. The other organs studied did not show differences. As a biochemical parameter of cartilage growth, the sulfate incorporation into costal and epiphyseal cartilage in vitro was measured, and it was found to be stimulated by both hormones after short-term treatment. Thus bacterially synthesized hGH behaves identically to pituitary-derived hGH with respect to body length, sulfate incorporation into costal and epiphyseal cartilage, body weight and organ growth of Snell dwarf mice, with one exception: increase of weight of the kidneys, as a function of body weight, was more pronounced after treatment with hGH than with bhGH. PMID- 3967844 TI - The C-peptide response to glucagon injections in IDDM and NIDDM patients. PMID- 3967845 TI - Prostaglandin synthesis inhibition reduces platelet aggregation in diabetes mellitus. AB - Platelet aggregation, platelet prostaglandin precursor fatty acids, glycaemia and lipid levels were studied in a group of insulin dependent diabetics whilst taking Aspirin (900 mg daily) and Dipyridamole (300 mg daily) and again two months after discontinuing this treatment. PMID- 3967846 TI - Pyridoxine (Vit. B6) decreases opioids-induced hyperprolactinemia. PMID- 3967847 TI - The effects of prolactin on rat testicular steroidogenic enzyme activities. AB - To investigate whether hyperprolactinemia directly affects rat testicular steroidogenesis, we examined the effects of prolactin (PRL) on microsomal 3 beta hydroxysteroid dehydrogenase (3 beta-HSD) 17-hydroxylase (17-OH), 17,20-desmolase (17,20-D), 17-ketosteroid reductase (17-KSR) and aromatase enzyme activities. Adult hypophysectomized, gonadotropin-treated Fisher rats were rendered hyperprolactinemic by isografting pituitaries under the kidney capsule. The controls received skeletal muscle. All rats were sacrificed 7 days later and serum PRL was measured in each animal. PRL levels were 198 +/- 14 ng/ml in the hyperprolactinemic rats and 4.3 +/- 0.6 ng/ml in the controls (P less than 0.001). The testes were resected, pooled according to PRL levels, and microsomes were prepared from each pool. The activities of the 3 beta-HSD, 17-OH, 17,20-D, 17-KSR and aromatase were measured using as substrates 14C dehydroepiandrosterone, progesterone, 17-hydroxyprogesterone, androstenedione and testosterone, respectively. Hyperprolactinemia was associated with significant decreases in 3 beta-HSD, 17-OH, 17,20-D, 17-KSR and aromatase activities when compared to controls (P less than 0.005). We conclude that prolactin may have a direct effect on rat testicular steroidogenesis which appears to be independent of changes in gonadotropin secretion. PMID- 3967848 TI - Circulating thyroglobulin and antithyroglobulin antibodies after fine needle aspiration of thyroid nodules. AB - Circulating thyroglobulin and antithyroglobulin antibodies were assayed in fifteen patients affected by solitary "cold" nodules of the thyroid who had undergone fine needle aspiration for cytologic diagnosis. The aim of the study was to investigate whether a minor insult to thyroid tissue such as fine needle aspiration is able to release thyroglobulin into the circulation and to induce the formation of antithyroglobulin antibodies. The results obtained are as follows: 1. Circulating thyroglobulin increased substantially after fine needle aspiration in 11 out of 15 patients. 2. Antithyroglobulin antibodies did not appear in any patient during a follow-up period of two months. 3. The magnitude of basal thyroglobulin and thyroglobulin increase after needle aspiration were unrelated to cytologic diagnosis. PMID- 3967849 TI - Hydrochlorothiazide lowers urinary hydroxyproline in parathyroidectomized rats. AB - This study was undertaken to examine the effects of hydrochlorothiazide treatment on urinary hydroxyproline excretion in parathyroidectomized rats. Urinary hydroxyproline (mumol/24 hr) fell significantly in thiazide-treated rats compared with control animals (5.66 +/- 0.37 versus 7.30 +/- 0.6, P less than 0.05, means +/- SEM). This fall in hydroxyproline excretion occurred without a decrease in glomerular filtration rate. It is concluded that the ability of thiazide diuretics to reduce urinary hydroxyproline excretion is not dependent upon suppression of parathyroid hormone-mediated bone turnover. PMID- 3967850 TI - Hepatitis B virus DNA in serum from patients with acute hepatitis B. AB - Sera from 77 consecutive patients with acute type B hepatitis were examined for hepatitis B virus DNA (HBV DNA) by a spot hybridization method. The median follow up time was 8 months (range, 1 week to 3 years). HBV DNA was detected in 26 (34%) patients on admission to the hospital. A significant positive correlation was found between short duration of symptoms and the presence of HBV DNA (p less than 0.025). Twenty-four (46%) of 52 HBeAg-positive patients were HBV DNA positive compared to 2 HBV DNA-positive patients of 25 HBeAg-negative patients (8%) (p less than 0.001). Four HBeAg-negative patients had serum HBV DNA initially or during follow-up; three had anti-HBe. Six of 77 patients with acute type B hepatitis (8%) became chronic HBsAg carriers, and HBV DNA was detectable from 5 months to more than 3 years after onset of symptoms. The presence of serum HBV DNA for more than 8 weeks after initial symptoms may predict development of a chronic HBsAg carrier state. In none of the chronic carriers was serum HBV DNA present after clearing of HBeAg. PMID- 3967851 TI - The diagnostic value of fasting individual serum bile acids in anicteric alcoholic liver disease: relation to liver morphology. AB - The aim of the present study was to evaluate the diagnostic value of measuring individual serum bile acids in patients with suspected alcoholic liver disease. A highly accurate and specific mass-fragmentographic technique with high sensitivity was used. Anicteric patients with fatty liver (n = 10) and liver cirrhosis (n = 9) were compared with healthy controls (n = 27). The measurement of serum bile acids did not discriminate patients with fatty liver from controls. In general, an increased serum level of cholic acid indicated more serious liver disease. Determination of chenodeoxycholic acid and deoxycholic acid did not add any further diagnostic information. PMID- 3967852 TI - Serum bilirubins in hepatobiliary disease: comparison with other liver function tests and changes in the postobstructive period. AB - Unconjugated bilirubin and its mono- and diester conjugates were measured by alkaline methanolysis and normal-phase high-performance liquid chromatography (AMHPLC) in 195 serum specimens obtained from 63 patients with various hepatobiliary disorders and from 47 healthy adult controls. With this assay, esterified bilirubins were undetectable in the controls, and detection of esterified pigment in a sample was interpreted as an abnormal result. Using this criterion, the AMHPLC result in the clinical anicteric patients (n = 39) was more frequently abnormal (87%) than the corresponding value of fasting serum bile acids (48%), SGPT (52%), total bilirubins (55%), alkaline phosphatase (71%) or gamma-glutamyl transpeptidase (71%). The cumulative frequency of abnormality of these tests was comparable to that of an abnormal AMHPLC result alone. All icteric patients had detectable esterified bilirubins as well as an increased alkaline phosphatase level, while a normal result was found for serum bile acids in 34%, for SGPT in 29% and for gamma-glutamyl transpeptidase in 11%, respectively. In most hyperbilirubinemic patients, total serum bilirubin levels, as determined by a conventional diazo method, exceeded the value obtained by AMHPLC. This discrepancy, which appears to reflect the presence of bilirubin covalently bound to serum protein, was particularly pronounced following desobstructive intervention in patients with obstructive jaundice, in whom the decline of serum bilirubins showed a fast and a slow disappearance component. The latter portion seemed to correspond with slow plasma clearance of bilirubin covalently linked to serum albumin, disappearing at a rate comparable to that of the albumin moiety. PMID- 3967853 TI - Quantitative analysis of major, minor and trace elements in gallbladder bile of patients with and without gallstones. AB - The concentration of 25 major, minor and trace elements in human bile was determined by inductively coupled plasma atomic emission spectrometry. Gallbladder bile was obtained during surgery from patients with cholesterol gallstones, pigment stones and with no biliary tract abnormalities (controls). Comparison of the concentration of elements (microgram per gram of solids) did not reveal any significant differences among the three patient groups. The in vitro nucleation time was not related to the concentration of any element measured. PMID- 3967855 TI - Biliary proteins and ductular ultrastructure. PMID- 3967854 TI - Effect of chronic ethanol ingestion on hepatic and intestinal acyl coenzyme a:cholesterol acyltransferase and 3-hydroxy-3-methylglutaryl coenzyme a reductase in the rat. AB - Two groups of rats were pair-fed diets in which 36% of the calories were provided by either ethanol or dextrimaltose. After 60 days on these liquid diets, rats fed ethanol were significantly smaller than control rats fed dextrimaltose. Serum cholesterol levels in ethanol-fed animals were 20% higher than control rats. Cholestasis was not observed histologically, and serum alkaline phosphatase and bilirubin levels were the same in both groups. The livers of animals ingesting ethanol accumulated triglycerides and cholesterol. The increase in cholesterol was due to an increase in cholesteryl esters. The cholesterol content of liver microsomes, however, was unchanged by ethanol feeding. A small increase in unesterified cholesterol was observed in intestinal microsomes prepared from animals receiving ethanol. Microsomal fatty acids in liver and intestine were unchanged by the ethanol diet. Chronic ingestion of ethanol in these animals failed to change acyl coenzyme A:cholesterol acyltransferase or 3-hydroxy-3 methylglutaryl-coenzyme A reductase activities in the intestine. In contrast, the activities of acyl coenzyme A:cholesterol acyltransferase and 3-hydroxy-3 methylglutaryl-coenzyme A reductase were significantly increased in the livers of rats receiving ethanol. Thus, the chronic ingestion of ethanol caused a marked accumulation of hepatic cholesteryl esters. This was associated with a significant increase in the activities of enzymes that control the rates of both cholesterol synthesis and cholesterol esterification in the liver. These observed changes in enzyme activities may contribute to the lipid accumulation which occurs in these livers. Chronic ethanol consumption did not alter cholesterol metabolism in the intestine. PMID- 3967856 TI - Effects of dexamethasone on albumin and collagen gene expression in primary cultures of adult rat hepatocytes. AB - To further our studies on collagen gene expression, we have evaluated the molecular basis for the finding that steroids decrease collagen synthesis in cultured hepatocytes. We studied the effects of dexamethasone on primary cultures of adult rat hepatocytes grown on tissue culture plastic in either serum supplemented medium or a serum-free hormonally defined medium. Cells were plated and allowed to attach for 24 hr in a mixture of serum-supplemented medium + hormonally defined medium. Cultures were then fed every 24 hr for 4 days under 1 of 4 conditions: serum-supplemented medium, serum-supplemented medium + dexamethasone, hormonally defined medium or hormonally defined medium + dexamethasone. On the fifth day, RNA was extracted. Dexamethasone did not affect the amount of RNA isolated; nor did it influence the quantitative translation of the mRNA in the rabbit reticulocyte lysate mRNA-dependent system. Employing hybridization analysis, dexamethasone resulted in increased albumin mRNA content in hepatocytes grown in serum-supplemented medium but had no affect on hormonally defined medium, and decreased type I in collagen mRNA content in cells grown in either serum-supplemented medium or hormonally defined medium. In cells cultured in hormonally defined medium, the beta-actin and procollagen mRNA levels were lower than those in serum-supplemented medium, but albumin mRNA levels were higher, and in fact equivalent to those in vivo. beta-Actin mRNA levels were not affected by dexamethasone in either serum-supplemented medium or hormonally defined medium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967857 TI - Sublobular compartmentation of pharmacologic events (SCOPE): metabolic fluxes in periportal and pericentral regions of the liver lobule. AB - New techniques have been developed employing microlight guides and miniature O2 electrodes which permit metabolic events to be studied noninvasively in periportal and pericentral zones of the liver lobule. These events include O2 uptake, fat and carbohydrate metabolism, monooxygenation and glucuronidation. The lobular distribution of maximal enzyme activities measured by immunohistochemical or microchemical techniques does not always correlate with metabolic flux rates as measured in periportal and pericentral regions with the new noninvasive methods. The region of the liver lobule exhibiting highest metabolic flux rates can be shifted to another region of the lobule by changing the direction of flow from anterograde to retrograde. These data are consistent with the hypothesis that many metabolic pathways (e.g., oxygen, carbohydrate and fat metabolism which are under dynamic short-term regulation) operate below maximal velocity in intact hepatocytes. PMID- 3967858 TI - Prospects for second and third generation hepatitis B vaccines. PMID- 3967860 TI - Etiology of fulminant viral hepatitis. PMID- 3967859 TI - Hepatic injury in the toxic oil syndrome. PMID- 3967861 TI - Culture of sinusoidal endothelial cells. PMID- 3967862 TI - Pigment gallstone formation in the cholesterol-fed guinea pig. AB - Female Hartley guinea pigs fed a 0.5% cholesterol-supplemented diet were found to form pigmented gallstones after 6 weeks (17/23) and 12 weeks (11/11), while only 2 of 44 animals fed a trace cholesterol diet formed gallstones over a comparable period. The light brown stones consisted primarily of aggregates of fine granular crystals, morphologically similar to calcium bilirubinate crystals. The stones were soluble in 0.1 N sodium hydroxide and were found to contain a substance which co-migrated with unconjugated bilirubin during thin-layer chromatography. Despite hypercholesterolemia (202 +/- 34 vs. 59 +/- 22 mg per dl in controls, p less than 0.05) and fatty infiltration of the liver, cholesterol-fed animals had a lithogenic index of only 0.22 +/- 0.04 in gallbladder bile as compared to a lithogenic index of 0.02 +/- 0.01 in animals fed the trace cholesterol diet. Accordingly, no cholesterol monohydrate crystals were found in any animals. Hematocrits among cholesterol-fed animals (47.6 +/- 1.2%) were lower than those of controls (54.8 +/- 1.3%, p less than 0.05) probably as a result of the cholesterol-induced hemolytic anemia which has been reported by others in this species. Fasting gallbladder volume was greater in cholesterol-fed animals (2.4 +/- 0.18 ml) than in controls (1.7 +/- 0.11, p less than 0.0025), and a comparable increase in gallbladder dry tissue mass was found. There was no evidence of biliary obstruction, however, and the gallbladder contractile response to octapeptide cholecystokinin was comparable in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967863 TI - Ammonia, octanoate and a mercaptan depress regeneration of normal rat liver after partial hepatectomy. AB - Four injections of subcoma doses of ammonium acetate, octanoic acid or dimethyl disulfide during the first 24 hr after two-lobe hepatectomy in normal rats markedly depressed DNA synthesis as reflected by liver thymidine kinase activity or the incorporation of tritiated thymidine into hepatic DNA. Recovery from the depressant effects of the three toxins took 16 to 28 hr. Similar doses of the same toxins injected hourly for 3 or 5 hr after the two-lobe hepatectomy had similar depressant effects on the early peak of ornithine decarboxylase activity measured at 4 or 6 hr. Recovery occurred within 3 hr perhaps because of the very short half-life of ornithine decarboxylase and its rapid regeneration time. These observations may have implications for the lack of regeneration observed in many patients with fulminant hepatic failure who have accumulated sufficient ammonia, methanethiol and fatty acids over periods of days or weeks to become encephalopathic. PMID- 3967864 TI - A radioimmunoassay procedure for type III procollagen: its use in the detection of hepatic fibrosis. AB - Recent studies suggest that the serum level of Type III procollagen (PC-III) could be a valuable, noninvasive monitor of hepatic fibrogenesis. We have developed a sensitive and specific radioimmunoassay for PC-III procollagen isolated and purified from fetal goat skin which shows high cross-reaction for human PC-III. In a double-blind study, serum samples taken from 8 normal volunteers and 50 patients at the time of liver biopsy were assayed for PC-III. Each biopsy was reviewed without knowledge of the radioimmunoassay results, and old or active fibrosis was graded on a 0 to 3 (none, minimal, moderate, severe) scale. There was a significant difference between serum concentrations of PC-III in normals (mean +/- S.D. = 72 ng per ml +/- 8) as compared to patients with biopsy evidence of active fibrosis (mean +/- S.D. = 153 ng per ml +/- 12; p less than 0.001). The serum concentration of PC-III showed a good correlation (r = 0.58; p less than 0.001) with the histological grade of active lobular fibrosis. Measurement of PC-III is a noninvasive test for detection of active fibrosis in the liver. PMID- 3967865 TI - Reversal of ethanol and indomethacin-induced suppression of hepatic DNA synthesis by 16,16-dimethyl prostaglandin E2. AB - Investigations were undertaken to determine effectiveness of 16,16-dimethyl prostaglandin E2 (dmPGE2) in overcoming the suppressive effects of ethanol and/or indomethacin on hepatic DNA synthesis. Adult litter mate Sprague-Dawley rats were subjected to sham operation or partial hepatectomy. Immediately after partial hepatectomy, and at 8-hr intervals for 24 hr, the rats were given: (a) ethanol with and without dmPGE2 or (b) indomethacin with and without ethanol and/or dmPGE2. DmPGE2 produced a significant increase in DNA synthesis in sham-operated (p less than 0.001) and untreated partially hepatectomized animals (p less than 0.025). Ethanol and indomethacin caused a 6- and 18-fold reduction, respectively, in hepatic DNA synthesis following partial hepatectomy. DmPGE2 overcame the inhibitory effect of ethanol (p less than 0.005) and indomethacin (p less than 0.0005) in partially hepatectomized animals. Mitoses were decreased concomitantly with ethanol and/or indomethacin-induced reduction in DNA synthesis and increased with administration of dmPGE2. It is concluded that dmPGE2 increases hepatic DNA synthesis and regeneration in normal rat liver and overcomes their inhibition when ethanol and/or indomethacin is given after partial hepatectomy. Timing of dmPGE2 administration is crucial. When given 30 min before ethanol, it completely inhibits suppression of regenerative activity; omission of this "priming" dmPGE2 dose results in only 44% of DNA synthesis obtained in control animals. PMID- 3967866 TI - A retrospective study of the role of delta agent infection in children with HBsAg positive chronic hepatitis. AB - The prevalence of intrahepatic delta antigen and/or anti-delta antibody was retrospectively investigated in 102 children with chronic HBsAg-positive hepatitis who were seen consecutively in three medical institutions between 1974 and 1982. Delta infection markers were found in 13 patients (12.7%) who exhibited high serum titers of anti-delta antibody; intrahepatic delta antigen was detected in ten. Eleven of the 13 children had severe progressive liver disease associated in all but one with absence of hepatitis B virus replication as evaluated by analysis of serum hepatitis B virus DNA. The factors which seem to increase the risk of delta infection in children who are hepatitis B virus carriers are geographic origin, a history of exposure to blood derivatives and age. A further 37 of 102 children had chronic active hepatitis (20 patients) or cirrhosis (17 patients) without evidence of delta infection. These results indicate that delta infection occurs in children with chronic hepatitis. This possibility should be considered in investigation of children with HBsAg-positive chronic liver disease. Although the delta agent is an important cause of progressive liver disease in children who are chronic HBsAg carriers, severe liver injury and especially cirrhosis can occur without evidence of delta infection. PMID- 3967868 TI - The diagnosis of bacterial peritonitis: comparison of pH, lactate concentration and leukocyte count. AB - It has been suggested that the hydrogen ion and lactate concentrations may be superior to the polymorphonuclear cell count (PMN) in ascitic fluid, in the diagnosis of bacterial peritonitis (BP). In order to compare the diagnostic accuracy of ascitic fluid measurements of pH, lactate, glucose and the PMN in BP, we analyzed the ascitic fluids of 70 consecutive patients in whom pH, lactate, glucose and the PMN count were measured in ascitic fluid and arterial blood. Fifty-one were cirrhotic patients with uninfected ascites, 14 had BP, one tuberculous peritonitis, two ascites secondary to peritoneal metastases and two with neoplastic liver involvement but without peritoneal metastases. Statistically, highly significant differences between patients with uninfected ascitic fluid and BP were observed for ascitic fluid PMN (122 vs. 2,686 per cu mm), ascitic fluid pH (7.45 vs. 7.24), arterial-ascitic fluid pH gradient (0.02 vs. 0.22), arterial lactate (12 vs. 25 mg per dl), ascitic fluid lactate (15 vs. 45 mg per dl) and arterial-ascitic fluid lactate gradient (-3 vs. -20 mg per dl). The most reliable diagnostic cutoff levels were determined for each of the parameters: PMN greater than 500 per cu mm; ascitic fluid pH less than 7.35; arterial-ascitic fluid pH gradient greater than 0.10; ascitic fluid lactate greater than 25 mg per dl; arterial-ascitic fluid lactate gradient less than -20 mg per dl; ascitic fluid glucose less than 60 mg per dl; arterial-ascitic fluid glucose gradient greater than 60 mg per dl.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967867 TI - White count, pH and lactate in ascites in the diagnosis of spontaneous bacterial peritonitis. AB - In order to evaluate the diagnostic accuracy of ascitic pH and lactate for early confirmation of spontaneous bacterial peritonitis (SBP), 109 consecutive patients with ascites were studied. The mean ascitic leukocyte [white blood cell (WBC)] and polymorphonuclear cell (PMN) counts, pH and lactate levels in 42 patients with sterile "normal" ascites were 124 +/- 157 per mm3, 41 +/- 77 per mm3, 7.502 +/- 0.097 and 11.1 +/- 7.9 mg per dl, respectively. Mean ascitic WBC and PMN counts were significantly increased in 10 patients with SBP (10,452 +/- 8,091 and 9,522 +/- 7,470 per mm3), in 10 patients with bloody ascites (2,591 +/- 4,284 and 1,057 +/- 1,494 per mm3) and in 11 patients with cytology positive malignant ascites (1,529 +/- 2,071 and 868 +/- 1,601 per mm3) (p less than 0.001). Mean ascitic pH was significantly reduced in SBP (7.335 +/- 0.048), in bloody ascites (7.384 +/- 0.037) and in cytology positive malignant ascites (7.355 +/- 0.167) (p less than 0.001). Mean ascitic lactate was also significantly elevated in these three groups of patients (36.8 +/- 17.0, 42.8 +/- 35.8 and 24.0 +/- 17.5 mg per dl, respectively; p less than 0.001) as well as in patients with bacteremia (51.6 +/- 78.0 mg per dl, p less than 0.005). However, ascitic pH less than 7.31, ascitic lactate greater than 33 mg per dl were observed only in three of the patients with SBP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967869 TI - Prior cognitive problems as the key to treating a patient with resistant depression. PMID- 3967870 TI - State mental health directors' priorities for mental health care. AB - The National Association of State Mental Health Program Directors surveyed all state mental health directors, through a series of mail questionnaires, to determine their national priorities for mental health care in the 1980s. In a ranking of 62 issues, the directors considered the top two priorities to be providing services and support programs in the community for the chronically mentally ill. Other highly ranked priorities included developing community residential programs, assuring continuation and funding of programs in a period of financial retrenchment, and developing a continuum of services for children and adolescents. A cluster analysis showed that within the overall group four different patterns of priorities emerged: issues related to certification and accreditation, to expansion of community programs both with and without a decrease in institution-based care, and to financial accountability. PMID- 3967871 TI - The fate of the public psychiatric system. AB - Psychiatry faces a vast array of problems today, including its inability to implement programs for the chronic mentally ill and to apply principles of differential therapeutics, the lack of funds for community services, and the continuing severe fragmentation of the psychiatric delivery nonsystem. Old solutions will not suffice. If the public mental health system is to survive, it must first be defined as comprising all settings, services, and funding for the severely and chronically mentally ill. And it must shift the balance of resources and services from institutional to community-based care. A range of financial and administrative mechanisms, such as various kinds of aggregate funding and a division of responsibility among levels of government, are available to accomplish that shift. PMID- 3967872 TI - National priorities: halfway there. PMID- 3967873 TI - The insanity defense: the case for abolition. AB - The author discusses psychiatrists' objections to the insanity defense, including the negative publicity generated by murder trials in which psychiatrists provide expert testimony. He also examines the legal profession's attitudes toward the defense and the pressure applied to expert witnesses through our adversarial system of justice. The abolition of the insanity defense might expedite the legal process, the author concludes, but it would not greatly affect the courtroom role of psychiatrists. Psychiatric evaluation would still be required in certain cases, such as those involving diminished responsibility and competency to stand trial. PMID- 3967874 TI - The insanity defense: a difficult necessity. AB - The author considers the merits of the insanity defense in light of three premises. First, a defendant's sanity must be taken into account both in assessing culpability and in assigning punishment for a crime. Second, all members of society must be protected against harmful acts. And third, it is the responsibility of psychiatrists to assess, but not to predict, the existence of mental illness. After briefly discussing the limitations of expert testimony and the adversarial demands of the judicial system, the author concludes that the insanity defense should be retained but altered, and that psychiatrists should bear the burdens of advocating for the mentally ill. PMID- 3967875 TI - Recent trends and issues in psychiatric-mental health nursing. AB - New and emerging roles for psychiatric-mental health nurses, certification programs for graduate and experienced baccalaureate nurses, and the emergence of clinical nursing research are only some of the many changes occurring in the field of psychiatric-mental health nursing that have resulted in a burgeoning literature. Through a review of the most recent of this literature, the author highlights the current trends and issues in psychiatric-mental health nursing practice, education, and research, as well as the historical antecedents of many of the issues and problems facing mental health nurses today. PMID- 3967877 TI - Inpatient group treatment on short-term acute care units. AB - The diverse levels of individual functioning and constantly changing membership in short-term acute care groups challenge the development of true group process. The authors review the recently developing literature on short-term acute care groups, emphasizing the unique characteristics of the groups, their goals, and the therapeutic techniques that can be used to lead them. They then present an approach to short-term acute care therapy that is based on five processes identified in the literature as therapeutic for inpatient ward milieus: containment, support, structure, involvement, and validation. The applicability of the processes to the ward group serves to unify group therapy with other ongoing inpatient treatment. PMID- 3967876 TI - The multidisciplinary treatment plan: a format for enhancing activity therapy department involvement. AB - A structured, goal-oriented format for enhancing the involvement of activity therapy disciplines in the multidisciplinary treatment planning process has been developed in a large private psychiatric teaching hospital. The format, an adaptation of the problem-oriented record, encompasses formal procedures for identifying and recording relevant problems, goals, methods, and objectives for activity therapy treatment. The benefits of this approach include the development of specific, measurable, attainable functional goals; increased accountability in treatment planning and delivery; less time spent in documentation; and education of other staff about the role and function of activities therapy. Patients have a better understanding of their goals and the steps needed to achieve them and show increased participation in the therapy process. PMID- 3967878 TI - Mental health consultation to a preschool following the murder of a mother and child. AB - The murder of a five-year-old boy and his mother disrupted the entire small community of the pre-school he had attended. A two-stage mental health intervention consisting of separate group sessions with the preschoolers, teachers, and parents was initiated to help them work through their grief and fear and to reverse their increasing isolation from one another. The reassuring presence of adults who were not struggling with the crisis and the creation of a supportive milieu relieved the children's anxiety, enabling them to discuss their fears and fantasies about the deaths, and alleviated the anxious mistrust and sense of lost personal security of the teachers and parents. The teachers were able to resume their professional functioning, and the parents were better able to assist their affected children. PMID- 3967880 TI - Academic psychiatry and the clergy: an analysis of ministerial referrals. PMID- 3967879 TI - The clinician's role in protecting patients' rights in guardianship proceedings. PMID- 3967882 TI - Admissions drop again, cost per case up. PMID- 3967881 TI - Sudden death. PMID- 3967883 TI - Health insurance on the statehouse floor: 1985 projections. PMID- 3967884 TI - Are consumers sensitive to hospital costs? PMID- 3967885 TI - Is this overbuilding, and why might it occur? PMID- 3967886 TI - H-Y transplantation antigen in human XO females. AB - When sensitized with human cultured fibroblasts of the XY and XO, but not XX, sex chromosomal types C57BL/6 female mice reject syngeneic male grafts accelerated (second set graft reaction). These findings demonstrate that the antigenic determinants of H-Y antigen of man and mouse are homologous and that XO females (at least those tested) carry the H-Y transplantation antigen. The results are discussed in the light of the question of differences between the H-Y antigen as defined by grafting and serology and the chromosomal localization of the H-Y structural gene(s). PMID- 3967887 TI - A new glucose-6-phosphate dehydrogenase variant, Gd(-) Tepic, characterized by moderate enzyme deficiency and mild episodes of hemolytic anemia. AB - A 16-year-old Mexican male of Japanese ancestry was found to have a new glucose-6 phosphate dehydrogenase (G-6-PD) deficient variant, named Gd(-) Tepic after the birthplace of the maternal grandmother. A younger brother was also affected and the two sisters were heterozygous. The mother, an obligatory heterozygote, did not show the abnormal variant and the possible explanation of this phenomenon is discussed. From the clinical standpoint, the propositus has had three mild hemolytic episodes while his siblings are so far asymptomatic. PMID- 3967888 TI - Localization of the thyroglobulin gene by in situ hybridization to human chromosomes. AB - The human thyroglobulin gene was mapped by in situ hybridization whereby a 3H labeled recombinant plasmid DNA containing a fragment of 2.3 kilobases of human thyroglobulin gene was hybridized to human chromosome preparations. A high proportion (25%) of hybridized metaphases exhibited silver grains at the distal portion of the long arm of chromosome 8. Analysis of the grain position at this site indicated that the chromosomal localization of the human thyroglobulin gene was 8q242-8q243. PMID- 3967889 TI - Linkage and recombination between fragile X-linked mental retardation and the factor IX gene. AB - Linkage analysis on a family with fragile X-linked mental retardation was performed using a Taq 1 restriction fragment length polymorphism detected by a cloned human coagulation factor IX cDNA. Two affected brothers in this sibship were found to have different factor IX RFLP alleles, indicating a recombinational event occurred between the two genes. Our data therefore indicate that the gene responsible for fragile X-linked mental retardation is not as tightly linked to the factor IX gene as the previously published data may suggest. PMID- 3967890 TI - Effect of oxidants and antioxidants on chromosomal breakage in Fanconi anemia lymphocytes. AB - Peripheral blood lymphocytes from eight Fanconi anemia (FA) patients, 14 FA heterozygotes, and nine normal subjects have been tested for their susceptibility to chromosomal breakage induction by diepoxybutane (DEB) and by two peroxides. In addition, the effect of five antioxidants was investigated in standard cultures and in cultures stressed either with DEB or with butylhydroperoxide (BHP) or with hydrogen peroxide (H2O2). DEB, BHP, and H2O2 dramatically increased the chromosomal breakage levels in homozygous and heterozygous FA cells. A partial correction of chromosomal instability was obtained by treating the patients' lymphocytes with antioxidants. A "protective" effect was also noted in the DEB or peroxide-stressed lymphocytes of patients and heterozygotes, grown in the presence of antioxidants. PMID- 3967891 TI - The hereditary transmission of high glutathione transferase activity towards trans-stilbene oxide in human mononuclear leukocytes. AB - High glutathione transferase activity towards trans-stilbene oxide has been observed in resting mononuclear leukocytes only in a portion of the individuals examined. Approximately 46% of a population of 248 individuals demonstrated this high activity. In addition, eight families have been investigated in order to elucidate the hereditary transmission of this activity. The results are consistent with a dominant expression of a single gene located on an autosomal chromosome for this high glutathione transferase activity. PMID- 3967893 TI - Prenatal selection and fetal development disturbances occurring in carriers of G6PD deficiency. AB - The incidence of spontaneous abortions in women with glucose-6-phosphate dehydrogenase (G6PD) deficiency was studied. In 78 families where the wife was a heterozygous carrier of G6PD deficiency the percentage of unsuccessful pregnancies with spontaneous abortions occurring in the first trimester was higher (21.7%, calculated from 258 pregnancies) than in the control group (9.3%, calculated from 678 pregnancies. PMID- 3967892 TI - 46,XY gonadal dysgenesis: is oncogenesis related to H-Y phenotype or breast development? AB - Among women with 46,XY gonadal dysgenesis, there is a high incidence of gonadal tumors. Because of evidence of a connection between occurrence of those tumors, H Y phenotype, and breast development, we surveyed 55 cases of 46,XY gonadal dysgenesis and 12 related cases involving chromosomal and/or skeletal abnormalities. Our survey, including three new cases presented here, indicates that H-Y phenotype but not breast development may be related to the development of the gonadoblastoma-dysgerminoma. Thus among women with 46,XY gonadal dysgenesis, there are H-Y- and H-Y+ classes, but gonadal tumors are found almost exclusively in the H-Y+ class. Yet one of our patients may represent an exception to the association of H-Y+ phenotype and gonadal tumors in this syndrome. PMID- 3967894 TI - Preparation and characterization of monoclonal antibodies to human neuron specific enolase. AB - Neuron-specific enolase (NSE) has been increasingly recognized as a marker for neuroendocrine tumors including small cell carcinoma of the lung (SCCL). To prepare monoclonal antibodies (MAbs) specific for human NSE, we first developed a simple method of purifying NSE by direct chromatofocusing of a crude extract of human brain tissue. BALB/c mice were then immunized with our preparation of NSE, and MAbs against NSE were generated utilizing a hybridoma technique. The antibodies were screened against both NSE and non-neuronal enolase (NNE) by a solid-phase radioimmunoassay (SPRIA). After cloning and subcloning of hybridomas, two groups of anti-NSE MAbs were identified by SPRIA. One group reacted specifically with NSE but not with its isoenzyme NNE, irrespective of whether antigens were glutaraldehyde fixed or unfixed. A second group reacted with both NSE and NNE when the latter were glutaraldehyde fixed, but surprisingly with neither antigen in the absence of fixation. Group I antibodies were further characterized by immunoblotting, and by immunocytochemistry of normal brain and liver sections and sections of SCCL. The results further supported the specificity of group I antibodies for NSE. These MAbs have potential utility in the diagnosis and management of neuroendocrine tumors, and in further understanding the biology of NSE. PMID- 3967896 TI - Program and abstracts from the Fourth Annual Congress for Hybridoma Research. February 3-6, 1985, San Francisco, California. PMID- 3967895 TI - Patterns of expression of class I antigens in the tissues of congenic strains of rat. AB - A comparative study of expression of class I major histocompatibility (MHC) antigens among lung, spleen, kidney, heart, liver, and brain tissues of the rat was performed. Monoclonal antibodies (MAbs) against RT1Aa determinants were conjugated to 125I and applied to frozen sections. Resulting autoradiograms showed antigen reactivity in lymphoid tissue, bronchial and alveolar epithelium, and endothelium of the lung. The lymphoid tissue of the lung and spleen demonstrated the antigen after shorter autoradiographic exposures than was required for the epithelial components of these organs. The kidneys were heavily labeled over the glomeruli, but less intensely over the tubular epithelium. RT1A antigen content of capillary endothelium of the heart was demonstrable before that of the muscle bundles. In the liver, autoradiographic sections revealed high determinant density in sinusoidal regions. Brain sections show reproducibly low levels of labeling, with the exception of vascular structures. All of these tissues from PVG-RT1c and PVG-RT1u animals show only background labeling. PMID- 3967897 TI - Role of macrophage cell surface sulphydryl groups in endocytosis, but not recognition of immune complexes. PMID- 3967898 TI - Binding of in vivo formed immune complexes by monoclonal mouse rheumatoid factors. PMID- 3967899 TI - Gm-3.2, a new granulocyte/macrophage alloantigen. AB - A monoclonal antibody defining a unique mouse neutrophil cell-surface antigen, Gm 3.2, is described. Gm-3.2 is found on all neutrophils in peritoneal exudates and in bone marrow, and is also present on macrophages activated by thioglycolate but is absent from lymphoid, kidney, liver, heart, and red cells. Gm-3.2 is a differentiation antigen of myeloid cells, as granulocyte/macrophage colony forming cells are Gm-3.2- while mature neutrophils are Gm-3.2+. Strain distribution pattern analysis shows linkage of the Gm-3 locus to the Ly-4, B2m, H 3 complex on chromosome 2. PMID- 3967900 TI - Abdominal injuries in children: an analysis of 348 cases. AB - Three hundred and forty-eight children from Skaraborg County, Sweden, admitted to hospital with abdominal injuries over a 30-year period (1951-1980), have been analysed and compared with all patients with abdominal injury (1407) admitted to hospital from the same area during the same period. The number of children admitted in the second half of the period was greater than during the first but the proportion of children compared with adults was considerably reduced. During the period abdominal injuries due to car accidents increased in adults but not in children. The most frequent cause of abdominal injury in children was a bicycle accident. Abdominal injury due to sport also increased over the period. Mortality decreased, with no deaths in the past 10 years, compared with 8.6 per cent mortality in the first 10 years of the period. PMID- 3967901 TI - Changing trends in the diagnosis and management of rupture of the spleen. AB - In this series of 80 consecutive patients with injured spleens scintigraphy was the diagnostic mainstay and was performed in 63 patients. Fifty-five patients were initially managed without operation. Two of them, however, underwent laparotomy respectively 1 and 2 days after admission because of increasing symptoms and signs. Twenty-seven patients underwent laparotomy, with successful conservative surgery in 8 and splenectomy in 19. However, in at least five of these it was thought in retrospect that repair of the spleen might have been possible. There were no deaths or serious morbidity from the injury to the spleen. It is concluded that no operation or operative repair of the spleen is the treatment of choice in the majority of patients with blunt injuries. In order to avoid loss of life as well as loss of the spleen, strict adherence to an aggressive, exact diagnostic process, using non-invasive diagnostic imaging and close clinical observation, as well as experienced, painstaking surgical techniques, is necessary. PMID- 3967902 TI - Peritoneal lavage in closed abdominal injury. AB - Peritoneal lavage is a sensitive method of detecting intra-abdominal injuries following closed abdominal injury. Our indications for peritoneal lavage are: severe head injury, severe thoracic injury, unexplained hypotension in a patient with possible blunt abdominal injury and patients on artificial ventilation. We present 40 patients with multiple injuries who underwent peritoneal lavage for suspected closed abdominal injury. Twenty-two lavages were positive and 19 laparotomies were performed, of which 18 revealed intra-abdominal injuries. Eighteen lavages were negative; no laparotomy was performed in this group. There was one false positive, but no false negative lavage. PMID- 3967903 TI - Free pleuroperitoneal liquid movement indicating diaphragmatic tear. AB - An unusual radiological feature, not mentioned in the literature, is reported. It has been observed in a patient with traumatic rupture of the diaphragm associated with intra-abdominal bleeding. This injury produced a free pleuroperitoneal movement of liquid demonstrated in the supine and erect chest radiographs. Since there is an associated abdominal injury in most cases of rupture of the diaphragm, this radiological sign might be more common. The importance of supine and erect chest radiography is reinforced in cases of multiple injuries. PMID- 3967904 TI - Pancreatic injury in association football. AB - A case is presented of isolated pancreatic transection sustained in the course of a game of Association Football. The difficulty of early diagnosis is discussed. Emphasis is laid on the importance of possible pancreatic injury in the normotensive patient and on inspecting the posterior abdominal structures on opening the lesser sac during laparotomy. PMID- 3967905 TI - Successful Whipple's operation for pancreatic injury. AB - A case is presented of severe pancreatic injury in a 30-year-old man following a road traffic accident. A Whipple's operation was performed successfully. Despite some postoperative complications, the patient is well and back at work 1 year after the operation. PMID- 3967906 TI - Closed abdominal trauma in a child causing avulsion of the common bile duct and gastric stasis. AB - A case of closed abdominal trauma causing complete transection of the supraduodenal common bile duct and gastric stasis in an 8-year-old boy is described. Surgical management involved re-establishment of biliary-enteric continuity and later gastric drainage to overcome gastric stasis. It is postulated that this child had sustained a traumatic vagotomy resulting in failure of gastric emptying. The literature does not report this complication of blunt abdominal injury. PMID- 3967907 TI - PIPIDA scan diagnosis of traumatic rupture of the gallbladder. AB - Eighteen days after injury, a patient was evaluated for bilious ascites with a 99mTc-PIPIDA (paraisopropyliminodiacetic acid) scan. A ruptured gallbladder was shown, and this finding was confirmed at exploration. Radionuclide scanning offers a sensitive, non-invasive approach for delineating disruption of the biliary tract, and should be considered when such a defect is suspected. PMID- 3967908 TI - Deaths (144) from road traffic accidents occurring before arrival at hospital. AB - One hundred and forty-four deaths occurring as a result of road traffic accidents are reported, with reference to circumstance of accident, cause of death, severity of injury and blood alcohol levels. In seven cases there may have been a contribution to death from aspiration of blood or vomit. In two other cases there were lesions which might have responded to the very early provision of full medical care. PMID- 3967909 TI - Can inguinal hernia be caused by a fractured spine? AB - Three patients who had suffered fractures of the body of the first lumbar vertebra reported the appearance of inguinal herniae shortly after resuming walking. It is postulated that a neurapraxia or axonotmesis of the first lumbar nerve root may weaken the conjoint tendon. PMID- 3967910 TI - Renal pelvi-ureteric injury in traumatic paraplegia. AB - Three cases of pelvi-ureteric injury associated with traumatic paraplegia are described. The diagnosis of such injuries is usually late and the consequences can seriously affect the outlook of the patient. The problems of late diagnosis are discussed and recommendations made concerning earlier diagnosis. PMID- 3967911 TI - Delayed pneumothorax and haemothorax following observation for stab wounds of the chest. AB - In a prospective study, 85 patients underwent simple observation for minor injuries of the pleural cavity as a result of penetrating injury of the chest. Seven patients (8 per cent) required delayed drainage, because of an increase in the size of the pneumothorax and/or haemothorax, but in all cases drainage was instituted within 24 hours. Haemopneumothorax is the most likely underlying disorder to require delayed drainage. Subcutaneous emphysema is of no value for identifying those cases likely to need delayed drainage. Twenty-four hours is adequate for the observation of patients with slight effects of penetrating wounds of the chest. PMID- 3967912 TI - The resuscitation of the severely injured in the accident and emergency department--a medical audit. AB - An audit of the medical care of the severely injured was conducted in the Accident and Emergency Department of the Royal Victoria Hospital, Belfast. Over a 6-month period the management of all patients admitted with an Injury Severity Score of 16 or over was critically assessed. Errors of management which occurred in 21 of the 36 patients are discussed. They were mainly related to the fact that 78 per cent of the patients arrived outside normal office hours when only inexperienced junior doctors staffed the department. The findings have drawn our attention to the need for both altering staffing arrangements and improving training in our department. PMID- 3967913 TI - Head and neck injuries to motorcycle and moped riders--with special regard to the effect of protective helmets. AB - In a consecutive series of 132 motorcycle and moped riders killed in 1977-1983 in southern Sweden and examined post mortem, almost half of the fatal injuries of the head and neck occurred remote from the point of impact, namely certain intracranial injuries without fractures, ring fractures of the base of the skull, disruption of the junction of the head and neck and injuries of the cervical spine. Ring fractures of the base of the skull were noticeably more frequent in motorcyclists than in car occupants who died. Injuries occurring remote from the point of impact were often the result of impacts against the anterior part of the head, especially against the face. All 5 riders suffering disruption of the junction of the head and neck were helmeted, which suggests that the helmet may promote such injuries. In some of these cases, no sign of impact against the head could be detected. The inertia of the head, enhanced by the helmet, is supposed to contribute to some of these injuries, which calls into question the protection provided by the helmet. Fatal head injuries at the point of impact were mostly found on the lateral-posterior part of the head. These injuries were often irrespective of whether or not a helmet was used. The points of impact were found mainly rung around the head. Protective helmets should be improved in order to give better protection against injuries at the site of impact, especially in the above-mentioned area, to give better protection of the face and to increase energy-absorbing capacity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3967914 TI - Management of bilateral internal jugular venous injuries. AB - We report the case of a 16-year-old boy admitted to hospital because of multiple stab wounds. Exploration under general anaesthesia revealed bilateral simultaneous injuries of the internal jugular vein. The management of these injuries is discussed. Optimal treatment requires preservation of at least one internal jugular vein. Both veins may be ligated but this can result in facial oedema and permanent cosmetic defects, and even in death due to cerebral oedema. PMID- 3967915 TI - Pertrochanteric fractures in elderly patients: treatment with Ender's nails, blade-plate or endoprosthesis? AB - Three comparable groups of elderly patients with unstable and displaced fractures of the trochanteric region of the femur were studied; 46 fractures had been fixed with Ender's nails, 53 with blade-plates and 69 with endoprostheses. Endoprostheses gave better results because of fewer mechanical complications and because of the best walking ability. PMID- 3967916 TI - Ankle fracture treated with the AO principle--an experience with 116 cases. AB - One hundred and sixteen cases of ankle fractures were classified by the AO system and treated by open reduction and internal fixation in accordance with the AO principles. The stabilization of the lateral malleolus was emphasized. Ninety-six cases were available for functional assessment with an average follow-up of 39 months. The results were good or excellent in 90 per cent of type A fractures and in 70-80 per cent of type B and C fractures. There was no death or non-union. Local complications included wound infection (8.6 per cent) and skin necrosis (3 per cent). This study illustrates the importance of exact anatomical reduction and stable internal fixation to allow early movement after an intra-articular fracture of the ankle. PMID- 3967917 TI - The importance of the deep volar compartment in crush injuries of the forearm. AB - Two cases are described of blunt injury to the forearm in the absence of bone injury, resulting in an acute deep volar compartment syndrome. The importance of the deep flexor compartment of the forearm is noted. The diagnostic pitfalls and the use of intra-compartmental monitoring are discussed. We emphasize that all such cases must be admitted and carefully studied as a matter of routine. If operation is undertaken, both the superficial and deep volar compartments must be adequately decompressed. PMID- 3967918 TI - Treatment of un-united fractures of the shaft of the humerus with bent nail. AB - The results of operative treatment of 78 cases of un-united fractures of the humeral diaphysis are reported. The operation consisted of medullary nail fixation, the nail being bent at the fracture site in order to engage the cortex above and below the fracture, and was followed by plaster splintage. Forty-nine cases showed evidence of union within 20 weeks and 21 united between 20 and 30 weeks. Of the remaining cases, two had broken nails and five were lost to follow up. PMID- 3967919 TI - The acutely locked knee--is a manipulation worth while? AB - Over a 10-year period, 85 consecutive patients presented to the Accident and Emergency Department with an acutely locked knee and were all treated by manipulation under anaesthesia. Out of 69 patients who could be adequately followed up, 46 (67 per cent) subsequently required arthrotomy for an internal derangement. In 41 of these patients there was a bucket-handle tear of a meniscus. Twenty-three patients (33 per cent) made a full recovery from manipulation alone. In view of the high incidence of correctable lesions, immediate arthroscopy and, if necessary, definitive operation would be a better treatment for the acutely locked knee. PMID- 3967920 TI - Lipopolysaccharide characteristics of pathogenic campylobacters. AB - Most Campylobacter jejuni strains are sensitive and most Campylobacter fetus strains are resistant to the bactericidal activity in normal human serum. We purified lipopolysaccharides from Campylobacter strains to determine whether their composition and structure relate to serum susceptibility. The lipopolysaccharide of two serum-sensitive strains was best isolated by the Galanos procedure, but for two serum-resistant strains a cold-ethanol extraction was optimal. For each lipopolysaccharide preparation, the ratio of 2-keto-3 deoxyoctonate to protein was increased by 100 to 1,000-fold over that of whole cells. For serum-resistant strains, total carbohydrates was a high proportion of lipopolysaccharide weight; for serum-sensitive strains, 2-keto-3-deoxyoctanate was a high proportion of total carbohydrates. By polyacrylamide gel electrophoresis, the lipopolysaccharide of serum-sensitive strains appeared rough, but for serum-resistant strains a smooth-type ladder was seen, with a minimal core region and several high-molecular-weight complexes. Proteinase K treated whole-cell lysates showed polyacrylamide gel electrophoresis profiles similar to that of pure lipopolysaccharide. Proteinase K-treated whole-cell lysates from seven serum-sensitive C. jejuni strains all had rough profiles, and five serum-resistant C. fetus strains all had smooth profiles. These studies indicate that lipopolysaccharide composition may be an important determinant of serum susceptibility among Campylobacter species and that serum resistance is usually associated with a smooth-type lipopolysaccharide. PMID- 3967921 TI - Iron-vibriobactin transport system is not required for virulence of Vibrio cholerae. AB - The possible requirement of a functional siderophore (vibriobactin)-mediated iron transport system in the pathogenicity of Vibrio cholerae was determined. Two mutants of V. cholerae defective in the iron-vibriobactin transport system were examined for their ability to multiply and elicit diarrhea in infant mice. One mutant, 40130, was unable to synthesize vibriobactin. The second mutant, 1510, was able to synthesize, but not transport, the siderophore. Both mutants retained the ability to multiply and produce disease in the infant mouse, and virulence was indistinguishable from the parent strains. This indicates that a functional iron-vibriobactin transport system is not essential for cholera pathogenesis. These mutants, like the wild-type strains, were found to have a ferric citrate iron uptake system and could utilize citrate or asparagine for growth in low-iron medium. Compounds of this type may increase the availability of iron to V. cholerae in the host. PMID- 3967922 TI - Cell cycle distribution patterns and generation times of L929 fibroblast cells persistently infected with Coxiella burnetii. AB - Coxiella burnetii established a persistent infection of various cell lines including L929 mouse fibroblasts. Although the basis for such persistence is unknown, the phenomenon does require continual growth, proliferation, and maintenance of viability of the host cells. We examined the effect of short- and long-term infection on the host cell's generation time and cell cycle. Flow cytometric studies of actively growing normal and infected cells stained with mithramycin or propidium iodide revealed no significant difference in cell cycle distribution patterns or changes in ploidy level associated with persistent infection with either phase I or phase II C. burnetii. The population doubling times of infected and normal cells were similar. PMID- 3967923 TI - Murine malaria: resistance of AXB/BXA recombinant inbred mice to Plasmodium chabaudi. AB - The level of resistance to infection with Plasmodium chabaudi is genetically controlled. We have previously reported that a single dominant gene is responsible for the variation in host resistance to malaria between susceptible A/J- and resistant C57BL-derived mice. In the present study, recombinant inbred strain analysis was performed with AXB/BXA recombinant inbred strains derived from A/J and C57BL/6 progenitors. Typing of 17 AXB/BXA recombinant inbred strains confirmed the unigenic control of inheritance in this particular strain combination and allowed us to demonstrate genetic linkage between the traits of resistance (defined as a prolonged survival and a low peak parasitemia) and the magnitude of splenomegaly. The influence of sex on the course of infection, which we previously reported in the examination of segregating populations (Stevenson et al., Infect. Immun. 38:80-88, 1982), was again demonstrated in the survey of RI strains. PMID- 3967924 TI - Lysozyme-mediated aggregation and lysis of the periodontal microorganism Capnocytophaga gingivalis 2010. AB - The ability of lysozyme to aggregate and lyse the gram-negative capnophilic periodontal microorganism Capnocytophaga gingivalis 2010 was monitored optically at 540 nm. Both hen egg white and chromatographically purified human lysozymes had significant but similar aggregation potentials for both logarithmic- and stationary-phase bacteria. In general, an increase in enzyme concentration resulted in a graded increase in both the initial and maximum changes in turbidity which occurred during the reaction period. The greatest change in turbidity occurred within the initial minutes of interaction of lysozyme and the cells, and the extent of aggregation paralleled a rapid depletion of lysozyme by the suspensions during the first minute of its incubation with the bacteria. Interestingly, the muramidase inhibitors N-acetyl-D-glucosamine and histamine did not block aggregation, whereas maleylation of lysozyme completely inhibited its aggregating ability. Demaleylation, however, restored aggregation activity comparable to the native enzyme, indicating that maleylated lysozyme retained its integrity and that aggregation was primarily dependent on charge. The addition of up to physiological concentrations of NaHCO3 and NaCl to cell aggregates resulted in varying degrees of deaggregation and lysis. Surprisingly, ultrastructural analysis of lysozyme-treated cells revealed morphological changes with or without the addition of salt. Damage appeared to occur at the blunted polar end of the cells where there was a large spherical outpouching bordered by a damaged cell envelope. Damaged cells uniformly contained dense granular cytoplasmic debris. In effect, the cationic enzyme lysed C. gingivalis 2010, which was not apparent in the spectrophotometric assay. The paradoxical finding that during bacterial aggregation there was lysis may be of significance to the further elucidation of lysozyme's antibacterial role in the gingival sulcus. PMID- 3967925 TI - Role of tetracycline in pathogenesis of chronic candidiasis of rat tongues. AB - Forty female Sprague-Dawley rats were randomly divided into two groups. Group 1 animals received tetracycline solution (0.1% during week 1 and 0.01% thereafter) as drinking water, as in previous studies. Group 2 animals received double distilled demineralized water. Animals in both groups were inoculated orally with an equal number of viable, mucosally pathogenic Candida albicans organisms. After 20 weeks, inspection of the tongues showed gross lesions in 16 of the 20 animals in group 1 and 17 of the 20 in group 2. These lesions were confirmed histologically. No significant difference in the number of lesions was noted between the two groups. However, the lesions in group 1 animals were significantly larger than those in group 2 animals. These results suggest that, given this mucosally pathogenic strain of C. albicans, the establishment of a chronic infection of the rat tongue is apparently not influenced by tetracycline treated drinking water as administered in this study. This suggests that antibiotic exposure is not an essential factor in the pathogenesis of this lesion. A larger lesion area, however, does appear to be related to the use of tetracycline solution as drinking water. PMID- 3967927 TI - Differential inhibition of macrophage microbicidal activity by liposomes. AB - In vitro culture of murine resident peritoneal macrophages with lymphokine (LK) rich leukocyte culture fluids induces enhanced microbicidal activity against amastigotes of the protozoan parasite Leishmania tropica. Macrophages infected with Leishmania and treated with LKs after infection acquire the capacity to kill the intracellular parasite within 72 h. When compared with control macrophage cultures treated with medium lacking LKs, 80 to 90% fewer macrophages treated with LKs contained amastigotes. In experiments designed to test liposome delivery of LKs to infected macrophages, addition of multilamellar liposomes composed of phosphatidylcholine and phosphatidylserine (molar ratio, 7:3) completely abrogated LK-induced microbicidal activity. Liposomes containing only phosphatidylcholine were not inhibitory. Inhibition of LK activity by the liposomes occurred regardless of whether the liposomes contained LKs. Liposomal inhibition of activated macrophage effector activity was limited to intracellular killing; LK-induced macrophage extracellular cytolysis (i.e., tumor cytotoxicity) was not affected by liposome treatment. These data indicate that elucidation of the effects of liposome composition on acquired host defense mechanisms may be useful for the design of drug delivery systems that allow expression or augmentation of immunologically induced mechanisms for the intracellular destruction of infectious agents. PMID- 3967926 TI - Modulation of in vitro natural cell-mediated activity against enteropathogenic bacteria by simple sugars. AB - Lymphoid cells from mouse Peyer's patches and spleens were tested in a 2-h in vitro assay for their natural activity against the enteropathogenic bacteria Salmonella typhimurium, Salmonella enteritidis, Salmonella tel aviv, and Shigella sp. X16. The antibacterial activity expressed by normal cells was detected against all the bacterial strains tested with the exception of Peyer's patch lymphocytes against S. tel aviv and splenocytes against Shigella sp. X16. To determine whether the different expression of natural antibacterial activity might be due to lectin-like proteins interacting with the saccharidic moieties of the bacterial wall, 11 simple sugars were preincubated with the effector cells before the in vitro assays. We found that some of them could block the natural antibacterial activity as well as induce antibacterial activity when this was not spontaneously expressed. Interestingly, a different panel of sugars among those employed was observed to affect the antibacterial activities for each of the above-mentioned bacterial targets and each effector cell. However, the same panel of sugars was able to block or stimulate the lymphocyte activity when bacteria with the same somatic antigens as two substrains of S. typhimurium and one strain of Salmonella schottmuelleri were employed. To further investigate the interaction between effector cells and bacteria, effector cells or Shigella sp. X16 targets were treated with proteolytic, glycolytic, and lipolytic enzymes before the in vitro assays. Furthermore, EDTA was used to analyze the role of divalent cations in this experimental system. The results obtained suggest that lectin-like proteins playing a role in this interaction are present not only on lymphocytes but also on bacteria and that divalent cations are essential for the expression of in vitro antibacterial activity. PMID- 3967928 TI - A role for anaphylactic sensitization in tumor control. AB - In order to evaluate the possible preventive role of an anaphylactic condition on tumor development, C57BL/6J mice were immunized or hyperimmunized by the intraperitoneal route with egg albumin in alum before the chemical induction of fibrosarcoma. Preimmunization using a protocol which elicits an optimal IgE response produced: (1) a significant reduction of tumor incidence; (2) an increase of survival time, and (3) a decrease of tumor growth rate in animals with higher IgE titers (greater than 640). On the other hand, hyperimmunized mice, which were suppressed in their anti-egg albumin IgE response, showed no changes in tumor incidence and survival time when compared to controls. Our results suggest a suppressive effect on tumor development related to the ability of the animal to mount an IgE response to antigens unrelated to the tumor. PMID- 3967929 TI - Intestinal absorption of bacterial antigens in normal adult mice. I. Preparation and characterization of the antigens. AB - The preparation of flagellin (FLA) from Salmonella adelaide and Boivin antigen (BA) from Vibrio cholerae is described. These two antigens differed chemically from each other and showed marked differences in their degradability by mouse intestinal juice in vitro and in their fate in the intact mouse when given intravenously. Unlike BA, FLA was rapidly degraded in intestinal juice and readily sequestered and degraded by the liver. The suitability of these antigens in oral absorption studies is discussed. PMID- 3967930 TI - Intestinal absorption of bacterial antigens in normal adult mice. II. A comparative study of techniques. AB - Marked differences were seen in the oral absorption of Boivin antigen (BA) and flagellin (FLA) using antigens labelled by 3H-dinitrophenylation. Thus, after feeding 3H-DNP-FLA, a large proportion of the label was rapidly absorbed, concentrated and degraded by the liver so that no antigenic material could be recovered from the circulation. In contrast, the absorption of 3H-DNP-BA was low and slow; the absorbed material appeared stable and not readily taken up by the liver, so that 8-20% of the non-dialysable radioactivity found in the plasma was precipitable by specific antibodies. Such observations could not be made when 125I-labelled antigens were used: deiodination readily occurred in vivo, and there was re-utilization of the released label. On the other hand, using everted gut sacs, it was possible to recover 125I-labelled antigenic material after transport. A technique of measuring unlabelled antigen absorbed in the intact animal is also described, which detects antigen by combination with radioiodinated antibodies injected intravenously into the animal. PMID- 3967931 TI - Studies on the significance of the R1 anti-reticulin antibody associated with gluten sensitivity. AB - The R1 type anti-reticulin antibody (ARA) is closely associated with gluten sensitive enteropathy. It disappears from the circulation within a few weeks of starting on a gluten-free diet and often reappears following gluten challenge. It is not clear how gluten ingestion leads to the production of the ARA. We have investigated four possibilities. (1) The ARA is simply a food antibody generated against meats in the diet. (2) The ARA is an anti-gluten antibody which cross reacts with reticulin. (3) Gluten binds to gut reticulin in vivo rendering reticulin autoimmunogenic. (4) Immune complexes of gluten and anti-gluten antibody bind to reticulin (by virtue of the affinity that gluten has for reticulin) to give the appearance of an ARA in immunofluorescence tests. Our results do not support any of these possible explanations, and the significance of the ARA remains obscure. PMID- 3967932 TI - Relation between components of the immune response in rats sensitized by aerosol and subcutaneous injections. AB - Relations between the appearance of various components of the immune response were analyzed in two groups of rats sensitized by aerosol and subcutaneous injections in the neck region, respectively. The relations were expressed by Spearman rank correlation coefficient and studied by cluster analysis. In the aerosol-sensitized animals, there was a close association between IgA and IgG antibody levels in bronchial fluid and these in turn were related to IgG levels in serum and more loosely to IgE levels in bronchial fluid. There was an apparent association between IgE antibody formation and mast cell maturation in cultures of regional lymph node cells and the appearance of mucous cells in the lungs. These variables seemed associated with spontaneous cell proliferation in vitro and the numbers of mast cells in the lungs. This indicates that local stimulation with antigen induces local immune responses and immune-mediated migration of cells. In subcutaneously sensitized animals, formation of IgG antibodies in vitro seemed related to the stimulated proliferation of regional lymph node cells. The levels of IgG and IgE antibodies in bronchial fluid and in serum also appeared to be related. Unlike the findings in aerosol-sensitized animals there was no apparent relation between the differentiation of mast cells and mucous cells. This was possibly due to lack of immune-mediated antigen-induced cell migration. The different immune response patterns in aerosol and subcutaneously sensitized rats should be considered when studies are designed aiming to explore the pathogenesis of allergic inflammatory diseases. The findings also indicate that the various parameters of immunity are more closely related in aerosol than in subcutaneously immunized animals. PMID- 3967933 TI - Standardization of Dermatophagoides pteronyssinus: assessment of potency and allergen content in ten coded extracts. AB - As part of the studies to establish an international reference preparation of Dermatophagoides pteronyssinus allergens, ten coded extracts of this mite were assessed in four laboratories. The extracts were compared for total potency using direct RAST, RAST inhibition and quantitative skin tests, and also for composition and major allergen content using crossed immunoelectrophoresis, crossed radioimmunoelectrophoresis, rocket immunoelectrophoresis and radioimmunoassay. In addition, the source materials were examined by light microscopy, and the extracts were examined for the presence of proteins/allergens derived from the culture media. To help with standardization, a new reference pool of sera from patients allergic to D. pteronyssinus was also established (National Institute of Biological Standards and Control, NIBSC, 82/528). The results showed that techniques are available for measurements of potency and allergen content. In several of the extracts, culture medium derived allergens and antigens were demonstrated. It also became clear that extracts varied not only in their total potency but also in the distribution of the identifiable allergens. In particular, extracts derived from isolated mites contained more AgX and/or Ag 23 relative to their content of antigen P1 (= Ag42). These studies lead to the choice of an extract for an international reference preparation (NIBSC 82/518) and helped to establish the methods used subsequently in the international collaborative study. PMID- 3967934 TI - Inhibition of anaphylaxis by inactivated lymphocyte clone with radiolabelled antigen. AB - 125I-labelled ovalbumin (OVA) antigen did not sensitize guinea-pigs and anaphylaxis did not develop after native OVA challenge. The radiolabelled antigen was fixed by lymphocytes with highly specific receptors for 125I-OVA and this condition produced a continuous radiation damage leading to inactivation of the cells. As the proliferative response of lymphocytes did not occur, no antibody production was detected. This was demonstrated by passive haemagglutination techniques. However, the immune response to a simultaneously given non radioactive antigen remained intact. It is supposed that radiation damage depended on specific activity of antigen destroying the antigen-specific lymphocyte clone selectively. The mechanism and the practical importance of the in vivo 'antigen suicide' is discussed. PMID- 3967935 TI - Suppression of IgE antibody response against ovalbumin by the chemical conjugate of ovalbumin with a polyaspartic acid derivative. AB - Ovalbumin was modified with alpha,beta-poly[(2-hydroxyethyl)-DL-aspartamide] which had been developed as a nontoxic plasma expander. Preadministration of the modified ovalbumin suppressed both primary and secondary anti-ovalbumin IgE responses. PMID- 3967936 TI - Studies on beta-lactoglobulin as an experimental allergen in rats. AB - The allergenicity of bovine beta-lactoglobulin (beta-LG) in rats was investigated by measurement of both mast cell-bound and circulating IgE antibody produced in response to immunisation with this cow's milk constituent. The responsiveness of the animals' peritoneal mast cells to in vitro challenge with beta-LG was determined by measurement of release of radiolabelled 5-hydroxytryptamine. Using aluminium hydroxide gel as adjuvant, the responsiveness of mast cells to beta-LG was transient, peaking at 21 days after immunisation. The optimal dose of injected beta-LG was 100 micrograms. Circulating IgE antibody to beta-LG, measured by ELISA, was also detected transiently during the 3rd week post immunisation. PMID- 3967937 TI - Histamine receptors on leukocytes: the binding of histamine serum albumin conjugates is non-specific. AB - It is commonly held that certain leukocyte sub-populations adhere selectively to histamine-serum albumin conjugates. A large number of soluble histamine, ethylamine and dimethylaminopropylamine conjugates were synthesised and labelled with fluorescein isothiocyanate (FITC). Although a number of conjugates bound to mononuclear cells and granulocytes our data showed this binding to be non specific. The binding of histamine conjugates to leukocytes was not inhibited by preincubation of cells with free histamine at concentrations of up to 10(-1) M nor was it pH sensitive. In addition, conjugates of ethylamine and dimethylaminopropylamine showed a similar binding pattern to that of histamine conjugates. We suggest that the observed binding may be due to modifications to the net charge of the carrier protein molecule. PMID- 3967938 TI - Enhancement of IgE-dependent eosinophil cytotoxicity to dinitrophenylated schistosomula by a nematode infection. AB - In order to obtain direct evidence for the involvement of IgE in the eosinophil mediated cytotoxicity, dinitrophenylated (DNP) schistosomula of Schistosoma japonicum coated with monoclonal IgE antibodies were examined as to whether they were killed by rat peritoneal eosinophils. The results indicated that the cytotoxicity of the eosinophils was dependent on a mouse monoclonal anti-DNP IgE antibody, but not on another monoclonal antibody specific to ovalbumin. Moreover, an enhanced cytotoxicity was observed when eosinophils were obtained from rats 4 weeks after infection with Nippostrongylus brasiliensis. PMID- 3967939 TI - Complement anaphylatoxins in idiopathic mixed cryoglobulinemia. AB - Basophil activation, observed in patients with idiopathic mixed cryoglobulinemia, has been related to the complement anaphylatoxins C4a, C3a and C5a. In the present study the plasma levels of the complement anaphylatoxins have been evaluated in 21 patients affected with idiopathic mixed cryoglobulinemia. The plasma concentration of C3a desArg was significantly higher in the patients than in the healthy controls; conversely the plasma values of C4a desArg were significantly lower. C5a desArg was not detectable in plasma from any subject. The high plasma level of C3a desArg in our patients may suggest a role for C3a anaphylatoxin in 'in vivo' basophil activation. No correlation was found between the plasma concentrations of C3a desArg or C4a desArg, the amount of cryoprecipitate and the clinical activity of the disease. PMID- 3967940 TI - Immunoglobulin E in feces from children with allergy. Evidence of local production of IgE in the gut. AB - Immunoglobulin E (IgE) was found by a double antibody radioimmunoassay technique (PRIST) in extracts of feces from 21 of 40 children with different kinds of allergy. 15 of the 22 children with gastrointestinal allergy and atopic dermatitis, but only 6 of the 17 patients with hay fever and/or bronchial asthma had detectable IgE in the extracts. The patients with gastrointestinal allergy also had the highest concentrations of fecal IgE, and the concentrations in feces did not correlate with the corresponding serum IgE levels. Furthermore, the presence of IgE in feces correlated with specific IgE antibodies in serum, measured as the sum of RAST classes to the food allergens wheat, fish, cow's milk and egg-white. IgE may therefore have been produced locally in the gut as a result of stimulation by food allergens. Since the concentrations of IgA in feces were also high in many children with allergy, and since some possibility of a positive correlation with high IgE concentration seemed to exist, the stimuli for local production of IgE and IgA may be interrelated. PMID- 3967941 TI - Changes of serum antibody activities to various dietary antigens related to gluten withdrawal or challenge in children with coeliac disease. AB - IgG, IgA, and IgM serum antibody activities to gluten, a gluten fraction called glyc-gli, and antigens from egg and cow's milk were monitored by an enzyme-linked immunosorbent assay (ELISA) in children with coeliac disease during treatment and gluten challenge. The IgA activity to gluten antigens showed in most patients a rapid and significant reduction after gluten withdrawal, whereas the IgG activity decreased more slowly. During gluten challenge, both these activities rose significantly, and the increases could usually be detected several months before overt clinical relapse. Such determinations, therefore, represent a valuable adjunct in the follow-up of children with coeliac disease. IgA activities to egg and cow's milk antigens likewise tended to decrease after gluten withdrawal and increase during challenge, but the changes were less consistent for individual antigens. Nevertheless, monitoring of IgA activities to a selection of dietary antigens other than gluten may be particularly valuable when it comes to evaluation of intestinal responses in patients on a gluten-free diet. PMID- 3967942 TI - Distribution of allergen activity and identification of the main IgE-binding glycopeptide of Parietaria judaica pollen. AB - Parietaria judaica pollen extract was separated by preparative isoelectric focusing and showed two allergenic components (A1 and A2) heterogeneously distributed within the pH gradient (pH 3-10). By fused-rocket immunoelectrophoresis, A1 was detected from pH 3 to 10, whereas A2 was only found at pH values below 8. Both components, A1 and A2, showed IgE-binding ability throughout their pH ranges, as determined by crossed-radio immunoelectrophoresis. In addition, all the preparative isoelectric focusing fractions contained the main allergenic polypeptide of P. judaica (Pj10) when analyzed by SDS-PAGE. This polypeptide was shown to be a glycopeptide or to be bound to a glycoprotein with alpha-D-mannopyranoside or alpha-D-glycopyranoside residues. Implication of charged sugar residues in the wide distribution of P. judaica allergens in a pH gradient is discussed. PMID- 3967943 TI - Studies on allergen and allergoid preparations from purified timothy (Phleum pratense) pollen extracts. III. Comparative investigations by skin prick tests and nasal provocation tests. AB - The allergenic activities of allergen (GEN) and allergoid (GOID) preparations from partially purified timothy pollen extract were investigated in quantitative skin prick tests and nasal provocation tests. In skin prick test GOID yielded significantly less activity than GEN. Approximately 90 times more protein of GOID than of GEN was necessary to elicit wheals of the same mean size as 1 mg/ml histamine control solution (1 HEP). In nasal provocation the patients seemed to react differently with respect to their nasal sensitivity to GOID. One group of patients showed equal sensitivity to GOID and GEN, whereas the second group showed higher thresholds to GOID. These differences in nasal sensitivity to GOID could be of practical value to predict the optimal dosage schedule for the treatment of patients with GOID. PMID- 3967944 TI - Studies on immunity in hybridoma-bearing mice. B. Immunity against the hybridoma. I. Studies on the immune state of mice after rejection of the hybridoma. AB - Anti-dinitrophenyl IgE secreting hybridoma B 53 cells may be rejected when injected subcutaneously in BALB/c mice. These mice are immune as they withstand without any ill effect the intraperitoneal injection of LD100 B 53 cells. Sera from mice which rejected the tumor have cytotoxic antibodies against the hybridoma, as shown by in vitro tests, but serum cannot transfer immunity to naive BALB/c mice against hybridoma B 53. Spleen cells from mice which have rejected the tumor might transfer immunity against B 53 hybridoma, and with Winn tests it has been shown that these spleen cells are very effective against the B 53 cells and also against the myeloma cells which were used for the fusion to construct the B 53 hybridoma. Subcutaneously injected B 53 cells not only produce anti-DNP IgE secreting tumors, but often also metastasize to spleen, and they are sometimes detected in the circulating blood. Mice with splenic metastasis or with detectable circulating B 53 cells generally die. However, we did observe one mouse with splenic metastasis which successfully rejected the tumor and became immune to B 53 cells. PMID- 3967946 TI - Growth inhibition of fibroblasts by progesterone and medroxyprogesterone in vitro. AB - This study was carried out to evaluate in vitro the beneficial effects observed in various aggressive fibromatoses (mediastinal, retroperitoneal, paraneoplastic fibrosis and desmoid tumors) after treatment with progesterone. Primary cultures of fibroblasts were prepared from fetuses of Swiss strain mice. Continuous fibroblast lines LM and Vero were also used. Moreover, cultures of non-fetal human fibroblast from skin and lung were employed. Epithelial tumor cell line HeLa was used as a control. All cultures were incubated with various doses of progesterone at concentrations from 1.4 X 10(-4) to 1.4 X 10(-3) M. Human cells and monolayers of fetal murine fibroblast were submitted to the action of medroxyprogesterone solution at the same concentrations as used for progesterone. Other steroids (estrone, estriol, testosterone and prednisolone) were used at the identical concentrations in the same vehicles. Progesterone affected all lines of fibroblasts studied and destroyed them within either 2-4 or 24-48 h depending on the steroid concentrations used. Medroxyprogesterone had a comparable effect on human cell lines and monolayers of fetal murine fibroblasts provided that the same ratio between the hormone concentration and the time of exposure was maintained. With higher medium concentrations shorter times of incubation were required for the destruction of fibroblast. However, to observe a degree of lysis similar to that elicited by progesterone, it was necessary to use 4 times higher concentrations of medroxyprogesterone. No effect on HeLa epithelial cells was observed nor were the controls affected by the steroids or diluents used at the appropriate concentrations. Results from incubation studies using monolayers of murine fibroblast and 14C-progesterone suggested that the cells were destroyed by the progesterone and not by a bioproduct of its metabolism. PMID- 3967945 TI - Pattern of the primary and secondary antibody responses elicited by TNP-LPS in mice. AB - Trinitrophenylated lipopolysaccharide (TNP-LPS) at high doses (30 micrograms) induces thymus-independent IgM and IgG anti-TNP responses. At low doses (0.3 microgram) it elicits only an IgM anti-TNP response. TNP-LPS primes for a secondary response of IgG type only when given at high doses (30 micrograms): this response is thymus dependent. PMID- 3967947 TI - UICC study group in basic and clinical cancer research: genomic changes and the origin of neoplasia. PMID- 3967948 TI - Effect of leukocyte activation on the formation of heterotypic tumor-cell aggregates in vitro. AB - Walker tumor cell (1 x 10(6) cells/ml) were incubated at 37 degrees C in a stirred cuvette with rat peritoneal exudate cells (9 x 10(6) cells/ml) with or without the synthetic leukocyte chemo-attractant fMLP (2 x 10(6) M) or biologically active concentrations of the major endogenous chemo-attractant, C5a. Aggregation, induced by the chemo-attractants, was detected after 3 min by a platelet aggregometer and by studying cytocentrifuge preparations. The response was amplified in the presence of cytochalasin B (5 micrograms/ml). Tumor cells could be identified in the aggregates by their morphology or by autoradiography after labeling with 3H-thymidine. Although tumor cells were incorporated into the leukocyte aggregates, there was no appreciable change in the number of aggregates formed between tumor cells themselves. Levine III human breast tumor cells (1 x 10(6)/ml) in heparinized human blood were incorporated into leukocyte aggregates within 30 min of adding 50 U cobra venom factor to activate complement. Aggregation correlated with a decrease in complement hemolytic activity (CH50). The aggregation reaction was not cytotoxic to tumor cells when evaluated by Trypan blue exclusion or by 51Cr release. We conclude that local tumor cells can be incorporated into aggregates formed when leukocytes are stimulated by chemo attractants. We postulate that intravascular activation of neutrophils might affect the localization of circulating tumor cells by incorporating them into microembolic cell aggregates and by causing damage to the pulmonary endothelium. PMID- 3967949 TI - Radioimmunodetection of murine mammary adenocarcinoma (TA3/Ha) lung and liver metastases with radioiodinated PNA. AB - Organ-specific lung and liver metastatic variants of the murine TA3/Ha mammary adenocarcinoma cell line were selected by sequential in vivo growth with intervening in vitro cell culture. These variants readily formed specific lung or liver metastatic lesions upon i.v. injection into A/J mice. TA3/Ha cells produce a large cell surface glycoprotein called epiglycanin, which contains a high proportion of Thomsen-Friedenreich (TF) antigenic structures. The presence of non cryptic TF has been associated with malignancy in humans and animals. We used peanut lectin agglutinin (PNA), which has a preferential affinity for TF antigenic structures, to determine whether these selected metastatic variants retained the TF antigen expression. In vitro, the TA3/Ha metastatic variant lines exhibited strong PNA binding similar to that seen with human RBC after neuraminidase treatment to expose the cryptic TF antigen. In contrast, the non epiglycanin-producing TA3/St subline did not bind PNA appreciably. Autoradiography of liver sections with TA3/Ha metastatic lesions after 125I-PNA i.v. indicated an avid uptake throughout the viable tumor mass and FITC-PNA staining of these tissue sections readily identified the metastatic tumors under fluorescence microscopy. Tissue biodistribution studies revealed that lung or liver containing the TA3/Ha metastatic variant nodules retained about 7 to 8 times as much of an i.v. dose of radioiodinated PNA as did controls, allowing for clear delineation of tumor-infiltrated lung or liver by gamma scintigraphy. These in vitro and in vivo tests confirm that the selected organ-specific TA3/Ha variants retained the binding characteristics of the parent TA3/Ha line. These observations illustrate the potential utility of radiolabelled PNA for the detection of TF-antigen-expressing tumors and metastases. This murine system with organ-specific TA3/Ha metastatic variants also provides a model for evaluation of various other macromolecular probes for tumor radioimmunodetection of metastatic lesions. PMID- 3967950 TI - Endocrine sensitivity of the receptor-positive T61 human breast carcinoma serially grown in nude mice. AB - A study was made on the effect of ovariectomy, 17 beta-oestradiol, and tamoxifen on the oestrogen and progesterone receptor-positive T61 human breast carcinoma grown in nude mice. The effect of the treatment was evaluated by the specific growth delay calculated on the basis of Gompertz growth curves, and by the changes in the cell cycle distribution monitored by flow cytometric DNA analysis. The results demonstrated that both oestradiol and tamoxifen induced a temporary growth delay, whereas ovariectomy of the host had no effect on the growth of the tumour. The oestradiol-induced tumour growth delay was accompanied by a decrease in the G1 fraction, an accumulation of cells in the S-phase, and polyploidy, whereas neither treatment with tamoxifen nor ovariectomy influenced cell cycle distribution. The results indicate that oestradiol and tamoxifen have different mechanisms of action. In addition, they were interpreted as indicating different mechanisms regulating ovarian-dependent tumour growth, on the one hand, and oestrogen and tamoxifen-induced tumour growth inhibition, on the other. The results support the view that the presence of receptors may be of importance but is not a sufficiently clear marker to allow prediction of the endocrine sensitivity of individual breast tumours. PMID- 3967951 TI - Structural characterization and biosynthesis of gp87, a melanoma-associated oncofetal antigen defined by monoclonal antibody 140.240. AB - The monoclonal antibody 140.240, which reacts with a melanoma-associated oncofetal antigen, identifies an epitope present on an 87 kd molecule present on the surface of melanoma cells. This molecule is a single-chain monomer, which by tunicamycin treatment and two-dimensional tryptic mapping has been shown to arise from a 77 kd polypeptide precursor (p77). This precursor is rapidly glycosylated to an 83 kd intermediate (gp83) which in turn is rapidly further glycosylated into the mature 87 kd glycopolypeptide (gp87). Neuraminidase treatment of the glycopeptides indicates that only gp87 contains accessible sialic acid moieties. PMID- 3967952 TI - Adoptive transfer of experimental autoimmune uveoretinitis in rats. Immunopathogenic mechanisms and histologic features. AB - In order to learn about the immunopathogenic mechanisms of experimental autoimmune uveoretinitis (EAU), the capacity of lymphocytes to transfer the disease was studied. EAU was transferred to naive syngeneic rats by intraperitoneal injection of spleen or lymph node (LN) cells from S-antigen immunized rats, following their incubation in culture with either S-antigen or concanavalin A (Con A). In contrast, the same cells did not cause inflammatory changes in the recipient eyes when injected intravitreally. The identity of the lymphocytes that transfer EAU was determined by using monoclonal antibody enriched subsets of lymphocytes. EAU was transferred by the subset of helper/inducer T-cells, but not by T-cells of the suppressor/cytotoxic subset. Recipient rats of spleen or LN cells cultured with S-antigen exhibited both humoral and cellular immune responses to S-antigen. On the other hand, recipients of spleen cells cultured with Con A developed only cellular immune response to S antigen. Yet, both groups of recipients fully developed EAU. The clinical and histologic changes in recipient rats closely resembled those in rats in which EAU was induced by active immunization. Severe tissue damage occurred at the photoreceptor cell layer, but inflammatory infiltration also was found in other ocular tissues. Involvement of polymorphonuclear leukocytes (PMNs) was noted throughout ocular tissues even in the eyes of recipients with no detectable antibodies to S-antigen, suggesting that the ocular PMNs infiltration in rats is not necessarily the result of an Arthus-like inflammatory process. PMID- 3967953 TI - Diurnal variation of corneal thickness in the cat. AB - Central corneal thickness of both eyes of seven cats was measured hourly for 72 hr using ultrasonic pachometry. The mean corneal thickness was 569 +/- 36 micron (mean +/- SD), and the diurnal variation was 49 +/- 14 micron (8.6% of corneal thickness). In a separate experiment, the corneal thickness of one eye of each of five cats was measured following 2 hr of natural sleep; 2 1/4 hr after eye opening, the corneas had thinned an average of 43 +/- 22 micron. The authors conclude that corneal swelling induced by eye closure during periods of sleep is the prime determinant of the diurnal variation in cat corneal thickness. In studies where corneal thickness is to be monitored over a period of time, it is possible to control against this large diurnal variation by ensuring that the cat is active for a period of two hours prior to pachometry measurements. PMID- 3967954 TI - Presence of Langerhans cells in the central corneas of normal human infants. AB - Nine normal adult and seven normal infant human corneas were studied for the presence of dendritic epithelial Langerhans cells in a masked fashion. Epithelial flatmounts were separated from the underlying corneal stroma using EDTA. The epithelial Langerhans cell densities were determined in the limbus as well as the peripheral, pericentral, and central corneal regions following staining with ATPase. Segments of the flatmounts were also studied by immunofluorescence to confirm that the dendritic cells contained class II histocompatibility antigens. The limbus, peripheral, and pericentral zones of adult and infant flatmounts contained similar densities of Langerhans cells. However, the central corneal Langerhans cell densities in infants were significantly elevated as compared with those in adults. These results suggest that Langerhans cells are a constant constituent of the human central corneal epithelium during late gestation and early infancy. They further suggest that perturbations of the corneal epithelium are not required for the presence of Langerhans cells in the corneal epithelium. PMID- 3967955 TI - Ocular penetration of (125I)IVDU, a radiolabeled analogue of bromovinyldeoxyuridine. AB - Following topical application of (125)IVDU, the radiolabeled analogue of bromovinyldeoxyuridine ([E]-5-[2-bromovinyl]-2'-deoxyuridine), as 0.5% or 0.3% eyedrops, to rabbits, (125I)IVDU appeared in the anterior chamber fluid at drug levels well above the minimum concentration (0.01 microgram/mL) required for inhibition of herpes simplex virus type 1 replication. These findings are consistent with the efficacy of 0.5% bromovinyldeoxyuridine eyedrops in the topical treatment of herpes simplex uveitis. PMID- 3967956 TI - Pericyte form and distribution in rat retinal and uveal capillaries. AB - Ultrastructural morphometric techniques were used to assess differences in endothelial cells and in pericyte structure and distribution in rat retinal and uveal capillaries. Retinal capillaries were significantly smaller than those in the three different uveal vascular beds, all of which were similar in size. Approximately 10% of the capillaries in the retina and choroid were formed by three endothelial cells, compared with 30% and 46% of capillaries sampled from ciliary processes and iris, respectively. The percentage of the capillary circumference covered by pericytes (46-58%) and the percentage of capillary sections with pericyte nuclei (12-16%) were similar in retina, iris, and ciliary processes. Corresponding data for the choriocapillaris indicated that pericyte coverage of these capillaries was approximately 50% of that observed in the other eye microcirculations. The number of pericyte processes per capillary varied markedly in the different vasculatures, with an average of three for capillaries in the retina and choriocapillaris and nine to eleven for capillaries in the iris and ciliary processes. These marked differences in capillary dimensions are consistent with the well-known capillary hemodynamic and functional differences of these tissues; however, the significance of the differences in pericyte shape, frequency and distribution in the different vasculatures of the eye is less clear. PMID- 3967957 TI - Bovine retinal angiogenesis factor is a small molecule (molecular mass less than 600). AB - Two methods were used to extract angiogenic activity from bovine retina. Both methods initially gave rise to nondialyzable (greater than 10,000 Mr) fractions with angiogenic activity. However, after anion exchange chromatography, 20% of the extracts from one of the two methods (method 2) contained a small molecule with angiogenic activity (Mr 300-600). Alcohol treatment of high molecular mass fractions from both methods also released a low molecular mass angiogenic factor (Mr 300-600). No angiogenic activity was left in the nondialyzable residue. The high molecular mass angiogenic fraction obtained by method 1 after DEAE-cellulose chromatography contained a protein immunologically and electrophoretically identical to bovine serum albumin. The low molecular mass retinal angiogenic factor was able to stimulate microvessel endothelial cell proliferation as well as being positive in the chick chorioallantoic membrane test. The presence of a protein carrier system for a small angiogenesis factor is proposed. This would explain discrepancies in the apparent molecular mass of retinal angiogenic factors described previously. PMID- 3967958 TI - The relationship between binocular rivalry and strabismic suppression. AB - Increment-threshold spectral sensitivity functions were determined for normal observers during binocular rivalry and for esotropic observers during strabismic suppression and under viewing conditions that normally induce binocular rivalry. Depending on the spatial and temporal properties of the test stimulus, the normal observers exhibited a wavelength-specific loss in sensitivity during the suppression phase of rivalry, which suggests that binocular rivalry differentially attenuates the sensitivity of the chromatic mechanisms relative to the luminance mechanisms. In contrast, regardless of the test stimulus dimensions, the esotropic observers did not manifest a wavelength-specific loss in sensitivity either during strabismic suppression or under conditions that normally induce binocular rivalry. The different patterns of suppression shown by the normal and esotropic subjects suggest that strabismic observers do not demonstrate normal binocular rivalry, and that strabismic suppression and normal binocular rivalry suppression are mediated by different neural mechanisms. PMID- 3967959 TI - Pattern ERG in amblyopia. AB - The authors have recorded pattern ERGs in 62 amblyopic children. In 12 who were occluded up until the morning of the test, the occluded eye response was reduced, and the ratio ([response amplitude of amblyopic eye]/[response amplitude of fellow eye]) was greater than unity. In the remainder, the ratio was considerably less than unity. Ratios of less than 1.0 were found for anisometropic, esotropic, exotropic, and microtropic amblyopes. The ratio was not related to visual acuity or to squint but was higher in those children whose vision was improved by orthoptic treatment. In a group of older children recalled to the clinic, the ratio was 1.0 in those who had maintained equal visual acuity and was less than unity in those children whose acuity had regressed after treatment, or had not improved during treatment. The reduction of the pattern ERG in amblyopes occurs without a corresponding reduction in the focal ERG. In adult amblyopes, the relationship between loss of acuity, loss of grating contrast sensitivity, and the reduction in the PERG is complex and may differ according to the type of amblyopia. PMID- 3967960 TI - Fluorescence/Raman intensity ratio for monitoring the pathologic state of human lens. AB - The authors have put quantitation of human lens fluorescence on a rational basis by using the accompanying Raman signal from lens protein as a normalization factor. The intensity ratio, Fluorescence/Raman (F/R), may be used to compare lenses of different ages when the exciting wavelength is long enough to give a measurable Raman signal. In younger lenses excited at 457.9 or 514.5 nm, the F/R shows a log increase with age. Older lenses, above 60 years of age, excited at 647.1 nm give a steeply rising sigmoid curve. In developing this procedure, the authors found that for each lens there is a characteristic wavelength that is called the critical wavelength (lambda critical). At wavelengths longer than lambda critical the Raman signal appears in the absence of a broad fluorescence peak; at shorter wavelengths the fluorescence intensity increases enough to overwhelm the Raman signal. For normal lenses, clear and not heavily pigmented, the lambda critical is age dependent, giving a curve that is a flattened sigmoid approximating a straight line. PMID- 3967961 TI - Urinary incontinence in the elderly. PMID- 3967962 TI - Taking stock. PMID- 3967963 TI - Drug therapy of the hyperlipidemias. PMID- 3967964 TI - Certification of outpatient diabetes education programs. PMID- 3967965 TI - Do you need a computer in your office? PMID- 3967966 TI - Post-accident radiation monitors. PMID- 3967968 TI - Health physics aspects of a research reactor fuel shipment. PMID- 3967967 TI - Dosimetric models of 3H from skin absorption following contact with T2 contaminated surfaces. PMID- 3967969 TI - A low-cost tritiated water solar evaporator. PMID- 3967970 TI - Plutonium particle size determination using an alpha-particle imaging system. PMID- 3967972 TI - Measurement of the 232Th content of gas mantles. PMID- 3967971 TI - Committed vs annual dose limits for internal radiation protection and control. PMID- 3967973 TI - Diffusion of a contaminant in fractured porous media. AB - A theoretical model is developed for diffusion from a finite source of buried contaminant through a porous medium containing a fracture that reaches to the atmosphere. Important quantities are shown to be the burial depth, source width and fracture width, the soil porosity, the diffusion coefficients in the soil and the (air-filled) fracture, and the decay constant of a radioactive contaminant. The flux across the soil-air interface is calculated and shown to be greatly increased by the presence of the fracture. The flux is found to increase with fracture width and source width, to decrease with increasing soil porosity and decay constant, and to decrease with increasing ratio of soil diffusion coefficient to air diffusion coefficient. PMID- 3967974 TI - Inhalation of U aerosols from UO2 fuel element fabrication. AB - Publication No. 30 of the International Commission on Radiological Protection (ICRP) assigns the uranium oxides UO2 and U3O8 to transportability class Y, i.e. the half-life of these compounds in the lungs is about 500 days. This assignment seemed not to be in accordance with our experience resulting from incorporation surveillance during UO2 fuel element fabrication. Persons who worked in atmospheres containing UO2 aerosols with activity concentrations significantly above the derived air concentrations (DAC) for class Y U showed much lower activity in the lungs than would be expected according to the ICRP. To understand this discrepancy, aerosol concentrations and aerosol particle-size distributions at work places with the possibility of UO2 incorporation, the activity of urine and feces and the lung activity of persons working at these places were measured in an investigation program. The results are only consistent with the ICRP lung model if one uses a measured biological half-life in the lungs of 109 days and a measured AMAD of 8.2 micron instead of the ICRP standard assumptions of 500 days and 1.0 micron, respectively. ICRP Publication No. 30 recommends application of specific parameters for health physics instead of standard model values. For the special conditions in our UO2 fuel fabrication plant we therefore derive limits of air concentrations, lung activities and fecal and urinary activity concentrations by applying our measured particle-size and lung-retention parameters to the ICRP model. Our special derived limits in comparison to class Y limits for U after ICRP Publication No. 30 for a 1-micron AMAD and 500-day half life (in brackets) are: (a) annual limit of intake: 6 X 10(4) Bq/y (1 X 10(3) Bq/y); (b) derived air concentration: 20 Bq/m3 (0.6 Bq/m3); (c) derived lung activity: 1.6 X 10(3) Bq; (d) derived fecal activity: 14 Bq/day; and (e) derived urine activity: 8.9 Bq/day. The committed dose equivalents calculated from our measured data and from our modified derived limits proved consistent for the different incorporation control methods (determination of air concentration, lung, fecal or urinary activity). The authors recommend that in accordance with ICRP Publication No. 30, the national rules and regulations on activity incorporation provide the possibility to derive special limits from specific work place parameters such as particle-size distributions and biological half-lives, thus supplementing the ICRP standard assumptions of 1 micron AMAD and biological half-lives of 0.5 days for class D, 50 days for class W and 500 days for class Y compounds. PMID- 3967975 TI - Distribution of gamma exposure rates in a reactor effluent stream flood plain system. AB - Ground-level gamma dosimetry surveys were conducted along the length of a radiocesium-contaminated reactor effluent stream flood plain system to determine the extent and patterns of isotope distribution over a decade after reactor releases were stopped. The maximum mean exposure rates were found at upstream locations near the source of the contamination and in a downstream sedimentary delta. Gamma exposure rates were not uniformly distributed and high exposure rates were generally restricted to small areas of the flood plain. There was little similarity in either the spatial distribution or magnitudes of maximum gamma exposure rates across flood plains along the stream. Frequency the measured exposure rates tended to be highly skewed and most closely approximated the log normal distribution in most areas along the stream. However, the complex and changing patterns of dose distributions strongly affected the ability to predict the probability of encountering unusually high exposure rates. Complex statistical and distributional models are required to provide precise descriptions of the dosimetry environment in such complex ecosystems and different models could be required on a site-by-site basis. PMID- 3967977 TI - Radiation exposure rates near brachytherapy patients containing 137Cs sources. AB - For 30 brachytherapy patients, whose lateral pelvic diameters, 2r, ranged from 28 to 47 cm, and who contained activities Ac of 137Cs expressed in equivalent milligrams of 226Ra, the normalized exposure rates, X(r)/Ac, in mR h-1 (mg Ra eq) 1 at 1 m lateral from the midline of the pelvis, can be expressed by X(r)/Ac = (1.3 +/- 0.5)e-(0.07 +/- 0.02)r. Patient and applicator effects that contribute to the large uncertainties in the model coefficients are identified. PMID- 3967976 TI - Natural radioactivity of Australian building materials, industrial wastes and by products. AB - The natural radioactivity due to the presence of 226Ra, 232Th and 40K in conventional raw materials and some solid industrial wastes and by-products which are being used or have a potential for use in the building and ceramic industries in Australia has been measured by gamma-ray spectrometry. The majority of materials examined in this work showed fairly low levels of radioactivity. Some samples of red mud, phosphogypsum, zircon products and fly ash did show higher levels of radioactivity than would be acceptable on the basis of a criterion formula for gamma-ray activity suggested for use in some OECD countries. But this higher level of radioactivity should not pose an environmental health problem when these materials constitute a relatively small portion of the materials used in a normal building. The present work has also shown that the radioactivity levels of some of the materials can be reduced through the removal of fines by sieving, as the fines seem to contain a higher concentration of radioactive nuclides. PMID- 3967978 TI - Computed tomography findings in thoracic and renal actinomycosis: case report and review of literature. PMID- 3967979 TI - Atrioventricular dissociation in rheumatic fever: report of a case. PMID- 3967980 TI - Lack of evidence for increased tolerance of rat spinal cord with decreasing fraction doses below 2 Gy. AB - The radiation tolerance of the spinal cord, both in man and in rats, has been shown to depend strongly on the size of the dose per fraction. With fraction doses down to about 2 Gy, the spinal cord tolerance can be predicted by a modified Ellis formula: D approximately N0.43. More recently alternative isoeffect formulas were based on the linear-quadratic (LQ) model of cell survival where the effect of dose fractionation is characterized by the ratio alpha/beta which varies from tissue to tissue. For the spinal cord, as well as for other late responding tissues, the ratio alpha/beta is small, in contrast to most acutely responding tissues. Both the Ellis-type formula, and to a lesser extent the LQ-model, predict a continuously increasing tolerance dose with decreasing fraction size. From the LQ model, the concept of "flexure dose" has been derived, which proposes the limit of effective fractionation to be about 0.1 alpha/beta. At this dose per fraction no significant further gain in tolerance would be detected. From previous experiments on the rat cervical spinal cord with doses per fraction down to about 2 Gy, the ratio alpha/beta was determined to be 1.7 Gy, and the LQ-model would predict a rise in tolerance with a reduction in fraction size to far below 2 Gy. Based on these predictions clinical studies have been initiated assuming a significantly increased tolerance by reduction of fraction size to about 1 Gy. However, in the present experiments no evidence was found for such an increase in tolerance with fraction sizes below 2 Gy. PMID- 3967981 TI - Intraoperative radiotherapy in the definitive treatment of localized carcinoma of the prostate. AB - A preliminary analysis of the effectiveness of intraoperative radiotherapy with an electron beam for the treatment of prostatic cancer in 14 patients is presented. The perineal approach was employed as an operative procedure for placing a treatment cone onto the tumor. The electron energy used for irradiation ranged from 10 to 14 MeV. Of five patients treated by intraoperative radiotherapy alone, four who received single doses of 3000 to 3500 cGy achieved local control. One of these patients, however, who received 3000 cGy, had a local recurrence occurred at the sixth year after the treatment. A patient treated with 2800 cGy failed. A single dose of 2000 or 2500 cGy was delivered intraoperatively to nine patients as a boost dose in conjunction with external irradiation of 5000 cGy for the treatment of pelvic lymph nodes. All nine patients achieved local control. None of the 14 patients developed any serious complication of the bladder, urethra or rectum, which has been associated with intraoperative electron irradiation. Although no definite conclusion can be drawn at present because of the small number of patients and insufficient follow-up, the results suggest that single doses of 3300 cGy by intraoperative radiotherapy alone or 2500 cGy as a boost in conjunction with external radiotherapy can be curative for prostatic cancer with minimal morbidity. PMID- 3967982 TI - Patterns of care studies: dose-response observations for local control of adenocarcinoma of the prostate. AB - Five hundred seventy-four patients with prostate cancer treated by external beam radiation therapy in the United States in 1973 to 1975 have been analyzed comparing radiation dose with in-field recurrence. Dose-response effects are observed for all cases (p = less than .05) and T-2 and T-3 tumors, but not for T 0, T-1 and T-4 tumors. For doses calculated at the center of the prostate, these observations suggest optimal control is obtained at no more than 6000 rad for T-0 and T-1 tumors; 6000-6500 rad for T-2 tumors; 6500-7000 rad for T-3 tumors; and that greater than 7000 rad is required only for T-4 tumors. The paraprostatic dose calculated at a point 4 cm lateral to the center of the prostate also shows a correlation of dose with infield failure for all cases (p = .01). Observations in individual T states suggest optimal control is obtained at no more than 6000 rad for T-0, T-1 and T-2 tumors, 6500-6999 rad for T-3 and greater than or equal to 7000 rad for T-4. These data suggest that for T-2 and T-3 cancers, extension in the periprostatic region must be treated. A comparison of central dose vs. stage indicates institutional policy rather than cancer volume determines the radiation dose used in treating prostate cancer. A change in institutional policies to treat with optimal doses as indicated by this study would result in an overall increase in local control and a decrease in complications. PMID- 3967983 TI - Protein synthesis, thermotolerance and step down heating. AB - The heat sensitivity of mammalian cells is modified by the cells' previous thermal history. If CHO cells are exposed to 42 degrees C or lower, they show resistance to subsequent heating at higher temperatures ("thermotolerance," TT); if the sequence is reversed, then an increased sensitivity is seen ("step-down heating," SDH). There is considerable evidence that protein synthesis is required for the development of tolerance, but nothing is known about the molecular events leading to SDH. We now show that for HA1 cells, the rate of protein synthesis (rPS) is related to both TT and SDH. The rPS of TT cells is 30% higher than of unheated cells. There is only a transient reduction of rPS during the exposure of TT cells to temperatures up to 43 degrees C with recovery occurring during heating. At higher temperatures, the effect is more severe and no recovery is observed. No recovery is seen during heating at 43 degrees C in previously unheated cells. On the other hand, SDH sensitization occurs in unheated cells and only when there is a severe and prolonged inhibition of the rPS (less than 10% of the control value). TT cells do not show SDH and also only show transient rPS reductions. Our results indicate that proteins must be synthesized for the development of TT and that SDH develops primarily as a consequence of the inhibition of the development of TT. PMID- 3967984 TI - Elevated levels of 70,000 dalton heat shock protein in transiently thermotolerant Chinese hamster fibroblasts and in their stable heat resistant variants. AB - The function of one or more shock proteins (HSPs) may be to confer protection of cells against thermal damage. The quantitative relationship between heat sensitivity and concentration of several HSPs was examined in thermotolerant Chinese hamster HA-1 cells and in their heat-resistant variants. Low molecular weight HSPs (22-27 kd) showed no correlation with cell survival. The best correlation was found between concentration of 70 kd HSP and the logarithm of cell survival. There was no difference between the HSP 70 induced by heat shock and that present in a constitutive form. The 70 kd HSP may actually confer heat resistance on cells, but in any case HSP 70 appeared to be the best predictor of heat response. PMID- 3967985 TI - A comparison of deep regional hyperthermia from an annular array and a concentric coil in the same patients. AB - Twenty-two patients with advanced pelvic or abdominal malignancy (or both) were treated on successive occasions with hyperthermia produced by an annular array (AA) (60-80 MHz, 500-1800 W forward power) and a concentric coil (CC) (13.56 MHz, 350-1000 W forward power). Both devices were compared with respect to acute toxicity and power limitations. There was no power limiting factor in pelvic heating in 7/14 patients treated with the AA, however 13/14 experienced power limiting sacrococcygeal pain with the CC. The 9 patients who underwent abdominal heating had a variety of power limitations with both devices. Thermal mapping was performed in 23 treatments with the AA and in 19 with the CC. Composite thermal maps of patients with similar thermometry sites show that heating patterns produced by the CC were predictable from theory and static phantom measurements. The AA achieved broader regional heating, particularly at depth, but heating patterns were less predictable. Spatial thermal dose (TD) analysis revealed higher minimum tumor TDs and more favorable mean tumor/normal tissue TD ratios with the AA than with the CC. We conclude that the AA is superior to the CC for pelvic treatment and that both devices have limitations in abdominal treatment. PMID- 3967986 TI - Use of a perfluorochemical emulsion to improve oxygenation in a solid tumor. AB - The ability of the perfluorochemical emulsion, Fluosol-DA, to oxygenate the naturally-occurring hypoxic cells of solid tumors was examined. BALB/c mice bearing EMT6 mouse mammary tumors were given in a single i.v. injection of 0.015 ml/g of Fluosol, and were then treated with 95% O2/5% CO2 for 30 min before irradiation with graded doses of X rays. The pretreatment increased the cytotoxic effect of the radiation, as assayed by colony formation in vitro. The dose response curve for the combination regimen was parallel to that for radiation alone, but was offset towards lower survivals. This change is consistent with the change which would be expected if the pretreatment decreased the proportion of hypoxic cells in the tumors. Studies with unoxygenated perfluorochemical emulsions in vivo and in vitro and studies with O2/CO2 alone in vivo suggested that the survival curve changes did not reflect either direct cytotoxic effects of the perfluorochemical emulsion or the O2/CO2-breathing, or radiosensitizing or physiologic effects of either agent alone. The data reported here suggest that oxygenated perfluorochemical emulsions may decrease the proportion of hypoxic cells in solid animal tumors and encourage further preclinical evaluation of these agents as potential adjuvants to radiotherapy. PMID- 3967987 TI - The optimal size of a posterior capsulotomy. AB - The optimal posterior capsulotomy diameter should be equal to the normal pupillary diameter in dark conditions to avoid glare and other undesirable optical aberrations. We studied 14 patients whose average pupillary diameter following cataract surgery was approximately 3.9 mm in scotopic conditions. PMID- 3967988 TI - Diagnosis and treatment of mysterious light streaks seen by patients following extracapsular cataract extraction. AB - Complaints of light streaks, such as might be seen with a Maddox rod or Bagolini lens, are becoming more common with the trend toward extracapsular cataract surgery. The light streaks are usually a result of high plus cylinders somewhere in the patient's optical system. Windshields, spectacles, contact lenses, lashes, an excessive tear meniscus, intraocular lens scratches, and posterior capsular opacification are possible causes that can be easily identified and treated. PMID- 3967989 TI - Managing dense retropseudosphakos membranes with a pars plana vitrectomy. AB - Formation of thick and occasionally dense retropseudophakos membranes and rapid fibrosis of the posterior capsule is a complication that adversely affects the outcome of intraocular lens implantation. We have observed this condition in 17 patients, most of whom presented with traumatic and congenital cataracts. It appears to occur more frequently in young individuals and children. Simple capsulotomy, by the limbal approach or with the YAG laser, does not reliably eliminate the membranes. We have used vitrectomy and scissors dissection through the pars plana to achieve good anatomical results. Postoperative visual acuity has been satisfactory, except in amblyopic eyes related to congenital cataracts. PMID- 3967990 TI - Interaction between ophthalmic drugs and intraocular lenses. AB - We evaluated the in vitro interaction between commonly used ophthalmic drugs and a series of intraocular lenses to determine if the lenses could act as a drug reservoir in the eye. Lenses examined included anterior and posterior chamber lenses as well as iris plane lenses. Assessment of lens uptake was made by immersing the lens for nine days in a radioactive drug solution with a concentration equal to that found in the anterior chamber one hour after drug administration. No evidence of drug uptake was found for any lens immersed in epinephrine, norepinephrine, dexamethasone, or chloramphenicol. PMID- 3967992 TI - Release of pupillary entrapment of a posterior chamber phacoprosthesis. PMID- 3967991 TI - Calculation of an IOL from the wide-angle optical model of the eye. AB - Currently used paraxial formulas for calculating the power of an intraocular lens (IOL) ignore the pupillary aperture of the eye (3.5 mm) and assume that the locations of the principal planes of the crystalline lens and cornea are known. For calculating IOL performance, only the axial point in the field is considered. The eccentricity of the ocular optical system and the probable error in the IOL centering are also ignored. The use of a wide-angle optical model of the aphakic eye for computation of the IOL would result in values that approach more closely those in the real eye. The performance of the implanted IOL could then be calculated in conditions that are much closer to reality. To obtain information on the precision required in preoperative measurement of the asphericity of the cornea, we have studied the effect of corneal asphericity on IOL performance. PMID- 3967993 TI - Microsurgery of the lens in high myopia for optical purposes. PMID- 3967994 TI - Anterior versus posterior chamber lenses. PMID- 3967995 TI - Astigmatism from lens tilt. PMID- 3967996 TI - Reactive cellular membrane on a glass fragment after two years in the anterior chamber. AB - An optically clear membrane composed of a continuous proteinaceous film and sessile cells of macrophage origin was present on the surface of a glass fragment removed from the anterior chamber of the eye of a nine-year-old boy almost two years after a perforating corneal injury. This finding indirectly contributes to the understanding of membranes formed by the inner eye during adaptation to an intraocular lens implant. PMID- 3967997 TI - An inexpensive semiautomated irrigation/aspiration system. AB - A new device for irrigating and aspirating the cortex is presented. The design features, including the module and disposable pack, and the method of use are described. PMID- 3967998 TI - Sandblasted end-cutting tip for posterior capsular vacuuming and polishing. PMID- 3967999 TI - Needleholder for 10-0 nylon. PMID- 3968000 TI - A menu-driven Lotus 1-2-3 template for intraocular lens calculation and automatic generation of an SRK constant. AB - A template for intraocular lens (IOL) calculation and data manipulation designed for the Lotus 1-2-3 is presented. The template is menu-driven, providing automatic IOL calculation, form generation, and personal SRK generation for three IOL lens types as selected by the surgeon. Minimal computer skill and no programming knowledge is required. The template design is available without cost to ophthalmologists. PMID- 3968001 TI - Effects of dehydration on the vasopressin response to immersion. AB - Nine healthy volunteers underwent three experimental procedures in random order. The protocols were 4 h of thermal dehydration followed by 2 h of head-out water immersion, 4 h of thermal dehydration followed by 2 h of chair rest, and 6 h of rest in the supine position. Four hours of heat exposure (50 degrees C) resulted in a body weight loss of approximately 3.5%. Plasma osmolality rose by approximately 5 mosmol/kg, mean arterial pressure (MAP) decreased from 85 to 78 mmHg, and body temperature increased from 36.8 to 38.6 degrees C. As a consequence of the combined action of hypertonicity, hypovolemia, hypotension, and hyperthermia, plasma arginine vasopressin (AVP) increased from 2.1 to 8.1 pg/ml after 4 h thermal dehydration. Changes in body weight, plasma osmolality, body temperature, and MAP were similar after either a subsequent 2 h of water immersion or 2 h of chair rest. However, during chair rest plasma AVP remained elevated (8.4 pg/ml), whereas during immersion plasma AVP decreased from 8.1 to 4.7 pg/ml. This was probably due to the central hypervolemia induced by immersion. Our results support the hypothesis that central hypervolemia rather than hypotonicity is the primary stimulus for AVP suppression during water immersion in dehydrated subjects. During the early immersion period hypoosmolality might contribute to the AVP suppression. PMID- 3968002 TI - Characterization by stimulation of medullary mechanisms underlying gasping neurogenesis. AB - Our purpose was to evaluate the hypothesis that neurons in the lateral tegmental field of the medulla comprise a pattern generator for neurogenesis of gasping. Stimulations in this area produced changes characteristic of pattern generators in other systems. These included shifts in gasping rhythm and refractory periods for eliciting gasps; the latter varied inversely with spontaneous gasping frequency. These responses were recorded from activities of phrenic and hypoglossal nerves of decerebrate, cerebellectomized, vagotomized, paralyzed, and ventilated cats. Gasping followed freezing the brain stem between pons and medulla. In addition to lateral tegmental loci, gasps were elicited by stimulating areas extending lateral to the nucleus ambiguus and medial to the contralateral medulla. These areas are envisaged to contain axons to or from the pattern generator of lateral tegmental field. Finally, stimulations in sites approximating nucleus tractus solitarius and nucleus ambiguus delayed spontaneous gasps and terminated ongoing gasps. Current required to terminate gasps fell during neural inspiration. Our data are consistent with the lateral tegmental field of medulla comprising a central pattern generator for gasping and pacemaker elements being a component of this pattern generator. PMID- 3968003 TI - Reflex depression of cardiovascular function during lung inflation. AB - These experiments were intended 1) to determine the cardiovascular reflex response initiated by lung inflation and 2) to determine the autonomic neural mechanisms that mediate the reflex responses. To test only the reflex effects of lung inflation and eliminate the associated mechanical effects thereof, we isolated the left airway and left pulmonary artery of dogs and performed static inflations of the left lung. Left lung inflation (LLI) to 30 cmH2O caused left ventricular systolic pressure, heart rate, and hindlimb vascular resistance to fall 20, 31, and 15%, respectively. When the hearts were paced to eliminate Bowditch effects, LLI caused left ventricular contractility, which was measured as dP/dt at 30 mmHg developed pressure and as the maximal rate of shortening of the contractile element, to fall 23 and 20%, respectively, and cardiac output (stroke volume) to fall 31%. Transection of the left cervical vagus nerve, interrupting most afferent and some efferent pathways from the left lung, virtually eliminated subsequent cardiovascular responses to LLI. Hindlimb vasodilation was mediated by alpha-adrenergic activity, and the fall in left ventricular contractile state was caused by a reduction in beta-adrenergic activity. The reflex bradycardia was mediated by increased cholinergic and decreased beta-adrenergic activity. These data establish that reflex mechanisms exist whereby expansion of the lung can reflexly modulate heart rate, ventricular contractility, systemic vasomotor tone, cardiac output, and stroke volume independent of the direct mechanical influence of lung expansion on these circulatory phenomena. PMID- 3968004 TI - Buffering capacity of deproteinized human vastus lateralis muscle. AB - The in vitro deproteinized vastus lateralis muscle buffer capacity, carnosine, and histidine levels were examined in 20 men from 4 distinct populations (5 sprinters, 800-m runners; 5 rowers; 5 marathoners; 5 untrained). Needle biopsies were obtained at rest from the vastus lateralis muscle. The buffer capacity was determined in deproteinized homogenates by repeatedly titrating supernatant extracts over the pH range of 7.0-6.0 with 0.01 N HCl. Carnosine and histidine levels were determined on an amino acid AutoAnalyzer. Fast-twitch fiber percentage was determined by staining intensity of myosin adenosinetriphosphatase. High-intensity running performance was assessed on an inclined treadmill run to fatigue (20% incline; 3.5 m X s-1). Significantly (P less than 0.01) elevated buffer capacities, carnosine levels, and high-intensity running performances were demonstrated by the sprinters and rowers, but no significant differences existed between these variables for the marathoners vs. untrained subjects. Low but significant (P less than 0.05) interrelationships were demonstrated between buffer capacity, carnosine levels, and fast-twitch fiber composition. These findings indicate that the sprinters and rowers possess elevated buffering capabilities and carnosine levels compared with marathon runners and untrained subjects. PMID- 3968005 TI - Role of muscle mass and mode of contraction in circulatory responses to exercise. AB - The roles of the mode of contraction (i.e., dynamic or static) and the active muscle mass as determinants of the cardiovascular responses to exercise were studied. Six healthy men performed static handgrip (SHG), dynamic handgrip (DHG), static two-knee extension (SKE), and dynamic two-knee extension (DKE) to local muscular fatigue in approximately 6 min. Increases in mean arterial pressure were similar for each mode of contraction, 29 +/- 5 and 30 +/- 3 mmHg in SHG and DHG and 56 +/- 2 and 48 +/- 2 mmHg in SKE and DKE (P greater than 0.05) but larger for KE than HG (P less than 0.001). Cardiac output increased more for dynamic than for static exercise and for each mode more for KE than HG (P less than 0.001). Systemic resistance was lower for dynamic than static exercise and fell from resting levels by approximately 1/3 during DKE. The magnitude of the pressor response was related to the active muscle mass but independent of the contraction mode. However, the mode of contraction affected the circulatory changes contributing to the pressor response. Equalization of the pressor responses was achieved by proportionately larger increases in cardiac output during dynamic exercise. PMID- 3968006 TI - Epinephrine, norepinephrine, and dopamine during a 4-day head-down bed rest. AB - Head-down bed rest at an angle of 6 degrees was used as an experimental model to simulate the hemodynamic effects of microgravity, i.e., the shift of fluids from the lower to the upper part of the body. The sympathoadrenal activity during acute (from 0.5 to 10 h) and prolonged (4 days) head-down bed rest was assessed in eight healthy men (24 +/- 1 yr) by measuring epinephrine (E), norepinephrine (NE), dopamine (DA), and methoxylated metabolite levels in their plasma and urine. Catecholamine (CA) and methoxyamine levels were essentially unaltered at any time of bed rest. Maximal changes in plasma were on the second day (D2): NE, 547 +/- 84 vs. 384 +/- 55 pg/ml; DA, 192 +/- 32 vs. 141 +/- 16 pg/ml; NS. After 24 h of bed rest, heart rate decreased from 71 +/- 1 to 63 +/- 3/min (P less than 0.01). Daily dynamic leg exercise [50% maximum O2 uptake (VO2 max)] used as a countermeasure did not alter the pattern of plasma CA during bed rest but resulted in a higher urinary NE excretion during postexercise recovery (+45% on D2; P less than 0.05). The data indicate no evident relationship between sympathoadrenal function and stimulation of cardiopulmonary receptors or neuroendocrine changes induced by central hypervolemia during head-down bed rest. PMID- 3968007 TI - Regional lung strain in dogs during deflation from total lung capacity. AB - Regional lung distortion during deflation from total lung capacity to functional residual capacity (FRC) in intact supine and prone anesthetized dogs was determined from the displacement of multiple metallic markers embedded in the lung parenchyma. Distortion was expressed as strain (epsilon), which is related to fractional length changes. In the supine position, transverse strain (epsilon yy) was larger than vertical strain (epsilon xx) and cephalocaudal strain (epsilon zz) in the upper lobe. The FRC of the lower lobe was smaller than FRC of the upper lobe and all strains were larger, but epsilon zz increased most and became equal to epsilon yy. In the prone position, epsilon yy was largest in all upper lobes and in three of four lower lobes. Strains and volumes of the upper and lower lobes were similar. The upper and lower lobes rotated slightly around different axes, indicating that interpleural fissures allow additional degrees of freedom for the lungs to conform to the thoracic cavity. In the prone position, there were no consistent gradients of strain or volume. These results indicate that, in determining the regional distribution of FRC in the recumbent dog, in addition to the effect of gravity on the lung, there are important interactions between lung and thoracic cavity shapes. PMID- 3968008 TI - Effect of breathing pattern on gas mixing in a model with asymmetrical alveolar ducts. AB - A model of the pulmonary airways was used to study three single-breath indices of gas mixing, dead space (VD), slope of the alveolar plateau, and alveolar mixing inefficiency (AMI). In the model, discrete elements of airway volume were represented by nodes. Using a finite difference technique the differential equation for simultaneous convection and diffusion was solved for the nodal network. Conducting airways and respiratory bronchioles were modeled symmetrically, but alveolar ducts asymmetrically, permitting interaction between convection and diffusion. VD, alveolar slope, and AMI increased with increasing flow. Similar trends were seen with inspired volume, although slope decreased at high inspired volumes with constant flow. VD was affected most by inspiratory flow and AMI and alveolar slope by expiratory time. VD fell approximately exponentially with time of breath holding. Eight different breathing patterns were compared. They had a small effect on alveolar slope and AMI and a greater effect on VD. The model shows how series and parallel inhomogeneity occur together and interact in asymmetrical systems: the old argument as to which is the more important should be abandoned. PMID- 3968009 TI - Influences of age and gender on human thermoregulatory responses to cold exposures. AB - To delineate age- and gender-related differences in physiological responses to cold exposure, men and women between the ages of 20 and 29 yr and 51 and 72 yr, wearing minimal clothing, were exposed at rest for 2 h to 28, 20, 15, and 10 degrees C room temperatures with 40% relative humidity. During the coldest exposure, the rates of increase in metabolic rate (W X m-2 or ml X kg lean body mass-1 X min-1 were similar for all groups. However, older women (n = 7) may have benefited from a larger (P less than 0.05) early metabolic (M) increase (40% within 15 min) than young men (18%) (n = 10), young women (5%) (n = 10), or older men (5%) (n = 10). A similar rapid M response in older women occurred during the 15 degrees C exposure. During all cold exposures, older women maintained constant rectal temperature (Tre) and young women maintained Tre only during the 20 degrees C exposures, whereas Tre of the men declined during all cold exposures (P less than 0.01). Changes in Tre and mean skin temperature (Ts) during cold exposure were largely related to body fat, although age and surface area/mass modified the changes in men. The data suggest that older men are more susceptible to cold ambients than younger people, since they did not prevent a further decline in their initially relatively low Tre. Despite greater insulation from body fat, the older women maintained a constant Tre at greater metabolic cost than men or younger women. PMID- 3968010 TI - Cardiovascular reactions to cold exposures differ with age and gender. AB - This study was conducted since virtually no information was available concerning age- and gender-related differences in cardiovascular adjustments to cold exposure. Men and women between the ages of 20 and 30 and 51 and 72 yr, wearing swim suits, rested for 2 h in 28, 20, 15, and 10 degrees C ambient temperatures (Ta), with 40% relative humidity. Cardiac output (Qc) and stroke volumes (Qs) were higher in younger than older subjects regardless of Ta. Cardiac output was not influenced by gender, but all cold exposures resulted in increased Qs and decreased heart rate in men but not women. Regardless of age or gender, Qc increased about 10% only during exposure to 10 degrees C. Cold exposure resulted in minimal increases in the mean systolic and diastolic pressures (Pa) of the younger subjects. The Pa of older subjects were higher than in the young during 28 degrees C exposures and increased during all cold exposures. Total peripheral resistance and forearm blood flows were higher in older than young subjects exposed to cold. Total peripheral resistance, systolic and diastolic Pa, and finger and forearm blood flows were not affected by gender, but hand plus forearm blood flows were higher in men than women exposed to 28 degrees C. Although Qc appeared adequate to meet increased oxygen demands of shivering in the older subjects, rising Pa may become limiting in extended exposures. A similar response in hypertensive or angina-prone individuals may result in some untoward responses. PMID- 3968011 TI - Determination of cardiac output using ensemble-averaged impedance cardiograms. AB - Although impedance cardiography provides safe and reliable noninvasive estimates of stroke volume in humans, its usefulness is limited by the necessity for subjects to be apneic and motionless. In an effort to circumvent this restriction we studied the validity of ensemble-averaging of impedance data in exercising normal subjects and in intensive-care patients. The correlation coefficient (r value) between 128 ensemble-averaged and standard hand-digitized determinations of stroke volume index from the same records taken during rest and exercise in six normal male subjects was +0.97 (P less than 0.001). The r value for ensemble averaged stroke volume indices during free breathing and breath hold in the same subjects was +0.92 (P less than 0.001), suggesting that breath hold did not significantly affect the stroke volume estimation. In 14 freely breathing hospital intensive-care patients the r value between simultaneous thermodilution cardiac output readings and ensemble-averaged impedance determinations was +0.87 (P less than 0.01). The results indicate that ensemble-averaging of transthoracic impedance data provides waveforms from which reliable estimates of cardiac output can be made during normal respiration in healthy human subjects at rest and exercise and in critically ill patients. PMID- 3968012 TI - Quantitative deposition of ultrafine stable particles in the human respiratory tract. AB - Theoretical models of particle deposition in the respiratory tract predict high fractional deposition for particles of less than 0.1 micron, but there are few confirming experimental data for those predictions. We have measured the deposition fraction of a nonhygroscopic aerosol in the human respiratory tract. The aerosol had a count mean diameter of 0.044 micron SD of 1.93, as measured with an electrical aerosol analyzer, and was produced from a 0.01% solution of bis(2-ethylhexyl) sebacate using a condensation generator. Subjects inhaled the aerosol using a controlled respiratory pattern of 1 liter tidal volume, 12/min. Deposition was calculated as the difference in concentration between inhaled and exhaled aerosol of five size fractions corrected for system deposition and dead space constants. Three deposition studies were done on each of five normal male volunteers. Means (+/- SE) for the five size fractions were 0.024 micron, 0.71 +/ 0.06; 0.043 micron, 0.62 +/- 0.06; 0.075 micron, 0.53 +/- 0.05; 0.13 micron, 0.44 +/- 0.04; and 0.24 micron, 0.37 +/- 0.06. These data demonstrate that deposition of inhaled particles in the 0.024- to 0.24-micron size range is high and increases with decreasing size. These observations agree with and validate predictions of mathematical models. PMID- 3968013 TI - Relationship of transdiaphragmatic pressure and latencies for detecting added inspiratory loads. AB - The purpose of this investigation was to measure changes in transdiaphragmatic pressure (Pdi) developed during graded elastic (E) and resistive (R) loaded breaths and to correlate the emergence of such changes with the load-dependent alterations in latency for detection (Tdet). Five healthy adults were studied using three protocols, i.e., graded E, graded R, and graded R in the presence of elevated background R. In each protocol, loads were added for single inspirations, 10 times in random order and separated by three to five unloaded breaths. Subjects pressed a signal marker as soon as loads were detected. Inspiratory flow (VI), inspired volume (VI), mouth pressure, and Pdi of loaded breaths and the preceding unloaded breaths were recorded and computer averaged. Patterns of VI and VI were not altered prior to detection of the smallest added E and R loads but decreased with the higher loads. Group mean patterns of Pdi showed graded increases during loaded breaths. Augmentation of Pdi preceded Tdet and occurred earlier as Tdet decreased with graded E and R loads. Elevating the background R delayed both Tdet of added R and the augmentation of Pdi. Results are consistent with the hypothesis that load-induced changes in diaphragmatic tension may play a sensory role in detection of inspiratory loads. PMID- 3968014 TI - Interaction of local and reflex thermal effects in control of forearm blood flow. AB - We measured forearm blood flow (ABF) bilaterally on six subjects during 15-min periods of leg exercise and the first 10 min of recovery. One forearm (control) was kept at about 33 degrees C skin temperature in all experiments. In experiments at ambient temperature (Ta) of 15 degrees C, the other arm (experimental) was kept at about 26, 33, and 40 degrees C, respectively, during three successive cycles of exercise and recovery. ABF in the 26 degrees C forearm was linearly related to and averaged 42% of control. The relation of ABF in the 40 degrees C forearm to control ABF showed a bend at control ABF of 4-5 ml X 100 ml-1 X min-1. Below the bend, experimental ABF average 213% of control. Above the bend, experimental ABF averaged 5.09 ml X 100 ml-1 X min-1 above control. In four subjects, after heating the experimental forearm to 40 degrees C, we measured ABF for 25-30 min at rest in Ta of both 15 and 25 degrees C. At 25 degrees C Ta, ABF in the heated forearms rose gradually, but control ABF showed little change. At 15 degrees C Ta, the effect on ABF of local heating to 40 degrees C was much reduced, apparently due to reflex vasoconstrictor signals. PMID- 3968015 TI - Reflex effects and receptor responses to upper airway pressure and flow stimuli in developing puppies. AB - We studied the changes in breathing pattern due to pressure and airflow stimuli applied to isolated upper airway in nine 1- to 14-day-old and six 29- to 35-day old anesthetized puppies breathing through a tracheostomy. Negative-pressure and flow, both inspiratory and expiratory, altered the breathing pattern only in the 1- to 14-day-old puppies, whereas positive pressure was ineffective in both age groups. Negative pressure caused apnea in 12% of the trials, expiratory flow in 18%, and inspiratory flow in 21%. When apnea did not occur there was a significant prolongation of inspiratory and expiratory time and a decrease of tidal volume of the first breath following the application of negative pressures. Section of the superior laryngeal nerves abolished the responses to pressure and flow. In nine 1- to 14-day-old and four 29- to 35-day-old puppies we recorded the activity of single units of the superior laryngeal nerves. We identified specialized receptors responding to pressure (68.5%), flow (2.7%), and contraction of upper airway muscles (drive, 28.8%). All types of receptors had a prevalent inspiratory-related activity. In the younger age group the discharge rate of pressure receptors at comparable negative pressures was lower than in older puppies. The strong inhibitory influences originating from the upper airway in the early stages of development presumably reflect different integrative properties of the central nervous system. PMID- 3968016 TI - Effects of contraction frequency and duty cycle on diaphragmatic blood flow. AB - The effects of diaphragmatic contraction frequency (no. of intermittent tetanic contractions/min) at a given tension-time index and of duty cycle (contraction time/total cycle time) on diaphragmatic blood flow were measured in anesthetized mongrel dogs during bilateral supramaximal phrenic nerve stimulation. Diaphragmatic blood flow was measured by the radionuclide-labeled microsphere method. Contraction frequency was varied between 10 and 160/min at duty cycles of 0.25 and 0.75. Diaphragmatic blood flow increased with contraction frequency from 1.47 +/- 0.13 ml X min-1 X g-1 (mean +/- SE) at an average of 18/min to 2.65 +/- 0.16 ml X min-1 X g-1 at 74/min (P less than 0.01) with a duty cycle of 0.25 and from 1.32 +/- 0.19 ml X min-1 X g-1 at an average of 15/min to 1.96 +/- 0.15 ml X min-1 X g-1 at 80/min (P less than 0.02) with a duty cycle of 0.75. At higher contraction frequencies diaphragmatic blood flow did not increase further at both duty cycles. In addition, diaphragmatic blood flow was higher with a duty cycle of 0.25 than 0.75 at all contraction frequencies. We conclude that frequency of contraction is a major determinant of diaphragmatic blood flow and that high duty cycle impedes diaphragmatic blood flow. PMID- 3968017 TI - Partitioning of respiratory mechanics in halothane-anesthetized humans. AB - In five spontaneously breathing anesthetized subjects [halothane approximately 1 minimal alveolar concentration (MAC), 70% N2O, 30% O2], flow, changes in lung volume, and esophageal and airway opening pressure were measured in order to partition the elastance (Ers) and flow resistance (Rrs) of the total respiratory system into the lung and chest wall components. Ers averaged (+/- SD) 23.0 +/- 4.9 cmH2O X l-1, while the corresponding values of pulmonary (EL) and chest wall (EW) elastance were 14.3 +/- 3.2 and 8.7 +/- 3.0 cmH2O X l-1, respectively. Intrinsic Rrs (upper airways excluded) averaged 2.3 +/- 0.2 cmH2O X l-1 X s, the corresponding values for pulmonary (RL) and chest wall (RW) flow resistance amounting to 0.8 +/- 0.4 and 1.5 +/- 0.5 cmH2O X l-1 X s, respectively. Ers increased relative to normal values in awake state, mainly reflecting increased EL. Rw was higher than previous estimates on awake seated subjects (approximately 1.0 cmH2O X l-1 X s). RL was relatively low, reflecting the fact that the subjects had received atropine (0.3-0.6 mg) and were breathing N2O. This is the first study in which both respiratory elastic and flow-resistive properties have been partitioned into lung and chest wall components in anesthetized humans. PMID- 3968018 TI - Assessment of pharyngeal airway stability in normal and micrognathic infants. AB - A current hypothesis for obstructive sleep apnea states that 1) negative airway pressure during inspiration can collapse the pharyngeal airway, and 2) neural control of pharyngeal airway-dilating muscles is important in preventing this collapse. To test this hypothesis we performed nasal mask occlusions to increase negative pharyngeal airway pressures during inspiration in eight normal and five micrognathic infants. Both groups developed midinspiratory pharyngeal obstruction, but obstruction was more frequent in micrognathic infants and varied in some infants with sleep state. The airway usually reopened with the subsequent expiration. The occasional failure to reopen was presumably due to pharyngeal wall adhesion. If airway obstruction occurred in sequential breaths during multiple-breath nasal mask occlusions in normal infants, there was a breath-by breath change in the airway pressure associated with airway closure (airway closing pressure); the airway closing pressure became progressively more negative. Micrognathic infants showed less ability to improve the airway closing pressure, but this ability increased with age. These findings suggest that nasal mask occlusion can test the competence of the neuromuscular mechanisms that maintain pharyngeal airway patency in infants. Micrognathic infants had spontaneous midinspiratory pharyngeal airway obstructions during snoring. Their episodes of obstructive apnea began with midinspiratory pharyngeal obstruction similar to that seen during snoring and nasal mask occlusions. These findings imply a similar pathophysiology for snoring, spontaneous airway obstruction, and obstruction during snoring. PMID- 3968019 TI - Molar absorptivities of human hemoglobin in the visible spectral range. PMID- 3968020 TI - Peripheral blood flow during rewarming from mild hypothermia in humans. AB - During the initial stages of rewarming from hypothermia, there is a continued cooling of the core, or after-drop in temperature, that has been attributed to the return of cold blood due to peripheral vasodilatation, thus causing a further decrease of deep body temperature. To examine this possibility more carefully, subjects were immersed in cold water (17 degrees C), and then rewarmed from a mildly hypothermic state in a warm bath (40 degrees C). Measurements of hand blood flow were made by calorimetry and of forearm, calf, and foot blood flows by straingauge venous occlusion plethysmography at rest (Ta = 22 degrees C) and during rewarming. There was a small increase in skin blood flow during the falling phase of core temperature upon rewarming in the warm bath, but none in foot blood flow upon rewarming at room air, suggesting that skin blood flow seems to contribute to the after-drop, but only minimally. Limb blood flow changes during this phase suggest that a small muscle blood flow could also have contributed to the after-drop. It was concluded that the after-drop of core temperature during rewarming from mild hypothermia does not result from a large vasodilatation in the superficial parts of the periphery, as postulated. The possible contribution of mechanisms of heat conduction, heat convection, and cessation of shivering thermogenesis were discussed. PMID- 3968021 TI - Effects of chronic exercise during aging on muscle and end-plate morphology in rats. AB - Terminal sprouting, myofiber atrophy, and fiber type changes were studied in soleus and distal gastrocnemius muscles of 21- and 26-mo-old rats and in rats who performed treadmill running from 21 to 26 mo. End-plate structure and muscle fiber types were demonstrated by staining for acetylcholinesterase and myosin ATPase activity. Terminal sprouting was expressed as the percentage of end plates with growth configurations. Fiber atrophy was assessed as percentage of small diameter fibers. In all three groups, the percentage of small-diameter fibers was significantly smaller and the percentage of growth configurations significantly larger in the soleus than in the gastrocnemius. The exercised-soleus group had a significantly higher percentage of growth configurations than the 26-mo controls, which had a higher percentage than the 21-mo controls. Percentages among gastrocnemius groups were not different. Fiber type was similar among gastrocnemius groups. However, the exercised-soleus had significantly more slow twitch fibers than the controls. These data suggest that the soleus responds differently to chronic exercise during aging than does the gastrocnemius. PMID- 3968022 TI - Influence of the heart on the vertical gradient of transpulmonary pressure in dogs. AB - Estimations were made of the vertical gradient of transpulmonary pressure (VGTP) from measurements of esophageal pressure in nine head-up dogs at functional residual capacity (FRC) when alive, when dead, and after total bilateral pneumothorax. The VGTP of 0.4 cmH2O/cm height in the alive state was abolished by pneumothorax, and roentgenograms showed that the heart moved in a caudal-dorsal direction. There was a small but significant increase in the VGTP on going from FRC to near total lung capacity (TLC) in alive head-up dogs. In eight dead head up dogs heart weight was increased by replacing various amounts of heart blood with Hg. The VGTP was significantly increased from 0.28 to 0.51 cmH2O/cm height. The fractional increase in the VGTP was similar to the fractional increase in heart weight. In five dogs extrapolation to zero heart weight gave an average VGTP of 0.14 cmH2O/cm height. We conclude that the lungs help support the heart in the head-up dog and that the VGTP is in part determined by the pressure distribution required for this support. PMID- 3968023 TI - Bilateral phrenic stimulation: a simple technique to assess diaphragmatic fatigue in humans. AB - Transdiaphragmatic pressure (Pdi) and the rate of relaxation of the diaphragm (tau) were measured at functional residual capacity (FRC) in six normal seated subjects during single-twitch stimulation of both phrenic nerves. The latter were stimulated supramaximally with needle electrodes with square-wave impulses of 0.1 ms duration at 1 Hz before and after diaphragmatic fatigue produced by resistive loaded breathing. Constancy of chest wall configuration was achieved by monitoring the diameter of the abdomen and the rib cage with a respiratory inductive plethysmograph system. During control the peak Pdi generated during the phrenic stimulation amounted to 34.4 +/- 4.2 (SE) cmH2O and represented in each subject a fixed fraction (17%) of its maximal transdiaphragmatic pressure. After diaphragmatic fatigue the peak Pdi decreased by an average of 45%, amounting to 18.1 +/- 2.7 cmH2O 5 min after the fatigue run, and tau increased from 55.2 +/- 9 ms during control to 77 +/- 8 ms 5 min after the fatigue run. The decrease in peak Pdi and the increase in tau observed after the fatigue run persisted throughout the 30 min of the recovery period studied, the peak Pdi amounting to 18.4 +/- 2.8 and 18.9 +/- 3.3 cmH2O and tau to 81.3 +/- 5.7 and 88.7 +/- 10 ms at 15 and 30 min after the end of the fatigue run, respectively. It is concluded that diaphragmatic fatigue can be detected in man by bilateral phrenic stimulation with needle electrodes without any discomfort for the subject and that the decrease in diaphragmatic strength after fatigue is long lasting. PMID- 3968024 TI - Fatigue and contraction of slow and fast muscles in hypokinetic/hypodynamic rats. AB - This investigation examined the effects of hypokinesia/hypodynamia (H/H) on fatigability and contractile properties of rat soleus (S) and gastrocnemius (G) muscles. Whole-body suspension for 1 wk was used to eliminate hindlimb load bearing functions and simultaneously permit voluntary isotonic contractions. Train stimulations (45/min, 16 min) resulted in significantly (P less than 0.05) faster rates of fatigue to lower asymptotes in G from H/H rats. Fatigue in the S was minimal at this stimulation frequency and differences between H/H and control animals were not significant. Contractile properties (twitch and tetanic) were measured before and after train stimulations. H/H suspension resulted in an increased twitch tension in G. However, H/H did not change train or tetanic tensions per gram or other G contractile properties. Peak twitch, train, and tetanic tensions, time to peak tension, one-half relaxation time, and twitch and tetanic peak rates of tension development and decline were unchanged by H/H in S muscles. These results indicate that 1 wk of H/H-induced muscle atrophy significantly increases fatigability in G but does not effect contractile properties of fast-twitch (G) or slow-twitch (S) muscles. PMID- 3968025 TI - Effect of outflow pressure on lung lymph flow in unanesthetized sheep. AB - Studies in anesthetized animals have shown that the flow rate from lung lymphatics (QL) depends on the pressure at the outflow end of the vessels (Po). We tested this in unanesthetized sheep prepared with chronic lung lymph cannula. We measured QL with the lymph cannula held at various heights above the olecranon and calculated Po as the height + QL X cannula resistance. QL decreased with increases in Po (delta QL/delta Po = -8.2 +/- 6.4 microliter X min-1 X cmH2O-1, mean +/- SD). We increased QL by raising left atrial pressure or infusing Ringer solution or Escherichia coli endotoxin and found that QL was even more sensitive to Po (delta QL/delta Po = -32 +/- 22). Cannula resistance caused a 9-70% reduction in QL. Changes in QL caused by increasing Po were not associated with changes in lymph protein concentration for up to 330 min. This indicates that increases in Po shunt lymph away from cannulated vessels but do not substantially effect microvascular filtration rate. The shunted lymph may flow into other vessels or collect in the lung. We conclude that QL does not accurately represent microvascular filtration rate because it depends on the cannula resistance and position at which the investigator chooses to place the cannula. PMID- 3968026 TI - A theory of diffuse light scattering by lungs. AB - We present a theoretical treatment of backscattered light from the interior of a lung illuminated by a thin beam of light normally incident on the pleural surface. An approximate formula is developed describing how the backscattered intensity varies with distance from the point of light entry. This is shown to depend markedly on the optical mean free path and on the effective extinction coefficient. We attempt to relate the optical mean free path to the mean alveolar size. This relationship is found to depend primarily on septal reflection and refraction. Reflection is treated quantitatively. Refraction is much more difficult and may have to be approached empirically. We present here the rudiments of a technique with implications for the possibility of dynamic stereology. PMID- 3968027 TI - Light scattering by lungs correlates with stereological measurements. AB - The pattern of light backscattered by lung tissue should depend strongly on the size of air spaces and equivalently on the internal surface area of the lung. To verify and apply this, we shone a laser beam into excised lungs through the pleural surface and measured the backscattered light surrounding the beam with a focused photodetector. The intensity, I, fell off as a function of distance, r, from the point of entry of light. The configurations of I(r) curves corresponded closely to theory over a 3-decade range of I. I(r) changed systematically with lung volume. The optical mean free path, lambda, was calculated from I(r) curves in a series of canine lobes fixed immediately after optical scanning and was compared with stereological measurement of mean linear intercept, Lm, an index of alveolar size. At high lung volumes the relation of lambda to Lm was consistent with reflection by alveolar septa. At lower lung volumes there appeared to be, additionally, a substantial refractive component. This technique is independent of current stereological methods and has the advantages of being noninvasive, continuous, and potentially applicable to dynamic events in unfixed lungs. PMID- 3968028 TI - Nodules are induced on alfalfa roots by Agrobacterium tumefaciens and Rhizobium trifolii containing small segments of the Rhizobium meliloti nodulation region. AB - Regions of the Rhizobium meliloti nodulation genes from the symbiotic plasmid were transferred to Agrobacterium tumefaciens and Rhizobium trifolii by conjugation. The A. tumefaciens and R. trifolii transconjugants were unable to elicit curling of alfalfa root hairs, but were able to induce nodule development at a low frequency. These were judged to be genuine nodules on the basis of cytological and developmental criteria. Like genuine alfalfa nodules, the nodules were initiated from divisions of the inner root cortical cells. They developed a distally positioned meristem and several peripheral vascular bundles. An endodermis separated the inner tissues of the nodule from the surrounding cortex. No infection threads were found to penetrate either root hairs or the nodule cells. Bacteria were found only in intercellular spaces. Thus, alfalfa nodules induced by A. tumefaciens and R. trifolii transconjugants carrying small nodulation clones of R. meliloti were completely devoid of intracellular bacteria. When these strains were inoculated onto white clover roots, small nodule-like protrusions developed that, when examined cytologically, were found to more closely resemble roots than nodules. Although the meristem was broadened and lacked a root cap, the protrusions had a central vascular bundle and other rootlike features. Our results suggest that morphogenesis of alfalfa root nodules can be uncoupled from infection thread formation. The genes encoded in the 8.7 kilobase nodulation fragment are sufficient in A. tumefaciens or R. trifolii backgrounds for nodule morphogenesis. PMID- 3968029 TI - Presence and regulation of the alpha-ketoglutarate dehydrogenase multienzyme complex in the filamentous fungus Aspergillus niger. AB - alpha-Ketoglutarate dehydrogenase has been demonstrated for the first time in cell extracts from the filamentous fungus Aspergillus niger. A minimum protein concentration of 5 mg/ml is necessary for detecting enzyme activity, but a maximum of ca. 0.060 mumol/min per mg of protein is observed only when the protein concentration is above 9 mg/ml. alpha-Ketoglutarate can partly stabilize the enzyme against dilution in the assay system. Neither bovine serum albumin nor a variety of substrates or effectors of the enzyme could stabilize the enzyme against inactivation by dilution. A kinetic analysis of the enzyme revealed Michaelis-Menten kinetics with respect to alpha-ketoglutarate, coenzyme A, and NAD. Thiamine PPi was required for maximal activity. NADH, oxaloacetate, succinate, and cis-aconitate were found to inhibit the enzyme; AMP was without effect. Monovalent cations including NH4+ were inhibitory at high concentrations (greater than 20 mM). The highest enzyme activity was found in rapidly growing mycelia (glucose-NH4+ or glucose-peptone medium). We discuss the possibility that citric acid accumulation is caused by oxaloacetate and NADH inhibition of the alpha-ketoglutarate dehydrogenase of A. niger. PMID- 3968030 TI - Phospholipids and lipopolysaccharide of Aeromonas hydrophila. AB - The phospholipids and lipopolysaccharide of Aeromonas hydrophila were characterized. Phosphatidylethanolamine and phosphatidylglycerol were the major phospholipid components. The outer membrane contained more phosphatidylethanolamine and less phosphatidylglycerol than the inner membrane, and the phospholipids of the outer membrane contained a higher proportion of saturated fatty acids. Only four fatty acids (C14:0, C16:0, C16:1, and C18:1) were found in the phospholipids. The lipopolysaccharide of A. hydrophila did not contain the eight-carbon sugar 3-deoxyoctulosonic acid nor did it contain C16:0, both of which are typical constituents of the lipopolysaccharide of many other species. PMID- 3968031 TI - Genetic and physical map of the 2,4-dichlorophenoxyacetic acid-degradative plasmid pJP4. AB - Plasmid pJP4 is an 80-kilobase, IncP1, broad-host-range conjugative plasmid of Alcaligenes eutrophus encoding resistance to mercuric chloride and phenyl mercury acetate and degradation of 2,4-dichlorophenoxyacetic acid, 2-methyl-4 chlorophenoxyacetic acid, and 3-chlorobenzoate. By the use of cloning, transposon mutagenesis, and restriction endonuclease analysis, a biophysical and genetic map of pJP4 was generated. PMID- 3968032 TI - Location and characteristics of enzymes involved in the breakdown of polygalacturonic acid by Bacteroides thetaiotaomicron. AB - When Bacteroides thetaiotaomicron is grown in medium which contains polygalacturonic acid (PGA) as the sole carbon source, two different polygalacturonases are produced: a PGA lyase (EC 4.2.2.2) and a PGA hydrolase (EC 3.2.1.15). Both enzymes are cell associated. The PGA hydrolase appears to be an inner membrane protein. The PGA lyase is a soluble protein that associates with membranes under certain conditions. The PGA lyase was purified to apparent homogeneity. It has a molecular weight (from sodium dodecyl sulfate polyacrylamide gel electrophoresis) of 74,000, a pH optimum of 8.7, a pI of 7.5, and a Km for PGA of 40 to 70 micrograms/ml. It requires calcium for maximal activity. The main product of this enzyme appears to be a disaccharide that contains a delta 4,5-unsaturated galacturonic acid residue. The PGA hydrolase can be solubilized from membranes with 2% Triton X-100 and has been partially purified. It has a pH optimum of 5.4 to 5.5, a pI of 4.7 to 4.9, and a Km for PGA of 350 to 400 micrograms/ml. The main product of this enzyme appears to be galacturonic acid. The specific activities of both PGA hydrolase and PGA lyase increase at the same rate when bacteria are exposed to PGA. The two enzymes therefore appear to be similarly regulated. PMID- 3968033 TI - Expression of cytochrome o in hydrogen uptake constitutive mutants of Rhizobium japonicum. AB - Mutant strains of Rhizobium japonicum constitutive for H2 uptake activity (Hupc) contained significantly more membrane-bound b-type cytochrome than did the wild type when grown heterotrophically. The Hupc strains contained approximately three times more dithionite- and NADH-reducible CO-reactive b-type cytochrome than did the wild type; the absorption features of the CO spectra were characteristic of cytochrome o. This component, designated cytochrome b', was not reduced by NADH in the presence of cyanide. Cytochrome o from the wild type (SR) and cytochrome b' from mutants SR476 and SR481 bound to CO with similar dissociation constants of 5.4, 7.4, and 5.6 microM, respectively. NADH-dependent reduction of cytochrome b' from SR476 and SR481 and the cytochrome o from SR followed pseudo-first-order kinetics with similar rate constants. Based on these spectral, ligand-binding, and kinetic measurements, it was concluded that cytochrome b' expressed by the Hupc mutants is equivalent to cytochrome o found in the wild type. H2, NADH, and succinate each reduced the same amount of total b-type cytochrome in membranes from SR481, and the rate of H2-dependent cytochrome o reduction was significantly less than with succinate or NADH as the reductants. It was concluded that neither cytochrome o nor any b-type cytochrome expressed by the Hupc mutants was unique to the H2 oxidation system. At low O2 concentrations, the inhibition of H2 and NADH oxidase activities by CO closely paralleled the binding of CO to cytochrome o rather than cytochromes a3 or c'. This suggested that NADH and H2 oxidation involved primarily cytochrome o as the terminal oxidase at low O2 tensions. PMID- 3968034 TI - Genetic analysis of integration mediated by single T-DNA borders. AB - Transformation of plant cells by the T-DNA of the Ti plasmid of Agrobacterium tumefaciens depends in part upon a sequence adjacent to the right T-DNA end. When this sequence is absent, the T-DNA is almost avirulent; when it is present, DNA between it and the left T-DNA border region becomes integrated in plants. To investigate further this process of DNA transfer and integration, we introduced the right border region and the nopaline synthase (nos) gene of plasmid pTiC58 into a variety of new positions around Ti plasmids. The border region functioned when separated from the remainder of the T-DNA by almost 50 kilobases. It also worked when placed outside of the T-DNA region where there were no known left border sequences with which to interact. Indeed, the nos gene could be transferred to plants even when no other Ti plasmid sequences were present on the same plasmid. These results may indicate that the sequence requirements for the left borders are not as stringent as those for the right borders. In addition, mutants with an extra copy of the right border region within their T-DNA were found to transfer or integrate only parts of the bacterial T-DNA region. It is possible that abnormally placed T-DNA borders interfere with the normal process of DNA transfer, integration, or both. PMID- 3968035 TI - Isolation and characterization of Erwinia chrysanthemi mutants defective in degradation of hexuronates. AB - Spontaneous and Tn9-induced mutants of Erwinia chrysanthemi were isolated which affect the degradative pathway of galacturonate and ketodeoxygluconate. The mutations were characterized both biochemically and functionally by complementation analysis and localized in the E. chrysanthemi chromosome. The kdgK gene mapped very close to ile, the kdgA gene was between trp and his, and the exuT-uxaC-uxaB-uxaA cluster was linked to thy. The different types of mutants obtained were consistent with an organization of the exu-uxa cluster into two transcription units, one containing the exuT gene, and the other containing the three uxa genes, with the transcription going from uxaC to uxaA. PMID- 3968036 TI - Immunological and structural relatedness of catabolic ornithine carbamoyltransferases and the anabolic enzymes of enterobacteria. AB - Purified catabolic ornithine carbamoyltransferase of Pseudomonas putida and anabolic ornithine carbamoyltransferase (argF product) of Escherichia coli K-12 were used to prepare antisera. The two specific antisera gave heterologous cross reactions of various intensities with bacterial catabolic ornithine carbamoyltransferases formed by Pseudomonas and representative organisms of other bacterial genera. The immunological cross-reactivity observed only between the catabolic ornithine carbamoyltransferases and the anabolic enzymes of enterobacteria suggests that these proteins share some structural similarities. Indeed, the amino acid composition of the anabolic ornithine carbamoyltransferase of E. coli K-12 (argF and argI products) closely resembles the amino acid compositions of the catabolic enzymes of Pseudomonas putida, Aeromonas formicans, Streptococcus faecalis, and Bacillus licheniformis. Comparison of the N-terminal amino acid sequence of the E. coli anabolic ornithine carbamoyltransferase with that of the A. formicans and Pseudomonas putida catabolic enzymes shows, respectively, 45 and 28% identity between the compared positions; the A. formicans sequence reveals 53% identity with the Pseudomonas putida sequence. These results favor the conclusion that anabolic ornithine carbamoyltransferases of enterobacteria and catabolic ornithine carbamoyltransferases derive from a common ancestral gene. PMID- 3968037 TI - Iron-regulated outer membrane protein OM2 of Vibrio anguillarum is encoded by virulence plasmid pJM1. AB - Vibrio anguillarum 775 harboring the virulence plasmid pJM1 synthesized an outer membrane protein of 86 kilodaltons, OM2, that was inducible under conditions of iron limitation. pJM1 DNA fragments obtained by digestion with restriction endonucleases were cloned into cosmid vectors and transferred into Escherichia coli. The OM2 protein was synthesized in E. coli, demonstrating that it is actually encoded by the pJM1 plasmid. Mobilization of the recombinant plasmids to V. anguillarum was accomplished by using the transfer factor pRK2013. A V. anguillarum exconjugant harboring the recombinant derivative pJHC-T7 and synthesizing the OM2 protein took up 55Fe3+ and grew under iron-limiting conditions, only in presence of the pJM1-mediated siderophore. Exconjugants harboring recombinant plasmids, such as pJHC-T2 which did not encode the OM2 protein, were transport negative. Membrane protein iodination experiments, together with protease treatment of whole cells, indicated that the OM2 protein is exposed to the outside environment of the V. anguillarum cells. PMID- 3968038 TI - Three-dimensional architecture of the cell sheath and septa of Methanospirillum hungatei. AB - The methanogenic bacterium Methanospirillum hungatei exists as filaments which have a very unusual cell wall architecture, comprising a long cylindrical sheath within which there may be many individual cells arranged in a line. The sheath has a two-dimensional crystalline structure, and the cells are separated within the tube by septa which also have a crystalline structure. We have used computer image processing of tilted-view electron micrographs to analyze the structure in negative stains of both of these components in three dimensions. The repeating unit of the sheath consists of four approximately spherical domains ca. 2.5 nm in diameter arranged in a row. Based on observations of the type of lattice imperfections that occur, we suggest that each of the domains represents a separate polypeptide subunit and that the subunits are incorporated into the wall one by one. The septa are circular plates of remarkably constant size. They are normally found as double layers. They are hexagonally symmetrical and consist of trimerically associated subunits which interact about dimer axes to form an open network containing large pores ca. 15 nm in diameter. PMID- 3968039 TI - Specific attachment of Agrobacterium tumefaciens to bamboo cells in suspension cultures. AB - Agrobacterium tumefaciens was tested for its ability to attach to tissue culture cells of bamboo, a monocotyledonous plant. Phase-contrast microscopy and kinetic experiments with radiolabeled bacteria showed that attachment to bamboo cells was indistinguishable from attachment to cells of dicotyledonous plants. Bacterial mutants defective in attachment to dicotyledonous plants showed similar behavior with bamboo, and extensive washing of the bamboo cells had no effect on the number of bacteria which attached. PMID- 3968040 TI - Role of ubiquinone in hydrogen-dependent electron transport in Rhizobium japonicum. AB - Direct evidence for the involvement of ubiquinone in H2 oxidation by Rhizobium japonicum was demonstrated; H2 reduced ca. 80% of the extractable ubiquinone. The inhibitor 2-n-heptyl-4-hydroxyquinoline-N-oxide blocked electron transport at a site between ubiquinone and the cytochromes. The results showed that no cytochrome component mediates electron flow from hydrogen to ubiquinone. PMID- 3968041 TI - Efficient transformation of Erwinia carotovora subsp. carotovora and E. carotovora subsp. atroseptica. AB - We used a modified version of the method of Hanahan (D. Hanahan, J. Mol. Biol. 166:557-580, 1983) to transform Erwinia carotovora subsp. carotovora and E. carotovora subsp. atroseptica with the plasmids pBR322, pBR325, and pAT153. The transformation frequency ranged from 1 X 10(2) to 4 X 10(4) colonies per micrograms of plasmid DNA. The nature of these transformants was confirmed by plasmid analysis. ColE1-based plasmids make potentially useful cloning vectors for the study of genes involved in the pathogenesis of this species. PMID- 3968042 TI - Mineralization and heat resistance of bacterial spores. AB - The heat resistances of the fully demineralized H-form spores of Bacillus megaterium ATCC 19213, B. subtilis var. niger, and B. stearothermophilus ATCC 7953 were compared with those of vegetative cells and native spores to assess the components of resistance due to the mineral-free spore state, presumably mainly from dehydration of the spore core, and to mineralization. Mineralization greatly increased heat resistance at lower killing temperatures but appeared to have much less effect at higher ones. PMID- 3968043 TI - Isolation of a DNA fragment containing replication functions from IncP2 megaplasmid pMG2. AB - Replication functions with IncP2 specificity were identified on a 3-kilobase DNA fragment isolated from the 400-kilobase Pseudomonas megaplasmid pMG2. PMID- 3968044 TI - Occurrence of 2-keto-deoxyoctonic acid 5-phosphate in lipopolysaccharides of Vibrio cholerae Ogawa and Inaba. AB - A phosphorylated 2-keto-3-deoxyoctonic acid (KDO) was released from the lipopolysaccharides of Vibrio cholerae Ogawa and Inaba after strong acid hydrolysis. The phosphorylated KDO was identified by gas-liquid chromatography and mass spectrometry after reduction and permethylation as KDO-5-phosphate and an isomer of it being phosphorylated at position 7 or 8. After treatment with alkaline phosphatase, KDO was detected by gas-liquid chromatography and mass spectrometry. It was indistinguishable from authentic 2-keto-3-deoxy-D-manno octonic acid. PMID- 3968045 TI - Borderline: an adjective in search of a noun. AB - Outpatients diagnosed as borderline (N = 100) were prospectively followed for 6 36 months and examined from phenomenologic developmental, and family history perspectives. At index evaluation, 66 met criteria for recurrent depressive, dysthymic, cyclothymic, or bipolar II disorders, and 16 for those of schizotypal personality. Other subgroups included sociopathic, somatization, panic agoraphobic, attention deficit, epileptic, and identify disorders. Compared with nonborderline personality controls, borderlines had a significantly elevated risk for major affective but not for schizophrenic breakdowns during follow-up. Prominent substance abuse history, tempestuous biographies, and unstable early home environment were common to all diagnostic subgroups. In family history, borderlines were most like bipolar controls, and differed significantly from schizophrenic, unipolar, and personality controls. It is concluded that, despite considerable overlap with subaffective disorders, the current adjectival use of this rubric does not identify a specific psychopathologic syndrome. PMID- 3968046 TI - The long-term management of bipolar disorders with lithium, carbamazepine, and antidepressants. AB - Carbamazepine is gaining recognition as a valuable drug in the treatment of patients with bipolar disorders who fail to respond to lithium. Clinical experience in the treatment of 90 bipolar patients is described: 48% responded to lithium alone or in combination with other standard drug treatments. A subgroup of 34 lithium nonresponders were treated with carbamazepine; of these, 17 (50%) responded to carbamazepine and 5 responded to carbamazepine plus lithium, for a total response rate of 65%. Issues of side effects, blood levels, and compliance are discussed. These observations support the efficacy and safety of carbamazepine and suggest the need for well-controlled double-blind studies. PMID- 3968047 TI - Euthyroid hyperthyroxinemia and rapid cycling affective disorder: case report. AB - A 32-year-old woman with rapid cycling bipolar illness had numerous clinical problems throughout 19 affective episodes and six hospital admissions within 34 months. Persistent hyperthyroxinemia, always associated with manic episodes, led to a diagnostic work-up that ruled out a primary thyroid dysfunction and pointed to oral contraceptives, appetite suppressants, and psychiatric illness as likely causes of elevated T4 values. The contention that an underlying thyroid hypofunction is the basis of rapid cycling is questioned. The extent to which a bipolar disorder increases T4 levels and the role of euthyroid hyperthyroxinemia in the pathogenesis of rapid cycling are discussed. PMID- 3968048 TI - Use of ECT in a depressed hypothyroid patient. AB - A case is presented in which a patient with recurrent unipolar depression responded to ECT, despite concurrent hypothyroidism. The relationship between thyroid function and response to antidepressant therapy is discussed. PMID- 3968049 TI - Disulfiram hepatotoxicity: case report. AB - Disulfiram has been widely used as an adjunct in the treatment of alcoholism and has relatively few side effects. An alcoholic patient who developed hepatotoxic reaction while on disulfiram therapy is described. Although such reactions may occur, the dangers of continued drinking outweigh the dangers of taking disulfiram for the alcoholic. PMID- 3968050 TI - Depression in Binswanger's encephalopathy responsive to tranylcypromine: case report. AB - A 69-year-old woman with clinical and CT scan evidence of Binswanger's encephalopathy was successfully treated for an accompanying depression with tranylcypromine. The changing clinical and CT findings in this disorder are discussed, as well as the implications for the care and study of elderly depressed patients. PMID- 3968051 TI - Observations in tardive dyskinesia. PMID- 3968052 TI - Similar distribution of schizophrenia and multiple sclerosis. PMID- 3968053 TI - Does the dexamethasone suppression test have clinical utility in psychiatry? AB - The dexamethasone suppression test (DST) has had unprecedented evaluation among biologic tests proposed for application to psychiatric patients. Several techniques for test administration have been devised, including the use of 1 mg of dexamethasone at bedtime, two plasma samples for assay of cortisol (ideally in the afternoon and evening of the following day), and a criterion of greater than 5 micrograms/dl to define nonsuppression. The DST has limited power in differentiating major depression from other acute, severe illnesses but may be useful in comparisons of selected patient populations with affective features or history, and may also have value in predicting and monitoring treatment response. Experience with the DST encourages the search for additional simple biologic tests to help evaluate psychiatric patients. PMID- 3968054 TI - Discussion of "controversies in psychiatry": depression in the medically ill, sleep disorders in the elderly, and the DST. PMID- 3968055 TI - Sleeping pills for the elderly: are they ever justified? AB - Sleep disturbances in the elderly are common but not trivial. They are almost always multiply determined by age-dependent changes in sleep (amount, composition, and circadian distribution), concurrent medical/neuropsychiatric disorders and their treatments, and psychosocial/environmental changes. Against this complex background, the widespread use of sleeping pills to treat insomnia in the elderly is inadequate and--because of delay in diagnosis, adverse effects on respiration during sleep, and impairment of daytime alertness--potentially dangerous. A more thoughtful, less reflexive, approach to the prescription of sleeping pills in the elderly is suggested. PMID- 3968056 TI - Suitability of primary monolayer cultures of adult rat hepatocytes for studies of cholesterol and bile acid metabolism. AB - Monolayer cultures of hepatocytes isolated from cholestyramine-fed rats and incubated in serum-free medium converted exogenous [4-14C]cholesterol into bile acids at a 3-fold greater rate than did cultures of hepatocytes prepared from untreated rats. Cholic acid and beta-muricholic acid identified and quantitated by gas-liquid chromatography and thin-layer chromatography were synthesized by cultured cells for at least 96 h following plating. The calculated synthesis rate of total bile acids by hepatocytes prepared from cholestyramine-fed animals was approximately 0.058 micrograms/mg protein/h. beta-Muricholic acid was synthesized at approximately a 3-fold greater rate than cholic acid in these cultures. Cultured hepatocytes rapidly converted the following intermediates of the bile acid pathway; 7 alpha-hydroxy[7 beta-3H]cholesterol, 7 alpha-hydroxy-4-[6 beta 3H] cholesten-3-one, and 5 beta-[7 beta-3H]cholestane-3 alpha, 7 alpha, 12 alpha triol into bile acids. [24-14C]Chenodeoxycholic acid and [3H]ursodeoxycholic acid were rapidly biotransformed to beta-muricholic acid. 3-Hydroxy-3-methylglutaryl coenzyme A reductase activity measured in microsomes of cultured hepatocytes decreased during the initial 48 h following plating, but remained relatively constant for the next 72 h. In contrast, cholesterol 7 alpha-hydroxylase activity appeared to decrease during the first 48 h, followed by an increase over the next 48 h. Despite the apparent changes in enzyme activity in vitro, the rate of bile acid synthesis by whole cells during this time period remained constant. It is concluded that primary monolayer cultures of rat hepatocytes can serve as a useful model for studying the interrelationship between cholesterol and bile acid metabolism. PMID- 3968057 TI - Heterogeneity of contractile proteins. A continuum of troponin-tropomyosin expression in mammalian skeletal muscle. AB - Comparison of the myofibrillar proteins from several adult rabbit skeletal muscles has led to the identification of multiple forms of fast and slow troponin T. In Briggs et al. (Briggs, M. M., Klevit, R., and Schachat, F. H. (1984) J. Biol. Chem. 259, 10369-10375) two species of rabbit fast skeletal muscle troponin T (TnT), TnT1f and TnT2f, were characterized. Here, the distribution of these fast TnT species and the alpha- and beta- tropomyosin (Tm) subunits is characterized in fast muscles and in single muscle fibers. Evidence is also presented for two forms of slow skeletal muscle TnT. The presence of each fast TnT species is associated with the presence of a different Tm dimer: TnT1f with alpha beta-Tm and TnT2f with alpha 2-Tm. Histochemical analysis shows that expression of the fast TnT-Tm combinations is not due to differences in the distribution of fast-twitch glycolytic and fast-twitch oxidative-glycolytic fiber types. The absence of a correlation between histochemical typing and the composition of the thin filament Ca2+-regulatory complex is more apparent in individual fast muscle fibers where both fast TnT-Tm combinations appear to be expressed in a continuum. The implications of these observations for mammalian skeletal muscle fiber diversity are discussed. PMID- 3968058 TI - Transbilayer movement of a fluorescent phosphatidylethanolamine analogue across the plasma membranes of cultured mammalian cells. AB - The internalization of a fluorescent analogue of phosphatidylethanolamine following its insertion into the plasma membrane of cultured Chinese hamster fibroblasts was examined. When liposomes composed of 50 mol % 1-acyl-2-(N-4 nitrobenzo-2-oxa-1,3-diazole)-aminocaproyl phosphatidylethanolamine (C6-NBD-PE) and dioleoylphosphatidylcholine were incubated with monolayer cell cultures at 2 degrees C, a spontaneous transfer of the fluorescent lipid from liposomes to cells occurred. As long as the cells were kept at 2 degrees C, the fluorescent lipid remained at the plasma membrane. However, if, after removing the fluorescent liposomes, the cultures were warmed to 37 degrees C, the C6-NBD-PE was internalized and resided in the nuclear envelope, mitochondria, and Golgi apparatus in addition to the plasma membrane. Delivery of the fluorescent lipid to the Golgi apparatus could be blocked by the addition of 2-deoxyglucose plus sodium azide to the incubation medium. Evidence is presented suggesting that while delivery of the fluorescent lipid to the Golgi apparatus was mainly dependent on endocytosis, delivery to the nuclear envelope and mitochondria occurred by rapid transbilayer movement of the lipid across the plasma membrane followed by translocation of lipid monomers. Rapid transbilayer movement of C6 NBD-PE across the plasma membrane was found to be a temperature-dependent process that was blocked below 7 degrees C. PMID- 3968059 TI - Different reactivities of brain and erythrocyte tubulins toward a sulfhydryl group-directed reagent that inhibits microtubule assembly. AB - There is considerable evidence that tubulin exists in multiple isotypes, differing in amino acid sequence and tissue distribution. Little is known, however, about the functional significance of these isotypes. Chicken erythrocyte beta-tubulin has been shown by peptide mapping to differ significantly from chicken brain beta-tubulin (Murphy, D. B., and Wallis, K. T. (1983) J. Biol. Chem. 258, 7870-7875). We now find that when the two tubulins, in their native states, are incubated with N,N'-ethylenebis(iodoacetamide) (EBI), a bifunctional sulfhydryl-directed reagent, microtubule assembly by brain tubulin is much more sensitive to inhibition by EBI than is erythrocyte tubulin assembly. The resistance of erythrocyte microtubule assembly to inhibition by EBI is correlated with a low reactivity of erythrocyte tubulin with [14C]EBI. This difference is most marked in the beta subunit which reacts 15 and 17% as well, respectively, with [14C]EBI as do the beta 1 and beta 2 subunits of brain tubulin. Also, erythrocyte beta reacts about 33% as well as does brain beta with iodo[14C]acetamide. These results suggest that a reactive sulfhydryl group, whose oxidation prevents microtubule assembly, is present in brain tubulin but absent or inaccessible in erythrocyte tubulin. Since purified erythrocyte tubulin self aggregates much more readily than does brain tubulin, it is conceivable that erythrocyte and brain tubulin may differ in that the latter may have its assembly subject to a complex regulation, while erythrocyte tubulin assembly may be regulated by a simpler mechanism. PMID- 3968060 TI - Cleavage of the polysialosyl units of brain glycoproteins by a bacteriophage endosialidase. Involvement of a long oligosaccharide segment in molecular interactions of polysialic acid. AB - Polysialosyl chains containing alpha 2-8-linked N-acetylneuraminic acid have been suggested to modulate the biological activity of a neural cell adhesion molecule. Polysialosyl glycopeptides isolated from developing brain were incubated with a bacteriophage containing endosialidase. Sialic acid oligomers up to 7 residues long were liberated both from the glycopeptides and colominic acid. The substrate specificity of the endosialidase was studied with sialic acid oligomers of different sizes prepared from colominic acid. It was found that the endosialidase required the simultaneous presence adjacent to the site of cleavage a minimum of 3 sialic acid residues on the distal side and a minimum of 5 sialic acid residues on the proximal (reducing end) side. From the fragments liberated by the enzyme the existence of polysialic acid chains up to at least 12 residues long in the glycopeptides were concluded. This was also supported by the interaction of the glycopeptides with a meningococcal group B polysaccharide antiserum, which was found to require 10 residues or more for binding. The results indicate that the brain polysialosyl glycopeptides contain a long polysialic acid segment, which is also specifically needed for certain molecular interactions. The implications of the findings for the biological properties of the neural cell adhesion molecule are discussed. PMID- 3968061 TI - Crystals of luciferase from Vibrio harveyi. A preliminary characterization. AB - Bacterial luciferase from Vibrio harveyi, the 77,000-dalton light-emitting enzyme of the marine bacterium, has been crystallized into a two million cubic Angstrom cell with P212121 symmetry. The cell constants are a = 59.6 +/- 0.4 A, b = 112 +/ 0.7 A, and c = 302 +/- 2 A. The reflections corresponding to the 302-A cell edge can be resolved by suitable collimation of the incident beam, without resorting to focusing mirrors. The crystals diffract to better than 3-A resolution and are large enough (0.7 mm) for data collection. The crystallization conditions are presented and general crystallization characteristics are discussed. PMID- 3968062 TI - Fidelity of DNA polymerases isolated from regenerating liver chromatin of aging Mus musculus. AB - DNA polymerase-alpha and -beta were fractionated from the chromatin of regenerating liver of young and old mice. The DNA polymerases were resolved from each other and partially purified by DEAE-cellulose, phosphocellulose, and DNA cellulose column chromatography. No significant age-related difference in the kinetics of heat inactivation was observed for either DNA polymerase. No age dependent difference was found in the fidelity with which these enzymes copied phi X174 DNA. These results suggest that the functional properties of these DNA polymerases do not change with age as is postulated in some theories of aging. PMID- 3968063 TI - Purification and characterization of short-chain, medium-chain, and long-chain acyl-CoA dehydrogenases from rat liver mitochondria. Isolation of the holo- and apoenzymes and conversion of the apoenzyme to the holoenzyme. AB - Short-chain, medium-chain, and long-chain acyl-CoA dehydrogenases were purified to homogeneity from rat liver mitochondria by sequential chromatography on DEAE Sephadex A-50, hydroxyapatite, Matrex Gel Blue A, agarose-hexane-CoA, and Bio-Gel A-0.5m. Molecular, immunological, and catalytic properties of the pure acyl-CoA dehydrogenases were investigated. The native molecular weights of these three enzymes were 160,000, 180,000, and 180,000, respectively. The subunit molecular weights of the three enzymes were estimated to be 41,000, 45,000, and 45,000, respectively, indicating that these enzymes are each composed of four subunits of equal size. The FAD content was calculated to be 1 mol/mol of subunit. While FAD binding by short-chain acyl-CoA dehydrogenase was very tight, that by medium chain acyl-CoA and long-chain acyl-CoA dehydrogenases was less tight. The medium- and long-chain acyl-CoA dehydrogenases were also purified to homogeneity as FAD free apoenzymes. The apoenzymes were converted to the fully active holoenzymes by incubation with FAD. The three acyl-CoA dehydrogenases were immunologically distinct from each other, i.e. the antibodies raised against the individual enzymes were monospecific and did not cross-react with any other acyl-CoA dehydrogenases. Our preparations of the three enzymes exhibited substrate specificities (as defined in Vappmax and Kappmax) significantly more specific than those of the previous preparations isolated from other sources. The substrate specificities were assessed also by measuring the activities in mitochondrial sonicates after selectively precipitating each enzyme with their individual monospecific antibodies. Butyryl-CoA was almost exclusively dehydrogenated by short-chain acyl-CoA dehydrogenase while C6-C10 acyl-CoAs were mainly dehydrogenated by medium-chain acyl-CoA dehydrogenase. C14-C22 acyl-CoAs were exclusively dehydrogenated by long-chain acyl-CoA dehydrogenase. C24 acyl CoAs were not dehydrogenated by this enzyme. Lauroyl-CoA appeared to be jointly dehydrogenated by the latter two enzymes. Branched-chain acyl-CoAs were not dehydrogenated by short-chain acyl-CoA dehydrogenase. In the presence of electron transfer flavoprotein or phenazine methosulfate, 2-enoyl-CoAs were identified as products from the corresponding enzyme/acyl-CoA reactions. PMID- 3968064 TI - Mechanism of action of short-chain, medium-chain, and long-chain acyl-CoA dehydrogenases. Direct evidence for carbanion formation as an intermediate step using enzyme-catalyzed C-2 proton/deuteron exchange in the absence of C-3 exchange. AB - The mechanisms of the initial interactions of three rat liver acyl-CoA dehydrogenases (short-chain, medium-chain, and long-chain acyl-CoA dehydrogenases) and their fatty acyl-CoA substrate were studied using enzyme catalyzed deuterium exchange. The reaction products were identified and quantitated using mass spectroscopy and 1H-NMR. When fatty acyl-CoA substrates were incubated with catalytic amounts of acyl-CoA dehydrogenase in D2O in the absence of an electron acceptor, a rapid monodeuteration of the substrate occurred to replace one of the prochiral C-2 hydrogens, while no C-3 hydrogens were exchanged with deuterium. The C-2 monodeuteration proceeded to the extent of 80% of the total amount of substrate added at 90 min and almost to completion at 120 min. The pKa values and optimum pD values for the C-2 proton/deuteron exchange reactions were 6.0 and 7.5, respectively, for each of the three acyl-CoA dehydrogenases. The apparent turnover numbers were 3.0, 3.3, and 0.5 s-1 for short-chain, medium-chain, and long-chain acyl-CoA dehydrogenases, respectively. These results provide the first direct evidence for carbanion formation via abstraction of a C-2 hydrogen by a base in the enzyme, as the first step of the catalytic pathway of acyl-CoA dehydrogenation. When the acyl-CoA dehydrogenases were reacted with moderate excesses of acyl-CoA substrates in D2O in the absence of an electron acceptor, maximum bleaching of the FAD absorbance and the appearance of the long wavelength absorbance, attributed to a charge transfer complex, were observed. However, the dehydrogenation products, 2-enoyl-CoAs, were produced either not at all or in an amount which represented only a minor fraction of the amount of the enzyme added, while the substrates in the enzyme substrate complexes rapidly turned over as indicated by the extensive monodeuteration which concomitantly occurred. Unlike previous hypothesis, these results indicate that the hydride ion transfer from C-3 of the substrate to the enzyme-FAD is not yet complete in the charge-transfer complex. The transfer of the hydride ion to alloxazine N-5 and the release of products are completed only in the presence of electron-transfer flavoprotein or another suitable electron acceptor. PMID- 3968066 TI - Synthesis and degradation of type I procollagen mRNAs in cultured human skin fibroblasts and the effect of cortisol. AB - The metabolism of type I procollagen mRNAs was studied in confluent cultures of human skin fibroblasts using the recombinant plasmids Hf677 and Hf32, which contain DNA sequences complementary to human pro-alpha 1(I) and pro-alpha 2(I) mRNAs, respectively. The ratio for the amount of pro-alpha 1(I) mRNAs to pro alpha 2(I) mRNAs was 2.06:1. These mRNAs were labeled during in vitro transcription of isolated nuclei in the ratio 2.16:1 and during a pulse in cellulo in the ratio 1.96:1, suggesting that the two species are synthesized in the ratio 2:1. No significant differences were found in the rates of degradation, the half-lives of the pro-alpha 1(I) and pro-alpha 2(I) mRNAs being 9.2 and 8.4 h, respectively. Addition of 10 microM cortisol to the growth medium reduced the amounts of the type I procollagen mRNAs by half in 6 h, leaving their ratio unaltered. Incubation of the cells with cortisol had only minor effects on the subsequent synthesis of the mRNAs in isolated nuclei in vitro, whereas the degradation rates in cellulo were distinctly accelerated. PMID- 3968065 TI - An essential cysteine residue located in the vicinity of the FAD-binding site in short-chain, medium-chain, and long-chain acyl-CoA dehydrogenases from rat liver mitochondria. AB - Medium-chain and long-chain acyl-CoA dehydrogenases from rat liver have been purified in two forms, holoenzymes containing FAD and apoenzymes which do not contain this cofactor. In contrast, short-chain acyl-CoA dehydrogenase can only be isolated as the holoenzyme. Marked differences in the reactivity to organic sulfhydryl reagents were observed between the apo and holo forms of these enzymes. While the two apoenzymes were severely inactivated by N-ethylmaleimide (NEM), p-chloromercuribenzoate (pCMB), and iodoacetate (IAA), the two corresponding holoenzymes were not susceptible to these reagents. The inactivation of the two apoenzymes by NEM followed pseudo-first order kinetics. Incubation of the apoenzymes with FAD completely prevented the inactivation by the organic sulfhydryl reagents. Methylmercury halides (iodide or chloride) inactivated both the apo and holo forms of medium-chain and long-chain acyl-CoA dehydrogenases. On the other hand, holo-short-chain acyl-CoA dehydrogenase behaved somewhat differently from the other two holoenzymes in that it was inactivated by pCMB (but not NEM or IAA) following a pseudo-first order process. The titration of the two apoenzymes with [14C]NEM and that of the holo-short chain acyl-CoA dehydrogenase with [14C]pCMB indicated that all three acyl-CoA dehydrogenases contain a single essential cysteine residue/subunit. In the inactivation of holo-medium-chain and holo-long-chain acyl-CoA dehydrogenases with methylmercury halide, the same essential cysteine residue was modified without perturbing or releasing the enzyme-bound FAD. The inactivations of the three holoenzymes by appropriate organic sulfhydryl reagents were prevented by prior incubation with substrate. These experimental results indicate that the essential cysteine residue is located in the vicinity of the FAD- and substrate binding sites within the active center of the enzymes. It appears, however, that this cysteine residue does not participate directly in FAD binding. PMID- 3968067 TI - Fatty acyl-AMP as an intermediate in fatty acid reduction to aldehyde in luminescent bacteria. AB - The acyl protein synthetase component (50K) of the fatty acid reductase complex from the luminescent system of Photobacterium phosphoreum has been found to catalyze the activation of fatty acid via formation of an enzyme bound acyl-AMP (carboxyphosphate mixed anhydride) immediately prior to the acylation of the enzyme. PPi-ATP exchange and nucleotide binding experiments are dependent on fatty acid and indicate that the fatty acyl-AMP is directly formed and that an adenylated enzyme intermediate is not part of the mechanism. The formation of acyl-AMP from fatty acid and ATP is reversible with a standard free energy of -2 kcal/mol, and is dependent on Mg2+. The fatty acyl-AMP intermediate has been isolated and shown to be part of the pathway of fatty acid reduction. The 34K component of the complex, which strongly stimulates the acylation of the 50K protein by fatty acyl-AMP or fatty acid and ATP, is not required for the formation of acyl-AMP showing that it differentially affects the fatty acid activation and acylation steps catalyzed by the 50K protein. PMID- 3968068 TI - Uptake of dibucaine into large unilamellar vesicles in response to a membrane potential. AB - Local amine anesthetics appear to exert their effects in the charged (protonated) form on the cytoplasmic side of excitable membranes. Two features of interest are the mechanism whereby these drugs move across the membrane to the inner monolayer and the actual membrane concentrations achieved. In this work, we have investigated the influence of a K+ diffusion potential, delta psi, on the transmembrane distribution and concentration of the local anesthetic dibucaine employing large unilamellar vesicle systems. It is demonstrated that egg phosphatidylcholine large unilamellar vesicles exhibiting a delta psi (interior negative) actively accumulate dibucaine to achieve high interior concentrations. 31P and 13C nuclear magnetic resonance studies show that the internalized drug is localized to the vesicle inner monolayer, and suggest that the protonated form of the anesthetic is the species that is actively transported. The inner monolayer anesthetic concentrations thus achieved can be an order of magnitude or more larger than predicted on the basis of anesthetic lipid-water partition coefficients. It is suggested that these effects may be related to the mechanisms whereby local anesthetics are localized and concentrated at their sites of action in nerve membranes. PMID- 3968069 TI - Competitive inhibition of cytochrome P-450scc by (22R)- and (22S)-22 aminocholesterol. Side-chain stereochemical requirements for C-22 amine coordination to the active-site heme. AB - Two diastereomeric aminocholesterols, (22R)-22-aminocholesterol and (22S)-22 aminocholesterol, are both found to be potent inhibitors of the biosynthesis of pregnenolone from cholesterol by purified bovine mitochondrial P-450scc. Both steroids are competitive versus cholesterol, but the stereochemically correct analog (22R)-22-aminocholesterol is bound approximately 1000 times more tightly than (22S)-22-aminocholesterol. The dissociation constants are 25 nM and 13 microM, respectively. Direct comparisons between spectroscopic and enzymatic properties of the two enzymesterol complexes and the 22-amino-23,24-bisnor-5 cholen-3 beta-ol complex are made, underlining the importance of the stereochemistry at the C-22 position. PMID- 3968070 TI - Characterization of Leishmania donovani acid phosphatases. AB - A crude membrane fraction from promastigotes of Leishmania donovani grown in a liquid culture medium containing 20% fetal calf serum was prepared by freeze thawing, centrifugation (200,000 X g, 30 min), and extraction with 2% (w/v) sodium cholate. After removal of the bile salt by chromatography on a Sephadex G 75 column, the solubilized membrane protein fraction, rich in acid phosphatase activity, was chromatographed on columns containing concanavalin A-Sepharose, QAE Sephadex, and Sephadex G-150 and G-100. Three distinct acid phosphatases were resolved: the major phosphatase activity (70% of the total) was L-(+)-tartrate resistant (designated ACP-P1) and corresponds to the acid phosphatase localized to the outer surface of the parasite's plasma membrane; the other two phosphatases (ACP-P2 and ACP-P3) account for the remaining 30% of the particulate acid phosphatase activity, and both of these enzymes are L-(+)-tartrate sensitive. Using a combination of sucrose density gradient centrifugation, gel filtration chromatography, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, it was determined that ACP-P1 is a 128,000-dalton protein composed of two subunits of 65,000-68,000 daltons. ACP-P1 has an isoelectric point of 4.1, a pH optimum of 5.5, hydrolyzes fructose 1,6-diphosphate, but no other sugar phosphates and dephosphorylates phosphotyrosine, yeast mannan, and the phosphorylated form of rat liver pyruvate kinase. ACP-P2 (pI, 5.4) and ACP-P3 (pI, 7.1) with molecular masses of 132,000 and 108,000 daltons, respectively, are both tartrate-sensitive and are distinguished from each other on the basis of their sensitivity to inhibition by polyanionic molybdenum complexes. These two phosphatases also have their pH optima in the pH 5.0-6.0 range, but have a considerably broader substrate specificity than ACP-P1. PMID- 3968072 TI - Stockpiling of DNA polymerases during oogenesis and embryogenesis in the frog, Xenopus laevis. AB - The amounts of the various forms of DNA polymerase (alpha 1, alpha 2, beta, and gamma) have been determined in oocytes, eggs, and embryos of the frog, Xenopus laevis. During oogenesis the relative proportions and absolute levels of all forms changed dramatically. In stage I (early) oocytes, DNA polymerase-gamma, the "mitochondrial" polymerase, was the predominant form. During oocyte growth, DNA polymerase-alpha 1 and -alpha 2 increased by more than 100-fold, DNA polymerase beta by 15-fold, and DNA polymerase-gamma by only 8-fold. During oocyte maturation and ovulation, the levels of all forms of DNA polymerase roughly doubled. The mature stage VI oocyte contained 5 orders of magnitude more DNA polymerase activity than is found in an individual somatic cell. DNA polymerase alpha 1 and -alpha 2, the "replicative" polymerases, were the predominant forms in mature oocytes and ovulated unfertilized eggs. During fertilization, the relative proportions and absolute levels of the four forms remained constant. During subsequent stages of embryogenesis, the total amounts of DNA polymerase alpha 1 and -alpha 2 declined slightly from cleavage through gastrulation, the stages of most rapid chromosomal DNA replication. The rapid increase in cell number during early embryogenesis establishes the same levels of DNA polymerase/cell as are present in adult somatic cells. After neurulation, the absolute levels of DNA polymerase-alpha 1 and -alpha 2 increased in proportion to increases in cell number. The absolute levels of DNA polymerase-beta remained constant, and the levels of DNA polymerase-gamma increased 2-fold throughout embryogenesis. PMID- 3968071 TI - Monoclonal antibodies against bovine milk lipoprotein lipase. Characterization of an antibody specific for the apolipoprotein C-II binding site. AB - Ten murine monoclonal antibodies have been produced that are specific for bovine milk lipoprotein lipase. One monoclonal antibody, bLPL-mAb-7, inhibited completely the apolipoprotein C-II (apo-C-II)-dependent enzymic hydrolysis of trioleoylglycerol in a phospholipid-stabilized emulsion, but had no effect on the hydrolysis of the water-soluble substrate p-nitro-phenylacetate. Four times more bLPL-mAb-7 was required to achieve 50% inactivation of lipoprotein lipase activity when the enzyme was preincubated with excess apo-C-II. Disruption of the binding of a dansyl-labeled apo-C-II peptide to lipoprotein lipase by bLPL-mAb-7 was demonstrated by resonance energy transfer, both in the presence and absence of lipid. This antibody thus appears to recognize the apo-C-II binding site of lipoprotein lipase. In addition, bLPL-mAb-7 also inhibited the lipoprotein lipase activity of human post-heparin plasma. PMID- 3968073 TI - Kinetics of tryptophan fluorescence enhancement in myofibrils during ATP hydrolysis. AB - The mechanism of ATP hydrolysis in myofibrils can be studied by following the time course of tryptophan fluorescence. Stoichiometric quantities of ATP produce an enhancement of the tryptophan fluorescence in stirred suspensions of rabbit psoas myofibrils at pCa greater than 7. Approximately 1 mol of ATP/myosin head is required to obtain the maximum fluorescence enhancement of 4-6%. Upon the addition of quantities of ATP greater than 1 mol/mol of myosin head, the fluorescence rapidly increases to a steady state, which lasts for a period that is proportional to the amount of ATP added. The fluorescence then decays to the initial level with a half-time of approximately 40 s at 20 degrees C. Hydrolysis of [gamma-32P]ATP at pCa greater than 7 in myofibrils has an initial burst of approximately 0.7 mol/mol of myosin head that is followed by a constant rate of hydrolysis. The duration of the steady state hydrolysis is identical to the duration of the enhancement of tryptophan fluorescence. A lower limit of 5 X 10(5) M-1 S-1 was obtained for the second order rate constant of the fluorescence enhancement by ATP. At pCa of 4, the duration of the fluorescence enhancement is one-tenth to one-twentieth as long as at pCa greater than 7; this is consistent with the increased steady state rate of ATP hydrolysis at higher calcium concentrations. The time course of the fluorescence enhancement observed in myofibrils during ATP hydrolysis is qualitatively and quantitatively similar to that observed with actomyosin-S1 in solution. These results suggest that the kinetic mechanism of ATP hydrolysis that has been well established by studies of actomyosin-S1 in solution also occurs in myofibrils. PMID- 3968074 TI - 4-Aminobutyrate aminotransferase reaction of sulfhydryl residues connected with catalytic activity. AB - 4-Aminobutyrate aminotransferase is inactivated by preincubation with N-(1 pyrene)maleimide (mixing molar ratio 10:1) at pH 7. The reaction with N-(1 pyrene)maleimide was monitored by fluorescence spectroscopy and the degree of labeling of the enzyme determined by absorption spectroscopy. The blocking of 2 cysteinyl residues/enzyme dimer is needed for inactivation of the aminotransferase. The time course of the reaction is significantly affected by the substrate alpha-ketoglutarate, which afforded complete protection against the loss of catalytic activity. Trypsin digestion of pyrene-labeled aminotransferase, followed by gel filtration and "fingerprint" analysis, revealed the presence of only one peptide tagged with the fluorescent probe. The reaction of approximately 1.9 SH residues/dimer with iodosobenzoate resulted in enzyme inactivation together with a formation of an oligomeric species of Mr = 100,000 detectable by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The cross-linked subunits are dissociated by addition of 2-mercaptoethanol which also restores full catalytic activity. Altogether, these observations are consistent with the concept that inactivation of 4-aminobutyrate aminotransferase by iodosobenzoate proceeds through disulfide bond formation between vicinal cysteinyl residues of the protein. It is postulated that the critical sulfhydryl groups of the enzyme are situated on opposite sides of the dimeric structure at the subunit interfaces. PMID- 3968075 TI - Ultrastructure of human coagulation factor V. AB - Purified single-chain human coagulation factor V (Mr approximately 330,000) was visualized by high-resolution transmission electron microscopy. The molecule was found to be composed of four major domains. Three similar sized (approximately 90 X 70 A) globular domains were linked via thin (approximately 30 A) spacers to a somewhat larger (approximately 165 X 138 A) central domain. The center-to-center distances between the larger central domain and each of the peripheral domains were found to be approximately 120 A. Incubation of factor V with thrombin resulted in a separation of the peripheral domains from the central domain. This indicates that the factor V domains now observed correspond to the previously characterized factor V fragments formed by limited proteolysis using thrombin. From these results, a model of the three-dimensional factor V structure, distinct from previous models, is proposed. PMID- 3968076 TI - Acid-catalyzed formation of isoprene from a mevalonate-derived product using a rat liver cytosolic fraction. AB - Isoprene formation in a rat liver cytosolic fraction is shown to be increased 146 fold by acid treatment. This acid catalysis is dependent upon prior incubation of the cytosolic fraction with DL-mevalonate and is stimulated when the incubation also contains ATP. Formation of isoprene proceeds linearly through 5 h of acid treatment and is nearly complete at 10 h. These results suggest that the acid catalyzed isoprene formation arises from the decomposition of dimethylallyl pyrophosphate via a carbonium ion mechanism. Chemical model studies using 3 methyl-2-buten-1-ol and 3-methyl-3-buten-1-ol (the alcohols corresponding to dimethylallyl pyrophosphate and isopentenyl pyrophosphate, respectively) confirm this hypothesis. At a pH less than or equal to 1, an 85% decomposition of 3 methyl-2-buten-1-ol to isoprene occurred after 24 h, while 3% of 3-methyl-3-buten 1-ol was converted to isoprene under identical conditions and time. It is concluded that the predominant immediate precursor of isoprene is dimethylallyl pyrophosphate and at low pH the ultimate fate of dimethylallyl pyrophosphate is complete conversion to isoprene. These conclusions have important biochemical and methodological implications. PMID- 3968077 TI - Interaction of S-acyl fatty acid synthase thioester hydrolase with fatty acid synthase. Direct measurement of binding by fluorescence anisotropy. AB - Treatment of S-acyl fatty acid synthase thioester hydrolase from the uropygial gland of Peking duck with pyrenebutylmethanephosphonofluoridate resulted in inactivation of the enzyme with covalent attachment of the pyrene derivative to the enzyme. One mole of the derivative was attached/mol of protein, most probably at the active serine. When avian fatty acid synthase was added to the modified thioesterase, the fluorescence anisotropy of the pyrene derivative increased dramatically. That this increase represented the functionally significant binding between the two proteins was suggested by the fact that increasing salt concentration resulted in concomitant loss in enzyme activity and fluorescence anisotropy. As the synthase concentration increased, anisotropy increased giving a saturation pattern. From a Scatchard plot analysis the association constant for the binding of the two proteins was calculated to be 10(6) M-1 and one-to-one stoichiometry was shown for this association. These results show that fluorescence anisotropy of the pyrene derivative attached to the thioesterase can be used to directly measure the binding of this enzyme to fatty acid synthase. PMID- 3968078 TI - Regulation of the biosynthesis of two distinct fatty acid-binding proteins in rat liver and intestine. Influences of sex difference and of clofibrate. AB - Two distinct fatty acid-binding proteins (FABPs) have been identified in rat intestine, gFABP (15,063 Da) which is confined to intestinal epithelium and hFABP (14,184 Da) which is found in both liver and intestine. We have examined the influence of sex difference and the effect of clofibrate, both of which affect cellular fatty acid metabolism and hFABP levels, on the concentration, and mRNA levels of both hepatic and intestinal FABPs. In the liver, hFABP concentration was approximately 2-fold greater in females and in clofibrate-treated males than in untreated male rats. These differences were not accompanied by changes in the fractional turnover of the polypeptide but rather by parallel increases in hFABP mRNA. In the intestine, the two FABPs exhibited different regulatory responses. Intestinal hFABP turnover was 33% greater in females than in males, whereas mRNA concentration was 50% greater. Thus, unlike hFABP in liver, there was no sex related difference in the steady-state level of hFABP in intestine. However, clofibrate treatment, similar to its effects in the liver, doubled intestinal hFABP protein and mRNA concentration. In contrast to hFABP, neither gFABP protein nor mRNA concentration were sex dependent, whereas clofibrate produced only a modest increase in gFABP concentration without significantly changing gFABP mRNA levels. The results indicate that the influence of sex difference and the effect of clofibrate on hepatic fatty acid metabolism are both associated with changes in hFABP synthesis mediated pretranslationally. The differential response of hFABP and gFABP in intestine suggests that these proteins play distinct roles in the cellular metabolism of fatty acids. PMID- 3968080 TI - Acetylcholinesterase: inhibition by tetranitromethane and arsenite. Binding of arsenite by tyrosine residues. AB - Tetranitromethane inhibits acetylcholinesterase with respect to the hydrolysis of both acetylthiocholine and indophenyl acetate. The loss of activity with indophenyl acetate, a poor substrate, is preceded by an increase in enzyme activity. Only 12 of the 21 tyrosine residues/monomer of enzyme are susceptible to nitration. Loss of activity with respect to indophenyl acetate occurs well after no further nitration of tyrosines occurs and must be due to the modification of other residues. Incubation of the enzyme with arsenite before nitration results in the nitration of only 10 tyrosines. This experiment reveals that the structural basis for the binding of arsenite is the formation of a diester with two tyrosine residues. PMID- 3968079 TI - Kinetics of reduction of Clostridium pasteurianum rubredoxin by laser photoreduced spinach ferredoxin:NADP+ reductase and free flavins. Electron transfer within a protein-protein complex. AB - The kinetics of reduction of oxidized Clostridium pasteurianum rubredoxin (Rdox) by free flavin semiquinones generated by the laser flash photolysis technique and by spinach ferredoxin:NADP+ reductase (FNR) semiquinone (also produced by flavin semiquinone reduction) have been investigated under anaerobic conditions. 5 Deazariboflavin semiquinone (5-dRf) rapidly reduces oxidized rubredoxin (Rdox) (k = 3.0 X 10(8) M-1 S-1) and oxidized ferredoxin:NADP+ reductase (FNRox) to the semiquinone level (k = 5.5 X 10(8) M-1 S-1). Lumiflavin semiquinone reduces Rdox more slowly (k = 1.3 X 10(7) M-1 S-1) and is not measurably reactive with FNRox. Absorption difference spectroscopy and difference CD indicate that Rdox and FNRox form a 1:1 complex at low ionic strength (10 mM), which is completely dissociated at higher ionic strength (310 mM). Apparent second order rate constants for reduction of Rdox in its free and complexed state by lumiflavin semiquinone are the same. Reduction of Rdox (both free and complexed) by free FNR semiquinone and intracomplex electron transfer were investigated using 5-dRf as the reductant. At I = 10 mM, a first order rate constant of 2.0 X 10(3) S-1 was obtained, which corresponds to the processes involved in intracomplex electron transfer from FNR semiquinone to Rdox. A second order reaction between free FNR semiquinone and complexed Rdox was also observed to occur (k = 5 X 10(7) M-1 S-1). At I = 310 mM, these reactions are not observed and the reaction of FNR semiquinone with free Rdox is second order (k = 4 X 10(6) M-1 S-1). PMID- 3968081 TI - Characterization of parathyroid hormone fragments produced by cathepsin D. AB - Cleavage of parathyroid hormone by cathepsin D was studied. Four primary products were detected and separated by high performance liquid chromatography. Two of the fragments are fluorescent and therefore contain residue 23 (tryptophan). These fragments are NH2-terminal in origin. The other two cross-react with antisera directed against COOH-terminal portions of the hormone; they are the complementary COOH-terminal fragments. Microsequencing and amino acid analysis showed that the two COOH-terminal fragments are 35-84 and 38-84 bovine parathyroid hormone. By CNBr cleavage and amino acid analysis, the two NH2 terminal fragments were shown to be the complementary 1-37 and 1-34 fragments. The 1-37 fragment is transitory and is rapidly hydrolyzed to 1-34, so that only relatively small amounts are detected at any one time. However, 34-84 was not converted to 38-84, although cleavage at other sites in the COOH-terminal fragments was observed with more exhaustive digestion. The 1-34 fragment appears to be the final product of the action of cathepsin D on parathyroid hormone. Both enzymatically produced NH2-terminal fragments were fully active in the renal membrane adenylyl cyclase assay system. PMID- 3968082 TI - Purification and characterization of 3-methyladenine-DNA glycosylase from calf thymus. AB - The 3-methyladenine-DNA glycosylase from calf thymus has been purified and characterized. Two species of Mr = 42,000 and 27,000 +/- 5% and Stokes radius of 27.5 and 22.4 A, respectively, were found. Only the lower molecular weight species were present in the nucleus; it was bound to chromatin and could be dissociated in the presence of 0.25 M KCl. The enzymatic properties of the two species appeared to be identical. Both enzyme species released 3-methyladenine, 7 methylguanine, and 3-methylguanine, listed in the order of decreasing activity. The chromatin-associated enzyme was purified to apparent homogeneity and found to be a basic protein having a pI greater than 9. It was completely inhibited by p hydroxymercuribenzoate, but this inhibition could be fully reversed by addition of excess 2-mercaptoethanol. Kinetic studies, heat inactivation, and inhibition experiments demonstrated that the 3-methyladenine and 7-methylguanine releasing activities were located on the same protein molecule. The enzymes showed no activity on methylated single-stranded DNA. No product inhibition was observed for any of the enzyme species, and the enzyme activity was optimal when the incubation was performed in the presence of 50 mM NaCl or KCl at pH values between 8 and 9. PMID- 3968083 TI - Stereoselectivity of microsomal epoxide hydrolase toward diol epoxides and tetrahydroepoxides derived from benz[a]anthracene. AB - We have examined the selectivity of rat liver microsomal epoxide hydrolase (EC 3.3.2.3) toward all of the possible positional isomers of benzo-ring diol epoxides and tetrahydroepoxides of benz[a]anthracene, as well as the 1,2-diol 3,4 epoxides of triphenylene. This set includes compounds with no bay region in the vicinity of the benzo-ring, a bay-region diol group, a bay-region epoxide group, and (for the triphenylene derivatives) both a bay-region diol and a bay-region epoxide. In all cases where both the tetrahydroepoxides and the corresponding diol epoxides were examined, there is a large retarding effect of hydroxyl substitution on the rate of the enzyme-catalyzed hydration. When the tetrahydroepoxides are fair or poor substrates (epoxide group in the 1,2-, 8,9-, or 10,11-position), the additional retardation introduced by adjacent hydroxyl groups causes the enzyme-catalyzed hydrolysis of the corresponding diol epoxides to be insignificantly slow or nonexistent. In contrast, a benz[a]anthracene derivative with an epoxide group in the 3,4-position, (-) tetrahydrobenz[a]anthracene (3R,4S)-epoxide, has been identified as the best substrate known for epoxide hydrolase, with a Vmax at 37 degrees C and pH 8.4 of 6800 nmol/min/mg of protein, and the two diastereomeric (+/-)-benz[a]anthracene 1,2-diol 3,4-epoxides, unlike all the other diol epoxides examined to date, are moderately good substrates for epoxide hydrolase. This novel observation is accounted for by the fact that the very high reactivity of the tetrahydrobenz[a]anthracene 3,4-epoxide system towards epoxide hydrolase is large enough to overcome a kinetically unfavorable effect of hydroxyl substitution. The enantioselectivity and positional selectivity of the enzyme have been determined for the tetrahydro-1,2- and -3,4-epoxides of benz[a]anthracene as well as the 1,2 diol 3,4-epoxides. When the epoxide is located in the 3,4-position, the benzylic carbon is the preferred site of attack, whereas for the enantiomers of the bay region tetrahydro-1,2-epoxides, the chemically less reactive non-benzylic carbon is preferred. The regio- and enantioselectivity of epoxide hydrolase are discussed in terms of a possible model for the hydrophobic binding site of this enzyme. PMID- 3968084 TI - Isolation and characterization of CAB-63, a novel calcium-binding protein. AB - A novel calcium-binding protein named CAB-63 (formerly called calregulin) has been purified from bovine liver 100,000 X g supernatant. The purified protein has been characterized with respect to its physical, chemical, and calcium-binding properties. It has an apparent molecular weight of 63,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 55,000 by sedimentation equilibrium centrifugation under nondenaturing conditions. It is an asymmetric molecule with a frictional coefficient of 1.69 and a Stokes radium of 44.2 A. Amino acid analysis has revealed 34.0% acidic residues, 14.0% basic residues, and 4.0% tryptophan. The acidic nature of the molecule is further confirmed by its isoelectric point of 4.65. In the presence of 3 mM MgCl2 and 150 mM KCl, CAB-63 binds 3.0 mol of calcium/mol of protein with an apparent Kd = 0.1 microM. Immunoblotting and Ouchterlony double-diffusion procedures have identified CAB-63 in a variety of bovine tissues. Immunocytochemical staining of both fibroblasts and cryotome-sectioned bovine liver further indicates that CAB-63 immunoreactivity is restricted to an elaborate system of perinuclear membranous vacuoles and cisternae indistinguishable from immunocytochemical staining of the endoplasmic reticulum. It is concluded that CAB-63 represents a major calcium binding protein whose subcellular organization suggests a possible role in the function of the endoplasmic reticulum. PMID- 3968085 TI - Ca2+/calmodulin-dependent protein kinase II. Isozymic forms from rat forebrain and cerebellum. AB - Ca2+/calmodulin-dependent protein kinase II, an abundant brain protein proposed to mediate a number of Ca2+-regulated processes in neuronal tissue, is composed of autophosphorylatable subunits of Mr 50,000 and 60,000/58,000. A recent study (McGuinness, T. L., Lai, Y., Greengard, P., Woodgett, J.R., and Cohen, P. (1983) FEBS Lett. 163, 329-334) suggested that this kinase exists as isozymes which vary in the relative ratio of these subunits in different tissues or species. Other studies (Walaas, S. I., Nairn, A. C., and Greengard, P. (1983) J. Neurosci. 3, 291-301, 302-311) provided evidence which suggested that the ratio of these phosphopeptides might vary in different brain regions. In the present investigation, we have tested this possibility by comparing Ca2+/calmodulin dependent protein kinase II purified from rat forebrain and cerebellum. The two kinases had similar purification characteristics, subunit compositions, physical properties, and substrate specificities. Gel filtration and sucrose density gradient centrifugation provided an estimated molecular weight of 550,000 for the forebrain kinase and 615,000 for the cerebellar kinase. The kinases from the two regions clearly differed in the relative proportions of the Mr 50,000 and 60,000/58,000 subunits. Three independent methods indicated that the forebrain kinase contained the Mr 50,000/(60,000/58,000) subunits in approximately a 3:1 ratio, while the cerebellar kinase contained the Mr 50,000/(60,000/58,000) subunits in approximately a 1:4 ratio. The forebrain kinase subunits were shown to be identical to the corresponding subunits of the cerebellar kinase by several criteria. The data are consistent with the existence in various brain regions of isozymic forms of Ca2+/calmodulin-dependent protein kinase II which differ in their relative subunit ratios. PMID- 3968086 TI - Mutations affecting the regulation of transcription of the cytochrome P1-450 gene in the mouse Hepa-1 cell line. AB - The cytochrome P1-450-dependent activity, aryl hydrocarbon hydroxylase, and cytochrome P1-450 messenger RNA levels were studied in wild-type Hepa1c1c7 cells and in aryl hydrocarbon hydroxylase-deficient mutants derived from this line. Tetrachlorodibenzo-p-dioxin (TCDD) induced both parameters approximately 50-fold in Hepa1c1c7 cells. Mutants in genes B and C that are affected in the functioning of the Ah receptor required for hydroxylase induction and dominant mutants had nondetectable or much reduced P1-450 mRNA levels and hydroxylase activities after TCDD treatment. Hybrids between wild-type cells and the dominant mutants were also deficient in these parameters. The dominant mutants therefore appear to express a trans-acting repressor of cytochrome P1-450 transcription. Mutants in gene A were heterogenous. Some lacked the mRNA completely; others were inducible for it; while still others (subgroup IV) had high levels even when they were grown without TCDD. These results suggest strongly that gene A is the structural gene for cytochrome P1-450. When subgroup IV mutants were cultured together with wild-type cells, they failed to express P1-450 mRNA in the absence of TCDD treatment. These cells probably accumulate an inducer that can be metabolized by aryl hydrocarbon hydroxylase. The inducer did not appear to be a component of the medium and therefore may be an endogenous ligand of the Ah receptor. PMID- 3968087 TI - Purification and partial characterization of alkaline phosphatase of matrix vesicles from fetal bovine epiphyseal cartilage. Purification by monoclonal antibody affinity chromatography. AB - Alkaline phosphatase of matrix vesicles isolated from fetal bovine epiphyseal cartilage was purified to apparent homogeneity using monoclonal antibody affinity chromatography. The enzyme from the butanol extract of matrix vesicles bound specifically to the immobilized antibody-Sepharose in the presence of 2% Tween 20 whereas the major portion of nonspecific protein was removed by this single step. Of various agents tested, 0.6 M 2-amino-2-methyl-1-propanol, pH 10.2, was the most effective in eluting 80-100% of the enzyme initially applied. Both Tween 20 and 2-amino-2-methyl-1-propanol associated with the eluted enzyme were effectively removed by the sequential application of DEAE-cellulose and Sepharose CL-6B chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the enzyme preparation treated with sodium dodecyl sulfate and mercaptoethanol showed the presence of a dominant band (using silver staining) corresponding to a molecular weight of 81,000. This molecular weight was nearer reported values for rat liver (Ohkubo, A., Langerman, N., and Kaplan, M. M. (1974) J. Biol Chem. 249, 7174-7180) and porcine kidney (Cathala, G., Brunel, C., Chapplet-Tordo, D., and Lazdunski, M. (1975) J. Biol. Chem. 250, 6040-6045) alkaline phosphatase, than to previously reported values for chicken (Cyboron, G. W., and Wuthier, R. E. (1981) J. Biol. Chem. 256, 7262-7268) and fetal calf (Fortuna, R., Anderson, H. C., Carty, R. P., and Sajdera, S. W. (1980) Calcif. Tissue Int. 30, 217-225) cartilage matrix vesicle alkaline phosphatase. The purified alkaline phosphatase was activated by micromolar Mg2+. The amino acid composition of cartilage alkaline phosphatase was found to be similar to that previously described for porcine kidney (Wachsmuth, E. D., and Hiwada, K. (1974) Biochem. J. 141, 273 282). Double immunoprecipitation data indicated that monoclonal antibody against cartilage alkaline phosphatase cross-reacted with fetal bovine liver or kidney enzyme but failed to react with calf intestinal or rat cartilage enzyme. Thus these observations suggest that alkaline phosphatase of matrix vesicles from calcifying epiphyseal cartilage is a liver-kidney-bone isozyme. PMID- 3968088 TI - Purification and characterization of heparinase from Flavobacterium heparinum. AB - Heparinase (EC 4.2.2.7) isolated from Flavobacterium heparinum was purified to homogeneity by a combination of hydroxylapatite chromatography, repeated gel filtration chromatography, and chromatofocusing. Homogeneity was established by the presence of a single band on both sodium dodecyl sulfate and acid-urea gel electrophoretic systems. Amino acid analysis shows that the enzyme contains relatively high amounts of lysine residues (9%) consistent with its cationic nature (pI 8.5) but contains only 4 cysteine residues/polypeptide. The molecular weight of heparinase was estimated to be 42,900 +/- 1,000 daltons by gel filtration and 42,700 +/- 1,200 daltons by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme is very specific, acting only on heparin and heparan monosulfate out of 12 similar polysaccharide substrates tested. It has an activity maximum at pH 6.5 and 0.1 M NaCl and a stability maximum at pH 7.0 and 0.15 M NaCl. The Arrhenius activation energy was found to be 6.3 kcal/mol. However, the enzyme is very sensitive to thermal denaturation and loses activity very rapidly at temperatures over 40 degrees C. Kinetic studies of the heparinase reaction at 37 degrees C gave a Km of 8.04 X 10(-6) M and a Vm of 9.85 X 10(-5) M/min at a protein concentration of 0.5 microgram/ml. By adapting batch procedures of hydroxylapatite and QAE (quaternary aminoethyl)-Sephadex chromatography, gram quantities of heparinase that is nearly free of catalytic enzyme contaminants can be purified in 4-5 h. PMID- 3968089 TI - Phosphorylation, transbilayer movement, and facilitated intracellular transport of diacylglycerol are involved in the uptake of a fluorescent analog of phosphatidic acid by cultured fibroblasts. AB - We have previously shown that a fluorescent derivative of phosphatidic acid, 1 acyl-2-[N-(4-nitrobenzo-2-oxa-1,3-diazole) aminocaproyl]phosphatidic acid (C6-NBD PA) is rapidly transferred from liposomes to Chinese hamster fibroblasts at 2 degrees C, resulting in intense labeling of the mitochondria, endoplasmic reticulum, and nuclear envelope, but not the plasma membrane. During this labeling, C6-NBD-PA is metabolized predominantly to fluorescent diacylglycerol (Pagano, R. E., Longmuir, K. J., Martin, O. C., and Struck, D. K. (1981) J. Cell Biol. 91, 872-877). In the present study we investigated the mechanism by which C6-NBD-PA enters cells and is translocated to intracellular membranes at low temperature. (i) When hydrolysis of C6-NBD-PA to diacylglycerol was prevented by using a nonhydrolyzable fluorescent phosphonate analog, intense labeling of the plasma membrane occurred but fluorescent lipid did not enter the cytoplasm of cells. (ii) Experiments using C6-NBD-PA and cells prelabeled with 32Pi demonstrated that some of the fluorescent diacylglycerol was rephosphorylated at 2 degrees C. (iii) When cells were treated with 1,3-[palmitoyl, N-(4-nitrobenzo-2 oxa-1,3-diazole)aminocaproyl]-glycerophosphate, the lipid was dephosphorylated to 1,3-diacylglycerol but its rephosphorylation could not be detected. Nevertheless, rapid labeling of cytoplasmic membranes occurred. (iv) Formation of fluorescent diacylglycerol at the plasma membrane by treatment of cells with fluorescent phosphatidylcholine followed by phospholipase C at 2 degrees C resulted in strong labeling of intracellular membranes. Based on these results, a working model is presented for the uptake and intracellular translocation of phosphatidic acid involving formation of diacylglycerol at the plasma membrane followed by its transbilayer movement, facilitated translocation to intracellular membranes, and rephosphorylation. PMID- 3968090 TI - Long-term results of the Chrisman-Snook operation for reconstruction of the lateral ligaments of the ankle. AB - The Chrisman-Snook procedure for instability of the lateral ankle ligaments, first described in 1969, reconstructs the anterior talofibular ligament and the calcaneofibular ligament using one-half of the peroneus brevis tendon, routed through tunnels in the fibula and calcaneus. In the present long-term evaluation of the results of this procedure, forty-eight of sixty ankles, in fifty-seven patients, were assessed after a mean follow-up of ten years (range, four to twenty-four years). The results were excellent in thirty-eight ankles, good in seven, fair in two, and poor in one. The two ankles with a fair result were improved but still had some persistent instability, while the ankle with a poor result (no improvement) was in a patient with generalized ligament laxity. All three patients with a fair or poor result had had a severe reinjury to the ankle. Based on the findings in this study, we concluded that this procedure will restore good long-term function in a high percentage of patients who are disabled by ankle instability due to unhealed or neglected tears of the lateral ligaments. PMID- 3968091 TI - The effect of core decompression on femoral head blood flow in steroid-induced avascular necrosis of the femoral head. AB - Previous reports from this and other laboratories have shown that the histological changes in the femoral head that are associated with steroid treatment are consistent with avascular necrosis of the femoral head. In this experiment, we studied the effect of core decompression on femoral head blood flow in steroid-treated rabbits using the microsphere technique. The results showed that there was a gradual decline of femoral head blood flow in animals that received weekly injections of methylprednisolone without core decompression. The femoral head blood flow in animals that underwent core decompression after six weeks of steroid treatment showed a gradual normalization within four weeks after core decompression. PMID- 3968092 TI - Effects of joint load on the stiffness and laxity of ligament-deficient knees. An in vitro study of the anterior cruciate and medial collateral ligaments. AB - We measured the effects of serial section of the medial collateral ligament and anterior cruciate ligament and of the anterior cruciate ligament and medial collateral ligament on anterior-posterior force-versus-displacement and tibial torque-versus-rotation response curves for seven fresh frozen cadaver knees at zero and 20 degrees of flexion before and after application of as much as 925 newtons of compressive load on the tibiofemoral joint. Section of the anterior cruciate ligament always increased anterior laxity in an unloaded specimen; joint load reduced this increase by a greater amount at zero degrees than at 20 degrees of flexion. Joint load was more effective in limiting anterior laxity in anterior cruciate-deficient specimens at low levels of applied anterior force; at higher levels of applied force, the effects of joint congruency were overcome and ligament restraints came into play. Section of the medial collateral ligament increased anterior laxity in an unloaded knee only for specimens in which the anterior cruciate ligament had been previously sectioned; joint load eliminated this increase at full extension but did not do so at 20 degrees of flexion. The medial collateral ligament was the more important of the two ligaments in controlling torsional laxity. Secondary section of either ligament (the other ligament having been sectioned first) produced a greater increase in laxity than did primary section of that ligament in an intact knee. Increases in torsional laxity due to primary section of either ligament were unaffected by the application of joint load. Joint load reduced increases in laxity that were due to secondary section of the medial collateral ligament. PMID- 3968093 TI - Hypoplasia of the trochlea of the humerus as a cause of ulnar-nerve palsy. Report of two cases. PMID- 3968094 TI - Familial multiple osteochondritis dissecans. Report of a kindred. PMID- 3968095 TI - Anterior sacro-iliac arthrodesis for post-traumatic sacro-iliac arthritis. A case report. PMID- 3968096 TI - Stress fracture of the first rib. A case report. PMID- 3968097 TI - Synovectomy of the elbow in rheumatoid arthritis. AB - The combined procedure of synovectomy and resection of the radial head was performed in thirty-five patients (forty-two elbows) with Stage-III or IV rheumatoid arthritis. These patients were followed postoperatively for a minimum period of two years (average, seven years). The result was graded as excellent in four, good in fifteen, fair in fourteen, and poor in nine elbows. Pain was diminished from the preoperative level in all but six elbows, but motion was not much improved. Synovitis recurred postoperatively in thirteen elbows, but in only five did the destructive process progress to a degree requiring a second operation. We think that synovectomy for relief of pain in the elbow is not contraindicated in the presence of Stage-III or IV rheumatoid disease, but that little improvement of elbow motion can be expected. PMID- 3968098 TI - Klippel-Feil syndrome associated with spinal stenosis. A case report. PMID- 3968100 TI - The anterior tarsal syndrome. PMID- 3968099 TI - Achilles tendon rupture following steroid injection. PMID- 3968101 TI - Talectomy for equinovarus deformity in myelodysplasia. AB - Nine patients with myelomeningocele (seventeen involved feet) had talectomy for the correction of equinovarus deformity. The age at surgery ranged from one year and eight months to seven years and four months old. The length of follow-up averaged seven years and four months and ranged from twenty-two months to twelve years. Fifteen feet had a good and two had a poor correction of the deformity of the hind part of the foot, the result being directly related to the intraoperative correction of the equinus deformity. The correction of the fore part of the foot was rated as good in eight, fair in one, and poor in eight feet. Residual deformity of the fore part of the foot compromised the functional result in six feet that had an acceptable correction of the deformity of the hind part. PMID- 3968102 TI - Long-term results of open sternocleidomastoid tenotomy for idiopathic muscular torticollis. AB - At the end of their skeletal growth, we evaluated the cases of sixty-seven patients who had had an open tenotomy of the sternal and clavicular origins of the sternocleidomastoid muscle for idiopathic muscular torticollis. The average length of follow-up was 15.4 years, and the average age at the last follow-up was 23.9 years. The patients were divided into three groups according to their age at the time of operation. Group I consisted of patients who were operated on between the ages of five months and six years; Group II, of patients who were operated on between the ages of seven and eleven years; and Group III, of patients who were operated on when they were twelve years old or older. According to our method of evaluation, 37 per cent of the patients had a good, 45 per cent had a fair, and 18 per cent had a poor result. The patients in Group I had the best results and those in Group III, the worst. In general, the patient's age at operation, the duration of the disease, and the severity of the deformity before the operation had the major effects on both cosmetic and functional results. PMID- 3968103 TI - Lower-extremity rotational problems in children. Normal values to guide management. AB - We studied 1,000 normal lower extremities of children and adults in order to establish normal values for the rotational profile. The intrauterine position of the fetus molds the femur by rotating it laterally and molds the tibia by rotating it medially. These molding effects usually resolve spontaneously during infancy, and then genetically determined individual differences are unmasked. Rotational problems should be clinically evaluated and the findings compared with the normal values provided by this study. Out-toeing in infants, medial tibial torsion in toddlers, and medial femoral torsion in young children are extremes of a normal developmental pattern. In the vast majority, these rotational variations fall within the broad range of normal and require no treatment. PMID- 3968104 TI - Radiographic analysis of a low-modulus titanium-alloy femoral total hip component. Two to six-year follow-up. AB - We performed a detailed serial radiographic analysis of the femoral component of 323 cemented low-modulus titanium-alloy total hip prostheses. There was a low incidence of femoral component loosening as manifested by radiolucent zones at the stem-cement interface or cement fractures. There was also a low incidence of resorption of the calcar and cortical hypertrophy. Comparison of our data with those of others indicated that the incidence of loosening, calcar resorption, and cortical hypertrophy was usually lower than with similarly designed conventional high-modulus Charnley stems. These findings appear to support computer-modeling studies that have predicted a more even distribution of stresses along the entire length of the stem of the titanium-alloy prosthesis. Of the two configurations of femoral components used, the straight stems demonstrated a significantly lower incidence of radiographic evidence of loosening, calcar resorption, and cortical hypertrophy than the curved stems did. These findings have provided sufficient biomechanical rationale for the evolutionary development of the second-generation femoral components, which incorporate many features of the straight stem. PMID- 3968105 TI - Ender nailing for peritrochanteric fractures of the femur. An analysis of indications, factors related to mechanical failure, and postoperative results. AB - Of 100 patients with a peritrochanteric fracture of the femur treated by the Ender technique, we reviewed the cases of seventy-nine after an average follow-up of 11.4 months in order to clarify the indications for the procedure and investigate variables that may affect the results. The variables that correlated with the failure rate appeared to be the quality of the reduction, the number of nails used, the experience of the surgeon with the technique, and the degree of fracture instability. Nail placement in terms of medial-lateral and anterior posterior positioning within the femoral head, however, did not appear to correlate. The Ender technique seems to be reasonably effective both for the treatment of stable intertrochanteric fractures and, if a good reduction and four or more nails are used, for the treatment of four-part unstable fractures. We do not recommend the technique for fractures with a subtrochanteric component unless mobilization of the patient can be delayed. PMID- 3968106 TI - Late results of synovectomy in juvenile rheumatoid arthritis. AB - We reviewed the records of 251 patients whose cases were diagnosed between 1958 and 1978 at the Children's Hospital Medical Center Special Treatment Center for Juvenile Arthritis. We used a computerized system that included retrieval of data on range of motion, pain, joint swelling, functional capacity, and radiographic changes at each six-month visit over the years that the patient was followed. For the patients who were operated on, the radiographic information was evaluated preoperatively and at the last radiographic follow-up (average, six years after operation). The data bank contained postoperative radiographic information for thirty-two of the joints that had been operated on. We reviewed the late results of forty-one synovectomies in thirty children. The data included range of motion, swelling, and pain before operation, at one and two years after operation, and at an average of 7.1 years of follow-up. There were few if any benefits from the operation with reference to pain or improvement of range of motion, but it did seem to provide permanent relief of the joint swelling. Furthermore, radiographic deterioration seemed to continue in the joints that had been operated on if they already had radiographic changes at the time of operation (late synovectomy). In the joints without radiographic changes at the time of operation (early synovectomy), there seemed to be a continuation of deterioration in those affected by polyarticular disease, while the changes were less pronounced in those affected by pauciarticular disease. We undertook this study with a positive attitude toward synovectomy in the treatment of juvenile rheumatoid arthritis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968107 TI - Local muscle flaps in the treatment of chronic osteomyelitis. AB - When large soft-tissue and osseous defects remain after debridement of a chronic osteomyelitic lesion, application of a local muscle flap can be an effective way to achieve wound closure. Utilizing this surgical technique and specific antimicrobial therapy for the causal microorganisms, the infectious process was eradicated in thirty-nine of forty-two patients with osteomyelitis who were followed for at least two years after treatment. The osteomyelitic process was post-traumatic in origin--that is, a complication of a fracture or its treatment- in twenty-eight patients, the result of soft-tissue trauma without a fracture in eight, a complication of elective surgery in three, and the result of hematogenous seeding in three patients. Nine of the forty-two patients had an infected non-union. The infectious process involved the tibia in 62 per cent of the patients. Pseudomonas aeruginosa was the most frequently isolated causal organism. A soleus or gastrocnemius muscle flap was most frequently utilized to achieve closure. In five patients, a combination of two muscle flaps was utilized. Although this technique successfully eradicated the infectious process in 93 per cent of the patients, twenty-two patients required additional surgical treatment. Six required such treatment for a persistent non-union and two, for weakened diaphyseal bone after eradication of the septic process. A cancellous bone-grafting procedure was performed in all eight patients after the muscle flap had healed, and union was achieved in six of them. One patient eventually requested an amputation for a persistent non-union, and the remaining patient had a fibular synostosis performed for a persistent tibial non-union. A local muscle flap can be used in patients with a large defect of soft tissue and bone after debridement of an osteomyelitic lesion if the flap can be elevated and transposed into the defect without compromising its vascular supply. Although they are not applicable to the treatment of all patients with osteomyelitis, local muscle flaps can be extremely useful in the treatment of this lesion. When combined with thorough debridement and specific antimicrobial therapy, it has become a successful technique in the management of chronic osteomyelitis. PMID- 3968108 TI - Split posterior tibial-tendon transfers in children with cerebral spastic paralysis and equinovarus deformity. AB - In the treatment of equinovarus deformity of the foot in children with cerebral spastic paralysis, to supplement heel-cord lengthening, we split the posterior tibial tendon and transferred its posterior half laterally into the peroneus brevis tendon. Thirty-seven operations were performed on thirty-one hemiplegic, quadriplegic, and diplegic children who were followed for a mean of eight years postoperatively (range, four to fourteen years), at which time twenty-six of the thirty-one children were skeletally mature. There were thirty excellent, four good, and three poor results. The results did not deteriorate with time. Thirty two of thirty-four children with good or excellent results had functioning dorsiflexors of the foot and were brace-free postoperatively. The children who had a poor result had recurrent deformity, but none had development of a calcaneal or calcaneovalgus deformity. PMID- 3968109 TI - Varus derotation osteotomy in the treatment of persistent dysplasia in congenital dislocation of the hip. AB - We have attempted to define the indications for and limitations of varus derotation osteotomy in the treatment of persistent dysplasia in congenital dislocation of the hip. We studied the cases of thirty-four patients (forty-four hips) who were divided into three groups according to age at operation, and evaluated the influence of femoral remodeling, age, acetabular response, instability, and pre-existing avascular necrosis with respect to the final results. The length of follow-up ranged from five to twenty-two years. Rapid return to a valgus femoral neck-shaft angle by remodeling was not a cause of failure in any age group. There were consistently good results in the patients who were less than four years old at the time of operation. Acetabular correction by remodeling occurred through the age of eight years, but four of thirteen hips in patients who were between the ages of four and eight showed persistent dysplasia despite the operative procedure. The results were less predictable as the patients approached the age of eight years. There was no benefit from isolated femoral osteotomy in ten of eleven hips in patients who were older than eight. Pre-existing avascular necrosis appeared to compromise the results of the procedure in all age groups. PMID- 3968110 TI - McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis. Long-term clinical follow-up and current indications. AB - Forty patients with forty-four unicompartmental McKeever metallic uncemented hemiarthroplasties were followed for five to thirteen years (average, eight years). Thirty-nine knees had a medial and five, a lateral arthroplasty. The age at surgery ranged from thirty-two to eight-two years (average, sixty-seven years). At the final follow-up, 70 per cent of the knees were rated as good or excellent. Seventy-nine per cent of the knees in patients who were less than sixty-five years old at the time of surgery were in these categories. Six knees (14 per cent) had required revision to either a unicompartmental or a bicompartmental total knee replacement. The average preoperative and postoperative knee flexion did not change, but knees with initially poor motion improved. The average preoperative flexion contracture of 10 degrees improved postoperatively to 5 degrees. Complications were rare and no cases of infection, peroneal palsy, or clinically detectable phlebitis occurred. Obesity did not seem to adversely affect the outcome. This study indicated that the McKeever unicompartmental metallic hemiarthroplasty can provide an attractive alternative in the treatment of unicompartmental degenerative arthritis when proximal tibial osteotomy is contraindicated or has failed or when the patient is too young, heavy, or active to consider total knee replacement. PMID- 3968111 TI - The use of the McKeever metallic hemiarthroplasty for unicompartmental arthritis. AB - We reviewed the results of sixty-one McKeever unicompartmental arthroplasties performed by the senior one of us (T. P.) for osteoarthritis of the knee. The average follow-up was five years (range, two to thirteen years). Forty-four (72 per cent) of the arthroplasties were rated as good to excellent. The average postoperative range of motion in these knees was 110 degrees. Six knees were rated as fair and eleven knees, as poor. The poor results appeared to be caused by degenerative arthritis involving ipsilateral compartments that had not been resurfaced with an implant. PMID- 3968112 TI - The effect of an incomplete interochanteric osteotomy on Legg-Calve-Perthes disease. AB - In an attempt to accelerate the healing process, an incomplete intertrochanteric osteotomy was performed over a ten-year period in fifty-three patients (fifty four hips) with Legg-Calve-Perthes disease. Radiographs of the hips that had been operated on were reviewed to establish the length of time that was required to attain completion of bone-healing of the femoral head and completion of the resorption stage of the disease. These healing times were then compared with those of a control group of thirty-six patients (forty-three hips) who had had non-operative treatment for Legg-Calve-Perthes disease in our institution, as well as with the data from other studies on this subject in the orthopaedic literature. In our experience, an incomplete intertrochanteric osteotomy did not in any way alter the rate of healing of Legg-Calve-Perthes disease. PMID- 3968113 TI - The management of traumatic spondylolisthesis of the axis. AB - Fifty-two patients with traumatic spondylolisthesis of the axis were admitted to the University of Maryland Spinal Injury Center between 1977 and 1982. There were fifteen Type-I fractures, twenty-nine Type-II fractures, three Type-IIa fractures, and five Type-III fractures. Associated neurological deficits were found in only four patients, although unassociated neurological deficits such as closed head injury were seen in eleven patients. Thirteen patients had other fractures of the cervical spine. Type-I fractures were stable injuries and were treated with collar protection. Most Type-II injuries were reduced with the patient in halo traction, and then immobilization in a halo vest was used. Type IIa injuries, as they showed increased displacement in traction, were reduced with gentle extension and compression in a halo vest. Type-III injuries were grossly unstable and required surgical stabilization. All of the fractures healed, although the use of early halo-vest immobilization for displaced fractures resulted in significant residual deformity. The radiographic patterns of the fracture types and the resulting data on clinical stability suggested a correlation between the fracture type and the mechanism of injury. Type-I injuries resulted from a hyperextension-axial loading force; Type-II injuries, from an initial hyperextension-axial loading force followed by severe flexion; Type-IIa injuries, from flexion-distraction; and Type-III injuries, from flexion compression. PMID- 3968114 TI - Intercondylar fractures of the humerus. An operative approach. AB - In this paper we review a series of thirty-four intercondylar fractures of the distal end of the humerus that were treated by open reduction over a ten-year period. The fracture patterns were classified according to the system of Muller et al. and a strict rating scale incorporating subjective data, objective motion, and the functional status of the involved elbow was used for the results. At a mean follow-up of 5.8 years, thirteen results were rated as excellent; fourteen, as good; four, as fair; and three, as poor. Complications included postoperative neuritis in five patients; three non-unions; and refracture, heterotopic bone, and deep sepsis in one patient each. PMID- 3968115 TI - Role of computed tomography and myelography in the diagnosis of central spinal stenosis. AB - In order to evaluate radiographic methods for diagnosing central lumbar stenosis, we reviewed the computed tomography scans and myelograms of twenty-four patients who underwent surgical decompression for central lumbar stenosis. In the diagnosis of central lumbar stenosis, the measurement of the anterior-posterior diameter of the osseous canal by computed tomography was less reliable than the measurement of the dural sac by myelography. The dimensions of the canal derived from computed tomography provided a correct diagnosis in 20 per cent of the patients, while myelography was accurate 83 per cent of the time. The effectiveness of computed tomography was improved when the cross-sectional area of the dural sac was measured. We suggest that a narrow dural sac, demonstrated by myelography or by computed tomography, reliably indicates central spinal stenosis. PMID- 3968116 TI - Radiography and computerized tomography in the diagnosis of incongruity of the distal radio-ulnar joint. A prospective study. AB - The diagnosis of subluxation or dislocation of the distal radio-ulnar joint may be difficult to confirm by routine radiographs. We undertook a prospective evaluation of fifteen patients with acute or chronic pain in the distal radio ulnar joint, using both standardized radiographs and computer assisted tomography. In the absence of a deformity of the distal end of the radius, a lateral radiograph made with the wrist in the neutral position accurately revealed incongruency of the distal radio-ulnar joint. When pain or cast immobilization prevented optimum positioning of the wrist for radiography, or when a deformity of the distal end of the radius was present, computer assisted tomography gave a more accurate determination of the congruency of the joint. PMID- 3968117 TI - Results of internal neurolysis of the median nerve for severe carpal-tunnel syndrome. AB - Thirty-six hands in thirty-two patients had internal neurolysis of the median nerve and carpal tunnel release for severe carpal-tunnel syndrome. Median-nerve function was evaluated in all hands using Weber two-point discrimination and electromyography. Thenar-muscle strength or bulk, or both, were recorded in thirty hands. Ten hands also had Semmes-Weinstein monofilament pressure-testing. The indication for neurolysis in these selected patients was the presence of any one of the following: an increase in two-point-discrimination values, thenar muscle atrophy, or denervation potentials in the thenar muscles. Twenty-two (76 per cent) of the twenty-nine hands that had had diminished two-point discrimination preoperatively regained normal sensibility. Seven (70 per cent) of ten hands that had had thenar-muscle weakness (grade 3 or less) preoperatively regained grade-4 or 5 strength. Nine (50 per cent) of eighteen hands that had had thenar-muscle atrophy regained normal muscle bulk. Seventy-six per cent of the patients in this series recovered sensation and 70 per cent recovered muscle strength, and the procedure was well tolerated. Although no studies comparing the results of treatment of severe carpal-tunnel syndrome with and without internal neurolysis have been reported, we think that neurolysis, if it is done by a surgeon who is skilled in microsurgery, is a safe and effective procedure for severe carpal-tunnel syndrome. PMID- 3968118 TI - Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. AB - In thirty-three normal cadaver knees from adults (mean age, twenty-nine years), the average length of the anterior cruciate ligament was 31 +/- 3 millimeters and the angle between the ligament and the long axis of the femur was 28 +/- 4 degrees with the knee at 90 degrees of flexion. We could find no macroscopic or microscopic evidence of discrete subdivisions of the anterior cruciate ligament. We studied the functional importance of the positions of the attachments of the anterior cruciate ligament. The distance between the central points of the normal attachment areas on the tibia and on the femur was found to be isometric during flexion and extension. The so-called over-the-top position on the femur was the least favorable of the positions that we tested, since it resulted in an average elongation of the ligament of ten millimeters with the knee in full extension as compared with full flexion. On the basis of the results in the present study, we suggest some basic principles for a standardized replacement operation for a deficient anterior cruciate ligament. PMID- 3968119 TI - Setting temperatures of synthetic casts. AB - We used a glass tube containing water at body temperature to simulate a lower limb and applied commonly used synthetic-cast materials to this artificial limb in order to measure the exotherm created by these materials. Tests were limited to six plies and were done with and without a pillow under the cast. If the instructions called for the use of dip water, we used water at 24, 32, and 40 degrees Celsius. Under these conditions, none of the commonly used synthetic materials created temperatures that were high enough to cause burns. PMID- 3968120 TI - The effect of age on bone composition and viability in the femoral head. AB - We studied the effect of age on bone composition and osteocyte viability in femoral heads from fifty-one subjects. The assessment included determination of: bone volume, ash weight, calcium, and phosphorus content; osteocyte viability in fresh sections stained for lactate dehydrogenase activity; microfractures in fresh sections after removal of marrow elements; bone area, the presence of metabolic bone disease, and the histology of microfractures in embedded calcified sections; and the extent of trabecular microfractures. Bone area and numbers of microfractures were also assessed in eight elderly hip-fracture patients. Bone volume decreased with age, but there was considerable variation in each age group, and no significant difference between men and women. Ash weight and the bone content of calcium and phosphorus also decreased with age, but were constant if corrected for bone volume. Almost all osteocytes were viable in subjects who were younger than twenty-five years, and thereafter viability progressively decreased to a mean of 74 per cent in the eighth decade of life. There was a significant negative correlation between osteocyte viability and age. There was no evidence of metabolic bone disease in any patient. The numbers of microfractures increased with age and correlated negatively with bone viability (r = -0.31, p less than 0.05); in simple linear correlation a relationship between bone area and microfractures could not be demonstrated but in multiple linear correlation, after the inclusion of bone viability, there was an additional negative correlation between numbers of microfractures and bone area (p less than 0.005). Bone area and numbers of microfractures in hip-fracture patients were similar to those in age-matched controls. PMID- 3968121 TI - Proteoglycans of human infant intervertebral disc. Electron microscopic and biochemical studies. AB - The ground substance of the intervertebral disc consists primarily of proteoglycans, which give the tissue its stiffness to compression and its resiliency. To investigate the structure and composition of these molecules, we extracted them from human infant nucleus pulposus under associative conditions and from human infant annulus fibrosus and cartilage end-plate under dissociative conditions. We examined the degree of aggregation, the composition, the electron microscopic appearance, and the dimensions of the proteoglycans of the intervertebral disc and compared their structure and dimensions with those of the proteoglycans from bovine hyaline cartilage. Aggregates represented 52 per cent of the proteoglycans of the nucleus pulposus between the ages of one and ten days but only 28 per cent between the ages of six and eight months. Preparations from the corresponding annuli contained 59 per cent aggregates at one to ten days and 47 per cent at six months. The corresponding cartilage end-plate preparations contained 45 and 40 per cent aggregates. The proteoglycans of the annulus fibrosus and cartilage end-plate contained more protein and less hexosamine than did those of the nucleus pulposus. Electron microscopy showed that approximately two-thirds of the aggregates from nucleus pulposus consisted of very short hyaluronate filaments with closely packed monomers. The other third had longer hyaluronate filaments and wider distances between monomers, and closely resembled the aggregates from the annulus fibrosus and cartilage end-plate. Aggregated monomers consisted of two segments: a thin segment connecting directly to the hyaluronic acid filament and a thick segment extending peripherally from the thin segment. The thin segment formed about 12 per cent of the total monomer length in the samples from all three disc tissues. The lower proportion of aggregated monomers, the lower protein content, and the smaller aggregates with closely packed monomers suggest that the nucleus pulposus may contain less link protein than do the annulus fibrosus and cartilage end-plate. Compared with proteoglycan aggregates from bovine hyaline cartilage, proteoglycan aggregates from human intervertebral disc were shorter and had fewer monomers and wider spacing between monomers. The aggregated monomers from the three components of the intervertebral disc had an average length of 209 +/- 90 nanometers, compared with 210 +/- 114 nanometers for monomers from hyaline cartilage of skeletally mature cows, 250 +/- 116 nanometers for monomers from hyaline cartilage of skeletally immature calves, and 288 +/- 108 nanometers for monomers from fetal animals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3968123 TI - Isolated carpal synchondrosis of the scaphoid and trapezium. A case report. PMID- 3968122 TI - Optimizing tourniquet application and release times in extremity surgery. A biochemical and ultrastructural study. AB - Despite numerous studies investigating the pathophysiology of tourniquet ischemia, definitive data at the cellular level have been lacking and no consensus regarding safe tourniquet-application times in extremity surgery has emerged. In light of the particular vulnerability of skeletal muscle to ischemic injury, we determined the degree of muscular metabolic derangement and cell damage produced by seven different protocols of tourniquet application and release, each providing three hours of total tourniquet time. We performed thirty six experiments on canine hind limbs, comparing the following time-patterns of tourniquet application: I--three sequential one-hour periods, II--two sequential one and one-half-hour periods, III--two hours followed by one hour, and IV--a single continuous three-hour application. Five and fifteen-minute reperfusion intervals between ischemic periods were compared for the first three time patterns, creating a total of seven different tourniquet protocols. Muscular metabolic derangement and cell injury were evaluated by monitoring changes in the cellular bioenergetic state (high-energy phosphate profile), cell pH, post ischemic leakage of creatine phosphokinase, and ultrastructural cell degeneration. At the intracellular level, the metabolic recovery of muscle during reperfusion was much faster than previous studies focusing on extracellular parameters have indicated. In all instances complete intracellular bioenergetic recovery occurred within five minutes after tourniquet release. The use of one or more five-minute reperfusion intervals significantly reduced the degree of ischemic cell injury, as indicated by a decrease in creatine phosphokinase leakage and myofibrillar destruction. No additional benefit was derived by extending the reperfusion periods to fifteen minutes. The longest period of continuous ischemia in each tourniquet-application protocol bore the closest relationship with the amount of cell damage produced. Within the spectrum of observed pathological changes, time-patterns I and II produced comparatively little muscle damage. PMID- 3968124 TI - Familial lumbar stenosis. Case report of three siblings. PMID- 3968125 TI - Rupture of the quadriceps tendon following dislocation of the patella. Case report. PMID- 3968126 TI - Anterior dislocation of the hip with ipsilateral basicervical fracture. A case report. PMID- 3968128 TI - Treatment of selected patients with an ununited fracture of the proximal part of the scaphoid by excision of the fragment and insertion of a carved silicone rubber spacer. PMID- 3968127 TI - Coccidioidal osteomyelitis in a child's finger. A case report. PMID- 3968129 TI - Pressure sores in elderly patients. The epidemiology related to hip operations. AB - The prevalence and onset of pressure sores was studied in 283 patients admitted to a general hospital with either fracture of the proximal femur or for elective hip surgery. Ninety patients developed pressure sores, of which 60 are reported in detail. Most were in women aged 70 or more who had been admitted with hip fractures. The majority of pressure sores started soon after admission, particularly on the day of operation, after which the numbers of new cases decreased. Half the patients had more than one pressure sore and the commonest sites were the sacrum, heels, and buttocks. The mortality in patients with pressure sores was 27% and their mean length of stay in hospital far exceeded that of other patients. The prevention of pressure sores in elderly patients requires more skill and attention than the nurse alone can offer; it demands the help of the whole orthopaedic team. PMID- 3968130 TI - Congenital vertical talus. The results of staged operative reduction. AB - Congenital vertical talus was diagnosed in 15 feet of 10 children, and was treated by operative reduction. Forefoot deformity was corrected first, using anterolateral soft-tissue release on 11 feet, and manipulation alone in four feet. After prolonged immobilisation in plaster the affected feet had posterior release at the ankle and elongation of the calcaneal tendon. Clinical and radiographic examination at follow-up 15 months to 21 years later showed that a satisfactory outcome had been achieved in 12 of the 15 feet. PMID- 3968131 TI - Ulnar impingement syndrome. AB - We report the ulnar impingement syndrome, which is caused by a shortened ulna impinging on the distal radius and causing a painful, disabling pseudarthrosis. Of the 11 cases reported, 10 were due to excision of the distal ulna after injury to the wrist; the other was a result of a growth arrest after a fracture of the distal ulna in a child. The symptoms are a painful, clicking wrist and a weak grip; clinical examination reveals a narrow wrist with pain on compression of the radius and ulna and on forced supination. Radiographs in the majority of cases show scalloping of the distal radius corresponding to the site of impingement. The mechanism by which ulnar impingement occurs after radio-ulnar convergence is illustrated. The plan of management for the young patient with traumatic dysfunction of the distal radio-ulnar joint is discussed; excision of the lower end of the ulna is not advised in such patients. PMID- 3968132 TI - Carpal tunnel syndrome in patients on haemodialysis. AB - Eight cases of carpal tunnel syndrome are reported, all of which developed in patients on haemodialysis for chronic renal failure. In each case the arm involved had been used for a fistula. The aetiology of the syndrome in these patients is discussed; it is multifactorial, but related to the sites of arteriovenous fistulae. Decompressing the carpal tunnel provides effective and lasting relief. PMID- 3968134 TI - The Watson-Jones Lecture 1984: Surgeons and writers. PMID- 3968133 TI - Slipped upper femoral epiphysis and primary juvenile hypothyroidism. AB - The pathogenesis of slipped upper femoral epiphysis is unknown but the condition has been linked with various endocrine disorders. Nine patients with slipped epiphyses in association with primary juvenile hypothyroidism are presented. In all patients, slipping occurred or symptoms developed in the affected hip before the hypothyroidism was diagnosed. A generalised pathology was suggested by the absence of trauma (8 patients), by bilateral slipping (6 patients), and by obesity and short stature in all patients. All cases had delayed skeletal maturation and characteristic metaphysial changes were seen on their radiographs. The clinical diagnosis of juvenile hypothyroidism can be difficult but it merits consideration in patients who have a slipped upper femoral epiphysis in association with short stature, obesity, delay in skeletal maturity, or any one of these. PMID- 3968135 TI - British Orthopaedic Association scientific papers. Abstracts. PMID- 3968136 TI - Trochanteric advancement for premature arrest of the femoral capital growth plate. AB - Premature closure of the growth plate of the femoral capital epiphysis associated with limitation of abduction and gluteal insufficiency is described. The indications for trochanteric advancement and the results obtained in the late treatment of Perthes' disease and of congenital dislocation are discussed. Nine hips treated after Perthes' disease had satisfactory results, in that all were improved; but in eight hips with deformity arising from congenital dislocation the outcome was less favourable. PMID- 3968137 TI - The management of primary acetabular dysplasia. Its association with habitual side-lying. AB - Fifty-one infants with limited abduction of the hip and acetabular dysplasia were, between 1969 and 1975, treated with abduction-adduction exercises, administered by the parents; no abduction devices were used. In 1983 a follow-up examination was carried out on 41 of these patients. Although at birth these children had characteristics similar to patients with congenital dislocation of the hip, none of their hips dislocated. At birth acetabular measurements showed that half the children had severe dysplasia and the other half slight dysplasia; the difference between the affected and the healthy hips was significant. At follow-up the gait was normal in all the patients. Movements at the hips were symmetrical and within normal limits in all but one patient. The acetabular angle, the centre-edge angle, the shaft-neck angle, the hip ratio, and the size of the femoral head were the same on the previously affected side as on the normal side. Nineteen of the children followed up had preferred lying on one side and dysplasia of the upper hip had developed. The significance of the sleeping position on the development of acetabular dysplasia is discussed. PMID- 3968138 TI - Avascular necrosis of the femoral head in sickle-cell disease. A series from the Guinea Savannah of Nigeria. AB - Of 899 patients with sickle-cell disease, aged between 6 and 28 years, who attended clinics in the Guinea Savannah of Nigeria in 1982 and 1983, 29 had symptoms of avascular necrosis of the femoral head. This group was studied in detail. Twenty-eight patients had haemoglobin-SS electrophoretic patterns and one had haemoglobin-SC. The male to female ratio was 1 to 1.6, and most of the patients were aged between 6 and 15 years at the onset of hip symptoms. These symptoms correlated with the radiographic lesions, but were not related to the age or sex of the patient. The radiographic lesions varied widely and were related to the age at onset of hip symptoms. A new radiological classification is proposed. PMID- 3968139 TI - Subluxation of the knee as a complication of femoral lengthening by the Wagner technique. AB - Twenty-one patients with leg-length inequality underwent femoral lengthening using the Wagner technique. When reviewed, seven were found to have varying degrees of posterior subluxation of the knee. Critical assessment demonstrated that each of these was associated with a hypoplastic femur. It is postulated that posterior displacement of the tibia on the femur occurred as a result of the distal femoral and intraarticular bony deficiencies. PMID- 3968140 TI - The natural history of anterior knee pain in adolescents. AB - Anterior knee pain in adolescents is generally recognised as a common but benign self-limiting condition. Although many operative procedures for its treatment have been proposed, there is little statistical evidence that they are more effective than expectant management. A group of 54 adolescent girls has been followed for two to eight years from presentation with anterior knee pain. Although some pain persisted in the majority, in many the symptoms declined in severity. This study provides a baseline for comparison with the results of operative intervention; it is suggested that surgical treatment is unproven and unnecessary. PMID- 3968141 TI - Fracture-separation of articular cartilage in the adult knee. AB - Seventy-six knees with fracture-separations of articular cartilage are described. The lesion involved the full thickness of the articular surface with exposed subchondral bone in 28 knees and only part of the thickness in 48. The clinical features and distribution of the lesions within the knee are described. PMID- 3968142 TI - Congenital contractural arachnodactyly. Report of a case and of an operation for knee contracture. AB - A patient with typical congenital contractural arachnodactyly followed up from the age of 12 years to the age of 48 is reported. He had spiderlike fingers and toes and marked contractures of the knees, ankles, toes, shoulders, elbows and fingers; the mobility of the hips and wrists was almost normal. Persistent knee contractures prevented him from walking. In his twenties he had an osteotomy of both femora and shortening of the patellar tendons which enabled him to walk for the first time in an upright position without external support. When seen at the age of 48 the range of movement of his knees was 0 to 90 degrees. He was working as a turner and had been doing so for almost 20 years. PMID- 3968143 TI - Arthrodesis for failed knee arthroplasty. A report of 20 cases. AB - Twenty consecutive patients treated by arthrodesis for failed knee arthroplasty are reviewed. Eight hinged, five stabilised and seven compartmental prostheses were removed, for infection (15 cases), loosening (4) and instability (1). One patient refused a second-stage operation but the remainder gained sound fusion. Infected knees had a two-stage procedure with temporary insertion of gentamicin loaded beads after removal of the prosthesis; all infections healed. Six arthrodeses using a Hoffmann-Vidal external fixator resulted in two temporary failures. One Ace-Fischer external fixation was successful. Of 10 primary attempts at arthrodesis with an intramedullary Kuntscher nail, nine were successful; the tenth fused after two more attempts by the same method. The two failures of external fixation and two failures after Charnley single-frame compression done elsewhere were successfully fused with intramedullary nails. Delayed union in three cases fused after prolonged fixation and repeated bone grafts. The indications for and methods of arthrodesis after failed knee arthroplasty are discussed. PMID- 3968144 TI - Intracompartmental pressure monitoring of leg injuries. An aid to management. AB - Acute compartment syndromes often develop insidiously and are often recognised too late to prevent permanent disability. Management is difficult as the compartment involved is seldom clinically apparent. By continuously monitoring the intracompartmental pressure these problems can be avoided: transient compartment syndromes can be differentiated from established ones and the correct compartment can be surgically decompressed. Pressure monitoring techniques were used in 28 patients; three developed a compartment syndrome requiring surgical intervention, seven had a temporary increase of pressure and in 18 the pressure remained unaltered. Of the three with compartment syndromes, one was unusual in that it affected the thigh and another, unique in our experience, affected both the thigh and the calf. Intracompartmental pressure monitoring significantly altered the management of two cases giving successful results with minimal intervention. PMID- 3968145 TI - Superficial peroneal nerve entrapment. A case report. PMID- 3968146 TI - Entrapment of the superficial peroneal nerve. Three case reports. AB - Entrapment of the superficial peroneal nerve is an unusual cause of pain in the ankle and foot. In such cases decompression of the nerve at the point of exit from the deep fascia will produce a good result. Three cases are described. PMID- 3968147 TI - Entrapment neuropathy of the superficial peroneal nerve. A bilateral case. AB - A 21-year-old female athlete presented with bilateral lumps in her calves which became painful on exercise. Exploration revealed entrapment of the superficial peroneal nerves. Her symptoms were relieved by fasciectomy. PMID- 3968148 TI - Free vascularised fibular graft in the treatment of congenital pseudarthrosis of the tibia. AB - Five cases of congenital pseudarthrosis of the tibia successfully treated by a free vascularised fibular graft are described. Follow-up ranged from 5 to 34 months with a mean of 17.5 months. The technique, which includes radical excision of abnormal bone and soft tissue around the pseudarthrosis, also permits primary bone lengthening, and correction of deformity. The early results indicate that satisfactory bony union is achieved in a relatively short period of time. PMID- 3968149 TI - The diagnosis of flat foot in the child. AB - The term flat foot is surrounded by confusion and there is little to help the clinician to identify cases which require treatment and to avoid treating many children unnecessarily. Research for 25 years has been aimed at elucidating this problem by identifying and evaluating a series of signs and tests. These tests allow the recognition of the abnormal foot as early as possible, when efficient treatment is likely to be most effective. The results indicate that evaluation of the flat foot should be based on a combination of signs, with most emphasis on the result of the great toe extension test. PMID- 3968150 TI - Plantar pressure measurements and the prevention of ulceration in the diabetic foot. AB - Static and dynamic measurements of foot pressure have been carried out on three groups of subjects: diabetic patients with neuropathy (with and without a history of ulceration), diabetic patients with no neuropathy, and normal subjects as controls. In many cases both techniques of measurement detected areas of abnormally high pressure under the foot, but in some cases a particularly high pressure spot was detected on only one of the tests and sometimes both methods were needed to reveal all the areas of the foot which might be considered to be at risk. The dynamic measurements tended to show multiple areas of high pressure better than the static measurements. Our results indicate the importance of making both types of measurement when seeking to devise suitable means of protecting the foot from ulceration. PMID- 3968151 TI - Idiopathic multicentric osteolysis with acro-osteolysis. A case report. AB - We report a case of multicentric massive osteolysis. A 52-year-old woman presented with a three-year history of progressive deformities of the hands. She had osteolytic lesions of the metacarpals and metatarsals, and resorption of the terminal phalanges. During follow-up over four years osteolysis spread to affect the ribs, clavicles, mandible, and long bones. There was no family history of any bone disorder and renal function was normal. Death resulted from resorption of the rib cage and post-mortem studies failed to reveal the cause of the osteolysis. PMID- 3968152 TI - The syndrome of idiopathic osteolysis. Classification, review, and case report. AB - Idiopathic osteolysis is characterised by a spontaneous onset without previous causative factors, followed by rapid destruction and resorption of the involved bones. This process can result in severe deformities with joint subluxation and instability. In certain forms an associated malignant nephropathy may develop. A case report is presented which illustrates the destructive nature of the process. PMID- 3968153 TI - Triceps contracture caused by injections. A report of 11 cases. AB - Eleven cases are reported of contracture of the triceps muscle following intramuscular injections. This occurred in one arm of each of 11 children aged from 6 to 13 years, all of whom had a definite history of repeated injections. In seven of the cases the injections were of oxytetracycline. On presentation only 30 degrees to 35 degrees of flexion was possible. Physiotherapy for 4 to 12 weeks produced improvement, but in four cases early operation for excision of fibrous tissue and lengthening of the triceps was necessary to restore adequate flexion. Four other cases required operation after late relapse. The condition is rare, and is compared with similar and more commonly reported contractures in the quadriceps and the deltoid muscles. PMID- 3968154 TI - Injection-induced contractures of the quadriceps in childhood. A comparison of proximal release and distal quadricepsplasty. AB - Thirty-two contractures of the quadriceps induced by injection in 17 children have been reviewed. The average age at presentation was 3 years 4 months. All the children had suffered a severe illness within the first few weeks of life and all had received intramuscular injections into the thigh. Three methods of treatment were used: conservative, distal quadricepsplasty, and proximal release. At follow up none of the patients treated by proximal release had an extension lag, which was present in 70% of those treated by distal quadricepsplasty. Apart from one case with slight improvement in the range of knee flexion, conservative treatment, at best, could only prevent further loss. The clinical presentation and management is described, and the advantages of proximal release are discussed. PMID- 3968155 TI - Present status of abdominal aorta imaging by computed tomography. AB - A seven-year experience with CT scanning in the diagnosis and evaluation of abdominal aortic aneurysms is reviewed. Two hundred twenty-six patients with suspected abdominal aortic aneurysms were studied, 12 being acute situations with possible rupture. In 15 no aortic pathology was seen. The diagnosis of an aneurysm regardless of its location was made in all instances and confirmed by other techniques and/or surgery. Location, size, extension and presence of thrombus were well delineated. Aortic rupture or leakage was demonstrated when present. Unsuspected involvement of the thoracic aorta, as well as the iliac arteries was shown. CT scanning is a technique that can safely, easily and accurately be used in the diagnosis of, follow-up and extension of aneurysmal disease regardless of its location or clinical situation and compares favorably with any other available technology. PMID- 3968156 TI - The effect of unilateral carotid endarterectomy on neuropsychological test performance in 53 patients. AB - Six psychomotor tests (Ravens matrices, finger tapping, spatial orientation, arithmetic, vocabulary, and short-term memory) were administered preoperatively, at 3-7 days and 3 months postoperatively to 53 patients undergoing unilateral carotid endarterectomy between 1978 and 1982. Standard operative technique included general anesthesia and Javid shunt. None of the patients experienced postoperative neurological deficit or significant complications. Individual and cumulative test scores were correlated with prior CVA, neurological examination, cerebral angiography, pre and postoperative computerized cerebral tomograms and intraoperative carotid flow measurements. Psychometric scores did not change postoperatively in 18 patients with prior CVA's. Forty-five patients operated upon for high grade stenosis (75% reduction in cross sectional diameter) had a significant increase in early post-endarterectomy test scores which returned to preoperative levels by three months postoperatively. Increase in intra-operative carotid artery blood flow correlated with improved test performance. We conclude that carotid endarterectomy of flow restrictive stenosis initially augments psychometric test performance but the improvement is not sustained at the third postoperative month. PMID- 3968157 TI - Techniques for temporary shunting of carotid arteries: experimental study in dogs. AB - In order to study possible differences among temporary shunts for carotid artery surgery, 4 types of shunts were studied in an experimental canine model of extracranial cerebrovascular insufficiency. Twenty five dogs were operated on and divided in five equal groups: one control group without shunt, two groups of animals with a short internal shunt and two groups with a long external shunt, catheters of two different gauges being used for each type of shunt. These shunts were evaluated by systemic arterial pressure (SAP), stump pressure (SP) and carotid blood flow, which were measured before and after carotid clamping, and 5 and 10 minutes after the release of blood flow through the carotid artery or through the shunts. Multivariate analysis of variance showed that all but the shorter and wider shunt acted as a stenosis in the carotid artery, with a decrease of 50% in blood flow. The analysis of other parameters did not show differences among the shunts, suggesting that even acting as a stenosis, no functional pressure alteration occurred with the different shunts in this model. PMID- 3968158 TI - Cerebral perfusion in dogs during pulsatile and non pulsatile extracorporeal circulation. AB - Eight dogs were cannulated for left heart bypass. Conventional roller pumps were used for bypass with one of the pump console modified to deliver pulsatile bypass. The experiments were performed at normothermia. Each dog was used as its own control. For measurement of cerebral blood flow (CBF) Xe133 was injected into vertebral artery and the gamma activity elimination over the skull was registered. In addition blood samples were withdrawn from the axillary artery and the sagittal sinus for measurement of blood gases. The CBF to the gray matter of the brain was significantly higher during the periods with pulsatile perfusion (P less than 0.01). This was probably due to decreased total cerebral vascular resistance (P less than 0.001). Mean aortic pressure also decreased when the mode of perfusion was changed from non pulsatile to pulsatile (P less than 0.05), indicating a general decrease of the peripheral vascular resistance. A good correlation was noted between the arteriovenous oxygen saturation difference (AV O2 diff) across the brain and the CBF (R = -0.77, P less than 0.01). PMID- 3968159 TI - Descending thoracic aortobifemoral bypass for occluded abdominal aorta: retroperitoneal route without an abdominal incision. AB - Severe juxtarenal aortic disease and occluded aortic bifurcation grafts have prompted surgeons to seek alternative routes when reoperating. We have modified the descending thoracic aortobifemoral bypass procedure by drawing the graft through a retroperitoneal tunnel to the left groin, thereby eliminating the need for an abdominal incision. The lower thoracic area is exposed through a left anterolateral thoracotomy incision and each common femoral artery is exposed by vertical incisions in the groins. The right limb is drawn through a retrorectus tunnel to the right groin for the final anastomosis. Experience with this technique in 12 patients has demonstrated less risk of atheroemboli, less blood loss, shorter operating time, and a more rapid postoperative recovery, than is the case in reentering the abdomen for a secondary aortic procedure. PMID- 3968160 TI - Open mitral commissurotomy: long-term results with echocardiographic correlation. AB - Over 11 years, 91 patients with isolated mitral stenosis underwent open mitral commissurotomy. Twenty-nine were 50 or more years old; 15 had had prior commissurotomies. Four (4.4%) died perioperatively; 87 were followed for one to nine years (average: five years). Overall actuarial survival was 94% at 5 years. Sixty-nine patients (79%) were NYHA Functional Class (FC) I or II at latest follow-up. Arterial embolism occurred in five patients; 14 patients (16%) had a second valve operation. Patients who remain in FC I or II and who are free of embolism and reoperation are classified as complication-free. Actuarial analysis demonstrated 76% to be so classified at five years after operation. Actuarial curves show that age older than 40 years, sex, previous commissurotomy, and "radical" versus simple open mitral commissurotomy did not influence survival or the incidence of good results. Follow-up M-mode and 2D echocardiograms were obtained in 42 patients. The estimated mitral orifice accurately separated FC I patients (orifice equal to or larger than 2 cm2) from FC II and FC III patients (orifice smaller than 2 cm2), and showed that echocardiographic evidence of a 2 cm2 or larger mitral orifice correlates with a good result. PMID- 3968161 TI - Enhanced cardiac performance following cardiopulmonary bypass. AB - Changes in cardiac performance during coronary revascularization surgery were followed in 22 selected patients with normal or mildly impaired left ventricles; vasoactive or inotropic drugs were generally avoided. Arterial pressure, filling pressures, and cardiac output were measured; stroke volume and work were calculated before induction of anesthesia, following sternotomy, soon after discontinuation of extracorporeal circulation, and one hour postoperatively. Induction and sternotomy were associated with a depressant effect on cardiac performance. After extracorporeal circulation, however, cardiac performance recovered, cardiac output increased to 7 +/- 0.5 l/min from a preoperative control of 4.9 +/- 0.3 L/min (p less than 0.002) without an elevation of atrial pressures. This increase in cardiac output after bypass resulted from decreased afterload and increased preload secondary to hemodilution. Cardiac performance approached control values early in the postoperative period. PMID- 3968162 TI - Surgical treatment of variant angina with positive cold pressor test. AB - Coronary artery spasm is provoked by exercise, cold pressor test and pharmacological agents during cardiac catheterization. We describe a patient in whom the coronary artery was excessively sensitive to cold pressor test, and who was treated by coronary artery bypass grafting (CABG) combined with cardiac denervation. Postoperative coronary arteriogram showed decreased sensitivity to cold pressor test with patent graft. These observations suggest that combined CABG with cardiac denervation is indicated for patients with fixed organic coronary artery narrowing and positive provocative test, and that postoperative cold pressor test during coronary arteriography is a useful, low risk method for the evaluation of the efficacy of cardiac plexectomy. PMID- 3968163 TI - Changing patterns in civilian arterial injuries. AB - A critical review of 185 patients with 211 arterial injuries over an eleven year period was performed to recognize the changing patterns in clinical findings, management and results. A ten fold increase in multiple arterial injuries as well as higher incidence of associated venous and visceral injuries occurred during the last five years. Despite this, the incidence of hypotension on arrival at hospital was reduced by half due to rapid transportation and resuscitation during transit. Shock in patients with only extremity injuries heralded dual injuries (arterial and venous). Lateral repair of both arterial and venous injuries has given way to end to end anastomoses, vein grafts and patch grafts. A greater tendency to repair all major arteries, most minor arteries, more liberal use of heparin, fasciotomy, intraluminal shunts, repair of venous injuries and extra anatomic bypass has been noted. Rapid patient retrieval, early resuscitation, improved recognition and management of arterial injuries has not lead to better limb salvage or survival. The apparent lack of benefit in limb salvage is probably due to the higher incidence of multiple arterial injuries and associated venous injuries as well as the willingness to attempt repair all major arterial injuries and reluctance to advise primary amputation. Early patient retrieval, rapid transportation and resuscitation during transit has increased the number of potentially unsalvageable patients (who would otherwise be declared dead on arrival) resulting in an unchanging mortality. PMID- 3968164 TI - Distal and proximal dissection of an abdominal aortic aneurysm. AB - A case of abdominal aortic aneurysm in which dissection developed in retrograde fashion into the thoracic aorta is reported. The aortogram showed findings similar to DeBakey Type-IIIb dissection. No intimal tear was seen in the thoracic aorta; however, the origin of the intimal tear was found in the abdominal aorta. Renal hypertension also developed due to distal dissection of the right renal artery. Closure of the primary intimal tear, partial closure of the false channel and removal of the right kidney were performed therefore, reattachment of vessels was not required. This was the first case in which a primary tear was seen in the abdominal aorta in our 37 surgical cases of dissecting aortic aneurysm. Three cases of retrograde dissection of abdominal aortic aneurysm have been reported in the English literature as far as we have determined. The importance of accurate detection of the origin of the intimal tear is emphasized. PMID- 3968165 TI - Double inferior vena cava and abdominal aortic aneurysm. AB - Duplicated inferior vena cava was found unexpectedly at the time of resection of abdominal aortic aneurysm. Resection of the aneurysm and preservation of duplicated vena cava was performed. Technical difficulties and embryology of this anomaly are discussed. PMID- 3968166 TI - Superior vena caval stenosis: a rare complication in permanent transvenous cardiac pacing. AB - An unusual case of superior vena caval stenosis associated with a permanent transvenous cardiac pacing wire and its successful treatment by surgical reconstruction using a pericardial patch is reported. PMID- 3968167 TI - Occluded persistent sciatic artery. AB - The case of a patient with ischemic symptoms due to occlusion of a persistent left sciatic artery is presented. Femoral arteriography revealed a tapering hypoplastic superficial femoral artery terminating as small branches in the distal thigh and a hyperplastic profunda femoris artery. Also, translumbar aortography demonstrated an abrupt occlusion of a hyperplastic left hypogastric artery just distal to the inferior gluteal artery. The popliteal artery was found to be patent and perfused by collaterals. A bypass graft using a composite E-PTFE prosthesis and an autogenous vein graft was successfully performed. PMID- 3968168 TI - Repair of caval lacerations during cardiac surgery. AB - Inadvertent tears to the atrial caval junction during open heart surgery can present as a disastrous complication. A method is described by which a flap of pericardium is mobilized and sutured over the caval laceration. Control of bleeding is facilitated and caval obstruction is minimized. PMID- 3968170 TI - Endothelial fenestral diaphragms: a quick-freeze, deep-etch study. AB - The route by which water, solutes, and macromolecules traverse the endothelial cell has long been a subject of study for both physiologists and cell biologists. Recent physiologic studies describe a slit-shaped pore (5.1-5.7-nm wide) as the communicating channel, although no channel of such dimensions has been visible in electron microscopic preparations. That this channel should be found within the fenestral diaphragm has long been suggested. In this report, by the aid of a new technique in tissue processing, we are able to demonstrate a possible morphologic correlate within the fenestral diaphragm of fenestrated capillaries. Quick freezing and deep-etching of whole tissue blocks allows the sublimation of water from the endothelial pores, thus leaving the channels through the diaphragms empty and readily replicated with a platinum-carbon shadow. The structure of the diaphragm was revealed thus to be composed of radial fibrils of 7 nm in diameter, interweaving in a central mesh, and creating by their geometric distribution, wedge-shaped channels around the periphery of the pore. The average channel had a maximum arc length of 5.46 nm. Fenestrated endothelia from various tissues, including endocrine and exocrine pancreas, adrenal cortex, and kidney peritubular capillaries, displayed the same diaphragmatic structure, whereas continuous capillaries in muscle had no such diaphragm. Photographic augmentation of electron micrographs of etched replicas displayed marked enhancement at n = 8, confirming an octagonal symmetry of the fenestral diaphragm. Finally, cationic ferritin, clearly visible as a marker after etching, heavily bound to the flowerlike structure within the fenestral pore. We conclude that the fenestral diaphragm contains the structure responsible for fenestrated capillary permeability and that the communicating channel has the shape of a wedge. PMID- 3968169 TI - Alpha-actinin from sea urchin eggs: biochemical properties, interaction with actin, and distribution in the cell during fertilization and cleavage. AB - A protein similar to alpha-actinin has been isolated from unfertilized sea urchin eggs. This protein co-precipitated with actin from an egg extract as actin bundles. Its apparent molecular weight was estimated to be approximately 95,000 on an SDS gel: it co-migrated with skeletal-muscle alpha-actinin. This protein also co-eluted with skeletal muscle alpha-actinin from a gel filtration column giving a Stokes radius of 7.7 nm, and its amino acid composition was very similar to that of alpha-actinins. It reacted weakly but significantly with antibodies against chicken skeletal muscle alpha-actinin. We designated this protein as sea urchin egg alpha-actinin. The appearance of sea urchin egg alpha-actinin as revealed by electron microscopy using the low-angle rotary shadowing technique was also similar to that of skeletal muscle alpha-actinin. This protein was able to cross-link actin filaments side by side to form large bundles. The action of sea urchin egg alpha-actinin on the actin filaments was studied by viscometry at a low-shear rate. It gelled the F-actin solution at a molar ratio to actin of more than 1:20, at pH 6-7.5, and at Ca ion concentration less than 1 microM. The effect was abolished by the presence of tropomyosin. Distribution of this protein in the egg during fertilization and cleavage was investigated by means of microinjection of the rhodamine-labeled protein in the living eggs. This protein showed a uniform distribution in the cytoplasm in the unfertilized eggs. Upon fertilization, however, it was concentrated in the cell cortex, including the fertilization cone. At cleavage, it seemed to be concentrated in the cleavage furrow region. PMID- 3968171 TI - Reversal of the posttranslational modification on Chlamydomonas flagellar alpha tubulin occurs during flagellar resorption. AB - We previously have shown that a posttranslational modification of alpha-tubulin takes place in the flagellum during Chlamydomonas flagellar assembly (L'Hernault, S. W., and J. L. Rosenbaum, 1983, J. Cell Biol., 97:258-263). In this report, we show that the posttranslationally modified alpha-3 tubulin is changed back to its unmodified alpha-1 precursor form during the microtubular disassembly that takes place during flagellar resorption. These data indicate that the addition and removal of a posttranslational modification on alpha-tubulin might be a control step in the assembly and disassembly of flagella. PMID- 3968172 TI - Sulfated proteoglycan synthesis by confluent cultures of rabbit costal chondrocytes grown in the presence of fibroblast growth factor. AB - We examined the effect of fibroblast growth factor (FGF) on proteoglycan synthesis by rabbit costal chondrocyte cultures maintained on plastic tissue culture dishes. Low density rabbit costal chondrocyte cultures grown in the absence of FGF gave rise at confluency to a heterogeneous cell population composed of fibroblastic cells and poorly differentiated chondrocytes. When similar cultures were grown in the presence of FGF, the confluent cultures organized into a homogenous cartilage-like tissue composed of rounded cells surrounded by a refractile matrix. The cell ultrastructure and that of the pericellular matrix were similar to those seen in vivo. The expression of the cartilage phenotype in confluent chondrocyte cultures grown from the sparse stage in the presence vs. absence of FGF was reflected by a fivefold increase in the rate of incorporation of [35S]sulfate into proteoglycans. These FGF effects were only observed when FGF was present during the cell logarithmic growth phase, but not when it was added after chondrocyte cultures became confluent. High molecular weight, chondroitin sulfate proteoglycans synthesized by confluent chondrocyte cultures grown in the presence of FGF were slightly larger in size than that produced by confluent cultures grown in the absence of FGF. The major sulfated glycosaminoglycans associated with low molecular weight proteoglycan in FGF exposed cultures were chondroitin sulfate, while in cultures not exposed to FGF they were chondroitin sulfate and dermatan sulfate. Regardless of whether or not cells were grown in the presence or absence of FGF, the 6S/4S disaccharide ratio of chondroitin sulfate chains associated with high and low molecular weight proteoglycans synthesized by confluent cultures was the same. These results provide evidence that when low density chondrocyte cultures maintained on plastic tissue culture dishes are grown in the presence of FGF, it results in a stimulation of the expression and stabilization of the chondrocyte phenotype once cultures become confluent. PMID- 3968173 TI - Effect of exogenous extracellular matrices on proteoglycan synthesis by cultured rabbit costal chondrocytes. AB - We examined the effect of an extracellular matrix (ECM), produced by either bovine corneal endothelial (BCE) cells or mouse PF HR-9 teratocarcinoma cells, on the ability of rabbit costal chondrocytes to re-express their phenotype once confluent. Rabbit chondrocytes seeded at low densities and grown on plastic tissue culture dishes produced a heterogeneous cell population composed of both overtly differentiated and poorly differentiated chondrocytes, as well as fibroblastic cells. On the other hand, cultures grown on BCE-ECM- or HR-9-ECM coated dishes reorganized into a homogeneous cartilage-like tissue composed of round cells surrounded by a refractile matrix that stained intensely with alcian green. The cell ultrastructure and that of their pericellular matrix were similar to those seen in vivo. The differentiation of chondrocyte cultures grown on the ECMs vs. plastic was reflected by a two- to three-fold increase in the maximal rate of incorporation of [35S]sulfate and [3H]glucosamine into proteoglycans. Furthermore, the ratio of 35S-labeled proteoglycans incorporated in the cell layer vs. those released into the medium was 1.5-2.5-fold higher when cultures were grown on the ECMs than on plastic. This suggests that the ECMs stimulate the incorporation of newly synthesized proteoglycans into a cartilaginous matrix. Since chondrocyte cultures grown on BCE-ECM or HR-9-ECM give rise to a homogeneous cartilage-like tissue even when seeded at low cell densities, they provide a model for the study of cell-substrate interactions that are responsible for the maintenance of the differentiated phenotype of chondrocytes. PMID- 3968174 TI - MAP3: characterization of a novel microtubule-associated protein. AB - Using monoclonal antibodies we have characterized a brain protein that copurifies with microtubules. We identify it as a microtubule-associated protein (MAP) by the following criteria: it copolymerizes with tubulin through repeated cycles of microtubule assembly in vitro; it is not associated with any brain subcellular fraction other than microtubules; in double-label immunofluorescence experiments antibodies against this protein stain the same fibrous elements in cultured cells as are stained by antitubulin; and this fibrous staining pattern is dispersed when cytoplasmic microtubules are disrupted by colchicine. Because it is distinct from previously described MAPs we designate this novel species MAP3. The MAP3 protein consists of a closely spaced pair of polypeptides on SDS gels, Mr 180,000, which are present in both glial (glioma C6) and neuronal (neuroblastoma B104) cell lines. In brain the MAP3 antigen is present in both neurons and glia. In nerve cells its distribution is strikingly restricted: anti-MAP3 staining is detectable only in neurofilament-rich axons. It is not, however, a component of isolated brain intermediate filaments. PMID- 3968175 TI - Developmentally regulated mRNAs in 3T3-adipocytes: analysis of transcriptional control. AB - We have investigated the regulation of mRNA synthesis during 3T3-adipocyte differentiation by measuring the transcription of specific genes in isolated preadipocyte and adipocyte nuclei. Transcription was assayed by hybridization of newly synthesized RNA to cDNA clones coding for glycerophosphate dehydrogenase (GPD), the induced protein of 13K which is shown here to be related to myelin protein P-2, the induced protein of 28K, actin, and two RNAs that are not developmentally regulated. Transcription of GPD and 13K was observed in adipocyte but not preadipocyte nuclei. Actin was transcribed in both types of nuclei but at a lower level in adipocytes. For most of the RNAs examined, there was a consistent relationship between amounts of nuclear transcription and the abundance of the corresponding cytoplasmic mRNA in adipocytes. However, 13K and 28K mRNAs are 10-100 times more abundant than would be predicted by their nuclear transcription alone. Preliminary mRNA turnover experiments in which 5,6-dichloro 1-beta-D-ribofuranosylbenzimidazole was used to inhibit mRNA synthesis suggest that these mRNAs are much more stable in the adipocyte cytoplasm than the other mRNAs examined. These results indicate that the transcription of specific genes is increased during adipocyte differentiation and suggest that other levels of control, particularly mRNA stability, may contribute to the relative abundance of certain developmentally-regulated mRNAs in adipocytes. PMID- 3968176 TI - Assembled and unassembled pools of clathrin: a quantitative study using an enzyme immunoassay. AB - Using polyclonal antibodies raised against clathrin, we have developed an enzyme linked immunoassay that can specifically measure the quantity of clathrin in crude cell extracts. We found that the quantity (weight percent of total protein) of clathrin was similar in cell types that exhibit large differences in their levels of endocytosis and exocytosis (lymphoid cells, 0.11%; liver cells, 0.07%, fibroblasts, 0.18%; myeloma cells, 0.16%). However, the quantity of clathrin was found to be significantly higher in brain cortex (0.75%). Cellular clathrin was separated by high-speed centrifugation into two fractions: an unassembled form present in high-speed supernatants and an assembled form (clathrin coats) present in the pellets. We show that the fraction of clathrin in the unassembled state varies considerably depending on the cell type studied (14% in brain cortex to 70% in lymphocytes). Our data support the view that the amount of clathrin (relative to total cell protein) in eucaryotic cells is not related to the extent of receptor-mediated endocytosis and intracellular membrane traffic. However, the fraction of assembled clathrin seems to be higher in endocytically and/or exocytically active cells. PMID- 3968177 TI - Processing and lysosomal localization of a glycoprotein whose secretion is transformation stimulated. AB - The major excreted protein (MEP) of transformed mouse fibroblasts is a mannose 6 phosphate-containing glycoprotein whose synthesis and secretion are increased in malignantly transformed 3T3 cells and whose synthesis is increased by treatment of 3T3 cells with tumor promoters or growth factors. When pulse-labeled extracts from Kirsten virus-transformed NIH 3T3 (KNIH) cells were immunoprecipitated using an antibody against secreted MEP, one cellular protein was immunoprecipitated that had the same molecular weight and tryptic peptide map as the secreted protein. Pulse-chase labeling experiments showed that 50-60% of this 39,000-mol wt form was secreted in transformed cells. Of the 40-50% remaining, approximately 5% was processed into two lower molecular weight forms (29,000 and 20,000) which are sequestered within the cell. Similar processing of these proteins was observed in the nontransformed parent NIH 3T3 (NIH) cells. However, in NIH cells, much less of the synthesized MEP was secreted. Measurements of steady-state levels of these three forms of cellular MEP by Western blot immunolocalization revealed approximately fourfold more MEP in KNIH cells than in NIH cells as well as differences in the relative distribution of MEP forms in transformed and nontransformed cells. Subcellular fractionation of KNIH cells on a Percoll gradient demonstrated a distribution of total MEP similar to that of several lysosomal enzymes. The light lysosomal/Golgi peak from these gradients contained both the precursor 39,000-mol-wt form of MEP and the 20,000-mol-wt form, whereas the heavy lysosomal peak was enriched in the 20,000-mol-wt form. The distribution of MEP forms was found to be similar in NIH cells except that the 29,000-mol-wt form was also seen to be enriched in the heavy lysosomal peak. This biochemical localization of MEP was confirmed by immunolocalization with light and electron microscopy. These data support the hypothesis that MEP is a lysosomal protein that is secreted by transformed cells. PMID- 3968178 TI - A 57,000-mol-wt protein uniquely present in nonproliferating cells and senescent human fibroblasts. AB - Mouse monoclonal antibody, S-30, was produced from hybridoma preparation from mice injected with the cytoskeleton extract of an in vitro aged culture of human fibroblasts derived from a 66-yr-old donor. The antibody stains positively the nuclei of the nonproliferating cells present predominantly in the senescent cultures of five selected fibroblast strains derived from donors of different age groups, whereas a negative reaction is observed in the cultures of their young counterparts. In the intermediate stage of the in vitro life span of these cell strains, a heterogeneous positive reaction for staining with S-30 antibody is observed in different subfractions of cell cultures. However, the expression of S 30 can be induced in the young fibroblasts at the early stage of their life by prolonged culturing to confluence. This induced expression of S-30 nuclear staining can be depleted upon subculturing at low cell density. Immunoelectron microscopy with colloidal gold-protein A complex demonstrates that the S-30 proteins are present in the nuclear plasma and at the region of nuclear envelope in a clustered arrangement. Immunoprecipitation of [3H]leucine labeled cell specimens shows that the antibody S-30 reacts with a protein with a molecular weight of approximately 57,000. PMID- 3968179 TI - Reconstitution of light-harvesting complexes and photosystem II cores into galactolipid and phospholipid liposomes. AB - Chlorophyll a/b light-harvesting complexes (chl a/b LHC) and photosystem II (PSII) cores were isolated from an octyl glucoside-containing sucrose gradient after solubilization of barley thylakoid membranes with Triton X-100 and octyl glucoside. No cation precipitation step was necessary to collect the chl a/b LHC. PAGE under mildly denaturing and fully denaturing conditions showed that the chl a/b LHC fraction contained chlorophyll-protein complexes CP27, CP29, and CP64. The PSII core material contained CP43 and CP47, and little contamination by other nonpigmented polypeptides. Freeze-fracture electron microscopy of the chl a/b LHC after reconstitution into digalactosyldiglyceride (DG) or phosphatidylcholine (PC) vesicles showed that the protein particles (approximately 7.5 +/- 1.6 nm) were approximately 99 and 90% randomly dispersed, respectively, in the liposomes. Addition of Mg++ produced particle aggregation and membrane adhesion in chl a/b LHC-DG liposomes in a manner analogous to that described for LHC-PC liposomes. Reconstitution of PSII cores into DG vesicles also produced proteoliposomes with randomly dispersed particles (approximately 7.5 +/- 1.6 nm). In contrast, PSII-PC mixtures formed convoluted networks of tubular membranes that exhibited very few fracture faces. Most of the protein particles (approximately 7.0 +/- 1.5 nm) were seen trapped between, rather than embedded in, the membranes. The interaction between the zwitterionic head group of the phosphatidyl choline and the negatively charged PSII core may be responsible for the unusual membrane structures observed. PMID- 3968180 TI - Fc receptor-mediated binding and endocytosis by human mononuclear phagocytes: monomeric IgG is not endocytosed by U937 cells and monocytes. AB - Fc receptor-mediated endocytosis of monomeric IgG1 by human mononuclear phagocytes was evaluated under conditions where aggregated IgG and insulin readily undergo receptor-mediated internalization. U937 cells or normal human peripheral blood monocytes were incubated at 37 degrees C in the absence of free radioligand after having first bound 125I-IgG1 at 0 degrees C. To determine the amount of cell-associated IgG1 internalized after varying periods of 37 degrees C incubation, surface-bound IgG1 was removed by sequential exposure of cells at 0 degrees C to a nonspecific proteinase for 1 h and to acetic acid at pH 3.2 for 3 min. The failure to develop a proteinase- and acid-resistant fraction, similar to that seen over time at 37 degrees C in parallel experiments with 125I-insulin and 125I-aggregated IgG, and the lack of degradation of the IgG1 released into the medium from the same cells over time show that these cells do not endocytose and degrade monomeric IgG by an Fc receptor-specific mechanism and suggest that constitutive recycling without degradation is unlikely to be occurring. These data fulfill one prediction of the hypothesis that receptor-receptor interaction triggers Fc receptor-mediated endocytosis. PMID- 3968182 TI - Anionized and cationized hemeundecapeptides as probes for cell surface charge and permeability studies: differentiated labeling of endothelial plasmalemmal vesicles. AB - To obtain small membrane markers easily accessible to the charged groups of the cell surface, we prepared, from hemeundecapeptide (HUP), three derivatives that maintain the peroxidatic activity: the anionized hemeundecapeptide, Mr 1,963, estimated diameter 1.68 nm, pl 3.5, for the detection of basic groups; and both a cationized hemeundecapeptide containing predominantly tertiary amino groups, Mr 2,215, estimated diameter 1.75 nm, pl 9.0, and a cationized hemeundecapeptide containing only primary amino groups, Mr 2,271, estimated diameter 1.75 nm, pl 10.6, for labeling acidic residues. The markers were perfused in situ in mice to label the luminal surface of fenestrated endothelium of pancreatic capillaries. Specimens were processed through the cytochemical reaction for peroxidatic activity and examined by electron microscopy. The anionized HUP and HUP (pl 4.85) marked the plasmalemma proper, the coated pits, and the membrane and diaphragms of plasmalemmal vesicles and transendothelial channels. The cationized HUP containing predominantly tertiary amino groups (pl 9.0) decorated all cell surface components with the exception of plasmalemmal vesicles and channels; the latter were, however, labeled by the cationized HUP containing only primary groups (pl 10.6), which suggests that these structures contain on their luminal surface very weak acidic residues of high pKa values. The fact that the membrane of plasmalemmal vesicles can discriminate against permeant cationic macromolecules only up to a pl of approximately 9.0 indicates that in the electrostatic restriction there is a charge limit. In the case of fenestrated capillary endothelium, the upper charge limit seems to be a pl of approximately 9.0. In these vessels, the charge discrimination is effective for molecules as small as 2 nm. PMID- 3968181 TI - Gene amplification-associated cytogenetic aberrations and protein changes in vincristine-resistant Chinese hamster, mouse, and human cells. AB - We carried out cytogenetic studies of four Chinese hamster, mouse, and human cell lines selected for high levels of resistance (500- to 4,000-fold) to vincristine (VCR) by a multistep selection procedure. All cells examined contained gene amplification-associated metaphase chromosome abnormalities, either homogeneously staining regions (HSRs), abnormally banding regions (ABRs), or double-minute chromosomes (DMs); control actinomycin D- and daunorubicin-resistant hamster lines did not exhibit this type of chromosomal abnormality. VCR-resistant Chinese hamster sublines exhibited both increased synthesis of the protein V19 (Mr 19,000; pl = 5.7) and increased concentrations of V19 polysomal mRNA. When VCR resistant cells were grown in drug-free medium, level of resistance, synthesis of V19, and amount of V19 mRNA declined in parallel with mean length of the HSR or mean number of DMs per cell. Cross-resistance studies indicate that VCR-resistant cells have increased resistance both to antimitotic agents and to a wide variety of agents unrelated to VCR in chemical structure and/or mechanism of action. Our studies of tubulin synthesis in Chinese hamster cells indicate no overproduction of tubulin or presence of a mutant tubulin species. Comparison with antifolate resistant Chinese hamster cells known to contain amplified dihydrofolate reductase genes localized to HSRs or ABRs strongly suggests that the HSRs, ABRs, or DMs of the Vinca alkaloid-resistant sublines likewise represent cytological manifestations of specifically amplified genes, possibly encoding V19, involved in development of resistance to VCR. PMID- 3968183 TI - Heparin regulates the collagen phenotype of vascular smooth muscle cells: induced synthesis of an Mr 60,000 collagen. AB - The effect of heparin on the biosynthetic phenotype of rat vascular smooth muscle cells (SMC) was investigated in vitro. Addition of heparin to the culture medium of early passage rat SMC resulted in a marked (3-15-fold) increase of a cell layer-associated Mr 60,000 protein that was sensitive to digestion by purified bacterial collagenase and contained significant amounts of hydroxyproline. Pulse chase analysis of heparin-treated SMC revealed that the Mr 60,000 collagen was a primary and abundant product of these cells and was not processed extracellularly to a smaller form. The inductive effect of heparin could be mimicked by iota carrageenan or dextran sulfates but not by hyaluronic acid, dermatan sulfate, or chondroitin sulfates. The induction was concentration dependent with a maximal effect observed at a heparin concentration of 10 micrograms/ml. Synthesis of the Mr 60,000 collagen increased 18-24 h after addition of heparin to the cultures. Following induction and subsequent removal of heparin, synthesis of the protein remained maximal for at least 12 h and required 72 h to return to a basal level. These data demonstrate that the biosynthetic phenotype of vascular SMC in vitro can be controlled, at least in part, by heparin and related polyanions and suggest a role for similar molecules endogenous to the vessel wall in the regulation of SMC function. PMID- 3968184 TI - The effect of heat shock on the cell cycle regulation of tubulin expression in Physarum polycephalum. AB - In the myxomycete Physarum polycephalum, tubulin synthesis is subject to mitotic cycle control. Virtually all tubulin synthesis is limited to a 2-h period immediately preceding mitosis, and the peak of tubulin protein synthesis is accompanied by a parallel increase in the level of tubulin mRNA. The mechanism by which the accumulation of tubulin mRNA is turned on and off is not clear. To probe the relationship between tubulin regulation and cell cycle controls, we have used heat shocks to delay mitosis and have followed the pattern of tubulin synthesis during these delays. Two peaks of tubulin synthesis are observed after a heat shock. One occurs at a time when synthesis would have occurred without a heat shock, and a second peak immediately precedes the eventual delayed mitosis. These results are clearly due to altered cell cycle regulation. No mitotic activity is detected in delayed plasmodia at the time of the control mitosis, and tubulin behavior is shown to be clearly distinct from that of heat shock proteins. We believe that the tubulin family of proteins is subject to regulation by a thermolabile mitotic control mechanism but that once the cell has been committed to a round of tubulin synthesis the "tubulin clock" runs independently of the heat sensitive system. In delayed plasmodia, the second peak of synthesis may be turned on by a repeat of the commitment event. PMID- 3968186 TI - Induction of stress proteins in chicken embryo cells by low-level zinc contamination in amino acid-free media. AB - It has been reported that chicken embryo cells deprived of exogenous amino acids for 4 hours synthesize stress (heat-shock) proteins. Herein, we show that amino acid deprivation is not sufficient to cause induction of stress proteins. Zinc contaminating a component of commercial cell culture medium used to prepare amino acid-free medium was an inducer in our cultures. In the absence of exogenous amino acids, the concentration of zinc ions needed for half-maximal induction of stress proteins was an order of magnitude lower than the dose required for cells in complete medium. Histidine and cystine, which have high affinities for zinc ions, were the amino acids most effective in blocking the induction of stress proteins by zinc. Problems posed by heavy metal ions in culture media and biologic fluids for searches for in vivo inducers of the cellular stress (heat shock) response are discussed. PMID- 3968185 TI - Orthogonal arrays in normal and injured respiratory airway epithelium. AB - Orthogonal arrays are found on plasma membranes of glial cells, in the central nervous system, on muscle plasma membranes at neuromuscular junctions, and on a variety of epithelial cells. These structures have been correlated with ion flux. With the aid of freeze fracture technique, orthogonal particle arrays were found on plasma membranes on airway epithelial cells of rats and hamsters. They have been found in abundance at the base of secretory cells throughout normal airway epithelium. These structures were found to increase in number during regeneration in response to injury and they were found in great numbers on plasma membranes of all airway cells in response to acute and chronic NO2 exposure. The lateral and basal plasma membranes of the respiratory epithelium are a new source for studying orthogonal arrays. The normal number and distribution of these arrays can be perturbed in response to mechanical and chemical injury. PMID- 3968187 TI - Induction of endoreduplication in temperature-sensitive mutants of rat 3Y1 fibroblasts. AB - Four temperature-sensitive mutants of rat 3Y1 fibroblasts belonging to separate complementation groups (3Y1tsD123, 3Y1tsF121, 3Y1tsG125, and 3Y1tsH203) are arrested mainly with a 2C DNA content, when cells proliferating at 33.8 degrees C are shifted up to 39.8 degrees C (Ohno et al., 1984). Zaitsu and Kimura (submitted for publication) showed that 3Y1tsF121 cells synchronized in the early S phase were arrested with a 4C DNA content at 39.8 degrees C. We studied the traverse through the S and G2 phases at 39.8 degrees C in the four ts mutants synchronized at the early S phase and found that 3Y1tsG125 and 3Y1tsH203 cells were arrested with a 4C DNA content as 3Y1tsF121, while 3Y1tsD123 cells went through S and G2 phases and underwent mitosis. When 3Y1tsF121 and 3Y1tsG125 mutants arrested at 39.8 degrees C were shifted down to 33.8 degrees C, a substantial fraction of the cells with a 4C DNA content started, with a certain lag period, DNA synthesis without intervening mitosis and underwent the first mitosis with a lag period similar to that in the cells arrested with a 2C DNA content. The tetraploid cells thus generated had a proliferating ability lower than that of diploid cells. PMID- 3968188 TI - Adaptive regulatory control of System A transport activity in a kidney epithelial cell line (MDCK) and in a transformed variant (MDCK-T1). AB - Adaptive regulatory control of System A activity was investigated using MDCK cells and a chemically induced, oncogenic transformant of MDCK cells, MDCK-T1. Within 7 hours after transfer to an amino-acid-deficient medium, A activity of subconfluent MDCK cells had maximally derepressed, but this activity in confluent MDCK cells and in subconfluent transformed cells showed little capacity for derepression. Amino-acid-starved, subconfluent MDCK cells were used to study trans-inhibition and repression of A activity by individual amino acids. Trans inhibition and repression were defined as the cycloheximide-insensitive and cycloheximide-sensitive components, respectively, of the total inhibition. Trans inhibition correlated well with substrate affinity, but repression did not. Trans inhibition and repression were further characterized using alpha-(methylamino) isobutyric acid (mAIB), a trans-inhibitor, and glutamate, an effective repressor. The apparent initial T 1/2 for inhibition by mAIB in the presence of cycloheximide was 0.5 hours, while that for repression by glutamate was 4.7 hours. Half-maximal inhibition by mAIB and repression by glutamate occurred at approximately 0.02 mM and 0.07 mM, respectively. Reversal of trans-inhibition by methionine occurred in the presence of cycloheximide within 1-4 hours after removal of methionine. The A system of the transformed MDCK-T1 cells showed elevated activity, little capacity for derepression, resistance to repression by amino acids, but retention of sensitivity to trans-inhibition. Kinetic analysis of mAIB uptake indicated that the A system of MDCK-T1 cells has become kinetically more complex in a manner which resembled amino-acid-starved rather than amino-acid-fed MDCK cells. These results suggest that the A system of MDCK T1 cells has become resistant to adaptive regulatory control. PMID- 3968189 TI - Isolation of pituitary fibroblast growth factor by fast protein liquid chromatography (FPLC): partial chemical and biological characterization. AB - Bovine pituitary fibroblast growth factor has been purified 222,000-fold to homogeneity by a combination of differential salt extraction, gel filtration, and ion exchange chromatography on Mono S column. Pituitary FGF is a single-chain polypeptide with an apparent molecular mass of 15,800 and an isoelectric point of 9.6. It is highly active in triggering the proliferation of bovine and human vascular endothelial cell [half-maximal stimulation at 23-40 pg/ml (1.5-2.6 pM) and saturation between 140 and 280 pg/ml (9.3-18.6 pM)]. It displays a similar activity on bovine vascular smooth muscle cells, corneal endothelial cells, granulosa and adrenal cortex cells, and rabbit costal chondrocytes. PMID- 3968190 TI - Relationship of finite proliferative lifespan, senescence, and quiescence in human cells. AB - Cell hybrids were formed between human diploid fibroblasts (HDF) and carcinogen transformed HDF to determine the relationship among: (1) finite proliferative lifespan, which we define as an age-related failure of a population to achieve one population doubling in 4 weeks; (2) arrest in a senescent state, which we define as cessation of DNA synthesis in a viable culture that is at the end of its lifespan by the above definition; and (3) arrest in a quiescent state, which we define as cessation of DNA synthesis in a young culture that is crowded or mitogen-deprived. HDF express all three of these phenotypes, which we have abbreviated FPL+, S+, and Q+, respectively. Carcinogen-transformed HDF are transformed to immortality (FPL-) and inability to achieve quiescence (Q-). They have no S phenotype because, by definition, this phenotype only exists in FPL+ cells. Fusion of FPL+, Q+, S+ HDF X FPL-, Q- carcinogen-transformed HDF produced hybrid clones that were FPL+, Q-, and S-, where the S- phenotype means that individual cells continued to synthesize DNA in cultures that had reached the end of their lifespan by our definition. These results are consistent with our hypothesis that senescent HDF and quiescent HDF may share a common mechanism for arrest in G1 phase. We have suggested that this could occur if the aging mechanism that is responsible for the FPL+ phenotype is a progressive decrease in the ability of cells to recognize or respond to mitogenic growth factors. If so, then cells would become physiologically mitogen-deprived at the end of their lifespan, which would cause them to arrest in the senescent state by the same mechanism that causes young cells to arrest in the quiescent state when they are mitogen-deprived. This hypothesis predicts that the FPL+ phenotype can be separated from the S+ phenotype--i.e., FPL+ cells can be S+ or S- --and that the Q and S phenotypes are linked--i.e., FPL+ cells are either Q+ and S+ or Q- and S . Both these predictions are supported by the present data. PMID- 3968191 TI - The stimulation of normal human melanocyte proliferation in vitro by melanocyte growth factor from bovine brain. AB - Cell culture conditions for the selective growth and serial propagation of normal human melanocytes from epidermal tissue are described. In addition to the presence of 2% fetal bovine serum, the human melanocyte cell culture environment contains the following growth factor supplements: epidermal growth factor (10 ng/ml), triiodothyronine (10(-9) M), hydrocortisone, (5 X 10(-5) M), insulin (10 micrograms/ml), transferrin (10 micrograms/ml), 7S nerve growth factor (100 ng/ml) cholera toxin (10(-10) M), and bovine brain extract (150 micrograms/ml). The ability to establish selectively the human melanocyte in vitro has been attributed to the contrast between human epidermal keratinocytes and melanocytes for attachment to fibronectin, while the growth of the human melanocyte has been attributed to the mitogenic activity of the growth factor-supplemented medium. Human melanocytes can be cultivated for at least 15 cumulative population doublings and are capable of [3H]-Dopa incorporation. The growth factor supplemented medium contains a neutral extract from bovine brain that is a potent source of a human melanocyte mitogen. The biological activity of melanocyte growth factor is described as a heat and alkaline-labile mitogen with an estimated molecular weight of 30,000 by gel exclusion chromatography and a weakly cationic isoelectric point. The mitogen is capable of stimulating the growth of quiescent populations of human melanocytes in vitro. The ability to isolate and propagate normal human melanocytes in vitro permitted an examination of the expression of fibronectin and tissue plasminogen activator. Human epidermal melanocytes established in culture do not contain either tissue plasminogen activator or fibronectin. In contrast, human melanoma cell lines contain immunologically detectable fibronectin and tissue plasminogen activator. The absence of tissue plasminogen activator and fibronectin in normal human melanocytes also occurs under conditions of co-cultivation with human melanoma cells. These contrasts between normal human melanocytes and human melanoma cells may be relevant to the metastatic capabilities of human melanoma. PMID- 3968192 TI - Neutral amino acid transport in embryonal carcinoma cells. AB - Neutral amino acid transport was characterized in the pluripotent embryonal carcinoma (EC) cell line, OC15. Ten of the thirteen amino acids tested are transported by all three of the major neutral amino acid transport systems--A, L, and ASC--although one system may make a barely measurable contribution in some cases. The characterization of N-methyl-aminoisobutyric acid (meAIB) transport points to this model amino acid as a definitive substrate for System A transport by OC15 cells. Thus, high concentrations of meAIB can be used selectively to block System A transport, and the transport characteristics of meAIB represent system A transport. Kinetic analysis of System A, with a Km = 0.79mM and Vmax = 14.4 nmol/mg protein/5 min, suggests a single-component transport system, which is sensitive to pH changes. While proline transport in most mammalian cells is largely accomplished through System A, it is about equally divided between Systems A and ASC in OC15 cells, and System A does not contribute at all to proline transport by F9 cells, an EC cell line with limited developmental potential. Kinetic analysis of System L transport, represented by Na+-independent leucine transport, reveals a high-affinity, single-component system. This transport system is relatively insensitive to pH changes and has a Km = 0.0031 mM and Vmax = 0.213 nmol/mg protein/min. The putative System L substrate, 2 aminobicyclo-[2,2,1]heptane-2-carboxylic acid (BCH), inhibits Systems A and ASC as well as System L in OC15 cells. Therefore, BCH cannot be used as a definitive substrate for System L in OC15 cells. Phenylalanine is primarily transported by Na+-dependent Systems A and ASC (83% Na+-dependent; 73% System ASC) in OC15 cells, while it is transported primarily by the Na+-independent System L in most other cell types, including early cleavage stage mouse embryos and F9 cells. We have also found this unusually strong Na+-dependency of phenylalanine transport in mouse uterine blastocysts (82% Na+-dependent). There is no evidence for System N transport by OC15 cells, since histidine is transported primarily by a Na+ independent, BCH-inhibitable mechanism. PMID- 3968193 TI - FACS analysis of a hyperthermia-induced alteration in Hoechst 33342 permeability and direct measurement of its relationship to cell survival. AB - Heat-induced alterations in CHO-10B cell Hoechst 33342 (Ho342) permeability in vitro were analyzed by flow cytometry. Immediately after 45.5 degrees C heating, uptake was decreased in a dose-dependent manner with cytotoxicity. Kinetic analysis indicated that a treatment that reduced cell survival to approximately 10%, reduced the maximal velocity, Vmax, to 53% of control and increased the dissociation constant, Km, to 156% of control. Also, little change in Ho342 efflux was found to occur from control up to 90 min after heating. Upon incubation at 37 degrees C after the heat treatment from 1 to 24 hr (depending on the severity of the dose) diffuse heterogeneity of Ho342 staining developed which was not evident immediately after heating. The altered staining was not due to the presence of trypan blue staining cells. Membrane permeabilization and nuclei isolation studies indicated that the lesion responsible was most likely a plasma membrane event. Induction of the heterogenous staining was not inhibited by either actinomycin D or hydroxyurea but was inhibited by incubation at 4 degrees C. An inverse correlation existed between Ho342 permeability and clonogenicity, with nearly a 10-fold difference in survival between the high and low fluorescence intensity sorted cells. Also, larger fractions of heat-sensitive S and G2M-phase cells were found in the highly fluorescent sorted fractions. These results are discussed in terms of the putative molecular events that may be involved in hyperthermic modulation of Ho342 permeability. PMID- 3968194 TI - Uptake of transferrin and iron by cultured rat placental cells. AB - This paper describes a method for the culture of rat placental cells. The method involved separation of the basal layer from the labyrinth and sequential digestion of the cells. The cells were demonstrated not to be fibroblasts and are described in terms of their appearance under the light and electron microscopes. Transferrin and iron uptake by the cells was examined and compared with results achieved using other methods of study. The results showed that transferrin bound to receptors on the cell surface and that the transferrin, once bound, was taken into the cell. Only this internalized transferrin was capable of donating iron to the cells. The iron was accumulated within the cells and did not appear to be released to the incubation medium. The apparent dissociation constant (Ka) for transferrin was found to be 6.96 X 10(6) M-1, a value similar to that described by earlier workers. The placental cells had 3.4 X 10(11) binding sites/microgram DNA, equivalent to approximately 1 X 10(6) sites/cell. From these data, and from the rate of accumulation of iron by the cells, the receptor turnover time was estimated as being between 5 and 10 min. PMID- 3968195 TI - Separation of the catecholamine metabolites 4-hydroxy-3-methoxy- and 3-hydroxy-4 methoxymandelic acid by reversed-phase high performance liquid chromatography. AB - The catecholamine metabolites 4-hydroxy-3-methoxy- and 3-hydroxy-4 methoxymandelic acid can be completely separated by reversed-phase high performance liquid chromatography with chemically bonded octadecylsilane as stationary phase and a citrate/ammonium phosphate buffer (pH 4.5) containing 8% methanol as mobile phase. The two isomers can be electrochemically detected and produce different hydrodynamic voltammograms. PMID- 3968196 TI - HPLC determination of clenbuterol in pharmaceutical gel formulations. AB - A quick, accurate, reproducible high performance liquid chromatographic (HPLC) method for the determination of clenbuterol in the presence of some common pharmaceutical preservatives (i.e., methyl and propyl paraben) is described. The method is specific enough to separate and determine clenbuterol in the presence of degradation products of the formulation components. Extraction of interfering formulation components provides the necessary clean-up to determine clenbuterol via HPLC. PMID- 3968197 TI - High performance liquid chromatographic determination of chlophedianol hydrochloride in "jung fei", a complex tablet formulation. AB - A high performance liquid chromatographic method is presented for the determination of chlophedianol hydrochloride in a complex tablet formulation. Tablets are dissolved in a water/acetonitrile (50/50) mixture. Samples are separated on an octadecylsilane column with a mobile phase of 70% acetonitrile and 30% aqueous solution of 0.005M 1-octanesulfonic acid, 1% acetic acid, and 1% diethylamine. Effluent is monitored by a spectrophotometric detector with a 254 nm filter. Chlophedianol is separated from a complex mixture of plant extracts and fillers in the tablets. PMID- 3968198 TI - Detection of Toxoplasma gondii antigens by a dot-immunobinding technique. AB - A sensitive assay for the detection of antigens of Toxoplasma gondii by spotting samples directly onto nitrocellulose paper was developed. The sensitivity ranged from 10 to 40 pg of antigen diluted in phosphate-buffered saline and 40 to 130 pg of antigen diluted in normal mouse serum, normal human serum, or human cerebrospinal fluid. T. gondii antigen in serum samples taken from mice infected with T. gondii was detectable by day 2 of infection. Antigen was also detectable in cerebrospinal fluid samples taken from four of six infants congenitally infected with T. gondii and in serum samples from two of these infants. PMID- 3968199 TI - Monoclonal and specific polyclonal antibodies for immunoassay of Clostridium difficile toxin A. AB - Monoclonal antibody, affinity-purified antibody, and monospecific antiserum against toxin A were produced. The monoclonal antibody was an immunoglobulin G2a kappa chain isotype that immunoprecipitated toxin A, as shown by crossed immunoelectrophoresis. These antibodies were compared by counterimmunoelectrophoresis, latex agglutination, and indirect enzyme-linked immunosorbent assay for their sensitivity in detecting toxin A. Our findings indicate that these antibodies may be useful as immunodiagnostic reagents for Clostridium difficile disease. PMID- 3968200 TI - Effect of refrigerated storage on cefaclor in Mueller-Hinton agar. AB - Cefaclor is less stable than most cephalosporins in media at 35 degrees C. We demonstrated that the activity of cefaclor in Mueller-Hinton agar diminishes continuously at 4 degrees C, resulting in a loss of two-thirds of the activity within 21 days. We recommend that agar dilution plates for this cephalosporin be prepared on the day of their use. PMID- 3968201 TI - Comparison of enzyme-linked immunosorbent assay, hemagglutination inhibition, and passive latex agglutination for determination of rubella immune status. AB - Hemagglutination inhibition, enzyme-linked immunosorbent assay (ELISA), and passive latex agglutination were used to test 495 human serum samples for determination of rubella immunity. Overall agreements for immune status were as follows: hemagglutination inhibition versus ELISA, 94.7% (469 of 495); hemagglutination inhibition versus passive latex agglutination (1:10 dilution), 99.2% (491 of 495); and passive latex agglutination (1:10 dilution) versus ELISA, 94.7% (469 of 495). Both ELISA and passive latex agglutination are satisfactory for rubella immunity screening, with the reservation that the ELISA method examined yielded a large number of false-negative results. PMID- 3968202 TI - Koserella trabulsii, a new genus and species of Enterobacteriaceae formerly known as Enteric Group 45. AB - The name Koserella trabulsii is proposed for a group of Enterobacteriaceae formerly called Enteric Group 45. This group consists of 12 strains that were originally identified as atypical Hafnia alvei. K. trabulsii strains were negative for indole production, Voges-Proskauer, H2S production, urea hydrolysis, phenylalanine deaminase, and acid production from glycerol, lactose, sucrose, and D-sorbitol; they were positive for methyl red, citrate (Simmons), lysine and ornithine decarboxylases, arginine dihydrolase (negative in 1 to 2 days and positive in 3 to 7 days), and acid production from cellobiose and melibiose; and they were resistant to the Hafnia-specific bacteriophage of Guinee and Valkenburg. They were tested for DNA relatedness by the hydroxyapatite method with 32PO4-labeled DNA from the designated type strain (CDC 3349-72, ATCC 35313). The 12 strains were 87 to 99% related in 60 degrees C reactions. Relatedness of K. trabulsii to 71 DNA hybridization reference strains of representative species of Enterobacteriaceae was 4 to 37%. It was 15 to 16% related to H. alvei. All strains were susceptible to nalidixic acid, sulfadiazine, gentamicin, kanamycin, and chloramphenicol, and 83% were susceptible to nalidixic acid, sulfadiazine, gentamicin, kanamycin, and chloramphenicol, and 83% were susceptible to tetracycline. Most of the strains were resistant or intermediate to penicillin, ampicillin, carbenicillin, colistin, and cephalothin. Five of the strains were isolated from wounds, three were from the respiratory tract, and one each was from a stool, knee fluid, water, and an unknown source. The clinical significance of this organism is not known; therefore, future studies should focus on its isolation and its relationship to human disease. PMID- 3968203 TI - In vitro antimicrobial susceptibility, plasmid analysis, and serotyping of epidemic-associated Campylobacter jejuni. AB - Campylobacter jejuni strains from 11 outbreaks were characterized by antimicrobial susceptibility, plasmid profile, and serotyping by the methods of Lior et al. and Penner and Hennessy. All 31 strains were susceptible to erythromycin, clindamycin, chloramphenicol, kanamycin, tobramycin, streptomycin, and gentamicin. A total of 21 strains from nine outbreaks were resistant to one or more of the following antimicrobial agents: tetracycline, metronidazole, ampicillin, or carbenicillin. Of the 31 strains, 19 possessed plasmid DNA; 4 of the strains containing plasmids were sensitive to all antimicrobial agents tested. All of the strains that were resistant to tetracycline contained a 38 megadalton plasmid, and these plasmids shared common nucleic acid sequences. No other antimicrobial resistance was associated with the presence of plasmid DNA. Eight outbreaks appeared to have been caused by a single serotype, whereas in three outbreaks multiple serotypes were found. In two of the three outbreaks with multiple serotypes, plasmid profiles were also indicative of multiple strains of C. jejuni. Antimicrobial susceptibility and plasmid profile are potentially useful epidemiological markers for C. jejuni and may be used to supplement serotyping. PMID- 3968204 TI - Escherichia fergusonii and Enterobacter taylorae, two new species of Enterobacteriaceae isolated from clinical specimens. AB - Escherichia fergusonii (formerly known as Enteric Group 10) and Enterobacter taylorae (formerly known as Enteric Group 19) are proposed as new species in the family Enterobacteriaceae. By DNA hybridization (32P, 60 degrees C, hydroxyapatite), strains of E. fergusonii were 90 to 97% related to the type strain (holotype) ATCC 35469. They were most closely related to Escherichia coli and more distantly related to species in other genera. E. fergusonii strains are positive for indole production, methyl red, lysine decarboxylase, ornithine decarboxylase, and motility. They ferment D-glucose with gas production and also ferment adonitol, L-arabinose, L-rhamnose, maltose, D-xylose, trehalose, cellobiose, and D-arabitol. They are negative for Voges-Proskauer, citrate utilization (17% positive), urea hydrolysis, phenylalanine deamination, arginine dihydrolase, growth in KCN, and fermentation of lactose, sucrose, myo-inositol, D sorbitol, raffinose, and alpha-methyl-D-glucoside. By DNA hybridization (32P, 60 degrees C, hydroxyapatite), strains of E. taylorae were 84 to 95% related to the type strain (holotype) ATCC 35317. Their nearest relative was E. cloacae, to which they were 61% related. Other named species were more distantly related. Strains of E. taylorae are positive for Voges-Proskauer, citrate utilization, arginine dihydrolase, ornithine decarboxylase, motility, growth in KCN medium, and malonate utilization. They ferment D-glucose with gas production and also ferment D-mannitol, L-arabinose, L-rhamnose, maltose, D-xylose, trehalose, and cellobiose. They are negative for indole production, methyl red, H2S production on triple sugar-iron agar, urea hydrolysis, phenylalanine deamination, lysine decarboxylase, gelatin hydrolysis, and fermentation of adonitol, i-inositol, D sorbitol, and raffinose. Both new species occur in human clinical specimens. Two strains of E. fergusonii were isolated from blood. Five stains of E. taylorae were isolated from blood, and one was from spinal fluid. These blood and spinal fluid isolates suggest possible clinical significance, but this point requires further study. PMID- 3968205 TI - Improved gas-liquid chromatography method for the identification of Clostridium difficile. PMID- 3968206 TI - Erythrocyte ferritin concentration in patients with myelodysplastic syndromes. PMID- 3968207 TI - Large bowel mucosal dysplasia and carcinoma in ulcerative colitis. AB - The clinicopathological details of eight cases of ulcerative colitis complicated by carcinoma of the colon are described. There was a total of 14 primary colonic cancers, six of which were not detected before pathological examination of the resection specimens. The reason for this may be related to atypical tumour growth patterns. Three occurred in flat mucosa, one in a mucosal plaque lesion, and another in polypoidal mucosa. The occurrence, distribution, and morphology of mucosal dysplasia were noted in both resection specimens and biopsies taken at varying stages before resection. Tumour was associated with normal and adjacent dysplastic mucosa of varying grades. The extent and grade of dysplasia were not reliable indicators of tumour differentiation or subsequent clinical outcome. Only two cancers were poorly differentiated. In five cases a total of 23 mucosal biopsies were taken, all less than 12 months before resection. Three rectal biopsies were graded positive for dysplasia and three colonic biopsies indefinite for dysplasia. The subsequent resection specimens showed both dysplastic and carcinomatous changes. Three rectal and 14 colonic biopsies were graded negative for dysplasia despite positive findings in the subsequent resection specimens. This anomaly is partly attributed to the patchy nature of dysplasia in colitic mucosa. Two cases illustrate the possibility of dysplasia pursuing a rapidly progressive course. The mucosal changes of ulcerative colitis were assessed using a recently introduced and standardised international classification. PMID- 3968208 TI - Morphometric assessment of reflux oesophagitis in fibreoptic biopsy specimens. AB - The oesophageal epithelium of patients with reflux oesophagitis has been studied by means of computer aided morphometry. Measurements of histological features were made on biopsies from six cases before and after treatment. The size and elongation of the nuclei and their variation, the number of nuclei per unit length or per unit sectioned area, and the size and number of nucleoli per nucleus were measured for two zones of the epithelium, the base layer and the intermediate layer, which were independent of section orientation. The measurements were analysed using discriminant analysis. Significant discrimination was found between the two groups. The most important parameters were the number of intermediate layer nuclei per sectioned square millimetre, the mean intermediate layer nuclear area, and the number of nuclei per millimetre of base epithelium. These parameters are consistent with increased cell turnover of the non-ulcerated epithelium before treatment. PMID- 3968209 TI - Diminished creatinine clearance in anorexia nervosa: reversal with weight gain. AB - To assess whether patients with anorexia nervosa have abnormalities in creatinine clearance, we measured plasma creatinine concentration, urinary creatinine excretion, and creatinine clearance in 10 patients with anorexia nervosa before and during treatment. Urinary creatinine excretion and creatinine clearance were diminished in all patients. Nine patients had significant decreases in their plasma creatinine and creatinine clearance was increased even when corrected for body weight and body surface area respectively. The patient who did not show these changes in plasma creatinine concentration and creatinine clearance had gained only 4% in body weight. Body weight and corrected creatinine clearance were significantly correlated, as were percentage increases in body weight and creatinine clearance. Thus anorexia nervosa is associated with a reversible decrease in creatinine clearance. Increase in body weight appears to be cardinal to the recovery of renal function in these patients. PMID- 3968210 TI - Plasma fibronectin and thyroid function. AB - Plasma fibronectin concentrations up to 85 mg/100 ml were found in hyperthyroid patients. There was a significant correlation between free thyroxine index and plasma fibronectin values. Hypothyroid patients had low to normal fibronectin concentrations. Parallel decreases of thyroid hormones and plasma fibronectin concentrations were noted during treatment with thiamazole. A direct effect of thyroid hormones on fibronectin synthesis seems probable. PMID- 3968211 TI - Sideroblastic colonies in erythroid cultures grown from normal human marrow. AB - Normal human erythroid progenitor cells from bone marrow were grown in culture using a methyl cellulose clonal assay technique. Sideroblastic erythroid cells were found in the majority of colonies examined at 14-17 days, and a few sideroblasts were found in some of the colonies examined after shorter periods of culture. Electron microscopy confirmed the presence of both intramitochondrial iron deposits and cytoplasmic ferritin aggregates. These morphological appearances probably represent an abnormality induced by the in vitro culture conditions and cannot be used as evidence for an intrinsic defect in haem synthesis. PMID- 3968212 TI - Gas chromatographic identification of Clostridium difficile and detection of cytotoxin from a modified selective medium. AB - A modification of an existing selective medium for Clostridium difficile is described. Inclusion in the medium of DL nor-leucine and p-hydroxyphenylacetic acid enables identification of C difficile to be made directly from primary isolation plates by gas chromatographic detection of caproic acid and p-cresol. Plugs of agar withdrawn from the selective medium also allow the detection of cytotoxin production in vitro. PMID- 3968213 TI - Study of precipitation reactions to Actinomyces israelii antigens in uterine secretions. AB - Uterine secretions were obtained from 110 women and analysed by counterimmunoelectrophoresis for the occurrence of precipitation reactions against Actinomyces israelii antigens. Precipitation reactions were found in secretions from seven women and a correlation was found between these reactions and long term use of plastic intrauterine devices. The precipitating components could not be proved to be immunoglobulins; neither could identity be shown with IgG precipitins in reference serum. The nature and the importance of the precipitating components are discussed. PMID- 3968214 TI - ICSH/ICTH recommendations for reporting prothrombin time in oral anticoagulant control. International Committee for Standardization in Haematology and International Committee on Thrombosis and Haemostasis. PMID- 3968215 TI - Giant cell myocarditis: evidence for the macrophage origin of the giant cells. AB - In order to elucidate the origin of giant cells in giant cell myocarditis a case has been studied immunohistologically using monoclonal antibodies against a variety of antigens, including those associated with muscle and macrophages. The results strongly suggest that the giant cells are derived from macrophages rather than the muscle cells. PMID- 3968216 TI - Assessment of dysplasia in colorectal adenomas: an observer variation and morphometric study. AB - Observer variation in the grading of dysplasia in 100 colorectal adenomas has been analysed by kappa statistics. Intraobserver agreement was only 70% and 67% for the two principal observers, and, as would be expected, interobserver agreement was even lower at 59% and 66%. Although the kappa values were significantly different from chance at the 0.1% level, there were substantial disagreements. When the study was extended to four observers, agreement between observer pairings was considerably worse (as low as 34%), and in four pairings the kappa values did not differ significantly from those expected by chance alone even at the 5% level. In an endeavour to improve agreement we adopted a percentage estimation grading method; but this failed to achieve any improvement when comparing overall grades. The percentage estimates of the two observers, however, showed a highly significant correlation. To identify the cytological features given most weight by the principal observers in assessing dysplasia we undertook morphometry on 30 adenomas using an image analysis computer. The nuclear to cytoplasmic ratio, variation in nuclear area, and variation in nuclear height above the basement membrane showed significant differences between mild, moderate, and severely dysplastic epithelia. While evaluation of these parameters therefore appears to be most important in the subjective interpretation of dysplasia, this study has shown that such evaluation is poorly standardised between observers and poorly reproduced within observers. Our findings of poor agreement in the grading of dysplasia in colorectal adenomas has serious implications for the assessment of dysplasia in inflammatory bowel disease, where the added problem of reactive cellular atypia brings greater complexity to these subjective judgments. PMID- 3968217 TI - Study of discrepancies in rubella haemagglutinin titrations and a reappraisal of diluents used in the rubella haemagglutination inhibition technique. AB - To elucidate inconsistencies in rubella haemagglutinin assays the components of the assay technique were examined. The results of carefully controlled assays of rubella haemagglutinin antigens from different sources in various plates and diluents with four species of indicator cells are reported. The quality and quantity of gelatin in the dextrose-gelatin-veronal buffered diluent commonly used in rubella haemagglutinin assays had a profound effect on the haemagglutination pattern and antigen titre. The veronal buffered saline used in the complement fixation test offered a valid alternative to the more complex diluents incorporating gelatin currently used in rubella haemagglutinin assays and haemagglutination inhibition tests. PMID- 3968218 TI - Comparison of five different methods of rubella IgM antibody testing. AB - Five tests for the detection of rubella specific IgM antibody were compared. They were the conventional method of sucrose density gradient fractionation, followed by haemagglutination inhibition; an anti-mu capture radioimmunoassay; and three commercially available enzyme linked assays: Rubazyme M, Rubenz M I, and its successor, Rubenz M II. The five methods detected similar numbers of rubella positive samples between seven and 35 days after the onset of symptoms; in the earlier stages, however, the radioimmunoassay and Rubenz M II were more sensitive. All three commercial kits were straightforward to use but produced misleading positive results with sera containing heterophil antibody. In considering sensitivity, specificity, and cost effectiveness together the Rubenz M tests were the most appropriate for routine use. With the recent withdrawal of Rubenz M I from the market only Rubenz M II is now available. If Epstein-Barr virus infection is excluded, Rubenz M II provides a reliable test for the diagnostic laboratory. PMID- 3968219 TI - A study of workload units in five microbiology laboratories. AB - A study of a modified Canadian unit system of measuring laboratory workload was undertaken in five joint Public Health Laboratory Service and hospital microbiology laboratories. Ten percent of the specimens received over six months were sampled, the number of units expended on each was recorded, and the results were analysed on a central computer. The process of gathering information in the absence of laboratory computers was time consuming and, despite careful planning, differences were found in the recording practices of the laboratories. The analysis of results did not lead to major changes in data gathering techniques because the same information about laboratory workload could be obtained by collecting numbers of clearly defined specimens. Analysis of workload units could be useful for particular purposes, such as comparing differences between laboratories using different techniques for the same investigation or assessing the possible benefits of automation. It must be appreciated, however, that workload units are measures of quantity not of laboratory performance. PMID- 3968220 TI - Microcomputer system for multistep specimen processing and reporting in a microbiology laboratory. AB - A microcomputer system for use in the sequential processing of specimens has been developed in a hospital microbiology department which receives 90 000 specimens a year. Data handling is performed directly through the computers without the use of cards or worksheets. The system facilitates the multistep processing of specimens and the servicing of results inquiries and provides an alphabetical daysheet of completed and incomplete work, report form printout, and automatic transfer of reported data to an existing on line database. The system includes on line break point antibiotic sensitivity testing and multipoint agar organism identification. The hardware was purchased as required at small cost per unit, and the software was written by the authors. More than 80% of specimens received are processed using the computers, the remainder being under development. The system has been running for three years without major breakdown. PMID- 3968221 TI - Effect of antibiotic concentration in a selective medium on the isolation of Clostridium difficile from faecal specimens. PMID- 3968222 TI - Optochin sensitivity of beta-haemolytic streptococci group A. PMID- 3968223 TI - Erythrocyte acetylcholinesterase in Hirschsprung's disease. PMID- 3968224 TI - Embryonic development of the rat cerebellum. I. Delineation of the cerebellar primordium and early cell movements. AB - Short-survival and long-survival thymidine radiograms, and methacrylate-embedded tissue from normal and X-irradiated rat embryos were used to delineate the neuroepithelial source of the cerebellum and trace the earliest cell movements. The cerebellar anlage, crescent shaped, is demarcated by two ventricular landmarks, the anterior extension of the tela choroidea of the fourth ventricle and the embryonic cerebellar fissure. The cerebellar tela choroidea extends from the medullary fourth ventricle posteromedially to the lateral recess of the pontine fourth ventricle anterolaterally. The embryonic cerebellar fissure begins caudally as a single midline incision beneath the fused posterior cerebellar primordium, then splits to follow the unfused cerebellar halves, first separating each from the isthmus then from the pons. The cerebellar primordium is divided into three parts. The lateral cerebellar primordium caps the lateral recess of the fourth ventricle; it is contiguous with the pons medially and separated ventrally from the anlage of the cochlear nuclei by the tela choroidea. The subisthmal cerebellar primordium is situated beneath the isthmus, medially lining the isthmus canal. Laterally and posteriorly, it is continuous with the lateral and postisthmal primordia. The postisthmal cerebellar primordium caps the postisthmal recess of the fourth ventricle and extends to the medullary fourth ventricle. As we shall describe later, each of these primordia is a source of different components of the developing cerebellum. Most cells of the superficially located nuclear transitory zone are labeled with 3H-thymidine administered on day E14 but not thereafter. A high proportion of the cells of the deeper cortical transitory zone could still be labeled on day E15. This supports the assumption made earlier that the first is composed of differentiating deep neurons, the second of Purkinje cells. The cells of the nuclear transitory zone originate in the lateral cerebellar primordium near the junction with the tela choroidea prior to the formation of the germinal trigone and migrate in a superficial position medially. Beginning on day E16, the nuclear transitory zone splits into two components. One has transversely oriented cells that seem to be the source of a decussating fiber tract, presumably the hook bundle of Russell. The other is composed of longitudinally oriented cells that apparently contribute fibers to the ipsilateral superior cerebellar peduncle. The translocation of the cells of the nuclear transitory zone from the cerebellar surface to its depth, to form the deep nuclei, and the radial migration of the cells of the cortical transitory zone to the surfa PMID- 3968225 TI - Cortical and brain stem afferents to the ventral thalamic nuclei of the cat demonstrated by retrograde axonal transport of horseradish peroxidase. AB - After horseradish peroxidase (HRP) injections into various parts of the ventral thalamic nuclear group and its adjacent areas, the distribution of labeled neurons was compared in the cerebral cortex, basal ganglia, and the brain stem. The major differences in distribution patterns were as follows: Injections of HRP into the lateral or ventrolateral portions of the ventroanterior and ventrolateral nuclear complex of the thalamus (VA-VL) produced retrogradely labeled neurons consistently in area 4 gamma (lateral part of the anterior and posterior sigmoid gyri, lateral sigmoid gyrus and the lateral fundus of the cruciate sulcus), the medial division of posterior thalamic group (POm), suprageniculate nucleus (SG) and anterior pretectal nucleus ipsilaterally, and in the nucleus Z of the vestibular nuclear complex bilaterally. Injections into the medial or dorsomedial portion of the VA-VL resulted in labeled neurons within the areas 6a beta (medial part of the anterior sigmoid gyrus), 6a delta (anterior part of ventral bank of buried cruciate sulcus), 6 if. fu (posterior part of the bank), fundus of the presylvian sulcus (area 6a beta), medial part of the nucleus lateralis posterior of thalamus and nucleus centralis dorsalis ipsilaterally, and in the entopeduncular nucleus (EPN) and medial pretectal nucleus bilaterally. Only a few neurons were present in the contralateral area 6a delta. After HRP injections into the ventral medial nucleus (VM), major labeled neurons were observed in the gyrus proreus, area 6a beta (mainly in the medial bank of the presylvian sulcus), and EPN ipsilaterally, and in the medial pretectal nucleus and substantia nigra bilaterally. Following HRP injections into the centre median nucleus (CM), major labeled neurons were found in the areas 4 gamma, 6a beta, and the orbital gyrus ipsilaterally, and in the EPN, rostral and rostrolateral parts of the thalamic reticular nucleus, locus ceruleus, nucleus reticularis pontis oralis et caudalis and nucleus prepositus hypoglossi bilaterally. The contralateral intercalatus nucleus also possessed labeled neurons. With HRP injections into the paracentral and centrolateral nuclei, labeled neurons were observed in the gyrus proreus and the cortical areas between the caudal presylvian sulcus and anterior rhinal sulcus ipsilaterally, and in the nuclei interstitialis and Darkschewitsch bilaterally. Minor differences in the distribution pattern were observed in the superior colliculus, periaqueductal gray, mesencephalic and medullary reticular formations, and vestibular nuclei in all cases of injections. PMID- 3968226 TI - Cytoarchitectonics of substantia nigra grafts: a light and electron microscopic study of immunocytochemically identified dopaminergic neurons and fibrous astrocytes. AB - Maturation of dopaminergic (DA) neurons and astroglia was studied in transplants of the substantia nigra grown for up to 7 months in the brain of rats. The investigation had three specific aims. The first was to observe effects of different transplant positions on the longevity of DA neurons. Second, the grafts were examined for changes of synaptic interactions and associations between DA neurons and astroglia. Third, an answer was sought to the question whether transplanted DA neurons migrate into the adjacent host brain. The grafts were taken from the ventral mesencephalon of rat embryos of different ages (day 14 to 18 of gestation) and placed into the cerebral cortex, tectum, cerebellum, or ventricles of newborn host animals. Following different times of survival the immunocytochemical localization of tyrosine hydroxylase (TH) and of glia filament protein (GFA) in the transplants were observed. In all of the transplantation sites, except for one, neurons of different morphologies that contained TH were found in the grafts. The cerebellar white matter of the host brain failed to support the long-term survival of DA neurons. The overall structure of mature substantia nigra grafts had some resemblance to intact substantia nigra (SN). On the ultrastructural level, it was found that morphological expression of some immature features of DA neurons, such as glial sheaths, somatic spines, and lack of oligodendroglia, persisted in mature grafts. Specific associations of DA neurons and astroglia in the grafts suggested that the cytoarchitectonic appearance of a given brain region may be related to the existence of particular neuron glia relationships. In contrast to intact SN, transplants revealed deficiencies in unlabeled pleomorphic boutons and contained some TH immunoreactive terminals. Migration of DA neurons and their processes into the adjacent host brain was rarely observed. PMID- 3968227 TI - Embryonic development of the rat cerebellum. II. Translocation and regional distribution of the deep neurons. AB - In thymidine radiograms and plastic-embedded sections, the migration of cerebellar deep neurons was traced from their germinal source to their final settling sites. The route proved to be roundabout and three developmental events could be distinguished during the process. First, between days E14 and E16, transversely oriented cells of the nuclear transitory zone move in an arc from the ventrolateral neuroepithelium of the lateral cerebellar primordium in a medial direction. Second, between days E16 and E18, the cells of the rostral component of the nuclear transitory zone assume a longitudinal orientation. We postulated that this is the period of axonogenesis, the longitudinally oriented cells issuing efferents that join the superior cerebellar peduncle ipsilaterally and the transversely oriented cells (representing the neurons of the caudal fastigial nucleus) sending decussating fibers to the uncinate fasciculus (the hook bundle of Russell). Third, between days E18 and E21, the earlier-produced superficial cells of the nuclear transitory zone and the later-produced deep cells of the cortical transitory zone (the young Purkinje cells) exchange positions. The descent of the deep neurons is in the direction of the fibers of the inferior cerebellar peduncle, which becomes distributed throughout the cerebellum on day E17. The ascent of the Purkinje cells is in the direction of the external germinal layer, which begins to spread from caudal to rostral on day E17. The three deep nuclei, the lateral (dentate), interpositus, and medial (fastigial), can be distinguished before their descent into the depth of the cerebellum, and by day E22 a small-celled and a large-celled subdivision is identifiable in each nucleus. PMID- 3968228 TI - Embryonic development of the rat cerebellum. III. Regional differences in the time of origin, migration, and settling of Purkinje cells. AB - The time of origin, site of origin, migratory path and settling pattern of the Purkinje cells of the cerebellar hemispheres, anterior vermis, and posterior vermis were investigated in thymidine radiograms and plastic-embedded materials from rat embryos ranging in age from 15 to 22 days. In the hemispheres there is a rostral-to-caudal cytogenetic gradient: the Purkinje cells of lobulus simplex, crus I, and crus II are produced earlier than the Purkinje cells of the paramedian lobule and paraflocculus, followed by the Purkinje cells of the flocculus. The Purkinje cells of the vermis, in general, are generated later than those of the hemispheres, and with a reverse gradient from caudal to rostral: the Purkinje cells of the posterior vermis (lobules X-VI) being produced ahead of the Purkinje cells of the anterior posteriorly directed wedge of early-produced Purkinje cells through the vermis. Evidence was obtained that the Purkinje cells of the hemispheres derive from the lateral cerebellar primordium capping the lateral recess of the fourth ventricle anteriorly. The Purkinje cells of the anterior vermis originate from the subisthmal cerebellar primordium medially lining the isthmal canal. The Purkinje cells of the posterior vermis originate in the postisthmal cerebellar primordium overlying the tela choroidea caudally. The young Purkinje cells migrate from the neuroepithelium to the surface of the cerebellum in a strictly caudal-to-rostral order, paralleling the spread of the EGL superficially from posteroventral to anterodorsal. This pattern is independent of the time of origin of Purkinje cells. In the posterior vermis the earliest-settling Purkinje cells of the uvula follow a short radial course, and a discrete Purkinje layer is formed 3 days after they are generated. In the anterior vermis the Purkinje cells of lobulus centralis, which follow an anterodorsal migratory course, are still settling on day E22, 7 days after their production, presumably awaiting the fusion of the cerebellar base anteriorly. The fissura prima forms medially at the interface region of Purkinje cells derived from the postisthmal and subisthmal cerebellar primordia. For 1-2 days after their settling, the Purkinje cells of the newly forming lobules can be distinguished by certain cytological criteria from the Purkinje cells in the more caudally-situated, earlier-settled lobules. PMID- 3968229 TI - The somatotopic organization of primary afferent terminals in the superficial laminae of the dorsal horn of the rat spinal cord. AB - Transganglionic transport of wheatgerm agglutinin conjugated horse-radish peroxidase (WGA-HRP) was used to reveal the central distribution of terminals of primary afferent fibers from peripheral nerves innervating the hind leg of the rat. In separate experiments the sizes and locations of cutaneous peripheral receptive fields were determined by electrophysiological recording techniques for each of the nerves that had been labeled with WGA-HRP. By using digital image analysis, the sizes and positions of the peripheral receptive fields were correlated with the areas of superficial dorsal horn occupied by terminals of primary afferents from each of these receptive fields. Data were obtained from the posterior cutaneous nerve of the thigh, lateral sural, sural, saphenous, superficial peroneal, and tibial nerves. The subdivisions of the sciatic nerve, the sural, lateral sural, superficial peroneal, and tibial nerves each projected to a separate and distinct region of the superficial dorsal horn and collectively formed a "U"-shaped zone of terminal labeling extending from lumbar spinal segments L2 to the caudal portions of L5. The gap in the "U" extended from L2 to the L3-4 boundary and was occupied by terminals from the saphenous nerve. Collectively, all primary afferents supplying the hindlimb occupied the medial 3/4 of the superficial dorsal horn with terminals from the tibial nerve lying most medially and occupying the largest of all the terminal fields. Afferents from the superficial peroneal lay in a zone between the medially situated tibial zone and the more laterally placed sural zone. Afferents from the posterior cutaneous nerve were located most caudally and laterally. Terminal fields from the posterior cutaneous and saphenous nerves differed from the others in having split representations caused presumably by their proximity to the mid-axial line of the limb. Comparisons between the peripheral and the central representations of each nerve revealed that 1 mm2 of surface area of the superficial dorsal horn serves approximately 600-900 mm2 of hairy skin and roughly 300 mm2 of glabrous skin. The vast majority of terminal labeling observed in the dorsal horn was found in the marginal layer and substantia gelatinosa, suggesting that small diameter afferents have an orderly somatotopic arrangement in which each portion of the skin surface is innervated by afferent fibers that terminate in preferred localities within the dorsal horn. PMID- 3968230 TI - Quantitative analysis of the dendrites of cat phrenic motoneurons stained intracellularly with horseradish peroxidase. AB - All the dendrites (N = 37) generated by four phrenic motoneurons were analyzed following intracellular injection of horseradish peroxidase. The dendritic arbors produced from each of these stem dendrites were studied in detail. The mean number of stem dendrites produced by a phrenic motoneuron was 9.7, their mean diameter was 6.0 micron, and their mean combined diameter was 58.3 micron. The length at which a phrenic motoneuronal dendrite terminated was 1,236 micron, with several end terminals extending more than 2 mm from the cell body. The mean value for the combined lengths of all segments originating from a single stem dendrite was 5.3 mm. A full spectrum of dendritic branching patterns was observed from simple (five unbranched) to complex, the latter producing up to ninth-order branches. Most terminal and nonterminal dendritic segments tapered, producing a mean diameter reduction of 34%, or approximately 9% per 100-micron length. All phrenic motoneurons exhibited a steady decrease in the combined dendritic parameter (sigma d3/2) with distance from the soma as a result of tapering and end-branch termination. The mean surface area and volume of a phrenic motoneuronal dendrite were 35.3 X 10(3) micron 2 and 25.9 X 10(3) micron 3, respectively. The dendrites constituted greater than 97% of the total phrenic motoneuronal surface area, with 75% of this area lying outside of a 300-micron radius from the cell body. The diameter of a stem dendrite was positively correlated with its combined dendritic length, number of terminal branches, dendritic surface area, and volume. Despite this strong correlation, the value of total dendritic surface area calculated using the power equation derived from the dendritic surface area versus stem dendritic diameter plot was not a consistent estimator of the total dendritic surface area directly measured for these four phrenic motoneurons. It is suggested that this inconsistency may be the result of a heterogeneity in the phrenic motoneuronal population and/or in the dendrites projecting to the different terminal fields. PMID- 3968231 TI - Bilateral cerebral metabolic alterations following lesion of the ventromedial thalamic nucleus: mapping by the 14C-deoxyglucose method in conscious rats. AB - The functional role of the ventromedial thalamic nucleus (VM) was investigated by means of the quantitative autoradiographic 14C-deoxyglucose method. Local cerebral glucose utilization (LCGU) was measured bilaterally in 53 discrete brain areas of conscious rats 1 week and 1 month following electrolytic lesion of the VM. There was no difference observed in the LCGU values between the two groups of lesioned animals. In the VM-lesioned rats glucose consumption was decreased in several ipsilateral (pre-frontal, frontal, cingulate, sensorimotor, visual) and in some contralateral (cingulate, sensorimotor, visual) cortical areas. Furthermore, LCGU values were depressed bilaterally in the striatum, hippocampus, dentate gyrus, substantia nigra compacta, superficial layers of the superior colliculus, oculomotor complex, and cerebellar dentate nuclei. Glucose utilization was diminished also in the deep layers of the superior colliculus and in the fastigial nucleus ipsilateral to the lesion. Within the thalamus, glucose metabolism was decreased in several nuclei either bilaterally (reticular, intralaminar, paralamellar mediodorsal) or ipsilaterally (lateroposterior, ventrobasal, ventrolateral, ventroanterior, and medioventral) to the lesion. A significant correlation between the percentage of injured VM and the regional metabolic depression was demonstrated in the areas displaying the most pronounced decrease in LCGU. These results support a widespread influence of the VM on brain function extending beyond the limits of purely motor systems and reveal the consequences of a unilateral lesion of the thalamus on metabolic activity in several contralateral structures. PMID- 3968232 TI - Gap junctions between non-pyramidal cell dendrites in the rat hippocampus (CA1 and CA3 regions): a combined Golgi-electron microscopy study. AB - Non-pyramidal cells in the rat hippocampus were examined with a combined Golgi electron microscopic method. The somata of non-pyramidal cells were ovoid, about 15 X 30 micron, and several smooth and/or varicose dendrites extended from them. With electron microscopy, Golgi-impregnated gold-toned non-pyramidal cells showed distinctive fine structural features. The somata displayed large nuclei and an extensive perikaryal cytoplasm. The nuclei showed extensive cytoplasmic invaginations, little heterochromatin, conspicuous nucleoli, and intranuclear rods composed of filamentous bundles. The perikaryal cytoplasm was rich in cell organelles such as well-developed cisternae of rough endoplasmic reticulum and Golgi apparatus, and numerous clusters of free ribosomes and mitochondria. Many synaptic boutons, most of which formed asymmetrical synapses, impinged upon the somata and dendrites. Gap junctions were seen on varicose dendrites of Golgi impregnated non-pyramidal cells. These gap junctions were patch-like, about 0.1 0.6 micron in diameter, and situated in the stratum radiatum or stratum oriens of the CA1 and CA3 regions 70-230 micron from the soma. They displayed a characteristic cytoplasmic semidense material undercoating the junctional membranes. The gap junctions were usually formed between impregnated and unimpregnated varicose dendrites. Thirteen of a total of 22 gap junctions involving the impregnated dendrites were situated singly, whereas the remaining nine were on four impregnated dendrites in clusters of two or three side by side. In the latter cases, two pairs of junctions were formed between pairs of dendrites running parallel to each other, and each of the other two pairs was formed among three dendrites, appearing to make a dendritic network bridged by gap junctions. One gap junction was seen between two impregnated dendrites originating from two identified Golgi-impregnated non-pyramidal cells. These observations revealed unequivocally that non-pyramidal cells in the hippocampus form gap junctions with one another on their dendrites. PMID- 3968233 TI - Ultrastructure of the dorsal motor nucleus of the vagus nerve in monkey with a comparison of synaptology in monkey and cat. AB - Neurons of the dorsal motor nucleus of the vagus nerve were studied following injections of horseradish peroxidase into the vagus nerve in a monkey (Macaca fascicularis). In frozen sections, the dorsal motor nucleus appeared to be completely filled by labeled medium-sized (20-30 micron in long axis) neurons. Labeled dendrites from these neurons often extended outside the borders of the nucleus into the nucleus of the tractus solitarius. In 1 micron thick plastic sections and ultrathin sections of the dorsal motor nucleus, two distinct types of neurons were observed with the light and electron microscope. Medium-sized neurons with abundant cytoplasm and an oval nucleus were retrogradely labeled with HRP, while small (10-15 micron in long axis) neurons with a paucity of organelles and an invaginated nucleus remained unlabeled. Medium-sized neurons outnumbered the small neurons by approximately five to one. The synaptic organization of the dorsal motor nucleus in monkey was studied and compared with that in cat. The porportions of different types of axosomatic synapses were similar in both species. Terminals containing round vesicles and making symmetrical or asymmetrical contact with the postsynaptic structure were more common than synaptic terminals containing pleomorphic vesicles. In both species, there was a slightly greater synaptic density on the medium-sized neurons than on the small neurons. The synaptic density in the monkey dorsal nucleus was greatest on the smallest dendrites in the neuropil and least on the somata. PMID- 3968234 TI - A laminar analysis of the number of round-asymmetrical and flat-symmetrical synapses on spines, dendritic trunks, and cell bodies in area 17 of the cat. AB - The number of synapses per unit volume of tissue (NV) has been estimated in individual laminae of the binocular and monocular regions of area 17 in six adult cats by using a method of size-frequency distribution. Separate estimates were obtained for RA synapses (containing round vesicles associated with asymmetric membrane differentiations) and for FS synapses (containing flat vesicles associated with symmetric membrane differentiations). For the total cortical thickness, the NV of all synapses is not statistically different between binocular (286 million per mm1(3] and monocular (281 million) regions, nor is it different between the two regions for any of the laminae. Eighty-four percent of synapses are of the RA type. Of those, 79% are found on dendritic spines, 21% on dendritic trunks, 0.1% on somata. FS synapses represent 16% of the total, with 31% of them on spines, 62% on dendritic trunks, and 7% on somata. The ratio of RA to FS synapses is kept relatively constant throughout the layers. A two-way analysis of variance shows no difference in the NV of either RA or FS synapses in the two regions nor in the NV or RA synapses between cats. It does, however, clearly demonstrate (p less than 0.001) interindividual differences for FS synapses. These variations between individual cats may be due to differences in age, breed, or environmental factors. In contrast to the relative uniformity of the NV of synapses between regions, the number of each type under 1 mm2 of cortical surface is 33% higher in the binocular region. This is due mainly to the greater thickness of the binocular region. PMID- 3968235 TI - Modification of fibrin matrix formation in situ enhances nerve regeneration in silicone chambers. AB - The spatial-temporal progress of nerve regeneration was examined in silicone chambers of three different volume capacities: 11, 25, and 75 microliter. In all chambers, the stumps of a transected rat sciatic nerve were sutured into the ends of the chamber leaving a 10 mm gap between the stumps. Chambers were implanted empty (E chambers) or prefilled with saline (PF chambers). A coaxial and continuous fibrin matrix had formed in all chambers by 1 week. In E chambers, the matrices had a proximal-distal taper that was more pronounced in E25 and E75 chambers due to significantly larger matrix diameters in the proximal region. At 3 weeks, vascular and Schwann cell migration and axonal regeneration were less advanced in the E25 and E75 than in the control E11 chambers. The retardation correlated with the presence of an avascular organization of circumferential cells. Saline prefilling affected the caliber and density of fibrin fibers in the 1 week matrices of PF25 and PF75 chambers. The matrices did not have a prominent taper and diameters were progressively larger with increasing chamber volume. Saline prefilling did not affect regeneration progress in 3 week PF11 chambers but did enhance regeneration in the PF25 chambers; a 1.5-fold larger diameter nerve formed at 3 weeks that contained 2.6-fold more axons. Progress in the PF75 chamber was retarded. We conclude that the volume, timing, and nature of the fluid filling a silicone chamber have significant influence on the formation of fibrin matrices. Alterations in matrix formation correlate with substantial changes in the subsequent progress of intrachamber regeneration events. PMID- 3968236 TI - A combined electron microscopic HRP and immunocytochemical study of the limbic projections to rat hypothalamic nuclei containing vasopressin and oxytocin neurons. AB - Light microscopic studies in our laboratory have indicated that the lateral septum, amygdala, and ventral subiculum project in a perinuclear fashion to the paraventricular (PVN), supraoptic (SON), and suprachiasmatic (SCN) nuclei (Oldfield et al., '82; Silverman and Oldfield, '84). In the present paper a combined anterograde HRP and immunocytochemical procedure has been used to determine the connectivity between these limbic efferents and peptide-containing processes emanating from the above mentioned hypothalamic nuclei. Synaptic associations were found to exist between efferents from (1) the septum and both vasopressin (VP)- and oxytocin (OX)-positive dendrites derived from cells in the PVN and SON, (2) the septum and VP dendrites dorsal to the SCN, (3) the ventral subiculum and both VP and OX dendrites arising from the PVN and SON, and (iv) the amygdala and VP dendrites from the PVN. These observations help clarify an apparent discrepancy between electrophysiological data, in which limbic efferents have been shown to influence the activity of VP and OX neurons in the PVN and SON, and anatomical evidence which indicates only a perinuclear innervation from these sites not encroaching on the hypothalamic nuclei themselves. In each case the synaptic connections are made on dendrites external to the nucleus: those lateral and ventrolateral to the PVN, dorsal to the SON, and dorsal or dorsolateral to the SCN. PMID- 3968237 TI - Effects of age on Meissner corpuscles: a study of silver-impregnated neurites in mouse digital pads. AB - Investigation focused on finding qualitative and quantitative evidence of age changes in the quantity of neural surface within Meissner corpuscles. These mechanoreceptors were studied in 53 mice (nine age-groups) ranging from 1.7 to 24 months old. Forepaw digital pads were formalin-fixed and frozen-sectioned parallel to each digit and perpendicular to the skin. Serial sections were then silver-impregnated to allow light microscopic examination of the neurites (axons) in corpuscles. From young (1.7-7 months) to middle age (9-15 months), neurites became more coarse, tortuous, ramified, varicose, and thus more complex. At old age (18-24 months), neurites seemed attenuated and showed more of an irregular winding, twisted, or tangled pattern with less parallel orientation to the skin surface than the regular spiraled, looped, or arched pattern typical at young and middle ages. Corpuscle size appeared greatest at middle age, smallest at young age. Dermal papillae not occupied by corpuscular neurites were most abundant at old age. The number of corpuscles per area and neurites per corpuscle decreased significantly with age, whereas the number of neurite bifurcations per corpuscle increased significantly. Morphometric analysis of neurites projected by a camera lucida onto a planimeter showed that the length of neurites meandering through a fixed interval of tissue increased significantly until age 12 months-evidence of increased tortuosity; the area of neurites measured within the same fixed interval, and the area of neurite terminals changed significantly as inverse parabolic functions of age-evidence of increased volume until middle age, which decreased thereafter. The general trend of these changes implied growth at young age and atrophy at old age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968238 TI - Distribution of GABA-T-intensive neurons in the rat hindbrain. AB - The pharmacohistochemical method previously used to identify the distribution in rat brain of gamma-aminobutyric acid transaminase (GABA-T)-intensive neurons has been applied to the rat pons and medulla. The method involves systemic administration of the irreversible GABA-T inhibitor Gabaculine and the detection, 12 to 15 hours after the injection of the newly synthesized GABA-T by histochemical means. GABA-T-intensive neurons were found to be rich in the following hindbrain structures: inferior colliculus, nuclei of the raphe system, nuclei parabrachialis dorsalis and ventralis, nucleus cuneiformis, nucleus vestibularis medialis, nucleus tractus spinalis nervi trigemini, nucleus vagus, nucleus cochlearis, nucleus reticularis lateralis, nucleus ambiguus, nucleus cuneatus lateralis, inferior olive, and reticular formation of the pons and medulla. Neurons of the deep cerebellar nuclei and the rostral portion of the lateral vestibular nucleus were negative for GABA-T but were surrounded by granular staining indicative of impinging GABA-T-rich nerve endings. These results provide further support for the hypothesis that GABA neurons are far more GABA-T-intensive than other neurons in the central nervous system. PMID- 3968239 TI - Identification of stapedius muscle motoneurons in squirrel monkey and bush baby. AB - The location of brainstem neurons which mediate the stapedius reflex was identified by injecting horseradish peroxidase into the stapedius muscle of squirrel monkeys and bush babies. Retrogradely labeled neurons, arranged in a one to three-cell column, were found medial to the main facial motor nucleus in squirrel monkeys and ventral to it in bush babies. Nissl, protargol, and acetylcholinesterase stains were subsequently used to identify and describe this unique column of cells. It was found that staining characteristics, as well as shape, size, and location, distinguish stapedius muscle motoneurons from closely associated cell groups. Furthermore, stapedius muscle motoneurons are morphologically similar to periolivary cells and morphologically dissimilar to cells within the facial motor nucleus. PMID- 3968240 TI - The organization of the lateral thalamus of the hooded rat. AB - Analysis of cytoarchitecture and connectivity showed that the lateral thalamus of the hooded rat is composed of eight nuclei. An examination of the cytoarchitecture permitted the identification of seven cellular fields: nucleus suprageniculatus (sg), nucleus lateralis posterior pars caudomedialis (lpcm), nucleus lateralis posterior pars lateralis (lpl), nucleus lateralis posterior pars rostromedialis (lprm), intramedullary area (ima), nucleus lateralis dorsale pars ventrolateralis (ldvl), and nucleus lateralis dorsale pars dorsomedialis (lddm). An analysis of the connectivity showed that lpl is further divisible into a rostral (lplr) and a caudal (lplc) sector, bringing the total number of nuclei to eight. Nucleus suprageniculatus, the most caudal element of the lateral thalamus, is composed of medium to large, fusiform, and multipolar neurons. It contains a terminal field of the projection of the superficial layers of the ipsilateral superior colliculus. Nucleus lpcm, found rostrolateral to sg, is loosely packed with large multipolar neurons. A terminal field of the superficial layers of the superior colliculus of both sides fits precisely within its cytoarchitectural boundaries. Nucleus lpl, a long cellular territory found lateral to lpcm, extends from the caudal pole of the dorsal lateral geniculate nucleus to the caudal pole of ldvl and contains round cells which are smaller and more densely packed than those of lpcm. Its caudal portion (lplc) contains another terminal field of the ipsilateral superior colliculus while its rostral portion (lplr) contains a terminal field of the projection of Area 17. Area 18 also projects to lplr, whereas Area 18a projects to both lplr and lplc. The intramedullary area, which occupies the fibrous zone between lpl and the dorsal lateral geniculate nucleus, contains round and fusiform neurons and is innervated by Area 18a. Nucleus lprm, situated medial to lpl, is characterized by round neurons which are frequently found in clusters. It is innervated by Areas 17, 18, and 18a. Nucleus ldvl is evenly packed with moderately large, polygonal cells and contains the complete terminal fields of both Areas 17 and 18. It also receives inputs from Area 18a. Finally, lddm, tightly packed with small, round cells and lying medial to ldvl, receives inputs from Area 4. PMID- 3968241 TI - Retinal pigment epithelial correlates of avian retinal degeneration: electron microscopic analysis. AB - The delayed amelanotic (DAM) strain of domestic chicken is characterized by an early, developmental onset of choroidal inflammation and destruction of both feather and choroidal melanocytes. Secondarily, retinal pigment epithelial (RPE) cells in the peripapillary region develop abnormalities, and a series of progressive histopathological changes ensues which includes reduction and ultimate loss of RPE-melanin granules and RPE-cell atrophy. The earliest sign of RPE-cell abnormality is a dramatic alteration in the distribution of intracellular melanin granules. Apical processes also show a lessening of contact with photoreceptor outer segments, leading in more advanced stages to their retraction and development of retinal detachments. Other progressive alterations in RPE cells include disorganization and loss of basal infoldings; size reductions and density increases in both mitochondria and myeloid bodies from early to advanced stages; appearance of large macrophages in the subretinal space; Loss of intercellular junctional complexes; and progressive reduction in the density of melanin granules. These abnormalities appear to spread in a cell by-cell, radial pattern, until widespread areas of the retina become severely pathologic and atrophic. The DAM chorioretinal disorder appears to show many of the histopathologic features which characterize experimentally induced uveitis and other ocular diseases which may result from hypersensitivity to, or autoimmune reaction against, pigments of the uveal tract. PMID- 3968242 TI - Torpedo electromotor system development: developmentally regulated neuronotrophic activities of electric organ tissue. AB - Explant cultures of electric lobe from 45-60 mm stage Torpedo embryos and both ganglionic and dissociated cell cultures prepared from 8-day chick ciliary ganglia have been used to determine whether the electric organs of Torpedo marmorata contain developmentally regulated neuronotrophic activity. Electric lobe explants were evaluated by measuring their neurone density, choline acetyltransferase (CAT0, and low salt, Triton X-100-soluble protein contents. Addition of soluble extracts prepared from the electric organs of late stage embryos (85-105 mm) to standard medium results in the maintenance of nearly theoretical neurone densities in electric lobe explants during a 7-day culture period. Soluble electric organ extracts from early embryonic stages (42-59 mm) do not increase neurone density relative to control cultures but cause an elevation in the CAT content of the explants over control values. On the basis of this analysis it is concluded (1) that late embryonic stage and adult electric organs contain neuronotrophic activity that allows electromotor neurones to survive in vitro and (2) that activity increases rapidly in the electric organs between the 59 nd 72 mm stages of development at a time when rapid increases in postsynaptic membrane markers in the electric organs occur and when peripheral synaptogenesis begins. The activity of late stage embryonic electric organs is heat stable and lost on dialysis. Using ciliary ganglion explants and evaluating both the initial fibre outgrowth and the CAT content after 4 days in vitro, trophic activity is found to be maximal at early embryonic stages (45-55 mm) and to decline thereafter. It is shown that the decline in activity is not due to an increase in toxicity. Using established dissociated ganglionic cell survival assays the specific activity of neuronotrophic factors allowing survival is constant between the 45 and 73 mm stages in the electric organs and then rapidly declines, but activity per electric organ increases rapidly between the 45 and 73 mm stages and then remains at a constant level. The use of poly-dl-ornithine substrates coated with heart-conditioned medium for the cell survival assay results in up to tenfold increase in the trophic titre of the electric organ extracts. The neuronotrophic activity supporting survival of ciliary motorneurones present in embryonic electric organs is heat labile and retained on dialysis. It is concluded that developing electric organs contain at least two neuronotrophic factors that have different properties and are differently regulated. Both factors may contribute during development to bringing naturally occurring electromotor neurone cell death to an end. PMID- 3968243 TI - Ganglion cells in retinae transplanted to newborn rats. AB - Cells projecting out of retinal transplants placed over the tectum of newborn rats were studied by labelling with horseradish peroxidase 1 month or more after transplantation. Using this technique, it was found that only cells with the dendritic characteristics of ganglion cells were labelled and, furthermore, that the major classes of ganglion cells seen in normal retinae were also present in the transplants. The cell body size histograms of ganglion cells in normal and transplanted retinae compared closely with each other. Dendritic trees were closely confined by the limits of the inner plexiform layer, and if that layer was folded or distorted, they were themselves frequently abnormal. While axons usually coursed over the surface of the retinal transplants, they quite often followed an anomalous course crossing the individual layers. It appears, therefore, that this transplantation procedure has relatively little impact on the ability of ganglion cells to develop many of their characteristic morphological features. Whether the different functional responses of the various ganglion cell classes are also preserved after transplantation is a matter for further investigation. PMID- 3968245 TI - Organization of thalamic projections in the nucleus accumbens and the caudate nucleus in cats and its relation with hippocampal and other subcortical afferents. AB - The organization of thalamic projections in the nucleus accumbens (NA) and the caudate nucleus of cats and its relation to other subcortical striatal afferents were studied with a retrograde tracing technique by use of lectin-conjugated horseradish peroxidase. The study showed that the paraventricular and medial parafascicular nuclei (PF) of the thalamus project to the medial NA and the parataenial and medial PF project to the lateral NA. The ventral tegmental area and substantia nigra pars dorsalis (SNpd) project to medial and lateral NA. The midline thalamic nuclei, rostral intralaminar nuclei, ventroanterior nucleus, medial and lateral PF, lateral posterior complex, and nucleus limitans project to medial caudate nucleus. The most medial substantia nigra pars compacta (SNpc) and rostral SNpd project to medial caudate nucleus. The center median, ventrolateral, and the central lateral nuclei of thalamus, SNpc, and SNpd project to lateral caudate nucleus. These results suggest that the thalamic and subcortical nuclei known to connect with the limbic and frontal cortices project to NA and medial caudate nucleus. Those thalamic nuclei connected with the motor system project to lateral caudate nucleus. The hippocampus projects selectively to medial NA. The amygdala, raphe, and other mesencephalic nuclei project only to NA and medial caudate nucleus. The organization of hippocampal, amygdala, and other subcortical afferents suggests that NA and caudate nucleus can be separated into medial "limbic" and lateral nonlimbic "sensory-motor" compartments. A brief review of the distribution pattern of some neurotransmitters, neuropeptides, and their receptors and behavior studies provides additional support to the concept that the striatum can be divided into several subcompartments. PMID- 3968244 TI - Afferent influences on brain stem auditory nuclei of the chicken: cessation of amino acid incorporation as an antecedent to age-dependent transneuronal degeneration. AB - Previous studies of the avian auditory system have revealed that removal of the peripheral receptor (the cochlea) leads to a transneuronal degeneration of auditory relay neurons in nucleus magnocellularis (NM) of the brain stem. An early manifestation of the degeneration which can be observed within 12 hours is a decrease of histochemical staining for RNA (Nissl staining); such a decrease could reflect an alteration in protein synthetic activity within the NM neurons. The present study evaluates this possibility by determining whether the cochlea removal led to an alteration incorporation of protein precursors in the target neurons which exhibit transneuronal degeneration and if so, how early the changes appeared. The cochlea was removed unilaterally in seventeen 10-day-old chicks and two 66-week-old mature chickens, and incorporation of protein precursors was evaluated in the neurons of NM at 0.5, 1.5, 3, 6, 12, and 24 hours following the cochlea removal. Each chick received an intravenous injection of 3H leucine, and was allowed to survive for 30 minutes after the injection of precursor. The brains were then prepared for autoradiography. The extent of incorporation by neurons in NM was determined by counting grains overlying each cell body and determining grain density/micrometers2 of neuron cross-sectional area. We found that auditory relay neurons whose synaptic inputs have been silenced exhibit dramatic decreases in protein synthesis within 30 minutes after removal of the cochlea; leucine incorporation was reduced by about 50%. In chicks sacrificed 3 to 24 hours after removal of the cochlea, some neurons (about 1/3) were entirely unlabeled despite heavy labeling of their neighbors and heavy labeling of all NM neurons on the opposite side of the brain. The remaining neurons exhibited about a 15% reduction in incorporation in comparison with the cells in the contralateral (control) NM. While the decreases in incorporation were apparent at all survival intervals, there was no consistent decrease in Nissl staining until 6 hours after cochlea removal. There were no changes in protein precursor incorporation following removal of the cochlea in adult birds, a result which is in keeping with the relative absence of transneuronal degeneration following removal of the cochlea at maturity. The results suggest a very rapid transneuronal regulation of protein metabolism within target neurons in young animals, perhaps by activity-related events. PMID- 3968246 TI - Primary afferent projections of the major splanchnic nerve to the spinal cord and gracile nucleus of the cat. AB - Splanchnic afferent projections to the spinal cord and gracile nucleus were labeled following the application of HRP to the central cut end of the major splanchnic nerve. Labeled afferent fibers were detected in the ipsilateral dorsal column, in Lissauer's tract (LT), in laminae 1, 5, 7, and 10, and in the dorsal gray commissure at T1-T13 levels of the spinal cord. Afferent projections were not identified in laminae 2-4. Collaterals from LT projected ventrally along the lateral and medial margins of the dorsal horn (called lateral and medial pathways, respectively). Afferents in the lateral pathway formed small bundles, spaced rostrocaudally at intervals of 300-1,000 microns, which passed medially at the base of the dorsal horn into laminae 5, 7, and 10 and to the contralateral spinal cord. Some afferents in the lateral pathway projected to the intermediolateral nucleus where labeled sympathetic preganglionic neurons were located. Afferents in the medial pathway entered the lateral aspect of the dorsal column and projected as a group near the midline rostrally to the medulla. The dorsal column pathway terminated in the ventral gracile nucleus in four or five clusters, each occupying a region ranging in size from 0.01-0.1 mm3 and separated in the rostrocaudal axis by distances of 400-800 microns. These clusters were concentrated in the middle and caudal portions of the nucleus below the obex. A comparison of the present results with those from earlier experiments on the central projections of afferent fibers from the heart, kidney, and pelvic organs demonstrates a consistent pattern of visceral afferent termination in the thoracolumbar and sacral segments of the spinal cord. This is not unexpected, since visceral afferent pathways to different organs perform similar functions, such as the transmission of nociceptive information and the initiation of autonomic reflexes. PMID- 3968247 TI - Afferent influences on brain stem auditory nuclei of the chicken: neuron number and size following cochlea removal. AB - The consequences of cochlea removal on neuron number and soma cross-sectional area were examined in the second order auditory nucleus (n. magnocellularis) of chickens. Both the age of the subjects at the time of cochlea (basilar papilla) removal (1-66 weeks) and the survival period (1-45 days) were varied. Neuron number and soma cross-sectional area were determined from Nissl stained sections. Additional material was processed to examine the relationship of ganglion cell loss to changes in n. magnocellularis. Neuron number decreased by 25-30% and soma cross-sectional area decreased by 10-20% ipsilateral to the cochlea removal in chickens operated on during the first 6 weeks after hatching. In contrast, in chickens operated on at 66 weeks posthatch neuron number decreased less than 10% and there was no change in soma area. The changes were rapid, being nearly complete 2 days after cochlea removal. An initial change (1 and 2 days after surgery) observed in animals operated on up to 6 weeks posthatch was the presence of a large number of neurons in which no Nissl substance could be detected. These results demonstrate an age-dependent change in the susceptibility of NM neurons to deafferentation. This change is not temporally related to other measures of functional maturation of the auditory system. PMID- 3968248 TI - Afferent influences on brain stem auditory nuclei of the chicken: changes in succinate dehydrogenase activity following cochlea removal. AB - We have examined one of the metabolic consequences of unilateral cochlea (basilar papilla) removal in the chick brain stem auditory system. We assessed changes in succinate dehydrogenase (SDH), a mitochondrial enzyme involved in energy metabolism, in neurons of second-order n. magnocellularis (NM) and third-order n. laminaris (NL). Chickens undergoing surgery at 10 days of age were perfused 4 hours to 35 days postlesion. Chickens 6 or 66 weeks of age at cochlea removal were examined 1 or 8 days after surgery. In all groups, cryostat sections were prepared for SDH histochemistry or Nissl staining. In normal chickens, NM cell bodies and NL neuropil contain SDH reaction product. In young birds, the density of SDH reaction product in NM shows a rapid biphasic response to cochlea removal. From 8 to 60 hours postlesion, density increases ipsilateral to cochlea removal; for survival times of 3-35 days, SDH density decreases in ipsilateral NM. In NL, no changes were observed until 3 days after cochlea removal. Then we observed a long-lasting decrease in density of SDH reaction product in the neuropil regions receiving input from the deafferented NM. All of these changes are age-dependent in that they were observed only following cochlea removal on or before 6 weeks of age. PMID- 3968249 TI - Vibrissae tactile stimulation: (14C) 2-deoxyglucose uptake in rat brainstem, thalamus, and cortex. AB - The right mystacial vibrissae of awake, adult rats were stroked at 4-6 times/second and brain regions which increased (14C) 2-deoxyglucose (2DG) uptake were mapped autoradiographically. The ventral parts of the ipsilateral spinal trigeminal nuclei pars caudalis (Sp5c), pars interpolaris (Sp5i), pars oralis (Sp5o), and the principal trigeminal sensory (Pr5) nuclei were activated. The lateral part of the ipsilateral facial (VII) nucleus (the region which innervates the vibrissae muscles) was also activated possibly via excitatory, trigeminal (Sp5c, Sp5i, Sp5o, Pr5) sensory afferents. A number of regions were activated contralateral to the sensory stimulus. Discrete patches of (14C) 2DG uptake occurred in deep layers of the superior colliculus (SCsgp). Dorsolateral and dorsomedial parts of the ventrobasal nucleus (VB), and posterior, dorsolateral parts of the reticular nucleus (R) of thalamus were activated, along with broad portions of the primary somatosensory cortex (SI) and second somatosensory cortex (SII). Though all layers of SI and SII cortex increased 2DG uptake, VB thalamic afferents to layers IV and Vc-Vla presumably accounted for the greater activation of these cortical layers during repetitive sensory stimulation of the vibrissae (RSSV). Activation of the above structures fits well with known anatomical data. However, the pattern of activation during RSSV was very different from that previously described during vibrissae motor cortex stimulation (VMIS). RSSV and VMIS both produced similar repetitive movements of all the mystacial vibrissae. However, only a few overlapping brain regions were activated during both RSSV and VMIS. These RSSV-VMIS overlap zones included Sp5o; rostral Sp5i; lateral VII; SCsgp; ventrobasal-posteromedial and ventrobasal-ventrolateral zones in thalamus; and a rostral region of SI probably anterior to the Woolsey vibrissae barrelfield in the dysgranular somatosensory (SI) cortex. Since RSSV and VMIS would both be expected to activate vibrissae proprioceptors, we have hypothesized that vibrissae proprioceptive input was processed in part in the RSSV-VMIS overlap zones. Convergence of motor-sensory inputs and other types of processing could have also occurred in these overlap zones. PMID- 3968250 TI - Autoradiographic localization of estrogen and androgen receptors in the sexually dimorphic area and other regions of the gerbil brain. AB - Autoradiography was used to localize sex hormone-accumulating cells in the gerbil brain. Some areas had a high density of both androgen and estrogen receptors. These areas included the lateral septum, the bed nucleus of the stria terminalis, the medial and cortical amygdaloid nuclei, the medial preoptic area (MPOA), the arcuate nucleus, the ventromedial hypothalamus, and the periventricular central gray. This distribution of hormone receptors agrees closely with that seen in other mammals. In contrast to what has been reported for other species, the distribution of estradiol-accumulating cells in the gerbil MPOA is different in males and females. Estradiol uptake in the posterior MPOA followed the morphology of a sexually dimorphic area (SDA) and was therefore sexually dimorphic. Moreover, the percentage of SDA cells that accumulated estradiol appeared to be higher in males than in females. The pattern of androgen accumulation also followed the morphology of the SDA but differed from the pattern of estrogen accumulation in one way. The uptake of 5 alpha-dihydrotestosterone in the SDA pars compacta (pc), a component of the SDA, was much greater than in the rest of the SDA. This was not true for estradiol. Since most females lack the SDApc, androgen uptake in the gerbil SDA may also be sexually dimorphic. Androgen uptake was more widespread than estrogen uptake in the brainstem. Brainstem nuclei that accumulated 5 alpha-dihydrotestosterone included the locus ceruleus, the dorsal raphe, the hypoglossal nucleus, the area postrema, the nucleus of the solitary tract, and the dorsal nucleus of the vagus. PMID- 3968251 TI - Quantitative electron microscopic observations on the non-neuronal cells and lipid droplets in the posterior funiculus of the cat after dorsal rhizotomy. AB - Adult cats were subjected to unilateral dorsal L6, L7, and S1 rhizotomies. After survival times of 1-1,552 days the different glial cell types, the perivascular cells, and the lipid droplet content of each cell type were studied quantitatively at the ultrastructural level in sections from the posterior funiculus at the L1 level. The number of astrocytes did not appear to change during the degeneration process. From 105 days postoperatively (p.o.), a marked reduction in the oligodendroglial cell population was observed. The number of microglial cells increased from 5 days p.o. onward. A large increase was observed particularly between 20 and 160 days p.o. The occurrence of pericytes was unchanged during the degeneration but the number of non-pericytic perivascular cells/blood vessel was increased from 10 days p.o. onward. The number of lipid droplets in the microglial cells increased early during the degeneration period. Subsequently an increase in lipid droplet number was observed in the astrocytes and somewhat later also in the non-pericytic perivascular cells. These findings have been interpreted to reflect a redistribution of lipid droplet material from the degenerating white matter to cells in the perivascular space during the observed time period. PMID- 3968252 TI - Sensory innervation of periodontal ligament of rat molars consists of unencapsulated Ruffini-like mechanoreceptors and free nerve endings. AB - The trigeminal ganglion (TG) of adult rats was injected with 3H-amino acids to label periodontal receptors by axonal transport; 20-24 hours after injection, samples of molar ligament were prepared for autoradiography and electron microscopy. Four types of neurites labeled from TG were found in the avascular ligament fiber regions: large, complex, Ruffini-like endings, lacking a capsule, but with finger extensions touching ligament collagen; smaller Ruffini-like endings, lacking a capsule and neural fingers; free bundles of unmyelinated axons; and free, small, myelinated axons. The vascular channels plus associated loose connective tissue that perforate the ligament contained labeled preterminal ensheathed axons, small Ruffini endings, and free unmyelinated or small myelinated axons. The incidence of labeled endings was about 5 X greater next to the lower third of the root than in the upper two-thirds or beneath the root. The TG myelinated axons (diameter range 2-15 microns) entered the ligament in sheathed nerve bundles; these branched to form numerous small preterminal axons that were surrounded by a periaxonal fluid space and a perineurial sheath. Terminal axons branched from nodes of Ranvier, left the preterminal chamber, and followed an extended branching course through the collagen fibers. Large, complex Ruffini-like endings had numerous mitochondria and were partially covered by special lamellar Schwann cells and complex basal lamina; vesicles and multivesicular bodies were found near exposed regions of the receptor. Smaller Ruffini-like endings lacked neural fingers and had a simpler structure and less elaborate Schwann cells. The structure of Ruffini-like endings was highly varied; thus a structural continuum may exist from the largest, most complex to the smallest, simplest Ruffini-like receptor. The TG unmyelinated axons entered the ligament in ensheathed bundles; they then branched into free bundles that were found in the avascular ligament or near blood vessels. No encapsulated receptors were found. PMID- 3968253 TI - Development of early brainstem projections to the tail spinal cord of Xenopus. AB - Horseradish peroxidase (HRP) was used to determine the sequence in which axons from different brain neurons reach the tail spinal cord during embryonic and early larval development of Xenopus laevis. Brainstem cells of several classes project to the tail at these stages: mesencephalic reticulospinal neurons of the nucleus of the medial longitudinal fasciculus, a variety of other reticulospinal neurons, vestibulospinal neurons, and a group of median basal cells which may be raphe neurons. Among the reticulospinal neurons the paired Mauthner cells are the most prominent. They and caudally situated reticular neurons are the first to label with HRP applied to the tail spinal cord (stage 37). Vestibulospinal and other reticular neurons begin to label next (stage 39), followed by mesencephalic and then median basal neurons (stage 41). Except for the Mauthner cells, the number of labeled cells belonging to each neuron class increases gradually as development proceeds. PMID- 3968254 TI - Topology of the central nucleus of the mustache bat's inferior colliculus: correlation of single unit properties and neuronal architecture. AB - The central nucleus of the mustache bat's inferior colliculus was studied in Golgi, Nissl, and fiber stained preparations; the neuronal organization and cytoarchitecture were correlated with the tonotopic maps revealed by single cell recordings. Three divisions of the central nucleus were defined by anatomical and physiological criteria: the anterolateral, medial, and dorsoposterior divisions. In horizontal sections, the anterolateral division has pronounced, semicircular fibrodendritic laminae. The dendritic fields of adjacent neurons form rostro caudally-oriented laminae related to the tonotopic sequence. The neurons in the medial division are similar in size and arrangement, but here the laminar orientation follows the lateral-to-medial axis, with less curvature. The dorsoposterior division has many small disc-shaped and stellate neurons and a different, somewhat less fully expressed, laminar orientation. Each division has a unique frequency representation and tonotopic organization which conform to the pattern of dendritic orientation. In the anterolateral division, frequencies from about 10 kHz to about 59 kHz are represented, whereas the frequency representation in the medial division ranges from about 65 kHz to 110 kHz, and higher. The dorsoposterior division has an isofrequency organization in which the best frequency is characteristic for each bat, ranging from 60 to 64 kHz and varying by only +/- 300 Hz. This frequency corresponds to the dominant echo frequency of the bat's echolocation signals. We suggest that the dorsoposterior division is a hypertrophied isofrequency lamina, with many neurocytological features comparable to the isofrequency laminae in the central nucleus of other mammals. PMID- 3968255 TI - Reflex connections of the facial and vagal gustatory systems in the brainstem of the bullhead catfish, Ictalurus nebulosus. AB - The primary gustatory sensory nuclei in catfish are grossly divisible into a vagal lobe and a facial lobe. In this study, the reflex connections of each gustatory lobe were determined with horseradish peroxidase (HRP) tracing methods. In addition, in order to determine the loci and morphology of the other brainstem cranial nerve nuclei, HRP was applied to the trigeminal, facial, glossopharyngeal, or vagus nerve. The sensory fibers of the facial nerve terminate in the facial lobe. The facial lobe projects bilaterally to the posterior thalamic nucleus, superior secondary gustatory nucleus, and medial reticular formation of the rostral medulla. The facial lobe has reciprocal connections with the n. lobobulbaris, medial reticular formation of the rostral medulla, descending trigeminal nucleus, medial and lateral funicular nuclei, and the vagal lobe, ipsilaterally; and with the facial lobe contralaterally. In addition, the facial lobe receives inputs from the raphe nuclei, from a pretectal nucleus, and from perilemniscal neurons located immediately adjacent to the ascending gustatory lemniscal tract at the level of the trigeminal motor nucleus. The gustatory fibers of the vagus nerve terminate in the vagal lobe, while the general visceral sensory fibers terminate in a distinct general visceral nucleus. The vagal lobe projects ipsilaterally to the superior secondary gustatory nucleus, lateral reticular formation, and n. ambiguus; and bilaterally to the commissural nucleus of Cajal. The vagal lobe has reciprocal connections with the ipsilateral lobobulbar nucleus and facial lobe. In addition, the vagal lobe receives input from neurons of the medullary reticular formation and perilemniscal neurons of the pontine tegmentum. In summary, the facial gustatory system has connections consonant with its role as an exteroceptive system which works in correlation with trigeminal and spinal afferent systems. In contrast, the vagal gustatory system has connections (e.g., with the n. ambiguus) more appropriate to a system involved in control of swallowing. These differences in central connectivity mirror the reports on behavioral dissociation of the facial and vagal gustatory systems. PMID- 3968256 TI - In vivo NMR imaging of sodium-23 in the human head. AB - We report the first clinical nuclear magnetic resonance (NMR) images of cerebral sodium distribution in normal volunteers and in patients with a variety of pathological lesions. We have used a 1.5 T NMR magnet system. When compared with proton distribution, sodium shows a greater variation in its concentration from tissue to tissue and from normal to pathological conditions. Image contrast calculated on the basis of sodium concentration is 7 to 18 times greater than that of proton spin density. Normal images emphasize the extracellular compartments. In the clinical studies, areas of recent or old cerebral infarction and tumors show a pronounced increase of sodium content (300-400%). Actual measurements of image density values indicate that there is probably a further accentuation of the contrast by the increased "NMR visibility" of sodium in infarcted tissue. Sodium imaging may prove to be a more sensitive means for early detection of some brain disorders than other imaging methods. PMID- 3968257 TI - MR imaging of pediatric cerebral abnormalities. AB - One hundred sixteen magnetic resonance (MR) imaging studies from 105 pediatric patients with a variety of cerebral abnormalities were reviewed to determine the diagnostic efficacy of MR in the pediatric population. All subjects tolerated the MR procedure well, although sedation was necessary for younger children. Compared with CT, MR proved to be advantageous in detection and characterization of the pathology in 23 of 105 patients, especially when the abnormality was located along the base of the brain and midline, or when it involved primarily the white matter. Intracranial calcification was the one abnormality not detected with MR although dense calcifications could be seen as areas of low signal intensity. Some characteristics of various pathological entities were compared in an attempt to differentiate among abnormalities in the same anatomical location: craniopharyngioma from optic chiasm and hypothalamic glioma, cystic glioma from arachnoid cyst, and chronic subdural hematoma from subdural hygroma. The lack of ionizing radiation in MR is of particular interest in pediatric neuroradiology since radiation is of special concern in the young age group. PMID- 3968258 TI - Computed tomography of cerebrovascular calcifications in postsurgical hypoparathyroidism. AB - Despite the extensive literature on the radiographic appearance of basal ganglia calcification in hypoparathyroidism, the vascular and perivascular deposits that are the hallmark of this disease have not been described radiographically. We report two patients with postsurgical hypoparathyroidism in whom such vascular calcification was observed on CT and was confirmed pathologically in one. The metabolic disturbance leading to the vascular deposits is discussed. PMID- 3968259 TI - Frequency shift artifacts in MR imaging. AB - Chemical shifts may be expressed as distortions and displacements in magnetic resonance (MR) images. Specifically, in two-dimensional Fourier transform reconstructions such shifts produce visible displacements in the direction of frequency encoding. This is readily observable at 0.26 T with phantoms comprised of in vitro solutions with known chemical shifts and human tissues with disparate fat content. Moreover, frequency shift artifacts are visible in routine abdominal scanning at the interfaces of structures of differing fat content. Two common examples of this involve the vertebral body and intervertebral disk and the kidney and surrounding retroperitoneal fat. Without appropriate changes in gradients, such distortions may be expected to increase with increasing magnetic field strength. PMID- 3968260 TI - Two benign CT presentations of thyroid-related papillary adenocarcinoma. AB - Two cases of thyroid-related papillary adenocarcinoma are presented. Both patients had clinically benign neck masses that were clearly separated from the thyroid gland. In both cases the thyroid gland was normal to clinical evaluation, CT, and 99mTc scanning. One patient had an occult thyroid carcinoma with a solitary metastatic node in the lateral neck, and the other patient had a rare carcinoma in a suprahyoid thyroglossal duct cyst that had been previously misdiagnosed as a cystic hygroma. PMID- 3968261 TI - Computed tomography of benign masseteric hypertrophy. AB - Benign masseteric hypertrophy (BMH), although an uncommon condition, is important in the differential diagnosis of parotid region masses. We believe CT is the ideal imaging modality for investigating patients with parotid region masses and that it has proved to be most useful in the diagnosis of masseteric hypertrophy. We present three cases of BMH and describe and discuss the CT findings and differential diagnosis of parotid region masses. PMID- 3968262 TI - Diagnosis of spinal arteriovenous malformation in a pregnant patient by MR imaging. AB - An intraspinal arteriovenous malformation (AVM) was diagnosed by magnetic resonance imaging in a pregnant patient. Serpentine areas of low signal intensity surrounded by cerebrospinal fluid were considered diagnostic of this surgically verified abnormality. In addition, T2 weighted images helped to determine the extent of the spinal canal occupied by the AVM. PMID- 3968263 TI - Malignant teratoma of the thyroid in an adult: CT appearance. AB - A case of malignant teratoma of the thyroid gland is presented. Computed tomography identified an inhomogeneous mass with dense calcifications involving the thyroid gland and compressing the upper airway. Enlarged, peripherally enhancing lymph nodes in the neck and mediastinum suggested its malignant etiology. PMID- 3968264 TI - Prolonged hepatic enhancement on computed tomography in a case of hepatic lymphoma. AB - Hepatic lymphoma is often very difficult to detect using any modality. A case of hepatic lymphoma appeared on rapid contrast infused CT as extremely prolonged and bizarre enhancement. The specific features included a widespread and aggressive appearance with a variable pattern of contrast enhancement. There was one localized area of apparent centripetal accumulation of contrast medium. The prolonged and irregular enhancement may be due to contrast medium "trapping" in interstitial spaces or even to the fact that a bolus technique was used. PMID- 3968265 TI - Demonstration of a splenic artery pseudoaneurysm by MR imaging. AB - The magnetic resonance (MR) features of a splenic artery pseudoaneurysm are described in a patient with recurrent pancreatitis. Correlation of MR, CT, and pathologic findings is made, and the advantage of MR imaging for the diagnosis of vascular abnormalities is outlined. PMID- 3968266 TI - Toxic dilatation in Crohn disease with CT correlation. AB - We describe the CT appearance of toxic dilatation in a patient with Crohn disease. The CT manifestations of this uncommon but important entity have not been previously described. The involved portion of the colon was mildly dilated and demonstrated pseudopolyp formation. Bowel wall thickening in this segment was minimal as expected in toxic dilatation. Intramural gas was identified representing pneumatosis intestinalis, an ominous sign in this condition. PMID- 3968267 TI - Bilateral "milk of calcium" renal cysts: CT findings. PMID- 3968268 TI - Computed tomography of prostatic abscess. AB - Although the CT appearance of prostatitis and prostatic carcinoma have been described, there are no reports of the CT diagnosis of prostatic abscess, an unusual complication of prostatic infection. The appearance of low attenuating, round, well demarcated regions within one or more lobes of the prostate gland by CT is suggestive of prostatic abscess. PMID- 3968269 TI - Computed tomography of hydrocele of the tunica vaginalis. AB - The CT appearance of hydrocele of the tunica vaginalis is described. Embryology of testicular descent and the anatomic relationship of the testis to the tunica vaginalis are described. PMID- 3968270 TI - Cystic lymphangioma of the pancreas: CT demonstration. PMID- 3968271 TI - CT demonstration of calcified subcutaneous masses following parenteral pentamidine isethionate injection. PMID- 3968272 TI - Computed tomography in lipoid pneumonia. PMID- 3968273 TI - A new barium paste for computed tomography of the esophagus. AB - A new 3% barium paste for use in CT of the esophagus was evaluated for its ability to coat the esophageal lumen in 31 patients. The esophagus was divided into proximal, mid, and distal segments to analyze the effectiveness of lumenal opacification. The average percent opacification of these segments was 74.5, 87.7, and 60.8%, respectively, for all patients. These results indicate that this product visibly coats the esophageal lumen in the majority of patients. We found that it is easy to use, is well tolerated, and did not produce scanning artifacts. We conclude that this new oral contrast agent could be used routinely in CT of the esophagus or in selected cases to clarify problem areas. PMID- 3968274 TI - Ipsilateral decubitus position for percutaneous CT-guided adrenal biopsy. AB - Positioning the patient on the side to be biopsied elevates and relatively immobilizes the diaphragmatic leaf on the dependent side, allowing percutaneous adrenal needle biopsy by a direct posterior approach without traversing lung tissue. The ipsilateral decubitus position was used successfully for biopsy of four small adrenal lesions in which lung precluded a direct posterior approach in the prone position. In addition, the relative stability of the diaphragmatic leaf further facilitated accurate needle placement. PMID- 3968275 TI - Computed tomography after gastrectomy in primary gastric carcinoma. AB - Thirty-eight patients with adenocarcinoma of the stomach and considered disease free following surgical resection of their primary neoplasm, underwent abdominal CT 1 month to 3 years after tumor removal. A total of 70 CT studies were obtained during this period. The most common findings were metastasis to lymph nodes (15 patients) and to the liver (nine patients). There were nine patients with local recurrence of the tumor. In the follow-up of patients after gastrectomy for carcinoma, CT was helpful in the diagnosis of local recurrence and distant metastasis, in guiding the biopsy of the suspected abnormalities, and in the evaluation of the results of treatment. PMID- 3968276 TI - CT appearance of appendicitis and its local complications. AB - During evaluation for occult fever or nonspecific abdominal pain CT will occasionally identify inflammatory disease of the appendix as the underlying cause. In these cases CT may also provide useful information about the presence of associated mesenteric inflammation, abscess, or perforation. Five cases are presented in which CT provided clinically useful information supplementing that gained from barium studies and clinical presentation. When a periappendiceal lesion is found, the extent and nature of inflammatory changes are shown directly rather than inferentially. PMID- 3968277 TI - Computed tomography of abdominal carcinoid tumor. AB - Computed tomography of the abdomen was performed in 10 patients with pathologically proven carcinoid tumor. In four patients numerous tiny punctate and radiating densities were seen in the mesentery. Two of these patients also had rounded mesenteric masses, 2.5-5 cm in diameter. The presence of punctate or radiating mesenteric densities reflecting desmoplastic reaction, when combined with rounded mesenteric masses or liver metastases, is highly suggestive of carcinoid tumor. The CT appearance of the hepatic metastases in this group of patients was also assessed and found to be nonspecific. PMID- 3968278 TI - Retroperitoneal manifestations of sarcoidosis on computed tomography. AB - Three patients with known or subsequently proven sarcoidosis had CT of the retroperitoneum because of clinical symptoms referable to this area. Gross splenomegaly was evident in all cases. The liver was massively enlarged in one patient and normal size in two patients. Lymphadenopathy was present in many nodal groups. PMID- 3968279 TI - Computed tomography of the tracheal bronchus. AB - Tracheal bronchus is an uncommon anomaly in which an ectopic bronchus arises from the trachea above the carina. It occurs on the right side and two types are described: "supernumerary," which is associated with a normal trifurcating right upper lobe bronchus, and "displaced," in which instance the ectopic bronchus supplies the apical segment of the upper lobe. The CT appearance of this anomaly is described in two cases. Findings include identification of a bronchus arising from the trachea in a section more cephalad than the carina and the presence of only two segmental bronchi arising from the anatomic right upper lobe bronchus when the anomaly is of the "displaced" type. Thin axial sections and coronal imaging display the tracheal bronchus to best advantage. PMID- 3968281 TI - CT demonstration of the coronary sinus. AB - The CT appearance of the coronary sinus is described and correlated with cadaver cross sections at similar levels. Enhanced scans in a patient with persistent left superior vena cava clearly demonstrate the various segments of the sinus. PMID- 3968280 TI - CT diagnosis of congenital intrapericardial masses. AB - Prior to the development of CT, cardiac and pericardiac masses were evaluated by chest roentgenography, angiocardiography, and echocardiography. In most cases preoperative diagnosis of a specific entity was impossible. Preoperative CT diagnosis of an intrapericardial developmental mass becomes possible because of the presence of fat, fat/fluid level, thick walled cysts, as well as globular calcifications, bones, teeth, water density fluid, and soft tissue. A report of a young woman with a ruptured and infected intrapericardial teratoma and an infant with an intrapericardial bronchial cyst is presented. PMID- 3968282 TI - CT observation of rib abnormalities: spectrum of findings. AB - The CT studies in 63 patients in which rib abnormality was identified or excluded were retrospectively analyzed. The CT features were detailed and correlated with other available radiographic findings as well as clinical data. Contiguous spread of tumor to rib or metastasis to rib characteristically showed subtle or complete segmental lytic rib destruction. An accompanying extrapleural soft tissue mass was frequently seen with metastatic disease and myeloma. In nine patients CT showed rib destruction that had been obscured on chest radiography by heart, diaphragm, mass, or pleural effusion. Other imaging studies prompted consideration of neoplasm in seven patients in whom CT clearly showed benign post traumatic or developmental lesions. Six patients had a clinically suspected chest wall mass excluded, leading to the diagnosis of Tietze syndrome. The ribs should be carefully inspected on all CT studies of the thorax and upper abdomen. Computed tomography is helpful when other imaging techniques, such as rib films or isotopic bone scans, have not resolved the question of clinically or radiographically suspected rib abnormality. PMID- 3968283 TI - CT characteristics of aortic atherosclerotic aneurysm versus aortic dissection. AB - In an attempt to better define criteria for the diagnosis of atherosclerotic aneurysm (AA) and aortic dissection (AD) using CT the scans of 60 documented aortic lesions were reviewed. Hyperdensity of the aortic wall at multiple levels was found to be specific for AD. Central displacement of atheromatous calcification and deformity of the residual aortic lumen were more common in AD than in AA. Peripheral location of aortic wall calcification and a round aortic lumen in cross section were more common in AA than in AD. Central calcification in AA appeared to be associated with a serious short-term prognosis in several cases. A thickened aortic wall of low density was more common in AA than in acute AD, but this relationship was not significant when acute and chronic ADs were considered as a single group. Wall thickness correlated with cross-sectional size of the aortic lesion in AA but not in AD. The mean maximum wall thickness exceeded 1 cm for both AA and AD and was not significantly different between the two; contrary statements have been made in the angiographic literature. PMID- 3968284 TI - In vivo 19F NMR imaging. AB - In vitro and in vivo 19F spectra and images were obtained using various clinically safe fluorinated compounds. Standard and chemical shift images were acquired in solutions of fluorinated anesthetics with the chemical shift images clearly separating signals arising from a mixture of halothane and methoxyflurane. The 19F images of halothane in rats were unsuccessful at anesthetic concentration. In vivo 19F nuclear magnetic resonance (NMR) images were acquired at 57.9 MHz in rats receiving chronic injections of 14% perfluorodecalin, 6% perfluorotripropylamine (Fluosol-DA). The liver accumulates Fluosol-DA in the reticuloendothelial cells to concentrations that allow images to be obtained in less than 30 min. Image intensity from the perfluorochemicals reflects reticuloendothelial cell activity and thus is a functional image. Conventional proton NMR images at corresponding levels confirmed that the 19F signal arose from the liver and not muscle or fat. The 19F NMR images of the large bowel and stomach in rats were obtained by filling the lumen with concentrated Fluosol-DA. High contrast anatomical images showing gross structure of the gastrointestinal tract were acquired in as little as 12 min. These data suggest that 19F NMR may have a potential role in clinical imaging. PMID- 3968285 TI - Computed tomography in the study of the development of the skull base: 1. Normal morphology. AB - We examined 11 human fetuses (18 to 30 weeks' gestation) with high resolution CT to study the developmental ossification of the two main component structures of the skull base, the temporal and sphenoid bones. Computed tomography, with its excellent contrast discrimination, allowed clear visualization of the morphology of ossifying centers. Skull base growth during this gestational period was found to be a dynamic event with rapid changes in morphology and interosseous relationships. The growth of the sphenoid body on CT corroborates the studies done by Kodama, who used dehydrated skulls. The temporal bone proceeded in a stepwise fashion; complete encapsulation of the membranous labyrinth occurred before it grew anteroposteriorly to form the apex and mastoid. PMID- 3968286 TI - Computed tomography in the study of the development of the skull base: 2. Anencephaly, the aberrant skull form. AB - The application of various radiographic modalities in the analysis of the paradigm aberrant skull of anencephalics is reported. Again, we found high resolution CT to be the most valuable modality. A detailed description of the skull base changes in anencephaly is presented, and the appropriate embryologic explanation is offered. PMID- 3968288 TI - Pedunculated pigmented basal-cell carcinoma on the buttock of a black man. AB - A pedunculated pigmented basal-cell carcinoma on the buttock of a black male is presented. Unusual features of this case include an atypical pendunculated appearance, suggesting nevus or neurofibroma, atypical location on a covered area of the body, and occurrence in a low-incidence racial group. PMID- 3968287 TI - Basal-cell carcinoma resulting from radiation therapy for hypertrophic tonsils. AB - Benign dermatologic conditions are no longer treated with therapeutic radiation because of the late complications that can result. One of the most serious complications that may occur is the development of skin cancer of various types. In this report, a patient received radiation for hypertrophic tonsils and later developed basal-cell carcinomas in the irradiated areas. PMID- 3968289 TI - A brief analysis of the Burow's wedge/triangle principle. AB - The Burow's wedge/triangle principle is analyzed and related to a variety of closure techniques that bear various names. The rationale for the application of these principles is reviewed. PMID- 3968291 TI - Punch grafting the crown and vertex. AB - Several different methods exist for surgical hair replacement of the vertex region of the scalp. Despite the more recent addition of alopecia reduction and flaps, small areas of crown baldness frequently, can best be handled cosmetically by well-planned and technically well-executed punch autografts. The methodology of hair transplantation of the vertex region of the scalp and the avoidance of cosmetic problems are discussed. PMID- 3968290 TI - Injectable collagen implant: histopathologic identification and longevity of correction. AB - This prospective study reports the results of the longevity of the correction achieved in 312 patients receiving injectable collagen implant and the histopathologic identification of the implant in the six who experienced reactions at the treatment sites. In reporting results in cosmetic patients, certain ones can be considered objective or factual, and other must be judged subjective. This study reports both kinds of results and proposes a new theory to explain the duration of the improvement. PMID- 3968292 TI - Management of temporal nerve injuries. AB - Transection of the temporal branch of the facial nerve results in paralysis of the frontalis muscle with subsequent inability to wrinkle the forehead. In addition there is ptosis of the eyebrow with upper visual field defects. The intent of this article is to outline an orderly, rational approach to the management of such injuries based on our experience with seven patients whose nerve was damaged during Mohs surgery for cancer ablation. Repair options include various combinations of direct brow-plasty, indirect temporal or coronal browlifts, and adjunctive upper lid blepharoplasty. PMID- 3968293 TI - Chronic radiodermatitis with dystrophic calcification treated with Mohs surgery. PMID- 3968294 TI - Symmetric basal-cell carcinoma of the auricles. PMID- 3968295 TI - A comparison of dopamine, dobutamine and isoproterenol in the treatment of shock. AB - Twelve patients in shock, defined as being present if the mean arterial blood pressure was less than 60 mm Hg, pulmonary arterial occlusion pressure was 15 mm Hg or greater, urine output was 20 ml or less for 2 consecutive hours, and there was clinical evidence of poor peripheral perfusion, underwent a comparative therapeutic trial with dopamine at 200 micrograms . min-1 and 400 micrograms . min-1 (2.5-5.5 micrograms . kg-1 . min-1), dobutamine 250 micrograms . min-1 and 500 micrograms . min-1 (3.5-7 micrograms . kg-1 . min-1) and isoproterenol 2 micrograms . min-1 and 4 micrograms . min-1 (0.025-0.055 micrograms . kg-1 . min 1). Isoproterenol at 2 micrograms . min-1, produced a significant increase in pulse rate, cardiac output, left ventricular stroke work index and decrease in mean pulmonary blood pressure and pulmonary arterial occlusion pressure and at 4 micrograms . min-1 a significant increase in stroke volume, mixed venous oxygen tension and decrease in right atrial pressure and systemic vascular resistance was also observed. Dopamine at 200 micrograms . min-1 produced a significant increase in cardiac output, pulmonary arterial occlusion pressure and mixed venous oxygen tension and at 400 micrograms . min-1 a significant increase in pulse rate, mean arterial blood pressure mean pulmonary blood pressure, right ventricular stroke work index, right atrial pressure and pulmonary arterial occlusion pressure and decrease in arterial oxygen tension was also observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968296 TI - Paralysis for ventilated patients? Yes or no? PMID- 3968297 TI - Scoring system to assess disease severity in children. AB - A scoring system to assess disease severity in children, based on therapeutic and diagnostic interventions, is suggested. The charts of 475 consecutive admissions to a multidisciplinary pediatric intensive care unit (PICU) were reviewed and therapeutic and diagnostic interventions (TDI) associated with more than 20% mortality identified. These were scored: TDI associated with 20-30% mortality - 1 point; 31-40% - 2 points; 41-50% - 3 points and more than 51% - 4 points. According to these values, a Pediatric Therapeutic and Diagnostic Intervention Score (PTDIS) was calculated for each patient. The study population may be divided, according to PTDIS and mortality, into three groups: moderately severe disease associated with up to 2.7% mortality and PTDIS less than 20; severe disease associated with up to 25% mortality and PTDIS less than 35; critically ill patients with more than 50% mortality and PTDIS greater than 36. PTDIS in survivors was 15.2 +/- 0.6 (mean +/- SE) and 43.6 +/- 1.1 in non-survivors. Pearson's correlation between PTDIS and mortality was R = 0.7162 at a significance level of p less than 0.0001. PTDIS and mortality were not found to be significantly correlated with sex, age or duration of hospitalization in the Unit. Sepsis, central nervous system infections and burns were the primary diseases, and shock, coma and patients after cardiopulmonary resuscitation the indications for admission to the Unit, associated with the highest mortality and PTDIS. This study demonstrates the efficacy of the suggested PTDIS system in accurately assessing severity of disease in a PICU patient population. PMID- 3968298 TI - Use of "bollards" to improve patient access during intensive care. AB - Permanent floor-mounted "bollards" have been installed in three Intensive Care Areas in the Oxford Teaching Hospitals. Each brings services to one bed and, because access around the head is greatly improved in comparison with the conventional arrangement with the head next to the wall, facilitates both emergency and routine care and improves the safety of the working environment for staff and patients. Differences between the bollards installed in the three units are described and the advantages and disadvantages of each discussed. It is concluded that a bollard should be located to the left of the head of the bed and that it should be about 1100 mm high and 500 mm square. At least two oxygen and vacuum outlets, one air outlet, six electric power sockets and connections for monitoring cables should be provided on the bollard with further power sockets on the adjacent wall. A length of equipment rail mounted across the head of the bed supports the suction equipment required for oral and respiratory tract care and storage space is provided on and below the work surface which is mounted on the wall behind the head of the bed. PMID- 3968299 TI - Transthoracic electrical impedance as an index of extracellular fluid volume in man. AB - Findings in 76 subjects without cardiac failure were analyzed to detect relationships between observed changes in transthoracic electrical impedance (TEI) and total body extracellular fluid volume (ECFV) during various manoeuvres and between absolute TEI and ECFV values. TEI was normalized to electrode distance (Z0/delta el) and ECFV to lean body mass (ECFV/LBM). A distinct relation was found between percent changes of TEI and ECFV (r = -0.76, p less than 0.0001) and between absolute Z0/delta el and ECFV/LBM values (r = -0.66, p less than 0.0001 for men; r = -0.61, p less than 0.0001 for women). It is concluded that in the same subject a change in TEI is possibly a sensitive index for a change in ECFV and that a single measurement of TEI, normalized to electrode distance, gives information about the state of hydration (ECFV) of patients without cardiac failure. PMID- 3968300 TI - An unusual case of non-traumatic pneumococcal mediastinal abscess. AB - A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient again developed respiratory failure and on chest X-ray pneumomediastinum was seen and later evidence of a mediastinal abscess. Conservative treatment, with antibiotics, effected complete cure. PMID- 3968301 TI - Pulmonary bulla and sudden death in a young aeroplane passenger. AB - We report a case of a young passenger who during a flight in an aeroplane suddenly lost consciousness and eventually died. The only pathologic finding was a lung bulla. The routine decompression in the passenger room during the flight may have caused expansion of the bulla with mediastinal compression or an increase of the pressure inside the bulla above lung bursting pressure resulting in systemic air embolism. Both mechanisms could have caused the patient's sudden collapse. PMID- 3968302 TI - Lowering pulmonary artery pressure in a patient with severe acute respiratory failure. AB - A case of pulmonary arterial hypertension on the basis of ARDS is presented. The cyclooxygenase inhibitor Ibuprofen is used to lower pulmonary arterial pressure, resulting in an improvement in the right ventricular function. PMID- 3968303 TI - The use of magnesium sulphate infusions in the management of very severe tetanus. AB - The use of magnesium sulphate infusions as an adjunct to the management of patients with very severe tetanus was studied in 10 subjects with persistent autonomic dysfunction despite heavy sedation. Satisfactory cardiovascular control was established in nine of these cases, and there were two deaths in the series, neither directly attributable to the tetanus itself. Haemodynamic measurements performed in six patients, showed that cardiac output was well preserved during magnesium infusions. There was a significant reduction in pulse rate (p less than 0.05) and systemic vascular resistance (p less than 0.01), with an increase in stroke volume (p less than 0.05). It is suggested that magnesium may be a useful adjunct to standard forms of management of such cases. PMID- 3968304 TI - Precordial ST segment depression during acute inferior myocardial infarction: early thallium-201 scintigraphic evidence of adjacent posterolateral or inferoseptal involvement. AB - To investigate the myocardial perfusion correlates of precordial ST segment depression during acute inferior myocardial infarction, a rest thallium-201 scintigram and a closely timed 12 lead electrocardiogram were obtained within 6 hours of the onset of infarction in 44 patients admitted with their first acute inferior myocardial infarction. Thirty-six patients demonstrated precordial ST segment depression (group 1) and eight did not (group 2). A perfusion defect involving the inferior wall was present in all 44 patients. Additional perfusion defects of the adjacent posterolateral wall (n = 20), the ventricular septum (n = 9) or both (n = 6) were present in 35 of 36 patients from group 1 compared with only 1 of 8 patients from group 2 (p less than 0.001). There was no significant difference in the frequency of multivessel coronary artery disease or disease of the left anterior descending artery between group 1 and group 2 or between patients with and those without a thallium-201 perfusion defect involving the ventricular septum. Thus, precordial ST segment depression during an acute inferior myocardial infarction is associated with thallium-201 scintigraphic evidence of more extensive involvement of the adjacent posterolateral or inferoseptal myocardial segments, which probably reflects the extent and pattern of distribution of the artery of infarction, rather than the presence of coexistent multivessel coronary artery disease or disease of the left anterior descending artery. PMID- 3968305 TI - Effect of high dose aspirin on coronary hemodynamics during pacing-induced myocardial ischemia. AB - The effects of aspirin on coronary hemodynamics and transcardiac concentrations of thromboxane B2 (the stable metabolite of thromboxane A2) were determined at rest and during pacing-induced myocardial ischemia in 11 patients with coronary disease. Control coronary sinus pacing increased both arterial thromboxane B2 (331 +/- 70 to 623 +/- 132 pg/ml, p less than 0.02) and coronary sinus thromboxane B2 (184 +/- 3 to 403 +/- 156 pg/ml, p less than 0.05), but positive transmyocardial gradients developed in only three patients. After 650 mg of oral aspirin, more than 90% inhibition of in vitro thromboxane B2 production was demonstrated and circulating thromboxane B2 was undetectable at rest and during pacing in all patients. Despite these changes in thromboxane B2 concentrations, coronary blood flow was unchanged by aspirin at rest (107 +/- 14 versus 112 +/- 13 ml/min, p = NS) and during pacing (189 +/- 29 versus 181 +/- 25 ml/min, p = NS). Myocardial lactate extraction was also unchanged at rest (24 +/- 7 versus 19 +/- 5%, p = NS) and during pacing (5 +/- 6 versus 9 +/- 5%, p = NS). No change occurred in the anginal threshold. Thus, aspirin does not have the vasoconstrictive properties that have been reported with another cyclo-oxygenase inhibitor, indomethacin. These findings also suggest that thromboxane A2 production does not play a major role in the pathogenesis of stress-induced ischemia. Nonetheless, intracoronary thromboxane A2 production in some patients may potentiate platelet activation and coronary thrombosis. Such patients may benefit from long-term aspirin therapy and can be treated with aspirin without risk of adverse coronary hemodynamic effects. PMID- 3968306 TI - Significance of inducible tachycardia in patients with syncope of unknown origin: a long-term follow-up. AB - The frequency of inducible tachycardia was assessed in patients presenting with syncope whose noninvasive evaluation did not reveal a cause for syncope. It was also determined whether treatment of tachyarrhythmias during programmed electrical stimulation would prevent recurrence of syncope. One hundred five patients were studied and 97 were followed up for a mean period of 25.8 months. Sixty-eight patients (65%) did not have inducible tachycardia. Sixty of these 68 patients could be followed up; 12 (20%) had recurrent syncope. Ventricular or supraventricular tachycardia was inducible in 37 patients (35%). The frequency of organic heart disease was not higher in this group or in those with inducible ventricular tachycardia as compared with those with inducible supraventricular tachycardia. Three patients with inducible ventricular tachycardia died suddenly or were resuscitated from cardiac arrest, and an additional seven had recurrent syncope; thus, the total recurrence rate was 27%. Of 23 patients undergoing effective therapy as predicted by electrophysiologic testing, 3 (14%) had a recurrent event. Results were significantly different in patients receiving ineffective therapy as judged by electrophysiologic testing. Of 13 patients in this latter category, 7 patients (54%) had recurrence of syncope or cardiac arrest (p less than 0.05). In three patients, recurrence took place a mean of 5 months after cessation of therapy; on resumption of effective therapy, no syncope recurred for 15.6 months (p less than 0.025). Tachycardia is frequently induced in patients with syncope of unknown origin, whether or not organic heart disease is present. Treatment of inducible tachycardia may prevent recurrence of syncope. PMID- 3968307 TI - Correlation of two-dimensional echocardiography and pathologic findings in porcine valve dysfunction. AB - Two-dimensional echocardiographic findings in porcine valve dysfunction were compared with pathologic findings in 10 patients (12 valves). Three specific echocardiographic findings were identified in patients with regurgitant lesions: prolapse, fracture and flail leaflets. Prolapse was associated pathologically with thinning of the leaflets, longitudinal tears close to the ring margin and acid mucopolysaccharide accumulation. Valve fracture was seen with and without prolapse and was accompanied pathologically by small pinpoint perforations or tears of the leaflet. A flail leaflet was seen with a linear tear of the free margin and was associated with calcific deposits. Mild degrees of fracture seen pathologically were missed on the echocardiographic study in five patients. Thickening or calcification, when present in moderate or severe amounts, was correctly identified by echocardiography. When all abnormal features were considered collectively, two-dimensional echocardiography correctly identified at least one of them in all patients. Therefore, two-dimensional echocardiography may prove useful in assessing the source of valvular regurgitation in patients with bioprosthetic valves. PMID- 3968308 TI - In vitro effects of argon laser radiation on blood: quantitative and morphologic analysis. AB - Use of the argon laser to recanalize stenosed arteries may require delivery of the beam through blood. To assess the degree of hemolysis and debris formation, 84 samples of citrated whole blood were exposed to argon laser radiation with varying power (1, 2 and 3 watts) and duration (5, 10, 20 and 40 seconds). Compared with control samples, only blood samples exposed to a power of 3 watts for 40 seconds showed a marked decrease in hematocrit (from 37 +/- 1.3 to 33 +/- 1.4%, p less than 0.01) and a marked increase in both free hemoglobin concentration (from 0.2 +/- 0.2 to 1.3 +/- 0.5 g/100 ml, p less than 0.01) and debris weight (from 0.9 +/- 0.3 to 2.8 +/- 0.5 mg, p less than 0.01). Scanning electron microscopy of debris from samples of whole blood, washed erythrocytes and platelet-rich plasma lased at 3 watts for 40 seconds documented the presence of membrane denaturation of blood elements, resulting in their fusion to form complex mesh-like conglomerates. Similar morphologic changes were observed in whole blood samples exposed to a "hot tip" rather than laser radiation. These data indicate that: 1) argon laser radiation with a power of 3 watts does not produce apparent hemolysis or debris formation for exposure periods up to 20 seconds, and 2) the effects of laser radiation on blood are probably mediated by thermal denaturation of cell membranes, as suggested by the same morphologic changes produced by thermal injury from a "hot tip." PMID- 3968309 TI - A format for integrating the interpretation of exercise ejection fraction and wall motion and its application in identifying equivocal responses. AB - The conventional interpretation of ejection fraction change with exercise may be limited because it does not consider the rest value, define equivocal responses or integrate wall motion data reproducibly. Thus, a format was developed for combined interpretation of rest and exercise radionuclide ejection fraction and wall motion by reviewing the reported data for the exercise responses of patients without prior myocardial infarction. The ejection fraction data of 202 normal patients and of 259 patients with coronary artery disease were first fitted to beta distributions. The true positive and false positive rates for coronary disease for each combination of rest and exercise ejection fraction were then determined directly from these distributions. A given rest/exercise ejection fraction combination was "normal" if the false positive rate was greater than the true positive rate, or "abnormal" if the true positive rate was greater than the false positive rate, and "equivocal" when the rates were similar (within a 50% confidence interval). This analytic format, which predicted an inverse relation between rest ejection fraction and the change required with exercise, was then validated prospectively in 854 patients without myocardial infarction (557 with and 297 without angiographic coronary artery disease). Using the conventional criterion of an abnormal test result (less than 0.05 absolute rise in ejection fraction with exercise or a wall motion abnormality), sensitivity was 85 +/- 2% and specificity only 42 +/- 3%. The statistical format had a sensitivity of 70 +/ 2% and specificity of 70 +/- 3%, resulting in a twofold increase in information content. This format has at least two advantages over conventional interpretation: 1) it provides an explicit definition of equivocal responses; and 2) it reproducibly integrates discordant ejection fraction and wall motion responses and allows for the combined analysis of other nonscintigraphic observations, such as age and sex. PMID- 3968310 TI - Laser catheter-induced atrioventricular nodal delays and atrioventricular block in dogs: acute and chronic observations. AB - Selective modification of atrioventricular (AV) nodal conduction, that is, induction of varying degrees of AV nodal delays or block (second or third degree), or both, was achieved with a pervenous laser catheter technique. In six adult mongrel dogs anesthetized with pentobarbital (Nembutal), 5F leads were placed through femoral and external jugular veins and placed into the right atrium and His bundle region. Through another femoral vein, a 200 micron optical fiber was inserted by way of a 7F catheter with a preformed curved tip. Guided by fluoroscopy and His bundle electrograms, the fiber's tip was positioned in the AV nodal region. After autonomic blockade was achieved with intravenous propranolol (5 mg) and atropine (1 mg), AV conduction was analyzed. An argon laser delivered 3 to 4 watts into the fiber in bursts of 10 seconds' duration until the desired degree of AV nodal delay or block (second or third degree) was manifested. Monitoring of His bundle electrograms was continued for 2 hours. Four weekly serial electrocardiograms were recorded, after which electrophysiologic studies were repeated. Acute post-lasing studies showed that: in all six dogs, the mean PR interval was prolonged from 116 ms (range 100 to 135) to 153 ms (range 120 to 185), with the prolongation being caused exclusively by AH lengthening from 68 ms (range 50 to 90) to 105 ms (range 65 to 140); the mean effective refractory period of the AV node increased from less than 185 ms (range less than 150 to less than 200) to 215 ms (range 190 to 280); and the mean atrial pacing cycle length, at which second degree AV nodal block was manifested, increased from 210 ms (range 160 to 260) to 261 ms (range 205 to 320).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968311 TI - Origin of the third heart sound: comparison of ventricular wall dynamics in hyperdynamic and hypodynamic types. AB - To investigate the left ventricular wall dynamics conducive to the third heart sound (S3) in both hyper- and hypodynamic filling conditions, eight dogs were studied in which an S3 was produced by hypoxemia and in eight others by acute mitral regurgitation. Pulse transit sonomicrometry crystals were used to measure external left ventricular dimension dynamics in the two principal axes. A miniature accelerometer was used to detect the epicardial S3 vibration. The development of the S3 was invariably associated with an increased peak velocity of long-axis external dimensional expansion in early diastole. This enhanced long axis filling activity was not dependent on increased global chamber or short-axis filling dynamics and sometimes occurred when global filling rate was unchanged. In addition, the short-axis filling rate was sometimes reduced as the S3 developed. It is concluded that the common denominator of S3 generation in this acute dog model is exaggerated long-axis diastolic expansion activity which is present in both hyper- and hypodynamic left ventricular filling. PMID- 3968312 TI - Magnesium deficiency and myocardial infarct size in the dog. AB - Although epidemiologic data suggest a relation between myocardial infarction death rates and dietary intake of magnesium, there are no experimental studies reflecting such a phenomenon. It is now reported that beagle dogs kept on a severely magnesium-deficient diet for 100 days develop a larger infarct than do control animals. Control animals were either kept on the same diet as experimental animals with supplementary magnesium, or were fed standard dog chow. The control groups were indistinguishable and were therefore pooled. Infarction was produced by occlusion of the left anterior descending coronary artery for 1 hour followed by 4 hours of reperfusion. Slices of ventricular myocardium, 5 mm thick, were made from the apex to the base. Ischemic muscle, considered to be the muscle at risk, was delineated by a microsphere-autoradiographic method, and necrotic muscle was delineated by tetrazolium stain. Involved areas were measured by planimetry, and these integrated to produce the volume. The volumes of muscle made ischemic were similar in the experimental and control groups. The volumes of necrotic muscle, however, were less in the control than in the experimental animals. The ratio of necrotic muscle volume to the volume of muscle at risk was greater in the experimental animals than in the control animals by a factor of almost two (p less than 0.004). These experiments indicate that, under the conditions used here, animals fed a magnesium-deficient diet develop a larger infarct than do control animals. This could occur either through decreased postocclusion collateral flow or increased vulnerability of the ischemic muscle in magnesium-deficient animals. Although these experiments cannot rule out an effect on postocclusion collateral flow, they do suggest that electrolyte abnormalities related to magnesium deficiency are of such a character as to increase myocardial vulnerability to injury. PMID- 3968313 TI - Encircling endocardial incision interrupts efferent vagal-induced prolongation of endocardial and epicardial refractoriness in the dog. AB - The purpose of this study was to test the hypothesis that vagal efferent nerves travel in the left ventricular subendocardium in a base to apex direction. Efferent vagal stimulation during constant background isoproterenol infusion prolonged left ventricular endocardial and epicardial effective refractory periods in a control state and after a left ventriculotomy performed while dogs were supported by cardiopulmonary bypass. After a 2 mm deep endocardial circumferential incision, efferent vagal stimulation still prolonged the effective refractory period at an endocardial site basal to the encircling endocardial incision, but no longer prolonged the effective refractory period at the endocardium or immediately overlying epicardium apical to the incision. Interpretation of these data suggests that efferent vagal fibers travel in the superficial subendocardium of the canine left ventricle in a base to apex direction, penetrating upward to innervate the epicardium. Conceivably, a lesion such as a subendocardial myocardial infarction could selectively interrupt efferent vagal innervation, leaving sympathetic innervation unopposed. This may be a source of some arrhythmias. PMID- 3968314 TI - Effect of regional ischemia on the left ventricular end-systolic pressure-volume relation in chronically instrumented dogs. AB - The slope of the left ventricular end-systolic pressure-volume relation has been proposed as a sensitive index of left ventricular function since it increases in response to positive inotropic agents and decreases with global depression of contractility. The effect of a segmental depression of left ventricular contractile function produced by circumflex coronary artery occlusion on the left ventricular end-systolic pressure-volume relation was evaluated in seven chronically instrumented dogs. Left ventricular volume was calculated from three ultrasonically measured, orthogonal left ventricular endocardial dimensions. Left ventricular pressure was measured with a micromanometer. The left ventricular end systolic pressure-volume relation was generated by occlusion of the inferior vena cava, before and after inducing regional ischemia, in the presence of autonomic blockade with propranolol and atropine. The end-systolic data in each dog, before and after coronary occlusion, were fit to the equation, P = E(V - V0), with r greater than or equal to 0.95 in all cases. Coronary occlusion shifted the left ventricular end-systolic pressure-volume relation to the right in each animal. During regional ischemia, the volume intercept (V0) increased from 10.1 +/- 7.8 to 20.4 +/- 9.8 ml (mean +/- SD) (p less than 0.005). The slope (E) of the left ventricular end-systolic pressure-volume relation was relatively unchanged. It is concluded that in intact dogs, regional left ventricular ischemia resulting from coronary occlusion produces a rightward shift of the left ventricular end systolic pressure-volume relation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968315 TI - Effects of flecainide on the electrophysiologic properties of isolated canine and rabbit myocardial fibers. AB - The electrophysiologic properties of flecainide, a new potent antiarrhythmic drug, are poorly defined. In this study, they were investigated by standard microelectrode technique in isolated cardiac muscle from rabbit and dog hearts. The concentrations of flecainide used were between 0.1 and 10.0 micrograms/ml. Flecainide produced a concentration-dependent decrease in maximal rate of rise of phase 0 of the action potential (Vmax), action potential amplitude and overshoot potential with an increase in the effective refractory period in ventricular muscle. Vmax was reduced by 52.5% after 1 microgram/ml of flecainide (p less than 0.001) and by 79.8% after 10.0 micrograms/ml (p less than 0.001). The corresponding values for Purkinje fibers were 18.6% (p less than 0.01) and 70.8% (p less than 0.001), respectively, but in these fibers the effective refractory period was shortened at the lower concentration and restored to control value at the higher concentration. The depression of Vmax by flecainide was frequency dependent. The action potential duration was lengthened by flecainide in ventricular muscle and shortened in Purkinje fibers. At high concentrations (10 micrograms/ml), flecainide depressed slow channel-dependent fibers. Purkinje fiber automaticity induced by isoproterenol was slowed by flecainide. The data indicate that the overall electrophysiologic effects of flecainide in isolated cardiac muscle are complex with a major depressant action on Vmax that may account for its dominant antiarrhythmic effects. It is also possible that the differential effects of the compound on the action potential duration and refractoriness in ventricular muscle and Purkinje fibers contribute to the known arrhythmogenic potential of the drug. PMID- 3968316 TI - Mechanisms of verapamil-induced conduction block in anomalous atrioventricular bypass tracts. AB - Verapamil, a calcium channel blocking agent, has been demonstrated to have depressive effects on the atrioventricular (AV) node but not anomalous AV bypass tracts. Of 39 patients with AV reciprocating tachycardia utilizing left-sided bypass tracts for retrograde conduction, intravenous infusion of verapamil (0.15 mg/kg) terminated the tachycardia in 31 patients. Verapamil interrupted the tachycardia circuit by inducing retrograde conduction block in the bypass tract rather than the AV node in 5 of these 31 patients. Electrophysiologic studies in these five patients revealed that verapamil-induced conduction block in the bypass tract could be accounted for by two distinctly different mechanisms. In three patients, verapamil induced alternating slow and fast AV nodal conduction resulting in alternating long and short cycle lengths during the tachycardia; consequently, development of the Ashman phenomenon in the bypass tract terminated the tachycardia. In the remaining two patients, the bypass tract exhibited properties similar to those of the AV node; verapamil prolonged the effective refractory period of the bypass tract, thereby terminating the tachycardia. Thus, depending on the functional properties of the bypass tract, verapamil may interrupt an AV reciprocating tachycardia circuit by exerting either a direct or indirect depressive action on the bypass tract. PMID- 3968317 TI - Effect of nifedipine on coronary hemodynamics in patients with left anterior descending coronary occlusion. AB - The mechanisms responsible for the beneficial effects of calcium channel antagonists in patients with effort angina were investigated by studying the coronary hemodynamic responses of the anterior left ventricular region before and after administration of nifedipine in 13 patients whose left anterior descending coronary artery was filled by flow from collateral vessels. Nifedipine was given bucally in a dose (10 or 20 mg) that decreased aortic pressure 5 mm Hg or more. Nifedipine increased collateral flow (regional thermodilution) in only three patients (p = NS), but consistently decreased coronary resistance in the left ventricular anterior region (p less than 0.05). Anterior region myocardial oxygen consumption did not change after nifedipine administration. Lactate metabolism was evaluated in eight patients: values were abnormal in four patients before nifedipine; after nifedipine, values remained abnormal in three of these patients and became abnormal in one other. During atrial pacing stress, angina occurred in all patients before nifedipine and at the same or lower heart rate in nine patients after nifedipine. After nifedipine administered at the same rate that induced angina during the control period, collateral flow and myocardial oxygen consumption were usually lower (both p less than 0.05), but anterior region coronary resistance was unchanged compared with control values. Lactate metabolism was not usually improved. Thus, although nifedipine maintained collateral flow while aortic pressure decreased, no consistent beneficial effect on pacing-induced angina was seen. PMID- 3968318 TI - Idiopathic degeneration of the aortic valve: a common cause of isolated aortic regurgitation. AB - To establish the etiology of isolated aortic valvular regurgitation, histologic examination was carried out on 27 consecutive surgically removed aortic valves from patients with aortic regurgitation. In 12 patients, the regurgitation was due to rheumatic or syphilitic valvular disease or a congenital bicuspid aortic valve. In the remaining 15, no etiology was apparent. In the latter group, seven aortic valves were identified by the surgeon as redundant and eight as thickened and retracted. Despite these gross differences, the histologic features of the 15 valves were similar and consisted of increased and disorganized elastic and collagen fibers, with variable quantities of acid mucopolysaccharide and calcium. Although small foci of myxomatous stroma were present, they did not differ substantially from those observed in age-matched competent aortic valves removed at necropsy, nor were they as extensive as described in reports of floppy aortic valves. Idiopathic degeneration was the most common cause of aortic regurgitation, occurring in more than half of the surgically treated patients. An underlying defect in the synthesis of collagen or elastic fibers, similar to that described in mitral valve prolapse, may be an important feature in aortic valve degeneration. PMID- 3968319 TI - Acute hemodynamic effects of increasing hemoglobin concentration in children with a right to left ventricular shunt and relative anemia. AB - The short-term effects of increasing hemoglobin concentration were evaluated at cardiac catheterization in seven children (aged 0.3 to 7.5 years) with a right to left ventricular shunt and relative anemia. Diagnoses were tetralogy of Fallot in six and L-transposition of the great vessels with ventricular septal defect and pulmonary stenosis in one. Before and 20 minutes after isovolumic partial exchange transfusion with 20 ml/kg packed red cells, the following variables were measured: hemoglobin, partial pressure of oxygen (PO2), oxygen consumption, oxygen saturation and pressure in the aorta, superior vena cava and right and left atria. After partial exchange transfusion, hemoglobin increased from 13.7 +/ 0.5 to 16.4 +/- 0.4 g/100 ml (p less than 0.001, mean +/- SEM). Aortic PO2 increased from 55.0 +/- 3.5 to 62.0 +/- 4.1 mm Hg (p less than 0.01) and aortic oxygen saturation increased from 84.3 +/- 2.3 to 90.9 +/- 1.3% (p less than 0.002). Effective pulmonary blood flow increased by 17% from 2.72 +/- 0.10 to 3.17 +/- 0.10 liters/min per m2 (p less than 0.01), and right to left shunt decreased by 59% from 1.44 +/- 0.29 to 0.59 +/- 0.10 liters/min per m2 (p less than 0.01). Systemic oxygen transport increased from 658 +/- 48 to 738 +/- 46 ml/min per m2 (p less than 0.002). After partial exchange transfusion, systemic vascular resistance increased from 15.9 +/- 1.1 to 20.0 +/- 1.4 units (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968320 TI - Mid-diastolic opening of the pulmonary valve after right ventricular infarction. AB - Premature opening of the pulmonary valve in mid-diastole before atrial systole was observed during inspiration in a patient with extensive right ventricular infarction. Transient inspiratory elevation of right ventricular diastolic pressure to a level exceeding pulmonary artery pressure was documented. Although forward flow into the pulmonary artery was seen on Doppler echocardiography after atrial systole, most of the flow continued to be in response to right ventricular contraction, despite extensive infarction. PMID- 3968321 TI - Persistent left superior vena cava and right superior vena cava drainage into the left atrium without arterial hypoxemia. AB - A 46 year old patient who presented with an acute myocardial infarction was discovered to have a systemic venous communication with the left heart during attempted insertion of a pulmonary flotation catheter. There was no evidence of cyanosis or systemic arterial desaturation. A right superior vena cava that emptied into the right superior pulmonary vein and a persistent left superior vena cava draining into the coronary sinus were confirmed pathologically after death related to a brain abscess. The embryology, physiology and noninvasive diagnostic approach to this unique venous anomaly are discussed. PMID- 3968322 TI - Auscultatory and echocardiographic features of mobile left atrial thrombus. AB - Free floating ball thrombus of the heart is a rare disorder that usually involves the left atrium, particularly in association with mitral stenosis and atrial fibrillation. The diagnosis of ball thrombus is suspected clinically when there are auscultatory changes in the intensity of the murmur of mitral stenosis. Two dimensional echocardiography is especially useful in the diagnosis of this condition. By combining phonocardiographic recordings with both M-mode and two dimensional echocardiography, attenuation and disappearance of the murmur were demonstrated as the mobile thrombus randomly drifted into the mitral valve orifice. Reappearance of the cardiac murmur was noted as the thrombus was expelled from the orifice. This study, combining simultaneous phonocardiography and two-dimensional echocardiography, identifies for the first time the relation between thrombus movement into the mitral aperture and changes of the murmur of mitral stenosis. PMID- 3968323 TI - Prominent right precordial R waves and myocardial infarction. PMID- 3968324 TI - Risk factor modification. PMID- 3968325 TI - Airways reactivity and asthma: significance and treatment. PMID- 3968326 TI - Regional and systemic immune responses to trinitrophenyl derivatives after intranasal and subcutaneous sensitization of mice. AB - The immune responses and accompanying inflammatory local reactions were analyzed in mice sensitized subcutaneously (SC) or intranasally. Administration of picrylsulfonic acid (PSA) by both routes for two 2- or 1-week periods with a 4 week interval resulted in delayed hypersensitivity responses. Serum antibodies of the IgG and IgE and some of the IgA isotype were found, particularly in SC sensitized animals. The latter animals also had levels of IgG antibodies in their bronchial fluid. Lymph node cells from mice sensitized for 2-week periods demonstrated high spontaneous proliferation. After culture together with spleen cells, these cells exhibited considerable numbers of mast cells, particularly after stimulation with pokeweed and antigen. The lungs from mice sensitized intranasally revealed increased numbers of mononuclear cells around large vessels and mucous cells in the bronchiolar epithelium, although there were individual differences between the animals. The mast cell numbers in the lungs were only slightly increased compared with numbers in nonimmunized animals subjected to ether anesthesia. Animals injected SC with PSA exhibited increased numbers of mast cells in their lungs compared with control mice. Mice sensitized with trinitrophenylated human serum albumin demonstrated some differences in their immune reactivity compared with animals immunized with PSA. Thus, no obvious delayed hypersensitivity appeared, but the IgG antibody titers were higher, and the IgE antibody titers were lower. The cellular responses assessed histologically demonstrated higher mononuclear cell numbers and lower mast cell numbers compared with those observed in animals sensitized with PSA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968327 TI - Factitious desquamative gingivitis simulating a possible immunologic disease. AB - A case of a unique factitious disorder resulted from self-inducement of oral lacerations, erosions, and abrasions. Previous medical investigations included evaluations by two general dentists, one oral surgeon, two periodontists, one internist, one otolaryngologist, and one infectious-disease physician. The patient had two gingival biopsies and one hospitalization. The lesions were unresponsive to several therapeutic regimens including temporary discontinuation of tooth brushing, antibiotics, and gingival dressings. The differential diagnosis included infectious, nutritional, immunologic, and factitious disorders. An apparent initial response to corticosteroids suggested the possibility of an immunologic inflammatory disease; however, no organic cause could be found. The enigma was resolved by discussion with the patient who reported that the lesions were self-induced and the manner in which this was done. PMID- 3968328 TI - The single exposure method for inhalation challenge with allergen. AB - We carried out inhalation challenge with a single exposure to a high concentration of allergen (the single exposure method) on 92 asthmatic patients. With the use of the 3 Hz forced oscillation technique, we could continuously and graphically estimate total respiratory resistance (Rrs) throughout the test. The subjects inhaled aerosolized house dust allergen (1:5 w/v) for 1 min during tidal breathing. As soon as Rrs reached twice that of baseline value or after 10 min from the start of allergen exposure, subjects inhaled aerosolized bronchodilator for 3 min. To evaluate the Rrs response curve to inhaled allergen, we defined provocation time (PT35-Grs) as the time from the start of allergen exposure to the point at which total respiratory conductance (Grs) decreased 35% from its baseline value and appearance time (Ta) as the time from the start of allergen exposure to the beginning of an increase in Rrs. We presume that Ta may reflect bronchial sensitivity to allergen, since Ta significantly correlated with a unit of allergen causing a decrease in FEV1 of 20% (r = 0.66; p less than 0.05) in the dosimeter method. We demonstrated that the single exposure method is comparable to the dosimeter method in evaluating bronchial responses to inhaled allergen and also demonstrated the reproducibility of bronchial response to inhaled allergen with the single exposure method. PMID- 3968329 TI - Bitolterol and albuterol metered-dose aerosols: comparison of two long-acting beta 2-adrenergic bronchodilators for treatment of asthma. AB - In this double-blind, parallel, single-dose study, bitolterol mesylate aerosol (three sprays, 1.11 mg) and albuterol aerosol (two sprays, 180 mcg) were compared for efficacy of bronchodilation in 120 adolescent and young adult patients with moderate to severe asthma. All patients required regular medications for asthma control. None was steroid dependent. Both medications gave effective bronchodilation within 5 min with maximum effect at 30 to 60 min. Mean percent increase in forced expiratory volume in 1 sec (FEV1) over baseline was higher for bitolterol than for albuterol at all test times up to 8 hr after a dose at which time 20% mean percent increase of FEV1 over baseline was still present in the bitolterol-treated patients. With albuterol mean percent increase in FEV1 fell to 15% over baseline at 5 hr after a dose. Differences in FEV1 increase between the two treatment groups were statistically significant at 4 to 8 hr after a dose. Patients with baseline FEV1 less than 50% of predicted normal had a response to bitolterol that was higher than that observed with albuterol treatment (p less than 0.1). Mean maximum percent increase in FEV1 and median duration of bronchodilation were greater with bitolterol than with albuterol, but the differences were not statistically significant. Both bitolterol aerosol and albuterol aerosol were demonstrated to be safe, effective, and long-acting bronchodilating agents. Both bitolterol and albuterol administered by aerosol had a rapid onset, and the maximum degree of bronchodilation was comparable. However, at the doses studied, bitolterol produced significantly higher increase in FEV1 over baseline at longer times after medication than did albuterol. PMID- 3968330 TI - Metabisulfite challenge in patients with idiopathic anaphylaxis. AB - Bronchospasm, urticaria, angioedema, and anaphylactoid reactions have been attributed to sulfiting agents. These compounds are commonly used as preservatives in some drugs and foods, often in restaurants. Oral challenges with sodium metabisulfite were performed in 12 patients with idiopathic anaphylaxis (IA). Nine of these had episodes possibly caused by sodium metabisulfite because of clear temporal relation of episodes of IA to restaurant meals. One patient who had severe urticaria with exacerbations with restaurant meals and 10 control subjects were studied. No urticarial, asthmatic, or anaphylactoid reactions occurred in our patients. Sulfiting agents did not trigger episodes of IA in these 12 patients or urticaria in the patient with severe chronic idiopathic urticaria. PMID- 3968331 TI - Occupational allergy to sunflower pollen. AB - Although the sunflower belongs to the Compositeae family, allergy to sunflower pollen is not common. The occurrence of occupational allergy to this pollen species made it possible to characterize cross-reactive patterns of Compositeae pollens in a human experimental model. A 24-yr-old man developed rhinitis and conjunctivitis over 5 yr of exposure to sunflower pollens, and asthma developed during the fifth year. All respiratory and occular symptoms disappeared after he was removed from exposure, but he had a food allergic reaction while he was eating honey containing 30% sunflower pollens. The diagnosis of occupational allergy was based on history, skin prick tests and RAST to the pollen. Bronchial provocation tests performed after removal from exposure confirmed the sensitivity to sunflower pollens but there was no nonspecific hyperreactivity. It was found by RAST inhibition that sunflower pollen does not cross-react with other Compositeae pollens tested or with sunflower seed. The honey that elicited food intolerance was demonstrated to inhibit significantly sunflower pollen RAST. PMID- 3968332 TI - Seasonal variation of in vitro lymphocyte proliferative response to ragweed antigen E. AB - Seasonal variation of symptoms and IgE response to short ragweed (SRW) allergens is well documented. Clinical symptoms generally parallel the rise and fall of the SRW-pollen count, whereas total and specific-IgE levels peak after the SRW-pollen season with a more gradual return to preseason levels. Because IgE synthesis is under T-lymphocyte control, we tested for seasonal variation in T cell proliferative response to SRW antigen E (AgE) in vitro. Nine untreated SRW sensitive and five nonallergic individuals were studied on 15 occasions from June 1981 through May 1982. In vitro proliferative index (SI) to AgE, serum total and specific IgE and SRW-pollen counts were measured; all persons studied kept daily symptom diaries. The mean SI was higher for the atopic group on all 15 sampling dates. The cumulative SI and the daily SI were statistically different between groups before, during, and after pollination. The peak SI for the atopic patients occurred almost 1 2/5 wk after the pollination peak, and the peak IgE antibody levels to SRW occurred at 5 2/5 wk after the pollination peak. We conclude that in vitro responsiveness to AgE is a specific response of allergic individuals and that this response demonstrates a significant seasonal component. PMID- 3968333 TI - Formaldehyde asthma--rare or overlooked? AB - A total of 230 persons who had been exposed to formaldehyde and suffered from asthma-like respiratory symptoms were examined between January 1, 1977, and May 31, 1983. All the subjects had a bronchial provocation test with formaldehyde. On the basis of the medical and occupational history of the patients, the specific bronchial provocation test, and other test results, 12 cases were considered to be caused by specific sensitization to formaldehyde. All subjects had been exposed occupationally. An exposure period of between 1 mo and 19 yr preceded the onset of symptoms. Three persons displayed no bronchial hyperreactivity as assessed with a histamine or metacholine provocation test. Eleven of the 12 reactions were triggered by about 2.5 mg/m3 and one reaction by about 1.2 mg/m3 of formaldehyde. The late reaction in 1 patient was completely blocked by the inhalation of 100 micrograms of beclomethasone di-isoproprionate before the challenge with formaldehyde. Seventy-one of the 218 subjects who did not react when they were challenged with formaldehyde demonstrated bronchial hyperreactivity. We conclude that formaldehyde asthma, although apparently a rare disease, is under reported. Removal from exposure has a favorable effect on the symptoms. Low domestic exposures, however, may maintain the symptoms in individuals already sensitized. PMID- 3968334 TI - Anaphylaxis. PMID- 3968335 TI - Comparison of rat fur, urine, saliva, and other rat allergen extracts by skin testing, RAST, and RAST inhibition. AB - Extracts of a wide range of materials associated with exposure to rats were prepared and their relative allergenic activities were measured by skin-prick testing of rat-sensitive patients, RAST for serum IgE, and RAST inhibition of dust collected from a rat room. Most potent on a dry weight basis were preparations of fur, urine, epithelia, and saliva (all irrespective of the sex of the rat) and of the dust. Extracts of shaved pelt, whole pelt, feces, and serum proved less effective, whereas those of sawdust or diet had negligible activity. The presence of similar allergens in the more potent extracts was suggested by multiple skin sensitivity to different source materials, by close correlation between RAST results, and by the extent of RAST inhibition for individual extracts. The allergenicity of fur and epithelia probably results largely from contamination with saliva and urine. PMID- 3968336 TI - Evaluation of quantitative aerosol techniques for use in bronchoprovocation studies. AB - To investigate airway physiology by use of inhaled aerosols, it is frequently necessary to measure the actual amount of material deposited on the airway wall as well as the site of particle deposition. To satisfy these needs, radiolabeled aerosols and gamma camera techniques have been used to measure regional deposition of inhaled particles. To make quantitative measurements of the amount deposited, previous investigators have used a "phantom" technique to indirectly calibrate the gamma camera for the attenuation of gamma rays through the lungs and chest wall. For this calibration, the phantom is a simulated lung containing a known amount of radioactivity. Radioactive counts emitted from the phantom are assumed to be attenuated in the same manner as the intact human lung. The present article describes a technique to determine directly the amount of inhaled aerosol deposited in the lung and simultaneously to calibrate the gamma camera for each individual subject. We used right angle light scattering and a gamma camera to measure individual values of the deposition fraction (DF) of inhaled aerosol deposited in the lung and the coefficient of attenuation (AC) of gamma rays in normal and obstructed lungs of human subjects. Radiolabeled monodisperse aerosols 1 and 2 microns in diameter were used. Knowledge of the activity of the inhaled aerosol (microcurie per liter), the volume inhaled, and the measured DF determined each subject's AC (counts per minute per microcurie). DF varied by an order of magnitude in normal (0.04 to 0.48) and obstructed (0.16 to 0.75) of subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968337 TI - Monkey dander asthma. AB - We recently cared for two patients who experienced acute asthma with exposure to dander of the cotton top tamarin, a species of New World monkey. Both patients had serologic evidence for an IgE antibody to monkey dander as determined by RAST and a positive immediate skin test response to an extract prepared from monkey dander. Furthermore, by RAST we were able to determine that cotton top tamarin urine and newborn cotton top tamarin dander had antigens that reacted with IgE in the serum of the affected patients. Thus we report two patients with asthma to monkey dander that appears to be mediated by an IgE mechanism. We also found that serum from a subject exposed to another species of New World monkey, the capuchin, yielded a positive RAST to the cotton top tamarin, suggesting that allergenic cross-reactivity may exist between the two species. PMID- 3968338 TI - Factors predisposing to exercise-induced late asthmatic responses. AB - Seventeen children developed reproducible early and late asthmatic responses (dual reactions) after cycle ergometer exercise. There was a significant correlation between the magnitude of their early and late reactions, emphasizing the direct relationship of these events. No significant differences were observed in the clinical severity of asthma, diurnal variations in FEV1, and extent of the early reaction after exercise between children with dual responses and 19 children with single reactions. These findings suggest that the occurrence of late reactions after exercise is not determined by differences in severity of disease or baseline airway reactivity in the asthmatic subjects. This view is supported by the finding that there was no significant difference in the dose of acetylcholine necessary to elicit a 20% decrease in FEV1 between eight children with dual response and seven children with single early response after exercise. The rate of spontaneous recovery from early reactions was slower in children with dual responses, suggesting that this variable may predict development of late phase reactions in exercise-induced asthma. PMID- 3968339 TI - Severity of asthma in skin test-negative and skin test-positive patients. AB - The standardized records of 144 asthmatic patients have been analyzed to determine whether the severity of their condition was correlated with the presence or absence of positive intradermal skin test reactions to a panel of seven allergen extracts (dust, feathers, Alternaria, Hormodendrum, mixed tree pollen, mixed grass pollen, and ragweed pollen). The skin tests were totally negative in 71 of the subjects, whereas in 73 subjects there was a strongly positive response to two or more allergens. The skin test-negative patients were older than the skin test-positive ones and had a shorter duration as well as a later onset of asthma. Also, they had lower serum-IgE levels and a lower frequency of a family history of atopic disease. Moreover, the skin test-negative group lost more time from their normal activities, required more visits to their doctor as a result of asthma, and were more frequently treated with oral corticosteroids. They additionally had greater air trapping on pulmonary function tests. However, when the groups were adjusted for the discordance in their age and duration of asthma, they tended to converge in the level of the variables that described the severity of their asthma. Thus the severity of asthma was found to be relatively similar in skin test-negative and skin test-positive patients. PMID- 3968340 TI - Clinical and EEG evaluation of seizures and seizure-like disorders. PMID- 3968341 TI - Teaching pediatric psychopharmacology: an interdisciplinary model. PMID- 3968342 TI - Multiple personality in adolescence: relationship to incestual experiences. PMID- 3968343 TI - Behavioral and cognitive impairments in children with epilepsy: the long-term effects of anticonvulsant therapy. PMID- 3968344 TI - Epileptic and pseudoepileptic seizures in childhood and adolescence. PMID- 3968345 TI - Preschool behavior can predict future psychiatric disorders. PMID- 3968346 TI - A psychodynamic study of psychosomatic dwarfism: a syndrome of depression, personality disorder, and impaired growth. PMID- 3968347 TI - Influence of early malnutrition on subsequent behavioral development. V. Child's behavior at home. PMID- 3968348 TI - Physiologic assessment of mother-infant attachment. PMID- 3968349 TI - Hallucinations in children. PMID- 3968350 TI - The child behavior checklist as a screening instrument for young children. PMID- 3968351 TI - Child psychiatrists seen through pediatricians' eyes: results of a national survey. PMID- 3968352 TI - Psychotic and depressed children: a new entity. PMID- 3968353 TI - Some relations between nutrition and aging. PMID- 3968354 TI - Increasing calcium intake lowers blood pressure: the literature reviewed. AB - Evidence to support an association between dietary calcium and blood pressure is presented in this article. Epidemiological surveys, animal experiments, and clinical trials support an inverse relationship between calcium and blood pressure. Several independent diet surveys have reported reduced consumption of calcium by individuals with hypertension. Animal experiments demonstrate an inverse correlation between calcium intake and blood pressure and reveal disturbances in calcium metabolism in hypertensive animals. Similar metabolic disturbances, including lower serum ionized calcium, elevated parathyroid hormone values, and increased urinary calcium excretion, have been reported in human hypertensives compared with normotensives. In addition, three recent experimental trials using 1 gm calcium carbonate supplements demonstrated that increasing calcium intake may reduce blood pressure in some human beings. Further clinical investigations are necessary to define the subset of patients who will respond to calcium therapy. Dietary sources of calcium to provide at least the RDA are recommended. Dairy products are suggested because in addition to calcium, they are valuable sources of potassium and magnesium, which may also lower blood pressure. If a patient cannot tolerate dairy products, oral calcium supplements are indicated. PMID- 3968355 TI - Zinc levels of hospitalized elderly. AB - Zinc status was evaluated in 99 consecutive elderly patients admitted to a geriatric assessment unit. The assessment of zinc status was based on measurement of plasma, erythrocyte, and urinary zinc levels by atomic absorption spectrophotometry; serum lactic dehydrogenase and alkaline phosphatase by standard laboratory methods; and dietary intake by the food frequency questionnaire method. Mean (+/- standard deviation) plasma zinc concentration was 72 +/- 16 micrograms/100 ml (N = 91). Although 67% of the group had plasma zinc levels in the deficient range, only three patients had values below the normal range for erythrocyte zinc and none fell below the reference range for urinary zinc per 24 hours (N = 15) or the urinary zinc:creatinine ratio. Mean values for the other parameters of zinc status were 1.27 +/- 0.26 micrograms/10(9) RBC for erythrocyte zinc, 285 +/- 217 micrograms/24 hours for urinary zinc, and 588 +/- 309 micrograms/gm for the urinary zinc:creatinine ratio. Serum alkaline phosphatase and lactic dehydrogenase were not specific indicators of zinc status. Forty-six percent had adequate and 54% inadequate dietary intakes (N = 46). Twenty percent were receiving an inadequate intake of meat products, suggesting that the majority (80%) were ingesting an adequate supply of zinc-rich foods. Zinc status appeared to be adequate in this population. PMID- 3968356 TI - Pantothenic acid status of pregnant and lactating women. AB - Pantothenic acid nutritional status was evaluated longitudinally in 26 pregnant women (experimental group) during their third trimester of pregnancy and at 2 weeks and 3 months postpartum. Seventeen nonpregnant and nonlactating women (control group) participated at the same time intervals. All the women were assessed by the intake calculated from a reported 2-day dietary record and by fasted blood, plasma, and 24-hour urinary levels of pantothenate determined by a radioimmunoassay. Estimated daily mean dietary pantothenate intake and the vitamin density for the experimental group were not statistically different from those for the control group. The dietary pantothenate intake averaged 2.75 mg/1,000 kcal. Average pantothenate blood level of the experimental group was lower than that of the control group. No significant difference was found between the two groups in the pantothenate levels of fasting plasma and urinary excretion. When they did not take pantothenic acid supplements, members of the experimental group had intakes less than the Estimated Safe and Adequate Daily Dietary Intake and lower mean blood values than the members of the control group. This suggests that pregnant and lactating women need to consume more pantothenate to maintain a blood vitamin level similar to that of nonpregnant women. This may be achieved by an increased caloric intake, if desirable, or by more careful selection of foods high in the nutrient. PMID- 3968357 TI - Dietary recall method comparison for hospitalized elderly subjects. AB - A study was made to compare accuracy of the 24-hour recall, including both number of items recalled and amounts of food eaten, for elderly subjects using three methods: I, unaided oral recall, II, printed questionnaire, and III, interview with actual-size color pictures of foods. Sixty hospitalized patients, age 65 to 94, were interviewed. Factors studied for influence on scores were age, sex, educational level, obesity, place of residence, and food preparer. Results showed no significant difference in scores owing to method used, except that 30 subjects above the median age of 76 scored higher on number of items recalled and amounts of food eaten when using the printed questionnaire. None of the demographic factors studied made a significant difference in scores. PMID- 3968358 TI - Occurrence sampling in a residence hall foodservice: cleaning times for selected vegetables. AB - Objectives of this study were to analyze work functions in a vegetable pre preparation unit of a large residence hall foodservice using occurrence sampling and to determine cleaning times for selected vegetables. Data were collected in the early spring for 14 consecutive days. Total hours worked were 349.5; 2,174 observations were recorded. Percentage labor time and minutes expended were calculated for cleaning selected vegetables. Average cleaning times were established for minutes per pound and purchase unit for carrots, celery, head lettuce, leaf lettuce, yellow onions, and red and white potatoes. PMID- 3968359 TI - Financing nutrition services in a competitive market. AB - Budget deficits and inflationary medical care costs threaten nutrition services, which until recently have been funded largely by federal, state, and local revenues. Nutritionists and dietitians responding to demands in the marketplace should develop innovative programs and pursue new sources for financing through the private sector, third-party payers, business/industry health promotion, and consumer fees for their services, as well as targeted federal, state, and locally funded food assistance, nutrition education, and health care programs. Trail blazing dietitians are successfully offering their services in health maintenance organizations (HMOs), hospital or industry fitness programs, private practice, voluntary health agencies, and official agency programs. With the new federalism, nutritionists must articulate their role in comprehensive health care and market their services at the state and local levels in addition to the federal level. Nutrition services are defined to include assessment, planning, counseling, education, and referral to supportive agencies. Data management, managerial, and marketing skills must be developed for dietitians to compete effectively. Basic educational preparation and continuing education for practicing professionals must develop these competencies. PMID- 3968360 TI - Effectiveness of the dietitian-technician team on a burn unit. AB - A study was conducted to determine whether the clinical registered dietitian (R.D.) on the burn and trauma unit of an 863-bed medical center was able to perform more efficiently when a part-time dietetic technician (D.T.) was employed and whether the R.D.-D.T. team had an influence on the nutritional status of burn patients. The authors audited a random sample of medical records of burn patients from the year prior to employment of the D.T. (year 1, N = 44) and the year following her employment (year 2, N = 41) to determine the quantity and frequency of nutrition information charted. Results indicated that the percentage of records charted by the R.D. in year 2 increased significantly over the percentage in year 1, as did recommendations for nutrition support. Mean percentage of nutrition recommendations that the R.D. documented for total patient days also increased significantly. Data were insufficient to determine the influence of the R.D.-D.T. team on the nutritional status of patients. With part-time technician assistance, the dietitian had more time to screen and monitor patient records; to plan, implement, and evaluate nutrition care; and to make recommendations for aggressive nutrition support. PMID- 3968361 TI - Anthropometric measurements for Asian and Caucasian elderly. AB - While differences in height and weight were observed, the results of this study indicate that there are similarities between Caucasian and Asian-American elderly in skin-fold measurements and prevalence of obesity. These results illustrate the value of skinfold thickness as a more accurate measure of adiposity than indexes on the basis of weight for given height. In addition, our results provide evidence for ethnic similarities in the distribution of subcutaneous fat and the prevalence of obesity in elderly Caucasians and Asian-Americans. PMID- 3968362 TI - Hospice care: an opportunity for dietetic services. PMID- 3968363 TI - Documentation: the missing link in evaluation. PMID- 3968364 TI - Femoral neck fractures in the geriatric population: the influence of perioperative health upon the selection of surgical treatment. AB - The use of a primary prosthetic replacement such as an Austin-Moore hemi arthroplasty in patients sustaining fractures of the femoral neck has been associated with increased post-operative medical morbidity and mortality. A retrospective review was performed using the medical records of patients greater than 59 years of age who sustained femoral neck fractures and were treated with either internal fixation or primary hemi-arthroplastic replacement at Loyola University Medical Center between 1969 and 1979. Peri-operative data were reviewed and evaluated using computer-aided statistical analysis. Comparing the two forms of surgical treatment, statistically significant factors associated with primary hemi-arthroplastic replacement included: pre-injury nursing home residence, pre-injury ambulation requiring assistance, age greater than 79 years, slight elevation in serum creatinine values, abnormal electrocardiograms in patients over 77 years of age, time from injury to surgery of four or more days, and the use of spinal anesthesia (P less than 0.05). Factors associated with internal fixation were: patient age of 79 years or less, independent ambulation, non-nursing home residence, normal lab values, normal EKGs, less than four days from injury to surgery, and the use of general anesthesia. Within the limits imposed by a retrospective review in this specific patient population, there appears to be a tendency for older, less healthy patients to have been treated with primary hemi-arthroplasty. Possibly the previously reported increased post operative medical morbidity and mortality associated with this procedure, as compared with internal fixation, may be a result of biased patient selection, and not a fault of the procedure. PMID- 3968365 TI - Comparison of the use of reserpine versus alpha-methyldopa for second step treatment of hypertension in the elderly. AB - A retrospective chart analysis was conducted on all new elderly hypertensive patients referred to a community hypertension clinic who were being treated with either reserpine or alpha-methyldopa plus a diuretic. There were no significant differences between the two groups on entry in age, gender, co-morbid diagnoses, or systolic or diastolic blood pressure. There were no significant differences between the two groups in terms of side effects over three years, but the proportion of persons having compliance problems was significantly lower in the reserpine group. Mean diastolic pressures were significantly lower after one, two, and three years, and systolic pressures were lower after one and two years in the reserpine group. Reserpine is at least as effective as alpha-methyldopa in treating hypertension in the elderly and is associated with fewer problems in compliance. PMID- 3968366 TI - Estimating stature from knee height for persons 60 to 90 years of age. AB - Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in the nonambulatory elderly person, or its value may be spurious if measured in those elderly persons with excessive spinal curvature. Simple equations are presented for estimating the stature of elderly men from a recumbent measure of knee height and for elderly women from a recumbent measure of knee height and age. The 90 per cent error bounds for these equations for an individual are about plus or minus 6.0 cm. Knee height is highly correlated with stature. PMID- 3968367 TI - Families and the gravely ill: roles, rules, and rights. PMID- 3968368 TI - Geriatric education: what the medical schools are doing now. AB - For a survey of geriatric education in medical schools in the United States in 1983, data were received from one hundred schools. Increasing numbers of schools are providing required geriatric curriculum, and over 80 per cent of schools offer fourth-year electives. Ninety per cent of schools have physician faculty in geriatrics, affiliated with major departments, for an average of 2.5 full-time equivalents per school. Training sites are expanding to include many noninstitutional settings. Issues of curriculum content and impact, as well as faculty development, require further investigation. PMID- 3968369 TI - Tamper-resistant packaging: is it elder-resistant, too? AB - A tamper-resistant package has an indicator or barrier to entry that, if breached or missing, can reasonably be expected to provide visible evidence to consumers that tampering has occurred. Regulations to implement tamper-resistant packaging on all over-the-counter drugs and certain cosmetics began in February 1983. Tamper-resistant packaging, like child-resistant packaging, may impede access by the elderly and other adults who have mental, motor, and/or sensory disabilities. This article describes: the reasons for the increasing use of over-the-counter medications in the prevention and treatment of the major causes of morbidity and mortality in the elderly; the types of difficulties encountered in opening tamper resistant packaging; the causes of these inaccessibility problems; the methods to correct them; and testing procedures to determine whether the existing designs of tamper-resistant packaging are accessible by the elderly and adults with selected disabilities. Testing of individual types of tamper-resistant packaging, multiple types of tamper-resistant packagings on the same container, and combinations of tamper-resistant packagings and child-resistant packagings on groups of normal elderly people and those with selected disabilities is necessary to guarantee accessibility to the growing number of therapeutically efficacious nonprescription medications used by these populations. PMID- 3968370 TI - Improving the use of pneumococcal vaccine through a strategy of hospital-based immunization: a review of its rationale and implications. PMID- 3968371 TI - Survival for 88 years with sinus venosus atrial septal defect. PMID- 3968372 TI - Pneumococcal pneumonia and septicemia resulting from a nontypable strain of pneumococcus. PMID- 3968373 TI - Nifedipine-induced psychosis. PMID- 3968374 TI - Munchausen's syndrome in an 85-year-old man. PMID- 3968375 TI - Effects of naloxone in treatment of senile dementia. PMID- 3968376 TI - Clinical trials in elderly persons. PMID- 3968377 TI - Behavioral correlates of computed tomographic (CT) scan changes in older psychiatric patients. AB - Fifty psychiatric inpatients aged 50 and over, with no hard neurologic findings, and with a variety of DSM-III diagnoses (adjustment disorder, affective illness, and dementia), were rated for behavioral and psychiatric symptoms using the Geriatric Rating Scale and the Nurse's Assessment of Global Symptomatology Elderly. These clinical ratings were correlated with computed tomographic (CT) scan assessments of various superficial cerebral regions as well as with linear measures of ventricular size. Behavioral deficits in activities of daily living (ADL) plus an interactional variable, inability to respond to requests, were correlated with superior temporal and inferior parietal CT abnormalities, particularly on the left side. Suspiciousness and peculiar thinking, mood lability and irritability, as well as impaired memory with confusion, perplexity, and disorientation were also associated with atrophy in these same regions. Prefrontal area defects correlated with mood lability and deficits in visual interactional responsiveness. Statistically controlling for effects of age and alcohol abuse did not alter the basic nature of these results. Regional cerebral specialization in relation to these results are discussed using concepts developed by Luria. PMID- 3968379 TI - Breast reconstruction after mastectomy. PMID- 3968378 TI - Stress and female physician administrators. PMID- 3968380 TI - Fetal alcohol syndrome: a clinical study. PMID- 3968381 TI - Teenage pregnancy. PMID- 3968382 TI - Computerization: unlimited horizons. PMID- 3968383 TI - Introduction to computer communications. AB - Telecommunications is the process of transmitting and receiving information, over the phone lines, by computer. This article will describe the hardware and software required to permit an office computer to participate in telecommunications. The article also describes various benefits to the practicing optometrist available through this new technology. PMID- 3968384 TI - Upsets in your appointment schedule shouldn't upset patients. PMID- 3968385 TI - What is visual training: a patient education handout. PMID- 3968386 TI - Ocularists are the fourth 'O' in eye care. PMID- 3968387 TI - Kienbock's disease. PMID- 3968388 TI - Fractures of the hook of the hamate--a failure of clinical diagnosis. AB - Two cases of a fracture of the hook of the hamate are described in which the diagnosis was clinically missed even though a fracture of the hook was considered. In one patient, the clinical diagnosis was thought to be ulnar wrist instability, and in the other, a pisiotriquetral injury. In one case, the diagnosis was confirmed only by a computerized tomography scan even though lateral tomograms were negative. PMID- 3968389 TI - Metacarpal rotational osteotomy. AB - Maximum metacarpal rotation and corresponding phalangeal correction were measured in 80 fingers of 40 cadaver hands. Total metacarpal rotation averaged 50 degrees to 52 degrees in the index, long, and ring fingers and 69 degrees in the small finger. Phalangeal correction averaged 36 degrees to 37 degrees in the index, long, and ring fingers and 50 degrees in the small finger (70% of rotation in the metacarpal). The orientation of the metacarpophalangeal joint was not a significant limiting factor. However, the deep transverse metacarpal ligament did limit maximum rotation at the metacarpal and the phalanx. The advantages of basal metacarpal osteotomy make this technique the procedure of choice for correcting malrotation of up to an average of 18 degrees to 19 degrees for the index, long, and ring fingers. For the small finger, 20 degrees to 30 degrees of correction is possible, depending on the direction of rotation. A table has been devised to predict the correction for individual digits. PMID- 3968390 TI - Soft tissue interposition arthroplasty for scaphoid nonunion. AB - Twenty-six patients with scaphoid nonunion were reexamined 22 to 39 years after Bentzon's soft tissue interposition arthroplasty was performed. All but one were satisfied, although three still had moderate pain. Mobility of the wrist was reduced by 20% to 25% and grip strength by 8%. The nonunion remained open and unstable in 16 of 25 radiologically reexamined cases. Carpal collapse, which had increased over time, was found in 15 cases, nine of which presented an unstable nonunion. Osteoarthritis had developed in five of 15 wrists with carpal collapse and in two of 10 without it. No significant osteoarthritis was found in any case earlier than 27 years after the operation. Thus, the risk of disability that is due to late degenerative changes of the wrist is small, even in the presence of carpal collapse. PMID- 3968391 TI - Retardation of finger growth after injury to the flexor tendons. AB - The absence of any part of the total mechanical force (i.e., flexor tendons) may be responsible for retardation of bone growth during a child's growth phase. The cause of retardation may be dedifferentiation of cartilage cells at the epiphyseal plate. Four cases in which unrepaired flexor tendons in digits caused retardation of growth illustrate this possible phenomenon. We feel that this is not a well recognized problem and thus deserves mention to stimulate further study. We believe that meticulous primary repair in children is desirable not only to preserve function, but also to prevent growth disturbances. PMID- 3968392 TI - The isolated digital cord in Dupuytren's contracture: anatomy and clinical significance. AB - This article describes the isolated occurrence of Dupuytren's pathologic fascial cords within digits of the hand. Thirty-seven cords were found in 32 patients with nearly half (45.6%) occurring in digits other than the small finger. Almost all patients (97.3%) had other clinical evidence of Dupuytren's disease. Cords were either single (83.8%) or double (16.2%) and originated from the periosteum at the base of the proximal phalanx in conjunction with adjacent ligaments and intrinsic tendons. They proceeded in an oblique direction to displace and then cross the neurovascular bundles before inserting on the bone and/or flexor tendon sheath of the middle phalanx. The average loss of extension of the proximal interphalangeal joint that resulted from these cords was 46 degrees, and surgical excision of the involved cords resulted in an average improvement of 24 degrees (53%). PMID- 3968393 TI - An ischemia-induced model of revascularization failure of replanted limbs. AB - Twenty-five amputated rat hindlimbs were replanted after various periods of warm ischemia. The incidence of limb failure that was due to the no-reflow phenomenon was found to be 0% after 2 or 3 hours of warm ischemia, 50% after 4 hours, and 80% after 5 hours of ischemia. Predictors of the occurrence of no-reflow were the presence of an increased number of venous red blood cell aggregates 5 minutes after replantation, the slope of the tissue pH curve that was recorded for 1 hour after replantation, and assessment of hydrogen washout flow to the foot pad. All limbs had excellent flow immediately after revascularization. The marked difference in flow that was detected 1 hour after replantation between the limb survival group (n = 16) and the limb failure group (n = 9) suggests an ongoing obstructive process. In those limbs that were successfully replanted, an 18% increase in femoral artery flow was found after revascularization compared with a 20% decrease in flow to the muscle and a 3% decrease to the foot pad. This supports the concept that arteriovenous shunting occurs after replantation. The presence of microthrombi that adhere to the vessel wall after replantation correlated well with limb failure. Our observations support ongoing arterial obstruction, arteriovenous shunting, and an altered thrombogenic-fibrinolytic system as factors that may be responsible for the no-reflow phenomenon. PMID- 3968394 TI - Granulomatous radial arteritis with bilateral, nontraumatic, true arterial aneurysms within the anatomic snuffbox. AB - A 69-year-old woman developed bilateral aneurysms of the anatomic snuffbox within 1 month of a short febrile illness that was consistent with polymyalgia rheumatica. Both were resected, and histologic study showed granulomatous arteritis. PMID- 3968395 TI - Embolotherapy in the treatment of congenital arteriovenous malformations of the hand: a case report. AB - This article describes the treatment of a painful ulcerating congenital arteriovenous malformation in the hand of a 39-year-old woman. Preoperative transcatheter embolotherapy was used to diminish vascularity and engorgement. Operative treatment consisted of a resection of angiomatous material and coverage with a pedicle flap. Preoperative transcatheter embolization of small feeder vessels may offer some advantage over the operative approach alone in treating congenital arteriovenous malformations of the hand. PMID- 3968396 TI - False aneurysm of the radial artery. AB - A 22-year-old man presented a large false aneurysm of the radial artery in the middle third of the forearm. A segment of the artery was resected and replaced with a vein graft. This lesion is uncommon, but should always be treated early because complications can be severe. PMID- 3968397 TI - SLAC wrist. PMID- 3968398 TI - Neuropathy after bupivacaine block. PMID- 3968399 TI - Molded polythene splint for mallet finger deformities. PMID- 3968400 TI - Clawhand deformity presumed secondary to Parkinson's disease. AB - A clawhand deformity presumed to be secondary to Parkinson's disease is described. No such association was found previously recorded in the literature. The marked limitation in hand function was improved by lengthening the extensor tendons, a 4-tail superficialis transfer to the intrinsic muscles, and capsulotomy of the metacarpophalangeal joints of the index and long fingers. PMID- 3968401 TI - Restoration of strong grasp and lateral pinch in tetraplegia: a comparison of two methods of thumb control in each patient. AB - Six patients with spinal cord injury who ranged in age from 25 to 42 years were selected for surgery that used a tendon transfer for opposition-adduction of one thumb and arthrodesis of the carpometacarpal joint of the other in each patient. At follow-up 2 to 6 years later, the hands with the opponens-adductorplasty had a slightly stronger lateral pinch (3.75 kg versus 3.31 kg), but the hands with the carpometacarpal arthrodesis had a somewhat stronger grasp (7.42 kg versus 6.86 kg). The patients did not exhibit a consistent preference for either method, but rather, were particularly pleased that their hands had been reconstructed differently, thereby allowing each to be somewhat "specialized" for certain activities. PMID- 3968402 TI - Interphalangeal fixation of the thumb in Moberg's key grip procedure. AB - A follow-up of Moberg's key grip procedure was performed to evaluate the adequacy of interphalangeal joint stabilization of the thumb by means of two methods of percutaneous pin fixation. Five of 16 patients in whom a single, smooth, 2 mm Kirschner wire had been used showed significant complications as a result of distal migration. None of the seven patients who had fixation with a specially designed, 3.2 mm, threaded, slotted pin had any complications. PMID- 3968403 TI - Functional wrist motion: a biomechanical study. AB - A triaxial electrogoniometer was used to measure functional wrist motion. Wrist motion was evaluated in 10 normal subjects who performed 52 standardized tasks. The wrist joint was found to have three degrees of freedom (flexion-extension, radioulnar deviation, and rotation). The normal functional range of wrist motion is 5 degrees of flexion, 30 degrees of extension, 10 degrees of radial deviation, and 15 degrees of ulnar deviation. PMID- 3968404 TI - The incomplete anterior interosseous nerve syndrome. AB - The anterior interosseous nerve syndrome involves paralysis of the flexor pollicis longus, flexor digitorum profundus of the index and long fingers, and the pronator quadratus. We have encountered 33 cases of an incomplete syndrome in which only the flexor pollicis longus or the flexor digitorum profundus of the index finger is either paretic or paralyzed. This entity must be distinguished from flexor tendon rupture, flexor tendon adherence or adhesion, and stenosing tenosynovitis. The nerve is usually compressed by fibrous bands that most commonly originate from the deep head of the pronator teres and to the brachialis fascia. Less common causes of compression are: fibrous bands from the superficial head of the pronator teres; bands from the superficialis arcade; the nerve running deep to both heads of the pronator; and compression by a double lacertus fibrosus. Patients presenting with paresis should be observed. Most will improve spontaneously without surgery. We recommend exploration and neurolysis of the anterior interosseous nerve in patients who present with complete paralysis of either muscle-tendon unit and who have shown no improvement as determined by physical examination or repeat electromyography after 12 weeks of observation. Recovery after neurolysis is often rapid and complete. PMID- 3968405 TI - Trigger wrist: a case report. AB - Previously published reports on trigger wrist have described triggering of the fingers at the wrist. We observed a case of true triggering of the wrist that was due to a nodule in the extensor carpi radialis longus tendon as it entered the second dorsal compartment. Reduction tenoplasty of the traumatic nodule and release of the second dorsal compartment relieved all symptoms. This is the first reported case that is accurately identified as trigger wrist. PMID- 3968406 TI - Experimental study of vascularized nerve grafts: multifactorial analyses of axonal regeneration of nerves transplanted into an acute burn wound. AB - Rat sciatic nerves were used in a comparative study of both vascularized and free nerve grafts that were transplanted into an acute burn wound. Electromyographic analyses of axonal regeneration were done at intervals from week 1 through week 24 after surgery. Biopsied sciatic nerves were processed for morphometric studies with the use of a fiber caliber analyzer. Motor nerve conduction velocity was faster in the vascularized nerve graft than in the free nerve graft until week 24 after surgery. Regenerated axons appeared earlier in the vascularized nerve grafts than in the free nerve grafts, and the density of large regenerated axons was greater in the former than in the latter group. It is suggested that preserving the vascular system of vascularized nerve grafts would decrease the likelihood of fibrosis and result in smooth regeneration of axons. PMID- 3968407 TI - Fracture-dislocations of all five carpometacarpal joints: a case report. AB - Injuries to all five carpometacarpal joints are rare. Only four cases have been reported in the English literature. A case of fracture-dislocations of all five carpometacarpal joints is presented. An excellent result has been obtained 2 years after open reduction and internal fixation. This case is the only one in the English literature so treated and with prolonged follow-up. PMID- 3968408 TI - Simultaneous subluxation of the metacarpophalangeal joints of all four fingers: a case report. AB - Simultaneous subluxation of the metacarpophalangeal joints of all four fingers is rare, and we have found no cases in the literature. A 45-year-old construction worker fell and dislocated the metacarpophalangeal joints of all the fingers of his left hand. Closed reduction by manipulation was successfully accomplished, and the patient returned to work within 5 months of his accident. He had a full range of motion 1 year later. PMID- 3968409 TI - Simultaneous closed dislocations of the metacarpophalangeal joints of the index, long, and ring fingers: a case report. AB - A patient with simultaneous closed dislocation of the metacarpophalangeal joints of the index, long, and ring fingers and an ipsilateral fracture of the radius with an associated fracture-dislocation of the distal radioulnar joint is presented. This is the first such case to be described. The mechanism of injury was a fall on an outstretched hand. The dislocations of the metacarpophalangeal joints were successfully reduced by open relocation through dorsal approaches. The fractured radius was treated with open reduction and plate fixation. The patient was placed in a dorsal extension block splint after surgery, and active motion was encouraged. Eleven months later, the patient could make a full fist and extend all fingers. Grip strength was 110 pounds in the right hand, and 100 pounds in the injured left hand. PMID- 3968411 TI - Simultaneous dislocation of the hamate and pisiform: a case report. AB - A 27-year-old man fell on his flexed wrist and simultaneously sustained a posteriorly dislocated hamate and a laterally dislocated pisiform. The hamate was openly reduced and fixed, and the pisiform was excised. The result was excellent. PMID- 3968410 TI - Irreducible dorsal dislocations of the proximal interphalangeal joint. AB - Dorsal dislocations of the proximal interphalangeal joint are common injuries, and reduction is usually obtained by manipulation. We describe four cases of dorsal dislocation in which attempts at reduction by manipulation were not successful. Three of these injuries were open and one was closed. At surgery, the main block to reduction in all cases was the palmar plate that had ruptured from its proximal attachment and was interposed between the joint surfaces. PMID- 3968412 TI - Isolated palmar dislocation of the trapezoid. AB - The first reported case of an isolated palmar dislocation of the trapezoid is described. Open reduction was necessary, but internal fixation was not used. The dorsal intercarpal and carpometacarpal ligaments were repaired. Six months later, range of motion and grip strength were normal. PMID- 3968413 TI - Posttraumatic sesamoid arthritis of the metacarpophalangeal joint of the thumb. AB - The articular interface between the radial sesamoid and the radial condyle of the metacarpal head, which is the radial subsesamoid joint, is the most frequently involved area of abnormality in the metacarpophalangeal joint complex. More than 85% of all adult cadavers demonstrate degenerative arthritis of the radial subsesamoid joint. Confusing this condition with degenerative arthritis of the metacarpophalangeal joint may lead to unnecessary joint fusions. The predisposition of the radial subsesamoid to degenerative arthritis is related to the asymmetry of the palmar condyles of the metacarpal. The ulnar sesamoid has a flatter and broader condyle compared with the radial sesamoid, which rides on a high, narrow ridge. Thirty-six patients with symptomatic sesamoiditis have been treated by sesamoidectomy since 1978. Twenty-one of these patients were available for follow-up examination between 1 and 5 years after surgery, and 19 had relief of proximal thumb pain after sesamoidectomy. PMID- 3968414 TI - NMR physics for physicians. PMID- 3968415 TI - Continuous monitoring of blood gases in the intensive care unit and operating room. Part 1: Non-invasive monitoring of oxygenation. PMID- 3968416 TI - Perspectives in small bowel imaging. PMID- 3968417 TI - Umbilical arterial rupture: a major complication of catheterization. PMID- 3968418 TI - Mood disorders: pharmacologic prevention of recurrences. A National Institutes of Health consensus report synopsis. PMID- 3968420 TI - Contracting questions for physicians: alternative delivery systems. PMID- 3968419 TI - Competition in the marketplace of medical care. PMID- 3968421 TI - Histochemical demonstration of estrogen and progesterone binding in endometriotic tissue and in uterine endometrium: A comparative study. AB - Estrogen and progesterone binding to endometriotic and endometrial tissue was studied histochemically using estradiol and progesterone fluorochrome derivatives (E2-bovine serum albumin-fluorescein isothiocyanate and progesterone-bovine serum albumin-tetramethylrhodamine isothiocyanate). Thirty endometriotic samples from 21 women were studied, together with endometrial specimens obtained simultaneously from 14 of the women. In 77% of the endometriotic samples binding of the estrogen conjugate was indicated by specific fluorescence in more than half of the epithelial cell population, and in 20% in less than half. The corresponding figures for the progesterone conjugate binding were 75 and 18%, respectively. Blocking studies indicated a reasonable degree of ligand specificity. In endometrial tissue the corresponding figures were 64 and 29%, respectively, for binding of the estrogen conjugate and 54 and 38%, respectively, for binding of the progesterone conjugate. In 7 of 13 cases where evaluable samples of both tissues had been obtained, the relative proportion of fluorescent cells, with either reagent, was similar in the two tissue types. Our results suggest that the cytoplasm of epithelial cells in endometriotic tissue and in uterine endometrium contains specific binding sites for both estrogen and progesterone. The binding pattern of the two conjugates in endometriotic tissue was unrelated to the menstrual phase. PMID- 3968422 TI - Distribution of tissue polypeptide antigen (TPA) in normal human tissues: Immunohistochemical study on unfixed, methanol-, ethanol-, and formalin-fixed tissues. AB - The distribution of tissue polypeptide antigen (TPA) was studied in unfixed, methanol-, 95% ethanol-1% acetic acid (EA)-, and formalin-fixed paraffin-embedded sections of all adult human tissues using an indirect immunoperoxidase method. The specific staining patterns were virtually identical in unfixed and alcohol fixed tissues, but in formalin-fixed tissues this similarity was found only after fixation for up to 24 hr and pretreatment with protease for 15 min. Although prolongation of formalin fixation beyond 48 hr increasingly diminished the TPA reactivity, TPA could still be demonstrated in tissues fixed in formalin for up to 6 months. TPA was found to be a cytoplasmic constituent of almost all adult human duct and cavity lining, simple, and stratified epithelia. TPA was not demonstrated in epidermis, renal proximal convoluted and testicular tubules, basket-like myoepithelial cells, nor in most glandular acini, including hepatocytes and pancreatic acinar cells. The TPA staining was also negative in all non-epithelial tissues, including lymph nodes and bone marrow. The well defined epithelial distribution and the comparable demonstrability in differently preserved tissues make TPA a useful tool for the identification of cells of epithelial character. PMID- 3968423 TI - Follicular dendritic cells in suspension: identification, enrichment, and initial characterization indicating immune complex trapping and lack of adherence and phagocytic activity. AB - Antigen-retaining follicular dendritic cells (FDC) have been identified and studied in sections of lymph nodes and spleen, but studies of these cells in culture have been extremely limited. The purpose of this study was to establish techniques to release these fragile cells from mouse lymph nodes in a viable state and to identify these cells routinely in lymph node cell suspensions. FDC were obtained from passively or actively immunized popliteal lymph nodes of mice injected in the footpads with 125I-labeled human serum albumin (HSA) or horseradish peroxidase (HRP). Lymph nodes were removed 1 hr after the footpads had been injected with collagenase. After another hour of incubation in vitro with collagenase, protease, and deoxyribonuclease, FDC were released by gentle teasing and enriched by centrifugation on a low density bovine serum albumin (BSA) or Percoll gradient. Most FDC with the associated radiolabel floated at densities greater than 1.06 g/ml on BSA or Percoll gradients. Slides of the FDC enriched fraction were prepared, using a cytobucket which allowed the cells to be affixed to glass slides by centrifugation in a less disruptive manner than by cytocentrifugation. FDC that were air-dried and fixed with 3% glutaraldehyde had a characteristic pink acidophilic cytoplasm after Wright's staining, and had a faintly basophilic euchromatic nucleus frequently with peripherally-clumped chromatin. In addition, these cells were large and irregularly shaped (up to 60 micron long). Fixation of FDC with 0.6% paraformaldehyde/ 0.9% glutaraldehyde on poly-L-lysine-coated slides resulted in a preservation of FDC which made possible visualization of long dendritic processes by Nomarski optics. Antigen presence on the cell surface was confirmed by autoradiography and, in the case of HRP, was also visualized enzymatically using diaminobenzidine. In contrast to resident peritoneal macrophages or some contaminating lymph node macrophages present on the same slides, FDC did not phagocytize opsonized sheep red blood cells (SRBC) or adhere to plastic surfaces although they did form rosettes with opsonized SRBC. Cell marker studies indicated FDC have a distinctive phenotype. They were positive for Ia, Fc receptor, and leukocyte common antigen, but negative for Thy 1, Ly-1, Ly-2, endogenous Ig, Mac-1, Mac-2, Mac-3, and F4/80, and negative to weakly positive for nonspecific esterase. Cultured FDC remained viable and retained radiolabeled antigen-antibody complexes on their surfaces and were significantly enriched for FDC.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3968424 TI - Generation of natural killer cell lines from murine long-term bone marrow cultures. AB - Functionally active natural killer (NK) cells with the ability to lyse 51Cr labeled YAC-1 lymphoma target cells are no longer detectable by 1 wk of culture in cultured marrow cells harvested from Dexter-type long-term marrow cultures (LMC). Interferon, which enhances NK cell-mediated target cell lysis, fails to induce NK activity from LMC cells even at high effector to target cell ratios. However, such LMC cells, when placed in secondary cultures in the presence of Con A-splenic leukocyte-conditioned medium (spleen-CM) generated a population of cells with NK activity within 1 wk. Kinetic studies showed that the generation of NK activity was not due simply to proliferation of a few surviving NK cells, but suggested derivation from NK precursors through clonal expansion and functional maturation. This NK activity was further shown to be associated with a subpopulation of cells bearing surface Thy-1, Ly-5, and NK-1 as well as asialo GM1 antigens but lacking Ly-1 antigen. The expression of Ly-2 antigen, however, was variable. Electron microscopy studies of isolated asialo-GM1-positive cells showed a uniform lymphoblastoid morphology with large cytoplasmic to nuclear ratios and prominent electron dense cytoplasmic granules characteristic of large granular lymphocytes. In support of the NK nature of such cultured cells was the ability of anti-asialo-GM1 and complement to abrogate, and of interferon to augment, target cell lysis. Isolated cell lines also showed target selectivity similar to NK cells. The implications of the studies on further analysis of the nature of NK precursors is discussed. PMID- 3968425 TI - Characterization of the natural killer-like lymphocytes in rheumatoid synovial fluid. AB - IgG Fc- cytotoxic cells found in the synovial fluid of patients with rheumatoid arthritis have natural killer (NK)-like characteristics but can kill NK-resistant cell lines as well. The phenotype of these cells was defined by complement mediated lysis with monoclonal antibodies. The synovial fluid killer cell activity was significantly reduced by treatment with complement and OKT11 and 4F2, but the cytotoxic T cells did not express the NK-related antigens OKM1 and Leu-7, nor the cytotoxic T lymphocyte-specific antigen, OKT8. These results demonstrate that the synovial fluid killer cells resemble the activated T cells generated in an autologous mixed leukocyte reaction or in the treatment of peripheral blood mononuclear cells with interleukin 2, and they are distinct from the conventional NK cells found in blood. PMID- 3968426 TI - The in vitro photosensitivity of systemic lupus erythematosus skin fibroblasts. AB - To investigate the role of DNA damage in the pathogenesis of systemic lupus erythematosus (SLE), we studied the ability of skin fibroblasts derived from SLE patients to recover from ultraviolet (UV) light radiation of varying wavelengths. Four of five SLE cell strains were more sensitive to UV-C (254 nm), sun lamp, and UV-A (320 to 400 nm) light than were normal cells. SLE cellular recovery was most sensitive to broad spectrum, long wavelength light. This hypersensitivity did not appear to result from the UV light activation of a clastogenic factor. Experiments which examined the DNA repair capacity of irradiated cells indicated that SLE fibroblasts may be able to excise certain DNA lesions as well as normal cells. The mechanisms responsible for the hypersensitivity of SLE cells remain under investigation. PMID- 3968427 TI - Adoptive transfer of autoimmune diabetes mellitus in biobreeding/Worcester (BB/W) inbred and hybrid rats. AB - Adoptive transfer of diabetes was accomplished by the injection of Con A activated acutely diabetic BB/W rat spleen cells into immunosuppressed diabetes resistant BB/W control rats and F1 hybrid offspring produced by BB/W X Lewis, BN, Yashida, and NEDH matings. Immune suppression methods that facilitated adoptive transfer of diabetes included neonatal thymectomy, cyclophosphamide, and splenectomy plus rabbit anti-rat lymphocyte serum injections. The successful transfer of BB/W diabetes to otherwise normal (BB/W X inbred)F1 rats and to diabetes-resistant BB/W animals suggests that antigenically normal pancreatic beta cells were destroyed by the injected effector cells. Diabetes-resistant BB/W control rats also evidenced diabetes after the injection of cyclophosphamide alone. The requirement for immunosuppression suggests that an intact immune system protects against adoptive transfer and diabetes in diabetes-resistant BB/W rats. PMID- 3968428 TI - Nuclear pore complexes deposited in the glomerular basement membrane are associated with autoantibodies in a case of membranous nephritis. AB - Massive deposits of organelles, morphologically identical with nuclear pore complexes (NP), were identified in the glomerular basement membrane of an individual with membranous nephritis. Analysis by immunofluorescence demonstrated that the patient's serum contained autoantibodies that became bound within intact cells to cellular components, including centrosomes or centrioles and filaments of the cytoskeleton. Furthermore, these antibodies became bound to numerous small structures at the nuclear periphery. The above evidence suggests that among the autoantibodies were some specifically directed toward the NP, and that the glomerular deposits were NP, possibly in association with IgG. PMID- 3968429 TI - Immunologic consequences of vaccination against abortion in mice. AB - CBA/J female mice have a high rate of fetal resorption when mated with DBA/2J males. This fetal wastage can be dramatically reduced by immunizing the female with BALB/cJ but not DBA/2J spleen cells. We report here that immunization with BALB/cJ (but not DBA/2J) spleen cells leads to 1) anti-paternal MHC antibody that is predominantly of the IgG1 isotype, and which disappears from the serum during pregnancy; 2) increased active suppression in both the spleen and placenta; and 3) an ability to adoptively transfer the fetal protection and placental suppression with serum from the immunized mice. Congenic absorption studies before adoptive transfer indicate that the active component of the serum is also directed against the paternal MHC haplotype. These results indicate that maternal humoral immunity can lead to increased fetal protection in correlation with local active suppression in the placenta. They also suggest an expansion of the placental immunoabsorbent hypothesis to include the induction of active suppression against maternal cell-mediated immunity. PMID- 3968430 TI - Lipopolysaccharide-treated RAW 264.7 cells produce a mediator that inhibits lipoprotein lipase in 3T3-L1 cells. AB - RAW 264.7 cells upon stimulation with lipopolysaccharide secrete a protein mediator(s) that suppresses lipoprotein lipase activity in differentiated 3T3-L1 cells. The mediator(s), which is absent from unstimulated culture supernatants, is nondialyzable and thermolabile. Preliminary characterization suggests that this mediator(s) may be the same as that previously found in medium from lipopolysaccharide-treated thioglycollate-elicited mouse peritoneal macrophage cultures. PMID- 3968431 TI - Regulation of secretory component by glucocorticoids in primary cultures of rat hepatocytes. AB - The present study examined the effects of steroid hormones on the production of secretory component (SC) by rat hepatocytes in cell culture. When hepatocytes were incubated in the presence of cortisol (10(-6) M), the levels of SC in media increased significantly after 2 days of incubation. This response was dose dependent and specific for glucocorticoids because progesterone, dihydrotestosterone, and estradiol had no effect. When estradiol was added to the incubation media along with dexamethasone, a known potent synthetic glucocorticoid, it diminished the glucocorticoid response. The addition of cycloheximide to incubation media significantly decreased the effect of dexamethasone on SC accumulation. These findings suggest that glucocorticoid regulation of hepatocyte SC most likely involves stimulation of its synthesis. In addition, our results suggest that endogenous glucocorticoids may play a role in enhancing the clearance of IgA from blood into bile in the intact animal. PMID- 3968432 TI - Elimination of terminal complement intermediates from the plasma membrane of nucleated cells: the rate of disappearance differs for cells carrying C5b-7 or C5b-8 or a mixture of C5b-8 with a limited number of C5b-9. AB - We have previously shown that multiple complement (C) channels are required for lysis of a nucleated cell in contrast to the single channel requirement for erythrocytes. To further investigate this multichannel requirement for nucleated cells, we examined the stability of terminal C complexes in the plasma membrane of Ehrlich ascites tumor cells. Ehrlich cells bearing C5b-7 or C5b-8 with or without C9 were incubated at 37 degrees C or 0 degree C for various time intervals before converting the remaining complexes to lytic C5b-9 channels. C5b 7, C5b-8, and C5b-8 in the presence of a limited number of C5b-9 complexes disappeared functionally from the plasma membrane at 37 degrees C, with initial half-lives of 31, 20, and 10 min, respectively. Disappearance of these complexes did not occur at 0 degree C, nor did disappearance occur at 37 degrees C when formed on sheep erythrocytes. The fate of C5b-8 complexes on the surface of Ehrlich cells was traced with colloidal gold particles bound to C5 determinants on C5b-8 with the use of immunoelectron microscopy. Colloidal gold could be seen on the cell surface after specific binding to cells carrying C5b-8 sites at 0 degree C. After incubating these cells at 37 degrees C, gold particles were internalized into the cell continuously via endocytic vesicles. It is postulated that terminal C complexes may stimulate or accelerate the removal of these complexes from the cell surface. PMID- 3968433 TI - 2-Chloroadenosine: a selective lethal effect to mouse macrophages and its mechanism. AB - In our studies on the effects of purine compounds on immune responses in vitro, we found that 2-chloroadenosine (2-Cl Ado) exhibited a potent lethal effect on a viability of mouse adherent cells derived from the peritoneal cavity. The lethal effect was specific for adherent peritoneal cells (PC) (macrophages) and was prevented by exogenous addition of adenosine (Ado) or coformycin, a potent inhibitor of adenosine deaminase. A rapid decrease of intracellular ATP content (26% of control) in adherent PC was observed soon after 1 hr exposure to 2-Cl Ado (0.1 mM), and this decrease of ATP was comparable with that of monoiodoacetate (MIA, 0.1 mM)- or NaN3 (5 mM)-treated adherent PC. The ATP decrease by 2-Cl Ado was restored to 88 or 90% of control value by 1 hr addition of Ado or coformycin, respectively. Polymorphonuclear cells and lymphocytes to which 2-Cl Ado did not exhibit the lethal effect did not cause a significant ATP decrease of the cells. Therefore, the data suggested that the reason for the lethal effect on adherent PC treated with 2-Cl Ado could be attributed to a rapid decrease of ATP content at an early time. We assume that 2-Cl Ado competes with intracellular Ado in macrophages and then causes the adenosine starvation resulting in the ATP decrease. PMID- 3968434 TI - Characterization of the opsonic and monocyte adherence functions of the specific fibronectin fragment that enhances phagocytosis of particulate activators. AB - The functional opsonic and monocyte adherence domains within the 180,000 m.w. opsonic fibronectin fragment (180K-opFnf) that selectively augments human monocyte phagocytosis of particulate activators of the alternative complement pathway were analyzed with Fab fragments of monoclonal anti-fibronectin antibodies BC7, CE9, BD4, AB3, and CPG1, and with fragments of intact human plasma fibronectin derived by cathepsin cleavage and isolated by affinity chromatography. Monoclonals AB3 and CPG1, which recognize epitopes within 40,000 daltons of the carboxy terminus of intact fibronectin, and the cathepsin D derived, disulfide-linked fragments that contain these epitopes each inhibited the opsonic function of 180K-opFnf. Monoclonals AB3 and CPG1 inhibited monocyte ingestion of rabbit erythrocytes (Er) by 60 and 50%, respectively, when 180K opFnf was pretreated with 20 micrograms of these monoclonals, but neither monoclonal affected the enhanced monocyte ingestion of Er pretreated with the fibronectin fragment. The pretreatment of Er with 5 micrograms and 40 micrograms of the disulfide-linked, cathepsin D derivatives isolated from high and low affinity heparin fractions, respectively, inhibited the proportion of ingesting monocytes by 60%, but these types of fragments had little effect when concurrently incubated with the opsonic fragment and Er. Monoclonals CE9 and BD4, which recognize epitopes located adjacent to or within the cell-adhesive domain of intact fibronectin, respectively, inhibited the monocyte adherence function of 180K-opFnf, as evidence by their comparable inhibitory effects when present before or after Er were opsonized with 180K-opFnf. When 20 micrograms of monoclonals CE9 and BD4 were each introduced before and after Er were opsonized with 180K-opFnf, monocyte ingestion was inhibited by 60 and 65% and by 51 and 60%, respectively. At 42 micrograms, cathepsin D-derived, non-gelatin-binding, low affinity heparin fragments that contained both BD4 and CE9 determinants or only the BD4 determinant inhibited monocyte ingestion by 53 and 74%, respectively, when concurrently incubated with 180K-opFnf and target Er, but were without effect when used to pretreat Er before the addition of 180K-opFnf. Thus, the inhibitory effects produced by monoclonals AB3 and CPG1 and by cathepsin D derived, disulfide-linked fragments containing their corresponding epitopes demonstrated that the opsonic domain within 180K-opFnf is immunologically similar to regions within the carboxy terminus of intact plasma fibronectin.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3968435 TI - Micromolar concentrations of free calcium provoke secretion of lysozyme from human neutrophils permeabilized with saponin. AB - Permeabilization of human neutrophils has been accomplished by using saponin, a cholesterol complexing agent, permitting experimental manipulation of the intracellular milieu. Access of ordinarily impermeable solutes, such as [14C] inulin or [14C]-sucrose, to the water space of the cells was considered the main criterion for permeabilization. Other criteria were substantial (50 to 80%) release of cytoplasmic lactate dehydrogenase and permeability to trypan blue. Successful permeabilization did not cause substantial release of the granule enzymes lysozyme or beta-glucuronidase. Washing the neutrophils, to remove soluble saponin and released cytoplasmic contents, and resuspension did not alter their permeabilized character. By supplementing the medium with CaCl2, thereby obtaining free Ca2+ concentrations of 1.5 X 10(-7) M to 10(-4) M, it was possible to stimulate lysozyme secretion from washed or unwashed permeabilized neutrophils. A total of 20 to 30% of the total cellular lysozyme was released during an incubation of 5 min at 37 degrees C. Secretion was inversely related to cell concentration. No beta-glucuronidase was secreted under these conditions and no response was obtained by using unpermeabilized cells. Thus, permeabilized neutrophils respond to increases in free Ca2+ alone, without resorting to conventional secretagogues. This system also permits the manipulation of intracellular constituents important for stimulus-response coupling. PMID- 3968436 TI - Extracellular release of rat eosinophil peroxidase (EPO) I. Role of anaphylactic immunoglobulins. AB - The release of intracellular peroxidase (EPO) was investigated in order to evaluate rat eosinophil activation by various immunoglobulin (Ig) isotypes. After successive incubations with purified rat IgG1, IgG2a, IgG2b, IgG2c, IgE, or IgM and their respective anti-Ig antisera, eosinophils released significant amounts of EPO (up to 26% of the intracellular content) only in the case of Ig with anaphylactic activities (IgG2a and IgE). Other classes and subclasses were unable to induce EPO exocytosis. Selective depletion and reconstitution experiments suggested that mast cells were not required in this process. Similar levels of EPO could be released after interaction of eosinophils with antigen-antibody complexes (IgG2a monoclonal antibody and Schistosoma mansoni antigen) immobilized on nonphagocytosable surfaces. These results indicate that EPO exocytosis can be obtained after cell activation with specific antibodies, and that this mechanism is independent of phagocytosis. A kinetic study of eosinophils from S. mansoni infected rats revealed that IgG2a and IgE cytophilic antibodies induced EPO release after incubation with either specific antisera or specific antigen, which suggests the in vivo relevance of such findings. The present work underlines the parallelism of interaction of anaphylactic-type Ig with eosinophils and with mast cells. Moreover, EPO release seems to represent an interesting marker of eosinophil activation, because close relationships were established between the present findings and previous work on the effector function of rat eosinophils. PMID- 3968438 TI - A visual study of chemotaxis of human lymphocytes using a collagen-gel assay. AB - Time-lapse cinematography was used to study the chemotactic responsiveness of human blood lymphocytes as defined by morphological orientation and directional locomotion in gradients. At present, evidence for lymphocyte chemotaxis is indirect since neither of these essential features can be demonstrated with Boyden filter assays. Few lymphocytes direct from blood were motile, but culture in vitro for 1-3 days increased the proportion of locomotor forms to 30-40%. These cells were placed on 3-D collagen gels, and a chemotactic source was presented nearby on a small filter placed on the surface of, or within, the gel. The minority of lymphocytes that were capable of locomotion showed chemotactic responses to filters soaked in lipopolysaccharide if fresh human serum (20%), but not heat-inactivated serum, was present. Lymphocytes responded by protrusion of a lamella in the direction of the gradient source: 76% of locomotor lymphocytes showed their first orientation into the 180 degrees sector facing the source. They then moved directionally towards the source. The response to purified C5 peptides was equivocal. The locomotor lymphocytes showed a chemotactic response to supernatant fluids derived from cultures of the adherent mononuclear cell fraction from human blood (greater than 80% monocytes), judged by the same criteria. No particular lymphocyte type constituted the locomotor population. After exposure to LPS-activated serum, both T and B lymphocytes showed locomotor forms. There were slightly more T4+ cells among the locomotor population than among the population as a whole. PMID- 3968437 TI - Effector mechanism of host resistance in murine giardiasis: specific IgG and IgA cell-mediated toxicity. AB - The role of specific serum and milk anti-Giardia muris antibodies in mediation of host-effector responses to this enteric pathogen is unknown. We have investigated antibody-dependent cell-parasite interactions, potentially important as mediators of protection against infection at the mucosal surface. Elicited mouse peritoneal neutrophils and macrophages were incubated with G. muris trophozoites in the presence of either serum or milk antibodies, and their adherence and phagocytosis of the parasites were assessed. The percentage of trophozoites with adherent neutrophils increased significantly in the presence of heat-inactivated immune rabbit serum (93.5% +/- 6.5) and immune mouse milk (54.4% +/- 11.3) and their purified IgG (35.2% +/- 9.7) and secretory IgA fractions (48.0% +/- 12.3) when compared with incubation in RPMI-10% FCS (21.7% +/- 13.9). Similarly, macrophage adherence to trophozoites increased from 49.7% +/- 14.3 in medium alone to respective values of 92.8% +/- 7.1 in immune rabbit serum and 77.3% +/- 11.0 in immune milk. Phagocytosis of parasites by macrophages also was enhanced after incubation in immune rabbit serum (48.0% +/- 4.0) and immune mouse milk (35.0% +/ 5.0) when compared with the percentage of trophozoites ingested when cells and parasites were incubated in RPMI-10% FCS (3.3% +/- 3.0). Transmission electron microscopy showed ingestion of parasites by neutrophils or macrophages after 15 min of incubation. Morphologic evidence of intracellular parasite injury was observed at 6 hr. A decrease in parasite infectivity also resulted when trophozoites were incubated with neutrophils or macrophages and a source of antibodies, and intragastrically fed to weanling mice. These observations show that both antitrophozoite IgG, secretory IgA, and mouse phagocytic cells interact in vitro to promote parasite clearance. Because both the humoral and cellular components of this system are found intraluminally in the small intestine and in milk, they may represent a biologically relevant protective response against giardiasis. PMID- 3968439 TI - Method to select mice in the steady state for biological studies. AB - Collection of small amounts of blood from the orbital sinus was found to be a satisfactory method for repeated sampling in mice, which means that these animals can be selected for further study on the basis of the leukocyte count. In biomedical research it is often necessary to have detailed information about the effect of injected material on the numerical course of circulating leukocytes. However, the present study has shown that 2 stress-producing procedures on 1 day disturb the steady state, and that this disturbance is expressed in changes in the number of leukocytes. Such stress could be avoided by alteration of the experimental design to include only 1 stressful situation each day. When blood was sampled in the orbital sinus on 1 day to determine the animals' condition and on the next day only the tail was punctured as sham injection, the number of blood leukocytes remained constant throughout the observation period. Comparative studies on the numbers of monocytes, lymphocytes, and granulocytes in blood from the tail, heart, and orbital sinus showed a systematic difference in the mean numbers of certain types of leukocytes. Statistically significant differences were found between the mean numbers of monocytes, lymphocytes, and granulocytes in orbital blood from normal mice of 5 specific pathogen-free strains, i.e., Cpb:SE (Swiss), CBA/Cpb, BALB/cCpb, C3H/Rij, and DBA/2Rij. PMID- 3968440 TI - One-step purification of mouse monoclonal antibodies from ascites fluid by hydroxylapatite chromatography. AB - A single-step method for purification of mouse monoclonal antibodies directly from ascitic fluids using hydroxylapatite column chromatography is described. The procedure yields highly purified IgG or IgM antibodies. The purified immunoglobulin is essentially free of contaminating mouse albumin, transferrin, and other ascites proteins, as determined by SDS-polyacrylamide gel electrophoresis. Hydroxylapatite chromatography can also separate monoclonal IgG antibodies from contaminating IgG antibodies found in ascites fluid of animals that have been immunosuppressed prior to ascites induction. Furthermore, the evidence presented here suggests that some hybridomas of SP2/0 origin synthesize an extraneous light chain resulting in the secretion of hybrid antibody molecules. PMID- 3968441 TI - A micro enzyme-linked immunosorbent assay for insulin antibodies in serum. AB - A solid-phase micro enzyme-linked immunosorbent assay for the measurement of insulin antibodies in serum is described and its performance compared with that of an established radiobinding assay. Interassay precision in the ELISA was 10% or less at widely spaced points on the dilution curves for human, porcine and bovine insulins. Specificity was demonstrated by substituting purified human gamma-globulin for the test serum and glucagon for the insulin. The influence on ELISA of endogenous insulin in the test serum was examined by measuring antibody binding before and after extraction of the insulin. The correlation between results from extracted and unextracted sera was 0.96 and the fit ideal: y = 1.00x + 0.38%. The correlation between the results of measuring insulin antibody in 256 diabetic sera by the 2 assays was r = 0.74, P less than 0.001 (human insulin) and r = 0.71, P less than 0.001 (porcine insulin). ELISA is cheap and simple to perform. We believe it may prove to be a practical alternative to radioassay in both the routine detection and investigative research of insulin antibodies. PMID- 3968442 TI - Germination of Bacillus thuringiensis var. israelensis spores in the gut of Aedes larvae (Diptera: Culicidae). PMID- 3968443 TI - Penetration of mosquito midgut wall by sheathed microfilariae. PMID- 3968444 TI - Response to the amoebocyte-producing organ of sensitized Biomphalaria glabrata after exposure to Echinostoma caproni miracidia. PMID- 3968445 TI - Autoradiographic localization of tritiated dihydrotestosterone in the flank organ of the albino hamster. AB - In the hamster flank organ, the growth of hair and growth of sebaceous glands are androgen-dependent functions. Although dihydrotestosterone (DHT) is known to be a potent stimulator of flank organ growth, there is no information about localization of DHT receptor sites in this organ. The purpose of this study was to use steroid autoradiography to localize DHT receptors in the hamster flank organ. Because steroid hormones are functional when translocated to nuclear receptors, nuclear localization by autoradiography defines receptor sites. In order to be able to visualize autoradiographic grains from radiolabeled androgens around hair follicles, albino hamsters were studied to avoid confusion between the grains and pigment granules which are abundant in the more common Golden Syrian hamster. Mature male hamsters castrated 24 hours earlier were given tritium-labeled dihydrotestosterone ( [3H]DHT). Using the technique of thaw-mount steroid autoradiography, 4-micron unfixed frozen sections were mounted in the dark onto emulsion-coated glass slides and allowed to develop for 4-6 months. [3H]DHT was found to be concentrated over sebocyte nuclei. The label was present peripherally as well as in differentiating sebocytes. There was no nuclear localization of [3H]DHT in animals pretreated with excessive quantities of unlabeled DHT. Steroid metabolites of [3H] DHT were assessed by thin-layer chromatography in paired tissue samples. Most of the label remained with DHT. Uptake was inhibited in the flank organ of hamsters pretreated with unlabeled DHT. Specific DHT receptors in the albino hamster flank organ are located in peripheral and differentiating sebocytes. Steroid autoradiography is a useful tool to study androgen interaction in the skin. PMID- 3968447 TI - Actinic degeneration in association with long-term use of PUVA. AB - To determine the extent of clinical actinic damage that occurred in association with exposure to oral methoxsalen photochemotherapy (PUVA), dermatologists at 16 university centers assessed the wrinkling, telangiectasia, and altered skin markings on the buttocks and the dorsa of the hands among 1380 patients treated with PUVA. These changes are similar to those seen in skin that is chronically exposed to sunlight. After more than 5 years of prospective study, patients with psoriasis exposed to PUVA showed a significant dose-dependent increase in the prevalence of clinical actinic degeneration of the skin of the buttocks (p less than .05, F-test). The prevalence of moderate or severe change among those patients exposed to high doses of PUVA (more than 160 treatments) was low (11%). The degree of increased clinical actinic degeneration noted on the dorsa of the hands was also significantly related to total exposure to PUVA (p less than .05, F-test). Our findings indicate that long-term PUVA exposure is associated with an increase in clinical actinic degeneration of the skin. However, the magnitude of this increase is small and, after more than 5 years, is of limited clinical consequence to most patients. PMID- 3968446 TI - Anti-inflammatory properties of an oxidized sterol. AB - A polar photoproduct of cholesterol oxidation, 7-ketocholesterol, was able to inhibit in a dose-dependent manner the mouse ear-swelling response to irritants such as croton oil or cantharidin. Its anti-inflammatory properties were much less than equivalent concentrations of hydrocortisone, but the oxidized sterol did not induce any systemic effects (as measured by thymolytic activity), as did topical hydrocortisone. It is concluded that 7-ketocholesterol has weak anti inflammatory activity, and its mode of action may be different from that of glucocorticoids. PMID- 3968448 TI - Establishment of proliferative, pure cultures of pigmented chicken melanocytes from neural tubes. AB - In order to obtain pure cultures of chicken melanocytes, neural tubes were excised from 22-somite stage embryos and placed in culture dishes to allow melanoblasts to migrate out and proliferate. The growth of contaminating cells was inhibited by maintaining the primary cultures in low-calcium and low magnesium medium supplemented with 32 nM 12-O-tetradecanoylphorbol-13-acetate (TPA). Subsequently the pure cultures of melanocytes were maintained in Ham's F 10 medium supplemented with TPA. The population doubling time was approximately 12 h. The cell density at confluency in medium containing 32 nM TPA, 80 nM TPA, or 32 nM TPA plus 1 nM cholera toxin was 3.4, 5.6, or 8.3 X 10(4) cells/cm2, respectively. The melanocytes were highly pigmented and had tyrosinase activities ranging from 0.7-5.0 mU/mg protein. PMID- 3968449 TI - Susceptibility of Campylobacter isolates to the bactericidal activity of human serum. AB - Although Campylobacter jejuni and related thermophilic organisms are more common human pathogens than are Campylobacter fetus, most bloodstream or systemic isolates are C. fetus. To understand the pathophysiology related to this observation, the authors studied susceptibility to the bactericidal activity of normal human serum of Campylobacter coli, C. jejuni, and C. fetus isolates from feces and blood. In standardized assays, 10 of 15 C. jejuni and related isolates showed 90% kill (mean, 90.6% +/- 5.9); under more stringent conditions, the relatively resistant strains were completely killed. In contrast, all C. fetus strains were highly serum resistant under both standard and stringent conditions. Killing of C. jejuni was ablated by heating serum to 56 C but restored by addition of complement. Both classical and alternative complement pathways may contribute to killing, and adsorption studies demonstrated antibody dependence. Serum resistance may permit systemic infection by C. fetus, whereas complement- and antibody-mediated serum sensitivity of C. jejuni may account for the relative infrequency of systemic invasion. PMID- 3968450 TI - Seroepidemiological studies of El Tor cholera in Bangladesh: association of serum antibody levels with protection. AB - In rural Bangladesh, family contacts of patients with cholera were studied prospectively to examine whether protection against colonization and disease due to Vibrio cholerae O1 was associated with circulating antibodies to V. cholerae. Family contacts (1,071) of 370 patients with cholera were visited daily for 10 days, cultured for V. cholerae, and queried about diarrhea. Sera collected on days 1 and 21 were assayed for vibriocidal antibodies, IgG and IgA antibodies to cholera toxin, and IgG antibodies to lipopolysaccharide (LPS). Vibriocidal titers of greater than or equal to 20 present in 50% of contacts by 20 years of age were associated with protection against both colonization and disease. An elevated level of IgG antitoxin was not associated with protection against colonization or disease but was the most sensitive indicator of recent symptomatic cholera and of immune response to the oral immunogen B subunit. IgG antibody to LPS and IgA antitoxin were of little value in predicting colonization or disease. PMID- 3968451 TI - An outbreak of infections with Acinetobacter calcoaceticus in burn patients: contamination of patients' mattresses. AB - During a 21-month period Acinetobacter calcoaceticus was the most common organism causing infections in a university burn center. Forty-three of 103 patients admitted became infected with this organism. Risk factors associated with burn wound colonization with Acinetobacter included larger burns and Foley catheter use; however, only a longer duration of hospitalization was an independent discriminator of colonization. Infection-control measures, including strict isolation and closure and repainting of the burn unit, did not prevent the transmission of Acinetobacter. An investigation found that wet mattresses served as environmental reservoirs of Acinetobacter. This finding led to a policy of discarding each patient's mattress on the day of the patient's discharge from the burn unit. Life table analysis demonstrated that this intervention led to a reduced risk of burn wound colonization with Acinetobacter (P less than .05) and ultimately resulted in the complete elimination of the organism from the burn unit. PMID- 3968452 TI - Failed rubella immunization in adults: association with immunologic and virological abnormalities. AB - Immunologic and virological studies were performed in 13 adults (12 women and one man) who failed to seroconvert (as shown by rubella hemagglutination-inhibition [HAI] techniques) after single or repeated courses of HPV-77 DE/5 or RA 27/3 rubella virus vaccine. Immunologic sensitization to rubella virus was assessed from six months to eight years (mean, 3.0 years) after the last course of rubella virus vaccine by using HAI, enzyme-linked immunosorbent assay (ELISA), single radial hemolysis (SRH), neutralization, and virus-specific lymphoproliferative techniques. Despite HAI seronegativity, 11 of 13 subjects demonstrated significant sensitization to rubella virus proteins, as indicated by ELISA (10 of 13), neutralization (9 of 11), SRH (4 of 11), and rubella lymphocyte stimulation techniques (9 of 13). In addition, rubella virus was isolated from three individuals by using cocultivation techniques with peripheral blood mononuclear cells. Failed rubella immunization in adults may have more significance than previously recognized in view of altered patterns of virus-specific immunity and the association of this failure with the rubella virus carrier state. PMID- 3968454 TI - Use of amantadine in the United States, 1977-1982. PMID- 3968453 TI - Population dynamics of ingested Clostridium difficile in the gastrointestinal tract of the Syrian hamster. AB - The population dynamics of Clostridium difficile in the hamster gastrointestinal tract were studied after intragastric inoculation with organisms and a 51Cr tracer. Seventy-eight percent of spores germinated within the small intestine within 1 hr. Germinated spores and vegetative cells both showed two phases of elimination from the hamster cecum--an initial phase of rapid death that was not affected by antibiotic treatment followed by a phase of complete inhibition of multiplication. The latter phase of inhibition was not seen in antibiotic-treated animals and was thus attributable to the indigenous flora. The 51Cr tracer mixed well with cecal contents and was eliminated exponentially with a dilution rate constant ranging from -0.46/hr to -0.31/hr in normal hamsters. The hamster cecum was therefore dynamically analogous to a continuous flow system, a finding supporting the concept that anaerobic continuous flow cultures are useful in vitro models of the cecal ecosystem. PMID- 3968455 TI - Delta infection in a hemodialyzed patient. PMID- 3968456 TI - Molluscum contagiosum, another sexually transmitted disease: its impact on the clinical virology laboratory. PMID- 3968458 TI - Laboratory diagnosis of Streptococcus pneumoniae pneumonia. PMID- 3968457 TI - Persistence of antibodies to Rickettsia conorii after an acute attack of boutonneuse fever. PMID- 3968459 TI - Specificity of persistence of antibody to the streptococcal group A carbohydrate in rheumatic valvular heart disease. AB - The specificity of the persistence of antibody to the streptococcal group A carbohydrate for mitral valve disease induced by rheumatic fever was examined. Levels of the antibody were determined in serum samples of 30 patients with rheumatic mitral insufficiency, 30 patients with mitral valve prolapse, and an equal number of normal individuals and patients with congenital heart disease. Antistreptolysin titers and anti-deoxyribonuclease B titers were also assayed in all sera. There were no differences in the incidence of elevated antibody titers or in the geometric means of the antibody titers for the normal individuals, the patients with congenital heart disease, and the patients with mitral valve prolapse. In contrast, the frequency of elevated anti-streptococcal group A carbohydrate titers and the geometric means of these titers were significantly higher in the patients with rheumatic mitral valve disease than in patients with mitral valve prolapse. This confirms the specificity of the persistent elevation of anti-streptococcal group A carbohydrate to patients with mitral valve disease induced by rheumatic fever and also suggests that the persistence of this antibody in patients with rheumatic valvular disease is not a result of a functional abnormality of the mitral valve. PMID- 3968460 TI - Autopsy calibration of carotid artery B-mode ultrasound imaging: effects of pressure on residual lumen size. AB - The accuracy of B-mode ultrasound (9 MHz) vascular imaging was studied on seven carotid arteries obtained at autopsy. Parallel cross-sectional images on five serial planes of each artery were compared with readings on corresponding sections of silicone rubber replicas of the vessel lumens and with histologic sections. A close correlation between ultrasound and cast measurements was observed (r = 0.88, p less than 0.01), and both corresponded well with histologic measurements. Longitudinal ultrasound views of the arteries were employed to determine changes of normal vessel diameter (maximum lumen diameter) and residual lumen diameter with increasing arterial pressure. In the specimens studied, compression of lesions occurred in addition to circumferential vessel enlargement, and the rate of compression of lesions exceeded that of circumferential vessel diameter enlargement. PMID- 3968461 TI - Effect of prior influenza virus infections on susceptibility of AKR/J mice to respiratory challenge with Legionella pneumophila. AB - Influenza virus administered intranasally to AKR/J mice, followed 3 days later by Legionella pneumophila inoculated intranasally, caused significantly greater mortality than did either of the two agents administered alone. Viable concentrations of both bacteria and viruses dropped in sequentially infected animals, despite the ultimate fatal outcome. Viral concentrations, however, did not decrease as rapidly in sequentially infected as in singly infected mice. Histopathologic lesions were consistent with viral replication aided by elaboration of a bacterial toxin. This observation contrasts with the more commonly observed sequence in which the bacterium proliferates after the virus interferes with host defense. Cell-free preparations were found to have toxic activity. PMID- 3968462 TI - Decreased natural killer cell activity in patients with zinc deficiency with sickle cell disease. AB - Zinc deficiency is associated with depression of a number of immune responses. To assess the relationship of zinc and natural killer activity, we studied natural killer activity in adults with sickle cell disease and in two normal volunteers rendered zinc deficient by dietary restriction. Natural killer activity was significantly lower in patients with sickle cell disease and zinc deficiency (5.1 +/- 2.9 lytic units per 10(6) cells) than in controls (11.7 +/- 5.0 lytic units per 10(6) cells). In the two volunteers, natural killer activity declined during zinc restriction and returned to near initial levels with zinc repletion. These results suggest that zinc deficiency is associated with a lowering of natural killer activity. PMID- 3968463 TI - Laminin selectively enhances monocyte-macrophage-mediated tumoricidal activity. AB - Recent evidence indicates that laminin may be involved in the phenotypic behavior and metastasis of certain tumor cells. We examined the effect of laminin on monocyte-macrophage killing of two human tumor lines, Malme-3M melanoma and CAK-I renal carcinoma. Laminin enhanced both monocyte- and macrophage-mediated tumoricidal activity against human melanoma cells but did not promote monocyte and macrophage killing of CAK-I renal carcinoma cells. Laminin promoted substratum adherence of melanoma cells in a concentration-dependent manner but had no effect on adhesion of the renal carcinoma cells. The monocyte-macrophage cytotoxicity promoted by laminin paralleled its effects on cell substratum adhesion. In addition to an effect on adhesion, laminin also promoted migration of the melanoma cells but not of the renal carcinoma cells. Laminin did not promote the adhesion of monocytes or macrophages. Laminin may promote monocyte macrophage tumor cytotoxicity by increasing the interaction of tumor and effector cells through its effect on target or tumor cells. PMID- 3968464 TI - Noninvasive analysis of skin iron and zinc levels in beta-thalassemia major and intermedia. AB - Diagnostic x-ray spectrometry, a method based on x-ray fluorescence analysis, was used for noninvasive determination of iron and zinc in two distinct skin areas, representing predominantly dermal and epidermal tissues, in 56 patients with beta thalassemia major and intermedia. The mean iron levels in the skin of patients with beta-thalassemia major and intermedia were elevated by greater than 200% and greater than 50%, respectively, compared with control values. The zinc levels of both skin areas examined were within the normal range. The data indicate that the rate and number of blood transfusions, which correlated well with serum ferritin levels (r = 0.8), are not the only factors that determine the amount of iron deposition in the skin (r less than 0.6). Other sources of iron intake contribute to the total iron load in the tissues, particularly in patients who are not given multiple transfusions. The noninvasive quantitation of skin levels may reflect the extent of iron deposition in major parenchymal organs. Repeated DXS examinations of the skin could monitor the clearance of iron from the tissues of patients with iron overload in the course of therapy with chelating agents. PMID- 3968465 TI - Covalent binding of acetaldehyde to hepatic proteins during ethanol oxidation. AB - Acetaldehyde production and the radiolabeling of hepatic proteins were determined in rat liver slices incubated with 14C-ethanol (10 mmol/L). Significant labeling of hepatic proteins occurred in the presence of protein synthesis inhibitors, indicating that, under these conditions, the radiolabeling of protein did not occur via de novo protein synthesis. Additional experiments indicated that the major source of protein-bound radioactivity derived from 14C-ethanol oxidation was the formation of 14C-acetaldehyde adducts with proteins. This conclusion was made from observations that pyrazole, an inhibitor of ethanol oxidation and, therefore, acetaldehyde formation, decreased radiolabeling of protein, whereas cyanamide, which elevated hepatic acetaldehyde levels, markedly increased the labeling of protein. Furthermore, L-cysteine, which can bind acetaldehyde and, therefore, act as an acetaldehyde trap, substantially reduced protein-bound radioactivity. It was also demonstrated that acetaldehyde formed both stable and unstable adducts with hepatic proteins and that unstable adducts may undergo conversion to form stable adducts during incubation. PMID- 3968466 TI - Use of aminophenylboronic acid affinity chromatography to measure glycosylated albumin levels. AB - A simple technique for the measurement of glycosylated albumin by affinity chromatography on m-aminophenylboronic acid agarose columns is presented. The technique relies on bromcresol green determination of albumin in the nonbound and bound fractions. There is a linear correlation between albumin concentration of the bound fraction and glycohemoglobin values in individuals. A control nondiabetic plasma pool with a glycohemoglobin value of 7.10% +/- 0.05% (mean +/- SEM) had a glycoalbumin value of 1.64% +/- 0.06%, while a diabetic control plasma pool with a glycohemoglobin value of 13.63% +/- 0.07% had a glycoalbumin value of 4.02% +/- 0.12%. Compared with results from the affinity technique, the preponderance of colorimetric reaction determined with the thiobarbituric acid procedure is nonspecific, in that it does not correlate with diabetic status or with values derived by the affinity procedure. The bulk of thiobarbituric acid reactive material is present in the fraction of albumin that does not bind to aminophenylboronic acid. This nonbound fraction contains plasma glucose, which significantly interferes with thiobarbituric acid determinations but only very slightly interferes with the affinity procedure. Prolonged incubation of plasma with 500 mg/dl glucose dramatically increases affinity-determined glycosylated albumin. Thiobarbituric acid reactivity increases much less, the increase being mainly in the fraction bound to aminophenylboronic acid. The percentage glycosylated albumin determined by the affinity technique in crude plasma samples differs very slightly, if at all, from that determined by purification of the albumin from plasma. The affinity technique appears very promising for eventual clinical applications in the management of diabetes. PMID- 3968467 TI - Lupus nephritis with thrombosis and abnormal fibrinolysis: effect of ancrod. AB - Recent evidence demonstrates that coagulation plays a role in mediating glomerular damage in patients with systemic lupus erythematosus and diffuse proliferative glomerulonephritis. Because of its beneficial effect in experimental glomerulonephritis, we treated patients with systemic lupus erythematosus and diffuse proliferative glomerulonephritis with ancrod, a drug known to lower fibrinogen levels and thought to activate fibrinolysis. Our patients had unusually severe renal disease; renal function was deteriorating in many. Before ancrod, vascular plasminogen activator levels were low, and levels of an inhibitor of plasminogen activation were elevated. Some patients had elevated plasmin inhibitor levels. Results were considered in two groups. In 13 patients characterized as fibrinolysis responders, the low vascular plasminogen activator and increased plasminogen activation inhibitor levels normalized. After ancrod, striking resolution of microvascular thrombosis occurred, which was associated with some improvement in renal function and blood pressure control. In five patients characterized as fibrinolysis nonresponders and who also had an elevated plasmin inhibitor (alpha 2-antiplasmin) level, normalization of fibrinolysis did not occur. There was little change in microvascular thrombosis, renal function, or blood pressure control in the fibrinolysis nonresponders. These preliminary observations demonstrate a disorder of fibrinolysis in patients with systemic lupus erythematosus with microvascular thrombi in the kidney. Ancrod therapy reverses this disorder rapidly in patients with a normal level of plasmin inhibitor and may lead to repair of glomerular damage. PMID- 3968469 TI - Cerebral CAT scan imaging in schizophrenic and bipolar patients. PMID- 3968468 TI - Normobaric hyperoxia in vivo inhibits fatty acid incorporation into sheep erythrocyte phospholipid in vitro. AB - Oxygen toxicity is a major complication of normobaric hyperoxia in therapeutic settings. Because alterations in membrane function occurring as a consequence of peroxidation of membrane phospholipid fatty acids may be an early event in the pathogenesis of oxygen-induced injury, we studied the effects of hyperoxia on the ability of the membrane to repair itself by incorporating fatty acid via the pathway for deacylation and reacylation in situ. Although the lung is the major site of clinically significant injury, the erythrocyte is also directly exposed to elevated PO2 in vivo. In this study, incorporation of [9,10(-3)H]-oleic acid into phospholipid has been measured in sheep erythrocytes in vitro after exposure of four animals to normobaric hyperoxia in vivo. [9,10(-3)H]-Oleic acid incorporation into erythrocyte phospholipid decreased within 24 hours and reached 50% of pre-exposure levels after 70 hours of exposure to 100% O2. No significant change in the fatty acid composition of membrane phospholipid was detected under these conditions. In contrast to the results with intact cells, incorporation of [9,10(-3)H]-oleic acid into phospholipid by isolated erythrocyte membranes prepared from the cells of two animals increased after 70 hours of exposure to 100% O2, indicating that the inhibition of fatty acid incorporation in intact erythrocytes does not result from irreversible inactivation of the enzymes involved in acylation of endogenous lysophospholipid. Because the ability of cells to replace membrane phospholipid fatty acids via deacylation and reacylation in situ could be important in the maintenance of membrane integrity during oxidative stress, the decrease in fatty acid incorporation by erythrocytes in vitro may reflect an early event in the pathogenesis of oxygen-induced cellular injury. PMID- 3968470 TI - Rabies in Kentucky. PMID- 3968471 TI - Management of papillary cancer of the thyroid. PMID- 3968472 TI - Cross-links between stereocilia in the human organ of Corti. AB - Human cochleae were fixed in glutaraldehyde, without the use of osmium. Cross links were seen between the stereocilia, similar to those we have previously reported for the guinea pig: first, stereocilia of the same row on each hair cell were joined by horizontally-running links; secondly, the shorter stereocilia had pointed tips, each giving rise to a single, vertically-pointing link, which ran upwards to join the adjacent taller stereocilium of the next row. We suggest that distortion of this link is involved in sensory transduction. The links were sparser than had been seen in the guinea pig which may be a reflection of the vulnerability of the links to non-optimal fixation, and the greater difficulty in producing good fixation in human specimens. PMID- 3968473 TI - Comparative crystallography of vertebrate otoconia. AB - Otoconial material was obtained from a number of vertebrates to determine the CaCO3 polymorph present. Otoconia and otoliths from bony fish, amphibians, and reptiles are primarily aragonitic; those from birds and mammals are calcitic. This paper summarizes data from all other investigators as well as presenting new data, particularly pertaining to reptiles. The significance, if any, of the relationship between taxonomic group and carbonate polymorph remains an intriguing question. PMID- 3968474 TI - Mucocoeles of the maxillary antrum. Description, case reports and review of the literature. AB - Mucocoeles of the maxillary antrum extensive enough to cause local bone destruction appear to be extremely rare. Such a case is reported with the appropriate pathological and radiological findings. Perusal of the literature suggests that this condition, unlike mucocoeles arising in other sinuses, may closely mimic a carcinoma and all authors stress the necessity for Caldwell-Luc surgery to be certain of the diagnosis. Som and Shugar (1980) describe features visible on CT scanning which may help to differentiate between mucocoeles, pyocoeles and carcinomata. In spite of the relatively high incidence of cysts of the antrum, it is thought unlikely that mucocoeles in this location would arise from such a cyst; indeed it is likely that all mucocoeles arise from blockage of the outflow tract of the appropriate sinus. There is a high incidence of maxillary sinus mucocoele in Japan following Caldwell-Luc surgery (Hasegawa et al., 1979). Noyek and Zizmor (1976) suggest that compartmentalization of the antrum after operation may leave islands of mucosa without drainage; such a collection may give rise to a mucocoele. PMID- 3968475 TI - Oral submucous fibrosis--treatment with hyalase. AB - Oral Submucous Fibrosis (OSMF) is a disease of unknown etiology. A total of 96 patients with Oral Submucous Fibrosis have received four regimens of treatment- local dexamethasone, local hyaluronidase, local combination of dexamethasone and hyaluronidase, and local placental extract. The patients were followed up for a period varying from 3 months to 2 years. The group of patients receiving hyaluronidase alone showed quicker improvement in symptoms although its combination with dexamethasone gave somewhat better longer-term results. A new regimen for the treatment of submucous fibrosis is recommended. PMID- 3968476 TI - Microsurgical reconstruction of the trachea in rats (an experimental study). AB - This study was carried out to evaluate the use of 'Zenoderm' (enzyme treated procine dermis) as a patch for the repair of tracheal defects in rats, with particular reference to its application in the treatment of some cases of tracheal stenosis. Fifty-three rats were included in the study. Using microsurgical techniques, a defect was created in the cervical trachea and repaired using a suitable patch of 'Zenoderm' (two groups with different sized defects). In a further group of rats, healing of the trachea was studied after excision of a segment and end to end anastomosis. A set number of rats were sacrificed after intervals of 14, 28, 91 and 182 days when the trachea was excised and evaluated. Healing of the tracheae following end to end anastomosis was satisfactory in all cases with no evidence of stenosis. The two groups of tracheae with Zenoderm patches showed progressive stenosis at the area of the repair but there was no evidence of respiratory obstruction or distress. The Zenoderm patch and the regenerating epithelium were both evaluated by light microscopy and scanning electromicroscopy. The Zenoderm patch showed gradual absorption and was replaced by host collagen. There was gradual regeneration of epithelium which showed slow maturation from flat non-ciliated epithelium to partially cuboidal and columnar epithelium with some cilia showing early differentiation to respiratory epithelium. In conclusion, this experimental study confirmed the biocompatibility of 'Zenoderm' in rats. It provided a suitable surface for regeneration of tracheal epithelium. Replacement of the patch by the host collagen is promising but requires further study to assess its rigidity and ability to withstand pressure changes in the trachea. PMID- 3968477 TI - 'Pseudotumors' of the clavicle subsequent to radical neck dissection. AB - The authors describe a rare complication of radical neck dissection, a 'pseudotumor' with fracture of the medial portion of the clavicle. Out of 899 radical neck procedures carried out in the ENT Department of Florence University, there were four such cases. PMID- 3968478 TI - Ossicular chain interruption with present acoustic reflex. PMID- 3968479 TI - Lateral sinus thrombosis in the eighties. AB - In spite of the increasing use of more efficient medical therapy, different types of otogenic intracranial complications continue to occur. A detailed description of two cases of lateral sinus thrombosis illustrates that its present-day clinical course can differ from the traditional clinical picture of the disease. PMID- 3968480 TI - Life-threatening epistaxis in pregnancy. PMID- 3968481 TI - Riedel's thyroiditis discovered at tracheostomy. AB - A 55-year-old woman with a long-standing history of diabetes mellitus controlled with insulin was admitted under the Medical Unit to the Royal Sussex County Hospital, Brighton, on 27 December 1981, with a history of diarrhoea and anorexia of several weeks' duration. Prior to admission she had complained of a cough and her condition had been deteriorating rapidly for two days. On admission she had signs of pneumonia and this was confirmed on chest X-ray which showed diffuse shadowing on the right. The patient was placed on antibiotics, but her condition worsened over the next 24 hours and she suffered a respiratory arrest from which she was, however, successfully resuscitated. Subsequent to this event she was transferred to the Intensive Therapy Unit. Here her condition continued to deteriorate, with bilateral pneumonic changes and an uncertain degree of cerebral damage. On 7 January 1982, the E.N.T. Department was approached with a view to performing a tracheostomy in view of the need for prolonged ventilation. The patient was noted to be clinically myxoedematous and thyroid function tests confirmed this with a free thyroxine level of 0.4 pmol./litre. Other thyroid function tests were: Total T4-2 nmol./l.; TBG-216 nmol./l.; T3U-107; FTI-2. The ESR was 54 mm. in the first hour. PMID- 3968482 TI - Selective attention deficits in high test anxious children: a failure to replicate. PMID- 3968483 TI - A follow-up study of 52 learning disabled adolescents. PMID- 3968484 TI - Achievement level, social class, and the self-concepts of mildly handicapped children. PMID- 3968485 TI - Bisensory integration: an encoding replication. PMID- 3968486 TI - Eye movements in dyslexia: their diagnostic significance. PMID- 3968487 TI - Implications of using microcomputers in classroom testing. PMID- 3968488 TI - Planning and organizing skills of poor school achievers. PMID- 3968489 TI - Changes in the traditional practice of surgery. PMID- 3968490 TI - Intraoperative thrombophlebitis prophylaxis. PMID- 3968491 TI - Laser therapy of tracheobronchial lesions: history and current use. PMID- 3968492 TI - Mohs' surgery for removal of skin carcinomas. PMID- 3968493 TI - The scope of chiropractic practice: limits reaffirmed. PMID- 3968494 TI - Diet and cardiovascular disease: the morbid connection. PMID- 3968495 TI - The challenge to contain costs. PMID- 3968496 TI - Rapid changes in growth hormone regulation and hypothalamic somatostatin after transection of anterolateral pathways to the medial-basal hypothalamus in the rat. AB - Plasma and pituitary GH content, in-vitro GH release and somatostatin-like immunoreactivity (SLI) in the stalk-median eminence were studied up to 7 days after making an anterolateral cut (ALC) around the medial-basal hypothalamus. Plasma GH concentration increased within 15 min to a very high level, then fell to a high level which was unchanged for several hours. The GH concentration then steadily decreased between days 2 and 7. The SLI content in the stalk-median eminence decreased to 3.5% of the control value within 3 days. The GH content of the anterior pituitary gland was 58.8% of the control value by 1 week after the operation but the in-vitro sensitivity to somatostatin of the GH cells failed to change. Pentobarbitone injection stimulated GH release in the sham-operated controls but decreased it in the rats with an ALC. These findings suggest that transection of somatostatin-containing fibres is followed by a rapid rise and a lasting high concentration of plasma GH which slowly returns towards lower levels in parallel with a marked depletion of pituitary GH content. In rats with transected somatostatin innervation of the median eminence, sodium pentobarbitone probably decreases GH secretion by depressing the secretion of GH-releasing hormone. PMID- 3968497 TI - Menstrual cycle and exposure to oestrogens unopposed by progesterone: relevance to studies on breast cancer incidence. AB - It is claimed that the exposure of women to oestrogens unopposed by progesterone increases the risk of breast cancer. Despite indirect evidence in support of this claim, the impracticability of monitoring oestrogen and progesterone levels in large numbers of women for prolonged periods of time has meant that no direct demonstration of the effect has been made. A possible technique is suggested. The ratio (R) of oestrogens to pregnanediol in urine has been used as an index of oestrogen exposure relative to progesterone. Samples were collected at weekly intervals on 700 occasions from 30 perimenopausal women, and on 519 occasions from 66 women with a history of regular menstrual cyclicity. Unusually prolonged episodes of unopposed high oestrogen excretion (R greater than or equal to 100 for greater than or equal to 2 successive weeks) were observed on 30 occasions in 15 of the perimenopausal women and on four occasions in the other women. In the perimenopausal group, these episodes occurred in 46.9% of the 32 menstrual cycles which were longer than 50 days compared with 6.9% of the 72 cycles which were shorter than 35 days (P less than 0.001). The association of prolonged episodes of unopposed high oestrogen excretion with long menstrual cycles suggests the possibility of using menstrual cycle length as an index of oestrogen exposure during the menopausal transition. PMID- 3968498 TI - Influence of angiotensin II on the concentration of arterial plasma electrolytes in anaesthetized sheep. AB - Angiotensin II and I significantly raised potassium and lowered sodium and chloride ion concentrations in arterial plasma, with peak changes occurring in the first 2 min of a 6-min infusion period. The octapeptide increased the arterial K+ level in a dose-dependent manner, but the response showed tachyphylaxis when multiple infusions of 6-min duration were administered after a recovery interval of only 5 min. Raising the arterial blood pressure by 20-33 mmHg with adrenaline and noradrenaline failed to account for the increase in arterial plasma K+ concentration produced by the two peptides. These findings, in particular the rise in K+ concentration, are discussed in relation to possible mechanisms by which angiotensin II affects arteriolar tone. PMID- 3968499 TI - Lack of direct inhibitory action of oxytocin on progesterone production by dispersed cells from human corpus luteum. AB - Suspensions of luteal cells were prepared from samples of human corpora lutea obtained during the luteal phase of menstrual cycles. Addition of oxytocin (1 mumol/l) to the various cell preparations had no effect on either basal production of progesterone or on steroidogenic responses to a range of concentrations of gonadotrophin. PMID- 3968500 TI - Passive immunization against progesterone inhibits endometrial sensitization in pseudopregnant mice and has antifertility effects in pregnant mice which are reversible by steroid treatment. AB - Pregnant mice were injected 32 h post coitum (p.c.) with a monoclonal antibody against progesterone (5.7 or 9.5 nmol immunoglobulin G (IgG)) or 0.9% (w/v) NaCl (controls). Progesterone was injected starting on day 2, 3, 4 or 5 p.c. Progesterone reversed the antifertility effect of the lower dose of antibody when replacement began on day 2, 3 or 4, though the number of implantation sites was reduced when treatment started on day 3 or 4. By day 5 only one of six treated animals remained pregnant, showing that antibody action was reversible only up to day 4. At the higher dose of antibody, exogenous nidatory oestrogen was also required. Pseudopregnant mice were injected 32 h p.c. with this antibody (5.7 nmol IgG) or 0.9% NaCl (controls). At 16.00 h on day 4 p.c., oil was injected into the lumen of one uterine horn and the magnitude of the decidual cell reaction was assessed 72 h later. Injected horns of antibody-treated females did not respond to intraluminal oil, whereas those of control mice increased fivefold in weight. Steroid treatment after the induction stimulus did not promote decidual growth, indicating that passive immunization reduced endometrial sensitivity. The results show that in the event that antibody fails to arrest the development of all embryos, the absence of endometrial sensitization will preclude the initiation of implantation, unless progesterone is given within 48 h of antibody treatment. PMID- 3968501 TI - The role of fetal adrenal hormones in the switch from fetal to adult globin synthesis in the sheep. AB - The switch from gamma (fetal) to beta (adult) globin production was studied by the analysis of globin synthesis in chronically cannulated ovine fetuses and newborn lambs. The gamma/alpha globin synthesis ratio decreased from 0.98 +/- 0.11 (S.D.) (n = 4 samples) at 100-120 days of gestation to 0.15 +/- 0.07 (n = 4) in lambs of 150-156 days post-conception, and the beta/alpha synthesis ratio increased from 0.04 +/- 0.06 (n = 4) to 1.13 +/- 0.21 (n = 4) over the same period. In bilaterally adrenalectomized fetuses, which survived in utero until 151-156 days, the gamma/alpha and beta/alpha synthesis ratios were 0.64 +/- 0.14 (n = 3) and 0.25 +/- 0.07 (n = 3) respectively in the 150- to 156-day period. Bilateral adrenalectomy did not affect the time of onset of beta globin synthesis, but significantly decreased the rate. In one bilaterally adrenalectomized fetus the infusion of increasing concentrations of cortisol restored the rate of beta globin synthesis to normal. Treatment of three intact fetuses with 100 micrograms cortisol/h for 3 weeks, from 100 to 121 days, did not affect the timing or rate of switch from gamma to beta globin synthesis. Thus fetal adrenal secretions, probably cortisol, affected the rate of change of gamma to beta globin synthesis but other factors must have been involved in the initiation of the switch. PMID- 3968502 TI - Calcitonin may modulate placental transfer of calcium in ewes. AB - In pregnant ewes bearing twin fetuses and fed an adequate Ca diet, the consequences of calcitonin (CT) deficiency (induced by thyroidectomy performed on day 30 of gestation, associated with daily thyroxine supplementation) differed according to the time of pregnancy. Such a deficiency had no significant effect either on fetal total body Ca content or on placental transfer of Ca in 77-day old fetuses. On the contrary, CT deficiency for 110 days (on day 140 of pregnancy) was associated with an increased Ca concentration in fetal total body and increased placental transfer of Ca from the dam to its fetus, which did not occur in five thyroidectomized ewes supplemented with thyroxine and CT. This indicates that CT might protect the skeleton of the pregnant female against excessive demineralization by modulating placental transfer of Ca, when such a transfer become important, during periods of intense mineralization of the fetal skeleton. PMID- 3968503 TI - Dopamine enters lactotrophs and reaches their secretory granules. AB - The presence of dopamine in the lactotroph cell, as well as in isolated prolactin secretory granules, was demonstrated by means of an histochemical reaction for electron microscopy. Biochemical assays further confirmed the presence of dopamine in the secretory granules. Autoradiographic preparations examined by light microscopy showed dopamine internalization in dispersed anterior pituitary cells. Isolated anterior pituitary lactotroph cells incorporated more [3H]dopamine than a fraction containing other anterior pituitary cells. PMID- 3968504 TI - Water and electrolyte contents, cell pH and membrane potentials of cultured turtle thyroid cells. AB - Water and electrolyte contents, cell pH, membrane potential and 125I- uptake were determined in cultured follicular cells of turtle thyroid. The Na+, K+ and Cl- concentrations in the cultured thyroid cells were 59.2, 119.0 and 50.9 mmol/l cell water respectively. Treatment with TSH (10 mu./ml for 24 h) increased the K+ and Cl- and decreased the Na+ concentrations in cells. The water and protein contents of these cells were 81.6 and 8.7 g/100 g cells respectively. The cell pH was 6.91. With glass micro-electrodes, the resting membrane potential of thyroid cells cultured in Medium 199 averaged 33.9 +/- 0.63 mV which is slightly higher than 29.8 +/- 1.6 mV as calculated from the data on the uptakes of [14C]methyltriphenylphosphonium and 3H2O by the cells. The potential varied linearly with the log of external K+ concentration (between 15 and 120 mmol/l) with a slope of about 24 mV per tenfold change in K+ concentration. Both TSH and cyclic AMP depolarized the cell membrane. Calculations based on the values for the electrolyte concentrations in cells and in culture medium indicated that Na+, K+ and Cl- were not distributed according to their electrochemical gradients across the cell membrane. Na+ was actively transported out of the cells and K+ and Cl- into the cells. Follicular cells of turtle thyroid cultured in the medium without addition of TSH formed a monolayer. Their iodide-concentrating ability was low and they did not respond to TSH with an increase in iodide uptake. In contrast, cells cultured in medium containing TSH tended to aggregate and organize to form follicles. They had higher ability to concentrate iodide and respond to TSH. PMID- 3968505 TI - Intravenous growth hormone: growth responses to patterned infusions in hypophysectomized rats. AB - Young hypophysectomized rats were maintained with chronic indwelling i.v. cannulae attached via swivels to a multichannel pumping system programmed to deliver GH in a continuous or pulsatile pattern for several days. Continuous i.v. infusions of human GH for 5 days produced dose-dependent increases in body weight and tail length, without increasing food intake. A comparison of GH infusions by the s.c. or i.v. route showed that the direct i.v. route was threefold more effective. Pulsatile i.v. infusions of human or bovine GH at two doses (12 or 36 mu./day, eight pulses/day, 5-min duration, every 3 h) produced greater increases in body weight than continuous i.v. infusions of GH at the same daily dose. Continuous infusions of bovine GH produced a lower growth rate in the second of two consecutive 5-day treatment periods, whereas the responses to pulsatile GH did not diminish with time. Both body weight gain and long-bone growth were affected by the frequency of GH pulses; nine pulses per day were more effective than three pulses per day which in turn produced larger growth responses than one pulse per day. Keeping GH pulse frequency constant and varying pulse duration (4, 16 or 64 min) did not affect growth rates. In conclusion, long-term pulsatile i.v. infusions of GH mimic the endogenous secretory pattern, and are most effective when given at the physiologically appropriate pulse frequency. PMID- 3968506 TI - Non-protein-bound oestradiol and progesterone in human peripheral plasma before labour and delivery. AB - Plasma samples were obtained at weekly intervals from the peripheral circulation of 12 women in the last 2-7 weeks of pregnancy. The concentrations of oestradiol and progesterone (isolated by chromatography) were measured by radioimmunoassay; the proportion of each hormone which was not bound to protein was measured by steady-state gel filtration. From these, the apparent concentration of the non protein-bound form of each hormone was calculated. The mean proportion of oestradiol not bound to protein varied from 0.84 to 2.71% in the different subjects, but within each subject variation was within experimental error. For progesterone, the mean proportion not bound to protein in the different subjects varied from 1.76 to 2.77%; within individuals the proportion remained essentially constant. There was no consistent, recognizable trend as labour approached in the concentration of oestradiol; the concentration of progesterone; the concentrations of non-protein-bound oestradiol or non-protein-bound progesterone; the ratio of the concentrations of progesterone and oestradiol; the ratio of the concentrations of non-protein-bound progesterone and oestradiol. In nine out of 12 subjects, the ratio of the concentration of non-protein-bound progesterone to that of non-protein-bound oestradiol was greater than the corresponding ratio based on total hormone concentrations. These results therefore provide no support for the hypothesis that human labour is preceded by alteration in the progesterone to oestradiol ratio which can be detected by measurement of these hormones in peripheral blood. PMID- 3968507 TI - Hormone concentrations, mammary development and milk yield in goats given long term bromocriptine treatment in pregnancy. AB - Ten British Saanen goats were treated daily with 5 mg bromocriptine intramuscularly from week 8 of pregnancy until week 20 (day 140). By comparison with untreated control goats (n = 8), concentrations of prolactin in plasma were suppressed throughout the treatment period and remained significantly lower until 3 days prepartum, parturition occurring on day 153 +/- 0.7 (mean +/- S.E.M., n = 10). Growth hormone concentrations were low, but the incidence of levels exceeding 1 microgram/l was increased in bromocriptine-treated goats. Plasma concentrations of placental lactogen, progesterone and oestrone sulphate were unaffected. The accumulation of pre-colostrum in the udder (lactogenesis stage I) was not affected by bromocriptine treatment in goats carrying twin fetuses, but in goats with single kids it was delayed by about 4-6 weeks to week 17 of pregnancy. Secretion could not be expressed from the udder and the concentration of alpha-lactalbumin in plasma remained low. Udder volume was significantly reduced in week 15-16 but not week 20-21 of pregnancy by bromocriptine treatment. Milk yields after 50 or 203 days of lactation were not significantly different from those in control goats. Placental lactogen concentrations in late pregnancy and udder volume in week 20-21 were the only variables measured which correlated with milk yield post partum. It is concluded that in vivo placental lactogen is an effective mammotrophic hormone, although less potent than prolactin as evidenced by the delay in lactogenesis stage I in bromocriptine-treated goats bearing single kids. PMID- 3968508 TI - Autoradiographic studies of androgen-binding sites in the rat urogenital sinus and postnatal prostate. AB - Binding sites of [3H]testosterone and [3H]dihydrotestosterone in the rat fetal urogenital sinus and postnatal prostate and vagina grown in vitro were examined by steroid autoradiography. Distinct nuclear incorporation of both androgens appeared between 14.5 and 16.5 days of gestation in rat fetuses. Nuclear labelling in the sinus was restricted to the mesenchyme surrounding the epithelium which showed no nuclear labelling. A similar distribution of labelled cells was observed in male and female sinuses up to 18.5 days of gestation. By 20.5 days of gestation, the labelling in the ventral mesenchyme of female urogenital sinuses became less intense but persisted in the mesenchyme of the dorsal sinus wall from which the vagina is formed. In the postnatal prostate, the epithelium showed nuclear [3H]testosterone labelling at 10 days coinciding with the onset of its functional differentiation. Epithelial labelling became more intensive at 4 weeks post partum while that of the mesenchyme declined. The results suggest two phases of androgen action: formation of the prostatic buds mediated by the androgen-activated mesenchyme of the fetal urogenital sinus and the differentiation of the postnatal prostatic epithelium directly stimulated by androgens. PMID- 3968509 TI - Peripubertal changes in the nature of LH. AB - Administration of pregnant mare serum gonadotrophin (PMSG) to peripubertal rats, aged 27 days, induces ovulation provided the animals weigh more than 60 g at the time of the injection. In an attempt to determine whether the apparent immaturity of the ovaries in smaller rats is associated with an inability of the pituitary gland to secrete LH, the biological and immunological properties of LH in peripubertal PMSG-treated rats were examined. A single injection of PMSG caused a marked hypersecretion of LH in rats aged 27 days. The LH in the plasma of rats weighing more than 60 g was active in both the radioimmunoassay and the cytochemical bioassay but that in smaller rats was active only in the former. Plasma from both groups of rats stimulated the release of testosterone from dispersed Leydig cells. Luteinizing hormone-releasing hormone stimulated the secretion, in vitro, of immunoreactive, cytochemically active LH by pituitary tissue from rats weighing over 60 g. The LH released in vitro from tissue from the smaller animals, like that in their plasma, was active in the radioimmunoassay but not in the cytochemical system. The results suggest that an abrupt change in the nature of LH occurs at puberty and that ovulatory cycles commence only when the pituitary gland secretes the adult form of LH with a full spectrum of biological activity. PMID- 3968510 TI - Oxytocin and vasopressin in rat hypophysial portal blood: experimental studies in normal and Brattleboro rats. AB - Oxytocin (OT) and vasopressin (VP) were measured by radioimmunoassay in hypophysial portal and peripheral blood from male Wistar rats and heterozygous and homozygous Brattleboro rats anaesthetized with urethane. In Wistar rats the concentrations of OT and VP were about 50 times greater than the concentrations in peripheral blood, whether or not the pituitary gland was left in situ during collection, and also considerably greater than the reported concentrations of the peptides in the cerebrospinal fluid. The release of both peptides was increased significantly by a lesion of the supraoptico-hypophysial tract that led to diabetes insipidus, but which left intact the external layer of the median eminence (ME). Concentrations of VP were undetectable in plasma from homozygous Brattleboro rats, but the portal plasma concentrations of VP in heterozygous Brattleboro rats were not significantly lower than in Wistar rats. The concentrations of OT in portal plasma from both types of Brattleboro rat were significantly higher than in Wistar rats. The output of VP and OT into hypophysial portal blood of Wistar rats was not significantly affected by electrical stimulation of the suprachiasmatic, supraoptic or paraventricular nuclei or the ME using two types of stimuli, one of which produced an increase in peripheral plasma concentrations of VP and OT in intact rats and a significant increase in the release of LH-releasing hormone into hypophysial portal blood. The output of VP and OT into portal blood was also not significantly affected by either adrenalectomy with or without injection of dexamethasone or the injection of either the 5-hydroxytryptamine (5-HT) synthesis blocker, parachlorophenylalanine, or the 5-HT uptake blockers, alaproclate or zimelidine. These results show that large amounts of OT as well as VP are released into hypophysial portal blood from fibres of the hypothalamo-neurohypophysial system that terminate in the external layer of the ME. Although distinct from the fibres that terminate in the pars nervosa (PN), the findings in Brattleboro rats show that the VP fibres of the ME system originate in neurones with a genomic mechanism for VP synthesis similar to that of the VP neurones that project to the PN. The lack of effect of adrenalectomy and the administration of 5-HT synthesis and uptake blockers must be interpreted with caution since the results obtained with electrical stimulation suggest that when the pituitary stalk is cut the release of OT and VP into portal blood approaches a maximum and may therefore be difficult to alter by experimental manipulation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3968511 TI - Drinking-induced changes in fowl adrenocortical activity: effect of visual and non-visual stimuli. AB - The deprivation of drinking water for 30 h resulted in increased corticosterone concentrations in the plasma of 8- to 10-week-old chickens. When water-deprived birds were allowed to drink ad libitum the corticosterone concentration declined within 45 min, to the level in hydrated controls, and remained suppressed thereafter. Similar reductions in the corticosterone concentrations were also observed in water-deprived chicks which were allowed to drink for only 5 min, 1 min or 5 s. The involvement of visual stimuli in mediating this adrenocortical response was demonstrated by a comparable decline in the corticosterone concentration in water-deprived birds which were presented with water but not allowed access to it. Non-visual stimuli also appeared to be causally involved in the adrenocortical suppression after drinking, since the intraperitoneal injection of tap water (40 ml per bird) also resulted in a lowering of the corticosterone level. However, in the absence of appropriate reinforcement from metabolic stimuli, a rebound in the corticosterone concentration was observed in birds prevented from drinking, in birds unable to satiate their thirst and in birds rehydrated (orally or intraperitoneally) without feeding. These results demonstrate adrenocortical suppression in water-deprived chickens after free access to food and water and the involvement of visual and non-visual stimuli in mediating this response. The maintenance of adrenocortical suppression is dependent upon metabolic stimuli associated with food and water intake. PMID- 3968512 TI - Contrasting effects of prolactin on luteal and follicular steroidogenesis. AB - To determine whether prolactin affects both luteal and follicular production of testosterone and oestradiol, pseudopregnant rats, either intact or hypophysectomized on day 8, were injected daily between days 8 and 9 with 1.5 i.u. human chorionic gonadotrophin (hCG), 250 micrograms prolactin or a combination of both. Control rats were given vehicle. On day 9, blood was obtained from the ovarian vein and corpora lutea and follicles were isolated and incubated in vitro for 2 h. Administration of hCG to intact rats increased ovarian secretion of testosterone and oestradiol dramatically, but did not affect progesterone secretion. Hypophysectomy on day 8 of pseudopregnancy was followed by a drop in ovarian steroid secretion. Prolactin treatment of hypophysectomized rats markedly enhanced progesterone production but had no stimulatory effect on either testosterone or oestradiol. In contrast, hCG dramatically enhanced ovarian secretion of both testosterone and oestradiol without affecting progesterone secretion. Prolactin administered together with hCG antagonized the stimulation of both testosterone and oestradiol secretion by hCG, yet increased progesterone production. When the specific effects of hCG and prolactin administration on follicles and corpora lutea were studied separately, it was found that hCG treatment in vivo greatly stimulated testosterone and oestradiol production by both tissues in vitro. Since hCG only marginally affected aromatase activity in the follicle, had no effect on aromatase activity in luteal cells and did not increase progesterone synthesis, it appears that hCG acts to increase the formation of androgen substrate for oestradiol biosynthesis. Prolactin, administered with or without hCG, inhibited both basal and hCG-stimulated testosterone and oestradiol synthesis by the follicle. In sharp contrast to its inhibitory effect on follicular production of steroids, prolactin appears to be essential for LH stimulation of testosterone and oestradiol by the corpus luteum. In the absence of prolactin, luteal cells gradually ceased to respond to LH and decreased their output of testosterone and oestradiol. Prolactin administration to hypophysectomized rats did not affect luteal cell production of either steroid. However, corpora lutea of rats treated with prolactin responded to the hCG challenge with an increase in testosterone and oestradiol synthesis. In summary, results of this investigation demonstrate that prolactin affects follicular and luteal production of testosterone and oestradiol in opposite ways.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3968513 TI - A solid-phase radioimmunoassay for human corticosteroid binding globulin. AB - A radioimmunoassay (RIA) for human corticosteroid binding globulin (CBG) has been developed using 125I-labelled CBG and a monospecific solid-phase CBG-antiserum (CBG-Ab-cellulose). In an RIA of serum CBG concentrations, pure CBG standards (1 100 ng protein) or samples (1:200) were incubated (16 h at 20 degrees C) with 125I-labelled CBG and CBG-Ab-cellulose. After addition of 2 ml 0.9% NaCl, the tubes were centrifuged, supernatants were aspirated and the 125I-labelled CBG bound to the CBG-Ab-cellulose pellet was counted. The specificity of the RIA was confirmed by parallel displacement curves for serial dilutions of male, female and pregnancy sera, as well as pure CBG standards. The mean +/- S.D. recovery (99 +/- 8%) of pure CBG (1.6-25.0 ng) added to a diluted serum sample verified the accuracy of the method, and a good correlation (r = 0.97; n = 43) existed between serum CBG cortisol binding capacity (nmol/l) measurements and CBG concentrations (mg protein/l) measured by RIA. Intra- and interassay precisions (C.V.) at low to high serum CBG concentrations were less than 5% and less than 9% respectively. The mean +/- S.D. serum CBG concentrations (mg protein/l) measured by the RIA were: 21.8 +/- 4.6 in boys (n = 12), 20.0 +/- 4.2 in girls (n = 9), 20.7 +/- 2.7 in men (n = 6), 20.5 +/- 2.9 in women (n = 6) and 47.1 +/- 10.5 in pregnant women (n = 5).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968514 TI - Identification and characterization of a human corticosteroid binding globulin variant with a reduced affinity for cortisol. AB - A corticosteroid binding globulin variant (CBGv) has been identified in a serum sample taken from an apparently healthy woman during late pregnancy. Identification was based on the observation that it exhibited approximately half the cortisol binding capacity expected when compared to its concentration measured by radioimmunoassay (RIA). Affinity purification of CBGv excluded the possibility that this anomaly was caused by assay interference, and demonstrated that immunoreactive CBGv was capable of binding cortisol. The CBGv had a molecular weight (63 800) similar to normal CBG, and no evidence of molecular aggregation was found by gel filtration. Although the electrophoretic mobility, isoelectric profile and immunochemical identity of CBGv appeared to be similar to normal CBG, it focussed as two distinct bands (pI 5.48 and pI 5.53) after desialylation with neuraminidase, unlike normal CBG which focuses only at pI 5.48. Investigation of the steroid binding characteristics of CBGv revealed a reduced association-rate constant (Ka = 1.05 X 10(9) l/mol) and dissociation half time (12.5 min) when compared with normal CBG (Ka = 1.39 X 10(9) l/mol and 25 min at 0 degree C) but an apparently normal steroid binding specificity. Although the physiological significance of this variant is not known, the cortisol concentration in the variant serum was within the normal range of women during late pregnancy. No other CBG variants were identified among other normal controls (n = 66) or nine patients with Cushing's syndrome. It is suggested that comparisons between cortisol binding capacity and RIA will reveal other variants of CBG, and lead to greater understanding of their physiological significance. PMID- 3968515 TI - Human thyroid cells in monolayer retain the ability to secrete tri-iodothyronine in response to thyrotrophin. AB - Confluent monolayer cultures of human thyroid cells secreted low levels of immunoassayable tri-iodothyronine (T3) and this process could be stimulated by TSH in a concentration-dependent manner. The characteristics of the response to TSH were related to the age of the thyroid cell culture both in terms of the relative sensitivity to TSH and the quantity of T3 released. Cells which had been in culture for 2-3 days (primary cultures) secreted high levels of T3 under unstimulated and TSH-stimulated conditions with a median effective dose (ED50) for TSH of 0.030 mu. TSH/ml. However, cells which had been subcultured and consequently had been in culture for a longer period of 6-7 days secreted lower levels of T3 under basal and stimulated conditions. This was approximately 30% of that released from primary cultures with and ED50 for TSH of 0.1 mu. TSH/ml. Reorganization of human thyroid cells into follicular structures was seen during growth with TSH but these cultures showed little response to subsequent acute stimulation by TSH; the return of a diminished, less sensitive response to TSH was seen after a recovery period of 8 h. The time-course of T3 release was dependent on the TSH concentration with low TSH concentrations stimulating T3 secretion after increased incubation periods. Human thyroid cells had lost the ability to concentrate and organify free iodide after several days in culture but were still secreting T3. This indicates the presence of intracellular stores of T3 which are released on stimulation with TSH, rather than new synthesis of T3. PMID- 3968516 TI - Social factors and puberty in female rats. AB - The effects of postweaning social conditions on the age of puberty were studied in female rats from an early- and a late-maturing strain. The postweaning living conditions consisted of the presence or absence of an adult rat (intact or gonadectomized male, or intact female), or of bedding soiled by adult males. The infantile females exposed to these conditions were caged either singly or with three peers. Puberty was studied in terms of first ovulation, verified always by ovarian histology. Females of the late-maturing strain living without peers reached puberty about 2 days earlier than females that grew up in groups of four, irrespective of the presence or absence of an adult animal. In neither strain was puberty accelerated by the presence of intact males or the soiled bedding of such males. These results do not support the view that in the rat pheromones from adult males enhance puberty in females, contrary to what is known to happen in the mouse. PMID- 3968517 TI - Effects of pregnant mare serum gonadotrophin and oestradiol benzoate on enzymes associated with xenobiotic metabolism in immature and hypophysectomized female rats. AB - Treatment of immature (22-day-old) female Sprague-Dawley rats with pregnant mare serum gonadotrophin (PMSG) resulted in a significant increase in hepatic microsomal cytochrome P-450 concentrations when compared with animals treated with 0.9% (w/v) NaCl solution. Cytochrome P-450 concentrations in microsomes from control and PMSG-treated animals were 0.49 +/- 0.07 and 0.78 +/- 0.18 nmol/mg microsomal protein respectively (mean +/- S.D.). When hypophysectomized rats were treated with PMSG no significant difference was observed between saline-treated and PMSG-treated animals (0.84 +/- 0.06 vs 0.88 +/- 0.08 nmol/mg microsomal protein). Cytochrome b5 concentration and NADPH-cytochrome c reductase and ferricyanide reductase activities were not significantly affected by PMSG treatment. Similar results were obtained when immature and hypophysectomized rats were treated with oestradiol benzoate. Hepatic glutathione (GSH) S-transferase activity was significantly stimulated over control values when hypophysectomized or immature animals were treated with PMSG, oestradiol benzoate or 3 methylcholanthrene. Treatment of animals simultaneously with PMSG or oestradiol benzoate and 3-methylcholanthrene resulted in higher transferase activity than did either treatment alone. Oestradiol benzoate or PMSG treatment of immature female rats resulted in an approximate twofold increase in hepatic aryl hydrocarbon hydroxylase (AHH) activity. However, AHH activity in hypophysectomized animals was not significantly increased by PMSG or oestradiol benzoate treatment. It is concluded that PMSG or oestradiol benzoate treatment of immature female rats resulted in increased total cytochrome P-450 concentration and AHH activity in hepatic microsomes. Glutathione S-transferase activity was also stimulated. Neither PMSG nor oestradiol benzoate stimulated cytochrome P-450 levels or AHH activity in hypophysectomized rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968519 TI - Medical ethics. PMID- 3968520 TI - Criteria-based evaluation and continuing medical education. PMID- 3968518 TI - Spontaneous production of fibroblast-activating factor(s) by synovial inflammatory cells. A potential mechanism for enhanced tissue destruction. AB - A characteristic feature of rheumatoid arthritis is hyperplasia of the synovial lining cells and fibroblasts, the source of tissue-degrading mediators, in association with the appearance and persistence of lymphocytes in affected joints. Diseased synovial tissue obtained at arthroscopy from 10 of 12 rheumatoid arthritis patients was found to release a factor(s) that could stimulate quiescent fibroblasts to proliferate in vitro. Mononuclear cells isolated from this synovial tissue and from the synovial fluid spontaneously produced fibroblast-activating factor(s) (FAF). In contrast, synovial tissue from patients with noninflammatory joint disease did not release FAF. By gel filtration, FAF was detected in two peaks (40,000 and 15,000 mol wt) that were consistent with the previously described peripheral blood T lymphocyte- and monocyte-derived factors with identical activity. The mononuclear cells were predominantly OKT3+/Leu-1+ T lymphocytes and OKM1+ cells of monocyte/macrophage lineage that expressed HLA-DR antigens, suggesting prior activation of these cells. Mononuclear cells isolated from the peripheral blood of these patients did not spontaneously secrete FAF. Lymphocytes and monocytes from the site of synovial inflammation appear to be activated in situ to produce factors that may contribute to the hyperplasia and overgrowth of the synovial membrane in rheumatoid arthritis. PMID- 3968521 TI - Clinical application of a high-risk scoring system on a family practice obstetric service. AB - A previously described antepartum risk-scoring system was evaluated in 113 consecutive deliveries done by family physicians to determine whether a request for obstetric or pediatric assistance could be predicted. In the defined low-risk group (score less than or equal to 3) assistance was requested in 12 of 72 patients. In the defined high-risk group (score greater than 3) assistance was requested in 23 of 41 patients. Out of 28 requests for obstetric assistance, 22 requests were for a specific skill (cesarean sections, difficult forceps, premature deliveries, shoulder dystocia, and retained placenta). All of the 27 requests for pediatric assistance were for acute resuscitation of the newborn. Reinforced in this study was the finding that a relatively small segment of patients (36 percent of the population) gave rise to most (67 percent) of the morbidity. Knowledge of this simple, reliable method to predict high-risk obstetric patients should help family physicians reduce maternal and infant morbidity. PMID- 3968522 TI - The relationship of breast feeding to third-day bilirubin levels. AB - The purpose of this study was to determine the relationship of feeding method to serum bilirubin levels on the third day of life. Two hundred eighty-one apparently healthy full-term neonates had third-day bilirubin levels drawn between 58 and 82 hours of age. Mean serum bilirubin levels were 5.6 mg/dL for formula-fed, 6.9 mg/dL for mixed-fed, and 7.5 mg/dL for breast-fed infants. The difference was statistically significant (P less than .01) between the formula fed and breast-fed groups. Breast-fed infants lost more weight by the third day than formula-fed infants (mean weight loss 180 g for breast-fed infants, 100 g for formula-fed infants). A third-day bilirubin levels among the feeding groups were then compared using an analysis of covariance with weight loss as the covariate. By this method, type of feeding was still a significant predictor of third-day bilirubin levels (P = .04) as was weight loss (P = .03). PMID- 3968523 TI - The use of patients' preferences in family practice. AB - The use of patients' preferences enables physician and patient to share responsibility for decision making. The use of preferences is especially appropriate when there is diagnostic uncertainty or when several alternative management strategies are available. When preferences are used, clinicians are likely to become sensitive to details of individual patients' lives that affect their illnesses and their responses to illnesses. Patient preferences may be influenced by how information is presented to them and by recent experiences in their own lives or in the lives of someone close to them. For effective decision making to occur, both physician and patient should be comfortable with the amount of decision-making responsibility given to each. PMID- 3968524 TI - Adult day centers: geriatric day health services in the community. AB - In the past decade, more attention has been devoted to community-based health care services for the impaired elderly. The adult day services center is one of the newer approaches to this kind of care. Adult day centers show a wide variety of services, staff, and settings, and these centers serve elderly patients with a wide variety of disabilities. Some day programs provide physical and psychosocial rehabilitative services; others offer longer term maintenance and supervision, social stimulation, and respite care. Many centers offer some combination of these services. For the family physician, this variation provides a range of health care choices and treatment options aimed at improving function and avoiding unnecessary or premature institutionalization of the elderly patient. PMID- 3968526 TI - Assessment of physician performance of cardiopulmonary resuscitation. AB - Physician performance was assessed in cardiopulmonary resuscitation (CPR) by the number and type of errors committed. In simulated arrests, physicians previously certified in advanced life support made fewer errors (5.6 vs 14.3, P = .007) than those not certified. Senior house staff made fewer errors than junior house staff (5.8 vs 10.9, P = .05). Guidelines for successful completion of these simulations were developed. This study indicates the need for continued physician education in CPR. PMID- 3968525 TI - Professional stress among family physicians. AB - Professional stress syndrome was investigated among residents, academic physicians, and community physicians in family practice. A survey including measures of physician stress, depression, locus of control, family and peer support, and medical practice characteristics was completed by 294 physicians. Univariate analysis of variance procedures were used for all statistical tests. Results revealed a significant positive correlation among perceived stress in medical practice, depression, and external locus of control. Decreased levels of stress were associated with higher scores on indices of family and physician-peer support. Differences in stress patterns between residents, faculty, and community physicians emerged on several critical variables. Residents felt professional duties interfered with family life to a greater extent than did faculty or practitioner colleagues. Community physicians report higher levels of family support, less idealism, and greater sense of personal control. The stress and coping model proposed illustrates how environmental, as well as internal, factors are affected by stress and serve as moderators of the stress response. PMID- 3968527 TI - Arthrocentesis. AB - Aspiration of the synovial joints is an important part of the diagnostic and therapeutic armamentarium of the physician and may provide vital information that can be obtained in no other way. As with any other technique in medicine, skill and safety in the aspiration of joints can be acquired only through careful study and continued practice in arthrocentesis. When appropriate preparations and precautions are observed, obtaining fluid from synovial joints is safe, relatively pain free, inexpensive, and extremely beneficial to the patient. PMID- 3968528 TI - Patient characteristics and endocervical cell recovery on Papanicolaou smears. PMID- 3968529 TI - Take these hands: an address to graduating family practice residents. PMID- 3968530 TI - Slow charge movement in mammalian skeletal muscle. AB - Voltage-dependent charge movements were measured in the rat omohyoid muscle with the three-microelectrode voltage-clamp technique. Contraction was abolished with hypertonic sucrose. The standard (ON-OFF) protocol for eliciting charge movements was to depolarize the fiber from -90 mV to a variable test potential (V) and then repolarize the fiber to -90 mV. The quantity of charge moved saturated at test potentials of approximately 0 mV. The steady state dependence of the amount of charge that moves as a function of test potential could be well fitted by the Boltzmann relation: Q = Qmax/(1 + exp[-(V - V)/k]), where Qmax is the maximum charge that can be moved, V is the potential at which half the charge moves, and k is a constant. At 15 degrees C, these values were Qmax = 28.5 nC/microF, V = 34.2 mV, and k = 8.7 mV. Qmax, k, and V exhibited little temperature dependence over the range 7-25 degrees C. "Stepped OFF" charge movements were elicited by depolarizing the fiber from -90 mV to a fixed conditioning level that moved nearly all the mobile charge (0 mV), and then repolarizing the fiber to varying test potentials. The sum of the charge that moved when the fiber was depolarized directly from -90 mV to a given test potential and the stepped OFF charge that moved when the fiber was repolarized to the same test potential had at all test potentials a value close to Qmax for that fiber. In nearly all cases, the decay phase of ON, OFF, and stepped OFF charge movements could be well fitted with a single exponential. The time constant, tau decay, for an ON charge movement at a given test potential was comparable to tau decay for a stepped OFF charge movement at the same test potential. Tau decay had a bell-shaped dependence on membrane potential: it was slowest at a potential near V (the midpoint of the steady state charge distribution) and became symmetrically faster on either side of this potential. Raising the temperature from 7 to 15 degrees C caused tau decay to become faster by about the same proportion at all potentials, with a Q10 averaging 2.16. Raising the temperature from 15 to 25 degrees C caused tau decay to become faster at potentials near V, but not at potentials farther away.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3968531 TI - Light-induced changes in GTP and ATP in frog rod photoreceptors. Comparison with recovery of dark current and light sensitivity during dark adaptation. AB - Light decreases GTP and ATP levels in purified suspensions of physiologically active frog rod outer segments still attached to their inner segment ellipsoids (OS-IS). (a) The GTP decrease is slower in OS-IS (t1/2 = 40 s) than in isolated outer segments (t1/2 = 7 s), which suggests there is more effective buffering in OS-IS. (b) The GTP decrease becomes detectable only at intensities greater than those required to saturate the photoresponse. As the intensity of a continuous light is increased over 4 log units, GTP levels decrease linearly with log intensity by as much as 60%. GTP is reduced to steady intermediate levels during extended illumination of intermediate intensity. (c) At levels of illumination bleaching greater than 0.003% of the rhodopsin, a decrease in ATP levels becomes detectable. (d) Following a flash, GTP levels fall and then rise with a recovery time dependent on the intensity of the flash. (e) After both 0.2 and 2% flash bleaches, the recovery of GTP levels parallels the recovery of light sensitivity, which is slower than the recovery of the dark current. This raises the possibility of a link between GTP levels and light sensitivity. PMID- 3968532 TI - The influence of transverse tubular delays on the kinetics of charge movement in mammalian skeletal muscle. AB - A model was developed to describe the kinetics of slow, voltage-dependent charge movement in the rat omohyoid muscle. To represent the electrically distributed nature of the transverse tubular system (t-system), we followed an approach similar to that described by Adrian and Peachey (1973 J. Physiol. [Lond.]. 235:103), and approximated the fiber with 12 concentric cylindrical shells. Incorporated into each shell were capacitative and conductive elements that represented the passive electrical properties of the t-system, and an element representing the mobile charge. The charge was assumed to obey a two-state scheme, in which the redistribution of charge is governed by a first-order reaction, and the rate constants linking the two states were assumed to depend on potential according to the constant field expression. The predictions of this "distributed two-state model" were compared with charge movements experimentally measured in individual fibers. For this comparison, first, the passive electrical parameters of the model were adjusted to fit the experimental linear capacity transient. Next, the Boltzmann expression was fitted to the steady state Q vs. V data of the fiber, thereby constraining the voltage dependence of the rate constants, but not their absolute magnitude. The absolute magnitude was determined by fitting the theory to an experimental charge movement at a single test potential, which in turn constrained the fits at all other test potentials. The distributed two-state model well described the rising and falling phases of ON, OFF, and stepped OFF charge movements at temperatures ranging from 3 to 25 degrees C. We thus conclude that tubular delays are sufficient to account for the rounded rising phase of experimental charge movements, and that it is unnecessary to postulate higher-order reaction schemes for the underlying charge redistribution. PMID- 3968534 TI - Polypeptide synthesis of Dugbe virus, a member of the Nairovirus genus of the Bunyaviridae. AB - The replication of Dugbe (DUG) virus, a member of the Nairovirus genus of the Bunyaviridae, has been investigated. During the infection of BS-C-1 cells a virus specific c.p.e. was initially observed followed by recovery of the cell monolayer but with continued production of infectious virus. Six DUG virus-induced polypeptides were identified with apparent molecular weights, determined by gel electrophoresis, of 92000 (p92), 82000 (p82), 77000 (p77), 52000 (p52), 48000 (p48) and 34000 (p34). The polypeptides p77 and p34 were detected in purified DUG virions but not in extracts of virus-infected cells pulse-labelled with [3H]leucine. Polypeptides p48 and p52 were found in both purified virus preparations and in extracts of infected cells. p82 and p92 were found only in lysates of infected cells. When two-dimensional gel electrophoresis was used to analyse infected cells, p48 was found to have a net positive charge. PMID- 3968535 TI - Requirement of methionine for the replication of canine distemper virus in Vero cells. AB - The replication of canine distemper virus (CDV) in Vero cells was found to require certain amino acids such as arginine, methionine and valine. The deprivation of methionine caused the most marked reduction in virus yield. In cells cultured in medium deprived of methionine, the early processes of viral replication such as adsorption, penetration and uncoating of virus occurred at normal rates, but the syntheses of viral RNA and protein were markedly reduced. The addition of S-adenosylmethionine to methionine-free medium resulted in the growth of CDV to the level obtained in cells with complete medium. Moreover, cycloleucine, which is known to reduce the methylation of mRNA by inhibiting the synthesis of S-adenosylmethionine, also inhibited the growth of CDV, and the addition of methionine or S-adenosylmethionine reversed the inhibitory effect of cycloleucine. The possibility of an inhibition of methylation of mRNA in methionine-deprived cells is discussed. PMID- 3968533 TI - Na/H exchange in cultured chick heart cells. pHi regulation. AB - The purpose of this study was to establish the existence of Na/H exchange in cardiac muscle and to evaluate the contribution of Na/H exchange to pHi regulation. The kinetics of pHi changes in cultured chick heart cells were monitored microfluorometrically with 6-carboxyfluorescein and correlated with Nai content changes analyzed by atomic absorption spectrophotometry; transmembrane H+ movements were evaluated under pH stat conditions. After induction of an intracellular acid load by pretreatment with NH4Cl, a regulatory cytoplasmic alkalinization occurred with a t1/2 of 2.9 min. pHi regulation required external Na+ and was concomitant with transmembrane H+ extrusion as well as a rapid rise in Nai content in an Na/H ratio of 1:1. Microelectrode recordings of membrane potential demonstrated directly the electroneutral character of pHi regulation. Acid-induced net Na+ uptake could be either stimulated by further decreasing pHi or inhibited by decreasing pHo; Na+ uptake was unaffected by tetrodotoxin (10 micrograms/ml), quinidine (10(-3) M), DIDS (10(-4) M), Clo-free solution, or HCO3 free solution. Amiloride (10(-3) M) maximally inhibited both pHi regulation and Na+ uptake; the ID50 for amiloride inhibition of Na+ uptake was 3 microM. Nao dependent H+ extrusion showed half-maximal activation at 15 mM Nao; Li+, but not K+ or choline+, could substitute for Na+ to support H+ extrusion. Cao-free solution also stimulated acid-induced Na+ uptake. We conclude that pHi regulation following an acid load in cardiac muscle cells is by an amiloride-sensitive, electroneutral Na/H exchange. Stimulation of Na/H exchange up to 54 pmol/cm2 X s indicates the rapidity of this exchange across cardiac cell membranes. Na/H exchange may also participate in steady state maintenance of pHi. PMID- 3968536 TI - On the evolution of the terminal redundancies of Klebsiella phage No. 11 and of coliphages T3 and T7. AB - The phylogenetic relationship between Klebsiella phage No. 11 and the classical coliphages T7 and T3, postulated in a previous study, was investigated at the nucleotide level by sequencing the termini of phage No. 11 DNA. This DNA was found to have a terminal redundancy of 181 base pairs. Comparison of the terminal sequences of T7, T3 and No. 11 DNA suggests that the terminal redundancies of the three phages contain different expansions and variations of the short 'founder sequence' 5' TTAACCTTGGG 3' of a common ancestor. PMID- 3968537 TI - Structural analysis of the gene coding for hepatitis B virus surface antigen and its product. AB - The entire genome of hepatitis B virus (subtype adr) has been cloned into pBR322. The clones could be classified into at least seven groups by their restriction endonuclease cleavage maps. The nucleotide sequences of the hepatitis B surface antigen (HBsAg)-coding regions for five clones were determined and compared with published sequences of the HBsAg gene including those of adw, ayw, adyw and adr. The 13 available versions of the amino acid sequence of the polypeptide, predicted from the nucleotide sequences, were analysed in terms of the established specificities of the HBsAg, including the four subtypes. The analysis indicated that a relatively hydrophilic region of the HBsAg protein, spanning amino acid residues 110 to 160, specifies the major (w) and (r) subtype system. The (w/r) subtype appears to depend on changes in one or more variable amino acids at positions 47, 110, 113, 126 and 160 of the HBsAg polypeptide. PMID- 3968538 TI - Changes in glycosylation of rubella virus envelope proteins during maturation. AB - Tunicamycin treatment of radioactively labelled infected Vero cells followed by electrophoresis in polyacrylamide gels showed that the mol. wt. of the putative polypeptide backbones of GP59(E1) and GP43(E2), the intracellular counterparts to the envelope proteins E1 and E2 of rubella virus, were 53000 and 34000, respectively. Two possible intermediates in the glycosylation of GP43(E2) were also identified. [3H]Mannose-labelled E1, E2, GP59(E1) and GP43(E2) were digested with Pronase and the glycopeptides separated by gel filtration. GP59(E1) contained glycopeptides in two size classes, designated R1.5 and R2.1; E1 contained these and an additional size class, R2.7. GP43(E2) contained glycopeptides in three size classes, R1.5, R2.1 and R2.7; E2 contained these and size class R3.3. The glycopeptides derived from GP59(E1) and GP43(E2) were all sensitive to endoglycosidase H treatment whereas the glycopeptides of E1 and E2 contained both sensitive and resistant components. PMID- 3968539 TI - The Fv-2 gene controls induction of erythroid burst formation by Friend virus infection in vitro: studies of growth regulators and viral replication. AB - When infected in vitro with Friend virus complex, the bone marrow cells of susceptible mice form large colonies (bursts) of erythroblasts after 5 days of culture in semi-solid medium. This virus-induced burst growth occurs without the addition of erythropoietin (EP) which is normally required for erythroid progenitor growth in vitro. Erythroid progenitor cells from C57BL/6 mice infected in vitro with Friend virus are resistant to virus-induced burst growth, while cells from the B6.S mouse strain, which is congenic with C57BL/6 but possesses the 'Friend virus sensitivity' alleles at the Fv-2 locus, are susceptible. This susceptibility of the B6.S cells demonstrates that virus-induced burst growth is regulated by the Fv-2 gene. Two mechanisms by which the Fv-2 locus could control virus resistance were analysed. The possible modulation of the erythroproliferative effect of the virus by soluble substances which either promote burst growth in the sensitive strains or inhibit growth in the resistant strain was examined. Also, the possible restriction of virus infection or replication in resistant (Fv-2rr) haemopoietic cells was investigated. In a variety of experimental conditions designed to test the effects of soluble growth promoters on bone marrow cells infected in vitro, the resistance of C57BL/6 cells to erythroid burst formation could not be overcome. Neither could resistance be transferred to co-cultured sensitive cells by any soluble substances produced in culture by C57BL/6 cells. Use of haemopoietic cells from C57BL/6 animals in various physiological states of haemopoiesis also did not overcome the resistance to virus-induced burst growth. Quantification of several parameters of viral replication in whole marrow cultures or in erythroblasts from bursts of the Fv-2 sensitive and Fv-2 resistant congenic mouse strains showed that haemopoietic cells of both strains support virus growth equally well. These data suggest that Fv-2rr-mediated resistance to the erythroproliferative effect of Friend virus infection in vitro is an inherent property of an erythroid progenitor target cell and is not determined by external factors. The resistance is also not due to restriction of virus replication. PMID- 3968540 TI - Intracellular type A retrovirus movement associated with an intact microtubule system. AB - Intracytoplasmic type A particles known to be precursors to type B retroviruses in murine, hamster and marsupial cells are closely associated with microtubules and microtubule organizing centres. In this publication, the active participation of microtubules in the intracellular transport of the particles to the cell surface has been examined in NIH 3T3 cells infected with M432 virus using vincristine sulphate (VCR) as inhibitor of microtubule polymerization. The release of virus at different times after exposure to VCR was quantified by reverse transcriptase determinations of cell supernatants and by electron microscopic quantification of the number of virions at the cell surface using freeze-dried whole cell replicas. These studies indicate that VCR inhibits both microtubule polymerization and virus release, and thus suggest that intact cytoplasmic microtubules are necessary for intracellular transport and release of virus. PMID- 3968541 TI - Further studies on the role of neuraminidase and the mechanism of low pH dependence in influenza virus-induced membrane fusion. AB - The role of neuraminidase and the mechanism of low pH dependence in influenza virus-induced membrane fusion have been studied further using fowl plague virus (FPV, H7N1). Two specific anti-FPV neuraminidase antisera obtained from chickens immunized with recombinant virus strains inhibited viral neuraminidase activity without influencing its haemagglutinating activity. These sera totally inhibited the FPV-induced fusion of erythrocytes and partially reduced haemolysis. But both fusion and haemolysis activities could be restored by external addition of Vibrio cholerae neuraminidase, indicating participation of neuraminidase in FPV-induced membrane fusion. With regard to low pH-dependent fusion by influenza virus, it was found that erythrocytes of various species showed different pH optima for haemolysis by FPV and that erythrocytes could be sensitized for fusion and haemolysis by FPV at neutral pH if they had been pretreated with a low pH buffer. These results demonstrated that surface properties of erythrocytes rather than that of the virus are critical in the low pH-dependent fusion and haemolysis by influenza viruses. PMID- 3968542 TI - Inhibition of the growth of human coronavirus 229E by leupeptin. AB - The protease inhibitor leupeptin prevented multiplication of the human coronavirus strain 229E in cultures of MRC-C cells. The IC50 of leupeptin in plaque reduction tests was 0.4 micrograms/ml, whereas growth of host cells was unaffected by leupeptin at 50 micrograms/ml. Inhibition of plaque formation could be prevented by the addition of proteases to the overlay medium. In single-cycle growth experiments, leupeptin reduced virus yield only if added within 2 h of infection, indicating its action on an early stage of virus replication. PMID- 3968543 TI - Chronic hepatitis A: an historical note. PMID- 3968544 TI - Detection of hepatitis B virus DNA in serum and relation with the IgM class anti HBc titers in hepatitis B virus infection. AB - Sera from four groups of patients wtih different serologic markers of HBV infection were examined for HBV DNA using molecular hybridization technique and for IgM class anti-HBc using an ELISA based on the antibody capture principle. Results of HBV DNA assay were generally in good agreement with the presence of HBeAg. However, HBV DNA was found in 13% of anti-HBe+ sera and in one patient with anti-HBc as a sole marker. IgM anti-HBc was detected at high titers in acute hepatitis B patients and was also present during the "window-period." This marker was also found, though less frequently when other markers for HBV infectivity were absent, in chronic hepatitis B patients and healthy carriers. From these findings we conclude that the HBV DNA assay provides a reliable method of detecting the infectious agent, particularly in anti-HBe+ sera and sera with anti HBc as a sole marker. The assay for IgM anti-HBc is useful for establishing the diagnosis of recent infection in patient with anti-HBc as a sole marker, and during acute hepatitis with very high aminotransferase values, a condition in which HBV DNA may be undetectable. PMID- 3968545 TI - Psychosis in children of Holocaust survivors: influence of the Holocaust in the choice of themes in their psychoses. AB - This report examines psychotic symptoms in children of Holocaust survivors. The authors present two cases that show how the manifestations of schizophrenia were influenced by the Holocaust. The cases show how the effects of one generation's trauma are seen in the symptoms and behavior of the next. PMID- 3968546 TI - Propranolol and depression revisited: three cases and a review. AB - The occurrence of major depressive episodes as complications of treatment with propranolol has been a matter of controversy. Three cases are reported of depressions meeting DSM-III criteria following administration of propranolol for medical conditions. Possible relationships between beta blockade and affective illness are discussed. PMID- 3968547 TI - Focal cognitive deficits accentuated by depression. AB - A patient with a postoperative posterior right hemisphere lesion underwent neuropsychological testing during a major depressive episode, and again following remission of the depression. Qualitative visuoconstructive deficits typical of right hemisphere damage were present when the patient was depressed, but were absent following treatment of the depression. Verbal intelligence, cooperation, and vigilance were normal. The case suggests that depression may accentuate focal cognitive signs of fixed lesions in the absence of global impairment of function. PMID- 3968548 TI - Reality monitoring in mania and schizophrenia. The association of thought disorder and performance. AB - Manic (N = 20) and schizophrenic (N = 20) patients, equally divided into thought disordered (TD) and non-thought-disordered (NTD) subgroups were compared to a normal contrast sample (N = 10) on their reality-monitoring ability (i.e., recognition of the source of presentation of information in their memory). It was found that TD manics and TD schizophrenics had different problems in reality monitoring, in that TD schizophrenics had problems in differentiating information that they had said from information that they had thought and TD manics had problems in discriminating information presented by two external sources. In addition to their problems in reality monitoring, TD patient in general had a response bias that was different from that manifested by normal subjects in both the present and earlier investigations. Normals and NTD patients performed similarly through-out, which indicates that there were no correlations of diagnosis and performance in the absence of thought disorder. The results of the present investigation were related to earlier reports of attentional deficits in manics and controlled information-processing deficits in TD schizophrenics. Finally, a tentative model of schizophrenic speech disorder, incorporating the present data with earlier reports of controlled information deficits, was advanced. PMID- 3968549 TI - Early parental discipline and adult self-destructive acts. AB - Forty-five male inpatients with major depressive episodes by DSM-III criteria (296.2, 296.3, 296.5) were examined for correlates of inpatient self-destructive behavior. It was found that 44% of the variance for inpatient self-destructive acts could be accounted for by a combination of history of severe childhood discipline and parental conflict. Losses experienced during childhood were of less importance than these measures of family instability. Such information may be of use in the clinical prediction of self-destructive acts by depressed patients. PMID- 3968550 TI - Neuroendocrine investigation of depression in mentally retarded patients. A pilot study. AB - As part of a pilot study, eight adults with severe mental retardation were screened for the presence of endogenous depression by the standard 1-mg overnight dexamethasone suppression test (DST). The eight had been rigorously screened to rule out potential for false-positive DST. Two of the eight patients demonstrated nonsuppression, and a third had borderline results. Of these three, two manifested behavioral disturbances that could be attributed to major depressive disorder. The authors discuss the results, the difficulty diagnosing psychiatric disorders in severely retarded persons, and the proposed utility of the DST in this area. PMID- 3968551 TI - Amoxapine for the treatment of psychotically depressed subjects. A pilot study. AB - The treatment of psychotic depression remains controversial, although most studies suggest that the combination of an antipsychotic and an antidepressant agent is most beneficial. The authors describe an open-label study of the treatment of psychotic depression using amoxapine, an agent with both antidepressant and antipsychotic properties. Of the six patients treated, two improved dramatically within the first week of treatment, whereas for the remaining four treatment had to be discontinued due to lack of efficacy or side effects. Amoxapine appears to be effective in some cases of psychotic depression, but side effects and known risks of treatment diminish its usefulness. PMID- 3968552 TI - Methylglyoxal-bis(guanylhydrazone) in hormone-resistant adenocarcinoma of the prostate. AB - Methylglyoxal-bis(guanylhydrazone) (MGBG), an inhibitor of polyamine synthesis, was administered to 35 patients with hormone-resistant advanced adenocarcinoma of the prostate in doses of 500 or 600 mg/m2 per week intravenously. Of 31 patients with bidimensional measurable soft-tissue lesions, 25 had an adequate trial, defined as four or more doses. Six (24%; 95% confidence limits, 8% to 32%) patients achieved a partial remission (greater than or equal to 50% reduction in tumor size) in soft-tissue disease. Response was noted to start after one to two doses and persisted for a median of three months (range, 1 to 4 months). Toxicity was tolerable, and significant myelosuppression was not observed. The lack of response in osseous metastases may be secondary to the short duration of remission or to the presence or inducibility of the enzyme ornithine decarboxylase in bone. Since some animal prostatic cancer tumor models are sensitive to cytotoxic drugs that produce polyamine inhibition, clinical trials of MGBG combined with other inhibitors of the polyamine pathway should be explored. PMID- 3968553 TI - Acute effects of salmon calcitonin in multiple myeloma: a valuable method for serial evaluation of osteoclastic lesions and disease activity--a prospective study of 125 patients. AB - Hypocalcemia induced by salmon calcitonin (SCT) was evaluated in 125 patients with multiple myeloma (MM) and compared with 20 normal individuals (NCs) and 20 individuals with monoclonal gammopathy of undetermined significance (MGUS). It is now well documented that the maximum hypocalcemia (M delta CA) induced in man by SCT is related to the prevailing rate of osteoclastic resorption. In patients with MGUS, the level of M delta CA was normal. Conversely, the M delta CA was significantly abnormal in patients with MM (P less than .0001 for differences between NC/MGUS patients) and was correlated with (1) initial calcium levels (P less than .001), (2) the extent of lytic bone lesions (LBLs) (P less than .01), and (3) the myeloma cell mass (P less than .001) plus disease activity. The M delta CA was found to be of predictive value for new LBLs with or without hypercalcemia and to have dramatic influence on the survival of patients with MM. We conclude that the SCT-induced hypocalcemia test is of significant importance in the evaluation of the instantaneous rate of bone resorption and in the prognosis of patients with MM. PMID- 3968554 TI - Analysis of treatment results in craniopharyngioma. AB - A retrospective study of 30 patients treated primarily with surgery for craniopharyngioma between 1965 and 1980 was conducted. There were 13 children and 17 adults in this series. Apparent total surgical removal was obtained in six children and eight adults; the remaining patients had subtotal resection. Radiation therapy was used for salvage in five patients and after complete cyst removal in one. The ten-year survival rate was 80% in children and 30% in adults. The five-year survival was ten of 11 patients with childhood craniopharyngioma and seven (41%) of 17 patients in the adult group. Seven of 13 patients in the childhood group experienced surgically documented recurrence after first surgery. Seven of 17 patients recurred after first surgery in the adult group. Four died of operative complications. Morbidity demonstrated by quality of survival was high in these patients. PMID- 3968556 TI - Radical excision of craniopharyngioma. Results in 20 patients. AB - A series is presented of 20 craniopharyngioma patients who were treated between 1977 and 1981. All 20 cases underwent radical tumor resection via a frontotemporal craniotomy, with a concomitant temporal tip resection. All operations were performed by the senior author. The operative mortality rate was 5%, and the major morbidity rate 22.2%. The average follow-up period was 3.1 years. The role of radical surgical extirpation in adults is emphasized: the results compare favorably with the current radiotherapeutic and more conservative surgical statistics. PMID- 3968555 TI - Changes in criteria for tumor response. PMID- 3968557 TI - Methylprednisolone half-life during simultaneous barbiturate treatment and mechanical hyperventilation of neurosurgical patients. AB - The pharmacokinetics of methylprednisolone sodium succinate (MP) were studied in six neurosurgical patients under intensive treatment with large doses of MP, barbiturates, and mechanical hyperventilation. The study showed a remarkable level of enzyme induction within 24 hours after starting treatment, when the first blood samples were taken. The half-life (t 1/2) for MP during barbiturate and hyperventilation therapy was found to be reduced by a mean 55% (p less than 0.01) in relation to the t 1/2 of MP when administered alone. Studies on the day after termination of barbiturate intake indicated a tendency for an increase in the t 1/2 of MP, but it was not significantly different from the pretermination assessment (p greater than 0.05). On the basis of this study it is not possible to determine if the change in t 1/2 alone is governed by enzyme induction or by a combination of this plus a change in the distribution and clearance of the steroid. The clinical implication of these findings is that patients who are undergoing steroid treatment and at the same time are sedated with barbiturates should have their MP dose increased in order to compensate for the marked reduction of t 1/2 of MP. PMID- 3968558 TI - Outcome from severe head injury in children and adolescents. AB - A consecutive series of 37 children (17 years old and under) with severe head injury is presented. The data confirm that morbidity and mortality are lower in children than in adults: 51% of these young patients had a good recovery or moderate disability at 6 months. The mortality rate in this series (33%) is higher than in some reports, but probably more closely approximates the death rate from these injuries in an unselected pediatric population than do statistics from tertiary care hospitals. There was no significant relationship between age and outcome in this age group, but mass lesions and uncontrolled intracranial hypertension adversely affected outcome. Diffuse cerebral swelling was commonly seen on computerized tomography scans, and generally was associated with a satisfactory outcome (75%). Two of 13 deaths were considered preventable, emphasizing the narrow therapeutic safety margin and extreme care required in treating these patients. PMID- 3968559 TI - Epidermoid cysts of the posterior fossa. AB - Epidermoid cysts originating in the paramedian basal cisterns of the posterior fossa are congenital lesions that grow to a large size through slow accumulation of desquamated epithelium. These lesions grow between and ultimately displace cranial nerves, vascular structures, and the brain stem, causing a long course of progressive neurological deficits. The onset of symptoms usually occurs during the fourth decade of life. Epidermoid cysts are easily diagnosed with computerized tomography scans, which characteristically show a low-density extra axial pattern. The primary surgical objective is to decompress the mass by evacuating the cyst contents and removing nonadherent portions of the tumor capsule; portions of the capsule adherent to vital structures should be left undisturbed. Aseptic meningitis is the most common cause of postoperative morbidity, and its incidence may be minimized by intraoperative irrigation with steroids followed by systemic therapy with dexamethasone. Symptomatic recurrences that occur many years after surgery should be managed with conservative reoperation. PMID- 3968560 TI - ICP patterns and isotope cisternography in patients with communicating hydrocephalus following rupture of intracranial aneurysm. AB - Intracranial pressure (ICP) was continuously recorded, isotope cisternography was performed, and the ventricular system size was evaluated on serial computerized tomography scans in 39 patients. All of these patients had communicating hydrocephalus after subarachnoid hemorrhage (SAH) from rupture of an intracranial aneurysm. The studies were carried out in both the acute stage (within 7 days after SAH) and the communicating hydrocephalus stage. In patients in the acute stage who had no ventricular dilatation, but who later developed communicating hydrocephalus, the resting ICP was high, and an ICP pattern of B-wave activity was seen; there was no delay in cerebrospinal fluid (CSF) absorption on isotope cisternography. Patients with communicating hydrocephalus in whom ICP recordings were started within 63 days after SAH had a pattern of plateau waves in conjunction with B-waves, and there was a marked delay in CSF circulation. In general, patients with higher resting ICP's had more frequent ICP irregularities. Patients with communicating hydrocephalus in whom recordings were begun more than 6 months after SAH had a low and flat ICP pattern, and there was no delay in CSF absorption in spite of bilateral convexity blocks on isotope cisternography. The results suggest that the ICP pattern of plateau waves in conjunction with B-waves can be regarded as a sign of delayed CSF absorption; hence, shunting procedures may be indicated in patients with plateau waves in conjunction with B-waves visualized on continuous ICP recordings. PMID- 3968561 TI - Intramedullary spinal cord metastasis. A clinicopathological study of 13 cases. AB - A retrospective autopsy study of 627 patients with systemic cancer disclosed 153 patients with metastasis to the central nervous system (CNS) and 13 patients with intramedullary spinal cord metastasis (ISM). Thus, the frequency of ISM was 8.5% of cases of metastasis to the CNS and 2.1% of all cases of cancer. Bronchogenic carcinoma accounted for 11 cases of ISM, and breast carcinoma and melanoma for the other two. There were two distinct patterns of spinal cord involvement, indicating spread of tumor to the cord by two different routes. In nine of the 13 ISM patients a metastasis was found deep within the spinal cord, unassociated with leptomeningeal carcinomatosis; this most likely resulted from hematogenous spread of tumor from a pulmonary source. In the other four patients there was focal or multifocal direct extension of leptomeningeal metastatic tumor across the pia into the parenchyma of the cord. Only four of the 13 patients had a clinical myelopathy; in three of these four this was the presenting feature of an occult lung cancer. PMID- 3968562 TI - Pattern-reversal visual evoked potentials in patients with hydrocephalus. AB - Pattern-reversal visual evoked potentials (VEP's) in response to whole- and half field stimulation were studied in 10 patients with hydrocephalus. Abnormalities consistent with optic nerve dysfunction were recorded in four patients. Two patients had response asymmetry to half-field stimulation, which suggested dysfunction of the visual pathway in the right hemisphere. The remaining four patients had normal responses. Measurement of VEP's was repeated after the surgical treatment of hydrocephalus in four patients, and showed marked improvement in two of the three patients with preoperative abnormalities. This study suggests that, in patients with hydrocephalus, VEP's are more sensitive than clinical methods in detecting visual pathway dysfunction and that they can be useful in the follow-up monitoring of surgically treated hydrocephalic patients. PMID- 3968563 TI - Wide variation in risk of wound infection following clean neurosurgery. Implications for perioperative antibiotic prophylaxis. AB - The authors have prospectively examined the occurrence of postoperative wound infection following clean neurosurgery in 936 patients. Fewer than 1% received perioperative antibiotic prophylaxis. The overall rate of deep wound infection was 2.6%; no deaths were directly attributable to these infections. Deep wound infections occurred significantly more frequently following craniotomy (4.3%) than following spinal (0.9%) or other clean neurosurgery. Among craniotomies, the deep wound infection rate varied significantly from 11% following repeat operations for recurrent gliomas to 2.5% following non-tumor surgery. Risk of deep wound infection varied more than 11-fold depending on the type of clean neurosurgical operation. It is most feasible to demonstrate the potential efficacy of perioperative antibiotics in clean neurosurgical procedures with the greatest risk of postoperative wound infection. The potential benefit from such prophylaxis would be greatest for patients undergoing these high-risk operations. PMID- 3968564 TI - Classification and treatment of spontaneous carotid-cavernous sinus fistulas. AB - An anatomical-angiographic classification for carotid-cavernous sinus fistulas is introduced and a series of 14 patients with spontaneous carotid-cavernous sinus fistulas is reviewed to illustrate the usefulness of such a classification for patient evaluation and treatment. Fistulas are divided into four types: Type A are direct high-flow shunts between the internal carotid artery and the cavernous sinus; Type B are dural shunts between meningeal branches of the internal carotid artery and the cavernous sinus; Type C are dural shunts between meningeal branches of the external carotid artery and the cavernous sinus; and Type D are dural shunts between meningeal branches of both the internal and external carotid arteries and the cavernous sinus. The anatomy, clinical manifestations, angiographic evaluation, indications for therapy, and therapeutic options for spontaneous carotid-cavernous sinus fistulas are discussed. PMID- 3968565 TI - Eosinophil degranulation in the capsule of chronic subdural hematomas. AB - A previously unrecognized role of eosinophils in chronic subdural hematomas is described. Outer membranes of hematomas with marked infiltration by eosinophils were studied ultrastructurally with particular attention to the degranulation of these cells. In all of the five cases studied, degranulation was observed. Disintegration of the cells contributed to the release of granules. The free granules, the matrix of which has been demonstrated to contain plasminogen, were often circulating in the vascular lumen and trapped among the aggregated platelets. They were also found within the fragile vascular wall surrounded by fibrinoid material and in the edematous perivascular interstitium. Some of the perivascular eosinophils showed frank solubilization of granule matrix contents in spite of unaltered crystalloids. These findings suggest a role of eosinophils in the development of local hyperfibrinolysis within the outer membranes, which might contribute to the fluidity of chronic subdural hematomas and the resultant leakage of blood from the vessels in the capsules. PMID- 3968566 TI - The perforating branches of the middle cerebral artery. A microanatomical study. AB - The perforating branches (PFB's) of the middle cerebral artery (MCA) were studied in 34 unfixed brain hemispheres which were injected with a polyester resin and dissected under the operating microscope. Five hundred and eight vessels were identified and their site of origin, branching pattern, outer diameter (OD), and length recorded. Four hundred and two PFB's (79%) originated from the main trunk of the MCA before its division; the remaining 106 vessels (21%) had their origin from branches of the MCA as follows: superior trunk, 43 vessels (8.5%); inferior trunk, 30 vessels (6%); middle trunk, four vessels (0.8%); early temporal branch, 27 vessels (5.3%); and early frontal branch, two vessels (0.4%). The number of PFB's in each hemisphere varied from five to 29 (mean 14.9 +/- 0.7 vessels). The great majority of PFB's (96%) originated along the proximal 17 mm of the MCA. The PFB's arising in the first 10 mm had a mean OD of 0.35 +/- 0.01 mm and a mean length of 9.25 +/- 0.19 mm, and those arising from the second 10 mm had a mean OD of 0.47 +/- 0.02 mm and a mean length of 16.67 +/- 1.4 mm. A clear distinction between a medial and lateral group of PFB's was present in only 14 hemispheres (41%). In nine hemispheres (26%), perforating vessels from the anterior cerebral artery (A1 segment) and from the recurrent artery of Heubner replaced the medial group of PFB's of the MCA. In one case this group originated in an accessory MCA. In three hemispheres (9%) a small anastomosis (OD 0.2 mm) was seen between a PFB of the recurrent artery of Heubner and one of the MCA. From a total of 508 PFB's, 255 vessels (50%) originated as single vessels, while 253 vessels (50%) originated as branches of common stems. The OD of the single vessels ranged from 0.1 mm to 1.1 mm (mean 0.39 +/- 0.02 mm), and the length from 3 to 20 mm (mean 10.8 +/- 0.2 mm). The common stems ranged in OD from 0.6 to 1.8 mm (mean 0.87 +/- 0.04 mm), and in length from 1 to 15 mm (mean 4.1 +/- 0.4 mm). The clinical application of these anatomical data to the management of aneurysms and arteriovenous malformations of the MCA, and in the field of interventional neuroradiology is described. The most frequent pathological entities involving the perforating vessels are also discussed. PMID- 3968567 TI - Somatosensory evoked potentials as a measure of experimental cerebral ischemia. AB - Somatosensory evoked potentials (SEP's) reflect the integrity of the central neuronal pathway, and as such may be used to assess function that remains during a variety of cerebral insults. To evaluate the natural history and utility of SEP's during experimental cerebral ischemia and infarction, SEP's were measured in 17 adult cats at 24 hours and 1 hour prior to right middle cerebral artery (MCA) occlusion, and again immediately afterward and at either 6 hours (five cats) or 24 hours (six cats) post-occlusion. Before occlusion of the right MCA, the SEP's were identical in the right and left hemispheres. After occlusion, there was a significant slowing of the interpeak latency of the first positive peak (P1) in the right hemisphere (3.53 +/- 0.6 msec before compared to 3.99 +/- 0.6 msec after occlusion, p less than 0.001). Maximal slowing in right hemisphere P1 latency was seen in those animals in which the stroke extended into the thalamus (4.38 +/- 0.1 msec). This was significantly slower than left hemisphere values (3.92 +/- 0.32 msec, p less than 0.01). The ipsilateral cortical components of the SEP's, the second positive peak (P2), and the major negative deflection (MN) were slowed in all cats immediately after right MCA occlusion compared to preocclusion measurements (p less than 0.001). Severe infarcts in the mid-suprasylvian and posterior ectosylvian gyri (including the somatosensory cortex) resulted in a greater slowing of the latency of MN compared to less severe infarcts in that region (20.6 +/- 3.9 msec versus 16.4 +/- 1.1 msec, p less than 0.05). There was a precipitous decrease in the amplitude or voltage of the ipsilateral P2-MN complex immediately after occlusion (5.32 +/- 0.4 microV before compared to 0.98 +/- 0.3 microV after occlusion, p less than 0.001). Therefore, the central latencies and cortical amplitudes of the SEP's are sensitive experimental tools as indicators of the onset and extent of a cerebral ischemic insult. PMID- 3968568 TI - The ectopic pituitary gland in cases of craniopharyngioma. Report of two cases. PMID- 3968569 TI - Transoral transclival removal of a schwannoma anterior to the craniocervical junction. Case report. AB - The transoral route was used to remove a schwannoma situated anteriorly at the craniocervical junction. By a relatively simple technique, a watertight closure of the dura and nasopharynx was obtained combined with continuous cerebrospinal fluid (CSF) diversion, first by lumbar drainage and then via a lumboperitoneal shunt. This modification of the standard procedure provides a useful method to prevent CSF fistula formation following transoral intradural surgery. PMID- 3968570 TI - Fibroblastic tumor of the abducens nerve. Case report. AB - Tumors of the cranial nerves are uncommon, and are usually schwannomas or neurofibromas. The authors describe a case of a fibroblastic tumor involving the sixth cranial nerve. Based upon electron microscopy and immunohistochemistry, the tumor was not of nerve-sheath origin, but was comprised of fibroblasts. Clinical, radiographic, and pathological material are presented, and the literature is discussed. This represents the third case report of a tumor of the abducens nerve, and the first report of a fibroma of a cranial or peripheral nerve. PMID- 3968571 TI - Transcallosal approach to the contralateral ventricle. Technical note. AB - Recent experience with an intraventricular arteriovenous malformation (AVM) demonstrated the usefulness of a transcallosal approach to the contralateral ventricle. Although this technique provides excellent exposure, its application has not been stressed in the literature. A brief description of the technique and its value is presented. PMID- 3968572 TI - Retraction system for transsphenoidal surgery. Technical note. AB - A retraction system has been developed for transsphenoidal surgery to use together with a conventional self-retaining speculum. The system comprises an attachment to the speculum, a self-retaining retractor, and a slim tapered brain spatula and pronged hook. The spatula or hook is secured with the self-retaining retractor and the attachment. The retractor can also be fixed to the Sugita multipurpose head frame. The system may be used to retract the bulging diaphragma sellae and tumor tissues, and to stop bleeding from the dural venous sinus or tumor bed, so the surgeon can continue the procedure with both hands. PMID- 3968573 TI - Subdural hematomas in infants. PMID- 3968574 TI - Suprasellar recurrence of third nerve neurinoma. PMID- 3968575 TI - Bone mineral densitometry. PMID- 3968576 TI - A radiation primer. PMID- 3968577 TI - Thyroid iodine content and serum thyroid hormone levels in autoimmune thyroiditis: effect of iodide supplementation. AB - The relationship between thyroid iodine content (TIC) measured by x-ray fluorescence and serum TSH, T4, and T3 levels was investigated under iodide supplementation (0.5 mg/day for 1 to 9 mo). In five euthyroid control patients, whose TIC ranged from 2.5 to 14 mg, the TIC increased from 1.5 to 4 mg after 4 wk of treatment and had a tendency to plateau when the treatment was pursued. No significant changes in serum T4, T3, and TSH levels have been observed in these control subjects. Fourteen patients with autoimmune thyroiditis with low TIC (0-5 mg) were also studied. In six patients, the TIC increased significantly (3-10 mg over initial value after 3-7 mo of treatment). In parallel, there was a significant increase in serum T4 levels (35-150% over initial value) while T3 levels were modified in only two patients. In five patients serum TSH level decreased and was two- to seven-fold lower than before treatment whatever was its initial value; however, the spectrum of changes varied among patients from slight increase to a complete normalization of hormonosynthesis. In the eight other patients, iodide supplementation aggravated the thyroid disorders during the first months of treatment. The thyroid hormone blood levels dropped significantly in six patients (percent decrease below initial value: 20-100%) and was unchanged in the two others. An increase in the TSH blood level (X2-6) was observed in all patients except one. Concomitantly, the iodine stores were progressively depleted in three patients, unchanged in three and increased in two. When iodide treatment was pursued, an escape from this organification block was observed in two patients. PMID- 3968578 TI - Gallbladder function: methods for measuring filling and emptying. AB - Cholescintigraphy with [99mTc] disofenin was used to determine the optimal dose and method of administration of the octapeptide of cholecystokinin, and to determine the kinetics of gallbladder filling and emptying in 22 patients without disease of the liver or gallbladder. The peak filling rate of the gallbladder occurred at 30 min after injection; filling was complete at 1 hr. A 45-min constant intravenous infusion of the octapeptide 20 ng/kg X hr resulted in progressive emptying of the normal gallbladder; the mean ejection fraction at 45 min was 77.2 +/- 4.9%. A 1-min injection of 20 ng/kg resulted in a rapid, short lived emptying; the mean ejection fraction was 52.2 +/- 9.3%. Doubling or halving the infusion dose produced no greater response or a smaller response. We conclude that a constant 45-min infusion technique is superior to short injection times, because of more complete emptying, no side effects, and more consistent response. PMID- 3968579 TI - Pulmonary scintigraphy in a patient with multiple pulmonary arteriovenous malformations and pulmonary embolism. AB - The scintigraphic findings in a patient with multiple pulmonary arteriovenous malformations (AVMs) complicated by superimposed pulmonary embolism are reported. Although pulmonary AVMs may cause small subsegmental scintigraphic abnormalities, the demonstration of perfusion defects which are segmental or larger should strongly suggest the presence of superimposed pulmonary embolism in a patient with multiple pulmonary AVMs. PMID- 3968580 TI - False-positive subtraction scintigram of the parathyroid glands due to metastatic tumor. AB - A focus of increased uptake on a 201Tl minus 99mTc subtraction scintigram of the parathyroid glands was found in a patient with persistent hypercalcemia. This area was not caused by an abnormal parathyroid gland but by an enlarged lymph node containing metastatic tissue from an adenocarcinoma of the ovary. PMID- 3968581 TI - A count-based algorithm for attenuation-corrected volume determination using data from an external flood source. AB - We discuss the basic features of a count-based algorithm for attenuation corrected volume determination, for use with planar gamma camera images. The attenuation correction is arrived at by combining the results of two 180 degrees opposed images with a transmission image obtained with an external flood source. A sample of the imaged radioactive volume is used to convert the attenuation corrected count to an absolute volume. The algorithm is best suited to the measurement of small to medium-sized volumes of uniform activity, such as are encountered in cardiac blood-pool imaging. PMID- 3968582 TI - Advertising and the scholarly journal. PMID- 3968583 TI - Potential of palladium-109-labeled antimelanoma monoclonal antibody for tumor therapy. PMID- 3968584 TI - Brain scan: a useful tool in detection of neurosyphilis. PMID- 3968586 TI - Dietary calcium and vitamin D: risk factors in the development of atherosclerosis in young goats. AB - Effects of supplemental dietary calcium and vitamin D on lipid distribution and aortic mineralization were examined in young goats. Twenty-four goats, 2-4 wk of age, were allotted one of four dietary treatments for a 20-wk period and fed a basal milk diet (Basal), a calcium-supplemented diet (Basal + Ca), a cholecalciferol-enriched diet (Basal + D3) or a diet with both calcium and cholecalciferol (Basal + Ca + D3). Goats in the Basal + Ca group had plasma cholesterol concentrations that were 16.6% of those of the Basal group. Percentage absorption and fecal excretion of total lipids were unaffected by dietary treatment. Generally, total lipid and cholesterol concentrations were unaltered in liver, other viscera and carcass tissues. Dietary cholecalciferol increased concentrations of cholesterol and total lipid in aortas, whereas dietary calcium decreased total lipids in aortas. Concentrations of calcium, magnesium and total ash were increased in aortas by dietary treatment, with a marked increase observed in the Basal + Ca + D3 group. Sudan IV and gross calcium staining in aortas revealed both lipid and mineral deposition that confirmed composition data. A high intake of vitamin D accompanied by excessive intake of calcium seems to accelerate the development of atherosclerosis. Supplemental calcium with normal amounts of vitamin D, however, is hypocholesterolemic and seems protective against the atherogenic process. PMID- 3968585 TI - Copper and zinc absorption in the rat: mechanism of mutual antagonism. AB - The influence that copper and zinc exert on each other's absorption was studied by using the isolated, vascularly perfused rat-intestine system. In the first series of experiments, rats were fed for 1 wk one of nine diets, with different copper and zinc concentrations representing low, adequate and high dietary metal intakes. Copper concentrations were 1, 6 and 36 mg/kg diet and zinc concentrations were 5, 30 and 180 mg/kg. The small intestine was perfused with M199 tissue culture medium containing 6 mg/L copper and 30 mg/L zinc. Neither metal was found to significantly alter the other's absorption. High dietary zinc increased metallothionein-bound copper but did not change the intracellular copper concentration. In the second series of experiments, the dietary copper and zinc concentrations were held at 6 mg/kg and 30 mg/kg, respectively, while the metal concentrations in the luminal perfusate were changed (from 1 to 36 mg/L and from 5 to 180 mg/L for copper and zinc, respectively). The higher copper concentrations in the perfusate increased zinc accumulation in mucosal cells and decreased the zinc transferred to the portal perfusate at the highest luminal zinc concentration. These data indicate that a competition and/or inhibition of a pathway for zinc out of the mucosal cell occurs at high luminal copper concentrations. High luminal zinc concentrations in the perfusate decreased the copper concentration in the mucosal cell cytosol and the amount transferred to the portal effluent. These results taken together indicate that a competition and/or inhibition of copper or zinc intake into intestinal cells occurs when the luminal concentration of the respective congener is very high. PMID- 3968587 TI - Severe feed restriction of pregnant swine and rats: effects on postweaning growth and body composition of progeny. AB - Rats and swine were restricted in feed during pregnancy to determine the effect on postnatal growth and development of the progeny. Restriction of rats to 50% of preconception feed intake during the first 2 wk of gestation was associated with higher body weight of the progeny at 21 wk postpartum than was ad libitum feeding throughout gestation. However, maternal intake during gestation had no effect on perirenal and gonadal fat weight or adipocyte size in male and female offspring at 160 d of age. Restriction of swine to one-third of recommended feed intake during the first 10 wk of pregnancy was associated in the progeny with less perirenal and subcutaneous backfat and smaller adipocytes in depot fat compared with progeny of adequately fed swine. It is concluded that feed restriction of pregnant rats to one-half of preconception intake for the first two-thirds of pregnancy results in increased weight gain in the resulting progeny while restriction of swine to one-third of the recommended feed allowance during the first two-thirds of pregnancy results in reduced postweaning weight gain and decreased fat accretion during young adulthood. PMID- 3968588 TI - Effects of dietary carbohydrate on mitochondrial composition and function in two strains of rats. AB - BHE and Wistar male, weanling rats were fed either a 65% sucrose or a 65% cornstarch diet. They were killed at 50 d of age; livers were excised and used for the determination of the fatty acids of mitochondrial phospholipid or used to determine the effect of such diets on the dependence on temperature of succinate supported respiration. Neither diet nor strain affected either the total quantity of phospholipids or the quantities of the individual phospholipids. However, analysis of variance revealed strain and diet differences in the fatty acyl moieties of the phospholipids: sucrose-fed rats had more stearic (18:0) and less linoleic acid (18:2) than did starch-fed rats; BHE rats had more arachidonic acid (20:4) than did Wistar rats. There were no significant differences in either transition temperature or in the lower or upper activation energies determined from the biphasic Arrhenius plot. Although fatty acid compositional differences were observed, these differences had little effect on the membrane-associated, succinate-supported respiration. PMID- 3968589 TI - Effect of starch ingestion on plasma glutamate concentrations in humans ingesting monosodium L-glutamate in soup. AB - Plasma glutamate concentrations in human subjects are markedly lower when monosodium L-glutamate is ingested in a water solution containing partially hydrolyzed starch than when ingested in water alone. This study was carried out to investigate whether starch ingested as crackers had a similar effect. Eight normal adult subjects (four male, four female) ingested three servings of a beef consomme providing 50 mg/kg body weight monosodium L-glutamate. One serving was consomme alone, the other two were accompanied by sufficient crackers to provide 0.25 or 0.5 g starch per kilogram body weight, respectively. Ingestion of consomme containing glutamate significantly increased the mean plasma glutamate concentration above baseline to a mean peak value 30 min later. The peak after consumption of 0.5 g starch per kilogram body weight, but not 0.25 g/kg body weight, was significantly lower than when consomme alone was ingested. These data indicate that simultaneous ingestion of metabolizable carbohydrate with glutamate has a marked effect on the plasma glutamate response and indicate that the threshold value for carbohydrate is greater than 0.25 g/kg body weight. PMID- 3968590 TI - Effect of zinc deficiency on methionine metabolism, methylation reactions and protein synthesis in isolated perfused rat liver. AB - A perfusion technique was utilized to assess the rate of absorption and metabolism of L-methionine by livers isolated from rats fed a diet deficient in zinc. The endogenous concentration of S-adenosyl-L-methionine in the livers from the zinc-deficient rats was near normal, while the concentration in pair-fed controls was approximately 50% of that found in normal livers (ad libitum fed). The rate of uptake of methionine by the livers isolated from zinc-deficient rats was significantly less than in the pair-fed or ad libitum-fed controls. The synthesis of L-methionine, S-adenosyl-L-homocysteine and S-adenosylmethionine was not impaired in the livers from the zinc-deficient rats. However, the methyl group of the S-adenosylmethionine turned over much more slowly in the livers from zinc-deficient rats than in either control group. This was reflected in the depressed rates of methylation of various macromolecules, particularly DNA and histones. The synthesis of nuclear proteins (histones and nonhistone chromosomal proteins) was depressed in the livers from zinc-deficient rats. The reduced synthesis of chromosomal proteins and marked reduction in DNA methylation would be consistent with the finding that DNA biosynthesis and cellular proliferation are markedly depressed in zinc-deficient animals. PMID- 3968591 TI - Bioavailability of vitamin E in rats fed graded levels of pectin. AB - Dietary pectin at levels of 0, 3, 6 and 8% was fed ad libitum to rats for 8 wk to evaluate whether the bioavailability of vitamin E fed at 0.001% of the diet was affected by pectin. Rats fed 3% pectin were not different in any vitamin E parameters from those fed 0% pectin. By the end of the study body weights were significantly lower in the 6 and 8% pectin groups after adjusting for their nonsignificant trend of lower food intake. At wk 8, liver vitamin E levels were reduced in the 6 and 8% pectin group compared to values at the start of the study. Both groups had significantly higher red blood cell hemolysis compared to 0% pectin at 8 wk. Fecal fat excretion was not different among the diet groups, but weights of the small and large intestines were significantly increased in rats fed 6 or 8% pectin compared to those fed 0 or 3%. Our results show that 6 and 8 but not 3% dietary pectin decreased vitamin E availability in rats. PMID- 3968592 TI - Cellular growth in iron-deficient rats: effect of pre- and postweaning iron repletion. AB - Effects of iron deficiency and repletion pre- and postweaning on cell growth in young rats were studied. Pregnant dams were fed 6 or 250 ppm iron. On d 2 of lactation, half of the dams in each group were fed the opposite diet. On d 17, cell growth in the crossed-over groups was similar to controls showing that cellular development is impaired only when the iron deficiency is present during gestation and lactation. In a second experiment pup littermates of dams fed 6 (D), 12 (M) and 250 (C) ppm iron were weaned to either the same diet as fed to their dams DD, MM or CC; repleted with iron DC, MC; or fed the deficient diet CD until 42 d of age. After dietary iron repletion, cell numbers in thymus (DC and MC) and liver (DC) were greater than those of deficient littermates, but were less than those of controls (CC). Iron repletion postweaning reduced the cardiac hypertrophy (DC vs. DD and MC vs. MM) and increased splenic cell number compared to unrepleted deficient littermates (DC vs. DD). Thus, the severity and reversibility of impaired cellular growth is dependent on the timing and severity of the deficiency and the organ affected. PMID- 3968593 TI - The disaccharide effect of sucrose feeding on glucuronide excretion and bile concentration of injected phenolphthalein in guinea pigs. AB - The hypothesis tested was that feeding guinea pigs sucrose produces a more rapid concentration in the bile and excretion in the feces and urine of substances catabolized by the liver than does feeding invert sugar (50:50 mixture of glucose and fructose). Fifty male guinea pigs of the Hartley strain were divided into two groups of 25 animals each and fed for 4 wk repelleted nonpurified diet with 20% of total energy provided by sucrose or invert sugar. At the end of 4 wk all 50 animals were injected i.p. with a dose of 15 mg/kg body weight of phenolphthalein. Phenolphthalein is excreted almost quantitatively in feces. After injection all guinea pigs were housed in metabolism cages. Urine and feces were recovered and analyzed for free glucuronic acid and glucuronide content by a modified naphthoresorcinol procedure over 24 h. Guinea pigs fed sucrose produced more urine than those fed invert sugar, although there was no difference in water intake. After 24 h 15 animals in each group were killed, and the bile was sampled from their gall bladders to determine its phenolphthalein content. The remaining 10 animals in each group were held three additional days when they were killed and their bile was sampled to determine its phenolphthalein content. All biliary phenolphthalein was in conjugated form. Guinea pigs fed sucrose had less free glucuronic acid in their feces than those fed invert sugar. Feeding sucrose resulted in a higher bile conjugated phenolphthalein content 4 d after injection than did feeding invert sugar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968594 TI - Chelation of iron in plant nutrient solutions. PMID- 3968595 TI - Workplace health education. Principles in practice. AB - The application of psychological principles that lead to the acquisition of skills, knowledge, attitudes, and behaviors for improving safety and health conditions in the work environment is illustrated by case examples. The emergent pattern of successful occupational health education can be described as a process consisting of instruction, psychological reinforcement, and establishment of new norms of safe behavior for workers. To realize maximum effect from education programs, occupational physicians and other occupational health professionals should upgrade and expand their understanding of health education as well as their health education skills. PMID- 3968597 TI - The use of lay readers of chest roentgenograms in industrial screening programs. AB - A study was conducted to test the feasibility of training lay persons to screen chest x-ray films for professional readers in an industrial screening program and to use the International Labor Office classification of the pneumoconioses for silicosis. With minimal training the lay readers agreed with the professional readers on the presence or absence of silicosis in 72.6% of the films and missed only 3.2% of the silicosis identified by the professional readers. The lay readers were able to identify only 17.1% of the pathology other than silicosis; however, it appeared that they identified some of these conditions as silicosis. Considering this, the lay readers missed only 27.0% of the other pathologies. It was concluded that, with more extensive training, lay persons could be taught to screen chest X-ray films for professional readers in an industrial screening program. PMID- 3968596 TI - Standard threshold shift criteria. An investigation of the most reliable indicator of noise-induced hearing loss. AB - Definition of a standard threshold shift (STS) and its use as an early indicator to identify those employees with deteriorating hearing are necessary aspects of hearing conservation programs in industry. STS criteria were evaluated using techniques borrowed from decision theory and signal detection theory to separate audiometric threshold shifts into true-positive and false-positive shifts. The current Occupational Safety and Health Administration definition of a "change in hearing threshold relative to the baseline audiogram of an average of 10 dB or more at 2, 3 or 4 kHz in either ear" and the American Academy of Otolaryngology Head and Neck Surgery recommendation of a "10 dB or greater change for the worse for either the 0.5, 1, 2 kHz pure tone average or the 3, 4, 6 kHz pure tone average, in either ear" were supported. Revision of baselines after an STS occurs is recommended. PMID- 3968598 TI - Essential aspects of a medical screening program. PMID- 3968599 TI - Radium luminizers--selection effects. PMID- 3968600 TI - Color measurement and discrimination. AB - Theories of color-difference measurement provide a quantitative means for predicting whether two lights will be discriminable to an average observer. Consider the following color-measurement hypothesis. Suppose that two lights evoke responses from the color channels that we write as vectors, U and U'. The vector difference dU = U - U' is itself a set of channel responses that will result from the presentation of some light. I test the hypothesis that U and U' will be discriminable only if the light that gives rise to their differential, dU, is detectable. In the absence of a luminance component in the difference stimulus, dU, the vector-difference hypothesis holds well. In the presence of a luminance component, the theory is clearly false. When a luminance component is present, discrimination judgements depend largely on whether the lights U and U' are in separate, categorical regions of color space. PMID- 3968601 TI - Ellipsometry of the human retina in vivo: preservation of polarization. AB - A new apparatus for in vivo retinal-scattering experiments incorporating Mueller matrix ellipsometry is described. The basic principle is that the state of polarization of the entrance beam is modulated, after which the Stokes vector of the exit beam is assessed. Results show that nearly 90% of the degree of polarization of the entrance beam is preserved after double passage of the ocular media and retinal scattering. Changes in the state of polarization are studied in terms of a rotation around an eigenvector on the Poincare sphere. These studies show that the type of change in the state of polarization of the totally polarized component is probably caused by a linearly birefringent process. PMID- 3968602 TI - Colors of monochromatic lights that vary in contrast-induced brightness. AB - Using a color-naming procedure, two subjects described monochromatic lights, ranging from 450 to 630 nm, that were surrounded by perceptually unique-white fields of variable retinal illuminance. The test fields were 0.6 deg and 10, 100, or 1,000 Td. The surrounds, which were 4.5 deg in outer diameter, ranged from 0 to approximately 31,000 Td. From the resulting color-naming functions, equal-hue contours were derived, with surround intensity plotted against wavelength, for the spectral unique hues and the binary hues blue-green, green-yellow, and yellow red. The wavelengths for unique blue, unique yellow, and blue-green were essentially invariant with changes in surround intensity. The spectral locus for unique green was also invariant at higher test-field intensities, but, at lower levels, it generally shifted toward shorter wavelengths as surround intensity increased. Nonmonotonic shifts were found for green-yellow and yellow-red. The contrast and the wavelength requirements for the color brown were nearly invariant with the changes of test-field intensity. Over the full range of surround intensities, subjects described the test fields as consisting of one or two hues plus white or black, depending on the surround level, but never (except for one subject at the lowest test-field intensity) white and black simultaneously and cospatially. This opponent aspect of black and white was compared with that associated with the chromatically opponent processes. PMID- 3968603 TI - To shave or not to shave intravenous sites. PMID- 3968604 TI - Nursing home glaucoma and visual acuity screening results in Garfield County. PMID- 3968605 TI - Self-monitoring of blood glucose. PMID- 3968606 TI - Interstitial haemosiderin in the lungs of sudden infant death syndrome: a histological hallmark of 'near-miss' episodes? AB - The occurrence of multiple intrathoracic petechial haemorrhages in sudden infant death syndrome is well-documented and undisputed. We describe a study of 24 consecutive sudden infant deaths in which Perls' method for staining of iron in lung sections has been employed in addition to standard post-mortem procedures. Haemosiderin-containing macrophages have been demonstrated in 13 infants in subpleural and interstitial lung tissue in the absence of local fresh interstitial haemorrhage; ten of these infants had no evidence of respiratory tract inflammation and died mainly between one and three months of age. Eleven babies without haemosiderin showed evidence of inflammatory lesions and were predominantly four months or older at death. The demonstration of previous haemorrhagic foci in babies showing no other pathological abnormality may represent a histological hallmark of previous 'near-miss' episodes of hypoxaemia from whatever cause. PMID- 3968607 TI - Correlates of biopsy-studied nephropathy in young patients with insulin-dependent diabetes mellitus. AB - We have correlated pathologic findings in kidney biopsies from 12 adolescents with proteinuria or hypertension with severity of limited joint mobility (LJM) and retinopathy. We compared mean glucosylated hemoglobin (GHB) and clinical findings in these patients with those in patients without proteinuria or hypertension. Severity of LJM correlated with basement membrane thickening. Protein excretion correlated with degree of mesangial matrix increase and basement membrane changes. Retinal changes were related to basement membrane thickness and duplication. Despite treatment, blood pressures were significantly higher in patients with nephropathy than in the comparison group. Glycemic control status was generally poor and did not correlate with pathologic changes. The narrow spectrum of control did not permit assessment of possible effects of milder metabolic derangement. However, the similarity of GHB values in the groups with and without nephropathy implicates other factors. The group with clinical nephropathy had more LJM than did the comparison group, reaffirming LJM as a risk factor for early microvascular disease. Biopsy changes of nephropathy may begin relatively early in the course of diabetes (less than 7 years in three of our patients) and is already advanced when proteinuria appears. PMID- 3968608 TI - Effect of supplemental fluids on human milk production. AB - The effect of supplemental fluid intake on milk production was evaluated in a randomized, crossover design study of breast-feeding mothers. Twenty-six women whose infants were growing well with breast-feeding alone were enrolled in the study when their infants were 90 to 120 days of age. Twenty-one women consumed at least a 25% increase in fluids (mean 59%, range 26% to 140%). Mean daily milk production was 814 +/- 163 ml/day in the baseline period and 797 +/- 157 ml/day during increased fluid intake. There was no significant change in milk production between study periods and no significant relationship between percent increase in fluid intake and change in milk production nor between volume of fluid intake and volume of milk produced. PMID- 3968609 TI - Gastroesophageal reflux in patients with cystic fibrosis. AB - Children with cystic fibrosis (CF) and their asymptomatic siblings were surveyed to determine the incidence of symptomatic gastroesophageal reflux. A subgroup of patients with CF with poor nutritional status were studied with esophageal manometry, 24-hour esophageal pH recording, and pulmonary function testing before and after initiation of supplemental continuous nighttime nasogastric feeds. Of 68 patients with CF greater than or equal to 5 years of age, 20.6% experienced regurgitation and 26.5% had heartburn. In the control group of 23 asymptomatic siblings greater than or equal to 5 years of age, none experienced regurgitation and 5.6% had heartburn. Among the patients there was no significant association between symptoms of gastroesophageal reflux and bronchodilator therapy. Eight patients had normal lower esophageal sphincter pressure of 24.8 +/- 8.8 mm Hg and thoracoabdominal pressure gradient of 11.4 +/- 4.6 mm Hg; peristalsis and upper esophageal sphincter pressure were normal. There was a significant increase in reflux episodes, episodes greater than 5 minutes, duration of the longest episode, and percent time esophageal pH was less than 4 in patients, compared with published control data, for the entire 24-hour period and during sleep. During sleep, continuous nasogastric feeding significantly increased episodes of reflux, but did not result in an increase in percent time esophageal pH was less than 4, and was not associated with evidence of aspiration or deterioration in pulmonary function. Our findings indicate that symptoms of gastroesophageal reflux, heartburn, and regurgitation are more frequent in patients with CF than in asymptomatic siblings and that gastroesophageal reflux is significantly more common in patients with CF than in controls. Nighttime nasogastric feedings can safely be used as a means of nutritional rehabilitation in patients with CF. PMID- 3968610 TI - Elevated serum immunoreactive pancreatic cationic trypsinogen in acute malnutrition: evidence of pancreatic damage. AB - We used a sensitive probe of pancreatic dysfunction, serum immunoreactive cationic trypsinogen, to study 50 infants and children with varying degrees of malnutrition. Patients were classified into subgroups according to the severity of malnutrition. Mean serum trypsinogen concentration was significantly elevated in 25 patients with "severe" malnutrition (77.4 +/- 42.0 ng/ml, P less than 0.001) and in 23 with "moderate" malnutrition (55.2 +/- 16.1 ng/ml, P less than 0.02) compared with the mean value (32.5 +/- 10.4 ng/ml) for well-nourished controls. The level of circulating trypsinogen tended to rise with increasing severity of malnutrition. There was no relationship between serum trypsinogen and other variables such as age, specific diagnosis, or mode of feeling. Elevated serum trypsinogen levels could not be attributed to renal disease or cystic fibrosis. In patients who showed an improvement in nutritional status, serum trypsinogen tended to revert toward normal. Elevated serum trypsinogen values in acutely malnourished infants and children may result from pancreatic acinar cell damage or regurgitation of enzymes from obstructed pancreatic ducts. PMID- 3968612 TI - Autism associated with Williams syndrome. PMID- 3968611 TI - Mycotic cervical lymphadenitis following oral mucositis in children with leukemia. AB - Four children developed mycotic cervical lymphadenitis while receiving cytotoxic chemotherapy for acute leukemia. Neutropenia, oral mucositis, and broad-spectrum antibiotic administration preceded the appearance of lymphadenitis in each case. Enlarged tender cervical lymph nodes of mycotic origin were not clinically distinguishable from lymphadenitis of bacterial or viral origin. Although cervical lymphadenitis was the initial clinical manifestation of deep fungal infection, computerized tomography of the chest and abdomen subsequently demonstrated asymptomatic pulmonic, splenic, or hepatic lesions characteristic of fungal abscesses in all four children. These findings demonstrate the importance of microbiologic identification of the etiologic agents of cervical lymphadenitis following mucositis and neutropenia in children with leukemia. PMID- 3968613 TI - Systemic hypertension secondary to peripheral vascular anomalies in patients with Williams syndrome. PMID- 3968614 TI - Myocardial infarction associated with supravalvular aortic stenosis. PMID- 3968615 TI - Felty syndrome in juvenile arthritis. PMID- 3968616 TI - Hypoparathyroidism: a possible cause of rickets. PMID- 3968618 TI - Localized intestinal perforations after enteral administration of indomethacin in premature infants. AB - Four very-low-birth-weight infants developed localized intestinal perforations after enteral administration of indomethacin. The clinical picture and histologic findings were unlike those seen in necrotizing enterocolitis. PMID- 3968617 TI - Rickets of prematurity: calcium and phosphorus supplementation. AB - Seventy-four infants weighing less than 1500 gm at birth were fed enterally from birth until day 47. Group A (18 infants) were given SMA Gold Cap: group B (18 infants), supplementary calcium to 21 mmol/L (84 mg/dl); group C (16 infants), further calcium supplementation to 31.2 mmol/L (125 mg/dl); and group D (22 infants), milk with calcium content 31.2 mmol/L (125 mg/dl) and phosphorus supplementation to 15.7 mmol/L (49 mg/dl). The addition of calcium reduced the radiologic evidence of rickets, and combined calcium and phosphorus supplementation maintained plasma alkaline phosphatase activity within the normal range for 6 weeks. PMID- 3968619 TI - Coagulation and fibrinolytic factors in the first week of life in healthy infants. AB - Coagulation and fibrinolytic factors were determined daily in 74 healthy term and preterm infants to obtain a reference standard. A gestational age dependency was determined for antithrombin III, factor II, and plasminogen. The mean concentrations of antithrombin III and factor II in preterm infants increased to term values within the first week of life. Factor X levels declined independent of vitamin K administration. The values for the fibrinolytic system (alpha 2 antiplasmin and plasminogen) remained stable. PMID- 3968620 TI - Somatosensory evoked potentials as an adjunct to diagnosis of neonatal spinal cord injury. PMID- 3968621 TI - Infant mortality: relationship between neonatal and postneonatal mortality during a period of increasing perinatal center utilization. PMID- 3968622 TI - Adverse drug reactions in general pediatric outpatients. AB - We used a recently developed diagnostic adverse drug reaction (ADR) algorithm and an intensive telephone surveillance program to monitor all courses of prescription and nonprescription drug therapy in a general pediatric group practice for 1 year. A total of 3181 different children visited the practice during the year and received 4244 separate courses of drug therapy. Adverse symptoms were noted in 473 (11.1%) of these courses of therapy. Of 534 total adverse symptoms, however, only 24 scored as definite and 176 as probable ADRs. The main ADRs noted were antibiotic-associated gastrointestinal complaints and rashes, and various manifestations of CNS stimulation with bronchodilators. Sociodemographic variables significantly associated with the risk of a definite or probable ADR were socioeconomic status (P less than 0.0001), ethnic origin (P = 0.0015), and age (P less than 0.05). Treatment-related risk factors included treatment by a practitioner outside the study practice (usually during nonoffice hours) (P less than 0.001) and administration of a dosage above the range recommended by the manufacturer (P less than 0.001). Half the ADRs were judged as inconsequential by the children's parents, and most of the remainder resulted in only minor morbidity. Half were judged to be highly or probably preventable. Our results suggest that ADRs do not occur commonly in general pediatric outpatients and that most are mild and self-limited. PMID- 3968623 TI - Effects of domperidone therapy on symptoms and upper gastrointestinal motility in infants with gastroesophageal reflux. AB - We evaluated the effect of domperidone, a novel prokinetic agent, on symptoms and esophageal and gastric motility in 15 infants (six boys), mean age 7.9 months, with moderate to severe gastroesophageal reflux (GER) and upper gastrointestinal motility disturbances. Patients received domperidone orally for 6 weeks and underwent weekly assessment of five GER-associated symptoms, weight change, and side effects. Mean total symptom scores significantly improved after treatment (P less than 0.01). Vomiting, "spitting," and coughing each improved significantly. Postprandial reflux time (defined as esophageal pH less than 4.0) and percent peristaltic esophageal contractions improved significantly (p less than 0.05). Gastric fundic contractions, present in only four infants before treatment, occurred in nine after domperidone administration. Although mean gastric emptying of isotope-labeled formula was not improved, it improved greater than or equal to 10% over baseline in nine patients. Peristaltic amplitude, lower esophageal sphincter pressure, and esophageal acid clearance time were unchanged. Side effects were minimal. We conclude that domperidone is a useful and safe agent for treatment of gastroesophageal reflex in infants because it addresses the motility abnormalities inherent in the pathophysiology of the disorder. PMID- 3968624 TI - Propranolol therapy for portal hypertension in children. AB - Administration of propranolol to 13 children with portal hypertension reduced splenic pulp pressure by greater than 50 mm H2O (P less than 0.01) in approximately 2 weeks, when the pulse rate became three fourths the initial rate. The influence was found to be greater in compensated than in decompensated portal hypertension. This observation might be interpreted to mean that the effect of propranolol in the reduction of portal venous pressure results not only from decreased intestinal blood flow secondary to decreased cardiac output but also to the stimulation of sympathetic nervous system alpha-adrenoreceptors of the portal tract. Although arterial blood pressure changes were not significant, peripheral venous pressure was reduced significantly (P less than 0.01). We conclude that propranolol has considerable usefulness in treating portal hypertension in children. PMID- 3968625 TI - Low-dose streptokinase-induced clot lysis of an occluded arteriovenous fistula. PMID- 3968626 TI - Denver Developmental Screening Test: cultural variables. PMID- 3968627 TI - Rotazyme test in neonates. PMID- 3968628 TI - Fragmentation of care, Journal style. PMID- 3968629 TI - Estimation of glomerular filtration rate in infants. PMID- 3968630 TI - Erratum: "Incorrect" corrected bromide space. PMID- 3968631 TI - Use of povidone-iodine for intravaginal and periumbilical antisepsis. PMID- 3968632 TI - Potentially dangerous theophylline dose recommendations in The Harriet Lane Handbook. PMID- 3968633 TI - Early furosemide therapy of RDS. PMID- 3968634 TI - Effects of drugs on schedule-controlled behavior in rats during chronic haloperidol administration. AB - Dose-response curves for haloperidol, phencyclidine, morphine, meperidine and cimetidine were determined in rats trained under a multiple fixed-ratio 30, fixed interval 5-min schedule of reinforcement. Haloperidol, morphine, meperidine and cimetidine decreased both fixed-ratio and fixed-interval rates of responding. Phencyclidine had a biphasic effect on overall response rates in both components: response rates increased and then decreased as the dose was increased. After these dose-response curve determinations, chronic daily treatment with haloperidol (0.3 mg/kg i.p.), after the behavioral session, was initiated. After 6 weeks of chronic treatment with haloperidol, the dose-response curves were redetermined for all the drugs, while haloperidol continued to be administered after the session. During chronic haloperidol administration, the dose-effect curves for haloperidol, morphine, meperidine and cimetidine were not modified consistently; however, chronic haloperidol treatment enhanced the effects of phencyclidine as shown by a shift of the dose-response curves to the left during both fixed-ratio and fixed-interval components. Four weeks after chronic haloperidol had been discontinued, low doses of haloperidol produced smaller rate decreasing effects than they had previously. PMID- 3968636 TI - Performance maintained by orally delivered phencyclidine under second-order, tandem and fixed-interval schedules in food-satiated and food-deprived rhesus monkeys. AB - Three monkeys were each tested under a second-order fixed interval (FI) schedule with fixed-ratio (FR) components, a tandem FI FR schedule and an FI schedule while either food deprived or food satiated. Under the second-order schedule, every sixteenth lip-contact response on a drinking spout produced a brief stimulus and the first FR 16 begun and completed after the 60-min interval elapsed resulted in both the brief stimulus and access to orally delivered phencyclidine. The tandem schedule was similar, except that brief-stimulus presentations during the 60-min interval were omitted, and the third schedule was an FI 60 min. The reinforcer, orally delivered phencyclidine, was available only at the end of the 60-min session. The number of drug deliveries was either "limited" (300) or "unlimited" (for 1 hr) to determine whether increased responding due to food deprivation would occur in the absence of increased drug intake. Under all conditions response rates were nearly twice as high during food deprivation as they were during food satiation. The number of phencyclidine deliveries available at the end of the session has no systemic effect on the rate of pattern of responding, but quarter-life values were consistently lower during food deprivation than they were during food satiation. Under the tandem and FI schedules, overall response rates were much lower than under the second-order schedule, and quarter-life values were higher. When water was substituted for phencyclidine under each schedule condition, response rates and liquid deliveries generally declined to below phencyclidine levels indicating that the drug had been functioning as a reinforcer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968635 TI - Elevated brain tryptophan and enhanced 5-hydroxytryptamine turnover in acute hepatic heme deficiency: clinical implications. AB - Administration of 3,5-dicarbethoxy-2,6-dimethyl-4-ethyl-1,4-dihydropyridine, a suicide inhibitor of hepatic cytochrome P-450, to phenobarbital-pretreated rats rapidly causes a marked and sustained hepatic heme depletion and results in porphyria. We have shown that this event results in marked impairment of hepatic tryptophan pyrrolase activity and consequently in elevated tryptophan content and enhanced 5-hydroxytryptamine (5-HT) turnover in the brain of such porphyric rats. All these effects were reversed by administration of exogenous heme. Using an indirect assay of 5-HT-dependent function, we now show that this elevated 5-HT turnover in porphyric animals is associated with enhanced serotonergic tone. We also show that it can be potentiated by tryptophan administration, reversed by administration of exogenous heme, alleviated by treatment with p chlorophenylalanine, an inhibitor of 5-HT synthesis, and attenuated by administration of valine, an amino acid that is known to compete with tryptophan uptake in the brain. In patients with hepatic porphyria, acute hepatic heme depletion results in severe, often life-threatening attacks. These attacks are hallmarked by neuropsychiatric symptoms of unknown etiology, but that can often be successfully treated by i.v. administration of heme. Because acute hepatic heme depletion may also be expected to compromise hepatic tryptophan metabolism in such individuals, our findings raise the possibility that elevated tryptophan content and 5-HT turnover in the brain may play a role in the neurological dysfunction associated with acute attacks of hepatic porphyria. PMID- 3968637 TI - Regional blood flow changes in response to mildly pressor doses of triglycyl desamino lysine and arginine vasopressin in the conscious dog. AB - Arginine vasopressin (AVP) is used to treat esophageal variceal hemorrhage but has the drawbacks of rebleeding and reported coronary insufficiencies. In conscious dogs (n = 23) we compared AVP and an analog, triglycyl desamino lysine vasopressin (TDLVP), for arterial pressor responses and changes in regional blood flow. Dogs were infused with saline (n = 5), AVP (n = 7) or TDLVP (n = 7), and blood flow was measured with microspheres during control, infusion and postinfusion in 46 tissue sections including pieces of the esophagus, stomach, liver, kidney, spleen, heart, skin, muscle and brain. TDLVP (1.0 micrograms/kg/min) and AVP (0.025 micrograms/kg/min) produced a similar mean arterial pressure increase of 23 mm Hg and a heart rate decrease of 38 beats/min. TDLVP sustained the increase in mean arterial pressure and reduction in heart rate at 30 min postinfusion whereas AVP did not. Neither AVP nor TDLVP showed a reduction in brain, kidney or liver flow; however, both produced reductions (73 and 61%, respectively, P less than .01) in mucosal-esophageal flow. Only TDLVP reduced mucosal-fundus blood flow (P less than .01). Endocardial flow was reduced (27%) in both TDLVP and AVP groups; however, heart rate also decreased during this time and a linear correlation between these two measurements yielded a value for r2 of 0.83. Thus, TDLVP offers a therapeutic alternative to AVP in treating gastroesophageal varices due to its longer duration of action as represented by the sustained reduction in esophageal and mucosal-fundus flow. PMID- 3968638 TI - Systemic and coronary hemodynamic effects of pinacidil, a new antihypertensive agent, in awake dogs: comparison with hydralazine. AB - We compared the systemic and coronary hemodynamic effects of four successive doses of pinacidil, a new experimental antihypertensive agent, with hydralazine in awake normal dogs. The two agents produced comparable dose-dependent decreases in total peripheral vascular resistance, but, compared to hydralazine, pinacidil has only a minor inotropic effect, as evidenced by the changes in cardiac output, left ventricular dP/dt and dP/dt/P. Unlike hydralazine, pinacidil produced the changes only after aortic pressure had decreased significantly. The inotropic effects of pinacidil were abolished by propranolol pretreatment, suggesting that these effects are mediated by beta adrenergic receptors, probably secondary to sympathetic activation of the baroreceptor reflex. In addition, although myocardial oxygen consumption and coronary blood flow were increased by both hydralazine and pinacidil, left ventricular work increased only after hydralazine administration. Coronary sinus oxygen saturation increased to a much greater degree after pinacidil (from 20 +/- 2 to 70 +/- 4%) than after hydralazine and the fall in myocardial oxygen extraction was greater with pinacidil, suggesting that pinacidil has a greater coronary vasodilator effect. Finally, the systemic and coronary vasodilator effects of pinacidil probably are not mediated via prostaglandins, beta receptor stimulation or adenosine because indomethacin, propranolol or aminophylline treatment had no effect upon its vascular effects. Thus, it appears that pinacidil differs from hydralazine in its mode of action and probably exerts its vasodilator effect by a direct action on vascular smooth muscle. PMID- 3968639 TI - Effects of nisoldipine on cardiocirculatory dynamics and cardiac output distribution in conscious rats at rest and during treadmill exercise. AB - This study examined the effects of the dihydropyridine derivative nisoldipine (1.6 micrograms/kg/min) on hemodynamics and regional blood flow (radioactive microspheres, 15 +/- 5 microns) in conscious rats at rest and during treadmill exercises (35 feet/min, 5 min). Nisoldipine significantly reduced systemic vascular resistance (-38%) and mean arterial pressure (-17%) and increased heart rate (P less than .05). Skeletal muscle blood flow was increased and vascular resistances in the skeletal muscle, in renal and coronary arteries and in part of the gut circulations were significantly reduced (all P less than .05). Left ventricular end-diastolic pressure was unchanged by the drug both at rest and during exercise. At exercise, nisoldipine significantly increased skeletal muscle blood flow in four of eight skeletal muscle regions investigated; however, the increase in total skeletal muscle flow was less pronounced compared to the changes at rest. The vasodilator effect of nisoldipine in the renal and splanchnic circulations was markedly attenuated by the exercise-induced vasoconstriction in these circulatory beds. We conclude that nisoldipine is a potent vasodilator of skeletal muscle and coronary and renal arteries. It appears to possess highly selective effects on vascular smooth muscle as compared to its direct cardiac effects. PMID- 3968640 TI - Reversal by the calcium antagonist nisoldipine of norepinephrine-induced reduction of GFR: evidence for preferential antagonism of preglomerular vasoconstriction. AB - We have demonstrated previously that the organic Ca++ antagonist diltiazem augments the glomerular filtration rate (GFR) of the isolated perfused rat kidney during norepinephrine (NE) - induced vasoconstriction. These earlier studies, however, did not elucidate the precise mechanism or site of action responsible for this effect. Nisoldipine (NIS) interacts with the same Ca+2 channels as diltiazem but differs in its physicochemical properties, binding characteristics and tissue specificity. We examined, therefore, the effects of NIS using an identical model. Renal perfusate flow and GRF were assessed in the isolated perfused rat kidney under conditions of constant renal perfusion pressure (100 mm Hg). NIS (10(-7) M) completely reversed the NE-induced reduction in GFR but was significantly less effective in augmenting renal perfusate flow. In additional series of experiments, filtration pressure was estimated during these manipulations by monitoring ureteral pressure during ureteral occlusion (stop flow pressure). The NE-induced decrease in GFR was accompanied by a reduction in stop-flow pressure, which was abolished by the subsequent administration of NIS. Thus, nisoldipine preferentially attenuated NE-induced constriction of preglomerular resistance vessels but was less effective in reversing the effects of NE on postglomerular arterioles. These findings indicate that separate postreceptor mechanisms mediate the activation of pre- and postglomerular vessels by NE. PMID- 3968641 TI - Amphetamine attenuates the stimulated release of dopamine in vivo. AB - Carbon-fiber voltammetric electrodes have been used to measure the release of dopamine in the caudate nucleus of an anesthetized rat. Release is induced by electrical stimulation of the medial forebrain bundle. The amplitude of the observed release is attenuated by i.p. injection of amphetamine. A similar attenuation is induced by reserpine; however, at a slower rate. The combined regimen of amphetamine (1 or 10 mg/kg) and electrical stimulation does not deplete striatal dopamine levels and thus the decreased release of dopamine is not a result of depleted dopamine stores. Benztropine (25 mg kg-1) is able to cause a short term inhibition of the action of amphetamine (1 mg kg-1). The dopamine agonist pergolide (0.5 mg kg-1) does not affect the stimulated release. Haloperidol (1.0 mg kg-1) increases the amount of DA release, but is unable to attenuate the inhibition caused by amphetamine. Thus, it appears that the actions induced by amphetamine are a result of interaction with the neuronal uptake carrier and subsequent transport of dopamine from a functional to nonfunctional pool. In isolated striatal synaptic vesicles, amphetamine is found to block dopamine uptake and induce its release. This in vitro evidence provides a possible mechanism for the observed in vivo actions of amphetamine. PMID- 3968642 TI - Cardiovascular effects of losulazine hydrochloride, a peripheral norepinephrine depleting agent, in nonhuman primates. AB - THE CARDIOVAscular actions of losulazine hydrochloride, a peripheral norepinephrine-depleting agent in rodents, have been determined in conscious cynomolgus monkeys. Acute oral administration of losulazine at 0.1, 1, 10 and 30 mg/kg evoked dose-related hypotensive responses in the absence of significant alterations of heart rate. Although variable, the acute hypotensive effects of losulazine were associated with both reductions of peripheral vascular resistance and reductions in cardiac output. Acute oral administration of doses of losulazine ranging from 0.1 to 30 mg/kg did not cause orthostatic hypotension. Blockade of prostaglandin synthesis and of cholinergic, beta adrenergic and histaminergic receptors did not abolish the hypotensive effect of losulazine at 1 mg/kg i.v. Ganglionic blockade abolished the hypotensive effect of losulazine (1 mg/kg i.v. and 10 mg/kg p.o.), indicating that the hypotensive activity of losulazine was dependent on the presence of sympathetic neuronal activity. Additive combination studies of losulazine and nitroprusside, phentolamine, reserpine or guanethidine implied that losulazine, reserpine and guanethidine had the same site of action, i.e., inhibition of adrenergic neuron function. A comparison of the profiles of effect of losulazine, guanethidine, guanadrel and reserpine on blood pressure, heart rate, blood pressure responses to norepinephrine and tyramine and blood pressure after desipramine pretreatment indicated that losulazine and reserpine had similar mechanisms of action. The data presented in this report are consistent with the conclusion that losulazine reduced arterial blood pressure in nonhuman primates via depletion of norepinephrine from postganglionic adrenergic neurons. PMID- 3968643 TI - Reactivity and possible significance of hydroxylamine and nitroso metabolites of procainamide. AB - We have demonstrated previously that procainamide is metabolized to a hydroxylamine. The reactivities of this hydroxylamine and of the closely related nitroso derivative toward biological molecules were investigated with the objective of exploring possible mechanisms of procainamide-induced lupus. The hydroxylamine of procainamide was found to bind covalently to microsomal protein to a much greater degree than did procainamide and, in contrast to procainamide, it did not require metabolic activation. However, the hydroxylamine is readily converted nonenzymatically to the nitroso derivative, and reducing agents such as ascorbate and NADPH, which reduce the nitroso derivative to the hydroxylamine, blocked covalent binding. This suggests that the nitroso derivative is the reactive species for covalent binding. Furthermore, glutathione had been shown previously to block covalent binding of procainamide metabolites, and the nitroso derivative, but not the hydroxylamine, reacted rapidly with glutathione forming a sulfinamide derivative. The covalent binding of the nitroso derivative to microsomal protein appears to involve sulfydryl groups, because it, like the glutathione adduct, was readily cleaved by mild acid. In contrast, the nature of the covalent binding to albumin and histone protein appears different from that to microsomal protein in that most of the binding was stable to mild acid. The reactivity toward DNA was much less than that to protein. The observation that both the reactivity of nitrosoprocainamide and the specificity of antinuclear antibodies in procainamide-induced lupus are to histone protein rather than the DNA supports the hypothesis that this reactive metabolite plays a role in the etiology of procainamide-induced lupus. PMID- 3968645 TI - High-affinity lead binding proteins in rat kidney cytosol mediate cell-free nuclear translocation of lead. AB - The PbII binding characteristics of the previously reported (Oskarsson et al., 1982) PbII binding proteins of rat kidney cytosol were investigated further. Saturation and Scatchard analysis of 203Pb binding in whole cytosol and in 40% saturated ammonium sulfate precipitated fractions disclosed a class of relatively high-affinity sites with an apparent Kd of approximately 50 nM and binding capacities of approximately 41 and 9 pmol/mg of protein, respectively. Two 203Pb binding proteins with approximate molecular masses of 63K and 11.5K daltons and a high molecular weight component (greater than 200K) were isolated by Sepharose-6B column chromatography. The time course of association of 203Pb with cytosol and the 63K protein showed maximum binding at 18 hr which was stable up to 25 hr at 4 degrees C. The approximate half-time dissociation rate (T 1/2) of specifically bound 203Pb to the 63K protein was 100 min at 4 degrees C whereas the 11.5K protein showed little dissociation of specifically bound ligand at this temperature. Saturation analysis of the three isolated proteins disclosed low capacity, high-affinity sites with similar apparent Kd values to the cytosol assay. Sucrose density gradient analysis of kidney cytosol showed approximate sedimentation coefficients of 2S, 4.6S and 7S for the 11.5K, 63K and the high molecular weight proteins, respectively. Competitive binding studies with cytosol demonstrated displacement of 203Pb by PbII, CdII and ZnII ions but not CaII ions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3968644 TI - Stereoselective behavioral effects of N-allylnormetazocine in pigeons and squirrel monkeys. AB - The behavioral effects of the stereoisomers of N-allylnormetazocine (NANM) were compared with those of phencyclidine (PCP) in pigeons and squirrel monkeys responding under a multiple fixed-interval fixed-ratio (FI FR) schedule of food presentation. Intermediate doses of (+)-NANM or PCP produced transient increases in FI responding in monkeys and sustained increases in FI responding in pigeons; higher doses decreased FI and FR responding in both species. In contrast to its enantiomer, (-)-NANM failed to increase FI responding significantly in either species; at high doses, (-)-NANM decreased FI and FR responding. In monkeys, (-) NANM was about 10 times more potent than (+)-NANM in decreasing responding, whereas in pigeons (-)-NANM was about equipotent with (+)-NANM. In both species, (-)-NANM, but not (+)-NANM, antagonized the rate-decreasing effects of morphine on FI and FR responding. In monkeys, the effects of (-)-NANM, but not (+)-NANM or PCP, were antagonized by naloxone; the doses of naloxone required to antagonize the effects of (-)-NANM were more than 100 times higher than those required to antagonize the effects of morphine. In pigeons, naloxone did not systematically alter the effects of (-)-NANM, (+)-NANM or PCP. Haloperidol reduced or eliminated the increases in FI responding produced by intermediate doses of either (+)-NANM or PCP in pigeons, but did not antagonize the decreases in FI or FR responding produced by high doses of PCP or either stereoisomer of NANM. The results demonstrate a high degree of stereoselectivity in the behavioral effects of NANM. The levorotatory isomer had opioid-antagonist and non-opioid agonist effects in pigeons and mixed opioid agonist-antagonist effects in monkeys. The dextrorotatory isomer, on the other hand, had effects similar to those of PCP in both species. PMID- 3968646 TI - Acrylonitrile-induced gastric mucosal necrosis: role of gastric glutathione. AB - Acrylonitrile [vinyl cyanide (VCN)] induces acute hemorrhagic focal superficial gastric mucosal necrosis or gastric erosions. In this report the authors have studied the mechanism of the VCN-induced gastric erosions. VCN-induced gastric lesions are coupled with a marked decrease of gastric reduced glutathione (GSH) concentration. Pretreatment of rats with various metabolic modulators (cytochrome P-450 monooxygenase and GSH) before VCN demonstrated that there is an inverse and highly significant correlation between gastric GSH concentration and the VCN induced gastric erosions. Pretreatment of rats with sulfhydryl-containing compounds protected against the VCN-induced gastric necrosis and blocked the VCN induced gastric GSH depletion. Furthermore, pretreatment of rats with atropine, which blocks muscarinic receptors, protected rats against the VCN-induced gastric erosions. The working hypothesis is that depletion and/or inactivation of critical endogenous sulfhydryl groups causes configurational changes of cholinergic receptors and increases agonist binding affinity, which, among other actions, leads to the causation of gastric mucosal erosions. PMID- 3968647 TI - Weight and vaginal opening in the albino rat. AB - The body weight of rats at spontaneous vaginal opening (Wvo) was related to the weight at weaning (Ww) and the time elapsed between the two events (tvo) by the following equation: Wvo = aj + bWw + ctvo + residual where aj is the litter effect present when both the male and female young are reared together. When only female young are raised, aj may be replaced by a, so that in this instance there is no litter effect. Further model differences were noted for young raised under different conditions. PMID- 3968648 TI - Ovarian activity in Booroola X Romney ewes which have a major gene influencing their ovulation rate. AB - A marked difference in both the function and composition of individual ovarian follicles was noted in Booroola X Romney ewes (6-7 years of age) which had previously been segregated on at least one ovulation rate record of 3-4 (F + ewes, N = 21) or less than 3 (++ ewes, N = 21). Follicles in F + ewes produced oestradiol and reached maturity at a smaller diameter than in ++ ewes. In F+ ewes (N = 3), the presumptive preovulatory follicles were 4.4 +/- 0.5 (s.e.m.) mm in diameter and contained 2.1 +/- 0.3 X 10(6) (s.e.m.) granulosa cells, whereas in ++ ewes (N = 3), such follicles were 7.3 +/- 0.3 mm in diameter and contained 6.5 +/- 0.8 X 10(6) cells. During a prostaglandin (PG)-induced follicular phase, the secretion rate of oestradiol from ovaries containing 3 presumptive preovulatory follicles in F + ewes was similar to that from ovaries with only one such follicle in ++ ewes. We suggest that the putative 'gene effect' in F + ewes is manifested during early follicular development and that it may be mediated via an enhanced sensitivity of granulosa cells to pituitary hormones. As a consequence, the development of 3 preovulatory follicles in F + ewes may be necessary to provide a cell mass capable of producing the same quantity of oestradiol as that from one preovulatory follicle in ++ ewes. PMID- 3968649 TI - Prolonged survival of the Graafian follicle and fertilization in the Japanese greater horseshoe bat, Rhinolophus ferrumequinum nippon. AB - After the mating season of the Japanese greater horseshoe bat in mid- or late October, only the right ovary maintained a single Graafian follicle throughout hibernation until early April. During this time the ovum was in prophase of meiosis I (resting stage) with many large lipid droplets as a nutrient source. In synchrony with stigma formation, there was resumption of meiotic activity, separation of the cumulus oophorus from the granulosa layer and dispersion of the follicle cells just before ovulation in spring. The block to polyspermy seemed to reside in the zona pellucida, because no spermatozoa could be detected in the perivitelline space of the 6 fertilized ova examined, although a second spermatozoon was recognized in the zona pellucida of 3 ova. PMID- 3968650 TI - Cloprostenol-induced luteolysis in the marmoset monkey (Callithrix jacchus). AB - A single intramuscular injection of 0.5 micrograms cloprostenol was not luteolytic on Day 6 or 7 of the ovarian cycle (N = 3), but was luteolytic in some animals (3/5) on Day 8 and 9 and luteolytic in all 23 animals treated between Days 10 and 17 of the ovarian cycle, and in 7 animals treated between Days 19 and 43 of pregnancy. Luteal function was monitored by measurement of progesterone in peripheral blood using a simple and rapid non-extraction assay. There was a dramatic fall in peripheral blood progesterone to less than 10 ng/ml within 24 h of cloprostenol injection; progesterone remained at this low level until the day after post-treatment ovulation. The interval from cloprostenol injection to ovulation in animals treated between Days 8 and 17 was 10.7 +/- 0.3 days. A similar interval was found in pregnant animals. Embryos recovered from the uterus after cloprostenol treatment were morphologically normal (23/24). PMID- 3968651 TI - A low molecular weight extract of bovine serum albumin stimulates rabbit blastocyst cell division and expansion in vitro. AB - Fraction V bovine serum albumin (BSA) was dissolved in 5% formic acid and filtered through a molecular filter with a cutoff of Mr 10 000. The freeze-dried filtrate stimulated increased cell division of cultured rabbit morulae to blastocysts (up to 8-fold increase in cell number) and increased blastocyst expansion (greater than 2-fold). These results show that some samples of commercial BSA contain an embryonic growth factor of a low molecular weight. PMID- 3968652 TI - Effect of surgery and efferent duct ligation on testicular blood flow and testicular steroidogenesis in the rat. AB - A moderate reduction in testicular blood flow was observed in both testes 24 h after unilateral efferent duct ligation without any corresponding change in testosterone secretion as indicated in the peripheral blood, in testicular venous blood, or in testicular tissue fluid. At 21 days a pronounced unilateral decrease in blood flow was associated with the extensive degeneration of tubules in the testis on the ligated side. These changes were also associated with decreased testosterone secretion by the testis on the ligated side, although Leydig cell function was not abolished since testosterone in the tissue increased rather than decreased. It is therefore concluded that testicular blood flow may play an important role in the changes of testosterone secretion that follow unilateral efferent duct ligation. PMID- 3968654 TI - Testosterone secretion during gubernacular development and testicular descent in the dog. AB - Serum testosterone concentrations ranged from 0.24 to 1.45 nmol/l between Day 53 post coitum (p.c.) until Day 40 post partum (p.p.) and did not show variations that could be correlated with the process of testicular descent. The intratesticular androgen appeared to be mainly testosterone, its concentration being about 5000-fold higher than that in serum whereas 5 alpha dihydrotestosterone could not be demonstrated. The intratesticular testosterone concentration at the initiation of gubernacular regression (Day 0) was apparently, but not significantly, higher than at Day 49 p.c. and at Day 40 p.p. The ability of the neonatal canine testis to synthesize testosterone was indicated by increased serum testosterone concentrations after hCG stimulation. PMID- 3968653 TI - The presence of glucose increases the lethal effect of alpha-chlorohydrin on ram and boar spermatozoa in vitro. AB - Ram cauda epididymal spermatozoa were incubated for 10 min at 34 degrees C with or without 1.0 mM-RS-alpha-chlorohydrin before (1) 5 mM-D-glucose or (2) 10 mM-L lactate plus 1 mM pyruvate or (3) 5 mM-D-glucose plus 10 mM-L-lactate plus 1 mM pyruvate or (4) no substrate was added. Without alpha-chlorohydrin, the motility, the ATP concentration and the energy charge of the spermatozoa were maintained for 240 min by substrate combinations 1-3 but with no added substrate (4) the motility declined after 60 min. All the values decreased dramatically after 10 min in spermatozoa exposed to alpha-chlorohydrin in substrate conditions 1 and 3 (glucose present) but alpha-chlorohydrin had no significant effect in conditions 2 and 4 (no glucose) except after prolonged incubation. In a dose-response experiment glucose-dependent ATP dissipation began to occur with 0.025 mM-RS alpha-chlorohydrin. A similar effect was seen in boar spermatozoa exposed to 0.1 5.0 mM-alpha-chlorohydrin and 5 mM-D-glucose. With boar spermatozoa the presence of 10 mM-L-lactate and 1 mM-pyruvate as well as glucose prevented the loss of ATP. We conclude that this concerted action of alpha-chlorohydrin and glucose is probably responsible for the contraceptive action of alpha-chlorohydrin and propose that it may depend on 'futile substrate cycling' in the glycolytic pathway. PMID- 3968655 TI - Patterns of protein synthesis in endometrial tissues from ovariectomized rats treated with oestradiol and progesterone. AB - Groups of ovariectomized rats were taken as controls or given hormonal treatment mimicking the successive steps in the sequence of ovarian secretions leading to implantation. Total endometrium or separated epithelium and stroma were incubated in vitro with [35S]methionine. Dissolved proteins were submitted to two dimensional polyacrylamide gel electrophoresis (pH range 5-7), followed by autoradiography. Priming with oestradiol (2 days) and subsequent treatment with progesterone (3 days) enhanced the synthesis of 12 and 14 polypeptides, respectively, which are specific for each of these treatments. Progesterone also suppressed the production of 10 oestrogen-dependent proteins both in the epithelium and the stroma. When an oestrogen-progesterone-oestrogen treatment was given, synthesis of all but 4 of the progesterone-induced polypeptides in the epithelium was inhibited while 5 of the proteins abolished by progesterone in this tissue compartment reappeared. These results are compatible with a mechanism of implantation acting at the epithelial level by lifting of intrauterine inhibition and stimulation by embryotrophic substances. PMID- 3968656 TI - Distribution of ovarian follicular populations in the dairy cow within 35 days after parturition. AB - Ovaries were obtained at slaughter from 12 Holstein dairy cows at 15, 25 or 35 days after their 4th calving. Non-atretic and atretic antral follicles were separated into 6 size classes according to size and the numbers in each class were expressed as a percentage of the total for each ovary. Non-atretic follicles of diameter 0.16-0.28 mm decreased from 27.5% at Day 15 to 1.5% at Day 35 whereas those of 0.29-0.67 mm and 0.68-1.57 mm diameter increased from 37.4 to 47.2% and from 11.5 to 17.3% respectively (all P less than 0.05). The proportions of follicles measuring 1.58-3.68, 3.69-8.56 and greater than 8.56 mm remained almost constant. The atretic follicles of 0.29-3.68 mm varied significantly in number according to the post-partum interval and to whether they were in the ovary containing the CL of pregnancy. It is concluded that the CL of pregnancy and/or the conceptus have a carry-over effect on the rate of growth of the antral follicles even after parturition. PMID- 3968657 TI - Advancement of reproductive activity, seasonal reduction in prolactin secretion and seasonal pelage changes in pubertal red deer hinds (Cervus elaphus) subjected to artificially shortened daily photoperiod or daily melatonin treatments. AB - Prepubertal red deer hinds were subjected to shortened daily photoperiod (8 h light per day, N = 3) or a daily (afternoon) melatonin injection (N = 4) for 83 days starting on 8 January, 2 weeks after the summer solstice. Compared with control hinds (N = 3) these treatments caused premature moulting of summer pelage, reduced serum prolactin concentrations to barely detectable levels about 34 days earlier than usual and advanced the date of mating. Calves were born earlier (P less than 0.005) in the hinds exposed to a shortened photoperiod (12 November +/- 1.7 days) and melatonin treatment (11 November +/- 3.2 days) than in control hinds (13 December +/- 7.9 days). Serum progesterone levels recorded before the first detected oestrus indicated that silent ovulations had occurred in many of the hinds (6 of 10) in this experiment. This study demonstrated the role of shortened daily photoperiod in red deer and indicated that the effects of reduced photoperiod observed were mediated by melatonin. PMID- 3968658 TI - Photoperiodic regulation of reproductive development in male white-footed mice (Peromyscus leucopus) born at different phases of the breeding season. AB - Male white-footed mice were maintained from birth in chambers equipped with latitudinal timers programmed to simulate the natural progression of daylengths at 42 degrees N latitude. Mice were born into photoperiods starting on 1 April, 15 July, 15 September or 27 October. Testes and seminal vesicles of April- and July-born mice were mature at 60 days of age; puberty was delayed by several months in animals born into the September and October photoperiods but these mice became fecund at about 3.5 months of age, independent of current photoperiod. Therefore, increasing daylengths of late winter do not appear to synchronize the reproductive development of overwintering juveniles born at different times during the previous breeding season. PMID- 3968659 TI - Further investigation of the role of progesterone in the control of embryo transport in the mouse. AB - Combined ovariectomy and adrenalectomy retarded mouse embryo transport while either operation alone did not. Serum progesterone levels were reduced after ovariectomy and after the combined operation but detectable levels were still present on Day 4 following both procedures. Embryo transport was also retarded after administration of testosterone propionate. This effect was abolished by progesterone and was not mimicked by 5 alpha-dihydrotestosterone. From these results it is concluded that progesterone influences embryo transport and that androgenic effects are probably a result of antagonism of progesterone. PMID- 3968660 TI - Twenty-four-hour profiles of prolactin and testosterone in ram lambs exposed to skeleton photoperiods consisting of various light pulses. AB - Individual groups of 6 ram lambs were housed within a controlled environment and exposed to one of 6 photoperiod schedules. Groups I and II received 8 (short day) or 16 (long day) h of continuous light, respectively; Groups III, IV and V were exposed to asymmetrical skeleton photoperiods consisting of a main light period of 7 h followed 9 h later by a light pulse of 1 h, 15 min or 1 min duration, respectively, and Group VI was exposed to a symmetrical skeleton photoperiod consisting of two 1-h light pulses positioned 16 h apart. After 4 weeks of treatment serum concentrations of prolactin and testosterone were measured over 24 h. Long-day responses characteristic of the 16L:8D photoperiod (i.e. elevated prolactin and reduced testosterone) were obtained in each of the asymmetric light pulse treatment groups, but whereas prolactin was elevated over the full 24 h in lambs exposed to 16L:8D, two prominent nocturnal prolactin releases were largely responsible for the high 24-h mean prolactin values in Groups III, IV and V. Reduced serum testosterone in these same groups could not be attributed to a diurnal pattern of secretion but was associated with an overall decrease in testosterone pulse frequency. Prolactin and testosterone levels in Group IV were intermediate between those observed in lambs exposed to 8 or 16 h of light. In summary, light pulses of short duration (1 min) positioned at 17 h after dawn can produce endocrine changes in lambs similar to those observed in lambs exposed to 16 h of continuous light. PMID- 3968661 TI - An interaction between season of calving and nutrition on the resumption of ovarian cycles in post-partum beef cattle. AB - Angus cows were first mated at approximately 27 months of age in 2 herds, calving 21 July to 15 September (Group E) or 9 September to 30 October (Group L). The cows were fed a high (H) or medium (M) plane of nutrition for 55 days before and 40 days after calving. There was a mean liveweight difference of 35 kg between cows in Groups EH + LH and Groups EM + LM immediately after calving and at 40 days after calving. Immediately after calving cows in Groups EH + EM were 11 kg heavier than cows in Groups LH + LM, but there was no difference at 40 days after calving. There was a significant interaction between calving time and nutrition in the return of cyclic ovarian function assessed from both interval to first oestrus and first elevated progesterone concentration. Mean intervals from calving to first oestrus were 66.7, 82.7, 56.7 and 62.3 days in Groups EH, EM, LH and LM respectively. These data demonstrate that season of calving influences resumption of ovarian cycles even at a constant high plane of nutrition and that season of calving interacts with nutrition such that effects of season are more likely to be expressed under conditions of low nutrition. PMID- 3968662 TI - Reproductive characteristics of a free-ranging population of Cape mountain zebra (Equus zebra zebra). AB - In a population of free-ranging Cape mountain zebra, median age at first foaling was 67 months (range 38-105 months), median foaling interval was 25 months (range 13-69 months) and annual foaling rate was 32%. Foaling rates of younger and older mares were similar. Foals were born all year round with a peak corresponding to the rainy season (summer). Conception occurred later in the season when the spring was dry. PMID- 3968663 TI - Influence of 2-deoxy-D-glucose and energy substrates on guinea-pig sperm capacitation and acrosome reaction. AB - When guinea-pig spermatozoa were suspended in a minimal culture medium (MCM-PL), 2-deoxy-D-glucose (100 microM) and 2-amino-2-deoxy-D-glucose (100 microM) were potent inhibitors of the acrosome reaction without affecting the sperm motility, whereas the N-acetyl derivative 2-acetamido-2-deoxy-D-glucose (2 mM) had no inhibitory effect. The addition of D-glucose (2 mM) partly inhibited the percentage acrosome reaction of spermatozoa suspended in Medium MCM-PL, but DL alpha-glycerophosphate (2 mM) and myo-inositol (2 mM) had no effect. In addition, DL-alpha-glycerophosphate (2 mM) did not overcome the inhibitory effect of 2 deoxy-D-glucose on the sperm acrosome reaction. The inhibitory action of 2-deoxy D-glucose (100 microM) on the sperm acrosome reaction assessed after a 3-h incubation was irreversible and was only completely effective if the sugar was added within 30 min of the start of incubation. When spermatozoa suspended in Medium MCM-PL were treated with 2-deoxy-D-glucose (100-200 microM) for an extended incubation up to 6 h, the inhibitory effect of 2-deoxy-D-glucose was partly overcome. Spermatozoa treated with 2-deoxy-D-glucose had significantly reduced concentrations of ATP after incubation for 2 h in Ca2+-free media, compared with the ATP concentrations of spermatozoa preincubated for 2 h in Ca2+ free media that supported acrosome reactions. The addition of Ca2+ (5 mM) caused a rapid decrease in ATP concentrations of spermatozoa suspended in Medium MCM-PL, while the addition of the monovalent ionophore monensin (50 microM) and Ca2+ stimulated sperm acrosome reactions as well as an additional decline in the sperm ATP concentrations. However, monensin (50 microM) in the absence of Ca2+ caused only a slight decline in the sperm ATP concentrations over the 15-min incubation period. The depletion of the sperm ATP concentrations by 2-deoxy-D-glucose may retard completion of the capacitation process and the resultant acrosome reaction. PMID- 3968664 TI - Identification and preliminary characterization of a sperm-binding protein in normal human semen. AB - In the seminal plasma of normal men a protein, immunologically related to a major protein (RSV-IV) secreted from the rat seminal vesicle epithelium, was detected by competition with RSV-IV in a specific radioimmunoassay using a rabbit anti RSV IV antiserum. The protein was partly (80%) purified by column chromatography; characterization by gel electrophoresis indicated that the protein is slightly basic and has a molecular weight of 140 000. The protein was present on the surface of human spermatozoa as well as in the ejaculates of azoospermic men and it is believed to be a sperm-binding protein. PMID- 3968665 TI - Ovarian follicular populations and preovulatory enlargement in Booroola and control Merino ewes. AB - To investigate the factors contributing to the different ovulation rates observed in two strains of sheep (Booroola 5.2, Merino 1.2), in-vivo monitoring of follicular kinetics followed by histological examination of both ovaries was performed during the late luteal and follicular phases. Ewes of both strains were either ovariectomized at Day 13, or had the 3 largest follicles of each ovary ink labelled at Day 13 and were ovariectomized at Day 15, or had the 3 largest follicles of each ovary ink-labelled at Days 13 and 15 and were ovariectomized 16 h after the beginning of oestrus (N = 6 per time per strain). In another experiment, the age effects on the follicular populations of these two strains were also studied. There were 2-4 times more primordial follicles and 1.5-2 times more preantral follicles in the ovaries of Booroola than in control Merino ewes, although the number of antral follicles was the same. The percentage of normal follicles in this population was higher in Merino than Booroola ovaries. In Booroola ewes, there was no correlation between the number of antral follicles per ovary and the ovulation rate at the previous cycle (r = 0.22). This suggests that follicle numbers do not play a key role in the high ovulation rate of the Booroola strain. The number of follicles initiating growth from the primordial pool, the number of growing follicles disappearing at the preantral stage, the pattern of antrum development, granulosa cell multiplication and appearance of atresia differed between strains. The reasons for the high ovulation rate of the Booroola strain became clear when preovulatory enlargement was followed by ink labelling. An extended period of time during which recruitment of ovulatory follicles takes place, together with a low incidence of selection and the ability of the follicles to wait for ovulation are the features involved in this high ovulation rate. PMID- 3968666 TI - Cataracts in children. PMID- 3968668 TI - Psychotherapy research. PMID- 3968667 TI - Effect of different drinks on fluid and electrolyte losses from a jejunostomy. AB - The effectiveness of 5 different solutions on the absorption of fluid and electrolytes was tested in 7 patients with a proximal intestinal stoma and large fluid losses, all of whom previously needed intravenous infusions to maintain balance. In 4 patients it proved possible to replace the intravenous infusions with an enteral supplement. The WHO glucose/electrolyte solution without added potassium (NaCl 3.5 g, NaHCO3 2.5 g, glucose 20 g/l) gave satisfactory results, though was slightly less effective than a solution containing more sodium in which maltose was substituted for glucose. Neither sucrose nor an oligosaccharide (Caloreen) gave an advantage over glucose in the formulations used. In 3 patients losses were so great, and absorption of sodium from oral solutions so small, that intravenous supplements had to be continued. These 3 patients could be distinguished from the other 4 by the fact that more than 250 ml emerged from the stoma during the 3 hours after a drink of 500 ml of glucose/electrolyte solution. In all patients a drink of water or tea led to a loss of sodium from the stoma; water should be restricted in such patients and replaced by a glucose/electrolyte solution. PMID- 3968669 TI - Patient flow patterns in a recovery room and implications for staffing. AB - A detailed analysis of the occupancy of a new recovery room in a small district general hospital was undertaken during the initial three months of its use. The main problems were found to be irregular workload, consistently high patient occupancy over lunchtime, and difficulty in matching traditional nursing shifts to periods of heavy workload. PMID- 3968670 TI - Nutritional status of patients with leg ulcers. AB - A group of 30 consecutive patients from a leg ulcer clinic were compared with age and sex-matched controls in respect of 11 indices which may reflect nutritional deficiency. Twenty-one controls and 23 patients showed a total of 92 abnormalities, of which 48 were classified as severe. Mean indices were not significantly different in the two groups apart from a lower haemoglobin in patients and raised serum ferritin in controls. PMID- 3968671 TI - Breast cancer--patient choice of treatment: preliminary communication. AB - Forty patients who have undergone treatment for breast cancer (mastectomy or lumpectomy plus radiotherapy) were assessed, both preoperatively and at intervals up to one year following surgery, using tests of anxiety, depression, body satisfaction, marital adjustment, self-esteem, sociability and life change. The women were also interviewed to assess degree of concern about the disease, appearance and treatment. Wherever appropriate, patients were given a choice of treatment. Very little adverse psychosocial reaction has been found. It would appear that this is largely because most patients could opt for treatment which resulted in minimal disfigurement. PMID- 3968672 TI - Immune complex-associated deafness: preliminary communication. AB - During the last year patients presenting with progressive bilateral or sudden sensorineural deafness of unknown aetiology have been investigated for possible abnormal immune activity. Twenty-six cases are reported in which significantly raised circulating immune complexes were present, together with 2 cases of clinical autoimmune deafness where the complexes were normal. Thirty-six control subjects were also studied. Following a review of the clinical features, the pathogenesis of this new association with sensorineural deafness is discussed. In some cases the aetiology is probably autoimmune, and in others related to infection. In certain patients the deafness has been partly reversed by medical treatment with systemic steroids or plasma exchange. It is hypothesized that circulating immune complexes may reflect a previously unrecognized final common pathophysiological pathway in a variety of cochleovestibular disorders. PMID- 3968673 TI - Induced thrombosis of abdominal aortic aneurysm. PMID- 3968674 TI - Adult respiratory distress syndrome associated with flurazepam overdose. PMID- 3968675 TI - Carbimazole-induced jaundice. PMID- 3968676 TI - Hairy cell leukaemia presenting as spontaneous urethral rupture. PMID- 3968677 TI - Mycosis fungoides associated with acanthosis nigricans. PMID- 3968678 TI - My doctor. PMID- 3968679 TI - Catheter embolization: causes and prevention. PMID- 3968680 TI - Nucleoside conjugates. 6. Synthesis and comparison of antitumor activity of 1 beta-D-arabinofuranosylcytosine conjugates of corticosteroids and selected lipophilic alcohols. AB - Five new P1-(steroid-21-yl)-P2-(1-beta-D-arabinofuranosylcytosin-5'-yl)pyro phosphates (ara-CDP-steroids), five 1-beta-D-arabinofuranosylcytosine 5'-O (alkyl)phosphates (ara-CMP-alkyl esters), and two P1-(alkyl)-P2-(1-beta-D arabinofuranosylcytosin-5'-yl)pyrophosphat e (ara-CDP-alkyl esters) have been prepared and evaluated against L1210 lymphoid leukemia in culture and in mice (C3D2F1/J). These include ara-CDP-11-deoxycorticosterone (6a), ara-CDP-cortisone (6c), ara-CDP-corticosterone (6d), ara-CDP-cortexolone (6e), and ara-CDP prednisone (6g), ara-CMP hexadecyl ester (7a), ara-CMP 1-cyclohexylmethyl ester (7b), ara-CMP 1-adamantylmethyl ester (7c), ara-CMP 2-(1-adamanthyl)ethyl ester (7d), ara-CMP 2-chloroethyl ester (7e), ara-CDP hexadecyl ester (9a), and ara-CDP 1-cyclohexylmethyl ester (9b). The in vitro antitumor results indicated that ara CDP-steroids were as active as the previously reported ara-CMP-steroids and that ara-CMP and ara-CDP-alkyl esters were less growth inhibiting than ara-CDP steroids and ara-C. However, the in vivo antitumor results indicated that ara-CDP steroids were generally less effective than the previous monophosphate derivatives. Among them ara-CDP-corticosterone (6d) and the known ara-CDP cortisol (6b) showed greater efficacy than ara-C with ILS value of 152% and 209%, respectively, at the optimal dose of 40 and 80 (mg/kg)/day for 9 days, while that of ara-C was 138% at the optimum dose of 9.2 (mg/kg)/day. Generally, ara-CMP alkyl esters (7a-e), given ip to the L1210 leukemic mice, were found to be toxic and ineffective. However, ara-CDP hexadecyl ester (9a) showed marginal activity (ILS, 38%). These preliminary results support the thesis that the ara-C conjugates of this type may require a lipophilic and naturally occurring moiety for improved efficacy. PMID- 3968681 TI - Synthesis, stereochemistry, and analgesic activity of 4-mono- and 4,4 disubstituted 1,2,3,4,5,6-hexahydro-2,6-methano-3-benzazocines. AB - The synthesis of 4-alkyl-, 4-aralkyl-, and 4-alkenyl-1,2,3,4,5,6-hexahydro-2,6 methano-3-benzazocines is described together with some 4,4-disubstituted and 8 hydroxy derivatives. Evidence of the stereochemistry of the 4-substituent was from 1H and 13C NMR. In the 4-methyl series the equatorial epimer 1b has a higher analgesic (hot-plate) potency than 1a, and 10a, 10c, and 10f are also good agonists. 5a afforded analgesic properties without an antagonist component. Surprisingly 10d, bearing an 8-OH function, was without analgesic activity, contrasting with the significant hot-plate activity exhibited by 1,2,3,4,5,6 hexahydro-3,5,6-trimethyl-2,6-methano-3-benzazocine. If the assumption is made that the more active enantiomorph in members of this series is configurationally related to (-)-morphine, then it may be that the enantiotopic edge in hexahydro 2,6-methano-3-benzazocines has a narrow steric requirement for analgesic responses. PMID- 3968682 TI - Enzyme-activated irreversible inhibitors of monoamine oxidase: phenylallylamine structure-activity relationships. AB - Seventeen 2-aryl-3-haloallylamine derivatives were prepared and evaluated as inhibitors of monoamine oxidase (MAO, EC 1.4.3.4). The synthesis of these compounds was achieved from either alpha-methylstyrene or ring-substituted phenylacetic acid derivatives. With one exception, these 2-arylallylamines were found to be enzyme-activated, irreversible inhibitors of MAO. The most potent inhibitors were ring-substituted derivatives of (E)-2-phenyl-3-fluoroallylamine with IC50 values ranging from 10(-6) to 10(-8) M. Selectivity for the A and B form of MAO was found to depend on the nature of aromatic ring substitution. In general, hydroxyl substitution favored the inactivation of the A form of MAO, while very selective B inhibitors were obtained when the aromatic ring was substituted with a 4-methoxy group. (E)-2-(4-Methoxyphenyl)-3-fluoroallylamine and (E)-2-(3,4-dimethoxyphenyl)-3-fluoroallylamine proved to be in vitro as selective for the B form of MAO as deprenyl. PMID- 3968683 TI - 22-Hydroxycholesterol derivatives as HMG CoA reductase suppressors and serum cholesterol lowering agents. AB - A series of 22-hydroxycholesterol derivatives with a modified side chain terminus was prepared. These agents were evaluated in vitro and in vivo for their ability to suppress HMG CoA reductase, the rate-limiting enzyme of cholesterol biosynthesis. In tissue culture assays, 22-hydroxycholesterol as well as the side chain modified analogues were potent inhibitors of HMG CoA reductase. However, only those sterols with a modified side chain terminus were effective suppressors of liver reductase when administered ig to rats. 22-Hydroxy-25-methylcholesterol (4a) and 25-fluoro-22-hydroxycholesterol (15a) significantly lowered serum cholesterol levels when administered ig to primates; 25-chloro-22 hydroxycholesterol (15b) and the analogue with a cyclopropyl terminus, 20b, were ineffective. The cholesterol-lowering sterols did not significantly alter lipoprotein levels; however, the two compounds have been shown to inhibit acyl coenzyme A:cholesterol acyl-transferase (ACAT) in tissue culture studies. PMID- 3968684 TI - Analogues of aminoglutethimide: selective inhibition of aromatase. AB - In exploring further the structural features that influence the relative efficacy of analogues of aminoglutethimide [1, 3-(4-aminophenyl)-3-ethylpiperidine-2,6 dione] as inhibitors of the cholesterol side-chain cleavage enzyme system desmolase and the estrogen forming system aromatase, analogues have been synthesized in which the aminophenyl substituent is replaced by pyridyl or substituted pyridyl. The 4-pyridyl analogue 5 [3-ethyl-3-(4-pyridyl)-piperidine 2,6-dione] is a strong competitive inhibitor of aromatase (Ki = 1.1 microM; value for 1, 0.60 microM), which exhibits a type II difference spectrum (Ks = 0.28 microM; value for 1, 0.13 microM) but is noninhibitory toward desmolase. The 2- and 3-pyridyl analogues (3 and 4) inhibit neither enzyme system. 1-Amino-3-ethyl 3-phenylpiperidine-2,6-dione (2) is a strong and selective inhibitor of desmolase but the 4-pyridyl analogue 10 [1-amino-3-ethyl-3-(4-pyridyl)-piperidine-2,6 dione] is a weak inhibitor of desmolase and aromatase. Analogues of 5 having a less basic aromatic substituent, namely, the N-oxide 11 and the 2,3,5,6 tetrafluoro derivative 13, were also prepared. The latter is a weak inhibitor of aromatase and the former inhibits neither enzyme system. PMID- 3968685 TI - Chemistry and antitumor evaluation of selected classical 2,4-diaminoquinazoline analogues of folic acid. AB - A series of six 2,4-diaminoquinazoline analogues of folic acid which bear close structural resemblance to methotrexate, 1a, were synthesized by unequivocal routes. Three of these have not been described previously, while complete structural characterization of the remaining compounds is presented for the first time. Each of the compounds was a potent inhibitor of dihydrofolate reductase (DHFR) from rat liver or L1210 leukemia cells having I50 values in a range similar to that of 1a. However, a wide divergence in inhibitory activity toward the growth of human gastrointestinal adenocarcinoma or L1210 leukemia cells in vitro was observed. Compounds having a normal folate configuration at positions 9 and 10 were more inhibitory than their isomeric reversed-bridge counterparts. The N-formyl modifications were the least active of the compounds studied. Unsubstituted or N-methyl modifications competed effectively with tritiated 1a for uptake into L1210 leukemia cells, while N-formyl modifications did not. Against an L1210 cell line resistant to 1a by virtue of altered transport and overproduction of DHFR, partial but not complete cross-resistance was observed for certain analogues. Of the three compounds selected for in vivo evaluation against L1210 leukemia in mice, two had a similar level of antitumor activity to that of 1a. The compound 5,8-dideazamethopterin, 2b, however, was slightly more active than 1a but at substantially reduced dose levels. PMID- 3968687 TI - Substituted 5H-dibenz[b,g]-1,4-oxazocines and related amino acids with antiinflammatory activity. AB - During an investigation of the antiinflammatory properties of a number of tetracyclic derivatives of 6,8-dichlorodibenz[b,f]oxepin-10(11H)-one, the ring expanded 1,3-dichloro-5H-dibenz[b,g]-1,4-oxazocine (9) was prepared and found to be considerable pharmacological interest. It was subsequently found that the corresponding ring-opened amino acid 66, a close analogue of the antiinflammatory agent fenclofenac, also possessed significant antiinflammatory activity, superior both to the dibenzoxazocine and to fenclofenac. These findings prompted extensive synthetic programs in both areas, and a number of derivatives in the amino acid series showed potencies considerably in excess of the standard compound. These phenylacetic acids, however, were significantly more ulcerogenic than fenclofenac whereas the corresponding dibenzoxazocines showed few signs of ulcerogenicity at doses up to 1 g/kg. PMID- 3968686 TI - Resolved monophenolic 2-aminotetralins and 1,2,3,4,4a,5,6,10b octahydrobenzo[f]quinolines: structural and stereochemical considerations for centrally acting pre- and postsynaptic dopamine-receptor agonists. AB - A detailed structure-activity relationship is revealed for resolved, centrally acting dopamine (DA) agonists acting on both pre- and postsynaptic DA receptors. The compounds resolved are 5- and 7-hydroxy-2-(di-n-propylamino)tetralin and cis- and trans-7-hydroxy-4-n-propyl-1,2,3,4,4a,5,6,10b-octahydrobenzo [f]quinoline. By the superimposition of the structures of the more active enantiomers of these compounds with those of known dopaminergic agonists, apomorphine and ergolines, a new DA-receptor model is proposed as an outgrowth of current DA-receptor theories. One of the most important concepts of this receptor model is its emphasis on the possible positions taken by the N-substituents of dopaminergic compounds. One of these positions i sterically well defined while the other direction is sterically less critical. The model has been used to explain the lack of dopaminergic activity of some previously reported structures and also to predict properties of novel structures, including inherent chirality, which should be active at DA receptors. Hopefully, this heuristic DA-receptor model will lead to the discovery of more selective and potent pharmacological tools, which ultimately might lead to the development of therapeutic agents for treating diseases of dopaminergic function in the central nervous system. PMID- 3968688 TI - Bile acids with cyclopropane-containing side chain. 2. Synthesis and properties of 3 alpha,7 beta-dihydroxy-22,23-methylene-5 beta-cholan-24-oic acid (2 sulfoethyl)amide. AB - The preparation of 3 alpha,7 beta-dihydroxy-22,23-methylene-5 beta-cholan-24-oic acid (2-sulfoethyl)amide (5) by the one-step EEDQ-induced conjugation between ursodeoxycholic acid "cyclopropylog" (4) and taurine is described. The presence of a cyclopropyl ring adjacent to the amide bond is shown to make it resistant to degradation by intestinal bacteria. This new cyclopropylog is neither deconjugated at the C-24 amide bond nor 7-dehydroxylated when incubated with human stools in anaerobic conditions. PMID- 3968689 TI - Fluorine-containing amino acids and their derivatives. 4. Synthesis and antibacterial activity of threo and erythro 1-fluorodehydroxylated chloramphenicol analogues. AB - Both threo and erythro 1-fluorodehydroxylated chloramphenicol analogues were synthesized and tested for antimicrobial activity. None showed antibacterial or antifungal activity, clearly demonstrating that substitution of the secondary hydroxyl group with fluorine abolishes the antibacterial activity of the parent compound, chloramphenicol. This finding sharply contrasts with that of previous workers, in which fluorination of the 3-hydroxyl group enhanced antibacterial activity against many chloramphenicol-resistant strains. PMID- 3968690 TI - 3,4-Diphenyl-1H-pyrazole-1-propanamine antidepressants. AB - A small series of compounds is described in which a narrow SAR has identified N,N dimethyl-3,4-diphenyl-1H-pyrazole-1-propanamine, 3, as a potential antidepressant with reduced side effects. The isomeric N,N-dimethyl-4,5-diphenyl-1H-pyrazole-1 propanamine was completely inactive in the primary antidepressant screens. Compounds were synthesized by Michael addition of acrylonitrile to diphenylpyrazole followed by reductive alkylation of the resultant diphenylpyrazolepropionitriles. Compound 3 was equipotent with imipramine in standard antidepressant assays in animals but showed no significant anticholinergic action and did not antagonize the antihypertensive effects of clonidine and guanethidine. PMID- 3968691 TI - Education in our society. PMID- 3968692 TI - To see ourselves. PMID- 3968693 TI - Students' ratings of instructors in a multidiscipline course. AB - Multidiscipline courses employing small group bedside teaching techniques are difficult to evaluate. At the University of Ottawa School of Medicine, a simple rating system by the students was employed to monitor a 180-hour clinical methods course that involved lectures, laboratories, and small group teaching at the bedside. This monitoring system allowed course organizers to evaluate over 3,000 hours of teaching provided by nearly 250 instructors in 20 different divisions and departments. Examples are reported in this article which demonstrate how the rating system was used to detect unsatisfactory areas in the course. Analysis of the ratings allowed the course organizers to understand the difficulties better than without it and in most cases to correct them. PMID- 3968694 TI - Statistical analysis of examinations to detect cheating. PMID- 3968695 TI - Family practice and internal medicine residents' values related to future medical practices. PMID- 3968696 TI - A course on teaching for house officers. AB - A pilot course on clinical teaching methods was given to 11 volunteer third-year medical residents. The course consisted of four weekly two-hour sessions designed to cover the areas in which house officers do the most teaching. Both clinical and nonclinical educators participated as faculty members in an attempt to create balance in perspective. A homogeneous group was invited to volunteer to create an atmosphere in which trust, common experience, and clinical experience could be used to maximum advantage by the faculty. A relaxed "nonclassroom" atmosphere was created that facilitated interchange. The course was uniformly well received. Though only a pilot course, the experience suggests that formal education in the field of clinical teaching is well received by house staff members. PMID- 3968697 TI - Recommendations of the General Professional Education of the Physician report. PMID- 3968698 TI - Clinical competence. PMID- 3968699 TI - Costs of medical education. PMID- 3968700 TI - Premedical syndrome. PMID- 3968702 TI - The teaching hospital and medical education: one-room schoolhouse, multiversity, dinosaur? PMID- 3968701 TI - Medicine: a learned profession? PMID- 3968703 TI - Reflections on medical education: concerns of the student. PMID- 3968704 TI - Phagocytosis by human leukocytes, phagosomal pH and degradation of seven species of bacteria measured by flow cytometry. AB - Phagocytosis by human leukocytes, phagosomal pH and degradation of seven species of bacteria were studied by a flow cytometric method. The percentage of phagocytosing leukocytes was similar for all bacterial strains examined, but Salmonella typhi and Neisseria meningitidis were more slowly phagocytosed than other bacteria. The phagosomal pH surrounding the different bacterial species 15 min after the start of phagocytosis were: Streptococcus pneumoniae 4.4; N. meningitidis 4.9; Str. pyogenes 5.1; Staphylococcus aureus 5.2; Escherichia coli 5.3; S. typhi 5.4; and Klebsiella pneumoniae 5.7. For longer incubation periods, the phagosomal pH remained nearly constant. Staph. aureus, E. coli and S. typhi were the most readily degraded of the species tested. The proteins of all bacteria were degraded more rapidly than their DNA as determined by measurements of the loss of fluorescein-isothiocyanate-fluorescence and ethidium bromide fluorescence, respectively. The rate of degradation varied from one bacterial species to another. The degradation of proteins and DNA was maximal for bacteria residing in a phagosomal environment estimated to be between pH 5.2 and 5.4. PMID- 3968705 TI - Electronmicroscopy of the surface of Pasteurella haemolytica. AB - The surfaces of Pasteurella haemolytica, biotype A, serotypes 1, 2, 6, 7 and 9 and of P. haemolytica, biotype T serotypes 3, 4, 10 and 15 were examined by transmission electronmicroscopy with ruthenium red staining and polycationic ferritin labelling, by scanning electronmicroscopy, and by light microscopy. Electronmicroscopy showed that the surface of strains of P. haemolytica biotype A was covered by irregular protrusions which were probably capsular material. The surface and general morphology of P. haemolytica biotype T were distinct from those of biotype A. PMID- 3968706 TI - Polymorphism of a mycobacterial antigen participating in cell-mediated immunity. AB - The cross-reactivity of crude sonic extracts of six species of mycobacteria was studied by skin tests in mice and guinea pigs immunised with live Mycobacterium tuberculosis strain H37Rv, and in patients with pulmonary tuberculosis. All slowly growing mycobacteria elicited a strong delayed hypersensitivity response, M. vaccae a moderate response and M. phlei a poor or no response. A specific target antigen for cell-mediated immunity, known to be present in M. tuberculosis, was also present in all the mycobacteria studied. This shared antigen was shown, by immunoprecipitation tests, to be identical in all the slowly growing species but only a partial reaction of identity was obtained with M. phlei. It is concluded that the antigen shared by the slowly growing mycobacteria is immunodominant in cell-mediated immunity. PMID- 3968708 TI - Endourology--a continuum. PMID- 3968707 TI - Degradation of human immunoglobulins G and M and complement factors C3 and C5 by black-pigmented Bacteroides. AB - Strains of Bacteroides, Capnocytophaga and Fusobacterium were examined by immunological methods for their ability to degrade the human serum proteins IgG, IgM, C3 and C5. The proteolytic activity of the strains was measured in terms of the breakdown of serum into trichloroacetic acid-soluble material. Only black pigmented Bacteroides strains showed proteolytic activity. Strains of B. gingivalis degraded IgG, IgM, C3 and C5, strains of B. intermedius IgG and C3, strains of B. endodontalis C3 and IgG and a strain of B. loeschei degraded only IgG. These findings are discussed in relation to the pathogenicity of the black pigmented Bacteroides. PMID- 3968709 TI - Medullary carcinoma of the thyroid. Retrospective diagnosis using current technics on late metastases. PMID- 3968710 TI - Erythema multiforme following swimming in a chlorinated pool. PMID- 3968711 TI - Black and white psychiatrists: therapy with blacks. AB - This paper is one of a series of reports on the findings of a survey on psychotherapy with nonpsychotic black patients and black and white psychiatrists. The responses of the two groups of psychiatrists are presented and analyzed, focusing on their clinical experiences with their black patients. The differences between the two groups of psychiatrists on the presenting problems, unconscious conflicts, and role of racism with their black patients are among the clinical areas examined and discussed.The psychiatrists treated similar types of black male and female patients; however, the survey results indicate that a large proportion of white psychiatrists have little or no experience treating blacks. Although there were more similarities than differences in responses of black and white psychiatrists to clinical questions, there were differences in the frequency and order in which problems were rated. For example, both groups of psychiatrists rated developing new coping mechanisms as the most frequent problem in stages of the treatment process for both sexes. However, white psychiatrists rated a majority of the problems in stages of the treatment process as occurring more frequently than did black psychiatrists. The findings substantiate difficulties with clinical treatment by a therapist who has a racial, ethnic, or cultural background different from that of his patient. PMID- 3968712 TI - Survival guilt and the Afro-American of achievement. AB - Success is not without psychological pain for many individuals, and is known to be particularly burdensome for many Afro-Americans. Untoward responses get in the way of ongoing success and dilute their wishes/efforts to make meaningful contributions to others who are struggling to climb another rung in the "achievement ladder." Health professionals must remain alert to these problems, and work toward developing and providing effective intervention services-both for guilty achievers and for those who perceive that they have been left behind. PMID- 3968713 TI - Liposuction surgery: an office procedure. AB - The author describes liposuction surgery and points out the merits of performing the procedure in an office setting. PMID- 3968714 TI - A nutrition-physical fitness intervention program for low-income black parents. AB - An 8-week program taught nutrition and aerobic exercise to obese, low-income black mothers of children under 3 years. A reduction in risk factors for cardiovascular disease in the mothers was anticipated. Culturally adapted aerobic dancing was well-suited for exercise. It was assumed that children would ultimately adopt their parents' changed life style. The program demonstrated a significant reduction in heart rates at rest, but no significant change in heart rates with stress. A significant reduction in body-fat percentage was measured, whereas overall weight reduction was not significant. The consumption of vitamin C, protein, fat, and sodium was reduced. Intake of calcium, iron, carbohydrates, and vitamin A rose significantly. The results indicate the potential effectiveness of such dual intervention programs. Further study would be necessary for more conclusive results and recommendations. PMID- 3968715 TI - Carcinoma of the esophagus in blacks. AB - The incidence of esophageal carcinoma in the United States in white males is 6 per 100,000, compared with 20 per 100,000 in black males. The average 5-year survival for both groups is 5 percent. This study is a comprehensive analysis of esophageal carcinoma in blacks in the Pittsburgh area from 1957 to 1982. Family history, sex, age, ethnic background, social history, occupation, educational level, symptoms and signs, diagnosis, histopathology, cancer staging, treatment, and survival are reviewed. This information may expand our knowledge of esophageal cancers in blacks as well as all patients afflicted with this dreadful disease. PMID- 3968716 TI - Health care in Denmark. PMID- 3968717 TI - An unusual angiographic appearance of aorto-iliac disease presenting as the Leriche syndrome. AB - An unusual angiographic presentation of Leriche syndrome is described that demonstrates short segment occlusions of iliac arteries with bilaterally symmetrical post-stenotic dilatations. PMID- 3968718 TI - Cellular integrity is required for inhibition of initiation of cellular DNA synthesis by reovirus type 3. AB - Synchronized HeLa cells, primed for entry into the synthesis phase by amethopterin, were prevented from initiating DNA synthesis 9 h after infection with reovirus type 3. However, nuclei isolated from synchronized cells infected with reovirus for 9 or 16 h demonstrated a restored ability to synthesize DNA. The addition of enucleated cytoplasmic extracts from infected or uninfected cells did not affect this restored capacity for synthesis. The addition of ribonucleotide triphosphates to nuclei isolated from infected cells stimulated additional DNA synthesis, suggesting that these nuclei were competent to initiate new rounds of DNA replication. Permeabilization of infected cells did not restore the ability of these cells to synthesize DNA. Nucleoids isolated from intact or permeabilized cells, infected for 9 or 16 h displayed an increased rate of sedimentation when compared with nucleoids isolated from uninfected cells. Nucleoids isolated from the nuclei of infected cells demonstrated a rate of sedimentation similar to that of nucleoids isolated from the nuclei of uninfected cells. The inhibition of initiation of cellular DNA synthesis by reovirus type 3 appears not to have been due to a permanent alteration of the replication complex, but this inhibition could be reversed by the removal of that complex from factors unique to the structural or metabolic integrity of the infected cell. PMID- 3968719 TI - E1a regions of the human adenoviruses and of the highly oncogenic simian adenovirus 7 are closely related. AB - Simian adenovirus 7 (SA7) is a highly oncogenic virus, capable of causing tumors in hamsters upon the direct injection of viral DNA. We determined the transcriptional organization of the transforming region and compared it with that of the human adenoviruses. This analysis demonstrated that there are two independently promoted transcription units similar to the E1a and E1b regions of the human adenoviruses. The nucleotide sequence of the SA7 E1a region demonstrated considerable homology with the human adenoviruses, both in the sequences that regulate E1a expression and in the encoded polypeptides. The amino acid homology was reflected in the ability of SA7 to complement the growth of human adenoviruses mutant in the E1a region. Furthermore, we found two regions of amino acid homology unique to SA7 and the highly oncogenic human adenovirus 12. PMID- 3968720 TI - Sindbis virus proteins nsP1 and nsP2 contain homology to nonstructural proteins from several RNA plant viruses. AB - Although the genetic organization of tobacco mosaic virus (TMV) differs considerably from that of the tripartite viruses (alfalfa mosaic virus [AlMV] and brome mosaic virus [BMV]), all of these RNA plant viruses share three domains of homology among their nonstructural proteins. One such domain, common to the AlMV and BMV 2a proteins and the readthrough portion of TMV p183, is also homologous to the readthrough protein nsP4 of Sindbis virus (Haseloff et al., Proc. Natl. Acad. Sci. U.S.A. 81:4358-4362, 1984). Two more domains are conserved among the AlMV and BMV 1a proteins and TMV p126. We show here that these domains have homology with portions of the Sindbis proteins nsP1 and nsP2, respectively. These results strengthen the view that the four viruses share mechanistic similarities in their replication strategies and may be evolutionarily related. These results also suggest that either the AlMV 1a, BMV 1a, and TMV p126 proteins are multifunctional or Sindbis proteins nsP1 and nsP2 function together as subunits in a single complex. PMID- 3968722 TI - Replication and polypeptide synthesis of Mill Door/79, an orbivirus isolated from ticks from a seabird colony in Scotland. AB - The replication and polypeptide synthesis of orbivirus isolate Mill Door/79, a member of the Kemerovo serogroup, were studied. In Vero cells cell-associated virus exceeded cell-free virus by about 2 log10 PFU/ml. Attempts to purify the virus resulted in the demonstration of five polypeptides. Thirteen virus-induced polypeptides and 10 segments of double-stranded RNA were identified in infected cells. Partial proteolysis demonstrated homology between some polypeptides. PMID- 3968723 TI - The re-entry nephrostomy catheter for endourological applications. AB - A re-entry nephrostomy catheter has been developed for most endourological procedures. The 24F self-retaining catheter has an 18 cm. extension that allows access to the ureter for introduction of a safety guide wire during 2-stage percutaneous nephrolithotomy. The catheter also is an ideal drainage tube and stent following 1-stage stone extraction. PMID- 3968721 TI - Sequence comparisons of the anemia- and polycythemia-inducing strains of Friend spleen focus-forming virus. AB - A nucleotide sequence analysis carried out on the envelope gene of the anemia inducing strain of the Friend spleen focus-forming virus (F-SFFVA) reveals that its product has some unique features in common with previously described polycythemia-inducing strains of F-SFFV (F-SFFVP). (i) It contains an amino terminus that is highly related to the gp70 of mink cell focus-inducing viruses, (ii) it is a fusion protein containing the amino terminus of gp70 and the carboxy terminus of p15E, and (iii) it lacks the R-peptide normally found at the carboxy end of the p15E region. Although the envelope genes of F-SFFVA and F-SFFVP are quite similar overall, they do show sequence variation, particularly at the 3' end in the p15E-related region. These variations may contribute to previously observed differences in the response of F-SFFVP- and F-SFFVA-infected erythroid cells to regulatory hormone or to differences in the way the envelope glycoproteins are processed. The long terminal repeat regions of F-SFFVA and the Lilly-Steeves strain of F-SFFVP were also sequenced and compared with each other and with a previously published sequence of another F-SFFVP long terminal repeat. The sequences were found to be reasonably similar to each other but different from their ecotropic parent, Friend murine leukemia virus, as a result of a deletion of one copy of the direct tandem repeat in the enhancer regions. The observation that all SFFVS have this common change in the long terminal repeat enhancer region raises the possibility that it is required for pathogenicity. PMID- 3968724 TI - Effect of percutaneous nephrostolithotomy on renal function. AB - In 15 patients with 17 stone-containing renal units renal function studies were performed before and 2 to 3 months after percutaneous nephrostolithotomy. The creatinine clearance of the operated renal units was calculated from the total creatinine clearance and differential renal function was obtained with radionuclides. Changes in the cortical images of the operated kidney also could be determined from the radionuclide scans. There was no significant change in the creatinine clearances when all of the operated kidneys were considered. However, there was significant improvement in the function of 12 units containing infectious stones in which preoperative function was reduced. Percutaneous nephrostolithotomy preserves or improves renal function and can be used for all types of renal stones. PMID- 3968725 TI - Late sequelae of ultrasonic lithotripsy of renal calculi. AB - We examined 82 patients 12 to 43 (mean 22) months after renal calculi had been removed by ultrasonic lithotripsy. Recurrence was noted in 2 patients but this correlated to the previous stone-forming rate. Smaller fragments that had remained in 9 patients were passed in 2, removed percutaneously in 2 and unchanged in the remainder. There was no evidence of hypertension or urinary tract infection related to the procedure. There were 62 patients available for computerized tomography and 11 per cent of the kidneys showed minute calcifications not visible on plain films. Barely visible scarring was noted on the fibrous capsule posterior to the lower pole in 22 per cent of the cases and on the abdominal wall along the former nephrostomy tract in 46 per cent. However, a cortical scar was noted in only 1 kidney and no arteriovenous fistulas were found. On dimercapto-succinic acid scans it was impossible to localize the puncture site and serial 131iodine-hippurate renograms available in 18 patients showed a 7.6 plus or minus 2.8 per cent (mean plus or minus standard error of mean) increase in function. We conclude that percutaneous nephrolithotripsy with ultrasound is a safe and effective procedure with minimal late morbidity. PMID- 3968726 TI - Bacteremic urosepsis: a phenomenon unique to elderly women. AB - Bacteremia constitutes a major challenge to the aged patient because the pathophysiological derangements that ensue pose an immediate threat to life. Compared to younger adults the elderly suffer bacteremia more frequently in association with pneumococcal pneumonia and salmonella enteritis/colitis. A prospective study to detect bacteremia was performed on 68 consecutive women with pyelonephritis requiring hospitalization. The data indicate that bacteremia occurs more frequently in elderly than in young women with nonobstructive pyelonephritis. PMID- 3968728 TI - Renal trauma: re-evaluation of the indications for radiographic assessment. AB - We studied prospectively 359 consecutive patients with blunt (306) or penetrating (53) renal trauma to refine the indications for radiographic evaluation. Various factors, including the degree of hematuria, presence of shock and associated injuries easily assessable at the time of initial evaluation, were correlated with the severity of renal injury to determine whether any combination of parameters will separate patients with renal contusions from those with significant renal injuries (minor and major lacerations, and vascular injuries). We identified 3 groups: group 1-85 patients with gross hematuria or microscopic hematuria and shock after blunt trauma (including all 23 with significant renal injuries), group 2-221 patients with microscopic hematuria but no shock after blunt trauma (all with renal contusions) and group 3-53 patients with penetrating trauma. No combination of parameters was able to predict a severe injury in group 3. Our data support radiographic evaluation in groups 1 and 3. However, because all patients in group 2 had renal contusions and experienced no complications from nonoperative management we believe that excretory urography, which is time consuming and costly, can be avoided in patients with microscopic hematuria but no shock after blunt renal trauma. PMID- 3968727 TI - Renal parenchymal appearance on 123iodine-hippurate renoscintigrams and excretory urograms. AB - In 61 patients with vesicoureteral reflux renal scar formation was diagnosed by excretory urography and 123iodine-hippurate scintigrams. Scar formation on the nephrograms was detected in the upper, middle and lower zones of the kidneys on tomography exposures. Scintigraphic detection of scars was performed on the computerized uptake of the parenchymal phase. Maximal time elapse between the 2 investigations was 1 year. Excretory urography revealed 37 kidneys with a total of 74 regional scars. On scintigraphy 57 kidneys were judged to have 102 scars. There were 281 regions judged to be identical on the scintigram and the nephrogram. A true positive ratio (sensitivity) of 0.46 and a true negative ratio (specificity) of 0.90 were noted for the excretory urogram, compared to a sensitivity of 0.64 and a specificity of 0.81 for renography. The study confirms an over-representation of scars judged from scintigrams, which calls for further investigation of scar formation detection. PMID- 3968729 TI - Superior mesenterorenal bypass for renal revascularization with infrarenal aortic occlusion. AB - The technique of renal revascularization using a saphenous vein bypass graft from the superior mesenteric artery is described. This operation has been performed for the correction of renal artery stenosis in 4 patients with atherosclerotic aortic occlusion. When the requisite conditions are present, mesenterorenal bypass offers a safe and effective method of renal revascularization, and is preferable to aortic replacement in selected patients. PMID- 3968730 TI - The value of transvascular embolization in the treatment of renal carcinoma. AB - In a consecutive series of 62 patients with renal carcinoma transvascular embolization has been evaluated in regard to its limitations, complications, influence on the surgical procedure and success of treatment. Of 47 planned embolizations 36 could be accomplished. Total embolization was achieved in 29 of the 36 cases (81 per cent). One case was complicated due to displacement of the embolization material to the femoral artery. The subjective impression of the surgeon was that embolization facilitated nephrectomy, although this could not be proved by objective measurement of the duration of operation and perioperative blood loss. Survival after embolization and nephrectomy was no better than after nephrectomy alone. PMID- 3968731 TI - Bladder leiomyosarcoma: a review of 10 cases with 5-year followup. AB - Of 10 patients with leiomyosarcoma of the bladder followed for a minimum of 5 years 4 remain free of disease at 5, 6, 6 and 9 years, respectively, following partial cystectomy. An additional patient who was treated sequentially by radiation, radical cystectomy and chemoimmunotherapy survived for 10 years before death of metastatic disease. Wide surgical extirpation (partial or radical cystectomy) remains the curative treatment of choice. PMID- 3968732 TI - Surgical reconstruction for complete urinary incontinence: a 10 to 22-year followup. AB - A 22-year followup study was performed on 27 children and 7 adults treated surgically for complete urinary incontinence. The etiology of the incontinence was iatrogenic, traumatic or congenital. The patients had undergone a urethral reconstruction that created a physiological sphincter by ureteral reimplantation and trigonal tubularization. Success was defined if a patient was dry with no leakage or stress urinary incontinence and partial success was noted if the patient wore 1 to 3 perineal pads per day that were moist to damp. Of 7 adults 4 (57 per cent) were dry and 2 (29 per cent) were considered a partial success, compared to 19 (70 per cent) and 1 (3 per cent), respectively, of 27 children. Postoperatively, no significant residual urine was present and the excretory urograms were normal. Failures and alternative treatments for failures are discussed. PMID- 3968733 TI - Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis. AB - The anatomical location of the branches of the pelvic plexus that innervate the corpora cavernosa has been identified previously in stillborn male neonates and fetuses. Based upon these observations, the techniques of radical retropubic prostatectomy and cystectomy have been modified to avoid injury to the autonomic innervation of the corpora cavernosa. However, the exact anatomical relationships of these nerves to the prostate, urethra and other pelvic structures in adults are unclear, since the initial anatomical studies of the pelvic plexus were performed in stillborn neonates in whom the accompanying vessels and fascia had been removed. Because these nerves are microscopic in size and can only be identified by their association with other pelvic structures, it was believed that a more refined understanding of the anatomy was necessary. In an effort to identify precisely the relationship of the cavernous branches of the pelvic plexus to the lateral pelvic fascia and the branches of the prostatovesicular arteries and veins, the following study was performed. Shortly after death a 60 year-old man was perfused completely with Bouin's fixative solution. The entire bladder, prostate, urethra, penis, corpora cavernosa, rectum, and pelvic sidewall fascia and musculature were removed en bloc. The specimen was serially sectioned transversely at 10 mu thickness, and every tenth section was stained with hematoxylin and eosin. An anatomical reconstruction in 3 dimensions was performed and illustrated. Thus, the specific location of the nerves that innervate the corpora cavernosa and their important relationships to the urethra, prostatic capsule, Denonvilliers' fascia and pelvic floor vasculature have been identified. PMID- 3968734 TI - Penile neuropathy in insulin-dependent diabetes mellitus. AB - The dorsal nerve of the penis has been linked closely to penile erection and response. We measured the nerve conduction velocity of the dorsal nerve of the penis, latency of the bulbocavernosus reflex and pudendal evoked potential in 23 normal men and 20 insulin-dependent diabetics with impotence. The conduction velocity of the dorsal nerve of the penis was significantly slower in diabetic than in normal men and passive gentle elongation of the penis by weight stretching enhanced the slowing. In contrast, the bulbocavernosus reflex and pudendal evoked potential showed no significant differences between the 2 groups. We demonstrate the potential usefulness of measurement of the conduction velocity of the dorsal nerve of the penis in the detection of penile neuropathy. PMID- 3968735 TI - Verrucous carcinoma of the penis. AB - We reviewed 13 cases of verrucous carcinoma, accounting for 5 per cent of the penile cancers seen during a 25-year interval. Although the typical verrucous pattern predominated minute foci of invasive squamous carcinoma were identified in 3 patients. All patients were followed for at least 6 years and none has died of the malignancy. Wide surgical excision, usually requiring partial or total penectomy, is the treatment of choice. PMID- 3968736 TI - The role of the spermatic cord layers in the development of varicoceles. AB - The theory that insufficiency of the spermatic cord layers could be the etiological factor in the development of varicocele is reviewed critically. A prospective study of 40 patients operated upon for a left indirect inguinal hernia was done. The spermatic cord layers were excised as a routine part of the operation but combined manual and Doppler examinations revealed no postoperative reflux into the pampiniform plexus. We conclude that the spermatic cord layers probably do not have a major role in the pathogenesis of varicocele. PMID- 3968737 TI - Radical prostatectomy with adjuvant radioactive gold for prostatic cancer: a preliminary report. AB - A total of 71 patients with prostatic carcinoma underwent radical prostatectomy combined with instillation of radioactive gold seeds between January 1, 1977 and July 1, 1982. Gold seeds were implanted intraoperatively into the region of the prostatic vascular pedicles and surrounding fibrolymphatic tissue after removal of the prostate and seminal vesicles. Of the patients with disease confined to the prostate clinically 46.7 per cent had microscopic extraprostatic local tumor extension. We believe that patients with extraprostatic local tumor derive therapeutic benefit from the addition of adjuvant radioactive gold seeds at prostatectomy. Because of the inaccuracy of clinical staging by rectal examination, we have elected to use radioactive gold seeds in all of our patients at prostatectomy. To date, local recurrence has been noted in 5.6 per cent of our patients and systemic progression in 14.1 per cent. PMID- 3968738 TI - Radioisotope renography in spinal cord injury. AB - Isotope renography was compared to excretory urography, voiding cystourethrography and endogenous creatinine clearances in 52 spinal cord injury patients. Renogram abnormalities were detected in 86 per cent of the cases. The most common abnormality was the delay of isotope excretion from the renal cortex and pelvis. Anticholinergic medication significantly reduced these excretion delays. A subgroup containing 22 newly injured patients was evaluated separately. Renogram abnormalities in this subgroup were associated with normal excretory urography and normal creatinine clearances. We postulate that the defect producing upper tract deterioration in spinal cord injury begins early, is obstructive to renal drainage, does not increase with time and probably requires early intervention with anticholinergic medication or transurethral sphincterotomy to prevent upper tract damage. PMID- 3968739 TI - Pediatric anatrophic nephrolithotomy. AB - A 15-year experience with pediatric anatrophic nephrolithotomy was reviewed. There were 11 procedures performed in 10 patients. Average patient age was 9.43 plus or minus 1.54 years (standard error of the mean). Preoperative urine cultures were positive in 6 of 11 cases. Metabolic or structural defects were identified in all patients. Postoperative morbidity was minimal. Adequate followup was available in 9 patients, for an average length of 4.6 plus or minus 0.96 years. Stones recurred in 7 of 9 patients (78 per cent) but in 2 the new calculi were small and asymptomatic. Anatrophic nephrolithotomy can be performed safely in children but a high incidence of structural and metabolic abnormalities predisposes these patients to recurrent stones. PMID- 3968740 TI - Xanthogranulomatous pyelonephritis in children. AB - Xanthogranulomatous pyelonephritis usually occurs in women 50 to 60 years old, and has the distinct clinical presentation suggestive of a renal mass. Since 1963 an increasing number of children with xanthogranulomatous pyelonephritis have been reported in the literature, with data suggesting that the characteristics of the disease are different from those in adults. We compared our children with xanthogranulomatous pyelonephritis to adults who had been described in the literature and to our cases of chronic pyelonephritis to determine whether xanthogranulomatous pyelonephritis in children is an entity as clearly different from chronic pyelonephritis as it is in adults. Twenty-one cases were eliminated from the study because of incomplete charts. We found 39 cases in which nephrectomy had been done for an anatomical diagnosis of chronic or xanthogranulomatous (8) pyelonephritis. Average age at presentation, duration of clinical course and sex distribution were similar in both groups. The left kidney was involved more often in both groups. Severe malnutrition, urolithiasis, reno cutaneous fistula and negative urine cultures were more frequent in cases of xanthogranulomatous pyelonephritis, while obstructive nonlithiasic uropathy occurred more often in cases of chronic pyelonephritis. Microorganisms were similar in both groups and Escherichia coli was isolated most frequently. All cases of xanthogranulomatous pyelonephritis were of the diffuse type with areas corresponding to all histological stages. Our study suggests that perhaps in children xanthogranulomatous pyelonephritis occurs the same as chronic pyelonephritis, and is determined possibly by an affected immune response secondary to malnutrition and by the presence of urolithiasis. PMID- 3968741 TI - Prognostic features in infants with obstructive uropathy due to posterior urethral valves. AB - The histories of 22 infants presenting during the first year of life with obstructive uropathy due to posterior urethral valves were analyzed to determine outcome and prognostic features. Mean patient age at the time of the initial surgical intervention was 39 days, and the mean duration of followup inclusive of renal function data was 5.8 years. One patient died (5 per cent) and one had end stage renal disease. The mean preoperative and postoperative serum creatinine concentrations during the initial hospitalization were 3.1 and 1.4 mg. per dl., respectively. Neither value was significantly predictive of the creatinine concentration at final followup. In contrast, the nadir creatinine value during the first year of life correlated significantly with final renal function. Children with nadir creatinine values less than or equal to 0.8 mg. per dl. by 12 months of age maintained creatinine levels less than or equal to 1.1 mg. per dl. at the time of final evaluation, whereas children with higher values during the first year of life were likely to have progressive renal failure. Of 19 final creatinine determinations 6 were normal and 5 exceeded 1.5 mg. per dl. Proteinuria, hypertension, renal biopsy findings, urinary infection, unilateral nephrectomy and type of surgery did not correlate significantly with functional outcome. Followup studies of longer duration are needed to determine the ultimate outcome of these patients, more than half of whom had some degree of renal insufficiency at final evaluation. PMID- 3968742 TI - The abdominal neourethra in children: technique and long-term results. AB - The abdominal neourethra is a continent bladder tube that is applicable to selected children with anatomical urinary incontinence or urinary retention and a nonnavigable urethra. A 5 to 8-year followup is presented in 6 children in whom the abdominal neourethra afforded normal micturition through it or permitted intermittent catheterization. All children were dry between bladder emptyings as a result of a continence mechanism that combined a long elastic tube and a cephalad neourethral abdominal opening with a rectus striated muscle sphincter. PMID- 3968743 TI - Polytetrafluoroethylene injection for urinary incontinence in children. AB - We have treated 11 children for urinary incontinence with one or more endoscopic injections of polytetrafluoroethylene (Teflon) into the external urethral sphincter region. The procedure is simple to perform and without significant complications. Long-term results have been gratifying, with cure or improvement in 8 of the 11 patients. PMID- 3968744 TI - Renal masses. PMID- 3968745 TI - Pheochromocytoma with hypercalcemia: case report and review of literature. AB - We report a case of severe hypercalcemia and a pheochromocytoma of the right adrenal gland. The patient underwent adrenalectomy, following which the hypercalcemia disappeared. Parathormone assay of the adrenal tumor revealed high levels of activity despite normal serum parathormone activity. This suggests that the etiology of hypercalcemia in patients with pheochromocytoma is related to ectopic secretion of a parathormone ectopic peptide-like substance. PMID- 3968746 TI - Partial nephrectomy for a renal oncocytoma associated with tuberous sclerosis. PMID- 3968747 TI - Supradiaphragmatic renal cell carcinoma tumor thrombus: indications for vena caval reconstruction with pericardium. AB - Supradiaphragmatic extension of tumor thrombus from a renal cell carcinoma presents a major surgical challenge. The use of cardiopulmonary bypass, hypothermia and cardiac arrest with temporary exsanguination has allowed for successful surgical excision of these tumors. A renal cell carcinoma on the right side with a supradiaphragmatic tumor thrombus still may only partially occlude the vena cava. The collateral venous circulation of the left renal vein may be developed poorly and a pericardial patch can allow successful reconstruction of the inferior vena cava. If the tumor arises on the left side continued venous drainage of the right kidney is mandatory to prevent venous infarction of the right kidney. The entire vena cava also might be reconstructed theoretically with pericardium. PMID- 3968749 TI - Urethral duplication and complete bladder exstrophy. AB - Urethral duplication is a rare anomaly that has been classified into epispadiac, hypospadiac, spindle, Y-duplications and collateral varieties. We report a case of an accessory urethra associated with complete bladder exstrophy in which the accessory urethra was integrated into the epispadias repair. To our knowledge this is the first case reported of urethral duplication associated with bladder exstrophy. PMID- 3968748 TI - Covered exstrophy and visceral sequestration: a rare exstrophic variant. AB - We report a case of covered exstrophy and sequestration of a segment of bowel on the surface of the abdomen, which is a rare variant of the exstrophic complex. The external genitalia and urinary continence were normal. Simple excision of the ectopic bowel was curative. PMID- 3968750 TI - Cowper's syringocele causing incontinence in an adult. AB - We report on a man with post-void incontinence owing to a dilated Cowper's duct (syringocele), which was cured by endoscopic marsupialization. The clinical, radiographical and pathophysiological features of Cowper's lesions are reviewed briefly. PMID- 3968751 TI - Penile replantation: current concepts. AB - We describe the microvascular repair of a traumatically lacerated penis (the fifth such case in the literature) and outline a uniform plan of management with which one can expect restoration of function and an adequate cosmetic appearance. Microvascular repair represents the most physiological method of reconstruction, with a lower incidence of urethral stricture disease, skin loss and sensory impairment. PMID- 3968752 TI - Bilateral papillary cystadenoma of the epididymis as a component of von Hippel Lindau's syndrome: report of a case presenting as infertility. AB - We report a case of bilateral papillary cystadenoma of the epididymis thought to be a component of the von Hippel-Lindau syndrome. The patient was hospitalized initially because of infertility. He had undergone a craniotomy 2 years previously for the diagnosis of a cerebellar hemangioblastoma. Funduscopy had revealed angiomatous lesions of the left eye. The von Hippel-Lindau syndrome is discussed briefly and the importance of long-term urological followup for possible presentation of silent renal carcinoma is emphasized. Patients with bilateral epididymal papillary cystadenoma are prone to have other components of the von Hippel-Lindau syndrome, and clinical studies are indicated in all such patients. PMID- 3968754 TI - Re: Bacteriology of branched renal calculi and accompanying urinary tract infection. PMID- 3968753 TI - Actinomycosis of the prostate. AB - We report a case of actinomycosis of the prostate with symptoms of acute prostatitis. Laparotomy was required to establish an etiological diagnosis. Long term therapy with erythromycin resulted in a clinical cure. PMID- 3968755 TI - Re: Treatment of male urethral calculi. PMID- 3968756 TI - Re: Urodynamic abnormalities in neurologically normal children with micturition dysfunction. PMID- 3968757 TI - Torsion and the contralateral testicle. AB - The histologic effect of unilateral torsion on the contralateral testicle in adult Noble rats was examined. Utilizing detorsion or orchiectomy at 3 hours and 24 hours after torsion, the effect of early and late treatment of these changes was reviewed. The histologic changes consisted of loss of tubular spermatozoa, clumping of chromatin within the spermatocytes, the presence of Sertoli-only cells, evacuolization of Sertoli cytoplasm and germinal epithelial sloughing. Depression of spermatogenesis and decrease in the mean seminiferous tubular size was seen in the "normal" testicle after unilateral torsion. This effect was negated by early treatment with either orchiectomy or detorsion. Late detorsion does not negate these effects and late orchiectomy only partially negates them. Despite the depressed tubular function, the presence of early spermatogenic elements seen in the majority of the tubules in the "normal" testicle implies the possible reversibility of these changes. PMID- 3968758 TI - Adrenergic and non-adrenergic contraction of isolated urethral muscle from rabbit and man. AB - Isolated urethral muscle from rabbit and man was subjected to electrical field stimulation and the components of the resulting contraction were analyzed. Contraction usually consisted of 2 main components. One was rapidly developing, non-adrenergic and atropine-resistant. The other developed more slowly and was sensitive to alpha-adrenoceptor blockade and to chemical sympathectomy with 6 hydroxydopamine. By lowering the temperature from 37C to 20C, these contraction components could be separated from each other. Both could be blocked by tetrodotoxin but the effects of this drug were not consistent in human tissue. Characteristic for the initial contraction component was its dependence on the tension of the preparation; it increased with increasing tension. The adrenergic part of the contraction could be effectively blocked by phentolamine and prazosin, whereas rauwolscine was less effective. Atropine and scopolamine also inhibited the adrenergic part of the contraction, whereas acetylcholine caused a transient increase. The non-adrenergic contraction component was less sensitive to deprivation of extracellular Ca2+ than the adrenergic; almost 40 per cent remained after exposure to Ca2+ free solution for 40 min., whereas the adrenergic component disappeared after 20 min. exposure. Light and electron microscopic investigation revealed 3 distinct layers of the rabbit urethral wall, 1 outer consisting of smooth and striated muscle, 1 middle consisting of smooth muscle only, and a submucosal layer where vessels and smooth muscle cells were found. Removal of the longitudinal muscle layer did not change the responses to electrical stimulation. The results suggest that the electrically induced adrenergic activation of urethral muscle of both rabbit and man was mediated mainly via alpha-adrenoceptors and that this muscle is innervated not only by sympathetic, adrenergic nerves but also by a type of nerve able to release a non cholinergic, contraction-mediating transmitter. PMID- 3968759 TI - Possible role of hyaluronate in experimental renal stone formation in rabbits. AB - We produced renal stones in rabbits by modifying Itatani's method, ligation of the right ureter followed by ureteroneocystostomy 1 week later. Renal stones formed in all animals within 2 weeks after ureteroneocystostomy. We measured the components of glycosaminoglycan in the stone matrix, renal tissue and urine by 2 dimensional electrophoresis. Glycosaminoglycan of the stone matrix consisted solely of hyaluronate. Glycosaminoglycan of the control normal urine consisted of only chondroitin sulfate, although hyaluronate was contained in urine in the hydronephrotic and stone forming period. Glycosaminoglycan of the control normal kidney consisted mainly of hyaluronate and chondroitin sulfate, while hyaluronate was the main component of glycosaminoglycan in the stone forming kidney. From these results, it is clear that hyaluronate is the most important component of glycosaminoglycan in the early stone forming period. PMID- 3968760 TI - Architecture of calcium oxalate monohydrate urinary calculi. AB - We have developed a partial dissolution method which enabled us to observe the internal architecture of urinary calculi. Using this method with improved organic matrix fixative, we studied the architecture of small calcium oxalate monohydrate urinary calculi with special attention to crystal-matrix interrelations. Calculi, we have observed, are invariably composed of 3 distinct zones. A core area is composed of randomly aggregated plate-like crystals with tendency of rosette formation. This core area is surrounded by an intermediate layer which shows prominent radial striations. This layer is composed of radially arranged piles of sheet-like crystals which extend beyond many layers of lamination. This layer gradually shifts to a peripheral layer where concentric laminations are prominent and each layer of lamination is composed of minute crystals which have lost radial arrangement. The organic matrix is observed only at the outside of the crystals, and matrix-rich crystal-poor bands separate each layer of concentric lamination. The concentric lamination seems to be a manifestation of the altered density of organic matrix which encrusted on the developing calculi and offered a milieu for crystal growth within. PMID- 3968761 TI - Regulation of urinary bladder capacity by endogenous opioid peptides. AB - Naloxone administered to chloralose or ketamine anesthetized cats reduced urinary bladder capacity. Successive cystometrograms revealed that naloxone in doses of 0.5 microgram./kg. to 15 micrograms./kg. i.v. reduced the volume necessary to evoke micturition by 10 to 50 per cent, respectively. The effect was maximal within a few minutes, remained constant for about 1/2 hour and returned to control values over the next 2 to 3 hours. Following return to control, subsequent doses of naloxone produced no further effect on capacity. In chloralose anesthetized animals naloxone also increased the frequency and amplitude of low amplitude pressure waves on the tonus limb of the cystometrogram. Intrathecal administration of naloxone to the sacral spinal cord did not significantly reduce the volume necessary to evoke micturition even at large doses, but did increase the amplitude of micturition contractions. These data, along with previous reports, suggest that mu receptors in the brainstem alter urinary bladder capacity, while delta receptors in the spinal cord modulate the magnitude of bladder contractions. Pharmacological manipulation of these receptor systems could provide a tool for the management of neurogenic bladder dysfunction. PMID- 3968763 TI - Gerodontology: 'long in tooth' but not short of dental care. PMID- 3968762 TI - Research on aging burgeons as more Americans grow older. PMID- 3968764 TI - Leads from the MMWR. Dental caries and community water fluoridation trends- United States. PMID- 3968765 TI - Leads from the MMWR. Poliomyelitis--Finland. PMID- 3968766 TI - Leads from the MMWR. Tuberculosis--United States, 1984. PMID- 3968767 TI - Nursing homes after nuclear war: neglected medical resources. PMID- 3968768 TI - Polycythemia and nuclear 'exposure'. PMID- 3968769 TI - Maternal cigarette smoking: effect on infant birth weight. PMID- 3968770 TI - Coffee intake and elevated cholesterol and apolipoprotein B levels in men. AB - Coffee intake from three-day diet records was studied in association with plasma lipoprotein concentrations in a cross-sectional sample of 77 middle-aged American men to determine the significance and form of their interrelationships. The number of cups consumed per day correlated positively with levels of apolipoprotein B (r = .27, P less than or equal to .01) and became more strongly correlated when adjusted for age, cigarette use, adiposity, aerobic capacity, nutrient intake, and stress. Coffee intake also correlated with total cholesterol and low-density lipoprotein (LDL) cholesterol levels when adjusted for these confounding factors. Graphic analyses revealed that plasma concentrations of apolipoprotein B and LDL-cholesterol were unrelated to intake of up to 2 cups of coffee per day and positively associated with intake exceeding 2 to 3 cups. These results suggest that male heavy coffee drinkers have lipoprotein profiles suggestive of increased cardiovascular disease risk, although the causality remains to be determined. PMID- 3968771 TI - Potable water as a source of Legionnaires' disease. AB - A three-year epidemic of legionnaires' disease in a hospital was dramatically curtailed following hyperchlorination of the potable water supply. The hypothesis that potable water was the source for the outbreak was further supported by isolation of Legionella pneumophila (the agent of legionnaires' disease) from the hospital water supply, observation that a sudden upsurge had occurred in the number of cases following a peculiar manipulation of the hospital water system, and documentation of a 30-fold increase in concentration of organisms in the water when this manipulation was artificially recreated. Thus, potable water may be an important source of epidemic legionnaires' disease and continuous hyperchlorination a method of control. PMID- 3968773 TI - Herpes zoster. The treatment and prevention of neuralgia with adenosine monophosphate. AB - Thirty-two adults were enrolled in a randomized, placebo-controlled double-blind trial of intramuscular injections of gel-sustained adenosine monophosphate (AMP) given three times a week for up to four weeks for acute herpes zoster. Adenosine monophosphate moderately reduced the pain soon after the start of treatment, decreased desquamation time, and promoted faster healing of the skin than placebo treatment. Adenosine monophosphate treatment reduced virus shedding and cleared the virus faster than in placebo-treated subjects. At the end of the initial four week treatment period, 88% of AMP-treated patients were pain free, as opposed to only 43% in the placebo group. After four weeks, all patients who had not recovered from pain started receiving AMP treatment without breaking the code. All these patients recovered from pain within three weeks after initiation of treatment. No recurrence of pain or lesions was experienced from three to 18 months after the end of treatment. Adenosine monophosphate, a natural cellular metabolite, showed no side effects or toxicity during and after the treatment. PMID- 3968772 TI - Predicting outcome from hypoxic-ischemic coma. AB - Outcome from coma caused by cerebral hypoxia-ischemia (eg, cardiac arrest) was compared with serial neurological findings in 210 patients. Thirteen percent of patients regained independent function at some point during the first postarrest year. Computer application of new multivariate techniques to the prospectively observed findings generated easily utilized rules that classified patients by likely outcome. At the time of initial examination, 52 patients (one fourth of the total population) had absent pupillary light reflexes, and none of these patients ever regained independent daily function. By contrast, the initial presence of pupillary light reflexes, the development of spontaneous eye movements that were roving conjugate or better, and the findings of extensor, flexor, or withdrawal responses to pain identified a smaller group of 27 patients, 11 (41%) of whom regained independence in their daily lives. By 24 hours after onset, 93 poor-outcome patients were identified by motor responses that were absent, extensor, or flexor and by spontaneous eye movements that were neither orienting nor roving conjugate; only one regained independent function. This contrasts with recovery in 19 (63%) of 30 patients who at that time showed improvement in their eye-opening responses and obeyed commands or had motor responses that were withdrawal or localizing. Similarly simple rules distinguished between good- and poor-prognosis patients on postarrest days 3, 7, and 14. PMID- 3968774 TI - Inadvertent intravenous administration of racemic epinephrine. PMID- 3968775 TI - Vanishing pancreas. Lipomatous infiltration of the pancreas. PMID- 3968776 TI - Adenosine monophosphate for the treatment of varicella zoster infections: a large dose of caution. PMID- 3968778 TI - Accent on communication. PMID- 3968777 TI - Leads from the MMWR. Measles--Hawaii. PMID- 3968779 TI - Expert witness testimony. PMID- 3968780 TI - The insanity defense. PMID- 3968781 TI - Epinephrine for anaphylactic shock. PMID- 3968782 TI - Frozen sections. PMID- 3968783 TI - Magnesium sulfate and digitalis-toxic arrhythmias. PMID- 3968784 TI - Blood counts in male parenteral drug users. PMID- 3968785 TI - Blood lead and blood pressure. Relationship in the adolescent and adult US population. AB - Heavy lead exposure has been connected to cardiovascular disease, but modest exposures encountered in the general environment have not been associated previously with disease risk. The relationship between blood lead levels and blood pressures was examined using data from the second National Health and Nutrition Examination Survey. A direct relationship was found between blood lead levels and systolic and diastolic pressures for men and women and for white and black persons aged 12 to 74 years. Blood lead levels were significantly higher in younger men and women (aged 21 to 55 years) with high blood pressure, but not in older men or women (aged 56 to 74 years). In multiple regression analyses, the relationship of blood lead to blood pressure was independent of other variables for men, but not for women. Dietary calcium and serum zinc levels were inversely related to blood pressure. PMID- 3968786 TI - An outbreak of Pontiac fever related to whirlpool use, Michigan 1982. AB - Fourteen of 23 female members of a church group experienced an acute self-limited illness characterized by chills, fever, chest pain, cough, and nausea, consistent with the diagnosis of Pontiac fever. All 14 affected women had used a whirlpool located in the women's locker room during a racquetball party. Legionella pneumophila serogroup 6 was isolated from the women's whirlpool. Nine of 14 cases showed a seroconversion to heat-fixed antigen prepared from the L pneumophila serogroup 6 isolate. Aerosol size studies show that the whirlpool aerator produced water droplets small enough to travel deep into the tracheobronchial tree but large enough to transport L pneumophila. This outbreak demonstrated that Pontiac fever may be associated with L pneumophila serogroup 6, that whirlpools can serve as a reservoir for these organisms, and that seroconversion can occur in the absence of illness. PMID- 3968787 TI - The urban paramedic's scope of practice. PMID- 3968789 TI - Inappropriate use of fresh-frozen plasma. PMID- 3968788 TI - Consensus conference. Fresh-frozen plasma. Indications and risks. PMID- 3968790 TI - Serum electrolyte changes in near-drowning victims. PMID- 3968791 TI - FDA approves lithotripter for kidney stone shattering. PMID- 3968792 TI - Leads from the MMWR. Compendium of animal rabies vaccines, 1985--prepared by National Association of State Public Health Veterinarians, Inc. PMID- 3968793 TI - The FDA and drug uses: reprise. PMID- 3968794 TI - Medication similarities. PMID- 3968796 TI - Arsenic exposure. PMID- 3968795 TI - Hazards of some pediatric cribs. PMID- 3968797 TI - Akathisia from prochlorperazine. PMID- 3968798 TI - Complications of silicone implant. PMID- 3968799 TI - Lipid Research Clinics Coronary Primary Prevention Trial results. PMID- 3968800 TI - Dihydroergotamine-heparin prophylaxis of postoperative deep vein thrombosis. PMID- 3968801 TI - Satellite and commercial medical clinics. Report of the Board of Trustees: Part I. PMID- 3968802 TI - Neuropsychologic detection of abnormal mental decline in older persons. AB - We conducted comprehensive neuropsychologic assessment in normal 60- to 88-year old persons and in patients with dementia of various causes, matched for age and sex. Patients with dementia performed significantly poorer on tests of short-term memory, temporal orientation, visual perception, and language. Further data analysis, including multivariate classification procedures, identified a combination of three tests (Visual Retention, Controlled Oral Word Association, and Temporal Orientation) that in a cross-validation study correctly classified 89% of cases with a high degree of probability. Only 6.5% of cases were misclassified, while 4.5% were in a questionable, borderline category. The battery constituted by these three discriminating tests provides a brief, easily administered neuropsychologic screening instrument that may be used by a variety of health professionals for the detection of abnormal mental decline in older persons. PMID- 3968803 TI - The decision to 'unmedicate'. PMID- 3968804 TI - Rare hyper-, hypothyroid states require unconventional therapies. PMID- 3968805 TI - From the NIH. Radionuclide therapy for arthritic knees. PMID- 3968806 TI - Leads from the MMWR. Reye syndrome--United States, 1984. PMID- 3968808 TI - Causes of night cramps. PMID- 3968807 TI - 'Two locomotives'. PMID- 3968809 TI - Postvasectomy congestive epididymitis. PMID- 3968810 TI - Diuresis related to cold exposure. PMID- 3968811 TI - 'Break dancers' bursitis'. PMID- 3968812 TI - Reduced physician surplus. PMID- 3968813 TI - Salty taste in the mouth. PMID- 3968814 TI - Competency and consent to treatment. PMID- 3968815 TI - Caffeine analgesia. PMID- 3968816 TI - Catheter-induced lesions of the right side of the heart. A one-year prospective study of 141 autopsies. AB - We examined prospectively for one year the hearts from 141 consecutive autopsy cases in which a central catheter was present at the time of death. Three deaths were attributable to catheter use, two to perforation. Furthermore, mural thrombi were present in 33 (33%) of 99 patients with pulmonary arterial catheters and in 12 (29%) of 42 patients with central venous catheters. The incidence of pulmonary emboli or bacteremia was no greater in patients with thrombi than in those without. The use of central catheters may thus be complicated by perforation or the development of mural thrombi. Although the thrombi may embolize or may become infected, the incidence and clinical significance appear to be low. The incidence of catheter-related deaths in our autopsy population does not necessarily reflect the incidence in a population of living patients. PMID- 3968817 TI - Micturition syncope. A reappraisal. AB - We prospectively studied 33 patients with micturition syncope. Of these, eight were young (mean age, 25 years), healthy individuals whose diagnostic evaluation gave normal findings. The remaining 25 patients were older (mean age, 60 years), and 16 were women. This group had an average of 3.8 acute and chronic illnesses per patient, and was taking 3.5 medications per patient. Physical examination disclosed orthostatic hypotension in 22 of these 25 patients. Therapy was directed at improving orthostasis. Over a mean of 15.3 months, no recurrent micturition syncope or sudden death occurred in the entire group. We conclude that there are two groups of patients with micturition syncope. A group consisting of young healthy men has been well described previously. Our larger group, however, consisted of older patients, more often women with multiple illnesses and the majority having orthostatic hypotension. PMID- 3968818 TI - Adult scurvy. AB - Scurvy is a disease that can mimic other more serious disorders such as deep vein thrombosis, vasculitis, and systemic bleeding disorders. Because the clinical features of scurvy are no longer well appreciated, scorbutic patients are often extensively evaluated for other disorders. Familiarity with the risk factors for and clinical manifestation of scurvy can facilitate earlier diagnosis. We report three patients who highlight the epidemiology, clinical features, and differential diagnosis of scurvy. PMID- 3968820 TI - Infant mortality and the low-birth-weight infant. PMID- 3968819 TI - Scorpaenidae envenomation. A five-year poison center experience. AB - This article describes 51 cases of Scorpaenidae envenomation, 45 of which were lionfish stings to aquarists or fish handlers. The primary manifestation of envenomation in all victims was intense local pain. Various other local and systemic symptoms were also noted. Immersion in hot water produced either complete (80%) or moderate (14%) symptomatic relief in 94% of the victims. This simple and effective treatment was generally unknown to emergency personnel treating these patients. PMID- 3968821 TI - Surface coil magnetic resonance imaging. PMID- 3968822 TI - Renal dysfunction after arteriography. AB - Acute renal failure has been observed in patients undergoing angiography in which a hypertonic triiodinated contrast medium is used. To ascertain the incidence of renal dysfunction and the clinical risk factors, we did a prospective study in which creatinine clearance was measured before and immediately after 120 arteriographic procedures. Thirty-seven patients (31%) sustained a significant reduction in creatine clearance after arteriography. No specific risk factor could be determined. Our findings, however, indicate that patients with preexisting renal insufficiency or diabetes mellitus are not at a higher risk for sustaining a fall in creatinine clearance after angiography. PMID- 3968823 TI - Ectopic pregnancy in relation to previous induced abortion. AB - Women who were hospitalized for ectopic pregnancy in five hospitals in King County, Washington, were interviewed concerning history of induced abortion. For comparison, women who delivered a live-born child during this same time period were also interviewed. Relative to women who had never undergone an abortion, the risk in those who had was increased to a modest degree, but this increase could well have been the result of chance (relative risk, 1.4; 95% confidence interval, 0.7 to 2.6). For women who had two or more abortions, the relative risk was 1.8 (95% confidence interval, 0.5 to 7.1). Our results suggest that legal abortion as performed during the past decade in the United States does not carry a large excess risk for future ectopic pregnancy, but larger studies will be needed in order to determine more precisely the magnitude of any excess that does exist. PMID- 3968824 TI - Doxycycline-induced esophagitis. PMID- 3968825 TI - Pharmacologic suppression of the fetal adrenal gland in utero. Attempted prevention of abnormal external genital masculinization in suspected congenital adrenal hyperplasia. AB - 21-Hydroxylase deficiency results in congenital adrenal hyperplasia and leads to masculinization of the external genitalia of affected females. This complication could be avoided if fetal adrenal gland function were suppressed. A woman with mild 21-hydroxylase deficiency whose previous female child had classic congenital adrenal hyperplasia with masculinization was given dexamethasone beginning at the tenth week of gestation. Maternal estriol and cortisol values indicated rapid and sustained fetal and maternal adrenal gland suppression. At 39 weeks' gestation, the patient was spontaneously delivered of a female neonate with normal external genitalia. Postnatal tests indicated the infant was a single heterozygote for 21 hydroxylase deficiency. This study demonstrates prolonged suppression of the fetal adrenal gland with dexamethasone and suggests it might prevent abnormal masculinization in fetuses with severe congenital adrenal hyperplasia. PMID- 3968826 TI - Improved detection of early iron deficiency in nonanemic subjects. AB - We measured the complete blood cell count, including the index of RBC size heterogeneity (RBC distribution width [RDW]), in 181 subjects without anemia to determine whether RDW became abnormal earlier in the development of iron deficiency than did other variables. In 163 subjects selected only for otherwise normal blood cell counts, an increased RDW was 66% specific (48/73) and 100% sensitive (48/48) for decreased serum iron saturation. Stool guaiac testing was equally specific but less sensitive. In 13 subjects with polycythemia, as iron deficiency developed, RDW increased a minimum of four weeks before mean cell volume changed. In one apparently normal young woman, an abrupt isolated rise in RDW revealed a newly developed low serum transferrin saturation; all values remained normal during serial testing of four other normal subjects. We conclude that RDW is the part of the routine blood cell count that first becomes abnormal during the development of iron deficiency. PMID- 3968827 TI - Manpower issues for a surgical specialty: the impact of oversupply. PMID- 3968828 TI - Magnetic resonance 'sees' lesions of multiple sclerosis. PMID- 3968829 TI - Leads from the MMWR. Multiple outbreaks of Kawasaki syndrome--United States. PMID- 3968830 TI - Leads from the MMWR. Recent trends in illicit drug use among young people- Canada. PMID- 3968831 TI - Diagnosis of meralgia paresthetica. PMID- 3968832 TI - Mycosis fungoides treated with acyclovir. PMID- 3968833 TI - Phenylpropanolamine exposure and subsequent hospitalization. PMID- 3968834 TI - Kinetic analysis of lipoproteins. PMID- 3968835 TI - Obligatory running and anorexia nervosa. PMID- 3968837 TI - Computerized biofeedback training aids in spinal injury rehabilitation. PMID- 3968836 TI - Cytologic manifestations of cervical and vaginal infections. I. Epithelial and inflammatory cellular changes. AB - We used multiple logistic regression to analyze microbiological and clinical correlates of inflammatory and epithelial cell changes on Papanicolaou-stained cervical smears in patients from a sexually transmitted disease clinic. Among randomly selected patients, increased numbers of histiocytes and polymorphonuclear leukocytes and the presence of transformed lymphocytes were associated with Chlamydia trachomatis infection, while increased lymphocytes were associated with Trichomonas vaginalis infection; minimal squamous atypia was associated with yeast infection; and moderate squamous atypia and koilocytosis were associated with cervical condylomata visualized by colposcopy. Among patients referred for cervicitis, C trachomatis infection was also associated with reactive or atypical metaplastic cells. Distinct inclusions were seen by Papanicolaou smear in only 22% of C trachomatis infections. In randomly selected patients, however, the presence of transformed lymphocytes or increased histiocytes had a sensitivity of 95%, a specificity of 75%, and a positive predictive value of 50% in relation to isolation of C trachomatis, and could therefore be used for selection of patients for confirmatory testing for C trachomatis infection. PMID- 3968838 TI - Leads from the MMWR. Update: acquired immunodeficiency syndrome--Europe. PMID- 3968839 TI - Leads from the MMWR. Update: influenza activity--United States. PMID- 3968840 TI - Prophylaxis of postoperative deep venous thrombosis. PMID- 3968841 TI - Activated charcoal in phenobarbital overdose. PMID- 3968842 TI - Antibiotic therapy for Vibrio vulnificus infection. PMID- 3968843 TI - Diuretics and coronary heart disease. PMID- 3968844 TI - Efficacy of influenza vaccine in nursing homes. Reduction in illness and complications during an influenza A (H3N2) epidemic. AB - From December 10, 1982, to March 4, 1983, when influenza A (H3N2) viruses circulated in Michigan, outbreaks of influenza-like illness were identified in seven nursing homes in Genesee County; 272 (27%) of 1,018 residents were affected. Unvaccinated residents were more likely than vaccinated residents to become ill (risk ratio [RR], 2.6; 95% confidence interval [Cl], 1.8-3.6) and were subsequently more likely to be hospitalized (RR, 2.4; 95% Cl, 1.2-4.8), develop roentgenographically proven pneumonia (RR, 2.9; 95% Cl, 1.6-5.3), or die (RR, 5.6; 95% Cl, 1.2-9.1). Similar observations were made during investigations in six of the eight remaining nursing homes in Genesee County, in which 57 (12%) of 458 residents became ill sporadically. These findings suggest that influenza vaccine can reduce the incidence and severity of influenza virus infections among the elderly and chronically ill and underscore the importance of vaccination programs for those in nursing homes and in the general community. PMID- 3968845 TI - Effect of danazol on coagulation parameters and bleeding in hemophilia. AB - Danazol was given orally at a dose of 600 mg/day to six hemophiliacs for eight to 14 weeks. All patients showed a significant decrease in activated partial thromboplastin time (APTT) beginning with the first measurement (two weeks) and persisting until use of the drug was discontinued. However, a corresponding increase in the deficient factor activity could not be consistently demonstrated. Despite the shortened APTT, bleeding episodes continued in the severe hemophiliacs and the patient with Christmas disease. In four patients, bleeding appeared to increase in severity or change in pattern, and in two cases the bleeding manifestations did not respond to usual factor infusions but responded to discontinuation of the drug therapy and further factor replacement. Euglobulin lysis times were measured in five patients (one hemophiliac and four with nonhemophilic conditions) who were receiving danazol. The lysis times were markedly shortened. Increased fibrinolytic activity may be responsible for the increased bleeding manifestations in danazol-treated hemophiliacs. PMID- 3968846 TI - Danazol and hemophilia. PMID- 3968847 TI - Medical schools face challenge of preparing physicians to care for fast-growing elderly population. PMID- 3968848 TI - Leads from the MMWR. Hepatitis B among dental patients. PMID- 3968849 TI - Curb those tubes. PMID- 3968850 TI - When to perform biopsies on enlarged lymph nodes in young patients. PMID- 3968851 TI - Dogs bites. PMID- 3968852 TI - Type A botulism from sauteed onions. Clinical and epidemiologic observations. AB - Twenty-eight persons were hospitalized in Illinois with neurologic signs and symptoms compatible with botulism in October 1983. Twelve patients required ventilatory support, and 20 patients were treated with trivalent ABE antitoxin; one patient died while still in the hospital six months after onset of illness. Type A toxin and/or type A Clostridium botulinum were subsequently identified in specimens from 18 patients. Case-control studies implicated sauteed onions made from fresh raw onions and served on a patty-melt sandwich in a local restaurant as the vehicle of transmission. Although the original sauteed onions were not available for toxin testing, type A toxin was detected in washings from a wrapper in which a patty-melt sandwich was taken home by one of the ill persons. Also, type A C botulinum was cultured from five of 75 raw onions taken from the restaurant. This outbreak implicated an unusual vehicle for botulinal toxin that was initially not suspected and demonstrates the importance of considering all theoretically possible food items as potential vehicles for toxin until epidemiologic and laboratory data have been collected and analyzed. PMID- 3968853 TI - The deoxyuridine suppression test identifies subtle cobalamin deficiency in patients without typical megaloblastic anemia. AB - Four patients had serum cobalamin levels that were initially thought to be falsely low. None of the patients had the typical hematologic and clinical features of cobalamin deficiency and the three so tested had normal cobalamin absorption and/or gastric function. However, the deoxyuridine suppression test result was abnormal in all four cases. The abnormality was improved by adding cobalamin in vitro but, in three of the four cases, was not corrected and, indeed, was made worse by the addition of methyl tetrahydrofolate. These results established metabolically the presence of cobalamin deficiency. The recently improved cobalamin radioassays may be unmasking some atypical and, heretofore, unappreciated cobalamin-deficiency states (only one of our four patients would have come to attention with the older radioassays). These can be identified with the deoxyuridine suppression test, particularly when specific in vitro additives are included. PMID- 3968854 TI - Increased cimetidine clearance in burn patients. AB - To determine the etiology of the decreased efficacy of cimetidine in burned and critically ill surgical patients, we studied the kinetics and dynamics of the drug in eight burned patients at a mean of 12 days after the burn. The kinetics were compared with those of nine healthy controls. The elimination half-life of cimetidine in burned patients was significantly reduced (2.2 v 1.5 hours), and total clearance significantly increased (8.2 v 13.3 mL/min/kg). Creatinine and total cimetidine clearance were highly correlated with size of the burn. In the patients studied, 63% of the dose was excreted in eight hours, compared with 45% after 24 hours in controls. Gastric pH was maintained at 4 or higher as long as plasma levels of cimetidine were held above 0.5 microgram/mL. Thus, the increased clearance of cimetidine might explain the decreased effectiveness of this drug in burned and possibly other surgical patients. Dose schedules may need to be altered to compensate for the enhanced clearance of this drug. PMID- 3968855 TI - A potential use of the National Death Index for postmarketing drug surveillance. AB - A particularly difficult problem for both the Food and Drug Administration and the pharmaceutical manufacturer is evaluation of the importance of spontaneous reports of suspected drug-associated fatalities. These reports are rare, and usually no accurate denominator data on drug use exist. This article proposes that the National Death Index be used to calculate mortality rates for selected drugs as part of the postmarketing surveillance efforts of the government and manufacturers. When hypotheses are generated from spontaneous reports and/or the mortality data, additional studies can be conducted on the cohorts that were identified for mortality follow-up. PMID- 3968856 TI - Campylobacter infections today. PMID- 3968857 TI - Satellite and commercial medical clinics. Report of the Board of Trustees: Part II. PMID- 3968858 TI - Myocardial ischemia. AB - As one of the cause of acute myocardial ischemia, coronary vasospasm has attracted attention increasingly in clinical cardiology. We developed animal model of coronary vasospasm associated with transient myocardial ischemia by administration of histamine or serotonin in atherosclerotic miniature swine. Early systolic dysfunction as well as subendocardial NADH production of the ischemic region occurred within 10 sec after coronary occlusion, but ST segment started to elevate around 30 sec after occlusion in the isolated rat heart. As the important determinant factors of myocardial infarct size, the preocclusive perfusion area as well as collateral flow area could be measured quantitatively by use of double isotopes autoradiograms, and the close correlation was found between the salvaged area and collateral flow area in dogs. An importance of advancement in basic cardiology and development of new research techniques have been emphasized. PMID- 3968859 TI - Animal models of coronary spasm and the pathophysiological events in regional vascular hypercontraction. AB - An animal model of coronary spasm was designed 1) to reproduce coronary spasm similar to that seen in patients with variant angina, 2) to determine whether hypercontraction of the vascular smooth muscle occurs at the site of the spasm, 3) to document the relationship between functional and structural changes of the vascular wall and 4) to characterize the pathophysiological features of coronary spasm. After balloon de-endothelialization and feeding of a high cholesterol diet in mongrel dogs and Gottingen miniature pigs, there was evidence of vascular hypercontraction associated with arteriosclerotic changes. Coronary spasm of more than 75% narrowing of the artery was provoked with ischemic signs in miniature swine. These events could be repeatedly provoked by an intracoronary injection of histamine following pretreatment with cimetidine. The site of hypercontraction corresponded well with the site of the de-endothelialization, an area where the basal vascular tone was increased and was related to histamine activity. Thus, the present animal model will shed light on mechanism involved in vasoactive angina pectoris and aid in clarifying the pathophysiology of vascular smooth muscle. PMID- 3968860 TI - Recent advances in cardiopulmonary resuscitation. PMID- 3968861 TI - Quantitative radiocardiography in patients with patent ductus arteriosus. AB - Analytical models of the analog computer simulation method of radiocardiogram (RCG) were revised to obtain quantitative hemodynamic evaluations in patent ductus arteriosus (PDA). The theoretical and technical aspects are herein outlined, and the effects of clinical application discussed. Twenty-six patients with a left-to-right PDA shunt were studied by the revised RCG models, and the results were compared with oxymetric or echocardiographic data. Between RCG and oxymetry, the systemic blood flow (SBF) findings agreed well (r = 0.91), but in oxymetry, the pulmonary blood flow (PBF) findings were generally seen greater than in RCG (r = 0.81), and the oxymetric shunts appeared larger than in RCG (r = 0.75). This is because oxymetry cannot avoid the direct effects of the uneven partition of shunt flow to the lungs, whereas RCG can, in addition, measure the mean PBFs and SBFs. RCG may thus be said to be superior to oxymetry in assessing PDA shunts. Furthermore, RCG can estimate the mean left and right heart volumes (LHV and RHV) at the same time; the RCG LHV was found to correspond to the echocardiographic left ventricular end-diastolic volume (LVEDV) (r = 0.89). Moreover, the obtained relation between the RHV/LHV (Y) and the shunt ratio (X) proved to be the same that calculated theoretically (Y = -X + 1.0) in uncomplicated patients. Patients not presenting this relation may be assumed to suffer some condition complicating the PDA. In effect, the analog computer simulation method of RCG is a unique non-invasive means of obtaining quantitative analyses in PDA and in other congenital shunt diseases as well. PMID- 3968863 TI - Morphological study of ventricular septal defect associated with obstruction of the aortic arch among Japanese. AB - This report describes racial differences in the morphology of ventricular septal defects associated with coarctation or interruption of the aortic arch. Twenty three heart specimens with obstruction of the aortic arch associated with ventricular septal defects collected in southern Japan were studied. Six specimens had an interrupted aortic arch and the remaining 17 cases had coarctation of the aorta. Fifteen cases (65.2% of the total) had malalignment defects with posterior deviation of the conal and/or truncal septum. In contrast to Anderson's report, only one case of perimembranous defect with aortic overriding was seen in our series. These anatomical findings suggest that the majority of ventricular septal defects associated with coarctation or interruption among Japanese is a malalignment defect with left ventricular outflow tract obstruction. PMID- 3968862 TI - Effects of long use of a beta-blocker, carteolol, on exercise hemodynamics in hypertensives. AB - The symptom limited maximal exercise was performed by a supine bicycle ergometer before and 12 weeks after oral carteolol therapy in 10 patients with essential hypertension of WHO Stage 1 and 2. At rest, arterial blood pressure (BP) and venous pressure (VP) significantly declined after therapy, while heart rate (HR), cardiac index (CI), stroke index (SI) and systemic vascular resistance (SVR) were not significantly changed. The maximal exercise work of post-therapy was similar to that of pre-therapy in 9 patients and increased in one. When compared with the pre-therapy values at each work load of exercise, carteolol caused significant decreases in systolic BP, mean BP, HR and CI, and a significant increase in SVR, while SI and VP were not significantly changed. Plasma levels of renin activity, aldosterone, and catecholamines were not altered by carteolol throughout the study at rest and with exercise. It may be concluded that the inhibition of HR increase by carteolol results in a reduced cardiac output during moderate and severe exercise and then suppresses the elevation of BP, so that carteolol makes it possible to achieve more exercise with less cardiac work. PMID- 3968864 TI - Serum N-acetyl-beta-D-glucosaminidase activity in a large population--a useful index of cardiovascular impairment. AB - Serum N-acetyl-beta-D-glucosaminidase (NAG) levels were measured in 1080 residents in Tanushimaru, Fukuoka, aged 20 to 84 years old, during a periodical epidemiological survey performed in 1982. Thirteen pregnant women were excluded from this study. Serum NAG levels showed an increase with age, but were not different between sexes. We found high serum NAG values in those with high blood pressure, high serum total cholesterol, low serum HDL-cholesterol, or reduced creatinine clearance rate, and women with high serum uric acid, increased skinfold thickness, or high hematocrit. Multiple regression equation was as follows: NAG = 3.53 + 0.07 (age) + 0.14 (hematocrit) + 0.03 (total skinfold thickness) + 0.04 (systolic blood pressure) - 0.03 (HDL-cholesterol) - 0.04 (mean blood pressure) - 0.01 (creatinine clearance). The multiple correlation coefficient was 0.37 (F = 24.4). We suggest that NAG may be a useful index in screening cardiovascular impairment and for cardiovascular risk factors. PMID- 3968865 TI - Clinical characteristics of coronary artery spasm: electrocardiographic, hemodynamic and arteriographic assessment. AB - We studied the clinical characteristics of 153 patients with angina pectoris associated with coronary artery spasm (CAS). The study was designed to investigate the relationship of CAS to ST segment deviation and to the site of fixed stenosis, and hemodynamic alteration during a spastic event. Analysis of coronary arteriograms and multilead electrocardiograms obtained simultaneously from 170 events of CAS by the use of radioluscent carbon-fiber electrodes resulted in 58 events with ST elevation which were related to total occlusion of major coronary arteries due to CAS; another 54 events with ST depression, in which the affected coronary arteries demonstrated severe but incomplete occlusion, or total occlusion but were visualized via collateral vessels; and remaining 58 events without ST deviation showing mild occlusion. The results indicate a close correlation between magnitude of CAS and ST segment deviation. CAS occurred at the site of pre-existing fixed stenosis including minor plaque defect in 133 patients and at apparently normal site in 20 patients. In the former group, only four patients had triple vessel disease, while 95 had nonsignificant fixed lesion. In the latter group, 10 patients had minor lesion distant from the site of CAS. Thus, CAS is closely related to fixed stenosis, which may have but a limited role as a cause of CAS. Hemodynamic measurements during spastic events were obtained from 49 patients including 41 events with spasm of the left anterior descending artery (LAD) and 21 events with spasm of the right coronary artery (RCA). The onset of an increase in left ventricular (LV) filling pressure and a reduction in LV dP/dt preceded ST segment deviation in all events. The first hemodynamic variable manifested in the spastic event was the reduction of LV contraction dP/dt in the majority of patients. The increase of LV filling pressure was greater in LAD spasm than RCA spasm (11 +/- 6 mmHg vs 7 +/- 4 mmHg, P less than 0.0125) and in events with ST elevation than with ST depression (11 +/- 5 mmHg vs 6 +/- 5 mmHg, p less than 0.001). Right ventricular functional impairment was mild in most patients during CAS. The study indicates that mechanical impairment precedes electrical impairment during CAS and that LAD spasm with ST elevation represents the most severe LV dysfunction. PMID- 3968866 TI - Role of atherosclerosis in spontaneous periodic contractions of isolated postmortem human coronary arteries. AB - The role of atherosclerosis in coronary artery spasm was studied by morphometrical examinations of isolated postmortem human coronary arteries that were used for the observation of spontaneous periodic contractions. Isometric tension of coronary ring segments from seventy-six cadavers was recorded in a bath containing physiological saline solution. According to the degree of atherosclerosis, the segments were classified into three groups: minimum intimal lesion (Group I), moderate intimal lesion (Group II) and severe atherosclerotic lesion (Group III). Results were analyzed by a chi-square test. The incidence of the spontaneous periodic contractions was 45% in the proximal portion. Of the segments in which the contractions occurred, 83% were in Group II. There were significant differences in the incidence between Group I and II (33% vs 80%; p less than 0.02) and Group II and III (80% vs 25%; p less than 0.001), respectively. According to the characteristics of the atherosclerosis, there were significant differences in incidence of the contractions between circumferential thickening and eccentric thickening in Group II (63% vs 28%; p less than 0.001). In conclusion, the spontaneous periodic contractions occur most frequently in the segments in which (1) the degree of atherosclerosis is moderate rather than minimum or severe and (2) the characteristics of atherosclerosis is circumferential thickening instead of eccentric thickening. PMID- 3968867 TI - Activated neutrophils disrupt endothelial monolayer integrity by an oxygen radical-independent mechanism. AB - We have measured the effect of activated neutrophils on endothelial monolayer integrity in vitro by assessing the capacity of endothelial monolayers on polycarbonate filters to exclude 125I-albumin. Although formylmethionyl-leucyl phenylalanine (FMLP)-activated neutrophils failed to induce 51Cr-release or detachment after 4 hours of incubation with endothelial monolayers cultured in polystyrene wells, FMLP-activated neutrophils produced a marked increase in the passage of 125I-albumin across bovine aortic or pulmonary artery endothelial monolayers on polycarbonate filters. This effect was evident as early as 30 minutes following the addition of FMLP-activated neutrophils to the monolayer and reached 180% over control values at 2 hours (p = 0.001). Light and transmission electron microscopic examination of the polycarbonate filters exposed to FMLP activated neutrophils revealed focal disruption of the endothelial monolayers. Chronic granulomatous disease neutrophils produced similar disruption of the endothelial monolayer at 2 hours. Moreover, catalase and superoxide dismutase failed to reduce significantly the neutrophil-mediated increase in 125I-albumin passage at 2 hours. Cell-free postsecretory supernatants of FMLP-activated neutrophils, leukotriene C4, and platelet activating factor did not induce a significant increase in 125I-albumin passage across the endothelial monolayers. Of note, FMLP-activated neutrophils from a patient with a congenital abnormality of neutrophil adhesion and chemotaxis did not induce disruption of the monolayer or increase 125I-albumin passage. We conclude that activated neutrophils mediate rapid, nonlytic disruption of endothelial monolayer integrity by an oxygen radical-independent mechanism that requires neutrophil-endothelial contact. PMID- 3968868 TI - Radiation-induced quantitative alterations in prenatal thymic development in the beagle dog. AB - Quantitative morphology of the canine fetal thymus was studied to evaluate the age-dependent radiosensitivity of the developing immune system. Pregnant beagle dams received abdominal 60Co gamma exposures (200 R) or were sham irradiated at one of three ages in gestation, 30, 40, or 45 days. The mean calculated dose to each fetus was 1.5 Gray. One-half of the fetuses in each litter were harvested by hysterotomy at 5 days and one-half at 10 days post-irradiation (PI). The volumes of the thymic lobules and lobular cortices were significantly reduced at 5 and 10 days PI when compared with age-matched controls. Thymic cortical volumes in irradiated fetuses were reduced between 13 and 29% from control volumes by 5 days PI and 8 and 13% by 10 day PI. Thymic medullary volumes in irradiated fetuses were reduced 18 to 23% by 5 days PI and 27 to 54% by 10 days PI. The reductions in medullary volumes in fetuses irradiated at 35, 40, and 45 days of gestation and evaluated at 10 days PI were 54, 38, and 27%, respectively. Although injury to both thymic cortices and medullas was greater following exposures earlier in gestation, damage to medullas was relatively more severe than in cortices following exposure at any one age. The degree of reduction of medullary volume reflects thymic epithelial injury and is surprising since thymic epithelium is considered to be radioresistant in the adult. Such injury may have serious consequences postnatally as normal differentiation of T cell subpopulations is dependent upon the integrity of the thymic microenvironment. Damage to the thymic microenvironment could result in defects in immunologic regulation and in immune deficiencies. PMID- 3968869 TI - Prophylaxis of superior mesenteric artery occlusion shock in rabbits by antilipopolysaccharide (anti-LPS) antibodies. AB - Occlusion of the superior mesenteric artery (SMA) is known to produce lethal shock in experimental animals, probably due to the presence of endotoxins released from the gut. A 60-min SMA occlusion shock was produced in 20 rabbits. Eight were pretreated with equine antilipopolysaccharide (anti-LPS) hyperimmune plasma, and seven survived (87.5%) for 10 days. However, only 2 out of 12 (16.6% chi 2 = 9.73, P less than 0.001) control rabbits survived. These results support the concept that endotoxins are involved in the etiology of SMA occlusion shock and that anti-LPS therapy may therefore be useful in the prevention of endotoxic shock. PMID- 3968870 TI - Canine left ventricular function during experimental pancreatitis. AB - Left ventricular contractility following induction of experimental pancreatitis (EP) was studied. Contractility was evaluated by analyzing the left ventricular end systolic pressure-diameter relationship (sigma ES). Sigma ES is independent of large changes in preload, afterload, and heart rate, but sensitive to changes in ventricular contractility. Following injection of 100,000 IU trypsin in 4% taurocholate into the pancreas to induce EP, seven of eight dogs survived 5 hr. These dogs exhibited an initial significant reduction in mean arterial pressure (MABP) which stabilized at 90% of control at 3-5 hr post-EP. Cardiac output (CO) dropped slowly after EP induction (from 3.08 +/- 0.43 to 2.22 +/- 0.22 liters/min) associated with no significant change in peripheral resistance. Stroke work and stroke volume were markedly depressed reflecting the changes in MABP and CO. No consistent changes in +dP/dt or -dP/dt were observed. The ratio of endo/epicardial blood flow was unchanged as was blood Ca2+ levels throughout the experiment. Ventricular contractility as reflected by sigma ES tended to improve (from 49.7 to 69.6 mm Hg/mm at 4 hr following EP). Therefore, it was concluded that these animals exhibited no loss of ventricular contractility during EP. PMID- 3968871 TI - Myocardial biopsy drill: construction details and techniques. AB - The modification of currently available dental equipment to construct a myocardial biopsy drill by the technique of Poole et al. (P. E. Poole, G. F. Norris, R. M. Lewis, and J. W. Covell, J. Appl. Physiol. 24: 832, 1968) is described. In dogs, five to seven full-thickness myocardial cores 3 mm in diameter and weighing 40 to 70 mg could be obtained consistently with the drill without affecting left ventricular function. The positive pressure/negative pressure system allowed separation of contaminating blood from the myocardial sample and rapid myocardial freezing. Assessment by a modification of the technique of Estabrook et al. (R. W. Estabrook, J. R. Williamson, R. Frenkel, and P. K. Maitra, In R. W. Estabrook and M. E. Pullman (Eds.), Methods in Enzymology, New York: Academic Press, 1967. Vol. 10, p. 474). yielded myocardial ATP levels of 32.12 +/- 0.90 nmole/mg of protein. PMID- 3968872 TI - Effect of surgery on tumor-induced accelerated coagulation in a rat carcinoma. AB - Accelerated coagulation detected by thromboelastography has been reported in early stages of tumor growth. The present investigation was conducted to determine the changes in tumor-induced accelerated coagulation following complete and partial resection of the tumor. Male Fisher rats were divided into four groups: (1) control, (2) tumor-bearing rats, (3) complete resection, (4) partial resection. In groups 2, 3, and 4 a 2-mm3 piece of squamous cell carcinoma (NCI 11095) was implanted subcutaneously in the left flank. Seven days later blood samples were obtained from the tumor and control groups and tested on a thromboelastograph to determine the effect of the tumor on the coagulation of the hosts. Six weeks following the initial tumor implantation a sham operation was performed on group 2, complete resection on group 3, and a partial resection on group 4. After a rest period of 3 weeks blood samples were obtained from the four groups of rats and tested on a thromboelastograph. The results indicate that there is a significant acceleration of coagulation in tumor-bearing animals. The effect of surgery on this tumor-induced phenomenon depends on the type of procedure performed. Complete resection returns the coagulation status toward normal whereas sham operation or a partial resection do not. In this tumor model, hypercoagulability of the blood, therefore, indicates the presence of residual tumor. PMID- 3968873 TI - gamma-Aminobutyric acid plasma levels and brain binding in Eck fistula dogs. AB - It has been hypothesized that gamma-aminobutyric acid (GABA), the principle inhibitory neurotransmitter of the mammalian brain, contributes to the neural inhibition of hepatic encephalopathy. Eck fistulae were created in seven dogs and celiotomy alone performed in five dogs to determine plasma GABA levels, brain GABA binding, and synaptic membrane changes in dogs after creation of Eck fistulae. Eck fistula dogs lost 19 +/- 9% body weight, lost hair, ate poorly, and developed atrophic livers with classic hepatic histological changes. Control dogs maintained body weight, normal behavior, and normal liver histology. Plasma GABA levels were elevated significantly in the Eck fistula dogs (312 +/- 105.9 nM) both as compared to controls (154.4 +/- 69.8) and to preoperative levels (161.6 +/- 56.7, P less than 0.05). Brain GABA binding for animals sacrificed at 6-9 weeks was not statistically different from sham-operated dogs sacrificed at 6 weeks (1.87 +/- .54 pmole/mg protein vs 1.186 +/- 24, P less than 0.2). Synaptic membrane fluidity and cholesterol were likewise unchanged. Plasma GABA levels are increased significantly following complete portal diversion but do not correlate with the degree of encephalopathy. GABA binding to neural membranes are not significantly increased in Eck fistula dogs. These findings do not support a direct relationship between plasma GABA levels and neurologic impairment in Eck fistula dogs. PMID- 3968874 TI - Evaluation of myocardial preservation using 31P NMR. AB - The purpose of this study was (1) to monitor myocardial high-energy phosphate content and recovery of left ventricular (LV) contractile function following normothermic graded cardiac ischemia and single-dose hypothermic potassium cardioplegia, and (2) to assess the temporal limits of LV functional recovery during single-dose cardioplegia maintained at 17 degrees C. Rabbit hearts (30) were perfused, equipped with an LV balloon, paced at 240 beats/min, and placed in a nuclear magnetic resonance (NMR) magnet. Hearts underwent either graded, global normothermic ischemia or potassium cardioplegia arrest maintained at 17 degrees C for 1 hr. Myocardial high-energy phosphate level, LV contractility, and temperature were monitored continuously. Phosphocreatine (PCr) fell to 10 +/- 2, 2 +/- 1, and 0% of control and ATP to 70 +/- 3, 19 +/- 7, and 0% of control at 10, 40, and 60 min of 37 degrees C ischemia. After 1 hr of reperfusion, regression analysis of final developed pressure (DP) on end ischemic ATP (EIATP) content revealed: DP = 1.02 EIATP + 18 (r = 0.95). Following single-dose cardioplegia, maintained at 17 degrees C, PCr fell to 16 +/- 3% of control at 60 min while ATP fell only to 92 +/- 5% control. With reperfusion, recovery of DP was 100%. It was concluded that (1) PCr serves as an energy buffer for ATP, (2) EIATP predicts recovery of LV function, (3) single-dose cardioplegia maintained at 17 degrees C provides complete myocardial preservation for up to 60 min. PMID- 3968875 TI - Studies of bile lipids and bile acids of wild North American black bears in Nova Scotia, showing a high content of ursodeoxycholic acid. AB - Does ursodeoxycholic acid (UDC) production protect hibernating species of Ursidae against gallstone disease? Five wild bears (Ursis Americana) were studied. Older bears had more UDC than younger ones, suggesting UDC production is an acquired phenomena. Bile salt pools were 10 times larger than that of man and were characteristically conjugated with Taurine alone. The relative composition of the principal lipids in bear bile fell well within the range of cholesterol solubility. Cholesterol gallstones are not reported in Ursidae, probably because of the large bile acid pool and high UDC content. PMID- 3968876 TI - Infusion of very hypertonic saline to bled rats: membrane potentials and fluid shifts. AB - Anesthetized rats were subjected to a moderate degree of hemorrhagic shock, lowering their mean arterial pressure to approximately 50 mm Hg for approximately 100 min. At the end of the shock period, resting skeletal muscle transmembrane potentials had depolarized from a baseline value of -82 mV to -65 mV; intracellular water had increased by 13%; and intracellular sodium and chloride contents had doubled. Eight rats were then given an infusion of very hypertonic saline (2400 mOsmole/kg, calculated osmolality) in a volume equal to only 10% of the volume of shed blood; another eight rats were given the equivalent amount of sodium and chloride in an isotonic solution (volume equal to 80% of shed blood). The mean arterial pressure in the rats that were given the very hypertonic saline returned to 81 mm Hg, compared to 55 mm Hg in the animals given normal saline. The membrane potentials in the hypertonic group polarized back to near normal- 78 mv--compared to no changes in the normal saline group. Intracellular water returned to preshock values in the hypertonic group as did intracellular sodium and chloride contents. Cellular contents in the normal saline group remained at shock levels. It was concluded that, in rats, infusion of small amounts of hypertonic saline can reverse some of the cellular abnormalities induced by hemorrhagic shock. PMID- 3968877 TI - Mural collagen in experimental reflux esophagitis in rats. AB - Changes in the collagen content of the esophageal wall in reflux esophagitis were studied in rats subjected to surgically induced and biochemically monitored pancreaticobiliary reflux into the esophagus. Reflux periods of 7, 14, 28, and 42 days were followed by a reflux-abolishing operation, which resulted in healing of the esophagitis. The collagen content of the esophageal wall at the end of the reflux period was higher than control values obtained from normal nonoperated rats, with a significant difference after 42 days of reflux. Strictures were not observed. After abolition of the reflux the esophageal collagen content showed an initial drop, but then increased with the period of observation to give a significant rise (P less than 0.05) as compared with control rats which had been subjected to 7, 28, and 42 days of reflux. The meaning of the results for the understanding of the sequelae of reflux esophagitis is discussed. PMID- 3968878 TI - Dementia of the Alzheimer's type: clinical overview. PMID- 3968879 TI - A survey of health promotion programs of Tennessee employers. PMID- 3968880 TI - Infant High Risk Registry in Tennessee. PMID- 3968881 TI - I have what? Illness and the medical profession (whom I admire). PMID- 3968882 TI - Alzheimer's disease--a major health problem. PMID- 3968883 TI - Radiation therapy of seminoma of the testis. AB - This study is a review of 66 patients with a diagnosis of testicular seminoma, treated at the Department of Radiation Oncology, University of Louisville, from 1959 to 1978. Sixty-four of the patients were diagnosed as pure seminomas and two as spermatocytic type. The age of the patients ranged from 16 to 75 years with a median of 39. Fifty-four patients (82%) presented with swelling or mass in the testis, 7 patients with pain, 1 patient with hydrocele, and 4 patients had seminoma diagnosed incidentally. The distribution was equal for both right and left sides. There were 39 (59%) and 27 (41%) patients in stages I and II, respectively. All stage I patients received only infradiaphragmatic irradiation by a "hockey stick" field, and the majority of them received a dose of 3,200 3,600 rads in 3-4 weeks time. Stage II patients received elective irradiation to the mediastinum and neck region, in addition to the infradiaphragmatic irradiation. The 5-year actuarial survival rates for stage I and II seminomas are 96% and 92%, respectively. There were no serious complications during follow-up. The role of elective irradiation in stage I disease is discussed with a brief review of the literature. PMID- 3968884 TI - Colonization of nonmelanocytic cutaneous lesions by dendritic melanocytic cells: a simulant of acral-lentiginous (palmar-plantar-subungual-mucosal) melanoma. AB - Four cases of colonization of nonmelanocytic lesions by dendritic melanocytic cells are reported, one in a verruca vulgaris of the lip, one in a squamous cell carcinoma in situ of mucous membrane overlying a tonsil, one in a lesion of lichen simplex chronicus with a nevocellular nevus of the external ear, and one in a dermatofibrosarcoma protuberans (Bednar tumor). This is an important biological process of melanocytes that must not be confused with the acral lentiginous (palmar-plantar-subungual-mucosal (P-S-M) melanoma. It is probably much more common than the paucity of published reports would indicate. PMID- 3968885 TI - Primary lymphoma of Meckel diverticulum: a case report. AB - A case of a primary lymphoma of Meckel's diverticulum in a 6-year-old Iraqi boy presenting clinically as acute appendicitis is reported. Exploration revealed a ruptured gangrenous Meckel's diverticulum with an ileo-ileal intussusception at the diverticulum origin. A fairly comprehensive search through the English language literature has failed to reveal any other report of a primary lymphoma of Meckel's diverticulum leading to acute intestinal obstruction. PMID- 3968886 TI - Primary carcinoma of the gall bladder: a review of a 16-year period at the University Hospital. AB - A review of the most relevant clinical data of patients with primary carcinoma of the gall bladder referred to our hospital over a 16-year-period has indicated that this is the third most common and aggressive cancer of the gastrointestinal tract. The disease occurs predominantly in elderly females who often present with extremes of clinical symptoms indicating benign biliary disease on the one hand and incurable malignant disease on the other. Laboratory and roentgenographic data tend to confirm the clinical diagnosis of this almost entirely incurable disease. The overall 5-year survival of the patients with primary carcinoma of the gall bladder is less than 1%; a majority of the patients are dead in less than 6 months. PMID- 3968887 TI - Primary intracranial germinoma with massive ventriculoperitoneal shunt metastases. AB - Ventriculoperitoneal shunt metastases from primary intracranial germinomas are extremely rare. To date, only three case reports of this phenomenon have appeared in the literature. We present the case of a 25-year-old black male who developed ventriculoperitoneal shunt metastases 10 months following diagnosis of an intracranial germinoma. Radiotherapy destroyed most of the intracranial tumor, but abdominal metastases became progressive and were not treated with radiotherapy. The role of radiotherapy in the treatment of ventriculoperitoneal shunt metastases is examined and previous cases in the literature are reviewed. PMID- 3968888 TI - Analysis of pancreatoduodenectomy. AB - Between 1956 and 1982, there were 55 pancreatoduodenectomies performed at the Medical University of South Carolina by 19 different surgeons. There were 26 resections for adenocarcinoma of the head of the pancreas and 16 resections for carcinoma of the ampulla of vater, carcinoma of the extrahepatic biliary ducts, and carcinoma of the duodenum. There were seven resections for chronic pancreatitis. There were two resections for trauma and three resections in the (1960s) for carcinoma of the stomach. There was one resection for cystadenocarcinoma of the pancreas. In the patients with carcinoma of the pancreas, resection was only performed when there was no gross evidence of extension beyond the parenchyma of the pancreas. Analysis of the resected specimen revealed 44% of the pancreatic carcinomas subsequently had positive lymph nodes. None of these patients became long-term survivors. Failure of the pancreato-jejunostomy was the most serious complication, occurring in 7 of 55 resections. There were no fistulas where a mucosal to mucosal anastomosis was performed to join the pancreas with the jejunum. The five-year survival for all patients with carcinoma of the pancreas was 11.6%. The 3 five-year survivors were from resections performed between 1956 and 1970. During these years, the mortality rate for the procedure was 21%. From 1970 to 1982 there were no five year survivors from carcinoma of the pancreas. However, the mortality rate was 10.6%. The history and current controversies over this surgical procedure are reviewed. PMID- 3968889 TI - Total pelvic exenteration for advanced carcinoma of the lower colon. AB - Thirteen patients with advanced carcinoma of the lower colon and no evidence of extrapelvic metastasis were submitted to total pelvic exenteration. Nine of the 13 patients had ureteral urinary diversion by the ileal segment conduit. Three had colonic conduit bladder using the terminal portion of the descending colon. One patient had bilateral uretero colonic anastomosis. The operative mortality rate was 7.7%. Determinate 5-year survival rate of 38.5% was achieved. Histological examinations of the surgical specimen revealed associated abscesses adjacent to the tumor in six cases, although the cancer extended to the bowel wall and adhered to the surrounding structures in all specimens. Total pelvic exenteration assures a better quality of life, lessening of symptoms, disease control and, in selected patients, a cure. PMID- 3968890 TI - The mortality rate from lung metastases in animals inhaling nitrogen dioxide (NO2). AB - A study was carried out to determine the interrelationship between the inhalation of nitrogen dioxide (0.4 +/- 0.50 ppm), lung metastases development from circulating cancer cells, and death rate from such metastases. C57 BL/6J mice were used in these experiments. Animals were divided into control and NO2-exposed groups, and were exposed to filtered air and 0.4 ppm of NO2, respectively. Following 12 weeks of exposure, all animals were infused intravenously with syngeneic, viable B16 melanoma cells. The results indicate that a subpopulation of NO2-exposed animals showed a significant increase in mortality rate during the early part of the experiment. The interpretation is that animals especially sensitive to the NO2 insult developed extensive metastases at an early stage. The question raised is whether or not the progression of human cancer is influenced by the inhalation of noxious pollutants in the ambient atmosphere. PMID- 3968892 TI - Recurrence rate of positive margin basal cell carcinoma: results of a five-year prospective study. AB - The few previous studies on recurrence of incompletely excised basal cell carcinoma are retrospective, and the reported recurrence rate ranges from 19% to 67%. In a prospective study design, wer found a recurrence rate of 41% and 34 surgically excised positive-margin basal cell carcinomas. The mean time until tumor recurrence was 24.6 months. The mean follow-up time in those patients remaining free of tumor was 61.4 months. PMID- 3968891 TI - Desmoid tumor--review and follow-up of ten cases. AB - Ten cases of desmoid tumor, diagnosed, treated, and followed during the past 11 years, were reviewed and the patients reexamined. Two were up to 3 years, two up to 5 years, and four up to 11 years after excision. The remaining two patients were lost to follow-up. The 10 patients included one male and nine females; six females were of childbearing age and three were postmenopausal. In four females the desmoid tumor was located near various surgical scars. In the one recurrent desmoid it was most probably related to both repeated traumatization of the abdominal wall due to pregnancies and hyperestrogenism. All the surgical margins of resection were microscopically involved by the process. An open liver biopsy, performed simultaneously with the excision of the recurrent desmoid, showed benign nodular hyperplasia compatible with hyperestrogenism. Estrogen and progesterone receptors of this desmoid were negative. In the present series follow-up revealed, in contrast to general agreement, that in spite of incomplete excision, the recurrence rate was low. We suggest that the surgical approach to desmoid tumors could be less radical, except possibly for lesions in patients with multiple causative factors. PMID- 3968893 TI - Coexistence of aldosteronoma and pheochromocytoma in an adrenal gland. AB - An extremely rare case is reported in which aldosteronoma and pheochromocytoma coexisted in an adrenal gland. Although the patients presented with clinical features of primary aldosteronism, preoperative examination showed an elevation of both plasma aldosterone and urinary catecholamines. Histology of the removed adrenal gland revealed that, concurrently with a round mass of adrenocortical adenoma, the adrenal medulla was totally occupied by the typical structure of pheochromocytoma. PMID- 3968894 TI - Priapism as the presenting feature of renal cell carcinoma. AB - We describe a case of renal cell carcinoma with metastasis to the penis clinically presenting with priapism. Six such cases found in the literature are reviewed. Neoplastic disease is far advanced in these cases and therapy is only palliative. PMID- 3968895 TI - Trends in the management of breast cancer. AB - Responses of general surgeons to a questionnaire on breast cancer were analyzed to determine the current trends in the management of this disease. A 21-item questionnaire was mailed to members of the New Jersey Chapter of the American College of Surgeons in 1982 and the responses, received on noncoded, anonymous answer sheets, were analyzed for frequency distribution. These responses were compared to previously recorded responses to the same questions for 1971 and 1977. Seventy-six percent of the respondents in 1982 performed needle aspirations often or always, compared to 36% in 1971 and 80% in 1977. The use of routine mammography has increased from 16% in 1971 and 20% in 1977 to 38% in 1982. Modified radical mastectomy is now the most common type of procedure employed in the management of stage I breast cancer, with 89% of respondents in favor of this approach compared to 15% in 1971 and 60% in 1977. Fifty-nine percent of the respondents are not opposed to breast reconstruction following mastectomy versus 14% in 1971 and 49% in 1977. For patients with axillary nodes, chemotherapy with multiple agents was recommended by 76% of general surgeons in 1982, compared to 58% in 1977. These results indicate a continuing trend towards increasing use of needle aspiration and routine mammography for diagnosis and for employment of chemotherapy with multiple agents in the adjuvant treatment of patients with positive axillary nodes. Furthermore, modified radical mastectomy is the operation of choice for stage I cancer of the breast for increasing numbers of surgeons. PMID- 3968896 TI - Thyroid nodules in the irradiated patient--an indication for total thyroidectomy. AB - Eight patients who received radiation therapy to the head, neck, or chest during infancy, childhood, or adolescence are reported. In these individuals, the presenting abnormality was a nodule of the thyroid gland, which was found to be benign at surgery. All patients were subsequently found to harbor a malignant lesion of the contralateral lobe. On the basis of this study and the discussion presented, we feel that a total thyroidectomy is the indicated therapeutic procedure in previously radiated patients presenting with a cold nodule. PMID- 3968897 TI - Multimodal approach in the therapy of stage III female breast cancers. AB - One thousand thirty-seven female breast cancers were treated at the Cancer Institute (WIA), Madras, between 1965 and 1978. Five hundred twenty-one of them (ie, just over 50%) were in stage III, with extensive local disease, unsuitable for surgery ab initio. Four hundred twelve of them (group A) received radiation therapy (RT) initially and 109 (group B) a combination of radiation and chemotherapy (CT). In 68% of the former and 77% of the latter the tumours became resectable after this preliminary treatment. Radical mastectomy in group A and Patey's mastectomy in group B were performed. The material in these two groups was similar. The five-year survival NED in group A was 45%, and in group B 64.61%. Adequate surgery following RT and CT seemed essential to improve survival. The impact of added chemotherapy (CT) was mainly felt in the node positive cases. PMID- 3968898 TI - Surgical intervention of countless metastatic lung lesions: a case report. AB - A patient with countless metastatic bilateral lung lesions from sarcoma of an extremity was treated surgically. The patient is alive in good physical condition nearly 2 years following the surgery. Although there are residual pulmonary metastases, they appear to be stational. Surgical intervention of countless metastatic lung lesions may be indicated in selected cases. PMID- 3968899 TI - Castleman's tumor with retroperitoneal location: a malignant-appearing benign tumor. AB - A case of a large retroperitoneal tumor in the pararenal region is presented. The tumor had an initial appearance of a malignant neoplasm both radiographically and at operation but histopathologically it turned out to be a rare benign tumor, Castleman's disease. Based on the benign nature of this lymphoid tumor extensive surgical procedures should be avoided as limited excision of the tumor appears to have been curative in all the patients reported in the literature. PMID- 3968900 TI - The steroid hormone receptors in tumors of adipose tissue. AB - The clinical evidence suggests that the steroid hormones may influence the biologic course of tumors of soft tissue. In an attempt to characterize the possible steroid hormone dependency of soft tissue, we studied the incidence and distribution of cytosolic receptors for the steroid hormones in benign and malignant tumors of adipose tissue origin. All specimens were assayed for the steroid hormone receptors by charcoal dextran technique and analyzed by the method of Scatchard. The results show a high incidence of cytosolic estrogen and glucocorticoid receptors in tumors of adipose tissue origin except in lipoma and well differentiated liposarcoma. The binding parameter of these receptors suggests that the receptors may be responsive to physiologic steroid hormonal milieu. PMID- 3968902 TI - Observations on 100 patients with continuous intraoperative monitoring of intramyocardial pH. The adverse effects of ventricular fibrillation and reperfusion. AB - Intramyocardial pH and temperature data recorded in 100 patients undergoing cardiac operations were analyzed to elucidate the effects of ventricular fibrillation and reflow. All patients underwent a single period of aortic clamping. Systemic hypothermia (25 degrees C) and intermittent cold crystalloid K+ cardioplegia were employed for myocardial protection. Baseline myocardial pH was 6.88 +/- 0.03 at a temperature of 36.5 degrees +/- 0.2 degree C. During the period of hypothermic ventricular fibrillation prior to aortic clamping, ventricular fibrillation did not affect myocardial pH in 45 patients (Group 1). In 21 patients (Group 2), it caused a significant drop in intramyocardial pH despite cooling. Group 2 patients had a higher incidence of valvular heart disease and left ventricular hypertrophy. They also exhibited low intramyocardial pH values during the subsequent periods of aortic clamping and reflow, indicating inadequate myocardial protection. During the period of reflow, reperfusion acidosis (pH less than 6.8 at 32 degrees C) was encountered in 39 patients (Group B) as opposed to 37 patients (Group A) whose pH remained well above 6.8 during that period. Group B patients had a higher incidence of valvular heart disease and left ventricular hypertrophy, tended to have more ischemic anterior walls prior to cardiopulmonary bypass, sustained longer periods of aortic clamping, had intramyocardial pH evidence of suboptimal protection during aortic clamping, were affected more adversely by ventricular fibrillation during reflow, and tended to have a higher operative mortality. Thus: Depending on the underlying myocardial disease, the adequacy of protection during aortic clamping, and the conditions of reflow, intramyocardial pH in man can fall significantly during ventricular fibrillation and reflow. The metabolic correlate of injury with reflow is a reperfusion acidosis that can reach as low as pH 5.98. When encountered, reperfusion acidosis can be minimized by prompt defibrillation. PMID- 3968901 TI - Chondrosarcoma of the head and neck--the value of computed tomography. AB - Chondrosarcomas of the head and neck represent a small percentage and differ in their treatment and prognosis compared with chondrosarcomas elsewhere. Four different cases of chondrosarcoma are presented. One arose intracranially, two in the jaws, one of which followed irradiation for a retinoblastoma, and the last represents chondrosarcomatous transformation in cervical spine Paget disease which is exceptionally rare. Computer tomography (CT) plays an important role in delineating the extent of the tumor with visualization of bony destruction, associated soft-tissue mass, and calcification, information which is extremely important for surgical and therapeutic planning. CT can be vital in suggesting the best possible site for biopsy which is particularly important in this group of neoplasms where the histological diagnosis may be difficult. PMID- 3968903 TI - Indications for ultrafiltration in the cardiac surgical patient. AB - Ultrafiltration is an extracorporeal technique that employs the principle of convective solute transport across a semipermeable membrane and by which plasma water is removed from blood. Ultrafiltration has been employed in 74 cardiac surgical patients intraoperatively, preoperatively, and postoperatively. In 55 patients with clinical evidence of excess body water, the ultrafilter was employed at the start of cardiopulmonary bypass. The amount of ultrafiltrate removed was 2,914 +/- 1,662 ml (SD), and the fluid balance was -219 +/- 1,298 ml (SD). In 17 patients the ultrafilter was inserted during bypass because of excess reservoir volumes, low hematocrit, or prolonged bypass time. The amount of ultrafiltrate removed was 1,450 +/- 898 ml (SD), and the fluid balance was 1,296 +/- 2,161 ml (SD). One patient with cardiopulmonary failure and nutritional depletion underwent slow continuous ultrafiltration preoperatively along with intravenous alimentation, producing a positive nitrogen balance and improvement in cardiorespiratory failure. One patient underwent slow continuous ultrafiltration for severe, diuretic-resistant congestive heart failure postoperatively. After 9 days of ultrafiltration, there was an 8 kg weight loss, an improvement in congestive heart failure, and a return of the response to diuretics. From this experience my colleagues and I have developed the following indications for ultrafiltration in the cardiac surgical patient: during cardiopulmonary bypass to prevent further fluid accumulation in the patient with clinical evidence of excess body water; during bypass to prevent excess fluid balance in a patient whose bypass time will be greater than 2 hours; during bypass when the pump reservoir volumes are excessive and/or the hematocrit is less than 18%; preoperatively or postoperatively to increase caloric intake in the fluid-overloaded patient; and preoperatively or postoperatively to reverse severe congestive heart failure in the diuretic-resistant patient. PMID- 3968904 TI - Surgical repair of tetralogy of Fallot. Long-term follow-up with particular emphasis on late death and reoperation. AB - Early and late results in 309 patients undergoing repair of tetralogy of Fallot between 1960 and 1982 were analyzed with respect to independent determinants of operative mortality, late reoperation, and late death. Follow-up extended to 22 years and totaled 2,743 patient-years. The operative mortality rate was 4.9% +/- 1.3%. Multivariate logistic regression analysis revealed that only young age, long cardiopulmonary bypass time, and (probably) extent of right ventricular outflow tract patch were independent significant determinants of operative mortality. Patients who required a transannular right ventricular outflow tract patch and those who underwent repair without any outflow tract patch were at higher risk than those who received a separate right ventricular and/or pulmonary artery patch. The long-term results were highly satisfactory: Only 15% +/- 3% of patients required reoperation 13 years postoperatively, and 85% +/- 4% of discharged patients were alive 16 years later. Time-dependent linear stepwise multivariate discriminant analysis showed that extent of right ventricular outflow tract patch (transannular greater than none greater than right ventricular and/or [separate] pulmonary arterial), longer ischemic arrest time, previous palliative shunt, and primary suture closure of the ventricular septal defect were the only covariates that independently portended a higher likelihood of reoperation. Similarly, only older age, absence of hypoxic spells, and reoperation were significantly and independently related to the probability of late death. The results of these analyses demonstrate that intracardiac repair of tetralogy is a durable procedure for upwards of 20 years; however, high-risk subsets of patients can be identified in terms of operative mortality, reoperation, and late death. Thus, there is still a need for improvement, particularly future research devoted to better understanding of the electrophysiological mechanisms responsible for arrhythmias, electrosurgical and medical arrhythmia therapy, and right and left ventricular mechanics after repair of tetralogy of Fallot. PMID- 3968905 TI - Chylothorax: an assessment of current surgical management. AB - The development of chylothorax is a serious and often life-threatening clinical entity. Optimal management of this problem has not been well defined to date. We reviewed our experience with chylothorax in patients of all ages during the past 10 years. Ages ranged from 2 days to 69 years. The etiologies were traumatic in 17 and congenital or idiopathic in three. Six patients (five infants) were treated nonoperatively with either repeated thoracenteses or chest tube drainage. Fourteen patients (11 infants) underwent operative treatment: transthoracic thoracic duct ligation (five patients), pleuroperitoneal shunting (seven), pleuroperitoneal shunting combined with reoperation on a patient with congenital heart disease (one), and reoperation alone on a patient with congenital heart disease (one). Duration of preoperative therapy ranged from 9 days to 2 months (average 3.3 weeks). Five of six (83.3%) patients treated nonoperatively died. Of the surgically treated group, only two of 14 (14.3%) died, and 11 of the 12 survivors had resolution of the chylothorax and immediate clinical improvement. Our experience suggests that both pediatric and adult patients respond poorly to nonoperative treatment of chylothorax and that this treatment has a high mortality rate. Post-traumatic and congenital chylothorax should be treated operatively after a limited trial (1 to 2 weeks) of nonoperative therapy. Pleuroperitoneal shunting may offer a reasonable and effective alternative to thoracotomy and thoracic duct ligation. PMID- 3968906 TI - Venoarterial bypass: a technique for spinal cord protection. AB - In the present study, we examined the effects of various levels of oxygen tension on spinal cord blood flow while using somatosensory evoked potentials to monitor spinal cord sensory function during hypoxia. In this experiment, six adult, mongrel dogs were heparinized and placed on right atrial-femoral artery bypass with an oxygenator in the bypass circuit. The aorta was cross-clamped proximal to the left subclavian artery, and bypass flow and fluid balance were adjusted so as to maintain a distal aortic perfusion pressure of greater than 80 mm Hg. Oxygen flow to the oxygenator was lowered by graded decrements to provide decreasing levels of oxygen tension, which ultimately approached pure venoarterial bypass. Each successive oxygen level was maintained for 30 minutes. Spinal cord blood flow was measured with radioactive microspheres, and latency and amplitude of somatosomatic evolved potentials were continuously monitored. The somatosensory evolved potential signal was invariably present as long as the distal aortic pressure was greater than 80 mm Hg; there were several transient hypotensive episodes (less than 5 minutes), which were accompanied by reversible loss of somatosensory evolved potentials. The spinal cord blood flow increased from 13.6 to 119.7 ml/100 gm/min as the distal oxygen tension fell to a mean value of 30 mm Hg, while latency of somatosensory evolved potentials increased 19.3% and amplitude decreased 43.3%. These results suggest the following conclusions: (1) In response to hypoxia, spinal cord blood flow dramatically increases and somatosensory evolved potentials deteriorate (increase in latency and decrease in amplitude). (2) However, during prolonged hypoxia, spinal cord sensory function can be maintained by sufficiently high flow rates and perfusion pressures. (3) Somatosensory evolved potentials can be used to monitor continuously spinal cord sensory function under these conditions. PMID- 3968907 TI - Influence of age at operation on late results with subclavian flap aortoplasty. AB - Despite the popularity of subclavian flap aortoplasty for repair of aortic coarctation, reported experience and follow-up in neonates is surprisingly limited. This paucity of reports prompted this review of age-related late recurrence rates. Of 83 patients having subclavian flap aortoplasty from 1976 to 1983, 60 were less than 8 weeks of age at operation (mean 2.6 weeks). Operative and late mortality were 18% and 14%, respectively. After a mean follow-up of 26 months, 10 patients have experienced recurrent coarctation (a mean of 10 months elapsed between operations). For 23 patients older than 8 weeks of age at operation (mean 20 months), operative and late mortality were 13% and 10%, mean follow-up is 16 months, and no patient has yet experienced recurrence. Thus, 75% of infants less than 8 weeks of age at operation are free of recoarctation at 2 years, and 100% of older children are free of recoarctation at 2 years (p = 0.06). Review of the literature corroborates our findings. The difference in recurrence rates may be due to age-dependent involution of residual coarctation tissue unavoidably left in place during subclavian flap aortoplasty. We conclude that subclavian flap aortoplasty is effective for correction of coarctation in infants, but patients less than 8 weeks old have a significant risk of early recurrence. Based on this review and our recently reviewed experience with end-to end anastomosis, our preference is to use the latter in this age group when technically feasible. PMID- 3968909 TI - Pulmonary artery balloon counterpulsation in the management of right heart failure during left heart bypass. AB - Pulmonary artery balloon counterpulsation was instituted in 10 pigs when right ventricular failure limited cardiac output. Global myocardial depression was produced by infusion of propranolol, and the left ventricle was fully supported by left heart bypass. A stable model of failure was achieved in six pigs. Following application of pulmonary artery balloon counterpulsation right atrial pressure decreased from 18.2 +/- 2.1 to 15.9 +/- 2.5 mm Hg (p less than 0.05). Cardiac output increased from 416 +/- 94 to 758 +/- 127 ml/min (p less than 0.001). Right ventricular stroke work increased from 0.29 +/- 0.07 to 0.65 +/- 0.12 gm X m. (p less than 0.05). There was no cardiac output before or after institution of balloon counterpulsation in four pigs studied during ventricular fibrillation or asystole. We conclude that pulmonary artery balloon counterpulsation improved cardiac output and right ventricular stroke work in a model of right ventricular failure where the pulmonary circulation was unaltered and the left ventricle supported by left heart bypass. Balloon counterpulsation was not effective during ventricular fibrillation or asystole. Pulmonary artery balloon counterpulsation should be considered when right ventricular failure limits cardiac output during left heart bypass. PMID- 3968908 TI - Sudden blowout rupture of the myocardium after infarction: urgent management. Report of four cases. AB - Blowout rupture of the myocardium is intended to describe a syndrome of sudden hemodynamic deterioration after myocardial infarction. Characterized by abrupt hypotension, cardiac tamponade, or electromechanical dissociation, it is an emergency of the first order with no time for cardiac catheterization. Frequently one must make the diagnosis and race for the operating room almost simultaneously. We have managed four such patients, one with a ruptured false aneurysm and three patients with acute rupture of recently infarcted myocardium. All patients were placed on femoro-femoral bypass initially and all survived operation. Two patients died in the hospital of irreversible brain damage and two are long-term survivors. A high index of suspicion, a well-coordinated operating team, and a willingness to take the bold step to the operating room, frequently on the basis of clinical judgment alone, are necessary to salvage patients with this syndrome. PMID- 3968910 TI - Modified Blalock-Taussig shunt in infants and young children. Clinical and catheterization assessment. AB - The effectiveness of 19 modified Blalock-Taussig shunts performed with expanded polytetrafluoroethylene was evaluated clinically and by cardiac catheterization with angiography 4 to 24 months after operation. Fifteen patients underwent operation in infancy. Conduit diameters included 4 mm (nine cases), 5 mm (eight cases), and 6 mm (two cases) sizes. Two of the 4 mm conduits failed after 1 year following implantation. The remaining 17 shunts (89%) remained widely patent. In patients with patent shunts, the oxygen saturation values were significantly improved from the preoperative values. Two children demonstrated associated subclavian artery occlusion distal to the graft anastomosis. There were no deaths. Thirteen children underwent more complete elective cardiac repair 5 to 24 months later. Although the modified Blalock-Taussig procedure is an effective short-term alternative to the classic Blalock-Taussig shunt, the effectiveness of the 4 mm diameter conduit may be limited without postoperative anticoagulant therapy. PMID- 3968911 TI - Tetralogy of Fallot with absent pulmonary valve. Early and late results of surgical treatment. AB - From 1957 through September, 1983, 35 patients with tetralogy of Fallot and absent pulmonary valve underwent operation. Two subgroups of patients were recognized: minimally symptomatic (Group A, n = 21) and markedly symptomatic (Group B, n = 14). Group B patients were symptomatic at an earlier age and were younger at operation. Ages ranged from 1 day to 42 years (mean = 7.8 +/- 7.4 SD). Repair consisted of closure of the ventricular septal defect and relief of the right ventricle-pulmonary artery pressure gradient (nine patients received a tissue valve). In five patients, partial resection and/or plication of the aneurysmal pulmonary arteries also was performed. Operative mortality was 4.8% in Group A and 35.7% in Group B. In up to 25 years of follow-up, there was one late death in Group A (an early case with complete heart block); the remaining 19 patients are asymptomatic. In Group B, there were four late deaths, three related to cardiopulmonary insufficiency. These results indicate pulmonary valve insufficiency is tolerated well in minimally symptomatic patients. For markedly symptomatic patients, results may be improved if repair includes establishment of pulmonary valvular competence and reduction of size and length of aneurysmal pulmonary arteries. PMID- 3968912 TI - Congenital aortic stenosis with hypoplasia of the left sinus of Valsalva. Anatomic reconstruction of the aortic root. AB - Evaluation of the aortic root in 13 patients with congenital aortic stenosis aged 2.5 to 24 years (mean 8.3 years) has revealed morphologic characteristics of asymmetry of the aortic root caused by a small (hypoplastic) left sinus of Valsalva associated with a supravalvular ridge above the left coronary ostium and dysplasia of the aortic valve. The asymmetry resulted in folding and buckling of the left aortic cusp. The aortic valve was classified as bicuspid in 11 of the 13 patients. Preoperative aortography was characteristic and revealed the diagnosis in all patients. The average left ventricle-aorta systolic pressure gradient was 81 mm Hg. Operative repair consisted of an oblique aortotomy extended in a spiral fashion to the right and posteriorly into the left sinus of Valsalva. Seven patients had further mobilization of the posterior commissure with a second incision to the right of the commissure into the noncoronary sinus. Slightly fused valve commissures were opened in 12 patients. Aortic root reconstruction was accomplished with a spiral Dacron patch and posterior commissural repositioning. Follow-up catheterization at 9 to 35 months (mean 24 months) in five patients demonstrated an average outflow tract systolic gradient of 28 mm Hg and a more symmetrical appearance of the aortic root. PMID- 3968913 TI - Atrioventricular septal defect with balanced ventricles and malaligned atrial septum: double-outlet right atrium. Report of two cases. AB - An unusual form of atrioventricular septal defect was found at operation. The anatomy was that of a primum atrial septal defect with deviation of the atrial septum to the left. Thus from the right atrium both right and left atrioventricular valves could be seen. The left-sided valve was tricuspid. Repair was achieved by closure of the septal commissure of the left-sided valve ("cleft"), excision of the lower part of the atrial septum, and insertion of a pericardial patch. The lower part of the patch was sutured between the left and right atrioventricular valves. A specimen with similar anatomy is also described. PMID- 3968914 TI - The surgical treatment of atrial myxomas. Clinical experience and late results in 33 patients. AB - Thirty-three patients (28 female and five male) from 17 to 70 years of age (mean age 48 years) underwent excision of left atrial myxomas between 1957 and 1981 at The Cleveland Clinic Foundation. Twenty-four patients presented with congestive heart failure, three with tachyarrhythmias, two with syncope, and one each with angina, peripheral embolization, hemoptysis, and recurrent pleural effusions. Symptoms were present from 1 to 72 months before operation (mean 11.2 months). Thirty-one tumors originated from the atrial septum and two from the mitral valve anulus. Twenty-nine tumors were pedunculated, and four were sessile; they weighed from 20 to 112 gm (mean 57 gm). No right atrial or ventricular tumors were identified. The myxomas were successfully removed in all patients, either by shaving them from the atrial septum (n = 17) or by excising a portion of normal atrial septum with the tumor (n = 16). One death (3.0%) occurred 8 days after operation as a result of multiple tumor emboli to the coronary circulation. Follow-up is current and complete in all cases (range 1 to 25 years, mean 6.7 years). Twenty-eight patients are in New York Heart Association Class I, and the remaining four patients are in Class II. No recurrent myxomas have been identified clinically or by echocardiography in any patient. Altogether, 24 patients have been studied by two-dimensional echocardiography up to 20 years after operation (mean 4.0 years). In this series, excellent results were obtained by simple excision of the tumor, with or without a margin of normal atrial septum. Long-term clinical and echocardiographic follow-up is recommended since late recurrence, although rare, has been reported. PMID- 3968915 TI - Use of the Shaw Scalpel in pacemaker operations. AB - Pacemaker carriers are at risk when undergoing operations involving the use of diathermy. The Shaw Scalpel utilizes a method by which the cutting edge of the blade is heated to a selected temperature that seals blood vessels as they are cut. No electrical currents are passed to or through the patient and there is no sparking or electrical arcing to the tissue. This apparatus was used as the sole method of thermal coagulation in 20 patients undergoing replacement of pacemaker batteries. PMID- 3968916 TI - Myasthenia gravis-associated antibodies in asymptomatic thymoma. AB - Serum antibodies associated with myasthenia gravis were evaluated before and after therapy in an asymptomatic patient having a malignant thymoma. The case illustrates that myasthenia-associated antibodies may also be useful as a tumor marker of thymoma in the work-up of mediastinal masses, in evaluating therapy of thymoma, and possibly in detecting recurrence of thymoma and potential for developing myasthenia gravis. PMID- 3968917 TI - Percutaneous drainage of lung abscess. PMID- 3968918 TI - Papaverine irrigation of vein grafts. PMID- 3968919 TI - The utility of synthetic and regression estimation. Techniques for local health planning. AB - Health planning agencies have long had a need for local area data on issues such as health status, utilization, and preventive care. Synthetic estimation and regression techniques have been advanced for use in adjusting national or regional data from the NCHS Health Interview Survey (HIS) to the local area based on demographic and other pertinent variables. To evaluate the accuracy and utility of these techniques for local health planning, estimates of certain key HIS variables were obtained from a telephone survey of 2,500 randomly selected households located in the Central Maryland Health Systems Agency (CMHSA). This paper presents results of the comparison between these telephone estimates and the corresponding estimates derived from the national HIS. The techniques are evaluated on the basis of data generally available to local planning agencies. PMID- 3968920 TI - After-hours telephone access to physicians with access to computerized medical records. Experience in an inner-city general medicine clinic. AB - The authors examined the effect of after-hours telephone access to physicians and physician access to computerized medical records on hospitalizations and emergency room (ER) visits in an inner-city, adult, general medicine clinic. Patients were randomly assigned to a control (C) and two study groups (S1 and S2). Patients in study groups S1 and S2 had after-hours telephone access to physicians. Computerized medical records were accessible to physicians only for callers in study group S2. During the initial 18 months of study, only 7.6% of eligible patients called the after-hours service, a rate of 6 calls/1,000 patients/month (200 calls/1,849 patients/18 months). Repeated promotion of the service was subsequently undertaken, and 19.4% of the patients used the service during the final 12 months of study, a rate of 24.1 calls/1,000 patients/month (467 calls/1,616 patients/12 months). There were no significant differences in hospitalizations or ER visits among the control and two study groups. PMID- 3968921 TI - The determinants of spatial distribution of hospital utilization in a region. AB - This article presents a series of models for explaining hospital utilization. The models belong to the multinomial logit class, which relate the probability of hospital selection to factors that include travel time between patients and hospitals, hospital attractiveness factors, physician characteristics, and patient characteristics. Separate models for different population groups (sex, age, socioeconomic classes) and medical services (general medicine, obstetrics, pediatrics, psychiatry, and general surgery) are estimated and compared with the general hospital model. The results, which are based on an extensive data base and new estimation procedures, are superior to those of past studies. A number of differences between utilization patterns for the various populations are also observed. PMID- 3968922 TI - Development and validation of a measure of dental patient satisfaction. AB - As part of the Washington State Dental Auxiliaries Project, a 42-item measure of patient satisfaction with dental care was developed. The measure is comprised of 13 subscales: dentist-patient relations, technical quality of care, access, patient waiting time, cost, facilities, availability, continuity, pain, auxiliaries performing expanded duties, staff-patient relations, staff technical quality of care, and office atmosphere. The measure was developed from a set of 52 items included in a questionnaire administered to the patients of private dental practices in Washington state. Usable questionnaires were returned by 30.8% of patients receiving questionnaires in 1979, 40.1% in 1980, and 34.0% in 1981. Factor analysis plus categorization of items by a panel of professionals were used initially to group items into subscales. Contribution to internal consistency was the final criterion for an item's inclusion in a subscale. Internal consistency of subscales ranged from 0.44 to 0.80. The concurrent validity of subscales was assessed by relating patient satisfaction to characteristics of the dental practices. The following statistically significant relationships between subscales and criterion variables were observed: dentist patient relations and percent of patients seen by the dentist; access and number of weeks appointments must be booked in advance; patient waiting time and actual patient waiting time; continuity of care and percent of patients seen by the dentist; auxiliaries performing expanded duties and delegation to auxiliaries; and staff technical quality and percent of hygienist restorations with satisfactory quality. Each relationship was in the expected direction. PMID- 3968923 TI - Factors influencing the diagnosis of mental disorder among primary care patients. AB - Understanding the role primary care physicians play in the recognition and management of mental disorder among their patients is a research topic that has assumed considerable importance because of the high prevalence combined with low recognition of mental morbidity in primary care settings. Patient characteristics that influence diagnostic patterns have been one important focus of this research. This paper presents data from a study in two primary care departments in a large comprehensive health care clinic in central Wisconsin. During a 3 month period, 1,452 attenders at these clinics were assessed using a brief psychiatric screening scale, and special study forms were completed by the primary care clinicians. Consistent with previous research, reason for visit, psychiatric symptoms, and prior knowledge of the patient are significant predictors of physician diagnosis of mental disorder. Additionally, pattern of physician practice, as represented by differences between the two types of clinics, was a strong predictor of both diagnosis and treatment. The lack of significant effects of sex and previous medical utilization is contrary to previous research. Key words: mental disorders; diagnosis; primary care. PMID- 3968924 TI - Patient exposition and physician explanation in initial medical interviews and outcomes of clinic visits. AB - To replicate an earlier study and explore associations between verbal behaviors in patient-physician interactions and outcomes of care, 102 visits to a medicine walk-in clinic were tape-recorded, transcribed, and coded according to the Verbal Response Mode (VRM) system. Questionnaires given before and after the clinic visit and telephone interviews 1 week and 4 weeks after the visit were used to measure patient satisfaction, compliance, and change in symptoms. Data were collected on patients' sociodemographic characteristics, illness characteristics, and health beliefs. Two verbal exchanges were examined: in the medical history, the Patient Exposition exchange, which was measured as the frequency with which patients make statements about their illnesses in their own words; and in the conclusion, the Physician Explanation exchange, which was measured as the percentage of physician statements that are factual. These verbal indexes showed correlations with patient satisfaction, thus replicating the earlier study, but no significant correlations with compliance. Analysis of variance showed that the association between verbal exchanges and patient satisfaction remained after controlling for physician differences and for patient age, education, and belief in the controllability of the illness. PMID- 3968926 TI - Crisis intervention. Interpretation and practice by HMOs. PMID- 3968925 TI - Effect of initiation, termination, and reinitiation of consultant clinical pharmacist services in a geriatric long-term care facility. AB - The effect of initiation, termination, and reinitiation of consultant clinical pharmacist services of drug regimen review and physician communication on patient drug use in a 72-bed geriatric long-term care facility was assessed at five points in time: initiation, termination, reinitiation, then 3 months and 3 years after reinitiation of services. Both times when the consultant was retained, drug use was cut almost in half (46.1% and 42.7%, respectively), with essentially the same number of established diagnoses per patient at each point in time. Conversely, before the consultant services were initiated, and when the consultants services were terminated, drug use was twice as great as when consultant pharmacist was retained. Regularly scheduled drugs increased 59%, and pro re nata (prn) drug increased 200% during the period between the termination and reinitiation of consultant services. There was also a lower admission, discharge, and death rate as well as higher hospitalization rate when the consultant was retained. It appears that the consultant clinical pharmacist has an impact on drug cost in long-term care facilities that is reversed when drug regimen review is removed and renewed when services are reinitiated. PMID- 3968927 TI - [Occurrence and diagnosis of congenital adrenal hyperplasia in Swedish children]. PMID- 3968928 TI - [Phylogeny of gastro-entero-pancreatic neurohormonal peptides]. PMID- 3968929 TI - [Early contact disturbances in children--screening, diagnosis and limitation problems]. PMID- 3968930 TI - [Experiences with rectal cancer in routine health care. Lack of preoperative macroscopic spreading of cancer gives a better 5-year survival of patients]. PMID- 3968931 TI - [Sigmoidostomy and quality of life--good planning can relieve the problems]. PMID- 3968932 TI - [Wegener's granulomatosis--a retrospective study of 11 patients]. PMID- 3968933 TI - [Determination of osmolarity gap is an useful method in the diagnosis of methanol poisoning]. PMID- 3968934 TI - [A case of Streptococcus suis meningitis--a new occupational disease in Sweden?]. PMID- 3968935 TI - [Maternal mortality--a global problem. Half a million are still dying during labor every year]. PMID- 3968936 TI - [Perilymph fistulas--symptoms and indications for tympanoscopy]. AB - In the last two years thirteen cases of perilymph fistula were treated by tympanoscopy and covering with connective tissue. Recovery of hearing was not observed in 4 totally deaf ears, but improvement was recorded in each of 9 cases with impaired hearing. Vertigo disappeared in 10 of 11 cases without any correlation with the degree of hearing loss. We perform tympanoscopy in suspected perilymph fistula, because prognosis is uncertain, spontaneous recovery with remaining defects may induce menieriform syndrome, and pathway of infection should be closed. The diagnosis of a perilymph fistula must be solidified in cases of sudden deafness with vertigo, sudden hearing loss changing to the worse during medical treatment, sudden hearing loss without recovery during medical treatment, sudden hearing loss and subsequent onset of vertigo. PMID- 3968937 TI - [Bilateral caloric long-term irrigation as a method for the differentiation of tonal tinnitus]. AB - In 307 subjects with tinnitus aurium, the parameters frequency, loudness, and masking levels did not correlate significantly with the basic diseases. As a new possibility in differentiation between tinnitus of central or peripheral origin, bilateral caloric long-term irrigation of the ear canal is presented. Using warm water leads to an increase, cold water to a decrease in the loudness of tinnitus. Such results were found in cases of Meniere's disease and noise-induced hearing loss. An explanation of this phenomenon lies in the hypothesis of tinnitus genesis established by Tonndorf. PMID- 3968938 TI - [Primary adenocarcinomas of the larynx]. AB - Adenocarcinomas of the larynx are rare. They may arise primarily, but can also be of metastatic origin. The tissue of the first biopsy is often insufficient to assume one of these two possibilities with a probability high enough for designing a therapeutic concept. In two cases of laryngeal adenocarcinomas, large series of laryngeal sections were made. With these sections, we were able to show that some additional histologic criteria ascertained thereby, will contribute towards a safer decision for or against a primary adenocarcinoma. Special attention was given to the varying grades of differentiation and modes of growth. Adenomatous structures, which may represent the matrix of the tumour, and premalignant stages, such as dysplasia or in situ carcinoma, were also looked for. Whenever the decision primary versus metastatic growth is clinically relevant, additional biopsies from the tumour's neighbourhood are, therefore, recommended. PMID- 3968939 TI - [Metal plate osteosynthesis and follow-up irradiation. An animal experiment study]. AB - Osteosynthesis by titanium plates represents a versatile tool for immediate rehabilitation in head and neck oncologic surgery. If followed by radiation therapy, however, plate rejection and bone necrosis may be the result, as dose increases have been shown at the critical tissue-metal interface. Therefore an experimental study on rabbits was conducted to examine the effect of a 60 Gy radiation therapy after titanium plate osteosynthesis of the femur. Histologic examination showed no impairment of the radiated bone; all plates and screws were fixed closely by healthy bone tissue. Therefore, titanium plate osteosynthesis, followed by radiation therapy, seems to be possible; scrupulous observation of some modalities concerning radiation therapy as well as operative technique is, however, recommended. PMID- 3968940 TI - [Peritumor lymph flow]. AB - The peritumoural lymph current of 28 tumours of the head and the neck was analysed by using colloidal 198Au. In 10 cases a mostly unilateral, sometimes also a bilateral, flow of the radiomarker into the lymphatic system was seen. Whereas the flow was independent of the stage, it depended on the localisation of the tumour, the tonsillar and retrolingual regions being more effectively perfused than the larynx. If there was a detectable lymph current, clinical and histological metastases were often present in the lymph nodes. The peritumoural lymph current is an important factor in the lymphogenous formation of metastases. PMID- 3968941 TI - [7 years' experience with tracheal transverse resection]. AB - During the last seven years, 19 patients with several stenoses of the cervical trachea underwent segmental resection of the trachea in our department. 7 cases required supplementary surgical correction of the airways prior to the operation. In 16 cases, primary success was achieved. 3 cases were cured by secondary repair of restenosis. All our patients could be decannulated. PMID- 3968942 TI - [Helium-neon laser--a possibility for the topodiagnosis of tracheal stenoses]. AB - Exact knowledge of the upper and lower border of a tracheostenosis is important for success or failure in a transverse resection of the trachea. Using an angular optical equipment of 90 degrees, the upper margin of the stenosis can be focussed endoscopically in case of localisation problems, and projected on the front side of the trachea by the helium-neon laser beam. Even in case of tracheal displacement caused by a tumour, or induration of the soft tissues of the neck due to x-rays, the helium-neon laser beam will be an important orientation aid. PMID- 3968943 TI - [A case of granulomatous stomatitis as the initial manifestation of Crohn disease]. AB - A case of a 38-year old female patient is reported, showing a severe granulating inflammation of the oral mucosa which was revealed as an oral manifestation of Crohn's disease. Clinical and histological alterations of oral mucosa caused by the disease, are demonstrated, and differential diagnosis is discussed. PMID- 3968944 TI - [Significance of the glycerol test for the diagnosis of sensorineural hearing disorders]. AB - 140 patients with various forms of sensorineural hearing loss were examined via the glycerol test (Klockhoff). In 66% of the cases with Meniere's disease, a typical temporary threshold shift could be seen. 17 patients with fluctuating hearing loss of unknown etiology without vestibular symptoms showed a similar effect; they were classified as belonging to the group of the cochlear type of Meniere's disease. In 34% of cases with clinically assured diagnosis of Meniere's disease, glycerol did not induce improvement in hearing. Repeated glycerol tests revealed varying results; shortly after a Meniere attack, the glycerol test was usually negative, whereas shortly before the next attack the glycerol test changed to positive. These data support the specificity of the glycerol test: The results depend on the presence of endolymphatic hydrops at the time of examination. Positive results of the glycerol test were also seen in the cases of reduced sensorineural hearing associated with syphilis, as well as in cases of cerebrospinal pressure changing synchronously with fluctuating hearing loss (Lindsay and Zajtschuk). In all other cases of sensorineural hearing losses, no positive effect of the glycerol test has been found. PMID- 3968945 TI - Medical and legal management of adult acute epiglottitis. AB - A case of acute epiglottitis without prior treatment in a 64-year-old hypertensive alcoholic male is reported. A correct diagnosis was made in the emergency room and tracheostomy deferred as airway seemed adequate. A trial course of medical therapy under close observation was felt indicated. A detailed history up to the time of death, 8 hours after admission, will be presented as well as the findings at post mortem. Nine months later the executor of the estate filed a $2 million malpractice suit against the defendant doctor and the defendant hospital for wrongful death. A pretrial deposition was held followed by an offer to settle. This was refused and a trial date set in Superior Court. One week before trial another offer to settle was made by the plaintiff for $12,500 from each of the two defendants. This offer was accepted. PMID- 3968946 TI - Central presbycusis. AB - The phenomenon of central presbycusis has been investigated employing a central auditory battery in elderly individuals with essentially normal hearing. The studies indicate a progressive loss in central auditory competence measured by simultaneous binaural challenges and frequency and temporal distortion tests. The rate of failure is related to age, on the whole, but there is increasing variability from the normals with seniority. The hearing disability in noise or speech competitive environments is explained by these data. Auditory disabilities related to poor articulation and rapid speech presentation are identified by other tests in the battery. Central presbycusis, in addition to the peripheral form, does exist and further compounds the hearing disorder in many elderly. PMID- 3968947 TI - The pectoralis myocutaneous flap for salvage of necrotic wounds. AB - The authors have utilized six pectoralis major myocutaneous flaps in attempts to salvage extensive necrotic wounds of the pharynx and neck. The flap was employed in the following situations: massive necrosis of the entire neck skin with both carotid artery systems exposed, radiation necrosis of the neck skin with exposure of carotid artery, dehiscence of gastric pull-up from pharynx with resultant carotid exposure, failed trapezius flap in a radionecrotic oral cavity, and two cases of pharyngocutaneous fistula with extensive soft tissue necrosis. These flaps achieved healing in all cases. One death occurred 3 weeks following complete cutaneous healing secondary to a ruptured carotid pseudoaneurysm. One flap underwent total skin loss but the entirety of the muscle survived and the fistula was successfully closed with the back of the muscle being subsequently skin grafted. One case of dehiscence of the flap from oral mucosa resulted in a minor exposure of mandible with limited osteoradionecrosis controlled by topical means. This flap has performed extremely well in these precarious and difficult situations that previously may not have been salvageable. It has also been effective in abbreviating the required hospitalization and wound care. We conclude that the pectoralis myocutaneous flap should be the primary choice for the management of extensive postsurgical wound necrosis. PMID- 3968948 TI - The role of supraomohyoid neck dissection at the time of supraglottic laryngectomy. AB - Uncontrolled cervical metastasis is the most common source of failure in the surgical treatment of supraglottic carcinoma. This study was designed to determine the value of supraomohyoid neck dissection in patients undergoing supraglottic laryngectomy. The rationale for considering the role of supraomohyoid neck dissection is that such a dissection encompasses the subdigastric and midjugular nodes which are the first echelon of lymphatic drainage of the supraglottic larynx. Thirty-eight patients with a diagnosis of epidermoid carcinoma of the supraglottis were treated by subtotal supraglottic laryngectomy (SSL). Ten patients underwent SSL with no neck dissection, 16 patients underwent SSL with supraomohyoid neck dissection (SOHD)--9 unilateral and 7 bilateral, and 12 patients underwent SSL with radical neck dissection (RND). The 3 groups had comparable T classifications. All of the SSL and SSL with SOHD patients were classified as N0. Of the 12 patients treated with SSL and RND, 4 were classified as N0, 4 as N1, 3 as N2, and 1 as N3. The patients were studied to determine the incidence and pattern of subsequent neck disease, survival, complications, and length of hospitalization. The data indicates that supraomohyoid neck dissection offers little benefit as an adjunct to supraglottic laryngectomy. PMID- 3968949 TI - Immediate reconstruction after total laryngopharyngoesophagectomy and mediastinal dissection. AB - Advanced or recurrent carcinoma surrounding the tracheostoma in a previously laryngectomized patient is most effectively treated with transsternal radical dissection of the upper mediastinum and relocation of the trachea to the upper chest. The use of the pectoralis major myocutaneous flap, now enables the head and neck surgeon to perform immediate reconstruction and provide protection for the great vessels after mediastinal dissection for stomal recurrence. Formerly, patients with stomal recurrence also involving the cervical or upper thoracic esophagus were poor surgical candidates. Frequently, patients succumbed to their disease before the continuity of the digestive tract could be re-established. Currently, at our institution, this vexing reconstructive problem is solved with immediate, one-stage reconstruction. The esophagus is replaced by transposing the stomach through the posterior mediastinum and anastomosing to the tongue base, "gastric pull-up." The mediastinal defect is closed with the concomitant use of the pectoralis myocutaneous flap. The muscular portion of the myocutaneous flap provides excellent coverage for the great vessels of the upper mediastinum. Our experience with 39 patients who underwent this procedure between 1979 and 1983 is presented. PMID- 3968950 TI - Tape attachment therapy for correction of congenital malformations of the auricle: clinical and experimental studies. AB - After the auricular cartilage of 5-week-old rabbits was bent and fixed by suture, the cartilage increased in thickness in a short period of time. The thickness was maximal 6 weeks later and slightly greater than that of the control cartilage 12 weeks later. At this stage, the auricle was fixed in curved form. There was no difference in the morphology of cartilage cells between the bent group and the control. Tape attachment therapy is very simple. We propose that surgical treatment should be designed after a few months of tape attachment therapy. In the present work, the effect of taping was graded good in 4 cases of Stahl ear, 1 case of atypical cryptotia, and 2 other cases. In 2 cases of cup ear the result was fair, but this deformity with marked auricular aplasia was not curable by this conservative treatment. PMID- 3968951 TI - Pulsatile tinnitus: a dehiscent jugular vein. AB - A case is reported of a female patient with subjective tinnitus synchronous with her pulse, in the left ear. A dehiscent high seated jugular vein was found in the middle ear. A surgical technique is presented using a septal cartilage homograft to cover the dehiscent vein. PMID- 3968952 TI - Sino-orbital aspergillosis associated with total ophthalmoplegia. AB - Invasive aspergillosis of the paranasal sinuses involving the orbit is termed sino-orbital aspergillosis. Prognosis of sino-orbital aspergillosis, complicated by impaired visual acuity and neurological signs, is disastrous and usually fatal. We herein report two patients with sino-orbital aspergillosis associated with total ophthalmoplegia. One patient was successfully treated with surgical eradication including orbital exenteration. In contrast, the other died of cerebral infarction, probably due to fungal thrombosis of the middle cerebral artery, despite repeated local debridement followed by orbital exenteration and administration of antifungal agents. Experience with these cases strongly indicates the necessity of prompt surgical eradication, including orbital exenteration if necessary, in the treatment of sino-orbital aspergillosis. PMID- 3968953 TI - Clinician reliability in rating voice improvement after laryngeal nerve section for spastic dysphonia. AB - A recent study by Aronson and DeSanto (1983) showed that, although section of the recurrent laryngeal nerve to relieve adductor spastic dysphonia effected considerable improvement in nearly 100% of the voices immediately after surgery, within the next 3 years 64% had returned to their preoperative status or worse. These findings were based on ratings by one speech pathologist, and the study was not designed to measure the reliability of the rater's judgments. PMID- 3968954 TI - Conservation surgery for cancer of the larynx in the elderly. AB - The postoperative course was evaluated for 458 consecutive patients, all over the age of 56 years, who had undergone laryngeal conservation surgery in the last 10 years. One hundred seventy-one patients aged 66 and over made up the "elderly" group and 287 patients, aged between 56 and 65 years formed the control group. It was confirmed that cordectomy and frontolateral laryngectomy are feasible even in elderly patients. Bronchopneumonia is the most frequent and serious complication after supraglottic laryngectomy. Therefore this operation should be performed in the elderly patient only after a thorough evaluation of cardiac and respiratory function. Prophylactic neck dissection should not be done for N0 necks and the second therapeutic neck dissection in N2 cancers should be staged 6 or more weeks later. Hemilaryngopharyngectomy and subtotal reconstructive laryngectomy with cricohyoidpexis are not advisable in elderly patients. PMID- 3968955 TI - Measurement of auditory brain stem potentials in Bell's palsy. AB - Auditory brain stem potentials (ABP) were recorded in 27 patients with Bell's palsy during the early phase of the disease and 1-3 months later. Pathological findings were observed in 6 patients, the dominant features being prolonged brain stem transmission time and diminished amplitude of the second wave. The extension of the pathological process in the so called idiopathic peripheral facial paralysis appears to vary. The observation of brain stem involvement in some patients with Bell's palsy may have important clinical implications. PMID- 3968956 TI - Intramuscular hemangioma of the head and neck. AB - Intramuscular hemangiomas are unusual tumors in the head and neck region that occur most frequently in the masseter muscle and are often confused with parotid neoplasms. Four cases are described and the literature reviewed. The diagnosis and management of these tumors are discussed in view of the fact that accurate preoperative diagnosis is unusual and tumor recurrence rates high. Increased awareness of the clinical presentation of intramuscular hemangiomas should enhance diagnostic accuracy and facilitate optimal treatment planning. PMID- 3968958 TI - Method for anchoring nasogastric feeding tubes. PMID- 3968957 TI - Intratracheal thyroid: an unusual cause of upper airway obstruction in a newborn. AB - The proper management of upper airway obstruction requires prompt recognition, correct diagnosis, and appropriate treatment. Of all the causes of upper airway compromise, intratracheal thyroid is one of the least common, especially in the newborn. The majority of cases reported involve adults or adolescents, mostly in European countries. The English literature has fewer cases, none involving a newborn. The authors report a case they believe to be the first example in the English language of obstructing intratracheal thyroid in a newborn. The authors' experience and literature review of this rare anomaly are presented in an effort to acquaint others with this often unthought of cause of airway compromise. PMID- 3968959 TI - Flap tracheostomy in sleep apnea patients. PMID- 3968961 TI - Simple audio equipment for use in patients with radionecrosis. PMID- 3968960 TI - Closure of pharyngocutaneous fistulae with the rhomboid flap. AB - This technique has been used successfully in 15 cases of pharyngocutaneous or antrocutaneous fistulae. Only 1 case failed which later closed with conservative management. PMID- 3968962 TI - [Resistance to arboviruses in Yugoslavia]. PMID- 3968963 TI - [Clinical, diagnostic and therapeutic aspects of human trichinosis]. PMID- 3968964 TI - [3 water-borne epidemics of acute type A viral hepatitis in schools in Slavonia between 1981 and 1982]. PMID- 3968965 TI - [Dissecting aortic aneurysm--importance of early diagnosis]. PMID- 3968966 TI - [Respiratory function during physical loading]. PMID- 3968967 TI - [Treatment of spasm of the facial nerve with acupuncture]. PMID- 3968968 TI - [Notes from medical terminology (25)]. PMID- 3968969 TI - [Potential fatal interaction of verapamil and propranolol]. PMID- 3968970 TI - [Changes in the electrocardiogram during bronchoscopy]. PMID- 3968971 TI - Long-term desipramine treatment attenuates clonidine-induced suppression of ventral tegmental self-stimulation. AB - Long-term administration of the tricyclic antidepressant desipramine did not change the rate of self-stimulation responding in the A10 (ventral tegmental) area but significantly attenuated the suppressive effect of the selective alpha 2 adrenergic agonist clonidine on this behavior. These findings demonstrate an involvement of noradrenergic mechanisms in the regulation of ventral tegmental self-stimulation and further suggest that adaptive changes in inhibitory presynaptic noradrenergic receptors may be involved in desipramine's antidepressant effects. PMID- 3968973 TI - Reduced high affinity cholecystokinin binding in hippocampus and frontal cortex of schizophrenic patients. AB - Cholecystokinin (CCK) binding sites were assessed in post-mortem brain membrane preparations from controls and schizophrenic patients. 125I-BH CCK33 specific binding was reduced by 40% (p less than 0.02) in the hippocampus and by 20% (p less than 0.01) in the frontal cortex of schizophrenic patients compared with controls. There were no differences in 125I-BH CCK33 binding between the two groups in the amygdala, temporal cortex or caudate nucleus. PMID- 3968974 TI - Heritable differences in turning behavior of rats. AB - An attempt was made to breed strains of strongly and weakly rotating rats. A strain difference in rotation parameters was limited to females and developed gradually over eight generations before asymptoting. Unexpectedly, a left-sided population bias developed in both male and female rats bred for weak rotation. It is suggested that testosterone modulates several aspects of the inheritance of cerebral lateralization. PMID- 3968972 TI - Determination of tyrosine, tryptophan and their metabolic derivatives by liquid chromatography-electrochemical detection: application to post mortem samples from patients with Parkinson's and Alzheimer's disease. AB - A procedure is described for the rapid determination of the major indoles and catechols. Analysis with picogram detection limits was done by high-pressure liquid chromatography on a C18 reverse-phase column using electrochemical detection (LCEC). This method provides a comprehensive list of compounds which can be simultaneously determined in brain samples and for which there is no necessity of derivatization or pre-column purification. The regional distribution of 9 neurochemicals from rat brain and the levels of 10 neurochemicals from human brain are presented. DOPA, TYR, NE, MHPG, DOPAC, 5-HIAA, TRP, DA, HVA, 3-MT and 5 HT were detected in the caudate nucleus and putamen. The levels of neurochemicals from the caudate and putamen of a demented patient with Parkinson's disease were variably decreased; catechol and indole losses were greatest in the putamen. The levels of neurochemicals in the caudate and putamen of patients with Alzheimer's disease (SDAT) were also variably decreased; loss of NE was seen only in putamen and losses of DA, HVA and 5-HT were uniform across both caudate and putamen. The CSF of SDAT patients showed changes in NE only. PMID- 3968975 TI - The biochemical and behavioral effects of phospholipase A2 and morphine microinjections in the periaqueductal gray of the rat. AB - In order to characterize the in vivo action of phospholipase A2 (PLA2) on opiate receptors and opiate-induced behaviors, the effects of injections of PLA2 into the periaqueductal gray region (PAG) of the rat were assessed on free fatty acid (FFA) release, opiate-binding levels, and morphine-induced behaviors. Rats received bilateral PAG injections of 2 micrograms of PLA2 while anesthetized. One hour later, regions around the cannulae tracts in PLA2-treated rats contained over 2.5 times more FFA than saline-injected controls, and 3H-dihydromorphine binding was reduced on average more than 70%. In another series of experiments, conscious rats were given 2 micrograms of PLA2 prior to 10 micrograms of morphine through cannulae chronically implanted into the PAG. PLA2 did not significantly attenuate morphine-induced analgesia as measured by the tail-flick test to radiant heat, but did prevent the explosive motor behavior observed following morphine injections alone. PLA2 by itself did not induce analgesia, but did cause explosive motor behavior 2 hr after the injections. Neither lysophosphatidylcholine nor trypsin resulted in motor seizures following PAG injections. It was concluded that the behavioral effects of PLA2 result from the unique properties of the enzyme, rather than generalized membrane damage, and that the opioid sites and mechanisms that mediate analgesia are different from those associated with explosive motor behavior. PMID- 3968977 TI - Serotonin produces a reversible concentration dependent decrease of population spikes in rat hippocampal slices. AB - Superfusion of slices of rat dorsal hippocampus in vitro with serotonin (5-HT) reversibly decreases the amplitude of the CA1 population spike evoked by stimulation of stratum radiatum. The magnitude of the drug effect is concentration dependent and is greater on submaximal than on maximal population spikes. Concentration-response curves were generated using population spikes 30 60% of maximum by superfusion with increasing concentrations of 5-HT interspersed with perfusion of drug free medium. The EC50 for 5-HT was 3.2 microM. Repeated applications of a maximal dose of 5-HT did not produce tachyphylaxis. The reversibility, reproducibility and concentration dependence of the 5-HT response in the rat hippocampal slice makes this preparation useful for rigorous pharmacological classification of the receptor(s) involved. PMID- 3968976 TI - Carbon tetrachloride-induced inhibition of hepatocyte lipoprotein secretion: functional impairment of Golgi apparatus in the early phases of such injury. AB - Functional change of liver Golgi apparatus during carbon tetrachloride (CCl4) poisoning was demonstrated both in rat isolated hepatocytes and in the whole animal. The "in vitro" experimental model provided evidence of Golgi derangement early after giving the haloalkane. The "in vivo" analyses also showed that such an alteration involves both formative and secretory sides of the subcellular structure. PMID- 3968978 TI - Physiological plasma concentrations of cholecystokinin stimulate pancreatic enzyme secretion and gallbladder contraction in man. AB - The present study was undertaken to determine whether infusion of cholecystokinin (CCK) to plasma concentrations comparable to those found after a meal stimulates pancreatic enzyme secretion and gallbladder contraction. Plasma CCK concentrations were measured by radioimmunoassay using antibody T204, which binds to all carboxyl-terminal CCK-peptides containing the sulfated tyrosine region. Ingestion of a standardized test meal in 7 normal subjects induced significant increases in plasma CCK from 2.0 +/- 0.2 pmol/l to levels between 4.6 +/- 0.6 and 7.3 +/- 1.0 pmol/l (p less than 0.05-p less than 0.0005). Infusion of 2.5 pmol/kg X h CCK 33 resulted in significant increases in plasma CCK from 2.0 +/- 0.2 to 3.9 +/- 0.3 pmol/l (p less than 0.0005). This infusion of CCK induced significant increases in trypsin secretion from 0.5 +/- 0.1 to 1.4 +/- 0.2 KU/15 min (p less than 0.005) and in bilirubin output from 1.6 +/- 0.7 to 30.3 +/- 8.0 mumol/15 min (p less than 0.05). It is concluded that physiological plasma concentrations of CCK stimulate pancreatic enzyme secretion and gallbladder contraction in man. PMID- 3968979 TI - Catecholamines in plasma and erythrocytes of rats with transplantable pheochromocytoma. AB - Accumulation of catecholamines in erythrocytes (RBC) was compared to rising plasma levels of catecholamines at weekly intervals following transplantation of pheochromocytoma (line P-259) in the New England Deaconess Hospital rat strain. Additionally changes were investigated during a 12 hour interval after tumor was established in PHEO rats. Starting 2 weeks after tumor implant, the concentrations of norepinephrine (NE) and dopamine (DA) in RBC paralleled and correlated strongly with rising levels of plasma NE and DA which were maximum by 4 weeks. Four to 6 weeks after implant, the RBC to plasma (L/P) concentration ratio of NE was 30% higher in PHEO rats than controls (p less than 0.05) indicating a shift in distribution of NE between the 2 circulating pools. Three measurements, 6 hours apart, showed that mean arterial pressure, plasma and RBC NE and DA concentrations were highest in AM in both PHEO and control groups. Shifts in DA were smaller and did not rise in PM as did NE suggesting DA may reflect tumor secretion and NE, tumor secretion plus sympathetic neuronal activity. PMID- 3968980 TI - Decreased cardiac lipoprotein lipase activity in rats treated chronically with adriamycin. AB - Rats treated chronically with the anticancer agent adriamycin (1.5 mg/kg/week X 14 weeks) exhibited cardiac and renal lesions typical of anthracycline toxicity, and had serum hyperlipidemia characterized by 4 to 10 fold elevations in all lipoprotein classes. Heparin-releasable lipoprotein lipase activity measured in perfused heart preparations was decreased 69% in adriamycin-treated rats compared to saline-treated controls. Residual (non-heparin-releasable) activity was not significantly different after adriamycin treatment. The decrease in functional cardiac lipoprotein lipase may account, at least in part, for the serum hyperlipidemia observed in adriamycin-treated rats, and might play a role in the development of heart muscle disease. PMID- 3968982 TI - Age related increased threshold for electroshock seizure in BDF1 mice. AB - The thresholds for inducing the minimal and maximal electroshock seizures were examined in relation to age in BDF1 mice of both sexes. The 50 percent effective intensities for the maximal electroshock seizure (tonic hindlimb extensor component) were lowest in the youngest age groups (6-month-old) for both male (10.68 mA) and female (9.18 mA) animals. The threshold increased with age and became significantly higher at 24 months (14.00 mA, 12.70 mA for male and female mice respectively). There was also a further increase in threshold at 30 months for both sexes. Similarly, the threshold for inducing the minimal seizure also increased with age but the differences in mean threshold levels between the youngest and oldest groups were much smaller in comparison to the maximal seizure. It was concluded that the threshold for inducing electroshock seizures significantly increases with age in mice of both sexes. PMID- 3968981 TI - Elevation of red cell sodium-lithium countertransport in hyperlipidemias. AB - Red cell Na-Li countertransport was measured in 78 normal subjects, 64 patients with essential hypertension, and 67 patients with hyperlipidemias. Both hypertensive and hyperlipidemic patients had elevated Na-Li countertransport compared to normal controls (p less than 0.001). Subjects with hyperlipidemia and hypertension had higher countertransport (p less than 0.02) than patients with only hyperlipidemia. Normotensive hyperlipidemic subjects had higher countertransport than normotensive and normolipidemic controls (p less than 0.02). This suggest that hypertension and high plasma lipids can influence independently the Na-Li countertransport. In another group of 52 normotensive subjects, Na-Li countertransport was positively correlated with serum total and free (unesterified) cholesterol, phospholipids and triglycerides. No correlations were found with HDL-cholesterol or HDL-phospholipids. A very high positive correlation was found between Na-Li countertransport and plasma acetylcholinesterase (p less than 0.005). These findings suggest that plasma lipids, probably through membrane lipids, can affect the maximal rate of the Na Li exchange in red cells. The relationship between plasma or membrane lipids and cation transport should be further studied in erythrocytes and other cells. PMID- 3968983 TI - Platelet serotonin content and uptake in spontaneously hypertensive rats. AB - Platelet serotonin (5-HT) content and uptake were studied in male SHR and WKY at various ages. Blood was withdrawn from the carotid artery under anesthesia and 5 HT levels determined from platelet rich plasma (PRP) using a HPLC technique coupled with an electrochemical detection method. Platelet 5-HT uptake was studied by incubating PRP at 37 degrees C for 10 sec with increasing concentrations of 3H-5HT. Lineweaver- Burk plots of 3H-5HT uptake were linear suggesting simple Michaelis- Menten uptake kinetics. The SHR had more platelets than age-matched controls and consequently a higher blood circulating pool of 5 HT. Nevertheless, the 5-HT platelet levels were similar to those of their age matched rats. The 5 week-old SHR and WKY had greater numbers of platelets and higher 5-HT platelet levels than the older rats of both strains. The affinity constants (Km) and the maximal velocities (Vmax) of platelet 5-HT uptake did not differ significantly between the 12 week- and the 6 month-old SHR and WKY. These data suggest that the SHR do not show the same impairment in platelet 5-HT metabolism as observed in essential hypertension in man. PMID- 3968984 TI - Demonstration of endogenous "imipramine like" material in rat brain. AB - The extraction and partial purification of an endogenous "imipramine- like" material from rat brain is described. The endogenous factor obtained after gel filtration and silica chromatography inhibits [3H] imipramine specific binding and mimics the inhibitory effect of imipramine on [3H] serotonin uptake in both brain and platelet preparations. The effects of the endogenous material are dose dependent and it inhibits [3H] imipramine binding in a competitive fashion. The factor is unevenly distributed in the brain with high concentration in the hypothalamus and low concentration in the cerebellum. PMID- 3968985 TI - Incorporation of trans fatty acids into submandibular salivary gland lipids. AB - Three groups of rats were fed diets containing 20% corn oil, 20% margarine stock (MS) or 19% MS + 1% corn oil. Diets were fed for 12 weeks, 1 week of pregnancy, 3 weeks of lactation and 8 weeks post-weaning. The incorporation of trans octadecenoate into various lipids of the submandibular salivary gland (SMSG) homogenates and plasma membranes was studied. Trans octadecenoate was incorporated into all the lipid fractions studied. Its levels were the highest in phosphatidylethanolamine. The double bond index of phospholipid fatty acids in the plasma membranes of the SMSG was substantially lower in the group fed 20% MS. The fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene (DPH) was generally higher in the membranes of SMSG from rats fed MS than that of the other two groups, thus indicating lower fluidity. Also, the breakpoints in fluorescence polarization were at a higher temperature in the membranes from rats fed MS as compared with those fed corn oil. Lower fluidity of plasma membranes of SMSG observed in rats fed 20% MS may result in modification of the activities of membrane-bound enzymes. PMID- 3968986 TI - The interaction of human plasma low density lipoproteins with glycosamino glycans: influence of the chemical composition. AB - Human plasma of 5 normolipemic individuals was incubated for 24 hr at 37 C in the presence or in the absence of lecithin:cholesterol acyltransferase (LCAT) inhibitors. Plasma stored at 4 C served as a control. The low density lipoprotein (LDL) fractions of the samples were isolated and investigated with respect to changes in chemical composition and complexing activity with glycosamino glycans (GAG). Incubation of plasma in the presence of LCAT inhibitors caused a significant increase of LDL triglycerides at the expense of cholesteryl esters. Incubation with active LCAT not only changed the core but also the surface constituents (decrease in phospholipids and in free cholesterol). The amount of GAG bound per mg of LDL was not uniformly changed in samples incubated after LCAT inhibition. LDL isolated from plasma incubated in the presence of LCAT, on the other hand, showed a significant reduction in GAG binding. The ratio of free cholesterol:GAG in the complex was most significantly reduced in LCAT-modified LDL. There was in addition a highly significant correlation between the LDL:GAG ratio in the complex and the free cholesterol and phospholipid content of the LDL samples. It is concluded that alterations in surface lipid constituents of LDL strongly affect their interaction with sulfated polysaccharides, an effect which may be relevant also in vivo for the interaction of LDL with cell surfaces and intercellular matrices. PMID- 3968987 TI - A mild, rapid, and efficient method of lipid extraction for use in determining vitamin E/lipid ratios. AB - A new, general method for lipid extraction and measurement of vitamin E/total lipid ratios in tissue and cell samples has been developed. The new extraction procedure uses a combination of sodium dodecylsulfate, ethanol and n-heptane, and is mild, clean, convenient, efficient and rapid (less than or equal to 5 min). The efficiency of the new method has been confirmed for human plasma, red blood cells and rat liver homogenate by the comparison of the yields of vitamin E, O acyl lipid and cholesterol with the yields obtained following conventional extraction procedures. Extraction efficiency also has been confirmed for multilamellar vesicles composed of known quantities of vitamin E, egg lecithin and cholesterol. PMID- 3968988 TI - A colorimetric assay of pancreatic lipase: rapid detection of lipase and colipase separated by gel filtration. AB - A rapid assay for pancreatic lipase (E.C., glycerol-ester hydrolase 3.1.1.3) is described. The assay is based on the color change of a pH indicator as butyric acid is released from the substrate tributyrin. A mixture made with tributyrin and the water soluble components of the assay is ideally suited for use as a rapid test as, for example, when assaying chromatography fractions. Quantitative data can be obtained by measuring the disappearance of absorbance at 557 nm versus a blank reaction. The assay has been used in the rapid preparation of colipase-free lipase and colipase. PMID- 3968989 TI - Effect of type of diet and feeding status on modulation of hepatic HMG-CoA reductase in rats. AB - The effect of diet type and feeding status on hepatic HMG-CoA reductase (HMGR) [mevalonate: NADP+ oxidoreductase (acylating CoA); EC 1.1.1.34] was studied in rats. Animals fed a ground, commercial, stock diet exhibited higher expressed and total activities of HMGR in the fed state than animals fed a semi-purified diet. The differences did not appear in meal-trained animals when measured before the onset of the meal after a 22-hr fast. When expressed activity was taken as a per cent of total activity, fed animals from both diet groups used about 10% of their available activity. When animals on commercial diets were fasted, 20% of the activity was expressed. Fasted animals on the semi-purified diet also increased the per cent of expressed reductase activity, but this increase was not as great (13.3%). These data suggest that, in the rat, regulation of cholesterol synthesis in response to decreased total HMGR during fasting and increased levels after a meal results from alterations in the percentage of enzyme which is expressed. The semi-purified diet used here resulted in consistently lower levels of HMG-CoA reductase activity than the commercial diet regardless of feeding pattern. PMID- 3968990 TI - [Double-indicator radionuclide study of liver metastases]. AB - 75Se-methionine as a diagnostic agent was shown to possess a varied activity as regards metastatic liver tumors which manifested themselves in a great variability: from enhanced to the absence of its incorporation in the "cold zones" detected with the help of colloid 113mIn. An analysis of the data on 63 patients with cancers of different sites with liver metastases showed that the diagnostic value of 75Se-methionine combined with colloid 113mIn reached 90%. It was concluded that 75Se-methionine could serve as a valuable diagnostic test in the detection of malignant liver tumors. PMID- 3968991 TI - [Diagnosis and treatment of arm edema following combination therapy of breast cancer]. AB - A lymphographic and phleobographic study of the lymph and blood outflow in 61 patients with postmastectomy upper limb edema showed that a complete block of the lymphatic vessels was observed in 86.5% and a partial block in 13.5% of the patients. Combined injuries of the lymphatic vessels and major veins aggravated the degree of limb edema. The presence of upper limb lymphostasis in the compensated venous outflow is an indication to the use of the microvenous shunting or dermatoplastic operations. PMID- 3968992 TI - [Significance and organizational principles of a quality assurance program in nuclear medicine]. AB - The paper is concerned with the general organizational principles of the quality guarantee programme in nuclear medicine at all levels of the health care system and with the significance of its implementation in order to improve the quality of radionuclide diagnostic studies, to lessen radiation exposures and to utilize resources effectively. PMID- 3968993 TI - [Tissue irradiation doses in roentgenologic examinations of thoracic organs]. AB - The paper is concerned with the results of experimental studies on the equivalent doses of irradiation of 11 organs and tissues by which one can calculate effective equivalent doses per study. Calculation were done on an anthropomorphous phantom of "conventional" man with the help of a thermoluminescent dosimetric system based on lithium fluoride. Equivalent doses were evaluated by the mean calculated value. The tabulated results make it possible to determine equivalent doses. PMID- 3968994 TI - [Adoption of new radiation measures and units in medical radiology. Methodological problems]. PMID- 3968995 TI - [Equipment for calibrating thermoluminescent dosimeters]. PMID- 3968996 TI - [Sensitivity to neutrons of heterogeneous ionization chambers]. AB - The authors obtained theoretical and experimental data on the sensitivity to monochromatic and reaction neutrons of ionization chambers with different sizes of the air cavity between tissue equivalent walls. Significant difference of the sensitivity to neutrons of such heterogeneous chambers was noted as compared to that of homogeneous tissue equivalent ionization chambers. However proceeding from the results of the study we can determine with the precision of 10% the absolute absorbed doses in the dosimetry of biomedical investigations using neutrons of different energies. PMID- 3968997 TI - [Basis for allowable errors in determining doses to patients during roentgenologic examinations]. AB - Basing on the utilization of the benefit-injury concept the authors put forward an approach to the substantiation of permissible errors in the values of the mean doses intended for the patient's critical organs in x-ray examination. It was shown that in the elaboration of methods to determine the mean tissue doses one should aim at reaching a mean quadratic error of +/- 30% in their values. PMID- 3968998 TI - [Parametric images in nuclear cardiology]. AB - Parametric or the so-called functional images found an application in modern nuclear cardiology for the processing of radiodiagnostic data, particularly those of radionuclide ventriculography. The process of obtaining parametric images incorporates the transformation of digital scintigrams using arithmetic or more complicated mathematical procedures. As a result of it valuable radiodiagnostic parameters on the point of spatious resolution of the digital scintigrams are singled out from the whole complex of scintigraphic information. This method of scintigraphic data processing with obtained parametric images is recommended for a wider use in the other areas of nuclear medicine too. PMID- 3968999 TI - [Experimental and clinical basis for the use of 111In-DTPA for radionuclide cisternography]. AB - Modern radiopharmaceuticals are used to get information on the anatomy and function of the liquor system, i. e. they make it possible to monitor a radionuclide biological behavior in vivo by external detection. Complex compounds like diethylene triamine pentacetic acid (DTPA) labeled with 111In or 99mTc are the most common radionuclides used abroad to study the liquor system pathology. The clinicoexperimental studies on the use of the 111In-Ca-DTPA complex for radionuclide cisternography elaborated in this country, took 2 years. Experiments on animals showed that 70% of the administered amount of the radionuclide left the liquor pathways 4 h later. The administration of a clinical dose 5 times as high demonstrated the drug safety. The Soviet radiopharmaceutical was evaluated by comparing under clinical conditions 3 radionuclides: 111In-DTPA (France), 99mTc-DTPA (FRG) and 111In-Ca-DTPA (USSR). The radiological picture of radionuclide distribution by the liquor pathways did not depend on the drug. Radiological signs showed a direct correlation with a disease entity. PMID- 3969000 TI - [Significance of radioimmunologic studies in the diagnosis, assessment of severity and prognosis of myocardial infarct]. AB - The authors presented the results of a radioimmunoassay of myoglobin (MG), MV fraction of creatine phosphokinase (CPK), hypophyseal thyrotropic hormone, peripheral thyroid hormones and testosterone in 150 patients with acute myocardial infarction. A high informative value of the radioimmunoassay was shown. The MG level and MV-CPK activity as well as the functioning of the hypophyseal-thyroid system were shown to be directly correlated with the severity of disease and were of prognostic value. A considerable suppression of hypophyseal and thyroid function coinciding with the maximum values of myoglobinemia in the most severe cases was noted. Three variants of the testosterone content were singled out in patients with acute myocardial infarction. Paroxysmal rhythm disorders in the 1st variant (up to 300 ng/100 ml) and A-V blockades (over 1000 ng/100 ml) in the 3rd variant were frequently noted. PMID- 3969001 TI - [Treatment of patients with bronchial asthma with autologous blood after preliminary exposure extracorporeally to roentgen radiation]. AB - A therapeutic method including extracorporeal x-ray irradiation of the autoblood of patients with bronchial asthma complicated by cortisone dependence and polyvalent drug intolerance, has been elaborated and clinically tested. The use of this method brings about good short-term results in 90% of cases and good long term results in 40% of cases (14-38 months). It provides an opportunity to give up corticosteroids in more than 60% of patients and to decrease the hormone dose in the rest of cortisone-dependent patients with bronchial asthma. The above therapeutic method can be used as an independent type of treatment, especially in the presence of polyvalent drug allergy and as an element of multiple modality therapy of bronchial asthma patients. The method was used under inpatient conditions only. No side effects were marked in the course of the clinical trial. To carry out this type of therapy, patients should be thoroughly screened. PMID- 3969002 TI - [Results of radio- and chemoradiotherapy of malignant nasopharyngeal neoplasms]. AB - The paper is concerned with the results of open field gamma-beam therapy and gamma-therapy using gamma-beam forming agents. Besides, a method of simultaneous chemo- and radiotherapy was used for 175 nasopharyngeal cancer patients. Of them 2 had Stage II tumors, 22 Stage III tumors, 151 (first admitted for treatment as well as those with recurrences and tumor metastases), by local spread and regional and distant metastatic spread, had Stage IV tumors. A single focal dose was 1.4-2.5 Gy, the summary dose 55-70 Gy. In simultaneous chemo- and radiotherapy using gamma-beam forming agents the values of a single and the summary focal dose did not lessen; a single and the summary dose of chemotherapeutic drugs got less and equaled 1/2-2/3 of standard dosages. The chemotherapeutic component of multimodality chemotherapy was indicated with regard to a tumor histological structure. The best results were achieved in the group of patients on multimodality chemo- and radiotherapy. Of 75 patients, a complete or partial tumor resorption was noted in 71. With the use of all the methods of radio- and multimodality therapy the 3-year survival was 41.1%, the 5 year survival 19.4% (34 patients out of the 175). PMID- 3969003 TI - [Pathology of the rat mesenteric lymphatic bed in acute radiation sickness]. AB - The authors have shown that in the medullary, intestinal and cerebral forms of acute radiation disease pathological changes of the lymphatic microvessels manifested themselves in the form of lymphostasis at the climax of disease in the medullary form of acute radiation disease and at the climax and in the terminal period in the intestinal form. A characteristic feature of the lymphatic channel involvement in the medullary form of acute radiation disease was a large number of erythrocytes in the lumen of the lymphatic vessels at the climax of disease. No changes of the mesenteric lymphatic channel of the rats were noted in the cerebral form. On the other hand, the presence of a large number of newly formed capillaries in the young rats at the climax of disease indicate the persistence of the proliferative ability of the lymphatic microvessel endothelium and its significant radioresistance. PMID- 3969004 TI - [Assessment of the deficiency in the T3 pool in hypothyroidism]. AB - The leading role of the endocellular ways in the T3 formation among the thyroid hormones was revealed. Therefore new approaches to the evaluation of thyroid function disorder are required. On the basis of the radioimmunoassay the authors have devised a new method of the determination of quantitative deficiency of the T3 pool in the body. The author present the first results of its use in clinical practice for the evaluation of the severity of hypothyroid conditions and control over the efficacy of hormonal substitution therapy. PMID- 3969006 TI - [The 1982-1983 Taylor Lectures in the USA]. PMID- 3969005 TI - [Teaching medical radiology to foreign students]. AB - The paper is concerned with activities aimed at improvement of teaching medical radiology to foreign students. To overcome language difficulties and differences in the national secondary school educational systems, summary lectures with schemes are proposed enabling foreign students to rapidly orientate in the studied material during their independent work. Reference materials for foreign students contribute to the motivation of foreign students' cognition and drawing the teaching process near conditions of the students' future working activities. PMID- 3969007 TI - [Automated system for radionuclide data processing in emergency conditions]. PMID- 3969008 TI - [Case of intracranial hemangiopericytoma]. PMID- 3969009 TI - [Beta-therapy (32P) of chronic eczema]. AB - Beta-therapy with 32P was provided to 22 chronic eczema patients. A dose of 25 Gy given in 5 sessions resulted in a cure of 19 patients within 3 years of follow up. Hyperpigmentation of the skin was noted in 2 patients. PMID- 3969010 TI - [Pancreatoscanography with 75Se-methionine following glucose loading]. AB - Altogether 110 patients with different pancreatic diseases were examined on the Picker magna-scanner 500 I (USA) with 75Se-methionine (9.2 MBq). Glucose load at a dose of 0.33 g/kg is recommended 50 min before examination increasing RP accumulation in the pancreas parenchyma and improving scanographic image. It is pointed out that the coincidence of scanographic and pathohistological diagnoses in pancreas cancer is noted in 62.5%, in cystic formations in 89%, and in chronic pancreatitis in 93% cases. PMID- 3969011 TI - Metabolic and hormonal factors as predictors of nitrogen retention in obese men consuming very low calorie diets. AB - The ability to conserve body protein during very low calorie diets in ten obese men was observed to correlate with plasma free amino acid concentrations, urinary N tau-methylhistidine: creatinine ratios, resting oxygen consumption, and serum triiodothyronine levels. A diet consisting of only protein, 1.3 g/kg ideal body weight/24 h, was given for 40 days. Cumulative nitrogen deficit ranged from -64 g to -227 g. Nitrogen balance on days 36 to 40 ranged from + 1.37 g/24 h to -3.30 g/24h. Nitrogen balance during this period had a significant direct correlation with pre-diet concentrations of branched-chain amino acids (r = 0.69 to 0.89), methionine (r = 0.85), histidine (r = 0.66), alanine (r = 0.73), arginine (r = 0.70), ornithine (r = 0.66), total essential (r = 0.87, and nonessential (r = 0.68) amino acids, with initial serum levels of triiodothyronine (r = 0.66) and with the fall in triiodothyronine over the 40 days (r = 0.79). Initial resting oxygen consumption was directly correlated (r = 0.78) with final nitrogen balance and inversely with total nitrogen loss (r = -0.81). On day 0, triiodothyronine levels also correlated positively (r ranging from 0.71 to 0.93) with plasma concentrations of several essential and nonessential amino acids. These correlations suggest that individuals who ultimately will or will not achieve nitrogen equilibrium during very low calorie diets can be identified prior to dieting. These data are consistent with the hypothesis that individuals with higher initial protein flux and triiodothyronine levels are better able to adjust the balance between synthesis and degradation to attain nitrogen equilibrium during hypocaloric dieting. PMID- 3969012 TI - Impairment of induction of delta-aminolevulinic acid synthase by gluconeogenic amino acids and carbohydrates in vitro. AB - This study was undertaken in a system of chick embryo liver cells incubated in Earle's Basal Salt Solution with hormones. Impairment of induction of delta aminolevulinic acid synthase (ALAS) by allyl-isopropylacetamide (AIA) was observed in the presence of glucose. Fructose and various gluconeogenic substances including gluconeogenic amino acids had a similar effect. Leucine, which is purely ketogenic, did not influence induction of ALAS. SH-containing amino acids increased induction of ALAS by AIA. The glucose analogues 3-O methylglucose and 2-deoxyglucose did not impair induction of ALAS by AIA. The inhibitory effect of glycerol, fructose, and glycine was not affected by 3-O methylglucose but was reversed by 2-deoxyglucose. The results indicate that the salutary effects of proteins on acute attacks of hepatic porphyria are probably caused by their gluconeogenic properties and that glucose-6-phosphate, or metabolite of glucose-6-phosphate that is not in the glycolytic pathway, is the active agent that leads to the glucose-like effect. PMID- 3969013 TI - Sequence of alcohol-induced initial changes in plasma lipoproteins (VLDL and HDL) and lipolytic enzymes in humans. AB - The sequence of alterations in the concentration and composition of different plasma lipoproteins following alcohol intake is not known. We therefore monitored the concentrations of cholesterol, triglycerides, phospholipids, and proteins in the major lipoprotein fractions (VLDL, LDL, HDL2, and HDL3) in ten nonalcoholic healthy male volunteers who were given 5.5 g of alcohol per kilogram of body weight during 21/2 days (a weekend). In addition, lipoprotein lipase activity was measured in post-heparin plasma and in adipose tissue and hepatic lipase activity was measured in post-heparin plasma before and after the experiment. in a separate control experiment, the same subjects received meals and liquids without alcohol. Blood alcohol levels remained below 1.5 g/L. Alcohol caused a progressive increase in the fasting VLDL triglyceride and phospholipid concentrations, both of which were doubled during the experiment (P less than 0.001). In contrast, the VLDL cholesterol levels remained unchanged until the third morning, when there was a slight increase. The LDL triglyceride and phospholipid concentrations also rose without simultaneous changes in the LDL cholesterol concentration. Consistent with these changes, the HDL cholesterol concentration showed no response to alcohol during the experiment, but the HDL phospholipid level rose from 76 to 99 mg/dL (P less than 0.001). This was reflected as an increase in the HDL2 concentration from 124 to 158 mg/dL (P less than 0.01), whereas no change occurred in the HDL3 level. The increment of HDL2 concentration was due to a rise of its triglycerides, phospholipids, and apoproteins A-I and A-II but not to a rise of cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969015 TI - Cholesterol homeostasis in lean and obese male Zucker rats. AB - Studies were performed in male Zucker rats to determine the metabolic effect of genetic obesity on whole body cholesterol homeostasis. Lean and obese mature Zucker rats were studied during intake of either a chow diet or a semisynthetic diet containing 10% corn oil; in addition growing animals were studied during constant body weight gain on a chow diet. Under all conditions the obese Zucker rats had significantly higher levels of total plasma cholesterol and triglyceride; however, measurements of the specific activity of hepatic 3-hydroxy 3-methylglutaryl coenzyme A reductase and of the rate of whole body cholesterol synthesis by sterol balance techniques demonstrated that the lean and obese animals did not differ in their endogenous rates of cholesterol synthesis. When sterol balance data were calculated per kilogram body weight, lean male Zucker rats synthesized a greater amount of cholesterol per day than obese animals. These studies demonstrate that the obese male Zucker rat, in many ways a model of human obesity, does not overproduce cholesterol and thus fails to exhibit one of major characteristics of the obese human. PMID- 3969014 TI - Treatment of osteoporosis with calcitonin, with and without growth hormone. AB - A 24 month randomized parallel study of the treatment of postmenopausal osteoporosis with calcitonin alone v calcitonin alternating with growth hormone (combined treatment) was conducted. Each group received 1000 mg daily of oral calcium supplements. The rate of change in total body calcium for the combined and calcitonin groups was + 1.68%/yr and + 1.33/yr, respectively (P less than .05). However, the difference in the two groups was not statistically significant. Further, the total body calcium level did not increase after 12 to 18 months of treatment. There was significant difference in the rates of change of bone mineral content (BMC) of the radius for the two groups, with a loss of BMC in the combined treatment group (F = 4.80, P less than .05). Calcitonin treatment is effective in producing an increment in bone mass. The addition of growth hormone to this regimen appears to have a deleterious effect on cortical bone mass. PMID- 3969016 TI - The contribution of hepatic metabolism to diet-induced thermogenesis. AB - In order to examine the possible contribution of the liver to diet-induced thermogenesis, we examined the metabolism of hepatocytes from rats that had been fed a varied choice of highly palatable human food items ("cafeteria feeding"). Liver cells derived from cafeteria-fed rats that had been fasted for 20 hours showed marked increases in rates of respiration and gluconeogenesis in the presence of glycerol or sorbitol. These cells were also much less sensitive to the inhibitory effects of rotenone than were hepatocytes of control animals. hepatocytes from fasted cafeteria-fed rats also demonstrated a substantially enhanced rate of fatty acid oxidation and ketogenesis, which did not appear to be correlated with cellular demands for adenosine triphosphate (ATP). This apparent fall in metabolic efficiency was confirmed by calorimetric studies, which indicated augmented cellular heat production. These changes in hepatic metabolism, associated with cafeteria-feeding, suggest that the liver may have a significant role in diet-induced thermogenesis. PMID- 3969017 TI - Erythrocyte heat production in human obesity: microcalorimetric investigation of sodium-potassium pump and cell metabolism. AB - Changes in overall cellular metabolism, induced by specific inhibition of the Na K-pump, were determined in erythrocytes from 33 normal and 25 obese subjects. Cellular metabolism was determined by measurement of heat production rates in erythrocytes suspended in plasma with and without the cardioactive glycoside, ouabain. Specific inhibition with ouabain induced the same decrease of the heat production rate in the two groups (14 +/- 5 mW/L for normal subjects and 13 +/- 5 mW/L for obese subjects). In neither group was there a correlation between the ouabain-inhibitable rate of metabolism and body weight. The present study results do not give support to the suggestion that a defect in the Na-K-pump activity would exist in the erythrocyte of human obese subjects and could not therefore be of importance in the pathogenesis of the disease. PMID- 3969018 TI - Impaired adrenal reserve in the Watanabe Heritable Hyperlipidemic rabbit: implications for LDL-receptor function in steroidogenesis. AB - The cholesterol required for steroidogenesis may be provided by the novo biosynthesis or through the delivery of cholesterol by the circulating lipoproteins. By studying adrenocortical function, structure and biosynthetic capacity in an animal model devoid of the classical, high-affinity low density lipoprotein (LDL) receptor pathway, the respective roles of de novo cholesterolgenesis and lipoprotein cholesterol delivery were investigated. The Watanabe Heritable Hyperlipemic (WHHL) rabbit lacks the LDL-receptor pathway. The activity of the rate-limiting enzyme in cholesterolgenesis, 3-hydroxy-3 methylglutaryl coenzyme A (HMG-CoA) reductase was 4- to 15-fold greater than normal in the WHHL adrenal gland. The basal corticosterone concentrations were normal in the WHHL rabbit; however, the corticosterone concentration increased by less than 50% of normal after an intravenous ACTH injection. Electron-microscopic evaluation of adrenocortical cells from the WHHL rabbits disclosed significantly increased mitochondrial surface area and diminished amounts of cytosolic lipid and lysosomal area. These data indicate that the mammalian adrenal gland utilizes endogenously synthesized cholesterol as well as cholesterol delivered through the LDL-receptor pathway. Moreover, in the absence of the LDL-receptor pathway, endogenously produced cholesterol is sufficient for normal basal glucocorticoid function. PMID- 3969019 TI - Spatial learning disabilities and underachievement among university anatomy students. AB - In this study the relationship between underachievement in anatomy and spatial ability (both geometrical and anatomical) is investigated. Subjects were second year medical students at the University of Cape Town from 1980 to 1983. Geometrical spatial ability was measured using a battery of three-dimensional exercises involving the sectioning, joining, translation, rotation and visualization of simple solid objects. Anatomical spatial achievement was measured using university practical examination scores of April, June and October, as well as students' scores on those items in the April, June and November MCQ anatomy examinations which were classified as spatially three dimensional by a panel of lecturers in anatomy. Non-spatial anatomical achievement was measured using the university essay examination scores of April, June and November, together with students' scores on the non-spatial items in the MCQ anatomy examinations. From 1980 to 1983 it was found that students who failed the battery of geometrical spatial exercises and/or recorded large, persistent deficits on spatial MCQs relative to non-spatial MCQs, scored significantly lower marks in practical anatomy examinations throughout the year than those students who scored well in the battery of geometrical spatial exercises. Spatially competent and spatially inept students performed equally well on the non-spatial MCQs and the non-spatial essay examinations. Borderline and failing students recorded the greatest deficits in anatomical spatial scores (for whom losses of approximately 18% occurred in practical examinations in anatomy). Since potential failures with persistent spatial handicaps can be readily identified by mid-year, a programme of differentiated teaching methods is recommended for these students. PMID- 3969020 TI - Dental students as operators: emotional reactions. AB - The importance of the personality of the dentist in the dental treatment of the anxious patient has been recognized for some time. However, there has been little research into the emotional reactions of dental students in similar stressful situations. This investigation, using specific psychological tests, examined the emotional reactions of clinical dental students (n = 99) not only as operators but also as patients. The data were analysed on the basis of normative values for the psychological tests compared with those values obtained by the dental students. This analysis was repeated on a sex-differentiated basis and on the basis of high and low state anxiety scores. The results suggest that emotions present in dental students may interact with those of the patient and lead to unwanted repercussions. PMID- 3969021 TI - The learning style of medical students. AB - Recent research indicates that students' learning styles and approaches to study may have a significant bearing on their academic success. A study was undertaken on first-, third- and final-year medical students to analyse their preferred learning styles and approaches to study, using the Lancaster Approaches to Learning Inventory. The results showed that students entering the medical school had preferences which were more similar to science students' than arts students'. The medical students had high scores on reproducing orientation (surface approach) in all years tested. The first-year students had low scores on meaning orientation (deep approach) but the scores from students in later years showed a progressive rise. The implications of these results with regard to selection, teaching and assessment are explored. However, this preliminary study does not allow us to differentiate between the effect of student preference and that of the context and the environment in which they study. PMID- 3969022 TI - Medical chemistry: evaluation of active and problem-oriented teaching methods. AB - In the preclinical phase of basic medical education at the Karolinska Institute in Stockholm, Sweden, chemistry extends over 16 weeks and changes were made to the teaching methods during 7 of those weeks--one in organic chemistry and 6 in intermediary metabolism. The number of lectures was reduced and problem-oriented group tasks wee introduced instead which required a higher level of student responsibility for individual learning. Teaching and group tasks were designed to give the students a better understanding of the biochemical processes in their entirety as well as the way these are controlled in the human body. From this base the students will be enabled to discuss and understand physiological, pathological and medical phenomena. Experience and results show that student performance in examinations improved significantly, that students acquired a better understanding and a more comprehensive grasp of the subject, and a noticeably more positive interest in medical chemistry. They remember approximately 60% more a few years after completing the course than do students who have been instructed in a more traditional manner, and although the load of the teachers has increased by some 20% in respect of scheduled time, the instructors have gained in improved student contact and a wider knowledge of their subjects. The results have remained the same for each course since the change was introduced in 1977. Due to new admission criteria, more students now have less knowledge of mathematics and chemistry, and more students have social circumstances that make independent studies more attractive (family obligations and financial obligations).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969023 TI - Objective measurement of clinical performance. AB - The aggregate score technique is a new method to assess problem-solving in an actual encounter with a simulated patient. The technique focuses on diagnosis, investigations and management, and results in the derivation of a score for each area based on the comparison of items listed by a student to those of a criterion group. The paper describes a series of studies which were designed to establish the reliability and concurrent validity of the method. PMID- 3969024 TI - The clinical learning environments in medicine, paediatrics and surgery clerkships. AB - Using questionnaires, the students of the 1981 graduating class from McGill's Faculty of Medicine were investigated for their perceptions of the nature of the clinical instruction and of the roles of the consultant, resident and intern staffs during clerkships in medicine, paediatrics and surgery. Personal student diaries were used to assess time spent on various clinical activities. The results indicated that students perceived learning to be different in the three disciplines, with the acquisition of clinical skills (technical and problem solving skills) greater in medicine and surgery than in paediatrics, and the acquisition of interpersonal skills and factual knowledge greater in paediatrics than in medicine and surgery. Students perceived themselves as passive observers in surgery and formed personal relationships more easily with staff in medicine and paediatrics than in surgery. In contrast, students perceived more emphasis on team effort in surgery. Time spent on activities related to direct patient encounter was greatest in medicine. The findings suggest that the learning environments in clinical disciplines are not homogeneous and this has implications for curricular planning and clinical teaching. PMID- 3969025 TI - Recall of medical information by students and doctors. AB - Students in different years of study and from two different medical schools, and a few doctors, read fixed order case descriptions, commented on the case items and tried to reproduce the case descriptions from memory. It was found that typical cases were not reproduced better than atypical cases, nor did the amount of recall differ significantly in different subject groups. Qualitative measures of recall, however, point to a shift in cognitive organization during the different years of study. PMID- 3969026 TI - Pre-admission academic predictors of the goals of a primary care-oriented medical school. AB - This study investigated the relationship of two widely-used preadmission academic predictors (undergraduate grade point average and the Medical College Admission Test) to a sequence of four goals for a primary care-oriented medical school. Graduates from the first four classes of a new medical school (n = 237) were used in the study. Correlation and multiple regression analysis were performed. It was concluded that pre-admission academic variables (undergraduate GPA and MCAT) are useful in screening for academic success in medical school (especially for preclinical courses) and licensability (especially NBME Part 1 and 2). Furthermore, no useful predictor of residency performance or choice of a primary care specialty was identified. Provisos related to the conclusions and future research directions are discussed. PMID- 3969027 TI - Prostaglandins--role in gastric mucosal cytoprotection. PMID- 3969028 TI - The gastric mucus cells--structural considerations. PMID- 3969029 TI - Gastric mucus--physical properties in cytoprotection. PMID- 3969030 TI - Gastric mucus--chemistry, synthesis and secretion. PMID- 3969031 TI - The gastric mucosal barrier. PMID- 3969032 TI - The medical research institutes of Australia. PMID- 3969033 TI - Advising patients to stop smoking. PMID- 3969034 TI - Vindesine in the treatment of refractory haematological malignant diseases. AB - Vindesine, a cytotoxic drug related to vincristine and vinblastine, was used in the treatment of refractory haematological malignant disease in 25 patients. Short-term benefits such as the lowering of leukaemic blast-cell counts and the alleviation of symptoms, particularly resolution of bone pain, were observed in some patients; however, long-term benefit was elusive. In general, the drug was well tolerated, and it was possible to administer vindesine without further neurological toxicity to some patients who previously had suffered from neuropathy. Vindesine may well have a place in the treatment of tumours which respond to vinca-alkaloid therapy in patients in whom previous therapy has produced neurotoxicity, and for the relief of troublesome symptoms, particularly bone pain, in heavily pretreated patients. PMID- 3969035 TI - A smoking cessation programme for use in general practice. AB - The effectiveness of a smoking intervention programme based in general practice was evaluated at six months by a randomized controlled trial. In the programme, general practitioners achieved a 33% success rate compared with 3% in a control group. Reported abstinence was checked by blood tests for cotinine, carboxyhaemoglobin and thiocyanate. The majority of patients considered that their chances of success were greater if a doctor administered the programme, and that having the results of lung function and blood tests explained in relation to the risks of cardiovascular and respiratory diseases constituted a strong incentive to stop smoking. Two cases illustrating a successful and a failed outcome of the programme are described. If one quarter of general practitioners in Australia adopted this programme in their practice, approximately 150,000 new abstainers could be expected each year. PMID- 3969036 TI - Passive cigarette smoking and patients with asthma. AB - A study of the effect of passive smoking on patients with asthma is presented. Six patients were exposed for one hour to the air in a room in which tobacco smoke was produced mechanically over that period. The effects on symptoms, lung function and airways sensitivity to inhaled histamine were then measured and compared with the same patient's responses during a control day when they inhaled smoke-free air. All six patients developed chest tightness and symptoms similar to an attack of asthma. The findings of respiratory and sensitivity tests suggest: (i) that passive smoking may trigger asthma attacks in subjects who suffer from asthma and (ii) that the airways of such subjects show increased histamine reactivity four hours after the passive smoke exposure. PMID- 3969037 TI - Uses of heparin and warfarin. PMID- 3969038 TI - Compliance with medication regimens in children. Can it be improved? PMID- 3969039 TI - Wheezy bronchitis. PMID- 3969040 TI - Transmission of AIDS, and blood donors. PMID- 3969041 TI - USA v. USSR: the kids lose. PMID- 3969042 TI - Intravascular bronchioloalveolar tumour. A 20-year survival. AB - An unusual case of intravascular bronchioloalveolar tumour in a 40-year-old Chinese woman is reported. The woman has survived 20 years after radiological abnormalities were first noted in her lungs. This slowly progressing endothelial lung tumour has only recently been recognized as a distinct pathological entity. PMID- 3969043 TI - Policy on the treatment of cigarette dependence. PMID- 3969045 TI - Therapeutic trial in hypertension. PMID- 3969044 TI - Screening and the health care of children. PMID- 3969046 TI - Medical watershed. PMID- 3969047 TI - Alcohol and drowning. PMID- 3969048 TI - Tandem seat belt. PMID- 3969049 TI - Vegemite allergy? PMID- 3969050 TI - Straddling Virchow's triad. PMID- 3969051 TI - Circumsion and hygiene. PMID- 3969053 TI - Resuscitation in status asthmaticus. PMID- 3969054 TI - Non-antipodean smoking view. PMID- 3969052 TI - Antibiotics and elective cholecystectomy. PMID- 3969055 TI - Infection of the sole of the foot. PMID- 3969056 TI - Cholera. PMID- 3969057 TI - Naltrexone for opioid addiction. PMID- 3969059 TI - Phase II study of daunorubicin in previously untreated patients with advanced colorectal carcinoma. AB - Fourteen patients with advanced measurable colorectal cancer were treated with daunorubicin hydrochloride (DNR). The drug was administered at a dose of 15 mg/m2 on day 1 through 3 and 8 through 10. After a 4-day rest period DNR was given in weekly injections of 15 mg/m2. There were no partial or complete responses. This study failed to confirm the previously reported therapeutic activity of this agent in colorectal carcinoma, using an identical dose and schedule. We have initiated a phase 1 study of daunorubicin to identify a maximum tolerated dose using an every 3-week schedule for future phase II trials in solid tumors. PMID- 3969058 TI - Antibiotics and immunomodulation: effects of cefotaxime, amikacin, mezlocillin, piperacillin and clindamycin. AB - The effects of 7 days' chemotherapy on the humoral and cellular parameters of the host immune system are described. In Balb/c mice the effects of cefotaxime, amikacin, mezlocillin, piperacillin and clindamycin were examined. The delayed type hypersensitivity reaction, as well as the IgM and IgG responses, were suppressed by four of the five drugs tested: cefotaxime, amikacin, mezlocillin and piperacillin. One to two weeks after completion of chemotherapy with cefotaxime and amikacin, these parameters returned to normal values, whereas the mezlocillin- or piperacillin-modified reactions were still suppressed after 20 days. The concanavalin A and lipopolysaccharide-induced proliferative activities of mouse spleen cells were suppressed, especially by mezlocillin. The possible consequences of the immunomodulating effects of antibiotics for antimicrobial chemotherapy are discussed. PMID- 3969060 TI - Malignant mesothelioma. PMID- 3969061 TI - Endobronchial metastases from carcinoma of the breast. AB - We report the case histories of four patients with endobronchial metastases from breast cancer, two of whom died of resultant respiratory insufficiency. To aid in earlier diagnosis and thus permit more rapid application of specific therapy, we characterized the epidemiology and presenting symptoms of these patients and 38 additional patients with endobronchial metastases from breast carcinoma that have been reported in the literature. The average age at presentation with endobronchial metastases was 55, and the average time from diagnosis of the breast primary lesion to the endobronchial metastasis was 77 months. Cough occurred in 71% of patients; wheezing and hemoptysis occurred in 25%. Segmental atelectasis occurred in 57% on chest roentgenogram. Average survival of patients from the time of diagnosis of endobronchial metastasis was 21 months; median survival was 19 months. PMID- 3969062 TI - Continuous ambulatory peritoneal dialysis for psoriasis. PMID- 3969063 TI - Primary malignant melanoma in an ovarian cystic teratoma. A case report and literature review. PMID- 3969064 TI - Vitiligo-like syndrome following the use of fluphenazine enanthate. PMID- 3969065 TI - Peer review in Missouri. PMID- 3969066 TI - Interactions of dopamine agonists with brain D1 receptors labeled by 3H antagonists. Evidence for the presence of high and low affinity agonist-binding states. AB - The interactions of dopaminergic agonists and antagonists with 3H-antagonist labeled D1 dopamine receptors of rat striatum have been characterized. [3H]Flupentixol has been found to selectively label D1 dopamine receptors when its binding to D2 dopamine receptors is blocked by the inclusion of D2 selective concentrations of unlabeled spiroperidol or domperidone. Antagonist/3H-antagonist competition curves are of uniformly steep slope (nH = 1.0) suggesting the presence of a single D1 dopamine receptor. Agonist/3H-antagonist competition curves are extremely shallow (nH less than or equal to 0.5) for agonists of high relative efficacy, suggesting the presence of heterogeneous populations of agonist-binding states of the D1 dopamine receptor. Computer-modeling techniques were used to estimate affinities and relative site densities for these heterogeneous binding states. This analysis indicates that the ratio of agonist affinities for low and high affinity agonist-binding states is correlated with agonist relative efficacies in activating adenylate cyclase in membrane homogenates. Under the assay conditions employed, the addition of saturating concentrations of guanine nucleotides reduced, but did not abolish, the relative density of high affinity agonist-binding sites. These binding data can, at least in part, be explained by postulating two states of the D1 dopamine receptor, inducible by agonists but not by antagonists and modulated by guanine nucleotides. PMID- 3969067 TI - Interactions of dopaminergic agonists and antagonists with dopaminergic D3 binding sites in rat striatum. Evidence that [3H]dopamine can label a high affinity agonist-binding state of the D1 dopamine receptor. AB - The interactions of dopaminergic agonists and antagonists with 3H-agonist labeled D3 dopaminergic binding sites of rat striatum have been characterized by radioligand-binding techniques. When the binding of [3H]dopamine and [3H]apomorphine to D2 dopamine receptors is blocked by the inclusion of D2 selective concentrations of unlabeled spiroperidol or domperidone, these ligands appear to label selectively the previously termed "D3" binding site. Antagonist/[3H]dopamine competition curves are of uniformly steep slope (nH = 1.0), suggesting the presence of a single D3 binding site. The relative potencies of antagonists to inhibit D3 specific [3H]dopamine binding are significantly correlated with their potencies to block D1 dopamine receptors as measured by the inhibition of both dopamine-stimulated adenylate cyclase and [3H]flupentixol binding activities. The affinities of agonists to inhibit D3 specific [3H]dopamine binding are also correlated with estimates of these agonists' affinities for the high affinity binding component of agonist/[3H]flupentixol competition curves. Both D3 specific [3H] dopamine binding and the high affinity agonist-binding component of dopamine/[3H]flupentixol competition curves show a similar sensitivity to guanine nucleotides. Taken together, these data strongly suggest that the D3 binding site is related to a high affinity agonist-binding state of the D1 dopamine receptor. PMID- 3969068 TI - A photoaffinity ligand for dopamine D2 receptors: azidoclebopride. AB - In order to label D2 dopamine receptors selectively and covalently by means of a photosensitive compound, azidoclebopride was synthesized directly from clebopride. The dissociation constant (KD) of clebopride for the D2 dopamine receptor (canine brain striatum) was 1.5 nM, while that for azidoclebopride was 21 nM. The affinities of both clebopride and azidoclebopride were markedly reduced in the absence of sodium chloride. In the presence of ultraviolet light, azidoclebopride inactivated D2 dopamine receptors irreversibly, as indicated by the inability of the receptors to bind [3H]spiperone. Maximal photoinactivation of about 60% of the D2 dopamine receptors occurred at 1 microM azidoclebopride; 30% of the receptors were inactivated at 80 nM azidoclebopride (pseudo-IC50). Dopamine agonists selectively protected the D2 receptors from being inactivated by azidoclebopride, the order of potency being (-)-N-n-propylnorapomorphine greater than apomorphine greater than (+/-)-6,7-dihydroxy-2-aminotetralin greater than (+)-N-n-propylnorapomorphine greater than dopamine greater than noradrenaline greater than serotonin. Similarly, dopaminergic antagonists prevented the photoinactivation of D2 receptors by azidoclebopride with the following order of potency: spiperone greater than (+)-butaclamol greater than haloperidol greater than clebopride greater than (-)-sulpiride greater than (-) butaclamol. The degree of D2 dopamine receptor photoinduced inactivation by azidoclebopride was not significantly affected by scavengers such as p aminobenzoic acid and dithiothreitol. Furthermore, irradiation of striatal membranes with a concentration of azidoclebopride sufficient to inactivate dopamine D2 receptors by 60% did not significantly reduce dopamine D1, serotonin (S2), benzodiazepine, alpha 1- or beta-noradrenergic receptors. This study describes the use of a novel and selective photoaffinity ligand for brain dopamine D2 receptors. The molecule, in radiolabeled form, may aid in the molecular characterization of these receptors. PMID- 3969070 TI - Interaction of warfarin with human serum albumin. A stoichiometric description. AB - Reversible binding of warfarin to defatted serum albumin was studied by equilibrium dialysis at pH 7.4, in a 66 mM sodium phosphate buffer at 37 degrees. The binding isotherm could be described by two stoichiometric binding constants, K1 in the range 141,000 to 192,000 M-1 and K2 at 39,000 to 57,000 M-1. At least two additional molecules could be bound but gave indeterminate binding constants. The product K3 X K4 was about 4.7 X 10(7) M-2. Different site models were possible, either one high affinity and several low affinity sites, or two high affinity sites, cooperative, independent, or anticooperative, together with two low affinity sites. Binding affinity for the first warfarin molecule did not vary with pH in the interval from 6 to 9. The affinity decreased with increasing concentrations of sodium sulfate, sodium chloride, and calcium chloride, depending upon ionic strength. Specific effects of chloride and calcium ions were not observed. Light absorption spectra indicated that the warfarin anion was bound to albumin. All observations were consistent with a binding process involving albumin and the warfarin anion, without participation of hydrogen ions and not influenced by the N-B conformational transition of albumin. PMID- 3969069 TI - Rapid reciprocal changes in adrenergic receptors in intact isolated hepatocytes during primary cell culture. AB - In hepatocytes freshly isolated from adult female rat livers, catecholamine stimulated glycogenolysis is mediated predominantly by alpha 1-adrenergic receptors, and to only a minimal extent by beta 2 receptors. Primary cell culture of these hepatocytes results in a switch in the adrenergic control of glycogenolysis from an alpha 1 to a predominant beta 2 type of response. To investigate whether this switch is due to an alteration in the plasma membrane receptor composition, we characterized alpha 1 and beta 2-adrenergic receptors in both freshly isolated and cultured hepatocytes, using radioligand-binding techniques. Binding of the selective alpha 1-adrenergic antagonist [3H]prazosin and the beta-adrenergic antagonist [125I]pindolol to intact freshly isolated hepatocytes was of high affinity, saturable, and of appropriate specificity for an alpha 1- and beta 2-adrenergic receptor, respectively. Equilibrium binding studies evaluated by a computer-assisted curve-fitting procedure indicated interaction with a single class of high affinity sites for radiolabeled prazosin (KD = 126 +/- 10 pM; Bmax = 93,000 +/- 5,500 sites/cell) and pindolol (KD = 66 +/ 6 pM; Bmax = 2,000 +/- 700 sites/cell). In intact hepatocytes and in membranes prepared from these hepatocytes, competitive inhibition curves revealed the coexistence of two different sites with high and low affinities for agonists at both alpha 1- and beta 2-adrenergic receptors. When isolated hepatocytes were kept in monolayer cell culture for up to 72 hr, the switch in adrenergic control of glycogenolysis (phosphorylase a activation) from an alpha to a beta pathway was confirmed and was associated with a progressive decrease in the number of alpha 1 receptors and an increase in beta 2-adrenergic receptor density, without marked change in the affinity of agonists or antagonists. To investigate the mechanism(s) of this reciprocal change, a number of perturbations were examined including alterations in the composition of the culture medium and the influence of various hormones and inhibitors of cellular function. De novo protein synthesis is implicated in both receptor alterations as the inhibitors cycloheximide and actinomycin D prevented the increase in beta- and attenuated the decrease in alpha-adrenergic sites. The other perturbations were without effect. Thus, these studies provide evidence for a coupling of the functional alteration in glycogenolysis to changes at the receptor level per se. The mechanism underlying the reciprocal changes in hepatocyte adrenergic receptors during culture remains undefined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3969071 TI - Characterization and mechanism of formation of reactive products formed during peroxidase-catalyzed oxidation of p-phenetidine. Trapping of reactive species by reduced glutathione and butylated hydroxyanisole. AB - OFF products of horseradish peroxidase (EC 1.11.1.7)-catalyzed oxidation of p phenetidine were isolated and reactive species were trapped with reduced glutathione (GSH) and butylated hydroxyanisole (BHA). When BHA was added to a reaction mixture after 5 min, subsequent TLC and mass spectrometric analysis revealed the formation of an adduct of BHA and 4-(ethoxyphenyl)-p-benzoquinone diimine (A). The diimine derivative (A) was unstable and its expected degradation products, 4-(ethoxyphenyl)-p-benzoquinone imine (B) and ammonia, were recovered from the reaction in stoichiometric amounts. Ethanol was an early product of the reaction presumably resulting from radical coupling reactions and its formation agreed with the combined production of A and B, suggesting that this was its sole route of formation. The addition of GSH to a reaction at various times and subsequent TLC and high performance liquid chromatographic analysis revealed the presence of at least seven conjugates. Two conjugates were identified by fast atom bombardment mass spectrometry, one as a mono-GSH conjugate of A and another as a mono-GSH conjugate of B. When purified [14C]B was mixed with [3H]GSH, three conjugates were isolated by high performance liquid chromatography, two of which were tentatively identified as di-GSH conjugates. The conjugates isolated existed in both oxidized and reduced forms which could be easily interconverted by redox processes. The production of such reactive species and their conjugates in vivo may be a useful indicator of peroxidase-catalyzed metabolism. PMID- 3969072 TI - Bromobenzene metabolism in isolated rat hepatocytes. 18O2 incorporation studies. AB - Bromobenzene metabolites have been determined in incubations of hepatocytes isolated from untreated, phenobarbital-treated, and beta-naphthoflavone-treated rats. The total formation of bromobenzene metabolites was increased 9-fold in incubations with hepatocytes isolated from phenobarbital-treated rats, and the percentage of total metabolites recovered as bromobenzene-3,4-dihydrodiol and 4 bromocatechol was more than doubled, compared to incubations using hepatocytes from untreated rats. The formation of 2-bromophenol and bromobenzene-2,3 dihydrodiol was increased more than 10-fold in incubations of hepatocytes from beta-naphthoflavone-treated rats, as compared to those of hepatocytes from untreated rats, but recovery of 4-bromocatechol was unchanged. The mechanism of 4 bromocatechol formation from bromobenzene was investigated by examining the incorporation of 18O from 18O2 and H218O into 4-bromocatechol during incubations of bromobenzene with hepatocytes from untreated and phenobarbital-treated rats. Potential metabolic precursor molecules of 4-bromocatechol were also incubated individually with isolated hepatocytes, in order to clarify their roles in 4 bromocatechol formation. The results of these studies show that 4-bromocatechol is formed in intact cells almost exclusively from bromobenzene-3,4-dihydrodiol, rather than from the bromophenols. The bromophenols are, instead, mostly conjugated. The rapid and extensive conjugation of the bromophenols by intact cells may restrict their role as precursors of 4-bromocatechol, while bromobenzene 3,4-dihydrodiol is well converted into 4-bromocatechol by hepatocytes. PMID- 3969073 TI - Variations among untreated rabbits in benzo(a)pyrene metabolism and its modulation by 7,8-benzoflavone. AB - The metabolism of benzo(a)pyrene by rabbit liver microsomes can be stimulated or inhibited by 7,8-benzo(a)flavone (ANF) depending on the distribution of specific P-450 enzymes present within the microsomes. Treatment of rabbits with either 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or rifampicin leads to an increase of hepatic microsomal metabolism of benzo(a)pyrene. ANF stimulates the rate of benzo(a)pyrene metabolism catalyzed by microsomes isolated from rabbits treated with rifampicin by 3-fold. In contrast, ANF moderately inhibits the activity of microsomes from TCDD-treated rabbits. Variations in the benzo(a)pyrene hydroxylase activity of microsomes from untreated rabbits apparently reflect differences in the expression of P-450 1, a constitutive form of P-450. Thus, the benzo(a)pyrene hydroxylase activity of microsomes from untreated rabbits, which varies from 0.40 to 1.5 nmol/min/mg of protein, is directly correlated with the microsomal concentration of P-450 1. The metabolism of benzo(a)pyrene by microsomes containing high concentrations of P-450 1 is inhibited by a monoclonal antibody specific for this cytochrome to approximately the rate exhibited by microsomes with a low concentration of P-450 1. The benzo(a)pyrene activity stimulated by ANF in microsomes with a low concentration of P-450 1 is not inhibited by the monoclonal antibody. The activity of P-450 1 is inhibited by ANF at concentrations that stimulate other constitutive forms of P-450. Thus, ANF produces offsetting effects on benzo(a)pyrene metabolism in microsomes from untreated animals by stimulating the activity of at least one cytochrome and inhibiting P-450 1-mediated activity. PMID- 3969074 TI - Gastro-esophageal cytology. PMID- 3969076 TI - Differential response of human fibroblasts to the cytotoxic and mutagenic effects of UV radiation in different phases of the cell cycle. AB - The effects of DNA repair on UV-induced mutagenesis and cell killing in human diploid skin fibroblasts in different phases of the cell cycle were studied. The cells were synchronized in G1 by culturing at 30 degrees C. Using this synchronization method, it could be demonstrated that cells irradiated at 30 degrees C and allowed to carry out excision repair for various lengths of time, show a much lower mutation frequency than cells irradiated in the exponentially growing state. Irradiation in early G1 gives rise to less mutations than irradiation in S. However, the surviving fraction is not decreased when cells are irradiated in S in comparison with irradiation in G1. Moreover, there is no recovery from UV-induced lethal effects when irradiated cells are kept stationary at 30 degrees C for various periods of time. This is in contrast with the results obtained with density-inhibited fibroblasts held at 37 degrees C, which show a recovery from the UV-induced lethal effects. PMID- 3969075 TI - Induction by modified purines (2-aminopurine and 6-N-hydroxylaminopurine) of chromosome aberrations and aneuploidy in Syrian hamster embryo cells. AB - The modified purines, 2-aminopurine and 6-N-hydroxylaminopurine, are known point mutagens in prokaryotic organisms. 2-Aminopurine is much less potent than 6-N hydroxylaminopurine in inducing gene mutation in mammalian cells in culture and this corresponds to the relative activity of these two compounds in inducing tumors in rats and neoplastic transformation of Syrian hamster embryo cells in culture. We report here that these modified purines can induce chromosome aberrations, including chromatid gaps, breaks, and exchanges, as well as numerical chromosome changes in Syrian hamster embryo cells. These chromosome mutations occur over the concentration range of chemical needed to induced morphological transformation of the same cells. It is not known how nucleic base analogs induce chromosome mutations; however, this activity must be considered in attempting to understand the mechanism by which these agents induce neoplastic transformation of cells. PMID- 3969077 TI - Superoxide dismutase isoenzymes in tissues and plasma from New Zealand black mice, nude mice and normal BALB/c mice. AB - In various types of autoimmune disease, an increased frequency of spontaneous chromosome breaks has been reported. Plasma from such patients induces chromosome breaks in normal cells. Exposure of plasma to superoxide radicals increases the breakage activity, and addition of superoxide dismutase protects against it. The New Zealand black mouse is an animal model of autoimmune disease which displays the breakage phenomenon. To test for the possibility that the breakage is related to deficient protection against superoxide radicals, the activities of superoxide dismutase isoenzymes were determined in tissues and blood from New Zealand black mice and compared with the activities of normal BALB/c mice. No differences between the strains were revealed in tissue EC-superoxide dismutase, CuZn superoxide dismutase and Mn superoxide dismutase activity. The erythrocyte superoxide dismutase activities were also equal. The plasma EC-superoxide dismutase activity was 35% lower in the New Zealand black mice than in the BALB/c mice. Between euthymic BALB/c mice and nude mice, previously reported to be deficient in tissue superoxide dismutase activity, no difference could be demonstrated. PMID- 3969078 TI - An evaluation of heterologous antibodies to lactate dehydrogenase-C in the detection of mutations. AB - We report that we are unable to repeat consistently the results published by Ansari et al. (1980) using antibodies to detect mutations in lactate dehydrogenase-C (LDH-C, previously called LDH-X) directly in sperm of mice exposed to the mutagen procarbazine. The approach made use of the interspecies differences in the antigenic sites between the LDH-C of the rat and mouse in sperm. The visualization of mutations in mouse LDH-C was based on the detection of alterations in antigenic sites of mouse LDH-C such that mouse sperm would bind the antibody that was specific for rat LDH-C (presumptive mutants); the antibody was termed specific when it immunofluorescently labeled rat sperm but not mouse sperm. The original work reported increases in the frequency of occurrence of mouse sperm that would bind rat-specific antibody from mice treated with procarbazine as compared control mice; a single absorbed antiserum was used throughout the experiments. In this study, we found that there is too much variation in the frequency of mouse sperm that react with rabbit antibodies to purified rat LDH-C for the system to be useful in mutagenesis studies. The fundamental criterion of antibody specificity was maintained as in the original work. The frequency of labeled mouse sperm depended on the absorption of the antibody on mouse proteins, indicating that the factors denoting a presumptive mutant were associated with the mouse proteins. In some experiments, the frequency of labeled mouse sperm was higher among sperm from procarbazine-treated mice than among sperm from control mice. This increase, however, was not consistently reproducible. After extensive absorption of the antibody on mouse proteins, no presumptive mutants were observed in sperm from treated and control animals; these antibodies continued to immunofluorescently label rat sperm. The absence of presumptive mutants with highly absorbed antibody suggests that natural variation between species may not be appropriate as markers for the detection of mutations without a thorough knowledge of the number of independent events at the DNA level required to produce a change in antigenic recognition. PMID- 3969079 TI - Effects of X-irradiation on cell-cycle progression, induction of chromosomal aberrations and cell killing in ataxia telangiectasia (AT) fibroblasts. AB - Survival, cumulative labeling indices, chromosomal aberrations and cell-cycle distribution by flow microfluorometry (FMF) were studied in fibroblasts from normal and three ataxia telangiectasia (AT) families after X-irradiation during density-inhibition of growth and immediate release by subculture to low density. Homozygotic AT (proband) fibroblasts were very hypersensitive to cell killing by X-irradiation (D0 = 40-45 rad). Fibroblasts from AT heterozygotes (parents) were minimally hypersensitive, with D0's (100-110 rad) slightly lower than those for normal fibroblasts (D0 = 120-140 rad). There were three different response groups for a G1 phase block induced by 400 rad of X-rays: (1) minimal or no G1 block was observed in AT homozygote cell strains; (2) 10-20% of the cells were blocked in G1 in normal cell strains; and (3) 50% or more of the cells were blocked in AT heterozygote strains. FMF profiles and cumulative labeling indices showed that homozygotic AT cells irradiated in plateau phase moved into the S-phase following subculture with no additional delay over non-irradiated controls. Homozygotic AT cells showed not only a 4-5 times higher frequency of X-ray-induced chromosomal aberrations than normal strains, but approximately 30% of these were of the chromatid-type. There were no differences in the frequency or type of X-ray induced chromosomal aberrations between normal and heterozygotic AT cells. PMID- 3969080 TI - Sodium arsenite enhances the cytotoxicity, clastogenicity, and 6-thioguanine resistant mutagenicity of ultraviolet light in Chinese hamster ovary cells. AB - Cytotoxicity, chromosome aberrations, and mutations to 6-thioguanine resistance were synergistically increased by incubating the ultraviolet light (UV) irradiated Chinese hamster ovary (CHO) cells in medium containing sodium arsenite. However, the frequencies of sister-chromatid exchanges and mutations to ouabain resistance induced by UV were not synergistically increased by sodium arsenite. The synergistic effect of sodium arsenite on UV-induced chromosome aberrations varied with cell-harvesting time and decreased with increasing time intervals between UV and sodium arsenite treatments. PMID- 3969081 TI - The effect of 3-aminobenzamide on the frequency of X-ray- or neutron-induced chromosome aberrations in cycling or non-cycling human lymphocytes. AB - 3-Aminobenzamide (3-AB) is a potent inhibitor of poly(ADP-ribose) synthesis in mammalian cells. It was found to cause a 2-fold increase in dicentric frequency following X-irradiation of 9-18 h PHA-stimulated human lymphocytes, while 3-AB by itself had no effect on aberration frequency. In contrast to previously reported data, however, our results indicate that 3-AB does not increase the frequency of aberrations following either neutron or X-ray exposure of unstimulated (G0) human lymphocytes. Although 3-AB incubation after X-ray exposure in G1 caused a large increase in dicentrics, there was no effect of 3-AB incubation following neutron exposure in G1. The implications of these experiments are presently uncertain, but they do, however, suggest the importance of cycling cells for 3-AB to exert its enhancement effect, presumably on some step of DNA repair. Furthermore, these data support the hypothesis that there are different mechanisms of chromosome aberration induction with fission neutrons and X-rays (at X-ray doses above 50 rad). PMID- 3969082 TI - Induction of aneuploidy by mitotic arrestants in mouse bone marrow. AB - Most human and animal carcinogens induce gene mutation, chromosome breakage or other types of DNA lesions. However, recent studies indicate that some carcinogens do not directly damage DNA, but may cause missegregation of chromosomes resulting in aneuploidy production. Aneuploidy-producing agents pose serious genetic hazards to the human population. Such agents may cause genomic imbalance not only in somatic cells which may result in cancer development, but also in germinal cells which may result in the production of abnormal offspring (e.g. Down's syndrome). To limit human exposure to potential aneuploidy-producing agents, such agents must first be identified in experimental animals. The present study demonstrates that vinblastine and colcemid are capable of inducing aneuploidy in bone marrow cells of treated mice. Both of these compounds are chemotherapeutic agents that arrest mitosis by interfering with the formation of spindle microtubules. Single intraperitoneal injections of vinblastine, at a dose of 9 mg/kg, were found to produce 1.5-5.2% of hyperdiploidy in all of the 10 treated mice sampled at 17-96 h after injection. Only the frequency of hyperdiploidy was determined because hypodiploid cells could result from artifactual chromosome loss during slide preparation. At 0.9 mg/kg, vinblastine was found to produce 0.5-3.5% of hyperdiploidy in 8 of the 10 treated animals. The frequency of hyperdiploid cells in animals treated with colcemid was low. A dose as high as 37 mg/kg was found to produce only 0.5-1% of hyperdiploidy in 3 of the 10 treated animals, and hyperdiploidy was observed only in animals sampled at 17-24 h. In 10 mice treated with saline alone, no hyperdiploid cells were observed. Unlike cell cultures where vinblastine and colcemid had been shown to be equally effective in producing aneuploidy, vinblastine was found in this study to be a much more potent aneuploidy inducer than colcemid in mice. PMID- 3969083 TI - Contribution of primary aromatic amines to the mutagenicity of gasifier tars and coal oils. AB - Two reactions that chemically alter primary aromatic amines (PAA) were used to assess the contribution of these compounds to the indirect bacterial mutagenicity of tar from an experimental low Btu gasifier. The first reaction, nitrosation, effectively eliminated the mutagenicity of several PAA standards and a coal oil when run in a low pH media (1.2). When applied to gasifier tar, extensive direct (not requiring metabolic activity) mutagenicity was generated. This direct mutagenicity limited the interpretation of results. When the pH of the reaction media was raised to 2.5, the mutagenicity of PAA standards and the coal oil were still greater than 90% eliminated, however, no direct mutagenicity was observed for the gasifier tar. Furthermore, only 61% of the indirect (requiring metabolic activation) mutagenicity was eliminated. Acetylation reduced the indirect activity of most primary amine standards by greater than 79%. Acetylation of the tar likewise eliminated part, but not all, of the activity, whereas most of the activity of the coal oil was eliminated. These results indicated that a much lower percentage of the mutagenic activity of low Btu coal tar samples was due to primary aromatic amines than was the case for coal oil. PMID- 3969084 TI - SCE in lymphocytes of patients treated with single, large doses of diazepam. AB - When using the SCE test for evaluation of exposure in vivo to potential mutagens/carcinogens, it is necessary to consider possible confounding factors. In studies of possible mutagenic effects of pharmacological treatment the effect of concomitant administration of other agents such as sedatives may have to be considered. In order to assess whether diazepam per se influences SCE we have examined SCE in peripheral lymphocytes in 34 persons before and after oral administration of a single large dose of diazepam. 18 men and 16 women undergoing minor surgery of the hand received diazepam 0.2 mg kg-1 body weight orally on the day of operation, and venous blood samples were drawn on the day before the operation and again 2-5 h after the administration of diazepam. Both within cigarette smokers and non-smokers there was no statistically significant change of SCE following diazepam. It was concluded that there was no indication, from the SCE test, of an immediate mutagenic effect of a single large dose of diazepam and that such medication is not a confounding factor in studies by the SCE test. PMID- 3969085 TI - Inability of chrysotile asbestos fibers to modulate the 2-acetylaminofluorene induced UDS in primary cultures of rat hepatocytes. AB - There is now growing evidence that asbestos fibers could act in association with genotoxic compounds, either as cocarcinogens or promoters, in the process of carcinogenesis. The hepatocyte/UDS assay system has been taken to advantage to investigate the capacity of fibers to modulate the effects of genotoxic compounds on the cell, as we previously demonstrated the hepatocytes can engage in phagocytosis of chrysotile fibers. Measurement of UDS was performed by a biochemical procedure involving liquid scintillation counting (LSC) of a purified DNA fraction as well as by radioautography. Both LSC and radioautography revealed that chrysotile asbestos fibers UICC B at concentrations up to 100 micrograms/ml do not elicit UDS, whereas 2-acetylaminofluorene (2-AAF) at low concentrations (0.05-0.625 micrograms/ml) significantly induces it in parallel positive controls. In an attempt to test the cocarcinogen hypothesis, cultures of hepatocytes were simultaneously exposed for 20 h to 2-AAF (0.05 and 0.25 micrograms/ml) and asbestos fibers (1 and 10 micrograms/ml) given as simple mixtures. It was found that the 2-AAF-induced UDS activity was the same whether fibers were present or not. This was observed with both UDS evaluation procedures at all concentration combinations selected. An analysis of variance applied to the data collected from several experiments confirmed that there was no significant 2-AAF-fiber interaction. Our data suggest the absence of intrinsic genotoxic properties for chrysotile fibers. They also indicate that the modulation of the cellular response to genotoxic agents by asbestos fibers is not detected under our test conditions and may require longer-term exposures to be expressed. PMID- 3969086 TI - Pancreatic fluid secretion and protein hyperconcentration in cystic fibrosis. AB - To study pancreatic protein and water secretion in 28 patients with cystic fibrosis and 21 controls matched for pancreatic acinar function as defined by trypsin secretion, we used a quantitative-marker perfusion technique and continuous intravenous secretin-pancreozymin stimulation. Regardless of the level of pancreatic acinar function, secretions from the patients contained significantly higher concentrations of protein than those from the controls. Total protein output and albumin:protein ratios were not increased in secretions from the patients, but their fluid secretion was significantly decreased at any level of pancreatic function. A significant linear correlation was found between protein and volume secretion in the patients (r = 0.86, P less than 0.001), most of whom had a fluid output of less than 4.2 ml per kilogram of body weight per hour. No such relation was found in the control subjects, whose flow was always above 4.2 ml per kilogram per hour. We conclude that fluid secretion in patients with cystic fibrosis may be a rate-limiting factor in protein output and that a limited flow of hyperconcentrated protein secretions may predispose to protein precipitation and ductal obstruction in the pancreas. PMID- 3969087 TI - Thiopental-related immune hemolytic anemia and renal failure. Specific involvement of red-cell antigen I. PMID- 3969088 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 6-1985. Progressive pneumonitis after chemotherapy for breast carcinoma. PMID- 3969089 TI - Economic considerations in emergency care. What are hospitals for? PMID- 3969090 TI - Economic and legal considerations in emergency care. PMID- 3969092 TI - Shy-Drager syndrome. PMID- 3969091 TI - Labeling of ibuprofen for over-the-counter use. PMID- 3969094 TI - The case of neurology. PMID- 3969093 TI - Idiopathic pulmonary hemosiderosis and adenocarcinoma of the lung. PMID- 3969095 TI - Cigarette advertising and media coverage of smoking and health. PMID- 3969096 TI - Amelioration of polyuria by amiloride in patients receiving long-term lithium therapy. AB - Vasopressin-resistant diabetes insipidus is a common side effect of the treatment of affective disorders with lithium. We studied the effect of amiloride on lithium-induced polyuria in nine such patients receiving maintenance lithium therapy who had a vasopressin-resistant defect in urinary concentrating ability. After a mean (+/- S.E.) of 24 +/- 6 days of amiloride administration, the urine volume fell (from 4.7 +/- 0.6 to 3.1 +/- 0.3 liters per 24 hours; P less than 0.005), and the urine osmolality increased (from 228 +/- 35 to 331 +/- 34 mOsm per kilogram of H2O; P less than 0.001). The decrease in urine output was sustained during six months of observation in the absence of any significant change in plasma levels of lithium, potassium, or bicarbonate; urinary excretion of sodium or lithium; or creatinine clearance. Amiloride administration was also associated with a significant increase in urine osmolality (from 575 +/- 54 to 699 +/- 48 mOsm per kilogram of H2O; P less than 0.005) measured after fluid deprivation and the injection of exogenous vasopressin. We conclude that amiloride mitigates lithium-induced polyuria, at least partly, by blunting the inhibitory effect of lithium on water transport in the renal collecting tubule. Thus, amiloride may provide a specific therapy for polyuria in lithium-treated patients while obviating the need for potassium supplementation in the treatment of this kind of polyuria. PMID- 3969098 TI - The treatment of acute pancreatitis: a continuing challenge. PMID- 3969097 TI - Hepatic hemorrhage without rupture in preeclampsia. PMID- 3969099 TI - Transferring the terminally ill. PMID- 3969100 TI - Smoking and cardiomyopathy. PMID- 3969101 TI - Evening administration of alpha interferon. PMID- 3969102 TI - Prenatal diagnosis of Zellweger cerebrohepatorenal syndrome. PMID- 3969103 TI - Amyloid (type AA) in a patient with hypogammaglobulinemia. PMID- 3969104 TI - Reporting the failure of medical devices. PMID- 3969105 TI - Thiamine-dependent beriberi. PMID- 3969106 TI - What price management? PMID- 3969107 TI - The distress of internship. Causes and prevention. PMID- 3969108 TI - Acquired ciliary defects in nasal epithelium of children with acute viral upper respiratory infections. AB - Ciliary function and mucociliary clearance are primary mechanisms of defense in the respiratory tract. We found that infections by several common respiratory viruses in children were associated with ciliary abnormalities that could be detected on ultrastructural examination of the nasal epithelium. Dysmorphic ciliary forms involving microtubular aberrations were observed most often in the early stages of illness in focal sites of the nasal mucosa. Normal epithelial organization and ciliary ultrastructure appeared to be reestablished during the convalescent period, from 2 to 10 weeks after infection. These observations suggest that interference with ciliogenic mechanisms leading to transient, compromised mucociliary clearance may represent a fundamental pathophysiologic disturbance in some respiratory viral infections. PMID- 3969109 TI - Effect of parathyroidectomy on bone aluminum accumulation in chronic renal failure. AB - In some patients with chronic renal failure, bone mineralization becomes defective after parathyroidectomy for secondary hyperparathyroidism. Because aluminum deposition in bone is associated with impaired bone formation and osteomalacia, we retrospectively studied bone-biopsy specimens from patients on hemodialysis who were not exposed to dialysate contaminated with aluminum, to determine whether aluminum accumulation on bone surfaces was enhanced by parathyroidectomy. Serial biopsy specimens taken before and after parathyroidectomy revealed an increase in the rate of aluminum deposition on the surface of mineralized bone after parathyroidectomy in each of the six patients studied. The accelerated rate of aluminum accumulation could not be explained by changes in the oral aluminum intake. The mean rate of bone formation (+/- S.E.M.) before parathyroidectomy was higher in the six patients than in six control patients who did not undergo parathyroid surgery (586 +/- 147 vs. 237 +/- 85 micron2 per square millimeter per day; P less than 0.05). After parathyroidectomy, the rate of bone formation fell to levels below normal (148 +/ 32 vs. 311 +/- 29 micron2 per square millimeter per day; P less than 0.05) but was not significantly different from the rate in the control group (319 +/- 126 micron2 per square millimeter per day). We conclude that parathyroidectomy in patients with chronic renal failure is associated with enhanced aluminum deposition on the bone surface, possibly as a result of low bone formation. Patients with secondary hyperparathyroidism who may be candidates for parathyroidectomy should be evaluated for aluminum excess before surgery, so that treatment with aluminum chelation may be considered. PMID- 3969110 TI - Molecular biology and viral pathogenesis: clinical spinoff. PMID- 3969111 TI - Reversible parkinsonism related to meperidine. PMID- 3969112 TI - Corticosteroids for septic shock. PMID- 3969113 TI - Cancer in relatives of children with central nervous system neoplasms. PMID- 3969114 TI - Complement activation during hemodialysis. PMID- 3969115 TI - Overhead on NIH grants. PMID- 3969116 TI - The case of the fitting flyer. PMID- 3969117 TI - Prenatal x-ray exposure and childhood cancer in twins. AB - We conducted a case-control study to investigate the relation between prenatal exposure to x-rays and childhood cancer, including leukemia, in over 32,000 twins born in Connecticut from 1930 to 1969. Twins as opposed to single births were chosen for study to reduce the likelihood of medical selection bias, since twins were often exposed to x-rays to diagnose the twin pregnancy or to determine fetal positioning before delivery and not because of medical conditions that may conceivably pre-dispose to cancer. Each of 31 incident cases of cancer, identified by linking the Connecticut twin and tumor registries, was matched with four twin controls according to sex, year of birth, and race. Records of hospitals, radiologists, and private physicians were searched for histories of x ray exposure and other potentially important risk factors. Documented prenatal x ray exposures were found for 39 per cent of the cases (12 of 31) and for 26 per cent of the controls (28 of 109). No other pregnancy, delivery, or maternal conditions were associated with cancer risk except low birth weight: 38 per cent of the cases as compared with 25 per cent of the controls weighed under 2.27 kg at birth. When birth weight was adjusted for, twins in whom leukemia or other childhood cancer developed were twice as likely to have been exposed to x-rays in utero as twins who were free of disease (relative risk, 2.4; 95 per cent confidence interval, 1.0 to 5.9). The results, though based on small numbers, provide further evidence that low-dose prenatal irradiation may increase the risk of childhood cancer. PMID- 3969119 TI - Prenatal x-ray exposure and twins. PMID- 3969118 TI - Chromosome translocation t(14;22) and oncogene (c-sis) variant in a pedigree with familial meningioma. PMID- 3969120 TI - Treatment of chronic renal failure: an update. PMID- 3969121 TI - Megacorporate health care. A choice for the future. PMID- 3969123 TI - Unrecognized myocardial infarction. PMID- 3969122 TI - More on ear-canal hair and the ear-lobe crease as predictors for coronary-artery disease. PMID- 3969124 TI - Infarction-associated pericarditis. PMID- 3969125 TI - Increased susceptibility of women to alcohol: is beer the reason? PMID- 3969126 TI - Pulmonary epithelial permeability in hyaline membrane disease. PMID- 3969127 TI - Benign methylmalonic aciduria. PMID- 3969128 TI - Misapplication of alveolar gas equation. PMID- 3969129 TI - Allopurinol and bolus fluorouracil. PMID- 3969131 TI - Systemic errors in the use of the Mellits-Cheek equation to predict body fat in lean females. PMID- 3969130 TI - Cushing's disease caused by an ectopic pituitary adenoma within the sphenoid sinus. PMID- 3969132 TI - Cost of antibiotic prophylaxis after penetrating abdominal trauma. PMID- 3969133 TI - Laboratory animals. PMID- 3969135 TI - Medical versus animal antibiotics in resistance. PMID- 3969134 TI - Optic fibres, water tanks and the hydrolysis of ATP. PMID- 3969136 TI - T-cell receptor genes and ataxia telangiectasia. PMID- 3969137 TI - Differentiation of a bipotential glial progenitor cell in a single cell microculture. AB - Although it is known that most cells of the vertebrate central nervous system (CNS) are derived from the neuroepithelial cells of the neural tube, the factors determining whether an individual neuroepithelial cell develops into a particular type of neurone or glial cell remain unknown. A promising model for studying this problem is the bipotential glial progenitor cell in the developing rat optic nerve; this cell differentiates into a particular type of astrocyte (a type-2 astrocyte) if cultured in 10% fetal calf serum (FCS) and into an oligodendrocyte if cultured in serum-free medium. As the oligodendrocyte-type-2 astrocyte (0-2A) progenitor cell can differentiate along either glial pathway in neurone-free cultures, living axons clearly are not required for its differentiation, at least in vitro. However, the studies on 0-2A progenitor cells were carried out in bulk cultures of optic nerve, and so it was possible that other cell-cell interactions were required for differentiation in culture. We show here that 0-2A progenitor cells can differentiate into type-2 astrocytes or oligodendrocytes when grown as isolated cells in microculture, indicating that differentiation along either glial pathway in vitro does not require signals from other CNS cells, apart from the signals provided by components of the culture medium. We also show that single 0-2A progenitor cells can differentiate along either pathway without dividing, supporting our previous studies using 3H-thymidine and suggesting that DNA replication is not required for these cells to choose between the two differentiation programmes. PMID- 3969138 TI - Politicians prepare action. PMID- 3969139 TI - Psychophysics. Structured representation in low-level vision. PMID- 3969140 TI - Basement membrane nomenclature. PMID- 3969141 TI - Loss of spatial phase relationships in extrafoveal vision. AB - Objects in peripheral vision are not simply blurred but lack quality of form. Assuming that the visual system performs a (patchwise) Fourier analysis of the retinal image (for review see ref. 2), it has been suggested that this disadvantage of peripheral vision may be due to the inability to encode properly spatial phase relationships. This is of great interest for neurological research as certain visual pathologies imply alterations of perceived form. Previous attempts at measuring phase sensitivities failed to distinguish between the detection of phase-related changes in contrast and phase coding in the visual system. We separated these processing strategies by applying the iso-second-order texture paradigm of Julesz to the discrimination of compound gratings. Our results, reported here, show that the energy detection properties of both foveal and peripheral vision are comparable, however, independently of scale, peripheral vision ignores the relative position of image components. PMID- 3969142 TI - NIH research. Administration makes rings around congressional edict. PMID- 3969143 TI - Antibiotics in animals. PMID- 3969144 TI - Radiation casualties in a nuclear war. PMID- 3969145 TI - Serotonin-containing cell charged with growth cone arrests. PMID- 3969147 TI - Warnock proposals in trouble. PMID- 3969146 TI - Targeting of a foreign protein to chloroplasts by fusion to the transit peptide from the small subunit of ribulose 1,5-bisphosphate carboxylase. AB - Chimaeric genes can be constructed which fuse the transit peptide of a small subunit of the chloroplast-located ribulose 1,5-bisphosphate carboxylase with a bacterial protein. The fusion protein is translocated into chloroplasts and cleaved in a similar way to the small subunit polypeptide precursor. PMID- 3969148 TI - UK agonizes on embryo research. PMID- 3969150 TI - Fever in autistics. PMID- 3969151 TI - Upside-down world in bat's brain. PMID- 3969149 TI - Human and animal rights. PMID- 3969152 TI - Are introns structural elements or evolutionary debris? PMID- 3969153 TI - CG doublet difficulties in vertebrate DNA. PMID- 3969154 TI - A variant of the mammalian somatotopic map in a bat. AB - Two ordered representations of the body surface, S-I and S-II, have been described on the cortical surface of the brains of a variety of mammals; additional separate topographical maps have been found in the somatosensory cortex of the cat and monkey. Except for minor variations in the placement of the body parts, the basic somatotopy of the maps is remarkably consistent across species. As the reasons for this consistency and the minor variations are unclear, we examined the somatotopy of the bat, whose body plan has been modified extensively so that the forelimb can be used for flight. We report here that in both S-I and S-II of the grey-headed flying fox, not only is the representation of the distal forelimb displaced from its usual position on the map, but the digits are directed caudally instead of rostrally as they are in all other mammals studied. The variant somatotopy appears to reflect the postural differences between flying and walking mammals, supporting the notion that topographical maps may have functional significance apart from their point-to point connections with the sensory periphery. PMID- 3969155 TI - Detection of single base substitutions in total genomic DNA. AB - Certain single base substitutions causing genetic diseases or resulting in polymorphisms linked to mutant alleles, alter a restriction enzyme cleavage site and can therefore be detected in total genomic DNA using DNA blots. Many base substitutions do not lead to an altered restriction site, but these can be detected using synthetic oligonucleotides as hybridization probes if the DNA sequence surrounding the base substitution is known. In the case of beta thalassaemia, where 22 different single base mutations have been identified, a large number of probes would be required for diagnosis. An approach which was used to detect mutations in viral DNA involves the S1 nuclease treatment of heteroduplexes formed between wild-type and mutant DNA. Although certain single base mismatches are cleaved by S1 nuclease (ref. 11 and T. Shenk, personal communication), many other mismatches examined by this procedure are not cleaved (B. Seed, personal communication; R.M.M., unpublished data). Heteroduplexes between mutant and wild-type subgenomic fragments of double-stranded reovirus RNA migrate slower than the corresponding homoduplexes in polyacrylamide gels containing 7 M urea, but it is not known whether this method is applicable to DNA heteroduplexes containing single base mismatches. Here we describe a procedure that involves the electrophoretic separation of DNA heteroduplexes in a well characterized gel system. We show that four different human beta-thalassaemia alleles with known single base mutations can be detected with as little as 5 micrograms of total genomic DNA. The method should be useful in the localization and diagnosis of mutations associated with genetic diseases. PMID- 3969156 TI - Intron-dependent evolution of chicken glyceraldehyde phosphate dehydrogenase gene. AB - The function of introns in the evolution of genes can be explained in at least two ways: either introns appeared late in evolution and therefore could not have participated in the construction of primordial genes, or RNA splicing and introns existed in the earliest organisms but were lost during the evolution of the modern prokaryotes. The latter alternative allows the possibility of intron participation in the formation of primordial genes before the divergence of modern prokaryotes and eukaryotes. Blake suggested that evidence for intron facilitated evolution of a gene might be found by comparing the borders of functional protein domains with the placement of introns. We therefore examined glyceraldehyde phosphate dehydrogenase (GAPDH), a glycolytic enzyme, because it is the first protein for which the following data are available: X-ray crystallographic studies demonstrating structurally independent protein 'domains' which were highly conserved during the divergence of prokaryotes and eukaryotes; and a study of genomic organization which mapped introns in the gene. Sequencing of the chicken GAPDH gene revealed 11 introns. We report here that sites of three of the introns (IV, VI and XI) correspond closely with the borders of the NAD binding, catalytic and helical tail domains of the enzyme, supporting the hypothesis that introns did have a role in the evolution of primitive genes. In addition, other biochemical and structural data were used to construct a model of the intron-mediated assembly of the GAPDH gene that explains the existence of 10 introns. PMID- 3969157 TI - The transmission of AIDS. PMID- 3969158 TI - Ice-free cryopreservation of mouse embryos at -196 degrees C by vitrification. AB - The failure of complex mammalian organs, such as the kidney, to function following freezing to low temperatures is thought to be due largely to mechanical disruption of the intercellular architecture by the formation of extracellular ice. Classical approaches to the avoidance of ice formation through the imposition of ultra-rapid cooling and warming rates or by gradual depression of the equilibrium freezing point during cooling to -80 degrees C have not been adequate. An alternative approach relies on the ability of highly concentrated aqueous solutions of cryoprotective agents to supercool to very low temperatures. At sufficiently low temperatures, these solutions become so viscous that they solidify without the formation of ice, a process termed vitrification. When embryo suspensions are cryopreserved using conventional procedures, this supercooling behaviour allows intracellular vitrification, even in the presence of extracellular ice. We have therefore used mouse embryos to examine the feasibility of obtaining high survival following vitrification of both the intra- and extracellular solutions and report here that in properly controlled conditions embryos seem to survive in high proportions after cryopreservation in the absence of ice. PMID- 3969159 TI - Retinotopic order appears before ocular separation in developing visual pathways. AB - In mammals, the major subcortical visual structures receive projections from both eyes, with the uncrossed projection being smaller than the crossed. Each projection is arranged as a separate orderly map of one hemiretina. Although these hemiretinal maps are separate in the nuclei, they are aligned so that the representations of points in the visual field are in register, thus there is a continuity of visual field representation between them. During the early development of the binocular pathways, terminals from the two eyes overlap almost entirely. As development proceeds, terminals arising from each eye segregate to form the adult pattern. In the present study, local retinal lesions were made in ferrets at various stages in development before the separation of the projections from the two eyes. A neuronal tracer was then injected into the damaged eye, defining the pattern of projection from that eye. As reported here, the lesion resulted in a limited interruption in the pattern of terminal label on both sides of the brain, demonstrating that terminals from each eye are arranged in an orderly retinotopic manner at this stage. hence, during later development, as one projection is reduced relative to the other, the two maps must slide in relation to each other. PMID- 3969161 TI - Sex and frequency of gene conversions in meiosis. PMID- 3969162 TI - [Treatment of tubal pregnancy]. PMID- 3969160 TI - Functional innervation of cultured hippocampal neurones by cholinergic afferents from co-cultured septal explants. AB - The rat hippocampus receives a strong cholinergic innervation from the medial septum; information about the development and function of this pathway could help to elucidate the mechanisms of memory functions. Previous electrophysiological studies have shown that septal stimulation in vivo facilitates commissural and perforant path inputs and that stimulation of intrahippocampal cholinergic fibres in vitro produces a slow depolarization of rat hippocampal CA3 pyramidal neurones and increases their excitability. We describe here a different approach to the investigation of this system, by co-culturing slices of young rat hippocampus and septum, then recording the effects of septal nucleus stimulation on single voltage-clamped hippocampal CA3 pyramidal neurones. Under these conditions acetylcholinesterase-staining (presumed cholinergic) fibres grow out from the septum into the hippocampus. Single septal stimuli produce a short-latency non cholinergic fast excitatory postsynaptic current, whereas trains of stimuli produce a slow inward current augmented by neostigmine and suppressed by atropine; hence this has a cholinergic origin. Our experiments provide both the first demonstration that functional synapses can be established between explanted cholinergic and cholinoceptive neuronal systems from the mammalian brain in organotypic culture and the first description of cholinergic slow excitatory postsynaptic currents in the mammalian central nervous system. PMID- 3969163 TI - [Eye disorders in 4 patients with acquired immunodeficiency syndrome]. PMID- 3969164 TI - [Juvenile polyglandular insufficiency syndrome]. PMID- 3969165 TI - [Experimental medical biology in the Utrecht State University curriculum]. PMID- 3969166 TI - [Children with urination problems in constipation]. PMID- 3969167 TI - [The Public Mental Health New Note]. PMID- 3969168 TI - [The report "Second interim advice concerning the early detection of breast cancer"]. PMID- 3969169 TI - [The diagnosis of acute kidney insufficiency]. PMID- 3969170 TI - [Aluminum: a light metal or a dangerous poison?]. PMID- 3969171 TI - [The interaction between food, nutritional status, metabolism and orally administered antimicrobial agents]. PMID- 3969172 TI - [The psychological development of children with low birth weight]. PMID- 3969173 TI - [Screening for raised serum phenylalanine levels in women of reproductive age in Volendam]. PMID- 3969174 TI - [Undetected phenylketonuria in a family]. PMID- 3969175 TI - [10 years' national screening study of the incidence of phenylketonuria in the Netherlands; 3d report of the National Advisory Phenylketonuria Commission]. PMID- 3969176 TI - [Malignant neuroleptic syndrome: successful treatment of a patient with bromocriptine]. PMID- 3969177 TI - [Burns caused by hydrogen fluoride]. PMID- 3969178 TI - [Hydrothorax in ascites and its treatment with a peritoneovenous shunt]. PMID- 3969179 TI - [Treatment of a patient with ergotism]. PMID- 3969180 TI - [Monocular hematoma: an innocent black eye?]. PMID- 3969181 TI - [Getting up suddenly: physiological and clinical significance of acute cardiovascular consequences]. PMID- 3969182 TI - [The influence of age on cardiovascular reactions to postural changes]. PMID- 3969183 TI - [The risk of spinal herniation in spinal cord compression; lumbar or cervical myelography]. PMID- 3969184 TI - Aluminium-induced anaemia in haemodialysis patients. AB - It appears well established that a microcytic, hypochromic anaemia is present in patients receiving regular haemodialysis treatment, who also suffer from chronic aluminium intoxication. This characteristic anaemia is slightly improved following deionization or reverse-osmosis treatment of dialysate water. Iron deficiency has been tentatively excluded as a cause of this anaemia by measurement of serum ferritin levels. The exact mechanisms involved in the pathogenesis of this anaemia are still to be fully elucidated but a disturbance in haem synthesis and porphyrin metabolism seems probable, and secondary effects of PTH in the bone marrow may be involved. Evidence has accumulated that aluminium is the most likely ion responsible for this anaemia but other ions, trace metals in excess or deficiency and potentially toxic substances cannot be excluded yet. PMID- 3969185 TI - Oral aluminum administration to uremic, hyperparathyroid, or vitamin D supplemented rats. AB - In the present study, the role of factors was investigated that could possibly lead to changes in plasma and tissue aluminum (A1) concentrations following oral A1 exposure. In chronically uremic rats that received an oral A1 supplementation of 150 mumol/g diet during 4 weeks, a significant increase in mean (+/- SEM) liver A1 content was observed when compared to sham-operated, pair-fed control rats (9.9 +/- 2.0 versus 4.8 +/- 0.65 nmol/g wet weight, p less than 0.02). No such difference was found in non-A1-supplemented rats. Plasma A1 and the A1 content of other organs studied except muscle were not increased in uremic as compared to control animals. In rats with hyperparathyroidism secondary to a calcium-poor diet, mean liver and bone A1 content was significantly decreased when not A1-exposed (2.5 +/- 0.13 and 62 +/- 5.5 nmol/g, respectively) and normal when A1-supplemented (4.7 +/- 0.59 and 120 +/- 23 nmol/g, respectively) as compared to normal control rats without A1 supplementation (5.1 +/- 1.5 and 170 +/- 17 nmol/g, respectively). However, in the hyperparathyroid rats, mean plasma A1 concentration was higher than in control, euparathyroid rats. In rats with exogenous hyperparathyroidism (parathyroid extract) a significant increase in liver A1 content was observed when compared to control rats (8.1 +/- 0.95 versus 5.3 +/- 0.53 nmol/g, p less than 0.05). In A1-supplemented normal rats treated with 1,25(OH)2 vitamin D3 during 4 weeks, liver A1 content was significantly lower than in control rats receiving vehicle solution only (2.9 +/- 0.76 versus 5.7 +/- 0.59 nmol/g, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969186 TI - Analytical identity of an inhibitor of sodium transport isolated from human serum and urine. AB - Inhibitors of sodium transport purified from serum and urine of healthy and uremic subjects show the same elution pattern on columns of a weak anion exchanger (DEAE Sephadex A-25), reverse-phase chromatography (Separon SI C 18) and gel permeation chromatography (Separon Hema 300 Glc). Moreover, their thin layer chromatographic mobility (DC-Alufolien Cellulose) in nine solvent systems is the same. These identical physicochemical properties document satisfactorily their identity, which permits the use of the urinary inhibitor of sodium transport for structure studies. PMID- 3969187 TI - Serum immunoreactive erythropoietin levels in patients with polycystic kidney disease as compared with other hemodialysis patients. AB - Serum erythropoietin levels were randomly collected and measured by a sensitive radioimmunoassay in a hemodialysis population. For analysis, the patients were divided into two groups: those with polycystic kidney disease and those with other kidney diseases. In 12 polycystic kidney disease patients, serum erythropoietin was 22.6 +/- 2.4 mU/ml, hematocrit 29.7 +/- 1.0%, and absolute reticulocyte count 17.0 +/- 4.1 X 10(4)/microliters. In 24 other kidney disease patients, serum erythropoietin was 12.4 +/- 0.7 mU/ml, hematocrit 21.2 +/- 0.8%, and reticulocyte count 7.5 +/- 1.5 X 10(4)/microliters. Serum erythropoietin was 18.5 +/- 0.7 mU/ml in normal controls. Polycystic kidney disease patients manifested higher hematocrit, reticulocyte counts, and serum erythropoietin levels when compared to other kidney disease patients (p less than 0.01). The data suggest (1) an inappropriately low serum erythropoietin level for the severity of anemia in uremic hemodialysis patients and (2) that greater availability of erythropoietin results in more effective erythropoiesis, even in the uremic environment. PMID- 3969188 TI - Asymmetric septal hypertrophy in uremic-normotensive patients on regular hemodialysis. An M-mode and two-dimensional echocardiographic study. AB - We have observed a high incidence (36.4%) of asymmetric septal hypertrophy (ASH), detected with the use of M-mode (MME) and two-dimensional echocardiography (2DE), in normotensive patients with chronic renal failure on maintenance hemodialysis without signs of cardiac diseases. ASH was detected by conventional MME in 11 cases and was confirmed with the use of 2DE in 8 cases showing a diagnostic concordance of 72.7% between the two methods. After dialysis the MME study of the left ventricular (LV) performance showed an evident impairment of cardiac index (CI) due to reduction of LV volume in addition to an abnormality of septal function. The presence of ASH does not impair the percentage of fractional shortening (FS%), the mean circumferential shortening (mean Vcf) and the ejection fraction (EF%), probably because of a compensatory performance of the LV posterior wall. Predialysis serum creatinine and fasting triglycerides have been found significantly higher in the group with ASH. ASH may be considered as a focal and early form of myocardial involvement in uremic patients on regular hemodialytic treatment. PMID- 3969189 TI - Substitution of a starch polymer for glucose in peritoneal dialysis. AB - We compared a starch-derived polymer (molecular weight = 900) as the osmotically active agent in peritoneal dialysate (3 and 6% solutions) to results obtained with commercially available glucose dialysate (1.5 and 4.25%). 12 dogs were dialyzed with glucose for 7 days, and 9 received the polymer for 5 days. For dialysate exchanges with an intraperitoneal residence of 240 min the 1.5 and 3% solutions generated similar volumes of ultrafiltrate as did the 4.25 and 6% solutions. However, for exchanges of 960 min the 1.5% dialysate was significantly reabsorbed when compared to the other dialysate concentrations. The serum polymer concentration increased with continued dialysis. The rate of transfer from dialysate to serum in man must still be determined. The lower diffusivity of the polymer will certainly be evidenced. For certain clinical applications where diminished ultrafiltration occurs, the polymer may be of benefit to man. PMID- 3969190 TI - Interference of heparin with peritoneal solute transport. AB - To verify the action of heparin on peritoneal transport, we selected 20 patients on acute peritoneal dialysis and performed two 2-hour cycles with 2,000 cm3 of a 1.5% solution, adding 2,000 units of heparin to the second cycle. The patients were also randomized into 2 groups: group A, adding 1.5 mg gentamycin/kg to the dialysate of cycle I (without heparin), and group B, adding the same dose of gentamycin to cycle II (with heparin). At the end of each of the two cycles blood and dialysate were drawn for urea, creatinine, glucose, proteins and gentamycin levels, using peritoneal clearances of urea and creatinine, glucose absorption and net protein loss to compare cycle I with cycle II. We found that the peritoneal transport of creatinine and urea was improved (p less than 0.02; p less than 0.05) and glucose absorption increased (p less than 0.01) with heparin, without any significant change in protein loss. Contrary to common belief, heparin in a 1,000-U/l dose improved the absorption of gentamycin from the dialysate (p less than 0.01). PMID- 3969191 TI - Effect of oral carnitine supplementation on disturbances of lipid metabolism in the uremic rat. AB - Carnitine deficiency has recently been incriminated in the pathogenesis of the disturbed lipid metabolism observed in hemodialysis patients. The present study was performed to investigate the effects of L-carnitine administration on the lipid metabolism of rats with experimental chronic renal failure as compared to normal rats. Three groups of rats were studied: the first had induced chronic uremia, the second was sham-operated and pair-fed with the first, and the third was sham-operated and fed ad libitum. Serum triglycerides were significantly higher in uremic rats than in control animals of both groups. In addition to triglycerides, serum total cholesterol and phospholipids were also increased in uremic rats. The fractional clearance rate of Intralipid [K2(%)] was decreased in uremic as compared to control animals. The in vivo oxidation of radiolabeled palmitate was lower in uremic than in ad libitum-fed control animals but not lower than in pair-fed control rats. The daily oral administration of L-carnitine to uremic rats was associated with stable serum triglycerides. On the contrary, serum triglycerides increased significantly in the untreated uremic rats over the same period of time. Serum total cholesterol and phospholipids remained similar in the presence and the absence of L-carnitine treatment. The intravenous fat tolerance test of carnitine-supplemented uremic rats improved slightly, although not significantly, when compared to that of untreated uremic rats. In conclusion, oral L-carnitine supplementation in chronically uremic rats had only modest or no effects on several plasma lipid parameters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969193 TI - Electron microscopic studies in a long-term follow-up of a case of congenital nephrotic syndrome. AB - A boy presenting with a severe congenital nephrotic syndrome diagnosed by histological analysis at the age of 3 weeks was biopsied again 7 years later. The ultrastructural glomerular basement membrane abnormalities depicted in the first biopsy were no longer present in the second one. The number of completely hyalinized glomeruli was not significantly decreased. The GFR remained normal, but a moderate persistent, non-selective proteinuria (800 mg/24 h) was noted without oedema. The patient however developed a progressive perceptive deficit of hearing. PMID- 3969192 TI - Acetate versus lactate in peritoneal dialysis solutions. AB - The acid-base characteristics of two peritoneal dialysis solutions containing either lactate or acetate are compared and the time course of changes in intraperitoneal pH following instillation into the abdominal cavity is measured. The concentration of titratable acid (cTA) is 5.58 mmol/l or 7 times as high in solutions containing acetate as in those containing lactate (0.79 mmol/l). The buffer capacity, -dcTA/dpH, is 11.43 and 1.82 mmol/l, respectively. Following intraperitoneal instillation of 1.5 liter of the solutions, the time course is 2 3 times as long before intraperitoneal pH reaches 7 using acetate (18 min) as when using lactate (7 min). The above mentioned difference in acid-base characteristics as well as an individual acetate intolerance is supposed to be the cause for the development of abdominal pains and peritoneal irritation observed in some patients using acetate-containing solutions. 123 mmol/l of sodium bicarbonate is to be added to the acetate solution to raise the pH value from 5.6 to 7.4. Neutralization using sodium bicarbonate will thus result in sodium intoxication of the patient. The use of lactate instead of acetate for peritoneal solutions is advocated. PMID- 3969194 TI - A new plethysmograph for detecting arterial pulse waves in rat tail. AB - A new plethysmograph for detecting arterial pulse waves in the rat tail is described. With the objective of indirectly measuring the arterial blood pressure in small animal tails an easy-to-build plethysmographic chamber is presented. Essentially in this apparatus the atmospheric air insulated in the chamber is used as the transmitter of the volume changes caused by the arterial flow. By this methodology details of the pulse wave morphology are clearly visible, including the dicrotic notch. It is demonstrated that his chamber combines simplicity with accuracy. PMID- 3969195 TI - Spontaneous parathyroid hemorrhage in a hemodialysis patient. PMID- 3969196 TI - Organization of angiotensin II immunoreactive cells and fibers in the rat central nervous system. An immunohistochemical study. AB - The distribution of angiotensin II (AII)-immunoreactive cells and fibers was examined in adult male Sprague-Dawley rats with and without colchicine pretreatment. As seems to be the case for a number of other neuropeptides, AII is preferentially found in brain stem, hypothalamic, and limbic structures involved in the control of homeostatic functions. AII-stained cell bodies were most prominent in magnocellular parts of the paraventricular and supraoptic nuclei, and cells were also found in parvocellular parts of the former. Other hypothalamic nuclei containing cell bodies include the suprachiasmatic nucleus, the medial preoptic area, and perifornical parts of the lateral hypothalamic area. Of considerable interest was robust staining in several of the circumventricular organs, in particular the subfornical organ, where both cells and fibers were found. The results of water deprivation and nephrectomy suggest that this staining does not represent uptake of circulating peptide, but instead, represents AII-containing neural connections. In the thalamus, AII-stained cells were found in the paraventricular nucleus, the central medial nucleus, the nucleus reuniens, and rostral parts of the zona incerta. Two cell groups in the basal telencephalon, in the dorsal part of the bed nucleus of the stria terminalis and in the medial nucleus of the amygdala, lay at either end of an AII stained pathway coursing through the stria terminalis. In the midbrain, immunoreactive cells were found in the interpeduncular and peripeduncular nuclei, and one pontine cell group was detected in the most lateral part of the lateral parabrachial nucleus. The only AII-stained cells in the medulla were in the nucleus of the solitary tract, near the margin of the area postrema. Fibers were found at all levels of the central nervous system, from the olfactory bulbs to the spinal cord, where terminal fields were observed in the substantia gelatinosa and in the intermediolateral cell column. Longitudinally oriented fibers were present throughout the periventricular fiber system and in the medial forebrain bundle, including its caudal extension in ventrolateral parts of the brain stem. It is suggested that, at many different levels, AII serves as both a hormone and neurotransmitter for fluid balance. PMID- 3969197 TI - Hormone content and movement of neurosecretory granules in the rat neural lobe during and after dehydration. AB - Neurohypophyses from rats dehydrated and rehydrated for different periods of time have been analyzed by morphometry of electron micrographs and their oxytocin and vasopressin contents measured by radioimmunoassays. The time course of disappearance and reappearance of neurosecretory granules (NSG) parallels that of the hormone content of the neurohypophysis. Depletion of NSG during dehydration first occurs in the nerve endings and only later in the swellings. No change of the volumetric density of the microvesicles was detected but the time course of changes in the volumetric density of the endocytotic vacuoles varies according to the secretory state of the tissue. There was a significant increase in the volume of the gland 3 days after the beginning of the rehydration. This increase was associated with an increase in the volumetric density of the pituicytes. No change of the total number of endings, swellings and axons was observed. This demonstrates a hypertrophy of the pituicytes. The present work gives strong support to the concept of a preferential release of the granules located in the endings. It also shows that, after depletion of the NSG in the neural lobe, newly synthetized granules at the onset of rehydration move first to the endings and 2 days later arrive in the swellings coming presumably either directly from the hypothalamus or from the endings. Furthermore, the results confirm previous work which has demonstrated that membrane retrieval in neurohypophysial nerve endings occurs via vacuoles. PMID- 3969198 TI - Correlation of luteinizing hormone surges with estrogen nuclear and progestin cytosol receptors in the hypothalamus and pituitary gland. I. Estradiol dose response effects. AB - The present studies were designed to answer three questions: (1) how will a progressive increase in serum estradiol (E2) in ovariectomized (OVX) rats affect progesterone (P4)-induced luteinizing hormone (LH) surge concentrations? (2) Can steroid-induced LH surges be correlated with estrogen nuclear receptor (E2Rn) and progestin cytosol receptor (PRc) levels in brain regions known to regulate LH secretion, and (3) do differences in pituitary responsiveness to LHRH in E2- or E2P4-treated OVX rats parallel changes in E2Rn and PRc concentrations in this gland? 1 week after ovariectomy of adult cyclic rats (day 0), Silastic E2 capsules were placed subcutaneously at 09.00 h and produced serum E2 levels of 6 8 (low), 12-19 (medium) and 27-37 (high) pg/ml, respectively. 2 days later (day 2), some rats also received Silastic P4 capsules subcutaneously which elevated serum P4 concentrations to 10-12 ng/ml. In rats with low serum E2, P4 treatment induced peak serum LH levels of 913 ng/ml. When serum E2 was increased to the medium or relatively high physiologic range, P4 treatment resulted in LH surge levels of 4,686 and 5,030 ng/ml. OVX controls and E2-treated OVX rats were sacrificed at 10.00 h on day 2 and E2Rn and PRc were measured concurrently in the preoptic area (POA), mediobasal hypothalamus (MBH), corticomedial amygdala (CMA) and pituitary gland (PIT). Raising serum E2 from OVX levels to the low range significantly increased both E2Rn and PRc in MBH and PIT, but not in the POA or CMA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969199 TI - Correlation of luteinizing hormone surges with estrogen nuclear and progestin cytosol receptors in the hypothalamus and pituitary gland. II. Temporal estradiol effects. AB - In these studies we examined the temporal parameters of estradiol (E2) priming required before progesterone (P4) amplifies the surge release of luteinizing hormone (LH) in short-term ovariectomized (OVX) rats. Thereafter, we correlated the time of appearance and concentrations of estrogen nuclear (E2Rn) and progestin cytosol (PRc) receptors in brain regions known to be involved in the surge release of LHRH. Steroid receptor concentrations were also measured in the pituitary gland. 1 week after OVX (day 0), Silastic capsules containing E2 (150 micrograms/ml in oil s.c.) were placed at 09.00 h. The serum E2 concentrations produced by these capsules peaked (41 +/- 2.1 pg/ml) at 10.00 h on day 0 and declined thereafter to values which ranged between 19 and 10 pg/ml on days 1 through 4. Some of these E2-treated rats also received 2 P4-containing Silastic capsules (50 mg/ml s.c. in oil) at 09.00 h on either days 0, 1, 2, 3 or 4. Serum P4 concentrations produced by such capsules were 9.3 +/- 0.5 ng/ml. Blood was collected sequentially at 09.00 h and at hourly intervals from 12.00-18.00 h on the day that the animals received the P4 capsules and 10.00 and 15.00 h samples also were taken from each group the next day. LH surges occurred in these E2 treated rats in the afternoons of days 2-4, but not on days 0 and 1. P4 treatment on day 1 elicited an LH surge and on days 2-4 it amplified plasma LH surge concentrations and advanced by 1 h the time of release of this gonadotropin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969200 TI - Naloxone-induced dissociation of oxytocin and prolactin releases. AB - Immobilization of adult male rats resulted in concomitant, significant releases of prolactin (PRL) and oxytocin (OT). Naloxone (0.2 mg/kg, i.p.) administration 30 min prior to initiation of restraint resulted in a significant diminution of the PRL response to stress. On the other hand, a significant augmentation of OT release was observed. These results demonstrate that concomitant releases of OT and PRL in response to a given physiologic stimulus (stress) can be dissociated and suggest that the hypothalamic events which are responsible for the release of these hormones during stress are different. PMID- 3969201 TI - Type I complex partial seizures of hippocampal origin: excellent results of anterior temporal lobectomy. AB - Seventeen patients had type I complex partial seizures (CPS) with three consecutive phases: initial motionless staring, oral-alimentary automatisms, and reactive quasipurposeful movements during impaired consciousness. Fifteen patients had stereoelectroencephalography. Focal or regional 8- to 20-Hz low voltage epileptiform paroxysms in either hippocampus (10 patients), amygdala (1 patient), or both (1 patient) preceded initial motionless staring. Focal sphenoidal or nasopharyngeal ictal paroxysms preceded seizures in three other patients who underwent lobectomy. All 15 patients are seizure-free 2 to 11 years after temporal lobectomy. Type I CPS are most commonly of hippocampal origin. PMID- 3969202 TI - Gait apraxia in normal-pressure hydrocephalus: patterns of movement and muscle activation. AB - We made gait recordings in 11 patients with normal-pressure hydrocephalus. Sagittal rotations in hip, knee, and ankle joints were determined with intermittent light photography or with polarized light goniometry. In eight patients, gait muscle activation was determined with integrated surface EMG from six leg muscles on one side. We assessed the patterns of movement and muscle activity by averaging data from 20 gait cycles. Reduced speed and range of movements, short steps, small foot-floor clearance, and low swing-to-stance ratio were typical. The activation of the calf muscles was regularly premature and low. In severe disorders, there was continuous activity in the antigravity muscles acting on hip and knee joints. Gait records verified improvement after CSF drainage or shunting. PMID- 3969203 TI - The clinical utility of ambulatory cassette EEG. AB - We obtained ambulatory EEG monitoring (A/EEG) before intensive monitoring in 33 patients newly referred to an epilepsy center. The A/EEG yield of evidence to support a diagnosis of epilepsy was 83% of that of intensive monitoring and 2.5 times that of routine EEG. Accuracy of A/EEG analysis was confirmed by two blind reviews for each tape, with only three misreadings among 99 interpretations rendered. Among 25 patients with specifically diagnostic referrals, A/EEG served the purpose of admission as well as intensive monitoring in 60%. Episodes not accompanied by A/EEG change required behavioral observation for correct identification. PMID- 3969204 TI - Lumbosacral spinal evoked potentials in patients with multiple sclerosis. AB - Lumbosacral spinal evoked potentials were recorded percutaneously in 22 MS patients with spinal symptoms and in 24 age-matched normal volunteers. Latencies, durations, and areas of waves R and A (level S1) as well as S and P2 (level Th12) were analyzed. The most significant result observed in the MS group was a reduction of the ratio between the areas of P2 and S. The reduction was strongly correlated with intensity of spasticity, but not with other clinical features. The P2/S ratio can thus be proposed as an electrophysiologic measure of spasticity. PMID- 3969205 TI - Brain gamma-aminobutyric acid deficiency in dialysis encephalopathy. AB - We measured levels of gamma-aminobutyric acid (GABA) in the CSF and in the autopsied brain of patients with dialysis encephalopathy. GABA concentrations were low in the CSF of three of five living patients. Mean GABA content was reduced by 30 to 50% in five brain regions (frontal, occipital, and cerebellar cortex, caudate nucleus, and medial dorsal thalamus) in five fatal cases. GABA content was normal in brain regions where GABA is characteristically reduced in Huntington's disease. Choline acetyltransferase activity was diminished (by 25 to 35%) in cerebral cortex of the dialysis encephalopathy patients. PMID- 3969206 TI - Disappearance of high-incidence amyotrophic lateral sclerosis and parkinsonism dementia on Guam. AB - The high incidence rates of amyotrophic lateral sclerosis (ALS) and parkinsonism dementia (PD) occurring among the Chamorros of Guam have declined to rates only slightly higher than those observed in the continental United States. This decline has occurred principally among males, especially those born after 1920 and living in areas where calcium and magnesium levels are low in soil and water. The male-to-female ratio among affected patients now approaches unity, compared with ratios of 2 to 1 for ALS and 3 to 1 for PD three decades ago. These changes are consistent with the hypothesis that the previously high incidence resulted from defects in mineral metabolism and secondary hyperparathyroidism, provoked by nutritional deficiencies of calcium and magnesium, with resultant deposition of calcium and aluminum in neurons. PMID- 3969207 TI - Low dosages of bromocriptine added to levodopa in Parkinson's disease. AB - Thirty-six patients with Parkinson's disease, on levodopa, were admitted to a double-blind, parallel, 40-week study of adjunct bromocriptine in dosages increased by 2.5 mg every 4 weeks. A 37% improvement of the mean neurologic deficit score was obtained at the maximal daily dosage of 20 mg. Improvement was greatest in patients with mild disease. The wearing-off effect, off-dose abnormal involuntary movements, and leg pains, associated with levodopa, improved in over 70% of patients at an average dosage of 13 mg. Only 15% of patients had adverse reactions severe enough to necessitate discontinuance of the drug. Abnormalities of mental state were less severe than expected, but two patients had exacerbations of angina pectoris. PMID- 3969208 TI - Guillain-Barre syndrome in a Danish county. AB - In a retrospective population-based study, we reviewed clinical records of 51 patients with Guillain-Barre syndrome (GBS) during the years 1965 to 1982. The mean annual age-adjusted incidence rate was 1.14 per 100,000 people. Compared with reports from Israel, Danish and Swedish patients with GBS seem to have more extensive and more severe symptoms, although survival rate and recovery prognosis are probably the same. PMID- 3969209 TI - Oligoclonal bands in multiple sclerosis: clinical-pathologic correlation. AB - Although oligoclonal banding is a characteristic feature of MS spinal fluid, some patients do not show this abnormality. Four of 18 consecutive patients with autopsy-proven MS had no oligoclonal bands (OB) in CSF during life or at postmortem. Patients with OB had numerous plasma cells in meninges and plaques (confirmed in sections stained for cytoplasmic immunoglobulin). The four patients without bands had few or no identifiable plasma cells. Therefore, lack of OB correlates with both inactivity of plaques and absence of plasma cells in plaques or meninges. This is another form of heterogeneity in MS. PMID- 3969210 TI - Epidemiology of brain tumors: the national survey of intracranial neoplasms. AB - A national survey, based on a probability sample of patients admitted to short term hospitals in the United States during 1973 to 1974 with a discharge diagnosis of an intracranial neoplasm, was conducted in 157 hospitals. The annual incidence was estimated at 17,000 for primary intracranial neoplasms and 17,400 for secondary intracranial neoplasms--8.2 and 8.3 per 100,000 US population, respectively. Rates of primary intracranial neoplasms increased steadily with advancing age. The age-adjusted rates were higher among men than among women (8.5 versus 7.9 per 100,000). However, although men were more susceptible to gliomas and neuronomas, incidence rates for meningiomas and pituitary adenomas were higher among women. PMID- 3969211 TI - Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism. AB - We studied a 68-year-old man who died after 13 years of progressive dementia, rigidity, bradykinesia, mild tremor, stooped posture, slow and shuffling gait, dystonia, blepharospasm, apraxia of eyelid opening, anarthria, aphonia, and incontinence. At autopsy, he had generalized brain atrophy with large deposits of iron pigment in the globus pallidus, caudate, and substantia nigra. Axonal spheroids were found in the globus pallidus, substantia nigra, medulla, and spinal cord. The neurochemical analysis of the brain revealed marked loss of dopamine in the nigral-striatal areas, with relative preservation of dopamine in the limbic areas. This is the oldest case of familial Hallervorden-Spatz disease reported and the first with neurochemical analysis of the brain. PMID- 3969212 TI - L-dopa-induced respiratory disturbance in Parkinson's disease suppressed by tiapride. AB - L-dopa treatment provoked an irregular breathing pattern and dyspnea in a patient with Parkinson's disease. This side effect strongly limited adequate antiparkinsonian treatment with L-dopa. Simultaneous administration of L-dopa and tiapride resulted in improvement of parkinsonian symptoms and suppressed the respiratory side effect completely. PMID- 3969213 TI - Medium-chain triglyceride (MCT) diet in intractable seizure disorders. AB - Seventeen patients with intractable seizures have been treated with the medium chain triglyceride (MCT) diet. All had frequent (often daily) seizures despite multiple medications. Age range was 12 months to 13 years. Types of seizures included myoclonic, akinetic, focal motor, atypical absence, generalized tonic, and tonic-clonic. Five patients achieved total seizure control, and anticonvulsants were decreased or stopped. Five others had some improvement in seizure control. No change was seen in two. In two cases, parents could not deal with the diet, even though total control had been achieved in one case. The diet had to be discontinued in three others because of side effects (diarrhea, vomiting, irritability). Intractable seizures of all types may respond to treatment with the MCT diet. This mode of therapy has few side effects, is tolerated well in most instances, and can result in reduction or discontinuation of anticonvulsant medications. PMID- 3969214 TI - Effect of alcohol on dystonia. AB - An intravenous infusion of a 250-ml, 10% ethanol solution decreased dystonic scores in five of seven patients with spasmodic torticollis, but had no effect in patients with Meige syndrome, tardive dystonia, or generalized torsion dystonia. Alcohol may temporarily decrease some forms of dystonia. PMID- 3969215 TI - Brainstem auditory evoked potentials in early diagnosis of basilar artery occlusion. AB - Brainstem auditory evoked potentials (BAEPs) were recorded in the acute and chronic phases of two patients with basilar artery occlusion. BAEPs in the acute phase showed disappearance of the waves before CT evidence of a definite low density area in the brainstem. In one patient, the waves reappeared in the chronic phase, suggesting the importance of monitoring BAEPs in the acute phase. PMID- 3969216 TI - Serum C-reactive protein as detector of pretreated childhood bacterial meningitis. AB - Serum C-reactive protein (CRP) levels were measured at presentation to the hospital in 15 children with proven bacterial meningitis (BM) pretreated with antibiotics. CRP exceeded the upper normal limit of 19 mg/l in all cases; the mean value was 195 mg/l (range, 55 to 375 mg/l). On the other hand, CRP levels were normal in 12 patients with viral meningitis or meningoencephalitis. Rapid determination of serum CRP should be performed whenever BM is suspected. PMID- 3969217 TI - Hyperthermia after discontinuance of levodopa and bromocriptine therapy: impaired dopamine receptors a possible cause. AB - Hyperthermia, with no signs of any underlying infection, may occur in the course of neuroleptic malignant syndrome, fatal catatonia, heat stroke, or malignant hyperthermia. We describe hyperthermia as a complication after discontinuance of antiparkinsonian treatment with levodopa/carbidopa and bromocriptine. Impaired nigrostriatal, hypothalamic, and mesolimbic dopaminergic functions could be involved in pathogenesis. PMID- 3969218 TI - Autonomic neuropathy associated with autoimmune disease. AB - Mononeuropathy multiplex and mixed sensorimotor neuropathy are known complications of systemic vasculitis and related autoimmune disorders. Autonomic dysfunction is not generally considered a neurologic complication of these diseases. We report two patients who came to neurologic attention because of autonomic dysfunction and were then discovered to have autoimmune disease. Autonomic dysfunction may be the presenting sign of autoimmune disorders, which should be considered in the differential diagnosis of acquired autonomic disturbances. PMID- 3969219 TI - Head injury as a risk factor for Alzheimer's disease. AB - A case-control study was performed in which the frequency of prior head injury was assessed in 78 patients with dementia of the Alzheimer type (DAT) and 124 control subjects matched for age, sex, and race. A history of head injury with loss of consciousness was reported in 25.6% of patients and 5.3% and 14.6% of hospital and neighborhood controls, respectively. Matched-pair analysis of patients and hospital controls yielded an odds ratio of 4.50, which was significant (p less than 0.01). The ranges of times of occurrence of head injuries were similar in patients and controls, spanning several decades. The findings suggest a possible etiologic role for head injury in DAT. PMID- 3969220 TI - Demyelinating encephalopathy in Lyme disease. AB - A 38-year-old man from southeastern Connecticut developed a diffuse encephalopathy with partial complex seizures, followed weeks later by arthritis, cryoglobulinemia, and increased serum IgM. CT showed confluent low-density lesions in the deep cerebral white matter consistent with demyelination. Neither the encephalopathy nor the CT abnormalities improved. Lyme disease was diagnosed serologically 4 years later. PMID- 3969221 TI - Enhanced auditory postauricular evoked responses after corticobulbar lesions. AB - The auditory postauricular response is an evoked "microreflex" that is generated in the posterior auricular muscle. This potential, which has two prominent components at latencies of 12 and 16 msec, is best recorded with neck extensor or facial muscles under tension, but it is not recorded if scalp muscles are relaxed. We describe markedly enlarged postauricular responses after upper motor neuron lesions above the foramen magnum. PMID- 3969222 TI - Nomifensine exacerbates orofacial dyskinesia in hypothyroidism. PMID- 3969223 TI - Measures of violence. PMID- 3969224 TI - Blepharospasm due to unilateral diencephalon infarction. PMID- 3969225 TI - Temporal lobe epilepsy and the Bear-Fedio personality inventory. PMID- 3969226 TI - Blink rate as clinical indicator. PMID- 3969227 TI - Other reports of pilomotor seizures. PMID- 3969228 TI - Temporal lobe encephaloceles: etiology of partial complex seizures? PMID- 3969229 TI - Management of chronic pain. AB - Pain is an unpleasant, subjective experience which escapes objective measurements. It is the normal response to the disruption of healthy tissues, but its persistence beyond the period of healing should alert the practitioner to other unrecognized causes. On the other hand, learned pain is a condition resulting mainly from socio-emotional factors in the absence of progressive, invasive and, most of the time, demonstrable pathology. The key to success in the management of a painful condition is an accurate diagnosis followed by appropriate intervention and treatment. A complete history and a detailed physical examination, complemented by ancillary laboratory tests and consultations, when necessary, offer the best approach to initial management. This article discusses the pathophysiology of pain, the diagnostic approach and therapeutic interventions for evaluation and management of pain patients. The role of multiple factors as reinforcers of pain behavior deserves careful attention, and a comprehensive, multi-disciplinary approach may be indicated in selected cases. PMID- 3969230 TI - Invasion of privacy. PMID- 3969231 TI - Intrauterine fetal death in twins after 32 weeks of gestation. AB - A retrospective review of the outcome in multifetal pregnancies from January 1, 1980 to July 31, 1983 was undertaken to evaluate the role of nonstress test, followed by contraction stress test when indicated, in reduction of intrauterine fetal deaths in twins after 32 weeks of gestation. Of the 90 twin pregnancies managed under the authors' protocol, there were no intrauterine fetal deaths. Intervention leading to delivery occurred in six twin pregnancies with an abnormal nonstress test followed by an equivocal or positive contraction stress test. The authors believe that routine use of weekly nonstress tests after 30 weeks of gestation coupled with contraction stress tests when indicated, and use of other parameters of fetal assessments such as ultrasound, intrauterine fetal death in twin gestation after 32 weeks of gestation, can be significantly reduced. PMID- 3969232 TI - Blood and total fluid content of menstrual discharge. AB - Twenty-eight regularly menstruating female volunteers made careful collections of their sanitary pads and tampons on a daily basis throughout one menstrual period in such a way that the total fluid volume of the menstrual discharge could be accurately measured independently of the blood loss. The percentage contribution of blood (equivalent to mixed venous blood from the cubital fossa) to the total varied very greatly from woman to woman (1.6 to 81.7%) with a mean of 36.1 +/- 3.6% (+/- SEM). There was a highly significant correlation between total fluid loss and blood loss (r = 0.911, P less than .001). The proportion of blood remained approximately the same for different total volumes and on different days of the cycle. Women using no contraception or who had undergone tubal sterilization had similar ratios of blood to total fluid loss, whereas intrauterine device (IUD) users had a higher ratio (P less than .025) and oral contraceptive users a lower ratio that just reached statistical significance (P less than .05). It seems probable that the major component of the fluid loss that cannot be accounted for by blood is from endometrial tissue fluid rather than vaginal or cervical secretions. PMID- 3969233 TI - Reactions to emergency hysterectomy. AB - The recovery from emergency hysterectomy of 18 Chinese patients is described. During the recovery period, patients experienced fear, depression, anger, doubt, selfreproach, and multiple somatic complaints without physical origins. Sexual activity was reduced. The recovery course was particularly difficult for those patients who were nonsymptomatic before operation, those who still wanted to bear more children, and those who lacked family support. These women needed continuous reassurance and ample opportunities to ventilate their feelings. None of the patients had psychiatric sequelae requiring expert consultation after the operation. It is emphasized that the reactions and needs of these patients deserve recognition, attention, and follow-up. PMID- 3969234 TI - Discordant human chorionic gonadotropin results: causes and solutions. AB - This study was performed to demonstrate the phenomenon of discordant human chorionic gonadotropin (hCG) results, in which some serum specimens are positive in one hCG detection procedure but negative in another procedure. Nine different quantitative hCG procedures were used to document discordant hCG results in 22 cases. A two-site monoclonal antibody immunoradiometric assay had the least tendency to give aberrant low-positive hCG values in nonpregnant patients without neoplasms. Potential causes of discordant hCG results are discussed, and guidelines for dealing with them are suggested. Recommended approaches include analysis in an alternate hCG detection procedure that uses a different technology for collection of antigen-antibody complex, dilution analysis, and sequential hCG analysis. PMID- 3969235 TI - Pessary test in women with urinary incontinence. AB - Thirty women with urinary incontinence underwent detailed preoperative and postoperative clinical and urodynamic evaluation before and after the pessary test. The urodynamic changes observed with the pessary test (P less than .01) were very similar to those seen after corrective incontinence surgery. The pessary test differentiated patients with bladder instability from those complaining of stress urinary incontinence with a correctable anatomic defect. Pre- and postpessary test voiding urethrocystometry and uroflometry demonstrated absence of urethral obstruction to the free flow of urine. The pessary test is a simple, inexpensive, reliable diagnostic and prognostic tool. It simulates the results of anticipated incontinence surgery and restores continence without causing compression of the urethra as does the Bonney test. PMID- 3969236 TI - Laboratory reliability of the Papanicolaou smear. AB - Variation in clinical cytology diagnoses was examined at the microscope and in the cytology laboratory as a unit. Results provide preliminary information about the comparability of cytologic diagnosis under specified conditions. In onsite proficiency testing using "normed" smears with a wide range of findings, 814 individual cytotechnologists and cytopathologists from 306 laboratories in 44 states made the target diagnosis in 63.8% of 8929 cases. False negative diagnoses were made in 7.5% of 4520 smears with moderate dysplasia through frank malignancy, and false positive diagnoses were recorded in 8.9% of 3808 smears with no more than benign atypia. Evaluation of a sample of actual work output from two laboratories showed 3.2 to 3.4% false positive and 4.8 to 11.2% false negative diagnoses on the cases rescreened. PMID- 3969237 TI - Immediate versus delayed hysterectomy for endometrial carcinoma: surgical morbidity and hospital stay. AB - Presented is a retrospective review of the intraoperative complications, postoperative morbidity, and length of hospitalization in 138 patients with stage I endometrial carcinoma treated at Yale-New Haven Hospital from January 1, 1977 to December 31, 1981. One group (stage IA, grade 1) was treated with surgery alone; two groups were treated with preoperative intracavitary radium, followed with either an immediate or a delayed hysterectomy. The three groups were comparable in age, weight, and major preoperative medical problems. The mean estimated blood loss during surgery and transfusion requirements during hospitalization were similar for all three groups. The duration of the surgery in the immediate group was longer than the other two groups. The occurrence of febrile morbidity and major postoperative complications in the three groups was similar, except for bacteriuria, which was significantly more common in the immediate group. The length of the postoperative hospitalization was the same for each group; however, the delayed group as compared with the immediate group had a total hospitalization of two days longer. Hence, in the current study, immediate hysterectomy did not significantly increase the surgical or postoperative morbidity rate, compared with delayed hysterectomy. The single hospital stay in the former treatment group represented cost containment. PMID- 3969238 TI - Paraaortic lymph node radiotherapy in cancer of the uterine corpus. AB - From 1973 through 1982, 48 women received 4500 to 5075 rads to the paraaortic lymph nodes as part of their primary management for cancer of the uterine corpus. One patient developed severe enteric morbidity. Five-year survival rates were 52% in the total group, 57% in clinically staged patients, and 47% in surgically staged patients. Patients with surgically confirmed pelvic lymphatic spread had a five-year survival rate of 67%. Patients with surgically confirmed paraaortic spread alone or pelvic and paraaortic spread had five-year survival rates of 47 and 43%, respectively. Eighty-eight percent of recurrences were outside of the radiation portals. In contradistinction to much of the last decade's literature, radiation therapy has salvaged a substantial fraction of patients with nodal metastases, and morbidity rates have been acceptable. PMID- 3969239 TI - Persistence and distribution of estrogen receptor in advanced epithelial ovarian carcinoma after chemotherapy. AB - Estrogen receptor in tumor cytosol extracts from primary ovarian adenocarcinomas and/or from their metastatic foci was measured for determination of whether or not estrogen receptor content is preserved after chemotherapy. Tumor tissue was analyzed from 36 patients who had not received chemotherapy and from 16 patients after varying periods of chemotherapy. The percentages of relatively estrogen receptor-rich tumors (with more than 35 fmol estrogen receptor per milligram soluble protein, or with more than 1200 fmol estrogen receptor per gram tissue wet weight) were similar in the two groups (31 and 37%). In three of four patients who had specimens analyzed both before and after chemotherapy, there was little difference between the levels of estrogen receptor in the initial sample and in samples taken after ten to 32 months of chemotherapy. In one patient, a decrease in the amount of receptor after chemotherapy appeared to be related to the sampling technique used. There was no discernible effect of treatment on the prevalence or amount of estrogen receptor in metastases. No correlation was observed between estrogen receptor levels and the histologic type or grade of the tumor or the patients' survival. The data suggest that chemotherapy has little effect on measurable receptor levels in ovarian epithelial carcinomas. When present in one tumor site, receptor can be expected to be present in a majority of other sites in the same patient. PMID- 3969240 TI - Ovarian carcinoma: a multivariate analysis of prognostic factors. AB - Five hundred and fifty six women with invasive epithelial ovarian carcinoma were assessed for postoperative treatment between 1966 and 1976. The records of this group were reviewed retrospectively. Sixteen characteristics of the patient and tumor were analyzed for prognostic significance by univariate and multivariate techniques. Tumor grade, the presence of residual disease, and patient performance status are identified as stage-specific independent prognostic factors. These independent factors define patient subsets with good, intermediate, and poor prognosis within each stage. The results show that more effective treatment strategies are required for patients in poor prognosis subsets. Estimates of tumor grade, extent of residual disease, and performance status should be included in reports of treatment outcome. PMID- 3969241 TI - Cytologic diagnosis of endometrial adenocarcinoma using the Endo-pap sampler. AB - Six hundred ambulatory women were screened with the Endo-pap cytology sampler in two medical centers. None of the women developed complications from the use of the instrument. Their smears were routinely processed together with cervical cytology smears. One hundred fifty-three of these women had a tissue diagnosis by endometrial biopsy, dilatation and curettage, or hysterectomy. Adequate cytology specimens were obtained in 93% of these patients. In these 153 patients, 32 (18%) had a tissue diagnosis of endometrial adenocarcinoma, and 31 patients had a tissue diagnosis of endometrial hyperplasia. The cytology samples obtained with this device were diagnostic of endometrial adenocarcinoma in 30 (94%) of these 32 patients and ten (32%) of the patients with endometrial hyperplasia. Two patients (1.6%) were diagnosed falsely positive. The Endo-pap cytology sampler is considered a safe and effective screening tool for endometrial adenocarcinoma. Its value in diagnosing endometrial hyperplasia remains to be determined. PMID- 3969242 TI - Obstetric forceps pad designed to reduce infant trauma. AB - The use of the standard obstetric forceps has been associated with varying degrees of maternal and fetal trauma. To reduce the degree of skin markings, a pliable polyurethane pad with selfadherent backing has been designed, which can be applied to each blade of the forceps. One hundred five neonates who required forceps-assisted deliveries were observed for evidence of skin trauma immediately after delivery and again at 24 hours. Padded forceps significantly reduced craniofacial visible skin markings when compared with the skin markings produced by the unpadded forceps. The addition of the pad to the forceps blade had no adverse effect on the mother, and obstetricians encountered no problems in the application and use of the pads. PMID- 3969243 TI - Hepatic rupture associated with pregnancy: treatment with transcatheter embolotherapy. AB - Spontaneous rupture of the liver associated with pregnancy is a rare and very serious complication, usually occurring in association with eclampsia or preeclampsia. Survival has generally been dependent on early recognition of characteristic signs and symptoms and prompt surgical intervention. Even with surgery, maternal mortality approaches 40% and fetal mortality is even higher. The diagnosis can usually be firmly established based on the clinical and radiographic findings presented in this article. Reported is a patient with hepatic rupture successfully treated by transcatheter embolization of the hepatic artery. It is the authors' belief that if such a patient is clinically stable enough to undergo angiography, then transcatheter embolotherapy is a reasonable alternative to surgery. PMID- 3969244 TI - Unusual mullerian anomalies associated with distal extremity abnormalities. AB - A 13-year-old girl was evaluated with nonfamilial mullerian anomalies consisting of bilateral blind uterine horns, a separate cervical remnant, and total vaginal agenesis. The observed musculoskeletal abnormalities of the distal extremities differed from those usually associated with both nonfamilial mullerian agenesis (Rokitansky-Kuster-Hauser syndrome) and the familial syndromes associated with mullerian anomalies. The pattern of mullerian dysgenesis is unusual in that the entire vagina is absent and a cervical remnant separate from the two blind uterine horns is present in the midline in the normal course of the paramesonephric ducts. PMID- 3969245 TI - Ingredients of survival: breast self-examination. AB - Most women perform breast self-examination poorly. A method is described to assist the patient in overcoming fear and gaining confidence through demonstration and daily practice at home. PMID- 3969246 TI - What matters is what is left inside not what is removed: how about twins? PMID- 3969247 TI - The fetal heart rate W-sign. PMID- 3969248 TI - Autoimmune phenomena and endometriosis. PMID- 3969249 TI - The right to die: your rights, your patient's rights. PMID- 3969250 TI - The elements of malpractice. PMID- 3969251 TI - Is Ohio heading for another malpractice crisis? PMID- 3969252 TI - Defensive medicine. Health care with a pricetag. PMID- 3969253 TI - Community hospital's experience with penile prosthesis. PMID- 3969254 TI - Hemipelvectomy for neoplasms not originating in the pelvis. AB - 10 patients underwent hemipelvectomy, mainly for sarcomas originating high in the thigh, or melanomas and epidermoid carcinomas metastatic to the groin. 1 patient died postoperatively, 3 lived 5-12 years and 1 died of unrelated cause 2 years after the operation, all free of recurrence. Tumors treated successfully were large and with indolent locoregional growth, often despite repeated unsuccessful local treatment attempts. These tumor characteristics should be considered as favorable features, in selecting such patients for hemipelvectomy. Conversely 3 patients with melanoma had short history before and died soon after the operation, contraindicating hemipelvectomy in locally advanced melanoma. PMID- 3969255 TI - Colon adenocarcinoma-associated nuclear antigens. AB - Colon adenocarcinoma-associated chromosomal nonhistone proteins were determined in rat colon adenocarcinoma chromatin and in colon chromatin of Sprague-Dawley rats treated with 1,2-dimethylhydrazine (DMH) by the enzyme-linked immunosorbent assay method. The specific nuclear proteins are tissue-specific oncofetal antigens. They were also detected in fetal rat colon chromatin but not in adult rat colon chromatin. The specific tumor-associated nonhistone proteins were identified by immunoblot. The molecular weight ranges of these proteins were 79,000-89,000 and 40,000-56,000 daltons. Administration of DMH to Sprague-Dawley rats induced colon tumor and colon tumor-associated nonhistone proteins in the chromatin. However, DMH failed to induce colon tumor and tumor-associated nonhistone proteins in Lobund-Wistar rats. PMID- 3969256 TI - Characterization of human adenomatous polyps of the colorectal bowel by means of DNA distribution patterns. AB - 64 human adenomatous polyps of the colorectal bowel were investigated by histological examination and by flow cytometrical analysis providing DNA distribution patterns. The histological investigation yielded tubular adenomas (TA) in 41 and tubulo-villous adenomas (TVA) in 23 cases. Epithelial dysplasia or carcinomatous degeneration was found in 23 TA and in 11 TVA. Cell cycle stage analysis revealed no different values for TA and TVA without dysplasia, neither for TA and TVA with mild to moderate dysplasia. TVA with severe dysplasia exhibited a significantly higher proportion of cells with G2M phase DNA content than cases without dysplasia or mild to moderate dysplasia. TA and TVA without dysplasia were characterized by diploid DNA distribution patterns. TA with dysplasia showed aneuploid DNA stem lines in 4 of 20 cases, carcinomas arisen from TA in all 4 cases investigated. TVA with dysplasia were characterized by aneuploid DNA stem lines in 1 of 8 cases, carcinomas arisen from TVA in all 4 cases examined. It may be concluded that the DNA distribution patterns do not attribute different biological values to TA and TVA, 2 groups of adenomatous polyps which are characterized by different histological criteria. PMID- 3969257 TI - Hormonal and chemotherapeutic treatment of prostatic carcinoma; Dunning adenocarcinoma of the prostate in Copenhagen-Fischer rats. AB - The relative efficacy of hormonal, chemical, or combined therapy was investigated in a prostate cancer animal model. 96 Copenhagen-Fischer hybrid rats were implanted with equal-sized fragments of the Dunning H strain transplantable prostatic adenocarcinoma. These animals were randomly assigned to 1 of 6 treatment groups: (1) control, (2) testosterone, (3) testosterone followed by cyclophosphamide, (4) cyclophosphamide, (5) orchiectomy or (6) orchiectomy followed by cyclophosphamide. Animals in the control group had the shortest survival, fastest tumor growth rate, and largest tumor size. Testosterone, when compared to the control group, did not accelerate tumor growth. Cyclophosphamide alone, orchiectomy alone, cyclophosphamide plus orchiectomy, and testosterone plus cyclophosphamide were each equally effective in decreasing tumor growth rate. Tumor size in the testosterone plus cyclophosphamide-treated animals was equivalent to that in orchiectomized animals. The survival of all groups treated with cyclophosphamide was reduced because of toxicity. Testosterone administered prior to cyclophosphamide eliminated and shortened survival from cyclophosphamide. The best overall results were obtained by orchiectomy alone, orchiectomy plus cyclophosphamide, and testosterone plus cyclophosphamide. Although chemotherapy alone was effective in shrinking tumor size, it was highly toxic. PMID- 3969258 TI - Relative value of oestrogen receptor assay, lactoferrin content, and glucose-6 phosphate dehydrogenase activity as prognostic indicators in primary breast cancer. AB - Oestrogen receptor content, lactoferrin, hexokinase, and glucose-6-phosphate dehydrogenase levels were measured in cytosol from 25 primary breast cancers and 3 fibroadenomas. Both hexokinase and glucose-6-phosphate dehydrogenase activity were higher in malignant tissue as compared to benign breast lesions. Oestrogen receptor concentration and lactoferrin content failed to predict the development of metastatic disease, while glucose-6-phosphate dehydrogenase activity was significantly higher in cytosol from those tumours which subsequently metastasized compared to those which remained localized. PMID- 3969259 TI - Indocyanine green angiography of submacular choroidal vessels in the human eye. AB - Indocyanine green angiograms of the macular region in 40 human eyes were evaluated in order to demonstrate the characteristics of the circulatory patterns of the submacular choroid. During both the early and the late phases of choroidal fluorescence nonuniform fluorescence was found. This implies the existence of watershed zones between choroidal arteries and between choroidal veins. A horizontal line running through the fovea was found to form a boundary between arterial systems, and also, in the majority of cases, between venous system. PMID- 3969260 TI - Retinal detachment during glaucoma therapy. Review. A case report of an occurrence of retinal detachment after using membranous pilocarpine delivery system [Pilokarpin lameller (Ocusert) 11 mg]. AB - Miotic-induced retinal detachment (RD) is a condition that is not recognized as such by common consent. Clinically it has been shown that all miotic agents, whether strong or weak, can precipitate an RD, if there are additional contributing factors like high myopia, peripheral lattice degeneration of the retina, pathological vitreoretinal changes and previous history of an RD in the other eye, which all increase the basic risk of RD. Pilokarpin lameller 11 mg represents a form of miotic therapy having initially only a moderate accommodative and miotic effect, which further declines to a level of steady state during the next hours. Because the time interval after which a new Pilokarpin lameller unit is required lasts up to 1 week, the total amount of accommodation and miosis is much smaller than when applying daily 2% pilocarpine drops. However, it seems important, before the start of any kind of miotic therapy, to perform a careful examination and management of virtually all detachment-prone patients. This case report deals with an RD which occurred after 2 days of treatment with Pilokarpin lameller (Ocusert) 11 mg in a myopic patient who had a juvenile type of glaucoma and previous history of an RD in the other eye. PMID- 3969261 TI - Light and electron microscopical study of the conjunctiva in sicca syndrome. AB - Conjunctival biopsies of 11 patients with sicca syndrome were studied under light and transmission electron microscopy. The notable findings were vasculitis of the conjunctival vessels. There were severe changes in the microvilli, namely a loss of microvilli and decrease in their height, measuring approximately 1,000-2,000 A, in comparison with microvilli of the control conjunctiva, measuring 4,000 A in height. There was no branching yet or fusion of microvilli. PMID- 3969262 TI - [Incomplete central vein occlusion. A clinicopathologic case report]. AB - A 71-year-old patient died 4 weeks after the occurrence of incomplete occlusion of the central retinal vein. Histology of the two bulbi was compared with the photographic and fluorescenceangiographic findings of the fundus. Histologic evaluation showed that the occlusion had been caused by a thickening of the vein wall due to proliferation of fibrocytes and histiocytes just behind the lamina cribrosa. There were no signs of phlebitis or thrombosis. PMID- 3969263 TI - Quantitative monitoring of fundus changes. AB - The proposed method allows to discover and quantify small changes in series of fundus photographs which are normally not directly comparable. The principle of geometric conformality of small parts between the fundus and its photographs is developed into a practical method of stereoscopic measurement, numerical adjustment and quantitative evaluation. Very high accuracy is possible without special conditions on repeated fundus photography. The aim is to create a theoretical and methodical basis for ophthalmoscopic change detection with image processing computers. PMID- 3969264 TI - Desmoid tumor in the maxillary sinus: a case report. AB - Desmoid tumor in the maxillary sinus is a rare condition. The present case occurred in a 37-year-old male complaining of left nasal obstruction and dull pain in the nape of the neck. The clinical picture, pathology, diagnosis and prognosis are discussed and the literature is reviewed. PMID- 3969265 TI - Benign pedunculated tumours of the hypopharynx. 3 case reports, 1 with late malignant transformation. AB - Benign pedunculated tumours of the hypopharynx are very rare. Only a few cases of hypopharyngeal fibrolipomas have been reported. This paper adds 2 more cases with characteristic clinical features. We also present a case of recurrent fibromatous tumours of the hypopharynx with malignant change after 20 years. Malignant transformation of an originally benign hypopharyngeal tumour is extremely unusual. The clinical and pathological aspects of pedunculated benign tumours of the hypopharynx are discussed. Symptoms and signs are few and uncharacteristic. The diagnosis is difficult and often delayed. There is a risk of suffocation by laryngeal obstruction by the tumour. When the accurate diagnosis is established, the treatment of choice should be a lateral pharyngotomy with complete removal of the tumour. Long-term follow-up is recommended. PMID- 3969266 TI - Speech discrimination in advanced otosclerosis following stapedectomy. AB - This paper studies the changes in speech discrimination following stapes surgery in patients with advanced otosclerosis. Two thirds of these patients showed a postoperative improvement in the discrimination score with obvious correlation with closure of bone-air gap. The results were slightly worse in comparison to those obtained on otosclerotic patients with good bone conduction. In advanced otosclerosis even a minimal impairment in bone conduction and/or an incomplete closure of the gap interfere with discrimination. PMID- 3969267 TI - Protective effect of fosfomycin against aminoglycoside ototoxicity. AB - The protective effect of fosfomycin against aminoglycoside (dibekacin)-induced ototoxicity was studied in rats. Rats were injected with 100 or 50 mg/kg of dibekacin with or without 500 mg/kg of fosfomycin for 60 or 120 consecutive days. Inner ear damage appeared to be more reduced histopathologically in animals given both dibekacin and fosfomycin than in animals given dibekacin alone. Similarly, renal damage appeared to be reduced histopathologically and functionally by the combined administration of dibekacin and fosfomycin. The mechanism of reduced ototoxicity may be as follows: fosfomycin inhibits the accumulation of dibekacin in the kidney, and reduces its concentration in the kidney and serum. Consequently, the amounts of dibekacin reaching the inner ear are decreased, and ototoxicity is reduced. PMID- 3969268 TI - Quantitative measurement of smooth pursuit using a continuously changing sinusoidal wave in normal subjects. AB - In order to examine the frequency of a target wave and induced eye movements we designed and developed a new target wave (continuously changing sinusoidal wave). This target wave consisted of 20 sinusoidal waves from 0.1 to 2.0 Hz with 10 degrees amplitude (peak-to-peak amplitude is 20 degrees). Several parameters were calculated quantitatively with a microcomputer in normal subjects, and the following conclusions were obtained: The amplitude gain (peak-to-peak amplitude of eye movements/peak-to-peak amplitude of the target wave) and the retinal error velocity were appropriate parameters for representing the input and output of smooth pursuit. The limit of smooth pursuit was 1.2 Hz. PMID- 3969269 TI - Efficiency and limitations of the upper airway mucosa as an air conditioner evaluated from the mechanisms of bronchoconstriction in asthmatic subjects. AB - To elucidate a limit to the efficiency of the upper airway mucosa as an air conditioner, the temperatures of the inspiratory air and mucosa were measured in the cervical trachea. Both of them were affected only minimally by change of atmospheric air temperature during resting nose breathing, but were affected greatly by change of mode of breathing. During hyperventilation through the mouth, when the atmospheric air temperature was 1 degree C, a temperature difference of 9 degrees C was noted between inspiratory air in the cervical trachea and body temperature, together with a mucosal temperature fall by 1.86 +/ 0.61 degree C. Wearing of a mask caused a rise of 3 degrees C in the inspiratory air temperature in the cervical trachea. PMID- 3969270 TI - Symposium on the anterior cruciate ligament, part I. PMID- 3969271 TI - Acute repairs of the anterior cruciate ligament--past and present. AB - This article begins with a discussion of the anatomy, mechanism of injury, diagnosis, and natural history of untreated anterior cruciate ligament tears. The patient selection criteria and the present technique for repair of the anterior cruciate ligament are then described. PMID- 3969273 TI - Augmentation of acute rupture of the anterior cruciate ligament. AB - Acute repair and augmentation of anterior cruciate ligament rupture is indicated in the active individual who is going to place excessive demands on the knee. Repair of any other ligament injury with the addition of augmentation of the anterior cruciate ligament repair provides a better chance for functional stability and lessens the incidence of secondary meniscal injury. PMID- 3969272 TI - Treatment of acute anterolateral rotatory instability. AB - This article provides an account of the experience at the Hughston Orthopaedic Clinic in diagnosing and treating acute anterolateral rotatory instability of the knee. Clinical evaluation, surgical exposure and repair, and postoperative rehabilitation are detailed, with emphasis on an integrated approach to treatment, with the goal of restoring stability and function to the injured knee. PMID- 3969274 TI - Blood supply to the anterior cruciate ligament and supporting structures. AB - The blood supply to the knee arises from a vascular plexus that surrounds the joint. The descending genicular artery, the medial and lateral inferior genicular arteries, the medial and lateral superior genicular arteries, the middle genicular artery, and the anterior and posterior tibial recurrent arteries contribute vessels that supply the various structures of the knee. The intra articular soft tissues of the knee (the infrapatellar fat pad and synovium) mediate the blood supply to the cruciate ligaments, and preservation and utilization of these tissues should be considered when repair or reconstruction of the anterior cruciate ligament is being performed. PMID- 3969275 TI - Embryology, anatomy, and function of the anterior cruciate ligament. AB - Our basic science knowledge predicates all enlightened discussions of anterior cruciate ligament morbidity and the principles of its reconstruction. To provide a framework for this symposium, the salient anatomy, embryology, and biomechanical functions of this complex structure are presented. PMID- 3969277 TI - The classification of knee ligament instability. AB - In summary, this classification and the clinical tests that accompany it are presented to help clarify a commonly used language for these instabilities. The clinical examination of the knee is based on the anatomy; if one grasps the anatomy, functions, and rotations, one can comprehend the knee joint. PMID- 3969276 TI - Mechanism of injury and pathology of anterior cruciate ligament injuries. AB - The strides made in the last decade, such as contributions of Noyes and colleagues (secondary restraints), and Cabaud and coworkers (augmentation), Arnoczky and associates (microvascularity), and Peterson (elimination of the cross-body block), are enormous. An appreciation of the mechanics and pathology of the acute ACL injury is essential in the management of the acute and/or chronic ACL-deficient knee. This knowledge is helpful, as it relates to the blood supply, the secondary restraints, the role of augmentation, and injury prevention. A broad spectrum of recent research has been productive and is clinically applicable to our practice of sports medicine. PMID- 3969278 TI - [New possibilities in consulting psychiatry]. PMID- 3969279 TI - [Heavy metal pneumoconiosis]. PMID- 3969280 TI - [Pancreatic pseudocyst causing colon stenosis]. PMID- 3969281 TI - [Fatal dose of paraquat]. PMID- 3969282 TI - [Ethical implications of alternatives to induced abortion and corrective surgery]. PMID- 3969283 TI - [Clinical and epidemiological study of patients with deep vein thrombosis (1973 1982)]. PMID- 3969284 TI - [Cholescintigraphy in the diagnosis of biliary reflux after esophageal and gastric operations]. PMID- 3969285 TI - [Pregnancy risk in physically handicapped women]. PMID- 3969286 TI - [Bartter syndrome]. PMID- 3969287 TI - [Surgical treatment of aneurysm of the ascending aorta]. PMID- 3969288 TI - [Use of Nifedipine (Corinfar) in hypertensive emergencies]. PMID- 3969289 TI - [Spontaneous perforation of the choledochus in adults]. PMID- 3969290 TI - [Mycoplasma causing puerperal fever]. PMID- 3969291 TI - The radiographic clues in the diagnosis of bone dysplasias. PMID- 3969292 TI - Causes of congenital unilateral pulmonary hypoplasia: a study of 33 cases. AB - A review of the roentgenograms and clinical records of 33 children with primary congenital underdevelopment of one lung showed that 9 patients had simple pulmonary hypoplasia, 8 had anomalous venous return to the right atrium or the inferior vena cava (scimitar syndrome), 7 had an absence of the ipsilateral pulmonary artery, 7 had an accessory diaphragm, and 2 had a pulmonary sequestration adjacent to a small diaphragmatic hernia. PMID- 3969293 TI - Normal radiographic heart volume in the neonate. 3. Comparison with the cardiothoracic ratio. AB - The diagnostic power of the heart volume and the cardiothoracic ratio in congenital heart disease in neonates has been compared. A consecutive series of 130 children with suspicion of heart disease examined radiologically at between 48 h and 15 days of age were followed for 14 +/- 10 months. Of these, 16 (12%) were diagnosed as having congenital heart disease. The number of false positive and negative diagnoses was less for heart volume than for cardiothoracic ratio using +2 SD as limit for pathology. Accuracy, sensitivity and specificity was 84, 75, and 85% respectively for heart volume and 73, 57, and 75% for cardiothoracic ratio. Cases that were false positive with both methods were significantly more often examined between 48 and 72 hours of age indicating that the explanation might be a somewhat late closure of the ductus arteriosus. PMID- 3969294 TI - Barium enema findings (? segmental colitis) in four neonates with bloody diarrhea -possible cow's milk allergy. AB - Four neonates with sudden onset of bloody diarrhea and barium enema findings suggestive of segmental colitis are reported. The infants were not very ill and in all four, the condition was self-limiting. An exact etiology for the condition was not determined but in all of the infants a possible association with cow's milk intolerance was suggested. PMID- 3969295 TI - The variable manifestations of dysplasia epiphysealis hemimelica. AB - Dysplasia epiphysealis hemimelica (DEH) is an osteocartilaginous overgrowth involving one or multiple epiphyses or ossification centers, usually in a lower extremity on one side of the body. Characteristically the involvement is hemimelic i.e. either the medial or lateral part of the ossification center is involved. We have studied 24 patients with DEH and are adding 15 new cases to the literature. Because of the variable manifestations of the dysplasia and its different degrees of involvement in the affected children, we have subdivided it into localized, classical and generalized forms. In the generalized form, there is involvement of a whole lower extremity from the pelvis to the foot, and some of these patients show megaepiphyses with enlargement of a whole epiphyseal center, not only its medial or lateral part. We have also described and illustrated other special features of the dysplasia especially the advanced bone age and the metaphyseal and growth plate involvement. PMID- 3969297 TI - Multiple benign mesenchymomata of the chest wall. AB - Chest wall mesenchymoma is a rare benign tumour arising from the ribs and occurring in infants, being usually present from birth. The few previously documented cases have been of solitary tumours. A 6-week-old infant presented with two separate lesions demonstrating specific radiological signs, and on isotope scanning with Technetium MDP a high uptake of the agent was demonstrated. PMID- 3969296 TI - Rectal extrusion of the catheter and air ventriculography following bowel perforation in ventriculo-peritoneal shunt. AB - Ventriculo-peritoneal shunt is frequently carried out in infantile hydrocephalus. The peritoneal shunt has a lower morbidity than ventriculo-atrial shunts and severe complications are uncommon. Abdominal complications include intestinal perforation, shunt migration, inguinal hernia, cerebrospinal fluid pseudocysts and hollow viscus perforation. A few cases of catheter extrusion from the rectum, vagina, umbilicus and urethra have been described. We report a new case of intestinal perforation with rectal extrusion of the catheter associated with a ventriculogram. PMID- 3969298 TI - Fifteen dorsal vertebrae and rib pairs in two siblings. AB - Born to consanguionous parents, two siblings were each found to have fifteen dorsal vertebrae and rib pairs: one had Hirschsprung's disease, the other had a low type of anal atresia. PMID- 3969299 TI - Multisynostotic osteodysgenesis. AB - A sporadic case of multisynostotic osteodysgenesis is reported in a 15-day-old female infant with urogenital abnormalities. The main radiological findings were craniosynostosis, radiohumeral synostosis, femoral bowing and fractures. The typical combination of clinical and radiologic findings allow the ready recognition of this syndrome. Seven earlier cases have been reported, five sporadic and one familial; in two sisters. PMID- 3969300 TI - Abstracts of the 27th annual meeting of the Society for Pediatric Radiology. Las Vegas, Nevada, 6-8 April 1984. PMID- 3969301 TI - Absence of diffusible inhibitor of glutamate dehydrogenase in the hepatocytes of Reye syndrome patients. AB - Hepatic glutamate dehydrogenase (GDH) activity was measured in postmortem specimens obtained from two stage V Reye syndrome patients and in three postmortem specimens of normal human liver. The Reye syndrome specimens showed the hepatic mitochondrial enzyme deficits in GDH and monoamine oxidase activities that are characteristic of Reye syndrome. GDH activity was linear with the amount of supernatant fraction added, both for Reye and normal liver preparations: moreover, the activities of mixtures of Reye and control supernatant fractions were the sums of the activities of the individual components. This means that the activity difference between Reye and normal GDH activity is not due to a diffusible inhibitor in the Reye hepatocytes or to an activator of GDH in the normal control hepatocytes. Serum obtained from six Reye cases during neurologic deterioration was added to normal hepatic GDH preparations to test for a serum inhibitor of FDH. Highly variable effects were found, with two serum samples producing marked inhibition and others showing weak inhibition, no effect, or stimulation of GDH activity. The inhibitor was not removed by charcoal treatment and most of the activity was retained by a 10,000 dalton Diaflo membrane, signifying either that the compound had a high molecular weight or that it was bound to serum protein. We conclude that the decreased activity of GDH in Reye hepatocytes is not due to an intracellular diffusible inhibitor, and that serum effects are quite variable and are not directly related to intracellular changes in GDH activity. PMID- 3969302 TI - Red cell glycolytic intermediates and adenosine triphosphate in preterm infants on the first day of life. AB - Red cell glycolytic intermediates and ATP were evaluated in 47 appropriate for gestational age preterm infants on the 1st day of life who were divided into three groups on the basis of gestational age: 28-30, 31-33, and 34-36 wk. The results were compared to those previously obtained in term infants. The concentrations of glucose-6-phosphate, total triose phosphates, and ATP were significantly higher than in term infants but appeared to be appropriately elevated for the young mean age of the red cell population. The concentration of red cell 2,3-diphosphoglycerate (2,3-DPG) was significantly decreased when compared to term infants and was lowest at 28-30 wk gestation. The content of red cell 3-phosphoglycerate was increased in term infants and was inappropriately elevated for the age of the red cell population at 28-30 wk gestation. This pattern of glycolytic intermediates was suggestive of a young red cell population metabolizing at an increased glycolytic rate with increased flow through the phosphoglycerate kinase step rather than the 2,3-DPG bypass in "normal" preterm infants. Two preterm infants of 28-30 wk gestation with low red cell intracellular pH were also evaluated and had markedly decreased concentrations of red cell 2,3-DPG and ATP and all phosphorylated intermediates distal to the phosphofructokinase reaction, indicative of a cross-over at the phosphofructokinase step secondary to acidosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969303 TI - IgD in human colostrum. AB - Simultaneous colostrum (C) and plasma samples (P) from 14 women, 1 to 5 days postpartum, were examined. Total IgD and specific IgD antibodies to beta lactoglobulin, bovine serum albumin, Bermuda grass, and alpha-gliadin were measured by solid phase radioimmunoassay. The geometric mean concentrations of IgD were 35.8 (range 2.2-410) micrograms/dl for colostrum and 591.3 (range 72 4100) micrograms/dl for plasma. Six subjects had a specific IgD antibody C/P ratio more than 10-fold greater than the total IgD C/P ratio, suggesting enhancement of antibody to a specific antigen in the mammary gland. All six had C/P ratios suggestive of local enhancement of IgD antibody to Bermuda grass, and two met this criterion for enhancement of IgD antibodies to beta-lactoglobulin, bovine serum albumin, or alpha-gliadin. Specimens for these studies were obtained during the peak grass pollen season. Seventeen additional subjects were studied to compare total IgD in colostrum and plasma with total IgG and serum albumin. The mean C/P ratio for IgD (0.055 +/- 0.015) exceeded the C/P ratio for total IgG (0.015 +/- 0.003) or total albumin (0.020 +/- 0.002). For 14 of 17 subjects the colostrum/plasma ratio for IgD exceeded the C/P ratio for albumin or IgG. Data were transformed logarithmically and correlation coefficients calculated. For albumin versus IgG in colostrum, there was a strong correlation, r = 0.865, p = 0.001. This was different from albumin versus IgD, r = 0.489, p = 0.046 and from IgD versus IgG, r = 0.556, p = 0.020. These analyses support a different mechanism of entry of IgD into milk compared to IgG or albumin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969304 TI - The effect in newborn rabbits of overfeeding on fat deposition, gross energetic efficiency, and metabolic rate. AB - Newborn rabbits were overfed by encouraging them to suckle from two lactating does. Rabbits fed in this way (double fed) were compared with littermate controls (single fed) at age 7, 14, and 21 days. The double-fed rabbits gained weight more rapidly and at each age contained a higher percentage of fat than their single fed counterparts. During the 1st wk the double fed rabbits stored some of their extra fat in the cervical and interscapular adipose lobes. Double-fed rabbits utilized their feeds more efficiently than single fed rabbits in that they gained more weight per unit milk intake and their gross energetic efficiency was 10-20% higher. In a second series of experiments oxygen consumption rate was measured in single- and double-fed rabbits at ages 7, 14, 21, and 28 days. The relation between oxygen consumption and body weight were similar. We conclude that rabbits respond to over-feeding with an increased rate of weight gain associated with extra fat deposition, and this is associated with increased energy efficiency. PMID- 3969305 TI - Gestational changes in the germinal matrix of the normal rhesus monkey fetus. AB - To explain the reported predisposition to germinal matrix hemorrhage in premature infants, pathogenetically important morphological features of the germinal matrix should be present in the 3rd trimester and rapidly change near term. Such features were sought in this study of the germinal matrix and its vasculature in normal rhesus monkey fetuses. The matrix cells, glia, ependyma, and capillaries showed no important structural changes during the 3rd trimester. The terminal vein tributaries were greatly enlarged by 148 days, but cellular and collagen support in their walls was minimal at this time. The latter features developed by the final days of gestation. These findings do not support a structural immaturity or specialization of the germinal matrix predisposing to germinal matrix hemorrhage. Our results, therefore, support the recent emphasis on physiological parameters in the pathogenesis and prevention of germinal matrix hemorrhage. PMID- 3969306 TI - Maturation of sucrase-isomaltase complex in human fetal small and large intestine during gestation. AB - Sucrase-isomaltase complex is expressed in human small intestine throughout gestation and in the large intestine between 12 and 30 wk. The molecular form of the enzyme was studied in the brush-border membrane fractions by the immunoblotting method. Before 30 wk of gestation, the enzyme is present only as the high molecular weight prosucrase-isomaltase, while from 30 wk until birth the two subunits are also present. The fetal enzyme, as its proform and as its two subunits, has a faster mobility in sodium-dodecylsulfate polyacrylamide gel electrophoresis, than the adult enzyme (removal of sialic acid residues from fetal enzymes emphasizes this difference). The colonic and the small intestinal fetal enzymes are identical. PMID- 3969307 TI - Biosynthesis of fatty acids by lactating human breast epithelial cells: an evaluation of the contribution to the overall composition of human milk fat. AB - The objective of this study was to characterize the fatty acid biosynthetic pathway of the lactating human breast. Mixed cell populations, obtained by centrifugation of human milk, were enriched in breast epithelial cells by a selective adsorption procedure. Confirmation of the identity of the breast epithelial cells was obtained immunohistochemically. These viable breast epithelial cells incorporated radioactively labeled acetate predominantly into fatty acids with less than 16C atoms. The presence of the two key enzymes characteristic of the medium-chain fatty acid biosynthetic pathway of nonruminants, fatty acid synthetase, and thioesterase II, was demonstrated both qualitatively, by immunohistochemistry, and quantitatively, by enzyme assay. The results indicate that the lipogenic system of the human breast is qualitatively very similar to that of rats, mice, and rabbits, which also secrete milk fats containing medium-chain fatty acids. Quantitatively, however, the mammary fatty acid biosynthetic pathway appears to be less active in humans than in these other species. PMID- 3969308 TI - Rheology of fetal and maternal blood. AB - Rheological parameters were measured in 10 pairs of mothers and newborns. Whole blood viscosity was similar despite a higher fetal hematocrit (47.0 +/- 5.1 versus 35.5 +/- 12.0%, mean +/- SD, p less than 0.05). When the hematocrit of the suspension of red cells in plasma was adjusted to 45%, the viscosity was significantly lower in the fetal blood over a wide range of shear rates (0.52-208 S-1). The main reason for the lower viscosity in the fetal blood was the lower plasma viscosity as compared to the maternal blood (1.08 +/- 0.05 versus 1.37 +/- 0.08 centipoise, p less than 0.05); this in turn was attributable to a lower total plasma protein concentration (4.74 +/- 0.71 versus 6.47 +/- 0.64 g/dl, p less than 0.05). All protein fractions were lower in the fetal plasma. The assessment of red cell deformability by filtration through polycarbonate sieves revealed that the resistance of a fetal red cell was three times higher than that of a maternal red cell in a 2.6-micron pore, but there was no significant difference in resistance for these red cells in 6.9-micron pores. This higher filtration resistance of fetal red cells through the small pores was mainly due to their large volume (115.4 +/- 10.8 versus 93.5 +/- 5.9 fl, p less than 0.001). Measurements on membrane-free hemoglobin solutions indicated that the internal viscosity of these two types of red cells was not different.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969309 TI - The effects of sodium nitroprusside on blood flow and oxygen delivery to the organs of the hypoxemic newborn lamb. AB - Vasodilators are used in newborns under conditions where hypoxia may be prominent. To study the effects of vasodilator therapy on organ oxygen delivery we measured blood flow (using radioactive microspheres) and arterial oxygen content in six chronically catheterized newborn lambs. Cardiac output and its distribution were measured during normoxia, hypoxia (10% O2 and 5% CO2), and hypoxia with a nitroprusside infusion. Hypoxia decreased oxygen content but did not change heart rate, mean blood pressure, or cardiac output. When nitroprusside was infused during hypoxemia, oxygen content and heart rate were not affected, but mean arterial blood pressure fell (39% decrease). During hypoxemia, blood flow increased to the heart, brain, and carcass but decreased to the gastrointestinal tract. When nitroprusside was infused during hypoxemia, blood flow decreased to the heart, brain, kidneys, and carcass. Oxygen delivery (arterial O2 content X blood flow) decreased to the brain as well as to kidneys, stomach, and carcass when nitroprusside was given to the hypoxemic lamb. PMID- 3969310 TI - Quantitative evaluation of the extent of hepatic enzyme changes in Reye syndrome compared with normal liver or with non-Reye liver disorders: objective criteria for animal models. AB - Five enzymes were measured in 50 liver specimens (18 normal liver, 20 Reye liver, 12 diverse liver disorders other than Reye syndrome). The enzymes were: glutamic dehydrogenase (E.C. 1.4.1.3), monoamine oxidase (E.C. 1.4.3.4), lactate dehydrogenase (E.C. 1.1.1.27), D-glucose-6-phosphate dehydrogenase (E.C. 1.1.1.49), catalase (E.C. 1.11.1.6). The Reye syndrome group showed significant decreases in glutamic dehydrogenase (56%) and monoamine oxidase (70%) compared to normal control tissue and these changes were not characteristic of the non-Reye liver disorder group as a whole. Neither catalase nor lactate dehydrogenase appeared to be altered significantly in the Reye or in the abnormal control group compared with normal controls. Thus, only the prominent decreases in the mitochondrial enzyme activities appeared to be highly characteristic of Reye syndrome. Paradoxically, the means of the five hepatic enzymes and the admission levels of two serum enzymes indicative of liver damage (alanine and aspartate aminotransferase) were remarkably similar for both survivors and nonsurvivors of Reye syndrome. PMID- 3969312 TI - Plasma and urinary catecholamines in patients with cystic fibrosis. AB - In 43 patients with cystic fibrosis (age 8-23 yr, 26 boys and 17 girls) attending a summer camp in a mountain rehabilitation center and in 25 parents (heterozygotes) plasma epinephrine, norepinephrine, dopamine and plasma activity of dopamine-beta-hydroxylase were determined as well as the 24-h excretion of the free urinary amines (epinephrine, norepinephrine, dopamine), their O-methylated products (metanephrine, normetanephrine, 3-methoxytyramine) and the urinary phenolic acids (vanilmandelic and homovanillic). Also the metabolic breakdown product of serotonin in urine, the 5-hydroxyindoleacetic acid, was determined. Significantly elevated plasma dopamine (0.03-0.45 nmol/liter for controls versus 1.70-2.21 nmol/liter for cystic fibrosis) and slightly higher plasma norepinephrine levels were found in patients with cystic fibrosis. An increased 5 hydroxyindoleacetic acid excretion was noticed in adolescent patients which correlated with the disease state and the extent of lung involvement. No abnormalities of plasma amine levels were seen in the parents of the patients. Despite controversial results, CF patients seem to have an alteration in catecholamine metabolism which is reflected in higher plasma dopamine levels. PMID- 3969311 TI - Chronic granulomatous disease: uptake and intracellular activity of fosfomycin in granulocytes. AB - In chronic granulomatous disease (CGD) polymorphonuclear leukocytes (PMN) are unable to kill phagocytized catalase-positive bacteria. Therefore, patients with CGD are prone to infections and dependent on antimicrobial agents able to penetrate PMN membranes and to act intracellularly. Owing to their good lipid solubility, trimethoprim/sulfamethoxazole and rifampicin passively diffuse the membrane. In contrast, fosfomycin is transported actively into the cell. In normal PMN, it reaches cellular-to-extracellular ratios of 1.83 after 15 min, in CGD-PMN 2.18 after 30 min. At concentrations between 16 and 200 mg/liter, fosfomycin was able to kill staphylococci surviving within CGD-PMN, thus compensating for the bactericidal deficiency in CGD. A combination of low concentrations of fosfomycin (8 mg/liter) plus rifampicin (0.06 mg/liter) was more effective at the intracellular level than either agent alone. Apart from a stimulation of PMN-chemiluminescence of yet unknown significance, the agent did not interfere with other neutrophil functions. Clinical investigations are indicated to study whether fosfomycin can be added to the small number of antibiotics useful in CGD. PMID- 3969313 TI - The influence of NaCl supplementation on the postnatal development of urinary excretion of noradrenaline, dopamine, and serotonin in premature infants. AB - The present study was designed to investigate the role of noradrenaline (NA), dopamine (DA), and serotonin (5-HT) in the adaptation of premature infants to alterations of sodium balance. Urinary excretion of NA, DA, and 5-HT was measured spectrofluorimetrically in a group of low birth weight premature infants with (group S) and without (group NS) NaCl supplementation. Group NS consisted of 10 infants with a birth weight of 1200-1750 g (mean, 1493 g) and gestational age of 28-31 wk (mean, 30.1 wk). Group S included 10 infants with mean birth weight of 1414 g (range, 1150-1600 g) and mean gestational age of 30.5 wk (range, 27-32 wk). Measurements were made on the 7th day and weekly thereafter until the 5th wk of life. NaCl supplementation was given in a dose of 3-5 and 1.5-2.5 mEq/kg/day for 8-21 and 22-35 days, respectively. In group NS, mean urinary excretion of NA and DA increased from 8.6 +/- 1.5 and 15.8 +/- 2.4 micrograms/day to maximum values of 21.4 +/- 5.5 (p less than 0.05) and 33.4 +/- 6.0 micrograms/day (p less than 0.01) in weeks 2-3, respectively. 5-HT excretion averaged about 60 micrograms/day and showed no consistent change during the course of the study. NaCl supplementation prevented the rise of NA and DA excretion above the initial baseline values. The postnatal course of 5-HT excretion, however, remained unaffected by NaCl supplementation. Urinary excretion of NA in weeks 2-3 (p less than 0.05) and DA in weeks 2-4 (p less than 0.05) were significantly lower in group NS. PMID- 3969314 TI - Prematurity and lecithin-cholesterol acyltransferase deficiency in newborn infants. AB - The occurrence of hyperlipidemia and fat accumulation in certain tissues of premature newborn infants is known. Lecithin-cholesterol acyltransferase (LCAT) catalyzes esterification of free cholesterol and is important in the transport and disposal of lipids. Cord plasma LCAT activity of full-term newborn infants is nearly one-half of that present in the adult plasma. The present study also has found a significant positive correlation between cord plasma LCAT activity and gestational age of the newborn. The ratio of circulating cholesterol ester to free cholesterol was significantly lower only in newborn infants with gestational age less than 32 wk, in comparison to full-term newborn infants or adults. LCAT deficiency and decreased cholesterol ester formation may be responsible for the inadequate lipid clearance in premature newborn infants. PMID- 3969315 TI - The action of dopamine upon brown adipose tissue. AB - We increased the mass of interscapular brown adipose tissue in rats by dietary manipulation ("cafeteria" feeding), cold exposure, or by both. The animals were then used to determine the temperature response of the interscapular brown adipose tissue to dopamine or norepinephrine. These results, and the increase in blood glycerol values, were very similar for either catecholamine. These findings suggest that dopamine may have a role in releasing energy from brown adipose tissue similar to that of norepinephrine in the newborn infant. PMID- 3969316 TI - Cardiac maturation in an hypoxic milieu: implications for arrhythmias in hypoxemic defects. AB - Newborn rabbits were raised in either hypoxic or normoxic environments for 3 months. Data from electrophysiological studies carried out on isolated sinoatrial and ventricular preparations from the two groups show that the hypoxic group had changes in cellular transmembrane electrical activity that could be the basis for disorders of rate and conduction in vivo. This model will be useful to study the etiology and therapy of some arrhythmias seen in cyanotic congenital hypoxemic heart disease. PMID- 3969317 TI - Comparison of anterior cerebral artery blood flow velocity and cerebral blood flow during hypoxia. AB - Measurement of anterior cerebral artery blood flow velocity with a continuous wave bidirectional Doppler was compared with cerebral blood flow (CBF) measured with radioactive microspheres in 11 paralyzed newborn lambs during hypoxic hypoxia. The Doppler probe was maintained in a fixed position during each experiment. The objectives of the study were to validate this noninvasive technique that is being used widely in the clinical setting to qualitatively assess changes in CBF, and to evaluate which of the velocity parameters measured provide the most information. Diastolic velocity (DV), peak systolic velocity (PSV), area under the velocity curve (AUC), and pulsatility index (PI) were examined under conditions of varied arterial oxygen content and compared to microsphere CBF. DV (r = 0.72, p less than 0.001), AUC (r = 0.72, p less than 0.001), and PSV (r = 0.63, p less than 0.001) demonstrated stronger correlations with changes in CBF than did the PI (r = -0.41, p less than 0.05). DV (r = 0.81, p less than 0.001), AUC (r = 0.80, p less than 0.001), and PSV (r = 0.75, p less than 0.001) also exhibited stronger relationships with changes in arterial oxygen content than did the PI (r = -0.36, p less than 0.05). These data demonstrate that changes in cerebral blood flow velocity are useful qualitative measures of changes in cerebral blood flow. However, the utility of this technique is dependent upon a stable probe position, and assessment of the actual velocity measurements (DV, PSV, AUC) rather than simply the pulsatility index. PMID- 3969318 TI - Effects of acidosis on fetal and maternal blood coagulation: a fetal lamb model. AB - The effects of fetal acidosis (mean pH 6.93) on fetal and maternal blood coagulation were measured. Test results from 10 fetal lambs and mother ewes (127 +/- 2 days mean gestation) before and after fetal lactic acid infusions were compared to test results from eight control fetal lambs and mother ewes (127 +/- 3 days mean gestation) before and after control glucose infusion. Significant changes found in acidotic fetal lambs not seen in control fetuses included an increase in the white blood cell count (mean 2800/mm3 before to 3600/mm3 after acidosis; p = 0.0009), a shortening of the thrombin time (mean 17.8 s before to 11.2 s after acidosis; p = 0.0001), and decreases in the activities of factor V (mean 57% before to 37% after acidosis; p = 0.0014) and factor IX (mean 35% before to 29% after acidosis; p = 0.0128). There was also a reduction in the concentration of fibrinogen (mean 147 mg/100 ml before to 125 mg/100 ml after acidosis; p = 0.0492) but no significant changes in the levels of fibrin monomer, fibrinogen/fibrin degradation products, or antithrombin III. In vitro exposure of five different fetal whole blood samples to a pH of 6.9 for 2 h at 37 degrees C did not result in significant changes in any of the coagulation factor activities. A significant decrease in the level of factor V was also found in the mother ewes of the acidotic fetuses (mean 141% before to 113% after acidosis; p = 0.006) and a decrease in the level of maternal factor IX approached significance (mean 119% before to 102% after acidosis; p = 0.0564).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969319 TI - Radioimmunoassay for type I procollagen in growth hormone-deficient children before and during treatment with growth hormone. AB - Type I procollagen concentrations were measured by radioimmunoassay in sera from 14 growth hormone-deficient children before and during 12 months of treatment with human growth hormone. Basal procollagen levels were lower than those of control children and comparable to those of normal adults. With treatment, the mean procollagen level increased into the range of the control children and was significantly greater than the baseline level at 1, 2, 3, and 12 months (p less than 0.01; p less than 0.05). Although there was no significant statistical correlation between the growth velocity during treatment and the serum procollagen level, there was a suggestion that a high basal procollagen may be predictive of a less than optimal response to human growth hormone. PMID- 3969320 TI - Studies on requirements for amino acids in infants with disorders of amino acid metabolism. I. Effect of alanine. AB - Two infants with disorders of propionate metabolism were studied at 7 months of age to determine optimum levels of intake of protein and calories to meet the requirements for essential amino acid for growth in infancy, and at the same time minimize the accumulation of toxic intermediates. An effect of alanine was found that permitted growth at otherwise limiting levels of protein intake. This was not simply an effect of nonessential nitrogen as neither glycine nor glutamic acid could substitute for alanine in this protein-sparing effect. This appears to represent further evidence of the relationship between alanine and the branched chain amino acids and of the importance of the alanine-glucose cycle in human physiology. PMID- 3969321 TI - The metabolic and endocrine milieu of the human fetus and mother at 18-21 weeks of gestation. I. Plasma amino acid concentrations. AB - Plasma levels of 17 amino acids were measured in 10 conscious mothers and their minimally stressed fetuses (mean body weight 302 g) at 18-21 wk gestation. Simultaneous blood samples were taken from the maternal antecubital vein, and from the fetal umbilical vein and artery by fetoscopy prior to termination of pregnancy. The mean concentrations of all amino acids were significantly higher in the fetal (2.26 mmol/liter) than in the maternal (0.96 mmol/liter) circulation, the total molar concentration of amino acids was 2.4 times greater in fetal than in maternal plasma. There was a significant positive relationship between maternal and fetal levels for most amino acids; the mean umbilical concentration difference was significantly positive for glycine, alanine, isoleucine, leucine, phenylalanine, and histidine. PMID- 3969322 TI - Loss of intellectual function in children with phenylketonuria after relaxation of dietary phenylalanine restriction. AB - Fourteen patients with classic phenylketonuria (PKU) were treated with a phenylalanine restricted diet from early infancy. All had satisfactory dietary control, with serum phenylalanine concentrations ranging between 2 to 5 mg/dL. Dietary restriction was discontinued in all these children between ages 5 and 6 years, and a free diet allowed. Developmental testing was performed using the Cattell Infant Intelligence Scales (1 to 2 years), Stanford-Binet Intelligence Scale (2 to 4 years), Wechsler Intelligence Scale for Children (WISC) and the revised version (WISC-R) (less than 5 years). Mean IQ for the group (Stanford Binet and WISC) at termination of dietary therapy was 104 +/- 13. Four to 7 years after discontinuation of dietary therapy, mean IQ for the group was 90 +/- 13. The severity correlated, to some degree, with duration of unrestricted diet, but not with initial serum phenylalanine concentrations, age at initiation of therapy, or IQ at time diet was discontinued. Several children are experiencing difficulties, both attentional and academic, in school. Two children have had a change in the EEG from normal to abnormal. Neurologic testing performed after 4 to 7 years off diet demonstrated deficits in visual-motor integration or cognitive problem-solving in most children. The mean developmental age for the group for perceptual-motor integration was 1.2 years below the mean chronologic age of the group. This deterioration in intellectual function suggests that discontinuation of the phenylalanine-restricted diet is hazardous for some children with classic phenylketonuria. PMID- 3969323 TI - Utilization and morbidity: random or tandem? AB - Earlier studies have shown that one in eight children persist in being high users of health care services over long periods of time and, conversely, about the same proportion of children are consistently low users. As these studies failed to discover reasons for these persistent deviations from average, this study explored three possible explanations: persistent morbidity, mental health problem, and familial patterns of use. Although all three phenomena were associated with both persistence of high utilization of services as well as an overall large number of visits, the number of types of morbidity was the most significant correlate of high use. Children who were constantly low users of services were much more likely to have only a few types of morbidity whereas children who were constantly high users were much more likely to experience a wide variety of types of problems. These findings suggest that an understanding of the demand for health services requires an understanding of the interrelationships of illnesses within individuals rather than a focus on particular illnesses or particular types of illnesses. PMID- 3969324 TI - Physician knowledge and clinical behavior regarding automobile safety for children. AB - A mail survey was conducted in May 1983 of pediatricians and family and general practitioners in San Antonio, TX, to assess their influence on automobile safety of patients. Information on sociodemographic data and personal and professional behavior with respect to automobile safety for children was elicited. A 17-item knowledge index was significantly correlated with physician's own use of seat belts, number of children less than 5 years old, exposure to use of child restraints during residency, clinical behavior (asking about use of child restraints during the first and subsequent well-child visits, instructing parents about automobile safety for children, dispensing literature in the office), being a pediatrician, and being Board certified. Knowledge was inversely correlated with physician's age. Education of parents by physicians about automobile safety for children was infrequent. Only 29% of physicians always or usually ask at the first well-child visit if child restraints are being used. Only 8% of physicians received training during their residencies; this points to a need for educating physicians in automobile safety for children. PMID- 3969326 TI - Are toy guns too dangerous? AB - Toy guns with projectiles may injure young children. A study was undertaken to assess the danger posed by these toys and the regulations governing them. US Consumer Product Safety Commission (CPSC) data indicate that toy guns with projectiles cause relatively few injuries, mostly to young boys. The magnitude of the problem is smaller than that of nonpowder and powder firearms. Most often, toy gun injuries are to the face and eyes. Of the estimated 818 injuries in 1980 and 1981, 2.9% required hospitalization. More than 400 days were lost from school and work, and there were nearly 3,000 days of restricted activity due to these toy gun injuries. The hazard posed by toy guns with projectiles can be reduced through the legitimate regulatory authority of the Consumer Product Safety Commission with minor impact on retail cost, toy industry sales, and the play value of the toys. The yearly cost to consumers from increased regulation would probably be similar to the annual cost of the injuries. Regulation is warranted to protect young children who use these toys. PMID- 3969325 TI - National Reye syndrome surveillance, 1982. AB - Despite the fact that influenza B was the primary influenza virus strain during the winter of 1981-1982, only 213 cases of Reye syndrome were reported to the Centers for Disease Control (CDC) between Dec 1, 1981 and Nov 30, 1982. This national reported incidence of 0.33 cases per 100,000 children less than 18 years of age is the lowest reported incidence since the Centers for Disease Control began surveillance in 1973. This relatively low incidence probably reflected, at least in part, the fact the influenza B activity was spotty and the illness relatively mild the winter of 1981-1982. The 213 cases were reported from 43 states; and in 56% of the patients, Reye syndrome occurred following a respiratory illness. The mean age of the children was 7.0 years; there were equal numbers of girls and boys; and 93% were white. Of the ten black patients, 80% were less than 1 year of age compared with 9% of the white patients. Of the 208 patients with reported admission stage, 45% were admitted in stage I or 0, a slightly lower proportion than that observed in the previous 2 years. Salicylate levels were obtained in 55% of the patients and were reported as "detectable" in 81% compared with 96% in 1981 (P = .003, chi 2). Of the 200 patients with known outcome, 70 patients died (a case fatality ratio of 35%). PMID- 3969328 TI - Written explanation of temperament scores. PMID- 3969327 TI - Factors affecting head growth and intellectual function in children of drug addicts. AB - The effect of maternal heroin and methadone use on head growth and neurodevelopmental performance was studied in preschool children of untreated heroin addicts (n = 25), women receiving methadone therapy (n = 26), and a drug free comparison group (n = 41) who had been followed from birth. The mean birth head circumference of both groups of drug-exposed infants was significantly below that of the comparison group; however, the only factors determined by multiple regression analysis as associated with head size at birth were maternal nutritional status and birth weight. By preschool age, head size did not differ significantly among groups. The factors associated with postnatal head growth were birth weight, intrapartum risk score, and race. Data show an increased incidence of low-average and mildly retarded intellectual performance in the drug exposed children. Regression analyses demonstrated that amount of prenatal care, prenatal risk score, and home environment were most predictive of intellectual performance and that the degree of maternal narcotic use was not a significant factor. PMID- 3969329 TI - Use of noninvasive tests to predict significant jaundice in full-term infants: preliminary studies. PMID- 3969330 TI - Prediction of digoxin treatment failure in infants with supraventricular tachycardia: role of transesophageal pacing. AB - Transesophageal atrial pacing was used to initiate and terminate tachycardia in 24 infants (seven female and 17 male, aged 1 to 34 days) with ECG documentation of supraventricular tachycardia. Six infants received no chronic treatment, and chronic oral digoxin prophylaxis was administered to 18 infants in an effort to prevent recurrences of tachycardia. In these 18 infants, the effectiveness of digoxin therapy in preventing the initiation of tachycardia by transesophageal pacing was compared with its ability to prevent spontaneous recurrences of supraventricular tachycardia. While receiving chronic oral digoxin therapy, tachycardia could be reinitiated in 15/18 (83%) infants. In these infants, the cycle length of tachycardia and the atrioventricular interval were the same before and during chronic digoxin treatment. Three infants in whom tachycardia could not be initiated during chronic digoxin therapy had no spontaneous recurrences during 6 months of follow-up, whereas 10/15 (67%) infants in whom tachycardia could be reinitiated had clinically significant recurrences in spite of chronic digoxin therapy. Six infants who received no chronic drug treatment had no documented recurrences during 6 months of follow-up. This study demonstrates that digoxin was effective in preventing significant spontaneous recurrences of supraventricular tachycardia in only 8/18 (44%) infants treated with digoxin. The ability to initiate supraventricular tachycardia with transesophageal pacing may be useful in determining which digoxin-treated infants are at risk for recurrence. Finally, not all infants with supraventricular tachycardia require chronic prophylaxis; six of the untreated infants had no documented recurrences. PMID- 3969331 TI - Parent-specific adjustments for evaluation of recumbent length and stature of children. AB - A clinical "parent-specific" method for evaluating recumbent length and stature of children, allowing for the stature of parents, is presented. This method uses midparent stature and allows adjustment of recumbent length (birth to 3 years) and stature (3 to 18 years) of US children relative to National Center for Health Statistics growth charts. The method is based on parent-child relationships for 586 midparent-child pairs participating in the Fels Longitudinal Study, and on more than 16,000 serial measurements of recumbent length and stature. The method provides a clinical tool to separate the normal genetic contribution of parental stature to stature of children from other factors that affect stature such as malnutrition or disease. PMID- 3969333 TI - Palpebral fissure length in black and Hispanic children: correlation with head circumference. AB - Palpebral fissure length and head circumference were measured in 170 black and 170 Hispanic normal children aged 1 month to 16 years. Eye measurement values were compared with those for white children. It was found that black children have longer palpebral fissures than whites and in certain age groups, than Hispanics. A statistically significant correlation between palpebral fissure length and head circumference was established in black children. PMID- 3969332 TI - High-altitude pulmonary edema with absent right pulmonary artery. AB - High-altitude pulmonary edema potentially is fatal. Adults with unilateral absence of a right pulmonary artery are particularly susceptible to high-altitude pulmonary edema. The occurrence of high-altitude pulmonary edema was documented in a child with congenital absence of the right pulmonary artery. Improvement occurred only upon descent to low altitude. Physicians should be aware of this life-threatening condition in children ascending to high altitude, particularly in individuals with unilateral absence of a pulmonary artery. PMID- 3969334 TI - Progressive diaphyseal dysplasia: evaluation of corticosteroid therapy. AB - Progressive diaphyseal dysplasia is characterized clinically by crippling leg pain, fatigue, headache, poor appetite, muscle weakness, and waddling gait. Twelve affected patients, aged 2 years 4 months to 40 years, were treated with intermittent courses of low doses of prednisone given in a single dose on alternate mornings for periods ranging from 6 months to 10 years. The average initial dose of prednisone was 0.6 mg/kg/d, and average maintenance dose was 0.3 mg/kg/d. Relief of all crippling symptoms was achieved in all patients. No untoward serious side effects have been observed, and the growth of children was not slowed. However, corticosteroid therapy should be restricted to patients suffering from crippling pain. The mechanism through which steroids act remains undefined. PMID- 3969335 TI - Value of random urinary homovanillic acid and vanillylmandelic acid levels in the diagnosis and management of patients with neuroblastoma: comparison with 24-hour urine collections. AB - Urinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels were determined in random samples and in 24-hour collections from 13 patients with neuroblastoma and 22 patients without neuroblastoma. Random sample levels were compared with levels in 24-hour collections and showed a positive correlation of 95% for HVA (N = 59) and 93% for VMA (N = 52). No false positives or false negatives occurred using random samples for diagnosis. Nonneuroblastoma (normal) HVA (N = 126) and VMA (N = 119) levels are reported for different age groups. Sequential random HVA and VMA determinations in patients with neuroblastoma during and after therapy are shown. Random urinary HVA and VMA levels are shown to be adequate for utilization in the diagnosis of neuroblastoma and sequential determinations of random HVA and VMA are shown to be helpful in the follow-up of those patients. PMID- 3969336 TI - Premature infants in car seats. AB - Advancements in health care have made it possible for many premature infants weighing less than 2.2 kg (5 lb) to be discharged from the hospital. Medical professionals, however, have no information available from which to make recommendations on which child safety seats are most appropriate for safely transporting the low-birth-weight infant. Current federal safety standards do not specify the minimum weight of an infant for which a seat is appropriate. The suitability of various types of infant car safety seats for premature infants was documented by placing 2.0-kg (4 lb 8 oz) babies in a representative sample of seat models. Ease and ability of the seat to fit the size of the infant and allow for proper positioning of the baby was noted. Each seat was measured from the seat back to crotch strap and shoulder strap to seat bottom to provide a basis for comparison of various seat models. Convertible seats with seat back to crotch strap height of 14 cm (5 1/2 in) or less provided relatively good support for the infant. Seats with longer seat back to crotch strap distances allowed the infant to slouch. Seats with lap pads or shields were uniformly unacceptable. PMID- 3969337 TI - Serious head injury in infants: accident or abuse? AB - The medical records and computed tomography (CT) scans of all children less than 1 year of age admitted to the hospital with head injury over a 2-year period were reviewed. Sixty-four percent of all head injuries, excluding uncomplicated skull fracture, and 95% of serious intracranial injuries were the result of child abuse. The occurrence of intracranial injury in infants, in the absence of a history of significant accidental trauma, such as a motor vehicle accident, constitutes grounds for an official child abuse investigation. PMID- 3969338 TI - Nutrient intakes of formula-fed infants and infants fed cow's milk. AB - Twenty-four-hour dietary intake data from the second National Health and Nutrition Examination Survey (NHANES II), 1976-1980, were analyzed to compare nutrient intakes among infants 7 to 12 months of age who were fed mixed diets containing solid foods and either infant formula or cow's milk. Solid foods fed to the infants in both groups were low in iron and linoleic acid, and high in sodium, potassium, and protein, relative to Recommended Dietary Allowances. Infants who were fed cow's milk received lower median intakes of iron (7.8 mg v 14.9 mg), linoleic acid (1.8 g v 6.1 g), and vitamin C (39 mg v 64 mg), and higher median intakes of protein (41 g v 25 g), sodium (1,000 mg v 580 mg), and potassium (1,630 mg v 1,020 mg) than formula-fed infants. Seventy-five percent of the infants fed cow's milk had iron intakes below the Recommended Dietary Allowance; 69% had sodium intakes above the range of estimated safe and adequate daily dietary intake. Linoleic acid provided less than 3% of energy intake for 74% of the infants fed cow's milk. Differences in nutrient intakes were due not only to different concentrations of nutrients in each of the milk feedings but also to the different amounts and types of solid foods fed to the two groups of infants. PMID- 3969339 TI - Lack of adverse side effects of oral ferrous sulfate therapy in 1-year-old infants. AB - An evaluation was made of 278 healthy-appearing 1-year-old infants who were tested for iron deficiency to determine the relative frequency of adverse side effects attributable to oral iron treatment. After obtaining parental informed consent, laboratory tests of iron status were performed on venous blood and infants with hemoglobin level greater than 10.5 g/dL were randomly chosen to receive 1.2 mL of ferrous sulfate (FeSO4) drops (about 3 mg of iron per kilogram per day) or equal volume of placebo for 3 months. After 3 months of treatment, infants were to return to the clinic for repeat blood testing, compliance estimation, and evaluation for possible adverse side effects. There was no significant difference (P greater than .50) in the frequency of vomiting, diarrhea, or fussiness in iron-treated infants (6%) compared with placebo-treated infants (9%). Constipation was slightly more frequently reported (P = .03) in placebo-treated infants (9%) than in iron-treated infants (1%). Compliance with therapy was confirmed in 179 completely evaluated infants by the lack of remaining medication at 3 months, the higher incidence (P less than .0001) of dark stools reported among iron-treated infants, and the changes in laboratory tests of iron status. No parents reported dark stools as an adverse effect of therapy. It is concluded that once daily, moderate-dose FeSO4 therapy given to fasting 1-year-old infants results in no more gastrointestinal side effects than placebo therapy. PMID- 3969340 TI - Fasgrolia. PMID- 3969342 TI - American Academy of Pediatrics Committee on Hospital Care: Relationship between hospital-based and private practice physicians. PMID- 3969341 TI - American Academy of Pediatrics Committee on Nutrition: Use of oral fluid therapy and posttreatment feeding following enteritis in children in a developed country. PMID- 3969343 TI - Infant bioethics committees. PMID- 3969344 TI - Hyperosmolar oral medication and necrotizing enterocolitis. PMID- 3969345 TI - Overpsychologized. PMID- 3969346 TI - Vitamin K deficiency. PMID- 3969347 TI - Risk factors of diabetic retinopathy. PMID- 3969348 TI - Does statistical significance equal real significance. PMID- 3969349 TI - Effect of phototherapy on albumin binding of bilirubin. PMID- 3969350 TI - Comparison of phototherapy results in small-for-gestational-age and appropriate for-gestational-age infants weighing less than 2,000 grams. PMID- 3969351 TI - Morbidity and mortality associated with exchange transfusion. PMID- 3969352 TI - Neonatal and infant mortality in relation to phototherapy. PMID- 3969353 TI - Metabolic aspects of phototherapy. PMID- 3969354 TI - Ambient light and phototherapy conditions of eight neonatal care units: a summary report. PMID- 3969355 TI - Photodosimeter badge system. PMID- 3969357 TI - An epidemic of perinatal listeriosis serotype 1b in Hispanics in a Houston hospital. PMID- 3969356 TI - Unsuspected bacteremia caused by Branhamella catarrhalis. PMID- 3969358 TI - Transfusion-associated acquired immunodeficiency syndrome in a twin infant. PMID- 3969359 TI - Mycobacterium chelonei abscess. PMID- 3969360 TI - Multiple enteric pathogens in hospitalized pediatric patients with autumn gastroenteritis. PMID- 3969361 TI - Elimination of rubella and congenital rubella from the United States. PMID- 3969362 TI - Ceftriaxone administered once or twice a day for treatment of bacterial infections of childhood. AB - Twenty-six children received a single daily intravenous dose of ceftriaxone, 50 mg/kg, for a variety of bacterial infections including abscess (5), cellulitis (5), periorbital cellulitis (5), bacteremia without focus (4), osteomyelitis (2), pneumonia (2), pyelonephritis (2) and otitis media (1). Organisms isolated from infectious foci were Staphylococcus aureus (9), Streptococcus pneumoniae (6), Streptococcus pyogenes (3), Escherichia coli (2); and Haemophilus influenzae type b, nontypable H. influenzae, Group B streptococcus, Pasteurella multocida, Haemophilus parainfluenzae and satelliting streptococcus (1 each). Microbiologic cure was achieved in 20 of 22 (91%) infections and clinical cure in 25 of 26 (96%). Fifteen possible adverse reactions occurred in 34 patients evaluable for drug safety; most were mild and self-limited. Neutropenia developed in two patients necessitating discontinuation of ceftriaxone in one, followed by prompt resolution. Seventeen children received ceftriaxone, 75 mg/kg/day, in two divided doses for a similar variety of infections. Bacteriologic and clinical cure rates of 100 and 94%, respectively, were demonstrated. Leukopenia developed in one patient and resolved when ceftriaxone was discontinued. Once a day dosing of ceftriaxone in pediatric patients provides greater ease of administration combined with efficacy equal to that achieved with a divided dosage schedule. PMID- 3969364 TI - Man, animals and antibiotic resistance. PMID- 3969363 TI - Ceftriaxone in the treatment of infections caused by Staphylococcus aureus in children. AB - Ceftriaxone is a new parenteral cephalosporin with a prolonged half-life and an expanded Gram-negative spectrum. Before it can be used as a single agent for infections of unknown etiology, its efficacy in treating infections caused by Gram-positive organisms, particularly Staphylococcus aureus, must be proven. Ceftriaxone was administered to 12 children for treatment of infections due to S. aureus alone or in the presence of other organisms. Sites of infection included soft tissue, respiratory tract, bone and joint. Patients received ceftriaxone at 68 to 100 mg/kg/day in two doses for 3 to 20 days. Clinical and bacteriologic responses were satisfactory in all patients. One patient experienced abdominal pain during infusion and another developed a skin rash. Five patients had platelet counts of 500,000/mm3 or greater; four had an eosinophil count of 7% or greater and one patient had transient neutropenia. These abnormalities resolved during or after therapy. Ceftriaxone was a safe and effective single antibiotic for the treatment of infections caused by S. aureus in children. PMID- 3969365 TI - Neonatal septicemia and meningitis in Gottingen, West Germany. AB - Data were analyzed from 181 infants treated for neonatal septicemia and/or meningitis between 1962 and 1974 (n = 88) and between 1975 and 1982 (n = 93). In addition to an increase in the incidence of septicemia (1962 to 1974, 0.88 case/1000 live births (LB)/year; 1975 to 1982, 2.0 cases/1000 LB/year), there was also a change in the pattern of infection. Group B streptococcal infections were first observed in 1975. Infections with Escherichia coli increased (1962 to 1974, 0.25 case/1000 LB; 1975 to 1982, 0.75 case/1000 LB), while those with Pseudomonas aeruginosa decreased (1962 to 1974, 0.15 case/1000 LB; 1975 to 1982, 0.1 case/1000 LB). Although the incidence of meningitis was similar in both time periods (0.5 case/1000 LB), the relative number of cases declined (1962 to 1974, 51 of 88 patients; 1975 to 1982, 23 of 93 patients). Case fatality also decreased during the second time period (1962 to 1974, 53%; 1975 to 1982, 29%). The most common predisposing factors for septicemia were prolonged rupture of membranes (21 of 93 cases) and prematurity (41 of 93). Blood analysis showed that the immature/total neutrophil ratio was more consistently abnormal (60% of the cases) than were total counts of white blood cells, neutrophils or immature neutrophils. PMID- 3969366 TI - Tuberculous epididymitis as a cause of testicular pseudomalignancy in two young children. PMID- 3969367 TI - Fungal peritonitis in children undergoing peritoneal dialysis. PMID- 3969368 TI - Elevated mumps antibody titers in the cerebrospinal fluid suggesting chronic mumps virus infection in the central nervous system. PMID- 3969369 TI - Promotional effects of testosterone and dietary fat on prostate carcinogenesis in genetically susceptible rats. AB - Germfree (GF) Lobund strain Wistar (LW) rats, fed vegetable diet L-485, have developed prostate adenocarcinomas spontaneously (10% incidence) at average age 34 months. Conventional LW rats, implanted with testosterone at age 4 months, developed a higher incidence of prostate cancer after an average interval of 14 months: 24% had developed gross tumors, and 40% when it included microscopic tumors. Preliminary results indicate that testosterone-treated LW rats that were fed the same diet, which was supplemented with corn oil up to 20% fat, developed prostate cancer after intervals of 6-12 months. Aged GF Sprague-Dawley (SD) rats have not developed prostate cancer spontaneously. Conventional SD rats fed diet L 485 and treated with testosterone developed only prostatitis. Experimental designs should consider genetic susceptibility as a basic prerequisite for studies on experimental prostate cancer. PMID- 3969370 TI - DHT in prostate cancer tissue--a guide to management and therapy. AB - In 24 untreated stage D2 prostate cancer patients with prostate DHT levels greater than 2.5 ng/g, 20 initially responded to therapy with partial objective progression (POR) or were objectively stable (OS) for 12 or more months while four patients relapsed in less than 1 year. Of eight patients with prostate DHT levels less than 2.0 ng/g, five had either objective progression or were objectively stable for 6 months or less; two other patients have completed remissions ranging from 16 to 24 months while one patient remains objectively stable for 21 months to date. DHT concentrations were also measured in prostate tissue of patients with advanced prostate cancer in relapse following either DES or castration with or without estrogen therapy. Although castration, medical or surgical, usually leads to DHT concentrations of less than 2.4 ng/g, two out of 20 surgical castrates and four out of nine estrogen-treated patients had values above this level. These differences suggest that (1) increased tissue DHT levels of DES-treated patients may be due to inadequate dosage or decreased compliance, and (2) increased tissue DHT concentrations greater than 2.4 ng/g in castrates suggests an adrenal cortical androgen contribution to the prostate DHT level. These studies suggest that DHT measurements in prostate cancer tissue are of value in predicting response in untreated prostate cancer patients and of directing therapy in patients who are in relapse after orchiectomy or estrogen therapy. PMID- 3969371 TI - Heterogeneity of steroid binding sites in prostatic carcinoma: morphological demonstration and clinical implications. AB - Prostatic neoplasms were studied for estrogen binding using four methods. Two employed fluorescent estrogen histochemical ligands, one was a new immunocytochemical technique using specific monoclonal antibodies to human estrophilin, and the last procedure was conventional biochemical dextran-coated charcoal assay. Results indicated that the fluorescent ligands recognized closely associated but separate estrogen-binding sites (putative type II sites) which in turn differed from the binding site measured biochemically. Studies with the monoclonal antibodies were nearly always negative, suggesting that prostatic estrogen receptor might vary antigenically from that present in breast and endometrium. Histochemical and biochemical androgen-binding studies were also compared and showed a close association. In the prediction of hormonal response in advanced prostate cancer both showed high sensitivity and low specificity. The addition of estrogen-binding data did not improve the predictive value of the androgen-binding histochemical assay. However, combining results of the biochemical and histochemical androgen-binding assays resulted in significant improvement of the specificity without loss of sensitivity, suggesting that there is a degree of positive interaction between the binding sites assayed by the two methods. PMID- 3969372 TI - Metabolic action of prolactin in regressing prostate: independent of androgen action. AB - The mechanism of the observed synergistic effect of prolactin and androgen on the lateral lobe of the rat prostate is not established. The observation that prolactin alone delayed the rate of loss of weight, protein, and DNA of the lateral lobe in castrated rats has led us to question the assumption that the effect of prolactin is produced by a modification of recognized androgen-induced intracellular changes. The present study was conducted to explore whether or not the sites of prolactin action in the rat prostate coincided with those recognized as the androgen effect. Two anterior pituitaries from female donors were grafted under the right renal capsule of adult male Sprague-Dawley rats. Seven days later, bilateral orchiectomy and unilateral nephrectomy were performed in these rats. In one half of the animals, the kidney bearing the pituitary grafts was removed. In the other half, the contralateral kidney was removed. Seven days following the orchiectomy-nephrectomy, animals bearing the pituitary grafts had a higher level of serum prolactin (93 +/- 7 ng/ml, mean +/- SE) than in those without the graft (26 +/- 3 ng/ml). This condition of hyperprolactinemia was associated with the delay of castration-induced regression in the lateral prostate. The rate of protein degradation, as judged by the amount of radioactivity remaining in the tissue following a single i.v. pulse of 3H-leucine 24 hr before orchiectomy-nephrectomy, was significantly slower in the lateral prostate in graft-bearing animals than in those without grafts. However, the rate of protein synthesis, as judged by both in vitro and in vivo incorporation of 3H leucine into the protein fractions of the prostate, was not significantly different between the two groups. Nor was the total activity of cathespin D in the lateral prostate different. These results were not consistent with parameters known as the effect mediated through androgen-controlled mechanisms. We therefore conclude that the action of prolactin in the regressing rat prostate is probably not mediated through the action of androgen. PMID- 3969373 TI - The effects of estradiol-17 beta on the ultrastructure and subcellular distribution of zinc in the prostatic epithelium of castrated rats. AB - Male Sprague-Dawley rats, previously castrated for a 7-day period, were maintained on either a low or high dose of estradiol-17 beta for 3 days. Some areas of the prostatic epithelium in the lateral lobe exhibited the ultrastructural characteristics of the untreated, intact animals in response to the small dose of estrogen. The ventral lobe by comparison was not similarly affected. This stimulation in the lateral prostate was not reflected by comparable changes in the subcellular distribution of zinc. PMID- 3969374 TI - Grading of prostatic cancer (I): An analysis of the prognostic significance of single characteristics. AB - This paper contains the first part of an attempt to quantitate the impact on prognosis of various parameters used in grading of prostatic cancer. Out of 346 patients of Elmer Belts series, 113 were identified whose tumors showed homogeneity with respect to single characteristics of a total of 12 parameters applied for grading in Mostofi's system. By this procedure it was possible to eliminate the possible influence on prognosis of the presence of several tumor formations within the same tumor. By using overall and intercurrent death corrected survival as end points, the impact of each of the 12 parameters on prognosis was studied. Only the architecture of the tumor (the parameter "glands"), variation in size and shape of the nucleus (anaplasia), and grade significantly influenced overall survival. In addition, corrected survival was significantly dependent on the amount of tumor seen and on the presence of mitoses. Subsequently, an attempt was made to replace "grade" by single parameters which had been shown previously to be of prognostic significance. It turned out that this was not possible. Grade is largely dependent on architecture and nuclear pleomorphism, but neither one of these parameters alone can reproduce "grade." Multivariate analysis was next used to further determine the prognostic weight of the individual parameter, and, if possible, to construct a new, more efficient grading system. These results will be reported separately [8]. It is unknown at the present time what the impact of several architectural formations within the same tumor on prognosis may be. The number of different formations found ranges from 1 to 4 in this material; 668 different formations belonging to 346 tumors were graded. The results of this analysis will be reported in part two of this series of papers [7]. PMID- 3969375 TI - Park Nicollet Medical Center. Sense of history gives sense of direction. PMID- 3969376 TI - Effects of sports and exercise in pregnancy. With guidelines for patients. PMID- 3969377 TI - Check ... checkmate. Countering the con games of drug abusers. AB - Physicians can avoid being manipulated by drug-abusing patients by being aware of the games and strategies they may use. The first step is to call the game and recognize the conning behavior for what it really is. Only then can physicians stay ahead of the game. PMID- 3969378 TI - National immunization policymaking. A controversial endeavor. PMID- 3969379 TI - Reduction in hepatic lipid and plasma estradiol in estrogenized chicks injected with ascorbic acid. AB - Injecting White Leghorn chicks every other day with 20 mg ascorbic acid significantly reduced the increase in liver weight and lipids caused by feeding a diet with 0.1% dienestrol diacetate. In chicks fed two different basal diets containing 0.1% dienestrol diacetate, injecting chicks every other day with 20 mg alpha-tocopherol did not significantly reduce liver weight or lipids while the ascorbic acid injections did. Injecting meat-type chicks implanted with estradiol with 10 mg ascorbic acid daily significantly reduced liver weight, liver lipids, and plasma estradiol, but injecting with 8 mg alpha-tocopherol daily had no significant effect. PMID- 3969380 TI - Short-term effect of dietary cholesterol on tissue n-6 fatty acids in fat deficient rats. AB - Weanling female rats raised on a fat-free diet for 8 weeks were then given the same diet supplemented with 0, 0.25, 0.5, or 1% by weight of cholesterol in addition to 10% of safflower oil for 3 days. Fatty acid compositions of cholesteryl esters (CE), triglycerides (TG), and phospholipids (PL) in liver and plasma were examined. Cholesterol feeding increased plasma and liver cholesterol contents and also affected the patterns of n-6 polyunsaturated fatty acids. There were no consistent changes in either plasma and liver TG which contained little 20:3n-6 and 20:4n-6. The levels of 20:3n-6 increased in plasma and liver PL, while proportions of 20:4n-6 decreased in liver and plasma CE. However, the absolute amount of 20:4n-6 in cholesteryl esters increased because of a threefold rise in cholesteryl ester levels. The changes might be attributable to an increased utilization of 20:4n-6 for cholesterol transport and/or an inhibition of delta 5-desaturation of n-6 fatty acids by cholesterol feeding. PMID- 3969381 TI - The effects of vitamin B6 deprivation with 4-deoxypyridoxine in meal-fed rats. AB - Weanling male rats were trained to consume a control diet in one 4-hr meal a day. Rats were then fed one of three experimental diets for 7 days: (a) control diet minus B6 (-B6); (b) control diet (B6); or (c) control diet restricted to food intake of -B6 (B6R). Xanthurenic acid excretion was greater before and after a tryptophan load in -B6 than in B6R. Body weight gain, food intake, and food efficiency were not different between -B6 and B6. However, in B6R body weight gain, food intake and food efficiency were lower than that in both -B6 and B6. Serum glucose (12-16 hr after meal) and percentage body fat were similar in all three groups. No differences were found in organ size between the -B6 and both control groups indicating that short-term deprivation and deoxypyridoxine did not affect organ size. No significant differences were observed for serum growth hormone (GH), pituitary GH, serum prolactin (PRL), or pituitary PRL among the three groups. When meal fed, differences were minimized between B6 deprived and unrestricted control (B6) rats in body weight gain, food intake, food efficiency, and body composition. PMID- 3969383 TI - Inhibition of mitochondrial carnitine palmitoyl transferase A in vivo with methyl 2-tetradecylglycidate (methyl palmoxirate) and its relationship to ketonemia and glycemia. AB - The oral hypoglycemic agent, methyl 2-tetradecylglycidate (Me-TDGA), which inhibits in vitro mitochondrial carnitine palmitoyl transferase A (CPT-A) was used to study the relationship of CPT inhibition to changes in ketonemia and glycemia in normal and diabetic rats. After oral administration of Me-TDGA, the CPT activity of isolated rat liver mitochondria was substantially reduced with only the presumed outer enzyme fraction CPT-A released by digitonin treatment showing reduced activity. Mitochondrial fatty acyl-CoA synthetase was not inhibited. Oral doses of 0.1-2.5 mg/kg Me-TDGA produced both a dose-dependent lowering of plasma ketones and an inhibition of liver CPT. With single doses in excess of 2.5 mg/kg, po, heart and skeletal muscle CPT were also consistently inhibited. The effect on the liver enzyme persisted for at least 48 hr following 1 mg/kg, po, while the effect on ketones disappeared by 36 hr. The degree of inhibition of liver CPT produced by Me-TDGA was not altered by diabetes or the dietary state. At low doses (0.05-0.25 mg/kg, po), the most sensitive parameter was inhibition of hepatic CPT. Both plasma ketones and CPT were lowered with doses 10-fold less (0.1 mg/kg) than were required for blood glucose lowering, thus making Me-TDGA the most potent hypoketonemic compound known. In conclusion, inhibition of liver beta-oxidation at the stage of CPT-A by Me-TDGA can explain the potent hypoketonemic effects of this compound in fasted normal and diabetic rats. Higher acute doses are needed for both inhibition of muscle CPT and lowering of blood glucose. PMID- 3969382 TI - Reduced sympathetic neuronal uptake (uptake1) in a genetic model of desoxycorticosterone-NaCl hypertension. AB - The effect of desoxycorticosterone (DOC)-NaCl treatment upon sympathetic neuronal uptake of norepinephrine (uptake1) was evaluated in strains of hypertension resistant (SBN) and -prone (SBH) rats. Uninephrectomized animals were given either a placebo pellet sc and tapwater (untreated) or a 25-mg DOC pellet and 1% NaCl. Four weeks later, tail systolic pressure was significantly higher in DOC NaCl SBH, 183 +/- 3 mm Hg, than SBN, 141 +/- 2 (P less than 0.01). [3H]Norepinephrine (NE) uptake was determined in heart slices of all four groups by incubation in Krebs buffer at 37 degrees C for 20 min at several concentrations. Preliminary studies confirmed that this is a measure of uptake1. Heart slices of DOC-NaCl-treated SBN and SBH rats had significantly reduced NE uptake at concentrations of 10-80 nM (P less than 0.01); there was no significant difference between SBN and SBH in this regard. Untreated SBH rats have been shown to have a defect in baroreflex regulation when normotensive. The results raise the possibility that the greater increase in arterial pressure caused by DOC-NaCl in SBH compared to SBN may be related to both the inborn difference in reflex function and an acquired reduction in inactivation of norepinephrine by sympathetic neuronal uptake. PMID- 3969384 TI - Measurement of fasciculations as motor nerve ending discharges in the rat: a dose related effect of neostigmine. AB - The muscle fasciculations caused by neostigmine and similar agents are the result of a primary drug action on motor nerve endings. Asynchronous, repetitive firing of action potentials are evoked at motor nerve endings which are then transmitted to muscle. A dose-response relationship between neostigmine dose and the rate of/or total neural activity has been established in the rat. This fasciculatory response to neostigmine can serve as an index of motor nerve ending excitability and may be useful in assessing the effects of certain pathological states or drug actions at the neuromuscular junction. PMID- 3969385 TI - A new method for the visualization of subepicardial coronary arteries in small isolated mammalian hearts. AB - A model is described which permits direct visualization of large coronary arteries in a supported modified perfused heart preparation, using a perfluorochemical (FC-43) as perfusate. Filling of a large coronary artery with Patent Blue Dye is recorded by gated photography (color arteriography). The technique is applicable to the study of reactivity (spasm) of coronary arteries in hearts of small and large animals (rats, rabbits, dogs). The technique has the following advantages: preservation of vascular endothelium, adequate oxygenation, avoidance of major surgical intervention to implant sensors for the detection of changes in coronary diameter, quantitative evaluation of time dependent changes in geometry of large coronary arteries and simultaneous measurement of large coronary vessel and total coronary vascular resistance. PMID- 3969386 TI - Lipoprotein and protein binding of the calcium channel blocker diltiazem. AB - The plasma protein binding properties of the calcium channel blocker diltiazem were studied using a three-chamber equilibrium dialysis system. Diltiazem is 81% bound to human sera with significant inter-individual variation. The relative binding of diltiazem by lipoproteins and alpha 1-acid glycoprotein was higher than by albumin. The binding to low density lipoprotein was strong and appeared not to be associated with the surface apoprotein. PMID- 3969388 TI - Prevention of physical and mental congenital defects. Part A: The scope of the problem. Proceedings of an international conference of the Institut de la Vie. Strasbourg, France, October 10-17, 1982. PMID- 3969387 TI - Antiserum to prolactin lowers blood pressure (BP) in spontaneously hypertensive rats. AB - The role of PRL in the development of hypertension in the SHR was examined by administering PRL antiserum to neonatal SHR. On days 2-7 post partum, male SHR were injected with 50 microliters/day of either antiserum to PRL (which chronically lowers plasma PRL), normal rabbit serum (NRS), or 0.9% NaCl. Heart rate, BP, and body weight were measured biweekly on weeks 6-14 of age. Anti-PRL lowered BP vs. NaCl on weeks 6, 8, 12, and 14 (range 7-17 mm Hg lower). NRS animals showed BP differences from the NaCl group only on weeks 6 and 14, with no consistent effect. Heart rates fell during the study in the NaCl and anti-PRL groups but not in the NRS group. Anti-PRL and NRS groups had higher heart rates than did the NaCl group. Body weights did not differ between groups except on week 14, when the NRS group weighed less than the NaCl group. These results suggest that while PRL is involved in BP regulation in the SHR, it is not involved in the pathogenesis of the genetic hypertension seen in the strain. In addition, the results suggest that the serum treatment may have caused heart damage which led to an elevation in the heart rates of the serum-treated groups. PMID- 3969389 TI - Malformations and tumours in infants. PMID- 3969390 TI - Comparative developmental pathology of malformations of the central nervous system. PMID- 3969391 TI - [Advances in neurological maturation in various pathological pregnancies]. PMID- 3969392 TI - Early mammalian development. PMID- 3969394 TI - The magnitude of the problem of congenital malformations. AB - A number of controversies and unsolved problems listed in Table I have been discussed. We hope that we will have time at this conference to discuss the many factors which could contribute to the prevention of congenital malformations and mental retardation. If a consensus can be reached on some of the important issues, we may even gain enough momentum to implement some of the suggestions made by the participants of this conference. It is interesting that the development of new knowledge, new etiologies, and new therapies has solved some problems, but has created new difficulties and the need for new solutions. Attending this conference are experts in experimental teratology, clinical teratology, epidemiology, child development, and genetics. A common trait of scientists is to aggrandize the merits of their own field and minimize the importance of their competitors. In reality, all of these fields have made major contributions to our understanding and preventing of congenital malformations. The scientist who is willing to utilize the expertise of many fields can frequently develop new concepts. During this week we all will have the opportunity to broaden our areas of expertise, learn from each other, and possibly synthesize some new concepts or implement some constructive recommendations. PMID- 3969395 TI - Benefits and limits of model systems in developmental biology and toxicology (in vitro techniques). PMID- 3969396 TI - Use of mammalian models in teratology. PMID- 3969393 TI - Organogenesis. PMID- 3969397 TI - Pelvic tilt. Intratester reliability of measuring the standing position and range of motion. AB - The purpose of this study was to examine intratester reliability of a test designed to measure the standing pelvic-tilt angle, active posterior and anterior pelvic-tilt angles and ranges of motion, and the total pelvic-tilt range of motion (ROM). After an instruction session, the pelvic-tilt angles of the right side of 20 men were calculated using trigonometric functions. Ranges of motion were determined from the pelvic-tilt angles. Intratester reliability coefficients (Pearson r) for test and retest measurements were .88 for the standing pelvic tilt angle, .88 for the posterior pelvic-tilt angle, .92 for the anterior pelvic tilt angle, .62 for the posterior pelvic-tilt ROM, .92 for the anterior pelvic tilt ROM, and .87 for the total ROM. We discuss the factors that may have influenced the reliability of the measurements and the clinical implications and limitations of the test. We suggest additional research to examine intratester reliability of measuring the posterior pelvic-tilt ROM, intertester reliability of measuring all angles and ROM, and the pelvic tilt of many types of subjects. PMID- 3969398 TI - Investigation of a new motor assessment scale for stroke patients. AB - The purpose of this paper is to present and describe a motor assessment scale (MAS) for stroke patients and to report on the investigation of two aspects of its reliability. The MAS is a brief and easily administered assessment of eight areas of motor function and one item related to muscle tone. Each item is scored on a scale from 0 to 6. To check interrater reliability, we videotaped five stroke patients while they were being assessed with the MAS. These scores were used as the criterion ratings. Twenty raters then assessed these patients, and their results were correlated with the criterion ratings. We determined test retest reliability by assessing on two occasions, separated by a four-week interval, 14 stroke patients whose recovery was considered to be stable and by correlating these scores. The MAS was found to be highly reliable with an average interrater correlation of .95 and an average test-retest correlation of .98. PMID- 3969399 TI - Quantitative measure of cutaneous sensation. Two-point discrimination values for the face and trunk. AB - This study was performed to assess two-point discrimination ability for skin areas of the face and trunk. Using a compass-type instrument, I determined two point discrimination values for three areas on the face and eight, nonoverlapping regions of the neck and trunk in a sample of 43 healthy young adult men and women. Mean values for the face ranged from 14.9 mm over the eyebrow to 10.4 mm along the lateral aspect of the mandible. Values for the neck and trunk ranged from 35.2 mm for skin of the lateral neck to 55.4 mm for the region immediately lateral to the C7 spinous process. I also found interindividual variation in two point discrimination ability for a given skin area. Except for skin overlying the body of the mandible, where values for women were lower than those measured in men, no significant differences in discrimination ability were found between men and women. Although assessment of two-point discrimination is useful in the clinical evaluation of certain types of patients, the existence of intraindividual and interindividual differences suggests that therapists must interpret the results of these tests with caution. PMID- 3969400 TI - Physical therapist role satisfaction in the treatment of the spinal cord-injured person. AB - The purpose of this article is to discuss role satisfaction and role deprivation experienced by the physical therapist during rehabilitation of the spinal cord injured person. Physical therapist goals to promote patient independence may be in conflict with the therapist experiencing role satisfaction. The patient therapist relationship is examined and recommendations for therapist behaviors that foster a positive and productive interaction are given. PMID- 3969401 TI - Compression of the deep palmar branch of the ulnar nerve. A case report. AB - This case report demonstrated the use of EMG and nerve conduction studies to assist in delineating the site of the injury of an ulnar nerve lesion in the hand and to show nerve recovery after decompressive surgery. PMID- 3969402 TI - Evaluating the adult with cerebral palsy for specialized adaptive seating. AB - Physical therapists may not expect to have a pronounced effect on the neuro developmental function of the cerebral palsied adult because the neuroplasticity of the child is no longer present in the adult. Adapting the environment to such an adult, therefore, becomes of utmost importance. The wheelchair may be the most important structure of the environment for cerebral palsied adults. I present methods for assessing the severely involved adult client and evaluating adaptations of the wheelchair for therapeutic seating. The anterior and posterior tilt of the pelvis and the vertical angle of the backrest are emphasized in achieving therapeutic seating for the severely multiply handicapped adult. PMID- 3969403 TI - Physical therapists' notes and outcomes of physical therapy. A case of insufficient evidence. AB - This article addresses the problem of documenting the outcomes of physical therapy. This is a timely issue because new approaches to reimbursing health-care costs will favor those providers and professions able to demonstrate sufficient benefits to patients to justify prospective cost reimbursement. To assess the adequacy of existing outcome data, we conducted detailed longitudinal audits of 63 geriatric patients' medical records. For nearly half of these patients, the records contained insufficient data to document any improvement in physical functioning. The number of treatments administered correlated with functional improvements documented, but diagnostic related group classifications and patient demographics did not. We found practicing physical therapists overestimated the amount of outcome data recorded and documented some areas of physical functioning more frequently than others. A wider scope for functional assessment and greater standardization in record keeping are advocated. We discuss implications for clinical practice and research and offer a new instrument for quantifying outcomes. PMID- 3969404 TI - Psychosocial adjustment and craniofacial malformations in childhood. AB - Forty-three children between the ages of 6 and 13 years with congenital facial anomalies underwent psychosocial evaluation prior to surgery. Also evaluated were healthy children matched to the craniofacial subjects by sex, age, intelligence, and economic background. Relative to this comparison group, the craniofacial children were found to have poorer self-concept, greater anxiety at the time of evaluation, and more introversion. Parents of the craniofacial children noted more frequent negative social encounters for their children and more hyperactive behavior at home. Teachers reported more problematic classroom behavior. Examination of these results revealed craniofacial malformations to be associated with psychosocial limitations rather than marked deficits. These children tended to function less well than the comparison children, but with few exceptions, they were not functioning in a psychosocially deviant range. Explanations for the observed circumscribed impact of facial deformity include the use of denial as a coping mechanism, possible diminished significance of appearance for younger children, and the restricted environment experienced by most of the subjects. It can be predicted that time would render these protective influences ineffective, so that adolescent and young adult patients could be at far greater psychosocial risk. PMID- 3969405 TI - Problems encountered in contouring a reconstructed ear of autogenous cartilage. AB - One-hundred and sixty-six patients were followed up for a year following transplantation of costal cartilage, and we studied the relationship between the clarity of contours of the reconstructed ear and the condition of the scar on the anterior chest following removal of the cartilage. The contours of the reconstructed ear were evaluated on a four-point scale, and the condition of the scar on the anterior chest was evaluated on a three-point scale. Our results showed that in patients with a predisposition to develop wide or hypertrophic scars on the anterior chest, the contours of the ears were often observed to be poorly defined. PMID- 3969406 TI - Diagnosis and reconstruction of the human temporomandibular joint after trauma or internal derangement. AB - This study reviewed the standardized records of 1100 patients with the symptoms of temporomandibular joint syndrome. Of these patients, only 4.5 percent required surgical intervention. The remaining patients were found to have masticatory muscle spasm and were treated by conservative dental methods. Over half the surgical patients had significant macrotrauma to the jaws in their past history. In addition, electromyographic measurement of the masseteric silent period duration in these patients did not reveal muscle spasm. These factors further serve to differentiate the surgical patient from the patient with myofascial pain dysfunction. The patients selected for surgery demonstrated moderate to severe joint disease and required arthroplasty with partial meniscectomy. A surgical technique is presented demonstrating the reconstruction of the meniscus with silicone implant. This same surgical technique is studied in 10 monkeys, and their joints are examined histologically. The results of surgery reveal that 87 percent of the patients reported improvement 1 year after surgery. In all patients complaining of temporomandibular joint clicking or crepitus, surgery produced complete alleviation of these symptoms. The results of surgery were also associated with a 62 percent increase of jaw opening. Histologic evaluation of the human meniscal resections revealed that in addition to an anatomic displacement of the meniscus, there are also significant cellular changes. These changes consisted of calcification, a decrease in cellularity, hyperemia, and a decrease in elastin content. PMID- 3969407 TI - The pectoralis minor vascularized muscle graft for the treatment of unilateral facial palsy. AB - A series of 10 pectoralis minor vascularized muscle transfers to reanimate the face in unilateral facial palsy are presented. The procedure is carried out in two stages. The first stage constitutes a nerve graft from the functional contralateral facial nerve to the preauricular region of the paralyzed side. Six months later, the pectoralis minor is transferred to the denervated side of the face with restoration of its neurovascular pedicle. The muscle is well suited to its new position with respect to length and bulk, as well as its fanlike shape. The diameter of its vascular pedicle is comparable with the facial vessels. The results demonstrate function in 8 of the 10 grafts, the two failures relating to early vascular thrombosis rather than an inability to reinnervate the muscle grafts. PMID- 3969408 TI - Monitoring muscle viability using evoked M waves. AB - The experiments described reveal the direct relationship between blood flow and evoked electrical activity in muscle flaps. It is demonstrated that monitoring of EMWs will detect vascular occlusion to a muscle flap within 1 hour. Detecting failure this soon provides the surgeon an opportunity for reexploration and salvage of a muscle flap before irreversible change has occurred. Correlations with observed muscle contraction and intramuscular temperature changes are also made. PMID- 3969409 TI - Dermodress: a new, temporary skin substitute for extensive deep burn coverage. AB - A chemically treated bovine skin, Dermodress, is presented as a long-term skin substitute. Dermodress was applied over denuded surfaces of debrided deep burns and was kept in place for up to 56 days. Dermodress adheres to all contours of the debrided surfaces, has hemostatic effect and does not present any signs of infection or rejection. Dermodress can be removed in stages according to the availability of autografts, which may be applied immediately, since the exposed areas are clean and suitable for immediate grafting. Our clinical experience shows that Dermodress has most of the required properties of a long-term temporary skin substitute. PMID- 3969411 TI - An evaluation of eight methods of using fluorescein to predict the viability of skin flaps in the pig. AB - The brightness of the fluorescence of fluorescein can be increased by the use of special (interference) filters that allow visualization of the dye when much smaller doses have been given. Standard random-pattern skin flaps were made in pigs and low (1 mg/kg) and high (500 mg) doses of fluorescein were given intravenously. The dye distribution in the flaps was evaluated visually, photographically, and with a dermofluorometer. All the methods proved reasonably accurate in predicting survival, although in an occasional flap, readings by all the methods were off by as much as 3.5 cm. The traditional Wood's lamp visualization proved to be as accurate as any of the newer methods. The inaccuracies of the fluorescein test are probably inherent in the method, since it only measures vascularity at the time the dye is given--and blood supply can change. The main advantage of low-dose fluorescein is that it allows repeated injections at reasonably close intervals. For serial observations, the dermofluorometer is unquestionably the best method. PMID- 3969410 TI - Chemically induced vasospasm: the effect of ischemia, vessel occlusion, and adrenergic blockade. AB - Vasospasm in revascularized tissue can compromise tissue perfusion even though the microsurgical anastomoses remain patent. Circulating catecholamine stimulates peripheral vasoconstriction. Chemical vasospasm was induced by the intraarterial administration of norepinephrine to denervated rat hind limbs. Heel pad blood flow was assessed by laser-Doppler velocimetry. Mean blood flow was 463 +/- 106 in the denervated leg and 337 +/- 50 in the opposite (intact) leg (p less than 0.01). Flow in the denervated leg decreased 78 percent (463 +/- 106 to 100 +/- 23) within 5 minutes of norepinephrine administration and did not return to normal for 30 minutes. Norepinephrine administration in the presence of 1 and 3 hours of ischemia decreased flow at 5 minutes to 6.6 and 6.0 percent of normal, respectively (31 +/- 14, 28 +/- 14, control 100 +/- 23; p less than 0.001). Administration of intraarterial norepinephrine distal to a femoral artery occluded for 1 and 5 minutes reduced flow following clamp release to 11.2 and 7.1 percent of normal 5 minutes after clamp release (52 +/- 9, 33 +/- 7, control 100 +/- 23; p less than 0.001). Comparison of the 1-minute and 5-minute groups to each other showed a significant flow decrease in the 5-minute group (p less than 0.007). This indicates that the observed decrease in flow was related both to the presence of a vessel occlusion and to the length of the occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969412 TI - Plastic surgeons on the make. PMID- 3969413 TI - Management of congenital bilateral cleft nose. AB - A rare case of nasal clefting was presented to illustrate and emphasize the following points: The workup of nasal clefting should be complete to rule out associated deformities. Marked improvement may be noted with normal growth during the first few years of life. The surgical procedure employed a primary V-Y flap harvested from the central excess of nasal skin based on a very thin vascular area at the nasal columella. At this primary procedure, the flap was telescoped on itself to provide fullness in the nasal tip area. It was also split, and two transposition flaps were inset into the gap left behind by rotating the ala into normal position. The donor area of the V-Y flap provided easy access to the intercanthal area so that the excess skin on the bridge of the nose could be reduced. Two subsequent minor procedures were required for adjusting irregularities in the tip. PMID- 3969414 TI - Hamartoma of the tongue: two case reports. AB - Hamartoma designates an excessive focal overgrowth of mature normal cells and tissues in an organ or tissue composed of identical cellular elements. Two cases of hamartoma at the back of the tongue are reported. Histologically they comprised fibrous tissue, fat, salivary gland lobules, and smooth muscle. The literature is reviewed and discussed. PMID- 3969415 TI - A rat restraining cage for IV infusion in epigastric flap studies. AB - A rat restraining cage is described for use in epigastric flap studies requiring IV infusions of 24 hours or more. The device is simple, effective, and reliable; it appears to be less stressful for the rat than other methods of restraint. PMID- 3969416 TI - The patient, the plastic surgeon, and informed consent: new insights into old problems. PMID- 3969417 TI - Polyurethane-coated breast implant. PMID- 3969418 TI - Silicone expander with self-contained valve. PMID- 3969420 TI - Standards of photography. PMID- 3969419 TI - A new light for the Dingman-Millard mouth gag. PMID- 3969421 TI - Pectoralis major for mandibular reconstruction. PMID- 3969422 TI - Cigarette smoking and skin flap survival in the face lift patient. PMID- 3969424 TI - T- and three-flap nipple reconstruction. PMID- 3969423 TI - Medial confluence of the breast. PMID- 3969425 TI - [Crisis intervention with adolescents--a short-term therapy in ambulatory psychiatric service]. PMID- 3969427 TI - [Thematic concordance--development of a process parameter in psychotherapy]. PMID- 3969426 TI - [Self-exchange drive of pedophilic patients]. PMID- 3969428 TI - [Time concept and duration in illness]. PMID- 3969429 TI - [Pension neurosis: a psychosocial arrangement. I]. PMID- 3969430 TI - Consultation-liaison fellowships: effect on internists' attitudes toward psychiatric consultation. PMID- 3969431 TI - Psychological and neuropsychological aspects of COPD. PMID- 3969432 TI - Hypoglycemia: the standard and the fiction. PMID- 3969433 TI - The psychiatrist as physician. PMID- 3969434 TI - Atypical neuroleptic malignant syndrome responsive to conservative management. PMID- 3969435 TI - Metyrapone for depression and delirium secondary to Cushing's syndrome. PMID- 3969436 TI - Psychiatric complications of closed head trauma. PMID- 3969437 TI - Distributions of cell populations within alpha-particle range of plutonium deposits in the rat and beagle testis. AB - Plutonium is not uniformly distributed in testicular tissues; thus some cell populations may receive larger or smaller radiation exposures than would be expected if the nuclide were uniformly distributed. The distributions of cell populations within alpha-particle range of Pu deposits in rat and beagle testes were determined. The data were collected from autoradiographs of testicular tissues containing 241Pu. A cell distribution factor (CDF) was determined for each cell population and is defined as the average number of each cell type within alpha-particle range of each observed Pu deposit relative to the number of each cell type that would be expected within alpha-particle range of each Pu deposit, if the deposits were distributed uniformly. In addition, the percentage of the spermatogonial stem cell population within alpha-particle range of Pu deposits was determined. In rats, the CDF for the spermatogonial stem cells is about 2.2. This value is similar to other enhancement and inhomogeneity factors reported for rodents in the literature. In beagles the CDFs to all cells in the seminiferous epithelium were less than the rats. In addition, the percentage of spermatogonial cells within alpha-particle range of Pu concentrations in the interstitial tissues was a factor of about 3 less in the dog than in the rat. The largest CDFs seen in both species were in the interstitial tissues, particularly for Leydig cells. Because the organization of testicular tissues in the beagle is quite different from rodents but more similar to human, the results from this study suggest that extrapolations from rodents to humans may tend to overestimate the potential for radiation exposure to spermatogonial stem cells as well as the fraction of the spermatogonial stem cell population at risk to exposure from internally deposited 239Pu. PMID- 3969438 TI - Polyfunctional radiosensitizers. VII. Radiosensitization by conformationally restricted isomers of a nitroxyl biradical in vitro. AB - Bothtrans-N,N'-bis(2,2,6,6-tetramethyl-1-oxyl-4-piperidinyl)-1, 2 diaminocyclopropane[Ro31-2269] and its cis isomer [Ro 31-2778] selectively sensitized hypoxic Chinese hamster cells, line V-79-753B, to radiation by decreasing both the D0 value and extrapolation number, whereas a related dibasic monoradical Ro 31-2655 decreased D0 alone. Although sensitization was maximal after a 1-hr cell-drug contact time, cells continued to accumulate both Ro 31 2269 and Ro 31-2778 when this contact time was increased up to 3 hr. There was no evidence for competition between either biradical and 2,2,6,6-tetramethyl-4 piperidinol-N-oxyl (TMPN) at equimolar concentration or biradical and 0.82 microM oxygen when cells were equilibrated with the biradicals for 3 hr prior to irradiation in the presence of mixtures of either oxygen and biradical, TMPN and biradical, or TMPN alone. Furthermore, when cells were equilibrated with an equimolar radical concentration of the trans isomer Ro 31-2269 and TMPN for 1 hr prior to irradiation in the presence of the mixture, there was no appreciable effect on sensitization of the slope of the hypoxic cell survival curve, but shoulder modification was reduced. When cells were equilibrated with the trans isomer Ro 21-2269 prior to irradiation in combination with 2.92 microM oxygen, cell survival was similar to that seen for cells irradiated with this concentration of oxygen alone. Examination of the plasma membrane from cells equilibrated with the trans biradical Ro 31-2269 showed that the drug accumulated in the membrane when compared with the concentration found in whole cells. Experiments with the conformationally-unrestricted biradical bis(2,2,6,6 tetramethyl-1-oxy-4-piperidinyl) succinate [Ro 03-6061] showed that when cells were equilibrated with the compound for 1 hr prior to irradiation in hypoxia in the presence of a mixture containing an equimolar radical concentration of TMPN, there was an increase in both the slope and the extrapolation number compared with values for hypoxic cells irradiated in the presence of this biradical alone. Furthermore, when cells which had been equilibrated with Ro 03-6061 were washed free of the drug, there was a residual decrease in both the D0 and extrapolation number of the hypoxic cell survival curve for at least 3 hr after removal of the compound. The results are discussed in terms of a model to account for sensitization by these compounds. PMID- 3969439 TI - The effects of abdominal irradiation on intestinal transport in the rat as assessed with isolated epithelial cells. AB - The time course of the effect of exposure to sublethal irradiation on transport of several substrates by the intestine has been studied using isolated enterocytes. Rats received a single dose of 6 Gy to the abdomen, and isolated intestinal epithelial cells were prepared 3, 7, and 14 days later. The ability of the cells to take up D-glucose, L-leucine, and glycyl-L-leucine was assessed using 2.5-min incubation periods and was compared with the uptake in control cells. It was found that the protein content of the cells increased after irradiation, and although some of this was the result of increased binding of albumin to the cells there was also a nonspecific increase in most cell proteins. Consequently uptake data were expressed per unit number of cells and not per milligram of cell protein. Comparison of uptake expressed in this way showed that D-glucose and glycyl-L-leucine uptake was elevated 3 days after irradiation while that of L-leucine was unaffected. By 14 days after irradiation the glucose and glycyl-L-leucine uptake had returned to normal but the L-leucine transport was depressed. These data indicate that the effects of irradiation upon substrate transport in the intestines are not uniform and that although the cell population is initially reduced the remaining cells can compensate by increasing their transport capacity. PMID- 3969441 TI - On tests of equal effect per fraction in microcolony assays of survival after fractionated irradiations. AB - H. D. Thames, Jr. and H. R. Withers [Br. J. Radiol. 53, 1071-1077 (1980)] propose a test of an equal effect per fraction in microcolony assays after fractionated radiation, in which the total effect is measured by counting microcolonies derived from surviving cells in a tissue. The factors considered to influence the cytocidal effect per fraction are incomplete repair, repopulation, and synchrony. The statistics used in the method are criticized and conditions are given under which the test should not be used. An alternative method of testing for an equal effect per fraction is proposed. The pros and cons of each test are discussed and compared using some mouse jejunal crypt cell survival data. PMID- 3969440 TI - Cellular and molecular repair of X-ray-induced damage: dependence on oxygen tension and nutritional status. AB - Cellular and molecular repair was studied at 23 degrees C using split-dose recovery and alkaline elution techniques, respectively, as a function of cellular oxygen and nutrient conditions. Hypoxic cells (0.001% O2) in full medium showed a partial reduction in the level of sublethal damage (SLD) repair relative to aerated cells (21% O2, OER equal to 3.2 relative to 0.001% O2); the respective repair kinetics were similar with a common repair half-time of 30 min. Similarly, hypoxic cells showed a slight reduction in strand break rejoining capacity compared to aerated cells. Under nutrient deprivation, anoxic cells displayed no SLD repair or strand break repair, while aerated cells exhibited the same level of SLD and strand break repair as for well-fed cells. In addition, nutrient deprived cells at low O2 levels (0.03%, OER equal to 1.15) displayed normal SLD and strand break repair capability. These results indicate that both nutrient and O2 deprivation are necessary for complete inhibition of cellular and molecular repair, and low levels of O2 (0.03%) can effectively reverse this inhibition. PMID- 3969442 TI - Repopulation kinetics in irradiated mouse lip mucosa: the relative importance of treatment protraction and time distribution of irradiations. AB - The repopulation kinetics of the irradiated lip mucosa of mice has been investigated. Split-dose experiments showed that, in this tissue, repopulation starts within 3 days after the first irradiation and increases exponentially within 10 days. To assess the relative importance of protraction and distribution of irradiations as a function of time, 10 fractions were given in (1) 3 days (three irradiations per day with a 4-hr interval), (2) 11 days (daily fractions), or (3) two short courses, each consisting of five fractions given in 1.5 days separated by a rest period of 8 days, with an overall time of 11 days. The results show that by protracting the treatment from 3 to 11 days (with daily irradiations) repopulation accounts for recovery of approximately 13 Gy. Delivering the radiation in two short courses separated by a rest period leads to an additional recovery of approximately 5 Gy. The most plausible explanation for this observation is that repopulation is much more efficient during the rest period between the two courses than during continuous daily irradiation. Although the regimen of two short courses with a rest period spares the acute reaction, it will not enhance the late tolerance. Before thorough knowledge about the repopulation kinetics of the tumors can be gained, caution should be observed for indiscriminate use of split-course multiple-fraction-per-day (MFD) regimens for treating various tumors. PMID- 3969443 TI - A comparison of the effects of hyperthermia on cell growth in human T and B lymphoid cells: relationship to alterations in plasma membrane transport properties. AB - Hyperthermic exposure (39-43 degrees C) for 1 or 2 hr impairs growth and Na+ dependent amino acid transport in both a radiosensitive human T (Molt-4) and a radioresistant B (RPMI 1788) lymphoid cell line. The heat damage to Na+-dependent amino acid transport in both cell lines is reversible under the conditions tested. Cell growth, as judged by increases in cell number, is decreased in both cell lines after hyperthermic treatment (43 degrees C, 1-hr exposure). This decrease in growth correlated with the damage to, and recovery of, the Na+ dependent amino acid transport system. However, the sensitivity to heat of both growth and Na+-dependent amino acid transport appears to differ in Molt-4 which is somewhat more sensitive to hyperthermia (T-cell line) vs RPMI-1788 (B-cell line). In the case of Molt-4, the rate of growth is decreased for about 60-80 hr after cells are exposed for 1 hr at 43 degrees C; whereas increases in cell number in the RPMI 1788 is observed within 40 hr after the heat treatment. The differences observed in cell growth and transport in these two lymphoid cell lines are attributed to the manner in which heat affects (i) the transport parameters in Molt-4 vs RPMI 1788 (i.e., the Michaelis-Menten constants Km and Vmax) and (ii) the putative plasma membrane sulfhydryl protein(s) which modulates Na+-dependent amino acid transport. PMID- 3969444 TI - Effect of confluent holding on potentially lethal damage repair, cell cycle progression, and chromosomal aberrations in human normal and ataxia telangiectasia fibroblasts. AB - The effects of confluent holding recovery on survival, chromosomal aberrations, and progression through the life cycle after subculture of human diploid fibroblasts X-irradiated during density inhibition of growth have been examined. The responses of three normal strains were determined and compared with those of four ataxia-telangiectasia (AT), an AT heterozygote, and two hereditary retinoblastoma strains. The capacity for potentially lethal damage repair (PLDR) was slightly reduced in retinoblastoma cells and almost absent in AT cells, but normal in an AT heterozygote. The decline in chromosomal aberrations seen in normal cells during confluent holding was absent in AT cells, consistent with the lack of PLDR. Following subculture, all irradiated AT fibroblasts progressed through the cell cycle to the first mitosis with no delay. AT heterozygotic and retinoblastoma cells showed both an enhanced delay in the initiation of DNA synthesis and a large fraction of cells irreversibly blocked in G1 as compared with normal cells. Both the delayed entry into S and the G1 block were reduced by confluent holding. These results indicate that AT homozygotic and heterozygotic cells respond quite differently to X irradiation. PMID- 3969445 TI - Effect of intercellular contact on DNA conformation, radiation-induced DNA damage, and mutation in Chinese hamster V79 cells. AB - Chinese hamster V79 cells, when grown as small spheroids in suspension culture, are more resistant to killing by ionizing radiation than when grown as monolayers. We have attempted to determine whether this enhanced survival following irradiation is reflected in DNA damage and repair at the structural level (by measuring alkali-induced DNA unwinding rates from strand breaks) and at the functional level (by measuring resistance to forward mutation at the HGPRT locus). For a given dose of radiation, the unwinding of DNA in high salt/weak alkali was less complete for spheroid DNA than for monolayer DNA, and the rate of repair of radiation damage was faster in spheroid DNA. These differential responses were lost 8 hr after separation of spheroids into single cells, coinciding with loss of radioresistance measured by clonogenicity. In addition, spheroid cells showed fewer numbers of induced mutants per Gray, although, for a given level of survival, the mutation frequency for monolayers and spheroids was identical. These results suggest that conformational changes in DNA resulting from cell growth as spheroids might enhance repair of radiation-induced lesions. PMID- 3969446 TI - The Northwick Park catheter stand. PMID- 3969447 TI - What is caring? PMID- 3969448 TI - Bladder pressure studies combined with micturating cysto-urethrography. PMID- 3969449 TI - The non-stochastic dose limit for members of the public. Advice from the National Radiological Protection Board. PMID- 3969450 TI - Film faults and CT imaging. PMID- 3969451 TI - Cancer epidemiology. PMID- 3969452 TI - Epidemiology and the radiographer. PMID- 3969453 TI - The epidemiology of cancer in Africa. PMID- 3969454 TI - Radionuclide imaging. PMID- 3969455 TI - Stress views of the ankle joint in lateral ligament injury. PMID- 3969456 TI - Candida esophagitis: accuracy of radiographic diagnosis. AB - Candida esophagitis was diagnosed radiographically in 106 patients. Endoscopy was performed in 32 of these patients, and the diagnosis was confirmed in 27. The diagnosis was missed radiographically in seven other cases proved endoscopically. Thus, Candida esophagitis was diagnosed on esophagography in 80% (27/34) of proved cases, with five false-positive examinations. Single-contrast technique was employed in nine cases with a sensitivity of 55%, and double-contrast technique was used in 25 cases with a sensitivity of 88%. With double-contrast technique, esophagography appears to be a more accurate method for diagnosing Candida esophagitis than has been suggested in the literature. PMID- 3969457 TI - Dysphagia in patients with gastric cancer and a normal esophagram. AB - Five patients presented with dysphagia but did not have abnormal esophageal motility or morphology on the esophagram. Each was found to have a malignant gastric tumor which did not appear to involve the gastroesophageal junction, and this was confirmed surgically in 2 cases. In 2 patients, diagnosis was delayed as a result of failure to examine the stomach following a normal esophagram. In the absence of abnormal esophageal motility, changes involving the gastroesophageal junction, or cerebral metastases, it is postulated that the dysphagia represented a nonspecific regional response to functional obstruction of the upper gastrointestinal tract secondary to an infiltrating neoplasm of the stomach. The fact that the esophagram was normal emphasizes the possibility that gastric lesions in patients with dysphagia may be missed when only a routine esophagram is employed. The authors recommend that the stomach be examined when no apparent cause for dysphagia can be discerned above the gastroesophageal junction. PMID- 3969458 TI - Omental cakes: colonic involvement by omental metastases. AB - The authors describe 7 cases of pelvic malignancy (4 ovarian, 1 bladder, 1 cervical, and 1 endometrial) in which pathological examination demonstrated involvement of the transverse colon by contiguous spread from the greater omentum. Most patients had a pelvic mass at the time of presentation. All also had evidence of intraperitoneal seeding in the anterior rectosigmoid, the superior border of the sigmoid, or the medial border of the cecum, ascending colon, or ileum. Barium-enema examination showed predominant involvement of the superior border of the transverse colon with a mass effect, nodularity, and tethered mucosal folds, although focal or diffuse areas of circumferential narrowing were also identified. This appearance may be indistinguishable from direct extension of gastric carcinoma via the gastrocolic ligament; however, a pelvic mass or intraperitoneal colonic seeding should alert the radiologist to possible malignant spread from the greater omentum. PMID- 3969459 TI - Salpingitis isthmica nodosa: radiologic and clinical correlates. AB - Salpingitis isthmica nodosa (SIN) is thought to be an inflammatory condition of the fallopian tubes and is strongly associated with infertility and an increased risk of ectopic pregnancy. The diagnosis is best made radiographically at hysterosalpingography (HSG), where the characteristic finding consists of multiple nodular diverticular spaces in close approximation to the true tubal lumen. We reviewed 1,194 HSGs performed over a five year period and identified 45 patients who had SIN (4%). There was a high rate of primary infertility (37.5%) and ectopic pregnancy (9.4%). Of 70 involved tubes, 62 (89%) had evidence of associated inflammation on historic, radiologic, surgical, or histologic grounds. We conclude that SIN is a disorder most likely acquired during the fertile years, and that the lesion is either a direct consequence of infection or that--once present--it predisposes the patient to subsequent infections. PMID- 3969461 TI - Incompetent perforating veins: comparison of varicography and ascending phlebography. AB - A comparison of the accuracy of incompetent perforating vein visualization using varicography and ascending phlebography is reported. A technique for varicography is described. Sixty-one legs of 50 patients were examined using both methods. In the calf, varicography and ascending phlebography were almost equally accurate, but for the demonstration of incompetent perforating veins of the gastrocnemius muscle and midthigh, varicography was considerably more accurate. It is concluded that varicography is a safe, simple, and accurate method for demonstrating incompetent perforating veins and complements the more conventionally employed ascending phlebography. PMID- 3969460 TI - Excretory urography in current practice: evidence against overutilization. AB - Excretory urography could be performed less frequently if some combinations of genitourinary signs and symptoms were found to be predictive of either a specific disease or normality. To explore this possibility, the authors conducted a prospective study involving more than 3,000 patients at three institutions (a teaching hospital, a community hospital, and a health maintenance organization). Predictive algorithms were obtained by application of a polychotomous logistic regression model but did poorly at differentiating normal from abnormal patients or arriving at a specific diagnosis. Selection of patients on the basis of the logistic model would have required testing 90% of all patients in order to detect 95% of those with abnormal urograms. These results suggest that current clinical selection criteria for excretory urography are effective, and that present frequency of utilization is appropriate. PMID- 3969462 TI - Conspicuity and uncertainty in the radiographic detection of lesions. AB - Conspicuity refers to how well a given feature stands out from surrounding structures. While this concept is being used increasingly as a qualitative descriptor, attempts to express it in quantitative form have not been entirely successful. It is necessary to quantitate detectability and also to ascertain that the detected feature is indeed the one being sought. The author has introduced the concept of uncertainty, a quantity derived from false-positive rates. Experiments show that the resulting expression of conspicuity correlates well with the probability of detecting lesions on chest radiographs and may also be used to compare imaging techniques so as to determine their relative accuracy. PMID- 3969463 TI - ROC and contrast detail image evaluation tests compared. AB - Using both contrast detail and receiver operating characteristic (ROC) evaluation tests, we evaluated different quality images, produced with different film-screen combinations. ROC curves were obtained for six observers who were attempting to detect lung nodules and pulmonary infiltrates. The contrast detail curves were obtained from images of regular circular test patterns of differing contrast, which had been presented to the observers. Our results indicate that contrast detail tests can be used for relative ranking of image systems prior to detailed ROC testing. PMID- 3969464 TI - Percutaneous extraction of urinary calculi: use of the intercostal approach. AB - The authors achieved successful percutaneous extraction of urinary calculi via an intercostal approach in 24 patients. In one patient, a large hydrothorax developed and thoracentesis was required; 2 patients had moderate and 6 minimal pleural fluid collections which did not require treatment. No patient had pneumothorax. Intercostal puncture provides direct access to the upper and middle poles of the kidney when they lie above the twelfth rib and subcostal angulation is not feasible. Such an approach is advantageous for stones in the ureter, as well as renal stones which are inaccessible from the lower pole. Fluoroscopy should be performed when planning the puncture in order to avoid the lung, and a working sheath is recommended. PMID- 3969465 TI - Thrombosed synthetic hemodialysis access fistulas: failure of fibrinolytic therapy. AB - Seven episodes of acute thrombosis occurring in five patients with polytetrafluoroethylene dialysis fistulas were treated with local infusions of low-dose streptokinase. Bleeding from previous dialysis puncture sites necessitated stopping the infusion in six out of seven patients, although in one of these six, the graft reopened. The seventh patient had never been dialyzed through the graft and thrombolysis was achieved without incident. Surgery was avoided in only one patient. The authors contend that in these patients the risks of fibrinolytic therapy outweigh the benefits. Surgical thrombectomy, coupled with intraoperative angiography and possible angioplasty, is the preferred method of treating these patients. Venography prior to the creation of the fistula helps the surgeon avoid diseased vessels and may avert early failure of the fistula. PMID- 3969466 TI - Obstructive jaundice secondary to benign hepatic cyst. AB - A case of hepatic cyst causing obstructive jaundice is presented. Following percutaneous aspiration of the cyst, the jaundice was relieved. Modern interventional radiologic techniques can provide prompt diagnosis and treatment, thus avoiding major surgery and prolonged hospitalization. PMID- 3969467 TI - The immotile cilia syndrome: radiological manifestations. AB - The immotile cilia syndrome (ICS) is an uncommon disorder characterized by specific and genetically determined defects of cilia that cause upper and lower respiratory disease. We reviewed the radiographic patterns in 30 patients who had ICS (15 females, 15 males) and ranged in age from newborn to 26 years. Except for two neonates, sinusitis and otitis were present in all patients. Chest radiographic abnormalities, universally present, included bronchial wall thickening, hyper-inflation, segmental atelectasis or consolidation, and segmental bronchiectasis. Situs inversus, present in 50% (7 females, 8 males), was not an essential part of this disorder. Radiologically, the disease progresses from bronchial wall thickening with or without hyperinflation, to increasing hyperinflation plus parenchymal changes including segmental atelectasis, consolidation, and bronchiectasis. There is also a predilection for anatomic middle lobe abnormalities. The radiological appearance and clinical state have similarities to cystic fibrosis, although they are less severe and less progressive. ICS should be considered in the differential diagnosis of slowly progressive chronic lung disease, sinusitis, and otitis. PMID- 3969468 TI - Ulcerative and granulomatous colitis in children. Comparison of double- and single-contrast studies. AB - The authors reviewed 49 double-contrast and 27 single-contrast barium-enema examinations (BE) in 71 children with suspected inflammatory bowel disease. The diagnosis was proved in 41 patients, of whom 36 underwent proctoscopy and 5 had advanced disease which was treated surgically within 3 to 30 days after BE; the other 30 children served as controls. BE and proctoscopy were compared with regard to sensitivity (detection of disease) and accuracy (categorization as ulcerative or granulomatous colitis). Sensitivity was 93% for double-contrast and 82% for single-contrast BE. Both detected all cases of advanced disease; in early disease, double-contrast BE detected 91% of cases and single-contrast BE 70%. Colitis was correctly categorized as ulcerative or granulomatous in 93% with double-contrast BE and 86% with single-contrast BE. Specificity within the control group was 100% with both techniques. The authors conclude that both types of BE exhibit similar sensitivity in advanced disease, but the double-contrast technique is more accurate in detecting early disease. PMID- 3969469 TI - Greater trochanteric overgrowth: development and surgical correction. AB - Greater trochanteric advancement (GTA) is an orthopedic procedure designed to correct the biomechanical consequences of overgrowth of the greater trochanter by moving the greater trochanter and its attached muscles laterally and distally. Thirty-one children with trochanteric overgrowth who had secondary pelvic instability (Trendelenburg sign) were studied and underwent a total of 33 GTA procedures. The clinical and radiologic prerequisites for successful surgery are presented. In addition, the radiographic methods of measuring the lateral position of the trochanter, the articulotrochanteric distance, and the amount of trochanteric overgrowth are discussed. Measurements made on preoperative and postoperative radiographs revealed that surgery achieved a mean displacement laterally of 12.1 mm and distally 21 mm. Clinically, there were few complications (two children with mild myositis, one with broken hardware, one with delayed union of trochanter). Pelvic instability had disappeared in the 25 of the 30 patients who could be evaluated. PMID- 3969470 TI - Medulloblastoma in infants and children: computed tomographic follow-up after treatment. AB - Thirty-six proven cases of medulloblastoma were reviewed by serial CT follow-up examinations from 4 months to 10 years, 2 months after the initial diagnosis, with a mean follow-up time of 3 years, 9 months. The children ranged in age from 10 months to 16 years, 7 months at the time of follow-up. The tumor recurred at the primary site in 20 cases (56%). Leptomeningeal metastasis was demonstrated on CT in 14 cases (39%); seven of these patients also presented with solid subarachnoid metastases. Thirteen patients (36%) showed evidence of severe brain atrophy, which was confined to the posterior fossa in seven of the 13. Calcification resulting from mineralizing microangiopathy developed in five cases (14%), including three patients who had extensive dystrophic calcification in the corticomedullary junction and the deep-seated nuclei of the cerebrum and cerebellum. Only one case of leukoencephalopathy was observed. The patterns of tumor recurrence in the posterior fossa that is severely deformed by surgery and other treatment modalities and leptomeningeal spread of tumor are discussed. PMID- 3969471 TI - Origin of spinal arteriovenous malformation and normal cord vasculature from a common segmental artery: angiographic and therapeutic considerations. AB - The dural type of spinal arteriovenous malformation (AVM) can be cured by excision or by embolization of the nidus. The common origin of the blood supply to the malformation and to the cord from the same segmental artery would profoundly affect therapeutic choices. This anatomic situation was encountered in two of nine such lesions. The angiographic appearance and the importance of recognizing this common origin is discussed. PMID- 3969472 TI - Computed tomography in the evaluation of Brown syndrome of the superior oblique tendon sheath. AB - Computed tomographic (CT) findings in 4 patients with superior oblique tendon sheath syndrome (congenital or acquired Brown syndrome) are described. When the inferior oblique muscle moves the eye upward, the superior oblique muscle normally relaxes, while its tendon lengthens and slides freely through the trochlea. In Brown syndrome this process is somehow restricted, which is most apparent during attempts at elevation when the eye is adducted, resulting in an apparent inferior oblique "palsy" (pseudopalsy). Brown syndrome is the most common cause of an apparent isolated limitation of the inferior oblique muscle. CT is a valuable tool in understanding the pathophysiology and management of acquired Brown syndrome, showing thickening and inflammatory changes of the reflected portion of the superior oblique tendon. PMID- 3969473 TI - Cervical tuberculous adenitis: CT manifestations. AB - Cervical tuberculous adenitis is being seen with increasing frequency in the United States; in the appropriate clinical setting it should be included in the differential diagnosis of an asymptomatic neck mass. Patients are typically young adults who are recent arrivals from Southeast Asia. A history of tuberculosis is not always elicited nor is the chest radiograph always abnormal. All of these patients have positive purified protein derivative tests unless they are anergic. The CT findings may lead to the diagnosis. Several CT patterns of nodal disease can be seen in tuberculous adenitis; some may mimic benign and neoplastic disease. The presence of a multiloculated or multichambered (conglomerate nodal) mass with central lucency and thick rims of enhancement and minimally effaced fascial planes is highly suggestive of tuberculous adenitis, especially if the patient has a strongly positive tuberculosis skin test. PMID- 3969474 TI - Magnetic resonance imaging of prosthetic heart valves. AB - To evaluate the safety of magnetic resonance (MR) imaging of prosthetic heart valves, nine different synthetic and tissue valves were studied ex vivo. Deflection was measured in 0.35-tesla (T) and 1.5-T superconducting magnets and at the edge of the bore of a 2.35-T electromagnet in field gradients of 5, 1.1, and 6.3 mT/cm, respectively. No valve deflected in the 0.35-T magnet; six synthetic valves deflected 0.25 degrees-3 degrees in the 1.5-T magnet; all valves deflected 1 degree-27 degrees at the edge of the 2.35-T magnet. Each valve was then submerged in a vial of water and the temperature was measured immediately before and after each of two spin-echo imaging sequences in the two superconducting magnets. No significant temperature rise followed exposure in either magnet. Image distortion varied from negligible to severe in both imagers; magnitude of distortion paralleled magnitude of deflection. These data suggest that patients with present-day prosthetic heart valves can be safely imaged in present-day MR imagers and that prosthesis-induced artifacts will not interfere with interpretation in most instances. PMID- 3969475 TI - Magnetic resonance imaging in the diagnosis and staging of renal and perirenal neoplasms. AB - Thirty-one adult patients underwent magnetic resonance (MR) imaging after CT scans had demonstrated findings consistent with renal cell carcinoma. MR images were interpreted prospectively and independently of the CT findings. Because the CT scanning was performed at multiple institutions by many examiners, this study was not a direct comparison of CT versus MR. The preoperative diagnoses and staging of the neoplasms, as judged by MR, were compared with those obtained at laparotomy (n = 28), autopsy (n = 1), or biopsy (n = 2). Correct preoperative diagnoses were rendered in 31 patients (100%) on the basis of MR findings. The anatomic staging of 27 renal cell carcinomas was correctly performed by MR in 26 patients (86%). When compared with results of previous studies of the value of CT in the diagnosis and staging of renal neoplasms, MR appears to have several advantages in determination of the origin of the mass; the evaluation of vascular patency; the detection of perihilar lymph node metastases; and the evaluation of direct tumor invasion of adjacent organs. MR is sensitive in determining the extent of tumor thrombus and in evaluating invasion of the inferior vena caval wall. MR should assume an important role in the diagnosis and staging of renal neoplasms. PMID- 3969476 TI - Acute injury of the ligaments of the knee: magnetic resonance evaluation. AB - Eleven acutely injured knees and 13 normal knees were examined by magnetic resonance imaging (MRI) to assess the value of this modality in detecting acute ligamentous injury of the knee. The presence of torn ligaments in the injured knees was determined by arthroscopy and/or arthrotomy in ten cases and clinical follow-up in one case. The anterior and posterior cruciate ligaments (ACL and PCL) were demonstrated by sagittal spin echo (SE) images through the intercondylar notch (TE = 30 ms; TR = 2,000 ms). The tibial and fibular collateral ligaments (TCL and FCL) were evaluated on coronal SE images (TE = 30 ms, TR = 200 or 530 ms; TE = 120 ms, TR = 2,000 or 2,120 ms). The ACL and PCL were considered torn on MR if they appeared disrupted or were not seen in their normal anatomical positions. The collateral ligaments were considered torn if abnormal high-intensity signal was noted in adjacent soft tissues on TE = 120 ms images or if disruption of a ligament was apparent. Eleven of 15 torn ligaments and 80 of 81 normal ligaments were correctly identified by these criteria. It is concluded that MR imaging may be useful in detecting acute injury of ligaments of the knee. PMID- 3969477 TI - Tissue distribution and magnetic resonance spin lattice relaxation effects of gadolinium-DTPA. AB - Gadolinium-DTPA complex (Gd-DTPA) is a potential clinical magnetic resonance (MR) contrast agent that enhances images primarily by decreasing spin-lattice relaxation time (T1) in tissues in which it localizes. This study was designed to determine the immediate tissue distribution of intravenously administered Gd-DTPA in selected organs of interest as a function of administered dose and tissue Gd DTPA concentration. An intravenous bolus of Gd-DTPA with a tracer quantity of Gd 153 was administered to three groups of rabbits at the following doses: 0.01 mM/kg (n = 6); 0.05 mM/kg (n = 6); 0.10 mM/kg (n = 6). A control group received sham injections. Five minutes after Gd-DTPA was administered, all animals were killed; samples of serum, lung, heart, kidney, liver, and spleen were analyzed in a 0.25 T MR spectrometer to measure T1, and then in a gamma well counter to determine tissue concentration of Gd-DTPA. Tissue distribution (per cent dose/tissue weight in g) at five minutes after injection was proportionally constant over the range of doses given. Tissue concentration varied linearly with injected dose (r greater than 0.98 for all tissues). Relaxation rate (1/T1) varied linearly with injected dose and with tissue Gd-DTPA concentration (r greater than 0.97 for all tissues). The order of tissue relaxation rate response to a given dose was: kidney greater than serum greater than lung greater than heart greater than liver greater than spleen. We conclude that because of its extracellular distribution and linear relaxation rate versus concentration relationship, Gd-DTPA enhancement in MR images may be a good marker of relative organ perfusion. PMID- 3969478 TI - Magnetic resonance relaxation times of percutaneously obtained normal and abnormal body fluids. AB - Seventy-three fluid samples obtained via percutaneous aspiration and drainage were analyzed by proton magnetic resonance spectroscopy. The fluids included abscess contents, bile, ascitic fluid, cyst and pseudocyst fluid, urine, hematomas, pleural fluid, lymphoceles, seromas, cerebrospinal fluid, pancreatic ductal fluid, and necrotic tumor. They were grouped by their clinical etiology and analyzed with respect to their inherent magnetic relaxation properties. In addition, some of the samples were tested for the following chemical parameters which were correlated with T1 and T2 values: total protein content (n = 36), osmolality (n = 24), specific gravity (n = 11), and amylase levels (n = 23). A large overlap was found in the T1 (spin-lattice) and T2 (spin-spin) relaxation times of the fluids; however, the mean T1 values of abscesses and hematomas were significantly lower than those of other fluids. Similar variability was seen in T2 values, though hematomas and abscesses again could be distinguished by shorter relaxation times. The spin-lattice (1/T1) and spin-spin relaxation rates (1/T2) showed a moderate correlation with total protein content, osmolality, and specific gravity. It is concluded that there is some predictability to MR analysis of body fluids, though the overlap in magnetic relaxation times limits specificity. PMID- 3969479 TI - Hemodynamic effects of rapid and slow infusions of manganese chloride and gadolinium-DTPA in dogs. AB - The acute hemodynamic effects of two paramagnetic contrast materials, manganese chloride and gadolinium-DTPA, were examined in dogs using ultrasonic dimension gauge crystals. Slow infusions (more than 15 minutes) of MnCl2 (0.1 mm/kg) or Gd DTPA (0.1 mm/kg) via an infusion pump had no significant hemodynamic effects. When given in just over 1 minute, Gd-DTPA produced elevated left ventricular (LV) end diastolic pressure and minor dilation of the ventricle and slowed diastolic filling. MnCl2, given rapidly, reduced systemic vascular resistance, resulting in hypotension. It also reduced LV volume and had less marked diastolic effects (probably secondary to the amount of hypotension created). With both agents, these side effects waned after 5-10 minutes. It is concluded that both Gd-DTPA and MnCl2 can be given safely in 0.1-mm/kg doses when administered as a slow, continuous infusion. The acute hemodynamic effects of Gd-DTPA are consistent although minor. While the acute effects of Gd-DTPA are small, neither agent is sufficiently innocuous to be given as a rapid injection in clinically unstable patients. Slow, intravenous infusion of Gd-DTPA or MnCl2 is likely to be tolerated well by even severely ill individuals. PMID- 3969480 TI - Dynamic CT features of hepatic abscesses. AB - Forty hepatic abscesses were examined with dynamic computed tomography (CT). A "double target sign," consisting of a hypodense central area surrounded by first a hyperdense ring and then a hypodense zone, seems to be highly suggestive of abscess formation. In 12 cases, the hepatic parenchyma surrounding the lesion demonstrated transient hyperdensity after contrast injection, possibly due to localized hepatic venous obstruction secondary to acute hepatic inflammation. This is similar to the appearance of an arterioportal fistula. PMID- 3969481 TI - The spleen in Hodgkin disease: diagnostic value of CT. AB - Findings of CT of the spleen were compared with those of histologic examination in 35 patients who had Hodgkin disease. CT provides a simple way to calculate splenic size. This index is also of value in the assessment of the histologic state of the spleen. An accuracy rate of 91%, specificity of 94%, and a sensitivity of 89% in diagnosing splenic localization of lymphoma was found in this study. PMID- 3969482 TI - Computed-tomographic and conventional linear-tomographic evaluation of tracheobronchial lesions for laser photoresection. AB - Laser therapy is a new modality for treatment of airway lesions. We examined 18 patients prior to laser photoresection of tracheobronchial lesions. Thirteen had cancers involving the distal trachea, carina, and/or proximal bronchi; five had benign lesions of the middle or proximal trachea. Each patient was examined by conventional linear tomography (CLT) and computed tomography (CT). CT was valuable in patients who had lesions of the distal trachea, carina, and/or proximal bronchi. Its particular usefulness, and its advantage relative to CLT, consisted in its ability to delineate vascular structures adjacent to the planned area of photoresection. Neither CLT nor CT was helpful in evaluation of benign lesions of the proximal trachea. PMID- 3969483 TI - Calf hematoma mimicking thrombophlebitis: sonographic and computed tomographic appearance. AB - Five patients with calf hematomas presented with signs and symptoms suggesting thrombophlebitis, obscuring the correct diagnosis. Venography showed no venous thrombosis; further diagnostic studies using ultrasound and/or computed tomography provided the correct diagnosis in all patients. Ultrasound showed a hypoechoic mass clearly demarcated from surrounding soft tissue, while computed tomography showed a well-defined mass whose density depended on the age of the hematoma. PMID- 3969484 TI - Assessment of regional wall motion and perfusion by multigated myocardial scintigraphy after intracoronary Tl-201. AB - Fourteen patients undergoing intracoronary thrombolysis for acute myocardial infarction had intracoronary injection of thallium-201 to assess myocardial salvage after reperfusion. Scintigrams of the perfused myocardium were gated and compared with both ungated scans and radionuclide ventriculograms (multigated blood pool scintigrams) to determine the value of gated perfusion images for studies of both perfusion and regional wall motion. Multigated and ungated thallium images provided comparable information about regional myocardial perfusion. Correlation between multigated thallium images of regional wall motion and radionuclide ventriculograms was poor (tau = 0.44). Assessment of wall motion was most accurate in well-perfused segments and least accurate in partially perfused segments. PMID- 3969486 TI - Digital chest radiography: performance evaluation of a prototype unit. AB - Measurements of the physical performance of a prototype digital chest unit (DCU) are presented. The parameters evaluated were entrance skin exposure, system exposure response and dynamic range, system modulation transfer function (MTF), image noise levels, detective quantum efficiency (DQE) of the detector, and scatter suppression efficiency. Compared with conventional chest imaging systems, the unit has markedly greater exposure latitude, limited spatial resolution, a lower detector DQE, and virtually scatter-free images. Routine clinical exposure levels are comparable with the 1982 national average. PMID- 3969485 TI - Kr-81m ventilation imaging: clinical utility in suspected pulmonary embolism. AB - The results of Kr-81m/Tc-99m ventilation-perfusion (VP) lung scintigraphy were correlated with the results of pulmonary angiography for 74 patients suspected of having pulmonary embolism (PE). Among patients having a diagnostic scan, the sensitivity and specificity of scintigraphy were 91% and 94%, respectively. Also, 157 consecutive cases of Kr-81m/Tc-99m VP lung scintigraphy were reviewed, and the frequency of an indeterminate scan was found to be 22%. A similar frequency was found for VP scintigraphy with xenon-133. Of eight patients who had indeterminate scans due to the presence of a single VP mismatch, four were demonstrated to have PE by angiography. Kr-81m is an excellent agent for VP scanning in cases of suspected PE, offering accuracy in diagnosis as well as favorable physical properties. PMID- 3969487 TI - Ultra-high-strip-density radiographic grids: a new antiscatter technique for mammography. AB - We conducted a comprehensive study on the application of ultra-high-strip-density (UHSD) grids to mammography for the improvement of image contrast. These UHSD grids have strip densities of 70 to 100 lines/cm. After investigating the performance of mammographic grids with various design parameters through Monte Carlo simulation studies, we made prototypes of UHSD grids having lead strip thicknesses of 20 to 37 micron, aluminum interspacer thicknesses of 80 to 120 micron, and grid ratios of 2 to 6. The UHSD grids can be placed inside the cassette without a Bucky tray and thus will not increase geometric unsharpness. The measured physical characteristics and the phantom images obtained confirmed our findings in the simulation studies. A 40 to 90% increase in contrast was achieved at Bucky factors of 2 to 3.5; these results are comparable with those from conventional antiscatter grid techniques in mammography. The potential usefulness of the UHSD grids was demonstrated in a preliminary clinical comparison of mammograms. PMID- 3969488 TI - Tenckhoff peritoneal dialysis catheters: the use of fluoroscopy in management. AB - Manipulation of the Tenckhoff catheter under fluoroscopic guidance is a useful procedure in patients who undergo chronic ambulatory peritoneal dialysis (CAPD). We reviewed 50 manipulations in 28 patients. There were no significant complications attributable to the procedure. Ten per cent of the manipulations were performed for visceral pain, 40% for malfunction within the first two weeks of catheter placement, and the remaining 50% for malfunction after two weeks of adequate dialysate flow. Overall, an initial success rate of 88% was recorded, and, after long term study, a durable success rate of 58% was demonstrated. Early malfunction (i.e., within the first two weeks) is a more ominous prognostic indicator than previously realized, with only 30% of these manipulations ultimately succeeding vs. 60% of manipulations in late onset catheter failure. Nevertheless, at least one attempt is warranted in manipulation of a malfunctioning Tenckhoff catheter. PMID- 3969489 TI - Barium suspension formulation for use with the bubbly barium method. AB - A new medium density barium suspension is described for the biphasic contrast examinations of the upper gastrointestinal tract. It is designed for the bubbly barium method, and combines good mucosal coating properties in the double contrast phase of the examination with transparency in the single contrast graded compression phase. PMID- 3969490 TI - Temporomandibular joint: magnetic resonance imaging. AB - Magnetic resonance (MR) imaging of the temporomandibular joint was performed in two subjects using a 1.5 T experimental imaging system equipped with a 6.5 cm surface coil antenna. Normal and pathologic anatomy were demonstrated with exquisite detail. Anterior displacement of the joint meniscus was clearly visible in the symptomatic subject, consistent with arthrographic confirmation. PMID- 3969491 TI - Bone scintigraphy in neonatal osteomyelitis. PMID- 3969492 TI - Computed tomography in the evaluation of diverticulitis. PMID- 3969493 TI - Control of poliomyelitis in Bulgaria: experience of two decades. PMID- 3969494 TI - [The analyst as detective, the detective as analyst]. PMID- 3969495 TI - [Significance of the basic principle for the psychoanalytic method]. PMID- 3969496 TI - [Convergence of linguistic and psychoanalytic text studies. Exemplified by a case report from the Balint group]. PMID- 3969497 TI - [From the archives of psychoanalysis. Pinocchio]. PMID- 3969498 TI - [Polymyositis and dermatomyositis in the metropolitan hospital complex of the Panama Department of Social Security. 1973. Clinical review and effects of treatment]. PMID- 3969499 TI - [9 years of the Cancer Register of Panama]. PMID- 3969500 TI - [Evaluation of hematologic values of a suburban population]. PMID- 3969501 TI - [Infectious endocarditis in Santo Tomas Hospital, 1974-1984]. PMID- 3969502 TI - [Monitoring of intracranial pressure]. PMID- 3969503 TI - [Nutritional evaluation of flour from shrimp heads. By-product residue]. PMID- 3969504 TI - [Cutaneous reactivity of the Panamanian population against 3 fungus antigens]. PMID- 3969506 TI - Effects of phosphate and calcium infusion on renal phosphate transport in the dog. AB - The effect of phosphate infusion on renal tubular handling of calcium and phosphate was examined in dogs which had been thyroparathyroidectomized (TPTX) immediately prior to the studies. Phosphate infusions in TPTX animals caused a small decrease in total and ultrafilterable plasma calcium, and decreased phosphate reabsorptive capacity in the proximal tubule and loop segment. Infusion of CaCl2 during phosphate loading to offset the fall in plasma calcium prevented the reduction in proximal phosphate reabsorptive capacity. However, between the proximal and distal sampling site, the reduction in phosphate reabsorptive capacity could not be prevented by CaCl2 administration. These data are consistent with the presence of two phosphate transport systems; one in the early proximal tubule, modulated by changes in plasma calcium level, and a second in the loop segment, which is independent of calcium. While the data suggest that the depression of proximal phosphate reabsorption during phosphate infusion may be secondary to the fall in plasma calcium concentration, they do not exclude a direct effect of infused phosphate on proximal phosphate reabsorption that may be antagonized by an opposing direct effect of the calcium infusion. PMID- 3969505 TI - Effect of free fatty acids on renal metabolism of very low density lipoprotein triglyceride. AB - Metabolism of very low density lipoprotein-triglyceride (VLDL-TG) was studied in the isolated perfused rat kidney (IPRK). Recirculating perfusate consisted of Krebs-Henseleit bicarbonate buffer containing 6% defatted albumin and VLDL-TG which has been labelled in vitro with 14C-tripalmitin. Results show that the IPRK catabolizes VLDL-TG. Renal removal of VLDL-TG from perfusate was impaired in the presence of 1.0 mM palmitate. A lower palmitate concentration, 0.4 mM, was without effect. It is concluded that high concentrations of circulating free fatty acids impair renal metabolism of fatty acids derived from VLDL-TG. PMID- 3969507 TI - Quantitative method for the determination of glycosaminoglycans from small quantities of glomerular basement membranes. AB - A simple, sensitive, and efficient method is described for the quantitative determination of glycosaminoglycans from bovine renal glomerular basement membranes. After release from glomerular basement membrane by protease treatment, the glycosaminoglycans were isolated by a modified DEAE-cellulose column chromatographic procedure. Quantitation of glycosaminoglycans was achieved by hexuronate measurements with a microadaptation method employing m hydroxydiphenyl. This procedure has proven useful in analyzing small samples of basement membranes as little as 0.75 mg. The glycosaminoglycan was identified as heparan sulfate by cellulose acetate electrophoresis and nitrous acid treatment. PMID- 3969508 TI - Permselectivity and proteinuria in 'minimal-lesion' nephrosis. PMID- 3969509 TI - Renal albumin reabsorption in normal and sodium maleate-treated rats. AB - The normal filtered load of albumin at the rat glomerulus was estimated to be 18 mg/24 h X g kidney weight by means of micropuncture studies. Total nephron fractional reabsorption was 91%. The proximal convoluted tubule accounted for 72% of total reabsorption followed by an additional 12% in the loop of Henle. Only minimal protein uptake occurred in more distal parts of the nephron. Na maleate, given at a dosage of 2 mM/kg body weight 2 h prior to micropuncture, inhibited tubular albumin uptake in the proximal convoluted tubule. As in controls there was no measurable protein uptake beyond the loop of Henle. These results indicated that tubular reabsorption of albumin was virtually completed by the early distal convoluted tubule. Maleate was found to be a potent inhibitor of protein transport in the proximal convoluted tubule resulting in a fractional excretion of albumin of 50%. PMID- 3969510 TI - Evolution, cardiac failure, and water metabolism. Presidential address. AB - In this essay, I take the liberty of doubting the widely held view that congestive cardiac failure is due to an inability of the heart to provide enough oxygen for the needs of the body. Instead, the syndrome is best explained by an inappropriate and prolonged stimulation of the neurohumoral defense reaction that developed during evolution to support exercise and preserve life. PMID- 3969511 TI - Dependence of protein synthesis on aortic pressure and calcium availability. AB - Increased aortic pressure accelerated protein synthesis in control-beating and arrested-drained hearts supplied with either glucose or pyruvate. Elevation of perfusion pressure from 60 to 120 mm Hg increased oxygen consumption in control beating but not in arrested-drained preparations. Energy availability, as assessed by adenylate energy charge or creatine phosphate/creatine ratio, or both, was increased in arrested-drained hearts supplied with glucose and perfused at 60 and 120 mm Hg aortic pressure. In control-beating or arrested-drained hearts supplied with pyruvate, energy availability was not improved by elevation of aortic pressure from 60 to 120 mm Hg. An increase of perfusate calcium concentration from 0.5 to 5.0 mM in control-beating Langendorff preparations supplied with glucose and perfused at an aortic pressure of 90 mm Hg doubled oxygen consumption and decreased energy availability, but had no effect on the rate of protein synthesis. In arrested-drained hearts supplied with either glucose or pyruvate and calcium concentrations ranging from 0.5 to 5.0 mM, the rates at 120 mm Hg aortic pressure were 11-25% higher than at 60 mm Hg. These findings provide no evidence to implicate increased oxidative metabolism, energy availability, or extracellular calcium concentration as important factors in the mechanism that accounts for the effects of increased aortic pressure on protein synthesis. PMID- 3969512 TI - Phosphorus two-dimensional NMR spectroscopy of perfused rat hearts. AB - The theory behind the technique of two-dimensional (2-D) NMR is presented with particular reference to 2-D J-spectroscopy and 2-D exchange spectroscopy. Experiments are described in which both these types of 2-D NMR are applied to the isolated perfused rat heart. Possible advantages of 2-D techniques and future applications to physiological systems are discussed. PMID- 3969513 TI - Disturbances of the heart structure and function in chronic hemolytic anemia, their compensation with increased coronary flow, and their prevention with ionol, an inhibitor of lipid peroxidation. AB - The structure and function of heart muscle were studied in rats with chronic hemolytic anemia induced by phenylhydrazine. Contractural lesions, myocytolysis, fatty dystrophy, and small-focal necrosis were found in the myocardium along with hypertrophy. The disturbances were accompanied by a compensatory increase in the coronary flow by 2.5-fold during myocardial contractions. When the coronary flow of isolated hearts was experimentally decreased to the control level, a great depression of the contractile function developed. Administration of the antioxidant ionol, an inhibitor of lipid peroxidation, simultaneously with phenylhydrazine did not prevent the development of the hemolytic anemia, but decreased by 2 times the degree of hypertrophy and the amount of the lesion foci in the heart muscle. It also significantly inhibited the compensatory increase of coronary flow and completely eliminated depression of the heart contractile function during the normalization of coronary flow. The data allow a suggestion that hemolytic anemia is accompanied by activated lipid peroxidation, this process playing a role in the myocardial damage of anemia. Antioxidants can prevent such damage. PMID- 3969514 TI - Intercellular junctions and the cardiac intercalated disk. AB - Cardiac muscle cells are equipped with three distinct types of intercellular junction--gap junctions, "spot" desmosomes, and "sheet" desmosomes (or fasciae adherentes)--located in a specialized portion of the plasma membrane, the intercalated disk. Gap junctions are responsible for electrical coupling and the transfer of small molecules between cells, whereas the desmosomelike junctions (also known as adherens junctions) provide strong intercellular adhesion. The adhesion sites formed by the "spot" desmosome anchor the intermediate-filament cytoskeleton of the cell; those formed by the fascia adherens anchor the contractile apparatus. An understanding of the ultrastructure of these junctions helps explain how they carry out their functions, and new observations in this field have been made through the application of ultrarapid freezing techniques in conjunction with freeze-fracture electron microscopy. With recent findings from biochemical and immunocytochemical studies, this understanding is now being extended to the molecular level. PMID- 3969515 TI - Extracellular structures in heart muscle. AB - The extracellular matrix of heart muscle contains a considerable variety of structures. We have systematically studied the morphology of these structures using several methods of fixation and microscopy. Endomysial connections between cells are comprised of struts of collagen [1] as well as combinations of elastin fibers, collagen fibers, and microfibrils. The rest of the extracellular matrix is filled with a polyanionic lattice of unit collagen fibrils, microthreads, and granules. In the course of these investigations, we have observed regions of structural continuity across the sarcolemma, from endomysial collagen struts to Z bands. We have also correlated the mechanical resistance to stretch with orientation of epimysial collagen fibers and sarcomere lengths in living as well as fixed rat papillary muscles. Our observations suggest that the extracellular skeletal framework plays an important role in normal cardiac function. PMID- 3969516 TI - Ventricular collagen matrix and alterations. AB - There is a complex extracellular structural matrix in the heart. This matrix appears to be composed of a variety of fibrils and fibers extending from the cell surface to the basal lamina and from the basal lamina to the matrix. The extensions into the extracellular region interconnect with a system of collagen bundles. The latter are so located that they would tether the myocytes to each other as well as tether the capillaries to the myocetes. There is an extensive weave of collagen analogous to the perimysium of skeletal muscle that separates groups of myocytes. The weave surrounding a group of myocytes is connected to adjacent weave patterns by long, tendonlike structures. The collagen matrix around cells disappears 2-3 hr after coronary-artery occlusion. In the periinfarct region of viable cells, the matrix is similarly lost and is replaced by scarlike collagen. Encephalomyocarditis virus causes a similar loss of the matrix in necrotic as well as some adjacent nonnecrotic regions. Replacement of the lost matrix is by scar tissue. The long-term appearance of the replacement fibrosis closely resembles the appearance of diffuse fibrosis as seen in a variety of conditions. These observations suggest that diffuse fibrosis can occur secondary to loss of the matrix both with and without myocyte necrosis. This may help explain the diffuse left ventricular fibrosis as seen in a variety of human disease. PMID- 3969517 TI - High-time-resolution 31P NMR studies of the perfused ferret heart. AB - A cell is described that has enabled isolated Langendorff-perfused ferret hearts to be studied in a Bruker WM200 widebore superconducting nuclear magnetic resonance (NMR) spectrometer. Left ventricular pressure was monitored with a latex balloon catheter, and the hearts were paced with a stimulator triggered from the spectrometer's central computer, enabling gated studies to be performed. Suitable radiofrequency filtering for the pacing leads is described. Phosphorus (31P) NMR was used to determine internal pH and the concentration of phosphorylated metabolites under resting conditions. The perfusion rate is shown to affect the phosphocreatine/ATP ratio at low flow rates, but the removal of phosphate from the perfusate is shown not to affect metabolite levels or the internal pH. The time resolution of the method is assessed and its potential for monitoring transient effects illustrated by studies of the effects of acetylcholine and cyanide-induced anoxia. The cardiac gated 31P NMR experiment is discussed and four spectra, corresponding to mid- and end systole and mid- and end diastolic are presented. No effects of cycling of high-energy phosphates are evident in these results. PMID- 3969518 TI - Interaction of amphiphilic molecules with biological membranes. A model for nonspecific and specific drug effects with membranes. AB - The nonspecific interactions of propranolol, timolol, and ethanol with model and sarcoplasmic reticulum membranes were determined utilizing radioisotopic association differential scanning calorimetry, and neutron diffraction. Differential scanning calorimetry performed on mixtures of these amphiphilic compounds and model membrane bilayers composed of dimyristoyllecithin showed that propranolol was approximately 25 times more lipid-soluble than timolol and at least 100 times more lipid-soluble than ethanol. Neutron diffraction showed that the solvation of propranolol was within the fatty acyl chain region of the lipid bilayer. This solvation correlated with the effect of propranolol to inhibit ATP dependent calcium transport in isolated rabbit skeletal muscle sarcoplasmic reticulum, a membrane that lacks beta-adrenergic receptors. In contrast, the major site of interaction of ethanol was within the aqueous compartment hydrating the sarcoplasmic reticulum membrane. A model for nonspecific drug interaction with the sarcoplasmic reticulum membrane based on the site of interaction of these amphiphiles and their relative potencies to inhibit calcium transport by these membranes is proposed. In principle, this model could be extended to specific drug interactions with membranes. PMID- 3969519 TI - Impaired acetaldehyde metabolism in partially hepatectomized rats. AB - Two-thirds hepatectomy in rats resulted in elevated blood ethanol and acetaldehyde levels as compared to those of sham operated and CCl4-induced toxic injured rats. The acetaldehyde/ethanol ratio increased also. Although the liver mass regenerated within 3 days, ethanol metabolism remained disturbed. Mitochondrial aldehyde dehydrogenase activity was significantly diminished only following partial hepatectomy. The results suggest that abnormal ethanol and especially acetaldehyde metabolism in partially hepatectomized rats is not due simply to reduced liver tissue but to a diminished aldehyde dehydrogenase activity in the remaining tissue. PMID- 3969520 TI - Hemorrhagic shock in the dog. I. Correlation between survival and severity of shock. AB - A prerequisite elucidating the pathomechanism of hemorrhagic shock are reproducible experimental models, leading to a predictable outcome. Two concepts have been reported to be a good predictor for the outcome both employing a fixed hypotension level: total oxygen deficit and shed blood volume uptake. To correlate these two models we subjected 31 dogs to a standardized hemorrhagic shock procedure. Besides determination of acid-base status, hematocrit, mean arterial pressure, and cardiac output, these two parameters were measured continuously. Seventeen dogs survived the shock procedure, 14 died within 24 h. During shock, neither oxygen deficit nor any other parameter mentioned above correlated with the final outcome of the shock state. The only significant difference between surviving and non-surviving animals during this period was the amount of uptake. The non-surviving dogs exhibited a higher uptake volume, indicating an incipient collapse of the microcirculation. Terminating the duration of hypotension at an uptake volume of 5% of the maximum shed blood, all animals survived, while after an uptake volume of 15% about 50% of the dogs died. Using uptake volumes of various degrees in a hemorrhagic shock model as the endpoint of the hypotensive stress, it seems possible to produce reliable survival rates. PMID- 3969522 TI - Intravenous spiral support for the prevention of outflow-tract stenosis in av shunts for hemodialysis? AB - Intraluminal spiral support of bovine heterografts (Solcograft-P) offers promising mechanical characteristics for av-shunts. Using a tunneling technique the spiral prevents twisting and kinking during subcutaneous placement and allows prolonged and vigorous post-puncture compression for hemostasis without compromising shunt flow. Canine experiments (femoro-femoral loop) suggest that additional insertion of the spiral into the efferent vein for some centimeters can prevent or delay the development of outflow-tract stenosis, the main cause of late shunt failure (0% (0/5) vs. 75% (3/4) significant stenosis; total patency rate 90% (9/10); follow-up 3 months). Preliminary clinical results with brachio cephalic/basilic av-shunts in the forearm (loop) support our experimental investigations. In all eight patients the shunt is functioning perfectly without reinterventions being necessary (mean follow-up 8.8 months, totally 55 dialysis months). In five patients the shunt was used early for hemodialysis (days 1-10 post operation). Angiographically, stenoses developed in the outflow-tract in five of six shunts, but only one stenosis was observed in the spiral-supported venous segment where it usually occurs. In some cases shunt function was preserved by collaterals from the nonstenotic spiral-supported venous segment despite occlusion of the main efferent vein. Thus, it appears that a spiral placed into the graft and efferent vein is suitable to prolong the functional life of av-shunts. PMID- 3969521 TI - Cytostatic drug effects on human clonogenic tumor cells and human bone marrow progenitor cells (CFU-C) in vitro. AB - Human tumor cells from a squamous cell carcinoma of the lung and from a malignant melanoma and human bone marrow progenitor cells were cultured in a methylcellulose monolayer system. To obtain tumor material for repeated experiments with human tumor specimens, human xenografts grown in the nude mouse system were used. The cultures were incubated continuously with adriamycin, actinomycin-D, bleomycin, cisplatinum, and melphalan. Dose response curves for bone marrow and tumor cell colonies were established. A comparison of bone marrow and tumor cell colony dose response curves might be useful for the assessment of the drug sensitivity of tumor cells independent of in vivo pharmacologic data and duration of drug exposure. PMID- 3969523 TI - The key role of sex dependency on kidney citrate metabolism in the rat. AB - An evaluation of the potential role of the kidney in the regulation of the blood citrate level under different acid-base statuses and various diets was performed. Twenty-four hours after bilateral nephrectomy there was a highly significant increase in the blood citrate concentrations in female rats, whereas the blood citrate levels either remained unchanged or decreased in bilateral nephrectomized male animals. Our data clearly indicate a key role of sex dependency on kidney citrate metabolism in the rat. PMID- 3969524 TI - Osmotic fragility of drug carrier erythrocytes. AB - Erythrocytes have been proposed as biogradable cellular carriers for drugs. Potentials of this therapeutic approach are organ-specific targeting, protection and prolonged in vivo function of the encapsulated drugs. Previous studies demonstrated the advantage of a hypo-osmotic dialysis procedure for macromolecule loading resulting in cells that are closely similar to normal erythrocytes. Osmotic fragility of unloaded and loaded "carrier" erythrocytes was studied both in respect of shelf-life and in vivo survival. Sudden haemolysis which is characteristic for normal erythrocytes was never obtained with carrier erythrocytes. Haemolysis appeared at all osmotic pressures and increased stepwise indicating the existence of various cell populations. However, the majority of cells were haemolysed at lower values of the osmotic fragility curve. Osmotic fragility was highly increased when cytotoxic chemotherapeutics were encapsulated, and these cells appeared as spherocytes using scanning electron microscopy. Osmotic fragility proved to be a simple but reliable method for the in vitro evaluation of carrier erythrocytes and the effect of the encapsulated substances. PMID- 3969525 TI - [Possibilities of identifying the assailant in rape cases by serologic testing of semen stains]. PMID- 3969526 TI - [Polyostotic eosinophilic granuloma with pituitary insufficiency]. PMID- 3969527 TI - [Drug-induced hyperthyroidism]. PMID- 3969528 TI - [Relation of biochemical indicators of bone remodeling in healthy children and adolescents]. PMID- 3969529 TI - [Changes in blood calcium during physiologic and pathologic pregnancy]. PMID- 3969530 TI - [The effect of a diet enriched with marine and freshwater fish on the levels of plasma lipids after 3 months of administration]. PMID- 3969531 TI - [Family environment in childhood and suicidal behavior]. PMID- 3969532 TI - Application of the Beckman JE6-B Elutriator System in the isolation of human monocyte subpopulations. AB - Beckman Instruments recently developed an improved version of their JE-6 Elutriator Rotor. At 3000 rpm (867 X g), lymphocytes were eluted from the chamber at flow rates of 10 to 18 ml/min. Small monocytes (362 mu 3) were collected at 18 ml/min over 400 ml while the larger monocytes (395 mu 3) were retained in the chamber until the flow rate was increased to 28 ml/min. These parameters differ from those previously reported by us when we used Beckman's original commercial version of the JE-6 Elutriator Rotor. The new JE-6B rotor required an increase of centrifugal force from 625 to 867 X g generated by an increase in rpm from 2500 to 3000, as well as an increase in flow rates to collect both small (17 to 18 ml/min) and large (26 to 28 ml/min) monocytes. The monocytes collected using the new rotor with the revised protocol have the same physical and functional properties as those collected with the earlier version using our previously published protocol. PMID- 3969533 TI - Distribution of HLA genotypes in sibs of patients with acute leukaemia. AB - More unaffected sibs than expected have the same HLA genotypes as their sib with acute leukaemia. This seems not to be due to the restricted heterogeneity in HLA antigens described in the parents of sibs with acute leukaemia. PMID- 3969534 TI - Quantification of bone lytic lesions and prognosis in myelomatosis. AB - Degree and extent of lytic bone lesions were quantified at diagnosis in 69 patients with myelomatosis (MM). longest survival was found in patients with minimal lytic lesions and shortest survival was found in those either without bone lesions or with severe and extensive lesions. Among the 12 patients without bone lesions only 6 were Durie & Salmon stage I and only 1 later developed a single lesion. Based on these data, bone involvement in MM does not seem to be a reliable predictive factor of survival in all cases. This suggests the existence of 2 distinct types of MM: 1 with tumour and 1 without. Lytic lesions could have a prognostic value only in the 1st type. PMID- 3969535 TI - Binding of human IgA fragments to protein A-Sepharose studied with an ELISA method. AB - An enzyme-linked immunosorbent assay method was developed to investigate the binding of IgA fragments to protein A. The method proved to be specific and highly sensitive. Contamination with IgG did not interfere with the detection of IgA binding to protein A, and less than 10 ng of IgA could be detected. Four of nine IgA proteins tested bound to protein A to different extents. The binding was not disturbed by reduction and alkylation of the IgA proteins. Four-chain F(abc)2 and F(ab')2 fragments of the protein A-reactive IgA proteins also bound to protein A. On reduction and alkylation these fragments formed two-chain Fabc and Fab' fragments. Of these, Fabc did not bind, whereas both Fab' and IgA1-protease produced Fab fragments did bind to protein A. These results demonstrate that the Fab fragment has a binding site for protein A. It is suggested that the protein A binding site is located on the CH1 domain of the IgA1 molecule. On Fabc fragments this binding site may be blocked because of structural alterations. PMID- 3969536 TI - Isopycnic ultracentrifugation of immune complexes. AB - Isopycnic ultracentrifugation is frequently applied for preparative isolation of macromolecules. Using bovine serum albumin (BSA)-anti-BSA antibody complexes as a model system, isopycnic banding of complexes was observed in CsCl, Nycodenz, and sucrose gradients. In CsCl gradients, free antigen or antibody could not be separated from the immune complexes. Variations in antigen to antibody ratio from equivalence and in the amount of complement present during complex formation resulted in zone broadening and banding at slightly lower densities in Nycodenz. This was not observed in sucrose. Serum immune complexes were isolated from patients with rheumatoid arthritis or ankylosing spondylitis. Banding of in vivo formed immune complexes was observed more frequently in sucrose than in Nycodenz. PMID- 3969537 TI - [Extra-aortic aneurysms. Analysis of 163 aneurysms in 142 patients]. AB - 163 extraaortic arterial aneurysms in 142 patients from autopsy and biopsy material were analyzed. The mean age of the autopsy cases was 71.3 years and of the biopsy cases 52.1 years. The mean age of all the cases was 61.3 years for men and 53.2 years for women. A predominance of the male sex was evident, with an overall ratio of 4:1. The majority of aneurysms were localized in the main arteries of the lower extremities below the aortic bifurcation. Among the etiologic factors, arteriosclerosis was by far the most important, whereas inflammatory disorders and degenerative lesions of the media (medionecrosis of Erdheim and Gsell, mucoid degeneration of media) were less frequently the reason for aneurysm formation. In contrast to the aorta, inflammatory alterations of the arteries which were responsible for aneurysm formation were usually caused by bacterial infections (mycotic aneurysms). In spite of the increasing nicotine consumption of the female population, an increase in female patients with arteriosclerotic aneurysms was not detected. PMID- 3969539 TI - [Extensive intra-abdominal tumor masses in primary osteomyelofibrosis]. AB - A 65-year-old female suffering from agnogenic myeloid metaplasia developed multiple gradually growing tumor masses in the abdomen 4 years after splenectomy. At death, the abdominal cavity was mainly dominated by these masses. At autopsy, histological examination of the tumor tissue revealed extramedullary hematopoiesis with an intensive fibroblastic reaction whose appearance was very similar to the fibrous bone marrow. Pathogenesis, complications and therapy of this unusual manifestation of extramedullary hematopoiesis in agnogenic myeloid metaplasia are discussed. PMID- 3969538 TI - [Current aspects in the evaluation of radiation risk: from the risk to organs to total injury risk (effective equivalent doses)]. AB - For the estimation of the health risks of radiation in man by low radiation doses as well as to compare the man-made radiation exposure with the natural one, it is proved useful and necessary to estimate the effective dose-equivalent. It is not sufficient to take only into consideration the radiation exposure of bone marrow and gonads. Due to an external irradiation source as well as by incorporation of radioactive materials, various tissues and organs in the human body will simultaneously be exposed. This is best illustrated by the component of the "natural" radiation exposure with radon, attributable more or less to our living conditions. The incorporation of radon and its daughters in the lung with its cancer causing risk is not evaluated in the determination of the gonads and bone marrow dose. The effective dose-equivalent is being estimated for the evaluation of possible radiation risk by the carcinogenic and mutagenic effectiveness of radiation (stochastic radiation risk) with weighting factors. For the genetic risk solely 25% and for the somatic risk 75% are granted, whereas the risk factor "breast tissue" dominates. PMID- 3969540 TI - [Acute graft-versus-host disease following a single transfusion of erythrocytes]. AB - A 50-year-old severely immunodeficient woman with malignant non-Hodgkin lymphoma died from graft-versus-host disease due to transfusion of a single unit of packed red cells. Three days after this transfusion a maculo-papular rash appeared, followed by generalized erythroderma refractory to therapy and eventually progressing into generalized ulcero-squamous dermatitis. This case, and a review of other similar cases published elsewhere, prompt the authors to recommend prophylactic irradiation of blood products prior to their administration to patients with cellular immunodeficiency, particularly in cases of acute leukaemia or malignant lymphoma where patients receive intensive radio- and/or chemotherapy regimens. To appreciate the degree of cellular immunodeficiency in such risk patients, simple criteria should be developed to assess the efficiency of the cellular immune system. PMID- 3969541 TI - [Diuretics and antihypertensive agents in chronic kidney insufficiency: comparison of the effects of metolazone and furosemide]. AB - Increasing dosages of two potent diuretic agents (5, 10, 20 mg metolazone or 40, 80, 160 mg furosemide) were compared in 35 patients with hypertension and chronic renal failure. In cases with insufficient blood pressure control, 10 mg pindolol was given as a second drug. Finally, patients not responding to a betablocker diuretic combination received 100 mg hydralazine as a third drug. Both diuretics had comparable antihypertensive potency during a treatment period of up to 12 weeks. Maximal antihypertensive response was observed under 10 mg metolazone or 160 mg furosemide. However, only in 25% of our patients blood pressure was normalized with diuretic monotherapy (metolazone or furosemide). The remaining cases needed either an additional betablocker or a combination of three different antihypertensive agents. Under these conditions a substantial proportion of our patients (20%) did not reach the therapeutic goal (diastolic blood pressure less than 95 mm Hg). These results document the difficulties of hypertension management in chronic renal failure. An early change to the stepped-care approach should be made in all cases with insufficient blood pressure response to potent diuretics. PMID- 3969542 TI - [Can carboxyhemoglobin determination be performed in family practice?]. AB - Carboxyhemoglobin concentrations were measured in venous (EDTA) blood samples from 16 cigarette smokers. The determinations were carried out up to 72 hours after venipuncture in blood stored at 20 degrees C and 37 degrees C and after hemolysis and storage at 20 degrees C. No special precautions to avoid exposure of the samples to room air were taken. Comparison of these determinations with an "ideal" reference value (immediate determination, no O2 access) indicates that changes in COHb concentrations are minimal for the first 48 hours (range of mean concentration changes: -0.28% COHb to +0.19% COHb). It is concluded that COHb determinations in venous blood samples yield reliable results for practical diagnostic purposes, even without time-consuming and costly conservation procedures. PMID- 3969543 TI - [Deep accidental hypothermia without cardiorespiratory arrest]. AB - A case is reported of profound accidental hypothermia with spontaneous cardiac activity in a patient presenting several risk factors. The rewarming from 23.5 degrees C to 36.5 degrees C by partial cardio-pulmonary bypass was carried out without complications and in particular without cardiac arrythmia. As far as we are aware this is the twelfth case of profound accidental hypothermia reported in the literature in which rewarming was carried out by this method and the fourth case not involving cardiac arrest. Rapid rewarming by partial cardio-pulmonary bypass could be useful in patients with profound accidental hypothermia without cardiac arrest, the most serious complication being, precisely, cardiac arrest during rewarming. PMID- 3969545 TI - How the trypanosome changes its coat. PMID- 3969544 TI - [Medical problems in refugees from Sri Lanka (Tamil)]. AB - Recently many refugees from Sri Lanka have arrived in Europe. The purpose of the present investigation was to analyze the subjective complaints and diagnoses in these refugees. One hundred refugees (97 males, 3 females, age 19 to 42 years) were investigated. The most common reasons for consulting a general internist were cough (23%), general pain in soft tissue and joints (21%), disorders of the gastrointestinal tract (19%) and ear or throat complaints (15%). In 43% of the patients no diagnosis could be established. 58 patients were investigated for parasites in stool: 57% of these patients had hookworms, 12% non-pathogenic protozoon, 9% Entamoeba histolytica cysts, and 2% Giardia lamblia. In 12% of the patients the diagnosis was tonsillitis or pharyngitis, in 7% bronchitis, pneumonia or asthma and in 5% arterial hypertension. Various other diagnoses were established in 48 patients. With the exception of the high frequency of intestinal parasites, complaints and diagnoses in these refugees were the same as in a comparable European population. PMID- 3969546 TI - Sex-related factors in acute carbon monoxide intoxication in one strain of mice. AB - In the OF1 mouse strain, males are less resistant than females to acute carbon monoxide intoxication. Castration of males increases their resistance to carbon monoxide. For Neonates injected with four different doses of testosterone (20-500 mg per kg) or oestradiol (2-50 mg per kg), more effect on resistance to carbon monoxide in the (adult) mice was found for oestradiol than for testosterone. Pregnancy decreases resistance to carbon monoxide intoxication. Experiments performed with males and females of different ages, in various societal conditions, show the effects of sex-related dimorphism and aggressiveness. The sex-related difference in carbon monoxide resistance is not modified by a previous hypoxic stress (nitrogen hypoxia, carbon monoxide intoxication, sodium cyanide injection) but is suppressed when the CO intoxication is carried out at a low ambient temperature (13 degrees C). PMID- 3969547 TI - Zinc and copper concentrations in the hair of workers from zinc based industries in India. AB - Some trace elements have been identified as potential hazards following long term exposure, and recently there has been intense work on different elemental exposure studies. Hair being the most convenient biopsy material has enabled the study of these elements in the human body and periodic sampling provides rates for their uptake. The present study has been done to compare the concentration of zinc and copper in human hair of the workers from the zinc based industry at Udaipur. The study shows that the concentration of zinc is higher in smelter workers than in the population of Udaipur city; the value of zinc in the mine workers is close to that of Udaipur city subjects. However, the correlation between the two elements is significant at p less than 0.01 for zinc mine workers. PMID- 3969548 TI - Major metals in human cancer: calcium, magnesium, sodium and potassium. AB - Major elements calcium, magnesium, sodium and potassium in normal and neoplastic tissues were determined by atomic absorption spectrophotometry. Samples of neoplastic tissues were taken from surgically resected materials from different regions; oral, respiratory, gastro-intestinal, breast, reproductive regions and bone marrow and diverse types of neoplasms. Samples from areas which, on gross examination, looked normal were designated as uninvolved and were also analysed together with controls from normal Indian subjects. In neoplastic tissues concentrations of magnesium, sodium and potassium were found to be enhanced, while variability was noted for the distribution of calcium in the normal and malignant state. PMID- 3969549 TI - Heart panel's conclusions. PMID- 3969550 TI - Heart panel's conclusions. PMID- 3969551 TI - Testing for trichinosis. PMID- 3969552 TI - Nigerian geophagical clay: a traditional antidiarrheal pharmaceutical. AB - The chief geophagical clay entering the West African market system comes from the village of Uzalla, Nigeria. Village inhabitants ascribe antidiarrheal properties to the clay, and they use it in traditional medicinal preparations to counteract intestinal problems. Mineralogical analyses demonstrate a striking similarity between the Uzalla village clay and the clay in the commercial pharmaceutical Kaopectate. PMID- 3969553 TI - Flurbiprofen: a potent inhibitor of alveolar bone resorption in beagles. AB - The nonsteroidal anti-inflammatory drug, flurbiprofen, a potent cyclooxygenase inhibitor, significantly decreases the resorption of alveolar bone in naturally occurring chronic destructive periodontal disease in beagles. This observation indicates that arachidonic acid metabolites are important in the alveolar bone loss of periodontitis and suggests a use for flurbiprofen in the management of bone resorption disease. PMID- 3969554 TI - A single recombinant plasmid expressing two major outer surface proteins of the Lyme disease spirochete. AB - A gene bank of DNA from the Lyme disease spirochete was constructed in the plasmid pBR322. Plasmid pTRH32, a recombinant that in Escherichia coli expresses the two major outer surface proteins of the Lyme disease spirochete, was identified. One of the recombinant products, designated OspA, represents a surface protein that appears to be common to all Lyme disease spirochetes, whereas the other recombinant product, designated OspB, represents a more variable surface protein. This recombinant plasmid provides a foundation for future studies on the epidemiology and pathogenesis of Lyme disease as well as on the genetic organization of the etiologic agent. PMID- 3969555 TI - The goldfish as a retinex animal. AB - In an experiment designed to test color constancy in a situation comparable to that used in E. H. Land's experiments with human observers, goldfish were trained to approach a particular color within a richly colored but variable "Mondrian" background. They retained the ability to identify colors accurately even when the spectral composition of the illuminant was radically altered in generalization tests. Since the behavior of fish resembles that of human beings in these tests, Land's retinex theory seems to apply to a relatively primitive vertebrate as well as to humans. PMID- 3969556 TI - Heat generated by the dark-adapted squid retina in response to light pulses. AB - A rapid increase in the temperature of the dark-adapted squid retina evoked by a brief light pulse was detected with a pyroelectric detector. The amount of heat generated by the retina in response to a pulse of blue light of moderate intensity was far greater than that produced by direct conversion of the stimulating light by the retinal pigments into thermal energy. D-Glucose in the medium was required to maintain the ability of the retina to produce light-evoked thermal responses. PMID- 3969557 TI - Evidence for an antiaphrodisiac in the sweat bee Lasioglossum (Dialictus) zephyrum. AB - Male Lasioglossum (Dialictus) zephyrum in the field are attracted to models impregnated with the odor of virgin females. The number of males responding increases with increasing odor concentration. Once a male has contacted a model, its attractiveness to other males is reduced, suggesting that the male may contribute an antiaphrodisiac cue so that other males avoid mated females. PMID- 3969558 TI - Descending efferents from the superior colliculus relay integrated multisensory information. AB - By means of their efferent projections to motor and premotor structures, the cells in the deep superior colliculus are intimately involved in behaviors that control the orientation of the eyes, pinnae, and head. These same efferent cells receive multiple sensory inputs, thereby apparently enabling an animal to orient its receptor organs in response to a wide variety of cues. This sensory convergence also provides a system in which motor responses need not be immutably linked to individual stimuli but can vary in reaction to the multitude of stimuli present in the environment at any given moment. PMID- 3969560 TI - NIH study. PMID- 3969561 TI - Vaccines against parasitic diseases. PMID- 3969559 TI - Lead and IQ scores: a reanalysis. PMID- 3969562 TI - The T-cell receptor--the genes and beyond. PMID- 3969563 TI - Virus-heart link studied. PMID- 3969564 TI - Evidence for a detrimental effect of bicarbonate therapy in hypoxic lactic acidosis. AB - Lactic acidosis, a clinical syndrome caused by the accumulation of lactic acid, is characterized by lactate concentration in blood greater than 5 mM. Therapy usually consists of intravenous sodium bicarbonate (NaHCO3), but resultant mortality is greater than 60 percent. The metabolic and systemic effects of NaHCO3 therapy of hypoxic lactic acidosis in dogs were studied and compared to the effects of sodium chloride or no therapy. Sodium bicarbonate elevated blood lactate concentrations to a greater extent than did either sodium chloride or no treatment. Despite the infusion of NaHCO3, both arterial pH and bicarbonate concentration decreased by a similar amount in all three groups of dogs. Additional detrimental effects of NaHCO3 were observed on the cardiovascular system, including decreases in cardiac output and blood pressure that were not observed with either sodium chloride or no treatment. Thus there is evidence for a harmful effect of NaHCO3 in the treatment of hypoxic lactic acidosis. PMID- 3969565 TI - Asymmetric illumination contrast: a method of image formation for video light microscopy. AB - Images with high resolution and exceptionally broad gray scale can be obtained by the application of video contrast enhancement to an optimized procedure for imaging transparent objects with oblique rays of illumination. This technique is simple to set up. A conventional microscope with a light source whose position can be adjusted and a video camera with controls for gain and black level are the only essential components. Features such as high resolution, optical sectioning, control of contrast, and operation under low light intensity make this technique preferable, in several instances, to currently used video microscopy techniques. PMID- 3969566 TI - Two gustatory systems: facial and vagal gustatory nuclei have different brainstem connections. AB - The gustatory sense in catfish consists of two dissociable components, a facial nerve system used for food selection and a vagal nerve system involved in swallowing. Neural tracing experiments demonstrate that the primary sensory nucleus for the facial gustatory system is connected to the reticular formation and trigeminal nuclei. In contrast, the primary sensory nucleus for the vagal gustatory system is connected to the motoneurons that mediate swallowing. These results provide anatomical evidence for parallel gustatory systems within the vertebrate central nervous system. PMID- 3969567 TI - Continued expression of neonatal myosin heavy chain in adult dystrophic skeletal muscle. AB - The expression of myosin heavy chain isoforms was examined in normal and dystrophic chicken muscle with a monoclonal antibody specific for neonatal myosin. Adult dystrophic muscle continued to contain neonatal myosin long after it disappeared from adult normal muscle. A new technique involving western blotting and peptide mapping demonstrated that the immunoreactive myosin in adult dystrophic muscle was identical to that found in neonatal normal muscle. Immunocytochemistry revealed that all fibers in the dystrophic muscle failed to repress neonatal myosin heavy chain. These studies suggest that muscular dystrophy inhibits the myosin gene switching that normally occurs during muscle maturation. PMID- 3969568 TI - Prolactin stimulation of maternal behavior in female rats. AB - Inexperienced, hypophysectomized female rats treated with steroids were used in experiments to investigate the roles of the pituitary gland and prolactin in the expression of maternal behavior. Administration of ovine prolactin or treatment with ectopic pituitary grafts, which release prolactin into the circulation, stimulated maternal care in these females toward rat young. Steroid treatment alone, while stimulating maternal behavior in rats with intact pituitary glands, did not facilitate maternal responsiveness in hypophysectomized females. These findings indicate a stimulatory behavioral role for pituitary prolactin in the establishment of maternal care and suggest that exposure to prolactin during pregnancy helps to stimulate the immediate onset of maternal behavior at parturition. PMID- 3969569 TI - Sculpting horizons in organic chemistry. AB - Organic chemistry as a discipline derives from and impacts on the biological and abiological world in which we live. Its challenges lie in the areas of structure, reactivity, techniques, and concepts. Powerful structural tools reveal structures from biology that range from control of insect development and behavior to whole new metabolic pathways in humans. Unnatural products create beautiful new molecular shapes whose properties cannot be predicted as well as catalysts that function with enzyme-like control. From structure flows reactivity. Exploration of known reactions points to new directions, and development of new reactions offers the opportunity of streamlined synthetic design. Emerging new techniques offer new dimensions for performing and studying reactions as well as the hope for developing new ones. Merging disparate facts into unified concepts increases predictive capabilities. The extraordinary difficulty of finding the resultant of many small effects may obscure the presence of general theories, creates the art in the practice of the science, and challenges the practitioner. From these general themes derives the quest for selectivity--chemo-, regio-, diastereo-, and enantio-. An examination of the fundamental underpinnings of the applications of organic chemistry reveals that, while impressive strides have been made, the science is best described as being between infancy and childhood. The cross fertilization between organic chemistry and molecular biology vividly illustrates a merging of chemistry and biology. PMID- 3969570 TI - Molecular structure of troponin C from chicken skeletal muscle at 3-angstrom resolution. AB - The x-ray structure of chicken skeletal muscle troponin C (TnC), the Ca2+-binding subunit of the troponin complex, shows that the protein is about 70 angstroms long with an unusual dumbbell shape. The carboxyl and amino domains are separated by a single long alpha helix of about nine turns. Only the two high-affinity Ca2+ Mg2+ sites of the COOH-domain are occupied by metal ions resulting in conformational differences between the COOH- and NH2-domains. These differences are probably important in the triggering of muscle contraction by TnC. Also the structure of TnC is relevant in understanding the function of other calcium regulated proteins, in particular that of calmodulin because of its strong similarity in amino acid sequence. PMID- 3969571 TI - Effects on Trichinella spiralis of host responses to purified antigens. AB - Purification of two antigens (48-kilodalton polypeptide and a group with major subunits of 50 and 55 kilodaltons) from the infective larvae of the parasitic nematode Trichinella spiralis was recently reported. Immunization of mice with either of these antigens induces strong resistance to a subsequent challenge infection. In the study reported here the mechanism of this resistance was investigated by monitoring the parasite's life cycle in mice immunized with the antigens. Immunized mice were able to expel intestinal adult worms and to inhibit the fecundity of adult female worms at an accelerated rate compared to control mice. Accelerated expulsion and inhibition of fecundity may account entirely for the level of resistance induced by immunization. Although the effects of the immune response apparently are exerted on adult worms, the target antigens are expressed only by developing larvae. This suggests that immune effector mechanisms act on intestinal larvae in such a way that they develop into defective adults. PMID- 3969572 TI - Case of the season. Acute aortic dissection compressing and occluding the right pulmonary artery. PMID- 3969573 TI - Juxtaepiphyseal aneurysmal bone cyst. AB - Nine cases of aneurysmal bone cyst arising in juxtaepiphyseal locations with gross invasion of the adjacent growth plate are reported. In five of these patients an abnormality of growth, due to premature fusion of the affected growth plate, ultimately developed. Treatment of these lesions should attempt to avoid this complication, which appears to be more common than has been appreciated in the past. These nine cases represent 23% of 39 cases of aneurysmal bone cyst occurring in a long bone adjacent to an open epiphyseal plate. This series was extrapolated from a total of 198 cases of aneurysmal bone cyst in the files of the Istituto Ortopedico Rizzoli, Bologna, Italy. PMID- 3969574 TI - Scintigraphy of aggressive fibromatosis. AB - Thirteen patients with aggressive fibromatosis underwent skeletal scintigraphy and computed tomography as part of their preoperative staging. Bone involvement was visible on plain radiographs of three patients. For the other 10 patients, the presence or absence of bone involvement was shown best by computed tomography (CT) in five instances, and best by scintigraphy only once. The two studies were equally useful four times. Although skeletal scintigraphy has previously been found to be very accurate for the evaluation of bone involvement by soft tissue sarcomas, it was less useful in these patients with aggressive fibromatosis. PMID- 3969575 TI - Widespread osteonecrosis of the foot in systemic lupus erythematosus: radiographic and gross pathologic correlation. AB - A patient with systemic lupus erythematosus required an amputation of the foot related to the presence of vascular disease and infection. Radiographs obtained prior to amputation revealed osteonecrosis in virtually every bone of the foot. Radiographic-pathologic correlation documented this widespread osseous involvement. Although ischemic necrosis of bone is a well-known feature of systemic lupus erythematosus, its localization in the small bones of the foot is rare. PMID- 3969576 TI - Xeroradiography in beta-thalassaemia. AB - Xeroradiographic investigations of the skull, hand, and elbow were performed on 27 patients with homozygous beta-thalassaemia. The results were compared with plain radiographic examinations. Xeroradiography, because of its technical properties (i.e. edge contrast enhancement and wide latitude), was shown to demonstrate cortical thinning of long bones, swelling of the diploic space in the skull, and reticulated patterns in the elbow better than standard radiography. Moreover, the use of "positive" mode imaging was shown to have advantages in the study of the skull and extremities. PMID- 3969577 TI - Enchondroma protuberans of the rib. AB - Enchondroma protuberans of the rib may be indistinguishable from osteochondroma or chondrosarcoma. The problems of needle biopsy and the confusion which arose in the preoperative and intraoperative evaluation of two previous cases from the literature were avoided in the present case by total resection of the lesion. Where possible, total resection is recommended for accurate diagnosis. PMID- 3969578 TI - Driller wrist (vibratory arthropathy). AB - Driller wrist is an occupational disease with pathophysiologic changes resulting from recurrent use of vibratory tools. The entity includes the clinical finding of Raynaud phenomena with or without associated bone changes in the wrist. Osseous involvement is usually mild and is associated with cystic changes of the carpals and occasionally other structures. Two cases are reported, one with typical cystic abnormalities and the other with more severe disease which progressed to joint instability. PMID- 3969579 TI - Carpal ligamentous laxity with bilateral perilunate dislocation in Marfan syndrome. AB - A case of persistent bilateral perilunate dislocation unrelated to trauma in a patient with Marfan syndrome is discussed. This finding is believed to be a manifestation of the generalized ligamentous laxity occurring in this disorder. Radiographs of eight additional Marfan syndrome patients failed to demonstrate similar carpal instability. Because some carpal derangements are dynamic events, stress views or wrist fluoroscopy may be necessary to demonstrate unsuspected carpal instability in Marfan patients. PMID- 3969581 TI - Case report 290. Fibrous dysplasia of calvaria (multiple sclerotic lesions). PMID- 3969580 TI - Bilateral avulsion fractures of the anterior superior iliac spines in sprinters. AB - Three cases of bilateral pelvic avulsion fractures in adolescent sprinters are reviewed. An-acute avulsion fracture of the anterior superior iliac spine (ASIS) occurred during active running in three teenaged sprinters. Radiography confirmed a healed fracture of the contralateral ASIS. The clinical features and radiologic appearances are characteristic. The pathophysiology of this type of unique pediatric fracture is discussed. Conservative treatment is successful. PMID- 3969582 TI - Case report 296. Fibrogenesis imperfecta. PMID- 3969583 TI - Case report 297. Loosening of a total hip replacement caused by metastatic carcinoma (primary in the lung). PMID- 3969584 TI - Case report 299. Metastatic liposarcoma. PMID- 3969585 TI - [Ethical norms and problems in surgery]. PMID- 3969587 TI - [Tumors and pseudotumors of the ribs]. PMID- 3969586 TI - [Tracheal stenoses and tracheoesophageal fistulae from the viewpoint of resuscitative care]. PMID- 3969588 TI - [Adjuvant chemotherapy in colorectal carcinoma]. PMID- 3969589 TI - [Venesection and subacute hemodilution in the treatment of ischemic complications of the foot in diabetics]. PMID- 3969590 TI - [Acute hemolytic streptococcal gangrene]. PMID- 3969591 TI - [Cryosurgical treatment]. PMID- 3969592 TI - [A simple instrument we constructed for arterial embolectomy]. PMID- 3969593 TI - [Long-term experience and results after operations for spontaneous pneumothorax]. PMID- 3969594 TI - Experience with fluphenazine hydrochloride injection. PMID- 3969595 TI - Sunburn, vitamin A and cell-mediated immunity. PMID- 3969596 TI - Plasma exchange in Goodpasture's syndrome. PMID- 3969597 TI - [Chronic active hepatitis caused by nitrofurantoin: a case report]. AB - A case of nitrofurantoin-induced chronic active hepatitis in a woman of 79 years is presented. The patient recovered spontaneously when the drug was withdrawn. Liver function tests should be performed on patients undergoing intermittent treatment with nitrofurantoin. PMID- 3969598 TI - HLA antigens and non-insulin-dependent diabetes mellitus in young South African Indians. AB - HLA, A, B and C antigens were determined in 84 South African Indian patients with non-insulin-dependent diabetes mellitus (NIDDM) in whom age of onset was under 35 years and in 760 healthy Indian controls. Increased frequencies of Aw24, B15 and Bw61 were seen in the patients, but the corrected P value was not significant. Among Indians of North Indian origin, however, there was a significant association between B15 and NIDDM (corrected P less than 0,012; relative risk 4,8). In Indians of South Indian origin no clear association with any specific HLA antigens was seen, although there was a slight increase in the frequency of Aw24 (uncorrected P less than 0,007; corrected P greater than 0,05). The findings in this study serve to emphasize the heterogeneity of diabetes mellitus, since no association between NIDDM and HLA antigens has been noted in whites. PMID- 3969599 TI - [Postpartum sterilization and the private practitioner]. AB - A postpartum programme of sterilization was initiated by private practitioners at the Paarl Hospital in 1968. The unit was later taken over by the University of Stellenbosch and a total of 4704 procedures had been completed by the end of 1983. Most of the doctors trained in the method are now in private practice. The sterilization-to-delivery ratio of 1 in 5 indicates that +/- 200 000 postpartum sterilizations would be requested in South Africa, if the Paarl figures are projected to the rest of the country. The most effective method of mobilizing our medical manpower would be a fair fee per procedure. South Africa cannot afford the present continued burden of unwanted and unplanned births. PMID- 3969600 TI - Hypothalamic-pituitary sarcoidosis. A case report. AB - A 42-year-old woman suffered from sarcoidosis and hypothalamic-pituitary involvement. When she presented initially, an abnormal chest radiograph and abnormal features on histological examination of the lymph nodes, which showed caseating granulomas, suggested a diagnosis of tuberculosis. Failure to respond to antituberculosis therapy and the progressive development of symptoms of both posterior and anterior pituitary deficiency prompted a review of the initial diagnosis. Subsequent dynamic tests of hypothalamic and pituitary function indicated lesions at both the hypothalamic and pituitary levels. Further tests, including the Kveim reaction, favoured a diagnosis of sarcoidosis. This case illustrates the uncommon association of caseating granulomas with sarcoidosis and documents hypopituitarism due to combined hypothalamic and pituitary disease caused by sarcoid infiltration. PMID- 3969601 TI - The repair of vesicovaginal fistulas with omentum. A review of 59 cases. AB - The treatment of 59 consecutive vesicovaginal fistulas is described. Five patients were treated by simple vaginal repair; in 52 patients repair was carried out with the aid of an omental pedicle. Only 2 of these patients are not fully continent; 1 awaits further surgery and 1 has stress incontinence but refuses a further operation. A further 2 patients were treated by urinary diversion. The cure rate was 93%. The value of omentum in overcoming fibrosis and tissue loss is discussed. PMID- 3969603 TI - Curiosa paediatrica IX: circumferential persistence of the anal membrane. AB - A clinical observation of persistence of the circumferential part of the anal membrane, not infrequent in Xhosa babies, is described and discussed. PMID- 3969602 TI - Cardiopulmonary arrest after the administration of magnesium sulphate. A case report. AB - The death of a patient from cardiopulmonary arrest after the administration of magnesium sulphate for imminent eclampsia is reported. It has long been recognized that magnesium sulphate provides rapid control of convulsions in eclamptic patients with minimal sedative effects on both mother and fetus. However, because of the neuromuscular blocking action of magnesium and the narrow margin between therapeutic and toxic serum levels, the drug must be given with caution. A regimen for magnesium sulphate administration is advocated which allows safe and effective control of convulsions in eclampsia. PMID- 3969604 TI - Bacterial inoculum and the activity of antimicrobial agents. AB - Experimental and clinical infections have concentrations of bacteria that are greater than the concentrations used in the laboratory for the determination of in vitro activity. When realistic concentrations are used, the antibiotic activity is reduced. The optimum selection of antibiotics may require a re examination of the laboratory procedures for the determination of sensitivity data. PMID- 3969605 TI - Inhibition of human pancreatic secretion by terbutaline as a potential agent for treating patients with pancreatic fistula. AB - We studied the effects of terbutaline on secretin-stimulated duodenal juice output in six healthy volunteers. When administered intravenously to healthy volunteers, terbutaline significantly inhibited secretin-stimulated output of duodenal juice and bicarbonate. After administration of terbutaline to one patient with an external pancreatic fistula, daily output of pancreatic juice decreased and the fistula closed. Significant side effects were not observed. These observations suggest that terbutaline inhibits human pancreatic secretion. Terbutaline may be useful in treating patients with external pancreatic fistula. PMID- 3969606 TI - Cystic dilation of the common bile duct. AB - Nineteen male and female patients with cystic dilation of the common bile duct were treated by total removal of the choledochal cyst and reconstruction using a Roux-en-Y end to side hepaticojejunostomy. Follow-up study was 18 years for some patients. Our data suggest that this disease is highly correlated with an anomalous pancreaticobiliary junction and its sequelae, and that previous treatment by internal drainage is not uniformly successful. After radical surgical treatment and reconstruction, no deaths occurred in any of the patients. All early complications were treated with success by conservative means. With the use of the criteria of Alonso-Lej, there was a clinically significant shift in the status of the choledochal cyst from type 2 before operation to type 1 after operation. Our long term experience with this group of patients leads us to recommend total excision of the choledochal cyst and end to side hepaticojejunostomy for treating patients with cystic dilation of the common bile duct. PMID- 3969607 TI - Aggressive fibromatosis. AB - Fifteen patients with aggressive fibromatosis are presented. The patients ranged in age from one to 64 years, an average of 26 years, and the median time of follow-up study after treatment was ten years (a range of 2.5 to 22.0). Within this period, 60 per cent (nine of 15) of the tumors recurred. In a survey of the literature, when simple excision was compared with wide extirpation, the latter was found significantly superior (p less than 0.01) in terms of limiting a recurrence of the tumor. The results of a pathoanatomic study found that the number of mast cells and the size of the primary tumor could not prognosticate the clinical course. It was concluded that aggressive fibromatosis should be evaluated and treated like a low malignant soft tissue tumor. PMID- 3969608 TI - A comparison of the effects of cyclosporin A and standard agents on primary wound healing in the rat. AB - Eighty-six Sprague-Dawley rats were randomly allocated to three treatment groups given tap water (control group), cyclosporin A (CSA group) and azathioprine and prednisone (AP group). Two incisions, one skin and one musculofascial, were made in each rat with a standardized technique. The healed incisions were subjected to tensiometery at days eight and 15 after operation. Histologic examination was undertaken on some wounds. The results indicate that cyclosporin A in clinical doses does not inhibit skin or musculofascial healing in the rat. Azathioprine and prednisone immunosuppression significantly retarded skin healing on day eight postoperatively although this had returned to control levels on day 15. Azathioprine and prednisone did not affect musculofascial healing at the administered dose. In the sections available for study, there were no qualitative histologic differences between groups at both days eight and 15 postoperatively. PMID- 3969609 TI - Routine endoscopy of the upper gastrointestinal tract in the evaluation of obstructive jaundice. AB - Our experience with flexible end-viewing EGD in the patient with jaundice demonstrated an over-all low specificity (19 per cent) for clinically significant lesions in this patient population. The discovery of synchronous lesions of the upper gastrointestinal tract in 12 patients did not change our diagnostic or therapeutic planning. Therefore, we believe that there is little justification for the increased costs and patient discomfort involved in routine EGD which should be abandoned in instances of obstructive jaundice and should be used only when more specific indications for its use are present. PMID- 3969610 TI - Peritoneal lavage in patients with normal mentation and hematuria after blunt trauma. AB - The need for diagnostic peritoneal lavage in the confused or obtunded patient with trauma is universally accepted. The use of peritoneal lavage in patients without neurologic impairment is controversial. The usefulness of diagnostic peritoneal lavage in patients with blunt trauma, hematuria and normal mentation was studied. In this subgroup, exploratory laparotomy was required in 44.6 per cent of the patients. Operation was four times more common for nonurogenital than urogenital injuries. Peritoneal lavage was 92 per cent accurate in predicting the need for laparotomy. Omission of peritoneal lavage resulted in either missed injury or serious diagnostic delay in 12 per cent of the patients. Patients presenting with hematuria after blunt trauma need evaluation for associated nonurogenital injury and would be well served by diagnostic peritoneal lavage. PMID- 3969611 TI - A clinical review of shotgun wounds to the chest and abdomen. AB - Since a controversy exists over whether patients with truncal shotgun wounds should have selective or mandatory exploration, we reviewed the records of 1,222 patients with truncal missle wounds treated over a six year period at our institution. Based upon a detailed review of 42 of these patients, who had sustained shotgun wounds, we believe that not all patients with truncal shotgun wounds require mandatory surgical exploration. That, in fact, a subgroup of patients can be identified who can be safely managed nonoperatively, based upon the pattern of the injury and the clinical status of the patient at the time of arrival to the emergency room. PMID- 3969613 TI - Where have all the surgeons gone? PMID- 3969612 TI - Surgical treatment of adenocarcinoma of the stomach in a community hospital. AB - The experience with the surgical treatment of adenocarcinoma of the stomach in a community hospital from 1970 to 1979 is presented. The single most important prognostic factor for survival is the extent of disease at the time of operation. Positive regional nodes or distant metastases are associated with a dismal survival regardless of treatment. Other variables such as histologic findings, tumor morphologic features or location did not affect survival in our series. Although fewer and somewhat less radical operations were performed by a large number of community surgeons, the results were comparable to those reported elsewhere. The results depended most strongly on the extent of disease at operation. Aside from a fortunate and unexplained decrease in the incidence of adenocarcinoma of the stomach in this country, the best hope for decreased mortality in the future lies with earlier detection at a surgically curable stage. PMID- 3969614 TI - Use of the EEA stapling device in anastomoses of the small intestine. AB - A technical modification is described for introducing the EEA stapler into the small intestinal lumen for anastomosis without creating an additional enterotomy. This method, which permits a more rapid formation of anastomoses, has been used to form Roux-en-Y jejunojejunostomies without extensive complications in six patients. Such a technique may have particular application when multiple anastomoses are contemplated in fragile patients with chronic disease. PMID- 3969615 TI - A simple technique for resection of the uncinate process during pancreatectomy. AB - Difficulty in resection of the uncinate process of the pancreas often results in significant hemorrhage. Partial vascular occlusion of the superior mesenteric vein with resection of the lateral wall allows complete removal of all pancreatic tissue with minimal blood loss. PMID- 3969616 TI - Proximal decompression by tube appendicostomy with pull through procedures in pediatric operations. AB - The technique of tube appendicostomy for proximal decompression of anastomosis at the anus and colon after pull-through operations in children is described. It has been used in 29 patients with good results without complications and allows for decompression of gas and liquid stool in the immediate postoperative period. It avoids the need for a third operation when used in conjunction with an initial distal ostomy. PMID- 3969617 TI - Television choledochoscopy. AB - Present techniques of intraoperative cholangiography and choledochoscopy have not completely solved the problem of the common bile duct stone that is missed. Televised choledochoscopy provides an improved imaging technique which should facilitate stone retrieval. A similar television endoscopic technique has already become standard among orthopedic surgeons performing diagnostic and therapeutic arthroscopy. This equipment can be shared by surgeons specializing in orthopedic or general surgery. PMID- 3969618 TI - Revascularization of popliteal and below-knee arteries with polytetrafluoroethylene. AB - The expanded polytetrafluoroethylene (PTFE) graft (Gore-tex) is the most frequently used synthetic graft when an alternative to autologous saphenous vein is required. Early results have been encouraging. In the present paper we report on 6 years of results from 153 above-knee (AK) femoropopliteal bypass grafts, 74 below-knee (BK) femoropopliteal bypass grafts, and 54 femorotibial/peroneal bypass grafts. The main indication for the vascular reconstruction was severe ischemia. Preventive antibiotics were given to 95% of the patients. Minimum observation time was 1 year after implantation. There was no operative death. Graft infection was seen in less than 5% of patients. The 6-year cumulative limb salvage rate was 87% for patients with severe ischemia in the AK femoropopliteal bypass group, 59% for those in the BK femoropopliteal bypass group, and 57% for those in the femorotibial/peroneal bypass group. The graft patency rate was 88% at 2 years and 78% at 6 years for the AK femoropopliteal bypass group, for whom the operative indication was disabling claudication, and 81% and 68%, respectively, when the indication for the vascular procedure was severe ischemia. The cumulative graft patency rate was 53% and 43% at 2 and 6 years, respectively, after implantation of BK femoropopliteal bypass grafts and 43% and 39% for femorotibial/peroneal bypass procedures. The expanded PTFE (Gore-tex) graft seems therefore to be a good alternative when an autologous vein is not available, even for reconstructions well below the knee joint. PMID- 3969619 TI - Analysis of surgical treatment for carcinoma situated in the cervical esophagus. AB - Between 1960 and 1982, 64 operations were performed for carcinoma of the cervical esophagus including the cervicothoracic segment. Of these 64 patients, 12 underwent cervical esophagectomy and 52 had total esophagectomy. Visceral replacements were employed in 61 patients by the skin flap (3 cases), the intestine pedicle graft (10 cases), and the stomach tube (48 cases). The operative mortality rate associated with cervical esophagectomy was 33.3% and that with total esophagectomy was 5.8%. The 5-year survival rate for patients who had cervical esophagectomy was 16.7% and that for patients with total esophagectomy was 30.0%. A direct comparison of the surgical results of cervical and total esophagectomy should not be discussed at the same level, because the cervical esophagectomy operations were performed before 1967. However, the discussion of histologic examinations for removed lymph nodes and resected esophagus will be of value. Analysis of these histologic findings was performed aggressively and we obtained the following results. Total esophagectomy completely removes the intramural invasive cancer cells in the anal stump of resected esophagus, and then dissection of the intrathoracic, including cervical, lymph nodes is possible. In addition to these merits, stomach replacement for esophageal reconstruction has the advantage of the only anastomosis (pharyngogastrostomy) as compared with the other visceral replacements. For these reasons it may be recommended that total esophagectomy with stomach replacement is adequate for the treatment of the advanced carcinoma situated in the cervical esophagus. PMID- 3969620 TI - Inferior mesenteric artery aneurysms. AB - Two patients were treated for asymptomatic aneurysms of the inferior mesenteric artery during reconstructive operation for infrarenal aortic disease. These lesions were discovered incidentally during arteriographic study in one case and during operation in the second case. Including these two patients, the number of reported inferior mesenteric artery aneurysms now totals 13. The etiology, manifestations, and treatment of the currently reported aneurysms are compared with eight previously published cases in which detailed clinical data were presented. Although the natural history of these rare aneurysms remains undefined, operative intervention appears appropriate for all mycotic lesions and certain other aneurysms, such as those in patients undergoing aortic operation. PMID- 3969621 TI - Comparison of axillounifemoral and axillobifemoral bypass operations. AB - Routine use of axillobifemoral (ABF) bypass has been advocated because this operation is thought to achieve better patency than the axillounifemoral (AUF) procedure. In 5 years we performed 34 AUF and 22 ABF bypass operations for limb salvage in high-risk patients using 6 mm polytetrafluoroethylene grafts. Five year cumulative life table patency rates for AUF bypasses were 71% with reoperation (secondary patency) and 44% without reoperation (primary patency). These values were not significantly different (p greater than 0.5) from those for ABF bypasses (77% and 50%, respectively). Five-year limb salvage results (AUF 73%; ABF 89%) were also not significantly different (p greater than 0.1). Correlation of arterial outflow characteristics with graft patency revealed that 78% of the patients who never had graft occlusion had occluded superficial femoral arteries (SFA) demonstrated at the first operation, while 79% of the patients who experienced graft closure had comparable SFA occlusions. Our aggressive approach to graft thrombosis included angiographic study of the inflow arterial system. This revealed that 16% of the failed grafts were associated with hemodynamically significant stenosis of the donor subclavian artery. Our results indicate that AUF bypass is the procedure of choice for unilateral limb ischemia in high-risk patients who require an axillary source and that patency of the SFA does not affect outcome. These results also emphasize the need to obtain angiographic evaluation of the inflow system. PMID- 3969622 TI - Serial fluorometric documentation of fluorescein dye delivery. AB - Since its introduction in 1980, fiberoptic fluorometry has improved the precision and objectivity of the fluorescein test as a means to delineate nutritive blood flow and predict tissue viability. This study was undertaken primarily to determine if fiberoptic fluorometry could be repeated reliably at close time intervals. Four injections of fluorescein dye were administered at varying dose and time schedules to determine what factors influenced the repeatability of this technique. The results confirm the high accuracy of fluorometric indices as a means to predict the ultimate fate of a skin flap. A method of scanning the flap within 2 minutes after injection of 1.5 mg/kg of fluorescein dye correctly predicted the fate of almost 100% of flap sections. Repeated injections of 1.5, 3.0, and 6.0 mg/kg of dye at 15-minute intervals provided virtually identical predictions of flap viability. Thus fluorometry is readily repeatable and should be of value in assessing the state of tissue perfusion as well as changes in perfusion caused by pharmacologic manipulation or surgical intervention. PMID- 3969623 TI - Perigraft seromas complicating arterial grafts. AB - A collection of clear, sterile fluid, confined within a nonsecretory fibrous pseudomembrane surrounding a vascular graft, is a specific clinicopathologic entity termed perigraft seroma. Our experience with four such cases prompted a clinical study of our own material and that of others. A comprehensive survey, including the entire North American Chapter of the International Society for Cardiovascular Surgery membership, provided 279 cases for detailed analysis. Material most commonly involved were knitted Dacron (54%) and polytetrafluorethylene (34%), with knitted Dacron in the axillofemoral position accounting for 31% of the cases. The fluid was documented as serum by biochemical and electrophoretic analysis. Histopathologically, the grafts were noted to be poorly incorporated into the surrounding tissues, and the graft lining was covered by a flimsy, fibrous layer with a degenerated fibrin-protein matrix noted in the interstices of the graft. These findings pertained to both polytetrafluoroethylene and Dacron; neither acute nor chronic inflammatory changes were noted. The cyst membrane was comprised of nonsecretory cells, primarily fibroblasts. Treatment was highly variable. Graft replacement provided a 92% cure rate, and the authors advocate removal of the original graft and cyst membrane with placement of a new graft of material other than the original along a different anatomic route. However, in elderly, poor-risk patients, resolution may occasionally be achieved by "watchful waiting" with or without multiple aspirations. PMID- 3969624 TI - Renal and cardiovascular response to nonhypotensive sepsis in a large animal model with peritonitis. AB - We studied the functional effects of intraperitoneal sepsis on systemic hemodynamics in general, and on renal function in particular, in sheep in whom bacterial peritonitis was induced by cecal perforation. In the first group of seven sheep (group 1) fluid was administered throughout the period of sepsis to maintain pulmonary capillary wedge pressure as close to presepsis values as possible. These sheep exhibited hemodynamic changes known to be associated with sepsis in man: increased cardiac output and decreased systemic vascular resistance. In a second group of seven sheep (group 2) fluid intake was restricted; compared with group 1, these sheep demonstrated a smaller increase in cardiac output that did not persist and that was associated with an increase in the systemic vascular resistance during the septic period. Plasma renin levels increased fivefold in group 2 but were unchanged in group 1. Serial renal biopsies during the septic period revealed that all sheep had evidence of tubular cell damage on electron microscopy: cell swelling, loss of the microvillous brush border, and cell necrosis. Both groups of sheep also demonstrated marked tubular proteinuria similar to that found in humans with generalized sepsis. Despite this, sheep in group 1 exhibited no functional renal changes: creatinine clearance levels rose slightly from control values, urine concentrating ability was unimpaired, and fractional excretion of sodium increased appropriately in response to a sodium load. In contrast, group 2 sheep exhibited a fall in creatinine clearance levels but fractional sodium excretion did not fall as would have been expected were renal function entirely normal. The results suggest that generalized "hyperdynamic" sepsis induces tubular cell damage and tubular proteinuria by an unknown mechanism. However, this does not necessarily produce renal impairment since the glomerular filtration rate does not fall unless volume contraction is also allowed to occur. PMID- 3969626 TI - Hypoglycemia with glycerol infusion as antineoplastic therapy: a hypothesis. PMID- 3969625 TI - Perioperative blood transfusion has prognostic significance for breast cancer. AB - The transfusion-induced immune suppression that prolongs kidney graft survival for transplant patients may be detrimental to patients with malignancies. We studied the relationship of blood transfusion to the disease-free survival of 169 patients with operable breast cancer who had undergone mastectomy with axillary dissection at Mount Sinai Hospital between 1964 and 1972. The cumulative 5-year disease-free survival rate for patients who had received transfusions was 51% compared with 65% for patients who had not received blood (p = 0.0210). The two groups of patients were comparable in age, stage, discharge hemoglobin values, proportion of radical mastectomies, and duration of follow-up. Admission hemoglobin values were lower and operative blood loss was higher among patients who had received transfusions, and significant survival differences were noted in relation to operative blood loss: 69% of women with estimated blood loss less than the mean of 370 ml were free of disease at 5 years compared with 50% of women with higher intraoperative losses (p = 0.0279). However, the first year after operation the association of survival with transfusion was highly significant (77% for those who had received transfusions, 94% for those who had not, p = 0.0096), whereas survival rates in relation to operative blood loss differed by only 7% during the same interval (p = 0.1182). These results indicate that perioperative blood transfusion may be a significant prognostic factor for patients undergoing mastectomy for operable breast cancer. PMID- 3969627 TI - Endoscopic removal of an intragastric Angelchik antireflux prosthesis. AB - Four months after insertion of an Angelchik esophageal antireflux prosthesis, a 60-year-old man was seen with epigastric pain and vomiting. Upper gastrointestinal studies demonstrated intragastric migration of the prosthesis. The prosthesis was intact and the straps were untied , and gastroscopic removal was accomplished by pulling out the prosthesis. Surgeons using this prosthesis should be aware of this unique potential complication of erosion into a viscus. PMID- 3969628 TI - Tenckhoff catheter administration of intraperitoneal fluid and electrolytes for long-term management of intractable ileostomy diarrhea: a case report. AB - Often, maintenance of fluid and electrolyte homeostasis is the most challenging dilemma posed by short bowel syndrome. This report describes the management of a patient with intractable, dehydrating, salt-wasting diarrhea after small and large bowel resection for Crohn's disease complicated by rectal cancer. Intraperitoneal fluid and electrolyte therapy delivered through a Tenckhoff catheter was used to achieve long-term outpatient stability without chronic intravenous therapy. The concept of intraperitoneal fluid and electrolyte therapy is discussed and its potential role in the treatment of short bowel syndrome is described. PMID- 3969629 TI - Antithrombin III deficiency: an etiology of Budd-Chiari syndrome. AB - This report documents a unique case of Budd-Chiari syndrome associated with antithrombin III deficiency and massive thrombus in the superior vena cava and right atrium. This aberration of the coagulation mechanism is proposed as an etiologic factor in the pathogenesis of hepatic venous obstruction whenever the cause is obscure. Antithrombin III was restored to a level adequate to permit thrombus extraction with cardiopulmonary bypass and relief of portal hypertension with a mesoatrial shunt. The protocol for reversing this hypercoagulable state with fresh frozen plasma and warfarin (Coumadin) is discussed, and technical innovations employed in the management of this complex problem are described. PMID- 3969630 TI - A new method of noninvasive estimation off ambulatory venous pressure. PMID- 3969631 TI - In vivo calibration of the photoplethysmograph transducer. PMID- 3969632 TI - Acute cholangitis caused by ruptured hydatid cyst. PMID- 3969634 TI - Keeping company with the Texas legislature. PMID- 3969633 TI - Rupture after nonresective treatment of abdominal aortic aneurysms. PMID- 3969635 TI - The association of irradiation with less-than-radical surgery in various types of cancer. PMID- 3969636 TI - Aminocaproic acid for bleeding in thrombocytopenic patients. PMID- 3969637 TI - Burns involving area heating: enduring the Texas winter. PMID- 3969638 TI - Severe Vibrio cholerae sepsis and meningitis in a young infant. PMID- 3969639 TI - Diagnosis and management of constipation and encopresis in childhood. PMID- 3969640 TI - [Are "epidemiologically significant medical emergencies" in intercontinental airports possible?]. PMID- 3969641 TI - [Tropical fitness of vacation tourists and workers]. PMID- 3969642 TI - [What should the practicing physician know about flight medicine?]. PMID- 3969643 TI - [Vaccinations for travel to a foreign country. Update for the year 1985]. PMID- 3969645 TI - [Travel at an advanced age]. PMID- 3969644 TI - [Advice for pregnant patients, breast feeding women and families with small children before travel to the tropics]. PMID- 3969646 TI - [Prevention and therapy of acute altitude sickness]. PMID- 3969647 TI - [Is it a tropical disease? What should the practicing physician know?]. PMID- 3969648 TI - Travelers' diarrhea. PMID- 3969649 TI - [Giardiasis and amebiasis]. PMID- 3969650 TI - [Poisonous animals--a travel medicine problem?]. PMID- 3969652 TI - Role of automatic staplers in the aetiology of bronchopleural fistula. AB - The incidence of bronchopleural fistula in 130 patients who had pneumonectomies has been reviewed. Patients were divided into two groups according to the type of automatic stapler used to close the bronchus. From January 1979 to February 1982 the parallel jaw stapler (TA-55) was used in 71 patients (group 1). The new hinged jaw stapler (Premium TA-55) was used in 59 patients from March 1982 to April 1984 (group 2). The incidence of bronchopleural fistula was 4.2% in group 1 and 15.2% in group 2 (p less than 0.05). The two staplers were tested on a cadaveric bronchial preparation. Radiographs were subsequently taken of the stapled segments. These showed that with the Premium TA-55 closure of staples was not uniform, being incomplete near the hinge unlike the old style TA stapler, which achieves complete and uniform closure of the staples. It is concluded that this undoubtedly contributes to the significantly higher incidence of bronchopleural fistula, and that the new hinged jaw stapler in its present design is not recommended for use during pneumonectomy. PMID- 3969651 TI - Smoking, allergy, and the differential white blood cell count. AB - Dutch workers have proposed that people with asthma and those smokers who develop chronic airflow obstruction share a common allergic constitution. To study whether smoking itself is associated with indicators of allergy, we have examined 237 men aged 51-61 years (120 smokers, 73 ex-smokers, and 44 non-smokers) who were recruited to a long term study of lung function in 1974, at which time men with a clinical diagnosis of asthma were excluded. Smokers, ex-smokers, and non smokers did not differ in personal or family history of allergic disease, but the prevalence of positive responses to skinprick tests was greater in ex-smokers (59%) than in the other two groups (33% and 34%). In men with negative responses to skinprick tests total serum IgE was greater in smokers (log10 mean 1.41 IU/ml) and in ex-smokers (log10 mean 1.53 IU/ml) than in non-smokers (log10 mean 1.12 IU/ml). In men with positive skin test responses serum IgE was similar in the three groups (log10 mean ranging from 1.68 to 1.78 IU/ml). Geometric mean total white cell counts in the peripheral blood were higher in smokers (7.34 X 10(9)/l) than in non-smokers (5.82 X 10(9)/l); the value in ex-smokers (6.16 X 10(9)/l) was intermediate. Absolute blood eosinophil counts were increased in smokers disproportionately to the increase in total white cell count. Thus smoking is associated with small increases in some markers of allergy. These changes are probably acquired after the onset of smoking but sequential studies are required to amplify these cross sectional observations. Smokers whose skin test responses are positive appear more likely to give up smoking. PMID- 3969653 TI - Experiences with prosthetic reconstruction of the trachea and bifurcation. AB - Extensive tracheal resections were performed to avoid imminent asphyxia in nine patients. Airway continuity was restored with either a straight or a bifurcated Neville prosthesis. One patient had progressive perichondritis and the remaining eight had advanced malignancy. Three patients died of complications due to the prosthesis, 15 days, seven months, and 10 months after operation. Five patients from their underlying disease and one patient is alive 13 months after reconstruction. PMID- 3969654 TI - Fluorescence as a guide to bronchial biopsy. AB - The presence of fluorescence was assessed in 34 unselected patients undergoing bronchoscopy, 11 of whom suffered from bronchial carcinoma. Bronchoscopic inspection was carried out with white light and then repeated with blue light after the injection of 2 ml of 10% sodium fluoresceinate. Fluorescence was graded visually. Seventy six pairs of biopsy specimens were obtained. Of 38 specimens from non fluorescent areas, histological appearances were normal in 34. Slight inflammation was observed in three biopsy specimens, and in one there was evidence of tumour even though the specimen was obtained some distance from the primary tumour. Of 38 biopsy specimens from fluorescent areas, histological examination showed appearances of moderate inflammation in 10, severe inflammation in 10, tuberculosis in one, and carcinoma in 11. In six instances histological appearances were normal. Five normal subjects who were smokers were also examined by the same technique. Appearances of metaplasia were found more often in areas showing fluorescence than in areas not showing fluorescence. Bronchial fluorescence is considered to be related to alteration in vascularity and is not specific for carcinoma. The most fluorescent areas are generally the most pathological and visible tumour is very fluorescent, but moderate degrees of fluorescence are difficult to interpret. Biopsy of every fluorescent area seems excessive. PMID- 3969655 TI - Lung function in the elderly. AB - Data are presented on the FEV1 and forced vital capacity (FVC) of elderly people living at home. These were derived from a survey of 418 persons over the age of 70 years and thus provide standards for the assessment of elderly persons. There was a decline in FEV1 and FVC cross sectionally with age and a continued adverse effect of smoking. A history of cough and phlegm was strongly related to impairment of lung function. PMID- 3969656 TI - Effects of pneumothorax or pleural effusion on pulmonary function. AB - The effects of pneumothorax or pleural effusion on respiratory function as measured by the commonly applied tests were investigated by studying 13 patients (six with pneumothorax, seven with effusion) with and, as far as possible, without air or fluid in the pleural cavity. Measurements included spirometric volumes, carbon monoxide transfer factor (TLCO), and KCO by the single breath method, maximum expiratory flow-volume curves, and subdivisions of lung volume estimated by both inert gas dilution and body plethysmography. In patients with pneumothorax "pleural volume" was estimated as the difference between lung volumes measured by dilution and thoracic gas volume measured by plethysmography. In patients with effusion the change in "pleural volume" was equated with the volume of fluid subsequently aspirated. "Total thoracic capacity" (TTC) was estimated by adding total lung capacity (TLC) measured by dilution and "pleural volume." Both effusion and pneumothorax produced a restrictive ventilatory defect with reductions of vital capacity, functional residual capacity, and TLC. In the patients with effusion TTC fell after aspiration, suggesting that the pleural fluid produced relative expansion of the chest wall as well as compression of the lung. In patients with pneumothorax, however, there was no difference in TTC with and without air in the pleural space. In the presence of pleural air or fluid there was a slight decrease in TLCO and increase in KCO, with a small but significant increase in the rate of lung emptying during forced expiration. PMID- 3969657 TI - A place for aspiration in the treatment of spontaneous pneumothorax. AB - In a retrospective survey of 195 patients with spontaneous pneumothorax, 100 had a deep (greater than 20%) air space. Thirty one patients were considered unsuitable for aspiration because of complicating disease. Sixty nine patients were treated by aspiration, and in 45 of these reexpansion was sufficient for the case to be managed as shallow pneumothorax while the patient remained ambulant. The average initial aspiration from the 69 patients was 1 X 1 litres. The intrapleural pressure was subatmospheric in only 22 (49%) of the 45 successfully aspirated patients. A chest radiograph several hours after aspiration is the principal control required for this treatment. The recurrence rate was 11.1%. Of 95 patients with a shallow pneumothorax, 3 were intubated for progressive lung collapse and the remainder were encouraged to lead a normal life. The recurrence rate was 11.6%. Retrospectively, it was concluded that 137 patients (70%) had a closed pneumothorax at diagnosis. Primary intubation of all patients with a deep pneumothorax would have represented overtreatment. PMID- 3969658 TI - Solitary squamous papilloma of the bronchus. AB - A case of solitary squamous papilloma of the bronchus is described and 11 other cases from the reports published worldwide are reviewed. These tumours present in middle aged men with symptoms similar to those of bronchial carcinoma. Treatment by bronchoscopic removal or lobectomy is usually curative. Symptoms are similar to those of bronchial carcinoma, but a correct preoperative diagnosis permits more conservative surgery to be carried out. Difficulties in the histological classification of papillary tumours of the bronchus are discussed. PMID- 3969659 TI - Pleural mesothelioma treated by fast neutron therapy. PMID- 3969660 TI - Thoracic actinomycosis presenting as a brachial plexus syndrome. PMID- 3969661 TI - Pulmonary eosinophilia associated with cutaneous larva migrans. PMID- 3969663 TI - Asthma and irreversible airflow obstruction. PMID- 3969662 TI - Progressive tracheobronchial polychondritis: need for early diagnosis. PMID- 3969664 TI - Bronchial reactivity to inhaled histamine and annual rate of decline in FEV1 in male smokers and ex-smokers. AB - We examined the relations between bronchial reactivity, baseline FEV1, and annual decline of height corrected FEV1 (delta FEV1/ht3) over 7.5 years in 227 men (117 smokers, 71 ex-smokers, and 39 non-smokers). Men with a clinical diagnosis of asthma or receiving bronchodilator treatment were excluded. Bronchial reactivity was determined as the provocation concentration (PC20) of inhaled histamine sufficient to reduce FEV1 by 20%; subjects were divided into reactors (PC20 less than or equal to 16 mg/ml) and non-reactors (PC20 greater than 16 mg/ml). Thirty per cent of smokers, 24% of ex-smokers, and 5% of non-smokers were reactors. When smokers who were reactors were compared with non-reactors, the reactors showed a lower baseline FEV1 as percentage predicted in 1981-2 (85% v 108%), and a faster delta FEV1/ht3 (14.1 v 9.2 ml/y/m3). Baseline FEV1 correlated with PC20 in both smokers (rs = 0.51) and ex-smokers (rs = 0.61), and all 15 subjects with an FEV1 under 80% of the predicted value were reactors. In ex-smokers delta FEV1/ht3 was similar in reactors and non-reactors (m 9.0 v 7.4 ml/y/m3), despite significant differences in baseline FEV1. When analysis was confined to men with a baseline FEV1 over 80% predicted, the prevalence of reactors was significantly increased among smokers and slightly increased among ex-smokers compared with non-smokers, though the mean FEV1 was higher in the non-smokers. Bronchial reactivity was not increased in smokers aged 35 years or less. In smokers delta FEV1/ht3 was faster in those with a personal history of allergy (usually allergic rhinitis), but was not related to a family history of allergic disease, total serum immunoglobulin E level, absolute blood eosinophil count, or skinprick test score. delta FEV1/ht3 was also faster in all subjects taking beta blocker drugs. Thus increased bronchial reactivity was associated with accelerated decline of FEV1 in smokers. Although the association could be a consequence of a lower lower baseline FEV1, a trend towards increased reactivity was found in smokers with normal baseline FEV1 and delta FEV1/ht3 was dissociated from increased reactivity in ex-smokers. These findings are compatible with the "Dutch hypothesis," but the association between allergic features and accelerated delta FEV1/ht3 was relatively weak, and increased reactivity may follow rather than precede the onset of smoking. PMID- 3969667 TI - [Congenital hypothyroidism. A somatic re-evaluation of 26 children in which the diagnosis was done during the neonatal period]. PMID- 3969666 TI - [Children with congenital hypothyroidism. Psychomotor development]. PMID- 3969665 TI - [A nation-wide screening program for congenital hypothyroidism in Norway]. PMID- 3969669 TI - [Thromboembolism in Crohn disease. A case report]. PMID- 3969668 TI - [Screening of congenital hypothyroidism. An analysis of children diagnosed in 1965-74]. PMID- 3969670 TI - [Clinical application of flow cytometry]. PMID- 3969672 TI - [Nosocomial infections. Guidelines for prevention and control of postoperative wound infections]. PMID- 3969671 TI - [Cytotoxic drug regimen at Tynset hospital. Experiences after a change of routines at a local hospital]. PMID- 3969673 TI - [Health protection of the mentally disabled. Medical services--a study at the Naerlandheimen central institution]. PMID- 3969674 TI - [Pain as a matter of conscience]. AB - Veterinarians have a professional responsibility towards animals, owners and society. This responsibility is determined by understanding as well as by a sense of justice and fairness. Its relationship with all sorts of objections of a zootechnic, economic, social and ethical nature may be rather strained. This not only holds good for practising but also for dealing with animals intended for slaughter or experimentation as well as for acting in an official setting. When we look about us, views both on responsibility and the importance of objections are seen to be gradually changing. Pain and experience of pain as theme of this congress is symptomatic of this re-orientation. The first part of this paper is concerned with the manner in which these altered views are gradually gaining attention in society. The discussion is based on an elementary outline of the development of veterinary medicine, a differentiation being made between a mythical, a technical and a discerning approach. The second part is a discussion of the way in which veterinarians should cope with this criticism in their professional conduct. This is appropriate for two reasons. To begin with, veterinarians are becoming increasingly aware of the fact that they bear responsibility for the welfare of animals. Secondly, a point of view is expected of veterinarians in concrete situations. PMID- 3969675 TI - [Onion poisoning]. PMID- 3969676 TI - [New Legislation on Animal Medications]. PMID- 3969677 TI - In vivo and in vitro effects of azaconazole on renal function in the Fischer 344 rat. AB - Azaconazole is an experimental agricultural fungicide which has shown promise for use in controlling powdery mildew on crops and bean rust. This study examined the nephrotoxic potential of a single intraperitoneal azaconazole injection (0.4 or 0.6 mmol/kg) or daily azaconazole administration (0.1 or 0.3 mmol/kg/day) for 7 days in male Fischer 344 rats. The in vitro effects of azaconazole on the accumulation of organic ions by renal cortical slices also were examined. Acute azaconazole administration (0.4 or 0.6 mmol/kg, i.p.) produced a marked decrease in urine volume at 6 h. By 48 h urine volume was still decreased in the 0.6 mmol/kg group but not the 0.4-mmol/kg group. Proteinuria (++) and slight hematuria were seen in the 0.6-mmol/kg group on both treatment days. Accumulation of p-aminohippurate (PAH) by renal cortical slices was stimulated in both azaconazole-treated groups while tetraethylammonium (TEA) accumulation was not altered. No changes in blood urea nitrogen concentration, kidney weight or renal morphology were produced at 48 h postinjection by either azaconazole dose. Daily administration of azaconazole (0.1 or 0.3 mmol/kg/day) did not significantly alter any of the renal parameters studied. Incubation of renal cortical slices with increasing concentrations of azaconazole from 10(-5) M to 10(-3) M caused a continued reduction in TEA accumulation. PAH accumulation was decreased significantly following incubation with azaconazole 10(-5) or 10(-3) M. These results indicate that azaconazole is capable of producing acute, reversible renal effects at doses equal to or less than 0.6 mmol/kg and altering organic ion transport both in vivo and in vitro. The lack of marked renal effects following exposure to azaconazole is favorable for the development of this compound as an agricultural fungicide. PMID- 3969678 TI - Effect of phthalate esters on energy coupling and succinate oxidation in rat liver mitochondria. AB - Isolated rat liver mitochondria were exposed to mono- and di-n-butyl phthalate (MBP and DBP) and mono- and di(2-ethylhexyl)phthalate (MEHP and DEHP) and examined for effects on mitochondrial energy-dependent processes, including oxidative phosphorylation and active K+ uptake. Additional studies on the effects of these phthalate esters on succinate oxidation and on mitochondrial membrane integrity are also included. DBP and MEHP stimulated succinate state 4 respiration, impaired K+-valinomycin induced swelling with succinate, ascorbate, or ATP as the energy sources, and inhibited succinate state 3 respiration and succinate cytochrome c reductase activity. MEHP was found to act as a non competitive inhibitor of succinate dehydrogenase activity, with an apparent Ki = 2.4 X 10(-4) M. At concentrations which uncouple energy linked reactions, MEHP and DBP produced only slight energy-independent swelling and release of soluble proteins from isolated mitochondria. MBP caused only slight stimulation of state 4 respiration and impairment of K+-valinomycin induced swelling with each of the 3 energy sources, however, of the 4 phthalate esters, it produced the greatest energy-independent swelling and led to the greatest release of soluble mitochondrial proteins. DEHP had no apparent effect on any of these processes except for slight impairment of ATP-dependent K+-valinomycin induced swelling. It is concluded that phthalate ester toxicity in liver mitochondria is due to uncoupling of energy linked reactions and/or inhibition of succinate dehydrogenase activity. Uncoupling by MBP may involve disruption of mitochondrial membrane integrity, while uncoupling by DBP and MEHP is probably due to an increase in membrane permeability to H+ and other small ions. PMID- 3969679 TI - Protective effects of zinc acetate toward the toxicity of nickelous acetate in rats. AB - Zinc pretreatment is known to ameliorate the acute and chronic effects of the toxic heavy metal, cadmium. However, the ability of zinc to decrease the toxicity of other metals has not been widely investigated. Therefore, this study was designed to determine the effects of zinc pretreatment on the acute toxicity of nickel. Male Fischer rats received either nickel alone (i.p.), zinc alone (s.c.), zinc plus nickel, or saline (i.p. and s.c.; controls). In the lethality studies, the dose of nickel was 115 mumol nickel/kg (as nickel acetate) while for all other studies the dose was 95 mumol nickel/kg. Zinc was given in multiple doses of 300 mumol zinc/kg (as zinc acetate) at -24, 0 and +24 h relative to nickel (total zinc dose 900 mumol/kg) for lethality studies or -24 and 0 h for studies 24 h and under in duration (total dose 600 mumol/kg). Zinc pretreatment significantly increased the 14-day survival of nickel-related rats. Zinc did not, however, prevent the reduction in weight gain over 2 weeks seen with nickel treatment. Histopathologically, at 120 h following nickel exposure, kidneys in the group receiving nickel alone generally showed moderate nephropathy (multifocal proximal tubule degeneration with necrosis) while in the zinc plus nickel group the nephropathy was generally mild. Zinc pretreatment had no apparent effect on the pharmacokinetics of nickel over 24 h as assessed by urinary excretion, blood levels or organ distribution. Zinc pretreatment also did not alter the subcellular distribution of renal nickel 6 h after nickel exposure. Enhanced synthesis of metallothionein did not appear to play a critical role in the reduction of nickel toxicity, since renal concentrations of this metal binding protein, although elevated compared to control, were not different in rats receiving zinc and nickel or zinc alone. Zinc pretreatment did, however, have marked effect on nickel-induced hyperglycemia, reducing both the duration and severity of elevated blood glucose levels. Results of this study show that zinc can prevent some of the toxic effects of nickel and that the mechanism of this action does not appear to involve either metallothionein or alterations in the pharmacokinetics of nickel. PMID- 3969680 TI - Inhalation of isopropanol: induction of activating and deactivating enzymes in rat kidney and liver. Increased microsomal metabolism of n-hexane. AB - Rats were exposed to isopropanol by inhalation of 200,2000 and 8000 ppm for 2 weeks with a daily exposure of 6 h. A pilot group exposed to 8000 ppm was given a recovery period of 4 weeks. Kidney and liver microsomal metabolism of n-hexane was investigated in vitro concomitant with activities of cytochrome P-450 and GSH enzymes and blood concentration of isopropanol and its metabolite acetone. A dose dependent increase was observed in the formation of all metabolites of n-hexane in both organs. Of special interest was the 9%, 80% and 198% increase of the preneurotoxic metabolite 2-hexanol in kidney microsomes. Cytochrome P-450 was increased 14%, 40% and 43% in kidney after 200, 2000 and 8000 ppm, respectively, and 10% and 19% in liver at 2000 and 8000 ppm. The activity of glutathione S transferase was unaffected in kidney but elevated in liver, while GSH levels were elevated in both organs. The elevated level of kidney cytochrome P-450 did not return to normal during the 4-week-recovery period in contrast to liver cytochrome P-450. It is thus indicated that cytochrome P-450 and associated microsomal enzymes are more easily inducible and the changes more persistent in kidney than in liver. Our observations suggest that cytochrome P-450-mediated metabolic activation of n-hexane in the kidneys may have toxicological relevance in addition to liver metabolism, and that coexposure to isopropanol and n-hexane may represent an enhancement of the health hazard from n-hexane, possibly due to the isopropanol metabolite acetone. PMID- 3969681 TI - Effect of synthetic antioxidants on hydrogen peroxide formation, oxyferro cytochrome P-450 concentration and oxygen consumption in liver microsomes. AB - Synthetic antioxidants lead in vitro to increased H2O2 formation in rat liver and lung microsomes and in guinea pig and hamster liver microsomes. Butylated hydroxyanisole and ethoxyquin are more potent than propyl-, octyl-, and dodecyl gallate; butylated hydroxytoluene is only weakly active. Extra production of H2O2 is maximal at antioxidant concentrations between 50 and 500 microM and is dependent on the concentration of NADPH. It is paralleled by increased microsomal oxygen consumption and decreased concentration of oxycytochrome P-450 and is enhanced by pretreatment of the animals with phenobarbital. Both the endogenous and the antioxidant-stimulated H2O2 production are inhibited by metyrapone. In vivo administration of ethoxyquin and butylated hydroxyanisole in the diet leads to decreased oxycytochrome P-450 concentrations but not to increased H2O2 formation in liver microsomes. No extra production of H2O2 was observed in a glucose oxidase or xanthine oxidase system; rather, inhibition occurred in the latter system. Our data suggest that antioxidants enhance the oxidase function of cytochrome P-450. This effect is discussed in view of the known toxicity of these food additives. PMID- 3969682 TI - The use of anti-ricin antibodies to protect mice intoxicated with ricin. AB - Antibodies raised in rabbits to ricin or its constituent polypeptide chains are effective at rescuing mice from ricin intoxication if given soon enough after administration of the toxin. The maximum safe period for intravenous injection of 100 micrograms antibody is 40 min after intravenous injection of 1 microgram ricin, increasing to 640 min in the case of subcutaneously injected ricin. The antibodies raised against the isolated A and B chains are as effective as those against whole ricin. The antibody is as effective when administered intracerebrally as by the intravenous route; this result, combined with the very high toxicity for ricin administered intracerebrally suggests a neurotoxic role for the lectin. PMID- 3969683 TI - Enhanced peroxisomal beta-oxidation of fatty acids and glutathione metabolism in rats exposed to phenoxyacetic acids. AB - Peroxisomal beta-oxidation of fatty acids and the activities of glutathione metabolizing enzymes in rat liver were measured after administration of 2,4 dichlorophenoxyacetic acid (2,4-D), 4-chloro-2-methylphenoxyacetic acid (MCPA), clofibrate [ethyl], 2-(p-chlorophenoxy)-2-methylpropionate], glyphosate (N phosphonomethyl glycine, a herbicide not structurally related to phenoxy acids) or saline for 14 days. beta-Oxidation increased by 6-fold in the group given clofibrate, 3-fold in the 2,4-D-treated group, and 2-fold in the MCPA-treated group over the level in the controls (saline-treated). Glyphosate did not increase beta-oxidation. No significant change in reduced glutathione content from that in controls was found in any of the treated groups. Glutathione reductase activity increased by about 40% after administration of either 2,4-D or MCPA, and glutathione peroxidase activity increased by 30% in animals given MCPA. A slight decrease in glutathione S-transferase activity was found in the group treated with clofibrate. The marked increases in peroxisomal beta-oxidation of fatty acids were accompanied by only minor changes in the activities of enzymes involved in glutathione-dependent inactivation of organic hydroperoxides and other oxygen-centred reactive agents. PMID- 3969684 TI - Metabolism and excretion of orally administrated arsenic trioxide in the hamster. AB - It was shown that a single dose of arsenic trioxide administered to hamsters was chiefly methylated in vivo into methylarsonic acid (MAA) and dimethylarsinic acid (DMAA), and that inorganic arsenic accounted for the major portion of total arsenic that deposited in organs and tissues, followed by MAA and DMAA in decreasing sequence of significance. The single oral dose of arsenic trioxide was followed by a very small amount of trimethylarsenic compounds (TMA) occurring only in the liver but not in any other organs, tissues, blood or feces. The distribution pattern of arsenic in the blood following the single oral dose of arsenic trioxide was such that inorganic arsenic and MAA occurred chiefly in the blood cells; DMAA, chiefly in the plasma; and the arsenic compounds disappeared rapidly from blood. The single oral dose of arsenic trioxide was further followed by excretion of an amount of arsenic equivalent to about 60% of the administered dose: 49% in the urine and 11% in the feces. In other words, more arsenic tended to be excreted in the urine. DMAA accounted for the major portion of arsenic excreted in the urine and feces, and this finding re-confirmed that DMAA is the major metabolite of arsenic trioxide. Although it is believed that arsenic trioxide is not converted into TMA, the results of the present study suggest that a very small amount of arsenic trioxide is converted into TMA in the liver. PMID- 3969685 TI - Simultaneous mainstream-sidestream smoke exposure systems I. Equipment and procedures. AB - Equipment and procedures for the simultaneous exposure of cell cultures and rodents to mainstream and sidestream smoke are described. Whole smoke or the gas phase of smoke can be generated and manipulated under a wide range of conditions. Identical smoke can be used for the exposure of cell cultures, perfused lungs, and for the exposure of experimental animals. The equipment is relatively inexpensive, and can be used by a small laboratory for efficient, controlled smoke exposure studies. Total particulate matter data are used to illustrate the flexibility of smoke generation, manipulation, and dose variables which can be obtained with the exposure systems. PMID- 3969686 TI - Changes in rat lung structure and composition as a result of subchronic exposure to acrolein. AB - Groups of Fischer-344 rats were exposed to either filtered air, 0.4, 1.4, or 4.0 ppm acrolein for 62 days (6 h/day, 5 days/week). Mortality was observed only in the 4.0 ppm chamber, where 32 of 57 male rats died, but none of the 8 exposed females died. The lungs of the 4.0 ppm group were heavier than those of the larger control animals. Relative to controls, there was a 20% increase in total dry lung weight while the percent dry weight decreased 1.5% in the high dose group. This increased dry weight and the absence of significant changes in the DNA and protein content per unit dry weight indicated that the greater lung weight observed in this group was in part due to increased cellularity. Lung connective tissue content was increased as a result of subchronic acrolein exposure. The amount of elastin per unit dry weight was 173% of control values in the animals exposed to 4.0 ppm acrolein. Collagen levels were elevated in both the 1.4 and 4.0 ppm groups, 113 and 137%, respectively, of control values. Histologically, the 4.0 ppm animals demonstrated bronchiolar epithelial necrosis and sloughing, bronchiolar edema with macrophages, and focal pulmonary edema. Exposure related lesions were observed in only 3 of the 31 rats examined from the 1.4 ppm chamber and in none of the animals exposed to 0.4 ppm acrolein. PMID- 3969687 TI - Manganese dioxide induces alveolar macrophage chemotaxis for neutrophils in vitro. AB - Workers exposed to airborne manganese dioxide (MnO2) may develop pneumonia resistant to chemotherapy. Previous animal experiments have demonstrated that exposure to airborne MnO2 induces an invasion of neutrophils into the airways 4 12 h after exposure. Experiments were undertaken to further study the role of alveolar macrophage (AM) in the development of this response. Guinea pig lung lavage fluid was centrifuged and washed, and cell suspension incubated on one side of a leukocyte migration chamber. MnO2 (2.5 mg/ml) was incubated with the cells for different time periods. Peritoneal neutrophils from guinea pigs were isolated and incubated on the other side of the chamber. Observations of the free lung cells demonstrated that phagocytosis of the MnO2 particles commenced immediately and was virtually completed within 30 min. Cells from control animals caused small directional migration across the filter. Cells which had phagocytosed MnO2 particles showed a significantly higher degree of neutrophil migration. The data suggest that pneumonia, in terms of neutrophil invasion into the lungs after MnO2 exposure, is associated with an activation of AM with subsequent release of neutrophil recruiting factor. PMID- 3969688 TI - Studies on the toxicity of the antitumour agent N-methylformamide in mice. AB - Aspects of the toxicology of N-methylformamide (NMF), an investigational antitumour agent, were studied in mice. After injection of NMF at its LD10 (800 mg/kg) dosage the total peripheral white blood cell and platelet counts were unchanged in BALB/c mice. A mild granulocytosis was seen in this strain after administration of the LD50 (2300 mg/kg) dosage. Plasma activity of the enzyme sorbitol dehydrogenase in BDF1 mice was markedly increased after either a single injection of not less than 800 mg/kg or a chronic treatment of not less than 400 mg/kg/day over 5 days indicating the drug to be hepatotoxic. Plasma activities of L-alanine and L-aspartate aminotransferases were also increased after the chronic treatment. Chronic administration of NMF was less hepatotoxic than single dose administration of the same total dose and also increased the antitumour efficacy of NMF against the M5076 sarcoma. These results indicate that the maximum therapeutic benefit of NMF might be obtained by the use of chronic schedules and that the drug is not myelosuppressive. PMID- 3969689 TI - Increased hepatotoxicity of acetaminophen by concomitant administration of caffeine in the rat. AB - Since caffeine is frequently co-administered with acetaminophen, it is of clinical interest to study the effect of caffeine on the hepatotoxicity of acetaminophen. In male Sprague-Dawley rats fasted for 18 h, concomitant administration of caffeine (0.1 g/kg, i.p.) as judged by increased serum enzyme activities and increased incidence of hepatic necrosis. Careful observations on hepatotoxicity are suggested when acetaminophen is prescribed with caffeine. PMID- 3969690 TI - Elective treatment of regional lymph nodes in malignant melanoma. AB - Malignant melanoma of Clark level II to V was studied in 96 patients. An elective dissection or elective irradiation of the regional lymph nodes was performed in 45 patients, whereas 51 patients were not treated electively. No statistically significant differences were observed as to the survival or recurrence-free time in the regional lymph nodes in either of these two patient groups. Between the patient groups with or without selective treatment, there was not any significant difference either, even when the prognosis and recurrence of the patients were correlated to the invasion level of the primary melanoma according to Clark or Breslow. PMID- 3969691 TI - On the therapy of induratio penis plastica (Peyronies disease) by means of radium moulages. AB - In the past 50 years 2210 patients suffering from induratio penis plastica were admitted to our department. In 69% of the cases an improvement could be observed within 18 months after radium moulage therapy. By improving radium protection the therapy may now be performed without any significant exposure of the testes. A 15 year old patient is the youngest case reported in world literature. Trend analyses show a case shift towards the senium. PMID- 3969692 TI - [Effect of antineoplastic agents and ionizing radiation on a human testicular cancer heterograft]. AB - Chemotherapy has afforded a high percentage of definitive cures in advanced testicular cancer. Nevertheless some patients with large tumor burden still succumb to chemorefractory disease. Therefore preclinical and clinical evaluation of new drugs and agents not primarily used against this type of disease are still mandatory. For preclinical drug screening purposes heterotransplantation of specific human tumors yields a model with high validity for tumor markers and drug response. Heterotransplantation of a human embryonal testicular cancer was used for simultaneous testing of established agents such as cisplatin, melphalan, bleomycin, vinblastine, etoposide and adriamycin and some newer derivatives such as PHM or mafosfamide. Furthermore agents such as procarbazine, dacarbazine and methyl-CCNU that cross the blood-brain-barrier displayed some interesting activity. The results hint at a unique chemosensitivity pattern of the xenograft line, with some accordance between clinical response to vinblastine and bleomycin and good response of the xenografts to bleomycin but not to vinblastine. Radiotherapy was also effective against this tumor line, but there was not much difference in response when the schedule of fractionation was changed. It is concluded that a combined modality approach might salvage patients with residual, chemorefractory disease. PMID- 3969693 TI - [Dose output at an image intensifier with peak value- or mean value-control]. AB - X-ray fluoroscopy equipment with automatic brightness control works either on the principle of peak value control or mean value control. The different modes of operation of both control types have the consequence that different dose rate values are regulated if a homogeneous phantom is used. The controlled value using peak value control lies a factor of 1.4 higher than by mean value control. A theoretical consideration about the effect of different dose rate contrast distributions at the image intensifier with regard to the peak and mean values of both types of brightness control results in conditions, which an inhomogeneous phantom must satisfy to yield the same mean dose rate in both cases. By means of an inhomogeneous phantom construction in accordance with these conditions it is possible to compare the dose rate and also image quality parameters of different X-ray units with different types of brightness control. PMID- 3969694 TI - The response to AIDS. PMID- 3969696 TI - Hepatitis B surveillance in employees of a community blood center. AB - Over a period of 10 years, 185 employees of a community blood center were screened for evidence of hepatitis B virus (HBV) infection. Included were laboratory personnel (64%), phlebotomists (27%), and administrative employees (9%). HBV markers were detected in 5.8 percent of the individuals at the time of enrollment in the study. During the study period, seven clinical cases of HBV occurred, all in laboratory personnel. Four of the infections were in personnel involved primarily in donor processing. The other three were in individuals working in research areas. In addition, four asymptomatic HBV infections were identified on the basis of seroconversion from anti-HBs negative to positive. The annual incidence of HBV infection per 100 tested employees at risk (1.6%) indicates that blood bank personnel, despite their frequent exposure to blood, are not at high risk of developing HBV infection. PMID- 3969695 TI - Improved detection of hepatitis B surface antigen (HBsAg) in blood donors by monoclonal radioimmunoassay. AB - We evaluated the performance of a monoclonal radioimmunoassay (M-RIA) with enhanced sensitivity and high specificity for hepatitis B surface antigen (HBsAg) in blood donors. The results were compared to a conventional RIA that used polyvalent antibodies (P-RIA). Analysis of 6409 American blood donors not reactive by P-RIA revealed an additional 1.4 HBsAg-positive donors per 1000 by M RIA, or an approximate 60 percent, improvement in HBsAg detection rate. Furthermore, in 995 Israeli blood donors negative by P-RIA, 11 additional HbsAg positive donors were identified. The 55 percent improvement in detection rate was similar to that observed with American blood donors. Since several of the newly identified HBsAg-positive blood donors had antibodies to the core antigen (anti HBc) as the only serologic evidence of recent or past hepatitis B exposure, we studied an additional 68 anti-HBc-positive individuals with the M-RIA. It was found that 26 percent (18/68) reacted only by M-RIA and not by P-RIA. These findings suggest that there are blood donors with HBsAg undetectable by P-RIA. PMID- 3969697 TI - A solid-phase antiglobulin test. AB - A solid-phase antiglobulin test was developed as an alternative to hemagglutination for compatibility testing. The solid-phase endpoint of red cell adherence allowed results to be read visually or spectrophotometrically. This method was easier to perform than a hemagglutination antiglobulin test and had increased sensitivity without loss of specificity. PMID- 3969698 TI - Measures to decrease the risk of acquired immunodeficiency syndrome transmission by blood transfusion. Evidence of volunteer blood donor cooperation. AB - We studied whether volunteers giving blood to the Greater New York Blood Program (GNYBP) cooperated with procedures implementing public health recommendations intended to decrease the risk of acquired immunodeficiency syndrome (AIDS) transmission by blood transfusion. Predonation medical screening was expanded to exclude donors who might be ill with AIDS. To exclude possible asymptomatic carriers of the disease, members of groups at increased risk of AIDS were asked either not to give blood or to give it for laboratory studies. A confidential questionnaire, administered to all donors after medical screening, provided the vehicle for donors to advise the GNYBP whether their donation was for laboratory studies or for patient transfusion. We found that the number of male donors decreased; AIDS-related questions in medical history led to a 2 percent increase in donor rejections; 97 percent of donors said their blood could be used for transfusions; 1.4 percent said their blood could be used for laboratory studies only; and 1.6 percent did not respond. Only units designated for transfusion were released to hospitals. People who indicated that their donation was for laboratory studies had a higher prevalence of markers for hepatitis B virus and of antibodies to cytomegalovirus. White cell counts and helper/suppressor T lymphocyte ratios were not significantly different in the two groups. We conclude that volunteer donors have cooperated with the established procedures. None of the laboratory assays identified blood units donated by individuals who, based on information about AIDS high-risk groups, designated their donation for laboratory studies. PMID- 3969699 TI - In vivo studies of the long-term 51Cr red cell survival of serologically incompatible red cell units. AB - The long-term survival of serologically incompatible red cell units was measured in five patients with antibodies to high-frequency antigens. Initially, the survival of 1 ml of 51Cr-labeled incompatible red cells was measured over 1 hour. After demonstrating that the 1-hour survival times were successful (greater than 70%), each patient then received 5 ml of the same 51Cr-labeled red cells followed by the transfusion of the remainder of the red cell unit. The long-term T 1/2Cr survival for each case was patient 1 (anti-McCa), 15 days; patient 2 (anti-JMH), 12 days; patient 3 (anti-Kna), 31 days; patient 4 (anti-McCa), 12 days; and patient 5 (anti-Hya), 14 days. Each antibody tested in an in vitro homologous macrophage assay showed less than 5 percent phagocytosis. Anti-JMH was the only antibody to react with IgG subclass antisera and was determined to be IgG4. The macrophage assay, IgG subclass testing, and short-term (1 hour, 1 ml) 51Cr survival studies all indicated that the short-term survival was good. However, only the measurement of long-term survival with transfused units of serologically incompatible red cells was able to determine the actual survival, and "clinical significance" of the alloantibodies. Determining the actual long-term survival by the method described here can be of importance for patients requiring chronic red cell transfusion. PMID- 3969700 TI - Anti-Dob implicated as the cause of a delayed hemolytic transfusion reaction. AB - A 27-year-old, gravida 3, para 2 woman experienced a delayed hemolytic transfusion reaction. She had anti-Dob in both serum and eluate 8 days after infusion of 6 units of Do(b+) red cells. No antibody had been detected prior to transfusion. By the 15th day after transfusion, there was no evidence of survival of red cells from any of the 6 units. Anti-C and anti-M were demonstrated later, but 29 months after transfusion, no atypical antibodies were detectable. The evidence suggests anti-Dob should be considered an antibody of potential clinical significance until contrary evidence becomes available. PMID- 3969702 TI - The effects of pH and agitation on platelet preservation. AB - Platelet concentrates made with an initial pH of 7.85 or 6.85 by addition of alkali or acid were stored at 22 degrees C on tumbler or horizontal agitators. The combination of a high pH and use of a tumbler rotator was associated with a 40 percent reduction in platelet count, fragmentation of platelets, release of lactate dehydrogenase, and a marked loss in response to adenosine diphosphate. Similar, but less striking changes occurred in acidified platelet concentrates stored on the tumbler rotator. Preservation was good for both alkaline and acidified concentrates stored on the horizontal agitator. These in vitro studies showed that, even at a pH of up to 7.7, gently agitated platelets were relatively undamaged for up to 60 hours, while vigorous agitation destroyed platelets at the same pH. PMID- 3969701 TI - Lymphocytaplasmapheresis in Devic's syndrome. AB - A pregnant 26-year-old woman with Devic's syndrome manifesting as paraplegia and visual loss was treated with multiple courses of lymphocytaplasmapheresis. Clinical improvement was temporally related to the lymphocytaplasmapheresis. She relapsed when treatment was stopped and improved with reinstitution of therapy. Thereafter, further treatments were not required and she delivered a normal infant. PMID- 3969703 TI - Enhancement of the indirect anti-platelet antibody test and its application to platelet immunology. AB - Comparisons in the same patients of platelet-bound anti-platelet antibody (APA) levels (direct test) with serum APA levels (indirect test) frequently do not give the same results. Indirect test results frequently are negative or marginally elevated even though platelet-bound antibody is greatly increased on direct testing. The most likely cause for these differences between the two tests is insufficient binding of serum antibody to test platelets in vitro. In an effort to enhance in vitro antibody binding, we examined four test modifications affecting platelet attachment. Rabbit anti-human platelet antisera (absorbed with their specific human donor leukocytes to remove HLA- and granulocyte-specific antibodies) were combined under various conditions with human platelets and tested in a modified antiglobulin consumption test utilizing rabbit IgG. The test conditions varied: incubation time of the serum APA-platelet mixture at 37 degrees C; age of the test platelet pool; ionic strength of the mixture (varied through incorporation of a low-ionic-strength solution (LISS); and vortex agitation for 30 seconds prior to the addition of sera. Optimal attachment in standard phosphate-buffered saline took place in 60 minutes using test platelets stored for either 3 or 30 days, and yielded mean values for rabbit immune sera of 9.9 fg of IgG per platelet. Preincubation controls yielded a mean of 0.7 to 1.5 fg per platelet. Incorporation of LISS or vortexing of test platelets did not affect the results of control, but both modifications substantially increased test values of immune sera to 15.8 and 17.3 fg of IgG per platelet, respectively. Combining LISS with vortexing did not further increase values. PMID- 3969704 TI - Granulocyte concentrates. Glucose concentrations and glucose utilization during storage at 22 degrees C. AB - Neutrophil metabolism is dependent on the available stores of either exogenous or endogenous glucose. We studied 38 granulocyte concentrates collected by four different centrifugal cytapheresis systems: Haemonetics model 30, IBM 2997, Fenwal CS-3000, and Fenwal Celltrifuge II. Extracellular glucose concentrations were measured immediately following collection and after 24 hours of storage. The Fenwal CS-3000 produced the highest concentrations of platelets and leukocytes, and the units had the lowest initial glucose levels and pH. After 24 hours of storage, there was a mean glucose of 1.7 mg per dl in the Fenwal CS-3000 granulocyte concentrates and 9 of 12 units had no detectable glucose. In contrast, concentrates collected from other systems had sufficient glucose available to support neutrophil metabolism for a longer period. PMID- 3969706 TI - Replacement therapy for congenital Factor X deficiency. AB - We studied a young woman with severe (less than 1%) congenital factor X deficiency during a 2-year period in order to document the levels of factor X required to provide hemostasis for vaginal bleeding, epistaxis, and hemarthroses, as well as during surgery. Factor X levels of 9 to 17 percent, achieved with fresh-frozen plasma (FFP) were satisfactory for minor bleeding. Hemostasis was achieved during emergency surgery for hemoperitoneum by increasing the factor X level to 35 percent with a Factor IX concentrate, followed with infusions of FFP to maintain levels between 10 and 20 percent for 6 days postoperatively. These data suggest that factor X levels of 10 to 20 percent are sufficient for hemostasis in factor X-deficient patients even in the immediate postoperative period. PMID- 3969705 TI - Long-term cryopreservation of red cells from patients with sickle cell disease. AB - Twelve units of red cells (RBCs) from patients with sickle cell disease were glycerolized and frozen for periods of 1 to 3 years. The freeze-thaw hemolysis (mean 11.6% +/- 2.1% SEM) and in vitro process recovery (mean 74.4% +/- 3.7% SEM) were similar to those of sickle RBCs frozen for shorter periods of time. There was a weak positive correlation between duration of frozen storage and cell losses during deglycerolization. The adenosine triphosphate and 2,3 diphosphoglycerate levels of the thawed RBCs were within an acceptable range (mean 3.4 +/- 0.2 mumol/g Hb and 18.0 +/- 0.8 mumol/g Hb, respectively). Long term cryopreservation of sickle (Hb SS) RBCs opens the possibility of exploring autologous transfusion to treat sickle cell disease patients during anemic episodes that are not due to sickling. PMID- 3969707 TI - Neonatal Th activation. AB - A case is reported of a 1-month-old infant with bowel obstruction and suspected sepsis whose red cells were found to be Th activated during the course of evaluating weakened A antigen activity. Neither Th activation nor weakened A antigen activity was present on the red cells of either parent. The Th activation and the weak reactivity obtained with commercial anti-A reagents were unrelated. PMID- 3969708 TI - Chloroquine reduces antigen strength. PMID- 3969709 TI - A substance in papain extracts causes agglutination of Dantu-positive red cells: another pitfall for the unwary. PMID- 3969710 TI - Positive direct antiglobulin tests at birth without demonstrable maternal antibody. PMID- 3969711 TI - Hemolysis of donor red cells in "two thirds-one third" solution. PMID- 3969712 TI - pH effect on anti-N reactivity. PMID- 3969713 TI - Adoptive immunotherapy of metastatic B16 melanoma with allogeneic immune cells sensitized to minor histocompatibility antigens. AB - Host mice bearing pulmonary metastases of B16 melanoma were treated by adoptive immunotherapy with allogeneic donor lymphocytes. Rejection of the allogeneic donor cells by the host was delayed by pretreatment immunosuppression of the host with cyclophosphamide and selection of donors that were matched at the major histocompatibility complex (MHC) but disparate for background minor histocompatibility genes. Adoptively transferred normal nonimmune donor cells exhibited no therapeutic activity. However, allogeneic MHC-matched donor cells that were primed in vivo and secondarily sensitized in vitro to host minor histocompatibility antigens expressed on normal lymphocytes were cytotoxic to B16 tumor cells in vitro and mediated a dose-dependent antitumor effect in vivo following i.v. infusion. The therapeutic activity of sensitized allogeneic cells, which presumably reflected recognition of minor histocompatibility antigens expressed both on normal host tissues and on malignant B16 tumor cells, was not associated with any detectable toxicity to these transiently immunosuppressed tumor-bearing hosts. PMID- 3969714 TI - Genetic control of production of IgG antibody against allogeneic erythrocytes in rats. PMID- 3969715 TI - Proceedings of the Tenth International Congress of the Transplantation Society. August 26-31, 1984, Minneapolis, Minnesota. PMID- 3969716 TI - Transplantation immunology and monitoring. PMID- 3969717 TI - Transplantation. Immunogenetics. PMID- 3969718 TI - Facilitation of allograft survival and immunological tolerance. Blood transfusion. PMID- 3969719 TI - Facilitation of allograft survival and immunological tolerance. Immunological tolerance. PMID- 3969720 TI - Immunosuppression. Cyclosporine. PMID- 3969721 TI - Immunosuppression. Total lymphoid irradiation. PMID- 3969722 TI - Immunosuppression. Antilymphocytic agents. PMID- 3969723 TI - Immunosuppression. Pharmacologic agents. PMID- 3969724 TI - Immunosuppression. PMID- 3969725 TI - Organ preservation and sharing. PMID- 3969726 TI - Current controversies in transplantation. PMID- 3969727 TI - Transplantation. Social and ethical considerations. PMID- 3969728 TI - Mechanisms of allograft rejection. PMID- 3969729 TI - Proceedings of the Tenth International Congress of the Transplantation Society. August 26-31, 1984, Minneapolis, Minnesota. PMID- 3969730 TI - Transplantation. Maternal-fetal relationships. PMID- 3969731 TI - [Visual diagnosis with the transportable lighting-through system, Lixiscope]. PMID- 3969732 TI - [Internal hernia after conisation]. PMID- 3969733 TI - [Painful retraction of the testes during coitus]. PMID- 3969734 TI - [Acute abdomen caused by ruptured echinococcal cyst]. PMID- 3969735 TI - [Injury pattern in the casualty department of a central hospital]. PMID- 3969736 TI - [Epithelial ovarian cancer. Recent aspects in treatment]. PMID- 3969737 TI - [Has alteration of the postoperative treatment of ovarian cancer affected the survival rate? Assessment of a 7 year period]. PMID- 3969738 TI - [Routine biopsy from the cervix uteri in patients with metrorrhagia and normal cytological findings]. PMID- 3969739 TI - [Treatment of lateral ligament rupture of the ankle. Prospective comparison of operative and conservative treatment]. PMID- 3969740 TI - [Benign bone tumor on the back of the hand--carpal bossing. Conservative or surgical treatment?]. PMID- 3969741 TI - [Continuing training of patients with advanced ankylosing spondylitis]. PMID- 3969742 TI - [Drug-induced immunologic diseases]. PMID- 3969743 TI - [Principles of allergic reactions]. PMID- 3969745 TI - [The principle of universality]. PMID- 3969744 TI - [Update on cutaneous allergies]. PMID- 3969746 TI - [Clinical evaluation of the D-xylose test]. PMID- 3969747 TI - [Ganglionary cirrhosis... does that mean anything to you?]. PMID- 3969749 TI - [Value of the atropine test in the confirmation of brain death]. PMID- 3969748 TI - [Food habits and their role in health promotion]. PMID- 3969750 TI - [The prayer of the anxious patient]. PMID- 3969751 TI - [Allergic rhinitis]. PMID- 3969752 TI - Treatment of renal cell carcinoma with renal infarction, delayed nephrectomy, medroxyprogesterone, and xenogeneic immune RNA. AB - The authors have used xenogeneic immune ribonucleic acid (RNA) in the treatment of patients with renal cell carcinoma. This has been used in conjunction with renal artery embolization, delayed nephrectomy, and progestational therapy, using immune RNA derived from sheep cell lymphocytes immunized with patient's tumor. Four of 5 patients with Stage I disease had extremely large primary tumors. This group is alive with no evidence of disease at twelve to twenty-four months. There are no Stage II tumors in this group. One patient with Stage III tumor is alive at twenty-two months without evidence of disease. Three patients with metastases are stable at five to twenty-two months. Two patients have progressive disease at three and six months. This treatment has not been effective in patients with massive tumor burden. The results in the other groups are encouraging. PMID- 3969753 TI - Squamous cell carcinoma of renal pelvis. AB - Squamous carcinoma of the renal pelvis was diagnosed in only 11 of 2,166 renal tumors (0.5%) seen over a twenty-seven-year period. The combination of an insidious onset and a prolonged duration of symptoms (median: 5 months) resulted in all patients having invasive disease at diagnosis. Ten patients died two to twenty-eight months after diagnosis (median survival: 5 months), and only 1 patient is currently alive at nine months. We conclude that the treatment of choice is radical nephrectomy followed by adjuvant chemotherapy. PMID- 3969754 TI - Comparative evaluation of impotence with vibration and nocturnal monitoring. AB - Vibratory stimuli were used for diagnostic evaluation of 130 impotent patients. The stimuli were applied to the glans penis, and erectile response was measured and displayed on a recorder. The erectile response to vibration was compared with nocturnal penile tumescence (NPT) monitoring and to artificially produced full erection. At the present time vibratory stimuli do not represent an alternative diagnostic method to NPT. However, the two methods are complementary. Erectile activity during vibration was detected in 43 of 130 patients. For these 43 patients further evaluation with NPT monitoring would not be necessary. Because vibration evaluation is performed as an outpatient procedure, it can contribute to a significant cost reduction in the evaluation of impotent patients. PMID- 3969756 TI - Cystitis with ureteral reflux caused by ureaplasma urealyticum. AB - The authors present a case of a fifteen-year-old boy with urgency, suprapubic pain, hematuria, and pyuria with negative routine urine cultures. Cystoscopy revealed gross cystitis, and VCUG showed bilateral reflux and ureteral dilatation. Renal arteriograms, percutaneous renal biopsy, and bladder biopsy also were performed. After finding a positive culture for Ureaplasma, therapy with doxycycline rendered the patient asymptomatic and reflux improved on follow up VCUG. Ureaplasma urealyticum should be considered in patients with symptomatic pyuria and negative routine cultures. Ureteral reflux, reversible with appropriate therapy, may be part of the infectious process. PMID- 3969755 TI - Functional evaluation of new experimental model of microsurgical tubulovasostomy in rat. AB - The function of a new experimental microsurgical model of tubulovasostomy is evaluated. The model is represented by an end-to-end tubulodeferential anastomosis after removal of the proximal (juxtaepididymal) half of the vas deferens and segmental unfolding of the distal part of the epididymal tubule. Both anastomosed segments are evaluated for responsiveness to norepinephrine and field stimulation. The results are discussed in terms of accurate selection of segments to be anastomosed on the basis of their morphofunctional correlates; in fact, it seems worth replacing the segments removed only with others endowed with equivalent properties. PMID- 3969757 TI - Metastatic cervical carcinoma masquerading as bilateral renal abscesses. AB - A case is presented of a thirty-seven-year-old woman with bilateral renal masses interpreted as abscesses on computerized tomography (CT) scan. Subsequent renal exploration revealed metastatic cervical carcinoma, which is a relatively rare entity. PMID- 3969758 TI - Complete ureteral triplication with ectopia. AB - A case of complete ureteral triplication is reported and a brief review of the literature is presented. PMID- 3969760 TI - Toward bloodless nephrotomy during Gil-Vernet pyelolithotomy. PMID- 3969759 TI - Complete duplication of bladder and urethra. AB - An unusual case of complete duplication of bladder and urethra is reported. The pertinent literature is reviewed and treatment discussed. PMID- 3969761 TI - Improved aid in management of neurogenic bladder. PMID- 3969762 TI - Nephrogenic adenoma. AB - Nephrogenic adenoma is an uncommon, benign, apparently metaplastic response of urothelium to chronic infection or irritation. Endoscopically, these lesions easily can be mistaken for malignant tumors, and their scarcity only heightens the possibility of this error. A case report of nephrogenic adenoma accompanied by endoscopic photographs is presented to improve awareness and avoid inappropriate therapy. PMID- 3969764 TI - Vicarious excretion of contrast medium in patients without azotemia. AB - Although excretion of urographic iodinated contrast agents via the biliary and gastrointestinal tract is not uncommon in patients with renal insufficiency, such vicarious excretion is unusual in the presence of normal renal function. The observation of such vicarious excretion in 2 patients with acute unilateral ureteral obstruction and no azotemia is reported in conjunction with review of the appropriate literature and suggestion of possible etiologies. PMID- 3969763 TI - Growth and modeling of urothelial papillary tumors. AB - The development of urothelial papillary tumors (UPT) has been interpreted from some histologic patterns to suggest that intraurothelial vascularization and opening of urothelial nests that have grown in the lamina propria are basic processes for the development, growth, and modeling of UPT. These basic processes can combine in different ways to form the complex structures that compose UPT. PMID- 3969765 TI - Staging lymphadenectomy should be an antecedent to treatment in localized prostatic carcinoma. AB - Our own data, as well as those of many other workers, suggest that clinicians cannot depend on primary lesion Gleason scoring alone to predict the incidence of positive nodes in patients with prostatic cancer. We continue to find node involvement in 20 per cent or more of patients with Gleason 2 through 4 primary lesions. Furthermore, we continue to find that a large number (nearly 40%) of patients with Gleason 8 through 10 primary tumors do not have lymph node spread. Because of the significance of node status on patient prognosis and its potential impact on treatment decisions, we continue to advocate surgical lymph node staging in patients with localized prostate cancer. PMID- 3969766 TI - Staging lymphadenectomy should not be an antecedent to treatment in localized prostatic carcinoma. AB - The current controversy focusing on regional node evaluation in patients with prostatic carcinoma has been engendered by the enhanced biologic risk created by regional lymph node extension. The data indicate that node-positive disease is a systemic disorder and, as such, is not controlled by local treatment, such as lymphadenectomy combined with either radical removal of the primary malignancy or local radiation therapy. If lymphadenectomy is only prognostic and not therapeutic, it is reasonable to argue that any form of anatomic staging that permits the identification of nodal extension is a replacement for staging lymphadenectomy. PMID- 3969767 TI - [Sensitivity and reactivity of the vestibular analyzer in children]. PMID- 3969768 TI - [Roentgenological diagnosis of labyrinthine fistulas in chronic suppurative otitis media]. PMID- 3969769 TI - [Phenomenon of accelerated sound volume increase and the critical analysis of the mechanism of its development]. PMID- 3969770 TI - [Variant of the quantitative evaluation of hearing function based on the data from speech audiometry]. PMID- 3969771 TI - [Electromyography study of facial nerve function in the diagnosis of acoustic neuroma]. PMID- 3969773 TI - [Characteristics of tympanometry and hearing function during breathing under excessive pressure]. PMID- 3969772 TI - [Cerebrovascular disorders and ischemic stroke in patients with chronic suppurative otitis media, simulating otogenic intracranial complications]. PMID- 3969774 TI - [The laryngeal lumen after functional resection with endoprosthesis]. PMID- 3969776 TI - [Medico-genetic consultation in monosymptomatic sensorineural deafness]. PMID- 3969775 TI - [Possibilities of computerized tomography in the diagnosis of laryngopharyngeal cancer]. PMID- 3969777 TI - [Method of tympanoossicular allotransplantation]. PMID- 3969778 TI - [Otogenic brain abscess with spontaneous rupture into the middle ear]. PMID- 3969779 TI - [Case of multiple cerebellar abscesses associated with brain abscess]. PMID- 3969780 TI - [Necrotic external otitis]. PMID- 3969781 TI - [Bronchial foreign body in a patient with a history of laryngectomy]. PMID- 3969782 TI - [Phlegmon of the neck as a complication of tonsillectomy]. PMID- 3969783 TI - Adenovirus DNA synthesis is coupled to virus assembly. AB - The relationship between viral DNA synthesis and virion assembly was studied in adenovirus type 2 infected HEp2 cells. When cells were infected at the restrictive temperature with ts3, an assembly-negative mutant which permits normal viral DNA and protein synthesis, labeled and shifted to the permissive temperature, only de novo synthesized nonradioactive viral DNA was encapsidated. This suggested that only concurrently synthesized DNA is encapsidated. Blocking protein or DNA synthesis with cycloheximide or hydroxyurea after the temperature shift inhibited virus assembly. Therefore efficient virus assembly requires both concurrent protein and DNA synthesis. When DNA synthesis was arrested by shifting ts125 infected cells to the restrictive temperature, protein synthesis continued but assembly was completely blocked. Sucrose gradient sedimentation analysis of nuclear extracts of wt and ts3 infected cells provided evidence in support of a physical coupling between replication complexes and virus assembly complexes. Further evidence of coupling was also shown by preferential pulse labeling of the molecular right end of the genome isolated from reversibly cross-linked assembly intermediate particles. While DNA replication is not dependent on concurrent virion assembly, at least some significant proportion of replication complexes appear to be coupled to and are prerequisite for virion assembly. PMID- 3969784 TI - Relating cistrons and functions in bacteriophage PM2. AB - An approach to correlate functions with cistrons in bacteriophage PM2 is presented. Two of the temperature-sensitive mutants obtained differed from the wild type in heat sensitivity and four differed in host range. Comparison of the electrophoretic patterns of DNA from cells infected at the restrictive temperature with those obtained in wildtype infection revealed that viral DNA bands were absent with three additional mutants. Complementation analysis assigned the four host range mutants to cistron I and the three mutants defective in DNA synthesis to cistron IV. Recombination frequencies were used to locate cistrons III and IV on the partial genetic map of PM2. PMID- 3969785 TI - [The effect of silymarin on lipids in the blood and liver in steatosis]. PMID- 3969786 TI - [The incidence and course of glucose tolerance disorder in familial hyperlipoproteinemia]. PMID- 3969787 TI - [Present possibilities of controlling diabetic nephropathies]. PMID- 3969788 TI - [Choledocholithiasis. Views on its origin, diagnosis and therapy]. PMID- 3969790 TI - [Acute antihypertensive and diuretic effects of Metipamide VUFB]. PMID- 3969789 TI - [HBsAg positive blood donors]. PMID- 3969791 TI - [Significance of the determination of haptoglobin in chronic diseases of the liver]. PMID- 3969792 TI - [Blood lipids and type of behavior in patients at risk of ischemic heart disease]. PMID- 3969795 TI - [Experience with repeated hemoperfusion through a Czechoslovak manufactured system using activated charcoal--Hemasorb C]. PMID- 3969793 TI - [Combination of methyldopa and diuretics in the treatment of hypertensive disease]. PMID- 3969794 TI - [Catalytic activity of aspartate aminotransferase in erythrocytes in chronic kidney failure]. PMID- 3969796 TI - [Pulmonary edema due to hydrochlorothiazide]. PMID- 3969798 TI - High frequency of anti-A and anti-B haemolysins in certain ethnic groups of Nigeria. AB - Out of 11,480 blood donors, 5,380 (46.9%) belonging to a blood group O were screened for the presence of anti-A and anti-B haemolysins. Strong haemolysins (complete lysis of A and/or B cells) were detected in 1,739 (32.3%) of these blood donors. A striking observation was the high frequency of these haemolysins amongst ethnic groups originating from the southern part of Nigeria. Possible causes and consequences during blood transfusion and pregnancy are discussed. PMID- 3969797 TI - Normal salivary mucin contains the gastrointestinal cancer-associated antigen detected by monoclonal antibody 19-9 in the serum mucin of patients. AB - Monoclonal antibody 19-9 produced by a hybridoma prepared from spleen cells of a mouse immunized with a human colon carcinoma cell line, detects an antigen in sera from many patients with gastrointestinal and pancreatic cancer. This antibody is directed against a carbohydrate with the sugar sequence (Formula: see text) In many gastrointestinal and pancreatic cancers this sequence occurs in a monosialoganglioside containing a sialylated Lea-active pentasaccharide (sialylated lacto-N-fucopentaose II, IV3-alpha-NeuNAc-III4-alpha-Fuc-LcOse4). In the sera of cancer patients the antigen occurs as a mucin. The antigen is also found in salivary mucin from many normal individuals belonging to the Le(a+b-) or Le(a-b+) blood group but not in salivary mucin from normal individuals belonging to the Le(a-b-) blood group. There is more antigen in mucin from individuals belonging to the Le(a+b-) blood group than in mucin from individuals belonging to the Le(a-b+) blood group. PMID- 3969799 TI - Nomenclature for factors of the HLA system 1984. PMID- 3969800 TI - The assay of fibronectin in blood products. PMID- 3969802 TI - Infections due to halophilic vibrios. PMID- 3969801 TI - Vibrio vulnificus revisited. PMID- 3969803 TI - Mediastinal germinoma: two cases. PMID- 3969804 TI - Appendico-uterine fistula: case report. PMID- 3969805 TI - Decreased prolactin secretion by decidual tissue of pre-eclampsia in vitro. AB - In vitro prolactin (hPrl) secretion by explants of decidual tissue was studied in pre-eclampsia and normal controls. Our results indicate diminished hPrl production by decidua of pre-eclampsia as compared to the normal controls. Incubation of normal decidual tissue in the presence of serum obtained from pre eclamptic patients did not induce an inhibitory effect on hPrl production. PMID- 3969806 TI - Age- and sex-associated modification of plasma melatonin concentrations in man. Relationship to pathology, malignant or not, and autopsy findings. AB - Plasma melatonin concentrations were determined in 757 unselected elderly patients aged 80.9 +/- 9.7 years. The daytime (8-9.30 h) plasma levels of melatonin were in the so-called normal range in only one third of the population whereas 65% of the subjects had abnormal levels of the hormone, most often decreased i.e. less than 0.17 nmol/l (53%) and sometimes increased i.e. 0.43 nmol/l or higher (12%). A control group of healthy elderly subjects showed the same distribution as the entire population. A sex-difference with significantly higher levels of plasma melatonin in elderly women was observed. With respect to pathology and autopsy findings high levels of the hormone correlated with cancer, chronic renal failure, cardiovascular disease, biological inflammatory syndrome and diabetes. Low levels correlated with neurologic disease, tobacco or alcohol addiction. However, some of these relations were found to be sex-related as they were observed in women but not in men. Our data indicate that pineal function seems to be often altered in elderly human subjects and suggest potential diagnostic applications of melatonin determination. PMID- 3969807 TI - Progression of cardiovascular disease in acromegalic patients treated by external pituitary irradiation. AB - Cardiovascular complications are a major cause of morbidity and mortality in acromegaly and seem to be related to the long duration of the disorder. Conventional external pituitary irradiation for acromegaly produces a consistent, but slow, fall in elevated serum growth hormone (GH) levels. It has not been established whether such treatment is effective in preventing the development of cardiovascular complications. The evolution of cardiovascular disease has therefore been studied in 11 acromegalic patients followed up for a mean 10 years (range 3-17) after external pituitary irradiation. At the final follow-up fasting serum GH were significantly (P less than 0.01) lower than pre-irradiation levels, but cardiovascular events (myocardial infarction, dysrhythmias, hypertension, major arterial disease, heart failure) increased significantly in prevalence (P less than 0.01) during this period. Electrocardiographic abnormalities also increased in prevalence. At the final follow-up 6 patients had cardiomegaly on chest X-ray and echocardiographs (10 patients) were abnormal in every case. All 11 patients had evidence of complete or partial anterior hypopituitarism. We confirm that external pituitary irradiation is effective in reducing elevated serum GH levels in acromegaly, but suggest that such a slow reduction in serum GH levels does not retard the development of cardiovascular complications. PMID- 3969808 TI - Negative feedback effects of oestradiol-17 beta on luteinizing hormone in female rhesus monkeys under different seasonal conditions. AB - Suppression of luteinizing hormone (LH) by sc implanted oestradiol-17 beta (E2) pellets was examined in 4 ovariectomized female rhesus monkeys during the breeding season, the non-breeding season and during the transition between the breeding and non-breeding season. Immunoreactive LH was suppressed to 58, 78 and 75% of untreated levels for the respective seasonal conditions. Bioactive LH was suppressed to 29, 49 and 33% of baseline. Bioactive LH (determined by testosterone release from rat interstitial cells) was significantly correlated (r = 0.84) with immunoactive LH from the same samples. It is concluded that E2 treatment of ovariectomized female rhesus monkeys results in suppressed levels of LH, regardless of the time of year. PMID- 3969809 TI - Effect of iodide treatment on iodine concentration and volume of endemic non toxic goitre in childhood. AB - In a total of 195 children and adolescents of both sex (mean age 12.9, range 5-17 years) with endemic non-toxic goitre the thyroidal iodine concentration (IC) was determined using X-ray fluorescent scanning on admission and during iodine (100 micrograms daily) and L-thyroxine (3 micrograms/kg body weight daily) treatment respectively. Additionally the thyroid volume was measured sonographically in a longitudinal study including 46 patients before and after 4-8 months of iodine supplementation (100 micrograms daily). The IC was 305 +/- 144 micrograms/g. It compared well with that of adult goitre patients (288 +/- 109 micrograms/g) and was significantly inferior to the value of normal controls (389 +/- 170 micrograms/g). Under L-thyroxine therapy the IC further decreased (243 +/- 144 micrograms/g), whereas patients receiving iodide showed an increase of the IC (570 +/- 197 micrograms/g). The mean TSH level fell from 2.3 +/- 0.9 microU/ml to 1.4 +/- 0.6 microU/ml. The average T4/TBG (thyroxine binding globulin) ratio showed a slight increase which, however, was not significant. The mean goitre volume decreased by 40%. It was evidenced that iodide is useful not only in the prophylaxis of non-toxic goitre but also as a more physiologic treatment than thyroid hormones, at least for young subjects with simple diffuse goitres. PMID- 3969810 TI - Thyroid carcinoma and thyroiditis in an endemic goitre region before and after iodine prophylaxis. AB - Iodine prophylaxis was introduced to the moderately severe goitre endemic area in Salta, Argentina, in 1963. All thyroidectomies from a 20 year period were reviewed, and 148 thyroid malignancies carefully studied. The period from 5 to 15 years after iodization was associated with a lower frequency of follicular carcinomas and a higher frequency of papillary carcinomas than the period before and up to 5 years after prophylaxis. Lymphoid infiltration in the non-tumorous thyroid was relatively infrequent before iodine prophylaxis: it was much higher in each of the post-prophylaxis periods. These results, in agreement with other studies, support the view that an increased iodine intake is associated with an increased incidence of papillary carcinoma of the thyroid and thyroiditis. PMID- 3969811 TI - Development of thyroid autoimmunity. AB - Two blood samples were taken at an interval of 5 years in a continuing epidemiological study of a rural population in south-western Finland with an age range of 40-64 years at commencement. Paired sera of 680 subjects were tested for antibodies against thyroglobulin and thyroid microsomal antigen. In the seroconversion cases the titres in the second specimens were either low or medium but never high. In the cases selected on the basis of the highest titres in the follow-up specimens, the titres in the baseline specimens were either high or medium but never low. These findings suggest that the emergence and the development of thyroid autoimmune seroreactions are slow processes. PMID- 3969812 TI - Treatment of myxoedema coma--factors associated with fatal outcome. AB - Treatment of myxoedema coma has been associated with a high mortality. The causes of death were analysed in this paper by retrospective study of the records of 11 myxoedema coma patients. The serum thyroxine (T4) and triiodothyronine (T3) levels were estimated retrospectively from the amounts of hormone given to the patients by a two-compartment model. Seven patients died and 4 survived. The patients who died were significantly older (78.9 +/- 2.2 years, mean +/- SEM) than those who survived (66.8 +/- 3.7 years). The initial heart rate was lower in the decreased group, but both groups had increased their heart rate on treatment. The surviving patients showed an increase in body temperature during the first 3 days of treatment, in contrast to the patients who eventually died. The deceased patients had received larger amounts of thyroid hormone and had calculated levels of T3 that were nearly twice as high as those of the surviving patients. Old age and a high serum level of T3 are determinants for the fatal outcome of myxoedema coma. Our analysis underscores the importance of using a cautious replacement regimen in myxoedema coma patients. PMID- 3969813 TI - Suppressive effect of prolactin on oestrogen-induced secretion of LH by sequentially perifused rat hypothalamus-pituitary. AB - The effect of prolactin (Prl) on oestrogen-induced gonadotrophin secretion was examined in vitro in a sequential double chamber perfusion system. As control groups, mediobasal hypothalamus (MBH)-pituitary pairs or pituitaries without the MBHs were perifused with Medium 199. As an experimental group, MBH-pituitary pairs were perifused with Medium 199 containing 1 micrograms/ml of rat Prl. These groups were stimulated with 10(-7) M oestradiol-17 beta (E2) for 30 min, and luteinizing hormone (LH) in the serial fractions of effluent was measured. In the control group of MBH-pituitary pairs perifused with medium without Prl, secretion of LH began to rise within 30 min after the beginning of stimulation, reached a peak 30 min after the end of stimulation and then remained at a plateau for the rest of the experimental period, whereas in the control group of pituitaries alone no significant response was observed. In the experimental group perifused with medium containing Prl, LH-secretion showed peaks 20 and 80 min after the end of E2-stimulation, respectively, and the first peak was significantly (P less than 0.01) less than the level in the control group. These data demonstrate that Prl at this concentration suppressed the rapid LH release induced by E2. Its site of action is suggested to be at the hypothalamic level, and its possible mechanism of action is discussed. PMID- 3969814 TI - Plasma concentrations of 1-deamino-8-D-arginine vasopressin after intragastric administration in the rat. AB - A sensitive and specific radioimmunoassay for 1-deamino-8-D-arginine vasopressin (DDAVP) was developed. Plasma concentrations of DDAVP after intragastric administration were determined in non-fasted rats and a dose-related increase in plasma levels was obtained. The immunoidentity of plasma DDAVP and standard was established by high performance liquid chromatography (HPLC). Correlation of biological and immunological responses of DDAVP was assessed using the antidiuretic effect in the Brattleboro (diabetes insipidus) rat. PMID- 3969815 TI - Effects of small doses of bovine TSH on serum levels of free and total thyroid hormones, their degradation products, and diiodotyrosine. AB - Bovine TSH was administered iv to 10 normal volunteers in doses of 2.5, 7.5, 15 and 30 mU/kg. Brisk elevations of serum diiodotyrosine occurred already after the smallest dose (mean, +183%) while larger doses had only slight additional effects. T3 rose much higher than T4 (+71% compared to +23% after 15 mU bTSH/kg), and free thyroid hormones exhibited changes similar to total T3 and total T4. The mean absolute increase in serum fT3 ranged from 2.03 to 9.04 pmol/l and proved to be an easily measurable parameter for the TSH effect. Dose-response effects were seen for the increase of fT4, fT3 and T3. TBG and rT3 did not change but the degradation product 3,3'-T2 showed large increments of serum levels. There was no correlation between the response of T3 and T4, fT3 and fT4, or diiodotyrosine and any of the other parameters of thyroid function. The interindividual differences in the magnitude of thyroid hormone response to TSH were considerable, and there was no relationship between this response and thyroid volume by ultrasound. We conclude that direct stimulation of the thyroid gland with bTSH in small doses leads to consistent increases of thyroid hormones, especially T3 and fT3, that the response varies between individuals, and that the precursor diiodotyrosine is released together with thyroid hormones. PMID- 3969816 TI - Cushing's syndrome associated with bilateral adrenal adenomas. AB - The fifth case of Cushing's syndrome with bilateral adrenocortical tumours is described. By the hormonal dynamic studies both tumours have been shown to be autonomous in the secretion of cortisol. Histopathologically, both tumours were identified as benign adrenocortical adenomas without nodules, and the right one was a so-called black adenoma. A high concentration of cortisol was obtained from both tumour tissue extracts. The differential diagnosis of Cushing's syndrome due to bilateral adrenocortical adenomas from primary adrenocortical nodular dysplasia is briefly discussed. PMID- 3969817 TI - Effects of simulated increases in body weight on the growth of limb bones in hypophysectomized rats. AB - The purpose of this study was to subject groups of hypophysectomized male and female rats each to a simulated specific 10% increase in body weight, to a maximum of a doubling of body weight, in order to study the effects of quantified, increased, intermittent, compressive forces on limb bone growth. Chronic centrifugation was employed. 21-day-old Sprague-Dawley rats were used. After 60 days of centrifugation, the rats were sacrificed. The humerus, radius, ulna, femur and tibia were removed from each animal, cleared of all soft tissues, and the bone lengths measured on Helios calipers with an accuracy of 1/20 mm. The data were corrected for differences due to individual body weight by dividing bone lengths by the cube root of the body weight of the same animal. Tukey's studentized multiple-range test was performed to identify aggregations (sets) of force groups between which there are significant differences. The data suggest that the simulated increases in body weight, within the range used for this study, enhance bone growth in hypophysectomized female and male rats similarly - hypophysectomy being a condition known to inhibit bone growth. PMID- 3969819 TI - [Morphological behavior of the renal corpuscle of the garden dormouse during hibernation]. AB - We studied 20 garden dormouses (Eliomys quercinus), 10 of which had hibernated. The renal tissue was fixed in Bouin's fluid, embedded in paraffin and sectioned at 7 microns; the sections were stained with azocarmin. These preparations were studied with an optical microscope (Leitz SM-Lux). Hibernation causes an increase in the corpuscular, glomerular and Bowman capsular areas. We thought that this statistically significant increase in the size of the corpuscular structures might be due to the glomerular blood stasis and larger flow of plasma ultrafiltrated towards the capsular space, because of an intense vasoconstriction of the efferent arteriole; this vasoconstriction is due to sympathetic stimulation and renin hypersecretion. PMID- 3969818 TI - Effects of simulated increases in body weight from birth on the growth of limb bones in rats. AB - The purpose of this study was to subject groups of newborn male and female Sprague-Dawley rats each to a specific 10% simulated increase in body weight, to a maximum of a doubling of body weight, to study the effects of quantified, increased, intermittent, compressive forces on limb bone growth. Chronic centrifugation was employed. After 90 days of centrifugation the rats were sacrificed. The humerus, radius, ulna, femur, and tibia were removed from each animal, cleared of all soft tissues, measured and weighed. Tukey's Studentized multiple range test was performed to identify aggregations (sets) of force groups between which there are significant differences. The data suggest that newborn male and female rats subjected to simulated increases in body weight, within the range used for this study, undergo enhanced general body growth and limb bone growth. PMID- 3969820 TI - Physiological cross-section of the human jaw muscles. AB - The cross-sectional areas of the masseter, temporalis, medial pterygoid and lateral pterygoid muscles were determined by means of computer tomography in 16 male subjects with healthy dentitions. The physiological cross-section (PCS) of these muscles was predicted from the previously determined relationship between PCS and scan cross-sections. In our subjects, mean total PCS of the jaw muscles was twice as high as in cadavers with few natural teeth. The average distribution of total PCS over the four muscles was the same in the two groups. There was considerable individual variation. Strong correlations in cross-sectional area were only found between the masseter and medial pterygoid muscles. Variation in PCS of these two muscles determines 80% of the variation in combined cross sectional area. PMID- 3969821 TI - Development and morphology of rat synovial membrane. AB - The development of the knee joint and synovial membrane in Wistar rats was studied from the 13th fetal day until adulthood by means of light microscopy, transmission electron microscopy and scanning electron microscopy. Using acid phosphatase and peroxidase methods, the different cell types of synovial membrane could be identified. PMID- 3969822 TI - The caudal heart of fish: not a lymph heart. AB - The caudal heart is traditionally regarded as part of the lymphatic vessel system in fish. Recently, however, a secondary blood vessel system has been demonstrated in this class of vertebrates, while the existence of lymphatics was questioned. In corrosion cats of the secondary system it is shown that the caudal heart functions as a venous pump in the secondary circulation. Contrary to current views fish do not have true lymphatic vessels. Theories on the phylogeny of lymphatics therefore should be revised accordingly. PMID- 3969823 TI - Effects of starvation on the ultrastructure of the mouse parathyroid gland. AB - Ultrastructural changes of the parathyroid glands of starved mice were examined. The parathyroid glands of the starved mice showed a decrease in the volume of Golgi complexes and storage granules and an increase in the volume of lipid droplets, and contained more heterogeneously dense bodies and multivesicular bodies compared with that of the control mice. In addition, the volume of mitochondria, cisternae of granular endoplasmic reticulum and secretory granules and the number of prosecretory granules appeared to be decreased compared to those of the control mice. Myelin-like structures were observed in the parathyroid glands of the starved mice. The results of our study provide support for the hypothesis that starvation exerts an inhibitory influence not only on the synthesis but also on release of parathyroid hormone. PMID- 3969824 TI - [Adrenergic innervation of the smooth muscle cells of the cauda epididymis of the mouse]. AB - The adrenergic innervation in the smooth muscle of the cauda epididymidis of the mouse was investigated by a fluorescence technique using glyoxylic acid and by electron microscopy. As in other species, this innervation is well developed in the terminal segment of the epididymis. It varies according to muscular type: the small myocytes of the proximal zone of the tail have a visceral contractile innervation, while for the typical muscle of the distal region, the pattern is a multiple-unit one. In the mouse, the nexus are more numerous than in man and in the monkey, and constitute a facilitating factor. PMID- 3969825 TI - Descent of the testis in the fetal calf. A summary of the anatomy and process. AB - The descent of the testis in the fetal calf is reviewed, and the role in that process of the swelling reaction of the gubernaculum testis is discussed. The testes of 30 Dutch Friesian fetuses were examined by dissection and light microscopy of sections prepared from chemically and frozen-fixed specimens. The gubernaculum remains unattached to the scrotal fasciae until descent is completed. Shortening of the intra-abdominal gubernaculum and displacement of the testis begins at fetal week 11; the swelling reaction of the gubernaculum occurs between weeks 14 and 15. The testis is at the deep inguinal ring by week 15, and by week 20 it is in the scrotal position and the gubernaculum has regressed. It is proposed that the swelling of the gubernaculum dilates the vaginal ring and enlarges the inguinal canal. The clinical importance of these anatomical relationships and changes is discussed. PMID- 3969826 TI - Bone mineral content of limb bones of male weanling rats subjected to 30 and 60 days of simulated increases in body weight. AB - The purpose of this study was to subject groups of male rats each to a specific 10% simulated increase in body weight, ranging from 1.1 to 2.0 g. Constant centrifugation was employed. After 30 and 60 days, rats were sacrificed and perfused with 10% BNF. The humerus, radius, ulna, femur, and tibia were removed, cleared of all soft tissues, weighed, decalcified with EDTA, and reweighed. Bone mineral content (BMC) was determined using the formula: [(Wu - Wd) divided by Wu] X 100. Tukey's multiple range test was used. The data suggest that male weanling rats subjected to simulated increases in body weight, within the range used in this study, undergo enhanced BMC, a bimodal curve describing the relationship between BMC and simulated increases in body weight. PMID- 3969827 TI - Calcification in breast arteries. The frequency and severity of arterial calcification in female breast tissue without malignant changes. AB - 94 breast specimens without malignant changes, from women 30-89 years of age, were investigated for arterial calcification, graded in three degrees. In 40 specimens calcification of the vessels was found. The frequency of calcified vessels and the three grades of calcification varied with age, grade I predominating in the medium age-groups and grade III dominating in the oldest age groups. It is concluded that calcification of breast arteries is a frequent degenerative age-related change, most severe in the oldest age-groups. PMID- 3969828 TI - The histomorphology of Kaposi sarcoma in three homosexual men. AB - Three homosexual men with acquired immunodeficiency syndrome (AIDS) were referred to Hvidovre Hospital, Copenhagen, during 1981. Biopsies from lymph nodes (case 2), skin (case 1 and 3), oral mucosal membrane (case 1) and lung (case 3) revealed Kaposi Sarcoma (KS). Furthermore, KS was found at autopsy in several other organs in case 3. While the tumor morphology of the lymph nodes, the oral mucosal membrane, and the internal organs was identical to that of classical KS, the skin lesions appeared different. Macroscopically, the skin lesions in case 1 and 3 were alike, but microscopically, the lesions in the two cases differed from each other. In both cases small tumor infiltrates were dispersed in the dermis with interjacent preserved dermal tissue. In case 1 the tumor infiltrates were composed of different vascular structures including irregular slits formed by dermal collagen fibres lined with long slim tumor cells. In case 2 the infiltrates were mainly composed of solid collections of pale tumor cells with faintly stained nuclei. The difficulties in establishing a diagnosis of KS on skin biopsies from patients with AIDS are emphasized. PMID- 3969830 TI - Stereology of the rat kidney during compensatory renal hypertrophy. AB - Different renal structures were studied during the initial phases of compensatory renal hypertrophy. Four days after unilateral nephrectomy, kidney weight had increased by 31%, total glomerular volume by 17%, and glomerular filtration surface by 10%. After 24 days, kidney weight had increased by 44%, glomerular volume by 24%, and filtration area by 22%. The proximal tubules increased their cell volume and diameter significantly after four days (30% and 11%), but tubular length did not increase until later. We conclude that during compensatory renal hypertrophy glomerular growth is less pronounced than tubular growth, and that the increase in filtration surface area is not sufficient to explain the increased glomerular filtration rate after nephrectomy. Proximal tubules initially grow transversally and only later on longitudinally, the two growth phases possibly corresponding to cellular hypertrophy and hyperplasia. PMID- 3969829 TI - Relation of blood group carbohydrates to differentiation patterns of normal and pathological odontogenic epithelium. AB - The distribution of epithelial cell surface antigens was studied in normal odontogenic epithelium from 20 fetuses and in odontogenic epithelium from 15 ameloblastomas, 16 odontogenic keratocysts, 15 follicular and 15 radicular cysts. The cell surface carbohydrates were detected using antibodies with reactivity for the blood group antigens A, B, H type 2 (A and B precursor) and N acetyllactosamine (N-lac, H type 2 precursor) by an immunofluorescence technique. The expression of the blood group carbohydrates differed considerably in normal fetal odontogenic epithelium from that in ameloblastomas and odontogenic cysts. The A, B and H type 2 antigens were demonstrated in odontogenic keratocysts and in follicular and radicular cysts. Expression of the blood group carbohydrates was similar in follicular and radicular cysts but differed from that seen in odontogenic keratocysts by the failure to detect N-lac in the latter. The antigens A, B, H type 2 and N-lac were not expressed in any of the ameloblastomas including types with palisading of basal cells and polarization of basal cell nuclei and types with a plexiform pattern with cuboidal or polyhedral shaped peripheral cells. The findings indicate that epithelium of ameloblastomas can be distinguished from odontogenic cyst epithelium by differences in expression of cell surface carbohydrates with blood group specificity. PMID- 3969831 TI - Electrical resistance of arterioles and venules in the hamster cheek pouch. AB - The electrical resistance of the vascular endothelium was determined on single microvessels in the hamster cheek pouch in order to obtain information about this variable in a mammalian preparation. So far, the technique has only been applied to frog microvessels. The technique consists of injection of current into the vascular lumen via a microelectrode and recording of the ensuing intravascular potential distribution by a second microelectrode. Cable theory was used for the analysis. The average diameter of the vessels under study was 41 micron for arterioles and 28 micron for venules. The average resistance of the vessel wall at 37 degrees C was 19 omega cm2 and 3.3 omega cm2, respectively. For the venules this is somewhat lower than what has been recorded on muscle capillaries (Olesen & Crone 1983) in the frog at room temperature, whilst the values on arterioles are rather similar. The calculated sodium permeabilities, PNa+, were for arterioles 4 X 10(-5) cm X s-1 and for venules 23 X 10(-5) cm X s-1. The high permeability values for arterioles and venules indicate that the vascular exchange function may not be limited to capillaries only. PMID- 3969832 TI - Osmotic properties of the chromogranins and relation to osmotic pressure in catecholamine storage granules. AB - The soluble proteins (chromogranins) of bovine chromaffin granules have been studied by micro-osmometry with semi-permeable membranes (UM2, PM10 and PM30 with cut-offs greater than 1, greater than 10 and greater than 30 kD, respectively) at 1 = 0.15 and pH 5-8 for protein concentrations up to 20 mg X ml-1. After lysis of chromaffin granules in phosphate buffer pH 6, the released chromogranins behaved as aggregating solutes, consistent with an inconspicuous osmotic pressure contribution from the chromogranins at the protein concentration of the intact granules. Thus, in the presence of phosphate about 90% of the molecules behaved as colloids with Mr = 30,300 at c = o. After lysis in phosphate-free buffers the chromogranins behaved as highly non-ideal solutes in a manner which was incompatible with isotonicity at the protein concentration of the intact granules. About two-thirds of the molecules in the lysates in Na-succinate pH 5-6 and K-acetate pH 6 exhibited Mr = 66,000 and 79,000, respectively. In dilute solutions (less than 12 mg protein X ml-1) and ATP/protein ratios corresponding to those in the intact granules, the UM2 pressures were markedly increased, indicating release of polypeptides with Mr 2000-3000 from aggregates. CaCl2 was without specific effect on the colloid osmotic pressures but reduced the ATP dependent increase in pressure, suggesting release of molecules twice the size of those released by ATP alone. A model is presented for the contribution of the chromogranins to osmotic pressure regulation in the bovine adrenomedullary catecholamine-storing granules. PMID- 3969834 TI - Free and forced diving in ducks: habituation of the initial dive response. AB - Response habituation in pekin ducks was observed during a study of the early phase of the dive response. This is interpreted as the orienting response and strongly suggests higher CNS influence in the initial phase of the forced immersion heart rate response. Repeated forced dives (20-30 s) of restrained ducks were performed with 40 s recovery period between dives. During the first dives, the ducks' heart rates fell 69% (272 +/- 8 to 83 +/- 32 beats X min-1, means +/- SE) of pre-dive values. The extent of this bradycardia decreased progressively as the dives were repeated. After 60 dives, the heart rates dropped by only 29% (248 +/- 3 to 177 +/- 25 beats X min-1 for pre-dive value). Voluntary diving of the ducks, lasting 5-20 s, caused no diving bradycardia. They showed breathing tachycardia which caused a 25% increase in heart rates above diving level (160 +/- 5 to 200 +/- 12 beats X min-1). PMID- 3969833 TI - Activation of glycogen phosphorylase by electrical stimulation of isolated fast twitch and slow-twitch muscles from rat. AB - The influence of muscle contraction, induced by electrical stimulation, on the activity of glycogen phosphorylase, the contents of high-energy phosphates, hexose-monophosphates and lactate have been studied in isolated extensor digitorum longus (EDL) and soleus muscles from rats. The activity of phosphorylase a + b was about nine times higher in fast twitch muscles (EDL) than in slow-twitch soleus and remained unchanged during the stimulation. A pronounced increase of phosphorylase a occurred during the stimulation in EDL muscle. Stimulation with a frequency of 50 Hz for 10 s and 2 Hz for 90 s resulted in a 44 fold and five-fold increase in phosphorylase a, respectively. In contrast, stimulation of soleus muscle resulted in only a minor increase of phosphorylase a. The rate of glycogenolysis increased in both muscles during the stimulation but the increase was four to five times higher in the EDL than in soleus muscle. The content of phosphocreatine (PCr) before stimulation was much higher in EDL than in soleus but similar after the stimulation. This resulted in a three- to four-fold higher release of inorganic phosphate (Pi) in EDL than in soleus during contraction. Pi has previously been shown to be present in a limiting amount for the activity of phosphorylase and the increase during contraction is of importance for increasing the glycogenolytic rate. It is concluded that the higher glycogenolytic capacity in fast-twitch muscles compared to slow-twitch muscles is due to: (1) higher content of phosphorylase a + b, (2) higher degree of transformation of the enzyme into the a form during contraction, and (3) higher content of PCr, which liberates a large amount of Pi during contraction. PMID- 3969835 TI - Seasonal changes in the relative importance of different avenues of heat loss in resting and running reindeer. AB - Exhaled air temperature (Te), respiratory frequency (f), and rectal temperature (Tb) were measured in two reindeer before, during and after running for 45 min at a constant speed of 9.2 km X hr-1 on a level treadmill at different ambient temperatures (Ta), in summer with fur insulation at a minimum and in winter with fur insulation at its prime. Before and immediately after the 45-min running period, skin temperature (Tsk) and radiative surface temperature (Tr) were also measured. Te, Tsk and Tr decreased at rest with decreasing Ta both summer and winter Tb was elevated during running except at low Ta in summer. During running Tsk, Te and f were higher in winter than in summer, while Tr was higher in summer than in winter. The changes in Tr and Tsk in response to running were more pronounced on the legs than on the trunk. It is suggested that in the running reindeer the body surface is an effective avenue of heat loss during summer, while heat dissipation by way of the respiratory tract attains increased importance in winter, when fur insulation is at its best. PMID- 3969836 TI - Seasonal changes in lipogenesis and lipolysis in isolated adipocytes from Svalbard and Norwegian reindeer. AB - Arctic reindeer exhibit marked seasonal changes in fat deposition and mobilization. At intervals throughout the year, therefore, we have measured feed intake of both Svalbard (SR) and Norwegian reindeer (NR) together with the seasonal changes in size, lipogenic and lipolytic capacity of isolated adipocytes from both sub-species. Feed intake of both NR and SR was maximal in August, but declined thereafter, reaching minimum values in January (NR) and March (SR), 55 and 69% below the August value, respectively. NR and SR adipocyte volume changed in parallel and were reduced to the same extent (69%) from their maximum in August to their minimum in May. Adipocyte lipogenic capacity, measured as acetate incorporation into cellular lipid at saturated acetate concentrations, was lowest in January (NR adipocytes) and March (SR adipocytes), 92 and 90%, respectively, below the maximum values, which were obtained in August. Lipolytic capacity, measured as maximum adrenaline-stimulated glycerol release, was high in SR adipocytes from March through to October and in NR adipocytes from July through to January. Minimum lipolytic capacity, on the other hand, was found in January (SR adipocytes) and March (NR adipocytes). The present findings may be explained by alterations in lipogenic enzyme activity and in the lipolytic activation system. PMID- 3969837 TI - Three tests of cortisol secretion in adult endogenous depressives. AB - Seventy-nine drug-free adult patients fitting RDC criteria for major depressive disorder endogenous subtype (EMDD), and 64 normal adult volunteers, were studied at pretreatment with at least one of three tests of cortisol secretion. The tests were: 1) Mean half-hourly cortisol concentrations from 1 p.m. to 4 p.m. (1-4 PM CORT); 2) plasma cortisol response to 0.15 mg/kg of dextroamphetamine hydrochloride (DACT) in the afternoon; 3) dexamethasone suppression test (DST) using 1 or 2 mg. Thirty-six depressive and 27 volunteers underwent all three tests. Analysis of the data was performed for each test singly, for all pairs of tests and for all three tests in same subjects. Results show that the single most sensitive cortisol test for depressions is the DACT (72%), with a specificity of 88%. These tests may measure different underlying pathophysiologies associated with depression. PMID- 3969838 TI - Relationship between CSF noradrenaline levels, C-EEG indicators of activation and psychosis ratings in drug-free schizophrenic patients. AB - A significant increase of cerebrospinal fluid (CSF) noradrenaline (NA) levels, probably reflecting a rise of central noradrenergic activity, has been observed in a sample of acute schizophrenic patients as compared with a population of subjects without personal or family history of major psychoses. CSF NA levels have been found to be significantly correlated with computerized EEG (C-EEG) indicators of arousal (negative correlation with alpha relative activity and positive correlation with alpha barycentric frequency and beta relative activity in frontal and central leads). No significant relationship has emerged between CSF NA concentration and psychosis ratings on CPRS as well as platelet MAO activity. These findings seems to confirm the link between central noradrenergic hyperactivity and the condition of enhanced arousal of the schizophrenic patient, although the role of this condition in the pathophysiology of schizophrenia (primary phenomenon or non-specific consequence of the stress related to the illness?) remains to be elucidated. PMID- 3969839 TI - Normal ventricles in chronic schizophrenics. AB - The computed tomography (CT) scans of 46 chronic schizophrenic patients and 46 controls were studied using ventricular-brain ratio. Ewans' index, and cella media index. None of the indices used revealed significant differences between the patient and the control groups. PMID- 3969840 TI - Long-term course of acute reactive paranoid psychosis. A follow-up study. AB - The study comprises a retrospective evaluation of the case records of 49 first admission patients with acute reactive paranoid psychosis and of the subsequent follow-up almost 10 years later, with special reference to clinical and social course and outcome. Ten of the 41 followed-up patients were diagnosed schizophrenic in the observation period and a further five fulfilled the Catego Class S+ at a PSE interview. Three patients were diagnosed affective psychosis and one fulfilled Class M?. Three patients were diagnosed paranoid psychosis and four more fulfilled Class P+/P? while six patients had reactive psychosis relapses but were non-psychotic at follow-up. During the observation period the number of disabled pensioners increased from three to 21, and at follow-up only seven patients were well-adjusted in their family and work. The need is stressed for valid predictors in the prognosis of acute paranoid psychoses with or without associated stressful life events. PMID- 3969842 TI - Longitudinal studies of drug abuse in a fifteen-year-old population. 2. Antecedents and consequences. AB - A representative, stratified sample of ninth-graders of comprehensive school 1968 were followed retrospectively and prospectively in files from hospitals and Social Welfare Administration and in other official registers. Those who had stated high-frequency drug use in a school questionnaire, those who had attended special classes or had dropped out of school appeared to a larger extent than the average ninth-graders in social and child psychiatric registers during childhood. Over a follow-up period of 11 years they had a large over-consumption of drug related psychiatric and social care. They were more often sick-listed and assessed to be without income than the average year cohort. The women had children before 20 years of age and the men were exempted from military service to a higher extent. PMID- 3969843 TI - Validity of questionnaires in population studies on drug use. AB - The concurrent validity of questionnaires in population studies on drug use was tested by comparing information from registers and interviews in two populations of young people from Gothenburg. The questionnaire items' sensitivity and specificity according to criteria and their capacity for prediction of drug use and no drug use and correct classification were calculated. Considering criteria weaknesses and other sources of errors, the validity of the questionnaire items was good. This conclusion is basic to longitudinal population studies which aim at clarifying the prognosis of drug abuse among young people. PMID- 3969841 TI - Longitudinal studies of drug abuse in a fifteen-year-old population. 1. Drug career. AB - A representative, stratified sample from a year cohort of ninth-graders, mostly 15 years of age, examined in 1968 with a questionnaire, was followed over a decade in official registers. After 5 and 8 years, subsamples were also interviewed. During the period in question there was a polydrug abuse pattern in the area of Gothenburg, the second city in Sweden with approx. 450,000 inhabitants. The sample comprised 1,047 individuals and the whole year cohort 5,367. The estimated proportions of registered drug abusers in the cohort were 9% men and 8% women. 3% men and 5% women had drug careers for 2 years or less, 1% men and 0.2% women for 10 years or more. Those who became registered had with few exceptions stated drug use in the school questionnaire or had attended special classes or dropped out of school prematurely. After 5 years 60-80% of the registered abuse remained among the men in these groups and 30-40% among the women. According to interviews abuse remained in 70-90% of men who had admitted drug use in the school survey and in 50-60% of the women from the same groups. According to both registers and interviews intravenous abuse of central stimulants had increased among men but decreased among women. After 11 years, 20 60% of the registered abuse remained in men and 5-60% in the women. PMID- 3969844 TI - The development of the vertebral column. PMID- 3969845 TI - Trauma care--a race against time. PMID- 3969846 TI - Amyotrophic lateral sclerosis with dementia. PMID- 3969847 TI - Doomsday: Friday the 13th of November, 1987 or Out of gas, the end of the world is coming. PMID- 3969848 TI - Psittacosis. PMID- 3969849 TI - Promoting compliance pays off. PMID- 3969850 TI - Taking chance out of the Rx-OTC switch. PMID- 3969851 TI - A transitional category: how APhA's policy would work. PMID- 3969853 TI - Building bridges of cooperation and understanding. PMID- 3969852 TI - Ibuprofen. PMID- 3969855 TI - Calcium-channel blockers: present status and future directions. PMID- 3969854 TI - Patient-centered community pharmacy: a mirage. PMID- 3969857 TI - Functional differences in blood vessels determined from studies with calcium channel blockers. Functional changes in forearm resistance vessels of men with primary hypertension. AB - Vascular smooth muscle is activated through 2 major systems. One, which can be inhibited by calcium-entry blocking agents, involves the influx of calcium through potential-sensitive channels. The other, which can be inhibited by sodium nitroprusside, involves the entry of calcium through agonist-controlled channels and probably its mobilization from within the cell as well. Human veins, muscular arteries and resistance vessels show differing patterns of response to agents that selectively inhibit the 2 activation systems. The responses indicate that physiologic contractions of cutaneous veins and muscular arteries depend on the agonist-controlled system; contractions of veins induced by high concentrations of potassium depend on the potential-sensitive system as, probably, does local spasm in arteries. The tone of resistance vessels depends on a balance between the potential-sensitive and agonist-controlled systems. The forearm resistance vessels of men with primary hypertension respond to verapamil with larger-than normal dilatation compared with that induced by nitroprusside. This is interpreted as showing an increased contribution to resistance vessel tone from the potential-sensitive system. This functional abnormality does not depend on the inhibition of sodium pump activity that is known to occur in hypertension, because it cannot be reproduced by local infusion of ouabain. It probably results from a primary disorder of calcium handling by the cell membrane. PMID- 3969856 TI - Comparative effects of calcium-channel blocking agents on left ventricular function during acute ischemia in dogs with and without congestive heart failure. AB - To examine the relative potencies of verapamil, nifedipine and diltiazem on left ventricular (LV) function under ischemic conditions, 20 conscious closed-chest dogs that had partial occlusion of their circumflex coronary arteries were studied. Myocardial blood flow was measured by microspheres, LV function by radionuclide angiography. Drug effects were compared at doses causing equal decreases in mean arterial pressure (MAP) and in coronary vascular resistance of the nonischemic zone. Global ejection fraction (EF) and EF of the ischemic region were significantly decreased by verapamil (p less than 0.002) and increased by nifedipine (p less than 0.001); diltiazem caused no significant changes. Verapamil significantly increased peak diastolic filling rate (p less than 0.001); nifedipine also increased diastolic filling rate but only at doses that markedly decreased MAP and coronary vascular resistance. Diltiazem was not significantly different from placebo. For doses causing an equal decrease in MAP, verapamil decreased heart rate (p less than 0.001), and diltiazem and nifedipine increased heart rate (p less than 0.05). Myocardial ischemic zone flow remained unchanged during placebo, verapamil, diltiazem or nifedipine infusion. To study the influence of heart failure on the hemodynamic effects of the calcium-channel blocking agents, 6 foxhounds underwent total occlusions of the left anterior descending coronary artery, resulting in myocardial infarction, volume loading to increase left atrial pressure and partial occlusion of the circumflex coronary artery. Verapamil depressed global left ventricular ejection fraction and increased left atrial pressure to as high as 40 to 45 mm Hg. In contrast, nifedipine decreased left atrial pressure and increased global EF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969858 TI - Chest pain and "normal" coronary arteries--role of small coronary arteries. AB - To study the mechanism of chest pain in patients with insignificant epicardial coronary artery disease, 50 patients underwent great cardiac vein (GCV) flow, oxygen content and lactate determinations at rest and during pacing, and left ventricular end-diastolic pressure (LVEDP) measurements at rest and after pacing. Twenty-four patients having typical chest discomfort during pacing demonstrated significantly lower increase in flow from baseline (36 +/- 18% versus 86 +/- 24%, p less than 0.001) and decrease in coronary resistance (-17 +/- 12% versus -43 +/ 7%, p less than 0.001) compared with 26 patients without pacing-induced chest pain, despite no significant difference in myocardial oxygen consumption (MVO2) between the 2 groups. Lactate consumption at a heart rate (HR) of 150 beats/min was significantly less (28.3 +/- 21.5 versus 51.3 +/- 35.8 mM X ml/min, p less than 0.001) and the increase in LVEDP from rest to after pacing was significantly greater (5 +/- 2 versus 1 +/- 2 mm Hg, p less than 0.001) in the chest pain group. After administration of ergonovine, 0.15 mg intravenously, to 46 of these patients, 31 had typical pain either at rest (1 patient) or during pacing. This group had significantly lower increase in flow (38 +/- 20% versus 107 +/- 38%, p less than 0.001), and decrease in coronary resistance (-16 +/- 12% versus -45 +/- 11%, p less than 0.001) compared with the 15 patients not having chest pain, despite no significant difference in MVO2 between the 2 groups. Patients with chest pain also had lower lactate consumption at a HR of 150 beats/min (39.2 +/- 23.6 versus 65.3 +/- 46.3 mM X ml/min, p less than 0.01), greater arterial-GCV oxygen difference (12.5 +/- 1.3 versus 11.6 +/- 1.0 ml O2/100 ml, p less than 0.05), and a more marked increase in LVEDP from rest to after pacing (11 +/- 3 versus 5 +/- 2 mm Hg, p less than 0.001). Quantitative coronary arteriography demonstrated no significant luminal narrowing of the epicardial coronary arteries in response to ergonovine. These data are consistent with the hypothesis that some patients with chest pain and angiographically normal epicardial coronary arteries have dynamic abnormalities of the small coronary arteries or coronary microcirculation that cause abnormal vasodilator reserve or vasoconstriction, resulting in myocardial ischemia and angina pectoris. PMID- 3969859 TI - Medically directed at-home rehabilitation soon after clinically uncomplicated acute myocardial infarction: a new model for patient care. AB - Medically directed at-home rehabilitation was compared with group rehabilitation which began 3 weeks after clinically uncomplicated acute myocardial infarction (AMI) in 127 men, mean age 53 +/- 7 years. Between 3 and 26 weeks after AMI, adherence to individually prescribed exercise was equally high (at least 71%), the increase in functional capacity equally large (1.8 +/- 1.0 METs) and nonfatal reinfarction and dropout rates equally low (both 3% or less) in the 66 men randomized to home training and the 61 men randomized to group training. No training-related complications occurred in either group. The low rate of reinfarction and death (5% and 1%, respectively) in the study as a whole, which included 34 patients with no training and 37 control patients, reflected a stepwise process of clinical evaluation, exercise testing at 3 weeks and frequent telephone surveillance of patients who underwent exercise training. Medically directed at-home rehabilitation has the potential to increase the availability and to decrease the cost of rehabilitating low-risk survivors of AMI. PMID- 3969860 TI - Early positive exercise test and extensive coronary disease: effect of antianginal therapy. AB - The effect of antianginal therapy on the incidence of an early positive exercise response as a screening tool for 3-vessel and left main (LM) coronary artery disease (CAD) was examined. Fifty-seven men with stable angina pectoris underwent bicycle ergometry before and after long-acting nitrate or calcium antagonist therapy was instituted. An early positive response was defined as signs of myocardial ischemia at low levels of myocardial and total body workload (corresponding to a workload of less than 300 kpm/min). Thirty-nine patients (68%) had an early positive response before therapy, compared with 14 (24%) after therapy. Of 24 patients undergoing coronary angiography, 12 had 3-vessel CAD (including 2 with LM), 5 had 2-vessel CAD, 6 had 1-vessel CAD and 1 patient had no CAD. The sensitivity and specificity of an early positive response in predicting 3-vessel/LM CAD changed from 92% and 58% before to 42% and 75% after therapy. The positive and negative predictive values changed from 69% and 88% before to 63% and 63% after therapy. It is concluded that antianginal therapy reduces the value of an exercise test as a screening tool for 3-vessel/LM CAD. PMID- 3969861 TI - Effect of coffee on exercise-induced angina pectoris due to coronary artery disease in habitual coffee drinkers. AB - The acute effects of coffee on exercise-induced angina were studied in 17 men with coronary artery disease using a double-blind treadmill protocol. Ingestion of either 1 or 2 cups of caffeinated coffee increased the exercise duration until onset of angina (8 and 12%, respectively, p less than 0.05), whereas decaffeinated coffee had no effect. The extent of ST-segment depression and the heart rate-blood pressure product at angina were similar after drinking caffeinated and decaffeinated coffee. Exercise duration until 0.1 mV of ST segment depression, as well as the heart rate, blood pressure and double product at angina and at 0.1 mV of ST-segment depression were similar after drinking caffeinated or decaffeinated coffee. The mean serum caffeine levels (+/- standard deviation) after ingestion of 1 and 2 cups of caffeinated coffee were 1.97 +/- 1.0 and 3.89 +/- 1.6 micrograms/ml, respectively. The acute ingestion of 1 to 2 cups of caffeinated coffee had no deleterious effect on exercise-induced angina pectoris in patients with coronary artery disease. PMID- 3969862 TI - Propranolol-verapamil versus propranolol-nifedipine in severe angina pectoris of effort: a randomized, double-blind, crossover study. AB - To compare a propranolol-verapamil with a propranolol-nifedipine combination in patients with severe angina of effort, 16 patients (11 men and 5 women, aged 56 +/- 8 years [mean +/- standard deviation]) with more than 5 episodes/week of angina and a positive exercise tolerance test despite propranolol (229 +/- 44 mg/day [range 180 to 360]) were maintained on this dose of propranolol and, in addition, received verapamil (360 mg/day) and nifedipine (60 mg/day) for 3 weeks each in a double-blind, randomized fashion. In comparison with propranolol alone, anginal frequency and nitroglycerin usage were reduced by propranolol-verapamil but not by propranolol-nifedipine. Exercise time (standard Bruce protocol) was similar for the 2 combinations (6.4 +/- 2.0 minutes with propranolol-verapamil, 6.6 +/- 2.1 minutes with propranolol-nifedipine, difference not significant), but the magnitude of ST-segment depression at peak exercise was less (p less than 0.05) during propranolol-verapamil (0.03 +/- 0.06 mV) than during propranolol alone (0.18 +/- 0.07 mV) and propranolol-nifedipine (0.08 +/- 0.07 mV). Left ventricular ejection fraction at rest was higher (p less than 0.05) with propranolol-nifedipine (0.62 +/- 0.10) than with propranolol-verapamil (0.58 +/- 0.10), but neither differed from ejection fraction at rest with propranolol alone (0.59 +/- 0.08). Ejection fraction at peak exercise was similar during all 3 periods. In 2 patients, verapamil caused weakness, lightheadedness, and severe sinus bradycardia (40 to 48 beats/min), and the dosage was reduced (blindly) to 240 mg/day, with the alleviation of bradycardia and associated symptoms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969863 TI - Hemodynamic and metabolic effects of diltiazem during coronary sinus pacing with particular reference to left ventricular ejection fraction. AB - To determine the systemic and coronary hemodynamic effects of diltiazem at rest and during pacing, 14 patients with stable angina pectoris undergoing coronary angiography were studied before and after 0.165 mg/kg (n = 7) and 0.25 mg/kg (n = 7) of intravenously administered diltiazem. Hemodynamic variables, metabolic measurements and left ventricular (LV) ejection fraction (EF) were obtained at rest and during coronary sinus (CS) pacing before and during diltiazem administration. Lactate production during control pacing turned into extraction after diltiazem (p less than 0.05). At rest, systemic resistance was reduced by 21% (p greater than 0.01) and mean arterial pressure by 12% (p less than 0.01); cardiac index increased from 2.4 +/- 0.4 to 2.6 +/- 0.4 liters/min/m2 (p less than 0.01), with no significant change in heart rate. The mean pulmonary artery pressure increased from 17 +/- 2 to 19 +/- 3 mm Hg (p less than 0.01), but other hemodynamic variables were not affected. Diltiazem given during pacing reduced the mean aortic pressure (from 112 +/- 15 to 104 +/- 15 mm Hg, p less than 0.05), but other hemodynamic variables were not affected significantly. LVEF decreased 16%, from 0.63 +/- 0.9 to 0.53 +/- 0.8 with CS pacing (p less than 0.01); when the pacing was performed after diltiazem administration the 8% decrease in LVEF from 0.64 +/- 0.09 to 0.59 +/- 13 was less marked (p less than 0.01). Diltiazem had no significant effect on LVEF at rest. The overall data suggest that the ischemic manifestations of CS pacing are attenuated by diltiazem in doses of the drug that exert no significant depressant effect on LV function in patients with coronary artery disease. PMID- 3969865 TI - Follow-up after coronary arterial reperfusion with intravenous streptokinase in relation to residual myocardial infarct artery narrowings. AB - Short- and long-term changes in residual stenosis of the myocardial infarct related coronary arteries in patients with successful reperfusion by intravenous streptokinase have not been determined until now. In 15 patients the residual diameter stenosis decreased significantly from 62 +/- 9% after 24 hours to 55 +/- 13% in the fourth week (p less than 0.005). Quantitative angiographic analyses in 61 patients with patent infarct-related coronary arteries in the fourth week revealed a mean diameter stenosis of 61 +/- 13%. The patients were followed up 34 +/- 10 months. Sixteen had elective coronary artery bypass surgery or percutaneous transluminal coronary angioplasty (PTCA). Eighteen without coronary artery bypass surgery or PTCA had undergone repeat angiography after 26 +/- 9 months. Twenty-five (41%) have had a residual diameter stenosis greater than 65% in the fourth week. A stenosis greater than 65% was found in: 4 of 5 patients with late reinfarction; 3 of 7 with 1-vessel coronary artery disease and persistent angina, compared with none of 11 with a stenosis less than 65%; 6 of 7, whose silent reocclusion had been found at long-term follow-up compared with 1 of 9 with a residual stenosis less than 65%. In 8 patients with persistent patency of the infarct artery, the stenosis had decreased significantly from 55 +/- 6% to 36 +/- 12% (p less than 0.005). Correspondingly, there was a significant improvement in the infarct-related left ventricular wall motion disorders.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969864 TI - Familial aggregation and early expression of hyperapobetalipoproteinemia. AB - Family history is an important predictor of coronary risk. However, this relation, in large part, is not explained by the known risk factors such as systemic hypertension or hyperlipidemia. In the present study, plasma lipid, lipoprotein lipid, and plasma low-density lipoprotein (LDL) apoB levels were measured in 66 offspring (myocardial infarction [MI] offspring) of 24 families in which an index parent had premature coronary artery disease and hyperapobetalipoproteinemia. These results were compared to those obtained in 207 control children and young adults. Univariate analysis revealed that plasma LDL apoB and all other lipid and lipoprotein levels except high-density lipoprotein cholesterol were significantly higher in the MI offspring. Multivariate analysis showed plasma LDL apoB and LDL cholesterol best differentiated the MI offspring from control children and young adults. Of the 66 children, 22 had hyperapobetalipoproteinemia, of whom only 7 had clearly abnormal LDL cholesterol or plasma triglyceride levels. Thus, a substantial portion of children born to a parent with premature coronary artery disease and hyperapobetalipoproteinemia have the same disorder of lipoprotein metabolism. PMID- 3969866 TI - Prognostic significance of precordial ST-segment depression during inferior acute myocardial infarction. AB - To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V1, V2 and V3 had significantly larger infarctions as assessed by a QRS scoring system. Hospital mortality was 4% (3 of 75) among patients without ST depression, and 13% (11 of 87) in patients with ST depression. The relation between the amount of ST depression and hospital mortality was significant (p less than 0.001 by logistic regression), and remained significant (p less than 0.003) after adjusting for other potentially prognostic factors. Among patients discharged from the hospital, the 5-year survival was 92% in those without precordial ST depression and 80% in those with precordial ST depression (p = 0.058 by the Cox model). Precordial ST-segment depression on the admission electrocardiogram during an inferior acute myocardial infarction indicates a larger infarction, predicts a higher hospital mortality and suggests a worse long-term prognosis after discharge. PMID- 3969867 TI - Isosorbide dinitrate sublingual therapy for inferior myocardial infarction: randomized trial to assess infarct size limitation. AB - To assess the potential of isosorbide dinitrate sublingual therapy for limiting myocardial infarct size, 41 patients with inferior acute myocardial infarction (AMI) were studied. Twenty patients were randomly assigned to the control group and 21 to the treatment group. Patients in the treatment group received 10 mg of isosorbide dinitrate every 2 hours for 72 hours. To estimate infarct size, QRS scoring, peak creatine kinase (CK) serum levels and CK curves were used. There were no significant differences between the 2 groups in maximal or cumulative activity of CK or QRS score (percent of left ventricle infarcted: 16% in the control group, 17% in the treatment group). In both groups the QRS score increased significantly by 13 hours after AMI, and the increase was highly significant by 19 to 23 hours. Thus, sublingual isosorbide dinitrate at the dosage given did not reduce infarct size in patients with inferior AMI. PMID- 3969868 TI - Frequency of pericardial effusion as determined by M-mode echocardiography in acute myocardial infarction. AB - A pericardial friction rub occurs in 6 to 16% of patients after acute myocardial infarction (AMI), but the incidence of pericardial effusion (PE) is not known. M mode echocardiography was done 1, 3 and 5 days after AMI in 43 consecutive patients admitted within 24 hours of AMI, and PE was detected in 16 (37%). The PE was small in 7 patients, moderate in 6 and large in 3. A pericardial friction rub developed in 8 (19%), of whom only 4 had PE. Pleuritic chest pain diminished by sitting up and relieved by antiinflammatory agents developed in 12 (28%), of whom only 5 had PE. The peak creatine kinase level was significantly higher in patients with PE (1,769 +/- 1,003 U) than in those without (1,181 +/- 838 units). More patients with PE were in Killip classification II, III or IV (11 of 16 [69%] vs 9 of 27 [33%]). The presence of PE was not associated with age, site of AMI, development of Q waves, use of heparin or previous AMI. In conclusion, PE as detected by M-mode echocardiography is frequently present after AMI, and its presence is not closely associated with the occurrence of a pericardial friction rub or typical pericardial pain. PMID- 3969869 TI - Contractile properties of the left ventricle with aneurysm. AB - Twenty-five patients with an anterior wall acute myocardial infarction (AMI) were studied by 2-dimensional echocardiography (2-D echo) 3 to 5 days after the onset of chest pain, and serially over 3 to 24 months to determine if a particular pattern of contractility may predispose to left ventricular (LV) aneurysm formation. No subject had a prior AMI. In 8 subjects LV aneurysm eventually developed (group I), usually within 2 to 4 weeks of AMI; in 17 patients LV aneurysm did not develop (group II). Percent fractional shortening of the basal and midventricular segments was significantly better in group I subjects than in group II subjects (29 +/- 2% vs 20 +/- 2%, p less than 0.01, respectively, for the basal segment, and 23 +/- 1% vs 17 +/- 2%, p less than 0.02, respectively, for the midventricular segment). Infarct size as determined by peak creatine kinase isoenzyme levels was large in both groups, and there was no statistically significant difference between their mean values (2,099 +/- 620 IU vs 1,334 +/- 249 IU for groups I and II, respectively). Severe asynergy of the infarcted myocardium was present in all group I subjects and in 9 of 17 group II subjects on the initial 2-dimensional echocardiographic study. These results indicate that LV aneurysm formation depends on a critical imbalance of myocardial forces where strong LV segments cause bulging of weakened ones. PMID- 3969870 TI - Usefulness of electrophysiologic testing in evaluation of amiodarone therapy for sustained ventricular tachyarrhythmias associated with coronary heart disease. AB - The prognostic importance of electrophysiologic studies in patients with sustained ventricular tachyarrhythmias treated with amiodarone was prospectively studied in 100 consecutive patients. Sustained ventricular tachycardia (VT)/ventricular fibrillation (VF) was inducible in all patients before amiodarone therapy. After amiodarone administration 2 groups of patients were identified. In group 1 patients the ventricular tachyarrhythmia was no longer inducible and in group 2 patients the arrhythmia remained inducible. In group 1, no recurrent arrhythmia occurred during a follow-up of 18 +/- 10 months. In group 2, 38 of 80 patients (48%) had arrhythmia recurrence during a follow-up of 12 +/- 9 months. The difference between group 1 and 2 could not be explained by clinical variables, amiodarone doses or plasma concentrations, or electrocardiographic variables. In patients in whom cardiovascular collapse or other severe symptoms where noted during electrophysiologic study after amiodarone treatment, recurrences caused sudden death (n = 12). However, in patients in whom the induced arrhythmia produced moderate symptoms, the recurrent arrhythmia was nonfatal VT (n = 26). Electrophysiologic testing provides clinical guidance and predicts prognosis in patients treated with amiodarone as it does for the evaluation of other antiarrhythmic agents. PMID- 3969872 TI - Results of late programmed electrical stimulation and long-term electrophysiologic effects of amiodarone therapy in patients with refractory ventricular tachycardia. AB - Thirteen patients with refractory, recurrent, life-threatening ventricular tachycardia (VT) underwent electrophysiologic testing before and after long-term amiodarone therapy. Nine patients (69%) had coronary artery disease, 3 (23%) had nonischemic cardiomyopathy and 1 patient (8%) had mitral valve prolapse. At control electrophysiologic study, programmed electrical stimulation (PES) induced VT in all patients: sustained VT in 11 and nonsustained VT in 2 (9 beats and 31 beats). After oral loading with amiodarone, 1200 mg/day for 14 days, followed by maintenance therapy with 408 +/- 20 mg/day (mean +/- standard error of the mean), repeat PES at 6 +/- 1.6 months revealed inducible VT in 12 of 13 patients: sustained VT in 11 and nonsustained VT (32 beats) in 1 patient. Inducible VT was suppressed in only 1 patient. Amiodarone significantly increased sinus cycle length, PR interval, QRS duration and right ventricular effective refractory period. Insignificant increases in AH, HV and QTc intervals were noted. At 24 +/- 2 months, 8 patients (62%) (all with inducible VT at late PES) were free of clinical arrhythmic events (syncope or sudden death), compared with 5 patients (38%) (4 with inducible VT at late PES) with events. There were no significant differences in the induced VT cycle length, VT cycle length change, ease of inducibility or hemodynamic response to induced VT at late PES in patients with and without arrhythmic events.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969871 TI - Cardiac arrest and sudden death in patients treated with amiodarone for sustained ventricular tachycardia or ventricular fibrillation: risk stratification based on clinical variables. AB - Multivariate analysis of 11 clinical variables was performed in 104 patients with sustained, symptomatic ventricular tachycardia (VT) or ventricular fibrillation treated with amiodarone to determine variables predictive of subsequent cardiac arrest or sudden death. Twenty-five patients (24%) had fatal or nonfatal cardiac arrest after 7.3 +/- 6.2 months (mean +/- standard deviation) of therapy. Multivariate analysis identified an ejection fraction of less than 0.40, syncope or cardiac arrest before amiodarone therapy, and VT (3 or more consecutive ventricular premature complexes) during predischarge ambulatory electrocardiographic monitoring as variables associated with a high risk of subsequent fatal or nonfatal cardiac arrest (p less than 0.03). Patients who had these 3 clinical variables had a much higher predicted incidence of cardiac arrest at 6 months (62%) and 12 months (76%) than did patients with an ejection fraction greater than 0.40, without syncope or cardiac arrest before amiodarone therapy, and without VT during predischarge ambulatory electrocardiographic monitoring (2% and 5%, respectively) (p less than 0.02). Risk stratification using clinical variables can predict which patients are at high risk of recurrent cardiac arrest or sudden death during amiodarone therapy. PMID- 3969873 TI - Comparison in the same patient of two programmed ventricular stimulation protocols to induce ventricular tachycardia. AB - In 24 consecutive patients with documented ventricular tachycardia (VT) (22 patients) or fibrillation (VF) (2 patients), results of 2 programmed ventricular stimulation protocols to initiate VT/VF were prospectively studied. Seventeen patients had VT/VF after a healed myocardial infarction (MI) and 7 patients had idiopathic VT. In both protocols (designated 1 and 2), the right ventricular (RV) apex was paced at 100 beats/min, using a maximum of 2 ventricular premature complexes (VPCs) given at twice diastolic threshold. This protocol had a sensitivity of 25%. In protocol 1, the pacing site was changed to the RV outflow tract and the previous steps were repeated; in protocol 2, the pacing rate was increased to 120 and 140 beats/min at the RV apex, also using a maximum of 2 VPCs. The next step in protocol 1 consisted of increase of current strength to 20 mA and repeating previous steps at the RV apex and RV outflow tract, with a maximum of 2 VPCs; in the next step in protocol 2, three VPCs were used during sinus rhythm and pacing was performed at rates of 100, 120 and 140 beats/min. In protocol 1, therefore, only stimulation site and current strength were changed, while in protocol 2 only pacing rate and number of VPCs were modified. Protocol 1 had a sensitivity of 54% and protocol 2 a sensitivity of 83%. The sensitivity of protocol 2 was statistically higher than that of protocol 1 (p less than 0.05). In the group of patients with VT after MI, the sensitivity was 66% for protocol 1 and 93% for protocol 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969874 TI - Late potentials in normal subjects and in patients with ventricular tachycardia unrelated to myocardial infarction. AB - Fifty normal male and female athletes, or athletically active subjects, were evaluated, and a search for low-amplitude late potentials in the terminal part of ventricular activation was performed. Recordings from 3 normal men met the definition of abnormal late potentials, and were indistinguishable by present analytic techniques from those encountered in patients who have ventricular tachycardia (VT) after myocardial infarction (MI). Of 24 patients studied, 11 had VT, but only 2 had had an MI, which occurred in the remote past. Another patient had 1 narrowed coronary artery on arteriography. Group differences could be demonstrated using amplitudes and durations of late potentials, but late potentials generally did not prove the impressive marker of the patient with VT, which other workers, as well as ourselves, have encountered in patients after MI. Late potentials were an impressive marker in a subset of the VT group in whom cardiomegaly developed. Thus, the absence of late potentials is an effective marker in the normal subject, but the presence of late potentials is not an effective marker in identifying the patient with non-MI-related, nonsustained VT before development of cardiomegaly. PMID- 3969875 TI - Ventricular arrhythmia induced by programmed ventricular stimulation after acute myocardial infarction. AB - The prevalence, characteristics and clinical significance of ventricular electrical instability with programmed ventricular stimulation was studied in 50 hemodynamically stable patients 17 to 40 days after acute myocardial infarction (AMI) using double extrastimuli at 2- and 10-mA intensity and from 2 right ventricular sites. Ventricular electrical instability was defined as induction of 10 or more consecutive intraventricular reentrant beats. Of 50 patients, 23 (46%) had ventricular electrical instability (10 of these had sustained ventricular tachycardia [VT] induced). No significant differences were observed between patients with and without ventricular electrical instability with respect to age, site of AMI, coronary prognostic index, maximal level of CK, number of narrowed coronary arteries and presence of severe wall motion abnormalities. During a mean follow-up of 11.2 months no patient died suddenly. During repeated Holter recordings patients with ventricular electrical instability had a higher incidence of nonsustained VT than did patients without ventricular electrical instability. PMID- 3969877 TI - Continuous electrical activity during sustained monomorphic ventricular tachycardia. Observations on its dynamic behavior during the arrhythmia. AB - Catheter mapping was performed during sinus rhythm and monomorphic ventricular tachycardia (VT) in 56 consecutive patients with sustained, monomorphic VT. Forty two patients had an old myocardial infarction (VT-old MI group), 6 patients had right ventricular dysplasia (VT-RV dysplasia group), and 8 patients had idiopathic VT (idiopathic-VT group). Continuous electrical activity was recorded in 15 of 42 patients of the VT-old MI group (36%), 5 of 6 of the VT-RV dysplasia group (83%), and in 0 of 8 patients in the idiopathic VT group (0%). In 17 of 20 patients with continuous electrical activity during VT, observations on the dynamic behavior of continuous electrical activity during VT revealed at least 1 of the following characteristics: spontaneous disappearance and reappearance of continuous electrical activity without changes in rate, morphologic pattern or axis of VT; pacing-induced transient termination of continuous electrical activity without termination of VT; spontaneous disappearance of continuous electrical activity during VT as a rate-dependent phenomenon; Wenckebach-like conduction to other areas resulting in transient and periodic continuous electrical activity; dependence of continuous electrical activity on ventricular activation pattern during VT; pacing-induced change from a noncontinuous electrogram into continuous electrical activity without prevention of termination of VT; and termination of continuous electrical activity after antiarrhythmic drugs without termination of VT. Continuous electrical activity was always recorded in the aneurysm and never over normal heart areas. At the sites where continuous electrical activity was recorded during VT, potentials recorded during sinus rhythm were abnormal. Our observations suggest that several electrophysiologic phenomena can simulate continuous electrical activity during monomorphic VT. Transient, continuous electrical activity is a frequent phenomenon that represents electrical activity from abnormal areas not necessarily required to perpetuate VT. PMID- 3969876 TI - Bretylium: relations between plasma concentrations and pharmacologic actions in high-frequency ventricular arrhythmias. AB - Although it is widely assumed that the early arrhythmogenic and pressor responses to bretylium are caused by catecholamine release from the adrenergic neuron, this assumption has not been systematically studied in humans. Pharmacologic responses to a placebo infusion and 3 separate bretylium infusions (2.5, 5.0, 10 mg/kg over 60 minutes) were assessed in 6 patients with recurrent, nonsustained ventricular tachycardia. Plasma bretylium concentration, blood pressure (BP), plasma norepinephrine (NE) concentration, arrhythmia frequency and adrenergic neuronal blockade (assessed by the presence or absence of reflex venoconstriction) were measured. Adrenergic blockade was seen with every bretylium infusion and at a time when relatively small amounts of bretylium had been administered (range 160 to 750 mg, median 252). Temporal relations (p less than 0.03) were noted among the time of onset of adrenergic neuronal blockade, onset of the pressor response, increase in NE plasma concentration and increase in ventricular arrhythmia frequency. BP responses during the infusions were linearly related to change in plasma NE at the time of development of adrenergic neuronal blockade. Bretylium plasma concentrations higher than 3 micrograms/ml were frequently associated with a short-lived pressor response. There was a significant relation (p less than 0.06) between the increase in plasma NE during the infusion and an increase in ventricular arrhythmia frequency. Reduction in arrhythmia frequency was seen in only 1 patient, beginning 6 hours after the development of adrenergic neuronal blockade.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969878 TI - Arrhythmias induced during termination of supraventricular tachycardia. AB - Pacing is being used frequently for the treatment of drug-resistant, paroxysmal supraventricular tachycardias (SVT). SVT can usually be terminated by pacing, but arrhythmias may be induced which interfere with the safety of antitachycardia pacing. To quantify these pacing-induced arrhythmias, 453 attempts to terminate SVT in 111 patients were analyzed. The patients were 6 to 73 years old (mean 41); 62 were male. Seventy-six patients had SVT using an accessory atrioventricular bypass, and 35 patients had intranodal SVT. Single and then, if required, multiple ventricular and atrial premature beats and overdrive pacing were delivered from the atrium and ventricle. A pacing-induced arrhythmia occurred in 9% of all attempts (34% of patients). Atrial flutter or fibrillation (AF) was the most frequent arrhythmia (in 8% of all attempts and sustained in 75%). Atrial vs ventricular pacing resulted in a 12% vs 2% incidence of AF. AF was unrelated to age, sex, atrial size and SVT type, and was predominantly induced by multiple premature beats. In 6 patients a different SVT and in 2 patients a nonsustained ventricular tachycardia was induced. In 6 patients SVT could only be terminated by initiating another arrhythmia. Thus, AF is frequently induced during attempted pacing termination of SVT. To limit the risk of AF, a single premature beat should preferentially be used to terminate SVT. In 6% of patients, SVT can only be terminated by inducing another arrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969879 TI - Maximal hand blood flow in hypertensive and normal subjects. AB - The present study examined whether patients with systemic hypertension have evidence of structural vascular changes, whether such changes can be detected in early stages of hypertension and whether they are reversible with treatment. Hypertensive and normal subjects were studied under conditions of maximal vasodilation in which flow at a given driving pressure was considered to give an index of structural changes in resistance vessels. Thirty-two subjects were separated into 4 groups: 8 with sustained hypertension, 8 with intermittent hypertension, 8 treated hypertensive subjects maintained at systolic pressures of less than 125 mm Hg with drugs for 5 years, and 8 normal subjects. Flow was measured by venous occlusion plethysmography after 10 minutes of ischemia, using a water-filled plethysmograph at 43 degrees C. Arterial blood pressure was measured by the arm cuff method. Transmural pressure, calculated as mean arterial minus external pressure, was varied by imposing varying external hydrostatic pressures. Flow at a transmural pressure of 85 mm Hg was calculated for each subject from the least-mean-square plot of transmural pressure vs flow. Mean flow for normal subjects was 41 ml/100 ml/min and differed significantly from that for sustained hypertensive patients (30 ml/100 ml/min), treated hypertensive patients (33 ml/100 ml/min), and intermittent hypertensive patients (32 ml/100 ml/min) (p less than 0.05). There was no overlap between sustained hypertensives and normal subjects, but half of the treated hypertensive patients were normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969880 TI - Vascular hemodynamic impedance in congestive heart failure. AB - The objective of this study was to determine whether pulse-contour analysis could provide a measure of the differences in peripheral vascular state between patients with congestive heart failure (CHF) and healthy persons. Vascular hemodynamic impedance parameters were determined from brachial artery pressure waveforms recorded in 14 patients with CHF, aged 20 to 55 years (mean 36 +/- 12) and in 7 healthy control subjects, aged 22 to 55 years (mean 33 +/- 12). Cardiac output, heart sounds and electrocardiogram were also monitored. Cardiac output was 32% lower (p less than 0.01) and heart rate was 43% higher (p less than 0.001) in the CHF group than in the control group. The mean arterial pressure did not differ between groups. Systemic vascular resistance was 47% higher (p less than 0.05) and distal vascular compliance 73% lower (p less than 0.001) in the CHF group than in control group. Proximal vascular compliance was unchanged. These studies suggest that distal compliance assessed from pulse-contour analysis is a more sensitive and specific index than systemic vascular resistance to the vascular changes in CHF. PMID- 3969881 TI - Effects of upright and supine position on cardiac rest and exercise response in aortic regurgitation. AB - The effects of upright and supine position on cardiac response to exercise were assessed by radionuclide ventriculography in 15 patients with moderate to severe aortic regurgitation (AR) and in 10 control subjects. In patients with AR, heart rate was higher during upright exercise, but systolic and diastolic blood pressure and left ventricular (LV) output were similar during both forms of exercise. LV stroke volume and end-diastolic volume were not altered during supine exercise. LV end-systolic volume increased and ejection fraction decreased during supine exercise, but both were unchanged during upright exercise. Of 15 patients, 5 in the upright and 12 in the supine position had an abnormal LV ejection fraction response to exercise (p less than 0.01). Right ventricular ejection fraction increased and regurgitant index decreased with both forms of exercise and was not significantly different between the 2 positions. Thus, posture is important in determining LV response to exercise in patients with moderate to severe AR. PMID- 3969882 TI - Myxoid degeneration of the aortic valve and isolated severe aortic regurgitation. AB - Clinical and pathologic data were reviewed in 55 patients who had valve replacement for pure aortic regurgitation (AR) during a 6-year period. The clinical histories established the cause for AR in 34 cases: 11 rheumatic, 13 infective endocarditis, 4 congenital, 4 associated with aortic aneurysms and 2 the Marfan syndrome. In the valves from the other 21 patients, 13 had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucopolysaccharides and cystic change. Myxoid degeneration was also the primary pathologic abnormality in the 2 patients with the Marfan's syndrome, in 3 patients with a history of rheumatic disease and in 1 patient with a history of infective endocarditis. The patients with myxoid degeneration of uncertain origin were predominantly elderly (average age 63 years), had a long standing history of systemic hypertension (77%) and had coronary artery disease (46%); 85% were male. In these patients the replacement valves were not larger than those of the other groups studied, indicating that dilatation of the aortic anulus was not a significant factor in the pathogenesis of the valve disease. These findings indicate that myxoid degeneration of the aortic valve is common (36% of all valves examined) and, in many cases, may be secondary to long standing systemic hypertension. PMID- 3969883 TI - Value of multiple echocardiographic views in the evaluation of aortic stenosis in adults by continuous-wave Doppler. AB - Fifty-two adults referred for evaluation of aortic stenosis (AS) were studied using continuous-wave and pulsed Doppler echocardiography. Three windows were used to determine which approach (apical, right parasternal or suprasternal) yielded optimal results. Doppler-derived peak aortic valve gradients were compared with the peak gradients measured at cardiac catheterization in 23 patients. High-velocity jets were best recorded from the cardiac apex and less frequently from the right parasternal and suprasternal areas. However, gradients from the right parasternal area correlated best with cardiac catheterization findings, although recordings could be made from this window in only 49% of the patients. Velocities from the suprasternal window were significantly (p less than 0.01) lower than those from the apex or right parasternal areas. Gradient underestimation from the suprasternal window tended to increase with age of the patient (p less than 0.01). When the maximal Doppler derived gradient from any window was compared with catheterization measurements, the correlation coefficient was 0.86. Gradients derived from Doppler velocities accurately predicted severe (more than 50 mm Hg) gradients at catheterization. Thus, Doppler echocardiography is useful in evaluation of AS when several windows are used for optimal assessment of aortic valve gradient. PMID- 3969884 TI - Echophonocardiographic estimates of pulmonary artery wedge pressure in mitral stenosis. AB - The efficacy of noninvasive indexes for predicting pulmonary artery wedge (PAW) pressure was reviewed in 77 patients with mitral stenosis. M-mode echocardiography and phonocardiography were used to measure the aortic valve closure-mitral valve E-point interval (A2-E) and the electrocardiographic Q wave mitral valve closure interval (Q-C) close to the time of diagnostic cardiac catheterization. During catheterization, in 65 patients PAW pressure was measured and in 12 left atrial (LA) pressure was measured. The A2-E and Q-C intervals taken alone had only modest correlation with PAW pressure (r = -0.54 and r = 0.46, respectively). The correlation was weakest in patients with atrial fibrillation and best in sinus rhythm when heart rate variation between invasive and noninvasive studies was within +/- 5 beats. Substitution of V-wave pressure for mean PAW pressure and correction for variation in blood pressure improved the A2-E correlation (r = -0.64), as did combining the A2-E and Q-C intervals into a ratio [(Q-C)/(A2-E)] (r = 0.62). However, the best results were obtained in patients where LA pressure was measured directly (r = -0.91 for A2-E), suggesting the PAW pressure is not always an accurate reflection of LA pressure. In conclusion, many factors in addition to LA pressure affect the Q-C and A2-E intervals which, in many situations, decrease their predictive value. However, if used appropriately, these intervals may allow an estimation of PAW pressure. PMID- 3969885 TI - Two-dimensional echocardiographically guided pericardiocentesis: experience in 117 consecutive patients. AB - Pericardiocentesis guided by 2-dimensional echocardiography has been used at the Mayo Clinic since April 1980. The 2-dimensional examination localizes the pericardial fluid. Particular note is made of the place on the body wall closest to the fluid. An entry track that permits puncture of the pericardial sac without damage to any vital structure is then selected for the pericardiocentesis needle. Between April 1980 and March 1984, 132 consecutive pericardiocenteses in 117 patients were done by this technique. The volume of fluid obtained ranged from 75 to 1,700 ml (mean 650). Seventy percent of the taps were done for therapy, 21% for diagnosis, and 9% for both therapy and diagnosis. A Teflon-sheathed "intracath" needle was used to complete 80% of the pericardiocenteses. In the other 20%, a large catheter was secondarily introduced and connected to a closed drainage system. There were no deaths related to the procedure. One symptomatic pneumothorax occurred. There were 3 minor complications. Two-dimensional echocardiographic imaging of the heart and pericardial fluid permits a safe and effective means of performing pericardiocentesis. PMID- 3969886 TI - Magnetic resonance imaging of constrictive pericardial disease. AB - Gated magnetic resonance imaging of 5 patients with suspected constrictive pericardial disease was performed using a superconducting magnet operating at 0.35 Tesla. Results were compared with those of echocardiography and hemodynamic measurements in all patients, with chest films in 5, computerized tomography in 2 and with histologic findings in 3. Pericardial thickness exceeded 5 mm in 4 patients and was 5 mm in 1 patient. Absence of magnetic resonance signal from the thickened pericardium was observed with extensive calcific deposits, and increased intensity of the thickened pericardium was associated with inflammatory disease. Dilatation of the right atrium, venae cavae and hepatic veins, and right ventricular narrowing was observed in all patients. The ventricular septum was straight in all patients. Magnetic resonance imaging allows both measurement of pericardial thickness and depicts internal cardiac anatomy without exposure to radiation or use of contrast medium. Satisfactory imaging with a large field of view can be performed in the presence of lung disease, thoracic deformity or surgical "hardware"--conditions that limit echocardiography and computerized tomography. The inherently 3-dimensional data permit imaging in any plane without loss of resolution. Thus, magnetic resonance appears to be the noninvasive method of choice for the diagnosis of constrictive pericardial disease. PMID- 3969888 TI - Billowing, floppy, prolapsed or flail mitral valves? PMID- 3969887 TI - "Submaximal" predischarge exercise testing after acute myocardial infarction: who needs it? PMID- 3969889 TI - Enticing real and potential cardiovascular researchers away from research. PMID- 3969890 TI - Straddling atrioventricular valve: two-dimensional echocardiographic diagnosis, classification and surgical implications. AB - The usefulness of subclassifying the anatomic variations of straddling and overriding atrioventricular (AV) valve by 2-dimensional echocardiographic observation were evaluated. Chordae straddling into a contralateral ventricle were subdivided into type A (chordae inserting into the contralateral ventricle near the crest of the ventricular septum), type B (chordae inserting along the contralateral ventricular septum) and type C (chordae inserting into the free wall or papillary muscles of the contralateral ventricle). Overriding AV valve anulus was described as minor (less than 50% of the anulus committed to the contralateral ventricle), major (about 50% of the anulus committed to each ventricle), and double-inlet ventricle (greater than 50% of both AV valves committed to a single ventricular chamber). In 52 patients straddling AV valve was diagnosed by echocardiography and confirmed by direct examination at surgery or autopsy. In 60 of 66 straddling AV valves (91%), the diagnosis and the degree of straddling (type A, B or C) were correctly identified by 2-D echocardiography. Major associated cardiac defects included double-outlet right ventricle (31%), complete transposition (23%), corrected transposition (19%), double-inlet ventricle (19%) and other complex defects (8%). Twenty-two patients (42%) had right-sided straddling, 21 (40%) had left-sided straddling and 9 (17%) had straddling of both AV valves. In 41% of the patients, straddling AV valve had a major impact on the type of surgery or the surgical outcome. Of these valves, 52% were type C (severe), 26% type B and 22% type A straddling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969891 TI - Accuracy of two-dimensional echocardiography in the diagnosis of congenital heart disease. AB - To assess the accuracy of 2-dimensional (2-D) echocardiography in the evaluation of cardiac anatomy in patients with congenital heart disease, 2-D echocardiograms were performed in 126 infants and children before cardiac catheterization and angiocardiography. The segmental echocardiographic analysis included determination of intracardiac, great artery, systemic venous and pulmonary venous anatomy. The 126 patients had 259 separate cardiovascular abnormalities, of which 226 (87%) were prospectively identified by 2-D echocardiography. There were 8 false-positive diagnoses. The most common lesions and the sensitivity and specificity of echocardiography were: patent ductus arteriosus, 41 patients (83% and 100%, respectively), ventricular septal defect, 35 patients (86% and 100%); atrial septal defect, 26 patients (85% and 99%); pulmonary valve stenosis, 25 patients (77% and 97%), transposition of the great arteries, 16 patients (100% and 100%); and total anomalous pulmonary venous connection, 14 patients (85% and 100%). Less common defects and their rate of detection included coarctation of the aorta, 10 of 12 patients; atrioventricular canal, 10 of 10 patients; tetralogy of Fallot, 10 of 10 patients; aortic valve stenosis 8 of 8 patients; right aortic arch, 8 of 8 patients; interrupted aortic arch, 4 of 4 patients; and unilateral pulmonary vein atresia, 0 of 1 patient. In 33 patients (26%), the errors in echocardiographic analysis were judged to have surgical importance. Most errors were the result of overlooking or misinterpreting data that had been appropriately recorded on videotape. Pulmonary valve stenosis and patent ductus arteriosus are the lesions most likely to be misdiagnosed by ultrasound studies relying on imaging alone. PMID- 3969892 TI - Pre- and postoperative electrophysiologic assessment of children with secundum atrial septal defect. AB - Sinus node (SN) and atrioventricular node (AVN) dysfunction after repair of atrial septal defect (ASD) may be caused by inherent nodal abnormalities and not related to altered hemodynamics. To assess the preoperative prevalence and postoperative persistence of nodal dysfunction, 21 consecutive children, mean age 5.4 years, underwent electrophysiologic evaluations before ASD repair. Preoperative SN recovery time was prolonged in 11 patients and was associated with abnormal AVN response to rapid atrial pacing in 5. There were no significant differences in age, hemodynamic values or shunt size between children with normal and those with abnormal nodal function. Atrial and AVN refractory periods were normal. The ASD was repaired in 9 children with SN dysfunction. Electrophysiologic studies performed 4 to 16 months after surgical correction showed improvement in all electrophysiologic values. However, SN function remained abnormal. Significant decreases were observed in atrial (p less than 0.05) and AVN (p less than 0.05) refractory periods, with increased atrial conduction velocity (p less than 0.01) and AVN Wenckebach response to atrial pacing (p less than 0.01). ASD repair improved nodal and atrial muscle electrophysiologic function, theoretically by relieving stress on atrial impulse propagation. SN and AVN dysfunction may persist as an inherent part of the ASD complex. PMID- 3969893 TI - Local abnormalities of right ventricular depolarization after repair of tetralogy of Fallot: a basis for ventricular arrhythmia. AB - Ventricular arrhythmia is common after repair of tetralogy of Fallot (TF) and may cause sudden death. To explore the mechanisms, ambulatory electrocardiographic monitoring and electrophysiologic studies were undertaken, without the use of provocative tests, in 22 patients 5 to 24 years (mean 13) after repair. His Purkinje and right ventricular (RV) apical activation times were measured to assess conduction. Endocardial mapping of the right ventricle was performed, with additional recordings from the left ventricle in 10 patients, to detect abnormalities of local depolarization and repolarization. Local RV electrograms were fractionated or delayed in 12 patients (55%) at 1 or more RV sites (septum in 7 patients, outflow in 7, free wall in 2 and apex 1 patient), reflecting disordered depolarization, but left ventricular recordings were normal in all. Ventricular arrhythmia out of hospital was more common (p less than 0.05) and more severe (p less than 0.01) in the patients with depolarization abnormalities than in those with normal electrographic findings. In contrast, there was no association between ventricular arrhythmia and conduction disturbances. Abnormalities of RV repolarization, consisting of low-frequency signals after the T wave, were observed in 17 patients (77%), but were not associated with arrhythmia. Thus, ventricular arrhythmia during daily life was associated with fractionated depolarization at multiple sites in the right ventricle. This suggests that there are widespread areas of RV myocardial damage that provide substrates for ventricular tachycardia. PMID- 3969894 TI - Assessment of hemodynamic status in the intensive care unit immediately after closure of ventricular septal defect. AB - Hemodynamic values measured 12 to 24 hours postoperatively in the intensive care unit (ICU) were compared with those measured at a later cardiac catheterization in 68 patients after closure of ventricular septal defect (VSD). A pulmonary arterial (PA) saturation of more than 80% or a pulmonary to systemic blood flow ratio (Qp:Qs) greater than 1.5 in the ICU were sensitive indicators for identifying patients at risk of having a hemodynamically significant residual left-to-right shunt (Qp:Qs greater than 1.5) at catheterization. Measurement of PA pressure in the ICU was a useful predictor of PA pressure at catheterization. In the absence of factors known to alter PA pressure, measurement of PA pressure in the ICU overestimates what it will be at a subsequent cardiac catheterization. Early assessment of hemodynamics after closure of VSD is useful in identifying patients at risk of having hemodynamically significant residual VSD and those who may have persistent PA hypertension. PMID- 3969895 TI - Comparison of ventricular function after Senning and Jatene procedures for complete transposition of the great arteries. AB - Postoperative right (RV) and left ventricular (LV) volume characteristics in patients with complete transposition of the great arteries were studied to compare ventricular function after Senning and Jatene procedures and to analyze RV dimensional change during systole in patients after the Senning procedures. RV end-diastolic volume (EDV) was 181 +/- 74% of normal (mean +/- standard deviation) and RV ejection fraction (EF) was 0.48 +/- 0.09 in 15 patients who underwent the Senning procedure. In 9 patients who underwent the Jatene procedure, LVEDV was 152 +/- 27% of normal and LVEF was 0.61 +/- 0.09. One patient with aortic regurgitation, 1 with aortic regurgitation and residual ventricular septal defect, and 1 with aortic regurgitation and generalized LV wall hypokinesia of unknown cause had large LVEDVs. Pulmonary ventricular EDV and EF were within normal ranges except in the patients with persistent pulmonary hypertension, who had large EDVs and low EFs regardless of the anatomic type of ventricle, either the left or right. The study of RV dimensional change in the Senning group showed a reduced systolic shortening of the anteroposterior diameter compared with the preoperative transposition of the great arteries and normal. This reduced shortening may be related to postoperative adhesion of the RV free wall to the anterior chest wall and fixation of the atrium secondary to the intraatrial repair. In conclusion, systemic ventricular function after intraatrial repair for complete transposition of the great arteries is depressed by unavoidable residua and sequelae: persistent RV hypertension, anatomy of the right ventricle and, possibly, postoperative adhesions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969896 TI - Analysis of phase-angle histograms from equilibrium radionuclide studies: correlation with semiquantitative grading of wall motion. AB - Quantitative wall motion assessment from gated radionuclide left ventriculograms using phase analysis was studied in 14 subjects (6 normal volunteers and 8 patients with previous acute myocardial infarction). The standard deviation and skewness of the phase-angle histograms were determined from both global and segmental left ventricular (LV) regions of interest (septal, apical and posterolateral). Studies were performed at rest, after administration of atropine and after combined administration of phenylephrine and atropine. Both the standard deviation and skewness showed significant correlations with semiquantitative wall motion scoring. From the global analyses, the highest correlations were found after atropine administration (r = 0.86, p less than 0.001 for standard deviation and r = 0.72, p less than 0.001 for skewness). Nevertheless, deterioration in global wall motion scores correlated poorly with directional changes in standard deviation (r = 0.06, difference not significant) or skewness (r = 0.33, p less than 0.05). No significant correlation between skewness or change in skewness and wall motion scores were found with the segmental analyses. The maximal correlation between segmental standard deviation and segmental wall motion grading was again noted after atropine administration (r = 0.68, p less than 0.001), but deterioration in grading did not correlate with similar deterioration of the standard deviation (r = -0.05, difference not significant). Based on 90% confidence limits for normal standard deviation and skewness, an abnormal standard deviation (greater than 14.5) identified 13 of 28 wall motion disorders (sensitivity 46%), whereas an abnormal skewness (greater than 1.4) identified 1 of 28 wall motion disorders (sensitivity 4%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3969897 TI - Myocardial infarct size threshold for two-dimensional echocardiographic detection: sensitivity of systolic wall thickening and endocardial motion abnormalities in small versus large infarcts. AB - This study evaluated the ability of 2-dimensional echocardiography to detect myocardial infarcts of varying sizes. Echocardiography was performed in 29 closed chest, conscious dogs 2 days after circumflex coronary artery occlusion, and the ultrasonic recordings were analyzed for regional abnormalities in either wall thickening or endocardial motion. Acute myocardial infarct (AMI) size and extent were assessed by morphologic examination. In 5 dogs, coronary occlusion failed to produce AMI; in these dogs wall thickening analysis showed no abnormalities (100% specificity), and endocardial motion analysis yielded 1 false-positive result (80% specificity). In 24 dogs an AMI developed; infarcts larger than 18% of left ventricular mass uniformly resulted in echocardiographically detectable contraction abnormalities. When the AMI was small (1 to 6% of left ventricular mass) and primarily subendocardial, the sensitivity of echocardiography was poor: Only 3 of 10 of the dogs with a small AMI had abnormalities by wall thickening, and only 1 of 10 by endocardial motion. Thus, in this canine model of AMI, 2 dimensional echocardiography was insensitive to small, subendocardial AMI. If this is so in humans as well, it is a potential limitation of the clinical use of echocardiography in the detection of AMI. PMID- 3969898 TI - Aspirin or dipyridamole individually prevent lipid accumulation in primate vein bypass grafts. AB - Although platelet inhibition with both aspirin and dipyridamole is widely prescribed for patients with coronary artery bypass grafts, data are lacking to prove that combined drug therapy has greater efficacy in preserving graft integrity than either drug given independently. Thus, the ability of combined vs single drug therapy to reduce cholesterol and apolipoprotein-B accumulation were compared in autologous cephalic veins grafted into femoral arteries of 23 stump tailed macaque monkeys. Ten monkeys were studied in 2 phases. They were treated with aspirin (80 mg/day) during 1 phase and with dipyridamole (50 mg/day) during the other phase. Five monkeys received aspirin plus dipyridamole in combination and 8 received no medication and served as controls. When grafts were removed 3 months after insertion cholesterol and apolipoprotein-B concentrations in grafts were similar for groups treated with aspirin, with dipyridamole, and with the drugs combined, and in each of the treated groups these concentrations were significantly reduced compared with grafts from untreated control monkeys. Cholesterol and apolipoprotein-B concentrations in grafts from the treated groups were similar to concentrations in normal ungrafted veins, whereas cholesterol and apolipoprotein-B levels in grafts from control monkeys were significantly greater than those in ungrafted veins (250% and 925% of normal, respectively). Our findings reaffirm the ameliorative effect of anti-platelet drugs in reducing the accumulation of lipid in vein bypass grafts and indicate that the efficacy of aspirin or dipyridamole given individually equals that of the combination of these drugs in this subhuman primate model. The relation of the lipid-lowering effect of these agents to their antithrombotic effect is uncertain. PMID- 3969899 TI - In vivo assessment of left ventricular wall and chamber dynamics during transient myocardial ischemia using cine computed tomography. AB - Using a new computed tomographic (CT) scanner design that uses a rapidly moving focused electron beam, 50-ms CT scans were obtained at 2 axial levels simultaneously through the hearts of 6 dogs in order to analyze left ventricular (LV) wall thickness and cross-sectional chamber area after acute occlusion of the left anterior descending coronary artery (LAD). Ten or fifteen 50-ms CT scans (rate of 17 scans/s through the middle of the left ventricle were performed in 1 second (cine acquisition) during intravenous administration of contrast medium at rest, 60 seconds after acute occlusion of the LAD, and 60 seconds after release of the occlusion. The percent extent of systolic wall thickening of the potentially ischemic anterior segment was 37 +/- 15% (+/- standard deviation) in the control state and -5 +/- 6.5% during LAD occlusion (p less than 0.01). There was no significant difference in the percent change in LV luminal area from end diastole to end-systole between the control state (50 +/- 19%) compared with LAD occlusion (47 +/- 21%). There were no significant differences in the extent of systolic wall thickening or LV luminal area between the control state and 60 seconds after release of occlusion. The alterations in regional myocardial function during acute ischemia are characterized by wall thinning during systole in the jeopardized segment and no significant change in global LV function. These features can be assessed by cine computed tomography during a solitary heart cycle. PMID- 3969902 TI - Coffee, tea and cholesterol. PMID- 3969903 TI - Evaluation of coronary anatomy using high-speed volumetric computed tomographic scanning. PMID- 3969900 TI - Effects of transient increased afterload during experimentally induced acute myocardial infarction in dogs. AB - Alterations in afterload may occur during acute myocardial infarction (AMI), but it is unknown whether such alterations cause long-term changes in the left ventricular topography or alter healing of the AMI. AMI was produced by ligation of the left anterior descending coronary artery in open-chest dogs. Eight dogs were randomized to a methoxamine group with an infusion dose of 30 micrograms/kg/min starting 1 hour after ligation for 4 hours to increase systemic systolic pressure by 40 to 50 mm Hg, and 8 were randomized to a saline control group (n = 8). Seven days later the dogs were killed and the hearts examined. The ratio of infarct wall thickness to noninfarct wall thickness was 1.13 +/- 0.03 (mean +/- standard error of the mean) in control dogs and was 0.98 +/- 0.03 in the dogs treated with methoxamine (p less than 0.005). An expansion index was determined as previously reported and expansion was considered to have occurred if this index exceeded 1.09. The expansion index was 0.98 +/- 0.06 in the control group and 1.18 +/- 0.07 in the methoxamine group (p less than 0.05). Histologic analysis suggested a lag in the healing rate in the methoxamine-treated dogs. Thus, early, brief increases in afterload cause infarct expansion and thinning and appears to slow the early healing phase of AMI in dogs. PMID- 3969901 TI - Comparative electrophysiologic effects of adenosine triphosphate and adenosine in the canine heart: influence of atropine, propranolol, vagotomy, dipyridamole and aminophylline. AB - The electrophysiologic effects of adenosine triphosphate (ATP) and adenosine and the modification of these effects by atropine, propranolol, vagotomy, dipyridamole and aminophylline were studied in a canine model. Both ATP and adenosine exerted transient, dose-dependent negative chronotropic and dromotropic effects on the sinoatrial and atrioventricular nodes, respectively. At all doses tested, the effects of ATP were more pronounced. Treatment with either atropine or propranolol plus bilateral cervical vagotomy attenuated the effects of ATP but not of adenosine. In the presence of propranolol plus vagotomy, both the negative chronotropic and dromotropic effects of ATP and adenosine were enhanced and attenuated in a similar manner by dipyridamole and aminophylline. Thus, when ATP and adenosine are injected rapidly into the right atrium of the intact canine heart, vagal involvement in the mechanism of action of ATP but not of adenosine is mainly responsible for the difference in the magnitude of the electrophysiologic effects of these 2 compounds, and only a small part of the electrophysiologic effects of ATP are the result of its degradation to adenosine. PMID- 3969904 TI - Left main coronary artery spasm: angiographic demonstration during spontaneous angina. PMID- 3969905 TI - Cold-induced immersion injury: a potential hazard of the cold pressor test. PMID- 3969906 TI - Doppler detection of acquired ventricular septal defect. PMID- 3969907 TI - Acute cardiac rupture and tamponade: angiographic appearance. PMID- 3969908 TI - Selective inhibition of thromboxane-related platelet function by low-dose aspirin in patients after myocardial infarction. PMID- 3969909 TI - Fatal bioprosthetic regurgitation immediately after mitral and tricuspid valve replacements with Ionescu-Shiley bioprostheses. PMID- 3969910 TI - Polymorphous ventricular tachycardia provoked by lidocaine. PMID- 3969911 TI - Do all pacemakers need both antibradycardia and antitachycardia pacing features? PMID- 3969912 TI - Macroreentry within the His-Purkinje system initiated by atrial premature complex. PMID- 3969913 TI - Strut fracture and disk embolization of a Bjork-Shiley mitral valve prosthesis. PMID- 3969914 TI - Tricuspid anular dilatation and failure of tricuspid leaflet coaptation in tricuspid regurgitation. PMID- 3969915 TI - Usefulness of Doppler echocardiography in detecting tricuspid valve stenosis. PMID- 3969916 TI - Dynamic intracavitary left atrial echoes in mitral stenosis. PMID- 3969917 TI - Noninvasive detection of anomalous origin of the left main coronary artery from the pulmonary trunk by pulsed Doppler echocardiography. PMID- 3969918 TI - Origin of the right from the left main coronary artery (single coronary ostium in aorta). PMID- 3969919 TI - Calcified right ventricular outflow tract aneurysm after repair of tetralogy of Fallot. PMID- 3969920 TI - Aortic aneurysm after patch aortoplasty for coarctation in childhood. PMID- 3969921 TI - Deglutition syncope and atrioventricular block selectively induced by hot food and liquid. PMID- 3969922 TI - A new echocardiographic classification of left atrial myxoma. PMID- 3969923 TI - More on Bazett's formula. PMID- 3969925 TI - M-mode echocardiography for diagnosis of atrial flutter. PMID- 3969924 TI - Carotid sinus hypersensitivity: beneficial effects of dual-chamber pacing. PMID- 3969926 TI - Analysis of risk factors for sudden death after acute myocardial infarction. PMID- 3969927 TI - Intravenous beta blockade in acute myocardial infarction. PMID- 3969928 TI - Light and electron microscopic examination of the mature decidual cells of the rat with emphasis on the antimesometrial decidua and its degeneration. AB - Rat gestation sites were obtained on days 10 through 16 of normal pregnancy. Light and electron microscopic examination of day-10 sites revealed a consistent complex pattern of stromal cell morphologies. Six distinct regions were identified: an antimesometrial region of epithelioid decidual cells that form the gestation chamber containing the embryo and extraembryonic membranes; an abembryonic antimesometrial decidual region, the decidual crypt, where the cells are separated by large extracellular spaces; a mesometrial region with granule containing cells and mesometrial decidual cells; a region of spiny cells that are lateral to the antimesometrial decidual cells and continuous with the mesometrial decidual cells; and a region of undifferentiated stromal cells adjacent to the myometrium. Between days 12 and 16, the antimesometrial decidua becomes thinner and is eventually sloughed into the newly formed uterine lumen. The role of the antimesometrial decidual cells is discussed with reference to trophoblast invasiveness, protein synthesis, and especially remodeling of the gestation chamber. Differences between decidua and deciduoma are considered. PMID- 3969929 TI - Structure of taste buds in foliate papillae of the rhesus monkey, Macaca mulatta. AB - Taste buds in foliate papillae of the rhesus monkey were examined by electron microscopy. Three distinct cell types were identified. Type I cells were narrow elongated cells containing an oval nucleus, bundles of intermediate filaments, several Golgi bodies, and characteristic apical membrane-bounded dense granules. These cells exhibited morphological variations: some had a moderately dense cytoplasm, perinuclear free ribosomes, and flattened sacs of rough endoplasmic reticulum; others had a more lucent cytoplasm, dilated irregular rough endoplasmic reticulum, lysosome-like dense bodies, and lipid droplets. Type II cells typically contained a spherical, pale nucleus, a prominent nucleolus, supranuclear and infranuclear Golgi bodies, mitochondria with tubular cristae, and one or two centrioles. This cell type, too, showed some variation in the relative amounts of ribosomes and smooth endoplasmic reticulum, which varied inversely with each other. Type III cells were characterized by a clear apical cytoplasm essentially devoid of ribosomes and containing microtubules. In a few type III cells, the peri- and infranuclear regions contained many ribosomes and some rough endoplasmic reticulum. In most Type III cells, there were large numbers of dense and clear vesicles in the peri- and infranuclear regions; some of the vesicles were grouped in synapse-like arrangements with adjacent nerves. The morphological variations exhibited by all three cell types could be accounted for by age differences in each of the cells. This would be consistent with the notion that cell renewal occurs in each of the three cell populations. PMID- 3969930 TI - Quantitative ultrastructural characteristics relating to transport between luteal cell cytoplasm and blood in the corpus luteum of the pregnant rat. AB - The synthesis and secretion of progesterone by the corpus luteum (CL) may be limited or controlled by transport mechanisms operating between circulating blood and luteal cell cytoplasm. To examine this possibility, the structural features involved in transport, including membrane surface areas and diffusion distances, were quantitated in the CL of 16-day pregnant rats. One ovary from each of eight rats was fixed by perfusion via a cannula inserted into the parametrial artery, and two CL from each ovary were processed for electron microscopy and examined with standard morphometric techniques. For comparison, one CL from each of a further eight ovaries was diced into small cubes, fixed by immersion, and analyzed similarly. In perfusion-fixed CL, there was a substantial volume of vascular space (20% of the total) and interstitial space (5%) and an extensive surface area of capillaries (441 mm2 per CL). The luteal-cell membrane had numerous projections which increased its surface area by a factor of 3.08. Almost 60% of the luteal-cell surface directly faced a capillary, and a further 37% faced interstitial space which probably extended to a capillary surface. Only 3% was in direct contact with a neighboring luteal cell. Despite the extensive interstitial space the harmonic mean thickness, an estimate of likely effective diffusion distance between luteal cell cytoplasm and blood, was only 0.42 micron. This was less than half of the calculated arithmetic mean thickness owing to the presence of surface projections and an uneven capillary endothelium. Results from immersion-fixed CL were qualitatively similar; but the proportion of interstitial space was only 59% of that in perfusion-fixed CL, and the contribution of surface projections to the total area of luteal-cell membranes was significantly reduced. Collectively, these results suggest that membranes and spaces between blood and luteal-cell cytoplasm are structured so as to minimize transport distances. PMID- 3969931 TI - Tolerance to glucose polymers in malnourished infants with diarrhea and disaccharide intolerance. AB - The response of infants with diarrhea and lactose intolerance to feedings containing soy protein and sucrose (Sobee), and/or to a carbohydrate free formula (RCF), to which glucose polymers (GP) were added, was assessed in twenty patients. They all were less than ten months of age and had varying degrees of malnutrition. Eleven had acute diarrhea and nine had chronic diarrhea. None of them had classical enteropathogenic strains and parasites in the stools. All had lactose intolerance when feedings were begun with cow's milk formula and some also had sucrose intolerance when fed sucrose containing soy formulas. They had persistent loose stools and excreted feces with an acid pH and with carbohydrates, thus they were given dietary treatment with RCF with GP. There were 9 patients with acute diarrhea and lactose intolerance (1 of them also had sucrose intolerance), who improved on RCF with GP feedings; but 2 patients (lactose and sucrose intolerant) failed to respond to this diet. There were six patients with chronic diarrhea and lactose intolerance (four of them also had sucrose intolerance), who improved on RCF with GP formula, but there were three patients who failed on this treatment. These data show that some infants with diarrhea, malnutrition, and lactose-sucrose intolerance may also develop intolerance to GP and require further dietary management with glucose as the source of carbohydrate in the diet. PMID- 3969932 TI - Effect of storage time and temperature on folacin and vitamin C levels in term and preterm human milk. AB - A survey of infant feeding practices indicated that 40% of the mothers who breast fed their infants frequently expressed and stored their milk in the home refrigerator/freezer prior to feeding. Effects of different lengths of storage time on the levels of folacin and vitamin C in both term (T) and preterm (PT) human milk were examined. Folacin and vitamin C intakes of most mothers were such that the levels of these vitamins in milk appeared to have reached saturation. Folacin levels in T and PT milk were similar but were lower in both after three months of freezer storage compared to one week of storage. Vitamin C content in PT milk was significantly higher than that in T milk and did not change after three months of freezer storage, whereas the vitamin C level in T milk decreased significantly. After 24 hr refrigeration of T milk, vitamin C content was lower but the folacin level was similar to that observed prior to refrigeration. The findings indicated that T or PT human milk, stored for 3 months in the freezer, would provide the recommended allowance of vitamin C but not of folacin for infants. PMID- 3969933 TI - Enhancement of calcium absorption in rats by coadministration of glucose polymer. AB - Glucose polymer derived from corn starch is widely used in infant formula and nutritional supplements as a readily digestible, low osmolarity source of calories. We have previously observed that glucose polymer causes a marked increase in intestinal calcium absorption in patients with intestinal malabsorption and in normal subjects. The present study investigates the effect of concurrently administered glucose polymer on intestinal 45calcium absorption in rats. The effect of glucose polymer on calcium absorption was compared to that of equivalent doses of dextrose or lactose. Femur radioactivity was determined as an index of calcium absorption. Carbohydrates were prepared at doses of 0.5, 2.0 and 4.0 mg/g body weight and administered with 45Ca by stomach gavage. Control rats received 45Ca in water alone. Coadministration of glucose polymer resulted in a dose-dependent increase in calcium absorption. At the highest dose of polymer studied calcium absorption was 75% greater than in control animals. Administration of lactose and dextrose also resulted in a dose-dependent increase in calcium absorption. Calcium absorption was 122 and 67% greater than controls when 4 mg/g BW lactose and dextrose were given with the 45Ca. We conclude that glucose polymer stimulates calcium absorption in rats similar to lactose and glucose. These results suggest that glucose polymer may be a useful therapeutic adjunct in patient groups in which there is a desire to increase intestinal calcium absorption. PMID- 3969934 TI - Exercise and protein intake effects on urinary 3-methylhistidine excretion. AB - A 28-day study was conducted with 13 adult men to determine the effect of weight lifting exercise and protein intake level on urinary 3-methylhistidine (3MH) excretion. Subjects were fed the RDA for protein [0.8 g/(kg BW X d)] or 3 X RDA; there were no-exercise and exercise groups at each intake. Comparisons of last 14 day, least-squares means among groups did not reveal differences in data treated by lean body weight [3MH/(kg LBW X d)] or by urinary creatinine excretion [3MH/(kg UCE X d)], but 3MH/(kg LBW X d) excretions were higher for exercise than no-exercise subjects. Regression analyses revealed linear, increasing trends in the 3MH/(kg LBW X d) data for RDA-exercise (p less than 0.03), 3 X RDA-exercise (p less than 0.01), and 3 X RDA-no-exercise (p less than 0.01) groups; 3MH/(g UCE X d) group data plots overlapped. Our findings for 3MH/(kg LBW X d) indicate that a weight lifting program was associated with increased 3MH excretions from adult males. As an index of skeletal muscle catabolism, an increase in 3HM excretion represents an increase in tissue catabolism. No significant effect of 3 X RDA protein intake on last 14-day 3MH excretions was observed; however, linear increases in 3MH/(kg LBW X d) for 3 X RDA-no-exercise subjects suggests a relationship. Trends of exercise- or protein intake-enhanced 3MH excretion could be masked by data as 3MH/(g UCE X d) if exercise or 3 X RDA protein intake can expand the body creatine pool independent of skeletal muscle mass. PMID- 3969935 TI - Effects of exercise on riboflavin requirements: biological validation in weight reducing women. AB - The present study was designed to evaluate our previous estimates for riboflavin requirement, 0.96 mg/1000 kcal during nonexercise and 1.16 mg/1000 kcal during exercise in overweight women. Two groups of 6 weight reducing women consumed either 1.16 mg riboflavin/1000 kcal (HR) or 0.96 mg/1000 kcal (MR). The study was two, 3 period by 2 treatment (exercise or nonexercise) crossover designs, one design at each level of riboflavin. Erythrocyte glutathione reductase activity coefficients (AC) significantly increased in both groups from 1.16 +/- .02 to 1.20 +/- .03 in group HR and from 1.31 +/- .04 to 1.36 +/- .02 in the MR group during nonexercise and exercise, respectively. ACs increased in the HR group due to an increase in total enzyme activity while ACs increased in the MR group due to a decrease in basal enzyme activity reflecting decreased flavin availability. There were no differences in aerobic capacity, weight loss, nor change in lean body mass between the two groups. Thus, 0.96 mg/1000 kcal was not adequate during either nonexercise or exercise periods while the 1.16 mg/1000 kcal was adequate. PMID- 3969936 TI - Decreased antibody formation in iron-deficient rat pups--effect of iron repletion. AB - Rats were fat diets containing 6, 12, or 250 ppm iron throughout gestation and lactation. On day 17, pups immunized with sRBC were used to determine antibody synthesis by the Jerne plaque assay. In both iron-deficient groups, antibody formation was decreased by at least 50% compared to controls. For 3 weeks beginning on day 21, iron-deficient pups were fed either a control diet (35 ppm iron) or the same iron-deficient diet as fed to the dam. IgG and IgM formation was only slightly improved in repleted rats and remained significantly below that of rats fed the control diet throughout the experiment. In contrast, 250 ppm iron pups fed an iron-deficient diet postweaning had significantly decreased IgG and IgM production compared to littermates fed a control diet postweaning. Maternal iron deficiency during the critical pre- and postnatal growth periods may result in long-term impairment of humoral immunity that is not corrected by dietary iron repletion after weaning. PMID- 3969937 TI - Effect of zinc intake on copper excretion and retention in men. AB - To determine the influence of zinc intake on copper excretion and retention, nine men consumed diets containing 2.6 mg of copper/day and 1.8, 4.0, 6.0, 8.0, 18.5 or 20.7 mg of zinc/day for one- or two-week periods in a 63-day study. Copper and zinc in the diet and copper in plasma were determined weekly; fecal copper was determined daily and averaged within each week. The weekly mean (+/-SEM) plasma copper concentrations (81 +/- 3.3 to 100 +/- 5.8 micrograms/dl) remained within the normal range throughout the study. Fecal copper and apparent copper retention were influenced by the level of dietary zinc and the duration it was fed. When 18.5 mg of zinc/day was fed for two consecutive weeks following a lower zinc intake, fecal copper was elevated and apparent copper retention was reduced after a one-week lag. Thus, an intake of zinc only 3.5 mg/day above the RDA for men reduced apparent retention of copper at an intake of 2.6 mg/day. PMID- 3969938 TI - Nutrient intakes among selected North American populations in the Lipid Research Clinics Prevalence Study: composition of fat intake. AB - Components of fat and their relationship to total energy are described for 2,368 white male and 2,200 white female adults, aged 20-59 years, for whom 24-hour dietary recalls were completed between 1972 and 1975 in nine North American populations as a part of the Lipid Research Clinics (LRC) Program Prevalence Study. Men had higher absolute intakes of total fat and cholesterol than women, although both sexes consumed diets similar in relative composition of polyunsaturated, saturated, and monounsaturated fatty acids. Marked geographical differences in intakes of energy, total fat, and dietary cholesterol were observed. Compared with data from dietary surveys conducted in the 1960's the LRC data showed that consumption of cholesterol had decreased by the early 1970's, whereas consumption of polyunsaturated fatty acids appears to have increased, resulting in a higher ratio of polyunsaturated to saturated fatty acids. However, comparison of current dietary guidelines with these data, which are based on a single dietary recall, showed that few LRC participants met the recommendations of the Senate Select Committee on Nutrition and Human needs for dietary fat intake. PMID- 3969939 TI - Nutrient intakes among selected North American populations in the Lipid Research Clinics Prevalence Study: composition of energy intake. AB - Mean energy intake and its components are presented for 4,568 white adults, 20-59 years, who participated in a population survey at nine North American Lipid Research Clinics (LRC). Nutrient intake was evaluated by a 24-hour dietary recall. Mean energy intakes ranged from 3200 kcal at age 20 to 2400 kcal at age 59 for men (2150-1650 for women). Protein intake, about 15% of energy intake, exceeded 1 g/kg body weight at all ages. Carbohydrate intake was about 40-45% of kcal, starch provided 14-20%, and estimated sucrose intake provided about 6-14%. Sex- and age-related differences varied for each macronutrient. Mean alcohol intake, for those reporting alcohol consumption, contributed 6-18% of energy for women, and 8-15% for men. Comparisons are made with data from the Health and Nutrition Examination Survey I and from the USDA Nationwide Food Consumption Survey, with the Recommended Dietary Dietary Allowances, and with the Dietary Goals. PMID- 3969940 TI - Serum vitamin B12 levels in parturients, in the intervillous space of the placenta and in full-term newborns and their interrelationships with folate levels. AB - Serum vitamin B12 levels were determined in a group of 51 parturients as well as in their babies and placentas. The results obtained showed that newborns had 2.3 times higher vitamin B12 levels than their mothers and that the concentrations of this vitamin in the intervillous space of the placenta was 1.3- and 3.2-fold those encountered in the blood of newborns and mothers, respectively. These findings indicate that vitamin B12 accumulation by the placenta may represent an important factor in providing sufficient amount of this essential nutrient to the fetus. The relationship between folate and vitamin B12 concentration in the maternal, fetal and placental sera was also investigated. The highly significant correlation coefficient encountered and significantly higher serum folate concentrations in the group of parturients who received vitamin B12 supplementation during pregnancy indicate a close metabolic interrelationship between vitamin B12 and folate. PMID- 3969942 TI - Effects of season and illness on the dietary intake of weanlings during longitudinal studies in rural Bangladesh. AB - Longitudinal, quantitative studies of the dietary intake of 70 weanlings between five and 30 months of age from two Bangladeshi villages have been analyzed to determine the effects of season and illness on dietary intake. During 1014 days of observation, all foods consumed by the children were weighed by a field worker present in the home; 24-hour breast milk intake was estimated from 12-hour test weighings. Inter-individual differences explained 29% to 50% of the variance in consumption of selected nutrients and foods during 632 studies conducted when children were free from diarrhea and fever. Multiple linear regressions controlling for inter-individual differences indicated that 60-day seasonal periods explained a significant proportion of the variation in intake. Average energy consumption (kcal/kg/d) was approximately one-third greater during the post-harvest periods than during the pre-harvest monsoon period. Breast milk intake varied similarly even after controlling for age-related decreases. Consumption of rice and wheat, the major non-breast milk sources of energy and protein, had distinct seasonal patterns, thus limiting the overall seasonal variability in cereal intake. Older children, particularly boys, benefited more from the post-harvest relative abundance of food. The intake of most nutrients was significantly depressed by approximately 10% during febrile illnesses. Minor decreases in intake with other illnesses were not statistically significant. PMID- 3969943 TI - Interrelationships of moderate and high alcohol consumption with diet and health status. AB - Relationships of habitual alcohol consumption with diet and nutritional status were studied in 179 middle-class males with a wide range of alcohol consumption. One-day food records, diet histories, blood samples and data on alcohol consumption and meal patterns were collected. When data were analyzed by linear regression, there was a trend toward increased energy intake as alcohol consumption increased; however when the population was divided into tertiles based on alcohol consumption, the energy intakes were not significantly different between the tertile groupings. As alcohol intake increased, there was a decrease in percent of energy derived from protein, fat, and carbohydrate and the nutritional quality of the diet declined. Changes in health status, as measured by blood chemistries, were associated with both moderate and high alcohol consumption, although only three abnormal mean values were found in the upper tertile group. PMID- 3969944 TI - Resting energy expenditure in malnutrition. PMID- 3969941 TI - Gallstones and diet in Tel Aviv and Gaza. AB - To study the possible association between diet and gallstones we investigated these two variables in two populations in Tel Aviv and Gaza with presumed differences in both. Gallstones were more frequent in Jews in Tel Aviv than in Arabs in Gaza, 12.1% versus 3.8% (p less than 0.001). This difference was fully accounted for by the 60+ age groups in both populations. There were no significant differences in the frequency of gallstones among the 20-39 and 40-59 age groups. Numerous and marked differences in diet composition were found between both populations. Energy, carbohydrate and fiber intake was higher in Gaza. The consumption of unsaturated fats was greater in Gazans and their P/S ratio was higher, 0.92 versus 0.70 in Tel Aviv. Beef and fish were usually eaten in Gaza while poultry was more frequently consumed in Tel Aviv. There were also differences in vitamin and mineral consumption. It cannot be determined which, if any, of these dietary differences is related to the lower frequency of gallstones in the older population of Gaza. Alternatively it could be the diet eaten in Gaza many decades ago, presumably poorer in protein and fat, which is responsible for these differences. PMID- 3969945 TI - Age and resting metabolism. PMID- 3969946 TI - High energy expenditures influence the plasma lipid concentrations effected by dietary differences. PMID- 3969947 TI - Workshop on introduction of food to infant. Berkeley, February 20-23, 1983. PMID- 3969948 TI - The role of taste in the infant diet. PMID- 3969949 TI - Introduction of food to infants. Genetic-environmental considerations. PMID- 3969950 TI - Infants of low birth weight: special needs and problems. PMID- 3969951 TI - Infant physiology, nutritional requirements, and lactational adequacy. PMID- 3969952 TI - The "why" and "when" of introducing food to infants: growth in young breast-fed infants and some nutritional implications. PMID- 3969953 TI - Relationship of maternal nutrition to nutrition of the post-three-month-old infant. PMID- 3969955 TI - The anthropology of others and of ourselves related to the weanling. PMID- 3969954 TI - The transitional infant: behavioral development and feeding. PMID- 3969956 TI - Social policy issues in the introduction of food to infants: limitations of government. PMID- 3969957 TI - Carcinoma of the anal canal: a study of 79 cases. AB - Seventy-nine cases of carcinoma of the anal canal treated initially by surgery and having a minimum follow-up of five years were reviewed. It was found that all of the tumors were basically squamous cell carcinomas. They were divided into five histologic categories: keratinizing squamous cell carcinoma (52 cases), nonkeratinizing squamous cell carcinoma (6 cases), basaloid squamous cell carcinoma (11 cases), squamous cell carcinoma with mucous microcysts (6 cases), and pseudoadenoid cystic squamous cell carcinoma (4 cases). There was considerable overlap among the categories. The neoplasms also were stratified according to depth of invasion: 4 into submucosa only, 30 into smooth muscle of the anal sphincter, and 45 into perianal tissue. There were no significant differences in survival among the histologic categories but marked differences relating to depth of invasion: none of the 4 patients with submucosal invasion died of tumor, whereas 8 of the 30 with smooth muscle invasion and 35 of the 45 with perianal tissue invasion did so. The histologic categories also did not differ significantly in regard to the rates of lymph node metastasis (either at the time of initial surgery or later) or local recurrence; however, the rate of distant metastasis was higher in pseudoadenoid cystic squamous cell carcinoma (three of four cases) than in the other categories (11 of 75 cases combined). Based on our pathologic and clinical findings, we believe that there is no entity "cloacogenic carcinoma," "transitional cell carcinoma," "basaloid carcinoma," or "mucoepidermoid carcinoma" in the anal canal separable from squamous cell carcinoma, and we therefore suggest that these terms be dropped (or restricted to appropriate tumors in other locations). Pseudoadenoid cystic squamous cell carcinoma was the most distinctive of our histologic categories and is deserving of further study. PMID- 3969958 TI - Immunoglobulins in certain CNS disorders: a study of CSF Ig classes G, A, M, D, and E concentrations. AB - Concentrations of cerebrospinal fluid (CSF) Ig classes G, A, M, D, and E have been reported in various neurologic disorders, viz, aseptic meningitis, multiple sclerosis, benign tumor, malignant tumor, and hydrocephalus. In aseptic meningitis, IgG and IgM were found to be either normal or elevated, whereas concentrations of IgA, IgD, and IgE were normal. Multiple sclerosis patients had IgG, IgA, and IgM, either normal or elevated, but IgD and IgE were on the lower end of the normal. Malignant tumor patients had elevated concentrations of IgG, IgA, IgM, and IgE, but their IgD was on the lower end of the normal. In benign tumor population IgA and IgE, and in hydrocephalus IgG and IgA, were found to be elevated in most of the patients. On statistical analysis, significant differences were observed between the means of the normal group and that of the patients' group for all the five immunoglobulins. By linear regression, a statistical relationship was observed between IgA - IgG, IgM - IgG, IgA - IgM and IgA + IgM - IgG in these neurologic disorders. PMID- 3969959 TI - Medically useful criteria for analytic performance of laboratory tests. AB - To establish medically useful guidelines for analytic precision of commonly used clinical laboratory procedures, the authors conducted a mail survey of physicians selected randomly from national lists of specialists. They were asked to review, briefly, outlined clinical problems and select the change in test results that would alter their diagnosis or treatment or prompt further assessment of the patient's condition. The responses were used to calculate goals for laboratory precision that are sufficient to meet the present requirements of the average physician. The medically useful limits were compared with existing performance of laboratories as reported in national proficiency surveys and regional quality control programs. Almost all the common laboratory procedures they studied are being assayed at a precision level adequate for the perceived needs. The authors suggest that, for the more common constituents, further progress in clinical laboratory testing will depend on factors other than the improvement of analytic precision. PMID- 3969960 TI - Spurious red blood cell parameters due to serum cold agglutinins: observations on Ortho ELT-8 cell counter. AB - The pattern of spurious red blood cell parameters caused by serum cold agglutinins has been well characterized for the Coulter counters but not the Ortho ELT-8. The pattern consists of a spurious increase in mean corpuscular volume (MCV), a discrepancy between the hemoglobin and the hematocrit, the latter falsely reduced and consequently a MCHC value greater than 36%. Since MCHC rarely exceeds 36% in health or disease, it is an important clue to the spurious nature of the macrocytosis caused by cold agglutinins. The authors have studied five examples of cold agglutinin induced artefact on the Ortho ELT-8 counter. Although a pattern similar to that for the Coulter counters was anticipated, three of the five patients failed to show the characteristics "internal discrepancy" and a MCHC value greater than 36%, despite a marked spurious elevation of MCV. In two of the three patients a classical pattern of cold agglutinin artefact was observed on a Coulter S Plus IV counter with only a modest elevation of MCV. Possible explanations for the observed pattern on the ELT-8 and its implications are discussed. PMID- 3969961 TI - Red blood cell distribution width index in some hematologic diseases. AB - The red blood cell distribution width index (RDW) was determined in a group of anemic male patients and normal male blood donors. Elevated mean RDW values were found in the anemic patients, with the highest value seen in sickle cell anemia, sickle cell-beta thalassemia, sickle cell trait, beta-thalassemia trait, and iron deficiency in decreasing order of magnitude. The mean RDW of the normal male subjects was 11.3. It was found that the RDW was proportional to the reticulocyte count, with the highest values in the patients with the highest reticulocyte count (sickle cell anemia). One clinical value of the RDW therefore may lie in its capacity for reflecting active erythropoiesis. For example, patients with normal or near-normal hemoglobin and with high RDWs may be suspected of having an elevated reticulocyte count that may indicate a hemoglobinopathy, such as sickle cell trait or thalassemia trait. PMID- 3969962 TI - Concurrent occurrence of adenocarcinoma and carcinoid tumor in the stomach: a composite tumor or collision tumors? AB - A morphologic curiosity is presented in a polypoid gastric tumor combined with adenocarcinoma and carcinoid tumor. It is likely that those two represent a composite tumor; however, the authors think it is more likely that they are two concurrent, independent collided tumors. PMID- 3969963 TI - A benign cystic teratoma with gastrointestinal tract development. AB - The clinical and histologic features of a benign cystic teratoma with histologic evidence of almost full gastrointestinal tract development are discussed. The literature has previously described only bowel epithelium, segments of bowel, appendix, and esophagus separately. This is the first report of almost complete development of the gastrointestinal tract in a benign cystic teratoma. In this teratoma, the entire gastrointestinal tract from esophagus to colon is represented histologically. PMID- 3969964 TI - Muddy lung. AB - A 31-year-old man, a racing car driver, was submerged in muddy water as the result of an accident. He died from respiratory failure after a 17-day clinical course. Foreign body granulomatosis and massive fibrosis of the lung were revealed at autopsy. The crystalline foreign bodies mainly were composed of silicon and ranged in size from 20 micron to 500 micron in diameter (average, 90 micron). Their distribution in the lungs corresponded to the areas of lung carnification. In this study, the authors demonstrate that near drowning in muddy water causes pulmonary silicate granulomatosis associated with carnificating fibrosis of the lung and term the pulmonary changes "muddy lung." PMID- 3969965 TI - The relation of platelet size and count: its importance in diagnosing platelet disorders. PMID- 3969966 TI - Person-centered approaches to primary prevention in mental health: situation focused and competence-enhancement. AB - This article considers two families of person-centered approaches to primary prevention in mental health, i.e., situation-focused and competence-enhancement. Rationales and examples of effective programs are presented for both clusters. Similarities and differences between the two approaches are considered as are their special advantages and limitations. Although the approaches differ somewhat in terms of their conceptual footings, prime methodologies, natural target groups, and in the timing of their applications, they share the same ultimate goal, i.e., strengthening the psychological wellness of the population at large. In that sense, they complement system-level primary prevention approaches based on social change. PMID- 3969967 TI - Depressive symptoms among women employed outside the home. AB - Researchers who attempt to explain why paid employment is a source of psychological distress for some women must consider how a number of factors in the work and nonoccupational environments influence a woman's reaction to employment outside the home. We examined four aspects of the job that may be a source of distress for working women: job dissatisfaction, pay dissatisfaction, commitment to the work role, and full versus part-time employment. Of these, pay dissatisfaction and commitment to the work role emerged as significant predictors of depressive symptoms. With regard to home-related roles, neither help with housework nor the presence of young children in the home exerted a significant direct effect on psychological distress. Young children at home did, however, have a significant interaction effect with a woman's sex role beliefs. Finally, the presence of a conflict between the work and home roles was also a significant predictor of depression. PMID- 3969968 TI - Measurement of adolescents' life events: the junior high life experiences survey. AB - The first of these two studies examined the relationship between adolescents' scores on a social desirability questionnaire and scores of negative, positive, and total life events. Only number of positive events was significantly related to social desirability. The second study compared various scoring strategies with respect to their intercorrelation and their ability to predict adolescents' maladjustment (depression, anxiety, and number of missed school days). The results demonstrated that (a) total number of events and readjustment-weighted life change scores were equally predictive of the maladjustment criteria; (b) negative events, but not positive events, however scored, were significantly related to the maladjustment criteria; (c) indices based on psychologist-judges' ratings of event desirability were not more predictive of the maladjustment criteria than were indices based on the adolescents' self-reports; and (d) uncontrollable negative events and controllable negative events were equally predictive of the maladjustment criteria. PMID- 3969970 TI - Organizational size and perceptions in a residential treatment program. AB - Centralization of a residential mental health treatment program from three small houses to one large facility provided a naturally occurring opportunity to study the effect of organizational size on the perceptions held by clients and staff. Quantitative data were repeatedly collected on their perceptions of themselves, the organization as a whole, and subgroups within the organization during their involvement in both the small and large social contexts. Results of repeated measures analyses of variance provided considerable support for the theoretically derived hypotheses of heightened anxiety, self-impoverishment, more negative views of the psychosocial environment, and greater psychological distance in the large organizational context. PMID- 3969969 TI - Recent stressful life events and young children's school adjustment. AB - A group of 211 first-to fourth-grade children who had experienced one or more recent stressful life events were compared to a demographically matched sample of 211 children who had not experienced such events on measures of school adjustment problems and competencies. Stressful life events were found to be associated with the presence of more serious school adjustment problems and fewer competencies. Those associations were strongest for children who had experienced multiple recent stressful events. The importance of preventive interventions for this at risk group was emphasized and future research steps in the area were considered. PMID- 3969971 TI - Defective neutrophil motility. PMID- 3969972 TI - Infant care advice: a cautionary comment. PMID- 3969973 TI - Infant walkers and cerebral palsy. PMID- 3969974 TI - Suppositories do decrease bilirubinemia. PMID- 3969975 TI - The Coffin-Siris syndrome. PMID- 3969976 TI - Academic general pediatrics and the practitioner. The interface in education. PMID- 3969977 TI - Changing cognitive outcome in preterm infants with hyaline membrane disease. AB - One hundred seventy-four preterm survivors of hyaline membrane disease, born 1961 through 1971, were followed up for at least six years with serial psychological and neurological evaluations. This relatively mature population had a mean birth weight of 2,133 g and gestational age of 34.6 weeks. All children had consecutive preschool and school age psychological tests. The mean preschool test score was 91 (SD = 13) and the mean school age score was 101 (SD = 16). The ten-point difference between the mean preschool and school age test scores was significant. Perinatal variables and indexes of disease severity did not correlate with test scores. Higher test scores were correlated with higher paternal educational and employment levels. Improving test scores by school age may be due to test instruments that measure different cognitive skills and/or the diminishing effects of prematurity. PMID- 3969978 TI - Peritonitis in children undergoing continuous ambulatory peritoneal dialysis. AB - During a four-year period there were 77 episodes and 15 recurrences of peritonitis in 30 children treated with continuous ambulatory peritoneal dialysis for periods of one to 39 months (mean, 15.3 months). The incidence was one episode per 6.0 patient-months. Organisms cultured included Staphylococcus epidermidis (17 episodes), Staphylococcus aureus (15 episodes), and fungi (four episodes). Special culture techniques were needed to ensure a high yield of positive cultures. Peritonitis was usually treated with intraperitoneal administration of cefazolin sodium, and 61% of the episodes were treated at home. There was one death, from Candida peritonitis, and catheters were removed in 11 children because of resistant or recurrent peritonitis (eight cases) or fungal peritonitis (three cases). Peritonitis rates were highest in children who had difficulty performing bag changes aseptically but who could not be transferred to hemodialysis and in hospitalized patients. PMID- 3969979 TI - Measles reimmunization in children immunized before 1 year of age. AB - An outbreak of measles presented an opportunity to examine the immune response of children initially immunized with measles vaccine before 1 year of age to reimmunization at 15 months of age with measles, mumps, and rubella vaccine. Eighteen previously immunized children had higher acute and convalescent hemagglutination inhibition titers than 13 control children. None of the previously immunized children had measles-specific IgM appear in convalescent serum samples. These results indicate a brisk secondary immune response to measles reimmunization in children immunized before 1 year of age. They support the recommendation of the American Academy of Pediatrics of reimmunization at 15 months of age for those children whose initial measles immunization was before 1 year of age. PMID- 3969980 TI - Skin diseases encountered in a pediatric clinic. A one-year prospective study. AB - To determine the frequency and nature of skin disorders encountered in a medical center pediatric clinic, we prospectively surveyed 1,547 patient visits during a one-year period. A primary skin complaint had prompted 6% of all of the visits and 9% of the visits that were for reasons other than well-child care. More than 21% of the visits featured either a skin complaint or a skin finding. Among 235 visits by children with primary or secondary skin complaints, the most frequent diagnoses included skin infections (36%), diaper dermatitis (16%), and atopic dermatitis (9%). Although the range of skin lesions encountered was very broad, the great majority (86%) of diagnoses fell within nine general categories. Because dermatologic problems constitute such an important component of primary care pediatric practice, appropriate emphasis should be placed on teaching basic principles of dermatology to pediatricians both during and after residency training. PMID- 3969981 TI - The academic pediatrician and the practicing pediatrician. An educational team. AB - Pediatric education in the contemporary United States requires the cooperation of an educational team of both academic and practicing pediatricians. The latter have been handicapped in their appropriate function as teachers and role models by exposure to students in the wards and clinics of teaching hospitals, the natural habitats of academic pediatricians. Evidence is offered to indicate that practicing pediatricians are significantly more effective as teachers and role models when medical students are exposed to them in their own offices. PMID- 3969982 TI - Hepatobiliary scintigraphy for cholestasis in congenital hepatic fibrosis. Diagnosis and treatment. AB - A 9-year-old child with congenital hepatic fibrosis had dilated intrahepatic bile ducts and recurrent cholangitis. Choleretic agents were administered to prevent recurrent cholangitis. Response to treatment was monitored with serum bile acid concentrations and computer-assisted technetium Tc 99m iprofenin (Pipida) scintigraphy. Dehydrocholic acid with meals improved hepatobiliary excretion of the radioactive isotope and lowered serum bile acid levels but did not prevent cholangitic attacks when used alone. Sulfamethoxazole and trimethoprim used alone prevented infection, but a steady rise in serum bile acid concentrations suggested increasing cholestasis. During combined drug treatment, the patient remained free of cholangitis for at least two years. Optimal therapy of congenital hepatic fibrosis with cholestasis but without mechanical biliary obstruction may involve the combined use of a choleretic such as dehydrocholic acid plus a suppressive antibiotic. PMID- 3969983 TI - Transbronchial lung biopsy in pediatric and adolescent patients. AB - Since data are unavailable on the role of transbronchial lung biopsy (TBB) in pediatric and adolescent patients, we reviewed our two-year experience in 12 patients (median age, 14.5 years). In all 12, the indication for TBB was a persistently abnormal chest roentgenogram (nine with multilobar infiltrates, two with unilateral infiltrates, and one with a cavitary lesion). Overall, a specific diagnosis was made by TBB in six patients, including three patients with sarcoidosis, one with lymphoma, and two with eosinophilic granuloma. In three additional patients, nonspecific histologic findings on TBB combined with clinical findings, roentgenographic patterns, and supplemental laboratory data helped support a diagnosis. Although the need for general anesthesia and the small size of the biopsy specimens may limit the usefulness of TBB in most pediatric patients, TBB may be a useful alternative in carefully selected patients. PMID- 3969984 TI - A study of risk factor complexes in early adolescent delinquency. AB - A study was undertaken to document the existence of multiple forms of risk among a sample of 53 delinquents between the ages of 11 and 16 years. When compared with an age-matched comparison group from the same region, the delinquent youngsters were far more likely to show clusters of vulnerability in the areas studied (medical, neurodevelopmental, educational, behavioral, socioeconomic status, family disruption, and cognitive). When cluster analysis was applied to the delinquent group, three subgroups emerged sharing certain traits and accounting for 70% of the cohort. The early identification of so-called risk factor complexes may be helpful in the prevention of delinquency. PMID- 3969985 TI - Hepatic dysfunction and cardiovascular abnormalities. Occurrence in infants, children, and young adults. AB - In infants and children, the effect of heart failure and/or cyanotic heart disease on the liver has not been well documented, nor has there been any comparison between the degree of liver dysfunction and hemodynamic factors. Sixty five patients with cardiovascular abnormalities were examined. Hepatic function, as indicated by laboratory data and histologic liver studies, was compared with the following categories of cardiovascular dysfunction: hypoxemia, systemic venous congestion, and low cardiac output. If any one of these factors was present, or any combination, abnormalities of liver function were usually noted. Patients with both hypoxemia and systemic venous congestion had marked hepatic dysfunction. Those with low cardiac output had the most severe abnormalities. Serial studies indicated that liver function correlated with cardiac status. PMID- 3969986 TI - Cystic fibrosis and gastroesophageal reflux in infancy. AB - Gastroesophageal reflux (GER) was initially diagnosed in two black infants, aged 5 and 9 months, as a cause of their chronic lung disease and failure to thrive. Both infants were treated with bethanechol chloride as part of the management of their GER, but respiratory failure developed in both patients and they required ventilatory support. Both infants had severe air trapping, CO2 retention, difficulty in being weaned from mechanical ventilation, and Staphylococcus aureus cultured from their respiratory tract secretions. These factors led to the suspicion of cystic fibrosis (CF), and this diagnosis was subsequently confirmed by sweat test. The condition of both infants improved substantially on withdrawal of bethanechol therapy and the institution of a regimen of CF care. The early diagnosis of GER in these infants may have led to a delay in diagnosis and treatment of CF. PMID- 3969987 TI - Nuchal cord as a cause of neonatal anemia. AB - Nuchal cord was documented in 437 neonates consecutively admitted to the newborn nursery at The University of Texas Medical Branch Hospital, Galveston. The prevalence of anemia in the nuchal cord group (venous hemoglobin level of less than 13.2 g/dL or hematocrit of less than 39.2%) was compared with that in a control group. None of the controls was anemic. Five of 27 neonates with tight nuchal cord and four of 30 with loose nuchal cord were anemic. Anemia in the tight nuchal cord group was usually observed early, and in three infants was manifest by hypotension, necessitating transfusion. Anemia associated with loose nuchal cord occurred later and was asymptomatic. This study emphasizes the increased risk of anemia associated with nuchal cord and demonstrates the need for hemoglobin and hematocrit determinations in neonates with this obstetrical complication. PMID- 3969988 TI - Neonatal Borrelia species infection (relapsing fever). AB - Two cases of neonatal Borrelia infection occurred. The first was in a 30-hour-old Bedouin neonate who had been delivered of a febrile mother in a tent. She was admitted to the hospital on the second day of life in a good, general state. Her condition deteriorated a few hours after admission when jaundice, hepatosplenomegaly, and hemorrhage appeared. Borrelia organisms were found on peripheral blood smear. The patient died 16 hours after admission. Findings from the physical examination of the mother were normal, and no Borrelia organisms were seen in her blood smears. The second case was in a 15-day-old male newborn who was admitted to the hospital with severe jaundice, hepatosplenomegaly, bleeding tendency, and evidence of severe acidosis. Multiple spirochetes were found in blood and CSF smears. His clinical course was fulminant, and despite massive antibiotic treatment, he died within 24 hours of admission. Three weeks prior to delivery, the mother had had a febrile illness. Examination of the mother and her blood at the time of the illness of her son did not disclose any abnormalities. PMID- 3969989 TI - Eosinophilic fasciitis: a distinct entity? PMID- 3969990 TI - Dup(4p)del(9p) in a familial mental retardation syndrome. Resemblance to de Lange syndrome detected by high-resolution banding. AB - A young woman with features resembling de Lange syndrome had a normal banded karyotype. Similar phenotypes were present in a maternal aunt and uncle. Utilizing high-resolution banding, the propositus was found to have a chromosomal abnormality characterized by dup(4p)del(9p). Using the same banding technique, her mother and two of her siblings were identified as having balanced reciprocal translocations. Chromosome studies with high-resolution banding should be performed in these instances even in the presence of a normal banded karyotype. Determining a chromosomal basis for the phenotype may lead to a significant reproductive risk in individuals with balanced chromosomal rearrangements and may afford them with the opportunity to pursue prenatal diagnosis. PMID- 3969991 TI - The incidence of isolated craniosynostosis in the newborn infant. AB - The incidence of isolated, nonsyndromatic craniosynostosis in a newborn population was found to be 0.6 per 1,000 live births. The distribution by anatomic types was metopic suture, 50%; sagittal suture, 28%; coronal suture, 16.5%; and lambdoid suture, 5.5%. We found a higher incidence of trigonocephaly than has been reported previously. PMID- 3969993 TI - Cortisol levels and clonidine administration. PMID- 3969992 TI - Low-dose oral clonidine. A simple and reliable growth hormone screening test for children. AB - We evaluated the efficacy and side effects of a low dose of oral clonidine hydrochloride on growth hormone release in 24 healthy short children; ten received 100 micrograms (group A) and 14 received 50 micrograms (group B). The mean +/- SD growth hormone peak at 60 minutes was 14.5 +/- 6.3 mg/mL in group A v 11.6 +/- 6.1 mg/mL in group B. Failure rate (growth hormone less than 10 mg/mL) was 10% in group A and 36% in group B. The drop in cortisol levels was similar in both groups. Blood pressure did not change significantly, and only mild somnolence was noted in all. A single dose of oral clonidine hydrochloride approximating 100 micrograms/sq m, followed by one blood sample after 60 minutes seems to be an effective and safe screening test for growth hormone deficiency in short children. PMID- 3969994 TI - Pertussis vaccine production. PMID- 3969995 TI - Carbamazepine in febrile seizures. PMID- 3969996 TI - Nonsurgical (spontaneous) spleno-renal shunt presenting as an abdominal mass: case report and review of the literature. AB - A case of an unusually large nonsurgical (spontaneous) spleno-renal shunt presenting as an abdominal mass is described. The diagnosis was first suggested by the finding of a lobulated, serpiginous, contrast-enhancing mass in the left upper quadrant of the abdomen by body CT scanning, and then confirmed by selective abdominal angiography. This represents the first report of the use of body CT scanning with contrast enhancement in the diagnosis of nonsurgical (spontaneous) spleno-renal shunts. PMID- 3969997 TI - Secretory diarrhea in mixed connective tissue disease. AB - Intractable diarrhea of 2 years' duration was evaluated in a patient with mixed connective tissue disease and dilatation of the proximal small bowel. Stool analysis revealed secretory diarrhea. Intestinal perfusion studies showed that the jejunum was secreting water and electrolytes. Chloride and bicarbonate secretion against an electrical gradient suggested active anion secretion. Absorption in the ileum was normal. No evidence for bacterial colonization of the small bowel, protein-losing enteropathy, or a hormonal cause of intestinal secretion could be found. This case report suggests that water and electrolyte secretion in dilated segments of small bowel may be another cause of diarrhea in cases of gastrointestinal involvement by systemic connective tissue disease. PMID- 3969998 TI - Rectourethroperineal fistula in Crohn's disease. AB - We report the ninth case of a rectourethral fistula in Crohn's disease. The patient had undergone numerous surgical procedures for complications of severe ileocolitis before developing a rectourethroperineal fistula. His symptoms were confined to urine leaking from the perineal opening; the most common symptom of rectourethral fistula in Crohn's disease. He underwent surgical repair by an abdominoperineal approach and has been free of recurrence for a period of 2 years. The literature suggests that the incidence of rectourethral fistulae in patients with Crohn's disease is approximately 0.3% and that this complication comprises 6.2-11.1% of all genitourinary fistulae in Crohn's disease. PMID- 3969999 TI - Sclerosing cholangitis associated with autoimmune hemolytic anemia and hyperthyroidism. AB - A patient presented with autoimmune hemolytic anemia and sclerosing cholangitis. Six years later he was found to be hyperthyroid. Although sclerosing cholangitis has been associated with other autoimmune disorders, it has not been reported in association with either autoimmune hemolytic anemia or hyperthyroidism. Sclerosing cholangitis is a chronic fibrosing inflammatory disease process which may include parts or all of the biliary tree including the gallbladder. Although this disorder has been reported to occur with a variety of autoimmune disorders, it has not been previously associated with autoimmune hemolytic anemia and hyperthyroidism. PMID- 3970000 TI - Clinical significance of fasting serum bile acid in the long-term observation of chronic liver disease. AB - Fasting serum bile acid (FSBA) was serially measured by a fluorescent enzyme method in a follow-up study of 61 patients with chronic liver disease. In chronic inactive hepatitis, fluctuation of FSBA was within the normal range in both the exacerbated state and in remission. In chronic active hepatitis, FSBA was abnormally elevated in both states, but the difference was not significant. In chronic active hepatitis where FSBA was elevated in the remission state above its value in the exacerbated state, exacerbation of the disease occurred repeatedly during the follow-up period. In compensated liver cirrhosis progressing into the decompensated form, FSBA levels increased before a decrease in the serum values of albumin, cholesterol, and cholinesterase, and an elevation of bilirubin. In liver cirrhosis, FSBA levels increased above 100 microM, 1-4 months before the appearance of ascites. PMID- 3970001 TI - Pneumatosis coli simulating hepatomegaly. AB - A patient with pneumatosis coli presenting as an abdominal mass is reported. A review of the pathogenesis and treatment is also covered. PMID- 3970003 TI - Where do we go from here? PMID- 3970002 TI - Gastroenterology and the law. PMID- 3970004 TI - Mucus secretion in hypertrophic, hypersecretory, protein-losing gastropathy. AB - A 48-year-old man presented with giant folds of the gastric mucosa, hypoalbuminemia, and hypersecretion of acid. In vivo labeling of plasma proteins by 51CrCl3 disclosed an abnormal gastric protein clearance. Mucus secretion, evaluated by the output of dry matter, mucosubstance constituents (hexosamine and fucose), protein (by the method of Lowry), and sodium were five to eight times those in nine healthy volunteers, but were normalized by the histamine-H2 receptor antagonist cimetidine. The proportion of dry matter and protein was the same in the patient and in healthy subjects, indicating that the loss of plasma protein into the stomach probably occurred as part of an abnormally great secretion of mucus. PMID- 3970005 TI - Gastric pseudopolyposis: a new clinical manifestation of type A gastritis. AB - Three cases of type A gastritis associated with multiple polypoid lesions of the body of the stomach are presented. The endoscopic congo-red test showed the red to black color changes of the sprayed congo-red only on the top of the polypoid lesions. The endoscopic methylene-blue test revealed no dye absorption on the antral mucosa or on the top of the polypoid lesions, while the dye was absorbed on the flat mucosa surrounding the top of the polypoid lesions. Histological examinations revealed well-preserved oxyntic glands on the top of the polypoid lesions. The flat mucosa showed marked atrophy or intestinal metaplasia. There have been several reports of experimental models of type A gastritis, where chief and parietal cells decreased in considerable number. These findings and the experimental models suggest that the polypoid lesions resulted from atrophic changes of type A gastritis. The top of the polypoid lesions is the residual oxyntic glands. The lesions, therefore, should be called "gastric pseudopolyposis." The spontaneous disappearance of the polypoid lesions seen in one case is thought to be a result of a further progression of the atrophic gastritis. A pronounced G-cell increase was noted in the antrum and lower body of the stomach. This is considered a secondary phenomenon following the marked reduction of acid secretion. PMID- 3970006 TI - Primary squamous cell carcinoma of the stomach. AB - Primary squamous cell carcinoma of the stomach is a rare lesion. Fewer than 80 such cases are found in the literature. The present case meets strict criteria and, despite direct extension into the liver, an aggressive surgical resection followed by chemotherapy seems to have effected a cure. PMID- 3970007 TI - Patterns of treatment of gallstone ileus over a 45-year period. AB - All patients with gallstone ileus admitted to our institutions between 1938 and 1982 were retrospectively analyzed by grouping the patients into 10-year periods. Forty-five patients were studied, of whom 39 required operation. When hospital statistics for admissions, length of stay, and mortality rates from the Mount Sinai Hospital were compared to the gallstone ileus data, it was found that there has been no significant change in the admission rate for these patients. The mortality rate and length of stay of gallstone ileus patients has also remained constant over the past 25 years despite the general hospital decrease in both of these numbers. There has been no change in the complication rate, duration of symptoms prior to admission, or the preoperative diagnostic rate of gallstone ileus during the duration of this study. PMID- 3970008 TI - Warfarin absorption after massive small bowel resection. AB - Small bowel resection is often accompanied by malabsorption and nutritional deficiencies. Malabsorption of drugs may also occur; however, few reports have been published. We treated five patients with oral warfarin for thrombotic problems after substantial small bowel resection. All five had a documented hypoprothrombinemic response to the warfarin (patient prothrombin time: control greater than 1.5). Maintenance warfarin doses were up to 10 mg/day. Oral warfarin appears to be well absorbed after removal of the majority of the jejunum and ileum. This may indicate a proximal site of warfarin absorption. PMID- 3970009 TI - Membrane expansion as a mechanism explaining the antisickling action of ticlopidine observed in vitro. AB - Ticlopidine, a platelet antiaggregant, has shown some efficacity in a clinical trial in patients with sickle cell disease. We have studied this agent in vitro to evaluate its effects on sickle erythrocyte. Ticlopidine effects sickling in vitro not by direct interaction with hemoglobin, but via strong binding to the red cell membrane. The density of the whole cell population is decreased when cells are treated with 0.1 mM ticlopidine, which is higher than the concentrations of 1 microM potentially achievable in vivo. Since hemoglobin concentration influences the delay time for gelling, its decrease in the red cell could have a beneficial effect. Such a partial inhibition of the polymerization is shown by oxygen equilibrium studies at various ionic strengths. PMID- 3970010 TI - Increased Heinz body formation and impaired erythrocyte pentose phosphate shunt function during pregnancy. AB - The erythrocytes of 90 pregnant women were evaluated for the presence of in vivo or in vitro oxidant damage. The reduced glutathione (P less than 0.005) and the membrane reduced sulfhydryl (P less than 0.001) concentrations were decreased in fresh erythrocytes. Following incubation with acetylphenylhydrazine, Heinz body formation was significantly increased (P less than 0.001). Both the increase in Heinz body formation and the reduction in membrane reduced sulfhydryl content correlated strongly with duration of pregnancy. Glucose consumption was significantly decreased before, but not after, new methylene blue stimulation. Pentose phosphate shunt activity was impaired both before (P less than 0.05) and after (P less than 0.001) stimulation. No changes were observed in pentose phosphate recycling. The only alteration observed in the activity of the enzymes of the pentose shunt was an elevation of 6-phosphogluconate dehydrogenase activity. Although the clinical significance of these findings remains to be determined, medications with an oxidant potential should be used judiciously during gestation. PMID- 3970011 TI - Changes in cellular ferritin content during myeloid differentiation of human leukemic cell lines. AB - The human promyelocytic cell lines HL-60 can be induced to undergo differentiation to either granulocyte- or macrophage-like cells. We followed the changes in the synthesis and content of ferritin in this and other cell lines during differentiation. Ferritin content of HL-60 cells ranged from 11 to 81 fg/cell, depending on the clone tested. Following exposure to dimethylsulfoxide (DMSO) or retinoic acid (RA) an increase in ferritin and a decrease in total protein synthesis was observed, resulting in increased ferritin content, reaching a peak after 2 days. This increase occurred prior to the appearance of the typical morphological and functional characteristics of mature granulocytes. A correlation was found between concentrations of DMSO effective in inducing differentiation and the increase in ferritin content. Other inducers of granulocyte differentiation had a similar effect, while 12-O-tetradecanoylphorbol 13-acetate (TPA), an inducer of macrophage differentiation, had not. Another human cell line (U-937), which was induced into monocyte-like cells by RA, showed a twofold increase in ferritin content following differentiation. Addition of iron to the culture medium increased ferritin content of both differentiating and non-differentiating cells, but the former responded to lower concentrations of iron. The increase in ferritin during differentiation, however, was not related to an accelerated iron uptake. The present results suggest that changes in the intracellular ferritin of the developing myeloid cells may play a regulating role in the process of maturation of these cells. PMID- 3970012 TI - Rapid accurate absolute granulocyte count determination during severe leukopenia using the flow cytometer. AB - The absolute granulocyte count (AGC) in 125 blood samples from patients with total white blood cell counts of less than 1,000/microliter was estimated using three different methods, which were then compared for efficiency and accuracy. The three methods were 25 cell differential counts using Wright's-stained blood smears, granulocyte percentage estimates from WBC counting chambers, and combined narrow- and wide-angle light-scatter characteristics determined on a flow cytometer. A survey of clinical laboratories at University Hospital Cancer Centers revealed that the smear differential was the most-often-used method in those laboratories even when less than 25 cells could be counted. Consequently the data obtained from the counting chamber and flow cytometer methods were compared to the smear differential "standard" using linear regression, and outliers were identified. There was good correlation between AGC determined by smear differential and WBC counting chamber (correlation coefficient .911) and excellent correlation between the AGC determined by smear differential and the flow cytometer method (correlation coefficient .970). The flow cytometer method used in this investigation required minimal specimen preparation, and test results were available at a rate of 60 seconds/sample. The ease of sample preparation, speed, and statistical reliability of test results makes the flow cytometer an attractive alternate method of determining granulocyte counts on leukopenic patients as compared to the stained blood smear differential. PMID- 3970013 TI - Spurious thrombocytopenia produced by the interaction of rheumatoid factor with antiplatelet antibody. AB - A patient had spurious thrombocytopenia resulting from a mechanism not previously described. Whereas in prior reports the in vitro phenomenon of platelet clumping has been effected by either EDTA-dependent or temperature-dependent antibodies capable of direct platelet agglutination, neither the IgG nor the IgM fractions of this patient's serum demonstrated such activity. However, agglutination was produced by incubating allogeneic platelets with the IgG fraction followed by a room temperature incubation with the rheumatoid factor-positive IgM fraction. The data support a new mechanism for spurious thrombocytopenia resulting from the interaction of a cold-reactive rheumatoid factor with antiplatelet antibody. PMID- 3970014 TI - Extravascular hemolysis following the administration of cefamandole. AB - Hemolytic anemia occurred in a 70-year-old female after a five-day course of intravenous cefamandole. The patient's serum contained an IgG antibody which was reactive with red blood cells which had been coated in vitro with cefamandole but not with uncoated cells. An in vitro assay of allogeneic mononuclear phagocytosis of cefamandole-coated red cells sensitized with the patient's anti-cefamandole indicated that the anti-cefamandole could induce significant phagocytosis. The anti-cefamandole was easily inhibited in vitro by cefamandole as well as by a variety of related cephalosporins indicating broad cross-reactivity, with the antigenic site primarily the 7-amino-cephalosporanic acid nucleus. Penicillins could inhibit the anti-cefamandole but only when using concentrations 3-10 X those of cephalosporins. Eleven examples of anti-penicillin tested failed to react with cefamandole-coated red cells. Screening of 344 random sera from hospitalized patients found only five (1.5%) reactive with cefamandole-coated red cells; three of these sera were also reactive with penicillin-coated red cells. The patient's hemolysis subsided following cessation of the drug. This is the first report of anti-cefamandole-induced hemolytic anemia. PMID- 3970015 TI - Autosomal dominant polycystic kidney disease: presentation, complications, and prognosis. AB - Fifty-three symptomatic adults with autosomal dominant polycystic kidney disease were studied retrospectively for a mean follow-up of 12 years (range 10 months to 33 years). Diagnosis was confirmed by either x-ray, ultrasound, laparotomy, or autopsy. Commonest presenting clinical findings were flank pain (30%), hypertension (21%), symptomatic urinary tract infection (UTI) (19%), gross hematuria (19%), and palpable masses (15%). A total of nine patients (17%) progressed to end-stage renal disease. Change in renal function measured using the reciprocal of plasma creatinine plotted against time was linear for each individual patient with a maximum functional decline of 0.7 mg/dL/yr (slope = 0.07). Past the age of sixty renal failure was uncommon. Easily controlled hypertension developed in 64% attended by mild retinopathy. UTIs were common (53%), often recurrent (61%), precipitated by instrumentation in 6 of 14 patients (43%), leading to death in two (33%). Renal calculi were extremely common (34%) and had no defined metabolic cause. The presence of hematuria (64%), gross or microscopic, bore no relationship to the decline in renal function. Pregnancy was normal in these patients with no increase in fetal or maternal morbidity or mortality. We conclude the following: Renal functional deterioration is linear, less than previously reported, and bears no relationship to hematuria. Hypertension is common, easily treated, and causes minor end-organ damage. Renal calculi are frequent. Urinary tract instrumentation often induces infection with considerable morbidity and mortality and must be avoided. Pregnancy is not contraindicated if renal function is normal. The prognosis for survival in this disease is better than previously reported. PMID- 3970017 TI - Amelioration of hemodialysis-associated hypotension by the use of cool dialysate. AB - The effect of a reduction in dialysate temperature on BP during hemodialysis was studied in seven patients with end-stage renal disease suffering frequently from intradialytic hypotension. Each patient received six dialyses using 34.4 degrees C dialysate. These treatments were preceded (six dialyses) and also followed (six dialyses) by control periods using a 36.7 degrees C bath. Symptomatic hypotension was defined as systolic BP below 100 mm Hg associated with typical symptoms of hypotension requiring treatment with intravenous (IV) fluid. Cool dialysate reduced the frequency of symptomatic hypotension from 0.58 to 0.05 episodes per dialysis (P = less than 0.016). In addition, the rate of fall of mean BP during treatment was substantially slowed with the reduction in dialysate temperature (P = 0.002). Cool dialysate (34.4 degrees C) substantially ameliorates hemodialysis associated hypotension. PMID- 3970016 TI - Vancomycin prevents polytetrafluoroethylene graft infections in pediatric patients receiving chronic hemodialysis. AB - Polytetrafluoroethylene (PTFE) grafts have been a useful addition to the pediatric hemodialysis vascular access armamentarium. In this study, 17 pediatric patients underwent 331 total months of hemodialysis via PTFE grafts. There was a statistically significant (P less than .025) decrease in the incidence of graft infections in 12 patients (235 patient-months) while receiving prophylactic parenteral vancomycin compared with 9 patients (96 patient-months) while receiving no vancomycin (0% v 44%). Vancomycin side effects were uncommon and mild. Vancomycin is a safe and effective agent for the prevention of PTFE graft infections in pediatric patients receiving chronic hemodialysis. PMID- 3970018 TI - Severe reactions during hemodialysis. AB - Severe reactions during dialysis occurred in 1.7% of hemodialysis patients. Respiratory distress, agitation, pruritus, and alterations in BP were the dominant clinical findings, and one patient suffered a respiratory arrest. It is not clear whether this syndrome is due to toxic substances or to an allergic reaction, although the presence of eosinophilia in three of five affected patients would suggest the latter mechanism. Disconnecting the patient from the extracorporeal circuit invariably improved the symptoms. Current evidence implicates the dialyzer as the most likely culprit, and our experience suggests that none of the commonly used dialysis membranes are truly biocompatible. PMID- 3970019 TI - Acute anaphylactoid reactions in hemodialysis. AB - Our recent experience with membrane reactions in three hemodialysis patients is reported. We believe that two distinct populations manifest this reaction. First, well-known chronic hemodialysis patients may be exposed to inadequately rinsed new membranes. The etiology may be related to ethylene oxide either as a direct toxin or as a hapten attached to serum proteins. Adequate attention to dialysis membrane priming should eliminate this particular reaction. In the second group, the patients are new to the unit (transients) and frequently arrive with little information on prior care. Two of our patients and at least one other in the literature demonstrate markedly elevated IgE levels. This suggests an IgE mediated mechanism; whether this is related to the membrane type, ethylene oxide, or a currently undetermined allergen remains uncertain. PMID- 3970020 TI - Hydrothorax in continuous ambulatory peritoneal dialysis: successful treatment with intrapleural tetracycline and a review of the literature. AB - Recurrent hydrothorax complicating peritoneal dialysis has been considered a contraindication to continuing peritoneal dialysis. In the continuous ambulatory peritoneal dialysis (CAPD) population this problem has generally required a change of dialytic modality. Talc poudrage has been attempted to ameliorate the problem but has met with limited success. We report a successful case of intrapleural instillation of tetracycline to induce a pleural symphysis and prevent recurrence of peritoneal dialysis-related hydrothorax in a patient who refused any alternative mode of dialysis. We also review the literature, pathophysiology, epidemiology, diagnosis, and management of this compromising problem. PMID- 3970021 TI - The assessment of risk factors in 462 patients with acute renal failure. AB - Risk factors associated with the mortality of patients with acute renal failure (ARF) were investigated. This was accomplished by a review of 462 patients with ARF and the utilization of a logistic regression analysis to develop a model that can be used to predict the mortality odds for an ARF patient. The significant risk factors were age, oliguria, pulmonary and cardiovascular complications, jaundice, and hypercatabolism. Based on these factors, our model was able to account for 77% of the mortality associated with ARF. PMID- 3970023 TI - Workplace health education: who should educate? PMID- 3970022 TI - Cytotoxicity and negligible genotoxicity of borax and borax ores to cultured mammalian cells. AB - The cytotoxicity and genotoxicity of refined borax and borax ores were studied in cultured mammalian cells. In V79 Chinese hamster cells, C3H/10T1/2 mouse embryo fibroblasts, and diploid human foreskin fibroblasts, crude borax ore, kernite ore, and refined borax were all cytotoxic. The lowest concentrations at which cytotoxicity was observed were 0.02 mg/ml and 0.1 mg/ml for borax ore in C3H/10T1/2 and human fibroblasts, respectively, 0.2 mg/ml for kernite ore in both cell types, and 0.1 mg/ml for refined borax in both C3H/10T1/2 and human fibroblasts. The cytotoxicity was dose dependent above these concentrations. The concentrations of borax ore, kernite ore, and refined borax that reduced the relative plating efficiency to 50% were approximately 3.2, 1.6, and 0.8 mg/ml, respectively, in human fibroblasts and were 0.8 mg/ml for all three substances in C3H/10T1/2 cells. All three borax samples were not significantly mutagenic in assays for mutation to ouabain resistance in human fibroblasts an C3H/10T1/2 cells and were at most only weakly mutagenic in an assay for mutation to 8 azaguanine resistance in V79 Chinese hamster cells. Refined borax did not induce neoplastic transformation in C3H/10T1/2 cells. Crude borax ore and kernite ore induced weak transformation that was not dose-dependent and was not reproducible in another experiment. Therefore, borax and its ores are cytotoxic to mammalian cells at high (mg/ml) concentrations and are at most weakly mutagenic but not significantly oncogenic as measured in a cell transformation assay. PMID- 3970024 TI - Evaluating a filter device used for intermittent intravenous drug delivery to newborn infants. AB - Injection of aminoglycosides into a filter chamber was compared with retrograde injection into i.v. tubing for delivery of intermittent drug dosages at low infusion rates in neonates. In 50 infants receiving gentamicin sulfate and 21 receiving amikacin sulfate for at least two days by retrograde i.v. infusion, peak and trough concentrations of the drugs were obtained. A subsequent dose was administered using the filter device, and peak and trough concentrations were obtained. For each infant, the difference between trough and peak concentration (delta C) was compared for the two methods. In vitro testing for gentamicin concentration was performed using the same infusion systems (10 trials for each system). For both in vivo and in vitro testing, the infusion flow rate was 10 mL/hr. For infants receiving gentamicin, delta C was greater for the filter device in 32, greater for retrograde infusion in 13, and equal in 5. The mean gentamicin delta C was significantly greater for the filter chamber method than for retrograde infusion. The in vitro studies showed significantly better gentamicin recovery with the filter device than with retrograde infusion. For amikacin, delta C was greater for the filter device in 15 infants, but the mean amikacin delta C was not significantly different for the two methods. At low flow rates commonly used in infants, the infusion system using the filter device was equal to or superior to retrograde infusion for ensuring complete delivery of intermittent drug doses. PMID- 3970025 TI - Stability of meperidine hydrochloride, promethazine hydrochloride, and atropine sulfate in plastic syringes. AB - The stability of a combination of meperidine hydrochloride 50 mg, promethazine hydrochloride 25 mg, and atropine sulfate 0.4 mg in plastic syringes at room temperature was studied. The samples were tested for each drug after 0.5, 1, 3, 6, and 24 hours in the syringes. Freshly prepared mixtures of the drugs in glass containers were used as controls, and three trials using separate test mixtures were performed. A gas chromatography procedure was used; atropine was separated from the mixture and assayed alone for greater accuracy. Drug concentrations in the plastic syringes were not significantly different from controls at any of the test times. A mixture of meperidine hydrochloride, promethazine hydrochloride, and atropine sulfate in dosages commonly administered as a preoperative medication was stable for 24 hours in plastic syringes. PMID- 3970027 TI - Regional hospital pharmacy information index. AB - An index system was developed that provides participating hospitals with an up-to date list of regionally available written materials used in hospital pharmacy practice. Eight acute-care hospitals agreed to participate in developing the index to avoid duplication of effort in producing original materials. A regional drug information center agreed to maintain the index and serve as the central repository for the materials. Newsletters and bulletins were given high priority for coverage by the system, followed by drug monographs and directed studies and residency projects. A three-year back-index period was set for most categories to ensure that the index was current. Only active entries were listed for investigational drug lists, i.v. drug administration monographs, and extemporaneously compounded drug products. Other categories were drug administration policies, unusual drug information requests, and patient-oriented drug information. The representatives provided the relevant materials from their institutions, and it was categorized and indexed. The index was entered on a word processor, which permits efficient updating. The index has been useful to the participating hospital pharmacy departments. As the system is tested through use, it will be evaluated formally and refined. PMID- 3970026 TI - Compatibility of furosemide with aminoglycoside admixtures. AB - The compatibility of furosemide with i.v. admixtures containing each of five different aminoglycosides was studied. Admixtures of amikacin 2 mg/ml, gentamicin 1.6 mg/ml, kanamycin 2 mg/ml, netilmicin 1.5 mg/ml, and tobramycin 1.6 mg/ml (as the sulfate salts) were prepared in both 5% dextrose injection and 0.9% sodium chloride injection in minibags. Furosemide injection 4 ml (40 mg) was then added to each admixture, and the admixtures were examined visually and microscopically for precipitate. The macroscopic and microscopic evaluations were repeated 15 minutes and 24 hours after mixing. To simulate Y-site injection of furosemide, furosemide injection 1 ml (10 mg) was added to 1 ml of each aminoglycoside admixture in a syringe. For admixtures in which precipitates formed, the pH was recorded before and after adding furosemide to subsequent admixtures and also after dropwise addition of 1N sodium hydroxide until the precipitate dissolved. Precipitates were identified using spectrophotometric analysis and melting point determinations. Addition of furosemide resulted in a precipitate only in admixtures containing gentamicin sulfate or netilmicin sulfate; the results for the simulated Y-site injection study were the same. Spectrophotometric analysis and melting point determinations revealed that the precipitate was furosemide. Because furosemide precipitates when added to admixtures containing either gentamicin sulfate or netilmicin sulfate in 5% dextrose injection or 0.9% sodium chloride injection, furosemide should be administered separately or the i.v. tubing should be flushed thoroughly before and after administering this drug via a Y-injection site. PMID- 3970028 TI - Methods of inventory control. AB - Various methods for controlling inventory are described, and the advantages and disadvantages of each are discussed. The open-to-buy (OTB) budget method limits purchases to a specific amount of funds available for purchasing pharmaceuticals during a specified period. The emphasis of the OTB method is financial control of the pharmacy inventory. Although it is useful in monitoring and adjusting the dollar value of the inventory, it should be combined with other methods for a total inventory control system. The primary emphasis of the short-list method is to provide accurate and timely inventory information to the person responsible for order placement. The short list identifies the items that are in short supply. It is the most common feedback and control mechanism in use, but it is best suited for settings where duplicate or reserve stock is maintained and monitored by more rigorous methods. The main objective of the minimum and maximum method is to determine when and how much to order of each item. It also provides limited dollar control. The major disadvantage of this method is the time it requires to establish the minimum and maximum levels and to update them regularly to reflect changes in demand. The stock record card method is used to record information on the movement of goods in and out of the storage area. Stock cards can also be used to monitor inventory levels and facilitate order initiation. It is probably the optimum method to be used alone. The most effective system of inventory control is one employing a combination of these methods tailored to meet the institution's needs and available resources. PMID- 3970029 TI - Crystal formation after reconstituting cefazolin sodium with 0.9% sodium chloride injection. PMID- 3970030 TI - Hearing or sight defects and drug use in the elderly. PMID- 3970031 TI - Use of serum theophylline concentrations in ambulatory patients. PMID- 3970032 TI - Pharmacy in the twenty-first century: results of a strategic-planning conference. AB - The results of a strategic-planning conference that focused on what pharmacy in the United States would be like in the year 2010 are presented. The 50-plus conferees considered papers by 14 health-care thought-leaders and then, meeting in small groups, made projections for pharmacy based on four possible future scenarios: Continued Growth, Decline and Stagnation, Disciplined Society, and Transformation. Among the specific issues addressed in each scenario were the nature and quantity of pharmaceutical services sought, total drug volume, classes of drugs, and pharmacy practice location, pharmacy personnel needs, and which outcomes are most likely to occur. The Continued Growth option was thought to have the best chance of occurring. Major factors expected to influence pharmaceutical services over the next 25 years included an increasingly elderly population, more widespread health promotion and wellness activities, a decline in health-care expenditures as a proportion of Gross National Product, and an increase in home remedies. It was felt that most pharmacists will practice as part of mega-health-care enterprises or chain pharmacies. PMID- 3970033 TI - ASHP members' concepts of institutional pharmacy in the year 2000. AB - Trends in institutional pharmacy practice were identified, and ASHP members' views of these trends were evaluated in a futures study. A list of statements concerning the practice of institutional pharmacy in the year 2000 was developed using a modified Delphi method. A random sample of 3000 active ASHP members received the questionnaire and were asked to estimate the probability that each of the 42 statements would occur by the year 2000. The responses were analyzed to reduce the number of variables to common factors. A total of 1276 of the returned questionnaires were usable. Six factors were identified: pharmacy-medicine linkage, advanced training or degree, drug administration, quality assurance and accreditation, supportive personnel, and pharmacy-nursing conflict. There were differences in the mean values of responses of items related to various factors when they were compared by sex, age, position held, degree held, and residency training. The key trends predicted were that advanced training or degrees will be necessities in the year 2000, institutional practice will be composed of multiple tracks, postgraduate education will be required of clinicians and administrators, turf conflict with nurses will increase, and accreditation standards and other safeguards for quality health care will continue to be required and will increase. The trends in how ASHP members conceptualized the future of their profession can provide insight for individuals developing programs in pharmacy education, health-care administration, institutional practice, and the pharmaceutical industry. PMID- 3970034 TI - Neoplasms in rheumatoid arthritis: update on clinical and epidemiologic data. PMID- 3970035 TI - Epidemiology of cancer in rheumatoid arthritis: methodologic pitfalls. AB - Studies that try to associate immunoinflammatory disease, typified by rheumatoid arthritis, and malignancy have been limited by several important methodologic difficulties. Usually the hypothesis examined has been one of an increase in incidence of one or more specific neoplasms, and sometimes this hypothesis has been generated after examining the data. Some of the more common methods for assessing risk, including case reports and small series, case-control studies, hospital-based studies, and animal studies, and the competing risk fallacy can create problems of interpretation and can skew the results. The ideal study is one in which a random sample of 1,000 or more patients with rheumatoid arthritis are followed prospectively from disease onset to death and the data compared with total population data over the same period. Ideally, there would be perfect follow-up and autopsy information available on all patients and all control patients. Such studies of course will not be available. However, those studies that are designed best fail to associate rheumatoid arthritis with malignancy, although certain specific malignancies do appear associated with alkylating agent therapy for rheumatoid arthritis. PMID- 3970036 TI - Cancer and rheumatoid arthritis: epidemiologic considerations. AB - Statistical methods used to investigate the epidemiology of cancer in rheumatoid arthritis are reviewed and their relative merits discussed. A cohort analysis of cancer morbidity was carried out on a consecutive series of 489 patients with rheumatoid arthritis seen at the Queen Elizabeth Medical Centre, Birmingham, United Kingdom between 1964 and 1978 and followed to December 31, 1983. Forty-two cancers were observed in the series in comparison with 31.13 expected (p less than 0.05) on the basis of cancer morbidity rates for the West Midlands region. The excess was due to the high relative risk of cancers of lymphatic and hematopoietic tissues (observed = 11, expected = 1.27, relative risk = 8.7, p less than 0.001). The effects of confounding factors, including duration of rheumatoid arthritis and hospital selection on the level and pattern of risk over time were examined. When two cases diagnosed soon after first attendance at hospital were excluded, lymphomas (ICD 200, 201, 8th Revision) showed a pattern of increasing relative risk with time from five years after first attendance. The increasing risk appears to be unrelated to the use of immunosuppressive or cytotoxic drugs. PMID- 3970037 TI - Rheumatoid arthritis and cancer studies based on linking nationwide registries in Finland. AB - Two separate registries that cover the whole population of Finland have been linked in order to study the occurrence of cancer in patients with rheumatoid arthritis. The two registries involved were the Social Insurance Institution's Population Register, which collects information on medication for certain chronic diseases since 1967 including rheumatoid arthritis, and the Finnish Cancer Registry, which has data on all cancer patients in Finland since 1953. The 213,911 person-years' follow-up of 46,101 individuals with rheumatoid arthritis revealed 1,202 cases of cancer. The relative risk of cancer was 1.15 in males and 1.01 in females. The observed number of cases significantly exceeded that expected in Hodgkin's disease, non-Hodgkin's lymphomas, multiple myeloma, and leukemia. In general, the incidence of epithelial tumors was as expected. These findings were further supported by studying the occurrence of subsequent new primary cancers among patients with rheumatoid arthritis and cancer. PMID- 3970038 TI - Review of United States data on neoplasms in rheumatoid arthritis. AB - Relatively sparse literature developed during the past 30 years that sought to characterize the relationship of rheumatoid arthritis to neoplasms. The past decade has seen added concern over possible oncogenic effects of cytotoxic agents now used to manage some patients with rheumatoid arthritis. Acquisition of unambiguous data is complicated by the fact that the cumulative incidence of cancer in the general population exceeds 30 percent, and that most studies have insufficient patient numbers, duration follow-up, and attention to age, sex, race, or known etiologic agents. Thus, it is not surprising to find reports that cancer incidence is high, low, or unchanged in rheumatoid arthritis. Although equally ambiguous data were accumulated concerning potential neoplasm-inducing effects of cytotoxic drugs, concern is justified in relation to increased frequency of bladder cancer after cyclophosphamide and acute leukemia following alkylating agents. PMID- 3970039 TI - Incidence of neoplasms in patients with rheumatoid arthritis exposed to different treatment regimens. AB - Immunosuppressive drugs have been used during the last 30 years in treatment of patients with severe rheumatoid arthritis. The drugs commonly used are cyclophosphamide and chlorambucil (alkylating agents), azathioprine (purine analogue), and methotrexate (folic acid analogue). There is evidence that all four immunosuppressive drugs can reduce synovitis, but disease activity almost always recurs after therapy is stopped. Since adverse reactions are frequent, less than 50 percent of patients are able to continue a particular drug for more than one year. Since it takes three to 12 months to achieve maximal effects, those patients who are unable to continue the drug receive little benefit from it. Patients treated with alkylating agents have an increased risk of development of acute nonlymphocytic leukemia, and both alkylating agents and azathioprine are associated with the development of non-Hodgkin's lymphoma. Cyclophosphamide therapy increases the risk of carcinoma of the bladder. There have been several long-term studies of patients with rheumatoid arthritis treated with azathioprine and cyclophosphamide and the incidence of most of the common cancers is not increased. Data on the possible increased risk of malignancy in rheumatoid arthritis are still being collected, and until further information is available, the use of immunosuppressive drugs, particularly alkylating agents, in the treatment of rheumatoid arthritis should be reserved for patients with severe progressive disease or life-threatening complications. PMID- 3970040 TI - Incidence of cancer in rheumatoid arthritis and other disorders after immunosuppressive treatment. AB - A prospective study in the United Kingdom of 1,634 patients without transplants treated with immunosuppressive drugs (68 percent with azathioprine, 28 percent with cyclophosphamide) found an excess of non-Hodgkin's lymphoma and squamous cell skin cancer, suggesting that the excesses (although larger) of the same malignancies found among transplant recipients are not due solely to the foreign antigens of the graft. A separate analysis of the 643 patients with rheumatoid arthritis found a 13-fold increase of non-Hodgkin's lymphoma (whether treated with azathioprine or cyclophosphamide). This increase is not significantly different from the excess in similarly treated patients with other disorders in the study. In patients with rheumatoid arthritis not receiving immunosuppressive drugs, this excess is greater than that in a Finnish population and lower than that in another United Kingdom population. The findings are consistent with other evidence that immunosuppression favors the development of non-Hodgkin's lymphoma, which includes the excess of malignancies found among transplant recipients, long term renal dialysis patients, and patients with certain primary immunodeficiency disorders. The higher risk among transplant recipients may reflect the effects of the foreign antigens, the more intensive immunosuppressive therapy, or both of these factors. In addition, the predilection for the brain, which is a well-known feature of the lymphomas after transplantation, may also apply (to a lesser extent) to other patients after immunosuppressive treatment, judging from the increasing numbers of case reports in such patients of this exceedingly rare type of malignancy. In view of the evidence of an increase of non-Hodgkin's lymphoma in rheumatoid arthritis in the absence of immunosuppressive treatment, any additional increase is likely to be small in absolute terms. Nevertheless, it needs to be weighed against the clinical benefits. PMID- 3970041 TI - Occurrence of malignant neoplasms in the Rochester, Minnesota, rheumatoid arthritis cohort. AB - The medical records of all patients with rheumatoid arthritis diagnosed in Rochester, Minnesota, from 1950 to 1975 were examined to determine how many of them had malignant neoplasms. Follow-up averaged more than 14 years with outcome diagnoses complete in 98 percent of cases. All diagnoses of malignant neoplasm in this cohort were identified through the centralized record system based at the Mayo Clinic. Approximately 40 percent of these patients with rheumatoid arthritis were at least 60 years old at diagnosis. For comparison, the expected number of malignancies has been calculated using age-specific and site-specific rates from previous Rochester studies and the number of years of observation from date of diagnosis of rheumatoid arthritis to the date of last examination. Risk ratios have been calculated by dividing the observed number by the expected number of malignancies. Exact 95 percent confidence intervals around the risk ratios were calculated assuming that the observed number of cases has a Poisson distribution and that the expected number is fixed. Those patients with rheumatoid arthritis who had a malignancy before diagnosis have been analyzed separately, because they are at a higher risk. With the exception of multiple myeloma, no association was found between rheumatoid arthritis and subsequent cancer of any site. PMID- 3970042 TI - Cancer in rheumatoid arthritis: a prospective long-term study of mortality. AB - Eight hundred and five consecutive patients with definite or classic rheumatoid arthritis, representative of a general population, were followed prospectively over an average of 12 years with 94 percent follow-up, during which time 233 patients died. Mortality rates were increased in rheumatoid arthritis by approximately 50 percent compared with population controls. "Excess deaths" (78) were due, in part, to disease-related causes, infections, and gastrointestinal problems secondary to therapy. Thirty-one deaths (14.1 percent) were due to malignancy, compared with 22.8 percent in non-age-adjusted population controls. Frequency of malignancy type (colon seven, lung four, breast three, prostate three, leukemia three, ovary three, stomach two, and lymphoma zero) did not differ significantly from the general population. Age-adjusted figures showed lower malignancy rates for patients with rheumatoid arthritis except after age 80. Two treatments were suitable for analysis. Gold-treated patients trended toward lower malignancy rates (11 versus 17 percent) than did those not treated with gold, and prednisone-treated patients had less malignancy (11 versus 20 percent) than did those not treated with prednisone. These data indicate that there is not an important increase in deaths due to malignancy in rheumatoid arthritis, and that at least two treatments, gold and prednisone, are not associated with higher risk of malignancy. PMID- 3970043 TI - Multiple primary malignancy as a model for the study of cancer occurrence in rheumatoid arthritis. AB - Research approaches to the study of multiple primary malignancy can be helpful in the study of cancer occurrence in rheumatoid arthritis. Research on multiple primary malignancy suggests that an observed increased risk of cancer in rheumatoid arthritis could be due to shared host susceptibility to both diseases, shared risk factors, rheumatoid arthritis-caused changes predisposing to cancer, biased research, chance, or the therapy used in the treatment of rheumatoid arthritis. All of these factors should be considered before concluding that treatment was the cause. Multiple primary malignancy research suggests that sophisticated analyses are needed in order to evaluate cancer risks following therapy. There may be long latency periods between therapy and cancer onset. Drugs may have been given in various dosages, sequences, and combinations and for different durations. Persons with chronic diseases such as rheumatoid arthritis are often difficult to follow over time; hence, there may be variable follow-up intervals for subjects. All of these problems must be taken into account in analyses of cancer risk. PMID- 3970044 TI - Monitoring activity of fibrinolytic agents. PMID- 3970045 TI - American medical education. Has it created a Frankenstein? AB - The solutions to the problems cited and to many others regarding medical education in America are not simple ones. But it is clearly time to recognize that this system is failing to produce physicians that best meet the needs of the patient, society, and the medical field in general. It is essential for those of us involved in medical education to recognize these facts and to make major changes to help correct them. Failure to do so will only increase the severity of the problems. PMID- 3970046 TI - Pregnancy in women with renal disease and moderate renal insufficiency. AB - Data were gathered on 25 pregnancies in 23 women with moderate renal insufficiency as defined by a serum creatinine level of 1.4 mg/dl or greater prior to or at the onset of pregnancy. Twelve of the women had primary glomerular diseases, five (accounting for seven pregnancies) had interstitial diseases, and six had other renal diseases. In seven women with baseline serum creatinine levels ranging from 1.7 to 2.7 mg/dl, pregnancy was accompanied by a decline in renal function that was believed to be greater than expected from the natural history of the disease. The change ranged from a rise in serum creatinine level of 1.2 mg/dl to a functional decline that required dialysis. In 14 women (16 pregnancies), renal function either remained stable or declined to a degree consistent with the natural history of the disease. In two, the follow-up period was not long enough to judge the effect on the natural history of the disease. In 14 pregnancies, development or worsening of hypertension occurred. In nine, the diastolic blood pressure rose to 110 mm Hg or greater, and delivery was required because of hypertension. Twenty-three of 25 pregnancies ended in live births (92 percent) and 21 babies survived (84 percent). Fourteen of the 23 live births were premature. It is concluded that, in a substantial fraction of women with moderate renal insufficiency, pregnancy is accompanied by a decline in renal function; however, the fetal survival is much better than previously reported. PMID- 3970047 TI - Phase II trial of recombinant leukocyte A interferon in patients with advanced chronic lymphocytic leukemia. AB - Recombinant leukocyte A interferon is a highly purified single molecular species of alpha-interferon prepared by recombinant DNA methods. In 1982, a phase II trial to evaluate the efficacy of recombinant leukocyte A interferon for patients with previously treated chronic lymphocytic leukemia was begun, and 19 patients were entered in this study. Patients received one of two dose schedules depending on their pretreatment platelet counts. Those with platelet counts greater than 100,000/mm3 received 50 X 10(6) units/m2 intramuscularly three times weekly, with dose reductions to 25 X 10(6) units/m2 and 5 X 10(6) units/m2 for unacceptable toxicity. Those with platelet counts less than 100,000/mm3 received 5 X 10(6) units/m2 intramuscularly three times weekly. Toxicity was dose-dependent and included fever, chills, fatigue, anorexia, myalgias, headache, leukopenia, and thrombocytopenia. Response was evaluable in all but one of the patients entered in this study. Two of the 12 patients treated with 50 X 10(6) units/m2 had a partial response, three had no response, and seven had progressive disease. Of the six patients starting at 5 X 10(6) units/m2 in whom response was evaluable, two had no response and four had progressive disease. Five patients with progressive disease (three at 50 X 10(6) units/m2 and two at 5 X 10(6) units/m2) had an acceleration of disease while receiving recombinant leukocyte A interferon. It is concluded that the dose and schedule of recombinant leukocyte A interferon therapy tested in this study are not effective in previously treated patients with advanced chronic lymphocytic leukemia. PMID- 3970048 TI - Pulmonary vascular response during Raynaud's phenomenon in progressive systemic sclerosis. AB - Progressive systemic sclerosis and Raynaud's phenomenon are associated with a distinctly vascular form of pulmonary involvement and pulmonary hypertension. To investigate a possible underlying vasospastic predisposition in these patients, the pulmonary vascular response to Raynaud's phenomenon induced by cold-water hand immersion was examined in nine patients. Four patients had pulmonary fibrosis and four patients had the CREST syndrome; no patient had pre-existing pulmonary hypertension. During Raynaud's phenomenon, there was no significant rise in mean pulmonary artery pressure (15 +/- 3 versus 15 +/- 2 mm Hg, p = NS) or pulmonary vascular resistance (112 +/- 38 versus 118 +/- 50 dynes X second X cm-5, p = NS) over baseline, despite a significant rise in mean aortic pressure (104 +/- 14 versus 92 +/- 11 mm Hg, p less than 0.01) and systemic vascular resistance (1,700 +/- 450 versus 1,500 +/- 470 dynes X second X cm-5, p less than 0.01). It is concluded that pulmonary vasospasm with transient pulmonary hypertension does not occur in patients with progressive systemic sclerosis and Raynaud's phenomenon during episodes of Raynaud's phenomenon. Abnormal pulmonary vasospasm in these patients in response to other stimuli, however, is not excluded. PMID- 3970049 TI - Diagnosing early Lyme disease. AB - The diagnostic value of clinical, culture, and serologic findings was studied prospectively in 41 patients with early Lyme disease. Fifteen patients had erythema chronicum migrans alone, and 26 had clinical evidence of disseminated infection, most commonly affecting the brain or meninges, other skin sites, lymph nodes, or joints. Of 40 blood cultures, only one, from a patient with disseminated infection, yielded spirochetes. One of 10 patients tested with localized infection had an elevated IgM response to the Lyme spirochete (200 units or greater) during acute disease. Two to three weeks after beginning antibiotic therapy, four of the 10 patients had elevated specific IgM or IgG responses (200 units or greater). Of the 22 patients tested with disseminated disease, 10 initially had elevated levels of specific IgM or IgG, and 12 had such responses by convalescence. Because of the low yield of cultures and the delay in the specific antibody response, recognition of the clinical picture remains very important in diagnosing early Lyme disease. PMID- 3970051 TI - Care of patients with incurable, chronic neoplasm. One patient's perspective. PMID- 3970052 TI - Sculpture of a new academic discipline. Four faces of academic general internal medicine. PMID- 3970050 TI - Mitral valve prolapse requiring surgery. Clinical and pathologic study. AB - The clinical, hemodynamic, surgical, and pathologic findings in 30 patients who required mitral valvular surgery and who had a preoperative diagnosis of mitral valve prolapse were reviewed. The mean age of the patients was 59.5 years; 28 patients were over 45 years of age and 10 were over 60 years. Surprisingly, 20 were males. A long history of systolic murmur was common, whereas symptoms of heart failure were of abrupt onset. At the time of surgery, a local holosystolic murmur typical of mitral regurgitation was present, although a mid- to late systolic click was not heard in any of the patients. Electrocardiographic abnormalities were present in all patients, with 13 patients demonstrating atrial fibrillation. Only four patients had a normal heart size radiographically. Echocardiography confirmed the radiographic findings, in that 27 patients demonstrated left atrial and ventricular enlargement. All 29 patients undergoing cardiac catheterization and angiography demonstrated a prolapsing mitral valve with severe regurgitation. Surgical and pathologic examination revealed findings characteristic of a myxomatous valve in all patients, with 19 also demonstrating ruptured chordae tendineae. This study demonstrates that heart failure requiring valvular surgery occurs in a subset of patients with mitral valve prolapse. In this subset, males predominate and most are over 50 years of age. These patients may be asymptomatic for many years, demonstrating mild to moderate mitral valvular regurgitation, before heart failure develops. PMID- 3970053 TI - Micturition-induced hypertension in a 58-year-old woman. PMID- 3970054 TI - Hyperalgesic pseudothrombophlebitis. New syndrome in male homosexuals. AB - Five male homosexuals, four of whom had Kaposi's sarcoma, presented with painful swelling of the lower extremity. The overlying skin was erythematous and exquisitely tender. Deep vein thrombosis was strongly suspected in all patients. Venography, however, revealed no evidence of venous occlusion. This condition, which in this report is termed the hyperalgesic pseudothrombophlebitis syndrome, appears to be another unusual manifestation of the acquired immune deficiency syndrome. It should be considered among the entities known to mimic deep vein thrombosis and must be recognized in order to prevent unnecessary anticoagulation in these patients. PMID- 3970055 TI - Runner's macrocytosis: a clue to footstrike hemolysis. Runner's anemia as a benefit versus runner's hemolysis as a detriment. AB - This report of a runner in whom progressive macrocytosis developed with increasing mileage deals with the hematologic adaptations to exercise, introduces the concept of "runner's macrocytosis" as a compensated hemolysis of older red cells, and makes a case for "runner's anemia" as a benefit versus "runner's hemolysis" as a detriment. It presents the characteristic hematologic profile of footstrike hemolysis and explores the influence of racing, different levels of training, and different shoes. It shows that runner's hemolysis can be reduced by reducing mileage but not necessarily by changing shoes, and it suggests that runner's hemolysis can impair race performance by preventing the attainment of an optimal red cell mass and, in time, by evolving into iron-deficiency anemia. PMID- 3970056 TI - Osteolytic Paget's bone disease in a young man. Rapid healing with human calcitonin therapy. AB - Paget's bone disease is rare in young adults. Severe osteolytic Paget's bone disease in a 28-year-old man was found to respond, clinically, biochemically, and radiographically, within one month to daily subcutaneous injections of 0.5 mg of synthetic human calcitonin. After two years of therapy, he remains asymptomatic and has no biochemical evidence of Paget's bone disease while receiving injections three times a week. Despite aggressive disease, young patients may rapidly demonstrate the same beneficial response to synthetic human calcitonin therapy as has been observed in middle-aged or elderly patients with Paget's bone disease. PMID- 3970057 TI - Venous air embolism. Life-threatening complication of orogenital sex during pregnancy. AB - Vaginal insufflation in pregnant women leading to acute venous air embolism has been appreciated by obstetricians and pathologists for several decades. Initially described as a complication of powder insufflation for treatment of trichomonal vaginitis, insufflation-induced air embolism has been more recently associated with orogenital sex. The case herein illustrates a typical history that is almost pathognomonic. Clinical and laboratory abnormalities as well as treatment measures are briefly described. Familiarity with this syndrome is essential if prompt and appropriate therapy is to be rendered. PMID- 3970058 TI - Anaphylactic reaction and cardiopulmonary arrest following intravenous cyclosporine. AB - Cyclosporine, a new immunosuppressive agent useful in recipients of a variety of organ transplants, has been associated with a number of adverse effects, most notably nephrotoxicity. This report describes a woman about to undergo liver transplantation in whom intravenous administration of cyclosporine was associated with an apparent anaphylactic reaction resulting in cardiopulmonary arrest. Similar reactions have thus far not been reported after oral administration of cyclosporine. Intravenous cyclosporine must be administered under close supervision and should be avoided in any patients with a history of prior allergic reactions to the drug or to a component of its intravenous formulation. PMID- 3970059 TI - Limb loss due to transvenous endocardial pacemaker therapy. AB - Although intravenous thrombosis frequently complicates placement of transvenous endocardial leads in patients with permanent pacemakers, clinical manifestations of upper extremity thrombosis are uncommon. Most, including upper extremity edema, cervical venous engorgement, and even superior vena cava syndrome, can be successfully managed with conservative therapy. In the patient described in the present report, clinical manifestations of pacemaker-electrode thrombosis were neither mild nor responsive to conservative therapies: in this patient, pacemaker electrode thrombosis ultimately required amputation of the right upper extremity. Complications of the magnitude described in this patient emphasize the need for continual review of the indications for pacemaker therapy as understanding of the risk-benefit ratio of this procedure broadens. PMID- 3970060 TI - Pernicious anemia and giant cell myocarditis. New association. AB - The association of pernicious anemia, an autoimmune disease, with other immunologic disorders such as dermatitis herpetiformis, Hashimoto's thyroiditis, hypothyroidism, hyperthyroidism, vitiligo, adrenal insufficiency, adult-onset immunoglobulin deficiency, hypoparathyroidism, and possibly diabetes mellitus has been reported. The association of pernicious anemia with giant cell myocarditis, a rare fatal illness believed by some to represent an autoimmune abnormality occurring with other autoimmune diseases such as thymoma, systemic lupus erythematosus, dermatomyositis, thyrotoxicosis, Wegener's granulomatosis, and Sjogren's syndrome, is reported for the first time. A common underlying autoimmune abnormality is suggested. PMID- 3970061 TI - Evaluation of a peritoneal dialysis solution containing polymer. AB - Glucose is used in peritoneal dialysate to produce the gradient for ultrafiltration. The peritoneal membrane's low reflection coefficient for glucose imposes a demand for high transmembrane concentrations, perhaps adding unwanted body burden of glucose. A polymer with a lower permeation rate used as an osmotic agent would circumvent this. We evaluated the mass transfer coefficient (mtc), T1/2 disappearance from the peritoneal cavity and ultrafiltration capabilities of a 900 dalton (Mn) starch derived polymer. We compared an 8% (455 mOsm/L) and a 10% (484 mOsm/L) polymer (Pol) solution to available dialysate solutions containing 2.5% (399 mOsm/L) and 4.25% (491 mOsm/L) X glucose (Glc). The dialysate compositions were otherwise similar. Using a randomized complete block design, 5 anephric dogs maintained on chronic peritoneal dialysis were studied. The mtc (ml/min) was greater for the glucose than the polymer solutions (p less than 0.05): 2.5%-13 and 4.25%-14 vs 8%-5 and 10%-6. The T1/2 disappearance (min) was also greater (p less than 0.05): 2.5% Glc-112 and 4.25% Glc-111 vs 8% Pol-281 and 10% Pol-252. Over a 180 min. period the 2.5% glucose solution generated the least volume of ultrafiltrate (ml, p less than 0.05): 2.5% Glc-113 and 4.25% Glc 589 vs 8% Pol-640; 10% Pol-912. We conclude that the lower permeation rate of the polymer yields ultrafiltration at a lower dialysate osmolality. A polymer solution may be a feasible alternative to glucose. PMID- 3970062 TI - Elaboration of the phenotypic changes of the upper limbs in the Neu-Laxova syndrome. AB - We present two new cases and data from a detailed study of the upper limbs (structural changes, the state of peripheral nerves, arteries, muscles and bones) of three stillborn infants with the Neu-Laxova syndrome. The morphogenesis of many of the examined anatomical structures in these fetuses was anomalous. The origin of these anomalies is discussed. PMID- 3970063 TI - Decision making: whether or not to have prenatal diagnosis and abortion for X linked conditions. PMID- 3970064 TI - Duplication of hands and feet, multiple joint dislocations, absence of corpus callosum and hypsarrhythmia: acrocallosal syndrome? AB - We describe a 14-month-old female infant with absence of corpus callosum, atrophy of optic nerve, peculiar face, complex polydactyly, multiple joint abnormalities, and femoral shortness. The similarities to and differences from previously reported cases of this kind suggest that our patient has a new type of acrocallosal syndrome. PMID- 3970065 TI - The Neu-Laxova syndrome. PMID- 3970066 TI - Multicore disease in sibs with severe mental retardation, short stature, facial anomalies, hypoplasia of the pituitary fossa, and hypogonadotrophic hypogonadism. AB - We describe a family in which two adult sibs presented with a history of congenital nonprogressive myopathy, severe mental retardation and evidence of mild generalized weakness, short stature, musculoskeletal deformities, facial anomalies, sexual infantilism, and radiologic evidence of pituitary hypoplasia. The parents were first cousins. An excess of other, apparently unrelated, genetic conditions were present in other family members. Results of histochemical and electron microscopy studies of muscle biopsies from both affected individuals were compatible with multicore disease. This newly described syndrome likely is an autosomal recessive trait and appears to be the first reported association of multicore disease with mental retardation. PMID- 3970067 TI - Brief clinical report: syndrome of telecanthus, hypertelorism, strabismus, and pes cavus in father and son. AB - We report on a father and son who have telecanthus, hypertelorism, strabismus, and pes cavus. In addition, the son has hypospadias, bilateral inguinal hernia, clinodactyly and camptodactyly of fingers bilaterally, a small tissue mass on the tip of his nose, and radiographic findings including flared metaphyses of long bones and osteopenia. PMID- 3970069 TI - Trisomy 13 in the child of two carriers of a 13/15 translocation. AB - We report on an infant girl with trisomy 13 resulting from an inherited 13-15 Robertsonian translocation identified in a family from a small Spanish village of only 2,100 inhabitants. Both parents and several other relatives had a balanced 13-15 translocation. PMID- 3970068 TI - Tandem duplication of proximal 22q: a cause of cat-eye syndrome. AB - A boy with bilateral colobomas, preauricular pits, and developmental delay had a 46,XY,22q+ karyotype. His parents had normal chromosomes. The abnormality of 22q was interpreted as a de novo tandem duplication of 22q11.1----q11.2. Although no anal abnormality was identified, his manifestations are otherwise consistent with those of the cat-eye syndrome. Blood marker results and the levels of galactosidase-2, galactosidase-B and arylsulfatase-A, which are known to be coded on 22q, are normal. PMID- 3970070 TI - De novo 21q interstitial deletion in a retarded boy with ulno-fibular dysostosis. AB - A 9-year-old boy was referred for evaluation of multiple anomalies and mental retardation. Skeletal abnormalities had been noted at birth: joint contractures, right acetabular "dysplasia," ulno-fibular dysostosis, and bilateral talipes equinovarus with calcaneocuboid fusion. Additional findings at 9 years included short stature, unusual facial appearance, camptodactyly of several digits, undescended testes, and syndactyly of toes 4 and 5. On psychological testing he was found to be moderately retarded. Cytogenetic analysis of chromosome bands using Q, GTG, R, and C banding showed an interstitial deletion of 21q; karyotype designation: 46,XY, del (21)(pter----q11.2::q22.1----qter). Parental chromosomes were normal. Manifestations in this boy, including the joint contractures, are similar to those described in the monosomy 21 syndrome. Ulno-fibular dysostosis has not been reported previously with abnormalities of chromosome 21. To our knowledge, this is the second patient reported with an interstitial deletion of chromosome 21, and the patients are phenotypically dissimilar. PMID- 3970071 TI - Deletions of the long arm of chromosome 10. AB - Patients with a partial deletion of the long arm of chromosome 10 are rare. We report eight new cases involving various segments of 10q: one terminal deletion (10q26), four (8;10) translocations resulting in terminal deletions (10q26) and duplications (8q24.3), a de novo interstitial deletion (10q23), an interstitial deletion due to a (10;13) translocation (10q11.2----10q22.1), and a ring (10p15-- -10q26). PMID- 3970072 TI - Craniosynostosis and unilateral ulnar aplasia. PMID- 3970073 TI - Kindler syndrome in two related Kurdish families. AB - We describe a 19-year-old girl with Kindler syndrome. She has suffered from bullae on pressure areas of the skin since birth. These healed with atrophic scars and caused marked atrophy of the skin of the palms and soles and wrinkled and parchment-like skin of the dorsum of the hands and feet. Since infancy the patient has also suffered from severe photosensitivity on exposed areas and developed poikiloderma on the skin of her face, neck, chest, and upper back. Since age 17 years the patient has been free of bullae but moderate photosensitivity exists. Oral examination showed limitation of mouth opening, ankyloglossia, overjet malocclusions, and atrophy of buccal mucosa with widespread white macules. Results of laboratory tests were within normal limits. The proposita's parents (family 1) are Jews of Kurdish origin and first cousins. She is the only one affected among five siblings. Family 1 is related to a second family (family 2) through a common great-grandfather. The parents of family 2 are first cousins and they have three affected children. An autosomal recessive mode of inheritance of Kindler syndrome is suggested in these two related families. PMID- 3970074 TI - Duplication 5q(5q22----5q33): from an intrachromosomal insertion. AB - We report on an infant with an as yet undescribed partial duplication 5q(q22--- 5q33). He had a number of the already recorded manifestations of partial trisomy 5q, namely microcephaly, growth retardation, brachydactyly, long flat philtrum, thin upper lip vermilion and downturned angles of mouth and apparently low set ears. He survived only 6 months. He inherited his duplication from a maternal intrachromosomal insertion; thus he represents a pure dup(5)(q22----5q33). PMID- 3970075 TI - X;14 translocation:an exception to the critical region hypothesis on the human X chromosome. AB - We report on a family in which an X;14 translocation has been identified. A phenotypically normal female, carrier of an apparently balanced X-autosome translocation t(X;14)(q22;q24.3) in all her cells and a small interstitial deletion of band 15q112 in some of her cells had 2 offspring. She represents a fifth case of balanced X-autosome translocation with the break point inside the postulated critical region of Xq(q13 q26) associated with fertility. The break point in this case is located in Xq22, the same band as in four previously published exceptional cases. In most of her cells, the normal X was inactivated. Her daughter, the proposita, has an unbalanced karyotype 46,X,der(X), t(X;14)(q22;q24.3)mat, del(15)(q11.1q11.3)mat. She is mildly retarded and has some Prader-Willi syndrome manifestations. She has two normal 14 chromosomes, der(X), and deletion 15q11.2. Her clinical abnormalities probably could be attributed to the deletions 15q and Xq rather than 14q duplication. In most of cells, der(X) was inactivated. We assume that spreading of inactivation was extended to the 14q segment on the derivative X. Late replication and gene dose studies support this view. Another daughter, who inherited the balanced X;14 translocation and not deletion 15 chromosome, is phenotypically normal. PMID- 3970076 TI - Distal renal tubular acidosis syndromes: a pathophysiological approach. AB - Ammonium is the most important component of renal acid excretion. A reduced rate of ammonium excretion is the common feature of the group of diseases called distal renal tubular acidosis. We have presented an alternative approach to patients with distal acidification defects based upon the pathophysiology of these disorders. Accordingly, the purpose of this review is to describe a revised classification based on our current understanding of collecting duct hydrogen ion secretion and ammonium addition to the lumen of the distal nephron. We have subdivided these defects into four groups: disorders of the collecting duct proton pump (pump defects); failure to generate and/or maintain an appropriate electrical gradient to favor hydrogen ion secretion (voltage defects); back-leak of hydrogen ions across an abnormally permeable collecting duct membrane (gradient defects), and diminished availability of NH3 in this nephron segment (NH3 defects). These four subtypes can be identified by measuring the urine pH and PCO2 under appropriate circumstances and evaluating the renal excretion of ammonium and potassium. PMID- 3970078 TI - Glomerular sclerosis in patients with massive obesity. AB - In animals with reduced renal mass increased glomerular filtration is associated with accelerated glomerular sclerosis. Whether hyperfiltration causes glomerular damage in humans is unknown. Since increased glomerular filtration occurs in obesity, the amount of glomerular sclerosis found in renal autopsy tissue from 46 patients with massive obesity was compared to that found in 46 normal body weight controls. Despite increased kidney weight and glomerular size, obese patients had the same proportion of completely sclerosed glomeruli as controls. In addition, no focal segmental glomerular sclerosis was seen in the obese group. It is concluded that patients with massive obesity have increased kidney weight and nephron size consistent with hyperfiltration. Nevertheless, massively obese patients do not appear to have increased glomerular sclerosis. PMID- 3970077 TI - Influence of the calcium content of the diet on the incidence of mild hyperoxaluria in idiopathic renal stone formers. AB - Urinary oxalate excretion was measured in 101 male idiopathic calcium (Ca) stone formers studied on 3 dietary conditions (free-choice, Ca-enriched, and low-Ca diet). The population consisted of 38 normocalciuric and 63 hypercalciuric patients. Mean oxalate excretion was similar in normocalciuric and in hypercalciuric patients, on free-choice as well as on Ca-enriched diet. In both conditions the incidence of hyperoxaluria (greater than or equal to 435 mumol/24 h) within each group of stone formers was also similar, ranging from 11 to 22%. On low-Ca diet, however, mean oxalate excretion increased significantly (p less than 0.01) in hypercalciurics but not in normocalciurics; on this diet, the incidence of hyperoxaluria was particularly high in the hypercalciurics (33%), compared with the normocalciurics (13%). On low-Ca diet, oxalate excretion was positively correlated with the estimated degree of intestinal absorption of calcium (p = 0.01). These results show that among idiopathic stone formers, mild hyperoxaluria is not a rare finding and that this disorder can be encountered in each group of patients; its incidence, however, is influenced by the calcium content of the diet. On a low-Ca diet, patients with intestinal Ca hyperabsorption are particularly prone to develop hyperoxaluria, an observation which leads to question the relevance of such a dietary advice unless oxalate intake is simultaneously reduced. PMID- 3970079 TI - Idiopathic unilateral gross hematuria in the pediatric patient. AB - Microscopic hematuria is not an uncommon finding in the pediatric population. Since gross hematuria elicits parental and physician concern, its presence may result in extensive investigation. Unilateral hematuria is an unusual feature of gross hematuria, particularly in the pediatric patient. Although a number of structural and pathologic entities have been described to account for the laterality, in the majority of instances no overt underlying process has been uncovered. Unilateral hematuria appears to be benign, idiopathic, and has a prognosis no different than other idiopathic hematurias in the pediatric age group. PMID- 3970080 TI - Hemoptysis and acute renal failure in a young man. PMID- 3970081 TI - Hydrochlorothiazide-amiloride in the treatment of congenital nephrogenic diabetes insipidus. AB - The effects of treatment with hydrochlorothiazide combined with amiloride were compared to hydrochlorothiazide treatment alone in 2 brothers with congenital nephrogenic diabetes insipidus. Whereas both modalities of treatment resulted in reduction in voiding frequency and urine volume, decrease in daily fluid intake and increase in urine osmolality, the two-drug combination was found to be superior to hydrochlorothiazide alone by preventing urinary potassium losses, hypokalemia, and alkalosis. It was also found that amiloride had a certain additive effect to the thiazide in terms of increasing initial urinary sodium excretion, reducing urine volume and free water clearance, and lowering serum sodium concentration and osmolality. Similar comparison of the hydrochlorothiazide-amiloride regimen to treatment with the hydrochlorothiazide tolmetin combination in 1 of the patients revealed that the effectiveness of both diuretic modalities was close with slight advantage of the former. Treatment of the 2 patients for 10 months with hydrochlorothiazide and amiloride showed no adverse effects and consistent reduction in fluid intake and urine volume. It is concluded that the hydrochlorothiazide-amiloride regimen is superior to hydrochlorothiazide alone and can be a satisfactory alternative to the hydrochlorothiazide-prostaglandin synthetase inhibitor combination in the treatment of congenital nephrogenic diabetes insipidus. PMID- 3970082 TI - The genital tract in female children with imperforate anus. AB - A retrospective study was undertaken to determine the type and frequency of genital tract anomalies that occur in female children with imperforate anus. The functional outcome and optimal management of the genital tract anomalies were also studied. Primary vaginal anomalies occurred in 22 of 72 patients assessed, and uterine anomalies occurred in 18 of 51 patients assessed. For 17 patients, who were 13 years of age or older, information was available on genital tract function. Of these 17 patients, five had severe vaginal scarring. A previous vaginoplasty or cloacal abnormality was a predictor of poor vaginal function. It is suggested that vaginoplasty, in cases in which it is possible, be delayed until puberty. PMID- 3970083 TI - Fetal and neonatal effects of indomethacin used as a tocolytic agent. AB - beta-Mimetic agents are currently recommended for tocolysis. Serious adverse reactions including maternal death may complicate their use. Prostaglandin synthetase inhibitors are effective tocolytic agents. Reports of potential adverse effects have limited clinical use in North America. This study reports the perinatal outcome in 167 infants exposed to indomethacin used for tocolysis in gestations of less than 35 weeks. The rate of preterm delivery was 41.3% (69 of 167). No cases of premature closure of the ductus arteriosus or persistent fetal circulation were observed. The overall perinatal mortality was 17 per 1000 (1.7%). The results support the view of other uncontrolled reports that a short course of indomethacin used for tocolysis in gestations of less than 34 weeks is without deleterious effects on fetus or neonate. Its ease of administration and maternal safety offer advantages over beta-mimetic agents, and prospective comparisons of both should be undertaken. PMID- 3970084 TI - A prospective study of blood pressure in pregnancy: prediction of preeclampsia. AB - A prospective study of blood pressure recording was conducted in 1000 patients, at each antenatal visit, with the use of an automatic random-zero sphygmomanometer. In 46 patients, among 808 primigravid women, who developed preeclampsia, the diastolic and mean blood pressures were significantly elevated compared to values at the first antenatal visit (p less than 0.01, 9 to 12 weeks). This difference was sustained throughout pregnancy until delivery by at least 10 mm Hg as compared to pressures in the normotensive group. Sensitivity for predicting preeclampsia early in pregnancy with an elevated blood pressure measurement (130 to 135/80 to 85 mm Hg) ranged from 16% to 57% while specificity ranged from 75% to 98%. The results substantiate an early vasospasm (9 to 12 weeks) in those women destined to develop preeclampsia. PMID- 3970085 TI - Minibolus diazoxide in the management of severe hypertension in pregnancy. AB - Severe hypertension poses immediate and potentially lethal maternal risks. Prompt reduction in blood pressure should be an urgent priority, with concomitant anticonvulsant therapy. Previous reports confirm intravenous diazoxide to be an effective agent. Concern exists over adverse reactions associated with bolus injection of the standard 300 mg dose. Many physicians are unaware that diazoxide may be given in increments. This study describes the use of diazoxide in 34 patients with severe preeclampsia. They received minibolus injections of 30 mg every 1 to 2 minutes. The maximum dose required was 150 mg and no maternal hypotension occurred. Maternal side effects were minimal and no cases of fetal distress occurred; a perinatal mortality was zero. It appears that minibolus diazoxide rapidly lowers maternal blood pressure without the adverse effects described with a standard bolus dose. Its advantages are contrasted with the limitations of conventional hydralazine therapy. PMID- 3970086 TI - The treatment of grade 3 cervical intraepithelial neoplasia with cryotherapy: an 11-year experience. AB - The results of treatment of 453 patients with grade 3 cervical intraepithelial neoplasia by cryotherapy are presented. After excluding 31 patients who were lost to follow-up, the failure rate of primary treatment in the remaining 422 patients was 7.1% (30 patients). Outpatient re-treatment of those with persistent disease achieved an overall cure rate of 98%. Statistical analysis to determine prognostic significance with regard to persistent disease was carried out on the following variables: grade, size, and type of freeze. Type of freeze was the only variable to show statistical significance. Cryotherapy remains an effective outpatient modality for the treatment of grade 3 cervical neoplasia. A rigid protocol of patient selection and meticulous cryotherapy technique play a large role in obtaining the high cure rates reported in this study. PMID- 3970087 TI - Obstructive uropathy associated with endometriosis. AB - Although endometriosis involving the urinary tract is uncommon, it is responsible for considerable morbidity. A review of eight cases at two Ottawa teaching hospitals from 1979 to 1983 revealed obstructive uropathy in seven patients. There was permanent loss of kidney function in two, ovarian remnant syndrome in two, and patient and family history of renal disease in three. The diagnosis of endometriosis was not made before operation in four patients. Endometriosis was localized in four patients and generalized in the remaining four, while four patients had significant uterosacral nodularity. The conclusion reached after study of this small but important population is that physicians should have a heightened awareness of this uncommon but serious manifestation of the disease. Earlier diagnosis might be achieved on the basis of a high index of suspicion and careful physical and pelvic examination. The liberal use of intravenous pyelography even in cases of minimal endometriosis is urged. Intensive and prolonged follow-up of all patients with the diagnosis of endometriosis is recommended until the menopause has been reached. Treatment of obstructive uropathy requires meticulous surgical intervention and we recommend ovarian ablation with adjuvant hormonal therapy in most circumstances. PMID- 3970088 TI - A case report of primary adenocarcinoma of the fallopian tube. AB - The apparently smallest primary adenocarcinoma (2.3 mm in diameter) of the fallopian tube ever described was diagnosed by repeated blind sectioning of the surgical specimen after the preoperative finding of an abnormal cervical Papanicolaou smear and the subsequent finding of abnormal cells in fluid obtained by laparoscopic peritoneal lavage, although a survey of the patient for a primary cancer was negative. PMID- 3970089 TI - The changing concepts of condyloma. A retrospective study of colposcopically directed cervical biopsies. AB - Human papillomavirus has been implicated in the etiology of cervical intraepithelial neoplasia. A retrospective audit was conducted on all colposcopically directed biopsies performed from June through November, inclusive, in the years 1980 and 1982, a total of 317 cases. In 1980, the misdiagnosis rate for condyloma was 88.9% (69 of 78) and, in 1982, the misdiagnosis rate was reduced to 28.5% (40 of 140). On review, the association of cervical intraepithelial neoplasia with condyloma was 73% (107 of 146), p less than 0.005. The differences in mean ages of patients with condyloma alone, cervical intraepithelial neoplasia with condyloma, and cervical intraepithelial neoplasia alone were significant, p less than 0.02. When condyloma is not recognized, the pathologist tends to overdiagnose grade 3 cervical intraepithelial neoplasia as shown in 28 original cases; 16 of 28 (57.1%) were condyloma alone on review. Fifteen (53.6%) of these 28 patients underwent a cone biopsy or hysterectomy when a less radical procedure would have been acceptable. The morphologic changes indicating cervical condyloma were not fully appreciated by the pathologist, and this resulted in overdiagnosis and later overtreatment by the gynecologist. PMID- 3970090 TI - The epidemiology of urethral-vesical dysfunction in the female patient. AB - The specific purposes of this report are twofold: (1) to summarize the descriptive epidemiology of urethral-vesical dysfunction in a population of 1439 female patients referred for urodynamic evaluation of symptoms and (2) to analyze the association between demographic, clinical, and investigative data. On the basis of urodynamic studies, abnormalities were classified into four types: anatomic dysfunction, 60%; neuromuscular dysfunction, 20%; neuropathic dysfunction, 12%; and miscellaneous dysfunction, 8%. Analyses and cross tabulations of clinical data vis-a-vis investigative studies reveal poor correlation between subjective clinical data and urodynamic diagnoses. The clinical symptoms of urethral-vesical dysfunction in the female patient may be confusing and complex. Urodynamic evaluation of symptoms and clinical data is of value in the design of a rational therapeutic program for such patients. PMID- 3970091 TI - Angiographic arterial embolization in the management of postoperative vaginal hemorrhage. AB - Recently great success was achieved at the Toronto General Hospital in treating patients with postoperative vaginal hemorrhage by angiographic methods. A retrospective review was performed from 1975 to 1984 on eight patients treated by this technique for nine separate episodes of hemorrhage with a mean estimated blood loss in excess of 5000 ml. Success was achieved in seven episodes despite failure of various vaginal and abdominal approaches. One of the failures was due to previous bilateral hypogastric artery ligation that made the bleeding branch inaccessible to the angiography catheter. The other patient developed bleeding following cesarean section which did not respond to angiographic embolization due to faulty technique. Both of these patients were eventually cured by abdominal surgery. We feel that angiographic embolization is the procedure of choice in the management of postoperative vaginal hemorrhage when conservative management has failed or is inappropriate; it can be lifesaving when all other attempts to stop the hemorrhage have failed. PMID- 3970092 TI - Perinatal factors associated with death or handicap in very preterm infants. AB - That death or major developmental handicap is associated with prematurity and low birth weight is well recognized. The importance of other perinatal factors related to presentation and management, however, is far from certain. In an attempt to elucidate the importance of some of these factors, data from 383 live born infants delivered at 26 to 30 weeks' gestation were analyzed. All infants were born in a tertiary perinatal unit and long-term follow-up had been carried out on the survivors for at least 1 year. A group of 39 infants who died in the neonatal period and 34 infants with long-term handicap were compared with matched normal control infants. Perinatal factors related to outcome were analyzed and it was found that, while initial poor condition at birth was correlated with death, there were few predictors of subsequent handicap. More refined methods of both prenatal and neonatal assessment are required to define these factors. PMID- 3970093 TI - A prospective study of microbial infection in stillbirths and early neonatal death. AB - No morphologic cause of death was found in 67.8% of 33 perinatal deaths. The mothers had experienced a previous loss in 48% of cases. Inflammation occurred in 65.6% of the cases of perinatal death compared to 4% of a control group (p less than 0.001) and in 73.1% of organism-positive cases of perinatal death compared to 7.1% of organism-positive cases of the control group (p less than 0.001). Incidence of maternal fever or prolonged membrane rupture was not statistically significant. Bacteria were present in 33.3% of the cases of perinatal death (not significant), with more pathogenic strains occurring in this group (p = 0.0028); 75.0% had inflammation compared to 0% of the control group (not significant). Genital mycoplasmas were detected in 78.8% of cases of perinatal death compared to 32.3% of control cases (p less than 0.001). Positive cultures (p = 0.0142) and elevated antibody titers in the fetus or neonate (p = 0.00052) or in the mother (p = 0.0122) occurred significantly more often than in control cases. Inflammation occurred in 78.9% of mycoplasma cases (p = 0.00032); incidences of maternal fever and prolonged membrane rupture were not significantly different. In perinatal death cases 20% had evidence of viruses, and 3.2% had evidence of chlamydia. Evidence of mixed microorganisms occurred in 46% of cases of perinatal death. However, 78.6% (11 of 14) with only one organism had Ureaplasma urealyticum (33.3% overall). Of the Ureaplasma-positive cases, 72.7% had inflammation, 45.5% had fever, and only 18.2% had prolonged membrane rupture compared to 28.6%, 0%, and 16.6%, respectively, in a negative-microorganism group with perinatal deaths. Our observations strongly support the concept that infection is a major cause of perinatal death and that genital mycoplasmas play a significant role. PMID- 3970094 TI - Does dihydrotestosterone induce atresia in the hypophysectomized immature female rat treated with pregnant mare's serum gonadotropin? AB - This study was originally designed to test the hypothesis that the binding of luteinizing hormone in granulosa cells decreases with atresia. The hypophysectomized immature female rat that was primed with pregnant mare's serum gonadotropin and treated with dihydrotestosterone was used as a model for atresia. Histochemical analysis of acid phosphatase was used as a marker for atresia and topical autoradiography with iodine 125-labeled human chorionic gonadotropin for binding of luteinizing hormone. Histologically, there was no significant difference in atresia, acid phosphatase, or 125I-labeled human chorionic gonadotropin binding in antral follicles between control animals given pregnant mare's serum gonadotropin and animals treated with pregnant mare's serum gonadotropin and dihydrotestosterone. Assessment of the total follicular population, however, showed that dihydrotestosterone at dosages of 1 and 5 mg/kg resulted in decreases in atresia of 48% and 58%, respectively. Although these data disprove our hypothesis, they strongly suggest that dihydrotestosterone decreases follicular atresia by increasing the number of small preantral follicles. PMID- 3970095 TI - The distribution of accelerations of the human fetal heart rate at 38 to 40 weeks' gestational age. AB - In order to further understand the use of antepartum fetal heart rate monitoring we measured the distribution, in time, of two, three, or five fetal heart rate accelerations of greater than or equal to 15 bpm for greater than or equal to 15 seconds and of greater than or equal to 10 bpm for greater than or equal to 6 seconds in 12 healthy pregnant women at 38 to 40 weeks' gestation. The length of time necessary to measure 50% or 95% of intervals containing five accelerations would be substantially reduced by changing to a definition of two or three accelerations. However, an observation interval of at least 80 minutes is required to include the longest time interval of two, three, or five accelerations. These data may suggest new strategies for decreasing time and expense of fetal heart rate testing. PMID- 3970096 TI - Maternal death associated with sickle cell trait. AB - A case report is presented of a patient with sickle cell trait who died an abrupt intrapartum death precipitated by probable peripartal cardiomopathy and apparently aggravated by intravascular sickling. Notable autopsy findings included massive sicklemia in all organ systems. PMID- 3970097 TI - Trial of labor in the patient with a prior cesarean birth. AB - The increasing incidence of cesarean birth has become quite controversial. The practice of delivering virtually all women with a prior cesarean section by repeat cesarean section is open to debate. In a large institutional practice, with rapid availability of all support services, selective attempts to deliver women vaginally, after a prior cesarean section, is appealing. A prospective 1 year study on all patients with a prior cesarean delivery commenced July 1, 1982. There were 1209 patients, of whom 751 (62%) underwent a trial of labor and 614 (82%) achieved vaginal delivery. There was no maternal mortality or perinatal mortality attributed to the trial of labor process. Oxytocin usage occurred in 38% of this population. The incidence of uterine rupture and scar dehiscence was similar in the various study subgroups. The overall group of women undergoing a trial of labor had significantly fewer postpartum complications and shorter hospital stays. PMID- 3970098 TI - Current controversies in obstetrics: wrongful life and forced fetal surgical procedures. PMID- 3970099 TI - Nonstressed antepartum cardiotocography in patients undergoing elective cesarean section--fetal outcome. AB - In a prospective study of 409 patients monitored with nonstressed antepartum cardiotocography and delivered by elective cesarean section, cardiotocography was requested for 170 because of clinical indications. This group had higher incidences of abnormal cardiotocography (p less than 0.001), fetal growth retardation (p less than 0.001) and neonatal deaths (p less than 0.025) than had the group without such requests, suggesting that clinicians effectively selected the high-risk pregnancy for testing of fetal well-being. Cardiotocographic evidence of critical reserve was found in 17 of 170 patients (10%) tested for a clinical indication and in none of the 239 patients in the control group. Patients with abnormal cardiotocography results had significantly higher incidences of cord arterial blood pH less than 7.26 (p less than 0.05) and Apgar scores of less than 6 at 1 minute (p less than 0.001), showing that an abnormal cardiotocogram is indicative of a fetus at risk of having hypoxia. PMID- 3970100 TI - Fetal acidosis, 2-chloroprocaine, and epidural anesthesia for cesarean section. AB - Amide-linked local anesthetic agents, such as lidocaine and bupivacaine, can become "trapped" in their ionized forms on the fetal side of the placenta, and therefore their net transfer across the placenta is increased. An ester-linked local anesthetic agent, 2-chloroprocaine, is rapidly metabolized, and placental transfer is limited. Since the metabolism of 2-chloroprocaine by fetal plasma is slower than in maternal plasma, the potential for ion trapping exists. The purpose of this study was to determine the disposition of 2-chloroprocaine and its metabolite, chloroaminobenzoic acid, in relation to the umbilical cord vein pH at delivery, and specifically, to determine whether ion trapping exists. Epidural anesthesia with 2-chloroprocaine was administered to 44 women at term prior to cesarean section. At delivery the levels of 2-chloroprocaine and chloroaminobenzoic acid in maternal plasma and umbilical cord vein were quantitated. Neonates were divided into two groups based on the umbilical cord vein pH at delivery. Ten of the 44 patients delivered neonates with a pH less than or equal to 7.25 (acidotic group) while 34 delivered neonates with a pH greater than 7.25 (nonacidotic group). The mean umbilical cord vein pH in the acidotic and nonacidotic groups was 7.22 +/- 0.03 and 7.32 +/- 0.03, respectively (p less than 0.001). There were also no differences between the groups in maternal and neonatal clinical characteristics or in the total dose of 2 chloroprocaine administered or the drug-to-delivery interval. The pharmacologic results did not demonstrate a statistical difference in the concentration of 2 chloroprocaine or chloroaminobenzoic acid in the maternal vein or umbilical cord vein at delivery between the two groups. Thus the results of this study demonstrate that placental transfer of 2-chloroprocaine is not influenced by fetal acidosis. Therefore these data suggest that 2-chloroprocaine may be the drug of choice when fetal acidosis or distress is anticipated. PMID- 3970101 TI - Autonomic hyperreflexia: a mortal danger for spinal cord-damaged women in labor. AB - Reproductive care of women with spinal cord damage demands knowledge of such women's reproductive potential and the specific complications to which these women are prone during pregnancy and childbirth, especially autonomic hyperreflexia. Fertility in cord-damaged women of reproductive age is generally undiminished as are libido, ability to have intercourse, and ability to bear children. Frequent complications of cord-damaged pregnant women include urinary tract infection, anemia, pressure sores, sepsis, unattended birth, and autonomic hyperreflexia. Autonomic hyperreflexia or autonomic dysreflexia occurs during labor in up to two thirds of women with cord lesions above T-6. Autonomic hyperreflexia results from noxious stimuli including distention of the bladder, cervix, or rectum, which evokes mass triggering of sympathetic and parasympathetic afferents that are uninhibited by supraspinal centers below the cord lesion. Autonomic hyperreflexia manifests itself with sudden onset of marked hypertension and headache during uterine contractions, as well as bradycardia or tachycardia, various cardiac dysrhythmias, and marked diaphoresis with piloerection and flushing above the level of the cord lesion. We describe the second reported occurrence of intraventricular hemorrhage due to autonomic hyperreflexia during labor and detail recommendations for anticipating and mitigating this potentially lethal complication of parturition in cord-damaged women. Pregnancy and parturition are best carried out with informed cooperation of the patient and of obstetric, cord rehabilitation, anesthetic, and nursing personnel. PMID- 3970102 TI - Malformations and chromosome anomalies in spontaneously aborted fetuses with single umbilical artery. AB - Presence of a single umbilical artery was noted 13 times among a series of 879 consecutively collected, spontaneously aborted embryos and fetuses. This rate of 1.5% is approximately twice that reported from the largest series of term births. Eight of the 13 fetuses had additional serious malformations. Of nine successfully karyotyped fetuses, six had chromosome anomalies. All six occurred in fetuses with severe malformations in addition to the single umbilical artery. The presence of single umbilical artery with other major anatomic defects may be a significant predictor of the presence of chromosome anomalies in live births. Early recognition of offspring with chromosome anomalies will be useful in counseling the family and in managing the care of the infant. PMID- 3970103 TI - Evaluation of a new tampon device for cytologic autocollection and mass screening of cervical cancer and its precursors. AB - A new autocollection tampon device for obtaining material for cervical cytologic testing was compared with cervical scraping and endocervical aspiration in order to evaluate the cytodiagnostic results. In 1428 cases there proved to be a 94% correlation between these methods. In addition, both smears were compared in a group of patients known to have neoplastic disease of the cervix. In evaluating cervical cancer both techniques detected 100% of the cases. However, the smears, both regular and tampon, were able to diagnose only 96.5% and 89% of grade 3 lesions and 86% and 81% of grades 1 and 2 lesions, respectively. False negative results occurred in 8.2% of the regular smears and 15% of the tampon smear group. These preliminary data, if confirmed by more broad and in-depth studies, suggest the new autocollection tampon may be a useful tool for mass cervical screening. PMID- 3970104 TI - Combined morphologic and cytochemical grading of serous ovarian tumors. AB - The potentiality of DNA analysis to complement morphologic evaluation in classifying serous ovarian tumors as adenoma, borderline malignancy, or invasive adenocarcinoma was investigated in a series of 54 tumors. The DNA analyses were performed on histologic tumor sections. The primary diagnoses were borderline tumor in 24 cases and invasive adenocarcinoma in 30 (World Health Organization classification). When the specimens were reviewed, 17 of the 54 tumors were reclassified, after which the series consisted of 9 adenomas, 24 borderline tumors, and 21 invasive adenocarcinomas. Rising histologic malignancy grade was associated with increasing numbers of cells showing high DNA content. The DNA levels in the adenomas thus were within the diploid range of a normal cell population. They were somewhat higher in the borderline tumors and were highest in the invasive adenocarcinomas. Though no clear-cut intergroup demarcation was discernible, there was a subgroup of adenocarcinomas with greatly elevated DNA levels, indicating high biologic malignancy. The observations suggested that DNA analyses can complement histologic malignancy grading and can be useful for the recognition or highly malignant tumors among invasive adenocarcinomas. PMID- 3970105 TI - C-reactive protein in pregnancy and in the postpartum period. AB - Serum C-reactive protein levels were measured by means of the nephelometric immunoassay technique in 215 pregnant women at various gestational ages. The results indicate a positive correlation of serum C-reactive protein levels with gestational age. In addition, we studied serum C-reactive protein concentrations in 37 pregnant women in labor and during the postpartum period. Delivery was accomplished by either the vaginal or abdominal route and was associated with significant C-reactive protein production. PMID- 3970106 TI - Transient ventricular dysfunction associated with cesarean section in a patient with hyperthyroidism. AB - Pulmonary artery catheterization was performed prior to surgery in a severely hyperthyroid patient undergoing cesarean section. A transient but significant decline in left ventricular performance was observed in conjunction with the stress of operation. A parallel is suggested between this phenomenon and the documented exercise-induced reduction of left ventricular function in nonpregnant hyperthyroid patients. PMID- 3970107 TI - Increase in cervical extensibility during labor induced after isolation of the cervix from the uterus in pregnant ewes. AB - Surgical transection of the cervix was done on eight ewes in late pregnancy. This procedure resulted in most of the length of the cervix being mechanically disconnected from the uterus. Labor was induced by injection of dexamethasone phosphate into a fetal hind limb during operation in four of the eight ewes. The success of the induction of labor was confirmed by observation of increased uterine activity and by measurement of the concentrations of progesterone and 17 beta-estradiol in peripheral plasma. Ewes were put to death approximately 48 hours after injection of dexamethasone and the extensibility of the isolated portion of the cervix was determined. Cervices taken from ewes in which labor had been induced were found to have softened considerably compared to control cervices taken from ewes in which the cervix had been transected without induction of labor. The results suggest that cervical softening can still occur during labor in the absence of any direct mechanical or local vascular connection between the cervix and uterus. PMID- 3970108 TI - Human fetal breathing: associated changes in heart rate and beat-to-beat variability. AB - A computerized quantification of fetal heart rate and beat-to-beat variability was performed during and between fetal breathing episodes. Sixteen healthy pregnant women at term participated in the study. The results indicate that fetal breathing is associated with a significant increase in beat-to-beat variability (from 4.48 +/- 1.66 between breathing episodes to 5.80 +/- 2.04 during breathing episodes, p less than 0.01) and a small but significant decrease in fetal heart rate (from 142.7 +/- 8.6 bpm between breathing episodes to 140.4 +/- 8.6 bpm during breathing episodes, p less than 0.05). PMID- 3970109 TI - Disposition of meperidine and normeperidine following multiple doses during labor. I. Mother. AB - Normeperidine, the active meperidine metabolite, has been implicated in adverse neonatal effects that may occur following administration of meperidine to parturients. However, recent studies have suggested that normeperidine levels are not high enough to have adverse effects following single low doses of meperidine. It is not clear what occurs following multiple injections. Therefore the purpose of this study was to quantitate plasma levels of meperidine and normeperidine in the mother following multiple doses of meperidine over long time periods and to determine the half-life of normeperidine. Twelve mothers who received multiple intravenous doses of meperidine were studied. The results show that both meperidine and normeperidine accumulate in maternal plasma following multiple injections and that the half-life of normeperidine averages 20.6 hours. The data suggest that maximum exposure of the fetus to both meperidine and normeperidine would result from multiple doses to the mother because of a continued diffusion gradient from mother to fetus. PMID- 3970110 TI - Disposition of meperidine and normeperidine following multiple doses during labor. II. Fetus and neonate. AB - It has been suggested that continued diffusion gradients from mother to fetus would exist and that both meperidine and normeperidine would accumulate in the fetus following multiple doses of meperidine to the mother during labor. However, no pharmacokinetic data are available. Therefore, the purpose of this study was to document the disposition of meperidine and normeperidine in the fetus and neonate following multiple doses of meperidine to the mother over long time periods. Twelve infants were studied. The results show surprisingly high concentrations of both meperidine and normeperidine in fetal blood at delivery. In addition, the amount of normeperidine increased with time in umbilical cord blood, the ratio of normeperidine to meperidine increased with time, and the umbilical artery-to-vein ratio of meperidine (but not normeperidine) was greater than one following long drug-to-delivery intervals. The data also suggest that with long drug-to-delivery intervals the levels of normeperidine may become clinically important and that the elimination of both compounds by the neonate is prolonged. The study suggests that multiple doses to the mother over long time periods result in maximum accumulation of both meperidine and normeperidine in fetal tissues. PMID- 3970111 TI - The frustrations of chronic pelvic pain. PMID- 3970112 TI - False phosphatidylglycerol with Helena Fetal Tek 200 thin-layer chromatography method for fetal lung maturity. PMID- 3970113 TI - Ruptured corpus luteum with hemoperitoneum. PMID- 3970114 TI - Neuroretinal rim areas and visual field indices in glaucoma. AB - Magnification-corrected measurements of neuroretinal rim area of the optic disk were correlated to visual field indices calculated from 49 thresholds of Octopus program JO. The indices express overall reduction and localized disturbances of retinal sensitivity. The study was composed of 123 subjects, including 23 normal subjects, 49 patients suspected of having glaucoma, and 51 patients with glaucoma. The neuroretinal rim area was highly significantly correlated with both visual field indices; the index for overall loss of retinal sensitivity had a somewhat higher correlation coefficient than the index expressing localized visual field changes. Adequate fit of visual field data on rim area was achieved by quadratic regression. PMID- 3970115 TI - Degenerative retinoschisis with giant outer layer breaks and retinal detachment. AB - Five unusual cases of retinal detachment were caused by giant (more than 90 degrees) posterior breaks in the outer layer of degenerative retinoschisis. All retinas were successfully reattached by a variety of surgical techniques. The two cases managed with scleral buckling required subsequent buckle removal because of macular distortion. Treatment with cryotherapy or laser, together with intraocular air and postoperative positioning, gave better anatomic results. PMID- 3970116 TI - Treatment of corneal opacification in mucolipidosis IV with conjunctival transplantation. AB - Mucolipidosis IV is a rare, inherited metabolic storage disease producing progressive psychomotor retardation and congenital corneal clouding. Histopathologic studies have shown that the corneal epithelium is strikingly involved with intracytoplasmic vacuolated storage material with relative noninvolvement of the corneal stroma and endothelium. Additionally, it has been noted that epithelial removal results in corneal clarity. We treated a 28-month old patient with mucolipidosis IV with conjunctival transplantation with donor conjunctiva from an unaffected sibling. Improved corneal clarity resulted and has persisted with a follow-up of one year. PMID- 3970117 TI - Oculocerebrocutaneous syndrome. AB - A female infant was found at birth to have an oculocerebrocutaneous syndrome in which the main clinical features include orbital cyst, cerebral malformations, accessory skin tags, and focal hypoplasia or "punched-out" skin lesions. This case, like the four previously reported, was sporadic. PMID- 3970118 TI - Impact of referral bias on evaluation of cataract surgery. AB - Patients from a defined population (Olmsted County, Minnesota) who underwent cataract extraction during 1980 were compared with referral patients operated on at the Mayo Clinic to determine whether selective referral of patients introduces bias into studies conducted at academic centers. Rates of cataract extraction in Olmsted County increased continuously with increasing age and, in the older groups, were greater among females than males. The overall age- and sex-adjusted annual rate, 120 per 100,000 population, was considerably lower than that for 1980 in the United States, 209 per 100,000 population. A significantly greater proportion of referral patients had coexistent diabetes mellitus (P less than .05) and underwent other ophthalmic surgical procedures in combination with cataract extraction (P less than .001). Previous ophthalmic disorders were also more frequent among referral patients. Because selection for referral can distort data, this possible source of bias must be considered when interpreting data. PMID- 3970119 TI - Histopathologic correlative study of Kelman-style flexible anterior chamber intraocular lenses. AB - Three of 16 eyes in which Kelman flexible anterior chamber lenses were implanted were obtained for postmortem examination, and the lenses and globes were analyzed histopathologically. Thirteen additional lenses, removed surgically secondary to various complications, were studied by scanning electron microscopy. All of the lenses ere well finished and none showed evidence of degradation or cracking of the polymethylmethacrylate optics or foot plates. Some of the lenses showed deposition of inflammatory debris or erythrocytes, reflecting a clinical history of uveitis. In some cases, the problems seemed to be related to variations in surgical technique or improper sizing. PMID- 3970120 TI - Broken semiflexible intraocular lens implant. AB - The haptic of a semiflexible anterior chamber intraocular lens (Kelman Quadraflex) broke inside the eye of a 70-year-old man. No history of major eye or head trauma could be elicited from the patient. Clinical manifestations included inferior corneal edema progressing toward the optical axis resulting from a free floating haptic segment of the lens implant inside the anterior chamber. A significant decrease in endothelial density was documented over a short period of time. The surgical management of this case included removal of the free-floating haptic segment, removal of the lens implant, penetrating keratoplasty, and vitrectomy. Final visual acuity was 20/70. PMID- 3970121 TI - Cardiovascular effects of topical beta-blockers during exercise. AB - In two different medical centers, a total of 24 normal individuals (mean age, 31 years) participated in a double-masked, three-way crossover single-instillation comparison of betaxolol 1%, timolol 0.5%, and placebo. After each ocular treatment, cardiovascular characteristics were measured during ten-minute treadmill exercise periods. No significant differences in heart rate or double product (heart rate X systolic pressure) were seen between treatment with betaxolol and administration of placebo. However, when the same subjects were treated with timolol, they demonstrated significant (P less than .05) reductions in these values at various measurement times compared with placebo and betaxolol treatments. No significant differences in mean arterial pressure were detected after any of the treatments. PMID- 3970122 TI - Treatment of blepharospasm with botulinum toxin. AB - In 43 patients (81 eyes) with blepharospasm resistant to other forms of therapy, 149 outpatient injections of botulinum A toxin were given into the orbicularis oculi muscle. Subsequent follow-up periods ranged from ten to 210 days. Orbicularis oculi spasm, eyelid forced closure, and eyebrow spasm all decreased substantially over the first ten days following the initial injection. Patients with essential blepharospasm, hemifacial spasm, or previous surgery all responded in a similar fashion. This beneficial effect was transient, however, and additional treatment was required for sustained relief. Twenty-five patients received multiple injections with a mean interval of 65 days. Results of second and third injections were similar to the first in rapidity of onset and duration of effect. Complications were local, mild, and transient, and no systemic side effects were noted. PMID- 3970123 TI - Systemic absorption and cardiovascular effects of phenylephrine eyedrops. AB - We studied 24 patients undergoing vitreoretinal surgery to compare the systemic absorption and cardiovascular effects of 2.5% aqueous and 10% viscous ophthalmic solutions of phenylephrine hydrochloride. Plasma levels measured in patients receiving two drops of 10% viscous solution were consistently higher ten, 20, and 60 minutes after instillation (P less than .02). Although the mean systolic and diastolic blood pressure was generally higher with the 10% viscous solution, the difference was not statistically significant. Blood pressure was high in several isolated cases. Because maximum plasma levels are achieved within ten to 20 minutes after topical instillation, phenylephrine eyedrops should be administered under close observation so that if an adverse reaction occurs it can be readily treated. PMID- 3970124 TI - Relationship of senile macular degeneration to ocular pigmentation. AB - We prospectively evaluated 650 consecutive white patients with senile macular degeneration and compared them to a control group of 363 patients. Ocular pigmentation (iris color and fundus pigmentation) was recorded for each patient, as was hair color (as a child and young adult) and age at evaluation. Patients were from the New England states and Florida. Our most significant finding was that 494 patients with senile macular degeneration (76%) had light-colored irides compared with 145 of the controls (40%). Fundus pigmentation closely corresponded to iris pigmentation (P less than 0.01). Hair color was blond or light brown in 370 of the patients with senile macular degeneration (57%) and in 105 of the controls (29%). Further, there was a tendency for individuals with lightly pigmented irides to have senile macular degeneration at an earlier age than those with dark irides (P less than .01). Thus, increased ocular pigmentation tends to decrease the risk of developing senile macular degeneration. PMID- 3970126 TI - Xerophthalmia, the deadly disease. PMID- 3970125 TI - Silicone oil and its influence on electrophysiologic findings. AB - Twenty patients with complicated retinal detachments who were treated with scleral buckling procedures, vitrectomy, and temporary silicone oil filling underwent electrophysiologic tests before and after silicone oil removal. Electroretinographic responses were markedly low or even absent as long as the silicone oil was in the eye but a few days after silicone oil removal the electroretinographic amplitudes had increased in all 20 patients and did not change significantly thereafter. In 12 patients the basic level of the electrooculogram was low as long as the oil was in the eye but was at least twice the previous value in seven patients after oil removal. A light peak of more than 150% occurred in two patients before oil removal and in six after oil removal. PMID- 3970127 TI - Activation of ciliary body melanoma metastasis after abdominal surgery. PMID- 3970128 TI - A new silicone oil pump. PMID- 3970129 TI - Cyclosporine penetration into the anterior chamber and cerebrospinal fluid. PMID- 3970130 TI - An improved contact-lens holder for vitreous surgery. PMID- 3970131 TI - Corneal curvatures in premature infants. PMID- 3970132 TI - Allopurinol and cataracts. PMID- 3970133 TI - Immunologic basis for the pathogenesis of pterygium. PMID- 3970134 TI - Retinal degeneration in vitamin B12 disorder associated with methylmalonic aciduria and sulfur amino acid abnormalities. PMID- 3970135 TI - Episodic unilateral mydriasis and migraine. PMID- 3970136 TI - Endothelial regeneration. VII. Lack of intimal proliferation after defined injury to rat aorta. AB - Rat aortas were denuded of endothelium by the use of catheters, which removed either a zone 10-15 cells wide or a zone 90-120 cells wide. Each animal received 3H-thymidine at 1, 16, and 24 hours before death, and groups of 3 animals were killed at 2, 3, 4, and 7 days after the small injury or 4, 5, 7, 14, and 42 days after the large injury. Scanning electron microscopy showed that the smaller injury was rehealed with endothelium by approximately 72 hours, and the large injury was repopulated by endothelium after 7-8 days. In aortas subjected to the 10-15-cell-wide injury, no intimal thickening nor intimal smooth-muscle proliferation was observed. After the larger injury, no obvious intimal thickening was present, although a few intimal cells were observed at sites where the internal elastic lamella was discontinuous. No significant increase in smooth muscle-cell replication was detected in these aortas at any time after injury. PMID- 3970137 TI - The teratogenic effects of a bis(dichloroacetyl)diamine on hamster embryos. Aortic arch anomalies and the pathogenesis of the DiGeorge syndrome. AB - A study of the teratogenic effects of Fertilysin, a bis(dichloroacetyl)diamine, on hamster embryos was undertaken for a comparison of Fertilysin-induced malformations with the DiGeorge syndrome of human patients, a rare birth defect characterized by thymic and parathyroid gland agenesis, abnormal facies, and aortic arch malformations. In treated hamsters, malformations of the aortic arches were found to be consistently produced, and many of these anomalies could not be explained by conventional methods of analysis. A pathogenetic scheme to classify malformations of the aortic arch and great vessels is offered, including a revision of Celoria and Patton's classification of interrupted aortic arches. It is suggested that the DiGeorge syndrome is a syndrome of truncated pharyngeal arch development with two general forms: 1) agenesis of or incomplete development of the sixth pharyngeal arch with pulmonic circulation through the fifth arch; 2) agenesis of or incomplete development of the fifth and sixth pharyngeal arches with pulmonic circulation through the fourth arch. The third aortic arch may descend into the thorax under these circumstances. PMID- 3970138 TI - Phenotypic expression of Hodgkin's and Reed-Sternberg cells in Hodgkin's disease. AB - The phenotypic expression of Hodgkin's and Reed-Sternberg (H-RS) cells was determined by analysis with a panel of monoclonal antibodies and peanut agglutinin (PNA) by an immunohistochemical technique. Seven antibodies, including T200, anti-HLA-DR, anti-Leu 10, A1G3, anti-Tac, OKT9, and anti-Leu M1, were found to react with a great majority of H-RS cells. In some cases, H-RS cells also bound PNA. Other antibodies, including those highly specific for T cells (eg, Lyt 3) and B cells (eg, B1, anti-Leu 14) were consistently negative. The results argue against the derivation of H-RS cells from T or B lymphocytes. The H-RS cells were also negatively stained with antibodies which react with monocytes (OKM1, Mo-2, 63D-3), follicular dendritic cells (DRC-1), and natural killer/killer cells (Leu 7, Leu 11a, B73.1). The presence of Leu M1 and Tac in H RS cells is of interest. Anti-Leu M1 positivity was seen in all 20 of Hodgkin's disease (HD) cases tested and should provide a very useful reagent for differential diagnosis of HD from other reactive and neoplastic conditions. Tac normally is present only on activated T cells. The presence of Tac in H-RS cells may reflect expression of T-cell growth factor receptor or a closely related protein during a stage of neoplastic transformation. Although the nature of the neoplastic cell of HD cannot be determined by these studies, they are consistent with an origin from interdigitating reticulum cells. Both H-RS cells and interdigitating reticulum cells have a similar antigenic phenotype (Leu M1+, T200+, HLA-DR+, Leu 10+, A1G3+, and OKT9+) and a similar pattern of lysosomal enzyme activity. PMID- 3970139 TI - Liver glutathione depletion induced by bromobenzene, iodobenzene, and diethylmaleate poisoning and its relation to lipid peroxidation and necrosis. AB - The mechanisms of bromobenzene and iodobenzene hepatotoxicity in vivo were studied in mice. Both the intoxications caused a progressive decrease in hepatic glutathione content. In both instances liver necrosis was evident only when the hepatic glutathione depletion reached a threshold value (3.5-2.5 nmol/mg protein). The same threshold value was evident for the occurrence of lipid peroxidation. Similar results were obtained in a group of mice sacrificed 15-20 hours after the administration of diethylmaleate, a drug which is mainly conjugated with hepatic glutathione without previous metabolism. The correlation between lipid peroxidation and liver necrosis was much more significant than that between covalent binding and liver necrosis. This fact supports the view that lipid peroxidation is the major candidate for the liver cell death produced by bromobenzene intoxication. Moreover, a dissociation of liver necrosis from covalent binding was observed in experiments in which Trolox C (a lower homolog of vitamin E) was administered after bromobenzene poisoning. The treatment with Trolox C, in fact, almost completely prevented both liver necrosis and lipid peroxidation, while not changing at all the extent of the covalent binding of bromobenzene metabolites to liver protein. PMID- 3970140 TI - Immature sinus histiocytosis. Light- and electron-microscopic features, immunologic phenotype, and relationship with marginal zone lymphocytes. AB - The light-microscopic, ultrastructural, and immunohistochemical features of immature sinus histiocytosis were studied in 10 lymph nodes with the histologic picture of toxoplasmic lymphadenitis and compared with the features of lymphoid cells present in the marginal zone of the splenic white pulp. Areas of immature sinus histiocytosis consisted largely of medium-sized lymphoid cells with markedly irregular nuclei and abundant pale cytoplasm. Using a panel of monoclonal antibodies, the predominating lymphoid cells were found to carry the B cell phenotype B1+Ba1-sIgM+sIgD-OKIa1+. Admixed were variable numbers of larger, blastic lymphoid cells, small lymphocytes, histiocytic elements, and polymorphonuclear granulocytes. The marginal zone of the splenic white pulp was composed of a similar mixture of cells, and marginal-zone lymphocytes demonstrated an analogous immunohistochemical phenotype. Our results indicate that immature sinus histiocytes are B-lymphoid cells that are closely related to marginal zone lymphocytes. As such, immature sinus histiocytes may have a role similar to that of marginal-zone lymphocytes, which have been claimed to transport antigens or immune complexes toward the follicular center or to serve as precursors of plasma cells. We suggest that immature sinus histiocytosis represents an abnormal expansion of the marginal zone, normally present at the sinusoidal pole of lymphoid follicles. The reason for this marginal-zone hyperplasia, recognized as immature sinus histiocytosis in a variety of reactive lymph node conditions, may be a maturation arrest in the normal development of immature sinus histiocytes into small, sIgM+ sIgD+ lymphocytes. PMID- 3970141 TI - Ultrastructural features of Adriamycin-induced skeletal and cardiac muscle toxicity. AB - In this study, the authors examined the effect of the anti-tumor agent Adriamycin, a known cardiotoxin, on mouse heart, diaphragm, and gastrocnemius muscle. Using an established model of Adriamycin cardiac toxicity, they found that 4 days after the intraperitoneal injection of 20 mg/kg of Adriamycin, characteristic heart lesions, including vacuolation of the sarcoplasmic reticulum, interstitial edema, and mitochondrial degeneration, were demonstrated in all treated animals. Furthermore, similar, but much more severe, myocyte damage was demonstrated in the diaphragm; muscle toxicity followed a decreasing gradient of injury from the peritoneal to the thoracic surface of the tissue. On the other hand, treatment with Adriamycin resulted in an increase in the size and number of lipid droplets in the red fibers of the gastrocnemius muscle without any other ultrastructural evidence of drug-induced damage to myocytes. An examination of the pharmacokinetics and metabolism of Adriamycin after intraperitoneal treatment revealed that relative drug levels in muscle (diaphragm much greater than heart much greater than gastrocnemius) paralleled the degree of ultrastructural damage observed. This study indicates that treatment with Adriamycin can produce significant injury to non-cardiac muscle in a fashion that strongly resembles the characteristic pattern of Adriamycin-related damage to the heart, and that the degree of myocyte damage is apparently dependent upon the Adriamycin concentration in the tissue. PMID- 3970143 TI - Skeletal muscle injury and repair in marathon runners after competition. AB - Elevated serum creatine kinase MB isoenzyme (CK-MB) activity in marathon runners after competition may arise from injury to skeletal muscle, myocardium, or a combined tissue source. Normal radionuclide myocardial scintigraphy and the selective increase in skeletal muscle CK-MB reported in such runners strongly suggest a peripheral source. To understand this biochemical finding, the authors examined gastrocnemius muscles by electron microscopy from 40 male marathon runners at intervals after competition and from 12 male nonrunners. Muscle from runners showed post-race ultrastructural changes of focal fiber injury and repair: intra- and extracellular edema with endothelial injury; myofibrillar lysis, dilation and disruption of the T-tubule system, and focal mitochondrial degeneration without inflammatory infiltrate (1-3 days). The mitochondrial and myofibrillar damage showed progressive repair by 3-4 weeks. Late biopsies showed central nuclei and satellite cells characteristic of the regenerative response (8 12 weeks). Muscle from veteran runners showed intercellular collagen deposition suggestive of a fibrotic response to repetitive injury. Control tissue from nonrunners showed none of these findings. The sequential morphologic changes in runners suggest that the increase in skeletal muscle CK-MB is a marker of cellular regeneration. PMID- 3970144 TI - Group treatment of adolescents: an overview. AB - Four distinct but related categories of group intervention with adolescents are proposed as a means of reducing the confusion of terminology within the "group" field. Major theoretical and methodological issues in group treatment of adolescents are delineated. Stress is placed on the need for special training of practitioners and proper balancing of groups, along with a flexible approach aimed at fostering workable groups. PMID- 3970142 TI - Phenotypic and karyotypic changes induced in cultured rat hepatic epithelial cells that express the "oval" cell phenotype by exposure to N-methyl-N'-nitro-N nitrosoguanidine. AB - A diploid population of cultured rat hepatic epithelial cells that expresses the "oval" cell phenotype was exposed briefly and repetitively to N-methyl-N'-nitro-N nitrosoguanidine (MNNG), and the effect on more than 20 phenotypic properties was evaluated during the neoplastic transformation of the population. MNNG treatments of this hepatic epithelial cell population resulted in a progressively increasing phenotypic alteration and heterogeneity including changes in specific activities of several cellular enzymes and expression of isozymes, synthetic functions, and various in vitro growth properties. Changes in phenotypic expression were clustered episodically and were associated with major karyotypic changes. The development of increasing phenotypic heterogeneity preceding and accompanying tumorigenicity in cultured liver epithelial cells in vitro and the specific phenotypes that occur resemble superficially the pattern of phenotypic changes that occur in hepatocytes during chemical hepatocarcinogenesis in vivo. The results of this study provide the basis for future investigations to further elucidate the mechanistic and linkage relationship between specific pretumorigenic and paratumorigenic phenotypes and tumorigenicity. PMID- 3970145 TI - Impasses to the resolution of custody and visitation disputes. AB - This paper presents a typology of divorce situations that are highly vulnerable to intense and prolonged disputes over the custody and care of the children. The impasses to settling the conflicts are described and counseling/mediation implications outlined. The approach is based on a preliminary study of 80 divorcing and disputing families of multiethnic and mixed socioeconomic class that, despite mediation in the courts, were still entrenched in disputes. PMID- 3970146 TI - Assessment of families in psychiatric emergencies. AB - Families of patients coming to a psychiatric emergency service pose severe professional and emotional challenges. Interviewing the patient and family together has advantages for patient, family, and interviewer. The traditional emergency assessment is greatly enhanced by attention to the family perspective and to the broader social context. Such information effectively facilitates problem-solving and negotiation of disposition. The importance of the interviewer's mature, flexible functioning is emphasized. PMID- 3970147 TI - Hysteria in childhood: a note on Proctor's incidence figures 27 years later. AB - Confirmation of Proctor's 1958 estimate of high incidence of hysterical phenomena among a rural child psychiatric population is provided by recent observations on a small, random sample of children referred for psychological assessment in Australia. Demographic and other similarities between the two groups are discussed, and tentative directions for treatment are noted. PMID- 3970149 TI - Homelessness in America: myths and realities. PMID- 3970148 TI - Early home environment and retrospective recall: a test for concordance between siblings with and without psychiatric disorders. AB - Case control studies are a reasonably rapid and inexpensive method of developing causal hypotheses concerning the role of early environment on the development of psychiatric pathology. The current study tested an interview designed to assess early home environment on a group of patients with alcoholism or depression, on a control group free of psychiatric disorder, and on close-in-age siblings in each group. Findings demonstrated substantial agreement, suggesting that interviews requiring recall of childhood environment may be reasonably valid; patient status did not appear to influence agreement or, presumably, validity. PMID- 3970151 TI - Comparison of abusive and nonabusive families with conduct-disordered children. AB - This study set out to define the relative contribution of psychological, sociological, and parent-child interactional variables in 19 abusive and 21 nonabusive families with conduct disordered children. Low family income and mother's report of having been abused as a child were found to be the most potent variables discriminating abusive from nonabusive families. Implications of the study findings are considered. PMID- 3970150 TI - Social support in black, low-income, single-parent families: normative and dysfunctional patterns. AB - Structural and functional features of social networks and demographic variables were explored in a study of 50 clinic-referred and 76 nonclinic black, low income, single-parent families. Dysfunctional families evidenced asymmetrical reciprocity within network relationships and had more stressful home environments than did nonclinical families. It is suggested that diagnostic evaluation of these families should assess the level of meaningful support provided by the social network. PMID- 3970152 TI - The effects of self-help and psychotherapy intervention on child loss: the limits of recovery. AB - Results of a longitudinal study of the effects of bereaved parents' participation in a self-help group and in psychotherapy are presented. Active self-help group participants evidenced unique changes in attitudes about bereavement. Reasons for lack of differences in mental health, marital, and parental roles are discussed. PMID- 3970153 TI - School refusal: the heterogeneity of a concept. AB - Finer discrimination among school refusers may help clear the confusion surrounding the school refusal syndrome. This paper reviews two aspects of the literature-that dealing with etiological theories and that which explicitly addresses the heterogeneity of the school refusal concept. Variables that consistently emerge as potential discriminators among school refusers are identified, and an attempt is made to determine their interrelationships. PMID- 3970154 TI - A preventive intervention program for the newly separated: final evaluations. AB - Results of 30-month and four-year follow-ups of a six-month preventive program for people recently separated were even more favorable than the positive follow ups at six and 18 months. At 30 months, intervention group members scored significantly higher than control group members on dependent measures of adjustment, had significantly fewer separation-related problems, and reported significantly greater separation-related benefits. At four years, intervention group members continued to report significantly more satisfactory levels of adjustment and life quality, although the differences were not as great. Benefits did not all appear at the same time, or equally in men and women, and some benefits did not appear until well after the program ended. Data on marital status transitions during the four-year follow-up period are analyzed, and suggestions are offered for further enhancing program effectiveness. PMID- 3970155 TI - Effect of therapeutic ultrasound intensity on subcutaneous tissue temperature and ulnar nerve conduction velocity. AB - Twenty subjects completed 5 min. periods of sonation, at each of six US intensities, over the ulnar nerve in the proximal forearm. All posttreatment NCV's differed significantly from the respective pretreatment velocities. The immediate posttreatment NCV associated with placebo US was significantly (p less than 0.01) less than that observed immediately pretreatment (2.81 m/s), while the five clinical US intensities produced significantly increased immediate posttreatment velocities: 0.5 w/cm2 (2.23 m/s) at (p less than 0.05), and 1.0 w/cm2 (2.78 m/s), 1.5 w/cm2 (3.15 m/s), 2.0 w/cm2 (4.47 m/s) and 2.5 w/cm2 (2.97 m/s) at (p less than 0.01). The posttreatment velocities associated with the five clinical intensities were all significantly greater (p less than 0.01) than that associated with placebo US. Subcutaneous tissue temperatures were directly related to the intensity of US. Not until US intensity had reached 1.5 w/cm2 did the heating effect of US negate the cooling effect of the US transmission gel, to produce significantly increased subcutaneous tissue temperatures after 5 min. sonation. The decreased ulnar motor NCV's associated with placebo US are attributed to the cooling effect of the US transmission gel. The increased ulnar motor NCV's associated with the clinical intensities of US are attributed to the deep heating effect of US. The breakdown of this linear relationship at 2.5 w/cm2 intensity suggests that at this point heating on the nerve and/or the mechanical effects of US were of sufficient magnitude so as to limit the increase in conduction velocity. Sonation over an area of approximately 4.5 times the soundhead for 5 min., along the proximal forearm, at clinical intensities did not have a bipositive effect on motor NCV. PMID- 3970156 TI - Short latency somatosensory evoked potentials during active hand movements. AB - This study was designed to investigate the effect of active movement on spinal and cortical evoked responses. During voluntary hand movements the cervical and cortical short latency somatosensory evoked potentials (SEP) elicited by stimulation of the median nerve at the wrist were studied in nine healthy subjects. The latencies of the SEPs were not affected by active movements whereas the peak to peak amplitudes of the main cervical (N13-P15) and the main cortical (N20-P25) deflections were significantly reduced. The cortical subcomponents (N16 and N17), probably reflecting thalamic and thalamocortical activity, were not significantly affected by movements. The amplitude reductions in the cervical and cortical recordings might be related to proprioceptive feedback from the muscle afferents. PMID- 3970157 TI - Orthodromic sensory nerve conduction of the medial and lateral plantar nerves. A standardization. AB - A standardized method of obtaining orthodromic distal sensory latencies of the medial and lateral plantar nerves is presented. Forty-one normal volunteer subjects were tested. Stimulation is carried out on the plantar aspect of the base of each toe using ring electrodes. Surface recording electrodes are placed posterior to the medial malleolus over the tarsal tunnel at points measuring 14, 16, 18 and 20 centimeters from the dorsum of the base of the great toe. Sixty four evoked responses were averaged utilizing an electronic averaging technique and temperature was maintained at 31 degrees centigrade. Mean and standard deviation values of the distal sensory latency are reported for each toe. The reliability and ease in performance of these conduction studies will make them necessary and useful aids in the electrodiagnostic evaluation of tarsal tunnel syndrome, peripheral neuropathies and other local neuropathic conditions. Case studies are presented demonstrating the usefulness of this testing. PMID- 3970158 TI - Effects of dietary potassium depletion and mineralocorticoid excess on renal Cl conservation in the dog. AB - Preexisting dietary K+ depletion (KD) in dogs exaggerates the renal acid excretory response to mineralocorticoid hormone (MCH) and attenuates the renal Cl reabsorptive response without altering the Na+ reabsorptive response. The exaggerated acid excretory response has been postulated to be an electrophysiological consequence of a defect in renal Cl- reabsorption caused by KD. To investigate the specific effects of KD on renal Cl- transport in dogs, we assessed renal Cl- conservation during dietary Cl- restriction in KD adrenalectomized dogs maintained on physiological replacement doses of MCH. After a 16-day period of dietary K+ restriction and physiological MCH replacement, reduction of dietary NaCl from 5.0 to 0.25 mmol X kg-1 X 24 h-1 was attended by reduction in urinary Cl- excretion to values less than intake and to significantly lower values than in K+ -replete controls. In a subsequent experimental period of continued Cl- restriction and administration of DOC (15 mg/24 h, i.m.), urinary Cl- excretion decreased further in both groups to stable values, but the values were significantly greater in KD (2.7 +/- 0.4 vs. 1.1 +/- 0.1 meq/24 h, P less than 0.05) and the cumulative retention of urinary Cl- was significantly less (10.3 +/- 1.4 vs. 29.5 +/- 6.7 meq, P less than 0.05). These findings demonstrate that preexisting dietary KD accelerates chronic renal Cl- conservation in response to dietary Cl- restriction under conditions in which MCH supply is normal and fixed but that it impairs maximal renal Cl- -conserving ability in response to MCH excess. PMID- 3970159 TI - Load dependence of HCO3 and H2O reabsorption in the early proximal tubule of the Munich-Wistar rat. AB - Studies were undertaken in Munich-Wistar rats to evaluate the influence of variations in the filtered load of bicarbonate (FLHCO3) and water [single nephron glomerular filtration rate (SNGFR)] on the pattern of reabsorption along the accessible proximal tubule. SNGFR and FLHCO3 were varied by examining animals under conditions of hydropenia, plasma and extracellular volume expansion (VE), and VE plus aortic constriction. Water and HCO-3 reabsorption rates were measured at intervals along the proximal tubule, from very early segments to late segments, and these values compared with previous measurements in euvolemic rats. The earliest accessible portion of the proximal tubule reabsorbed HCO3 and water avidly; 40-55% of FLHCO3 and 18-20% of SNGFR were reabsorbed within the first millimeter. Moreover, when FLHCO3 was increased to as high as 2,400 pmol/min, HCO3 reabsorption rate in the first millimeter of the tubule increased concomitantly, reaching values as high as 1,000 pmol X mm-1 X min-1. In a similar fashion, water reabsorption in the first millimeter increased in direct relation to increases in SNGFR, reaching values as high as 13 nl X mm-1 X min-1 at SNGFR values of 70 nl/min. These results indicate that the early proximal tubule has much higher HCO3 and water reabsorptive rates and a stronger load dependence than has been found in later segments of the proximal tubule. The early proximal tubule thus appears to play a critical role in the maintenance of glomerulotubular balance. PMID- 3970161 TI - Effect of magnesium loading on magnesium delivery to the juxtamedullary end descending limb. AB - Previous micropuncture and microperfusion studies in acutely hypermagnesemic rats have yielded conflicting results with respect to magnesium transport in Henle's loop. The following experiments were performed to reexamine, by micropuncture of papillary end-descending limb, whether magnesium undergoes intratubular secretion in magnesium-loaded rats. Group 1 animals served as normal controls; group 2 animals received an acute intravenous magnesium load; group 3 animals were orally magnesium loaded for 3 wk before receiving an acute intravenous magnesium load during micropuncture; group 4 animals were acutely thyroparathyroidectomized and water loaded before receiving an acute magnesium load. Fractional magnesium delivery to the end-descending limb did not differ from the corresponding value observed in the superficial proximal tubule in normal animals (67 +/- 5.3 vs. 76 +/- 7.6%). Acute magnesium loading raised plasma magnesium concentration and fractional magnesium excretion more than twofold but did not change fractional magnesium delivery to the end-descending limb or superficial nephron significantly from control values (75 and 73%). Chronic oral magnesium loading raised daily urinary magnesium excretion threefold (183 vs. 53 mumol X day-1 X 100 g body wt-1, P less than 0.05), but acute magnesium loading in this group did not significantly alter fractional delivery to the end-descending limb (85 +/- 10%, NS). Increasing intratubular flow rate while acutely raising plasma magnesium concentration (group 4) also did not induce intratubular magnesium secretion. The absence of significant changes in fractional magnesium delivery to the end-descending limb during magnesium loading suggests that intratubular magnesium secretion, if at all present, is very small and of questionable significance. PMID- 3970160 TI - Adaptation of phosphate transport in phosphate-deprived LLC-PK1 cells. AB - Sodium-dependent transport of phosphate was studied in LLC-PK1 cells that had been deprived of phosphate (Pi). Compared with control cells (fed with 2 mM Pi) a twofold increase in the rate of Na-Pi cotransport was observed in cells incubated for 15 h in a phosphate-free medium, whereas transport of L-alanine and the specific activity of alkaline phosphatase were not changed. The same adaptive response was observed with apical membrane vesicles isolated from Pi-deprived cells. In both experimental systems Pi deprivation caused a change in the Vmax but not in the apparent Km (for Pi) of the cotransport system. Adaptation of the Na-Pi cotransport was triggered by free phosphate concentrations between 0 and 100 microM. Over the first 20 h the adaptive response was found to be a linear process that could be prevented by 70 microM cycloheximide. Adapted cells that were re-treated with phosphate showed a rapid (less than 3 h) decrease in the Na Pi transport. The data suggest that LLC-PK1 cells adapt to low Pi conditions by increasing the rate of the Na-Pi cotransport, which is located in the apical membrane. Two mechanisms may be involved in the adaptive response: a long-term process involving new protein synthesis, and a short-term response involving activation-inactivation of transport systems already existing. PMID- 3970162 TI - Renal nerve activity in conscious rats during volume expansion and depletion. AB - The role of renal nerve activity (RNA) in the renal response to isotonic saline volume expansion and furosemide-induced volume depletion was studied in conscious rats consuming a low (LNa), normal (NNa), or high (HNa) dietary sodium intake. In the control state, right atrial pressure (RAP) and UNa V were directly related and RNA was inversely related to dietary sodium intake, being 12.9 +/- 0.7, 10.9 +/- 1.1 and 8.7 +/- 0.6 units in LNa, NNa, and HNa rats, respectively. During volume expansion, RAP and UNa V increased and RNA decreased in all three dietary groups; however, the peak increase in UNa V was greater in the LNa (88 +/- 6 mueq/min) than NNa (34 +/- 9 mueq/min) or HNa (32 +/- 6 mueq/min) rats. The greater natriuresis in LNa was associated with a larger decrease in RNA in LNa ( 6.1 +/- 0.5 units) than in NNa (-3.4 +/- 0.4 units). The greater contribution of inhibition of RNA to the increased natriuretic response to volume expansion in LNa compared with NNa rats was further examined in renal denervated animals. Bilateral renal denervation substantially reduced the natriuretic response to volume expansion in LNa rats (-70%) but had no significant effect in NNa rats ( 15%). During volume depletion, RAP decreased, whereas UNa V and RNA increased in all three dietary groups. After the peak of the furosemide natriuresis, UNa V was lower in the LNa rats than in the NNa or HNa rats at any level of increased RNA, consistent with a role for the renal nerves in the normal renal adaptive response to sodium/volume depletion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970164 TI - Aldosterone-stimulated transmethylations are linked to sodium transport. AB - The effect of aldosterone (Aldo) on phospholipid (PL) biosynthesis in cultured toad bladder epithelial cells was studied in cells incubated with [1,2 14C]choline and [methyl-3H]methionine over a 5-h period. Aldo (10(-7) M) did not alter the uptake of either precursor but significantly stimulated the incorporation of both labels into phosphatidylcholine (PC), the only PL labeled. 3H labeling of PC increased 29% and 14C incorporation into PC increased 34% in cells exposed to Aldo. A similar 30% increase in protein carboxymethylation occurred in cells treated with Aldo. 3-Deazaadenosine (DZA), a methylation inhibitor, abolished the Aldo-stimulated increase in PC labeling from [3H]methionine. PC labeling from [1,2-14C]choline was not affected by DZA. Basal and Aldo-stimulated protein carboxy-methylation were inhibited by DZA. DZA (300 microM) caused a mild decrease in basal short-circuit current (ISC) but completely inhibited the ISC response to 10(-7) M Aldo. Inhibition was complete when DZA was added up to 2 h following exposure to Aldo, and was reversible. Cells previously exposed to Aldo showed a significant increase in ISC within 2 h following removal of DZA. We conclude that Aldo stimulates PL methylation, protein carboxymethylation, and turnover of PC from choline. Inhibition of methylation reactions coincides with the inhibition of ISC response to Aldo. PMID- 3970163 TI - Physiological and morphological responses of the rat kidney to reduced dietary protein. AB - Renal physiological and morphological adjustments to a reduced protein diet were studied in young Munich-Wistar rats. Two groups of animals were used for the correlative physiological-morphological studies: normal protein (NP, 24% dietary protein) rats and reduced protein (LP, 8% dietary protein) rats. Both groups were fed their respective diets for 4-5 wk and had free access to drinking water. Physiological measurements of GFR and urea clearance were made on five animals from each group. These data showed that the changes in renal function specifically and almost exclusively affected the handling of urea. There was no difference in GFR between the NP and LP rats. Urea clearance was substantially reduced in LP rats. Morphological analyses were made on perfusion-fixed kidneys of five animals from each group. Selected slices were examined and photographed by light and electron microscopy. These data showed no difference in size and number of elements within the vascular bundles but showed significantly smaller lumina of the thin limbs of the short-looped nephrons and a significant thinning of the wall of the thin descending limbs of the long-looped nephrons. These morphological changes may in part be responsible for the observed physiological adjustments to a reduced protein diet. An additional group of rats (6 NP and 5 LP, all dehydrated) were analyzed for distribution of solutes within the inner medulla. The data showed that the concentration of urea, but not that of Na+, was reduced at the papillary tip in LP rats. PMID- 3970165 TI - Crystal accumulation and very high short-circuit currents in rabbit urinary bladder. AB - We describe a condition in rabbits characterized by CaCO3 crystal accumulation and very high short-circuit current (Isc) in the urinary bladder. The incidence of the condition was high in rabbits kept for 2 mo or more in the vivarium. The crystal mass in the bladder increased with age or time until it occupied up to one-third of the bladder volume and occasionally aggregated as stones, and the urine attained a sludgy consistency. In animals with sludgy urine, the urine excreted had a crystal content 20 times lower than that of urine contained in the bladder at time of death, implying retention of crystals in the bladder. Kidney stones were not detected in rabbits with bladder crystals, and bladder crystals were absent in rabbits with kidney stones induced experimentally by uremia. In old rabbits with sludgy urine the Isc, a measure of Na+ transport, was up to 46 microA/cm2 and averaged 12 microA/cm2, seven times the Isc of rabbits with nonsludgy urine. The increased Isc was entirely amiloride sensitive. Noise analysis showed it to arise entirely from increased channel density, without change in single-channel current. With one possible exception, we could not find bacterial infection or abnormalities in plasma aldosterone, GFR, or urinary [Na+], [Ca2+], pH, or osmolality that could explain the condition. The exception is that some unidentified component accounting for half the osmolality of nonsludgy urine is absent or at low concentration in sludgy urine. It remains unknown why the condition develops and whether CaCO3 crystals cause high Isc or vice versa or whether both result from a third factor. PMID- 3970166 TI - Prostaglandins in the sodium excretory response to altered renal arterial pressure in dogs. AB - Acute variations in renal arterial pressure are associated with corresponding alterations in absolute and fractional sodium excretion even under conditions of highly efficient autoregulation of renal blood flow (RBF) and glomerular filtration rate (GFR). Since prostaglandins recently have been implicated in the regulation of sodium excretion, we investigated the hypothesis that the renal prostaglandin system participates in "pressure natriuresis." Anesthetized sodium replete dogs were subjected to partial carotid artery constriction to elevate systemic arterial pressure. Under these control conditions, sodium excretion was 103 +/- 18 mueq/min (n = 17) and urinary prostaglandin E2 excretion averaged 4.6 +/- 1.5 ng/min (n = 8). Decreases in renal arterial pressure within the auto regulatory range reduced sodium excretion (2.1%/mmHg) and prostaglandin E2 excretion (1.7%/mmHg), whereas GFR and RBF were not affected. There was a significant correlation between the changes in sodium and prostaglandin E2 excretion rates (r = 0.932, P less than 0.01). In nine dogs treated with indomethacin, sodium excretion was reduced by 70% while GFR and autoregulatory capability were unaffected. There was a marked attenuation of the effect of changes in arterial pressure on sodium excretion, with this parameter exhibiting changes averaging 0.6%/mmHg (P less than 0.001). These observations suggest that the renal prostaglandin system may exert an important influence on the pressure natriuresis mechanism. PMID- 3970167 TI - Adenosine antagonist aminophylline attenuates pacing-induced coronary functional hyperemia. AB - The role of adenosine in pacing-induced hyperemia was examined in 10 dogs. Left coronary blood flow (LCBF), left ventricular O2 extraction [(a-v)O2], and myocardial O2 consumption (MVO2) were monitored. Heart rate (HR) was initially paced at 120 beats/min and then increased to 180 beats/min to elicit a hyperemic response (delta LCBF). During the hyperemia, the vasodilatory response to exogenous adenosine (FAd) was tested. HR was then returned to the initial level, and 20 min after injection of aminophylline (100 mg iv) HR was again increased to 180 beats/min. The response to adenosine was again tested. The pacing-induced increase in MVO2 (delta MVO2) was not affected by aminophylline (P greater than 0.05). However, after aminophylline, the flow response slope delta LCBF/delta MVO2 was decreased by about 20% (P less than 0.05), and the extraction-response slope delta (a-v)O2/delta MVO2 was increased by 100% (P less than 0.05). FAd was also decreased by aminophylline, and the magnitude of the reduction was correlated with the decrease in the flow-response slope (r = 0.82). These results suggest that endogenous adenosine may play an important role in coronary functional hyperemia induced by increases in heart rate. PMID- 3970168 TI - Cellular Ca2+ monitored by aequorin in adenosine-mediated smooth muscle relaxation. AB - We studied the effect of adenosine on cytoplasmic ionized calcium-force relationships in vascular smooth muscle (VSM) and determined the dose dependence of the observed effects. The bioluminescent protein aequorin was used as an index of cytoplasmic ionized calcium and was chemically loaded into ferret portal vein strips. The VSM strips were contracted with 33 mM potassium (K+), 5 X 10(-6) M phenylephrine (PE), or electrical stimulation. Force and aequorin light, i.e., cytoplasmic ionized calcium, were simultaneously recorded. Adenosine pretreatment (3.7 X 10(-6) M) reduced both force and light responses in contractures with K+, PE, or electrical stimulation. In contrast, the addition of adenosine during PE or K+ contractions decreased force without a change in light. Dose-response curves for the effects of adenosine on K+ contractures indicated that at low doses adenosine decreases force and cytoplasmic ionized calcium but that at high concentrations (greater than 3.7 X 10(-6) M) adenosine increases light and apparently relaxes VSM by desensitizing the myofilaments to cytoplasmic ionized calcium. PMID- 3970170 TI - Aortic bulb-aortic orifice hemodynamics in left ventricle-systemic arterial interaction. AB - Experiments were conducted in open-chest dogs in which ascending aortic blood flow (Q) was measured with an electromagnetic flow probe, and pressure was measured in the left ventricle (LV) and ascending aorta. The aorta just distal to the flow probe was occluded suddenly, causing the aortic bulb (AB) to be the only part of the arterial system to be in communication with the LV during clamped beats. Pressure and flow data from preocclusion, occlusion, and occlusion-release periods were analyzed to assess AB compliance (CAB) and the longitudinal impedance properties of inertance (LVO) and resistance (RVO) in the AB-aortic orifice region. In five dogs (avg wt 24.2 kg), the mean and range of values were as follows: CAB = 45 (31-55) X 10(-4) cm5/dyn; LVO = 1.86 (0.76-2.88) dyn X s2 X cm-5, RVO = 4.07 (0.66-8.55) dyn X s X cm-5. The volume-accommodating actions of CAB caused actual LV outflow to be characteristically different from Q and aortic clamped beats to be nonisovolumic. Actions of the AB were found to be important in the estimation of arterial characteristic impedance as a component of LV afterload and in the estimation of the LV pump properties of time-varying elastance and internal resistance. PMID- 3970169 TI - Regional blood flow and O2 transport during hypoxic and CO hypoxia in neonatal and adult sheep. AB - We compared regional blood flow in unanesthetized newborn lambs with that in adult sheep during acute, isocapnic hypoxic hypoxia [HH, 40-50% reduction of arterial O2 content (CaO2)]. The HH response in lambs and adults was qualitatively similar in heart, brain, and skeletal muscle, where flow increased; and in spleen, where it decreased. The response differed in skin and kidney, where flow decreased in lambs and was unchanged in adults, and in small intestine, where it was unchanged in lambs and increased in adults. Thus vasoconstriction during HH was less prominent in skin, kidney, and small intestine in adults. However, the trend toward lesser vasoconstriction in the adult cannot be attributed to a diminishing carotid chemoreflex and/or a more prominent vasodilatory lung inflation reflex because the same trend occurred during carbon monoxide hypoxia (COH). COH reduces CaO2 but stimulates neither the carotid chemoreflex nor, since hyperpnea is absent, the lung inflation reflex. Within each age group the responses to COH and HH were qualitatively the same. These data therefore provide no evidence for an active carotid chemoreflex in unanesthetized postnatal sheep. This is either because the peripheral circulatory effect of the chemoreflex is suppressed by the lung inflation reflex or, less likely, because the chemoreflex does not operate in the sheep at this level of HH. PMID- 3970171 TI - Charged amphiphiles regulate heart contractility and sarcolemma-Ca2+ interactions. AB - We have used charged amphiphiles as phospholipid analogues to modulate the interaction of Ca2+ with myocardial sarcolemma. The amphiphiles were dodecyl sulfate, dodecyltrimethylamine, and lauryl acetate; these are anionic, cationic, and neutral molecules, respectively. The hydrophobic alkyl chain is identical in each case; only the hydrophilic head group is varied. The anionic dodecyl sulfate (50-100 microM) augmented the Ca2+ binding and Na+-Ca2+ exchange activity of sarcolemmal vesicles by approximately 80% and increases the contractility of rabbit papillary muscle. Both developed force and its derivative were increased by approximately 100% with no increase in rest tension. Cationic dodecyltrimethylamine (20-100 microM) produced nearly opposite effects. Neutral lauryl acetate (100 microM) had little apparent effect on any measurement. The charged amphiphiles should be useful tools for further elucidation of excitation contraction coupling processes in a variety of contractile tissues. PMID- 3970172 TI - Assessment of autonomic function in humans by heart rate spectral analysis. AB - Spectral analysis of spontaneous heart rate fluctuations were assessed by use of autonomic blocking agents and changes in posture. Low-frequency fluctuations (below 0.12 Hz) in the supine position are mediated entirely by the parasympathetic nervous system. On standing, the low-frequency fluctuations increase and are jointly mediated by the sympathetic and parasympathetic nervous systems. High-frequency fluctuations, at the respiratory frequency, are decreased by standing and are mediated solely by the parasympathetic system. Heart rate spectral analysis is a powerful noninvasive tool for quantifying autonomic nervous system activity. PMID- 3970173 TI - Oxygen dependence of energy metabolism in contracting and recovering rat skeletal muscle. AB - The relationship between the oxygen supply and the energy metabolism in perfused rat hindlimb muscles was evaluated both during contractions and during recovery from contractions. The 31P-nuclear magnetic resonance (NMR) technique and conventional biochemical methods were used. Significant correlations were found between the oxygen delivery and the oxygen consumption, lactate release and glucose uptake, respectively. An increased degree of fatigue was observed at the lower oxygen deliveries. In both the soleus and gastrocnemius muscles the oxygen delivery correlated with the intramuscular concentrations of phosphocreatine, lactate, and glycogen. The 31P-NMR experiments showed a correlation between the oxygen delivery and the steady-state level of the phosphocreatine-to-inorganic phosphate (PCr+Pi) ratio during the contraction period. The rate of recovery in PCr/Pi after the contractions was also dependent on the oxygen delivery. The results demonstrate a causal relationship between the oxygen supply and the energy state in contracting as well as recovering skeletal muscles. PMID- 3970174 TI - Reflexes fail to reduce pressor activity of vasopressin in spontaneous hypertension. AB - Pressor responses and heart rate responses were recorded in spontaneously hypertensive rats (SHR) and in Wistar-Kyoto (WKY) rats during intravenous infusions of arginine vasopressin and phenylephrine under two experimental situations, first when cardiovascular reflexes were impaired by pretreatment with a ganglionic blocking agent (pentolinium) and second, when reflexes remained intact. In rats with ganglia blocked, pressor responses of SHR to vasopressin or to phenylephrine were similar to those of WKY rats. In rats with intact reflexes, pressor responses of SHR to phenylephrine were also similar to those of WKY rats but, in contrast, pressor responses of SHR to vasopressin were enhanced. Heart rate fell much more for any given elevation of blood pressure in WKY rats than in SHR during infusions of vasopressin and phenylephrine, and the bradycardia associated with these pressor agents was largely abolished by pentolinium. The results are consistent with the hypothesis that baroreflexes buffer the pressor activity of vasopressin in the normotensive WKY rat and that an impairment of baroreflex activity in SHR contributes to the enhanced pressor activity of vasopressin in these rats. PMID- 3970175 TI - Effects of ouabain, low K+, and aldosterone on hypoxic pressor reactivity of rat lungs. AB - It can be postulated that inhibition of lung tissue Na+-K+-ATPase might potentiate hypoxic pulmonary vasoconstriction by depolarizing some excitable cell or, in contrast, that it might blunt the hypoxic response by reducing cellular metabolic rate and sensitivity to hypoxia. Thus the purpose of this study was to test in isolated rat lungs whether hypoxic pressor reactivity was related inversely or positively to Na+-K+-ATPase activity. Dose-pressor response curves to hypoxia, angiotensin II, or KCl were measured under control conditions and after exposure either to one of two inhibitors of Na+-K+-ATPase, ouabain, and low K+ solution or to a stimulator of Na+-K+ pumping, aldosterone. Ouabain and low K+ depressed the response to hypoxia but had little effect on that to angiotensin II. The response to KCl was increased by ouabain. Aldosterone potentiated the hypoxic response. These results do not support the idea that membrane depolarization due to inhibition Na+-K+ pumping is a component of hypoxic vasoconstriction. They do suggest a positive relationship between Na+-K+-ATPase activity and hypoxic pressor reactivity and are consistent with the idea that Na+ K+-ATPase activity might influence hypoxic reactivity indirectly by altering cellular energy metabolism. It is also possible that the results were somehow due to changes in intracellular [Na+] or transmembrane Na+ gradient, rather than to changes in energy metabolism. PMID- 3970176 TI - Selective parasympathectomy of automatic and conductile tissues of the canine heart. AB - From right thoracotomy (T4-T5), the canine heart was suspended in its pericardium to expose its major venous inputs. Vagal and sympathetic trunks were prepared for electrical stimulation (10-20 Hz, 5.0 ms, 3-5 V) before and after each separate denervation procedure. Vagal stimulation was instituted with and without concurrent atrial pacing. The following surgical interventions were performed. 1) The superior vena cava was cleared of connective and nervous tissues from the pericardial reflection caudally to the level of the right pulmonary artery. 2) The azygos vein was cleared, tied, and sectioned. 3) The right pulmonary veins were isolated and cleared intrapericardially. 4) The dorsal surface of the atria was dissected between the right and left pulmonary veins and painted with phenol. Each step in the procedure elicited successive stepwise deletion of parasympathetic influences on sinoatrial tissues of the canine heart with only minor ablation of sympathetic inputs. 5) Dissection of the triangular fat pad at the junction of the inferior vena cava and inferior left atrium eliminated the remaining parasympathetic efferent input to the heart with dramatic deletion of atrioventricular block during either left or right vagal stimulation, again with preservation of most of the sympathetic innervation. These experiments clearly demonstrate differential and selective inputs of parasympathetic pathways to sinoatrial (SAN) and atrioventricular (AVN) regions of the dog heart but relatively little interference with sympathetic distributions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970177 TI - Circulatory effects of splanchnic nerve stimulation in developing swine. AB - The relative maturity of immediate intestinal circulatory responses to efferent splanchnic nerve stimulation for 20 s was tested in 34 piglets (1 day-1 mo old) under pentobarbital anesthesia (15-30 mg/kg). Aortic pressure, heart rate, and superior mesenteric arterial flow (measured by electromagnetic flow transducers) were recorded simultaneously. Intestinal vascular resistance was calculated as mean aortic pressure/mean arterial flow. Resistance increased in most animals during experimental inhibition of the carotid sinus baroreceptor reflex. Transection of the splanchnic nerve decreased mesenteric resistance in all animals. Nerve stimulation at 2 Hz was not effective in all of the youngest animals; at 3 Hz, mesenteric resistance increased in all animals. The latency of this response was shorter at each increase in stimulation frequency. The aortic pressure rise associated with splanchnic nerve stimulation was greater with each increase in frequency. This rise was attenuated or absent after adrenalectomy and during postganglionic fiber stimulation. The vasoconstrictor effect of splanchnic nerve stimulation was attenuated after alpha-adrenergic receptor blockade with phentolamine in a dose (0.25-0.75 mg/kg) that blocked vasoconstrictor effects of norepinephrine (0.5 micrograms/kg). We conclude that alpha-adrenergic mechanisms are functional, although not mature, and that sympathetic vasoconstrictor tone is present in the intestinal circulation of swine at birth. PMID- 3970178 TI - Exercise training modifies myocardial mitochondria and myofibril growth in spontaneously hypertensive rats. AB - We tested the hypothesis that exercise training provides a stimulus that could modify the decrement in mitochondria-to-myofibril volume ratio characteristic of myocardial cells hypertrophied in response to a pressure overload. Spontaneously hypertensive rats (SHR) were trained 5 days/wk on a treadmill at 70-90% maximal VO2 between the ages of 6 and 16 wk corresponding to the development of hypertension and cardiac hypertrophy. The training program increased maximal VO2 and effected a resting bradycardia but did not alter blood pressure, left ventricular hypertrophy, or peak cardiac output. Our stereological data from electron micrographs shows that the decrement in mitochondrial volume density and the increase in myofibril volume density characteristic of SHR compared with their normotensive controls (WKY, Wistar-Kyoto rats) were reversed. Thus the relative volumes of mitochondria and myofibrils and their ratio in trained SHR were similar to those of the WKY group. The similarity was noted in myocytes from both the subepicardium and subendocardium. These data suggest that exercise training facilitates a proportional growth of energy-producing and energy consuming organelles in SHR and that this effect is not secondary to modification of blood pressure or left ventricular mass. PMID- 3970179 TI - Correlation between cardiac performance and plasma catecholamine levels in conscious dogs. AB - We correlated levels of circulating norepinephrine (NE) and epinephrine (Epi) induced by 1) infusions, 2) treadmill exercise, and 3) hemorrhage with left ventricular (LV) function in conscious dogs instrumented for the measurement of LV and arterial pressures, LV diameter, and calculations of indexes of myocardial contractility. With infusions of NE, significant hemodynamic changes were observed only when plasma levels of NE exceeded 1,000 pg/ml. While statistically significant, the increase in rate of rise of LV pressure (LV dP/dt) at these levels was relatively slight, i.e., 8 +/- 2.3%. With further increases in catecholamines (greater than 1,000 pg/ml) good correlations were observed with increases in arterial pressure and myocardial contractility. Similar results occurred with infusions of Epi. Moderate treadmill exercise doubled LV dP/dt, while NE and Epi rose by only 563 +/- 128 and 292 +/- 50 pg/ml, respectively. Hemorrhage (30 ml/kg) decreased all indexes of contractility but increased plasma NE by 1,108 +/- 206 pg/ml and Epi by 1,475 +/- 266 pg/ml. Despite arterial NE and Epi levels 10-20 times those during exercise, infusions were unable to reproduce the peak changes in contractility seen with exercise. Infusions of NE or Epi to equal the plasma levels during exercise increased contractility by only 5-10%. In view of the marked disparity between levels of circulating catecholamines and LV function during exercise, hemorrhage, and catecholamine infusion, we conclude that circulating catecholamines do not adequately reflect the degree of inotropic stimulation to the myocardium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970180 TI - Efferent vagal innervation of canine ventricle. AB - The route efferent vagal fibers travel to reach the left ventricle is not clear and was the subject of this investigation. We measured left ventricular and septal effective refractory period (ERP) changes during vagal stimulation and a constant infusion of norepinephrine, before and after phenol was applied at selected sites of the heart to interrupt efferent vagal fibers that may be traveling in that area. Phenol applied to the atrioventricular (AV) groove between the origin of the right coronary artery anteriorly to the posterior descending branch of the circumflex coronary artery completely eliminated vagal induced prolongation of ERP in the anterior and posterior left ventricular free wall and reduced, but did not eliminate, ERP prolongation in the septum. A large (3-cm radius) epicardial circle of phenol prevented vagal-induced ERP prolongation within the circle in all dogs, while a small (1-cm radius) epicardial circle of phenol failed to prevent vagal-induced ERP changes within the circle in any dog. An intermediate (2-cm radius) circle eliminated vagal effects on ERP in 13 of 18 dogs. Arcs of phenol, to duplicate the upper portion of the circle, applied sequentially from apex to base eliminated efferent vagal effects only when painted near or at the AV groove. We conclude that the majority of efferent vagal fibers enroute to innervate the anterior and posterior left ventricular epicardium cross the AV groove within 0.25-0.5 mm (depth of phenol destruction) of the epicardial surface.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970181 TI - Striatal neuronal responses to scrotal temperature changes and dopaminergic drugs. AB - Seventy-nine units in the striatal region were examined in 48 urethan anesthetized rats. When these units were classified by their thermal responsiveness, proportions of the cold-responsive, warm-responsive, and thermally unresponsive units were 25.4, 35.4, and 39.2%, respectively, of the total units tested. Either microiontophoretically or systemically administered apomorphine (a dopamine agonist) and haloperidol (a dopamine antagonist) affected (inhibited and/or excited) most (86.5-100%) cold-responsive units. In contrast, only a small percentage of the warm-responsive (28.6-43.8%) or thermally unresponsive (0-19.2%) units were affected by both apomorphine and and haloperidol. Furthermore it was found that most (73-100%) cold-responsive units were inhibited by apomorphine but excited by haloperidol; the inhibitory responses of the unit activity induced by apomorphine were antagonized by haloperidol. The reciprocal relationships between apomorphine and haloperidol were not observed in most warm-responsive (76.2-85.7%) or thermally unresponsive (80.8-100%) units. The data demonstrate that many striatal neurons are influenced by thermal afferent activation in the scrotum. The results also provide a neuronal basis for the hypothesis that the dopaminergic receptors located in the cold-responsive neurons of the striatum have effects on metabolic heat production in rats. PMID- 3970182 TI - Morphometry and calcium contents in appendicular and axial bones of exercised ovariectomized rats. AB - To determine the effects of exercise and ovariectomy on calcium status in selected appendicular and axial bones, female Sprague-Dawley (8-9 mo) rats were assigned to groups based on the following combinations: control (C) or ovariectomized (O); sedentary (S) or exercised (E); and length of treatment (2 or 4 mo). Exercise consisted of treadmill running for 1 h/day, 5 days/wk at a speed of 14.1 m/min and 8 degrees elevation. After death, femurs, tibia-fibula complexes, ribs (T7), and vertebrae (T7) were excised, cleaned, and weighed, and selected morphometrics were measured. Tensile strength was measured for the femurs, and all bones were then acid-hydrolyzed and calcium concentration determined spectrophotometrically. Bone [Ca2+] was significantly greater for CE and OE animals when compared with their sedentary counterparts (CS, OS). Within 4 mo calcium losses were evident in the femur and tibia of the ovariectomized animals, and the moderate exercise program was of insufficient intensity to alter this loss. The average stress to failure for femur from all groups was 1.13 +/- 0.11 N/m2. However, the effects of exercise appeared beneficial in the axial bones where [Ca2+] increased in the ovariectomized animals. PMID- 3970183 TI - Renal and extra-renal excretion of calcium in the marine teleost, Gadus morhua. AB - The calcium turnover, with particular emphasis on the routes and rates of excretion, was investigated in the Atlantic cod, Gadus morhua. A very rapid internal redistribution of injected 45Ca was demonstrated, with the decline in the plasma concentration conforming to the power function f(t) = 8.83% X t-0.585. The clearance for 45Ca and [3H]inulin were both linearly correlated to urine flow and showed a ratio (Cca/CIn) of 2.6:1. Likewise a linear correlation between the renal and extra-renal excretion of 45Ca could be demonstrated with a ratio of 1:0.47, indicating that the renal route of excretion is of major importance in this species. The renal excretion of calcium was estimated to be 4.2 mumol X kg-1 X h-1 and the total calcium excretion to be 6.2 mumol X kg-1 X h-1. Calculations are presented, suggesting that the balance between intake and excretion of calcium can be explained in terms of growth of the animal, which would allow for an increase in the amount of body calcium of approximately 5 g X yr-1. It is also concluded that because about two-thirds calcium is excreted via the renal route, the kidneys may be the most important site for the regulation of calcium excretion in the cod. PMID- 3970184 TI - Osmoregulation and vasopressin secretion during pregnancy in Brattleboro rats. AB - Osmoregulation during pregnancy was compared in Brattleboro rats completely lacking vasopressin [homozygous (DI)], those with partial deficiency [heterozygous (HZ)], and control Long-Evans (LE) animals. Plasma osmolality (Posmol) was decreased 10-16 mosmol/kg near term in each group, whereas urine osmolality (Uosmol) was similar to that of virgin controls. This was accompanied by significant increments in water turnover similar in HZ and LE and massive in the gravid DI. Chronic vasopressin treatment increased Uosmol less in pregnant DI compared with virgins (P less than 0.001), and urinary prostaglandin E2 was increased in all gravid groups. Captopril per os failed to implicate the renin angiotensin system in the altered water ingestive behavior of pregnancy. Basal arginine vasopressin pressure (PAVP) was similar in gravid and virgin HZ and LE, whereas the osmotic threshold for AVP secretion was lower in both pregnant groups. Increasing Posmol by dehydration or hypertonic saline led to similar increments in plasma AVP (PAVP) in pregnant and nongravid rats of each group, but sensitivity of the system delta P AVP/delta P osmol was significantly lower in HZ, a difference compatible with the decreased pituitary AVP content in the HZ strain. Data are consistent with decreases in the osmotic thresholds for AVP release (in HZ and LE) and thirst (in DI) and a need for increased AVP secretion during pregnancy. PMID- 3970185 TI - Central pathways relaying cardiovascular afferent information to amygdala. AB - It has been suggested that cardiovascular information to the amygdala is relayed through the paraventricular nucleus of the hypothalamus (PVH) and the parabrachial nucleus (PB;7). To test this possibility spontaneously firing units in the amygdala of 12 chloralose-anesthetized cats were monitored for changes in firing frequency during electrical stimulation of PVH and PB and for their responsiveness to baroreceptor (BA) and chemoreceptor (CA) activation. In the ipsilateral amygdala 27 of 140 units responded to PVH stimulation, 9 of which also responded to CA and none to BA, whereas 46 of 150 units responded to PB stimulation, 11 of which also responded to CA and 2 to BA. To demonstrate the relative contribution of the PVH and PB in relaying cardiovascular information to the amygdala, in an additional six cats, the effect of neuronal block and lesions of these two nuclei on potentials evoked in the amygdala by stimulation of the buffer nerves was tested. Reversible neuronal block with injections of procaine in the PB significantly attenuated these evoked potentials. Electrolytic and chemical (kainic acid) lesions in the same PB sites also were effective in attenuating the responses. The potentials were unaltered by injection of procaine in the PVH. These results indicate that the PB is a site of relay of chemoreceptor and of some baroreceptor information from the medulla to the amygdala. PMID- 3970186 TI - Contribution of activation-inactivation dynamics to the impairment of relaxation in hypoxic cat papillary muscle. AB - Previous investigation of conventional isometric twitches of normothermic cat papillary muscle has shown that hypoxia prolongs relaxation, and this prolongation is actually accentuated during early reoxygenation. Our aim was to identify how hypoxia and reoxygenation affect the coupled processes of activation and inactivation that govern the time course of internally generated contractile tension (Ti). Activation and inactivation are modeled as first-order processes with rate constants ka and ki, respectively, and the overall isometric muscle as an underdamped second-order lag system driven by Ti. The analytical expression (To) for the externally recorded tension is dominated by two exponential terms incorporating ka and ki. Accurate least-squares fits of digitized twitches to To yielded estimates of ka and ki at 1- to 3-min intervals during control oxygenation, hypoxia, and early and late reoxygenation. Results follow. Compared with control, normothermic hypoxia prolonged activation [at 15 min ka decreased 61% from control, 35.5 +/- 6 (SE) s-1, P less than 0.05] and accelerated inactivation (at 15 min, ki increased 69% from control, 6.0 +/- 0.5 s-1, P less than 0.05). In early reoxygenation (1-3 min) activation remained impaired and inactivation returned to control levels (ki decreased 16% from control, NS). In late reoxygenation (15 min) both processes reverted to control. Thus inactivation kinetics can be dissociated from activation kinetics. Impaired relaxation in normothermic hypoxia is due to prolonged activation, whereas inactivation is actually accelerated. The further impairment of relaxation in early reoxygenation is due to rapid return of inactivation to control at a time when activation is still prolonged. PMID- 3970187 TI - Insulin hypoglycemia, cerebral metabolism, and neural function in fetal lambs. AB - The effect of insulin-induced hypoglycemia on cerebral oxidative metabolism (CMRO2) was studied in nine late gestational fetal lambs using the radiolabeled microsphere technique for cerebral blood flow and brachiocephalic to sagittal sinus blood O2 content differences. After 4 h insulin infusion to the fetus, arterial glucose fell from control levels of 0.96 +/- 0.11 (SE) to 0.69 +/- 0.09 mmol X l-1. CMRO2 was reduced from 199 +/- 23 to 155 +/- 22 mumol X 100 g-1 X min 1 (P less than 0.05), and cerebral glucose uptake fell from 31 +/- 4 to 25 +/- 4 mumol X 100 g-1 X min-1 (P less than 0.02). During both euglycemia and hypoglycemia, 6 mumol glucose were taken up for each micromole of O2, indicating that glucose was the sole metabolic substrate for oxidative metabolism. Although there was no change in fetal electrocortical activity during the hypoglycemia, fetal breathing movements were present only 19.4 +/- 3.4% of the hypoglycemic hours compared with 36.8 +/- 2.6% of the control period (P less than or equal to 0.01). These results suggest that during rapidly induced fetal hypoglycemia, blood-brain barrier transport of glucose can limit cerebral glucose and O2 uptake, and this decrease in cerebral metabolism is associated with a lowered incidence of fetal breathing movements. PMID- 3970188 TI - Vasopressin in plasma and ventricular cerebrospinal fluid during dehydration, postural changes, and nausea. AB - The responses of plasma and ventricular cerebrospinal fluid (CSF) vasopressin concentration to dehydration, postural changes, and induction of nausea were studied in 21 patients with hydrocephalus of various etiology. The 24-h dehydration test evoked a significant increase in plasma osmolality and vasopressin concentration, whereas the concentration of vasopressin in CSF was unchanged. Head-up tilt to 50 degrees for 45 min with a tilt bed resulted in a modest increase of plasma vasopressin in patients who did not develop presyncopal symptoms, but no changes were seen in CSF vasopressin. Induction of nausea by subcutaneously injected apomorphine provoked a marked (20- to 50-fold) rise in plasma vasopressin concentration within 15 min, and the plasma concentration was significantly increased above base-line values for 60-120 min. Despite the prolonged period of high plasma vasopressin concentration CSF vasopressin was not influenced by the apomorphine injection. The findings suggest that the concentration of vasopressin in the CSF is controlled by mechanisms other than the well-known osmotic and nonosmotic stimuli of vasopressin release into the blood. PMID- 3970189 TI - [14C]deoxyglucose incorporation into rat brain regions during hypothalamic or peripheral thermal stimulation. AB - The central nervous structures involved in thermoregulatory responses induced by hypothalamic or peripheral thermal stimulation were investigated in conscious rats by means of the 2-deoxy-D-[14C]glucose ([14C]-DG) autoradiographic technique. According to autoradiographs, many brain regions with significant increases or decreases in [14C]-DG incorporation were observed during thermoregulatory responses. Based on the present changes in [14C]-DG incorporation of brain regions obtained from two kinds of thermal stimulation, the following conclusions were drawn. 1) The medial preoptic area and the medial forebrain bundle are common sites for development of thermoregulatory responses being activated during cooling and warming. 2) The anterior hypothalamic area is activated during hypothalamic or peripheral warming and not during cooling. 3) The ventromedial hypothalamus, dorsomedial thalamus, caudate-putamen, globus pallidus, pars compacta of the substantia nigra, red nucleus, and the midbrain reticular formation are activated with hypothalamic or peripheral cooling. 4) The lateral preoptic area, suprachiasmatic nucleus, ventroposteromedial thalamus, pars reticulata of the substantia nigra, and the hippocampus change their activities only during peripheral cooling and warming. PMID- 3970190 TI - Postrenal modification of urine in birds. AB - The role of the cloaca and lower intestine in the postrenal modification of urine was studied in conscious normally hydrated desert quail. The birds were studied for a period of 12 days during which they were in intake-output balance. It was calculated that of the combined mixture of urine-feces entering the lower intestine, 47% water, 62% sodium, and 49% potassium were reabsorbed. If this material is considered as coming from the ureteral urine, then the composition of the ureteral urine entering the lower intestine was changed as follows: 77% water, 72% sodium, and 82% potassium were reabsorbed. For urate, 68% of the total present in ureteral urine was degraded in the lower intestine. In terms of the filtered load produced by the kidneys, the lower intestine reabsorbed 1.5% filtered water, 0.4% filtered sodium, and 46% filtered potassium. The total filtered loads reabsorbed by the combined efforts of the kidney and lower intestine were 99.5% water, 99.8% sodium, and 88% potassium. It appears that the cloaca and lower intestine of birds may serve a similar function to that of the distal nephron in mammals, making the fine adjustments in water and sodium reabsorption from the urine. PMID- 3970191 TI - Metabolic, ionic, and electrical responses of gerbil brain to ischemia. AB - The effects of short- or long-term complete cerebral ischemia were studied in the gerbil brain using a multi-parameter monitoring system. Metabolic (NADH redox state) and hemodynamic responses were monitored by surface fluorometry reflectometry. Ionic activities (K+ and pH) were measured by surface macroelectrodes. Electrical activity was evaluated by monitoring the general electrocorticogram (ECoG) as well as local DC steady potential (two sites). Two groups of gerbils were studied to compare the effects of 4-5 min occlusions with those of 30 min complete ischemia. During bilateral carotid artery occlusion the cortex is exposed to complete ischemia resulting in the complete depletion of O2 with attendant maximal reduction of NADH. Extracellular K+ began to increase as soon as energy reserves were decreased with a time course suggesting two different kinetic areas. Surface pH decreased very shortly after the occlusion. During the recovery phase, NADH was reoxidized soon after recirculation, whereas the pH and K+ recovery showed a short delay. ECoG did not recover even when all other parameters reached base-line levels. The recovery of all the measured parameters was correlated to the duration of the ischemic insult; i.e., the recovery from 30 min of ischemia took significantly longer than after 5 min of ischemia. We conclude that pH recovery depends on recirculation and adequate O2 supply to the tissue, whereas K+ recovery required not only an adequate O2 supply but also the integrity of the adenosine triphosphatase system. PMID- 3970192 TI - Function of vasopressinergic neurons in rats under conscious and anesthetized conditions. AB - The responses of vasopressinergic neurons to acute salt loading and to graded hemorrhage were studied in rats under conscious and anesthetized conditions. Chronically cannulated rats were used in this study so that pre- and postanesthetic conditions could be studied in the same animals. Anesthesia induced by a combination of ketamine hydrochloride and pentobarbital sodium (Nembutal) did not cause a release of vasopressin-associated neurophysin (VP RNP). In response to infusion of 18% saline, animals in the anesthetized state had significantly greater increases in plasma osmolality (Posmol) and plasma sodium concentration than animals in the conscious state. However, the rate of increase in plasma VP-RNP concentration ([VP-RNP]) as well as the relationship between [VP-RNP] and Posmol were not significantly different for the two states. Graded hemorrhage caused similar rates of increase in [VP-RNP] for animals under conscious and anesthetized conditions. These data suggest that anesthesia induced by ketamine plus pentobarbital sodium does not change the responsiveness of vasopressinergic neurons to acute salt loading and to graded hemorrhage. PMID- 3970193 TI - Regulation of bone mineral loss during lactation. AB - The effects of varying dietary calcium and phosphorus content, vitamin D deficiency, oophorectomy, adrenalectomy, and simultaneous pregnancy on bone mineral loss during lactation were examined in rats. Unless otherwise stated, the diet contained 0.47% calcium and 0.3% phosphorus and the rats were given 26 nmol of vitamin D3. Femur ash weights were determined after 21 days of lactation and on age-matched nonlactating rats. Decreasing dietary calcium to 0.02% caused an increased loss of bone mineral, whereas increasing dietary calcium to 1.4% increased plasma calcium levels to 12 mg/100 ml but did not diminish the bone mineral loss observed during lactation. Varying dietary phosphorus did not have a major effect on bone mineral loss during lactation. In vitamin D-deficient rats, bone mineral loss during lactation was independent of dietary calcium levels and slightly greater than the loss observed in vitamin D-replete rats fed the normal calcium diet. Oophorectomy and adrenalectomy did not produce changes in femur ash weights of nonlactating rats or reduce bone mineral loss during lactation. Rats mated during their postpartum estrus and thus simultaneously pregnant and lactating, lost the same amount of bone mineral as caused by lactation alone. PMID- 3970194 TI - Inhibition of hexose transport in adipocytes by dexamethasone: role of protein synthesis. AB - The ability of the synthetic glucocorticoid, dexamethasone, to alter 3-O methylglucose transport was investigated using isolated rat adipocytes. A maximally effective dose of dexamethasone (10(-7) M) inhibited transport up to 80% within 60-90 min. Inhibition of transport was evident as early as 15-30 min after addition of steroid, and was prevented by both actinomycin D and cycloheximide. When added within 45 or 60 min after dexamethasone, actinomycin D interfered with the cells' ability to respond to the steroid but had no effect when added between 60 and 90 min or longer after the steroid. Cycloheximide interfered with steroid-induced inhibition of transport when added at any time before the 15- to 30-min period immediately preceding the transport assay. This interference with hormone action appeared to be independent of the length of time cells were exposed to dexamethasone before addition of cycloheximide. Thus cells that were maximally inhibited by dexamethasone by 90 min became only partially inhibited when cycloheximide was added at 90 or 120 min, and cells were incubated for an additional 60 or 30 min, respectively. These findings are consistent with the following: dexamethasone inhibits glucose oxidation as a result of inhibiting hexose transport; inhibition of transport by dexamethasone requires the synthesis of RNA during the first 45-60 min after steroid addition and requires protein synthesis during the entire incubation period with dexamethasone; and transport is inhibited within minutes after protein synthesis is initiated. PMID- 3970195 TI - Brown adipose tissue in cafeteria-fed hamsters. AB - Hamsters consuming a "cafeteria diet" had more brown adipose tissue than did chow fed hamsters. The growth of the brown fat depots in cafeteria-fed hamsters was accompanied by increases in tissue protein and cytochrome oxidase. To assess the thermogenic capacity of brown fat mitochondria, the binding of GDP to isolated mitochondria was measured. Mitochondrial GDP binding was not affected by feeding the cafeteria diet for 4 wk, but more prolonged cafeteria feeding for 8 wk did, however, increase the binding of GDP to isolated mitochondria. The morphology of brown adipose tissue was altered during cafeteria feeding. The brown adipose tissue of cafeteria-fed hamsters had more large unilocular cells than did the brown adipose tissue of chow-fed hamsters. In addition, the average adipocyte diameter was greater in brown adipose tissue of cafeteria-fed hamsters. These data support the presence of a dietary regulation of brown adipose tissue growth in hamsters. The growth of brown adipose tissue in hamsters eating the cafeteria diet appears to result largely from proliferation of adipocytes, as evidenced by the increases in tissue protein and cytochrome oxidase during cafeteria feeding, but some hypertrophy of the adipocytes also occurs. A dietary regulation of brown fat thermogenic capacity is also apparent but this regulation is evident only after more prolonged periods of cafeteria feeding. Hamsters eating a cafeteria diet increase their caloric intake but have the same or greater body weight gain efficiency as do chow-fed animals. The absence of dietary stimulation of thermogenesis may underlie the similar efficiencies of weight gain in chow- and cafeteria-fed hamsters. PMID- 3970196 TI - Analysis of tricarboxylic acid cycle using [14C]citrate specific activity ratios. AB - The information content of citrate carbon specific radioactivity ratios in steady state 14C isotopic studies has been analyzed. Sixteen steady-state equations resulted containing five unknowns, 14 equations in terms of citrate carbon specific radioactivity ratios, and two modified forms of the "CO2 ratio" equation. Although each of the 16 equations is not independent, there is more than one independent equation for each variable. These additional equations may be used to test the assumptions on which the model is based. Each of the five unknowns is defined as the probability of flux around a complete cycle, either the tricarboxylic acid (TCA) cycle or a futile cycle such as pyruvate- oxaloacetate--pyruvate. To solve these equations for the five unknowns, an investigator need only measure the specific radioactivity of various citrate carbons and the 14CO2 production rate. The study did not yield a direct expression for net flux between pyruvate and 4-carbon TCA cycle intermediates. However, these equations do place certain constraints on the net flux through this important pathway. PMID- 3970197 TI - Intestinal triglycerides are derived from both endogenous and exogenous sources. AB - Although studies have indicated that the small intestine is capable of utilizing endogenous substrates for triglyceride synthesis in the absence of dietary lipid, the importance of the endogenous contribution to total intestinal triglyceride production during absorption has not yet been defined. In this study we have examined the quantitative contribution of endogenous triglyceride production during different luminal lipid loads. By use of a mesenteric lymph fistula rat model with total parenteral nutritional support, mesenteric lymphatic triglyceride transport was investigated. Our results indicate that, during absorption, a substantial fraction (greater than 50%) of total triglyceride is derived from endogenous sources. Increased luminal fatty acid loads lead to an increase in both endogenous and exogenous triglyceride production. Incorporation of luminally infused oleic acid into triglyceride carried by chylomicrons is dependent on the luminal fatty acid load, while incorporation of oleic acid into very low-density lipoprotein (VLDL) triglyceride is saturable. We conclude that both chylomicron and VLDL are involved in transporting triglyceride derived from both endogenous and exogenous sources. The different patterns in the partition of endogenous and exogenous triglyceride into chylomicrons and VLDL suggest that these two lipid-carrying lipoproteins are probably packaged differently in the small intestine. PMID- 3970198 TI - Characterization of conductive pathways in guinea pig distal colon in vitro. AB - Isolated mucosal sheets of guinea pig distal colon were studied in vitro in Ussing-type chambers, using a computer-controlled voltage clamp. A conductance of 8-12 mS/cm2 and spontaneous variations of the potential difference (Vt, -4 to +6 mV) and the short-circuit current (Isc, -1.6 to +1.5 mu eq X cm-2 X h-1) were observed. With use of a green feed diet these variations could be entirely attributed to the rate of Na transport. Unidirectional Na and Cl fluxes were measured, and for Na, K, and Cl transport the individual conductances and directions were estimated from the changes in Vt and Isc, using the appropriate blockers amiloride, barium, and piretanide. The sum of the electrogenic Na, K, and Cl transport determines the spontaneous electrical behavior of this epithelium. Na transport was further characterized with transepithelial and transapical current-voltage relations. Apical Na entry occurred by diffusion, intracellular Na activity was 12 mM, and apical Na permeability was calculated as 0.02 cm/h. This study represents the first in vitro investigation of electrogenic transport in this epithelium and shows that it closely resembles transport mechanisms found in rabbit colon. PMID- 3970199 TI - Gastric H+ and HCO3- secretion in response to sham feeding in humans. AB - Sham feeding (SF) was used to evaluate the effect of physiological vagal stimulation on gastric acid (H+) and bicarbonate (HCO3-) secretion in humans, as well as on parietal and nonparietal volume secretion. A recently validated method, derived from a two-component model of gastric secretion, was employed. SF increased both H+ secretion from parietal cells (P less than 0.001) and HCO3- secretion from nonparietal cells (P less than 0.01), although the H+ response was greater and more prolonged. Atropine significantly inhibited not only H+ secretion but also HCO3- and nonparietal volume secretion. Peak H+ secretion during SF averaged approximately 27 mmol/h, whereas peak HCO3- secretion averaged approximately 6 mmol/h. When H+ secretion was already maximally stimulated by an intravenous pentagastrin infusion, SF actually reduced gastric juice acidity and osmolality due to neutralization of H+ by HCO3- and to dilution of H+ by nonparietal secretions. These studies therefore indicate that vagal stimulation induced by SF increases both H+ and HCO3- secretion in humans and that this process is cholinergically dependent. PMID- 3970200 TI - Reduced vascular sensitivity to norepinephrine in portal-hypertensive rats. AB - The development of portal hypertension following chronic portal vein stenosis is accompanied by a significant increase in intestinal blood flow. The present study was designed to determine whether intestinal vascular sensitivity to norepinephrine (NE) is also affected by chronic portal vein stenosis. Using a blood-perfused, in situ rat small intestine preparation, we found that, when compared with control animals, a significantly greater molar concentration of NE was required to achieve the same proportional increase in intestinal vascular resistance in portal-hypertensive animals. The mean ED50 value (+/-SE) for the portal-hypertensive group (704.3 +/- 186.1 nM) was significantly greater (P less than 0.05) than the mean ED50 value for the control group (271.4 + 48.1 nM). This finding implies that sympathetic maintenance of intestinal vascular tone may be impaired following chronic portal vein stenosis, possibly accounting for part of the intestinal hyperemia associated with portal hypertension. PMID- 3970201 TI - Intestinal membrane lipid composition and fluidity during development in the rat. AB - We have characterized microvillus membrane (MVM) lipid composition and derived estimates of membrane fluidity using fluorescence polarization [with 1,6-diphenyl 1,3,5-hexatriene (DPH) as the probe] in MVM from the jejunum and ileum of suckling (day 14-20) and mature postweaning (day 28-49) rats. The anisotropic values are lower (i.e., increased fluidity) in MVM from jejunum and ileum of suckling rats compared with values from MVM of mature rats, suggesting a more disordered molecular environment in MVMs of suckling animals, although the ileal MVM was relatively less fluid than jejunal membranes in both groups. Anisotropic determinations in protein-free MVM liposomes demonstrate that protein-lipid interactions are major determinants of fluidity estimates. Arrhenius plots of DPH anisotropies in MVM and MVM liposomes indicate a thermotropic lipid-phase transition at 23 degrees C in mature rat jejunum and ileum; however, no clear transition point was observed in 14- to 20-day animals. In addition, both the jejunal and ileal MVM in suckling animals contained greater amounts of total lipid, cholesterol, and phospholipid per milligram protein than did mature MVM preparations. Membrane phospholipid composition changed with age, with a decrease in sphingomyelin and an increase in phosphatidylcholine in the jejunum of the postweaning animal and with similar weight ratios of saturated to unsaturated fatty acids in both age groups. The data demonstrate that the small intestinal MVM manifests both age-dependent and regional proximal-distal differences in lipid composition and biophysical properties.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970202 TI - Vasoactive intestinal polypeptide, cholecystokinin, glucagon, and bile-oleate induced jejunal hyperemia. AB - The purpose of this study was to evaluate the roles of vasoactive intestinal polypeptide (VIP), cholecystokinin (CCK), and glucagon in the local regulation of the lipid-induced intestinal hyperemia. Total blood flow and the arteriovenous hormone concentration gradient were measured in isolated jejunal loops of anesthetized dogs with either saline, bile (10% in normal saline), oleic acid (40 mM in normal saline), or oleic acid and bile in the lumen. The bile-oleic acid mixture increased both blood flow (+21 +/- 7%) and VIP release (+118 +/- 7%), while CCK release was considerably less. There was a transient rise in glucagonlike immunoreactivity but no change in pancreatic glucagon release. Neither bile nor oleic acid alone altered either local blood flow or hormone release. Infusion of VIP into the arterial circulation of the jejunum significantly reduced vascular resistance (-11 +/- 4%) but at a dose (150 ng . min-1 X 100 g-1) 10 times that released in response to the bile-oleic acid mixture. This study indicates that oleic acid increases both blood flow and intestinal hormone production only when present in the lumen in micellar form and suggests that VIP could play a role in the jejunal vascular response to fat. PMID- 3970203 TI - Physiological variations in canine gastric tone measured by an electronic barostat. AB - Gastric tone may mediate gastric accommodation and emptying; however, it cannot be recorded by manometric methods. We have developed an electronic barostat that maintains a constant pressure (2 mmHg) within an air-filled bag and have validated the system in vitro and in vivo. In four conscious dogs, the bag was introduced orally into the stomach, and gastric tone was monitored from the barostat as variations in intrabag volume. Simultaneously, we recorded upper gut pressure activity by implanting manometric catheters. Studies were performed in fasting and fed (200-ml solid meal) dogs. The barostat system did not distort fasting motor activity. Intrabag volume correlated with manometrically measured fundic pressure activity. However, tonic changes undetected manometrically were clearly registered by the barostat. Meal induced marked changes in gastric tone. A receptive relaxation during feeding was followed by a low-tone accommodation period. Later, the barostat registered a sustained high tone until the return of the fasting pattern. We conclude that the electronic barostat measures physiological variations in gastric tone that are not recorded by conventional systems. PMID- 3970204 TI - Sulfobromophthalein inhibition of glutathione and methylmercury secretion into bile. AB - The mechanism through which sulfobromophthalein (BSP) inhibits the biliary secretion of glutathione (GSH) and methylmercury was examined in male rats anesthetized with pentobarbital sodium. The biliary secretion rates of GSH and methylmercury were measured following the bolus intravenous administration of various doses of BSP, the GSH conjugate of BSP (BSP-SG), and phenol-3,6 dibromphthalein disulfonate (DBSP, a nonmetabolizable analogue of BSP). The effects of BSP on GSH secretion were dose dependent; at a dose of 120 mumol/kg the rate of GSH secretion fell close to zero. DBSP also inhibited GSH secretion, although the inhibition was not as complete as observed after BSP administration; at a dose of 180 mumol/kg GSH secretion fell to 18% of control. BSP-SG, in contrast, had no effect on GSH secretion into bile when given at a dose of 120 mumol/kg. At doses of 240 and 360 mumol BSP-SG/kg, there were only minor changes in the rate of GSH secretion. The changes in GSH secretion induced by these dyes were accompanied by proportional changes in glutathione disulfide (GSSG) secretion into bile, so that the molar ratio of GSSG to GSH in bile remained within the range of 0.07-0.18. In all experiments the changes in methylmercury secretion were parallel to the changes in GSH secretion. The results suggest that the BSP-induced inhibition of GSH, GSSG, and methylmercury secretion into bile is due to the direct inhibition of the biliary GSH transport process. PMID- 3970205 TI - Acid secretion by frog gastric mucosa is electroneutral. AB - The action of a newly developed, specific inhibitor of the gastric proton pump, omeprazole, was investigated using intact frog gastric mucosa. Omeprazole was found to inhibit acid secretion, and the inhibition could be reversed with glutathione or 2-mercaptoethanol. Inhibition was not stimulus specific, occurring with histamine, carbachol, and forskolin. With hypertonic solutions bathing the mucosal surface, omeprazole inhibition of acid secretion did not change the tissue conductance, whereas inhibition by thiocyanate or cimetidine resulted in a significant decrease in conductance. With high-K+ (greater than 80 mM) sulfate solutions bathing both surfaces, omeprazole inhibition of acid secretion resulted in no change in transtissue potential difference. In chloride solutions, omeprazole caused an increase in potential difference and short-circuit current. These results provide evidence that the proton pump in frog gastric mucosa is electroneutral. PMID- 3970206 TI - Sleeve device functions as a Starling resistor to record sphincter pressure. AB - In 1976 Dent (Gastroenterology 71: 263-267) introduced a sleeve-catheter device for obtaining continuous recording of lower esophageal sphincter pressure. The infused sleeve accommodates for axial sphincter movement by providing a large surface of collapsible membrane that is capable of sensing maximal sphincter pressure at any point along the sleeve. Although sleeve performance was tested previously, the precise physical principal of its function has not been delineated. This study tests the hypothesis that the sleeve device functions as a Starling resistor. The term "Starling resistor" is an eponym that designates the physics of fluid flow through collapsible tubes. When pressure at any point along an infused collapsible conduit is greater than the intraluminal pressure at the distal end of the conduit, partial collapse occurs at some axial location along the conduit where the transmural pressure equals zero. The location of zero transmural pressure is termed the "equal pressure point" (EPP). The partial collapse at the EPP causes a local change in luminal resistance that is directly related to the magnitude of the external pressure at the EPP and accompanied by a corresponding change in the pressure upstream from the EPP. A correlate to the performance of Starling resistors is that the pressure upstream to the EPP is not affected by the downstream pressure, so long as the downstream pressure is less than the external pressure. To test our hypothesis, we evaluated sleeve performance in vitro using a two-chambered model that allowed application of static or oscillatory pressures at one or two sites along the sleeve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970207 TI - Phosphate excretion in uremic rats: effects of parathyroidectomy and phosphate restriction. AB - As progressive renal failure develops, phosphate excretion per functioning nephron increases, thus preserving homeostasis. To test whether dietary phosphate supply might contribute to the regulation of renal phosphate excretion in the uremic setting, groups of male Sprague-Dawley rats that were either parathyroidectomized (PTX) or sham PTX (S-PTX) and either five-sixths nephrectomized (Nx) or sham Nx (S-Nx) were studied following a 4-wk dietary regimen consisting of 0.1 or 0.7% phosphate. For Nx rats fed the 0.7% phosphate diet the fractional excretion of phosphate (FEPi) was enhanced (47 +/- 6 vs. 21 +/- 3%) and the maximum tubular reabsorption of phosphate per milliliter GFR (TmPi/GFR) was suppressed (1.65 +/- 0.19 vs. 2.33 +/- 0.19 mumol/ml). FEPi was unchanged by PTX in these Nx animals (42 +/- 6 vs. 47 +/- 6%). TmPi/GFR remained suppressed in PTX, NX animals when compared with S-Nx, PTX controls (3.38 +/- 0.33 vs. 5.07 +/- 0.41 mumol/ml). For rats fed the 0.1% phosphate diet Nx did not affect TmPi/GFR in either S-PTX (5.40 +/- 0.43 vs. 4.97 +/- 0.34 mumol/ml) or PTX (7.03 +/- 0.23 vs. 6.98 +/- 0.21 mumol/ml) animals. For both S-Nx and Nx animals the effects of PTX and dietary phosphate restriction on TmPi/GFR were independent and additive. In all groups of animals, tubular reabsorption of phosphate per milliliter GFR (TRPi/GFR) dropped acutely with continued infusion of phosphate once TmPi/GFR was achieved. Thus, a resetting of TRPi/GFR occurs among Nx rats in response to both chronic dietary phosphate deprivation and acute intravenous phosphate loading.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970208 TI - Response of isolated renal arterioles to acetylcholine, dopamine, and bradykinin. AB - The effect of acetylcholine (ACh), dopamine (DA), and bradykinin (BK) on vascular tone was examined in interlobular arteries and superficial afferent and efferent arterioles isolated from rabbit kidney. A single microvessel was dissected and cannulated, and lumen diameter was measured at a fixed intraluminal pressure. ACh caused a dose-dependent relaxation of norepinephrine-induced tone in all three vessel types. Significant relaxation (10-20%) was observed with 10(-8) M ACh and higher concentrations caused complete relaxation. In afferent and efferent arterioles DA caused a dose-dependent relaxation that was indistinguishable from the one caused by ACh. However, DA was much less effective on interlobular arteries. Significant relaxation was not observed until 10(-5) M DA, and 10(-4) M caused only a 30-40% relaxation. In afferent arterioles atropine blocked the effect of ACh, and metoclopramide selectively inhibited DA-induced relaxation. BK (10(-9) to 10(-5) M) caused a dose-dependent relaxation of norepinephrine-induced tone only in efferent arterioles. BK, either in the bath or lumen, had no effect on the preglomerular microvessels. ACh and DA also caused relaxation of afferent arterioles with spontaneous tone while all three vasodilators relaxed efferent arterioles with spontaneous tone. The results demonstrate segmental heterogeneity for these vasodilators in the rabbit renal microvasculature, with ACh causing relaxation in all three vessel types, DA acting primarily on the glomerular arterioles, and BK affecting only the efferent arteriole. PMID- 3970209 TI - Characterization of a new model for the study of pressure-natriuresis in the rat. AB - The acute relationships between the urinary excretion of sodium and water and renal perfusion pressure were characterized in the rat using a new in vivo model of pressure diuresis. Neural and hormonal influences on the kidney were held constant by denervating the kidney and by maintaining fixed high plasma levels of vasopressin, aldosterone, corticosterone, and norepinephrine levels by intravenous infusion. Renal perfusion pressure (RPP) was varied above and below control using specially designed aortic clamps. Increasing RPP within the autoregulatory range from 90 to 160 mmHg produced 5- to 20-fold increases in urine flow and sodium excretion with no detectable changes in glomerular filtration rate, renal blood flow, or peritubular capillary pressure. The slope of the line relating urine flow and RPP averaged 2 microliter X min-1 X kidney-1 X mmHg-1 rise in RPP. If RPP was first lowered to 90 mmHg, urine flow could be doubled by increasing RPP by as little as 5 mmHg. Uninephrectomy 7-12 days before an experiment did not alter the renal pressure diuresis relationship. The presence of intact renal nerves, however, was found to shift the relationship between urine flow and RPP to the right. The magnitude of the response produced by elevations in pressure using this new model of pressure diuresis was greater than when RPP was increased using carotid occlusion or epinephrine infusion as in previous studies. The results indicate that small changes in arterial pressure may have a greater influence on sodium and water excretion than has been previously recognized. PMID- 3970210 TI - Abnormal pressure-diuresis-natriuresis response in spontaneously hypertensive rats. AB - The renal responses to changes in perfusion pressure (RPP) were studied in spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) to determine whether an abnormality in the pressure-diuresis phenomenon could be involved in the resetting of kidney function in hypertension. Differences in the neural and endocrine background to the kidneys were minimized by denervating the kidney and by holding plasma vasopressin, aldosterone, corticosterone, and norepinephrine levels constant by intravenous infusion. In WKY, increasing renal perfusion pressure 54 mmHg, from 103 to 157 mmHg, produced a ninefold increase in urine flow and sodium excretion with no measurable change in renal blood flow (RBF) or glomerular filtration rate (GFR). In SHR, increasing renal perfusion pressure 54 mmHg, from 133 to 187 mmHg, produced only a fourfold increase in urine flow and sodium excretion. GFR, RBF, and peritubular capillary pressures were well autoregulated and were similar in the SHR and WKY at pressures above 110 mmHg. These results indicate the presence of intrinsic changes in the kidney of SHR that enhance fractional tubular reabsorption and impair the pressure-diuresis response. This blunting of the renal pressure-diuresis phenomenon in SHR may represent the functional resetting of the kidney that is necessary for sustained hypertension. PMID- 3970211 TI - Effects of aldosterone on potassium recycling in the kidney of adrenalectomized rats. AB - Recent studies have suggested that potassium, like urea, undergoes medullary recycling. The present cortical and papillary micropuncture studies were designed to confirm the existence of medullary potassium recycling and to determine whether acute infusions of aldosterone affected this phenomenon. Thus, nephron segmental analysis of potassium and sodium transport was conducted in adrenalectomized Munich-Wistar rats and similarly prepared rats that received aldosterone acutely to achieve physiological blood levels. The clearance results demonstrated that aldosterone has an acute antinatriuretic and a kaliuretic effect, whereas the micropuncture studies demonstrated that 1) aldosterone increases potassium secretion between early and late distal tubule punctures; 2) aldosterone causes an increase in delivery of potassium to the papillary collecting duct; 3) aldosterone does not increase potassium secretion across the papillary collecting duct; and 4) aldosterone significantly increases medullary potassium recycling as evidenced by increased quantities of potassium present at the bend of the loop of Henle in response to aldosterone infusions. Thus, the studies confirm the existence of potassium recycling and suggest that this phenomenon is a feedback system that, in part, regulates urinary potassium excretion. PMID- 3970212 TI - Passive potassium transport in the proximal convoluted tubule. AB - Potassium transport in the isolated proximal convoluted tubule (PCT) of the rabbit was studied to determine the importance of concentration-dependent passive processes in potassium reabsorption. Net potassium flux was measured with an initial perfusate potassium concentration of 4 mM and bath potassium concentration of 2, 4, or 6 mM. When bath concentration was 6 mM, there was net potassium secretion in both superficial (SF) and juxtamedullary (JM) PCT. When bath concentration was 2 mM, there was net reabsorption in both groups of tubules. The apparent permeability coefficients were found to be significantly higher in JMPCT (2.96 +/- 0.37 pmol X mm-1 X min-1 X mM-1) than in SFPCT (1.94 +/ 0.34 pmol X mm-1 X min-1 X mM-1). We also attempted to uncover an active potassium reabsorption process by inhibiting water flux, but not other transport processes, by the imposition of a transtubular osmotic gradient. When the perfusate was made 30 mosmol/kg H2O hypertonic to the bath, there was net fluid entry of 0.38 +/- 0.09 nl/min, accompanied by a significant decline in net potassium flux. The collected fluid-to-perfusate potassium concentration ratio was not significantly less than zero, thereby not providing evidence for active potassium reabsorption. These studies suggest that a primary mode of potassium reabsorption in this segment is due to its movement along a transepithelial gradient established by fluid reabsorption. We have been unable to identify an active component of potassium reabsorption. PMID- 3970213 TI - Glucocorticoid activation of Na+/H+ exchange in renal brush border vesicles: kinetic effects. AB - Administration of the synthetic glucocorticoid dexamethasone to adrenalectomized rats increased Na+/H+ exchange activity in isolated renal brush border membrane vesicles. Treatment altered the initial rate of Na+ uptake by increasing Vmax (19.90 +/- 2.17 vs. 27.32 +/- 1.50 nmol.mg protein-1.5 s-1) and not the apparent affinity KNa+ (8.33 +/- 1.11 vs. 7.94 +/- 1.60 mM). Dexamethasone treatment resulted in a proportional increase in 1 mM Na+ uptake at every intravesicular pH measured. When these data were analyzed by the Hill equation, it was found that dexamethasone treatment did not change the apparent number of H+ binding sites (1.24 vs. 1.26) or the [H+]0.5 (0.33 vs. 0.32 microM) but increased the apparent Vmax (0.98 vs. 0.55 nmol.mg protein-1.2 s-1). It was also found that dexamethasone injections of 60 micrograms/100 g body wt resulted in maximum stimulation of exchange activity and that a significant increase in amiloride sensitive Na+ uptake was detected within 12 h after a single dose of dexamethasone. PMID- 3970214 TI - Plasma volume expansion is necessary for edema formation in the rate with Heymann nephritis. AB - Edema formation in nephrotic syndrome has been attributed to intravascular volume depletion resulting from leakage of plasma water into the interstitial space and activating secondary renal sodium retention. However, clinical studies indicate that edematous patients with nephrotic syndrome may have normal or expanded plasma volumes. We evaluated the relationship between plasma volume and edema formation in control rats and rats with chronic renal failure (CRF) produced by 7/8 nephrectomy. In each group, plasma volume and 22Na space were measured during the control period and after induction of hypoalbuminemia from passive Heymann nephritis. Rats with CRF had expanded plasma volume during the initial period (4.23 +/- 0.46 vs. 3.32 +/- 0.68 ml/100 g body wt) that became significantly more expanded (to 5.44 +/- 1.16 ml/100 g body wt) when they became nephrotic as 22Na space also increased. Plasma volume and 22Na space did not change in the sham operated rats when nephrosis was produced. Plasma renin activity was lower in the CRF rats during the control period than in the sham-operated rats and fell significantly during the nephrotic period when edema developed. Nonnephrotic rats had a plasma colloid osmotic pressure (COP) of 17.8 +/- 4.3 mmHg compared with 8.5 +/- 2.9 mmHg when nephrotic. Despite this large difference in COP, both nephrotic and nonnephrotic rats exhibited the same relationship between plasma volume and extravascular sodium space, a measure of edema formation. Hypoproteinemia is not sufficient for edema formation in the rat with passive Heymann nephritis; concomitant plasma volume expansion resulting from CRF is a necessary additional component. PMID- 3970215 TI - Electrochemical profile of K+ and Na+ in the amphibian early distal tubule. AB - Double-barreled microelectrodes selective to either potassium or sodium were used to determine the transepithelial potential difference (VTE) and the intraluminal activity of potassium (alpha LuK) or sodium (alpha LuNa) in the early distal tubule (EDT) of Triturus waltlii in vivo; luminal activities were compared with the corresponding plasma ion activities, alpha PtK and alpha PtNa. The transepithelial equilibrium potentials for potassium (EK(TE] and sodium (ENa(TE] were computed from the respective transmural chemical distributions: they were used to assess the transepithelial electrochemical potential differences [(V EK)TE and (V-ENa)TE]. By dividing the raw data into three groups of 30% total tubular length (0-30, 31-60, 61-90%), the following results were obtained. 1) VTE increases from +15 to +20 mV (lumen positive) between the first and second portion of the EDT but remains constant thereafter. 2) The alpha LuK/alpha PtK ratio decreases steadily along the EDT from 1.92 to 1.66 and then to 1.32. 3) The values of alpha LuNa/alpha PtNa in the same three subdivisions are 0.79, 0.44, and 0.45. 4) The (V-EK)TE difference is largely positive along the whole EDT: +32, +33, and +27 mV. 5) The (V-ENa)TE difference declines from +9 mV (first portion) to values statistically not different from zero in the last two thirds of the EDT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970216 TI - A model of proximal tubular bicarbonate absorption. AB - A model is presented that utilizes determinants of acidification defined from microperfusion studies in the rat to stimulate the effect on absolute bicarbonate absorption along the entire proximal convoluted tubule. Net bicarbonate absorption is considered to consist of active transcellular proton secretion in parallel with passive paracellular bicarbonate diffusion. The rate of proton secretion is calculated as a function of luminal bicarbonate concentration using Michaelis-Menten kinetics. The K1/2 is modified by luminal flow rate and the Vmax by peritubular bicarbonate concentration. Solute-solvent interactions and axial heterogeneity are also included as determinants of proton secretion rate. The model demonstrates that a given percentage stimulation or inhibition of active proton secretion leads to a much smaller effect on absolute proximal bicarbonate absorption along the entire tubular length. This blunting of the stimulation or inhibition is greatest when filtered bicarbonate load is limited by decreases in glomerular filtration rate or plasma bicarbonate concentration. In addition, the model shows that flow dependence is greater at low plasma bicarbonate concentrations, whereas the effect of extracellular fluid volume expansion is greater at high plasma bicarbonate concentrations. Agreement between the model predictions and the results of free-flow micropuncture studies from our laboratory is good with the exception of the effect of raising plasma bicarbonate concentration. This discrepancy is resolvable by allowing the effect of peritubular pH to increase along the length of the tubule, a hypothesis that requires verification. PMID- 3970217 TI - Electrophysiological evidence for Cl secretion in shark renal proximal tubules. AB - The electrophysiology of shark proximal tubules (Squalus acanthias) was investigated using conventional microelectrodes and cable analysis. Under in vitro perfusion with symmetrical Ringer solutions, tubule transepithelial resistance was 36.3 +/- 2.3 omega X cm2 (means +/- SE, n = 44). Other electrophysiological variables varied widely under control conditions. In unstimulated tubules (n = 16) the transepithelial voltage (VT,o) was lumen positive (1.2 +/- 0.2 mV), the basolateral membrane potential (Vbl,x) was -61.3 +/- 1.6 mV, and the fractional resistance of the apical membrane (fRa) was 0.67 +/- 0.02. Spontaneously stimulated tubules (n = 28) had lumen-negative VT,o values (-1.5 +/- 0.4 mV), low Vbl,x values (-41.3 +/- 1.7 mV), and low fRa values (0.30 +/- 0.02). The stimulated state can be induced in unstimulated tubules via treatment with cAMP. Multiple microelectrode impalements in a single tubule revealed epithelial cells sharing similar electrophysiological properties. Selective ion substitutions in the tubule lumen and peritubular bath uncovered an increased Cl conductance in the apical membrane of spontaneously and cAMP stimulated tubules. Anthracene-9-carboxylic acid tended to reverse the stimulated state, and furosemide hyperpolarized Vbl,x. These results constitute the first evidence for secretory Cl transport in a renal proximal tubule. The electrophysiological responses to ion substitutions, stimulators, and inhibitors are strikingly similar to those of known Cl-transporting epithelia. PMID- 3970218 TI - Determination of the sodium transport pool in epithelia from tracer fluxes: a simplified approach. AB - The epithelial content of tracer Na can be calculated either from the exponential increase of unidirectional transepithelial Na tracer fluxes observed after addition of labeled Na to the solution bathing the luminal side of isolated epithelia or from the linear portion of the rate of accumulation of label in the serosal solution. The second method is not only simpler, because fewer data points are required and no logarithmic transformations are necessary, but also more accurate, as shown in experiments with stripped epithelia of rabbit descending colon. From the difference in tissue Na tracer content in the absence and presence of amiloride, which blocks luminal Na uptake, a Na concentration in the transport pool of 8-10 mM is obtained, assuming that all cells participate in active transport. From a comparison of the intracellular Na concentration derived from current-voltage relations of the apical Na entry step with the Na concentration in the epithelial Na transport pool, an estimate may be obtained of what fraction of the cell mass is involved in active Na transport. PMID- 3970219 TI - An improved bioassay method for determining natriuretic activity of atrial extracts. AB - Extracts of mammalian atrial tissue contain potent natriuretic substances known collectively as atrial natriuretic factor (ANF). The purposes of the present experiments were: 1) to improve on existing bioassay methodology for the detection of ANF activity in atrial extracts, and 2) to compare the ANF activity of atrial extracts prepared from Brattleboro-stain diabetes insipidus (DI) rats with that from normal and water-deprived Long-Evans (LE) rats. A pool of atrial tissue extract (AE) was prepared from normal Sprague-Dawley rats for use as a standard against which unknown AE samples could be compared. Five doses, ranging from 27 to 432 micrograms of AE protein, were assayed in the Sprague-Dawley bioassay rats. Phosphate-buffered saline (PBS) vehicle and ventricular tissue extracts were also assayed. Statistical analysis of several log dose-response relationships revealed that the bioassay response most appropriate in determining relative natriuretic activity of AE was the log of the experimental/control ratio for sodium excretion. The bioassay was used to demonstrate that PBS atrial extracts from both water-deprived LE rats and DI rats contain more natriuretic activity than do PBS atrial extracts from LE rats. PMID- 3970220 TI - Effects of reduced resistive afterload on left ventricular pressure-volume relationship. AB - In seven anesthetized, beta-blocked dogs, we investigated the effects of a reduction in systemic vascular resistance (SVR) on left ventricular (LV) systolic mechanics. LV pressure and volumes (scintigraphic techniques) were measured in base-line condition, after opening one and then two arteriovenous fistulas (AVF). Volume was infused to maintain LV end-systolic pressure (LVESP). Despite a constant ESP, the mean end-systolic volume (LVESV) fell from 42 to 31 ml (P less than 0.025) when the SVR fell from 81 to 48 units (P less than 0.0025), and the LVESV fell further to 24 ml (P less than 0.0025) when the SVR was decreased to 30 units (P less than 0.025). In six similarly prepared dogs, aortic flow was measured, and when resistive afterload decreased, instantaneous flow increased. Since end-diastolic volume was not significantly changed when resistive afterload decreased, instantaneous LV volume decreased despite constant systolic LV pressure. In two of these dogs, LV pressure-volume (PV) trajectories were drawn for the ejection period. When SVR decreased there was a marked leftward shift of the PV trajectory as the end of ejection was approached. It is concluded that at a given contractile state and ventricular pressure, alterations in resistive load directly affect rate and extent of ventricular shortening. PMID- 3970221 TI - Effects of coronary and extravascular pressure on intramyocardial and epicardial blood velocity. AB - In open-chest anesthetized dogs we measured phasic coronary blood velocity in an epicardial artery (left anterior descending), a small epicardial artery (within 0.5 cm before penetration into the myocardium), and an intramyocardial artery (septal) during changes in perfusion pressure and extravascular pressure. Circumflex artery diameter was also measured during pressure changes to directly assess vascular compliance. At low and normal arterial pressures (less than 125/86 mmHg) and during aortic insufficiency, the phasic character of blood flow velocity in the large epicardial arteries was markedly different from that in the small epicardial and septal arteries: there was retrograde systolic blood flow velocity in the septal artery and small epicardial artery, whereas antegrade blood flow velocity persisted in the left anterior descending artery. At pressures greater than 150/106 mmHg, the differences in the phasic character of blood flow velocity in the left anterior descending artery from that in the septal artery and small epicardial artery were small and decreased as aortic pressure increased. At pressures greater than 125 mmHg, the cross-sectional area change per millimeter of mercury was approximately three times less than at pressures between 30 and 75 mmHg, indicating decreased coronary compliance at the higher pressures. Increasing extravascular pressure in the septum (right ventricular hypertension) greatly increased retrograde systolic blood flow velocity in the septal artery (P less than 0.05). However, right ventricular bypass (0 right ventricular pressure) did not alter the phasic nature of blood flow velocity in the septal artery. From these results we confirmed that epicardial capacitance is inversely related to distending pressures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970222 TI - Uptake and metabolism of norepinephrine by endothelium of dog pulmonary artery. AB - The contribution of endothelium of dog pulmonary artery to the extraneuronal metabolism of norepinephrine was determined. Pulmonary artery was cut into helical strips; the endothelium was removed from half of the strips by gently stroking them with a wooden applicator stick. All strips were immersed in l [3H]norepinephrine (2 X 10(-7) M) and mounted for superfusion. Superfusate was collected continuously before, during, and after electrical stimulation (10 V, 2 ms, 2 Hz). Column chromatography was used to separate [3H]norepinephrine and its radiolabeled metabolites in superfusate. Quantitation was by liquid scintillation spectrometry. Previous studies have established that 3,4-dihydroxyphenylglycol is of neuronal origin and that O-methylated metabolites are of extraneuronal origin. Since cocaine prevented neuronal uptake of norepinephrine, the reduction in metabolites of norepinephrine of extraneuronal origin in arteries with endothelium removed represented the contribution of endothelium to extraneuronal metabolism. O-Methylated metabolites were decreased from 3.50 to 2.17 X 10(3) dpm/2 ml of superfusate during basal conditions preceding electrical stimulation and from 11.16 to 6.94 X 10(3) dpm/2 ml of superfusate during electrical stimulation when endothelium had been removed. Decreases in extraneuronal metabolite production continued throughout the basal periods following stimulation. These studies suggest that in small pulmonary artery a substantial amount of the total norepinephrine that is released at the neuroeffector junction may be metabolized following uptake into endothelium. PMID- 3970223 TI - Function of the pericardium and pericardioperitoneal canal in elasmobranch fishes. AB - Previous studies of cardiac function in elasmobranch fishes have not included the influence of the pericardioperitoneal canal on pericardial pressure and volume and thus on cardiac function. Accordingly, we studied the function of the pericardium and pericardioperitoneal canal in sharks and rays. We found negative pericardial pressure that rose to a plateau of approximately 0 mmHg when fluid was infused into the pericardium with the canal undisturbed. However, this pericardial pressure elevation caused severe cardiac tamponade. After the canal was occluded, the pressure plateau was substituted with an exponential rise. We injected radioisotopes into the pericardial cavity and obtained scintigrams several hours later. The scans and counts of body fluids and tissues indicated absorption, disputing the suggestion that the primary function of the canal may be inadequate absorption of pericardial fluid. We conclude that the pericardioperitoneal canal maintains negative pericardial pressure, which is a prerequisite in elasmobranch fishes and may serve to regulate pericardial pressure level to optimize cardiac function in relation to changes in cardiac size. PMID- 3970224 TI - Microsphere passage through intestinal circulation: via shunts or capillaries? AB - Significant quantities of 9-micron microspheres (20-30%) are not trapped in the intestine following intracardiac or intra-arterial injection, but reach venous blood. Some investigators propose that the passage of 9-micron spheres measures blood flow through noncapillary connections. Because frequency distributions of intestinal capillary diameters and 9-micron spheres overlap, microspheres could simply pass through capillaries. Therefore, we developed simple probabilistic models to predict both the size distribution and the percentage of injected spheres [9 +/- 1 (SD) micron] that should appear in venous blood. Chief assumptions in models are that microsphere delivery and sphere diameter are independent and that microspheres pass through capillaries of equal or larger size. The passage predicted by the models was consistent with values in canine intestinal circulation, demonstrating that passage through capillaries [7.38 +/- 1.4 (SD) micron] adequately accounts for spheres in venous blood. Because the diameters of nominal 9-micron spheres were distributed too narrowly to show a marked sieving effect on passage through the intestinal circulation, we also injected microspheres varying from 5 to 20 micron in diameter. This mixture demonstrated a marked sieving effect. The predicted frequency distribution for microsphere diameters in venous blood agreed with the observed distribution. Our models demonstrate that the passage of 9-micron spheres through capillaries, rather than through "shunts," adequately accounts for the appearance of spheres in venous blood and suggests that the frequency distribution of venous microspheres can provide an in vivo method for estimating the frequency distribution of intestinal capillary diameters. PMID- 3970225 TI - Effect of high doses of aspirin on pulmonary hemodynamics and lung water. AB - The purpose of this study was to determine if aspirin, in doses that elevate plasma salicylate concentrations to values reported in patients with salicylate induced pulmonary edema, produce pulmonary vasoconstriction in a canine, isolated perfused left lower lung lobe (LLL) preparation. In 10 LLL's, aspirin (avg 97.8 mg/dl plasma) caused LLL arterial pressure to rise from 9.1 +/- 0.3 to 23.0 +/- 1.8 (SE) Torr. In contrast, no vascular pressure changes were observed in placebo treated control LLL's. Sodium meclofenamate and indomethacin, structurally dissimilar cyclooxygenase inhibitors, elicited similar responses to aspirin, suggesting that a mechanism involving products of prostaglandin cyclooxygenase was involved in producing the vasoconstriction. The double-occlusion technique was used to localize the sites of the vasoconstriction. The results suggested that all three drugs caused both lobar arterial and venous tone to increase. Although high doses of aspirin produced pulmonary vasoconstriction in the isolated, perfused LLL, the aspirin-treated LLL's gained less weight and extravascular water than the control lobes. PMID- 3970226 TI - Vasomotor response to hormonal norepinephrine in canine cerebral and hindlimb vessels. AB - We calculated the percent change in initial vascular resistance during open loop intra-arterial infusions of norepinephrine (NE) in 12 acutely denervated isolated canine brains and 5 acutely denervated perfused hindlimbs. The studies were repeated on seven chronically denervated brains devoid of perivascular sympathetic fibers. All tissues were free of residual anesthetic. Half-maximal responses were obtained at similar plasma NE concentrations in both the control brains (ED50 13.1 +/- 3.8 X 10(-6) M) and hindlimbs (ED50 9.22 +/- 2.3 X 10(-6). The maximal response was much greater in the limb vasculature (490.3 +/- 30.1%) than in the cerebral vasculature (107.2 +/- 9.5%). A fourfold increase in cerebral vascular sensitivity was noted 3 days after sympathetic gangliectomy (ED50 3.44 +/- 0.74 X 10(-6) M), without any significant change in the maximal response (101.3 +/- 5.7%). Plasma levels of NE observed in resting dogs did not constrict either vascular bed; elevated levels of NE observed in stress dogs would minimally constrict limb vessels but not acute or chronically denervated cerebral vessels. These in situ results confirm that NE does not play a significant role as a physiological vasomotor hormone and suggest that prejunctional neuronal uptake of NE is not responsible for the observed differences in cerebral and hindlimb vascular response. Furthermore, it is unlikely that denervation hypersensitivity to circulating NE plays a role in pathological cerebral vasoconstriction (vasospasm) following subarachnoid hemorrhage. PMID- 3970227 TI - Mathematical models of arterial transmural transport. AB - A finite-element model (FEM) and corresponding five-parameter analytical model (AM) were derived to study the one-dimensional transport of chemically reactive macro-molecules across (x) arterial tissue. Derivations emphasize chemical activity [a(x)], its gradient, and water flux as driving forces for chemical reactions and transport. The AM was fitted to 28 measured 125I-albumin transmural concentration [c(x)] curves giving parameter estimates of diffusivity (DA), convective velocity (nu A), and so on as functions of pressure (P), location (z) along the vessel, etc. The FEM was used to study 1) intimal-medial a(x) associated with molecular sieving and medial edema, 2) reversible binding, and 3) errors of AM in analysis of c(x). Results are as follows. Average relative error for the 28 AM fits was 5.3%. Only estimates of DA and nu A had acceptable coefficients of variation. DA (approximately 0.10 X 10(-7) cm2 X s-1) decreased with P, increased with z to a maximum, and then decreased; nu A was approximately proportional to P (approximately 0.12 X 10(-7) cm X s-1 X mmHg-1) and decreased slightly with z; distribution coefficient (epsilon F) decreased with z and was smaller for serum than for simple albumin reagent. Assumed boundary conditions for AM were associated with approximately 1.4% error in AM c(x). Parameter estimates were sensitive to wall inhomogeneity, e.g., approximately 15% error. In conclusion, the AM and FEM simulated measured c(x) well; the FEM is useful for study of mechanisms, experimental designs, and AM errors; trends of AM parameter estimates suggest dependence on P, z, and composition of reagent for further FEM and experimental study. PMID- 3970228 TI - A theoretical model of a compliant arterial stenosis. AB - Recent clinical and experimental evidence indicates that coronary artery stenoses may rapidly change their size and shape in response to alterations in vasomotor tone and intraluminal pressure. This theoretical study models a partially compliant arterial stenosis to examine the hemodynamic impact of these alterations. In rigid vessels, a 98% reduction in luminal area would predictably produce subendocardial ischemia in the resting state. In contrast, stenoses, with part of the arterial wall normal by the underlying plaque, responded to vasoconstriction and to changes in intraluminal pressure. With part of the arterial wall normal by the plaque, both vasoconstriction and decreases in intraluminal pressure could increase the hemodynamic severity of the stenosis. Further, the more eccentrically positioned the underlying plaque was, the greater the effects of vasoconstriction and intraluminal pressure on stenotic severity. Thus the morphological configuration of the plaque and the normal wall segment in the stenosis appear to be important determinants of the hemodynamic response of the stenosis to vasoconstriction and blood pressure changes. In turn, these changes in stenotic severity can greatly influence flow through the vessel. PMID- 3970229 TI - Phenothiazine suppression of transient depolarizations in rabbit ventricular cells. AB - We have examined the effects of trifluperazine and fluphenazine on action potentials and transient depolarizations of rabbit ventricular cells. Isolated myocytes were prepared by perfusing rabbit hearts with low calcium enzyme containing solutions, and action potentials were stimulated at 1 Hz and recorded using patch-type pipettes. In normal saline, 10 microM trifluperazine or fluphenazine shifted the action potential plateau to more negative potentials and increased the rate of phase 2 repolarization. Transient diastolic depolarizations appeared in solutions containing 50 nM isoproterenol plus 1 microM strophanthidin. These transient depolarizations were abolished by the addition of 10 microM trifluperazine or fluphenazine. In addition, spontaneous transient depolarizations were occasionally observed, and these too were abolished by the phenothiazines. Because these compounds are potent inhibitors of calmodulin, these data raise the possibility that calcium-calmodulin-regulated processes are important in the generation of arrhythmogenic transient depolarizations. PMID- 3970230 TI - Glucose transport by lobster hepatopancreatic brush-border membrane vesicles. AB - Epithelial brush-border membrane vesicles (BBMV) were made from lobster hepatopancreas by using Mg2+ precipitation. Alkaline phosphatase, Na+-K+-ATPase, and cytochrome c oxidase activities in these vesicles were enriched 15.0-, 1.0-, and 0.19-fold, respectively, compared with activities of a washed original homogenate pellet, indicating a relatively pure apical membrane preparation reduced in basolateral or organelle contamination. Complete vesicular closure was confirmed with electron microscopy and equilibrium [3H]D-glucose uptake experiments using various transmembrane osmotic gradients. Glucose uptake was stimulated by a transmembrane Na+ gradient but not by an identical K+ gradient or by a Na+ gradient in the presence of phloridzin. Electrogenicity of Na+-dependent glucose transport was confirmed in two ways. First, an anion permeability sequence indicated glucose uptake was stimulated in the following order: SCN- greater than Cl- greater than gluconate- greater than SO4(2-). Second, an outwardly directed valinomycin-induced K+ diffusion potential, rendering the vesicle interior electrically negative, enhanced glucose uptake compared with K+ loaded vesicles lacking the ionophore. Glucose influx occurred by a combination of carrier-mediated transfer, illustrating Michaelis-Menten kinetics, and nonsaturable "apparent diffusion." pH (same on both sides) strongly influenced Na+-dependent glucose uptake according to the sequence: pH 6.0 greater than pH 7.4 greater than pH 8.0. Increased proton concentration lowered the Michaelis constant for glucose transport and increased the apparent diffusional permeability of the membrane to the sugar. Maximal carrier-mediated glucose transport rate was largely unaffected by pH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970231 TI - Plasma corticosterone and volume after preoptic recess lesions and volume depletion. AB - The effects of extracellular fluid volume depletion on plasma corticosterone concentration (Pcort) and plasma volume in rats were determined after recovery from either electrolytic ablation of the periventricular tissue surrounding the anteroventral third ventricle (AV3V region) or control surgery. Rats received either furosemide injections and sodium-free chow or isotonic saline injections and continued access to sodium-replete food. One week after these injections some animals were decapitated and trunk blood collected for analysis of Pcort by radioimmunoassay. The remainder of the rats were implanted with femoral arterial catheters to obtain blood samples for measurement of plasma and blood volumes by calculating dilution of 125I-labeled serum albumin. Volume-replete rats with AV3V lesions had significantly higher Pcort concentrations and smaller plasma and blood volumes than volume-replete control-operated animals. Furthermore, volume depletion induced by furosemide caused a significant increase in Pcort concentration only in rats with AV3V ablations, whereas plasma and blood volumes were significantly lowered in both groups. These data demonstrate that AV3V periventricular ablation results in a chronic elevation of Pcort in the volume replete animals and an exaggerated glucocorticoid response to volume depletion. These data show that decreased PV characteristic of animals with AV3V lesions is not due to glucocorticoid insufficiency. PMID- 3970232 TI - Activation of branched-chain keto acid dehydrogenase by exercise. AB - The present study was conducted to investigate the metabolic regulation of leucine oxidation during exercise. Ten rats per group were run at 27 m/min (0% grade) on a treadmill for 30 and 120 min or until exhausted, and the total and basal activity of branched-chain keto acid dehydrogenase was examined in the muscle, liver, and heart. The total activity of the dehydrogenase in the heart, liver, or skeletal muscle was unchanged by exercise. However, exercise increased the basal activity levels of the dehydrogenase about 10-fold in muscle and 5-fold in heart. The basal dehydrogenase activity in the liver was unchanged by exercise. Activation of the dehydrogenase in both muscle and heart was statistically elevated after 30 min exercise and continued to increase during the remainder of the exercise bout. The basal activity of the dehydrogenase returned to resting levels by 10 min postexercise. The activation of the dehydrogenase in muscle and heart during exercise likely is due to dephosphorylation because activity of the enzyme in mitochondria isolated from exercised muscles reverts to control values when the mitochondria are incubated in the presence of ATP. Thus the increased leucine oxidation observed during exercise is due to activation of the branched-chain keto acid dehydrogenase by dephosphorylation. This is the first example of a large increase in branched-chain keto acid dehydrogenase activity caused by a physiological process. This demonstrates that the muscle's latent capacity of oxidize branched-chain amino acids is much larger than previously thought and that this capacity is used in exercising muscle. PMID- 3970233 TI - Differential effects of food restriction on pituitary-testicular function in mice. AB - The reproductive responses of two species of wild rodents, house mice and deer mice, were evaluated following a 30% reduction in food intake for 5 wk. These animal models were chosen as prototypes of other rodent species because each employs unique functional adjustments when confronted with reduced resources in their natural habitats. Modest inanition failed to alter pituitary-testicular function in house mice; neither spermatogenesis nor plasma concentrations of luteinizing hormone (LH) and testosterone were modified. In sharp distinction, deer mice exposed to restricted food intake showed significant reductions in plasma LH and testosterone and an accompanying loss in spermatogenesis. Reduced food intake also caused pronounced shifts in the temporal organization and amount of wheel-running activity in both animal models, albeit in a dichotomous fashion. House mice exhibited the same amount of wheel-running activity throughout inanition, but the diel periodicity of locomotor behavior was shifted from the dark to the light period. Deer mice, in comparison, significantly curtailed wheel running activity during the dark hours but ran in precise phase relationship with the light-dark cycle. Taken together, our results establish that the male reproductive system and its supporting neuroendocrine and behavioral correlates can be disrupted by modest levels of food restriction in certain animal models. PMID- 3970235 TI - Renal mechanoreceptors in nonhuman primates. AB - The present experiments provide the first description of the afferent discharge characteristics of renal mechanosensitive receptors in the nonhuman primate. Twenty-seven single units with mechano-sensitive receptor activity were obtained. Afferent discharge occurred regularly (pulse synchronous) or irregularly (pulse asynchronous) under spontaneous respiration. The activity of pulse synchronous units was increased by partial occlusion of the renal vein and elevation of arterial pressure. Impulse activity decreased or disappeared during bleeding or renal arterial occlusion. The impulse activity of pulse asynchronous units was increased by partial occlusion of the renal vein. The impulse activity of silent units was induced only by partial occlusion of the renal vein. An increase in ureteral pressure (50 mmHg) produced an increase or induced impulse activity in only three of the 27 fibers tested. Compression of the kidney or renal venous occlusion was associated with a decrease in systemic arterial pressure, whereas renal arterial occlusion produced a rise in systemic arterial pressure. An increase in ureteral pressure (50 mmHg) did not produce a change in arterial pressure. PMID- 3970234 TI - Water and ion shifts in skeletal muscle of humans with intense dynamic knee extension. AB - Six subjects performed one-legged dynamic knee-extension. Blood samples were drawn from the femoral artery and vein, and muscle biopsies were obtained from the quadriceps muscle. Leg blood flow was measured by the thermodilution technique, and 3H-inulin was infused for determination of extra- and intracellular muscle water shifts. During the submaximal work load (S) muscle lactate increased, whereas muscle pH remained almost constant; after maximal exercise (M) the values markedly increased for lactate and decreased for pH. Except for a release of lactate from the exercising muscles, K was continuously released throughout S, and this release increased during M. Immediately when the muscles relaxed, the K release was converted to a K re-uptake. The calculated K loss, based on v- a and flow values, agreed with the decrease in muscle K content from 458 mmol/kg dw at rest to 414 mmol/kg dw at exhaustion (P less than 0.05), as analyzed on the muscle biopsies. Muscle water content increased during S mainly because of an increased extracellular H2O, whereas during M the largest increase occurred in intracellular H2O (H2Oi). Because of the simultaneous K loss and H2Oi increase in the exercising muscle the intracellular [K] was calculated to decrease from 165 mM at rest to 129 mM at exhaustion. This decrease and an increase in extracellular [K] from 4.5 mM at rest to greater than 6.0 mM at exhaustion affects the muscle membrane excitability. Muscle fatigue may thus not only be caused by changes within the cell, affecting energy metabolism or actin myosin reaction, but may be located at the membrane protecting the cell against overload. PMID- 3970236 TI - Hyperdipsia in rats after electrolytic lesions of nucleus medianus. AB - Ablation of the ventral portion of nucleus medianus (vNM) in rats produced a temporary adipsia or hypodipsia that was accompanied by pronounced urinary fluid losses. When ad libitum drinking resumed, about half of the brain-damaged animals became hyperdipsic, exhibiting chronic two- to threefold elevations in their daily water intakes during the nocturnal hours of the day-night cycle. Rats that remained normodipsic after vNM ablation usually exhibited hyperdipsia if they were food-deprived overnight. The basis for the hyperdipsia produced by vNM ablation was not clear. The elevated water intakes appeared not to result from chronic urinary fluid losses, because hyperdipsic rats were able to concentrate their urine during the day, when they drank little. Moreover, the animals did not seem to be volume depleted; their plasma renin activities were not elevated, and they drank normally in association with meals. These and other findings suggest that vNM lesions damage neural substrates that control drinking behavior, and the hyperdipsia results from this rather than from physiological changes produced by the lesion. PMID- 3970237 TI - Impaired drinking responses of rats with lesions of nucleus medianus: circadian dependence. AB - The drinking behavior of rats with electrolytic lesions of ventral nucleus medianus (vNM) was examined during acute hyperosmolality and hypovolemia. The brain-damaged animals were impaired in their drinking responses to systemic treatment with hypertonic saline or polyethylene glycol solution when they were tested during the day. However, apparently normal drinking responses to both dipsogenic challenges were observed when the same animals were pretreated with the stimulant drug, caffeine, or when they were tested at night. These results suggest that lesions of vNM may produce complex alterations in the control of drinking behavior rather than the destruction of sensory receptors. The lesions appear to disrupt both circadian influences on drinking and activational components of drinking that normally serve to facilitate the behavioral response. The present results, together with similar findings for rats given lesions of the subfornical organ, support recent proposals that periventricular tissue bordering the rostral wall of the third cerebral ventricle plays an important role in the central control of drinking. PMID- 3970239 TI - Organization of sympathetic responses to distension of urinary bladder. AB - Distension of the urinary bladder can cause reflex pressor responses, which appear to be mediated by increased sympathetic activity. However, preganglionic upper thoracic sympathetic activity is excited inconsistently by bladder distension in intact and spinal animals. The objective of this investigation was to determine if any of the postganglionic nerves originating from thoracic and lumbar spinal segments are consistently excited by vesical afferent nerves. Responses of external carotid, renal, and splenic sympathetic nerves to distension of the urinary bladder were evaluated in chloralose-anesthetized cats. In addition, the potential preferential spinal segmental distribution of vesico sympathetic reflexes was assessed by comparing the magnitudes of external carotid, renal, and splenic nerve responses. Distension of the urinary bladder with 5-35 ml saline initiated vesical contractions to pressures of 45-90 cmH2O and caused inconsistent changes in arterial pressure and activity of renal and splenic sympathetic nerves. External carotid nerves were excited by this stimulus. Vesical distension with 12-50 ml saline caused contractions to vesical pressures of 135-175 cmH2O and produced consistent increases in arterial pressure and activity of all three nerves. Thus activation of vesical afferent nerves by high pressure produced excitation of upper thoracic vasomotor neurons and of two major components of splanchnic and lumbar sympathetic outflow. The magnitudes of external carotid, renal, and splenic sympathetic responses were not different, illustrating that propriospinal circuits thought to mediate vesicosympathetic responses are not organized segmentally. PMID- 3970238 TI - Brown adipose tissue lipectomy leads to increased fat deposition in Osborne Mendel rats. AB - Inter- and subscapular brown adipose tissue depots were removed from nine female Osborne-Mendel rats. These lipectomized animals and nine sham-operated controls recovered from surgery for 7 days at 25 degrees C and were then placed on a highly palatable liquid diet. All animals were maintained for a 2nd wk at 25 degrees C before being switched to 8 degrees C. After 9 wk in the cold, animals were killed, and the brown adipose tissue was dissected from scapular, cervical, thoracic, perirenal, and axillary regions. Total brown fat pad mass, protein content, brown adipocyte number, citrate synthase activity, and beta-hydroxyacyl CoA dehydrogenase activity in each of the dissected brown fat depots were significantly less than those of the sham-operated controls. Thus there was incomplete metabolic compensation in the remaining brown fat depots after the removal of the scapular brown fat in the lipectomized rats. The mass and lipid content of the retroperitoneal white adipose depot were significantly increased in the lipectomized rats as was their carcass fat content (up 14%). Food intake of the lipectomized rats was slightly but significantly decreased. These data indicate that a reduction in the amount of functional brown fat is accompanied by increased body fat accretion and are thus consistent with the hypothesis that decreased brown adipose thermogenesis can lead to altered energy balance and increased white fat deposition. PMID- 3970240 TI - Effect of stimulation of nucleus raphe dorsalis on carotid blood flow. I. The monkey. AB - The dorsal raphe nucleus (DRN) and surrounding midbrain of 16 anaesthetized monkeys were stimulated electrically, and carotid blood flows were measured with electromagnetic flow probes. Stimulation of the DRN caused a frequency-dependent decrease (vasodilatation) in both internal and external carotid vascular resistance, which was abolished in both circulations by bilateral section of the facial nerve intracranially. These vasodilator responses were unaltered by intravenous administration of muscarinic cholinergic or by alpha- or beta adrenoceptor antagonists. A postdilatation constrictor response, observed in the external carotid circulation, was blocked by the alpha-adrenoceptor antagonist phentolamine. It is concluded that projections of the DRN through the greater superficial petrosal branch of the facial nerve mediate vasodilatation in both internal and external carotid circulations. PMID- 3970241 TI - The time course of information-processing deficits in schizophrenia. AB - A visual backward masking task was used to specify the time course of the information-processing dysfunction in 19 schizophrenic patients and 15 matched control patients using novel interstimulus intervals. The authors found that the information-processing deficit in schizophrenic subjects occurred at interstimulus intervals of greater than 60 msec and less than 500 msec. These data are compared with the results of evoked-potential and other psychophysiological studies. The visual-processing impairment is specific and time-linked rather than a reflection of the effects of gross psychopathology or medication in schizophrenic individuals. PMID- 3970242 TI - The behavioral high-risk paradigm and bipolar affective disorder, VIII: Serum free cortisol in nonpatient cyclothymic subjects selected by the General Behavior Inventory. AB - The degree of biologic concordance between bipolar affective disorder and cyclothymia was assessed within a 3-hour protocol of cortisol functioning. Cyclothymic subjects, selected by the General Behavior Inventory, showed cortisol hypersecretion approaching that of subjects with major affective disorders; they also showed poor modulation of cortisol levels over time, the degree of which was related to increased current level of depression and to a chronic, intermittent depressive course. These results not only support the validity of the General Behavior Inventory but also suggest that cyclothymic subjects with a chronic depressive course may experience persistent biologic disturbance similar to that found during episodes of major depression. PMID- 3970243 TI - The nosologic status of borderline personality: clinical and polysomnographic study. AB - The REM latencies of 24 nonschizotypal borderline outpatients--who were not in the midst of a major depressive episode--were in the range of those of 30 patients with primary major depression but were significantly shorter than those of 16 patients with nonborderline personality disorders and 14 nonpsychiatric controls. Also, more of the borderline subjects had lifetime diagnoses of affective disorder, such as dysthymic, cyclothymic, and bipolar II disorder, and of a spectrum of anxiety and somatization disorders. The authors conclude that contemporary operational criteria for borderline disorder identify a wide net of temperamental disorders with strong affective coloring rather than a unitary nosologic entity. PMID- 3970244 TI - Occupation-induced posttraumatic stress disorders. AB - The authors describe a variant of posttraumatic stress disorder that presents as a somatoform disorder. Applying clearly specified diagnostic criteria, they found that seven of 21 patients who were severely disabled by medically unexplained symptoms following occupational exposure to toxic substances had atypical posttraumatic stress disorder, while three patients had typical posttraumatic stress disorder and the remainder suffered from somatoform disorders. Analysis of these cases revealed specific exposure factors and personality characteristics that favor the development of atypical posttraumatic stress disorder. The authors discuss the theoretical, clinical, and therapeutic advantages of this diagnosis. PMID- 3970245 TI - The relationship between syndrome and personality disorder in DSM-III: experience with 2,462 patients. AB - The authors studied the relationship between DSM-III axis I and axis II diagnoses in 2,462 medical center patients. Personality disorders were most commonly associated with substance use disorders and with the anxiety and somatoform disorders traditionally classified as neuroses. There was a particularly strong connection between antisocial personality disorder and substance abuse. The psychotic and major affective illnesses were significantly less often associated with personality disorders. The results of this study suggest a need for refining the criteria for several DSM-III categories. Overall, the separate personality disorder axis in the DSM-III system provides information not contained with the syndromal classification alone. PMID- 3970246 TI - The fences of psychiatry. PMID- 3970247 TI - The norepinephrine-to-epinephrine ratio in patients with a history of suicide attempts. AB - Norepinephrine and epinephrine were measured serially in 24-hour urine collections from 99 male psychiatric inpatients with mixed diagnoses. The group was blindly divided into those with a previous history of at least one suicide attempt (N = 38) and those without such a history (N = 61). The ratio of norepinephrine-to-epinephrine levels was significantly lower in the group with a history of suicide attempts. The authors discuss the possibility that a low norepinephrine-to-epinephrine ratio is a risk factor for suicidal behavior. PMID- 3970248 TI - Self-inflicted gunshot wounds: lethality of method versus intent. AB - The authors studied 30 patients treated at an urban trauma center for self inflicted gunshot wounds, most or all of which would have been fatal without emergency treatment. About half the patients had used alcohol or drugs immediately before wounding themselves, and slightly more than half had experienced interpersonal conflict just before the incident. Thirteen of the 30 were women. Only nine were given diagnoses of major depressive episode or dysthymia; none of the patients had written suicide notes. These data indicate that the reported demographic and clinical characteristics of impulsive, violent self-injury must be reexamined. PMID- 3970249 TI - Medication nonadherence due to feelings of loss of control in "biological depression". AB - While the biological explanation of depression has been expected to help patients accept the illness, some patients do not accept that they cannot control it psychologically. This reaction may interfere with adherence to drug treatment. PMID- 3970250 TI - Results of the dexamethasone suppression test in psychiatric patients with and without weight loss. AB - Rates of nonsuppression on the dexamethasone suppression test were compared in 32 psychiatric inpatients with reported weight loss and 32 psychiatric inpatients without weight loss who were matched for age, sex, and diagnosis. There was no significant difference in rate of nonsuppression. PMID- 3970251 TI - Neurophysiological correlates of sibling pairs discordant for bipolar affective disorder. AB - Eleven sibling pairs discordant for bipolar disorder were compared on the basis of computerized EEGs and auditory evoked potentials. The findings suggest that CNS overarousal may be characteristic of trait bipolar disorder. PMID- 3970252 TI - Prevalence of multiple personality among inpatients and outpatients. AB - A survey of psychiatric inpatients (N = 50) and outpatients (N = 100) indicated that about 10% had multiple personality and an additional 5%-20% had amnesia for early traumatic experiences. PMID- 3970253 TI - Depression and adrenal function in spinal cord injury. AB - Of 32 patients with spinal cord injury, 14 had a DSM-III diagnosis of depressive disorder: 12 had major depression (five with melancholia) and two were dysthymic. In those with major depression, a dexamethasone suppression test lacked sensitivity (30%) and specificity (50%). PMID- 3970254 TI - Plasma serotonin levels in agoraphobia. PMID- 3970255 TI - Topics in Soviet psychiatry. PMID- 3970256 TI - Are results on the dexamethasone suppression test affected by ethnic background? PMID- 3970257 TI - The availability of D-phenylalanine and DL-phenylalanine. PMID- 3970259 TI - Sensitization to thioridazine through sexual intercourse. PMID- 3970260 TI - Hypnosis as a diagnostic tool. PMID- 3970258 TI - Dopamine agonists and neuroleptic malignant syndrome. PMID- 3970261 TI - Treatment of major depression and Parkinson's disease with combined phenelzine and amantadine. PMID- 3970262 TI - Importance of medical anthropology in clinical psychiatry. PMID- 3970263 TI - Case report of sudden and unexpected death after tricyclic overdose. PMID- 3970264 TI - The course of psychiatric disorder, III: Longitudinal principles. AB - The authors studied 28 patients hospitalized for functional psychiatric disorder in an attempt to explore systematically the course of psychiatric disorder. Data collected over the 2-year period following discharge suggested the existence of eight longitudinal principles for understanding the course of psychiatric disorder. These principles reflect identifiable phases and some of the factors involved in a patient's remaining in one phase or moving on to a new phase. The clinical and research implications of these principles are described. PMID- 3970265 TI - Secondary disaster victims: the emotional effects of recovering and identifying human remains. AB - The author conducted a questionnaire survey of the 592 U.S. Air Force personnel involved in transporting and identifying the bodies of the almost 1,000 persons who died in Jonestown, Guyana; 225 (38%) of the personnel involved returned the questionnaire, as well as 76 (22%) of 352 individuals who were not involved in the operation. The Guyana respondents reported significantly more short-term dysphoria, which was more pronounced in those younger than 25 years of age, those who were black, those who were enlisted men rather than officers, and those with more exposure to the bodies. The author discusses the implications of these findings in planning future disaster relief programs. PMID- 3970266 TI - White House Cases: psychiatric patients and the Secret Service. AB - Delusional visitors to the White House or other government offices (often seeking a personal audience with the President) are interviewed by the Secret Service and then sent to Saint Elizabeths Hospital if they are considered mentally ill and potentially dangerous to themselves or others. A review of the demographic characteristics and diagnoses of 328 of these "White House Cases" treated at the hospital between 1970 and mid-1974 showed that these patients were most commonly unmarried, white, and male, and most had a diagnosis of paranoid schizophrenia. Although 22% of this group have threatened some prominent political figure, to date none of this study's patients has attempted to assassinate any such government official. PMID- 3970267 TI - A study of 15 matricidal men. AB - The authors studied 15 men who committed matricide. The majority were diagnosed as having chronic schizophrenia and had been living alone with their mothers. Other diagnoses included substance-induced psychosis and impulse disorders. Specific psychodynamic and environmental factors can be identified for each diagnostic category. The authors conclude that the matricidal impulse evolves through successive stages of psychological development; therefore, the motives for matricide are varied and correlate with the level of psychological development or regression. PMID- 3970268 TI - The dexamethasone suppression test and mood following stroke. AB - Dexamethasone suppression tests (DSTs) were given to 65 acute and chronic stroke patients. For patients who had had a stroke less than 1 year earlier, nonsuppression on the DST was significantly associated with the presence of poststroke depression. The authors, who used the DSM-III symptom criteria for major depression, found that DST sensitivity was 67% but specificity was only 70%. False positive tests in the stroke patients seemed related to large lesion volume. The DST, although of limited clinical utility in this population because of false positive tests, may help define more homogeneous subtypes of poststroke depression for research. PMID- 3970269 TI - The impact of depression in old age on close social relationships. AB - Changes in the ratings of intimacy of personal relationships in depressed elderly patients were studied over a 1-year period. Those patients who had recovered by the end of the year were significantly more likely to report an improvement in the quality of their close relationships then were patients who had a poor clinical outcome. Changes in reports of intimacy were due not only to the effect of depression on the quality of relationships but also to independent life events occurring in the follow-up period. PMID- 3970270 TI - Geropsychiatric consultation in a university hospital: a report on 67 referrals. AB - The author describes the evaluation and treatment of 67 patients 60 years old or older who were referred to a consultation-liaison service in a university hospital. Age, sex, referring service, reasons for referral, psychiatric diagnosis, and interventions or recommendations were determined. Primary psychiatric diagnoses included depression (24%), dementia (19%), delirium (18%), schizophrenia (16%), and personality disorders (12%). Recommendations or interventions included advice in the use of psychotropic medications (61%), assistance with competency issues (25%), recommendation for further medical evaluation or treatment (36%), individual psychotherapy (28%), family therapy (25%), disposition planning (24%), and transfer to a geropsychiatry unit (12%). Hospitalized elderly patients with emotional problems represent a unique diagnostic and therapeutic challenge. PMID- 3970271 TI - Dose and plasma levels of nortriptyline and chlorpromazine in delusionally depressed adolescents and of nortriptyline in nondelusionally depressed adolescents. AB - Eight adolescents with major depressive disorder were treated with nortriptyline and six adolescents with delusional depression were treated with combined nortriptyline and chlorpromazine. Dose and plasma levels of nortriptyline for the two groups were compared. The delusional group receiving combined drug treatment needed significantly less nortriptyline than did the nondelusional group receiving only nortriptyline to obtain similar mean steady state plasma levels of the drug. The mean plasma chlorpromazine levels were quite low. PMID- 3970272 TI - Gender identity in childhood and later sexual orientation: follow-up of 78 males. AB - Two groups of males were evaluated on parameters of gender identity, initially in boyhood and later in adolescence or young adulthood. One group was composed of 66 clinically referred boys whose behaviors were consistent with the diagnosis of gender identity disorder of childhood. The other group consisted of 56 volunteers selected on the basis of demographic matching. Two-thirds of each group were reevaluated for sexual orientation; 30 of the 44 who previously had shown extensive cross-gender behavior and none of the 34 in the comparison group were bisexually or homosexually oriented. PMID- 3970273 TI - DSM-III in Botswana: a field trial in a developing country. AB - The author found that DSM-III criteria were generally applicable to the diagnoses of a series of new and repeat outpatients studied under field conditions in Botswana, a developing African country. Some problems were encountered, however, with axis II, which was not commonly used. Other clinical aspects of the patients are commented on, including the rarity of acute psychoses and culture-bound syndromes. PMID- 3970274 TI - Hysterical psychosis: an empirical approach. AB - Criteria for hysterical psychosis set forth by Hollender and Hirsch were systematically applied to a representative sample of 217 patients hospitalized for the first time in their lives for functional psychiatric illness. Surprisingly, no patients who met all of these criteria were found. PMID- 3970275 TI - Agitation-increased electromyogram activity in the corrugator muscle region: a possible explanation of the "Omega sign"? AB - The corrugator muscle region of the forehead has special significance in producing facial expressions associated with depression. Darwin observed in 1872 that contractions in the corrugator region produce peculiarly formed wrinkles on the forehead, referred to as "Omega Melancholium." In the present study, results from 61 right-handed, drug-free women with major depressive disorder showed a significant positive correlation between facial corrugator EMG values and psychomotor agitation. Results were not due to differences in severity of depression. These data offer preliminary evidence that agitation is reflected in corrugator muscle activity and may explain the "Omega sign" of melancholia. PMID- 3970276 TI - Brainstem and vermis atrophy in catatonia. AB - The computerized tomographic scans of five catatonic patients and five matched controls were blindly assessed. The catatonic patients showed preponderant atrophy of the brainstem and cerebellar vermis. Catatonia may be associated with lesions in these areas. PMID- 3970277 TI - Clonazepam in the treatment of recurrent symptoms of depression and anxiety in a patient with systemic lupus erythematosus. AB - A patient undergoing steroid therapy for systemic lupus erythematosus developed symptoms of depression and anxiety that did not respond to conventional drug therapy. A regimen of clonazepam, an anticonvulsant drug, did relieve the symptoms. PMID- 3970279 TI - Behavioral treatment in two cases of obsessive-compulsive disorder with concomitant bipolar affective disorder. AB - The authors describe two cases of obsessive-compulsive disorder with concomitant bipolar affective disorder. Behavior therapy consisting of in vivo exposure plus response prevention controlled the obsessive-compulsive symptoms only after the affective illness was well controlled pharmacologically. PMID- 3970278 TI - Biochemical RBC abnormalities in drug-free and lithium-treated manic patients. AB - RBCs from two lithium-free manic patients displayed lower choline transport and higher choline concentrations and methionine S-adenosyltransferase activity than those of controls. Lithium therapy decreased RBC methionine S-adenosyltransferase activity to normal, decreased choline transport further, and increased choline concentrations further. PMID- 3970280 TI - Separate heritability of alcoholism and psychotic symptoms. AB - The authors identified 259 alcoholic probands and 507 first-degree relatives. Alcoholic relatives of probands with psychotic symptoms were significantly more likely to have psychotic symptoms than those related to probands without psychotic symptoms. This finding suggests separate genetic transmission. PMID- 3970281 TI - Three cases of posttraumatic anorexia nervosa. AB - Three patients developed anorexia nervosa after car accidents that caused physical injuries. These cases suggest that anorexia nervosa can be secondary to real or perceived figure distortion and that some cases may be caused by it. PMID- 3970282 TI - Iron pigment in the brain of a man with tardive dyskinesia. AB - A 64-year-old man with bipolar affective disorder developed persistent tardive dyskinesia following an overdose of lithium and haloperidol. Two years later he died of unknown causes. Neuropathologic examination revealed extensive deposition of iron in basal ganglia and substantia nigra. PMID- 3970283 TI - Trazodone-induced mania following desipramine-induced mania in major depressive disorders. PMID- 3970284 TI - More positive supreme court views on psychiatry. PMID- 3970285 TI - Three case reports of a single homicidal adolescent. PMID- 3970287 TI - Pseudoseizure in a child with epilepsy. PMID- 3970286 TI - Pridinolum mesylate and neuroleptic malignant syndrome. PMID- 3970288 TI - Psychotic processes in delirium. PMID- 3970289 TI - Auditory hallucinations in a prelingually deaf man? PMID- 3970290 TI - Asylum not the answer for the chronically mentally ill. PMID- 3970291 TI - Brief psychotherapy may not precipitate decompensation. PMID- 3970292 TI - A psychoanalytic view of the relationship between delusional depression and bipolar disorder. PMID- 3970293 TI - Diagnosis of posttraumatic stress disorders in Vietnam veterans. PMID- 3970294 TI - Predicting optimal lithium dose. PMID- 3970295 TI - An optimistic view of community consultation. PMID- 3970296 TI - Acral arteriovenous tumor. A clinicopathologic review. AB - We reviewed 47 cases of a distinctive, benign vascular tumor, acral arteriovenous tumor. Study of the clinical histories of patients with this tumor emphasized the difficulty of making a clinical diagnosis. Most of the tumors were asymptomatic and were found in generally healthy middle-aged or elderly male patients. Distribution was acral; 79% of the tumors were located on the head or extremities. Histologic study showed a component of capillary nevus in some cases in addition to the typical venous and arteriovenous channels. PMID- 3970297 TI - Parathyroid gland morphology in nonparathyroid hormone-mediated hypercalcemia. AB - Occasionally, patients with other causes of hypercalcemia undergo parathyroidectomy for suspected primary hyperparathyroidism. We studied the parathyroid glands from 12 persons with nonparathyroid hypercalcemia. Glands from these individuals were similar to normal glands in size and fat:parenchymal ratio, showing neither atrophy nor hyperplasia. A distinctive histologic feature, also seen in hyperparathyroid hypercalcemia, is the presence of pale, vacuolated cells arranged in a trabecular pattern. Recognition of normal parathyroid parenchymal weight and the nonspecific nature of these vacuolated cells is necessary to prevent false-positive diagnoses of parathyroid hyperplasia. For glands which have not been weighted, parenchymal cross-sectional area can only be used as a rough index of parenchymal weight. PMID- 3970298 TI - Differences between nonfamilial and familial cardiac myxoma. AB - Comparison of certain clinical and pathologic features among patients who have nonfamilial cardiac myxoma with those of patients who have familial cardiac myxoma showed statistically significant differences. Nonfamilial cardiac myxoma was a disorder of middle-aged (mean age, 51 years) women (76%), usually occurred in the left atrium (86%) as a single tumor (94%), and had no particular associated conditions. Familial cardiac myxoma, on the other hand, was a disorder of young (mean age, 24 years) men (66%), was less commonly in the left atrium (62%), was often multicentric (33%), and was occasionally associated with unusual or rare conditions (20%). PMID- 3970299 TI - Cronkhite-Canada syndrome associated with a rectal cancer and adenomatous changes in colonic polyps. AB - A 52-year-old man with the clinical features of Cronkhite-Canada syndrome developed rectal cancer. Radiologic and endoscopic examinations revealed gastrointestinal polyposis. Histologic examination of the biopsied polyps showed cystic dilatation of glands with an inflammatory stroma. A later biopsy from a rectal polyp proved to be an adenocarcinoma. The totally resected colon and upper rectum had an ulcerated rectal cancer and numerous polyps; most of the polyps showed histological changes typical of the syndrome. Only three polyps had adenomatous changes at their surfaces. Adenomatous and carcinomatous changes of epithelia can occur in non-neoplastic polyposis of Cronkhite-Canada syndrome from which presumably a carcinoma can develop, as in the present case. PMID- 3970300 TI - Fibrolipomatous hamartoma of nerve. A clinicopathologic analysis of 26 cases. AB - Nineteen cases of fibrolipomatous hamartoma of nerve without macrodactyly and seven cases with macrodactyly are discussed. Twenty-five involved the hand, wrist, palm, and finger, and one case involved the foot. Nineteen patients had isolated fibrofatty enlargement of nerve, while seven had macrodactyly in addition to the peripheral nerve changes. Involved nerves included the median nerve, ulnar nerve, an unidentified nerve near the elbow, and a nerve on the dorsum of the foot. Four of nine patients with neurologic symptoms of pain or paresthesias had physical findings compatible with compression neuropathy, and two others were described as having carpal tunnel syndrome. Most patients had been aware of a mass for several years. Microscopically, the lesion was characterized by fibrofatty enlargement of nerve with massive epineural and perineural fibrosis. In two of the cases with macrodactyly, the fibrofatty enlargement of the nerve was associated with overgrowth of bone and the surrounding subcutaneous tissues. In one case, the perineural fibrosis was associated with metaplastic bone. The histogenesis of fibrofatty overgrowth of nerve has been disputed. Mature fat cells have been described within the normal nerve sheath, and it is thought that proliferation of these cells leads to the fatty enlargement of the nerve and its coverings. The relationship of these neural changes to the development of macrodactyly remains controversial. Follow up in 18 patients (69%) reveals a benign course following biopsy, limited excision, or division of the flexor retinaculum in the wrist. PMID- 3970301 TI - Diffuse malignant peritoneal mesothelioma in a 13-year-old girl. Report of a case and review of the literature. AB - A case of diffuse malignant peritoneal mesothelioma in a 13-year-old girl is described. The patient had a short history of abdominal pain, distention, and tenderness. At laparotomy she was found to have ascites and numerous nodules and plaques affecting the peritoneal cavity and the omentum. A diagnosis of diffuse pseudotumoral deciduosis was made, which on review was revised to malignant peritoneal mesothelioma. The patient's condition gradually deteriorated and she died 8 months after diagnosis in spite of administration of combination chemotherapy. PMID- 3970302 TI - Swamp rice farming: possible effects on endemicity of schistosomiasis mansoni and haematobia in a population in Liberia. AB - To obtain a better understanding of the possible influence of swamp rice farming on the patterns of Schistosoma mansoni and Schistosoma haematobium infections, the populations of two communities in rural liberia were studied. In one village, Balama (population of 435), swamp rice farms were initiated six years before the survey; in the other nearby community, Gbarta (population of 216), swamp rice farms had not yet been initiated. The prevalence of S. mansoni infection in Balama was 87% vs. 9% in Gbarta (P less than 0.01). The geometric and arithmetic mean egg counts for all infected subjects in Balama were respectively 263 and 671/g feces. in Gbarta, the geometric and arithmetic mean egg counts were 150 and 129/g feces. S. haematobium eggs were detected in 42% of subjects in Balama vs. 11% in Gbarta (P less than 0.01). Hematuria correlated with the presence of S. haematobium eggs in urine. These data indicate that there is a significantly higher prevalence and intensity of schistosomiasis mansoni and haematobia in a community where swamp rice farming has been utilized for 6 years compared to a nearby village where this water irrigation and drainage practice has not yet been implemented. PMID- 3970303 TI - Regression of splenomegaly and hepatomegaly in children treated for Schistosoma haematobium infection. AB - During a study in Kenya of the relationships between Schistosoma haematobium infection and anemia and growth, evidence was found to suggest that this infection was associated with splenomegaly in children, and that both splenomegaly and hepatomegaly regressed in children treated for urinary schistosomiasis, compared with a placebo group. These results imply that S. haematobium is partially responsible for the splenomegaly and hepatomegaly found in this malarious area, and that treatment for S. haematobium may cause a significant regression of splenomegaly and hepatomegaly in children. PMID- 3970304 TI - Statistical aspects of hydatid disease in Greek adults. AB - A retrospective study was undertaken to estimate the incidence of hydatidosis among Greeks over 18 years of age. Discharge and operating room records in all community and private hospitals during the period 1 January 1969 to 31 December 1975 were reviewed, and new hydatid patients were registered. Hydatid disease was diagnosed in 4,202 adults. The average annual incidence of all hospital cases was 9.77 per 100,000 population. The diagnosis was confirmed at surgery in 3,397 patients (80.84%). The average annual surgical incidence was 7.89 per 100,000 inhabitants. The incidence of the disease varied among different geographic areas in the country; its percentage was highest in rural areas. In this series, both sexes were equally involved (P greater than 0.1). Solitary organ involvement occurred in 95.88% of cases. Cysts were localized in the liver in 69.64% and in the lungs of 23.43% of the cases with single organ involvement. Liver involvement was more frequent in women, while lung involvement was more frequent in men (P less than 0.001). PMID- 3970305 TI - Single dose mebendazole therapy for soil-transmitted nematodes. AB - Four hundred and fifty subjects were included in a study of the prevalence of soil-transmitted nematodes in Ujung Pandang, South-Sulawesi, Indonesia. Trichuriasis was the most prevalent infection (93.3%), followed by ascariasis (80.2%) and hookworm infection (19.5%). Among 156 subjects who were given 500 mg of mebendazole in a single dose, treatment resulted in cure rates of 93.4%, 77.6%, and 91.1%, and average egg-count reduction rates of 99.0%, 92.8%, and 98.3%, for ascariasis, trichuriasis, and hookworm infections, respectively. Mebendazole appeared to be equally effective against necatoriasis and ancylostomiasis. The drug was well tolerated and almost no side effects were observed. Single dose mebendazole treatment appears to be relatively inexpensive, convenient, and effective in mass treatment for the control of intestinal nematode infections, especially in highly infected communities. PMID- 3970307 TI - A case of natural concurrent human infection with two dengue viruses. AB - The first documented case of concurrent human infection with 2 dengue viruses is reported. Dengue 1 and 4 viruses were isolated from the serum of a 16-year-old male during the 1982 outbreak in Puerto Rico. The illness was mild and does not support the hypothesis that double infection with dengue viruses leads to more severe hemorrhagic disease. PMID- 3970306 TI - Study of current and new drugs in a murine model of acute paracoccidioidomycosis. AB - A new murine model of acute paracoccidioidomycosis, whose features include pulmonary infection with dissemination, was used to study the efficacy of currently available drugs and new agents which might be useful clinically. Two oral imidazole drugs, ketoconazole (KTZ) and Bay l 9139 (l9); two oral triazoles, Bay n 7133 (n7) and ICI 153,066 (ICI); and two polyenes, amphotericin B (AMB) and N-D-ornithyl-amphotericin B methyl ester, were studied. KTZ was superior to n7 and l9, particularly after a less lethal challenge. The polyenes could diminish dissemination, but had only modest effects on the pulmonary infection; AMB appeared slightly more effective. ICI was the most effective drug studied, approximately 5-10 times more potent than KTZ on a milligram/kg body weight basis; it had marked effects on both pulmonary and disseminated disease. These initial applications of the model to therapeutic evaluation suggest sufficient flexibility and utility, with information obtainable after relatively short experiments. PMID- 3970308 TI - Mechanical transmission of Rift Valley fever virus by hematophagous Diptera. AB - Experimental studies were conducted to determine if hematophagous Diptera were capable of mechanical transmission of Rift Valley fever (RVF) virus to laboratory animals. All species tested (Glossina morsitans, Aedes aegypti, Aedes taeniorhynchus, Culex pipiens, Stomoxys calcitrans, Lutzomyia longipalpis, and Culicoides variipennis) mechanically transmitted the virus to hamsters. Mechanical transmission rates for G. morsitans ranged from 0-100%, with the probability of mechanical transmission positively correlated with initial viremia titer and negatively correlated with the time after virus exposure. Mechanical transmission of RVF virus to lambs was demonstrated with both G. morsitans and Cx. pipiens. These findings demonstrated that mechanical transmission of RVF virus by hematophagous flies may contribute to the natural transmission and dissemination of this virus. PMID- 3970309 TI - Five drug regimens for treatment of acute toxoplasmosis in squirrel monkeys. AB - Five drug regimens for the treatment of acute toxoplasmosis were compared in a monkey model. Systemic disease that is almost always fatal in squirrel monkeys within 7-9 days was produced by oral inoculation of a brain suspension made from mice chronically infected with the Beverly strain of Toxoplasma gondii. All untreated controls died of toxoplasmosis (6/6) while treatment gave the following results: sulfamethoxazole, 0/3; spiramycin, 5/5; clindamycin/sulfadiazine (CLD/SLD), 0/4; pyrimethamine/sulfadiazine (PYR/SLD), 0/5; trimethoprim/sulfamethoxazole (TMP/SMZ), 0/4. Three of the five monkeys treated with CLD/SLD died during or shortly after the experiment from probable CLD toxicity. Sulfonamides alone or in combination with PYR or TMP were significantly more effective than spiramycin in treating toxoplasmosis in this model. The dose regimen used in this study did not allow us to determine if the addition of PYR or TMP changed the protection of sulfa alone. PMID- 3970310 TI - Human cutaneous leishmaniasis acquired in Texas. AB - Four cases of autochthonous human cutaneous leishmaniasis have been identified in south-central Texas since 1980. The patients presented with chronic ulcerating papules on the face, earlobe, and lateral thigh. In two patients, the infections healed without treatment. In the other two patients, the lesions healed following treatment with intramuscular sodium stibogluconate or topical antimony potassium tartrate. Serologic testing of family members, using four different techniques, indicates that asymptomatic infections may occur. These are the first reported cases of cutaneous leishmaniasis acquired in Texas since 1974. Organisms isolated from patients in 1974 and 1980 belonged to the Leishmania mexicana complex when tested by the isoenzyme technique. Although no animal reservoir or insect vector has been identified, six species of sand flies belonging to the genus Lutzomyia do inhibit this part of Texas. Accumulated evidence strongly suggests that cutaneous leishmaniasis is endemic in south-central Texas. PMID- 3970311 TI - Trypanosoma brucei rhodesiense: enhancement of infection rates in the tsetse fly, Glossina morsitans, by feeding artificial bloodmeal mixtures. AB - Low mature salivary gland (SG) infection rates (6%) in less than 24-hour-old flies fed on blood containing bloodform trypanosomes can be significantly enhanced by feeding flies an artificial mixture containing procyclic forms in a red cell: culture medium mixture (procyclic mixture, SG rate = 21.0%). However, enhancement is not solely a function of the use of procyclic forms since blood forms fed to flies in the same red cell: culture medium mixture produce SG rates (15.4%) intermediate to those of blood forms in blood and procyclic mixtures. Use of these artificial mixtures produces a similar result in 24- to 48-hour-old flies and also tends to equalize their infection rates with those found in less than 24-hour-old flies. The possible relationships between the different infection rates observed and digestive proteinases in the tsetse fly are discussed. PMID- 3970312 TI - Evidence against the existence of specific Schistosoma mansoni subpopulations which are resistant to irradiated vaccine-induced immunity. AB - When mice are immunized with irradiated Schistosoma mansoni cercariae a proportion of the subsequent cercarial challenge always escapes killing and matures to egg-laying adults. This report investigates the possibility that incomplete immunity in this system is governed by a genetically-determined insusceptibility of a particular schistosome subpopulation. To do this we tested whether more immunoresistant schistosomes would develop following successive passages of progeny of the resistant worms through immunized mice. Mice were immunized with 500 50 Krad-irradiated cercariae, and challenged with normal cercariae when immunity was at its peak. After five successive passages through snails and immune mice, progeny of those parasites which escaped immune killing were no more refractory to vaccine-induced resistance than the original stock maintained in nonimmune mice. Additionally, the "passaged" isolates did not differ from the original stock in their ability to induce protection following irradiation. Our results indicate that with this model of acquired resistance incomplete immunity is unlikely to be due to a subpopulation of the parasites possessing a genetically-determined insusceptibility to killing. PMID- 3970313 TI - The fate of challenge schistosomula in the murine anti-schistosome vaccine model. AB - Mice exposed to irradiated cercariae of Schistosoma mansoni develop a partial resistance to subsequent parasite challenge. In this study we utilized histopathologic methods to investigate the fate of both the immunizing and challenge cercariae in C57BL/6J mice. After immunization by percutaneous infection, a large number of the 50 Kr irradiated organisms could be detected in tissue sections of lung. However, as early as 2 weeks after immunization, the majority of these schistosomula apparently had died, leaving residual inflammatory foci. The numbers of these foci then gradually declined during the next 4 weeks of examination. Cercarial challenge of mice vaccinated 4 weeks previously provoked an intense eosinophil-enriched inflammatory response in percutaneously exposed ear pinnae. Despite these pronounced tissue reactions, no evidence of significant parasite damage or attrition was detected in this migration site. In contrast, schistosomula arriving in the lungs of vaccinated mice produced a greater number of residual inflammatory foci than did larvae appearing in the lungs of normal mice. In addition, challenge schistosomula were cleared from the lungs of vaccinated mice at a slower rate than they were from the lungs of control mice. These observations suggest that the lung is a major site of parasite attrition for both immunizing and challenge infections in the mouse irradiated vaccine model. PMID- 3970314 TI - Don't fix nothin that ain't broke. PMID- 3970315 TI - Eighty-four potential second-look operations based on sequential carcinoembryonic antigen determinations and clinical investigations in patients with recurrent gastrointestinal cancer. AB - In our study of patients with resected primary gastrointestinal cancer, slope analysis of the post-operatively increasing carcinoembryonic antigen time courses signaled relapse in about 80 percent of the patients up to 12 months before positive clinical diagnosis. In 29 patients, clinical confirmation of the relapse could be obtained only after second-look surgery. Slope analysis generally differentiated localized from metastatic disease and therefore also predicted the site of relapse. A first evaluation of 84 patients with potential cases of second look operations provided evidence for a significant increase in survival. Recently, the evaluation of individual carcinoembryonic antigen doubling times was used to derive an individual prognosis since doubling times strongly correlated with the survival of untreated patients. On this basis, it was clearly possible to show the benefit of second-look operation, since patients with resectable recurrences exhibited longer survival times compared with patients with similar carcinoembryonic antigen doubling times without treatment. Moreover, the introduction of monoclonal antibodies with increased specificity for malignant states, has facilitated the selection of patients for second-look operation because unspecific carcinoembryonic antigen elevations are less frequent and recurrent disease can be predicted more reliably due to the higher carcinoembryonic antigen increments associated with malignant growth. PMID- 3970316 TI - Hepatic resection for isolated metastasis from colorectal carcinoma. AB - Surgical results were analyzed in 36 patients who had undergone hepatic resection for metastases from colorectal carcinoma. Survival was not altered by the type of surgical resection nor in the presence of solitary compared with multiple lesions. No difference in survival from the time of liver resection was noted in patients staged as Dukes' B and Dukes' C (metachronous liver metastasis) in comparison to patients who presented with synchronous liver metastases. Overall median survival was 22 months with no 5 year survivors to date. There is a tendency for recurrence to occur in extrahepatic sites, which emphasizes the need for an effective chemotherapeutic agent. PMID- 3970317 TI - Malignant rectal carcinoid: a sequential multidisciplinary approach for successful treatment of hepatic metastases. AB - A malignant rectal carcinoid metastatic to the liver presents a formidable challenge. The uniformly fatal course in patients with liver metastases (average survival of 2 years) justifies an aggressive approach. Although in an occasional patient the tumor is resectable, most are managed by chemotherapy, which generally is of limited effectiveness. Although certain drug combinations such as 5-fluorouracil and streptozotocin have achieved higher response rates, these responses are often brief (3 to 4 months) and poorly documented. Surgical hepatic dearterialization and, more recently, hepatic intraarterial embolization are quite effective in inducing regression in a variety of hepatic neoplasms, including metastatic carcinoids, but these are usually temporary. We have been timely instructed on the value of combined therapy by a patient who is a long term survivor of a metastatic carcinoid to the liver. She is the only survivor among a group of 14 patients who had an average survival of 17 months. This patient emphasizes the benefit of combined hepatic dearterialization and chemotherapy in patients with metastatic carcinoid to the liver. She initially had intrahepatic infusion of 5-fluorouracil and streptozotocin through the surgically placed hepatic artery and portal vein catheters, but this was curtailed after 2 months because of catheter sepsis. She then had four sequential selective hepatic intraarterial embolizations with Gelfoam over a 16 month period. She also received systemic therapy with 5-fluorouracil and streptozotocin during a major portion of this period (10 months). Significant tumor regression was documented radiologically. Although she had another trial with intrahepatic chemotherapy infusion using surgically placed catheters, this was again discontinued because of catheter sepsis, and systemic chemotherapy was resumed. Currently, the patient is asymptomatic, has excellent performance status, and continues to show objective tumor regression on a program of systemic therapy with fluorodeoxyuridine and doxorubicin. She has survived more than 7 years with liver metastases from a rectal carcinoid. PMID- 3970318 TI - Desmoid tumors and their management. AB - Nineteen cases of desmoid tumors were reviewed, being intraabdominal. Five of the 7 were associated with polyposis coli. The remaining 12 cases were distributed in different anatomic locations. Sixteen patients were treated with resection either alone or in combination with radiation or hormonal treatment. There were two deaths due to unrelated causes, and the rest of the patients (89 percent) are alive. At present, 16 of the surviving 17 patients are disease-free with a mean follow-up of 6 years. In two of eight patients who were initially treated with wide excision at our center, local recurrence developed, and five patients treated with resection elsewhere were referred because of recurrence. Six patients treated with simple resection and adjuvant radiation remain free of disease with a mean follow-up of 5 1/2 years. PMID- 3970319 TI - Breast masses in adolescent patients in Trinidad. AB - In our study, fibroadenoma was the most common breast mass found in adolescent girls. The frequency of mammary dysplasia seems to increase with age. There was one case of granular cell tumor of the breast and an unusual case of metastatic ovarian carcinoma presenting as a breast mass. PMID- 3970320 TI - Ranitidine as an inhibitor of liver regeneration. AB - The effects of ranitidine, a new H2-receptor antagonist, on liver regeneration were investigated using a protocol described previously. The animals in Group I had standard two-thirds hepatectomy. In Group II, the rats received an 8 mg/kg intramuscular dose of ranitidine immediately and 24 and 48 hours after two-thirds hepatectomy. In Group III, the rats had the same amounts of ranitidine after a sham operation. Mortality rate, liver weight restoration, mitotic activities of the residual livers, and serum levels of aminotransferases were examined from 24 hours to 14 days after operation. The mortality was very high in Group II (45 percent), whereas no rats died in Group I, and only 1 of 35 animals died in Group III. Administration of ranitidine after hepatectomy resulted in suppression not only of liver restoration, but also of the mitotic activities of hepatocytes. The serum aminotransferase levels in Group II had a tendency to increase after hepatectomy, compared with the levels in Group I. Using light microscopy, we detected that the hepatectomized group treated with ranitidine (Group II) underwent profound liver steatosis and marked dilatation of sinusoidal spaces. The present and previous observations by us indicate that ranitidine also inhibits, like cimetidine, liver regeneration after hepatectomy. The causes of the inhibitory effects of both cimetidine and ranitidine on hepatocyte cell division have also been discussed herein. PMID- 3970321 TI - Experimental evaluation of gastric banding for treatment of morbid obesity in pigs. AB - The effectiveness and complications of gastric banding were evaluated in 15 miniature pigs. A Gore-tex or Dacron graft was employed to encircle the stomach. The animals were divided into five groups, three pigs in each group. Group 1 had a 13 mm pouch stoma with a Gore-tex band, Group 2 had a 16 mm pouch stoma with a Gore-tex band, Group 3 had a 13 mm pouch stoma with a Dacron band, Group 4 had a 16 mm pouch stoma with a Dacron band, and Group 5 had a sham operation. The weight variation in the control group was significantly higher than that in the other groups at the ninth postoperative week (p less than 0.05). There was no significant difference among Groups 1, 2, 3, and 4. The gastric band had migrated distally in seven pigs. It was located in the body of the stomach in four animals and in the pylorus in three. These three pigs died from stenosis of the pylorus. The band had eroded and penetrated all stomach layers in three other animals. There was no difference in the incidence of postoperative complications between the Gore-tex and Dacron band groups. The use of this simple operation in the treatment of the morbidly obese patient should be applied with caution. PMID- 3970322 TI - Dysphagia and lower esophageal sphincter abnormalities after proximal gastric vagotomy. AB - We studied 96 patients subjected to elective proximal gastric vagotomy for intractable duodenal ulceration. Dysphagia was a frequent finding and occurred in 32 percent. It appeared in the immediate postoperative period and usually lasted for 1 to 2 months without any abnormalities in lower esophageal sphincter function. In five patients, dysphagia was severe and, although transient, was associated with changes in lower esophageal function simulating those observed in achalasia. The mechanism of these motor abnormalities is probably due to a reversible neuromuscular dysfunction of the lower esophageal sphincter. PMID- 3970323 TI - Consequences of intraperitoneal bile: bile ascites versus bile peritonitis. AB - Recent experience with patients with bile ascites and bile peritonitis prompted a review of other case histories in the medical literature of these conditions. The clinical courses of 24 patients with bile ascites and 34 with bile peritonitis were reviewed. Bile ascites occurred most often as a postoperative complication of biliary tract operations and also occasionally after trauma. Clinical signs were minimal except for abdominal distention, and operations were delayed for an average of 30 days. Peritoneal fluid was sterile in the 11 patients studied. In contrast, bile peritonitis occurred most commonly after spontaneous perforation of the gallbladder or hepatic ducts but also after trauma. All patients had severe signs of peritoneal irritation, and operation was performed earlier, at a mean of 4 days after onset of symptoms. Of 11 patients with specimens of their peritoneal fluid cultured, 6 had sterile fluid and 5 had bacteria. Although both bile salt concentration and bacteria have been implicated in the development of bile peritonitis rather than bile ascites, our understanding of the mechanisms involved is still incomplete. PMID- 3970325 TI - Endoscopic decompression in partial small bowel obstruction. AB - Upper gastrointestinal endoscopy has been applied successfully in the management of patients with small bowel obstruction. In one group of patients after gastrectomy with a Roux-Y limb obstructed at the level of the transverse mesocolon, the endoscope was manipulated into this segment, and the tip was deflected in four directions with release of the kink. Conventional wisdom depends heavily on the interpretation of the upper gastrointestinal series, which in all five patients in this report proved to be incorrect. It was only through the endoscopic examination that the anastomoses were found to be patent, and the kinked segment of jejunum, once identified, could be released by endoscopic manipulation. Two patients required repeat endoscopy, and at last follow-up, all patients were eating well with no recurrence of symptoms. In the second group of patients with distal small bowel obstruction who normally would be considered for Miller-Abbott tube management, it was possible to decompress the stomach, duodenum, and upper jejunum endoscopically with immediate clinical and radiographic improvement. In addition, it was also possible to place the Miller Abbott tube into the small bowel at the same time and thus avoid the 2 to 3 days of delay in advancing the tube beyond the pylorus. All patients had improvement and there were no complications. Although two required laparotomy several weeks later, they too were improved by the endoscopic procedures. The immediate decompression and rapid intubation represent significant advances in the management of patients with small bowel obstruction. PMID- 3970324 TI - Portoenterostomy diversion. Experimental study in antireflux technique. AB - Ascending cholangitis was induced in dogs by performing a biliodigestive Roux-Y anastomosis. Then two valvular antireflux mechanisms were performed on separate groups of these dogs with the aim of preventing the onset of ascending cholangitis. One was performed by a laterolateral plicature at the intestinal anastomosis and the other by invagination of the mucosa in the nonworking loop that had been anastomosed to the bile duct. All the dogs underwent analytic tests over a period of 3 months and histopathologic tests at the end of the study period. Results showed cholangitis and pericholangitis in the liver biopsy specimens of the group with no antireflux valve, to a lesser degree in the group with laterolateral plicature, and almost none in the animals with the invaginated valve. PMID- 3970326 TI - Colonic pseudo-obstruction in surgical patients. AB - Colonic pseudo-obstruction (Ogilvie's syndrome) may occur in surgical patients, particularly those who have had orthopedic or blunt trauma, have uremia or diabetes, have complex metabolic or cardiac failure, have metastatic cancer involving the lymph nodes and neural tissue, or are addicted to narcotics. Although a single true cause has not been identified by fulfilling Koch's postulates, the clinical pattern has been recognized in a variety of surgical patients, and this pattern must be distinguished from true obstruction of the colon. Tumor or internal hernia may constitute an obstruction, but the important differential diagnosis of cecal volvulus must be excluded. Ischemic colitis may be confused with Ogilvie's syndrome or may follow it. Gangrene, infarction, and perforation may ensue as colon diameter increases and particularly if cecal distention reaches above 14 cm. This arbitrary number for cecal dilatation should not be awaited before treatment is instituted if signs of devitalization of the gut or peritoneal signs have developed in the patient. Treatment has changed recently with the widespread application of colonoscopy. Endoscopy is helpful in relieving distention but may also be dangerous in the patient with a massively distended colon, particularly at the level of the thin-walled cecum. Colonoscopy also appears to be associated with a high rate of treatment failure and recurrence. Surgical decompression may take the form of cecostomy or may require exteriorization or resection of the colon if infarction has occurred. A series of 12 patients has been presented. The patients were all referred to a single surgeon in a university medical center over a 4 1/2 year period with clinical patterns not suggestive of a common cause but a similar clinical evolution of Ogilvie's syndrome. The prognosis for such patients in whom the complication is recognized early and in whom decompression is performed endoscopically or surgically is encouraging. If recognition is late and particularly if perforation and gangrene result, mortality is nearly 50 percent. PMID- 3970327 TI - Felty's syndrome: when is splenectomy indicated? AB - The spectrum of disease was assessed in 43 patients with Felty's syndrome. Twenty three underwent splenectomy. Although complete remission of neutropenia occurred in only two nonoperated patients, most of the patients had no serious infections during the subsequent period of observation. Operative morbidity was minimal in the splenectomized patients. On the basis of natural history of this condition, splenectomy should probably be restricted to neutropenic patients with serious or recurrent infections, patients with severe anemia requiring transfusions, those with the rare circumstance of profound thrombocytopenia, and those with non healing leg ulcers. PMID- 3970329 TI - An extended Kocher incision for bilateral adrenalectomy. AB - The anterior approach for excision of the adrenal glands is preferred when dealing with phenochromocytoma, carcinoma, lesions greater than 6 cm in diameter, or when upper abdominal exposure is necessary for intraabdominal procedures to be performed simultaneously with adrenalectomy. We describe an extended Kocher incision for bilateral adrenalectomy and abdominal exploration. This affords excellent exposure and wound healing without incurring total denervation of the upper abdomen. We recommend it as the optimum anterior approach to the adrenal glands. PMID- 3970328 TI - Substernal goiter. Analysis of 80 patients from Massachusetts General Hospital. AB - Eighty patients at the Massachusetts General Hospital underwent resection of substernal goiter in the years 1976 to 1982. Mean age of the 50 women and 30 men was 56 years, and 10 (19 percent) had undergone prior thyroid surgery. The most common symptoms were cervical mass (69 percent), dysphagia (33 percent), and dyspnea (28 percent); 13 percent were asymptomatic. On examination, cervical mass was present in most (90 percent) but not all patients, 51 percent were obese, and more than one third had tracheal deviation. Fifty-one of 52 patients tested were euthyroid and one was mildly hypothyroid. Chest radiographs showed tracheal deviation in 79 percent and soft tissue mass in 56 percent. Seventy-eight patients underwent resection through a cervical collar incision only; one had cervical incision plus upper partial sternotomy; and one required cervical incision plus full median sternotomy. Pathologic examination revealed multinodular goiter in 41 (51 percent), follicular adenoma in 35 (44 percent), and Hashimoto's thyroiditis in 4 (5 percent). Mean goiter weight was 104 g, and the mean greatest dimension was 9 cm. Occult papillary carcinoma was found in two patients. There were no deaths or major complications. Analysis of our data indicate the following: (1) Substernal goiter may exist in the absence of symptoms or signs. (2) Extensive radiologic evaluation and thyroid function testing are rarely required. (3) With rare exceptions, substernal goiter represents an extension of a cervical growth through the thoracic inlet and can be approached through a cervical collar incision. (4) Histologically, these are multinodular goiters or follicular adenomas, although Hashimoto's thyroiditis may occur. (5) Given the small but present risks of acute stridor or occult malignancy and the negligible surgical risk, operation should be recommended. (6) Patients should be followed since, with or without levothyroxine, goiters may recur. PMID- 3970330 TI - Evaluation of a new, improved surgical drainage system. AB - A new, improved drainage system has been specifically designed to provide either closed suction drainage for the ambulating patient or sump drainage for the patient confined to bed. This drainage system is made of silicone that has a hydrogel coating with a low coefficient of friction. This coating facilitates removal of the drain from the wound cavity and reduces the adherence of blood clots in the drainage system. A filter assembly is attached to the air vent lumen to remove particulate matter and bacteria from the air. Clinical evaluation of the filtered sump drainage system has confirmed its superiority over closed suction in its efficiency of removing fluids from the wound. PMID- 3970331 TI - Perineal hernias after proctectomy. A new approach to repair. AB - Perineal herniation of pelvic organs rarely occurs after abdominoperineal resection of the rectum, but it does present a difficult surgical dilemma. The case of a patient with perineal herniation of the small bowel and urinary bladder into a proctectomy wound has been described. This was repaired using a transabdominal pelvic sling with Marlex followed by gracilis muscle transplantation. Review of the literature yielded 18 previous case reports of perineal hernia after proctectomy, and the results of various surgical approaches have been detailed and discussed. The technique of gracilis muscle transplantation offers a definite advantage when the hernia occurs in a contaminated perineal wound. PMID- 3970332 TI - Choledochocele and recurrent pancreatitis. Diagnosis and surgical management. AB - A case history has been presented that reports a rare type III choledochal cyst (choledochocele) and describes the association of a choledochocele and recurrent acute pancreatitis. The most reliable diagnostic technique, as used in our patient and supported by our literature review, is endoscopic retrograde cholangiopancreatography. This case further supports surgical correction employing transduodenal sphincteroplasty. This procedure is highly recommended for management of the intramural choledochocele (type IIIc), especially when associated with recurrent pancreatitis. Finally, patients who present with recurrent pancreatitis without the usual historical or diagnostic findings of biliary tract or alcoholic disease should have a choledochocele included in the differential diagnosis. PMID- 3970333 TI - Diazepam premedication in children. Plasma levels and clinical effects. AB - Oral diazepam 0.25 mg/kg or 0.5 mg/kg was employed as premedication in one hundred and one children undergoing elective surgery. The drug failed to modify the rise in cardiorespiratory indices of preanaesthetic anxiety compared with control values, and there was no difference between the two doses assessed by a sedation scoring system. 0.25 mg/kg diazepam produced less sedation in children under 5 years old, compared with those 5 years and older, whereas 0.5 mg/kg produced no difference between the older and younger age groups. The plasma levels of diazepam were greater postoperatively in the 0.5 mg/kg group. There was no relationship between plasma diazepam and recall at induction, and pre anaesthetic amnesia was not enhanced with the higher premedication dose. PMID- 3970334 TI - Emergency surgery complicated by thyrotoxicosis and thyrotoxic periodic paralysis. AB - A general anaesthetic was administered for emergency surgery to a patient with a bleeding gastric ulcer in the presence of undiagnosed thyrotoxicosis. The case is presented to illustrate firstly how hyperthyroidism may be masked by other acute illnesses, and secondly an unusual complication of thyrotoxicosis. The anaesthetic management of thyrotoxic patients undergoing incidental emergency surgery is discussed. PMID- 3970335 TI - Idiopathic pulmonary haemosiderosis. The peri-operative anaesthetic management of a patient for open lung biopsy. AB - The peri-operative anaesthetic management and hazards of a patient with idiopathic pulmonary haemosiderosis are described in association with the relevant known clinical and pathological data. PMID- 3970336 TI - Anaesthesia for colobronchial fistula. AB - The case of a patient with a colobronchial fistula is presented. The anaesthetic management using endobronchial intubation and one-lung anaesthesia is described and the problems presented by this rare condition discussed. PMID- 3970337 TI - Paraplegia following epidural potassium chloride. AB - A patient is presented in whom 15 ml of 15% potassium chloride (30 mM) mixed with bupivacaine was injected epidurally for relief of pain resulting from widespread pelvic malignancy. Within minutes the patient complained of severe pain in both the lower limbs and rapidly became paraplegic with bladder and bowel incontinence. The paraplegia was permanent. The transient symptoms of pain may have been partly due to the irritant effects of a hyperosmolar solution of potassium chloride in the epidural space, while the permanent neurological damage might have been due to the very high extracellular concentration of potassium leading on to a depolarising phenomenon initially followed by nerve tissue necrosis. PMID- 3970338 TI - Delayed cardiac tamponade. AB - A case report of cardiac tamponade is described which did not manifest itself until the patient was allowed to breathe spontaneously. Changes in intrapericardial pressure during spontaneous and controlled ventilation are discussed. PMID- 3970339 TI - Ischaemia following selfadministered intra-arterial injection of methylphenidate and diamorphine. A case report of treatment with intra-arterial urokinase and review. AB - A patient presented with a painful, oedematous, cyanosed hand having injected a solution of diamorphine and methylphenidate into his radial artery. Treatment was started with heparin and vasodilators. Benefit from this was limited and a course of intra-arterial urokinase was instituted. This gave almost total resolution of the injury. The mechanisms producing ischaemia following intra-arterial injection of drugs of abuse and possible treatment are discussed. PMID- 3970340 TI - Anaesthesia equipment malfunction. AB - Anaesthetic equipment was studied to determine whether the accuracy was improved and failure rate decreased by routine maintenance and calibration by a biomedical technician. Each piece was evaluated, and then repaired and rechecked at intervals by the same technician. Equipment failures were divided into three types: first, equipment that was completely nonfunctional; second, equipment that was functional but inaccurate; and third, equipment that was functional and accurate but needed minor repairs. The percentage of equipment failures in each group was compared on initial evaluation and after 6 months. Of the 311 pieces of equipment, 40% needed repair at the time of the initial survey; 80% was nonfunctional, and 18% was functional but inaccurate. After six months on a maintenance schedule, only 15% of the equipment needed repair, 3% was nonfunctional, and 6% was functional but inaccurate. The difference between the total percentage of equipment failure initially and after six months was statistically significant. After a regular maintenance, calibration, and checkout schedule by a biomedical technician was instituted, there was a significant improvement in the accuracy of the equipment and a reduction in the percentage of equipment needing repair. PMID- 3970341 TI - Selectatec switch malfunction. AB - Malfunction of a Selectatec switch mechanism is reported which resulted in complete cessation of gas flow to the patient system. Anaesthetists are alerted to this potential hazard. PMID- 3970342 TI - Variations on a theme: splitting ratio. AB - An expression for the splitting ratio (bypass gas/gas through vaporizing compartment) is derived formally. The factors affecting volatile agent gaseous fraction and, more importantly, partial pressure are discussed in relation to changes in temperature and barometric pressure. Low-boiling point, high saturated vapour pressure anaesthetics are more susceptible to the influence of barometric pressure variations. PMID- 3970343 TI - Fibre-optic assessment of tracheal tube position. A comparison of tracheal tube position as estimated by fibre-optic bronchoscopy and by chest X-ray. AB - The distance between the tip of a tracheal tube and the carina was measured in twenty five patients who required tracheal intubation and artificial ventilation of the lungs. Two methods of evaluation of this distance--limited-optic bronchoscopy and chest X-ray--were compared. There was no significant difference between the distance measured by either method. The advantages of checking tracheal tube placement by fibre-optic bronchoscopy are discussed. PMID- 3970344 TI - The need for analgesic cover after ENT surgery--comparison of nefopam and papaveretum. AB - Intra-operative intramuscular injections of either papaveretum 0.3 mg/kg or nefopam 0.4 mg/kg were given to alternate patients to promote smooth emergence from ENT anaesthesia in a consecutive series of 40 children. Observations over a period of 30 minutes following completion of surgery showed that emergence was satisfactory in 19 out of 20 children given papaveretum, and in 15 out of 20 children given nefopam. The study confirms that this indication for papaveretum is justifiably popular and that nefopam is a useful alternative mainly because it does not cause respiratory depression. There are no previous reports of the use of nefopam in children. PMID- 3970346 TI - Effect of morphine on gastric emptying. PMID- 3970345 TI - Anaesthetic carrier gases. Their effect on middle-ear pressure peri-operatively. AB - The effects of three different anaesthetic carrier gases on middle-ear pressure in the operative and postoperative periods was assessed. Patients receiving oxygen and oxygen-enriched air did not have significant changes in middle-ear pressure. The changes associated with the use of nitrous oxide as the carrier gas were reversed with return of pharyngeal reflexes or after prolonged inhalation of 100% oxygen. In patients undergoing middle-ear surgery or those with pre-existing middle-ear disease, we suggest that oxygen-enriched air is the anaesthetic carrier gas of choice. PMID- 3970348 TI - Peripheral actions of narcotics. PMID- 3970347 TI - Profound bradycardia with verapamil and halothane. PMID- 3970349 TI - A hazard of pre-oxygenation. PMID- 3970350 TI - Benign muscle spasm during anaesthesia. PMID- 3970351 TI - Protection of the topping-up syringe during epidural analgesia. PMID- 3970352 TI - Thiopentone and ophthalmoplegia plus. PMID- 3970353 TI - Ventilatory efficiency in children with caudal analgesia. PMID- 3970354 TI - A safety measure for the Vygon Desilet central venous placement set. PMID- 3970356 TI - Be aware and read. PMID- 3970355 TI - Effect of left-to-right, mixed left-to-right, and right-to-left shunts on inhalational anesthetic induction in children: a computer model. AB - We describe a seven-compartment physiologic model of inhalational anesthetic induction with circulatory shunts that was used to simulate inhalational anesthetic induction in children with congenital heart disease. Our conclusions based on this model are that left-to-right (L-R) shunting has little effect on speed of induction; right-to-left (R-L) shunting significantly slows induction of N2O and halothane anesthesia; and adding an L-R shunt to a preexisting R-L shunt will attenuate the slowing of induction caused by the R-L shunt. PMID- 3970357 TI - Skin blood flow measured by thermal clearance method in anesthesia. PMID- 3970358 TI - Psychomotor tests and "street fitness". PMID- 3970359 TI - Perianesthetic ischemic episodes cause myocardial infarction in human--a hypothesis confirmed. PMID- 3970360 TI - Does perioperative myocardial ischemia lead to postoperative myocardial infarction? AB - To determine if a relationship exists between perioperative myocardial ischemia (ST segment depression greater than or equal to 0.1 mV) and postoperative myocardial infarction (PMI), nonparticipating observers recorded all ECG, hemodynamic, and other events between arrival of patients in the operating room and onset of cardiopulmonary bypass during 1,023 elective coronary artery bypass operations (CABG). The roles of preoperative patient characteristics, quality of the operation limited by disease as rated by the surgeon and duration of ischemic cardiac arrest as risk factors for PMI also were quantified. ECG ischemia occurred in 36.9% of all patients, with almost half the episodes occurring before induction of anesthesia. PMI was almost three times as frequent in patients with ischemia (6.9% vs. 2.5%) and was independent of when ischemia occurred. Ischemia was related significantly to tachycardia but not hypertension nor hypotension and was frequent in the absence of any hemodynamic abnormalities. The anesthesiologist whose patients had the highest rate of tachycardia and ischemia had the highest rate of PMI. Although neither single nor multiple preoperative patient characteristics related to PMI, suboptimal quality of operation and prolonged ischemic cardiac arrest increased the likelihood of PMI independent of the occurrence of myocardial ischemia. The authors conclude that perioperative myocardial ischemia is common in patients undergoing CABG, occurs randomly as well as in response to hemodynamic abnormalities, and is one of three independent risk factors the authors identified as related to PMI. PMI is unrelated to preoperative patient characteristics such as ejection fraction and left main coronary artery disease, and its frequency will relate primarily to perioperative management rather than patient selection. PMID- 3970361 TI - Reduced anesthetic requirement after electrical stimulation of periaqueductal gray matter. AB - To determine whether electrical stimulation of the periaqueductal gray region decreases anesthetic requirement, the authors studied the effect of such stimulation on the MAC of halothane and 60% nitrous oxide in 33 patients. These patients, who were undergoing implantation of a radio-frequency-coupled receiver and connection of that receiver to electrodes previously implanted in the periaqueductal gray area, were assigned randomly to receive (n = 16) or not receive (n = 17) electrical stimulation 1 h before surgery. The mean value (+/- SEM) for the minimum alveolar concentration of halothane combined with 60% nitrous oxide was significantly less (P less than 0.001) for patients who were stimulated preoperatively (0.15 +/- 0.05%) than for those who were not (0.51 +/- 0.02%). The authors conclude that stimulation of the periaqueductal gray region decreases anesthetic requirements and believe that at least three mechanisms are possible: a nonspecific narcotic-like effect, a specific effect on a pain pathway, or an effect on specific neural pathways that affect anesthetic requirements secondary to changes in regional concentrations of neurotransmitters. PMID- 3970362 TI - Effectiveness of sodium nitroprusside as a function of total peripheral resistance in the anesthetized dog. AB - To determine the influence of background vasomotor tone on the effectiveness of sodium nitroprusside in decreasing total peripheral resistance, experiments were performed on 12 open-chest dogs under halothane anesthesia. In the first experiment, the vasomotor condition of six dogs was changed by altering the background infusion rate of phenylephrine (0,40, and 0 microgram/min). Increasing background phenylephrine infusion from 0 to 40 micrograms/min significantly enhanced the effectiveness of nitroprusside in decreasing total peripheral resistance. In contrast, the effectiveness of nitroprusside in decreasing arterial pressure was not altered significantly. In a second experiment on six other dogs, phenylephrine was infused continuously at 40 micrograms/min, and the vasomotor condition was changed by the infusion of phentolamine (0, 60-100, 0 microgram/min). Phentolamine significantly diminished the effectiveness of nitroprusside in decreasing peripheral resistance. In contrast, the effectiveness of nitroprusside in decreasing arterial pressure was not altered significantly. Stepwise linear regression analysis indicated that the background peripheral resistance was the hemodynamic variable that could account partially for the changes in nitroprusside effectiveness. Increasing background total peripheral resistance significantly enhanced the effectiveness of nitroprusside in decreasing total peripheral resistance. PMID- 3970363 TI - Lidocaine constricts or dilates rat arterioles in a dose-dependent manner. AB - The microvascular effects of varying concentrations of lidocaine were evaluated with the use of videomicroscopy in an in vivo rat cremaster muscle preparation. Animals were anesthetized with chloralose and urethane and breathed room air spontaneously. Mean arterial pressure and heart rate were measured via a carotid artery cannula. The cremaster muscle was suffused with a balanced electrolyte solution and pH, temperature, PO2, PCO2, and osmolarity were controlled. Internal diameters of fourth-order arterioles in the cremaster muscle were measured with an electronic vernier system. In one group of animals (n = 7), arteriolar diameters were measured every 30 s during a 10-min control period, a 10-min period of topical application of lidocaine hydrochloride, and a 10-min recovery period. Lidocaine hydrochloride, 10(0), 10(1), 10(2), 10(3), or 10(4) micrograms X ml-1, produced changes in arteriolar diameters to 88.9 +/- 0.9, 79.0 +/- 1.3, 67.5 +/- 2.4, 60.1 +/- 3.4, and 127.1 +/- 7.2 per cent of control, respectively (P less than 0.001). In a second group of animals (n = 4), fourth-order arteriolar diameters were measured during administration of intravenous lidocaine, 1.2 mg X kg-1 bolus plus 0.3 mg X kg-1 X min-1. Vasoconstriction to 91.3 +/- 0.9% of control was observed (P less than 0.001). These results demonstrate a biphasic dose-dependent response to lidocaine. At lesser concentrations, including those that occur in the plasma of patients during intravenous infusion or nerve blocks, dose-related vasoconstriction occurred. Lidocaine, 10(4) micrograms X ml-1, a concentration similar to that which occurs at the site of injection during infiltration, nerve block, or epidural anesthesia, produced vasodilation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970364 TI - The effects of ketamine on venous capacitance in rats. AB - The purpose of this study was to examine the effects of ketamine and pentobarbital on venous capacitance in rats. Venous capacitance was assessed by measuring the mean circulatory filling pressure (MCFP) at three levels of blood volume in conscious rats as well as during anesthesia with ketamine (125 mg/kg, ip) or pentobarbital (50 mg/kg, ip). MCFP was measured during brief periods of circulatory arrest produced by inflating an indwelling balloon in the right atrium. MCFP was maintained during ketamine anesthesia at a level similar to that measured in conscious animals, while it was decreased (P less than 0.01) during pentobarbital anesthesia both at normal blood volume and following hemorrhage. These results suggest that ketamine did not alter but pentobarbital increased venous capacitance. The slope of the regression line relating MCFP and blood volume was not altered by ketamine but was increased (P less than 0.05) by pentobarbital, which suggests that ketamine did not alter but pentobarbital decreased total vascular compliance. These results suggest that ketamine maintains but pentobarbital decreases venous tone. PMID- 3970365 TI - Cardiovascular responses to hemodilution and controlled hypotension in the dog. AB - Cardiovascular responses to acute hemodilution and controlled hypotension were studied in mongrel dogs anesthetized with halothane and paralyzed with pancuronium. Regional blood flows were determined by microsphere injections. Hemodilution to an hematocrit of 23% was produced by removal of whole blood and simultaneous infusion of Ringer's lactate solution. Subsequently, hypotension to a mean arterial pressure of 55 mmHg was produced for 90 min by intravenous infusion of trimethaphan. The hypotension resulted entirely from a 55% decrease in total peripheral resistance. Thirty minutes after initiation of controlled hypotension, there were significant increases in blood flow to the brain, liver, skeletal muscles, and diaphragm. However, at 30 min, calculated oxygen delivery had decreased to brain (-16%), renal cortex (-51%), heart (-45%), and retina ( 44%). By 90 min, retinal, adrenal, and renal cortical blood flows were decreased significantly relative to control, and cerebral blood flows had returned to control levels. Absence of changes in acid-base status during the period of hemodilution and hypotension may indicate that whole body oxygen delivery was maintained at adequate levels. However, major decreases in calculated oxygen delivery after 90 min to critical tissue beds such as renal cortex (-67%) and retina (-78%) indicate that extension of the procedure past 30 min may involve risks that are not warranted by the benefits. PMID- 3970366 TI - Regional myocardial lidocaine concentration determines the antidysrhythmic effect in dogs after coronary artery occlusion. AB - Ischemic ventricular dysrhythmias were produced in 40 of 47 anesthetized mongrel dogs by high ligation of the left anterior descending coronary artery. Dysrhythmias were treated with a single iv bolus of 20, 40, 80, or 120 mg of lidocaine (L) in order to determine the dose at which approximately 50% of animals had an antidysrhythmic response. Cardiac output and regional myocardial blood flow (RMBF) were measured by using radionuclide labeled microspheres. Lidocaine concentration [( L]) was measured from samples of arterial and venous blood and normal and ischemic myocardium. All dogs treated with 40, 80, or 120 mg of L had an antidysrhythmic effect. However, with 20 mg of L the dysrhythmia persisted in 12 and resolved in 14. With 20 mg of L, ischemic myocardial [L] was greater in dogs with an antidysrhythmic effect than in those with persistent dysrhythmias (1.14 +/- 0.12 vs. 0.76 +/- 0.04 micrograms X g-1), but no difference was seen for arterial, venous, and normal myocardial [L]. Ischemic RMBF was higher in the dogs that had an antidysrhythmic effect than in those that did not, 9.8 +/- 1.5 versus 6.9 +/- 1.3% of normal. With 20 mg of L, [L] in ischemic myocardium correlated well with ischemic RMBF. The antidysrhythmic response to L had a threshold at a tissue concentration of greater than or equal to 1.0 microgram X g-1 (chi-square = 8.55, P less than 0.005). For this model, the [L] in ischemic myocardium during acute ischemia correlates with the antidysrhythmic response to L, while the concentration in normal myocardium or blood does not. PMID- 3970367 TI - The pharmacokinetics of d-tubocurarine with surgery involving salvaged autologous blood. AB - The disposition of d-tubocurarine (dTc) was assessed when a bolus and infusion dosage regimen was used to obtain relaxation during major orthopedic surgery on the spine. Renal clearance of dTc was 0.63 +/- 0.23 ml X min-1 X kg-1 and was correlated with creatinine clearance. Total plasma clearance of 1.21 +/- 0.40 ml X min X -1 X kg-1 was lower than that found in many previous studies, and the predetermined continuous dTc infusion produced an apparent plateau in plasma concentrations of 1.8 +/- 0.3 micrograms X ml-1. Despite the operative blood loss, these concentrations were greater than anticipated and were associated with a more intense neuromuscular blockade than the infusion was designed to produce. Autologous blood transfusion was used to reduce the reliance on homologous donor blood, and the erythrocytes from the 2.2 +/- 1.2 1 of blood loss during the procedure were reinfused after intraoperative salvage, washing, and centrifugation. With 80 +/- 23 mg dTc administered, 1.4 +/- 0.8% was recovered from the fluid discarded after centrifugation. These results indicate that even massive intraoperative blood loss will not entail a significant reduction in the amount of dTc present in the body. PMID- 3970368 TI - A modification in the training requirements in anesthesiology: requirements for the third clinical anesthesia year. American Board of Anesthesiology. AB - In order to continue to enhance the educational quality of residency training in anesthesiology and ultimately to improve patient care, the American Board of Anesthesiology has adopted a modification in the curriculum for the 4-year Continuum of Education in Anesthesiology to provide for a CA-3 year replacing the Specialized Year and the Alternate Pathways. This CA-3 year will be required for residents beginning their CA-1 year of training on or after May 1, 1986. There will be a 2-year transition period beginning May 1, 1984, to facilitate its implementation. PMID- 3970369 TI - Successful treatment of accelerated junctional rhythm with propranolol: possible role of sympathetic stimulation in the genesis of this rhythm disturbance. PMID- 3970370 TI - Gastroduodenal reflux of irrigating solution during percutaneous lithotripsy for intrahepatic cholelithiasis. PMID- 3970371 TI - Upper airway obstruction following cyst-to-peritoneal shunt in a child with a Dandy-Walker cyst. PMID- 3970372 TI - Ventricular tachycardia resulting from central venous catheter tip migration due to arm position changes: report of two cases. PMID- 3970373 TI - The use of magnesium sulfate in the anesthetic management of pheochromocytoma. PMID- 3970374 TI - Airway management in a patient with sleep apnea using a permanent silicone tracheal cannula. PMID- 3970375 TI - Does hyperkalemia contraindicate the use of bupivacaine or the use of succinylcholine to treat bupivacaine-induced toxicity in humans? PMID- 3970376 TI - Changes in serial platelet counts following massive blood transfusion in pediatric patients. PMID- 3970377 TI - A neglected source of nitrous oxide in operating room air. PMID- 3970378 TI - Lamp placement and the Miller I laryngoscope blade. PMID- 3970379 TI - A case of artifactual S-T depression. PMID- 3970380 TI - An unusual source of leak in the anesthesia circuit. PMID- 3970381 TI - A new partial spiral tube for nasotracheal intubation. PMID- 3970382 TI - Time of peak hypotension during rapid induction approximates time of peak brain halothane tension in the dog. PMID- 3970383 TI - Postoperative methemoglobinemia in a neonate. PMID- 3970384 TI - More about masseter spasm and malignant hyperthermia. PMID- 3970385 TI - Tracheal intubation in an infant with Treacher-Collins syndrome--pulling out the tongue by a forceps. PMID- 3970386 TI - Elective tracheal intubation in the prone position for a neonate with Pierre Robin syndrome. PMID- 3970387 TI - Crying-induced bronchospasm in childhood asthma: response to medical management. AB - Crying-induced bronchospasm (CIB), cough and/or wheeze greater than or equal to 5 minutes during or after crying behavior, is a common feature of childhood asthma. Sixty CIB patients were evaluated during a 6-month clinical treatment study consisting of environmental and pharmacologic (xanthines, beta-agonist stimulants, and corticosteroids) interventions. Both CIB (P = .007) and non-CIB (P = .0005) symptoms were significantly reduced. CIB asthma had lesser reduction in wheezing than non-CIB (P less than .001), suggesting that nebulized medication and/or behavioral interventions may be of benefit to further reduce CIB symptoms. PMID- 3970388 TI - Evaluation of lung sounds by telephone. AB - We evaluated the utility of a newly designed electronic stethoscope that can be used with the telephone system. Nine patients with wheezing, crackles, or other adventitious sounds were evaluated by a physician examiner who used a conventional stethoscope and another physician who received the signal of the electronic stethoscope via telephone. When their findings were compared, it was found that physicians agreed in 95% of observations. The potential uses of the electronic stethoscope are discussed. PMID- 3970389 TI - Normal nasal cytology in infancy. AB - Nasal cytology in the first year of life has rarely been utilized diagnostically because of an early report that nasal eosinophilia is a common finding in normal young infants. Using an improved sampling technique with a flexible nasal probe, we obtained nasal mucosal specimens for histologic examination from 22 healthy infants and five infants with upper respiratory tract infections. None of the healthy infants had nasal eosinophilia and no adverse effects were noted during the sampling procedure. We concluded that the present sampling technique is as safe and effective in infants as in children and adults and that the majority of healthy young infants do not have nasal eosinophilia. PMID- 3970390 TI - Cross-reactivity between Parietaria judaica and Parietaria officinalis. AB - The relative allergenicities of Parietaria judaica and Parietaria officinalis have been studied by in vivo and in vitro techniques and a strong resemblance has been shown, with common allergenic polypeptides, though they differ in a group of anodic proteins. In vivo activity was very similar and both pollen extracts reacted with sera from patients who were sensitive to P. judaica, thus demonstrating a high rate of cross-reactivity. Extracts from both species may therefore be used interchangeably in diagnosis and immunotherapy. PMID- 3970391 TI - Anaphylaxis after ingestion of raw celery. PMID- 3970392 TI - Cross-allergenicity among the grasses. AB - RAST inhibition was employed to determine the allergenic relationship of five common western grasses (brome, quack, western wheat, salt, and grama), three southern grasses (Bermuda, Johnson, and Bahia), and six common northern grasses (timothy, June, rye, red top, meadow fescue, and sweet vernal). The patterns of cross-allergenicity suggested by these studies were compared to those suggested by the botanical classification of these grasses. There was significant cross allergenicity among the grasses studied. Brome, western wheat, and quack grasses demonstrated RAST inhibition patterns similar to the northern grasses. Salt and grama grasses exhibited close allergenic relationships to Bermuda grass, which was allergenically distinct from the northern grasses. Johnson grass appeared to share allergenicity with both the northern grasses and Bermuda grass. Bahia shared allergenicity with the northern grasses, but also possessed some unique allergens. Timothy and Bermuda grass appeared to account for all of the RAST inhibiting activity contained in the other grasses studied with the possible exception of Bahia grass. PMID- 3970393 TI - Prehospital endotracheal tube airway or esophageal gastric tube airway: a critical comparison. AB - This study compares two similar groups of patients in cardiopulmonary arrest with ventricular fibrillation (VF). In the survival study group of 296 patients, 148 patients received an endotracheal tube airway (ETA) and 148 patients received an esophageal gastric tube airway (EGTA), the improved version of the esophageal obturator airway (EOA). Survival rates, both short term (ETA = 35.8%, EGTA = 39.1%) and long term (ETA = 11.5%, EGTA = 16.2%), and neurological sequelae of survivors showed no statistically significant difference between the two groups (P greater than .05). In addition, we found that success and complication rates of intubation were similar. Training time was longer for the ETA. We conclude that both airways have a place in the prehospital setting. PMID- 3970394 TI - An effective surrogate for impact studies. AB - Nineteen unembalmed (fresh) cadavers were used in 21 experiments to test restraint systems in automobile impact studies. Some were mounted in a rearward firing sled; others were placed in standard cars during collisions. Prior to and after testing, each cadaver was evaluated. After each experiment a postmortem examination was performed. High-speed registering cameras (1,000 to 2,000 frames per second) were used and multiple telemetric recordings were made. The radiographic and pathologic changes were similar to those seen in patients following high-velocity accidents. Results were compared with those of car accident victims admitted dead on arrival to one of our hospitals. This study is a progress report. The results are being used to improve existing restraint systems and to evaluate experimental models. PMID- 3970395 TI - Hepatitis B prevalence in emergency physicians. AB - The seriousness of hepatitis B (HBV) as an occupational hazard to health care workers is well documented. The prevalence of serologic markers for this disease in the general US population is less than 5%, but in medical and dental workers it is significantly higher: 16% in general dentists, 28% in surgeons, 23% in anesthesia personnel, and 30% in emergency department nurses. This study, done under the auspices of the American College of Emergency Physicians (ACEP), focused on the prevalence of HBV markers in emergency physicians. Twenty-five percent of the 1983 ACEP Scientific Assembly attendees participated in the serosurvey. Physicians already vaccinated against hepatitis B were excluded. The majority of participants (58%) were community emergency physicians between 30 and 39 years of age who had six or more years in emergency medicine. A total of 94% of the physicians indicated no prior history of hepatitis, and of these 13.1% had serologic markers for HBV. Including the 10 physicians with both HBV markers and history of hepatitis, the overall prevalence for markers in this study was 15.5%. This prevalence was five times greater than the general population. Emergency physicians should be considered a high-risk group for HBV infection. PMID- 3970396 TI - Efficacy of activated charcoal and magnesium citrate in the treatment of oral paraquat intoxication. AB - The binding capacity of activated charcoal for paraquat was evaluated in vitro and in vivo and compared with Fuller's earth. In vitro activated charcoal absorbs paraquat and is as effective as Fuller's earth. Activated charcoal's absorbing capacity for paraquat is increased when it is suspended in magnesium citrate and is maximal at pH 7.8. Paraquat (200 mg/kg) administered orally to male mice, followed 30 minutes later by activated charcoal, Fuller's earth (4 gm/kg), and magnesium citrate (0.01 cc/gm) resulted in a survival rate of 31% in the controls, 63% in the activated charcoal and Fuller's earth groups, and 69% in the magnesium citrate group (P values not significant). When activated charcoal was administered concomitantly with magnesium citrate, the survival rate was improved significantly to 94% (P less than 0.01). The efficacy and greater availability of activated charcoal and magnesium citrate make these materials the treatment of choice for gastrointestinal decontamination in oral paraquat poisoning. PMID- 3970397 TI - Rat bites: fifty cases. AB - A prospective study of 50 patients with uninfected rat bite wounds was undertaken to determine the natural incidence of wound infection without prophylactic antibiotics. All open wounds were cultured; bacterial isolates were cultured from 30% of wounds. Of bacterial isolates, 43% were Staphylococcus epidermidis and the remainder were Bacillus subtillus, diphtheroids, and alpha hemolytic Streptococcus. Only one patient (2%) developed an infection. Seventy-two percent of the bites occurred while the patient was sleeping, probably accounting for the fact that 84% of the wounds were on the exposed areas of the upper extremities and face. Treatment recommendations include good surgical management and avoidance of prophylactic antibiotics due to a low natural infection rate. If the wounds become infected, then a cephalosporin or penicillinase-resistant penicillin should be sufficient for treatment with appropriate surgical care of the wounds. Rabies prophylaxis usually is not required, but we suggest that tetanus prophylaxis is mandatory because most of our patients were deficient in this regard. PMID- 3970398 TI - Expansion of emergency medicine's responsibilities for preclinical education of medical students. AB - Many medical schools have required emergency medicine courses for freshmen medical students, usually through participation in BLS (basic life support) or EMT activities. For several years students at our institution have participated in a required emergency medical technician-ambulance grade (EMT-A) course. While retaining much of the material presented in that original EMT-A course, the course has now been expanded to serve as the medical students' introduction to clinical medicine. This expansion resulted from the belief that emergency medicine provides initial patient contact in the presence of a faculty uniquely suited to introduce the broad domain of clinical medicine to the medical student. Emergency physicians, more than any other specialists, must possess the ability to obtain an incisive history promptly, perform an accurate physical examination, and arrive at an assessment with limited laboratory and radiologic data. Initial access to the clinical education of medical students provides the opportunity to direct their efforts in a prioritized fashion, and thus helps to organize their thought processes for further development as clinicians. Departments of emergency medicine should be willing to accept this incremental responsibility for the introduction of the medical student to the clinical and laboratory assessment of patients. PMID- 3970399 TI - Quality assurance in the emergency department. AB - A coordinated approach to quality assurance is essential for managing the complexities of health care in the emergency department. Nearly every activity in the emergency care setting has implications that fall under the quality assurance umbrella. A comprehensive quality assurance program for the emergency department at Michael Reese Hospital was built through a process of defining, further developing, and coordinating existing quality assurance activities. Several new activities were developed to fill identified gaps. The program follows traditional quality assurance concepts for monitoring structure, process, and outcome elements of emergency care. Key principles that are the foundation of the program include active participation by all staff levels (clinical and nonclinical), standardized documentation, and specifically defined review mechanisms. PMID- 3970400 TI - Fatal systemic fluorosis due to hydrofluoric acid burns. AB - A patient with a 70% hydrofluoric acid burn developed systemic dissemination of fluoride ion from a 9% to 10% body surface area exposure on the lower extremities. Severe hypocalcemia and intractable ventricular arrhythmias resulted. This case is the second documented occurrence of hypocalcemia from hydrofluoric acid burns. It is the first case to document myocardial injury and systemic fluorosis from a skin burn. PMID- 3970401 TI - Fatal overdose from a sustained-release theophylline preparation. AB - A 26-year-old woman ingested approximately 9 g of theophylline (Theodur). She exhibited agitation, generalized seizures, hyperglycemia, hypokalemia, hypomagnesemia, hypophosphatemia, and diuresis. Later in her hospital course rhabdomyolysis, myoglobinuria, and acute renal failure occurred. Hemodialysis was performed to correct electrolyte imbalance. She subsequently died of intractable shock and hyperkalemia. This case illustrates the metabolic abnormalities which may occur with severe theophylline intoxication. PMID- 3970402 TI - Fatal ventricular fibrillation following verapamil in Wolff-Parkinson-White syndrome with atrial fibrillation. AB - A 29-year-old man with Wolff-Parkinson-White syndrome and atrial fibrillation developed fatal ventricular fibrillation shortly after receiving intravenous verapamil. The patient presented with an irregular pulse of 190. A total of 23 mg of verapamil was administered in small intravenous doses over 35 minutes. The ventricular rate accelerated as verapamil was administered, and fatal ventricular fibrillation followed. Three theoretical mechanisms by which verapamil may enhance conduction of atrial fibrillation in Wolff-Parkinson-White syndrome, predisposing to ventricular fibrillation, are mentioned. PMID- 3970403 TI - Left tension pneumothorax masquerading as anterior myocardial infarction. AB - Spontaneous pneumothorax is an emergency that can present with variable signs and symptoms. Diagnosis of pneumothorax can be difficult, particularly in patients who present with unusual clinical findings. The electrocardiographic changes that develop with left pneumothorax are not widely known and can mimic acute myocardial ischemia. Our patient was admitted to the Cardiovascular Intensive Care Unit because of characteristic changes on the electrocardiogram. An admission chest film revealed left tension pneumothorax. PMID- 3970404 TI - Tension pneumopericardium following blunt chest trauma. AB - A 12-year-old victim of an automobile-pedestrian accident appeared to develop severely compromised cardiac output shortly after intubation and positive pressure ventilation. Anteroposterior and lateral chest films showed air within the pericardial sac. After pericardiocentesis and withdrawal of air, cardiac function improved markedly as evidenced by a rise in blood pressure and a slowing of the pulse. A catheter was left in the pericardial sac for several days. The patient remained hemodynamically stable throughout the hospital stay and was subsequently discharged. Documentation of this degree of tamponade from air in the pericardium is quite uncommon. PMID- 3970405 TI - Anaphylactic reactions to zomepirac. AB - Three cases of apparent anaphylactoid reactions to zomepirac sodium (Zomax) are reported. One patient initially appeared to have a dissecting abdominal aortic aneurysm with vascular collapse. The second patient experienced conjunctival pruritus after each of several doses of zomepirac before emergency department presentation with acute dyspnea and urticaria. The third patient had been admitted previously with a diagnosis of rule out myocardial infarction, which in retrospect was probably a zomepirac reaction. All three recovered uneventfully. PMID- 3970406 TI - Use of fab fragments of digoxin-specific antibodies in the therapy of massive digoxin poisoning. AB - A case of massive digoxin ingestion with multiple arrhythmias, consisting of high grade A-V block and ventricular ectopy not responsive to lidocaine, is described. The arrhythmias ceased following administration of digoxin-specific Fab fragments. The patient improved and was transferred to the psychiatric unit. PMID- 3970407 TI - Prisoners in the emergency department. AB - Eight issues in the care of prisoners in the ED have been examined. Close to one half million persons are incarcerated at any time in the United States, and the numbers can be expected to increase. When seeing prisoners in the ED, the physician must keep in mind two facts: 1) prisoners have a right to medical care; and 2) incarceration demands that certain considerations be made regarding the correctional environment when evaluating, treating and, most importantly, discharging a prisoner back to the cell. PMID- 3970408 TI - Research for fun and profit. PMID- 3970409 TI - Health care for prisoners. PMID- 3970410 TI - Tarso-metatarsal dislocation without associated fractures. PMID- 3970411 TI - Pneumomediastinum in a young male cocaine user. PMID- 3970412 TI - Early recognition of diaphragmatic injuries from blunt trauma. AB - Rupture of the diaphragm from blunt trauma was identified in 42 patients in four years. The contribution of peritoneal lavage in identifying these injuries was examined. More than 93% of the ruptured diaphragms were identified within 24 hours. Peritoneal lavage was positive in 89% of patients who had no other source of intraabdominal hemorrhage. Chest radiography alone identified 41% of the patients who had diaphragm injury. If the peritoneal lavage is negative and the best radiograph is not diagnostic but suspicion of diaphragm injury remains, the lavage catheter can still be used to instill contrast into the peritoneum. Peritoneal lavage, when used in combination with chest radiography, is a reliable, rapid, and simple aid in identifying ruptured diaphragms from blunt trauma. PMID- 3970413 TI - Evaluation of cytopathologic changes induced in chicken tracheal epithelium by Mycoplasma gallisepticum in vivo and in vitro. AB - Changes in tracheal epithelial surfaces induced by Mycoplasma infection in vivo and in vitro included release of mucous granules followed by exfoliation of ciliated and nonciliated epithelial cells. Light microscopy, scanning electron microscopy, and transmission electron microscopy confirmed that the loss of cilia from individual cells was infrequent. Epithelial cells typically lost their intercellular connections, rounded up, exfoliated, and then lysed--giving rise to a population of cellular organelles, such as mitochondria and cilia intermixed with mucus to form the exudate found within the tracheal lumen. Repair of the epithelial surface was effected by basilar epithelial cells differentiating and filling in the spaces formed by exfoliated cells. These cells were hypertrophied, nonciliated at 14 days after infection in vivo, and covered with microvilli. In sectioned material obtained during the infection, there was increasing epithelial thickness due to cellular infiltration and edema. Tracheal rings in vitro showed similar changes to those seen in vivo, except that exfoliation was more severe and occurred earlier. In addition, there were no cellular infiltration due to the lack of a vascular supply and only a small amount of mucus due to the smaller number of mucous cells available to release into the tracheal lumen. PMID- 3970414 TI - Development of enzyme-linked immunosorbent assays for the detection of Fusobacterium necrophorum antibody in animal sera. AB - Enzyme-linked immunosorbent assays (ELISA) for the detection of Fusobacterium necrophorum antibody in the sera of rabbits, cattle, and sheep were developed, using a ribosome-rich extract (RRE) from F necrophorum as the antigen. Test character, including optimal antigen dilution and substrate incubation periods, was established, using rabbit, bovine, and ovine antisera produced against RRE from isolates of F necrophorum. Rabbit antisera produced against 7 other species of bacteria were used to test the specificity of the F necrophorum RRE antigen. Cross-reactivity was not detected. Sera from 50 feedlot cattle were examined with the bovine ELISA. Of the 50 samples, 43 (88%) were positive for F necrophorum antibody. The ELISA developed in this study were sensitive and specific and appear to be readily adaptable to serologic investigations of F necrophorum. PMID- 3970415 TI - Indwelling rumino-reticulum bolus radio beacon. AB - A miniature battery-powered radio beacon attached to a stainless steel bolus housing an osmotic pump is described. When the bolus, of sufficient size and density to be retained in the reticulum, is administered to ruminants the radio signal can be received, using a standard AM broadcast receiver up to a range of 1.5 m. The unit allows making a simple and inexpensive verification that the drug delivery system is still within the rumino-reticulum during long-term drug delivery studies and making an external estimation of the internal anatomic location of the device. PMID- 3970416 TI - Fatigue characteristics and biocompatability of a totally implantable bone growth stimulator in ponies. AB - Materials fatigue and gross biocompatability of an implantable bone growth stimulator (BGS) were assessed in a 6-month trial using 6 ponies. The forelegs of each pony were implanted with a BGS; the right leg implant had the cathode and cathode lead preconnected by the manufacturer, and the left leg implant was connected at surgery. Evaluation was by radiographic and clinical examination at the beginning and end of the experimental period. Six of the 12 cathode leads (50%) and 7 of the 12 cathodes (58%) were broken at 6 months. All of the implanted preconnected cathode and insulated cathode leads and 33.3% of the surgically connected cathodes and insulated cathode leads were connected at the titanium connector socket at 6 months. This BGS may exhibit wire fatigue greater than 50% of the time when used in the distal extremity of the horse. PMID- 3970417 TI - Equine tracheobronchial lavage: comparison of lavage cytologic and pulmonary histopathologic findings. AB - Differential cell counts were done on bronchial lavage specimens from 166 horses. Postmortem gross and histologic examinations were done to determine the pathologic diagnosis of the lungs from these horses. Ninety-two (55%) were normal, 18 (11%) had interstitial pneumonia, 13 (8%) had bronchopneumonia, 13 (8%) had focal eosinophilia, 11 (7%) had diffuse eosinophilia, 11 (7%) had chronic bronchitis, and 8 (5%) had suppurative bronchitis. Little relationship was found between cellular features of the lavage specimens and the pathologic status of the lungs of individual horses. PMID- 3970418 TI - Isolation of bovine eosinophils by density gradient centrifugation. AB - A method for the isolation of an enriched population (greater than 60%) of bovine eosinophils was developed, using density gradient centrifugation. Eosinophils were isolated from peripheral blood by centrifugation on a density gradient medium of sp gr 1.092. Viability was greater than or equal to 95%, and the isolated eosinophils were found to be functional in chemokinetic and antibody dependent cellular-cytotoxicity assays. This method represents a simple, rapid method for obtaining bovine eosinophils that can be used in a variety of assays of eosinophil function. PMID- 3970419 TI - Venous blood pressure relative to the development of bovine udder edema. AB - Cranial superficial epigastric (milk vein) and jugular venous blood pressure were measured in 8 cows with udder edema and in 3 normal control cows at least 2 weeks before parturition, at parturition, and 2 weeks after parturition. Cows with udder edema had a significant mean increase (P less than or equal to 0.05) in cranial superficial epigastric venous pressure at parturition when compared with pressures 2 weeks prepartum and 2 weeks postpartum. Unaffected control cows had an insignificant increase in cranial superficial epigastric venous pressure during these 3 periods of measurement. There was an insignificant increase in jugular venous blood pressure during the 3 periods of measurement in affected and control cows. A correlation was observed between mammary blood flow and cranial superficial epigastric blood pressure at parturition (r = -0.659, P less than or equal to 0.05). PMID- 3970420 TI - Activity of closantel in the prevention of Gasterophilus and Strongylus vulgaris larval infections in equine foals and yearlings. AB - Two controlled tests were conducted in equine foals and yearlings to determine the optimal oral dosage and the duration of activity of closantel for the prevention of Gasterophilus spp larval infections. Additional data were collected on the activity of closantel against Strongylus vulgaris larval infections. In experiment 1, 12 foals and 12 yearlings were equally allocated to 4 experimental groups, and were given oral treatments with closantel at dosages of 0 (nontreated controls), 2, 5, or 8 mg/kg of body weight every 2 months during bot season. The foals and yearlings were allowed to graze on open pasture throughout the experiment to provide a natural source for bot and helminth infections. All animals were euthanatized and necropsied 6 weeks after the final treatment. Closantel was highly effective (98.6% to 100%) at all doses in preventing Gasterophilus spp larval infections in the foals, but only the 8 mg/kg dose had significant (P less than 0.05) activity (99.7%) in the yearlings. This dose also significantly reduced the numbers of 4th-stage and immature adult S vulgaris (86.0%) in the mesenteric arteries as compared with nontreated controls. In experiment 2, 9 foals and 9 yearlings received a single oral treatment of 8 mg of closantel/kg of body weight; 3 foals and 3 yearlings were kept as nontreated controls. Groups of 6 treated (3 foals, 3 yearlings) and 2 control (1 foal, 1 yearling) animals were euthanatized and necropsied 1, 2, and 3 months after treatment. Closantel remained effective for 2 months in preventing infections of G intestinalis larvae in these foals and yearlings. Clinical signs of toxicosis were not observed in the treated animals of either study. PMID- 3970421 TI - Postmortem magnesium concentration in bovine vitreous humor: comparison with antemortem serum magnesium concentration. AB - The range for postmortem vitreous humor Mg2+ concentration in 97 healthy cattle was 1.8 mg/dl to 2.72 mg/dl at 23 C for a 48-hour postmortem interval. The postmortem vitreous Mg2+ concentration closely paralleled the antemortem serum Mg2+ concentration at 23 C. Low environmental temperature (4 C) had no effect on postmortem vitreous concentration. However, high environmental temperatures (30 C) significantly (P less than 0.05) reduced postmortem vitreous Mg2+ concentration at the 36-hour postmortem interval. It was concluded that postmortem vitreous humor Mg2+ determination could be a useful diagnostic aid in cattle for detecting Mg2+ imbalances for at least 48 hours after death, provided the postmortem environmental temperature did not exceed 23 C after 24 hours. PMID- 3970422 TI - Efficacy of oral clorsulon in the treatment of Fasciola hepatica infections in calves. AB - Twenty calves at each of 2 Arkansas locations were inoculated with infective Fasciola hepatica metacercariae. After 56 days, the calves at each site were randomly assigned by weight to 2 treatment groups of 10 calves/group; vehicle control or clorsulon at the rate of 7 mg/kg of body weight. All treatments were given orally as a suspension. Calves were killed 6 weeks after treatment and F hepatica counts were performed for all animals. At the 2 sites, mean levels of efficacy were 96% and 91%. Adverse reactions to clorsulon or the vehicle were not observed in the calves. PMID- 3970423 TI - Heavy metals in fluids and tissues of fetal calves and in young calves of nursing cows exposed or not exposed to anaerobically digested wastewater sludge. AB - Fetal fluid, diaphragm muscle, heart, kidney, and liver from 14 four- to five month-old calf fetuses were analyzed for Zn, Cu, Cd, Cr, Ni, Pb, and Fe. The same tissues and bone were examined from postparturient calves 30, 60, and 120 days of age. Weaned calves (8 to 9 months old) were necropsied and diaphragm muscle, heart, kidney, liver, brain, and bone were analyzed. Additional calves from cows exposed or not exposed to anaerobically digested sludge were placed in a feed yard at weaning for a feeding period of 150 days and then were killed and necropsied. Heavy metal content of the aforementioned tissues was compared with the same tissues obtained from peer calves weaned, killed, and necropsied 150 days earlier. Zinc, Cu, and Fe were up to 11 times higher in fetal livers than in control or exposed postparturient calves. These concentrations declined after birth and stabilized at approximately the concentrations observed in adult cattle at about 12 to 14 months of age. Cadmium accumulated to a greater extent in kidneys and livers of exposed calves than in control calves. However, the accumulation did not produce a detectable effect upon the functional or morphologic characteristics of the organs examined. Other metals were present at low levels and were generally not remarkably different in control and exposed animals. PMID- 3970424 TI - Preliminary study of the pharmacokinetics and toxicopathy of deoxynivalenol (vomitoxin) in swine. AB - Study was made of the pharmacokinetics and toxicopathy of deoxynivalenol (DON, vomitoxin) given IV to swine. In the 24 hours after swine were given DON, clinical signs of vomiting, diarrhea, muscular weakness, tremors, and twilight coma were similar to those observed with other 12,13-epoxytrichothecenes. Hypoglycemia and pancreatic islet cell lesions were observed which indicated that DON-induced changes in intermediary metabolism may be an insidious aspect of DON intoxication. Histopathologic examination of all organ systems revealed pancreatic acinar and islet cell necrosis and mild lympholysis of the mesenteric lymph nodes. The renal excretion of DON was altered by IV infusion of saline solution. Pharmacokinetic findings may indicate that DON was both secreted and reabsorbed by the renal tubules. The half-life of DON ranged from 2.08 to 3.65 hours. Residues of DON were not found in skeletal muscle of swine at 24 hours after dosing. PMID- 3970425 TI - Platelet and fibrinogen kinetics in healthy and African swine fever-affected swine: [75Se]selenomethionine-labeling study. AB - Platelet and fibrinogen survival times were determined in healthy pigs and in pigs infected with African swine fever (ASF) virus. Cohort labeling with [75Se]selenomethionine was performed. The platelet survival time in healthy pigs was 5.3 +/- 0.7 days, and the fibrinogen survival time was 6.7 +/- 0.8 days. Early deaths and profound thrombocytopenia prevented calculation of accurate platelet and fibrinogen survival times in ASF virus-infected animals. The ASF virus-infected pigs died of extensive hemorrhage and effusions while thrombocytopenic; however, there was normal thrombocytopoiesis during infection, as measured by incorporation of the radionuclide into platelets. There was a slight decrease in plasma fibrinogen concentration when the platelet count decreased. A dysfunctional fibrinogen was present late in the infection. PMID- 3970426 TI - Measurement of portal and hepatic blood flows using a modified method for surgical placement of catheters in the major splanchnic vessels of sheep. AB - A modified catheterization and para-aminohippurate dye dilution technique was used to measure portal and hepatic blood flows in sheep. Blood flows (mean +/- 1SD) for 7 healthy sheep were 1.54 +/- 0.71 L/min and 1.98 +/- 0.75 L/min for portal and hepatic flows, respectively. Blood flow measurement was facilitated when dye injection rates produced blood para-aminohippurate acid concentrations greater than 15 mg/L. Uniform mixing of dye with blood was confirmed in 1 sheep with 2 portal vein catheters. Surgery to place the catheters was facilitated by using a ventral para-costal approach. Blood gas analysis was useful in confirming the placement of the catheters. Useful catheter life in this experiment was 41 days, which was longer than in previous reports. Treating the catheters with an organo-silane preparation, protecting the catheters against dislodgement, and use of a belly bandage to minimize damage to the external parts of the catheter may have prolonged catheter life in this experiment. PMID- 3970427 TI - Haemonchus contortus and Ostertagia circumcincta: fenbendazole treatment and abomasal permeability changes in sheep. AB - Effects of fenbendazole (7.5 mg/kg of body weight infused during 90 minutes) on abomasal transmural potential difference (PD), pH, and ionic concentrations were determined in 8 lambs fitted with permanent abomasal cannulae. Four sheep were treated before inoculation and on day 28 after inoculation, with 200,000 3rd stage Ostertagia circumcincta larvae and 4 others were similarly inoculated with 15,000 3rd-stage Haemonchus contortus larvae. In worm-free lambs, the unique effect was an increase in Na+ concentration of the abomasal contents. The O circumcincta or H contortus-inoculated lambs had an increase in PD, pH, and Na+ concentrations. Treatment further increased these concentrations, but the effects on PD occurred and ceased earlier in sheep inoculated with O circumcincta than in those inoculated with H contortus. The results indicated that part of the changes were linked to substances produced by the parasites or by the host. The increase in PD and pH was associated with a decrease in K+ concentration and indicated that these substances stimulated HCO3- transfer. PMID- 3970428 TI - Surgical transplantation of adult Dirofilaria immitis to study heartworm infection and disease in dogs. AB - Heartworm infections were established in dogs by surgical transplantation of adult heartworms into the external jugular vein. The heartworms were obtained from donor dogs that had been infected with large numbers of infective larvae. This heartworm model standardized the infection with a known number of heartworms of a known age and sex. This paper presents the methods for obtaining heartworms from donor dogs, for selection of recipient dogs, and for transplantation of heartworms. PMID- 3970429 TI - Neutrophil function in the dog: shape change and response to a synthetic tripeptide. AB - Isolated dog neutrophils exposed to known chemotactic factors assumed a bipolar configuration in suspension. This response was initiated within 2 minutes with a gradual return to spherical shape. The rate of return to sphere was positively correlated with the dose of stimulant. Dog neutrophils exposed to N formylmethionyl-leucyl-phenylalanine (fMLP) did not adapt to bipolar conformation and did not bind radiolabeled fMLP. These findings are consistent with other species (pig and cow) that also did not respond to fMLP. PMID- 3970430 TI - Electrophysiologic studies of the facial reflexes of the dog. AB - Reflexes associated with the trigeminal and facial nerves were investigated electromyographically in 14 barbiturate-anesthetized dogs. Using subcutaneous needle electrodes, electrical stimulation of the infraorbital, frontal, and zygomaticofacial branches of the trigeminal nerve produced reflex contractions of the ipsilateral orbicularis oculi muscle. Cutaneous and subcutaneous electrical stimulation of the internal auricular branches of the facial nerve also produced reflex contractions of the ipsilateral orbicularis oculi muscle. After sectioning of this branch between the vagus and facial nerves, electrical stimulation of the proximal portion of the auricular branch of the vagus nerve produced reflex contractions of the ipsilateral orbicularis oculi muscle. After sectioning of the auricular branch of the vagus nerve; electrical stimulation of the proximal portion of the caudal and middle internal auricular nerves did not produce reflex contractions of the ipsilateral orbicularis oculi muscle. Subcutaneous electrical stimulation of the palpebral nerve produced reflex contractions and direct-evoked muscle activity of the orbicularis oculi muscle. Subcutaneous electrical stimulation of the infraorbital and middle mental nerves produced reflex contractions of the rostral belly of the digastricus muscle. PMID- 3970431 TI - Pharmacokinetics of flunixin meglumine in dogs. AB - The pharmacokinetics of flunixin meglumine, a potent nonsteroidal anti inflammatory agent, were studied in 6 intact, awake dogs. Plasma samples were obtained up to 12 hours after IV administration of flunixin meglumine. Flunixin concentration was determined, using high performance liquid chromatography. Plasma data best fit a 2-compartment model. Distribution half-life was 0.55 hour; elimination half-life was 3.7 hours; volume of distribution (area) was 0.35 L/kg; volume of distribution at steady state was 0.18 L/kg; volume of the central compartment was 0.079 L/kg; and total body clearance was 0.064 L/hr/kg. Flunixin concentrations obtained over a 6-hour period in 3 dogs with septic peritonitis did not differ significantly from those obtained from healthy dogs. PMID- 3970432 TI - Aqueous outflow in the beagle: unconventional outflow, using different-sized microspheres. AB - Normal drainage of aqueous humor from the anterior chamber of the canine eye occurred through the angular aqueous plexus and uveoscleral route. In order to understand more clearly, uveoscleral outflow with regard to larger sized tracer particles and the possible influence that varying intraocular pressure (IOP) may have on them, microspheres of 3 sizes, 0.5, 1.0, and 3.0 micron, were perfused at 3 different IOP (20, 50, and 75 mm of Hg) for 3 different times (30, 60, and 90 minutes). Presence of spheres was detected by light microscopy and scanning electron microscopy, and verified by transmission electron microscopy. By 30 minutes of perfusion, all 3 sphere sizes thoroughly infiltrated the anterior uveal trabecular meshwork. At normotensive pressure (20 mm of Hg), spheres of each size penetrated the outer anterior extension of the ciliary musculature and entered the supraciliary space. Only 0.5- and 1.0-micron spheres moved posteriorly into the suprachoridal space. At hypertensive pressures, movement of the tracer particles increased markedly toward the posterior uveal trabecular meshwork. However, 3.0- and 1.0-microns spheres did not enter the supraciliary space and suprachoroidal space, respectively. Spheres also entered the iris, mostly at its root. They remained comparably sparse at different perfusion times and IOP. The present study supported evidence for uveoscleral outflow (vs uveovortex) in the dog and indicated that passage of materials through this pathway may be influenced by IOP when these substances are within a critical size range. PMID- 3970433 TI - Scanning electron microscopy of the canine atrioventricular bundle and moderator band. AB - The atrioventricular (AV) bundle and the moderator band in the canine heart were examined by scanning electron microscopy. The AV bundle and the moderator band both were comprised of large, cylindrically shaped cells. These cells were highly organized into bundles, with minimal lateral communication between bundles. There was extensive cell-to-cell communication between cells within a bundle. The end branching of individual cells was prominent, with some interbundle communication. These results are discussed in relationship to the electrophysiologic properties of the AV bundle and the conduction velocity. PMID- 3970434 TI - Efficacy of a combined paste formulation of praziquantel/febantel against immature Echinococcus granulosus and immature Echinococcus multilocularis. AB - A combined paste formulation of praziquantel (1 mg/kg of body wt)/febantel (10 mg/kg) given for 3 consecutive days gave 100% clearance of immature Echinococcus granulosus and E multilocularis in experimentally infected dogs. The formulation was extremely convenient to administer. Adverse reactions were not noted in the treated animals. PMID- 3970435 TI - Experimental babesiosis in coyotes and coydogs. AB - One splenectomized and 6 intact coyotes (Canis latrans), and 2 coydogs were experimentally inoculated with a recent isolate of Babesia gibsoni. The disease was mild in intact animals, was fatal in the splenectomized coyote, and was characterized by a regenerative hemolytic anemia with the PCV decreasing to 16% in intact animals and to 6% in the splenectomized coyote. Peak parasitemia ranged from 3% to 21% of erythrocytes infected and was inversely correlated to PCV. Serum lactate dehydrogenase, bilirubin, and globulin concentrations were increased in all infected animals. Three weeks after inoculation, specific antibody titers increased to 1:65,536 and remained elevated in the chronically infected animals. The splenectomized coyote had progressive weakness until death, 24 days after inoculation. Intact animals had splenomegaly and anorexia at the height of infection. The splenectomized coyote had generalized edema, omental petechiae, renal and hepatic degeneration, membrano-proliferative glomerulonephritis and congestion, extramedullary hematopoiesis, lymphoid hyperplasia, and severe hemosiderosis in an accessory spleen. The only consistent change in the intact animals was splenomegaly. PMID- 3970436 TI - Amaranthus retroflexus (redroot pigweed): inability to cause renal toxicosis in rabbits. AB - Rabbits fed Amaranthus retroflexus (redroot pigweed) did not develop lesions of renal toxicosis reported in other species fed this plant. In feeding trials using adult and weanling rabbits, A retroflexus did not produce indications of renal involvement in rabbits. In both trials, treated rabbits had increased weight loss when compared with controls; however, the weight loss was not attributed to a toxic effect, but to previously described decreased palatability of Amaranthus spp. PMID- 3970437 TI - Dimensions of the rabbit femur during growth. AB - In the rabbit, the femur grew rapidly in length during the first 4 weeks of life of the animal. Growth continued at a slower rate up to 8 to 10 weeks of age and then reached a plateau. A similar growth pattern (rapid increase followed by a plateau) was seen for the dimensions of the femoral head, neck, and shaft. Significant growth differences between the left and right femurs did not occur. PMID- 3970438 TI - Influence of dietary calcium on lead poisoning in mallard ducks (Anas platyrynchos). AB - Forty-five mallard ducks were allotted into 3 dietary groups. Group I was fed pelleted calcium-supplemented corn; group II was fed a pelleted commercial duck ration; and group III was fed cracked corn. Ten ducks of each group were given four No. 4 lead shot via an esophageal tube, and 5 ducks of each dietary group were kept as pair-fed controls. Anorexia and weight loss were most severe in the treated group III ducks. Group III had a maximum reduction in food consumption of 87% followed by a slight improvement in appetite; they lost 35% of their initial body weight. Group I treated ducks had a reduction in food consumption of 64% that eventually returned to the quantities consumed at the start of the experiment; group I ducks lost 18% of their initial body weight. Group II treated ducks maintained healthy appetites during the experiment and had a weight gain of 2% of their initial body weight. The number of ducks that became moribund and were euthanatized differed significantly among the treated groups with 100% of group III, 50% of group I, and 0% of group II treated ducks becoming moribund. All 3 groups of treated ducks had increased protoporphyrin IX concentrations compared with controls. Groups I and III lead-treated ducks had significant (P less than 0.05) reductions in erythrocyte counts, PCV, hemoglobin concentrations, and mean corpuscular hemoglobin concentrations as compared with controls. Group II had reduced hemoglobin concentration and mean corpuscular hemoglobin concentration compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970439 TI - Colonic motor responses in the pony: relevance of colonic stimulation by opiate antagonists. AB - The electrical and mechanical activity of the digestive tract and its response to the administration of opiate agonists and antagonists was assessed from electrodes and strain gauges chronically implanted on the jejunum and the cecocolonic segments in 3 ponies given a diet of hay and concentrates. Before the drugs were given, 10 to 17 migrating myoelectric complexes/day were recorded on the small intestine, and a rhythmic motor activity (base line) was observed on the proximal portion of the colon at the rate of 3.5 to 6.6/hour. Propagated contractions from the proximal to the distal portion of the colon occurred at the rate of 1.5 to 2.3/hour. Each pony was used as its own control and was given morphine (0.5 or 1 mg/kg of body weight, IV) or fentanyl (0.01 or 0.05 mg, IV) at weekly intervals. After an early phase of inhibition of the overall activity that lasted from 0.5 to 3 hours, depending on the dose, the resting muscle tone of the colonic activity was increased for a dose-dependent period. Propagated contractions only reappeared at the end of this 2nd phase. The opiate antagonist naloxone (0.5 mg/kg, IV) elicited a marked propulsive activity on the left replicated colonic segment, characterized by an increase in the number of propagated contractions. The N-methyl-quaternary analog of naloxone (methylnaloxone, which presumably entails selective action at opiate receptors outside the CNS) was also effective, indicating peripheral effects at the dosage level used (0.5 mg/kg, IV). Seemingly, an inhibitory opioid system exists in the control of colonic motor function in ponies and the possible usefulness of opiate antagonists to relieve hypomotility resulting in colonic impaction and constipation. PMID- 3970440 TI - Electroencephalographic patterns of clinically normal, sedated, and tranquilized newborn foals and adult horses. AB - To establish a clinically practical procedure for recording the equine EEG, 25 healthy adult horses and 6 newborn foals were used. Recordings were taken with the animals alert and tranquilized, confined in metal stocks, or physically restrained. The dominant alert waveforms of adult horses were fast activity (25 to 40 Hz) with medium-to-low voltages (5 to 40 microV-dominant 10 to 15 microV). Underlying this fast activity was slower (0.5 to 4.0 Hz) activity with medium-to low voltages (10 to 40 microV). Twelve of the 25 adult horses had EEG frequencies in the alpha frequency range (10 to 15 Hz, 10 to 50 microV). Eight horses were given xylazine and 17 were given acetylpromazine. Those given xylazine had generalized slowing with several distinct frequency patterns (25 to 40 Hz, 5 to 30 microV; 10 to 15 Hz, 10 to 80 microV; and 0.5 to 4.0 Hz, 10 to 90 microV). Horses given acetylpromazine had fast activity (25 to 40 Hz) with medium-to-low voltages (5 to 40 microV). Underlying this activity were slower waveforms (1 to 4 Hz) with medium-to-low voltages (5 to 10 microV). Occasional well-formed spindle activity was observed (10 to 14 Hz, 10 to 50 microV). Acetylpromazine had little effect on the EEG recording, whereas xylazine exerted a substantial effect. All leads were synchronous with lower voltages in the left frontal, right frontal, and transfrontal leads. The alert pattern of a newborn foal was characterized by low frequency (2 to 6 Hz) with medium-to-high voltages (20 to 90 microV).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970441 TI - Dairy herd problem with mastitis caused by a rapidly growing Mycobacterium species. AB - Intramammary infections by a nonspeciated Mycobacterium of Runyon group IV increased in the dairy herd at the Beltsville, Md, Agricultural Research Center during 4 years, and were cultured from 9.7% of 300 quarter samples from clinical mastitis cases in 1982. The infection was mildly acute, without systemic involvement, and refractory to therapy but self-terminating, usually at the end of lactation. Invasion of the mammary gland commonly followed stress, either calving or previous clinical mastitis, and was most frequent in August and September. Transmission of this mycobacterial intramammary infection from cow to cow was far more likely in free-stall barns than in tie stalls, and seemed not to be associated with machine milking. PMID- 3970442 TI - Production responses of lactating dairy cows and heifers given thiabendazole at parturition. AB - A field trial was conducted to examine the effects on productivity of dairy cattle in 6 herds given thiabendazole at parturition. Criteria examined were milk and fat production, calving interval, services per conception, culling rate, and (in a subset of cows) hematologic response. Analysis of the data for all cows as a group did not indicate a significant effect. For first-calf heifers in 1 herd, a significant (P less than 0.01) and economically important increase in milk production was observed; why the effect was seen was not determined. PMID- 3970443 TI - Enhancement of lymphocyte blastogenesis and neutrophil function by avridine in dexamethasone-treated and nontreated cattle. AB - The lipoidal amine, N,N-dioctadecyl-N',N'-bis (2-hydroxyethyl) propanediamine (avridine or CP 20,961), formulated in liposomes, was evaluated for its effect on leukocyte kinetics, lymphocyte blastogenesis, and polymorphonuclear leukocyte (PMN) function in dexamethasone-treated and nontreated cattle. In the 1st experiment, cattle were given avridine in a single IM injection of 0.1, 1.0, or 10 mg/kg of body weight. All doses induced swelling at the injection site, a febrile response, and a leukocytosis due to a neutrophilia. Mononuclear cell numbers were normal. All 3 groups of avridine-treated animals had a higher mean lymphocyte blastogenic response to mitogens on the 4 days after administration than did the control nontreated animals. Avridine administration was associated with an enhanced ability of PMN to ingest Staphylococcus aureus and to mediate antibody-dependent cell-mediated cytotoxicity (ADCC). The highest dose (10 mg/kg) was associated with a depression of the ability of PMN to iodinate protein. An effect of avridine on PMN random migration under agarose or nitroblue tetrazolium (NBT) reduction was not observed. In a 2nd experiment, cattle were given no treatment, 0.04 mg of dexamethasone/kg IM, or 10 mg of avridine/kg IM followed 24 hours later by 0.04 mg of dexamethasone/kg. Dexamethasone administration caused a leukocytosis due to a neutrophilia with normal mononuclear cell numbers, an enhancement of PMN random migration under agarose, and an inhibition of NBT reduction, iodination, and ADCC activity of PMN. Dexamethasone did not have a detectable effect on lymphocyte blastogenesis or on ingestion of S aureus by PMN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970444 TI - Vasculitis associated with ovine progressive pneumonia virus infection in sheep. AB - Vasculitis, involving small muscular arteries and arterioles, was found in 5 of 18 sheep naturally infected with ovine progressive pneumonia (OPP) virus and in 5 of 11 sheep experimentally infected with OPP virus. In order of frequency, arterial lesions were seen in carpal joint capsules, kidneys, meninges, brains, lungs, and tracheas. The lesions were intramural edema and hemorrhage, mononuclear cell infiltration, fibrinoid necrosis of media, and thrombosis. The vascular lesions were frequently associated with interstitial pneumonitis, arthritis, and encephalitis also induced by OPP virus. PMID- 3970445 TI - Arthritis associated with ovine progressive pneumonia. AB - Chronic nonsuppurative arthritis developed in carpal and tarsal joints of border Leicester sheep that were naturally or experimentally infected with ovine progressive pneumonia (OPP) virus. Clinical signs of arthritis began at 1 to 6.2 years of age (1 to 5.7 years after inoculation of OPP virus) and slowly progressed in severity until the sheep died or were killed. The joint lesions were characterized by edema, hyperemia, hyperplasia, and necrosis of the synovial membrane; by necrosis and erosion of articular bone; by necrosis and fibrosis of subchondral bone; and by extensive periarticular fibrosis. The OPP virus alone was isolated from arthritic joints. In 7 of 14 sheep, the arthritis was associated with interstitial pneumonitis induced by the virus. Therefore, it was concluded that OPP virus was the cause of arthritis in this group of sheep. PMID- 3970446 TI - Single intravenous and multiple intramuscular dose pharmacokinetics and tissue residue profile of gentamicin in sheep. AB - Single and multiple dose gentamicin regimens were compared in sheep to determine the relevant pharmacokinetic differences. Seven mature sheep were given 10 mg/kg of gentamicin by IV bolus. Serum concentrations were monitored for 19 days. Four weeks after the initial bolus, gentamicin was administered IM (3 mg/kg every 8 hours) for 7 days. Ewes were euthanatized and necropsied at 1, 8, and 15 days after termination of the IM regimen and the tissues were assayed for gentamicin. Serum concentrations were analyzed using a triexponential equation. The IV kinetic studies revealed an alpha half-life (t1/2) of 0.31 +/- 0.14 hours, beta t1/2 of 2.4 +/- 0.5 hours, and gamma t1/2 of 30.4 +/- 18.9 hours. Multiple IM dose kinetic studies revealed a beta t1/2 of 2.8 +/- 0.6 hours and gamma t1/2 of 82.1 +/- 17.8 hours. After multiple dosing, gamma t1/2 was significantly longer than after the single IV bolus (P less than 0.05). Twenty-four hour urine collection accounted for 75% to 80% of the total IV dose. Renal cortical gentamicin concentration reached 224 micrograms/g of tissue and then decreased, with a 90-hour t1/2. Renal medullary gentamicin concentration reached 18 micrograms/g with a 42-day t1/2. After multiple dosing, liver gentamicin concentration reached 11 micrograms/g and skeletal muscle concentrations were less than or equal to 0.6 micrograms/g. Route or duration of administration significantly affected the gamma-phase serum concentrations, which may influence gentamicin nephrotoxicosis. The present study also illustrated the complexities in predicting aminoglycoside withdrawal times for food-producing animals before slaughter. PMID- 3970447 TI - Effects of cryotherapy on the palmar and plantar digital nerves in the horse. AB - The duration of anesthetic effect and the histopathologic changes resulting from a controlled freeze of the palmar and plantar digital nerves in the horse were evaluated. Two techniques were compared: (i) nerves were frozen by direct application of the cryoprobe after surgical exposure and (ii) nerves were frozen by percutaneous application of the cryoprobe to the overlying skin. Return of skin sensation and ability to detect a stimulus were used to determine return of nerve function. The duration of anesthetic effect was significantly (P less than 0.005) longer for nerves frozen after surgical exposure than for those frozen by the percutaneous technique (mean 156 days vs 47.5 days). At the termination of the study, horses were euthanatized and all nerves were examined histologically. Neuromas-in-continuity were observed in 10 of 28 frozen nerves. Classification was based on the involvement of the supporting fibrous connective tissues of the nerve, endoneurium, perineurium, and epineurium. The direct technique of freezing the nerve after surgical exposure was repeatable and could be used to provide temporary neurectomy in the horse. The percutaneous technique caused a temporary loss of pain perception, but could not be relied on to interrupt nerve function for longer than a few weeks. PMID- 3970448 TI - Effects of gastric distention-volvulus on coronary blood flow and myocardial oxygen consumption in the dog. AB - Gastric distention-volvulus (GDV; at 50 mm of Hg gastric inflation pressure) was experimentally induced in 8 dogs anesthetized using pentobarbital. Hemodynamic indices including heart rate, mean arterial pressure, cardiac output, and coronary blood flow (4 dogs) were measured during a 20-minute period of GDV and for 10 minutes after decompression. Arterial and coronary venous oxygen tensions were also measured for calculation of myocardial oxygen extraction (7 dogs) and myocardial oxygen consumption (4 dogs). Dogs were monitored for 72 hours postoperatively for the occurrence of arrhythmias, then were euthanatized for gross and histologic examination of the heart. Experimental GDV resulted in significant (P less than 0.05) decreases in cardiac output (89%), mean arterial pressure (45%), and coronary blood flow (50%) compared with control values. Myocardial oxygen extraction increased (30%) and overall myocardial oxygen consumption decreased (50%), compared with control values. Evidence of subendocardial necrosis was seen in 6 dogs, 4 of which had developed ventricular arrhythmias 8 to 24 hours postoperatively. PMID- 3970449 TI - Surgery for bronchogenic carcinoma in the elderly. PMID- 3970450 TI - Lung cancer risk and vitamin A consumption in New Mexico. AB - The association between dietary intake of vitamin A and lung cancer risk was examined in a population-based, case-control study of 447 patients and 759 control subjects in New Mexico. A food frequency interview was used to measure usual consumption of total vitamin A retinol, preformed vitamin A, and carotene. With all respondents combined, the odds ratios for lung cancer increased as intakes of total vitamin A and carotene declined but did not vary with intake of preformed vitamin A. When the subjects were stratified by ethnic group, Hispanic or non-Hispanic (Anglo) white, significant effects of vitamin A consumption were limited to the Anglos. In the Anglos, the protective effects of total vitamin A and carotene consumption were present in males and females, but varied strongly with cigarette smoking habits. In Anglo smokers, significant increases in the odds ratios with declining intake were observed in former but not in current smokers. Among the former smokers, significant effects of total vitamin A and carotene consumption were present only in those who had stopped smoking for 6 to 15 yr. Limitation of the protective effect of vitamin A and carotene consumption to past smokers has important implications for the design of clinical trials and for cancer control strategies. PMID- 3970451 TI - Pulmonary function and respiratory symptoms in polyvinylchloride fabrication workers. AB - We performed preshift and postshift spirometry and administered a standardized respiratory symptoms questionnaire to 174 white males currently employed in polyvinylchloride (PVC) fabrication to examine the acute and chronic respiratory effects of work exposure. Although there were no significant differences between the in-plant comparison group and any department with potential exposures, there was evidence for respiratory effects in the combined group of comparison and exposed workers. In the combined group, duration of employment was significantly associated with decrements in adjusted cross-shift ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), preshift FEV1/FVC, and prevalence of chronic cough and chronic phlegm. In nonsmokers, the prevalences of chronic wheeze and chest tightness were high (36.0 and 50.5%, respectively). The age-adjusted prevalence of chronic wheeze in nonsmokers was also elevated 3.54 fold when compared with that in a community study in the literature. We conclude that the cross-sectional design and in-plant comparison group may mask the effects of exposures on the entire plant population, and that employment in this plant is associated with patterns of obstructive air-flow limitation and respiratory symptoms consistent with exposure to pulmonary irritants. These results suggest that possible agents of pulmonary effects in PVC fabrication are not limited to vinyl chloride monomer, PVC dust, and PVC thermal degradation products. PMID- 3970453 TI - Effects of heat and humidity on the responses of exercising asthmatics to sulfur dioxide exposure. AB - Twenty-two asthmatic young adult volunteers, predetermined to be reactive to sulfur dioxide (SO2) with exercise at normal room temperature, were studied to document short-term effects of SO2 exposure under hot conditions, both humid and dry. For comparison, similar exposures were conducted at mild temperatures. All subjects were exposed in an environmental control chamber to all possible combinations of 2 atmospheric conditions (purified air and 0.6 ppm SO2), 2 temperatures (near 21 and 38 degrees C), and 2 levels of relative humidity (near 20 and 80%). Exposures involved 5 min of heavy exercise (target ventilation rate, 50 L/min) plus brief warm-up and cool-down periods. Body plethysmographic measurements and symptom questionnaire interviews were administered before and at the end of each exposure. Response was expressed in terms of change in airway size or change in intensity of symptoms during exposure. Atmospheric condition showed the most marked and significant overall effect on physiologic responses; temperature and humidity effects were also significant. High temperature and high humidity tended to mitigate the bronchoconstriction produced by 0.6 ppm SO2 exposure: group mean specific airway resistance approximately tripled at 21 degrees C and low humidity, but increased by less than 40% at 38 degrees C and high humidity. Temperature and humidity affected symptoms less consistently than physiologic responses, but in general, symptom responses paralleled physiologic responses. PMID- 3970452 TI - Endotoxin in cotton dust and respiratory function decrement among cotton workers in an experimental cardroom. AB - To study the various reactions of gram-negative bacteria and their endotoxins observed in workers exposed to cotton dust, experiments were undertaken where cotton mill workers carded cottons from different geographic locations, each containing different amounts of bacterial endotoxins. Exposure was determined as the vertical elutriator dust and endotoxin levels. Measurements were made of the forced expiratory volume in one second (FEV1) and the number of blood neutrophils before and after work, and the prevalence of symptoms of byssinosis was recorded. There was a significant correlation between the vertical elutriator endotoxin levels and the group mean changes in FEV1 (p less than 0.01) but no correlation between vertical elutriator dust levels and changes in FEV1. There was also a dose-response relationship between the endotoxin levels and the presence of symptoms of byssinosis in the exposed workers as well as between endotoxin levels and an increase in blood neutrophils. This observation supports findings from several previous studies and suggests that endotoxin triggers the mechanisms responsible for the decrease in respiratory function in the byssinosis syndrome. Other constituents of cotton dust could also be of importance for this reaction. PMID- 3970454 TI - Aminophylline and its influence on ventilatory endurance in humans. AB - The purpose of this study was to evaluate whether the previously demonstrated improvement in contractile tension of diaphragmatic muscle with aminophylline results in improved ventilatory endurance. We measured the maximal sustained ventilatory levels during prolonged isocapnic hyperpnea as an index of ventilatory muscle function. This measurement was made in 7 normal subjects and 7 patients with chronic obstructive pulmonary disease during the intravenous administration of saline and aminophylline on 2 separate days. The order of administration of the infusions was randomized. Although both groups showed slightly higher sustained ventilatory levels during aminophylline infusion, the magnitude of change was small and unlikely to have a significant clinical benefit in the setting of respiratory muscle fatigue. PMID- 3970455 TI - Inspiratory muscle training in patients with chronic obstructive pulmonary disease. AB - To investigate the effects of inspiratory muscle resistive loading training (IMT) on exercise performance in chronic obstructive pulmonary disease (COPD), 13 patients undergoing standard pulmonary rehabilitation were divided into control (n = 6) and experimental (n = 7) groups. Prior to training, we measured inspiratory muscle strength and endurance, resting pulmonary function, and exercise performance on a bicycle ergometer (a progressive test and an endurance test at two thirds of maximal work load). We then determined their resistive loads for training by measuring their 10-min maximal sustainable resistance. Training by patients in the experimental group involved inspiring against a predetermined resistive load. The control subjects breathed through a sham training tube, so that studies were performed in double-blind fashion. The training consisted of 15-min sessions twice daily for 4 wk. The IMT dramatically improved inspiratory muscle endurance--represented as either sustainable inspiratory pressure (SIP) or endurance time at 60% of maximal inspiratory mouth pressure (Pimmax) at functional residual capacity. The SIP of the trained group increased from 29 +/- 11 to 46 +/- 11% of Pimmax (p less than 0.005). Training slightly increased inspiratory muscle strength (p less than 0.05), as determined by Pimmax. In contrast, resting pulmonary function and performance of both progressive and constant-load exercise remained unchanged. We conclude that 4-wk IMT in a pulmonary rehabilitation setting improves inspiratory muscle endurance in patients with COPD without changing pulmonary function or exercise performance. PMID- 3970456 TI - Role of serum in stimulation of polymorphonuclear leukocyte, luminol-dependent chemiluminescence by influenza A. AB - Granulocyte membrane perturbation activates oxidative metabolism with the release of highly reactive species (O2-, H2O2, OH., and 'O2) and emission of light (chemiluminescence (CL)). Using the CL response as a measure of oxidative metabolism, we assayed the effects of influenza A on the granulocyte respiratory burst. Human polymorphonuclear leukocytes (PMNs) were isolated by Ficoll-Hypaque cushioning and dextran sedimentation. The isolated PMNs were incubated with egg grown influenza A (H3N2) virus, or a medium control, in the presence of 1 microM luminol and fresh autologous serum (10%). No light emission occurred during the incubation of PMNs with the medium control. Influenza A (33 to 50% egg-infective doses (EID50):1 PMN) stimulated PMN light emission with a maximal response (48,386 +/- 10,764 cpm/10(6) PMN) occurring at 37 degrees CL was dependent on the virus dose with a diminished response (6,041 +/- 3,200 cpm/10(6) PMN) occurring at a lower infectivity of 10 EID50:1 PMN. Chemiluminescence responses were similar with infective and with noninfective virus particles (heat inactivated, 56 degrees C X 2 h). Fresh serum was necessary for the influenza virus to cause a CL response. A significant correlation (p less than 0.01) existed between the level of light emission and the hemagglutination-inhibiting (HI) antibody titer to influenza A of the autologous serum. Virus in the absence of detectable antibody did not stimulate CL. The virus-associated CL was completely inhibited if autologous serum was heated (56 degrees C X 30 min) or if the PMNs were pretreated with cytochalasin B (5 mcg/ml X 5 min). These findings suggest that influenza A-associated PMN CL requires antibody, complement, and phagocytosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970458 TI - Computerized tomography in the diagnosis of lymphangioleiomyomatosis. AB - We describe a subject with lymphangioleiomyomatosis who presented with chylothorax but who had an otherwise normal chest radiograph. The diagnosis was established by means of whole-body computerized tomographic scanning, which demonstrated asymptomatic involvement of the lungs, lymphatics, and kidneys. This diagnostic modality offers the potential for noninvasive serial monitoring of this rare condition, and in doing so provides an opportunity to obtain a better understanding of the disease process. PMID- 3970459 TI - Sarcoid myopathy with elevated creatine phosphokinase. AB - Acute inflammatory myopathy complicating sarcoidosis is rare, and its prognosis and appropriate therapy have not been defined well. We describe a patient with chronic sarcoidosis who, during a 3-month period, developed an acute proximal myopathy associated with marked elevations in creatine phosphokinase (CPK) and extensive granulomatous inflammation on muscle biopsy. High-dose corticosteroids were dramatically effective in inducing remission, with resolution of all signs and symptoms of the myopathy and normalization of CPK. PMID- 3970457 TI - Transbronchial needle aspiration in the diagnosis of pneumonia in a canine model. AB - We evaluated the risk, sensitivity, and specificity of transbronchial needle aspiration (TBNA) in a canine model of unilateral Streptococcus pneumoniae pneumonia and compared the results with our previous studies of these parameters in transthoracic needle aspiration (TTN), a catheter-brush (CB), and transbronchial biopsy (TBB) in the same model. The TBNA was performed in 10 dogs with right lower lobe S. pneumoniae pneumonia. The procedure was uncomplicated, but both the sensitivity and specificity were low (3 of 10 cultures yielded S. pneumoniae; only 1 of the 3 was a pure culture). This compares unfavorably with our experience with the other procedures: 9 of 10 cultures were pure with TBB and CB, and the remaining culture was sterile; 10 of 10 were pure with TTN. Given the present unprotected form of the bronchoscopic aspirating needle, TBNA does not appear to be useful in the diagnosis of bacterial pneumonia despite its usefulness in the diagnosis of intrathoracic malignancy. PMID- 3970461 TI - The lucid interval in stroke following carotid endarterectomy. AB - In 789 carotid endarterectomies, there were 39 neurologic deficits in 543 cases (7.1%) performed with a shunt and nine neurologic deficits in 246 cases (3.7%) performed without a shunt in a community where surgeons were divided and inflexible with regard to the use of shunts. In the cases performed without a shunt, seven of the nine neurologic deficits were preceded by a lucid interval, suggesting that the use of a shunt might have benefitted no more than two cases in this group. The mortality related to deficits following a lucid interval was 44 per cent, whereas the mortality of immediate deficit was 13 per cent. This supports a policy of immediate operation for stroke following a lucid interval. PMID- 3970460 TI - Wound hematomas after carotid endarterectomy. AB - Wound hematomas, following carotid endarterectomy, are uncommon but potentially lethal complications. The management of 13 patients with this condition is presented. Factors that appeared to predispose to hematoma formation included perioperative use of platelet inhibitory drugs and postoperative hypertension. When the diagnosis of neck wound hematoma is made after carotid endarterectomy, prompt evacuation under local anesthesia is recommended. PMID- 3970463 TI - Preoperative cardiac screening before peripheral vascular operations. AB - Myocardial infarction continues to be a major cause of morbidity and mortality after peripheral vascular operations. In this study, radionuclide angiography (RNA) of the heart was used to delineate the cardiac risk. In 78 patients, there were 53 abnormal RNA studies. Twenty-seven patients with abnormal RNA underwent coronary angiography. Six aortocoronary bypasses were performed prior to or in conjunction with the vascular operation without complications. Ninety major operations were carried out in these 78 patients. There was no myocardial infarction in patients with normal RNA. There were two postoperative fatal myocardial infarctions in patients with abnormal RNA giving a procedure mortality of 2.2 per cent. In 11 patients, the proposed operation was changed. Thirteen patients with abnormal RNA had no cardiac symptoms. Three patients in this subgroup underwent aortocoronary bypass. It was concluded that RNA can effectively identify the cardiac risk in patients undergoing peripheral vascular operations. Routine coronary angiography may be unnecessary as patients with normal RNA have minimal risk of myocardial infarction. PMID- 3970462 TI - Carotid endarterectomy. One solution to the stroke problem. AB - Stroke is most often the result of extracranial cerebral artery disease; stroke carries a high initial mortality and morbidity and portends an increased risk of subsequent stroke or myocardial infarction. Stroke is also a preventable disease in more than one half of patients, either by approximate treatment of premonitory transient ischemic attacks or by appropriate evaluation of otherwise asymptomatic carotid bruits. Combined patient education and referring physician awareness should result in a declining incidence of stroke in this country. Two hundred carotid endarterectomies were performed over a 4-year period by senior residents under the direct supervision of the authors. Operative mortality was 1.5 per cent; perioperative stroke, 1.5 per cent; temporary neurologic deficit, 1 per cent; and temporary cranial nerve injury, 1 per cent. Analysis of these patients and of the literature supports an aggressive approach to carotid endarterectomy for patients with focal transient ischemic attacks and a more cautious approach for patients with prior stroke or asymptomatic stenoses. PMID- 3970464 TI - Pseudotumor of the lung. AB - Benign lung tumors in children are rare. An equally uncommon finding is the inflammatory pseudotumor, a lesion that is grossly similar to a tumor and yet cannot be histologically defined as a neoplasm. They have been called xanthomas, histiocytomas, solitary mast cell granulomas, and xanthogranulomas by various authors. There is a tendency to overtreat these lesions as if they were malignant. In previous reports, lobectomy has been the usual treatment for these tumors. If a pseudotumor is suspected at exploratory thoracotomy, a wedge resection and frozen section should be considered. When these benign lesions are easily accessible, they can be enucleated, leaving all of the normal pulmonary tissue intact without compromising cure. PMID- 3970465 TI - The role of contrast arteriography in suspected arterial injuries of the extremities. AB - The records of 215 patients presenting with 218 penetrating or blunt injuries to the extremities from 1977 through 1983 have been reviewed. All patients presenting with pulsatile hemorrhage, expanding hematoma, or absent distal pulses were explored immediately. Patients with injuries in close proximity to a major artery but without classical signs of arterial injury were explored routinely from 1977 through 1980. Thereafter, similar patients were evaluated initially with contrast arteriography and explored only if arteriographic abnormalities suggested arterial injury. Routine exploration of proximity injuries has been compared with selective exploration based on contrast arteriography. Sixty-one patients (group 1) underwent routine exploration for proximity injuries. Vascular injuries were detected in ten (16%) patients, while 51 (84%) of the explorations were negative. Eighty-four patients (group 2) with proximity injuries were studied arteriographically. Ten patients (11.9%) were explored on the basis of abnormal arteriograms, and eight arterial injuries were confirmed. Two (2.4%) of the 84 patients in this group had negative explorations. The use of contrast arteriography enabled the authors to reduce their negative exploration rate from 84 to 2.4 per cent in the management of proximity injuries. PMID- 3970466 TI - Infrarenal aortic aneurysms. Asymptomatic versus symptomatic. AB - Between 1978 and 1983, 103 patients underwent operations for infrarenal abdominal aortic aneurysms (AAA). Fifty-seven patients (group I) had elective procedures without a death and with a morbidity of 19 per cent. Thirty-three patients (group II) had symptomatic but nonruptured AAA, while 13 patients (group III) had ruptured AAA. In group II, the mortality was 6 per cent and in group III, 37 per cent, while the morbidity was 33 and 100 per cent, respectively. There was no morbidity or mortality from pulmonary emboli, as all patients had prophylactic inferior vena cava interruption at the time of operation for their AAA. These results substantiate the necessity for early and aggressive treatment in patients with AAA, as the mortality and morbidity, once symptoms develop, remain prohibitive. PMID- 3970467 TI - Principles of monitoring for the radiation protection of the population. PMID- 3970468 TI - Late relapse among patients treated for Hodgkin's disease. AB - Of 1360 consecutive patients with Hodgkin's disease treated at Stanford University, 1312 patients (96%) had complete remission, but 424 patients had a relapse. Fifty-five patients had relapses 36 months or more after completion of therapy. The actuarial risk of relapse in patients disease-free 3 years after therapy was 12.9%. The occurrence of late relapse was significantly related to stage I disease and nodular sclerosis histologic subtype. Late relapse was detected in 88% of patients by history, physical findings, or chest radiographs. Most patients with stage III and IV disease had late relapses in previously irradiated nodes or extranodally, but patients with stage I and II disease had late relapses primarily in unirradiated nodes. Disease-free survival after salvage therapy for late relapse was similar to that seen after treatment of earlier relapse. Prolonged surveillance of patients for late relapse is necessary after treatment of patients with Hodgkin's disease. PMID- 3970469 TI - Danazol therapy for autoimmune hemolytic anemia. AB - We evaluated the use of danazol in 15 patients with autoimmune hemolytic anemia of the warm antibody type. Danazol, 600 to 800 mg/d, was added to previous regimens or given initially in conjunction with high-dose prednisone treatment. Twelve patients with autoimmune hemolytic anemia associated with nonmalignant disorders or idiopathic autoimmune hemolytic anemia and 1 of 3 patients with underlying neoplasms showed a rise in hematocrit within 1 to 3 weeks. Thereafter, glucocorticoid doses were tapered to a minimum requirement or stopped. Once remission was sustained, the dose of danazol was reduced to 200 to 400 mg/d. Although levels of erythrocyte-bound IgG antibody and C3 decreased with therapy, only the decrease in C3 was statistically significant (p less than 0.05) in this limited study. Danazol was effective regardless of the severity of the disorder and success or failure of previous treatments. Danazol is valuable in the treatment of autoimmune hemolytic anemia and may be better suited than glucocorticoids for long-term management. PMID- 3970470 TI - Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. AB - We studied renal plasma flow and glomerular filtration rate during graded blood pressure reduction induced with sodium nitroprusside infusion in 16 hypertensive patients with atherosclerotic renovascular disease. Eight patients with unilateral disease tolerated pressure reduction from 205 +/- 9 (SE)/103 +/- 2 mm Hg to 146 +/- 6/84 +/- 3 mm Hg (p less than 0.01) with no change in total renal function. In 8 other patients with bilateral renal arterial stenosis (all arteries 70% or more stenosed), similar pressure reduction produced marked but reversible decrements in plasma flow (152 +/- 28 mL/min to 66 +/- 13 mL/min; p less than 0.01) and glomerular filtration rate (38 +/- 8 mL/min to 16 +/- mL/min; p less than 0.01). In 4 patients restudied after revascularization, sensitivity of renal function to pressure changes was no longer present. These data indicate that vascular stenosis to the entire renal mass may limit function and provide a means for evaluating patients at risk for loss of renal function during antihypertensive therapy. PMID- 3970471 TI - Furosemide absorption altered in decompensated congestive heart failure. AB - We assessed whether patients with decompensated congestive heart failure had altered absorption of oral furosemide. Pharmacokinetic and pharmacodynamic responses were studied in 11 patients receiving their usual oral dose of furosemide while decompensated, and after attaining normal weight. Seven patients also received 25 g of oral D-xylose to further assess intestinal absorption. A 57% decrease in lag time (p = 0.033), a 27% decrease in time to peak serum concentration (p = 0.041), and a 29% increase in the peak serum furosemide concentration (p = 0.008) were seen in compensated as compared to decompensated patients. No significant change was seen in absorption or elimination half-lives, area under the serum concentration versus time curves for furosemide, or in absorption of D-xylose. Although the pharmacodynamics of furosemide were reduced compared to normal subjects, there was little difference in the compensated and decompensated states. Our results show an alteration in furosemide absorption in decompensated congestive heart failure. PMID- 3970472 TI - Splenectomy does not cure the thrombocytopenia of systemic lupus erythematosus. AB - Fourteen patients with systemic lupus erythematosus had splenectomies done between 1960 and 1982 for treatment of severe thrombocytopenia. Thrombocytopenia persisted or recurred within 1 month postoperatively in five patients and within 6 months in three others. Three patients had late recurrence (18, 30, and 54 months after splenectomy); in two it was probably related to withdrawal of immunosuppressive agents or corticosteroids. Median lowest platelet count before splenectomy and median platelet count at relapse or failure of splenectomy were both 8000/microL. Only two patients maintained normal platelet counts without need for corticosteroids or other treatment. These results differ from those in patients with idiopathic thrombocytopenic purpura. Other treatments should be tried before splenectomy is done for thrombocytopenia in patients with systemic lupus erythematosus. PMID- 3970473 TI - Hypothyroidism and phenytoin intoxication. PMID- 3970474 TI - An analysis of the knowledge base of practicing internists as measured by the 1980 recertification examination. AB - The performance of practicing internists on the American Board of Internal Medicine's 1980 Recertification Examination was examined in two studies. In the first study, a psychometric common-item equating technique was used to compare the performance of 1980 recertification candidates with that of 1979 certification candidates. Results showed that the knowledge base of practicing internists was similar to that of residents completing training. The second study analyzed the performance of 1980 recertification candidates to determine whether being certified or having an interest in a subspecialty affects a physician's performance on items in that area. The results showed that subspecialists do significantly better than general internists on items pertaining to their area of specialization. Similar outcomes were found for internists with a special interest in a subspecialty area. These findings establish the importance of continued periodic evaluation and support the development of an evaluation tool tailored to the physician's area of concentration. PMID- 3970476 TI - Relapsing fever: new lessons about antibiotic action. PMID- 3970475 TI - Calcium channel blockers in the prophylactic treatment of vascular headache. PMID- 3970477 TI - Intravenous amrinone: an advance or a wrong step? PMID- 3970478 TI - The quinolones. PMID- 3970479 TI - Surgery or no surgery for primary hyperparathyroidism. PMID- 3970480 TI - Blood lead levels, dietary calcium, and hypertension. PMID- 3970481 TI - Chemical dependence. Health and Public Policy Committee, American College of Physicians. AB - The American College of Physicians believes that chemical dependence should receive increased recognition as a medical illness that requires medical diagnosis and treatment and greater educational attention. The College encourages physicians to help prevent, diagnose, and treat chemical dependence. Referral of patients to community resources, with appropriate support and patient counseling as well as patient and public education, are important components of this treatment. PMID- 3970482 TI - Medical education, hospitals, and health care on Taiwan. PMID- 3970483 TI - Pulmonary toxicity of amiodarone: apparent double reporting of four cases. PMID- 3970484 TI - Amiodarone and the liver. PMID- 3970485 TI - Amiodarone and the thyroid. PMID- 3970486 TI - Hemophilia and the acquired immunodeficiency syndrome. PMID- 3970487 TI - Hypoalbuminemia, diarrhea, and the acquired immunodeficiency syndrome. PMID- 3970488 TI - Molluscum contagiosum and the acquired immunodeficiency syndrome. PMID- 3970489 TI - The humanities in medical schools. PMID- 3970490 TI - The cost of gastrointestinal endoscopy. PMID- 3970491 TI - Immunoglobulin M antibody to hepatitis B core antigen and fulminant hepatitis B. PMID- 3970492 TI - Ranitidine and hepatotoxicity. PMID- 3970493 TI - Carcinoid tumor, atrophic gastritis, and iron deficiency anemia. PMID- 3970494 TI - Diet, exercise, and bone mineral content. PMID- 3970495 TI - Haloperidol and torsades de pointes. PMID- 3970496 TI - Procainamide, quinidine, and lupus erythematosus. PMID- 3970497 TI - Spurious hypochloremia and renal insufficiency. PMID- 3970498 TI - Acyclovir and disseminated varicella zoster and encephalitis. PMID- 3970499 TI - Meniere's disease: a long-term follow-up study of hearing loss. AB - Twenty patients suffering from Meniere's disease or Lermoyez syndrome were studied with respect to the time course of their hearing loss. Careful history taking as well as repeated audiometry over long time spans (5-20 years) resulted in a longitudinal study of hearing loss at the standard audiometric frequencies. From these time series, correlation coefficients were computed between the changes in both ears at identical frequencies, and for changes in the same ear at different frequencies. Correlations between changes in hearing loss in both ears were more obvious in bilateral Meniere's disease than in unilateral disease. Correlations between changes in hearing loss at different frequencies were also more pronounced in Meniere's disease ears than in normal ears. If was found that recovery of hearing loss after an attack was nearly identical each time it occurred in the same ear, but differed between ears and patients. This deterministic finding in the otherwise random course of the hearing loss as a function of time may be important in deciding what mechanisms cause fluctuating hearing loss in Meniere's disease. PMID- 3970500 TI - Endotracheal tube movement in the preterm neonate: oral versus nasal intubation. AB - Endotracheal intubation of a preterm infant cadaver was performed both orally and nasally to assess the relative movement of the endotracheal tube with changes in head position. For each method of intubation, anteroposterior radiographs were obtained with the head in neutral, flexed, extended, and laterally rotated positions. The results indicate slightly increased movement of the nasotracheal tube with flexion and rotation, and markedly increased movement with extension. The possible relationship between tube movement and the development of subglottic stenosis is discussed. PMID- 3970501 TI - Conscious sedation for procedures under local or topical anesthesia. AB - For many surgical procedures in otolaryngology general anesthesia is not required, but it is difficult to block completely all noxious sensations with local or topical anesthesia. Intravenously administered antianxiety and analgesic drugs can make the procedure more tolerable for the patient. A technique of conscious sedation based upon titrating diazepam to specific eye signs and fentanyl to specific end points is described. Safety is maintained by ensuring that the patient is always in verbal contact with the surgeon. The rationale for administering the sedative before the narcotic is presented along with the treatment of side effects and untoward responses to the drugs. PMID- 3970502 TI - The arcuate eminence. Topographic orientation in middle cranial fossa surgery. AB - The superior semicircular canal (SSC) is an important landmark in the middle cranial fossa approach to the temporal bone. This landmark is frequently located by its topographic association to the arcuate eminence. An anatomic study is reported which examines the relationship of the arcuate eminence to the SSC. Techniques for orientation to the internal auditory canal by the middle cranial fossa approach are reviewed and a technique for localizing the SSC when no arcuate eminence is discernible is presented. 1) In 15% of temporal bone specimens, no arcuate eminence was discernible. 2) Of those specimens with an arcuate eminence, 50% demonstrated that the arcuate eminence was rotated posteriorly from the SSC. 3) Despite displacement of the arcuate eminence, the SSC tended to remain perpendicular to the petrous ridge and 60 degrees from the internal auditory canal. 4) Because of their variable relationship, the arcuate eminence should not be used as a substitute for the SSC in the topographic orientation to the internal auditory canal. 5) A technique for locating the SSC when the arcuate eminence is indiscernible is presented. PMID- 3970503 TI - Vocal efficiency and aerodynamic aspects in voice disorders. AB - The variation of vocal efficiency for the mean values for normal subjects was investigated in patients with laryngeal disease. The relative contributions of mean flow rate and intrapulmonic pressure to the variation of efficiency were explored to explain aerodynamic aspects in voice disorders. Vocal efficiency was determined by use of expressions involving simultaneous values of sound pressure level, mean flow rate, and intrapulmonic pressure. The intrapulmonic pressure was noninvasively obtained by plethysmographic and pneumotachographic methods. Values of vocal efficiency were generally abnormally low for the types of larynges studied. An aerodynamic-biomechanical classification of laryngeal disease was inferred from the data: 1) large chink of glottis, associated with high flow rate; 2) mass on vocal fold, associated with high values of both flow rate and intrapulmonic pressure; and 3) high stiffness of vocal fold, associated with high values of intrapulmonic pressure. PMID- 3970504 TI - Malignant transformation in inverted papilloma. AB - The detection of markers associated with malignancy will help in the early identification of tumors and assessment of the success of treatment in patients suffering from carcinoma. Three characteristics investigated in this study were found to differentiate a premalignant inverted papilloma from a benign simple nasal polyp. PMID- 3970505 TI - Symptom improvement of spastic dysphonia in response to phonatory tasks. AB - It has been acknowledged that for many patients with spastic dysphonia, reflexive phonation remains essentially free of the spasticity that characterizes this disorder. The purpose of this paper is to document the extent to which various phonatory tasks change the patient's voice. We retrospectively reviewed 37 patients with spastic dysphonia evaluated at the Center for Communication Disorders of Lenox Hill Hospital, New York, between 1977 and 1981. The patients' responses to various phonatory tasks were observed. These tasks were grouped into the following ten categories: noncommunicative vocalization, primitive communication, speech superimposed on noncommunicative phonation, communicative phonation with varied mode of vocal fold vibration, normal communicative phonation with unusual pitch, normal communicative phonation with unusual emphasis, normal communicative phonation with normal laryngeal adjustments, use of the vocal folds in an artistic manner, speech in which normal auditory feedback was eliminated, and speaking with whisper which was not associated with vocal fold vibration. The results are summarized as follows: 1) whispered speech always resulted in an improvement of the symptom, in most cases markedly; 2) there was a tendency for a task that was more effective in reducing spasticity to be reduced in communicative function; 3) there was a tendency for a task that was more effective in reducing the spasticity to deviate more from the normal mode of phonation; and 4) there were some patients in whom an improvement occurred with elimination of auditory feedback. PMID- 3970506 TI - Effects of pressure on bone resorption in the middle ear of rats. AB - Laminaria, a hygroscopic seaweed, was used to induce pressure within the rat tympanic cavity. Resorption of the bulla and cochlear walls occurred in all animals within 2 weeks. Cochlear fistulas were observed in four of nine animals after 2 weeks and in nine of 11 animals after 3 weeks. Preswelled laminaria inserted in the same area induced minimal bone resorption after 2 and 3 weeks. In animals given indomethacin following insertion of laminaria, both granulation tissue formation and bone resorption were inhibited. Collagenase appeared localized in the inflammatory granulation tissue in the bone-resorption area, especially in fibroblasts, mononuclear cells, and osteoclasts. Results of this study suggested that pressure created by laminaria caused bone resorption by stimulating osteoclasts and granulation tissue. PMID- 3970507 TI - Age-related cochlear hair cell loss in the chinchilla. AB - The spiral organ of the chinchilla was studied by the surface-preparation technique in four different age groups: 1 month, 6 months, 1 year, and 4 years, to assess age-related hair cell loss. Decrease in hair cell population is linearly related to age, and damage rate of outer hair cells is greater than that of inner hair cells. The mean percentage of damaged total outer hair cells was 0.60%, 1.16%, 1.71%, and 7.07% in animals in 1 month, 6 months, 1 year, and 4 years of age, respectively. Outer hair cell loss was greatest in the apex of the cochlea and, of these cells, the outermost row was the most affected. Damage to inner hair cells also increases with age. Age-related apical cochlear cell loss in the chinchilla is comparable to that observed in other laboratory animals. PMID- 3970508 TI - Changing relationships between structure and function in the cochlea during recovery from intense sound exposure. AB - This study examines the relationship between the morphological and electrophysiological changes in the guinea pig cochlea at intervals following exposure to intense sound (5 kHz, 125 dB SPL, 30 minutes). The cochlear compound action potential (N1) audiogram (2-30 kHz) was determined within one hour or 1, 7, 14, or 28 days after exposure. When these organs of Corti were examined by scanning electron microscopy, most (92%) showed damage to hair cells and supporting cells around the 5-kHz region. The number of damaged hair cells increased significantly (p less than 0.01) in the first 24 hours following exposure, but there was no significant change thereafter. In contrast, the initial extensive loss of function (maximum at 8-12 kHz) recovered partially during the first 24 hours but also showed no significant further change. All morphological lesions occurred within regions corresponding tonotopically to the N1 threshold losses, but only the larger lesions, which were observed seven or more days after exposure, fully reflected the extent of the loss of N1 thresholds. This indicates that functionally important damage to the cochlea is usually more extensive than indicated by topographical abnormalities in the organ of Corti. PMID- 3970510 TI - Spontaneous cerebrospinal fluid otorrhea. PMID- 3970509 TI - Effect of high intensity impulse noise on the vascular system of the chinchilla cochlea. AB - Changes in the vasculature of the chinchilla cochlea were quantitatively assessed 45 days after impulse noise exposure of either 155- or 160-dB peak sound pressure level. The condition of the vessels in the lateral wall and spiral lamina of each cochlea was evaluated in terms of 20 morphological parameters. Multivariate statistical analysis identified the parameters that were significantly affected by the noise exposure. Evaluation of these significant parameters indicated a net reduction in blood flow to the cochlea. All of the noise-exposed cochleas showed vascular changes when compared to controls, and the magnitude of these changes was related to the amount of hair cell loss. The vascular changes are presumed to be permanent. PMID- 3970511 TI - [Neurologic evaluation of the newborn infant during the first week in the mother's room]. PMID- 3970512 TI - [Convalescence of the newborn infant at risk]. PMID- 3970513 TI - [Cerebral palsy at 1 year of age. Proposal for evaluating motor disorders]. PMID- 3970514 TI - Perception, action, and cognition in early infancy. PMID- 3970515 TI - [Neurologic evaluation of the low-risk newborn infant in the first hours of life]. PMID- 3970516 TI - Urinary lactate dehydrogenase isoenzyme analysis in adult population. AB - This investigation was a systemic study on an adult population of urinary lactate dehydrogenase (LDH) isoenzyme analysis for the distinction between upper and lower urinary tract infections. The study included 160 urine samples from patients and healthy individuals. On the basis of clinical symptoms, urinary bacterial colony counts, renal function tests and radiologic findings, the adults were divided into pyelonephritis group, cystitis group, pelvic lesion group, and control group. This technique correctly identified 23 of 26 patients with pyelonephritis by the presence of elevated LDH-V (over 10 percent) and all of 12 patients with cystitis by the presence of elevated LDH-I (over 60 relative units) but low LDH-V (below 10 percent or lower than LDH-I). In the pelvic group, the results of eight patients were consistent with cystitis and four with pyelonephritis. Our study confirms the sensitivity and specificity of the LDH isoenzyme technique for the differential diagnosis of urinary tract infection on adult patients and is consistent with previous studies on pediatric patients. However, one should be cautious to interpret the results of LDH isoenzymogram before extra-urinary tract lesions are excluded. PMID- 3970517 TI - Leukocyte counts in 7,739 healthy black persons: effects of age and sex. AB - White blood cell counts (WBC) were measured in 7,739 healthy black individuals, ages one through 84 years, to determine normal values for different age and sex groups. The mean WBC was highest in children one to two years of age, regardless of sex. The mean count decreased progressively in both males and females during preschool years, reaching a nadir in females six to 10 years of age and in males 11 to 15 years of age. Females in the age groups 11 to 15, 16 to 20, 21 to 30, and 31 to 40 years had consistently higher mean WBC than males in the same groups (p less than 0.001, p less than 0.001, p less than 0.001, and p = 0.01, respectively). These differences may be ultimately related to hormonal physiology during the reproductive years, since they were not present in the older age categories (41 to 50, 51 to 60, and over 60 years). In both males and females over 60 years of age, the mean WBC was lower than in the 21 to 50 years age group. The mean and percentile values for each age and sex group from this large, healthy, non-institutionalized population can be used as a reference for normal WBC in black subjects. PMID- 3970518 TI - Use of C-terminal parathyroid assays in a large metropolitan hospital. AB - The use of C-terminal parathyroid (C-PTH) assays, performed at a commercial laboratory, was evaluated for one year at Charity Hospital, New Orleans. Of 72 patients, the most frequent diagnosis was primary hyperparathyroidism (1 degree HPT) (n = 17, 24 percent), followed by malignancy (n = 15, 21 percent), chronic renal disease (n = 10, 14 percent), and thiazide diuretics (n = 5, 7 percent). In the 1 degree HPT group, all were hypercalcemic (mean serum calcium, 11.6 ml per dL) and had elevated C-PTH. Patients with malignancy had higher mean serum calcium levels than patients with 1 degree HPT. Three patients with malignancy had elevated C-PTH; two had suspected coexisting 1 degree HPT and neoplasm; and one had suspected pseudohyperparathyroidism. Patients with chronic renal disease undergoing dialysis treatment had the highest C-PTH recorded (all had elevated C PTH) but only 50 percent were hypocalcemic. Three of the five patients on thiazide diuretics had increased C-PTH, indicating that the withdrawal of this drug may unmask underlying hyperparathyroidism. Appropriate reasons for ordering C-PTH include evaluation of hypercalcemia (n = 32, 44 percent) or hypocalcemia (n = 12, 17 percent); indicated clinical reasons not included in the hyper- or hypocalcemic groups, including chronic renal disease in patients undergoing dialysis or transplant (n = 5, 7 percent); in suspected 1 degree HPT, (n = 5, 7 percent); and in patients with renal stones (n = 2, 3 percent) or on thiazide diuretics (n = 2, 3 percent). Based on laboratory and clinical criteria, C-PTH assay was appropriately used in 81 percent of the patients surveyed (58/72). PMID- 3970519 TI - Fast hemoglobins and red blood cell metabolites in citrate phosphate dextrose adenine stored blood. AB - Blood was drawn from 10 fasted, healthy volunteers and stored under standard blood bank conditions in citrate-phosphate-dextrose-adenine (CPDA-1). Blood was sampled before storage (Day 0) and on Days 5, 12, 19, 26, and 35. Laboratory testing for glucose, HbAla + b, HbAlc, pyruvic acid, lactic acid, adenosine triphosphate (ATP), 2, 3-diphosphoglycerate (2,3DPG), plasma free hemoglobin (Hb) and pH (blood gases) were performed. In addition, P50 was also serially measured in two of the individuals and in their stored blood. Significant elevations of HbAla + b and HbAlc (fast hemoglobins) were found on Days 12 and 19 of storage (p less than 0.05). These elevations of fast hemoglobins are due to hypoxia, acidosis, and hyperglycemia. Following the initial elevation of the fast hemoglobins (Hbs), there was a decline in their concentration, from Day 12, which could partly be explained by cell death. PMID- 3970520 TI - Acute non-lymphocytic leukemia in a lymph node concurrent with Hodgkin's lymphoma. AB - A case of a 40 year-old woman with Hodgkin's disease who developed acute non lymphocytic leukemia (ANLL) accompanied by several abnormal chromosomal findings is illustrated. A very unusual coincidental finding was the coexistence of Hodgkin's lymphoma and ANLL in the same lymph node. PMID- 3970521 TI - Heparin inhibition of ferredoxin-NADP reductase in chloroplast thylakoid membranes. AB - Heparin, an anionic polysaccharide, inhibited the ferredoxin-catalyzed reduction of NADP in spinach chloroplast thylakoid membranes. Under the same conditions of assay, heparin did not interfere markedly with photoreduction of methyl viologen, anthraquinone sulfonate, or ferredoxin. A kinetic analysis of the heparin-induced interference with NADP photoreduction showed partial competitive inhibition. Heparin also interfered with NADPH oxidation by membrane-bound ferredoxin-NADP reductase (with dichlorophenol-indophenol as the acceptor) by a mechanism that involves partial competitive inhibition. This reaction was sensitive to the presence of salts; increasing ionic strength increases the heparin Ki for inhibition of NADPH oxidation. These results show that heparin binds to ferredoxin-NADP reductase, and in doing so interferes with binding to the reductase by both ferredoxin and NADP(H). Since heparin is redox inactive and does not interfere with the photophosphorylation reaction, it is a useful inhibitor of thylakoid membrane reactions which require the catalytic activity of ferredoxin-NADP reductase. PMID- 3970522 TI - Mechanistic studies on carboxypeptidase A from goat pancreas: role of arginine residue at the active site. AB - Chemical modification of carboxypeptidase Ag1 from goat pancreas with phenylglyoxal or ninhydrin led to a loss of enzymatic activity. The inactivation by phenylglyoxal in 200 mM N-ethylmorpholine, 200 mM sodium chloride buffer, pH 8.0, or in 300 mM borate buffer, pH 8.0, followed pseudo-first-order kinetics at all concentrations of the modifier. The reaction order with respect to phenylglyoxal was 1.68 and 0.81 in 200 mM N-ethylmorpholine, 200 mM NaCl buffer and 300 mM borate buffer, pH 8.0, respectively, indicating modification of single arginine residue per mole of enzyme. The kinetic data were supported by amino acid analysis of modified enzyme, which also showed the modification of single arginine residue per mole of the enzyme. The modified enzyme had an absorption maximum at 250 nm, and quantification of the increase in absorbance showed modification of single arginine residue. Modification of arginine residue was protected by beta-phenylpropionic acid, thus suggesting involvement of an arginine residue at or near the active site of the enzyme. PMID- 3970523 TI - Metabolism of propionate to acetate in the cockroach Periplaneta americana. AB - Carbon-13 NMR and radiotracer studies were used to determine the precursor to methylmalonate and to study the metabolism of propionate in the cockroach Periplaneta americana. [3,4,5-13C3]Valine labeled carbons 3, 4, and 26 of 3 methylpentacosane, indicating that valine was metabolized via propionyl-CoA to methylmalonyl-CoA and served as the methyl branch unit precursor. Potassium [2 13C]propionate labeled the odd-numbered carbons of hydrocarbons and potassium [3 13C]propionate labeled the even-numbered carbons of hydrocarbons in this insect. This labeling pattern indicates that propionate is metabolized to acetate, with carbon-2 of propionate becoming the methyl carbon of acetate and carbon-3 of propionate becoming the carboxyl carbon of acetate. In vivo studies in which products were separated by HPLC showed that [2-14C]propionate was readily metabolized to acetate. The radioactivity from sodium [1-14C]propionate was not incorporated into succinate nor into any other tricarboxylic acid cycle intermediate, indicating that propionate was not metabolized via methylmalonate to succinate. Similarly, [1-14C]propionate did not label acetate. An experiment designed to determine the subcellular localization of the enzymes involved in converting propionate to acetate showed that they were located in the mitochondrial fraction. Data from both in vivo and in vitro studies as a function of time indicated that propionate was converted directly to acetate and did not first go through tricarboxylic acid cycle intermediates. These data demonstrate a novel pathway of propionate metabolism in insects. PMID- 3970524 TI - Biosynthesis of monoterpenes: demonstration of a geranyl pyrophosphate:(-)-bornyl pyrophosphate cyclase in soluble enzyme preparations from tansy (Tanacetum vulgare). AB - Tansy (Tanacetum vulgare L.) produces an essential oil containing the optically pure monoterpene ketone, (-)-camphor, as a major constituent. A soluble enzyme preparation from immature leaves of this plant converts the acyclic precursor [1 3H]geranyl pyrophosphate to the bicyclic monoterpene alcohol borneol in the presence of MgCl2, and oxidizes a portion of the borneol to camphor in the presence of a pyridine nucleotide. The identity of the major biosynthetic product as borneol was confirmed by chemical oxidation to camphor and crystallization of the derived oxime to constant specific radioactivity. The stereochemistry of the borneol was verified as the (-)-(1S,4S) isomer by oxidation to camphor, conversion to the corresponding ketal with D-(-)-2,3-butanediol, and separation of diastereoisomers by radio-gas-liquid chromatography. When enzyme reaction mixtures were treated with a mixture of acid phosphatase and apyrase, following an initial ether extraction of labeled borneol, additional quantities of borneol were generated, indicating the presence of a phosphorylated derivative of borneol. This water-soluble metabolite was prepared by large-scale enzyme incubations with [1-3H]geranyl pyrophosphate (plus phosphatase inhibitor), and the identity of the initial cyclization product was established as (-)-bornyl pyrophosphate by direct ion-exchange chromatographic analysis and enzymatic hydrolysis. The pathway for the formation of (-)-(1S,4S)-camphor was therefore identical to that previously demonstrated for the (+)-(1R,4R) isomer, involving cyclization of geranyl pyrophosphate to bornyl pyrophosphate, hydrolysis of this intermediate to borneol, and oxidation of the alcohol to the ketone. The labeling pattern of the product derived from [1-3H2, U-14C]geranyl pyrophosphate was determined by oxidation of the biosynthetic borneol to camphor and selective removal of tritium by exchange of the alpha hydrogens at C3 of the ketone. This labeling pattern was identical to that observed previously for the (+) isomer, suggesting the same mechanism of cyclization, but of opposite enantiospecificity. Some properties of the antipodal (+)- and (-)-bornyl pyrophosphate cyclases were compared. PMID- 3970525 TI - Characterization of the acidic lectins from winged bean seed (Psophocarpus tetragonolobus(L.)DC). AB - The seeds of winged bean, Psophocarpus tetragonolobus(L.)DC, contain two distinct groups of lectins characterized by different erythrocyte hemagglutinating specificities and isoelectric points. Three acidic lectins (I, II, and III) (pI approximately 5.5) were purified to apparent homogeneity by chromatography on Ultrogel AcA44 and SP-Sephadex C-25. These lectins are glycoproteins with relative molecular mass of 54,000. The total carbohydrate content of the acidic lectins was 7% and was comprised of mannose, N-acetylglucosamine, fucose, and xylose in amounts corresponding to 9.2, 4.8, 1.6, and 7.0 mol/54,000 g, respectively. Electrophoresis in dodecyl sulfate, in the presence and absence of 2-mercaptoethanol, gave a single subunit of apparent relative molecular mass 30 32,000, somewhat higher than expected from the native relative molecular mass. On isoelectric focusing in 8 M urea the subunits of the acidic lectins did not show any significant charge heterogeneity as found for the winged bean basic lectins. The acidic lectins have very similar amino acid compositions. They contain essentially no half-cystine, 1-2 methionine residues, and are rich in acidic and hydroxy amino acids. The amino-terminal sequences of lectins II and III were identical while the amino-terminal sequence of lectin I contained five differences in the first 25 residues; the acidic lectins showed extensive sequence homology with the winged bean basic lectins, the other one-chain subunit lectins and the beta subunit of the two-chain subunit legume lectins. The acidic lectins agglutinated trypsinized human (type A, B, AB, and O) erythrocytes but not trypsinized rabbit erythrocytes. They were inhibited by various D-galactose derivatives and D-galactose-containing disaccharides and trisaccharides. N Acetylgalactosamine was the best inhibitor, and the specificity appears to be directed to beta-D-galactosides. However, compared with winged bean basic lectins and soybean lectin, the winged bean acidic lectins show a low affinity for the inhibitory sugars. PMID- 3970526 TI - Guanidinoacetate methyltransferase activity in tissues and cultured cells. AB - Guanidinoacetate methyltransferase, the enzyme catalyzing the last step in creatine biosynthesis, has previously been considered to be restricted to a few tissues, but it has been found to occur in the cultured cells H4Az C2 rat hepatoma, N4TG1 mouse neuroblastoma, and IMR-90 human fetal lung fibroblast, as well as in skeletal and cardiac muscle of the rat. Activity was highest in the hepatoma, but tissues and cultured cells of nonhepatic origin had 5-20% of the activity of rat liver. Dialyzed 100,000g supernatants prepared from cultured cells or skeletal muscle tissue yielded values for apparent Km in the range of 1.2-3.4 microM for S-adenosylmethionine and 0.050-0.096 mM for guanidinoacetate. Intact monolayers of the three types of cultured cells converted labeled guanidinoacetate in the culture medium to creatine, which was identified by chromatographic behavior and by reaction with creatine kinase. The amounts of guanidinoacetate converted to creatine by fibroblasts and neuroblastoma cells during an 18-h period of incubation suggested that synthesis was proceeding at rates approaching Vmax, even in medium containing the relatively low physiological concentrations of guanidinoacetate. Fibroblast and neuroblastoma cell monolayers also have the capacity to take up creatine provided in the culture medium. The amounts of creatine taken up by monolayers of those cells were measured under the same conditions that were used for measurement of creatine synthesis. Comparison of the amounts of creatine synthesized with the amounts taken up showed that synthesis can make a significant contribution to intracellular pools of creatine plus phosphocreatine in fibroblasts and neuroblastoma cells. PMID- 3970527 TI - The demethylation of guaiacol by a new bacterial cytochrome P-450. AB - Spectroscopic studies were carried with a cytochrome P-450 in Moraxella sp., strain GU2, that could grow on guaiacol or 2-ethoxyphenol as the sole source of carbon and energy. The dissociation constant of the guaiacol-cytochrome complex was estimated to 0.15 microM, as determined in vivo or using the cell soluble extract. Cytochrome P-450 could also bind 2-ethoxyphenol, 2-propoxyphenol, and 2 butoxyphenol, and the dissociation constants have been determined in each case. Metyrapone depressed the degradation of guaiacol by whole bacteria, and was bound competitively to guaiacol with a constant of about 0.8 mM. Some catechol was excreted by the bacteria when growing on either guaiacol or 2-ethoxyphenol. Catechol and the other product of guaiacol demethylation, formaldehyde, were further oxidized by the bacteria. All the data available so far are consistent with cytochrome P-450 in Moraxella GU2 as a hydroxylase for the guaiacol side chain, behaving as a nonspecific O-dealkylase with broad specificity for guaiacol and homologous compounds with a longer carbon part in the side chain. PMID- 3970528 TI - Purification and properties of calmodulin from adrenal cortex. AB - Calmodulin (CaM), a multifunctional calcium binding protein with no known enzymatic activity, has been purified to homogeneity from bovine adrenal cortex. The purification included anion exchange on DE-52 cellulose, ammonium sulfate precipitation, and separation by molecular sieving on Sephadex G-150. The yield of CaM from 900 g of whole adrenal was 150 mg. Adrenocortical CaM showed a molecular weight of 18,000 on polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, an isoelectric point of 4.1, and demonstrated a characteristic shift in mobility on polyacrylamide gels in the presence of calcium. The spectral properties of adrenocortical CaM differed slightly from those of CaM isolated from bovine brain. Minor differences were observed in peptide maps and amino acid composition between adrenocortical and brain CaM, but adrenocortical CaM contained a single trimethyl-lysine residue characteristic of all mammalian forms of CaM isolated to date. Adrenocortical CaM is biologically active in the stimulation of activator-deficient phosphodiesterase, and showed a half-maximal effective concentration (EC50) of 3 nM for stimulation of adenylate cyclase from Bordetella pertussis. PMID- 3970529 TI - The synthesis and secretion of gastric mucus glycoprotein by mucosal cells cultured in the presence of ethanol. AB - The effect of ethanol on the synthesis and secretion of mucus glycoprotein in gastric mucosal cells was investigated. The mucosal cell suspensions were subjected to a short-term (4 h) culture in the presence of 0-1.5 M ethanol, with [3H]proline and [3H]palmitic acid as markers for glycoprotein synthesis and acylation. The synthesized labeled mucus glycoprotein was isolated from the incubation medium (extracellular glycoprotein) and from the mucosal cells (intracellular glycoprotein), and analyzed. Depending upon the ethanol concentration in the cell culture medium, two distinct effects on the synthesis and secretion of mucus glycoprotein were observed. The cells cultured in the presence of 0.02-0.1 M ethanol showed increased ability for the incorporation of [3H]proline and [3H]palmitic acid, and for the secretion of the newly assembled mucus glycoprotein. The synthesis of the glycoprotein increased 18-fold, acylation 5-fold, and secretion 10-fold. The synthesized glycoprotein, however, contained four to five times less of acyl-bound fatty acids. Ethanol at 0.1-1.5 M caused a marked reduction (62-64%) in the mucus glycoprotein synthesis, but the amount of glycoprotein released to the medium remained constant. This indicated that higher concentrations of ethanol caused the release of the preformed intracellular mucus glycoprotein reserves. The results demonstrate that gastric mucosal cells incubated in the presence of ethanol exhibit impaired synthesis and secretion of mucus glycoprotein, and that the severity of impairment depends upon the ethanol concentration. PMID- 3970530 TI - Comparative activity of rat liver dihydrofolate reductase with 7,8-dihydrofolate and other 7,8-dihydropteridines. AB - The various interactions of rat liver dihydrofolate reductase with two unconjugated 7,8-dihydropteridines, 7,8-dihydrobiopterin and 6-methyl-7,8 dihydropteridine, have been compared with those of 7,8-dihydrofolate and folate. Of particular interest was the reactivity demonstrated by 7,8-dihydrobiopterin because of the potential physiological significance of this reaction both in the regeneration of tetrahydrobiopterin, a cofactor for various biological hydroxylations, and as a step in the biosynthesis of this compound from GTP. Kinetic experiments gave Km values of 0.17, 6.42, and 10.2 microM for 7,8 dihydrofolate, 7,8-dihydrobiopterin, and 6-methyl-7,8-dihydropteridine, respectively, with Vmax = 6.22, 2.39, and 1.54 mumol min-1 mg-1. With folate the enzyme showed high affinity (Km = 0.88 microM) but low Vmax (0.20 mumol min-1 mg 1). The natural cofactor was NADPH and a Km of approximately 0.7 microM was measured with each substrate. The enzyme was activated by both p hydroxymercuribenzoate and urea when assayed with 7,8-dihydrofolate but was inhibited when 7,8-dihydrobiopterin was the substrate. The pH optimum for dihydrofolate reduction was 4 with enhancement at pH greater than or equal to 5.5 in the presence of 1 M NaCl. Peak activity with 7,8-dihydrobiopterin occurred at pH 4.8; this was shifted to pH 5.3 but was not enhanced by 1 M NaCl. Inhibition with methotrexate was similar whether the enzyme was assayed with either the conjugated or unconjugated 7,8-dihydro derivatives. The rat liver enzyme, highly unstable after purification, was stabilized in the presence of the nonionic detergent, Tween-20 (0.1%); however, the comparative properties toward the conjugated and unconjugated substrates were not altered by this treatment. PMID- 3970531 TI - Purification and properties of rat brain pyruvate kinase. AB - Rat brain pyruvate kinase was purified to near homogeneity by a three-step process involving ammonium sulfate precipitation and phosphocellulose and Blue Sepharose CL-6B column chromatography. The enzyme migrated on polyacrylamide gel along with a commercial sample of rabbit muscle pyruvate kinase. The enzyme showed a hyperbolic relationship with phosphoenolpyruvate and ADP, with apparent Km's of 0.18 and 0.42 X 10(-3) M, respectively. The enzyme was inhibited by ATP, the effect being more pronounced at unsaturating concentrations of phosphoenolpyruvate. L-Phenylalanine was found to be a strong inhibitor of the enzyme, with the Ki for inhibitor being 0.11 mM. The inhibition by phenylalanine was more pronounced at pH 7.4 than at pH 7.0, and appeared to be competitive with phosphoenolpyruvate. L-Alanine and fructose 1,6-bisphosphate prevented the inhibition of the enzyme by phenylalanine. Ca2+ was found to be a strong inhibitor of the enzyme, and the inhibition was more marked at saturating phosphoenolpyruvate concentrations. The kinetic properties of the purified brain pyruvate kinase suggest that the enzyme may be distinct from the muscle or liver enzymes. PMID- 3970532 TI - Phosphorus-31 nuclear magnetic resonance investigation of the in vivo regulation of intracellular pH in cell suspension cultures of Nicotiana tabacum: the effects of oxygen supply, nitrogen, and external pH change. AB - 31P NMR was used to study the in vivo response of intracellular phosphorus containing compounds of cell suspension cultures of Nicotiana tabacum to extracellular events. Limitation of the oxygen supply in a static system (sealed tube) caused a strong pH decrease of the cytoplasm and a smaller fall in the vacuolar pH. The rate of this process was independent of the age of the cells, except for those at the end of the growth cycle where either reserve supplies of inorganic phosphate have been depleted or metabolism has ceased. The cells can be returned quickly to their normal pH and metabolic status by reoxygenation after depletion times as long as 4.5 h. Regassing with N2 after anaerobiosis also caused the return of the nearly normal pH status, which indicates that rapid cell acidification is caused almost entirely by CO2 accumulation. In a second type of anaerobiosis, attained by continual passage of N2, cytoplasmic pH fell only slowly to a constant value higher than in the static case. Here acidification appeared to arise, at least in part, from lactate accumulation. Provided aeration occurred, the cytoplasm was maintained at a constant pH of 7.5 +/- 0.1 for changes in the medium pH value between 6.5 and 3. The biochemical and biotechnological implications of these results are discussed. PMID- 3970533 TI - Substrate-induced structural changes of the pyruvate dehydrogenase multienzyme complex. AB - The time course of the overall reaction catalyzed by the pyruvate dehydrogenase multienzyme complex produces an unexpectedly high lag (tau = 8 S) even in the presence of saturating concentrations of its substrates. The preincubation of the pyruvate dehydrogenase complex with one of the substrates alone decreases the duration of this lag, and all the substrates of the pyruvate dehydrogenase component (E1) and dihydrolipoyl transacetylase component (E2) together (pyruvate, thiamine pyrophosphate, and CoA) result in the complete disappearance of the lag. The reduction of the dihydrolipoyl dehydrogenase component (E3) of the pyruvate dehydrogenase complex with the substrates of the complex in the absence of NAD+ produces significantly different quenching in the FAD fluorescence, and then the reduction with the substrates of E3 as dihydrolipoic acid and dithioerythritol. (The formation of FADH2 was not observed in the system.) The higher fluorescence quenching in the presence of substrates of pyruvate dehydrogenase complex compared to the effect caused by the substrates of the E3 component (dihydrolipoic acid and DTE) indicates conformational changes additionally manifested in the fluorescence properties of the enzyme complex. The substrate-induced quenching of the enzyme-bound FAD fluorescence shows biphasic kinetics. The rate constant of the slow phase is comparable with the rate constant calculated from the time duration of the lag phase observed in the overall reaction. The kinetic analysis of both intensity and anisotropy decrease of the FAD fluorescence suggests a consecutive transmittance of an all substrate coordinated, induced conformational changes directed from the pyruvate dehydrogenase-via the lipoyl transacetylase--to the lipoyl dehydrogenase. Two simultaneous conformational effects caused by binding of the substrates can be distinguished; one of them results the fluorescence of the bound FAD to be more quenched, while the other makes the FAD more mobile. The first-order rate constants of both these conformational changes were determined. The present observations suggest that the pyruvate dehydrogenase complex exists in a partially inactive state in the absence of its substrates, and it becomes active due to conformational changes caused by the binding of its substrates. PMID- 3970534 TI - Modulation of rat liver hydroxymethylglutaryl-CoA reductase by protein phosphatases: purification of nonspecific hydroxymethylglutaryl-CoA reductase phosphatases. AB - Four phosphoprotein phosphatases, with the ability to act upon hydroxymethylglutaryl (HMG)-CoA reductase, phosphorylase, and glycogen synthase have been purified from rat liver cytosol through a process that involves DEAE cellulose, aminohexyl-Sepharose-4B, and Bio-Gel A 1.5 m chromatographies. Protein phosphatase II (Mr 180,000) was the major enzyme (68%) with a very broad substrate specificity, showing similar activity toward the three substrates. Phosphatases I1 (Mr 180,000) and I3 (Mr 250,000) accounted for only 12 and 15% of the total activity, respectively, and they were also able to dephosphorylate the three substrates. In contrast, phosphatase I2 (Mr 200,000) showed only phosphorylase phosphatase activity with insignificant dephosphorylating capacity toward HMG-CoA reductase and glycogen synthase. Upon ethanol treatment at room temperature, the Mr of all phosphatases changed; protein phosphatases I2, I3, and II were brought to an Mr of 35,000, while phosphatase I1 was reduced to an Mr of 69,000. Glycogen synthase phosphatase activity was decreased in all four phosphatases. There was also a decrease in phosphatase I1 activity toward HMG-CoA reductase and phosphorylase as substrates. The HMG-CoA reductase phosphatase and phosphorylase phosphatase activities of phosphatases I2, I3, and II were increased after ethanol treatment. Each protein phosphatase showed a different optimum pH, which changed depending on the substrate. The four phosphatases increased their activity in the presence of Mn2+ and Mg2+. In general, Mn2+ was a better activator than Mg2+, and phosphatase I1 showed a stronger dependency on these cations than any other phosphatase. Phosphorylase was a competitive substrate in the HMG-CoA reductase phosphatase and glycogen synthase phosphatase reactions of protein phosphatases I1, I3, and II. HMG-CoA reductase was also able to compete with phosphorylase and glycogen synthase for phosphatase activity. Glycogen synthase phosphatase activity presented less inhibition in the low-Mr forms. A comparison has been made with other protein phosphatases previously reported in the literature. PMID- 3970535 TI - pH-dependent conformational transformation in mung bean glyceraldehyde-3 phosphate dehydrogenase. AB - In thermal inactivation at pH 7.3 and below, the tetrameric apo-glyceraldehyde-3 phosphate dehydrogenase of mung beans lost half of its activity more rapidly than the rest, suggesting a pairwise arrangement of subunits (or a C2 symmetry). At pH 8.6, the activity was lost in a single exponential decay, characteristic of functional identity of sites as in a tetrahedral arrangement of subunits (or a D2 type symmetry). At intermittent pH values, the kinetics of thermal inactivation were consistent with the presence of a mixture of C2- and D2-symmetry conformations. In "sudden pH change" experiments, the observed thermal inactivation kinetics were characteristic of the final pH at which the enzyme was heated. Thus, the interconversion of the two conformations is facile and very fast. There is no gross change in molecular weight of the enzyme between pH 7.3 and 8.6. PMID- 3970536 TI - Pyruvate-dependent oxidative phosphorylation in erythroid and myeloid tumor mitochondria. AB - The pyruvate-supported oxidative phosphorylation activity was determined in mitochondria isolated from the fast-growing erythroid and myeloid tumors of hematopoietic origin. Normal bone marrow and liver mitochondria were used for comparison. In the absence of primers, both tumor mitochondria exhibited a pyruvate-dependent respiratory state 4/state 3 transition, which was totally inhibited by either alpha-cyanocinnamate or arsenite. The transition rate increased in a concentration-dependent manner from 5 to 100 microM pyruvate, where the maximum activity was reached. Increasing the concentration to 500 microM and beyond, however, resulted in decreasing state 3 respiratory jump with little or no jump demonstrable at concentrations above 5 mM. Moreover, the addition of high concentrations of pyruvate during the respiratory state 3 caused a blockage of that state which was reestablished by the addition of succinate or alpha-ketoglutarate. These results clearly show the capacity of erythroid and myeloid tumor mitochondria to actively utilize low concentrations of pyruvate to support their oxidative phosphorylation activity. The reason for the absence of activity found with the high concentration, however, is not readily apparent. PMID- 3970538 TI - The effect of pressure on fetal and neonatal liver mitochondrial membranes. AB - The effects of pressure on late fetal and neonatal rat liver mitochondria have been investigated. High hydrostatic pressure, as produced by isopycnic centrifugation in sucrose and glycogen gradients, altered the mitochondrial membranes of 1- and 7-day-old rats. Most of the mitochondrial enzymes, chosen for their known submitochondrial location, had a trimodal distribution in the sucrose gradients. In the glycogen gradients, a shift of the mitochondria to a lower density was noticed. Fetal liver mitochondria were resistant to the hydrostatic pressure exerted during isopycnic centrifugation experiments under different conditions such as sucrose and glycogen density gradients. The submitochondrial compartment tracer enzymes exhibited an unimodal distribution. Experimental temperatures set at 15 degrees C had a protective effect from hydrostatic pressure alterations in the neonatal liver mitochondria, whereas no effects were noticeable in the fetal mitochondria. Experiments in a hydraulic compression chamber showed that outer membranes of fetal mitochondria were more fragile and the inner membranes more resistant to compression than in the early stages after birth. PMID- 3970537 TI - Further characterization of the reassembly of creatine kinase and effect of substrate. AB - Upon exposure to 8 M urea, creatine kinase from rabbit muscle exhibited a rapid increase in intrinsic fluorescence and a rapid decrease in fluorescence polarization. Polarization changes were complete after 5 min, while fluorescence changes continued for at least 15 min. Fluorescence polarization changes accompanying reassembly were complex, and appeared to involve a concentration dependent reaction. Enzyme sampled at intervals during denaturation exhibited refolding kinetics displaying two first-order rate constants, the first dependent and the second independent of the duration of exposure to urea. There was evidence for an additional renaturation step, occurring within the mixing phase of the denatured protein with solvent. Reactivation kinetics and yield of reactivated enzyme exhibited a dependency upon length of exposure to denaturant. The exposure of renaturing creatine kinase to trypsin was shown to prevent further reactivation, and provided use of a method to determine reactivation rates at discrete intervals after initiation of reassembly. The presence of 2 mM MgADP during reactivation enhanced the rate of reactivation immediately after initiation of reactivation. Reactivation was not accelerated if nucleotide substrate was added after reactivation was initiated nor did nucleotide substrate increase the overall reactivation yield. The presence of MgADP also enhanced the rate of refolding at an early stage as judged by changes in intrinsic fluorescence and resistance to tryptic hydrolysis. While in addition to MgADP, creatine phosphate accelerated resistance by refolding creatine kinase to trypsin, according to the other criteria measured, the phosphagen substrates did not promote reactivation or renaturation. The unfolding-refolding studies and role of substrate in reassembly were consistent with a mechanism involving at least two steps, possibly involving cis-trans isomerization of proline. These data also supported the suggestion that the formation of the nucleotide binding region is an early event in the refolding of creatine kinase in vitro. PMID- 3970539 TI - The growth-supporting activity of a retinoidal benzoic acid derivative and 4,4 difluororetinoic acid. AB - Two synthetic retinoids were examined for their ability to support growth in male vitamin A-deficient rats. One of the compounds, (E)-4-[2-(5,6,7,8-tetrahydro 5,5,8,8-tetramethyl-2-naphthalenyl)-1 -propenyl]-benzoic acid (TTNPB), was found to be highly effective; it was 35-fold more active than all-trans-retinoic acid. Thus, the in vivo results were in agreement with the in vitro activity of this compound published by previous investigators, and support the view that this compound may be useful in determining the molecular mechanism of action of the retinoids. Another analog, 4,4-difluororetinoic acid, was only 12% as effective as retinoic acid. However, the possible instability of this compound and the electronegativity of the fluoro groups prohibited conclusions concerning the biological function of metabolic modification on the 4 position of retinoic acid. PMID- 3970540 TI - Conformational changes in plastocyanin. AB - The visible and near-uv absorption and circular dichroic spectra were determined for spinach and poplar plastocyanin under a variety of conditions. The visible spectra showed that the copper center was invariant to changes in species, chemical modification with ethylenediamine, and addition of high concentrations of salt [2.7 M (NH4)2SO4]. In contrast, the near-uv spectra were sensitive to these conditions. Reduction of plastocyanin also altered its near-uv absorption and circular dichroic spectra. It is unlikely that these spectral changes were due to charge transfer bands since the near-uv CD spectrum of apo-plastocyanin was almost identical to that of reduced plastocyanin. There were no corresponding changes in the far-uv spectra which monitor protein secondary structure. The most likely explanation is that the protein has a flexible tertiary conformation. Conformational changes may be important in regulating electron transport. If plastocyanin is a mobile electron carrier, differential binding of the oxidized and reduced forms of plastocyanin to its reaction partners cytochrome f and P700 could facilitate electron transport. PMID- 3970541 TI - Improved isolation and purification of rat liver peroxisomes by combined rate zonal and equilibrium density centrifugation. AB - Two different peroxisome preparations were isolated from male rat liver by using total homogenate (TH) as the starting material for one and the light mitochondrial (L) fraction for the other. The technique worked out is based on rate zonal (RZ) centrifugation in a sucrose gradient and subsequent isopycnic centrifugation in a Nycodenz gradient. The peroxisome fraction isolated from the L fraction consisted of 97-98% peroxisomal protein with catalase activity 49-fold enriched over TH. The peroxisome preparation isolated directly from TH represented about 55% of the total liver peroxisome population and had catalase activity 43-fold enriched compared with TH. The contribution of peroxisome protein to the liver protein was calculated to be in the range 1.82-2.02%. Peroxisomes isolated from TH were considerably more heterogeneous in size than peroxisomes isolated from the L fraction. Comparison of the polypeptide patterns of both preparations by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed some quantitative differences. Several major polypeptides were found to be exclusively located in the peroxisome membrane. These polypeptides migrated in the gel with apparent molecular masses of 69, 42.5, 36, 26, 21, and 15 kDa. PMID- 3970543 TI - Variation in hepatic microsomal cytochrome P-450 1 concentration among untreated rabbits alters the efficiency of estradiol hydroxylation. AB - The metabolism of 17 beta-estradiol was examined using both rabbit liver microsomes and highly purified forms of rabbit liver microsomal cytochrome P-450. The predominant microsomal metabolite of 17 beta-estradiol is the 2-hydroxylated product. 2-Hydroxyestradiol is also the principal metabolite in reconstitution experiments in which P-450 1 exhibits the greatest Vmax, ca. 6 mol min-1 mol P 450 1(-1), vs less than 0.6 mol min-1 mol P-450(-1) for forms 2, 3b-, 3b+, 3c, 4, and 6. In addition P-450 1 has the lowest Km, ca. 2 microM. This suggested that microsomes which differ in their content of P-450 1 would also differ in the kinetic parameters characterizing the 2-hydroxylation of 17 beta-estradiol. Microsomes containing low amounts of P-450 1, less than 0.1 nmol/mg protein, exhibit a low-efficiency (Vmax/Km) 2-hydroxylase activity. Microsomes containing elevated concentrations of P-450 1, greater than 0.3 nmol/mg protein, exhibit a substrate dependence suggestive of an additional high-efficiency enzyme. The latter is specifically inhibited by a monoclonal antibody that recognizes P-450 1. These results indicate that the elevated expression of P-450 1 in microsomes leads to a marked increase in the apparent first-order rate constant for the 2 hydroxylation of 17 beta-estradiol, as it does for the 21-hydroxylation of progesterone. This should have a marked effect on the metabolism of these two steroid hormones at concentrations that are likely to occur in vivo. PMID- 3970542 TI - Developmental changes in the activities of peroxisomal and mitochondrial beta oxidation in chicken liver. AB - The activities of peroxisomal and mitochondrial beta-oxidation and carnitine acyltransferases changed during the process of development from embryo to adult chicken, and the highest activities of peroxisomal beta-oxidation, palmitoyl-CoA oxidase, and carnitine acetyltransferase were found at the hatching stage of the embryo. The profiles of these alterations were in agreement with those of the contents of triglycerides and free fatty acids in the liver. The highest activities of mitochondrial beta-oxidation and palmitoyl-CoA dehydrogenase were observed at the earlier stages of the embryo; then the activities decreased gradually from embryo to adult chicken. The ratio of activities of carnitine acetyltransferase in peroxisomes and mitochondria (peroxisomes/mitochondria) increased from 0.54 to 0.82 during the development from embryo to adult chicken. The ratio of activities of carnitine palmitoyltransferase decreased from 0.82 to 0.25 during the development. The affinity of fatty acyl-CoA dehydrogenase toward the medium-chain acyl-CoAs (C6 and C8) was high in the embryo and decreased with development, whereas the substrate specificity of fatty acyl-CoA oxidase did not change. The substrate specificity of mitochondrial carnitine acyltransferases did not change with development. The affinity of peroxisomal carnitine acyltransferases toward the long-chain acyl-CoAs (C10 to C16) was high in the embryo, but low in adult chicken. PMID- 3970544 TI - Content and synthesis of glycolytic enzymes and creatine kinase in skeletal muscles and normal and dystrophic chickens. AB - A number of workers have reported that avian muscular dystrophy causes alterations in the levels of certain enzyme activities in "fast-twitch" muscle fibers but has little effect on enzyme activities in "slow-twitch" muscle fibers. In the present work, the effects of this disease on the content and relative rates of synthesis of a number of glycolytic enzymes and the skeletal muscle specific MM isoenzyme of creatine kinase in chicken muscles was investigated. It was shown that (i) the approximate 50% reductions in steady-state concentrations of three glycolytic enzymes (aldolase, enolase, and glyceraldehyde-3-P dehydrogenase) in dystrophic breast (fast-twitch) muscle result predominantly from decreases in relative rates of synthesis, rather than accelerations in relative rates of degradation, of these proteins in the diseased tissue; (ii) in contrast to the situation with the glycolytic enzymes, muscular dystrophy has only minor effects (25% or less) on the content and relative rate of synthesis of MM creatine kinase in breast muscle fibers; (iii) the muscular dystrophy associated alterations in content and synthesis of the glycolytic enzymes in breast muscle fibers become apparent only during postembryonic maturation of this tissue; and (iv) as expected, muscular dystrophy has no significant effect on the content or relative rates of synthesis of glycolytic enzymes in slow-twitch lateral adductor muscles of the chicken. These results are discussed in terms of the apparent similarities between the effects of muscular dystrophy and surgical denervation on the protein synthetic programs expressed by mature fast-twitch muscle fibers. PMID- 3970545 TI - Endogenous ADP ribosylation of high mobility group proteins 1 and 2 and histone H1 following DNA damage in intact cells. AB - Endogenous ADP ribosylation of nonhistone high-mobility group (HMG) proteins and histone H1 was studied in cultured mouse mammary tumor cells following treatment with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). MNNG treatment of cells caused a rapid and transient increase in ADP ribosylation of histone H1 and HMG 1 and 2, whereas (ADP-ribose)n on HMG 14 and 17 was not affected. 3-Aminobenzamide, an inhibitor of (ADP-ribose)n synthetase, prevented the increase in ADP ribosylation of histone H1 and HMG 1 and 2. This inhibitor enhanced the cell-killing effect of MNNG, but had no significant effect on the removal of methylated purines. The preferential increase in ADP ribosylation of HMG 1 and 2 and histone H1 may be necessary for cell recovery from DNA damage. PMID- 3970547 TI - [Epidemiological studies on pancreatic cancer]. AB - An epidemiological study on pancreatic cancer was performed, using for evaluation reports from the Ministry of Public Welfare and the National Pancreatic Cancer Registration Committee and cases experienced at the First Department of Surgery in Kobe University Hospital. The incidence of pancreatic cancer was found to have increased over the lost few decades. Aged subjects with family histories of malignant diseases and cases having past histories of chronic pancreatitis were affiliated with the high-risk group for this disease. Cigarette smoking and beverage consumption were also shown to be increased risk factors for pancreatic cancer. Poor results obtainable with the types of treatment presently available for pancreatic cancer indicated the clinical significance of applying screening methods for subjects in the high-risk group. PMID- 3970546 TI - Metabolic pathways as enzyme complexes: evidence for the synthesis of phenylpropanoids and flavonoids on membrane associated enzyme complexes. AB - In earlier studies [G. Hrazdina, G. J. Wagner, and H. W. Siegelman (1978) Phytochemistry 17, 53-56; G. J. Wagner and G. Hrazdina (1984) Plant Physiol. 74, 901-906], evidence was obtained suggesting that the endoplasmic reticulum was a site for phenylpropanoid and flavonoid metabolism in petal tissue, and that (a) multienzyme complex(es) might be involved in this metabolism. Now, the possible role of membrane-bound multienzyme complexes in phenylpropanoid and flavonoid metabolism in three tissues has been investigated by (1) correlating enzyme induction kinetics and rates, (2) examining the molecular weight of putative complexes, (3) channeling of substrates, (4) determining the susceptibility of bound activities to trypsin digestion, and (5) investigating the structurally linked latency of bound activities. Results suggest that at least a part--and possibly the entire pathway--from phenylalanine to flavonoids is membrane (endoplasmic reticulum) associated, and that this metabolism is facilitated by a multienzyme complex. Phenylalanine ammonia lyase, the first enzyme of the biosynthetic sequence, and a flavonoid glucosyltransferase, the last, appear to be located in the lumen of the membranes. Cinnamate 4-hydroxylase is membrane embedded, while other enzyme activities appear to be weakly associated with the cytoplasmic face of endoplasmic reticulum membranes. PMID- 3970548 TI - [Early diagnosis of pancreatic cancer by routine CT scanning; significance of the pancreatic bile duct scanning]. AB - Early recognition of dilated tail-side pancreatic duct and liver-side bile duct is one of the main diagnostic goals for an early diagnosis of pancreatic cancer. In order to attain these objectives, a new scanning method involving Target Volume Scan for the pancreas as a routine CT scanning modality has been devised. The picturing capability of this imaging method for the pancreatic bile duct and its role in the early diagnosis of pancreatic cancer are discussed. In phantom experiments, clinical experiments and clinical applications, the pancreatic duct within the pancreas body and the intra-hepatic bile duct, which were expanded into a cylindrical form of pure circular cross section with a diameter greater than 2 mm, have been pictured as continuous, linear, low-density regions. Similarly, the pancreatic duct within the pancreas head and the choledoch duct with diameters greater than 3 mm have also been pictured as low-density circular areas. In healthy pancreatic bile ducts, the tail section of the pancreas head and the intra-hepatic bile duct do not appear in scans, and although 70% of healthy choledoch ducts have been pictured, many deformed lumens have been observed in cross section. The conditions for obtaining successful images of lumens depended upon the degree of intra-lumen filling with either pancreatic juice or bile rather than the diameter of the lumen. Consequently, pancreatic cancer, which causes changes in the pancreatic duct and bile duct lumen, can be detected as a discontinuity in the image of the lumen obtained in the Target Volume Scan, regardless of the cancer, suggesting that the Target Volume Scan could be an important diagnostic imaging tool for the early detection of pancreatic cancer. PMID- 3970549 TI - [Surgical results and problems of pancreatic cancer]. AB - Twenty-nine surgically resected specimens of pancreatic head cancer were examined from a clinicopathological stand point. Serial sections 3 to 5 mm in thickness were cut from each specimen to demonstrate the precise histopathological extent of cancer. Tumor size histologically determined was then divided into several groups as follows: t1 (less than 2 cm in diameter), t2a (2.1-3.0 cm), t2b (3.1 4.0 cm), t3 (4.1-6.0 cm) and t4 (greater than 6.1 cm). The number of cases in each group was 3 in t1, 10 in t2a, 9 in t2b, 6 in t3 and 1 in t4. Tumor size was not always correlated with prognosis and it was necessary to consider other important influential factors, namely, invasion to the serosa of the pancreas (s factor), retroperitoneal infiltration beyond the pancreas (rp factor), and regional lymph node metastasis (n factor). All patients with a positive s factor died less than 2 years after surgery, while the survival rate of s factor negative patients was 41% at 2 years and 8% at 5 years. Survival rate of patients with positive n factor was 13% at 2 years and 6% at 5 years, and that of n factor negative patients was 71% at 2 years and 33% at 5 years. Survival rate of patients with positive rp factor was 21% at 2 years, while that of rp factor negative patients was 75% at 2 years and 50% at five years. Positive rp factor patients comprised 100% of t1, 80% of t2a, 89% of t2b and 83% of t3. This suggested that rp factor was the most important factor even in cases of t1. Furthermore, the frequency with which retroperitoneal surgical margins of specimens were infiltrated ranged from 64% of patients with extended retroperitoneal dissection by the translateral retroperitoneal approach, to 100% of those without such procedure. These results indicate that retroperitoneal radical dissection is basically necessary for pancreatic cancer and that a newer approach combined with some other modality also needs to be done. PMID- 3970550 TI - [Clinical studies on the reaction of the skin to various doses of Su polysaccharide in cancer patients]. AB - The reaction of skin to 10-micrograms and 20-micrograms quantities of Su polysaccharide (Su-Ps) were examined in 117 patients with cancer, and the results obtained were as follows. Reaction was a little greater to the 20-micrograms dose than to the 10-micrograms dose, but the two parameters were much correlated with each other. The rates of patients showing positive reactions to each dose were 30.8% for 10-micrograms and 34.2% for 20-micrograms. The reactions were augmented by administration of OK-432. The augmentation of skin reaction by OK-432 was more prominent at 20-micrograms doses than at 10-micrograms doses, therefore appearing to be Su-polysaccharide dose-dependent. The ideal Su-polysaccharide dose for Su Ps skin reaction thus seemed to be 20-micrograms. PMID- 3970551 TI - [Intra-arterial infusion chemotherapy using a subcutaneously implanted silicone reservoir--with special reference to the method]. AB - Sixty patients with advanced cancers were treated with intraarterial infusion chemotherapy using a subcutaneously implanted silicone reservoir. Forty-nine patients were catheterized from a branch of the left subclavian artery. The results were as follows. (1) In spite of some technical difficulties, catheterization from a branch of the left subclavian artery was minimally invasive, and catheter trouble using this route was less frequent than that occurring when the profound femoral arterial route was employed. (2) Implantation of the catheter end using a silicone reservoir liberated the patients from restrictions in their daily lives, and with this method, intraarterial infusion chemotherapy could be carried out easily when required without hospitalization. We conclude that this procedure is a beneficial method of intraarterial infusion chemotherapy for patients with advanced cancers. PMID- 3970552 TI - [Antitumor effects of recombinant human leukocyte interferon (rIFN-alpha A) on human malignomas transplanted into nude mice]. AB - The antitumor effects of recombinant human leukocyte interferon (rIFN-alpha A) on human malignant melanomas (SK-14 and AM-1) were studied using a nude mouse-human tumor xenograft system. Intratumoral administration of 6 X 10(5)U of rIFN-alpha A significantly inhibited proliferation of SK-14 and inhibited that of AM-1 moderately. This result indicated that the sensitivity of human melanoma to rIFN alpha A varied with the cell line. The effects of rIFN-alpha A were found to be dose-dependent, in that it was necessary for a relatively large dose of rIFN alpha A to be injected in order to produce an appreciable effect on human tumors. Antitumor activities achieved depended on the routes of administration used, intratumoral being more effective than intraperitoneal. The effects of rIFN-alpha A were about equal to those of human lymphoblastoid interferon (HLBI). PMID- 3970553 TI - [A study on the correlation between the concentration of antitumor agent and the clinical effect. An experience with THP-ADM]. AB - A new anthracycline antibiotic agent, THP-adriamycin (THP-ADM) was administered to patients with malignant head and neck tumors. Among them, intraarterially injected cases achieved excellent primary effects; 3 CR, 4 PR and 2 NC out of 9 cases. Patients received THP-ADM 10 mg/body every other day, to a total of 100 mg. In order to elucidate the factors responsible for this result, the concentration level of THP-ADM in plasma, blood cells and in tumor tissue was measured by high-performance liquid chromatography at various time intervals. Changes in concentration of THP-ADM were similar in both intraarterial and intravenous cases. Among these, the concentration levels in blood cells were always higher than in the plasma and were reduced rapidly with the passage of time; about hour 1 after administration, THP-ADM levels diminished considerably, especially in the plasma. On the other hand, in tumor tissue, the concentration level was exceedingly high at 1 hour after injection, and was still high-24 hours later. In intraarterial cases, these levels were about seventy times higher than in intravenous cases at 1 hour after injection. From these observations, the authors found a very good correlation between the tissue concentration level and the clinical effects obtained. PMID- 3970554 TI - [Phase II study of VP-16 (capsule) in malignant lymphomas. A cooperative study]. AB - A new semisynthetic podophyllotoxin derivative VP-16 has been evaluated in a phase II study on malignant lymphomas. The drug was administered orally by capsule at a dose of 100mg twice a day for 5 consecutive days at 3-4-week intervals to a total of 53 patients. Objective responses were noted in 9 patients (25%), 4 with CR and 5 with PR, out of 36 patients with non-Hodgkin's lymphoma, while none of 5 patients with Hodgkin's disease responded. Two of 5 patients with adult T-cell lymphoma attained a PR. Overall objective response rate was 24%. Dose-limiting toxicity was hematologic and alopecia was also observed. Gastrointestinal toxicity was moderate. These results demonstrated that VP-16 administered as an oral capsule is effective against malignant lymphomas and suggested a lack of clinical cross-resistance to standard chemotherapeutic agents. PMID- 3970555 TI - [Preoperative treatment with 5-fluorouracil (5-FU) in gastric and colorectal cancer]. AB - Preoperative chemotherapy with 5-FU was carried out on patients with gastric and colorectal cancer. 5-FU was given at a dose of 500 mg daily with a drip infusion for 7 days (Group A), with a one-shot intravenous infusion daily (Group B) and orally for 7 days (Group C). Histological effects were evaluated, using the criteria proposed by Ohboshi. In group A for gastric cancer and in group C for colon cancer, the histological response was stronger at the edge of the cancer than at its surface. In group C for gastric cancer and in group A for colon cancer, the histological response was more remarkable at the surface of the cancer than at its edge. The histological effects on metastatic lymph nodes in gastric cancer were the same as for the cancer nests in groups A and C. 5-FU used as a drip infusion or orally was more effective on metastatic lymph nodes of gastric cancer than on metastatic lymph nodes of colon cancer. 5-FU was detected at a high concentration in tumor tissues of gastric cancer in group A, Grade II response being obtained in 3 of 7 patients. Changes in regional lymph nodes, plasma and other organs in cases of combined resection were not obtained with regard to either the concentration of 5-FU or the histological findings for all three groups. PMID- 3970556 TI - [Chemosensitivity of human gastrointestinal and breast cancer xenografts in nude mice]. AB - Experimental chemotherapies for 15 human cancers xenografted into nude mice were performed using 14 anticancer agents including 6 drugs in clinical use. Treatment with each single agent was performed for every cancer line using the maximum tolerated dose through continuous daily (antimetabolites) or intermittent (cytocidal agents) schedules. Effectiveness of each drug was evaluated by inhibition rate (IR) calculated from mean tumor weights of both treated and untreated groups. Response to a treatment was judged as effective when the IR was higher than 58%. Response rate of each drug was as follows; MMC was 67%, UFT 67%, CPA 47%, FT-207 40%, ACNU 33%, ADR 27%, SOAz 87%, 5'-DFUR 80%, MXT 20%, Leakadine 17%, M-83 17%, CAM 0% and GANU 0%. Generally, the experimental results for each drug on the xenografts was in good accordance with the known clinical effect of each drug on the same type of cancer. On the other hand, individual cancer xenografts showed considerable differences in chemosensitivity. Some tumors were sensitive to a majority of the drugs, whereas some were resistant to many of them. Each cancer line seemed to retain individuality in its spectrum of chemosensitivity irrespective of whether it originated from the same organ or whether it was of similar histologic type. This fact suggests the necessity of selecting drugs effective to the individual tumor when considering a patients chemotherapy regime. PMID- 3970557 TI - [Effect of human recombinant beta-interferon on natural killer activity of peripheral lymphocytes in cancer patients]. AB - After human recombinant beta-interferon (ReIFN-beta) was administered to 13 cancer patients intrathoracoperitoneally and by intravenous drip infusion every day or 3 times a week, the effect of peripheral lymphocytes on natural killer (NK) activity was studied. When ReIFN-beta was given every day or 3 times a week, the NK activity was notably enforced, and was maintained throughout the period of administration. NK activity was also enforced regardless of whether ReIFN-beta was given intravenously on intrathoracoperitoneally. By the administration of ReIFN-beta, pleural effusion and ascites in three patients were depleted, and in one patient, Douglas' cul-de-sac tumor disappeared. It was therefore suggested that ReIFN-beta was effective against the cavity of carcinomatosis. PMID- 3970558 TI - [Effect of OK-432 on activated lysozyme in monocytes and neutrophils --comparison of intravenous and intramuscular administrations]. PMID- 3970559 TI - [Analysis of cell surface properties by flow-cytometry in malignant lymphoma]. PMID- 3970560 TI - [Spontaneous regression of BALB/c mouse tumor]. PMID- 3970561 TI - [Experimental animal information file: Millardia meltada]. PMID- 3970562 TI - Neonatal auditory brainstem response cannot reliably diagnose brainstem death. AB - In two newborn infants who had experienced severe asphyxial insults, and who showed noticeable signs of brainstem dysfunction, all components of the auditory brainstem response except the eighth nerve potential became undetectable. Both babies survived, their brainstem responses returned, and one of them is judged to be developmentally normal at the age of 18 months. Clinical signs of brainstem dysfunction with complete cessation of conduction in the brainstem auditory pathway cannot be taken, therefore, as a sign of irreversible brainstem damage in the human newborn. PMID- 3970563 TI - Thirty deaths from asthma. AB - The features associated with 30 childhood deaths from asthma in the period 1962 83 are reviewed. There was an annual death rate of 0.47/100 000 population at risk in the later part of this period in Avon county. Asthma deaths occurred in chronic severe sufferers at night and, although there was usually time for effective treatment, inadequate management probably contributed to the deaths, with deficiencies in corticosteroid treatment being a major feature. Twelve of the 30 patients who died had never attended hospital. A greater proportion of girls died than would have been predicted from the proportion attending hospital. The survey indicates a need for more effective education of laymen and doctors on asthma. PMID- 3970564 TI - Single dose pharmacokinetics of trimethoprim. AB - Single oral dose trimethoprim pharmacokinetics were determined in 18 children aged 3 months to 13 years. Trimethoprim suspension was rapidly absorbed and quickly and widely distributed. The mean clearance was considerably faster and the elimination half life considerably shorter than values reported in adults. Only one third of the administered drug dose was recovered from the urine within 24 hours which is considerably less than in adults, suggesting that children may metabolise a greater proportion of the dose given. Urine trimethoprim concentrations greatly in excess of minimum inhibitory concentrations for common pathogens were rapidly achieved and sustained for at least 16 hours. PMID- 3970565 TI - Choice of electroencephalographic investigation. PMID- 3970566 TI - Rectal aminophylline in the management of apnoea of prematurity. AB - Rectal suppositories as an alternative to intravenous aminophylline in the management of recurrent apnoea were studied in 41 preterm infants of mean gestation 28.3 weeks and mean birthweight 1176 g. Therapeutic blood concentrations were obtained two hours after a rectal loading dose of 10 mg/kg, with steady concentrations and maximum reduction in apnoeic episodes (from a mean of 0.5 per hour to 0.09 per hour) within 24 hours on a maintenance dose of 10 mg/kg/day. There was good correlation between the rectal dose and the plasma theophylline concentration. Several infants showed a significant reduction in Pco2 when treated with aminophylline. Side effects were related to the plasma theophylline concentration and were not seen at concentrations less than 14 mg/l. PMID- 3970567 TI - New insulating material in maintenance of body temperature. AB - Flectalon, web of aluminised polyvinylchloride fibres, has been formulated to minimise radiant heat losses and to provide conventional insulation. Critical temperature determinations were used to assess the insulating efficacy of this and other swaddling materials in infants. The critical temperature for a baby 2 to 10 days old was 31 degrees C when naked and 23 degrees C when wrapped in a Silver Swaddler or a sheet and two blankets. The use of a quilt made with Thinsulate or Hollofil with a mass per unit area of 160 to 180 g/m2 reduced the critical temperature to 19.5 degrees C, while Flectalon of comparable weight reduced the critical temperature to 13.8 degrees C: Flectalon is thus an efficient insulator. The risk of overheating was studied by monitoring swaddled babies, rectal temperatures at various ambient temperatures. Some forms of swaddling caused increases in rectal temperatures at "normal' hospital temperatures, implying risks from warmer environments and assessments of swaddling materials should, therefore, include medical evaluation of efficiency and safety. Flectalon merits assessment in other groups at risk from hypothermia. PMID- 3970568 TI - Micromethod for bleeding time in the newborn. AB - A new method of measuring bleeding time using an Autolet device is described. Normal ranges of bleeding time and volume of blood used in the test have been defined in a population including preterm babies. Abnormal values have been shown in newborns with a variety of problems, and an abnormality of bleeding time has been found to precede intraventricular haemorrhage. PMID- 3970569 TI - Cardiac arrhythmias misdiagnosed as epilepsy. AB - A mother and three children presenting with syncope induced by exercise and emotion were diagnosed as epileptic. They, and three symptom free children, showed frequent ventricular and supraventricular tachyarrhythmias on ambulatory electrocardiographic monitoring. Three died before the correct diagnosis of disordered sympathetic innervation of the heart was made, but episodes of syncope and cardiac arrhythmias in the survivors have been successfully treated by propranolol. PMID- 3970570 TI - Perinatal hepatitis B virus detection by hepatitis B virus-DNA analysis. AB - Maternal transmission of hepatitis B virus infection in relation to the hepatitis B e antigen/antibody system and serum hepatitis B virus-DNA were evaluated. Results indicate that hepatitis B virus-DNA analysis can identify hepatitis B serum antigen positive mothers who may transmit infection to their offspring. PMID- 3970571 TI - Laxative abuse and secretory diarrhoea. AB - Three children with chronic diarrhoea secondary to laxative abuse are reported. Growth disturbance, a previously unrecognised feature of this form of abuse, is recorded. PMID- 3970572 TI - Changing patterns of substitute care. PMID- 3970573 TI - Complications of diazoxide in the treatment of nesidioblastosis. AB - Two children with hypoglycaemia secondary to hyperinsulinaemia were treated with diazoxide. They suffered serious side effects of cardiac failure and truncal ataxia. PMID- 3970574 TI - Accidents in Malawi. AB - The frequency and types of children's accidents during a two month period in Malawi are described, showing that these are at least as numerous as in developed countries. It is suggested that preventive measures and an improvement in immediate treatment are required. PMID- 3970575 TI - Re-evaluation of saliva for monitoring theophylline concentrations. AB - Variability of the mixed saliva/plasma theophylline relation was examined in seven children aged 2 to 13 years. Good correlation between plasma and saliva concentrations was found, but on the three occasions there was considerable inter and intrapatient variability. There was no significant or consistent relation between unstimulated and stimulated saliva concentrations or between saliva concentrations and sample volumes. Plasma theophylline concentrations cannot be predicted accurately from saliva values. PMID- 3970576 TI - Cow's milk and anemia in preterm infants. AB - Introduction of pasteurised cows' milk to the diet of preterm infants before 36 weeks' postnatal age caused iron deficiency without anaemia. Cows' milk before 24 weeks was associated with iron deficiency and anaemia. The cause was either inadequate absorption or increased loss rather than reduced intake of iron. PMID- 3970577 TI - Management of gastro-oesophageal reflux. AB - Parental reassurance and thickened feeds are the only requirements in the management of infants with reflux when this is the sole detectable gastro oesophageal abnormality. In view of the strong propensity for spontaneous clinical resolution and the excellent results achieved by conservative management, infants with reflux due to a partial thoracic stomach (hiatal hernia) uncomplicated by a stricture should be treated in the first instance by postural therapy, with or without thickened feeds and supplements of antacids, domperidone, and cimetidine. Those showing no response after an adequate period of conservative treatment should have an antireflux operation. The Belsey MK IV type of fundoplication is preferred. Only an exceptional patient will require to be treated surgically before 12 months of age. The same surgical antireflux procedure, combined with oesophageal dilatations as necessary, is the treatment of choice for patients with a partial thoracic stomach complicated by a reflux oesophageal stricture. A similar treatment regimen should be followed for patients with reflux after repair of an oesophageal atresia. Surgical correction is mandatory for all infants with reflux due to a large combined hiatal hernia. PMID- 3970578 TI - Apnoea monitors and sudden infant death. Report from the Foundation for the Study of Infant Death and the British Paediatric Respiratory Group. PMID- 3970579 TI - Outcome for congenital hypothyroidism. PMID- 3970580 TI - Selective bronchial intubation for pulmonary emphysema. PMID- 3970581 TI - Transient hyperphosphatasaemia. PMID- 3970582 TI - Integration of child health services: an introduction. PMID- 3970584 TI - Mitogenic effects of sera from normal and psoriatic subjects on human skin fibroblasts. AB - Sera from normal and psoriatic subjects had similar mitogenic effects when added to monolayer cultures of human skin fibroblasts. Fibroblasts derived from a psoriasis patient proliferated faster in both types of sera than fibroblasts from a normal subject, despite similar rates of proliferation in foetal calf serum. The psoriatic fibroblasts appeared to be inherently capable of a greater response to human serum mitogens than the normal fibroblasts. PMID- 3970583 TI - Clinical and biological studies of 26 cases of xeroderma pigmentosum in northeast district of Japan. AB - Twenty-six patients with xeroderma pigmentosum (XP), who live in the Northeast (Tohoku) District of Japan, were examined for the clinical characteristics of UV induced DNA synthesis (unscheduled DNA synthesis, UDS) and UV sensitivity of skin fibroblasts or lymphoblastoid cells, or both. A history of consanguineous marriage within two generations was found in 19 of 26 cases (73%). Two pairs of siblings showed similar manifestations and almost the same levels of UDS and of UV sensitivity. Squamous cell carcinoma, basal cell carcinoma, or both were observed on the exposed skin in 14 patients, but no malignant melanoma was found. Cancer had developed in approximately 71% (10/14) of the cancer-bearing patients by the age of 20, and 8 of them belonged to the UDS-deficient group. Neurological manifestations were associated with nine patients, including 3 with typical de Sanctis-Cacchione syndrome (DSC), and most of the cells derived from these patients had a UDS level less than 10% of that of the normal cells. A clear correlation between the levels of UDS and UV sensitivity, on the one hand, and the severity of clinical manifestations on the other could not be detected, but it seems that the UDS-deficient group is generally much more sensitive to UV in terms of cell killing and the induction of sister chromatid exchange (SCE) than the UDS-proficient group. After a photosensitivity test, one patient with mild skin manifestations showed distinct skin tanning without preceding erythema. PMID- 3970585 TI - The sensitizing capacity of Compositae plants. VI. Guinea pig sensitization experiments with ornamental plants and weeds using different methods. AB - Experimental studies in guinea pigs using ether extracts of 20 different species of the Compositae plant family were carried out with the open epicutaneous method (OET) and the guinea pig maximization test (GPMT). The results demonstrate that Cnicus benedictus (blessed thistle), Chrysanthemum leucanthemum (marguerite, ox eye daisy) and Helianthus debilis (dwarf sunflower) are strong sensitizers while Helenium amarum (bitterweed), Gaillardia amblyodon (blanket flower), Artemisia ludoviciana (prairie sage), Ambrosia trifida (giant ragweed) and Solidago virgaurea (goldenrod) are medium sensitizers. Twelfe species revealed only a weak or no sensitizing capacity; among those were corn flower, wormwood, mugwort, coltsfoot and dandelion. Cross-reactivities were observed in a considerable number of the investigated plant species. The sensitizing power as well as the observed cross-reactions depend on the occurrence of sesquiterpene lactones which have an alpha-methylene group exocyclic to the lactone in common ("immunologic requisite"). As a practical consequence, patients suffering from allergic contact dermatitis due to Compositae species are strictly requested to avoid contact with the offending species and all related species to prevent recurrences of their skin lesions. PMID- 3970586 TI - Electron microscopic study on Langerhans cells and related cells in lymph nodes of DNCB-sensitive mice. AB - To understand contact hypersensitivity, it is important to know the kinetics of Langerhans cells (LC) and related cells in the lymph node (LN), as well as in the skin. For this purpose, we tried experimentally to induce increased numbers of LCs, Birbeck granule-like structure (BgS)-containing cells, and interdigitating reticulum cells (IDC) in DNCB-sensitive mice and studied them by means of electron microscopy with the following results: (1) cytologically, LC, BgS containing cells and IDC were closely related; (2) BgS seemed to arise from rough surfaced endoplasmic reticulum (r-ER), and BgS-containing cells were midway in nature between LC and IDC from the morphological view point. From these findings, it appears that IDC, BgS-containing cells, and LCs were simultaneously involved in the contact hypersensitivity reactions of LNs. PMID- 3970587 TI - Synthesis of glycosaminoglycans and collagen in skin fibroblasts cultured from a patient with lichen myxedematosus. AB - A patient is described with typical skin lesions of lichen myxedematosus and IgG type lambda paraproteinemia. Fibroblasts cultured from the skin of the patient and from the skin of control persons were used to study glycosaminoglycan and collagen synthesis; the cultures were labelled with 3H-glucosamine and 3H proline, respectively. Fibroblasts from the patient grew to a cell density which was lower than that of the control fibroblasts. The production of glycosaminoglycans was increased in lichen myxedematosus cultures, so that the ratio of hyaluronic acid to sulphated glucosaminoglycans was higher in the patient's cultures than in control cultures. Collagen production in the patient's cultures was about half of that in control cultures, whereas the ratio of type III to type I collagen was normal. PMID- 3970588 TI - Effects of histamine on collagen synthesis by cultured fibroblasts derived from guinea pig skin. AB - Fibroblast-like cells derived from guinea-pig skin were cultured for 3 h in the presence of various concentrations of histamine. The total protein synthesized was determined by the incorporation of radioactive proline, and the collagenous protein synthesized was measured by the incorporation of labeled hydroxyproline in the cell layer and medium. Synthesis of both total and collagenous protein increased in the presence of histamine in the concentration range of 10(1)-10(3) micrograms/ml. The ratio of collagen to total protein synthesized also increased at these concentrations. However, in no case was an increase found when H1 antagonist (chlorpheniramine) and H2 antagonist (cimetidine) were added with the histamine. DNA synthesis was not affected by histamine at the concentrations used. These results suggest that histamine increases the synthesis of collagen by fibroblast-like cells through H1 and H2-receptors. PMID- 3970589 TI - The genetic basis of porphyria cutanea tarda. AB - In order to confirm the genetic character of porphyria cutanea tarda (PCT), the quantitative and qualitative porphyrin excretion from 56 unrelated PCT patients and 259 relatives was analyzed by a sensitive fluorimetric thin-layer chromatographic technique. Porphyrin excretion abnormalities were observed in 111 (35.24%) of the 315 subjects studied. Of the 259 relatives, 55 (21.24%) suffered from manifest (24 cases) or subclinical (31 cases) PCT. The relatives from the older generation or a generation similar to the propositi were more frequently affected than those from a younger generation. A clear family incidence was observed in 32 families, while PCT was apparently limited to the propositi in the remaining 24. It is discussed whether these latter families correspond to the so called "sporadic" type of PCT or include porphyric gene carriers lacking biochemical expression of the disease. While the measurements of the activity of the defective enzyme (uroporphyrinogen decarboxylase) for the genetic research of PCT turned out to be impracticable in hepatic tissue and contradictory in erythrocytes, our study confirms that the familial character of this disease may be revealed by the chromatographic analysis of the porphyrin excretion pattern. PMID- 3970590 TI - Measurement of rheumatoid factors by an enzyme-linked immunosorbent assay (ELISA) and comparison with other methods. AB - IgM rheumatoid factor (RF) was measured in the sera of 48 rheumatoid patients and of 48 age and sex-matched normal controls by the Rose-Waaler and latex agglutination tests, a rate nephelometer, and an enzyme-linked immunosorbent assay (ELISA). Good correlation was obtained between all assays. The rate nephelometer assay was the easiest and quickest to perform and gave results in international units/ml. The Rose-Waaler was the least sensitive assay and the most difficult to perform and interpret. Both the latex agglutination and the ELISA were sensitive, though some overlap of patient and control sera was seen with all the assays. In addition to IgM RF the ELISA was used to measure IgG RF and IgA RF in both rheumatoid and control sera. Although some normal sera had detectable amounts of IgG and IgA RF, the levels of both were significantly raised in the rheumatoid sera. IgG RF levels were lower after pepsin digestion of the sera, suggesting that IgM RF interfered with the assay for IgG RF unless this treatment was included. PMID- 3970591 TI - Use of simple analgesics in rheumatoid arthritis. AB - The usefulness of anti-inflammatory drugs in rheumatoid arthritis (RA) is beyond dispute. The role of simple analgesics is less clear and has been disputed. A survey of 21 rheumatologists indicated that a majority sometimes supplemented anti-inflammatory treatment of RA with simple analgesics. A random sample of 120 RA patients treated by the same doctors revealed that 47% ranked pain relief as the most desirable objective of their treatment and 54% were taking analgesics regularly. Of those receiving analgesics as well as non-steroidal anti inflammatory drugs 48% considered the former to be the more effective preparations. Almost half the patients on analgesics were taking drugs without the knowledge of the rheumatologists, who may have underestimated their patients' desire for pain relief. PMID- 3970592 TI - Refractory massive pleural effusion in systemic lupus erythematosus treated with talc poudrage. AB - The case of a 31-year-old black male is presented with recurrent pleural effusion secondary to active SLE. Treatment with corticosteroids, azathioprine, plaquenil, and tetracycline pleural sclerosis was unsuccessful. Disease control was finally achieved by pleural talc poudrage. PMID- 3970593 TI - Osteonecrosis at multiple sites in a patient with systemic lupus erythematosus. AB - Osteonecrosis of multiple joints is described in a patient with systemic lupus erythematosus. PMID- 3970594 TI - Acute systemic lupus erythematosus with fatal pneumonitis and disseminated intravascular coagulation. AB - We reported the case of a 40-year-old female with acute onset of systemic lupus erythematosus, followed rapidly by the development of fatal pneumonitis and disseminated intravascular coagulation. The likely relationship between these events and the therapeutic options are discussed. PMID- 3970595 TI - Salivary scanning in rheumatoid arthritis. PMID- 3970596 TI - Spontaneous enterogastric reflux gastritis and esophagitis. AB - Enterogastric reflux gastritis and esophagitis is best known after gastric resections and pyloroplasty but it also occurs spontaneously in the nonoperated patient. Forty-two patients are presented who meet the criteria for the diagnosis: constant burning epigastric pain, worse after meals, unrelieved by antacids and diet; endoscopic demonstration of a gastric bile pool; endoscopic biopsy proof of gastritis and esophagitis; and hypochlorhydria. Patients with mild and moderate stages of the disease can benefit from metoclopramide therapy which improves the gastric emptying mechanism. Of the surgical patients with intractable symptoms, 90% were women, 90% had marked hypochlorhydria, 83% had biliary disease, current or remote, and 50% had anemia. With vagotomy, antrectomy, and Roux-Y anastomosis 45-60 cm downstream, the clinical response has been most encouraging. PMID- 3970597 TI - The prognosis of gastric outlet obstruction. AB - A retrospective study was undertaken to examine the prognosis of gastric outlet obstruction with specific reference to patients with obstruction due to peptic ulcer. During the 10-year period 1970-1979, 68 patients with gastric outlet obstruction were admitted to our hospital. Obstruction was caused by peptic ulceration in 55 of these patients, all of whom initially were managed conservatively. Thirty-four, however, required surgical decompression during their first admission for obstruction, and 11 needed surgery for a subsequent episode of obstruction. Of the ten patients who have not undergone surgery, six died within 3 years of their first episode of obstruction and three of the four survivors continue to have recurrent obstructive symptoms. Overall, 92% (45/49) of patients who have lived for more than 3 years after their presentation with gastric outlet obstruction due to peptic ulcer have required surgery for relief of obstruction. PMID- 3970599 TI - Alcohol-related trauma. The surgeon's responsibility. AB - Four thousand fifty-six consecutive emergency room trauma visits in a small community hospital were evaluated to determine the extent of coexisting alcohol usage. The magnitude of the alcohol problem is documented in this series by the fact that more than 40% of the patients requiring admission had elevated blood alcohol tests. Eight of nine traumatic fatalities were alcohol-related. The need for early recognition of problem drinkers is emphasized by the fact that 85% of known alcoholics are not receiving formal treatment. Reasons for failure to recognize the problem are discussed. The responsibility of the surgeon aggressively to pursue early identification is stressed. PMID- 3970598 TI - Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity. AB - To evaluate the long-term frequency and severity of anemia and selected vitamin and mineral deficiencies after gastric exclusion surgery for morbid obesity, the authors prospectively examined hematologic and nutritional parameters in 150 consecutive patients. These patients underwent a standardized gastric exclusion procedure during a six-year period (1976-1982) and were closely followed for up to seven years (mean, 33.2 months). Anemia developed in 36.8% of the population at a mean time from operation of 20 months. It was more frequent in women than in men (p less than 0.01), and it required transfusions in 3.5% of the population. A low serum iron concentration developed in 48.6%, iron deficiency in 47.2%, a low serum vitamin B12 concentration in 70.1%, vitamin B12 deficiency in 39.6%, and RBC folate deficiency in 18% of the population. Both iron and folate deficiencies responded to oral replacement. As a result of the high frequency and severity of anemia and nutritional deficiencies noted, all gastric exclusion patients should, as a minimum, be placed on oral multivitamin preparations containing iron, folate and vitamin B12. In addition, it is imperative that these patients be followed closely for the remainder of their lives with appropriate studies and replacement as necessary. PMID- 3970600 TI - Blunt intestinal trauma. A modern-day review. AB - During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accidents and therefore commonly had multisystem injuries. Sixty of these patients suffered 83 major injuries in the form of perforation or mesenteric injury resulting in ischemic bowel. This group accounted for 6.9% of the 870 patients who had celiotomy for blunt trauma during this period. Several significant observations were made. All injuries, except one, were diagnosed by peritoneal lavage. Only two duodenal injuries were present. Perforations involving the jejunum and ileum were distributed throughout the entire length of the small bowel. Colon injuries comprised one-fourth of the major injuries, with most occurring in the ascending and sigmoid colon. There were 16 deaths, 6 of which occurred as a result of complications from the bowel injury. PMID- 3970602 TI - Hepatic resection of colorectal metastases. Influence of clinical factors and adjuvant intraperitoneal 5-fluorouracil via Tenckhoff catheter on survival. AB - This report analyzes an experience with 33 hepatic resections for metastatic colorectal cancer over a 7-year period and with intraperitoneal 5-FU administered as a postresection adjuvant in 21 of these patients. Particular emphasis is placed on the identification of clinical determinants of postresection survival. There was no operative mortality in this series. Postoperative complications occurred in 27% of patients, and the incidence of complications correlated with intraoperative blood loss (p = 0.002). Two- and 4-year estimated survivals were 72% and 53%, respectively. Patients with three or fewer metastases resected or with unilobar disease had improved survival when compared with patients having more than three metastases or bilobar disease, respectively (p less than 0.05). Disease-free survival was improved in patients with microscopically negative resection margins (p = 0.019). Dukes' stage of the primary lesion, interval between bowel resection and detection of hepatic metastases, method of detection of metastases, preoperative CEA level, and type of operation performed were not predictive of postresection survival. Intraperitoneal 5-FU was well tolerated. There was a trend toward improved survival in patients receiving adjuvant chemotherapy, but this was not statistically significant. It is concluded that the number of metastases resected, the distribution of the metastases, and the technical adequacy of the excision are all predictive of outcome following hepatic resection of colorectal metastases. Encouraging results with the use of intraperitoneal 5-FU as a postresection adjuvant have led to the initiation of a prospective randomized trial investigating this modality at the NCI. PMID- 3970601 TI - Major hepatic resection for metachronous metastases from colon cancer. AB - Hepatic resection of metastatic colorectal cancer is being performed with increasing frequency. Reports describe wide variations in survival after resection of solitary of multiple metastases. In 23 consecutive patients having major hepatic resection for metachronous metastases from colorectal cancers, 18 patients had one, two, or three metastases and five had four or more individual metastases; the cure rate of one, two, or three metachronous metastases was comparable to reports of resected solitary simultaneous metastases. The median maximum diameter of metastases in patients both surviving and dead was 7 cm. Features separating surviving from dead patients were resection margins of at least 1 cm and fewer than four metastatic nodules. All patients with four or more hepatic metastases died of disease, 80% with further liver metastases. Only three of 18 (17%) patients with one, two, or three metastases developed further hepatic lesions. This study suggests that the biology of the hepatic metastatic disease is paramount; timing of the hepatic resection is of little importance. Delayed resection of suitable biologic situations does not impair survival opportunities, and early resection of inappropriate biologic situations with more than three hepatic metastases does not improve survival. Therefore, programs of early detection with the use of carcinoembryonic antigen (CEA) screening or "second look" operations will not increase cure rates. PMID- 3970603 TI - Late results after surgical treatment of renovascular hypertension. A follow-up study of 122 patients 2-18 years after surgery. AB - During the period 1963-1980, 122 patients were operated on for renovascular hypertension at surgical department D, vascular section, Rigshospitalet, Copenhagen. Seventeen patients, with a median age of 24 years, had fibromuscular hyperplasia and 95 patients, with a median age of 48 years, had atherosclerosis. Twenty-four of the latter had bilateral renal artery lesions and 71 had unilateral disease. Ten patients had various other causes of renovascular hypertension. Operative mortality was 4.9%, decreasing to two per cent in the last 8 years. At discharge, 71% of the patients were normotensive without medication, 18% were improved, and 11% were unimproved. At follow-up in 1982, the actuarial 10-year survival rates for patients with unilateral and bilateral atherosclerotic disease were 65% and 48%, respectively. There was no difference between survival rates for patients with fibromuscular hyperplasia and an age- and sex-matched, population. Sixty-nine patients were reexamined with a median follow-up of 9 years. Of the survivors with atherosclerosis, 87% benefitted from the operation: 50% were normotensive without medication and 37% were improved. Of patients with fibromuscular hyperplasia, 93% benefitted from operation: 79% were normotensive and 14% were improved. The results support the value of surgery in patients with renal fibromuscular hyperplasia and to the long-term benefits of surgical treatment of patients with atherosclerotic renovascular disease. PMID- 3970604 TI - Criteria for selection of future physicians. AB - Academic achievement correlates poorly with clinical performance of physicians, so it is probably more important to select college students for medical school admission who will be superior physicians than to select those who will be excellent medical students. Before such selection criteria can be developed, a valid description of a superior physician must be determined. The relative importance of 87 characteristics of a superior physician, based on a previously published list, was determined by asking medical school faculty members to rate them. The resulting description of a superior physician is valid, because it correlated very highly (r = 0.87, p less than 0.001) with the published ratings of the same characteristics from decades earlier in another part of the country, and because it was constant across many subgroups. The faculty was also asked to rate how easily each characteristic could be taught, and those ratings were validated by high correlations across several subgroups. The importance and the teachability ratings were combined into a nonteachable-important index (NTII) that provides a rank order of traits that are important but cannot be taught easily. These are the characteristics that should be used in selecting future physicians. PMID- 3970605 TI - Criteria of humanity. Defining the indefinable. PMID- 3970606 TI - Is routine postoperative nasogastric decompression really necessary? AB - Controversy exists regarding the need for nasogastric tube decompression and the incidence of complications resulting from its use following major intra-abdominal surgery. To determine the value of such tubes, 100 patients were managed after surgery with a nasogastric tube in situ until the passage of flatus per rectum (Group I). In a second group of 100 patients, no nasogastric tube was placed after surgery unless vomiting, gross distention, or overt obstruction occurred (Group II). In Group I, the nasogastric tube remained in place an average of 6 days and five patients required replacement of the tube after its initial removal. In Group II, nasogastric intubation was required at some point after surgery in six patients. No aspiration pneumonia, nasal septum necrosis, anastomotic leak, or wound dehiscence was seen in either group. There were three wound infections in Group I and two in Group II. The most obvious difference was the increased comfort and mobility of the group of patients treated without routine nasogastric decompression (Group II). Routine use of the nasogastric tube adjunct to patient care following gastrointestinal tract surgery may be safely eliminated. PMID- 3970607 TI - Intraoperative myocardial protection: a comparison of blood and asanguineous cardioplegia. AB - Cardiac arrest was achieved in 84 patients using asanguineous cardioplegia and in 97 patients using cold blood potassium cardioplegia. The patient groups were similar in age, sex ratio, and preoperative risk factors. Other than the cardioplegic solution used, the conduct of each operation was identical. There were no differences in mean total pump time (118 minutes for the asanguineous cardioplegia group versus 117 minutes for the cold blood cardioplegia group) or cross-clamp time (73.5 versus 70 minutes, respectively). However, the blood cardioplegia group had a greater number of distal anastomoses per patient (3.9 versus 3.7; p less than 0.05). Myocardial protection was assessed clinically and by serial electrocardiograms. Cellular integrity was determined by release of the myocardial isoenzyme of serum creatine kinase (CK-MB). Cellular morphology was studied in 6 randomly selected patients in each group by electron microscopic examination of left ventricular myocardial samples obtained before and after bypass. Three patients given blood cardioplegia and 5 given asanguineous cardioplegia required intraaortic balloon counterpulsation at termination of bypass. There were no ultrastructural changes in either group. Electrocardiographic changes (Minnesota code) occurred in 12 of 84 patients receiving asanguineous cardioplegia versus 12 of 97 patients receiving cold blood potassium cardioplegia. To maintain a satisfactory cardiac index (greater than 2.0 L/min/m2), 38 of 84 patients given asanguineous cardioplegia versus 25 of 97 patients given blood cardioplegia required inotropic support up to 24 hours postoperatively (p less than 0.05). Infarct size determined from CK-MB release was significantly greater (p less than 0.05) in patients given asanguineous cardioplegia (36.27 gm-equivalents) than in those given blood cardioplegia (26.7 gm-equivalents).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970608 TI - Comparison of blood cardioplegia to electrolyte cardioplegia on the effectiveness of preservation of right atrial myocardium: mitochondrial morphometric study. AB - The right atrium differs from the left ventricle in two respects during cardioplegic arrest: a higher proportion of noncoronary collateral flow is delivered to the right atrium, and the atrium is frequently excluded from topical ice cooling because of its higher position relative to the left ventricle. These factors result in early rewarming of atrial myocardium. To the best of our knowledge, the surgical literature contains no reports on whether blood cardioplegia can provide better atrial myocardial preservation than electrolyte cardioplegia. Twenty consecutive patients who underwent cardiac operations were randomly selected to receive blood cardioplegia (Group 1) or electrolyte cardioplegia (Group 2). Hypothermia was achieved by systemic cooling and continuous topical cooling with ice slush. Stereological morphometric study of mitochondria was performed on 40 biopsy specimens taken from the right atrium prior to aortic cross-clamping (preischemia) and at the end of ischemia. In Group 1, total aortic cross-clamp time was 72.8 +/- 32.5 minutes. The mean mitochondrial surface area before ischemia was 0.224 +/- 0.032 mu 2 and after ischemia, 0.336 +/- 0.032 mu 2, a 50.0% increase in mitochondrial size. In Group 2, total aortic cross-clamp time was 69.7 +/- 30.9 minutes. The mean mitochondrial surface area before ischemia was 0.205 +/- 0.025 mu 2 and after ischemia, 0.439 +/- 0.111 mu 2, an average increase in mitochondrial size of 114.2%. There was no significant difference between the two groups in mitochondrial size before ischemia. However, after ischemia the mean mitochondrial surface areas were significantly different (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970609 TI - Surgical treatment of mitral systolic click syndrome: results in 37 patients. AB - From 1974 to 1983, 37 symptomatic patients with mitral systolic click (Barlow's syndrome) underwent mitral valve repair. In 11 patients (30%), the click syndrome was associated with minor mitral regurgitation. Thirty-two patients (86%) had chest pain, 20 had arrhythmia (54%), and 20 had dyspnea as a major complaint. In 5 patients, the arrhythmia was serious, and in 2 of them, it was potentially life threatening. Mitral annuloplasty using a collar prosthesis was performed in 33 patients with posterior leaflet plication in 2, shortening of the chordae in 1, and commissural plication in 2. In 4 patients, commissural plication was performed. One of these patients also required cusp plication and shortening of the chordae, and another required repair of ruptured chordae. There were no operative or late cardiac-related deaths at a mean follow-up of 4.7 years (range, 1 to 10 years). Sixty-two percent of patients with prolapse alone and 91% of those with associated regurgitation were improved by at least one New York Heart Association Functional Class, with 60% of patients obtaining relief of one or more symptoms. In the presence of major symptoms, mitral annuloplasty offers symptomatic relief for some patients with mitral systolic click syndrome without valve incompetence, but it gives substantially better results in patients with mitral regurgitation. PMID- 3970610 TI - Recurrence of thymoma: clinicopathological features, therapy, and prognosis. AB - Factors influencing the recurrence or persistence of thymoma after therapy were investigated in 127 patients with thymoma, including 75 with thymoma and myasthenia gravis. The rate of recurrence or persistence was 19% (24 of 127 patients) overall, 11% (8 of 75 patients) in myasthenic thymoma, and 31% (16 of 52 patients) in nonmyasthenic thymoma. The more advanced the clinical stage, the higher the rate of recurrence or persistence. The recurrence/persistence rate for patients with the same clinical stage was higher in those with nonmyasthenic thymoma (8% in Stage I, 11% in Stage II, 36% in Stage III, and 75% in Stage IV) than in those with myasthenic thymoma (0 in Stage I, 13% in Stage II, 18% in Stage III, and 20% in Stage IV). The prognosis for patients having subtotal resection of tumor was good in myasthenic thymoma (recurrence/persistence rate, 17%) in contrast with nonmyasthenic thymoma (recurrence/persistence rate, 78%). These results suggest that nonmyasthenic thymoma is more malignant than myasthenic thymoma. Postoperative radiotherapy was effective in preventing the recurrence or persistence of thymoma after therapy. PMID- 3970611 TI - Traumatic diaphragmatic hernia: a continuing challenge. AB - Traumatic diaphragmatic hernia is an uncommon but important problem in the patient with multiple injuries. Since diaphragmatic injuries are difficult to diagnose, those that are missed may present with latent symptoms of bowel obstruction and strangulation. From 1957 to 1982, we treated 41 patients with traumatic diaphragmatic hernias. In 39 patients (95%), diaphragmatic hernia followed blunt trauma. The herniation occurred on the right side in 14 patients and on the left side in 29; it was bilateral in 2. Twenty-four patients had diagnostic chest radiographs, and an additional 11 had abnormal but nondiagnostic studies. Peritoneal lavage was of little value in making the preoperative diagnosis. Twenty-three patients underwent laparotomy only, 13 required thoracotomy alone, and 5 had combined laparotomy and thoracotomy. There were 7 deaths (17%) from associated injuries. Only one missed injury was encountered; a second delayed hernia, initially treated elsewhere, was repaired 45 years after the original trauma. Traumatic diaphragmatic hernia should be suspected on the basis of an abnormal chest radiograph in the trauma victim with multiple injuries. Right-sided injuries occur more commonly than previously thought and often require dual incisions (laparotomy and thoracotomy) for diagnosis and treatment. The organization of emergency care for such patients is critical in avoiding the potential of long-term sequelae. PMID- 3970612 TI - Permanent pacing through a persistent left superior vena cava: an approach and report of dual-chambered lead placement. AB - The patient with a persistent left superior vena cava who requires permanent pacing presents difficulties if no right superior vena cava is present or if it is encountered unexpectedly at pacemaker implantation. A case is presented that illustrates potential problems and suggests a general approach to this situation. Successful transvenous universal pacemaker insertion through a persistent left superior vena cava is reported. PMID- 3970613 TI - Aneurysm of main pulmonary artery in a neonate with airway obstruction and heart failure: long-term survival after pulmonary artery aneurysmectomy and patent ductus arteriosus ligation. AB - A neonate was seen with complete atelectasis of the left lung secondary to compression of the left main bronchus by a congenital aneurysmal main pulmonary artery. Operation consisted of pulmonary artery aneurysmectomy and ligation of an associated patent ductus arteriosus. Follow-up (3 years after operation) demonstrated complete resolution of the atelectasis and congestive heart failure. PMID- 3970614 TI - The use of Gore-Tex graft reinforced with external rings in pediatric cardiac surgery. PMID- 3970615 TI - Administration of hypothermic cardioplegia in the presence of aortic regurgitation. AB - Two technical maneuvers are presented to make the administration of cardioplegia feasible in the presence of moderate aortic valve incompetence. In the first maneuver, the cardioplegic solution is administered through a double-lumen balloon catheter inserted retrograde through the aortic wall and the aortic valve into the left ventricle; the inflated balloon obstructs the aortic orifice while the solution is injected through the proximal hole. In the second, after proximal anastomoses of the saphenous vein grafts are performed, the portion of the aorta from which the vein grafts rise is excluded by double cross-clamping and the cardioplegic solution is injected into this excluded segment. PMID- 3970617 TI - Ascending-distal aorta bypass. PMID- 3970616 TI - A simplified technique for grafting the first septal perforating branch of the left anterior descending coronary artery. AB - A technique for facilitating the identification and grafting of the first septal perforating branch of the left anterior descending coronary artery is described. This technique makes endarterectomy of the vessel unnecessary. PMID- 3970618 TI - Hemorrhage during redo sternotomy. PMID- 3970619 TI - Ethanol vapor entrapment under drapes. PMID- 3970620 TI - Electrical behavior of the heart after high-potassium cardioplegia. PMID- 3970621 TI - Fractional excretion of sodium. Exceptions to its diagnostic value. AB - Determining the cause of acutely deteriorating renal function is a common problem in clinical nephrology. The fractional excretion of filtered sodium (FENa) has been demonstrated to be a reliably discriminating test between prerenal azotemia and acute tubular necrosis. However, with increasing clinical use of the FENa, numerous reports of low FENa (less than 1%) have appeared. The clinical settings of these reports include oliguric and nonoliguric acute tubular necrosis, urinary tract obstruction, acute glomerulonephritis, hepatorenal syndrome, renal allograft rejection, sepsis, and drug-related alterations in renal hemodynamics. One particular urinary index cannot be expected to reliably discriminate between prerenal azotemia and acute renal failure in all cases. The utility of the FENa test in the differential diagnosis of acute renal failure must be interpreted in conjunction with the patient's clinical course and the use of additional urinary and serum tests. PMID- 3970622 TI - Blood eosinophilia in patients undergoing maintenance peritoneal dialysis. AB - To determine the prevalence of blood eosinophilia in patients receiving maintenance peritoneal dialysis, routine peripheral WBC counts of 49 such patients were reviewed. In 29 patients, blood eosinophilia was noted. Elevations in blood eosinophil counts tended to be mild and episodic. They were often associated with concomitant elevation of peritoneal fluid eosinophil counts. Possible predisposing factors included recent peritoneal catheter insertion and antibiotic therapy for peritonitis. PMID- 3970623 TI - Altered skin elastic fibers in hypothyroid myxedema and pretibial myxedema. AB - Elastic fibers account for 2% of dermal volume and are responsible for normal skin resiliency. We investigated a disorder of the dermal elastic component as the mechanism for the decreased elasticity of skin in myxedema. Skin biopsy specimens were obtained from patients with thyroid diseases and normal subjects matched for age, sex, and biopsy location. Elastic fiber concentration, determined by computerized morphometric analysis of Verhoeff-van Gieson-stained sections, was significantly lower than normal in hypothyroid and pretibial myxedema. The decreased elastin concentration was not a consequence of the glycosaminoglycan infiltration. Ultrastructural studies of myxedematous skin showed wide variability of elastic fiber diameter and decreased microfibrils. Myxedema (hypothyroid and pretibial) is consistently associated with quantitative and qualitative defects of dermal elastic fibers. PMID- 3970624 TI - Diagnosis of liver involvement in early syphilis. A critical review. AB - The diagnosis of liver involvement in early syphilis has always posed problems because of its rarity and the difficulty of excluding coincidental liver disease caused by a multitude of pathogens. Case reports deal predominantly with jaundiced homosexual men in whom syphilis is discovered later, and the prospective studies of patients with early syphilis disclose only mild biochemical abnormalities in liver function test results. There is no single characteristic feature attributable to early syphilitic hepatitis. Even liver histologic findings are variable. At least in those patients who have jaundice, there is a likelihood of coincidental viral hepatitis. Therefore, the evidence to implicate Treponema pallidum as a liver pathogen in early syphilis is not convincing. PMID- 3970625 TI - Medicine and health care along the Silk Road. China's population control program among the national minorities. AB - Travel along the Silk Road where many of China's national minorities live gives a new insight into the population growth problem. As a whole China's "one-child-for one-family" campaign seems to have succeeded in controlling its national population, although the government takes a more liberal attitude toward the national minorities. PMID- 3970626 TI - Sclerodactyly in a patient with mycosis fungoides. AB - A 44-year-old man had mycosis fungoides and generalized plaque disease involving 80% of his skin surface with diffuse lymphadenopathy and alopecia of the scalp and groin. In addition, distal to the wrist, there were sclerodermatous changes involving the skin of the hands with associated sclerodactyly of all digits with loss of normal palmar creases. There were no subungual telangiectasis or digital ulcers. The changes in the hand that occurred in this case, no doubt arose as a result of the patient's neoplasm. Abnormalities of collagen biosynthesis and degradation probably occur with mycosis fungoides as a result of the extensive infiltration of the epidermis and dermis with malignant cells. To our knowledge, the association of sclerodactyly with mycosis fungoides has not been previously reported. PMID- 3970627 TI - Hypercalcemia in the neuroleptic malignant syndrome. AB - The neuroleptic malignant syndrome (NMS) developed in a 32-year-old man following fluphenazine enanthate administration. Hypercalcemia was initially present, perhaps reflecting release of calcium from skeletal muscle stores. The elevated serum calcium levels support the existence of a peripheral muscle abnormality in the pathogenesis of the NMS and provides another point of similarity between NMS and malignant hyperthermia. PMID- 3970628 TI - Acute tubular necrosis after inhalation exposure to methylene chloride. Report of a case. AB - Nephrotoxic reaction occurred after inhalation exposure to methylene chloride. This exposure is associated with acute renal failure, myoglobinuria, hypocomplementemia, and liver enzyme elevations. Pathologic specimens, both light and electron microscopic, demonstrate renal tubular damage. We conclude that methylene chloride may have potential as both a hepatotoxic and nephrotoxic agent when inhaled at high concentrations over an extended period of time. PMID- 3970629 TI - Cystic fibrosis. An adult perspective. AB - We treated a patient with an unusual case of cystic fibrosis in whom the diagnosis was not made until age 42 years, the predominant clinical manifestation was recurrent pancreatitis, and the chest roentgenogram and results of pulmonary function tests were normal between bouts of pneumonia. As cystic fibrosis may simulate more benign conditions often seen in adults, the diagnosis must be suspected and confirmed for optimal management. Internists must play an increasingly important role in the diagnosis and management of this disease. PMID- 3970630 TI - Radiation-associated recurrent parathyroid adenoma. AB - Recurrent parathyroid adenoma occurred in a patient who had received radiation treatments to the lateral aspect of the pharynx for lymphoid hyperplasia at the age of 10 years. The interval between the development of the first and second adenomas was 20 years. Although an association between head and neck irradiation and primary hyperparathyroidism is known, we believe this to be the first report of recurrent hyperparathyroidism in an irradiated patient. PMID- 3970631 TI - Factitious lowering of the serum potassium level after cardiopulmonary resuscitation. Implications for evaluating the arrhythmogenicity of hypokalemia in acute myocardial infarction. AB - Hypokalemia has been suggested as a predisposing factor to the development of fatal arrhythmias in acute myocardial infarction. Evidence cited to support this concept has been derived largely from studies in which the determination of the serum potassium level was made following a cardiac arrhythmia and/or arrest, and often following cardiopulmonary resuscitation (CPR); this postresuscitation potassium level has been considered to be representative of the prearrest value. In the patient described herein, serial determinations of serum potassium obtained fortuitously before and intentionally following sudden unexpected cardiac arrest in a hospitalized patient demonstrate that the prearrest serum potassium level cannot be inferred from electrolyte values obtained after CPR. PMID- 3970632 TI - Eosinophilic fasciitis, reactive hepatitis, and splenomegaly. AB - Eosinophilic fasciitis (EF) is an acute, idiopathic inflammatory disorder often manifested by tender swelling of the extremities after extreme physical exertion. It is usually without visceral complications. I treated a 25-year-old man with EF who had reactive hepatitis and splenomegaly. To my knowledge, the former has never been reported and the latter only once. PMID- 3970633 TI - Coexistence of myeloid metaplasia with myelofibrosis and hairy-cell leukemia. AB - A 42-year-old man with severe pancytopenia and myelofibrosis underwent splenectomy seven months after onset of his symptoms; the leukocyte, platelet, and hematocrit levels became normal. Myeloid metaplasia was identified in the liver and spleen. Progressive lymphocytosis started eight months after splenectomy, and after 66 months a florid hairy-cell leukemia was diagnosed; the circulating cells were B type with micro K surface markers. Anemia and thrombocytopenia reappeared and were controlled initially with daily prednisone; chlorambucil was later added. At that time, the peripheral blood had more than 150 megaloblastoid-appearing normoblasts per 100 leukocytes. The PAS stain was positive in 95% to 100% of these cells; the B-cell surface markers were no longer identified. Further treatment failed to control the lymphoproliferative and myeloproliferative syndromes; the patient died 99 months after splenectomy. On autopsy, infiltration by hairy-cell leukemia cells and erythroid precursors was observed in the bone marrow, liver, lymph nodes, and other organs. PMID- 3970634 TI - Reversible Pelger-Huet anomaly associated with ibuprofen therapy. AB - A patient had a case of acquired-reversible pseudo-Pelger-Huet anomaly associated with a hypersensitivity reaction. Seven weeks after the illness, the hematologic anomaly was no longer present. PMID- 3970635 TI - 'Page kidney'. Hypertension caused by chronic subcapsular hematoma. AB - Conditions analogous to an experimental model of hypertension described by Page in 1939 are called "Page kidney." In chronic subcapsular hematoma, the most common clinical counterpart to Page's model of renal parenchymal compression, a review of the literature reveals that hypertension is usually cured by nephrectomy, but is seldom cured by mere evacuation of the hematoma. To our knowledge, no patient remaining hypertensive after evacuation has undergone nephrectomy. In the patient described herein, a liquified subcapsular hematoma reaccumulated after it was drained percutaneously, and therefore it had to be evacuated surgically. Persistent renin-mediated hypertension, however, prompted curative nephrectomy. The response to more prolonged percutaneous drainage might have guided more effective initial surgery. PMID- 3970636 TI - Radiographic contrast medium--induced glossitis. AB - A new complication of intravenous radiographic contrast medium administration is recognized: severe glossitis. The pathophysiology of adverse reactions to contrast media is briefly reviewed. PMID- 3970637 TI - Acute renal failure as a complication of obstructed jaundice. PMID- 3970638 TI - Salt restriction in hypertensive patients. PMID- 3970639 TI - Noonan syndrome and hyperextensible finger joints. PMID- 3970640 TI - Nonpersimmon gastric phytobezoar. PMID- 3970641 TI - Cystic thyroid nodules. PMID- 3970642 TI - Activated charcoal reborn. Progress in poison management. PMID- 3970643 TI - Meeting the challenge of the medical lecture. PMID- 3970644 TI - Are 'indexes' an index of physician performance? PMID- 3970645 TI - Trends in the therapy for mild hypertension. A word of caution. PMID- 3970646 TI - Near drowning in the dead sea. Electrolyte imbalances and therapeutic implications. AB - Unusual serum electrolyte abnormalities developed in eight patients who nearly drowned (ND) in the Dead Sea. Elevations in serum calcium and magnesium levels in particular required specific therapeutic intervention. The Dead Sea has a uniquely high concentration of calcium, magnesium, sodium, potassium, and chloride. The unusual serum electrolyte elevation that was observed in the ND victims in the Dead Sea apparently reflected the large solute load to which they were exposed. Four patients died subsequent to ND. Near drowning in the Dead Sea therefore represents a clinical entity that is associated with a high fatality rate and in which unrecognized major electrolyte abnormalities, in addition to the known respiratory complications, may influence the outcome. PMID- 3970647 TI - Evaluation of pindolol dosage in hypertension by automatic indirect BP monitoring. AB - Pindolol, a nonselective beta-adrenergic blocking drug, lowered systolic and diastolic BP equally well during once-daily and twice-daily dosage. Side effects were few. Absence of supine bradycardia distinguished this drug from other beta adrenergic blockers and likely was attributable to the agent's intrinsic sympathomimetic activity. Blood pressure variability was less during therapy. Automatic indirect BP monitoring reliably confirmed office and home BP recordings and indicated good control throughout waking and sleeping periods. PMID- 3970648 TI - Group G streptococcal bacteremia. The clinical experience at Boston University Medical Center and a critical review of the literature. AB - Twenty-six patients with bacteremia caused by group G streptococci were seen during a 29-month period. Our findings suggest that the epidemiology of these infections has not changed appreciably during the last 15 years. The disease occurs most commonly as an acute community-acquired infection in older persons with underlying conditions predisposing to skin breakdown. Patients with these bacteremias fall into three categories: those with associated cutaneous infection only; those with serious focal infection; and those with probable infection. Underlying neoplastic conditions were relatively uncommon (25%) in our series compared with others (65%). In contrast to recent reports emphasizing this complication, endocarditis was uncommon in our patients. A prompt response to therapy with beta-lactam antibiotics occurred in most of our patients. PMID- 3970649 TI - Metastatic bacterial endophthalmitis. AB - Metastatic bacterial endophthalmitis has been reported infrequently in the antibiotic era. We recently encountered five cases of metastatic bacterial endophthalmitis during an eight-month period. The diagnosis was made by blood culture in four of the cases and a positive vitreal aspirate in the fifth case. The organisms included: Staphylococcus aureus, Streptococcus pneumoniae, and groups G and B streptococci. Underlying diseases included endocarditis, lymphoma, and facial trauma. One patient had no identifiable source of infection. The diagnosis was delayed in two of the patients, despite early ophthalmologic consultation. The outcome was poor, four of the five patients lost all useful vision. Development of eye symptoms in the setting of gram-positive bacteremia should be suggestive of this entity. An aggressive diagnostic and therapeutic approach with intravitreal antibiotics might improve the outcome. Our observation of five cases during eight months in one hospital suggests that metastatic endophthalmitis may be more common than is generally appreciated. PMID- 3970650 TI - Acute chest pain in the emergency room. Identification and examination of low risk patients. AB - Clinical and laboratory data from 596 patients who came to an emergency room complaining of chest pain indicated that no single variable could identify low risk patients as well as a normal ECG. A combination of three variables--sharp or stabbing pain, no history of angina or myocardial infarction, and pain with pleuritic or positional components or pain that was reproduced by palpation of the chest wall--defined a very-low-risk group in which ECGs did not add accuracy to the evaluation and were potentially misleading; however, only 48 patients (8%) fell into this category. Standard cardiac enzyme levels were of almost no use as an emergency room indicator of myocardial infarction. These findings emphasize the difficulty of identifying patients at low risk for myocardial infarction or unstable angina in the emergency room without consideration of many factors from the history, the physical examination, and the ECG. PMID- 3970652 TI - The importance of leukocyturia in young adults. AB - The records of 1,000 asymptomatic male air force personnel were examined retrospectively for the results of 15 yearly examinations (1968 through 1983) of urinary sediment, beginning with subjects aged 18 to 33 years. The cumulative incidence of four to six or more WBCs per high-power field on one or more examinations was 31.8% after an average of 12.2 examinations per person over the 15-year period. In 107 subjects the WBCs were found on two or more occasions within five consecutive examinations. In 106 subjects, 140 urine cultures were sterile. In 28 cases the urine was also sterile after culture for Mycobacterium tuberculosis. Intravenous pyelograms, obtained in eight cases, were normal. Renal biopsy in one case with recurrent hematuria and trace proteinuria showed focal glomerulonephritis. All subjects are currently active and free of urinary symptoms an average of 7.6 years after detection of leukocyturia. PMID- 3970651 TI - Facilitating patient acceptance of a psychiatric referral. AB - There are five common ways in which a patient may object to a physician's suggestion of a psychiatric referral. The patient may reject the referral because of the social stigma of being a psychiatric patient; because the referral damages his or her self-esteem; because the patient does not understand the role of emotions in physical discomfort; because the patient feels rejected by the referring physician; or because of the effects of psychiatric illness. Following a thorough medical workup, the physician can best discharge his or her responsibility to the patient by paying attention to these possible misunderstandings. The physician can discuss the role of social stigma, offset the blows to the patient's self-esteem, educate the patient about the psychosomatic model of disease, and assure the patient of the physician's continuing interest and involvement. PMID- 3970653 TI - Failure to suspect and diagnose thalassemic syndromes. Interpretation of RBC indices by the nonhematologist. AB - A three-year review of the medical records of 76 patients with apparent thalassemic syndromes (mean corpuscular volume, greater than 75 cu micron; RBC count, greater than 5 X 10(6)/cu mm) was performed to assess overall physician response to this information at a midwestern teaching institution. Abnormal indices were recognized in only 50% of the cases; in only 32% of cases was a thalassemic syndrome considered in the differential diagnosis. Residents in internal medicine failed to recognize microcytic indices and to consider thalassemic syndromes 42% and 59% of the time, respectively. Even though hemoglobin electrophoresis was performed in 25 patients, in only 15 (56%) of the 25 cases was beta-thalassemia proved or alpha-thalassemia presumptively diagnosed. In 17% of all cases, the patients were treated with iron without diagnostic findings on iron studies and/or in spite of data suggesting a thalassemic syndrome. The RBC indices are an underused portion of the complete blood cell count, and readily apparent thalassemic syndromes are often not considered. PMID- 3970654 TI - The benefits of systematic fiberoptic flexible sigmoidoscopy. AB - We used the flexible fiberoptic sigmoidoscope (FFS) on 656 subjects who were receiving their yearly physical examinations. Neoplastic disease was disclosed by the FFS in 138 subjects (21%), including 26 adenocarcinomas, 19 of which were out of reach of a rigid sigmoidoscope. Nineteen of the subjects whose adenocarcinomas were found by the FFS had barium enemas, which detected the carcinomas in only 11. Routine FFS in asymptomatic persons is helpful in detecting both premalignant and malignant lesions, it should be seriously considered as a part of regular preventive physical examinations. PMID- 3970655 TI - Unique features of group B streptococcal arthritis in adults. AB - Group B streptococci have rarely been reported to cause serious infection in adults and even less frequently to result in septic arthritis. We reviewed our clinical and radiologic experience with septic arthritis and uncovered five cases of infectious arthritis caused by group B streptococci. Unlike previously described patients with monoarthritis and complete recovery, our patients displayed polyarticular involvement. The infection in some cases was aggressive, resulting in destruction of multiple joints. Therefore, the series supports the view that this uncommon pathogen may produce an aggressive polyarthritis with the potential for serious functional damage and permanent morbidity. Culture and identification of a group B streptococcal pathogen and prompt institution of therapy can help avoid these complications. PMID- 3970656 TI - Wheelchair cushion effect on pressure and skin temperature. AB - Eight wheelchair cushions representing five types of materials were evaluated in two population groups, able-bodied and spinal cord injured (SCI). Objective factors such as area of first light, pressure, tuberosity and thigh temperatures, and subjective factors such as cosmesis, handling ability, and purchase were studied. Twenty subjects (10 men and 10 women; 10 SCI and 10 able-bodied) from 16 to 35 years of age were chosen to participate in the study. Pressure was measured with the Pressure Evaluation Pad and skin temperature of each ischial tuberosity and posterior thigh was determined. Temperature differences were not significant among cushions but the alternating pressure and foam cushions produced consistently higher temperatures compared to other cushions for both groups of subjects. No significant differences among cushions were found for area of first light, cosmesis, handling ability, or purchase. However, three cushions were rated acceptable in cosmesis while three different cushions were rated acceptable in handling ability by all subjects. No cushion rated a perfect score by all subjects regarding purchase but all the SCI subjects said they would purchase the air-filled cushion. Overall pressure differences were not significant but large individual variations were observed. The authors believe that pressure produced by wheelchair cushions should be measured with a standard device such as the Pressure Evaluation Pad, and that, to reduce the incidence of pressure sores, cushion use in each patient should be modified on the basis of initial and periodic assessment of both objective and subjective factors. PMID- 3970657 TI - Hand rehabilitation after great toe transfer for thumb reconstruction. AB - A comprehensive rehabilitation program for patients who have undergone a great toe to hand transfer for thumb reconstruction can significantly affect eventual functional outcome. When the thumb is amputated near the metacarpophalangeal joint, such a transfer provides a useful and aesthetic thumb substitute. Goals of rehabilitation are to promote optimal functioning of the reconstructed hand by maximizing range of motion, preventing reduction of the first web space, facilitating adequate sensory return, and maximizing strength, coordination, and endurance. Therapeutic modalities include edema control, passive and active exercises, static and dynamic splinting, massage, sensory reeducation, and graded functional activities. Emotional adjustment and vocational adaptation are additional therapeutic concerns. Case histories of two patients are briefly reviewed along with pre- and posttransfer assessments of range of motion, strength, sensation, and dexterity. PMID- 3970658 TI - Oral rehabilitation to maintain independence. AB - A child born with missing or deformed upper extremities must learn to develop alternatives for the activities of daily living (ADL). To assure an independent existence, substitutes for nonfunctioning arms and hands must be developed. Teeth can replace hands for all activities that require pinch and grasp, as well as to support adaptive devices for turning pages, typing, drawing and painting. However, without carefully planned dental care, teeth, particularly incisors and canines, will show excessive wear if used for hands over the years. Loss of teeth threatens independence in self-care and in ADL, and loss of self-esteem. Oral health can be restored and retained to maintain function, independence, and esthetics. This case presentation illustrates a challenge and obligation of dentistry in rehabilitation. PMID- 3970660 TI - Grip and pinch strength: normative data for adults. AB - The primary purpose of this study was to establish clinical norms for adults aged 20 to 75+ years on four tests of hand strength. A dynamometer was used to measure grip strength and a pinch gauge to measure tip, key, and palmar pinch. A sample of 310 male and 328 female adults, ages 20 to 94, from the seven-county Milwaukee area were tested using standardized positioning and instructions. Right hand and left hand data were stratified into 12 age groups for both sexes. This stratification provides a means of comparing the score of individual patients to that of normal subjects of the same age and sex. The highest grip strength scores occurred in the 25 to 39 age groups. For tip, key, and palmar pinch the average scores were relatively stable from 20 to 59 years, with a gradual decline from 60 to 79 years. A high correlation was seen between grip strength and age, but a low to moderate correlation between pinch strength and age. The newer pinch gauge used in this study appears to read higher than that used in a previous normative study. Comparison of the average hand strength of right-handed and left-handed subjects showed only minimal differences. PMID- 3970659 TI - Behavior modification of abnormal gait and chronic pain secondary to somatization disorder. AB - An interdisciplinary team, which included a physiatrist, psychologist, physical therapist, occupational therapist, social worker, and nursing staff, undertook the treatment of a 33-year-old woman with a 16-year history of gait problems and multiple somatic complaints. Previously, she had been followed by a number of physicians and had undergone both invasive and noninvasive diagnostic procedures as well as several surgical procedures. After limited response to such treatment, she was referred to the outpatient PM&R clinic for evaluation. Physical and psychologic study led to a primary diagnosis of somatization disorder, leading to inpatient treatment which combined a systematic gait-training program, withdrawal of reinforcement for maladaptive disability-related behavior, and reinforcement of increases in normal activities. The patient attained all of the goals in her program in 11 weeks. PMID- 3970661 TI - Chronic pain: electromechanical recording device for measuring patients' activity patterns. AB - Many authors have recommended the development and use of automated recording devices as alternatives to self-report measures of activity patterns in chronic pain patients. An electromechanical device is described that can be used to measure downtime or uptime in chronic pain patients. This monitor has several advantages over mercury tilt-switch devices including freedom from plane dependence, resistance to artifact associated with rapid or vigorous movements, and the flexibility to permit conceptualization of sitting time as either uptime or downtime, depending upon placement of the position switch. The monitor consists of a miniature electronic timer, a switching delay circuit and battery pack, an electromechanical position switch, a belt with carrying cases, and a battery recharger. The device has high reliability (agreement coefficients of 1.0) and concurrent validity (r = 0.99) for both downtime and uptime assessments. Research applications and clinical use of this device are discussed as well as directions for the further development of automated recording devices. PMID- 3970662 TI - Gait abnormalities in tibial nerve paralysis: a biomechanical study. AB - Gastrocnemius-soleus dysfunction is a frequent result of cauda equina lesions and peripheral neurophathies and of stroke and brain injury. Temporary tibial nerve paralysis constitutes a comparable laboratory condition which allows the controlled examination of aspects of these disabilities. The biomechanical effects of temporary tibial nerve paralysis in six normal young adult volunteers were examined to quantitatively define the gait abnormalities resulting from gastrocnemius-soleus paralysis and to provide a basis for the assessment of the effectiveness of different orthotic designs in restoring a normal gait pattern. The motion of the right lower extremity, ground reactive forces acting on the right lower extremity, timing of gait events and step length were recorded, first during normal ambulation and then during ambulation after a right tibial nerve block. Step length was reduced bilaterally after the nerve block (p less than 0.005); the reduction was greater for the left (unblocked) step than for the right (blocked) step (p less than 0.005). Right heeloff was delayed until the time of left heelstrike in all subjects after the right tibial block. Right heeloff occurred later (p less than 0.005) while left heelstrike occurred earlier than normal (p less than 0.005). The shorter left step length and earlier left heelstrike resulted from a reduction in the forward progression of the right hip (p less than 0.001). When subjects were deprived of the plantarflexion activity necessary to counteract dorsiflexion moments at the ankle, they delayed the forward progression of the center of pressure (p less than 0.001) to avoid the unstable collapse of the foot into dorsiflexion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970663 TI - Neurologic examination in stroke rehabilitation: adequacy of its description in clinical textbooks. AB - Medical textbooks were reviewed to establish how well they presented those aspects of examination of the nervous system which are important in stroke rehabilitation. In addition, information was sought concerning such factors as the presence of instructions for the examiner and patient, grading and interpretation of results, and the importance of observer variation which can influence results of periodic neurologic examination of stroke patients. Study results demonstrated that the description of the neurologic examination which should be used in stroke rehabilitation was often incomplete and poorly defined. Material provided little interpretation for the physical signs which might be found. Factors which might influence results of periodic examination of the nervous system in stroke patients received little attention. There is an urgent need to develop a standardized form of clinical examination to meet the needs of practitioners who assess neurologic status in stroke rehabilitation. PMID- 3970664 TI - Topical antimicrobial toxicity. AB - Three topical antibiotics and four antiseptics (1% povidone-iodine, 0.25% acetic acid, 3% hydrogen peroxide, and 0.5% sodium hypochlorite) were directly applied to cultured human fibroblasts to quantitatively assess their cytotoxicity. The four antiseptics were found to be cytotoxic; all of the cytotoxic agents except hydrogen peroxide were subsequently found to adversely affect wound healing in an animal model. Comparison of bactericidal and cytotoxic effects of serial dilutions of these four topical agents indicated the cellular toxicity of hydrogen peroxide and acetic acid exceeded their bactericidal potency. Bactericidal noncytotoxic dilutions of povidone-iodine and sodium hypochlorite were identified. These experiments provide evidence that 1% povidone-iodine, 3% hydrogen peroxide, 0.5% sodium hypochlorite, and 0.25% acetic acid are unsuitable for use in wound care. This sequence of experiments could be used to identify bactericidal, noncytotoxic agents prior to their clinical use. PMID- 3970665 TI - Internal iliac artery revascularization in the treatment of vasculogenic impotence. AB - Five impotent men underwent internal iliac artery revascularization in conjunction with end-to-side aortobifemoral bypass after preoperative testing suggested a vasculogenic cause for impotence. All patients had abnormal preoperative penile/brachial arterial pressure indices (mean, 0.42 +/- 0.12). Following operation, all patients regained erectile capability and had normal postoperative penile/brachial indices (mean, 0.80 +/- 0.06). One patient developed retrograde ejaculation, emphasizing the need for meticulous nerve sparing dissection with this operation. Internal iliac artery revascularization in conjunction with end-to-side aortobifemoral bypass is effective in relieving vasculogenic impotence in properly selected patients. PMID- 3970666 TI - Splenic phagocytic function after partial splenectomy and splenic autotransplantation. AB - We investigated splenic reticuloendothelial activity after splenic preservation procedures to determine their effect upon the phagocytic function of the spleen. We performed the following procedures in Sprague-Dawley rats: sham laparotomy, total splenectomy, hemisplenectomy, subtotal splenectomy, or total splenectomy with intraperitoneal splenic autotransplantation. At nine weeks after operation, phagocytic function of the spleen was determined by measuring radiocolloid uptake. Mean (+/- SEM) splenic phagocytic indices for sham laparotomy (41.2 +/- 2.9), hemisplenectomy (44 +/- 2.9), and subtotal splenectomy (43.2 +/- 5.2) were similar; however, the phagocytic index was reduced markedly after autotransplantation (15.8 +/- 2.2). These data demonstrate that the phagocytic function of the spleen after hemisplenectomy and subtotal splenectomy correlates highly with the weight of the splenic remnant; however, phagocytic function after autotransplantation remains reduced even after accounting for differences in splenic weight. PMID- 3970667 TI - Reliability and sensitivity of frozen-section pancreatic biopsy. AB - A collaborative Veterans Administration and University of California, Davis Medical Center group of 586 patients with histologically proved pancreatic carcinoma was reviewed. During laparotomy, 159 patients underwent 251 frozen section pancreatic biopsies with subsequent permanent section examination of the same tissue block. All 112 positive frozen-section diagnoses were corroborated on permanent sectioning. The 47 patients with false-negative biopsy specimens were equally divided between sampling and interpretation error. We conclude that in this group of 159 pancreatic cancer patients, 30% failed to be correctly diagnosed by intraoperative frozen-section biopsy. This failure was due to patient sampling and interpretation error in equal proportion. Interpretation error rates were not influenced by the type or number of biopsies. Patient sampling error is apparently reduced by repeated biopsy, and specimen sampling error occurred less frequently with wedge biopsy. PMID- 3970668 TI - Hyperbilirubinemia following distal splenorenal shunt. AB - To assess the incidence, pathogenesis, and associated morbidity and mortality of hyperbilirubinemia following the distal splenorenal shunt, hepatic hemodynamics, liver function, and clinical course were evaluated before and after this procedure in 78 cirrhotic patients. Individuals with a peak postoperative bilirubin level greater than 5 mg/dL had a higher preoperative bilirubin concentration, worse Child's score, longer hospital stay, and higher mortality than patients with a peak postoperative bilirubin level less than 5 mg/dL. Mean preoperative and postoperative hepatic portal perfusion and sinusoidal pressure were similar in both groups. When only patients with minimally elevated preoperative bilirubin levels (less than 2 mg/dL) were analyzed, 83% of individuals who developed postoperative hyperbilirubinemia (level, greater than 5 mg/dL) had a major alteration in hepatic hemodynamics as manifested by either complete portal vein thrombosis or a marked change in sinusoidal pressure (greater than 4 mm Hg). Although preoperative hepatic functional reserve is the major determinant of postoperative bilirubin concentration, alterations in hepatic hemodynamics secondary to the distal splenorenal shunt may also play a role. PMID- 3970669 TI - Candida sepsis. Implications of polymicrobial blood-borne infection. AB - Eighty-three patients with 117 episodes of candidemia were reviewed to examine the clinically significant variables and the results of treatment for this problem. Mortality was 52%. Patients who had bacteremia either synchronously or metachronously in association with Candida species had poorer survival rates. Staphylococcal and enterococcal species were the most frequently associated bacteria. Patients with Candida parapsilosis had better survival rates than patients with other species. Portals of entry for fungemia were catheters, wounds, the urinary tract, and the peritoneal cavity, but were undefined in 54% of patients. Antifungal chemotherapy could not be identified as affecting the outcome in these patients. It is suggested that candidemia in most patients represents a failure of host defense, and that septicemia of either bacteria or fungi may arise from the gastrointestinal tract in critically ill, immunocompromised patients. PMID- 3970670 TI - Knee arthrodesis for failed total knee arthroplasty. AB - The use of arthrodesis to salvage failed total knee arthroplasty is reviewed in nine patients. Prosthetic failure was due to infection in six cases, aseptic loosening in two cases, and instability in one case. The techniques of arthrodesis included six Hoffman external fixators, two fluted intramedullary rods (3M-Orthopedic Products Division, St Paul), and one pulsing electromagnetic field stimulator. Arthrodesis was successful in eight of nine patients, averaging 5.4 months to union. All eight patients resumed a painfree functional level of activity. Meticulous surgical technique and appropriate method of arthrodesis are emphasized. PMID- 3970671 TI - Efficacy of pharmacologic glucagon in acute experimental pancreatitis. AB - Microcirculatory derangements in the pancreas associated with acute pancreatitis may contribute to a low-flow state and lead to pancreatic necrosis. This study investigated the effects of glucagon, a selective mesenteric arterial dilator, on pancreatic ischemia in canine bile-trypsin-induced pancreatitis (BTP). Measurements of cardiac Index (CI), total pancreatic blood flow (QP), pancreatic oxygen consumption (O2CP), and pancreatic arteriovenous shunt flow (QAVS) were obtained prior to and after inducing BTP. Bile-trypsin-induced pancreatitis was induced in 18 dogs. Nine received lactated Ringer's solution alone (LRPAN) at 6.5 mL/kg/hr, nine received lactated Ringer's solution plus continuous Intravenous (IV) glucagon hydrochloride (GLUPAN) at 1.0 micrograms/kg/min, and nine undergoing periportal dissection without BTP received IV glucagon (GLUCON). Following BTP, CI, QP, and O2CP decreased significantly and QAVS remained unchanged in crystalloid-treated animals (LRPAN). Glucagon administration (GLUPAN) transiently increased CI and QP but failed to improve O2CP and did not change QAVS. The decrease in O2CP observed after BTP in association with a constant QAVS suggests a metabolic block to oxygen uptake at the cellular level. Glucagon in pharmacologic doses does not reverse abnormalities in O2CP and is therefore of questionable physiologic benefit in the treatment of acute pancreatitis. PMID- 3970672 TI - Combined pancreatic duct and upper gastrointestinal and biliary tract drainage in chronic pancreatitis. AB - In 55 patients undergoing pancreaticojejunostomy for intractable abdominal pain, common bile duct obstruction occurred in 29% (16/55) and duodenal obstruction occurred in 15% (8/55). Serum alkaline phosphatase and total and direct serum bilirubin levels were significantly higher in patients with intrapancreatic common bile duct stenosis. Transient upper gastrointestinal (UGI) tract obstruction was common with chronic pancreatitis; however, if symptoms persisted beyond 2 weeks, fixed duodenal obstruction was likely. Endoscopic retrograde cholangiopancreatography and UGI roentgenograms and endoscopy were useful in confirming mechanical obstruction to the biliary and UGI tracts, respectively. There was no difference in operative mortality and morbidity from combined drainage procedures compared with pancreaticojejunostomy alone. The biliary and UGI tracts should be investigated in symptomatic patients both before and after pancreaticojejunostomy. Combined drainage of the pancreatic duct and UGI and biliary tract is safe and effective treatment for obstructing complications of chronic pancreatitis. PMID- 3970673 TI - Endarterectomized superficial femoral artery as an arterial patch. AB - Eighty-six patients underwent 90 profundaplasties for lower extremity ischemia using endarterectomized superficial femoral artery (ESFA) or vein as an arterial patch. Standard length profundaplasty was performed in 60 limbs and extended profundaplasty in 28. Seventy-two were performed for limb salvage and 18 for severe claudication. Fifty-four limbs underwent inflow reconstruction and profundaplasty, while 36 others had profundaplasty alone. Three-year cumulative patency rates were employed to compare the type of autogenous patch material to the profundaplasty length, operative indications, and procedures. In all groups, ESFA performed as well as vein. Endarterectomized superficial femoral artery patch angioplasty provides comparable long-term results to vein patch in patients undergoing profundaplasty, and demonstrates its durability as a vascular patch in situations where autogenous tissue is required or preferred while preserving the saphenous vein for later use. PMID- 3970674 TI - Iatrogenic vascular injury. A reducible problem. AB - During a six-year period 46 patients were treated for iatrogenic vascular injuries at the University of Texas Health Science Center, San Antonio. Diagnostic procedures led to 24 injuries, while therapeutic procedures were responsible for 22 vascular injuries. Trauma to the brachial and femoral arteries and the subclavian vein accounted for the majority of injuries. The most frequently encountered injuries were intimal tear, thrombosis, and laceration. Lateral suture, thrombectomy, and intimal repair were the most commonly employed forms of vascular repair. Postoperative complications were not related to the vascular injuries. Conclusions drawn from this review were as follows: (1) most injuries occur in nonsurgical areas of the hospital; (2) most injuries are related to improper placement, use, or manipulation of catheters; (3) mortality in these cases is caused by the underlying disease process; and (4) long-term sequelae secondary to the vascular injuries are rare. PMID- 3970675 TI - Relationship between vasa vasorum and blood flow to vein bypass endothelial morphology. AB - In order to define the respective roles of the vasa vasorum blood supply and intraluminal arterial blood flow in maintaining the endothelial integrity of in situ vein bypasses, we have carried out two separate but interrelated experiments in a canine model. In vivo studies on eight dogs demonstrated that even in the absence of intraluminal blood flow the vasa vasorum maintained endothelial integrity and also showed that the endothelium was very sensitive to the loss of the vasa vasorum blood supply. In a second group of experiments on 14 in situ vein bypasses we studied the effect of division of the vasa vasorum immediately after arterialization of the bypass. This experiment showed that arterialization of the vein maintained endothelial integrity despite division of the vasa vasorum. PMID- 3970677 TI - Inability of Japanese rubella vaccines to induce antibody response in rabbits is due to growth restriction at 39 degrees C. AB - We have compared the kinetic growth patterns of To-336, MEQ11, KRT, and SK2 rubella vaccine strains licensed in Japan at 37 degrees and 39 degrees C with those of progenitor wild strains of rubella virus. The growth of vaccine strains was depressed at 39 degrees C to a level about 3 log10 lower than that at 37 degrees C. The difference in virus titer attained by wild strains at 37 degrees and 39 degrees C was less than tenfold. The growth potential at 39 degrees C paralleled the immunogenic marker of rubella virus, i.e. the capability of virus to induce antibody response upon subcutaneous injection in rabbits for all wild and vaccine strains examined, including one strain at an intermediate level of attenuation. Several clones were isolated from the progeny produced by a vaccine strain during the growth at 39 degrees C. Among them were partial revertants in immunogenic marker as well as in the growth potential at 39 degrees C. It was concluded that the immunogenic marker of rubella virus in rabbits represented its capability to replicate at the body temperature of the animal. PMID- 3970676 TI - Interaction of K papovavirus with hamster cells: transformation of glial cells in vitro but failure of the virus to produce central nervous system tumors in vivo. AB - Primary cultures of lungs, kidneys, and glial cells derived from midgestation Syrian hamsters were inoculated with 10(5) hemagglutinating units of murine K papovavirus and were serially subcultivated to allow appearance of lines of persistently infected or transformed cells. K virus did not replicate in renal cell cultures and produced only transient productive infection of lung cells. Evidence of K virus-induced cell transformation was not detected in either of these cultures. Inoculation of glial cultures with K virus, however, resulted initially in a protracted infection in which 80--100 percent of cells expressed K virus V antigen for 18 subcultivations and in which cloning experiments suggested that all cells in the culture contained the viral genome. After 18 subcultivations numbers of positive cells rapidly diminished, and cells appeared which exhibited altered morphology and density dependence. These altered cells (KVHG3 cells) grew well in serum-free media, could be cloned in soft agar, and were negative for infectious virus or K virus V antigen. Although KVHG3 cells did not exhibit staining when reacted with antisera to K virus T antigen, Southern blot analysis of these cultures demonstrated the presence of K virus DNA integrated into the host chromosomal DNA and indicated that some rearrangement of the viral genome had occurred. Attempts to produce tumors in hamsters with these cells were unsuccessful, as were attempts to induce tumors in newborn hamsters by intracranial inoculation of K virus. The present study demonstrates that K virus is capable of causing productive infection and cell transformation in primary cultures of fetal hamster glial cells but that other hamster cell types are relatively resistant to the virus and that both K virus and K virus-transformed hamster cells are poorly oncogenic for hamsters in vivo. PMID- 3970678 TI - Ammonium-5-tungsto-2-antimoniate (HPA23) can prevent fox rabies. AB - HPA 23, used at 120 mg/kg, can prevent fox rabies when it is administered at the time of infection: this compound has protected two foxes. It has also delayed the time of death in thirteen other foxes. PMID- 3970679 TI - [Handling of food without change of quality--dream or reality?]. PMID- 3970680 TI - [Is processing of foods without loss of quality possible?]. PMID- 3970681 TI - [Can the quality of foods by common household preparation be improved?]. PMID- 3970682 TI - [How can losses in nutritive value in community care be prevented?]. PMID- 3970683 TI - Changes in micronutrients due to industrial processing. PMID- 3970685 TI - [Effect of industrial processing and household preparation on dietary fats]. PMID- 3970684 TI - Influence of processing on protein quality. PMID- 3970686 TI - [Biological effect of hydrated and esterified fats]. PMID- 3970687 TI - Age associated alteration of lidocaine metabolism is position selective. AB - Patterns of associated alterations in N-deethylation, 3-hydroxylation, and aromatic methylhydroxylation of a single substrate, lidocaine in liver microsomes from 0.7 - 28 months old Fischer 344 rats were examined. These three patterns were all different from one another. In addition to this position selectiveness, a clear sex difference was observed in the pattern of alteration in N deethylation. These results are consistent with the hypothesis that age associated alterations in drug metabolism are caused by age associated alterations in relative abundance of multiple species of cytochrome P-450. PMID- 3970688 TI - [A0-phenylalanyl] relaxin (porcine): an active intermediate. AB - A [phenylalanylA0] relaxin has been isolated as a byproduct during large scale porcine relaxin preparations, using ion exchange chromatography on CM-cellulose at pH 7.8 followed by high performance liquid chromatography on reversed phase columns. The elongation at the N terminus of the A-chain has been demonstrated by amino acid and sequence analyses of the isolated and carboxymethylated relaxin-A chain. The phenylalanyl relaxin and B29 relaxin are indistinguishable by circular dichroism spectroscopy, in mouse pubic ligament assay, and radioimmunoassay. The occurrence of phenylalanyl relaxin may be caused by an incomplete conversion of prorelaxin to relaxin. PMID- 3970689 TI - Hyperthermia and polyamine biosynthesis: decreased ornithine decarboxylase induction in skin and kidney after heat shock. AB - The effect of hyperthermia treatments on ornithine decarboxylase (ODC) induction in mouse tissue was determined both in vitro and in vivo. In vitro, the addition of 12-0-tetradecanoylphorbol-13-acetate (TPA) to adult mouse skin pieces incubated at 37 degrees C in serum-free MEM led to a dramatic increase in epidermal ODC activity 5 hours following treatment. In contrast, incubation temperatures of 40 degrees C for the entire 5 hour incubation period rendered the skin pieces unresponsive to TPA for ODC induction. This inhibition of ODC induction was not the result of thermal skin kill, inactivation of TPA, or a general effect on epidermal protein synthesis. The inhibition of ODC induction could be reversed by switching the incubation temperature back to 37 degrees C. In vivo, raising the core body temperature in male mice to 41 degrees C for 1 hour resulted in a 78% decrease in kidney ODC activity. The kidney DNA synthesis and protein synthesis remained unaltered following the whole body hyperthermia treatments. PMID- 3970690 TI - Structural identification of platelet activating factor in psoriatic scale. AB - Platelet activating factor was isolated from the lesional scale of psoriatic patients using the method described by Bligh and Dyer (8). The extract was subjected to thin layer chromatography, and the region of the plate co-migrating with platelet activating factor removed. A portion of each sample was assayed for aggregating activity using washed guinea-pig platelets and the remainder treated with phospholipase C, derivatised, and subjected to reversed phase high performance liquid chromatography. Fractions were analysed for platelet activating factor using capillary gas chromatography-mass spectrometry. Nanogram quantities of platelet activating factor were recovered from 100 mg scale and both the C16 and C18 alkyl substituents were present in the ratio 3:1, C16:C18. PMID- 3970691 TI - A screened electrostatic potential model of hydration for conformational analysis of biomolecules. AB - A screened electrostatic potential model of hydration which could avoid the time consuming Monte-Carlo procedures is derived from the study of the dielectric effect of a water molecule in the vicinity of two charges. It is shown that the molecular dielectric constant depends on the distance, sizes and signs of the interacting charges. The model is used to evaluate the hydration energy of the tetrapeptide (TYR-GLY-GLY-PHE) conformations. Results are in good agreement with Monte-Carlo calculations. PMID- 3970692 TI - Formation of pentachlorophenol as the major product of microsomal oxidation of hexachlorobenzene. AB - On incubation of [14C]-hexachlorobenzene with microsomes from livers of rats induced with hexachlorobenzene, the major product (80-90%) was pentachlorophenol. The only other detectable metabolite, tetrachlorohydroquinone (4-15%), was presumably formed from pentachlorophenol. A considerable amount of radioactivity (5-10% of the amount of extracted metabolites) was covalently bound to protein. Microsomes derived from male hexachlorobenzene--induced rats gave by far the highest conversion (approx. 1% of substrate). Microsomes from female hexachlorobenzene--induced rats were 3 times less efficient. Microsomes from untreated and 3-methyl-cholanthrene--treated animals gave less than 5% of the amount of pentachlorophenol formed by microsomes from hexachlorobenzene--induced male rats, while phenobarbital and aroclor 1254-induction resulted in formation of 51% and 34% respectively. PMID- 3970693 TI - Polarized photoacoustic, absorption and fluorescence spectra of chloroplasts and thylakoids oriented in polyvinyl alcohol films. AB - The polarized photoacoustic, absorption and fluorescence spectra of chloroplasts and thylakoids in unstretched and stretched polyvinyl alcohol films were measured. The intensity ratios of fluorescence bands at 674 nm, 700 nm, 730 nm and 750 nm, and the polarized fluorescence excitation spectra are strongly dependent on light polarization and film stretching. In stretched films, thylakoids exhibit predominantly 674 nm emission. The ratio of photoacoustic signal to absorption is different for light polarized parallel and perpendicular to film stretching. This difference is large in the region of chlorophyll a and carotenoids absorption in which the fluorescence excitation spectra are also strongly dependent on light polarization and film stretching. The observed spectral changes are explained by reorientation of pigment molecules influencing the yield of excitation transfer between different pigments. PMID- 3970694 TI - Evidence for Ca++-calmodulin control of transplasmalemma electron transport in carrot cells. AB - Cultured carrot cells exhibit transmembrane ferricyanide reduction through a plasma membrane redox system, which may be associated with an iron reduction and uptake system in plant roots. Here we provide evidence for the inhibition of transplasma membrane ferricyanide reduction by four different Ca2+-calmodulin type antagonists, calmidazolium, trifluoperazine, pimozide and fluphenazine. These compounds inhibit in low concentrations (approximately 5-10 microM) in a time-dependent manner. Higher concentrations (50-100 microM) are required to inhibit transmembrane ferricyanide reduction in 10 min rather than in 30 min. The permeable calcium chelator, TMB-8, also inhibits transmembrane ferricyanide reduction in carrot cells. Since the redox system is controlled by hormones, the effects of anticalmodulin agents on hormone response may be mediated through the redox system. PMID- 3970695 TI - Interaction of morphine and naloxone with mixed monolayers of lecithin and gangliosides. AB - Monomolecular films of lecithin, gangliosides or lecithin/gangliosides mixtures were studied on a Langmuir through in order to examine the interactions between these lipids and opioid agonists or antagonists. Lecithin alone did not interact in a monolayer structure with opioids. However, gangliosides and lecithin/gangliosides mixtures were expanded by both morphine and naloxone. The expansion of ganglioside-containing monolayers was greater with morphine than with the antagonist, naloxone. PMID- 3970696 TI - Effect of monensin on myoblast fusion. AB - Monensin, at a concentration of 0.5-10 microM, completely (100%) and reversibly inhibits fusion of embryonic chick myoblasts in vitro. At the same time, monensin administration leads to a marked accumulation of glycopeptides inside the cells and a decrease of those secreted into the medium. Chromatography of the intracellularly retained glycopeptides on Con A-Sepharose shows that the increase is most pronounced in the high-mannose fraction. Mild proteolysis of cells labeled with [2-3H]mannose releases less radioactivity from the surface of monensin-treated than from control cells, although the amount of total radioactivity is almost four times higher than in the control cells. Since it has now been established that monensin interferes with the intracellular transport of newly synthesized glycoproteins it is assumed that its inhibitory effect is the result of the inability of glycoprotein(s) essential for myoblast fusion to reach the cell surface. PMID- 3970697 TI - An intermediate in cyclic beta 1-2 glucan biosynthesis. AB - Incubation of UDP-[14C]Glc with the inner membranes of Agrobacterium tumefaciens leads to the formation of cyclic beta 1-2 glucan and trichloroacetic acid insoluble compounds. The proteolysis products of the latter show a positive charge in acid and a negative charge in alkaline buffers. The cyclic beta 1-2 glucan and the trichloroacetic acid insoluble compounds yield the same products on partial acid hydrolysis. Addition of excess non-radioactive UDP-Glc to the reaction mixture nearly stops the formation of radioactive beta 1-2 glucan and leads to a rapid fall of radioactivity in the trichloroacetic acid precipitate. Alkaline treatment of the insoluble compounds under conditions of beta elimination leads to the partial release of free saccharides (about 30%). It is concluded that beta 1-2 glucan chains are built up joined to a protein and then released as free cyclic beta 1-2 glucan. PMID- 3970698 TI - Immunoreactive fibroblast growth factor in cells of peritoneal exudate suggests its identity with macrophage-derived growth factor. AB - Peritoneal exudate cells were collected from thioglycollate stimulated mice, extracted an examined for the presence of immunoreactive and bioactive fibroblast growth factor (FGF). The crude extract stimulated in a dose dependent fashion the proliferation of vascular endothelial cells derived from the bovine aortic arch. The extract also showed a parallel and dose-dependent inhibition of binding in a highly specific radioimmunoassay for FGF. The immunoreactive FGF (ir-FGF) contained in the extract was retained on a heparin-sepharose affinity column as is characteristic of pituitary FGF. Reverse-phase HPLC of the macrophage-derived material reveals one biologically active form of FGF which coelutes with the major form of immunoreactivity. The results demonstrate the presence of FGF in these cells and suggest that at least one of the hitherto unidentified mitotic activities in these extracts is due to a mitogen indistinguishable from FGF. PMID- 3970699 TI - Heparinlike molecules with anticoagulant activity are synthesized by cultured endothelial cells. AB - Cultured microvascular endothelial cells isolated from rat epididymal fat pads produce glycosaminoglycans that accelerate thrombin-antithrombin complex formation. The heparinlike nature of these macromolecules was established by complete destruction of their anticoagulant activity employing purified Flavobacterium heparinase. Only 15% of the biologic activity of these complex carbohydrates was expressed when the heparin binding domain on the protease inhibitor was chemically modified at the Trp 49 residue. The anticoagulantly active species contains disaccharides which constitute the unique antithrombin binding region of the mucopolysaccharide. Removal of the biologically active heparinlike components from endothelial cells with 0.05% trypsin suggests that these molecular species are present on the cell surface. PMID- 3970700 TI - Dolichol-sugar derivative synthesis in human breast cancer cell line (T47D). Effects of estrogens and antiestrogens. AB - In the present paper we report evidence about the formation of polyprenyl phosphate monosaccharides, their elongation products and the assembly of dolichyl diphosphate-oligosaccharide to endogenous T47D clone 11 proteins upon incubation with [14C]glucose. The influence of estradiol and two nonesteroidal antiestrogens -nafoxidine and tamoxifen- was examined on the dolichol pathway in T47D cell cultures. Estradiol (1 nM) does not change the rate of synthesis of dolichyl phosphate-sugar derivatives in contrast to nafoxidine and tamoxifen both a micromolar concentration, which induce a remarkable decrease in the formation of dolichol-sugar derivatives. In addition, T47D cells were pretreated with nafoxidine or tamoxifen during one hour, fresh medium supplemented with estradiol was added to the cells simultaneously with [14C]glucose. Results indicated that estradiol after nafoxidine induces a slight increase in the polyprenyl-sugar derivatives formation, however, estradiol after tamoxifen decreases the synthesis of these substances. PMID- 3970701 TI - Different genes code for alkaline phosphatases from human fetal and adult intestine. AB - Alkaline phosphatases from human adult intestine and fetal intestine (meconium) were purified and compared. Electrophoresis in SDS showed one band of protein in the former. There were three bands of protein in the latter, all with essentially the same peptide map. Thus, two of the bands probably arose by proteolysis of the third, which was largest (Mr 73000). In gradient gels of polyacrylamide the alkaline phosphatase from fetal intestine showed only one band of protein coincident with the band of activity (Mr 151000). Radiolabeled mapping showed that the tryptic peptides of the alkaline phosphatase from fetal intestine were distinctly different from those of adult intestine and human liver, and placenta, indicating a gene distinct from the three that code for the enzyme in liver/kidney/bone, placenta, and adult intestine. PMID- 3970702 TI - A re-examination of the effects of chymotrypsin and trypsin on the erythrocyte membrane surface topology. AB - Silver/Coomassie blue staining of human erythrocyte membrane electrophoretograms permits simultaneous visualization and color differentiation of asialoproteins, sialoglycoproteins and lipids in the same gel. Using this technique evidence is provided that chymotrypsin cleaves glycophorin A as well as band 3. The chymotryptic fragmentation pattern of glycophorin A in situ intact cells was different from that generated by trypsin treatment. Chymotryptic cleavage of band 3 generated two Coomassie blue stained fragments at 62,000 and 38,000 Mr, whereas simultaneous cleavage of glycophorin A dimer and glycophorin A B heterodimer yielded yellow silver stained fragments at 68,000 and 47,000 Mr. Trypsin cleaved glycophorin A dimer (88,000 Mr) and monomer (38,000 Mr) to form membrane associated fragments of Mr = 40,000 and 18,000 respectively. PMID- 3970703 TI - Inhibition of binding of the platelet-activating factor AGEPC to platelets by the AGEPC analog rac-3-(N-n-octadecylcarbamoyloxy)-2-methoxypropyl 2-thiazolioethyl phosphate (CV-3988). AB - CV-3988, rac-3-(N-n-octadecylcarbamoyloxy)-2-methoxypropyl 2-thiazolioethyl phosphate, is a specific inhibitor of the platelet-activating activity of 1-O alkyl-2-acetyl-sn-glycero-3-phosphorylcholine (AGEPC or PAFacether). Concentrations of CV-3988 between 10(-8) and 10(-7) M inhibited AGEPC-induced aggregation of washed human platelets in a dose-related manner (IC50 = 2.9 +/- 1.1 X 10(-8) M CV-3988) whereas concentrations of CV-3988 as high as 4 X 10(-6) M did not diminish platelet aggregation by thrombin or adenosine diphosphate. The binding of [3H] AGEPC to platelets was inhibited by CV-3988 in a concentration dependent manner (IC50 = 6.7 +/- 1.8 X 10(-8) M). Compared to AGEPC, CV-3988 has a 1000-fold lower affinity for the AGEPC receptor. CV-3988 did not stimulate platelet metabolism of AGEPC as assessed by thin-layer chromatographic analysis of [3H] AGEPC extracted from platelet suspensions after four hours of incubation. Thus these studies indicate that CV-3988 inhibits platelet activation by AGEPC by inhibiting binding of AGEPC to its specific platelet receptor. PMID- 3970704 TI - Development of transformed phenotype induced by a human ras oncogene is inhibited by interferon. AB - Mouse IFN inhibited the development of transformed foci in NIH 3T3 cultures transfected with the viral Ha-MuSV(ras) and Mo-MuSV(mos) oncogenes, or with the human bladder carcinoma ras EJ/T24 DNA. IFN treatment five or seven days after transfection was still effective in inhibiting the oncogenic transformation, but did not inhibit significantly the biochemical transformation induced by pSV2-neo or Ecogpt DNA, so that inhibition of ras-induced transformation was not a result of a general effect on the transfection process. Treatment with IFN did not alter the expression of ras EJ/T24 DNA after the transformed phenotype had been established. PMID- 3970705 TI - A substrate analog inhibitor for arylsulfatase reduces NK cell cytotoxicity. AB - A synthetic aromatic sulfonate (I), which has been found to be an effective inhibitor of arylsulfatase, reduces NK-cell mediated cytotoxicity by ca. 60% at 10 microM concentration. At lower concentrations the effect is concentration dependent, but no further reduction of cytotoxicity is observed at concentrations above 10 microM. PMID- 3970706 TI - Calcium- and calmodulin-dependent phosphorylase kinase activity in porcine uterine smooth muscle. AB - Porcine uterine smooth muscle phosphorylase kinase has been partially purified. The enzyme was activated about 1.5-2.0-fold by exogenous calmodulin. Half maximal stimulation was observed at about 100 nM calmodulin. The activation was dependent on calcium and was maximum at pH 7.5 in the range of pH from 6 to 9. This activation was completely abolished by 100 microM trifluoperazine. The result suggested that unlike slow and cardiac muscles, phosphorylase kinase of uterine smooth muscle showed similar response to calmodulin with that of fast muscle. The physiological role of the calcium and calmodulin-dependent activation of myometrium phosphorylase kinase is briefly discussed. PMID- 3970707 TI - Membrane regulation of liver and lung microsomes under low oxygen tension. AB - A highly monitorized animal model has been developed for the study of the influence of low oxygen tension on lipid composition, microviscosity and regulation of enzyme activities involved in the phospholipid synthesis of hepatic and pulmonary microsomes. Microviscosity decreased in liver microsomes whereas no difference was shown in that of microsomal membrane core of hypoxemic lung. Nevertheless, phospholipid and cholesterol content of both liver and lung membranes changed significantly. Microsomal membranes of hypoxemic liver increased the unsaturation degree of fatty acids, whereas hypoxemic lung membranes become more saturated, mainly due to the increase of palmitic acid. The adaptive response of lung was confirmed by the high increase of the deacylation reacylation mechanism. PMID- 3970708 TI - Intermembrane linkage mediated by tubulin. AB - Two membranes from brain lipids were formed in the presence of brain tubulin and their electrical potentials were simultaneously measured. When electrical pulses were applied across one of them, displacements of the potential of the other membrane were found even when the membranes were not in contact. This effect was observed only in the presence of polymerized tubulin. It was not found in the presence of depolymerized tubulin or in other control experiments. The findings suggest that the microtubule fiber networks may serve as an interconnecting system between membranes or membrane bounded compartments. PMID- 3970709 TI - Apo E-mediated uptake and degradation of normal very low density lipoproteins by human monocyte/macrophages: a saturable pathway distinct from the LDL receptor. AB - Normal human fasting very low density lipoproteins (n-VLDL; d less than 1.006 g/ml) were demonstrated to be taken up and degraded by human monocyte-macrophages via a saturable process distinct from the previously described LDL and scavenger receptors. Through the use of apolipoprotein-phospholipid complexes, apolipoprotein E (apoE) was identified as the ligand mediating recognition of n VLDL by this receptor. PMID- 3970710 TI - Specific binding of [3H] mepyramine to histamine H1-receptors in the sarcolemma from porcine aorta and coronary artery. AB - We studied the subcellular distribution and the properties of [3H] mepyramine binding in the porcine vascular smooth muscle. A close correlation was observed between the specific binding activity of [3H] mepyramine and the extent of the enrichment of sarcolemmal marker enzyme in 4 subfractions obtained by sucrose density gradient centrifugation of the aortic microsome. In the binding isotherm in the sarcolemmal fractions from the aorta and coronary artery, there was no difference in the Kd value, but the Bmax of the coronary artery was significantly lower than that of the aorta. Thus, there is a single type of high affinity mepyramine binding site in the porcine vascular smooth muscle sarcolemma and the number of H1-receptors of the coronary artery may be smaller than that of the aorta. PMID- 3970711 TI - GAWK, a novel human pituitary polypeptide: isolation, immunocytochemical localization and complete amino acid sequence. AB - During the course of reverse-phase high pressure liquid chromatography (RP-HPLC) purification of a postulated big ACTH (1) from human pituitary gland extracts, a highly purified peptide bearing no resemblance to any known polypeptide was isolated. The complete sequence of this 74 amino acid polypeptide, called GAWK, has been determined. Search on a computer data bank on the possible homology to any known protein or fragment, using a mutation data matrix, failed to reveal any homology greater than 30%. An antibody produced against a synthetic fragment allowed us to detect several immunoreactive forms. The antisera also enabled us to localize the polypeptide, by immunocytochemistry, in the anterior lobe of the pituitary gland. PMID- 3970712 TI - A non-fluorescent complex of chlorophyll a with plastocyanin. AB - A complex between chlorophyll a and plastocyanin has been prepared by dialysis of mixtures of chlorophyll in Triton X-100 micellar solution with the protein. The complex appears to contain no more than one chlorophyll per plastocyanin molecule, and is non-fluorescent, whether the protein is in the oxidized or reduced state. The lack of fluorescence suggests that the chlorophyll is adsorbed very close to the Cu center. PMID- 3970713 TI - pH-dependent conversion of liver-membranous alkaline phosphatase to a serum soluble form by n-butanol extraction. AB - Alkaline phosphatase released from rat liver plasma membrane under usual conditions was electrophoretically not identical with a soluble form in serum which was derived from the liver. The liver-membranous alkaline phosphatase, however, was converted to the serum-soluble form when the liver plasma membrane was treated with n-butanol under the acidic conditions lower than pH 6.5. Such pH dependent conversion of the enzyme was not observed in plasma membrane of rat ascites hepatoma AH-130 cells. The converting activity for alkaline phosphatase was detected not only in plasma membrane but also in lysosomal membrane of rat liver. PMID- 3970714 TI - Binding of sanguinarine to deoxyribonucleic acids of differing base composition. AB - The binding of the alkaloid sanguinarine to natural DNAs of differing GC content has been studied by spectrophotometry and viscometry techniques. Binding parameters determined from spectrophotometric measurements by Scatchard analysis, according to an excluded-site model, indicate a very high specificity of sanguinarine binding to GC rich DNA. In the strong binding region, the increase of contour length of DNA depends strongly on its base composition, being larger with GC rich DNA than with AT rich DNA. It is concluded that the alkaloid binds preferentially to the GC pairs in DNA template. PMID- 3970715 TI - The effects of primaquine stereoisomers and metabolites on drug metabolism in the isolated perfused rat liver and in vitro rat liver microsomes. AB - The effect of the antimalarial drug primaquine, its stereoisomers and its proposed metabolites, on the metabolism of substrates for mixed function oxidase, has been studied in isolated perfused rat livers (IPRL) and/or in vitro microsomal suspension. Following acute administration to an IPRL preparation, racemic primaquine produced a dose related reduction in the hepatic clearance of antipyrine which at the highest dose of primaquine (5.0 mg) represented a decrease to 46% of control values. Antipyrine clearance was reduced to a comparable extent by the (+) and (-) isomers and the racemic mixture (each at a dose of 2.5 mg) with mean reductions of 45, 49 and 47%, respectively. These changes in clearance were reflected by significant increases in half-life relative to control. The apparent volume of distribution of antipyrine was unchanged in all experiments. Racemic primaquine and its (+) and (-) isomers were equipotent in inhibiting aminopyrine N-demethylase activity, producing reductions of 56, 59 and 55%, respectively, relative to control values. These three compounds also produced corresponding reductions of 73, 58 and 73% in ethoxyresorufin O-deethylase activity. The N-acetyl and 5-hydroxy derivative of primaquine produced inhibitory effects comparable to that seen for the parent drug. In contrast the carboxylic acid metabolite of primaquine, 6 desmethylprimaquine and 5-hydroxy-6-desmethyl primaquine did not influence aminopyrine N-demethylase activity. These results indicate that the propensity to inhibit drug metabolism by these primaquine related substances, is influenced by functional group substitution rather than the optical activity of the parent drug. PMID- 3970717 TI - 9th European Workshop on Drug Metabolism. Pont-a-Mousson, France, 11-15 June 1984. PMID- 3970716 TI - Levels of S-adenosylmethionine and S-adenosylethionine in four different tissues of male weanling rats during subchronic feeding of DL-ethionine. PMID- 3970718 TI - Subcellular distribution and properties of a clofibrate-induced aldehyde dehydrogenase from rat liver. AB - The influence of hypolipidemic drug clofibrate on the activity of aldehyde dehydrogenase with different substrates was studied in subcellular fractions of rat liver homogenate. It was shown that under the action of clofibrate the content of the enzyme was increased 2-3-fold in purified peroxisomal fraction as well as in microsomes and mitochondria. No difference was found in the cytoplasmic fraction. Partial purification of clofibrate-induced aldehyde dehydrogenase from microsomes was undertaken. The enzyme is apparently membrane bound. It has a molecular weight of 187,000 and a subunit size of 47,000, indicating that the molecule is a tetramer. An induced aldehyde dehydrogenase is active with several aliphatic and aromatic aldehydes but not with formaldehyde and glyceraldehyde. The enzyme has Km-values in the millimolar range for acetaldehyde, propionaldehyde, benzaldehyde and phenylacetaldehyde and in the micromolar range for nonanal. Both NAD and NADP serve as coenzymes for the purified aldehyde dehydrogenase. According to substrate specificity, kinetic and molecular properties clofibrate-induced aldehyde dehydrogenase appears to be identical to normal liver microsomal enzyme. PMID- 3970719 TI - Excretion pattern and metabolism of hexachlorobutadiene in rats. Evidence for metabolic activation by conjugation reactions. AB - Excretion, covalent binding and metabolism of hexachloro-1,3-butadiene (HCBD), a nephrotoxic and nephrocarcinogenic compound, have been studied in female rats. Seventy-two hours after administration of a single oral dose of 1 mg/kg [14C]HCBD, 5.3% of the dose were exhaled as unchanged HCBD and 76.3% were metabolized and excreted in urine and feces or exhaled as 14CO2. After a 50 mg/kg dose of [14C]HCBD, the amount of exhaled parent compound was nearly unchanged at 5.4%. At the higher dose the gastro-intestinal absorption of HCBD appeared to be saturated with the result that unchanged HCBD constituted the major portion of the 69% radioactivity eliminated. Covalent binding to proteins in kidney and liver agreed well with the organ-specific toxicity of HCBD: binding was higher in the kidney, independent of the dose. It increased significantly when the rats were pretreated with phenobarbital, an inducer of monooxygenases; it decreased when the inhibitor piperonyl butoxide was given. Urinary radioactivity in 24 hr urine was separated by column chromatography into four fractions. High performance liquid chromatography, radio gas chromatography and gas chromatography/mass spectrometry were used for further separation and identification. Two major metabolites were identified as pentachlorobutadiene methylthio ether and pentachlorobutadiene carboxymethylthio ether. Their formation is plausibly explained via glutathione conjugation, which appears to be the first step in HCBD metabolism. The mechanism of the conjugation at the olefinic double bond of HCBD is explained by an addition-elimination reaction. This pathway, which appears to lead to a destabilization of the HCBD molecule, could explain the distinct nephrotoxic effects of HCBD. PMID- 3970720 TI - Heterogeneity of rabbit hepatocytes for bile secretion after acinar zone 3 damage induced by bromobenzene. Effect of bilirubin and bile salt infusions. AB - Anaesthetized rabbits were used to study the effect of bromobenzene-induced hepatic damage to the acinar zone 3 on bile flow, bile salt, sodium secretion as well as bilirubin transport in basal conditions or with infusion of sodium glycodeoxycholate. The bromobenzene-pretreated animals exhibited in basal conditions a lower bile flow (44%) than that of the controls, with a smaller decrease in bile salt output (27%) and sodium output (29%), whereas no modification in endogenous bilirubin excretion was observed. The bile salt independent fraction of secretion (BSIF) was reduced significantly after the toxic lesion both in terms of absolute and relative values. The hepatocytes of the periportal zone were capable of excreting the totality of bilirubin presented to the liver, regardless of the extent of bile flow or the input of bile salts. The infusion of bilirubin at 1.0 mumole/kg/min led to a fall in bile flow which was attributed to the interference of the pigment with the BSIF. The maximal bilirubin excretion was significantly smaller in bromobenzene-pretreated animals than in the controls, which could be due to the incapacity of the intoxicated rabbits to recruit quiescent hepatocytes. When glycodeoxycholate was administered under conditions of maximal bilirubin transport, bile flow increased as did bile salt secretion in both controls and animals with damaged livers. However, clear differences persisted between the two, which could be attributed not only to the volume fraction of necrosis but also to an interference by bilirubin with the hepatic handling of bile salts. Maximal bilirubin excretion increased in a similar way in both groups after glycodeoxycholate administration. It is proposed that glycodeoxycholate infusion facilitates the hepatic depletion of bilirubin, probably by stimulating transport processes. PMID- 3970721 TI - Potentiation of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU)-induced cytotoxicity in 9L cells by pretreatment with 6-thioguanine. AB - 9L Rat brain tumor cells were treated with 0.2 microM 6-thioguanine for 48 hr, which produced a 40% cell kill, a small (15%) inhibition of cell growth, and an accumulation of cells in S-phase. Maximum incorporation of [14C]6-thioguanine into cellular DNA occurred after 24 hr of incubation; 70% of the label was incorporated into DNA as 6-thio-2'-deoxyguanosine. Pretreatment of 9L cells for 48 hr with 0.2 microM 6-thioguanine potentiated the cytotoxicity of 1,3-bis (2 chloroethyl)-1-nitrosourea (BCNU) by 50% with a dose enhancement ratio of 1.5, and caused a 30% increase in the number of BCNU-induced sister chromatid exchanges (SCEs) and a 50% increase in DNA crosslinks formed, compared to treatment with BCNU alone. Used as a single agent, 6-thioguanine induced a significant number of SCEs. Results suggest that these effects may be related to the increased formation of DNA crosslinks, possibly as the result of the formation of S6-(2-chloroethyl)-6-thioguanine in cellular DNA. PMID- 3970722 TI - The effects of acetaldehyde and 2,3-butanediol on rat embryos developing in vitro. AB - The embryotoxicity of two ethanol metabolites, acetaldehyde and 2,3-butanediol, have been examined in cultured 10-day Albino Wistar rat embryos over a 2-day period. At acetaldehyde concentrations of 100 and 260 microM, no significant effects were observed on embryonic protein, DNA, somite development, gross morphology, or viability. 800 microM was overtly toxic causing rapid death and necrosis. 2,3-butanediol at a culture medium concentration of 25 mM had no effect on any of the above parameters. The significance of these results in relation to other animal experiments with these compounds and possible ramifications regarding the aetiology of the human Fetal Alcohol Syndrome are discussed. PMID- 3970723 TI - Activation and inactivation of bovine caudate acetylcholinesterase by trivalent cations. AB - Kinetic analysis of the interaction of trivalent cations with mammalian brain acetylcholinesterase revealed at least three distinct concentration-dependent effects on enzyme activity. Acetylcholinesterase was purified from bovine caudate nucleus by affinity chromatography to a specific activity of 1.1 mmoles acetylthiocholine X hr-1 X (mg protein)-1. The cations studied included the chloride salts of lanthanum, terbium, yttrium and scandium in low and high ionic strength buffers (2 mM Pipes +/- 0.1 M NaCl). At low ionic strength, high affinity noncompetitive or allosteric activation was observed at very low cation concentrations (1-10 microM); at higher concentrations (50-200 microM) these cations were noncompetitive inhibitors; and at 200-500 microM they exerted a mixed competitive-noncompetitive inhibition. Activation by low cation concentrations was not evident in high ionic strength buffers, while enzyme inhibition by all the trivalent cations was similar at low and high ionic strength. Inhibition by all of the multivalent cations was fully reversed by a 10 fold excess of EDTA or by a 100-fold dilution of the inhibited enzyme. The water soluble carboxyl group affinity reagent, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide, was shown to specifically block the activating effect of the multivalent cations supporting the suggestion that the beta- or "activator" peripheral anionic sites (P1) involve a carboxyl group outside the enzyme active site. PMID- 3970724 TI - Effect of aryl hydrocarbon hydroxylase induction on the in vivo covalent binding of 1-nitropyrene, benzo[a]pyrene, 2-aminoanthracene, and phenanthridone to mouse lung deoxyribonucleic acid. AB - The effect of aryl hydrocarbon hydroxylase induction on the covalent binding of 1 nitropyrene (1-NP), benzo[a]pyrene (BaP), 2-aminoanthracene (2-AA), and phenanthridone (PNDO) to mouse lung DNA was investigated. Cytochrome P-450 dependent monooxygenases were induced in mouse lung by intratracheal instillation of BaP, Aroclor-1254, or coal gas condensate (CGC) 24 hr before instillation of [3H]BaP, [3H]-2-AA, [14C]-1-NP, or [14C]PNDO. All inducing agents increased the amount of radioactivity of [3H]BaP, [3H]-2-AA, and [14C]-1-NP or metabolites bound to DNA. However, pretreatment with BaP resulted in the highest amounts of radiolabels covalently bound to DNA. At 4 hr after instillation of radiolabels in BaP-induced mice, the amounts of [3H]BaP, [3H]-2-AA, and [14C]-1-NP bound to DNA were increased 5.4-, 5.2-, and 160-fold above that of control levels; the amount of 1-NP bound to DNA was fifty times higher than the amount bound by BaP. Labeled compounds were still bound to DNA 1 week after administration. [14C]PNDO was not bound to DNA in uninduced or induced mice. Based on the amount of labeled compounds bound to DNA, pretreatment of mice with BaP and CGC induced enzymes with similar specificities; however, enzymes induced by Aroclor were less effective in the metabolism of labeled compounds to DNA-bound products. These data show that specific cytochrome P-450-dependent monooxygenases are inducible in mouse lung and suggest that pre-exposure to inducing agents may be important in the potential toxicity to proximal tissues in direct contact with inhaled xenobiotics. PMID- 3970725 TI - Amelioration of cyclosporin-induced nephrotoxicity in rats by induction of hepatic drug metabolism. AB - The aim of this study was to determine the effect of altered hepatic drug metabolism on the nephrotoxic and immunosuppressive properties of cyclosporin A (CsA) in the rat. From a consideration of the structures of those CsA metabolites identified so far, it seemed probable that the metabolism of CsA would occur at the hepatic cytochrome P-450 (cyt P-450) enzyme system. CsA (50 mg/kg/24 hr) administered orally for 14 days resulted in significant increases in both serum urea concentration and urinary N-acetyl-beta-D-glucosaminidase activity, accompanied by renal proximal tubular vacuolation. The concomitant administration of either Aroclor 1254 (25 mg/kg/24 hr, i.p.) or phenobarbitone (PB) (40 mg/kg/24 hr, i.p.) but not 3-methylcholanthrene (3-MC) (15 mg/kg/72 hr, i.p.) resulted in abolition of the nephrotoxicity, assessed both biochemically and histologically, whilst the suppressive effect on the humoral response to SRBC was unaltered. Phenobarbitone also significantly decreased serum CsA concentrations. These results suggest that the PB-inducible set of cyt P-450 isoenzymes may be responsible or partly responsible for hepatic CsA metabolism. PMID- 3970726 TI - Disappearance of sex difference in rat liver drug metabolism in old age. PMID- 3970727 TI - Modulation of thyroid hormone actions on hepatic drug metabolism by androgens and estrogens. PMID- 3970728 TI - Liver regeneration after carbon tetrachloride intoxication in the rat. PMID- 3970729 TI - Trihexyphenidyl--further evidence for muscarinic receptor subclassification. PMID- 3970731 TI - The binding of antihistone antibodies to Crithidia luciliae kinetoplasts is growth cycle-dependent. AB - The Crithidia luciliae immunofluorescence (CLIF) assay is widely used to test for native DNA (nDNA) antibodies in the diagnosis and management of systemic lupus erythematosus. However, sera from patients with drug-induced lupus erythematosus or rheumatoid arthritis, which should not contain nDNA antibodies, occasionally react with the CL kinetoplast. We examined 36 sera from patients with systemic lupus erythematosus, rheumatoid arthritis, Sjogren's syndrome, and drug-induced lupus erythematosus, who had positive CLIF tests. All 36 sera were also antinuclear antibody-positive with homogeneous and/or peripheral staining patterns on mouse kidney substrates. After hydrochloric acid extraction of the CL smears to remove histone and other nuclear protein antigens, 14 of the 36 sera no longer produced a positive result on the CLIF test. Ten of these 14 sera again gave a positive CLIF result after the hydrochloric acid-extracted Crithidia substrate had been reconstituted with purified histone. These studies demonstrated that kinetoplast binding was due to antihistone antibodies in at least 10 of 36 initially CLIF-positive sera. Antihistone antibodies were then purified with a histone-affinity column, and these purified antibodies were reactive with CL kinetoplasts. Thus, the CLIF test is not specific for nDNA antibodies. Additional studies using CL from different days of culture indicated that histone antigen expression in the CL kinetoplast was a function of the life cycle of this organism and is most readily detected 2 days after initiation of culture. PMID- 3970730 TI - HLA gene frequencies in children and adults with systemic onset juvenile rheumatoid arthritis. AB - The HLA genetic region was studied in 51 patients with systemic onset juvenile rheumatoid arthritis: 35 with childhood onset and 16 with adult onset (adult Still's disease). HLA genotypes were established by including family members, 261 of whom were also typed in the study. The most marked difference between patients and controls involved the HLA-DR4 gene, which occurred with a frequency of 0.348 in the childhood onset patients and 0.170 in the controls (chi 2 = 8.97, P = 0.0028, adjusted P = 0.017). In contrast, the adult onset patients showed a marginal increase in HLA-DR7, but were similar to controls with respect to HLA DR4. HLA-Bw35 was increased in children with systemic onset disease, in accordance with earlier findings. The results suggest that patients with systemic onset juvenile rheumatoid arthritis have complex HLA associations which are different in childhood onset and adult onset disease. PMID- 3970732 TI - Abnormal calcium and magnesium stores in erythrocytes and granulocytes from patients with inflammatory connective tissue diseases. Relationship to inflammatory activity and effect of corticosteroid therapy. AB - The mass fraction of Ca and Mg in isolated erythrocytes and granulocytes was measured using the nuclear microprobe technique. Conspicuous abnormalities were observed in cells from patients with rheumatoid arthritis and other inflammatory arthritides. Compared with the normal cellular content, total Ca was increased an average of 3 times in erythrocytes and 5 times in granulocytes. Total granulocyte Mg was increased about 3 times, whereas erythrocyte Mg was reduced to as much as 60% of normal. These abnormalities were less prominent or were absent in scleroderma patients, except for levels of granulocyte Ca, which were increased more than 3 times beyond normal in this patient group. A significant positive correlation was found between serum haptoglobin and erythrocyte or granulocyte Ca content among these patients, but not between haptoglobin and erythrocyte or granulocyte Mg values. During corticosteroid treatment, a significant increase in erythrocyte Mg and a significant reduction in erythrocyte Ca were noted, but normalization of these levels was not achieved. Granulocyte Ca was also significantly reduced, while granulocyte Mg remained unaltered. Serum levels of Ca and Mg were within normal ranges and were not influenced by corticosteroid therapy. The results indicate that at least Ca abnormalities in erythrocytes and granulocytes are associated with the intensity of the inflammatory process and that the amounts of Ca and Mg in these cells are influenced by potent antiinflammatory therapy. PMID- 3970733 TI - Circulating natural killer cells in Sjogren's syndrome. AB - Reduced natural killer (NK) cell activity of peripheral blood lymphocytes (PBL) has been reported in a number of diseases including Sjogren's syndrome (SS). In this study, we used 2 monoclonal antibodies directed toward NK cells (anti-Leu-7 and anti-Leu-11) for determining NK cell activity in 29 patients with SS (9 with primary SS and 20 with secondary SS). The NK activity of PBL was simultaneously determined by the 51Cr release method using K562 as target cells. Contrary to previous reports, we did not find reduced NK activity of PBL in our patients compared with sex- and age-matched healthy controls. Although the percentage of Leu-7+ cells was significantly higher in the patients than in the controls (P less than 0.05), the absolute number of circulating Leu-7+ cells was not different between the groups. The percentage of Leu-11+ cells, however, was not significantly different between the patients and the controls, but the number of circulating Leu-11+ cells was significantly fewer in the patients than in the controls (P less than 0.05). Between the primary and secondary SS groups, no significant differences were found in NK cell activity or in the percentage of Leu-7+ or Leu-11+ cells. Furthermore, we found a significant correlation of NK activity with the percentage of Leu-11+ cells (P less than 0.05) in the controls as well as the SS patients, although a significant correlation was not identified between NK activity and the percentage of Leu-7+ cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3970735 TI - Postgastrectomy blind loop syndrome and the arthritis-dermatitis syndrome. PMID- 3970736 TI - Bone crisis of Gaucher's disease due to bone ischemia: a case report. PMID- 3970734 TI - Soluble mediators from mononuclear cells increase the synthesis of glycosaminoglycan by dermal fibroblast cultures derived from normal subjects and progressive systemic sclerosis patients. AB - Dermal fibroblast cultures from patients with progressive systemic sclerosis (PSS) synthesize up to 5 times more glycosaminoglycan (GAG) than normal cultures. In an in vitro model of fibroblast-lymphocyte interactions, we show that the supernatants of activated mononuclear cells (MNC) modulate GAG synthesis, as measured by the incorporation of 3H-glucosamine into GAG following incubation of the confluent fibroblast monolayers with active supernatant preparations. GAG accumulation was selectively increased up to 18 times in normal dermal fibroblast cultures. Cell viability was not affected, and 3H-thymidine uptake and cell numbers were depressed in cultures treated with the supernatants. In contrast to normal dermal fibroblast cultures, PSS fibroblasts responded to MNC supernatants by only a 1-2-fold increase in GAG. Supernatants of concanavalin A-activated PSS MNC had higher stimulatory activity than those of normal MNC. Supernatants made with MNC that had been depleted of monocytes on Sephadex G-10 columns were only minimally stimulatory. The GAG-stimulatory supernatants modulated the synthesis, but not the degradation of GAG. Gel filtration on a calibrated Sephadex G-100 column indicated the presence of stimulatory activity in both the 50,000 and 15,000 molecular weight fractions. These activities were trypsin-sensitive, but had different susceptibilities to heat. The active column fractions also contained interleukin-1 activity, as shown in an assay measuring proliferation of mouse thymocytes. Like our factors, interleukin-1 preparations increased GAG in normal and PSS dermal fibroblasts. Products of activated MNC may modulate normal and pathologic processes in human skin. PMID- 3970737 TI - Multicentric reticulohistiocytosis: a cause of dysphagia with response to corticosteroids. PMID- 3970738 TI - A followup study of children exposed to gold compounds in utero. PMID- 3970739 TI - Correction of data on salicylate and indomethacin concentrations in cartilage. PMID- 3970740 TI - Renal malakoplakia and systemic lupus erythematosus. PMID- 3970741 TI - Pregnancy and systemic sclerosis. PMID- 3970742 TI - Coexistent rheumatoid arthritis and gout. PMID- 3970743 TI - Epidemiology of juvenile arthritis in Rochester, Minnesota. PMID- 3970744 TI - Hyodeoxycholic acid: a new approach to gallstone prevention. AB - Hyodeoxycholic acid and its isomer, 6 beta-hyodeoxycholic acid, when added to a lithogenic diet prevented the formation of cholesterol gallstones and crystals in prairie dogs. This beneficial effect occurred in the presence of bile supersaturated with cholesterol. Hyodeoxycholic acid abolished the feedback inhibition of hepatic hydroxymethylglutaryl coenzyme A reductase activity, the rate-limiting enzyme of cholesterol synthesis, and prevented elevations in serum and liver cholesterol observed in animals fed a 0.4 percent cholesterol diet. The gallbladder bile of the animals fed hyodeoxycholic acid and 6 beta-hyodeoxycholic acid contained abundant liquid crystals. This suggests that these bile acids prevented the transition of cholesterol from its liquid crystalline phase to solid crystals and stones. PMID- 3970745 TI - Coronary perfusion pressure during cardiopulmonary resuscitation. AB - Currently, there is no way to measure the effectiveness of cardiopulmonary resuscitation in humans. The literature suggests that minimum aortic diastolic and estimated coronary perfusion pressures during cardiopulmonary resuscitation (CPR) in the animal model correlate with higher resuscitation rates. Six patients were studied during CPR to determine the arterial diastolic and estimated coronary perfusion pressures (arterial minus right atrial diastolic pressures). Mean arterial pressures were 27/11 mm Hg, central venous pressures were 32/10 mm Hg, and the mean estimated coronary perfusion pressure was only 1 mm Hg. None of the six patients survived. This study demonstrates that the techniques of measuring hemodynamic values during CPR is practical. Poor estimated coronary perfusion pressures were obtained from the six patients studied. This study should be extended to include a large number of patients to determine whether these hemodynamic parameters can be used as prognostic indicators of successful resuscitation in humans. PMID- 3970746 TI - The impact of a physician-staffed mobile intensive care unit. AB - In the United States, mobile intensive care units (MICU) staffed by paramedical personnel are the means by which virtually all patients are transported to hospitals. However, in many other countries, MICUs are physician-staffed. The role of physicians in the MICU in delivering emergency pre-hospital care in Israel was examined. In one year's experience on a physician-attended MICU, 1,200 of 3,919 patients (31%) were definitively treated in the pre-hospital phase and not transported to a hospital facility. A careful follow-up of these patients is reported. In 235 cases death was pronounced by the MICU physician, and the patient was not transported. In 965 cases, the problem was diagnosed and the patient treated without a referral for further immediate treatment. Follow-up was obtained for 869 (90%) of these patients, of whom 843 (97%) required no additional emergency attention during the 48-hour follow-up period. The use of a physician-attended MICU reduces the service load on emergency departments. PMID- 3970747 TI - The use of antibiotics in the initial management of recent dog-bite wounds. AB - The use of antibiotics in the initial management of dog-bite wounds presented within eight hours of injury was studied. Of 211 wounds occurring in 150 patients seen during the study period, 66 wounds occurring in 33 patients comprised the study sample. All wounds were managed according to a strict protocol that included cleaning, debridement, and pressure irrigation. The wounds studied were randomly assigned to either an antibiotics (penicillinase-resistant penicillin or erythromycin) or placebo group. Two of the 35 antibiotic-treated wounds became infected, and three of the 31 placebo-treated wounds became infected. There was no significant difference in outcome between antibiotic and placebo groups. Hand wounds became infected significantly more often than other wounds. The administration of a penicillinase-resistant antibiotic is not indicated in the initial management of dog-bite wounds presented within eight hours of injury. PMID- 3970748 TI - Methanol poisoning complicated by myoglobinuric renal failure. PMID- 3970749 TI - Extensive isolated inferior vena caval injury following blunt trauma. AB - A patient with an isolated blunt-trauma laceration involving almost the entire infrarenal vena cava was successfully treated by ligation and resection without sequelae. Diagnostic and therapeutic aspects of the injury are discussed. PMID- 3970750 TI - The effect of time since training on house officers' retention of cardiopulmonary resuscitation skills. AB - Currently, the American Heart Association (AHA) recommends that physicians be certified in cardiopulmonary resuscitation (CPR) every two years. This study was undertaken to determine the effects of time since training on retention of CPR skills of physicians and to identify at what point performance deteriorates to a level requiring retraining with supervised practice. The physicians' performance of CPR one year or less after training was compared with that of more than one year after training. Thirty-three medical residents who had been taught CPR by the same instructor were tested without warning for one-person CPR on a recording mannikin. Performance was evaluated according to AHA Heartsaver criteria. The data were analyzed by organizing all CPR steps or behavioral objectives into three categories: assessment, skills (which included ventilation and compression), and sequence (which included calls for assistance). The data suggest that the knowledge of CPR sequence remains stable and that assessment improves while skill performance deteriorates after one year. This apparent contradiction in overall CPR performance may relate to the effect of experience. Assessment may improve because of involvement in actual resuscitations in the hospital. Deterioration of skills may reflect the fact that senior residents do not actually perform CPR, but become team leaders and thereby lose their skills, or that poor performance is not corrected in actual "code" situations. If a two year certification standard is maintained, CPR skill testing at least every 12 months should be considered. If skills have deteriorated, hands-on-practice should be undertaken at that time. PMID- 3970751 TI - Salicylate-induced pulmonary edema: clinical characteristics in children. AB - A five-year retrospective study of pediatric salicylate intoxications (serum level greater than 300 micrograms/ml) revealed that 2/20 patients developed salicylate induced pulmonary edema. These patients had significantly higher initial anion gaps (P less than 0.02) and serum salicylate determinations (P less than 0.001) and tended to be younger with lower initial serum potassium and arterial carbon dioxide measurements. Both patients in the salicylate-induced pulmonary edema group died, whereas none in the non-pulmonary edema group died. Unlike other reports, these data suggest that pulmonary edema is not rare in severe pediatric salicylate ingestion and correlates with high serum salicylate levels and anion gaps. Early, aggressive detoxification, supportive therapy, and hemodynamic monitoring would appear to be indicated in these patients. PMID- 3970752 TI - Thermal injury caused by hot pack application in hypothermic children. PMID- 3970753 TI - Gas gangrene, diabetes, and cholecystitis. PMID- 3970754 TI - Clinically significant methemoglobinemia from inhalation of isobutyl nitrite. PMID- 3970756 TI - Removal of esophageal foreign bodies using a Foley catheter in adults. PMID- 3970755 TI - Trauma and hypothermia. PMID- 3970757 TI - Controlled clinical trials in emergency medicine. AB - In this first article of a series on controlled clinical trials in emergency medicine, an overview of the structure of such studies and the relevant issues related to study design, data generation, statistical analysis, and reporting are presented. The importance of precise patient selection, randomization and stratification, blinding, and equivalent therapeutic intervention in study design has been discussed. In addition, precise outcome and measurement criteria, assessor qualifications, deficiencies in data, appropriate sample-size selection, and reporting are also presented. Although an idealized framework for the conduct and analysis of a controlled clinical trial is provided, it should be appreciated that design and analytical compromises may at times be difficult to avoid in clinical research. Future articles in this series will discuss randomization in clinical trials, alternatives to randomization, beta error and sample-size determination, the statistical and analytical issues related to imperfections in the execution of a trial, and issues related to the reporting of clinical trials. PMID- 3970758 TI - The acute asthmatic in the emergency department: the decision to admit or discharge. PMID- 3970759 TI - Emergency hospital infrastructure in Belgium. PMID- 3970760 TI - The emergency medical system in Japan. PMID- 3970761 TI - Physician-staffed mobile ICUs. PMID- 3970762 TI - A call to study improved cardiac life support. PMID- 3970763 TI - Clinicians and research. PMID- 3970764 TI - Low-energy defibrillation: safe and effective. AB - During cardiopulmonary bypass, 150 cardiac surgical patients were prospectively evaluated for the number, energy, current, and success rates of direct current (DC) shocks required to terminate reperfusion ventricular fibrillation (1 degree) or ventricular fibrillation occurring subsequent to a nonfibrillatory reperfusion rhythm (2 degrees). Thirty-one percent of 1-J shocks and 58% of 2.5-J shocks defibrillated. Above 2.5 J, the defibrillation success rate reached a plateau of 50-60%. Myocardial resistance decreased significantly after the first shock but remained stable during subsequent shocks. Lower defibrillating currents and myocardial resistances than had been previously reported were observed. The feasibility of low-energy defibrillation during cardiopulmonary bypass was therefore documented. PMID- 3970765 TI - Pathological aspects of transcutaneous cardiac pacing. AB - Although electrical energy has the potential to produce myocardial injury, the risk of tissue damage from transcutaneous cardiac pacing is largely unknown. This study reports the anatomical findings of a canine transcutaneous stimulation study. Ten dogs had 100-mA, 20-msec (pulse duration), transcutaneous impulses delivered across the thorax for 30 minutes at a rate of 80 stimuli per minute. Seventy-two hours later the animals were sacrificed, and the heart, lungs, and tissues of the chest wall were examined for pathological changes. Gross and microscopic lesions consistent with electrically induced myocardial damage were found in all hearts examined. These lesions included myocardial pallor and focal myofibril coagulation necrosis in the right ventricular outflow tract and perivascular microinfarcts in the posterior left ventricular myocardium. These lesions were not extensive; less than 5% of the right ventricular free wall and less than 1% of the left ventricular posterior wall were involved. Lesions of this extent would not be expected to cause clinically detectable changes in cardiovascular status. Short-term use of transcutaneous pacing appears to be safe. Determination of the potential for clinically significant injury with long term use requires further study. PMID- 3970766 TI - Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. AB - Records on 1,297 people with witnessed out-of-hospital cardiac arrest, caused by heart disease and treated by both emergency medical technicians (EMTs) and paramedics, were examined to determine whether or not early cardiopulmonary resuscitation (CPR) initiated by bystanders independently improved survival. Bystanders initiated CPR for 579 patients (bystander CPR); for the remaining 718 patients, CPR was delayed until the arrival of EMTs (delayed CPR). Survival was significantly better (P less than 0.05) in the bystander-CPR group (32%) than in the delayed-CPR group (22%). Multivariate analysis revealed that the superior survival in the bystander-CPR group was due almost entirely to the much earlier initiation of CPR (1.9 minutes for the Bystander-CPR group and 5.7 minutes for the delayed-CPR group; P less than 0.001). There were significantly more people with ventricular fibrillation (VF) in the bystander-CPR group (80%) than in the delayed-CPR group (68%); and, for people in VF, the survival rate was significantly better if they had received bystander-CPR (37% versus 29%). The authors conclude that early initiation of CPR by bystanders significantly improves survival from out-of-hospital cardiac arrest, and they suggest that it may do so by prolonging the duration of VF after collapse and by increasing cardiac susceptibility to defibrillation. The benefit of this early CPR, however, appears to exist within a rather narrow window of effectiveness. It must be started within 4-6 minutes from the time of collapse and must be followed within 10-12 minutes of the collapse by advanced life support in order to be effective. PMID- 3970767 TI - Lactic acidosis as a predictor of downtime during cardiopulmonary arrest in dogs. AB - Studies have shown that over 50% of cardiovascular deaths occur before hospitalization. A major factor associated with survival in cases of out-of hospital cardiac arrest is the time from cardiovascular collapse to the initiation of cardiopulmonary resuscitation (CPR) or "downtime." The purpose of this study was to determine whether blood lactate levels could be used to predict downtime in the canine cardiac arrest model. Femoral arterial and Swan-Ganz catheters were placed in 22 mongrel dogs, and ventricular fibrillation was electrically induced. The dogs remained in ventricular fibrillation without ventilation for 5, 10, 15, 30, or 60 minutes. After the predetermined fibrillation time, a left anterolateral thoracotomy was performed, and open-chest cardiac massage was begun. Arterial and mixed venous lactate levels were determined for every 5 minutes during 30 minutes of cardiopulmonary resuscitation. The correlation coefficient between the mixed venous and arterial lactate levels was 0.96 or greater during all stages of resuscitation. Peak serum lactate level increased linearly in relation to downtime. The increase in lactate level was not evident until after CPR was begun, and it remained at peak levels or decreased insignificantly, despite optimal open-chest CPR. Linear regression analysis revealed that 84% of the variability in serum lactate levels could be explained by downtime differences. In this model, blood lactate level is a reliable and objective measure of downtime and may be a useful indicator of the adequacy of CPR if levels decrease or remain stable. The clinical implications of this study lie with the use of blood lactate levels in the emergency department to guide the aggressiveness of resuscitative efforts. PMID- 3970768 TI - Rapid change in pulmonary vascular hemodynamics with pulmonary edema during cardiopulmonary resuscitation. AB - Previous studies have shown that pulmonary edema occurs in half of all pre hospital cardiac arrest victims who cannot be successfully resuscitated and is a major cause of hypoxemia and poor lung compliance during resuscitation. Pulmonary vascular hypertension and elevation of pulmonary capillary wedge pressure have been observed during cardiac resuscitation in humans. To further define the time course of the pulmonary hemodynamic changes, pulmonary artery diastolic pressure (PAd) was measured on a computerized trend recorder prior to, during, and immediately after arrest in three adult patients. Prior to arrest, PADP was 20.9 +/- 3.1 mm Hg. The PADP rose in all three patients by an average of 30.6% after 5 10 minutes and 71.3% after 10-15 minutes of CPR. Peak PADP reached 35.8 +/- 5.1 mm Hg (difference from pre-arrest level significant, P less than 0.001). In both patients who were resuscitated successfully, the PADP returned to baseline within 5 minutes of effective spontaneous circulation. The finding that such hemodynamic changes occur rapidly during resuscitation and can reverse quickly with resumption of effective spontaneous circulation is consistent with the time course for the early development of pulmonary edema. Development of pulmonary edema many hours following successful resuscitation likely involves other mechanisms. PMID- 3970769 TI - Pre-hospital IAC-CPR versus standard CPR: paramedic resuscitation of cardiac arrests. AB - Recent studies evaluating interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR) have demonstrated a significant increase in cardiac output, mean arterial pressure, and cerebral perfusion, as compared with standard CPR. A clinical evaluation of IAC-CPR effectiveness on resuscitation outcome has not been reported. A prospective randomized study comparing IAC-CRP with standard CPR for resuscitation of prehospital cardiopulmonary arrest was undertaken using the Milwaukee County Paramedic System. The patients were randomized following endotracheal intubation into IAC-CPR and standard CPR groups. Since October 1983, 291 patients have qualified for the study group. Of these, 146 patients had standard CPR, and 45 (31%) were successfully resuscitated. Of the 145 patients treated with IAC-CPR, 40 (28%) were successfully resuscitated. Chi-square analysis reveals no significant difference between these groups. To determine whether abdominal compression increases regurgitation, the frequency of emesis before and after intubation was analyzed. No significant difference was found between the IAC-CPR and standard CPR groups. Thus, IAC-CPR applied by paramedics in the field to patients following intubation does not improve cardiac resuscitation rates. PMID- 3970770 TI - Improved short-term neurological recovery with flunarizine in a canine model of cardiac arrest. AB - A 10-minute cardiac arrest was produced in dogs by electrical fibrillation of the heart. Recovery of cerebral function was monitored by estimating the cerebral metabolic rate of oxygen consumption (CMRO2), cerebral blood flow (CBF), electroencephalograph (EEG) and extent of neurological deficit. The study group received flunarizine (0.1 mg/kg intravenously) at the beginning of resuscitation, while control animals were given the drug vehicle. By four hours after resuscitation, CMRO2 in flunarizine-treated dogs was 121 +/- 43% of pre-arrest baseline, as compared with 37 +/- 9% in control animals (P less than 0.02). In the flunarizine group, CBF was 83 +/- 21% of baseline, while it was only 31 +/- 8% in controls (P less than 0.01). As compared with the control group, no other significant changes were detected in electrocardiographic, hemodynamic, or biochemical parameters in the flunarizine-treated dogs. A significant improvement in the visual EEG score (P less than 0.001) and neurological deficit (P less than 0.05) was seen in flunarizine-treated dogs six hours after ischemic insult. PMID- 3970771 TI - Effect of interposed abdominal compression during CPR on central arterial and venous pressures. AB - Despite the problems inherent in estimating blood flow from pressure, determination of systolic arterial pressure during cardiopulmonary resuscitation (CPR) is common and probably valuable as an indicator of potential systemic flow. The addition of interposed abdominal compression (IAC) to closed-chest CPR has been promoted because of its potential to increase systolic arterial pressure during CPR. Interposed abdominal compressions have also reportedly increased diastolic arterial-central venous pressure difference (DA-DCVP) and, thus, have the potential to increase coronary vascular flow. Two distinct methods of CPR were studied in conjunction with IAC. In six humans, there was no significant increase late in the resuscitative process in systolic arterial pressure or in DA DCVP difference with IAC as compared with the two methods of CPR studied without IAC. PMID- 3970772 TI - Epicardial versus parietal pericardial defibrillation. AB - This study evaluated the energy requirements for porous electrodes implanted on the parietal pericardium versus those for porous electrodes implanted on the epicardial surface of the heart. Defibrillation with a 2.5-cm porous electrode implanted on the parietal pericardium was successful in 42% of all episodes of ventricular fibrillation. The minimal energy requirement ranged from 30-68 J, with an average of 46 J. Epicardial defibrillation was successful in approximately 80% of all episodes. The average maximal energy was 21.3 J. There was histological evidence of subepicardial damage in the parietal defibrillation group. This may be related to the higher energy required to defibrillate in this group. However, in this group frequent, large, external shocks were required to defibrillate the dogs' hearts. Theoretically, there may be some physiological and surgical advantages to an intact pericardium. However, the high energy requirement and the low success rate for defibrillation with a porous electrode on the parietal pericardium negate the feasibility of this route of defibrillation with a permanent implantable system. PMID- 3970773 TI - Abdominal counterpulsation in cardiopulmonary resuscitation: animal models and theoretical considerations. AB - Abdominal counterpulsation improves blood flow during otherwise standard CPR in animal models and in electronic models of the circulation. The method generates both central aortic and central venous pressure pulses. Success depends upon maximizing the former and minimizing the latter. Solution of a simple, first order, differential equation may provide insight into proper technique. The equation suggests that the central arteriovenous pressure difference is maximized when pressure is applied directly over the abdominal aorta and when fluid loading is avoided. Proper technique may be critical in generating the largest possible arteriovenous pressure difference. PMID- 3970774 TI - Cardiac arrest: lessons from the Fifth Purdue Conference. PMID- 3970775 TI - Impressions from the Fifth Purdue Conference: it's time to re-emphasize defibrillation. PMID- 3970776 TI - [Short latency somatosensory evoked potentials in children with congenital central nervous system disorders]. PMID- 3970777 TI - [A follow-up study of 1007 epileptic children with anticonvulsant therapy]. PMID- 3970778 TI - [Subacute sclerosing panencephalitis. A clinical and electroencephalographic study]. PMID- 3970779 TI - [Bioavailabilities of three different phenytoin powders sold in Japan]. PMID- 3970780 TI - [Two case reports of cerebrovascular disorder after radiation therapy]. PMID- 3970781 TI - [A case of hemichorea presenting caudate infarction by CT scan]. PMID- 3970782 TI - [Diagnosis of neurologic syndrome in children in France]. PMID- 3970783 TI - Limitations of a QRS scoring system to assess left ventricular function and prognosis at hospital discharge after myocardial infarction. AB - The value of a QRS scoring system derived from 12 lead electrocardiograms to estimate left ventricular ejection fraction was assessed in a prospective study of 285 hospital survivors of myocardial infarction. In these patients both the QRS score and ejection fraction were measured by radionuclide ventriculography at discharge. The correlation between ejection fraction and QRS score was weak. In 22 patients who died during six to 12 months follow up the ability of the ejection fraction and QRS score to predict mortality was assessed in terms of sensitivity, specificity, predictive value of a positive and negative test, and efficiency. For ejection fraction less than 40% and a QRS score greater than or equal to 6 sensitivity was respectively 73% and 64%, specificity 73% and 56%, predictive value of a positive test 18% and 11%, predictive value of a negative test 97% and 95%, and efficiency 73% and 56%. Both ejection fraction and QRS score may be used to identify patients at low and high risk during one year follow up, but, contrary to initial expectations, the QRS score appears to be of little value in estimating ejection fraction and is less accurate than ejection fraction in predicting late survival in hospital survivors of myocardial infarction. PMID- 3970784 TI - Coronary artery disease and haemostatic variables in heterozygous familial hypercholesterolaemia. AB - Haemostatic variables were measured in 61 patients with heterozygous familial hypercholesterolaemia, 32 of whom had evidence of coronary heart disease. Age adjusted mean concentrations of plasma fibrinogen and factor VIII were significantly higher in these patients than in the 29 patients without coronary heart disease, but there were no significant differences in serum lipid concentrations between the two groups. Comparisons in 30 patients taking and not taking lipid lowering drugs showed lower values for low density lipoprotein cholesterol, high density lipoprotein cholesterol and antithrombin III, and a higher high density lipoprotein ratio while receiving treatment. The results suggest that hypercoagulability may play a role in the pathogenesis of coronary heart disease in patients with familial hypercholesterolaemia. PMID- 3970785 TI - Abrupt withdrawal of atenolol in patients with severe angina. Comparison with the effects of treatment. AB - The effects of abrupt withdrawal of atenolol, a long acting cardioselective beta blocker, were studied in 20 patients with severe stable angina pectoris admitted to hospital for coronary arteriography. During the 144 hour postwithdrawal period no serious coronary events occurred. Mean and maximal daily heart rates rose steadily for at least 120 hours. No important arrhythmias were noted on ambulatory electrocardiographic monitoring. Treadmill exercise testing at 120 hours showed little reduction in the times to angina, ST depression, and maximal exercise when compared with those recorded at 24 hours. This deterioration was small when contrasted with the improvements in these indices produced by atenolol treatment in a similar group of patients not admitted to hospital. No change in catecholamine concentrations or acceleration of the heart rate response to exercise occurred after atenolol withdrawal, suggesting that rebound adrenergic stimulation or hypersensitivity was absent or insignificant. Catastrophic coronary events after beta blockade withdrawal (the beta blockade withdrawal syndrome) have occurred almost exclusively in patients taking propranolol, many of whom had unstable angina at the time of withdrawal. This study showed that in patients with stable angina, even when severe, the abrupt withdrawal of atenolol can be expected to result in only minor clinical consequences. The risk to any patient of so called rebound events after withdrawal of beta blockade seems to be related to both the clinical setting and the agent being used. PMID- 3970787 TI - Vegetations in infective endocarditis. Clinical relevance and diagnosis by cross sectional echocardiography. AB - Cross sectional echocardiography identified vegetations in 45 of 62 (73%) patients who had clinical evidence of active infective endocarditis. The sensitivity of this technique in diagnosing vegetations in infective endocarditis was 93% and the specificity 89%. The predictive value of a positive test was 96% and that of a negative test 80%. Vegetations were detected with a similar frequency on the aortic and mitral valves. The incidence of valvar incompetence, congestive heart failure, and the need for surgical intervention was similar in the patients with and without vegetations. Embolism occurred in 47% of those patients with vegetations and in 12% of those without. The mortality rate was 27% in those with vegetations, and no patient without vegetations died. Thus cross sectional echocardiography is accurate in diagnosing vegetations in patients with infective endocarditis, and this finding identifies patients at high risk of embolic complications and death. PMID- 3970786 TI - Atrial septal aneurysm--a potential cause of systemic embolism. An echocardiographic study. AB - Atrial septal aneurysm is an uncommon condition. Between 1981 and 1984 10 cases of atrial septal aneurysm were diagnosed by real time cross sectional echocardiography performed in 4840 patients. The aneurysm was associated either with mitral valve prolapse (three patients) or with atrial septal defect (three patients) or occurred in isolation (four patients, two of whom had had a previous embolic event leading to the diagnosis of atrial septal aneurysm by cross sectional echocardiography). During cross sectional echocardiography the aneurysm appeared as a localised bulging of the interatrial septum, which was best seen in the subcostal four chamber view and in the parasternal short axis view at the level of the aortic root. The aneurysm either protruded into only the right atrium (five patients) or moved backwards and forwards between the right and the left atria during the cardiac cycle (five patients). This motion pattern might be related to changes in the interatrial pressure gradient. The two patients who had had a systemic embolism were given anticoagulant treatment, but none underwent surgery. It is concluded that the true prevalence of atrial septal aneurysm might have been underestimated before the routine use of cross sectional echocardiography, that cross sectional echocardiography enables definitive diagnosis of this condition by a non-invasive technique, and that an atrial septal aneurysm should be suspected and looked for by cross sectional echocardiography after an unexplained systemic embolism. PMID- 3970788 TI - Pre-excitation due to accessory sinoventricular connexions associated with coronary sinus aneurysms. A report of two cases. AB - Ventricular pre-excitation occurred in two cases in which the accessory pathways between the atria and the ventricles were histologically identified as being associated with aneurysmal malformations of the coronary sinus. In one case the connexions were in the posterior wall of the coronary sinus aneurysm and were not related to the atrioventricular annulus; in the other, a connexion was situated in the anterior wall of the aneurysm in close apposition to the annulus and superficially resembled a Kent fibre. These connexions were considered to be of sinus venosus origin and to represent a modification of the muscular sheath that normally surrounds the coronary sinus but does not continue along the coronary veins. One of the posterior wall connecting bundles was composed of abnormally large Purkinje-like fibres; this may have played some role in the manifestation of the pre-excitation by reducing any mismatch impedance. PMID- 3970789 TI - Tachycardia induced myocardial dysfunction. A reversible phenomenon? AB - Four patients with myocardial dysfunction related to tachycardia underwent electrophysiological studies, which showed a re-entrant supraventricular tachycardia using an accessory atrioventricular connexion. Serial assessment of left ventricular function by echocardiography before and after control of the tachycardia indicated a variable degree of reversibility. Endomyocardial biopsy in two patients detected non-specific histological changes. Because of the possible role of ischaemia in this condition effective control of prolonged tachycardia is needed to prevent deterioration of myocardial function. PMID- 3970790 TI - Disopyramide induced second and third degree atrioventricular block in patients with bifascicular block. An acute stress test to predict atrioventricular block progression. AB - Syncopal attacks in patients with bifascicular block may be due to both ventricular tachyarrhythmias and intermittent atrioventricular block in addition to non-cardiac causes and lead to antiarrhythmic treatment with drugs or pacemaker or both. The acute electrophysiological effect of intravenous disopyramide 2 mg/kg body weight given over five minutes on the His-Purkinje system was assessed in 27 patients with chronic bifascicular block undergoing evaluation for permanent pacemaker treatment. The predictive value of this pharmacological stress test as regards the development of atrioventricular block during follow up was analysed. The HV interval increased (mean 43%) and the QRS duration was prolonged (mean 24%). Intrahisian or infrahisian second or third degree atrioventricular block occurred in 14 patients after disopyramide administration, requiring temporary pacing in four of them. Before the electrophysiological study 15 of the 27 patients had had at least two syncopal attacks of suspected cardiac origin but no evidence of second or third degree atrioventricular block. Second or third degree atrioventricular block was subsequently recorded in five of these 15 patients during a mean of two years follow up. The sensitivity, specificity, and predictive value of second or third degree atrioventricular block produced by disopyramide administration including subsequent atrial pacing--a positive disopyramide test--as regards later development of atrioventricular block were 80%, 90%, and 80% respectively. Intravenous administration of disopyramide to patients with bifascicular block and syncopal attacks of suspected cardiac origin may provoke atrioventricular block and asystole requiring immediate temporary pacing. Furthermore, a positive disopyramide test seems to have a significant value in predicting the later development of atrioventricular block. PMID- 3970791 TI - A complicated case of mitral valve disease. AB - A patient with rheumatic mitral stenosis and previous cerebral embolism had a myocardial infarction during cardiac catheterisation. She later developed severe mitral regurgitation one year after open valvotomy and at valve replacement was found to have a papillary tumour of the mitral valve. Unexplained low cardiac output occurred four days after operation. Postmortem examination showed thrombotic occlusion of the xenograft prosthesis, a complication not previously seen with tissue valves. Both of these rare events were suggested by the patient's clinical course and could have been diagnosed with cross sectional echocardiography. PMID- 3970792 TI - Mitral obstruction in bacterial endocarditis. AB - Mitral obstruction due to a large vegetation of acute Streptococcus viridans endocarditis occurred in a 47 year old man. Serial echocardiography documented the rapid growth of the vegetation and its haemodynamic effects. Emergency mitral valve replacement was performed too late to reverse the course of fatal septic shock. PMID- 3970793 TI - Verapamil in primary pulmonary hypertension. AB - An 8 year old girl with primary pulmonary hypertension and signs of heart failure was given 17.5 mg of verapamil injected into the pulmonary artery over 25 minutes to test for the reversibility of pulmonary arteriolar obstruction. Pulmonary artery pressure fell from 70/50 to 35/25 mm Hg. Treatment with 40 mg verapamil by mouth four times daily was started, and she was discharged. She gradually became asymptomatic and resumed the activities of a normal child of school age. On recatheterisation seven months later her pulmonary artery pressure was 30/10 mm Hg. She was still doing well 12 months after the start of treatment. PMID- 3970794 TI - Lead specificity of the maximum ST/heart rate slope response. PMID- 3970795 TI - Blood cyanide and thiocyanate concentrations produced by long-term therapy with sodium nitroprusside. AB - Blood cyanide (HCN) or plasma thiocyanate (SCN) concentrations, or both, were measured in 30 patients (ages 11 months-72 yr) receiving sodium nitroprusside (SNP) for 12-314 h. Sequential measurements in three of these patients (infused 5, 12 and 13 days) showed that HCN concentrations varied with dose rate, while SCN concentrations increased linearly with increasing SNP dose. The accumulated data confirmed that the rate of administration (0.3-6.5 micrograms kg-1 min-1) determined the plasma HCN concentrations (0-3.8 mumol litre-1; y = 0.267 X 0.0733; r = 0.64; n = 51; P less than 0.001). Thus, if prolonged exposure to plasma HCN concentrations greater than 1 mumol litre-1 is to be avoided, the maximum safe sustained dose rate of SNP will lie near to 4 micrograms kg-1 min-1. Likewise, the SCN results (30--880 mumol litre-1) confirmed the close relationship between plasma concentrations and the total SNP dose (0.44-32.9 mg kg-1; y = 24.6x + 74.9; r = 0.95, n = 51, P less than 0.001). Therefore, we suggest that, to avoid SCN toxicity (plasma SCN greater than 1.75 mumol litre-1), in the absence of SCN monitoring, the total SNP dose should be less than 70 mg kg 1 in patients with normal renal function. PMID- 3970796 TI - Non-verbal response to intraoperative conversation. AB - In a double-blind study, 33 patients (herniorraphy, cholecystectomy and orthopaedic) were randomly assigned to either suggestion or control groups. Under known clinical levels of nitrous oxide and enflurane or halothane anaesthesia, suggestion patients were exposed to statements of the importance of touching their ear during a postoperative interview. Compared with controls, suggestion patients did touch their ear (tetrachoric correlation 0.61, P less than 0.001) and they did so more frequently (Mann-Whitney U test, P less than 0.02). All suggestion patients were completely amnesic for the intraoperative spoken suggestion, despite inquiries which included hypnotic regression to the operation. PMID- 3970797 TI - Comparison of the ocular effects of atropine or glycopyrrolate with two I.V. induction agents. AB - Atropine and glycopyrrolate combined with either methohexitone or thiopentone were compared with the induction agent alone in patients undergoing electroconvulsive therapy. Patients acted as their own controls in each sub-group defined by induction agent. Pupil size, muscle twitches, presence of hiccups and the extent of oropharyngeal secretions were noted. Methohexitone produced a greater and more prolonged increase in pupil size than did thiopentone. The subsequent pupil size following the atropine-methohexitone mixture was significantly greater than that following the glycopyrrolate-methohexitone mixture. The combination of atropine with thiopentone produced a greater "secondary" mydriasis than thiopentone alone, or thiopentone combined with glycopyrrolate. The effect of the glycopyrrolate-thiopentone combination did not differ significantly from that of thiopentone alone. Methohexitone was associated with a greater incidence of hiccups, muscle twitching and excessive salivation. PMID- 3970798 TI - Pattern of CNS recovery following reversal of neuromuscular blockade. Comparison of atropine and glycopyrrolate. AB - Recovery from anaesthesia was compared, in a group of patients (n = 25) receiving a mixture of glycopyrrolate and neostigmine (to reverse non-depolarizing neuromuscular blockade), with recovery in a group of patients (n = 25) receiving an atropine-neostigmine mixture. Recovery following anaesthesia was more rapid in the patients receiving the glycopyrrolate-neostigmine mixture. PMID- 3970800 TI - Effect of a mixture of pyridostigmine and atropine on forced expiratory volume (FEV1), and serum cholinesterase activity in normal subjects. AB - Pyridostigmine 0.143 mg kg-1 (maximum 10 mg) and atropine 0.0143 mg kg-1 (maximum 1 mg) were administered i.v. to six healthy male volunteers. Peripheral venous blood samples were drawn for measurement of serum cholinesterase activity. Maximum inhibition of the enzyme was found 5 min after injection with a decrease to 27 +/- 5% (mean +/- SEM) of the original activity. Forced expiratory volume in the first 1s (FEV1) was measured at fixed time intervals for 90 min. No decrease in FEV1 was observed; on the contrary, there was a small increase. We conclude that atropine effectively antagonizes the muscarinic side-effects of pyridostigmine on bronchial smooth muscle tone and bronchial secretions, when administered in clinical doses to normal human subjects. PMID- 3970799 TI - Comparative pharmacology of the ketamine isomers. Studies in volunteers. AB - The clinical and electroencephalographic (EEG) effects of the individual ketamine isomers were compared with the racemic mixture in five volunteers who received each drug on a separate occasion. Racemic ketamine 275 +/- 25 mg, s(+) ketamine 140 +/- 21 mg or R(-) ketamine 429 +/- 37 mg produced an anaesthetic state lasting 6 +/- 2 min (mean +/- SD). However, the EEG evaluation of the R(-) isomer revealed less overall slowing, and an absence of the large slow wave complexes produced by the S(+) isomer and the racemic mixture. The pharmacokinetic profiles for the individual isomers of ketamine did not differ significantly from the racemic mixture. Even though the apparent anaesthetic state produced in these healthy volunteers did not differ qualitatively between the three drug groups, recovery times (assessed using a standardized battery of psychometric tests) were consistently shorter following the individual isomers compared with the racemic mixture. The serum ketamine concentrations associated with regaining consciousness and orientation were consistent with an S(+):R(-) isomer potency ratio of 4:1. In terms of their ability to impair psychomotor function, the S(+):R(-) potency ratio varied from 3:1 to 5:1. After comparable degrees of CNS depression, we conclude that the more potent S(+) isomer of ketamine was associated with a more rapid recovery of psychomotor skills than the currently used racemic mixture. PMID- 3970801 TI - Effects of increasing depth of anaesthesia on phrenic nerve and hypoglossal nerve activity during the swallowing reflex in cats. AB - The effects of increasing depths of anaesthesia on phrenic nerve (PN) activity and hypoglossal nerve (HN) activity during the swallowing reflex elicited by stimulation of the superior laryngeal nerve (SLN) were investigated in 10 cats. Swallowing induced by SLN stimulation always coincided with a characteristic brief burst of PN activity and a large amplitude burst of HN activity. These characteristic responses of PN and HN activities were not influenced by either bilateral vagotomy or neuromuscular blockade, indicating that the characteristic responses of PN and HN activities can be used as indicators of the swallowing reflex in vagotomized and paralysed animals. The results obtained in such animals showed that increasing depth of anaesthesia depressed progressively the swallowing reflex. Detailed analysis of HN activity revealed also that SLN stimulation elicited three different responses of HN activity which had different sensitivities to anaesthesia. However, the characteristic response observed during the swallowing reflex was the most sensitive to increasing depth of anaesthesia. PMID- 3970802 TI - Chronotropic and dromotropic effects of atropine and hyoscine methobromide in unanaesthetized dogs. AB - Atrial pacing at progressively increasing frequencies was performed in 12 awake dogs through electrodes implanted aseptically in the right atrium and led out through the skin of the neck. Heart rate and the Wenckebach point (the minimum pacing frequency for which a second degree A-V block first appeared) were measured by electrocardiography. The responses of the sino-atrial and auriculo ventricular nodes to atropine and hyoscine methobromide were characteristically bimodal. Slowing of the heart rate and atrioventricular conduction appeared with the lower doses of atropine (6.25 micrograms kg-1 i.v) and hyoscine methobromide (0.4 micrograms kg-1 i.v.); at doses of atropine 12.5 micrograms kg-1 i.v. and hyoscine methobromide 1.56 micrograms kg-1 i.v., only atrioventricular conduction was slowed; an acceleration of heart rate and atrioventricular conduction occurred in response to the higher doses of both drugs. These results show, in the awake dog, that the effects of atropine and hyoscine methobromide on heart rate and atrioventricular conduction are entirely comparable when appropriate doses are used, and reveal a difference in the responsiveness of the sino-atrial and auriculo-ventricular nodes to these drugs. PMID- 3970803 TI - Infusion rates for I.V. anaesthesia. PMID- 3970804 TI - Management of blunt trauma to the cervical portion of the trachea. PMID- 3970805 TI - Extradural droperidol potentiates extradural opioids. PMID- 3970806 TI - Difficult intubation. PMID- 3970807 TI - 0.75% bupivacaine. PMID- 3970808 TI - Medical gas delivery systems. PMID- 3970809 TI - Predictive chemosensitivity testing. PMID- 3970810 TI - Combined modality management of local and disseminated adult soft tissue sarcomas: a review of 257 cases seen over 10 years at the Christie Hospital & Holt Radium Institute, Manchester. AB - Over a 10 year period, between 1974-1984, 257 adult cases of tissue sarcoma have been evaluated in the Department of Medical Oncology, Christie Hospital, Manchester. At registration locally advanced or metastatic diseases was present in 162 (63%). The male/female ratio was 1.5:1 and median age 54 years (range 14 85). The commonest sites were lower limb (33%), visceral (21%), trunk (13%), retroperitoneum (12%) and upper limb (10%). Leiomyosarcoma (27%), liposarcoma (14%) malignant fibrous histiocytoma (10%) and neuro plus fibrosarcomas (15%) were the most frequent histological subtypes. A high proportion of uterine sarcomas (17%) is a point of distinction from many other series. Histological grade was specified in 72% of cases and the distribution (Grade I--27%; II--6%; III--67%) reflected a referral bias towards advanced disease. Local resection of the primary tumour was performed in 76% of cases. In many instances this only amounted to 'shelling out' and true compartmental excisions were rare. Amputation was performed in 31% of patients with limb sarcomas. Ninety-eight patients (38%) had experienced one or more local recurrences prior to referral and the overall local recurrence rate was 56%. Suitable patients (78%) received chemotherapy, 50% entering multicentre trials in collaboration with the EORTC. The commonest regime used in patients with advanced disease was CYVADIC which produced an overall response rate of 37%. Ifosfamide, used as a single agent in 16 patients, induced 3CR and 5PR for an overall response rate of 50%. When used in combination with MTX and VADIC, there was no difference in response rate, but numbers in these pilot studies were small. Seventeen high risk patients received adjuvant chemotherapy with VAC, but the results (11 relapses) were disappointing. An EORTC trial, comparing adjuvant CYVADIC chemotherapy with control has accrued 307 patients, 49 of these from the Christie Hospital. Preliminary results within this centre - 13/25 relapses in the control arm, 5/23 in the chemotherapy arm-suggest an advantage for chemotherapy but the data are statistically not significant. Post-operative radical radiotherapy after resection of the primary tumour or local recurrence was performed in 51 patients, with local control in 65% of cases, although metastases developed in 41%. At the time of analysis (1st April 1984) 98 (38%) were alive, of whom 72 showed no evidence of disease and 52 had never relapsed. Malignant disease was the cause of death in 92%. Overall survival was not influenced by sex, but patients less than 40 years of age fared significantly better (P less than 0.001).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3970811 TI - Characteristics of human tumour xenografts transplanted under the renal capsule of immunocompetent mice. AB - Human tumour lines established in athymic nude mice were grafted under the renal capsule of immunocompetent mice. Grafts from 27 human tumour lines comprising 9 malignant melanomas, 10 sarcomas, 2 colon carcinomas, 4 lung carcinomas and 2 mammary carcinomas, grew well under the renal capsule of the immunocompetent mice and retained morphological and functional characteristics of the parent tumours, as judged by light and electron microscopy and immunohistochemical examinations. Numerous mitoses were detected. Granulation tissue and necrosis were not predominant features. After Day 4, the grafts became infiltrated from the periphery by mouse inflammatory cells. The infiltration could be prevented by pretreatment of the animals with cyclophosphamide. Anti-human antibodies were detected after Day 3. Single cell suspensions from the subrenal grafts were able to form colonies in soft agar. and upon reimplantation in nude mice, subcutaneous tumours were formed showing that the grafted tumour tissue had also retained its malignant character. Altogether the results support the view that human tumour xenografts grow well under the renal capsule of immunocompetent mice and that the grafts retain important characteristics of the original tumour. PMID- 3970813 TI - The shedding of viable cells into the local lymph by tumours growing in the gut of rats. AB - Suspensions of syngeneic sarcoma cells were injected into the Peyer's patches of rats from which the mesenteric nodes had been removed. By later cannulating the thoracic duct of such rats it was possible to collect peripheral intestinal lymph that had come directly from the tumour bearing area without being filtered through a regional node. The number of viable tumour cells in the lymph coming from the tumours was monitored by culturing the whole lymph cells in a limiting dilution assay. The tumours grew to a diameter of approximately 1 cm in 25 days and during this time tumour cells were present in the lymph at a ratio of approximately 1 tumour cell per 10(5) lymph cells. In euthymic rats this number declined as the immune response developed. In athymic rats the number increased by approximately 10 fold during the experiments. It was concluded that the shedding of viable cells parallels the linear, not the volumetric dimensions of the tumour. PMID- 3970812 TI - Oestrogen receptor status and the response of human breast cancer cell lines to a combination of methotrexate and 17-beta oestradiol. AB - We have investigated the modifying influence of 17-beta oestradiol (E2), on the cytotoxicity of methotrexate (MTX) towards two cell lines derived from human breast carcinoma. E2 (10(-7) M-10(-6) M) significantly reduced the antimetabolic effects of the drug towards an E2 non-responsive cell line, MDA-MB-436, whilst potentiating the action of MTX in an E2 responsive line, MCF-7. Similarly, E2 (10(-6) M) partially reversed the anti-proliferative effects of MTX in the MDA-MB 436 line and potentiated growth inhibition in the E2 responsive cells. This potentiation was not observed if E2 was replaced by the less biologically active alpha-isomer. In both cell lines pharmacological concentrations of the E2 reduced intracellular levels of MTX achieved during a 48 h treatment period. The latter finding is consistent with the ability of E2 to protect MDA-MB-436 cells from the action of MTX. Potentiation of the effects of MTX towards MCF-7 cells occurs despite reduced intra-cellular drug levels. PMID- 3970814 TI - Goblet cell changes during intestinal adaptation to azoxymethane and enteric bypass in the rat. AB - Numbers of intestinal goblet cells containing specific acid mucins were determined in male Sprague-Dawley rats receiving azoxymethane (total dose 90 mg kg-1) with or without jejunoileal bypass (JIB). Controls had injections of vehicle and sham bypass. Thirty weeks postoperatively colorectal length and crypt depth were increased by azoxymethane and further increased by JIB. JIB doubled the yield of intestinal tumours (P less than 0.01). Goblet cells containing sulphomucins normally predominated throughout the intestinal tract. Contents of sulphomucins and especially sialomucins were consistently higher in the small bowel and colon of rats receiving azoxymethane alone, but again the highest values were observed in animals with azoxymethane plus JIB. Both small-bowel bypass and azoxymethane stimulate adaptive growth of the colon and small bowel remaining in circuit. Goblet-cell hyperplasia is a feature of this response, and sialomucins are preferentially secreted by the adapting epithelium. PMID- 3970815 TI - Sunburn and malignant melanoma. AB - We investigated the relationship between cutaneous malignant melanoma and multiple sunburns in the Queensland population. Interview data were gathered from 236 case-control pairs concerning their lifetime experience of severe sunburns, their occupational and recreational sun exposure, and their skin type. Excluding the lentigo maligna melanoma subtype, an association between multiple sunburns and melanoma was evident. After controlling for other major risk factors there was a significant dose-response relationship (P less than 0.05): the estimated relative risk associated with 2-5 sunburns in life was 1.5, and with 6 or more was 2.4. This observation extends the hitherto circumstantial evidence of a causal relationship between exposure to solar ultraviolet radiation and melanoma, and suggests that precautionary measures could prevent the development of this disease in a proportion of cases in fair-skinned populations. PMID- 3970816 TI - Oesophageal cancer in Zulu men, South Africa: a case-control study. AB - The high rate of oesophageal cancer amongst southern African blacks has also been recorded amongst the Zulus. Data embracing a wide spectrum of factors pertaining to socio-economic status, nutrition, exposure to carcinogens, tobacco and alcohol usage and traditional health practices were obtained from 211 hospitalized oesophageal cancer patients and compared with hospital population controls matched for age and urban-rural background. Stepwise logistic regression analysis with adjustment for age effects showed that four of the many factors could adequately model the odds of being a cancer case. They were the daily consumption of purchased maize meal (relative risk (RR) 5.7) currently smoking commercial cigarettes (RR 2.6), pipe smoking (RR 2.1), and a reduction of risk in those using butter or margarine daily (RR 0.51). Further significant differences (P less than 0.05) in 12 other factors suggest that those with rural assets but an ability to earn a modest income external to the subsistence economy are at highest risk. They represent a transitional state of Westernisation which is characterised by excessive smoking habits and a diet having a low vitamin and mineral density. These results provide further evidence for the need to combat smoking and for a program of nutrient enrichment of maize meal. PMID- 3970818 TI - Influence of tumour size on human prostate tumour metastasis in athymic nude mice. PMID- 3970817 TI - Tumour cords in 52 human bronchial and cervical squamous cell carcinomas: inferences for their cellular kinetics and radiobiology. AB - Tumour cords have been measured in 33 cases of squamous cell carcinoma (SCC) of the bronchus and 19 cases of SCC of the uterine cervix. The overall mean cord radius for SCC in both sites was 104 microns, similar to the overall mean for various tumours in rodents. For tumour cells adjacent to blood vessels in cords of SCC, the mean Mitotic Index was 2.1% and from this value a rapid potential doubling time could be inferred (approximately 31 to 66 h). The proportion of dead cells within cords of cervical SCC was higher than in animal tumours. Using measured values for cord radius and published equations that describe the diffusion and consumption of oxygen in metabolising tissue, an attempt was made to calculate the oxygen partial pressure in vessels of cords of these SCC. PMID- 3970819 TI - A method for improving light collection by 600% from square cross section flow cytometry chambers. PMID- 3970820 TI - The influence of information and daily contact on children's attitudes towards aphasic children. PMID- 3970821 TI - Cognitive slippage, test anxiety, and responses in a group testing situation. PMID- 3970822 TI - Schools and smoking: school features and variations in cigarette smoking by children and teachers. PMID- 3970824 TI - The validity of a short form of the Coopersmith Self Esteem Inventory. PMID- 3970825 TI - The effect of adjuvant arthritis on the subsequent local inflammatory response in rats. AB - An assessment was made of the cellular inflammatory response to the subcutaneous implantation of sterile nitrocellulose discs and polyvinyl sponges in both normal rats and rats with adjuvant-induced arthritis. It was found that from 3 days after adjuvant injection the treated animals exhibited a reduced accumulation of inflammatory cells onto the nitrocellulose discs and that this impairment in response was not apparent until the discs had been retained for longer than 24 h. When discs were implanted after non-arthritogenic doses of adjuvant constituents or injection of brewer's yeast no effect was seen on the subsequent response. When polyvinyl sponges were used in adjuvant-treated animals a similar initial reduction in cellular accumulation was observed, which was later followed by increased cell numbers associated with enhanced granuloma formation. Differential cell counts revealed that both neutrophil and mononuclear cell types were affected. Some of the possible mechanisms involved in these observations are discussed. PMID- 3970823 TI - Teacher stress and psychoneurotic symptoms. PMID- 3970826 TI - Lysozyme as a measure of cellular dynamics in the lesions of leprosy. AB - The levels and distribution of lysozyme-positive cells and exudate were studied in leprosy lesions through the spectrum, in untreated and treated patients, in relapse and in reactions. Altogether 124 skin biopsies were examined by the immunoperoxidase technique. Monocytes, neutrophil-polymorphs and mast cells were the most conspicuous cells seen. Lysozyme proved to be a useful means of indexing renewal of these cells in the lesions. Peak numbers of monocytes were seen in lesions of active lepromatous leprosy (LL) and of tuberculoid leprosy (TT), at poles of opposite immunological performance. In TT the stimulus for recruitment was delayed hypersensitivity (DH). A decline in DH from TT towards the middle of the spectrum, mid-borderline, was accompanied by a fall in monocyte level. Furthermore, reacting lesions due to enhanced DH also had increased numbers of monocytes. On the other hand reactions associated with immunological deterioration were similar to active lepromatous leprosy (LL) and monocyte influx was raised in response to the stimulus of free multiplication of bacilli in both cases. In TT delayed hypersensitivity acted also to promote the rapid transformation of monocytes to epithelioid and giant cells all of which were strongly positive for lysozyme. This was in contrast to much lower levels in histologically similar macrophage-epithelioid cells of BT granulomas. Lysozyme synthesis was not seen in macrophages after ingestion of M. leprae. Early foamy change was made conspicuous by lysozyme deposited in phagocytic vacuoles, but old foam cells in regressing lepromas were negative. Lysozyme bound to dead extracellular M. leprae but not to viable or intracellular organisms. Dead bacilli or immune complexes appeared to be the stimulus for neutrophil-polymorph recruitment, mainly in reactions. PMID- 3970827 TI - Silicon contents in normal, fatty streaks and atheroma of human aortic intima: its relationship with glycosaminoglycans. AB - The silicon (Si) content and glycosaminoglycans (GAG) of normal, fatty streaks and atheroma of human aortic intima was measured. The Si content in fatty streaks and/or atheroma was significantly higher than in normal human aortic intima (P less than 0.05). The GAG content in human aortic intima was inversely correlated with the severity of atherosclerosis as described in many reports. However, the percentage composition of dermatan sulphate (DS) in total GAG was found to increase with the advance of atherosclerosis, and was significantly higher than that in normal and fatty streaks (P less than 0.001, P less than 0.01, respectively). In human aortic intima, a significant negative correlation was seen between Si content and the content of each GAG except GlcUA-GalNAc-6 sulphate (CS-6-S), and a significant positive correlation was noted between Si content and the content of each lipid. Interestingly, the percentage composition of DS in total GAG showed a significant positive correlation with Si content in human aortic intima (r = 0.603, P less than 0.005). These results suggest the increase in Si in the aortic intima is related to the occurrences and/or progression of atherosclerosis, whether primary or secondary. PMID- 3970828 TI - A possible role for antibodies against spectrin in the interaction between erythroblasts and macrophages in vitro. AB - The nature of serum factors which participate in the interaction in vitro between dimethylsulphoxide-induced Friend leukaemia erythroblasts (IFLE) and syngeneic mouse peritoneal macrophages was investigated. When heat-inactivated newborn calf serum (HI-NBCS) was depleted of IgG its activity to promote the association of neuraminidase-treated 59Fe-labelled IFLE (59Fe-IFLE) with macrophages was markedly reduced but could be restored by the addition of bovine IgG. Trypsin treatment of macrophages caused incomplete inhibition of their subsequent association with both untreated and neuraminidase-treated 59Fe-IFLE in the presence of HI-NBCS. When spectrin, the major red cell cytoskeleton protein, was added to HI-NBCS there was a dose-related inhibition of the association with macrophages of both untreated and neuraminidase-treated 59Fe-IFLE. Moreover a mouse monoclonal antibody against spectrin promoted the interaction of neuraminidase-treated 59Fe-IFLE with macrophages. Mouse sera which supported the association of neuraminidase-treated 59Fe-IFLE with macrophages were found to contain anti-spectrin antibodies. These results suggest that IgG antibodies mediate the interaction between erythroblasts and macrophages via trypsin sensitive and trypsin-resistant receptors on the macrophage surface and that at least some of the antibodies show specificity for spectrin. PMID- 3970829 TI - Hyperlipoproteinaemia and atherosclerosis in rabbits fed low-level cholesterol and lecithin. AB - Dutch-Belted rabbits were fed for 18 months an atherogenic semipurified gel diet containing 14% hydrogenated coconut oil and 0.06% cholesterol (approximately 0.15 mg/kcal) or a non-atherogenic basal gel diet containing the same ingredients but with no coconut oil or cholesterol. Rabbits fed atherogenic diet developed hypercholesterolaemia (means 733 mg/dl at 16 months) and plasma lipoprotein (LP) distribution shifted from a pattern in which high-density lipoproteins (HDL) predominated to one in which very-low-density lipoproteins (VLDL) were predominant. Total cholesterol/triglyceride ratio in d less than 1.006 LP changed from 0.3 to 1.8. Plasma cholesterol and LP distribution returned to normal in rabbits fed atherogenic diet for 18 months followed by atherogenic diet plus 3% soya lecithin for an additional 4 months. Rabbits fed atherogenic diet for 18 months had extensive, usually full circumference fibromuscular plaques in main branches of coronary arteries and all portions of aorta which compromised lumen area by almost 50%. These lesions were modified in rabbits fed atherogenic diet plus lecithin. The plaques lacked foam cells and cholesterol clefts, were less cellular with a distinct fibrous surface and occupied less space. Animals fed basal diet did not develop hypercholesterolaemia (means 86 mg/dl at 16 months), although distribution of plasma LP shifted slightly in favour of increased low density lipoproteins (LDL) and decreased HDL compared with rabbits fed standard commercial diet. Basal diet rabbits had no coronary atherosclerosis and only minimal focal foam cell lesions in proximal aorta. Liver injury including fatty change, cholangitis and portal fibrosis occurred in animals fed atherogenic diet. Thus, rabbits fed appropriate diets low in cholesterol accumulate cholesterol enriched LP in their plasma and develop lesions in abdominal aorta and main branches of coronary arteries which are similar to those in man. Also, in this experimental model, dietary lecithin promotes a return to normal of the LP distribution profile and removal of lipid from established atherosclerotic plaque. PMID- 3970830 TI - Urethral infection in male chimpanzees produced experimentally by Mycoplasma genitalium. AB - Four young male chimpanzees were inoculated intra-urethrally with a strain (G37) of Mycoplasma genitalium which had been isolated from the urethra of a patient with non-gonococcal urethritis. Two of the chimpanzees became infected as indicated by persistent recovery of the organisms from the urethra for 13 weeks and by an antibody response measured by both metabolism inhibition and micro immunofluorescence techniques. The numbers of organisms isolated from both animals increased about 4 weeks after inoculation and antibody development was first detected 1 week later. The infected animals developed a minimal and inconsistently detected urethral polymorphonuclear leucocyte response which was not seen in those that were uninfected, nor in a chimpanzee that had been given medium only. The organisms were not isolated and the cellular response was not observed after treatment of the infected chimpanzees with oxytetracycline. One of the animals that had been infected was re-inoculated with strain G37 six months after successful treatment, but although the titre of serum antibody had diminished to its original level urethral recolonization did not occur. The organisms in the inoculum were not attenuated, however, because they infected another chimpanzee that had not had previous experience of M. genitalium. The results are discussed in relation to the potential of this mycoplasma to produce urethritis in man. PMID- 3970831 TI - Isolation, barrier properties and lipid analysis of stratum compactum, a discrete region of the stratum corneum. AB - We have isolated the lowest region of human and pig stratum corneum as an integral layer which we have termed the stratum compactum. This preparation is resistant to disruption by enzymes, 6 M urea, Triton X-100 and solvents. Our evidence suggests that all cells of the stratum corneum may be equally permeable to aqueous soluble materials but that penetration of materials through the corneum depends on the state of cohesion between cells and of the organization of intercellular lipid species. As the cells move up towards the outside of the stratum corneum the cohesive forces are reduced due to desmosome degradation and lipid modifications with ultimate dyshesion and sloughing of individual cells. PMID- 3970832 TI - How reliable are sunscreen protection factors? PMID- 3970833 TI - Retinoids and PUVA in psoriasis. PMID- 3970834 TI - An inherited nail dystrophy principally affecting the great toenails. PMID- 3970835 TI - The thin layer rapid use epicutaneous test (TRUE-test), a new patch test method with high accuracy. AB - The thin layer rapid use epicutaneous test (TRUE-test) is a new patch test, in which the allergens are incorporated in a thin, flexible solid vehicle on a water impermeable backing. The vehicle shows good stability for allergens, which are crystallized, micronized or emulsified into a gel. The TRUE-test produces an exact dosage, even surface spread and high bioavailability for the allergens. This solves the problems of low bioavailability, uncertain dosage and uneven surface distribution which are commonly seen when petrolatum is used as the vehicle. PMID- 3970837 TI - An evaluation of sunscreens in patients with broad action-spectrum photosensitivity. AB - The photoprotection afforded by three sunscreens available by prescription in the U.K. has been studied in patients with severe broad action-spectrum photosensitivity. All products investigated exhibited high protection against UV B radiation in accordance with the protection factors quoted by the respective manufacturers. On the other hand, the protection against UV-A ranged only from fair to poor. The need for a sunscreen which has good protection against UV-A is shown to be important for the satisfactory management of patients with severe broad action spectrum photosensitivity. PMID- 3970836 TI - Serial liver biopsies in psoriatic patients receiving long-term etretinate. AB - Twenty psoriatic patients treated with etretinate have been followed in a prospective study of liver biopsies. Twelve patients were followed up for 3 years, with four liver biopsies each. No significant damage to the liver was found during etretinate therapy. Etretinate may be stored in the fatty tissues of the liver or other body areas for prolonged periods. PMID- 3970838 TI - Characterization and activity of phospholipase A2 in normal human epidermis and in lesion-free epidermis of patients with psoriasis or eczema. AB - The kinetic properties of phospholipase A2 isolated from single large specimens of normal human epidermis and 'uninvolved' (lesion-free) psoriatic epidermis were determined. The enzymes from the two sources behaved identically with respect to changes in protein concentration, Ca2+ concentration and pH, but the enzymes responded differently to changes in substrate concentration. Furthermore, the specific activity of the enzyme derived from lesion-free psoriatic epidermis was higher than that from normal epidermis under all conditions used. Increased specific activity of the enzyme in the lesion-free epidermis was also found when biopsy specimens taken from thirty-five patients with psoriasis vulgaris at varying severity were compared with biopsies of normal epidermis from thirty-one control volunteers (P less than 0.001). Mixing experiments, in which homogenates of lesion-free psoriatic epidermis and control epidermis were combined, suggested that the relatively low activity of the enzyme in normal epidermis was due to the presence of an inhibitor. As the activity of the enzyme was not elevated in the lesion-free epidermis from twelve cases of eczema, which is also an inflammatory condition of the epidermis and superficial dermis, it is suggested that the raised phospholipase A2 activity demonstrated in the lesion-free epidermis of psoriasis may play an important role in the pathogenesis of the disease. PMID- 3970839 TI - The effects of thermal stimulation on the ultrastructure of the human atrichial sweat gland. II. The duct. AB - The duct of the human atrichial sweat gland, after thermal stimulation, exhibited increased cytoplasmic vesiculation, particularly of the luminal cells, a widening of the intercellular spaces, and the presence of particulate matter in the lumen. The luminal cells of the coiled zone also displayed varying degrees of apical disruption, most probably due to filtration of cell fluid through the terminal web of microfilaments. This zone seems to have a secretory as well as an absorptive role. Specialized junctions (intercellular bridges, gap junctions and tight junctions) were found amongst the basal and luminal cells of the wall of the ascending duct. PMID- 3970840 TI - Anatomy of striae. AB - The histopathology of striae distensae is disputed; different authorities give contradictory accounts of the microscopic changes, especially in elastic fibres. We re-evaluated the problem by taking eight elliptical biopsies across striae. Six were examined by light microscopy with appropriate stains for elastin and collagen. Two were prepared for scanning electronmicroscopy (s.e.m.), using a procedure which removes collagen, enabling the elastic network to be seen in its native form. By light microscopy, striae were sharply demarcated from normal skin, consisting mainly of fine, straight bundles of collagen arranged parallel to the surface. Fine elastic fibres were disposed similarly without fragmentation, fraying or curling. By s.e.m., the elastic network was found to be extraordinarily dense and well developed with many fine, curled fibres in random array. It was evident that the routine stains for elastin greatly underestimated the abundance of elastic fibres, probably because immature fibres contain insufficient protein matrix. The horizontal packing of collagen bundles was confirmed by s.e.m. These findings support the view that striae distensae are scars. There is no evidence that they form by stress-induced rupture of the connective tissue. PMID- 3970842 TI - Target-like skin lesions in primary amyloidosis. AB - A case of primary amyloidosis is described, during the course of which transient, purpuric haloes appeared around long-standing Campbell de Morgan spots, forming target-like lesions of the skin. PMID- 3970841 TI - Familial primary cutaneous amyloidosis. AB - Primary cutaneous amyloidosis is uncommon in Europeans. A British family is described in which an extremely rare variant was inherited as an autosomal dominant. The subtlety of physical signs in this family contrasted with the severity of the associated pruritus. Transepidermal elimination of amyloid was a characteristic histological feature. PMID- 3970843 TI - A case of sclerodermatomyositis with cutaneous amyloidosis. AB - A case of sclerodermatomyositis with secondary localized cutaneous amyloidosis is reported. To our knowledge, this is the first report of this complication. PMID- 3970844 TI - Dapsone and oxygen intermediates. PMID- 3970845 TI - Extensive pityriasis alba and atopic dermatitis. PMID- 3970846 TI - Placental transport of low molecular weight heparin in the pregnant sheep. AB - Standard heparin, an effective treatment for antepartum thromboembolic disease, is thought to be safe for the fetus since it does not cross the placenta. Recently, a number of low molecular weight heparins have been prepared which have been shown to produce less bleeding than standard heparin for an equivalent antithrombotic effect in experimental animals. These observations suggest that the low molecular weight heparins may also provide superior antithrombotic therapy in antepartum thromboembolic disease. However, it is not known whether the low molecular weight heparins cross the placenta. To determine this, we examined the pharmacokinetics of 125I-labelled standard heparin and a low molecular weight heparin, and their anticoagulant effects in mother and fetus, using a pregnant sheep model. Catheters were inserted into maternal and fetal femoral arteries at 108-119 d gestation (term: 147 d). 1-3 days later the mothers were given a bolus i.v. injection of 5000 anti-Xa units of 125I-labelled standard heparin or low molecular weight heparin, CY 222. Nine serial blood samples were collected over 4 h from both mother and fetus for measurements of radioactivity, anti-Xa activity (chromogenic) and activated partial thromboplastin times. When therapeutic levels of standard and CY 222 heparins were achieved in the mother, there was no detectable radioactivity or anticoagulant effect in the fetus. We conclude that standard heparin and the low molecular weight CY 222 do not cross the placenta in the pregnant sheep. PMID- 3970847 TI - Reduced thromboplastin activity in blood monocytes and reduced sensitivity to stimuli in vitro of blood monocytes from pregnant women. AB - The thromboplastin activity in blood monocytes from 18 normal third trimester pregnant women has been compared with a group of 20 healthy non-pregnant women. The thromboplastin activity in unstimulated monocytes from the normal pregnant group was on average 40% of the activity in the non-pregnant group (P less than 0.01). In endotoxin stimulated monocytes, the thromboplastin activity was also significantly lower in the pregnant group as compared to the non-pregnant group (P less than 0.001). Fibrinogen and factors V, VII and VIII were significantly higher in the pregnant than in the non-pregnant group, whereas no difference was observed in AT-III, prekallikrein and alpha 2-antiplasmin levels. PMID- 3970848 TI - The effect of retinoids on CFU-GM from normal subjects and patients with myelodysplastic syndrome. AB - Five retinoid analogues differ in their effects on the growth of CFU-GM from normal human marrow. At concentrations above 10(-6) M all have inhibitory activity. This is maximal with 13-cis-retinoic acid. At lower concentrations the effect of retinoids is usually to reduce clone size rather than clone numbers though 10(-8)-10(-7) M etretinate increases clone size. The incubation of marrow cultures in the presence of 10(-6) M all-trans retinoic acid showed that in normal subjects colony counts are never reduced to less than 45% of the control value and total clone counts to less than 70% of the control value. In cultures from patients with myelodysplastic syndrome 20 out of 34 cases showed a greater inhibition of colony numbers than normal and 14 out of 35 cases showed a greater reduction in total clone numbers than normal. The results suggest that CFU-GM from some patients with myelodysplastic syndrome may have a greater sensitivity than normal to the inhibitory effect of retinoic acid. PMID- 3970849 TI - Membrane cross bonding in red cells in favic crisis: a missing link in the mechanism of extravascular haemolysis. AB - Red cells of G6PD (D-glucose-6-phosphate:NADP+ 1-oxidoreductase; G6PD) deficient (Mediterranean variant) subjects were studied during a fava bean haemolytic crisis. Two representative cases are described. In Case 1, haemolysis was still going on. In more than 50% of the red cells the Hb was confined to one part of the cell, leaving the other part as transparent as a Hb-free ghost. In this part the membranes appeared tightly bonded because swelling did not peel apart the bonded membrane areas. This feature is defined as membrane cross bonding (MCB). In Case 2, haemolysis had terminated and MCB-cells were less than 1%. MCB was reproduced in vitro by incubating G6PD-deficient whole blood with 1 mM divicine for up to 10 h. Subsequent shrinkage of red cells in hypertonic plasma (400 mOsm) resulted in the rapid formation of MCB. Membrane modifications by divicine, contained in fava beans, followed by osmotic shrinkage in the kidney and/or squeezing in the microcirculation are proposed as the cause of MCB during the favic crisis. MCB reduces the effective surface area of red cells. This is a plausible cause for sequestration by the reticulo-endothelial system. Intravascular haemolysis observed in favic crisis cannot be explained by mechanical forces, but it is possible that the effective surface area is reduced by MCB to such an extent that red cells lyse osmotically. PMID- 3970850 TI - Comparison of eosinophils in acute nonlymphocytic leukaemia associated with the t(8;21) and inv(16). PMID- 3970851 TI - Cerebrospinal fluid concentrations of cytosine arabinoside during intravenous therapy with intermediate dose: a preliminary report. PMID- 3970852 TI - Plasma cell acid phosphatase score in multiple myeloma and related disorders. AB - A detailed classification of plasma cells stained for acid phosphatase activity is introduced. With this method, patients with multiple myeloma, non-myeloma gammopathies, reactive plasmacytosis and other diseases in which plasma cells are involved, were investigated. The results show that our method can discriminate between multiple myeloma and reactive plasmacytosis. The overlap between multiple myeloma and other monoclonal gammopathies is much smaller than observed in other studies. Surprisingly low levels of acid phosphatase activity were found in the cells from patients with lymphoplasmacytoid immunocytoma. It is concluded that the acid phosphatase score can be of value for studying disorders in which plasma cells are involved. PMID- 3970853 TI - Serial incidence of bone marrow GM-CFC prior to the development of acute non lymphoblastic leukaemia in a child treated for non-Hodgkin's lymphoma. AB - A child treated for NHL developed acute non-lymphoblastic leukaemia 27 months after stopping treatment. Serial in vitro bone marrow studies showed a normal incidence of GM-CFC following treatment. However, GM-CFC incidence dropped at least 15 months prior to the development of leukaemia. This was associated with an asymptomatic neutropenia but no disturbance of bone marrow morphology. It is concluded that sub-clinical disturbances of bone marrow function may play an important part in leukaemogenesis. PMID- 3970854 TI - Effects of hyperthermia on the myelograms of adult and fetal guinea-pigs. AB - The myelograms of adult guinea-pigs at various stages after brief exposure to hyperthermia were compared with those of control animals. The proportions of neutrophil and eosinophil metamyelocytes and of intermediate normoblasts were significantly reduced for at least 24 h after exposure and the proportions of neutrophil polymorphs and lobulated eosinophils were significantly increased over this period. The mitotic index was reduced for up to 5 h. Morphological changes in cells included hypersegmentation of nuclei, pyknosis, necrobiotic changes, development of pseudopodia, and abnormalities of mitosis. The myelograms of newborn guinea-pigs which had been heated on days 20-23 of pregnancy showed no significant changes. PMID- 3970856 TI - Heterogeneity of hereditary and acquired factor X deficiencies by combined immunochemical and functional analyses. AB - Limited information is available regarding molecular abnormalities associated with derived factor X deficiencies. In order to assess the types of molecular aberrations that may occur in this group of haemostatic diseases we have analysed plasmas of 33 individuals from 28 kindred exhibiting factor X deficiency. These included those of hereditary type, transiently acquired deficiency as well as factor X deficiency associated with amyloidosis. Plasmas were analysed by one stage assays for factor X activation by the extrinsic coagulation pathway, intrinsic coagulation pathway and Russell's viper venom. Selected plasmas were analysed in two-stage assays. Normal factor X concentration by specific radioimmunoassay was 6.38 +/- 1.29 micrograms/ml. Factor X associated with factor X deficiency were grouped by their specific activities measured for the three activation pathways and antigen concentration. The results suggest that a broad spectrum of molecular aberrations exist in the factor X deficiency states. The most common group of factor X deficiency was associated with abnormal activation of factor X by all three pathways. Variants of factor X associated with primary amyloidosis and transient acquired deficiency appeared to be abnormal molecules and not just reduced factor X concentration. Hereditary abnormal factor X molecules include the spectrum of potential defective molecules. The relationship of factor X structure to function and the heterogeneity of these defective molecules is discussed. PMID- 3970855 TI - Thrombocytopenia in SLE and related autoimmune disorders: association with anticardiolipin antibody. AB - Anticardiolipin antibody levels were determined in 116 patients with systemic lupus erythematosus and related autoimmune disorders. Forty-three of these patients had a history of thrombocytopenia--36 of whom had SLE, three primary Sjogren's syndrome, two rheumatoid arthritis and two mixed connective tissue disease. IgG anticardiolipin antibody levels were raised in 31 (72%) of the 43 patients and IgM anticardiolipin antibody levels were raised in 19 (44%). There was a strong statistical correlation between thrombocytopenia and raised anticardiolipin antibody levels of both the IgG (P less than 0.001) and IgM (P less than 0.01) immunoglobulin classes. Of the 20 patients with the highest IgG anticardiolipin antibody levels 16 had a history of thrombocytopenia. We suggest that anticardiolipin antibodies may play a direct role in mediating platelet destruction in autoimmune disorders. PMID- 3970857 TI - Purification of antithrombin 'Vicenza': a molecule with normal heparin affinity and impaired reactivity to thrombin. AB - Antithrombin III (AT) 'Vicenza', a previously described dysfunctional AT associated with familial thrombosis, has been isolated by heparin affinity chromatography. The purified molecule has been investigated by SDS-polyacrylamide gel electrophoresis and crossed immunoelectrophoresis after incubation with different amounts of thrombin. A normal affinity for heparin has been demonstrated. However, evidence is produced that AT 'Vicenza' poorly inhibits thrombin. Present data suggest that AT 'Vicenza' consists of a population of two molecules, half of which does not form a complex with thrombin however and loses its heparin affinity upon thrombin treatment. PMID- 3970858 TI - Immunoassays of factor IX antigen using monoclonal antibodies. AB - Monoclonal antibodies to factor IX were produced by immunization of balb/c mice with purified factor IX and fusion of spleen cells with SP-1 murine myeloma cells. Antibody producing hybrids were detected by an enzyme linked immunoassay (ELISA) and by coagulation inhibitor (Bethesda type) methods. Monoclonal antibodies with titres of greater than 1 X 10(5) tested by the ELISA and 5000 8000 inhibitor units were obtained. A new ELISA method was developed using one of these monoclonal antibodies to quantitate factor IX antigen (IXAg) in plasma samples from patients with hereditary factor IX deficiency. In addition a two site solid phase immunoradiometric assay (IRMA) for factor IX was established. The results of these new methods were compared with those obtained on the same plasma samples using conventional factor IX coagulation assays and the Laurell rocket method. The lower limit for the detection of IXAg by the ELISA was approximately 0.01 unit per ml whilst that for the IRMA was about 0.001 unit per ml (normal plasma = 1 unit per ml). The lower detection limit for IXAg using the Laurell rocket method was about 0.06 units per ml. The improved sensitivity of the new immunoassays enabled quantitation of low levels of IXAg in patients with moderately severe factor IX deficiency and confirmed the presence of excess IXAg compared to IX activity (IXC) in a relatively high proportion of cases (28 out of 51 tested). Results of testing plasma from obligate carriers confirm the suggestion that measurements of IXAg and IXC may improve the classification of carrier status in these kindred. PMID- 3970859 TI - The myelodysplastic syndrome: analysis of laboratory characteristics in relation to the FAB classification. AB - A detailed study of 43 newly diagnosed cases of myelodysplastic syndrome (MDS) shows that many of the morphological features of blood and bone marrow are common to the different FAB groups. In addition, there is no clear distinction between the groups with regard to CFU-E, BFU-E or CFU-GM colony growth in vitro or ferrokinetic assessment of erythropoiesis in vivo. The interrelationships between all the parameters we have studied have been examined and there is little correlation between erythroid colony formation in vitro, the percentage erythroblasts in the bone marrow, erythroid output measured by ferrokinetics and the peripheral blood reticulocyte count, all of which appear to measure different aspects of erythropoiesis. Reduced erythroid colony growth and a high degree of ineffective erythropoiesis in vivo are common in all groups and appear to be an early manifestation of abnormal function. Decreasing marrow iron turnover is more closely related to increasing numbers of marrow blast cells than any other index of erythropoiesis. PMID- 3970860 TI - Fluctuating deformability of oxygenated sickle erythrocytes in the asymptomatic state and in painful crisis. AB - A new gravity filtration technique for the study of sickle cell deformability has shown a significant loss of filterability of oxygenated erythrocytes on day 2 of painful crisis in eight patients with homozygous sickle cell anaemia; there was no increase in irreversibly sickled cell (ISC) count. Serial study (mean of 5.2 occasions) in six out-patients when asymptomatic also showed considerable fluctuation in sickle cell filterability with time; this was again independent of ISC count. Erythrocyte filtration methods demonstrate fluctuations in the rheology of sickle cells that are not detected by ISC counts and which are probably secondary to clinically occult, as well as overt, vaso-occlusive events in the microcirculation. PMID- 3970861 TI - Myelodysplastic syndromes: a scoring system with prognostic significance. AB - 141 patients with MDS were classified according to the FAB criteria and followed up for a period of 4-192 months. It was recognized that patients with RAEBT had a uniformly poor prognosis. However, there was a wide variation in survival among the other subgroups. A score of 1 was assigned to each of the following presenting haematological features: bone marrow blasts greater than or equal to 5%, platelets less than or equal to 100 X 10(9)/l, neutrophils less than or equal to 2.5 X 10(9)/l and Hb less than or equal to 10.0 g/dl. Therefore the score for each patient ranged between 0 and 4. There were no statistically significant differences between those patients who scored 0 or 1, or between those who scored 2 and 3. Therefore patients were put into three groups: Group A (score 0 or 1), Group B (score 2 or 3), Group C (score 4). The differences in survival between each of the three groups are highly significant (P less than 0.00001). This system further separates patients with RA, RAS, RAEB into good and bad prognostic groups. This study also confirms that deaths due to cytopenias are more common than those due to transformation to AML. The use of this scoring system in conjunction with the FAB criteria for MDS should serve as a prognostic tool on which to base treatment. PMID- 3970862 TI - The relationship between vessel wall injury and venous thrombosis: an experimental study. AB - The relative importance of stasis, vessel wall damage and hypercoagulability in the pathogenesis of venous thrombosis remains disputed. While the combination of local vascular stasis and systemic hypercoagulability can be shown to produce experimental thrombi within a few minutes, it has been claimed that vessel wall damage is also a necessary component of venous thrombogenesis. In this experimental study, mechanical crushing of the jugular veins produced patchy areas of denuded endothelium, with underlying vessel wall oedema, as seen by ultrastructural examination. While the exposed subendothelium became covered with activated platelets following restored blood flow, there was no fibrin formation after 5 min. When blood flow was restored for 60 min following the crush injury, white cells could be seen adhering to and migrating through the vessel wall, although there was still no visible fibrin. The addition of venous stasis for 20 min did not lead to the formation of stasis thrombi in association with the damaged areas. The present experiments demonstrate that, far from there being subtle endothelial damage contributing to acute venous thrombosis, even readily demonstrable damage is a poor stimulus to fibrin formation at local sites of vessel wall injury. PMID- 3970863 TI - Properties and characterization of vesicles released by young and old human red cells. AB - We have presently demonstrated morphologic differences between young and senescent red cells following 18 h of metabolic depletion in vitro. Young and old red cells both form echinocytes, whereas only young cells demonstrated myelin forms or microspheres. Furthermore, vesicles were released in greater quantities into the cell-free supernatant from young cells. Isolated vesicles from both young and old red cells contained lipids, intrinsic membrane proteins (especially band 3), and haemoglobin, and they were also enriched in acetylcholinesterase (AChE). Young cells produced more vesicles than old cells but the composition of the low density vesicles was similar except that haemoglobin-spectrin complex was found exclusively in vesicles from young cells. Oxidation of young red cells prior to metabolic depletion prevented both myelin formation and vesicle release. PMID- 3970864 TI - Red cell kinetics in thalassaemia intermedia: its use for a prospective prognosis. AB - A kinetic study of erythroid cell production and destruction (radioactive iron incorporation, red blood cell survival time, bone marrow scintigraphy) was performed in 12 cases of thalassaemia intermedia (six adults and six children), classified retrospectively, and compared to that performed in 17 cases of Cooley's anaemia. Our results confirm the genetic heterogeneity of these cases, the level of Hb F varies from 30% to 100% and the non alpha/alpha chain synthesis is only statistically superior to that seen in Cooley's disease. On the other hand, the kinetic study clearly separates the cases who are, or will be, clinically intermediate, showing a higher radioactive iron medullary uptake, a less ineffective erythropoiesis than that seen in Cooley's disease, and a greater peripheral haemolysis. In our study, no overlap was seen between the two groups. Iron kinetic study is then of prognostic interest and may help in therapy decisions, transfusion regimen and iron chelation, and splenectomy. PMID- 3970865 TI - The flow of blood cell suspensions through 3 microns and 5 microns Nuclepore membranes: a comparison of kinetic analysis with scanning electron microscopic examinations. AB - This study was designed to investigate the effect of red and white cells on the flow of dilute suspensions of blood cells through 3 microns and 5 microns Nuclepore membrane filters. The rate of flow of blood cell suspensions through 3 microns or 5 microns membranes declines continually due to occlusion of pores by slow cells. The cells which occlude 3 microns pores exceed the number of white cells about seven-fold. Electron microscopic examination of a used membrane confirms that these slow cells are not white cells but are red cells which are visibly damaged. With 5 microns membranes, the number of slow cells is entirely consistent with them being white cells. Again, electron microscopic examination confirms that 5 microns pores are occluded by white cells. With both types of membrane, the same kinetic analysis is valid and yields information about the behaviour of red cells during the filtration procedure. PMID- 3970866 TI - Falsely prolonged prothrombin time due to an inhibitor to human thromboplastin. PMID- 3970867 TI - Respiratory disease in foundry workers. AB - A survey was carried out in a steel foundry in Brisbane to evaluate the nature and frequency of respiratory symptoms and to assess ventilatory function. The foundry used many moulding processes including the Furane, Isocure, Shell, carbon dioxide, and oil sand systems. Nasal symptoms and wheeze were often reported, particularly by workers in the general foundry and core shop, and on a semiautomated line. By contrast, workers in the aftercast section not exposed to fumes or vapours from the various moulding processes reported these symptoms less often. Of 46 workers exposed to moulding fumes and vapours, 11 had developed a wheeze while working at the foundry. Wheeze and other respiratory tract symptoms were often attributed by the workers to exposure to substances at work, particularly from the Shell process which uses phenol formaldehyde resin and hexamethylenetetramine. Symptoms were reported also, but less often, on exposure to materials used in the Furane process (urea formaldehyde and furfuryl alcohol) and the Isocure process (methylene diphenyl diisocyanate, phenol formaldehyde, and dimethylethylamine). Ventilatory function studied over Monday and Friday showed a small and inconsistent changes. The six subjects working on the semiautomated line showed a small decrease in FEV1 (+/- SEM) (208 +/- 70 ml) only on Monday; this differed significantly from that in 17 aftercast workers (9 +/- 50 ml, p less than 0.05). Ventilatory function recorded before work on Monday morning showed no evidence of chronic airway obstruction in any group. Most environmental measurements were below the threshold limit values (TLV) except in the general foundry, where furfuryl alcohol was detected at concentrations of up to 50 ppm and formaldehyde at 4 ppm. The onset of symptoms in relation to exposure to various fumes and vapours suggests that both irritant and hypersensitivity mechanisms are present. As environmental modifications had occurred recently the apparent hypersensitivity may relate to past exposure levels above the TLV. PMID- 3970868 TI - Lung function after exposure to barley dust. AB - Six men handling barley were followed up over two working days and their flow volume curves were measured every two hours. All experienced falls in ventilatory capacity of up to 800 ml with changes in the shape of the flow volume curve in five men. Five volunteers not previously exposed to barley dust sat in a silo for two hours. Decreases in ventilatory capacity ranging from 200 ml to 800 ml were found, with recovery taking up to 72 hours. All subjects had decreases in flow at 50% vital capacity but little or no change in flow at 75% vital capacity. In three subjects there was a drop in specific conductance that lasted for less than 24 hours. Two subjects were similarly exposed on a second occasion when transfer factor for carbon monoxide was measured in addition to flow volume curves. There was a decrease in transfer factor but no change in transfer factor per unit volume (Kco). PMID- 3970869 TI - Coexposure to toluene and p-xylene in man: uptake and elimination. AB - Eight male subjects were experimentally exposed to toluene, p-xylene, and a combination of toluene and p-xylene in order to study the influence of coexposure and exposure to different levels of each solvent on their uptake and elimination. The exposures were performed for four hours at exposure levels equivalent to or lower than the Swedish threshold limit value for toluene, 300 mg/m3 (3.2 mmol/m3). During and after the exposure, solvent concentrations were measured in blood and in expired air. In addition, the pulmonary ventilation rate was measured during the exposure. Decreases in the blood/end exhaled air concentration ratio were found for both toluene and p-xylene when given in combination compared with separate exposure. The total solvent uptake relative to the exposure level was decreased after exposure to the higher solvent concentrations, and the apparent clearance was also decreased after exposure to the higher concentrations of solvent. Finally, the blood solvent concentrations were lower at the end of the exposure compared with the maximal concentration during each exposure condition. In the kinetics of toluene and p-xylene the total amount of toluene or p-xylene, or both, seems to be of major importance. The change in blood/end exhaled air concentration ratio may indicate an effect of coexposure. PMID- 3970871 TI - Sperm as an indicator of reproductive risk among petroleum refinery workers. AB - A questionnaire study of men in a wastewater treatment plant of a petroleum refinery showed twice the rate of fetal loss in the period during employment in the plant compared with the periods before and after. Questions regarding the interpretation of that study and continuing concern about reproductive risk prompted us to perform a cross sectional evaluation of sperm concentration and morphology. After adjustment for an abstinence period, the mean sperm concentration of the 74 unexposed men did not differ significantly from that of the 34 exposed men (79.9 million/cm3 v 68.2 million/cm3, p(1) = 0.16). The two groups also had a similar proportion of sperm with abnormal morphology (49.1% v 44.5%, p(1) = 0.94). This lack of association remained when degree of exposure, age, use of alcohol and marijuana, past illness or fever, use of baths or sauna, and history of urological problems were considered. These results are most consistent with the absence of sperm mediated reproductive problems. PMID- 3970870 TI - Coexposure to toluene and p-xylene in man: central nervous functions. AB - Sixteen men were studied in an exposure chamber to assess the effect of four hours' exposure to toluene (3.25 mmol/m3), xylene (2.84 mmol/m3), a mixture of toluene and xylene (2.20 + 0.94 mmol/m3), and a control condition. With the aid of microcomputers, subjects performed tests of simple reaction time, short term memory, and choice reaction time immediately after entering the chamber, after two, and after four hours' exposure. The results indicate that the performance on the tests was unaffected by exposure. In the light of this result the risk of an acute effect on central nervous functions after exposure for four hours at concentrations that do not exceed the Swedish threshold limit values was considered to be minimal. PMID- 3970872 TI - Effects of whole body vibration on biogenic amines in rat brain. AB - The effects of whole body vibration on the concentrations of noradrenaline (NA), dopamine (DA), and serotonin (5-HT) in the whole brain and brain regions of rats were investigated. Compared with control rats, vibration with 20 Hz frequency decreased the brain concentration of NA only when the acceleration (intensity) was increased to 5.0 G (p less than 0.05). The concentration of DA in the whole brain was not affected by acceleration. When acceleration was kept at a constant 0.4 G level and rats were exposed for the same 240 minute period to 5, 20, or 30 Hz vibration, neither NA nor DA concentrations changed in the whole brain. Regional changes in the concentration of biogenic amines in the brain of rats exposed to vibration of 20 Hz and 5.0 G showed few significant differences. Thus NA significantly decreased only in the hypothalamus (p less than 0.01), although in the hippocampus the decrease was nearly significant (p less than 0.10). The concentration of 5-HT significantly increased in the hypothalamus and cerebellum (p less than 0.05). DA tended to increase in the cortex and decrease in the striatum (p less than 0.10). These experiments seem to indicate that NA in the whole brain and especially in the hypothalamus is a better indicator of vibration exposure than 5-HT, and that NA is affected by the intensity but not by the frequency of vibration. NA and 5-HT in the hypothalamus change in the opposite direction. DA concentrations in the brain are basically unaffected by vibration. PMID- 3970873 TI - A note on "Job related mortality risks of Hanford workers and their relation to cancer effects of measured doses of external radiation". PMID- 3970874 TI - Vinyl chloride: the evidence for human carcinogenicity in different target organs. PMID- 3970875 TI - Health of workers exposed to electric fields. AB - The results of health questionnaire interviews with 390 electrical power transmission and distribution workers, together with long term estimates of their exposure to 50 Hz electric fields, and short term measurements of the actual exposure for 287 of them are reported. Twenty eight workers received measurable exposures, averaging about 30 kVm-1h over the two week measurement period. Estimated exposure rates were considerably greater, but showed fair correlation with the measurements. Although the general level of health was higher than we have found in manual workers in other industries, there were significant differences in the health measures between different categories of job, different parts of the country, and in association with factors such as overtime, working alone, or frequently changing shift. After allowing for the effects of job and location, however, we found no significant correlations of health with either measured or estimated exposure to electric fields. PMID- 3970876 TI - Mortality of workers in an automobile engine and parts manufacturing complex. AB - A proportionate mortality ratio (PMR) study was conducted using data on workers from three local unions representing an integrated automobile factory composed of forge, foundry, and engine (machine and assembly) plants. Ninety four percent of the death certificates were obtained for all active and non-active workers who died during the period 1 January 1970 to 31 December 1979 and were vested in union and company benefit programmes. Observed numbers of deaths were compared with expected numbers based on two standards, the proportionate mortality among men in the United States 1970-9 and among men in Erie County 1975. There was close agreement between the number of observed and expected deaths by either standard of comparison among white auto workers in the forge and foundry plants. Valid analyses of cause specific mortality among non-whites could be conducted for the foundry plant only. Although there was raised PMR for deaths due to diseases of the circulatory system using the Erie County standard, none of the other cause specific PMRs was significant. Although based on small numbers, the risk of cancer of the lung was significantly high in non-whites under age 50 in the foundry (PMR = 2.6; p less than 0.05). The cause specific PMRs for whites in the engine plant were statistically significant for malignant neoplasms (1.2) and all external causes (0.62) based on the US white male standard. Analysis of cancer specific mortality among white men in the machining/assembly plant showed significant excesses for cancer of the digestive system (PMR=1.5), particularly of the liver (PMR=2.6) and pancreas (PMR=1.9); cancers of the respiratory system (PMR=1.4 using the Erie County standard); and cancer of the urinary bladder (PMR=2.3). Workers employed for more than 20 years showed statistically increased mortality ratios for cancers of the digestive system (1.9), particularly cancer of the pancreas (2.3) and cancer of the rectum (2.8). Individuals whose employment began during or before 1950 exhibited increased PMRs for cancers of the digestive organs (1.8), particularly of the pancreas (2.5) and of the bladder (3.4). Workers whose employment began after 1950, on the other hand, exhibited raised PMRs for cancers of the respiratory system (1.5) and of the kidney (3.2). Since the foundry and forge plants did not start production until 1955, mortality associated with those work settings may be greater in the future. PMID- 3970877 TI - Biological exposure limits: the fetus and EEC politics. PMID- 3970878 TI - Minor psychiatric morbidity in employed young men and women and its contribution to sickness absence. AB - An epidemiological survey of male and female executive officers in the Civil Service showed a prevalence of 33% of minor psychiatric disorders. Follow up one year later found that only half were better. The presence of minor psychiatric disorder was associated with increased rates of sickness absence, particularly certified absence. Such a high prevalence, associated as it is with handicap to the individual and consequences for the working environment, indicates the need for early medical detection and treatment. PMID- 3970879 TI - Experimental study on the enhancement of the neurotoxicity of methyl n-butyl ketone by non-neurotoxic aliphatic monoketones. AB - The neurotoxicity of methyl n-butyl ketone is known to be enhanced by combination with methyl ethyl ketone. This study was conducted to clarify the potentiating effect of aliphatic monoketones on the neurotoxicity of methyl n-butyl ketone. Rats were subcutaneously injected in the back with 4 mmol/kg/day of methyl ethyl ketone, methyl n-propyl ketone, methyl n-amyl ketone, or methyl n-hexyl ketone mixed with an equimolar dose of methyl n-butyl ketone five days a week for 20 weeks. The maximum motor fibre conduction velocity and the distal latency were measured every two weeks in the tail nerves of the treated animals and controls. All the monoketones tested enhanced the neurotoxicity of methyl n-butyl ketone. Of the compounds tested, methyl n-hexyl ketone, which had the longest carbon chain, enhanced the neurotoxicity of methyl n-butyl ketone most strongly. These results suggest that the length of the carbon chain of the aliphatic monoketones combined with methyl n-butyl ketone was related to the enhancement of the neurotoxicity of the neurotoxic compound. PMID- 3970880 TI - Partition coefficients of some industrial aliphatic hydrocarbons (C5-C7) in blood and human tissues. AB - Saline/air, blood/air, olive oil/air, and tissue/air (lung, kidney, liver, brain, muscle, heart, and fat) partition coefficients were determined for nine aliphatic hydrocarbons: n-pentane, 2,2-dimethylbutane, 3-methylpentane, 2-methylpentane, methylcyclopentane, n-hexane, cyclohexane, 3-methylhexane, and n-heptane. Blood/air partition coefficients were found to range between 0.38 (n-pentane) and 1.9 (n-heptane) and the value of the tissue/air partition coefficients rose from n-pentane to n-heptane. The tissue/air partition coefficients were significantly correlated with the blood/air partition coefficients (r = 0.92-0.98). According to the slope of the regression lines, the mean solubility of the nine aliphatic hydrocarbons in the different tissues was higher than in blood by the factors: lung 1.4 (range 1.2-2.1) heart 3.9 (range 0.5-4.5), liver 5.6 (range 5.5-13.5), kidney 5.2 (range 1.6-5.8), brain 6.5 (range 5.8-10.7), muscle 7.6 (range 1.8 8.8), and fat 205 (range 104-254). The blood/air and olive oil/air partition coefficients were significantly correlated with the boiling points and the molecular weights of the aliphatic hydrocarbons studied. PMID- 3970882 TI - Neurophysiological studies on workers exposed to lead. AB - Nerve conduction and somatosensory evoked potential studies were undertaken on 46 workers exposed to a combination of organic and inorganic lead. In addition electroencephalograms were carried out on 20 of the workers; the results were compared with those obtained for workers not exposed to lead. The workers exposed to lead had a mean blood lead concentration of 2.35 mumol/l (48.7 micrograms/100 ml), whereas the concentration for workers not exposed to lead was 0.76 mumol/l (15.8 micrograms/100 ml). The mean maximum motor conduction velocities of the median and the posterior tibial nerves were significantly lower in the workers exposed to lead than in the controls. Similarly, the distal latency for these two nerves was significantly prolonged for the workers exposed to lead. No significant differences for the two groups of workers were seen in the nerve conduction and distal latency measurements of the median (sensory) and the sural nerves. The EEG studies of the 20 workers exposed to lead showed no abnormalities. The somatosensory evoked potential of the median (sensory) and posterior tibial nerves were significantly prolonged when measured at the negative and positive deflections. The results suggest that, in addition to nerve conduction velocities, somatosensory evoked potential and distal latency are suitable measurements to detect subclinical neurological damage among workers exposed to lead. As these changes were seen at blood lead concentrations of 2.35 mumol/l (48.7 micrograms/100 ml) there may be a need for more stringent monitoring of workers exposed to lead. PMID- 3970881 TI - Total contribution of airborne lead to blood lead. AB - A nine year study of blood lead concentrations and isotope ratios carried out on a married couple shows that pulmonary deposition cannot account for all the airborne lead in blood; that lead from bone may comprise 70% of blood lead; and that during pregnancy blood lead may double due to mobilisation of lead from bone. PMID- 3970883 TI - Recovery from paraquat pneumonitis. AB - New Zealand white rabbits were evaluated for recovery from paraquat induced pneumonitis six weeks after the last exposure. The animals were exposed to a respirable aerosol of 100 ml distilled water or 250 mg paraquat in 100 ml distilled water. Blood gases, breathing frequency, and body weights were recorded before and at regular intervals after exposure. Groups included control and two paraquat exposures (separated by a five day interval). Morphometric and pathological measurements were made at death either three days or 42 days after the second exposure. The animals killed three days after the second exposure showed hypoxia, decreased breathing frequency, decreased body weight, increased A aO2 gradient, decreased per cent macrophages in bronchoalveolar lavage fluid, increased per cent neutrophils in bronchoalveolar lavage fluid, increased lung weight, and reduced lung volume compared with animals allowed to recover. None of these measures differed between control animals and animals allowed to recover, except that animals exposed to paraquat had significantly increased lung volume and lung weights. Pathological changes noted three days after two exposures were no longer found six weeks after exposure. It is concluded that rabbits exposed to paraquat aerosol develop a severe pneumonitis that resolves if exposure is stopped and recovery time is allowed; physiological abnormalities remain, however. PMID- 3970884 TI - Gassings due to methylene chloride, xylene, toluene, and styrene reported to Her Majesty's Factory Inspectorate 1961-80. AB - For the period 1961-80, 118 cases of industrial gassings caused by the solvents methylene chloride, xylene, toluene, and styrene were reported to Her Majesty's Factory Inspectorate. The data have been collated and analysed according to the predetermined criteria of age, sex, mode and circumstances of use, clinical effect, and outcome. The means of collection of the data and their objectivity is discussed. The study shows the narcotic effect of these solvents and underlines the dangers of their use in confined spaces. Symptoms were most commonly attributable to the nervous and respiratory systems. The problem of addiction and the vulnerability of the younger worker is also discussed. PMID- 3970885 TI - Cancer morbidity among workers in the telecommunications industry. AB - A retrospective cohort study of 2918 workers in the telecommunications industry in Sweden recorded the cancer morbidity for the period 1958-79. Cases of cancer were collected from the Swedish Cancer Registry for this period and information on work characteristics was collected for the entire period of employment. The total cancer morbidity was as expected. There was no excess risk of lung cancer but an excess risk of malignant melanoma of the skin was detected (SMR = 2.6, 12 cases). This excess risk was particularly associated with work environments where soldering was practised. Estimates of the SMR became larger with the assumption of a longer induction/latency period. PMID- 3970886 TI - Ventilatory responses of normal subjects to flax dust inhalation: the protective effect of autoclaving the flax. AB - A homogeneous batch of dew retted hackled flax was divided into two portions. One was untreated and the other was steamed for 45 minutes at 125 degrees C in three pressure/vacuum cycles in an autoclave. Dust was collected when the two flaxes were separately processed by industrial doubler and stapler machines. From untreated flax 7.2 g of dust was collected per kilogram of flax after two processing operations. From the steamed flax 4.4 g of flax was obtained per kilogram after four operations. A method was devised to disperse the dust in a room to produce dust levels similar to those encountered in a dusty mill (4.5-5.7 mg/m3). Twelve normal volunteers from the managerial staff of the linen industry of Northern Ireland inhaled the dust over six hour periods. With the untreated flax decreases were obtained in mean forced expiratory measurements of 7.6% in FEV1 and 4.5% in FVC (p less than 0.01). A double blind crossover comparison of similar levels of untreated and steamed flax dusts showed 30% less impairment of the forced expirations with steamed than with untreated flax (p less than 0.05). If these responses reflect the long term airway effects of flax dust then the steaming of flax may help in reducing byssinosis. PMID- 3970887 TI - Determinants of changes in FEV1 over a workshift. AB - Measurement of workshift change in FEV1 is a useful predictor of respiratory disease among cotton workers and grainhandlers. Certain factors affect this measurement and must be considered in the analysis. Response varies with the time of day at which the measurement is taken. Tobacco smoking, immediate skin reactivity to common allergens, age, and initial level of FEV1 are other factors that must be considered when this measurement is used to study effects of occupational exposure to respiratory hazards. PMID- 3970888 TI - Statistical derivation of a standardised procedure for counting expectorated alveolar macrophages as indicators of occupational air pollution. AB - A biological test in which counts of expectorated alveolar macrophages are used to evaluate lung irritation attributable to occupational air pollution has been applied to workers exposed to dust and gas pollution. To determine the optimum allocation of resources when performing the test, the sampling and counting procedures have been evaluated statistically. Alveolar macrophages (AM) were recovered from workers at an iron works, an aluminium plant (one large and one small group), and from a small group of non-exposed smokers; the number of subjects was 213. Sampling was repeated with the small group at the aluminium plant (27 subjects) on three consecutive days and the small group of non-exposed smokers on five (3 subjects). AM were counted from smear slides using a light microscope. A standard random effects model was used as the basis for estimating the expectation of the log-transformed overall means (mu) and the variances (var(mu)) of the two categories at the aluminium plant and of the non-exposed smokers. The costs connected with finding mu consist of the financial expenses and the working efforts and time used to perform the test. The precision and reproducibility of the test are closely related to the variability in the results, var (mu). To optimise the costs but still obtain reproducible results, AM should be counted in four drops of expectorate from each of three samples from at least 10 to 20 subjects. PMID- 3970889 TI - Dysbaric hazard of a new fishing method in Hong Kong: case report. PMID- 3970890 TI - Mortality experience of electrical engineers. PMID- 3970891 TI - Allergy to laboratory animals. PMID- 3970892 TI - Changing problems and priorities in obstetrics. AB - National perinatal mortality data suggest that the root causes of many deaths may lie in the environmental circumstances in which the mother grew up. Aberdeen primigravidae under the age of 20 years who gave birth to a baby with a birthweight of less than 2500 g between 1968 and 1972 were divided into those where there was an associated obstetric complication and those where the cause of the low birthweight infant was 'unexplained'. The 'unexplained' group were more often smaller, underweight, cigarette smokers, and from relatively large families in the lower socioeconomic classes. Investigations of case records and by interview revealed that the mothers of these primigravidae were similarly disadvantaged and it is argued that further improvement in perinatal health and mortality will depend on the elimination of this continuity of social disadvantage. PMID- 3970893 TI - Pre-eclampsia in second pregnancy. AB - A total population of pregnant women from Aberdeen City District 1967-1978 has been studied. There were 29 851 pregnancies and 6637 women had a first recorded pregnancy between 1967 and 1978 and had two or more pregnancy events. As expected the incidence of pre-eclampsia in a second pregnancy was less than that in a first pregnancy, but it was dependent on the outcome of the first pregnancy. If the first pregnancy was complicated by proteinuric pre-eclampsia than the incidence of the condition in the second pregnancy was similar to that in a first pregnancy, but women who were normotensive in the first pregnancy had a reduced incidence of the condition in the second pregnancy. The incidence of proteinuric pre-eclampsia after early abortion (less than 13 weeks), either spontaneous or induced was similar to the population incidence in a first pregnancy, but after a late spontaneous abortion the risk of proteinuric pre-eclampsia was significantly reduced. Change of civil status of the offspring from first to second pregnancy did not affect the incidence of pre-eclampsia in a second pregnancy. There was an effect of birthweight in that women who had proteinuric pre-eclampsia in conjunction with a low-birthweight baby (less than 2500 g) in their first pregnancy had double the incidence of proteinuric pre-eclampsia in their second pregnancy. Only a pregnancy of 37 weeks or more is likely to offer protection or 'immunity' to pre-eclampsia in a second pregnancy and even then the effect is moderated by the development of pre-eclampsia in the first pregnancy. PMID- 3970894 TI - The impact of screening on the incidence of cervical cancer in England and Wales. AB - Age-specific incidence curves for clinical cancer of the cervix in England and Wales show progressive changes over the period 1963-1978; in particular, a large reduction in incidence is seen in the age group 35-54. Since screening on any scale began in the early 1960s, we have investigated how much of this reduction in incidence in the middle age range can be attributed to detection of pre invasive disease. Data on registrations of in-situ cancer have been used to estimate the patterns that might have been observed in the absence of screening. The results indicate clear cohort effects on incidence, with rising rates in the generations born 1906-1921 and since 1931, with a fall in the decade between. In addition to this, screening has probably led to a substantial reduction in the number of cases of clinical cancer in women aged 35-54, but has had little effect over the age of 60 where virtually no screening has been performed. Below age 35 the observed increase in incidence may be considerably less than it would have been in the absence of screening. PMID- 3970895 TI - Complications of cone biopsy related to the dimensions of the cone and the influence of prior colposcopic assessment. AB - A retrospective study of the complications of cone biopsy showed that among 915 women examined between the years 1976 and 1982, 121 (13%) had primary or secondary haemorrhage, 153 (17%) cervical stenosis and 39 (4%) subsequent infertility or an abnormal pregnancy. Cervical stenosis was commonest among women who had had long cones removed. Stenosis occurred more often in the group of women who had been assessed by colposcopy before operation but this was due to the fact that prior colposcopy selected a favourable group of patients with lesions of limited extent that were susceptible to treatment by local destructive therapy, so that prior colposcopic assessment resulted in the removal of longer cones. PMID- 3970896 TI - Spontaneous resolution of cervical warty atypia: the relevance of clinical and nuclear DNA features: a prospective study. AB - A selected group of 51 patients with histological features of cervical warty atypia was observed for 1 year. Initial features were compared with a cohort of 50 patients with CIN. Twenty-four patients showed resolution of the warty atypia, in 19 it remained unchanged, and in eight patients CIN or microinvasive disease was present on repeat biopsy. The DNA patterns obtained by tissue imprint of the initial biopsies and subsequent integrated densitometry, using a Vickers M85 scanning densitometer, showed that warty atypias could be objectively distinguished from CIN, but that the method could not predict the group of warty atypias that would resolve. There was no clinical feature or group of features which allowed a means of predicting the outcome of such lesions. PMID- 3970897 TI - Malakoplakia of the pelvic peritoneum in pregnancy. Case report. PMID- 3970898 TI - The internal concentration of K+ in isolated rat liver mitochondria. AB - A simple osmotic method has been developed to determine the internal K+ concentration of mitochondria by determining the concentration of external K+ at constant osmotic pressure at which metabolically inhibited mitochondria neither shrink nor swell. This concentration has been found to correspond to approx. 80 85 mM in freshly isolated mitochondria and considerably lower after additional centrifugation procedures. Since mitochondria are in osmotic equilibrium with the suspending medium (in this case, 0.32 osmolal), and K+ is the primary exchangeable internal ion, a significant proportion of the internal osmotic pressure must be exerted by the sucrose. Results for experiments determining internal K+ after centrifuging mitochondria at various G values confirm the reports of Sitaramam et al. (Sitaraman, V. and Sarma, M.K.J. (1981) Proc. Natl. Acad. Sci. USA 78, 3441-3445 and Sambasivarao, D. and Sitaramam, V. (1983) Biochim. Biophys. Acta 722, 256-270) that centrifugation induces the entry of sucrose in mitochondria isolated in a sucrose medium. PMID- 3970899 TI - The effects of cation-induced and pH-induced membrane stacking on chlorophyll fluorescence decay kinetics. AB - We have compared the effects of thylakoid membrane appression by electrostatic screening and by charge neutralization on the room-temperature chlorophyll fluorescence decay kinetics of broken spinach chloroplasts. Monovalent and divalent metal cations induce both a structural differentiation of thylakoid membranes and a lateral segregation of pigment-protein complexes. These phenomena have distinct effects on the F0- and Fmax-level chlorophyll fluorescence decay kinetics at different levels of added cation. We further find specific cation effects, particularly on a 1-2 ns decay component at the Fmax fluorescence level, that are proposed to be related to the effectiveness of electrostatic screening as determined by the hydrated metal ionic radius. Distinct pH-induced effects on chlorophyll fluorescence decay kinetics are associated with the alternative mechanism of electrostatic neutralization to induce membrane stacking. These observations are used to construct a model of chlorophyll fluorescence emission that accounts for the variable kinetics and multiexponential character of the fluorescence decay upon membrane appression. PMID- 3970900 TI - Structure-function studies of canine cardiac sarcolemmal membranes. II. Structural organization of the sarcolemmal membrane as determined by electron microscopy and lamellar X-ray diffraction. AB - The morphological and ultrastructural properties of highly purified canine cardiac sarcolemmal vesicles, prepared by a modification (Colvin, R.A., Ashavaid, T.F. and Herbette, L.G. (1985) Biochim. Biophys. Acta 812, 601-608) of the method of Jones et al. (Jones L.R., Madlock, S.W. and Besch, H.R. (1980) J. Biol. Chem. 255, 9971-9980), were examined by several techniques. Thin-section electron microscopy showed predominantly intact unilamellar vesicles with little staining beyond the lipid bilayer boundaries. Freeze-fracture electron microscopy demonstrated that the majority of particles are approx. 90 A diameter and present at a density of 780 +/- 190 micrometers-2 (+/- S.D.). If it is assumed that some of these particles represent the (Na+ + K+)-ATPase, the finding that they are largely confined to the convex fracture face suggests a predominant right-side out orientation of these sarcolemmal vesicles that is consistent with biochemical assays. The sarcolemmal membrane width measured by electron microscopy (unhydrated membrane width of 50-70 A) is consistent with the unit cell dimensions of 56-77 A determined by lamellar X-ray diffraction (hydrated membrane width). A unit cell dimension of 56-62 A was also found by X-ray diffraction for sarcolemmal lipids extracted from these preparations, indicating that the isolated sarcolemmal preparations do not contain a significant surface coat (glycocalyx). As both cardiac and skeletal sarcoplasmic reticulum membranes have a 80-100 A membrane width, these findings demonstrate that the purified sarcolemmal membrane is structurally distinct from both cardiac and skeletal sarcoplasmic reticulum. In contrast to the protein-rich skeletal sarcoplasmic reticulum membrane, which contains a single essential protein responsible for the regulation of cytosolic Ca2+ concentration, the sarcolemma is a lipid-rich membrane that contains a variety of proteins associated with many regulatory functions served by this membrane in cardiac muscle. PMID- 3970901 TI - Comparison of the transport of 42K+, 22Na+, 201Tl+, and [99mTc(dmpe)2 X Cl2]+ using human erythrocytes. AB - The ability of isolated human erythrocytes to exchange Na+ for K+ via (Na+ + K+) ATPase was used to study the characteristics and interactions of the transport of both alkali metal and synthetic monovalent cations. Both efflux and influx studies were carried out and the results showed that: (1) Efflux of 22Na+ from human erythrocytes was stimulated by the addition of either of K+, or Tl+ at 10 mM and inhibited by the addition of ouabain. Unlabeled K+ and the addition of [99Tc(dmpe)2 X Cl2]+ (dmpe, 1,2-bis(dimethylphosphino)ethane) at 5 mM had no effect on 22Na+ efflux. (2) Influx of 42K+ was inhibited by the addition of ouabain, unlabeled K+, or Tl+. 201Tl+ influx was more rapid and of a greater magnitude than 42K+ influx. [99Tc(dmpe)2 X Cl2]+ had no effect on 42K+ uptake. (3) Influx of 201Tl+ was inhibited by ouabain and by the addition of unlabeled Tl+. Addition of [99Tc(dmpe)2 X Cl2]+ at 5 mM resulted in an inhibition of 201Tl+ influx. (4) [99Tc(dmpe)2 X Cl2]+ influx resembled that of 42K+ with respect to rate and magnitude. Influx of [99mTc(dmpe)2 X Cl2]+ was shown to be unaffected by ouabain, unlabeled K+ or Tl+. Addition of 5 mM [99Tc(dmpe)2 X Cl2]+ initially had no effect on [99mTc(dmpe)2 X Cl2]+ influx, however, a time-dependent stimulation of the influx of the [99mTc(dmpe)2 X Cl2]+ was observed. We conclude that the influx of the various alkali, metal and synthetic monovalent cations into erythrocytes is mediated by different mechanisms. Most clearly, the influx of [99mTc(dmpe)2 X Cl2]+ is not by a mechanism similar to that of utilized by K+ or Tl+. PMID- 3970902 TI - Correlation of androgen-responsiveness of Shionogi mouse mammary carcinoma cell lines with binding of dihydrotestosterone to nuclear envelopes. AB - Purified nuclear envelopes have been isolated from an androgen-responsive and two androgen-unresponsive cell lines of the Shionogi mouse mammary carcinoma. The binding of dihydrotestosterone to nuclear envelope fractions isolated from the three variant cell lines is correlated with the androgen-responsiveness of the cell line. Nuclear envelopes prepared from the two androgen-unresponsive cell lines did not bind dihydrotestosterone specifically following incubation with radioactive dihydrotestosterone from 2.5 to 45.0 nM at 20 degrees C for 18 h. Under the same binding conditions, nuclear envelopes prepared from the androgen responsive cell line demonstrated saturable, specific binding of dihydrotestosterone. Scatchard analysis revealed a class of binding sites with an apparent Kd of 14.2 nM and a maximum binding capacity of 28.7 fmol/mg protein. Proteinase and heat treatments resulted in the complete loss of androgen-binding activity, whereas DNAase treatment resulted in the loss of 38% of the binding activity. The binding sites were specific for dihydrotestosterone. Testosterone was only a weak competitor and estradiol did not compete. Extraction with concentrations of KCl up to 1.0 M did not result in loss of androgen binding. PMID- 3970903 TI - Effect of cholesterol on Ca2+-induced aggregation and fusion of sonicated phosphatidylserine/cholesterol vesicles. AB - Small unilamellar vesicles composed of phosphatidylserine (PS) and cholesterol at various ratios were employed in studying the effect of cholesterol on Ca2+ induced vesicle aggregation and fusion using the Tb/dipicolinic acid assay. The leakage of preencapsulated Tb3+ was also measured. The analysis of the data provided estimates for the rate of aggregation C11, and the rate of fusion per se, f11. An increase in cholesterol contents results in a decrease in C11 values. Similarly, aggregation of PS/cholesterol vesicles is slower than that of PS vesicles in the presence of 650 mM NaCl. With 100 or 200 mM NaCl, the overall fusion rate of PS/cholesterol vesicles is slower than that of PS vesicles; the rate being reduced by an increase in cholesterol contents. With 600 mM NaCl, the overall fusion rate of PS/cholesterol 9:1 vesicles is faster than that of PS vesicles, and results are well-simulated by assuming no delay in vesicle aggregation up to dimers. Emerging f11 values are larger in PS/cholesterol than in PS vesicles. An analysis of fusion kinetics of several lipid concentrations shows that f11 values of PS/cholesterol 3:1 vesicles are 5-times larger than those of PS vesicles, when fusion occurs in a medium containing 200 mM NaCl and 1.5 mM Ca2+. The increase in Na+ concentration from 100 to 200 mM, or 600 mM results in a 50- or 150-fold reduction in f11 values of PS vesicles. It is suggested that incorporation of cholesterol in PS vesicles results in enhancement of Ca2+-induced fusogenic capacity. PMID- 3970904 TI - Effects of phenylamide herbicides on the physical properties of phosphatidylcholine membranes. AB - A number of phenylamide herbicides are observed to uncouple electron transport in isolated chloroplasts and mitochondria and alter the H+ permeability of artificial liposomes. Several of these phenylamides were incorporated into phosphatidylcholine multilamellar and small unilamellar vesicles to measure their effects on the physical properties of membranes. X-ray diffraction analysis of the multilamellar vesicles revealed that the herbicides partitioned into the hydrocarbon chain region of the bilayer, but caused only minimal perturbations on hydrocarbon chain packing. 31P-NMR spectroscopy of these multilamellar vesicles showed both a broadening and lowering of the phase transition temperature of the bilayer lipids upon addition of the herbicides. 13C-NMR spectroscopy of small, unilamellar phosphatidylcholine vesicles was performed to measure the effects of the phenylamides on the chemical shifts and the spin-lattice relaxation times of the individual phosphatidylcholine carbon atoms. None of the added compounds had any measurable effect on the 13C-NMR chemical shifts of the phosphatidylcholine. However, the herbicides significantly modified spin-lattice relaxation times of certain of the lipid carbon atoms. These results generally indicate that the herbicides orient in the lipid bilayers such that the hydrocarbon chains of the phenylamides associate with the hydrocarbon chains of the lipid, whereas the phenyl moiety resides in the polar region of the bilayer. PMID- 3970905 TI - The effect of amino acids and dipeptides on sodium-ion transport in rat enterocytes. AB - Sodium efflux from isolated intestinal epithelial cells was measured during incubation with several different free amino acids and dipeptides. L-Leucine, which is cotransported with sodium across the brush border membrane, significantly stimulated the total sodium efflux and almost all of this increase involved the ouabain-sensitive flux, i.e., the active component. In contrast, glycyl-L-leucine had little or no effect on active sodium efflux either in the presence or absence of 0.1 mM bestatin, a peptide hydrolase inhibitor. A second dipeptide L-carnosine (beta-alanyl-L-histidine) which is poorly hydrolysed by enterocytes also had no effect upon sodium efflux. However, glycylglycine, which has been shown to be cotransported with sodium, did stimulate the ionic efflux. In addition, measurement of sodium uptake by sheets of small intestine showed that glycyl-L-leucine, carnosine and glycyl-L-proline failed to increase the uptake of the ion, while glycylglycine did significantly stimulate sodium uptake. These data indicate that some dipeptides are not cotransported with sodium, while others are. This suggests that there may well be multiple peptide transporters with very different characteristics in the brush border membrane of enterocytes. PMID- 3970906 TI - Reversible and irreversible modification of erythrocyte membrane permeability by electric field. AB - Electric fields of a few kV/cm and of duration in microseconds are known to implant pores of limited size in cell membranes. We report here a study of kinetics of pore formation and reversibility of pores. Loading of biologically active molecules was also attempted. For human erythrocytes in an isotonic saline, pores allowed passive Rb+ entry formed within 0.5 microsecond when a 4 kV/cm electric pulse was used. Pores that admitted oligosaccharides were introduced with an electric pulse of a longer duration in an isosmotic mixture of NaCl and sucrose. These pores were irreversible under most circumstances, but they could be resealed in an osmotically balanced medium. A complete resealing of pores that admitted Rb+ took approximately 40 min at 37 degrees C. Resealing of pores that admitted sucrose took much longer, 20 h, under similar conditions. In other cell types, resealing step may be omitted due to stronger membrane structures. Experimental protocols for loading small molecules into cells without losing cytoplasmic macromolecules are discussed. PMID- 3970907 TI - Interaction between the subunits of human erythrocyte spectrin using a fluorescence probe. AB - Fluorescence labeling of spectrin subunits was performed with N-(1 anilinonaphthyl-4)maleimide (ANM) to study the interaction between alpha and beta subunits. The fluorescence anisotropy of both ANM alpha and ANM beta increased linearly with the addition of nonfluorescent beta or alpha subunit, and saturated at a protein ratio about 1, indicating that 1 mol alpha subunit binds to 1 mol beta subunit with high affinity in vitro. Furthermore, this binding seemed to be reversible, because the anisotropy value decreased when an excess fo nonfluorescent alpha was added to the ANM alpha/beta mixture. The anisotropy of ANM alpha attained a maximum level within l min after addition of the same quantity of nonfluorescent beta at 12 degrees C, and the anisotropy of this mixture decreased rapidly when an excess of nonfluorescent alpha was added. These findings suggested that both the binding process of beta to ANM alpha and the dissociation step of ANM alpha from the ANM alpha-beta complex were quite rapid. The results obtained here imply that dynamic interaction between alpha and beta subunits of spectrin should be taken into account in understanding the role of the spectrin molecule in the cytoskeletal mesh. PMID- 3970908 TI - Preparation of multilamellar vesicles of defined size-distribution by solvent spherule evaporation. AB - A novel method of preparing multilamellar vesicles is described. The process involves dispersing in aqueous solutions small spherules of volatile hydrophobic solvents in which amphipathic lipids are dissolved. The lipids form vesicles when the solvents are evaporated in the proper manner. The resulting vesicles have been characterized morphologically with microscopy and electron microscopy. The method yields multilamellar vesicles with a defined size distribution which can be adjusted by varying the duration of mechanical agitation of the spherules and by varying the concentration of amphipathic lipids in the solvents. This is the first fundamentally new method of multilamellar vesicle preparation since Bangham's report in 1965 (Bangham, A.D., Standish, M.M. and Watkins, J.C. (1965) J. Mol. Biol. 13, 238-252). PMID- 3970909 TI - Characteristics of collagen-induced fibrinogen binding to human platelets. AB - Polymerized type I calf skin collagen induced a time-dependent specific binding of 125I-fibrinogen to washed human platelets. Binding occurred more rapidly in a shaken rather than in an unstirred system. It was linear in the range 0.05-0.3 microM added fibrinogen and was saturated at higher fibrinogen concentrations (more than 0.8 microM). Scatchard analysis showed a single population of binding sites (16530 +/- 5410 per platelet) with a Kd = 0.53 +/- 0.23 microM. Collagen induced 125I-fibrinogen binding to platelets was completely inhibited by ADP antagonists such as creatine phosphate/creatine phosphokinase and AMP, and partially inhibited by pretreatment of the platelets with aspirin. With both normal and aspirin-treated platelets a close correlation was observed between the amount of 125I-fibrinogen bound and the extent of dense granule secretion. Our results confirm that fibrinogen becomes bound to platelet surface receptors during collagen-induced platelet aggregation and suggest that secreted ADP is an essential cofactor in this process. PMID- 3970910 TI - Kinetics of water transport in sickle cells. AB - This paper reports the results of stopped-flow studies on differences in the kinetics of osmotic water transport of sickle and normal erythrocytes. The kinetics of inward osmotic water permeability are similar in sickle and normal red blood cells. In contrast, the kinetics of outward water flux are significantly (approx. 38%) decreased in sickle cells. Deoxygenation does not modify the water influx kinetics in either type of cells, but accelerates considerably the rate of water efflux in sickle cells. No significant variation of water transport kinetics was observed in density-separated cell fractions of either type. The results suggest that membrane-associated hemoglobin may decrease the outward water permeability and that in deoxygenated sickle cells the fraction of hemoglobin S near the lipid bilayer is lower than in oxygenated conditions. PMID- 3970911 TI - Alternative-substrate inhibition of L-lactate transport via the monocarboxylate specific carrier system in human erythrocytes. AB - The L-lactate/proton symport system of the red blood cell membrane was studied under conditions of alternative-substrate inhibition by glycolate. At constant pH of the medium glycolate caused competitive inhibition of L-lactate transport. In Lineweaver-Burk plots of 1/v against 1/[H], on the other hand, glycolate caused an uncompetitive inhibition. These observations indicate, that the monocarboxylate carrier exhibits ordered substrate binding, with the proton binding first. PMID- 3970912 TI - Phospholipid aliphatic chain composition modulates lipid class composition, but not lipid asymmetry in Clostridium butyricum. AB - The phospholipid composition of the butyric acid-producing clostridia is responsive to the degree of enrichment of the lipids with cis-unsaturated fatty acids. When Clostridium butyricum and Clostridium beijerinckii are grown on oleic acid in media devoid of biotin, the acyl and alk-1-enyl chains of the phospholipids become highly enriched with 18:1 and C19-cyclopropane. Under these conditions there is a marked increase in the glycerol acetals of the major plasmalogens of these organisms. We have grown both species on mixtures of palmitate and oleate in the absence of biotin. The alk-1-enyl chains were highly enriched with C18-unsaturated and C19-cyclopropane residues at all but the highest ratios of palmitate to oleate (80:20, w/w) added to the medium. At ratios of palmitate to oleate greater than or equal to 40:60, the saturated acid was incorporated predominantly into the phospholipid acyl chains in both organisms. The effects of increasing unsaturation of the acyl chains as the ratio of oleate to palmitate was increased was examined in C. butyricum. In cells grown on mixtures of palmitate and oleate equal to or exceeding 40% palmitate, the ratio of glycerol acetal lipid to total phosphatidylethanolamine (PE) was relatively constant. As the proportion of oleic acid added to the medium was increased, the ratio of glycerol acetal lipid to PE increased from 0.7 to 2.0. Thus the ratio of the polar lipids appears to respond to the content of phospholipids that contain two unsaturated chains. The fraction of PE present as plasmalogen remained relatively stable (0.82 +/- 0.05) at varying ratios of medium oleic and palmitic acids. Both the glycerol acetal of ethanolamine plasmalogen, and ethanolamine plasmalogen, are shown to be 80% or more in the outer monolayer of the cell membrane. These two polar lipids represent approx. 50% of the phospholipids in cells grown on exogenous fatty acid. The bulk of the remainder is polyglycerol phosphatides. We suggest that the ability of both species to grow with highly unsaturated membranes is related to their ability to modulate their polar lipid composition. PMID- 3970913 TI - Evidence of essential disulfide bonds in angiotensin II binding sites of rabbit hepatic membranes. Inactivation by dithiothreitol. AB - Radiolabelled angiotensin II binds to a single class of high-affinity binding sites on purified rabbit hepatic membranes. The binding is specific, reversible and saturable. Displacement studies using angiotensin and various analogs of angiotensin II disclosed a structure-activity profile similar to that found in physiologically relevant angiotensin II receptor sites. Treatment of membranes with the reducing agent, dithiothreitol, causes a significant decrease in the affinity of angiotensin II binding sites for the native ligand. This effect is mimicked by a 15-fold higher concentration of the monosulfhydryl derivative, 2 mercaptoethanol. Kinetic studies also indicated that dithiothreitol increases the rate of dissociation of bound ligand from the membrane without significantly affecting the association rate. In contrast, treatment of membranes with the metal chelators, ethylenediaminetetracetic acid (EDTA) and ethyleneglycol bis(beta-aminoethyl ether)-N,N'-tetracetic acid (EGTA), does not affect the binding of radiolabeled angiotensin II. Furthermore, dithiothreitol inhibited the binding of angiotensin II to a solubilized partially purified preparation of angiotensin II-binding protein from the same tissue and also increased the dissociation of bound angiotensin II. This indicates that the effect of the sulfhydryl reagents on the membrane binding sites is the result of a direct alteration of the binding sites rather than a gross modification of the structure of the membrane. PMID- 3970914 TI - Local anesthetic-phospholipid interactions. The pH dependence of the binding of dibucaine to dimyristoylphosphatidylcholine vesicles. AB - The interaction of the local anesthetic dibucaine with unilamellar vesicles of dimyristoylphosphatidylcholine was studied by equilibrium dialysis. Saturating binding profiles (as a function of dibucaine) were found, with apparent association constant ranging from 1.26 X 10(3)M-1 to 2.57 X 10(3)M-1 as pH is increased from 5.0 to 7.5. The number of phospholipid molecules comprising a binding site was found to be about 5 at each pH. Analysis of the data was also achieved using the Stern model, which takes into account the electrostatic effect on binding of the cationic drug due to the build up of a surface potential. PMID- 3970915 TI - Serum-induced net K+ influx performed by the diuretic-sensitive transport system in quiescent NIH 3T3 mouse fibroblasts. AB - In serum deprived NIH 3T3 mouse cells the diuretic-sensitive transport system performs K+ self-exchange. The addition of serum which stimulates cell proliferation induces a net influx of K+, carried out by the diuretic-sensitive transport system. Thus, serum growth factors appear to induce a change in the mechanism of action of the diuretic-sensitive transporter from K+ self-exchange to an uphill transport pumping K+ into the cell. I propose here that this uphill uptake of K+ contributes to the increase of intracellular K+ content, found in the early G1 phase of the cell cycle. PMID- 3970916 TI - Pyruvate prevents the ATP depletion caused by formaldehyde or calcium-chelator esters in the human red cell. AB - Formaldehyde released during hydrolysis of calcium-chelator esters incorporated into cells blocks glycolysis in the human erythrocyte (Tiffert, T., Garcia Sancho, J. and Lew, V.L. (1984) Biochim. Biophys. Acta 773, 143-156). This blockade is due to the inhibition of glyceraldehyde-3-phosphate dehydrogenase by NAD+ depletion caused by enzymatic oxidation of formaldehyde coupled to NADH production. The addition of pyruvate to the incubation medium prevents or reverts ATP depletion. PMID- 3970917 TI - Decrease by cycloheximide of calcium binding and nonesterified fatty acids in rat intestinal Golgi-enriched membrane fractions. AB - Rat intestinal Golgi-enriched membrane fractions bind more Ca2+ than do basolateral and microvillus-enriched membrane fractions, and this uptake is reduced by vitamin D-deficiency. The effect of the protein synthesis inhibitor, cycloheximide, on this Ca2+ binding was determined in rat fed a normal, vitamin D sufficient diet. Cycloheximide, 1.5 mg/kg, rapidly reduced protein synthesis (measured by [3H]leucine incorporation) to 12% of control values within 15 min, but Ca2+ binding diminished gradually to 50% of control values by 60 min. Ca2+ transport across gut sacs was also decreased. The reduction in Ca2+ binding was not due to an alteration in vesicle morphology or to a direct effect of cycloheximide. Nonesterified (free) fatty acids, the probable binding sites for Ca2+ in these membrane fractions, were reduced by cycloheximide to 48% of control values by 60 min. There was no significant change in total lipid phosphate. Cycloheximide may affect the synthesis of proteins necessary for the presence of nonesterified fatty acids in these Golgi membranes. PMID- 3970918 TI - In vitro inhibition of rat small intestinal absorption by lipophilic organic cations. AB - Cationic, lipid-soluble organic compounds may interfere with cation-mediated membrane transport processes. Thus, small intestinal absorption may be influenced by lipophilic organic cations. Therefore a series of arylalkylamines was studied in the concentration range from 0.5 to 20 mmol/l for their effect on the transport of various monosaccharides and leucine in the rat small intestine in vitro by means of the tissue accumulation technique. Whereas the monophenyl substituted monoamines (e.g. benzylamine, 2-phenylethylamine, 3 phenylpropylamine) did not show a significant effect on the active transport, the corresponding omega,omega-diphenyl derivatives exhibited a strong inhibition of the active transport of the sugars and the amino acid. These monoamines and drugs of similar structure (e.g. benzoctamine, diphenydramine) exhibited a mixed or non competitive type of inhibition which correlated quite well with their octanol water partition coefficients. In contrast, di- or triamines (e.g. harmaline, imipramine, pyrilamine) revealed a rather pure competitive type of inhibition. These findings tentatively suggest a different mode of action on the active transport by lipid-soluble organic amines according to the molecular charge distribution. In addition, membrane vesicles were used to examine the effect of the different amines on the sucrase activity. Regarding the cation-dependent hydrolysis of sucrose, however, no distinct pattern developed. PMID- 3970919 TI - Temperature effects on osmotic fragility, and the erythrocyte membrane. AB - Results are reported on the temperature-dependence of intact-cell surface area, isotonic volume, hemolytic volume, and ghost steady-state surface area and volume, using several techniques of resistive pulse spectroscopy. Temperature was found not to alter the intact cell surface area permanently: the area remains constant at 130 +/- 1 micron 2, at temperatures ranging from 0 to 40 degrees C. Temperature does alter the steady-state volume of the cells, with a colder temperature inducing swelling by about 0.29 micron 3/deg. C. Such a temperature induced volume change is sufficient to explain only approximately half of the fragility differences which result from temperature changes. The remainder was found to result from higher temperatures enabling a substantial transient increase in surface area of intact cells (up to at least 14% of 40 degrees C), with a corresponding increase in the cell's hemolytic volume (up to 21%). The hemolytic volume apparently increases linearly with temperature, since steady state ghost volumes are found to increase linearly with the temperature at which the ghosts were produced. In the steady state (at high temperature), the membranes of electrically-impermeable resealed ghosts can remain extended by more than 10%, compared with membranes of the corresponding unhemolyzed, intact red cells. PMID- 3970920 TI - Phase properties of the aqueous dispersions of n-octadecylphosphocholine. AB - Properties of the aqueous dispersions of n-octadecylphosphocholine are examined by differential scanning calorimetry, fluorescence depolarization, light scattering, 31P-NMR, pig pancreatic phospholipase A2 binding, and X-ray diffraction. On heating, these dispersions exhibit a sharp lamellar to micelle transition at 20.5 degrees C. The lamellar phase consists of frozen (gel-state) alkyl chains which do not bind phospholipase A2. The kinetics of the transition are asymmetric: the micelle to lamellar transition is very slow and the lamellar to micelle transition is fast. It is suggested that the lamellar phase is a frozen chain bilayer in which the chains interdigitate. PMID- 3970921 TI - Sodium-induced aggregation of phosphatidic acid and mixed phospholipid vesicles. AB - Sodium-induced aggregations of sonicated vesicles prepared from synthetic phosphatidic acid and from its 1:1 mixtures with synthetic phosphatidylethanolamine and phosphatidylcholine were studied by turbidimetric measurements. The aggregation reactions were almost completely reversible on change in the Na+ concentration, pH or temperature. The threshold concentrations of Na+ for aggregations of pure dipalmitoylphosphatidic acid vesicles and mixed dipalmitoylphosphatidylethanolamine- and dimyristoylphosphatidylcholine dipalmitoylphosphatidic acid vesicles were found to be 200, 310 and 550 mM, respectively, at 25 degrees C and pH 7.2. The hydrocarbon chain lengths of phosphatidic acid and phosphatidylethanolamine had little effect on the threshold concentrations. The threshold concentrations for phospholipid vesicles composed of phosphatidic acid alone or its 1:1 mixture with phosphatidylethanolamine were changed by varying either the pH or temperature, while that for phosphatidylcholine-phosphatidic acid vesicles was almost independent of the pH and temperature, implying that aggregation of the latter vesicles is induced by a somewhat different mechanism. PMID- 3970922 TI - Significant potassium ion accumulation at the external surface of Myxicola giant axons. AB - Potassium accumulation associated with outward membrane potassium current was investigated experimentally in Myxicola giant axon. During prolonged voltage clamp pulses to positive transmembrane potentials, the K+ equilibrium potential may approach zero mV, suggesting massive K+ accumulation outside the axonal membrane to concentrations many-fold higher than those in the bathing medium. The potassium accumulation can be satisfactorily described by a three-compartment model, consisting of the nerve fiber, a restricted physiological periaxonal space and the bulk solution. The average thickness, theta, of the periaxonal space is calculated as 177 +/- 59 A, i.e., comparable to that in the squid, while the permeability coefficient of the external barrier, PKs, was calculated to be (1.4 +/- 0.4) X 10(-4) cm/s. These conclusions are well supported by morphological study. PMID- 3970923 TI - The effects of pressure and cholesterol on rotational motions of perylene in lipid bilayers. AB - Using steady-state fluorescence polarization measurements, an isothermal pressure induced phase transition was observed in dimyristoyl-L-alpha-phosphatidylcholine multilamellar vesicles containing perylene. The temperature-to-pressure equivalence, dT/dP, estimated from the phase transition pressure, P1/2, is about 22 K X kbar-1, which is comparable to values determined from diphenylhexatriene polarization (Chong, P.L.-G. and Weber, G. (1983) Biochemistry 22, 5544-5550). In addition, we have employed a new method, introduced in this paper, to calculate the rate of in-plane rotation (Rip) and the rate of out-of-plane rotation (Rop) of perylene in lipid bilayers. The effects of pressure and cholesterol on the rotational rates of perylene in two lipid bilayer systems have been examined. They are 1-palmitoyl-2-oleoyl-L-alpha-phosphatidylcholine (POPC) multilamellar vesicles (MLV) and 50 mol% cholesterol in POPC (MLV). Rop is smaller than Rip due to the fact that the out-of-plane rotation requires a larger volume change than the in-plane rotation. Cholesterol seems not to affect Rop significantly, but pressure causes a decrease in Rop by about a factor of three. In contrast, the effects of pressure and cholesterol on Rip are less straightforward. At 1 atm cholesterol increases Rip by a factor of about two. Similarly, in the absence of cholesterol 1.5 kbar pressure essentially triples Rip. However, if both cholesterol is added and pressure is applied, Rip decreases sharply. The possible interactions between cholesterol and perylene are discussed. PMID- 3970924 TI - The effect of ethanol on the passive Ca permeability of human red cell ghosts measured by means of arsenazo III. AB - Ethanol in the range of 0.76-2.40 M caused an immediate increase in the Ca permeability of the plasma membrane of resealed human red blood cell ghosts in which intracellular free Ca could be continuously monitored by means of the Ca chromophore arsenazo III. At a given concentration of ethanol, the Ca permeability increased markedly a few minutes following the mixing of the ghosts and the ethanol, and continued to increase over at least the next 30 min. Preincubating the ghosts in ethanol for 15, 60 and 120 min before measuring the rate of free Ca accumulation, progressively increased the effect of a given concentration of ethanol. These results indicate that the effect of a given concentration of ethanol is a complex function of concentration and exposure time. The effects of ethanol in this concentration range were completely reversible. The resealed ghosts used in these experiments were depleted of ATP to avoid interference from the Ca pump and all experiments were carried out with 150 mM KCl on both sides of the membrane to minimize changes in either the volume or membrane potential associated with activation of the Ca-dependent K channel. PMID- 3970925 TI - Thermodynamic reversibility of phase transitions. Specific effects of alcohols on phosphatidylcholines. AB - The gel-to-fluid phase transitions of several phosphatidylethanolamines (PE's) and phosphatidylcholines (PC's) have been investigated in the presence of three short-chain alcohols. The effects of the alcohols on the thermodynamic reversibility of these transitions was studied and it was found that the transitions for PC's are not thermodynamically reversible at relatively high alcohol concentrations. The PE transitions are thermodynamically reversible for all alcohol concentrations, and the PE's do not exhibit the biphasic effects of alcohol on the transition temperature previously reported for the PC's (Rowe, E.S. (1983) Biochemistry 22, 3299-3305). The biphasic transition temperature effects and the thermodynamic irreversibility of PC transitions at high alcohol concentrations appear to be correlated with the induction of a fully interdigitated gel phase recently reported in the literature (Simon, S.A. and McIntosh, T.J. (1984) Biochim. Biophys. Acta 773, 169-172). The biological significance of these findings is discussed. PMID- 3970926 TI - General and local anaesthetics perturb the fusion of phospholipid vesicles. AB - The effects of general and local anaesthetics on Ca2+-induced fusion of negatively charged lipid vesicles have been investigated. Vesicles composed of phosphatidylcholine and phosphatidic acid (2:1 molar ratio) were induced to fuse using 5 mM free Ca2+. Fusion, assessed by an increase in size using gel filtration techniques and confirmed by electron microscopy, displayed a dependence on Ca2+ and Mg2+ concentration and on temperature. The inhalational anaesthetics halothane, methoxyflurane and diethyl ether enhanced fusion as did the uncharged local anaesthetic benzocaine. In contrast, the charged local anaesthetics lignocaine and bupivacaine inhibited the fusion process. It is suggested that the enhancement observed with the inhalational anaesthetics and benzocaine was mediated by an effect on lipid fluidity and the inhibition observed with the charged tertiary amine anaesthetics was due to an antagonism towards Ca2+. PMID- 3970927 TI - Comparative structural aspects of cation binding to phosphatidylserine bilayers. AB - X-ray diffraction data recorded for monovalent and divalent cation complexes of a series of phosphatidylserines (PS) varying in chain length reveal a simple structural pattern. Only two bilayer structural types differing in hydrocarbon chain tilt but with similar polar group conformations are observed for (i) anhydrous acidic PS, (ii) anhydrous K+-PS, and (iii) Li+, Mg2+, Ca2+, Sr2+, Ba2+, and Pr3+ complexes of 'hydrated' PS. The X-ray diffraction data suggest that PS becomes dehydrated on complexing with Li+, Mg2+, Ca2+, and other divalent cations and adopts either the chain untilted (form I) or tilted (form II) bilayer structure. PMID- 3970928 TI - Changes in the structural organization of chromatin during spermatogenesis in the rat. AB - In this study, histone H4 was shown to be extensively hyperacetylated in mid spermatids of the rat during the time period when the entire complement of histones is replaced by basic spermatidal transition proteins. The degree of hyperacetylation of histone H4 was minimal in pachytene spermatocytes. Therefore, the hyperacetylation appears to be directly involved in the histone replacement process late in spermatogenesis in mid-spermatids. In order to investigate further the possible effects of histone H4 hyperacetylation and the other dramatic changes in the nuclear proteins on the structure of chromatin in germinal cells, we examined the thermal denaturation profiles of chromatin from various purified germinal cell types. Our analyses revealed that chromatins from pachytene spermatocytes and early spermatids have similar thermal denaturation profiles, with their major thermal transitions slightly lower than those for rat liver. However, the major thermal transitions for chromatin from mid-spermatids are much lower than those from pachytene spermatocytes and early-spermatids. We propose that the greatly lowered thermal stability of mid-spermatid chromatin represents a dramatic relaxation or decondensation of the chromatin in this cell type in preparation for the replacement of histone by the basic spermatidal transition proteins and that the decondensation is due in large part to the extensive histones hyperacetylation which occurs in these cells. PMID- 3970929 TI - DNA repair and replication in human fibroblasts treated with (+/-)-r-7,t-8 dihydroxy-t-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene . AB - DNA repair and replication were examined in diploid human fibroblasts after treatment with (+/-)-r-7,t-8-dihydroxy-t-9,10-epoxy-7,8,9,10 tetrahydrobenzo[a]pyrene (BPDE-I). Unscheduled DNA synthesis exhibited a linear response to BPDE-I concentrations up to 1.5 microM and a saturation plateau after higher concentrations. Maximal unscheduled DNA synthesis was observed in the first hour after treatment with synthesis diminishing progressively thereafter. Half-maximal unscheduled DNA synthesis was seen within 4-6 h after treatment with 0.7 microM BPDE-I. DNA replication was inhibited by BPDE-I in a dose- and time dependent fashion. The mechanisms of this inhibition were characterized by velocity sedimentation of pulse-labeled nascent DNA in alkaline sucrose gradients. Very low concentrations of BPDE-I (0.03 and 0.07 microM) were found to inhibit replicon initiation by up to 50% within 30-60 min after treatment. Recovery of initiation following these low concentrations was evident within 3 h after treatment. Higher concentrations of carcinogen inhibited DNA synthesis in active replicons. This effect was manifested by a reduction in incorporation of precursor into replication intermediates of greater than 1 X 10(7) Da with the concurrent production of abnormally small nascent DNA. When viewed 45 min after treatment with 0.17 microM BPDE-I the combination of these two effects partially masked the inhibition of replicon initiation. However, even after treatment with 0.33 microM BPDE-I an effect on initiation was evident. These results reveal a pattern of response to BPDE-I that is quite similar to that produced by 254 nm radiation. PMID- 3970930 TI - Reduced ribosomal binding of eukaryotic elongation factor 2 following ADP ribosylation. Difference in binding selectivity between polyribosomes and reconstituted monoribosomes. AB - The biological activity of elongation factor 2 (EF-2) following NAD+ - and diphtheria-toxin-dependent ADP-ribosylation was studied (i) in translation experiments using the reticulocyte lysate system and (ii) in ribosomal binding experiments using either reconstituted empty rat liver ribosomes or programmed reticulocyte polysomes. Treatment of the lysates with toxin and NAD+ at a NAD+/ribosome ratio of 4 resulted in a 90% inhibition of the amino acid incorporation rate. The inhibition was overcome by the addition of native EF-2. At this level of inhibition more than 90% of the EF-2 present in the lysates was ADP-ribosylated and the total ribosome association of EF-2 was reduced by approx. 50%. All of the remaining unmodified factor molecules were associated with the ribosomes, whereas only about 3% of the ribosylated factor was ribosome associated. The nucleotide requirement for the binding of EF-2 to empty reconstituted rat liver ribosomes and programmed reticulocyte polysomes was studied together with the stability of the resulting EF-2 X ribosome complexes using purified 125I-labelled rat liver EF-2. With both types of ribosomes, the complex formation was strictly nucleotide-dependent. Stable, high-affinity complexes were formed in the presence of the non-hydrolysable GTP analogue guanosine 5'-(beta, gamma-methylene)triphosphate (GuoPP[CH2]P). In contrast to the reconstituted ribosomes, GTP stimulated the formation of high-affinity complexes in the presence of polysomes, albeit at a lower efficiency than GuoPP[CH2]P. The formation of high-affinity complexes was restricted to polysomes in the pretranslocation phase of the elongation cycle. Low-affinity post translocation complexes, demonstrable after fixation, were formed in the presence of GTP, GuoPP[CH2]P and GDP. In polysomes, these complexes involved a different population of particles than did the high-affinity complexes. In the binding experiments using reconstituted or programmed ribosomes, the pretranslocation binding of EF-2 observed in the presence of GuoPP[CH2]P was reduced by approx. 50% after ADP-ribosylation, whereas the post-translocation binding in the presence of GDP was unaltered. The data indicate that the inhibition of translocation caused by diphtheria toxin and NAD+ is mediated through a reduced affinity of the ADP-ribosylated EF-2 for binding to ribosomes in the pretranslocation state. PMID- 3970931 TI - Chromatin dynamics. Fast and slow modes of nucleosome movement revealed through psoralen binding and repair. AB - Psoralen adducts, when formed in DNA at low frequencies that permit extensive survival of normal and repair-deficient cells, are found in both linker and core regions of nucleosomes, but are slightly enriched in the linker sites. The relative frequencies of adducts obtained with 5-methylisopsoralen and angelicin, which form only monoadducts, and 8-methoxypsoralen and trimethylpsoralen, which form monoadducts and cross-links, represent an enrichment in linker DNA that is approx. 2-3-fold higher per nucleotide than in core DNA. 5-Methylisopsoralen monoadducts, which are initially in linker DNA, become randomized during 12 h of growth. This suggests a slow lateral movement of nucleosomes with respect to DNA and implies that linker and core regions of DNA are not permanent assignments. Randomization of 5-methylisopsoralen adducts is independent of the synthesis of DNA, RNA, protein, or poly(ADP-ribose) and is also independent of DNA repair. Excision repair of these adducts, in contrast, causes rapid local changes in nucleosome conformation and an initial increase in staphylococcal nuclease sensitivity that reverts to the sensitivity of bulk chromatin in less than 1 h. Chromatin, therefore, can undergo at least two distinct dynamic changes under physiological conditions: a slow randomization of the nucleosomes with respect to DNA, and a rapid but transient local rearrangement to facilitate repair. PMID- 3970932 TI - Histone crosslinking patterns indicate dynamic binding of histone H1 in chromatin. AB - Crosslinking of histone H1 molecules to each other and to the core histones with bifunctional reagents in mouse liver nuclei and chromatin was compared with that under the conditions of random 'contacts' between these molecules. The patterns of crosslinking of the H1 subfractions (H1A, H1B, and H10) to each other in nuclei, chromatin and in solution at different ionic strengths due to random collisions were essentially the same. Moreover, the contacts between the H1 molecules were qualitatively the same in nuclei, chromatin and in solution also at the level of the chymotryptic halves of the H1 molecules. The contacts between the H1 molecules and the core histones in nuclei were similar to those obtained in chromatin at 70 mM NaCl, when H1 molecules readily migrate, and at 0.6 M NaCl, when H1 molecules are dissociated from chromatin. We conclude that spatial arrangement of H1 subfractions and mutual orientation of H1 molecules in isolated nuclei are random-like at least in terms of cross-linking. The static and dynamic models of histone H1 binding to chromatin compatible with the known data are considered. Although unequivocal verification of the models is not possible at present, the dynamic models do correspond better to recent data on the location of the histone H1 in nuclei and chromatin. PMID- 3970934 TI - A novel magnesium-dependent structural transition of chicken erythrocyte chromatin in situ. AB - Lowering magnesium concentration below the value of 1 mM leads to a structural transition of chicken erythrocyte chromatin in situ, which results in a change in its fragmentation by pancreatic DNAase (DNAase I) from double-nucleosome to 100 basepairs mode. At 0.75 mM MgCl2, the pattern of chromatin fragmentation by DNAase I is similar to that generated by DNAase II, and it is further changed at lower concentrations of magnesium. This transition is, at least partly, reversible, and is, presumably, related to packing of the 25-30 nm chromatin fiber into higher-order structures. PMID- 3970933 TI - Coordinate regulation of histone mRNAs during growth and differentiation of rat myoblasts. AB - To determine whether histone genes are coordinately regulated, histone mRNA concentrations were measured in exponentially growing L6 myoblasts, S-phase synchronized myoblasts and in differentiating myoblasts. The levels of various histone mRNA subspecies declined rapidly and coordinately once myoblasts were given the signal to differentiate. mRNA levels were reduced on average to 1-5% of the amount observed in exponentially growing cells by 48 h after the signal to differentiate. The reductions occurred in concert with the cessation of DNA synthesis as the cells differentiated. Inhibition of DNA synthesis by treating myoblasts with Ara-C or hydroxyurea resulted in a histone mRNA half-life of 10-13 min for each of the histones examined. One example of non-coordinate regulation was observed however among the H4 mRNA subspecies in S-phase synchronized cells. The levels of two major subspecies of H4 mRNA increased coordinately in S-phase compared to levels observed in cells growing exponentially. A third subspecies of H4 mRNA on the other hand was found to decline by 50%. These studies suggest that the majority of histone mRNA subspecies are under coordinate control, although one exception has been noted among the subspecies of histone H4. PMID- 3970935 TI - Protein synthesis by hepatic mitochondria isolated from carbon tetrachloride exposed rats. AB - Hepatic mitochondria isolated from rats 40 h after dosage with 1.1 ml/kg CCl4 are uncoupled and display structural damage. Mitochondrial function returns during hepatic recovery. Because the products of mitochondrial protein synthesis are essential to mitochondrial structure and function, the effects of CCl4 on the rate of mitochondrial protein synthesis, and on the products, was studied using mitochondria from CCl4-exposed rats during the early, maximum development and resolution stages of CCl4-induced mitochondrial damage. Rates of mitochondrial protein synthesis (incorporation of [35S]methionine) were elevated 300% over that of mitochondria from non-exposed rats 17 h after exposure; depressed by 50% at 40 h and above control at 113 h. When the radiolabeled products of incorporation were separated and examined by autoradiography, a novel, low-molecular-weight band, of approx. 9700, was apparent 40 h after CCl4 exposure. A band of similar molecular weight appeared when control mitochondria were incubated without an exogenous supply of ATP. Mitochondria from exposed rats which displayed rates of protein synthesis greater than control consistently had a relative increase in a band that corresponded in size to that of cytochrome oxidase subunit I. It was concluded that the loss of mitochondrial function induced by CCl4 could not be attributed to inhibition of mitochondrial protein synthesis, and that the mitochondria may not always synthesize protein in constant proportions. PMID- 3970937 TI - Human beta-glucuronidase. Studies on the effects of pH and bile acids in regard to its role in the pathogenesis of cholelithiasis. AB - Human bile contains a considerable amount of endogenous beta-glucuronidase. The effects of pH and bile acids on its activity have been studied in regard to its role in the pathogenesis of cholelithiasis. beta-Glucuronidase, purified from human liver to homogeneity, was structurally stable between pH 4 and 10, but was active only over a much narrower range of pH, with a pH optimum of 5.2. The inactivation below pH 4 was due to its irreversible denaturation, whereas the inactivation at higher pH was due to a true reversible pH effect on the enzyme velocity. Kinetic studies revealed that hydrogen ion acted as a substrate directed activator of the free enzyme, but not the enzyme-substrate complex, with a molecular dissociation constant of 4 X 10(-6). The enzyme activity was not affected by unconjugated bile acids, primarily due to their extremely low water solubility. Conjugated bile acids, on the other hand, exerted heterogeneous and pH-dependent effects on the enzyme. At pH 5.2, taurocholic acid and glycocholic acid were substrate-directed activators of the enzyme; taurochenodeoxycholic acid and taurodeoxycholic acid, competitive inhibitors; and glycochenodeoxycholic acid and glycodeoxycholic acid, mixed inhibitors. At pH 7.0 all taurine and glycine conjugates behaved as substrate-directed activators. Though beta-glucuronidase activity at pH 7 was only 23% of its maximal activity at pH 5.2, conjugated bile acids tended to restore its activity to a certain extent at pH 7. Thus, endogenous beta-glucuronidase could play a significant role in pigment cholelithiasis. PMID- 3970936 TI - Normal rate of DNA breakage in xeroderma pigmentosum complementation group E cells treated with 8-methoxypsoralen plus near-ultraviolet radiation. AB - Treatment of normal and xeroderma pigmentosum complementation group E skin fibroblasts with 8-methoxypsoralen plus repeated doses of near-ultraviolet radiation elicited a marked increase in DNA strand breakage during a subsequent incubation. No such induction of breaks was noted with cells from xeroderma pigmentosum groups A and D. The results suggest that the gene product which is deficient in xeroderma pigmentosum group E cells is involved in a critical step of DNA repair of far-ultraviolet photoproducts but not so in the repair of psoralen cross-links. PMID- 3970938 TI - Early stages in the trifluoroethanol-induced unfolding of hen egg-white lysozyme and its complex with (GlcNAc)3. AB - The trifluoroethanol-induced unfolding of hen egg-white lysozyme was studied by circular dichroism. It was shown that if the H2O/trifluoroethanol ratio is above 10:1 (v/v), the unique three-dimensional structure of the protein is not affected, whereas within the ration 10:1-2.8:1 (v/v), this structure is partially unfolded. At the ratio 2.4:1 (v/v), the native conformation of lysozyme is completely disrupted and the conformational transition fits a two-state model. A similar effect was observed for the trifluoroethanol-induced unfolding of the lysozyme-(GlcNAc)3 complex. Within the H2O2 trifluoroethanol ratio 15:1-5.5:1 (v/v), the characteristic intensities of the Cotton effects which arise from the association of (GlcNAc)3 with the active site of lysozyme, diminished and approached those exhibited by lysozyme itself at the same H2O trifluoroethanol ratios. This shows that (GlcNAc)3 is released from the protein surface in early stages of the unfolding process. At the ratio 2.4:1 (v/v), the lysozyme-(GlcNAc)3 complex was completely disrupted and the protein unfolded. It is suggested that a considerable alteration in hydration of the lysozyme molecule caused by trifluoroethanol increases protein surface fluctuations, causing the release of (GlcNAc)3 from the active site of lysozyme. PMID- 3970939 TI - Resonance Raman detection of a v(Fe-CO) stretching frequency in cytochrome P 450scc from bovine adrenocortical mitochondria. AB - Resonance Raman scattering experiments on CO-complexed cytochrome P-450scc from bovine adrenocortical mitochondria demonstrate the simultaneous enhancement of v(Fe-CO) stretching and bound v(C-O) stretching frequencies at 477 and 1953 cm-1, respectively. These assignments were made on the basis of frequency shifts with the isotope 12C18O. This unusually low v(Fe-CO) stretching frequency in cytochrome P-450scc, compared with other CO-complexed hemoproteins such as CO hemoglobin and -myoglobin, is presumably due to the thiolate ligation to the heme iron trans to CO and due to the linear and perpendicular configuration of CO binding to the heme. PMID- 3970940 TI - Purification and characterization of rat kidney L-alanine: 4,5-dioxovalerate transaminase and inhibition by hemin. AB - Rat kidney L-alanine:4,5-dioxovalerate transaminase (EC 2.6.1.43), which may be involved in the formation of aminolevulinic acid in mammalian cells, was purified 82-fold to apparent homogeneity with a 19% yield. Molecular weight of the enzyme, as estimated by gel filtration, was found to be 225 000. In polyacrylamide gel electrophoresis under denaturing conditions, the enzyme moved as a single band corresponding to an Mr of 37 000, suggesting that the enzyme is composed of six identical subunits. The Km values of L-alanine and 4,5-dioxovalerate are 2.9 and 0.25 mM, respectively. The enzyme had an optimum activity at pH 6.6 and was most active at 65 degrees C. Among some amino acids tested, L-alanine proved to be the most efficient amino donor, and the enzyme was also stereospecific for the L isomer. The effect of intermediate metabolites of heme biosynthesis, for example, delta-aminolevulinic acid, protoporphyrin, hemin and bilirubin has been studied on purified L-alanine:4,5-dioxovalerate transaminase. Amongst these metabolites, hemin and protoporphyrin were found to be effective inhibitors. PMID- 3970941 TI - Purification of particulate malate dehydrogenase and phosphoenolpyruvate carboxykinase from Leishmania mexicana mexicana. AB - The particulate activities of Leishmania mexicana mexicana amastigote malate dehydrogenase (L-malate:NAD+ oxidoreductase, EC 1.1.1.37) and phosphoenolpyruvate carboxykinase (ATP:oxaloacetate carboxy-lyase (transphosphorylating) EC 4.1.1.49) have been purified to apparent electrophoretic homogeneity by hydrophobic interaction chromatography using Phenyl-Sepharose CL-4B, affinity chromatography using 5'AMP-Sepharose 4B, and gel filtration using Sephadex G-100. Malate dehydrogenase was purified 150-fold overall with a final specific activity of 1230 units/mg protein and a recovery of 63%. Phosphoenolpyruvate carboxykinase was purified 132-fold with a final specific activity of 30.3 units/mg protein and a recovery of 20%. Molecular weights determined by gel filtration and SDS-gel electrophoresis were 39 800 and 33 300 for malate dehydrogenase and 63 100 and 65 100 for phosphoenolpyruvate carboxykinase, respectively. Kinetic studies with malate dehydrogenase assayed in the direction of oxaloacetic acid reduction showed a Km(NADH) of 41 microM and a Km(oxaloacetic acid) of 39 microM. For malate oxidation there was a Km(malate) of 3.6 mM and a Km(NAD) of 0.79 mM. Oxaloacetic acid exhibited substrate inhibition at concentrations greater than 0.83 mM and malate was found to be a product inhibitor at high concentrations. However, there was no modification of enzyme activity by a number of glycolytic intermediates and cofactors, suggesting that malate dehydrogenase is not a major regulatory enzyme in L. m. mexicana. The results show that these L. m. mexicana amastigote enzymes are in several ways similar to their mammalian counterparts; nevertheless, their apparent importance and unique subcellular organization in the parasite make them potential targets for chemotherapeutic attack. PMID- 3970942 TI - Reaction of 5'-p-fluorosulfonylbenzoyl-1,N6-ethenoadenosine with histidine and cysteine residues in the active site of rabbit muscle pyruvate kinase. AB - The inactivation of rabbit muscle pyruvate kinase by 0.3 mM 5'-p fluorosulfonylbenzoyl-1,N6-ethenoadenosine at pH 7.8 is biphasic. The first phase proceeds rapidly to yield a partially active enzyme (46% residual activity) followed by a slower rate which leads to total inactivation. The inactivation of the first phase can be reversed by addition of 20 mM dithiothreitol, whereas the second phase is unaffected. These two phases have second-order rate constants of 250 M-1 X min-1 (dithiothreitol-sensitive reaction) and 52 M-1 X min-1 (dithiothreitol-insensitive reaction), respectively. Marked protection against inactivation is afforded by phosphoenolpyruvate and by metal-nucleotide complexes in the presence of free metal, indicating that reaction occurs in the region of the active site. Loss of approximately two sulfhydryls per enzyme subunit correlates well with the dithiothreitol-sensitive inactivation, suggesting that this phase of the inactivation may be attributable to disulfide formation. Incorporation of about one mole of fluorescent reagent per enzyme subunit correlates closely with the dithiothreitol-insensitive phase of inactivation, yielding a modified histidine residue. The quantum yield of the fluorescent sulfonylbenzoyl-1,N6-ethenoadenosine-pyruvate kinase is only 0.007, as compared to 0.54 for the parent nucleoside 1,N6-ethenoadenosine. The quenched fluorescence is consistent with stacking of the sulfonylbenzoyl moiety on the purine ring in the modified enzyme, which suggests that the altered histidine may be located in the adenine region of the metal-nucleotide binding site. PMID- 3970943 TI - The mechanism of activation of lipoprotein lipase by apolipoprotein C-II. The formation of a protein-protein complex in free solution and at a triacylglycerol/water interface. AB - The binding of lipoprotein lipase to a fluorescently labelled apolipoprotein C-II in free solution has been followed by measuring fluorescence anisotropy. The formation of a weak, binary complex in which a single apolipoprotein C-II molecule associates non-cooperatively with each subunit of the dimeric enzyme was observed. The dissociation constant for this complex in 0.05 M NaCl is 0.2 X 10( 6) M and it is weakened markedly by raising the salt concentration and by the binding of heparin to the enzyme. The assembly of the same protein-protein complex on the surface of glycerol trioleate globules has been monitored by steady-state and pre-steady-state kinetics. In these circumstances the lipoprotein lipase-apolipoprotein C-II interaction is much tighter (Kd = (7-10) X 10(-9) M) and is insensitive to salt and heparin. The mechanism of activation of the enzyme at low concentrations of apolipoprotein C-II is described by a kinetic model in which apolipoprotein C-II binds preferentially to the form of the enzyme which is associated with the triacylglycerol substrate. This preference leads to a stabilization of the enzyme-substrate complex, thus reducing the apparent Ks. PMID- 3970944 TI - A study on the allosteric interaction between the major binding sites of human serum albumin using microcalorimetry. AB - The binding of warfarin and oxyphenbutazone to albumin has been studied at pH 6.8 and pH 9.2 by measuring the heat of binding of these ligands to their high affinity binding sites on albumin (delta Ho'1). The -delta Ho'1 values for the binding of warfarin at pH 6.8 and 9.2 and oxyphenbutazone at pH 6.8 and 9.2 were found to be 16.9(+/- 0.6), 28.8(+/- 0.6), 10.5(+/- 0.4) and 17.4(+/- 0.6) kJmol 1, respectively. The Gibbs energies (delta Go'1) corresponding to these delta Ho'1 values cover a much smaller range. The pH dependences of delta Go'1 and delta Ho'1 are explained in terms of pK shifts in the albumin upon binding warfarin or oxyphenbutazone. Diazepam, which binds to a site on albumin which is different from the warfarin-oxyphenbutazone binding site, increases - delta Ho'1 for the binding of warfarin and oxyphenbutazone to albumin at pH 6.8, but it does not influence the -delta Ho'1 at pH 9.2. This phenomenon may be attributed to an allosteric interaction between the diazepam binding site and the warfarin binding site. This allosteric interaction must have its origin in a phenomenon other than the N-B transition. PMID- 3970945 TI - Structural and functional analysis of spectrin from neonatal erythrocytes. AB - Spectrin was purified by rate zonal sedimentation from low-salt extracts of red cell membranes from neonatal and adult blood. Neonatal and adult spectrin cosedimented in sucrose density gradients, comigrated on SDS gels and displayed identical two-dimensional chymotryptic 125I-labelled peptide maps. Neonatal spectrin and adult spectrin exhibited equivalent affinity for both neonatal and adult ankyrin sites on spectrin-depleted inverted membrane vesicles. Purified spectrin heterodimers from neonatal and adult red cells displayed similar self association equilibrium constants in a fluid phase dimer-dimer association assay. These results suggest that the unique membrane characteristics of the neonatal erythrocyte are not due to a structural or functional alteration of spectrin. Several alternative hypotheses involving other membrane proteins and their linkages are discussed. PMID- 3970946 TI - Ultraviolet light- and ozone-induced changes in pyridinoline, a trisubstituted 3 hydroxypyridinium crosslink of collagen. AB - Pyridinoline photo-degraded with the formation of photoproducts absorbing diffusely around 260-290 nm (pH 7) and sharply at 232 nm (pH 1). Subsequent heating partially regenerated the original pyridinoline, also producing new products absorbing at 417/440 nm (pH 7) and 300/412 nm (pH 1). Pyridinoline (pH 7) and its new products (pH 7 and pH 1) also underwent ozone-induced degradation. PMID- 3970947 TI - Preparation and properties of highly-purified Vibrio costicola polynucleotide phosphorylase. AB - Vibrio costicola polynucleotide phosphorylase (polyribonucleotide: orthophosphate nucleotidyltransferase, EC 2.7.7.8) has been purified to electrophoretic homogeneity. It has an approximate molecular weight of 220 000 and consists of identical subunits with an approximate molecular weight of 72 000. The enzyme appears to be a fairly typical polynucleotide phosphorylase with respect to its pH optima, substrate specificity and requirement for a divalent cation cofactor. However, the effect of salt concentration on its physiologically important phosphorolysis activity suggests that it is a moderately halophilic enzyme, able to function at the intracellular ionic strength of the bacterium. In addition, its ADP polymerization activity is remarkably stimulated by polylysine. PMID- 3970948 TI - The molecular size of Myxicola infundibulum chlorocruorin and its subunits. AB - The molecular shape and size of the extracellular chlorocruorin of Myxicola infundibulum was determined using scanning transmission electron microscopy and its dissociation in the presence of sodium dodecyl sulfate (SDS) was investigated using polyacrylamide gel electrophoresis. The shape of the chlorocruorin is that of a two-tiered hexagon with a vertex-to-vertex diameter of 29.0-29.5 nm and a height of 19.0-19.7 nm: it appears to be smaller by 5-10% relative to several annelid extracellular hemoglobins examined by scanning transmission electron microscopy. The quaternary structure of the chlorocruorin appears to be sensitive to Ca(II) concentration; dissociation fragments of the whole molecule were observed, consisting of octamers an dimers of one-twelfth subunits. The unreduced chlorocruorin dissociated into two subunits with estimated molecular masses of 23 000 (1) and 60 000 (2); the reduced chlorocruorin dissociated into subunits with estimated molecular masses of 13 000 (I), 14 000 (II) and 30 000 (III). SDS polyacrylamide gel electrophoresis of reduced subunits 1 and 2 showed that subunit 1 corresponded to subunit III and that subunit 2 dissociated to subunits I and II. Densitometry of the polyacrylamide gels indicates that 85-90% of the Myxicola chlorocruorin consists of disulfide-bonded tetramers of polypeptide chains of about 15 000. Such a pattern of subunit aggregation has not been observed previously in annelid extracellular hemoglobins and chlorocruorins. PMID- 3970949 TI - The interaction of hemerythrin with sodium dodecyl sulfate and the release of iron from the product with desferrioxamine B. AB - The interactions with sodium dodecyl sulfate (SDS) of methemerythrin, the anionic derivatives and oxyhemerythrin from Phascolopsis gouldii have been examined at 25 degrees C, I = 0.5 M and pH 6.3 and 7.8. Absorbance changes in the 350-500 nm range were used to monitor the rates. The denaturation is slow (k = 10(-2)-10(-3) s-1) and only slightly dependent on SDS concentration. Perchlorate is a very effective inhibitor of the SDS reaction with methemerythrin, and it is concluded that rapid binding of SDS near to the cysteine-50 site is an essential to unfolding. Myohemerythrin (from Themiste zostericola) and the monomeric N ethylmaleimide derivatives of methemerythrin from P. gouldii and T. zostericola, in contrast, react rapidly with SDS. The products from denaturing of all proteins appear similar, having reduced alpha-helix content, very small absorbance in the 350-500 nm region and loss of anion or oxygen binding capacity. They do, however, retain the two irons, which can readily be removed with desferrioxamine B. PMID- 3970950 TI - Plasmalogenase in hamster heart. AB - In this study, the presence of plasmalogenase for the hydrolysis of the alk-1 enyl bond at the C-1 position of 1-alkenyl-2-acyl-sn-glycero-3 phosphoethanolamine (ethanolamine plasmalogens) in the hamster heart was examined. A new spectrophotometric assay was developed for this study, in which the aldehyde released by the hydrolysis of the plamalogenase was oxidized to carboxylic acid by the action of aldehyde dehydrogenase, with the production of the molar equivalent of NADH. The results obtained from the spectrophotometric assay were comparable to those obtained by determining the rate of ethanolamine plasmalogens utilized during the reaction. However, the sensitivity of the spectrophotometric assay for plasmalogenase was shown to be 25-fold higher than with the methods described previously and enzyme activity could be detected with 1 micrograms of microsomal protein. Hamster heart plasmalogenase activity was located exclusively in the microsomal fraction, and the enzyme displayed a pH optimum at 8.5. The enzyme showed no absolute requirement for divalent metallic cations. PMID- 3970951 TI - Effects of injecting exogenous lipid transfer protein into rats. AB - Rats were injected intravenously with preparations of partially purified lipid transfer protein isolated from human plasma. Cholesteryl ester transfer activity disappeared from the plasma of recipient rats with a t1/2 of about 10 h and after 24 h had fallen to a level comparable to that in human plasma. By contrast there was no measurable cholesteryl ester transfer activity in the plasma of control rats. Plasma collected from rats 24 h after the injection was subjected to ultracentrifugation at 1.225 g/ml; lipoproteins in the 1.225 g/ml supernatant were subsequently separated by both gel filtration chromatography and gradient gel electrophoresis. The major change in the treated animals was a total loss of the large, cholesteryl ester-rich, apolipoprotein E-rich high-density lipoproteins, HDL1, which are prominent in the plasma of control rats. This loss of HDL1 unmasked an obvious peak of low-density lipoproteins that had been obscured in the control rats. Other changes in the treated rats included an increase in the relative cholesteryl ester content of very-low-density lipoproteins and the emergence of a peak of triacylglycerol in the high-density lipoproteins. PMID- 3970952 TI - Transhepatic transport of taurocholic acid in normal and mutant analbuminemic rats. AB - To elucidate a possible function of plasma albumin in vectorial transport of various cholephilic organic anions, such as bile acids, plasma clearance and transhepatic transport of radioactive taurocholate were studied in vivo in normal and mutant analbuminemic rats. Intravenous administration of taurocholate was followed by its rapid disappearance from the circulation in both animal groups. However, plasma clearance of taurocholate was significantly larger in analbuminemic (68.3 ml/min per kg of body weight) than in normal rats (29.8 ml/min per kg of body weight) at a dose of 8 mumol/kg of body weight. The increased plasma clearance in analbuminemic rats was accompanied by a more prompt biliary secretion of the ligand than occurred in normal animals; 79 and 42% of the injected dose was recovered in analbuminemic and normal rat bile, respectively, within 10 min after administration. Ultrafiltration analysis revealed that the binding of taurocholate to serum protein(s) was significantly lower in analbuminemic rats as compared with that in normal rat serum; 24 and 76% of taurocholate bound to protein fractions of analbuminemic and normal rat serum, respectively, at 0.5-mM ligand concentration. Binding of taurocholate to cytosolic proteins of normal and analbuminemic liver were similar; 23 and 28% of taurocholate bound to protein fractions from analbuminemic and normal rat, respectively, at 10 mg protein/ml and 20-microM ligand concentration. These results indicate that plasma albumin does not play a role in directing circulating taurocholate to the liver and that transhepatic transport of the bile acid increases with the increase in concentration of unbound ligand in the circulation. PMID- 3970954 TI - Biosynthesis of sterols and bile acids in rat liver epithelial cell lines. AB - A rat liver epithelial cell line growing in a serum-supplemented medium expressed biosynthetic pathways of bile sterols and of free and conjugated chenodeoxycholic and cholic acids, the main primary bile acids of the liver. They were identified and measured by gas chromatography-mass spectrometry. The bile steroid secretion in the serum-supplemented cell line was established upon incubation in a serum free medium which was demonstrated to sustain cell growth, allowing elimination of the interference of exogenous bile steroids and effectors. The free bile acid secretion was also expressed in a subline adapted to proliferate in this serum free medium, i.e., a basal medium supplemented with 4 g/l albumin carrying 7.6 muequiv./l of a mixture of six long-chain free fatty acids but without any addition of hormones and growth factors. In addition, the rat liver epithelial cell line growing in the serum-supplemented medium maintained, with time, a steady-state of bile acid secretion over a lifespan of 500 days. In the two types of liver epithelial cell lines, dexamethasone and chenodeoxycholic acid supplementation exerted, individually, either a stimulating or an inhibiting effect on the bile acid secretion concurrently with the hydroxylation of chenodeoxycholic acid into alpha-muricholic acid. PMID- 3970953 TI - Substrate specificity of fatty-acyl-CoA ligase in liver microsomes. AB - The substrate specificity of fatty-acyl-CoA ligase in liver microsomes has been studied in a system in which fatty acids are present initially as complexes with unilamellar vesicles of phosphatidylcholine. The latter were prepared by cosonication of phospholipids and different fatty acids. As compared with previous studies of the enzyme the activity of acyl-CoA ligase is several-fold higher for assays carried out with fatty acid substrates added as components of a bilayer. This was true for all fatty acids studied. Also as compared with data reported previously in the literature there was a systematic relationship between the structure of fatty acids, activity at Vmax for synthesis of acyl-CoA and avidity of binding to the ligase. Activity at Vmax was greatest for lauric acid and decreased with increasing chain length. The apparent avidity of enzyme for fatty acids was greatest for octanoic acid and decreased as chain length increased. PMID- 3970955 TI - The effect of hypercholesterolemia on guinea pig platelets, erythrocytes and megakaryocytes. AB - This study has examined the effect of diet-induced hypercholesterolemia on guinea pig platelets, erythrocytes, megakaryocytes and plasma. The cholesterol/phospholipid ratios of plasma and erythrocytes began to increase after one day on the diet and increased steadily for two weeks and more slowly thereafter until 30 days. In contrast, the cholesterol/phospholipid ratio of platelets remained constant for 4-5 days, then increased until reaching a maximum of about 0.85 in two weeks. Thus, the time-course for increase of the cholesterol/phospholipid ratio is different for platelets than for erythrocytes and plasma. The increase in the cholesterol/phospholipid ratio of megakaryocytes was small and not dependent on the degree of increase in the plasma cholesterol/phospholipid ratio. The cholesterol esters of both platelets and megakaryocytes increased with time for two weeks. The increase in megakaryocyte cholesterol esters appeared to precede that of platelets. The protein content of platelets and megakaryocytes and average megakaryocyte size were increased. Normal platelets incubated in plasma from hypercholesterolemic guinea pigs did not accumulate excess cholesterol, but erythrocyte cholesterol increased 45% in 6 h under the same conditions. Cholesterol synthesis in megakaryocytes was depressed 50-80% by cholesterol feeding and by in vitro incubation of the cells in hypercholesterolemic plasma. The data suggest that the platelets and erythrocytes may accumulate excess cholesterol by different mechanisms. The effects of cholesterol feeding on megakaryocytes and the lag in accumulation of cholesterol in platelets relative to erythrocytes and plasma suggest that a defect in the megakaryocyte may be a primary determinant of accumulation of cholesterol in platelets. PMID- 3970956 TI - Characterization of two molecular species GD3 ganglioside from bovine buttermilk. AB - Two gangliosides, representing 85% of total lipid-bound sialic acid, have been isolated from bovine buttermilk and characterized. Both contained long-chain base, glucose, galactose and sialic acid in the molar ratio 1:1:1:2, and gave, upon sialidase treatment, a neutral glycolipid, characterized as lactosylceramide. Partial acid hydrolysis, permethylation analysis and chromium trioxide oxidation indicated their basic oligosaccharide portion to be NeuAc alpha 2----8NeuAc alpha 2----3Gal beta 1----4Glc. The difference between the two forms was exclusively in the ceramide moiety of the molecule, one containing mainly long-chain (C22-C25) fatty acids and an equimolar proportion of C16 and C18 long-chain bases, and the other mainly palmitic acid and C18 long-chain base. PMID- 3970957 TI - Core modification of human low-density lipoprotein by artificial triacylglycerol emulsion. AB - To determine whether an apolipoprotein-free artificial triacylglycerol emulsion can substitute for VLDL in studying cholesterol ester-triacylglycerol exchange processes between triacylglycerol-rich lipoproteins and cholesterol ester-rich lipoproteins, we used Intralipid to modify human plasma LDL. Intralipid was incubated with LDL in the presence of lipoprotein-poor plasma (d greater than 1.21 g/ml) at 37 degrees C. Intralipid served as an acceptor for cholesterol ester and as a donor of triacylglycerol, modifying the low-density lipoproteins so that triacylglycerol became the major core lipid in the particle - the contribution of cholesterol ester to LDL mass decreased from 38% to 18%, while that of triacylglycerol increased from 4.9% to 26%. On lipolysis most added LDL triacylglycerol (59-72%) was hydrolyzed, resulting in a smaller particle than the "native' LDL particle with net loss of cholesterol ester. Incubation of LDL with the original Intralipid emulsion resulted in modified LDL with a high relative weight of phospholipid (27.7%). On removal of excess phospholipid from Intralipid and incubation of the resultant "washed' Intralipid with LDL, the relative weight of phospholipid in modified LDL decreased to 20%, which was similar to that observed after incubation of LDL with VLDL. We demonstrate that artificial triacylglycerol emulsion can indeed substitute for VLDL in neutral lipid exchange processes, and further confirm that transfer of core cholesterol ester and triacylglycerol occurs independently of the apolipoproteins present in triacylglycerol-rich lipoproteins and LDL. PMID- 3970958 TI - The molecular species composition of diacyl-, alkylacyl- and alkenylacylglycerophospholipids in rabbit alveolar macrophages. High amounts of 1 O-hexadecyl-2-arachidonyl molecular species in alkylacylglycerophosphocholine. AB - The relative composition of molecular species of diacyl-, alkylacyl- and alkenylacylglycerophospholipids in rabbit alveolar macrophages was determined with reverse-phase high-performance liquid chromatography (HPLC). Diacylglycerophosphocholine (GPC) (22.3% of the total glycerophospholipids), alkylacylGPC (11.3%) and alkenylacylglycerophosphoethanolamine (GPE) (15.8%) were the predominant glycerophospholipids in rabbit alveolar macrophages. DiacylGPE (6.9%), diacylGPI (5.5%) and diacylGPS (3.6%) also occurred. 1,2-Diradyl-3 acetylglycerol derived from glycerophospholipids were each resolved into 19 separate peaks with reverse-phase HPLC. By gas-liquid chromatographic quantitation of each peak, 19-29 different molecular species were identified. DiacylGPC, GPE and GPS were mainly composed of saturate, monoene and diene species, such as the 16:0-16:0, 16:0-18:1, 18:0-18:1, and 18:0-18:2 species. The predominant molecular species composing diacylGPI was the 18:0-20:4 species, which represented 40% of this glycerophospholipid. Distinct differences were found in the distributions of arachidonyl molecular species between diacyl- and ether-containing GPC and GPE. Although diacylGPC and GPE included a small amount of arachidonyl molecular species, the 16:0-20:4 species was by far the most prevalent one which composed alkylacylGPC (39% of the total) and alkenylacylGPE (49% of the total). The 16:0-20:4 species of alkylacylGPC and alkenylacylGPE together comprised 60% of the total arachidonyl molecular species of glycerophospholipids. The high amounts of the 16:0-20:4 species in alkylacylGPC may serve as a good source of both the potent platelet-activating factor and the products of arachidonic cascade in the stimulated alveolar macrophages. PMID- 3970959 TI - Arachidonic acid metabolites stimulate phosphatidylcholine secretion in primary cultures of type II pneumocytes. AB - There is evidence from whole animal and intact lung studies that prostaglandins are involved in the regulation of surfactant secretion. To explore this further we examined the effect of arachidonic acid on secretion of phosphatidylcholine in primary cultures of adult rat type II pneumocytes. Arachidonic acid stimulated phosphatidylcholine secretion and this effect was dependent on concentration in the range 1-8 microM. Arachidonic acid (8 microM) stimulated secretion by 79% from a basal rate of 1.17% total cellular phosphatidylcholine secreted in 90 min to 2.09%. We examined the effects of inhibitors of arachidonic acid metabolism on the stimulatory effect. Nordihydroguairaretic acid (0.1 microM), a lipoxygenase inhibitor, reduced the stimulatory effect by 64%. The same concentration of cyclooxygenase inhibitors had no effect. We conclude that arachidonic acid metabolites stimulate surfactant secretion in type II cells. Whether this effect is mediated by leukotrienes or other products remains to be established. PMID- 3970961 TI - Hepatic lipase activity increases after liver denervation in the rat. AB - We have investigated the effects of hilar denervation of rat liver upon the activity of hepatic lipase determined in tissue extracts. Denervated animals had an enzyme activity of 7.89 +/- 0.37 mU/mg protein, compared to 6.45 +/- 0.43 in sham-operated controls (mean +/- S.E.; P less than 0.05). We conclude that hepatic innervation may contribute to the regulation of hepatic lipase activity. PMID- 3970960 TI - Incorporation of [3H]palmitate and [14C]choline into disaturated phosphatidylcholines in rat alveolar macrophages. AB - We studied the synthesis of disaturated phosphatidylcholines in rat alveolar macrophages and, in some cases, compared it with that which occurs in isolated alveolar type II cells. Alveolar macrophages suspended in phosphate-buffered medium incorporate palmitate, choline and glycerol into disaturated phosphatidylcholines. The time-course for incorporation of palmitate into disaturated phosphatidylcholines is linear for 20-30 min and reaches a maximum in 2-3 h. Incorporation is dependent on extracellular palmitate with a Vmax (at 1 mM) of 1.53 nmol palmitate incorporated into disaturated phosphatidylcholines per 5 X 10(5) cells per 2 h and a K 1/2 of 0.19 mM palmitate. Exposure of the cells to zymosan particles increases incorporation of palmitate disaturated phosphatidylcholines by almost 2-fold, while cholinergic and beta-adrenergic agonists have no effect. On a per cell basis, alveolar macrophages incorporate only one-third to one-half as much palmitate into disaturated phosphatidylcholines as do type II cells isolated by centrifugal elutriation. The following results suggest there is extensive remodeling of disaturated phosphatidylcholines in alveolar macrophages: (1) palmitate- and choline-labeled disaturated phosphatidylcholines are catabolized by the cells; (2) the products of catabolism are palmitate and water-soluble choline products; (3) addition of unlabeled palmitate and choline to the medium enhances catabolism of the labeled phospholipid. Addition of oleate also enhances catabolism, suggesting that modification of phospholipids is not specific for the saturated variety. Some of the recently labeled disaturated phosphatidylcholines is released from alveolar macrophages into the extracellular space. Several possible functions of alveolar macrophage disaturated phosphatidylcholines are discussed. PMID- 3970962 TI - The synthesis of sphingomyelin in the Morris hepatomas 7777 and 5123D is restricted to the plasma membrane. AB - The site of sphingomyelin synthesis in the rapidly growing Morris hepatomas 7777 and 5123D was determined by incubating plasma membrane, mitochondrial and microsomal membrane fractions with vesicles of phosphatidyl[methyl-14C]choline in the presence of phosphatidylcholine transfer protein. In agreement with a previous study on rat liver (Voelker, D.R. and Kennedy, E.P., 1982, Biochemistry 21, 2753-2759) we have demonstrated that sphingomyelin synthesis in these hepatomas is restricted to the plasma membrane. The greatly elevated sphingomyelin content of mitochondria and microsomes (Hostetler, K.Y., Zenner, B.D. and Morris, H.P., 1979, Cancer Res. 39, 2978-2983) suggests that rapidly growing hepatomas, in contrast to liver, have an effective mechanism of intracellular sphingomyelin transfer. PMID- 3970963 TI - Sterol synthesis in vitro in freshly isolated blood mononuclear leukocytes from familial hypercholesterolemic patients treated with probucol. AB - Sterol synthesis rates were measured in freshly isolated blood mononuclear leukocytes obtained from familial hypercholesterolemic patients undergoing treatment with either probucol alone or probucol plus cholestyramine. Subjects with heterozygous familial hypercholesterolemia on probucol had a significant 31% reduction in mononuclear cell sterol synthesis rates as compared to control patients; sterol synthesis in cells from homozygous familial hypercholesterolemic patients on probucol did not differ from that in control subjects. Addition of cholestyramine to probucol therapy in heterozygous familial hypercholesterolemic patients caused an increase in sterol synthesis rates equal to but not greater than control values, thus negating the decreased mononuclear leukocyte sterol synthesis associated with probucol administration alone. Probucol treatment effectively decreased plasma cholesterol levels in both homozygous and heterozygous familial hypercholesterolemic subjects; however, the data suggest that the drug may exert different effects on sterol synthesis in peripheral tissues depending upon the presence or absence of cellular receptors for low density lipoproteins. PMID- 3970964 TI - Accumulation of HDL-like lipoproteins in the plasma low-density fractions of tumor-bearing mice. AB - Outgrowth of the transplanted GRSL lymphoma in GR mice yielded several-fold increased blood plasma levels of low- and very-low-density lipoproteins, while high-density lipoproteins were strongly reduced. Changes in cholesteryl ester fatty acid profiles indicated an accumulation of HDL-like particles rather than LDL in the low-density fractions. By intravenous injection of [14C]cholesteryl ester-labeled HDL into tumor-bearing mice, conversion of HDL into lipoproteins of low density was demonstrated. PMID- 3970965 TI - Lysosomal localisation of cobalamin during absorption by the ileum of the dog. AB - The subcellular distribution of cobalamin during absorption in the dog ileum has been studied using analytical subcellular fractionation. Animals dosed orally with cyano[57Co]cobalamin were killed 2 h later, and postnuclear supernatant fractions prepared from homogenates of the ileal mucosa were subjected to isopycnic centrifugation on reorientating sucrose density gradients. Marker enzymes for the principal subcellular organelles and cyano[57Co]cobalamin were assayed in the gradient fractions. At 2 h, the distribution of cyano[57Co]cobalamin exhibited a major lysosomal localisation with only 30% of the counts being recovered in the soluble fractions. This observation was confirmed by preparing postnuclear supernatant fractions in digitonin, which selectively disrupted lysosomes and released their contents into the soluble fractions. Lysosomal localisation during passage through the ileal enterocyte strongly supports absorption of cobalamin by a process of receptor-mediated endocytosis in the dog. PMID- 3970966 TI - Subcellular localization and modification with ageing of glutathione, glutathione peroxidase and glutathione reductase activities in human fibroblasts. AB - Differential centrifugation and isopycnic equilibration in density gradients were used to localize glutathione (GSH), glutathione peroxidase and glutathione reductase in the subcellular organelles of WI-38 fibroblasts. GSH was present in all the subcellular fractions, whereas the glutathione peroxidase and reductase activities were restrained to the cytoplasm and the mitochondrial fractions. After equilibration in density gradients, the results showed the presence of GSH, glutathione peroxidase and glutathione reductase in both the cytoplasm and mitochondria. GSH was also located in plasma membranes and probably in peroxisomes, endoplasmic reticulum and lysosomal membranes. Evolution of GSH in ageing fibroblasts showed a sudden increase of its concentration just before cell death. The glutathione peroxidase activity already decreases in the early passages, while the decrease of the glutathione reductase activity was constant and reached a drastic low level at the end of the culture. In conclusion, GSH is probably involved in the cell degeneration associated with ageing but because of its multiple functions and its ubiquitous localization, it is difficult to assert to which extent this metabolite is implicated in the ageing process. PMID- 3970967 TI - Sequence-dependent changes in the chiroptical properties of DNA upon interaction with dipyrandium. AB - Interaction of dipyrandium with DNA and its dependence on the base sequence was studied using circular dichroism. It was found that calf thymus DNA and polynucleotide duplexes with alternating purine-pyrimidine sequences containing GC basepairs underwent similar alterations in the chiroptical properties upon binding of dipyrandium. The alterations suggest that these DNAs have similar B type structures which may kink at the dipyrandium binding sites. On the other hand, poly(dA-dT).poly(dA-dT) and especially poly(dA-dU).poly(dA-dU) exhibit some features of A-type structure. Poly(dA-dT).poly(dA-dT) changes its chiroptical properties little when complexed with dipyrandium, as if it contained some type of kinks as equilibrium structural elements. PMID- 3970968 TI - Conformations of alternating purine-pyrimidine DNAs in high-CsF solutions and their reversal by dipyrandium, ethidium and high temperature. AB - Chiroptical properties of synthetic DNAs with alternating purine-pyrimidine sequences were studied in high-CsF solutions. It was found that this salt transformed all the DNAs to non-canonical conformations like Z or X, which show striking negative bands in the long wavelength part of the CD spectra. The negative bands were reversed upon interaction with dipyrandium, ethidium and at high temperature. PMID- 3970969 TI - Characterisation of hemolysis induced by T-2 toxin. AB - The erythrocyte constitutes a good model system for the study of membrane associated toxicity events caused by the trichothecene mycotoxin, T-2. This study confirms that T-2 has a direct lytic effect on erythrocytes. Lysis of guinea pig red cells requires approx. 10(10) molecules/cell and reaches plateau values after 4-6 h. An activation energy, Ea approximately equal to 4.5 kcal was derived from the Arrhenius equation. By use of osmotic blockers of differing Stokes' radii, the functional size of the membrane lesion caused by T-2 toxin was shown to be smaller than 5.5 A. It is concluded that T-2 toxin may exert its toxic effects via the cell membrane. PMID- 3970970 TI - The purification and some properties of pig liver hyaluronidase. AB - Hyaluronidase (hyaluronate 4-glycanohydrolase, EC 3.2.1.35) has been isolated from pig liver and purified 1720-fold with an overall yield of 9.5%. The enzyme was purified using an acid-extraction technique followed by successive chromatography on DEAE-cellulose, two boronate affinity columns and Sephadex G 75. This final preparation, which was essentially homogeneous as determined by gel electrophoresis, was a single subunit enzyme of apparent molecular weight 70 000 with an isoelectric point of 5.0. No contaminant enzymes capable of degrading glycosaminoglycans could be detected in the final preparation. The substrate specificity of the enzyme was the same as for bovine testicular hyaluronidase; however, both the Km and V values were significantly lower for the pig liver enzyme with all of the substrates tested (hyaluronate, chondroitin 4-sulphate, chondroitin 6-sulphate). A full kinetic analysis of the enzyme using hyaluronate as a substrate showed that the activity of pig liver hyaluronidase was uncompetitively activated by either protons or NaCl. PMID- 3970971 TI - Characterization and immunohistochemical localization of rat salivary cobalamin binding protein and comparison with human salivary haptocorrin. AB - Rat saliva contains a cobalamin-binding protein that binds cobalamin as well as cobinamide. The protein binds cobalamin with an affinity constant of 8 X 10(10) l X mol-1, and it binds cobalamin over a more narrow pH range (pH 7.5-10) than does human haptocorrin. It has a Stokes radius of 2.45 nm as compared to the Stokes radius of 4.50 nm for human haptocorrin. Upon isoelectricfocusing it dissociates into four strong bands with pI between 7 and 8, while human haptocorrin dissociates into acid isoproteins. Since human haptocorrin binds to concanavalin A while rat haptocorrin does not, we suggest that rat haptocorrin lacks carbohydrate. The substance concentration of rat saliva haptocorrin is 0.04-12.9 nmol X l-1 (median 7.5 nmol X l-1, n = 9) for control animals. After stimulation with isoproterenol, a beta-adrenergic agent, the substance concentration is 46.4 96.6 nmol X l-1 (median 69.7 nmol X l-1, n = 8). Immunohistochemical studies show haptocorrin in the secretory acini of the submandibular and parotid glands of the rat. In the human submandibular gland, the protein is detected both in the mucous secretory acini and in the intercalated ducts. PMID- 3970972 TI - Reduction potential of iron in transferrin. AB - The reduction potential of Fe3+ in transferrin was measured spectrophotometrically by equilibration with methyl viologen in the presence of sodium dithionite. For an ionic strength near 0.1 M at 25 degrees C and pH 7.3 under 0.048 atm. CO2, half of the iron is reduced at a potential near -0.40 V (vs. standard hydrogen electrode). At least one disulfide bond of the protein is partially reduced at a potential of -0.44 V, as evidenced by reaction with [14C]iodoacetate. PMID- 3970973 TI - The liver is an organ site for the release of inosine metabolized by non glycolytic pig red cells. AB - The metabolic energy source used by the pig red cell, which is unable to metabolize blood-borne glucose, was examined. Potential physiological substrates include adenosine, inosine, ribose, deoxyribose, dihydroxyacetone and glyceraldehyde, of which inosine was previously implicated. A net ATP synthesis by red cells occurs during in situ perfusion through the adult miniature pig liver. HPLC analysis of the perfusate revealed the presence primarily of inosine and hypoxanthine. Inosine production by the liver was 0.015 mumol/g per min. Moreover, red cells maintain ATP when suspended in a balanced salt medium during a 6 h incubation at 38 degrees C, in which inosine is continuously infused to give an external concentration of no more than 3 mumol/l, mimicking its plasma level. Inosine consumption under these infusion conditions was 56 nmol/ml cell per h, which is two orders of magnitude lower than when inosine is present in millimolar concentration. The total red cell inosine consumption of 9.63 mumol/h is much less than the total liver inosine production of 212 mumol/h. These findings suggest that the liver is an organ site elaborating inosine, and that maintenance of a 3 mumol/l inosine in plasma is sufficient to meet the energy requirements of the pig red cells. PMID- 3970974 TI - Thyrotropin increases the iodine content of rat circulating thyroglobulin as measured by equilibrium density gradient centrifugation. AB - In previous work we demonstrated that circulating thyroglobulin contains very little or no iodine. We have now characterized circulating thyroglobulin following administration of thyrotropin (TSH) to determine whether its iodine content remains low or increases after stimulation. The iodine content of circulating thyroglobulin was estimated from its density determined by equilibrium density gradient (isopycnic) centrifugation. TSH stimulated thyroglobulin from 182 +/- 28 ng/ml to 571 +/- 83 ng/ml at 8-14 h. Circulating thyroglobulin in the basal state had a density consistent with very little or no iodine. Its density increased following TSH to a maximum at 8-14 h which was nearly the same as the density of thyroglobulin extracted directly from the thyroid. To determine whether selective peripheral metabolism, based on the degree of iodination, could account for the density shift, purified rat thyroid thyroglobulin was injected into thyroidectomized rats. The density of thyroglobulin remained unchanged for 25 h during which time it was metabolized by more than 97%. Therefore, selective metabolism of thyroglobulin based on iodine content did not occur. We conclude that TSH causes a marked increase in the iodine content of circulating thyroglobulin. It is most likely that in the basal state circulating thyroglobulin comes from selective release of poorly iodinated molecules, while after TSH, it comes from release of previously synthesized, iodinated and stored molecules. PMID- 3970975 TI - Reversible and irreversible interactions between elastin and plasma lipoproteins. AB - The interactions between radiolabeled, human plasma lipoproteins and elastin derived from bovine ligamentum nuchae were investigated using a washout technique. The interaction was characterised by Ki, a coefficient of irreversible binding, and Kr, the reversible partition coefficient. For both low-density lipoproteins (LDL) and high-density lipoproteins (HDL) the Ki values decreased as total lipoprotein concentration increased, suggesting that the binding is saturable, and were similar in magnitude to those measured by other workers using elastin derived from the human aorta. For both LDL and HDL the Kr values were independent of lipoprotein concentration in the range 0.1 microgram/ml-1.5 micrograms/ml. At a total protein concentration of 1.5 mg/ml in the incubation medium, the reversible interactions were comparable in magnitude to the irreversible. PMID- 3970976 TI - Ferritin in liver, plasma and bile of the iron-loaded rat. AB - Rats were loaded with iron. With overload, up to a 10-fold increase of the iron and ferritin protein content of the livers was measured. The plasma ferritin concentration increased gradually with the ferritin concentration in the liver. The ferritin concentration in the bile increased also and was in the same range as in the plasma. The ratio plasma ferritin concentration to bile ferritin concentration in individual rats decreased in the case of considerable iron overload. After intravenous injection of liver ferritin, less than 2% of the ferritin concentration that disappeared from the blood was found to be in the bile. Isoelectric focussing revealed that the microheterogeneity of liver and bile ferritin were identical, but slightly different from plasma ferritin. These results indicate that ferritin was not solely leaking from the plasma to the bile. Together with ferritin, iron accumulated in the bile. The iron content of the bile ferritin was in the same range as in fully iron-loaded liver ferritin. It is likely that ferritin in the bile is excreted by the liver and consists of normal iron-loaded liver ferritin molecules. In all circumstances, the amount of iron in the bile was much higher than could be accounted for by transport by the bile ferritin. The ferritin protein to iron ratio in the bile was 0.1-1.2, which was in the same range as was measured in isolated lysosomal fractions of the liver. Those results agree with the supposition that ferritin and iron in the bile are excreted by the liver though lysosomal exocytosis. PMID- 3970977 TI - Isolation and characterization of new proteins produced by the infusion of colchicine in goat mammary gland. AB - Three new proteins have now been isolated from goat milk obtained after colchicine is infused into the mammary gland. Two of the proteins are proline rich, and a third is a very acidic phosphoprotein. One of the proline-rich proteins is related compositionally to a sheep colostrum proline-rich protein, which has been shown to have a regulatory effect on the immune response (Janusz, M., Stavoscik, K., Zimecki, M., Wieczorek, Z., and Lisowski, J. (1981) Biochem. J. 199, 9-15). Other aspects of colchicine-treated milks are described. PMID- 3970979 TI - Comparison of the inhibitory effects of diverse amino acids and amino acid analogs on 12-O-tetradecanoylphorbol-13-acetate-induced ornithine decarboxylase activity in isolated epidermal cells. AB - At a concentration of 1.25 mM, 14 amino acids were capable of inhibiting the induction of ornithine decarboxylase (L-ornithine carboxy-lyase, EC 4.1.1.17) activity by the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) in isolated epidermal cells. The greatest percentages of inhibition of TPA-induced epidermal ornithine decarboxylase activity were as follows: cysteine, 98%; tryptophan, 74%; methionine, 64%; phenylalanine, 51%; glycine, 44%; asparagine, 43%; glutamic acid, 42%; leucine, 40%; and arginine, 39%. These amino acid treatments did not alter the time- and concentration-response curves for induction of ornithine decarboxylase activity by TPA. Moreover, there was no difference between the rates at which [3H]arginine, [3H]leucine, [3H]phenylalanine, [3H]methionine, [3H]tryptophan and [14C]cysteine were taken up by freshly isolated epidermal cells or incorporated into epidermal proteins. Arginine, phenylalanine and methionine inhibited the induction of ornithine decarboxylase activity by the tumor promoter to degrees comparable to those elicited by their analogs canavanine and homoarginine, beta-2-thienyl-DL-alanine, and ethionine, respectively. These amino acids and amino acid analogs did not alter the overall rate of protein synthesis. In contrast, both the amino acids and their analogs increased the rates of proteolysis in isolated epidermal cells, an effect which correlated well with the abilities of these different compounds to inhibit TPA-induced ornithine decarboxylase activity. Moreover, both methionine and phenylalanine decreased the half-life and increased the rate of heat denaturation of the TPA-induced enzyme, a result identical to that obtained after treatment with the analogs ethionine and beta-2-thienyl-DL-alanine, respectively. Taken together, these results suggest that millimolar concentrations of exogenous amino acids might induce the synthesis of abnormal proteins and nonfunctional enzymes. Therefore, it is speculated that the uptake of unbalanced amounts of amino acids into the epidermal target cells might alter the stability and the ultrastructure of the TPA-stimulated enzyme just as the amino acid analogs do. PMID- 3970978 TI - Accumulation and salvage of adenosine and inosine by isolated mature cardiac myocytes. AB - Reoxygenation of ischaemic, energy-depleted heart does not result in sufficiently rapid regeneration of normal adenine nucleotide concentrations for preservation of cardiac function and structure. Salvage of nucleoside as a mechanism for restoration of ATP in the post-ischaemic myocardium is limited by efflux of adenosine during ischaemia. Isolated cardiac myocytes have been used to establish the kinetics of uptake and salvage of adenosine and inosine, measuring the distribution of radioactive nucleoside incorporated into ATP, ADP and AMP. Maximum rates of catalysis of reactions on the salvage pathway, and of enzymes competing for substrates on the pathway, have been established in myocyte extracts. Myocytes have little capacity to salvage or catabolise inosine. Enzyme measurements indicate that salvage of adenosine should proceed at 7-8-times the rate exhibited by intact myocytes dependent upon extracellular adenosine as substrate. The data indicate that the rate of transport of adenosine is not determined by its metabolic utilization, but is the rate-limiting step in the salvage of adenosine. PMID- 3970980 TI - Stimulation of fibrinogen synthesis in cultured rat hepatocytes by fibrinogen fragment E. AB - Because of the inherent difficulties of experimentation in intact animals, we used primary monolayer cultures of non-proliferating adult rat hepatocytes to study the effects of fibrinogen degradation products on fibrinogen biosynthesis. The freshly isolated hepatocytes obtained by collagenase perfusion of the liver in situ were cultured in a chemically defined serum-free medium. The rate of fibrinogen synthesis in control cultures was 40-50 pmol/2.5 X 10(6) cells per 24 h. Additions of 20, 60 or 100 micrograms of homologous stage I fibrinogen degradation products had no effect on fibrinogen synthesis. In contrast, addition of the same amounts of homologous or heterologous (human) stage III fibrinogen degradation products resulted in a concentration-dependent increase in fibrinogen biosynthesis without affecting the rate of synthesis of albumin. When purified stage III fibrinogen degradation products D and E (human) were tested in 10, 30 or 50 micrograms/3 ml medium only fragment E showed a significant increase in fibrinogen biosynthesis (1.9-, 2.8- and 5.6-fold, respectively, over the control cultures). The presence of excess fibrinogen had no effect. These results suggest that fibrinogen fragment E may be a specific stimulator of fibrinogen biosynthesis which may play an important role in maintaining normal levels of plasma fibrinogen. PMID- 3970981 TI - Characterization of the interaction between factor Xa and bovine aortic endothelial cells. AB - Cultured bovine aortic endothelial cells incubated with Factor Xa activate prothrombin. Factor V, synthesized by the endothelial cells, or plasma Factor V and calcium are required for the reaction. In the present study, it has been demonstrated that 125I-Factor Xa binds specifically to endothelial cells. In addition, the activation of prothrombin by Factor Xa and aortic endothelial cells has been further characterized. The binding of 125I-Factor Xa to endothelial cells was saturable and reversible. The equilibrium dissociation constant (Kd) for 125I-Factor Xa binding was 3.6 X 10(-9) M, with 39000 molecules bound per cell. 125I-Factor Xa, inactivated by diisopropylfluorophosphate did not bind specifically to endothelial cells, indicating that the active site of Factor Xa was required for binding. Factor Xa, but not activated protein C, competed with 125I-Factor Xa for binding. Autoradiograms of sodium dodecyl sulfate polyacrylamide gels of cell lysates indicated that the radiolabeled material that bound to the cells had electrophoretic mobility identical to Factors Xa alpha and Xa beta. Although Factor X partially inhibited the binding of 125I-Factor Xa, Factor Xa did not inhibit the binding of 125I-Factor X, indicating that the zymogen and enzyme bound to different receptors. The relationship of the 125I Factor Xa binding which was measured in these studies to aortic endothelial cell prothrombin activation is unclear since an anti-Factor V IgG blocked prothrombin activation but not Factor Xa binding. Additionally, 125I-Factor Xa binds to nonvascular cells; these cells do not activate prothrombin in the presence of Factor Xa. Moreover, the calcium requirements for each reaction and the saturation curves of 125I-Factor Xa binding and prothrombin activation differ. Although these data do not exclude a relationship between Factor Xa binding and prothrombin activation, the binding of 125I-Factor Xa to aortic endothelium measured in these studies may be related to a separate cellular function. To further characterize prothrombin activation by Factor Xa and endothelial cells, the rates of thrombin generation by intact bovine aorta or endothelial cells derived from this tissue were compared and were found to be equivalent. These data indicate that vascular endothelium may serve as a physiologic surface for hemostasis. PMID- 3970982 TI - A model for direction selectivity in threshold motion perception. AB - Thresholds were measured for a moving line superimposed on moving sinusoidal gratings. When line and grating moved in the same direction significant subthreshold summation was observed over a range of spatial frequencies. For motion of the line and grating in opposite directions, summation was never observed. This supports the hypothesis that direction selective mechanisms are responsible for motion perception at threshold. Further analysis of the data produced estimates of the spatial frequency tuning of these mechanisms. A quantitative model is proposed to interpret the data, and it is suggested that flickering gratings are not decomposed into their moving components by the visual system. PMID- 3970983 TI - A model of the neural mechanisms responsible for pattern recognition and stimulus specific habituation in toads. AB - A neural model of the mechanisms possibly responsible for stimulus-specific habituation in toads is proposed. The model follows the hypothesis that prey predator recognition is performed by command units as a result of retina-tectum pretectum interaction. The model allow us to study the possible coding that the nervous system of toads uses for different prey stimuli, the neural mechanisms of habituation and dishabituation, and the dynamic changes that the command units may have during these processes. The model proposes specific hypothesis and experiments to clarify the nature of these processes and to test the validity of the command unit hypothesis. PMID- 3970984 TI - The application of parametric multichannel spectral estimates in the study of electrical brain activity. AB - A parametric autoregressive model was applied to the multichannel EEG time series. Small statistical fluctuations of the spectral estimates obtained from the short data strings made possible to follow the time changes of the signals. The multiple and partial coherences were calculated for the four channel process and compared with the coherences computed between the pairs of channels. From the study it followed that the partial coherences are the proper measure of the synchronization of brain structures and their intrinsic relationships. The partial phase spectra give the information about the phase delays. The advantages of the parametric description of signals in the frequency domain in respect to the modelling of dynamic systems was pointed out. PMID- 3970985 TI - Human pattern recognition: individually different strategies in analyzing complex stimuli. AB - Multidimensional scaling experiments were performed with "size" and "brightness" as parameters. Subjects (ss) had to rate the dissimilarity of pairs of discs differing in size or in brightness only, or in both parameters. It was then attempted to find a rule, by which the dissimilarity judgements of two dimensional differences can be predicted from judgements given for the one dimensional components. Minkowski-metrics were chosen as models, since for most of the ss the prerequisites for applying these metrics seem to be fulfilled. A simple procedure is described by which the one metric out of all Minkowski metrics can be found which gives the best description for the data of a subject (Fig. 4). Although the task and the parameters used were the same for all ss, individually best metrics differed considerably, indicating individually different modes of perceptual analysis: Most ss adhered, roughly, to either the City-block or the Euclidean metric (cf. Fig. 10). (Only City-block metric was to be expected, since "size" and "brightness" are generally thought to be "separable" parameters.) In addition, there were three ss with metrics clearly different from both the City-block and the Euclidean metric (best exponents around 1.4). In view of those substantial differences between individuals one has to be cautious against the practice of averaging data from different ss. PMID- 3970987 TI - An analysis of extracellular single muscle fibre action potential field- modelling results. AB - The radial variability of extracellular single muscle fibre action potential (SFAP) field was studied on the basis of an SFAP theoretical model originally constructed by Rosenfalck (1969). Amplitude and time parameters of the SFAP as a function of the radial distance r less than or equal to 10 mm from the fibre were described by simple mathematical expressions. The results obtained were compared with existing experimental data from different authors and discussed in detail. PMID- 3970986 TI - An optimal monitor of the electroencephalographic sigma sleep state. AB - A model has been proposed for a Markov-jumping sleep depth that modulates a white noise driven structure generating the sigma rhythm in the electroencephalogram. The corresponding maximum likelihood monitor, that continuously detects the current sleep stage from the observed electroencephalogram, has been derived and implemented. Simulations show high detection performances. PMID- 3970988 TI - [Determination of hemoglobin affinity for oxygen by a polarographic method]. AB - The method of determination of hemoglobin affinity for oxygen based on polarographic analysis and the method of half-saturation values P50 calculation are described. A special design of a polarographic cell is proposed for measurements in a wide temperature range. The results of temperature and pH dependences of the hemoglobin affinity for oxygen and erythrocytes of the White Sea cod are presented. PMID- 3970989 TI - [Genome expression of the DNA-containing human papovavirus in transformed human cells]. AB - In the course of study of the transformed cells of line 63 the phenomenon of cyclically repeated transitory infection of the level of separate cells accompanied by the periodically isolated DNA-containing virus has been shown. Virus reproduction was judged by the determination of the infectious and hemagglutinating activities and radioactivity. The application of activation methods (co-culturing, somatic hybridization and cells treatment with mytomycin C) led to the increase of virus synthesis in the transformed cells of line 63 during spontaneous production of it. We failed to express viral genome in refractor phase. PMID- 3970990 TI - [Possible modes of autorhythmic activity of a single neuron]. AB - The rhythmic impulse activity of the nerve cells is one of the characteristic phenomena often registered in the experiments on different objects. According to the nature of its origination it should be distinguished the evoked rhythmic activity from autonomic. The variants of interaction of pacemaker and membrane oscillators leading to the variety of regimes of autorhythmic activity of the neuron are discussed. The interaction of several membrane oscillators without the participation of the pacemaker autogenerator may lead to the authorhythmic reverberative (extracellular) activity. PMID- 3970991 TI - [Kinetics of Streptomyces baarnensis growth and antibiotic synthesis in batch and dialysis cultures]. AB - The kinetics of biomass and antibiotic formation in batch and dialysis culture of Streptomyces baarnensis at various initial concentrations limiting the substrate growth (glucose) has been studied. The antibiotic substances were synthesized by actively growing culture, its concentration in the cultural media was maximum in the log-phase. In continuous dialysis culture on the background of biomass lianer growth in the course of time the constant antibiotic concentration in the media proportional to the glucose input concentration has been established. The inactivation (decomposition) of antibiotic was immediately initiated after discontinuation of substrate supply and followed first kinetics order. Observed features were used for construction of kinetical model of antibiotic biosynthesis. A conclusion has been made that the dialysis culture gives opportunity for more effective antibiotic synthesis as compared with the batch one. PMID- 3970992 TI - Suicide and biochemistry. PMID- 3970993 TI - Manic symptoms: an indication for bilateral ECT. AB - As a follow-up to pilot observations that six manic patients who failed to respond to unilateral electroconvulsive therapy (ECT) recovered rapidly when switched to bilateral treatment, a retrospective study was conducted. Twenty-five patients who responded after switchover from unilateral to bilateral ECT, 25 age- and sex-matched controls, and 25 concurrent controls who responded to right unilateral ECT alone were evaluated. Demographic variables and DSM-III diagnosis did not discriminate between the groups, nor were they different in terms of electroencephalographic (EEG) findings, neuropsychological test results, numbers of ECT, and duration of seizure discharges. Standard assessments of psychopathology performed by independent psychiatrists showed no differences in ratings of psychosis or depressive phenomena. However, scales assessing manic symptoms showed highly significant differences with many more features of unrestrained behavior, elevated mood, hurried speech, and other typical features of mania in the patients who were switched from unilateral to bilateral ECT. Although there were no differences in prescribed drugs, the use of prn medications for sleep was greater in the experimental-switched patients than in controls. Patients who responded to unilateral ECT alone exhibited virtually no manic features, whereas those who demonstrated these characteristics failed to respond to unilateral ECT but benefited when switched to bilateral treatment. PMID- 3970994 TI - "Paradoxical" shortening of REM latency on first recording night in major depressive disorder: clinical and polysomnographic correlates. AB - Among 92 inpatients with major depressive disorders, variability in REM latency (RL) during the first two recording nights was assessed by means of an "adaptation coefficient" (AC = night 1 RL--night 2 RL X 100 divided by mean RL for nights 1 and 2). Although mean RL was very similar for both nights (48.1 and 50.7 min), individual ACs showed a gaussian distribution [range: -176.5-171.4; mean: -1.2 (67.3); median: -4.4]. Forty-two patients (45.7%) exhibited shortening of RL on night 2 compared with night 1 (positive AC, corresponding to an "expected" evolution), 48 patients (52.2%) displayed the opposite pattern (negative AC, corresponding to a "paradoxical" evolution), and two patients had identical values on both nights. Extent of increase in RL from first to second night (i.e., extent of "paradoxical" evolution) correlated significantly with increasing duration of current episode, earlier age of onset, and poorer clinical response to tricyclic antidepressants. A cutoff AC of -7 correctly classified 62% of patients according to treatment response. The research diagnostic criteria based retarded subtype of depression was associated with a more negative AC (i.e., a more "paradoxical" evolution), and the situational subtype was associated with a more positive AC (i.e., a more "expected" evolution) than the remainder of the sample. The subgroup with the most negative ACs (i.e., largest increases in RL from first to second night) also had longer sleep latencies, whereas the subgroup with the most positive ACs (i.e., largest decreases in RL) had higher REM activity and REM density as compared with the remainder of the sample. These results suggest that RL in major depression is not a static parameter and that the study of its within-subject variability can be helpful for diagnostic confirmation and prediction of treatment response. PMID- 3970995 TI - Cerebral blood flow decrements in chronic head injury syndrome. AB - Global and regional cerebral blood flow (CBF) has been reported to be decreased immediately after head injury. Since neuropsychological deficits in patients with chronic head injury syndrome persist long after the initial trauma, we studied CBF, which reflects cerebral metabolism and activity, and evaluated the results of neuropsychological tests in 12 alert, responsive patients aged 18-26, both 2 13 months after head injury and 1-12 months after they regained consciousness. Global CBF was significantly decreased in patients with head injury relative to age-matched normal controls. Four patients had well-localized injury; in three of these, CBF over the affected region was significantly decreased relative to the same region in the opposite hemisphere and relative to the same region in an age matched normal control. In one patient with right frontal injury, cognitive improvement on repeat testing was associated with a relative increase in right frontal CBF. The remaining eight patients had diffuse bilateral injury. Asymmetry ratios (larger value of mean hemispheric CBF divided by the smaller) were significantly higher for the group with localized dysfunction (1.2 +/- 0.08 vs. 1.0 +/- 0.01, p less than 0.01), suggesting homolateral decrease in CBF in this group. Three patients with diffuse injury underwent repeat studies 5-14 weeks later; all improved on psychological tests, and two had a significant increase in global CBF. These results suggest that the chronic sequelae of head injury include decreased CBF, presumably reflecting decreased cerebral metabolism, which correlates with the neuropsychological impairment. PMID- 3970996 TI - Electrodermal activity among subtypes of depression. AB - To determine whether subgroups of depressed patients could be differentiated on the basis of electrodermal activity (EDA), the skin conductance of 36 depressed patients was recorded for two experimental conditions. In the first condition, subjects heard 10 85-dB tones after receiving instructions that were intended to relax the patients. In the second experimental condition, subjects heard 12 105 dB tones, one-half of which were signal tones containing a brief gap in the middle. The subjects were required to respond to the tones containing the gap by pressing a foot pedal. No differences in tonic or phasic EDA were detected on the basis of unipolar or bipolar subtype, response to the dexamethasone suppression test, severity of depression, medication status, or sex. However, patients who exhibited features of psychomotor retardation had significantly lower levels of tonic EDA than did their nonretarded counterparts. The EDA of the depressed patients as a group was uniformly low. These results are consistent with other reports indicating that, with the exception of the retarded/nonretarded distinction, there are no differences in EDA among the various subtypes of depression. PMID- 3970997 TI - Transient grasp reflexes in schizophrenia. PMID- 3970998 TI - Repetitive head movements during REM sleep. PMID- 3970999 TI - Neurological dimensions of psychiatry. PMID- 3971000 TI - Brain stem auditory evoked potentials in unmedicated schizophrenic patients. PMID- 3971001 TI - Lithium in prophylactic therapy of manic-depressive illness: biochemical correlates of response. PMID- 3971002 TI - Effect of membrane protein concentration on binding of 3H-imipramine in human platelets. AB - Binding of 3H-imipramine to platelet membranes has been implicated as a marker for depression. Comparing 3H-IMI binding between depressed patients and normal subjects we observed an increase in the dissociation constant Kd with increasing membrane protein. This phenomenon was studied more rigorously in five normal subjects. Platelet membranes were prepared and adjusted to four concentrations of protein ranging from 100 to 800 micrograms/ml. The 3H-IMI binding parameters of maximum binding sites number (Bmax) and Kd were obtained by Scatchard analysis at each membrane concentration. A positive linear relationship was found between Kd values and the concentration of membrane protein in the assay, but no change was observed in Bmax. The variability in Kd values reported in the literature may be accounted for in part by the different concentrations of membrane protein used in various studies. PMID- 3971003 TI - Carbamazepine-induced reduction of blood levels of haloperidol in chronic schizophrenia. PMID- 3971004 TI - Plasma testosterone levels, depression, sexuality, and age. PMID- 3971005 TI - Psychopathology and epilepsy. PMID- 3971006 TI - Cauda epididymal sperm motility: a comparison among five species. AB - Rat spermatozoa are immotile in the cauda epididymidis and are kept quiescent by a protein which increases viscoelasticity of cauda luminal fluid. How species specific this phenomenon is, is unknown. In the present study, the motility of cauda epididymal spermatozoa of rats, hamsters, guinea pigs, rabbits and humans have been investigated. Sperm motility was observed in undiluted cauda sperm samples and in samples diluted with physiological diluents with or without Ca++, among others. Hamster sperm were studied in further detail to determine if the motility inhibiting factor in hamster cauda lumen fluid had characteristics similar to those previously described in the rat. Cauda fluid protein concentrations and apparent viscoelasticity were also determined and related to cauda sperm motility in all species. The results demonstrated that all species studied except rabbits have immotile sperm in their native cauda fluid and that additional Ca++ is not a factor in the initiation of motility. Cauda sperm immotility is not always related to fluid viscosity, however, so other as yet unknown mechanisms must be called upon in some species. The vigorous motility of rabbit spermatozoa in their native fluid implies that a fundamental difference exists in the relationship between epididymis and spermatozoa in rabbits from that observed in other species. PMID- 3971007 TI - Binding of 125I-succinylated concanavalin A to bovine spermatozoa. AB - This study characterizes interactions of 125I-succinylated concanavalin A (125I sucConA) with plasma membranes of intact bovine spermatozoa. Maximum binding was achieved by 30 min at 24 degrees C. Reversibility of binding was established by displacement of bound ligand with nonradioactive sucConA. Seventy-five percent of the bound sucConA was removed as a single kinetics class. When alpha methylmannoside was used as a competitive ligand, 90% of the sucConA was removed. Saturability of binding sites, however, was not achieved over the concentration range of 125I-sucConA examined (0.13 micrograms/ml to 77 micrograms/ml). Binding kinetics of this system was complex and linear Scatchard analysis was not appropriate. The degree of 125I-sucConA binding to spermatozoa was influenced (P less than 0.01) by different iodination batches of 125I-sucConA. Complications due to iodination of ligand and the complex nature of its interaction with the membrane preclude the use of 125I-sucConA for a quantitative study of sperm membrane features. PMID- 3971008 TI - Albumin-mediated changes in sperm sterol content during capacitation. AB - The role of albumin in mouse sperm capacitation was studied in relation to its activities as a lipid-solubilizing protein and a sterol acceptor. Two bovine serum albumins (BSA) which supported capacitation, Fraction V and fatty acid free, both contained cholesterol and phospholipid but were without detectable levels of serum high-density lipoprotein (HDL). The lipid content of BSA could be reduced by trichloroacetic acid (TCA) precipitation; however, removal of all detectable lipids required precipitation with ethanolic acetone and diethyl ether extraction. In medium supplemented with Fraction V, fatty acid-free, or TCA precipitated BSA, mouse sperm were capacitated as evidenced by their ability to fertilize eggs, concomitant with decreases in total cellular sterol and increases in phospholipid content. Delipidated BSA, fractionated on Sephadex G-100 in guanidine HCl also supported capacitation and mediated a 20% decrease in sperm sterol content, while cellular phospholipid levels remained unchanged. When BSA was modified by cholesterol augmentation, fertilization was inhibited in a cholesterol dose-dependent manner. These findings suggest that modulation of sperm lipid levels comprises an event of capacitation and that albumin mediates this process through its activity as a sterol acceptor. PMID- 3971009 TI - Roles of cell-to-cell communication in development. AB - Possible roles of cell-to-cell communication mediated by intercellular bridges and gap junctions in development of the female gamete and embryo are discussed. Synchronization of cell cycle events is presumably a role for intercellular bridges between germ cells. The follicle of the Cecropia moth reveals that an electrical polarity exists between nurse cells and oocytes which are connected by intercellular bridges and this polarity may generate differences that result in differentiation of the oogonia to become either the oocyte or nurse cells. Gap junction-mediated transfer of cyclic AMP, made in response to gonadotropin stimulation, between granulosa cells is discussed as a mechanism that allows cells within a tissue to respond to an external stimulus even though all cells in that tissue may not be exposed to the stimulus. A nutritional role for heterologous cell communication between follicle cells and the oocyte in oocyte growth is presented as an example of how gap junction-mediated communication can allow one cell type to influence the behavior of another cell type. During development, a restriction in communication between differentiating cells is frequently observed. Examples of this phenomenon in a mammal and an insect are presented. PMID- 3971010 TI - Communication and control in reproduction: the ubiquity of periodic phenomena. AB - Two statements will be presented and defended in this paper. First, it is claimed that oscillations are common in all biological systems. From the subcellular to the organismic levels of organization, oscillations are the normal operational mode for many biochemical and physiological control networks. Second, it will be demonstrated that periodic control offers several functional advantages over steady-state control. PMID- 3971011 TI - Estradiol and progesterone regulation of immunoglobulin A and G and secretory component in cervicovaginal secretions of the rat. AB - The present study examined the influence of hormones on the levels of immunoglobulins A (IgA) and G (IgG) and secretory component (SC) in cervicovaginal secretions of ovariectomized rats. Administration of estradiol to ovariectomized rats resulted in a significant decline in cervicovaginal content of IgA, IgG and SC. This response was dose dependent and was not prevented by administration of dexamethasone, a potent synthetic glucocorticoid, with estradiol. Treatment of ovariectomized rats with progesterone also lowered the levels of IgA and SC in cervicovaginal secretions. In contrast, dexamethasone had no apparent vaginal effect. The action of estradiol on cervicovaginal IgA, IgG and SC appears to be independent of uterine influence. This conclusion is based upon our observation that estrogen treatment of rats with ligations at their uterocervical junction still have decreased cervicovaginal IgA and SC levels. In parallel with this inhibitory effect, estradiol administration stimulated the accumulation of IgA and SC in uterine secretions. These findings indicate that the sex hormones play a role in regulating IgA, IgG and SC content in cervicovaginal secretions. In addition, it suggests that hormonal balance in females may influence the immune response of the reproductive tract to infectious disease. PMID- 3971013 TI - Chromium concentrations in serum, blood clot and urine from patients following total hip arthroplasty. AB - Chromium released from implant alloys may be incorporated into organometallic complexes as Cr3+ [Cr(III)] or CR6+[Cr(VI)]. Since Cr(VI) is far more biologically active than Cr(III), there is considerable interest in identifying the valence state that predominates in corrosion products, either in vitro or in vivo. It is known that erythrocytes display a unidirectional uptake of Cr(VI) while effectively excluding Cr(III). Thus it was felt that a study of the chromium content of blood clot, in comparison to chromium concentrations in serum and urine, could shed light on the valency question. Fourteen patients who received conventional polymethylmethacrylate cemented cobalt-chromium alloy/ultra high molecular weight polyethylene total hip replacements as well as seven control patients who underwent orthopaedic procedures without implantation were studied. Blood and urine specimens were obtained preoperatively, post-operatively and, for total hip patients, at routine early follow up. Chromium content was determined by electrothermal atomic absorption spectroscopy. A significant post operative rise in serum chromium content was observed for total hip replacement patients, as previously reported, but not for control patients. Unexpected day-to day variations in clot chromium content, without significant increases, were also observed. Longer time studies are required to determine chromium valence states in corrosion products in this model. PMID- 3971012 TI - Influence of high-density lipoprotein on estradiol stimulation of luteal steroidogenesis. AB - The aim of this investigation was to determine whether luteal cells utilize cholesterol derived from high-density lipoprotein (HDL) for steroidogenesis and whether estrogen enhances luteal utilization of exogenous sterol. Incubation of Day 15 corpora lutea (CL) with different doses of human HDL resulted in a dose dependent increase in progesterone production. HDL in vitro enhanced the overall steroidogenic capacity. However, the percentage of increases in 17 alpha hydroxyprogesterone, testosterone and estradiol were significantly less than that of progesterone. Day 12 hypophysectomized and hysterectomized pregnant rats were treated with either estradiol, testosterone or vehicle for 72 h. Serum pregnenolone and progesterone were markedly increased by the steroid treatment, yet in vitro production of progesterone by CL in all the groups was similar. However, in the presence of HDL in the media, only luteal tissues from steroid treated rats increased their progesterone output. The reduced production of progesterone by luteal cells of vehicle-treated rats was not due to an accumulation of pregnenolone but to an overall reduction in exogenous sterol utilization. In summary, results of this investigation suggest 1) luteal cells of pregnant rats effectively utilize cholesterol from HDL for maximal steroidogenesis, and 2) estradiol may stimulate luteal steroidogenesis, at least in part, by affecting the incorporation or utilization of cholesterol from HDL into the cell. PMID- 3971014 TI - Accelerated oxide growth on titanium implants during autoclaving caused by fluorine contamination. AB - Titanium implants were occasionally found to be strongly discoloured after autoclaving. The discolouration is shown to be due to an accelerated growth of the surface oxide that covers the implants. Oxide thicknesses up to 650 A have been observed, i.e. more than ten times thicker than on normal implants. By applying surface sensitive spectroscopies (SIMS and XPS or ESCA) it is also shown that these oxide films contain considerable amounts of fluorine, alkali metals and silicon. Screening tests with alkali-halide solutions identify fluorine as the impurity responsible for the accelerated oxide growth. Discolouration after autoclaving can be observed for fluorine contaminations down to the ppm level. In those cases where discolouration was observed in the clinical situation, the source of fluorine was the textile cloths in which the titanium implant storage box had been wrapped during the autoclaving procedure. The cloths contained residual Na2SiF6 which had been used as an additive to the rinsing water used in the last step of the cloth laundry procedure. Since the biocompatibility of titanium implants is closely related to their surface oxides it is advisable to avoid all sources of fluorine in the implant preparation procedures. PMID- 3971015 TI - Implant effects on polyurethane and silicone cardiac pacing leads in humans: insulation measurements and SEM observations. AB - Recently, polyurethane cardiac pacing leads have been under discussion because of some failures, probably due to modification of surface insulating properties. In order to verify the reliability of polyurethane versus silicone rubber as coating material, the authors, starting from previous clinical research, have carried out a study of electrical insulation related to implant time. At the same time the outer and inner lead surfaces have been submitted to scanning electron microscope (SEM) analysis. The results show, for the polyurethane leads, a significant increase in the leakage or currents in explanted samples, and a significant degradation (cracking) of the outer surfaces. PMID- 3971016 TI - The use of ellipsometry to study adsorption on hydrogels. AB - This paper discusses the application of ellipsometry to film thickness measurements of materials deposited on hydrogel surface. The fundamentals of ellipsometry and modelling of ellipsometric readings are presented. A system of buffer/protein/hydrogel/metallic substrate is analysed in detail; the effects of optical properties of buffer, protein, polymer and thickness of protein film on ellipsometry readings are discussed. Cell window effects on ellipsometric results may also be quite important. PMID- 3971017 TI - An in vitro study of zinc in dentine beneath cavities filled with two dental cements. AB - The concentrations of zinc ions in dentine in vitro beneath cavities filled with zinc oxide/eugenol and zinc phosphate cements were measured by atomic absorption spectrophotometry. No significant difference was recorded between the two materials over a period of 15 weeks. The clinical significance of this finding is discussed. PMID- 3971018 TI - Stability in rat plasma and serum of lysosomally degradable oligopeptide sequences in N-(2-hydroxypropyl) methacrylamide copolymers. AB - Soluble copolymers of N-(2-hydroxypropyl)methacrylamide (HPMA) were prepared containing either oligopeptide side chains terminating in rho-nitroaniline, or oligopeptide sequences forming crosslinks between polymer chains. Such copolymers have potential as targetable drug carriers and already it has been shown that oligopeptide side chains and oligopeptide crosslinks are degraded intracellularly by lysosomal enzymes. The susceptibility of these oligopeptide sequences to degradation on incubation with rat plasma or rat serum was evaluated by monitoring either the liberation of rho-nitroaniline or, with the crosslinked polymers, the change in molecular weight distribution. Release of rho nitroaniline from some of the polymers was not detectable, and from others proceeded very slowly, the maximum rate being from the side chain Gly-Gly-Phe-Leu Gly-Phe-NAp where 5.1% of the bound rho-nitroaniline was released by rat serum over a 5 h incubation period. No cleavage of crosslinked HPMA copolymers by plasma or serum was detectable even after a 24 h incubation period. PMID- 3971019 TI - Fatigue characterization of nine dental amalgams. AB - Dental amalgams prepared from nine commercially available dental amalgam alloys, including high copper ternary, high copper blend, and a conventional alloy, were evaluated for their compressive fatigue behaviour to at least 10(6) cycles. While the fatigue behaviour of all high copper amalgams was similar, statistically significant differences in cycles to failure amongst these amgalgams were detected as a function of load, with Sybraloy demonstrating the greatest overall resistance to fatigue failure. PMID- 3971020 TI - Stability of some soluble alginate solutions. AB - The stability of some water alginates against bacterial degradation was studied. The study was based on viscosity and pH measurements of some typical alginate solutions, containing suitable additives during an extended time period (222 days). PMID- 3971021 TI - Iron detoxification by haemoperfusion through deferoxamine-conjugated agarose polyacrolein microsphere beads. AB - The natural iron chelator deferoxamine was bonded to agarose-polyacrolein microsphere beads (APAMB). This novel deferoxamine-conjugated APAMB (DCA), when used as the sorbent in a plasma/haemoperfusion system, showed specific and rapid removal of iron from plasma and blood in vitro; in vivo experiments also showed specific iron removal. The advantages of this sorbent are minimal damage to biocompounds during haemoperfusion, high capacity and specificity to iron, and the possibility of reuse. PMID- 3971022 TI - Biophysical Society: Program and abstracts, twenty-ninth annual meeting, February 24-28, 1985, Baltimore, Maryland. PMID- 3971023 TI - Generalized binding phenomena in an allosteric macromolecule. AB - A general macromolecular partition function is developed in terms of chemical ligand activity, temperature and pressure for systems described by an array of species which are characterized by their state of allosteric conformation and ligand stoichiometry. The effects of chemical ligand binding, enthalpy change, and volume change are treated in a parallel manner. From a broad viewpoint all of these effects can be regarded as specific cases of generalized binding phenomena. This approach provides a general method for analyzing calorimetric and ligand binding experiments. Several applications are given: (1) Thermal scanning data for tRNAphe (P.L. Privalov and V.V. Filimonov, J. Mol. Biol. 122 (1978) 447) are shown to fit a general model with six conformational states. By application of linkage theory it is shown that sodium chloride is expelled as the molecule denatures. (2) The results of calorimetric titrations on the arabinose binding protein (H. Fukada, J.M. Sturtevant and F.A. Quiocho, J. Mol. Biol. 258 (1983) 13193) are shown to fit a simple two-state allosteric model. (3) A thermal binding curve is simulated for an unusual respiratory protein, trout I hemoglobin (B.G. Barisas and S.J. Gill, Biophys. Chem. 9 (1979) 235), in order to illustrate both the similarities and differences between enthalpy and chemical ligand binding processes. PMID- 3971024 TI - The influence of methanol on the interactions of calcium with the pyridine nucleotides. AB - The interactions of calcium with NAD+, NADH, NADP+ and NADPH in a 50% (by volume) methanol/water mixture (pH 7, 25 degrees C) were studied by calorimetry. The association constants for 1:1 complex formation were found to be 6.6 +/- 0.2, 270 +/- 76, 18 +/- 3 and 98 +/- 10 for NAD+, NADH, NADP+ and NADPH, respectively. Comparing these to the association constants for an aqueous system reveals that as the polarity of the solvent system is decreased the interactions involving NAD+, NADP+ and NADPH are all decreased. In contrast, the interaction involving NADH is markedly increased. All the interactions were found to be endothermic. PMID- 3971025 TI - Cation binding effects on the pH, thermal and urea denaturation transitions in alpha-lactalbumin. AB - The binding of monovalent (Na+, K+) and divalent (Ca2+, Mg2+) cations to bovine alpha-lactalbumin at 20 and 37 degrees C has been studied by means of intrinsic protein fluorescence. The values of apparent binding constants for these ions obtained at 37 degrees C are about one order of magnitude lower than those measured at 20 degrees C. Urea and alkali (pH greater than 10) induce unfolding transitions which involve stable partially unfolded intermediates for all metal ion-bound forms of alpha-lactalbumin. Heating induces similar partially unfolded states. Nevertheless, the partially unfolded states induced by heating, urea, alkaline or acidic treatments are somewhat different in their tryptophan residue environment properties. The results have been interpreted in terms of a simple scheme of equilibria between metal-free and metal-bound forms in their native, partially unfolded and unfolded states. The scheme provides an approach to the quantitative interpretation of any transition equilibrium shift induced by a low molecular mass species able to be bound by a protein. PMID- 3971026 TI - Construction and performance of a variable-frequency phase-modulation fluorometer. AB - We describe the construction and performance of a variable-frequency phase modulation fluorometer. This instrument, which provides modulation frequencies from 1 to 200 MHz, was constructed using commercially available components. To facilitate the introduction of these instruments into other laboratories we describe in detail the chosen components and the principles of operation. The present light source is a continuous-wave helium-cadmium laser, which provides convenient excitation wavelengths of 325 and 442 nm. Modulation of the incident light is provided by one of several electro-optic modulators. The extent of modulation ranges from 1.0 to 0.2 as the frequency increases from 1 to 200 MHz. Phase angles and demodulation factors are measured using the cross-correlation method. The closely spaced frequencies are provided by two direct frequency synthesizers. The phase and modulation measurements are accurate to 0.2 degrees and 0.002, respectively, from 1 to 200 MHz. This accuracy allows considerable resolution of complex decay laws. The usefulness of frequency-domain fluorometry for the resolution of multiexponential decays is illustrated by the analysis of several difficult mixtures. As examples, we resolved a two-component mixture of anthracene (4.1 ns) and 9,10-diphenylanthracene (6.3 ns), and confirmed that the intensity decay of NADH in aqueous buffer is at least a double exponential (0.2 and 0.86 ns). We also resolved an especially difficult mixture of anthracene (4.1 ns) and 9-methylanthracene (4.5 ns), and a three-component mixture with decay times of 1.3, 4.1 and 7.7 ns. Frequency-domain fluorometers appear to be particularly useful for determination of complex decays of fluorescence anisotropy. This capability is illustrated by the determination of rotational correlation times as short as 47 ps for p-bis[2-(5-phenyloxazolyl)]benzene (POPOP) in hexane at 40 degrees C, and by the resolution of the two correlation times of anisotropic rotators such as perylene and 9-aminoacridine. Resolution of two anisotropy decay times for 9-aminoacridine is a difficult test because these correlation times differ by less than 2-fold. The resolution of multiexponential decays of intensity and anisotropy possible with this instrument is at least equivalent to that obtained using state-of-the-art time-resolved instruments based on mode-locked laser sources. The ease and rapidity of frequency-domain measurements, the relative simplicity of the equipment, the accuracy of the measurements and the lack of significant systematic errors indicate that frequency-domain fluorometry will be widely useful in chemical and biochemical research. PMID- 3971027 TI - [Role of the neocortical and subcortical commissures in the interhemispheric transfer of visual information to the hippocampus]. AB - The light flash evoked potentials were recorded in the hippocamp of cats with transected left optic tract and cerebral commissures. The data obtained show a significant reduction in the response amplitude (by 1.5-2 times) in both hemispheres after unilateral transection of the optic tract. The minimal response amplitude (10-15 times less than normal) was recorded in the left hippocamp of cats with additional transection of the commissures of the endbrain, mesencephalon and diencephalon. In contrast, the latent period of the first and second components of the evoked potential was similar to that in the control group animals. It is suggested that the neocortical commissural visual inputs play the most important role in interhemispheric transmission of visual information to the hippocamp. PMID- 3971028 TI - [Development of the reactivity of the microcirculatory system of the rat mesentery during sexual maturation]. AB - Biomicroscopy was employed to study the time-course of microcirculatory reactivity in rat mesentery under the influence of adrenaline solution from the 3d to the 13th week of development. Variation in the microcirculatory reactivity in the mesentery in ontogenesis is associated with an increase in the sensitivity of microvessels to the action of vasoactive substances and with the organization of the microcirculatory bed becoming more complicated. Three stages were revealed in the development of microvascular reactivity in the course of formation of mesenterial microcirculation: early (3-5 weeks), characterized by relatively low sensitivity of microvessels; intermediate (7-8 weeks) marked by a progressive increase in microvascular sensitivity; mature (starting from the 13th week) characterized by the appearance of the definitive reaction pattern. PMID- 3971029 TI - [Effect of estradiol and other endocrine factors on the level and dynamics of estrogen receptors in the liver cells of rats]. AB - The authors studied the effects of different doses of estradiol (E2) on the level of estrogen receptors (ER) in female rat hepatocytes and the dynamics of ER distribution between the cytosol and nuclear cell fractions and compared the changes in the ER level in the liver in different endocrine states of the body. It was shown that the ER level in hepatocytes was far lower than in uterine cells and drastically increased during puberation and after ovariectomy. It was also found that the ER level in hepatocytes was dependent on pituitary functions. After a single injection of E2, the ER level in cytosol descended and that in the nucleus rose. The degree of ER reduction in cytosol and increase in the nucleus correlated with the dose of E2. The dynamics of intercombined changes in the levels of cytosol and nuclear ER was studied at different time intervals following the injection of different doses of the hormone. Some essential organ specific features of E2 reception in the liver were revealed. Different mechanisms of the control of ER content in the liver and uterus are postulated. PMID- 3971031 TI - [Rheological characteristics of the blood in long-term and quick adaptation to muscle loads]. AB - It was established in chronic experiments on 26 dogs that long-term adaptation to regular muscular activity caused a 19.6-46.1% decrease in blood viscosity. Hematocrit was lowered and red cell deformability improved. A correlation was observed between blood viscosity and its oxygen transport function. As a result of muscular training the role of plasma protein in blood viscosity increased and that of red cells declined. Single muscular activity produced a 48.2-81% increase in blood viscosity, while plasma viscosity remained unchanged. Trained animals had lower absolute values of blood viscosity even at the time of muscular effort as compared to those in untrained animals at rest. PMID- 3971030 TI - [A microsurgical model of cerebral ischemia]. AB - Microsurgery was performed on 102 rats of both sexes weighing from 150 to 250 g. Anesthesia was induced by injecting 1% hexenal into the abdominal cavity (1 ml/100 g bw). By median incision of the inferior third of the neck and upper third of the pectoris bone an extrapleural access to the mediastinum was actieved, where the common carotid and subclavian arteries were constricted distally to the branching out of the intrathoracic and proximally to the vertebral arteries. The EEG stopped being recorded at the 23 +/- 5th s, respiration stopped at the 4 +/- 0.3th min of cerebral ischemia. Blood pressure and heart rates, after a brief rise, gradually decreased with ischemia prolongation. Appearance of the EEG and respiration and the ECG and blood pressure after 10 min of cerebral ischemia took place within the first 20 min of the postischemic period. After cerebral ischemia lasting over 10 min all the animals died. PMID- 3971032 TI - [Electrical stability of mitochondrial membranes: the role of thyroid hormones and the fat component of the diet]. AB - Electric stability of the membranes of the mitochondria and liposomes formed from mitochondrial lipids was studied. The mitochondria were isolated from the liver of euthyroid or hyperthyroid rats kept on the diets with varying degree of food fat unsaturation. In the first group animals, butter was used as a fatty component of the diet whereas the second group animals received sunflower oil. The electric stability of the membranes of the mitochondria and respective liposomes appeared lower in the first group animals as compared with those in the second group animals. Hyperthyrosis was accompanied by the increased electrical stability of mitochondrial lipids in both the groups. At the same time the liposomal membranes were similar as regards the electric stability, whereas the electric stability of the mitochondrial membranes in the first group hyperthyroid and euthyroid rats was lower than in the organelles of the second group animals. It is thus assumed that the electric stability of the mitochondria is determined not only by the chemical composition of lipids but also by other factors. PMID- 3971033 TI - [Kinetic properties of blood plasma lecithin cholesterol acyltransferase in persons with hyper-alpha-lipoproteinemia]. AB - A study was made of the kinetics of the lecithin-cholesterol-acyltransferase reaction (LCAT-reaction) according to the substrate, nonesterified cholesterol of high density lipoproteins (HDLP) and of the effect produced by the medium pH and apoprotein E (apo-E) on the rate of the LCAT-reaction in blood plasma of subjects with hyper-alpha-lipoproteinemia. HDLP isolated from blood plasma of subjects with hyper-alpha-lipoproteinemia were used as substrate. Infranatants obtained from blood plasma of the test subjects after removing all lipoproteins with a density of 1.21 g/ml served as a source of the enzyme. The kinetic curve of the rate of the LCAT-reaction with one or two plateaus was found to be complex in nature; pH 7.4 and 8.0 were found to be optimal for the LCAT-reaction at high and low concentrations of HDLP, respectively. At a low HDLP concentration apo-E had no remarkable effect on the rate of the LCAT-reaction, while at a high HDLP concentration the rate of the LCAT-reaction was increased. It is assumed that more than two isoforms of LCAT are present in blood plasma of subjects with hyper alpha-lipoproteinemia. PMID- 3971034 TI - [Inhibition of phospholipid hydrolysis by phospholipase A2 in microsomal and mitochondrial membranes subjected to lipid peroxidation]. AB - The rate of phospholipid hydrolysis in rat liver microsomal and mitochondrial membranes catalyzed by phospholipase A2 was shown to decrease after ascorbate + Fe2+-induced lipid peroxidation. The degree of inhibition was linearly dependent on the amount of lipid peroxidation products (malonyl dialdehyde) accumulated in the membrane. The decreased phospholipid hydrolysis rate in membranes after lipid peroxidation was registered using phospholipases A2 from two sources: porcine pancreas and bee venom. It was established that the inhibitory action of phospholipid peroxidation products was not linked with a direct effect on the enzyme and was not caused by depletion of phospholipase reaction substrates (as a result of lipid peroxidation). A possible role of lateral separation of oxidized and non-oxidized lipid phases in the mechanisms of inhibition of phospholipid hydrolysis by phospholipase A2 is discussed. PMID- 3971035 TI - [Extraction of cholesterol from biological membranes with positively charged micelles of phosphatidylcholine]. AB - The content of cholesterol in red cell and platelet membranes was lowered in rabbits with experimental atherosclerosis after intravenous injection of positively charged micelles of soybean phosphatidylcholine. That lowering was accompanied by a reduction in membrane microviscosity, rise of the activity of Na,K- and Ca-ATPases of red cells, and a decrease in the rate of the ADP- and collagen-induced platelet aggregation. Injection of phosphatidylcholine gave rise to an increase in the blood serum content of phospholipids and cholesterol in high density lipoprotein fractions, to a reduction in the content of triglycerides and the atherogenicity index, as well as to the lowering of the microviscosity of high density lipoproteins. The aortal area affected by atherosclerotic lesions was 2 times less in the group of animals given phosphatidylcholine. PMID- 3971036 TI - [Role of bilirubin as a natural antioxidant in regulating lipid peroxidation intensity in acute viral hepatitis]. AB - Elevation of the content of lipid peroxidation (LPO) products in blood serum of patients with acute virus hepatitis (VH) is caused by an increase in the patients' blood serum lipids rather than by the intensity of peroxide reactions in lipids. There is a reverse correlation between the content of LPO products and bilirubin level and a direct correlation between lipid antioxidant activity (AOA) and bilirubin level. Marked antioxidant action of bilirubin that compares very favourably with the action of ionol (4-methyl-2,6-ditretbutylphenol) was demonstrated in the model of oxidation of methyl oleate. It was shown that the rise of lipid AOA during VH might be completely attributed to the antioxidant properties of bilirubin. It is suggested that elevation of bilirubin level and associated increase of lipid AOA during VH can be viewed as a reaction aimed at a decrease of the level of toxic products of LPO and intensification of reparative processes in the liver. PMID- 3971037 TI - [Human tumor lines transplantable to athymic mice and rats]. AB - Histological description of human cancer strains (lung carcinoma, laryngeal cancer, Jewing's sarcoma, fibrosarcoma, Wilms' tumor, renal carcinoma) transplanted into 6- to 8-week-old nude mice and 4- to 6-week old nude rats is presented. Human origin of these strains is proved by an analysis of lactate dehydrogenase isoenzymes. The growth rate of human cancer strains in rats is considerably higher than in mice. PMID- 3971038 TI - [Chromosome imbalance and cellular proliferation potential in vitro]. AB - The effect of chromosome unbalance on the cell proliferative potential (cloning efficiency) was studied. The proliferative potential of the cells obtained from spontaneous abortions with chromosome unbalance appeared drastically reduced as compared with the proliferative potential of the cells from medical abortions. Chromosome unbalance in postnatal cells did not lead to diminution of the proliferative potential as compared with control. PMID- 3971039 TI - [Morphological evidence of celiac ganglion hyperfunction in spontaneous hypertension in rats]. AB - To elucidate the role of the autonomous nervous system in formation of a specific renal "resetting", typical for arterial hypertension, in 8-week-old spontaneously hypertensive rats, a study was made of the morphology of the celiac ganglion as one of the main sources of renal innervation. Light and fluorescent microscopy demonstrate the hypertrophy of the neurons and their nuclei, an increase in the whole ganglion volume and the volume density of the SIF cells. This evidence for hyperactivity of the celiac ganglion attests to the involvement of the renal nervous system in the structural and functional reorganization ("resetting") at the early stages of hypertension as well as a manifestation of hyperactivity of the nervous system in this disease. PMID- 3971040 TI - Regulation of monocyte procoagulant by chemoattractants. AB - Various n-formylated peptides function as receptor-specific chemoattractants for both granulocytes and monocytes. Because these agents are important tools in the study of leukocyte function in vitro, we chose to examine their effects on leukocyte procoagulant activity. The synthetic chemotactic peptide N-formyl methionyl-leucyl phenylalanine (FMLP) induces a fourfold increase in procoagulant activity (PCA) in cultured human monocytes at an optimal dose of 5 X 10(-9) mol/L, whereas higher doses inhibit PCA response. Although nonadherent lymphocytes are not absolutely required for PCA expression, their presence significantly amplifies monocyte PCA. Irradiation of nonadherent lymphocytes before mixing them with FMLP and adherent cells abolishes their ability to amplify PCA. Kinetic studies demonstrate an increase in optimal dose FMLP stimulated PCA over time whereas high-dose inhibition of PCA generation occurs at various incubation times. Cell viability is unaffected by inhibitory concentrations of FMLP. Supernates from high-dose FMLP-stimulated cells fail to inhibit later expression of PCA by cells exposed to endotoxin. The cellular procoagulant remains cell-bound and exhibits characteristics of thromboplastin (tissue factor), including inhibition by concanavalin A and phospholipase C as well as the ability to shorten the clotting times of factor VIII but not factor VII-deficient substrate plasmas. These results suggest a complex system of lymphoid cell regulation of procoagulant generation by monocytes exposed to various chemotactic peptides in vitro. PMID- 3971041 TI - Down-regulation of K cell activity by neutrophils. AB - Human neutrophils, activated by phorbol-myristate acetate (PMA), (A-neutrophils), were found to suppress lymphocytic killer (K) cell-mediated antibody-dependent cellular cytotoxicity (ADCC). Resting (R) neutrophils, ie, PMA-untreated cells, were completely ineffective. Suppression was optimal when A-neutrophils were added at the beginning of the ADCC assay. Furthermore, A-neutrophils were found to cause an approximately 80% reduction in the number of Raji target cell-bound lymphocytes. These data indicate that A-neutrophils inhibit K cell activity by interfering with the target cell recognition. A-neutrophils were capable of reducing the percentage of Fc receptor (FcR)-bearing lymphocytes with a half-time of 7.2 minutes, through a process preventable by the serine-protease inhibitors tosyl-lysine-chloromethyl ketone (TLCK) and lima bean trypsin inhibitor (LBTI). Conversely, A-neutrophils caused a very slow decrease in the amount of Raji cell bound antibodies, as detected by the complement-mediated lytic assay. Thus, only lymphocyte FcR structures seem to be highly susceptible to neutrophil-derived TLCK- and LBTI-inhibitable proteases. Furthermore, supernatants from A neutrophils were found to inhibit K cell ADCC and lymphocyte binding to Raji target cells. In addition, LBTI prevented the A-neutrophil-dependent and the supernatant-dependent inhibition of both K cell ADCC activity and lymphocyte target cell conjugate formation. Together these data suggest that A-neutrophils suppress K cell function through a protease-mediated impairment of the FcR binding capacity. The results provide evidence that human neutrophils are endowed with mechanisms to regulate K cell ADCC activity. PMID- 3971042 TI - Specific identification of fibrin polymers, fibrinogen degradation products, and crosslinked fibrin degradation products in plasma and serum with a new sensitive technique. AB - A new method is described for identifying low concentrations of circulating derivatives of fibrinogen and fibrin, even when present in heterogeneous mixtures. This technique is applicable to plasma and serum and uses electrophoresis in 2% agarose in the presence of sodium dodecyl sulfate (SDS) followed by immunological identification of separated derivatives, using radiolabeled antifibrinogen antiserum and autoradiography. Unique electrophoretic patterns distinguish plasmic derivatives of crosslinked fibrin from those of fibrinogen and also identify crosslinked fibrin polymers produced by the combined action of thrombin and factor XIII on fibrinogen. The assay is sensitive to a concentration of 0.1 micrograms/mL of fibrinogen in serum or plasma. Fibrin polymers, plasmic degradation products of fibrinogen, and plasmic degradation products of crosslinked fibrin were detected in the plasma or serum of a patient with disseminated intravascular coagulation. Plasmic derivatives of both fibrinogen and crosslinked fibrin appeared in serum in the course of fibrinolytic therapy for pulmonary embolism, whereas during acute myocardial infarction a marked increase in the proportion of fibrin polymers in plasma was found in comparison with normal controls. Thus, the procedure can distinguish between the simultaneous processes of fibrin polymer formation, fibrinogenolysis, and fibrinolysis, and is sufficiently sensitive to detect relevant quantities of derivatives in pathologic conditions. PMID- 3971043 TI - Treatment of hairy cell leukemia with recombinant alpha 2 interferon. AB - Nine patients with progressive hairy cell leukemia were treated with subcutaneous injections of recombinant alpha 2 interferon (2 to 10 X 10(6) U/m2) three times weekly. Eight patients completed at least eight weeks of treatment and were evaluable; one patient with refractory thrombocytopenia died of an intracerebral hemorrhage after two doses of interferon. Seven of eight patients responded, with responses occurring as early as two weeks. Four patients also had resolution of their monocytopenia. No complete responses were seen with up to 30 weeks of treatment. Bone marrow biopsies demonstrated improvement in all eight patients. No unforeseen toxicity occurred, but most patients had transient myelosuppression during the first few weeks of treatment. Recombinant alpha 2 interferon is effective in the treatment of hairy cell leukemia, with acceptable toxicity. PMID- 3971044 TI - Effects of in vitro purging with 4-hydroperoxycyclophosphamide on the hematopoietic and microenvironmental elements of human bone marrow. AB - We describe the effects of 4-hydroperoxycyclophosphamide (4-HC) on the hematopoietic and stromal elements of human bone marrow. Marrow cells were exposed to 4-HC and then assayed for mixed (CFU-Mix), erythroid (BFU-E), granulomonocytic (CFU-GM), and marrow fibroblast (CFU-F) colony-forming cells and studied in the long-term marrow culture (LTMC) system. The inhibition of colony formation by 4-HC was dose and cell-concentration dependent. The cell most sensitive to 4-HC was CFU-Mix (ID50 31 mumol/L) followed by BFU-E (ID50 41 mumol/L), CFU-GM (ID50 89 mumol/L), and CFU-F (ID50 235 mumol/L). In LTMC, a dose related inhibition of CFU-GM production was noted. Marrows treated with 300 mumol/L 4-HC were completely depleted of CFU-GM but were able to generate these progenitors in LTMC. Marrow stromal progenitors giving rise to stromal layers in LTMC, although less sensitive to 4-HC cytotoxicity, were damaged by 4-HC also in a dose-related manner. Marrows treated with 4-HC up to 300 mumol/L, gave rise to stromal layers composed of fibroblasts, endothelial cells, adipocytes, and macrophages. Cocultivation experiments with freshly isolated autologous hematopoietic cells showed that stromal layers derived from 4-HC-treated marrows were capable of sustaining the long-term production of CFU-GM as well as controls. IN CONCLUSION: (1) Hematopoietic progenitors cells, CFU-Mix, BFU-E, and CFU-GM, are highly sensitive to 4-HC, whereas marrow stromal progenitor cells are relatively resistant. (2) Marrows treated with 300 mumol/L 4-HC that are depleted of CFU-Mix, BFU-E, and CFU-GM can generate CFU-GM in LTMC, suggesting that most primitive hematopoietic stem cells (not represented by CFU-Mix) are spared by 4 HC up to this dose. (3) Consequently, the above colony assays are not suitable tools for predicting pluripotent stem cell survival after 4-HC treatment in vitro. PMID- 3971045 TI - Kinetic characterization of a saturable pathway for rapid clearance of circulating fibrin monomer. AB - The mechanism of clearance of circulating fibrin monomer was investigated in rabbits through (1) study of decay in plasma concentrations of 125I-labeled monomers with variant fibrinopeptide content and (2) concurrent analysis of decay of the monomers relative to coinjected 131I-fibrinogen. Under the conditions employed, essentially all of the fibrin became distributed in a soluble form in plasma and decayed independently of the coinjected fibrinogen. Among the species of fibrin studied, monomer lacking fibrinopeptide A alone (alpha-fibrin) underwent very rapid clearance by a saturable mechanism that was not evident in relatively sluggish clearance of monomer lacking either fibrinopeptide B alone (beta-fibrin) or both fibrinopeptides A and B (alpha beta-fibrin). Decay of alpha fibrin conformed with a kinetic mechanism involving first-order permeation of the fibrin into extravascular space at a rate equivalent to that of permeation of fibrinogen; unlike fibrinogen, however, the alpha-fibrin underwent immediate absorption in parallel with permeation (t1/2 = 2.6 hours) at doses below an apparent saturating level of 3 mg/kg. At doses near the absorptive limit, the uptake accompanying permeation diminished as in a second-order kinetic mechanism, and at very high doses the plasma decay of the alpha-fibrin approached that of fibrinogen. The beta- and alpha beta-fibrins also permeated extravascular space in parallel with fibrinogen, but absorption proceeded sluggishly (t1/2 = 11 and 16 hours, respectively) at low doses and did not change with increasing dose. The uniquely rapid and saturable clearance of alpha-fibrin is suggested to involve uptake through the fibrin aggregation site that is blocked by fibrinopeptide A in fibrinogen and beta-fibrin and by tight binding to fibrinogen in soluble complexes formed by alpha beta-fibrin. A corollary of this hypothesis is that rapid uptake depends on dissociability of fibrin complexes for access to the aggregation site, a mechanism that is just the converse of uptake through aggregation. PMID- 3971046 TI - Pregnancy in carriers of high-affinity hemoglobins. AB - Pregnancy in female carriers of abnormal hemoglobins with great avidity for oxygen provides a unique opportunity to assess the importance of the usual difference in oxygen affinity between fetal and maternal blood. Outcome of pregnancy was recorded for carriers of hemoglobins Bethesda, Osler, and Yakima, whose p50s (9.5, 9.1, and 12 mm Hg at pH 7.4) were far lower than that of a normal fetus (23 mm Hg at pH 7.3). Neither spontaneous abortions nor intrauterine growth retardation could be attributed to the presence of high oxygen affinity in the mothers. In vitro simulations suggested that neither maternal or fetal polycythemia alone was sufficient to adjust for perturbation of the normal situation, and increased uterine and/or fetal blood flow probably provided additional compensation. PMID- 3971047 TI - Calmodulin antagonists inhibit and phorbol esters enhance transferrin endocytosis and iron uptake by immature erythroid cells. AB - Seven antagonists of the calcium-binding protein calmodulin were found to inhibit iron and transferrin uptake by reticulocytes. This inhibition could be completely accounted for by inhibition of the endocytosis and exocytosis of transferrin. When four of the antagonists were tested with the nucleated erythroid cells from the liver of the fetal rat, inhibition of iron uptake was also observed but at higher concentrations than required for the same degree of inhibition with reticulocytes. The tumor promoters phorbol 12-myristate 13-acetate (PMA) and phorbol 12,13-dibutyrate (PDB) were shown to increase the rates of iron and transferrin uptake by reticulocytes and fetal liver erythroid cells by accelerating the rates of transferrin endocytosis and exocytosis. Since these substances are known to stimulate the calcium-activated enzyme protein kinase C while calmodulin antagonists are inhibitory, it is concluded that this enzyme plays an important role in the endocytosis and intracellular cycling of transferrin, and iron uptake by immature erythroid cells. However, the possibilities that calmodulin is also involved or that the inhibitory effects of the calmodulin antagonists are due to nonspecific actions on the cell membrane cannot be excluded. PMID- 3971048 TI - The leftward deletion alpha-thal-2 haplotype in a black subject with hemoglobin SS. AB - We have identified a black individual with homozygous sickle cell anemia who is the silent carrier of alpha-thalassemia (genotype - alpha/alpha alpha) due to heterozygosity for the leftward deletion alpha-thal-2 haplotype. This deletion has not been described previously in a black subject and is the only leftward deletion that we have found among 255 alpha-thal-2 chromosomes from sickle cell subjects. Its effects on the clinical, hematologic, biosynthetic, and cellular pathology of sickle cell anemia resemble those reported for the common alpha thalassemia genotypes of the black population. PMID- 3971049 TI - Platelet density heterogeneity. PMID- 3971050 TI - Multiple myeloma and primary hyperparathyroidism. PMID- 3971051 TI - Mucosal iron binding proteins and the inhibition of iron absorption by endotoxin. AB - The uptake of iron from a tied off jejunal segment into the body after the injection of a 59Fe labeled test dose was decreased after the administration of endotoxin by about 80% in both normal and iron deficient animals.--In the iron deficient group the distribution of 59Fe in the cytosol fraction of jejunal mucosa between transferrin and ferritin was determined chromatographically; the amount of 59Fe in the ferritin fraction increased remarkably after the endotoxin treatment and the ratio of both was changed in favor of ferritin.--It is hypothesized that the association of the diversion of iron to the mucosal ferritin with the decrease of the transport of iron into the blood caused by endotoxin might be the consequence of abnormal oxidations in the mucosa measured by others in liver tissue. PMID- 3971052 TI - Determination of benzene and toluene in soils and plant material by azeotropic distillation. PMID- 3971053 TI - DDE residues and artificial incubation of loggerhead sea turtle eggs. PMID- 3971054 TI - Toxicity of a new pyrethroid insecticide, WL85871, to rainbow trout. PMID- 3971055 TI - Toxicity of adjuvants to bluegill. PMID- 3971056 TI - Average daily respiratory intake of polycyclic aromatic hydrocarbons in ambient air determined by capillary gas chromatography. PMID- 3971057 TI - Accumulation and elimination in mouse fat of compounds from the mothproofing agent Eulan WA Neu. PMID- 3971058 TI - Effect of the benzene fraction of petroleum on protein content in rat liver and kidney. PMID- 3971059 TI - Effect of intratracheal administration of DDT and endosulfan on cytochrome P-450 and glutathione-s-transferase in lung and liver of rats. PMID- 3971060 TI - Lipid peroxidation in lung and liver of rats given DDT and endosulfan intratracheally. PMID- 3971061 TI - Effects of a nonpersistent insecticide (Alsystin) on abundance patterns of breeding forest birds. PMID- 3971062 TI - Chromosomal aberrations in onion (Allium cepa) induced by water chlorination by products. PMID- 3971063 TI - Photolysis of aromatic compounds in water in the presence of hydrogen peroxide. PMID- 3971064 TI - A reassessment of clinical psychology as an applied science. AB - This paper advocates discarding the notion of clinical psychology as an applied science, with its emphasis upon the use of prevalidated procedures of assessment and treatment. The grounds are that, in scientific principle, there is no difference between practical clinical work and research. Each aims at maximizing the accuracy of our ideas about psychological dysfunctions and their manipulation, both therapeutic and experimental. They differ in: their general purpose; and the greater accuracy of research. One should therefore think in terms of a scientific approach to practical clinical psychology, conceptualizing it as a branch of psychological science. In assessment, the research finding of the relative specificity of psychological responses leads to describing and explaining each patient's particular psychological dysfunctions; using information-seeking interviews supplemented by the few validated procedures, and seeking guidance from general psychological and interview research and from general scientific method. In treatment, the main consequence is the development, in the course of clinical work, of therapies which: derive from general psychological and clinical research; are dysfunction-oriented; are critically eclectic; monitor outcome; and evaluate therapists' behaviour. Finally, the scientific approach requires evaluation studies of both assessment and treatment. PMID- 3971066 TI - The assessment of memory impairment: the relationship between different methods of evaluating dysmnesic deficits. AB - The relationship between three different methods of assessing memory impairment: cognitive tests, questionnaires, and observational rating scales, was assessed in 20 dysmnesic alcoholic in-patients. The cognitive tests were subdivided into those which measured everyday memory skills and those which were traditional experimental-laboratory tasks. All three methods were highly intercorrelated and the correlation between practical and experimental cognitive tests was also high. Memory test scores were not as highly correlated with either performance on perceptual-motor tasks or full-scale IQ. PMID- 3971065 TI - Expected and actual behavioural capacity after diffuse reduction in cerebral cortex: a review and suggestions for rehabilitative techniques with the mentally handicapped and head injured. AB - Expectations of residual function (and of potential therapeutic outcome) after brain damage are important factors in the selection of rehabilitation programmes. Drawing upon reports of what we call here association learning and memory in humans and animals, it is shown that this type of learning remains intact and may be mediated by subcortical brain structures, despite the often severe cognitive blunting which accompanies diffuse cortical brain damage. In retarded humans the application of association learning-based behaviour modification techniques may lead to the development of an adequate behavioural base-line on which to develop cognitive rehabilitation programmes. The implications of potentially valid neuropsychological extrapolations from animals to man are discussed. Finally suggestions are made concerning the interaction between association learning and more cognitive information-processing strategies, and the implications for behaviour modifications with retarded and head injured are considered. PMID- 3971067 TI - The clinical impact of job design. AB - This paper summarizes some of the evidence that particular features of jobs are associated with particular types of neurotic symptoms, in a way consistent with broader views both of cognitive psychology and biological studies of stress. Particular emphasis is placed on interactive effects of certain characteristics of individuals, making them more or less vulnerable to stress. PMID- 3971068 TI - Self-report measures of depression: some psychometric considerations. AB - This paper examines some aspects of the psychometric adequacy of existing self report depression measures, so that clinicians might better appreciate their reliability and validity. Issues addressed include the desirability of moderate rather than maximum test-retest and item homogeneity/internal consistency estimates; the distinction between measurement at the surface syndrome level vs. that at the fundamental source state/trait level; the importance of appropriate rather than arbitrary factor analytic procedures; and the need for multivariate measures instead of the single-scale instruments so often employed to measure depression in isolation from interacting emotions such as anxiety or stress. Apart from these more general issues, a number of specific criticisms is considered, along with recommendations for better self-report measures of depression. PMID- 3971069 TI - A test of cognitive vulnerability in individuals prone to depression. AB - Recovered unipolar depressed patients were compared with recovered anxious and non-psychiatric controls in depressed and neutral mood induction conditions to test the hypothesis that depression-prone individuals would demonstrate more negative cognitions with mild mood changes. Only the non-psychiatric controls showed significant mood changes and the hypothesis was not supported. PMID- 3971070 TI - The Golombok-Rust Inventory of Sexual Satisfaction (GRISS). AB - The Golombok-Rust Inventory of Sexual Satisfaction (GRISS) is a short 28-item questionnaire for assessing the existence and severity of sexual problems. The design, construction and item analysis of the GRISS are described. It is shown to have high reliability and good validity for both the overall scales and the subscales. PMID- 3971071 TI - Attributional style and depression. AB - The study aimed to test the prediction, arising out of Abramson et al.'s (1978) reformulated learned helplessness model of depression, that depressed individuals have significantly different attributions about the causes of events from non depressed individuals. No support was found for this hypothesis when comparing a depressed psychiatric sample with a matched normal group. Several hypotheses are offered to account for the failure to agree with previous studies. PMID- 3971072 TI - On the suicide of one's patient. PMID- 3971073 TI - Psychological components of psychopharmacological side effects. A clinical contribution. PMID- 3971074 TI - The "transference-countertransference neurosis" in psychoanalysis. An intersubjective viewpoint. PMID- 3971075 TI - The feedback process in diagnostic psychological testing. PMID- 3971076 TI - Life's happenings and organic disease. AB - There is a widespread belief among people and their doctors that what happens in life contributes to the cause of not only altered mood states but also organic lesional disease. Finding out whether it is true, with all the rigour of scientific method is a challenging task. PMID- 3971077 TI - Detection and management of syphilis in pregnancy. AB - Although uncommon, syphilis remains a serious disease, especially during pregnancy, when the outcome could be disastrous for the fetus. In spite of a commonly prevailing false sense of security, the disease is still with us and increasing in incidence in many countries. PMID- 3971078 TI - Loss of memory and concentration. AB - Loss of memory and concentration are common complaints, the significance of which may vary from the essentially trivial to the extremely sinister. Between these two extremes, they are found in a wide variety of conditions encountered within the majority of medical specialties. It is therefore important that every clinician have some competence in assessing them. PMID- 3971079 TI - Anal fissure. AB - Anal fissures are both common and disabling. Patients can be in pain for weeks before receiving effective treatment, and unnecessary discomfort may be prevented by timely operation. Existing forms of treatment are reviewed with particular reference to lateral subcutaneous sphincterotomy. PMID- 3971080 TI - Private practice--5. PMID- 3971081 TI - Cervical bruits and asymptomatic carotid stenosis. PMID- 3971082 TI - Pros and cons of day case surgery. PMID- 3971083 TI - Pain in the scrotum. AB - The symptom of pain in the scrotum is one that can occupy a large amount of a doctor's time and compromise his credibility with the patient. This need not be if he understands the physiology of pain production in the scrotum, and follows simple management guidelines. PMID- 3971084 TI - Blurred vision. AB - "My vision is blurred, doctor" is a complaint that often provokes acute anxiety in both the patient and doctor. The doctor, worried that he is about to miss a serious ocular or systemic disorder, may be hindered by the patient who, being convinced that he is going blind, is apt to offer a confusing and misleading history. PMID- 3971085 TI - Your accounts. Private practice--6. PMID- 3971086 TI - "It's me bowels". PMID- 3971087 TI - Dilemmas of perinatal intensive care. PMID- 3971088 TI - How to set up a drip and keep it going. PMID- 3971089 TI - Mentally ill doctors. AB - Most doctors are healthy and well adjusted individuals, for whom medical practice is rewarding and enjoyable. Some find it stressful and others break down under pressure. How and why do doctors break down, and what can be done to help them? PMID- 3971090 TI - Rheumatoid neck. AB - Rheumatoid arthritis of the cervical spine may cause spinal cord compression. The diagnosis may be delayed if the neurological features are wrongly attributed to an entrapment neuropathy or rheumatoid peripheral neuropathy. Neurological progression should be treated by a cervical fusion in patients who are otherwise fit. PMID- 3971091 TI - The determinants of attitudes towards social security recipients. AB - This study aimed to investigate the relationship between demographic variables (age, sex, education, vote and income), psychological beliefs (alienation, Protestant work ethic and Conservatism) and social security attitudes. Over 250 people from a variety of different backgrounds completed a number of standardized questionnaires. A factor analysis of the attitudes to social security scale revealed four clearly interpretable factors, which were later computed in four subscale scores. Analysis of variance showed that vote, Protestant work ethic, and Conservative beliefs most differentiated subjects' attitudes to social welfare. A canonical correlational analysis revealed three significant variates which showed age, alienation and the Protestant work ethic most closely related to social security attitudes. These results were discussed in terms of previous literature in this area and various social policy implications are considered. PMID- 3971092 TI - Diuresis and renal functional recovery in chronic retention. AB - Fifty-five patients with chronic urinary retention and incipient or actual renal failure were studied. In the majority of patients renal function improved after bladder decompression, irrespective of whether or not a diuresis occurred. Excessive loss of salt and water was rarely a matter of concern and most patients did not require intravenous fluid replacement. Several lost weight and experienced a fall in blood pressure during the period of diuresis without adverse effect upon renal functional recovery. A profound fall in blood pressure occurred in only three patients, all of whom required long-term sodium supplementation. It is concluded that the problem of salt and water loss after bladder decompression in patients with renal failure is exaggerated and difficult to predict. Over-enthusiastic replacement of fluid in strict accordance with output could readily lead to fluid overload and prolongation of the diuretic period. Therefore fluid replacement should be determined by the clinical condition of the patient and measurement of improving renal function with less emphasis on urine output and its electrolyte content. PMID- 3971093 TI - Unusual complication of foreign body in the bladder. PMID- 3971094 TI - Giant anterior urethral calculus associated with hypospadias and congenital meatal stenosis. PMID- 3971095 TI - Giant urethral calculus in a nine-year-old girl. PMID- 3971096 TI - Nephrogenic diabetes insipidus and obstructive uropathy. PMID- 3971097 TI - Vascular lesion of the verumontanum. PMID- 3971098 TI - Closure of urethral fistula by rhombic flap. PMID- 3971099 TI - Ureteroscopic placement of ureteric catheter for obstructing calculus. PMID- 3971100 TI - Technical modifications of Anderson Hynes pyeloplasty for congenital pelviureteric junction obstruction. PMID- 3971101 TI - Inhibition of spontaneous contractile activity in isolated human detrusor muscle strips by vasoactive intestinal polypeptide. AB - In a study of 75 isolated human detrusor muscle strips, spontaneous contractions and an associated sustained rise in basal tension were observed in 43 (57%). Vasoactive intestinal polypeptide (VIP) caused significant reductions in the frequency and amplitude of spontaneous contractions and a fall in basal tension. The results suggest that VIP may have a role as an inhibitor of spontaneous activity in the human detrusor. PMID- 3971102 TI - Treatment of the neuropathic bladder by enterocystoplasty and selective sphincterotomy or sphincter ablation and replacement. AB - Sixty-one patients with lower urinary tract neuropathy were treated surgically, either to achieve continence or to prevent or arrest renal deterioration, or both. Most were myelodysplastics and all but two were ambulatory. Three techniques were employed, depending on the detrusor/sphincter behaviour and the sex of the patient: enterocystoplasty alone, with or without selective sphincterotomy and/or intermittent self-catheterisation; total sphincter ablation and an artificial sphincter; or, most commonly, enterocystoplasty combined with sphincter ablation and an artificial sphincter. Continence was achieved in 58 patients, though nocturnal enuresis was sometimes a problem; renal deterioration was arrested in 13 of 14 patients and renal function remained stable in all of the other patients. PMID- 3971103 TI - Invasive bladder cancer treated by radical external radiotherapy. AB - Fifty-three consecutive, unselected patients with invasive bladder cancer, Stage T2 to T3, treated by radical radiotherapy have been reviewed. Cystectomy was reserved for patients with significant worsening of disease during treatment, histologically confirmed persistent or recurrent invasive tumour after treatment, or patients with intolerable symptoms due to radiation cystitis. In 64% of our patients a favourable tumour response to radiotherapy was seen, while a further 31% showed disease progression either during or on completion of radiotherapy. Cystectomy was performed on 22% of patients, mainly for radiation cystitis, and was not associated with a significant operative mortality rate. The crude 5-year survival rate was 42%. We conclude that radical radiotherapy is as effective as other forms of treatment for invasive bladder cancer, but that there remains a need to identify those bladder tumours destined to respond poorly to radiotherapy at an earlier stage. PMID- 3971104 TI - Prophylactic mezlocillin for transurethral prostatectomy. AB - In a randomised clinical trial of 100 consecutive patients treated by transurethral prostatectomy, half were given prophylactic intravenous mezlocillin. Blood cultures were obtained, the urine examined and the post operative progress of each patient was carefully followed. The results were analysed and a high incidence of bacteraemia and septicaemia was found. Single dose prophylactic mezlocillin was highly effective in preventing this complication. The presentation of septicaemia in mild and severe form is described and the aetiology discussed. Probable risk factors are identified and prophylactic and therapeutic measures described. PMID- 3971105 TI - Predictive value of pressure flow studies for the functional outcome of reconstructive surgery for hydronephrosis. AB - In 22 of 40 patients with unilateral hydronephrosis the pressure flow study was compared with the outcome of surgery. Seventeen of the 22 patients had impaired function before surgery as judged from the 2-min uptake on the renogram. The pressure flow study as a measure of pre-operative obstruction showed no relation to the functional outcome of surgery. Patients with obstructed pressure flow studies as well as those without signs of obstruction either remained stable or improved after surgery. It was concluded that pressure flow studies are of no value in predicting the outcome of surgery for hydronephrosis. PMID- 3971106 TI - Functional bladder neck obstruction. Results of endoscopic bladder neck incision in 131 consecutive patients. AB - Endoscopic diathermy incision of the bladder neck was carried out as a routine procedure in 131 consecutive male patients with an established diagnosis of functional bladder neck obstruction. Follow-up after 3 months revealed excellent symptomatic and urodynamic results. Morbidity was low and the post-operative stay in hospital short (median 2 days). Patients must be informed of the risk of retrograde ejaculation associated with the procedure and objective evidence of the diagnosis is essential. PMID- 3971107 TI - Management of congenital posterior urethral valves. AB - A series of 46 children treated by the author since January 1972 for congenital posterior urethral valves is presented: 22% were diagnosed at birth, 28% as neonates and 52% in the first 3 months of life. Ninety-three per cent had unilateral or bilateral dilatation of the upper urinary tract at the time the valves were diagnosed and 72% had ureteric reflux. Unilateral reflux occurred into the left ureter twice as often as the right. Renal failure was present at the time of diagnosis in 72% of all of the children but in 83% of those aged less than 3 months. Surface urinary diversion was used minimally during post-operative management and contributed little to the recovery of renal function. Reflux disappeared spontaneously in one-third of the refluxing ureters. Ureteric dilatation subsided spontaneously in 57% of dilated ureters. Surgery was performed mostly for reflux. Non-refluxing ureteric dilatation was made worse by surgery in a few instances and in others the dilatation improved with time rather than as a result of surgery. Renal function returned to normal in over 60% of the children who were in renal failure at diagnosis. Measurement of glomerular filtration rate was the most accurate method of predicting recovery of renal function: a value of less than 50% of normal for age at the time of diagnosis forecast persistent chronic renal failure with all its attendant complications. PMID- 3971108 TI - Teflon injection in stress incontinence. AB - Forty-six patients, 28 females and 18 males, underwent periurethral or perurethral Teflon injection. The results in females were satisfactory, especially where resting anatomy was normal. Male results were disappointing, no patients with post-prostatectomy stress incontinence being cured. PMID- 3971109 TI - The role of internal urethrotomy in the prevention of urethral stricture following transurethral resection of prostate. PMID- 3971110 TI - Cytotoxicity of latex urinary catheters. AB - After an epidemic of severe urethral strictures in cardiac surgery patients, all brand latex catheters marketed in Finland were investigated for cellular toxicity with eluates made from the catheters. Four of the seven brands, including the one involved in the stricture cases, showed marked cytotoxicity and inhibited almost all cell growth in various human cell cultures when a 30% catheter eluate was used. DNA histograms of cells cultured with toxic catheter eluate showed inhibition of DNA synthesis. Silicone catheters did not influence cell growth, which correlates with the finding that no new stricture cases were seen after the latex catheters were replaced with silicone ones. Attention is paid to the facts that international standards regarding urethral catheter toxicity are lacking and that catheter quality control is insufficient. PMID- 3971111 TI - Cannibalization of a gore-tex aortohepatic graft by the duodenum. PMID- 3971112 TI - Increased efficiency of transfusion practice in routine surgery using pre operative antibody screening and selective ordering with an abbreviated crossmatch. AB - In an effort to meet the increasing demands for blood to cover routine surgery and in order to reduce the amount of time-expired blood, we have adopted a system of grouping and screening patients' blood preoperatively but not crossmatching blood unless there is more than a 30 per cent chance that it will be used. This approach is based on schemes developed in the USA over the past three decades. If there is unexpected haemorrhage at operation and the patient's serum is known to be free of irregular antibodies, blood of the same ABO group is provided, with only an abbreviated crossmatch to check ABO compatibility. During the first 6 months in which the new scheme was in operation it is estimated that the laboratory crossmatched at least 3000 units of blood (44 per cent) less than it would otherwise have done. 336 units were transfused after an abbreviated crossmatch and, as expected, there were no haemolytic transfusion reactions. PMID- 3971113 TI - A 30-year survey of pulmonary embolism verified at autopsy: an analysis of 1274 surgical patients. AB - A retrospective study was undertaken of all surgical patients in Malmo, Sweden, during the period 1951-1980, in whom pulmonary emboli were found at autopsy. The autopsy rate was high throughout the period, ranging from 73 to 100 per cent. Of 5477 patients who died during the period, 1274 had pulmonary emboli (23.6 per cent), 349 of which were considered fatal, 353 contributory to death and 572 incidental. Fifty-one per cent of the patients were not operated upon. The number of contributory and incidental emboli increased over the period, to some extent probably reflecting greater thoroughness in postmortems. The frequency of fatal pulmonary emboli decreased in the last 5 year period. Pulmonary embolism was more rare in patients under 50 years of age. The proportion of females increased. In 24 cases major embolism emanated from thrombi around central venous catheters. This retrospective analysis of a large number of patients shows that pulmonary embolism continues to be a major cause of death in surgical patients, and in Malmo as common a cause of death in operated as in nonoperated patients. PMID- 3971114 TI - Tunnelling device for CAPD catheters. PMID- 3971115 TI - Abdominal aortic aneurysms in Western Australia: descriptive epidemiology and patterns of rupture. AB - All abdominal aortic aneurysms presenting to hospitals and coroners in Western Australia over an 11-year period (January 1971 to December 1981) have been reviewed. A total of 1237 abdominal aortic aneurysms were found. After age and sex standardization it was apparent that the prevalence of diagnosis of abdominal aortic aneurysms had increased from 74.8 per 100 000 to 117.2 per 100 000 for men over 55 years of age (increase of 56.7 per cent) and from 17.5 per 100 000 to 33.9 per 100 000 for women over 55 years of age (increase of 93.7 per cent) during this period. One hundred and twenty-three patients were identified by coroner's autopsy after sudden death from ruptured abdominal aortic aneurysms in whom there had been no previous diagnosis of abdominal aortic aneurysm. Between 1971 to 1981, 478 patients underwent surgery; 225 had elective resection of their aneurysm with a 4.0 per cent fatality rate, and 253 had emergency operations with a 31.2 per cent fatality rate. Seasonal variations contributing to the date of emergency presentation or death from rupture of abdominal aortic aneurysms indicated a possible influence of colder weather upon rupture. It is hoped that the information provided in this paper will be of use to surgeons and physicians involved in health care planning for similar populations. PMID- 3971116 TI - A study of the mechanical properties of fresh and preserved human femoral vein wall and valve cusps. AB - In the hope that some varieties of the post-phlebitic syndrome might be treated by implanting a preserved vein valve, studies have been made of the mechanical properties of vein valves and vein wall before and after preservation with glutaraldehyde. The ultimate tensile strength (breaking stress) and strain (extensibility) of strips of vein wall and valve leaflet were measured with a Nene tensiometer. The ultimate tensile strength of valve leaflet was found to be twice that of vein wall. Preservation in glutaraldehyde (0.2 per cent, pH 7.4, for 7 days) with valve cusps closed by a minimum head of pressure caused no change in breaking stress or extensibility. PMID- 3971118 TI - An atraumatic method of tunnelling cuffed central venous catheters. PMID- 3971117 TI - Vascular occlusion in the pathogenesis of complicated amoebic colitis: evidence for an hypothesis. AB - Amoebic perforation of bowel, the final and most serious manifestation of transmural amoebic colitis, is due to thrombotic occlusion of vessels supplying the segment of bowel with subsequent infarction and ischaemic necrosis. The ischaemic nature of the necrosis is confirmed by its shape and the demonstration of vascular thrombosis in the resected specimens of perforated amoebic colitis. Specimen angiography confirms the avascular area confined to the macroscopic lesions. Thrombotic occlusion and amoebic invasion of blood vessels have been demonstrated histologically. This new information suggests that amoebic perforation of the bowel is due to vascular compromise. PMID- 3971119 TI - Deranged liver blood flow patterns in the detection of liver metastases. AB - Hepatic flow scintigraphy has been used to evaluate 150 patients with gastrointestinal carcinoma. A normal range has been obtained on a group of 23 healthy volunteers. The flow scintigraphic findings have been correlated with the presence of metastases at the time of primary surgical therapy. The group of patients with livers ostensibly clear of metastases have been followed up over a one-year period. At one year the specificity of the investigation is 72 per cent with a sensitivity of 96 per cent. We conclude that flow scintigraphy is capable of not only detecting established hepatic metastases, but will also identify patients harbouring occult metastatic disease. PMID- 3971120 TI - Electrophysiological and manometric assessment of the pelvic floor in the solitary rectal ulcer syndrome. AB - Fifteen of twenty patients with the solitary rectal ulcer syndrome, eighteen of whom were women, had evidence of reinnervation in the external anal sphincter muscle as demonstrated by single fibre EMG and nine of these patients had an increased pudendal nerve terminal motor latency. In ten patients there was paradoxical puborectalis muscle activity on straining, but damage to the innervation of the external anal sphincter muscle was correlated with a history of straining, and with excessive perineal descent, rather than with paradoxical puborectalis activity. We suggest that this syndrome does not have a single cause. PMID- 3971121 TI - Changing patterns in colostomy closure: the Bristol experience 1975-1982. AB - The results of colostomy closure in 113 patients (1975-1982) were examined to determine whether the identification of risk factors or improvements in surgical management had made this procedure safer. Overall mortality was low (0.9 per cent), but faecal fistulas occurred in 16.5 per cent and the incidence of wound infection was high (34 per cent). Comparison of the first and second 4 year periods shows recent improvements in the rates of wound infection (24 versus 51 per cent: P less than 0.01) and anastomotic leakage (10 versus 30 per cent: P less than 0.05). A long delay (greater than 6 months) between creation and closure of the colostomy was associated with an increased incidence of postoperative diarrhoea compared with shorter periods of defunction (38 versus 14 per cent: P less than 0.01). The morbidity of colostomy closure is decreasing but remains an important clinical problem. PMID- 3971122 TI - R2/3 gastrectomy for gastric carcinoma: an audited experience of a consecutive series. AB - A consecutive series of 27 patients with gastric neoplasm (24 carcinoma, 3 lymphoma) have been staged at laparotomy using the Japanese criteria for macroscopic staging. In 20 patients the radical R2/3 resection was considered potentially curative as defined by the Japanese Society for Research in Gastric Cancer. The operative mortality in this subgroup was 1/20 (5 per cent) and 3/27 (11 per cent) in the entire series. Locoregional recurrence was not observed in the potentially curative group. Follow-up has varied from 6 months to 7 years. An overall survival of 12/27 (48 per cent) has been observed to date. Death from cancer dissemination is maximal in the first and second year after resection. The R2/3 resection was considered non-curative in seven patients. In this subgroup there were two postoperative deaths and four have died of metastatic disease within 12 months of the resection. The only 5 year survivor in this group had a gastric lymphoma. PMID- 3971123 TI - Truncal vagotomy and drainage: a comparison of elective and emergency operations. AB - A comparison has been made between truncal vagotomy and drainage (TV + D) performed from 1968 to 1981 in 209 patients electively and in 68 patients as an emergency. The male:female distribution was 167:42 and 59:9 with a significant difference (P less than 0.001) in the mean ages of 49 years and 55 years respectively. Major postoperative complications following emergency TV + D (22 per cent) were significantly more common (P less than 0.001) than following elective TV + D (6.7 per cent) with seven (10.3 per cent) and one (0.5 per cent) deaths respectively. Of 163 patients in the elective and 54 in the emergency group followed up for an average of 5.7 and 5.9 years respectively, 132 patients (81 per cent) and 46 (82.5 per cent) had a good functional result graded as Visick I and II, but 31 (19 per cent) and 8 (14.8 per cent) patients respectively had a poor result due to recurrent ulceration in 23 (14.1 per cent) after elective TV + D and in all 8 (14.8 per cent) after emergency TV + D. These results are not statistically different. Thus emergency TV + D carries a higher mortality and morbidity than elective TV + D, but the long term results are similar. This conclusion substantiates the equivalent effectiveness of emergency and of elective TV + D. PMID- 3971124 TI - Dilatation of benign oesophageal strictures. PMID- 3971125 TI - Infusion cholecystography. PMID- 3971126 TI - Long saphenous incompetence as a cause of venous ulceration. PMID- 3971127 TI - A 13-year review of jejunoileal bypass. AB - One hundred and eighty patients had a jejunoileal bypass performed during the years 1971-1982. By leaving only 14 in. (35 cm) of intestine in continuity a mean weight loss of 34.4 per cent (s.d. = 8.5) was achieved over 2 years and, unless the operation had to be reversed for complications, this weight loss was maintained. The improvement in quality of life for a majority of patients should not be undervalued. Two-thirds of patients required admission for complications and eight patients died (4 per cent). Many of these problems were provoked by an inability to control eating. There have been no hospital deaths since 1976 which we attribute to better management of complications and a policy of early reversal for patients with excessive weight loss and signs of metabolic failure. Despite performing jejunoileal bypass less often in recent years we are still frequently reversing patients with electrolyte disturbances, metabolic failure, urinary calculi or arthritis. Thirty patients (16.7 per cent) have been reversed, half more than 5 years after bypass. Metabolic failure may occur even after many years of stable weight reduction. Because this is not well known the insidious onset of new weight loss and malaise may not be recognized, or not associated with the bypass many years before. Indefinite outpatient surveillance is mandatory. Changes in the operation have not significantly affected results. There has been no serious liver dysfunction in the 7:7:CJ group but this may reflect better management of lesser metabolic disturbances. Jejunoileal bypass remains the most effective operation for gross obesity and, with experience, can be performed safely. However, the complication rate and difficulty maintaining satisfactory follow-up on large numbers of young patients makes it an unacceptable procedure on any major scale. PMID- 3971128 TI - Leg support for the postoperative protection of the heel in patients with diabetes mellitus. PMID- 3971129 TI - Prolonged ambulatory pH monitoring in patients following oesophageal transection and control subjects. AB - Prolonged ambulatory oesophageal pH monitoring using a radiopill was carried out in 19 patients following oesophageal transection for varices. The results were compared with 14 asymptomatic control subjects. The duration of oesophageal pH less than five while erect was significantly greater in the post-transection group than in the control subjects. The duration of pH less than 4 while erect was also greater following transection but this did not quite reach statistical significance. The number of reflux episodes did not differ between the two groups. There was no significant difference in duration or number of reflux episodes while supine between the two groups. PMID- 3971130 TI - Deep dyslexia, imageability, and ease of predication. AB - A development of existing theories of deep dyslexia is outlined. It proposes that the effects of imageability upon the ease of reading of words by deep dyslexics occur as a result of variation in the ease with which individual words summon semantic predicates, on the basis of which reading responses can be made. Ease-of predication scores are obtained for a corpus of nouns and found to be, as hypothesized, closely related to imageability scores. It is shown that the other major characteristics of deep dyslexia can also be accounted for by this proposed mechanism. These include the well-established effects of syntactic category (in particular, of the distinction between content and function words) upon reading. Further evidence is provided that this effect may be attributed to variation in ease of predication. PMID- 3971131 TI - A theory of verb form use in the speech of agrammatic aphasics. AB - Previous descriptions of the use of grammatical markers associated with verbs in the speech of agrammatic patients are shown to be grammatically inadequate. A more appropriate grammatical description, defined in terms of the complexity of the derivational properties of verb forms and the complexity of the semantic notions that verb forms can express, is presented which can handle facts about English and Italian agrammatism. However, this type of description is shown to be incapable of accounting in a natural way for certain further facts about agrammatic productions in English and Italian which need to be explained. A psycholinguistic model compatible with the grammatical description is then presented to account for these facts. The model, an elaboration of M. Garrett's (1975, in G. Bower (ed.), Psychology of learning and motivation, New York: Academic Press, Vol. 9) model of normal sentence production, involves the accessing of two stores during syntactic processing--one containing phrase fragments, the other function words. Agrammatic patients are claimed to suffer from a specific inability to access these stores; the resulting agrammatic production system is shown to account for a wide range of facts about agrammatism. PMID- 3971132 TI - Rapid recovery from aphasia: a detailed language analysis. AB - The paper presents a daily analysis of the language recovery of a patient who was globally aphasic at the time of her first observation and who had recovered language, as measured by the Western Aphasia Battery, at the time of her discharge 14 days later. The paper emphasizes the relatively regular growth of normal syntactic, lexical, and pragmatic features coupled with similar regular decreases in aphasic features. Observations of both phenomena are necessary to describe language recovery. PMID- 3971133 TI - A critique of Hoffman's analysis of schizophrenic speech. AB - In a recent paper (R. E. Hoffman, L. Kirstein, S. Stopek, & D. V. Cicchetti, 1982, Brain and Language, 15, 207-233), Hoffman et al. outlined a method of analyzing schizophrenic speech. This method is briefly described. When this method was applied to transcripts of psychotic speech in a subsequent study, major flaws in the system became evident. Despite its claims to be a semiobjective method there are still a great deal of intuitive judgments involved and the analyst has to make numerous ad hoc decisions. This applies particularly to the determination of deviance in a transcript. PMID- 3971134 TI - Reading: dissociation of the lexical and phonologic mechanisms. AB - Three distinct reading mechanisms have been proposed: the phonologic conversion system in which letters are converted to their sound equivalents (phonemes) before meaning is established, and two lexical or whole-word mechanisms in which a word (or root morpheme) is identified as a single unit rather than by phonologic conversion. The two lexical mechanisms differ in that one is inextricably linked to semantics but the other is not. The phonologic conversion system may depend more on the perisylvian phonologic system than do the lexical mechanisms, which may be mediated by left parietal or occipital areas or by the right hemisphere. Described here is a patient who had an infarction that partially isolated the perisylvian speech areas and disconnected the partially preserved lexical systems from the phonologic mechanism. He read visually presented orthographically irregular words but could not pronounce orally spelled irregular words. Although he could not read nonwords, he could pronounce orally spelled nonwords and orthographically regular words. These observations suggest that the lexical and phonologic conversion systems are functionally and anatomically distinct. PMID- 3971135 TI - The dissolution of language in Pick's disease with neurofibrillary tangles: a case study. AB - This paper is a detailed retrospective history of a patient who began to have difficulty with speaking and comprehension in 1967, and whose neuropathological examination at time of death 12 1/2 years later was consistent with a diagnosis of Pick's disease, complicated by neurofibrillary tangles. It follows the deteriorating course of his language abilities in the context of relatively less impaired general cognitive abilities, using two sources of information. The first is his own written record of his deteriorating abilities, shown in letters and notes he wrote over this period. The second is through an oral history obtained from the patient's family. The purpose of this report is to illustrate in detail the course of a degenerative condition and to suggest the utility of such descriptional records in increasing understanding of language deterioration in dementia. PMID- 3971136 TI - Temporal speech characteristics associated with anterior left hemisphere cortical and subcortical lesions: a preliminary case study report. AB - There is disagreement in the literature regarding the characteristics of cortical and subcortical forms of aphasia. M. L. Albert, H. Goodglass, N. A. Helm, A. B. Rubens, and M. P. Alexander (Clinical Aspects of Dysphasia, Vienna/New York: Springer-Verlag, 1980) state that the two are indistinguishable. The opposing view has been presented by M. A. Naeser, M. P. Alexander, N. Helm-Estabrook, H. L. Levine, S. A. Laughlin, and N. Geschwind (Archives of Neurology, 39, 1982) and A. R. Damasio, H. Damasio, M. Rizzo, N. Varney, and F. Gersh (Archives of Neurology, 39, 15-20, 1982), who suggest that subcortical aphasias are not adequately described by the classic, cortical aphasia descriptions. In this study the temporal speech characteristics of a neurologically normal individual, an aphasic patient with anterior cortical and subcortical lesion locus, and a second aphasic patient, whose lesion was limited to anterior subcortical structures, were studied utilizing acoustic analysis of isolated word and phrase productions. The results of this investigation showed individually unique temporal patterns in the speech of each of the subjects studied. While the results must be interpreted conservatively due to the small number of cases described, they do provide tentative support for the Naeser et al. (1982) and Damasio et al. (1982) position. Furthermore, the results demonstrate the potential value of combining sensitive radiographic and acoustic measures in future studies that seek to compare cortical and subcortical forms of aphasia. PMID- 3971137 TI - Is there parallel and independent hemispheric processing of intonational and phonetic components of dichotic speech stimuli? AB - The possibility of hemisphere interaction in the processing of spoken language was studied in two dichotic listening experiments. The stimulus material consisted of six CV syllable triplets each spoken with each one of six intonation contours. In Experiment I, 15 aphasic patients, 8 patients with unilateral right hemisphere lesions, and 10 normal controls were asked to identify the four components of a dichotic item from a multiple-choice (MC) set comprising all possible CV triplets and intonation contours. In Experiment II, 30 normal subjects were required to identify either the right or left ear stimulus alone from an MC set comprising the right and left ear stimulus together with the two wrong combinations of right ear CV triplet with left ear intonation and vice versa. It is concluded from the results that the left hemisphere is capable of processing both phonetic and intonational information and that there is neither the necessity nor the tendency for right hemisphere participation in the perception of spoken language. PMID- 3971138 TI - Distribution of immunoreactive Met-enkephalin-Arg6-Gly7-Leu8 and Leu-enkephalin in discrete regions of the rat brain. AB - The distribution of immunoreactive (ir) leucine-enkephalin (LE) and ir-methionine enkephalin-Arg-Gly-Leu (ME-RGL) in 101 microdissected rat brain and spinal cord regions was determined using specific and sensitive radioimmunoassays. The highest concentrations of LE and ME-RGL were measured in globus pallidus (5190 and 4378.8 fmol/mg protein, respectively). Very high concentrations of LE and ME RGL (greater than 750 fmol/mg protein) were found in the central amygdaloid nucleus, anterior hypothalamic nucleus, lateral preoptic area, nucleus of the solitary tract (medial and commissural parts), bed nucleus of stria terminalis, dorsomedial nucleus, parabrachial nuclei, periaqueductal gray and motor hypoglossal nucleus. Very high concentrations of ME-RGL were found in 14 additional brain regions including medial preoptic area, area postrema, nucleus ambiguus, periventricular nucleus, ventromedial nucleus, interpeduncular nucleus, paraventricular, arcuate and others. High concentrations of LE (between 500 and 750 fmol/mg protein) were found in 15 brain areas, among them the periventricular nucleus, medial preoptic area, suprachiasmatic nucleus, dorsal premamillary nucleus, ventromedial nucleus, arcuate nucleus, nucleus ambiguus, locus coeruleus, substantia nigra. High concentrations of ME-RGL were measured in 13 brain areas including the suprachiasmatic nucleus, lateral septal nucleus, raphe magnus, motor facial nucleus, lateral amygdaloid nucleus, sensory trigeminal nucleus, nucleus accumbens, caudate-putamen. Moderate concentrations of LE (between 250 and 500 fmol/mg) were found in 46 brain areas such as the lateral septal nucleus, nucleus accumbens, caudate-putamen, several amygdaloid nuclei, supraoptic nucleus, the perifornical nucleus, posterior hypothalamic nucleus, red nucleus. Moderate concentrations of ME-RGL were detected in 27 areas such as the median eminence, nuclei of the reticular formation, supraoptic nucleus, red nucleus and others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971139 TI - The origins of innervation of the esophagus of the dog. AB - This study defined the origins of extrinsic efferent and afferent innervation of the normal canine esophagus. When all the layers of the wall of the 3 esophageal regions (cervical, thoracic and abdominal) were injected with horseradish peroxidase (HRP), labeled nerve cells were found in the nucleus ambiguus (NA) and parasympathetic nucleus of X (PX) of the brainstem. Most labeled cells in the NA were located in the compact column (retrofacial nucleus) while labeled cells in the PX were located in separate rostral and caudal areas. There was no somatotopic organization in either the NA or PX. Labeled sympathetic postganglionic neurons were found in the cranial cervical, middle cervical, cervicothoracic, thoracic sympathetic trunk and celiacomesenteric ganglia. The HRP injection of the esophageal wall labeled sensory cell bodies in the glossopharyngeal, proximal and distal vagal, and C2-T6 spinal ganglia. There was no discernible pattern of distribution of labeled cells in the autonomic or sensory ganglia. When the HRP injections were confined to the mucosa-submucosa layers of the thoracic esophagus, a small number of labeled cells were identified in the NA; however, no labeled cells were found in the NA when injections were confined to the mucosa-submucosa of either the cervical or abdominal esophageal regions. With these confined injections, the labeled nerve cells appeared in the rostral part of the PX. Thus, it appeared that the internal tunics of the esophagus (i.e., the mucosa and submucosa) were innervated by neurons in the rostral PX while the muscular tunic was innervated by neurons in the caudal PX and the rostral NA. After mucosa-submucosa injections, labeled sympathetic neurons appeared in the same ganglia that were identified after whole wall injections and these had a similar random distribution. These injections also labeled neurons in the glossopharyngeal, proximal vagal, and distal vagal ganglia, but unlike the whole wall injections there was no labeling in the spinal ganglia. This suggested that the labeled cells of the spinal ganglia seen after whole wall injections conveyed impulses from the tunica muscularis and serosa. PMID- 3971140 TI - Gap-like junctions between neuron cell bodies and glial cells of crayfish. AB - Data reported up to now on neuron-glia relationships, show that neuron cell bodies and glial cells are separated by a narrow intercellular cleft which is considered as the microenvironment of the nervous system, and where neuron-glia exchange occurs. We present here evidence that neuron perikarya and ensheathing glial cells of the abdominal ganglia of the crayfish communicate through gap-like junctions. These junctions could constitute short circuits for ionic exchange between neuron perikarya and glial cells, probably with some degree of electrotonic coupling between neurons and glia. In the preparation described here, the intercellular cleft would play only a secondary role in neuron-glia communication. PMID- 3971141 TI - Branched projections of pallidal and peripallidal neurons to neocortex and neostriatum: a double-labeling study in the cat. AB - Double-labeling of basal forebrain neurons by retrograde axonal transport of different markers demonstrated afferents shared by the neocortex and neostriatum. A considerable double-labeled complement of neurons located in the globus pallidus (lateral pallidal segment) and the adjacent interdigitating basal nucleus of Meynert (peripallidal region) had branched axonal collaterals projecting to the precruciate, cingulate and prorean gyri as well as to the head of the caudate nucleus. PMID- 3971142 TI - Connections of the rabbit abducens nucleus. AB - Wheat germ agglutinated horseradish peroxidase was injected into the rabbit abducens nucleus under physiological control. Major projections from the reticular formation and the ipsilateral oculomotor, bilateral vestibular and bilateral perihypoglossal nuclei were demonstrated. A reciprocal connection with the ipsilateral perihypoglossal nuclei was also shown. We suggest that the perihypoglossal nuclei and the reticular formation are important premotor centers involved with plasticity of eye movements. PMID- 3971143 TI - Effect of kainic acid lesions of the cerebellar interpositus nucleus on eyelid conditioning in the rabbit. AB - It has been shown previously that unilateral electrolytic lesions of the cerebellar dentate-interpositus nuclei selectively abolish or prevent a classically conditioned nictitating membrane/eyelid response in rabbits but do not prevent retention or learning on the contralateral side. The present study demonstrates that kainic acid lesions of the dorsal interpositus nucleus are sufficient for this effect. PMID- 3971144 TI - Dye coupling and gap junctions between crustacean neurosecretory cells. AB - Neurosecretory cells in the X organ-sinus gland system of the crayfish were impaled and Lucifer Yellow was intracellularly iontophoresed. In some neurons the injected dye was transferred to neighboring neurons. The interneuronal dye transfer was between adjacent somata. Coupling was also observed between neurons and smaller cells, possibly glia. Gap junctions were identified by freeze fracture in neuron somata and glial cells in the X organ and also in neurosecretory axons in the sinus gland. PMID- 3971145 TI - Contralateral circling induced by tegmental morphine: anatomical localization, pharmacological specificity, and phenomenology. AB - Unilateral morphine application to sites in the ventral tegmentum caused contralateral circling. Positive sites were restricted to the region of the dopamine-containing cells in the ventral tegmental area and substantia nigra; rates were highest with ventral tegmental application. The opiate receptor antagonists naltrexone and naloxone blocked morphine-induced circling whether given before or during the sessions. Pimozide pretreatment also blocked morphine induced circling at doses that spared muscimol-induced circling. Morphine induced little postural asymmetry and induced forward locomotion in all 4 limbs. The radius of morphine-induced circling was large or small depending on the size of the test environment; thus the behavior was controlled by environmental (sensory) and not central (motor) constraints. These studies suggest that morphine-induced circling results from activation of dopaminergic circuitry involved in sensory motor integration, particularly that involved in forward locomotion. PMID- 3971146 TI - Subclasses of olfactory receptor cells and their segregated central projections demonstrated by a monoclonal antibody. AB - A library of monoclonal antibodies (MAbs) was generated against a homogenate of the rabbit olfactory bulb. One of them immunohistochemically distinguished a subgroup of olfactory nerves. Both in the olfactory bulb and the epithelium, this MAb labeled most olfactory receptor axons in the lateral but only a small fraction in the medial portion. These findings demonstrate a molecular heterogeneity among olfactory receptor cells and suggest a functional division between the lateral and the medial portions of the epithelium and the bulb. PMID- 3971147 TI - Numbers of regenerating axons in parent and tributary peripheral nerves in the rat. AB - This study is concerned with numerical parameters of axonal regeneration in peripheral nerves. Our first finding is that the number of axons that regenerate into the distal stump of a somatic nerve at a particular time after transection is partially dependent on the type of lesion used to interrupt the axons. The second question concerns the proportion of axons that regenerate into the distal stump of a parent nerve compared to the proportions that regenerate into tributary nerves that arise from the parent. The proportions of regenerated myelinated axons in the nerve to the medial gastrocnemius muscle and myelinated and unmyelinated axons in the sural nerve are the same as the proportions of myelinated and unmyelinated axons that regenerate into the distal stump of the sciatic nerve for the crush, 0 and 4 mm gap transections. Proportionally fewer axons regenerate into the tributary nerves following the 8 mm gap transection, however. This implies that the length of the gap has an influence on whether or not axons in tributary nerves regenerate in concert with axons in the distal stump of the parent nerve. The unmyelinated fibers in the nerve to the medial gastrocnemius muscle are different because they do not regenerate in proportion to those in the distal stump of the sciatic nerve. We also provide evidence to indicate that myelinated axons branch whereas unmyelinated fibers end blindly when they enter the distal stump after crossing a sciatic nerve transection. Finally the normal arrangement of perineurial cells seems to be disrupted after the sciatic nerve regenerates across a gap. PMID- 3971148 TI - Evidence for a 'paravascular' fluid circulation in the mammalian central nervous system, provided by the rapid distribution of tracer protein throughout the brain from the subarachnoid space. AB - The protein tracer, horseradish peroxidase (HRP), was infused into the lateral cerebral ventricles or subarachnoid space of anesthetized cats and dogs after insertion of a cisternal cannula to permit drainage of cerebrospinal fluid (CSF) and tracer solution. The intracerebral distribution of the tracer was then determined by light microscopy of serial brain sections after postinfusion intervals of 4 min-2 h. For the localization of HRP, sections were incubated with diaminobenzidine (DAB) or the much more sensitive chromogen, tetramethylbenzidine (TMB). The TMB reaction showed a consistent 'paravascular' distribution of tracer reaction product, within the perivascular spaces (PVS) around large penetrating vessels and in the basal laminae around capillaries, far beyond the termination of the PVS. After infusion of HRP over 4 min, arterioles were surrounded by the tracer, but capillaries and venules were usually less densely demarcated; by 6 min, however, the intraparenchymal microvasculature was outlined in toto throughout the forebrain and brainstem. Electron microscopy of sections incubated in DAB after 10 or 20 min HRP circulation confirmed the paravascular location of the reaction product, which was also dispersed throughout the extracellular spaces (ECS) of the adjacent parenchyma. Our results demonstrate that solutes in the CSF have access to the ECS throughout the neuraxis within minutes via fluid pathways paralleling the intraparenchymal vasculature. The rapid paravascular influx of HRP could be prevented by stopping or diminishing the pulsations of the cerebral arteries by aortic occlusion or by partial ligation of the brachiocephalic artery. The exchange of solutes between the CSF and the cerebral ECS has generally been attributed to diffusion, however, HRP enters the neuraxis along the intraparenchymal microvasculature far more rapidly than can be explained on this basis. This apparent convective tracer influx may be facilitated by transmission of the pulsations of the cerebral arteries to the microvasculature. We postulate that a fluid circulation through the CNS occurs via paravascular pathways. PMID- 3971149 TI - Abnormal behavioural changes associated with vasopressin-induced barrel rotations. AB - Arginine-8-vasopressin (AVP) was injected into the cerebral ventricles of rats in order to characterize the dose-response relations of the convulsant actions of AVP and to obtain a detailed description of other acute behavioural effects. The incidence of barrel rotations, a violent and apparently uncontrolled motor activity during which rats rotate about their long axis, was found to be dose dependent, with a threshold of between 1 and 10 ng per rat. Other behavioural effects of AVP including immobility, titubation, ataxia, backward walking, and inhibition of exploratory activities and of grooming were seen at doses as low as 100 pg. These behavioural effects occurred within 9 min after injection, and thus have the same time course as barrel rotations. These acute actions of AVP may be significant in interpreting the effects of AVP on cognitive processes and memory and should also be taken into consideration in the clinical use of AVP as an anti amnestic. PMID- 3971150 TI - Locomotor behavior following kindling in three different brain sites. AB - Spontaneous and drug-induced interictal and post-ictal locomotor behavior of rats was investigated following electrical 'kindling' of different limbic structures at 3 brain sites which differ in the relative amount of innervation from dopamine cells of the ventral tegmentum: nucleus accumbens (N.Acc.), amygdala (AMYG), and dorsal hippocampus (DHPC). Kindling produced decreases in spontaneous post-ictal locomotion that did not appear to depend on the site of stimulation, but produced region specific attenuations in spontaneous interictal behavior as well as amphetamine-induced interictal and post-ictal responses. The most dramatic decreases were seen in N.Acc. kindled animals and the least dramatic were seen in rats kindled via DHPC. These data suggest that the mesolimbic dopamine system may participate in the changes in locomotion seen following kindled seizures, and may also provide a model for the study of human post-ictal and interictal behavior. PMID- 3971151 TI - Evidence for a role of endogenous nerve growth factor in the functional sex difference in the adrenergic innervation of the male and female mouse submandibular gland. AB - In view of the remarkable sex difference in nerve growth factor (NGF) content in mouse submandibular gland (SMG), a direct comparison of the adrenergic innervation as represented by noradrenaline (NA) content in SMG, rate of losing NA after superior cervical ganglionectomy, post-reserpine recovery of NA and survival and growth of implanted neurons of superior cervical ganglion into SMG was carried out. The results showed that the NA contents in the intact male SMG and in the male SMG during the recovery from reserpinization were higher than those in the female. There were marked sex differences in patterns of the time course of post-ganglionectomy loss of NA in SMG and in the ability of SMG to support survival and growth of the implanted SCG neurons. These results indicate that NGF in the mouse SMG may play a functional role in the adrenergic neurons innervating the gland. PMID- 3971152 TI - Cerebrospinal fluid sodium concentration and salt appetite. AB - Infusion into a lateral brain ventricle (IVT) of different hypertonic (0.7 M) saccharide solutions decreased [Na+] of cerebrospinal fluid (CSF). Increased Na appetite of moderately Na-deplete sheep was observed during infusion of mannitol, L-glucose or L-fucose, while no change was observed during infusion of D-glucose, D-fucose, D-mannose, 2-deoxy-D-glucose, 3-O-methyl-glucose or fructose. In other experiments, increased Na appetite was observed during infusion of 2.3 mM phlorizin (a relatively specific blocker of Na-coupled glucose transport into cells) or 2.3 mM phlorizin plus 0.7 M D-glucose. In addition, phlorizin eliminated the characteristic decrease in Na appetite but did not affect the increase in water intake caused by IVT infusion of hypertonic NaCl which increased [Na+] of CSF. The results suggest that: (a) there are sensors within the neuropil which respond to change of [Na+] and influence Na appetite, and that these changes of [Na+] are induced deep within the neuropil by those saccharides which do not cross the blood-brain barrier or enter cells; change of CSF[Na+] alone is not sufficient to alter appetite but a change in brain extracellular fluid (ECF)[Na+] is probably necessary; (b) the theory is advanced that the stimulus for altered Na intake could be altered brain ECF[Na+] producing a change in cerebral intracellular fluid (ICF)[Na+] of the sensors; and (c) phlorizin, in reducing or blocking Na-coupled glucose transport, could increase Na appetite by producing a fall in ICF[Na+] of the specific neurones subserving sodium appetite or prevent a decrease in Na appetite caused by IVT infusion of hypertonic NaCl by preventing an increase in ICF[Na+] of this same neuronal system. PMID- 3971153 TI - Angiotensin-estrogen central interaction: localization and mechanism. AB - Intracerebroventricular (ICVT) administration of estradiol benzoate (EB) to ovariectomized female rats decreased drinking and pressor responses to central injections of angiotensin II (AII). Estrogen treatment does not have this effect in male rats. As EB given ICVT reaches many brain areas, the site of action of EB was localized using crystalline implants of EB in the medial preoptic area or the ventromedial nucleus of the hypothalamus. These areas were chosen as they have a high density of estrogen receptors. Only medial preoptic area application of estrogen decreased angiotensin II-induced drinking. Angiotensin receptor binding was examined in homogenates from different brain regions to determine if the mechanism through which estrogen decreases central responses to AII involves altered receptor function. Systemic EB did not affect AII receptor binding in several brain regions but binding was decreased in homogenates from the preoptic area and septum-thalamus blocks which encompassed structures (median preoptic nucleus, organum vasculosum, and subfornical organ) implicated in central actions of AII. The sex specificity of the effect of estrogen was dependent on sexual differentiation of the brain. Manipulation of the neonatal hormone environment, which alters this brain differentiation, also altered the characteristic responses of the two sexes to estrogen. Neonatal androgenization of females, which causes masculinization and defeminization, resulted in animals which as adults no longer responded to EB with decreased drinking. On the other hand, preventing the development of a male brain by neonatal castration produced animals which as adults tended to decrease their drinking following estrogen. In summary, this study found that EB acts in the preoptic area to depress AII induced responses by a site specific modulation of central AII receptors. Alteration of early brain development changed the responses of the two sexes to estrogen, perhaps by altering sexual differentiation of the preoptic area. PMID- 3971154 TI - Neural organization of the viscero-cardiac reflexes. AB - The reflex responses evoked in the postganglionic nerves to the heart were tested in chloralose-anaesthetized cats. Electrical stimulation of the A delta afferent fibres from the left inferior cardiac nerve evoked spinal and supraspinal reflex responses with the onset latencies of 36 ms and 77 ms respectively. The most effective stimulus was a train of 3-4 electrical pulses with the intratrain frequency of 200-300 Hz. Electrical stimulation of the high threshold afferent fibres (C-fibres) from the left inferior cardiac nerve evoked the reflex response with the onset latency of 200 ms. The C-reflex was present in intact animals and disappeared after spinalization. The most effective stimulus to evoke this reflex was a train of electrical pulses delivered at a frequency of 1-2 Hz with an intratrain frequency of 20-30 Hz. The most prominent property of the C-reflex was its marked increase after prolonged repeated electrical stimulation. We conclude that: (1) viscero-cardiac sympathetic reflexes may be organized at the spinal and supraspinal level; (2) viscero-cardiac sympathetic reflexes evoked by stimulation of the A delta and C afferent fibres from the left inferior cardiac nerve have different central organization. PMID- 3971155 TI - Vestibulo-ocular reflexes after selective plugging of the semicircular canals in the monkey--response plane determinations. AB - The contribution from different pairs of semicircular canals to the generation of horizontal vestibular nystagmus was examined in monkeys. Animals with different pairs of semicircular canals surgically plugged were accelerated sinusoidally at 1 Hz (a predictive stimulus) or with steps of angular velocity (a non-predictive stimulus) about an earth vertical axis while the head was placed in various static pitch positions. In normal animals, and in animals with only the lateral canals intact, horizontal nystagmus elicited with angular velocity steps is maximal at a static pitch angle of 15 degrees nose-down (relative to the horizontal stereotaxic plane). The response follows a cosine function of the pitch angle, approaches zero at an angle of 90 degrees to the optimal orientation, and finally reverses. In animals with only the vertical canals operating, direction specific horizontal nystagmus can still be elicited. Using velocity steps, a null plane at which nystagmus reverses can be determined. It is found at about 32 degrees nose-down and thus is different from the optimal plane of the lateral canals. Consequently, it is not possible to stimulate the lateral canals maximally without stimulating the vertical canals simultaneously. Using sinusoidal rotation, nystagmus is attenuated at the static pitch position of 32 degrees nose-down, but does not reverse direction with further pitching. PMID- 3971156 TI - Regional comparisons of brain glucose influx. AB - The regional influx of glucose across the blood-brain barrier and regional blood flow were studied simultaneously in conscious and restrained rats using the single pass bolus injection of [14C]butanol and [3H]D-glucose method. Glucose extraction by the cerebellum was about twice that of other brain regions. Thus, despite the lower cerebellar blood flow, the influx of glucose into the cerebellum was equivalent to that of the cerebral cortex and higher than that of the hippocampus over a wide range of plasma glucose concentrations. Because the local metabolic rate for glucose is higher in the cerebral cortex than in the cerebellum, the equal influx of glucose in these two regions means a relative oversupply of glucose to the cerebellum. In vivo analysis of blood to brain glucose transport kinetics showed similar plasma glucose concentrations at half maximal transport (Kt) in brain regions that were studied. The values for Kt ranged between 4.4 and 5.1 mM. Maximal transport capability (Tmax), on the other hand, was similar in the cerebral cortex and cerebellum but significantly lower in the hippocampus (P less than 0.05). The higher ratio of glucose influx to glucose utilization in the cerebellum may explain the clinical and experimental findings of relative resistance of the cerebellum to hypoglycemia while the lower Tmax in the hippocampus may be the mechanism underlying its selective vulnerability during pathophysiologic conditions associated with marked increments in brain oxidative metabolism, such as status epilepticus. PMID- 3971157 TI - Reward related neuronal activity in monkey dorsolateral prefrontal cortex during feeding behavior. AB - Extracellular single neuron activity was recorded in the dorsolateral prefrontal cortex (DL) during bar pressing for food reward. Most of the reward-related neurons were located around the rostral end of the principal sulcus. Neuronal activity was diminished, abolished, or reversed when quinine adulterated food (aversive food) was given as a reinforcement. Cue-related neurons tended to be located more caudally in the DL. The activity of these neurons was not modulated by the nature of the reward as much as that of the reward-related neurons. The results suggest that DL neurons are not functionally homogeneous. PMID- 3971158 TI - Noxious cardiac input onto neurons in medullary reticular formation. AB - Responses of reticular formation neurons to electrical stimulation of cardiopulmonary afferents as well as cardiac application of bradykinin were determined. Experiments were performed in chloralose anesthetized, vagotomized and sino-aortic denervated cats paralyzed with pancuronium. The medial reticular formation in the medulla was explored with microelectrodes until single neurons responding to electrical stimulation of the cardiac nerve were isolated. Electrical stimulation evoked an early (latency less than 40 ms) burst only (most common), both an early burst and a late burst, or a late (latency greater than 90 ms) burst only (least common) from medullary neurons. Cells were subsequently tested for responses to epicardial or intracardiac administration of bradykinin. Of the 62 neurons tested, one-third responded to bradykinin. Cells typically exhibited a bursting pattern of spontaneous activity; bradykinin enhanced the duration and intensity of the bursts. Neurons were also tested for somatic, visual and auditory input. Most cells were excited by somatic as well as auditory stimuli, while a fewer number also received visual input. Furthermore, most cells responsive to epicardial bradykinin also received these other inputs. The neurons recorded in this study may mediate cardiac pain, cardiovascular reflexes, alerting responses, and/or arousal responses. PMID- 3971159 TI - Postsynaptic dorsal column pathway of the rat. II. Evidence against an important role in nociception. AB - The response characteristics of neurons at the origin of the postsynaptic dorsal column (PSDC) pathway were determined in unanesthetized, decerebrated, spinalized rats. Sixty-four percent of PSDC neurons responded only to innocuous mechanical stimuli. Thirty-six percent responded to innocuous stimuli but were more powerfully activated by noxious pinch. Ninety-three percent of the tested PSDC neurons were not activated by any of several intensities of sustained, repeated noxious heating of their receptive fields. The failure of pinch-responsive PSDC cells to respond to thermal stimulation, even in sensitized skin, suggests that they do not receive a functionally significant input from C polymodal nociceptors, heat nociceptors, or mechanical-heat nociceptors. We conclude, therefore, that the postsynaptic dorsal column pathway is not importantly involved in nociception in the rat. PMID- 3971160 TI - Centrifugal fibers to the rat retina from the medial pretectal area and the periaqueductal grey matter. AB - Intraocular injections of several different retrograde tracers were made in albino rats. Retrogradely filled neurons were observed in two locations: the medial pretectal area and the contralateral periaqueductal grey matter, indicating that the pretectum and the mesencephalon are sources of centrifugal innervation to the rat retina. PMID- 3971161 TI - Effects of intrajugular hypertonic saline, vaginal distension and vulvar massage on activity of supraoptic neuroendocrine cells. AB - Activity of 40 single antidromically identified supraoptic neurons was recorded and evaluated in response to a combination of tactile, vulvar massage, vaginal distension, and slow intrajugular 1.2 M sodium chloride infusion in unanesthetized, randomly hydrated ewes. Estradiol-implanted Southdown ewes were prepared according to techniques described by Jennings et al. Only 4 spontaneous firing patterns were observed in the supraoptic nuclei. Analysis of evoked activity indicated that each stimulus evoked alterations in mean firing rates or increased numbers of short interspike intervals in some cells. The resultant activity of units to sequential vulvar massage and 1.2 M sodium chloride infusion suggests a possibility of separate mechanisms of release of oxytocin and vasopressin. PMID- 3971162 TI - Flash evoked responses in a song control nucleus of the zebra finch (Taeniopygia guttata castanotis). AB - The song of the zebra finch is facilitated and altered by the presence of a female. Thus, visual information should affect the song system of the bird. Visually evoked potentials can be recorded from n. hyperstriatum ventrale pars caudale (HVc). The long latency of this potential and its variability indicate several processing steps between primary sensory areas of the telencephalon and HVC. Within HVc, under these experimental conditions no interaction between acoustic and visual input could be demonstrated. However, at the dorsal border and within the shelf below HVc, visual information seems to enhance acoustically evoked potentials. PMID- 3971163 TI - Time-dependent changes in the binding parameters of muscarinic cholinergic receptors in the rat brain. AB - Using quantitative receptor autoradiography, effects of several incubation times on the binding parameters for [3H]quinuclidinyl benzilate [(3H]QNB) binding were investigated in 5 discrete regions of the rat brain. There were no differences in Bmax-values between 3 incubation times. On the other hand, Kd(app)-values markedly depended on the duration of incubation time. Furthermore, Scatchard plots at low [3H]QNB concentrations showed an abnormal binding behavior, i.e. deviation from the straight line representing a single population of the binding site. PMID- 3971164 TI - Cerebral cortex slices in sodium-free medium: depletion of synaptic vesicles. AB - Rat cerebral cortex slices superfused for 5 min in sodium-free medium after 30 min stabilization and 25-min superfusion periods in sodium-containing medium displayed a well-preserved tissue structure and mostly intact neurons and glial cells. Electron-microscopic morphometry showed the number of presynaptic terminals containing few (less than or equal to 10) vesicles to increase 3-fold after the 5-min depletion of sodium. The 90-min sodium depletion resulted in increased swelling and an additional decrease in synaptic vesicles. The results show that from a morphological point of view the substitution of sodium by choline with brain slice techniques is an eminently suitable method for studies on synaptic neurochemistry. PMID- 3971165 TI - Factors determining the variation of the afterhyperpolarization duration in cat lumbar alpha-motoneurones. AB - The duration of the afterhyperpolarization (AHP) in cat spinal alpha-motoneurones varies systematically with motoneurone type, being shorter in motoneurones projecting to fast-contracting muscle units. Recent experiments have shown that the AHP duration is correlated with the amount of sag found in the voltage response to injected constant current pulses. Using a model of the sag process, the present study shows that this correlation is likely to be causal to a substantial extent. Short AHP durations in fast motoneurones may thus be as much, or more, a consequence of a more developed sag process than of faster kinetics of the K conductance process underlying the AHP. This notion is also supported by the experimental observation of a decreased amount of sag and a prolonged AHP duration after axotomy. PMID- 3971166 TI - Partial characterization of endogenous phosphorylation conditions for hen brain cytosolic and membrane proteins. AB - The optimal conditions for endogenous protein phosphorylation with 5 microM [gamma-32P]ATP, 10 mM MgCl2 in preparations containing synaptosomal cytosol or membranes (shocked crude mitochondrial fraction P2) from adult hen brains were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, autoradiography and microdensitometry. Phosphate incorporation increased linearly with protein concentration from 75-125 micrograms/200 microliters in brain cytosol and was maximal at 75 micrograms/200 microliters in brain membranes. Optimal incubation times were 60-90 s for brain cytosol and 10-15 s for brain membranes. With the exception of the 20 kilodalton myelin basic protein in the membrane fraction, pH 6.5 is generally optimal. While temperature optima varied considerably with different bands, most of them were found between 35 and 45 degrees C. When identical preparations from hen and rat brain were co electrophoresed, one of the most striking differences was that the enhancement of phosphorylation of a 55 kilodalton doublet, which may be tubulin, by addition of 50 microM Ca2+ was at least 3 times greater in rat than in hen brain cytosol. Another species difference was apparent in the membrane fractions in which the 20 kilodalton hen brain presumptive myelin basic protein (MBP) was phosphorylated to approximately the same extent as that of the 16 and 20 kilodalton rat brain MBPs combined. PMID- 3971167 TI - Three sex dimorphisms in the granule cell layer of the hippocampus in house mice. AB - Inbred strains of mice differ in number of neurons in the dentate granule cell layer of hippocampus and in granule cell density. In a study of both sexes in 6 strains, females had significantly lower granule cell density than males of the same strain. Females of strains with high neuron numbers had significantly fewer granule cells than males of the same strain, while males and females of low neuron number strains did not differ from each other. Sizes of neuronal nuclei were examined in males and females of two strains. No significant strain difference was found, but females had significantly smaller nuclei. The results suggest that hippocampal function is associated with the differing adaptive roles of male and female house mice. PMID- 3971168 TI - Pharmacological modification of the light-induced responses of Muller (glial) cells in the amphibian retina. AB - The light-evoked responses of Muller (glial) cells were monitored by intracellular recording in the isolated, superfused retina of Xenopus laevis. Muller cells had dark resting potentials of -88.5 +/- 6.9 mV and small 1-2 mV light responses of variable waveform in normal Ringer's solution. Exposure to picrotoxin (0.5-1.0 mM) greatly enhanced the light response which then consisted of depolarizing transients (Vmax 5-15 mV) at stimulus onset and offset. GABA (5 10 mM) antagonized the picrotoxin effect and suppressed the light response, whereas 2-amino 4-phosphonobutyrate (0.10-0.15 mM) blocked selectively the 'on' transient. None of these agents appreciably modified the glial cells resting potential level. On the other hand, veratrine (6-9 micrograms/ml) depolarized the Muller cell by 4-13 mV and slowed and greatly reduced the light response. These effects were antagonized by tetrodotoxin (1-4 microM) which itself reduced the light response by 30-50% without altering its shape. On the basis of these findings, we suggest that alterations in the activity of the inner retinal neurons, i.e. amacrine and ganglion cells, are primarily responsible for the drug induced changes in the membrane potential and light-evoked responses of the Muller cell. PMID- 3971169 TI - Initiation of locomotion from the mesencephalic locomotor region: effects of selective brainstem lesions. AB - The effects of selected brainstem lesions on controlled treadmill locomotion produced by stimulation of the mesencephalic locomotor region (MLR) in postmamillary cats were determined in these experiments. The importance for the initiation of locomotion of projections from the MLR to rostral brainstem structures, described in a preceding paper, were examined by selective lesioning or by adjusting the level of the decerebration. The role played by the lateral vestibulospinal tract (LVST) in the initiation of locomotion was examined by lesioning Deiters' nucleus bilaterally. Contrary to previous claims, the results of the present experiments show that areas of the brainstem rostral to the MLR are not required for the initiation of locomotion by MLR stimulation. This finding eliminates the ventral tegmental area of Tsai and the substantia nigra, both implicated in the initiation of locomotion, as required participants in MLR stimulated locomotion. Bilateral Deiters' nucleus (DN) lesions did not significantly affect the initiation of locomotion from the MLR, nor did such lesions alter in a systematic fashion the amplitude or timing of EMG activity in flexor or extensor muscles of the hindlimb during MLR evoked walking. Joint angle changes during the locomotor cycle were also essentially unaltered by DN lesions. The significance of these findings regarding the brainstem structures which must be involved in the initiation of locomotion are discussed. PMID- 3971170 TI - Catecholamine-containing neurons and lymphoid cells in a lacrimal gland of the pigeon. AB - The Harderian gland of birds, a major lacrimal gland, contains a large population of lymphoid cells that produce IgA, a significant component of tears. Using histochemical techniques, we have examined the innervation of the gland. There was an extensive acetylcholine-esterase positive fiber network throughout the gland. However, catecholamine positive fibers were seen mainly associated with peripheral blood vessels and the lymphoid cell population which contained autofluorescent plasma cells. Ultrastructural examination showed that vesicle filled nerve varicosities were often seen near plasma cells and that some of these varicosities reacted positively for catecholamines. These anatomical data suggest that the lymphoid cell population may be affected by the autonomic nervous system. PMID- 3971171 TI - Is the intimate relationship between ligaments and marginal specialized cells in the snake's spinal cord indicative of a CNS mechanoreceptor? AB - Large neurons at the ventrolateral edge of the snake's spinal cord are intimately associated with ligaments that closely adhere to the whole length of the spinal cord. Ultrastructural studies show close similarities of these cells and their processes with those of other mechanoreceptors. Furthermore, the ligaments undergo changes within the intervertebral areas that would enhance focusing the stimulus to the receptor area. PMID- 3971172 TI - Activation of identified septo-hippocampal neurons by noxious peripheral stimulation. AB - Septo-hippocampal neurons (SHNs) were recorded from the medial septum-diagonal band area of rats anaesthetized with either urethane or fluothane. They were identified by their antidromic response to the electrical stimulation of the fimbria. Their responses to peripheral somatic noxious and non-noxious stimulation were studied. Non-noxious natural stimulations were relatively ineffective. In contrast, 68% of the SHNs were driven by noxious stimulation. The SHNs could be driven either by mechanical or thermal stimulation. Intraperitoneal injection of bradykinin excited about half of the SHNs. Some neurons were able to encode stimulus intensity (strength of the mechanical stimulation and/or temperature of the thermal stimulation). The receptive fields of the SHNs were large, usually involving half of the body or the whole body surface. These results suggest that SHNs, which are at the origin of the cholinergic septo hippocampal pathway, might be involved in cerebral mechanisms related to nociception. PMID- 3971173 TI - Projection of phrenic nerve afferents to the cat sensorimotor cortex. AB - The projection of phrenic nerve afferents to the sensorimotor cortex was studied in cats. The results of these experiments demonstrate that stimulation of phrenic nerve afferents elicits cortical evoked potentials (CEPs) in the sensorimotor cortex of cats. Cortical foci for CEPs classified as primary were found in areas 3b, 3a and 4 gamma. These foci were located medial to forelimb and lateral to hindlimb afferent representations in the sensorimotor cortex. PMID- 3971174 TI - A time-based stereoscopic depth mechanism in the visual cortex. AB - We propose a new depth mechanism, operating in the visual cortex, which uses temporal as well as spatial cues. By varying the timing of input to the two eyes, and the position of stimuli on the two receptive fields, we show that both temporal and spatial disparities influence the binocular responses of single cortical cells. PMID- 3971175 TI - [3H]Dexamethasone binding in rat frontal cortex. AB - The work described in this paper presents evidence for the existence of specific glucocorticoid receptors in the rat frontal cortex. Using [3H]dexamethasone we found a Kd approximately 6 nM and a Bmax approximately 270 fmol/mg protein, concentrations that were about 75% of those found in hippocampus. [3H]dexamethasone binding in the frontal cortex, like that in hippocampus, was regulated by the corticosterone: thus, one-week treatment with corticosterone results in a decrease and long-term adrenalectomy results in an increase in [3H]dexamethasone binding. Developmentally, as reported for other brain regions, [3H]dexamethasone binding in frontal cortex was low during the first week of life and then rose during the following 10 days to approximate adult levels. These results are discussed in terms of providing a possible mechanism for the influence of corticoids on catecholamine activity in the frontal cortex. PMID- 3971176 TI - The effects of repeated induction of long-term potentiation in the dentate gyrus. AB - Previous experiments have shown that long-term potentiation (LTP) generally lasts for only a few days or weeks. The LTP phenomenon would be more attractive as a memory model if it were more enduring. The experiments reported in this paper were designed to test the effects of repeated induction of LTP on the duration of LTP. Three groups of animals received 5 LTP-inducing stimulation sessions. In one group of animals, the stimulation sessions were administered every 24 h. In the 2nd group, the sessions were administered after the LTP effects had decayed to 50% of the peak values. In the 3rd group, the sessions were administered only after the response amplitudes had completely returned to pre-LTP baseline levels. None of the LTP measures were altered, in any group, as a result of repeated induction of LTP. The thresholds, the asymptotic levels of potentiation, and the decay rates were the same after each session. Other treatments may alter the duration of LTP effects, but repeated induction of LTP does not appear to have any lasting effects. PMID- 3971177 TI - The circadian rhythm in plasma melatonin concentration of the urbanized man: the effect of summer and winter time. AB - Plasma melatonin rhythms were measured in healthy urbanized persons between July 4 and 5 and between January 13 and 14. In contrast to findings in other mammals studied thus far, no difference in the duration of elevated night melatonin concentration was observed between summer and winter. In winter, melatonin rhythms were phase-delayed by about 1.5 h as compared with summer patterns. PMID- 3971178 TI - Effects of a distant noxious stimulation on A and C fibre-evoked flexion reflexes and neuronal activity in the dorsal horn of the rat. AB - In the halothane-anaesthetized rat, the responses of 49 neurons in the lumbo sacral cord and the reflex discharge in the common peroneal nerve following electrical stimulation of the sural nerve were recorded in order to study possible relations between neuronal events and reflex nerve discharges. A distant noxious stimulus (to activate Diffuse Noxious Inhibitory Controls (DNIC) of Le Bars et al.) was used as a conditioning stimulus. Only the responses of neurons receiving an input from both A and C fibres were studied. The neurons were classified as class 1 (low threshold mechanoreceptive input only, n = 2), class 2 (nonnoxious and noxious inputs, n = 34) or class 3 (responding to noxious stimuli only, n = 13). During conditioning stimulation the C fibre evoked discharge was inhibited in 32 out of 34 class 2 neurons. The A fibre-evoked discharge was simultaneously inhibited in 29 of these neurons. The main effect of the distant noxious stimulation on the C fibre evoked neuronal discharge was to decrease the discharge by a constant number of spikes, independent of the level of evoked activity. Only one class 3 neuron was inhibited during conditioning stimulation and none of the class 1 cells were influenced by DNIC. During conditioning stimulation the late and prolonged C fibre evoked reflex nerve discharge (latency 160-200 ms, duration up to several hundred ms) was strongly depressed. Concomitantly, a short-lasting reflex nerve discharge appeared over the interval 115-160 ms. This released reflex nerve discharge (RR) had a constant latency. There was no simultaneous change of the A beta evoked reflex nerve discharge. After the end of the distant noxious stimulation the late C fibre evoked reflex nerve discharge (latency 160-200 ms) recovered. Concomitantly, the RR disappeared. The possibility that the class 2 neurons and the class 3 neurons are intercalated in different reflex pathways is discussed. PMID- 3971179 TI - Naloxone reverses the antinociceptive action of clonidine in spontaneously hypertensive rats. AB - Earlier studies have shown that the antihypertensive action of clonidine is reversed by naloxone in hypertensive (SHR), but not in normotensive rats (WKY). We investigated the effects of clonidine and naloxone on pain sensitivity of SHR and WKY by using the formalin test (FT) and the tail-flick test (TFT). Using the FT, basal pain sensitivity was similar in SHR and WKY. Clonidine produced dose dependent analgesia (0.03-0.15 mg/kg i.p.), and it was more potent in SHR than in WKY. The effect of clonidine was partially antagonized by naloxone (2 mg/kg i.p.) in SHR, but not in WKY. Naloxone alone caused moderate analgesia in SHR and no effect in WKY. Using the TFT, SHR displayed a naloxone-reversible decrease in basal pain sensitivity, when compared to WKY. Clonidine was ineffective (WKY) or caused moderate hyperalgesia (SHR). These results indicate that the two pain tests activate different pain controlling mechanisms, with different sensitivity to the antinociceptive action of clonidine. In SHR, this action seems to involve the release of endogenous opioids. PMID- 3971180 TI - Direct intracellular measurement of non-linear postreceptor transfer functions in dark and light adaptation in Limulus. AB - Using one microelectrode inserted into a Limulus retinular cell, simultaneous recordings were made of the receptor potential evoked by light falling on that retinular cell and of the optic nerve action potentials generated in the eccentric cell coupled to that retinular cell. The postreceptor transfer function for sensory quantity was thereby examined directly between the retinular cell receptor potential and the eccentric cell action potentials over a more extended range than had been reported in previous studies. This transfer function exhibited a strong non-linearity; the function had 3 discrete linear segments. It is similar to the function relating extrinsic current to spike frequency in cat motoneuron. Light adaptation induced a shift of the transfer function. There were certain phenomenological similarities between the effect of light adaptation on the receptor and postreceptor transfer functions. But there were also enough dissimilarities to suggest that the mechanism of postreceptor adaptation is different than the receptor adaptation mechanism. PMID- 3971181 TI - The corpus callosum during postnatal undernourishment and recovery: a morphometric analysis of myelin and axon relationships. AB - This study was designed to compare morphometric relationships between myelin lamellae and axons in undernourished and well nourished developing rats, and in rats nutritionally rehabilitated for two weeks. Although sampling techniques employed in this study were not specifically designed to compare numbers of myelinated fibers in test and control populations, we did observe a trend indicating a reduction in the numbers of myelinated fibers. The mean numbers of myelin lamellae, from an average of all myelinated axons, were not different in control and test population. However, regression analysis of axon sizes by numbers of myelin lamellae revealed significant differences from the normal in 21 day-old undernourished rats. For callosal axons of any size, there were too few myelin lamellae in the undernourished rats. A partial recovery was observed in relatively small fibers by 35 days of age, but no recovery was observed in larger sized fibers. Comparison of the frequency distribution of axon circumferences of myelinated fibers revealed an increase in average axonal caliber. Computation shows that although mean numbers of lamellae were not altered by undernourishment, the axons themselves are increased in size by about 10%. This unexpected result indicates that the relationship normally governing the numbers of myelin lamellae is altered by postnatal nutritional deprivation, and that the relatively larger axon calibers do not produce in the ensheathing oligodendroglia any compensatory increase in the layers of myelin. PMID- 3971182 TI - Lesioning of the rat basal forebrain leads to memory impairments in passive and active avoidance tasks. AB - Effects of the bilateral electrolytic lesioning of the basal forebrain (BF), including the ventral globus pallidus, on passive or active avoidance tasks, were studied in male Wistar rats. A severe deficit in acquisition of passive avoidance response was produced by the lesioning in the posterior level of BF. The retention of the passive avoidance response was markedly disrupted with post training lesioning. Time-dependent but only slight recovery from the memory impairments was observed in the passive avoidance task given 4, 8 or 16 weeks after BF lesions. The acquisition of active avoidance response using a two-way shuttle box was also disturbed by BF lesioning. Retention of active avoidance response was clearly impaired by post-training lesions of the BF. The BF lesioned rats gradually acquired the passive avoidance performance when trained repeatedly at 24- or 48-h intervals, by giving a foot shock in case of avoidance failure. Extinction of the acquired passive avoidance response rapidly occurred in the BF lesioned rats. Furthermore, neurotoxic lesions of BF with kainic acid produced a significant impairment in acquisition of passive avoidance response. These results suggest that bilateral BF lesions impair the acquisition and retention of passive or active avoidance response, and that these impaired rats may be useful as an experimental model for Alzheimer's disease and senile dementia. PMID- 3971183 TI - [Prenatal diagnosis of atrioventricular block the fetal heart]. PMID- 3971184 TI - [Urologico-nephrologic status in patients who had acute cystopyelonephritis during pregnancy]. PMID- 3971185 TI - [Neglect of prenatal care and its consequences]. PMID- 3971186 TI - [Incidence of toxoplasmosis in occupationally exposed persons]. PMID- 3971187 TI - [Complications after plastic surgery of the vagina]. PMID- 3971188 TI - [Clinical experience with the treatment of giardiasis using ornidazole manufactured in Czechoslovakia]. PMID- 3971189 TI - [Inversio uteri in placenta accreta]. PMID- 3971190 TI - [Echinococcosis in gynecologic locations]. PMID- 3971191 TI - [Molecular aspects of the pathogenesis of hereditary spherocytosis]. PMID- 3971192 TI - Effect of dietary amino acids and metabolisable energy on the performance of broilers kept at high temperatures. AB - Increasing dietary metabolisable energy (ME) at particular amino acid: ME ratios significantly improved growth and food utilisation of broilers kept at moderate (18 to 26 degrees C) and high (25 to 35 degrees C) ambient temperatures during the finishing period from 22 d of age. The optimum amino acid: ME ratio varied with dietary ME concentration in the hot, but not in the moderate environment. Relatively greater increases in food intake and growth rate occurred in the hot environment when dietary ME was increased and the amino acid: ME ratio was reduced. The minimum rate of food intake did not coincide with the period of maximum temperature. Increasing the dietary protein at particular ME concentrations had little or no effect on the food intake and growth rate of birds kept at high temperatures. Supplementation with dietary fat had no beneficial effect on performance at high temperatures. The rectal temperatures of birds in the hot environment increased with age and, towards the end of the finishing period, when higher energy diets were fed. PMID- 3971193 TI - Circulating prolactin concentrations in chickens infected with Eimeria tenella. AB - 50000 oocysts of Eimeria tenella were inoculated into three-week-old cockerels and the effect of the infection (coccidiosis) on circulating concentrations of glucose, prolactin, sodium, potassium and haematocrit was determined. At day 5 of infection haematocrit was reduced and glucose was increased. From day 7 onwards prolactin concentration was elevated in infected birds compared with control and pair-fed birds. Plasma electrolytes were unchanged. It appears likely that loss of water resulting in osmotic changes during infection is the major reason for the observed changes in prolactin concentration in infected cockerels. PMID- 3971194 TI - Induction of a pause in laying by corticosterone infusion or dietary alterations: effects on the reproductive system, food consumption and body weight. AB - A pause in laying was induced in hens by infusing 30 micrograms corticosterone/h, feeding diets deficient in calcium or sodium and by food and water withdrawal. In hens infused with corticosterone, food consumption remained high and body weight was unchanged, although liver weight doubled. The other treatments were associated with a decline in food consumption and a loss of body weight but liver weight was unchanged. The weight of the ovary was reduced most severely in hens infused with 30 micrograms corticosterone/h, but the number of follicles weighing more than 12 mg was not altered by any of the treatments. A decrease in the number of large, yolk-filled follicles was matched by an increase in the numbers of small follicles. All treatments resulted in an increase in the number of atretic follicles. All treatments produced an elevation of plasma corticosterone concentrations within the normal physiological range, and a decrease in plasma LH concentrations. These features may constitute part of the physiological mechanism causing regression of the ovary and the cessation of egg-laying, but they do not prevent recruitment of small follicles to the stage which precedes entry into the hierarchy of large, yolky follicles. PMID- 3971195 TI - Biotin requirements of broiler breeders fed diets of different protein content and effect of insufficient biotin on the viability of progeny. AB - Production of eggs or normal chicks was depressed when practical diets containing 168 g or 137 g of crude protein (CP)/kg were not supplemented with synthetic biotin. Overall egg production and hatchability of fertile eggs was significantly (P less than 0.05) higher with the diets containing 137 g CP/kg. Biotin requirement was higher with the diet containing 168 g CP/kg and was estimated to be about 100 micrograms of available biotin/kg, equivalent to a daily intake of 16 micrograms for food-restricted hens. Biotin concentrations in egg yolk and chick plasma were related to maternal intake and increased with maternal age. The minimum yolk biotin concentration indicative of adequate maternal status was about 550 micrograms/g. Chicks from young hens fed insufficient biotin had the poorest biotin status at hatching and their growth potential and viability were reduced. PMID- 3971196 TI - Effects of an advance of darkness on the ovulatory cycle of the hen. AB - Hens maintained on 16 h light: 8 h darkness were subjected to an abrupt advance of darkness by between 4 and 13 h. When darkness was advanced so that it occurred less than 6 to 8 h after ovulation, the next expected preovulatory release of luteinising hormone (LH) and ovulation was usually delayed or blocked. This was associated with a reduction in the ability of injected ovine LH to stimulate the secretion of progesterone. When the advance meant that darkness occurred at more than 6 to 8 h after ovulation subsequent ovulations were advanced by as much as 5 h within a 3 d period. The hastening effect of an advance of darkness on follicular maturation was associated with an increased secretion of LH in response to injected progesterone. An advance of darkness by 4 or 7 h was associated with an earlier onset of the circadian increase in the secretion of corticosterone and changes in the tonic secretion of LH, notably a tendency for plasma concentrations of LH to increase during the first 4 to 5 h of advanced darkness, followed by a steep decline. PMID- 3971197 TI - Effect of the gut microflora on chick growth and utilisation of protein and energy at different concentrations of dietary protein. AB - The effect of the gut flora on chick growth and protein and energy utilisation at a marginal dietary energy level (calculated metabolisable energy value 11.7 MJ/kg) was determined with diets containing 227 or 293 g protein/kg. Germ-free (GF) and conventional (CV) chicks were reared for 10 d on the diets, and excreta were collected during the last 4 d. The chicks were killed and carcases and droppings were analysed for N and fat. The GF chicks grew significantly faster than the CV controls on both diets. The growth of CV chicks given the high protein diet was similar to that of GF chicks given the adequate protein diet. Protein and energy utilisation were significantly less for CV than for GF chicks on both diets. It was concluded that the energy requirement of CV chicks was greater than that of their GF counterparts, and that their poorer growth was due to utilisation of some dietary protein as an energy source. PMID- 3971198 TI - Multiple extractions of hormone receptors from mixed human breast tumors. AB - Multiple extractions of hormone receptors from mixed human breast tumors revealed a considerable amount of ER and PgR activity remaining in the second and third cytosol fractions extracted by the same tris buffer system (TEDG, pH 7.4, containing 10 mM tris, 1.5 mM EDTA, 2.0 mM dithiothreitol, and 10% glycerol). The incomplete and inefficient extraction of tumors with tris buffer system after only one homogenization and centrifugation is a serious concern in efforts to achieve accurate determinations of receptor concentrations which permit the accurate prediction of hormone responsiveness of breast cancers. PMID- 3971199 TI - Multiple myeloma--complete remission with high dose melphalan chemotherapy. AB - A patient with IgG3 lambda plasma cell myeloma characterized by anemia, hypercalcemia, hypoalbuminemia, renal insufficiency, osteolytic bone lesions, and serum and urinary light chains inadvertently received a dose of intravenous melphalan considerably greater than standard. A complete remission ensued characterized by normal protein and bone marrow studies. Healing of bone lesions occurred. This and two somewhat similar happenstances producing rare complete remissions in myeloma may have significant chemotherapeutic ramifications. PMID- 3971200 TI - Macrophages and tumor growth. II. Cell kinetics at the site of allogeneic tumor growth. AB - The sponge matrix allograft model made possible the growth of an AKR lymphoma in a certain percentage of BALB/c mice making progressors (tumor-bearing) and regressors (tumor-rejecting) simultaneously available. Mice bearing either an AKR kidney allograft or a sponge alone were used as controls. The cell population infiltrating the sponge was evaluated 2, 5, 10, 15, and 21 days after subcutaneous implantation. It consisted of macrophages, lymphocytes, and neutrophils. There was no difference between groups on Day 2 and Day 5. From Day 10 onwards, tumor growth was evident with a clear cut separation between progressors and regressors. The latter behaved like the two control groups except for a significant increase in lymphocytes on Day 21. The progressors showed a striking increase in total cell count from Day 10 onwards. Macrophages were the major population with a maximum value of 201 X 10(6) as compared to 8 X 10(6) in the regressors; their phagocytic and lysosomal activity remained similar in all groups. The lymphocytes showed no variation in absolute numbers but, because of the high cell count in progressors, their ratio to macrophages reached 1:50 on Day 10, making up only 2% of the cell population. Neutrophils were significantly increased in progressors as compared with the other groups. It can be concluded that in the presence of a foreign body reaction a marked influx of macrophages accompanies allogeneic tumor growth. PMID- 3971201 TI - Lymphatic delivery of monoclonal antibodies: potential for detection and treatment of lymph node metastases. PMID- 3971202 TI - The inhibitory effect of glycopyrrolate on human plasma-cholinesterase. AB - The in vitro inhibitory effect of glycopyrrolate and atropine on the hydrolysis of benzoylcholine at 50.0 microM concentration was determined in the plasma of 6 healthy volunteers at 37 degrees C and at 240 nm by the ultraviolet spectrophotometric method of Kalow. The 50 per cent inhibitory concentration (I50) of glycopyrrolate was found to be 1.0 mM and the I50 of atropine was 0.9 mM. This inhibitory effect of glycopyrrolate and atropine is moderate but its interaction with the in vivo hydrolysis of succinylcholine or that of ester-type of local anaesthetics in patients should be further studied. Although both glycopyrrolate and atropine inhibit PChE to the same extent, glycopyrrolate should be utilized in patients in whom inhibition of brain PChE or central effects ought to be avoided, since glycopyrrolate does not penetrate the blood brain barrier. PMID- 3971203 TI - Thrombocytopenia accompanying a reaction to protamine sulfate. AB - Catastrophic pulmonary vasoconstriction, an idiosyncratic reaction to protamine, occurred following cardiopulmonary bypass in a patient with mitral regurgitation. One minute following intravenous injection of 10 mg of protamine, systemic blood pressure decreased precipitously, accompanied by elevated pulmonary arterial pressure, decreased left atrial pressure, and a dilated and poorly contracting right ventricle. These changes spontaneously reversed over five minutes. Rechallenge with protamine was uneventful. Platelet count decreased from 76,000/mm3 to 12,000/mm3. Transient thrombocytopenia occurs predictably in dogs given protamine rapidly. Suggested mechanisms of idiosyncratic pulmonary vasoconstriction in patients should consider the role of the associated thrombocytopenia. PMID- 3971204 TI - Protamine induced arterial hypoxaemia: the relationship to hypoxic pulmonary vasoconstriction. AB - Protamine administration may induce arterial hypoxaemia in dogs and humans. However, the responsible mechanism has not been established. Protamine, as it is a pulmonary vasoactive substance, may interfere with normal hypoxic pulmonary vasoconstriction (HPV) and cause arterial hypoxaemia. This possibility was tested in dogs utilizing a one lung hypoxic model. One lung hypoxic ventilation decreased pulmonary blood flow in the hypoxic lung from 1022 +/- 96 ml X min-1 (mean +/- SEM) to 846 +/- 39 ml X min-1 (p less than 0.05) while increasing blood flow from 833 +/- 85 ml X min-1 to 1109 +/- 101 ml X min-1 (p less than 0.05) in the normoxic lung, resulting in 24 per cent effective diversion of blood flow. Protamine infusion, after heparinization, markedly elevated pulmonary vascular resistance in both lungs but preferentially in the normoxic lung (102 +/- 27 per cent increase in normoxic lung, 60 +/- 6.4 per cent increase in hypoxic lung) and significantly reversed the pulmonary blood flow shift induced by one lung hypoxic ventilation (effective diversion of blood flow was reduced to four per cent). Concurrently, arterial PO2 further decreased. Our results demonstrate that protamine interferes with effectiveness of pre-existing HPV and suggest that this mechanism, at least in part, may be responsible for arterial hypoxaemia observed after protamine infusion. The marked generalized pulmonary vasoconstriction with protamine appears to be the direct force that interferes with pre-existing auto regulatory HPV. In addition to the well known haemodynamic effects of protamine, protamine infusion may also cause arterial hypoxaemia in those patients in whom HPV plays a significant role in maintaining arterial oxygenation. PMID- 3971205 TI - Hepatitis due to repeated inhalation of methoxyflurane in subanaesthetic concentrations. AB - The authors present a case of hepatitis, which was due to repeated self administered inhalation of methoxyflurane in subanaesthetic concentrations for insomnia. The diagnosis of viral hepatitis, type A or type B, was excluded on the basis of serologic findings. This case is of particular interest in that methoxyflurane even in subanaesthetic concentrations caused hepatic damage on repeated exposure. PMID- 3971206 TI - Aspiration during induction of anaesthesia in patients with colon interposition. AB - The risk of aspiration during induction of anaesthesia in patients with oesophageal disease is not well defined, and controversy exists with respect to patients who have undergone pharyngeal-gastric colon interposition. Excellent gastrooesophageal competence has been documented in many of these patients, and propulsive peristalsis has been demonstrated in interposed colonic segments, suggesting that aspiration risk is low. This report, however, describes recent anaesthetic experiences in two patients with colon interpositions and shows that these patients may have markedly redundant interposed segments that retain food or other particulate residue and, thus, present a significant risk of particulate aspiration. Awake intubation may be the best approach to avoid aspiration in these patients. PMID- 3971207 TI - A new transtracheal catheter for ventilation and resuscitation. AB - We describe a new catheter for emergency ventilation of patients difficult to intubate. This catheter can be inserted through the crico-thyroid membrane or the first or second intertracheal ringspace with ease in an almost atraumatic fashion. The outside part of the device, with its dual attachment system, can be connected to conventional resuscitation equipment by its 15 mm male end or to a high-pressure oxygen source by its luer-lock fitting. A double angulation maintains the intratracheal portion of the catheter in the axis of the trachea and the external part in close contact with the larynx. A Velcro band attached to two lateral flanges keeps the catheter in place. The results of transtracheal catheterization of 48 patients by means of this new device are discussed. PMID- 3971208 TI - Cardiac arrest following administration of vancomycin. AB - A two-year-old female child status post-bilateral nephrectomies sustained a cardiac arrest following the central intravenous administration of vancomycin chloride. This report reviews the literature concerning the problems associated with the use of vancomycin chloride in the perioperative period. PMID- 3971209 TI - Anaesthesia for aortic arch aneurysm repair: experience with 17 patients. AB - Mortality and morbidity during aortic arch aneurysm repair is high despite improvements in surgical technique which attempt to assure brain protection during surgery. We successfully managed 17 patients using deep hypothermia and circulatory arrest. Anaesthesia consisted of pancuronium, fentanyl, plus isoflurane or halothane if needed. Pulmonary artery and arterial catheters were inserted. Surface cooling was performed followed by core cooling on cardiopulmonary bypass, using a heat exchanger. Total circulatory arrest was performed when esophageal temperature reached 12-14 degrees C after previous administration of thiopentone 30 mg X kg-1, methylprednisolone 2 gm, furosemide 40 mg and mannitol 25 gm. At that time the head was packed in ice and surgical correction performed. Mean arrest time was 36.5 +/- 13 minutes at a mean oesophageal temperature of 12.5 +/- 0.75 degrees C. No serious, permanent neurological deficit was found. Tracheostomy was required in five patients of whom two had chronic obstructive pulmonary disease (COPD). Two of these patients died of adult respiratory distress syndrome (ARDS) and renal failure. The reported technique is safe and can be easily used in patients undergoing aortic arch aneurysm repair. PMID- 3971210 TI - Evaluation of the jet injector in paediatric fibreoptic bronchoscopes. AB - The use of the Sanders venturi system during bronchoscopy in adults has been studied extensively. Its use in paediatric bronchoscopy has been limited because small changes in the characteristics of the system may produce large changes in the patient. With jet ventilation, peak inflation pressures and flow rates are influenced by the driving pressure, diameter and shape of the bronchoscope, the diameter of the injector and its length and angle from the axial line of the bronchoscope. Storz 3 mm, 4 mm and 5 mm rigid fibreoptic bronchoscopes were evaluated in a test lung with an injector of 1.5 mm internal diameter fixed in the side-arm at 20 degrees to the axial line. Pilling 3 mm, 4 mm and 5 mm rigid fibreoptic bronchoscopes were also examined using the standard injector with a 0.89 mm orifice in the axial line. The Storz bronchoscopes produced consistently higher peak inflation pressures and flow rates at all driving pressures in spite of the relatively large angle of the injector from the axial line. Caution is advised in the use of the Storz injector system as excessively high inflation pressures may be reached. PMID- 3971212 TI - Divers Alert Network (DAN) PMID- 3971211 TI - Anaesthetic considerations for major thermal injury. AB - Extensive thermal injury represents a major insult to body homeostasis. The anaesthetist, while providing anaesthesia for a multitude of debridement and reconstructive procedures, is also likely to assist in initial resuscitation and stabilization and subsequent intensive care management. A thorough understanding of the major systemic and end-organ effects after a major burn allow for a better appreciation of the many pertinent considerations for anaesthesia during the immediate post-burn phase as well as the later period of reconstruction and rehabilitation. PMID- 3971213 TI - Mass spectrometry in the operating room. PMID- 3971214 TI - An improved scavenger box for the cryoprobe. PMID- 3971215 TI - Respiratory depression following epidural morphine. PMID- 3971216 TI - Pelvic inflammatory disease and the general surgeon. AB - New causal agents of pelvic inflammatory disease that have recently been determined are Chlamydia trachomatis, anaerobic bacteria and penicillinase producing gonococci. It is also recognized that the pelvic infection is normally polybacterial. The symptoms produced by these organisms are so indefinite that diagnosis based on clinical findings alone is often difficult. The diagnosis of pelvic inflammatory disease should therefore be established by laparoscopy in these cases. Antibiotics capable of eradicating most pelvic infections are now available. As a result of their use, the primary therapy has become medical. The indication for surgery is, in essence, failed medical therapy. Ablative surgery should generally be delayed until adequate antibiotic therapy has been tried and found inadequate. Furthermore, the surgery should be conservative because the disease is often unilateral. Total abdominal hysterectomy and bilateral salpingo oophorectomy as a treatment for pelvic inflammatory disease should be the exception rather than the rule. PMID- 3971217 TI - Eosinophilic cystitis: pleomorphic manifestations. AB - Because eosinophilic cystitis is rare, the authors present two cases of this inflammatory condition. In one, eosinophilic ureteritis presented as ureteral obstruction; this is only the second such case to be reported. The literature on eosinophilic cystitis is reviewed. The condition affects people of all ages and its cause is unknown. The clinical presentation varies, but hematuria is a constant feature with urinary frequency and dysuria being common. Management is also variable, ranging from treatment for symptoms only to aggressive surgical therapy. PMID- 3971218 TI - Ender's nailing of hip fractures: the operation and the radiation hazards. AB - Sixty-two intertrochanteric and 3 subtrochanteric fractures of the femur were treated by Ender's nailing. The method was safe and effective in stable fractures but in unstable fractures malunion was common. Exposure of the operating team to radiation during the procedure was well within acceptable limits. PMID- 3971219 TI - Post-traumatic ischemic necrosis of the common bile duct. AB - A case of blunt injury to the extrahepatic bile ducts is reported. The injury was more likely caused by ischemia than by forces acting directly on the ducts. When disruption occurs at the time of injury, its recognition may be delayed considerably, because the leaked bile is encapsulated or remains sterile and is therefore well tolerated. When there is ischemia without disruption, as in the case presented, perforation due to necrosis may also take some time (days to weeks) to occur. In the interval, loss of appetite, nausea, vomiting, abdominal distension and jaundice may develop. Bile-stained ascitic fluid is present. PMID- 3971220 TI - Thrombosis of a prosthetic valve managed by thrombolysis: a case report. AB - Thrombosis of a prosthetic valve is one of the most serious cardiovascular events. Emergency replacement of the prosthetic valve has been the standard method of management but carries a high operative risk. This paper describes the successful use of streptokinase, given intravenously, to manage a patient with this complication in the acute phase. Eventually, operation was necessary because the presence of residual organized clot was suspected, but the procedure was performed electively 10 days later. PMID- 3971221 TI - Host-defence mechanisms in surgical patients: a correlative study of the delayed hypersensitivity skin-test response, granulocyte function and sepsis. AB - To identify associations between abnormal measurements and development of life threatening surgical sepsis, host-defence parameters were assessed in 2202 patients upon admission to hospital for operation. Measurements included the response to delayed type hypersensitivity (DTH) skin-test antigens, circulating blood-cell counts and hemoglobin levels, neutrophil adherence, chemotaxis, phagocytic and bactericidal function, and circulating serum albumin, serum globulin, serum immunoglobulin and complement levels. Sepsis was considered to be present when there was bacteremia, proven cholangitis or intracavitary abscess proven by operation or autopsy. The admission DTH response stratified patients into a reactive group (responding to two or more antigens out of five, 1373 patients), a relatively anergic group (with a response to one antigen, 306 patients) and an anergic group (with no antigen response, 523 patients). Sex, age and type of disease were similar in the three groups. There were abnormalities in neutrophil adherence, neutrophil chemotaxis, serum albumin and blood hemoglobin levels in all groups, compared with out-of-hospital controls. The reactive group had an 8% sepsis rate and a mortality of 4%, compared with 21% and 15% in the relatively anergic and 33% and 31% in the anergic groups respectively (chi 2 = 186, p less than 0.0001). The same observation was made in 1184 patients who were studied preoperatively: sepsis rates were 8%, 16% and 31% in the reactive, relatively anergic and anergic groups respectively (chi 2 = 76, p less than 0.0001) and mortality was 4%, 12% and 27% respectively (chi 2 = 99.7, p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971222 TI - Clinical implications of bacterial glycocalyx. PMID- 3971223 TI - Electron microscopic study of an infected Foley catheter. AB - A scanning and transmission electron microscopic study was made of material from the surface of a Foley catheter removed from an 87-year-old woman with antibiotic resistant bacteriuria. A thick, adherent bacterial biofilm was found. The sessile adherent bacteria were surrounded by an extensive exopolysaccharide glycocalyx that appears to be fundamental in the pathogenesis of catheter-associated urinary tract infections and their resistance to systemic antibiotic therapy. PMID- 3971224 TI - Experimental low colorectal anastomosis. AB - The authors evaluated a side-to-end colorectal anastomosis carried out by the abdominoperineal approach, in which opening of the mucosal layer of the colon, and therefore the lumen, is delayed for 4 days. This technique was compared to transabdominal end-to-end anastomosis performed as low as possible, using the circular stapler and hand-sewing with a one-layer technique. Experimental end-to end stapled and hand-sewn anastomoses were performed randomly in 24 female mongrel dogs. The operating time was similar for each group. Anastomoses were examined for leaks at 7 to 10 days digitally and by roentgenography after barium enema. At sacrifice 14 days after anastomosis, measurements were made of bursting strength and the distance of anastomoses from the anus. The degree of inflammation was evaluated histologically. There were three leaks in the hand sewn anastomoses and none in the experimental end-to-end stapled anastomoses. The mean bursting strength was similar for all three techniques. The mean distance from the anus was lowest for the experimental anastomoses. Inflammatory changes were least in the end-to-end stapled anastomoses. Two dogs in this group and one in the experimental group were incontinent postoperatively. The experimental anastomosis compares favourably to end-to-end stapled and hand-sewn anastomoses and may have some advantages for low anastomosis in man. PMID- 3971225 TI - Rectal prolapse in scleroderma: case report and review of the colonic complications of scleroderma. AB - Scleroderma of the colon is commonly associated with constipation, as was the case in a 70-year-old woman with rectal prolapse described by the authors. The chronic constipation in this patient may have been the cause of her rectal prolapse, but the onset of the prolapse and scleroderma at about the same time suggest that the scleroderma may have been a causative factor. A Ripstein repair of the prolapse was carried out. The authors discuss some of the complications of colonic scleroderma, which include megacolon, transverse and sigmoid colonic volvulus, telangiectasia, stenosis and diverticula and stercoral ulceration. PMID- 3971226 TI - Traumatic rupture of the tracheobronchial tree. AB - Rupture of the trachea and major bronchi usually results from blunt trauma to the chest. To define the characteristics of the condition, the mechanism of injury, presentation and hospital course, the authors reviewed seven cases of tracheobronchial rupture after blunt trauma. Four were injured in a motor vehicle accident, two had a crush injury and one child had a fall from a playground swing. The site of injury was the left main bronchus in three, membranous trachea in two and bilateral bronchi and bronchus intermedius in one patient each. Bronchoplastic repair was performed in four patients with salvage of lung tissue in three. One patient required pulmonary resection. Two patients with a laceration of the membranous trachea did not undergo operation. Two patients died secondary to associated head injuries; one patient underwent repair of the bronchus intermedius and one patient had a lacerated membranous trachea. The possible mechanisms of injury are: rapid deceleration with forward swing of the trachea, widening of the transverse diameter of the chest, exerting traction on the carina, and a rapid rise of airway pressure on impact. Surgical intervention is recommended at an early stage to avoid loss of lung tissue. PMID- 3971227 TI - State of the art. PMID- 3971228 TI - Fingertip amputation: review of 100 digits. AB - Evaluation of the functional results and complications of 100 fingertip amputations revealed no difference between the two most commonly used repairs; 52 injuries were treated by primary closure with residual viable skin flaps and 27 by split-thickness skin grafting. No decline in unfavourable functional results was found when patients evaluated 6 weeks after injury were compared to patients evaluated 42 weeks after injury, suggesting that delaying the patient's return to full activity by prolonging rehabilitation is unlikely to yield much improvement. Shortening the nerves in proximal amputations closed by residual flaps did not decrease nerve irritation. Resection of bone produced a mobile amputation-stump tip. While the mean time off work or return to full activity following skin grafting was 6 days less than it was after primary closure, the difference was not significant. PMID- 3971229 TI - Head injuries: a prospective, computerized study. AB - A prospective study of 3000 consecutive patients with head injury admitted to hospital showed a marked seasonal, daily and hourly variation and an overall male to-female ratio of 2.19:1. The majority of patients were in the second, third and fourth decades of life with a peak in the early part of the second decade. The incidence was highest in unemployed and welfare recipients. Traffic accidents were the leading cause followed by fights and falls. Drug or alcohol use, or both, was evident in 45.6% of cases. The number of head injuries caused by intoxicated individuals is not known. Most patients had a concussion only. There was no evidence that the patients with concussion who returned to full activity immediately had any more adverse effects than those advised to "take it easy" for about 1 week. PMID- 3971230 TI - Undergraduate education in surgery: a challenge. PMID- 3971231 TI - Surgical management of hydatid disease of the liver. PMID- 3971232 TI - Thrombosis of the ulnar artery. PMID- 3971233 TI - Ovarian cancer. AB - The behaviour of epithelial cancer of the ovary differs from that of other epithelial tumours that the general surgeon normally contends with for the following reasons: first, it often responds well to incomplete surgery as it is frequently sensitive to chemotherapy and, second, its method of spread is unique. Proper treatment of this lesion must take these characteristics into account. Immediate therapy is excision of the tumour mass and its principal metastases. This normally includes removing the uterus and its adnexae plus the omentum. Only when the remaining tumour masses are small will postoperative chemotherapy be effective. Moreover, the chemotherapy can only be given rationally if the extent of dissemination of the disease is carefully defined. The spread of this malignant tumour is most often by way of free-floating cells in the peritoneal cavity. The tumour cells subsequently deposit in "watersheds" throughout the peritoneal cavity and accumulate on the undersurface of the diaphragm and in the omentum. Staging, which describes this process and its variations, is therefore of great importance and is described in this paper in detail. PMID- 3971234 TI - Mitral valve replacement with Hancock porcine bioprostheses: up to 7-year follow up. AB - From February 1976 to May 1981 at the University of Ottawa Heart Institute, 137 mitral valves were replaced with the Hancock porcine bioprosthesis. This study concerns 111 patients (55 men, 56 women) who had single-valve replacement. The average age of the patients was 53.0 years. The predominant lesion in the 102 patients who were receiving their first substitute valve was stenosis in 46% and regurgitation in 42%. Preoperatively, 82% were New York Heart Association (NYHA) class III or IV. Additional procedures were performed in 44 patients (39.6%). The 26 patients who had multiple valves replaced were considered only for durability studies. Hospital mortality was 8.9% for isolated replacement and 22% for replacement associated with aortocoronary bypass grafting. At the time of discharge, 50% of patients were in atrial fibrillation, 14% were taking warfarin and 82% antiplatelet agents. Follow-up was available for a total of 374 patient years (average of 5.4 years per patient). The mean symptomatic improvement was 1.6 NYHA classes per patient. Actuarial analysis indicated a survival rate of 70% at 8 years. Of the 18 late deaths, 4 (22%) were valve-related. The rates of endocarditis and thromboembolism were 1.1% and 5.8% patient-year respectively. In the 137 prostheses at risk, intrinsic failure occurred at the rate of 4.7% patient-year for a cumulative rate of 35% at 8 years. The authors conclude that the Hancock porcine bioprosthesis provides good relief of symptoms in the mitral position with an acceptable rate of thromboembolism even without anticoagulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971236 TI - Transabdominal total fundoplication gastroplasty to control reflux: a preliminary report. AB - Transthoracic total fundoplication gastroplasty has been reported as having a low mortality and a 1.1% recurrence rate and to produce excellent results in 93.1% of patients, moderate results in 3.7% and poor results in only 2.8% of patients. In approximately 7.0% intercostal neuritis is a serious residual problem. The transabdominal total fundoplication gastroplasty uses the identical repair technique but avoids the chest-wall pain. Previous esophageal or gastric surgery and major esophageal shortening are contraindications to an abdominal approach. The authors report their results with 50 patients who underwent transabdominal total fundoplication gastroplasty and were followed up for 6 to 20 months. There was no mortality or major morbidity. Clinical follow-up was complete, 94% of patients were assessed by roentgenography and 72% by manometry. None had anatomic recurrence, 46 (92%) were asymptomatic and 4 (8%) had minor residual gastric symptoms of fullness or occasional epigastric pain. All were much improved and none had wound pain. Long-term follow-up of transabdominal total fundoplication gastroplasty is necessary; however, since the technique of repair is identical to the thoracic approach, the results should be similar. PMID- 3971235 TI - Preventing superficial phlebitis during infusion of crystalloid solutions in surgical patients. AB - Thirty patients who received routine intravenous therapy (3.3% dextrose and 0.3% normal saline at a rate of 100 mL/h) were randomized prospectively into two groups to receive an antiphlebitic mixture of heparin-hydrocortisone-sodium bicarbonate or placebo in a double-blinded fashion for 4 to 7 days. The code was then broken and the data were analysed using chi 2 analysis with respect to the clinical grade and incidence of phlebitis. Phlebitis developed in 2 of 14 study and 10 of 16 control patients. All study patients tolerated their intravenous lines longer and needed less restarting. The antiphlebitic mixture effectively prevented superficial infusion phlebitis in patients receiving dextrose-saline solutions. PMID- 3971237 TI - Congenital cervical salivary fistula. AB - A study of 35 lesions diagnosed as branchial cleft sinuses or fistulas identified a homogeneous subgroup characterized by ectopic salivary tissue, draining serous or mucoid fluid through a short sinus tract to the base of the neck anteriorly. These lesions should more properly be called congenital cervical salivary fistulas, since they may not arise from the branchial apparatus but rather from the embryonic placodal duct. PMID- 3971238 TI - Necrotizing enterocolitis: a chronic colonic disease. AB - While acute necrotizing enterocolitis is a common neonatal condition, the chronicity of the pathologic process is often overlooked. Between 1979 and 1983 at the Foothills Hospital in Calgary, a diagnosis of acute necrotizing enterocolitis was made in 211 infants. Seventeen infants (8%) required urgent surgical treatment in addition to standard medical management. Overall, 206 (98%) infants survived the acute episode. Long-term survival was 92% (194 children). The 12 late deaths were ascribed to chronic cardiovascular, pulmonary and cerebral diseases and "short gut syndrome". Colonic strictures developed in 9% of those treated medically; strictures distal to the mucous fistula developed in 50% of those requiring urgent resection and exteriorization. None of the strictures, which formed between 14 days and 18 months after the diagnosis was made, resolved spontaneously. They tended to be multiple and to involve longer segments in infants who required surgery. Diarrhea prolonged the morbidity in these children. The time course and varied presentation of strictures in this series suggests a rationale for management of infants who survive acute necrotizing enterocolitis. PMID- 3971239 TI - Delay in diagnosing gastrointestinal injury after blunt abdominal trauma in children. AB - Intestinal perforation after blunt abdominal trauma in children is rare and thus the diagnosis may be delayed. For this reason the authors reviewed their experience with 12 children to recommend a protocol for investigation that would reduce the delay in diagnosis. Of the 12 perforations, 2 were gastric, 2 duodenal, 7 jejunal and 1 colonic. The diagnosis of jejunal perforation, in particular, was usually delayed because free air was not seen radiologically in the first few hours after injury. This may be because of delayed rupture or spasm of the injured intestine. Serial films were valuable in aiding the diagnosis and are recommended, together with assessment of solid organ injury by radionuclide scanning. In this series peritoneal lavage was not used. No child died. PMID- 3971240 TI - Catheterization of the umbilical artery in neonates: surgical implications. AB - Catheterization of the umbilical artery is a common procedure in neonatal intensive care units. The authors studied the records of 100 consecutive newborns who underwent this procedure to review the indications for and complications of umbilical artery catheterization and to discuss preventive measures and alternative techniques. Only polyvinylchloride barium-impregnated catheters were used (nos. 3.5 and 5.0 French). The commonest indications were respiratory distress syndrome, asphyxia and congenital heart disease. Of the 100 infants, 75 weighed less than 2500 g. Ampicillin and calcium were the commonest medications infused (70 and 65 babies respectively). There were three major complications, two of which were gangrene of the lower extremity. Amputation of the foot was necessary in one and amputation of the toes in the other. The third complication was the development of gluteal necrosis. In all three cases, catheter placement was low and the infusion was ampicillin. In two of the babies, calcium was also administered. Minor complications were seen in 32 cases, with vascular spasm in the lower limb being the most common. All catheter tips were cultured; there was bacterial colonization in 13%, Staphylococcus epidermidis being the commonest organism. Proven necrotizing enterocolitis was seen in eight infants and was suspected in eight others. Blanching is a serious sign and was seen in the three infants with major complications. The infusion should be stopped immediately. When necrotizing enterocolitis is suspected, the catheter should be removed. PMID- 3971241 TI - Spinal cord injury in the work force. AB - Of 144 patients with spinal cord injury admitted to the Sunnybrook Medical Centre from 1974 to 1979, 25 (24 men) (17.4%) had sustained their injuries at work. The 25 patients ranged in age from 20 to 56 years, with more than half being in their third decade of life. Work-related spinal cord injury was more frequent in the thoracic region than spinal injuries from other causes. The injuries were generally severe, 24% of them being complete cord injuries (i.e., no sensory or motor function below the level of injury). The mean neurologic grade of these patients did not change substantially between the time of admission and discharge. The mortality was 8%. The pattern of spinal cord injury in this series was compared to that in the period 1948 to 1973, when 105 (29.3%) of 358 spinal cord injuries occurred at work, constituting the second most frequent cause of acute spinal cord injury, after traffic accidents. In the current series, only 17.4% sustained their injuries at work. This was the third most common cause of spinal injuries in this period after traffic accidents and sports-recreational injuries. Falls in industry were the most frequent mode of work injury from 1974 to 1979, compared with construction accidents in the earlier period. The number of work-related spinal cord injuries is still too high. Furthermore, the severe neurologic damage suffered and the lack of substantial improvement emphasize the importance of preventive efforts, especially in industry. The fact that work injuries now rank third as a relative cause of spinal injury may indicate an absolute decline in this type of injury, especially among construction workers. PMID- 3971242 TI - Surgical management of hydatid disease of the liver. AB - The authors review 143 consecutive, surgically treated cases of hydatid disease of the liver seen over the past 10 years. Of the 208 cysts found, 82 (39.4%) were complicated; the remainder were simple. The complications included rupture into the biliary system (16.3%), suppuration (11.0%), partial calcification of the pericyst (5.8%), intraperitoneal rupture (4.8%), bronchobiliary fistula (0.9%) and cystocutaneous fistula (0.5%). External capitonnage was the most commonly used surgical technique (63.0%), followed by cystectomy (17.8%), omentoplasty (10.6%), tube drainage (7.7%) and cystojejunostomy (0.9%). Capitonnage was carried out with or without tube drainage. The complications of surgery were higher with drainage than without. The main complications of surgery were infection in the residual cavity and biliary fistula. The patients who underwent external capitonnage without drainage or omentoplasty had good results with minimal complication rates (3.5% and 4.5% respectively). For the patients in whom the cystectomy was established, the complication rate was 8.1%. PMID- 3971243 TI - The Angelchik antireflux prosthesis. AB - A silicone collar containing circumferential tape was tied around the cardio esophageal junction in eight patients with symptomatic, refractory reflux, who were not good candidates for a standard antireflux procedure. A fine polypropylene tie or clip secured the knot. In two patients with large hiatal defects, the crura were approximated loosely. Mean operating time, including one cholecystectomy and one ventral hernia repair, was 51 minutes. Patients who underwent this simple operation had a combination of hypertension, heart disease, obesity and old age, and two had undergone horizontal gastroplasty previously for morbid obesity. The reflux was associated with hiatal hernia in seven of the eight patients. Preoperative studies included barium swallow roentgenography in all eight patients, and endoscopy, manometry and Bernstein test in six. All the studies were repeated postoperatively. Follow-up ranged from 17 to 48 months (mean 37.8 +/- 10.6 months). Postoperatively, there was a significant (p less than 0.01) improvement in symptoms, endoscopic findings and lower esophageal sphincter pressures. No prosthesis has migrated yet. PMID- 3971244 TI - Fournier's gangrene. AB - Fournier's disease--gangrene of the penis and scrotum--is an uncommon condition. During the past 6 years, five patients, whose cases are described, were admitted to Toronto General Hospital with this diagnosis. Four had preceding trauma (ischiorectal abscess, puncture wound, surgery) and four had pre-existing debilitating problems (diabetes, rectal carcinoma, acute lymphocytic leukemia, alcoholic cirrhosis). Appropriate treatment must include urgent radical surgery to remove all necrotic tissue, and combination antibiotic therapy directed against the likely organisms, which are aerobic gram-negative rods, gram-positive cocci and anaerobes. Clindamycin in combination with tobramycin or gentamicin proved to be effective in this series. PMID- 3971245 TI - Scientific editorials--a precious and scarce element in medical journals. PMID- 3971246 TI - Ascorbic acid and kidney stones. PMID- 3971247 TI - Treatment of enuresis. PMID- 3971248 TI - More comprehensive institutional geriatric services. PMID- 3971249 TI - Dialyser reuse: a study in applied medical ethics. AB - A dialysis unit's introduction of automated recycling of dialysers is described. The responses of the staff and the patients are outlined, along with the pertinent ethical issues. Suggestions regarding the educational processes necessary with any innovation in long-term medical care are discussed. PMID- 3971250 TI - Why treat doctors like pushers? AB - Harsher laws and enforcement procedures are making Canadian physicians more vulnerable to conviction as drug traffickers. The authors question this development on the grounds that it extends a drug prohibition policy that has failed in the past and has incurred intolerable social costs. To help envision an alternative, the authors discuss conflicting claims about the British tradition of permitting doctors to prescribe narcotics to addicts. They conclude that, with some restrictions, allowing Canadian doctors to prescribe narcotics according to their judgements of patient needs would be more efficacious than increasing the penalties they face for violating nonmedical norms. PMID- 3971251 TI - A survey of postgraduate training for family practice. AB - The results of a survey of Canadian primary care physicians for the Canadian Medical Association (CMA's) Task Force on Education for the Provision of Primary Care Services are reported. Recent Canadian medical school graduates in primary care practice reported that the three major training routes (rotating and mixed internships and family medicine residencies) each prepared them differently for practice. The graduates of 2-year family medicine residencies were more satisfied with their preparation than were the graduates of the other major training routes. A 2- or 3-year family medicine residency was preferred by 50% of the respondents, although only 33% of them had actually taken one of these routes. There was considerable agreement in the respondents' assessments of the types of postgraduate education needed for primary care practice. The results of this survey were consistent with the recommendations in the final report of the CMA's task force. PMID- 3971252 TI - Radiation oncology in Canada: the increasing manpower crisis. AB - Cancer has been the second most common cause of death in Canada for decades, and its nonsurgical management has largely been carried out by radiation oncologists for many years. Most of these specialists are not Canadian medical graduates, and the supply of suitably trained radiation oncologists is steadily diminishing in relation to the increasing numbers of patients referred to regional cancer centres. Consequently, the workload of each radiation oncologist has steadily increased to a level well beyond that recommended internationally, and it is still increasing. Unless more Canadian graduates can be attracted into the field, and unless more staff positions can be created in virtually all Canadian regional cancer centres, the high quality of patient care, teaching and research offered by radiation oncologists will suffer irreparably and will probably never recover to its former internationally recognized level. In this paper the author recommends ways in which to increase the number of radiation oncologists, though to be effective they will require the collaboration of provincial governments, medical schools, provincial cancer foundations and the medical profession. PMID- 3971253 TI - Influenza vaccination in the elderly: 1. Determinants of acceptance. AB - In the autumn of 1982 routine annual influenza vaccination was offered, by reminder letters and follow-up telephone calls, to 273 independent elderly individuals registered at a community health clinic in Hamilton, Ont. The demographic and geographic characteristics and the health beliefs of those who either accepted or did not accept the vaccine were compared. Among those who received reminder letters there were no significant differences in the rates of vaccine acceptance according to age, sex, household composition or ease of access to the clinic. The patients who reported having previously experienced side effects from the vaccine and perceived a lack of efficacy of the vaccine were more likely not to accept it this time. Both a lack of effort by health care providers (to promote vaccination) and patient behaviour appeared to contribute to pre-existing low levels of influenza vaccination coverage. Although physicians' efforts to inform patients about the vaccination clinics resulted in a tripling of the overall rate of acceptance of the vaccine, there remained a "hard core" of almost half the patients who were unwilling to receive the vaccine, apparently because they perceived its risks to outweigh its benefits. PMID- 3971254 TI - Allergic contact dermatitis due to a herbicide (barban). AB - Canadian farmers are using increasing amounts of herbicides. Often they do not use adequate skin protection. Two cases of severe allergic contact dermatitis due to the herbicide barban are described. Patch testing with various substances, including barban, confirmed the diagnosis. Sensitization studies in guinea pigs and in one of the authors showed that barban is a potent sensitizer. It is recommended that if skin contact with barban occurs the skin be washed immediately with soap and water. PMID- 3971256 TI - Professional courtesy: my colleagues will no longer be my brothers. PMID- 3971255 TI - Neurotoxic effects during vidarabine therapy for herpes zoster. AB - Two cases of neurotoxic effects resulting from therapy with vidarabine are described. Both patients were undergoing treatment for cutaneously disseminated herpes zoster complicating therapy for solid malignant tumours. Both had normal renal function. The serum levels of hepatic enzymes were normal in one patient and slightly elevated in the other. Neurotoxicity was first manifested in both patients by the development of intention tremors that progressed to gross tremors. Obtundation, coma and death ensued in one patient and pain syndromes in the other. Vidarabine-induced neurotoxic effects, which may occur in the absence of hepatic or renal dysfunction or treatment with another drug, may be mild initially but may progress rapidly to more serious, even life-threatening, conditions. Presentation of neurotoxic effects should be considered an indication for withdrawal of vidarabine. PMID- 3971257 TI - Doctors and health insurance: the British experience. PMID- 3971258 TI - Mall medicine--convenient, but what about quality of care? PMID- 3971259 TI - Allocating health care resources: a moral dilemna. PMID- 3971260 TI - Dr. Lucid's word rounds: putting in a good word for some good words. PMID- 3971262 TI - More on excipients and additives. PMID- 3971261 TI - Moderate drinking: an alternative treatment goal. PMID- 3971263 TI - Good laboratory practice before blood transfusion. PMID- 3971264 TI - Familial diabetes insipidus. PMID- 3971265 TI - The physician online. PMID- 3971266 TI - Tuberculous otitis media: an old disease revisited. PMID- 3971267 TI - The balance between research and medical education depends on scholarship. PMID- 3971268 TI - Influenza vaccination in the elderly: 2. The economics of sending reminder letters. AB - Reminder letters and follow-up telephone calls were used to increase influenza vaccination acceptance by 273 well elderly registered at an urban community health centre. The net effect of the reminder letters was to increase overall coverage to 43%, from 17% in the previous year. Follow-up telephone calls to patients who had not responded to the letters increased coverage to only 55%. Calculation of costs per additional vaccination given revealed that the use of reminder letters alone was much more cost-effective than follow-up telephone calls in increasing coverage. However, with the current fee-for-service reimbursement by medical care insurance in Ontario, neither means of improving vaccination coverage would result in net practice earnings. The implications for an effective and efficient annual influenza program in Canada are discussed. PMID- 3971269 TI - Acid neutralization capacity of Canadian antacid formulations. AB - A study was designed to determine the acid neutralization capacities (ANCs) of the new Canadian antacid formulations and to compare these products with standard antacid products in terms of lot-to-lot consistency, ANC, sodium and "calorie" contents, and price to the pharmacist. Twenty-three liquid and 18 tablet antacids were tested. The concentrated liquid antacids (Mylanta-2 Extra Strength, Amphojel 500, Gelusil Extra Strength, Maalox TC and Diovol Ex) were found to have the highest ANCs. Six of the tablet antacids (Amphojel, Amphojel Plus, Camalox, Gelusil-400, Maalox and Mylanta-2) were found to have greater ANCs than 15 of the liquid antacids. Between-lot variation exceeded that of within-lot variation in 10 of the 14 liquid antacids for which this variation could be tested. The concentrated liquid antacids provide the highest ANCs with the lowest dosage volume and sodium and calorie contents. Some tablet antacids have the potential to be used as alternatives to liquid antacids because of their high ANC and patient convenience. The inclusion of ANC on the labels of antacid products would assist in the rational determination of the dose of these products. PMID- 3971270 TI - Esophageal duplication cyst containing a foreign body. AB - About 10% to 15% of all duplication cysts in the alimentary tract are esophageal. Esophageal duplication cysts are intimately attached to the alimentary tract, are lined by mucous membrane and have smooth muscle. This paper describes a 2-year old child who presented with symptoms of progressive respiratory distress. A diagnosis of esophageal duplication cyst was made. At surgery a low cervical incision was made and the sternal manubrium split, thereby providing adequate exposure. The cyst was then removed. The most useful investigations were chest roentgenography and barium esophagography. Computerized tomography showed a small, round foreign body in the middle of the cyst that was subsequently found to be a bingo chip. Communication between the cyst and the esophagus was not obvious at the time of surgery and had not been demonstrated by barium esophagography. When complete excision of the cyst is not possible because of inflammatory reaction all the mucosa must be removed to prevent recurrence. Careful postoperative respiratory support and broad-spectrum antibiotic therapy are recommended. PMID- 3971271 TI - Lung cancer following therapy for Hodgkin's disease. AB - We describe a patient in whom lung cancer developed several years after he had received combined-modality therapy for Hodgkin's disease. The literature concerning second malignant diseases, particularly thoracic tumours, that occur following combined-modality therapy for cancer is reviewed. It is important to recognize these entities, because chest symptoms or findings on x-ray films may be misinterpreted as representing late recrudescence of the first neoplastic disease. PMID- 3971272 TI - Measles in Canada--update. PMID- 3971273 TI - Family violence: guidelines for recognition and management. AB - Chronic and intermittent abuse of one family member by another is common. Victims may be children who are sexually or physically abused, wives or live-in partners, or older relatives. Physicians are often the first points of contact for patients who have been abused, but the abuse is frequently concealed by the victims. Physicians should be alert to signs of battering such as bruises in various stages of healing, unusual behaviour in children and interpersonal difficulties in the family. There are a number of options in prevention and treatment, including referral to social service and legal authorities, calling on other resources in the family and helping the individual develop coping skills. This review also lists a large number of social agencies in Canada that are willing to help victims of abuse. PMID- 3971274 TI - The use of animals in research. PMID- 3971276 TI - Residential treatment of adolescents: a treatment model. AB - This paper outlines a residential treatment model for adolescents. An essential component of this model is its emphasis on rehabilitation. Thus, community involvement and, therefore, treatment within the community is a cornerstone of patient management. The model is currently operating with emotionally disturbed adolescents, some with concurrent chronic medical disabilities. Research protocol, evaluating its effectiveness, is in place and will be documented in a future paper. PMID- 3971275 TI - Mental illness and the media: an assessment of attitudes and communication. AB - Media coverage of psychiatric issues will reflect or influence public perceptions of the mentally ill. In order to explore the relationship between psychiatry and the media, an attitudinal questionnaire was administered to a systematic sample of 20 reporters, 20 psychiatrists, 20 medical outpatients with no psychiatric history, and 40 psychiatric inpatients. In addition, 4 psychiatric patients who had personal experience with media coverage were interviewed to determine the impact. Their stories are presented as clinical vignettes. The results of the questionnaire survey show that media reporters are no less accepting of mental illness than the other groups. A regression analysis of attitudinal predictors elicit education as more significant than age and media exposure. Yet low scores for the coverage by the media of mental illness were given by all groups with psychiatrists tending to be most critical. Reasons offered by reporters included "sensationalism sells" along with cost and time factors. Recommendations for both reporters and psychiatrists groups were collated, aiming at improving communication and ensuring a more positive emphasis and greater accuracy of media coverage of mental health issues. PMID- 3971277 TI - An assessment approach to couples with sexual problems. AB - We have described the assessment approach to couples with sexual complaints used in the McMaster Human Sexuality Clinic. Our approach takes into account a number of individual factors including intrapersonal and biological ones as well as issues of sexual socialization, gender role socialization and sexual orientation. Couple factors include relationship factors as well as factors dealing with sexual behaviours, attitudes and responses. In our view, the issues of sexual socialization and gender role socialization needs special emphasis in assessing such couples. We stress as well that the dichotomy between organic and functional is a misleading one and that for each individual and couple, any biological factors and the many supra-biological factors listed above, must be prioritized in terms of their role in symptom production. Such a priority list can then be used to map out treatment strategies. PMID- 3971278 TI - Psychophysiological responses to masked auditory stimuli. AB - Psychophysiological responses to masked auditory verbal stimuli of increasing intensities were studied in twenty healthy women. Two experimental sessions corresponding to two stimulation contents (neutral or emotional) were conducted. At each session, two different sets of instructions (attending or not attending to stimuli) were used successively. Verbal stimuli, masked by a 40-dB white noise, were presented to the subject at increasing intensities by increments of 5 dB starting at 0 dB. At each increment, frontal EMG, skin conductance and heart rate were recorded. The data were submitted to analyses of variance and covariance. Psychophysiological responses to stimuli below the thresholds of identification and detection were observed. The instruction not to attend the stimuli modified the patterns of physiological responses. The effect of the affective content of the stimuli on responses was stronger when not attending. The results show the possibility of psychophysiological responses to masked auditory stimuli and suggests that psychophysiological parameters can constitute objective and useful measures for research in auditory subliminal perception. PMID- 3971279 TI - Combining motherhood with psychiatric training and practice. AB - Psychiatric residency or practice is difficult to combine with motherhood. The experiences of 82 women psychiatrists surveyed in the last year (47 residents and 35 staff doctors) are reviewed in a number of related areas--the difficulties of pregnancy, maternity leave, child rearing and the conflicts between motherhood and practicing psychiatry. Part-time residency is explored from both the resident's and hospital's perspective. Suggestions to make practice or residency more compatible with child rearing are discussed. Other issues such as work-based day care, realistic tax credit for child care expenses, and the difficulties of obtaining reliable and good home help and child care are reviewed. There are numerous conflicts for women psychiatrists who work while their children are young and these problems need to be acknowledged and addressed by the profession. It is noteworthy that as well as a supportive spouse and good child care, the attitudes of colleagues and supervisors and the need for good role models were frequently cited as being critical to the success of combining a psychiatric career with motherhood. As more women enter the profession (approximately 50% of psychiatric residents in Canada are now female, and more than 50% of them plan to combine children with their profession at some stage of their career) the need to find creative and workable solutions to these problems becomes more pressing. PMID- 3971280 TI - A community-centered alcoholism assessment/treatment service: a descriptive study. AB - This paper describes socio-demographic, alcohol-related, legal, medical, behavioural and treatment characteristics of 407 patients with problems of alcoholism/drug abuse assessed over a period of three years in a community oriented assessment and treatment program. The results show that patients entering this program represent a cross section of alcoholics in the area. These patients are similar to those entering traditional outpatient and residential facilities on most demographic variables; severity of alcoholism, length of history, and previous treatment experience. However, they are slightly younger and differ significantly from the others on their sources of referral. Over the three year period a significant change has occurred in the relationship between the program and the sources of referral. The implications of these findings for planning comprehensive treatment services for alcoholism are discussed. PMID- 3971281 TI - Dear Brutus: dealing with unresponsiveness through supervision. AB - Psychotherapists often demonstrate unresponsiveness as a result of the influence of the psychotherapy subculture. Psychiatric residents and teachers in examining themselves may find this tendency which can be countered through psychotherapy supervision. The supervisor can help the resident to be more responsive by discussing the prevalence and dangers of unresponsiveness, and by showing example. The supervisor should make appropriate references to his own work as well as to some life experiences. Residents with a variety of backgrounds and interests in psychiatry, and teachers with varied experiences and eclectic orientations are less likely to encourage unresponsiveness than those with a predominating interest in psychotherapy alone. Teaching and supervision can encourage the developing psychotherapist toward a natural and appropriately responsive therapeutic style. PMID- 3971282 TI - Recovery and regression in concentration camp survivors: a psychodynamic re evaluation. AB - This paper focuses on the adaptive capacity of survivors, and, by reframing the psychodynamics of the "survivor syndrome", employing Object Relations theory and Self Psychology, attempts to shed light on the recovery process and the subsequent regressive responses in later life. Historically, an understanding of the survivor syndrome was impeded by the severity and uniqueness of the trauma. Survivors demonstrated symptoms that were not always congruent with the established diagnosis "traumatic neurosis", and conventional psychoanalytic psychotherapy which aimed at lifting the repression of the persecution often failed. Despite reports of "late" physiologic sequelae, recent work has focused on the survivor's capacity to recover. Survival during the persecution entailed maintaining perceptual defences, maintaining an attachment to the world and the objects in it, and despite the fragmenting effect of these two sets of mechanisms, maintaining an integrated sense of self. Three clinical vignettes are presented to demonstrate that during the recovery process a degree of reversal of the survival mechanisms was necessary. This required taking into oneself or acknowledging the anger evoked by the persecution, which, associated with the fragmenting effect of the persecution on the sense of self, often resulted in guilt and self-loathing, and affected the vicissitudes of the survivor's personal story. Often the self-selfobject function required bolstering by particular relationships. The triggers for later regression responses in survivors are events that evoke rage or serve as a symbolic bridge to memories of the persecution, and life changes that generate altered relationships that had served a self-selfobject function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971283 TI - [Right to refuse treatment by the involuntary patient: medico-legal considerations]. AB - Forensic topics are discussed in relation to the right to refuse treatment among involuntary hospitalized patients. A clinical case is reported emphasizing the medical and legal dilemmas which the psychiatrist has to cope with. Different legal procedures are examined and their deficiencies discussed; the right to refuse treatment is discussed with reference to recent cases heard in the U.S., The Charter of Rights of the Canadian Constitution 1981 and the "Charte des droits de la personne du Quebec". The recommended solution in cases of treatment refusal among involuntary patients centers on the judiciary determination of incompetency of such patients. PMID- 3971284 TI - Psychiatric interviewing and clinical skills. AB - Does the ability of medical students to assess and relate to their patients through the psychiatric interview reflect in traditional academic achievement scores? A previous publication by our group offers data suggesting that certain personality traits of final year medical students have a fundamental importance in determining a successful performance on a psychiatry rotation. As the literature is vague and contradictory about the relationship between the psychiatric interview and clinical performance, a study was developed to determine what outcome variables are associated with the performance of clinical clerks on the Psychiatric Interview. An attempt was made to develop and test a new scale designed to measure the Psychiatric Interview. The Psychiatric Interview Scale was used to measure performance on 33 final year medical students on a 1 month psychiatry rotation at a University of Toronto teaching hospital, and subsequently, as a basis for analysis and training of these students in interviewing. Inter-rater reliability of the Psychiatric Interview Scale was rho = 0.72 and internal reliability was 0.74. Psychiatric Interview Scores were compared with other achievement scores, and with patients' ratings of the students interviews. A significant correlation emerged between the Psychiatric interview scores and final clinical examinations, but surprisingly, there was no relationship between the patients' evaluation of the Psychiatric Interview and the raters' evaluations and a strongly significant negative correlation between patients' ratings and clinical scores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971285 TI - First-cousin marriages and psychiatric morbidity. AB - In a study of first-cousin marriages among the parents of a group of randomly selected schizophrenic and affective disorder patients, there was a significant number of such marriages in the schizophrenic group. PMID- 3971286 TI - Conversion mutism: case report and discussion. AB - Conversion mutism is an uncommon disorder that was in the past most frequently reported during wartime. Other than during wartime, young women are the most commonly affected and usually present shortly after a traumatic event. Both psychodynamic and behavioral elements are important etiologically and, thus the treatment should include both psychodynamic and behavioral methods. The patient described in this paper had underlying fears relating to sexual assault as well as behaviorally reinforced perpetuation of her symptom. She regained her speech after four weeks of combined psychodynamic and behavioral therapy. PMID- 3971287 TI - The privileges and the responsibilities of a surgical oncologist. AB - A surgical oncologist should teach at the undergraduate or postgraduate level, play a leadership role in oncology in either the community hospital or in an academic institution, encourage or participate in basic or clinical oncologic research, and foster interdisciplinary cooperation with the other oncologic specialists. The surgical oncologist should take an active role in educating the general surgical community through programs of the American College of Surgeons Commission on Cancer. Professional recognition of Surgical Oncology should be secured through the examination of surgical oncologists. The privilege of being a surgical oncologist carries with it the responsibility of recognition, certification, increased research effort and team involvement for optimal cancer care. PMID- 3971288 TI - James Ewing lecture. The process of metastasis. AB - Carcinoma begins in the epithelium, and after penetrating the basement membrane, either compresses or destroys surrounding normal cells. Small numbers of tumor cells detach from this invading tumor mass to float as tumor emboli in the interstitial compartment. These tumor emboli may travel for considerable distance in the interstitial compartment and may remain dormant in that location for long periods of time, until some event such as the ingrowth of blood vessels permits the cells to grow and divide. Some of the tumor emboli floating in the interstitial fluid will be washed through clefts in the small lymphatic capillaries to be carried along in the lymph stream to the regional lymph nodes or the vascular system. Lymphatic venous anastomoses throughout the body permit systemic dissemination of the cancer cells without passing through the lymph nodes, and tumor emboli return through the arterial capillaries to the interstitial compartment. The swifter the current, the less likely the pathologist is to observe tumor cells on random sections. A demonstration on microscopic slides of tumor cells in the larger lymphatics or the veins is a measure of the quantity of cells being disseminated rather than a demonstration of the qualitative factor of aggressive behavior. PMID- 3971289 TI - Prognosis of level V malignant melanoma. AB - Level V melanomas have been reported to have a poor prognosis, but in-depth analyses of prognostic factors and treatment have not been reported. From 1952 through 1982, 41 patients presented with primary Clark's Level V melanomas. There were 23 patients who presented with clinical Stage I disease and 18 with Stage II. Among Stage I patients, 9 were treated by wide excision alone and 13 underwent wide excision plus prophylactic regional lymph node dissection (RLND); 8 of 13 patients had histologically positive nodes. Twelve Stage II patients were treated by wide excision and RLND (including three hemipelvectomies), and four refused surgery. The 5-year survival was 52%. For Stage I patients, survival was 62% and disease-free survival (DFS) 28% at 5 years; 6 of 10 recurrences were local or regional only. Prophylactic RLND reduced the incidence of recurrence but did not appear to influence survival rates. Among 14 evaluable Stage II patients, overall survival was 60% and DFS 42% at 3 years; of 4 patients who subsequently had a recurrence, 3 had distant metastases. All seven patients with distant metastases at the time of first recurrence died of disease within 14 months (median, 4 months) of detection of metastatic disease. Primary melanomas of the foot (11 patients) and trunk (4 patients) appeared to have a worse prognosis than other sites. Ulceration (seen in 21 patients) did not appear to significantly influence outcome. These data suggest that most patients with Level V melanoma present with clinically localized disease. Prophylactic RLND did not significantly affect overall survival. The invasiveness of these deep tumors appears to reduce the influence of other factors, including primary site, sex, race, and ulceration. The prognosis of patients with Level V melanoma, even with clinically or histologically positive lymph nodes, is not hopeless, and these patients should be treated aggressively. PMID- 3971290 TI - Focal heating of V-2 tumors with a hybrid radiofrequency applicator. AB - A hybrid radiofrequency heating system previously reported to produce highly focused heating patterns at less than or equal to 10 cm depth in phantom models was utilized to selectively heat hypervascular, heat resistant rabbit V-2 tumors implanted in the left hindlimb. Spheroidal heating patterns 3 to 4 cm in diameter with minimal temperatures of 43 degrees C to 46 degrees C in two non-field perturbing probes at opposing edges of the tumor were consistently produced; however, temperature maxima 0.5 +/- 0.4 to 8.6 +/- 5.9 degrees C above minimum target temperatures of 43 degrees C and 46 degrees C, respectively, were observed. This led to both tumor regressions and adjacent normal tissue damage in some animals. These findings suggest this system may have application to selective heating of deep seated tumors, but that problems related to accurate thermal mapping and to intratumor temperature distribution must first be resolved. PMID- 3971291 TI - Estrogen receptor protein of breast cancer as a predictor of recurrence. AB - To assess the value of estrogen receptor protein (ERP) as a predictor of tumor recurrence, 556 patients treated by mastectomy between 1973 and 1978 for primary operable breast cancer had ERP determination of their tumors. All patients had histologically negative nodes. Two hundred fifty-six patients were ERP-positive, 233 were ERP-negative, and 67 were ERP-borderline. ERP-borderline patients showed recurrence and survival figures similar to ERP-negative patients and were grouped with them in the analysis. With a median follow-up of 75 months, overall survival for the entire group at 72 months was 93% with a disease-free survival of 85%. No difference in either overall survival or DFS was noted between the ERP-positive (94% and 83%, respectively) and ERP-negative (91% and 86%, respectively) groups. The incidence of recurrence in premenopausal women was 12% (14/115) in the ERP negative patients versus 17% (9/48) among the ERP-positive patients. This contradicts the current impression that ERP-negative, premenopausal patients have a poorer prognosis than ERP-positive patients. Postmenopausal patients had a 16% recurrence in both ERP-negative (27/171) and ERP-positive (31/202) categories. On the basis of 6-year median follow-up, it was concluded that ERP status is not an indicator of recurrence. In particular, patients with negative nodes should not be considered for adjuvant chemotherapy on the basis of negative estrogen receptor status of their primary tumors. PMID- 3971292 TI - Inhibitory effects of secretin on gastrin-stimulated rat colon neoplasms. AB - A study was done to determine if continuous administration of exogenous secretin would inhibit the trophic effect of elevated endogenous gastrin on colon neoplasms in rats. Colon tumors were induced in 37 Fisher rats by subcutaneous injection of 1,2-symdimethylhydrazine, 20 mg/kg, weekly for 18 weeks. Elevation of endogenous gastrin was achieved by antral exclusion surgery. Control rats received a sham operation. Subcutaneous osmotic minipumps delivered 35.5 U/kg/day of secretin for 7 days before the rats were killed. Rats receiving antral exclusion had significantly elevated serum gastrin levels and increased 3H thymidine incorporation into tumor DNA compared with sham rats (P less than 0.05). There was a significant decrease in tumor DNA uptake in antral exclusion rats that received secretin as compared with antral exclusion rats without secretin (P less than 0.05). Therefore it appears that gastrin does have a trophic effect on rat colon neoplasms and that secretin does inhibit this effect, in a dose-related manner. The results of this study imply that hormonal manipulation of colon cancer may eventually become a viable therapeutic modality. PMID- 3971293 TI - Adverse relationship between blood transfusions and survival after colectomy for colon cancer. AB - Random-donor blood transfusions are deliberately given before cadaver renal allografting to improve allograft survival. Since host modifications that improve the outcome of an allograft might be associated with a decreased ability of the host to control cancer growth, the relationship between blood transfusions and the outcome of 146 Dukes' stages A, B, and C colon cancers treated by resection during the years 1974 to 1979 was studied. It was found that 65 patients (45%) had been transfused and that at 5 years, overall survival was significantly better in the nontransfused patients compared to the transfused patients (0.68 and 0.51 5-year product limit survival fractions respectively; P = 0.03 for unadjusted log-rank comparison of entire survival curves). Relative risk of death due to cancer in transfused patients versus nontransfused patients was 2.3 (P = 0.05) when controlled for sex, age, stage, histologic differentiation, cancer location, and pre-resection hemoglobin level using Cox regression analysis. Thus, blood transfusion appears to be an additional important prognostic variable. The hypothesis suggested but not proven by these data that the outcome for some malignancies may be related to the immunomodulating effects of blood transfusions needs further study. PMID- 3971294 TI - An objective analysis of immediate simultaneous reconstruction in the treatment of primary carcinoma of the breast. AB - In January 1977, the authors developed a protocol to test the advisability and feasibility of immediate simultaneous reconstruction in the treatment of primary carcinoma of the breast. Initial concerns included the morbidity of the procedure, the potential for compromise of cure and of adjuvant cancer therapy, and the aesthetic acceptability of immediate reconstruction both to the patient and to the surgeon. All patients were seen preoperatively by both the oncologic surgeon (T.G.F.) and the plastic and reconstructive surgeon, (R.B.N.), and underwent modified radical mastectomy and simultaneous reconstruction. The initial protocol included only those patients with tumors 1 cm or smaller, but over the last 25 cases the protocol has been expanded to include any patient presenting with clinical Stage I carcinoma of the breast. To date, 70 such patients (ages 27-63 years) have undergone immediate simultaneous reconstruction as part of their treatment. Twenty-five patients had evidence of microscopic nodal disease (35.7%). All patients were offered adjuvant therapy, and in no case was therapy delayed beyond 4 weeks postoperatively. Three patients developed complications resulting in loss of implant (4.3%). All patients have been followed at regular intervals, and no patient has been lost to follow-up. In only one patient was there a local recurrence without distant disease. Survival curves are consistent with the stage of the disease. The surgical techniques utilized and the methods of patient selection are discussed. The authors conclude that this is a desirable and viable option in selected patients with primary breast cancer, and that immediate simultaneous reconstruction can be done with an acceptable morbidity and without compromise of cancer therapy. PMID- 3971295 TI - Squamous cell carcinoma of the upper aerodigestive tract in nonusers of tobacco. AB - Nine hundred forty-five patients with squamous cell carcinoma of the upper aerodigestive tract (SCC-UADT) were treated at three University of Louisville affiliated hospitals from 1970 through 1979. Retrospective analysis disclosed that 33 patients (3.4%) never used tobacco. This group offers interesting contrasts to the more prevalent tobacco-related epidermoid cancers. Cancers in nonusers of tobacco (mean age, 68 years) occurred approximately 10 years later than most epidermoid UADT cancers. Women predominated with a ratio of 2.7 to 1. Fifteen of 16 patients (94%) older than 70 years were women. Twenty-four of 33 primary lesions (72%) were in the oral cavity and two thirds of these were staged 0, I, and II (American Joint Commission [AJC]). Of the patients younger than 70 years of age, 42% were men, 42% had non-oral primaries, and most (74%) had advanced disease in AJC Stages III and IV. Second squamous cell primaries of the UADT developed in 6 of the 33 patients (18%) with an average of 48 disease-free months. Five of six were oral lesions in patients with original oral primaries. Of the 16 patients older than 70 years with small, localized oral cancers, conservative surgery failed in 9 (56%). Although 4 were salvaged by re-excision or radiation, 5 of these 16 patients in AJC Stage 0, I, and II died of this cancer (32%). The tendency for conservative initial surgical treatment in older patients is believed to be responsible for the higher than expected rate of treatment failure. An aggressive approach is recommended and further supported by the complete absence of surgical mortality in this group of patients. PMID- 3971296 TI - Experience with continuous regional chemotherapy and hepatic resection as treatment of hepatic metastases from colorectal primaries. A prospective randomized study. AB - Sixty-five patients with hepatic metastases from colorectal primaries were studied in a prospective randomized fashion. The five patients with solitary metastases all had resection of metastases and 50% were randomized to pump therapy. Of the 16 patients with multiple resectable metastases, 7 had pump only and 9 had resection plus pump. Although the difference was not significant, there was a trend of improved survival for the patients with resection plus pump. For the patients with unresectable disease, those patients with positive portal nodes had poor survival matching those patients with extra hepatic metastases. Patients with unresectable disease treated with pump had a 73% therapeutic response rate and a median survival of 22 months. Significant complications included chemical hepatitis and biliary stenosis. The long-term efficacy of continuous hepatic artery infusion versus the hazards of treatment and the financial cost will need further investigation. PMID- 3971297 TI - Results of a 400-patient carcinoembryonic antigen second-look colorectal cancer study. AB - Four hundred patients with resectable colon and rectal cancers were operated on by 37 surgeons at 31 institutions. Patients were monitored with carcinoembryonic antigen (CEA) level determinations and clinical examinations. One hundred thirty patients had recurrences, and 75 were reoperated on, with 43 reoperations CEA directed and 32 clinically directed. Two of 75 died within 1 month after the second operation. Twenty-two second-look patients remain free of disease 5 years after their second operation. The highest resectability of recurrent cancer occurred in patients with a CEA level below 11 ng/ml in whom the CEA level was determined at intervals of 1 to 2 months. PMID- 3971298 TI - Further experience with regional radiofrequency hyperthermia and cytotoxic chemotherapy for unresectable hepatic neoplasia. AB - The authors report on 178 patients with unresectable hepatic tumors who have been treated with 1 to 25 (median, 6) courses of radiofrequency hyperthermia (RFHT) and chemotherapy. In 137 patients, the hepatic tumors consisted of metastases from colorectal adenocarcinomas. For patients who had no previous therapy and who had colorectal metastases with no extraheptic disease, cumulative survival at 52 weeks' follow-up was 80.5% and partial tumor regression was seen in 78.4%. Among the 69 patients who previously had conventional treatment for their hepatic disease, partial regression was seen in 43.5%. We are no longer monitoring tumor core temperature routinely, as the invasive methods currently in use yield irreproducible results; the risks to the patient cannot be justified in view of the questionable relevance of the data obtained. A prospective randomized study of systemic chemotherapy with or without RFHT in patients with colorectal hepatic metastases is in progress. PMID- 3971299 TI - Bronchopulmonary Kulchitzky cell carcinomas. A new classification scheme for typical and atypical carcinoids. AB - Typical and atypical carcinoids constitute less than 5% of lung tumors. They and small cell undifferentiated lung cancers (SCLC) belong to the same family of apudomas arising from bronchopulmonary Kulchitzky cells. To reflect the overlap among these cancers, the authors suggest calling them Kulchitzky cell carcinomas (KCC); to indicate their spectrum of aggressiveness, the authors suggest calling typical carcinoids KCC-I, atypical carcinoids KCC-II, and small cell cancers KCC III. One hundred fifty-six KCCs were reviewed: 115 were KCC-I and 41 were KCC-II. The ratio of women to men equals 2:1. At time of initial diagnosis, all patients with KCC-I, except one patient, were in Stage I. Among patients with KCC-II, 16 (39%) were in Stages II or III at time of presentation. The incidence of carcinoid syndrome was 1.9%. Treatment was lobectomy in 112 (72%) of patients, the remainder having lesser resections or pneumonectomy in approximately equal distribution. Our data cannot support the use of radical resection in the treatment of KCC because none of the patients died of local recurrence. The mean diameters of KCC-I and -II tumors were 1.5 and 2.8 cm, respectively. Increased mitotic activity and tumor necrosis were reliable criteria for diagnosing KCC-II. Electron microscopic examination did not help in differentiating KCC-I and KCC II. Thorough sampling of the entire tumor was found to be mandatory for precise diagnosis and for differentiation from KCC-III (SCLC). Measurement of nuclear DNA was done using integrated optical density (IOD) by image analysis. The IODs of KCC-I, -II and -III were 1.36, 1.55 and 1.94, respectively. These significant differences (P less than 0.001) correlated with the aggressiveness of the cancers. Of patients with KCC-I, 1.7% succumbed to KCC; this included one patient reported to have died of KCC-III (SCLC). Of 41 patients with KCC-II, 11 (27%) died of KCC; this includes at least 3 deaths from KCC-III. PMID- 3971300 TI - Colon carcinoma in children and adolescents. A review of 30 cases. AB - Carcinoma of the large bowel is rare in persons under the age of 30, and generally presents with advanced stages of disease. From 1964 to 1984, 30 patients presented with nonfamilial large bowel malignancies. Seventeen patients were male, and 13 female (age range, 8-25 years). In 15 patients the primary was in the right transverse colon. In 26 patients the lesion was above the peritoneal reflection. Classification by Dukes' staging demonstrated Stage B in 3 patients, Stage C in 7 patients, and Stage D in 20 patients. Twenty-five patients had a mucinous variety of adenocarcinoma. Surgery at initial laparotomy consisted of biopsy (10 patients), palliative segmental resection (7 patients) and complete resection (13 patients; survival in each of these groups ranged from 1 to 15 months (median, 6 months), 6 to 36 months (median, 8 months) and 7 months to 14 years (median, 6 months), respectively. The only long-term survivors are three patients who had complete resection, two of whom are surviving free of disease after 5 and 15 years, respectively. Common sites of abdominal recurrence were the omentum (6 patients) and ovaries (7 patients). All patients received chemotherapy. In 16 of 24 evaluable patients, responses lasting 3 to 18 months were observed. Five patients also received radiation therapy. Follow-up of these patients included computed tomographic scans, ultrasound, and determination of carcinoembryonic antigen (CEA) levels. The CEA level in 9 of 23 patients did not correspond with the presence of either residual disease or progression of disease. Chemotherapy combined with a second-look surgical procedure in selected cases may improve the proportion of patients surviving and the duration of survival. PMID- 3971302 TI - Malignant melanoma and pregnancy. AB - Confusion exists concerning the influence of pregnancy on survival in patients with malignant melanoma. To evaluate this problem a retrospective computer-aided study was performed of women in the child-bearing years treated for Stage I cutaneous melanoma at the Duke University Comprehensive Cancer Center. Fifty eight women were identified who had melanoma arise during pregnancy (Group 1) and 43 patients were noted who became pregnant within 5 years of diagnosis of their melanoma (Group 2). Appropriate control groups matched for the clinical variables of age, primary site, and stage of disease and the pathologic variables of Clark's Level, tumor thickness, ulceration, and histologic type were selected from the cohort of 2938 melanoma patients seen at Duke. Actuarial survivals for Group 1 and 2 patients did not differ from their respective controls, although the small number of deaths in each group resulted in wide confidence intervals. When actuarial disease-free intervals were plotted, there was a significant difference between women who had melanoma develop during pregnancy when compared to their controls (P = 0.04). In a multivariate regression analysis, after adjustment for the influence of the more significant prognostic factors for Stage 1 melanoma, including Clark's Level, ulceration and tumor thickness, the effect of pregnancy on disease-free interval became more apparent (P = 0.02). No difference in actuarial disease-free interval was noted in the melanoma patients who elected to become pregnant within 5 years of diagnosis (P = 0.31). A multivariate regression analysis confirmed this finding. These data indicate that although an intercurrent melanoma during pregnancy has a worse prognosis than the control groups, once a woman has been diagnosed as having a cutaneous melanoma, a subsequent pregnancy has no effect on recurrence rate or survival. PMID- 3971301 TI - Median sternotomy for metastatic lung lesions in 131 patients. AB - Aggressive management of malignant primary tumors and their metastatic manifestations is associated with improved survival outcomes. As investigators continue to focus attention on the ablation or control of pulmonary metastatic foci, surgery is gaining importance in the treatment of metastatic disease to the lungs and, in this context, is adjunctive to other therapeutic modalities. At Roswell Park Memorial Institute (RPMI), median sternotomy is preferred to unilateral or staged bilateral thoracotomies, since the former provides simultaneous access to both hemithoraces, whereas its lower morbidity facilitates the earlier resumption of systemic therapy. The RPMI experience, amassed from 131 patients and using this procedure, is presented and analyzed with respect to patient survival. PMID- 3971303 TI - Juvenile papillomatosis and breast carcinoma. AB - Juvenile papillomatosis (JP) is a breast tumor of young women featuring atypical papillary duct hyperplasia and numerous cysts, first described as a clinicopathologic entity in 1980. The disease is of interest because of the youth of these patients and the fact that the pathologic elements resemble those considered to be precancerous in older women. This report summarizes the findings in 180 patients enrolled in the Juvenile Papillomatosis Registry. The mean age at diagnosis was 23 years (range, 12-48 years; median, 21 years; mode, 18 years). No relationship was found with parity, age of menarche, or use of birth control pills. Fifty patients (28%) reported that one or more relatives had had breast cancer. Twelve (7%) patients reported a first degree relative (mother, 10; sister, 2), whereas in 38 (21%) breast cancer was limited to one or more secondary relatives, most often maternal (23/39 or 59%). Persistent (or recurrent) JP was found in 25 patients who had a subsequent biopsy, and 8 patients had bilateral JP. Pathologic analysis revealed focal epithelial necrosis, a feature often associated with carcinoma, in 30 (17%) cases predominantly in those with the most severe cytologic atypia of hyperplastic duct lesions (77%). Positive family history was reported by 33% (10/30) of women with epithelial necrosis and 27% (40/150) without this finding. Seven patients (4%) had breast carcinoma diagnosed concurrent with JP (ipsilateral, 5 cases; contralateral, 2 cases). A previously unreported finding is the diagnosis of carcinoma subsequent to JP in two cases (contralateral intraductal and ipsilateral microinvasive duct, respectively) with intervals of 8 and 9 years, respectively. The nine patients with carcinoma and JP tended to be slightly older at the time JP was diagnosed (mean, 27 years) and had a higher frequency of positive family history (56%) than those without breast cancer (mean age, 23 years; positive family history, 26%). These findings confirm earlier evidence that JP is a marker for families at risk and now indicate that the patient with JP may herself be in jeopardy of developing breast cancer coincidentally or at a later date. Wide local excision is adequate to control the lesion in most cases. Careful clinical surveillance is indicated for any woman who has juvenile papillomatosis and for her female relatives. The early age of onset of this unusually florid proliferative disease, and family history association, suggest there may be an underlying hormonal disturbance or genetic abnormality. PMID- 3971304 TI - Analysis of adenocarcinoma in Barrett's esophagus utilizing a staging system. AB - Based on a retrospective review of nine patients with adenocarcinoma in a Barrett's esophagus and the reports of similar cases in the literature, a staging system for this malignancy was devised. A progression of changes could be identified that corresponded to the stages. These changes consisted of dysplasia progressing to carcinoma in situ and invasive malignancy with metastases. Stage III disease carried the same grim prognosis as a similar stage of squamous cell carcinoma of the esophagus. Earlier stages of adenocarcinoma of the esophagus appeared to have a better prognosis. White men with symptoms of reflux esophagitis, esophageal strictures, and/or hiatal hernias who have Barrett's esophagus extending proximal to the distal 10 cm of the esophagus appear to have a propensity to develop adenocarcinoma of the esophagus. Consideration should be given to antireflux surgery and close follow-up by periodic esophagoscopy and biopsy of the esophagus in these patients. If neoplasia is found, the thoracic esophagus should be totally removed with the stomach or left colon anastomosed to the cervical esophagus. Because of the poor prognosis of Stage III disease, postoperative chemotherapy should be considered. PMID- 3971305 TI - Evolution and clinical application of a rapid chemosensitivity assay. AB - The clinical usefulness of the soft agar colony-formation assay of in vitro chemosensitivity developed by Hamburger and Salmon is limited by long turnaround time (2-3 weeks), low success rate for small specimens, and clumping artifacts that can lead to erroneous predictions of resistance (false-negative errors). An improved technique was developed for measuring in vitro growth by incorporation of tritiated thymidine that can be performed in 5 days. With this rapid assay, 819 tumors were processed, with an overall success rate of 59.3%. This result compared favorably to the overall success rate of 58.2% for 1591 colony-formation assays because more small specimens could be submitted for the rapid assay. Melanoma and ovarian cancer specimens grew particularly well (76% and 75% successful, respectfully). Sixty-five correlations of in vitro and in vivo responses are available to date. None of 30 tumors, predicted to be resistant in vitro responded to chemotherapy clinically. Patients whose tumors were predicted to be sensitive in vitro had a 43% clinical response rate. The assay appears to be particularly accurate for predicting clinical resistance to chemotherapy, possibly because clumping artifacts do not occur in this system and peak achievable plasma concentrations of chemotherapeutic agents can be used. Optimal in vitro drug concentrations and culture conditions are still being defined, and improved success rates are being seen with more recent specimens. The introduction of this technique underscores the fact that in vitro chemosensitivity tests must continuously evolve to maximize their clinical application. PMID- 3971306 TI - Association of chronic cystic mastopathy, xeromammographic patterns, and cancer. AB - The Breast Cancer Demonstration and Detection Project in Louisville (BCDDP-L) screened 10,128 women for cancer. From this screening, another project evolved wherein those patients diagnosed as having chronic cystic mastopathy (CCM) were followed over a 10-year period to evaluate any association between CCM and breast cancer. In all, 1396 breast biopsies were performed, with 165 cancers being diagnosed either on initial screening or during subsequent years. Three of these are excluded, since histopathologic slides could not be obtained for central review. Of this group, cancer was associated with CCM in 116 specimens and without CCM in 46 specimens. One subset of 355 patients with biopsy-proven CCM but no breast cancer was followed for 6 to 12 years, for a total of 2443.5 woman years of observation. Within this subset, a total of only four cancers occurred (4 cancers/2443.5 woman-years for 0.00164 cancers/woman-years). This incidence is not significantly different from the expected value. However, an estimate is provided as to the power of the test that could be obtained from a larger sample size derived from other BCDDPs. This group of 355 women was sorted into subsets by establishing a matrix matching ten histopathologic subdivisions of CCM against six subdivisions of Wolfe's xeromammographic (XM) patterns. The numbers of cancers in each cell of this matrix is reported. The results found no concentration of these four cancers in this matrix. PMID- 3971307 TI - Surgery for thyroid carcinoma. AB - The cases of thyroid carcinoma treated at this hospital during the period 1948 to 1981 were reviewed retrospectively. Nine hundred eighty-six patients with thyroid nodules were operated on. One hundred fifty-two were thyroid carcinoma (59 papillary, 36 mixed papillary-follicular, 30 follicular, 20 anaplastic, 5 medullary, and 2 Hurthle cell tumors). There was a 92% follow-up for a mean of 10 years. In the last decade, patients presented at a younger age, the female predominance was diminished, and 15% had had previous neck irradiation. Surgery consisted of total (27) or subtotal thyroidectomy (89), lobectomy or nodulectomy (24), and biopsy (12). Total thyroidectomy had an incidence of postoperative complications that was 20 times higher than that with partial thyroidectomy (P less than 0.001). Disease-related death, recurrence, and survivor status were discussed. There was no significant difference between total versus subtotal thyroidectomy. This study reaffirms the usefulness of subtotal resection and the avoidance of morbidity of more radical total thyroidectomy surgery. PMID- 3971308 TI - Surgical treatment of brain metastases. Clinical and computerized tomography evaluation of the results of treatment. AB - The results of treatment of brain metastases in a series of 125 patients who underwent surgery with or without postoperative radiation from 1978 through 1982 were analyzed. The major sites of primary tumor included the lung (40%), melanoma skin (11%), kidney (11%), colon (8%), soft tissue sarcoma (8%), breast (6%), and a variety of others (15%). At the time of craniotomy, disease was considered limited to the central nervous system in 63 patients (50%). After surgery, 83 patients (66%) were neurologically improved, and 26 (21%) had their deficits stabilized. The overall median survival was 12 months, and 25% lived 2 years. Eight patients (12%) are alive 5 years or more following surgery. Survival varied with site of primary tumor, location of brain metastasis, extent of systemic disease, and neurologic deficit at time of craniotomy. Over a follow-up period ranging from 18 months to 6 years, 42 patients (34%) developed either local recurrences or other sites of brain metastases. These data suggest that although craniotomy followed by radiation is highly effective in the initial treatment of selected patients with brain metastases, alternate therapies require investigation in view of the high central nervous system relapse rate in long term survivors. PMID- 3971310 TI - The influence of surgical margins and prognostic factors predicting the risk of local recurrence in 3445 patients with primary cutaneous melanoma. AB - Risk factors associated with local recurrences were analyzed from a series of 3445 clinical Stage I melanoma patients. In single-factor analysis, tumor thickness, ulceration, and increasing age were highly significantly predictive of recurrence (p less than 0.00001). After 5 years of follow-up, local recurrence rates were 0.2% for tumors less than 0.76 mm thick, 2.1% for tumors 0.76 to 1.49 mm thick, 6.4% for tumors 1.5 to 3.99 mm thick, and 13.2% for tumors 4.0 mm or greater in thickness. Ulcerated melanomas recurred more often than nonulcerated lesions (11.5% versus 1.9%). When analyzed as a continuous variable, increasing age increased the risk of local failure. In multifactorial analysis, all of these three factors remained independently predictive of local recurrence. Recurrences were more common with nodular melanomas (5.6%) compared to superficial spreading (2.5%) or lentigo maligna melanoma (2.5%), but this difference did not reach statistical significance (P = 0.115). Lower extremity (4.7%) and head and neck lesions (4.4%) recurred more frequently than upper extremity (1.6%) or trunk (1.2%) melanomas (P = 0.0217). The highest recurrence rates were observed in patients with melanomas located on the foot (11.6%) and hand (11.1%). The safety of conservative margins for the excision of low-risk melanomas was demonstrated in a review of 1151 consecutive patients with melanomas less than 1 mm thick where only one local recurrence was observed. Sixty-two percent of these patients had resection margins of 2 cm or less. In 95 patients local recurrence developed as the first site of relapse and were treated with surgical excision. The median survival for this group was 3 years, whereas 20% of this group survived 10 years. These data demonstrate that: (1) the risk of local recurrence rises with increasing tumor thickness, presence of ulceration, and age; (2) melanomas less than 1 mm thick have a very low local recurrence rate, even when excised with margins of 2 cm or less; and (3) local recurrence is a poor prognostic sign because regional and systemic metastases subsequently develop in many patients. PMID- 3971309 TI - Long-term survival and prognostic factors in patients with regional breast cancer (skin, muscle, and/or chest wall attachment). AB - Between 1948 and 1981, 1230 patients were diagnosed as having regional (skin, muscle, or chest wall attachment) breast cancer, and long-term survival was studied. In all patients, overall survival was 33% at 5 years, 19% at 10 years, and 9% at 20 years. Significant excess mortality due to breast cancer was observed throughout the 20-year follow-up period (P less than 0.002). The risk of breast cancer was highest in the 5-year period following diagnosis, and declined steadily from that time. Additionally, 308 patients diagnosed since 1968 were studied for the effect of prognostic factors. Clinical status of nodes (positive or negative) and presence or absence of peau d'orange were found to be significant prognostic factors in those patients. In those receiving radical surgery, the number of nodes and presence or absence of peau d'orange were found to be of prognostic significance. No effect of race, age, year of diagnosis, site of attachment, type of fixation, ulceration, edema, size of tumor, satellite nodules, or dimpling retraction on breast-cancer-specific survival was observed when the nodal status and peau d'orange were controlled. These data demonstrate that mortality in regional breast cancer is significant and is highly dependent on peau d'orange and nodal status. PMID- 3971311 TI - Radionuclide lymphoscintigraphy with technetium 99m antimony sulfide colloid to identify lymphatic drainage of cutaneous melanoma at ambiguous sites in the head and neck and trunk. AB - Frequently the primary lesion of high-risk cutaneous melanoma (level III, greater than or equal to 1.5mm; greater than or equal to 1.0 mm with ulceration) is in an ambiguous lymphatic drainage site on the trunk, pelvic and shoulder girdles, and head and neck area. Lymphoscintigrams were performed by a circumferential intradermal injection of the biopsy site using technetium 99m (99mTc) antimony sulfide colloid in a total dose of 0.2 to 0.6 mCi in a volume of 0.1 to 0.5 ml. Imaging was done with a large-field gamma camera with high-resolution parallel hole collimator. Technetium 99m antimony sulfide colloid is an ideal agent for lymphoscintigrams because of small particle size (3-30 micron), which permits early migration into the interstitial space and lymphatics and rapid pickup by lymph nodes. Although it is a gamma emmitter with high activity, it has a short half-life and does not induce tissue necrosis. It does not localize the site of lymph node metastases, but indicates only the drainage pattern. Images were obtained at 1, 5, 10, 15, 30, and 60 minutes, respectively, and then three times every hour. Surgery was usually performed 24 hours later. The majority of patients had lesions with ambiguous drainage sites: head and neck (4 of 5 patients) and trunk (9 of 13 patients). The drainage by scan was to unpredictive sites in 72%, and resulted in a change of treatment planning by location and extent of ablation with node dissection in 9 of 18 patients. Ambiguous dissection sites included: (1) question of preauricular dissection with parotidectomy versus posterior auricular and cervical dissection for selected scalp lesions; (2) low neck with or without axillary dissection for upper chest and shoulder lesions; and (3) axillary versus groin dissections for midflank lesions at zone of ambiguity between axilla and groin. It was concluded that preoperative 99mTc antimony sulfide lymphoscintigraphy is a highly useful planning technique in determining the appropriate lymphatic drainage basin for dissection in selected melanoma patients. PMID- 3971312 TI - Survival in bilateral breast cancer. AB - The presence of bilateral invasive breast cancer places the patient in a state of double jeopardy. At Memorial Sloan-Kettering Cancer Center, the overall 10-year recurrence rate for unilateral Stage I breast cancer was 16%, whereas the recurrence rate for simultaneous, bilateral Stage I breast carcinoma was 29%: almost twice as high. The average 10-year survival of all patients with negative axillary nodes was 57%. In this retrospective analysis of 403 patients with bilateral primary operable breast cancer treated at Memorial Sloan-Kettering Cancer Center, significant differences were noted in the disease-free survival between patients with bilateral noninvasive cancer, bilateral invasive cancer, and the combination of invasive and in situ cancers. Bilateral intraductal cancer and lobular carcinoma in situ offered an excellent prognosis. The combination of preinvasive cancer on one side and infiltrating carcinoma on the other had the next best survival. The in situ lesion, when treated by mastectomy, did not alter the patients' life expectancy from that of the general population with unilateral breast cancer, thus indicating that surgeons should strive to detect breast cancer in its preinvasive form. The 5- and 10-year relapse-free survival of patients with bilateral invasive disease, regardless of axillary nodal status and tumor size, was 60% and 51%, respectively, for patients with a bilateral presentation and 54% and 38%, respectively, for carcinomas presenting metachronously. More important in determining prognosis, however, was the number of axillary nodes involved and the level of involvement. Invasion of bilateral axillary nodes at all levels predicted a poor prognosis. Because of this shortened survival, systemic adjuvant therapy should be considered for patients with bilateral invasive disease. The most common preinvasive breast cancer was lobular carcinoma in situ and the most frequently invasive tumor was infiltrating duct cancer. Since a contralateral breast cancer at the time of definitive treatment of the first side does not always present as a mass or with positive mammography, a random biopsy of the second breast is recommended. This should be done in the upper, outer quadrant and should include the subareolar area. With prompt adequate treatment, it is expected that survival from bilateral breast cancer should improve. PMID- 3971313 TI - Endoscopic diagnosis and treatment of upper-tract urothelial tumors. A preliminary report. AB - The technique of transurethral ureteropyeloscopy allows many standard cystoscopic procedures to be extended into the upper urinary tract. This endoscopic method was used to evaluate 31 patients suspected to have urothelial malignancies of the ureter or renal pelvis. Twenty-eight of the patients had the procedure successfully completed (90%), 11 of whom were found to have urothelial tumors. Diagnostic ureteroscopic biopsy in three of these patients revealed high-grade, multifocal tumors and was followed by nephroureterectomy (two patients) or partial ureterectomy (one patient). However, in eight patients, ureteroscopy and biopsy revealed apparently localized, low-grade tumors which were treated by ureteroscopic fulguration or resection. The latter patients have undergone endoscopic surveillance every 3 months (average follow-up, 21 months). The technique of ureteropyeloscopy permits endoscopic access into the ureter and renal pelvis, enabling tissue diagnosis and better preoperative cancer staging without surgical exploration. Although follow-up is short, selected patients with low-grade tumors may be treated primarily by endoscopic means. PMID- 3971314 TI - Hereditary nonpolyposis colorectal cancer in a Navajo Indian family. AB - The purpose of this report is to describe a unique Navajo Indian kindred that manifests a tumor pattern consonant with hereditary nonpolyposis colorectal cancer (HNPCC). So far as we can determine this is the first report of HNPCC among American Indians. PMID- 3971315 TI - Fluorescent bodies in lymphocytes in chronic lymphocytic leukemia. AB - The relative frequency of lymphocytes with nuclear Y-body-like fluorescent structures (F-bodies) was examined in ten patients with chronic lymphocytic leukemia (CLL) and in ten normal individuals. In each patient, the frequency was significantly higher as compared to that of normal controls. Female CLL patients showed a significantly higher proportion of F-body-positive (F-body +) cells than male CLL patients, whereas in normal males and females similar frequencies of F body + cells were observed. There was no apparent relationship between the frequency of F-body + lymphocytes and the relative age of an individual. The presence of F-bodies in CLL had no obvious correlation with the presence of karyotypic abnormalities in these patients. Isolated T and B lymphocytes derived from four normal subjects showed no extra F-bodies as found in CLL patients. PMID- 3971316 TI - Background allelic variants in normal hemopoietic cells and Bloom's syndrome erythrocytes and the possible implication of somatic crossingover. AB - The existence of rare cells with blood group A or B phenotype among the red cells of AB heterozygotes is a well-known phenomenon. However, its origin remains unclear due to methodological problems. A direct quantitation of non-B and non-A erythrocytes in A1B donors revealed minor populations of only-A and only-B cells, respectively, both in a frequency of 10(-3). Null cells comprise, at the most, a fraction of about 5 X 10(5). In order to discriminate between somatic crossingover (SCO) and gene inactivation as the underlying mechanism, three individuals were selected who were double heterozygotes for the blood group (AB) and the linked locus of adenylate kinase (AK-2-1). Separation of cells with A or B phenotypes did not result in cosegregation of the AK isoenzymes. Thus, the variant blood group phenotypes represent the normal frequency of allelic silence, not the product of SCO. This sets a background variant level for the estimation of somatic recombination in blood cells from normal donors. Determination of variant phenotypes in a Bloom's syndrome patient, heterozygous for AB, gave a frequency six times higher than the value of normals. It is suggested that this elevated figure might indicate the frequency of SCO, which is known to be higher in Bloom's syndrome. PMID- 3971317 TI - MMC-E cells--origin and changes in karyotype accompanying malignant transformation. AB - Karyotype analysis of an established nontumorigenic cell line (MMC-E) indicated that the cells are of rat origin instead of mouse, as interpreted earlier. This cell line, now termed RE (rat epithelial) had a karyotype of 39,X,-5,-15, ?16,+t(3q11q) in the stem line. There was also one subline that had a karyotype of 40,X,-5,-15,-?16,+t(3q11q), +?t(5;?). Chromosome changes and frequency of sister chromatid exchanges (SCEs) were studied from seven malignantly transformed RE cell lines. These included cells transformed by Moloney murine sarcoma virus, the acute transforming retrovirus 3611-MSV, murine leukemia virus, or ethylnitrosourea. Changes in chromosomes #3 and #5 seemed to be associated with malignant transformation of RE cells. In addition to the t(3q11q) and monosomy for chromosome #5 seen in the parent cell line, monosomy for chromosome #3 and the t(5;?) were observed in all malignant cell lines. The latter changes either were absent (monosomy for chromosome #3) or present only occasionally [t(5;?)] in the parental cells. The results of SCEs showed that the malignantly transformed cell lines do not have increased frequency of SCEs as compared with that of the parental cell line. PMID- 3971318 TI - Cytogenetic study of ten carcinomas of the bladder: involvement of chromosomes 1 and 11. AB - In direct preparations of ten untreated transitional cell carcinomas of the bladder, chromosomes #1 and #11 were most frequently involved in structural changes (in at least seven tumors each). Three tumors had one or two 11p- chromosomes, and, in other tumors, chromosome #11 had taken part in translocations or isochromosome formation, which, except in one tumor, resulted in a loss of short arm material. Also, there was a tendency for the presence of fewer than expected normal chromosomes #11. Chromosome #1 anomalies are common in most types of tumor; however, chromosome #11 abnormalities, particularly the loss of short arm material, are not common and may thus characterize carcinoma of the bladder, a finding that is of interest in view of the location of an oncogene, c Ha-ras1, on 11p. Translocations probably involved chromosome #17 in four tumors. Structurally changed chromosomes #3 were seen in four tumors, including one or two 3q- chromosomes in two or possibly three tumors. PMID- 3971319 TI - Trisomy 7 in a lung carcinoid tumor: precocious index of malignant transformation? AB - A chromosomal study has been performed on a benign carcinoid tumor of the lung after short-term culture. A trisomy of chromosome #7 was found in all the metaphases. The significance of this finding is discussed in relation to the transformation process. PMID- 3971320 TI - Role of heterochromatin variation in the instability of a marker chromosome during tumor progression. AB - Karyotypic evolution of the poorly metastasizing tumorigenic RSV-transformed B77 3T3 fibroblast line was investigated both in highly metastasizing clones (selected by growth in hard agar) and in spontaneous metastases. Analysis of structural chromosome aberrations associated with the transition from the nonmetastatic to the metastatic phenotype was focused on a readily identifiable marker chromosome (A), displaying an extracentromeric heterochromatic region as a main feature promoting genetic instability. Well-defined changes in the structure of this marker were observed, both in vitro and in vivo, and invariably involved C-heterochromatic variation. In the metastatic clones, a specific rearrangement of the A chromosome was selected. This structural variant (B) showed two extracentromeric C-positive regions and probably originated from duplication of the segment of A included between the centromere and the internal C-band. On the other hand, selection of a modified form of chromosome A, not displaying the interpolated C-heterochromatin, had occurred in the extremely rare B77-3T3 spontaneous metastases. The connection among heterochromatin variants, genetic instability, and chromosome aberrations is discussed. PMID- 3971321 TI - Incidence and origin of symmetric and asymmetric dicentrics in Bloom's syndrome. AB - The incidence and origin of dicentric chromosomes has been analyzed in Bloom's syndrome (BS) lymphocytes. In diploid cells, the dicentrics are predominantly asymmetric, consisting of two nonhomologous chromosomes. In contrast, in tetraploid cells, the majority of dicentrics are formed by two homologs, which, judging from Q-banded metaphases, have broken at identical points. Our earlier assumption that most, possibly all, chromosome abnormalities in BS originate in S G2 is further supported by the present observation that only 26/79 cells with dicentrics also had a fragment. In other words, the dicentrics have not arisen in the previous G1 but in S-G2 of a preceding cell cycle. The symmetric dicentrics would arise in diploid cells from an adjacent counterpart to a mitotic chiasma between two homologs, and in tetraploid cells, from an adjacent exchange between two sister chromosomes in a diplochromosome. The asymmetric dicentrics can be assumed to result primarily from segregation of an adjacent QR between two nonhomologous chromosomes. Based on the frequency of symmetric dicentrics in tetraploid cells (25/61 cells), and assuming that the ratio of adjacent exchanges to mitotic chiasmata is around 1/50, we predict that the chiasma frequency in diplochromosomes of BS lymphocytes will turn out to be as high as 20/cell. PMID- 3971322 TI - Chromosome 12 rearrangement with breakage at the p11 level in hematologic disorders: report of four cases. AB - Four patients with chromosome #12 rearrangement at the p11 level are described. One had acute promyelocytic leukemia, one had myelofibrosis evoluting to acute undifferentiated leukemia, one had acute nonlymphoid leukemia (ANLL) secondary to Hodgkin's disease, and another had acute leukemia recurring after allogeneic bone marrow transplantation. This chromosome abnormality was always associated with other karyotypic aberrations, probably as a secondary event. Possible correlations with recent findings in oncogene research are discussed. PMID- 3971323 TI - Evaluation of chromosomal diagnosis for hereditary adenomatosis of the colorectum. AB - Hereditary adenomatosis, particularly familial polyposis coli (FPC) and Gardner's syndrome (GS), has been investigated from family pedigrees and chromosomal markers for precancer and cancer. FPC and GS are much alike in phenotypes. Studies are in progress to determine if the two adenomatous diseases are controlled by the same DNA sequence. Chromosome numerical and structural instability is a good diagnostic criterion for hereditary adenomatous diseases where risk factors are already determined to the level of 0.5 probability from pedigree analysis. This has been applied successfully at the pediatric age level to identify family members who carry the gene but have no adenomas in the colorectum. Sister chromatid exchange (SCE) did not distinguish plasma samples from FPC, GS, or solitary adenoma patients form each other or from controls with no adenomas. SCE did distinguish invasive from recurrent and noninvasive cancer. The chromosome #2 polymorphism observed at 2q-21.3 has not been confirmed as a deletion, but is under investigation with more refined methods. PMID- 3971324 TI - Electron microscopy of chromosomes: toward an ultrastructural cytogenetics? PMID- 3971325 TI - Hot bands: a simple G-banding method for leukemic metaphases. PMID- 3971326 TI - Isochromosome 12p in malignant testicular tumors. PMID- 3971327 TI - X chromatin, endomitoses, and mitotic abnormalities in human cervical cancer. AB - The incidence of X chromatin bodies and mitotic modifications and aberrations has been analyzed using Feulgen-squash preparations in 47 cervical cancers from Helsinki and 35 from Madison. Sixteen of the 82 tumors did not display any X chromatin bodies, and some others showed a lower than normal frequency, especially in the large nuclei. Different hypotheses to explain the absence of Barr bodies in female tumors have been reviewed. A new observation is that 44/82 tumors contained endomitoses. The metaphase/prophase ratio (M/P) was higher than 1.5 in all but three cases, reaching values as high as 23.0 (Madison) and 34.2 (Helsinki), and in one exceptional case, 51.8. The different types of cells, mitotic, endomitotic, and those with large to giant nuclei, form their own strands or layers. Cervical cancer is diagnosed earlier in Finland than in Madison due to a Pap mass screening program, and consequently, the survival of the patients after 5 years was 27/47 in Helsinki and 6/35 in Madison. No correlation could be established between the M/P (or other mitotic phenomena) or the stage and grade of the tumor, the age of the patient, or survival time. PMID- 3971328 TI - Cancer genes, multiple primary cancer, and von Hippel-Lindau disease. AB - Von Hippel-Lindau disease is inherited by an autosomal dominant gene that may show marked expressive variability of cancer phenotype in certain patients/families. We describe a patient with a strongly positive family history of this disease who, at age 28, underwent craniotomy with removal of a cystic cerebellar hemangioblastoma; at age 48, he developed syringomyelia of the spinal cord, became quadriplegic, and had a progressive downhill course. At autopsy, hemangioblastomas of the cerebellum and spinal cord were found, as well as a left renal cell carcinoma, an oat cell carcinoma of the lung, a hepatocellular carcinoma, and an atypical thyroid adenoma. This tumor spectrum appears to be unique, although chance cannot be excluded. It is possible, however, that these findings might represent an expression of the deleterious genotype that became evident because of this patient's prolonged survival from his initial cerebellar hemangioblastoma. PMID- 3971329 TI - Translocation 4;11 acute leukemia: three case reports and review of the literature. AB - Three children with acute leukemia and t(4;11)(q21;q23) are presented. Two of the cases showed very unusual karyotypic findings and long survival for the type of leukemia. In case B.T., the original karyotype change observed was t(4;11), with other changes (+4q-,+11q+,+6,+10) appearing during the last stages of the disease. In case R.B., the translocation was accompanied by many numerical and morphological chromosome changes, with a near-tetraploid chromosome number. In both of the above cases, remission was associated with a normal marrow karyotype. In case D.C., only the t(4;11) was observed. The number of cases with t(4;11) and acute leukemia published so far is 36, including the three cases presented by us. As this disease is usually characterized by a relatively short survival, the possible reasons for the remarkably long survival in two of our patients are discussed in relation to the rather unusual cytogenetic findings. PMID- 3971330 TI - Further evidence for nonrandom chromosome changes in carcinoma cells--a report of 28 cases. AB - A cytogenetic study was made of pleural and ascitic effusions from 28 carcinoma patients. Gross chromosome abnormalities were observed in each case. A selection against heteroploid cells occurred generally in long-term cell cultures. Although no further evidence for the existence of primary specific chromosome abnormalities was found in this study, we postulate three types of chromosome abnormalities in carcinoma cells: (a) primary, specific chromosome changes; (b) secondary, but nonrandom, chromosome changes; and (c) random chromosome changes. We feel that it may be a feature of the secondary changes to cause high mitotic instability, which leads to further karyotype variability, new changes of type b and c, and an increased potential for malignancy. PMID- 3971331 TI - Growth of diploid cells from breast cancers. AB - Cell cultures were derived from normal and cancerous breast tissues and from metastases by methods that selected for relatively adherent epithelial aggregates. Karyotypic analyses of first or second passage cultures yielded predominantly normal diploid cells. Nonclonal aberrations were more common in tumor-derived than in normal cultures. Three of the cultures that originated from metastases were characterized by abnormal clones. These results support observations based on DNA content, which indicate that a considerable fraction of breast cancers are composed predominantly of diploid cells. They differ greatly from chromosomal findings in long-term cultures of tumor effusions and thus emphasize the karyotypic diversity that can be found in tumors from a single tissue of origin--the breast. PMID- 3971332 TI - Common marker chromosomes in ovarian cancer. AB - Cytogenetic analysis of six cases of ovarian adenocarcinoma revealed the presence of common marker chromosomes. The chromosomes involved in rearrangements, were #1 (four cases), #3 (six cases), #6 (two cases), and #17 (three cases). Our data support the presence of previously reported common aberrations of certain chromosomes in ovarian cancer. The presence in all six cases of a 3p- marker chromosome, previously reported as a specific abnormality in small cell lung cancer, indicates that it can also be found in other types of cancer. PMID- 3971333 TI - Cytogenetic and cytokinetic analysis of lymphocytes from patients with hereditary adenomatosis of the colon and rectum. AB - The frequencies of chromosome aberrations, sister chromatid exchanges (SCEs), and cell cycle kinetics were examined in cultured lymphocytes from five patients with hereditary adenomatosis of the colon and rectum (ACR) [three patients with Gardner's syndrome (GS) and two patients with familial polyposis coli (FPC)]. The frequency of numerical chromosome aberrations was no different in metaphase cells at the first and second replication cycles (M1 and M2) in the ACR patients and control subjects. The percentage of structural chromosome aberrations in both M1 and M2 cells was somewhat higher in the ACR patients as compared with the controls. Neither spontaneous nor mitomycin C-induced SCE frequencies in the patients with ACR were different from the controls, except for one patient with GS, who showed a remarkably high spontaneous SCE frequency. This patient is the mother of a son who had hepatoblastoma. The cell replication index (RI) was lower in the GS patients than in the controls. However, the RI in the FPC patients did not differ from that of the controls. PMID- 3971334 TI - Multiple myeloma terminating in acute eosinophilic leukemia. AB - A 71-year-old woman with multiple myeloma was successfully managed for 8 years with melphalan (total dose 2056 mg). She developed a refractory anemia (myelodysplastic state), which terminated in acute eosinophilic leukemia. This form of acute leukemia, induced by chemotherapy, appears to be very rare. The cytogenetic changes, including 5q- and monosomy 7, were similar to those observed in other patients with acute nonlymphocytic leukemia as a secondary malignancy following treatments of other primary tumors. PMID- 3971336 TI - Chromosomal abnormalities in chronic lymphocytic leukemia. AB - Peripheral blood lymphocytes from five chronic lymphocytic leukemia (CLL) patients were cultured with PHA for 3-6 days. Chromosomal analysis with G-banding showed 25% of the diploid metaphases were pseudodiploid as a result of either a chromosomal deletion or a translocation. Abnormal clones with 18p- were seen in two patients, and two other patients had 18p- metaphases, but with other inconsistent abnormal chromosomes. None of the patients had trisomy 12, which has been thought by some to carry a poor prognosis. Although no conclusion can be reached regarding the significance of the chromosomal abnormalities in CLL, the type of chromosomal abnormalities in these patients suggests that they are the result of chromosomal breakage and abnormal repair. PMID- 3971335 TI - 14q- in two hairy cell leukemia patients. PMID- 3971337 TI - Cytogenetic findings in a case of Sezary syndrome. AB - Repeated cytogenetic studies were carried out on a Sezary syndrome patient during a 1-year period. The presence of a single clone of heteroploid (60-86 chromosomes) cells was a permanent finding in the PHA-stimulated blood cultures. The bone marrow was normal. Sister chromatid exchange (SCE) value was relatively lower in heteroploid cells. PMID- 3971338 TI - Radiation sensitivity of Bloom's syndrome lymphocytes during S and G2 phases. AB - In order to study chromosome sensitivity of Bloom's syndrome (BS) cells in relation to the replication stage, gamma-ray irradiation was performed immediately before adding bromodeoxyuridine (BrdU) to lymphocyte cultures of one BS patient and of one control. It was found that BS cells are much more sensitive to the irradiation than control cells at the end of S and at G2 phases. The rate of induction of chromosome breaks is significantly increased and that of chromatid breaks and exchanges is also increased, though to a lesser degree. Our results also favor the existence of a cell subpopulation in BS characterized by a slow cycle, a high spontaneous chromosome aberration rate, and a high radiation sensitivity. PMID- 3971339 TI - Double minutes in prematurely condensed chromatin of human tumor cells. AB - Comparative studies on the occurrence of double minutes (DMs) were performed on metaphases and prematurely condensed interphases (G1, G2) of cells from 28 cancerous effusions of 24 carcinoma patients. In 21 of these effusions, agreement between metaphase and prematurely condensed chromatin (PCC) data was obtained concerning occurrence or nonoccurrence of DMs (10 DM positive, 11 DM negative). In two cases, DMs were observed in metaphases only, whereas in five cases, they were found in interphases only. In normal cells, no DMs could be found, neither in metaphase nor in PCC. No causal correlation of the occurrence of DMs and cytostatic therapy was found. The data suggest that cytogenetic screening of prematurely condensed interphase cells from human tumors or cancerous effusions provides a valuable method for estimating the incidence of gene amplification in malignant cells, particularly in those with poor mitotic yield. PMID- 3971340 TI - Karyotypic evolution in patients with myelodysplastic syndromes. AB - Serial cytogenetic studies were performed in 33 patients with myelodysplastic syndrome in order to establish the frequency of karyotypic evolution and to correlate the chromosome and clinical findings during the course of the disease. Fifteen of the 33 patients (45%) showed abnormalities in the first cytogenetic study and this percentage increased to 57% during the course of the disease. A stable karyotype (normal or abnormal) was found in 19 patients (58%), whereas the rest (42%) showed an unstable karyotype. Trisomy 8, monosomy 7, and del5q were the most frequent abnormalities, not only at presentation, but also during karyotypic evolution. Seven patients (23%) with a known evolution proceeded to leukemia; four of them had stable (22%) and three unstable (25%) karyotypes; however, 33% of patients with unstable karyotypes and only 5% with stable karyotypes died from complications of the disease. Our results suggest that karyotypic evolution is relatively frequent in these patients; this evolution could be related to a poor clinical prognosis, either evolving to leukemia or death. PMID- 3971341 TI - Variability of chromosomes 1, 9, and 16 in children with malignant diseases. AB - Heterochromatic segments of chromosomes #1, #9, and #16 were analyzed in 38 children with malignant disease and 42 healthy persons. The analysis was carried out on C-banded metaphases obtained by peripheral blood culture. Using a quantitative method of analysis, an association was established between C-segment length of chromosome #9 and malignant disease in children. A disturbed quantitative relation of C-heterochromatin of chromosomes #1, #9, and #16 was also found in the group of children with malignant disease. PMID- 3971342 TI - The meaning of a clone. PMID- 3971343 TI - Absence of carcinogenicity of 1-nitropyrene, correction of previous results, and new demonstration of carcinogenicity of 1,6-dinitropyrene in rats. AB - 1-Nitropyrene (1-NP), 1,6-dinitropyrene (1,6-DNP) and 1,8-dinitropyrene (1,8 DNP), which are potent mutagenic components of diesel exhaust and air pollutants, were injected subcutaneously into the back of F344 rats. No tumor was induced by experimental day 650 in rats treated with 40 or 4 mg of 1-NP. On the other hand, 1,6-DNP at a total dose of 4 mg was demonstrated to induce sarcomas at the injection site in all 10 rats. 1,8-DNP at total doses of 0.4 and 0.04 mg also induced sarcomas in 10 and 9 out of 10 rats, respectively, by day 320. Our previous finding that 1-NP was carcinogenic was possibly due to contamination of the preparation with dinitropyrenes. PMID- 3971344 TI - Antitumor effect of intralesional injection with formalin-fixed Toxoplasma gondii organisms on Lewis lung carcinoma in Toxoplasma-infected mice. AB - The antitumor effect of formalin-fixed Toxoplasma organisms (f-Tp) as an immunostimulant was examined in Toxoplasma-infected female C57BL/6 mice using a syngeneic Lewis lung carcinoma (3LL). Toxoplasma-infected mice, intradermally inoculated with the tumor cells mixed with 10(5), 10(6) or 10(7) f-Tp, developed a marked antitumor effect, inhibition of tumor growth and prolongation of life span, in direct relation to the strength of the delayed-type hypersensitivity (DTH) reaction induced by f-Tp. The antitumor effect could also be observed even if an intralesional injection with f-Tp was performed 1, 3 or 5 days after the tumor inoculation. In a control, the injection with 2.5 X 10(6) live Mycobacterium bovis (BCG) in BCG-sensitized mice induced a significant antitumor effect, only when the BCG was injected in the mixture of tumor cells. These results demonstrate that the injection with f-Tp can induce a potent antitumor activity in mice with Toxoplasma infection. PMID- 3971345 TI - Comparative study on the carcinogenicity of N-nitrosodiethylamine and benzo[a]pyrene to the lung of Syrian golden hamsters induced by intermittent instillations to the trachea. AB - N-Nitrosodiethylamine (NDEA) and benzo[a]pyrene (B[a]P) were intratracheally instilled into female Syrian golden hamsters 15 times weekly for about 4 months. The total dose given was 15 mg. The control hamsters were given only phosphate buffer solution. During the total life span, tumor incidence rates in the NDEA and B[a]P groups were 100% and 46%, respectively, and no tumor developed in the controls. We concluded that the high rate of carcinogenicity of NDEA seen in the respiratory organs of Syrian golden hamsters must be given increased attention. PMID- 3971346 TI - Evidence of abnormality of lymphocyte uroporphyrinogen synthase in family members of patients with lymphoproliferative diseases. AB - Patients with active lymphoproliferative diseases (LPD) were shown to have high activity of lymphocyte uroporphyrinogen synthase (L-UROS), the enzyme which converts porphobilinogen to uroporphyrinogen. The mean L-UROS activity of 64 first-degree relatives of patients with LPD was significantly higher than that of a control group and 45% of these relatives had pathological values of L-UROS. L UROS activity was also determined in the spouses of 2 patients and was pathologically elevated in both. The pattern of pathological values among family members may indicate the presence of a communicable agent. PMID- 3971347 TI - The activation and DNA binding of 7-methylbenz[c]-acridine catalysed by mouse liver microsomes. AB - The metabolism of the carcinogen, 7-methylbenz[c]acridine (7MBAC), in liver microsomes prepared from untreated, and phenobarbital sodium (PB) and 3 methylcholanthrene (MC) induced male C57BL/6 mice was examined by high pressure liquid chromatography (HPLC). The abilities of control and MC induced liver microsomes to catalyse covalent binding of the carcinogen to DNA were comparable (60 pmol 7MBAC bound/mg DNA), although this maximum binding level observed was achieved at different 7MBAC concentrations for control (100 microM) and MC induced (25 microM) preparations. In vivo binding of 7MBAC to liver DNA was greater than that observed for lung DNA of the same animals but over 21 h bound 7MBAC levels decreased to a greater extent in liver than in lung. One fraction of a digest of in vitro alkylated DNA gave a fluorescence emission spectrum very similar to that of 7-methyl-1,2,3,4-tetrahydrobenz[c]acridine. This result suggests that diol epoxides functionalised at the 1,2,3,4-positions may be ultimate carcinogens derived from 7MBAC. PMID- 3971348 TI - Brain microsomal enzyme mediated covalent binding of benzo[a]pyrene to DNA. AB - The covalent binding of benzo[a]pyrene (BP) to calf thymus DNA by brain microsomes isolated from control and 3-methylcholanthrene (3-MC) treated rats was investigated. The influence of incubation time, pH, and concentrations of protein, BP and NADPH on covalent binding was investigated to obtain optimum conditions for the in vitro binding of [3H]BP to DNA. Treatment of rats to 3-MC resulted in a 1.53-fold increase in the brain microsomal mediated covalent binding of [3H]BP to DNA. Inhibitors of monooxygenase enzyme activity such as alpha-naphthoflavone, metyrapone, 1-benzylimidazole and ellagic acid significantly inhibited the binding of [3H]BP to DNA from control and 3-MC stimulated brain microsomes. Our results indicate that inhibitors and inducers of monooxygenases may modulate brain enzyme-mediated binding of polycyclic aromatic hydrocarbons (PAHs) to DNA. PMID- 3971349 TI - DNA ethylation in target and non-target organs of hamsters and rats treated with diethylnitrosamine. AB - Kinetics of ethylation of target and non-target organ DNA in vivo by diethylnitrosamine (DEN) was compared in rats and Syrian golden hamsters, since published reports indicate a single dose of DEN induces both kidney and liver tumors in rats and almost exclusively respiratory tract tumors in hamsters. Following treatment with 200 mg DEN/kg, 7-ethylguanine (7-etG) was lost more rapidly from hamster than from rat liver DNA, while O6-ethylguanine (O6-etG) persisted longer in hamster than in rat liver DNA. DNA ethylation was not detected in rat lung (non-target organ), while both 7-etG and O6-etG were quantitated in hamster lung (target organ) following DEN treatment. DNA ethylation in rat kidney DNA was approximately 1/10 of that in liver by 200 mg DEN/kg, and the persistence of 7-etG and O6-etG differed only slightly in these tissues. Ethylation of hamster liver DNA by DEN at doses between 20 and 200 mg/kg, as measured by 7-etG and O6-etG was proportional to the dose of carcinogen up to 160 mg/kg; at larger doses DNA ethylation sharply increased. Differences in the persistence of O6-etG between DEN-treated rats and hamsters cannot solely account for species differences in the organotropism of DEN carcinogenesis. PMID- 3971350 TI - Factors influencing the activity of dimethylnitrosamine demethylase in hamster, rat and chicken liver microsomes. AB - In vitro metabolism of dimethylnitrosamine (DMN) by liver microsomal fractions of hamster, rat and chicken revealed that the three species under certain assay conditions, were capable of metabolizing DMN at different rates (hamster greater than rat greater than chicken). The magnitude of the demethylase activity was found to be dependent on the nature of the buffer, the concentration of cytochrome P-450 (P-450) and the concentration of the substrate DMN. Enzyme activity was higher in Hepes buffer than in the phosphate buffer. Concentrations of phosphate higher than 20 mM inhibited the activity of the rat and chicken enzymes. This effect of phosphate was not a consequence of increase in ionic strength since KCl over a wide range of concentration failed to inhibit the activity. PMID- 3971351 TI - An 85-day study of butylated hydroxyanisole in the cynomolgus monkey. AB - Groups of 8 cynomolgus monkeys (Macaca fascicularis) were given 500, 125 and 0 mg/kg body wt butylated hydroxyanisole (BHA) by gavage in corn oil 5 times/week for 20 days, after which the high dose was halved. No significant adverse clinical signs nor abnormal fibroscopic observations were noted before the experiment was terminated at 85 days. Blood levels of glucose, albumin, chloride, red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT) and mean corpuscular hemoglobin (MCH) were altered in a dose related manner but the altered values were well within normal ranges reported for this species. While histopathology showed no treatment related effects, the mitotic index was elevated 1.9-fold in the distal esophagus of monkeys in the high but not in the low dose group. Liver weights were increased in a dose related manner but liver monooxygenases, with the exception of decreased ethoxyresorufin deethylase activity, were all within normal limits. BHA given orally to monkeys at about the maximum tolerated dose failed to induce the massive changes noted with rats given 2% dietary BHA. PMID- 3971352 TI - The contribution of epidemiological and experimental data to the control of environmental carcinogens. PMID- 3971353 TI - Cigarette smoking and bladder cancer in females. AB - In a hospital-based case-control study, 55 women with bladder cancer and 202 female surgical controls were compared for life-long smoking habits. The relative risk associated with cigarette smoking was 2.1; the proportion of bladder cancers attributable to such habit was estimated to be 22%. In comparison with a parallel study in men, it seems that age at diagnosis and age at start of smoking play a different role in the two sexes. PMID- 3971354 TI - Nicotine: a precursor for carcinogens. AB - Eric Boyland and collaborator demonstrated about 20 years ago that N' nitrosonornicotine (NNN), a suspected smoke constituent, was a lung carcinogen in mice and that thiocyanate, a major detoxification product of the smoke component hydrogen cyanide, catalyzes the endogenous formation of nitrosamines. Also, Boyland presumed that the enzymatic conversion of nicotine may contribute to the carcinogenic potential of cigarette smoke via reactive intermediates. Chemical, biochemical and bioassay data gathered since these first observations, support the concept that the nicotine-derived NNN and 4-(methylnitrosamino)-1-(3-pyridyl) 1-butanone (NNK) contribute significantly to the carcinogenic activity of snuff and cigarette smoke. Reactive metabolites of nicotine may also be carcinogenic factors. This hypothesis requires exploration. PMID- 3971355 TI - Comparison of liver tumor frequencies after intermittent oral administration of different doses of N-nitrosopyrrolidine in Sprague-Dawley rats. AB - N-Nitrosopyrrolidine (N-Pyr) was administered orally to 400 Sprague-Dawley rats. An additional group of 80 rats served as an untreated control. There were 5 individual groups in which the effects of different periods of dosing and varying intervals without treatment were compared. Individual doses corresponded to 0.0, 1.0, 1.2 and 2.0 mg/kg per day. The total dose (600 days after the start of the trial) always amounted to 600 mg/kg N-Pyr. Significantly different incidences of liver tumors were observed in the individual N-Pyr-treated groups. The findings support the assumption that tumor risks not only depend on individual and total doses of the administered carcinogen, but are also an age-related function. PMID- 3971356 TI - Quantitative aspects of the causes of the main human cancers in the light of initiating and promoting mechanisms. AB - The early work in the field of chemical carcinogenesis accomplished by Dr. Boyland has provided us with key concepts that can be applied today in the prevention of many kinds of human cancer. Broad understanding of the complex processes of cancer causation was achieved in the last 50 years. Thus, research on the action of chemical carcinogens through their reactive metabolites, the detection of such agents through rapid in vitro bioassays by the product of their interaction with DNA, and the consequences related thereto, has been applied to the qualitative and quantitative implications of such an interaction in relation to the etiology of human cancers. Beginning knowledge of the mechanisms of tumor promotion provides further means of controlling neoplastic processes because of the distinct qualitative and quantitative properties of promoters. The promotion phenomenon contributes extensively to the development of human cancer of the lung and nutritionally-linked cancers such as those in the colon, breast, or prostate. Their quantitative effects may be easier to limit than those due to genotoxic carcinogens, which would help substantially to lower the incidence of these important cancers. PMID- 3971357 TI - Enzymatic inactivation of N-nitroso compounds in murine blood plasma. AB - Murine blood plasma rapidly inactivates nitrosamides and nitrosocarbamates but not nitrosoureas. The mechanism of this inactivation in murine blood plasma has been investigated. The vast majority of activity (greater than 97%) was inhibited by serine hydroxylase inhibitors. Also, 92% of the activity was inhibited by bis(p-nitrophenyl)phosphate, a selective inhibitor of carboxylesterases. Decomposition products formed after blood plasma action on N-ethyl-N nitrosoacetamide or N-methyl-N-nitrosoethylcarbamate were separated and identified by gas chromatography. The products formed were consistent with a hydrolytic cleavage of the amidic bond. These observations are consistent with the idea that the major active factor(s) in plasma is a carboxylesterase(s). PMID- 3971358 TI - Metabolism and selective cytotoxicity of 9-beta-D-arabinofuranosylguanine in human lymphoblasts. AB - The selective toxicity of purine deoxyribonucleosides for T-lymphoblasts appears to be mediated by the selective accumulation of the corresponding deoxyribonucleoside triphosphates in these cells. This finding has led to a search for deoxyribonucleoside analogues which may have clinical utility in T cell lymphoproliferative disorders. 9-beta-D-arabinofuranosylguanine (ara-G) is a 2'-deoxyguanosine analogue which is 70-fold more inhibitory to the growth of T- than of B-lymphoblasts. It is less potent than ara-C but far more selective in its cytotoxic effect on T-cells. ara-G is not significantly degraded by purine nucleoside phosphorylase (EC 2.4.2.1) activity in T-lymphoblasts and is metabolized to 9-beta-D-arabinofuranosylguanine 5'-triphosphate. The accumulation of this metabolite directly correlates with inhibition of DNA but not of RNA or protein synthesis. MOLT-4 T-lymphoblasts were selected for ara-G resistance, and six clones were identified which exhibited a major degree of resistance to 2' deoxyguanosine but little or none to ara-C. Further characterization of clone 24B3 revealed a 600-fold increase in ara-G resistance, a 36-fold increase in 2' deoxyguanosine resistance, and only a 4-fold increase in 1-beta-D arabinofuranosylcytosine resistance. The 24B3 cell line accumulated less than 10% of 9-beta-D-arabinofuranosylguanine 5'-triphosphate and 2'-deoxyguanosine 5' triphosphate from the corresponding nucleosides as compared to wild-type MOLT-4 cells; in contrast, 1-beta-D-arabinofuranosylcytosine 5'-triphosphate accumulation was approximately 30% of control values. Thus, ara-G differs from 1 beta-D-arabinofuranosylcytosine in its selectivity for cultured T-lymphoblasts and may be of use as a chemotherapeutic or immunosuppressive agent. PMID- 3971359 TI - Regrowth and radiation sensitivity of quiescent cells isolated from EMT6/Ro-fed plateau monolayers. AB - A quiescent [denoted as Q(G0/G1)] subpopulation was isolated from EMT6/Ro-fed plateau monolayers by centrifugal elutriation. The median Coulter volume of these cells was significantly smaller than that of the original population from which they were elutriated. Using two-step acridine orange staining and dual parameter flow cytometric analysis, over 95% of quiescent cells were found to have G1 DNA content, and 80% of the cells had a decreased RNA content as compared to rapidly proliferating exponential G1 cells. After labeling for 24 hr (two doubling times) with [3H]thymidine, less than 2% of the quiescent cells incorporated [3H]thymidine as measured by autoradiography. The colony-forming efficiency of these cells was not significantly different from that of exponential cells. When such Q(G0/G1) cells were replated in fresh medium at a lower density, there was a lag time of 30 hr before any increase in cell number was detected, after which the cell-doubling rate matched that of exponential culture. Results obtained from the radiation dose-response curves showed that quiescent (G0/G1) cells were more radiosensitive than exponential G1 or unseparated fed plateau cells. PMID- 3971360 TI - Tumor progression in serial passages of the Dunning R3327-G rat prostatic adenocarcinoma: growth rate response to endocrine manipulation. AB - Serial passages of the poorly differentiated, androgen-sensitive R3327-G prostatic adenocarcinoma were used to study the progressive changes that occur in tumor growth rate and androgen sensitivity. Different in vivo transplant generations (21st to 28th) were compared. The tumor doubling and animal survival times resulting from the implantation of the 21st to 22nd generation (21-22G) tumor cells in intact male rats were significantly greater than those resulting from the implantation of 23-28G tumor cells. The most dramatic difference between early (21-23G) and late (26-28G) tumor generations, however, was in androgen sensitivity. The 26-28G tumors displayed androgen sensitivity only when implanted into animals castrated 2 to 7 days previously. Tumors grown in the pretreated castrates grew at a significantly slower rate than those in intact rats and the pretreated castrates had longer survival times than the intact rats. When 26-28G tumors were allowed to grow in intact rats to approximately 1 cu cm and then the rats were castrated, no significant difference in the growth rate between these tumors and tumors grown in intact rats was observed. In contrast, the androgen sensitivity of 21-23G tumors could be demonstrated, regardless of whether treatment was started before or after implantation. The fact that androgen sensitivity was still evident under certain conditions in late-generation R3327-G tumors demonstrates that the basic mechanism involving androgen response was still present, although functioning at a much reduced level. PMID- 3971361 TI - Immunotherapeutic potential in murine tumor models of polyinosinic-polycytidylic acid and poly-L-lysine solubilized by carboxymethylcellulose. AB - The systemic administration of multiple, nontoxic doses of polyinosinic polycytidylic acid and poly-L-lysine solubilized by carboxymethylcellulose [poly(I,C)-LC] eradicated established experimental and spontaneous pulmonary metastases. Optimal immunotherapy was schedule dependent, requiring three to five injections of poly(I,C)-LC per week for a minimum of 4 weeks; in addition, therapeutic efficiency was partially dosage independent. Immunotherapy by poly(I,C)-LC was found to be limited by tumor burden, although when combined with chemotherapy as a debulking regimen it resulted in increased survival with protocols in which poly(I,C)-LC alone was insufficient. These data suggest that the systemic administration of poly(I,C)-LC may provide a successful adjuvant therapeutic modality against cancer metastasis. PMID- 3971362 TI - Inhibition of queuine uptake in cultured human fibroblasts by phorbol-12,13 didecanoate. AB - The modified base queuine is inserted posttranscriptionally into the first position of the anticodon of tyrosine tRNA, histidine tRNA, asparginine tRNA, and aspartic acid tRNA. Phorbol-12,13-didecanoate (PDD) effects a decrease in the queuine content of tRNA in cultured human foreskin fibroblasts. The present data suggest that this results from a PDD-mediated inhibition of queuine uptake. Nonsaturable uptake was observed for tritiated dihydroqueuine (rQT3) for up to 2 hr at 10 to 1000 nM concentrations, while saturation of uptake was observed after 3 to 4 hr. Lineweaver-Burke analysis of concentration versus uptake revealed biphasic uptake kinetics with high and low Km components of approximately 350 and 30 nM, respectively. Competition by queuine of rQT3 uptake indicated that both compounds have equal affinity for the uptake mechanism. PDD inhibited rQT3 uptake but required 30 to 60 min of exposure before the uptake was completely blocked. The rQT3 efflux rate from cells was found to be 3 to 4 times greater than that of uptake, and PDD also inhibited the efflux reaction. The potential inhibitors furosemide, nitrobenzylthioinosine, ouabain, 7-methylguanine, 7-deazaguanine, guanine, guanosine, adenine, adenosine, hypoxanthine, and epidermal growth factor had no effect on rQT3 uptake. However, dipyridamole was immediately effective at reducing rQT3 uptake. PMID- 3971363 TI - [3H]Methotrexate loss from the rat brain following enhanced uptake by osmotic opening of the blood-brain barrier. AB - Right brain regions of anesthetized rats were loaded with [3,5,7-3H]methotrexate ([3H]MTX) or with [14C]sucrose by infusing the tracers into the right carotid artery, after the blood-brain barrier had been opened by right carotid infusion of a hypertonic arabinose solution. During the 6 hr following the procedure, the [3H]MTX concentration in 7 right-sided brain regions, when normalized to the plasma concentration integral during tracer infusion, fell, with an average half time of 4.8 hr as compared to less than 20 min for the initial rate of loss [14C]sucrose. Right-left brain concentration differences 3 hr after treatment were statistically significant (p less than 0.05) for [3H]MTX but not for [14C]sucrose. The results indicate that intracerebral [3H]MTX is lost more slowly than is intracerebral [14C]sucrose, possibly because [3H]MTX enters brain cells, whereas [14C]sucrose remains largely extracellular. PMID- 3971364 TI - Fatty acid-stimulated oxidation of methylazoxymethanol by rat colonic mucosa. AB - The present study examined fatty acid-initiated metabolism of methylazoxymethanol (MAM) to formaldehyde (HCHO) by the 10,000 X g soluble fraction of rat colonic mucosa, and the role of prostaglandin synthase and lipoxygenase activities in mediating this process. Incubation of MAM with soluble fractions of rat colonic mucosa, in the absence of arachidonate, resulted in significant HCHO production compared to that observed in buffer alone or with the heated tissue fractions. Addition of arachidonate (100 microM), linoleate (100 microM), or arachidonate hydroperoxide, but not palmitate, increased HCHO formation by 50%. Indomethacin (25 to 100 microM) suppressed basal and arachidonate-stimulated HCHO production by 25 to 50%. However, indomethacin did not influence linoleate or arachidonate hydroperoxide-induced increases in HCHO. These data suggested a peroxidative mechanism for MAM oxidation, that was mediated in part by arachidonate metabolism via the prostaglandin synthase system. 5,8,11,14-Eicosatetraynoic acid (25 to 500 microM) suppressed HCHO production by 30 to 80% in the absence of fatty acids, and abolished stimulation by arachidonate or linoleate, but not by arachidonate hydroperoxide. MAM was also oxidized by an NAD+-dependent dehydrogenase, as evidenced by MAM-mediated NAD reduction in 10,000 X g soluble fractions of rat colonic mucosa. On a molar basis, the ability of the soluble fraction of rat colonic mucosa to oxidize MAM by the NAD+-dependent dehydrogenase pathway and the fatty acid-stimulated pathway were similar. However, NADPH did not stimulate HCHO formation by MAM. Moreover, 7,8-naphthoflavone; 2-diethylaminoethyl-2,2 diphenylvalerate; and methimazole, inhibitors of mixed-function oxidase activity, did not suppress HCHO formation, implying that MAM was not metabolized by the colonic mixed-function oxidase activity. MAM metabolism to HCHO was 3 to 4 times greater by soluble fractions of superficial epithelial cells isolated from rat colon compared to those of the isolated proliferative epithelial cell pool. The results are consistent with a role for both the prostaglandin synthase and lipoxygenase systems of colonic mucosa in the oxidative metabolism of MAM. Enhanced oxidation of MAM by superficial cells of colonic epithelium which are preparing to slough may serve to protect the colon against the carcinogenic effect of this drug. PMID- 3971365 TI - Metabolism of nitrosamines by purified rabbit liver cytochrome P-450 isozymes. AB - The metabolism of nitrosamines by microsomal cytochrome P-450 (P-450) isozymes was studied in a reconstituted monooxygenase system. P-450 LM2, LM3a, LM3b and LM3c, LM4, and LM6 were purified, respectively, from the livers of phenobarbital treated, ethanol-treated, untreated, isosafrole-treated, and imidazole-treated rabbits. Of these isozymes, LM3a had the highest N-nitrosodimethylamine demethylase (NDMAd) activity with a Km of 2.9 mM and Vmax of 9.3 nmol/min/nmol. LM2, LM4, and LM6 exhibited NDMAd activity only at high N-nitrosodimethylamine concentrations, and isozymes LM3b and LM3c had poor activity even at the highest substrate concentrations examined. LM2, however, was more active than LM3a in the metabolism of N-nitrosomethylaniline. With each isozyme (LM3a or LM4), only one Km for NDMAd was observed, whereas with rabbit liver microsomes, multiple Km of 0.07, 0.27, and 36.8 mM were obtained. P-450 isozymes also catalyzed the denitrosation of nitrosamines at rates comparable to or lower than the demethylation, and the ratio of these two reactions was different with different nitrosamines. 2-Phenylethylamine and 3-amino-1,2,4-triazole, which were believed previously to affect NDMAd by mechanisms independent of P-450, were shown to be potent inhibitors of P-450-dependent NDMAd. These results further establish the role of P-450 isozymes in the metabolism of nitrosamines and indicate that LM3a is apparently responsible for the increased N-nitrosodimethylamine metabolism associated with ethanol treatment. PMID- 3971366 TI - Comparison of Class II HLA antigen expression in normal and carcinomatous human breast cells. AB - Class II HLA antigen expression in breast carcinoma and normal breast gland cells was compared using a method more accurate than immunofluorescence. This new method involves labeling membrane proteins with 131I and the anti-Class II HLA monoclonal antibody with 125I. The isolation and purification of the doubly labeled (125I-131I) immune complex was performed by affinity chromatography and chromatofocusing successively. When the specific activity of glycoproteins is known, the amount of glycoproteins which bind specifically to the anti-Class II HLA monoclonal antibody can be deduced. In breast carcinoma cells, 1.5 to 2% of the purified glycoproteins bind specifically to the monoclonal antibody, whereas less than 0.3% of normal breast gland cells binds. In contrast, leukemic cells, of which 80 to 90% possess Class II HLA antigens, 2 to 3% of Class II HLA glycoproteins bind specifically with the anti-Class II HLA monoclonal antibody. PMID- 3971367 TI - Increased repair replication in human lymphoid cells by inhibition of polyadenosine diphosphoribose synthesis with no increase in patch sizes. AB - Repair replication of alkylation damage in WIL-2 lymphoid cells is increased up to 7-fold by addition of 3-aminobenzamide, an inhibitor of polyadenosine diphosphoribose polymerase. This increase occurs without any change in the repair replication patch size and must therefore represent a large increase in the number of patches. The increase in the number of patches occurs without concomitant increase in the rate of excision of damaged sites. Therefore, it seems unlikely that 3-aminobenzamide plays any role in regulating ligation of repair patches, as commonly supposed. Instead, by inhibiting polyadenosine diphosphoribose polymerase or by other side effects, 3-aminobenzamide appears to elicit random nuclease attack of cellular DNA. The sites of attack are then repaired with patches of similar size, as are most other lesions. Nuclease attack may play a role in the increased cellular toxicity attendant on growth in 3 aminobenzamide. PMID- 3971368 TI - Effects of temperature on papilloma growth in the newt, Cynops pyrrhogaster. AB - The effects of temperature on skin papillomas of newts (Cynops pyrrhogaster) were studied. Newts bearing these tumors were maintained for 30 weeks at 4 +/- 1 (S.E.), 10 +/- 1, 13 +/- 2, 25 +/- 1, and 30 +/- 1 degree. The diameters of the papillomas were measured externally. They decreased at 4, 25, and 30 degrees, and increased at 10 and 13 degrees. The effect of temperature on the tumor growth or regression began to appear from around the 10th week. Furthermore, when the temperatures were changed, it was possible to reverse the growth or regression of the tumors. Histologically, cell layers of the tumors became thin at 4, 25, and 30 degrees, but there were some differences between 4 and 25 or 30 degrees. The pigment layers became thick, and epidermal cells invaded dermal layer at 4 degrees, and clumps of cells separated from the surface of the tumors at 25 and 30 degrees. Mitotic indices were lower at 4, 25, and 30 degrees than in normal epidermis, but were about 3 times as high as normal tissue at 10 or 13 degrees. The relation between these results in the laboratory and seasonal fluctuations of these tumors in nature is discussed. PMID- 3971369 TI - Cytotoxicity of the alkyl-linked lipoidal amine 4-aminomethyl-1-[2,3-(di-n decyloxy)-n-propyl]-4-phenylpiperidine (CP-46,665) in cells from human tumors and leukemias. AB - The alkyl-linked lipoidal amine 4-aminomethyl-1-[2,3-(di-n-decyloxy)-n-propyl]-4 phenylpiperidine (CP-46,665) inhibited the in vitro incorporation of tritiated thymidine into blasts of eight leukemias and cells of nine different solid tumors of human origin. This activity was well correlated with trypan blue dye exclusion, which was tested to assess cell membrane damage. Scanning electron microscopy revealed loss of cell surface features and severe cell membrane destruction after incubation with CP-46,665. These effects on thymidine uptake and single cell viability were accompanied by a clear loss of the reproductive capacities of human tumor and leukemic cells as measured in a human tumor stem cell assay after incubation with CP-46,665. The above-mentioned cytostatic and cytotoxic effects of CP-46,665 were dependent on dosage and incubation time. Destruction of leukemic blasts was often completed with greater than or equal to 5 micrograms/ml after an incubation of greater than or equal to 48 hr or greater than or equal to 10 micrograms/ml after an incubation of greater than or equal to 24 hr. Cells from solid tumors usually required a slightly higher drug concentration and longer incubation period for maximum killing. The alkyl-linked lipoidal amine CP-46,665 often showed considerably greater efficacy than did the alkyl-linked phospholipid rac-1-O-octadecyl-2-O-methylglycero-3-phosphocholine tested in comparison. In contrast to both drugs, 2-lysophosphatidylcholine showed only minor activity within the same dose range. PMID- 3971370 TI - Evaluation of monoclonal antibodies for the development of breast cancer immunotoxins. AB - Eighty-five antibodies recognizing breast cancer-selective antigens were conjugated to ricin toxin A-chain using a disulfide linkage. The cytotoxicities of the resulting immunotoxins were determined on breast cancer cells and normal human fibroblasts. Twenty-four antibodies formed immunotoxins that were toxic to at least one breast cancer cell line at concentrations of 10 nM or less but were nontoxic to human fibroblast lines used as negative controls. Some of the breast tumor-selective immunotoxins were as toxic as a conjugate between monoclonal anti transferrin receptor and ricin toxin A-chain (50% inhibition of cellular protein synthesis at approximately 0.1 nM). Another set of four immunotoxins were indiscriminately toxic to human breast tumor cell lines, two human fibroblast cell lines, and a human lymphoblastoid line. Several of the antibodies the toxin conjugates of which specifically killed breast cancer cell lines may be useful in cancer therapy, since they show a wide range of binding to individual breast tumors and cell lines and a limited range of binding to normal tissue types. PMID- 3971371 TI - Growth and function of thirty-four human benign and malignant thyroid xenografts in untreated nude mice. AB - Tissue was taken from 16 patients with benign thyroid lesions (10 nontoxic nodular colloid goiter, two follicular adenoma, one autonomous adenoma, one iodine-induced thyrotoxicosis, 2 Graves' disease) and 18 patients with malignant thyroid tumors [seven papillary, five follicular, five undifferentiated (anaplastic), and one medullalry carcinoma] and was xenotransplanted into the flanks of 124 syngeneic female BALB/c-nu/nu mice 6 weeks of age. Subsequently, without any further treatment, serum levels of thyroglobulin (TG), T3, T4, and thyroid-stimulating hormone were determined by radioimmunoassay at 4 or 5 weeks posttransplantation and at the end of the experimental time period of 4 months. All animals were autopsied. The grafts were examined by light microscopy and TG immunohistochemistry. Morphologically, the grafts of benign and malignant thyroid tumors showed features overall identical to the original tissue. Conversely, nontoxic nodular colloid goiter and Graves' disease grafts revealed a transformation to normofollicular structures. All benign thyroid grafts showed a stationary growth, as did most differentiated thyroid carcinomas. Tumor take rates in differentiated and in medullary carcinoma were 15%, and in undifferentiated carcinomas, 100%. In the cancer grafts, a correlation between resting phase (period until progressive tumor growth) and survival time of the corresponding patients was disclosed. All patients whose tumors were not taken by nude mice are still alive and show no signs of progressive tumor growth at 9 to 34 months after surgery. All but one patient with tumors revealing positive tumor take died within 3 months (resting phase, 3 weeks) or one year (resting phase, 7 to 14 weeks) after surgery. Integrity of hormonal function in benign and malignant xenografts at 4 months posttransplantation could be shown by significantly higher T3 and T4 serum concentrations in animals with benign thyroid tissues (T3, 1.69 +/- 0.13 nmol/liter; T4, 45.69 +/- 2.09 nmol/liter; S.E.) as compared to controls without grafted tissue [T3, 1.29 +/- 0.10 nmol/liter (p less than 0.05); T4, 33.39 +/- 2.71 nmol/liter (p less than 0.05)] and by increased TG serum concentrations in animals receiving benign (TG, 2.70 +/ 1.39 ng/ml) or malignant (e.g., TG in follicular carcinoma, 34.44 +/- 13.83 ng/ml; controls, 0.30 +/- 0.02 ng/ml) thyroid tissue. Thus, we conclude that benign and malignant thyroid xenografts in the nude mouse maintain full morphological and, regarding T3, T4, and TG serum levels, functional integrity for at least 4 months after transplantation. PMID- 3971372 TI - Effects of plasma treatment with purified protein A and Staphylococcus aureus Cowan I on spontaneous animal neoplasms. AB - Eleven dogs with spontaneous neoplasms were intensively treated with an immunoadsorption system consisting of a continuous flow centrifuge, Protein A Sepharose columns, and a semi-automatic elution system. Despite consistent and substantial lowering of immunoglobulin G levels, tumor regression was noted in only one of 11 dogs. In contrast, infusion of small volumes of plasma after incubation with heat and formalin-treated Staphylococcus aureus Cowan I resulted in a tumoricidal response in five of six animals. These results suggest that tumor necrosis is probably not induced by Protein A-mediated removal of humoral "blocking" factors. PMID- 3971373 TI - Induction of 5,6-ring-saturated thymine bases in NIH-3T3 cells by phorbol ester stimulated macrophages: role of reactive oxygen intermediates. AB - Because oxygen intermediates secreted by inflammatory leukocytes are postulated to play a role in potentiating carcinogenesis, we investigated the ability of macrophages to induce oxidative DNA damage in eukaryotic cells. Murine macrophages, obtained from sites of inflammation and stimulated with 12-O tetradecanoylphorbol-15-acetate, induced the formation of 5,6-ring-saturated thymine bases in the DNA of cocultured NIH-3T3 cells; macrophages or 12-O tetradecanoylphorbol-15-acetate alone did not induce such alterations. Reagent H2O2, at concentrations produced by macrophages in the ambient medium (i.e., approximately 10(-5) M), induced saturated thymines in the target cells in a dose dependent manner. The reaction between reagent H2O2 and cellular DNA was rapid, reaching maximum levels in 30 min, and similar amounts of saturated thymines were induced at 4 degrees or 37 degrees. The 3T3 targets were able to repair the saturated thymines rapidly (i.e., over 70% of the lesion was removed in 2 hr). Catalase completely inhibited macrophage-mediated induction of saturated thymines, although superoxide dismutase enhanced induction. Taken together, the data indicate that macrophages exposed to phorbol diesters can induce a specific, quantifiable lesion in the DNA of bystander eukaryotic cells and that reactive oxygen species from the macrophages participate in producing the lesion. PMID- 3971374 TI - Methylation and expression of rat kappa-casein gene in normal and neoplastic rat mammary gland. AB - The kappa-casein mRNA was evaluated in the rat mammary gland during functional differentiation and neoplastic growth. Using a dot-blot assay, the mRNA was barely detectable in the virgin gland; it steadily increased from the onset of gestation and leveled off during lactation. In rat mammary tumors, either primary (7,12-dimethylbenz(a)anthracene-induced) or transplanted (MTW9), the level of kappa-casein mRNA was about 2.5-fold lower than in the lactating gland, but an extensive variation among individual tumors was observed. There was no detectable kappa-casein mRNA in rat liver. In the mammary gland of virgin, 10-day pregnant, and nonlactating females, the DNA sequences within and/or around the kappa-casein gene were found to be hypermethylated at the HpaII-MspI sites as compared to 10 day lactating females. In the two tumors studied, the kappa-casein gene was partially methylated at the same sites. Prolactin treatment induced kappa-casein gene expression in the virgin rat mammary gland but did not result in a change of the methylation status at the HpaII-MspI sites. Under similar conditions of prolactin treatment, however, the methylation of the Sau96I sites was reduced, and an inverse correlation between the onset of kappa-casein gene methylation and kappa-casein gene expression was evident in both the virgin gland and the tumors. Thus, the expression of kappa-casein was found to be inversely correlated with the extent of methylation of the kappa-casein gene, except in the case of the prolactin-stimulated virgin gland. PMID- 3971375 TI - A new morphologically characterized cell wall preparation (whole peptidoglycan) from Bifidobacterium infantis with a higher efficacy on the regression of an established tumor in mice. AB - Three kinds of morphologically distinct cell wall preparations were isolated from heat-killed Bifidobacterium infantis and examined for the relative antitumor efficacy with syngeneic Meth A fibrosarcoma in BALB/c mice. Ultrastructural examinations revealed that cell wall skeleton (CWS) did not retain morphologically recognizable cell wall structure but showed fibrous structure. By contrast, a new cell wall preparation, whole peptidoglycan (WPG), which was isolated from whole cells without being subjected to physically destructive methods, completely retained the intact cell wall structure. When WPG was disrupted by sonic treatment, it retained some degree of physical integrity of cell wall structure, as compared with CWS. The results of chemical analysis indicated that the three cell wall preparations had similar chemical properties. A single s.c. injection of either CWS, WPG, or sonicated WPG in a mixture with tumor cells resulted in a significant suppression of the tumor growth. They were of equally high activity. However, when WPG, sonicated WPG, or CWS was injected intralesionally five times into mice bearing 5-day-old tumors, the incidence of complete tumor regression was demonstrated to decrease in the order of 70, 40, and 20%, respectively. The in vitro cytotoxicity test excluded the possibility that the tumor cell destruction was the result of direct cytotoxicity of the cell wall preparations. From these findings, it was concluded that WPG was an active stimulator of host-mediated response at the tumor-growing sites. PMID- 3971376 TI - Cytotoxic effect of anti-Mr 67,000 protein immunotoxins on human tumors in a nude mouse model. AB - We have studied the potential use of immunotoxins (ITs) for therapeutic treatment of human tumors in an experimental model of human neoplasia. We tested intact ricin IT for its antitumor activity against established tumors. CEM, a human T cell leukemia line expressing an Mr 67,000 cell surface antigen, and Daudi, a human B-cell lymphoma line which does not express the antigen, were found to be consistently tumorigenic in nude mice. ITs were synthesized using T101, a high affinity monoclonal antibody reacting with the Mr 67,000 protein determinant and intact ricin. We have shown for the first time that established CEM solid tumors in nude mice will regress following intratumoral injection of T101-ricin IT, while Daudi tumors will not. Selective activity of T101-ricin is dependent on systemic i.v. administration of lactose and local intratumoral injection of the T101-ricin IT with lactose. Intact ricin ITs require the presence of lactose to block native ricin binding and render them antigen specific when linked to monoclonal antibody. Killing of target was cell specific since (a) nonspecific (irrelevant) ITs did not cause the regression of CEM tumors, and (b) injection of large amounts of free T101 antibody prior to T101-ricin IT blocked antitumor activity. Selectivity was not absolute, since regression occurred in one of six animals given irrelevant IT, and blocking was observed in two of four mice. Intratumoral IT treatment with 1 or 2 micrograms of T101-ricin IT plus lactose was not harmful to mice in contrast to intratumoral ricin treatment, which killed all treated tumor-bearing mice at a dose of 0.3 micrograms. Without i.v. injection of lactose, intratumoral injection of T101-ricin IT was also effective in eliminating established tumors. However, this treatment did not result in the selective elimination of tumor, since Daudi tumors also regressed following T101 ricin IT treatment. IT, made with ricin A chain only (T101-A chain IT), was also tested against established CEM tumors. We found that high dosages of T101-A chain IT did not destroy CEM tumors when injected intratumorally, even in the presence of activating agents such as NH4Cl or the carboxylic ionophore X-537 A. In contrast, in vitro experiments demonstrated that T101-A chain IT plus activating agents had potent and selective cytotoxic effect against CEM cells. We conclude that ITs are specifically toxic to established tumors. Although selectivity is not absolute, ITs exhibit potential as a new class of antitumor reagents. PMID- 3971377 TI - Two monoclonal antibodies selective for human mammary carcinoma. AB - Mouse myeloma cells were fused with spleen cells from BALB/c mice immunized with the MCF-7 human mammary carcinoma cell line. Among hybridomas, two (3B18 and 15A8) were selected and cloned. Hybridoma 3B18 produces kappa-IgG1 antibodies that react with a cytoplasmic component of MCF-7 cells. In immunoperoxidase assays, 3B18 reacts with 27 of 31 specimens of human mammary carcinoma. It reacts most consistently with poorly differentiated and infiltrating ductal breast cancers, but it also reacts with isolated cells in 3 of 5 benign mammary pathological lesions with a variable distribution. The antibody does not react with normal mammary epithelium. It does not react with any normal human tissues, and it reacts with only one of 19 other cancers tested. Hybridoma 15A8 produces kappa-IgG1 antibodies that react with the surface membranes of the cells of two human breast cancer cell lines but not with a human fibroblast cell line. In immunoperoxidase assays, the antibody reacted with 28 out of 31 human mammary carcinomas. The antibody also reacts more weakly with normal human epithelial cells of breast, renal proximal tubule, skin, esophagus, and salivary gland, but no other normal tissue. The antibody was unreactive with 14 of 18 other malignant tissues tested. Since 3B18 and 15A8 detect antigens found predominantly in human mammary carcinomas and, possibly, distinguish overlapping categories of human mammary carcinomas, they may prove useful in determining the cellular lineage from which human mammary carcinomas arise, or they may have other clinical applications in breast cancer. PMID- 3971378 TI - In vitro differentiation of human melanoma cells analyzed with monoclonal antibodies. AB - Many monoclonal antibodies (MABs) have been produced against cell surface molecules of melanoma cells, and these reagents might help in the definition of stages of differentiation of the normal and the malignant cells. In an attempt to detect MAB-defined determinants that modulate with differentiation, we treated nonpigmented human melanoma cells with the tumor promotor 12-O tetradecanoylphorbol-13-acetate (TPA) at 16 nM. Differentiation could be induced in all 4 cell lines, as evidenced by growth retardation, development of projections, and induction of melanin or of premelanosomes in the projections as detected by transmission electron microscopy. Of the 9 MAB-defined cell surface antigens, three were shown to modulate with TPA-induced differentiation, as assessed by fluorescence microscopy and fluorescence-activated cell sorter analysis. Antigens detected by MABs 15.75 and 15.95 decreased in every one of the four cells after TPA induction of differentiation. The proteoglycan defined by 225.28S increased slightly in one, showed no change in another, and decreased in the remaining two. These three MAB-defined molecules thus are linked to differentiation and might help in designing a scheme of differentiation of the melanocyte lineage. PMID- 3971379 TI - Autoradiographic distribution of 14C-labeled 3H-imidazo[4,5-f]quinoline-2-amines in mice. AB - The highly mutagenic heterocyclic amines, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ), are formed during heating of protein-rich foods. In order to gain information about the distribution and fate of IQ and MeIQ in vivo, a whole-body autoradiographic study of i.v.-injected 14C-labeled IQ and MeIQ has been performed in male NMRI, pregnant NMRI, and female C3H mice. IQ and MeIQ showed similar distribution patterns. At short survival times, the autoradiograms were characterized by an accumulation of radioactivity in metabolic and excretory organs (liver, kidney, bile, urine, gastric and intestinal contents, salivary glands, nasal mucosa, and Harder's gland), as well as in lymphomyeloid tissues (bone marrow, thymus, spleen and lymph nodes) and in endocrine and reproductive tissues (adrenal medulla, pancreatic islets, thyroid, hypophysis, testis, epididymis, seminal vesicles, ampulla, and prostate). The liver and kidney cortex were identified as sites of retention of nonextractable radioactivity. IQ and MeIQ showed a strong affinity for melanin. IQ and MeIQ passed the placenta, but no radioactivity was retained in fetal tissues. The results pinpoint the liver as a site of IQ- and MeIQ mediated toxicity. Future studies of IQ and MeIQ may be guided by and clarify the role of other tissue localizations in the toxicity of IQ and MeIQ. PMID- 3971380 TI - Differential characteristics of two newly established human breast carcinoma cell lines. AB - Two human breast carcinoma cell lines, EP and MW, were established in culture from malignant pleural effusions. In addition to producing tumors in antithymocyte serum-immunosuppressed mice, both cell lines showed epithelial characteristics and anchorage-independent growth in soft agar. EP and MW differed in morphology (spindle-shaped versus round), chromosomal mode (hyperdiploid versus near triploid), estrogen receptor content (43.8 versus 5.1 fmol/mg protein), cloning efficiency (0.24 versus 15%), and activities (milliunits/10(6) cells) of creatine phosphokinase (25.7 versus 62.6) and lactate dehydrogenase (346.7 versus 778.5). Electron microscopy revealed that MW cells had more perinuclear filamentous material and more frequent intracytoplasmic vacuole formation than did EP cells. While having no effect on MW cells at the concentrations studied (10(-5) to 10(-11) M), beta-estradiol (10(-7) M) stimulated the growth of EP cells by 106% over the hormone-depleted control. In a variety of systems, EP was consistently the more drug sensitive of the two lines. In vitro, EP was significantly (p less than 0.001) more sensitive to methotrexate, vincristine, and 5-fluorouracil, respectively. In antithymocyte serum-mouse xenografts, EP displayed a greater response to three different dosages of a combination of cyclophosphamide, methotrexate, and 5-fluorouracil. One such dosage (cyclophosphamide, 32.0 mg/kg/day; methotrexate, 13.0 mg/kg/day; 5-fluorouracil, 190.0 mg/kg/day; for 1 day) reduced EP and MW tumor weights to 5.9 and 41% of controls, respectively. These results correlated well with the clinical responses. PMID- 3971381 TI - Carcinogenicity in rats of the nitrosated bile acid conjugates N nitrosoglycocholic acid and N-nitrosotaurocholic acid. AB - Two nitrosated bile acid conjugates, N-nitrosoglycocholic acid and N nitrosotaurocholic acid, were examined for carcinogenicity in a 2-year study with male Fischer rats using a 6-week p.o. dosing protocol with a total of 300 mg compound/rat. Both compounds were approximately equally carcinogenic and induced significant levels of hepatocellular carcinoma in 54 to 70% of the animals at risk. Gastric tumors of the glandular and aglandular stomach were observed in 12 to 13% of the treated rats. Although the incidence was not significant, these levels were much higher than those in historic controls. Malignant liver and gastric tumors were not detected in vehicle control rats. Alkaline phosphatase positive foci, putative early mucosal alterations which may precede neoplasia, were found in approximately 35% of the glandular stomachs of compound-treated rats but not in those of control rats. PMID- 3971382 TI - Differential formation of O6-ethylguanine in the DNA of rat brain chromatin fibers of different folding levels exposed to N-ethyl-N-nitrosourea in vitro. AB - Extended (histone H1-depleted), 11-nm-thick chromatin fibers and condensed 25- to 35-nm-thick chromatin fibers, representing the first and second level of DNA folding in chromatin, respectively, as well as nucleosome core particles, were isolated from fetal rat brain cells and briefly exposed to N-ethyl-N-nitrosourea (EtNU) in vitro. The O6-ethyl-2'-deoxyguanosine (O6-EtdGuo):2'-deoxyguanosine (dGuo) molar ration in DNA enzymatically hydrolyzed to 2'-deoxynucleosides was determined by competitive radioimmunoassay using an anti-O6-EtdGuo monoclonal antibody with an affinity constant for O6-EtdGuo of approximately 2 X 10(10) liters/mol. In comparison to naked DNA (O6-EtdGuo:dGuo relative value, 1.0) the O6 atom of guanine proved to be increasingly protected from ethylation by EtNU in the DNA of the histone H1-depleted chromatin fibers (relative value, approximately 0.6) and of the condensed chromatin fibers (relative value, approximately 0.4). From the O6-EtdGuo:dGuo relative values obtained for the DNA of nucleosome core particles (approximately 0.5) and of H1-depleted chromatin fibers (approximately 0.6), it follows that the accessibility of the O6 atom of guanine to the electrophilic ethyldiazonium ion generated from EtNU in internucleosomal DNA (protein free) is about twice that found in nucleosomal DNA. The overall O6-EtdGuo:dGuo molar ratio in the DNA of H5 rat hepatoma cells exposed to EtNU in vitro was similar to that of the DNA of the condensed 25- to 35-nm chromatin fibers. Since the bulk of genomic DNA is organized in the form of these chromatin fibers, the overall degree of intercellular O6-EtdGuo formation appears to be mainly determined by this folding level of DNA, and not, or only to a low degree, by the DNA folding levels of higher-order chromatin structures such as those found in large loops or domains of chromatin fibers within the cell nucleus. PMID- 3971383 TI - Ultrastructural studies of spontaneous in vitro transformation of cultured marrow monocyte-macrophage cells from a patient with congenital hypoplastic anemia. AB - The CM-S cell line was established from the bone marrow of a patient suffering from congenital hypoplastic anemia (syndrome of Diamond-Blackfan). The cells grew in suspension in liquid culture and were dependent for their continuous replication in vitro on growth factors produced by the same cells seeded at high density. Initially, undifferentiated blasts, immature myeloid, megakaryocytic and, rarely, erythroid cells were observed. Eventually, a population of cells with characteristics of monocyte-macrophage precursors predominated. These cells could be induced to terminal macrophage differentiation by incubation with the tumor promoter 12-O-tetradecanoylphorbol-13-acetate. During this period (over 150 continuous passages), the cells failed to form colonies in agar and to give rise to tumors when inoculated into athymic mice. On prolonged passages, however, the cells gradually increased their growth capacity in liquid culture and became capable of forming colonies in agar and tumors in animals. Ultrastructural studies revealed that the expression of differentiated traits markedly changed as a function of time: after 277 passages, the transformed cells, although displaying characteristics of monocyte precursors, appeared blocked at this stage and no longer responded to 12-O-tetradecanoylphorbol-13-acetate. PMID- 3971384 TI - Relationship between DNA ploidy, glandular differentiation, and tumor spread in human prostate cancer. AB - DNA ploidy was evaluated by flow cytometry for 45 human prostate carcinomas (34 prostatectomy specimens and 11 biopsies). Twenty tumors (44.4%) contained a distinct aneuploid stem line. All 11 tumors confined to the prostate gland (pathological Stage B) were diploid. The frequency of aneuploidy increased with advancing stage, and most tumors with distant metastases were aneuploid. The degree of glandular differentiation was characterized by the Gleason score. One third of tumors with a Gleason score of 5 to 6 were aneuploid, whereas over 70% of poorly differentiated tumors with a Gleason score of 9 to 10 were aneuploid. Among diploid tumors, 45.5% were localized carcinomas (Stage B), 36.4% were characterized by invasion outside the prostate (Stage C), and 18.2% formed pelvic nodal or distant metastases (Stages D1 and D2). In nearly two-thirds of patients with aneuploid tumors, pelvic nodal or distant metastases were found. When tumors were classified according to both DNA ploidy and degree of glandular differentiation, then subgroups of tumors with the highest and lowest degree of malignant potential became apparent. Only 7.1% of diploid tumors with a Gleason score of 5 to 6 formed metastases, but 80% of aneuploid tumors with a higher Gleason score (7 to 10) formed metastases. Diploid tumors with higher Gleason scores and aneuploid tumors with lower Gleason scores had intermediate frequencies of metastases. The presence of an aneuploid stem line in prostate carcinomas indicated that the tumor had spread outside the prostate gland or had metastasized. DNA ploidy may be an important prognostic factor for human prostate cancer. DNA ploidy and the degree of glandular differentiation considered together may improve prognostic evaluation of prostate carcinomas. PMID- 3971385 TI - Prognostic value of surface antigens in primary human breast carcinomas, detected by monoclonal antibodies. AB - Three monoclonal antibodies, raised against human milk fat globule membranes, have been applied to 194 primary human breast carcinomas. The detected antigenic sites were found to be heterogeneously distributed. A statistical association with estrogen receptor content and grade of anaplasia was found for two of the antigens, Mam 3a and Mam 3b. The presence of all three antigens was independent of menopausal status, age, primary lymph node metastases, and progesterone receptor status. Life table analysis showed a better survival for patients with tumors positive for Mam 3b. The effect of these variables on recurrence-free survival has been analyzed using a Cox regression model. It is found that the most important prognostic factors are the number of positive lymph nodes, the estrogen receptor content, and the menopausal status of the high-risk patients. The ability of a model based on these factors to predict recurrence is not significantly improved by including any of the three surface antigens. PMID- 3971386 TI - Elastosis in relation to prognosis in primary breast carcinoma. AB - The content of elastic tissue has been evaluated in 171 primary breast carcinomas. Of the tumors, 35% had no or very little elastic tissue in the malignant areas, 42% presented with medium elastosis, and 22% had gross elastosis. The occurrence of elastin has been related to different prognostic factors. An increasing amount of elastin was found with increasing amounts of estrogen receptor (p = 0.0003), while there was only a slight correlation to the progesterone receptor content. Furthermore, the highly differentiated tumors contained more elastin in their tumor tissue than the poorly differentiated tumors (p = 0.003), and parous women had significantly more elastin than nonparous women (p = 0.02). The presence of elastin was not, however, of any demonstrable prognostic significance. PMID- 3971387 TI - Standardized Nomenclature for Inbred Strains of Mice: eighth listing. AB - This paper presents a list of inbred strains of mice with their origins and characteristics, and a list of standard subline designations. PMID- 3971388 TI - Selective toxicity of a new lipophilic antifolate, BW301U, for methotrexate resistant cells with reduced drug uptake. AB - Three methotrexate (MTX)-resistant cell lines and their MTX-sensitive counterparts have been used to examine 2,4-diamino-6-(2,5-dimethoxybenzyl)-5 methyl-pyrido[2,3-d]pyrimidine (BW301U), a novel lipophilic antifolate, and compare its cytotoxicity with MTX and metoprine. Collateral sensitivity for both BW301U and metoprine was observed in CCRF-CEM/MTX R-cells, where MTX resistance appeared to be primarily due to a deficiency in drug uptake. This was particularly pronounced with BW301U which proved to be as effective in killing CCRF-CEM/MTX R as was MTX with the parental CCRF-CEM cell line. This effect was not seen in other cell lines, L5178Y/MTX or L1210/MTX R, where resistance to MTX was correlated with either an overproduction of 5,6,7,8 tetrahydrofolate:nicotinamide adenine dinucleotide phosphate oxidoreductase EC 1.5.1.3 (DHFR) or with combined uptake defect and increased DHFR levels, respectively. In each case, however, BW301U and metoprine, especially at high concentrations, were more effective than MTX in treating MTX-resistant cells. PMID- 3971389 TI - Cellular pharmacology in murine and human leukemic cell lines of diaziquone (NSC 182986). AB - We investigated the in vitro interaction with and antitumor effect on several murine and human leukemic cell lines of diaziquone (AZQ). L1210 cells accumulated AZQ from Roswell Park Memorial Institute Medium 1640 with or without newborn calf serum by a temperature-dependent and sodium azide-resistant process. AZQ inhibited, in a dose-dependent fashion, [3H]thymidine incorporation into L1210 cells, but this inhibition was slow to develop, requiring approximately 6 hr to become apparent. The minimal inhibitory concentration of AZQ for this process was 0.05 to 0.25 nmol/ml. AZQ was a much less effective inhibitor of L1210 cell [3H]uridine and [14C]valine incorporation. In suspension cultures, AZQ inhibited growth of L1210 and HL-60 cells at minimal inhibitory concentrations of 0.5 to 1 nmol/ml. In soft agar cultures, AZQ inhibited HL-60 cell cloning at minimal inhibitory concentrations of 0.1 to 0.3 nmol/ml. AZQ provoked a dose-dependent increase in oxygen consumption when added to intact L1210, HL-60, and K562 cells and was converted to an AZQ anion free radical by these cells. When the aziridine rings of AZQ were opened by acid treatment, the resulting molecule was not accumulated by L1210 cells, did not provoke O2 consumption, did not form free radicals when added to L1210 cells, and was a much less effective inhibitor of [3H]thymidine incorporation by L1210 cells than was AZQ. PMID- 3971390 TI - Vinca alkaloid-induced cardiovascular autonomic neuropathy. AB - To determine the incidence of vinca alkaloid (VA)-induced cardiovascular autonomic neuropathy (CAN), neoplastic patients were studied. Thirty-three of them were receiving chemotherapy regimens including VAs, and 30 were receiving chemotherapy without VA and were considered controls. Abnormal variation in blood pressure on standing, heart rate during deep breathing, and heart rate on standing was found in 27 (82%), 16 (48%), and 16 (48%) patients receiving VA versus nine (30%; P less than 0.01), three (10%; P less than 0.05), and one (P less than 0.001) controls, respectively. Of 198 tests performed, 100 were abnormal in patients receiving VA (51%) versus 33 of 180 tests in the controls (18%; P less than 0.001). Although abnormal clinical or electrocardiographic tests for CAN appeared significantly more frequently in patients who received high doses of VA (P less than 0.01), their incidence was not significantly different in patients greater than or equal to 60 years of age, in those who received doxorubicin, or in those who showed abnormal deep tendon reflexes. The consequences of VA-induced CAN might be especially important for potentially curable cancer patients. PMID- 3971391 TI - Phase I evaluation and pharmacokinetic study of weekly iv thymidine and 5-FU in patients with advanced colorectal carcinoma. AB - A phase I study of weekly iv thymidine (TdR) and 5-FU was carried out in patients with advanced colorectal carcinoma using two dosage schedules. Schedule 1 employed a 3-hour infusion of TdR (6-8 g/m2/hour) followed immediately by a bolus of 5-FU (100-200 mg/m2). Schedule 2 used a slightly larger dose of TdR (18 g/m2/hour for 1.5 hours), with 5-FU given 30 minutes after the TdR infusion was started. Myelosuppression was observed erratically at the higher doses of 5-FU. Diarrhea and severe fatigue were seen frequently with Schedule 1. CNS side effects were the dose-limiting effects for both schedules. For long-term use the maximally tolerated 5-FU doses were 100 mg/m2/week for Schedule 1 and 175 mg/m2/week for Schedule 2. In pharmacokinetic studies in five patients, both schedules produced prolonged plasma beta-half-lives of 5-FU (96-189 minutes). Extensive formation of floxuridine was seen with both schedules. It appears likely that CNS toxic effects are characteristic of TdR-containing 5-FU regimens and would limit the therapeutic potential of this approach. PMID- 3971392 TI - Phase II evaluation of bisantrene in patients with advanced non-small cell lung carcinoma. AB - Fourteen patients with measurable non-small cell lung cancer, who had not received prior chemotherapy, were treated with the anthracene derivative bisantrene. Although treatment was well tolerated, no antitumor activity was observed and all but two patients demonstrated disease progression before the third course of chemotherapy. We conclude that bisantrene does not have significant antitumor activity in non-small cell lung cancer. PMID- 3971393 TI - NMU-1, a new transplantable mouse lung tumor: biological and chemosensitivity properties in vivo. AB - NMU-1 is a lung adenocarcinoma induced by N-nitroso-N-methyl-urea in a BALB/c Lac Dp mouse and maintained in vivo by sc passages of tumor fragments. No spontaneous regressions have been observed. After sc implantation, NMU-1 metastasizes to the lung as shown by a bioassay. Seven established antitumoral drugs were used to evaluate the chemosensitivity of this neoplasm. Mitomycin, cyclophosphamide, and cisplatin statistically affected tumor growth, as evaluated by three end points (ie, tumor weight, increase in lifespan, and tumor growth delay). 5-FU, doxorubicin, and vincristine showed significant activity on two end points. Carmustine did not affect any end points. PMID- 3971394 TI - Endometrial adenocarcinoma in breast cancer patients receiving antiestrogens. PMID- 3971395 TI - Etoposide in the treatment of multifocal eosinophilic granuloma. PMID- 3971396 TI - Clinical evidence of a cumulative effect of high-dose cytarabine on the cerebellum in patients with acute leukemia: a leukemia intergroup report. PMID- 3971397 TI - Possible interactions between warfarin and antineoplastic drugs. PMID- 3971398 TI - [Bone metastases of malignant tumors. Pathophysiology of bone metastases]. PMID- 3971399 TI - [Incidence of metastases in various types of tumors and their distribution in the skeleton]. PMID- 3971400 TI - [Diagnosis of bone marrow and bone metastases]. PMID- 3971401 TI - [Therapy of bone marrow and bone metastases]. PMID- 3971402 TI - [Substance-induced liver injury as a model for evaluating hepatoprotective drugs]. PMID- 3971403 TI - [Results of tests of the hepatoprotective effect of silymarin in experimental animals]. PMID- 3971404 TI - [Improvement of the hepatoprotective effect of silymarin when administered by injection]. PMID- 3971405 TI - [Possibilities of influencing the hepatotoxicity of chemotherapeutics by the use of silymarin]. PMID- 3971406 TI - [Hepatotoxicity of thiobenzamide in rats]. PMID- 3971407 TI - [Changes in the activity of liver enzymes and other parameters during the administration of sulfadimidine]. PMID- 3971408 TI - [Permanent changes in the liver of rats after a single administration of cyclohexamide or dexamethasone in early postnatal ontogenesis]. PMID- 3971409 TI - [The effect of overheating on the level of growth hormone and large granular lymphocytes (LGL) in the blood]. PMID- 3971410 TI - [The response of plasma catecholamines in increased loading of trained runners and controls]. PMID- 3971411 TI - [Bartter's or pseudo-Bartter's syndrome?]. PMID- 3971412 TI - [Long-term treatment with in insulin infusion pump in a juvenile diabetic complicated by thyrotoxicosis and strumectomy]. PMID- 3971413 TI - Pattern of DNA synthesis and its effect on the classification of cells by flow cytometry. AB - A flow cytometer produces a DNA distribution which contains information about the proportions of cells in various phases of the cell cycle. In this report we show that the form assumed for the rate of DNA synthesis in a cell plays an important part in the estimation of those proportions. We compare three forms for the rate of DNA synthesis, one of which is derived from knowledge of the mechanism of DNA replication, and find that they give substantially different estimates of the proportions of cells in the G1 and G2 + M phases. PMID- 3971414 TI - Aspects of statistics in studies of cell proliferation. III. Alternative models give different results. AB - Alternative models for the analysis of the spatial distribution of cells in an intestinal crypt cross-section are discussed. It is shown that different, though reasonable, models lead to different conclusions. PMID- 3971415 TI - Cell kinetic studies of chick brain cells in culture: an autoradiographic study with [3H]- and [14C]-thymidine. AB - Labelling index, S-phase duration and cell-cycle time of proliferating brain cells from 6-day-old chick embryos in culture were investigated autoradiographically after labelling with [3H]- and/or [14C]-thymidine. The dissociated cells were cultured in the absence or in the presence of brain extract from 8-day-old chick embryos. Cultures contained essentially two cell types, which could be easily distinguished by the size of their nuclei: small nuclei identified as belonging to precursor cells of neurons and large nuclei corresponding to astroglial cells. The labelling index of astroglial cells (16.4%) was about 2 times higher than that of the neuronal cells (9.9%). Under the influence of brain extract the labelling index of neuroblasts was nearly doubled while that of the astroglial cells remained nearly unchanged. From double labelling experiments with [3H]- and [14C]-thymidine, the same S-phase duration of about 7 hr was found for both cell types cultured with or without brain extract. A cell-cycle duration of 39 hr for neuronal and of 29 hr for astroglial cells was found. The cycle times remained constant under the influence of brain extract. From the measured data mentioned above, a growth fraction of 50% (neuroblasts) and 68% (astroglial cells) was calculated in control cultures without brain extract. After addition of brain extract, the growth fraction increased for both cell types (neuroblasts: 92%; astroglial cells: 80%). The results demonstrate that more cells proliferate in the presence of brain extract, but the durations of the S-phase and the cell cycle remain unchanged. PMID- 3971416 TI - Cell kinetic studies in the epidermis of mouse. III. The percent labelled mitosis (PLM) technique. AB - Full PLM curves have been obtained for four sites in the mouse. The first peaks have been analysed by computer and the duration of the G2 + M and S phases determined together with their standard deviations. The full curves showed a general similarity for all four sites with no clear second peak. The data are compared with the published data for mouse and human epidermis using the in vivo PLM technique. The timing and shape of the first peak can vary considerably even for one site in mice. Hence, both G2 + M and S can vary in their durations. Cells labelled at one time of day exhibit different kinetic properties to those labelled at another time of day. The duration of G2 + M is shortest in dorsum labelled at 03.00 hours (3 X 2 hr) and longest in tail (up to 7 X 5 hr). The S phase is shortest in dorsum (6 X 3-7 X 2 hr) and longest in tail or ear (13 X 3 14 X 1 hr). There is also a very large standard deviation in tail and foot. There is little general variability when the psoriatic human data are considered, which is surprising. The general variability amongst the data from experimental mice might also be expected amongst humans which might make comparisons between the cell kinetics of normal and diseased skin difficult. PMID- 3971417 TI - Feedback regulation of the proliferation of the undifferentiated spermatogonia in the Chinese hamster by the differentiating spermatogonia. AB - In the seminiferous epithelium the differentiating spermatogonia proliferate following a very strict synchronous pattern, and undergo the S phase during parts of particular epithelial stages. The undifferentiated spermatogonia do not divide synchronously and display maximum proliferative activity in stages XI-III. Hence the S-phase-specific cytotoxic agent Ara-C kills different proportions of these two cell types dependent on the epithelial stage. We have studied the effect of several combinations of degrees of cell loss to both compartments on proliferation of the undifferentiated spermatogonia. It was found that when the differentiating spermatogonia are removed, the proliferation of the undifferentiated spermatogonia is not inhibited at epithelial stage III, as seen in controls. However, when the undifferentiated spermatogonia were already arrested in G1, removal of the differentiating spermatogonia did not evoke proliferation again. When the population of undifferentiated spermatogonia was reduced in an area where the differentiating spermatogonia were left intact, the inhibition of the proliferation of undifferentiated spermatogonia took place around stage III as usual. It is concluded that in the normal adult seminiferous epithelium, the length of the period of active proliferation of the undifferentiated spermatogonia is regulated by negative feedback from the differentiating spermatogonia. PMID- 3971418 TI - Effects of pulse labelling with tritiated thymidine on the circadian rhythmicity in epidermal cell-cycle distribution in mice. AB - The influence of pulse labelling with 50 microCi tritiated thymidine ( [3H]TdR) (2 microCi/g) on epidermal cell-cycle distribution in mice was investigated. Animals were injected intraperitoneally with the radioactive tracer or with saline at 08.00 hours, and groups of animals were sacrificed at intervals during the following 32 hr. Epidermal basal cells were isolated from the back skin of the animals and prepared for DNA flow cytometry, and the proportions of cells in the S and G2 phases of the cell cycle were estimated from the obtained DNA frequency distributions. The proportions of mitoses among basal cells were determined in histological sections from the same animals, as were the numbers of [3H]TdR-labelled cells per microscopic field by means of autoradiography. The results showed that the [3H]TdR activity did not affect the pattern of circadian rhythms in the proportions of cells in S, G2 and M phase during the first 32 hr after the injection. The number of labelled cells per vision field was approximately doubled between 8 and 12 hr after tracer injection, indicating an unperturbed cell-cycle progression of the labelled cohort. In agreement with previous reports, an increase in the mitotic index was seen during the first 2 hr. These data are in agreement with the assumption that 50 microCi [3H]TdR given as a pulse does not perturb cell-cycle progression in mouse epidermis in a way that invalidates percentage labelled mitosis (PLM) and double-labelling experiments. PMID- 3971419 TI - Cell population kinetics and DNA content during thyroid carcinogenesis. AB - The proliferation kinetics and DNA content of thyroid follicular cells in rats were studied by autoradiography and cytophotometry. Continuous treatment of animals with methylthiouracil (MTU) results in hyperplasia followed by tumour growth in the thyroid gland. The mitotic index (MI) increases from 0.006 +/- 0.002% in controls to 0.13 +/- 0.06% in hyperplasia and to 0.09 +/- 0.03% in malignant cells. The same is true for the labelling index (LI) which rises from 0.08 +/- 0.003% in controls to 1.4 +/- 1.1% in hyperplasia and to 1.0 +/- 0.6% in follicular adenomas. The S-phase duration (TS) is shortened from 8.0 +/- 1.2 hr in controls to 6.0 +/- 1.4 hr in animals treated for 9 months with MTU and prolonged to 15.4 +/- 2.1 hr in papillary carcinomas. In all MTU-treated animals a decrease in the value of the potential population doubling time (TPD) and thyroid weight doubling time (TD) was observed. The cell loss factor (phi) decreases in animals treated for 3 months with MTU and increases during the stage of tumour growth in the gland (animals treated 12-15 months with MTU). DNA measurements in the nuclei of hyperplastic and neoplastic thyroid tissues reveal cells with values exceeding that in control animals. However, no difference was found in the DNA content between thyroid adenomas and carcinomas, nor between thyroid hyperplasia and neoplasia. PMID- 3971420 TI - Alterations in metaphase durations in cells derived from human tumours. AB - With the use of time-lapse cinemicrography, we previously found that metaphase durations were significantly prolonged in SV40-transformed human fibroblasts when compared to untransformed controls. This was consistent with some earlier reports and suggested that prolonged metaphases could account for high metaphase/prophase ratios and possibly, in part, for increased mitotic indices seen in advanced tumours. However, there are inconsistencies in the literature and no comparable data available from malignant carcinomas. Presented in this paper are data from two cervical dysplasias, two cases of carcinoma in situ, nine malignant carcinomas and several other types of human cells. The results show that mean metaphase durations were prolonged in cells derived from most of the carcinomas but not from the other cell types. On the other hand, cytokinesis appears to progress more rapidly than normal in most of the tumour-derived cells. These and other findings indicate that the changes are a result of some metabolic alteration common to many but not all tumour cells. For reasons presented, we suggest as a working hypothesis that the alterations may be due to changes in calcium regulation, possibly resulting from alterations in mitochondrial metabolism. PMID- 3971421 TI - Muscle-specific expression of a gene affecting acetylcholinesterase in the nematode caenorhabditis elegans. AB - We have generated C. elegans animals that carry a duplication as a free chromosome fragment bearing an ace-1+ gene in an otherwise homozygous ace-1 ace-2 genetic background. The single ace-1+ gene in these animals is responsible for coordinated animal movement and acetylcholinesterase activity in the regions of the nerve ring and ventral and dorsal nerve cords, as judged by histochemical assay. We have used other genes on the free duplication whose cell-specific expressions have already been elucidated to identify particular genetic mosaics produced by spontaneous somatic loss of the duplication. The analysis of these mosaics has led us to conclude that the synthesis of acetylcholinesterase by muscle cells is primarily responsible for the coordinated movement conferred by the ace-1+ gene. PMID- 3971422 TI - The inhibitory effect of histamine on lymphoid tissue proliferation in mice. AB - Histamine, injected subcutaneously (10 mg/kg), inhibited the DNA synthesis response to a contact-sensitizing agent (picryl chloride) and also had an inhibitory effect on DNA synthesis in untreated mice. The synthesis was measured by 5-[125I]iodo-2'-deoxyuridine incorporation in spleen, lung, liver, and peripheral lymph nodes and the inhibitory effect was marked and consistent in spleen in both sensitized and nonsensitized animals, but was variable in the other tissues. Since histamine is believed to activate suppressor cells, it is suggested that the inhibition of DNA synthesis in picryl chloride-treated mice is due to the activation of those suppressor cells which limit the specific DNA synthesis in response to the contact-sensitizing agent. The inhibition of DNA synthesis in untreated mice could be due to the activation of suppressor cells that control the ongoing immune response to environmental antigens. PMID- 3971423 TI - [Mortality of malignant tumors of the genitalia in Czechoslovakian statistics]. PMID- 3971424 TI - [The effect of potassium sorbate on the growth of pathogenic and physiologic vaginal microflora in vitro]. PMID- 3971425 TI - [Initial experience with diagnostic aspiration biopsy of chorionic tissue in the 1st trimester of pregnancy]. PMID- 3971426 TI - [Detection of cervical cancer 0 within the catchment area of the II. Gynecologic Obstetrical Clinic of Charles University Medical School in the past 10 years]. PMID- 3971427 TI - [Personal experience with tubal sterilizations performed by the posterior uterine vault approach]. PMID- 3971428 TI - [Conflict between partners as a cause of gynecologic disorders and the possibility of family therapy]. PMID- 3971429 TI - [Sactosalpinx: etiopathogenesis, diagnosis and treatment]. PMID- 3971430 TI - [Social aspects of the risk of pregnancy in a large city]. PMID- 3971431 TI - [What is being treated today at Franz Spa?]. PMID- 3971432 TI - [Problems in the treatment of carcinoma of the uterine cervix in stages T1a and T1b]. PMID- 3971433 TI - [Changes in pneumocytes in fibrosing alveolitis]. AB - Some unusual changes of proliferating type II pneumocytes were shown by electron microscopy in idiopathic fibrosing alveolitis. New pneumocytes in cubic metaplasia were loosely connected by abundant microvillous processes. These were scarce on the apical surface but numerous on the basis where they are normally lacking. In the absence of basement membrane microvillous processes communicated directly with fibrosed interalveolar septum. PMID- 3971434 TI - [Pathomorphologic findings after catheterization]. AB - Thrombosis and its complications were studied in a group of 110 autopsies of patients who had had a subclavian vein cannulation. A unique complete obliteration of vena cava superior was found in connection with cannulation thrombosis related to the cause of death. A mycotic septicaemia occurred in two cases. "Floated-off cannules" were presented in five cases. PMID- 3971435 TI - [Diagnosis of Alzheimer's disease in old age]. AB - A diagnosis of Alzheimer's disease in persons at the age of 75-89 years is rarely established by clinician as well as by pathologist without aimed attention. As usual it is mixed up with cerebral arteriosclerosis or marasmus senilis. More than 10 drusen were found in a low-magnification field [400X] in hippocampal cortex and in area 21 and 39 according to Brodman of 19 persons in a group of 26 autopsies. Diagnosis of Alzheimer's disease based on this commonly used limitation was quite frequent, then. PMID- 3971436 TI - [Gaucheroid structures in macrophages in lipomelanic reticulosis]. AB - Gaucher-like tubular substructure was found in lysosomes of pigmentophages in 3 of 12 cases of lipomelanotic reticulosis. They were considered as reactive lesion similar to Gaucher's disease or Gaucher-like structures in myeloic leukaemia. They showed an identical basic picture in spite of the fact they differed a little in their fine structure. PMID- 3971437 TI - [Somatosensory evoked potentials in patients with stenoses of the cerebral arteries]. PMID- 3971438 TI - [Visual evoked potentials. III. Dynamics of changes during focal ischemia of the brain. Correlation with the degree of neurological deficit and blood circulation in the brain]. PMID- 3971439 TI - [Dystrophia myotonica]. PMID- 3971440 TI - [A study visit to Japan]. PMID- 3971441 TI - [Research program in the field of neurology and psychiatry. Projection for research in the 8th 5-year-plan]. PMID- 3971442 TI - [Narcolepsy and hypersomnia in children and adolescents]. PMID- 3971443 TI - [Long-term follow-up of the levels of iron in plasma and its total binding capacity in adolescents]. PMID- 3971444 TI - [Nuclear icterus in premature infants]. PMID- 3971445 TI - [Breast feeding and sodium levels in human milk]. PMID- 3971446 TI - [Agenesis of the trachea: pathologico-anatomic study]. PMID- 3971447 TI - [10 years' experience with intermittent peritoneal dialysis in children]. PMID- 3971448 TI - [Apolipoproteins--new findings on their biochemistry, physiology and significance in disease states]. PMID- 3971449 TI - [Incidence of neutropenia after extracorporeal circulation in cardiac surgery in children]. PMID- 3971450 TI - [Urolithiasis in pediatric nephrology practice]. PMID- 3971451 TI - [Problems of breast feeding in the rooming-in system]. PMID- 3971452 TI - [Endoscopic polypectomy of juvenile polyps in a child]. PMID- 3971453 TI - [Dietary therapy of malabsorption conditions]. PMID- 3971454 TI - [Forms of cooperation between the psychologico-pedagogic service in Mestec and pediatricians in Ostrava]. PMID- 3971455 TI - [The effect of the loss of parents on the psychosocial development of the child]. PMID- 3971456 TI - [Genesis of behavior disorders from early childhood to adolescence]. PMID- 3971457 TI - [Porphyria variegata with clinical manifestations in the first days of life]. PMID- 3971459 TI - [Functions of health care and dynamic processes within societies]. PMID- 3971458 TI - [The effect of serious diseases on the average life span of the population in Czechoslovakia]. PMID- 3971460 TI - [Factors influencing drug utilization. An example in the case of antidiabetics]. PMID- 3971461 TI - [Methods of evaluating drug therapy, particularly in cardiovascular diseases]. PMID- 3971462 TI - [Incidence of certain risk factors after several years in non-respondents in an epidemiologic study of primary prevention of ischemic coronary heart disease (ICHS)]. PMID- 3971463 TI - [A diagnostic center within the framework of socialist health services]. PMID- 3971464 TI - [Socialist morality and social pediatrics]. PMID- 3971465 TI - [Positive correlation between the prevalence of diabetes and higher averages wages in districts in Bohemia]. PMID- 3971466 TI - [Problems in occupational medicine in Malta]. PMID- 3971467 TI - [The present state of preparation for the 10th revision of the International Classification of Diseases]. PMID- 3971469 TI - Absolute configuration of trans-7,8-dihydroxy-7,8-dihydro-7-methylbenzo[a]pyrene enantiomer and the unusual quasidiequatorial conformation of the diacetate and dimenthoxyacetate derivatives. AB - The enantiomers of trans-7,8-dihydroxy-7,8-dihydro-7-methylbenzo[a]pyrene (7-MBaP 7,8-dihydrodiol) and of trans-7,8-dihydroxy-7,8,9,10-tetrahydro-7 methylbenzo[a]pyrene (7-MBaP 7,8-tetrahydrodiol) were directly resolved by high performance liquid chromatography (HPLC) using a commercially available column packed with an (R)-N-(3,5-dinitrobenzoyl)-phenylglycine derivative of gamma aminopropylsilanized silica. The absolute configurations of the resolved enantiomers were determined by the exciton chirality method. Circular dichroism (CD) spectral analysis of the quasidiequatorial benzo[a]pyrene 7R,8R-dihydrodiol enantiomer and its diacetate and dimenthoxyacetate derivatives indicated conformational changes were induced upon derivatization. However, the characteristic CD Cotton effects of the quasidiequatorial 7-MBaP 7,8-dihydrodiol and its diacetate and dimenthoxyacetate derivatives were similar indicating that the conformation of 7-MBaP trans-7,8-dihydrodiol was not altered upon derivatization. Proton nuclear magnetic resonance (NMR) spectral analyses confirmed that 7-MBaP 7,8-dihydrodiol, its diacetate and dimenthoxyacetate derivatives all have quasidiequatorial conformations. The results indicate that the methyl substituent of 7-MBaP 7,8-dihydrodiol maintains a quasiaxial position regardless of the size of the acyl derivatives linked to the hydroxyl groups. PMID- 3971468 TI - Single-strand breaks in DNA of hamster and human cells exposed to methyl methanesulfonate and ultraviolet light. AB - The number of single-strand breaks produced in DNA after exposure to UV light or to methyl methanesulfonate (MMS) was additive when cells were exposed to both agents in close succession. Repair of the damage from either agent was partially inhibited by cytosine arabinoside, resulting in higher break frequencies under all conditions of exposure. Exposure to both agents followed by growth in cytosine arabinoside resulted in break frequencies that were approximately the same as the sum of those from each agent individually. These findings contrast with previous results in which pyrimidine dimer excision and repair replication after exposure to UV light were inhibited by MMS. These observations are not due to cell permeability changes after alkylation, but can be explained if the complex of excision-repair proteins is only partially inactivated by alkylation. Initial incisions to start repair would still occur but only limited amounts of repair replication would ensue without actual removal of the pyrimidine dimers. PMID- 3971470 TI - DNA damage and repair in epithelial (mucous) cells and crypt cells from isolated colon. AB - Colon epithelium is made up of two general classes of cells, surface cells which are post-mitotic and crypt cells which contain the proliferative population. Their relative vulnerability to environmental damage and ability to perform DNA repair are important issues in colon carcinogenesis. DNA damage and repair was studied by the nucleoid sedimentation method in freshly isolated crypt cells for comparison with previous studies of post-mitotic surface epithelial cells. Suspensions of crypt cells were isolated from preparations of mouse colon by a series of sequential incubations in buffer containing 1.5 mM EDTA. Treatment of crypt cells for 30 min with 1.2 X 10(-6) M methyl methane sulfonate (MMS), photoaffinity labeling with 1 X 10(-6) M ethidium monoazide, lithocholic acid (2.5 X 10(-4) M) treatment for 1 h or X-irradiation at 1500 rads resulted in single-strand breaks in the DNA, which were repaired after 2 h of additional incubation. Interestingly, X-rays at 1000 rads and lithocholic acid (LA) (2.5 X 10(-6) M) after 30 min incubation failed to produce the detectable shift in nucleoid sedimentation characteristic of single-strand breaks, perhaps due to rapid repair by these proliferative cells. UV-irradiation failed to provoke strand incision as was also observed for the superficial post-mitotic cells in the previous studies. These studies showed the feasibility of studying DNA damage and repair processes in these two classes of colon epithelial cells in response to specific carcinogenic insult. PMID- 3971471 TI - Induction and degradation of Zn-, Cu- and Cd-thionein in Chang liver cells. AB - Human liver cells (Chang liver) were exposed to 5 micrograms Zn, 2.5 micrograms Cu or 1 microgram Cd/ml in cultured medium. These exogeneous heavy metals were accumulated by the cells and induced de novo synthesis of metallothionein after a 3-h incubation period. The production of Zn-, Cu- or Cd-thionein started in the cells with accumulation of 1 nmol Zn, 0.3 nmol Cu and 0.1 nmol Cd/mg cytosol protein and subsequently the amounts of metal-binding thioneins increased in agreement with the relative amount of metal accumulated in the cytosol over a 24 h period. When cells containing Zn- or Cu-thionein were placed in metal free medium, 70% or 25% of the zinc or copper bound to each original metallothionein was released after 3 h; bound metals decreased to 85% and 65% respectively after 24 h. The disappearance of metal from metallothionein correlated with increases of metal in the medium. On the other hand, 35S-counts incorporated into Zn- and Cu-thionein decreased only to 40% and 15% of the levels in the original metallothionein after 3 h; 35S-counts decreased to 65% and 45%, respectively, after 24 h, indicating that metals bound to metallothionein decreased more quickly than 35S-counts. These results suggest that metals were released from metallothionein and were excreted into the medium. However, 35S- and 109Cd-counts in Cd-thionein changed very little, if at all, in the cells even after a 24-h incubation period. Our data strongly suggest that Zn- and Cu-thionein are degraded in the cells, but that Cd-thionein remains longer than either Zn- or Cu thionein. When cells containing Zn-thionein were incubated in metal-free medium, Zn-thionein was digested in the cells and peptide fragments ranging about 200-400 daltons were excreted from the cells. PMID- 3971472 TI - In vitro interaction of 63-nickel(II) with chromatin and DNA from rat kidney and liver nuclei. AB - The interaction of nickel(II) with chromatin was studied in vitro and in isolated nuclei from rat liver and kidney. Nickel(II) bound to chromatin, polynucleosomes (DNA + histone octamer protein complex), and to deproteinized DNA both in intact nuclei and in vitro. The amount of nickel(II) bound depended on the concentration of nickel(II), the presence of chromosomal proteins and the binding sites on DNA which provide a stable coordination environment for nickel(II). The binding of nickel(II) to chromatin and to DNA in whole nuclei was much slower than in vitro indicating that assessibility of the DNA binding sites was influenced by the presence of the nuclear membrane, nuclear matrix and nuclear proteins and/or by the condensed nuclear structure of chromatin. Since DNA containing bound nickel(II) was isolated from chromatin, nickel(II) directly interacted with stable binding sites on the DNA molecule in chromatin. Nickel(II) was associated with the histone and non-histone nuclear proteins as well as the DNA in rat liver and kidney chromatin. Nickel(II) was found to bind to calf thymus histones in vitro. Nickel(II)-nuclear protein and -DNA interactions were investigated by gel electrophoretic analysis of in vitro incubation products. Although nickel-histone and nickel-non-histone protein interactions were completely disrupted by the electrophoretic conditions, fluorography revealed the presence of inert nickel(II)-DNA and/or nickel(II)-DNA-protein complexes. PMID- 3971473 TI - The in vitro interaction of naphthyridinomycin with deoxyribonucleic acids. AB - The binding of naphthyridinomycin (NAP) to deoxyribonucleic acid was investigated using radioisotope labeled antibiotic. Dithiothreitol (DTT) enhances complex formation in a concentration dependent fashion but was found to be slightly inhibitory at concentrations above 10 mM. [C3H3]-NAP-DNA complexes, formed in the presence or absence of reducing reagents, were stable to Sephadex G-25 chromatography and precipitation with ethanol, indicating a strong bond formed between the drug and DNA. Time course studies showed that the difference between the binding of activated and non-activated antibiotic was a DTT-dependent burst. This was followed by a second phase of binding which was similar in both the activated and non-activated antibiotics. The activation of the antibiotic by DTT was a reversible reaction at pH 7.9. The activated form at pH 5.0 was extremely stable and did not revert to the unactivated form even after an 8-h incubation period. Antibiotic-DNA complex formation was pH independent between pH 5.0 and 7.0 for activated NAP. The non-activated antibiotic bound to DNA much better at pH 5.0 than at physiological pH values. Release of antibiotic from complexes (as followed by long term dialysis) formed in the presence of DTT and at pH 5.0 was biphasic, suggesting that the drug can bind to DNA in more than one way. A constant rate of antibiotic release was observed at pH 7.9 with or without DTT. At pH 2.0 and pH 12.0, greater than 95% of the antibiotic is released from the complexes. Most of the acid released antibiotic is NAP while most of the base released antibiotic had decomposed to a more polar compound. NAP binds well to calf thymus DNA, poly(dG) . poly(dC), and T4 DNA but shows significantly less affinity for poly(dA) . poly(dT), poly(dA . dT) . poly(dA . dT), poly(dG), poly(dC), poly(dI) . poly(dC) or poly(dG . dC) . poly(dG . dC). This specificity of NAP for DNA is similar to that observed for the pyrrolo(1,4)benzodiazepine antibiotics and saframycin A and S; all of which bind to double stranded DNA through their carbinolamine or masked carbinolamine functionalities. Two mechanisms which can explain the need for activation of NAP are also proposed. PMID- 3971474 TI - Time-schedule dependency of the inhibiting activity of various anticancer drugs in the clonogenic assay. AB - To analyze the discrepancy between the in vitro response in the clonogenic assay and the clinical response, the time-schedule dependencies of various anticancer drugs were determined by comparing the inhibiting effect against colony formation by PC-7 cells treated with the drugs for 1 h with that of those treated for 24 h. According to their schedule dependency the drugs can be divided into a schedule dependent drug group (5-fluorouracil, methotrexate, bleomycin, pepleomycin, etoposide, cisplatin, teniposide, vindesine, and vinblastine) and a non-schedule dependent drug group (adriamycin, actinomycin D, ranomustine, mitomycin C, aclacinomycin, daunomycin, nimustine, melphalan, and KW 2083). In the clonogenic assay, the 1-h exposure schedule is appropriate for predicting clinical response for the non-schedule-dependent drugs. However, the effect of the schedule dependent drugs was underestimated in the same conditions. Therefore, it is necessary to test these drugs in the assay by 24-h exposure for a more accurate assessment of their antitumor activity. PMID- 3971475 TI - Clinical pharmacokinetics of oral CCNU (lomustine). AB - The plasma pharmacokinetics of orally administered CCNU (130 mg/m2) were studied in four patients using reversed-phase high-performance liquid chromatography (HPLC) analysis. Parent CCNU was not detected in the plasma of any of the patients, probably due to complete conversion to monohydroxylated metabolites during the 'first pass' through liver and gut. However, two monohydroxylated metabolites, trans-4-hydroxy CCNU and cis-4-hydroxy CCNU, were found at high concentrations, the relative amounts being about 6:4. Peak concentrations of the metabolites were reached 2-4 h after administration and were remarkably similar for all four patients, the total being 0.8-0.9 micrograms/ml. The metabolites were also detected in a tumour biopsy. Plasma clearance half-lives of the two metabolites were similar in each patient but showed a two-fold variation between patients, from 1.3 to 2.9 h. These results suggest that the antitumour activity and systemic toxicity of CCNU when given orally are due mainly to its monohydroxylated metabolites. Finally, comparison with data obtained in vitro and in mice showed that the nitrosourea exposures in these patients were at the lower limit of those required for significant antineoplastic activity. PMID- 3971476 TI - Comparison of the cellular pharmacology of doxorubicin in resistant and sensitive models of pancreatic cancer. AB - The cellular accumulation and retention of doxorubicin (ADR) was investigated in two models of pancreatic adenocarcinoma, which differ markedly in their sensitivity to ADR. In vitro studies revealed that the relatively resistant cell line, WD PaCa (or well-differentiated pancreatic adenocarcinoma of the Syrian hamster), actually had higher ADR cellular levels than the sensitive cell line, PD PaCa (or poorly differentiated pancreatic adenocarcinoma of the Syrian hamster). While the efflux of ADR from WD PaCa was greater, the overall retention of ADR by WD PaCa was comparable to PD PaCa. These results failed to document differences in accumulation or retention of ADR capable of explaining the difference in the sensitivity of the cell lines to ADR and indicate the need to search beyond attainable drug concentrations for mechanisms of primary ADR resistance. PMID- 3971477 TI - In vivo protection by protein A of hepatic microsomal mixed function oxygenase system of cyclophosphamide-treated rats. AB - At a high dose, cyclophosphamide (Cy, 200 mg/kg) causes depression of the enzyme activity of the hepatic mixed function oxygenase (MFO) system in Sprague-Dawley rats. The present report provides evidence for the early regeneration of the depleted enzyme activity in Cy-treated rats by purified protein A (P) of Staphylococcus aureus. Enzymes of the MFO system, such as aminopyrine demethylase and aryl hydrocarbon hydroxylase, were assayed and the content of cytochrome P 450 was determined. Inoculation of P (60 micrograms/kg) prior to Cy inoculation provides a better effect than P administration after Cy. The exact mechanism of P action is unknown. P-treated animals appear to have an ability to repair the damage caused by the toxic metabolites of Cy earlier than those in the Cy group. This property of protein A may become useful in accelerated regeneration of the enzyme activity in the hepatic MFO system following the toxic insult of Cy metabolites. PMID- 3971478 TI - Improved high-performance liquid chromatography assay of doxorubicin: detection of circulating aglycones in human plasma and comparison with thin-layer chromatography. AB - We compared doxorubicin and metabolite pharmacokinetic data obtained from thin layer chromatography (TLC) and high-performance liquid chromatography (HPLC) assay of plasma samples from six patients who had been treated with doxorubicin. Duplicate 1-ml samples were extracted with chloroform: isopropanol (1:1) and assayed using a sensitive HPLC system incorporating a dual pump gradient with tetrahydrofuran as the mobile phase and fluorescence detection. Duplicate 1-ml samples from the same specimens were assayed using a modification of a previously described TLC assay. Areas under the curve for doxorubicin by HPLC (3.36 +/- 2.30 microM X h) and TLC (4.16 +/- 2.50 microM X h) were not significantly different (P = 0.5). Terminal half-life of doxorubicin by HPLC (28.0 +/- 6.98 h) and TLC (23.2 +/- 7.8) (P = 0.29) and the calculated total-body clearances by HPLC (0.55 +/- 0.29 l/min) and TLC (0.45 +/- 0.23) (P = 0.55) were not significantly different. Areas under the curve for doxorubicinol by HPLC (2.75 +/- 1.4 microM X h) and TLC (2.53 +/- 7.1 microM X h) (P = 0.73) showed no significant differences. HPLC detected a mixed 7-deoxydoxorubicinol aglycone-doxorubicin aglycone peak, 7-deoxydoxorubicin aglycone, and two nonpolar, unidentified metabolites. TLC detected the following aglycone metabolites: doxorubicin aglycone, doxorubicinol aglycone, 7-deoxydoxorubicinol aglycone, an unidentified polar metabolite, and several unidentified nonpolar metabolites. From these data we conclude that HPLC and TLC detect concentrations of doxorubicin and doxorubicinol from human plasma equally well to concentrations of 7.0 nM (4 pmol injected doxorubicin). Aglycones do circulate in human plasma at concentrations above the detection limits of both assays. Doxorubicinol aglycone, which is detected by TLC but not by HPLC, may be formed from artifactual breakdown of doxorubicinol during TLC development. Unidentified nonpolar compounds seen on HPLC and TLC may represent further doxorubicin metabolism than previously described. PMID- 3971479 TI - Differential distribution and covalent binding of two labeled forms of methyl CCNU in the Fischer 344 rat. AB - The present study compares the organ distribution and covalent binding of MeCCNU labeled either within the carbamylating [( cyclohexyl-1-14C]MeCCNU; Chx-14C MeCCNU) or alkylating [( 2-chloroethyl-1,2-14C]MeCCNU; Cle-14C-MeCCNU) region of the compound in an animal model shown to be suitable for studying the nephrotoxicity of the nitrosoureas. Extraction of tissue homogenates with organic solvents of increasing polarity, and subsequent analysis of these extracts by HPLC showed fat to accumulate the highest concentration of parent compound. Kidney accumulated the highest levels of the more polar ether- and methanol extractable metabolites and/or degradation products of either cyclohexyl-derived or chloroethyl-derived 14C-MeCCNU. Striking differences were apparent in the accumulation, degradation and/or metabolism, and tissue distribution of covalently bound radioactivity for the chloroethyl and cyclohexyl moieties. For example, approximately twice as much cyclohexyl-derived 14C was bound covalently to protein of kidney than to protein of liver or lung. In contrast, approximately twice as much chloroethyl-derived 14C was bound to lung protein than to liver of kidney protein. No radioactivity was bound covalently to tissue DNA following Chx 14C-MeCCNU administration. On the other hand, at 4 h, chloroethyl-derived 14C was irreversibly bound to DNA in the relative amounts of kidney (5.0 nmol/mg), liver (2.7 nmol/mg), and lung (1.25 nmol/mg). These results demonstrate that MeCCNU metabolites and/or degradation products are preferentially accumulated in kidney, a primary target organ for MeCCNU toxicity. Moreover, kidney protein and DNA were subject to extensive carbamylation and alkylation reactions as measured by irreversibly bound cyclohexyl-derived and chloroethyl-derived 14C, respectively. These data suggest that the extent of irreversibly bound drug to tissue macromolecules may be a valid predictor of MeCCNU toxicity. However, the relative toxicological significance of either protein carbamylation or DNA alkylation in mediating MeCCNU-induced nephropathy is not yet understood. PMID- 3971480 TI - Utilization of the HTSCA and CFU-C assay to identify two new 2 chloroethylnitrosourea congeners of amino acid amides with increased in vitro activity against human glioma compared with BCNU. AB - AspCNU and SarCNU are two amino acid amide congeners (L-asparaginamide and sarcosinamide congeners) of chloroethylnitrosoureas. The in vitro myelotoxicity of these agents compared with BCNU at 1-8 micrograms/ml was determined in bone marrow cells from normal volunteers in the CFU-C assay. AspCNU and SarCNU were significantly (P less than 0.05) less myelotoxic than BCNU at equivalent microgram concentrations. SarCNU or AspCNU at 3 micrograms/ml demonstrate equivalent in vitro myelotoxicity to BCNU 1 microgram/ml. We used the human tumor stem cell assay (HTSCA) to investigate in vitro antitumor activity. We obtained four specimens of malignant glioma and one specimen of meningioma from patients not previously treated with chemotherapy. AspCNU and SarCNU were significantly (P less than 0.05) more active than BCNU at 1-3 micrograms/ml concentrations in the HTSCA in all four malignant glioma specimens. In the one meningioma specimen, BCNU was significantly (P less than 0.05) more active than either AspCNU or SarCNU at all concentrations studied. These results suggest that AspCNU or SarCNU at doses that should produce less myelotoxicity than BCNU may be more active than BCNU against gliomas. PMID- 3971481 TI - Comparative cytotoxicities of various morpholinyl anthracyclines. AB - A series of quinone- and sugar-modified analogs of adriamycin have been tested for growth inhibition of adriamycin-sensitive (P388/S) and -resistant (P388/ADR) sublines of P388 murine leukemia cells in vitro. P388/ADR is less resistant to analogs of adriamycin containing either a 3'-deamino-3'-(4"-morpholinyl) group, MRA; or a -(3"-cyano-4"-morpholinyl) group, MRA-CN, than to adriamycin. However, MRA-CN was the most potent growth inhibitor of either subline. This potency is reduced by either modification of the quinone unit with a 5-imino substituent or restriction of the cyano-morpholinyl ring by an oxygen bridge to the daunosamine sugar. The calcium antagonist verapamil substantially increases the cytotoxicity of adriamycin to P388/ADR but has no appreciable effect on the cytotoxicity of either MRA or MRA-CN. The results suggest that increased uptake and retention by both MRA and MRA-CN may contribute to their increased cytotoxicity, but that the intense potency of the cyano-morpholinyl analogs must be due to other unique properties of these compounds. PMID- 3971482 TI - The pharmacokinetics of 7-hydroxymethotrexate following medium-dose methotrexate therapy. AB - An unambiguous and specific HPLC assay was used to determine the pharmacokinetics of 7-hydroxymethotrexate (7-OHMTX) following the administration of moderate-dose methotrexate (MTX) 100 mg X m-2 to 37 patients with advanced head and neck cancer. There was marked interpatient variation but patient exposure to 7-OHMTX was considerable. There was, however, no correlation between the amount of 7 OHMTX produced and either tumour response or patient toxicity. PMID- 3971484 TI - Mechanism of DNA methylation by N-nitroso(2-oxopropyl)propylamine. AB - Using an in vitro assay system for measuring 7-methylguanine formation in DNA, it was demonstrated that N-nitroso(2-oxopropyl)propylamine (NOPPA) is converted into a methylating agent by a microsomal, cytochrome P-450 dependent mixed function oxidase from rat liver. Formation of propionaldehyde, but not formaldehyde, in this assay system, indicated that a single alpha-oxidation reaction on the propyl side chain of NOPPA leads to the formation of a methylating agent. A mechanism for this reaction is proposed. PMID- 3971483 TI - A case report and description of the pharmacokinetic behavior of intrapleurally instilled etoposide. AB - Etoposide, at a dosage of 100 mg/m2 (156 mg in 250 ml 0.154 M NaCl), was instilled through a thoracostomy tube into the left pleural cavity of a 60-year old woman with diffuse histiocytic lymphoma and a refractory, recurrent, malignant left pleural effusion. Etoposide concentrations in plasma and pleural cavity fluid were measured by a reverse-phase HPLC system with a C18-reverse phase column, a mobile phase of methanol: H2O (55:45) pumped at 1.2 ml/min, and detection by absorbance at 254 nm. Pleurodesis was successfully accomplished by this maneuver and there were no adverse clinical consequences. Absorption of etoposide from the pleural cavity was slow (approximately 0.2 ml/min). The pleural cavity exposure to etoposide, as measured by the area under the curve, was 46 times greater than if a similar dose had been given IV. Conversely, systemic exposure to etoposide, as assessed by plasma AUC, was less than 50% that associated with IV injection of a similar dose. PMID- 3971486 TI - Effect of subsequent treatment of chloroform or phenobarbital on the incidence of liver and lung tumors initiated by ethylnitrosourea in 15 day old mice. AB - The effect of subsequent administration of chloroform or phenobarbital on the incidence of ethylnitrosourea (ENU) initiated liver and lung tumors was investigated. Fifteen day old Swiss mice were administered ENU, and at weaning they started to receive either 1800 p.p.m. chloroform or 500 p.p.m. sodium phenobarbital in their drinking water. The mice continued to receive either chloroform or phenobarbital until 51 weeks of age. They were sacrificed at 52 weeks of age. ENU at 5 and 20 mg/kg, caused a dose-dependent increase in liver and lung tumors. The male mice were more sensitive to the induction of liver tumors, while no sex preference was observed for the induction of lung tumors. In male mice chloroform inhibited, while in female and male mice phenobarbital promoted spontaneous and ENU-induced liver tumors. Subsequent treatment with either chloroform or phenobarbital did not affect the incidence of ENU-induced lung tumors. In conclusion, when administered in the drinking water, chloroform inhibited while phenobarbital promoted hepatocarcinogenesis in mice. PMID- 3971485 TI - N-Acetyltransferase phenotypes in the urinary bladder carcinogenesis of a low risk population. AB - N-Acetyltransferase phenotypes were measured in 228 patients with tumours of the urinary bladder and 100 non-cancer controls. 63.6% of the patients and 54.0% of the controls were slow acetylator phenotypes (p less than 0.10). In general, 65% of bladder tumour patients and 59% of controls are slow acetylators (p less than 0.025). N-Acetyltransferases are involved in the metabolism of carcinogenic arylamines and thus could be an important factor in interindividual susceptibility to these agents. PMID- 3971487 TI - O6-Alkylguanine DNA alkyltransferase activity in monkey, human and rat liver. AB - Previous studies have shown that in in vitro assays using methylated DNA substrates, human and rat liver fractions were able to catalyse the repair of the promutagenic lesion O6-methylguanine (O6-meG). These studies have been extended to include monkey liver fractions and the repair of O6-ethylguanine (O6-etG). Human and monkey liver fractions have similar capacities for the repair of O6-meG and are 8-10 times more active than rat liver fractions. In all species examined, the liver extracts showed a lower capacity to repair O6-etG and the rate of repair was dependent on the degree of modification of the DNA substrate and the protein concentration used. The in vitro metabolism of dimethylnitrosamine (DMN), an alkylating carcinogen, by liver slices, has been previously demonstrated in these three species, but the activity in monkey liver was considerably lower compared with human and rat liver. The lack of evidence of a carcinogenic effect of DMN in the monkey liver could be correlated to this low capacity to metabolise DMN and the high O6-alkylguanine-DNA alkyltransferase levels in this organ. PMID- 3971488 TI - Interindividual variations in the activities of cytosolic and microsomal epoxide hydrolase in human liver. AB - Mammals have at least two epoxide hydrolases (EHs) with a broad significance in drug metabolism. One enzyme is localized in the endoplasmic reticulum and other membranes (EHm), and the other is in the cytosol (EHc). In the present study we found that humans differ greatly in the activities of these enzymes in liver. The specific activities in microsomes from 166 subjects (most of them patients suffering from hepatic diseases), measured with benzo[a]pyrene 4,5-oxide as the substrate, varied by a factor of 63. The activities in the cytosol, determined with trans-stilbene oxide as substrate varied 539-fold among 135 subjects. A subdivision into different diagnostic groups showed an increase in EHm activity (1.7-fold control) but not EHc activity in tuberculosis patients treated with rifampicin, ethambutol and isoniazid. No other diagnostic group showed significantly altered EH activities. Furthermore the activities did not differ between females and males, alcoholics and non-alcoholics or smokers and non smokers. In the 77 subjects where both EHc and EHm activities were determined, no correlation between them was observed, indicating separate biological control. PMID- 3971489 TI - Promoting effects of 1,4-bis[2-(3,5-dichloropyridyloxy)]benzene in mouse hepatocarcinogenesis. AB - The effects of phenobarbital (PB) and 1,4-bis[2-(3,5-dichloropyridyloxy)]benzene (TCPOBOP) on liver hyperplasia, induction of microsomal enzyme activities, and two-stage hepatocarcinogenesis were evaluated in B6C3F1 female mice. For 4 weeks four groups of mice received PB (500 p.p.m. in the drinking water), TCPOBOP (3 mg/kg i.p. once every week), PB together with TCPOBOP or corn oil vehicle i.p. TCPOBOP induced liver hyperplasia and hypertrophy and increased p-nitroanisole-O demethylase and aminopyrine-N-demethylase more than PB. Neither chemical changed UDPG-transferase activity. The association of PB and TCPOBOP gave the same effects as TCPOBOP alone. Other four groups of mice were treated with N-nitroso-N diethylamine at 7 days of age and then, starting from 8 weeks of age, received the above specified weekly treatments for 20 weeks and were then sacrificed. Hepatocellular nodules greater than 150 microns were found in all animals of all groups. Due to increased size of the liver compared to controls, the number of nodules/cm3 decreased after PB and TCPOBOP treatments given alone or together; however the mean volume of nodules and the percentage of liver volume occupied by nodules increased after TCPOBOP but not after BP treatment, and the association of PB and TCPOBOP was even more effective than TCPOBOP alone. Hepatocellular adenomas greater than 2.4 mm in diameter were observed in 5 of 10 TCPOBOP-treated mice (total of 11 nodules) and in 5 of 11 mice that received PB plus TCPOBOP (total of 15 nodules). Hepatocellular carcinomas were seen in one mouse treated with PB and in three mice given PB and TCPOBOP. PMID- 3971490 TI - DNA adducts formed from the probable proximate carcinogen, N-hydroxy-3,2' dimethyl-4-aminobiphenyl, by acid catalysis or S-acetyl coenzyme A-dependent enzymatic esterification. AB - The arylamine carcinogen 3,2'-dimethyl-4-aminobiphenyl (DMABP) has been proposed to be metabolically activated to DNA-binding derivatives through the formation of an N-hydroxy intermediate. In this study, the subsequent activation of N-hydroxy DMABP through acid catalysis or enzymatic esterification was examined. [Ring-3H]N hydroxy-DMABP was reacted with calf thymus DNA at pH 4.6 for 15 min to yield 370 arylamine residues per 10(6) nucleotides, while at pH 7.4 the binding was only two residues per 10(6) nucleotides. The DNA modified under acidic conditions was enzymatically hydrolyzed and analyzed by h.p.l.c. which indicated the presence of three major adducts. The products were identified by spectral and chemical properties as N-(deoxyguanosin-8-yl)-DMABP (60-70%), 5-(deoxyguanosin-N2-yl) DMABP (2-3%) and N-(deoxyadenosin-8-yl)-DMABP (1-3%). The same adducts have previously been detected in the liver and colon of rats administered DMABP or its hydroxamic acid. Incubation of rat hepatic or intestinal cytosol at pH 7.4 for 15 min with [ring-3H]N-hydroxy-DMABP in the presence of S-acetyl coenzyme A (AcCoA) and calf thymus DNA resulted in DNA binding at levels of 30-80 arylamine residues per 10(6) nucleotides. H.p.l.c. analysis of the DNA modified in the presence of AcCoA indicated the formation of the same adducts detected in the acid-catalyzed reactions. When arylhydroxamic acid N,O-acyltransferase assays were conducted with rat liver cytosol and N-acetyl-N-hydroxy-DMABP as the substrate, binding to nucleic acids was not observed. Similarly, 3'-phosphoadenosine-5'-phosphosulfate dependent sulfotransferase-mediated DNA binding could not be demonstrated. These data indicate that in a suitable acidic environment, N-hydroxy-DMABP will react with DNA to yield the same adducts found in vivo. Under neutral conditions, however, N-hydroxy-DMABP appears to undergo AcCoA-dependent transacetylation to an electrophilic acetoxy ester which will spontaneously react with DNA. PMID- 3971491 TI - Interaction of nucleophiles with the enzymatically-activated carcinogen, N hydroxy-2-acetylaminofluorene, and with the model ester, N-acetoxy-2 acetylaminofluorene. AB - A new method was devised to study adduct formation of N-acetyl-L-methionine (N-Ac met) with activated species of the carcinogen N-hydroxy-2-acetylaminofluorene (N OH-2-AAF). Following degradation of the adducts, the isomeric methylthio derivatives of 2-acetylaminofluorene (2-AAF) and 2-aminofluorene (2-AF) were separated and quantified by h.p.l.c. With the use of this method the nucleophilicity of N-Ac-met toward enzymatically produced N-acetoxy and N sulfonoxy derivatives of 2-AF and 2-AAF, respectively, and toward the synthetic model ester, N-acetoxy-2-acetylaminofluorene (N-OAc-2-AAF), was determined. For comparison, the interaction of tRNA and polyguanylic acid (poly G) with the above compounds was measured by standard procedures. tRNA was an efficient acceptor of enzymatically formed N-acetoxy and N-sulfonoxy derivatives as well as of N-OAc-2 AAF. The nucleophilicity of N-Ac-met toward enzymatically formed N-sulfonoxy-2 AAF was comparable with that of tRNA. However, its reactivity with N-OAc-2-AAF and enzymatically generated N-acetoxy-2-aminofluorene (N-OAc-2-AF) was only 20% of that of tRNA. Poly G was as reactive as tRNA toward synthetic N-OAc-2-AAF and enzymatically generated N-OAc-2-AF but was only 25% as efficient as tRNA or N-Ac met in accepting enzymatically formed N-sulfonoxy-2-AAF. The difference in the interaction of the three nucleophiles with N-OAc-2-AAF and N-OAc-2-AF compared with N-sulfonoxy-2-AAF indicate that N-OAc-2-AAF is not a general model of the ultimate electrophilic metabolites of 2-AAF. Studies of the kinetics of the interaction of N-OAc-2-AAF with N-Ac-met, tRNA and poly G demonstrated dependence of adduct formation on nucleophile concentration, indicative of a bimolecular mechanism. Arylamidonium or nitrenium ions are therefore not necessarily the ultimate electrophilic metabolites of 2-AAF obligatory for interaction with cellular nucleophiles. There was no evidence that nitrenium ions are intermediates in the cytosolic reduction of N-OH-2-AAF to 2-AAF. PMID- 3971492 TI - Effects of dietary calcium acetate on lead subacetate carcinogenicity in kidneys of male Sprague-Dawley rats. AB - Seven groups of 4-week-old male Sprague-Dawley rats, 30 animals/group, were fed for 18 months a commercial chow diet with or without 1% admixture of lead subacetate (Pb-Acet) and 0, 0.3, 1, 3 and 6% of calcium acetate (CaAcet). Feeding a 3% CaAcet-only diet did not produce any pathomorphological effects except for a slight decrease in body weights of the rats to 93% of that seen in the control rats. Feeding the 1% PbAcet-only diet decreased the growth rate of rats to 80% that of the control animals and increased the organ/body weight ratios of the kidneys and livers to 200% and 114% of the corresponding control values. Kidney tumors developed in 45% of the rats treated with PbAcet only, with the earliest appearing at 58 weeks. No tumors of other tissues were found in those rats. Feeding the PbAcet + CaAcet diets reduced the weights of rats from 74% to 54% of that of the control rats and increased the kidney/body weight ratio to 300% that of the control animals. The incidences of renal tumors increased in those rats to an average of 71% (p less than 0.03 versus the PbAcet-only diet), with no significant effects relative to the CaAcet contents in the diets. Primary non renal tumors were found only occasionally in rats fed the PbAcet + CaAcet diets, without significant differences among the various treatment groups. The renal lead accumulation at 18 months equalled 572 +/- 102, 295 +/- 43, 247 +/- 10, 168 +/- 9, and 162 +/- 6 micrograms/g dry weight (mean +/- S.E.M.; n = 22-24) for the 0, 0.3, 1, 3 and 6% CaAcet in the PbAcet diet, respectively. The hepatic accumulation of lead was 22.2 +/- 0.7 micrograms/g dry weight with no discernible differences among the various PbAcet + CaAcet treatment groups. The results indicate that CaAcet added to the PbAcet diet increases the toxicity of the lead salt, and tends to enhance the renal carcinogenicity of PbAcet, yet decreases the accumulation of lead in the kidneys. No significant adverse effects of the PbAcet and CaAcet treatments on the livers were found. PMID- 3971493 TI - Tobacco-specific and betel nut-specific N-nitroso compounds: occurrence in saliva and urine of betel quid chewers and formation in vitro by nitrosation of betel quid. AB - In order to evaluate exposure of betel quid chewers to N-nitroso compounds, saliva and urine samples were collected from chewers of betel quid with or without tobacco, from tobacco chewers, from cigarette smokers and from people with no such habit, and were analysed for the presence of N-nitrosamines by gas chromatography coupled with Thermal Energy Analyzer and alkaloids derived from betel nut and tobacco by capillary gas chromatography fitted with nitrogen phosphorous selective detector. The levels of the betel nut-specific nitrosamines, N-nitrosoguvacoline and N-nitrososoguvacine (the latter being detected for the first time in saliva), ranged from 0 to 7.1 and 0 to 30.4 ng/ml, respectively. High levels of tobacco-specific nitrosamines were detected in the saliva of chewers of betel quid with tobacco and in that of chewers of tobacco, ranging from 1.6 to 59.7 (N'-nitrosonornicotine), 1.0 to 51.7 (N' nitrosoanatabine) and 0 to 2.3 [4-(methyl-nitrosamino)-1-(3-pyridyl)-1-butanone] ng/ml. Urinary concentrations of certain N-nitrosamino acids, including N nitrosoproline, were determined as a possible index of exposure to nitroso compounds and their precursors in the study groups: no clear difference was observed. The betel nut-specific alkaloid, arecoline, was present at high levels in the saliva of betel quid chewers with or without tobacco. Nicotine and cotinine were also detected in saliva and urine of chewers of tobacco and of betel quid with tobacco. In order to assess whether N-nitroso compounds are formed in vivo in the oral cavity during chewing or in the stomach after swallowing the quids, the levels of N-nitroso compounds in betel quid extracts were determined before and after nitrosation at pH 7.4 and 2.1. The results indicate that N-nitroso compounds could easily be formed in vivo. The possible role of N-nitroso compounds in the causation of cancer of the upper alimentary tract in betel quid chewers is discussed. PMID- 3971494 TI - DNA binding of N-hydroxy-Trp-P-2 and N-hydroxy-Glu-P-1 by acetyl-CoA dependent enzyme in mammalian liver cytosol. AB - 3-Hydroxyamino-1-methyl-5H-pyrido[4,3-b]indole and 2-hydroxyamino-6 methyldipyrido[1,2-a:3',2'-d]imidazole, active metabolites of protein pyrolysate carcinogens, were further activated to DNA-binding species by an acetyl-CoA dependent enzyme in hepatic cytosol. This activity was supported also by N hydroxy-2-acetylaminofluorene instead of acetyl-CoA, and it was inhibited by iodoacetamide and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2) but not by diethyl-p-nitrophenylphosphate. The activity was observed in the cytosols of rats, mice and rapid acetylator rabbits, which possessed N-acetylation activity of 2-aminofluorene and Trp-P-2. On the other hand, the activity could not be detected in the cytosols of a dog and a slow acetylator rabbit. PMID- 3971496 TI - Repair of O4-methyldeoxythymidine residues in DNA by mammalian liver extracts. AB - The enzymatic repair of O4-methyldeoxythymidine (O4-MedT) by mammalian liver extracts was investigated in vitro using double-stranded poly[d(A-T) X d(A-T)] alkylated with N-[methyl-3H]-N-nitrosourea as a substrate. The removal of O4-MedT by monkey liver extracts was proportional to the protein concentration of the reaction mixture up to approximately 4 mg/ml, while kinetic analysis revealed the repair reaction reached a plateau by 2 h at 37 degrees C. The removal of O4-MedT could not be accounted for by contaminating nuclease activity, for greater than 90% of the 3-methyldeoxythymidine (3-MedT) was always recovered, whereas O4-MedT declined to as little as 25% of control values. A DNA-glycoslyase is not involved in the repair of O4-MedT, for O4-methylthymine, the free base, was not detected in supernatants from monkey liver reaction mixtures following incubation with substrate and precipitation of macromolecules with ethanol, even though analysis of nucleic acid digests of these assays revealed O4-MedT was lost from the substrate. The order of O4MedT repair activity in human, monkey, partially hepatectomized rat and methylguanine DNA-methyltransferase activity, with human and monkey most active, partially hepatectomized rat intermediate in activity and control rat least active. Our findings suggest the same, or a similarly regulated mammalian liver DNA-methyltransferase repairs O6-methylguanine and O4-MedT residues in DNA, yet the affinity of the enzyme(s) differs for these promutagenic adducts, as we estimate 30-50 O6-methylguanines would be repaired for every one O4-MedT repaired. PMID- 3971495 TI - Benzoyl peroxide promotion of transformation of JB6 mouse epidermal cells: inhibition by ganglioside GT but not retinoic acid. AB - Benzoyl peroxide (BzPo), a free radical generator with tumor promoting activity on mouse skin, is shown to promote neoplastic transformation of JB6 mouse epidermal cells in vitro. Repeated exposures to BzPo are required to readily detect promotion of transformation of JB6 cells. Markedly reduced net synthesis of the major epidermal ganglioside, trisialoganglioside GT1b, (GT) occurs with BzPo treatment as with other tumor promoters active in this system. Addition of ganglioside GT prevents transformation by BzPo while retinoic acid does not. PMID- 3971497 TI - Structural identification of the purine ring-opened form of N-(deoxyguanosin-8 yl)-4-aminoquinoline 1-oxide. AB - Alkaline pH treatment of N-(deoxyguanosin-8-yl)-4-amino-quinoline 1-oxide forms two quinoline derivatives. The two compounds were analyzed together by mass and 500 MHz 1H-n.m.r. spectroscopies and were identified as two 7,8-guanine ring opened rotamers: 1-(1'-deoxyriboside)-1-[6-(2,5-diamino-4-oxo-pyrimidinyl)]-3-(4 quino linyl 1-oxide) urea. PMID- 3971498 TI - The accuracy of inferring left ventricular volume from dimension depends on the frequency of information needed to answer a given question. AB - Left ventricular volume is an important variable in cardiovascular physiology. Because volume cannot be transduced directly, by necessity people measure one or more cardiac dimensions, then implicitly or explicitly estimate volume. Despite its common use, this practice has never been adequately justified. Previous validations of the use of left ventricular dimensions to infer volume have ignored the complexity of the relation between dimensions and volume, particularly over a broad range of hemodynamic states, and have not considered the frequency content of the volume signal needed to answer a given physiological question. We show that, strictly speaking, the assumptions underlying this practice are false. The resulting errors are of little practical consequence under many circumstances, whereas they can be quite important under other circumstances. We consider the frequency content of the volume signal to organize our examples and findings. In this general framework, we find that, for most assessments of volume change from dimension change at or below a frequency of about the heart rate (e.g., beat-to-beat end-diastolic volume), there is no limitation, provided all relevant dimensions are measured. However, for information at frequencies above the heart rate (i.e., rapid changes in volume or dimension), it is probably not possible to draw accurate conclusions about left ventricular volume from dimension data. PMID- 3971499 TI - Analysis of the pressor sympathetic reflex produced by intracoronary injections of bradykinin in conscious dogs. AB - The reflex hemodynamic effects of intracoronary bradykinin were tested in 20 conscious instrumented dogs. When the experiments were performed after full recovery from surgery and anesthesia, graded doses (10-300 ng/kg) of bradykinin always produced graded pressor responses, in the absence of any pain reaction. At the maximum pressor response obtained with 100 ng/kg, mean arterial pressure rose 28 +/- 3% from 89 +/- 4 mm Hg, left ventricular pressure 20 +/- 3% from 121 +/- 2 mm Hg, heart rate 30 +/- 4% from 88 +/- 5 beats/min, rate of change of left ventricular pressure 18 +/- 3% from 2812 +/- 65 mm Hg/sec (P less than 0.01). Higher doses of bradykinin did not produce greater responses. The magnitude of the response was similar when the injection was performed in either the left anterior descending (change in mean arterial pressure 29 +/- 3%) or circumflex (change in mean arterial pressure 27 +/- 2%) coronary artery. The reflex nature of the response was proved by its disappearance after appropriate pharmacological blockades; moreover, after vagotomy, the pressor rise was maintained, the heart rate response was reduced (change in heart rate 10 +/- 2%), and the inotropic response was enhanced (rate of change of left ventricular pressure 24 +/- 3%). This suggested that the afferent pathway of the pressor reflex was in the sympathetic nerves and that a subordinate vagal depressor reflex was also operative. No pain reaction was obtained even when injecting very large amounts (1000-2000 ng/kg) of bradykinin, which, instead, induced arterial hypotension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971500 TI - Possible mechanisms of ventricular arrhythmias elicited by ischemia followed by reperfusion. Studies on isolated canine ventricular tissues. AB - The purpose of this study was to develop an isolated tissue model in which arrhythmic activity could be generated in response to conditions encountered in ischemia followed by reperfusion, and in which intracellular recordings could be used to identify and study arrhythmogenic mechanisms. Isolated canine Purkinje fiber-papillary muscle preparations were superfused with modified Tyrode's solutions. Tissues were exposed to conditions observed in ischemia (hypoxia, acidosis, elevated lactate, zero substrate for 40 minutes). Superfusion with Tyrode's solution of "normal" composition was then reinstituted. Transmembrane recordings from Purkinje and muscle tissues were made, using standard microelectrode techniques. Ischemic conditions caused loss of membrane potential, shortened action potentials, depressed excitability, and progressive bidirectional conduction block between muscle and Purkinje tissues. Spontaneous activity, probably reentrant in origin, was observed. Return to nonischemic conditions resulted in a multiphasic sequence of responses in Purkinje fibers: prompt hyperpolarization, progressive depolarization to unresponsiveness, and final repolarization to control. The depolarization phase was accompanied by oscillatory afterpotentials which initiated extrasystoles. Final repolarization included a phase of automaticity at low membrane potentials, during which Purkinje tissue functioned as a parasystolic focus. Elevation of potassium concentration to 10 mM during the ischemic period did not alter the sequence of electrophysiological events during ischemic conditions or upon reperfusion. This study demonstrates that ischemia followed by reperfusion elicits an orderly sequence of electrophysiological events which may constitute important mechanisms of arrhythmia in vivo. PMID- 3971501 TI - Fate of intercellular junctions in isolated adult rat cardiac cells. AB - Freeze fracture and thin section techniques have revealed morphological changes in gap junctions and intercalated discs of adult rat myocytes following enzymatic dissociation. Cell separation leaves behind small vesicular remnants of formerly adjacent cells connected to the intact cell by gap junctions; in contrast, desmosomes cleave at the region of intercellular contact. Apparently, the next step in gap junction breakdown is internalization of the remnants. In thin section, lanthanum penetration reveals that the cleft of some apparently internalized gap junctions is in contact with the sarcolemma, while that of others is not. In freeze fracture replicas, cytoplasmic gap junctions frequently possess hexagonally packed domains of E-face pits separated by smooth regions that may correspond to separations of membranes of internalized junctions found in thin section. Study of material maintained overnight at 37 degrees C showed no surface junctional remnants; topologies of cytoplasmic gap junctions were generally complex, and concentric membrane vesicles were common. These observations suggest that enzymatic dissociation initiates a progressive, defined sequence of junctional internalization that begins with attached cell remnants and may have as the last determinable step the separation into single membranes inside the intact cell. PMID- 3971502 TI - Angiotensin II in rat brain comigrates with authentic angiotensin II in high pressure liquid chromatography. AB - Indirect evidence has implicated a role for central angiotensin II in blood pressure control. To answer directly the question of whether angiotensin II exists in the brain, independent of blood-borne angiotensin, and to quantify the amounts in different parts of the central nervous system, a sensitive radioimmunoassay was used to measure extracts of male adult rat brain hypothalamus and cortex after purification with high pressure liquid chromatography with a high recovery. The fractions coeluted with authentic angiotensin. Rats were nephrectomized bilaterally, and 24 hours later the brains were extracted in acetic acid and boiled. SepPak C-18 purification preceded reverse phase high pressure liquid chromatography. High pressure liquid chromatography revealed two peaks, one which comigrated precisely with [Ile5] angiotensin II, and another smaller peak which overlapped with [Ile5] angiotensin III. The highest levels were found in the hypothalamus (125 pg/g tissue), pituitary (190 pg/g tissue), spinal cord (199 pg/g tissue), and lower levels were found in cortex (60 pg/g tissue). The results demonstrate that the antibody which was previously used in the immunocytochemical localization of angiotensin in the hypothalamus detects authentic angiotensins. However, the study did not depend on just one antibody. A second antibody which we developed gave the same results. Molecular sieving using Sephadex G-25 with acetic acid revealed a distinct peak in the 1000 MW range and a smaller, higher molecular weight peak which needs further investigation. Spontaneously hypertensive rats did not have higher concentrations of hypothalamic angiotensin II than normotensive rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971503 TI - Optimal power generation by the left ventricle. A study in the anesthetized open thorax cat. AB - We studied the interaction of the left ventricle and the systemic arterial bed in the open thorax cat. In the steady state, the ventricle can be characterized by the pump function graph (i.e., the relationship between mean left ventricular pressure and mean outflow). From this pump function graph, the apparent source resistance of the heart is found. Apparent source resistance is defined as the ratio of the difference between maximal and actual mean left ventricular pressure, and mean outflow. The arterial system can be characterized by the ratio of mean aortic pressure and mean flow (peripheral resistance). The pressure and flow at which the heart operates is defined as the working point. We have investigated whether the ventricle in the intact cat is working optimally, i.e., that it cannot increase work output further at the end-diastolic volume, contractile state, and prevailing heart rate. This condition is considered as "matching" of ventricle and load. It could be shown that optimal power is transferred when the ratio of peripheral and apparent source resistance equals twice the ratio of mean aortic and mean left ventricular pressure (the matching principle). In four cats, we observed that mean aortic and mean left ventricular pressures are proportionally related. Mean external power (the time integral of the product of pressure and flow divided by cycle length) and steady power (the product of mean pressure and mean flow) were found to be proportional as well. These proportionalities allow for the calculation of peripheral resistance and mean external power from the pump function graph. Pump function graphs were determined in three groups: control (n = 9), atrial pacing (n = 8), and halothane (n = 5). We compared the ratio of peripheral and source resistance at the working point and at the point of optimal work output (expressed in steady ventricular power). It could be shown that, in all investigated groups, the power optimum and the working point coincide. It was concluded that circulatory control in the intact anesthetized cat keeps the ventricle at optimal work output under the conditions studied. PMID- 3971504 TI - Effect of reperfusion late in the phase of reversible ischemic injury. Changes in cell volume, electrolytes, metabolites, and ultrastructure. AB - The acute effects of reperfusion on myocardium reversibly damaged by 15 minutes of severe ischemia in vivo, were studied. Changes in the adenine nucleotide pool, cell volume regulation, myocardial calcium, and ultrastructure were studied at the end of 15 minutes of ischemia and after 0.5, 3.0, and 20 minutes of reflow. Before reperfusion, adenosine triphosphate and the adenylate pool decreased by 63% and 44% of control, respectively, and the adenylate charge was reduced to 0.65. After 3 minutes of reperfusion, the adenylate charge was restored to control by the rephosphorylation of adenosine mono- and diphosphate, but adenosine triphosphate was still reduced by 45%. Mild tissue edema was detected after 0.5 minute of reflow and persisted throughout 20 minutes of reperfusion. The increased tissue water was accompanied by a slight increase in sodium and a marked increase in tissue potassium. Although massive calcium accumulation develops when irreversibly injured tissue is reperfused, no calcium overload was detected during early reperfusion of reversibly injured myocytes. Reperfusion for 3 minutes exaggerated the mitochondrial swelling induced by 15 minutes of ischemia but after 20 minutes of reperfusion, myocardial ultrastructure was essentially normal except for rare swollen, or disrupted, mitochondria. Thus, the cellular abnormalities associated with brief periods of ischemia persist for variable periods of time after reperfusion of reversibly injured myocytes. First: although adenine nucleotide repletion occurs very slowly, the adenylate charge was restored after 3 minutes, indicating rapid resumption of mitochondrial adenosine triphosphate production. Second: calcium overload was not detected, but myocardial edema and increased potassium persisted throughout the 20 minutes of reperfusion. Third: the ultrastructural consequences of ischemia were nearly reversed after 20 minutes of reperfusion. PMID- 3971505 TI - Comments on "biochemical properties of membranes isolated from calcium-depleted rabbit hearts". PMID- 3971506 TI - Coronary diastolic pressure-flow relation and zero flow pressure explained on the basis of intramyocardial compliance. AB - In the controversy about the mechanisms determining the high zero flow pressures and the further interpretation of coronary diastolic pressure flow relations, this paper takes a stand in favor of intramyocardial compliance as the primary cause of the high zero flow pressures. An attempt has been made to estimate the compliance distribution within the coronary circulation and to show the specific effect of intramyocardial compliance on arterial and venous pressure-flow relations. Since no data are available on the distensibility of coronary arterioles and capillaries, these data were taken from studies on mesenteric vessels. Based on these data, it is shown that, depending on the transmural pressure, smooth muscle tone may either increase or decrease arteriolar compliance. A compliance distribution has been proposed based on assumed pressure, volume, and distensibility distributions. For all but the venous division of the circulation, experimental data on volume could be found in the literature. Based on this compartmental analysis, it is predicted that overall intramyocardial compliance may exceed epicardial arterial compliance by a factor 45. The literature presenting functional evidence for intramyocardial compliance effects has been reviewed. Experimental results on venous outflow during long diastoles have been analyzed. Pf = 0 coronary pressure at zero flow, is higher when measured later in diastole. It is shown that this may be explained by charging of intramyocardial compliance in the period before flow ceases. The discrepancy between results on pressure-flow relations in the fully dilated bed and autoregulated bed are related to the differences in pressure, resistance, and compliance distributions. PMID- 3971507 TI - Coronary pressure-flow relationships. Controversial issues and probable implications. AB - On the basis of the material discussed, our current assessments of the controversial points mentioned at the beginning of this article may be summarized as follows: Pf = 0, the minimum back pressure to coronary flow associated with a measurable conductance, is indeed greater than coronary outflow pressure (and usually left ventricular diastolic pressure, as well). Pf = 0 needs to be taken into account in attempts to determine coronary driving pressure. In maximally vasodilated beds, Pf = 0 derived from diastolic pressure-flow relationships exceeds coronary outflow pressure by at least a few mm Hg. Pf = 0 varies with coronary outflow and/or diastolic ventricular cavity pressure. When left ventricular preload is elevated, Pf = 0 exceeds outflow pressure by increasing amounts. Pf = 0 appears to be systematically higher and pressure-dependent in beds in which vasomotor tone is operative. An improved understanding of the nature of, and basis for, time-dependent changes in resistance and/or Pf = 0 during long diastoles in nonvasodilated beds is needed. The contour of pressure flow relationships which are free of reactive effects is curvilinear rather than linear. The degree of curvilinearity is substantial and can change with interventions. Curvilinearity is accentuated at lower pressures and may reflect changes in the number of perfused vascular channels as well as the caliber of individual channels. Capacitive effects need to be dealt with quantitatively in studies of pressure-flow relationships. Values of the capacitance which is involved in these effects vary with both pressure and tone. Capacitive flow also depends upon the instantaneous rate of change of pressure, which has not usually been defined in published studies. Although intramyocardial capacitance is large and plays an important role in systolic-diastolic flow interactions, a controlling role in diastolic coronary arterial pressure-flow relationships has not been established experimentally. In vasodilated beds, in-flow remains remarkably constant for several seconds after the brief transient associated with a step-change in the level of constant pressure perfusion during a long diastole. Calculations of coronary vascular resistance (by whatever method) remain of limited value, particularly when changes in response to an intervention are modest. Because of the curvilinear diastolic pressure-flow relationship, resistance is pressure-dependent and, at any given pressure, is probably best defined by establishing the slope of a diastolic pressure-flow curve which is free of reactive effects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971508 TI - Real-time kinetics of sarcomere relaxation by laser diffraction. AB - Kinetics of sarcomere movement were studied in real-time by laser diffraction. Instantaneous sarcomere shortening was measured during afterloaded twitches simultaneously with instantaneous shortening and tension of the whole trabecula excised from rat right ventricle. Resting sarcomere length at optimal length was 2.20 +/- 0.02 micron (mean +/- SEM). Maximum amplitude of sarcomere shortening was 0.30 +/- 0.01 and 0.16 +/- 0.01 micron, respectively, in twitches loaded with preload only, and in "isometric" twitches. When the isotonic load (expressed as a percentage of maximum isometric force TF) increased, the maximum velocity of sarcomere relaxation max Vr (micron/sec) decreased: max Vr = -4 exp (-2.5 X 10( 2) % TF); r = 0.95. The time course of sarcomere relaxation appeared to be progressively delayed when the total load increased from preload only up to "isometric" load. Sarcomere relaxation occurred in two successive exponential phases, a rapid phase [time constant (msec): tau 1] followed by a slower one (time constant: tau 2). When the total load increased, tau 1 increased and tau 2 decreased according to the linear relations: % TF = 0.2 tau 1 + 4.8 (r = 0.83) and % TF = -0.1 tau 2 + 157 (r = 0.95). The relative predominance of both the time course and the amplitude of these two phases depended upon the level of total load. The rapid process predominated at low load, the slow one at high load. The role of load and/or shortening in the time course of these two phases is discussed. PMID- 3971509 TI - Mechanisms of augmented segment shortening in nonischemic areas during acute ischemia of the canine left ventricle. AB - To examine the interaction between normal and nonischemic areas of the left ventricle during acute ischemia, we implanted midwall ultrasonic segment length gauges in the ischemic zone and in nonischemic areas of the canine left ventricle. During acute ischemia, end-diastolic pressure and segment length in the nonischemic areas increased. There was no change from control in the segment length at the time of aortic valve opening and closure. Thus, in nonischemic areas, total segment shortening, as measured by the percent change in segment length from the time of end-diastole to aortic valve closure, increased. This was due to an increase in isovolumic shortening (end-diastole to aortic valve opening) with no change in ejection shortening (aortic valve opening to closure). The progressive increase in isovolumic shortening in nonischemic areas over time was directly paralleled by the progressive development of the isovolumic lengthening or bulge in the ischemic zone. Nonischemic areas, whether adjacent, on the opposite wall, or distant to the ischemic zone, all behaved similarly. Adrenergic blockade did not qualitatively alter these findings. We conclude that acute ischemia induces a mechanical disadvantage which is greater than just the loss of contractile function by the ischemic segment. Despite the apparent hyperfunction of nonischemic areas, the increased total segment shortening is expended in stretching the ischemic zone during isovolumic systole. As a result, there is no significant "compensatory" increase in ejection shortening in nonischemic areas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971510 TI - Electrophysiological study of cardiovascular neurons in the rostral ventrolateral medulla in rats. AB - In urethane-anesthetized rats, electrophysiological recordings of spontaneously active neurons in the vasopressor area of the rostral ventrolateral medulla were analyzed for participation in cardiovascular regulation. A total of 138 units were found which were inhibited by transient increases in mean arterial pressure elicited by intravenous injection of norepinephrine, aortic occlusion, or electrical stimulation of the hypothalamus, with 100% inhibition occurring at 148 mm Hg. Histograms of postsystolic activity showed that these units had pulse synchronous rhythms which grew more prominent as arterial pressure increased. Furthermore, electrical stimulation of the superior laryngeal nerve, which elicited a vasodepressor response, strongly inhibited these units. Thus, these neurons were termed negatively correlated cardiovascular units. At least half of these cells project to or through the thoracic spinal cord. In addition, arterial pressure sensitivity is conveyed through carotid sinus and aortic arch afferents. Approximately half of the cardiovascular units are also excited by hypothalamic stimulation. Finally, analysis of neighboring cells showed that it is possible to distinguish between cardiovascular and respiratory units. These data are consistent with the concept of a medullary center which supports tonic sympathetic vasomotor tone and which mediates baroreceptor reflexes, as well as vascular responses of the defense reaction. PMID- 3971511 TI - Kinetics of thallium exchange in cultured rat myocardial cells. AB - The kinetics of thallium exchange in cultured rat myocardial cells were studied and compared to those of potassium in the same tissue. Studies were carried out using low concentrations (10 nM to 5 microM) of thallium-204, approximating those likely to be encountered during clinical myocardial scintigraphy. Both thallium uptake and release could be described by a single exponential with a half-time of exchange which was approximately half that of potassium and which was largely independent of extracellular thallium concentration. Some 60% of thallium uptake occurred via an "active" or ouabain-inhibitable mechanism which, in the absence of extracellular potassium, could be activated by low concentrations (10 nM to 5 microM) of thallium. The apparent Km for thallium on this active transport mechanism was 2-7 microM. Increasing extracellular potassium from 0-10 mM caused significant, concentration-dependent decreases in both the total and the active component of the thallium influx. Similarly nonradioactive thallium (0.10 microM to 0.10 mM) caused a concentration-dependent decrease in active potassium influx. Analysis of these results by both Lineweaver-Burk plots and Dixon plots confirmed competitive inhibition, potassium on thallium influx and vice versa, for the active component of the fluxes, and noncompetitive in the remainder. These findings indicate that active transport accounts for the greater portion of the influx of thallium and potassium, and that this active transport occurs via a common mechanism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971512 TI - Changes in cholinergic parameters associated with failure of conotruncal septation in embryonic chick hearts after neural crest ablation. AB - Cells from the neural crest over occipital somites migrate to the heart, where they give rise to parasympathetic postganglionic neurons as well as ectomesenchymal elements which contribute to conotruncal septation. With a microcautery needle, the neural crest over occipital somites was ablated bilaterally in chicken embryos at an early stage of development. Histological examination on incubation day 15 revealed conotruncal malformations, involving malformation or absence of the conotruncal septum in all embryos. Two peaks of embryo mortality were observed. One peak (incubation days 6-8) occurred at the same time as conotruncal septal closure; the second peak (incubation days 11-13) was concurrent with the onset of functional parasympathetic innervation. A disruption of parasympathetic innervation was indicated by: (1) a decrease in acetylcholinesterase staining, (2) a decrease (27%) in the number of ganglion cells in the conotruncus, (3) decreases in the acetylcholine content of atrium (31%) and ventricle (39%), and (4) a decrease (21%) in muscarinic acetylcholine receptor density on incubation day 15. Radiolabeled ligand-binding studies revealed no change in the affinity of cardiac muscarinic receptors for [3H]methylscopolamine (KD = 0.17-0.21 nM). Agonist-binding affinity and sensitivity to guanine nucleotides were similarly unaffected. The reasons for the limited extent of the parasympathetic lesion are unclear, but may involve recruitment of precursor cells from other regions of the neural crest, partial regeneration of the neural crest following surgical removal, or an alteration in the contribution of incoming sympathetic or preganglionic parasympathetic elements. No such plasticity was associated with neural crest contributions to the structural development of the conotruncus. Malformations were observed in all lesioned embryos. PMID- 3971513 TI - Interactions of vasopressin with the area postrema in arterial baroreflex function in conscious rabbits. AB - This study compares the effect of arginine-vasopressin with phenylephrine on arterial pressure, heart rate, and renal sympathetic nerve activity in conscious rabbits with and without functional arterial baroreflexes and in rabbits with lesions of the area postrema. In intact rabbits, progressive infusions of arginine-vasopressin result in large decreases in renal sympathetic nerve activity and heart rate for a given increase in blood pressure as compared to progressive infusions of phenylephrine. In sinoaortic-denervated rabbits, the responses of arterial pressure on heart rate and renal sympathetic nerve activity to both arginine-vasopressin and phenylephrine are markedly attenuated, indicating the necessity for afferent baroreceptor activity in this response. This observation indicates that arginine-vasopressin is acting centrally to enhance the baroreflex. A central site of action of circulating vasopressin may be the area postrema, since it is the only circumventricular organ in the hindbrain. Lesioning the region of the area postrema resulted in a normalization of the responses evoked with arginine-vasopressin and phenylephrine. There was no difference in the phenylephrine responses of arterial pressure on renal sympathetic nerve activity or heart rate in area postrema-lesioned animals, compared to control rabbits. Therefore, we conclude that the area postrema or its surrounding tissue is either a site of action of circulating arginine-vasopressin or contains fibers of passage from another site where arginine-vasopressin acts to enhance baroreflex activity. PMID- 3971514 TI - Calcium sensitivity of isometric force in intact and chemically skinned aortas during the development of aldosterone-salt hypertension in the rat. AB - We investigated the role of altered vascular calcium handling in the development of aldosterone-salt hypertension in the rat. The calcium sensitivity of isometric force in response to 50 mM KCl was compared in aortic rings from control and aldosterone-hypertensive rats. Over the entire range of calcium concentrations studied, responses in aortas from the hypertensives were significantly depressed compared to controls [ED50: aldosterone-hypertensive rats (n = 6), 0.739 +/- 0.137; controls (n = 7), 0.141 +/- 0.021 mM; P less than 0.001]. However, calcium sensitivity in response to 1 microM norepinephrine was similar in aortas from both hypertensives and controls [ED50: aldosterone-hypertensive rats (n = 7), 0.196 +/- 0.022; controls (n = 7), 0.180 +/- 0.024 mM]. The calcium sensitivity of Triton X-100 skinned aortic rings from aldosterone-hypertensive rats was likewise not significantly different from sensitivity in controls [ED50: aldosterone-hypertensive rats (n = 9), 3.61 X 10(-7) +/- 0.57; controls (n = 8), 3.89 X 10(-7) +/- 0.64 M]. Therefore, the observed decrease in calcium sensitivity in response to membrane depolarization in aortas from aldosterone hypertensive rats probably is not due to a change in calcium sensitivity of the contractile system itself. The time course for development of changes in calcium handling in vessels from the aldosterone-hypertensive rats was found to be quite different from the time course for changes in monovalent ion metabolism. Whereas increases in monovalent ion permeability reportedly appear as early as one week after the start of aldosterone-salt treatment, significant alterations in calcium handling were not apparent until after four weeks of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971515 TI - Structural and electrophysiological changes in the epicardial border zone of canine myocardial infarcts during infarct healing. AB - Structural and electrophysiological properties of the epicardial muscle which survives on the surface of transmural infarcts of the canine heart (epicardial border zone) were studied at different times after occlusion of the left anterior coronary artery (LAD). Isolated preparations were superfused in vitro, transmembrane potentials recorded, and impulse propagation mapped. In preparations from subacute infarcts (1 and 5 days), resting potential, action potential amplitude, upstroke velocity, and duration were all significantly reduced. Well-defined directional differences in propagation occurred. Propagation was more rapid in the direction perpendicular to the left anterior coronary artery than in the direction perpendicular to the base of the heart, because of the uniform anisotropic structure of the surviving muscle fibers which were arranged in tightly packed bundles oriented perpendicular to the left anterior coronary artery. The only ultrastructural abnormalities found in these muscle fibers was an accumulation of large amounts of lipid droplets. As the infarcts healed, resting potential, action potential amplitude, and upstroke velocity returned to normal by 2 weeks, although action potential duration decreased further. Lipid droplets had disappeared, and connective tissue had invaded the epicardial border zone, separating the muscle bundles. By 2 months, action potentials were normal, but the muscle fibers were widely separated and disoriented by the connective tissue (parallel bundles no longer were found). In these regions with a nonuniform anisotropic structure, the well-defined directional differences in impulse propagation were lost. However, activation was very slow, perhaps because of diminished connections between cells. The persistence of slow conduction in healed infarcts may contribute to the occurrence of chronic arrhythmias. PMID- 3971516 TI - The effects of ryanodine on calcium-overloaded sheep cardiac Purkinje fibers. AB - Prolonged exposure to high concentrations of strophanthidin produces an initial increase followed by a subsequent decrease of twitch tension. The slow decrease is termed calcium overload. The aim of the present work was to investigate the effects of ryanodine (an inhibitor of calcium release from the sarcoplasmic reticulum) on calcium-overloaded sheep cardiac Purkinje fibers. The fibers were voltage-clamped, and tension was measured while monitoring the intracellular calcium concentration with the photoprotein aequorin. When strophanthidin (10 microM) was applied to produce calcium overload, a depolarizing pulse produced twitch, and tonic components of tension and repolarization produced an aftercontraction. These components of tension were accompanied by corresponding increases of aequorin light. Ryanodine (1 microM) gave a transient increase of twitch tension. The twitch then decreased to very low levels. The aftercontraction and its corresponding aequorin light signal decreased monotonically on application of ryanodine. It has been suggested that the fall of force in calcium overload may be due to random diastolic release of calcium from the sarcoplasmic reticulum interfering with subsequent systolic calcium release. We suggest that the positive inotropic effect of ryanodine can be explained if ryanodine decreases the diastolic release of calcium. The transient positive inotropic effect of ryanodine reported here is therefore consistent with the hypothesis that the fall of force in calcium overload is due to diastolic calcium oscillations. PMID- 3971518 TI - Subfornical organ. Does it protect against angiotensin II-induced hypertension in the rat? AB - The purpose of this study was to examine the contribution of the subfornical organ to the chronic hypertension produced by intravenous angiotensin II infusion in rats. Male rats were instrumented with permanent arterial and venous catheters and housed in metabolism cages for daily measurement of arterial pressure, heart rate, water intake, water balance, and urinary electrolyte excretion. Angiotensin II was infused intravenously at a rate of 10 ng/minute for 5 consecutive days, preceded by 2 control days, and followed by 2 recovery days. Normal rats with an intact subfornical organ (n = 7), and rats with an electrolytic lesion placed such that greater than 80% of the subfornical organ was destroyed (n = 9), were studied using this infusion protocol. An additional group of eight rats did not receive angiotensin II, and, thus, served as a time control. Both groups of rats receiving angiotensin II exhibited significant elevations in arterial pressure during the 5-day hormone infusion period, but pressure in rats with subfornical organ lesions (delta 23-29 mm Hg) was increased significantly more than that of intact rats (delta 14-20 mm Hg). Water intake was significantly increased on the 3rd, 4th, and 5th days of angiotensin II infusion only in rats with lesions in the subfornical organ. In contrast to previous studies showing that an intact subfornical organ is required for normal pressor and drinking responses to acute elevations in circulating angiotensin II in the rat, the current experiments indicate that the presence of the subfornical organ actually inhibits these same responses during more chronic increases in plasma angiotensin II levels. PMID- 3971517 TI - Elevated plasma norepinephrine concentrations in decompensated cirrhosis. Association with increased secretion rates, normal clearance rates, and suppressibility by central blood volume expansion. AB - Plasma norepinephrine concentrations are elevated in patients with decompensated cirrhosis, and correlate inversely with urinary sodium and water excretion. Increased plasma norepinephrine concentrations may result from a decreased metabolic clearance rate or an increased secretion rate, possibly in response to a decreased "effective arterial blood volume." If the latter hypothesis is correct, plasma norepinephrine might be expected to be suppressed when central blood volume is expanded by head-out water immersion. In the present study, plasma norepinephrine secretion and clearance rates were determined by infusion of tritiated norepinephrine. Norepinephrine secretion rates were elevated in eight cirrhotic patients as compared to control subjects (1.50 +/- 0.25 vs. 0.26 +/- 0.08 micrograms/m2 per min, P less than 0.001), whereas clearance rates were similar (3.13 +/- 0.48 vs. 2.60 +/- 0.28 liters/min, NS). Baseline plasma norepinephrine concentrations were markedly elevated in the cirrhotic patients (830 +/- 136 vs. 185 +/- 12 pg/ml, P less than 0.001). Head-out water immersion significantly suppressed plasma concentrations of both norepinephrine (704 +/- 72 to 475 +/- 70 pg/ml, P less than 0.005) and epinephrine (121 +/- 33 to 57 +/- 10 pg/ml, P less than 0.05) in all seven patients studied. We conclude that the high circulating catecholamine concentrations in cirrhosis are secondary to increased secretion, rather than to decreased metabolic clearance, and are suppressible by central blood volume expansion. PMID- 3971520 TI - Advances in cardiology and escalating costs to the patient. PMID- 3971519 TI - The status of surgery for cardiac arrhythmias. AB - Successful surgical treatment of all forms of supraventricular tachyarrhythmias is dependent on accurate electrophysiologic guidance. Surgery for WPW syndrome is no longer experimental and should be offered to (1) patients with medically refractory reciprocating tachycardia associated with the syndrome, (2) patients with spontaneous atrial fibrillation who are at risk for sudden death, (3) patients with drug intolerance, and (4) young, otherwise healthy patients with symptoms that warrant more than minimal medical therapy. The current results of surgery for WPW syndrome would seem to lessen the likelihood that a major new method of superior nonpharmacologic treatment will emerge in the near future. Surgery for most other types of supraventricular tachyarrhythmias remains experimental and should be applied only under the most controlled circumstances and after satisfying the most rigid criteria for surgical intervention, the main indication being absolute medical refractoriness. The single exception at the present time is surgery for AV node reentry tachycardia, which appears to be easily cured by the new technique of discrete cryosurgery of the peri-AV nodal region of the lower right atrial septum. In a majority of patients, ventricular tachycardia can be successfully ablated surgically without the use of electrophysiologic mapping to guide the surgeon. If such an approach is taken, however, the surgical treatment of these complex arrhythmias becomes a completely service-oriented exercise. Although delivery of such a service is of undeniable importance, the potential for learning more about these complex and lethal arrhythmias is lost unless each patient is studied as comprehensively as possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971522 TI - Noninvasive study of left ventricular performance in obese patients: influence of duration of obesity. AB - We studied the performance of the left ventricle in 35 obese patients by means of noninvasive methods, including echocardiography, carotid arterial pulse tracing, and phonocardiography. Patients were divided into two groups according to the duration of obesity: group 1 included patients who had been obese for less than 15 years, and group 2 comprised patients who had been obese for more than 15 years. There were no differences in the degree of obesity and cellularity of adipose tissue between two groups. Left ventricular dimension and wall thickness, stroke volume, and cardiac output were significantly greater in both groups of obese patients than in nonobese control subjects. Group 2 had a significantly increased end-diastolic dimension index (DdI, calculated as end-diastolic dimension/cube root of body surface area), stroke index (SI), and radius/wall thickness ratio (R/Th) of the left ventricle compared with group 1. Multiple regression analysis showed that DdI, SI, and R/Th correlated significantly with the duration of obesity. We conclude that alterations of cardiac performance in obese patients with left ventricular enlargement and wall thickening is attributed not only to the excess of body weight but also to the duration of obesity. PMID- 3971521 TI - Concentration-dependent enhancement of junctional pacemaker activity by verapamil in man. AB - The effects of verapamil on junctional and sinoatrial activity were studied in eight patients with third-degree atrioventricular block and stable junctional rhythms. After intravenous infusion of verapamil three steady-state levels were reached as follows: 34 +/- 16 (SS1), 68 +/- 30 (SS2), and 129 +/- 54 (SS3) ng/ml. At each steady-state level, spontaneous sinus and junctional cycle lengths, QT intervals, junctional recovery times after ventricular pacing, blood pressure, and circulating catecholamine concentrations were measured. These measurements were compared with observations made during an identical protocol (except for the exclusion of verapamil infusions) on a control day. No significant changes were detected in the spontaneous sinus or junctional cycle length, junctional recovery times at a fixed pacing cycle length, blood pressure, or circulating catecholamine concentrations during the control day. In response to verapamil, the mean junctional cycle length decreased from a baseline value of 1320 +/- 239 to 1254 +/- 210, 1199 +/- 214, 1069 +/- 151 msec at SS1, SS2, and SS3 (p less than .01). Sinus cycle length (msec) was unaffected or slightly lengthened from 749 +/- 165 at baseline to 821 +/- 222 at SS1, 831 +/- 222 at SS2, and 817 +/- 175 at SS3 (NS). Mean blood pressure, circulating catecholamine concentrations, and corrected QT intervals were also unchanged by verapamil. Verapamil enhanced junctional pacemaker activity in patients with third-degree atrioventricular block, suggesting that (1) these rhythms originate in cells that are not suppressed by the slow-channel antagonism of verapamil and (2) the acceleration of junctional activity seen in response to verapamil reflects a verapamil effect rather than toxicity. PMID- 3971523 TI - Increased forearm vascular reactivity in patients with hypertension after repair of coarctation. AB - To determine whether altered vascular reactivity could contribute to hypertension after repair of coarctation, the change in forearm and calf vascular resistances to small intra-arterial infusions of norepinephrine were measured in six patients who had undergone surgical correction of coarctation of the aorta but still had upper extremity hypertension and compared with similar measurements made in five normotensive patients with mild heart disease. Only the mean upper extremity pressure was significantly greater in the group that underwent repair of coarctation (102 +/- 11 vs 83 +/- 5 mm Hg, p less than .05, for mean arm pressures and 96 +/- 13 vs 83 +/- 7 mm Hg for mean leg pressures in patients who had coarctation vs normotensive patients, respectively). Forearm and calf blood flows were measured in the right arm and leg with a mercury-in-plastic strain gauge plethysmograph. Forearm and calf vascular resistances were calculated by dividing mean arterial pressure of the appropriate extremity by the blood flow of that extremity. Norepinephrine was infused into the right brachial and femoral arteries of the patients at doses of 0.02, 0.05, 0.1, 0.2, 0.3, 0.5, and 0.7 microgram/min. Resting forearm and calf vascular resistances were similar in both groups of patients. The norepinephrine dose-response curves showed that control patients required more than three times the norepinephrine to produce the same percent increase in forearm vascular resistance (after 0.2 microgram/min forearm vascular resistance increased by 55% in the coarctation group, while the resistance in the control group increased by only 3%, p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971524 TI - Alternative diagnostic strategies for coronary artery disease in women: demonstration of the usefulness and efficiency of probability analysis. AB - Alternative strategies using conditional probability analysis for the diagnosis of coronary artery disease (CAD) were examined in 93 infarct-free women presenting with chest pain. Another group of 42 consecutive female patients was prospectively analyzed. For this latter group, the physician had access to the pretest and posttest probability of CAD before coronary angiography. These 135 women all underwent stress electrocardiographic, thallium scintigraphic, and coronary angiographic examination. The pretest and posttest probabilities of coronary disease were derived from a computerized Bayesian algorithm. Probability estimates were calculated by the four following hypothetical strategies: SO, in which history, including risk factors, was considered; S1, in which history and stress electrocardiographic results were considered; S2, in which history and stress electrocardiographic and stress thallium scintigraphic results were considered; and S3, in which history and stress electrocardiographic results were used, but in which stress scintigraphic results were considered only if the poststress probability of CAD was between 10% and 90%, i.e., if a sufficient level of diagnostic certainty could not be obtained with the electrocardiographic results alone. The strategies were compared with respect to accuracy with the coronary angiogram as the standard. For both groups of women, S2 and S3 were found to be the most accurate in predicting the presence or absence of coronary disease (p less than .05). However, it was found with use of S3 that more than one-third of the thallium scintigrams could have been avoided without loss of accuracy. It was also found that diagnostic catheterization performed to exclude CAD as a diagnosis could have been avoided in half of the patients without loss of accuracy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971526 TI - A Doppler echocardiographic method for calculating volume flow across the tricuspid valve: correlative laboratory and clinical studies. AB - In this study we tested a two-dimensional Doppler echocardiographic method for measuring volume flow across the tricuspid valve. Five anesthetized, open-chest dogs had a calibrated electromagnetic flow probe placed on the ascending aorta. Volume flow across the tricuspid valve was controlled by creating a variable femoral-to-pulmonary arterial shunt. Since no standard plane provided a direct view of the tricuspid valve orifice, tricuspid flow area was estimated by calculating a fixed circular flow orifice from the maximal late diastolic diameter of the tricuspid anulus in a four-chamber view. Doppler-determined velocities across the tricuspid valve and tricuspid anulus images in the four chamber view were obtained in inspiration and expiration. For 24 cardiac outputs (0.6 to 4.0 liters/min), inspiratory tricuspid flow determined by the Doppler method correlated minimally better (r = .90, SEE = 0.30 liter/min) than did expiratory measurements (r = .89, SEE = 0.35 liter/min) with the time-averaged systemic flow determined electromagnetically. Doppler-determined tricuspid volume flows in four-chamber and short-axis two-dimensional echocardiographic views from 10 children were then compared with values determined simultaneously by thermodilution during cardiac catheterization. In the children, Doppler determined flows in short-axis and four-chamber views, both in inspiration and expiration, were similar; when results for the two views were averaged in inspiration and expiration, the tricuspid flows predicted by the Doppler method were highly correlated (r = .98, SEE = 0.48 liter/min) with the results of thermodilution. The two-dimensional Doppler echocardiographic method provides a means of estimating volume flow across the tricuspid valve noninvasively. PMID- 3971525 TI - Determination of parameters of left ventricular diastolic filling with pulsed Doppler echocardiography: comparison with cineangiography. AB - To determine the relationship between Doppler-derived flow velocity through the mitral anulus and angiographic parameters of left ventricular filling, 30 patients were studied by two-dimensional echocardiography combined with pulsed Doppler echocardiography followed within 1 hr by left ventricular angiography. The average heart rate for each test was 69 beats/min. Doppler-derived parameters included: early peak diastolic velocity (E) and peak atrial velocity, peak filling rate computed as E X cross-sectional area of the mitral anulus derived from the annular diameter, normalized peak filling rate computed as peak filling rate divided by the left ventricular end-diastolic volume determined by two dimensional echocardiography, and half filling fraction derived from the time velocity integral of the Doppler-determined velocity curve. Frame-by-frame left ventricular volumes were obtained throughout diastole from single-plane cineangiograms. A volume-time curve with its derivative was generated by computer processing from which peak filling rate, normalized peak filling rate, and half filling fraction were measured. Morphologically, the Doppler-derived velocity profile resembled the derivative of the angiographic volume curve. In patients with reduced angiographic peak filling rates, early peak diastolic velocity was often decreased less than 45 cm/sec with a relative increase in peak atrial velocity resulting in an early peak diastolic velocity to peak atrial velocity ratio less than 1.0. There were no significant differences in mean values for peak filling rate, normalized peak filling rate, and half filling fraction by Doppler echocardiography vs angiography (296 vs 283 ml/sec, 1.9 vs 2.0 sec-1 and 0.55 vs 0.55, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971527 TI - Relationship of the lytic state to successful reperfusion with standard- and low dose intracoronary streptokinase. AB - The influence of a systemic lytic state on reperfusion obtained after intracoronary streptokinase (SK) therapy has been evaluated in 15 patients with acute myocardial infarction and complete coronary occlusion. Coronary angiographic studies and measurements of blood fibrinolytic parameters were repeated at 15 min intervals during the infusion of a standard dose of SK and were compared with the results with approximately one-tenth the standard dose. Successful reperfusion was obtained in only 20% (2/10) of patients receiving the low dose, compared with a 75% to 80% success rate in patients receiving the standard dose as initial treatment (4/5) or as follow-up treatment of patients in whom low-dose therapy failed (6/8). There was a striking association between reperfusion and development of the lytic state in that all 12 treatments resulting in reperfusion also caused a lytic state and all seven treatments that failed to produce a lytic state also failed to induce reperfusion (p less than .001). Among the successfully treated patients, the dose of SK that induced a lytic state was relatively constant. However, coronary arterial thrombi differed in susceptibility to treatment. Sensitive thrombi (5/12) dissolved before the lytic state occurred and at a lower SK dose than that needed to cause a lytic state; more resistant thrombi (7/12) required a longer time and a significantly larger SK dose to dissolve. These results indicate that intrinsic properties of the thrombus influence the rate and outcome of treatment and that a minimal dose of SK (about 200,000 U) is required to ensure lasting reperfusion in susceptible patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971528 TI - A prospective randomized study of the clinical efficacy and safety of transvenous cardioversion for termination of ventricular tachycardia. AB - The clinical efficacy and safety of transvenous cardioversion for termination of sustained ventricular tachycardia (VT) were examined by a prospective randomized study design in 22 patients (19 men, three women; mean age 64 +/- 9 years) with organic heart disease and sustained VT. Patients were randomly assigned to undergo an incremental low-energy protocol from 0.03 to 2.2 J (group A, 11 patients) or an incremental high-energy protocol from 0.5 to 10.0 J (group B, 11 patients). Transvenous cardioversion was performed during electrophysiologic studies in the control (drug-free) state and during serial antiarrhythmic drug testing in all patients. Both groups were comparable for demographic, disease and functional status, and electrophysiologic parameters. A total of 77 episodes of VT (group A, 45; group B, 32) were analyzed. The overall efficacy of transvenous cardioversion for termination of VT was 62% (group A 56% vs group B 72%; p less than .01). Antiarrhythmic drug therapy did not significantly enhance efficacy of transvenous cardioversion (control 59% vs drug 65%; p greater than .2). Stepwise discriminant analysis correlated successful transvenous cardioversion with longer VT cycle length (p less than .0005), higher energy (p less than .025), lower energy waveform tilt (p less than .025), shorter time to initial cardioversion attempt (p less than .025), and shorter QRS duration in sinus rhythm (p less than .05). Acceleration of VT was frequent (8% incidence per delivered shock). Thirty one percent of all incremental shock protocols were terminated because of this complication. After cardioversion, transient arrhythmias were common (bradyarrhythmias 23%, supraventricular tachyarrhythmias 12%). Displacement of electrode catheters after transvenous cardioversion was uncommon (3%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971529 TI - Transcatheter ablation: comparison between laser photoablation and electrode shock ablation in the dog. AB - To characterize and compare the effects of transcatheter laser and electrical energy on endocardium, 35 laser pulses were delivered to the endocardial surfaces of isolated canine hearts, and 33 endocardial lesions were produced by the transarterial delivery of either transcatheter laser irradiation or electrical shock in closed-chest anesthetized dogs. Laser-induced lesion dimensions in vitro and in vivo increased with increased total dose of energy; however, the lesions produced in vivo were different in morphology and were significantly larger than lesions produced by equivalent doses of energy delivered in vitro (p less than .05). Endocardial lesions produced in vivo by laser at 40 and 80 J (7.9 X 5.4 X 6.6 and 7.9 X 5.1 X 7.5 mm) were comparable in gross morphology and size to those produced by electrical shock at 100 and 200 J (8.5 X 6.6 X 6.6 and 10.0 X 8.5 X 8.2 mm, respectively; p = NS), but transcatheter electrode shock produced significantly more ventricular tachycardia (p less than .003), premature ventricular beats in the 7 min after energy discharge (p less than .05), and wall motion abnormality (p less than .005). Transcatheter laser photoablation can create controlled endocardial lesions with less energy and fewer deleterious effects than transcatheter electrode shock. PMID- 3971530 TI - Early detection of canine myocardial infarction by magnetic resonance imaging in vivo. AB - This study was undertaken to assess the ability of proton magnetic resonance imaging (MRI) to detect myocardial ischemia shortly after coronary artery occlusion. Fifteen dogs were studied before and serially for up to 6 hr after anterior descending or circumflex coronary artery ligation in vivo by gated MRI with a 0.15 tesla resistive magnet (resonant frequency of hydrogen 6.25 MHz). Image acquisition was by single-spin echo, with echo times (TE) of 30 msec and TE 60 msec, and modified inversion recovery pulse sequences. Excellent anatomic definition was observed. By 4 hr after coronary artery occlusion the signal in the infarct zone increased to 36 +/- 20% greater than that in the adjacent normal myocardium for the TE 30 msec sequence (p less than .01) and to 116 +/- 100% for the TE 60 msec sequence (p less than .05). The most intense increase in signal was noted with the TE 60 msec pulse sequence and because normal myocardium is not well visualized by this technique, acutely ischemic myocardium was clearly delineated. Inversion recovery imaging did not show areas of ischemia. Changes seen on MR images correlated well with the location of ischemic changes noted on microscopic examination of the excised hearts. MRI thus provides a noninvasive means for detection of ischemia early in the course of myocardial infarction. PMID- 3971531 TI - Proximal coronary vasomotor reactivity after exercise training in dogs. AB - The effects of exercise on large coronary vasoreactivity were determined in eight dogs trained by treadmill running for 8 weeks. Six nontrained dogs comprised the control group. The trained group showed a significant reduction in heart rate during graded submaximal exercise testing when compared with the controls, and resting plasma levels of norepinephrine (nontrained group, 331 +/- 99 pg/ml; trained group, 142 +/- 30 pg/ml; p less than .05) and epinephrine (nontrained, 424 +/- 105; trained, 258 +/- 45 pg/ml; p less than .05) were reduced significantly in the trained group. Epicardial coronary responses to intracoronary infusion of serotonin and phenylephrine were evaluated by quantitative coronary angiography, and myocardial blood flow was measured with 15 microns radioactive microspheres. Left ventricular/body weight ratio was similar in the trained (4.81 +/- 0.24 g/kg) and nontrained groups (4.79 +/- 0.17), and no differences were noted in resting myocardial oxygen consumption or coronary arteriovenous oxygen difference. The constriction of the proximal left anterior descending artery (LAD) in response to serotonin infusion was not different in the two groups, but the LAD and circumflex artery constrictor responses to phenylephrine were attenuated in the trained when compared with the nontrained dogs. The data indicate that endurance exercise diminishes the large epicardial coronary vasoconstrictor response to alpha-adrenergic stimulation, but not to serotonin. The blunted constrictor response in the trained animals suggests that exercise may be useful in reducing epicardial coronary vasoconstriction, which is thought to be important in some patients with coronary artery disease. PMID- 3971532 TI - AHA special report. Recommendations for standards of instrumentation and practice in the use of ambulatory electrocardiography. The Task Force of the Committee on Electrocardiography and Cardiac Electrophysiology of the Council on Clinical Cardiology. PMID- 3971533 TI - Advances in cardiology and escalating costs to the patient. View of the practitioner. PMID- 3971534 TI - Advances in research and escalating costs of patient care: summary. PMID- 3971535 TI - Serum potassium concentration as a risk factor of ventricular arrhythmias early in acute myocardial infarction. AB - Sixty patients with a first acute myocardial infarction and no current treatment with cardioactive drugs were included in a prospective study of the relationship between serum potassium concentration and the early occurrence of ventricular tachycardia and premature ventricular contractions (PVCs). Serum potassium level (range 2.5 to 5 mmol/liter) was estimated 3.8 +/- 2.5 hr (mean +/- SD) after the onset of the infarction, and Holter monitoring was performed during the subsequent 12 hr. In multivariate analysis, serum potassium level was negatively and age positively related to ventricular tachycardia. Among the subclasses of PVCs (frequent unifocal, multifocal, couplets, bigeminy), serum potassium concentration was negatively related to the frequent unifocal subclass; hypertension was related to couplets and to the presence of any of the subclasses, and serum aspartate aminotransferase concentration was related to multifocal PVCs. Heart failure leading to death was related to all subclasses of PVC. Serum potassium concentration is an independent inverse predictor of the occurrence of ventricular tachycardia and frequent unifocal PVCs early in acute myocardial infarction. PMID- 3971536 TI - Hemodynamic findings at rest and during mild supine exercise in adults with isolated, uncomplicated ventricular septal defects. AB - Fifty-two patients with isolated congenital ventricular septal defects (VSDs), studied for the first time at age 10 or older, were restudied an average of 16 years later (range 4 to 21). The study protocol included a symptom-limited bicycle ergometer test, M mode echocardiographic examination, and hemodynamic studies at rest and during mild supine exercise. Of the 52, 17 had been operated on an average of 19 years earlier (range 11 to 21) (group 1) and 35 with smaller defects were not operated on (group 2). Although more pronounced findings were made in group 1, a similar pattern was observed in group 2: In most subjects in both groups a subnormal working capacity was observed. A subnormal left ventricular fractional shortening and circumferential shortening velocity was noted in a high proportion at echocardiography. A number of hemodynamic aberrations were observed in a high proportion of patients during exercise but not at rest. Thus a subnormal increase in left and right ventricular cardiac output was found in addition to pathologic increase in right and left ventricular end-diastolic, pulmonary arterial, and pulmonary capillary wedge pressures. In group 1, elevated pulmonary arterial pressures before operation and/or small residual VSDs were associated with a poor hemodynamic outcome. In neither group could significant correlations be observed between hemodynamic aberrations, shunt size, and/or age. Among patients who underwent surgery, the earlier surgical trauma might have contributed to the functional aberrations, but in group 2 the only likely explanation for the findings seems to be the VSD itself. Possibly a long-standing VSD--found unnecessary to repair according to commonly accepted criteria--may lead to disturbed systolic function and increase in compliance of both ventricles via a chronic pressure and volume overload. PMID- 3971537 TI - Influence of coronary collateral blood flow on the development of exertional ischemia and Q wave infarction in patients with severe single-vessel disease. AB - The functional significance of coronary collateral flow from a nonobstructed supply artery was studied in 121 patients with severe (greater than or equal to 80%) single-vessel disease, 64 with and 57 without Q wave infarction. All patients underwent exercise thallium imaging and coronary angiography. On angiography, collateral flow was present in 85% of 74 occluded arteries compared with only 17% of 47 arteries with subtotal obstruction (p less than .001). Collateral flow was not seen in arteries with lesions of less than 90% obstruction. Collateral flow was present in 100% of 29 occluded arteries in patients without Q wave infarction compared with only 76% of 45 occluded arteries with Q wave infarction (p less than .005). Clinical variables did not correlate with collateral flow. Collateral flow did not prevent ischemia on exercise thallium imaging in patients without Q wave infarction: 30 of 33 (91%) with collateral flow had reversible thallium defects compared with 24 of 24 (100%) without collateral flow (p = NS). In patients with Q wave infarction, partially reversible exercise thallium defects (peri-infarctional ischemia) were more common with flow to the area from either subtotal obstruction (73%) or collateral flow (45%) than with no flow from total occlusion (27%; p = .05). In patients with severe single-vessel disease the presence of collateral flow is principally determined by coronary occlusion. Collateral flow may protect from Q wave infarction but does not prevent exercise ischemia on thallium imaging. PMID- 3971538 TI - Adaptation to the stress of tachycardia in patients with coronary artery disease: insight into the mechanism of the warm-up phenomenon. AB - Adaptation to exercise or the "warm up phenomenon" has been observed in some patients with angina pectoris. To investigate adaptation, eleven patients with exertional angina pectoris and angiographic evidence of coronary artery disease underwent two identical bouts of sequential tachycardia stress separated by a brief recovery period. Manifestations of ischemia were less during the second stress, as evidenced by a reduction in the severity of angina pectoris, less ST segment depression, and improved lactate extraction. Peak coronary blood flow during the second stress (81 +/- 20 ml/min) was not significantly different from that during the first (95 +/- 32 ml/min). Regional myocardial oxygen consumption, however, was significantly (p = .03) lower during the second stress (8.8 +/- 2.4 ml O2/min) when compared with the first (11.4 +/- 3.0 ml O2/min). Thus, patients with coronary artery disease can develop anginal tolerance to the stress of tachycardia similar to that observed after repeated bouts of exercise. A relative reduction in myocardial oxygen consumption, rather than an increase in coronary blood flow, appears to account for this phenomenon. PMID- 3971539 TI - Unstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Autopsy evidence of recurrent mural thrombosis with peripheral embolization culminating in total vascular occlusion. AB - Extensive microscopic examination of epicardial arteries and myocardium was performed in 25 cases of sudden death due to acute coronary thrombosis. Eighty one percent of the thrombi had a layered structure with thrombus material of differing age, indicating that they were formed successively by repeated mural deposits that caused progressive luminal narrowing over an extended period of time. This episodic growth of the thrombus was accompanied by intermittent fragmentation of thrombus in 73% of the cases, with peripheral embolization causing microembolic occlusion of small intramyocardial arteries associated with microinfarcts. The period of unstable angina before the final heart attack was, in all but one of 15 patients, characterized by such an ongoing thrombotic process in a major coronary artery where recurrent mural thrombus formation seemed to have alternated with intermittent thrombus fragmentation. The culmination of this "dynamic" thrombotic process in total vascular occlusion caused the final infarction and/or sudden death. PMID- 3971540 TI - Significance of adventitial inflammation of the coronary artery in patients with unstable angina: results at autopsy. AB - A quantitative analysis of adventitial inflammation of the coronary artery with intimal lesions is described in 12 patients who suffered coronary death and had had unstable angina (crescendo angina) at rest (group 1). After autopsy in these patients we examined epon-embedded cross sections by light and electron microscopy, paying particular attention to the adventitia, and compared these results with those in six patients who had had angina but died of noncardiac causes (group 2) and those in 22 patients who did not have angina (group 3). Of the 132 segments from group 1 patients, 39 (30%) were narrowed 76% to 100% by atherosclerotic plaque (group 2, 27%; group 3, 1%), and 23 (17%) had occlusive thrombi. Of the 264 sections (two from each segment) from group 1 that were examined, 98 (37%) (group 2, 15%; group 3, 9%) revealed clustered infiltration of inflammatory cells in the adventitia, half of which were associated with vascular nerve involvement. These findings in the adventitia may be related to the vasospastic component of unstable angina. PMID- 3971541 TI - Detection and characterization of acute myocardial infarction in man with use of gated magnetic resonance. AB - To evaluate the capability of magnetic resonance imaging (MRI) in the detection and characterization of alterations in signal intensity and T2 relaxation time in acutely infarcted relative to normal myocardium 16 adult patients and normal volunteers were studied by electrocardiographically gated proton MRI. The seven volunteers were entirely asymptomatic and had no history of cardiovascular abnormality. The nine patients had each suffered an acute myocardial infarction within 5 to 12 days before the MRI studies. The diagnosis in each patient was confirmed by electrocardiographic (ECG) criteria and elevated levels of fractionated creatine kinase (CK) isoenzymes. Electrocardiographically gated MRI was performed with a superconducting system operating at 0.35 tesla. MRI demonstrated infarcted myocardium as a region of high signal intensity relative to that of adjacent normal myocardium; regions of high intensity corresponded anatomically to the site of infarction as defined by the ECG changes. The mean percent difference between normal and infarcted myocardium was substantially greater on 56 msec images (70.2 +/- 21.3%) compared with 28 msec images (27.1 +/- 13.6%). Region of interest analysis revealed that infarcted myocardium had a significantly (p less than .01) prolonged T2 relaxation time (mean T2 = 80.9 msec) relative to that in normal myocardium (mean T2 = 42.3 msec) and relative to the mean T2 of left ventricular myocardium in the volunteers (mean T2 = 42.4 msec). An additional finding for each patient with myocardial infarction was a high intraluminal flow signal on 56 msec images, but this was also observed in normal subjects and is therefore a nonspecific finding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971542 TI - Cryothermal mapping of recurrent ventricular tachycardia in man. AB - Intraoperative reversible cryothermal mapping of recurrent ventricular tachycardia was performed in seven patients with left ventricular aneurysms with use of a 0 degrees C ice probe. A single, reproducible cryotermination site was found in each patient. The cryotermination site was uniformly located in an area where local electrograms obtained during ventricular tachycardia showed electrical activation during the diastolic portion of the surface electrocardiogram, and was different than the site of activation coincident with the onset of the QRS complex on the surface electrocardiogram (earliest reactivation site or ERS) by 4.5 +/- 2.7 cm (mean +/- SD) in five of seven patients. Sinus rhythm late potentials were recorded at the cryotermination site in five of six patients and from the ERS in one. In five patients, extensive subendocardial resection including both the ERS and cryotermination sites was performed. In two patients only the cryotermination site was excised. In six survivors, including one in whom only the cryotermination site was excised, ventricular tachycardia could not be induced 2 weeks after surgery and has not recurred during the follow-up period of 7 to 17 months (12 +/- 4.5 months, mean +/- SD). Reversible cryothermal mapping may provide additional important information not obtained by standard electrogram mapping of ventricular tachycardia that may help guide surgical therapy of recurrent ventricular tachycardia. PMID- 3971543 TI - Noninvasive pulsed Doppler echocardiographic detection of the direction of shunt flow in patients with atrial septal defect: usefulness of the right parasternal approach. AB - Noninvasive pulsed Doppler echocardiography combined with two-dimensional echocardiography by the right parasternal approach was performed to detect the shunt flow through the defect in 31 patients with suspected secundum atrial septal defect (ASD). A defect of the interatrial septum was seen on the two dimensional echocardiograms of 30 of 31 patients. In all the 30 patients, Doppler signals of shunt flow could be recorded by placing the sample volume in the center of the defect on the two-dimensional echocardiogram. Neither a defect nor Doppler signal indicating shunt flow were demonstrated in any of 15 normal control subjects. Cardiac catheterization indicated significant shunt flow in all the 31 patients with suspected ASD. Doppler signals obtained from the center of the defect showed left-to-right and/or right-to-left shunt flow patterns. The direction of the shunt flow was mainly left to right, with its peak in late systole and atrial systole in 28 of 30 patients; mainly right-to-left flow was present in the remaining two patients, who had Eisenmenger's syndrome. The direction of flow as predicted by the Doppler signal was confirmed by the coincidence of direction of flow as seen on the contrast two-dimensional echocardiogram. In 22 patients for whom the measurement of the pulmonary-to systemic flow ratio by oximetry was believed to be reasonably accurate, the ratio was fairly well correlated with Doppler-determined left-to-right shunt flow velocity (r = .71, SEE = 6.7 cm/sec).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971544 TI - Hemodynamic changes mimicking a vasodilator drug response in the absence of drug therapy after right heart catheterization in patients with chronic heart failure. AB - We suspected that patients with severe chronic heart failure may show hemodynamic changes after cardiac catheterization in the absence of drug therapy that could complicate assessment of the hemodynamic effects of new vasodilator and inotropic agents. To evaluate this phenomenon prospectively, hemodynamic variables were measured in 21 patients with heart failure 30 min and 2, 6, 24, and (in 12 patients) 48 hr after right heart catheterization, during which time therapy was not altered. During the first 2 hr we noted a significant increase in cardiac index and decreases in left ventricular filling pressure, mean arterial pressure, mean right atrial pressure, and systemic vascular resistance (p less than .01); a further decline in left ventricular filling pressure was noted over the next 24 hr, after which all hemodynamic variables remained stable. The magnitude of these hemodynamic changes resembled the effects of many established vasodilator drugs and was further enhanced after meals. These data indicate that hemodynamic improvement may be observed without any therapeutic intervention during the course of invasive studies in patients with severe chronic heart failure; such changes may lead investigators to attribute efficacy to ineffective drug therapy. To minimize the occurrence of such responses, we recommend that intravascular catheters be inserted the day before drug evaluation and that hemodynamic measurements be made with patients in a postprandial state. PMID- 3971545 TI - The long-term increase of baseline and reflexly augmented levels of human vagal cardiac nervous activity induced by scopolamine. AB - We tested the hypothesis that transdermal scopolamine increases vagal-cardiac nervous outflow over the long term in 16 healthy young men. Twenty-four hours after application of one scopolamine patch, the average RR interval was increased by 13% and the average standard deviation of the RR interval (taken as an index of the level of vagal-cardiac nervous activity) was increased by 31%. Baroreceptor-cardiac reflex responsiveness (as reflected by prolongation of RR interval provoked by graded neck suction) also was increased substantially. These findings suggest that vagal-cardiac nervous activity can be augmented pharmacologically in man on a long-term basis. Since vagal outflow influences cardiac electrical properties in an important way, these findings may have therapeutic implications. PMID- 3971546 TI - Production of systolic anterior motion of the mitral valve in dogs. AB - Production of an experimental preparation of systolic anterior motion (SAM) of the mitral valve was attempted for the purpose of clarifying its causal factors. Fourteen thoracotomized dogs under pentobarbital anesthesia were administered dobutamine, and the echocardiogram, left ventricular pressure, and aortic pressure of each were simultaneously recorded. In two of the dogs in which SAM was produced, two-dimensional echocardiograms were also obtained. Although SAM was absent in all 14 dogs before the administration of dobutamine, it appeared in nine of them after the drug was given. In seven of these dogs, the magnitude of SAM and outflow pressure gradient varied in a dose-dependent manner. No signs of asymmetric septal hypertrophy were observed in any of these dogs. SAM tended to occur even when there was no reduction in preejection period when narrowing of the left ventricular outflow tract was observed. On the two-dimensional echocardiograms, the position of coaptation of the mitral valve was shifted closer to the base of the anterior leaflet in the presence of dobutamine-induced SAM than before the drug was administered. Although the left ventricular cavity became narrow, it was not completely obliterated. This study demonstrates that experimental preparations of SAM can be produced by the administration of dobutamine with a relatively high success rate in normal dogs, and that experimental SAM is accompanied by an outflow tract pressure gradient. PMID- 3971547 TI - The relationship between proton nuclear magnetic resonance relaxation parameters and myocardial perfusion with acute coronary arterial occlusion and reperfusion. AB - Previous investigators have demonstrated that acute myocardial ischemia, whether followed by reperfusion or not, is associated with prolongation of the proton nuclear magnetic resonance (NMR) relaxation times T1 and T2. Heretofore, the relationship between the severity of ischemia and alterations of these relaxation times has not been assessed. In our studies, changes in T1 and T2 were compared with myocardial perfusion in dogs both before and during 30 and 60 min of coronary arterial occlusion. In addition, studies were performed to assess the impact of reperfusion on relaxation times after 30 and 60 min of coronary occlusion. In the reperfusion studies the relationship between myocardial relaxation times and flow during the preocclusion, occlusion, and the 15 min reperfusion periods were studied. In the occlusion-only preparations, there was a significant inverse relationship between the relaxation times and flow during occlusion. In the reperfusion preparations there was a significant direct relationship between T1 and T2 and flow during the period of reperfusion. There was no significant relationship between the relaxation times and flow during occlusion in groups that subsequently underwent reperfusion, and no relationship between T1 and T2 and preocclusion flow in either the occlusion-only or reperfusion groups. These data suggest that the proton relaxation times provide an indication of the severity of an ischemic insult. Since NMR images can be generated that are sensitive to differences in these relaxation parameters, NMR imaging may provide a means to assess noninvasively the severity of the myocardial ischemic insult. PMID- 3971548 TI - The relative merits of pulsus paradoxus and right ventricular diastolic collapse in the early detection of cardiac tamponade: an experimental echocardiographic study. AB - An inspiratory decline in systolic arterial blood pressure exceeding 10 mm Hg has been used clinically to identify hemodynamically significant pericardial effusions. Recently, the echocardiographic sign of right ventricular diastolic collapse (RVDC) has been shown to occur early in the course of cardiac tamponade in association with a hemodynamically important decline in cardiac output. This study was undertaken to compare the relative merits of pulsus paradoxus and the onset of RVDC in the early detection of cardiac tamponade in an unanesthetized canine preparation. We studied six chronically instrumented, conscious dogs with two-dimensional echocardiography during cardiac tamponade induced by continuous infusion of saline into the pericardial space. We recorded intrapericardial pressure, cardiac output (electromagnetic flowmeter), aortic (catheter-tip transducer) and right atrial blood pressures, heart rate, and respiration. None of the dogs had RVDC when the pericardial space was empty, but all dogs showed RVDC during cardiac tamponade. We found that RVDC was strongly related to all of the cardiac parameters evaluated (intrapericardial pressure, cardiac output, aortic blood pressure, heart rate, and stroke volume) and provided information on each that was independent of that provided by pulsus paradoxus. Furthermore, RVDC appeared to be more strongly related to most cardiac parameters than was pulsus paradoxus and to be more sensitive and specific than pulsus paradoxus in detecting changes in intrapericardial pressure early in cardiac tamponade. PMID- 3971549 TI - Position of the American Heart Association on research animal use. AB - Millions of Americans today are healthy, and other millions are alive, because of advances in the prevention and treatment of heart disease. Death rates from the major forms of heart disease have declined steadily since about mid-century, and the decline is continuing. Most recently, between 1972 and 1982, the death toll from cardiovascular disease declined 28 per cent. The decline is largely related to changes in life style and development of methods of treatment, many of which are based upon animal experimentation. These events encourage medical scientists to believe that most heart attacks, strokes and hypertension can ultimately be prevented or their onset can be deferred so that they do not cripple or kill people prematurely. PMID- 3971550 TI - YAG laser anterior capsulotomy. PMID- 3971551 TI - Pseudodendrites in soft contact lens wearers. PMID- 3971552 TI - Efficacy of hydrogen peroxide disinfection systems for soft contact lenses contaminated with fungi. PMID- 3971553 TI - Experience with soft bifocal contact lenses. PMID- 3971554 TI - Microkeratome lamellar corneal resection in the rabbit: a model for experimental study of the effects of Barraquer cryolathing techniques. PMID- 3971555 TI - Hyperlipoproteinemia with albumin-lipid complex: a novel type of hyperlipoproteinemia associated with insulin-resistant diabetes mellitus. AB - We describe a new phenotype of hyperlipoproteinemia in two members of a family with a high degree of consanguinity. Both have a history of uncontrolled diabetes mellitus without ketoacidosis, and a family history of coronary artery disease at a relatively early age. A high degree of insulin resistance was found. The abnormal lipoprotein(s) has alpha-lipoprotein mobility on cellulose acetate electrophoresis and has a relative density of less than 1.006 as determined by ultracentrifugation of serum collected after a short fast. The fraction isolated by ultracentrifugation contains about half of the serum cholesterol and triglycerides and most of the phospholipids; the major protein component is albumin. Immunoelectrophoresis showed low concentrations of beta-lipoproteins in both sera, and two abnormal precipitin bands against monospecific antiserum to antilipoprotein A; a third member of the family showed only one abnormal precipitin band against the same antibody. We tentatively propose an abnormal gene(s) as the underlying mechanism. The insulin-resistant diabetes mellitus, probably inherited separately, may aggravate the hyperlipidemia. PMID- 3971556 TI - Magnesium content of mononuclear blood cells. AB - The magnesium content of mononuclear blood cells may provide a better assessment of intracellular magnesium or total body magnesium status than does measurement of magnesium in plasma or erythrocytes. We describe a method for determining this, and report results for 20 normal volunteers. The mononuclear cells are separated with a discontinuous Ficoll-Hypaque gradient, washed, centrifuged at 400 X g, and lysed by sonication in 10 mmol/L NaCl. The magnesium in the cell lysate, with 2.93 g of added lanthanum oxide per liter, is determined by atomic absorption spectrometry. The mean mononuclear cell magnesium content in our volunteers was 70.7 (SD 14.1) fg per cell and 9.29 (SD 1.85) mg/g of DNA. The CVs for the determinations of magnesium, DNA, and cell count were 3.0%, 5.0%, and 8.7%, respectively. There was a significant correlation (r = 0.67, p less than 0.001) between results by the two methods of expressing magnesium content of mononuclear cells. However, by either method there were no significant correlations among results for magnesium concentration of mononuclear cells, plasma, or erythrocytes. PMID- 3971557 TI - Isolation and preliminary characterization of a monoclonal antibody that interacts preferentially with the liver isoenzyme of human alkaline phosphatase. AB - We have prepared murine monoclonal antibodies against isolated human bone alkaline phosphatase (ALP, EC 3.1.3.1). Hybridoma supernates were separately screened for reactivity against both human liver and bone ALP. Although most antibody-positive hybrids showed similar reactivity against both isoenzymes, one hybridoma produced an antibody that interacted preferentially with liver ALP. This antibody was purified and used to establish an immunoassay to differentiate liver ALP from bone ALP. When equal activities of the two isoenzymes (as determined by a conventional enzymic assay) were measured by the immunoassay, a fivefold greater response was obtained with liver than with bone ALP. The immunoassay can be used to measure the proportions of the bone and liver isoenzymes in mixtures of them. Cross reactivity with human placental and intestinal ALP is less than 3% relative to liver ALP. These findings support the feasibility of developing immunological methods to differentiate these isoenzymes in the clinical laboratory. PMID- 3971558 TI - Effect of bias in hematofluorometer measurements of protoporphyrin in screening programs for lead poisoning. AB - Values for erythrocyte protoporphyrin (EP), measured in our laboratory after extraction with ethyl acetate-acetic acid, were compared with hematofluorometer measurements made in 21 other laboratories. We found that: (a) for samples of patients' blood, hematofluorometer results were 11 to 28% lower than the extraction-based values, depending on the concentration of EP and the mathematical model used; (b) hematofluorometers had mean errors of 0 to 3% for federal proficiency-testing samples; (c) there were no performance differences between fresh and shipped blood for the six laboratories that were analyzing both; (d) a hematofluorometer with a 20% low bias at an EP concentration of 500 micrograms per liter of whole blood (by the extraction method) will not detect about a third of the children whose EP concentration exceeds that cutoff value; and (e) at this same cutoff value for EP, the extraction tests detects about 45% of children whose blood lead exceeds 300 micrograms/L, whereas a 20% low-bias hematofluorometer detects only about 37%. PMID- 3971559 TI - MM subisoenzymes of creatine kinase as an index of disease activity in polymyositis. AB - Creatine kinase (CK; EC 2.7.3.2), although the most commonly measured enzyme for assessing disease activity in polymyositis, is not always a reliable indicator of the extent and severity of myositis. Recently, the CK-MM isoenzyme has been found to undergo post-synthetic modifications upon release into the serum, such that electrophoretically identifiable sub-bands or subisoenzymes--MM1, MM2, and MM3- are produced. To determine the diagnostic and discriminative value of these subisoenzymes in polymyositis, we analyzed CK and its MM subisoenzyme forms in serum samples from 22 patients with myositis and from 23 controls. In the presence of inflammatory myositis and increased total CK activity, MM-patterns correlated with the clinical trend, often more accurately than did measurements of total CK. MM1 proportions greater than 30% of total CK-MM or ratios of MM3 to MM1 less than 1 were associated with an improving or stable condition, whereas MM1 activity less than 30% or MM3/MM1 greater than 1 reflected a deteriorating course of disease. Patients whose disease was assessed to be clinically deteriorating were clearly distinguished from patients with improving disease by their subisoenzyme patterns (p less than 0.01). Thus these patterns add significantly to the information obtainable by routine blood analysis. PMID- 3971560 TI - Rapid radiometric assay used to assess lactoferrin in granulocytes. AB - We describe a rapid, precise, and sensitive radiometric assay for human lactoferrin. In this typical "sandwich"-type assay, anti-human lactoferrin is adsorbed onto a polystyrene sphere and bound lactoferrin is detected by the subsequent binding of 125I-labeled anti-human lactoferrin. The assay is accurate for lactoferrin concentrations of 5 to 1500 micrograms/L and takes about 2.5 h to complete. The within-assay and interassay variations (CV) are 5% and 13%, respectively. Neither lysozyme nor heparin, substances that form complexes with lactoferrin, interfered with lactoferrin measurement by this method. The assay has been applied to the measurement of lactoferrin in polymorphonuclear leukocytes of both healthy adults and neonates. We found significantly (p less than 0.001) less lactoferrin in the latter, an abnormality that may be related to known functional deficits of polymorphonuclear leukocytes during the newborn period. PMID- 3971561 TI - Estimation of thyroxin, triiodothyronine, thyrotropin, free thyroxin, and triiodothyronine uptake by use of magnetic-particle solid phases. AB - We evaluated solid-phase radioassays involving small, uniform magnetic particles (MAGIC, Corning Medical), obtaining data on total serum thyroxin (T4), triiodothyronine (T3), thyrotropin (TSH), free thyroxin (FT4), and T3 uptake for a total of 301 serum samples from euthyroid patients; patients receiving replacement thyroxin; patients receiving estrogen, or who were pregnant; hyperthyroid, hypothyroid, and nonthyroidally ill patients; and patients receiving salicylates, phenytoin, or heparin. We found each procedure to be technically simple and precise (between-assay CVs for T4 2.8-8.2%, T3 9-7.4%, TSH 2.9-4.5%, FT4 3.6-11%, T3 uptake 2.2-3.7%). The magnetic separations are rapid (2 to 5 min), reproducible, and complete. Each MAGIC assay produced clinically appropriate results. These assay systems offer the convenience associated with noncentrifugation assays and excellent analytical performance. PMID- 3971562 TI - Galactose and galactitol in the urine of children with compound heterozygosity for Duarte variant and classical galactosemia (GtD/gt) after an oral galactose load. AB - An oral dose of galactose, 1 g/kg of body weight, was administered to 24 children with the Duarte variant/classical galactosemia genetic compound (GtD/gt) and to 16 controls ranging in age from 0.3 to 10.7 years. Urine was then collected for 3h. Excreted amounts of galactose and galactitol increased with age in all subjects, but were consistently greater in the compound heterozygotes. If related to urinary creatinine, galactosuria and galactitoluria were no longer age dependent, although as compared with the controls, urinary galactose was about three times and urine galactitol twice as high in the patients (p less than 0.01 for both). We found a statistically significant correlation between urinary galactitol and galactose in these patients. Moreover, urinary galactitol and galactose each correlated positively with the area under the plasma galactose curve, as well as with the peak value for plasma galactose after galactose ingestion. PMID- 3971563 TI - Human kininogens of low and high molecular mass: quantification by radioimmunoassay and determination of reference values. AB - Kininogens of low and high molecular mass, highly purified from human plasma, were used to raise antisera in rabbits. To obtain immunologically intact tracers, we labeled the kininogens by the lodogen method, followed by double chromatography, first on Sephadex G50 and then on Sephadex G200 for high molecular-mass kininogen or on G100 for low-molecular-mass kininogen. Both assays are sensitive, accurate, and reproducible. On an equimolar basis, the high molecular-mass kininogen cross reacted completely in the determination of low molecular-mass analyte. Moreover, the radioimmunoassay for the former was highly specific. After optimizing the time and temperature of incubation to provide rapid and reliable results, we determined 95% reference intervals from a large sample of healthy subjects (250 men, 200 women): 109-272 and 69-116 mg/L for the low- and high-molecular-mass kininogens, respectively. PMID- 3971564 TI - Radiochemical microassay of delta-aminolevulinic acid dehydratase activity in whole blood and bone marrow. AB - We describe an assay for delta-aminolevulinic acid dehydratase (EC 4.2.1.24) activity. Radioactive [14C]porphobilinogen, formed by action of this enzyme on [14C]delta-aminolevulinic acid, is purified by passage through an ion-exchange chromatographic column before measurement with a liquid scintillation counter. The radioactive substance in the final solution was identified as solely [14C]porphobilinogen by paper-chromatographic analysis. The present assay procedure requires only a 0.1-microL sample of blood and is about 100-fold more sensitive than the conventional colorimetric methods involving Ehrlich's reagent. Using this method, we found that activity of this enzyme in the bone marrow of rats decreases abruptly and sharply two weeks after birth. PMID- 3971565 TI - Headspace measurement of ethanol in blood by gas chromatography with a modified autosampler. AB - An autosampler intended for liquid injection into a gas chromatograph was modified to serve as an automatic headspace sampler by replacing the syringe with a 100-microL gas-tight syringe and shortening the needle that normally enters the vials for sampling. Instead of the usual 1.0 to 1.5 mL of liquid sample, the vials contained 200 microL of liquid; the vapor above the liquid was injected into the gas chromatograph. Blood samples from California drivers were analyzed for ethanol by using the modified autosampler and the values were compared with those obtained by two other methods: the Smith modified version of the Widmark diffusion desiccation oxidation method (J Lab Clin Med 38: 762, 1951) and direct injection of diluted blood into the gas chromatograph. The correlation coefficient between the headspace method described in this paper and the titration method was 0.984; with direct injection, 0.997. PMID- 3971566 TI - An L-lactate sensor with immobilized enzyme for use in in vivo studies with an endocrine artificial pancreas. AB - We report the features of a sensor for determining L-lactate. An oxygen sensor, coupled to a nylon net with chemically bound L-lactate oxidase (EC 1.1.3.2), is inserted into an artificial pancreas (Biostator, Miles) "downstream" from the glucose sensor. We used the sensor to continuously monitor the L-lactate concentration in blood after a "glucose clamp" experiment with a diabetic patient. L-Lactate determinations in blood drawn from the patient every 15 min agreed well with results obtained by use of the L-lactate sensor. PMID- 3971567 TI - 125I radioimmunoassay for 17 alpha-hydroxyprogesterone in plasma, for diagnosing and managing congenital adrenal hyperplasia. AB - This rapid, inexpensive, and sensitive radioimmunoassay (RIA) for plasma 17 alpha hydroxyprogesterone involves radioiodination. A single extraction with toluene/hexane removes an average 93% of the hormone from 0.1 mL of plasma. The extract is evaporated and the hormone is estimated by a simple, precise, and accurate 125I RIA involving a specific rabbit antiserum. A suspension of dextran coated charcoal is used to separate free and bound steroid. Inter- and intra assay CVs were less than 15 and less than 10%, respectively, and the sensitivity was 3 pg per assay tube. The regression equation for data on 17 alpha hydroxyprogesterone added to steroid-free plasmas was y = 0.94x + 2.2 (r = 0.99). However, the turnaround time is only one-half to one-tenth that for most 3H RIA (3 h vs 6 to 30 h). The ranges of values found for plasma from normal subjects, treated and untreated patients with congenital adrenal hyperplasia, and infants with newly detected congenital adrenal hyperplasia were, respectively, 1 to 11, 0 to 20, 30 to 620, and 270 to 4900 nmol/L. PMID- 3971568 TI - Reliability of the Hitachi sodium and potassium electrodes assessed. AB - We compared the Hitachi 705 E sodium/potassium electrode system with the Radiometer flame photometer for measuring concentrations of sodium and potassium ions in serum and plasma. Our data show that the Hitachi results are slightly but significantly (less than 0.001) lower than the flame photometer results: Na+ 1.33 mmol/L for serum and 2.24 mmol/L for plasma; K+ 0.062 mmol/L for serum and 0.082 mmol/L for plasma. The magnitude of the bias varied considerably from day to day, ranging from -0.10 to 2.33 mmol/L for Na+ in serum and from 0.00 to 0.11 mmol/L for serum K+; for plasma specimens the corresponding ranges were -0.03 to 5.97 mmol/L and 0.00 to 0.17 mmol/L. These variations probably reflected difficulties in reproducing the calibration from day to day, because the daily means for a serum pool varied in parallel. We occasionally encountered serious problems with reproducibility. PMID- 3971569 TI - Derivatives of cyclosporin compatible with antibody-based assays: I. The generation of [125I]-labeled cyclosporin. AB - The immunosuppressive drug cyclosporin A, has been successfully iodinated to a specific activity of 300 Ci per gram. 125I-labeled cyclosporin and [3H]cyclosporin are nearly equivalent as tracers in a radioimmunoassay in producing standard lines (suppression by unlabeled cyclosporin) and in assigning values to clinical samples. In addition, the [125I]-labeled cyclosporin has greater than twice the sensitivity, and it is stable to long-term storage. Use of a [125I]-labeled cyclosporin tracer is more convenient, more reproducible, more precise, and easier than the tritiated-cyclosporin alternative in radioimmunoassay of this compound. PMID- 3971570 TI - Molar absorptivity and the blank correction factor. AB - In photometry, where both the product formed and one or several reactants absorb light at the same wavelength, the absorbance of the "blank" of the sample at the end of the reaction may be less than that measured at the beginning of the reaction, because of consumption of reactant(s). The blank correction factor for the determined result with one light-absorbing reagent is epsilon P / (epsilon P epsilon R), where epsilon R and epsilon P are the molar absorptivities of the reagent and the product, respectively. We derived a factor for the case when more than one reagent absorbs light at the same wavelength as the measured product. This factor is independent of the concentration of reagent(s) and can correct the determined result or absorbance for the consumption of light-absorbing reagent(s) during the reaction. PMID- 3971571 TI - Probably myocardial infarction in a 14-year-old boy. AB - After vigorous physical activity a 14-year-old boy from a family with a strong history of cardiac disease developed symptoms consistent with a myocardial infarction, a relatively rare event in this age group. Isoenzyme patterns of creatine kinase and lactate dehydrogenase were consistent with the occurrence of an infarction. PMID- 3971572 TI - Ion-selective electrodes for sodium and potassium: a new problem of what is measured and what should be reported. AB - For clinical purposes the activities of Na+ and K+ obtained with ion-selective electrodes in undiluted whole blood or serum should be multiplied by an appropriate factor to obtain the same values as the substance concentrations obtained by flame photometry. The factor is primarily dependent on the mass concentration of water in normal plasma divided by the molal activity coefficient of Na+ (or K+) of normal plasma. We discuss the value of the molal activity coefficient of Na+ obtained by theoretical calculations and by direct measurement. The discrepancies between theory and measurement (gamma Na+ of 0.747 and 0.73, respectively) may be due to some binding of Na+ (protein binding or ion pair formation), a small and variable residual liquid-junction potential, or certainty about the appropriate value for the ionic strength of normal plasma (0.16 mol/kg or somewhat higher). PMID- 3971573 TI - Immunonephelometric determination of prealbumin in serum of newborns. PMID- 3971574 TI - Stabilization of the calmagite reagent for automated measurement of magnesium in serum and urine. PMID- 3971575 TI - Thyroid-function tests: response to a comment. PMID- 3971576 TI - Lack of influence of KCl on values for Na+ obtained with the Nova-1. PMID- 3971577 TI - Asymptomatic xanthinuria detected as a result of routine analysis of serum for urate. PMID- 3971578 TI - The Abbott TDx fluorescence polarization immunoassay and liquid chromatography compared for five anticonvulsant drugs in serum. PMID- 3971579 TI - Reliable pregnancy test procedure with urine and serum samples. PMID- 3971580 TI - EktaChem assay for phosphorus evaluated. PMID- 3971581 TI - Caffeine no longer measurable with theophylline channel of the TDx. PMID- 3971582 TI - Neglect of potassium binding to bicarbonate may result in overestimation of the residual liquid junction potential. PMID- 3971583 TI - Plasma creatine kinase/aspartate aminotransferase ratio in the diagnosis of acute myocardial infarction. PMID- 3971584 TI - A fluorescent biological compound that can cause error in enzymic triglycerides determination. PMID- 3971585 TI - Can externally deposited Se be removed from hair? PMID- 3971586 TI - Concentrations of Mg and Ca in serum are correlated in normal individuals. PMID- 3971587 TI - Semi-quantitative estimation of serum myoglobin by a rapid latex agglutination method: an emergency screening test for acute myocardial infarction. AB - The present study reports the evaluation of a new latex agglutination test for serum myoglobin (SMb). The time of agglutination of the latex particles coated with antibodies to myoglobin was measured in 172 serum specimens with known concentration of myoglobin quantitated by a radioimmunoassay (RIA), collected from myocardial infarction (MI) patients, subjects suffering from various diseases, and normal controls. Myoglobin levels in the samples were found to decrease exponentially with time of agglutination. Agglutination occurring within 1 min (result coded as + + + +) corresponded to 761 +/- 366 micrograms/l of myoglobin; between 1 and 2 min (+ + +), to 285 +/- 101 micrograms/l; between 2 and 3 min (+ +), to 85 +/- 47 micrograms/l; between 3 and 4 min (+), to 51 +/- 38 micrograms/l; and after more than 4 min (-), to 31 +/- 16 micrograms/l. Blood samples were serially drawn from 24 MI patients with short hospitalization delays; the rapid agglutination which was obtained in the specimens taken upon admission (20 results coded as + + + + and four as + + +) actually corresponded to markedly increased SMb levels. In contrast, serum creatine kinase (CK) activities were still less than 150 U/l in four patients (16.6%); CK-MB was less than 5 U/l in five cases (20.8%). Positive agglutinations for SMb were also obtained 4 and 8 h following admission in all subjects, confirming that the latex test is an early and very sensitive indicator for MI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971588 TI - Changes in human high density lipoproteins in patients with extra-hepatic biliary obstruction. AB - Plasma high density lipoproteins (HDL) from patients with obstruction of the common bile duct were studied by crossed immunoelectrophoresis and isoelectric focusing. All cholestatic HDL fractions were rich in phospholipids (51.5 +/- 9%) with high proportions of free cholesterol (13.8 +/- 1.5%). Moreover, crossed immunoelectrophoresis of sera against anti-Apo A revealed the presence of multiple immunoprecipitates sharply contrasting with the pattern formed by normal sera. Tandem crossed immunoelectrophoresis against anti-Apo A and anti-Apo B was performed with whole serum and with the HDL fraction from various cholestatic subjects. Crossed identity was observed for two of these precipitates, which could be explained by the decrease in HDL stability due to the detergent effect of bile salts. The most noteworthy changes found in cholestatic patients appeared to be the apolipoprotein pattern of HDL. Both Apo AI (48%) and Apo AII (5.5%) were greatly diminished and Apo E was present in remarkably high amounts (39%) with two additional isoforms (Apo E'1 and Apo E'2). PMID- 3971589 TI - Volatile carboxylic acid profiling in physiological fluids: direct injection into a gas chromatograph/mass spectrometer. AB - We present a procedure for the profiling of the volatile carboxylic acids and neutral compounds in blood or urine using the direct injection of the acidified sample into a gas chromatograph interfaced with a mass spectrometer by a jet separator. The non-volatile components remain at the head of the SP-1000 column while the volatile components move through the column. Up to sixty physiological samples can be analyzed before any degradation in mass spectrometer operating parameters is observed. PMID- 3971591 TI - An improved high-performance liquid-chromatographic determination of conjugated bile acids in serum using paired-ion chromatography. PMID- 3971590 TI - Serum and lymphocyte, aluminum and nickel in chronic renal failure. AB - In the past decade, aluminum has been recognized as a toxic metal in patients with chronic renal failure. It is, however, possible that other trace metals, such as nickel, may also have toxic actions in these patients. The plasma concentration of a metal, such as aluminum or nickel, may not provide a valid index of either tissue content or total body burden. In the study reported here, the aluminum and nickel content of lymphocytes was measured and compared with plasma concentrations in normal controls and patients with chronic renal failure. The findings suggest that lymphocytes may be of value as a nucleated 'tissue' for the assessment of trace metal status. PMID- 3971592 TI - Highly selective one-step chromatography of serum and urinary albumin on immobilized Cibacron Blue F3GA. Studies on normal and glycosyl albumin. PMID- 3971593 TI - A simplified method for the calculation of unbound or free testosterone by equilibrium dialysis of undiluted plasma. PMID- 3971594 TI - A method for the determination of nickel in water and serum by flameless atomic absorption spectrophotometry. PMID- 3971595 TI - The influence of cyclosporin A on the induction of experimental autoimmune thyroid disease in the PVG/c rat. AB - Using an experimental model of autoimmune thyroid disease we have investigated the influence of cyclosporin A (CyA) on the induction of the disease and its potential ability to prevent disease development. PVG/c rats (n = 80) neonatally thymectomized (day 21) and thence sublethally irradiated were divided into eight groups and received either no CyA or oral CyA (10 mg/kg body weight) for varying periods prior to and during disease induction. Serial serum measurements of thyrotropin (TSH) by radioimmunoassay and anti-thyroglobulin autoantibody by enzyme linked immunosorbent assay showed a progressive rise in untreated animals. The rise in serum TSH levels from 349 +/- 15 ng/ml (mean +/- s.e., normal less than 400 ng/ml) at 7 weeks of age to 526 +/- 61 ng/ml at 11 weeks and 820 +/- 54 ng/ml at 15 weeks was not significantly different in animals treated with CyA for periods ranging from 24 h prior to thymectomy to 7 days post-thymectomy. In contrast animals treated for 28 days post-thymectomy showed significantly lower levels of TSH at both 11 weeks (391 +/- 26; P less than 0.02) and 15 weeks (587 +/- 37; P less than 0.005) as compared with untreated animals. Similar though less dramatic changes were seen in intermediate groups. Autoantibody levels in untreated animals rose from initially undetectable levels to 0.451 +/- 0.07 OD (mean +/- s.e.) at 11 weeks and 0.581 +/- 0.041 OD at 15 weeks. Animals treated for at least 4 weeks after thymectomy with CyA had significantly lower levels of antibody at both 11 weeks (0.213 +/- 0.01; P less than 0.001) and 15 weeks (0.337 +/- 0.03; P less than 0.001) of age. Intermediate groups ranged in antibody levels depending on the duration of CyA treatment. Thyroid gland weight (12.7 +/- 2.4 mg/100 g body weight, mean +/- s.e.) and histological grade of thyroiditis (1.8 +/- 0.4, mean +/- s.e.) in the animals treated with CyA for 4 weeks, assessed when the animals were killed at 15 weeks, were smaller and had less severe thyroiditis than untreated thymectomized and irradiated animals (23.8 +/- 2.8 mg/100 g, P less than 0.02 and 2.9 +/- 0.2, P less than 0.05) killed at the same time. CyA given for long enough during induction of experimentally-induced autoimmune thyroid disease delayed the onset of disease and reduced its severity but could not prevent it given over time courses ranging from 48 h prior to thymectomy to 4 weeks after.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971597 TI - Human syncytiotrophoblast membrane proteins defined using a heterologous antiserum. AB - Detergent extracts of human trophoblast plasma membranes (TrPM) and of other fetal tissues from the same conceptus were prepared and the proteins separated by use of isoelectric focusing. A major band of isoelectric point (pI) 4.1 was present in TrPM together with minor bands of (pI) 4.9, 5.9, 7.3, 7.8 and 7.9. These bands were absent from non-trophoblastic fetal tissues. The pI 4.1 protein reacted with an 125I-labelled IgG fraction of a heterologous antiserum raised against TrPM and was found to have an apparent molecular weight of 100,000. This protein did not appear to be placental alkaline phosphatase, SP1, transferrin or human chorionic gonadotrophin. Many neoplastic cell lines tested also revealed a major protein band of pI 4.1 but it has not been established that this was the same protein as found in the TrPM preparations. PMID- 3971596 TI - Intestinal lymphangiectasia and thymic hypoplasia. AB - We have evaluated the immunological abnormalities present in a 6 year old patient with primary intestinal and generalized lymphangiectasia confirmed by intestinal, lung and lymph node biopsies. Lymphocyte loss through the gut was confirmed by the detection of lymphocytes in her stool. An increased enteric protein loss was suggested by hypoproteinaemia, peripheral oedema, and a very short half-life for i.v. immune serum globulin (3 days). Lymphocyte subpopulation analysis revealed a selective loss of T lymphocytes, with a proportionally increased loss of the OKT4 positive helper/inducer subpopulation. Functionally, there was a decrease in proliferative responses to some mitogens and to allogeneic cells, and a lack of T cell help for in vitro B lymphocyte differentiation into immunoglobulin secreting cells. Natural killer function was normal. In this patient, a concomitant thymic deficiency was documented by failure to identify thymic tissue on a thymus biopsy and by an absence or decrease of the serum thymic factor (thymulin) and thymosin alpha 1. No compensatory lymphopoiesis was detected in the bone marrow. In an attempt to increase T lymphocyte development, the patient was treated with thymosin fraction 5. Daily treatment with this preparation resulted in a transient clinical improvement which could not be sustained on a weekly thymosin treatment schedule. However, lymphocyte numbers did not increase during this treatment. The findings in this patient support the notion that T lymphocytes are needed to stimulate thymic epithelium. In situations of excessive loss of long lived T lymphocytes a secondary thymic atrophy may occur and further contribute to the development of a deficiency in cell-mediated immunity. PMID- 3971598 TI - Inhibition of contact sensitivity reactions to DNFB by topical cyclosporin application in the guinea-pig. AB - Contact sensitivity skin reactions to dinitrofluorobenzene (DNFB) were inhibited by twice daily topical application of cyclosporin (CsA, 2%) in normal guinea-pigs and in those with enhanced contact sensitivity reactions following pre-treatment with cyclophosphamide. In contrast to oral administration of CsA (25 mg/kg) for 4 days, topical application of the drug over the same period did not result in systemic absorption (as measured by radioimmunoassay) or in any evidence of nephrotoxicity. PMID- 3971599 TI - Characterization of the Fc(IgG) receptor on the pluripotential leukaemia cell K 562. AB - K-562 cells express an Fc receptor that is murine isotype IgG specific. The receptor was defined by rosette formation using sheep erythrocytes sensitized with murine monoclonal haemagglutinin (EA) of known isotype. Optimal rosette formation occurred at 4 degrees C or ambient temperature; however, the number of rosettes formed at ambient temperature decreased after 8 h whereas formed rosettes were stable at 4 degrees C. EA in which IgG2b was the immunoglobulin isotype gave high numbers of rosettes while IgG2a gave lower but significant numbers. Aggregated human IgG inhibited rosette formation of EA(IgG2a) more easily than those of EA(IgG2b), indicating a higher affinity of the Fc receptor for IgG2b. PMID- 3971600 TI - Natural killer cell activity in asthma. AB - Peripheral blood natural killer (NK) activity was analysed from 32 asthma patients and 13 control donors. Male patients and female patients with atopic asthma had significantly stronger NK activity against the leukaemic cell line K 562. Fractionation of patient mononuclear cells by discontinuous density gradient centrifugation suggested that large granular lymphocytes (LGL) were the main mediators of the NK activity in asthmatics. Based on the lytic unit calculations, the strong NK activity in asthmatics is mainly due to increased frequency of LGL in peripheral blood rather than activity of individual NK cells. PMID- 3971602 TI - Intravenous immune globulin for hypogammaglobulinemia: a comparison of opsonizing capacity in recipient sera. AB - Twelve severely hypogammaglobulinemic patients received infusions of alkylated immune globulin and two other native nonalkylated products. Administration was separated by an interval of 3 weeks. Serum was obtained prior to and at 24 hr and 3 weeks after each infusion for measurement of total IgG, specific and opsonizing antibodies. The latter was accomplished against Streptococcus pneumoniae types 5, 12F and 14 and zymosan using chemiluminescence methodology. Changes in total IgG concentrations were comparable for the three products. Prior to enrollment, IgG levels averaged 115 +/- 72 mg/dl, increasing to 779 +/- 399 at 24 hr postinfusion, and were 337 +/- 200 after 3 weeks. No differences among the products were seen in their ability to produce antibodies against Herpes simplex virus types 1 and 2, rubella, toxoplasma, cytomegalovirus, or tetanus. However, differences in opsonizing antibody were observed between alkylated and native IgG preparations. Peak chemiluminescence responses of neutrophils following opsonization of S. pneumoniae with native immune globulin were significantly higher than with alkylated IgG, indicating greater functional capacity. These studies suggest that native immune serum globulin provides a greater potential for augmenting host defense mechanisms against pneumococcal infection in hypogammaglobulinemic patients. PMID- 3971601 TI - Involvement of cell surface macromolecules sensitive to alkylating ketones in lysis by human peripheral blood NK cells. AB - Natural cytotoxicity (mediated by the B73.1+ subset) of human peripheral blood lymphocytes against the K-562 erythroleukaemia cell line is dramatically inhibited in a dose-dependent manner, by the small molecular weight protease inhibitors, tosyl-L-lysyl chloromethyl ketone (TLCK) and tosylamide phenyl-ethyl chloromethyl-ketone (TPCK), incorporated into the cytotoxicity assay or after brief effector cell (but not target cell) pre-treatment. The alkylating ketones primarily affect post-binding events in the lytic process by interference with cellular functions dependent upon protein synthesis. Although non-toxic under the conditions used, recovery of cytolytic function requires at least 72 h, implicating involvement of protein(s) with a minimum turnover time of 3 days. Protection of effector cell function from TLCK by prior treatment with the lectin Lens culinaris (lentil) agglutinin, which binds human peripheral blood lymphocytes to a three-fold greater extent than concanavalin A, indicated that the initial action of the agent is with cell surface rather than intracytoplasmic components. The data suggest that the alkylating ketones inhibit natural killer function by slowly reversible functional inactivation of cell-surface protease(s), which although not cytotoxic per se, may control the secretion of soluble lytic factors. PMID- 3971604 TI - Readability of literature written for cardiac patients. AB - The readability of 28 books and leaflets available to cardiac patients at a Dublin hospital was assessed. Mean required reading age was 14.3 years, and only 21% of the texts had a reading age of 12 or less. Fifty percent of 1088 cardiac patients attending the hospital had no more than an elementary school education and therefore would have been able to read at most one-fifth of the available patient literature. PMID- 3971603 TI - Inhalation of horseradish peroxidase by rabbits with specific IgE antibodies results in release into the circulation of platelet-activating factor and in lung lesions. AB - To further assess the role "in vivo" of platelet activating factor (PAF) in immediate hypersensitivity reactions in the lung, rabbits with either an IgE or an IgG response against horseradish peroxidase (HRP) were challenged with the antigen by aerosol for 1 hour. The animals were sacrificed 30 minutes after termination of the inhalation. The following observations were made: Upon inhalation of HRP, rabbits with circulating IgE antibodies showed signs of respiratory distress and released PAF into the circulation. The highest levels of circulating PAF were measured 20 to 30 minutes after the start of inhalation. PAF may contribute to the lung lesions found in these animals. Rabbits with IgG antibodies did not develop any early abnormalities upon challenge with HRP, this despite the fact that in some animals circulating specific IgE-sensitized basophils could be demonstrated. Anti-HRP IgG was able to block the "in vitro" degranulation of specific IgE-sensitized basophils when challenged with HRP. PMID- 3971605 TI - Delay in diagnosis of right atrial myxoma. AB - Clinical, echocardiographic, and nuclear angiographic findings in a 51-year-old woman who presented with a history of dyspnea are discussed. Initial echocardiography revealed no abnormality. However, a subsequent radionuclide angiogram revealed a filling defect on the right side of the heart. This represented a right atrial myxoma. Radionuclide angiography can provide a useful noninvasive tool in the diagnosis of intracardiac tumors when echocardiography has not been helpful. PMID- 3971606 TI - Treatment of perinfarction recurrent ventricular fibrillation by percutaneous pharmacological block of left stellate ganglion. AB - A patient suffering from an acute myocardial infarction presented on the seventh and eighth days of hospitalization recurrent episodes of ventricular fibrillation refractory to antiarrhythmic treatment. The life-threatening ventricular fibrillation was suppressed by percutaneous pharmacological block of the left stellate ganglion. PMID- 3971607 TI - Changes in plasma catecholamine concentrations in patients with coronary heart disease during pacing and physical exercise. AB - To study the difference in sympathetic activity during pacing the right atrium or during physical exercise in patients with coronary heart disease, we investigated circulating plasma catecholamine concentrations in the coronary sinus and brachial artery radioenzymatically in 11 male patients with well documented coronary artery disease. Heart rate was increased stepwise 20 beats/min from 90 beats/min up to 150 beats/min by pacing the right atrium and physical exercise was performed by increasing work load stepwise by 25 from 25 up to 100 W on an ergometric bicycle. Plasma noradrenaline and adrenaline concentrations were increased significantly only during physical exercise. In addition, there was an increase in arterial-coronary sinus noradrenaline difference during graded physical exercise, whereas no further release of noradrenaline from the myocardium occurred during pacing. An enhanced cardiac sympathetic tone in patients with coronary heart disease is discussed. It is suggested that atrial pacing is not an adequate stimulus evoking an overall increase of cardiac and peripheral sympathetic tone. PMID- 3971608 TI - Ruptured papillary muscle, a complication of myocardial infarction: clinical presentation, diagnosis, and treatment. AB - Ruptured papillary muscle due to myocardial infarction was encountered in 14 patients during the period 1975-1983. Five of the 14 patients had a history of angina pectoris and two had a history of prior myocardial infarction. Eleven patients with myocardial infarction developed additional pain due to myocardial ischemia and/or a murmur of mitral regurgitation and pulmonary edema within a week, 3 others had a prolonged course with intermittent pain due to myocardial ischemia and breathlessness for longer periods and then deteriorated. Thirteen of our 14 patients developed a murmur and all but one had pulmonary edema on the chest x-ray. Five patients had infarction patterns on the electrocardiogram, the remainder of the patients had only ST- and T-wave changes. Echocardiograms showed fine flutter and notching of the anterior mitral leaflets and vigorous contractions of the left ventricle. Only one patient was demonstrated to have a papillary muscle tip prolapsing into the left atrium on two-dimensional echocardiography. Twelve patients underwent surgery and 8 survived. Seven patients had single-vessel coronary disease, 4 involving the circumflex system and 3 involving the right coronary system. Four of the 7 patients with single vessel coronary disease survived surgery. Five patients went to surgery with the intra-aortic balloon pump in place and only 3 survived. Three others had the pump inserted intraoperatively and 2 of these survived. Six of 9 patients who had mitral valve replacement and coronary bypass survived. Ejection fraction ranged from 40 to 79%. Surgical survival did seem to be related to the extent of papillary muscle rupture, with the best results occurring in the group with a small portion of the tip ruptured. Seven patients had a stormy clinical course and required surgery within 10 days of rupture. Four of these 7 survived. It seems reasonable to believe that these patients who often have small infarction and limited coronary disease have good potential for survival. Our approach has been to move toward surgery once the diagnosis is made to avoid the sudden deterioration that frequently occurs. The surgical mortality in this group remains in the 30 to 40% range. PMID- 3971609 TI - Spinal stenosis and posterior lumbar interbody fusion. AB - One hundred forty-two patients with the common types of spinal stenosis were treated by posterior lumbar interbody fusion (PLIF). The majority of the patients had one or more decompressive procedures prior to PLIF. The results were excellent or good in 78%. A review of the literature concerning long-term results of decompressive procedures indicates a short-term failure rate of 15%-20% and about 50% failure by ten or more years after the operation. Anterior fusion in primary disc lesions produces admirable results but is of little value in spinal stenosis. Long-term reports of the success rates of posterior lumbar interbody fusion indicate that this operation combines the success rate of an anterior interbody fusion with the benefits of posterior decompression. PMID- 3971610 TI - The biomechanics of posterior lumbar interbody fusion (PLIF) in spondylolisthesis. AB - A biomechanic analysis of the lower lumbar segments leads to the recommendation that during posterior lumbar interbody fusion it is desirable to preserve the dorsal structures, particularly of the facet joints. The area of the interbody graft should cover an area as large as possible in order to attain the benefit of the compression forces through the tension of the anterior longitudinal ligament. Preservation of the midline structures or application of a tension clamp to add dorsal tension aids bony fusion. Salvage operations in patients with previously excised posterior elements require the addition of dorsal or dorsolateral fusion to PLIF. PMID- 3971611 TI - Treatment of failed posterior lumbar interbody fusion (PLIF) of the spine with pulsing electromagnetic fields. AB - This paper presents a technique and discusses the results of treating failed posterior lumbar interbody fusions (PLIFs) of the spine with pulsing electromagnetic fields (PEMFs). Thirteen male patients suffering from failed PLIFs, with an average time of 40 months since the last surgical fusion attempt, were the subjects of this study. PEMFs were applied by the patient according to strict criteria but in the comfort of their home. Initial and subsequent medical evaluations closely monitored the patient's condition and progress. PEMFs promoted a significant increase in bone formation in 85% (11 of 13) of the patient pool and achieved body-to-body fusion throughout the intervertebral disc space in 77% (ten of 13) over the treatment period. The treatment required no hospitalization, reduced morbidity, and avoided the risks associated with surgical intervention. The results suggest that this surgically noninvasive outpatient therapy may become a successful alternative treatment of failed PLIF. PMID- 3971612 TI - Clinical and roentgenographic assessment of total hip arthroplasty. A new hip score. AB - A new total hip scoring system is presented and applied in a group of patients who were treated by revision of total hip arthroplasty. The Mayo hip score combines clinical (80 points) and roentgenographic (20 points) data in a 100 point score. The roentgenographic input into the score decreased the percentage of good-to-excellent results because of the high frequency of roentgenographic signs of loosening. With the Harris rating, there were 63% good-to-excellent results, 12% fair results, and 26% poor results a mean of 4.25 years after component revision of total hip arthroplasty. With the Mayo system, there were 52% good-to-excellent results, 19% fair results, and 29% poor results a mean of 4.25 years after revision. A modification of the roentgenographic rating system would apply the Mayo hip score to noncemented total hip arthroplasties. PMID- 3971613 TI - One-stage versus two-stage bilateral autophor ceramic total hip arthroplasty. AB - Noncemented autophor ceramic total hip arthroplasty (ACTHA) has been developed in recent years for treatment of advanced hip diseases. Bilateral ACTHAs were routinely performed in two operations at a four- to six-month interval. There have been no reported series of one-stage bilateral ACTHAs. In this retrospective study, the authors compared 20 patients who had bilateral one-stage ACTHAs with 15 patients who had similar bilateral arthroplasties in two stages. The study revealed no significant differences in estimated intraoperative blood loss, postoperative hemovac drainage, total amount of blood transfusion, intra- or postoperative complications, or postoperative functional results in the two groups. There was no difference in achieving prosthesis stability by interface bone growth, in spite of a significant difference in weight-bearing status during the immediate postoperative period. The one-stage bilateral procedure, however, offered advantages over two-stage bilateral procedures, including shorter length of hospital stay (18 days versus 27 days), shorter operative time (148 minutes versus 245 minutes), shorter period of disability (86 days versus 202 days), and reduced economic costs (about 10% less). There was no increase in the risk of morbidity or mortality in the one-stage bilateral group. In selected cases, one stage bilateral ACTHA would be preferable. PMID- 3971614 TI - Air in painful total hip arthroplasty: diagnosis and treatment. AB - A 78-year-old woman presented with a painful total hip arthroplasty five years postoperation. Plain radiographs revealed air in the hip joint. Aspiration of the hip indicated hip sepsis, and arthrogram showed communication of the hip joint with the sigmoid colon. Cultures grew Bacteroides fragilis. Abdominal exploration showed a ruptured diverticulum that decompressed through the sciatic notch into the total hip arthroplasty. A colostomy was performed, and the hip joint was drained and debrided laterally at the same operation. The prosthesis was later removed with all cement, and the hip was converted to a Girdlestone resection. The authors conclude that air or gas shadows in a painful total hip arthroplasty are an ominous finding and mean either joint sepsis with a gas-forming bacteria or communication of the joint with a hollow viscus and sepsis. PMID- 3971615 TI - A comparative analysis of operative versus nonoperative treatment of grade III acromioclavicular separations. AB - Nonoperative treatment (accepting the deformity with early range of motion and strengthening exercises) was compared with surgical treatment by Bosworth claviculocoracoid screw fixation of complete acromioclavicular dislocations. Nonoperative treatment provided an equal if not superior result, with an earlier return to activities, sports, and work. Neither the "bump" nor the scar was a significant cosmetic complaint. Range of motion and strength were equal, despite the treatment. Both groups were significantly weak in shoulder external rotator muscle power. PMID- 3971616 TI - Posterior lumbar interbody fusion updated. AB - Based on over 45 years' experience in the surgical treatment of lumbar disc disease, it is recommended that the following operations be eliminated: the simple discectomy, which may cure the sciatica but not the back pain; the "decompressive laminectomy," which leaves the patient with painful instability and nerve-root scarring; and chemonucleolysis, which does not provide permanent relief of either low-back or leg pain. The PLIF technique is the answer to treatment of diseases of the lumbar spine and may be the operation of the future. PMID- 3971617 TI - Complications of Variable Axis total knee arthroplasty. AB - Three hundred seventy-six patients were treated by a Variable Axis total knee arthroplasty between 1974 and 1980 and were reviewed for mechanical and orthopedic complications of their surgery. Sixty-five patients had significant complications. Twenty-eight (7.4%) patients developed significant problems with their patellae, 13 (3.4%) patients required reoperation for patellar realignment, and four (1.0%) patients had a patellar resurfacing for retropatellar pain. Two (0.5%) cases of aseptic loosening of the femoral component required revision surgery. There was no aseptic loosening of the tibial component. Other complications included a ligamentous instability (2.9%), postoperative joint stiffness (1.6%), peroneal nerve palsy (1.3%), supracondylar fractures (1.0%), and postoperative joint infection (1.8%). PMID- 3971618 TI - Supracondylar fracture in a patient with total knee arthroplasty. A case report. AB - A supracondylar fracture occurred in a 48-year-old woman with rheumatoid arthritis and a total knee arthroplasty. The Rush pin technique required minimal surgical exposure and caused little disruption of surrounding soft tissue and blood supply. Soft tissues preserved inherent stability, allowing early range of motion and partial weight-bearing. Follow-up evaluation seven years later demonstrated maintenance of alignment and no loss of range of motion. PMID- 3971619 TI - Spondylolisthesis and related disorders. A correlative study of 105 patients. AB - A close relation exists among the alterations in the lumbosacral spine designated as spondylolysis, isthmic spondylolisthesis, degenerative spondylolisthesis, and prespondylolisthesis. While the former two conditions are probably caused by faulty development and subsequent minor traumata or repeated stresses, the third condition is caused by degenerative changes associated with anatomic variations; the fourth condition is a static insufficiency leading to faulty alignment. In 105 patients, the initial preferred management of these conditions was conservative. Thirty-four patients who developed persistent symptoms of spinal instability and/or intractable neurologic deficits were treated surgically. The results were generally successful. PMID- 3971620 TI - Odontoid fractures, with special reference to the elderly patient. AB - A retrospective review of 262 consecutive cervical spine fractures revealed that 41 (16%) were odontoid fractures. Twenty patients were younger than 40 years of age (19 fractures were the result of a motor vehicle accident), whereas 19 fractures occurred in subjects older than 60 (13 were the result of a fall). Fractures were of the Anderson-D'Alonzo Types I (one patient), II (19 patients), and III (21 patients). Significant displacement was present in 31 patients. Anterior and posterior displacement occurred equally, but most of the anterior fractures were seen in patients younger than 40, and the majority of the posterior fractures occurred in those older than 60. Primary fusion was performed in 12 cases. Conservative management was used in 26. Three patients died (one from a spinal cord transection and two from other injuries). In the conservatively treated group, the average time to healing was 12 weeks, but the overall nonunion rate was nine out of 26 (7/13 Type II, 2/13 Type III fractures). The halothoracic jacket was poorly tolerated in patients older than 75 years of age. If daily supervision is not possible, early C1-2 fusion or treatment in an appropriate brace seems superior in the elderly patient. PMID- 3971622 TI - Repair of avulsion of insertion of biceps brachii tendon. AB - An end-result study was made of 16 cases of avulsion of the insertion of the biceps brachii tendon. The follow-up period spanned one to 25 years post treatment (average, eight years). Fourteen of the 16 cases included in the study were acute cases with primary repair and reinsertion of the biceps tendon into the area of the radial tuberosity. One case, with the loss of function of the biceps muscle secondary to temporary paralysis of the musculocutaneous nerve, was explored. The tendon was found intact and did not require repair. The sixteenth case was included for comparison of a patient who chose to forgo surgical treatment. One surgical procedure, a modification of Bunnell's technique, was used in treating all patients from 1954 to 1977. The surgically repaired biceps showed various amounts of residual impairment, ranging from negligible to limited restriction of preinjury activities. The treatment successfully returned 14 patients to their previous occupations and activities. The one case not surgically treated of the ten work-related injuries resulted in continuing disability compensation based on no greater than 20% of the entire extremity. This end-result study substantiates the positive results of this surgical technique, presents modifications of the surgical repair procedures, and allows for a similar long-range study of other treatment techniques. The evaluation of treatment methods is easily attainable by low technological clinical methods. PMID- 3971621 TI - Upper extremity compartment syndromes following pit viper envenomation. AB - The treatment of pit viper envenomation by fasciotomy continues to be controversial because elevated intracompartment pressures have never been previously documented. Two patients with severe pit viper envenomation of the thumb had signs and symptoms of elevated intracompartment pressures. Elevated intracompartment tissue pressures were documented in both cases. Immediate fasciotomies were necessary to decompress the thenar and forearm compartments and, in one case, the upper arm as well. Ischemic tissues were noted at the time of the operation and confirmed the clinical and objective tissue pressure measurements of compartment syndromes. Both patients made complete functional recoveries following delayed primary closure. Intracompartment pressure monitoring should be routinely used in the management of pit viper envenomation to avoid disastrous sequellae. PMID- 3971624 TI - Multicentric giant cell reparative granuloma of the small bones of the hand. A case report and review of the literature. AB - Giant cell reparative granuloma (GCRG) usually occurs in the jaw, but a histologically identical lesion is occasionally seen in the small bones of the hands and feet. A 24-year-old man had GCRG involving the second metacarpal and the capitate. The involvement of a carpal bone and the presence of multiple lesions are unusual for this entity. PMID- 3971623 TI - The effect of surgical dissection on regional blood flow to the ulnar nerve in the cubital tunnel. AB - Regional blood flow to the ulnar nerve within the cubital tunnel of nonhuman primates was determined before and after surgical dissection by use of the hydrogen washout technique. The results indicate that anterior transposition is associated with a significant decrease in regional blood flow to the ulnar nerve for a period of at least three days. This relative ischemia was not noted following arcuate ligament incision or after medial humeral epicondylectomy. Vascular injection studies showed an abundant extrinsic arterial supply to the ulnar nerve, especially just distal to the groove that was apparently compromised during the anterior transposition. PMID- 3971625 TI - The anatomy of lumbar spondylosis. AB - To identify the major osseous, ligamentous, and neural relations of the lumbar spine pertinent to understanding the pathogenesis, diagnostic imaging, and therapy of lumbar spondylosis, 25 bony lumbar spines and 25 intact cadaver spines were studied both qualitatively and quantitatively. Pedicle anteroposterior dimension and obliquity and the relative interarticular process-interpedicle dimensions were found to be important osteologic determinants of the presence and size of lateral recesses at different vertebral levels and of the increasing size of each lateral recess as it descends. The varying length and relations of the osteoligamentous nerve root canals at different lumbar levels are a function of a progressively earlier exit from the dural sac by the lower lumbar nerve roots. Both the osteoligamentous nerve root canals and their terminal intervertebral canals showed significant normal narrowing at the level of the opposed intervertebral discs and facet joint capsules. This caused the normal nerve root canals to have a beaded appearance and the osteoligamentous intervertebral canals to have the appearance of long-necked gourds. These normally narrow areas correlate well with the spondylotic neural entrapment points. Narrowing of the disc interval is an important cause of many of the interdependent degenerative changes in the lumbar spine. Hence, its reconstitution should be a major goal of spondylotic surgery. PMID- 3971626 TI - Purpura fulminans. Medical, surgical, and rehabilitative considerations. AB - Purpura fulminans is a rare catastrophic disease of childhood that begins as a seemingly benign infectious process and subsequently progresses to high fever, purpuric ecchymosis of the skin, hypotension, disseminated intravascular coagulation, and gangrene. Initial treatment consists of resuscitation with Ringer's lactate, correction of clotting parameters with heparin, avoidance of adrenergic agents, and monitoring of limbs for compartment syndromes. Of 12 patients reported here, three had fasciotomies to limit the ischemic changes, but eventually 24 amputations were performed on the group as a whole. Delayed debridement of up to three weeks was the rule in order to allow ischemic tissue to fully demarcate. Split-thickness skin grafts were used to preserve as much length as possible, particularly where open growth plates were involved. Regardless of how hopeless the situation may initially appear, with prompt recognition and institution of appropriate care the prognosis for a productive life is good. PMID- 3971627 TI - En bloc clavicular resection: operative procedure and postoperative testing of function. Case reports. AB - Radical en bloc excision of the clavicle is effective treatment for neoplastic disease and does not impair normal activity of daily living. The subjective patients' assessments were good to excellent, as were the cosmetic results. There was full range of shoulder motion. Biomechanic testing revealed some weakness in shoulder abduction, flexion, and adduction but not in internal rotation, external rotation, or extension. PMID- 3971628 TI - Idiopathic adolescent scoliosis--a prototype of degenerative joint disease. The relation of biomechanic factors to osteophyte formation. AB - A study was performed to evaluate the presence of degenerative joint disease (DJD) in idiopathic adolescent scoliosis (IAS) and correlate DJD with biomechanic factors. The average age of the subjects was 19 years (range, 12-30). Osteophytes reflecting the presence of degenerative joint disease occurred in apophyseal and/or intervertebral joints of 74% of 100 subjects. Osteophytes were correlated with curve angle and apical rotation. Compression forces are of pathogenic significance in the localization of osteophytes in IAS. IAS can serve as a naturally occurring prototype for the study of the influence of biomechanic factors on the pathogenesis of DJD. PMID- 3971629 TI - The management of nonunions following high tibial osteotomies. AB - Nonunion is an uncommon complication of high tibial osteotomy. Reported techniques of treating such a complication include resection of the pseudarthrosis and cast immobilization with risk of joint stiffness and loss of alignment. The special AO/ASIF threaded external fixator with double clamps was used to treat three patients with nonunions following high tibial osteotomy for medial compartment osteoarthritis. The pseudarthrosis was not resected in any instance. All were allowed full unrestricted joint motion postoperation. Rapid healing of the osteotomy ensued. The external fixator achieved excellent stability and rapid union while maintaining joint motion. PMID- 3971630 TI - Influence of indomethacin on experimental bone metabolism in rats. AB - The effect of indomethacin on heterotopic and orthotopic bone formation in rats was analyzed with respect to dose and time of initiation of drug administration. Three weeks after implantation of demineralized bone matrix, the ash weight of implants from animals receiving the highest doses of indomethacin was approximately 25% lower than that of controls. The ash weight of implants was only affected in rats receiving indomethacin from the week before implantation or from the time of implantation. In a separate study, no effect on the rate of resorption measured by elimination of 3H-proline and 45Ca or on the amount of ash could be detected. Orthotopic bone remained unaffected by indomethacin treatment. The study showed that in order to inhibit experimental new bone formation, indomethacin must be present before or at the time of implantation of demineralized bone matrix. PMID- 3971631 TI - Interface mechanics and bone growth into porous Co-Cr-Mo alloy implants. AB - The interface mechanics and bone growth into porous Co-Cr-Mo alloy implants were evaluated. Three mean pore sizes (155, 235, and 350 microns) were studied for implants fabricated with one, two, and three layers of spherical powder particles and totally porous implants. All implants had a pore volume of 38%-40%. Ten implants were inserted transcortically in the femora of six adult mongrel dogs and were allowed to remain in situ for a period of 12 weeks. Postretrieval mechanical testing and histologic and microradiographic analyses were used to evaluate the implant systems. A statistically significant increase in interface shear strength (p less than .05) was determined as the number of powder particle layers was increased from one and two layers to three layers. However, a decrease in interface strength was determined for totally porous implants (seven to 12 particle layers) below the value for the single-porous-layer implants. Pore size, in the range investigated, was not found to influence the interface attachment strength. Neither pore size nor porous layer thickness was found to affect interface stiffness. Histologic and microradiographic sections revealed extensive mineralized bone growth deep into the pores of all implant types and often extending to the core of the one-, two- and three-layered porous-coated implants. Both mature haversian bone and less mature woven bone were found within the porous structure. Extensive but incomplete bone infiltration was found in the totally porous implants, with the remainder of the porosity filled with macrophage-laden connective tissue. No difference in the histologic response was observed as a function of pore size in any of the implant systems. Active bone labels were present at the 12-week time period, indicating continued bone remodeling. PMID- 3971632 TI - Calcification of cartilaginous matrix in culture by constant direct-current stimulation. AB - Forty-six femora of nine-day-old chick embryos were stimulated by 10 microA of constant direct current via platinum wire electrodes inserted into the diaphyses as cathodes in tissue culture. Apparent calcification in the hypertrophic cartilaginous region of the diaphyses was induced by the electric stimulation. This calcification was most remarkable on both ends of the diaphyses, where fine granules were observed in electron micrographs of the cartilaginous matrix. These granules were aggregates of fine needlelike crystals containing calcium and phosphorous demonstrable by X-ray microanalysis. Incorporation of 45Ca into the femora was significantly increased by the stimulation of up to 247% of the control. This matrix calcification was of interest because it occurred in avian embryonic cartilage that is normally resorbed uncalcified before it is replaced by bone. PMID- 3971633 TI - Appearance of osteoclasts and osteoblasts in electrically stimulated bones cultured on chorioallantoic membranes. AB - Tibial shafts from 15-day-old chick embryos were cultured on chorioallantoic membranes of chick embryos. These bones were stimulated by either constant-direct or constant-alternating current via platinum wire electrodes. Around the anodes of 10 microA constant direct-current stimulation, the number of osteoclasts was significantly larger than that of the control, and numerous osteoblasts were observed. Around the cathodes of this current, periosteum was thickened and accompanied by proliferation of osteoblasts. Slight bone resorption in the immediate vicinity of the cathodes was also observed. The periosteum between the two electrodes was significantly thickened by this current. The comparative study between equivalent constant direct-current and alternating-current stimulation showed a dominance of direct current. This model could be useful in investigations on electrical stimulation of bone in vivo. It produces fewer artifacts and shows activation of osteoclasts in association with activation of osteoblasts in electrically induced reactions of bone tissue. PMID- 3971634 TI - Peripheral nerve changes following epineurial injection of saline and blood in rat sciatic nerve. AB - The effects of warm saline and heparinized autogeneic blood injection on a rat sciatic nerve were observed by histologic, histochemic, and CT planimetry. Demonstrable intraneural degenerative changes and epineurial cellular proliferation were present in both groups. Hemosiderin deposits were present in the epineurium and intraneurally only in the blood group. Epineurial saline injection produces nerve damage; therefore, its use for the purpose of neurolysis is not recommended. Further investigations are needed to study the effect of nonheparinized blood injection. The use of computerized planimetry in assessing quantitative nerve damage proved to be feasible. PMID- 3971635 TI - Stress risers in bone. PMID- 3971636 TI - CT evaluation of interbody fusion. AB - Reformatted computed tomography (CT) of the spine is very useful in the evaluation of patients who have previously been treated by lumbar or cervical interbody fusions. It allows incontrovertible evidence of failure of osseous fusion as well as defines the major causes of residual or recurrent symptoms. As CT methodology becomes a routine procedure, it will be the primary diagnostic aid in evaluating postoperative posterior lumbar interbody fusion (PLIF) patients. PMID- 3971637 TI - Carbamazepine metabolism in man. Induction and pharmacogenetic aspects. AB - The metabolism of carbamazepine (CBZ) was studied in 3 groups of subjects: (1) 6 healthy volunteers given a single dose of 200mg carbamazepine; (2) 4 epileptic patients on carbamazepine monotherapy; and (3) 5 patients receiving carbamazepine in combination with other anticonvulsants. Carbamazepine kinetics in the patients were investigated by use of 15N-CBZ. The mean plasma clearances of carbamazepine were 19.8, 54.6 and 113.3 ml/h/kg in groups 1, 2 and 3, respectively. The increased clearance in the patients was mainly due to an induction of the epoxide diol pathway, as reflected by an increased urinary excretion of the trans-CBZ diol metabolite. The urinary excretion (as a percentage of the administered dose) of 9-hydroxymethyl-10-carbamoyl-acridan (9-OH-CBZ) was also increased, whereas the excretion of 2-OH-CBZ and 3-OH-CBZ in groups 2 and 3 were decreased in comparison with group 1. As it has been suggested that 9-OH-CBZ is formed from carbamazepine-10,11-epoxide (CBZ-E) or trans-CBZ-diol, the formation of 9-OH-CBZ was investigated in 3 patients with trigeminal neuralgia treated with carbamazepine or CBZ-E as monotherapy on separate occasions. The urinary excretion of 9-OH-CBZ was 1.9, 3.3 and 4.0% of the trans-CBZ-diol excretion during CBZ-E therapy and 23, 32 and 24%, respectively, during carbamazepine administration. Thus only a minor part of the 9-OH-CBZ excreted in urine during carbamazepine therapy is formed via the epoxide-diol pathway. Data on plasma concentrations of carbamazepine and CBZ-E, and on urinary excretion of trans-CBZ diol from 4 patients on carbamazepine therapy were used to calculate the plasma clearance of CBZ-E. The hydration of CBZ-E during carbamazepine therapy was found to be induced, but to a lesser extent than the epoxidation of carbamazepine. The interrelationship between carbamazepine-epoxidation and oxidative metabolic reactions of some other drugs was also studied in 8 healthy volunteers. Carbamazepine-epoxidation was not correlated to 4-hydroxylation of debrisoquine, oxidation of sparteine, 3- and 4-hydroxylation and demethylation of antipyrine, demethylation of amitriptyline, or total metabolism of theophylline. PMID- 3971638 TI - Accidental carbon monoxide poisoning. Emphasis on hyperbaric oxygen treatment. AB - Six cases of accidental carbon monoxide poisoning in children are presented. The importance of hyperbaric oxygen therapy as the cornerstone of treatment in the prevention of either acute or delayed complications is discussed. PMID- 3971639 TI - Scorpion sting in children. A review of 51 cases. AB - Scorpion sting in children is a hazardous and potentially lethal condition. Fifty one infants and children were admitted to the Pediatric Departments at the Hadassah-Hebrew University Hospitals in Jerusalem, during a 5-year period, following scorpion sting. Fifteen (29.4%) had severe systemic signs of envenomation and two (3.9%) died. Analysis of our data showed that patients with severe toxicity were brought to the hospital after a significantly longer time lapse than were the patients with mild-to-moderate symptoms. The current management of children with scorpion envenomation consists of administration of specific antivenom and close surveillance in an intensive care unit, where vital signs and continuous cardiac monitoring enable early initiation of therapy for life-threatening complications, such as cardiac and respiratory failure, convulsions, or hypertension. PMID- 3971641 TI - An intervention to improve follow-up of patients with otitis media. AB - We evaluated the effects of an educational intervention and telephone reminders on compliance with medication-taking and appointment-keeping for children with otitis media. During an initial interview we examined parents' health beliefs and other factors associated with compliance in our outpatient setting. The children were then systematically assigned to one of five study groups (G1-5). Parents in G1 received an educational session with a nurse and two follow-up telephone reminders. Parents in G2 received only two telephone reminders. Parents in G3 met with the nurse for an educational session only. Parents in G4 were exempted from interventions, while parents in G5 were exempted from the interventions and the initial interview. The telephone reminder significantly increased the return rate for follow-up appointments (p less than 0.05). This effect was not enhanced by combining it with an educational intervention focusing more on medication compliance. Relatively simple and inexpensive interventions such as the ones described here improve follow-up appointment-keeping for children with otitis media. This enhanced compliance behavior is important in obtaining better health outcomes for children with acute illnesses. PMID- 3971640 TI - Pneumococcal osteomyelitis. An unusual cluster of cases. AB - Between 1979 and 1981, 22 children with osteomyelitis and/or septic arthritis were hospitalized at Soroka University Hospital. Streptococcus pneumoniae was cultured in five of the children, four of whom were under 2 years of age. In four other children under 2 years of age, Haemophilus influenzae was cultured. Staphylococcus aureus was identified less frequently in the younger age group. In deciding on initial antibiotic therapy, the possibility of such a bacteriological spectrum should be considered. PMID- 3971642 TI - Hemolytic anemia following postnatally acquired rubella during the 1975-1977 rubella epidemic in Japan. AB - Hemolytic anemia following postnatally acquired rubella first was reported by Sato et al. in 1977. Thirteen cases of hemolytic anemia (including two cases of hemolytic uremic syndrome) following postnatally acquired rubella infection reported in a nationwide epidemic of rubella in Japan in 1975-1977 are reviewed in this article, and another case is added. Clinical symptoms of hemolytic anemia occurred 2 to 6 days from the onset of rubella rash. Direct Coombs test was positive in three of the 11 cases tested, and the indirect test was positive in two of the 13 cases. Hemolytic anemia should be considered as a complication of postnatally acquired rubella, though to date, it has only been reported in Japan. PMID- 3971643 TI - Stridor caused by vocal cord malfunction associated with emotional factors. AB - We describe two adolescent patients in whom a disorder of the vocal cords associated with emotional factors resulted in acute episodes of stridor. Adduction of the vocal cords on inspiration and abduction on expiration was found on indirect laryngoscopy. The problem responded to either placebo treatment or psychotherapy. The similarity between vocal cord dysfunction presenting as stridor and that presenting as asthma is discussed. The importance of diagnosing these functional problems in children is emphasized in order to avoid unnecessary diagnostic procedures and hazardous treatment. PMID- 3971644 TI - Mouthwash poisoning. Report of a fatal case. PMID- 3971645 TI - Neonatal theophylline neurotoxicity. AB - Despite the frequency with which theophylline is administered to premature infants, there are few reported cases of neurotoxicity. We describe a theophylline-treated premature infant with chronic bronchopulmonary dysplasia and hepatitis who displayed a focal seizure and irritability followed by other systemic signs of theophylline intoxication, at a postnatal age of 5 months. An unrecognized accidental drug overdose combined with a prolonged elimination half life were responsible for clinical intoxication. The potential mechanisms of theophylline's neurotoxicity are discussed briefly. PMID- 3971646 TI - Hodgkin's disease in siblings. PMID- 3971647 TI - Depression following pemoline withdrawal in a hyperactive child. PMID- 3971648 TI - The accuracy of the Ross Laboratories Adipometer skinfold caliper. PMID- 3971649 TI - Crossover and noncrossover designs in four-point parallel line analgesic assays. AB - Fifty-nine analgesic investigations designed as four-point parallel line crossover assays were examined. Sum of pain intensity differences (SPID) and total pain relief (TOTPAR) were the subjective response measures. Separate analyses with four-point crossover data and first-dose data (noncrossover) allowed comparison within each study of these two approaches. The crossover analysis allows for removal of the subject component of variance, which in these studies was a substantial fraction of the error variance (0.49 for SPID; 0.56 for TOTPAR). For this type of study, 2.4 times as many subjects would have to be recruited in a noncrossover design to obtain precision equivalent to that of the crossover design. Thus efficiency considerations argue for the crossover design in cases in which a treatment carryover effect may be assumed to be negligible. PMID- 3971650 TI - Effect of flecainide on cardiac output. AB - The effect of intravenous flecainide (2 mg/kg) on cardiac output was evaluated by a dye dilution method in six healthy nonsmokers. The study was of a double-blind, crossover, placebo-controlled, randomized, and balanced design. Cardiac output, heart rate, and stroke volume were measured 0, 10, 30, 60, 90, 120, 150, 180, and 240 minutes after the beginning of the flecainide infusion. Flecainide reduced cardiac output and stroke volume during the first 90 minutes and heart rate increased during the first 30 minutes after flecainide. Visual analog scales for alertness and dry mouth were determined 0, 10, 60, and 240 minutes after dosing. Alertness was reduced 60 minutes after flecainide, but there was no increase in dryness of the mouth. PMID- 3971651 TI - Nitroprusside vs. a nitroprusside-trimethaphan mixture for induced hypotension: hemodynamic effects and cyanide release. AB - Changes in hemodynamic variables and whole blood cyanide and plasma thiocyanate concentrations associated with the infusion of sodium nitroprusside were compared with those during administration of a mixture of sodium nitroprusside (25 mg) and trimethaphan camsylate (250 mg) in a solution of 5% dextrose in water in twenty subjects who required deliberate hypotension for major orthopedic procedures. Subjects were randomly assigned to receive nitroprusside alone (group 1; n = 10) or the nitroprusside-trimethaphan mixture (group 2; n = 10). All subjects received a similar anesthetic technique, consisting of 5 mg/kg thiopental, 1 mg/kg succinylcholine, 1% halothane, 0.2 mg/kg metocurine, and 60% nitrous oxide in oxygen. Mean arterial pressure decreased and was maintained at 55 mm Hg for 258 +/- 4 and 266 +/- 8 minutes in groups 1 and 2. Arterial hypotension was associated with a rise in cardiac output and heart rate in group 1 but not in group 2. Subjects in group 2 required less nitroprusside than did those in group 1 (1.39 +/- 0.3 and 5.82 +/- 0.63 micrograms/kg/min) because of the synergistic or additive action of the combination. After 4 hours of hypotension, the whole blood cyanide level rose from 3.5 +/- 1.1 to 96.6 +/- 14.0 micrograms/dl (1.35 +/ 0.27 to 37.2 +/- 5.4 mumol/L) in group 1 and from 3.7 +/- 1.1 to 22.7 +/- 4.2 micrograms/dl (1.42 +/- 0.4 to 8.7 +/- 1.6 mumol/L) in group 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971652 TI - Metoclopramide kinetics in patients with impaired renal function and clearance by hemodialysis. AB - Metoclopramide kinetics were examined in 24 adult patients with diminished renal function and in eight healthy subjects with normal renal function. Creatinine clearance correlated with metoclopramide plasma clearance, renal clearance, nonrenal clearance, and elimination t1/2. Regardless of renal function, renal clearance accounted for less than or equal to 21% of total plasma clearance. Nonrenal clearance was reduced in patients and accounted for most of the reduction in plasma clearance. The comparatively small plasma clearances in patients imply that maintenance doses should be reduced accordingly to avoid drug cumulation. Metoclopramide clearance by hemodialysis was also assessed in four patients. Metoclopramide losses from hemodialysis were relatively small compared to estimates of total body metoclopramide stores. Compensatory dosage increases are probably unnecessary for most patients. These data also suggest that hemodialysis is not likely to be effective in metoclopramide overdose. PMID- 3971653 TI - Effect of ketoconazole on hepatic oxidative drug metabolism. AB - Several clinical reports have suggested (but not demonstrated) that ketoconazole, a broad-spectrum antifungal drug, may inhibit hepatic oxidative drug metabolism in man. We recently demonstrated that ketoconazole inhibits caffeine and aminopyrine oxidation in the rat; we now study the influence of ketoconazole on theophylline and chlordiazepoxide kinetics in man. These studies were performed before and after varying doses of ketoconazole within the currently accepted therapeutic range. Ketoconazole had no effect on theophylline clearance, whereas the drug impaired chlordiazepoxide clearance from plasma. After a single dose of ketoconazole, there was a 20% decrease in clearance and a 26% decrease in volume of distribution without evidence of inhibition of drug metabolism. These changes apparently were not related to ketoconazole dose. After repetitive dosing with ketoconazole, chlordiazepoxide clearance decreased by 38% and was associated with reduced concentrations of its first oxidative metabolite, N desmethylchlordiazepoxide. We conclude that ketoconazole inhibits at least one subset of the hepatic mixed-function oxidase system, but is not as general an inhibitor of hepatic oxidative drug metabolism as cimetidine appears to be. For some coadministered drugs, ketoconazole may also have an effect on other kinetic parameters such as volume of distribution. Therefore, we caution that clinically important drug interactions may occur with the concurrent use of ketoconazole. PMID- 3971654 TI - Acute and chronic effects of sulindac on renal function in chronic renal disease. AB - The effects of oral sulindac on renal hemodynamics were studied in normal subjects, elderly persons with mild renal failure, and patients with chronic renal disease. Renal function was measured before dosing and 24 hours and 28 days after oral sulindac. Effective renal plasma flow was reduced in all subjects after 24 hours. Effective renal plasma flow and the glomerular filtration rate were not altered after 28 days in control subjects, whereas effective renal plasma flow, but not glomerular filtration rate, was lower after 1 month in subjects with renal disease. None of these changes are likely to be of major clinical significance. PMID- 3971655 TI - Tricyclic antidepressant and metabolite levels in chronic renal failure. AB - Serial blood samples were drawn from 12 patients undergoing hemodialysis who were receiving tricyclic antidepressants (TCAs). Samples were drawn before, during, and after a dialysis session (two to 17 sessions per subject). Samples were analyzed by HPLC before and after hydrolysis with beta-glucuronidase/sulfatase to determine the conjugated and nonconjugated metabolites. Analysis of these data in comparison with those of controls with depression and normal renal function showed that: (1) at steady state, tertiary and secondary amine TCA levels did not differ; (2) levels of the hydroxylated metabolites had greater variability and were somewhat higher at steady state; (3) levels of the conjugated hydroxylated compounds were markedly elevated, reaching 500% to 1500% normal; (4) the time to reach a steady-state level appeared to be slightly increased; and (5) elimination t1/2 s of unconjugated and conjugated drug forms were longer in our patients with normal renal function than those reported in the literature. Levels of the tertiary, secondary, and hydroxylated metabolites were not changed by dialysis, whereas there were substantial decrements in glucuronidated metabolite levels. These findings demonstrate increased concentrations of conjugated drug forms and suggest an abnormal distribution or delayed elimination of unconjugated and conjugated metabolites. These observations may shed some light on the apparent hypersensitivity of these patients to TCA side effects, particularly because glucuronides may exert peripheral pharmacologic effects. PMID- 3971656 TI - Ketoconazole kinetics in chronic peritoneal dialysis. AB - The kinetics of oral ketoconazole in serum and peritoneal fluid were studied in six patients with renal failure receiving peritoneal dialysis. A dose of 400 mg ketoconazole resulted in a maximum blood concentration of 2.3 +/- 1.7 microgram/ml (mean +/- SD), which occurred 3.3 +/- 1.6 hours after dosing. The serum t1/2 was 2.4 +/- 0.8 hours. Peritoneal clearance values were less than 1 ml/min, and peritoneal penetration reached 3.4% of the serum concentration by 5 hours. Protein binding studies were also performed. Compared with healthy controls, patients receiving peritoneal dialysis have significantly less ketoconazole serum protein binding. Fifty to eighty percent of the drug is protein bound in the peritoneal fluid, and the unbound concentration is in the same range as that in the serum of healthy individuals with "therapeutic" total ketoconazole levels of 1 to 2 micrograms/ml. PMID- 3971657 TI - Cigarette smoking and theophylline metabolism: effects of cimetidine. AB - The inhibition of theophylline metabolism by cimetidine was investigated in young male cigarette smokers (greater than 20 cigarettes/day) and nonsmokers by stable isotope methodology. Subjects received oral theophylline (510 mg/day) for 14 days and cimetidine (1200 mg/day) over days 1 to 7 or 8 to 14. On days 7 and 14, a tracer dose (10 mg) of stable isotope-labeled theophylline was injected intravenously with the oral dose of theophylline. Serial plasma samples were then obtained for 24 hours and both molecular forms of theophylline were assayed by mass spectrometry after purification by HPLC. Theophylline bioavailability, volume of distribution, and protein binding were of the same order in both groups and were not affected by cimetidine. Although the basal theophylline elimination rate constant was 46% greater and clearance was 54% greater in smokers than in nonsmokers, the proportionate changes in steady-state plasma concentrations, t1/2, and clearance due to cimetidine were much the same in both groups. Plasma thiocyanate concentrations were higher in smokers than in nonsmokers and were related to theophylline clearance. Our findings indicate that cimetidine inhibits theophylline metabolism to a similar extent in both smokers and nonsmokers. Determination of plasma thiocyanate levels may be valuable in the prediction of theophylline clearance. PMID- 3971658 TI - A Bayesian feedback method of aminoglycoside dosing. AB - We assessed the accuracy of a Bayesian method in providing dosing regimens to achieve desired serum aminoglycoside concentrations. This method calculates individual kinetics based on serum drug concentration data. Performance was analyzed by determining accuracy, bias, correlations of observed to desired serum drug concentrations, and the ability to achieve a target serum drug concentration. We also compared results from the Bayesian method with those resulting from the use of the predictive algorithm portion of the computer program and with routine physician dosing. The Bayesian method resulted in a high correlation coefficient (r = 0.913) between observed and predicted serum concentrations. Analysis of peak aminoglycoside concentrations indicated that the Bayesian method was more accurate and less biased than the predictive algorithm portion of the program or routine physician dosing. A similar trend occurred for trough concentrations. Finally, there were no statistically significant differences between the predicted and observed peak (6.4 +/- 1.5 and 5.9 +/- micrograms/ml) and trough (1.2 +/- 0.9 and 1.4 +/- 0.8 micrograms/ml) serum aminoglycoside concentrations with the Bayesian dosing method. There were significant differences for peak concentrations with the predictive algorithm portion of the program and for peak and trough concentrations with physician dosing. These data demonstrate the accuracy of the Bayesian dosing method in attaining desired peak and trough serum aminoglycoside concentrations. PMID- 3971659 TI - Mechanism of increased plasma urea after diuretic therapy in uraemic patients. AB - To clarify why diuretic therapy raises plasma urea in patients with chronic renal failure, three groups of uraemic subjects were treated with frusemide for 6 days. In group 1 (n = 9), frusemide significantly decreased body weight and increased average plasma urea from 18.7 mmol/l to 28.8 mmol/l (P less than 0.001). this rise in plasma urea was secondary to reduced urea excretion, which occurred in spite of an increase in urea filtration. In group 2 (n = 7), frusemide was associated with salt replacement, in order to prevent salt depletion; in these patients neither reduction in urea excretion nor increase in plasma urea occurred. In group 3 (n = 10), the marked diuretic-induced fall in urea clearance was found to be independent of enhanced proximal tubular reabsorption (measured in water diuresis). These results show that the rise in plasma urea is due to increased tubular reabsorption of urea, presumably in the distal part of the nephron, secondary to extracellular fluid (ECF) volume depletion. PMID- 3971660 TI - Splenic pooling of granulocytes. AB - The intrasplenic kinetics of granulocytes, isolated in plasma and labelled in plasma with 111In-tropolonate, have been studied in normal subjects, patients with negative studies for inflammatory disease and patients with positive studies, with the aim of identifying the nature of splenic activity seen after 111In-labelled granulocyte administration. Up to 40 min after injection, 111In activity was visible only in major blood vessels, liver and spleen, with slight, abnormal activity visible in most of those with positive scans. The time courses of uptake of hepatic and splenic activity were different, with liver activity rapidly reaching a plateau and splenic activity increasing mono-exponentially to a plateau achieved between 20 and 40 min. The clear difference between the shapes of the hepatic and splenic uptake curves and the magnitude of the splenic uptake rate constant indicated that splenic activity represented reversible uptake. The application of deconvolution analysis to the blood and splenic time-activity curves generated a splenic retention (or washout) curve consistent with dynamic exchange of granulocytes between blood and spleen. The slope of this curve indicated an intrasplenic granulocyte transit time of 9.3 (+/- SE 0.6) min. Taking splenic activity to be reversible, comparison of the 111In signal from the spleen 40 min after injection of 111In-labelled granulocytes with that given from the spleen after the injection of 111In-labelled erythrocytes (relative to their respective blood levels) indicated that intrasplenic granulocyte transit time was 14.4 (+/- SE 1.1) times that of erythrocytes. Based on actual erythrocyte time, this corresponds to a granulocyte transit time of 8.6-11.5 min, in close agreement with the estimate based on deconvolution analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971661 TI - Some problems associated with adenylate cyclase bioassays for parathyroid hormone. AB - A renal adenylate cyclase system was assessed for its suitability in the performance of parathyroid hormone (PTH) bioassays. Membrane preparations from 1 week old chicks were found to be more sensitive to PTH than material from humans, dogs or rats. Because of the presence of non-specific inhibitors and stimulators of adenylate cyclase in human serum, each serum sample was assayed in the presence and in the absence of a specific PTH inhibitor and the difference was used to calculate PTH activity. Calcium, an inhibitor of adenylate cyclase, was either removed from serum samples by pretreatment with Chelex resin or chelated during assay by means of EGTA. Human and bovine PTH (1-34) stimulated adenylate cyclase in this system to the same extent. The lower limit of detectability was 19.5 pg/ml (final concentration). The intra-assay coefficient of variation at a final concentration of 45 pg/ml was 18%. The index of precision was 0.08 +/- 0.04 (n = 7). When synthetic human PTH (1-34) was infused into three normal volunteers, the mean biological half-life of this material was found to be 3.2 min. PTH-like bioactivity could be routinely detected in sera from normal rats, while such activity was significantly decreased in rats subjected to thyroparathyroidectomy. PMID- 3971662 TI - An adenylate cyclase bioassay for parathyroid hormone: some clinical experiences. AB - An adenylate cyclase bioassay for parathyroid hormone (PTH) was evaluated in peripheral sera of ten normal subjects, 15 patients with various types of hypoparathyroidism, nine patients with malignancy-associated hypercalcaemia and 60 patients with primary or secondary hyperparathyroidism. The lower limit of detectability was 150 pg/ml in terms of synthetic human PTH (1-34). PTH-like bioactivity was not detected in normal subjects, in patients with surgical hypoparathyroidism, in patients with idiopathic hypoparathyroidism or in patients with malignancy-associated hypercalcaemia. Serum from one untreated pseudohypoparathyroid patient consistently contained PTH-like bioactivity. Bioactivity was detected in sera from 50% of patients with primary or secondary hyperparathyroidism. In two patients with secondary hyperparathyroidism calcium infusions suppressed this activity within 5 min. Both in primary and in secondary hyperparathyroidism there was a significant positive correlation between levels of PTH-like bioactivity, PTH immunoreactivity and the histological severity of the disease. PMID- 3971663 TI - Effect of prolonged bile duct obstruction in the rat on hepatic transport of bilirubin. AB - In order to investigate the effect of extra-hepatic biliary obstruction on bilirubin transport, bile flow was re-established after 5, 10, 15 and 28 days when the mean (+/- SEM) plasma bilirubin concentrations of the four groups of five rats were 226 +/- 17.9, 201 +/- 22.4, 178 +/- 8.1 and 145 +/- 3.8 mumol/l, respectively. After 12 h of bile drainage in the conscious animal, the mean plasma bilirubin concentrations of the four groups had decreased by 88, 86, 73 and 46%, respectively. The bile flow rate increased with the duration of the obstruction and was maximal in the 28 day obstructed rats, although the bilirubin output in these animals was significantly less than in the other groups. Histological evidence of biliary obstruction was apparent in the livers of the 5 and 10 day obstructed animals. After 15 days of obstruction cirrhosis developed. In conclusion, the disposal of endogenous bilirubin in the bile duct obstructed rat appears to be influenced by the development of cirrhosis. PMID- 3971665 TI - Leukaemic promyelocytes and normal bone marrow cells release a passive sodium transport modifier (inhibitin). AB - Previous studies have shown that leukaemic immature cells, specifically promyelocytes but not mature leucocytes, contain and release an inhibitor of ouabain-insensitive sodium transport (inhibitin). In the present study, medium from cultured leukaemic promyelocytes significantly reduced the ouabain insensitive sodium efflux from erythrocytes, whereas medium from the same cell line which had been made to differentiate did not have this effect. Culture medium from normal bone marrow cells (containing promyelocytes) also significantly (P less than 0.001) reduced ouabain-insensitive sodium efflux. These data suggest that inhibitin is secreted by primitive but not by mature leukaemic cells and normal bone marrow cells. PMID- 3971664 TI - A comparison of body protein determination in rats by in vivo neutron activation and carcass analysis. AB - Total body nitrogen (TBN) was determined in 16 rat carcasses ranging in weight from 55 to 550 g, by non-destructive 14 MeV neutron activation analysis (NAA). The rat carcasses were subsequently analysed for TBN by Kjeldahl digestion, for total body water (TBW) by loss of weight after freeze-drying and for body fat by adiabatic bomb calorimetry after subtraction of protein energy. TBN results by the two methods were in good agreement, the precision by NAA (coefficient of variation = 1.5%) being superior to that by chemical analysis (coefficient of variation = 2.8%). Body fat calculated by difference from a combination of measured TBW and NAA data agreed closely with bomb calorimetry measurements. The use of indirect estimates of TBW to determine fat gave poor results. A group of four growing rats was analysed sequentially by NAA four times in 2 weeks. The maximum total radiation dose received by each animal was less than 50 rem (less than 500 mSv) and no significant differences in growth rate were observed compared with non-irradiated control groups. 14 MeV NAA in vivo can be conducted with sufficient precision to measure 0.14 g TBN changes in growing rats at 2 weeks post-weaning. PMID- 3971666 TI - Total body potassium and water, and exchangeable sodium, in muscular dystrophy. AB - Total body potassium (40K method) and total body water and exchangeable sodium (both by isotope dilution) were determined in 26 boys, aged 5-17 years, with muscular dystrophy. Total body potassium values were compared with measurements in a large series of normal boys on the basis of height. Total body potassium was reduced even in the youngest patients and was only slightly higher in the older boys, despite their considerably greater height. Exchangeable sodium increased with increasing height in a way similar to that of normal boys. Total body water was also reduced but increased with growth, although to a lesser extent than expected for normal boys. The total body water measurements indicated that many of the affected boys were very obese, despite an apparently normal body weight. An intravenous bolus of 22Na distributed at a similar rate in boys with muscular dystrophy to that in normal males. In relation to the predicted values, total body potassium and 24 h urinary creatinine excretion of the affected boys both declined at a rate of 4% per year. PMID- 3971667 TI - Interaction of renal prostaglandins with the renin-angiotensin and renal adrenergic nervous systems in healthy subjects during dietary changes in sodium intake. AB - In six healthy subjects the role of renal prostaglandins (PG) in modulating the actions of the renin-angiotensin and renal adrenergic nervous systems on renal function was investigated. During high dietary sodium intake (350 mmol/day) for 4 days no changes in urinary excretion of PGE2, PGF2 alpha, noradrenaline or adrenaline were noted, whereas plasma renin activity (PRA) and urinary aldosterone excretion were suppressed. After 4 days of low sodium intake (35 mmol/day) urinary excretion of PGE2, aldosterone and noradrenaline, as well as PRA, had significantly increased. Inhibition of PG synthesis with indomethacin (2 mg/kg body weight) had no effects on renal function on day 5 of high sodium intake. Despite suppression of PRA and urinary aldosterone, indomethacin significantly reduced p-aminohippurate (PAH) clearance, glomerular filtration rate (GFR) and urinary sodium excretion on day 5 of low sodium intake, when urinary noradrenaline excretion remained high. The results point to the crucial role of the renal adrenergic nervous system in controlling renal vascular resistance and sodium conservation in healthy subjects during low sodium intake, which is unmasked when renal PG synthesis is blocked by indomethacin. Enhanced renal PG synthesis during sodium restriction therefore not only attenuates the vascular and tubular effects of the renin-angiotensin system but, more importantly, also those of the highly stimulated renal adrenergic nervous system. PMID- 3971668 TI - Maternal zinc and intrauterine growth retardation. AB - The levels of zinc in plasma, erythrocytes, polymorphonuclear (PMN) and mononuclear (MN) white cells were measured after delivery in women giving birth to appropriate-for-gestational-age (AGA) babies (group I mothers), or small-for gestational-age (SGA) babies (group II mothers) and in non-pregnant controls. Mean maternal plasma zinc and albumin levels 24-48 h after delivery were lower than in controls, but PMN and MN zinc levels were unchanged. PMN zinc levels were lower than those of MN cells. PMN and MN zinc levels were significantly lower in group II mothers than in group I, irrespective of smoking habits. There were no racial differences in peripheral white cell zinc levels. PMN, and to a lesser degree MN, zinc levels were lower in smoking than in non-smoking mothers. Erythrocyte zinc did not correlate with other zinc measurements nor with the size of the babies. Fetal erythrocyte zinc levels were one-third of maternal levels. A combination of smoking and/or low PMN zinc levels selects 85% of mothers having small-for-gestational-age babies. PMID- 3971669 TI - Some observations on the role of the abdomen in breathing in patients on peritoneal dialysis. AB - We studied a total of 29 patients on continuous ambulatory peritoneal dialysis (CAPD), who had no present or past respiratory impairment, before and after drainage of dialysate (2.324 +/- SE 0.033 litres). We measured spirometry, lung volumes and carbon monoxide transfer sitting and supine in 20 patients. The only statistically significant changes on drainage were a small increase in supine functional residual capacity (+214 +/- SE 61 ml, P less than 0.01) and a small fall in supine peak expiratory flow rate (-26.6 +/- SE 12.1 litres/min, P less than 0.05). Measurement of maximal mouth and transdiaphragmatic pressures in ten patients made under the same circumstances showed no statistically significant changes on drainage. A model of the abdomen demonstrates that fluid distension is likely to be better tolerated than gaseous distension, and review of previous studies suggests that a wide range of changes in intraabdominal fluid volume can be tolerated without respiratory embarrassment. These results suggest that fluid volumes used for CAPD do not interfere with breathing in patients with previously normal lungs. The nature of the mechanisms compensating for the fluid suggests that patients with chest disease should be able to tolerate this form of dialysis. PMID- 3971670 TI - Calmodulin levels in hypertensive rats. AB - Intracellular calmodulin levels were measured by direct radioimmunoassay in spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). Decreased calmodulin levels were demonstrated in the brain, heart, aorta and kidney of spontaneously hypertensive rats compared with those in Wistar-Kyoto rats. Calmodulin levels in the brain were also decreased in deoxycorticosterone acetate (DOCA)-salt rats, but not changed significantly in the heart, aorta and kidney compared with those in Wistar-Kyoto rats. These findings suggest that intracellular calcium-dependent regulatory systems are genetically disrupted in spontaneously hypertensive rats, but this is probably not an important factor in the development of hypertension. PMID- 3971671 TI - Altered metabolism of low density lipoprotein in humans after prolonged incubation in plasma. AB - Lecithin: cholesterol acyltransferase (LCAT) in combination with exchange and transfer proteins is known to alter the composition of all plasma lipoprotein fractions. Human plasma from healthy donors was incubated for 24 h at 37 degrees C in the absence and at 4 degrees C and at 37 degrees C in the presence of the LCAT inhibitors sodium iodoacetate (5 mmol/l), and the low density lipoprotein fractions (LDL) were isolated. LDL isolated from LCAT-active plasma (LDL-a) exhibited pronounced alterations in their surface material: the relative content of phospholipids and of free cholesterol was reduced and the content of tetramethylurea-soluble apolipoproteins was increased. LDL isolated from plasma incubated at 37 degrees C with or without sodium iodoacetate showed significantly increased triglyceride concentrations. The LDL fractions from LCAT-active and LCAT-inactive (LDL-i) incubates were iodinated with 125I and 131I respectively, and their metabolic behaviour was studied in humans. LDL-a was cleared from circulation at a slower rate as compared with LDL-i (t 1/2 = 3.17 +/- 0.47 vs 2.88 +/- 0.45 days). The apparent fractional catabolic rate of LDL-a, calculated according to a two-pool model, was reduced by 22.2 +/- 3.1%. Comparing LDL-a with LDL isolated from LCAT-inactive plasma which had been incubated at 37 degrees C, the changes in the metabolic variables were less pronounced. It is concluded that physiological alterations of the chemical compositions, caused by LCAT and exchange/transfer proteins, influence the metabolism of LDL. PMID- 3971672 TI - Platelet volume subpopulations in acute myocardial infarction: an investigation of their homogeneity for smoking, infarct size and site. AB - Mean platelet volume and count were measured in three groups: patients with acute myocardial infarction, a control group with myocardial ischaemia but no infarction and an asymptomatic group of young males. Mean platelet volume was significantly larger in the myocardial infarction group compared with the ischaemic heart disease group or the asymptomatic group. Two subpopulations were present within the myocardial infarction group. One subgroup had a large mean platelet volume and low count. The other subpopulation was indistinguishable, with regard to platelet count and mean volume, from the ischaemic heart disease group. Over 60% of the myocardial infarction group lay in the area of high platelet volume and low count compared with 13% of the ischaemic heart disease control group and 38% of the asymptomatic group. Acute myocardial infarction is likely to be associated with a large mean platelet volume and low count compared with the ischaemic heart disease group. There is no statistical evidence that this condition is related to smoking or size and site of infarct. This evidence suggests that large mean platelet volume and low platelet count could be a major risk factor for myocardial infarction. PMID- 3971673 TI - Mass and composition of the fat-free tissues of patients with weight-loss. AB - An estimate of the mass of fat-free tissue in the body can be calculated from body weight and skinfold thickness; this estimate is called the 'fat-free mass'. Total body potassium and nitrogen are alternative estimates. Factor analysis of data for healthy subjects has defined relationships between the true values of these three quantities and estimated the random component of the variance of each, i.e. the component independent of variations in the mass of fat-free tissue. The results indicated that all three were reliable measures of the mass of fat-free tissue. However, it is not known whether these findings are valid for patients who have lost weight. We have measured the same three quantities in 104 wasted patients with heart disease or disorders of the gastrointestinal tract. The patients' mean values were significantly less than corresponding values for healthy volunteers. The patients had a mean ratio of total body nitrogen to fat free mass similar to that of healthy subjects, but lower mean ratios of potassium to fat-free mass and nitrogen. These findings suggest that the potassium content of the patients' fat-free tissues was abnormally low. Factor analysis of the patients' data gave relationships between the true values of the three quantities similar to those for healthy subjects; however, total body potassium was 100-300 mmol lower in patients than in healthy subjects with the same fat-free mass or total body nitrogen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971674 TI - Haemodynamics of renal artery stenosis (a comment based on Ohm's law) PMID- 3971675 TI - Measurement of plasma angiotensin II. PMID- 3971676 TI - Update: Colorado Prescription Drug Abuse Coalition. PMID- 3971677 TI - Portrait of a prescription drug abuser. PMID- 3971678 TI - Clonidine and naloxone in ultrashort opiate detoxification. PMID- 3971679 TI - Metoclopramide-induced tetanus-like dystonic reaction. PMID- 3971680 TI - Severe hypersensitivity secondary to extended carbamazepine administration. PMID- 3971681 TI - Update on the new triphasic oral contraceptives. PMID- 3971682 TI - Efficacy of patient-controlled versus conventional analgesia for postoperative pain. AB - Patient-controlled i.v. administration and intramuscular administration of morphine sulfate were compared in a crossover study to determine their relative effectiveness in relieving postoperative pain. Twenty adult patients scheduled for abdominal surgery were randomly assigned to one of two groups; one group received i.v. morphine sulfate for 24 hours using a patient-controlled analgesia (PCA) device, after which they were given morphine sulfate i.m. for 24 hours. The treatment order was reversed for the other group. Amount of narcotic administered, respiratory rate, and levels of discomfort, activity, and sedation were assessed by the nursing staff every two hours. At the end of each 24-hour treatment phase, patients ranked their level of pain, amount of pain relief, level of sedation, ability to sleep, and ability to perform pulmonary toilet. Patients were also asked whether they preferred PCA or i.m. analgesic therapy for future surgery. Patients reported significantly less discomfort while using PCA than during i.m. morphine administration. No significant differences in amount of narcotic used, respiratory rate, nausea and vomiting, or levels of activity or sedation were noted for the two regimens. Patients' rankings of the two treatment modes did not differ significantly, but a majority of patients indicated a preference for future use of PCA. In these postoperative patients, administration of i.v. morphine sulfate by PCA was as safe as i.m. administration and possibly more effective in relieving pain. PMID- 3971683 TI - Analgesia with oral narcotics and added ibuprofen in cancer patients. AB - A scheduled regimen of oral narcotic analgesics was compared with a regimen of oral narcotic analgesics plus ibuprofen for analgesic efficacy in patients with cancer. Ten patients with metastatic cancer were randomly assigned to receive either ibuprofen 400 mg or a look-alike placebo four times daily in addition to each patient's existing regimen of scheduled oral narcotics. A two-period changeover study design was used. The 24-hour narcotic intake equated to injectable morphine was computed for each patient at baseline and during the nine study days. A visual analogue scale was used to evaluate pain relief, nausea, mood depression, daytime drowsiness and nighttime sleeplessness. The analgesic efficacy of the narcotic-ibuprofen combination was significantly greater than the analgesic efficacy of the narcotic-placebo combination. Eight patients demonstrated a positive treatment effect with added ibuprofen; the overall improvement in analgesia averaged 39.1% in these patients. There was no significant increase from baseline in the incidence of nausea, mood depression, daytime drowsiness or nighttime sleeplessness. At the doses used in this study, a treatment regimen of oral narcotic analgesics plus ibuprofen was more effective than oral narcotics alone in relieving pain associated with cancer. PMID- 3971684 TI - Prediction of theophylline clearance using condition correction factors. AB - The predictive ability of different mathematical manipulations of condition correction factors in estimating total body clearance of theophylline in acutely ill hospitalized patients was evaluated. Fifty acutely ill patients who were treated with constant aminophylline infusions were evaluated. Twenty-one patients were evaluated prospectively. Initial serum theophylline concentrations were ordered, and second concentrations were obtained at steady state. Twenty-nine patients were evaluated retrospectively and were included if two steady-state serum theophylline concentrations had been obtained. Each condition correction factor was determined by calculating the predicted normal clearance using a literature-derived clearance value and dividing it into the actual clearance obtained. The FDA condition correction factors were obtained by dividing the theophylline dose recommended for patients with a particular disease by the dose recommended for a normal patient. Pearson correlation coefficients for 15 mathematical manipulations were used to examine the relationship between the predicted clearance and actual clearance. The predictability of theophylline clearance using the mathematical manipulations decreased as the number of condition correction factors increased. The mean actual clearance for four patients with no condition correction factors was only 2% greater than the mean standard clearance found in a previous study. The use of 0.041 L/hr/kg as a standard clearance appears justified for calculating initial theophylline dosages in all patients. Patients with only one condition correction factor may use this factor to adjust dosage, but when more than one factor is present, the use of the other manipulations studied may result in either subtherapeutic or toxic serum concentrations. PMID- 3971685 TI - Salivary penetration of moxalactam. PMID- 3971686 TI - Amikacin pharmacokinetics in morbidly obese patients undergoing gastric-bypass surgery. PMID- 3971687 TI - Predicting serum gentamicin concentrations in patients undergoing hemodialysis. PMID- 3971688 TI - Evaluation of two methods for predicting initial lithium dosage without measuring serum concentrations. PMID- 3971689 TI - Progress and problems with pain. PMID- 3971690 TI - How reliable are serum digoxin assays? PMID- 3971691 TI - Choosing optimal sampling times for therapeutic drug monitoring. AB - Recent advances linking pharmacokinetic theory with the selection of optimal sampling times and the influence of sampling times on the interpretation of serum drug concentrations are discussed. For serum drug assay results to be interpreted easily, samples should be obtained during the postdistributive phase (for loading and maintenance doses) or at steady state (for maintenance doses). Beyond this, the choice of sampling times depends on whether peak, trough, or intermediate concentrations are being monitored. When intrapatient and interpatient variation in pharmacokinetic values are considered to be the principal components of variability, the best time for taking a single sample after a test dose in order to predict the average concentration during the steady-state dosage interval is when sample time equals 1.4 times the population half-life of the drug. Optimal sampling times to predict maximum or minimum steady-state concentrations may differ from those used to estimate the average concentration. Efforts to decrease the number of samples needed to estimate accurately steady-state drug concentrations have led investigators to test "single-point" prediction methods following a test dose. However, for drugs administered by continuous infusion, it seems prudent to assay more than one serum sample obtained before steady state is achieved; a single sample obtained too early could contribute to inaccurate predictions. Recommendations are presented for optimal sampling times for commonly monitored drugs. PMID- 3971692 TI - Treatment of trigeminal neuralgia: use of baclofen in combination with carbamazepine. AB - A patient with trigeminal neuralgia who became refractory to carbamazepine but responded well to the addition of baclofen to his regimen is described, and the drug and surgical treatment of trigeminal neuralgia are discussed. A 57-year-old white man sought medical help following a six-week history of paroxysmal pain in the right jaw. Rubbing the skin in the right third division of the trigeminal nerve produced a paroxysm of pain. Trigeminal neuralgia was diagnosed, and carbamazepine therapy was initiated with good results. Pain recurred upon discontinuation of the therapy, and carbamazepine was restarted. However, debilitating pain persisted despite continuous treatment that produced moderate postdose ataxia. Baclofen was added to the patient's regimen and increased to 60 mg daily with subsequent reductions in the carbamazepine dosages. The patient remained pain-free during the following 10 months. Carbamazepine is considered the drug of choice and is initially very effective in treating trigeminal neuralgia. However, many patients are forced to discontinue drug therapy because of intolerance or ineffectiveness and are faced with surgery as their only option. Baclofen does not appear to be as effective as carbamazepine when used as a single agent. However, its apparent synergism with carbamazepine and phenytoin combined with its low incidence of serious side effects make baclofen a valuable adjunct in the treatment of refractory trigeminal neuralgia. PMID- 3971693 TI - Toxicity and elimination of trazodone after overdose. PMID- 3971695 TI - Thoracic oncologic emergencies. PMID- 3971694 TI - Supraventricular tachycardias in the emergency room. PMID- 3971696 TI - Ambulatory management of thermal injuries. AB - The majority of thermal injuries that occur in this country can be adequately treated on an ambulatory-care basis. The determination regarding ambulatory care can be arrived at using the simple algorithm. The primary concern in outpatient burn care is the management of the burn wound. Aggressive wound cleansing, frequent dressing changes, and appropriate antimicrobials should permit rapid re epithelialization and prevention of bacterial infection. A nonhealing burn wound should be grafted if it takes more than two to three weeks to heal. Aftercare with splints and elastic compression may be required to obtain maximal functional and cosmetic results. PMID- 3971697 TI - Conspectus: up in smoke. PMID- 3971698 TI - Lightning injuries. AB - Lightning causes more deaths than any other weather phenomenon. It is an electrical current that will choose the shortest paths between the contact points of the human body and may involve vital structures in its pathway. Almost every organ system can be injured by the electrical current of lightning. A broad spectrum of complications resulting from damage to the various organ systems has been reported. The sequelae peculiar to this specific type injury will dictate the choice of therapy. PMID- 3971699 TI - Pelvic fractures and related clinical injuries. AB - Pelvic fractures represent major injuries by themselves, and are especially serious when associated with commonly occurring related clinical injuries. Initial evaluation of the trauma victim must include consideration of this injury and its related complications. Evaluation of the fracture and its related injuries must be well-directed and aimed at minimizing potential morbidity and mortality. A multi-disciplinary approach that includes consultation with the trauma surgeon, urologist, and orthopedic surgeon must be used. PMID- 3971700 TI - Hemorrhagic shock and trauma. PMID- 3971701 TI - The concussed patient. PMID- 3971702 TI - Estimation and removal of baseline drift in the electrocardiogram. AB - Estimation procedures for baseline drift have been developed using cubic spline, polynomial, and rational functions. In a test set of 50 electrocardiograms (ECGs), each of 2.5-sec duration, baseline stability was significantly improved by application of any of these methods, except rational function approximation. Amplitude histograms of clinical ECGs after subtraction of estimated baseline distortions showed only small baseline variations over the recording period. For a quantitative validation of the estimation procedures, 10 ECGs with artificial baseline drift were constructed and analyzed by correlation and mean square error calculations. From these comparisons, the polynomial approximation emerged as the most efficient method. PMID- 3971703 TI - Numerical integration in the reconstruction of cardiac action potentials using Hodgkin-Huxley-type models. AB - A comparison between traditional numerical integration methods and a new hybrid integration method for the reconstruction of action potential activity is presented, using a mathematical model of the cardiac Purkinje fiber (MNT model). It is shown that the hybrid integration method reduces importantly the overall computation time required for solving the Hodgkin-Huxley differential equations describing membrane electrical events. To accomplish this, the particular form of the gating variable equations is exploited to reformulate the step-by-step computation. In this way, the time increment can be made much larger compared with traditional methods when the membrane potential changes slowly. A mathematical analysis of the hybrid integration method is presented also, together with a numerical verification of its performance both for the propagated and nonpropagated membrane action potential. It is shown that the local error, that is the error arising at each integration step, and the cumulative integration error are strictly controlled by the membrane potential offset. Using the MNT model, the nonpropagated cardiac Purkinje action potential can be reconstructed in real time with an accuracy of 1% for the potential and 5% for the time of occurrence of its main features. In reconstructing propagated events, the hybrid integration method allows computation time savings by a factor of 10 or more compared to accurate Runge-Kutta schemes. PMID- 3971704 TI - Cross-correlation technique for arrhythmia detection using PR and PP intervals. AB - A combined, cross-correlation procedure for computerized arrhythmia detection is presented. It enables the classification of a wide range of arrhythmia and is based upon the determination of both P and QRS waves. The electrocardiogram (ECG) signal is recorded from external leads, digitized (10 bits of resolution) at 1.28 kHz and processed with a CDC 6600 computer. A normal beat is stored as a reference signal and the onsets of the P wave and the QRS complex are measured for determining the PR, PP, and RR intervals. The combined cross-correlation procedure is carried out between the template and each successive ECG waveform over two time intervals, the first of which includes the P wave and the second, the QRS complex. Prior to this correlation procedure each of the ECG waveforms is filtered through a nonrecursive digital bandpass filter (10 and 100 Hz for low and high cutoff frequencies, respectively). The cross-correlation functions are then calculated by means of a cross spectrum and Fast Fourier Transform algorithm. The maximum value of the normalized cross-correlation function and the time shift providing that value are searched for, allowing (1) determination of the similarity between the present beat and the normal reference beat, allowing for the discrimination of abnormal P and QRS shapes; (2) accurate measurement of the RR, PP, and PR intervals of this subsequent waveform. Applying this method enables a reliable detection of a wide variety of arrhythmia. PMID- 3971705 TI - Stepwise variable selection and maximum likelihood estimation of smoothing factors of kernel functions for nonparametric discriminant functions evaluated by different criteria. AB - Kernel functions are used to estimate the probability density functions of variables for nonparametric discriminant analysis. In connection with stepwise variable identification a stepwise maximum likelihood estimation procedure for the estimation of smoothing factors of the kernel functions is developed. This procedure allows a step-by-step estimation of smoothing factors for every variable which is considered to be added to the model or which is examined to substitute a variable in a model. Different criteria for model evaluation in stepwise discriminant analysis are discussed. Beside criteria, like distance and dependence functions and the error and nonerror rate, a criterion which considers the ratio of probability densities of different classes at point x is proposed for stepwise variable identification. An application of the procedures described in this study to a medical decision problem shows the importance of stepwise parameter estimation of kernel functions for nonparametric discriminant analysis and the role of different model evaluation criteria for the selection of the best subset of variables. PMID- 3971706 TI - Virtual leads for the ambulatory ECG monitoring: remarks on the persistency of their direction. AB - We attempt to improve the performances of the algorithms devoted to the computer based detection of arrhythmias by improving the quality of the tracings they have in input. This aim is pursued by building virtual tracings mathematically derived from the original ones. In this paper we describe the persistency in the time domain of the direction of some virtual leads. Such a persistency will tell us how often in a subject we must recalculate the virtual lead. They have been defined starting from the original tracings of the two leads belonging to the BIH/MIT Arrhythmia Database. We considered the width of the time window just more than the cycle duration: i.e., a severe experimental condition. We found there is no persistency and we have to recalculate continuously the direction of the virtual lead. The set consisting of only two original leads and the short window may have had a major influence on our results. About the specific contribution that the virtual leads take to the improving of the tracings quality, we have several examples where, in respect to the original tracings, the virtual tracings show a positive increase of the differences between normal and abnormal beats. PMID- 3971707 TI - Use of a computer in analysis of heart rate and blood pressure response to the Valsalva maneuver. AB - The relationship between systolic blood pressure (SBP) and R-R interval (RR) in phase II of the Valsalva maneuver was analyzed with the use of a nonlinear relation. The nonlinear relation introduced here includes time derivatives of SBP and RR, and is a natural extension from the linear one which defines the linear baroreflex sensitivity index (BRSI). The model equations of SBP and RR derived from the nonlinear relation predicted well the observed changes of SBP and RR in 11 normotensive subjects and 16 hypertensive patients. Two of the parameters of the relation were related to the activity of the compensatory mechanism, and discriminated well the hypertensives from the normotensives. For this analysis an interactive system of regression analysis has been developed to reduce the difficulties in the case of nonlinear regression curve fitting. The regression curves can be monitored on a graphic terminal during every regression step. The values of nonlinear parameters can be obtained easily and systematically with use of the system. PMID- 3971708 TI - Efficacy of cytology in the diagnosis of lung cancer. PMID- 3971709 TI - Precursors to malignant melanoma. National Institutes of Health Consensus Development summary. PMID- 3971710 TI - Managed health systems: a boon or bane for physicians? PMID- 3971711 TI - Continuous ambulatory peritoneal dialysis (CAPD). AMA Council on Scientific Affairs. PMID- 3971712 TI - Deciding for the incompetent patient: the development of public policy. PMID- 3971713 TI - Chemotherapy of testicular cancer at Yale: 1976-1982. PMID- 3971714 TI - Low anterior vs. abdominoperineal resection. A community hospital experience. PMID- 3971715 TI - A case study in the abdication of professional responsibility. Purple dots and red circles. PMID- 3971716 TI - An antitrust primer for physicians. PMID- 3971717 TI - Physicians' financial arrangement with hospitals. AMA Center for Health Policy Research. PMID- 3971718 TI - Reflections on medicine. Brain-dusting. PMID- 3971719 TI - Alcohol, law and public policy: historical foundations. PMID- 3971721 TI - Quarantine and AIDS. PMID- 3971720 TI - Sleep apnea contributing to respiratory failure in the Mounier-Kuhn syndrome. PMID- 3971722 TI - Consensus development summaries. Treatment of hypertriglyceridemia. National Institutes of Health. PMID- 3971723 TI - Agglutinate formation in serum samples mixed with intravenous fat emulsions. AB - The degree of fat agglutination (the so-called "creaming phenomenon") was measured in sera from 51 critically ill patients, 200 ambulatory patients and 24 healthy volunteers. A 400-microliter serum sample was mixed with 10 microliter of a fat emulsion (Intralipid), incubated at 37 degrees C, and examined after 2, 6, and 24 h. Almost all samples from critically ill patients exhibited creaming, as did 31% of the samples from ambulatory patients. Serum samples from healthy volunteers were incubated with purified C-reactive protein (CRP). At a CRP concentration of 40 mg/L, creaming was always observed. Creaming also occurred at normal serum levels of CRP, but at increased concentrations of other serum proteins. Finally, the creaming test was performed with 12 different fat emulsions, mixed with sera from critically ill and healthy subjects. Healthy sera produced no creaming and sera from critically ill patients invariably showed creaming with every emulsion. PMID- 3971724 TI - Increase in plasma lipofuscin levels of stored blood. AB - Venous blood samples from Caucasian men, collected in citrate-phosphate-dextrose anticoagulant and stored in plastic or in glass containers for 10-, 20- and 30 day periods at 4 degrees C, showed increasing levels of plasma lipofuscin (PL) substances. These levels were measured as the intensities of the 340-nm excitation maximum and the 440-nm fluorescence maximum of PL, using a fluorescence spectrophotometer. No increase in PL level was observed in plasma samples separated before storage. These observations suggest that the free radical activity of PL substances may confer toxic properties to stored blood used in large transfusions, and that stored blood may lose part of its osmotic, hemostatic, immunologic, and other physiologic functions as more plasma proteins are converted into lipofuscin. PMID- 3971726 TI - Pathophysiology of adult respiratory distress syndrome after sepsis and surgical operations. AB - To describe the natural history of adult respiratory distress syndrome (ARDS) from the circulatory viewpoint, we measured hemodynamic and oxygen transport variables in a series of 126 postoperative and 65 septic ARDS patients. All patients had hypoxemia unresponsive to conservative measures and required mechanical ventilation. Data from this series were compared with data from normal healthy volunteers and from postoperative patients who did not develop ARDS. In addition, the temporal sequence of cardiorespiratory changes in the ARDS patients was observed for a 48-h period before and after ARDS was diagnosed. Before the development of ARDS, both postoperative and septic patients exhibited hypovolemia, pulmonary vasoconstriction, suboptimal myocardial performance, and reduced oxygen delivery and consumption relative to the increased needs of the hypercatabolic state. Because these antecedent changes were greater in ARDS patients who died, their early correction (in addition to standard ventilatory support) may prevent the development of ARDS and decrease its mortality. PMID- 3971725 TI - Cardiorespiratory failure in toxic shock syndrome: effect of dobutamine. AB - Fifteen patients with toxic shock syndrome were seen in a 2-yr period at a university medical center. Five (33%) patients had severe cardiorespiratory failure and underwent hemodynamic monitoring before and during infusion of dobutamine hydrochloride (dobutamine). Three distinct hemodynamic stages were identified. Initially there was a hyperdynamic cardiovascular state with a high cardiac index (5.5 +/- 0.9 L/min X m2, mean +/- SEM), normal pulmonary artery wedge pressure (11.5 +/- 1.5 mm Hg), and low mean blood pressure (66 +/- 5 mm Hg). The second stage (decompensated) revealed myocardial dysfunction with decreased left ventricular fractional shortening. Serial two-dimensional and M mode echocardiograms performed on two patients showed left atrial and left ventricular end-diastolic diameters at the upper limits of normal. The mean blood pressure recorded for all five patients was essentially unchanged; however, cardiac index decreased to 3.1 +/- 0.4 L/min X m2 and wedge pressure increased to 17.5 +/- 2.1 mm Hg. This decompensated stage responded to iv infusion of dobutamine by an increase in cardiac index to 5.4 +/- 0.5 L/min X m2, a decrease in wedge pressure to 11.0 +/- 2.0 mm Hg, and an increase in mean blood pressure to 100 +/- 10 mm Hg. During recovery, echocardiograms returned to normal. All five patients developed severe adult respiratory distress syndrome. All had reversible ECG findings of sinus tachycardia, diffuse loss of voltage, flattened T waves and diffuse nonspecific ST-T wave changes. Our findings suggest a reversible toxic cardiomyopathy as the cause of cardiorespiratory failure in toxic shock syndrome. Our experience suggests inotropic support with dobutamine is beneficial in selected cases. PMID- 3971727 TI - Effect of reduced glutathione on hemodynamic responses and plasma catecholamine levels during metabolic acidosis. AB - The effects of reduced glutathione (GSH) on plasma catecholamine (CA) levels and hemodynamics were studied in seven severely acidotic dogs, before and after dopamine (DA) infusion. Seven other dogs, also acidotic, received lactated Ringer's solution instead of GSH. Although metabolic acidosis decreased cardiac index (CI) in both groups, the decrease was significantly less in the GSH group. The significantly increased systemic vascular resistance index (SVRI) in the control group was suppressed by GSH infusion, although similarly high plasma CA levels were maintained in both groups. This suggests that GSH has certain vasodilating effects not related to adrenosympathetic activity. CI did not improve and DA infusion significantly increased SVRI in the control group, whereas CI increased with a mild decrease of SVRI in the GSH group. The rise of plasma norepinephrine after DA infusion was low in the GSH group compared to the increase in the control group. This study suggests that during acidosis GSH improves hemodynamics and restores the effects of DA on cardiac output. PMID- 3971728 TI - Patient selection for iced versus room temperature injectate for thermodilution cardiac output determinations. AB - In 42 patients who required hemodynamic monitoring there was no statistically significant difference between mean cardiac output determined with iced vs. room temperature injectate. There was also no statistical difference in mean cardiac output values using iced vs. room temperature injectate when data were grouped according to body temperature, mean arterial pressure, and cardiac output. These results suggest that when cardiac output is measured by the methods described, the use of iced injectate is unnecessary in many critically ill patients. PMID- 3971729 TI - Cerebral preservation during cardiopulmonary resuscitation. AB - Thirty-two dogs subjected to 4 min of ventricular fibrillation were equally divided into four treatment groups: (a) immediate defibrillation (control); or 30 min of (b) standard CPR (SCPR), (c) simultaneous ventilation-compression CPR (SVC CPR), or (d) open-chest CPR (OCCPR). After 30 min of CPR, restoration of spontaneous circulation was attempted using drug therapy and countershocks and the animals maintained for 24 h or until refractory hypotension occurred. During CPR, OCCPR yielded higher mean arterial and lower central venous pressures than either external method. Circulation was restored in all control dogs, and by 24 h they had nearly normal neurologic deficit scores. In the SCPR group, the heart was restarted in six dogs. Five of these dogs had severe neurologic damage and did not survive 24 h. The animal that survived 24 h, however, was nearly normal neurologically. Although circulation was restored in five SVC-CPR dogs, all were brain-dead and none survived 24 h. In the OCCPR group, seven animals survived 24 h and their neurologic deficit scores were not significantly different from control values. We conclude that OCCPR is greatly superior to SCPR and SVC-CPR with respect to preservation of the brain during resuscitation. PMID- 3971730 TI - Forward displacement of the larynx for nasogastric tube insertion in intubated patients. AB - Simple insertion of a nasogastric (NG) tube was successful in only 52 of 100 anesthetized intubated patients. After the larynx was manually pulled forward, the NG tube was successfully inserted in 33 patients. In the remaining 15 patients, the NG tube was inserted only with the aid of a finger or a laryngoscope used with Magill forceps. The difficulty of NG tube insertion was not correlated with sex, age, weight, or type of endotracheal intubation. Forward displacement of the larynx by manually gripping and lifting the thyroid cartilage is a useful and safe maneuver that facilitates NG tube insertion in anesthetized intubated patients. PMID- 3971731 TI - Evaluation of a hands-on workshop as a teaching tool for critical care medicine. AB - Many medical students have difficulty correlating the principles of cardiorespiratory physiology with the practice of critical care medicine. We developed a workshop to make this transition easier. After a computer administered preworkshop test, groups of four students intubated a dog, and inserted arterial, peripheral, and pulmonary artery catheters. After baseline cardiorespiratory variables were measured, noncardiogenic pulmonary edema was created by administration of oleic acid via the right atrial port of the pulmonary artery catheter. Measurements were repeated after equilibration and again during the application of 5, 10, and 15 cm H2O of positive end-expiratory pressure. Monitoring techniques and calculation of physiologic variables and their significance were stressed; emphasis was also placed on the interrelationship between respiratory and cardiovascular manipulations. The educational validity of this workshop was confirmed by a significant improvement in the mean score of a post-workshop test over the mean preworkshop test score. PMID- 3971732 TI - Thoracic neurilemmoma: case report and review of the world literature. AB - Thoracic tumors are unusual and tend to occur in the posterior mediastinum. A case of anterior thoracic neurilemmoma is presented, with plain film, computed tomographic, and pathologic correlation. Diagnosis of chest wall masses, including the role of computed tomography, is discussed, along with the significance of calcification in these lesions. PMID- 3971733 TI - Solitary plasmacytoma of the sternum: diagnosis by computed tomography. AB - We report a large solitary plasmacytoma arising in the sternum of a 62-year-old man. On computed tomography the tumor demonstrated a multilobular appearance associated with bone destruction and expansion and absence of intrinsic calcification. Computed tomography was helpful in determining the size and extent of the tumor and in suggesting the correct diagnosis. PMID- 3971734 TI - Improving specificity of computed tomography in diagnosis of malignant mediastinal lymph nodes. AB - Four parameters of lymph node appearance on computed tomography were studied to improve specificity for malignancy in bronchogenic carcinoma: 1) node location, 2) homogeneity, 3) border definition, and 4) delineation by fat. Of 54 carcinoma patients, nodes were pathologically malignant in 21. Computed tomography showed enlarged nodes (over 1 cm) in 20 of these (true-positive rate, 96%), but also in 13 of the 33 patients with pathologically benign lymph nodes (false-positive rate, 39%). A combination of all four computed tomography parameters reduced the false-positive rate from 39 to 21% and decreased the true-positive rate from 96 to 86%. The criterion of border definition alone reduced the false-positive rate from 39 to 6%, but decreased the true-positive rate from 96 to 61%. The most useful computed tomography parameter was delineation, which reduced the false positive rate to 15% and decreased the true-positive rate only to 86%. The computed tomography appearance of enlarged lymph nodes may be used to improve selection of patients with enlarged nodes for preoperative biopsy. PMID- 3971735 TI - High-resolution computed tomography of the major salivary glands: current status. AB - At our institution, computed tomography is the procedure of choice for evaluation of suspected mass lesions of the major salivary glands. It affords exact anatomic localization of a mass and allows simultaneous examination of the contralateral gland and other regional structures of importance in salivary gland disease. Intravenous contrast medium enhancement is always utilized; however, concomitant sialography has never been necessary. Regional anatomy of the salivary glands with respect to computed tomography imaging and clinical material demonstrating its efficacy are presented. The neoplastic and nonneoplastic diseases affecting the salivary glands are reviewed. PMID- 3971736 TI - Computed tomography of septic joints. AB - Twenty-six patients with suspected or known septic joints who had been studied by computed tomography were retrospectively reviewed. Eighteen patients (20 joints) proved to have septic arthritis. Computed tomography was advantageous in patients with acute septic arthritis of deep-seated axial joints, such as the hip and sacroiliac, where it demonstrated particular soft tissue swelling as early as 36 hours after the onset of symptoms. In three patients, this finding on computed tomography was helpful in accurately localizing the disease process and facilitating a diagnostic closed needle aspiration biopsy procedure. Four patients had a primary osseous focus of infection in an adjacent epiphyseal region that was documented by computed tomography. Computed tomography was superior to conventional radiology in revealing early articular bone erosion in joints with curved and overlapping articular surfaces in five patients, and resulted in alteration of their treatment. Fat-fluid levels within the suprapatellar bursae were noted in one patient (two joints). Computed tomography is a valuable modality for evaluation of patients with suspected septic arthritis of axial joints, particularly in the acute stage. Furthermore, it is helpful for evaluation of possible periarticular abscess formation and can serve as a guide for a percutaneous drainage procedure. Computed tomography can also be used when articular bone erosion or medullary extension of osteomyelitis is suspected but not fully documented by conventional radiography. PMID- 3971737 TI - Computed tomography demonstration of retroperitoneal contrast material extravasation complicating translumbar aortography. AB - The computed tomography appearance of contrast material extravasated in the right perirenal space is presented. The complication occurred during test injection prior to translumbar aortography. The computed tomography findings were those of a right prerenal collection with high attenuation numbers representing contrast extravasation. Concurrent displacement of the second portion of the duodenum and inferior vena cava was present. No other retroperitoneal abnormalities were noted. The importance of computed tomography for early recognition and follow-up are emphasized. PMID- 3971738 TI - Long-term reproducibility of quantitative computed tomography vertebral mineral measurements. AB - Similar methods for measuring bone density using quantitative computed tomography have been proposed by Cann and Genant and by Firooznia et al. This study was done to evaluate the long-term reproducibility of quantitative computed tomography in the clinical setting. An anthropomorphic phantom was evaluated over an 18-month interval. A variation of +/- 2.2% was obtained, substantiating that quantitative computed tomography can be done in a reproducible manner over an extended time interval. PMID- 3971739 TI - Viscosity of iodinated contrast agents: significance for peripheral venous injection. AB - The meglumine salt of a urographic contrast agent is significantly more viscous than the comparable sodium salt. To noninvasively deliver a bolus to some patients it is often necessary to use a 21-gauge needle. The inherent resistance of a 21-gauge scalp needle results in approximately a 60% increase in injection time for the meglumine salt as opposed to the sodium salt. PMID- 3971740 TI - Megadolichobasilar anomaly associated with brain stem infarction: a case report. AB - A rare case of megadolichobasilar anomaly associated with localized brain stem infarction showing right hemiparesis and disturbance of consciousness is described. The etiologic mechanisms of brain stem infarction in this anomaly are discussed. The tortuosity and dilatation of the basilar artery were thought to play an important role in the pathogenesis of the brain stem infarction. PMID- 3971741 TI - Meningioma with intratumoral fat. AB - Fat within meningiomas is histologically not uncommon. Focal areas of low density on computed tomography scans within meningiomas have been demonstrated and are most often intratumoral cysts. The case presented demonstrates a focal area of low density within a meningioma that is proved histologically to be fat. PMID- 3971742 TI - Artifact-free computed tomography of the chest and abdomen in the severely ill patient. AB - A method is described for obtaining consistently high-quality images during nonneurologic computed tomography of the severely ill and uncooperative patient using a neuromuscular blocker to induce apnea. Careful control of respiration during data acquisition eliminates motion artifacts. PMID- 3971743 TI - AIDS and Kaposi's sarcoma. PMID- 3971744 TI - A comparison of methods of valve destruction with respect to acute thrombogenicity and flow rate of in situ femoral artery vein bypass grafts. PMID- 3971745 TI - Urinary thromboxane (TxA2) reflects dose-response tissue injury in humans. PMID- 3971746 TI - Sensitivity of colon blood flow to changing hemodynamics events. PMID- 3971747 TI - Physiologic effects of intrathoracic placement of Nissen fundoplication. PMID- 3971749 TI - More about the YAG. PMID- 3971748 TI - Blunt trauma and delayed colon injury. PMID- 3971750 TI - The pendulum swings again. Toward a rational use of theophylline. PMID- 3971751 TI - YAG laser photoresection of lesions obstructing the central airways. AB - Some patients with cancer and others with benign lesions which obstruct the central airways (larynx, trachea, major bronchi) can be treated with a laser. Ninety-nine patients were considered for treatment during the first 18 months of experience with a YAG (yttrium aluminum garnet) laser at Henry Ford Hospital; 55 patients were treated 82 times. Results were satisfactory (surgery was avoided) in eight of ten patients with benign lesions. Satisfactory results (doubling of airway size with relief of dyspnea/drainage of obstructive pneumonia) were obtained in 12 of 13 patients with bronchogenic carcinoma managed initially with the laser, and in 22 of 32 (69 percent) patients with recurrent malignancies. There were five minor and seven major complications, including two deaths. We conclude that laser treatment can relieve central airways obstruction with its associated symptoms of dyspnea and infection. Avoidance of complications requires a skillful approach, careful anesthetic management, and availability of back-up posttreatment intensive care. PMID- 3971752 TI - Bronchial and transbronchial lung biopsy without fluoroscopy in sarcoidosis. AB - Sixty-eight patients with a clinical diagnosis of sarcoidosis underwent flexible fiberoptic bronchial and transbronchial lung biopsies without the aid of fluoroscopy. Close observation of the normal respiratory excursions of the distal tracheobronchial tree and tactile sensations were found to be helpful in preventing pleural rupture. Sarcoidosis was histologically confirmed in bronchial or transbronchial tissue (or both) by this technique in 51 (76 percent) of 67 patients. Only a single pneumothorax and no significant bleeding resulted from this procedure. In the hands of experienced physicians, peripheral bronchial biopsies and transbronchoscopic lung biopsies are safe and accurate procedures even when performed in institutions where fluoroscopy is not immediately available. PMID- 3971753 TI - Right ventricular dysfunction in acute inferoposterior myocardial infarction. An echocardiographic and isotopic study. AB - We analyzed right ventricular (RV) regional wall motion by two-dimensional echocardiographic (2D echo) and multigated acquisition radionuclear (MUGA) studies in 104 patients with acute inferoposterior myocardial infarction (AIPMI). Sixty-eight patients (65 percent) had 2D echo RV regional wall motion abnormalities (RV dysfunction(RVD) group) while 36 patients showed no 2-D echo RV regional wall motion abnormalities (no-RVD group). The RVD group had a higher incidence of jugular venous engorgement (p less than 0.05), Kusmaul's sign, (p less than 0.05) complete atrio-ventricular block (p less than 0.05), and in hospital death (p less than 0.02). The RVD group had significantly higher 2-D echo RV end-systolic dimensions (p less than 0.005) and lower values of percentage of fractional shortening (%FS) (p less than 0.005) in the long and short axis of the RV four-chamber view than patients in the no-RVD group and a control group of 20 patients with normal hearts. There was no statistical significant difference in the 2-D echo RV end-diastolic dimensions among the three groups. Patients in the RVD group had a lower MUGA derived RV ejection fraction (EF) than patients in the no-RVD and control groups (26.5 +/- 13.2 vs. 46.3 +/- 7 and vs. 50.6 +/- 4, respectively; p less than 0.05). RVD was diagnosed by both 2-D echo and MUGA in 60 of 104 patients (57.7 percent) with a sensitivity for 2-D echo of 92 percent and 79 percent specificity (when compared to the MUGA study). The predictive value for a positive test was 88 percent and for a negative test 86 percent. The accuracy was 87.5 percent. Recognition of regional wall motion abnormalities by 2-D echo permits a prompt and accurate bedside identification of right ventricular dysfunction (RVD) within the first 72 hours of clinical onset. An enlarged RV 2D echo end-diastolic dimension was not a sensitive parameter for the diagnosis of this pathology, whereas an increased end systolic RV diameter and decreased RV %FS were better indicators of RV dysfunction in patients with acute inferoposterior wall myocardial infarction. PMID- 3971754 TI - Radionuclide angiography in the quantitation of mitral regurgitation. AB - First pass radionuclide angiography (RA) was used to assess its ability to detect and quantitate the presence of left-sided regurgitation due to isolated mitral regurgitation (MR). In this study the nuclear regurgitant fraction (NRF) obtained from first pass RA was correlated with the results of contrast ventriculography (CV) in 50 patients, 18 with and 32 without MR. The correlation between CV and RA in the confirmation and quantification of isolated MR revealed a sensitivity of 100 percent and a specificity of 97 percent in patients with LVEF greater than or equal to 35 percent. PMID- 3971755 TI - The effect of caffeine on cardiac rate, rhythm, and ventricular repolarization. Analysis of 18 normal subjects and 18 patients with primary ventricular dysrhythmia. AB - To determine clinical electrophysiologic effects of a moderate dose of caffeine, we compared prevailing cardiac rhythm and rate, the prevalence and frequency of ventricular dysrhythmia, and Q-T intervals in two populations over an initial 24 hour caffeine-free period and a subsequent 24-hour period in which caffeine was ingested in a dosage of 1 mg/kg of body weight at intervals of one half-life during waking hours. Group 1 was composed of 18 clinically normal subjects; group 2 was 18 subjects with frequent ventricular ectopic beats (VEBs) and no (n = 16) or minor (n = 2) cardiac disease. Sinus rhythm was the prevailing rhythm in all subjects at all times. For group 1, the mean sinus rate during the caffeine-free period was 77 +/- 10 beats per minute, compared to 73 +/- 9 beats per minute during the period of caffeine ingestion (not significant). Similarly, for group 2, the average sinus rate during the caffeine-free period was 76 +/- 11 beats per minute, not significantly different from the average sinus rate during the test period, 76 +/- 10 beats per minute. During abstention from caffeine, four of 18 subjects in group 1 had infrequent (less than 1/hr) VEBs, compared to nine of 18 during caffeine ingestion (not significant). In group 2, some 16 of the 18 subjects had VEBs during the caffeine-free period, with the frequencies varying from less than one VEB per hour to 1,449 VEBs per hour. During the test period, 14 of the 18 subjects in group 2 increased their VEB frequency, and the group's mean frequency rose from 207 +/- 350 VEBs per hour (control period) to 307 +/- 414 VEBs per hour (test period) (p less than 0.01). The Q-T interval in group 1, measured as the corrected Q-T interval (Q-Tc), averaged 0.430 +/- 0.027 during the caffeine-free period, not significantly different from the test period (0.425 +/- 0.019). The comparable Q-Tc values for group 2 were 0.424 +/- 0.018 during the caffeine-free period and 0.433 +/- 0.025 for the period of caffeine ingestion (not significant).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971756 TI - Treatment of theophylline toxicity with oral activated charcoal. AB - We treated 14 patients who had an initial serum theophylline concentration greater than 30 micrograms/ml (48.3 +/- 19.4 micrograms/ml) and symptoms of theophylline toxicity with oral activated charcoal (OAC). Thirty-gram doses of OAC were administered approximately every two hours for two to four doses. Ten patients tolerated OAC and demonstrated a reduction in theophylline half-life to 5.6 +/- 2.5 hours with resolution of symptoms. Three of these ten patients were treated in the emergency department and discharged, making hospitalization unnecessary. The four patients with the highest initial theophylline concentrations (76.6 +/- 17.7 micrograms/ml) vomited all doses of OAC. Three of these four patients were treated with charcoal hemoperfusion with a reduction in the half-life to 5.2 +/- 1.0 hours. These data support the use of OAC as the primary therapeutic modality in the management of patients with theophylline toxicity. Patients with very high theophylline concentrations (greater than 50 micrograms/ml), however, usually vomit the OAC and may require charcoal hemoperfusion. PMID- 3971757 TI - Roentgenographic and clinical staging of allergic bronchopulmonary aspergillosis. AB - Allergic bronchopulmonary aspergillosis (ABPA) is a disease of asthmatics that follows a protracted course. When ABPA is treated with high dose corticosteroids, it presents a difficult problem in clinical management. Five stages, based on clinical, roentgenographic, and immunologic criteria, have been identified as follows: (I) acute, (II) remission, (III) exacerbation, (IV) corticosteroid dependent asthma, and (V) pulmonary fibrosis. We studied 24 ABPA patients actively followed for up to 11 years at our institution. We conclude that while there are no unique roentgenographic findings to define a particular stage, clinicoroentgenographic staging does aid in therapeutic management. Two major roentgenographic contributions are (1) to establish the diagnosis by demonstrating proximal bronchiectasis, and (2) to provide a baseline for an individual patient against which to monitor progressive changes and remissions. PMID- 3971759 TI - Multiple puncture skin test and mantoux test in Southeast Asian refugees. AB - Skin test reactions to PPD applied by Mantoux techniques were compared with reactions to tuberculin tine test (PPD-tine); tuberculin, old tine test (OT tine); Aplitest; and Mono-Vacc, tuberculin, old (Mono-Vacc) in newly arrived refugees from Cambodia and Laos. The reaction to Mantoux test was accepted as the "true reading" and compared to the reaction size to one of the multiple puncture tests (MPT). A 2 X 2 table was constructed and sensitivity, specificity, false negative, and false positive rates computed over a broad range of cut-off points for MPT. The MPTs were very sensitive (100 percent to 78 percent) but lacked specificity (78 percent to 18 percent) when a cut-off of 1 mm was used. Predictably, as the cut-off is moved to larger reactions, sensitivity decreases and specificity increases. The relationship between the two is emphasized in a receiver-operator characteristics analysis. The MPTs are not intended for diagnostic use. Reaction to the MPT should be interpreted with the same careful consideration that clinicians use to interpret reactions to the Mantoux test. PMID- 3971758 TI - Multifocal Purkinje-like tumor of the heart. Occurrence with other anatomic abnormalities in the atrioventricular junction of an infant with junctional tachycardia, Lown-Ganong-Levine syndrome, and sudden death. AB - A 13-month-old boy with intermittent preexcitation (Lown-Ganong-Levine type) and paroxysmal tachycardias of 280 to 300 beats per minute died suddenly with cardiac arrest. At necropsy the only abnormalities were in the heart. There were multifocal Purkinje cell tumors in the conduction system, including one directly at the bifurcation of the His bundle. In addition, a fault in the central fibrous body was filled with an accessory communication between the mid-portion of the atrioventricular node and both the interventricular septum and the His bundle. This accessory communication connected with the Purkinje cell tumor. Although an atrioventricular nodal bypass was thus present and could account for the preexcitation and for reentrant tachycardias, there is also the anatomic basis for an automatic arrhythmia originating within one or more of the Purkinje cell tumors, particularly the one directly within the His bundle. Dispersion of elements of the conduction system within the central fibrous body resembled the normal fetal pattern. Whether this persistence of fetal dispersion of the atrioventricular node and His bundle within the central fibrous body is causally related to the presence of multifocal Purkinje cell tumors or is only coincidence merits further consideration. PMID- 3971760 TI - Carcinomatous and tuberculous pleural effusions. Comparison of tumor markers. AB - As an aid in the differential diagnosis of exudative pleural effusions, tumor markers were investigated. We measured immunosuppressive acidic protein (IAP), carbohydrate antigen 19-9 (CA 19-9), tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), adenosine deaminase (ADA), and alpha 1-acid glycoprotein (AGP) in the pleural fluid of 36 patients with carcinomatous pleural effusions and of 35 patients with tuberculous pleurisy because we have frequently found these diseases to be associated with exudative pleuritis. Tuberculous pleural effusions had significantly higher levels of IAP, ADA, and AGP than carcinomatous effusions (p less than 0.005). On the other hand, CEA, CA 19-9, and TPA were significantly higher in carcinomatous pleural fluids than in tuberculous fluids (p less than 0.05). There was a correlation between IAP and AGP levels, and their specificity was low. Therefore, combined assays of CEA, CA 19-9, and ADA may be useful in distinguishing pleural effusions due to malignancies from those of tuberculous origin. PMID- 3971761 TI - Ten-year experience with mycetomas in patients with pulmonary tuberculosis. AB - We studied 33 consecutive patients with tuberculous pulmonary cavities complicated by fungus balls to evaluate their treatment. Nineteen had surgical resection for massive or recurrent bleeding or possibility of tumor. One patient died of postpneumonectomy empyema (30-day surgical mortality, 5 percent). Fourteen had no surgery. No patient died of hemoptysis. Respiratory failure contributed most often to death. Hepatic complications and other problems of alcoholism were also prominent. Good results can be obtained by resection in these severely ill patients if care is taken to preserve functioning pulmonary tissue and to avoid complications of alcoholic hepatic disease. Within these constraints, tuberculous cavities complicated by mycetomas should be resected for massive or recurrent hemoptysis. PMID- 3971762 TI - Changes in distribution of lung perfusion and ventilation at rest and during maximal exercise. AB - A new method for evaluation of changes in the distribution of pulmonary perfusion and ventilation during exercise was applied to normal male volunteers. Ventilation and perfusion scans were done with the subjects seated on a bicycle ergometer. The resting studies utilized krypton 81 (81mKr) for ventilation and technetium 99m (99mTc) macroaggregate albumin intravenously for perfusion. Exercise studies were done when 80 percent of maximum predicted heart rate was maintained for five minutes and utilized 81mKr for ventilation and a tenfold dose of 99mTc for perfusion. Higher dose of 99mTc would minimize the effect of radioactivity left over from the resting study. This method allowed us to assess changes in ventilation and perfusion in normal subjects induced by exercise, but may also be applicable in a variety of cardiopulmonary conditions that affect pulmonary ventilation and perfusion or both. PMID- 3971763 TI - Evidence of lymphocyte alveolitis in Crohn's disease. AB - Cellular characteristics of bronchoalveolar lavage (BAL) were investigated in 18 consecutive patients with Crohn's disease, who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count and cellular viability of alveolar macrophages did not differ significantly between patients and control subjects. Percentage of alveolar lymphocytes was increased in 11 of 18 patients (from 18 percent to 79 percent). There was no apparent correlation between BAL differential cell count and abnormal pulmonary function tests noted in 11 patients, drug treatment or Crohn's disease site, and activity. These results demonstrate a high proportion of latent lymphocyte alveolitis as assessed by BAL, suggesting a latent involvement of the lung in Crohn's disease. PMID- 3971764 TI - Remission of invasive thymoma due to chemotherapy. Two patients treated with cyclophosphamide, doxorubicin, and vincristine. AB - Information regarding the effectiveness of chemotherapy in cases of invasive thymoma is limited. Two patients in whom the combination of cyclophosphamide, doxorubicin, and vincristine produced remission of invasive thymoma are described. The durations of remission were eight and seven months, respectively. In both patients, recurrence was observed at the site of bulky disease, and a secondary complete response continuing for 37 months was achieved in one of them with radiation therapy. PMID- 3971765 TI - A new pendant storage oxygen-conserving nasal cannula. AB - With increasing interest in reducing the cost of oxygen therapy, we recently designed an oxygen-conserving cannula. It reduces the oxygen supply flow necessary to achieve adequate oxygen saturation, but because it requires the use of a reservoir situated under the nose, some patients find it obtrusive. We therefore designed a similar system but displaced the reservoir away from the face and onto the anterior chest wall where it could be hidden from view by the patient's clothing. We evaluated this pendant conserving nasal cannula (PNC) in seven hypoxemic patients with chronic obstructive pulmonary disease. We compared oxygen saturations achieved using the PNC vs the standard steady flow nasal cannula (SNC) at 0.5 through 4 L/min. The mean improvement in oxygen saturation using the PNC vs the SNC was 3.3 percent at 0.5 L/min, 4.3 percent at 1 L/min and 3.1 percent at 2 L/min. These differences were statistically significant (p less than 0.001). The saturation achieved by the PNC at 0.5 L/min was equivalent to that achieved by the SNC at 1.8 L/min. We conclude that the PNC provides effective oxygen delivery to patients at supply flows substantially less than the SNC. The device is aesthetically acceptable to patients and its widespread use in patients requiring chronic oxygen therapy could bring about significant financial savings. PMID- 3971766 TI - Computed tomography of the heart and great vessels. PMID- 3971767 TI - Fuel chip-induced hypersensitivity pneumonitis caused by penicillium species. AB - Two cases of Penicillium-induced hypersensitivity pneumonitis in farmers handling fuel chips are presented. Attention should be paid to safe handling of all types of solid fuel (wood, chips, and peat) and other materials in which mold may grow. PMID- 3971768 TI - Bronchial atresia associated with a bronchogenic cyst. Evidence of early appearance of atretic segments. AB - We report a case of congenital lobar emphysema in an adult due to bronchial atresia and presenting characteristically with a solitary pulmonary nodule due to a mucous plug. In the same patient the presence of a bronchogenic cyst leads to a hypothesis that the atretic segment is the result of an insult occurring during the 5th or 6th week of intrauterine life rather than one occurring after airway development is complete. PMID- 3971769 TI - Sleep apnea in amyloidosis. AB - Obstructive sleep apnea (OSA) occurs in patients with narrowing of the pharyngeal airway due to a variety of pathologic conditions. We documented obstructive and mixed sleep apnea in a patient with narrowing of the airway caused by macroglossia associated with amyloidosis. Tracheostomy relieved the symptoms of OSA (hypersomnolence, confusion upon awakening, and hyperkinesis during sleep) despite the emergence of striking central sleep apnea following the procedure. PMID- 3971770 TI - Charcoal-containing empyema complicating treatment for overdose. AB - A 25-year-old man was treated with gastric lavage and activated charcoal for alcohol and drug overdose; immediately following the initial treatment he developed tension pneumothorax successfully managed with a chest tube. The patient presented four weeks later with a charcoal-containing empyema, an unreported condition heretofore. PMID- 3971771 TI - Chronic lung disease in cotton textile workers. PMID- 3971772 TI - Carboxyhemoglobin levels in banked blood. PMID- 3971773 TI - Limitations to quality control materials for CO-oximeters. PMID- 3971774 TI - Bronchoalveolar lavage and gold salt-induced pneumonitis. PMID- 3971776 TI - Chlorothiazide relieves asthmatic wheezing. PMID- 3971775 TI - Upper airway obstruction in Guillain-Barre syndrome. PMID- 3971777 TI - Infection with clindamycin-resistant bacteroides uniformis. AB - We report a case of osteomyelitis due to a strain of Bacteroides uniformis highly resistant to clindamycin. The patient failed to respond to intravenous clindamycin therapy and eventually required amputation. This is the first documented occurrence of high-level clindamycin resistance in a clinical isolate of B. uniformis. PMID- 3971778 TI - Chemotherapy of systemic murine infection due to beta-lactam antibiotic 'tolerant' and non-'tolerant' Staphylococcus aureus. AB - Two in vitro beta-lactam antibiotic (oxacillin, cefotaxime) 'tolerant' (MBC:MIC ratios = greater than 32) strains of Staphylococcus aureus served to intraperitoneally infect cyclophosphamide-pretreated (leukopenic) NMRI mice. With larger bacterial inocula (approximately 5 X 10(8) CFU) neither oxacillin nor gentamicin or netilmicin yielded optimal chemotherapeutic results. Only combination chemotherapy, in particular oxacillin combined with netilmicin, consistently reduced mouse mortality significantly (p less than 0.001). In contrast, moderate 'tolerant' staphylococcal inocula (approximately 2 X 10(8) CFU) were amenable to chemotherapy with either oxacillin or netilmicin, but not with cefotaxime or gentamicin. Oxacillin combined with either gentamicin or netilmicin resulted in significantly lowered murine mortality rates (p less than 0.001). Cefotaxime combined with either aminoglycoside antibiotic gave less satisfactory results. Systemic murine infections due to three non-'tolerant' strains of S. aureus were amenable to chemotherapy with oxacillin, cefotaxime or netilmicin alone and to combination chemotherapy. It is recommended that cases of life-threatening S. aureus infection, not complicated by acute endocarditis, initially be treated with oxacillin plus netilmicin until availability of laboratory results (antibiogram, documentation of 'tolerance'). PMID- 3971780 TI - On the art of caring. PMID- 3971779 TI - An enigma: the world of the child aphasic. AB - This glimpse into the reality of a child aphasic--a child with a problem whose cause, diagnosis, remedy, and prognosis are undefined--points to the need for further research and understanding of children who elude categories of treatment, yet must be helped to face the ineluctable tasks of adulthood. PMID- 3971782 TI - A tool for selecting residential child care workers: an initial report. AB - What strengths and talents make an outstanding child care worker? How can these qualities be measured? How can one predict whether an individual will succeed as a child care worker? The authors attempt to answer these questions by focusing on the "life themes" of highly rated child care workers and using a technique to measure these themes. PMID- 3971781 TI - Termination visits in closed adoptions. AB - Although either voluntary or involuntary termination of parental rights may be in a child's best interests, it is understandably difficult for a child to cope with final separation from parents. A "goodbye visit" can greatly help the separation process for both the child and the parents. PMID- 3971783 TI - Planning for group child care services: the "limited rationality" approach. AB - In the planning of services, the group child care agency faces many of the same issues as other human service organizations. The author analyzes one effort to improve the quality of service planning in two states through the training of key actors from group child care agencies. The experience led to conclusions about the risks of change and the usefulness of the rational model of decision making. Recommendations are offered for the introduction of planning concepts to key actors in agencies. PMID- 3971784 TI - [Operative technic on the hip: osteosynthesis or prosthesis]. PMID- 3971785 TI - [Ender nailing--pro and contra]. PMID- 3971787 TI - [Endoscopic occlusion treatment in patients with chronic pancreatitis]. AB - Between 1980 and 1983 an endoscopic occlusion of pancreatic duct was performed in 12 patients with chronic pancreatitis. In 4 patients it could be achieved a complete, in 8 patients only a partial occlusion. Four patients became free of pain whereas 5 patients have been operated on following an aggrevation of disease. After one year diabetes mellitus developed in 2 patients. We conclude that the endoscopic occlusion of the pancreatic duct may be recommended in some patients with defined diagnosis and special duct constellation. PMID- 3971788 TI - [Endoscopic necrosectomy with mediastinoscope following laparostomy for necrotizing pancreatitis]. PMID- 3971786 TI - [Autotransplantation of cold preserved human parathyroid gland tissue. Indications--technic--results]. AB - Autotransplantation of cryopreserved tissue is of increasing clinical value after parathyroid surgery became more common. The results in the literature show a high rate of non functioning grafts after autotransplantation of cryopreserved tissue in comparison to fresh autografted tissue. The reason for that is a partial necrosis of the tissue caused by the freezing and thawing process. To obtain better results after autotransplantation of cryopreserved tissue the rate of necrosis should be estimated. The loss of functioning cells should be compensated by autografting a greater amount of tissue fragments. PMID- 3971789 TI - [Surgical treatment of follicular thyroid gland cancer with obstruction of the upper airway and esophagus]. PMID- 3971790 TI - [Acute abdomen in congenital wandering spleen with complete pedicle torsion in childhood. Case report]. PMID- 3971791 TI - [Responsibility for optimal care and maximal information to the patient]. PMID- 3971792 TI - [Dynamic hip screw]. PMID- 3971793 TI - Gracilis muscle transposition in the treatment of fecal incontinence. Long-term follow-up and evaluation of anal pressure recordings. AB - The results after gracilis muscle transposition were studied in ten patients with a follow-up of six months to 17 years. Nine patients were continent for formed feces and the condition of one patient worsened after operation. Anorectal manometry was performed in eight of the ten patients. Evaluation of pressure recordings showed a normal image, both at rest and at maximal squeeze, in five patients. Low-pressure recordings at rest and at maximal squeeze were seen in two continent patients, in whom the tissue scarring resulted in narrowing of the anal canal. One patient with low-pressure recordings was completely incontinent. An attempt was made to explain the continence and low-pressure recordings. The results suggest gracilis muscle transposition to be a method of choice in patients with total incontinence who have no functional and sphincter. PMID- 3971794 TI - T-antigen expression by peanut agglutinin staining relates to mucosal dysplasia in ulcerative colitis. AB - Staining of 326 rectal mucosal biopsies from ulcerative colitis patients with peanut agglutinin (PNA), which binds to the T-blood group antigen and has been claimed to reflect a cancer-associated mucin alteration, showed highly significant direct associations with mucosal dysplasia (P less than 0.001), disease activity (P less than 0.001), and subsequent development of rectal cancer in a smaller series of patients (P = 0.005). Staining for normal colonic mucin by the Dolichos biflorus (DBA) lectin related significantly and inversely to dysplasia. Intense normal colon mucin staining by DBA related significantly (P less than 0.025) to long disease duration and to subsequent development of cancer (P = 0.02). The latter association is based on a small number of patients only and is not considered conclusive evidence, but may provide a link with goblet cell hyperplasia. The authors conclude that although T-antigen expression relates to dysplasia, the findings of "false" positive and negative rates of 22 and 33 percent respectively, make it unlikely that staining of biopsy sections for the T antigen by peanut agglutinin will contribute materially to routine assessment for dysplasia and cancer risk prediction in patients with ulcerative colitis. PMID- 3971795 TI - The totally implantable infusion pump in treatment of metastatic colorectal cancer. AB - Final evaluation of the Infusaid Pump system (Infusaid Corporation, Sharon, MA) for administration of regional chemotherapy must await completion of trials prospectively comparing survival of matched patients treated in this manner and patients treated by traditional systemic chemotherapy. A review of the current medical literature confirms our personal experience that response rates within the liver are high. Survival reports appear encouraging but this may represent an artifact in patient selection. An algorithm is presented to offer surgeons a reasonable and conservative means for selection of those colorectal cancer patients with metastatic involvement of the liver who are most likely to benefit from this system of drug delivery. PMID- 3971796 TI - The correlation between cholecystectomy and fecal bile acids, and large-bowel cancer induced with 1,2-dimethylhydrazine in mice. AB - The relationship between cholecystectomy and large-bowel cancer development was investigated in animal models. Female ICR mice underwent cholecystectomy, and received 15 weekly intragastric administrations (Experiment 1) or 10 weekly subcutaneous injections (Experiment 2) of 15 mg/kg body weight of large-bowel carcinogen 1,2-dimethylhydrazine (DMH). Autopsy at 28 weeks after surgery showed that cholecystectomized mice had a nonsignificantly increased incidence of large bowel carcinomas, compared to sham-operated and/or unoperated control mice (85 vs. 64 percent in Experiment 1; 31 vs. 16 and 20 percent in Experiment 2). Cholecystectomy alone without DMH treatment did not produce any cancer. Cholecystectomized mice excreted a significantly increased level of primary bile acids but an unchanged level of secondary bile acids in the feces, compared with unoperated control mice. It is obvious that cholecystectomy enhanced the development of DMH-induced, large-bowel carcinomas along with the change of fecal bile acid composition, suggesting that changes of bile acid metabolism after cholecystectomy may enhance or promote large-bowel carcinogenesis in man as well. This association of cholecystectomy and large-bowel cancer is not a strong one, however, as presented in epidemiologic as well as experimental studies. PMID- 3971797 TI - Mucosal proctectomy and ileostomy as an alternative to conventional proctectomy. AB - Endoanal mucosal proctectomy with preservation of the anal sphincters has been employed as an alternative to the traditional method of rectal excision in 23 patients with ulcerative colitis or Crohn's disease. Ten patients in whom the anal canal was left open and drained had uneventful postoperative courses. Of the remaining 13 patients in whom the top of the anal remnant was oversewn, four had local pelvic sepsis that resolved in a few weeks' time and one patient had a pelvic hematoma requiring relaparotomy and sphincter muscle excision. Postoperative disturbances in bladder or sexual function did not occur in any of the patients. At the latest follow-up (mean 21 months), all patients were fully satisfied with the result of the operation. On proctoscopic examination, an anal remnant, measuring approximately 3 cm from the anal verge, could be demonstrated. Its upper end had healed with a fibrous scar in 50 percent of the patients, whereas a small area of friable granulation tissue, sometimes with a short sinus tract was still observed in the others. The persistence of such lesions was associated with minor mucous discharge occasionally escaping from the anal canal. Biopsies disclosed regeneration of cylindric and transitional types of epithelium. The fate of these epithelial remnants remains to be seen. Endoanal mucosal proctectomy appears to be an attractive alternative to the conventional technique. It prevents a great deal of morbidity and enhances postoperative rehabilitation. PMID- 3971798 TI - Free perforation in Crohn's colitis. A ten-year review. AB - A review of 198 patients with Crohn's disease of the colon who presented over a ten-year period identified six patients with free perforation of the colon (3 percent). Five were females and all were known to have pre-existing Crohn's disease. Four were taking oral corticosteroids at the time of perforation. The sole male presented with acute toxic dilatation of the colon and had not received previous steroids. Pneumoperitoneum was seen in five of the six patients. Subtotal colectomy with ileostomy appears to be the optimum treatment in patients presenting with this complication of Crohn's disease. PMID- 3971799 TI - Use of Angelchik Anti-Reflux Prosthesis for repair of total rectal prolapse in elderly patients. AB - A modification of the technique suggested by Hopkinson for the repair of rectal prolapse via the perineal route is described. This technique involves the use of an Angelchik Anti-Reflux Prosthesis and is particularly suitable for elderly patients in whom abdominal rectopexy would be hazardous because of general health. PMID- 3971800 TI - The long-term results of excisional surgery for primary and recurrent Crohn's disease of the large intestine. AB - Two-hundred and seven survivors of excisional surgery for primary Crohn's disease of the large intestine have been followed for a mean period of 15 years (range, 7 to 25 years). Of the 45 patients who were treated by colectomy and ileorectal anastomosis, 32 (71 percent) developed recurrence in the terminal ileum, rectum, or ileum and rectum, (and in the duodenum in one). Most recurrences appeared during the first few years, but there appeared to be some continuing predisposition to recurrence indefinitely. Nineteen of the patients with recurrences proceeded to rectal excision and ileostomy. A total of 17 patients (3 percent) with or without recurrence had good functional results with a retained ileorectal anastomosis. Of the 162 patients who were treated by ileostomy and colectomy or proctocolectomy (rarely rectal excision and iliac colostomy), 24 (14.8 percent) had recurrences, usually in the bowel immediately above the stoma and, occasionally, more extensively elsewhere. Most recurrences manifested themselves in the first eight to ten years after operation, and the continuing predisposition thereafter was relatively slight. The inconvenience occasioned by the stoma in these 162 patients was rated as nil in 36.4 percent, negligible in 33.3 percent, moderate or severe in 25.3 percent, and ileostomy refashioning was performed in 5.0 percent with improvement in most instances. The overall condition of the 162 patients was considered to be excellent in 71 percent, fair in 22.8 percent, and poor in 6.2 percent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971802 TI - Fistulography for fistula-in-ano. Is it useful? AB - In order to assess fistulography for anal fistula, 25 fistulograms were reviewed. The results as for extensions and internal openings were compared with the surgical findings. Fistulograms were correct in only 16 percent. False-positive results occurred in 10 percent. Fistulography is inaccurate and unreliable. PMID- 3971801 TI - Keyhole deformity. Fact and fiction. AB - The purpose of this paper is to show whether there is a keyhole deformity, its surgical significance, and how often it occurred following surgery for ulcer-in ano. To do this, a retrospective study, over a 16-year period, of all patients admitted to the Ferguson Clinic with chief complaints of anal incontinence was undertaken. Of this group of patients, seven were identified as having questionable keyhole deformities, three of whom probably had classic defects. There were six females and one male. Only two of the deformities were associated with surgery for ulcer-in-ano. One of these was easily repaired and the other patient had a full rectal prolapse. In addition, of 186 patients undergoing fistula surgery, 77 who had posterior midline transsphincteric fistulas were studied and ten of these patients went on to complete recovery without any permanent problems resulting from severance of the sphincter. It can generally be concluded that, although there is such a defect as the keyhole deformity, it occurs only rarely, especially after surgery for ulcer-in-ano, and that many times it is not associated with anal incontinence. PMID- 3971803 TI - Parks' coloanal pull-through anastomosis for severe, complicated radiation proctitis. AB - A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum. PMID- 3971804 TI - Simultaneous occurrence of sigmoid and cecal volvulus. AB - A rare case of simultaneous sigmoid and cecal volvulus in a 60-year-old man is documented. The development of both conditions in the same patient simultaneously has not been reported previously. PMID- 3971805 TI - Isolated metachronous metastases to soft tissues of the buttock from a colonic adenocarcinoma. AB - The more common patterns of dissemination and recurrence of colonic cancer are known and well-documented. In contrast, extravisceral, distant soft tissue metastases are comparatively rare. Therefore, these metastases are not subject to meaningful generalizations, with the exception that they are often associated with widespread metastatic disease. This report describes the first case of carcinoma of the colon metastatic to the skeletal muscle of the contralateral buttock and the sciatic nerve without concurrent evidence of pelvic or distant metastases. Curative resection was not possible because of involvement of the proximal sciatic nerve. PMID- 3971806 TI - Prevention of colostomy in partial colonic obstruction by intraoperative rectal tube irrigation. AB - Four patients with partial obstruction of the colon, in whom adequate standard preparation for colonic resection was not possible, are presented. Clinically, these patients did not show sufficient signs of obstruction to require a preliminary colostomy. A technique of quarantining the area of tumor resection from the abdominal cavity is described, allowing for adequate preparation of the colon lumen at the site of anastomosis. After completion of the anastomosis, a large caliber (36 French) colonic tube is inserted, per rectum, through the anastomosis and the proximal colon irrigated with Betadine solution adequately emptying and sterilizing the lumen of the bowel to allow for primary anastomosis without a protective colostomy. The criteria for selection of patients for this technique are discussed. No complications, of significance, ensued. This method of intraoperative rectal tube irrigation, for prevention of colostomy in partial colonic obstruction, is safe when properly performed in the appropriate patient. PMID- 3971807 TI - Adenocarcinoma and colitis cystica profunda in a radiation-induced colonic stricture. AB - A case of adenocarcinoma of the rectum occurring 17 years after pelvic irradiation for squamous carcinoma of the cervix is reported. Earlier colonic resection had shown localized colitis cystica profunda in a radiation-induced colonic stricture. Colorectal cancer is an infrequent sequel to radiotherapy, which may occur many years after treatment of the primary tumor. Prolonged follow up of these patients is essential. PMID- 3971808 TI - Late failure of a stapled small-bowel exclusion procedure. AB - Late failure of a stapled small-bowel exclusion without transection of the bowel resulted in recurrence of an enterovaginal fistula. This necessitated reoperation and division of the small bowel, following which the patient has remained well. A review of the literature indicates that this problem might occur in similar procedures and suggests that the bowel should not only be cross stapled, but transected when performing exclusion procedures. PMID- 3971809 TI - Sigmoid diverticulitis with perforation and generalized peritonitis. AB - Sigmoid diverticulitis with perforation and generalized peritonitis is a grave complication of diverticular disease. To compare accurately the results of two operative approaches--proximal colostomy with drainage and proximal colostomy with resection or exteriorization--the authors assessed the clinical and pathologic features of 121 consecutive patients with perforating sigmoid diverticulitis. There were no differences between treatment groups in age, sex, mean duration of symptoms, clinical presentation, number of coexistent diseases, type of peritonitis or chronic corticosteroid use. Overall mortality for emergency operation was 12 percent. Mortality was significantly greater (P less than 0.05) among the 31 patients treated by colostomy and drainage (26 percent) than among the 90 patients treated by colostomy and resection or exteriorization (7 percent). Seven of the nine patients who died from persistent sepsis had undergone colostomy and drainage. Four clinical factors were found to be predictive of mortality (P less than 0.05): persistent postoperative sepsis, fecal peritonitis, preoperative hypotension, and prolonged duration of symptoms. These factors identified a subgroup of patients who, because of an increased risk of death, would be likely to benefit from the more complete eradication of the septic focus that is achieved by colostomy and resection. PMID- 3971810 TI - Endorectal ileal pull-through for ulcerative colitis and polyposis in children. AB - The marked reluctance to leaving a permanent ileostomy in a child is understandable; too often, however, before surgical therapy is accepted, the patient is permitted to decline to a hopeless state from which restoration is virtually impossible without operation. Endorectal ileal pull-through provides an attractive alternative. From 1972 to 1982 at Children's Hospital, G. Gaslini Institute, Genoa, nine patients with ulcerative colitis and eight patients with familial polyposis received this operation. Results are encouraging and support the more frequent use of this alternative. PMID- 3971811 TI - Anal incontinence following obstetrical injury. AB - Insufficient attention has been given to the anatomical anomaly as a predisposing factor for obstetrical injury. The operative approach and results in 28 patients indicate that excellent function can be achieved by recognition of the deformity and by the appropriate repair. PMID- 3971812 TI - Gastroduodenal polyps in familial polyposis coli. AB - A total of 26 patients with familial polyposis coli without extracolonic manifestations were examined by gastroduodenoscopy. Histologically verified polyps were found in 18 patients (69 percent, 95 percent confidence limits 48 86). Gastric adenoma was diagnosed in one patient, fundic gland polyposis in six patients, and duodenal adenomas in 12 patients. It is concluded that the incidence of gastroduodenal polyps is independent of the clinical presence of other extracolonic manifestations. It is advisable that polyposis patients should be followed with gastroduodenoscopy and biopsy of polyps. PMID- 3971813 TI - Are postoperative fever and/or septic complications prognostic factors in colorectal cancer resected for cure? AB - The authors have examined the survival rate of 111 patients with colorectal cancer (Dukes' A, B, and C stages) treated by potentially curative surgery. In particular, the survival has been evaluated with regard to the appearance of postoperative fever and/or septic complications. The preliminary results demonstrate that these factors do not significantly influence the long-term prognosis. PMID- 3971814 TI - The management of procidentia. 30 years' experience. AB - This is a retrospective study evaluating 179 patients with complete rectal prolapse operated on at the University of Minnesota affiliated hospitals from 1953 to 1983 with no mortality. One hundred and two of 138 patients who underwent abdominal proctopexy and sigmoid resection were followed from six months to 30 years with a recurrence rate of 1.9 percent. Twenty-two of the 33 patients who underwent perineal rectosigmoidectomy were followed from six months to three years with no recurrence. Nine patients who underwent abdominal proctopexy and subtotal colectomy because of colonic inertia associated with procidentia were followed from one to six years with no recurrence. Patient interviews revealed that 72 to 80 percent considered their results as excellent or good. Incontinence or persistent constipation caused the remaining patients to consider their results fair or poor, despite anatomic correction of the prolapse. Abdominal proctopexy and sigmoid resection was more likely to result in improvement of continence than was perineal rectosigmoidectomy. PMID- 3971815 TI - Squamous-cell carcinoma of the anus. A follow-up study of 65 patients. AB - The five-year survival rate in 72 patients who underwent treatment for squamous cell carcinoma of the anus in Stockholm County (1972 to 1978) has been studied. There were no differences in survival rates after rectum-preserving treatment (mainly consisting of irradiation +/- cytostatics +/- local excision) as compared with extensive surgery (abdominoperineal resection), even if the tumor size, location, and differentiation were taken into consideration. It therefore seems appropriate to suggest irradiation +/- cytostatics as the therapy of choice regardless of size, location, and differentiation of the tumor. PMID- 3971816 TI - Mucin abnormality of colonic mucosa in patients with familial polyposis coli. A new tool for early detection of the carrier? AB - Colonic mucosa in 62 patients with familial polyposis coli (FPC) was stained by a Periodic Acid-Thionin Schiff/Potassium Hydroxide/Periodic Acid-Schiff method in which the normal colonic mucosa usually stained red and carcinoma stained blue or purple. In FPC, 82.2 percent stained blue or purple, whereas 38.8 percent stained blue or purple in normal controls. The data suggest that sialomucin properties of the normal-appearing flat mucosa in FPC are different from those of the normal colon, and that this simple technique may be useful for the early detection of high-risk individuals in the FPC family. PMID- 3971817 TI - The association of synchronous neoplasms with occluding colorectal cancer. AB - To find and eradicate synchronous neoplasms, colonoscopy was performed before and after resectional surgery in 50 patients with "occluding colorectal cancer," defined as encroachment of the lumen by tumor to a degree that prevented passage of a colonoscope. Synchronous, frequently multiple adenomas were found in 29 (58 percent) of these patients. Three patients (6 percent) had synchronous invasive cancer as well. None of these lesions was detected by intraoperative palpation, even though 46 percent of them measured more than 1.0 cm in diameter. Synchronous neoplasms were found significantly more often in patients with occluding cancer than in patients with non-occluding cancer, investigated concurrently at the same hospital. The former patients appear to be in double jeopardy with respect to synchronous neoplasms, these being more prevalent and less accessible than in patients with non-occluding tumors. Moreover, most of the synchronous lesions are undetectable by palpation. These findings bear out the importance of early postoperative, as well as preoperative, colonoscopy in all patients with occluding colorectal cancer. PMID- 3971818 TI - Patient evaluation of the conventional ileostomy. AB - A survey of 322 ileostomates was undertaken to assess the impact of an ileostomy and determine problems that are encountered by patients. Most patients (72 percent) felt they led normal lives with the ileostomy and encountered fewer restrictions in life-style than with their disease. However, only 35 percent of patients felt their ileostomies functioned perfectly. Skin irritation (49 percent), offensive noise and odor (42 percent), detection of the appliance (17 percent), and difficulty in handling the appliance (29 percent) were some of the problems encountered. Psychologic problems were related to poor body image (22 percent) and sterility or impotence (12 percent). All of these problems, however, were less than had been anticipated. Various sources of information were available to the ileostomate. However, about 50 percent of patients felt they received inadequate preoperative information or counseling. PMID- 3971819 TI - Immediate colectomy and primary anastomosis for acute obstruction due to carcinoma of the left colon and rectum. AB - A consecutive series of 35 patients with acute obstruction due to carcinoma of the left colon (29) or rectum (six) were treated by primary resection with anastomosis. The operation usually took the form of a left hemicolectomy or sigmoid resection without a proximal colostomy. There were three operative deaths (8.5 percent) due to anastomotic dehiscence, bronchopneumonia, and pulmonary embolism, respectively. Nonlethal complications occurred in ten patients (anastomotic leakage in three, a ureteric fistula in one, and wound infection in six). The mean duration of hospital stay in patients without complications was 18 days (range, 12 to 35). The morbidity and mortality in this series did not exceed the cumulative morbidity and mortality that would be expected after staged surgery. Compared with staged surgery, immediate resection and anastomosis, by avoiding the problems of colostomy and reducing the length of hospital stay, have significant advantages for the patient. PMID- 3971820 TI - The relationship between different staging methods and survival in colorectal carcinoma. AB - A routine clinicopathologic (CP) staging system for patients who have had surgical resection for colorectal carcinoma was established at Concord Hospital in 1971. Research on this prospective series of resections has evaluated the CP staging system as a guide to prognosis. The aim of this study was to compare the CP system with the classic Dukes' staging system and its modified form introduced by Astler and Coller to determine which method provided the most accurate basis for prognosis. Life table survival analysis was used to examine the survival of 709 patients according to each staging system. Relative mortality rates for groups of patients cross-classified by each possible pair of staging systems were examined and the Cox regression model was used to determine the independent effects of staging by each system on survival. The CP system was found to have a stronger association with survival than either the classic Dukes' system or the Astler-Coller modification of the Dukes' system. The importance of supplementing data on the operative specimen with data about the spread of tumor beyond the limits of surgical resection is emphasized. PMID- 3971821 TI - Total and subtotal colectomy for colonic obstruction. AB - Colectomy (total or subtotal) is not the operation of choice for elective colonic cancer unless the patient is under 50 years of age, is undergoing curative resection, and has associated adenomatous polyps. Routine colectomy is not supported when a partial obstruction prevents preparation of the colon and interferes with proximal colonic examination. Colectomy (especially subtotal) is acceptable for the acutely obstructed colon but it is technically demanding and requires experience in patient selection. PMID- 3971822 TI - Anastomotic recurrences after low anterior resection. Stapled vs. hand-sewn. AB - A retrospective study was done comparing the rates of local recurrence in cancer of the rectum treated by low anterior resection using the stapling device or hand sewn. It was found that there was no increase in recurrences when the stapler was used, even though lower lesions were treated. PMID- 3971823 TI - Embryonal carcinoma of the testis associated with familial adenomatosis coli. Report of a case. AB - A rare case of embryonal carcinoma of the testis associated with familial adenomatosis coli is reported. The patient may serve as a case to support the hypothesis that familial adenomatosis coli is a systemic or generalized disease with tumorigenicity that is not restricted to the colon and rectum, and that a total colectomy with ileostomy is not always entirely curative. PMID- 3971824 TI - Perforated granulomatous colitis caused by Histoplasma capsulatum. AB - A 57-year-old man who presented with an acute abdomen and clinically was thought to have perforated colonic diverticulitis, was found to have transmural granulomatous inflammation and perforation of colon that was caused by Histoplasma capsulatum. Although involvement of any part of the gastrointestinal tract may occur with disseminated histoplasmosis, the complication of intestinal perforation requiring emergency surgery (particularly in the colon) is extremely rare and warrants this case report with discussion of the various clinicopathologic features of gastrointestinal histoplasmosis and the occurrence of primary intestinal histoplasmosis. PMID- 3971825 TI - Ileoanal anastomosis 24 years after total proctocolectomy for ulcerative colitis. AB - The efficacy of constructing an ileal pouch in association with an ileoanal anastomosis after mucosal proctectomy has been well established. Ordinarily, the pouch is fashioned at the time of mucosal proctectomy. This report describes a patient whose end ileostomy was successfully converted to a J-pouch 24 years after intersphincteric resection of his rectum for ulcerative colitis. Postoperative anal manometric data are presented, and the potential for applying this operation to other patients who have had previous intersphincteric rectal resections is discussed. PMID- 3971826 TI - Perineal and bladder necrosis following bilateral internal iliac artery ligation. Report of a case. AB - Abdominoperineal resection with pelvic sidewall dissection is not uncommonly performed for treatment of bulky primary or locally recurrent rectal neoplasms. Usually, the internal iliac arteries and veins are ligated bilaterally early in the course of the procedure to reduce intraoperative blood loss and to facilitate subsequent dissection of the pelvic sidewalls. No complications related to bilateral internal iliac artery ligation in this setting have been described previously. In this report, profound vesical and perineal necrosis after bilateral internal iliac artery ligation occurred in a female patient operated on for recurrent rectal cancer. If the internal iliac artery is ligated below the take-off of the gluteal vessels, perineal necrosis can be prevented. PMID- 3971827 TI - Acute hemorrhagic cholecystitis causing hemobilia and colonic necrosis. AB - Hemorrhagic cholecystitis is an uncommon cause of hemobilia. A patient with hemorrhagic acalculous cholecystitis and erosion of a hematoma into the colon with fistula formation is reported and operative management is discussed. PMID- 3971828 TI - Metastasis to the parotid gland from colorectal adenocarcinoma. AB - This manuscript presents only the fifth reported case in the literature of colorectal carcinoma with metastasis to the parotid gland. A 66-year-old white woman, referred to Roswell Park Memorial Institute, presented with a left parotid mass and a past history of undergoing right hemicolectomy for an adenocarcinoma of the ascending colon with synchronous liver metastases. The clinical presentation and treatment of the patient are discussed with a review of the literature. PMID- 3971829 TI - Mucosal advancement anoplasty. PMID- 3971830 TI - Ileal J pouch-anal anastomosis. Current technique. PMID- 3971831 TI - Malnutrition after gastric surgery. Association with exaggerated distal intestinal hormone release. AB - This study was designed to investigate the mechanism of excessive weight loss following gastric surgery. Twelve weight-stable and six weight-losing postoperative subjects were studied. The weight-losing subjects had lesser body mass based upon anthropometric measurements. All weight-losing subjects and six weight-stable subjects excreted excess breath hydrogen after a standard meal. The quantities of hydrogen excreted by the weight-losing subjects and weight-stable subjects with positive tests were not different, implying similar degrees of carbohydrate malabsorption. Peak breath hydrogen concentration occurred earlier in weight-losing subjects than in weight-stable subjects (2 vs 5 hr), indicating more rapid oral-cecal transit of the test meal in weight-losing subjects. Analyses of postprandial blood samples for eight different gastrointestinal hormones demonstrated exaggerated postprandial elevations in the concentrations of enteroglucagon and neurotensin. The results of these studies demonstrate close correlations between excessive weight loss after gastric surgery, rapid gastrointestinal transit as measured by excess breath hydrogen excretion, and increased release of hormones from the distal intestine. We conclude that these hormones are secreted in excess due to the rapid gastrointestinal transit and that rapid gastrointestinal transit may play a role in excessive weight loss after gastric surgery. PMID- 3971832 TI - Human pancreatic secretory protein profiles in pancreas cancer and chronic pancreatitis. AB - Pancreatic secretory protein profiles differed significantly between patients with chronic pancreatitis (CP) and pancreatic carcinoma (CA). Specific regions of the patterns were altered when CP versus CA and when CP versus normals were compared. Bands isoelectric in the region of pH 9-11 were elevated in CP. The possible identification of this band as lactoferrin is discussed. PMID- 3971833 TI - Coordinated motor activity of the human gastroduodenal region. AB - Using real-time ultrasonic imaging, and a test meal of 500 ml of dilute orange juice, we have studied the temporal relationships among contractions of the terminal antrum, pylorus, and proximal duodenum of 22 normal subjects. A total of 259 cyclical periods of motor activity were observed. Individual mean gastroduodenal cycle times ranged from 17.9 to 29.6 seconds (2.0-3.3 cycles/min). Terminal antral contractions (TACs) were observed in 98% of cycles and pyloric closure invariably occurred at the midpoint of these contractions. The pylorus then opened as the terminal antrum relaxed and remained open until the next TAC. Only 67% of TACs were associated with contractions of the proximal duodenum (DC), but 94% of these occurred about 1 sec (range 1 sec before to 2 sec after) after pyloric closure. Only 6% of DCs were ectopic, in that their occurrence was apparently uncoordinated with the TACs. Our observations demonstrate that after ingestion of a test meal, the human terminal antrum, pylorus, and proximal duodenum usually contract in a sequential coordinated manner, presumably under the control of the gastric slow wave. No evidence of independent pyloric closure was obtained. PMID- 3971834 TI - Endoscopic manometry of the pancreatic duct and sphincter zone in patients with chronic pancreatitis. AB - A possible mechanism for pain in alcohol-induced chronic pancreatitis is increased pancreatic duct pressure. A study has been done to compare sphincter of Oddi and pancreatic duct pressures in normal controls and patients with alcohol induced chronic pancreatitis who had recently had pain or who were pain-free. Pressures were measured in the sphincter of Oddi in 10 controls and 33 patients, in the pancreatic duct in six controls and 15 patients, and in the common bile duct in four controls and five patients during station pull-through at the time of an endoscopic retrograde cholangiopancreatogram. There was no significant difference in the mean pressures in the pancreatic duct, sphincter of Oddi (basal and phasic), and frequency of papillary contraction when comparing patients with alcoholic pancreatitis and controls. There was also no difference between patients with or without pain and patients with or without strictures. This study has not confirmed the hypothesis that increased pancreatic duct pressures may be incriminated as a possible mechanism of pain in alcoholic-induced chronic pancreatitis. PMID- 3971835 TI - Increased antral G-cell number and gastrin content in dogs after massive small bowel resection. AB - The effects of massive small-bowel resection on antral gastrin tissue concentration and G-cell number have been investigated in the dog. Tissue gastrin concentrations increased significantly after resection from 16.8 +/- 2.6 ng/mg wet weight to 30.3 +/- 3.2 ng. Immunoreactive gastrin cell number also increased from 29.8 +/- 2.5 cell/mm2 to 43.1 +/- 3.0 cells/mm2. Immunocytochemistry demonstrated that the hyperplastic gastrin cells were found in small groups, with the majority of the immunoreactivity located at the luminal pole of the cells. This finding, linked to hypogastrinemia in the dogs after massive small bowel resection, suggests that some of the hyperplastic G cells may have an exocrine rather than endocrine function. PMID- 3971836 TI - Ampicillin inhibits biliary cholesterol secretion. AB - There are compounds, other than bile salts, which influence biliary lipid composition. For example, the organic anions, bilirubin, and BSP, are secreted into bile and depress biliary phospholipid and cholesterol secretion. Ampicillin is also secreted into bile, but its effects on biliary lipid secretion are unknown. Therefore we measured biliary lipid secretion before, during, and after an ampicillin infusion. We infused bile salt pool depleted rats with a constant infusion of taurocholate. After biliary lipid secretion reached a steady state, the ampicillin solution was infused in a stepwise fashion. Within minutes after starting the ampicillin, bile flow and biliary ampicillin secretion increased. Simultaneously, biliary phospholipid and cholesterol, but not bile salt, secretion decreased significantly. The calculated lithogenic index of bile decreased significantly as well. Despite doubling the ampicillin infusion, neither biliary ampicillin, phospholipid, nor cholesterol secretion changed. After discontinuation of the ampicillin, bile flow and biliary ampicillin secretion decreased, while phospholipid and cholesterol secretion returned to normal. Ampicillin dramatically influences biliary lipid composition directly. It inhibits the biliary secretion of phospholipid and cholesterol, but not bile salt, and consequently reduces the molar percentage of cholesterol in bile. PMID- 3971838 TI - The "dawn phenomenon": how do we treat it? PMID- 3971837 TI - Gastric carcinoma presenting as double-channel pylorus on upper gastrointestinal series. AB - A double-channel pylorus or gastroduodenal fistula is a rare entity frequently acquired in association with penetrating peptic ulcer disease. The diagnosis is made by upper gastrointestinal series or by endoscopy. We report a 59-year-old man who presented with gastric outlet obstruction whose upper gastrointestinal series was typical of benign peptic ulcer disease demonstrating antral ulcers and a double-channel pylorus. At operation, gastric carcinoma infiltrating the pyloric channel and dividing it into two lumens was found. No gastroduodenal fistula was found. The "gastroduodenal fistula" on upper gastrointestinal series had been created by gastric carcinoma protruding into the pyloric channel and dividing the barium flow into two streams. One can no longer assume that a double channel pylorus is due to benign ulcer disease. PMID- 3971839 TI - Granuloma annulare secondary to self-monitoring of blood glucose. PMID- 3971840 TI - Improving the accuracy of blood glucose meters that use enzymatic reagent strips. PMID- 3971841 TI - Patient evaluation of fingerstick devices. PMID- 3971842 TI - The etiology of incapacitating, brittle diabetes. AB - Incapacitated brittle diabetic subjects are a small subset of insulin-dependent diabetic individuals who are unable to maintain a normal lifestyle because of frequent disruptions secondary to severe hyperglycemic and/or hypoglycemic episodes. Thirty incapacitated patients were referred for evaluation because the cause of their diabetic instability could not be determined by their personal physicians despite extensive patient training in correct diabetes management, frequent hospitalizations for observation, and multiple diagnostic testing. From the 30 patients, a diagnostic algorithm was developed (described in the companion article) from which the etiology of brittle diabetes could be established in 29. This article provides the clinical characteristics of each of the 30 patients, a description of the etiologic categories of brittle diabetes, and the clinical follow-up from the time that the etiologic diagnosis was established and treatment recommended. Although extensive medical records were sent with each patient, without prospective objective testing under rigidly controlled conditions, the correct etiologic diagnosis would not have been evident from the clinical presentation of the patient. Of equal importance in identifying the etiology of brittle diabetes was the acceptance and cooperation of the referring physician in providing close follow-up and repeat insulin challenge testing when necessary. In this referred patient population, eight subjects had factitious disease, eight were malingering, seven had communication deficits, two had gastroparesis, two had systemic insulin resistance, two had miscellaneous causes of brittle diabetes, and one patient remained undiagnosed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971843 TI - Continuous intravenous insulin infusion in the management of brittle diabetes: etiologic and therapeutic implications. AB - Continuous intravenous insulin infusion (CIVII) was used to treat five brittle insulin-dependent diabetic women (aged 16-29 yr) who had failed to achieve satisfactory glycemic control during intensified subcutaneous insulin treatment including continuous subcutaneous insulin infusion (CSII). Insulin was infused through an indwelling central venous catheter by a portable pump for 3-16 mo. During CIVII, only three subjects obtained satisfactory glycemic control and only for short periods. Generally, as with CSII, control was erratic and unpredictable and three subjects intermittently had high insulin requirements (200 U/day). By contrast, three stable insulin-dependent diabetic subjects achieved near normoglycemia within 1-3 days of starting CIVII with daily insulin dosages of 30 90 U. The lives of all five brittle subjects continued to be disrupted by frequent hospital admissions during CIVII treatment. Deliberate interference with their own treatment (including tampering with pumps and central venous catheters) was thought to be a major contribution to instability in two of the brittle subjects. In the others, the ineffectiveness of CIVII suggests that brittleness was not due solely to defective subcutaneous insulin absorption, as had previously been suggested in other CSII-unresponsive brittle subjects. Although CIVII has reportedly been successful in managing brittle diabetes, the technique may not be useful in all brittle individuals, as illustrated by the poor glycemic responses of these subjects and the serious complications (including local infection, septicemia, and thrombosis) they suffered. PMID- 3971844 TI - Rarity of a marked "dawn phenomenon" in diabetic subjects treated by continuous subcutaneous insulin infusion. AB - We assessed the quality of overnight glycemic control and the frequency of the "dawn phenomenon" (nadir-0800 h glycemic increase) in 41 insulin-dependent diabetic patients treated by continuous subcutaneous insulin infusion (CSII). Mean plasma glucose levels were near-normal during the 24 h and, in particular, constant throughout the night. In a subset of six patients overnight plasma free insulin concentrations were also constant during CSII. The majority of profiles (88%) showed a glucose nadir from 2.0 to 5.9 mmol/L (most frequently at 0600 h) and had an 0800 h value from 2.0 to 6.9 mmol/L (92%). A large proportion (46%) of profiles showed a zero or negative nadir-0800 h glycemic increase. In 22 patients with three or more profiles recorded at the same basal insulin infusion rate, only one of 103 profiles had a fasting glycemic increase greater than an arbitrary value of 5.0 mmol/L (5.3), although many patients exhibited small dawn glycemic increases (e.g., 14 of 22 had a mean increase of from 0 to 2 mmol/L). In 12 subjects a 15% reduction in basal insulin infusion rate increased the mean +/- SEM dawn glycemic increase from 0.58 +/- 0.25 mmol/L to 2.7 +/- 0.76 mmol/L (P less than 0.025) as well as significantly increasing the nocturnal nadir and 0800 h plasma glucose concentrations. Thus, a marked dawn phenomenon is rare when a single but adequate basal infusion rate is used for CSII, and this questions the need in the majority of patients for preprogrammable pumps with nocturnal infusion rate changes. PMID- 3971845 TI - Continuous peritoneal insulin infusion with portable pumps: factors affecting the operating life of the chronic catheter. AB - Fifty-nine chronic peritoneal catheters made of polyethylene covered with silastic were used to treat 43 IDDM patients peritoneally for 3-34 mo (mean 14 mo) with portable peristaltic pumps and U40 acidic insulin. The operative life of the catheters was determined by actuarial analysis. The mechanisms of catheter failure were determined by preremoval x-ray opacification, removal under laparoscopic examination, and electron microscopic analysis of the catheter. Factors such as age, sex, duration of diabetes, implantation and tunnelization procedures, length of the catheter, and rate of infusion were analyzed. The 50% survival rate of the catheters was 16 mo. Six catheters were irreversibly obstructed by intraluminal fibrin formation and/or extraluminal adhesions, although insulin precipitation was never encountered. Seven catheters had to be removed because of a persisting local infection. Other causes were negligible (misinsertion, irreparable break). The only factor significantly related to incidence of catheter failure was gender with respect to obstruction (1 obstruction among 24 women versus 5 among 19 men, P less than 0.03). PMID- 3971846 TI - Pharmacokinetics and bioavailability of injected glucagon: differences between intramuscular, subcutaneous, and intravenous administration. AB - Pharmacokinetics and bioavailability of 1 mg glucagon injected intramuscularly (i.m.), subcutaneously (s.c.), or intravenously (i.v.) were studied in 6 nondiabetic men rendered hypoglycemic by s.c. injection of 10 U regular insulin. At 90 min after the insulin injection, when blood glucose levels had fallen to a mean of 49 mg/dl, glucagon was administered. Ten minutes later plasma glucagon levels had risen from a mean of 246 to 3233 pg/ml (s.c. experiment) and from 250 to 2638 pg/ml (i.m. experiment). Accordingly, there was no difference in blood glucose behavior whether glucagon was injected s.c. or i.m. In the i.v. experiment, plasma glucagon levels were significantly higher during the first 15 min after the glucagon injection when compared with the other experiments. The initially high levels of plasma glucagon after i.v. administration were associated with a steeper rise of glycemia during the first 5 min after glucagon injection; the maximal increase of blood glucose was, however, not different when compared with the s.c. or i.m. route of glucagon administration. Thus, in case of severe hypoglycemia, therapeutically administered glucagon will be most efficient when injected i.v., but there is no difference between the i.m. and s.c. routes of administration with regard to the efficacy to increase blood glucose levels. PMID- 3971847 TI - Use of health services by diabetic persons. II. Hospital admissions. AB - Over a 10-mo period, a computerized admission discharge system was scrutinized to identify all persons with diabetes mellitus admitted to a general hospital in Christchurch, North Canterbury (population 342,000), New Zealand. The 274 admissions by 197 diabetic persons (42% were insulin treated, 14% were newly diagnosed, 44% were non-insulin-dependent) contributed to 3.6% of the total hospital admissions, with duration of stay being longer than for nondiabetic persons (13.6 versus 11.3 days, P = 0.05). Patients admitted were aged 11-91 yr (mean 59 yr); those over 50 yr of age were numerically the largest admission group. Although cardiovascular illnesses were the most frequent events precipitating admission (34%), potentially preventable admissions for reasons of infection, poor glycemic control, or hypoglycemia were found in all age groups. Just under half of the 902 registered insulin-treated diabetic patients living in this health region had at some stage participated in diabetes education programs at the time this admission survey was undertaken. Of these, only nine were admitted. The other 70 insulin-treated patients admitted who lived in this region had never had diabetes education. Overall, only 11.7% of patients admitted had received diabetes education. These data show that, for insulin-treated diabetic individuals at least, admission rates were substantially lower among those who were sufficiently motivated to attend diabetes education programs. PMID- 3971848 TI - The use of a county hospital emergency room by diabetic patients. AB - The use of a county hospital emergency room (ER) by diabetic patients was investigated by comparing ER visits for diabetes to a sample to total ER visits over a period of 1 yr. The major problems of ER use by diabetic patients were an excessive number of visits for diabetes complications, a high rate of hospital admissions from the ER, and the high cost of ER use. Approximately 20% of visits for diabetic patients were attributed to preventable complications of diabetes. The rate of hospital admissions from the ER was over four times greater for the diabetic patients than for the random sample. The median cost of an ER visit was nearly three times higher for diabetic patients than for the random sample. These problems may be best resolved through improved access to primary care and educational services that can assist the person with diabetes in self-management and prevention of the acute complications of the disease. PMID- 3971849 TI - The young adult with diabetes: impact of the disease on marriage and having children. AB - To investigate the impact of insulin-dependent diabetes mellitus on marriage and having children we studied 50 young adults (aged 20-35 yr) with onset of the disease less than 20 yr. The subjects studied (37 women and 13 men) included 17 single, 26 married, and 7 divorced/separated diabetic patients. Twenty-two spouses of the 26 married diabetic patients also participated in the study. A 35 item questionnaire was developed with a 4-point Likert scale format for responses and administered separately to the patients and their spouses. None of the young adults in this study had made a conscious decision to remain unmarried, but 14 of 50 had decided not to have children. Onset of diabetes before 9 yr was associated with a significantly higher marriage rate than later onset of diabetes. Although onset of the disease after age 13 yr was more often associated with a decision to remain childless compared with earlier onset, this difference was not significant. Both men and women with diabetes found that the disease had an impact on certain aspects of their marital life, at times leading to friction and causing a financial burden. Whereas spouses were perceived to be very supportive, there was disagreement between young diabetic subjects and their spouses as to the impact of the disease on family activities and finances, the partners with diabetes perceiving a greater effect on these aspects of their lives than did their spouses. PMID- 3971850 TI - Heart rate variability in diabetes: relationship to age and duration of the disease. AB - Heart rate variability (HRV) during deep breathing was studied with a neonatal heart monitor in 143 control subjects and 218 patients with diabetes (102 with IDDM and 116 with NIDDM). In the control group HRV decreased after age 20 by 4-5 beats per decade (from 29.7 +/- 5.8 beats at age 20-29 to 11.8 +/- 5.4 beats at age 60+). In all age groups HRV in IDDM was lower than in the controls, and both age and duration of diabetes played a role in the decrease of HRV (from 21.5 +/- 5.3 beats at age 20-29 to 6.3 +/- 5.4 at age 60+). In NIDDM aging seemed to play a less important role, and the influence of the duration of the disease was not statistically significant. In both groups of patients the frequency of HRV below the 2.5th percentile was 82% in those with symptoms and/or signs of autonomic neuropathy, 64% in patients with peripheral neuropathy only, and 36% in those who had no obvious signs or symptoms of neuropathy. Interindividual variability was pronounced, and age and duration of the disease together accounted for only 36% of the observed differences between IDDM and the controls. Determination of HRV with a standard neonatal heart monitor presents an easy, simple, and nonstressful test of cardiac autonomic neuropathy. The norms of the test are age related. PMID- 3971851 TI - Assessment of a new blood glucose strip: comparison of Visidex, Visidex II, and Chemstrip bG with Glucose Analyzer determination of blood glucose. AB - Chemical test strips for estimating blood glucose are reliable, rapid, and convenient when properly used. Ames (Miles Laboratories, Elkhart, Indiana) has recently introduced a new product, Visidex II, which does not require water for development. This study compares the Visidex II with its predecessor Visidex, an established test strip, the Bio-Dynamics Chemstrip bG (Boehringer-Mannheim, Indianapolis, Indiana), and plasma glucose as measured by standard laboratory methods. Determination of blood glucose by visual inspection by all chemical test strips gave an estimation of true plasma glucose, and was reliable in predicting those values that were hypo- and hyperglycemic, although Chemstrip bG tended to underestimate in the hypo- and euglycemic ranges. Visidex II is more convenient to use than Visidex and is equally reliable in estimating true plasma glucose. In addition, strips from 20 patient samples were read daily for 7 days. Reacted Chemstrip bG test strips began to deteriorate within 24 h, and showed a 27% decline in estimations by day 3. Reacted Visidex II strips were stable for 1 day, but then rapidly declined to 50% of the original estimation by day 4. PMID- 3971852 TI - A family development approach to studying factors in the management and control of childhood diabetes. AB - The study of family factors that relate to diabetes management and metabolic control is crucial because of the family's central role in this management. Four sequential phases of diabetes management are specified in this review: (1) the pre-onset stage; (2) the onset, crisis stage; (3) the accommodation stage; and (4) the stabilization stage. Each stage can be expected to influence the following stage. Thus, each is important to later management of the condition. No theory of family functioning provides a satisfactory framework for understanding the complex relationships between family development and diabetes. The Peabody Family Development Model is introduced as a more complex and systematic way of understanding the stages of management and the long-term view of the individual and family development. Individual and family are acting and reacting, and at the same time, coping with outside influences while moving from one life stage to the other. Historic factors of family and community influence one's view of the world and, consequently, the way regular routines are carried out. Individual characteristics influence individual behavior at any given point in time. The model has at its core a stress-support paradigm, and has an ecologic frame of reference. Behavior is a result of all preceding factors, and information processed is fed back into the system. The Peabody Family Development Model is a way to organize a variety of information on family functioning and to specify how it might relate to the control of diabetes in children. PMID- 3971853 TI - Brittle diabetes. PMID- 3971854 TI - Selective binding of the estradiol receptor to a region at least one kilobase upstream from the rat prolactin gene. AB - The interaction of the estradiol receptor with cloned DNA fragments from the prolactin gene was investigated using a competitive binding assay. A DNA fragment from the 5'-flanking region of the rat prolactin gene was able to bind the estradiol receptor selectively. DNA fragments representing most of the remaining 10 kb of the prolactin gene showed little or no selective binding to the estradiol receptor. The fragment from the 5'-flanking region which selectively binds the receptor is located between 1.2 and 2.0 kb upstream from the transcription initiation site rather than in a more proximal position as has been observed for the interaction of several other steroid hormone receptors with specific genes. Nucleotide sequence analysis demonstrated that this region of DNA contains two large segments of alternating purine-pyrimidine sequence. One of the alternating purine-pyrimidine regions is very large, containing more than 160 nucleotides of almost perfect poly(dG-dT). Further studies will be required to determine if the receptor interacts specifically with these interesting sequences. However, the ability of the estradiol receptor to bind to an upstream 5'-flanking region of the prolactin gene may be part of the mechanism which allows the receptor to stimulate the transcription of this gene selectively. PMID- 3971855 TI - Program and abstracts from the Fifth Annual Congress for Recombinant DNA Research. February 3-6, 1985, San Francisco. PMID- 3971856 TI - Neutropenia associated with mezlocillin and piperacillin. AB - Neutropenia associated with beta-lactam antibiotics has been widely reported since the first case was described in 1946. Cross-reactivity between beta-lactam antibiotics for this phenomenon rarely has been reported. This case describes the development of neutropenia after a course of mezlocillin, resolution upon discontinuation, and recurrence promptly after initiation of piperacillin, with resolution subsequent to discontinuation. Clinical practitioners should be aware that this adverse drug reaction has been associated with the newer beta-lactam antibiotics and that cross-reactivity may occur between these antibiotics. PMID- 3971857 TI - Drug-induced erythema multiforme: a possible immunologic pathogenesis. AB - A 37-year-old female developed erythema multiforme 17 days after beginning carbamazepine for complex partial seizures. The carbamazepine was discontinued and phenytoin begun. A new rash developed and phenytoin therapy was stopped. In vitro immunologic studies were conducted in an effort to understand the pathogenesis of the rashes. Enhancement of stimulated in vitro lymphocyte proliferation from the patient occurred in the presence of carbamazepine and phenytoin. Neither drug had an enhancing effect on lymphocyte proliferation from a control subject. These data, together with clinical data, strongly suggest an immunologic pathogenesis for drug-induced erythema multiforme. PMID- 3971858 TI - A survey of state board of pharmacy members and continuing education providers' views on continuing education. AB - Legally accountable to the public, state boards of pharmacy are continually confronted with the problem of maintaining the quality of pharmacy practice. One approach to accomplishing this task has been to implement mandatory continuing education requirements for relicensure. This study evaluated the perceived effectiveness and deficiencies of various states' continuing education regulations. A 40-question survey was mailed to 600 pharmacy board members and continuing education providers to determine their attitudes toward continuing education, support of mandatory continuing education, and their opinion of alternative methods for improving the quality of pharmacy practice. Responses from approximately one-half of those surveyed indicate board members and continuing education providers were positively disposed toward continuing education. However, there was room for improvement in most states' mandatory continuing education regulations. A relicensure examination was considered to be the best method to ensure competency, while mandatory continuing education was viewed as acceptable to pharmacists, and relatively easy to administer. The consequences of the study's findings for modifying state continuing education regulations is discussed. PMID- 3971859 TI - Comment: revised treatment of ulcerative stomatitis. PMID- 3971861 TI - Community pharmacists as drug information advisers. PMID- 3971862 TI - Factors associated with the elderly falling in intermediate care facilities. AB - In intermediate care facilities, the records of 41 patients who had fallen and 36 controls were reviewed retrospectively, and the two groups compared for demographics, diagnoses, blood pressures over the prior two months, and prescribed medication. Seven of the sample had a recent weight loss recorded; all seven were in the group that fell. The mean number of medications prescribed for the group of fallers was significantly greater than the mean prescribed for the control group. The mean number of medication changes during the two weeks prior to the fall was significantly greater than the mean number of medication changes during the two weeks prior to data collection for the control group. Our data suggest that caution should be exercised in multiple drug prescribing for patients in intermediate care facilities and that recent weight loss and medication changes may be risk factors for falling. PMID- 3971860 TI - Suspected procainamide-induced angioedema. PMID- 3971863 TI - Definition of clinical pharmacy as a specialty in clinical practice. Committee on Clinical Pharmacy as a Specialty. American Pharmacy Association. AB - Specialty credentialing has been discussed extensively and debated within pharmacy for more than ten years. Within the profession, there now appears to be a consensus on the need for and appropriateness of acknowledging professional practice areas as unique, defined entities. However, there remain substantive differences on how the definition of specialty practice should be constructed. One approach is to identify practice areas by functional activity (e.g., nuclear pharmacy, drug information) and/or therapeutic focus (e.g., psychopharmacy, clinical pharmacokinetics). A second approach is to define clinical pharmacy as a specialty practice that would, at least initially, coalesce clinical practitioners with the common denominator of an active role in the therapeutic decision-making process. The following document was developed by the Committee on Clinical Pharmacy as a Specialty (CCPS). The CCPS is independent of any formal organizational affiliations. It will serve as the preface to a petition that will be submitted to the Board of Pharmaceutical Specialties requesting recognition of clinical pharmacy as a specialty. The intention of the committee is to resolve the question of specialty status for clinical pharmacy through the Board of Pharmaceutical Specialties' review process. It is then hoped that pharmacy can move forward on the important issue of specialty credentialing. PMID- 3971865 TI - The DHSS restricted list of drugs--getting it right. PMID- 3971864 TI - Management of stroke: 12 hours to 2 months. PMID- 3971867 TI - [Therapy of nephrolithiasis]. PMID- 3971866 TI - [Diagnosis of nephrolithiasis]. PMID- 3971868 TI - [Effects of "new harmonization" on the right to charge and the reimbursement of costs of chief physicians]. PMID- 3971869 TI - [Endoscopic occlusion of a tumor-caused esophago-mediastinal fistula with a rapidly hardening amino acid solution]. PMID- 3971870 TI - [Endoscopy of the terminal ileum: diagnostic yield in 600 consecutive high colonoscopies]. PMID- 3971871 TI - [Infection after splenectomy]. PMID- 3971873 TI - [Intrapulmonary percussion. A new method of respiratory therapy]. AB - Intrapulmonary percussion with a high-frequency jet system is a new method in the treatment of respiratory impairment. It imitates the conventional percussion massage of the thorax by introducing high-frequency gas oscillations (300 impulses per minute) into the tracheobronchial system. In 14 patients with abnormal alveolo-arterial oxygen differences due to bronchial mucostasis ventilation was satisfactorily improved by its application. PMID- 3971872 TI - [Pulmonary hypertension in chronic respiratory tract obstruction: a combined study on haemodynamics and radionuclide ventriculography]. AB - In 44 patients with chronic obstruction of the respiratory passages pulmonary artery pressures were measured by Swan-Ganz catheter and right-ventricular ejection fraction by radionuclide ventriculography (equilibrium method). Although there was no linear correlation between the haemodynamic parameters of afterload or preload of the right ventricle and global right-ventricular ejection fractions, sensitivity and specificity of radionuclide ventriculography were very good (87% and 83%, respectively) for the recognition of pulmonary hypertension during exercise tests. Global right-ventricular ejection fraction in patients without pulmonary arterial hypertension had a normal and significant rise from 52% to 58% on exercise. In the group with pulmonary hypertension mean right ventricular ejection fraction fell during exercise from 47% to 46%. Radionuclide ventriculography in the assessment of right ventricular function, especially during exercise, provides useful pointers to the diagnosis of pulmonary hypertension due to chronic respiratory-tract obstruction. PMID- 3971874 TI - [Circulating platelet aggregates in patients with acute ischemic and so-called chronic cerebrovascular disorders]. AB - A modified platelet function test was assessed as a routine method in 71 normal subjects and 96 patients. In patients with cerebral infarction (33) and those with transitory ischaemic attacks (30) definite changes in platelet function were demonstrated. In patients with cerebrovascular insufficiency (33) there was significantly increased platelet aggregation, but in only 46% of these patients were the values over 3 standard deviations above the mean of the control group (71). PMID- 3971876 TI - [Therapy of Behcet's syndrome]. PMID- 3971877 TI - [Microsurgical treatment of trigeminal neuralgia]. PMID- 3971875 TI - [Diagnosis of Behcet's syndrome]. PMID- 3971878 TI - [Gold salts and glomerulonephritis]. PMID- 3971879 TI - [Possibilities and limitations of computerized tomography in the staging of the subdiaphragmatic spread of Hodgkin's disease]. AB - The value of computed tomography in the assessment of subdiaphragmatic spread was studied prospectively in 72 patients with so far untreated, histologically confirmed Hodgkin's disease. In 17 patients (23.6%) computed tomography (CT) diagnosed subdiaphragmatic involvement, with no false-positive results. In 55 (76.4%) CT was within normal limits. In 30 patients exploratory laparotomy gave false-negative results in 7 (23.4%). The causes of false-negative results in CT are that lymph-nodes which were not enlarged but involved were not demonstrated and spleen involvement was not identified. Including those correctly positively diagnosed cases (17), CT had a sensitivity of 70.8% and a false-negative rate of 29.2%. It is concluded that when CT is within normal limits only exploratory laparotomy can with certainty exclude subdiaphragmatic involvement. PMID- 3971880 TI - [Long-term results after local thrombolysis in acute massive pulmonary embolism]. AB - Intrapulmonary arterial infusions of urokinase (mean 1724 IU/kg X h) and heparin (mean 17 IU/kg X h) were given to 7 patients with acute massive pulmonary embolism. Pulmonary angiography and pulmonary artery pressure measurements were performed before, during and 15 months after the drug infusion. During the acute phase, pulmonary artery pressures were recorded daily while urokinase and heparin were administered until the pressures had become normal (after a mean of 6 days). 15 months later right heart catheterization was undertaken before and after ergometric exercise as well as bilateral leg venography. Before treatment pulmonary angiography demonstrated massive vascular obstruction which regressed markedly during and after drug infusion. Treatment also led to normalization of previously elevated pulmonary artery pressures. In addition, pulmonary artery mean pressures and total pulmonary vascular resistance became normal both at rest and on exercise in 6 patients. All patients had signs of acute leg vein thrombosis before treatment, but 15 months later phlebography demonstrated normal findings in 4 and residual findings of previous thrombosis in 3. Local thrombolysis of acute massive pulmonary embolism is thus a highly successful form of treatment. PMID- 3971881 TI - [Nuclear medicine diagnosis of motility disorders of the esophagus]. PMID- 3971882 TI - [Indications for synovectomy in chronic polyarthritis]. PMID- 3971884 TI - [Maprotiline--a supportive agent in asthma therapy]. PMID- 3971883 TI - [The environment and the immune system]. PMID- 3971885 TI - [Diabetes control under occupational conditions]. AB - 62 male diabetics worked in hospital workshops while their metabolic state was assessed. In each patient work activity, periods of work and rest and employment related eating breaks were maintained. The metabolic state was regularly tested during physical activity simulating their actual employed work. In these circumstances there was a definite fall in blood sugar levels in the course of the day. Low values and hypoglycaemia were more frequent depending on the degree of physical activity, especially in the morning. The management of diabetes was adjusted to these metabolic requirements. Insulin dose was decreased and (or) carbohydrates were taken more frequently or in larger amounts. This adjustment in diabetes management was recommended to the diabetics for their normal everyday employment activity. Control of the diabetes was better on discharge from hospital and for some time afterwards. PMID- 3971886 TI - [The role of splenectomy in the treatment of lymphomas of low malignancy]. AB - The effect of splenectomy was studied in 30 patients with non-Hodgkin lymphoma of low malignancy. Severe bacterial infections occurred in 9 patients. Follow-up of the total group of 72 patients-years revealed one infection requiring hospitalization per eight patient-years. With chronic lymphatic leukaemia there was no difference in the incidence of severe infection between splenectomized and non-splenectomized patients. In 12 patients the splenectomy produced favourable results in that in some (8) cytostatic treatment was no longer required, while in others (4) the dose of cytostatic drugs could be reduced after several months without any medication. Survival rate was not influenced by splenectomy. PMID- 3971887 TI - [Differentiated thyroid carcinoma in an endemic area. Clinical aspects, prognosis, therapeutic considerations]. AB - A retrospective analysis was undertaken of 179 cases of differentiated thyroid carcinoma (89 follicular and 90 papillary; first operations 1952-1977). At the time of the diagnosis there was no significant difference between the two types of malignancy as to age, sex, stage of tumour and degree of local radical operation. Nor was there any difference as to clinical course, but for papillary carcinoma the recurrence rate was higher and the survival time significantly shorter. Simple histological classification as to type did not help in prognosis. Compared with published reports, the unfavourable course of papillary carcinoma can be explained by the high proportion of haematogenous metastasizing tumours and the great prognostic significance of distant metastases, especially with papillary carcinoma. The differences in prognosis of other clinical examinations is ascribed to the broad spectrum of tumour-biological aggressivity which hides under the expression "differentiated carcinoma". Our results underline the need to take into account different clinical and histopathological influences which differ for each tumour type. PMID- 3971888 TI - [Capillarosclerosis of the efferent urinary tract as an indication of analgesic abuse. Incidence in unselected autopsies in a large West German town]. AB - In a prospective study conducted during one year, postmortem examination of 500 unselected adults revealed in 13 cases (2.6%) a marked capillarosclerosis of the mucosa of the renal pelvis, considered to be a reliable histological sign of phenacetin and paracetamol abuse. These results were obtained in four men (1.5% of the total number of autopsied men) and nine women (3.9% of the autopsied women). Thus, capillarosclerosis is 2.6 time more frequent in women than in men. PMID- 3971889 TI - [Clinical aspects and diagnosis of mesangial IgA-glomerulonephritis]. PMID- 3971890 TI - [The chief physician's right to command in the treatment of dying patients]. PMID- 3971891 TI - [Diagnosis of abdominal abscesses with gallium scintigraphy]. PMID- 3971892 TI - Respiratory distress in children. PMID- 3971893 TI - Croup. PMID- 3971894 TI - Deep neck infections and respiratory distress in children. PMID- 3971895 TI - Allergic causes of pediatric upper airway obstruction. PMID- 3971896 TI - Intralaryngotracheal thyroid. PMID- 3971897 TI - A 33-year history of ear pain. PMID- 3971898 TI - Differential effects of tamoxifen and analogs with nonbasic side chains on cell proliferation in vitro. AB - Structural analogs of the nonsteroidal antiestrogen tamoxifen, in which the basic dimethylaminoethoxy side chain was either absent or replaced with a variety of nonbasic side chains, were examined for their ability to inhibit the proliferation of a hormonally responsive cell line, MCF 7 human breast cancer. The degree of inhibition was compared with relative binding affinities for the estrogen receptor (RE) and a microsomal antiestrogen binding site (AEBS). All modifications resulted in loss of detectable affinity for AEBS. Replacement of the basic side chain of tamoxifen with a series of nonbasic side chains reduced affinity for RE by 78-93% except in the case of 1-(4-(1,2-diphenylbut-1 enyl)phenyl)-2,3-butanediol (ICI 145-680) where affinity was unchanged. When the basic side chain of tamoxifen was replaced by a hydroxyl group, to form the estrogenic analog ICI 141389 (Metabolite E), affinity for RE was reduced by 39%. ICI 141389 was a very weak inhibitor of MCF 7 cell growth, showing no significant growth inhibition at concentrations less than 10 microM. Despite the fact that ICI 145680 and tamoxifen had identical affinities for RE, ICI 145680 was a significantly weaker growth inhibitor than tamoxifen over the concentration range studied, i.e. 0.1-20 microM. Differences in potency were greatest at concentrations greater than 7.5 microM where the effects were not reversed by estradiol and where cytotoxicity played a major role in the decrease in cell numbers induced by tamoxifen. Like tamoxifen, ICI 145680 demonstrated both estrogen-reversible (at concentrations between 0.5-7.5 microM) and estrogen irreversible (10-20 microM) inhibition of MCF 7 cell proliferation which was associated with a concentration-dependent accumulation of cells in the G0/G1 phase of the cell cycle. In contrast to tamoxifen, however, ICI 145680 appeared not to possess cytotoxic activity. Whereas ICI 145680 was without effect on proliferation of the RE negative human breast cancer cell line, MDA-MB-330, at doses less than 20 microM, tamoxifen inhibited growth at concentrations greater than 5 microM, but with changes in cell cycle kinetic parameters that were markedly different from those seen in RE positive cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971899 TI - Immunomodulation in rats by transplantable anterior pituitary tumors. AB - The effect on the immune response of the MtT/W5 (W5), MtT/W10 (W10) tumors of Wistar-Furth rats and of MtT/F4 (F4) tumor transplantable in Fischer 344 rats was examined. Antibody response to sheep red blood cells and contact sensitivity reactions to dinitrochlorobenzene (DNCB) were used as immune parameters. In intact rats the W5 tumor suppressed the antibody response as much as did hypophysectomy (Hypox). The antibody response of Hypox rats was marginally improved by this tumor. Contact sensitivity was not suppressed in intact animals and the poor reactivity of Hypox rats was reconstituted to normal levels by W5. Treatment with bromocriptine (BRC) had no influence on tumor growth or on the immune reactivity of tumor-bearing hosts. The W10 tumor suppressed antibody formation, but not contact sensitivity in intact animals; the antibody and the DNCB response of Hypox animals was reconstituted partially, by this tumor. BRC treatment of tumor-bearing animals mimicked the effect of Hypox in this system. The F4 tumor suppressed antibody formation in intact rats and did not reconstitute the reactivity of Hypox rats. The DNCB response was not influenced by this tumor in intact animals and it was partially reconstituted in Hypox rats. Again, the reactivity of BRC-treated animals was similar to that of Hypox tumor bearing animals. These results indicate that pituitary tumors may alter the immune reactivity of their hosts significantly. PMID- 3971900 TI - Alcohol and fatty acid stimulation of neurotensin release from rat small intestine. AB - We have previously reported that neurotensin (NT) is released from the small intestine and elevated in the hepatic-portal circulation in response to the perfusion of the small intestine with a micellar solution of oleic acid. In order to determine the minimum acyl chain length and whether the presence of a carboxylic acid is necessary for the stimulation of NT release, the small intestine of anesthetized rats was perfused with test solutions of fatty acids of 2-, 4-, 8-, or 18-carbons or fatty alcohols of 2-, 4-, or 8-carbons at a concentration of 1 mM prepared in 2.4 mM taurodeoxycholate in 0.9% NaCl. Blood samples, collected from the superior mesenteric vein immediately before the start of the test perfusion and at 15-min intervals thereafter, were extracted immediately and radioimmunoassayed for NT-like immunoreactivity (NTLI) with a C terminal-directed antiserum. Perfusions of fatty acids with 4 or more carbons and alcohols of 2 or more carbons resulted in a significant elevation (P less than 0.05) in plasma levels of NTLI above the values obtained before the onset of perfusion. Perfusions with ethanol resulted in a value of 4.3 +/- 0.03 mg/dl (SEM) in blood from the superior mesenteric vein while there was no increase in ethanol levels in the peripheral circulation. Perfusion with taurodeoxycholate and 0.9% NaCl alone had no significant effect on plasma levels of the NTLI. In order to characterize the chemical nature of the elevated NTLI, plasma samples from animals perfused with test solution were collected, extracted, pooled, and subjected to HPLC. NT and its N-terminal metabolite, NT(1-8), were quantitated. NT was defined as material having the same retention time as synthetic NT standard and having comparable measurements using N- and C-terminal-directed antisera. Perfusions of fatty acids of four or more carbons and alcohols of two or more carbons resulted in a 2- to 4-fold increase of both NT and NT(1-8) levels in plasma. It is particularly interesting that perfusion with ethanol (2-carbons) causes an elevation in plasma NT, because perfusion with acetic acid (2-carbons) does not increase NTLI. The fact that perfusion of ethanol is effective in releasing intestinal NT suggests that NT may mediate some of the biological effects observed after the consumption of alcohol. PMID- 3971901 TI - The synthesis and metabolism of gonadal steroids in pouch young of the opossum, Didelphis virginiana. AB - We have measured steroid hormone biosynthesis from pregnenolone in ovaries and testes, aromatization of testosterone in gonads and peripheral tissues, and 5 alpha-reduction of testosterone in peripheral tissues of developing opossum pouch young. Sex of the newborn opossums is discernible grossly with development of the pouch in females and the scrotum in males approximately 10 days after birth. Differentiated endocrine function of ovaries and testes was demonstrable as soon as development of the pouch or scrotum was apparent. The testes synthesized testosterone, and ovaries aromatized androgens to estrogens as assessed by the conversion of [1 beta-3H] testosterone to 3H2O. This endocrine differentiation of the gonads occurs days or weeks before differentiation of the male and female urogenital tracts. As in other species, 5 alpha-reduction of [1 beta-3H] testosterone was high in urogenital sinus and urogenital tubercle. However, 5 alpha-reductase activity was highest in mesonephros and structures derived from the mesonephros. In wolffian and mullerian ducts of pouch young less than 10 days old, 5 alpha-reductase activity was greater than 50 pmol/h . mg protein and decreased by 19 days of age to approximately 3 pmol/h . mg protein, a pattern different than in eutherian mammals in which testosterone itself appears to mediate virilization of the wolffian ducts. These studies provide the framework for studies of the endocrine control of phenotypic sexual differentiation in the opossum. PMID- 3971902 TI - A corticosterone metabolite produced by A6 (toad kidney) cells in culture: identification and effects on Na+ transport. AB - A6 cells form typical tight epithelia when grown in culture on permeable supports and exhibit active Na+ transport [short circuit current (Isc)], which is stimulated by aldosterone and corticosterone. Previous studies demonstrated nuclear binding of polar corticosterone metabolites produced by the cells. This study was performed to determine whether sufficient quantities of the metabolite(s) are released into the medium of A6 cells for identification and to test for agonist activity on active Na+ transport. Cells were incubated in [3H]corticosterone (10(-8)-10(-4) M) for 24 h. Approximately 25-35% of the radiolabel, recovered in ethyl acetate extracts of medium, chromatographed on reverse phase HPLC as a single peak more polar than corticosterone. This derivative cochromatographed with 6 beta-hydroxycorticosterone (6 beta-OH corticosterone) on HPLC and normal phase high performance TLC. Mass spectroscopy of 6 beta-OH-corticosterone and the unknown yielded 10 identical molecular ions, including the molecular ion with a mass to charge ratio of 362 corresponding to the mol wt of 6 beta-OH-corticosterone stimulated Isc in A6 epithelia with a time course typical of a steroid and an EC50 of 10(-6) M. The Isc induced by 6 beta-OH corticosterone was equivalent to net Na+ flux, indicating active Na+ transport stimulation. At maximum effective concentrations of corticosteroids, 6 beta-OH corticosterone plus aldosterone induced a greater Isc stimulation than aldosterone alone, suggesting that at least a portion of the effect of 6 beta-OH corticosterone is mediated by a steroidal pathway other than that used by aldosterone. Also, corticosterone produced twice the Isc increase produced by aldosterone. Thus, 6 beta-OH-corticosterone may contribute to the enhanced corticosterone effect on Isc compared to aldosterone alone. PMID- 3971903 TI - The physiological role of relaxin in the pregnant rat. I. The influence of relaxin on parturition. AB - Length of gestation, duration of labor and delivery, and fetal survival were determined in control intact pregnant rats (group C). Pregnant rats were bilaterally ovariectomized on day 9 and given progesterone (P) implants and, in addition, one of the following injection regimens; estrogen (E; group OPE), E and porcine relaxin (R; group OPER), or porcine R (group OPR). Hormone treatments were given in doses designed to produce serum levels of these hormones similar to those observed in intact pregnant rats. The P implants were removed during the evening of day 21 to mimic the decline in serum P levels that normally occurs as a result of luteolysis. Animals in groups OPE and OPR exhibited significantly prolonged gestation, prolonged duration of labor and delivery, and reduced fetal survival compared with controls. Group OPER animals exhibited slightly but not significantly shorter length of gestation, similar duration of labor and delivery, and similar rate of fetal survival compared to control values. Group OPER animals showed normal maternal behavior and were able to suckle their young. PMID- 3971904 TI - The physiological role of relaxin in the pregnant rat. II. The influence of relaxin on uterine contractile activity. AB - In control intact rats (group C), the frequency of intrauterine pressure cycles (IUPC) declines steadily during pregnancy from 80-130 cycles/3 h on day 10 (D10) to 20-30 cycles/3 h on D20. The decline in frequency is due to increasingly prolonged periods of myometrial quiescence, which increase from 30-90 min/3 h on D10 to 120-150 min/3 h by D20. During the 24 h preceding labor, the frequency of IUPC remains at less than 15 cycles/h until 3 h prepartum, when there is an abrupt increase to 30 cycles/h. Ovariectomized pregnant animals treated with progesterone (P) and estrogen (E; group OPE) exhibit significantly greater frequency of IUPC and significantly lower incidence of myometrial quiescence than intact pregnant rats from D12 and for the remainder of pregnancy. Ovariectomized pregnant rats that received P, E, and porcine relaxin (R: group OPER) or P and porcine R only (group OPR) exhibited declining frequency of IUPC similar to that observed in group C animals. Group OPER rats exhibited prolonged periods of myometrial quiescence of similar duration to those observed in control intact rats. In group OPR animals, however, the periods of myometrial quiescence were considerably diminished during late pregnancy. Group OPER animals exhibited a pattern of myometrial activity during labor and postpartum similar to that of control animals. The results suggest an important role for R in the control of myometrial activity during the second half of pregnancy and parturition in the rat. PMID- 3971906 TI - Autoradiographic localization of [125I]-angiotensin II binding sites in the rat adrenal gland. AB - To gain greater insight into sites of action of circulating angiotensin II (Ang II) within the adrenal, we have localized the [125I]-Ang II binding site using in vitro autoradiography. Autoradiograms were generated either by apposition of isotope-sensitive film or with emulsion-coated coverslips to slide-mounted adrenal sections labeled in vitro with 1.0 nM [125I]-Ang II. Analysis of the autoradiograms showed that Ang II binding sites were concentrated in a thin band in the outer cortex (over the cells of the zona glomerulosa) and in the adrenal medulla, which at higher power was seen as dense patches. Few sites were evident in the inner cortex. The existence of Ang II binding sites in the adrenal medulla was confirmed by conventional homogenate binding techniques which revealed a single class of high affinity Ang II binding site (Kd = 0.7nM, Bmax = 168.7 fmol/mg). These results suggest that the adrenal medulla may be a target for direct receptor-mediated actions of Ang II. PMID- 3971905 TI - The physiological role of relaxin in the pregnant rat. III. The influence of relaxin on cervical extensibility. AB - Cervices from day 18 (D18) intact pregnant rats show significantly greater extensibility and ability to accommodate to extension than cervices from D9 pregnant rats. On D22, cervices from intact pregnant rats show even greater extensibility and accommodation to stretch. Cervices from ovariectomized pregnant rats treated with estrogen (E) and progesterone (P; group OPE) show markedly reduced extensibility and ability to accommodate to stretch compared with intact pregnant cervical tissue (group C) on both D18 and D22. Extensibility of group OPE cervices resembles that of cervices from D9 intact pregnant rats. Cervices from ovariectomized pregnant rats treated with E, porcine relaxin (R), and P (group OPER) or porcine R and P (group OPR) exhibit similar extensibility and ability to accommodate to stretch as cervices from intact pregnant rats on both D18 and D22. The importance of R for cervical softening during pregnancy and its interaction with E near term and during parturition are discussed. PMID- 3971907 TI - Plate binding assay for monoclonal anti-receptor antibodies. AB - A new procedure has been developed for rapid identification of monoclonal antibodies to the insulin receptor. The technique uses the ability of polyvinyl chloride plates coated with anti-mouse antibodies to specifically adsorb antibodies in hybridoma supernatants. Detection of anti-receptor antibodies is accomplished by allowing the adsorbed anti-receptor antibodies to bind radiolabeled hormone-receptor complexes. The method does not require pure receptor and can be adapted for studies of any receptor or binding protein where a labeled ligand is available. With small amounts of the insulin receptor (20-50 ng), the method could detect antibody concentrations as low as 300 pM. In summary, the assay is sensitive, rapid, and requires small amounts of impure receptor. PMID- 3971908 TI - Gamma-2MSH is natriuretic in the rat. AB - Previous reports suggest that peptides containing an amino acid sequence similar to that of ACTH-(4-10) increased Na excretion in the rat. gamma 2MSH contains such a sequence. An in vivo rat bioassay for natriuretic factors was employed to demonstrate the natriuretic action of gamma 2MSH. A significant natriuretic effect was observed, with a peak response 30-50 min following the bolus injections of 0.64, 6.4 or 64 pmol, but not with smaller or larger amounts of gamma 2MSH. A kaliuretic and diuretic action of gamma 2MSH was not consistently evident. gamma MSH may represent an endogenous compound involved in the physiological regulation of Na excretion. PMID- 3971909 TI - Estrogen synthetase activity in human term placental cells in monolayer culture. AB - Human term placental cells, isolated by trypsin treatment, were grown in culture with medium 199 and 10% fetal bovine serum for up to 1 week. Aromatase specific activity (+/-SE) of freshly isolated cells was low (0.63 +/- 0.04 pmol/min X mg protein; n = 15) compared to that of placental tissue before trypsin treatment (21.30 +/- 0.40 pmol/min X mg protein; n = 6). This activity in attached cells increased 10-fold 24 h after plating (6.32 +/- 0.75 pmol/min X mg protein; n = 19) and continued to increase up to 72-96 h (14.78 +/- 1.09 pmol/min X mg protein; n = 13) before declining to 6.50 +/- 1.40 pmol/min X mg protein (n = 4) after 120 h. The functional activity of the cells was assessed by daily measurements of hCG secretion into the medium. Secretion of hCG was maintained at about 0.3 micrograms/flask up to 48 h in culture, then rose rapidly to about 6.2 micrograms/flask from 96-168 h. The addition of 1 mM (Bu)2cAMP plus 1 mM theophylline to the culture medium 24 h after plating stimulated hCG secretion 7- to 8-fold relative to that by control cells, had no effect on aromatase specific activity 24 h after its addition, but decreased aromatase activity after 48 h. Freshly prepared cells were primarily (approximately 80%) mononucleated. With time in culture, the number and size of the multinucleated cells increased drastically until they accounted for virtually all of the cellular material in culture at 72 h. These morphological and functional changes in hCG secretion and aromatase activity suggest that trypsin-isolated cytotrophoblast cells differentiated in culture to form syncytiotrophoblast cells. PMID- 3971910 TI - Characterization of thyrotropin-induced increase in iodothyronine monodeiodinating activity in mice. AB - To further characterize the effect of TSH administration on thyroid iodothyronine monodeiodinating activity, we have evaluated the in vitro conversion of T4 to T3 (outer ring deiodination) and T3 to 3,3'-diiodothyronine (T2; inner ring deiodination) by mouse thyroid, liver, and kidney homogenates, comparing tissues from TSH-treated mice (0.1-200 mU bovine TSH, ip, for 1-3 days) with tissues from saline-treated controls. The in vitro conversion activity was studied in the presence of 1-20 mM dithiothreitol; most of the studies were carried out at 4 mM. Studies were carried out at optimal pH 6.5 for outer ring and 7.8 for inner ring deiodination. The iodothyronine monodeiodinase in mouse thyroid is similar to the ones in liver and kidney. It is heat labile (inactivated at 56 C for 5 min), inhibited by propylthiouracil (0.2 mM) and ipodate (0.2 mM), and unaffected by methimazole (up to 20 mM), ascorbate (up to 0.1 M) or KI (up to 20 mM). The mean +/- SE baseline rates of T4 to T3 and T3 to T2 conversion were 100 +/- 6.3 and 56.5 +/- 2.9 pmol/mg thyroid protein X 30 min at 37 C, respectively. A significant increase in each conversion activity was found after TSH treatment (0.2 U, ip, daily for 3 days); T4 to T3 conversion rose to 282 +/- 15.4, and T3 to T2 increased to 153 +/- 7.4 pmol/mg thyroid protein (P less than 0.001). A 12.8% increase in thyroid weight was found in the TSH-treated group (P less than 0.03 compared with saline control group). Similar but less marked increased in monodeiodinating activities were seen in the liver. A minimal but significant increase in inner ring monodeiodination with no significant increase in T4 to T3 converting activity was found in kidney, which, in the mouse, has markedly less outer ring deiodinase than liver or thyroid. The iodothyronine monodeiodinating activities did not increase until 12 h in thyroid and 48 h in liver after the first dose of TSH. Significant increases in T4 to T3 and T3 to T2 conversion were seen with doses of TSH as low as 0.1 mU (ip, daily for 3 days), and there was a linear dose-response thereafter. The decay of the increased iodothyronine monodeiodinating activities after a single dose of TSH (0.2 U) appeared to be linear, with a decay t 1/2 of 1.3 days for T4 to T3 conversion and about 1.0 day for T3 to T2 conversion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971911 TI - Fetal rat chondrocytes sequentially elaborate separate growth- and differentiation-promoting peptides during their development in vitro. AB - Chondrocytes isolated from the calvaria of rat fetuses proliferate and form cartilage when cultured in a chemically defined, serum-free medium, suggesting that they may elaborate self-regulatory factors. Conditioned media obtained from these chondrocytes stimulated DNA synthesis and proliferation when added to separate cultures of chondrocytes and the closely related osteoblast-like cells, but were not very effective in skin fibroblasts isolated from the same fetuses, as judged by [3H]thymidine incorporation and cell proliferation. Chondrocyte conditioned medium also promoted chondrocyte differentiation, augmenting 35SO4 incorporation, and the accumulation of type II collagen and cartilage-specific proteoglycan. Stimulation of growth and differentiation appears to be attributable to separate activities, released into the medium sequentially by the cultured chondrocytes during their proliferation and maturation phases. Media obtained from growing chondrocytes stimulated growth, but had little effect on 35SO4 incorporation. Media obtained from mature cultures promoted growth as well as 35SO4 incorporation. The mitogenic and sulfation activities were trypsin inhibitable, but exhibited different solubility characteristics and striking differences in their patterns of elution from gel filtration columns. These results suggest that chondrocytes elaborate autostimulatory peptides, the biological activities of which mirror, at least in part, the developmental stage of the donor cells. PMID- 3971912 TI - Association of spontaneous thyroiditis with the major histocompatibility complex of the rat. AB - Overt insulin-dependent diabetes mellitus in the rat is associated with the u haplotype of the rat major histocompatibility complex (MHC), RT1. Thyroiditis of sufficient severity to result in elevation of TSH levels is seen in Buffalo rats (RT1b). In order to examine the association of autoimmune thyroid disease with MHC gene products, we have crossed inbred Buffalo rats with diabetic BB rats and examined the RT1 genotype, the histology of thyroid and pancreatic tissue, and two indices of thyroid function. The data indicate that animals having pancreatic lymphocytic infiltration and insulinopenic overt diabetes mellitus had at least one RT1u haplotype. All but one animal having severe histological thyroid lymphocytic infiltration had at least one RT1b haplotype. Rats with severe thyroiditis had higher mean TSH levels than rats with normal histology or rats with mild thyroiditis. We conclude that gene products of the rat MHC affect the severity of spontaneous organ-specific autoimmune disease in terms of clinically apparent as well as tissue inflammatory disease. PMID- 3971914 TI - Glycosylation of ovine prolactin during cell-free biosynthesis. AB - Recently, a glycosylated form of ovine PRL (oPRL) was isolated from a crude pituitary preparation. As glycosylation of PRL was unexpected and because the composition of the oligosaccharide-containing peptide indicated the carbohydrate portion to be extensively degraded, studies of the glycosylation of oPRL during cell-free biosynthesis were initiated. Two glycosylated forms of oPRL can be recognized when biosynthesis occurs in ovine pituitary microsomes. Both forms are converted to mature PRL by digestion with endoglycosidase H and, thus, appear to contain only asparagine-linked, high mannose-type carbohydrate moieties. In contrast, immunoprecipitates from bovine pituitary microsomes consist of the expected (and nonglycosylated) pre-PRL and PRL. The results are consistent with the absence of a sequence segment in the bovine hormone which permits glycosylation (Asn-X-Ser- or Thr-) and the presence of the segment Asn31-Leu-Ser- in the ovine hormone. The occurrence of two glycosylated forms of oPRL is not understood; it may result from an additional site in oPRL capable of glycosylation. PMID- 3971913 TI - Transformation of chick oviduct progesterone receptor in vitro: effects of hormone, salt, heat, and adenosine triphosphate. AB - Effects of salt, heat, and ATP on the rate of sedimentation of chick oviduct progesterone receptor (PR) were examined under various conditions. Cytosol [3H]PR complex (PRc) sedimented as an 8S molecule in 10-35% glycerol or 5-20% sucrose gradients. Incubation of the oviduct cytosol containing [3H]PRc at either 23 or 0 C with 0.3 M KCl or 5-10 mM ATP for 1-4 h resulted in the appearance of a slower migrating form with a sedimentation rate of approximately 4S and a complete and concomitant disappearance of the 8S PR form. This transformation of the receptor was inhibited by molybdate and paralleled an increase in the affinity of the cytosol PRc toward DNA-cellulose, ATP-Sepharose, and isolated nuclei. The 8S to 4S transformation of PR could be achieved with the unliganded receptor. The effect of the hormone on the rate of the transformation of PR was examined. A gradual transformation of the 8S PR occurred with increasing time of incubation at 23 or 0 C with KCl or with 10 mM ATP. The ATP-induced transformation of the 8S form was complete by 2-4 h in both the presence and absence of progesterone. The transformation of PR by salt was complete by 1-2 h of incubation of the cytosol with 0.3 M KCl at 0 C and was slightly accelerated in the presence of the steroid. However, when the cytosol PR was thermally transformed by incubation at 23 C, the appearance of the 4S PR form was significantly accelerated in the presence of the hormone. While the addition of 10 mM ATP to the incubation mixture enhanced the rate of transformation of PRc by heat and salt, lower nucleotide concentrations (0.1-2 mM) inhibited the thermal conversion of the 8S PR (in both its liganded and unliganded forms) to the 4S form. In addition, other nucleoside triphosphates (CTP, GTP, and UTP) were also effective in inducing the 8S to 4S transformation of the unoccupied and the steroid-bound PR. The transforming effects of heat, salt, and ATP were cumulative, and a complete 8S to 4S transformation could be achieved within 5 min when all three were applied simultaneously. We conclude that ATP and other nucleoside triphosphates are effective modifiers of the process of transformation of the chick oviduct PR in vitro.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971915 TI - Differential distribution of androgen and estrogen receptors in rat pituitary cell populations separated by centrifugal elutriation. AB - The distribution of 5 alpha-dihydrotestosterone (DHT)-binding sites within specific pituitary cell populations, as compared with the estradiol (E2)-binding sites distribution, could be estimated after gonadotrope cell enrichment. Centrifugal elutriation allowed the purification of large gonadotropes from 42 day-old male rat pituitaries; this population contained 5.3 +/- 1.0% of the cells, 54 +/- 3% of the LH, and less than 5% of PRL. A gonadotrope-depleted fraction was also defined that contained more than 92% of the total PRL and was thus called the lactotrope population though it still contained small gonadotropes and most somatotropes. DHT and E2 receptors were quantified by multidose saturation analysis. The association constants (Ka) ranged from 0.2-0.5 X 10(9) M-1 both for E2 and DHT independent of the cell population. The binding of DHT was mainly observed in the gonadotropes (50-100 fmol/10(6) cells), while it was very low in the other cells (0.9-3 fmol/10(6) cells). E2-binding sites measured within the same cell populations showed a broader distribution than DHT binding sites. Whereas the ratio of binding DHT/E2 averaged 0.86 +/- 0.01 in the gonadotropes, it reached only 0.35 +/- 0.07 in the lactotropes. Thus, using enriched cell populations, our results demonstrate for the first time a quantitative selective distribution of androgen-binding sites as compared with the estrogen sites. PMID- 3971916 TI - Synthesis of placental protein 12 by human decidua. AB - The synthesis and secretion of placental protein 12 (PP12) were studied in tissue culture using explants of decidua, amnion, chorion, and placenta from seven full term pregnancies. The total amounts of PP12 in media and tissues were measured by RIA, and new protein synthesis and secretion by decidual explants were demonstrated by the incorporation of [35S]methionine into PP12 after 20 h of incubation with 12.5 microCi/ml [35S]methionine. Cycloheximide was used to study the effect of a protein synthesis inhibitor on the secretion of PP12 by decidua. Significantly more PP12 (P less than 0.001) was released into the medium from decidual explants than from chorion and amnion explants throughout the experimental period of 24 h. When incubated under identical conditions, placental explants released no detectable PP12. In decidual tissues and their culture media, the total amount of PP12 was 127.4% higher after incubation than before incubation (P less than 0.001). No increase was found when chorion and amnion were cultured. The addition of cycloheximide into cultures decreased the total amount of PP12 in the decidua and in its culture medium by more than 50%, indicating that one part of PP12 in decidua was performed and another part was newly synthesized. Decidual explants incorporated [35S]methionine into immunoprecipitable PP12 indicating new PP12 synthesis. In gel filtration, 77% of decidual [35S] PP12 eluted in the same position as purified PP12. In sodium dodecyl sulfate polyacrylamide gel electrophoresis, the migration mobility of [35S]PP12 was identical with that of purified PP12. Our results clearly demonstrate that PP12 is a decidual rather than a placental protein. PMID- 3971917 TI - Adenohypophysial dopamine content and prolactin secretion in the aged male and female rat. AB - In male rats the concentrations of dopamine (DA) in the adenohypophysis and of PRL in serum increase progressively with age. The increase in the DA content is not a consequence of reduced metabolism of DA, since the activities of the enzymes that deaminate (monoamine oxidase) and O-methylate (catechol-O methyltransferase) this amine are not reduced in the anterior pituitary of aged male rats; indeed, both type A and B monoamine oxidase activities are increased in the pituitaries of aged rats. The increased DA present in the aged adenohypophysis is not in a static pool but, as in young rats, is rapidly decreased by pharmacological treatments that reduce the activity of tuberoinfundibular DA neurons (gamma-butyrolactone), reduce the synthesis of DA in these neurons (alpha-methyltyrosine), or block DA receptors (haloperidol) in the adenohypophysis. All of these treatments increased serum PRL levels and reduced DA concentrations in the adenohypophysis of both young and aged rats. Similarly, in female rats, where age-related differences in BW and body composition are minimized, serum PRL concentrations and DA concentrations in the adenohypophysis of both young and aged rats changed in the same way after the administration of a DA agonist (apomorphine) or a DA antagonist (haloperidol). Apomorphine reversed the alpha-methyltyrosine-induced increase in serum PRL concentrations and the decrease in anterior pituitary DA content in both young and aged rats, although the latter animals appear to be more responsive to this drug. Similarly, aged rats were more sensitive to the increase in serum PRL concentrations and the decrease in anterior pituitary DA content caused by haloperidol. The actions of acute and chronically administered haloperidol are reversible, with the reduced DA content of the adenohypophysis and the elevated serum concentrations of PRL returning to respective pretreatment levels in both young and aged rats once treatment stops. The time course for recovery of serum PRL levels and anterior pituitary DA contents after both the acute and chronic haloperidol treatment is of longer duration in the aged rat, which is consistent with a decreased rate of clearance of haloperidol in these animals. Twelve daily injections of bromocriptine, a DA agonist, reduced serum PRL and anterior pituitary DA concentrations in both young and aged rats, and these effects persisted for up to 7 days after the injections were stopped.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971918 TI - A study of the role of the postnatal testes in determining the ontogeny of gonadotropin secretion in the male rhesus monkey (Macaca mulatta). AB - To further examine the role of the testes in determining the ontogeny of gonadotropin secretion in the male rhesus monkey, the time courses of circulating LH and FSH concentrations were determined using established RIAs in daytime and nighttime blood samples collected at weekly intervals from birth until 4 yr of age in intact animals (n = 7) and in males orchidectomized at approximately 1 week of age (n = 6). Estimates of plasma androgen (A) concentrations were obtained on nonchromatographed samples with a RIA that reacts with testosterone and other androgens. Plasma PRL concentrations were also determined by RIA, and body weight was monitored at weekly intervals. Testicular volumes were measured at weekly intervals after 1.8 yr of age in five animals. In intact animals, mean daytime plasma A concentrations during the first 3 months of infantile development ranged from 1-6 ng/ml. Daytime plasma A concentrations then declined to reach 0.5-1 ng/ml by 9 months of age, where they were maintained usually until 3 yr of age when circulating levels progressively increased to reach, by approximately 3.5 yr of age, mean levels (6 ng/ml) characteristic of fully mature males. During the transition from infantile to perpubertal development, circulating LH and FSH concentrations showed a pattern similar to that of A, with elevations during the first 2 months of life followed by a decline to undetectable concentrations. In contrast to A, however, distinct pubertal increments in circulating LH and FSH concentrations were not observed in daytime samples from intact animals. The first indication of the pubertal reactivation of the hypothalamic-pituitary-testicular axis was provided by a reemergence of nocturnal elevations in plasma A concentrations between 2-3 yr of age. These were followed shortly thereafter by detectable plasma LH concentrations in nighttime samples. Orchidectomy at 1 week of age resulted in a progressive and dramatic rise in circulating gonadotropin concentrations, which plateaued approximately 3 weeks later at values 1 order of magnitude greater than those observed in intact animals. This hypersecretion of LH and FSH was not sustained, however, and by 10 months of age, plasma gonadotropin concentrations in agonadal animals were indistinguishable from those in age-matched intact controls. These low levels of the gonadotropic hormones were maintained, in the absence of the testes, for approximately 2 yr until a second or "pubertal" postcastration hypersecretion of LH and FSH was observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3971919 TI - Partial purification and characterization of somatomedin from sheep serum. AB - A rapid, high yield preparative technique for the isolation of sheep somatomedin is reported. Purification of biologically active somatomedin from the 60% ammonium sulfate precipitate of sheep serum was accomplished using three gentle fractionation steps. Biological activity during purification was monitored using the rat adipocyte nonsuppressible insulin-like activity (NSILA) assay. A stepwise pH elution (pH 2.85, 3.5, 4.5, and 6.0) from SP-Sephadex resulted in the elimination of more than 99% of the serum proteins and a 500-fold enhancement of biological activity. The active fraction eluted at pH 6.0 and was further fractionated on Sephadex G-50 (fine) chromatography at pH 2.85. This resulted in about a 10,000-fold enhancement of activity over serum activity. The most active fractions from Sephadex chromatography were further separated on reverse phase HPLC in 0.1% trifluoroacetic acid using a linear gradient of 24-60% acetonitrile. The biological activity of the final preparation was enhanced 61,000- to 182,000 fold over that of serum (mean, 93,000-fold) when assayed in the NSILA assay. Protein yield was estimated to be 467 micrograms/liter serum. In addition to the NSILA activity, the final preparation demonstrated dose-dependent sulfation factor activity in the embryonic chick pelvic leaflet bioassay. Sheep somatomedin was active at physiological levels in both bioassays. Analysis of the somatomedin preparation by sodium dodecyl sulfate-electrophoresis at pH 8.8 showed that it was homogeneous by this criterion. The activity eluted from Sephadex G-50 was estimated to have a molecular size of 6900. Two Coomassie blue-stained bands were present in the final sheep somatomedin preparation after polyacrylamide gel electrophoresis at pH 3.2. Our purification process is a rapid, high yield technique which yields a polypeptide fraction enriched in NSILA and somatomedin like activity. The molecular size and biological activity in the NSILA and sulfation factor assays suggest that our sheep NSILA is analogous to somatomedins purified from other species of animals. PMID- 3971920 TI - Bovine thyrotropin has a specific bioactivity 5- to 10-fold that of previous estimates for highly purified hormone. AB - Bovine TSH (bTSH) was subjected to reverse phase HPLC using a Synchropak RP-P C18 column. Elution was with a linear gradient of 0-50% 1-propranol in 0.1% trifluoroacetic acid. Individual fractions were assayed for TSH bioactivity by the cultured thyroid cell cAMP response assay. Optimum separation of biologically active TSH was obtained at a mobile phase pH of 5. Under these conditions, bTSH purified by conventional chromatographic techniques to 25 U/mg protein was purified further to approximately 200 U/mg protein. These data indicate that bioactivity is only present in a relatively small fraction of the molecules in a highly-purified TSH preparation. The implications of these findings are discussed. PMID- 3971921 TI - Tripeptide aldehyde protease inhibitors may depress in vitro prolactin and growth hormone release. AB - The effects of novel nontoxic tripeptide aldehyde inhibitors of proteolytic enzymes were examined in order to investigate the possibility that serine-thiol protease(s) may be involved in PRL and GH secretion. Rat anterior pituitary cells maintained in culture for 7-8 days or freshly taken pituitary quarters were treated with BOC-DPhe-Pro-Arg-H (BOC-dPPA), DPhe-Pro-Arg-H (dPPA), BOC-DPhe-Leu Lys-H (BOC-dPLL), or BOC-DPhe-Phe-Lys (BOC-dPPL). Newly synthetized [3H]PRL and [3H]GH as well as immunoreactive (i) hormones (iPRL, iGH) were measured in the incubation media and cell homogenates. Four hours of incubation in the presence of 0.1 mM dPPA resulted in a 30% decrease of [3H]PRL and iPRL release by cell cultures; the inhibition by BOC-dPPA was 60% and 48%, respectively. [3H]PRL biosynthesis was unchanged or slightly decreased. The effect of these tripeptide aldehydes on [3H]GH and iGH release was less pronounced but statistically significant. Pituitary quarters treated with 1.0 or 3.0 mM BOC-dPPA release 20% and 57% less [3H]PRL than the controls. In the same system BOC-dPPA in a 1.0 mM concentration did not effect GH secretion, and 3.0 mM BOC-dPPA inhibited [3H]GH output by 27%. Forty micromolars of BOC-dPPL decreased by 47%, 0.2 mM by 79%, and 1.0 mM by 94% [3H]PRL release from pituitary quarters. GH secretion was not influenced. A similar selectivity was observed when BOC-dPLL was used. It is clear that by serine-thiol protease inhibitors whose effects are sequence and dose dependent, PRL and GH release are decreased. The relative inhibiting potency on PRL release was BOC-dPPL greater than BOC-dPLL greater than BOC-dPPA greater than dPPA. The biosynthesis of [3H]PRL was reduced only in the presence of the highest tripeptide aldehyde concentrations or long (8 h) exposure, and only 1.0 mM Boc-dPPL reduced [3H]GH biosynthesis by 30%. The data suggest that proteolysis may be involved in the process of PRL and GH release and the enzyme(s) in question may be serine-thiol protease(s). PMID- 3971922 TI - Ectopic pituitary grafts in mice: hormone levels, effects on fertility, and the development of adenomyosis uteri, prolactinomas, and mammary carcinomas. AB - Some endocrinological consequences of grafting hypophyses of mice to sites distant from the hypothalamic-pituitary portal vessels were investigated. Serum PRL levels in recipients rose within 3 weeks to levels seen during pregnancy, resulting in a premature increase in serum progesterone (P) levels. After 7 weeks, luteolytic effects were evident in BALB/c females, and P values had plateaued in the range of those seen in normal adult animals, while in BALB/c X C3H F1 hybrids, this effect was delayed, and P values rose, reaching, in some animals, levels reported during pregnancy. Despite continuing hyperprolactinemia, the fertility of graft-bearing females was reduced only slightly. By the 6th month, lesions of adenomyosis were frequent in uteri of C3H and F1 hybrids, but essentially absent from BALB/c animals. The number of corpora lutea was reduced in all experimental groups, yet serum P values were somewhat elevated in hybrid females and BALB/c animals bearing three grafts. Evidence is presented indicating that PRL enhances the action of P on both the estrogen-stimulating vagina and uterus. Small groups of grafted BALB/c and hybrid females not infected with exogenous mouse mammary tumor virus were allowed to survive until mammary cancers developed or until they reached 18 months of age. The grafts in the hybrids routinely became adenomatous, producing serm PRL levels of 1-21 X 10(3) ng/ml; only one secreted excessive GH. Adenomyosis wained in the aged hybrids, apparently due to declining ovarian function. The majority of the animals developed adenoid cystic mammary cancers that seemed to arise from areas of hyperplasia within dilated ducts rather than from alveolar hyperplasias, as is most frequently the case in mice carrying exogenous mouse mammary tumor virus. PMID- 3971923 TI - Heterogeneity in mouse seminal vesicle epithelial cells responding to androgen as evaluated by incorporation of [125I]iododeoxyuridine. AB - When the uptake of 5-[125I]iodo-2'-deoxyuridine ([125I]IdUrd) into the seminal vesicle of castrated mice was measured 3 days after starting injections of various doses of testosterone propionate (TP), logarithmic values of [125I]IdUrd uptake were proportional to the logarithmic doses of TP in the range of 0.04-2 micrograms/g BW. The [125I]IdUrd uptake values correlated well with the labeling and mitotic indices of epithelial cells. Since daily injections of 0.4 microgram TP/g BW did not increase significantly the weight or DNA content or protein content of the seminal vesicle, the [125I]IdUrd uptake is a sensitive index of androgen action. Moreover, this suggests that low doses of androgen induce division of epithelial cells without resulting in the increase in cell number. The [125I]IdUrd radioactivity in the seminal vesicle was measured 2-15 days after the injection of [125I]IdUrd, since the value represented the fraction of surviving cells synthesizing DNA at the time of [125I]IdUrd injection. When injections of 4 micrograms TP/g BW were continued, the incorporated radioactivity was retained. In contrast, continuous injections of 0.2 microgram TP/g BW did not maintain the radioactivity, of which incorporation was induced by the same dose of TP. Thus, the present result suggests the presence of heterogeneity in androgen-responsive epithelial cells of the seminal vesicle. PMID- 3971924 TI - Immunocytochemical study of mammalian progesterone receptor using monoclonal antibodies. AB - Five monoclonal antibodies were used for the immunocytochemical study of mammalian progesterone receptor (PR). Initial studies were aimed at defining the optimal experimental conditions for the detection of the receptor, with special emphasis on techniques likely to be used in clinical determinations and in immunoelectron microscopic localization. Specific immunoperoxidase staining was observed either in fixed, frozen sections or in sections of paraffin-embedded tissue. The latter method allowed a better preservation of cellular structures. Among the eight fixatives tested, glutaraldehyde, picric-acid formaldehyde, and paraformaldehyde proved satisfactory. Both indirect immunoperoxidase and the indirect antibody peroxidase-antiperoxidase methods could be used. In immature rabbits or castrated guinea pigs primed by estrogen, i.e. in conditions where its ligand was absent (or present in very low concentration), the PR was confined to the nucleus of immunoreactive cells. This was the case for all the cell types of the endometrium and the myometrium, for the immunostained cells of the oviduct, cervix, vagina, pituitary gland, and for the very weakly stained cells in the liver. No staining was observed in nontarget tissues for progesterone, such as diaphragm, spleen, and small intestine. Nuclear staining was also absent when various control antibodies replaced anti-PR antibodies. This result thus generalizes the observations made on the estrogen receptor, showing that there is no translocation of the receptor from cytoplasm to nucleus under the influence of the hormone. Moreover, a marked heterogeneity in immunostaining was observed among cells of the same type in several tissues, suggesting that there could be large differences in the hormonal sensitivity of individual cells. Cellular distribution of PR immunoreactivity was studied in the uterus, cervix, oviduct, and pituitary gland of rabbits and in the uterus and vagina of guinea pigs. A labeling was observed in all the cell types of the uterus (luminal and glandular epithelium, stroma, and muscularis). In the cervix, nuclear immunostaining was observed in the connective tissue of the lamina propria and in some epithelial and muscle cells. In the vagina, PR immunoreactivity was seen in the basal layers of the stratified squamous epithelium, in the connective tissue of the lamina propria, and in the smooth muscle. In the oviduct, the luminal epithelium, the connective tissue, and the muscularis were stained. In the pituitary gland, selective nuclear labeling was observed in a few scattered cells. PMID- 3971925 TI - Differential regulation of thyrotropin subunit apoprotein and carbohydrate biosynthesis by thyroid hormone. AB - The regulation of TSH apoprotein and carbohydrate biosynthesis by thyroid hormone was studied by incubating pituitaries from normal and hypothyroid (3 weeks post thyroidectomy) rats in medium containing [14C]alanine and [3H] glucosamine. After 6 h, samples were sequentially treated with anti-TSH beta to precipitate TSH and free TSH beta, anti-LH beta to clear the sample of LH and free LH beta, then anti LH alpha to precipitate free alpha-subunit. Total proteins were acid precipitated. All precipitates were subjected to electrophoresis on sodium dodecyl sulfate-polyacrylamide gels, which were then sliced and assayed by scintillation spectrometry. In hypothyroid pituitaries plus medium, [14C]alanine incorporation in combined and free beta-subunits was 26 times normal (P less than 0.001) and considerably greater than the 3.4-fold increase seen in total protein (P less than 0.05); combined and free alpha-subunits showed no specific increase in apoprotein synthesis. [3H]Glucosamine incorporation in combined alpha- and beta-subunits in hypothyroid samples was 13 and 21 times normal, respectively, and was greater than the 1.9-fold increase in total protein (P less than 0.05); free alpha-subunit showed no specific increase in carbohydrate synthesis. The glucosamine to alanine ratio, reflecting relative glycosylation of newly synthesized molecules, was increased in hypothyroidism for combined alpha subunits (P less than 0.001), but not for combined beta-subunits, free alpha subunits, or total proteins. In summary, short term hypothyroidism selectively stimulated TSH beta apoprotein synthesis and carbohydrate synthesis of combined alpha- and beta-subunits. Hypothyroidism also increased the relative glycosylation of combined alpha-subunit. Thus, thyroid hormone deficiency appears to alter the rate-limiting step in TSH assembly (i.e. beta-subunit synthesis) as well as the carbohydrate structure of TSH, which may play important roles in its biological function. PMID- 3971926 TI - Adenylate cyclase in the corpus luteum of the rhesus monkey. I. General properties and optimal assay conditions. AB - To characterize the adenylate cyclase system of the primate corpus luteum, we assayed the conversion of [alpha-32P] ATP to [32P]cAMP in preparations of luteal tissue obtained from rhesus monkeys on days 17-19 of the menstrual cycle. Basal, gonadotropin (hCG; 250 nM)- sensitive, and guanine nucleotide (5'-guanylyl imidodiphosphate [GMP-P(NH)P]; 10 microM)-sensitive cAMP production were influenced by the pH, osmolality, and ionic strength of the assay buffer. As the concentration of Mg+2 increased from 2 to 10 mM, adenylate cyclase activity was enhanced; however, the relative stimulation by hCG plus GMP-P(NH)P was maximal when the Mg+2 concentration approximated that of ATP plus EDTA. In contrast, the presence of Ca+2 inhibited basal, hCG-stimulated, and GMP-P(NH)P-stimulated cAMP production. Adenylate cyclase activity was substrate dependent at ATP concentrations from 0.7-4.5 mM; however, higher concentrations of ATP did not alter cAMP production. The relative stimulation by hCG and GMP-P(NH)P was independent of ATP levels when the ATP to Mg ratio was constant. The rate of cAMP production was constant during 30 min of incubation at 37 C, with the ATP concentration maintained at greater than 87% of initial levels. Adenylate cyclase activity was 10-fold greater in luteal tissue from the superovulated rat than in that from the cycling rhesus monkey; however, relative stimulation by hCG and GMP P(NH)P was qualitatively similar in the two species. Thus, we have demonstrated the existence of an adenylate cyclase system in the corpus luteum of the rhesus monkey during the menstrual cycle and have established some general properties and optimal assay conditions for the gonadotropin-sensitive adenylate cyclase. PMID- 3971927 TI - Detection of prolactin inhibitory activity in uterine epithelial cell secretions and rat serum. AB - We have shown that the uterus of the rat contains a substance that diminishes the release of the luteotropic hormone PRL by acting directly at the anterior pituitary gland. This study was designed to determine which cell type(s) within the uterus secretes this PRL inhibitory activity (PIA) and if PIA of uterine origin appears in circulation. Enzymatically dispersed cells from uteri of ovariectomized (OVX) rats were cultured for 24 h in serum-free Dulbecco's Modified Eagle's Medium. Estimation of PIA in the spent media from heterogeneous uterine cell cultures was evaluated after 24 h by the ability to suppress PRL release from confluent monolayers of cultured pituitary cells. Spent media from uterine cell cultures containing 0.125 X 10(6) or 0.25 X 10(6) cells/well failed to significantly suppress PRL secretion. However, media from 0.5 X 10(6) and 1 X 10(6) uterine cells/well induced 36% and 85% inhibition of PRL release, respectively, without affecting basal LH release. To determine which cell type(s) in the uterus is responsible for PIA secretion, whole uteri were partitioned into epithelial, stromal, and myometrial cell fractions by differential enzymatic dissociation. Varying numbers of cells from each fraction were cultured for 24 h. PIA in the spent media from the homogeneous uterine cell cultures was estimated by its ability to suppress PRL release from cultured anterior pituitary cells. Media from epithelial cell cultures suppressed PRL secretion in a dose-dependent fashion. Media obtained from cultures of a comparable number of stromal or myometrial cells had no significant effects on PRL secretion. LH secretion was unaffected by media obtained from any concentration of the various uterine cell types. Since cultured anterior pituitary cells treated directly with crude uterine extract for 24 h recover and secrete PRL at the same rate as untreated controls during a 72-h posttreatment interval, it is unlikely that the uterine PIA is either proteolytic or cytotoxic. To determine if PIA is detectable in peripheral circulation, sera obtained from OVX or OVX hysterectomized (OVX-HYST) donor rats were incubated with cultured anterior pituitary cells for 24 h. In response to the OVX sera, there was significant inhibition of PRL release. However, upon replacement of OVX sera with OVX-HYST sera, the inhibition was significantly reduced. Thus, PIA is higher in sera of rats bearing uteri. Taken together, these data suggest that the epithelial layer of the uterus secretes a PIA which probably reaches the hypothalamo-pituitary axis through the circulation. PMID- 3971929 TI - Efficacy of octa- and heptapeptide antagonists of angiotensin II as inhibitors of angiotensin III binding in the rat adrenal glomerulosa. AB - Angiotensin III (Ang III) is a carboxy-terminal 7-amino acid analog of angiotensin II (Ang II) with similar receptor binding affinity and biological activity in adrenal glomerulosa. Specific competitive antagonists have been synthesized for both compounds, and structure-activity studies have demonstrated that Ang II (octapeptide) antagonists compete better for Ang II receptors in adrenal glomerulosa than do Ang III (heptapeptide) antagonists. These differences were observed in spite of only 1 amino acid difference in chain length of antagonist analogs. These earlier observations by our group provided support for the current hypothesis that Ang III binding would be preferentially inhibited by Ang III antagonists compared to Ang II antagonists. To accomplish these studies, we used [125I]Ang III and [125I]Ang II as ligands and 5 pairs of heptapeptide and octapeptide antagonists with identical substituent amino acids in the carboxy terminal position. [Sar1,Ile8]- and des Asp1 [Ile8]Ang II did not differ in potency as antagonists of Ang II binding, but with 4 other pairs of antagonists, the octapeptide antagonists were more potent than the corresponding hepatapeptide antagonist. Six of 10 antagonists exhibited similar potencies as antagonists of equimolar concentrations of Ang II and Ang III. One heptapeptide antagonist was twice as potent against Ang III, and 3 octapeptide antagonists were more potent against Ang II. In general, the order of potencies of the 10 antagonists as inhibitors of Ang III binding was linearly related to their potencies against Ang II. Hence, our hypothesis of preferential activity of Ang III antagonists (compared to Ang II antagonists) as inhibitors of Ang III binding to adrenal glomerulosa was not borne out by the present studies. When this observation was combined with the finding of similar receptor densities of Ang III and Ang II receptors, we concluded that Ang III and Ang II probably bind to the same receptor site in the adrenal glomerulosa. PMID- 3971928 TI - The effects of hypophysectomy and administration of pituitary hormones on luteal function and uptake of high density lipoproteins by luteinized ovaries and adrenals of the rat. AB - The role of plasma lipoproteins and hypophyseal hormones in the maintenance of progesterone secretion by the rat corpus luteum was investigated. In the first experiment, rats were treated daily from days 1-6 of pregnancy with 5 mg/kg 4 aminopyrozolopyramidine (4APP), a blocker of hepatic lipoprotein secretion, or with 5 mg/kg 4APP and 1 or 2 mg ovine PRL or 0.1 ml 0.5% phosphoric acid (4APP vehicle). The administration of 4APP reduced serum cholesterol and progesterone levels on days 2-6 of pregnancy and ovarian progesterone on day 6. The reduced progesterone secretion had no effect on embryo implantation. PRL, in the doses used, was incapable of abrogating the effects of 4APP on circulating or ovarian progesterone levels. Ovaries and adrenals, but not kidneys, of pseudopregnant rats exhibited specific and saturable uptake of porcine high density lipoprotein (HDL). Time-course studies indicated that the uptake of HDL was rapid in ovaries compared to that in adrenals. Ovaries from rats not only exhibited uptake of porcine HDL, but also were capable of using it for progesterone synthesis. Immature rats were assigned to 7 groups of 16 rats each; 8 rats from each group received 4 mg/kg 4APP, and 8 received 4APP vehicle from day 1 of pseudopregnancy. Four groups underwent hypophysectomy on day 1 and received one of the following: 0.1 mg (30 IU/mg) ovine PRL, 0.1 mg ovine LH or 0.1 mg synthetic ACTH daily, or no replacement therapy. Three sham-hypophysectomized groups received 0.1 mg PRL or LH twice daily or no hormone treatment. On day 5 of pseudopregnancy, rats received intravascular HDL, as described above, and were killed 1 h later. Treatment with 4APP increased the adrenal uptake of HDL, but ovarian uptake was not different from that in the control group. Hypophysectomy reduced both adrenal and ovarian uptake of HDL. In adrenals only ACTH at the dose employed ameliorated reduction of HDL uptake induced by hypophysectomy, while in the ovaries, both PRL and LH reversed the effect of hypophysectomy. The effect of PRL on uptake was specific to [125I]HDL and did not alter [125I]albumin uptake. It is concluded that: 1) hypophysectomy reduces HDL uptake in the luteinized rat ovary; and 2) PRL and LH replacement therapy maintain ovarian uptake of HDL, suggesting a direct effect of these luteotropins on lipoprotein uptake. PMID- 3971930 TI - Effect of osmolality on aldosterone secretion. AB - The purpose of these experiments was to determine if the powerful effect of sodium chloride concentration on angiotensin II- and potassium-stimulated aldosterone secretion by isolated perfused adrenal glands is mediated by the sodium or chloride ion or by the obligatory change in osmolality. We used isolated Ringer's bicarbonate perfused canine adrenal gland preparations to determine the effects of a variety of isosmotic, hyperosmotic, and hyposmotic solutions on angiotensin II- and potassium-stimulated aldosterone secretion. When we increased the osmolality of the perfusion medium (8-10 mosmol) by the addition of NaCl, sucrose, mannitol, or glucose, angiotensin II-stimulated aldosterone secretion was inhibited to a similar extent, whereas urea addition had no effect. Similarly, when we increased the osmolality of the perfusion medium (8-10 mosmol) by the addition of NaCl, sucrose, or mannitol, potassium-stimulated aldosterone secretion was also inhibited to a similar extent. In contrast to the increase in angiotensin II- and potassium-stimulated aldosterone secretion observed during hyposmotic reductions in NaCl concentration, (addition of sucrose) did not increase angiotensin II- or potassium-stimulated aldosterone secretion. Even the marked increase in aldosterone secretion caused by large hyposmotic reduction in NaCl concentration did not occur with an equivalent isosmotic reduction in NaCl concentration. These results clearly demonstrate that changes in NaCl concentration affect aldosterone secretion by a mechanism sensitive to the osmolality. Moreover, since hyperosmolality caused by urea addition had no effect on angiotensin II-stimulated aldosterone secretion, changes in intracellular volume or composition appear to be an important modulator of aldosterone secretion. PMID- 3971931 TI - Regulation of rat cerebrocortical and adenohypophyseal type II 5'-deiodinase by thyroxine, triiodothyronine, and reverse triiodothyronine. AB - To further understand the regulation of type II iodothyronine 5'-deiodinase (5'D II) in the central nervous system and pituitary, we examined the response of this enzyme to the acute administration of T4, T3, and rT3 in hypothyroid rats. Enzyme levels were correlated with serum concentrations of T4 and T3 in thyroidectomized rats after acute administration of either iodothyronine and in animals with hypothyroidism of increasing severity induced by methimazole administration. Estimates of the tissue concentrations of the three iodothyronines, nuclear T3, and serum TSH levels were used to assess mechanisms and intrinsic potencies of the three iodothyronines. In four experiments, doses of T4 that reduced 5'D-II activity by 50% (ID50) ranged from 0.18-0.39 micrograms/100 g BW in the cortex and from 0.34-1.05 in the pituitary, whereas the corresponding ID50 values of rT3 were 1.0 and 3.5, and those of T3 were 4.0 and 5.0 micrograms/100 g BW. T3 doses that saturated nuclear receptors and fully suppressed TSH showed only modest suppression of 5'D-II levels in the cortex and pituitary. Based on estimates of the tissue hormone levels resulting in 5'D-II suppression, T4 and rT3 were much more potent than T3 in decreasing 5'D-II. These findings support the concept that the effect of these iodothyronines on 5'D-II is not mediated by the nuclear T3 receptor. The correlation of serum T4 and T3 with enzyme levels after acute injections of T4 or after chronic treatment with methimazole suggested that plasma T4 is probably the main physiological signal regulating 5'D-II. It is conceivable that rT3 produced locally from T4 also plays a role in the regulation of the enzyme. PMID- 3971932 TI - Enhancement of human growth hormone-stimulated mitogenesis of Nb2 node lymphoma cells by 12-O-tetradecanoyl-phorbol-13-acetate. AB - The tumor promoter 12-O-tetradecanoyl-phorbol-13-acetate (TPA) enhanced human (h) GH- and ovine PRL-stimulated mitogenesis of the Nb2-11C clone of rat lymphoma cells. Maximal enhancement of 25% in the proliferation rate was achieved with 20 nM TPA. The enhancing effect was found at all levels of hGH (0.031-2.0 ng/ml), but was more pronounced at lower hormone concentrations. TPA alone had no effect on cell proliferation, and its activity was absolutely dependent on the simultaneous presence of the lactogenic hormones. We have analyzed the changes that occurred in the distribution of cells in different phases of the cell cycle during the first 22 h after exposure to hGH and measured the proliferation rate through 3 days. We have found that the mitogenic effect of hGH resulted from 1) an increase in the rate of G0/G1----S transition, 2) a decrease in the lag period required for entry into the S phase, and 3) an increase in the number of cells entering this transition. TPA enhanced all three effects. Binding of [125I]hGH was not affected by prior exposure to TPA, suggesting that the effect of TPA is at a postreceptor level. Proliferation of an autonomous clone of Nb2 cells that does not require lactogenic hormones for growth was not stimulated by TPA, although these cells bound [3H]TPA to the same extent as the PRL-dependent Nb2 11C clone. PMID- 3971934 TI - Transcarinal mediastinal needle biopsy as a supplement to bronchoscopic evaluation of neoplastic lung diseases. AB - A screening method for detecting the dissemination of malignant tumours to the bifurcal lymph nodes is described. The procedure was performed in 300 patients. Malignancies were found in 255 cases, 216 of which were bronchogenic cancers. The transcarinal mediastinal needle biopsy (TMNB) was positive in 25% of all cases with malignant diseases, but in patients with anaplastic tumours a positive TMNB was found in 40%. No complications occurred, the method could be applied to out patients, and if positive, mediastinoscopy could be avoided. PMID- 3971935 TI - Diagnostic thoracoscopy in pleuro-pulmonary infiltrates without pleural effusion. AB - In seven patients with pleuro-pulmonary infiltrates without pleural effusion, an artificial pneumothorax was induced, followed by diagnostic thoracoscopy, as the first and only invasive investigation; in all cases the diagnosis was confirmed by this simple procedure. The method has a low mortality correlated to other alternative diagnostic methods. PMID- 3971933 TI - Norepinephrine amplifies human chorionic gonadotropin-stimulated androgen biosynthesis by ovarian theca-interstitial cells. AB - Ovarian theca-interstitial cells, when cultured in serum-free medium, secreted androgens in response to hCG stimulation. This production was dependent on time (maximum production attained after 96 h) and dose (half-maximal effective dose of hCG, 9 ng/ml). When the sympathomimetics norepinephrine, epinephrine, and isoproterenol were added to the medium, androgen production in response to hCG was enhanced by 100-300%. The ability of the catecholamines to stimulate androgen production was dependent on the continuous presence of hCG. Treatment with catecholamines alone did not induce theca-interstitial cells to produce androgens. Catecholamine stimulation of steroid hormone metabolism was selective for intermediates in the delta 4-pathway, with greatest increases occurring in the production of androstenedione and testosterone. It was found that the effect of the catecholamines on androgen production was dependent on both beta 1-and beta 2-adrenergic receptors. The acquisition of catecholamine responsiveness was specific to hCG; if theca-interstitial cells were induced to differentiate with either prostaglandin E2 or cholera toxin, then isoproterenol did not enhance androgen synthesis. The catecholamine-induced increases in androgen production were not due to a granulosa cell contribution of steroid. The interstitial cells are the only steroid-producing cells in the ovary that are directly innervated by norepinephrine-containing fibers of the sympathetic nervous system. Our finding of catecholamine-augmented androgen production provides a direct link between the autonomic nervous system and regulation of ovarian steroid synthesis. PMID- 3971936 TI - ERCP using a special catheter with external steering. A reliable aid in typical ERCP problems. AB - ERCP is the most sensitive procedure for opacification of the bile and pancreatic ducts. The procedure fails, however, in up to 60% of Billroth II resected patients, and in 5% of nongastrectomized patients, often owing to problems of papillary cannulation with the conventional ERC-catheter, or insufficient control in the bile duct. Therefore, we attempted to perform ERCP with a catheter provided with external steering, which can be introduced through the channel of any commercially available endoscope. This catheter permitted successful ERCP in 11 patients in whom conventional ERCP technique had failed. The endoscopic procedure with the catheter described was simple and reduced papillary cannulation problems in patients with juxtapapillary diverticulum and in those with Billroth II resection, and it permitted selective opacification of intrahepatic bile ducts or the cystic duct. PMID- 3971937 TI - A new method of identifying tumors of the papilla of Vater. AB - A new method, combining duodenoscopy and computed tomography, is described. This method is used to identify the irradiation area of tumors of the papilla of Vater with steel clips. PMID- 3971938 TI - Endoscopic surgery in the rectum. AB - A new transanal endoscopic operative technique permits microsurgery in the rectal cavity and the placing of surgical sutures. Compared with other procedures this one is non-aggressive, and there were not postoperative complications in twelve cases. A stereoscopic optical system, a new operating rectoscope and special surgical instruments, as well as a modification to an insufflation device are necessary for the endoscopic operation. PMID- 3971939 TI - Association of herpes virus infection of the esophagus and idiopathic inflammatory bowel disease. AB - A case of relapsing ulcerative esophagitis presumably due to herpes virus infection in temporary association with two relapses of an idiopathic inflammatory bowel disease is reported. PMID- 3971940 TI - Lithotripsy of urinary concrement in the sigmoid after ureterosigmoidostomy. AB - A urinary concrement which appeared in the sigmoid of a 63-year-old man after ureterosigmoidostomy was extracted by endoscopy. The stone was situated proximal to a radiogenic stenosis. Because of the disproportion between the stone and the sigmoidal stenosis, mechanical lithotripsy had to be done before the concrement could be completely extracted. PMID- 3971941 TI - Multiple mucosal bridge formations in the stomach, report of a case. AB - An unusual gastric lesion comprising multiple bridges in a 62-year-old woman is presented. Radiographic and endoscopic examination revealed several mucosal bridges and mucosal tags. The resected stomach showed eight mucosal bridges and five mucosal tags along the course of the mucosal folds in the fundic gland area, the former measuring 3 cm in diameter. This paper concludes with short discussion of the etiology of these proliferative gastric lesions from a clinicopathological standpoint. PMID- 3971942 TI - Primary gastric lymphoma versus gastric cancer. An endoscopic and radiographic study of differential diagnostic possibilities. AB - Eighteen patients with primary gastric malignant lymphoma were compared retrospectively with an age- and sex-matched group of patients with gastric cancer. It was found that a correct preoperative diagnosis was established in 8 out of 18 lymphoma patients (44%). Of the remaining patients eight were preoperatively diagnosed as cancers and two as benign ulcers. Malignancy was not suggested by biopsy or cytology in a total of six lymphoma patients. There was no difference as regards the size of the gastric lesion between the groups. A diffuse involvement of the stomach was found only in lymphoma patients. Furthermore, lymphoma patients often showed superficial stellate ulcers and a sharp margin between the lesion and the normal mucosa. It is suggested that these findings should make the investigator aware of the possibility of a gastric lymphoma. When this diagnosis is considered, great importance should be attached to obtaining large biopsies which possibly allow a correct preoperative diagnosis more often. PMID- 3971943 TI - Floating pancreatic duct concrements in chronic pancreatitis. Pain relief by endoscopic removal. AB - This report describes 3 patients with chronic relapsing pancreatitis, floating pancreatic duct concrements between 4 and 6 mm in diameter, moderate to advanced ductal changes, and repeated severe attacks of pain during acute relapses over a period of several months. Immediate relief of pain was achieved in all 3 patients by endoscopic papillotomy aimed at widening the main pancreatic duct and subsequent extraction or spontaneous passage of pancreatic duct concrements. On the basis of our experience with the patients presented here, endoscopic papillotomy widening the main pancreatic duct may be useful in some patients with chronic pancreatitis and floating pancreatic duct concrements. PMID- 3971944 TI - Epilepsy and psychosis: a comparison of societal attitudes. AB - Pioneer investigators in Nigeria have presented a gloomy picture of epilepsy as a highly infectious and disastrous disease in the eyes of the public. As a result, epileptic persons suffer untold social deprivations and discrimination in education, employment, housing, marital life, etc. These assertions have been repeated over the years more as a result of incidental observations while reviewing hospital cases than as products of attitude research on the subject. We assumed, therefore, that these statements should be considered as impressive hypotheses needing to be tested. By employing the Osgood semantic differential and the behavioral differential of Triandis, we assessed the attitude of the normal literate general public toward persons with epilepsy and "cured" psychotic patients and how closely the public would associate or socialize with these people. We also inquired into the public's opinion about the causes of epilepsy and psychosis, since this knowledge is necessary for attitude formation and change. On the whole, the general attitude toward epileptic patients is negative, and toward "cured" psychotic patients, positive. There are sex differences, in that males perceive epileptic patients more favorably than females do. However, both males and females would discriminate against both the epileptic and "cured" psychotic person in terms of employment, residential accommodation, friendship, and marital relations. The major perceived causes of epilepsy reported were heredity, witchcraft, and brain damage, in that order, not infection. About 25% admitted ignorance of the cause of epilepsy, as against 1% for psychosis. The psychoses were reportedly caused mainly by Indian hemp smoking, drug abuse, brain damage, and witchcraft, in that order.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3971945 TI - Preliminary Nigerian experience in the use of carbamazepine in children with intractable seizures. AB - There is insufficient clinical information about carbamazepine and other newer anticonvulsants from tropical African countries because high costs and limited availability have restricted the use of these drugs in the economically underdeveloped countries. The present communication reports the observed effects of carbamazepine in nine Nigerian children whose epileptic seizures had been intractable to various combinations of previously available anticonvulsants. In seven of these children, intractable seizures were associated with moderate to severe cognitive deficits and behavioral disturbances. Following institution of carbamazepine therapy, complete seizure control was achieved in four children, and significant reduction in seizure frequency occurred in another four. In three children complete seizure control was maintained with carbamazepine alone after withdrawal of all other medications. Among the seven children with cognitive and behavioral problems, improved seizure control was accompanied by significant psychotropic gains. No serious side effects occurred in any of the children during follow-up periods ranging from 2 to 7 years. Because of the favorable anticonvulsant and psychotropic efficacy of carbamazepine in the present study, coupled with the lack of serious side effects, it is recommended that the drug deserves wider use in African children with seizure disorders. PMID- 3971946 TI - Brain distribution of carbamazepine and phenobarbital given in combination in experimental epilepsy. AB - This study describes the brain distribution of carbamazepine (CBZ) and phenobarbital (PB) given intraperitoneally in combination to cats rendered epileptic by parenteral penicillin and by penicillin topically applied on neocortex. A control group of normal cats was also evaluated pharmacokinetically. Levels of both drugs were extremely low in brains of controls (CBZ 0.8 +/- 0.02 micrograms/g; PB 1.49 +/- 0.7 micrograms/g of fresh tissue), but higher levels were found in brains of epileptic cats with CBZ showing the greater increase (peak concentrations five- to sixfold higher than the corresponding CSF free fraction vs. three- to fourfold higher for PB). This might have been partially due to the ability of CBZ to prevent the metabolic alterations associated with severe convulsions, and hence the binding impairment. As this event had no effect of potentiation on CBZ anticonvulsant activity, the present data confirm previous reports indicating that there is no experimental evidence that two drugs are better than one in controlling epilepsy. PMID- 3971947 TI - HLA antigens and idiopathic epilepsy. AB - Fifty-two mentally normal Egyptian children with idiopathic epilepsy were human leukocyte antigen (HLA) typed. They were divided into two subgroups: generalized tonic-clonic seizures (36 cases) and absences (16 cases). When the frequencies of HLA antigens were compared statistically with those of 120 normal controls, HLA A9 was found to be significantly higher in the total epilepsy group and the two subgroups. This finding, together with the low HLA-A9 gene frequency in our group of normal Egyptians as compared with other ethnic populations, strongly suggests an association between antigen A9 and one or more of the polygenes controlling the development of idiopathic epilepsy. The relative risk indicated that persons having antigen A9 are 16 times more susceptible to epilepsy than persons lacking it. PMID- 3971948 TI - Unilateral limbic epileptic status activity: stereo EEG, behavioral, and cognitive data. AB - We report data from four patients with unilateral epileptiform status activity within different structures of the temporal lobe, recorded during stereoelectroencephalographic presurgical evaluation. The ictal clinical symptoms accompanying neocortical and mesiobasal limbic discharges (two patients with complex partial status epilepticus) consisted of various psychosensory and vegetative signs, which can be understood on the basis of the spatiotemporal analysis of the discharges. The other two patients with circumscribed long lasting mesiobasal limbic epileptiform activity represent unilateral pure limbic status epilepticus and were characterized by a marked behavioral syndrome (with stickiness, aggressivity, etc.) and a monomorphic gustatory aura continua, respectively. The latter patient, with left hippocampal discharges of nearly continuous epileptiform character, was also assessed with tachistoscopic tasks. Performance revealed cognitive impairment only in the epileptically discharging hemisphere and in dependence on the quality of the EEG pattern. After unilateral selective amygdalohippocampectomy, the two patients with limbic status epilepticus were seizure free and had markedly improved behavior and cognitive functions. Thus, patients with nonconvulsive status epilepticus represent an ideal model, although rare, to correlate behavior alterations and brain dysfunction. PMID- 3971949 TI - Selective inhibition of homocysteine-induced seizures by glutamic acid diethyl ester and other glutamate esters. AB - Homocysteine thiolactone causes convulsions when administered to animals, and has recently been reported to have excitatory effects on neurons in the central nervous system. Glutamic acid diethyl ester (GDEE) has previously been found to be an effective antagonist of the central excitation induced by homocysteine and is thought to be a selective antagonist of the quisqualate-sensitive excitatory amino-acid-receptor site. If an interaction of homocysteine with the quisqualate sensitive receptor site is responsible for its convulsive properties, GDEE might also block the induction of seizures by homocysteine. GDEE in a dosage of 4 mmol/kg almost completely blocked homocysteine-induced seizures in mice; smaller dosages had no effect or only slight inhibitory effects. Glutamic acid dimethyl ester (GDME) and glutamic acid gamma-methyl ester (GMME) also partially blocked homocysteine-induced seizures, but monosodium glutamate and glutamic acid gamma monoethyl ester (GMEE) had only a slight effect. None of the glutamate esters inhibited seizures induced by pentylenetetrazole. It is therefore suggested that certain types of seizures involve the quisqualic acid excitatory amino-acid receptor site. Homocysteine-induced seizures may serve as a model of seizures of this type, and GDEE, GDME, and GMME may be effective antagonists of such seizures. PMID- 3971950 TI - Bicuculline methiodide in the blood-brain barrier-epileptogen model of epilepsy. AB - Focal epilepsy can be produced by a blood-brain barrier (BBB)-excluded systemic convulsant (penicillin, folic acid, etc.) in the presence of a focal BBB lesion. Bicuculline methiodide, a gamma-aminobutyric acid blocking epileptogen, crosses the normal BBB of rats poorly and produces no consistent abnormality behaviorally or on EEG at 36 mg/kg. When the BBB is opened in 0.25 ml of cortex by 6,000 rad of alpha particles, by a pin trauma lesion, or by a heat lesion, the rats are normal clinically and on EEG. When these lesioned rats are challenged with bicuculline methiodide, 36 mg/kg, an intense, highly localized epileptiform discharge results that begins approximately 20 min after injection and lasts 30 90 min. The plausibility and experimental utility of the BBB-epileptogen model of epilepsy are enhanced by these observations. PMID- 3971951 TI - Dopaminergic supersensitivity after long-term administration of phenytoin in rats. AB - Male albino rats (n = 10) were injected with phenytoin (PHT) every day for 20 consecutive days and were tested on days 21 and 28 for their response to 1 mg/kg apomorphine, a dopamine-receptor agonist. Rats treated with PHT showed an increased responsiveness to apomorphine-induced stereotypy on day 28, which is evidence for dopaminergic supersensitivity after long-term treatment with the drug. In experiment 2, a supersensitivity response to apomorphine-induced stereotypy was noted on day 14 after 10 days of PHT administration. In experiment 3, after 17 days of PHT administration, rats were also supersensitive to the climbing response induced by apomorphine. These results may explain, in part, the clinical findings of orofacial dyskinesias produced by PHT in epileptic patients. PMID- 3971953 TI - An electroencephalographic demonstration of auricular reflex epilepsy. AB - Through electroencephalographic recording of an experimentally induced epileptic seizure, existence of the "auricular reflex epilepsy" described in about 30 reports dating from the past century is now objectively demonstrated. PMID- 3971952 TI - Spread of epileptic seizure activity in humans. AB - A computer-augmented approach to ictal EEG analysis has been developed. A method for determining both the predictability of one signal from another and the time delay between those two signals--the average amount of mutual information (AAMI) method--has been applied to representative seizures of two patients with focal onset seizures and one patient with generalized seizures. High AAMI values characterized the EEG derived from the sites of the epileptic foci. AAMI values were high in all sampled brain areas in the patient with generalized seizures. Time delays were not consistent in any subject. The results indicate that the AAMI technique can differentiate focal from generalized seizures and identify the site of seizure onset. PMID- 3971954 TI - Influence of retinol on carcinogen-induced sister chromatid exchanges and chromosome aberrations in V79 cells. AB - The influence of retinol (Rol) on sister chromatid exchanges (SCE) in V79 cells induced by six indirect and two direct carcinogens, and on chromosome aberration (CA) in V79 cells induced by four indirect carcinogens were studied. The indirect carcinogens used were aflatoxin B1 (AFB), cyclophosphamide (CPP), benzo(a) anthracene (BA), benzo(a)pyrene (BP), 9,10-dimethyl-1,2-benz(a)anthracene (DMBA), and 3-methylcholanthrene (MCA). The two direct carcinogens were ethyl methane sulfonate (EMS) and N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Rol effectively inhibited SCE and CA induced by AFB and CPP in a dose-dependent manner, but it had no effect on SCE induced by BA, BP, DMBA, MCA, EMS, and MMNG. To the contrary, Rol had an enhancing effect on CA induced by BP and DMBA. Altering the concentration of the metabolic activation system-S9 mix had a significant effect on inhibition of AFB and CPP induced SCE by Rol. A high ratio of Rol/S9 mix resulted in a maximum effect of inhibition of SCE frequencies. Using low concentrations of S9 mix and various doses of Rol close to physiological levels (2 micrograms/ml and below) demonstrated a dose-dependent inhibition of AFB- and CPP-induced SCE. The possibility that Rol exerts its anticarcinogenic effects by inhibiting certain forms of the cytochrome P-450 isoenzymes required for activation of precarcinogens, such as AFB and CPP but not those enzymes required by BA, BP, DMBA, and MCA, is discussed. PMID- 3971955 TI - Induction of forward mutation at the yg2 locus in maize by ethylnitrosourea. AB - We analyzed the kinetics of mutation induction at the yg2 locus in Zea mays by N ethyl-N-nitrosourea (ENU). ENU concentrations ranged from 0.1 to 10.7 mM and a linear, concentration-dependent response was observed for the induction of yg2 sectors in leaf 4 and leaf 5. For both leaf 4 and leaf 5 ENU exhibited one-hit kinetics consistent with either a point-mutational or chromosome-breakage mechanism of mutation induction. The mean induced mutation rate/mM ENU for the combined leaf 4 and leaf 5 data was 6.77 X 10(-4) mutations/locus/mM ENU. This value was used to compare the mutagenic effectiveness of ENU with ethyl methanesulfonate (EMS) and to calculate a rad equivalent for ENU. ENU was found to be 3.8-fold more effective than EMS. Based on their respective chemical reactivities with DNA, we propose that ENU predominantly induces point mutations at the yg2 locus. One rad of gamma radiation induced the same rate of mutation as an 8-hr exposure to a 6.71 X 10(-6) M concentration of ENU at 20 degrees C. PMID- 3971956 TI - Solvent interactions with test compounds and recommendations for testing to avoid artifacts. AB - Reports in the literature describing artifactual results owing to interactions of test materials with solvents are becoming more frequent. The present study was initiated to examine possible interactions of 1,1,3-trichloro-, 1,1,3,3 tetrachloro-, pentachloro- and hexachloroacetones with different solvents, since certain solvent effects with the last compound have been shown previously. Quantitative differences in levels of mutagenic potency were found for tri-, tetra-, and pentachloroacetone, dissolved in acetone or dimethyl sulfoxide (DMSO). On the other hand, hexachloroacetone without solvent was mutagenic, and this activity was enhanced when it was dissolved in DMSO; in acetone it was not mutagenic. A time-dependent reaction of hexachloroacetone with DMSO was the only test material-solvent interaction found in this study. The results show clearly that DMSO is not an appropriate solvent for hexachloroacetone. On the basis of these and previous results, we recommend consideration of the following strategy to help prevent reporting of artifactual results owing to interaction with solvents: Results from initial screening experiments should be confirmed in repeat experiments using a different solvent; and a different solvent should be used in confirming the findings of other investigators. Differences in results would indicate a need for further study. PMID- 3971957 TI - Mutagenesis assays of human amniotic fluid. AB - Extracts of amniocentesis samples from 144 women were tested for the presence of mutagenic substances using tester strain TA1538 in the Ames Salmonella/mammalian microsome mutagenicity test. Because the volume of amniotic fluid in these samples was limited (generally less than 10 ml), we investigated modifications of this mutagenesis assay that could increase its ability to detect effects from small quantities of test material. Using mutagenicity in samples of urine from smokers as a model, it appeared that improved ability to detect small amounts of mutagen could be obtained by reducing volumes of media and reagents while keeping the amount of test sample constant. This modification resulted in a test procedure capable of readily detecting mutagenicity in volumes of urine from smokers that were smaller than the volumes of amniotic fluid available. Tests of amniotic fluid extracts by this modified procedure showed small increases in revertants, about 50% above dimethylsulfoxide solvent control values. Results of procedures to control for technical factors possibly contributing to these increases suggested that the increased values could not be readily explained by contamination of test samples with mutagens during the extraction procedure. They also were not explained by alterations in spontaneous numbers of revertants associated with changes in the density of bacterial lawn growth. The increases suggest the presence of small amounts of mutagenic material in many of the amniotic fluid samples. At the doses employed, mutagenic activity in these samples was not associated with maternal smoking. PMID- 3971958 TI - Evaluation of chemicals used for drinking water disinfection for production of chromosomal damage and sperm-head abnormalities in mice. AB - Chemical oxidants are commonly added during water treatment for disinfection purposes. These chemicals have not been tested previously for their ability to induce genetic damage in vivo. Chlorine (hypochlorite and hypochlorous acid), monochloramine, chlorine dioxide, sodium chlorite, and sodium chlorate were evaluated for induction of chromosomal aberrations and micronuclei in bone marrow of CD-1 mice, and for induction of sperm-head abnormalities in B6C3F1 mice. Oral administration of chlorine at pH 8.5 (where hypochlorite predominates) at dose levels equivalent to approximately 4 and 8 mg/kg/day induced significant increases in the level of sperm-head abnormalities. There was no evidence of other effects with any of the disinfectants. Halogenated acetonitriles, which have previously been shown to form in the stomach following oral dosing of sodium hypochlorite to rats, were also tested in the sperm-head abnormality assay but gave no indication of an effect. PMID- 3971959 TI - Mutagenicity testing of di(2-ethylhexyl)phthalate and related chemicals in Salmonella. AB - Di(2-ethylhexyl)phthalate and 33 other phthalates, ethylhexanol derivatives, and related chemicals were tested for mutagenicity in Salmonella typhimurium strains TA98, TA100, TA1535, and TA1537 without metabolic activation and in the presence of rat and hamster liver S-9 metabolic activation systems. No mutagenic activity was seen with any of the chemicals tested. PMID- 3971960 TI - SCE induction is uncoupled from mutation induction in mammalian cells following exposure to ethylnitrosourea (ENU). AB - It has been suggested not only that sister chromatid exchange (SCE) induction might serve as a qualitative indicator of mutagenesis, but also that induced SCE frequencies are linearly related to induced mutation frequencies. The consistency of the relationship between SCEs and mutations was tested in the present work. Confluent Chinese hamster ovary (CHO) cells were exposed to ethylnitrosourea (ENU) and then held at confluency for various times prior to initiation of SCE and mutation assays. Cells held at confluency are typically thought to be arrested in their progression through the cell cycle, so that "S-dependent" processes such as fixation of mutations and formation of SCEs will not occur, while DNA repair processes might continue to operate. If repair processes reduce the number of SCE-inducing lesions during the holding period and, hence, reduce the subsequently determined SCE frequencies, then mutation frequencies should similarly be reduced if SCEs and mutations are related. It was observed, however, that induced SCE frequencies decreased exponentially with holding time, while mutation frequencies remained constant. Qualitatively similar results were obtained in log-phase cells. Cell cycle analysis demonstrates that confluent CHO cells can cycle, and ways are considered in which this might affect SCE and mutation frequencies. It is concluded that the decline in SCE frequency (with time) cannot be attributed solely to the presence of cycling cells in confluent cultures. It appears, therefore, that at least some forms of ENU-induced DNA damage that can lead to SCE were repaired and as such are distinct from those forms that are mutagenic. Thus SCEs are not necessarily related to mutations, because the two events may represent manifestations of different forms of DNA damage. Whether or not this represents a universal phenomenon that would hold true for agents other than ENU remains to be determined. PMID- 3971961 TI - Genotoxicity of the cooked-food mutagens IQ and MeIQ in primary cultures of rat, hamster, and guinea pig hepatocytes. AB - To investigate possible interspecies differences in the hepatocellular genotoxicity of the food-borne mutagens 2-amino-3-methyl-imidazo[4,5-f]quinoline (IQ) and 2-amino-3,4-dimethyl-imidazo[4,5-f]quinoline (MeIQ), primary cultures of rat, hamster, and guinea pig hepatocytes were established. The induction of DNA repair activity in cultures exposed to various concentrations of IQ and MeIQ was determined by liquid scintillation spectrometry. DNA repair responses to MeIQ were, in general, greater than those elicited by IQ. In all three preparations of rat and hamster hepatocytes and in two of three preparations of guinea pig cells, MeIQ produced statistically significant (p less than 0.05) repair responses. IQ stimulated significant levels of repair in all three rat hepatocyte preparations and in two of three hamster cell preparations. In guinea pig cells exposed to IQ, no significant repair activity was observed. These results indicate that the genotoxicity of IQ and MeIQ in hepatic cells in species-dependent. PMID- 3971962 TI - Dead cells don't form mutant colonies: a serious source of bias in mutation assays. PMID- 3971963 TI - Deinduction of transcription of Xenopus 74-kDa albumin genes and destabilization of mRNA by estrogen in vivo and in hepatocyte cultures. AB - The goal of this study is to explain the molecular basis of the marked deinduction of Xenopus albumin synthesis and secretion accompanying the activation of vitellogenin genes by estrogen. We have characterized by restriction analysis, DNA sequencing and hybrid-selected translation of mRNA, a cloned cDNA specifying the two 74-kDa albumins which constitute the predominant circulating form of albumin in Xenopus laevis. Using this recombinant DNA plasmid as a hybridization probe, we have determined the steady-state levels of albumin mRNA, the rate of transcription of the two 74-kDa albumin genes and the stability of the mRNA in male and female Xenopus hepatocytes in vivo and in primary cell cultures following estrogen treatment. In both whole liver and cultured hepatocytes estradiol caused a rapid drop in the steady-state levels of 74-kDa albumin mRNAs, which was reversed spontaneously in the continued presence of the hormone. The concentration of albumin mRNA was substantially higher in male than in female hepatocytes, the hormonal effect being more marked in male than in female hepatocytes. The decrease in steady-state levels of mRNA was anticipated in male hepatocytes by a 70% inhibition of rate of transcription of albumin genes within 2 h of exposure to estradiol, as measured by run-off transcription in liver nuclei isolated from animals treated in vivo or by determining the absolute transcription rate in cell cultures. In the latter the diminished transcription rate returned to normal within 12 h in the continued presence of the hormone. Estradiol caused a threefold destabilization of albumin mRNA in both male and female hepatocyte cultures to t 1/2 = 3 h and 2 h respectively. The combined effects on rate of or transcription and mRNA stability largely explain the changes in the steady-state levels of mRNA caused by hormone administration. Comparison of the kinetics of transcription rates of vitellogenin and albumin genes in vivo and in vitro reveals a striking reciprocity in the selective activation of the inducible genes and deinduction of the constitutively expressed genes at the early stages of response of Xenopus hepatocytes to estrogen. PMID- 3971964 TI - The major oligosaccharides in the large subunit of the hemagglutinin from fowl plague virus, strain Dutch. Structure elucidation by one-dimensional and two dimensional 1H nuclear magnetic resonance and by methylation analysis. AB - The N-glycosidically linked glycans in the large subunit (HA1) of the hemagglutinin from fowl plague virus, strain Dutch (containing about 15%, w/w, of carbohydrates), were liberated by alkaline hydrolysis, and were filtrated through Bio-Gel as the re-N-acetylated oligosaccharide alditols. One major fraction (90%, mol/mol) was obtained. It was subfractionated by concanavalin A affinity chromatography and was analyzed by methylation/capillary gas chromatography/mass fragmentography and especially by one-dimensional and two-dimensional 1H nuclear magnetic resonance. The major HA1 glycans, which are not sialylated, were thus found to comprise about 40%, 30% and 20% (mol/mol), respectively, of biantennary intersected, biantennary, and triantennary N-acetyllactosaminic ('complex') oligosaccharides. About two thirds of the internal GlcNAc residues in these glycans are substituted by Fuc(alpha 1----6), all the triantennary species carry the third Gal(beta 1----4)GlcNAc(beta 1----unit at the Man(alpha 1----6)-branch, and roughly one fourth of the N-acetyllactosamine units in the non-intersected biantennary oligosaccharides are incomplete. PMID- 3971965 TI - The activation of adenylate cyclase from small intestinal epithelium by cholera toxin. AB - ADP-ribosylation of membrane proteins from rabbit small intestinal epithelium was investigated following incubation of membranes with [32P]NAD and cholera toxin. Cholera toxin catalyzes incorporation of 32P into three proteins of 40 kDA, 45 kDa and 47 kDa located in the brush-border membrane. In contrast, basal lateral membranes do not contain any protein which becomes labeled in a toxin-dependent manner when incubated with cholera toxin and [32P]NAD. The modification of membrane proteins from brush border occurred in spite of the virtual absence in these membranes of adenylate cyclase activatable either by cholera toxin, vasoactive intestinal peptide (VIP) or fluoride. The three agents activated adenylate cyclase when crude plasma membrane were used. Cholera toxin activated fivefold at 10 micrograms/ml. Vasoactive intestinal peptide activated at concentrations from 10-300 nM, the maximal stimulation being sixfold. Fluoride activated 10-fold at 10 mM. When basal lateral membranes were assayed for adenylate cyclase it was found that, with respect to the crude membranes, the specific activity of fluoride-activated enzyme was 3.3-fold higher, VIP stimulated enzyme was maintained while cholera-toxin-stimulated enzyme showed half specific activity. Moreover, while fluoride stimulated ninefold and VIP stimulated fivefold, cholera toxin only stimulated twofold at the highest concentration. The results suggest that the activation by cholera toxin of adenylate cyclase located at the basal lateral membrane requires ADPribosylation of proteins in the brush border membrane. PMID- 3971966 TI - An oxygenation-linked dye binding to Limulus polyphemus hemocyanin. AB - The reaction of Limulus polyphemus hemocyanin with a dye, bromthymol blue, was examined by equilibrium dialysis, spectrophotometric titration and stopped-flow methods. Oxy-hemocyanin contained one binding site per hexamer unit. The dye binding was linked to oxygenation, and the affinity of the dye for the oxy form was about 10 times as high as that for the deoxy form. Conversely, the dye increased the O2 affinity of hemocyanin. Hemocyanin showed a simple hyperbolic binding curve in the bromthymol blue titration, whereas the time course of the reaction was generally biphasic. It was inferred from the kinetic analyses that the reaction proceeds in two steps. The first bimolecular step is characterized by an increase in the apparent pKa of the bound dye, while the second unimolecular step by a red shift of the absorption band of the unionized dye. The dye binding to partially oxygenated hemocyanin was examined spectrophotometrically; the fractional change in the binding was found to be ahead of the increase in the average degree of O2 saturation. It was concluded that the structural changes in hemocyanin which lead to the increased dye affinity take place at an early stage of the ligand binding sequence. PMID- 3971967 TI - Specific labeling of cytosolic and mitochondrial aspartate aminotransferases. AB - The apoisozymes of cytosolic and mitochondrial aspartate aminotransferase are both irreversibly inhibited by alpha-N-fluorodinitrophenyl-beta-N phosphopyridoxyldiaminopropi onate, an affinity-labeling reagent analog of the coenzyme. Analysis of the modified peptides shows that the active-site Lys-258, which in the holoenzyme binds the coenzyme pyridoxal 5'-phosphate, is labeled in both isozymes. Comparison with the results obtained using the parent compound 4' N-fluorodinitrophenylpyridoxamine 5'-phosphate, which labels only the cytosolic enzyme, provides information about differences in active-site reactivity and geometry. Labeling external to the active site occurs in both isozymes. In the cytosolic enzyme the very reactive Cys-45 is modified, in the mitochondrial enzyme the surface residue Lys-342 reveals a peculiar reactivity. PMID- 3971968 TI - Enzymes in polyelectrolyte complexes. The effect of phase transition on thermal stability. AB - Penicillin amidase, alpha-chymotrypsin and urease have been immobilized in water soluble nonstoichiometric polyelectrolyte complexes (N-PEC). N-PEC are formed by modified poly(N-ethyl-4-vinyl-pyridinium bromide) (polycation) and excess poly(methylacrylic acid) (polyanion). N-PEC are a new class of polymers capable, characteristically, of phase transitions solution in equilibrium precipitate induced by slight change in pH or ionic strength. Neither the chemical structure of the carrier nor the number of cross-linkages between an enzyme and a carrier change on phase transition. That gives an unique opportunity to elucidate the difference between enzymes immobilized on water-soluble and water-insoluble supports. A detailed study of the phase transition effect on thermal stability of the enzymes and protein-protein interactions has been carried out. The following effects were found. Pronounced thermal stabilization of penicillin amidase and urease may be achieved on two conditions: the enzyme is in the precipitate; (b) the enzyme is linked to the N-PEC nucleus. Then the thermal stability of N-PEC bound penicillin amidase increases 7-fold at pH 5.7, 60 degrees C, and 300-fold at pH 3.1, 25 degrees C, compared to the native enzyme. For urease, the thermal stabilization increases 20-fold at pH 5.0, 70 degrees C. The localization of enzyme on N-PEC has been established by titration of alpha-chymotrypsin bound to a polycation or polyanion with basic pancreatic trypsin inhibitor. Both in solution (pH 6.1) and in N-PEC precipitate (pH 5.7), an alpha-chymotrypsin molecule bound to a polyanion is fully exposed to the solution. If the enzyme is bound to a polycation, only 20% of alpha-chymotrypsin molecules in the precipitate and 40% in solution retain their ability for protein-protein interactions. This means that a polycation-bound enzyme is localized in the hydrophobic nucleus of the complex, whereas the polyanion-bound enzyme sits on the hydrophilic shell of the complex. On pH-induced phase transition (pH decreases from 6.1 to 5.7), there occurs a stepwise decrease in penicillin amidase activity which is due to a 9.8-fold increase in the Km for 2-nitro-4 phenylacetamidobenzoic acid. Change of the catalytic activity and thermal stability of N-PEC-bound penicillin amidase is fully reversible and reproducible. Such soluble-insoluble immobilized enzymes with controllable thermal stability and activity may be used for simulating events in vivo and in biotechnology. PMID- 3971969 TI - Mitochondrial and peroxisomal metabolism of glutaryl-CoA. AB - Using a fraction purified from liver peroxisomes, we demonstrate that products of the glutaryl-CoA oxidase reaction are glutaconyl-CoA and H2O2. No glutaconyl-CoA decarboxylation occurs with this fraction. In whole tissue homogenates, the handling of glutaryl-CoA by glutaryl-CoA dehydrogenase is inhibited when reoxidation of FADH2 is blocked. Under these conditions, glutaconyl-CoA decarboxylation, however, can still occur and 14CO2 is produced from labelled glutaryl-CoA in mole/mole ratio with H2O2. These data indicate that in the absence of its mitochondrial dehydrogenation, glutaryl-CoA is oxidized in peroxisomes to glutaconyl-CoA which is probably transferred to mitochondria where it is decarboxylated and further processed. This hypothesis allows coherent explanation for the observed organic aciduria in both glutaricaciduria types I and II. PMID- 3971970 TI - 1H and 15N NMR investigation of the interaction of pyrimidine nucleotides with ribonuclease A. AB - Extensive 1H and 15H NMR investigations of the nucleotide moieties capable of hydrogen bonding to ribonuclease A were carried out in order to gain more detailed information on the specificity of nucleotide-enzyme interaction. The 1H investigations focussed on those protons presumed to be involved in hydrogen bonding between the various nucleotides and the enzyme. In particular these were the imino protons of the uridine nucleotides and the amino protons of the cytidine nucleotides. The technique of 15N-1H double quantum filtering was applied for observation of the resonances of the latter in the nucleotide-enzyme complex. The downfield shift observed for the imino proton resonance of the uridine nucleotides was indicative of hydrogen bond formation to the enzyme. 15N NMR spectra of the free nucleotides and the nucleotide-enzyme complexes were also acquired to examine the possibility of hydrogen bond formation at the N3 site of both pyrimidine bases and the amino group of the cytidine nucleotides. The downfield shift observed for the 15N3 resonance of the uridine nucleotides and the upfield shift observed for the corresponding resonance of the cytidine nucleotides was evidence that the N3 moiety acts as hydrogen donor or hydrogen acceptor in the nucleotide-enzyme complex. The effect of complex formation on the 15N1 resonance of the respective bases was also studied. Both 1H and 15N NMR results indicated subtle differences between the complexes of the 2' and 3' nucleotides. The extent of hydrogen bonding as well as the arrangement of the nucleotide base at the active site of the enzyme varies in dependence on the position of the phosphate group. It is established that hydrogen bonding, though not the main binding force between the nucleotides and the enzyme, is certainly a major factor of RNase A specificity for pyrimidine nucleotides. PMID- 3971971 TI - The sub-cellular localisation and regulatory properties of pyruvate carboxylase from Rhizopus arrhizus. AB - Cell-free extracts of Rhizopus arrhizus contain exclusively cytosolic pyruvate carboxylase and NAD-glutamate dehydrogenase, a single mitochondrial isoenzyme of NADP-isocitrate dehydrogenase, and both mitochondrial and cytosolic isoenzymes of NADP-malate dehydrogenase (decarboxylating). Other enzymes examined have sub cellular localisations similar to those characteristic of mammalian liver. Purified preparations of R. arrhizus pyruvate carboxylase are subject to partial regulatory inhibition by L-aspartate and 2-oxoadipate. L-Glutamate acts as a less effective analogue of L-aspartate while 2-oxoglutarate is ineffective. Competition studies indicate the presence of separate inhibitory sites for L aspartate and 2-oxoadipate. Under routine assay conditions R. arrhizus pyruvate carboxylase shows significant activation by acyl derivatives of coenzyme A with long chain acyl CoA being more effective than acetyl-CoA. This activation is no longer observed in the presence of high concentrations of pyruvate, MgATP2- and HCO-3. The concentrations of L-aspartate and 2-oxoadipate required to give 50% inhibition ([I]0.5), and the maximal extents of inhibition, are increased by addition of acetyl-CoA. Acetyl-CoA increases the sigmoidal character of the relationship: initial rate/[L-aspartate], but decreases this parameter for the relationship: initial rate/[2-oxoadipate]. The studies indicate that R. arrhizus possesses an entirely cytosolic pathway for the conversion of glucose to fumaric acid and that both the organisation of pyruvate metabolism and the regulation of pyruvate carboxylase differ significantly in this organism as compared to that proposed previously for Aspergillus nidulans. PMID- 3971972 TI - epsilon-Crystallin, a novel avian and reptilian eye lens protein. AB - Gel filtration of Peking duck eye lens proteins reveals a component eluting just behind delta-crystallin and comprising approximately 10% of the total soluble protein. The native Mr of this additional component is estimated to be 120000; it appears to be composed of three identical chains of Mr 38000 and pI 7.5. Circular dichroic spectroscopy showed a relatively high alpha-helical content. No immunological cross-reactivity is found with alpha-, beta-, gamma- or delta crystallins, and partial amino acid sequence determinations likewise failed to reveal any similarity with other known crystallins. We conclude that this protein represents another and novel family of eye lens proteins, for which we propose the designation epsilon-crystallin. epsilon-Crystallin is translated from a 1450 base mRNA, which has been partially purified. epsilon-Crystallin is found scattered among avian and reptilian taxa, but not in other vertebrates. Its rate of evolutionary change seems to be as slow as that of alpha- and beta crystallins. PMID- 3971973 TI - Histone H5 promotes the association of condensed chromatin fragments to give pseudo-higher-order structures. AB - We describe two distinct situations in which chicken erythrocyte chromatin fragments associate in solution. The erythrocyte-specific histone H5 is implicated since chromatins that do not contain H5 do not show this behaviour. Well-defined oligomers of between approximately 6 and approximately 18 nucleosomes prepared at low ionic strength condense and associate when the ionic strength is raised to 75 mM, forming pseudo-higher-order structures. The associated forms, probably predominantly dimers, are stabilized by migration of about 10% of the H5, and of the minor lysine-rich histone H1, from the non associated forms, probably reflecting the preference of H5 for higher-order structures observed previously [Thomas, J. O. and Rees, C. (1983) Eur. J. Biochem. 134, 109-115]. Since the final (H1 + H5) content of the aggregate at 75 mM is never higher than that of the fragment prepared at low ionic strength, migration is probably to a small proportion of sites that have inevitably become vacant due to handling losses at the higher (but not at low) ionic strength. H5 thus maximizes its interactions in the condensed state of chromatin and even maintains the association of two or more fragments without continuity of the DNA. Aggregates of oligomers larger than about 18 nucleosomes may be too long to withstand hydrodynamic shear forces in the absence of such continuity. During nuclease digestion of nuclear chromatin, H5 and, to a lesser extent, H1, are released from the ends of very short fragments and bind to larger oligomers of various sizes leading to heterogeneous aggregates that survive exposure to low ionic strength. These aggregates, in contrast to those described above, have up to 60% more H5 and 20% more H1 than chromatin prepared at low ionic strength. Whether the excess H5 and H1 bind non-specifically or to a second low-affinity binding site on each nucleosome is not known. The associated forms described above (1) are well defined and potentially useful for structural studies, whereas the other aggregates (2) seem less likely to be directly relevant to the native structure of chromatin. PMID- 3971974 TI - Conformation of human IgG subclasses in solution. Small-angle X-ray scattering and hydrodynamic studies. AB - The structure of six human myeloma proteins: IgG1(Bal), IgG2(Klu), IgG3(Bak), IgG3(Het), IgG4(Kov) and IgG4(Pol), was studied in solution using small-angle X ray scattering and hydrodynamic methods. For IgG1(Bal) and IgG3(Het) the experimental data, including radius of gyration (Rg degree), radii of gyration of the cross-section (Rq1, Rq2), intrinsic viscosity [eta], sedimentation coefficient (S degree 20,w) and molecular mass, were interpreted in terms of structural models based on the Fab and Fc conformations, observed in crystal, by varying the relative positions of the Fab and Fc parts, i.e. their relative angles and distances. The values Rg degree = (6.00 +/- 0.05) nm, S degree 20,w = (6.81 +/- 0.10) S and [eta] = 0.0062 +/- 0.0005 cm3/mg obtained for IgG1(Bal) are compatible with a planar model in which the angle between the Fab arms is about 120 degrees. For IgG3(Het) the following data were obtained: Rg degree = (4.90 +/ 0.05) nm, S degree 20,w = (6.32 +/- 0.01) S and [eta] = (0.0065 +/- 0.0005) cm3/mg. The apparent contradiction between the higher molecular mass and lower Rg degree and S degree 20,w values for IgG3(Het) in comparison to IgG1(Bal) can be resolved by proposing a 'non-planar' (tetrahedral) molecular shape, in which the long hinge peptide is in a folded conformation and the two Fab and Fc parts are in a closely packed arrangement. In this model the angle between the two Fab arms is about 90 degrees, in the average position. The X-ray scattering and hydrodynamic behaviour of the IgG2 and IgG4 types of antibodies appeared to be similar to IgG1(Bal). The parameters of the two IgG3 proteins are similar while they are different to the others. PMID- 3971975 TI - Structural studies on the linkage unit between poly(galactosylglycerol phosphate) and peptidoglycan in cell walls of Bacillus coagulans. AB - Structural studies were carried out on the linkage units in the teichoic-acid- glycopeptide complexes isolated from lysozyme digests of the cell walls of Bacillus coagulans AHU 1366. On treatment with 47% hydrogen fluoride, the complexes gave a disaccharide characterized as glucosyl(beta 1----4)N acetylglucosamine together with major fragments, galactosyl(alpha 1--- 2)glycerol. By means of Smith degradation and partial acid hydrolysis, the teichoic acid chain was shown to be composed of the repeating units, galactosyl(alpha 1----2)glycerol-3(1)-phosphate, which were joined by phosphodiester bonds at C-6 of the galactose residues. The mild alkaline hydrolysis of teichoic-acid-linked glycan fragments yielded teichoic acid chains and disaccharide-linked glycan fragments, from which the disaccharide, glucosyl(beta 1----4)N-acetylglucosamine, was liberated by mild acid hydrolysis, whereas the same disaccharide linked to the teichoic acid chain was obtained by direct heating of the cell walls at pH 2.5. In addition, the presence of specialized glycerol phosphate units in the linkage region was shown by the isolation of tris(glycerol phosphate)3-glucosyl(beta 1----4)N-acetylglucosamine from the products of the Smith degradation of the teichoic-acid--glycopeptide complexes. Thus, it is concluded that the poly(galactosylglycerol phosphate) chain in the cell walls of B. coagulans AHU 1366 is linked to peptidoglycan through a novel linkage unit, bis(glycerol phosphate)-3-glucosyl(beta 1----4)N acetylglucosamine. PMID- 3971976 TI - Sequence of the 5'-end quarter of the human-thyroglobulin messenger ribonucleic acid and of its deduced amino-acid sequence. AB - Thyroglobulin, the dimeric glycoprotein (19 S, 2 X 330 kDa), specific to the thyroid gland, is the support for thyroid hormone synthesis. Elucidation of the mechanism for thyroid hormone synthesis requires the knowledge of the primary sequence of the protein. In this paper the sequence of the first coding 2190 nucleotides from the 5' end of the human mRNA is presented. This was obtained by sequencing two previously described overlapping clones and by construction and sequencing of a single-stranded cDNA corresponding to the 5' end of the mRNA. The nucleotide sequence represents a quarter of the human thyroglobulin mRNA, from which a polypeptide sequence of 730 amino acids at the NH2-terminal end of the monomer has been deduced. This sequence shows a repetition of five highly conserved motifs each of approximately 50 amino acids, the analysis of which allowed us to establish a consensus sequence. We have also demonstrated (a) the hormonogenic tyrosine residue recently described in the mature protein, which is located four amino acids after the NH2-terminal Asn; (b) a prepeptide signal of thyroglobulin secretion comprising 19 amino acids preceding the Asn residue, the NH2-terminal residue of the mature protein and (c) a six-signal tripeptide (Asn Xaa-Thr or Ser) of N-glycosylation of the chain. PMID- 3971977 TI - Stepwise unfolding of chromatin by urea. A flow linear dichroism and photoaffinity labeling study. AB - The unfolding of chromatin by urea (0-7 M) was studied by means of flow linear dichroism, photoaffinity labeling and nuclease digestion. The linear dichroism results indicate that the unfolding of the DNA is accomplished through two distinct transitions at 1-2 M urea and 6-8 M urea, respectively. The photoaffinity labeling studies indicate that an opening of the nucleosome histone core occurs above 2 M urea, accompanied by general loosening of the structure. Based on the results a model for the unfolding of chromatin fibers by urea is proposed, which includes a stretching of the linker DNA (0-2 M urea) followed by a "loosening" of the nucleosome core, possibly to a one-loop DNA conformation (2 6 M urea), and finally resulting in an almost total stretching of the DNA (greater than 6 M urea). PMID- 3971978 TI - Oxygen binding to dithionite-reduced chloroperoxidase. AB - Both the kinetics of ferric chloroperoxidase reduction by dithionite and the binding of molecular oxygen to ferrous chloroperoxidase have been studied. The oxyferrous chloroperoxidase decays spontaneously to the ferric enzyme. In addition the corresponding rapid-scan spectra have been recorded. The reduction reaction is caused by SO-.2 with a rate constant of (7.7 +/- 1.0) X 10(4) M-1 S 1. Oxygen binding occurs with a rate constant of (5.5 +/- 1.0) X 10(5) M-1 S-1 over the pH range 3.5-6. Oxyferrous chloroperoxidase has a Soret absorption peak at 428 nm and two partially resolved peaks at 555 nm and 588 nm. Isosbestic points occur at the following wavelengths: between ferrous and oxyferrous chloroperoxidase at 419, 545, 555 and 580 nm; between oxyferrous and ferric chloroperoxidase at 419, 487, 540, 609 and 682 nm. PMID- 3971979 TI - Purification and properties of NADH/NADPH-dependent p-hydroxybenzoate hydroxylase from Corynebacterium cyclohexanicum. AB - Crude soluble extracts of Corynebacterium cyclohexanicum, grown on cyclohexanecarboxylic acid, were found to contain 4-hydroxybenzoate 3-hydroxylase which functions with NADH as well as NADPH. The purified enzyme preparation was electrophoretically homogeneous and contained FAD as prosthetic group. The relative molecular mass of the enzyme was estimated to be about 47000 by native and denaturated acrylamide gel electrophoresis, indicating that it is monomeric. The enzyme was stable at 60 degrees C for 10 min. The enzyme was highly specific for p-hydroxybenzoate. The activity was inhibited by several aromatic analogues of p-hydroxybenzoate such as p-aminobenzoate, p-fluorobenzoate, o hydroxybenzoate, m-hydroxybenzoate, 2,4-dihydroxygenzoate, and 2,5 dihydroxybenzoate. The Km value for NADH was fairly constant, about 45 microM, in the pH range 7.0-8.4, whereas the Km value for NADPH increased from 63 microM to 170 microM as the pH rose from 7.0 to 8.4. V values in the same pH range, however, were approximately constant in both cases; about 30 mumol min-1 mg-1 for NADH, and 26 mumol min-1 mg-1 for NADPH. Mg2+ was required for full activity of the enzyme in low concentrations of phosphate buffer. The enzyme was inhibited by C1- which was non-competitive with respect to NADH, NADPH and p-hydroxybenzoate. PMID- 3971980 TI - The primary structure of alpha-lactalbumin from camel milk. AB - The primary structure of camel alpha-lactalbumin was determined by analysis of the intact protein, and of CNBr fragments and enzymatic peptides from the carboxymethylated protein chain. Results show that camel alpha-lactalbumin has 123 residues and a molecular mass of 14.6 kDa. The amino acid sequence is strictly homologous to alpha-lactalbumins characterized, but also exhibits extensive differences: 39 residues differ in relation to the bovine protein and only 35 residues are conserved among hitherto known alpha-lactalbumins with characterized structures. All residues ascribed critical structural or functional roles are strictly invariant in the camel protein. PMID- 3971981 TI - Coenzymic activity of NADP derivatives alkylated at 2'-phosphate and 6-amino groups. AB - Coenzymic activities of the following NADP derivatives were investigated: 2'-O-(2 carboxyethyl)phosphono-NAD (I), N6-(2-carboxyethyl)-NADP (II), 2'-O-(2 carboxyethyl)phosphono-N6-(2-carboxyethyl)-NAD (III), 2'-O-[N-(2 aminoethyl)carbamoylethyl]phosphono-NAD (IV), N6-[N-(2-aminoethyl)carbamoylethyl] NADP (Va), 2',3'-cyclic NADP, and 3'-NADP. Derivatives I and IV show the effects of modification at the 2'-phosphate group, and derivatives II and Va show those at the 6-amino group of NADP. As for enzymes, alcohol, isocitrate, 6 phosphogluconate, glucose, glucose-6-phosphate, and glutamate dehydrogenases were used. These enzymes were grouped on the basis of the ratio of the activities for NAD and NADP into NADP-specific enzymes (ratio less than 0.01), NAD(P)-specific enzymes (0.01 less than ratio less than 100), and NAD-specific enzymes (ratio greater than 100). For NADP-specific enzymes, modifications at the 2'-phosphate group of NADP caused great loss of cofactor activity. The relative cofactor activities (NADP = 100%) of derivatives I and IV for these enzymes were 0.5-20 and 0.01-0.5%, respectively. On the other hand, NAD(P)-specific enzymes showed several types of responses to the NADP derivatives. The relative cofactor activities of I and IV for Leuconostoc mesenteroides and Bacillus stearothermophilus glucose-6-phosphate dehydrogenases and beef liver glutamate dehydrogenase were 60-200%; whereas, for B. megaterium glucose dehydrogenase and L. mesenteroides alcohol dehydrogenase, the values were 0.8-8%. For NAD-specific enzymes, these values were 20-50%. The relative cofactor activities of 2',3' cyclic NADP and 3'-NADP were very low (less than 0.2%) except for beef liver glutamate dehydrogenase, B. stearothermophilus glucose-6-phosphate dehydrogenase, and horse liver alcohol dehydrogenase. Kinetic studies showed that the losses of the cofactor activity of NADP by these modifications were mainly due to the increase of the Km value. The mechanisms of coenzyme specificity of dehydrogenases are discussed. Unlike the 2'-phosphate group, the 6-amino group is common to NAD and NADP, and the effects of modification at the 6-amino group were independent of the coenzyme specificity of enzymes used for the assay. Derivatives II and Va had high relative cofactor activities (65-130%) for most of the enzymes except for isocitrate and glucose dehydrogenases (less than 1%) and L. mesenteroides alcohol dehydrogenase (20-60%). The cofactor activity of derivative III was generally lower than those of I and II. PMID- 3971982 TI - Thyrotropin modifies the synthesis of actin and other proteins during thyroid cell culture. AB - Primary cultures of dog thyroid cells have been used to study the effects of thyrotropin on the synthesis of proteins. The cells were cultured for 4 days in serum-free and thyrotropin-free conditions. Thyrotropin was then added for varying periods of time (6-96 h). In the absence of thyrotropin, the cells have an elongated flattened aspect. Exposure to thyrotropin for 6-24 h produces retraction and rounding up of cells whereas cells incubated with thyrotropin for longer periods of time have an epithelial cuboidal shape. After varying periods of culture the cells were labelled with [35S]methionine for 6 h and then analyzed by one- and two-dimensional gel electrophoresis, followed by autoradiography. The results were as follows. After exposure to thyrotropin for 32 h and 48 h, the synthesis of about 18 proteins was increased while that of about 14 others was decreased. After 6 h the labelling of three and five of these proteins was already increased or decreased, respectively. Some of the proteins whose synthesis is modified in the presence of thyrotropin were identified. Actin synthesis was markedly decreased with a maximum 24-48 h after the addition of thyrotropin. A modification in the ratio between alpha and beta tubulins was also observed together with very large changes in a group of proteins having both the relative molecular mass (30 000-40 000) and the isoelectric points of tropomyosins. Forskolin and cholera toxin caused the same qualitative and quantitative changes as thyrotropin; this suggests that the regulation by thyrotropin of the synthesis of several thyroid cell proteins is mediated by cAMP. In conclusion, the data obtained in this work might help to explain the molecular mechanisms by which thyrotropin (and cAMP) triggers the changes in cell shape which occur during thyroid cell culture. They also indicate that one of the main effects of thyrotropin takes place at the level of several proteins which belong to the cytoskeleton and which are involved in the definition of the cytostructure of the thyroid cells. PMID- 3971983 TI - A complex from cultured Chinese hamster ovary cells containing nine aminoacyl tRNA synthetases. Thermolabile leucyl-tRNA synthetase from the tsH1 mutant cell line is an integral component of this complex. AB - The size distribution of the 20 aminoacyl-tRNA synthetases from wild-type Chinese hamster ovary (CHO) cells and from the mutant cell line tsH1, containing a temperature-sensitive leucyl-tRNA synthetase, was determined by gel filtration. Nine aminoacyl-tRNA synthetases, specific for arginine, aspartic acid, glutamic acid, glutamine, isoleucine, leucine, lysine, methionine and proline, which coeluted as high-Mr entities (Mr approximately 1.2 X 10(6)), were further co purified to yield a multienzyme complex, the polypeptide composition of which was identical to that previously determined for the complex from rabbit liver. Immunoprecipitates obtained from crude extracts of wild-type and tsH1 mutant cells, using specific antibodies directed to the lysyl-tRNA or methionyl-tRNA synthetase components of the complex, displayed the same polypeptide compositions as that of the purified complex, thereby establishing the heterotypic nature of this complex. Although the activity of leucyl-tRNA synthetase from the mutant cells, grown at a permissive temperature, was low compared to that from the wild type, the polypeptide of Mr 129 000, corresponding to this enzyme, was present in similar amounts and occurred exclusively as a component of the high-Mr complex. Finally, we report that attempts to demonstrate phosphorylation of the components of the complex from cultured CHO, HeLa and C3 cells were unsuccessful. PMID- 3971985 TI - Intramolecular interactions, mesomerism and dynamics in actinomycin D studied by 15N NMR spectroscopy. AB - We present a detailed conformational study of 15N-labelled actinomycin D in different organic solvents using 1H, 15N and two-dimensional (2D) NMR techniques at 30.4 MHz and 50.6 MHz. The assignment of the threonine and valine 15N resonances to the individual residues on the alpha- or beta-lactone rings was achieved via heteronuclear shift-correlated 2D NMR experiments. The solvent perturbation studies allow an estimation of the solvent accessibility of the nitrogens and carbonyl groups. Evidence is presented that the pentapeptide rings of actinomycin D have different conformations in polar and in apolar solvents. The chromophoric N10 is efficiently solvent-protected, the solvent-dependence of its 15N resonance resulting from solvent interactions at other positions of the molecule and from solvent-dependent changes in the twisting of the chromophoric system. The chromophoric 2-amino nitrogen is shown to exhibit a strong sp2 character due to the formation of a conjugated system with the carbonyl group at C1. Such a conjugation requires a non-planar chromophoric ring system. Additionally, a hydrogen bond connecting the 2-amino and the 1-carbonyl group was detected. In some solvents, two resonances appear for the 2-amino nitrogen implying the presence of the 2-amino group in two different conformations. The possible implications of the non-planarity of the chromophore for the intercalation process and for the biological activity of the drug are discussed. PMID- 3971984 TI - Purification and characterization of two Cl- -activated aminopeptidases hydrolysing basic termini from human skeletal muscle. AB - Two aminopeptidases (I and II), hydrolysing basic termini, were purified to homogeneity (as judged by polyacrylamide gel electrophoresis) from human quadriceps muscle by anion-exchange chromatography and preparative electrophoresis. The electrophoretic migration rate of II was approximately 80% of that of I. Both enzymes had the following properties: optimum activity was at pH 6.5; addition of 0.15 M Cl- or Br- anions resulted in a 20-fold or 10-fold increase in activity respectively. There was little or no increase in activity on the addition of other anions, or divalent cations (0.05-5mM). Approximately 50% inhibition of activity was obtained in the presence of bestatin (0.1 microM), rho hydroxymercuriphenylsulphonic acid (0.1 microM), EDTA (10 mM), 1,10 phenanthroline (100 microM), N-ethylmaleimide (1 mM) and But-Thr-Phe-Pro (0.5 mM). The molecular mass was 72 000 Da (gel filtration). Only the arginyl and lysyl 7-amino-4-methylcoumarin (Amc) derivatives were appreciably hydrolysed; approximate Km values for the reaction of I and II with these substrates (10-250 microM) were estimated as follows: Arg-Amc, KmI = 70 microM, KmII = 270 microM; Lys-Amc KmI = 280 microM, KmII = 400 microM. Both enzymes hydrolysed dipeptides with Arg or Lys as the NH2-terminal amino acid, however this was not an absolute requirement for dipeptide hydrolysis. The action of I and II on physiologically active oligopeptides was very restricted, with only bradykinin, proangiotensin and neurotensin being appreciably degraded. The breakdown of these peptides did not occur by classical aminopeptidase action (i.e. hydrolysis of the NH2-terminal residues), but via cleavage of internal peptide bonds. These results suggest that I and II may be isoenzymes of a Cl- -requiring, thiol-type aminopeptidase, which hydrolyses basic termini. These enzymes may act primarily as dipeptidases, with a very restricted mode of action in the degradation of naturally occurring oligopeptides. PMID- 3971986 TI - Phosphatidylserine and ornithine-containing lipids of Bordetella, hemagglutinins of lipoamino acid structure, and their control in biomembranes. AB - From the observation by light and electron microscopy, it was proved that phosphatidylserine agglutinates human erythrocytes by the same mechanism as that of ornithine-containing lipids of Bordetella described previously. The proposed mechanism was that two erythrocytes were bound through some liposomes of the lipoamino acids by hydrophobic and ionic interaction, and hydrogen bonding, between the lipoamino acids and the lipids or proteins in the membranes of erythrocytes. Hemagglutinating activity of phosphatidylserine might be controlled so as not to be expressed in biomembranes, on the basis of the finding that the liposomes constituted of phosphatidylserine and more than equal quantities of phosphatidylcholine did not exhibit hemagglutinating activity. PMID- 3971987 TI - The crystal and molecular structure of the third domain of silver pheasant ovomucoid (OMSVP3). AB - OMSVP3 and OMTKY3 (third domains of silver pheasant and turkey ovomucoid inhibitor) are Kazal-type serine proteinase inhibitors. They have been isomorphously crystallized in the monoclinic space group C2 with cell dimensions of a = 4.429 nm, b = 2.115 nm, c = 4.405 nm, beta = 107 degrees. The asymmetric unit contains one molecule corresponding to an extremely low volume per unit molecular mass of 0.0017 nm3/Da. Data collection was only possible for the OMSVP3 crystals. Orientation and position of the OMSVP3 molecules in the monoclinic unit cells were determined using Patterson search methods and the known structure of the third domain of Japanese quail ovomucoid (OMJPQ3) [Papamokos, E., Weber, E., Bode, W., Huber, R., Empie, M. W., Kato, I. and Laskowski, M., Jr (1982) J. Mol. Biol. 158, 515-537]. The OMSVP3 structure has been refined by restrained crystallographic refinement yielding a final R value of 0.199 for data to 0.15 nm resolution. Conformation and hydrogen-bonding pattern of OMSVP3 and OMJPQ3 are very similar. Large deviations occur at the NH2 terminus owing to different crystal packing, and at the C terminus of the central helix, representing an intrinsic property and resulting from amino acid substitutions far away from this site. The deviation of OMSVP3 from OMTKY3 complexed with the Streptomyces griseus protease B is very small [Fujinaga, M., Read, R. J., Sielecki, A., Ardelt, W., Laskowski, M., Jr and James, M. N. G. (1982) Proc. Natl Acad. Sci. USA, 79, 4868 4872]. PMID- 3971988 TI - Purification and characterization of the low-molecular-mass (type X) collagen from chick-embryo tibial cartilage. AB - Type X collagen, synthesized in large amount by cultured tibial chondrocytes, is deposited in vivo in the epiphyseal cartilages of 17-day-old chick embryo tibiae. Here we report the extraction of this collagen from these cartilages by limited pepsin digestion and its purification to electrophoretic homogeneity by salt precipitation followed by agarose gel filtration. Identity of the collagen purified from cartilage with the type X collagen synthesized by cultured chondrocytes is confirmed by comparison of the amino acid compositions. The high glycosylation extent of type X collagen is reminiscent of the glycosylation extent of pericellular collagens. The possible role of type X collagen is discussed. PMID- 3971989 TI - Isolation of plasma membrane from human blood monocytes. Subcellular fractionation and marker distribution. AB - The isolation of plasma membrane from human peripheral blood monocytes is described. Monocytes were isolated by centrifugal elutriation, to eliminate an adherence step, thus minimizing functional and surface antigenic alterations to the cells. Monocytes were surface-labelled with a radiolabelled monoclonal antibody, 125I-WVH-1, and then disrupted by nitrogen cavitation. Membranes were separated according to equilibrium buoyant density by isopycnic centrifugation on a sucrose gradient. The subcellular membranes were localized using marker enzymes for the plasma membrane, 5'-nucleotidase and leucine 2-naphthylamidase (leucine aminopeptidase), and for intracellular membranes: galactosyltransferase (Golgi), arylsulfatase C (endoplasmic reticulum), monoamine oxidase (mitochondria), catalase (peroxisomes), beta-hexosaminidase and beta-glucuronidase (lysosomal vesicles) and lactate dehydrogenase (cytosol). The monoclonal antibody 125I-WVH-1 was shown to label the plasma membrane, as judged by known markers, and represents a highly specific trace label, applicable to the use of plasma membrane as an immunogen for monoclonal antibody production. The NAD-splitting enzyme, NAD+ nucleosidase, was detected and its presence on the plasma membrane was demonstrated. The subcellular localization of non-specific esterase in human mononuclear phagocytes is controversial. No evidence was found for alpha-naphthyl acetate esterase activity on the plasma membrane or in lysosomal vesicles. However, a membrane-bound esterase in fractions with properties similar to the smooth endoplasmic reticulum was detected. PMID- 3971990 TI - Carcinoma of the cervix stage T1b. A 15 years review of 256 cases. AB - 256 patients of the years 1965-1979 who suffered from collum carcinoma stage T1b were reviewed. Most of the neoplasmas were squamous cell carcinoma (81%). By tumor screening only 21% of the carcinomas were detected. The treatment was in most of the cases a radical hysterectomy (Wertheim-Meigs). Postoperative radiotherapy was performed in cases of poor differentiated carcinoma of if lymphatic nodes had been occupied by the tumor. Thus only 43 patients had no radiotherapy. A 5 year-follow-up was possible in 151 cases. Women older than 40 year showed a better prognosis than younger women. Patients treated only by radiotherapy had a five year survival rate of 88%. No difference in prognosis was observed, if radiotherapy was additionally performed. There was no significant difference of severe complications in either forms of treatment. PMID- 3971991 TI - Steroid receptors in human uterine carcinoma. Their biological importance and therapeutic implications. AB - Surgical material of primary uterine carcinoma from postmenopausal patients was analyzed with regard to cytosol content of estradiol (ER) and progesterone (PR) receptors, as well as their binding sites in nuclear compartment. A dextrancoated charcoal technique was used and binding data were calculated from Scatchard plots. In all examined specimens intracellular high-affinity, low-capacity estrogen - and progesterone-binding proteins (which have the characteristics of steroid receptors), with equilibrium dissociation constants (Kd's) of 10(-10)M and 10(-9)M respectively, have been observed in detectable levels. DNA binding ability of steroid-receptor complexes was examined and clearly demonstrated even at 4 degrees C by using DNA-cellulose slurry. Preheating of complexes at 25 degrees cause increased DNA binding ability in some specimens, but significant loss of this ability in other tumors. The relationship between the nuclear retention of steroid-receptor complexes and their interaction with nuclear components (giving a response) is discussed on the basis of steroid-responsive and unresponsive systems. Present investigation indicate that described steroid analysis may become an important tool in predicting the value of endocrine therapy in human uterine carcinoma. PMID- 3971992 TI - Surgery as diagnostic and therapeutic moment in the management of cervical cancer. AB - Therapeutical program in cervical cancer usually include surgical or radiotherapeutical interventions or a combination of the two, variously integrated with techniques and sequences of application. Treatment planning and evaluation of results are normally based on the classification into clinical stages codified by the FIGO. But this classification, though providing useful prognostic standards of judgement, has proved to be inadequate to identify specific therapeutical guidance. Within a single clinical stage different risk factors have been identified which influence prognosis thus determining the therapeutical treatment more than staging itself. Furthermore clinical staging has failed to predict the surgical stage correctly in a significant number of cases. The index of correction after surgical staging shows discrepancy in about 1/3 of cases. In these cases a therapeutical program based on clinical examination exclusively may prove to be inadequate. The results reported by Authors warrant a rational resort to operative staging in cervical cancer in order to establish the real topography of the original focus more correctly. This indication is further strengthened by the need to identify lymphatic involvement, notably of para-aortic nodes, in locally advanced cases since such an occurrence bears a significant influence on the patient's prognosis and possibility of treatment. On the bases of these considerations the Authors suggest surgery as primary treatment in the management of cervical cancer. PMID- 3971993 TI - Elevated serum levels of creatine kinase BB in breast cancer. AB - Creatine kinase BB serum levels were evaluated by radioimmunoassay in patients with benign or malignant breast pathology. Elevated enzyme levels were observed in 6 out of 20 (30%) patients with primary breast cancer. After surgery the levels fell to normal values only in patients without nodal involvement. Six out of 28 (21%) patients with benign breast lesions and 4 out of 38 (13%) patients with metastatic breast cancer also showed increased levels of the enzyme. Most of the patients with high creatine kinase BB serum levels were found to have estrogen and progesterone receptor-positive tumors. These findings suggest that creatine kinase BB can barely be considered a marker of malignancy in breast pathology, but rather an indicator of hormone dependency in breast cancer. PMID- 3971994 TI - Primary radical surgery in carcinoma of the cervix uteri. AB - Fifty patients with cervical carcinoma were treated by primary radical hysterectomy and transperitoneal pelvic lymphadenectomy by one surgeon and followed 10 to 20 years. Of 15 patients with pelvic lymph node metastases 10 received postoperative irradiation of whom 7 developed recurrence and died from cancer. Of 5 patients with metastases who did not receive radiotherapy, 3 developed recurrence: 1 with distant metastases died. The other 2 with localized recurrences were treated with radiotherapy and survived more than 9 years. The 5- and 10-year observed survival rates for stage I b patients were 85% and 76% respectively. PMID- 3971995 TI - Dysgerminoma. A report of five cases. AB - We analyzed five cases of pure dysgerminoma following the same schedule for the treatment, which were studied during the period of 1971 to 1983. The age of patients during the period of histological examination ranged from 15 years and 6 months to 28 years. All five patients had already had their "first menstruation". The above cases examined according to the clinical findings, the symptoms, the stage of the disease; the sort of treatment the place, the period and kind of therapy in case of reappearance of the disease and final survival. PMID- 3971996 TI - Incidence of dysplasia, carcinoma in situ and invasive carcinoma in colposcopic findings of atypical re-epithelization zone (A.R.Z.) and atypical transformation zone (A.T.Z.). AB - The Authors report their experience on 5518 colposcopic examinations and consider especially the findings of A.R.Z. and A.T.Z. and the correlation with cytologic and histologic aspects. They found a significant incidence of CIN (I, II, III) and invasive carcinoma by means of association of directed punch biopsies under colposcopic vision. Finally the importance of histological examination also in presence of negative cytologic findings is evidenced. PMID- 3971997 TI - Surgical treatment of intestinal occlusions in advanced ovarian carcinoma. AB - The Authors report encouraging results concerning the surgical treatment of intestinal occlusions in 31 patients affected by advanced ovarian carcinoma. They stress the need for an increasingly accurate association of chemotherapy and aggressive surgery and underline the vital role that total parenteral therapy has to play in improving these results which are, nevertheless, satisfactory. PMID- 3971998 TI - Androgenic juvenile granulosa cell tumour. Case report. AB - An androgenic juvenile granulosa cell tumour of the ovary in a postmenarcheal girl is presented. Distinctive histological features of this variant are stressed and virilizing effects are explained by an immunohistochemical study of hormones produced by granulosa and theca cells. PMID- 3971999 TI - Wertheim's radical hysterectomy with pelvic lymphadenectomy in the treatment of cervical carcinoma at the Obstetric and Gynecological Clinic of the University of Pisa. AB - The Authors report their experience in 49 operations of radical hysterectomy with pelvic lymphadenectomy in the treatment of stage I b and stage II cervical cancer. They describe particularly the precocious and late urinary complications and the arrangements made for their prevention. We had no uretero-vaginal fistula in 21 of the 49 patients, on whom a kind of roof and floor around the terminal tract of the ureters was created by placing some surgical stitches between the posterior wall of the bladder and the anterior lateral wall of the rectum. PMID- 3972000 TI - Stage 1 and 2 carcinoma of the cervix: review of complications in 140 cases treated in the years 1971-1980. AB - Complications of 140 cases of squamous carcinoma of the cervix treated by surgery are analyzed. Intra- and post-operative morbidity is considered; intra-operative morbidity was very low. Post-operative morbidity was mainly rappresented by early and late bladder dysfunction. Recurrence rate is analyzed; it is 10%. PMID- 3972001 TI - Uptake and inactivation of thrombin on aortic endothelium and neo-intima. AB - The aim of this study was to investigate the uptake and inactivation of thrombin on aortic endothelium and neo-intima developing on vascular grafts in pigs and dogs. Thrombin, measured with a synthetic chromogenic substrate, was found on the grafts, particularly on grafts with an incompletely developed neo-intima. After incubation of grafts and aortic segments with thrombin in vitro, significantly more thrombin was taken up on the grafts as compared to aortic endothelium. In the presence of plasma, surface-bound thrombin was inactivated much faster on aortic endothelium than on neo-intima. If surfaces loaded with thrombin in vitro were incubated with a balanced salt solution the enzyme was inhibited much more slowly. Thrombin activity on the neo-intima may contribute to graft thrombosis. PMID- 3972002 TI - Observations on the metabolic effects of partial jejunoileal bypass in streptozotocin-treated rats. AB - A 50% small bowel bypass was performed in diabetic rats (streptozotocin-treated) and in normal rats. Normal rats and diabetic rats were used as controls. Values of fasting blood glucose and oral glucose tolerance test showed a normalization and the disappearance of glycosuria, polyuria, polydipsia and hyperphagia in diabetic rats after surgery. Mean loss of weight 3 months after surgery was 9.1% in normal bypassed rats and 60.5% in the diabetic controls. After an initial postoperative weight loss of 33.4%, the diabetic bypassed rats gained subsequently their previous weight plus an increase of 7.2%. Improvement in carbohydrate metabolism appears to be independent of loss of weight and decrease in food intake in lean diabetic rats. Amelioration of diabetes after jejunoileal bypass is the result of several metabolic consequences, particularly the malabsorption of carbohydrates, fats and amino acids. PMID- 3972004 TI - Variations in transmucosal gastric potential difference during hemorrhagic shock in the rat. AB - Transmucosal gastric potential difference (TGPD) was measured in the antrum and fundus of the stomach in two groups of rats submitted to hemorrhagic shock. In the first group the stomach contained 2 cm3 of 0.1 N HCl and in the second 2 cm3 of physiological saline. After the hemorrhage both antral and fundal TGPD diminished significantly in both groups. Antral TGPD dropped from -20 to -6 mV (p less than 0.001) in the first group and from -22 to -12 mV (p less than 0.01) in the second group; fundal TGPD dropped from -41 to -16 mV (p less than 0.001) in the first group and from -40 to -17 mV (p less than 0.05) in the second group. 20 min after reinfusion of blood extracted during the hemorrhage, both antral and fundal TGPD returned to normal values in the rats instilled with physiological saline, while in those treated with HCl TGPD values remained at levels significantly lower than the baseline values (in the antrum -10 mV, p less than 0.001; in the fundus -25 mV, p less than 0.02). Only those rats whose stomachs contained HCl developed ulcers, mainly located in the fundus of the stomach. These results suggest that the energy metabolism of the cells of the gastric mucosa undergoes constant alteration from the earliest stages of hemorrhagic shock. These alterations are greater in the fundus than in the antrum, a fact compatible with the greater incidence of ulcers in the fundus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972003 TI - Gastric acid secretion during halothane, chloralose, pentobarbital and etomidate anaesthesia in the pig. AB - The gastric acid secretion in the awake state of the pig was compared to that during halothane, chloralose, pentobarbital and etomidate anaesthesia. After collection of basal juice, acid secretion was stimulated with pentagastrin in the dosages of 0.25, 1.00 and 4.00 micrograms/kg/h. Halothane strongly inhibited acid secretion, whereas acid secretion during chloralose anaesthesia was enlarged by a factor 6 as compared to that of the awake animal. The mean acid output after receiving pentobarbital was close to that of the awake condition, but the interindividual variation was large. Nearly identical values for acid secretion were found during etomidate anaesthesia, but with much higher consistency in the results. Etomidate anaesthesia seems to be the most suitable method for measurements of gastric acid secretion during anaesthesia in the pig. PMID- 3972005 TI - Antiplatelet aggregators inhibit development of stress ulcers in Sprague-Dawley rats. AB - Antiplatelet aggregators such as sulfinpyrazone (10 mg/kg), ticlopidine (200 mg/kg), and pyridine (0.1 mg/kg) significantly inhibited the degree of gastric ulceration in Sprague-Dawley rats subjected to cold restraint stress. The inhibition of platelet aggregation and that of microthrombus formation were evident in rats given antiplatelet aggregating drugs and exposed to cold stress. Therefore, platelet aggregation does play an important role in stress ulcer formation, and drugs which inhibit this aggregation should be given greater attention as to possible clinical application for treatment of stress ulcers. PMID- 3972007 TI - Failure to find attention differences between learning disabled and normal children on classroom and laboratory tasks. PMID- 3972006 TI - Effects of acute bleeding on oxygen supply to the skeletal muscle in dogs. AB - To study the effect of acute bleeding on the oxygen supply to the skeletal muscle, heparinized dogs were bled via an arterial cannula until mean arterial pressures of 25 and 50 mm Hg below initial value were reached. The shed blood was retransfused in reverse (50, 25 mm Hg) after correction of the acid-base imbalance in the dogs. Oxygen supply to the skeletal muscle was measured by means of a multiwire polarographic electrode placed on the sartorius muscle and was evaluated by means of ptO2 histograms. The ptO2 histograms showed that the oxygen supply to the skeletal muscle is severely impaired after a decrease in mean arterial pressure of 25 mm Hg. Further impairment was seen after a decrease in pressure of 50 mm Hg. During retransfusion tissue oxygenation was normalized only after all shed blood was retransfused and the initial mean arterial pressure was reached. PMID- 3972008 TI - Inservice teachers' assessed needs in behavioral disorders, mental retardation, and learning disabilities: are they similar? PMID- 3972009 TI - Investigation of the mechanism of protein turnover in HeLa S-3 cells by incubation at elevated temperatures. AB - An apparent paradox relating to the degradation of endogenous proteins in HeLa S 3 cells occurs at 45 degrees C, at which their proteolysis is considerably enhanced in vitro but completely inhibited in vivo. No significant differences in rates of degradation of short-lived (nascent) and long-lived ('existing') proteins synthesised at 37 degrees C were found when chased at temperatures up to 43 degrees C, but at 45 degrees C degradation of both categories was reduced to zero in vivo. Synthesis of protein was suppressed at temperatures above 41 degrees C, being reduced by up to 60% at 43 degrees C. Proteolysis in vitro proceeded 1.6-1.7 times faster at 45 degrees C than at 37 degrees C and neutral pH. Evidence is presented for the involvement of the basal system; the findings both in vivo and in vitro do not seem to implicate the lysosomal system, no firm indication being obtained of its 'induction' at elevated temperatures. The results are discussed in terms of the arrest of intracellular circulation at elevated temperatures, thereby reducing the delivery rate of proteins as substrates of the intracellular basal proteolytic enzyme system to negligible levels (i.e., to the frequency of encounters due solely to the diffusion of protein molecules with the cytoplasm). PMID- 3972010 TI - Towards a further understanding of the growth-inhibiting action of oxygen deficiency. Evaluation of the effect of antimycin on proliferating Ehrlich ascites tumour cells. AB - The effect of 1 microM antimycin on the proliferative properties, metabolism and basic cell composition of Ehrlich ascites tumour cells cultured in the second in vitro passage was studied. Continuous drug exposure of asynchronous cells caused rapid cessation of cell growth, characterized by the cell number and DNA, RNA and protein content of cultures. Cells cease to consume oxygen and enhance their glycolytic activity. Uptake of labelled thymidine into acid-insoluble material was far below that of the controls, whereas incorporation of labelled uridine exceeded that of controls, as was also observed with other inhibitors of the respiratory chain (sodium cyanide, 2-thenoyltrifluoroacetone, or anaerobiosis). The influence of antimycin on cells at different stages of the cell cycle was tested using cells enriched in either G1, S or G2 phase by centrifugal elutriation. DNA histograms (flow cytometry) and pulse-labelling index curves gave detailed insight into cell-cycle progression of antimycin-treated cells: G1 and early S cells remained stationary; G2 cells still passed from G2 into mitosis to remain subsequently in a non-growing state in G1; S cells were either slowed or halted. Supplementation of antimycin-containing cultures with exogenous pyrimidine nucleosides stimulated reprogression of G1 cells without changing their ATP content. The results of the current experiments are interpreted as supporting the concept that growth cessation of G1 cells under respiratory insufficiency is not predominantly caused by impairment of respiratory phosphorylation but may be the consequence of a lack of precursors for DNA and RNA synthesis. PMID- 3972011 TI - Characterization of DNA-protein complexes from the mitochondria of Xenopus laevis oocytes. AB - Mitochondrial DNA (mtDNA)-protein complexes (nucleoids) from Xenopus laevis oocytes were purified either on rate-zonal sucrose or isopyknic metrizamide gradients. From electron microscopic studies and staphylococcal nuclease digestion experiments mtDNA appears to be packaged into regular beaded structures. Protein electrophoretic analysis and M banding results show that mtDNA is associated with the membrane structures and also with few specific proteins including one acid-soluble polypeptide of 28 kD. PMID- 3972013 TI - Inhibition of phosphatidylcholine synthesis does not alter uptake of transferrin by LM fibroblasts. AB - The receptor-mediated endocytosis of diferric transferrin by LM fibroblasts has been examined to determine if de novo synthesis of phosphatidylcholine is required for this process. To test this possibility, LM cells were allowed to internalize [125I]transferrin in the presence or absence of exogenous choline. Under conditions in which de novo synthesis of phosphatidylcholine was reduced from 51% of the total to less than 10%, the initial rate of transferrin uptake was unaffected. These data suggest that the process of receptor-mediated endocytosis of transferrin can proceed normally in the absence of de novo phosphatidylcholine synthesis. PMID- 3972012 TI - Cell cycle variations in chromatin structure detected by DNase I. AB - We have recently developed a reproducible method for the use of DNase I as a sensitive probe of chromatin structure (Prentice, D A & Gurley, L R, Biochim biophys acta 740 (1983) 134) [12] and have used this probe to investigate chromatin structure during the interphase of the cell cycle. Chinese hamster cells (line CHO) were synchronized by: (1) mitotic detachment, to obtain M-phase cells; (2) isoleucine deprivation, to obtain G1-phase cells; and (3) sequential use of isoleucine deprivation followed by release into the presence of hydroxyurea, to obtain cells blocked at the start of S phase. The cells were released from the various blocking schemes and nuclei were isolated and digested with DNase I at various times. The digestion kinetics were monitored to detect possible changes in chromatin condensation through the cell cycle. The chromatin was much more accessible to DNase I in G1 phase than in S or G2 phase, with only small variations in structure detected in late G1 and very early S phase. From early S phase up to mitosis, the chromatin became increasingly condensed and inaccessible to DNase I action. These results support the concept of a chromatin condensation cycle during interphase as well as during mitosis. PMID- 3972014 TI - Effect of amino acids and cycloheximide on changes caused by vinblastine, leupeptin and methylamine in the autophagic/lysosomal system of mouse hepatocytes in vivo. AB - The number of autophagic vacuoles in hepatocytes of 24 h fasted mice in vivo increased manyfold following the administration of vinblastine, leupeptin and methylamine. The effect of each chemical is characterized by the predominance of a certain kind of vacuole. Vinblastine treatment is accompanied by a large proportion of vacuoles containing morphologically unaltered organelles, leupeptin causes preferential accumulation of dense and complex vacuoles, methylamine administration produces mostly large, electron-lucent, swollen vacuoles. The amounts of segregated and accumulated cytoplasmic material, expressed as percentage cytoplasm per hour, were 0.84%, 2.08% and 0.74% following vinblastine, leupeptin and methylamine treatment respectively. The actual rate of segregation was probably higher than this. Inhibition of degradation of the sequestered cytoplasmic material is proposed to be a main factor in the increase in the size of the autophagic/lysosomal compartment. Treatment with cycloheximide or exogenously added mixture of amino acids cut down the size of the autophagic/lysosomal system in control cells and strongly inhibited the accumulation caused by vinblastine, leupeptin and methylamine. PMID- 3972015 TI - Technique of labeling monocytes with 111In-Fe colloid for use in humans. AB - In order to follow monocyte kinetics in hematologic malignancies by means of radioactive labeling, three conditions are necessary: (a) no loss of monocytes during separation, (b) specific labeling of monocytes, and (c) normal functional capacities of the labeled monocytes. In this report a method is described that fulfills the first two conditions and can be executed with maintenance of sterility. Cell labeling was performed using a mononuclear cell suspension consisting of monocytes (20%-50%), lymphocytes (50%-80%), and with minor contamination by granulocytes, thrombocytes, and erythrocytes. This cell suspension was obtained by centrifugation of a leukocyte suspension on a gradient of 16% wt/vol and 22% wt/vol human serum albumin solutions. The recovery of monocytes with this enrichment method approached 100%. Monocytes were labeled by endocytosis of 111In-Fe colloid; monocytes were labeled significantly higher than lymphocytes (P less than 0.001) and granulocytes (P less than 0.01) (Wilcoxon's two-sample test). Cell viability after labeling was greater than 90%. PMID- 3972016 TI - Laboratory methods in experimental hematology: I. The diffusion-chamber technique in experimental hematology. PMID- 3972017 TI - Proliferation and maturation of murine megakaryocyte progenitor cells in a liquid culture system. AB - Murine megakaryocytes generated in a liquid culture system containing pokeweed mitogen-stimulated spleen-cell-conditioned medium were classified into four groups: heterogeneous colonies, homogeneous colonies, two-cell colonies, and solitary megakaryocytes. The ploidy distribution and ultrastructural cytoplasmic maturation were compared among the four groups. The mean ploidy of heterogeneous colonies was low and remained unchanged during the culture. In contrast, an intensive increase in DNA content of homogeneous colonies, two-cell colonies, and solitary megakaryocytes was observed. In ultrastructural analyses, type-I megakaryocytes (early immature megakaryocytes) were predominant in heterogeneous colonies. Type-II megakaryocytes (immature megakaryocytes) increased in homogeneous colonies and two-cell colonies. Type-III megakaryocytes (mature megakaryocytes) increased in two-cell colonies and solitary megakaryocytes. In the liquid culture system, megakaryocytes from two-cell colonies and solitary megakaryocytes could mature into platelet-producing megakaryocytes, whereas megakaryocytes from heterogeneous colonies and homogeneous colonies remained immature. PMID- 3972018 TI - Regeneration of erythroid progenitor cells in polycythemic mice treated with cyclophosphamide. AB - Mice with posthypoxic polycythemia treated with a sublethal dose of cyclophosphamide (Cy) were used as a model to investigate, by in vitro methods, the kinetics of regeneration of erythroid committed precursors (ECP) and to study the influence of erythropoietin (Ep) on those precursor cells. The results demonstrated that erythroid burst-forming units (BFU-E), early (d10) and late (d4), and erythroid colony-forming units (CFU-E) recover at different rates after Cy. Early BFU-E recovery was not Ep dependent and closely resembled regeneration of pre-erythropoietin-responsive cells (pre-ERC) found previously using the same experimental model. The absence of spontaneous recovery of mature BFU-E and CFU-E in the bone marrow and spleen of Cy-treated polycythemic mice, which is contrary to the findings in normal mice treated with Cy, indicates the importance of Ep for BFU-E (d4) and CFU-E regeneration. This was confirmed when exogenous Ep was injected. The effect on BFU-E (d4) of exogenous Ep injected into the polycythemic Cy-treated mice at the time when primitive BFU-E have regenerated considerably suggested an influence of Ep on the transition of BFU-E (d10) to BFU-E (d4). The fast regeneration of CFU-E in the spleen of normal mice and after Ep injection in polycythemic Cy-treated mice confirms the well-known and significant role of the spleen in mouse erythropoiesis under stress conditions. It could be suggested that the patterns of BFU-E (d4) and CFU-E recovery as well as Ep responsiveness closely resemble the findings observed earlier for ERC in the same experimental model. PMID- 3972019 TI - Stochastic model of human granulocyte-macrophage progenitor cell proliferation and differentiation. I. Setting up the model. AB - A mathematical model is constructed for the proliferation and differentiation of granulocyte-macrophage progenitor cells in response to the specific proliferation/differentiation stimulus granulocyte-macrophage colony stimulating activity (gm-CSA). The major objective of this model was to test an earlier conceptual model in which we proposed that clone size potential and sensitivity to gm-CSA are functional properties of granulocyte-macrophage progenitor cells, properties that gradually change as the cells differentiate down the granulocyte monocyte pathway. Another aim was to provide a tool for further analysis of the regulation of granulopoiesis and granulocyte-macrophage progenitor cell proliferation and differentiation. To formulate and then test the mathematical model, available experimental data were divided, one part being used to construct the model, and the other, the results of different and independent experiments, being used for model validation. This report describes the mathematical model and the estimation of model parameters using in vitro experimental results on the relationship between clone number and gm-CSA concentration and on the clone size distributions obtained under conditions of maximal stimulation by gm-CSA. The accompanying article shows how the model was then tested using data from three other types of experiment. PMID- 3972020 TI - Stochastic model of human granulocyte-macrophage progenitor cell proliferation and differentiation. II. Validation of the model. AB - In the accompanying paper we constructed a model for the proliferation and differentiation of granulocyte-macrophage progenitor cells in response to the specific proliferation/differentiation stimulus granulocyte-macrophage colony stimulating activity (gm-CSA). Here we have tested the model without altering the model parameters, which were estimated on the basis of two types of experiment (clone number versus gm-CSA dose-response curves and clone size distributions with maximal gm-CSA) by using these parameters to simulate additional independent experiments. These included data from separation experiments in which progenitor cells were separated on a basis of their density and were then tested for their sensitivity to gm-CSA and their proliferative capacity. In addition, other sets of experimental data (e.g., mean clone size versus time and colony versus gm-CSA dose-response curves and colony-to-cluster ratios) were also examined to detect whether the mathematical model provides an adequate representation of the data. The model gave a successful simulation of all experimental data. PMID- 3972021 TI - Occupational dust exposure and smoking. Different effects on forced expiration and slope of the alveolar plateau. AB - Indices of forced expiration (FEV1 and MEF25-75) were compared with the slope of Phase III of the single breath nitrogen test (%N2/1) in 1270 men, who, based on life occupational histories, were categorized as cement factory workers, blue or white collar workers, and farmers. The slope of Phase III was successfully determined in 1182 men. Irrespective of occupational category, the FEV1 and MEF was lower in present smokers than in ex-smokers, who in turn had lower values than never-smokers. With corresponding smoking habits, white collar workers showed on average higher values of FEV1 and MEF than the blue collar workers, the cement-exposed men and the farm workers. The slope of Phase III varied with smoking habits in a similar way, and among present smokers, the same occupational gradient was evident. However, no effect of occupation on the slope of Phase III could be traced in ex-smokers and never-smokers. It is concluded that the response of the lung to occupational exposure may differ from that of tobacco smoking. The combined use of indices from the forced expirogram and the slope of Phase III could yield valuable information in the study of occupational respiratory diseases. PMID- 3972022 TI - Immunological abnormalities in shrinking pleuritis with atelectasis. AB - The immunological status of 14 patients with shrinking pleuritis with atelectasis (SPA) was assessed by skin testing for delayed hypersensitivity reactions and in vitro tests of peripheral blood lymphocyte reactivity. The results were compared with those of 3 control groups, one consisting of healthy men, one of workers exposed to asbestos and one of workers exposed to quartz dust. Only 2 of 14 SPA patients showed a positive skin reaction to 2.4-dinitrochlorobenzene (DNCB). The cutaneous reactions to candida and varidase were significantly increased in the SPA group compared with the other groups (p less than 0.05). The response of the blood lymphocytes to stimulation with phytohaemagglutinin was significantly decreased in the SPA group (p less than 0.01), as was unstimulated lymphocyte proliferation (p less than 0.05). The results suggest a primary or secondary immune abnormality in the SPA group. The exact nature of the defect requires further elucidation. PMID- 3972023 TI - Neonatal pneumothorax, a rare complication of pulmonary cystic lymphangiectasis. AB - An unusual case of neonatal pneumothorax in a full-term female infant is reported. The collapse was caused by congenital pulmonary lymphangiectasis and rapidly led to death; the lesion was discovered at autopsy. Multiple cardiac malformations were also associated. The literature and pathogenesis are reviewed and discussed. PMID- 3972024 TI - The significance of the reflex bronchoconstriction provoked by gastroesophageal reflux in bronchial asthma. AB - To demonstrate the existence and assess the magnitude of reflex bronchoconstriction in asthmatics, triggered by gastroesophageal reflux, pulmonary function studies (forced expiratory spirogram, flow-volume loops and airway resistance) were performed during a Bernstein test in 21 adult patients with intrinsic asthma and in 15 controls. Six asthmatics and 7 controls had symptomatic reflux test and a positive standard acid reflux test. Bernstein test was positive in all symptomatic individuals and in 2 asthmatics with a negative standard acid reflux test. Changes in pulmonary function occur only in asthmatics with symptomatic reflux. Decreases were: FEV1 8.4 +/- 3.4; FEF25-75% 45 +/- 7.3; Vmax 15 +/- 8.4; and Sgaw 16 +/- 3.7. Although changes were statistically significant (p less than 0.05), the magnitude of decrease is rather small and unlikely to be felt by an asthmatic or produce wheezy dyspnea. Therefore, even though the presence of acid in the lower esophagus may produce reflex bronchoconstriction in some asthmatics with symptomatic reflux, this appears to be of little significance. PMID- 3972025 TI - Genetic factors in non-specific bronchial reactivity in rats. AB - Two bronchoconstrictory agents, serotonin (5 HT) and carbachol, were investigated in different inbred rat strains in order to delineate possible factors influencing the bronchial reactivity. The challenge was given intravenously and a single dose was given to an individual animal. Inbred strains of rats differed significantly from each other in their reactivity to 5 HT and to carbachol. IC rats were good reactors to both 5 HT and carbachol. RA rats were intermediate reactors to both agents. OM/N rats had a good reaction to 5 HT, but showed only a minor bronchoconstriction after carbachol. BN and LE rats were poor reactors to both agents. The strain reactivities to the 2 provocation agents were not related. Breeding studies, using a good reactor, IC, and a poor reactor, DA strain, showed that the bronchial reactivity to 5 HT was inherited with a pattern that fitted with the autosomal recessive way of inheritance, high reactivity being recessive. PMID- 3972026 TI - The critical period for corpus callosum section to affect cortical binocularity. AB - The period of time during which surgical section of the corpus callosum (CC) is effective in altering the physiological properties of cells in cat striate cortex was investigated. Cats which had the CC transected between 13 days and 24 weeks of age were studied using extracellular, single-unit recording procedures. Analysis of the results from 1,747 cortical units indicate that when the CC was sectioned prior to 19 days of age there was a reduction in the encounter rate of binocularly activated neurons and an increase in the proportion of neurons dominated by the contralateral eye. The decrease in cortical binocularity was observed in both simple and complex cell populations, and at all receptive field eccentricities studied (0-39 degrees). However, when the CC was sectioned after 19 postnatal days, no physiological changes were detected. Thus, in contrast with previous studies (Payne et al. 1980a, b) no changes were found following CC section in adult cats. The results therefore define a critical period which ends before 3 weeks of age during which corpus callosum section reduces striate cortex binocularity. Although the corpus callosum critical period is much shorter than the critical period for experiential alterations in cortical binocularity, the physiologically determined limits of the callosal critical period agree with the behaviorally determined limits previously found for the callosal critical period (Elberger 1984). PMID- 3972027 TI - Luminance and darkness detectors in the olivary and posterior pretectal nuclei and their relationship to the pupillary light reflex in the rat. I. Studies with steady luminance levels. AB - In order to identify the pretectal nucleus which contains pupillomotor cells in the rat, cells were sought which were sensitive to changes in luminance level at the eye. Two types were found: Luminance detectors which showed a graded increase in firing with increase in luminance, and darkness detectors which showed a graded increase in firing rate with graded dimming of luminance intensity. All luminance detectors were located in the olivary pretectal nucleus, whereas darkness detectors were located in the posterior pretectal nucleus. Consensual pupil responses were recorded in conscious normal and sympathectomised rats using an infra-red sensitive T.V. pupillometer. Pupil diameter varied 2mm in an approximately linear fashion over six log units range in luminance intensity. Sympathectomy produced a general constriction of the pupil, but the overall response to light was unaffected. The changes in pupil size occurred over the same range of luminance that the firing rates of both luminance and darkness detectors changed. The olivary pretectal nucleus may therefore be involved in pupilloconstruction in the light, and the posterior pretectal nucleus, with pupillodilation in the dark. PMID- 3972029 TI - Identification of the medullary swallowing regions in the rat. AB - The aim of the present study was to identify the central structures involved in the organization of the swallowing reflex in the rat. Using concentric bipolar electrodes, the medulla and pons were systematically explored in order to determine which central areas responded to stimulation by inducing swallowing. These areas, which were located in the dorsal medulla oblongata, were the solitary tract, the nucleus of the solitary tract (NST) and the adjacent reticular formation. Stimulation of the ventral ponto-medullary regions was ineffective with regard to the initiation of the swallowing reflex. The activity of medullary swallowing neurons was recorded using extracellular microelectrodes. These swallowing neurons responded with a burst of spikes (swallowing activity) which was closely linked to the swallowing reflex elicited by stimulation of the superior laryngeal nerve (SLN). Under SLN stimulation, the activity of some of the swallowing neurons furthermore showed an initial response consisting of 1 or 2 spikes after a brief latency. According to their location and the latency of their initial response, swallowing neurons were divided into two groups. Group I neurons were located in a dorsal area of the medulla oblongata corresponding to the NST and the adjacent reticular formation. All these neurons exhibited an initial response with a very short latency (1 to 4 ms), the swallowing activity of most of these neurons started before the onset of the swallowing motor sequence. Group II neurons were located either in a ventral area corresponding to the nucleus ambiguus and the surrounding reticular formation or in a dorsal and medial area corresponding to the hypoglossal nucleus and its vicinity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972028 TI - Cerebellar and olivary projections of the external and rostral internal cuneate nuclei in the cat. AB - The cerebellar projection of the external cuneate nucleus and the adjoining rostral part of the internal cuneate nucleus were investigated by means of anterograde transport of tritiated leucine. The cuneocerebellar tract terminates as mossy fiber rosettes in the granular layer. The termination area has a more or less spherical form with its centre at the ipsilateral side. It comprises the anterior and posterior vermes bilaterally and the ipsilateral hemispheral parts of the anterior and simple lobules, the medial aspect of the ansiform lobule and the paramedian lobule. Within this area the mossy fiber terminals are arranged in continuous sagittal strips, some of them clearly separated from one another. The strips were found in the cerebellar modules A-D. Concomitant bilateral projections to several subdivisions of the inferior olive were found. Some of these provide the anatomical substrate for the simultaneous activation of a number of mossy and climbing fiber zones observed in the anterior lobe following stimulation of different forelimb nerves. No evidence was found for a termination of mossy fiber collaterals in the central cerebellar nuclei. PMID- 3972030 TI - Convergence of sensory inputs in somatosensory cortex: interactions from separate afferent sources. AB - Intracellular recording techniques were used to test for cross-modality and topographic convergence among inputs to area 3a of cerebral cortex. Recordings were made within the projection area of group I afferent fibers of the deep radial nerve in barbiturate-anesthetized cats. Epsps were evoked in 90% of neurons (81/90) by electrical stimulation of more than one nerve of the contralateral forelimb. The deep radial nerve evoked the shortest latency epsps within this region of cortex and the only ones likely to be mediated by a monosynaptic thalamocortical pathway. However, the epsps evoked from other forelimb nerves (of deep or cutaneous origin) had mean latencies only a few milliseconds (1.3-3.0 ms) longer. Furthermore, there were a variety of interactions among inputs from separate afferent sources. The observed interactions included spatial facilitation, occlusion and afferent inhibition. The consequence of these interactions was that neuronal responses were shaped by combinations of effects from different topographic regions of the forelimb or of different modalities. The findings are interpreted as indicating a sharing of neurons among pathways to cortical neurons from separate afferent sources. Interactions between ascending pathways by way of such shared neurons may contribute to the modulation or plasticity of somatosensory responsiveness during behavior or after deafferentation. PMID- 3972031 TI - Different effect of methylazoxymethanol on mouse cerebellar development depending on the age of injection. AB - Methylazoxymethanol (MAM), a powerful antimitotic, has been extensively used to affect rodent CNS development. Here we show that MAM causes different effects on mouse cerebellum depending on the age of the injected pup. Sublethal doses were determined for each age. A single injection at birth permanently reduces the number of cells. In addition, the cytoarchitecture was greatly perturbed: Purkinje cells retained an immature aspect and were dispersed through the cerebellar cortex. A single dose of MAM injected into 5 day old mice also affected the number of cells but, at the level of light microscopy, the cytoarchitecture of the cerebellar cortex appeared not to be altered. Purkinje cells, however, showed some immaturity and degenerated around the 22nd postnatal day. This modulation of MAM effect appears to provide a good model for studying cerebellar ontogeny and neuronal plasticity. PMID- 3972032 TI - Efferent fibers from the motor cortex terminate bilaterally in the thalamus of rats and cats. AB - The anterograde transport of lectin-conjugated horseradish peroxidase (WGA-HRP) was here employed in order to visualize crossed corticothalamic efferents of the motor cortex in rats and cats. After WGA-HRP cortical injections in the rat retrogradely labeled cells were observed in the ipsilateral thalamus, and heavy anterograde labeling was observed both in the ipsi- and contralateral thalamus. The contralateral anterograde labeling was less intense than the ipsilateral one and it was distributed in the anterior intralaminar structures, in the parafascicular nucleus, in the ventromedial, ventrolateral and ventrobasal nuclei and in the posterior complex, symmetrically to the labeling observed on the ipsilateral side. Further experiments were made in the rat in order to ascertain that the bilateral anterograde labeling in the thalamus derived unilaterally from the cortex. To this purpose, kainic acid was injected unilaterally either into the frontal cortex or into the thalamus, and WGA-HRP was later injected on the same side in the frontal cortex. Moreover, WGA-HRP was injected into the frontal cortex after splitting of the corpus callosum. The results obtained in these experiments confirmed that cortical neurons projected bilaterally upon the thalamus. Further, these experiments indicated that at least the majority of the contralateral fronto-thalamic fibers crossed the midline in the thalamic massa intermedia. WGA-HRP injections into the pericruciate cortex in the cat confirmed the presence of anterogradely labeled terminals in the contralateral anterior and posterior intralaminar, ventral anterior, ventromedial and ventrolateral nuclei. The labeling was in all cases heavier in the intralaminar nuclei than in the other structures, but it was less intense than that observed in the rat.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972033 TI - Experimental test of two models for the generation of oblique saccades. AB - In this paper, we report a detailed study of the dynamic properties of horizontal, vertical and oblique saccades. These eye movements were measured with an improved version of the double-magnetic induction method in two rhesus monkeys. We found that onsets of orthogonal components of oblique saccades are so well synchronized in the monkey that a common initiation system seems likely. Saccade vectors obeyed a nonlinear peak-velocity/amplitude relationship in all directions. The peak-velocity/duration/amplitude relationship for components was not fixed, but depended on the relative size of the orthogonal component: for a component with a given size, its duration increased and its peak velocity decreased, as the saccade vector to which it contributed turned away from the component direction under consideration. This stretching effect, which reflects a nonlinearity in the system, was negligible for small saccade vectors but became very pronounced in large oblique saccades. These experimental data were confronted with quantitative predictions derived from two different models for the generation of saccades in two dimensions. It appears that a model which assumes the existence of synchronized, but otherwise independent, pulse generators for horizontal and vertical components must be rejected. An alternative model, featuring a nonlinear vectorial pulse generator followed by a decomposition stage which generates component velocity command signals from the vectorial eye velocity signal, provides good fit with the data. According to this common-source model, the two nonlinear phenomena observed, viz., the curvilinear peak-velocity/amplitude relationship of saccades in all directions and component stretching in large oblique saccades, are due to a single nonlinearity in the proposed vectorial pulse generator. A possible neural basis for the common-source model is discussed. PMID- 3972034 TI - Establishment of synaptic connections between explants of embryonic neural tissue in culture: experimental ultrastructural studies. AB - The development of synaptic interconnections between co-cultured explants of central and peripheral nervous tissue from chick embryos has been investigated by light and electron microscopy. Two sets of co-cultured explants were used: (a) dorsal root ganglion (DRG) and spinal cord and (b) retina and tectum. Both sets of co-cultured explants became linked by bundles of fibres but the most consistent results were obtained with the DRG-spinal cord explants. Thus axons from the DRG extended large distances across the culture substrate to reach and enter mainly the dorsal horn region of the spinal cord explants. In contrast retina-tectum links were less frequently established and were less extensive, possibly because there are fewer cells in retinal explants capable of establishing contacts in tectal explants than there are cells in DRG explants capable of establishing contacts in the spinal cord. In order to distinguish between synapses involving only neuronal elements within an explant and those involving ingrowing fibres, fibre bundles linking adjacent explants were transected and the preparations fixed two to six hours later. Electron microscope study of such cultures revealed degenerating neurites and terminals in the spinal cord explants receiving DRG fibres but none in the corresponding DRG explants. Retinal explants contain numerous synapses of many types but degenerating terminals could not be found within the retinal explants after nerve fibre transections. Degenerating neurites and terminals were found within tectal explants but they were fewer and more difficult to locate than those found within spinal cord explants. The reasons for such differences are discussed. PMID- 3972035 TI - Cerebral potentials and leg muscle e.m.g. responses associated with stance perturbation. AB - In order to investigate the neuronal mechanisms underlying the compensatory movements following stance disturbance, leg muscle e.m.g. responses and cerebral potentials evoked by a treadmill acceleration impulse were analysed. It was found that the displacement was followed by a cerebral potential of a latency of 40-45 ms and EMG responses in the calf muscles at a latency of 65-70 ms. The e.m.g. responses represented specific compensatory reactions to the mode of perturbation (with a gastrocnemius activation following positive acceleration but a tibialis ant. activation following negative acceleration). The cerebral potentials, however, showed a common pattern to both conditions. In addition, the leg muscle e.m.g. reactions were not altered by learning effects and by forewarning of displacement onset, while the amplitude of the cerebral potentials was significantly smaller in these conditions compared to those produced in response to randomly induced perturbations. It was therefore concluded that the leg muscle e.m.g. reactions are mediated by a polysynaptic spinal reflex pathway which depends on a supraspinal control. The cerebral potentials seem to represent afferent signals which can be supposed to be subjected to modification and processing by supraspinal motor centres, according to the actual requirements. PMID- 3972036 TI - Vestibular nuclei activity and eye movements in the alert monkey during sinusoidal optokinetic stimulation. AB - In the alert monkey (Macaca fascicularis) vestibular nuclei neurons and eye movements were recorded during sinusoidal optokinetic stimulation in the horizontal plane at frequencies between 0.02-3.3 Hz. Maximal stimulus velocity was generally kept constant at 40 deg/s, except for frequencies above 1 Hz. Eye movements showed a nystagmus-like pattern up to 0.2 Hz with a gain (change in eye position/change in cylinder position) greater than 0.8; at frequencies above 1 Hz the gain dropped to 0.35 at 3.3 Hz. A decrease in gain was accompanied by an increasing phase lag. Recordings in the vestibular nuclei were obtained from 'vestibular only' and 'vestibular plus saccade' neurons. Neurons with a strong eye position signal ('vestibular plus position') were excluded. The vast majority (87%) of neurons were not modulated at 0.2 Hz or higher frequencies of sinusoidal optokinetic stimulation, and were classified as 'low-frequency' type neurons. Compared to the response at constant stimulus velocity, sensitivity (imp X s 1/deg X s-1) dropped to 72% at 0.03 Hz and 16% at 0.1 Hz. A few neurons (13%) responding at 0.2 Hz (sensitivity on average 65% of the constant velocity response) were classified as 'high-frequency' type neurons. They did not respond above 1.0 Hz and showed no modulation with individual eye movements. The results suggest that the activity in the groups of vestibular nuclei neurons tested here is insufficient to account for the eye movements in response to sinusoidal optokinetic stimulation at frequencies above 0.1 Hz.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972037 TI - Release of cerebellar inhibition by climbing fiber deafferentation. AB - Cerebellar units were recorded extracellularly in rats before and after an intraveinous injection of 3-acetylpyridine destroying selectively the IO. All the Purkinje cells show a loss of the complex discharge between 2 h 15 min and 2 h 45 min after treatment. This time, called the "critical period" corresponds to the degeneration of the neurons of the inferior olive as revealed by the decrease of their metabolic activity. The simple spikes of the Purkinje cells increase their discharge frequency soon after the climbing fibers cease firing. On the contrary the firing frequency of the inhibitory interneurons does not show significant changes after degeneration of the inferior olive. The efferent cerebellar neurons, including cells of the cerebellar and vestibular nuclei receiving the axon terminals of the Purkinje cells, decrease their discharge rate up to thirty times during and after the critical period. It is demonstrated that this effect is due to the increased inhibitory activity of the Purkinje cells deafferented from the climbing fibers, whereas the deafferentation of the efferent cerebellar neurones from the collaterals of the olivary cells has little impact. PMID- 3972038 TI - Topography and trajectories of commissural fibers of the superior temporal region in the rhesus monkey. AB - The topography and trajectories of the commissural fibers of the superior temporal region (STR) are studied using the autoradiographic technique. The superior temporal region is connected with the opposite cerebral hemisphere by way of two commissures. The rostral third of the supratemporal plane (STP) and superior temporal gyrus (STG) sends commissural connections through the anterior commissure. The caudal portions of the STP and STG, including the primary auditory area, send their interhemispheric connections via the caudal corpus callosum only. The mid-portion of the STR sends interhemispheric fibers through both the corpus callosum and anterior commissure. In the mid-sagittal plane, interhemispheric fibers coursing in the anterior commissure are located in its ventral portions and those fibers coursing through the corpus callosum are located in its caudal portion rostral to the splenium. It appears that this pattern of interhemispheric connections of the STR is related to the architectonic characteristics of the areas of origin of the fibers. The rostral STR, which has less well-differentiated cortical lamination patterns, sends fibers via the anterior commissure while the posterior STR fibers, coming from more differentiated cortices, travel by way of the corpus callosum. PMID- 3972039 TI - A description of intra-amygdaloid connections in old world monkeys. AB - The intrinsic amygdaloid connections of the cynomolgus monkey were investigated using the autoradiographic method. Additional evidence concerning the origin of some intra-amygdaloid connections was provided by a series of rhesus monkeys with injections of horseradish peroxidase (HRP) in the amygdaloid complex. The experiments indicated that each of the major amygdaloid nuclei possesses a unique, organized set of intrinsic projections. Furthermore, there were large differences in the magnitude of the internal connections arising from or terminating in the various nuclei. The heaviest intrinsic projections arose from the lateral and basal nuclei while the central, medial, cortical, and accessory basal nuclei received the greatest number of these afferents. Thus, there was a clear trend for the bulk of these connections to run dorsally and medially within the amygdala. One important function of these intrinsic connections may be the integration of afferent sensory information from the various association areas which project to the amygdala. PMID- 3972040 TI - Nucleus accumbens and preoptic area stimulation: tuberoinfundibular single unit responses, modulation of electrical activity and gonadotrophin secretion. AB - Single unit activity was recorded from tuberoinfundibular neurones in urethane anaesthetized pro-oestrous rats. Responses following single shock (0.2 Hz) stimulation of the preoptic area/anterior hypothalamus (PO/AH) or nucleus accumbens (ACB) were recorded and computed for 137 single units. More cells were shown, by antidromic activation, to project to ACB (4 of 77) than to PO/AH (1 of 60). Fewer units were responsive to stimulation of ACB (p less than 0.02), those that were responsive showing a longer latency to the onset of response compared to that following PO/AH stimulation. Significantly (p less than 0.02) more slowly firing cells were found in the group of animals tested with stimulation of PO/AH. Delivery of high frequency stimulation to PO/AH resulted in a 21/2 fold increase in plasma luteinizing hormone (LH) levels (p less than 0.05), whereas ACB stimulated and control animals showed no increases in plasma LH concentrations. During delivery of the high frequency stimulation only one cell in the ACB group of animals was orthodromically affected (out of five tested). However, in the PO/AH group, five of the seven cells tested showed either excitation or inhibition during stimulation. The possibility that the functional connections demonstrated between ACB and the endocrine hypothalamus are involved in the expression of 'higher' brain functions, recognised during changing endocrine states, is discussed. PMID- 3972041 TI - Electrophysiological evidence for tectal efferents to the neurons projecting to the retina in a teleost fish. AB - Neurons projecting to the retina were identified electrophysiologically by antidromic responses in the preoptic retinopetal nucleus (PRN), which is the major origin of the centrifugal fibers to the retina in the filefish. Electrical stimulation of the optic tectum demonstrated that such neurons received excitatory inputs directly from the optic tectum. PMID- 3972042 TI - Burst activity of identified tecto-reticulo-spinal neurons in the alert cat. AB - Activity of tecto-reticulo-spinal neurons (TRSN), identified electrophysiologically and/or by intra-axonal HRP injections, was studied in alert cats during presentation of moving visual stimuli. A majority of TRSNs showed complex visuomotor properties: directionally selective visual responses in the absence of motor counterparts of orienting, enhanced bursting when stimuli triggered saccades, and no activation for spontaneous saccades. Highest intraburst frequencies were observed during active orienting towards novel, "interesting" objects. The more vigorous bursts usually contained repetitive grouped discharges attaining instantaneous frequencies up to 700 imp/s but average firing rates remained in the range of 120-300 imp/s. Intra-axonal HRP injections confirmed terminations of TRSN collaterals in the premotor areas of the lower brain stem, including the abducens nucleus, but also disclosed differences in the details of collateralization between neurons showing different types of visuo-motor activity. PMID- 3972043 TI - Neuronal chromatin changes in layer V pyramidal cells of somatomotor cortex after pyramidal tract lesions as demonstrated by [3H]actinomycin D binding. AB - Changes in chromatin structure of pyramidal tract neurons after medullary pyramidal tract lesions were examined autoradiographically utilizing [3H]actinomycin D (Act D) binding to nuclei in frozen sections of brain. After a right pyramidal tract lesion, the binding of Act D to nuclei of axotomized pyramidal neurons of somatomotor cortex layer V increased sharply at 1 and 5 days postoperation, compared with pyramidal cells of the left side or hippocampal control cells of the left hemisphere. At 3, 7, 9, and 11 days the axotomized cells showed significantly decreased binding compared with controls. The unoperated pyramidal cells showed a significantly decreased Act D binding at 2 h and 9 days postoperation compared with the ipsilateral hippocampal control cells. The data suggested that intrinsic neurons of the central nervous system had a response pattern of chromatin changes to axotomy that was basically similar to that of peripheral neurons (sensory ganglion cells). However, the response was compressed into the 1st week postoperation with only a brief reaction which might be correlated to axonal regeneration. This reaction was followed by a prolonged depression of Act D nuclear binding which may be associated with cellular atrophy. PMID- 3972044 TI - Age-related changes in the subiculum of Macaca mulatta: synaptic density. AB - Dendritic spines and synapses were quantitated in the subiculum of 12 Macaca mulatta from 7 to 29 years of age. Dendritic spines were analyzed in six dendritic foci of pyramidal neurons impregnated by the Golgi-Cox method. The dendritic foci examined were the apical shaft, apical oblique, apical tuft, apical terminal, basal terminal, and basal dendrites. Electron microscopic observations were made on synapses stained with ethanolic phosphotungstic acid. There was no difference in spine density between a group of young (7 to 12 years of age) and middle-aged (18 to 21 years) animals. The mean spine density was 1.09/microns for the young and 1.15/microns for the middle-aged animals. In contrast, the spine density of the old animals was 0.87/microns, which was significantly lower than the spine density found in the young and middle-aged animals. A loss of dendritic spines in the old animals occurred equally in all six dendritic foci. A decline in synaptic density in the aged animals were further evidenced by an ultrastructural analysis. The synaptic density of the old animals was 8.3 X 10(8)/mm3, significantly lower than 9.5 X 10(8)/mm3 and 10.2 X 10(8)/mm3 found in the young and middle-aged animals, respectively. This study on synaptic density demonstrated the decline in synaptic number as a function of age in M. mulatta. PMID- 3972045 TI - Age-related changes in the subiculum of Macaca mulatta: dendritic branching pattern. AB - The dendritic branching pattern was studied in the subiculum of nine Macaca mulatta from 7 to 28 years of age. Morphometric analysis of pyramidal neurons revealed significant age-related differences at various designated branch orders in both the centrifugal and centripetal ordering methods. There was continued branching and growth of the apical dendrites in adulthood. Basal dendrites did not show any added complexity, but rather showed continued growth of existing terminal branches. The three oldest animals showed a preferential loss of whole terminal branches on the apical portion of the dendritic tree, whereas shortening of existing terminal branches was the characteristic feature of the basal dendrites. Data obtained from the subiculum provide quantitative evidence indicating the considerable potential for dendritic plasticity beyond the early developmental stages and eventual loss of dendritic complexity in the old M. mulatta. PMID- 3972047 TI - Influence of the rate of temperature change on thermal thresholds in man. AB - Thermal thresholds (cool, warm, heat, heat pain) were determined in four skin regions (cheek, glabrous skin of the hand, hairy forearm, leg) of eight healthy human subjects. The thermostimulator was composed of Peltier elements and three rates of continuous stimulation were used: 1.4, 2.4, and 3.9 degrees C/s. Warm, heat, and heat pain thresholds increased with increasing rate of temperature change, and the increase was of equal magnitude with these three thresholds. However, the effect of increasing stimulus rate on cool thresholds was nonsignificant. Similar results were obtained in all skin regions studied. It is suggested that liminal warm, heat, and heat pain sensations are mediated by afferent fibers with conduction velocities of the same range (C-fibers) whereas liminal cool sensations are signaled by faster conducting afferent fibers. PMID- 3972046 TI - Effects of brain epinephrine depletion on thermoregulation, reflex bradycardia, and motor activity in rats. AB - Two hours after i.p. administration of 2-cyclooctyl-2-hydroxyethylamine (CONH), 1 aminomethylcycloundecanol (CUNH), 2,3-dichloro-alpha-methylbenzylamine (DCMB), or 7,8-dichloro-1,2,3,4-tetrahydroisoquinoline (SKF64139), the hypothalamic and brain stem epinephrine (EPI) contents of rat brain were decreased. Depletions of brain EPI with these phenylethanolamine N-methyltransferase (PNMT) inhibitors reduced the rectal temperatures of rats at ambient temperatures of 8 and 22 degrees C. The hypothermia in response to these PNMT inhibitors was due to decreased metabolism and cutaneous vasodilatation. The locomotor stimulant responses induced by thyrotropin-releasing hormone were also reduced by administration of any one of these PNMT inhibitors. On the other hand, acute administration of any of these PNMT inhibitors enhanced the reflex bradycardia induced by i.v. infusion of EPI. The data suggest that brain (particularly the hypothalamus and brain stem) EPI-containing neurons are involved in the regulation of body temperature, reflex bradycardia, and motor performance in the rat. PMID- 3972048 TI - Growth of optic tract axons in nerve grafts in hamsters. AB - Segments of peripheral nerve, transplanted to the brain or spinal cord, recently have been shown to support regeneration of axons from a variety of central neurons. However, long-tract axons, injured at considerable distances from their cell bodies, have proven refractory to such regenerative support. This report presents evidence for successful, although similarly limited, growth of retinal ganglion cell axons into peripheral nerve grafts placed in the optic tract of adult hamsters. The demonstration of such growth allows the possibility that the primary visual pathways may serve as an advantageous model system in which to study the mechanism of graft-effected regeneration of long-tract axons in the adult mammalian central nervous system. PMID- 3972049 TI - Effect of different degrees of brain ischemia and tissue lactic acidosis on the short-term recovery of neurophysiologic and metabolic variables. AB - The recovery of the EEG and somatosensory evoked responses (SER) as compared with recovery of the cerebral energy state was studied in rats during recirculation following different degrees of brain ischemia with varying tissue lactic acidosis. Reversible complete and incomplete ischemia was induced either by increasing the intracranial pressure (compression ischemia) or by carotid artery clamping combined with arterial hypotension. In incomplete ischemia the degree of tissue lactic acidosis was varied by manipulations of blood and brain glucose levels. Animals with an increase in brain lactate to about 25 mumol X g-1 (whole brain wet weight) during ischemia showed persistent failure of both cerebral energy metabolism and neurophysiologic restitution during the recirculation phase; if less than 20 mumol X g-1 metabolic recovery was almost complete. Despite a similar restitution of tissue energy metabolism in these animals, neurophysiologic recovery was inversely proportional to brain lactate concentrations during ischemia. At similar levels of ischemic tissue lactic acidosis, and despite a similar recovery of cortical energy state, the neurophysiologic restitution was clearly inferior after complete ischemia to that following incomplete ischemia. Three conclusions were drawn: (i) neurophysiologic variables were more sensitive indicators of postischemic persistent cerebral dysfunction than the cerebral energy state; (ii) the degree to which lactate accumulated in the ischemic brain influenced neurophysiologic restitution even if concentrations critical for metabolic recovery were not attained; and (iii) incomplete ischemia was less harmful than complete ischemia provided that tissue lactic acidosis was not excessive. PMID- 3972050 TI - Potassium and caffeine contractures in limb muscles of normal and dystrophic (C57 BL/6J dy2J/dy2J) mice. AB - The strength of contractures, produced by 15 to 146 mM [K]0 (as L-glutamate), was measured in isolated small bundles of muscle fibers from the fast-twitch extensor digitorum longus and from the slow-twitch soleus of normal and dystrophic (C57 BL/6J dy2J/dy2J) mice. The analysis of the relation between the maximal amplitude of the contracture vs the membrane potential and the time constant of relaxation of the K-contractures has shown that dystrophy induced an attenuation of the differences between fast- and slow-twitch muscles. The repriming of K contractures was more affected by changes in [Ca]0 in normal soleus than in normal extensor digitorum longus and this difference was unaffected by dystrophy. For both types of muscles, the ability of caffeine to produce contractures was reduced in dystrophic muscle and this modification was not related to a change in the fiber typing. PMID- 3972051 TI - Fiber analysis of the pyramidal tract of the laboratory rat. AB - Light and electron microscopic study of the pyramidal tract of the laboratory rat at a midbulbar level revealed the total number of myelinated fibers on one side to be about 200,000. They ranged from 0.2 micron to more than 5 microns, but clustered strongly in the neighborhood of 1.0 micron (mode of 0.9 micron and mean of 1.2 micron), forming the highly skewed fiber spectrum so familiar for mammalian pyramidal tracts and other central fiber pathways. Numerous small clusters of unmyelinated axons were found scattered throughout the tract, adding another 100,000 axons to the estimated number. Not only were the fibers exceedingly small, but also the degree of myelination relative to axon diameter varied widely, suggesting that conduction speed within the tract is not optimal for all fibers. In fact, about half of the fibers in the pyramidal tract would, in theory, conduct faster if they had no myelin wrapping. PMID- 3972052 TI - Pathophysiology of ammonia intoxication. AB - Ammonia intoxication affects postsynaptic inhibition and disturbs inhibitory neuronal interactions. This study investigated whether or not the effect of ammonia on postsynaptic inhibition was associated with a change of the EEG, i.e., a change in the function of the central nervous system such as in an encephalopathy. We showed that the effect of ammonia on postsynaptic inhibition was associated with a marked change of the EEG, and that this change was not due to an effect of ammonia on the brain stem reticular activating system. In addition, it was shown that in the central nervous system a NH+4 concentration of about 1 mumol/g affected postsynaptic inhibition. Because ammonia simultaneously affected postsynaptic inhibition and the EEG at a NH+4 tissue concentration comparable to that observed in encephalopathy, it is proposed that a dysfunction of postsynaptic inhibition caused the encephalopathy due to ammonia intoxication by simultaneously disturbing inhibitory neuronal interactions in many regions of the central nervous system. PMID- 3972053 TI - Comparative effects of topical perfusions of pentylenetetrazol in the mesencephalon and cerebral cortex of cats. AB - Push-pull perfusions of pentylenetetrazol (PTZ) were carried out in the mesencephalon and cerebral cortex (orbitofrontal, motor, and suprasylvian) of "encephale isole" cats, while EEG recordings from motor cortices and EMG of facial muscles were obtained. There were significant differences between perfusions in the mesencephalic reticular formation (MRF) and in the cerebral cortex: (i) EEG spikes not accompanied by muscular contractions occurred during perfusion of cerebral cortex (motor cortex included), but never with perfusions in MRF. (ii) In some instances muscular tonic and clonic contractions occurred in the absence of EEG spikes when perfusing the mesencephalon, but never with cortical perfusions. (iii) Both MRF and cortical perfusions induced EEG spikes accompanied by myoclonic seizures; however, muscular seizures were practically of the same amplitude in both sides after perfusion of the MRF and were predominant in the contralateral side after cortical perfusions. In addition, significantly less perfusion time (total dose) of PTZ was needed to induce such events in the MRF than in the cerebral cortex. (iv) Generalized seizures induced by cortical perfusions showed a clear predominance of contractions in the muscles contralateral to the perfusion site, whereas perfusions in the MRF induced generalized seizures indistinguishable from those produced by i.v. administration of PTZ. Results suggest that PTZ generalized seizures, closely resembling the so called "primary generalized seizures," result from activation of the MRF, whereas PTZ acting in the cerebral cortex produces a model of focal convulsions that may become secondarily generalized. PMID- 3972054 TI - 2,4-Dichlorophenoxyacetic acid (2,4-D) reduces acetylcholinesterase activity in rat muscle. AB - A single dose (200 mg/kg body weight, i.p.) of 2,4-dichlorophenoxyacetic acid (2,4-D), commonly used as a herbicide, caused significant decreases in acetylcholinesterase (AChE) activity in diaphragm and other muscles of the rat. The 4S, 10S, and 16S forms of AChE were affected. The effect was maximal 15 to 24 h after injection. Choline acetyltransferase (CAT) activity was not affected. Neither AChE nor CAT activities changed in sciatic nerve from 2,4-D-treated animals. Spontaneous locomotor activity decreased dramatically 4 h after 2,4-D treatment. Myotonia that was present 1.5 h after 2,4-D injection became maximal at 2 to 6 h. Twenty-four hours after drug injection, when animals were recovering from myotonia, spontaneous locomotor activity was still depressed to 50% of control values. Prolonged distal motor latencies were observed 15 to 24 h after drug administration. AChE activity and spontaneous locomotor activity returned to control values at 48 h. Thus, 2,4-D causes a decrement of end-plate AChE, as well as behavioral and electrophysiologic changes. Decreased activity of AChE may be an early step in development of the myopathy that occurs after large dose 2,4-D. PMID- 3972055 TI - Spinal neurons with branched axons traveling in both the dorsal and dorsolateral funiculi. AB - Antidromic search stimuli were delivered to cervical (C2-C3) dorsal and dorsolateral funiculi that were dissected apart from one another and from the rest of the spinal cord. Fifty-six neurons were antidromically identified in the dorsal horn of the lumbosacral enlargement. Of these neurons, 23 were activated antidromically from both the dorsal columns and the ipsilateral dorsolateral funiculus. The neurons were found at depths corresponding to laminae III and IV. About half of the neurons responded only to innocuous, tactile stimuli whereas the other half responded to both innocuous and noxious stimuli. The existence of neurons with branched axons ascending both the dorsal and dorsolateral funiculi raises the possibility that the dorsal column postsynaptic and spinocervical tracts may not be completely independent projections. PMID- 3972056 TI - Leishmania major: excreted factor, calcium ions, and the survival of amastigotes. AB - Mouse macrophages infected with amastigotes of Leishmania major contain about 40% more intracellular exchangeable calcium than control macrophages. Similar elevation of intracellular exchangeable calcium was observed in macrophages engulfing red blood cells coated with purified excreted factor from L. major. The rate of cytolysis of red blood cells coated with excreted factor was significantly lower than that of uncoated controls. Excreted factor strongly binds calcium; thus, the possible role of a microenvironment rich in calcium bound to excreted factor within the phagolysosome in protecting the amastigotes may be considered. PMID- 3972057 TI - Dermacentor variabilis: resistance to ticks acquired by mast cell-deficient and other strains of mice. AB - The acquisition of resistance to ticks was monitored in mice of six different strains. Mice were subjected to repeated infestations with Dermacentor variabilis larvae, different skin sites being used for each successive infestation. In the third and fourth infestations, resistance was expressed in three strains of mice (WBB6F1-W/Wv, WBB6F1-+/+, and CFW), as demonstrated by significant reductions in percentages of larvae engorging and in mean weights of fed larvae. Both WBB6F1 W/Wv mice, which are mast cell-sufficient strain attained significantly higher levels of resistance. It is suggested that mast cells may play a relatively minor role in the mechanisms of resistance in this strain of mice. C57B1 mice also expressed tick resistance in their third and fourth infestations as measured by reduced percentages of engorged larvae, but not by reduced mean larval weights. Possibly, the mechanisms of tick resistance in this strain differ from those in other strains. Two other mouse strains (C3H-HeJ and C3H-HeSn) remained relatively susceptible to tick feeding throughout five infestations. In secondary infestations of all strains tested, no resistance was evident. Instead, enhanced feeding of larvae appeared to occur. A new objective measurement of tick resistance is the mean weights of detached, unengorged larvae taken from resistant animals at the end of the infestation period. These were found to be consistently less than those from susceptible animals. PMID- 3972058 TI - Nippostrongylus brasiliensis: malabsorption in experimentally infected rats. AB - Glucose absorption and net small intestinal water movement were examined in rats infected with Nippostrongylus brasiliensis at Days 4, 6, 9, 13, and 19 after inoculation. Rats were infected with 4 X 10(3) N. brasiliensis third stage larvae. The entire small intestine was divided into three segments and each segment perfused simultaneously in vivo with Krebs-Ringer phosphate buffer containing 80 mM glucose, 6 X 10(5) dpm/ml [3H]glucose, and 6.2 X 10(3) dpm/ml [14C]polyethylene glycol. Rats perfused on Days 6, 9, 13, and 19 after inoculation showed a significant (P less than 0.05) decrease in glucose absorption rates from all three segments of the small intestine when compared to uninfected controls. In the three segments of uninfected rat small intestine and those perfused on Days 4, 13, and 19 after inoculation, net absorption of water occurred. However, in the proximal and distal segments perfused on Day 6 and the proximal segment perfused on Day 9, net water movement into the lumen occurred. This is the first report of depressed glucose absorption along the entire length of the small intestine during nippostrongylosis and contradicts previous reports of unaltered net glucose absorption in response to this parasite. PMID- 3972059 TI - Plasmodium gallinaceum: sporozoite activity in immune mosquito hemolymph. AB - Sporozoites of Plasmodium gallinaceum are relatively inactive in Hanks' balanced salt solution or in the hemolymph of the susceptible Aedes aegypti mosquito. They become agitated and very active in the presence of the hemolymph of the innately immune mosquito, Culex pipiens. Sporozoites from the latter are more infective in chicks than the former. This behavior is likely the result of stimulation or irritation by the adverse environment. PMID- 3972060 TI - Amblyomma americanum: requirement for host Fc receptors in antibody-mediated acquired immune resistance to ticks. AB - Guinea pig recipients of anti-tick immune serum or immune peritoneal exudate cells expressed 25 and 30% tick rejection, respectively, when challenged with Amblyomma americanum larval ticks. Previous studies have shown that IgG1 antibodies are responsible for the ability of immune serum to transfer resistance to ticks and to mediate the accompanying, and required, cutaneous basophil response. Since IgG1 antibodies induce mast cell-mediated passive cutaneous anaphylaxis and cutaneous basophil responses by interaction with cell surface Fc receptors, we investigated whether host Fc receptors were involved in the mechanism of antibody-mediated immune resistance to ticks. Recipients of immune serum pretreated intravenously with rabbit IgG failed to express resistance when challenged. In contrast, recipients of immune peritoneal exudate cells similarly pretreated expressed normal resistance. Sheep IgG had no inhibitory effect on the transfer of resistance by either immune serum or peritoneal exudate cells. Furthermore, recipients of immune serum pretreated with the Fc fragment from papain digestion of rabbit IgG failed to express resistance when challenged with ticks. Rabbit Fab and sheep Fc and Fab had no effect on the transfer of resistance by immune serum. Purity of rabbit Fc preparations was verified by the ability to inhibit mast cell-mediated passive cutaneous anaphylaxis due to high titered IgG1 antiovalbumin antibodies. Rabbit Fab and sheep Fc fractions did not inhibit passive cutaneous anaphylaxis reactions. These findings suggest that immunoglobulin Fc receptors on host cells, such as mast cells and basophils, are required for antibody-mediated immune rejection of ticks from guinea pigs. PMID- 3972061 TI - New trends in spleen research. PMID- 3972062 TI - On the evolution of the spleen. PMID- 3972063 TI - The fish spleen: structure and function. PMID- 3972064 TI - Structural characteristics of the mammalian spleen indicating storage and release of red blood cells. Aspects of evolutionary and environmental demands. PMID- 3972065 TI - Splenic architecture reflected in the connective tissue structure of the human spleen. AB - An analysis of the connective-tissue structure of the human spleen can give us information about the basic architecture of the organ. The most important part of the spleen is the lienic center around which the subcapsular zone forms an envelope, like a mantle. This zone has but little depth and develops superficially. The tangential radial beam net ('Tangentialbalkennetz') is formed partly by the radial trabeculae of the capsule and partly by the outer branches of the arbor trabecularis. This arbor divides into 5-6 branching orders. The branches of orders 1 to 3 surround the parenchyma of the spleen center's inner layer. The lienic lobuli which are found between the branches are relatively large and are connected very extensively with their parenchyma. The branches of orders 4, 5, and 6 enclose the lienic lobuli of the outer layer of the spleen center. The splenic lobuli are defined by the vascular course. Mostly they are provided with one or two arterial influxes and, as a rule, with only one venous drain. Their mutual delimitation is more of a functional than of a morphological nature. This led von Herrath to coin the term 'functional spleen lobuli'. The lienic envelope lies between the inside of the capsule and the outermost branchings of the arbor trabecularis. This arbor is subdivided, by the radial trabeculae, which never have any vessels, into elongated lobuli and serves first and foremost to regulate pressure. The lattice fibers are of high tensile strength and are extensions of the collagenous fibers seen at the microscopic level. PMID- 3972066 TI - In vivo and electron microscopic studies of the splenic microvasculature in mice. PMID- 3972068 TI - Terminating arterial vessels in red pulp of human spleen: a transmission electron microscopic study. PMID- 3972067 TI - The regulation of hemopoiesis in the spleen. PMID- 3972069 TI - New trends in spleen research: conclusion. PMID- 3972070 TI - Novel rearrangement of purines. AB - 6-Trichloromethyl-9-methylpurine (1) rearranges to 6-dichloromethyl-9-methyl-8 oxopurine (2) in aqueous mild acidic solution. The rearrangement is rationalized in terms of a reaction involving protonation, covalent hydration, prototropic equilibrium and/or a hydride transfer. An alternative mechanism involving a "positive' halogen compound and hypochlorous acid as an intermediary is also proposed. Compound 1 condenses with 4,5-diaminopyrimidine to give the purine pyrimidine Schiff base pair 4. PMID- 3972071 TI - Calcium uptake by sarcoplasmic reticulum from nerve-intact and standard skeletal muscle grafts. AB - A freely grafted rat soleus muscle exhibits a decrease in velocity and capacity of SR calcium uptake. This deficit is not prevented by maintaining neural connections (nerve-intact graft) during grafting. Thus the greater mechanical capability of nerve-intact grafts, relative to standard grafts, is not accompanied by any enhancement of the SR tubules. PMID- 3972072 TI - Effects of methylene blue on electrical behavior of myenteric neurons. AB - Intracellular recording methods were used to investigate the action of methylene blue on electrical behavior of myenteric neurons in guinea pig small intestine. The neurophysiological studies were done in parallel with studies on contractile activity of the intestinal musculature. Methylene blue depolarized the membranes, increased the input resistance, augmented excitability and reduced postspike hyperpolarizing potentials in AH/Type 2 myenteric neurons. These effects, with the exception of suppression of postspike hyperpolarization, were reversed by exposure to elevated calcium. The mechanism of action of methylene blue appeared to be suppression of calcium-dependent potassium conductance in the neuronal membranes. The neuronal action of methylene blue was manifest as a release of excitatory neurontransmitter substances which evoked contraction of the small intestinal longitudinal muscle. PMID- 3972073 TI - Smooth muscle in the hepatic artery, portal vein and hepatic vein within the liver of the raccoon and guinea pig. AB - The amount and arrangement of smooth muscle in the intrahepatic vessels suggests that the guinea pig would be a good animal model for studying mechanisms controlling intrahepatic portal vein blood flow, while the raccoon would be good for studying hepatic vein mechanisms of control. PMID- 3972075 TI - Evidence for reopening of the cranial neural tube in mouse embryos treated with cadmium chloride. AB - Use of the whole-embryo culture technique resulted in experimental evidence that the pathogenesis of exencephaly in mouse embryos after cadmium chloride treatment results from reopening of the cranial neural tube. PMID- 3972074 TI - Ocular instillation of naloxone increases intraocular pressure in morphine addicted patients: a possible test for detecting misuse of morphine. AB - The effect of conjunctival instillation of naloxone on intraocular pressure has been examined in morphine-addicted patients as compared to non-addicted healthy volunteers. Morphine-addicted subjects showed a lower basal value of intraocular pressure as compared to the control volunteers. The instillation of naloxone caused a normalization of intraocular pressure to a level similar to that of control volunteers. This test seems to be a useful screening method for detecting morphine addiction. PMID- 3972076 TI - The effect of castration, testosterone and estradiol on 14C-serotonin metabolism by organ cultures of male rat pineal glands. AB - The pineal gland of the male rat does not appear to rely on prior conversion of testosterone to estradiol for the stimulant effect of testosterone on pineal melatonin and 5-methoxytryptophol synthesis. PMID- 3972077 TI - Internal interactions within the human circadian system: the masking effect. AB - In the realm of human circadian rhythms, the masking effect is defined as the change in the course of deep body temperature induced by changes in the degree of physical activity, or by the alteration between sleep and wake. This effect is particularly obvious during internal desynchronization where the rhythms of deep body temperature, and the sleep-wake sleep cycle - i.e. one of the masking factors - run with different periods. Every sleep onset is accompanied by a rapid drop, and wake onset by a rapid rise in deep body temperature, each one with an overshoot of about 50% of the steady state variations. When rhythms are calculated, with the dominant temperature period as the screening period, exclusively from data obtained during sleep episodes, on the one hand, and from those obtained exclusively during wake, on the other, two average cycles emerge: the 'sleep temperature curve' and the 'wake temperature curve'. Both run in parallel but are separated by the 'masking effect'. As derived from many experiments, the mean masking effect amounts to 0.28 +/- 0.06 degree C. The masking effect also depends to some extent on the phase of the temperature rhythm; it is larger than average around the temperature maximum and during the descending phase of the temperature cycle, where the alertness commonly is highest and the probability to sleep, in general, and the REM sleep propensity, in particular, are smaller than average. This also can be interpreted to indicate that the sleep temperature curve is phase advanced relative to the wake temperature curve; this, on the average, by 0.9 +/- 0.3 h. If the individually determined amount of masking is added to the temperature data obtained during sleep, or subtracted from the temperature data obtained during wake, a temperature curve emerges that can be thought of as being 'purified' of the masking effect. Analyses of this artificial curve allow estimation of that part of the internal interactions uninfluenced by the masking effect. On the average, about half of the amount of interaction between the rhythm of sleep-wake and that of deep body temperature is explained by the masking effect, whereas the other half is 'oscillatory interaction'. Both types of interaction are inherent and inseparable parts of the circadian clock mechanism, as can be deduced from model considerations. PMID- 3972078 TI - The effect of surgery and anesthetic agents on granulocyte-chemiluminescence in whole blood. AB - The effect of anesthesia and major abdominal surgery on zymosan-induced chemiluminescence (CL) of neutrophil granulocytes was evaluated. CL was measured in diluted whole blood taken at distinct intervals within the perioperative period. In addition, blood samples from healthy volunteers were supplemented with ether and halothane to investigate the in vitro effect of these agents. The phagocytosis-induced CL was not found to be depressed by anesthesia and surgery. Only at supranarcotic concentrations was CL reduced. Surgery and anesthesia, therefore, do not appear to impair this defense system significantly under the conditions of this investigation. PMID- 3972079 TI - Sodium deoxycholate promotes the absorption of heparin administered orally, probably by acting on gastrointestinal mucosa, in rats. AB - Sodium deoxycholate (DOC), selected as a promoter of gastrointestinal absorption of heparin, was administered orally to rats, followed, at increasing intervals, by heparin. Maximal plasma clearing activity (PC) was obtained with a 60-min interval, though PC was still elicited after 24 h, suggesting that DOC acts on the gastrointestinal mucosa. Inhibition of blood coagulation was also observed after oral heparin. The suggestion that DOC increases heparin absorption is supported by increased plasma levels of heparin. No signs of several gastrointestinal damage were seen. PMID- 3972080 TI - Effect of fasting on skeletal muscle triglyceride content. AB - The effect of prolonged food deprivation on the triglyceride level in different types of skeletal muscle was studied in the rat. It has been found that fasting gradually reduces the triglyceride content in each muscle type. It is concluded that i.m. triglycerides play an important role as energy fuel during fasting. PMID- 3972081 TI - Demonstration of retinoic acid isomers in human urine under physiological conditions. AB - Untransformed retinoic acid has never been demonstrated in human excreta under normal physiological conditions. We have developed a two-step liquid chromatographic system for the demonstration of subnanogram amounts of this compound in human urine without administration of any precursor. PMID- 3972082 TI - In vitro amiodarone protein binding and its interaction with warfarin. AB - The binding of amiodarone to human plasma protein and to bovine serum albumin was studied by three different methods, ultracentrifugation, equilibrium dialysis and fluorescence spectroscopy. The fraction of amiodarone bound to plasma protein amounted to 96.3%. The changes in the binding properties of 1-anilino-naphthalene 8-sulfonate for bovine serum albumin using warfarin and amiodarone as independent inhibitors were analyzed in terms of binding site specificity. The findings indicated that amiodarone and warfarin have two different binding sites on bovine serum albumin, so a noncompetitive inhibition mechanism was indicated. On the basis of our data we cannot exclude other mechanisms of interaction besides direct displacement of one drug by another; nevertheless, metabolite interference between amiodarone and coagulation cofactors may better explain the enhancement of warfarin's pharmacological action in association with amiodarone. PMID- 3972083 TI - Effects of neuromuscular blockers on carnosine levels in rat skeletal muscle. AB - A 30-min treatment with neuromuscular blocking doses of either physostigmine or d tubocurarine was associated with a 44% or 36% (respectively) reduction in rat skeletal muscle carnosine levels in vivo. PMID- 3972084 TI - Influence of phenobarbital and TCDD on the hepatic metabolism of TCDD in the dog. AB - The influence of phenobarbital and TCDD pretreatment on the formation and biliary excretion of TCDD-metabolites following single doses of 3H-TCDD was investigated. Without pretreatment, 24.5% of the absorbed 3H-TCDD dose was excreted in the bile within 110 h. Phenobarbital did not influence this rate, whereas a single dose of 10 micrograms of unlabeled TCDD/kg b.wt nine days earlier resulted in a doubling of the amount of radioactive material eliminated in the bile (47.4%). PMID- 3972085 TI - Growth inhibitory, insecticidal and antifeedant effects of some antileukemic and cytotoxic quassinoids on two species of agricultural pests. AB - Several quassinoids, obtained by isolation and derivatization from Simaba multiflora and Soulamea soulameoides, were evaluated for growth inhibitory and insecticidal effects against the tobacco budworm (Heliothis virescens) and for antifeedant effects against H. virescens and the fall armyworm (Spodoptera frugiperda). The relative activity of the quassinoids as insect growth inhibitors generally paralleled their known relative potency as antileukemic and cytotoxic agents. PMID- 3972086 TI - IgG purification to measure the level of an iodinated thyroglobulin peptide, the 3,5,3',5' tetraiodo-l-tyrosyl-l-tyrosine in human serum. AB - Antibodies reacting with 3,5,3',5' tetraiodo-l-tyrosyl-l-tyrosine (I2Tyr-I2Tyr) were elicited in rabbits by immunization with an oxidized yeast conjugate coupled with I2Tyr-I2Tyr. Ion-exchange chromatography was used to purify immunoglobulins, in order to improve the specificity in measurement of I2Tyr-I2Tyr level in patient serum. IgG binding capacity versus I2Tyr-I2Tyr was considerably increased after immunoglobulin purification. PMID- 3972087 TI - Imprinting of the Peking duck (Anas platyrhynchos) and dependence on exposure to light during ontogenesis. AB - Embryos of Peking ducks were either incubated in complete darkness up t o hatching or were put into light one week before hatching. Control embryos were incubated under dim light conditions which corresponded broadly to the natural conditions. Under standardized imprinting conditions the controls and both groups of the light deprived ducklings showed the 'following response'. Most of the dark incubated embryos, however, did not distinguish between imprinting and test objects of different shapes. Since most of the embryos kept in darkness only for 21 days also failed to develop the capacity for shape discrimination, there is apparently a critical period for light influences on the development of this capacity at some time during the early prenatal period. PMID- 3972088 TI - Different biological behavior of AKR lymphoma cells from primary and metastatic tumors. AB - AKR lymphoma cells derived from primary s.c. tumors (PT) and cells from their metastases (MT) were inoculated into recipient mice in order to compare their malignant behavior. A higher malignant potential of MT compared to PT cells was found. The results support the hypothesis that metastasis is a process of selection of cells possessing a potential to metastasize, which preexist in the primary tumor. In the model used, both the selection of 'variants' of malignancy and the assay of malignancy were as close as possible to natural tumor progression. PMID- 3972089 TI - Selective effects of gonadal steroids on the response of peripheral serotonin receptors. AB - The maximal contraction provoked by serotonin (5-HT) in isolated stomach strips of adult rats, a functional index for peripheral 5-HT receptors, was sexually differentiated, androgen-sensitive, and estrogen refractory. This is at variance with the reported sensitivity of central 5-HT receptors to estrogen. PMID- 3972090 TI - Glia maturation factor influences recovery from injury in neonatal rat brains. AB - Newborn rats were injured with a puncture wound in one cerebral hemisphere. Experimental animals were treated with three i.p. injections of Glia Maturation Factor (GMF) at daily intervals starting from the time of injury, whereas control littermates were treated with equivalent amounts of bovine serum albumin. At 25 days old the size of the cerebral cortex at the plane of injury was measured on representative brain sections. In control rats the injured side was 18% smaller than the normal side whereas in GMF-treated animals the difference was only 1%. The results suggest a possible regulatory role of GMF in promoting tissue recovery from brain damage. PMID- 3972091 TI - Synkinesis in hemifacial spasm: results of recording intracranially from the facial nerve. AB - We show evidence that the motonucleus of the facial nerve is involved in producing the synkinesis in patients with hemifacial spasm. These results were obtained by recording from the intracranial portion of the facial nerve and from the orbicularis oculi muscle in patients operated upon for hemifacial spasm during electrical stimulation of the mandibular branch of the facial nerve. Also, the electromyographic response from the same muscle was recorded when the facial nerve was electrically stimulated at a location near the brainstem. The results show that it is unlikely that the symptoms of patients with hemifacial spasm can be explained on the basis of ephaptic transmission at the site of lesion of the facial nerve. PMID- 3972092 TI - Thiarubrine A, a bioactive constituent of Aspilia (Asteraceae) consumed by wild chimpanzees. AB - Two African species of Aspilia (Asteraceae), which are used medicinally by man and which are eaten by wild chimpanzees in an unusual manner, were found to contain the potent antibiotic thiarubrine A as a major leaf phytochemical. Its presence in leaf material strengthens the view that the feeding behavior of wild chimpanzees is related to special physiological or pharmacological effects on the animals. PMID- 3972093 TI - Platelet insulin receptor determination in non-insulin dependent diabetes mellitus. AB - The platelet membrane insulin receptors of healthy and non-insulin dependent (type 2) diabetic patients were studied. Receptor number and affinity proved to be decreased in type 2 diabetes mellitus. The changes in platelet insulin receptor characteristics are in good correlation with the alterations reported in other tissues or cells. The possible role of these phenomena in the pathogenesis of disturbed platelet function in diabetics needs further investigation. PMID- 3972094 TI - Emblica officinalis reduces serum, aortic and hepatic cholesterol in rabbits. AB - Emblica officinalis reduced serum cholesterol (p less than 0.001), aortic cholesterol (p less than 0.001) and hepatic cholesterol (p less than 0.001) significantly in rabbits. Emblica officinalis did not influence euglobulin clot lysis time, platelet adhesiveness or serum triglyceride levels. PMID- 3972095 TI - [Trituration kinetics and its effect on the granulometric properties and the dissolution rate of a poorly soluble drug: sulfadiazine]. PMID- 3972096 TI - [Projection of new drugs]. PMID- 3972097 TI - [Experimental nephrotoxicity after repeated administration of adriamycin. Histological study with the optical and electron microscope]. PMID- 3972098 TI - Domain structure and evolution in alpha-crystallins and small heat-shock proteins. PMID- 3972099 TI - The role of fibrinogen alpha C-domains in the fibrin assembly process. AB - Turbidity development registration and electron microscopic observation of the assembly process of the fibrin monomer and its derivative lacking in intact alpha C-domains (monomeric X1 fragment) have shown that these domains participate in fibrin polymerization, not as structural components, but as a factor promoting the ordered process of fibrin assembly. PMID- 3972100 TI - Essential structure for full enterotoxigenic activity of heat-stable enterotoxin produced by enterotoxigenic Escherichia coli. AB - Several analogues of heat-stable enterotoxins (STh and STp) produced by enterotoxigenic Escherichia coli were synthesized. Peptides (STh[6-18] and STp[5 17]) consisting of 13 amino acid residues from the Cys residue near the N terminus to the Cys residue near the C-terminus and linked by three disulfide bonds had the same biological and immunological properties as native STh and STp, respectively. The results indicated that the sequence with the 13 amino acid residues and three disulfide linkages is essential for full biological activity of ST. PMID- 3972101 TI - Complete amino acid sequence of a new type of lethal neurotoxin from the venom of the funnel-web spider Atrax robustus. AB - Robustoxin, the lethal neurotoxin isolated from the venom of the male Sydney funnel-web spider, Atrax robustus, is of unique structural type and physiological mode of action. The primary structure of this 42-residue peptide was determined to be H2N-Cys-Ala-Lys-Lys-Arg-Asn-Trp-Cys-Gly-Lys-Asn-Glu-Asp-Cys-Cys-Cys-Pro- Met-Lys-Cys-Ile-Tyr-Ala-Trp-Tyr-Asn-Gln-Gln-Gly-Ser-Cys-Gln-Thr-Thr-Ile- Thr-Gly Leu-Phe-Lys-Lys-Cys-H. The disposition of disulphide-bridged cysteine residues at both the amino- and carboxy-termini and as a triplet at residues 14-16 appears to have no precedent amongst neurotoxins. PMID- 3972102 TI - Partial sequence homology of human myc oncogene protein to beta and gamma crystallins. AB - The human cellular myc gene is one of about 20 cellular oncogenes which code for a variety of proteins including protein kinases and growth factors. The human gene is related to the avian myelocytomatosis leukaemia virus MC29 and produces a binding protein which may be involved in regulation of gene expression and cellular differentiation and proliferation. The crystallins are proteins in the eye lens synthesised at different stages of cell differentiation and proliferation, and whose short range order is necessary for lens transparency. Computer-based sequence comparisons show that beta Bp and gamma II crystallins, which show partial sequence homology and conservation of 'Greek Key' motives are also partially homologous to two regions on the human myc protein, though this protein probably does not conserve the 'Greek Key' structural motives. PMID- 3972103 TI - Very low density lipoprotein triglyceride kinetics during hepatic lipase suppression by estrogen. Studies on the physiological role of hepatic endothelial lipase. AB - The exact role of the heparin-releasable hepatic endothelial lipase has remained controversial. It has been suggested that it acts in concert with lipoprotein lipase in the step-wise delipidation of triglyceride-rich lipoproteins. On the other hand, there is evidence indicating that high density lipoprotein2 is the preferred substrate for hepatic lipase. Here, it is shown that a moderate (27%) suppression of hepatic lipase activity by estrogen did not impair removal of 3H labeled very low density lipoproteins (VLDL) triglycerides, suggesting that this enzyme is not a major regulator of VLDL catabolism under physiological circumstances. PMID- 3972104 TI - Structural homology between mouse liver and horse spleen ferritins. AB - Mouse liver ferritin is composed almost exclusively of polypeptide chains similar in molecular mass (22 kDa) to that characteristic of the major chain (H) found in heart ferritin isolated from human, horse or rat. In these species the predominant polypeptide of liver (L) is smaller (about 20 kDa). Here we show that mouse liver and horse spleen ferritins and apoferritins exhibit extensive structural homology as judged by the similarity in the diffraction patterns of their crystals grown from cadmium sulphate solutions. Implications of this finding are discussed. PMID- 3972105 TI - Amino acid sequence of human liver cathepsin B. AB - The complete amino acid sequence of cathepsin B (EC 3.4.22.1) from human liver was determined. The 252-residue sequence was obtained by automated solid-phase Edman degradation of the light and heavy chain resulting from limited proteolysis of the single-chain enzyme and of fragments produced by cyanogen bromide and enzymatic cleavage of the heavy chain. Human liver cathepsin B has 83.7% identical residues with the corresponding enzyme from rat liver. Comparison of both mammalian cathepsin B sequences with the sequence of papain provides further evidence that lysosomal and plant cysteine proteinases have evolved from a common ancestor and share a similar catalytic mechanism. PMID- 3972106 TI - The aerobic/anaerobic transition of glucose metabolism in Trypanosoma brucei. AB - The ratio of glycerol to pyruvate produced by T. brucei incubated with glucose at various oxygen tensions has been used as an index of the aerobic and anaerobic pathways of glucose metabolism. A minimal model is presented which fits the observed data. The value of the notional K of the aerobic/anaerobic transition from the model is close to that of the Km of trypanosomal glycerophosphate oxidase. The anaerobic pathway appears to be almost completely inoperative at oxygen tensions in the range of those found in venous and arterial blood. PMID- 3972107 TI - A role for Ca2+ in the effect of very low frequency electromagnetic field on the blastogenesis of human lymphocytes. AB - The DNA synthesis of lymphocytes triggered by phytohemagglutinin or phorbol myristate-acetate is strongly reduced by the externally applied electromagnetic field (ELF). Ca2+ uptake by stimulated lymphocytes is also reduced by ELF. The effect appears to be synergistic with that of the well-known calcium blocker agent, verapamil. PMID- 3972108 TI - Isolation and characterization of syncytiotrophoblast plasma membrane from human placenta. AB - Human full-term syncytiotrophoblast plasma membranes isolated by mechanical procedures (sieving and ultrasonic disintegration), purified by phase centrifugation, form a single band of 1.052 +/- 0.002 g/ml density in percoll gradient. The purity of the preparation was assessed by electron microscopy, enzyme analysis and beta 2-microglobulin determination. PMID- 3972109 TI - An ammonium sulphate fraction from rabbit reticulocytes increases the release of proteins from rat liver mitochondria. AB - Incubation of [35S]methionine labeled mitochondria from rat liver with rabbit reticulocyte lysate under the same conditions as those used in the import of mitochondrial protein precursors results in the release of mitochondrial proteins to the medium. Fractionation of the lysates with ammonium sulphate yields a fraction, essentially free of haemoglobin, which exhibits higher activity for the release of mitochondrial proteins than the starting lysate. The fraction has a molecular mass of greater than 10 kDa and is heat-sensitive. The release is insensitive to inhibitors of reticulocyte lipoxygenase. PMID- 3972110 TI - Inhibitors for distinction of three types of human glutathione transferase. AB - A set of inhibitors that are useful for distinction of three types of human cytosolic glutathione transferase is presented. The near-neutral transferase is inhibited most effectively by Cibacron blue (I50 = 0.05 microM), the acidic transferase by Cibacron blue (I50 = 0.5 microM), and the basic transferase by tributyltin acetate (I50 = 0.1 microM). The use of any of these two compounds makes possible differentiation between all three types of human transferase. PMID- 3972111 TI - Protective effect of the flavonoid silybin dihemisuccinate on the toxicity of phenylhydrazine on rat liver. AB - Phenylhydrazine is a hemolytic agent whose mechanism of action is related with the formation of free radicals and the induction of lipid peroxidation. The flavonoid silybin dihemisuccinate is an antihepatotoxic principle used in the treatment of many liver diseases; its mechanism of action has been ascribed to its antioxidant properties. This work demonstrates, using a hemoglobin-free perfusion system, the protective effect of the in vivo treatment of the rat with silybin dihemisuccinate on the hepatic glutathione depletion and lipid peroxidation induced by the infusion of phenylhydrazine into the perfusion buffer. PMID- 3972112 TI - 1H-NMR study of the interaction of aminopyrine with purified rat liver microsomal cytochrome P-450. AB - Longitudinal relaxation (T1) measurements for all lines (N(CH3)2, N(CH3), C(CH3), phenyl) in the aminopyrine 1H-NMR spectrum were used to study the interaction of aminopyrine with purified microsomal cytochrome P-450 from livers of phenobarbital-treated rats. The paramagnetic contribution to the observed T1(-1) values was determined from its dependence on aminopyrine concentration. The Solomon-Bloembergen equation was used to calculate between Fe3+ and aminopyrine distances in the enzyme-substrate complex. For all protons these distances are about 8 A. PMID- 3972113 TI - Solubilisation of cholesterol in human bile. AB - Two non-disruptive separation techniques (gel filtration, and CsCl density gradient ultracentrifugation) were used to characterise the mode of cholesterol transport in human bile. Both methods showed that biliary cholesterol is solubilised as a high--Mr non-micelle (lipoprotein) complex as well as the mixed micelle. The lipoprotein complex was separated between the densities 1.01 and 1.08, had a cholesterol to phospholipid ratio of 0.95 +/- 0.41 and contained protein (7-20% by wt). The mixed micelle on the other hand sedimented at d greater than or equal to 1.18, and had a cholesterol to phospholipid ratio of 0.41 +/- 0.13. Eighteen bile samples, obtained from either T-tube, gallbladder or endoscopy, were analysed, and without exception they all contained a fraction of biliary cholesterol in the non-micelle form. The results indicate that cholesterol is secreted, at least in part, as a lipoprotein complex independently of bile acids (mixed micelles). PMID- 3972114 TI - Localization of a new proteolytic site accessible in oxidized myosin rod. AB - We have compared the proteolysis pattern of reduced and oxidized myosin rods in which the five pairs of SH-groups were interchain crosslinked by employing CuCl2 or 5,5'-dithiobis-2-nitrobenzoate. In the tryptic digest of oxidized rod three new fragments appeared on SDS-polyacrylamide gel electrophoresis (chain masses of 100, 45, and 25 kDa). Based on the N-terminal sequences of the isolated peptides, it is concluded that oxidation creates a new cleavage site 102 residues away from the N-terminus of the rod, in the vicinity of one of the modified SH-groups (Cys 108). This observation indicates that S-S crosslinking of myosin rod leads to a local unfolding of the coiled-coil structure. PMID- 3972116 TI - Effect of dexamethasone on polypeptides synthesised in polymorphonuclear leucocytes. AB - The effect of a glucocorticoid on protein synthesis in human polymorphonuclear leucocytes (PMNLs) was investigated by two-dimensional gel electrophoresis. In the peripheral blood PMNLs of healthy laboratory personnel, the rate of incorporation of L-[35S]methionine into a least nine polypeptides was consistently influenced by dexamethasone in a dose-dependent manner, being increased in the case of seven polypeptides and decreased in the remainder. PMID- 3972115 TI - A triple helix model for the structure of chromatin fiber. AB - A model of chromatin fiber structure is presented in which a repeating unit of a trinucleosome forms a 3-dimensional zigzag. Twisting and compression of the zigzag result in a triple helix structure. The model is built mainly on the flow linear dichroism data showing that nucleosomal disc faces are tilted relative to the fiber axis, the orientation of nucleosomes does not change upon folding and unfolding of chromatin, and the orientation of nucleosomes is maintained by the globular domain of histone H1. PMID- 3972117 TI - The biosynthesis of 3 beta-hydroxy-5,7-androstadien-17-one by the horse fetal gonad. AB - Horse fetal gonadal tissue was incubated with 3 beta-hydroxy-5,7-pregnadien-20 one and 5,7-cholestadien-3 beta-ol and it was shown that both substrates were converted to 3 beta-hydroxy-5,7-androstadien-17-one. These findings support the proposal that in this tissue there is a 5,7-diene pathway producing 3 beta hydroxy-5,7-androstadien-17-one, the putative precursor of equilin in the placenta. PMID- 3972118 TI - Cationic amphiphilic drugs inhibit the synthesis of long-chain fatty acyl coenzyme A in rat brain microsomes. AB - The effect of cationic amphiphilic drugs (CAD) on the synthesis of thiol esters of coenzyme A with long-chain fatty acids was studied in microsomes of rat brain in vitro. The results indicate that propranolol, tetracaine and to a lesser extent, chloroquine, inhibit enzyme activity. Procaine and lidocaine did not inhibit enzyme activity in concentrations up to 0.8 mM. This inhibition seems to be directed primarily to the synthesis of polyunsaturated fatty acyl coenzyme A. The results also suggest that this inhibition may be due to the action of CAD on the microsomal membrane and not to an interaction of these drugs with the fatty acid substrates. PMID- 3972119 TI - Primary structural comparison of the preprohormones cholecystokinin and gastrin. AB - The nucleotide and amino acid sequences of rat preprocholecystokinin and porcine preprogastrin have been aligned and their secondary structures predicted. Both precursors are predicted to be largely in turn and helical configurations. The sequence homology and position of an intron which splits the preprohormones suggest their evolution from a common ancestral protein. PMID- 3972120 TI - ADP-ribosylation of metaphase and interphase nonhistones using [3H]adenosine as a radioactive label. AB - ADP-ribosylation of HeLa nonhistone proteins was investigated by using [3H]adenosine as an in vivo radioactive label. The aim was to determine basic differences in the patterns of modification of interphase and metaphase nonhistones. Fluorography revealed a relatively small number of modified proteins for isolated metaphase chromosomes. In addition to the core histones, a protein of 116 kDa, which is identified as poly-(ADP-ribose) polymerase, was a primary acceptor of [3H]adenosine. Two-dimensional gels revealed a profound difference in the modification of metaphase and interphase nonhistones. For interphase nuclei, 3H label was distributed among a large number of nonhistone acceptors. PMID- 3972121 TI - Pyridoxal phosphate-induced dissociation of the succinate: ubiquinone reductase. AB - Treatment of the soluble ubiquinone-deficient succinate: ubiquinone reductase with pyridoxal phosphate results in the inhibition of the carboxin-sensitive ubiquinone-reductase activity of the enzyme. The inactivation is prevented by the soluble homolog of ubiquinone (Q2) but is insensitive to the dicarboxylates interacting with the substrate binding site of succinate dehydrogenase. The reactivity of the pyridoxal phosphate-inhibited enzyme with different electron acceptors suggests that the observed inhibition is due to the dissociation of succinate dehydrogenase from the enzyme complex. The soluble succinate dehydrogenase was recovered in the supernatant after treatment of the insoluble succinate: ubiquinone reductase with pyridoxal phosphate. The data obtained strongly suggest the participation of amino groups in the interaction between succinate dehydrogenase and the ubiquinone reactivity conferring peptide within the complex. PMID- 3972122 TI - Amino acid sequence of the predominant basic protein in human seminal plasma. AB - The predominant basic protein in liquefied human seminal plasma is the major degradation product of the gel-forming protein secreted by the seminal vesicles. The amino acid sequence of this basic protein is presented. The basic protein contains 52 amino acid residues. It is devoid of cysteine, methionine, tryptophan, and leucine, but contains seven histidine residues located in the NH2 terminal half of the molecule. The calculated Mr of 5753 is in close agreement with that obtained from gel filtration in guanidine-HCl on Sephacryl S-200 (Mr = 6000). PMID- 3972123 TI - A new function of kininogens as thiol-proteinase inhibitors: inhibition of papain and cathepsins B, H and L by bovine, rat and human plasma kininogens. AB - The amidolytic activities of papain and rat liver cathepsins B, H and L were strongly inhibited by high (HMM) and low (LMM) molecular mass kininogens from bovine, human and rat plasmas, and their Ki values were estimated to be in the order of 10(-10) - 10(-11)M for papain and 10(-8) - 10(-9)M for cathepsins. The derivatives of bovine kininogens, HMM kinin-free protein, HMM kinin- and fragment 1 X 2-free protein, and LMM kinin-free protein also showed strong inhibitory activity toward these thiol-proteinases. These results suggest that a reactive site which interacts with thiol-proteinases is contained in the heavy chain portion in kininogens. PMID- 3972124 TI - Vasopressin rapidly stimulates phosphatidic acid-phosphatidylinositol turnover in rat anterior pituitary cells. AB - In cultured rat anterior pituitary cells, the agonist [Asu1,6, Arg8]vasopressin (AVP-A) increased by 1.5-fold 32Pi incorporation into phosphatidic acid (PA), as early as 15 s after its addition. Increased phosphatidylinositol (PI) labeling became significant 4 min after AVP-A addition. Dose-response measurements with AVP-A showed ED50 values of 76 and 62 nM for PA and PI labeling, respectively. Peptide corticotropin-releasing factor (CRF) (0.1 microM) did not affect the stimulatory effect of AVP-A on PA and PI labeling. These data suggest that stimulation of PI metabolism in corticotrophs may be one of the early events involved in the stimulation of ACTH release induced by vasopressin. PMID- 3972125 TI - Targeting of enzyme immobilized on erythrocyte membrane to collagen-coated surface. AB - It is suggested to use 'enzyme(s)-erythrocyte-antibody' complex for modulation of the microenvironment in definite compartments of blood circulation. A model system including peroxidase, human erythrocytes and anti-collagen antibodies was chosen to illustrate the principle. Peroxidase was conjugated to the erythrocyte surface via periodate-oxidized enzyme carbohydrate moiety; biotinylated antibodies were linked by avidin to the biotinylated erythrocytes. The properties of the immunocomplexes obtained have been investigated in an artificial system simulating an injured blood vessel wall. The advantages in using erythrocyte mediated immunoenzyme complexes for enzyme (drug) targeting are discussed. PMID- 3972126 TI - Choice of peptide and peptide length for the generation of antibodies reactive with the intact protein. AB - N-terminal peptides of bovine ribonuclease (RNase) of 20, 13 and 7 amino acid residues were isolated by reversed-phase high-performance liquid chromatography (HPLC). Antibodies were raised in mice against these peptides coupled to bovine serum albumin (BSA). It was shown that antibodies against the peptides reacted with the intact protein and that the immune response decreased with decreasing size of peptide. In order to obtain a satisfactory reaction with the intact protein, the peptide immunogen should be longer than 7 amino acids. PMID- 3972127 TI - Low level transport of IgA to bile via the asialoglycoprotein receptor. AB - The rat and rabbit transport IgA from blood to bile by a highly efficient transcellular pathway mediated by secretory component (SC). Other mammals do not express SC on liver hepatocytes, but they do transport a small amount of IgA to bile. In the first part of this study, human polymeric IgA was radiolabeled and depleted of SC binding activity by successive affinity adsorption. Transport of this preparation intact to rat bile was 4%, but was reduced to 2% when 50 mg unlabeled asialoglycoprotein was preadministered. The 2% decline corresponds to the percent of asialo-orosomucoid diverted to bile from the lysosomal pathway. In guinea-pigs, missorting of asialo-orosomucoid intact to bile was 10% of the injected dose. Transport of normal human IgA to bile was 1-2%, even though guinea pigs do not express SC in the liver. Excess unlabeled asialofetuin reduced the transport of asialo-orosomucoid by 10-fold and IgA by 6-fold. This demonstrates that the asialoglycoprotein receptor can mediate transport of IgA to bile in small amounts, but that this transport may be only a biological artifact resulting from limited fidelity of intracellular protein sorting. PMID- 3972128 TI - Federation of American Societies for Experimental Biology. 69th annual meeting, Anaheim, California, April 21-26, 1985. Abstracts of papers 2721-5496. PMID- 3972129 TI - Federation of American Societies for Experimental Biology. 69th annual meeting, Anaheim, California, April 21-26, 1985. Abstracts of papers 5497-8259. PMID- 3972130 TI - Federation of American Societies for Experimental Biology. 69th annual meeting, Anaheim, California, April 21-26, 1985. Abstracts of papers 8260-8843; 9001-9013. PMID- 3972131 TI - [Role of the lymphatic system in heparin S-35 resorption from the connective tissue of the paw in the dog]. AB - The mechanism of radioactive heparin S-35 transport in the connective tissue of hindlimbs, was studied in dogs. The transport was shown to occur only via lymphatic capillaries if the lympho-blood flow is present in prenodal lymphatic ducts of popliteal lymphatic nodes and v. saphena. The radioactive heparin appears in the blood in 20 min after its registration in lymph. PMID- 3972133 TI - [The locus coeruleus and neuronal activity of the thalamic reticular nucleus]. AB - The influence of LC stimulation on the unit activity (spontaneous and evoked by light flashes) of the thalamic reticular nucleus and the LGB was studied in adult cats. The LC stimulation was shown to result in the inhibition of the reticular units and facilitation of relay neurons of the LGB. PMID- 3972132 TI - [Physiological significance of specific immunoglobulins in regulating steroidogenesis in adrenal cortex cells]. AB - The data obtained suggest the existence of physiological immunoglobulin mechanisms regulating the functions of the cells including hormone--producing ones. Serologically identical antigens were revealed both in the blood and the extracts from adrenocortical cell nuclei of intact rats. Apart from that, autoantibodies to deoxyribonucleoprotein (DNP) of adrenocortical cells were found in the blood sera of normal animals. Immunoglobulins G (ig G) against adrenocortical cell nuclei, DNP and the nuclei partially devoid of DNP, were produced. The specific IgG were shown to stimulate the steroidogenesis in target cells. The penetration of the specific antibodies into the target cell nuclei in vivo was proved. The data obtained support the hypothesis of the nuclear mechanisms of antibody--caused cytostimulation. PMID- 3972134 TI - ["Learning" by subicular neurons and theta rhythm]. AB - In anesthetized cats, activity of subicular neurones was studied during dorsal hippocampal stimulation with single pulses or trains of pulses. Two different populations of neurones were observed in subicular region: one with phasic discharges in response to single and repetitive stimulation, and the other with inhibitory reactions. The second group of neurones changed activity in the course of repetitive stimulation and showed tendency towards driving phenomenon: the neurones started firing preceding each stimulus in the train. The extrapolation only occurred during trains of stimuli in theta range. Significance of hippocampal theta activity in the memory processes is discussed. PMID- 3972135 TI - [Electrophysiological study of the role of the cerebral cortex in the compensatory recovery of functions]. AB - Intracortical rearrangement of functions in the process of the compensatory rehabilitation of functions was studied in semichronical experiments using the technique of recording focal potentials in the parietal associative and somatosensory cortex after unilateral extirpation of their symmetrical regions. The recording zones for the focal associative and somatosensory (projecting) potentials were found to extend following the complete intracortical rearrangement (8-10 months after the unilateral extirpation). An assumption based on changes in the time-amplitude characteristics of the parameters of focal potentials recorded on the surface and at various levels of the somatosensory cortex of the intact hemisphere, was made that the positive wave of the focal surface response is not the result of deep (inner) negative potentials. As to the associative focal responses--no reversion of them could be observed across the whole depth of the cortex. PMID- 3972136 TI - [Patterns in the development of habituation in the cortical area of the visceral analyzer]. AB - In anesthetized cats, a gradual decrement of direct cortical responses was studied in associative and SII cortical areas, in neuronally isolated and in intact cortex. The habituation of direct cortical responses was more rapid in associative area of the intact cortex after deafferentiation of the cerebral hemisphere than in the neuronally isolated cortex. The mechanism of habituation in intact cortex of animals with neuronally isolated cortex is discussed. PMID- 3972137 TI - [Evoked hypothalamic potentials from the pelvic nerve]. AB - Comparative electrophysiological analysis of EPs in the posterior, tuberal and anterior hypothalamus to electrical stimulation of the pelvic nerve was performed in anesthetized and immobilized cats. The focus of maximal activity was revealed in the postero-lateral hypothalamus. "Visceral" responses of the hypothalamus evoked by the pelvic nerve stimulation had a long recovery cycle and were suppressed at a low-frequency stimulation. These findings suggest a poly-synaptic organization of the projection of pelvic afferent systems in the hypothalamus. PMID- 3972138 TI - [Neuronal organization of the somatovisceral afferent systems of the centromedian area of the thalamus]. AB - High responsiveness of the center median neurons to stimulation of radial, sciatic and splanchnic nerves was found in unterstrained cats. The mean latencies of the responses were 24.1 ms, 28.4 ms and 38.4 ms, resp. A considerable convergence (up to 82%) was revealed. The inhibitory type of interrelationships prevailed among the afferents under study, being more obvious during the somatic stimulations. Theoretical aspects of these and other findings are discussed from the standpoint of the thalamic unspecific level of the somato-visceral integration mechanisms. PMID- 3972139 TI - [Effect of nasal respiration on the electrical activity of skeletal musculature]. AB - Spontaneous electrical activity of human gastrocnemius and deltoid muscles was studied after physical overloading under the conditions of nasal or oral respiration. In nasal respiration, the electrical activity was enhansed as compared with oral respiration: stimulation of the nasal cavity receptors with air current seems to improve the respiratory center work and to produce optimal conditions for a wider irradiation of excitatory impulses from the respiratory center to the nerve-skeletal apparatus regulating the motor activity of the body. PMID- 3972140 TI - [Effects of excluding reticuloseptal input on hippocampal electrical activity in the cat]. AB - The effect of interruption of the reticulo-septal input on the electrical activity of CA1 and CA3 areas of the dorsal hippocampus was studied in cats. Lesion of the medial septal nuclei or the i.v. injection of chlorpromazine in low doses led to depression of the hippocampal theta activity. The reticulo-septal input is responsible for generation and the course of tonic sensory responses of the hippocampal neurons in both areas. The existence of the remaining principal types of sensory responses (phasic, complex) mainly depends upon the cortical input. The reticulo-septal input takes part only in the prolongation of these responses. PMID- 3972141 TI - [Participation of the dopamine-reactive system of the caudate nucleus in regulating instrumental conditioned reflexes of various degrees of complexity]. AB - Administration of dopamine into the dorsal part of the caudate nucleus' head hindered the instrumental feeding conditioning with tonic form of motor response in cats. In preliminarily conditioned animals, dopamine impaired the tonic phase of the conditioned response and, consequently, made them loose the ability to synchronize the food-seeking motor response with the moment of food reinforcement. Special series of experiments were performed to study the character of motor disturbances revealed in the tonic phase of the instrumental conditioning as well as their relation to the level of initial motivation. Role of the caudate nucleus dopamine-reactive system in the mechanism of delayed inhibition, is discussed. PMID- 3972142 TI - Properties of macrophages from low- and high-responder strains of mice. I. Effect of antigenic stimulation. AB - In the high-responder A/J mice a lower percentage of peritoneal macrophages express Fc receptors and accordingly phagocytize less intensely via these receptors than the macrophages of the low-IgG-responder C57BL/10ScSn strain. Similarly, the phagocytosis mediated by the receptors for foreign substances tested by CdCO3 microcrystals is lower in the A/J strain. Pinocytic activity was the same in both mouse strains. Intraperitoneal immunization with sheep red blood cells led to a prompt increase in Fc receptor expression and in both phagocytic and pinocytic activities in A/J mice, while in C57BL/10ScSn mice these activities remained unchanged. A similar effect was found when spontaneous and induced rosette formation with sheep red blood cells was studied. The opposite was true when the phagocytic activity of peripheral leucocytes to non-antigenic synthetic microspheres was studied; after immunization with sheep red blood cells a strong increase was observed not in the A/J but C57BL/10ScSn strain. The importance of these results for the regulatory role of macrophages in immune responses in the low- and high-IgG-responder strains of mice is discussed. PMID- 3972143 TI - Chinese medicine. PMID- 3972144 TI - Clonal heterogeneity in a case of Merkel cell carcinoma demonstrated by flow cytometry. AB - A 66-year-old female patient is presented in whom a rapidly growing tumour developed on the glabella. Light and electron microscopy confirmed Merkel cell carcinoma. Flow cytometry (FCM), performed of a tumour specimen, yielded multiple aneuploid stem lines. The FCM data are discussed with regard to the histological features and the biological behaviour of the tumour. PMID- 3972145 TI - New experimental approach to measure the skin-reflected light. Application to cutaneous erythema and blanching. AB - By modifying the blood supply in the upper part of the dermis, the colour of the skin is changed by any material in contact with it. This is a great difficulty when we want to measure the colour intensity in erythema or blanching. To avoid this problem, we designed and built a device which measures the skin reflectance value without any contact with the skin. The use of this device on man to study the skin blanching after application of dermocorticoids allows us to determine the more potent drug among a series (clobetasol propionate) and, for a given drug (betamethasone), the more efficient preparation (oil-in-water emulsion). The study of the effect of increasing irradiation doses of ultraviolet light show that the sensitivity of the device is equivalent to that of the clinical assessment and that the relationship between the irradiation dose and the skin reflectance is sigmoidal. PMID- 3972146 TI - Gonoblennorrhoea adultorum (gonococcal conjunctivitis)--a "disappearing disease" which does not disappear. AB - Gonoblennorrhoea adultorum (GA) still occurs in spite of contrary statements. During the last 10 years, 4 cases were seen in the Munich Clinic of Dermatology (constituting 0.19% of all patients with gonorrhoea). While the conjunctivae alone were involved in 3 of them, in 1 the cornea showed alterations as well. Thus, the disease has not lost its potential danger. Yet the newer cephalosporins seem to cure GA rapidly, even if given in a single dose (together with local treatment). PMID- 3972147 TI - Lymphocyte transformation test in patients with American leishmaniasis. AB - To determine the correlation between the lymphocyte transformation test (LTT) with phytohemagglutinin (PHA) and the clinical forms of American leishmaniasis (AL), duration of the disease and reaction to leishmanin, the authors studied 12 patients and compared them to 25 unaffected individuals. The ulcerated cutaneous form of the disease was observed in 4 patients, the ulcero-nodular lymphangitic form in 1, the mucous cutaneous form with destruction of the nose in 6, and the verrucous form in 1. General patient condition was satisfactory and the Montenegro reaction macroscopically positive with infiltrations of 5-15 mm in diameter. The results revealed no evidence of immunodeficiency among patients. No correlation was observed between clinical forms, duration of the disease and Montenegro reaction and LTT results. LTT with PHA does not appear to be an adequate indicator of the cell immune system in AL cases. PMID- 3972148 TI - Primary biliary cirrhosis associated with coeliac disease and dermatitis herpetiformis. AB - A 69-year-old man who 1 year previously got the diagnosis primary biliary cirrhosis presented a highly pruritic rash on the knees, elbows and in the inguinal region. Both clinically and histologically this was compatible with dermatitis herpetiformis, and dapsone treatment confirmed this. He was found to have jejunal atrophy, and after 1 year with gluten-free diet, biopsy showed almost full restoration of the villous pattern. He then only rarely had any skin problems. PMID- 3972149 TI - Staphylococcus aureus skin colonization in atopic dermatitis patients. AB - A study was conducted to compare the Staphylococcus aureus skin colonization of 21 patients with atopic dermatitis (AD) and 22 healthy controls. It was found that the total aerobe count (total CFU/cm2), the S. aureus fraction thereof and the S. aureus carrier frequency were significantly higher in apparently normal skin of AD patients than in healthy individuals. In addition, compared to normal skin of patients S. aureus density was 100 to 1,000 times higher in the 3 different kinds of lesional skin (dermatitic, lichenified and impetiginized sites). 190 S. aureus strains isolated from the skin of AD patients were tested for sensitivity to 5 topically used antibiotics and the results reported. Besides the biological consequences for the person affected by AD this severe colonization with S. aureus is of epidemiological importance. Several outbreaks of S. aureus infections by dispersal from dermatitic skin have been described. Therefore some preventive and therapeutic aspects are discussed. PMID- 3972150 TI - Epithelioid sarcoma. AB - Epithelioid sarcoma is a rare malignant tumor of the soft tissues with particular clinical and anatomicopathological characteristics. Histologically it is characterized by the presence of particular epithelioid cells. After a description of a recently observed case, the authors present a synthesis of the literature on the subject, paying particular attention to the clinical and histological aspects which facilitate an early and correct diagnosis. PMID- 3972151 TI - [Bullous malignant melanoma]. AB - We report the histological aspect of a superficial malignant melanoma in which a large bulla spontaneously formed by disruption of the cohesion between neoplastic cells and the epidermis. The neoplastic proliferation evaluated by incorporation of tritiated thymidine was moderately low. PMID- 3972152 TI - Dermatomyositis with prominent mucinous skin change. Histochemical and biochemical aspects of glycosaminoglycans. AB - Although there is occasionally remarkable accumulation of mucin in the skin lesion of dermatomyositis, no special attention has been paid in regard to mechanisms underlying it. We carried out histochemical and biochemical studies on materials obtained from one case of dermatomyositis, who showed the presence of abundant mucinous material stainable with alcian blue between the collagen bundles throughout the lesional dermis. The major component of the ground substance was identified to be hyaluronic acid. The activity of N-acetyl-beta glucosaminidase, exoglycosidase that degrades hyaluronic acid in serum of the patient, was equivalent to that of controls. However, heparan sulfate was greatly increased in the urine of the patient in comparison with that of the normal controls in which the major components were chondroitin 4-sulfate and chondroitin 6-sulfate. We think that the increase of hyaluronic acid in the lesional dermis is due to an excess production by the fibroblasts under some immunological stimulation, although its relation to the increased heparan sulfate excretion into the urine of the patient is obscure. PMID- 3972153 TI - Comparisons of human placental lactogen mRNA levels from placentas of diabetics and normal term. AB - Overt diabetes and gestational diabetes (1-2.5% of all pregnancies) has been related to perinatal mortality, increased macrosomia and increased frequency of other pregnancy complications. Human placental lactogen (hPL), a hormone similar to growth hormone, is produced by the placenta and is a potent antagonist to insulin action. While hPL's presence in maternal circulation induces a sparing effect on nutrients including glucose, it exacerbates diabetes during pregnancy and may well relate to other clinical complications. To explore possible regulation of hPL in diabetic pregnancy and specifically to examine gestational diabetes, we have evaluated the levels of placental mRNA coding for hPL synthesis as well as other parameters from diabetic and normal term patients. By in vitro translation assays using nuclease-treated reticulocyte lysate, no substantial differences in translatable hPL-mRNA were observed when comparing normal term (3.5% of total synthesis), gestational diabetic (3.4%) and Type C diabetic (3.5%). However, translatable hPL-mRNA in Type R diabetes which was 2.7% of total synthesis was slightly reduced in comparison to normal term. To determine more directly hPL-mRNA levels in gestational diabetic placentas and normal term placentas, total RNA preparations were evaluated qualitatively by northern blot and quantitatively by dot blot of RNA and cDNA hybridization to a nick-translated hPL-pMB9 plasmid. The northern blot revealed no major size differences of the mRNA and the dot blot hybridization was quantitatively similar for both gestational diabetics and normal terms per unit of total RNA. By direct analysis of DNA per g tissue we found the DNA content of placentas from gestational diabetics and normal term to be statistically the same.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972154 TI - Ribosomal-protein synthesis is not autogenously regulated at the translational level in Xenopus laevis. AB - Whether ribosomal-protein synthesis in Xenopus laevis is autogenously controlled at the translational level as is known to occur in prokaryotes has been studied. For this purpose ribosomal (r) proteins were prepared from X. laevis ribosomal subunits and group fractionated by ion-exchange chromatography. They were then added to an in vitro translation system directed by an oocyte mRNA fraction which contains template activity for r proteins. The synthesized radioactive products were analyzed by 2D gel electrophoresis and compared with controls. Similarly in vivo experiments were performed by microinjection of the fractionated proteins into the cytoplasm of Xenopus oocytes followed by incubation with [35S]methionine for different times. In all the experiments no evident effect of r proteins on the translation of their own mRNA was observed. PMID- 3972155 TI - Multiple levels of regulation of protein synthesis at fertilization in sea urchin eggs. AB - Fertilization of sea urchin eggs results in a large stimulation of protein synthesis. This increase in protein synthesis is mediated by the mobilization of stored maternal mRNA (mRNPs) into polysomes, but the details of the molecular mechanisms which regulate this process are not well understood. Using a sea urchin egg cell-free translation system, evidence has been obtained which indicates that the capacity to initiate protein synthesis on new mRNAs is limited. Addition of exogenous mRNAs failed to stimulate overall protein synthesis, whereas supplementing the system with a nuclease-treated reticulocyte lysate, an S-100 supernatant fraction, or purified eIF-2 stimulated nearly twofold. In addition, the levels of 43 S preinitiation complexes containing a 40 S ribosomal subunit and methionyl-tRNA were increased at pH 7.4 compared to pH 6.9, or when reticulocyte S-100 was added. However, other experiments showed clearly that mRNA availability may also regulate translation in the sea urchin egg. Sea urchin lysates only stimulated poorly the nuclease-treated reticulocyte lysate system, and the mRNPs in the sea urchin lysate did not bind to reticulocyte 43 S preinitiation complexes. Since purified sea urchin egg mRNA was active in both assays, the bulk of sea urchin mRNA must be masked in the egg, and remain masked in the in vitro assays. Thus, protein synthesis appears to be regulated at both the level of mRNA availability and the activity of components of the translational machinery. PMID- 3972156 TI - Differentiation of mammary epithelial stem cells to alveolar-like cells in culture: cellular pathways and kinetics of the conversion process. AB - The cuboidal epithelial stem cell line Rat Mammary (Rama) 25 can differentiate in culture to droplet, alveolar-like cells that form domes, secrete small amounts of casein, and bind peanut lectin after treatment with neuraminidase. Differentiation to droplet cells is accelerated by dimethyl sulfoxide (DMSO). Morphologically intermediate states (gray and dark) which occur in the order: cuboidal----gray----dark----dark droplet----doming cells have been identified along this pathway by time-lapse cinematography. The dark and dark droplet states are associated with increased peanut lectin binding capacity whereas casein is secreted mainly by cells in domes. Cells in cultures containing low concentrations of DMSO (less than 56 mM) acquire droplets predominantly in the dark state, whereas with higher concentrations of DMSO droplet formation is seen mainly in the gray state. Kinetic analysis both from time-lapse films and conventional microscopy, shows that increasing the concentration of DMSO prolongs the time spent in the gray state, decreases the time of initial appearance of droplet cells, and increases their subsequent rate of formation, without detectable effects on the rates of the remaining morphological transitions. DMSO also reduces the average rate of DNA synthesis and increases the average cell cycle time, particularly in the second (and subsequent) cell cycles after its addition. However, neither droplet nor doming cells are terminally differentiated. Thus a linear sequence of morphological states exists between the Rama 25 stem cells and the alveolar-like or more probably alveolar bud cells in vitro, and DMSO accelerates the overall conversion predominantly by truncating one of the steps in this pathway. PMID- 3972157 TI - Cell cycles in the male accessory glands of mealworm pupae. AB - During the pupal stage of Tenebrio molitor, the accessory reproductive glands of males grow by cell division. Within the secretory epithelium of the bean-shaped accessory glands (BAGs), cell numbers triple. In the tubular accessory glands (TAGs), the increase is 14-fold. There are two mitotic maxima in each gland. The first maximum occurs at 1-2 days while the second is at 4-5 days. The second maximum coincides with the major ecdysteroid peak described by Delbecque et al. [Dev. Biol. 64, 11-30 (1978)]. Nuclei were isolated from TAGs during the pupal mitotic bouts and during mitotic inactivity in the adult. After Feulgen or propidium iodide staining, the DNA content of these nuclear populations was measured by absorption cytophotometry or by fluorescence flow cytometry, respectively. The proportion of cells in each phase of the cycle was calculated using an iterative model. After mitoses have ended in the late pupa, the cells were arrested in G2. [3H]Thymidine was injected into 1- and 4-day pupae to pulse label cells of the TAGs. After allowing various periods from 4 to 60 hr for cells to progress through G2 to reach mitosis, fractions of labelled mitoses were determined by autoradiography. From the combined cytometric and autoradiographic data, the duration of each phase of the cell cycle was calculated assuming the population was in exponential growth. Cell cycles in 4-day pupal TAGs take 48 hr. G1, S, G2, and, M lasted 13, 14, 17, and 4 hr, respectively. PMID- 3972158 TI - Ecdysteroids accelerate mitoses in accessory glands of beetle pupae. AB - During the 9-day pupal period of Tenebrio molitor (the mealworm beetle), the cells of the male accessory glands undergo divisions for 7 days. There are two maxima in the mitotic activity in the glands in vivo, one at 1 day and the other at 4 days. The latter peak coincides with the large surge of ecdysterone occurring in the pupal stage. By the use of in vitro culture techniques, it has been demonstrated that the first bout of mitosis in both glands proceeds in basal medium, while the second bout of mitosis requires a physiological level of ecdysterone. Ecdysone was less effective than ecdysterone. Sensitivity to ecdysterone did not change significantly between Day 1 and Day 4 of the pupal stage. The results are discussed in relation to the effects of ecdysterone on cell division in mesodermal and ectodermal derivatives. PMID- 3972159 TI - Control of cell-cycle timing in early embryos of Caenorhabditis elegans. AB - A technique has been developed for extruding either substantial amounts of cytoplasm without nuclei or individual nuclei with small amounts of cytoplasm from early embryos of C. elegans after perforating the eggshell with a laser microbeam. This technique, in conjunction with laser-induced cell fusion, has allowed the altering of nuclear/cytoplasmic ratios and the exposing of the nucleus of one cell to cytoplasm from another. Using these approaches the roles of nuclei and cytoplasm in determining the different cell-cycle periods of the several blastomere lineages in early embryos have been examined. It was found that nuclei in a common cytoplasm divide synchronously; enucleated blastomeres retain a cycling period characteristic of their lineage; cycling period is not substantially affected by changes in the ratio of nuclear to cytoplasmic volumes or the DNA content per cell; the period of a cell from one lineage can be substantially altered by introduction of cytoplasm from a cell of another lineage with a different period; and short-term effects of foreign cytoplasm on the timing of the subsequent mitosis differ depending on position of the donor cell in the cell cycle. These results are discussed in connection with models for the action of cytoplasmic factors in controlling cell-cycle timing. PMID- 3972161 TI - Fertilization potential and electrical properties of the Xenopus laevis egg. AB - The membrane potential of Xenopus eggs was monitored continuously from prior to fertilization until early cleavage. A rapid decay of the initial potential of 33.1 +/- 8.1 (SD) mV (N = 14) upon impalement to a value of -19.3 +/- 4.2 (SD) mV (N = 68) suggested that insertion of the first electrode caused depolarization. Outward and inward rectification were observed when the resting potential was made more positive than about 5 mV or more negative than about -30 mV. Eggs were not activated by this level of current injection. Fertilization and activation evoked a membrane depolarization which was influenced by the external Cl- concentration, the nature of the halide species, and 4,4-diisothiocyanostilbene 2,2-disulfonic acid. Smaller transient depolarizations were associated with the initial stages of the fertilization potential but not with activation. Only when the fertilization potential was significantly diminished, as in high external Cl- or in the presence of Br- or I- solutions did polyspermy ensue. The input resistance of the unfertilized egg was 13.2 +/- 9.8 M omega (N = 26) and decreased about 200-fold at the peak of the fertilization potential to 0.077 +/- 0.020 M omega (N = 9). Ninety minutes after the onset of the fertilization potential and about 6 min after the start of furrow formation the membrane began a series of cleavage cycle-associated hyperpolarizations. These were unaffected by either the external Cl- concentration or other halide species. Reduction in amplitude of the fertilization potential had no apparent effect upon the normal elevation of the fertilization envelope or upon cleavage and later development. The fast electrical block to polyspermy appears to have a lower threshold in Xenopus compared with other species and is also effective at negative membrane potentials. PMID- 3972160 TI - Molecular characterization of anterior-like cells in Dictyostelium discoideum. AB - Prestalk cells are found in the anterior 15% of slugs of Dictyostelium discoideum and prespore cells are found in the remaining posterior portions. Neutral red staining as well as immunostaining with antisera prepared against spores or a spore-coat protein has indicated that there are cells in the posterior region which have properties similar to prestalk cells. This cell population, called anterior-like cells, has been isolated by density separation of posterior slug fractions. This anterior-like cell preparation contained approximately 80% neutral red-stained cells, none of which carried a surface antigen specific to prespore cells (MUD-1 antigen). These cells also lacked antigens recognized by antisera to the spore-coat proteins or by a prespore-specific monoclonal antibody isolated for this study (mLJ1). Anterior-like cells were found to modify the lysosomal enzymes acid phosphatase and alpha-mannosidase in a manner found specifically in prestalk cells. They also synthesized two prestalk-specific proteins and contain two prestalk-specific mRNA transcripts. Anterior-like cells also failed to express a large number of prespore-specific characteristics. Although very similar to prestalk cells, anterior-like cells differ from them in that they express a prespore-specific protein PSP59 and the levels of the prestalk-specific mRNA transcripts and one of the prestalk-specific proteins ST430 appear to be lower. PMID- 3972162 TI - Actin mRNA content in normal and delayed implanting mouse embryos. AB - Actin mRNA levels were measured in mouse eggs, early embryos, and delayed implanting blastocysts by a homologous, cloned recombinant DNA probe and "dot" blot methodology. A maternal store of 431 fg of actin mRNA was observed in the unfertilized eggs. This mRNA pool decreased 12-fold by the mid-two-cell stage. Actin mRNA levels were then observed to increase progressively from the eight cell to the blastocyst stage on a basis proportional to cell number. Late blastocysts contained 2400 fg actin mRNA per embryo (22 fg per cell). The cellular level decreased by about 20% in embryos induced into delay of implantation by ovariectomy of donor females. Reactivation of the delayed implanting blastocysts through hormonal manipulation in vivo or culture in vitro was accompanied by reestablishment of the level of cellular actin mRNA observed in normal blastocysts. PMID- 3972163 TI - The origin of pigment cells in embryos of the sea urchin Strongylocentrotus purpuratus. AB - A monoclonal antibody (SP1/20.3.1) that recognizes a cell surface epitope expressed by pigment cells in the pluteus larva of Strongylocentrotus purpuratus has been produced. Using indirect immunofluorescence, the epitope is first detected in nonpigmented cells of the vegetal plate after primary mesenchyme ingression. Between the beginning of gastrulation, and when the archenteron is one-third the distance across the blastocoel, SP1/20.3.1-positive cells are free within the blastocoel, at the tip of the archenteron, and dispersed within the blastoderm. Cells at the tip of the archenteron, and mesenchyme near the tip in later stages of gastrulation (secondary mesenchyme), do not express the SP1/20.3.1 antigen. By the completion of gastrulation all SP1/20.3.1-positive cells are dispersed throughout the epidermis. It has been concluded that in S. purpuratus pigment cell precursors are released from the vegetal plate during the initial phase of gastrulation. The cells migrate first to the vegetal ectoderm, and subsequently disperse throughout the ectoderm and develop pigment granules. PMID- 3972164 TI - Abnormal embryonic development induced by antibodies to rat visceral yolk-sac endoderm: isolation of the antigen and localization to microvillar membrane. AB - An antigenic substance was isolated from rat visceral yolk-sac endoderm of the 18th-20th days of gestation by extraction with the nonionic detergent Nonidet P 40, Sephacryl S-300 gel filtration, and Ricinus communis agglutinin affinity chromatography. The rabbit antiserum directed against this antigenic substance when injected into pregnant rats during the period of organogenesis caused abnormal embryonic development, fetal growth retardation, and embryonic death. Ouchterlony gel diffusion analysis demonstrated that the antiserum formed one immunoprecipitin band against the crude detergent extract and a complete identity between the present visceral yolk-sac antigen and the renal glycoprotein antigen previously isolated (C. C. K. Leung, (1982) J. Exp. Med. 156, 372-384). The antigen eluted from the antibody affinity column appeared to consist of two major peptides of 60 and 30 kDa when analyzed by SDS-polyacrylamide gel electrophoresis. Indirect immunofluorescent and immunoperoxidase localization studies at the light microscopic level demonstrated that both rat renal proximal tubule and embryonic visceral yolk-sac endoderm at various gestational stages (including the organogenetic period) shared the same antigen. Indirect immunoperoxidase localization studies at the electron microscopic level demonstrated that the antigen was a part of (or associated with) the microvillar membrane and membrane invaginations at the base of the microvilli of the renal proximal tubule and visceral yolk-sac endoderm. In vivo immunoperoxidase localization studies demonstrated that the teratogenic antibodies localized within the large phagolysosomes and the apical vesicles of the visceral yolk-sac endoderm. It is postulated that visceral yolk-sac pathology was induced by the antibodies. PMID- 3972165 TI - Stimulation of initial neural crest cell migration in the axolotl embryo by tissue grafts and extracellular matrix transplanted on microcarriers. AB - The present experiments were designed to test whether the onset of neural crest cell migration in the embryonic axolotl trunk is stimulated by surrounding tissues and their associated extracellular matrix (ECM). Tissue grafts, or embryonic ECM adsorbed in vivo onto inert "microcarriers" prepared from Nuclepore filters, were placed close to the premigratory neural crest cells, and the embryos were then incubated to a specific stage. The experiments were evaluated with light microscopy, SEM, and TEM. It was found that grafts from the dorsal epidermis were especially effective in locally stimulating initial neural crest cell migration in the region under the graft. The microcarrier experiments showed that the subepidermal ECM alone could initiate neural crest cell migration, implying that the ECM of the epidermal grafts was the stimulating factor. These results indicate that the premigratory neural crest cells along the trunk have migratory capability but that they need to be triggered from the environment, probably from the surrounding ECM, to start migration. It is proposed that ECM, as substrate for cell locomotion, initiates and regulates the onset of neural crest cell migration. PMID- 3972166 TI - Acquisition of the heat-shock response and thermotolerance during early development of Xenopus laevis. AB - The ability to synthesize a 68,000- to 70,000-Da protein (hsp) in heat-shocked early Xenopus laevis embryos is dependent on the stage of development. Whereas late blastula and later stage embryos synthesize hsp68-70 after heat shock, cleavage stages are incompetent with respect to hsp synthesis. In vitro translation experiments and RNA blot analyses demonstrate that enhanced synthesis of hsp68-70 is associated with an accumulation of hsp68-70 mRNA. Examination of the effect of heat shock on preexisting actin mRNA reveals that heat shock promotes a reduction in the levels of actin mRNA in cleavage embryos but has no discernible effect on actin mRNA levels in neurula embryos. Finally, the acquisition of the heat-shock response (i.e., synthesis of hsp68-70 and accumulation of hsp70 mRNA) during early Xenopus development is correlated with the acquisition of thermotolerance. PMID- 3972168 TI - Loss of hyaluronate-dependent coat during myoblast fusion. AB - Cultured myoblasts were found to exhibit extensive, Streptomyces hyaluronidase sensitive pericellular coats as revealed by exclusion of particles (fixed red blood cells). These coats are not discernible subsequent to fusion of the myoblasts to form myotubes. The myoblasts contained 2.5 times more hyaluronate attached to their cell surface than myotubes when the data was expressed per unit of protein, but no change in hyaluronate was evident on a per DNA basis. Hyaluronidase activities in the cultures were equivalent when expressed per unit of protein. We conclude that, although the myotubes accumulate larger amounts of protein than myoblasts, there is no compensatory increase in hyaluronate. PMID- 3972167 TI - Trophoblast giant cell release of placental lactogens: temporal and regional characteristics. AB - Placental lactogen (PL) production by rat trophoblast giant cells was studied using in vitro methods. The influence of trophoblast giant cell location within the conceptus and day of trophoblast giant cell isolation on the type of PL released in vitro were investigated. The effect of trophoblast giant cell location on the amount of PL, progesterone, and testosterone released in vitro was also evaluated. Trophoblast giant cells release two types of PLs in vitro; a high-molecular-weight lactogen, PL-1, and a low-molecular-weight lactogen, PL-2. The type of PL released by trophoblast giant cells was not influenced by their location within the conceptus at the time of dissection. Location did influence the amount of hormone produced by trophoblast giant cells. Mural trophoblast giant cells were more active in the production of PL, progesterone, and testosterone. The type of PL released by trophoblast giant cells is highly dependent upon the day of gestation the cells are removed for study. Trophoblast giant cells isolated on Day 10 of gestation release predominantly PL-1, while those cells isolated 24 hr later (Day 11 of gestation) release predominantly PL 2. The switch from PL-1 to PL-2 production that occurs in vivo does not occur under the in vitro conditions employed in this report. PMID- 3972169 TI - The effect of the suspensor and gibberellic acid on Phaseolus vulgaris embryo protein content. AB - The role of the suspensor in the early development of the dicot embryo has not yet been defined. It has been described as merely an anchor and also as the major route of nutrients into the embryo. In order to further elucidate the role of the suspensor, early 0.2-mm and late heart stage 0.5-mm Phaseolus vulgaris (var. Taylor's Horticultural) embryos have been examined in tissue culture. It is known that Phaseolus embryos in culture at low osmotic potential will germinate precociously and that embryos in culture at high osmotic potential will either fail to grow or form callus. Optimum sucrose concentrations for continued, normal embryonic development of 0.2 mm and 0.5 mm P. vulgaris in tissue culture with Gamborg B5 medium were determined to be 12 and 6%, respectively. Protein content was examined in embryos and suspensors. Results showed that both 0.2- and 0.5-mm embryos required an attached suspensor for maximum protein content. Protein levels were substantially decreased when the embryo was cultured detached from or without the suspensor. Gibberellic acid at 10(-6) to 10(-7) M restored the protein content to that of freshly excised embryos. PMID- 3972170 TI - Functional connections with foreign muscles made by a target-deprived insect motorneuron. AB - Metathoracic limb buds were removed unilaterally from Locusta migratoria embryos at 30% of embryonic development, thereby depriving limb-innervating neurons of the opportunity of innervating their normal target muscles. The operated embryos were allowed to hatch and develop to adulthood, and then the connections between the identified limb motorneuron Fast Extensor Tibiae (FETi) and body wall muscles on the operated side of the segment were determined electrophysiologically. FETi innervated a number of foreign muscles in the ipsilateral body wall in limb ablated locusts, showing that this neuron is not programmed to exclusively innervate its normal target muscle. PMID- 3972171 TI - Reversible, cell-heritable changes during the development of tobacco pith tissues. AB - Cytokinin requiring cells of Nicotiana tabacum L. cv "Havana 425" can be induced in culture to become cytokinin autotrophic. This process is known as cytokinin habituation. Earlier we showed that pith parenchyma tissue consists of inducible cells, which habituate at high rates when treated with cytokinin, and noninducible cells, which remain cytokinin requiring under these conditions. The inducible and noninducible phenotypes are determined states that arise during the development of the tobacco plant and are inherited by individual cells. Here we show that pith tissue of plants regenerated from cloned lines of noninducible cells exhibits the inducible phenotype indicating that noninducible cells, or their descendants, can become inducible. This change in competence for habituation appears to have an epigenetic basis; it is reversible, occurs at high rates, and depends on the developmental state of the cells. The habituated state occurs in two forms that can be distinguished by their difference in developmental potential. Habituated cells derived from inducible pith cells give rise to normal plants whose leaf and pith tissues require cytokinin for growth in culture. In contrast, habituated cells obtained by transferring noninducible cells on media with progressively lower cytokinin concentrations give rise to plants whose leaf and pith tissues exhibit a cytokinin-habituated phenotype in culture. PMID- 3972172 TI - Independent development of homologous pattern elements in the wing patterns of butterflies. AB - Rank correlation analyses demonstrate that the degree of color pattern development in each wing cell of Cercyonis pegala (Satyridae) and Smyrna blomfildia (Nymphalidae) is either weakly or not at all correlated with that in other wing cells. There is much greater individual variability in pattern development in different wing cells than there is in homologous wing cells on opposite wings. This finding indicates that differences in pattern development in adjacent wing cells are not due to developmental noise, but are programmed, and that pattern development in each wing cell is in large measure independent of that in other wing cells. PMID- 3972173 TI - Calmodulin level and cAMP-dependent protein kinase activity in rat spermatogenic cells and hormonal control of spermatogenesis. AB - The changes in intracellular calmodulin levels and cAMP-dependent protein kinase activities have been studied in the testis of normally developing and hypophysectomized rats. It appears that the onset of spermatogenesis which occurs on the first days of the postnatal development, is associated with a major (over fivefold) increase in the calmodulin level and enhancement of the cAMP-dependent protein kinase activity. On the contrary, hypophysectomy of adult animals is associated with a progressive decline in the calmodulin level and a rapid and regular decrease in the cAMP-dependent protein kinase activity. Moreover, measurements of the intracellular calmodulin level and cAMP-dependent kinase activity of isolated testicular germ cells or epididymal spermatozoa have shown that testosterone, administered to hypophysectomized rats as subcutaneous implants, maintains the concentration of these regulatory proteins to normal values. PMID- 3972174 TI - Analysis of changes in a yolk glycoprotein complex in the developing sea urchin embryo. AB - A sea urchin yolk glycoprotein complex (YGC) was isolated from several developmental stages by velocity centrifugation on sucrose gradients. The YGCs were analyzed by SDS-polyacrylamide gel electrophoresis to determine if the molecular composition of the YGC was changing during development. The mass of the YGC did not change with development. However, as development proceeded there were significant changes in the glycoprotein composition of the YGC isolated from either Lytechinus pictus or Strongylocentrotus purpuratus embryos. In both species the YGC isolated from eggs contained three major glycoproteins. The most abundant one had an apparent molecular weight of 190,000 and was designated GP 190. During development the three major egg YGC glycoproteins decreased in relative amounts as intermediate-molecular-weight glycoproteins increased. While these changes were detected in YGCs isolated from either species, the rate of change was much greater in S. purpuratus than in L. pictus. The most significant difference was observed in the rate of decrease in GP-190. In S. purpuratus, GP 190 showed a significant decrease by 8-10 hr postfertilization, while a similar decrease did not occur in L. pictus YGCs until 72 hr postfertilization. To determine how these changes were occurring, both amino acid and carbohydrate analyses were done on the YGC isolated from various stages. From examination of these data, it appeared that the molecular composition of the YGC was changing via very limited proteolysis. The intermediate and low-molecular-weight glycoproteins generated apparently remain assembled in the YGC, thus conserving its mass. PMID- 3972175 TI - Metabolic, fluorescent dye and electrical coupling between hamster oocytes and cumulus cells during meiotic maturation in vivo and in vitro. AB - Heterologous intercellular communication was determined qualitatively by lucifer yellow dye transfer and quantitatively by transfer of radiolabeled uridine metabolites and electrical current in hamster oocyte-cumulus complexes during meiotic maturation in vitro and in vivo. In addition, changes in cell resting potentials during maturation were recorded. Significantly less time was required for germinal vesicle breakdown (GVBD) in oocytes matured in vitro than in oocytes stimulated in vivo (1.81 +/- 0.06 hr, N = 13 vs 2.46 +/- 0.07 hr, N = 18, respectively, P less than 0.001). Resting potentials of the oocyte (RP-o) and cumulus cells (RP-c) significantly increased contemporaneously with GVBD in vitro (RP-o: from -18.9 +/- 3.2 mV to -33.2 +/- 2.9 mV, P less than 0.001; RP-c: from 16.3 +/- 1.9 mV to -27.5 +/- 2.6 mV, P less than 0.001) and in vivo after hCG injection (RP-o: from -16.8 +/- 5.9 mV to -30.1 +/- 3.9 mV, P less than 0.001; RP c: from -15.5 +/- 3.8 mV to -26.3 +/- 3.2 mV, P less than 0.001). RP-o and RP-c progressively increased with time of culture up to 7 hr (maximum time examined) while the values reached maxima in in vivo matured oocytes 4.5 hr post-hCG and subsequently declined concomitant with the onset of cumulus expansion. Cumulus to oocyte coupling decreased progressively with time after release from meiotic arrest both in vitro and in vivo, as assessed by a progressive reduction in transfer of either uridine marker or lucifer yellow from the cumulus cell to the oocyte. By 4.5 hr after hCG injection, cumulus expansion had begun in 100% of complexes examined. Expansion was extensive by 7 hr post-hCG and spread of lucifer yellow from a cumulus cell was limited to very few adjacent cumulus cells. Oocyte to cumulus cell metabolic coupling also decreased progressively with time in both treatment groups. Examination of the extent of heterologous ionic coupling revealed that ionic coupling exhibited biphasic and, bidirectionally parallel, increases during meiotic maturation. While these temporal changes were observed in both groups, the coupling ratios were much greater in those complexes matured in vitro than in vivo. These results show that dye, metabolic, and electrical coupling exist between the immature hamster oocyte and its surrounding cumulus cells but that during the early stages of meiosis, metabolic and dye coupling decrease, while electrical coupling increases biphasically. PMID- 3972176 TI - Development of cells containing catecholamines and somatostatin-like immunoreactivity in neural crest cultures: relationship of DNA synthesis to phenotypic expression. AB - The goal of our work is to understand the mechanisms which regulate the differentiation of embryonic neural crest cells into a number of adult cell types, including several classes of neurons. As one aspect of this analysis, the relationship between DNA synthesis and the ontogeny of cells with catecholamines and somatostatin-like immunoreactivity (SLI) in neural crest cell cultures has been investigated. Most of the precursors of the catecholamine- and SLI-positive cells carry out DNA synthesis. As these cells differentiate, their ability to carry out DNA synthesis declines. However, a small percentage of cells continue to synthesize DNA after they become catecholamine or SLI positive. There is no apparent difference between the temporal pattern of DNA synthesis in the precursors of catecholamine-positive cells with SLI and those without SLI. Thus, the time of withdrawal from the cell cycle does not distinguish the lineage of cells that are catecholamine and SLI positive from those that are catecholamine positive and SLI negative. PMID- 3972177 TI - Occurrence of a species-specific nuclear antigen in the germ line of Xenopus and its expression from paternal genes in hybrid frogs. AB - An abundant acidic germinal vesicle protein of 100,000 Da has been previously described in Xenopus laevis and termed N1. It is supposed to bind stored histones in the oocyte. Species-specific monoclonal antibodies (mABs) have been raised against the oocyte nuclear protein of X. borealis B3, that is equivalent to protein N1 of X. laevis. These mABs have been used to monitor paternal gene expression of B3 in hybrids between X. laevis and X. borealis. Protein B3 is accumulated in oocyte nuclei, shed into the cytoplasm of the egg upon germinal vesicle breakdown, and reaccumulated by the nuclei of the embryo. During development it appears to be gradually diluted in all cells of the embryo, its levels falling below the limits of detection after stage 50. In interspecies hybrids, the paternal antigen is not found in somatic cells, as judged by immunohistological criteria. Therefore it has been concluded that protein B3 is not expressed from the genes of the embryo and that the maternal store of B3 is sufficient to endow the nuclei of the embryo with this protein up to the feeding tadpole stage. This deduction is corroborated by radiolabeling experiments. The paternal antigen B3 is, however, specifically expressed in the germ line. In hybrids and in X. borealis it is first detected in the nuclei of oogonia and spermatogonia, but, in both sexes, it is undetectable during early meiotic prophase. In female germ cells, accumulation of B3 is resumed at the beginning of diplotene, concomitant with the onset of oocyte growth. The significance of the observed cell specificity of B3 during germ cell differentiation is discussed in relation to its postulated function as a histone storage factor. PMID- 3972178 TI - Phosphorylation of sea urchin sperm H1 and H2B histones precedes chromatin decondensation and H1 exchange during pronuclear formation. AB - Immediately following fertilization in the sea urchin, sperm-specific histones Sp H1 and Sp H2B are phosphorylated. Then, in parallel with chromatin decondensation, nearly all phosphorylated Sp H1 is lost from the pronuclear chromatin, with the concurrent assimilation of the egg phosphoprotein CS H1. Chemical cleavage of in vivo labeled Sp H1 and Sp H2B shows that serine phosphorylation occurs in the unusually long N-terminal region of these proteins. These regions contain tandemly repeated tetra- and pentapeptide units each containing serine, proline, and two basic amino acids. It is proposed that sperm chromatin decondensation may require prior phosphorylation of these unusual N terminal regions, whose function in the mature sperm may be to condense or stabilize its highly compact chromatin. PMID- 3972179 TI - Differentiation and the cell membrane excitability of teratocarcinoma OTT6050 in culture. AB - The electrophysiological properties of differentiated cells which were derived from teratocarcinoma OTT6050 in culture showed two different types of spike generation: (1) In the differentiated cells treated by retinoic acid, the action potential of cells involved Ca2+; (2) in the differentiated cells treated by both retinoic acid and nerve growth factor (NGF), the action potential of cells involved Na+ and CA2+. The results indicate that the effects of drugs appear to be important factors in the induction as well as in the regulation of cellular functions in the differentiated cells. PMID- 3972180 TI - Corneal stromal fibroblasts from adult rabbits retain the capacity to deposit an orthogonal matrix. AB - Stromal fibroblasts from the adult rabbit cornea were propagated in vitro, then injected into the vitreous compartment of normal rabbit eyes. In this environment the stromal cells deposited a matrix of imperfect orthogonal collagenous lamellae resembling normal corneal stroma. Extracellular matrices were also secreted by other ocular and nonocular cell types intravitreally, but no orthogonal regions were observed. The vitreous appears to provide some of the physical and humoral factors required to permit adult corneal fibroblasts to secrete a stroma-like matrix in the absence of embryonic tissue influences. PMID- 3972181 TI - Animal-vegetal polarity in the plasma membrane of a molluscan egg: a quantitative freeze-fracture study. AB - Using freeze-fracture electron microscopy, the numerical particle distribution in the fertilized Nassarius egg plasma membrane has been analyzed in four areas at different positions along the animal-vegetal axis of the egg. These areas can be distinguished by distinct microvilli patterns and differences in microvilli densities. In all areas, more IMPs (intramembrane particles) are present on the P face than on the corresponding E face. The ratio of the number of IMPs present on E and P face is similar in all areas (0.48-0.55) except for the most animal part of the vegetal hemisphere, where relatively more IMPs remain attached to the exterior half of the fractured membrane (E/P ratio = 0.88). The IMP density at the vegetal pole of the egg is considerably higher than in the animal hemisphere and in the animal part of the vegetal hemisphere. This difference is due to an increased number of IMPs in all size classes (4-18 nm). In the area adjacent to the vegetal pole the density of particles is also higher than in the two more animal areas, but here the difference is exclusively due to the smaller IMP size classes (4-8 nm). Statistical analysis of our data reveals that the area adjacent to the vegetal pole patch is significantly different from the other areas with respect to the distribution of the IMPs over the different IMP size classes. These results demonstrate the polar organization of the Nassarius egg plasma membrane. The possible role of this surface heterogeneity in the spatial organization of the egg cell and the later embryo is discussed. PMID- 3972182 TI - Cell lineage of zebrafish blastomeres. I. Cleavage pattern and cytoplasmic bridges between cells. AB - Patterns of cleavage and cytoplasmic connections between blastomeres in the embryo of the zebrafish, Brachydanio rerio have been described. The cell division pattern is often very regular; in many embryos a blastomere's lineage may be ascertained from its position in the cluster through the 64-cell stage. At the 5th cleavage, however, significant variability in pattern is observed, and alternative patterns of the 5th cleavage are described. The early cleavages are partial, incompletely separating blastomeres from the giant yolk cell. The tracer fluorescein-dextran (FD) was injected into blastomeres to learn the extent of the cytoplasmic bridging. It was observed that until the 10th cleavage, blastomeres located along the blastoderm margin maintain cytoplasmic bridges to the yolk cell. Beginning with the 5th cleavage, FD injected into a nonmarginal blastomere either remains confined to the injected cell, or if the injection was early in the cell cycle, the tracer spreads to the cell's sibling, through a bridge persisting from the previous cleavage. On the other hand, injected Lucifer yellow spreads, presumably via gap junctions, widely among blastomeres in a pattern unrelated to lineage. PMID- 3972183 TI - Cell lineage of zebrafish blastomeres. II. Formation of the yolk syncytial layer. AB - Dye coupling and cell lineages of blastomeres that participate in the formation of the yolk syncytial layer (YSL) in the zebrafish Brachydanio rerio have been examined. The YSL is a multinucleate layer of nonyolky cytoplasm underlying the cellular blastoderm at one pole of the giant yolk cell. It forms at the time of the 10th (sometimes 9th) cleavage by a collapse of a set of blastomeres, termed marginal blastomeres, into the yolk cell. Marginal blastomeres possess cytoplasmic bridges to the yolk cell before the YSL forms, and injections of fluorescein-dextran into the cells revealed that bridges between the yolk cell and blastoderm do not persist after this time. Injections of Lucifer yellow revealed that shortly after the YSL forms the yolk cell and blastoderm are dye coupled, presumably by gap junctions, and that this coupling disappears gradually during early gastrulation. Lineage analyses revealed that not all of the progeny of early marginal blastomeres participate in YSL formation. Although some descendants of marginal blastomeres remained on the margin during successive cleavages, neither "compartment" nor "strict lineage" models are sufficient to explain the origin of the YSL. It is proposed that the position of a cell on the blastoderm margin, and not the cell's lineage, determines YSL cell fate. PMID- 3972184 TI - Cell lineage of zebrafish blastomeres. III. Clonal analyses of the blastula and gastrula stages. AB - Aspects of the early lineages of blastomeres in the embryo of the zebrafish, Brachydanio rerio have been described. Because of the optical clarity of the embryo, lineages of selected cells can be followed directly by microscopy through many cell divisions. Also, it is shown here that the fluorescent molecules fluorescein-dextran and rhodamine-horseradish peroxidase can be used as cell lineage tracers, marking the clonal progeny of founding blastomeres. The labeled cells can be easily visualized in the live embryo, and utilizing a sensitive video camera to amplify fluorescence, the same clone may be examined repeatedly while the cells divide and migrate. Cells that descend from a single blastomere remain closely associated together through the end of the blastula stage. At the time when epiboly begins (early gastrula) cells in the labeled clone scatter and become dispersed among unlabeled cells. It has been observed that there is no invariant mapping of the embryo's midline (determined by the position of the embryonic shield in the gastrula) with respect to the early planes of cleavage. This finding shows that in the zebrafish the region of the embryo that a cell will occupy is not specified by the cell's early ancestory. PMID- 3972185 TI - Bone calcification and calcium homeostasis in rats with non-insulin-dependent diabetes induced by streptozocin. AB - The effect of mild, non-insulin-dependent diabetes (NIDDM) on bone calcification and calcium (Ca) homeostasis was studied in growing rats (males and females). The diabetic state was characterized by mild insulin deficiency, plasma levels being 73% of controls, and mild hyperglycemia, with nonfasting plasma glucose levels of 1.5 times normal. There was no difference in plasma levels of Ca, phosphate (Pi), magnesium (Mg), alkaline phosphatase, immunoreactive parathyroid hormone (iPTH), calcitonin, 25-(OH)vitamin D (25[OH]D), 1,25-dihydroxyvitamin D (1,25[OH]2D), and 24,25-dihydroxyvitamin D (24,25[OH]2D) between the NIDDM rats and their controls of either sex. Metabolic Ca and Pi balance studies revealed that the experimental animals of both sexes were in positive Ca and Pi balance similar to that of their controls. Histologic studies of the kidney and intestinal slices from the experimental group were normal. Ca and Pi bone content calculated per gram bone ash of the femur, mandible, and second and fourth caudal vertebrae, and the organic content in the bones of the NIDDM animals showed no difference from their controls. Femur bone density and tibial epiphyseal growth plate width and morphology were similar histologically in the experimental and control rats. No decreased osteoid content in the tibial bone was found in the diabetic rats compared with controls. Physiologic sex differences, consisting of lower plasma Pi, higher plasma calcitonin levels, increased ratio of femur dry bone weight to total body weight, and increased percentage of mineralized and total bone volume at the tibial metaphysis seen in female compared with male control rats were also seen in the diabetic animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972186 TI - Maturation of behavioral response. AB - The level of maturation of the auditory system markedly affects the results of all forms of infant hearing screening. The same test repeated in two weeks may yield significantly different results. The paper reviews some of the maturational changes which occur, considers male/female differences, and offers some normative developmental information about the preterm infant. PMID- 3972187 TI - Stimulus, response, and state variables in the testing of neonates. AB - This paper endeavors to answer three closely related questions: What motor behavior displayed by an infant may be considered to be a response to acoustic stimulation? What acoustic phenomena elicit such behavior? Does responsiveness vary with postconceptual age? Review of our work over the past decade reveals that we know the answers to the first two questions, but not the third. Briefly, arousal responses (eye and limb movements) are reliably elicited by wideband signals but not by narrowband signals. However, there is still confusion about whether preterm infants are more or less responsive than full term infants. PMID- 3972189 TI - Hearing-impaired babies and methods of communication. AB - Reviews the age of diagnosis and some of the philosophical arguments for and against newborn screening. Report results of a survey of parents on the question of early identification and interference with mother/child bonding. Finally, the paper reviews linguistic methods taught in Great Britain and presents data illustrating the advantage of an auditory/oral approach. PMID- 3972188 TI - The Crib-O-Gram in the NICU: an evaluation based on brain stem electric response audiometry. AB - This study evaluated the Crib-O-Gram as a screening test for hearing loss in NICU infants using Brain Stem Electric Response Audiometry (BERA) as the standard. Two Crib-O-Gram tests were administered to 280 babies within 48 hours of BERA testing. An additional 26 babies received BERA and one Crib-O-Gram test. Correlation coefficients for the two Crib-O-Gram scalar scores were calculated separately for a group of preterm (31 to 37 weeks) and a group of full term and older (38 to 54 weeks) infants, with values of 0.36 and 0.52, respectively. This indicates that the Crib-O-Gram has poor reliability for a screening test, particularly for preterm babies. Approximately one-third of babies with normal BERA thresholds failed Crib-O-Gram screening. The identification of hearing loss by Crib-O-Gram increased with the severity of the loss. Crib-O-Gram was able to identify moderately severe hearing losses in full term and older babies. PMID- 3972190 TI - Acquiring language through total communication. AB - Total communication provides an opportunity for very young children to receive training through both visual and auditory systems. Most children with severe hearing loss have auditory discrimination/perceptual problems in addition to a loss of hearing sensitivity. Because sophisticated assessment of auditory perceptual problems is not yet possible in hearing impaired infants, total communication provides immediate and consistent language input regardless of eventual determination of auditory perceptual skills. An illustration of a total communication program is provided. PMID- 3972191 TI - Diagnostic factors bearing on the use of cued speech with hearing-impaired children. AB - Cued Speech is a system which utilizes eight hand configurations and four locations of either hand for supplementing the visible manifestations of normal speech in such a way as to effectively eliminate the ambiguities of lipreading. Its effects upon language development and oral communication skills, supported by research data, suggest that it is a useful technique for inclusion in the array of tools available for use with young, hearing-impaired children. Use of diagnostic teaching, in addition to audiometric and other evaluations, is recommended for evaluation of conditions which suggest or discourage the choice of Cued Speech as a communication modality. Children are exposed to diagnostic teaching sequences in a progression which begins with auditory-only, then auditory/oral, then auditory/oral/cued speech, and finally (in some cases), manually coded English. In each stage, data should be collected on significant reactions and behavior for use in recommending a choice of communication mode. PMID- 3972192 TI - The role of the speech-language pathologist with hearing-impaired infants. AB - The educators of the deaf, the audiologists, and other similar professional groups appear to have reasonably clearly delineated roles to play in the management of the hearing-impaired child. Not so with the speech-language pathologist. This paper specifies such a role and offers a model for the delivery of speech-language pathology services to the hearing-impaired infant. PMID- 3972193 TI - The verbotonal method for management of young, hearing-impaired children. AB - The verbotonal method is effective for establishing good spoken language and listening skills. It is based on a developmental model of normal-hearing children, and emphasizes the importance of developing good rhythm, intonation and voice quality in hearing-impaired children. Specifically trained teachers/clinicians are combined with high quality amplification and vibrotactile input with System Universal Verbotonal Audition Guberina units. These units provide a wide frequency response with the option of modifying the frequency response through the cutoff frequency and slopes of filters to emphasize the optimal field of hearing of each hearing-impaired child. Through intensive intervention the rhythm and intonation patterns and the listening skills develop simultaneously. The goal is to integrate hearing-impaired children into regular educational and social situations. The integration rates are between 60 and 90%. The parents role is more supportive than therapeutic, and is designed to meet the needs and skills of each parent. PMID- 3972194 TI - Selecting amplification characteristics for young hearing-impaired children. AB - The task of selecting the electroacoustic characteristics of hearing aids for young hearing-impaired children continues to challenge many clinical audiologists. The rationale for a theoretically based approach to this problem is presented. Additionally, issues related to the choice of an idealized speech spectrum for a theoretical selection model are considered in relation to the acoustic environment and auditory needs of young hearing-impaired children. Finally, the preliminary version of a computer assisted speech spectrum approach, which facilitates the initial selection of frequency/gain and frequency/SSPL characteristics is presented. PMID- 3972195 TI - Interaction analysis of mother and hearing-impaired child. AB - Discusses a technique called "Interaction Analysis" and its application to hearing-impaired children and their families. The analysis focuses on six types of behavior: (1) protesting, (2) averting, (3) attending, (4) gestures, (5) vocalizations, and (6) touching. Case studies illustrate the method. PMID- 3972196 TI - The denial mechanism. AB - The paper explains parental use of denial of hearing impairment as a defense mechanism. It explains the clinician's role and influence at such a critical time, and offers suggestions and strategies for guidance. PMID- 3972198 TI - The pediatric audiologist: from magician to clinician. AB - The tremendous progress of pediatric-audiology during the past 30 years is reviewed. Early identification of infants with impaired hearing is based on a high-risk register, screening behaviorally and/or brain stem audiometry. Since many hearing losses have a late onset, it is important to cooperate closely with pediatricians and well-baby clinics. To stimulate their interest in detection, use of a calibrated 3000 Hz warble tone instrument is suggested. Diagnostic tests for infants involve respiration, behavioral patterns, middle ear impedance, and brain stem audiometry. For young children, tangible reinforcement operant conditioning audiometry (TROCA) visual reinforcement audiometry (VRA), and play audiometry are the methods of choice. Due to medical progress, many of the high risk factors have been ameliorated. Assessment of amplification for hearing impaired children is as sophisticated as for adults. The advantage of basing fitting procedures on functional gain is emphasized. Future goals in pediatric audiology are touched upon. Today, pediatric audiology has emerged from a mysterious beginning to a systematic clinical specialization. PMID- 3972197 TI - The role of the family physician--a front line view. AB - The role of the family physician in the identification and management of the hearing-impaired child is often misunderstood. This paper presents the family doctor's point of view, and explains some of the difficulties which that professional has in dealing with the hearing-impaired child. PMID- 3972200 TI - Simple steps to decrease computer downtime. PMID- 3972199 TI - Computer security: how safe are your records? PMID- 3972201 TI - The new frontier in management: cost accountability. PMID- 3972202 TI - NMR imaging: the next five years. PMID- 3972203 TI - Management information systems: new directions. PMID- 3972204 TI - Quality assurance at work: improving library services. PMID- 3972205 TI - St. Joseph's reviews BOND program incentives. PMID- 3972206 TI - Client satisfaction surveys: variables to watch out for. PMID- 3972207 TI - Nursing education. PMID- 3972208 TI - [Preparation of the general surgeon]. PMID- 3972209 TI - [Ciliary changes in interstitial pneumonia]. PMID- 3972210 TI - [Prophylaxis, detection and prevention]. PMID- 3972211 TI - Significance of diffuse granularity and nodularity of the esophageal mucosa at double-contrast radiography. AB - Out of 5000 consecutive double-contrast examinations of the esophagus, 50 cases presented a diffuse finely granular or nodular appearance of the mucosa. Endoscopy was subsequently performed in 38 cases and biopsy in the majority of these. In 23 of the 38 verified cases the diagnosis was reflux esophagitis. In the other 15 cases the diagnoses were: candidal esophagitis (4), leukoplakia (2), glycogenic acanthosis (1), and diffuse leiomyomatosis (1). A normal mucosa was demonstrated in 7 cases. Our study indicates that a radiologically granular or nodular appearance of the esophageal mucosa often indicates reflux esophagitis and less commonly identifies diffuse lesions of variable origin. PMID- 3972212 TI - Gastric interposition following transhiatal esophagectomy: radiographic evaluation. AB - Gastric interposition was achieved in 138 patients following transhiatal esophagectomy without thoracotomy. Among these, 33 had benign and 105 malignant lesions. All patients were evaluated on the 10th postoperative day with a barium swallow examination. However, if an anastomotic leak was suspected clinically before this time, a water-soluble contrast study was initially obtained. Early postoperative complications included anastomotic leaks (15), cricopharyngeal incoordination with aspiration (6), and gastric perforation (2). Late postoperative complications included anastomotic strictures (12), pyloric stenosis (4), recurrence of tumor (3), and transhiatal visceral herniation (2). Our technique of postoperative radiographic evaluation, particularly when a leak is suspected clinically, is discussed. PMID- 3972213 TI - Appearance of the intact lymphomatous stomach following radiotherapy and chemotherapy. AB - Gastric lymphoma can be treated effectively by a combination of chemotherapy and radiotherapy of the intact stomach; this often eliminates the need for gastrectomy. This article presents 21 patients with gastric lymphoma and compares the radiographic appearance of the intact stomach before and after treatment. There was a variable decrease in lymphomatous involvement of the stomach during the first several months after radiotherapy alone or in combination with chemotherapy. Gastric atrophy with diminished distensibility and constrictive changes was observed, but most remarkable was the appearance of linitis plastica. PMID- 3972214 TI - Computed tomography of chronic afferent loop obstruction: a case report and review. AB - The computed tomographic findings in a case of chronic afferent loop obstruction are presented. Multiple cystic abdominal masses which merge caudally are demonstrated. They display uniform diameter, thin rims, and attenuation numbers of water density. We agree with others who have advocated computed tomography as the investigative method of choice for this diagnosis. PMID- 3972216 TI - Gastric hemangioma associated with phleboliths. AB - We describe the third instance of successful preoperative diagnosis of gastric hemangioma based upon the identification of phleboliths associated with the lesion. Double-contrast radiographs of the stomach showed the extent of involvement by intramural hemangioma, which was subsequently resected. PMID- 3972215 TI - Crohn's disease involving the proximal stomach. AB - We report an unusual case of Crohn's disease of the esophagus and stomach. Unlike previously described cases, the disease in this patient affected the fundus and body while sparing the antrum of the stomach, and produced a mass effect simulating malignancy. PMID- 3972218 TI - Percutaneous abscess drainage. AB - We have drained 50 abscesses in 40 patients. The success rate was 100% for entering the abscess cavities and 98% for establishing catheter drainage. The success rate for treating the abscess (i.e., no surgery required) was 88%. We drained all abscesses for which a safe access route was available, regardless of the abscess's characteristics. Abscesses which are not unilocular may be successfully treated by percutaneous drainage. In critically ill patients and those unsuitable for surgery, catheter drainage is useful until the patient becomes stable. When surgery is not feasible, percutaneous procedures may be the patient's only hope for survival. PMID- 3972217 TI - Giant aneurysm of the splenic artery and huge varix. AB - Giant aneurysm of the splenic artery and huge varix accompanied by portal hypertension and splenomegaly are described. Computed tomography proved to be an ideal tool in the evaluation of both aneurysm and varix. Enhancement scan revealed giant aneurysm as a round mass in the splenic hilus and huge varix as one oval and one bell-shaped shadow adjacent to the spleen. They were diagnosed by angiography. PMID- 3972219 TI - Manometrically guided colon insufflation during double-contrast barium enemas. AB - The double-contrast enema's potential for high accuracy depends in part on consistently good inflation of the colon. However, optimal inflation is often not obtained because of deflation during filming, underinflation because of fear of perforating the colon, or patient discomfort. To help meet the dual requirements of ensuring consistently good bowel inflation while avoiding over-inflation, we have designed a modified insufflator which incorporates a manometer and allows accurate readings of intraluminal large-bowel pressures during or following insufflation. In more than 3000 examinations using this method we have experienced no complications. PMID- 3972220 TI - Roentgenographic features of acute nonobstructive appendicitis: a case report. AB - We document a case of acute nonobstructive appendicitis and critically evaluate the pertinent literature. Although undoubtedly a rare entity, nonobstructive appendicitis may occur and should be differentiated from a normal appendix by barium enema examination. Mucosal and intramural inflammatory abnormalities are described which permit the diagnosis of nonobstructive appendicitis. PMID- 3972221 TI - Effect of ileal infusion of intralipid on gastrointestinal transit, ileal flow rate, and carbohydrate absorption in humans after ingestion of a liquid meal. AB - The effects of ileal infusion of Intralipid on the time required for a radiolabeled liquid starch meal to empty from the stomach and reach a point in the ileum that was 230 cm from the teeth and on the ileal flow rates and the degree of carbohydrate absorption were measured in 5 normal volunteers. The subjects were intubated with a four-lumen polyvinyl tube. Studies were carried out on consecutive days in random order. Infusion of fat into the ileum (a) slowed the transit of a liquid meal through the stomach, (b) delayed the arrival of the liquid meal in the ileum and increased its residence in the upper small intestine, (c) reduced the average flow of digesta through the upper small intestine and altered the pattern of flow, (d) reduced the volume of the meal entering the ileum, and (e) reduced the degree of carbohydrate absorption in the upper small intestine. These results suggest that the presence of fat in the ileum may have a profound influence on the digestion and absorption of a meal. PMID- 3972222 TI - Mechanical activity of muscular "patch pouches" from cat and rabbit stomachs. AB - With a newly developed preparation (the gastric patch pouch), we compared the mechanical response of the proximal with that of the distal stomach to volume loads, drugs, and stimulation by an electrical field. Squares, 2 X 2 cm, were cut from the anterior and posterior walls of stomachs from cats and rabbits; the corresponding edges of opposing squares were sewn together. A luminal balloon served to change pouch volume and to monitor pouch pressure. Filling increased the width more than the length of most pouches; this difference was particularly marked in pouches from the rabbit fundus. Filling led to an initial pressure peak, after which pressure declined to a new baseline pressure plateau; emptying led to an initial pressure nadir, pressure recovery, and baseline pressure plateau. The difference between initial pressure and plateau pressure was larger in proximal than in distal pouches: hence, baseline pressures rose more sharply on filling and declined more steeply on emptying of antral than of proximal pouches. Pressure waves occurred in all antral pouches of cats and in some antral pouches of rabbits. Carbachol enhanced the pressure waves and isoproterenol inhibited them. In the fundic pouches, these drugs altered primarily the baseline pressure. Electrical field stimulation caused a relaxation in fundic pouches and a suppression of rhythmic contractions in antral pouches. The onset and the duration of nervous inhibition was comparable in fundic and in antral pouches. The baseline pressure of pouches was not affected by the presence or by the absence of the mucosa. This novel preparation is suitable to demonstrate differences in the volume-pressure relationships of the muscle coat of the proximal and the distal stomach. PMID- 3972223 TI - Shunt fascicles in the gastric myenteric plexus in five species. AB - Thick nerve bundles, called shunt fascicles, lie in the myenteric plexus of the stomach in guinea pig, rabbit, cat, opossum, and cynomolgus monkey. They enter the stomach at the cardia, either as extensions of the esophageal myenteric plexus or of vagal branches to the caudal esophagus, and radiate toward the greater curvature. They bypass ganglia in the orad part of the stomach but give off branches to ganglia in more caudad parts. They are more abundant in the gastric fundus and body than in the antrum; they are infrequent along the greater curvature of the antrum. About 4% of the fibers they contain are myelinated. Arterioles and venules follow shunt fascicles and give rise to perifascicular capillary networks. Shunt fascicles are prominent in the cat, opossum, and monkey; they are short, thin, and sparse in the rabbit and guinea pig. They do not appear to be extensions of the direct vagal branches to the stomach but may be special nerve pathways from the esophagus to parts of the stomach. PMID- 3972224 TI - Hepatic venocclusive disease associated with the consumption of pyrrolizidine containing dietary supplements. AB - Venocclusive disease, a form of Budd-Chiari syndrome, was diagnosed in a 49-yr old woman. The patient had portal hypertension associated with obliteration of the smaller hepatic venules. A liver biopsy specimen showed centrilobular necrosis and congestion. Analysis of food supplements the woman regularly consumed showed the presence of pyrrolizidine alkaloids. The major source was a powder purporting to contain ground comfrey root (Symphytum sp). We calculated that during the 6 mo before the woman was hospitalized, she had consumed a minimum of 85 mg of pyrrolizidine alkaloids (15 micrograms/kg body wt X day). The clinical and analytic findings were consistent with chronic pyrrolizidine intoxication, indicating that low-level, chronic exposure to such alkaloids can cause venocclusive disease. PMID- 3972225 TI - Cholangitis associated with Cryptococcus neoformans. AB - A 15-yr-old girl presented with complaints of right upper quadrant pain and jaundice. Elevation of serum alkaline phosphatase, signs of protal hypertension, and computed tomographic scan findings suggested a diagnosis of primary sclerosing cholangitis. However, cultures of the bile and of the common bile duct specimen obtained during a surgical procedure grew Cryptococcus neoformans. Treatment with amphotericin B was begun. An episode of upper gastrointestinal bleeding, however, led to the hepatorenal syndrome, and the patient died before antifungal therapy was completed. At autopsy, active sclerosing cholangitis associated with cryptococci involved the common bile duct. We suggest that opportunistic infection of the biliary tree should be considered in pediatric patients with presumed primary sclerosing cholangitis. PMID- 3972227 TI - Hyporesponse to hepatitis B vaccine. PMID- 3972226 TI - Epithelioid leiomyosarcoma originating in a hamartomatous polyp from a patient with Peutz-Jeghers syndrome. AB - A case of Peutz-Jeghers syndrome with long history and multiple resections is presented. Despite the large number of intestinal polyps in these patients, malignant transformations are rare. In this case, an epithelioid leiomyosarcoma developed within a single polyp. At the time of resection this tumor had already metastasized to the liver. The histology and ultrastructure of this tumor is presented. Reviews of the clinical syndrome and leiomyosarcoma are given, with discussion of the possible interaction of these two processes as presented in this patient. PMID- 3972228 TI - Clinical and morphologic effects of amiodarone on the liver. PMID- 3972229 TI - Choledochocele: its clinical spectrum. PMID- 3972230 TI - Gastric emptying of solid radiopaque markers in diabetic patients. PMID- 3972231 TI - Recombinant leukocyte a interferon treatment in patients with chronic hepatitis B virus infection. Pharmacokinetics, tolerance, and biologic effects. AB - Large doses of recombinant leukocyte A interferon were administered to 20 patients with deoxyribonucleic acid polymerase- and hepatitis B e antigen positive chronic hepatitis B to study the maximum tolerated dose, its pharmacokinetics, and its antiviral activity. The first group of 5 patients received a constant dose of 36 X 10(6) U/day for 28 consecutive days. When it was well tolerated, the second, third, and fourth groups (5 patients each) received 50, 72, and 100 X 10(6) U/day, respectively. All 20 patients completed the 28-day treatment. Hourly and daily profile of serum interferon level showed a dose dependent effect with an increasing dosage, and cumulative effects during the treatment. The mean peak serum interferon concentration ranged from 93 U/ml on day 1 in the first group to 1271 U/ml on day 28 in the fourth group. Inhibition of serum deoxyribonucleic acid polymerase activity and hepatitis B virus deoxyribonucleic acid during the treatment was compared between the groups with low doses (36 and 50 X 10(6) U) and high doses (72 and 100 X 10(6) U). Low doses of interferon suppressed deoxyribonucleic acid polymerase activity to the same extent as did the high doses. Prednisolone withdrawal was combined with interferon in 5 patients. Three patients treated with such combination became seronegative for hepatitis B e antigen during the treatment, whereas all 15 with interferon alone remained seropositive. These results suggest that a maximum antiviral effect of recombinant leukocyte A interferon is below the maximum tolerated doses. PMID- 3972232 TI - Oxygen supply to the liver in patients with alcoholic liver disease assessed by organ-reflectance spectrophotometry. AB - In the present study we have investigated hepatic hemodynamics in patients with alcoholic liver disease using reflectance spectrophotometry and the hydrogen clearance method. Analysis of 38 cases has shown that estimated regional hepatic tissue hemoglobin concentration, expressed as a difference in absorbance between 569 and 650 nm (delta Er569-650), decreased significantly with progress of fibrosis or fat accumulation in the liver. This suggests that the relative compression of the vascular compartment is due to the progress of alcoholic liver disease. Estimated hepatic hemoglobin concentration also correlated positively with prothrombin time, and negatively with serum gamma-globulin level and 15-min retention rate of indocyanine green. The difference in absorbance between 569 and 650 nm obtained by reflectance spectrophotometry was positively correlated with the regional hepatic blood flow as measured by the hydrogen clearance method. Thus, it is concluded that the estimated regional hepatic-tissue hemoglobin concentration decreases with progress of fibrosis and fat accumulation in the liver, and that this decreased oxygen supply to the liver may have an important role in the progress of alcoholic liver disease. PMID- 3972233 TI - Omeprazole: effective, convenient therapy for Zollinger-Ellison syndrome. AB - The acute and long-term effects of omeprazole on gastric acid secretion were examined in 11 patients with Zollinger-Ellison syndrome. Basal gastric acid secretion was inhibited by 50% 3 h after a single 60-mg dose of omeprazole and 78% 4 h after administration of omeprazole. Patients were treated with a single daily dose of omeprazole, and the dose requirement was defined as the lowest dose of omeprazole that would reduce gastric acid secretion to less than 10 mEq/h during the last hour before the next dose. The mean daily dose requirement was 70 mg (range 20-160 mg). Ten of the 11 patients were given omeprazole once a day and 1 patient required omeprazole every 12 h. When omeprazole was discontinued after several months of therapy, mean basal gastric acid secretion was inhibited by greater than 50% 48 h after administration of omeprazole. Omeprazole continued to inhibit gastric acid secretion during 1-9 mo of therapy and patients remained free of toxicity or side effects related to omeprazole. Omeprazole is a highly effective inhibitor of gastric acid secretion in patients with Zollinger-Ellison syndrome. Because of its potency and long duration of action, omeprazole offers an advance in convenient medical therapy for Zollinger-Ellison syndrome compared with the histamine H2-receptor antagonists. PMID- 3972234 TI - Elevated serum and antral gastrin in obese (ob/ob) mice. AB - Elevations in serum gastrin concentration of six to seven times were found in postabsorptive 5- and 10-wk-old, but not 30- and 40-wk-old, obese mice in comparison with the appropriate lean controls. At 10 wk of age a fourfold hypergastrinemia was also evident in (ob/ob) mice denied food for 48 h. In 10-wk old (ob/ob) mice that had eaten the same amount of food as lean mice from weaning, serum gastrin was six times that of lean controls. Antral gastrin concentration was 54% higher in fed 10-wk-old (ob/ob) mice than in lean mice. No relationship was found between alterations in serum gastrin and measures of gastrointestinal size or proliferative status. Maximal gastric acid output, expressed with respect to oxyntic mucosal dry weight, was reduced by 52% in 10-wk old (ob/ob) mice compared with lean controls. It is concluded that the hypergastrinemia of 10-wk-old (ob/ob) mice is not caused by hyperphagia, but may be a consequence of reduced acid inhibition of gastrin release. PMID- 3972236 TI - Intestinal spirochetosis of the vermiform appendix. AB - A series of 681 surgically removed appendices were examined for spirochetes. Five hundred seventy-four appendices were removed because of suspected acute appendicitis; the rest were removed per occasionem. One hundred six of the former were histologically normal, whereas 421 showed acute appendicitis. The remaining 47 specimens showed a variety of other pathological conditions, for example, tumors and diverticula. Spirochetes were found in 13 (12.3%) of the appendices removed from patients clinically suspected to suffer from acute appendicitis, but whose appendices were otherwise histologically normal (pseudoappendicitis). Only 3 patients (0.7%) with histologically confirmed acute appendicitis (p less than 0.05) did show spirochetes in their appendices. Of the 107 patients who had their appendices removed per occasionem, 2 patients (1.9%) had spirochetosis (p less than 0.05). The ultrastructure of the spirochetes obtained from appendices with spirochetosis was studied by means of negative staining and ultrathin sectioning. The morphology of these spirochetes was very similar to that of Brachyspira aalborgi, a spirochete recently isolated from rectal biopsy specimens obtained from patients with colorectal spirochetosis. PMID- 3972235 TI - Functional and structural changes in intestinal smooth muscle after jejunoileal bypass in rats. AB - Active stress and cross-sectional area of intestinal muscle were assessed in tissues taken from unoperated rats, from rats that had undergone bypass of 70% of the small bowel, and from rats that had undergone transection and anastomosis of the bowel. Thirty-five days after operation, muscle from the intestine of transected and bypassed animals elicited active stresses that were equal to or greater than those developed by muscle taken from unoperated animals. The total cross-sectional areas of the in-continuity segment and the area and thickness of the muscle layers of both the in-continuity and bypassed segments were greater when compared with unoperated animals. Significant differences also existed among tissues taken from bypassed and transected animals. Additionally, transection induced increases in active stress, area of muscle in the distal intestine, and circular muscle thickness in the mid- and distal intestine when compared with tissues from unoperated animals. These findings support the hypothesis that intestinal bypass induces increases in functioning smooth muscle tissue. PMID- 3972238 TI - Elevations in gonadotrophin concentrations and milt volumes as a result of spawning behavior in the goldfish. AB - In many male mammals and birds, exposure to sexual stimuli results in acute elevations of circulating luteinizing hormone (LH) and testosterone (T); a similar phenomemon has now been observed in the male goldfish (Carassius auratus). Mature males placed with either a receptive female or stimulus pairs of spawning goldfish had gonadotrophin (GtH) concentrations and expressible milt (sperm) volumes that were significantly greater than those of males kept in all male groups. This stimulatory effect lasted from 20 min to at least 2 hr for GtH (20 degrees) and from less than or equal to 1 hr to greater than or equal to 24 hr for milt (14 degrees). When males were separated from the spawning pair by either a solid or perforated clear partition, no elevations of GtH or milt levels occurred. In contrast, these values increased in males placed in contact with a spawning pair, even when that pair contained no female, but a male induced to perform female sexual behavior by treatment with prostaglandin. These results suggest that, in goldfish, access to a spawning situation is necessary for rapid elevations in GtH and milt. Furthermore, it appears that the males must be sexually active in order for these physiological changes to occur, as males that failed to engage in courtship behavior with a spawning pair had GtH and milt values not different from isolated fish. This suggests that male sexual behavior and elevations in milt and GtH are concurrent events that share a common activation pathway in the brain. The increase in milt may be due to both neurally and hormonally mediated events that ensure milt availability for imminent spawning activity. PMID- 3972237 TI - Duodenal ulcerogens cysteamine and propionitrile induce gastroduodenal motility alterations in the rat. AB - The effects of the duodenal ulcerogens cysteamine and propionitrile on gastroduodenal myoelectric activity and intraluminal pressure in the fasted rat as well as on contractility of isolated gut muscle strips were investigated. Duodenal ulcerogens, unlike the nonulcerogen but toxic analogue ethanolamine, caused an early disruption of the myoelectric migrating complex, a marked increase in the spiking activity, and a decrease in the frequency of the slow waves in the duodenum. Both the increased spiking activity and the decreased slow wave frequency were dose dependent for cysteamine. Manometrically recorded contractions at the stomach corpus, midantrum, and antropyloric region as well as in the proximal duodenum of the conscious rat showed decreased contractions at the corpus and midantrum and an increase at the pyloric and duodenal sites during an intravenous infusion of cysteamine. In vitro studies demonstrated that circularly or longitudinally cut muscle strips taken from different regions of the stomach and duodenum responded to cysteamine with increased contractility. In summary, the duodenal ulcerogens cysteamine and propionitrile rapidly induce motor abnormalities in the stomach and duodenum of the rat. In vitro studies suggest that a cholinergic mechanism may be involved. It is possible that motor changes play a role in the pathogenesis of the experimentally induced duodenal ulcers. PMID- 3972239 TI - Neuroendocrine control of glycogen mobilization in the freshwater snail Lymnaea stagnalis. AB - In the freshwater snail Lymnaea stagnalis the anterior mantle region, which mainly consists of large numbers of special glycogen-storing cells, is an important depot for the energy reserves of this snail. In organ culture experiments the central nervous system (CNS), in contrast to other tissues, both inhibits glycogen synthesis (measured as incorporation of [14C]glucose into glycogen) and stimulates glycogen breakdown in anterior mantle tissue (measured as a decreased retention of prelabeled glycogen). These effects are dose dependent, with saturation at the highest doses tested. High-potassium Ringer solution stimulates the secretion of a CNS factor which induces glucose release by anterior mantle tissue. This glucose-release-stimulating effect of the CNS is also dose dependent, but saturation of the response was not achieved. It is concluded that inhibition of glycogen synthesis and stimulation of glycogen breakdown and glucose release are probably effects of a single neurohormone which controls glycogen mobilization from the storage cells in the mantle. Like similar factors in other animal phyla, this putative neurohormone is referred to as a hyperglycemic factor. PMID- 3972240 TI - A factor from bursa of Fabricius inhibits in vitro the chorionic gonadotropin response of the chick testis. AB - The effect of bursa of Fabricius on the endocrine function of the chick testis was studied using an isolated testis cell preparation. Testosterone secretion, both basal and under hCG stimulation, was measured in the incubation medium. The bursal extract inhibited the response of the testis cells to hCG detected as a reduced testosterone secretion. The normal basal secretion of the testis cells was not modified by the bursal extract. To analyze some characteristics of the bursal factor, fractions of approximately known molecular weight were obtained by filtering through Amicon membranes. The active factor was found in the fraction corresponding to 1000-10000 Da. Its activity disappeared after heating of trypsin incubation, suggesting the peptidic nature of the bursal factor. Tissue extracts from gut and spleen did not modify the hCG response of the testis cells. There was inhibition of the hCG response by thymus extracts of the newly hatched chicken. These results add new evidence of a modulatory effect of the immunogenic organs on the endocrine function of the testis in the newly hatched chicken. PMID- 3972241 TI - Pituitary cysts in the sea lamprey of the Great Lakes, Petromyzon marinus L. AB - Large epidermal cysts that occur in the adenohypophysis of spawning lampreys develop as a consequence of destructive invasion of the parenchyma by an epithelium derived from the same anlage as the medial nasopharyngeal duct. The lumina of the cysts contain a carbohydrate-rich secretory material which is a mixture of epithelial mucins. An array of histochemical methods was used to show the kinship of the cysts with the mucin-secreting epidermis of the duct. These cysts appear to be unique to the cyclostomes and to have no obvious adaptive benefit. PMID- 3972242 TI - Seasonal variations in parameters of milt production and in plasma concentration of sex steroids of male rainbow trout (Salmo gairdneri). AB - Concentrations of testosterone (T), 11-ketotestosterone (11-KT) and 17 alpha hydroxy-20 beta-dihydroprogesterone (17 alpha 20 beta P) were measured by a direct radioimmunoassay technique in the plasma of male rainbow trout, Salmo gairdneri, from two winter-spawning strains and one autumn-spawning strain. There was no evidence that milt production, its volume and density or the ionic composition of the seminal plasma could be related to the levels of 11-KT or T. Peak plasma T levels were reached just before production of milt could first be detected by handstripping. The concentration of 17 alpha 20 beta P remained elevated throughout the period of milt production and there was evidence that this steroid might be associated with the control of the ionic composition of seminal plasma. PMID- 3972243 TI - Environmental and hormonal control of the seasonal egg laying period in field specimens of Lymnaea stagnalis. AB - A study has been made in field specimens of Lymnaea stagnalis of the relationship between environmental factors (temperature, photoperiod, and food) and spontaneous ovipository activity as well as oviposition evoked by injection of the ovulation hormone (CDCH) during a 1-year cycle. It appeared that spontaneous egg laying started in mid-May and ended in mid-September. It is concluded that it is the quantity of assimilated food that triggers the onset of the egg laying season. Its termination is very likely determined by a synergistic action of environmental factors. It is suggested that these factors control the activities of the CDCH-producing neuro-endocrine caudo-dorsal cells. In winter the snails are completely insensitive to injected CDCH, although many large oocytes are present in the gonad. During 2 months before and after the egg laying season, however, many injected snails respond to CDCH. It is argued that these phenomena are caused by changes in the activities of the endocrine dorsal bodies, which control vitellogenesis and the activities of the female accessory sex organs. The changes in the activities of the dorsal bodies are probably controlled by the synergistic actions of the previously mentioned environmental factors. Oviposition latency (interval between CDCH injection and start of oviposition) is much shorter during the egg laying season than in the nonreproductive period. This must be ascribed to the direct effects of temperature. PMID- 3972244 TI - Enhanced triiodothyronine production in crested newts bearing permanent lesions to the anterior preoptic area. AB - In the crested newt, permanent lesions to the anterior preoptic area brought about an enhancement of triiodothyronine (T3) production. This was not mediated by prolactin, since the effect was demonstrable also in ergocryptine (CB 154) treated animals. The observed rise in circulating T3 levels in the ergocryptine treated surgical animals confirms that lesions to the anterior preoptic area stimulate pituitary thyrotrophic activity, resulting in the activation of the thyroid gland. PMID- 3972245 TI - Plasma cortisol levels of female rainbow trout (Salmo gairdneri) at the end of the reproductive cycle: relationship with oocyte stages. AB - The concentrations of plasma cortisol were determined in two populations of female rainbow trout at the end of their reproductive cycles. In females ending vitellogenesis or having oocytes with germinal vesicles in peripheral positions, mean cortisol levels were low (about 8 to 10 ng/ml). Cortisol concentrations remained low during oocyte maturation (about 8 and 11 ng/ml). In contrast, a 3 fold cortisol increase was observed in females sampled in the postovulation period (about 26 and 31 ng/ml). These results are discussed in relation to other studies on endocrinological changes during the spawning season with emphasis on the possible role of cortisol in reproduction in female teleosts. PMID- 3972246 TI - Effect of 17 alpha-methyltestosterone on the skin and gonads of freshwater male silver eels. AB - Male silver eels kept in fresh water (FW) were injected with 17 alpha methyltestosterone (MT). They received 5, 10, 15, or 20 injections (8 micrograms/g every other day) or 6 or 9 injections (4 or 2.5 micrograms/g once a week) and were killed 24 hr after the last injection. Compared to solvent injected controls, the treated eels appeared darker, the eye diameter was enlarged, the head and the pectoral and caudal fins were black and the melanophore index was maximal. The thickness of the skin (epidermis plus dermis) was significantly increased. Macroscopically, the organs of Syrski (juvenile testes) were slightly larger and less translucent, but the maximal gonosomatic index reached only 1-1.2 in two fishes. Stimulation started in the anterior part of the gonad. Microscopically, all stages of spermatogenesis and spermiogenesis were observed. After 20 injections (high dose, 40 days) or 6 (one case only) and 9 injections (low dose, 57 days), spermatids and spermatozoa were present. These positive results are compared to the negative data previously reported in other countries. The mode of action of the androgen is discussed. It is suggested that it acts for the most part directly on the gonad, but a participation of the pituitary cannot be ruled out, although gonadotrophs appeared only slightly stimulated. PMID- 3972248 TI - Zinc nutriture in the elderly. AB - Emerging national attention to problems of aging in the mid-to-late 1970s stimulated research to better define zinc status and requirements of the older population. The commercial exploitation of hair analysis as a way to diagnose trace element deficiencies is unfortunate. Although hair zinc levels have been useful in comparing zinc status of population groups, usefulness of this technique with respect to assessment of the individual is extremely limited. PMID- 3972247 TI - Translocations in Dictyostelium discoideum. AB - Fourteen translocations of independent origin were identified in Dictyostelium discoideum on the basis of segregation anomalies of diploids heterozygous for these chromosome rearrangements, all of which led to the cosegregation of unlinked markers. Many of these translocations were discovered in strains mutagenized with MNNG or in strains carrying mutations affecting DNA repair; however, spontaneous translocations were also obtained. Haploid mitotic recombinants of the rearranged linkage groups were produced from diploids heterozygous for the translocations at frequencies of up to 5% of viable haploid segregants; this is at least a ten-fold higher frequency than that seen with diploids not heterozygous for translocations (approximately 0.1%). These haploid recombinants included both translocated and nontranslocated strains. The T354(II, VII) translocation and possibly the T357(IV, VII) translocation reduce the chromosome number to n = 6; haploids carrying 11 other translocations all have karyotypes with n = 7. Genetic characterization of the T357(IV, VII) translocation showed that the bwnA and whiC loci normally found on linkage group IV were physically linked to the linkage group VII loci couA, phgA, bsgB and cobA. PMID- 3972249 TI - Managing geriatric hypertension: a brief review. AB - The possibility of "pseudo hypertension" should be suspected in geriatric patients who, despite high blood pressure measurements, have vessels that feel rigid, have minimal vascular damage in the retina or elsewhere, and who experience inordinate postural dizziness despite cautious therapy. It should be remembered that sluggish baroreceptor function and reduced cardiovascular sensitivity to catecholamines make the elderly more sensitive to natural or drug induced falls in blood pressure. PMID- 3972250 TI - Total joint replacement: latest developments for the geriatric patient. AB - Total joint replacement has significantly improved the treatment of patients with severe, disabling arthritis. Following replacement of the hip, knee, shoulder, or elbow, the vast majority of patients can expect excellent pain relief and functional improvement. The components of a successful total joint replacement include proper patient selection, optimal preoperative and postoperative management of associated medical problems, meticulous surgical technique, a comprehensive rehabilitation program, and proper prophylaxis against infection. PMID- 3972251 TI - Supraventricular tachyarrhythmias: atrial flutter and atrial fibrillation. AB - Symptoms range from mild palpitations to overt cardiac failure and cardiogenic shock, depending on the ventricular rate and the patient's underlying cardiac status. Drug therapy is the mainstay treatment. In atrial fibrillation, digoxin is used to control the ventricular response and therefore improve cardiac function. Verapamil may also be used for this purpose. PMID- 3972252 TI - Effect of heating on the contractile properties of triceps surae and maximal power output during jumping in elderly men. AB - The electrically evoked contractile properties of the triceps surae and short term (less than 2 s) maximal power output during vertical jumping have been examined before and after heating (by water immersion) in 5 elderly men aged 70 +/- 5 years. Leg immersion in water at 44 degrees C for 30 min produced a 3.4 degrees C rise in muscle temperature (Tm) and was associated with a significant (p less than 0.001) reduction in maximal time to peak tension and half relaxation time of the twitch, but was without affect on maximal twitch, tetanic (20 and 50 Hz) and voluntary tensions. However, at 10 Hz maximal tetanic tension was reduced (p less than 0.05) from 604 +/- 104 to 422 +/- 142 N. During vertical jumping from a force platform, peak power output (W) was significantly (p less than 0.05) increased from 1,155 +/- 212 to 1,381 +/- 307 W after heating. The rise in W was due to a small increase in both take-off velocity and the exerted force, and was reflected in a 3-cm increase in the height jumped from the force platform. It is concluded that the contractile characteristics of elderly triceps surae can be modified by heating and a rise in Tm does effect a change in the capacity of the muscle to generate power. PMID- 3972253 TI - Age-related incidence of reperfusion- and reoxygenation-induced ventricular tachyarrhythmias in the isolated rat heart. AB - Reperfusion- and reoxygenation-induced ventricular tachyarrhythmias were studied on 6-month-old (adult) and 24-month-old (senescent) Langendorff perfused rat hearts. The incidence of arrhythmias was significantly higher in the group of senescent hearts. Furthermore, the reperfusion- and reoxygenation-induced contracture was also more frequent in the group of senescent hearts. The interrelation between contracture and arrhythmias might represent an indirect evidence to suggest that alterations in cell calcium homeostasis have an important role in the origin of both phenomena and, possibly, in their increased incidence in the senescent heart. PMID- 3972254 TI - Effect of donor age on clonal differentiation of human skin fibroblasts in vitro. AB - Human skin fibroblasts of about the same population doubling level, derived from donors of different age, were cloned. After 14 days of growth, the clones were morphologically classified, and cell counts were performed. Significant differences between the three age groups (infant, young adult, old adult) examined concerned the percentual clone type distribution. The size of a single clone depended on the clone type referring to the differentiation level of the cells in all age groups. PMID- 3972256 TI - The effect of age on the cardiovascular responses to isometric exercise: a test of autonomic function. AB - Isometric exercise, promulgated as a test of autonomic function, has not been investigated in the elderly. Increasing age does not affect the cardiovascular responses to isometric exercise. Variability studies during fatiguing isometric exercise confirm that it is a valuable test of autonomic function in the elderly. PMID- 3972255 TI - The effect of age on the circadian rhythms of 23 liver or brain enzymes from C57BL/6J mice. AB - Mice were standardized to 12 h of light exposure alternating with 12 h of darkness and were fed ad libitum. The mice in the first group were 8 weeks old and in the other 104-116 weeks old. Subgroups of 7 animals from each age group were killed at 6 circadian stages. Enzyme activities of 23 enzymes from liver or brain were measured by an analysis of variance for each age group. All but 1 enzyme from young mice, and all but 9 from older mice showed significant changes over time (p less than 0.01). The data from the 22 enzymes from young mice and the 14 enzymes from old mice were fit to the cosinor regression model to further characterize the rhythm. 15 enzymes from the young and 8 from the aged mice showed a significant regression to a 24-hour cosine curve (p less than 0.01); of the 8, 7 were the same enzymes in both groups. Amplitude changes, where they could be compared from the cosinor data (7 enzymes), were not statistically different. When total variance was compared, 12 enzymes showed unequal variance. Of these, old mice had the larger variance in 9 enzymes. Another difference between the young and the old was changes in mean enzyme activities. 12 enzymes from aged mice had decreased mesors, 2 had increased mesors, and 9 were unchanged. In general, our data suggest that some enzyme activity rhythms were lost, others were altered and a few were not affected by aging. In the case of many enzymes, older mice have a diminished ability to synchronize to the light signals. PMID- 3972258 TI - [Cardiovascular function of female telephone operators in the information service during work]. PMID- 3972257 TI - Body composition in elderly people. I. Determination of body composition by multiisotope method and the elimination kinetics of these isotopes in healthy elderly subjects. AB - The body composition of 40 healthy elderly and 20 healthy young subjects was determined and compared. It was found that the age-related changes were more marked in females than in males. Total body water was decreased as a consequence of diminished lean body mass. Extracellular fluid volume remained unchanged, while plasma volume increased. Thus, the liquid components of lean body mass were redistributed between the intracellular and extracellular spaces. The elimination kinetics of isotopes were not significantly different between young and aged subjects, except the elimination of radiosulfate. PMID- 3972259 TI - [Diagnosis of congenital lung pathology in patients with dust-induced lung diseases]. PMID- 3972260 TI - [Phenotypic variability in the content of the serum protein haptoglobin in exposure of the body to exogenous and endogenous factors]. PMID- 3972261 TI - [Characteristics of the course of chronic hepatitis in workers coming in contact with florine compounds]. PMID- 3972262 TI - [Aspects of assessing homeostatic function in acute peroral poisonings]. PMID- 3972263 TI - [Effect of the types of agricultural work on the functional indices of the gastroduodenal system in healthy persons and peptic ulcer patients]. PMID- 3972264 TI - [Interaction of chromium and silver in the body (an experimental study)]. PMID- 3972266 TI - [Physiological basis for the standard number of workers servicing metallurgy equipment]. PMID- 3972265 TI - [Significance of the petrographic and elemental composition of anthracite in assessing its pathogenic action (experimental research)]. PMID- 3972267 TI - [Cardiovascular reaction in an orthostatic test on persons with varying levels of general physical work capacity]. PMID- 3972268 TI - [Early diagnosis of chronic vinyl chloride poisoning]. PMID- 3972269 TI - Comparison of weight, depth, and diagnostic adequacy of specimens obtained with 16 different biopsy forceps designed for upper gastrointestinal endoscopy. AB - The influence of endoscopic forceps variables (size, design, and make) on biopsy specimen weight, depth, and diagnostic adequacy has been studied in vitro on normal human stomach, and in vivo at endoscopy in dog and in patients. Greater pressure during the biopsy procedure yielded significantly heavier, deeper, and histologically more acceptable specimens. Standard sized forceps (diameter 2.4 mm) and those with ellipsoid cups consistently produced larger specimens than the smaller 'paediatric' forceps (1.8 mm) and those with round cups. Deeper specimens were also obtained using the standard forceps. In vitro and in vivo in the dog, the standard sized forceps also produced specimens of greater diagnostic adequacy than the paediatric forceps. At endoscopy in patients, however, we could not detect any influence of the size, shape, and presence of forceps spike or fenestration on the diagnostic adequacy of the specimens. PMID- 3972270 TI - Acid and gastrin responses during intragastric titration in normal subjects and duodenal ulcer patients with G-cell hyperfunction. AB - Amino acid induced acid and gastrin responses during intragastric titration at pH 2.5 and 5.5 were compared in normal subjects and duodenal ulcer patients with G cell hyperfunction. The latter were identified on the basis of raised basal or maximal acid outputs and increased gastrin responses to feeding. In normal subjects the mixed amino acid meal stimulated only modest increases in serum gastrin, and the highest observed increase was about 30% that after a standard meal. In contrast, in the G-cell hyperfunction group the highest gastrin concentrations were similar to those after a standard meal. In the G-cell hyperfunction group the increment in serum gastrin at pH 2.5 expressed as a proportion of that at pH 5.5 was 0.29 indicating that the capacity of acid to inhibit gastrin release was well established in these patients. Acid secretory rates were close to maximal at both pH 2.5 and 5.5 during intragastric titration in the ulcer patients, but in normal subjects acid output was about 50% maximal at 2.5 and close to maximal at 5.5. The results suggest that the enhanced gastrin response to feeding in G-cell hyperfunction patients is because of increased sensitivity to amino acid stimulation rather than to diminished acid-inhibitory mechanisms. PMID- 3972272 TI - Elastosis in diverticular disease of the sigmoid colon. AB - Diverticular disease of the sigmoid colon is an increasingly common clinical problem in the ageing population of western industrialised countries but the mechanism by which the disease develops remains unknown. The muscular abnormality is the most striking and consistent feature and this has been studied by light and electron microscopy in 25 surgical specimens of uncomplicated diverticular disease and in 25 controls. This is the first ultrastructural study of human colonic muscle to be published and shows that the muscle cells in diverticular disease are normal; neither hypertrophy nor hyperplasia is present. There is, however, an increase in the elastin content of the taeniae coli by greater than 200% compared with controls: elastin is laid down between the muscle cells and the normal fascicular pattern of the taeniae coli is distorted. There is no alteration in the elastin content of the circular muscle. As elastin is laid down in a contracted form, this elastosis may be responsible for the shortening or 'contracture' of the taeniae which in turn leads to the characteristic concertina like corrugation of the circular muscle. Such a structural change could explain the altered behaviour of the colon wall in diverticular disease and its failure to change on treatment with bran. PMID- 3972271 TI - Regulation of vitamin D and calcium metabolism after gastrectomy. AB - Fifteen men, who had undergone Billroth I gastrectomy and 19 men who had undergone Billroth II gastrectomy were studied with respect to vitamin D and other indices of calcium metabolism. The Billroth I group had hypocalcaemia, raised concentration of serum alkaline phosphatase, and reduced bone mineral content. The same biochemical disturbances were found in the Billroth II group, but bone mineral content was normal. In neither of the groups was found signs of increased bone resorption. The calcium absorption was situated in the lower part of the normal range and the fractional absorption and elimination rates were normal. The 25OHD concentrations in both groups were reduced (p less than 0.05 0.01) and the 1.25(OH)2D concentrations raised (p less than 0.01-0.001). The 1,25(OH)2D concentrations were inversely related to bone mineral content, but directly related to signs of bone turnover and calcium absorption. We suggest that the high 1,25(OH)2D concentration is the result of a compensatory process with the aim of preventing hypocalcaemia. PMID- 3972274 TI - Crohn's disease in Blackpool--incidence and prevalence 1968-80. AB - The occurrence of Crohn's disease has been studied in a population of approximately 300,000 in Blackpool, a seaside town in the north of England, and the surrounding area. Between 1968 and 1980, 156 patients resident in the area were diagnosed as having Crohn's disease - an annual incidence of 4 per 10(5). For the years 1971-75, the incidence was 3.3 per 10(5) and for 1976-80 it was 6.1 per 10(5). The trend is upwards but there was an apparent fall in incidence in 1974-75. In 1979 there was a peak incidence of 8 per 10(5). Over the period of study, there was an increase in all three anatomical types, small intestinal, large intestinal, and mixed disease but this increase was most marked for purely large intestinal disease. Of the 156 cases, 35% had small intestinal disease at presentation, 35% had large intestinal disease and 30% had mixed disease. The overall sex ratio was female to male 1.89:1 but highest for large bowel disease 2.6:1. Analysis of age at presentation at different sites shows a unimodal distribution for small intestinal and mixed disease with a peak in the third and fourth decades. Large bowel Crohn's disease shows a bimodal distribution with peaks in the third and eighth decades. During the period of study we identified 185 cases of Crohn's disease in the study population. On 31 December 1980, 141 patients with the condition were living, a prevalence of 47 per 10(5). PMID- 3972273 TI - Cell kinetics and in vitro clonogenicity of primary colorectal cancer: clinicopathological relationships and the implications for chemotherapy. AB - Cells with the capacity for clonogenic growth in vitro can be isolated from primary human colorectal carcinomas. In this study colonies were grown, composed of cells which expressed epithelial membrane antigen and CEA, confirming their neoplastic character. Adequate growth for assessing the cytotoxicity of drugs for use in clinical chemotherapy regimes was obtained from 64% of the specimens. Colony forming efficiency of the tumour cells was not related to clinical stage or pathological grade of the parent tumour. The S-Phase fraction of the tumour was established in vitro using pulse thymidine labelling. The thymidine labelling index for Dukes' stage A and B tumours was significantly higher (median 15.7%, range 10.1-23.6%) than for Dukes' stages C and D (median 11.7%, range 0.1-13.6%). Colony forming efficiency in vitro was independent of the thymidine labelling index of the tumour. These findings are discussed with reference to the known heterogeneity of colorectal adenocarcinomas. PMID- 3972275 TI - Role of the faecal stream in the maintenance of Crohn's colitis. AB - The role of the faecal stream in the maintenance of the inflammation in Crohn's disease has been studied. Small bowel effluent and a sterile ultrafiltrate of it were reintroduced into the defunctioned colon of patients with Crohn's colitis treated by split ileostomy. The systemic effect of these challenges on the patients was assessed clinically and by laboratory tests, and the effect on the local disease was assessed by endoscopy, histology, and quantitative analysis of lamina propria plasma cell populations. There was little response to the ultrafiltrate challenge. In contrast the clinical responses to challenge with ileostomy effluent were marked in some patients. One patient relapsed and eight others had clinically detectable responses. On the other hand changes in laboratory, endoscopic, histological, and morphometric tests in response to the faecal challenge were less pronounced. The only significant changes in the laboratory results were a relative lymphopenia (p less than 0.05) and a raised ESR (p less than 0.02) after seven days challenge with the effluent. The plasma cell density also increased but not significantly. In conclusion, these results suggest that factors greater than 0.22 microns in the faecal stream are responsible for the maintenance and exacerbation of inflammation in Crohn's disease. PMID- 3972276 TI - Role of plasmapheresis in primary biliary cirrhosis. AB - Five patients with primary biliary cirrhosis and prolonged cholestasis underwent intensive plasmapheresis. The indications for plasmapheresis included intractable pruritus or hypercholesterolemia and xanthomatous neuropathy. Patients noted a rapid improvement of pruritus and fatigue which was sustained as long as plasmapheresis was continued. Cholesterol levels were lowered an average of 10.3 mmol/l and xanthomata were reduced in three of four patients. Two patients with painful neuropathy caused by xanthomata experienced relief of this symptom. The liver and spleen size were not affected by plasmapheresis, and activities of aminotransferases, alkaline phosphatase and titres of mitochondrial antibody remained unchanged. We conclude that plasmapheresis has a role in the therapeutic management of patients with advanced primary biliary cirrhosis who are disabled by the complications of pruritus, xanthomatous neuropathy, or hypercholesterolemia with xanthoma formation. PMID- 3972277 TI - Kaposi's sarcoma of the bowel--presenting as apparent ulcerative colitis. AB - Persistent diarrhoea with mucus-production developed in a 37 year homosexual man, and an initial diagnosis of ulcerative colitis was made after barium enema examination and rectal biopsy. The patient later developed cutaneous lesions which proved to be Kaposi's sarcoma, and the bowel lesion was also subsequently shown to be Kaposi's sarcoma. This tumour occurred as a manifestation of the acquired immune deficiency syndrome (AIDS). The patient was treated with alpha interferon, with partial regression of the skin lesions, but progression of the bowel tumour. Because of severe bowel symptoms, including episodes of subacute intestinal obstruction, the localised bowel disease was treated with radiotherapy. In view of the increasing incidence of AIDS, a diagnosis of Kaposi's sarcoma must be considered in homosexual men presenting with persistent diarrhoea, for which no infectious cause can be demonstrated. PMID- 3972278 TI - Acute fulminating amoebic colitis: survival after total colectomy. AB - Acute fulminating amoebic colitis is a very uncommon complication of amoebiasis. Most patients die, with or without surgery. We report such a patient who survived after total colectomy. If an excision of diseased colon is done, an exteriorising procedure should be added and primary anastomosis avoided. PMID- 3972279 TI - Congenital short pancreas: a report of two cases. AB - We report two adult cases with partial agenesis of the pancreas. Their radiological features, including endoscopic retrograde pancreatography are demonstrated. The significance of developmental anomalies involving the pancreas is emphasised. PMID- 3972280 TI - Absent ileal uptake of IF-bound vitamin B12 in vivo in the Imerslund-Grasbeck syndrome (familial vitamin B12 malabsorption with proteinuria). AB - A Syrian family is described with three children who had inherited selective vitamin B12 malabsorption associated with proteinuria. (Imerslund-Grasbeck syndrome). Although inherited the defect was apparently not present at birth. A third child had less severe vitamin B12 malabsorption, was not vitamin B12 deficient and had no proteinuria. Studies on two of the affected children with subcellular fractionation of the uptake of radioactive vitamin B12 by ileal tissue in vivo indicate a defect in the ileal receptors for IF-bound vitamin B12. These findings are different from the single in vitro experiment on a patient with this condition that has been previously reported. PMID- 3972281 TI - Cholestatic jaundice in the haemolytic-uraemic syndrome: a case report. AB - The haemolytic-uraemic syndrome is the term used to describe the symptom complex of acute oliguric renal failure, haemolysis, and thrombocytopaenia. The pathogenesis of the syndrome is unknown though several factors have been postulated as important. Gastrointestinal disease is now recognised as a regular feature of the syndrome but hepatic involvement is uncommon and limited to occasional jaundice, hepatosplenomegaly and rises in serum transaminase values. A patient is described in whom cholestatic jaundice occurred during the prodromal illness. Its presence is unexplained but might indicate infection with an unrecognised hepatotropic agent or else lack of enteral nutrition during the prodromal phase. PMID- 3972282 TI - Secretin and pancreatic enzyme secretion. PMID- 3972283 TI - In vitro determination of small intestinal permeability. PMID- 3972284 TI - Can primary endometrial carcinoma stage I be cured without surgery and radiation therapy? AB - The data on 19 cases of primary endometrial carcinoma, stage I (mean age 28.0 years), cured by the administration of hydroxyprogesterone caproate without surgery and radiation therapy are presented. Clinical recovery in 15 cases was confirmed by repeated cytological and histological examinations of the endometrium. Hydroxyprogesterone caproate dose per course ranged within 25.0-83.0 g. In 4 patients with moderately differentiated cancer (G2), hormonal treatment was carried out in combination with chemotherapy. When tumor regression was confirmed histologically, steroid contraceptives were administered to induce an artificial menstrual cycle. At the closing stage of therapy clomiphene citrates were given in succession to restore the ovulatory cycle. Perspectives of administration of progestogens in young women with stage I endometrial carcinoma as a separate method of therapy are discussed. PMID- 3972285 TI - Bone metastasis in vulvar carcinoma. AB - Bone metastasis secondary to vulvar carcinoma, especially that involving distant bone, is an infrequent clinical entity. Three cases are reported in which the patients developed pathologic fractures within 8 months following radical surgery for advanced vulvar carcinoma. The incidence of bone metastasis secondary to vulvar carcinoma is reviewed. PMID- 3972286 TI - Assessment of morbidity and mortality in primary cytoreductive surgery for advanced ovarian carcinoma. AB - Even with wider application of cytoreductive surgery for advanced ovarian cancer, there is still a lack of adequate documentation concerning morbidity and mortality associated with this surgery. The purpose of this paper is to provide such information. This report is based on a retrospective analysis of 60 patients with Stage III and IV disease who had maximal cytoreductive surgery at the Long Island Jewish-Hillside Medical Center between January 1975 and February 1982. This analysis was focused on variables related to morbidity and mortality associated with the procedure. The results indicated that operating time, blood loss, intraoperative and postoperative complications, postoperative morbidity, and the length of hospital stay were acceptable. Only one operative mortality was encountered. The presence of a gynecologic oncologist in the operating room was crucial in carrying out optimal cytoreductive surgery. It is concluded that morbidity and mortality in primary maximal cytoreductive surgery for advanced ovarian carcinoma are acceptable and the surgery should be performed if feasible. PMID- 3972287 TI - Endodermal sinus tumor of the infant vagina. AB - A case of endodermal sinus tumor of the infant vagina is reported with long-term survival after successful therapy by surgery, chemotherapy, and radiation. The previous 26 reported cases are reviewed and the problems of therapy and long-term management are discussed. Therapy of these tumors should be monitored by alpha fetoprotein radioimmunoassay. PMID- 3972288 TI - Spontaneous intracranial hemorrhage in a patient with ovarian carcinoma. AB - A patient with an advanced adenocarcinoma of the ovary developed spontaneous central nervous system (CNS) bleeding as initial evidence of brain involvement by a tumor. The rarity of this phenomenon in patients with ovarian tumors is emphasized and the incidence and course of brain metastases in ovarian cancer are reviewed. Similar to previous reports, our patient had extra abdominal systemic disease at the time CNS involvement was diagnosed. Although good short-term results were achieved with whole-brain irradiation, the prognosis for these patients remains dismal. The incidence of brain metastases may increase in patients with advanced ovarian malignancies given the possibility of achieving long-term survival in a significant percentage of women with widespread disease being currently treated with intensive systemic chemotherapy. PMID- 3972289 TI - Cauda equina compression secondary to metastatic carcinoma of the uterine corpus: preservation of neurologic function and long-term survival following surgical decompression and radiation therapy. AB - Spinal cord or cauda equina compression secondary to epidural metastasis rarely develops in patients with endometrial carcinoma and the early signs and symptoms of compression can therefore be inadvertently overlooked. A 78-year-old patient who developed bone metastasis with destruction of the fifth lumbar vertebral body and blockage of the cauda equina at L-4, L-5 as the only sites of metastasis is reported. This occurred 2 years after initial treatment of a stage IB, well differentiated, grade I, adenosquamous carcinoma of the endometrium. The patient remains alive, with good neurological function and free of metastatic disease, 2 1/2 years following vertebrectomy, radiation therapy, and adjuvant Provera (medroxyprogesterone acetate) therapy. This patient represents the only case of metastatic endometrial cancer with cauda equina compression in the literature in whom long-term disease-free follow-up has been noted. PMID- 3972290 TI - Whole abdominal and pelvic irradiation in patients with minimal disease at second look surgical reassessment for ovarian carcinoma. AB - Aggressive cytoreductive surgery followed by combination chemotherapy for stage III ovarian carcinoma has resulted in a significant percentage of complete clinical responses. However, 30-50% of patients with no clinical evidence of disease are found to have residual carcinoma at second-look surgical reassessment. Because recent reports have indicated a high degree of effectiveness utilizing abdominal and pelvic irradiation as primary therapy for ovarian carcinoma with small residual disease, the authors treated eight patients found to have residual disease of less than 1 cm at second-look reassessment with either open field or split field abdominal and pelvic irradiation. All eight patients had initially undergone aggressive cytoreductive surgery and seven of the eight patients had received multidrug chemotherapy. Patients were treated either at the National Cancer Institute or the Naval Hospital Bethesda both with and without intraperitoneal radiation sensitizers. Fifty percent of the patients required early termination of therapy due to myelosuppression. All eight patients have recurred and three have died. Six of the eight patients have required major surgical procedures for gastrointestinal complications. Based on this experience, we cannot advocate this form of therapy in patients with minimal residual ovarian carcinoma following second-look surgical reassessment. PMID- 3972291 TI - Endometrial carcinoma in premenopausal women: a clinicopathological study. AB - A clinicopathological review of 106 cases of premenopausal endometrial carcinoma has confirmed the good prognosis in such patients. Women less than 40 years old were more likely to be nulliparous, over 80 kg in weight, and to present with irregular or heavy and irregular bleeding, than women 40 years or older. Seven patients developed malignancies at other sites. A detailed pathological review of 32 cases revealed poor prognostic features in 30% of patients; corpora lutea were identified in the ovaries of 13 patients. It is suggested that factors other than anovulation are related to the development of endometrial cancer in the over 40 age group. PMID- 3972292 TI - Unusual skeletal metastases in carcinoma of the cervix. AB - In a series of 1347 patients with carcinoma of the cervix, 62 or 4.6% had metastatic spread to the bones. Bone metastasis correlated with more advanced disease, occurring in 39.1% of patients with Stage II disease. The role of isotope bone scanning and of the radiographic skeletal survey in the investigation of carcinoma of the cervix is considered. Eight patients having unusual radiographic appearances of skeletal metastases are discussed. PMID- 3972293 TI - Stage I carcinoma of the endometrium: a 5-year experience utilizing preoperative cesium. AB - A treatment protocol for the management of stage I endometrial carcinoma utilizing preoperative cesium is evaluated. One hundred and twelve consecutive patients were treated according to this protocol over a 5-year period. Based on this experience and a literature review a new protocol is recommended. The significant changes include primary surgery without preoperative cesium, primary treatment based on grade without regard to uterine size, modified radical hysterectomy for G3 tumors, pelvic radiotherapy for clear cell carcinoma confined to the pelvis regardless of depth of invasion, cytoxan, adriamycin, and cis platinum for papillary serous tumors, and postoperative vaginal cuff cesium for G2 and G3 tumors not requiring pelvic radiotherapy. PMID- 3972294 TI - Squamous carcinoma of the vagina: treatment, complications, and long-term follow up. AB - Seventy-five cases of primary squamous cell carcinoma of the vagina treated at the University of Pennsylvania are reviewed with long-term follow-up presented. These comprised 2.5% of all female genital malignancies treated during 1958 to 1980 inclusive. Patients treated during that time with non-squamous cell cancers have been excluded. Patients are analyzed with regard to stage, therapy, complications, and survival. Sixty-five percent of patients were stage I or II. Five-year survival for the entire group was 45%. Patients treated with radical surgery other than exenteration did well, with 7 of 8 surviving 5 years. Serious treatment complications were mostly related to radiation therapy and primarily involved the bowel and bladder. Three patients died of complications. Recurrence carried a grave prognosis as 30 of 33 patients with recurrence died of disease. Most recurrences were diagnosed within the first year following treatment. Patients with advanced disease were more likely to have distant recurrences. Although radiation therapy is generally the treatment of choice, radical surgery can yield excellent results when used in carefully selected patients. With meticulous attention to radiation dosage and technique it is hoped that treatment morbidity can be reduced. Optimal treatment of advanced disease may require some form of adjuvant systemic therapy. PMID- 3972295 TI - Prognostic factors in carcinoma of the vulva. AB - The clinical and pathologic characteristics of epidermoid carcinoma of the vulva in 84 women treated by vulvectomy were evaluated in relation to inguinal node status and survival. Tumor diameter, depth of invasion, clinical node status, vascular invasion, and pattern of invasion were all individually correlated with the pathologic status of the inguinal nodes. However, when evaluated in combination, only the clinical status of the inguinal nodes, the depth of invasion, and the pattern of invasion (in this order of significance) were predictive of pathologic inguinal node status. Tumor diameter, inguinal node status, depth of invasion, pattern of invasion, and vascular invasion were individually correlated with survival. When evaluated in combination, the clinical diameter of the lesion was the most important predictor of survival; depth of invasion and vascular invasion contributed additional information. PMID- 3972296 TI - Changing pattern of cervical carcinoma: a report of 709 cases of invasive carcinoma treated in 1970-1974. AB - Seven hundred and nine new cases of carcinoma of the uterine cervix were treated by surgery, radiotherapy, or both at Helsinki University Central Hospital between 1970 and 1974. Of these, 241 (34.0%) died of the disease during the 5-year follow up period. Three hundred and eighty-three (53.9%) of the patients were operated on and in 112 (29.3%) of them the stage of the disease had been underestimated preoperatively. This was mainly due to the undetected lymph node involvement observed first at operation in 72 cases (18.8%). In 237 of the patients carcinoma was confined to the cervix according to findings at operation but in 24 (10.1%) of them a relapse or metastasis was observed within 5 years. Comparison of the results for 1970-1974 with those from the same hospital for 1926-1969 revealed a reversal in the steady improvement in the total 5-year survival rates. It is concluded that, even if the incidence of cervical carcinoma in Finland is to decrease, the prognosis for the disease may become poorer. This is mainly due to a shift in the peak incidence of cervical carcinoma to older age groups. Also a mass screening program is likely to decrease the relative number of slowly growing, less aggressive type of the disease. PMID- 3972297 TI - Lymphangiosarcoma of the edematous thigh after radiation therapy for carcinoma of the vulva. AB - A 66-year-old patient was treated with external radiation therapy for an advanced carcinoma of the vulva. Seven years later, a lymphangiosarcoma developed in her edematous lower extremity. Lymphangiosarcomas have been reported to occur in postmastectomy patients; however, this is only the third case in a patient with a gynecologic primary malignancy. In anticipation of possible increased use of radiation therapy in vulvar carcinoma, gynecologists should be aware of this rare, highly aggressive neoplasm. PMID- 3972298 TI - Pseudoobstruction of the colon complicating choriocarcinoma. AB - Colonic pseudoobstruction is an enigmatic condition which can mimic mechanical obstruction clinically and lead to spontaneous cecal perforation. A patient who was treated for choriocarcinoma developed colonic pseudoobstruction and appropriate evaluation permitted nonsurgical management. The etiologies, diagnosis, and management of colonic pseudoobstruction are discussed. PMID- 3972299 TI - [Corium interpositionplasty of the elbow and wrist joint]. AB - The problems involved in the reconstruction of upper extremities, in particular their differentiated movement and the intentionality of the patient concerned are briefly discussed. Three cases presenting typical indications for the interposition of the dermis in the wrist and elbow joints are presented. On the basis of our observations, the indications for implantation of a prosthesis are rare. PMID- 3972300 TI - [Steindler-plasty in paralysis of the elbow flexor muscles]. AB - In 1918, Steindler described an operation technique in which the origins of the wrist flexors are displaced proximally from the ulnar epicondyle. In this way, these muscles attain a usable flexor function at the elbow joint. In the last seven years, we have carried out this surgical technique in nine patients. These comprised patients with incomplete upper arm plexus paresis, poliomyelitis and congenital multiple arthrogryposis. The active flexor function of the elbow joint differed in strength but always led to a marked improvement in use of the affected limb. The biomechanical problems of this surgical technique are commented on. PMID- 3972302 TI - [Intraoperative function diagnosis in the care of brachial plexus injuries]. AB - Using somatosensory evoked potentials during the operation it is possible to get the following information concerning brachial plexus function: Function of the roots. Which parts of the brachial plexus are completely destroyed and which are in regeneration? From which level is it possible to repair an injured nerve with a nerve graft? In cases of severe upper arm injuries: Is there function in the brachial plexus and is it appropriate to do a replantation? PMID- 3972301 TI - [Median nerve--compression syndrome caused by atypical palm muscle]. AB - A compression syndrome of the median nerve was caused by an atypical M. flexor digiti indicis in the palmar area and carpal tunnel. Apart from its anomalous anatomy, this muscle showed an abnormal histological structure. A persistent median artery was also seen in the carpal canal. PMID- 3972303 TI - [Indications for free groin flap-plasty in severe forearm injury (case report)]. AB - A case with a severe gun shot wound of the palmar ulnar distal forearm and wrist is presented. The initial treatment included reconstruction of the ulnar nerve by means of nerve grafts and soft tissue coverage using a free microvascular groin flap. This represents a procedure which is certainly applied only very exceptionally at our department. Inspite of consequent complete flap necrosis due to arterial thrombosis, sensory recovery was sufficient for protective sensibility. The probable reasons of arterial thrombosis are discussed. PMID- 3972304 TI - [Free flap-plasty in a larger soft tissue defect of the hip and gluteal region]. AB - The purpose of this paper is to show a case in which we felt at the end, that the chosen procedure did not fulfill our expectations and in which an alternative procedure would have been preferable. In a 47 year old woman a deep, healed soft tissue defect between the left trochanter and the iliac crest was built up with a free latissimus dorsi musculocutaneous flap. The original plan was to suture the vessels to the gluteal vessels and the nerve to the gluteal nerve. The muscle would have been placed in such a way that the muscle fibres would run from the iliac crest to the trochanter to replace the lost gluteal muscle. This plan was proved on a cadaver dissection. In reality, however, the local vessels were not suitable in size. The flap vessels had to be attached directly to the femoral vessels in the groin area. The flap had, therefore, to be orientated in a different way. The final result gave an insufficient correction of the contour with no functional correction. It was felt in retrospect that contour correction without functional correction would probably have been better performed with an inferior rectus femoris musculocutaneous free flap. PMID- 3972305 TI - [Experimental studies on artificial prostheses in microvascular surgery]. AB - The need for microvascular grafts in replantation and free tissue transfer is well recognized. Variable results are reported in the literature. Therefore, an experimental study was undertaken to assess the suitability of an expanded PTFE (Polytetrafluoro-ethylene) as a microvascular graft. A 2.0 mm diameter graft was implanted in the artery and the vein of the rabbit. No graft in the venous system remained patent. From these animal experiments we conclude that there is no clinically applicable synthetic micro-graft available. PMID- 3972306 TI - [Allogeneic lymph vessel transplantations in the early phase]. AB - Syngeneic and allogeneic grafts of segments of the thoracic duct from rats were investigated in the first fifteen days after transplantation. The patency rate- evaluated by the passage of blue dye--of the allogeneic transplants was almost equal to that seen in the syngeneic grafting. By direct exploration there were no changes to be seen in the syngeneic and allogeneic transplants. Investigations by electron microscopy showed no major reactions to the syngeneic grafts during the observation time: The endothelium always was completely detectable and the subendothelial layer of collagen fibrils was not dislocated. By contrast, the allogeneic transplants showed considerable alterations as disintegration of the collagen fibrils and a partial loss of endothelium occurred after eight to ten days. After fifteen days, however, the formation of a neointima could be demonstrated. Despite the observed alterations there was no loss of function in the allogeneic transplants. PMID- 3972308 TI - [Immobilization of the scaphoid bone (alterative between upper and forearm plaster)]. AB - As a result of the lengthy rehabilitation of the non-injured but fixed elbow in the treatment of scaphoid fractures or pseudarthroses in a longarm plaster cast, a modification has been developed, which inhibits supination and pronation of the forearm while the flexion-extension movement of the elbow is permitted by the incorporation of a hinge. PMID- 3972307 TI - [Modified patient positioning in long-term hand surgery intervention by regional anesthesia]. AB - The authors report a modified positioning of patients for long-term handsurgical operations under regional anaesthesia. After equalizing the level of hand- and operating table, the operating table is tilted 10-15 degrees towards the hand table. The upper limb is abducted only 30-40 degrees and then rotated outwards. This guarantees a comfortable positioning of the patients for a longer period of time. PMID- 3972309 TI - Recognizing depression in patients receiving medical care. AB - Depression is a common condition among patients receiving medical care but often goes unrecognized by care providers. After discussing research on the prevalence, recognition, and treatment of depression in general health care settings as well as the factors associated with psychological distress among nonpsychiatric patients, this article explores how social workers can help improve the identification and management of depression in such settings. PMID- 3972310 TI - Educating phobic clients about the physiology of their feelings. AB - Phobic individuals may be further frightened by the physical symptoms that are the body's response to fearful stimuli. Educating them about the physiology of the human nervous system can provide them with reassurance. This article describes the physiological bases of common physical responses to panic and explains how information about these responses can be used in phobia therapy. PMID- 3972311 TI - Predicting social workers' expenditure of time with hospital patients. AB - Increasing concern about productivity in hospitals led to this study of the amount of time social workers typically spend with and in behalf of hospitalized patients. Among the variables the authors studied, the patient's demographic characteristics had little explanatory power, whereas psychosocial acuity, or need for services, and the types of services delivered were the best predictors of the amount of social work time expended in the patient's behalf. PMID- 3972312 TI - A comprehensive approach to treating infertility. AB - Infertility frequently provokes a life crisis that involves the loss of self esteem and adaptive functioning. Drawing on clinical experience in counseling infertile individuals and couples and leading support groups for such clients, the author analyzes this crisis in terms of the emotional stages experienced by the individual and defines the therapeutic role of the social worker in guiding clients through the tasks of resolution. PMID- 3972313 TI - Health concentrations in schools of social work: the state of the art. AB - The demand for specialized training for social workers in the health field has required schools of social work to reexamine the curricula they offer students interested in health care. The study reported here surveyed graduate schools throughout the country to determine the prevalence and characteristics of health concentrations in social work curricula and the problems and implications concerning the development of concentrations that are to be addressed by the profession as a whole. PMID- 3972314 TI - Intrauterine treatment: meeting the psychosocial needs of the family. AB - Recent advances in diagnostic ultrasound have made in-utero treatment of the fetus possible. This article identifies the stresses experienced by families engaged in such treatment and presents a detailed protocol for intervention at each stage of the process--from the decision to undergo treatment to the postpartum period and discharge. PMID- 3972316 TI - [Forensic demands of medical expert testimony]. PMID- 3972315 TI - Things that go beep in the night: home monitoring for apnea. AB - Home equipment for cardiorespiratory monitoring now makes it possible for parents to manage more effectively the risks of apnea, or prolonged breathing pauses, in infants. This article examines the features of a social work program that provides parents of apneic infants with education and support. It also demonstrates the important contribution of social work to monitoring. PMID- 3972317 TI - [Breast feeding behavior and attitude to pregnancy in rooming-in patients]. PMID- 3972318 TI - [Analysis of ionized calcium in the intensive care unit is indispensable. Introduction of a suitable measuring method]. PMID- 3972319 TI - [Verapamil dosage in hepatitis. Plasma concentrations in hepatitis patients and patients with healthy livers]. PMID- 3972320 TI - [Principles of medical ethics--attempt at status determination. Argument with the concept of euthanasia]. PMID- 3972321 TI - [Intensity control and performance evaluation in jogging. Relations between respiratory step frequency and blood lactate level]. PMID- 3972322 TI - [Significance of physical training in hypertension treatment from the epidemiologic and clinical viewpoints]. PMID- 3972323 TI - [Is ice hockey a dangerous sport?]. PMID- 3972325 TI - [Erotic and martial-like relations of the elderly in residential homes. Key role of the physician in counseling and care in the home]. PMID- 3972324 TI - [Onset of effect of isoxicam and piroxicam. A double-blind parallel study]. PMID- 3972326 TI - [Phosphate therapy of recurrent calcium calculus disease. Current status]. PMID- 3972327 TI - [Anxiety as challenge. A phenomenon that also has positive effects on personal development]. PMID- 3972328 TI - [Allergy, pseudoallergy, intolerance--potential causes of adverse food reactions]. PMID- 3972329 TI - [Dietary treatment of hyperlipoproteinemia. Reduction of atherogenic lipid fractions in normal subjects]. PMID- 3972330 TI - [Lung embolism: diagnostic evaluation important, but often difficult]. PMID- 3972331 TI - [Antimicrobial activity of josamycin in the respiratory tract]. PMID- 3972332 TI - [Traumatic late apoplexy]. AB - "Traumatic late apoplexy" is a sudden cerebrovascular attack subsequent to traumatic cerebral lesion. According to Bollinger's concept, on which the term "traumatic late apoplexy" is based, this process was always a cerebral haemorrhage following trauma and appearing several days or weeks after the accident. In the discussions which followed after Bollinger had introduced this concept, the time sequence of this incident was fixed and the interval between trauma and apoplexy defined as occurring between the 6th day and the 8th week after the injury. However, cerebrovascular disease would have to be excluded; if this condition could not be verified with reasonable certainty, the patient would have to be at least less than 40 years of age. However, the pathological process always had to be "established" morphologically. This concept and this definition were extended a few decades later on the basis of progress made in the knowledge and treatment of cerebrovascular lesions. It was found that the pathological process need not be confined to haemorrhages only; every other traumatic cerebral lesion could be included which resulted in "apoplexy" in the clinical sense of the term with some delay after the trauma. Therefore, this article includes all modern concepts on such processes and discusses the various types of traumatic cerebral lesions which can occur in our present technological age. Reports published in literature are scrutinised and analysed more closely, and guidelines and hints are given which can be helpful in expertising work. The list of references is very extensive. PMID- 3972333 TI - [Psychogenic psychoses. A review of the clinical picture, genesis, prognosis and therapy]. AB - The concept of psychogenic psychosis has always been regarded with scepticism, since it seems to harbour a contradiction in itself: Psychogenic mental disturbances are amenable to a rational approach, that is to say, they are understandable, whereas psychoses are incomprehensible mental disease patterns in respect of their content and course. Nevertheless, psychogenic psychoses have been described fairly often ever since scientific psychiatry came into being; in fact, they are being diagnosed quite frequently in some countries. For the purpose of helping to clarify these theoretical and practical difficulties, the article explains the history of the concept, the clinical patterns of manifestation, and the course of psychogenic psychoses, as well as the concept of their origin. An attempt is made to reconcile the immanent contradictions, and to demonstrate that this is actually a fruitful extension of the scope of the theoretical fundamentals of psychiatry. PMID- 3972334 TI - Prolactin levels in pregnancy: comparison of normal subjects with patients having micro- or macroadenomas after early bromocriptine withdrawal. AB - 14 previously infertile patients, 11 with radiologically abnormal fossae, and a mean prolactin level of 761 ng/ml (range 49-4,500 ng/ml) conceived on 19 occasions during bromocriptine treatment. So far, 15 healthy infants have been delivered. Treatment was withdrawn soon after conception and the subsequent prolactin changes compared with those of 44 normal subjects. Prolactin levels returned to pretreatment values in 7, but stayed within our normal range (less than 350 ng/ml) in the 6 remaining patients studied. No patient developed signs or symptoms of tumor enlargement. 2 patients, 1 of them with the largest tumor, have now normal prolactin levels and can be considered as cured. Bromocriptine treatment can restore fertility and be safely withdrawn during pregnancy even in patients presenting with large tumors. Nevertheless, patients should be carefully monitored and treatment with bromocriptine re-introduced if necessary. PMID- 3972336 TI - Fate of parathyroid hormone during hemodialysis and ultrafiltration. AB - In order to shed light on the discrepant changes in plasma immunoreactive parathyroid hormone (iPTH) during hemodialysis (HD) and ultrafiltration (UF) in end-stage renal failure, the influence of filtration of PTH fragments on the iPTH level in plasma was examined in 2 sets of experiments: in vitro dialysis of 125I bPTH 1-84, 125I-hPTH 1-34 and 125I-hPTH 53-84 added to plasma was successively performed through a cuprophane membrane. Gel filtration on a Biogel P-100 column and subsequent counting of the eluate were performed with the plasma before and after dialysis, and with the dialysate fluid after dialysate fluid after dialysis. An ultrafiltrate obtained from a patient with renal failure was also analyzed for iPTH with a 'C-' and with an 'N-terminal' antiserum (GP 500 MA and AS 211/32), and so was his plasma before and after UF, and after a subsequent dialysis session. Fluid obtained by lavage of the filter with acetic acid after dialysis was also analyzed. Chromatography with measurements of iPTH in the eluate was performed in each case, and the procedure was repeated applying a different transmembrane pressure. Immunoreactive material found in the concentrated ultrafiltrate, but not in plasma, was characterized by means of dilution curves in different RIA performed with the C-terminal antiserum preincubated with various synthetic PTH fragments. Results showed that intact PTH does not cross the cuprophane membrane during both in vitro dialysis and in vivo UF. The 1-34 fragments are poorly dialyzed in vitro; either they stick to the membrane or they are disintegrated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972335 TI - Species variation in the binding of hGH to hepatic membranes. AB - The binding of 125I-labeled human growth hormone (hGH) to liver membranes from several different species was studied to determine the lactogenic or somatotropic hormone nature of the receptors. Liver membranes from several species of the class of Mammalia bound significant quantities of 125I-hGH. Goat, sheep, rat, mouse, and rabbit liver membranes exhibited the highest binding with cow, pig, human, and hamster liver membranes exhibiting severalfold less binding. The binding of the dog and cat liver membranes exhibited relatively high nonspecific binding. Fish and chicken liver membranes did not bind appreciable quantities of 125I-hGH. In all species except for dog and cat in which 125I-hGH bound to the membranes, hGH was the most effective competitor for binding. The mean ID50 for hGH and all membranes was 2.4 X 10(-9) M. Human liver membranes exhibited the smallest ID50, 4.9 X 10(-10) M. In sheep liver membranes, bovine growth hormone (bGH) was equipotent to hGH in competing for 125I-hGH binding. bGH also demonstrated significant competition for 125I-hGH binding in pig and cow membranes. Ovine prolactin (oPrl) exhibited significant competition for 125I-hGH only in rodent membranes. The ID50 for oPrl was 3- to 10-fold greater than for hGH in the rat, hamster, and mouse liver membranes. The ID50 for oPrl in the sheep liver membranes was 13-fold greater than that of hGH. We conclude the following: (1) There appears to be a species specificity of hGH binding that may be phylogenetically significant and may result from variations in the structure of the hormone or the receptor. (2) The competitive binding properties of hGH are fairly consistent within phylogenetic orders. (3) The simple designation of lactogenic or somatotropic for hormones and receptors is insufficient to characterize the binding properties of this group of hormones. PMID- 3972337 TI - Effects of oxytocin, vasotocin and alpha-MSH on renal function in the nonhuman primate. AB - We determined the effect of oxytocin, alpha-melanocyte stimulating hormone (alpha MSH) and arginine vasotocin on renal function of the macaque monkey. The only significant effect of the peptides was that alpha-MSH had an antidiuretic effect and vasotocin had both an antidiuretic and natriuretic effect. PMID- 3972338 TI - Mental illness among nursing home patients. PMID- 3972339 TI - Applied clinical ethics or universal principles. PMID- 3972340 TI - Puppetry as a therapeutic tool for hospitalized children. PMID- 3972341 TI - The coming of the corporation and the marketing of psychiatry. AB - After briefly reviewing the current dynamic status of corporate for-profit multihospital chains, the author traces their historical antecedents from early 20th century advances in medical care and medical education to the present economic and political environment that is so conducive to their growth. The chains' success in increasing their profitability in the general health care field through pricing and marketing strategies and efficient use of personnel has raised several concerns, but in combination with several other factors it has ensured the movement of for-profit corporations into the psychiatric field. The implications of this movement for the provision of psychiatric services are discussed, particularly the thrust to define psychiatry as a group of separately marketable products. PMID- 3972342 TI - Patterns of staff perception of difficult patients in a long-term psychiatric hospital. AB - In a study to determine which psychiatric patients are perceived by staff as most difficult to treat, clinical staff from several disciplines rated problem behaviors of 127 long-term inpatients in a private psychiatric hospital; staff also rated overall treatment difficulty, progress, and prognosis. No single patient characteristic determined staff's perception of patients as difficult to treat. Instead, four clusters of patient characteristics contributed to this perception; in decreasing order of influence, they are withdrawn psychoticism, severe character pathology, suicidal-depressed behavior, and violence-agitation. The study also showed that the patients who are considered particularly difficult are perceived as improving less and as having a poor prognosis. PMID- 3972343 TI - Impact of AIDS-related cases on an inpatient therapeutic milieu. AB - As more individuals whose lives are affected by acquired immune deficiency syndrome (AIDS) begin to need psychiatric hospitalization, psychiatric staffs must be prepared to handle the strong feelings aroused by the disease. The authors present case vignettes of four patients with AIDS-related problems admitted to a voluntary acute-stay ward of a teaching hospital. They then discuss the largely indifferent reaction of the other ward patients to the AIDS-related patients, the tense and fearful reaction of the staff, and the subsequent interruption of the usual functioning of the therapeutic milieu. To develop an optimal management plan, the authors recommend attention to specific principles of patient and milieu assessment. PMID- 3972344 TI - The day center and its role as a social network. AB - The author discusses the importance of building a social network for chronic mentally disabled patients living in the community. A literature review that includes cross-cultural studies suggests the chronic mentally disabled fare better in the community if they have a support system that provides assigned roles and regular contact with people and that does not produce great stress. The Fennell Program Day Center, an activity and social program for the chronic mentally disabled, is described, with emphasis on its role in providing a social network for its clients. By keeping expectations low and enhancing a family-like atmosphere, staff have been able to help clients develop reciprocal social relationships. PMID- 3972345 TI - More than a gateway: the role of the emergency psychiatry service in the community mental health network. AB - The authors describe how an emergency psychiatry service in an inner-city general hospital has been able to expand its functions and strengthen its ties to community mental health agencies. A major factor in helping the emergency unit build closer relationships with community agencies is its contract with the state to perform evaluations of all admissions to the state hospital psychiatric unit serving the catchment area. The emergency unit performs triage and provides backup for the agencies, coordinates the management of multi-agency cases, and holds weekly educational conferences for agency staff. Using case examples, the authors illustrate how unit and agency staff collaborate to ensure continuity of patient care. PMID- 3972346 TI - Sexuality education for staff in long-term psychiatric hospitals. PMID- 3972348 TI - Disclosing diagnosis: a parent's view. PMID- 3972347 TI - Self-inflicted ocular removal by two psychiatric inpatients. PMID- 3972349 TI - Renovation plan solves hospital's lab needs. PMID- 3972351 TI - Elderly care campus gives new life to old hospital. PMID- 3972350 TI - Pharmacy relocation cuts costs, increases revenues. PMID- 3972352 TI - Local area networks: an emerging resource. PMID- 3972353 TI - Public hospitals in a private market. Interview by Emily Friedman. PMID- 3972354 TI - Is this overbuilding, and why might it occur? Part 2. PMID- 3972355 TI - 1984's floating-rate debt heralds a trend. PMID- 3972356 TI - Short-term issues are perfect for pooling. PMID- 3972357 TI - Firm's plans may result in the top medical credit card. PMID- 3972358 TI - Nationally branded products come to health care. PMID- 3972359 TI - Hospital labs: close or go commercial? PMID- 3972360 TI - Mobile MRIs establish market access at low cost, minimal risk. PMID- 3972361 TI - Physician pressure prompts CA surgicenter. PMID- 3972362 TI - Planning freestanding facilities: space and cost concerns. PMID- 3972363 TI - Renovation: a tool for hospital commercialization. PMID- 3972364 TI - Elderly 21 percent of population by 2040. PMID- 3972365 TI - Multihospital systems target continuum of care strategy. PMID- 3972366 TI - Elder abuse victims estimated at 1 million. PMID- 3972367 TI - Diversification push drives day care rise. PMID- 3972368 TI - Lifecare undergoing changes in delivery, settings, and ownership. PMID- 3972369 TI - Swing-bed program's success spurs proposals to expand eligibility. PMID- 3972370 TI - MHAs and the new hospital job market. PMID- 3972371 TI - Medical practice: why does it vary so much?. Interview by Emily Friedman. PMID- 3972372 TI - Product management spurs emphasis on medical records. PMID- 3972373 TI - Planning PPOs to minimize antitrust risk. PMID- 3972374 TI - Hospital executives rate the press. PMID- 3972375 TI - Missouri-Kansas coalition pushes change with PPAs. PMID- 3972376 TI - Physicians' cost cuts spur PPO's success. PMID- 3972377 TI - Dedicated preadmission testing center cuts costs, LOS. PMID- 3972378 TI - Technology, costs highlight ethical issues. PMID- 3972379 TI - Medical device hazard reports required. PMID- 3972380 TI - Service continues while facility revamps. PMID- 3972381 TI - Big business embraces alternate delivery. PMID- 3972382 TI - Successful hospitals pay for performance. PMID- 3972383 TI - What makes consumers select a hospital? PMID- 3972384 TI - Managing interhospital patient transfers. PMID- 3972385 TI - Atherosclerosis: new horizons. PMID- 3972386 TI - Incidence and significance of intrarenal vasculopathies in patients with systemic lupus erythematosus. AB - A clinicopathologic autopsy study of the vascular changes in the kidneys of 100 patients with systemic lupus erythematosus was undertaken. Necrotizing arteritis was found in seven patients, mucinous intimal thickening in nine, onion-skin intimal thickening in two, and renal vein thrombosis in two. Active necrotizing arteritis was present most frequently in the arterioles and interlobular arteries, with healing necrotizing arteritis predominating in the arcuate and interlobar arteries. These events were closely related to the activity of glomerular lesions, and immunologic vascular injury seemed to be the causative factor. Rapidly progressive renal failure and severe hypertension had characterized the clinical courses of the patients. Mucinous intimal thickening, present in the arterioles and interlobular arteries, had been accompanied by accelerated hypertension. Although dialysis or accelerated hypertension may have been causes, other factors, including glucocorticoid therapy, must be considered. In one patient with class II lupus nephritis, renal vein thrombosis was considered the cause of the nephrotic syndrome. These vasculopathies, often detected in patients with lupus at autopsy, seem to alter the clinical course. PMID- 3972387 TI - Pulmonary vascular disease and hypertension after valve surgery for mitral stenosis. AB - The reduction of pulmonary hypertension that occurs within 24 hours of valve replacement for mitral stenosis is well documented, but patients who die after surgery have not been adequately studied. Clinical and autopsy data for 16 patients who died following mitral valve replacement were reviewed. The emphasis was on preoperative and postoperative pulmonary arterial pressure and pulmonary vascular disease, including arterial, venous, and capillary changes. Morphologic features were graded and summed to obtain an additive histologic assessment (AHA). Patients were divided into three groups: 1) those who had uneventful operations and early postoperative periods but died prior to discharge; 2) those who had postoperative difficulty, with identifiable acute anatomic causes of death; and 3) those who had postoperative difficulty, with no apparent acute anatomic cause of death. In group 1 (n = 4) the preoperative pulmonary arterial pressure was 43 +/- 17 mm Hg, and AHA ranged from 0 to 4; in group 2 (n = 5) the preoperative pulmonary arterial pressure was 60 +/- 15 mm Hg, but AHA ranged only from 2 to 5. In group 3 (n = 7) the preoperative pulmonary arterial pressure was 59 +/- 12 mm Hg; AHA ranged from 6 to 9, significantly higher than that of the other groups (P less than 0.005). Three patients from group 3 had elevated pulmonary arterial pressure (60, 52, and 50 mm Hg three, six, and 15 days after surgery, respectively). Two additional patients had right heart failure with normally contracting left ventricles terminally. It is concluded that some patients with mitral stenosis who die after surgery with persistently elevated pulmonary arterial pressure have sufficiently severe pulmonary vascular disease to account for their persistent pulmonary hypertension and death. PMID- 3972388 TI - Black thyroid: clinical manifestations, ultrastructural findings, and possible mechanisms. AB - Ultrastructural examination of three black thyroid glands showed lysosomal accumulations of lipofuscin-like pigment and granular electron-dense material in association with 1) a minocycline-associated black thyroid with normal thyroid function; 2) a minocycline-associated black thyroid with a significant inflammatory component, fibrosis, and primary hypothyroidism; and 3) a black thyroid gland with no exposure to minocycline. The deposition of the pigments in the three cases resulted in macroscopically recognizable black thyroid glands. It is speculated that an imbalance in lysosomal function accounts for this abnormality. The glandular hypofunction documented in case 2 is unique and confirms the need to monitor function carefully in patients who are receiving minocycline. In one case electrondense deposits were identified in the thyroid gland interstitium. PMID- 3972389 TI - Dysplasia, dysplastic melanocytes, dysplastic nevi, the dysplastic nevus syndrome, and the relation between dysplastic nevi and malignant melanomas. PMID- 3972390 TI - Biliary cystadenocarcinoma arising in a congenital cyst. AB - The case of a biliary cystadenoma containing foci of cystadenocarcinoma is reported, along with the first electron microscopic description of this lesion. Both neoplastic and congenital origins have been implicated in the pathogenesis of biliary cystadenomas. In this case hamartomatous bile ducts were found, supporting a congenital origin for at least some biliary cystadenomas. Careful pathologic evaluation is emphasized since malignant degeneration can be detected only after thorough sectioning. PMID- 3972391 TI - Genetics and the atomic bombs. PMID- 3972392 TI - Familial occurrence of hemolytic disease of the newborn due to AO blood group incompatibility. AB - The extent of the familial occurrence of hemolytic disease of the newborn due to AO blood group incompatibility between mother and fetus was examined. The records of all families in which the mother had blood group O and two or more babies had blood group A, with one of them having been born at Women & Infants Hospital of Rhode Island in the index year of 1979, were examined. Eighty-nine of these families fulfilled criteria intended to exclude causes of hyperbilirubinemia other than AO blood group incompatibility. The peak bilirubin level in each infant was graded as normal, elevated, or severely elevated. The relations between birth order and peak bilirubin level, between peak bilirubin levels in the first and second babies in each family, and between gestational age and peak bilirubin level were assessed. The first two of these relations showed effects at the 0.10 and 0.05 significance levels, respectively. It is concluded that the risk of hyperbilirubinemia attributable to AO blood group incompatibility is greater for the second than for the first baby at risk in a sibship, that the risk is yet greater for the second if the first was also affected, and that, in the latter case, there is also increased risk of marked hyperbilirubinemia. PMID- 3972393 TI - Pathologic features of the femoral head in Mseleni disease. AB - Severe but atypical osteoarthritic deformities were found in each of 12 femoral heads removed during total hip arthroplasty for Mseleni disease. Although degenerative and regenerative changes were present throughout the cartilage, there was a paucity of eburnation. Histomorphometric analysis of bone at the line of excision indicated that mild osteomalacia was present in four of the 12 specimens. The percentage of the endosteum occupied by osteoid was 9.7 +/- 7.96 (SD) in the patients with Mseleni disease, compared with 5.6 +/- 4.33 in seven African black and 4.1 +/- 2.13 in 13 American white control subjects. The mean thickness of the osteoid seams was not increased. The findings suggest that osteomalacia is not a major pathogenetic factor in Mseleni disease. PMID- 3972394 TI - Pulmonary cryptococcosis. AB - Observation of an unusual pulmonary distribution of cryptococci in a patient at autopsy prompted a review of 36 patients with pulmonary cryptococcosis listed in the autopsy files of The Johns Hopkins Hospital. The patients ranged in age from 2 to 89 years (mean, 49 years), 19 were female, and 18 were black. All but three patients had underlying debilitating diseases, and 23 patients had received steroids and/or chemotherapy. In 25 patients (69 per cent) cryptococcosis was a major factor contributing to death, through pulmonary disease in ten, systemic involvement in seven, and central nervous system disease in eight. In 15 patients (42 per cent) cryptococcosis was diagnosed clinically. Four basic morphologic patterns were observed: 1) Seven patients (19 per cent) had one or more peripheral pulmonary granulomas. In three of these patients the granulomas were apparently quiescent, and no other lesions were found. 2) Nineteen patients (53 per cent) had what has been called granulomatous pneumonia, with intra-alveolar proliferating organisms and varying degrees of inflammatory response, which, when present, ranged from acute inflammation to diffuse intra-alveolar granulomas with giant cells. 3) In seven patients (19 per cent) organisms were present diffusely within alveolar capillaries and interstitial tissues, and reactions ranged from little or no inflammation with numerous organisms to few organisms with miliary granulomas. 4) In three patients (8 per cent) both intra-alveolar and intravascular organisms were present in massive numbers, and the primary route of infection was uncertain. Fatalities from pulmonary and generalized infection occurred in patients in each histologic group. The results show marked variability both in pathologic reaction to cryptococci and in the clinical appreciation and significance of pulmonary cryptococcosis. PMID- 3972395 TI - Primary acquired melanosis of the conjunctiva. AB - Forty-one cases of conjunctival primary acquired melanosis (PAM) were studied to determine the frequency of progression to malignant melanoma and to establish prognostic parameters for progression to melanoma. Two subdivisions were identified: lesions with cytologically atypical melanocytes (PAM with atypia, 28 lesions, 68.3 per cent) and those lacking cytologically atypical melanocytes (PAM without atypia, 13 lesions, 31.7 per cent). None of the lesions of PAM without atypia progressed to melanoma. Thirteen of the 28 lesions of PAM with atypia (46.4 per cent) progressed to melanoma. Progression to melanoma was more frequent in the lesions of PAM with atypia if basilar hyperplasia was not the dominant histologic pattern (90 per cent progression, P = 0.02) or if any epithelioid cells were present (75 per cent progression, P = 0.02). It was not possible to determine which lesions were atypical on the basis of clinical appearance. Lesions at risk for the development of melanoma should be totally extirpated. PMID- 3972397 TI - Incidence of IgA-related nephritides in American Indians in New Mexico. AB - The racial distribution of the findings in 664 renal biopsies was studied for the state of New Mexico. The incidence of IgA-related nephritides (Berger's disease and Henoch-Schonlein purpura) was significantly greater in American Indians than in Hispanics and Anglos; IgA-related nephritides were found in 38 per cent of renal biopsies in American Indians. The clinicopathologic presentations of IgA related nephritides were similar in the three ethnic groups. PMID- 3972396 TI - Malignant melanoma of the conjunctiva. AB - One hundred thirty-one cases of conjunctival melanoma in which biopsies had been performed were studied to determine potential factors that might affect outcome in patients with these lesions. Two groups of lesions were identified: those associated with primary acquired melanosis (melanoma with PAM, 98 cases, 74.8 per cent) and those without primary acquired melanosis (melanoma without PAM, 33 cases, 25.2 per cent). The overall mortality rate in the 131 cases was 26 per cent (34 of 131); the mortality rate due to melanoma with PAM was 25.5 per cent (25 of 98), and that due to melanoma without PAM was 27.3 per cent (9 of 33). If PAM was associated with the lesion, the presence of atypical melanocytes within the epithelium (pagetoid invasion) was a sensitive indicator of subsequent metastasis. Tumor thickness may also be useful for predicting subsequent metastases. None of the histologic parameters studied proved useful for predicting outcome in patients who had melanomas without PAM. The presence or absence of nevi had no effect on prognosis. PMID- 3972398 TI - Sarcoidosis of the breast. AB - Breast involvement by sarcoidosis is rare, with only a few adequately documented cases reported in the literature. Differentiation from other granulomatous processes is important, so that the proper treatment method can be selected. One such case is described, and the current literature is reviewed. PMID- 3972399 TI - Teratoma of the umbilical cord. AB - A case of teratoma of the umbilical cord is described. Four previous reports of this entity are briefly reviewed, and a detailed description of the current case is presented. The histogenesis of teratomas at this unusual site is discussed. The features that distinguish teratomas of the umbilical cord and placenta from acardius fetus are enumerated. PMID- 3972400 TI - Vessel-nerve intermingling in benign infantile hemangioendothelioma. PMID- 3972401 TI - Clinical laboratory--past, present, and future: an opinion. AB - In this review we have tried to identify some of the management issues affecting laboratories in the past, present, and future. In particular, we have focused on the increases in utilization and cost and have attempted to demonstrate some of the factors affecting the supply and demand sides of these issues. In the absence of a price mechanism to allocate resources, alternative strategies to evaluate and regulate laboratory use were discussed. Although promise is held out by some of these approaches, they are not, in our view, fully workable at this stage. We suggest that, in the interim, sound medical direction and management of the laboratory as a production function can be of benefit in inhibiting, if not actually controlling, cost increases. In particular, we recommend concentration on the management of technology because of its crucial role in laboratory costs and utilization. Emerging trends in clinical laboratory and monitoring technologies suggest that issues relating to decentralization, quality control, and funding will have to be addressed in the near future. The prime motivation for clinical laboratory use, i.e., the generation of answers to clinical questions, seems destined to continue and expand. The challenge for practitioners, researchers, and policy-makers is to harness, evaluate, and manage the technologies that can best contribute to both medical practice and health. PMID- 3972402 TI - Myoid hamartomas of the breast. AB - Tumors containing smooth muscle are rare in the breast. A myoepithelial origin for the myoid component of such lesions was postulated in previous reports. Myoepithelial hyperplasia has long been recognized as a common component of some breast lesions, including sclerosing adenosis, papillomas, and fibroadenomas. Three breast tumors composed of variable admixtures of adipose tissue, fibrous tissue, and smooth muscle are described. The authors postulate that the myoid component of two of the three lesions may have arisen in a milieu of myoepithelial hyperplasia. The origin of the myoid component in the third case is not clearly defined. PMID- 3972404 TI - Pathologic pulmonary findings in children with the acquired immunodeficiency syndrome: a study of ten cases. AB - Lung tissue and tissue from the lymphoreticular system obtained at open biopsy and/or autopsy were studied in ten children with the acquired immunodeficiency syndrome (AIDS). One or both parents of nine of the children had AIDS or risk factors for AIDS. The remaining child had hemophilia. The following pulmonary lesions were seen: 1) diffuse alveolar damage (DAD), 2) Pneumocystis carinii and/or cytomegalovirus pneumonitis, 3) lymphoid interstitial pneumonitis (LIP), and 4) desquamative interstitial pneumonitis (DIP). Combinations of such factors as mechanical ventilation, oxygen therapy, and opportunistic infection played a role in the pathogenesis of DAD. Opportunistic infections were related to the defective cell-mediated immunity in these children. The clinical, epidemiologic, immunologic, and pathologic features of the thymuses of these patients indicate that the immune deficiency was unlikely to have been of congenital origin. The immunologic abnormalities may also have been related to the pathogenesis of LIP and DIP. Neither LIP nor DIP has been described in adults with AIDS. Open lung biopsy is of practical importance in the diagnosis and treatment of pulmonary disease in children with AIDS. PMID- 3972403 TI - Immunoreactive neuron-specific enolase, bombesin, and chromogranin as markers for neuroendocrine lung tumors. AB - Sixty-four lung tumors were evaluated for the presence of immunoreactive neuron specific enolase (NSE), bombesin (Bn), and chromogranin (Cg) to assess their value as markers for neuroendocrine cells in the histologic diagnosis of pulmonary neoplasms. Staining was correlated with the presence and density of neurosecretory granules (number of neurosecretory granules per unit cytoplasmic cross-sectional area) as determined by planimetry on electron micrographs. The cytoplasmic density of neurosecretory granules was significantly greater in the carcinoid tumors than in the small cell carcinomas (P less than 0.001). Neuron specific enolase was localized in all of the neuroendocrine granule-bearing tumors but was also present in 57 per cent of the nonneuroendocrine carcinomas. Bombesin was present in 68 per cent of the neuroendocrine tumors and in less than 1 per cent of the nonneuroendocrine tumors. Staining for Cg appeared to correlate with the density of neuroendocrine granules, with staining in carcinoid tumors but no staining in small cell anaplastic carcinomas. A panel of antibodies may be required for the reliable identification of neuroendocrine lung tumors by immunohistochemical techniques. PMID- 3972405 TI - Pulmonary air cysts in cystic fibrosis: relation of pathologic features to radiologic findings and history of pneumothorax. AB - One lung obtained from each of 21 consecutive autopsies in adolescents and young adults with cystic fibrosis was studied prospectively by macroscopic morphometry and light microscopy to determine the prevalence, morphology, and radiographic appearance of subpleural air cysts, which potentially contribute to spontaneous pneumothorax. In 15 lungs, 41 cysts of three anatomic types were identified: bronchiectatic cysts (23), interstitial cysts (13), and emphysematous bullae (5). All cysts were significantly more numerous in the upper lobe. Bronchiectatic cysts had the largest mean diameter, occupied from less than 1 per cent to 47.7 per cent of upper lobe volume in nine patients, and produced large multiloculated hyperlucencies on chest radiographs in five cases. All six lungs with prior pneumothorax contained at least one cyst, but no significant difference was found in the type or proportion of lung volume occupied by cysts between lungs with and without pneumothorax. Patients with large cysts had significantly lower chest radiograph scores, but there was no correlation between the proportion of lung volume occupied by cysts and patient age or duration of either symptomatic lung disease or colonization by bacteria. On chest radiographs only bronchiectatic cysts with conglomerate diameters of greater than 3 cm were visible. Smaller lesions could not be separated from ring shadows produced by bronchiectasis. PMID- 3972406 TI - Preserved human remains from the southern region of the North American continent: report of autopsy findings. AB - Autopsies were performed in six naturally mummified bodies from the southern area of North America. The cause of death was established with reasonable certainty in two (abdominal stab wound and sand pneumoconiosis); was somewhat speculative in one (atelectasis secondary to bronchial obstruction by an aspirated tooth); and was undetermined in three. The value of such studies is discussed, and the synergistic effect of interdisciplinary contributions is emphasized. PMID- 3972407 TI - Morphogenesis and possible precursor lesions of invasive carcinoma of the papilla of Vater: epithelial dysplasia and adenoma. AB - Surgical specimens from 58 invasive carcinomas of the papilla of Vater were studied histomorphologically. Tubular or villous adenomas, adenomatous residues, and microadenomas were found in the vicinity of the carcinomas in 91.4 per cent of the cases; moderate or severe epithelial dysplasia in adenomatous structures or in surface and ductal epithelium was present in 81 per cent of the cases. The results of the present histomorphologic study support the hypothesis that invasive carcinomas arise from pre-existing mucosal lesions, such as adenoma or dysplasia. PMID- 3972408 TI - Inflammatory fibroid polyp of the ileum. AB - Inflammatory fibroid polyp, a rare, benign lesion of the gastrointestinal tract, arises from the submucosa. It consists of loose fibrous stroma of stellate cells and thin-walled blood vessels infiltrated by inflammatory cells, especially eosinophils. The lesion described in the present report is the largest inflammatory fibroid polyp reported to date; it occurred in the ileum, heretofore considered a rare location, and had a marked extramural component, which has not been described previously. Clinically, symptoms vary and are nonspecific. Inflammatory fibroid polyp must be considered in the diagnosis of polypoid and/or extramural masses of the gastrointestinal tract, especially of the stomach and ileum. PMID- 3972409 TI - Non-Hodgkin's lymphoma presenting as malignant pericardial effusion and cardiac tamponade. AB - A case of malignant lymphoma, Rappaport histiocytic type, in which the initial clinical presentation was malignant pericardial effusion with cardiac tamponade is presented. The pathogenesis of malignant pericardial effusion is discussed, and the value of cytology in the diagnosis of malignant pericardial effusion is emphasized. PMID- 3972410 TI - Malignant histiocytosis in childhood. PMID- 3972411 TI - Manifestation of the fragile site Xq27 in fibroblasts. IV. Clones from a heterozygous female do not manifest this site homogeneously on either the early or late replicating X chromosome. AB - Fibroblasts from a heterozygous carrier for the Martin-Bell syndrome, who manifests the fragile site Xq27, were cloned to separate the population carrying the primary defect on the active X chromosome from the population with this defect on the inactive X. Clones with this defect on the active X manifest the fra(X)(q27) whereas clones from the other population are fra(X)-negative (Steinbach et al. 1983b). In this project, the replication status of the X chromosome manifesting the fra(X)(q27) was studied in seven clones with this defect on the active X. The results obtained on the clones were very similar to the results obtained from uncloned fibroblasts and lymphocytes. In the clones the fragile site was found manifested on the early replicating X in 73 cells and on the late replicating X in four cells. Since the defect is located on the active X chromosome of these cells the manifestation of the fragile site on the late replicating X suggests that the defect and the fragile site cannot be identical. It is concluded that there is no obligate synteny of this defect and the manifested fragile site. PMID- 3972412 TI - Fragile sites and structural rearrangements in cancer. AB - We retracted information from a computerized databank which contains the cytogenetic findings of 17,000 patients with leukemia and lymphoma. Cytogenetic data from patients with solid tumors were compiled from Dr. Mitelman's catalogue on "Chromosome aberrations in cancer". We compared the observed distribution of breaks in chromosome bands involved in structural rearrangements with the random distribution of breaks generated by Monte Carlo simulation and showed that a majority but not all of the bands known to contain a fragile site are involved in structural aberrations in cancer and that some of them are associated with specific chromosome structural changes in specific types of cancer. PMID- 3972413 TI - New data on the in-situ position of the inactive X chromosome in the interphase nucleus of human fibroblasts. AB - The in situ spatial distribution of nucleolus-organizing-region (NOR) bearing chromosomes in relation to the inactive X chromosome was studied during interphase in human fibroblasts. The respective positions of these chromosomes were examined in 30 growing and 32 resting fibroblasts from reconstructed nuclei, using nucleoli and the Barr body as ultrastructural markers. Experimental values for the distance between the nucleoli and the Barr body were estimated by their coefficient of closeness and compared to the uniform distribution. The following results were obtained: the distribution patterns for the two populations of nuclei were similar, the distribution of the NOR-bearing chromosomes in relation to the inactive X chromosome varied and differed significantly from a uniform distribution, and in many cases the Barr body was observed to be in a juxta nucleolar position. The internal distribution revealed by this study is compared with the data in the literature, especially with the conflicting data obtained by other methods used to determine the interphase arrangement of chromosomes. The relationship between interphase and metaphase arrangements such as can be deduced with these methods, is discussed in relation to the mechanisms of the formation of metaphase plates or chromatid translocations. PMID- 3972414 TI - Level of translatable messenger RNA coding for argininosuccinate synthetase in the liver of the patients with quantitative-type citrullinemia. AB - The translation activity of mRNA coding for argininosuccinate synthetase in total RNA extracted from the liver of three patients with quantitative-type citrullinemia was determined using a cell-free translation system. In two patients, the hepatic content of the enzyme was about 20% of the control value, whereas translatable mRNA level for the enzyme was similar to or slightly lower than those of control livers. In the third patient, the enzyme content was about 50% of the control value, and mRNA activity for the enzyme was low normal. These results indicate that at least in the first two patients, the decrease in the enzyme protein is due either to increased degradation of the enzyme or to decreased translation in the patient's liver. PMID- 3972416 TI - AB0 blood group incompatibility and inbreeding effects: evidence for an interaction. AB - It is known that consanguinity reduces the chances of maternal-foetal incompatibility but it is not known whether inbreeding influences the expression of the effects of such incompatibility. This paper investigates and finds evidence for an interaction between inbreeding and AB0 blood group incompatibility on the expression of neonatal mortality, sibship precocious mortality, neonatal jaundice, asphyxia, and sex ratio, through screening of 3923 consecutive newborns. Inbreeding and incompatibility individually showed variable effects on the above parameters, but their interaction was such that, in the presence of inbreeding, incompatibility reduced the incidence/relative risk of all the above factors. Such a uniform negative interaction was presumed to be due to homozygosity of some pleiotropic genes caused by inbreeding. PMID- 3972415 TI - A male with a monocentric Yq isochromosome and presence of a Yp-specific DNA sequence. AB - We describe clinical features and laboratory findings in a physically and mentally retarded male with underdeveloped testes, a seemingly monocentric isochromosome of Yq but the presence of a Yp-specific DNA sequence at a single dose of unknown genomic localisation, and the presence of H-Y antigen at normal male titer. Our data contribute to the fine mapping of the human Y chromosome by correlating phenotypic features with results from karyotypic, immunologic, and molecular hybridisation analyses. PMID- 3972417 TI - Supernumerary microchromosomes identified as inverted duplications of chromosome 15: a report of three cases. AB - Supernumerary bisatellited microchromosomes detected in three unrelated patients were identified as inverted duplications of chromosome 15. Each of these chromosomes contained a small euchromatic interstitial band presumably derived from the proximal portion of region 15q1. The clinical significance of this material was difficult to assess. Two of our cases were ascertained as the result of routine amniotic fluid studies. One of the affected fetuses had an unusual form of mosaicism 46,XY/48,XY, + inv dup(15), + inv dup(15), but no apparent developmental abnormalities. The inv dup (15) of the second fetus was familial in origin; no phenotypic abnormalities or evidence of mosaicism were detected in the carrier parent. The third inv dup(15) was found in a 20.5-month-old boy referred for developmental retardation. The clinical findings in this case were similar to those seen in patients with large inv dup(15)'s and did not suggest Prader-Willi syndrome. PMID- 3972418 TI - Improved identification of heterozygotes for homocystinuria due to cystathionine synthase deficiency by the combination of methionine loading and enzyme determination in cultured fibroblasts. AB - Previous data on tentative identification of the carrier state for homocystinuria due to cystathionine synthase deficiency using methionine loading or measurement of cystathionine synthase activity in tissue extracts are conflicting. We studied the results of standardized oral methionine loading in 20 obligate heterozygotes and compared them with those of determination of cystathionine synthase activity in cultured fibroblasts. Special attention was devoted to our recently reported observation on the small but striking differences in methionine metabolism between healthy pre- and postmenopausal women and men. Fasting and after load peak levels of methionine in serum did not discriminate the carriers from the control subjects. The mean fasting level of total homocysteine was only significantly higher in the group of premenopausal heterozygotes than in the corresponding control group. Nevertheless, the individual values overlapped with the normal range in 4 of 12 premenopausal heterozygotes. After loading peak levels of total homocysteine in 18 out of the 20 obligate heterozygotes exceeded the upper limit of the ranges in the three control groups. Thus, this parameter discriminated 90% of the obligate carriers. Measurement of cystathionine synthase activity in cultured fibroblasts from a skin biopsy identified the obligate heterozygotes to a similar degree (85%). No significant correlation between the measurements of cystathionine synthase activity and the after load peak levels of total homocysteine in the individual heterozygotes was established. Combination of both methionine loading and determination of cystathionine synthase activity in cultured fibroblasts identified all of these carriers. PMID- 3972419 TI - Partial trisomy 22--an old case reexamined. PMID- 3972420 TI - No difference in dermatoglyphics of fingers and palms between phenylketonuria patients and controls. PMID- 3972421 TI - Haptoglobin groups in dementia of Alzheimer type and multi-infarct dementia. AB - Haptoglobin (Hp) groups were determined in 65 patients with dementia of Alzheimer type (DAT) and 74 with multi-infarct dementia (MID). The increased Hp1 gene frequency among patients with DAT described by other investigators could not be confirmed in this study. The patients showed no significant difference from the controls with respect to phenotype and gene frequencies, and there were no significant differences between early and late onset cases of DAT. PMID- 3972422 TI - A comparative study of albumin variants found in Brazil. AB - 10 rare albumin variants found in Brazil have been compared with 6 others, discovered elsewhere, through horizontal starch gel electrophoresis in four buffer systems. Belem V can be clearly distinguished from Naskapi but shows the same mobility as Maku (= Belem III) in two different pHs. Coari II, Manaus I and Porto Alegre II can be separated from all others in three buffer systems. Belem II (= Mexico) and Belem I also show unique patterns, but Coari I, Porto Alegre I and Belem IV could not be distinguished from Santa Ana. The possibly synonymous Belem III-Belem V-Maku should have originated from an Amerindian gene pool, but Coari I-Porto Alegre I-Belem IV-Santa Ana may have a Caucasoid origin. PMID- 3972423 TI - Some remarks on linkage with a quantitative character. AB - A sample of 539 Polish families and 2,500 individuals were analysed to determine whether there was any evidence of linkage between the dermatoglyphic pattern elements on fingertips and blood groups. The results of the present study did not show any indication of linkage between dermatoglyphic patterns on fingertips (ulnar loops, radial loops, whorls and arches) and the ABO, MN, Rh, Kell and Xg blood groups. PMID- 3972424 TI - Segregation and linkage analyses of 72 leprosy pedigrees. AB - Data on 72 families with multiple cases of leprosy were analyzed for a susceptibility gene linked to the HLA loci. We conducted segregation analysis with the program POINTER and identity of HLA types by descent analysis to determine the most likely mode of inheritance. We then conducted linkage analysis with the program LINKAS, first assuming linkage equilibrium and then allowing for linkage disequilibrium and etiological heterogeneity. Segregation results suggest a recessive mode of inheritance, especially for the tuberculoid forms of leprosy. The linkage results, limited to tuberculoid forms and assuming a recessive model, suggest a hypothesis of loose linkage with no unlinked locus. When an additive model is assumed, the best fit is obtained with a hypothesis of complete linkage (theta = 0.0) with heterogeneity. We currently favor the additive model as the more plausible one. PMID- 3972425 TI - Atrichias and hypotrichoses: a brief review with description of a recessive atrichia in two brothers. PMID- 3972426 TI - Transferrin variant D Chi in tribals in Eastern India. PMID- 3972427 TI - Glutamate pyruvate transaminase null allele (GPT0) in the Navajo. AB - During genetic linkage studies of retinitis pigmentosa in a Navajo Amerindian family, an apparent null allele of erythrocyte GPT (GPT0) was observed in a man and 2 of his daughters. This is the fourth description of a (GPT0) allele, the first outside of Europe and the first in the Navajo. PMID- 3972428 TI - Lymphocyte emigration from lymph nodes by blood in the pig and efferent lymph in the sheep. AB - Two types of experiment using local labeling of lymph nodes with FITC showed that lymphocytes emigrate from lymph nodes, predominantly in blood in the pig and in efferent lymph in the sheep. In the first type of experiment with the pig, few cells emigrated via the lymph, while the number of labelled cells in the blood increased progressively and the indices in mesenteric blood were always higher than in jugular blood in simultaneously-drawn samples. However, in the sheep, when efferent lymph flowed freely, very low numbers emerged in blood and continuing large numbers of lymphocytes emerged in efferent lymph. In the second type of experiment carried out wholely under anaesthetic on mesenteric lymph nodes in pigs and sheep, and on superficial inguinal lymph nodes in pigs, the lymph node was isolated, the lymph and venous drainage collected and only the arterial supply maintained. Large numbers of FITC+ lymphocytes emigrated via the vein in pigs with either node cannulation (i.e. up to 7% blood lymphocytes were labelled with an emigration rate of approximately 10(8) cells/hr) but in sheep, while lymph contained approximately 30-80% labelled cells and the emigration rate was also approximately 10(8) cells/hr, the mesenteric blood contained very few labelled cells (approximately 0.2%, giving a mean venous emigration rate of 2.7 X 10(6)/hr). Study of the type of lymphocytes emerging from labelled pig lymph nodes and spleen during the phase of major emigration showed that sIg+ B and E rosette-forming T cells, but almost no Null cells, are involved. PMID- 3972429 TI - Natural killer (NK) cells and graft-versus-host disease (GVHD): no correlation between the NK cell levels and GVHD in the murine P----F1 model. AB - Graft-versus-host disease (GVHD) was induced in (CBA X C57BL/6) F1 mice by i.v. injection of 50 X 10(6) parental spleen cells. The GVHD induced an enhanced NK (anti-YAC-1) cytotoxicity during the first 2 weeks after the spleen cell transfusion. This cytotoxic activity was shown to be mediated by asialo GM1 positive, partially Thy-1-positive and nylon-wool (NW) non-adherent cells, thus being classical NK cells. Depletion of NK-cell activity from donor and/or recipient mice with anti-asialo GM1 antibody prior to the spleen cell transfer did not prevent the GVHD as judged by the splenomegaly assay. Also, when NK activity was potentiated with polyinosinic-polycytidylic acid (pIC), no effect on the GVHD was seen. These data suggest that NK cells are not crucial for the development of GVHD in this model. PMID- 3972430 TI - The rapid rejection of allogeneic lymphocytes by a non-adaptive, cell-mediated mechanism (NK activity). AB - The fate of allogeneic lymphocytes (AO or DA) transferred to non-immune PVG recipients was studied in the light of previous evidence (Heslop & McNeilage, 1983; Rolstad & Ford, 1983) that allogeneic lymphocytes can be rapidly destroyed in certain strain combinations of rats and mice by a mechanism that is distinct from either T-cell mediated immunity or an alloantibody response. AO lymphocytes injected into PVG recipients were discriminated from syngeneic lymphocytes within 15-30 min of i.v. injection, as testified by the excess release of 51Cr into the lymph plasma of the recipient. The following experiments were intended to distinguish between natural antibody and natural killer (NK) cells as the mechanism responsible for the allogeneic lymphocyte cytotoxicity (ALC) displayed by PVG rats. Nude rats treated from birth with anti-mu chain serum and shown to be lacking B and T lymphocytes, as well as being profoundly deficient in immunoglobulin, displayed more aggressive ALC than did control nude rats which, in turn, showed stronger ALC than did euthymic rats. Serum from PVG nude rats exerted no inhibitory or destructive effect on allogeneic lymphocytes in an antibody-dependent cellular cytotoxicity system, an assay of graft-versus-host activity, or when injected into 3-4-week-old PVG rats which had not yet developed ALC. Treatment of nude rats with anti-asialo GM 1 antiserum depressed ALC and NK activity in parallel, thus adding to a wide range of circumstances in which ALC and NK activity are closely correlated. In conclusion, ALC is implemented by a non-adaptive, cell-mediated mechanism independent of immunoglobulin, but the precise identity of the effector cell in the recipients' lymphatic tissues remains to be settled. PMID- 3972431 TI - Effects of vitamin E and selenium deficiencies on rat immune function. AB - The effects of dietary restriction of vitamin E and selenium were studied in male Long-Evans hooded rats. Weanling animals were maintained for 5-6 weeks on torula yeast-based diets, with or without the addition of vitamin E (150 IU/kg) or selenium (0.5 mg/kg), to form the following dietary groups: +E, +Se; +E, -Se; -E, +Se; -E, -Se, and a fifth group pair-fed with the -E, -Se group. This latter group exhibited a decreased rate of growth similar to the -E, -Se group. Lymphocyte blastogenesis in response to mitogens was decreased in animals fed the diets deficient in either vitamin E or selenium, and also in the pair-fed group. Very marked suppression of mitogen responses was seen in the doubly deficient group, as well as a greater loss of viability during culture. Spleen cell mediated antibody-dependent lysis of chicken erythrocytes was increased in the doubly deficient group, although this difference could be abolished by the addition of catalase, but not indomethacin, to the culture medium. Dietary deficiency of vitamin E and selenium had no discernible effects on alveolar macrophage function, as measured by cell-mediated antibody-dependent cytolysis, killing of Staphylococcus aureus or regulation of T-lymphocyte blastogenesis. PMID- 3972433 TI - Local and systemic immune response to orally administered liposome-associated soluble S. mutans cell wall antigens. AB - The aim of the present study was to develop an immunization procedure which preferentially stimulated the IgA system of rats, with release of IgA in secretions. Rats immunized by intragastric route with liposome-associated soluble antigen extracted from Streptococcus mutans cell wall, showed a significantly higher IgA (and IgG) response than did rats injected with the soluble antigen alone. In saliva, maximal antibody titres were obtained 11 days after the beginning of intubations for IgA, and 16 days for IgG. After a booster immunization, the secondary response occurred very quickly in saliva and, like the primary response, it was almost exclusively of the IgA class. This demonstrates, on one hand the existence of immunological memory in the IgA system and, on the other, the efficiency of liposomes as insoluble adjuvants in eliciting an immunological response. PMID- 3972432 TI - Ontogenic changes in secretory component expression by villous and crypt cells of rat small intestine. AB - In order to determine whether the rat small intestine exhibits quantitative changes in the synthesis of the secretory component (SC) during growth, epithelial villus and crypt cells were isolated from jejunal segments at intervals after birth up to adulthood. SC concentration was measured in each cell fraction by immunoradiometric assay and compared to sucrase activity, an enzyme marker of the differentiated villus enterocyte. The following results were observed. (i) Adult rats showed a characteristic decreasing concentration gradient of SC from the crypts (mean concentration in crypt cells: 636 +/- 173 ng/mg protein) to the villus tip (mean concentration in villus cells: 152 +/- 17 ng/mg protein). This gradient was the reverse of that found for sucrase activity. (ii) In young sucklings (10 days old), SC was virtually absent in both villus and crypt cells, but its concentration progressively increased in weanling rats and reached adult levels by day 40 postpartum. (iii) The crypt to villus cell gradient of SC, absent in sucklings up to day 20, developed during the fourth postnatal week. (iv) Treatment of 10-day-old suckling pups with pharmacological doses of either corticosterone or L-thyroxine for 3 consecutive days failed to induce the precocious synthesis of SC by jejunal enterocytes, but produced significant (P less than 0.01) decreases in concentration. Under the same conditions, sucrase activity was markedly enhanced. In conclusion, major changes in the ability of the immature crypt cell to produce the specific receptor for transepithelial transport of polymeric immunoglobulins occur during the fourth week of rat life. The initiation of this ontogenic process is not triggered by the dietary and hormonal changes known to control the maturation of other functions linked to the differenciated villus cell, such as sucrase activity. PMID- 3972434 TI - Quantitative and spectrotypic analysis of paternal IgG2a expression in normal and allotype-suppressed mice. AB - The synthesis and clonal diversity of IgG2a molecules bearing the paternally inherited immunoglobulin allotype have been examined in the offspring of matings between BALB/c mothers (Igh-1a) and SJL or C57BL/10 males (both Igh-1b) using a sensitive quantitative single radial immunodiffusion in gel assay and isoelectric focusing with autoradiography. In normal litters, the first detectable paternally marked IgG2a is extensively polyclonal in both F1 crosses (i.e. diversity precedes expression); however, there is a delay of 2-3 weeks in the first appearance of the clonally diverse set of molecules when these are coded by the SJL genome, compared with the C57BL/10. Delayed maturation of allelically excluded Igh-1b-expressing B cells in the (BALB/c X SJL)F1 may explain the unique susceptibility of these offspring to chronic allotype suppression when exposed to maternal anti-Igh-1b antibodies in early life. We find that, although such suppressed mice may begin life with a (delayed) synthesis of polyclonal IgG2a of paternal allele (Igh-1b), the condition of chronic suppression later imposed in the majority of mice is associated with spectrotype (clonal) simplicity. PMID- 3972435 TI - Blood clearance and tissue localization of soluble aggregates of IgG in NZB/W and NZB mice. AB - We studied the capacity of the mononuclear phagocytic system (MPS) of NZB/W and NZB mice to clear trace and saturating doses of soluble heat-aggregates of IgG (A IgG) from the blood. Mature female NZB/W mice (aged 5-7 months) with early glomerulonephritis showed no differences in MPS clearance of A-IgG compared with younger NZB/W mice without glomerulonephritis. In contrast, mature NZB mice had a more rapid clearance of A-IgG and greater MPS localization of A-IgG than their younger counterparts. Further studies showed that older NZB/W mice (greater than 10 months) had a slightly more rapid clearance of A-IgG than 2-5-month-old mice (t 1/2 = 3.34 +/- 0.27 SEM vs 3.76 +/- 0.34 SEM, P less than 0.01), whereas NZB mice mice older than 10 months of age had a markedly more rapid clearance than 2 5-month-old NZB mice (t 1/2 = 2.84 +/- 0.15 SEM vs 3.76 +/- 0.32, P less than 0.005). The more rapid clearance seen in NZB mice was partly explained by greater splenic localization of A-IgG and appeared to be restricted to Fc- and/or C3b receptor mediated clearance, in that clearance of aggregated albumin was not changed. We conclude that NZB/W mice have no impairment in MPS clearance capacity at the onset of their glomerulonephritis, and slightly increased clearance capacity late in the course of their disease. Thus, the presence of circulating immune complexes and the development of glomerulonephritis in NZB/W mice is unlikely to be due to a diminished MPS clearance capacity. NZB mice have an increase in MPS capacity to clear A-IgG as a function of age. PMID- 3972436 TI - The effect of lactation on the transport of serum-derived IgA into bile of sheep. AB - The effect of lactation on the selective transport of IgA from serum into bile and the relationship between volume of milk production and IgA recovery in bile was examined in sheep following intravenous injection of radiolabelled dimeric IgA. Bile: plasma radioactivity ratios for lactating and non-lactating sheep were 6.20 +/- 1.50 and 1.97 +/- 0.35, respectively, and in lactating sheep the milk : plasma ratio was 8.20 +/- 0.81. When biliary flow rates and milk yield were taken into account, 7.3% and 42.0% of the radiolabelled IgA present in plasma at 1 min after injection was recovered in bile and milk, respectively, of low milk yielding ewes, whereas in high milk yielding ewes, recoveries were 4.0% and 66.0%, respectively. The data suggest that during lactation there is an overall increase in transport of IgA into bile, possibly due to the effect of lactogenic hormones on secretory epithelia, but that there may be competition between hepatocytes and mammary epithelial cells for available serum-derived IgA, depending on the secretory activity of the gland. PMID- 3972437 TI - The effect of adjuvants and prior immunization on the rate and mode of uptake of antigen into afferent popliteal lymph from sheep. AB - Experiments were carried out to determine the effect of a range of adjuvants on the antibody response of sheep to a subcutaneous injection of ovalbumin. Incomplete Freund's adjuvant (IFA) was the best of the repository type adjuvants. From a range of soluble immunopotentiating substances tested, the polyion DEAE dextran, or dextran sulphate, produced the greatest enhancement of the response. These results were confirmed in a factorial experiment, but no interactions were found between various classes of adjuvants. Further experiments were carried out to determine the effect of superior adjuvants, prior immunization or intradermal injection on the rate and mode of uptake of antigen from the injection site to afferent lymph. These experiments showed that, with IFA, most antigen is retained at the injection site, less than 15% entering lymph by 3 days. There was some delay in antigen uptake with adjuvant 65, while for aluminium phosphate precipitated antigen, the rate of uptake was the same as following a saline injection. There was some delay in uptake of antigen following injection with DEAE-dextran or in primed sheep but, following intradermal injection, the rate of uptake into lymph was the same as aqueous antigen injected subcutaneously. Experiments in which the distribution of radioactive antigen between cells and plasma in lymph was examined showed that, in unprimed sheep, virtually all antigen is unassociated with cells. In primed sheep, however, about 0.5% of antigen in lymph was found to be cell-associated. Gel filtration of lymph plasma from primed sheep demonstrated that nearly all the antigen in lymph is carried to the node as high molecular weight material, presumably antigen-antibody complexes. PMID- 3972438 TI - Effects of multiple oral dosing on IgE synthesis in mice: oral sensitization by albumin extracts from seeds of Jack fruit (Artocarpus integrifolia) containing lectins. AB - The IgE antibody response was studied in DBA/2 mice; the mice were pretreated orally with albumin extracts from seeds of Jack fruit (Jackalbumin) and subsequently immunized subcutaneously with Jackalbumin mixed with ovalbumin (OA) and a synthetic adjuvant, muramyl dipeptide (MDP). The allergenicity of Jackalbumin was evaluated by its capacity to induce a specific IgE response which was measured by passive cutaneous anaphylaxis (PCA) and by degranulation of washed peritoneal mast cells following antigen challenge (Jackalbumin or OA). Antibody against the crude extracts and anti-lectin (FIISP) IgE responses were also tested by PCA. After being fed eight doses of 1 mg Jackalbumin, DBA/2 mice became immunized: i.e. specific IgE antibody responses were observed and the peritoneal mast cells became sensitized. An increase in IgE response was verified in mice that were pre-fed and subsequently immunized. The results indicated that: the albumin extracts from Jack seeds, containing lectins, can be allergenic by the oral route; multiple oral doses with these extracts can induce an enhancement of the IgE response on subsequent subcutaneous immunization; antigenically, Jackalbumin does not seem to cross-react with OA; the lectins contained in the albumin fraction from Artocarpus seeds were also shown to be allergenic; the IgE titres showed an inverse correlation to the degree of purification of the lectin used for PCA challenge. PMID- 3972439 TI - Anaphylactic-like reaction of small intestinal epithelium in parasitized guinea pigs. AB - Antigens derived from Trichinella spiralis were used to challenge, in vitro, sensitized jejunum from infected guinea-pigs while monitoring ion transport properties of the tissue. Antigen challenge resulted in dose-dependent increases in trans-epithelial electrical potential difference and short circuit current. Both antigen-stimulated electrical alterations and Schultz-Dale contractions were demonstrated in small intestinal tissue after the passive transfer of immune serum containing anti-trichinella homocytotropic antibodies. PMID- 3972440 TI - Model of experimental chronic osteomyelitis in rats. AB - We describe here a Sprague-Dawley rat model for chronic osteomyelitis. Staphylococcus aureus and sodium morrhuate were implanted by either microdrilling or direct needle injection into the tibiae of rats. Of 107 rats, 87 (81%) developed osteomyelitis when a high-speed drill was used for implantation, and 27 (51%) of 53 rats developed osteomyelitis by direct needle inoculation (chi square = 9.81, P less than 0.01). Demonstrated histopathological changes included the presence of resorption bays filled with osteoclasts. Quantitative microbiological monitoring of tibial count confirmed disease chronicity, yielding stable numbers of CFU (10(6.29 +/- 0.27) ) of S. aureus over 70 days. Infected animals became anemic and lost weight. The erythrocyte sedimentation rates and leukocyte counts were not elevated. Roentgenograms provided the best correlation with the number of organisms in infected tibiae (r2 = 0.80). Rats with infected tibiae were treated with either oxacillin (120 mg/kg per day) or ceftriaxone (50 mg/kg per day). Treatment over 14 or 28 days reduced S. aureus counts in tibiae but did not reliably sterilize infected bones, suggesting that this model was resistant to prolonged antimicrobial therapy. PMID- 3972441 TI - Reaction of human sera with Eubacterium brachy: isolation and characterization of an extracellular antigen. AB - Recent studies have demonstrated an association of Eubacterium sp. with the subgingival microflora of patients with chronic periodontitis. One species, Eubacterium brachy, was evaluated to determine the possible mechanisms by which this microorganism may contribute to these diseases. Of 167 sera evaluated by double diffusion in agar, 20.8% displayed reactivity with a sonicated preparation of E. brachy. An extracellular antigen was identified in the culture supernatant fluid which reacted with antibodies in human sera. This antigen was isolated by methanol precipitation and purified by gel filtration. When tested by an enzyme linked immunosorbent assay, all sera displayed some reactivity. Lines of identity were not shared with other species of Eubacterium, but were shared with other clinical isolates of E. brachy. The reactive antibody was identified as immunoglobulin G by immunoelectrophoresis, verified by enzyme-linked immunosorbent assay, and found to be capable of complement fixation. The monosaccharides and amino acids of the extracellular antigen were identified by high-pressure liquid chromatography. This antigen was shown to have a molecular weight of 170,000 and to share a line of identity with the sonicated preparation of E. brachy. The possible role of the organism in the immunopathology of periodontal diseases is discussed. PMID- 3972442 TI - Cholate-dependent killing of Giardia lamblia by human milk. AB - We showed previously that nonimmune human milk (NHM) kills Giardia lamblia trophozoites in vitro and presented evidence that killing requires the bile salt stimulated lipase of milk. Since this enzyme is activated by bile salts, killing should be dependent on the presence of bile salts. We now show that killing by fresh NHM or NHM stored at -70 degrees C is totally dependent on sodium cholate (a bile salt). With less than 0.4 mM cholate, no parasites were killed, whereas with 1 mM cholate, greater than 99.7% were killed by 5% NHM in 30 min. Moreover, killing activity was completely heat labile. The G. lamblia-killing activity of human milk was greatly altered by storage at -10 or -20 degrees C. In less than 23 days, the 50% lethal dose decreased, cholate dependence was lost, and killing activity became heat stable. In contrast, the activity of milk stored at -70 degrees C remained unchanged. Milk lipase activity, like killing activity, became cholate independent during storage at -10 or -20 degrees C. On the basis of these results, we hypothesize that killing of G. lamblia by fresh NHM or NHM stored at 70 degrees C depends on bile salt-stimulated lipase, which must be activated by bile salts. In contrast, NHM stored at -20 degrees C accumulated free fatty acids which kill G. lamblia. In support of this thesis, milk stored at -10 degrees C had a concentration of 18.7 mM free fatty acids compared with only 1.1 mM in an identical sample stored at -70 degrees C. PMID- 3972443 TI - Mucosal nasopharyngeal immune responses of horses to protein antigens of Streptococcus equi. AB - Mucosal nasopharyngeal immunoglobulin A (IgA) and IgG responses to proteins of Streptococcus equi were studied in horses after the experimental production of strangles. S. equi-specific IgA and IgG titers in nasopharyngeal mucus were much higher in samples from animals 1 to 2 weeks after challenge than in samples from control animals. Although IgA was the major immunoglobulin in nasal mucus, there was more antibody activity associated with IgG as measured by radioimmunoassay. Great differences between the specificities of antibodies in nasal mucus and in serum were detected. IgA and IgG of mucus origin recognized only two major proteins with molecular weights of about 41,000 and 46,000 in acid extracts of S. equi and gave no detectable reaction with culture supernatant proteins. Only one protein of about 62,000 molecular weight was recognized in acid extracts of an equine strain of S. zooepidemicus. In contrast, immunoglobulins in serum recognized a great variety of proteins in culture supernatants and acid extracts of S. equi and S. zooepidemicus which did not include those proteins recognized by immunoglobulins in mucus. These findings provide good evidence for the independence of the local and systemic immune responses of the horse to S. equi. Horses rechallenged shortly after recovery from the first infection were resistant to challenge with an inoculum of S. equi 10 times greater than that to which they were originally susceptible. This resistance appeared to be independent of the levels of bactericidal antibody in serum. We therefore suggest that immunity to S. equi infection is mediated by locally produced nasopharyngeal antibodies. PMID- 3972445 TI - Actinobacillus actinomycetemcomitans strains Y4 and N27 adhere to hydroxyapatite by distinctive mechanisms. AB - Actinobacillus actinomycetemcomitans strains Y4 and N27 absorb to spheroidal hydroxyapatite in roughly the same numbers per milligram of substrate and with the same tenacity as two previously tested Cytophaga species. Although the two strains of A. actinomycetemcomitans exhibited similar affinities and number of binding sites for SHA, their response to enzyme treatment and heating were very different. The capacity of strain Y4 to attach to spheroidal hydroxyapatite was diminished by treatment with proteases and phospholipases and was unaffected by neuraminidase, while strain N27 was unaffected by proteases and phospholipases and lost its binding capabilities when treated with neuraminidase. PMID- 3972444 TI - Role of fibronectin in human monocyte and macrophage bactericidal activity. AB - Fibronectin is a high-molecular-weight glycoprotein found as a soluble dimer in plasma and as an insoluble multimer in tissues. It has been proposed that plasma fibronectin facilitates phagocytic removal of lysed cells and damaged tissues. Fibronectin binds avidly to several species of gram-positive bacteria and enhances staphylococcal and streptococcal attachment to cultured cells. Determination of whether fibronectin will enhance the bactericidal activity of monocytes and macrophages has not been reported. The bactericidal activity of freshly isolated monocytes, cultured monocytes, or lymphokine-activated macrophages was tested in the presence of either dimeric or multimeric fibronectin. Freshly isolated monocytes and lymphokine-activated macrophages killed Staphylococcus aureus effectively in the absence of fibronectin or whole serum. In contrast, monocytes cultured for 7 to 10 days had diminished staphylocidal capacity. When the monocytes were cultured with either dimeric or multimeric fibronectin, however, bactericidal capacity was maintained. Thus, although fibronectin did not enhance the bactericidal activity of mononuclear phagocytes, both multimeric and dimeric fibronectin were effective at maintaining the bactericidal capacity. PMID- 3972446 TI - Identification and occurrence of Vibrio cholerae flagellar core proteins in isolated outer membrane. AB - Sodium dodecyl sulfate-urea polyacrylamide gel electrophoresis of outer membranes from a flagellated and an isogenic nonflagellated strain of Vibrio cholerae (classical, Inaba) suggested that two proteins were absent from the nonflagellated strain. Immunoblot examination of such preparations demonstrated that two proteins, present only in outer membrane from the flagellated strain, were associated with flagella. Analysis of purified flagellar cores from strains CA401 and N16961 (El Tor, Inaba) by electron microscopy, sodium dodecyl sulfate urea polyacrylamide gel electrophoresis, and immunoblotting showed that these two proteins, with apparent molecular weights of 47,000 and 49,000, composed the flagellar core. Antiserum specific for flagellar core proteins did not agglutinate or inhibit the motility of intact V. cholerae. These latter findings suggested that, for intact cells, the flagellar core proteins are not accessible to antibody. PMID- 3972447 TI - Invasion of HEp-2 cells by fecal isolates of Aeromonas hydrophila. AB - Human diarrheal isolates of Aeromonas hydrophila were found to be invasive in HEp 2 cell monolayers. Microscopic examination of two isolates from patients with symptoms of dysentery revealed that infected HEp-2 cells contained up to 50 bacteria localized within areas of the cytoplasm. A quantitative invasion assay was developed, using viable counts of total intracellular bacteria. Five fecal isolates of A. hydrophila were classified as invasive, with an average of 0.1 up to 2 bacteria per HEp-2 cell, as compared to 7 for an invasive Escherichia coli strain. 3 other fecal isolates, 1 reference strain, and 10 water isolates of A. hydrophila were similar to a noninvasive E. coli strain, with less than 0.008 bacteria per HEp-2 cell. All isolates were screened for plasmid DNA; no common plasmid was found in the invasive strains, and the loss of a 6.0-megadalton plasmid from one of these strains had no observable effect on invasiveness. Thus some A. hydrophila isolates are capable of cellular penetration and replication, and this may be an important chromosomally determined virulence property of the organism. PMID- 3972448 TI - Experimental cecitis in gnotoxenic chickens monoassociated with Clostridium butyricum strains isolated from patients with neonatal necrotizing enterocolitis. AB - An animal model for Clostridium butyricum necrotizing cecitis has been developed in axenic chickens inoculated orally between 2 and 50 days of life. Cecitis was obtained with two C. butyricum strains isolated from neonatal necrotizing enterocolitis and not with a Clostridium beijerinckii strain from dairy products; the rate of colonization of the intestinal tract by this strain was lower than that obtained with C. butyricum strains. The clinical findings showed a slow gain in body weight. The cecitis lesions were well developed 3 and 4 weeks after oral inoculation, including enlargement with an increase of the cecum weight-body weight ratio, a marked hyperplasia, congestion, inflammatory infiltrate and pneumatosis of the cecal wall and mesentery, hemorrhage in the lamina propria and submucosa, and ulcerations and necrotic areas in the mucosa. By immunofluorescence and electron microscopy, the bacterial cells were located in the cecal lumen and in necrotic areas of the mucosa. The presence of 4% lactose in the diet seemed to be a prerequisite for the development of cecitis in chickens. A gradual rise of fluorescent antibodies in the sera was observed. PMID- 3972449 TI - Effect of toxic shock syndrome toxin 1 on chicken embryos. AB - Staphylococcus aureus strains associated with toxic shock syndrome produce toxic shock syndrome toxin 1 (TSST1). This toxin has a variety of biological effects, including enhanced lethality in rabbits in the presence of sublethal amounts of lipopolysaccharide (LPS). Because chicken embryos are highly susceptible to LPS, the synergistic effect of TSST1 and LPS was examined in this system. Although TSST1 per se had no effect on chicken embryos, it potentiated the lethal effect of LPS. The 50% lethal dose of LPS was greatly reduced in the presence of up to 10 micrograms of TSST1 per ml. However, at high doses of TSST1 (greater than 100 micrograms/ml), no enhanced lethality was observed. The lowest dose of TSST1 tested which potentiated lethality was 10 ng/ml. PMID- 3972450 TI - Interferon-induced inhibition of Chlamydia trachomatis: dissociation from antiviral and antiproliferative effects. AB - The yield of infectious Chlamydia trachomatis was analyzed in human (HeLa) and mouse (McCoy) cell lines treated with the human interferon (IFN) subtypes IFN alpha A and IFN-alpha D, with their hybrids [IFN-alpha AD (BglII), IFN-alpha AD (PvuII), and IFN-alpha DA (BglII)] constructed in vitro from their expression plasmids, or with IFN-beta 1 or buffy coat IFN. In HeLa cells, a significant inhibition of Chlamydia infectivity was obtained with IFN-alpha D, IFN-alpha DA (BglII), and buffy coat IFN. In McCoy cells, IFN-alpha AD (BglII) and IFN-alpha AD (PvuII) induced a strong degree of inhibition of Chlamydia infectivity. In McCoy cells, there was a correlation among the antichlamydial, antiviral, and antiproliferative activities of the different IFNs tested. In HeLa cells, however, the ability of a particular IFN subtype to inhibit Chlamydia infectivity did not always correlate with its inhibitory effects on encephalomyocarditis virus replication or with its antiproliferative activity. PMID- 3972451 TI - Relative hydrophobicities of Actinomyces viscosus and Actinomyces naeslundii strains and their adsorption to saliva-treated hydroxyapatite. AB - The present study examined 42 strains of Actinomyces spp. to determine whether adsorption to saliva-treated hydroxyapatite (SHA) of the selected strains of this prominent group of dental-plaque bacteria correlated with hydrophobicity. The relative hydrophobicity of the strains was determined by their adsorption to hydrophobic gels (i.e., phenyl-Sepharose) and their aggregation in ammonium sulfate. Within serogroups the relative hydrophobicity for the strains was similar. The relative adsorption of strains to SHA was also similar within the respective serogroups. Strains which were relatively hydrophobic, as judged by their binding to the hydrophobic gel and aggregation in low concentrations of ammonium sulfate, adsorbed well to SHA. Strains which adsorbed poorly to SHA were relatively hydrophilic since they did not bind well to the hydrophobic gel and were only aggregated in relatively high concentrations of ammonium sulfate. Tween 80, a nonionic detergent known to inhibit hydrophobic interactions, blocked binding of cells to the hydrophobic gel, suggesting that hydrophobic interactions had been inhibited. However, Tween 80 exhibited no influence on the adsorption of cells to SHA. Thus, although there was a strong statistical correlation between the relative hydrophobicity of a strain and its adsorption to SHA, the data were consistent with the view that other interactions, such as ionic bonds and interactions between complimentary macromolecules, are involved in adsorption of the Actinomyces strains to SHA. PMID- 3972452 TI - Identification of a 68-kilodalton protective protein antigen from Bordetella bronchiseptica. AB - A 68-kilodalton (kd) outer membrane protein antigen of Bordetella bronchiseptica has been identified by using monoclonal antibodies that recognized two nonoverlapping determinants. Antibody BB05 also reacted with homologous proteins from Bordetella pertussis and Bordetella parapertussis but not with another 12 organisms from various bacterial genera. Passive injection of BB05 antibody protected mice from aerosol infection with B. bronchiseptica as shown by reduced mortality and reduced pathology of turbinate bones. The 68-kd B. bronchiseptica antigen was purified by BB05-based affinity chromatography and evaluated for its potency to immunize mice actively against either intraperitoneal or aerosol challenge with B. bronchiseptica. Immunization with the 68-kd antigen in incomplete Freund adjuvant significantly reduced the levels of mortality in intraperitoneally challenged mice. In the aerosol infection model, injection of the 68-kd antigen with complete or incomplete Freund adjuvant or saponin reduced the bacterial counts in the lungs of infected mice. These results suggest that the 68-kd protein may represent a potential "protective" antigen of B. bronchiseptica. PMID- 3972453 TI - Effects of iron and desferrioxamine on infections with Yersinia enterocolitica. AB - The effects of iron-dextran and the iron chelator desferrioxamine B mesylate (Desferal) on the course and outcome of experimental yersiniosis were investigated. Yersinia enterocolitica strains representing the three leading serogroups pathogenic for humans, O3, O8 and O9, were studied. In mice, iron dextran reduced the median lethal dose of intraperitoneally administered Y. enterocolitica O3 and O9 ca. 10-fold, whereas Desferal reduced this value more than 100,000-fold. Experiments in which Y. enterocolitica was given orally to mice and intraconjunctivally to guinea pigs confirmed that Desferal markedly increased the susceptibility of animals to yersiniosis. Although serogroup O8 yersiniae were inherently more virulent for laboratory animals, they were less affected by Desferal than were O3 or O9 strains. In vitro experiments indicated that Desferal promoted growth of Y. enterocolitica under iron-limiting conditions and suggested that the enhanced virulence of O8 yersiniae may be due to their comparatively low requirement for iron. The adverse effect of Desferal on the course of experimental infection with Y. enterocolitica may partly explain the heightened susceptibility of iron-overloaded patients to systemic yersiniosis. PMID- 3972454 TI - Increased translocation of bacteria from the gastrointestinal tracts of tumor bearing mice. AB - Aerobic gram-negative bacilli and other indigenous gastrointestinal (GI) bacteria are important opportunistic pathogens in immunosuppressed cancer patients. These same bacteria frequently translocate from the GI tracts of mice immunosuppressed by single injections of certain anticancer drugs or by T-lymphocyte impairments. Since similar cellular and humoral immune deficiencies may be present in the tumor-bearing host, we sought to determine if progressive growth of a tumor alone would be sufficient to enhance the translocation of indigenous bacteria from the murine GI tract. Pathogen-free DBA/2 mice were injected intraperitoneally with 10(6) viable sarcoma 180 (S-180) cells or 0.5 ml of sterile buffer. Mesenteric lymph nodes, livers, spleens, and kidneys were tested for the presence of translocated aerobic GI bacteria on various days after tumor injection. Immunity was assessed by measuring footpad delayed-type hypersensitivity and serum hemagglutinins to sheep erythrocytes. Overall, translocated aerobic GI bacteria infected 33 of 92 S-180-bearing mice (36%) and only 9 of 99 control mice (9%) (P less than 10(-6)). Cumulatively, 50 of 460 sites (10.9%) in S-180-bearing mice were infected with translocated GI bacteria as opposed to only 9 of 485 sites (1.9%) in control animals (P less than 10(-7)). GI bacteria often translocated to infect more than one site in tumor-bearing mice, but not in controls. Aerobic gram-negative bacilli translocated 11 times in tumor-bearing mice, but only once in controls, even though the mean cecal population levels of these bacteria were relatively low (range, 4.33 to 5.28 log10 bacteria per g). The population levels of cecal aerobic bacteria were similar in S-180 and control mice throughout the period of observation. S-180 mice had significantly suppressed (P less than 0.04) delayed-type hypersensitivity and serum hemagglutinin responses when sensitized 4 or 8 days after S-180 injection. S-180 growth was associated with a neutrophilic leukocytosis and a slight drop in platelet counts; no bleeding was detected. Thus, the translocation of gram-negative bacilli and other indigenous aerobic bacteria from the GI tract to the mesenteric lymph nodes and other organs was increased in immunosuppressed S-180-bearing mice, and this increase was not caused by bacterial overgrowth in the intestines or by neutropenia. PMID- 3972455 TI - Systemic Coccidioides immitis infection in nude and beige mice. AB - The course of experimental systemic Coccidioides immitis infection was assessed quantitatively and histologically in beige mice, congenitally athymic nude mice, and their respective normal counterparts. After intravenous inoculation with 50 arthroconidia, the number of viable C. immitis cultured from the spleens, livers, and lungs progressively increased throughout the assay in the organs of all mice. During the first 2 weeks of infection, significantly greater numbers of CFU were recovered from the spleens and livers, but not the lungs, of nude mice than from the respective organs of their phenotypically normal littermates. Significantly greater numbers of CFU were cultured from the lungs and spleens of beige mice compared with the number recovered from their functionally normal littermates. After intranasal inoculation, extrapulmonary dissemination of C. immitis occurred at an equal rate and resulted in similar organ burdens in nude mice and their normal littermates. Histological examination of infected tissues revealed a characteristic mixed inflammatory cell infiltrate in euthymic mice; the response in nude mice was less severe, consisting predominantly, if not solely, of granulocytes. In addition, in tissue sections from nude mice, but not in those from their euthymic counterparts, mature spherules were frequently observed to be devoid of an associated inflammatory response. The inflammatory lesion in beige mice contained a predominance of mononuclear cells, whereas their littermates responded with a typical mixed granulomatous infiltrate. Collectively, these results provide evidence supporting the hypothesis that resistance to C. immitis infection involves two primary cell populations, one under the direct influence of T-cells and the other independent of T-lymphocytes. PMID- 3972456 TI - Selective detection of Mycoplasma hyorhinis using cloned genomic DNA fragments. AB - A 13-kilobase DNA fragment from a genomic library of Mycoplasma hyorhinis demonstrated specific Southern hybridization and dot hybridization when tested against a group of different mycoplasmas. This probe selectively recognized M. hyorhinis sequences in purified DNA, broth-grown organisms, and infected cell cultures, providing a direct method for differential detection of this species. PMID- 3972457 TI - Inhibition of neutrophil phospholipase A2 by p-bromophenylacyl bromide, nordihydroguaiaretic acid, 5,8,11,14-eicosatetraynoic acid and quercetin. AB - The lipoxygenase and/or cyclooxygenase inhibitors nordihydroguaiaretic acid (NDGA), 4,8,11,14-eicosatetraynoic acid (ETYA) and the bioflavonoid, quercetin, also inhibit phospholipase A2 (phosphatidase 2-acyl hydrolase; EC 3.1.1.4) activity of neutrophil acid extracts and sonicates. The IC50 are 13 microM for NDGA, 22 microM for ETYA, and 100 microM for quercetin when measured on the neutrophil acid extracts; the IC50 obtained with the sonicates are 11 microM, 12 microM and 57 microM, respectively. p-Bromophenylacyl bromide (BPB) inhibits the phospholipase A2 activity of neutrophil acid extracts with an IC50 of 10 microM. In contrast, intact neutrophils incubated for up to 1 h with BPB, washed to remove the drug, and sonicated to expose the phospholipase A2, lose less than 20% of their activity. This strongly suggests that BPB does not inhibit neutrophil function by preventing phospholipase action. PMID- 3972458 TI - Enhanced lung clearance of antigen in immunised mice. AB - A mouse model is described which enables a semi-quantitative assessment of antigen clearance from the lung. The distribution of antigen presented to the non sensitised lung is examined and shown to be reproducible using a simple in vivo inoculation technique. Preliminary studies demonstrate that antigen clearance is significantly enhanced after parenteral immunisation and that the effect is antigen specific. Applications of the model to further studies of respiratory challenge are suggested. PMID- 3972459 TI - Reduction of antigen-induced contraction of sensitized guinea-pig tracheal smooth muscle in vitro by calmodulin inhibitors. AB - The effect of two calmodulin inhibitors, 1-[bis(p-chlorophenyl)methyl]-3-[2,4 dichloro-beta-(2,4-dichlorobenzylox y) phenethyl]imidazolinium chloride (R 24571) and chlorpromazine (CPZ) on antigen-induced contraction of guinea-pig tracheal smooth muscle was studied. Ketotifen, an anti-allergic compound, was used as a comparative drug. Contraction of sensitized guinea-pig trachea induced by antigen challenge was reduced by all three agents. The two calmodulin inhibitors effected relaxation of contraction of guinea-pig trachea induced by histamine and leukotriene D4 (LTD4). Ketotifen relaxed histamine-induced contraction, but hardly affected LTD4-induced tone. Contrary to chemical mediator induced tone, all examined agents had no effect on resting tone. These three agents shifted histamine- and LTD4-induced concentration-contraction curves to the right. They produced a downward displacement of the maximum, without a parallel shift in histamine- and LTD4-induced concentration-contraction curves. The two calmodulin inhibitors did not affect the antigen-induced release of histamine and SRS-A from sensitized guinea-pig lung tissue. Ketotifen slightly inhibited the release of histamine. These results suggest that R 24571 and CPZ, calmodulin inhibitors, reduced an antigen-induced contraction of sensitized guinea-pig trachea in vitro mainly by affecting the contractility of tracheal smooth muscle by chemical mediators but not by interfering with the release of mediators. PMID- 3972460 TI - Murine lymphocyte responses to purified components of rye grass pollen extract. AB - The ability of lymphocytes obtained from mice treated with whole rye grass pollen extract or purified major allergen components (R7--apparent molecular weight 31,000; R14a-apparent molecular weight 11,000) to proliferate in culture on challenge with these allergens has been studied. Whole rye grass pollen extract was found to stimulate responses with lymphocytes from all treated but not non treated animals, whereas the purified allergens failed to effect proliferation except with cells obtained from animals treated with the homologous allergen. These results accord with previous observations that, of the antigen present in the whole rye grass pollen extract, the components showing greatest immunogenicity in murine systems are not those commonly regarded as being the major allergens in man. The mouse may not thus provide a relevant model of human immune responses to rye grass pollen extracts. PMID- 3972461 TI - Double lumen subclavian hemodialysis cannulas. PMID- 3972462 TI - Intravascular degranulation of polymorphonuclear neutrophils during hemodialysis. The effects of pretreatment with colchicine. AB - Polymorphonuclear neutrophil (PMN) counts, plasma activity inducing PMN aggregation, augmenting PMN adherence and chemotactic activity were estimated during hemodialysis (HD) with cuprophane membranes. All these plasma activities are accepted as related to the presence of activated complement (C). The same estimations were made for hemodialyzed patients pretreated with colchicine. The results, especially comparison of plasma activities in blood entering and leaving the dialyzer, indicate that significant amounts of activated C components are generated within the patients vascular bed. The PMN entrapped in the pulmonary microcirculation that undergo subsequent degranulation are most probably the source of these C components. This concept was confirmed by the results for patients pretreated with colchicine, who had significantly less of the activities generated in the patients own circulation. PMID- 3972463 TI - The effect of recycle on the continuous centrifugal processing of blood cells. AB - Recycle configurations are presented for continuous-flow blood cell separation systems. A sample design calculation is presented for a single-stage unit with recycle. Increases in blood-cell collection efficiencies may be obtained with recycle, and various design configurations are proposed. PMID- 3972464 TI - Stagewise separation to improve continuous centrifugal blood cell separators. AB - Staging is a technique used to improve blood cell collection efficiencies. In this paper, fractional cell recoveries are presented as functions of hematocrit as well as flow distribution. Material balances are presented, and the effect of increasing the number of stages studied in relation to increases in white blood cell collection efficiencies. PMID- 3972465 TI - The pathogenesis of uremic encephalopathy (UE). PMID- 3972466 TI - Arterio-venous hemodiafiltration (A-V HDF): a possible way to increase urea removal during C.A.V.H. PMID- 3972467 TI - Cardiac performance in chronic renal failure. PMID- 3972468 TI - An analysis of some risk factors for lung cancer in Hong Kong. AB - Lung cancer has been the major cause of cancer death in Hong Kong for more than a decade. Although it is known that some 95% of male cases can be attributed to smoking, the etiological factors in women remain elusive. Among "never-smoked" female cases, increases in attributable risk from passive smoking were limited to only some of the histological types of lung carcinomas, and an overall analysis of all types did not reveal any significant increase in relative risk from this source. Other environmental factors which encourage bronchial irritation are suspected. Methodological differences may explain the differences in proportional distributions of histological lung tumor types noted between previous reports, and the risk values attributed therein to active and passive smoking. PMID- 3972469 TI - Use of irradiated mouse fibroblasts to improve the cloning and adaptation to culture of human melanoma cells. AB - By using irradiated BALB/c 3T3 mouse fibroblasts as feeder cells, we obtained a marked increase in the cloning efficiency of the 9 human melanoma cell lines that were tested. Four of these melanoma lines had a cloning efficiency that was lower than 0.0007 in the absence of feeder cells. In the presence of irradiated 3T3 cells, their cloning efficiency ranged from 0.017 to 0.26. For most melanoma cell lines the growth rate of cultures that were seeded at a low cell density was also increased by the use of 3T3 feeder cells. In high-density cultures, no effect was observed with most cell lines. The 3T3 effect was reversible. The pattern of surface antigens expressed by melanoma cells grown in the presence of 3T3 was similar to that observed without 3T3. The effect of feeder cells on the adaptation to culture of 5 primary melanomas was also tested. A definite improvement in cell yield was obtained with 4 of these melanomas. PMID- 3972470 TI - Studies on clonal heterogeneity in two spontaneously metastasizing mammary carcinomas of recent origin. AB - We have studied the clonal heterogeneity of 2 spontaneously metastasizing mammary carcinomas which recently arose spontaneously in C3H/He female retired breeders. Cells of early (2nd to 5th) transplant generations of these tumors were cloned by a combination of semi-solid agarose colony formation and limiting dilution techniques. Growth characteristics of the various clones in vitro and their tumorigenicity in vivo were evaluated. Subsequently, the role of host immunity and of interclonal interactions in regulating growth of the different clones in vivo were analyzed. We found that, whereas all 16 clones isolated from one tumor (T-58) grew rapidly in vivo and in vitro, 10 clones isolated from the second tumor (MT-2) showed a wide disparity in their growth rates in vivo. Taken together, these clones could generally be divided into 3 categories: (1) rapidly growing lines which grew in vivo at rates similar to or higher than those of the parental line; (2) slow-growing lines which grew more slowly than the parental line; and (3) non-growers which failed to produce tumors in vivo with doses of up to 5 X 10(6) cells injected either s.c. or i.v. but grew in vitro at rates comparable to the parental line. No correlation could be established between the various growth potentials exhibited by these tumor lines and tumor cell morphology in vitro and in vivo, as determined by light and electron microscopy. Sublethal irradiation (550-650 R) of young animals prior to tumor inoculation, or before inoculation of tumor cells into old, low NK syngeneic mice, failed to modify the growth of slow-or non-growing lines in vivo, indicating that host cellular defense mechanisms against the clones, if existent, were not mediated by NK or radiosensitive B or T cells. When clonal interactions were studied by the simultaneous injection of different clones in vivo at different s.c. sites, we found that a slow-growing line failed to modify the growth rate of a rapidly growing line, but accelerated the growth of a second slow-growing line injected simultaneously on the contralateral side, and that this enhancement of tumor growth was radioresistant. A mixture of these 2 lines also grew more rapidly than the individual lines alone. Our findings suggest that phenotypic variations in tumorigenicity can be found in clonal lines derived from spontaneous primary tumors and that these variations are not related to cell cycle properties as measured in vitro.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3972471 TI - Neoplastic transformation of human diploid fibroblasts (KMST-6) by treatment with 60Co gamma rays. AB - Normal fibroblasts (KMS-6) derived from a human embryo were transformed in culture into neoplastic cells (KMST-6) by repeated treatment with 60Co gamma ray irradiation. Repeated treatment was necessary to obtain transformation. Control normal cells exhibited normal karyotype (46, XX) and stopped dividing due to cellular ageing at the 40th passage. The transformed cells are presently growing indefinitely (140th passage) and exhibit prominent karyologic aberrations, both numerical and structural. These 2 characteristics, indefinite growth and abnormal karyotype, are thought to be the most important parameters for neoplastic transformation of human fibroblasts. Other indispensable parameters are the presence of active mitotic figures on confluent cell sheets and colony-type morphology. Transformed cells grow into colonies with relatively smooth edges, while normal fibroblasts form colonies with jagged edges, due to the protrusion of growing fibroblasts. Other parameters, such as elevated plating efficiency, enhanced colony formation in soft agar, low serum requirement for growth, high saturation density, and acquisition of transplantability, are not reliable in the early stages of transformation. These parameters probably appear at rather later stages of transformation following several cell divisions. Among other characteristics, the transformed KMST-6 cells exhibit a B-type isozyme pattern of glucose-6-phosphate dehydrogenase, lactate-dehydrogenase isozyme pattern of human origin, no evidence of viral infection and no production of C-type virus particles. PMID- 3972472 TI - Common acquired naevi and the risk of malignant melanoma. AB - The relationship between common acquired naevi and malignant melanoma of the skin was assessed in a case-control study. IN 183 patients and 183 controls matched for sex, age and area of residence, there was a strong association between the presence of pigmented naevi on the arms and melanoma. In comparison with persons having no naevi on the arms, the crude relative risk of melanoma was 28.0 when naevi were present. After adjusting for hair colour, propensity to sunburn and lifetime sun exposure, the final risk estimate was 30.1. Family history did not appear to be a determinant of disease independent of the above risk factors. PMID- 3972474 TI - Procoagulant activity of mouse and human cultured cells following various types of transformation. AB - The presence of fibrin deposits in the microenvironment of tumor cells has been reported repeatedly and considered to play an important role in tumor biology. Among the mechanisms by which fibrin may be deposited in tumors, procoagulant activities (PCA) of different types have been described in cancer cells. The present study was aimed at establishing whether the nature of cellular PCA was a characteristic associated with malignant transformation. PCA of normal and transformed cells was investigated on pairs of murine and human origin. The transformed counterparts were obtained after treatment with low-dose radiation, chemical carcinogen, viral infection or after in vitro spontaneous immortalization. Both before and after any type of transformation cell PCA was of the tissue thromboplastin type, identified on the basis of biological criteria: requirement of factor VII for its expression and lack of inhibition by the serine protease inhibitor diisopropylfluorophosphate (DFP). Transformed cells of murine origin showed significantly lower activity than their normal counterparts, whereas all the transformed human cell lines expressed significantly higher activity than normal. An inverse correlation between the levels of PCA and the cell density in culture was observed in all but one of the lines tested. These findings suggest that the factor X activating property described in some tumors or in transformed cells cannot be considered as a general marker of transformation. PMID- 3972475 TI - The concept of authorship. PMID- 3972473 TI - Characterization of tumor progression from threshold tumor inocula: evidence for natural resistance. AB - An examination of the variant generation and selection hypothesis of tumor progression was undertaken using the NK-sensitive, NAb-sensitive SL2-5 lymphoma in the threshold inoculum model of tumor progression. Tumor cells obtained from the i.p. injection site expressed increased heterogeneity for sensitivity to syngeneic NAb and to NR measured in the 131IUdR-labelled tumor elimination assay. Cells retrieved from the s.c. injection site exhibited reductions in sensitivity to NR which correlated with decreases in sensitivity to syngeneic NAb and NK cells in vitro. These data confirm and extend our previous observations with the NK-resistant L5178Y-F9 lymphoma and further substantiate the evidence for the participation of NAb and NK cells in host-mediated anti-tumor resistance. Characterization of the model revealed that the selection for reduced sensitivity to NR in thymus-depleted AT x BM mice and normal animals could not be distinguished, suggesting that thymus-independent mechanisms may be major contributors to the surveillance of nascent tumors. The decreases in susceptibility to NR occurred in a stepwise and time-dependent manner in accord with the sequential multistage concept of progression. Furthermore, the selection for tumor cells which exhibited reductions in sensitivity to NR correlated with selection for increased tumorigenicity, in keeping with the idea that progression is associated with development towards an increasingly autonomous tumor. PMID- 3972476 TI - Association of an accessory atrioventricular pathway and ipsilateral bundle branch block. AB - We performed electrophysiological study and radionuclide phase imaging in a patient with intermittent Wolff-Parkinson-White syndrome type A and left bundle branch block. The presence of a left-sided accessory pathway was proven by eccentric retrograde atrial activation. Phase-imaging revealed delayed left ventricular phase angles when left bundle branch block was present in the electrocardiogram. There was an advance of early phase angles at the ventricular insertion of the accessory pathway as well as delayed phase angles in the rest of the left ventricle when the pre-excitation pattern was seen electrocardiographically. PMID- 3972477 TI - Discontinuous propagation: an hypothesis based on known cardiac structural complexities. PMID- 3972478 TI - Myocardial ischemia due to dynamic small vessel coronary artery disease. PMID- 3972479 TI - Medical care and mortality: racial differences in preventable deaths. AB - We analyzed deaths of blacks and whites in Alameda County, California where previous studies have documented consistent racial inequalities in health services. We classified each death during 1978 as due to preventable and manageable conditions or as "non-preventable" according to lists compiled by the Working Group on Preventable and Manageable Diseases chaired by Dr. David Rutstein. The total death rate for blacks 0-65 years of age exceeded that of whites by 58 percent (p less than .01). Rates of death due to preventable and manageable conditions for persons aged 0-65 years were 77 percent higher for blacks than for whites (p less than .01). More than one-third of the excess total death rate of blacks relative to whites could be explained by the excess of potentially preventable deaths. Our findings suggest that inequalities in health services reinforce broader social inequalities and are in part responsible for disparities in health status. Improvements in the health and longevity of blacks and other oppressed groups might be achieved by improved access to existing medical, public health, and other preventive measures. PMID- 3972480 TI - Racial inequality and occupational health in the United States: the effect on white workers. AB - While a number of studies have shown that black workers in the United States face higher levels of occupation-related hazards to health and safety than do whites, even controlling for differences in education and experience, little attention has been paid to the implications of racial inequality for the overall level of hazard in the economy. Alternative theories of the causes of occupational diseases and injuries imply that greater inequality helps white workers, by assigning them to the safer jobs, or on the contrary hurts white workers, by weakening the unity and bargaining power of the workforce as a whole. This article analyzes the impact of racial inequality on the level of hazard reported by white workers. Consistent with the institutional and Marxian theories of the labor market, the statistical findings indicate that white workers employed in occupations and industries containing greater numbers of blacks report greater exposure to hazard than comparable white workers in occupations and industries employing fewer blacks. PMID- 3972481 TI - Ideology and injury prevention. AB - Data from a recently completed study of head injuries reveal that many of these injuries, and deaths from these injuries, result from interpersonal violence and automobile accidents. Such injuries are normally difficult to prevent. In this study it was found that much of the interpersonal violence involves family members and many of the vehicle accidents, especially those that result in death, happen to pedestrians. Prevention thus becomes even more difficult. Based upon these data and observations, five categories of prevention strategies are generated and evaluated. It is determined that the four strategies usually within the domain of traditional prevention (inaction, education, legislation, and design alterations) are not likely to prevent many head injuries or injuries in general. A fifth category is thus recommended. This category requires meaningful involvement of people into work that impacts on the social and political reality of their lives. The prevailing ideology of prevention offered by the health professions is considered and is found to be in opposition to our fifth prevention category. The implications of this opposition are examined and the search for improved health is considered in this context. PMID- 3972482 TI - Brazil: the health care model of the military modernizers and technocrats. AB - Post-1964 political changes in Brazil had dire implications for the health sector as successive governments pursued economic and social policies which aggravated inequities and benefitted narrow elites. The "military modernizers" embraced a concept of development inimical to basic human needs, an economic model favoring growth over distribution and development over social welfare, and budget priorities favoring vocal, urban middle sectors at the expense of marginal populations. The result was deteriorating health and social conditions among the majority of the population that did not share in the benefits of the "economic miracle." PMID- 3972483 TI - The closure of a factory and its impact on health. AB - SKF, one of Sweden's foremost corporations, is the world's largest producer of bearings. In the seventies, largely as a consequence of Japanese competition, in order to maintain its preeminent position, SKF embarked on a program of global rationalization and automation. One of the consequences of these measures was a decrease in the size of the overall SKF workforce and the closure of factories in a number of countries. One of the casualties was the manufacturing operation of SKF Canada Ltd. The following article concentrates on the consequences of the shutdown for employees. It is seen that over five surveys conducted over a two and a half year period the impact of the shutdown on some dimensions was the same for former employees and their wives. On others, former employees responded differently than their wives. Overall, however, the closure of SKF Canada Ltd., in terms of stress, economic hardship, and ill-health, was devastating for both former employees and their wives. PMID- 3972485 TI - Oculocutaneous diseases. PMID- 3972484 TI - The world economic crisis and the children: United States case study. AB - This is a review of the United States experience with issues of child health and services as they relate to changes in economic trends. No existing data systems are entirely adequate for reporting on the current health status of children. An important consideration for the monitoring of children's health in the United States is the status of subgroups such as those who are disadvantaged for reasons of poverty, discrimination or geographic isolation. Ample evidence confirms that children living in poverty suffer adverse health consequences and that the proportion of children living in poverty in the United States has increased steadily since 1975 and dramatically since 1981. Most measures of health status and health risks for children show steady improvements throughout the 1970s. The exercise of public responsibility for financing and providing essential services and supports held constant or improved during this period, especially during the recession of 1974-75. The health status and risks for children since 1981 appear to be adversely affected which must be attributed to a combination of circumstances that include serious recession, increased poverty rates for households with children and diminished health benefits and social support services. These findings suggest that when either local or widespread economic reversals are anticipated, health services and social supports for children need to be expanded rather than contracted. PMID- 3972486 TI - Sarcoidosis: a multisystem disorder with prominent ocular and cutaneous involvement. PMID- 3972487 TI - Ocular side effects of systemic therapy of cutaneous diseases. PMID- 3972488 TI - Ocular complications of atopic dermatitis and other eczemas. PMID- 3972489 TI - Social experimentation self-process or social role. AB - The present article uses Lifton's protean man concept to describe a pattern of social experimentation with new religious, cultic and self-growth groups in contemporary American society. However, proteanism or social experimentation is understood herein to signify a positive search by some for meaning, identity and community, and to describe more aptly a new social role, rather than a new form of self-process. We delineate the social experimenter role and its various support systems within society (i.e., the cultic/self-growth subculture, the entrepreneurs of experience, and the cominant culture itself). In conclusion, we discuss the popularity of social experimentation in contemporary American society in relation to: the human need to explore and grow; the opportunities afforded by modern society; and the conflicts between various interest groups in society. PMID- 3972490 TI - Public attitudes towards mental illness--the effects of behaviour, roles and psychiatric labels. AB - A questionnaire to assess various elements of public attitudes towards the mentally ill was given to 108 subjects. 5 hypotheses were tested. Public attitudes towards mental illness are more rejecting than accepting. Social rejection increases with increasing severity of disturbance in behaviour. Public attitudes towards the mentally ill are related to social class as measured by occupational status and to age of the respondent. Rejection of the mentally ill is decreased by the availability of a non-deviant alternative label. Attitudes of the general population towards the mentally ill will be influenced by the label of mental illness as well as by behaviour indicative of mental illness. All the hypotheses were confirmed with one exception - negative public attitudes were not found to be related to social class as measured by occupational status. Public attitudes towards the mentally ill are more diverse than previous research would imply. Possible future research directions are discussed. PMID- 3972491 TI - Social tolerance of the mentally ill in the Mexican American community. AB - This work is a comparative study of social tolerance toward mental illness. The central concern is with the orientation of the Chicano toward these phenomena. The aim is to determine whether or not attitudes that Mexican Americans hold toward mental illness differ from those of other Americans. Survey research methods are used to conduct a comparative study of two ethnically distinct groups - Anglo and Mexican American. Attitudes toward mental illness are measured by a social distance scale. High to low tolerance toward the mentally ill is measured. The questions range from close personal to more distant association, such as whether or not one would mind having his or her children marry someone considered to be mentally ill, to whether or not one would mind working with such a person. We have found that sex, age and education are the primary variables associated with attitudes towards mental illness. Better educated Chicanos are clearly more tolerant of the mentally disabled than the little schooled. The gender of the respondents also appears significant in determining the extent of their tolerance. Older Chicanas with less education are the least tolerant of the mentally ill, while younger women are more tolerant than the older. And the Chicano tends to be tolerant whatever his educational level. There is little difference in tolerance between Chicanos and Anglos. PMID- 3972492 TI - The use of the term 'borderline patient' by Scottish psychiatrists: II. Conceptual and descriptive analysis. AB - A descriptive and conceptual analysis of the use of the term 'borderline patient' by Scottish psychiatrists revealed that they view borderline patients as being near the psychotic end of the illness spectrum, with a marked propensity towards brief, reactive, reversible, paranoid or schizophrenic reactions. There is clear evidence that the term is not used to refer to patients who in the United States would be labelled borderline schizophrenic. Individual American diagnostic schemata would omit features held to be of major importance by Scottish psychiatrists when diagnosing borderline patients. In an earlier study, Macaskill and Macaskill (1981) found that the term 'borderline patient' although not in the official nomenclature, was used by over one in four Scottish psychiatrists to delineate a syndrome which they felt should be included in contemporary diagnostic systems because of its prognostic and therapeutic implications. This study provided the first demographic information on the use of the term in the United Kingdom, but did not permit direct comparisons at conceptual and descriptive levels with studies in the United States where the term is widely used and recognised in the official nomenclature of the American Psychiatric Association's Diagnostic and Statistical Manual--III (1980). Research into the use of the term schizophrenia, for example by Cooper et al (1972), has shown that major differences in usage between the United Kingdom and the United States have occurred with serious implications for the cross-cultural validity of research findings in schizophrenia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972493 TI - Work assessment in the current economic climate. PMID- 3972494 TI - Koro: how culturally specific? AB - Koro has been described as an acute anxiety state related to the fear of penile shrinkage into the abdomen with resultant death. This partial depersonalization disorder is found primarily among the people of the Malay Archipelago and Southern Chinese, with extremely rare incidences documented in the West. The symptomology of Koro is commonly said to be linked to ancient Chinese medical beliefs on sexual functioning and is therefore referred to as a culturally bound syndrome. Our paper summarized the case of an American male with Koro-like symptoms. It compares the Western concept of penis loss to the Chinese or Malaysian concept, and then proposes a combined hypothesis for the development of Koro. PMID- 3972495 TI - Post release adjustment of day and inpatients. AB - A comparison was made of the post-release adjustment of patients who were treated in the day hospital and those by the inpatient service. The patients diagnosed as schizophrenics, psychopaths and neurotics, living with their families, who were able to work prior to hospitalization were chosen for samples. In addition, the patients of the two samples were matched with regard to age, the number of hospitalizations and the length of the last one. The day hospital sample consisted of 85 patients and the inpatient sample of 92. Four aspects of social adjustment during the 18 months after discharge were particularly stressed: rehospitalization, working ability, interpersonal relations and role functioning in the family. No significant difference between day and full-time patients with regard to these aspects of post-release adjustment were revealed. PMID- 3972496 TI - Long-term effects of Q-switched ruby laser on monkey anterior chamber angle. AB - In an attempt to clarify whether pulsed lasers might be able to cause permanent fistulas from the anterior chamber to the interior of the canal of Schlemm, slightly suprathreshold, low energy, small diameter Q-switched ruby laser pulses were applied to the trabecular meshwork of nine eyes of six rhesus monkeys. Clinical examinations during the next 2 months disclosed no adverse effect on the cornea, iris, lens, or retina. There was transient mild inflammation in five eyes. Intraocular pressure was not changed significantly; the facility determined by perfusion of the anterior chambers at 2 months was normal. Light microscopy and scanning electron microscopy show localized trabecular lesions; some are slightly indented, but there is no persistent penetration to Schlemm's canal. Endothelial cells, confluent with those of the cornea, cover the inner (anterior chamber) surface of the lesions. Cross-sections through the center of a lesion show that trabecular meshwork and Schlemm's canal have been obliterated by the treatment and healing; these changes are similar to those previously seen after argon laser monkey trabecular treatment. In the untreated areas, between pulsed laser application sites, trabecular meshwork and Schlemm's canal are normal by light microscopic and scanning electron microscopic examination. Any effect on IOP from this particular type of pulsed laser treatment of the trabecular meshwork is probably not due to trabeculopuncture and flow of fluid through the fistula. PMID- 3972497 TI - A two-dimensional scanning ocular fluorophotometer. AB - For certain studies of the dynamics of fluorescein in the anterior segment of the eye it would be advantageous to measure fluorescent intensity from several anatomic regions of the cornea and anterior chamber simultaneously or in rapid succession. In the present paper we describe a device called a two-dimensional scanning ocular fluorophotometer that we have designed and built to measure fluorescein concentration in a horizontal section through the cornea and anterior chamber. The 488-nm wavelength beam of an argon laser is mechanically scanned through the target area (70 microW total power at the eye) and fluorescent light is measured with a photon-counting photomultiplier tube. A single anterior posterior scan requires 100 msec and is divided into 33 sample time periods of 3 msec each. Thirty anterior-posterior scans are made within 3 sec. A two dimensional array of fluorescein concentration is reconstructed from the data. Concentrations ranging from 3 X 10(-10) gm/ml to 3 X 10(-6) g/ml are measured in a single scan. Examples of scans through the anterior chamber and cornea after topical and systemic administration of fluorescein are presented. These scans illustrate how this instrument can be used to measure two types of regional differences in fluorescein concentration, the "pupillary aqueous bubble" following topical administration and the radial concentration gradient in the cornea following systemic administration. PMID- 3972498 TI - Perfusion outflow facility in the rabbit eye. Stabilization by EACA. AB - The time-dependent increase in apparent facility of outflow (washout effect) that occurs with prolonged perfusion of the eye has imposed limitations on the study of aqueous humor dynamics. The washout effect in postmortem in situ rabbit eyes, undergoing constant pressure perfusion with a saline perfusate, can be attenuated dramatically by adding to the perfusate the serine protease inhibitor and antifibrinolytic agent epsilon-aminocaproic acid (EACA) at a concentration of 3.8 X 10(-3) molar. Washout curves from 13 pairs of rabbit eyes, plotted as outflow facility versus time, were fitted by linear regression, and their washout slopes calculated. The washout slope of all of the 13 eyes perfused with normal saline + EACA was lower in magnitude (less washout) than the paired control eye in the same animal, perfused with a control perfusate of normal saline + leucine. Wilcoxon signed rank test yielded P less than 0.001. This suggests that a significant component of the washout effect may be mediated by fibrinolytic activity, or by some EACA sensitive component of the aqueous drainage pathway, and that addition of EACA to a saline perfusate may be useful for blunting the washout effect in prolonged perfusion studies. PMID- 3972499 TI - Maturation of Rb+ and PAH accumulation by rabbit anterior uvea and choroid plexus. AB - In vitro accumulation of radioactive para-aminohippuric acid (3H-PAH) and rubidium (86Rb+) by the anterior uvea, ciliary processes, and the choroid plexus was evaluated in tissues from newborn and various aged rabbits. Accumulation of PAH was present in the anterior uvea at 1 day of age (tissue to media ratio, T/M, of 2.1 +/- 0.2) and remained at this level for the first 14 days of life. Accumulation did not rise to adult levels until 21 days of age (T/M 5.5 +/- 0.6). Rubidium accumulation in the anterior uvea, a measure of Na+, K+-pump activity, was higher than adult values 6 hr after birth (T/M25.2 +/- 0.9). Activity remained elevated through day 28 and did not fall to adult levels until day 60 (T/M 13.4 +/- 0.6). Accumulation studies on isolated ciliary processes were similar to those obtained from anterior uveal tissue. Daily subcutaneous injections of penicillin (300,000 units/kg/day) for 1 week had no effect on anterior uvea PAH accumulation (penicillin T/M was 1.7 +/- 0.1 and saline control T/M was 2.0 +/- 0.2). Accumulation of either 3H-PAH or 86Rb+ by the choroid plexus was present 1 day after birth in amounts that were similar to adult values and did not change during the 90 days of testing. PMID- 3972500 TI - Quantification of glaucomatous visual field defects with automated perimetry. AB - A method to quantify different glaucomatous visual field defects is presented. Three visual field indices are calculated: the short-term fluctuation, the mean defect, and the corrected loss variation. The method was applied to visual fields tested with program JO on the Octopus automated perimeter. The indices of 130 glaucoma suspects and 50 glaucoma patients were compared with 100 normal controls. The indices provide good detectability of visual field defects and easy follow-up. PMID- 3972501 TI - Progressive retinal atrophy in the Abyssinian cat. Clinical characteristics. AB - Ninety-four cases of a hereditary retinal degeneration in household Abyssinian cats were found in Sweden, mainly during a 3-year period. The disease was investigated by ophthalmoscopy, fluorescein angiography, electroretinography, and light microscopy. A bilateral retinopathy was usually first seen in affected cats at the age of 1.5-2 years. Fluorescein angiography did not demonstrate abnormalities of etiological significance to the disease process. A reduction mainly of a- and b-wave amplitudes in the ERG indicated a generalized photoreceptor disease. Light microscopy showed that the photoreceptor layer was primarily affected, while other retinal layers were mainly normal. The midperipheral and peripheral retina was affected more severely than the retina of the posterior pole until late stages of disease, when there was a generalized loss of photoreceptors. The clinical and laboratory findings suggest that PRA in these Abyssinian cats is a heritable photoreceptor degenerative disease with a fairly slow rate of progression. PMID- 3972502 TI - Lysis of herpes simplex virus (HSV) infected targets. IV. HSV-induced change in the effector population. AB - Herpes simplex virus type 1 (HSV-1) stimulation of peripheral blood lymphocytes from patients (PBL-P) with both recurrent corneal and oral-facial HSV-1 lesions results in altered natural killer (NK) activity. Freshly isolated PBL-P exhibit high lysis of HSV-1 infected allogeneic fibroblasts but low lysis of uninfected fibroblasts. After stimulation with HSV-1, PBL-P exhibit markedly increased lysis of uninfected fibroblasts such that the HSV-1 infected and uninfected fibroblasts are lysed with equal efficiency. The NK activity in freshly isolated PBL-P is mediated by effector cells that are phenotypically distinct from those responsible for the NK activity in HSV-1 stimulated PBL-P. In freshly isolated PBL-P most of the lysis of HSV-1 infected fibroblasts is mediated by lymphocytes expressing the phenotype OKM1+, OKT3+, and Leu-7+. After incubation with HSV-1, most of the lysis of HSV-1 infected and uninfected fibroblasts is mediated by lymphocytes that express the OKM1 antigen but lack detectable OKT3 or Leu-7 antigens. The change in function and phenotype appears to reflect in part the activation of Leu-7-, OKM1+, and OKT3- precursors of cytotoxic lymphocytes that are inactive in freshly isolated PBL-P. PMID- 3972503 TI - The presence of cytotoxic autoantibody to lacrimal gland cells in NZB/W mice. AB - New Zealand Black and White F1 hybrid mice (NZB/W mice) spontaneously develop an autoimmune disease which provides us with a suitable animal model for Sjogren's syndrome. With increasing age, these mice develop foci of mononuclear cell infiltration in the lacrimal and salivary glands, which closely resemble the lesions seen in patients with Sjogren's syndrome. We studied the cell-mediated and antibody-mediated immune responses of NZB/W mice to lacrimal gland cells. Lacrimal gland acinar cells were isolated from 2-month-old NZB/W or BALB/c mice for the target of 51Cr-release assay. There was no statistically significant difference in the spleen cell-mediated cytotoxicity to lacrimal gland cells among NZB/W mice of different ages (2, 5, and 8 months old). With increasing age, on the other hand, we found a statistically significant increase in the titers of autoantibodies to lacrimal gland cells in NZB/W mice, while aged BALB/c mice did not develop such antibodies. Fractionation of pooled positive sera by gel filtration revealed that this cytotoxic activity was mostly recovered in the IgM fraction. The tissue absorption study showed that these antibodies cross-reacted with salivary gland and kidney. PMID- 3972504 TI - A technique for obtaining basal corneal epithelial cells. AB - A technique has been developed for obtaining a cell suspension enriched (89%) in basal corneal epithelial cells. Eleven millimeter corneal buttons were removed and placed in culture medium containing low (10 microM) calcium. The posterior half of the stroma was removed with forceps. Three superficial cuts were made with a Bard-Parker blade on the anterior half of the cornea, which was then incubated for 18 hr at 35 degrees C. Nonadherent cells were brushed off after the incubation and basal cells were harvested after a 1-hr incubation in Dispase II. Cell viability estimated by Erythrocin beta exclusion was 90%. Further evidence of viability was that the cells adhered to their native substrate, the denuded basal lamina. The authors protocol provides a method for analyzing the biochemistry of a known population of epithelial cells and makes available a defined source of cells for culture. PMID- 3972505 TI - Predicting refractive alterations with hydrogel keratophakia. AB - Hydrogel lenticules are being used as intracorneal lens (ICL) implants for refractive keratoplasty. The experimental surgical success can be evaluated through an understanding of their effect on the optical system of the cornea. An algorithm that utilizes elementary optics can be used to calculate the total corneal power produced through intracorneal lens implantation via either pocket or microkeratome dissection. Two groups of animal experiments involving ICL implantation using both pocket and microkeratome dissections were performed on Rhesus monkeys. The predicted effects of the surgical techniques were compared with the measured effects obtained via streak retinoscopy. The mean difference and standard deviation of the measured minus the predicted values for the pocket dissection group is -0.59 +/- 1.52 D, N = 7. The respective difference for the microkeratome group is -0.19 +/- 1.07 D, N = 4. These small differences illustrate the accuracy of the algorithm in predicting the effects of refractive keratoplasty with hydrogel intracorneal lenses. PMID- 3972506 TI - Effect of stimulus orientation on the latency and amplitude of the VEP. AB - VEPs were recorded using 5.0 c/deg square wave gratings presented at vertical and oblique (45 deg) orientations and phase-alternated at two rates, 6 alternations/sec and 12 alternations/sec. In agreement with previous reports, VEP amplitude was smaller for obliquely oriented gratings than for vertically oriented gratings at both alternation rates. Unlike previous studies, however, the authors found that VEP latency was longer for obliquely oriented gratings at the slower (6/sec) alternation rate. PMID- 3972507 TI - Permanence of the visual recovery that follows reverse occlusion of monocular deprived kittens. PMID- 3972508 TI - Cholecystokinin in the cat retina. Action of exogenous CCK8 and localization of cholecystokinin-like immunoreactivity. AB - The effects of applying cholecystokinin (CCK8) iontophoretically onto cat retinal ganglion cells were studied in the optically intact eye of the cat. CCK8 suppressed both the maintained and the light evoked discharge of brisk ganglion cells, irrespective of their being on- or off-center, brisk-transient, or brisk sustained and independent of the state of light adaptation. The inhibitory action of CCK8 in the cat retina is opposite from its excitatory action in other parts of the brain. Using an antiserum to cholecystokinin, immunoreactivity was localized in horizontal cells and amacrine cells of the cat retina. Inconsistently immunoreactivity also was found in ganglion cells and fibers. PMID- 3972509 TI - Species variations in distribution of S100 in retina. Demonstration with a monoclonal antibody and a polyclonal antiserum. AB - The S100 protein has been found consistently in glial cells both in the central nervous system (CNS) and peripheral nervous system (PNS). However, in the retina we find substantial species variation in the distribution of this protein. Immunohistochemically, in the human retina we do not find any S100. In the rabbit retina it is present both in Muller cells and in astrocytes and in the chicken retina it is in neurons. This demonstrates how misleading it can be to use the distribution of a protein in one species to generalize about the distribution of the same protein in other species. It is also clear that even though immunohistochemical staining for the S100 protein could be used to study pathologic conditions that involve Muller cells in guinea pigs, hamster, rat, and rabbit retina it is going to be of limited value in investigations of the same conditions in the human eye. PMID- 3972510 TI - Spatial contrast transfer functions of the pattern-evoked electroretinogram. AB - Pattern ERGs in response to pattern-reversal stimuli varying in spatial frequency (range: 0.2-9.03 cycles/deg) and contrast (range: 0.03-0.93) were recorded from two normal male subjects. At most spatial frequencies the response amplitude increased linearly up to the highest contrast without saturation. From the amplitude-versus-contrast plots spatial contrast-transfer functions were derived for different levels of contrast. The sensitivity of the reversal response showed a spatial selectivity around 4 cycles/deg, which was more pronounced at low, rather than at high, contrast values. Good agreement with the psychophysical contrast-sensitivity curve was found. The procedure described permits a quantitative analysis of the sensitivity of the retina to spatial contrast stimuli and could be helpful in the diagnosis of diseases of the eye and the optic nerve. PMID- 3972511 TI - Acrylamide effects on the macaque visual system. I. Psychophysics and electrophysiology. AB - Oral acrylamide produces axonal swelling and later degeneration and gliosis in the distal optic tract, especially within the lateral geniculate nucleus, of macaque monkeys. Measures of visual thresholds and cortical-evoked potentials were used to study the time course of visual changes during exposure to acrylamide in macaque monkeys. Contrast sensitivity, visual acuity, and flicker fusion frequency were reduced during exposure, and only flicker fusion recovered rapidly and completely after exposure. Pattern-reversal-evoked responses exhibited increased latency and reduced amplitude during dosing but substantially recovered after exposure. Visual acuity and contrast sensitivity for high spatial frequencies were decreased throughout the 140 days of testing after dosing. These results suggest an acute general depression of visual capacities as the initial effect of acrylamide exposure, whereas later effects were confined to high spatial frequencies. PMID- 3972513 TI - Spatial contrast sensitivity deficits in monkeys produced by optically induced anisometropia. AB - An anisometropia was simulated in infant rhesus monkeys by securing a high powered minus lens (-10 D) in front of one eye. The anisometropia rearing procedure was initiated at 30 days of age and was continued for durations of 30, 60, or 90 days. Behavioral measurements of spatial contrast sensitivity obtained when the animals were 9 months of age indicated that the monkeys treated for 30 days had equal or nearly equal contrast sensitivities and cut-off spatial frequencies in the two eyes. The 30-day monkeys also demonstrated normal binocular summation for threshold stimuli. In contrast, the monkeys treated for either 60 or 90 days showed a significant reduction in contrast sensitivity in the defocused eyes for spatial frequencies greater than 1.0 cycles/deg and failed to show an improvement in contrast sensitivity under binocular viewing conditions. The cut-off spatial frequencies obtained at moderate luminance levels for the defocused eyes of the 60- and 90-day monkeys were slightly more than 1.0 octave lower than the cut-offs for the nondeprived eyes and, like humans with anisometropic amblyopia, the deficits in the spatial resolving capacity of the defocused eyes were observed over a large range of background luminances. The results indicate that the lens-reared monkey is a promising model for anisometropic amblyopia in humans. PMID- 3972512 TI - Acrylamide effects on the macaque visual system. II. Retinogeniculate morphology. AB - Oral acrylamide dosing for 6-10 weeks produced axonal swellings with neurofilament accumulation in the distal optic tract and lateral geniculate nucleus of macaques. No swellings were seen in the retina or optic nerve. Monkeys that were killed 6-8 months after similar dosing showed a marked neuronal degeneration in the visual pathways that was more pronounced after two than after a single period of exposure. This degeneration was characterized by the following: loss of ganglion cells in central retina with relative sparing of other retinal neurons; disproportionate degeneration of temporal to central optic nerve and the dorsal optic tract; and neuronal atrophy in parvocellular layers of the lateral geniculate nucleus, with relative sparing of magnocellular layers. The pattern of neuronal loss suggests that one type of retinal ganglion cell or its axon may be especially vulnerable to damage by acrylamide. The selective neuronal damage produced by acrylamide may help explain the nature of the visual dysfunction associated with this intoxication. PMID- 3972514 TI - Accommodation demand and deprivation in kitten ocular development. AB - The effects of accommodation demand and deprivation on the development of ocular optics was investigated in four groups of kittens (total n = 29). Group 1 consisted of five normal kittens; group 2 (nine kittens) had monocular radial keratotomy to induce relative hypermetropia and more accommodation demand as well as to impart interocular refractive differences (anisometropia); group 3 (eight kittens) received daily monocular atropine; and group 4 (seven kittens) had binocular radial keratotomy combined with daily monocular atropine. Regular examination provided documentation of ocular development from the first through the sixth months of life. Subsequently, the focal lengths of the crystalline lenses were determined in vitro. An apparent tendency for kitten eye pairs to grow toward isometropia, even when anisometropia had been induced early in life, was seen in those eyes in which the accommodative mechanism had been left intact (groups 1 and 2), but without accommodation anisometropia resulted (groups 3 and 4). There was relatively more elongation of the globe (3.08 +/- 0.22%) as well as shorter than normal focal lengths of the crystalline lens (-4.91 +/- 1.62% anterior, -2.78 +/- 1.54% posterior) in the eyes of the second group, and the eye pairs regained isometropia. In those eyes of the third and fourth groups that received atropine daily, there was relatively less elongation of the globe (-3.09 +/- 0.59% and -3.22 +/- 0.67%, respectively) and shorter crystalline lens focal lengths (-3.50 +/- 1.18% and -4.62 +/- 1.07% anterior, -2.64 +/- 1.02% and -1.59 +/- 0.62% posterior, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972515 TI - The development of eye alignment in normal and naturally microstrabismic kittens. AB - The development of interocular alignment was pupillographically measured from eye opening throughout the first half year of life in normal kittens and in kittens deriving from a naturally strabismic cat colony. Whereas the cyclorotatory component of age dependent changes did not differ between the two groups, the horizontal divergence of the optical axes was increased in the future esotropes during the whole observation period. Surprisingly the divergence angle of the optical axes was correlated with the convergence angle of the visual axes as determined during cortical receptive field analysis at 7-9 months of age. The authors suggest a theory that might explain the microstrabismic misalignment of the visual axes with an intraretinal defect. PMID- 3972516 TI - Comparison of pattern VEPs and preferential-looking behavior in 3-month-old infants. AB - Studies of visual acuity in human infants between 1 and 6 months of age using the visual-evoked potential (VEP) and forced-choice preferential looking (FPL) have shown that acuity is one to two octaves higher by VEP estimates than by FPL estimates. In an attempt to study these differences, the authors obtained both VEP and FPL data from 26 3-month-old infants. VEP data were obtained with gratings of 0.31, 0.62, 1.25 and 2.50 cycles/deg, which were counterphase alternated at 2 Hz. FPL data were obtained for stationary gratings using either the method of constant stimuli or a staircase procedure. Our study revealed three major findings: (1) recordable VEPs can be obtained for spatial patterns that are below threshold by behavioral measures; (2) the use of different scoring criteria that yields comparable VEP and FPL group mean acuities does not yield a significant correlation between VEP amplitude acuity and FPL acuity for individual infants, probably because of the inherent "noise" in each technique; and (3) when VEP latency rather than amplitude is used to estimate acuity, there is a significant correlation between electrophysiology and behavior. PMID- 3972517 TI - Preferential-looking assessment of fusion and stereopsis in infants aged 1-6 months. AB - The ability of infants to discriminate zero-disparity stimuli from both reverse contrast (rivalrous) and disparate (stereoscopic) stimuli was investigated in a two-alternative, forced-choice, preferential-looking paradigm. Few infants under 4 months of age demonstrated discrimination for any stimulus pairing. Of the infants tested at 4 months of age, approximately 70% preferred zero-disparity stimuli to reverse contrast stimuli, and 82% preferred stereoscopic stimuli to zero-disparity stimuli. Nearly 100% of 5- and 6-month-old infants exhibited these preferences. These findings suggest that sensory fusion is not present at birth but develops rapidly over the first 6 months of life. The time course for the development of sensory fusion was similar to the time course for the development of stereopsis in nine infants tested longitudinally. PMID- 3972518 TI - An electrophysiologic study of rabbit ciliary epithelium. AB - Microelectrode recordings from cells in rabbit ciliary epithelium have been made in vitro. Ionophoresis of Lucifer Yellow dye from microelectrodes during measurements of potential confirmed that the recordings were intracellular. Dye passed from the impaled cells into adjacent cells in both the nonpigmented and pigmented layers of the epithelium. Electrical coupling between epithelial cells also was observed. The mean (+/- SD) values of the potential measured across the basolateral membranes of the nonpigmented cells was -65 +/- -15 mV (n = 77); the mean value of the input resistance at this intracellular recording site was 37 +/ 28 M omega (n = 17). The membrane potential was reduced by raising the concentration of extracellular potassium but unaffected by changes in the concentrations of sodium, chloride, or bicarbonate ions. After a period of deprivation of extracellular potassium, the cells hyperpolarized without a measurable change in membrane resistance when potassium was restored to the bathing solution; this transient response to potassium was abolished by preincubation with ouabain or by bathing the epithelium in a solution lacking sodium. It was concluded that the ciliary epithelial cells are permeable to potassium but exhibit only a low permeability to sodium, chloride, or bicarbonate ions; that the cells possess an electrogenic Na/K pump; and finally, that all of the cells in the epithelium function as a syncytium. PMID- 3972519 TI - Hexitol production by canine retinal microvessels. AB - Hexitol-producing activity has been quantitated in microvessels isolated from retina and cerebral cortex of dogs, a species known to develop a retinopathy similar to that seen in diabetic patients. Both the retinal and cerebral microvessels produce galactitol from galactose, but at a rate several-fold less than that seen in canine lens epithelium. This hexitol-producing activity of the microvessels is not an artifact of erythrocyte contamination and can be inhibited by the aldose reductase inhibitor, Sorbinil. PMID- 3972520 TI - DNA repair synthesis in the rat retina following in vivo exposure to 300-nm radiation. AB - Quantitative autoradiography was used to study the incorporation of 3H-thymidine into the retina of albino rats following in vivo exposure to 300-nm radiation. Relative to background labeling in unexposed eyes, there was 8-20 times as much label per unit area in the outer nuclear layer, inner nuclear layer, and ganglion cells of 300-nm exposed retinas. The photoreceptor inner segments also showed thymidine labeling in both control and exposed retinas. PMID- 3972521 TI - Light exposure can reduce selectively or abolish the C-wave of the albino rat electroretinogram. AB - The ERG (electroretinogram) of the albino rat is reported to lack a c-wave. Observations of our own suggested that the conditions of light-rearing are important. Consequently, the authors recorded c-waves in two groups of albino rats. One group was reared from birth in dim illumination (dark-reared) and the other in 12/12 cyclic light (light-reared). Rats were tested after birth from 22 days to about 1 year. All dark-reared animals had a c-wave. Rats reared in cyclic light typically had no detectable c-wave. Physiologic and anatomic evidence suggests this consistent difference, c-waves present in dark-reared animals but absent or diminished in light-reared animals, is probably not due to extensive light induced retinal damage. No consistent differences between the two groups were seen in a- or b-wave thresholds, a- or b-wave intensity-response functions, and in the time-course of b-wave dark adaptation. PMID- 3972522 TI - 5 beta-Dihydrocortisol: possible mediator of the ocular hypertension in glaucoma. AB - 5 beta-dihydrocortisol potentiates the action of topically applied dexamethasone in raising the intraocular pressure (IOP) in young rabbits. Dexamethasone (0.06%) plus 5 beta-dihydrocortisol (0.1 and 1.0%) elevated the IOP 7-10 mmHg within 18 days of treatment. By contrast, 0.06% dexamethasone alone raised the IOP 3 to 4 mmHg in a similar period of time. Since 5 beta-dihydrocortisol accumulates abnormally in cultured cells derived from the outflow region of the eye from patients with primary open angle glaucoma (POAG), a similar potentiation in man may account for the sensitivity of these patients to the IOP raising effect of glucocorticoids. Further, this metabolite may potentiate endogenous glucocorticoids resulting in the ocular hypertension characteristic of POAG. PMID- 3972523 TI - Catecholamines in human aqueous humor. AB - Aqueous humor catecholamine levels were measured in 14 patients admitted to hospital for cataract or glaucoma surgery. Norepinephrine was detected in all patients. Epinephrine was detected in one patient who had received a preoperative retrobulbar injection of epinephrine. Dopamine was not detected in any patients. The highest level of norepinephrine was detected in cataract patients with normal intraocular pressures (mean = 7.18 nmol/l). PMID- 3972524 TI - ARVO 1985. The Association for Research in Vision and Ophthalmology Incorporated. Annual spring meeting, Sarasota, Florida, May 6-May 10, 1985. Abstracts. PMID- 3972525 TI - Iohexol vs. diatrizoate. A comparative study in intravenous urography. AB - A randomized double-blind study comparing the use of iohexol with diatrizoate in intravenous urography was performed in 435 patients in nine centers. Contrast media were evaluated for safety, incidence of adverse side effects, and efficacy. Multiple hematologic and biochemical parameters were observed, as well as blood pressure and pulse, at intervals before and after injection. Severity, nature, and duration of side effects were recorded together with the attending physician's clinical assessment. Coned radiographs of the kidneys were done immediately after injection and were repeated at 1-, 5-, 10-, and 20-minute intervals. Films were evaluated for quality of image. A significantly higher number of excellent studies were obtained with iohexol than with diatrizoate. Remarkably few side effects and adverse reactions reported for iohexol establish the safety and suitability of this nonionic contrast medium for intravenous urography. PMID- 3972526 TI - Iohexol and metrizamide for urography in infants and children. AB - The new nonionic contrast medium iohexol, was compared with metrizamide in a double blind investigation. Urography was performed in 40 children below 6 years of age. Adverse reactions were negligible. A small decrease in erythrocyte volume fraction (hematocrit) values after the injection was found in both groups. Excellent films were obtained in most patients and no difference in diagnostic quality between the two media was observed. PMID- 3972527 TI - Iohexol vs. metrizamide in studies of glucose metabolism. A survey. AB - Nonionic contrast media represent a significant advance for myelography due to their substantially lower neurotoxicity. Some side effects have been noted with metrizamide, however. Origins of adverse effects have not been clearly defined. Studies reviewed here investigated the effects of two nonionic contrast media, metrizamide and iohexol, on glucose metabolism in neural tissue cells in vitro using rat hippocampal tissue slices. Isotonic metrizamide produced metabolic disturbances that may partially explain some clinical adverse effects. It was hypothesized that iohexol, which, unlike metrizamide, does not contain a 2-deoxy D-glucose component, would not have this effect. A series of in vitro experiments compared the two media. Results showed no evidence that iohexol caused metabolic disturbances, but in vitro there was a depressive effect on metabolism from hypertonicity. In vivo water will rapidly diffuse toward hypertonic areas, thus neutralizing the osmotic effect. The lesser metabolic effect suggests that iohexol would be safer than metrizamide for subarachnoid examinations. PMID- 3972528 TI - Cranial and spinal cerebrospinal fluid absorption and the clearance of water soluble myelographic contrast media. A review. AB - Following myelography, water-soluble contrast media are cleared from the subarachnoid space with the cerebrospinal fluid via the cranial and spinal absorption pathways. These cerebrospinal fluid absorption pathways are reviewed. The effects of removal of excessive quantities of cerebrospinal fluid, increased numbers of cells in the cerebrospinal fluid, and dehydration are discussed. PMID- 3972529 TI - Contrast enhanced brain CT comparison between iohexol and metrizoate. AB - The commonly used contrast medium metrizoate (Isopaque Cerebral) or the new nonionic iohexol was injected intravenously for enhancement of cranial CT in a randomized double blind study. Each group consisted of 105 patients. No serious reactions occurred. Ten patients receiving metrizoate had minor reactions of mainly allergic type, whereas only one patient receiving iohexol reacted. No differences in enhancement efficiency could be observed. PMID- 3972530 TI - Pediatric angiocardiography with iohexol. AB - A nonionic contrast medium (iohexol) was evaluated for safety and efficacy in pediatric angiocardiography in this study of 15 patients, age 6 to 82 months. Patients carried a preliminary diagnosis of congenital heart disease. Subjects were injected with iohexol, 350 mg iodine/ml of solution with an average volume of 2.46 ml/kg of body weight at a rate of 9 to 14.5 ml/sec. The parameters evaluated included vital signs, intravascular BP, ECG changes, discomfort, and adverse reactions. No adverse reactions were noted in 14 of 15 patients. No significant changes in axillary temperature of ECG were observed. Intravascular blood pressure showed only moderate changes. After 24 hours, creatine phosphokinase (CPK) plasma concentrations increased significantly. Serum electrolytes remained unchanged. Image quality was deemed excellent considering variations in injection site and flow condition of the heart. Iohexol caused remarkably little discomfort and no adverse effects. PMID- 3972531 TI - Contrast media-induced nephrotoxicity. Survey and present state. AB - Reports of renal failure induced by contrast media are increasing. Adverse effects of contrast media on kidney function include diuresis, changes in renal blood flow, osmotic nephroses, albuminuria, enzymuria and, most important, glomerular filtration rate. Animal studies indicate that the new nonionic contrast medium, iohexol, has fewer adverse effects on kidney function than the ionic media currently used. Three clinical studies offer some evidence of the effect of iohexol on renal function, but it is not yet possible to conclude that lower nephrotoxicity found in animals will also be found in man. Further clinical studies are warranted, and careful monitoring of contrast media clearance is recommended in all high-risk patients. PMID- 3972532 TI - Injurious effects of contrast media on human vascular endothelium. PMID- 3972533 TI - Computers and your practice--can you really use one? PMID- 3972534 TI - Informed consent for breast cancer patients. PMID- 3972535 TI - Congenital non-parasitic solitary cyst of the liver. PMID- 3972536 TI - Aphorisms. PMID- 3972537 TI - The use of autologous blood recovery in major aortic surgery. Experience of 15 cases with Haemonetic Cell-Saver III system. PMID- 3972538 TI - Acute ruptures of the lateral ligament of the ankle. PMID- 3972539 TI - Breast or bottle? A statistical model for studying maternal intent. PMID- 3972540 TI - Spinal cord ischaemia following repair of the ruptured thoracic aorta: a successful outcome. PMID- 3972542 TI - Cholecystectomy. PMID- 3972541 TI - Spontaneous rupture of utero-ovarian veins in pregnancy. PMID- 3972543 TI - Septic complications following cholecystectomies. PMID- 3972544 TI - Gangrene requiring amputation in meningococcal infection. PMID- 3972545 TI - Analysis of 178 deaths in a rural practice. PMID- 3972547 TI - Congenital adrenal hyperplasia in the Republic of Ireland, 1966-1982. PMID- 3972546 TI - Height measurement in children: a comparison of methods. PMID- 3972549 TI - A review of neonatal transports. PMID- 3972548 TI - Primary sclerosing cholangitis. PMID- 3972550 TI - Review of one thousand and forty cholecystectomies: the value of operative cholangiography. PMID- 3972551 TI - A case of streptococcus bovis endocarditis and colonic carcinoma. PMID- 3972552 TI - Is it necessary to crossmatch blood routinely for patients undergoing transurethral resection of the prostate? PMID- 3972553 TI - Anesthetic management of 646 consecutive cesarean section cases. AB - A retrospective analysis of 646 consecutive cesarean deliveries during a 1-year period was performed. The indications for cesarean section, techniques of anesthesia, fetal and maternal outcome, and complications were evaluated. Of 646 cesarean deliveries, 153 (23.7%) were elective and 493 (76.3%) nonelective. Regional block was the main anesthetic technique used for the elective (88.3%) and the nonelective (79.3%) operations. Maternal complications were few and reversible. In 96% of the newborns the Apgar score was greater than or equal to 7 at 5 min. These results suggest that regional block is the preferred anesthetic technique for cesarean section. PMID- 3972554 TI - Interictal electroencephalography in night terrors and somnambulism. AB - Night terrors and somnambulism (NTS) are defined as disorders of arousal occurring in children during Stage 3 to 4 of NREM (non-rapid eye movement) sleep. In this study, the interictal EEG recordings in 35 neurologically normal children with clinical NTS were studied. Sixteen children (47%) had disturbed records including: localized slow, spike or sharp wave activity; generalized bursts of high voltage, sharp waves, spikes and slow delta activity or spike and wave complexes; and episodic high-voltage delta activity during wakeful rest. This percentage represents half the incidence of interictal EEG abnormalities in childhood epilepsy, but far greater than the 10 to 15% found in healthy children. PMID- 3972555 TI - Lactose malabsorption in Israeli children. AB - Lactose malabsorption during childhood was studied in 110 Jewish children in Israel, using the lactose hydrogen breath test. Sixty-eight subjects (61.8%) were lactose malabsorbers, 41 (60.3%) of whom were lactose-intolerant with symptoms evidenced during or following the tests, whereas 27 (39.7%) were symptom-free (tolerant malabsorbers). In the youngest age-group (4 months to 3 years), no lactose malabsorption was detected, whereas in the higher age-groups the prevalence of lactose malabsorption increased with age. The percentages of lactose malabsorption in the age-groups 3 to 6, 6 to 12 and 12 to 16 years were 56.5, 65.2 and 75.0%, respectively. The percentages of lactose-intolerant subjects also increased in the same age-group, to 26.5, 39.1 and 65.0%. There were no significant differences in lactose malabsorption and tolerance between the various ethnic groups tested. The peak values of breath hydrogen were higher in lactose-intolerant than in lactose-tolerant malabsorbers. PMID- 3972556 TI - Paracetamol overdosage in Jerusalem. AB - Forty-nine subjects were identified in the years 1978-83 in four major hospitals in Jerusalem as suspected of paracetamol overdosage. The apparent yearly incidence of paracetamol overdosage in the Jewish population in Jerusalem increased from 0.6/100,000 in 1978 to 4.5/100,000 in 1983. Two subgroups were identified: 13 children, the majority aged 2 to 4 years; and 36 young adults less than 39 years old, mostly in the 18- to 21-year age-group. In children, overdosage was caused by accident, in adults by attempted suicide. Morbidity was minimal, and transient liver function disturbances were found in only two subjects. Toxic levels were found in 2 of the 20 cases tested for paracetamol plasma concentration. Nevertheless, 31 subjects (63%) were hospitalized, and 29 of these were treated with N-acetylcysteine. The availability of the plasma paracetamol assay for diagnosis and of N-acetylcysteine as a specific antidote makes it possible to deal more effectively with the problem of paracetamol overdosage as a community health hazard. PMID- 3972557 TI - Exercise-induced asthma in schoolchildren. A pilot study in two Haifa districts. AB - The prevalence of exercise-induced asthma was studied in 313 Haifa schoolchildren, 160 living in an unpolluted urban area close to the sea and 153 living in a rural kibbutz (communal agricultural settlement) in the proximity of polluting industries. The overall prevalence was 8.6%; it was higher in the kibbutz group, but the difference was not significant. The prevalence tended to fall with increasing age and did not change with sex. PMID- 3972558 TI - Applications of auditory evoked potentials to evaluate hearing disorders: assets and limitations. AB - A variety of auditory evoked potentials for audiometric use are briefly reviewed and their assets and shortcomings discussed. Auditory brainstem evoked potentials provide the most audiometric parameters per patient evaluation time. Illustrative case reports are summarized to demonstrate the assets and pitfalls in evoked potential audiometric evaluations. Frequency contents of the stimulus used to evoke the potentials, the normative values for parameters evaluated, and the notion that the potentials reflect only the functioning of their generators must be constantly borne in mind. The primary concern must be the patient's welfare, and unnecessary procedures should be avoided. PMID- 3972559 TI - Anorexia nervosa, laxative abuse, hypopotassemia and distal renal tubular acidosis. AB - A case of anorexia nervosa in a 28-year-old woman with laxative abuse, hypopotassemia and severe metabolic acidosis, is described. The diagnosis of classical renal tubular acidosis, Type I, was confirmed by our inability to decrease urinary pH beyond 5.5 and to increase ammonia excretion during an ammonium chloride loading test. A bicarbonate loading test and normal plasma aldosterone with high renin activity excluded proximal renal tubular acidosis, hyporeninemic-hypoaldosteronemic renal tubular acidosis and Bartter's syndrome. The inability to increase ammonium excretion during severe metabolic acidosis following ammonium chloride loading did not favor the possibility of a transient physiological adaptation of ammoniagenesis at the tubular cell level, related to potassium depletion. Although mental disorder, laxative abuse, abstinence from food intake and severe potassium depletion intermingled in a vicious cycle, we assume that one of the following possibilities may explain the clinical presentation in our patient: either two separated and unrelated disorders, or laxative abuse as the cause of renal tubular acidification impairment. PMID- 3972560 TI - Terminal ileitis in a patient with systemic lupus erythematosus. PMID- 3972561 TI - Effect of prophylactic atropine administration on electrocardiographic changes during percutaneous liver needle biopsy. PMID- 3972562 TI - Torsade de pointes and carcinoma. A case report with a brief review of the causes of delayed repolarization arrhythmias. PMID- 3972563 TI - Living wills and dying in Hawaii. PMID- 3972564 TI - Predisposing, precipitating and relieving factors in different categories of headache. PMID- 3972565 TI - Tension headaches: muscle overactivity or psychogenic pain. PMID- 3972566 TI - Atypical facial pain: a reappraisal. PMID- 3972567 TI - A distinctive facial thermographic pattern in cluster headache--the "chai" sign. PMID- 3972568 TI - Autonomic nervous system dysfunction in common migraine. PMID- 3972569 TI - The utility of the Millon Behavioral Health Inventory in the study of chronic headaches. PMID- 3972570 TI - Psychometric characteristics of the Bakal Headache Assessment Questionnaire. PMID- 3972571 TI - Further study of the smoking habits of hospital nurses. PMID- 3972572 TI - A survey of residents in the Royal Scottish National Hospital using the Wessex Case Register Schedule. PMID- 3972574 TI - Smoking in Glasgow: a report on the Glasgow 2000 Project baseline survey. PMID- 3972573 TI - The anticonvulsant clinic: its value in the long-term management of refractory epilepsy. PMID- 3972575 TI - [Oral methotrexate therapy: pro and con]. AB - For the patient suffering from severe disabling psoriasis, there is now a choice of three possible therapeutic modalities: PUVA, retinoid, or cystostatics. We have had the most experience with methotrexate, as it has been used to treat psoriasis for more than 30 years. For this reason, there is also extensive experience with regard to the risk benefit ratio for this drug. Treatment with methotrexate requires normal kidney function, liver, and bone marrow function. Pregnancy is an absolute contraindication. Methotrexate is hepatotoxic. Fibrosis and cirrhosis are not uncommon when the cumulative dosage exceeds 1.5 g; methotrexate-induced liver cirrhosis is not, however, a rapidly progressing disease. Treatment with methotrexate requires regular laboratory control, and experience to date also indicates that liver biopsy specimens should be taken during treatment. PMID- 3972576 TI - [Peritoneal dialysis and leukopheresis in psoriasis: indications and contraindications]. AB - Twenty-four patients with severe psoriasis were treated with continuous peritoneal dialysis and ten patients with repeated leukopheresis, with comparable clinical results: about 20%-30% of the patients had complete remission of the lesions during the therapy, about 40% showed spontaneous regression of above 50% of psoriatic lesions, and the remaining patients had some improvement. However, despite partial improvement during treatment, the psoriatic lesions of the patients that were previously unresponsive to any external and internal treatment disappeared within 2-3 weeks, after discontinuation of dialysis or leukopheresis, with the use of anthralin or tar ointments. Peritoneal dialysis and leukopheresis seem to be useful methods of treatment for especially resistent and widespread psoriasis in patients having contraindications to other methods, i.e., PUVA and/or aromatic retinoids. PMID- 3972577 TI - [Dithranol and combined treatment procedures: pro and con]. AB - The combination of different antipsoriatics or treatment regimens should increase the therapeutic effect and reduce the adverse reactions. The combination of dithranol and tar (cignolin-salicyl-vaseline + tar, CSVT) reduces dithranol erythema and increases the antipsoriatic effect. CSVT treatment is highly effective, but patients tend to accept it less than other treatment regimens. On the other hand, Goeckerman therapy (tar + UV irradiation) is more accepted but less effective. Combinations of dithranol with UV irradiation or with tar and UV irradiation (Ingram regimen) are not advantageous. Dithranol and Goeckerman therapy are relatively secure treatment regimens, as they have been applied for more than 50 years without knowledge of significant late defects. PUVA therapy, although highly effective, is not superior to dithranol therapy. Even though PUVA therapy is more easily accepted than dithranol treatment, PUVA therapy should be applied only in severe cases. The combinations of aromatic retinoid with (selective) UVB irradiation (ReSUP) or with PUVA therapy (RePUVA) are highly effective. Retinoids can reduce the UV doses and most likely limit the risk of late damage. For routine treatment, ReSUP is preferable to RePUVA therapy. PMID- 3972578 TI - ["Minute therapy" of psoriasis with dithranol and its modifications. A critical evaluation based on 315 patients]. AB - A total of 315 psoriasis patients were treated on the basis of short-contact "minutes" therapy: 230 with 0.1-3% dithranol-2% salicylic acid-white soft vaseline (DSV) for 10-20 min daily; 85 patients in left-right comparison with modified therapeutic schemes. The object was to study the influence of concentration, contact time, psoriasis type, self-treatment at home, frequency of application, ointment base, and the admixture of corticosteroids on the efficacy of "minutes therapy." The clearing quotient for the individual psoriasis types was varied; it reached on an average 75% with a treatment period of 29.4 days. Even lower dithranol concentrations below 1% proved efficacious with part of the patients. Self-treatment at home and irregular applications diminished the efficacy. Neither prolongation of the contact time to 1 hr nor the addition of corticosteroids to dithranol did anything to improve the therapy results. The relapse-free period averaged 3.9 months. Undesirable irritation was avoided to a great extent by adjustment of the treatment intensity to individual tolerances. The simultaneous application of dithranol and corticosteroids did not hinder or diminish the dithranol erythema. For additional safety, a preliminary test treatment can be confined to a limited area for 1 week. Fortunately, the staining due to dithranol brown can be reliably removed from certain textiles and from the bath tub or shower cabin by the use of hypochlorite. PMID- 3972579 TI - [Local treatment of psoriasis with glucocorticosteroids]. AB - With regard to indications for topical treatment of psoriasis with glucocorticosteroids, the resorptive toxicity and topical side effects of the drug are decisive. Equivalent therapeutical agents, such as dithranol, UV light and retinoids, limit their supplementary use in the management of this disease. PMID- 3972581 TI - [Climate therapy of psoriasis: critical evaluation]. AB - As with many chronic, recurrent skin diseases, psoriasis in all its forms is within the domain of dermatological climatotherapy. However, this is only successful in genuinely stimulating climates, such as in the North Sea islands or in particularly high alpine regions (over 1500 m) under correct topographical conditions. If dermatological climatotherapy is to retain its justifiably good name, care must be taken not to misuse this important therapeutic means (unsuitable climates), or it may be discredited due to insufficient conditions and thus poor results. PMID- 3972580 TI - [Tar treatment of psoriasis]. AB - Tar is generated by dry distillation of coal or wood. Crude coal tar, tar extracts or refined tar products are used for therapy. Tar exerts an antipsoriatic effect by reducing cell proliferation. This effect is enhanced when tar is applied in combination with UV irradiation. The phototoxic reactions induced by several tar components in combination with UV-A cannot be employed for therapeutic purposes, since the painful smarting reaction prevents the application of the large UV-A doses required for therapy. Tar applied together with anthralin has recently been found to decrease the irritative qualities of anthralin. Due to the potential carcinogenic properties of tar, uncontrolled applications are to be avoided. PMID- 3972582 TI - A method of estimating the risks from ingested radionuclides. AB - A technique is presented for estimating the number of radiation-induced cancers in organs exposed following the ingestion of radionuclides. The method takes into account the dose rate, the sex and the age of the individuals exposed. It assumes a linear no-threshold response and does not incorporate biological repair mechanisms. Two examples are presented which demonstrate that although the dose equivalent limits may be the same, the different dose rates involved result in different risks. PMID- 3972583 TI - Measurement of 210Pb atmospheric flux in the Pacific Northwest. AB - Monthly atmospheric flux of 210Pb in Seattle, WA, has been measured over a period of 7 yr. Direct correlation exists between monthly rainfall and the 210Pb deposition; however, for the same amount of rainfall the 210Pb deposition varies from year to year. The mean annual input of 210Pb is 0.44 dpm/cm2 and the standard error of the mean is +/- 0.24 dpm/cm2. A 4.4-fold fluctuation in the 210Pb annual flux was observed during this investigation. PMID- 3972584 TI - Air-ground interface correction factors for gamma emitters in air. AB - For isotropic point photon sources above an air-ground interface, the spectral energy fluences at the ground have been calculated by the Monte Carlo method for source energies in the range 50 keV-10 MeV. The source heights and the horizontal source-detector distances varied from 0.05 to 5 mean free paths in air. Air ground interface correction factors have been calculated and then analytically approximated. The greatest deviations from unity were found for 100-keV sources located on the ground. Near the source, kerma free in air is enhanced by 30%, and far from the source it is reduced by a factor of 3. PMID- 3972585 TI - Dose-rate conversion factors for external exposure to photon emitters in soil. AB - Dose-rate conversion factors have been calculated for external exposure above ground to monoenergetic photon emitters in soil. These factors give external dose rates per unit source concentration in soil. The calculations are based on the point-kernel integration method and assume that the source concentration at any depth in soil is uniform over an infinite surface parallel to the ground plane. Dose-rate factors in air at a height of 1 m above ground are tabulated for discrete photon energies between 0.01 and 10 MeV and for source depths in soil between 0 and 300 cm. Application of the results for plane sources in soil to the calculation of photon dose rates from distributions of sources with depth in soil is described, and dose-rate factors are tabulated for the particular cases of uniform slab sources of finite thickness and sources which are exponentially distributed with depth. We also demonstrate how dose-rate factors in air for monoenergetic photon sources are used to estimate dose-rate factors for body organs of exposed individuals and for the spectrum of photons from radioactive decay. The calculations in this paper show that allowing for downward migration of radionuclides in soil can result in significant reductions in external dose compared with the usual assumption that radionuclides which are deposited on the ground surface remain there until removal by radioactive decay. PMID- 3972586 TI - Adsorption of Pu, Pb and Cd to mouth surfaces during oral administration to mice. AB - Substantial adsorption of Pu, Cd and Pb onto mouth surfaces of mice occurs during consumption of drinking water that contains these elements. If this adsorption is not taken into account, the amounts deposited in the eviscerated carcass (muscle plus skeleton) after gastrointestinal absorption are overestimated by 2-9 times for the experiments described. An evaluation of data indicate that significant adsorption can also occur during gavage administration. Methods are described for estimation of amounts deposited in the carcass after exposure of mice to these metals via drinking water or gavage. PMID- 3972587 TI - Evaluation of radiation dose from a coal-fired power plant. PMID- 3972589 TI - The activities and total transformations in the GI tract for ingested radionuclides. PMID- 3972588 TI - Exposure from a fluoroscope without the deadman exposure switch depressed. PMID- 3972590 TI - A comparison of radionuclide concentrations in 1956 and 1973 Enewetak beach material. PMID- 3972591 TI - Organizationally sponsored health services research. AB - Organizations, particularly large multi-institutional health delivery systems, have begun to sponsor their own research programs as a consequence of the scope and complexity of management and governance decisions they face. These research programs are functionally integrated into the organization and serve as a strategic management planning and decision-making tool. Their primary purpose is seen to be the comprehension, analysis, synthesis, application, and evaluation of the vast amount of information available within the organization and from the health delivery system. Their emphasis is on making research results relevant to organizational goals and objectives, applicable to organizational decisions, and utilized. Organizationally sponsored researchers, it has been shown, face a particularly complex set of management and research requirements in building their programs. Developing the research agenda and establishing an infrastructure for the conduct of research are critical to success. Once accomplished, the organizationally sponsored researcher does have particular advantages in conducting the research and in seeing the findings used to improve health care delivery. We have cited and addressed a number of concerns or issues relating to the emergence of organizationally sponsored research. Some are specious in origin; others arise out of an incomplete understanding of the systems of evaluation and reward which have traditionally applied to professional researchers. It is in terms of the intended beneficiary of the research and the extent to which the results are made to apply directly to the organizational manager that differences emerge--not in the quality or quantity of research accomplished, in the use of inductive or deductive approaches, or in the objectivity of results. PMID- 3972592 TI - Multi-institutional arrangements: relationships between governing boards and hospital chief executive officers. AB - This investigation focuses on the impact of multi-institutional arrangements on the role of governing boards in limiting or enhancing the managerial autonomy of individual hospitals. Data from a 1979 Special Survey by the American Hospital Association (N = 4213) are used to examine governing board-administrator relationships as a function of the degree of autonomy and scope of responsibility of the hospital governing board. It is hypothesized that governing boards responsible for multiple hospitals or for multiple nonhospital organizations and those boards accountable to a higher organizational authority will exercise more formal control over hospital chief executive officers (CEOs) than will boards of single or autonomous hospitals. The analysis assumes that formal control by the governing board over the management function of the individual hospital is exercised partly through soliciting or limiting participation by hospital administrators in key policy decisions and through the evaluation of administrative performance. Therefore, it is anticipated that hospitals governed by boards with multiple responsibilities as well as hospitals governed by boards accountable to a higher authority will be (1) less likely to have CEOs who are members of the governing board executive committee, (2) more likely to have annual performance reviews of the CEO by the governing board, and (3) more likely to have such reviews conducted according to preestablished criteria. Study results provide general support for the hypotheses with respect to hospital boards with multiple responsibilities: the data suggest that such boards do exercise greater control over hospital administrators and these effects do appear to be stronger for hospitals in the private sector. Hospitals governed by boards accountable to a higher authority, however, are more likely to have CEOs who are members of the governing board executive committee--a pattern in direct opposition to that hypothesized. Furthermore, these boards are no more likely to conduct annual CEO performance reviews than are boards with more autonomy. Boards accountable to higher authorities are more likely, however, to use preestablished criteria when such reviews are conducted. This general pattern is similar whether hospital boards are accountable to religious authorities, to investor-owned corporate boards, or to the boards of not-for-profit multi-institutional systems. A different pattern emerges, however, for boards accountable to a state, county, or local government authority.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3972593 TI - Organizational stress in the hospital: development of a model for diagnosis and prediction. AB - A model of organizational stress in the hospital was developed and tested. The model utilized measures of organizational climate, supervisory practices, and work group relations as predictors of the amount of role conflict and ambiguity that nurses perceived in providing patient care. Role conflict and ambiguity were treated as variables that intervene between organizational variables and the level of stress that the nursing staff experienced. Nursing stress was viewed as a direct cause of job dissatisfaction and as an indirect cause of absenteeism among the nursing staff. Data from 158 registered nurses, licensed practical nurses, and nursing assistants on seven nursing units in a 1,160-bed private teaching hospital were used to estimate the parameters of a structural equation model. The model was used to predict the results of a survey feedback project designed to change the supervisory style used on the units. Pre- and posttest data from four surgical units were used to validate the model. The findings suggest that, as predicted, supervisory practices that led to more open expression of views and joint problem solving resulted in reduced role conflict, ambiguity, and stress; increased job satisfaction; and lower levels of absenteeism among the nursing staff. PMID- 3972594 TI - Intervention strategies to enhance well-being in later life: the status and prospect of guided change. PMID- 3972595 TI - A proposed research agenda for health promotion and disease prevention for children and the elderly. PMID- 3972596 TI - Health promotion and disease prevention for children and the elderly. PMID- 3972598 TI - Temporal approach to the TMJ, the orbit, and the retromaxillary-infracranial region. AB - Anatomical and surgical details of the author's temporal approach to the temporomandibular joint (TMJ), the orbit, and the retromaxillary-infratemporal space are described using drawings and photographs taken during surgery. The approach is advocated because it gives any desirable access to the operating fields without leaving a visible scar in the face and because it preserves the condyle and, thereby, the integrity of the TMJ. PMID- 3972597 TI - Some challenges to health services research on children and the elderly. PMID- 3972599 TI - Complications associated with free jejunal graft reconstruction of the pharyngoesophagus--a multiinstitutional experience with 52 cases. AB - Fifty-two patients who underwent reconstruction of the pharynx and esophagus using the free jejunal graft were retrospectively reviewed. The complications were categorized into those associated with the resection, those associated with the harvesting of the graft, and those related to the reconstruction per se. In this series, the graft failure rate was 7.6% with an overall success rate of 90.3%. Graft necrosis was found to be the most serious complication occurring in four patients. Methods of detection of graft necrosis and management of these complications are discussed. PMID- 3972600 TI - Treatment of choice for squamous carcinoma of the tonsillar fossa. AB - The records of 160 patients with squamous cell carcinoma of the tonsillar fossa treated from 1968 through 1979 were reviewed. Biologic behavior, local and regional findings, and other prognostic factors were evaluated. patients were treated by either radiation alone (112 patients), radiation followed by planned neck dissection (31 patients), surgery alone (11 patients), or surgery combined with radiation (6 patients). Analysis of the data supports the recommendation that radiation be used as treatment for T1, T2, and early T3 lesions, whereas surgery alone or combined with radiation is best employed for advanced T3 or T4 tumors. Primary tumor control rates with radiation as the initial modality were 100% for T1 lesions, 89% for T2, 68% for T3, and 24% for T4. In addition, the control of cervical metastases with radiation therapy for patients with neck disease staged N0 through N3b was excellent (95%). In instances where a planned neck dissection was done 5 weeks after radiation, the control of cancer in the neck was 100%. The incidence of distant metastases was 10% and was not affected by the selection of therapy. The 2- and 5-year determinate survival figures for 112 patients treated with radiation therapy alone was 67% and 48% respectively, while 31 patients treated with radiation therapy followed by neck dissection achieved survival rates of 70% (2 year) and 58% (5 year). The criteria for selection of treatment are discussed. PMID- 3972601 TI - A model for staged compression of the vascular pedicle in a porcine myocutaneous flap. AB - There is a need for a laboratory model that would allow assessment of the effects of vascular pedicle compression in the myocutaneous flap. We describe a technique as used in the pig that responds to the needs of technical reproducibility and sequential compromise of vascular flow as measured by laser velocimetry and dermofluorometry. PMID- 3972602 TI - Bilateral chylothorax complicating radical neck dissection: report of a case with no concurrent external chylous leakage. AB - Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Six cases are reported in the English literature. All of these patients' cases were associated with a concurrent external chylous fistula, as evidenced by the appearance of a milky fluid confirmed to be chyle by chemical determination. Chyle had also been noted to leak during the operation. This presentation illustrates an additional case of bilateral chylothorax occurring after radical neck dissection, and the first case, to our knowledge, with no concurrent external lymph leakage. Anatomic and physiologic considerations are presented and possible mechanisms of pathogenesis are discussed. Chylothorax has two major complications--respiratory and metabolic. A short summary of the modern concepts of treatment is presented. PMID- 3972604 TI - Occipital arteriovenous fistulae. AB - Occipital arteriovenous fistulae may be congenital or traumatic. The distinguishing characteristics of each and diagnosis by dynamic computed tomographic (CT) scanning, obviating the need for angiography, is outlined and illustrated by a case report. The indications for surgery and operative approach are discussed. PMID- 3972603 TI - Unusual anatomic presentations of inverting papilloma. AB - Due to their tendency to recur, and a potential for malignancy, inverting papillomas of the nasal cavity and paranasal sinuses pose a challenge to the head and neck surgeon. Although the majority of these benign neoplasms arise from the lateral nasal wall, middle meatus, and ethmoid complex, they occasionally originate from atypical areas in which Schneiderian membrane is present. Four unusual anatomical presentations of inverting papilloma are presented and discussed. PMID- 3972605 TI - [The surgical treatment of tennis elbow]. PMID- 3972606 TI - [Supracondylar humerus fractures in children]. PMID- 3972607 TI - [Choice of implant material in fractures of the proximal femur]. PMID- 3972608 TI - [Late problems following conservative and surgical treatment of fractures of the distal tibia]. PMID- 3972609 TI - Experimental model for bone allografts with and without immunosuppression and microsurgical revascularization. PMID- 3972610 TI - [Trans-sphincteric anorectal sectional resection]. PMID- 3972611 TI - [Postsplenectomy sepsis in adults]. PMID- 3972612 TI - [Septic complications of splenectomy]. PMID- 3972613 TI - Early prognosis of acute pancreatitis. PMID- 3972614 TI - The role of phospholipase A2 in respiratory failure of acute pancreatitis. PMID- 3972615 TI - [Early prognostic value of levels of 6 pancreatic enzymes in blood and peritoneal fluid in acute pancreatitis]. PMID- 3972616 TI - [Acute pancreatitis and respiratory complications. An experimental study]. PMID- 3972617 TI - [CT evaluation of intra-arterial chemotherapy in liver metastases]. PMID- 3972618 TI - [Tumors of the biliary tract]. PMID- 3972619 TI - [Hospital statistics, documentation quality and data protection. Problem solving with a minicomputer]. PMID- 3972620 TI - [Current complication rate and mortality in cancer surgery]. PMID- 3972621 TI - [Infection in the surgical environment. Computerized prospective study]. PMID- 3972622 TI - Insufficiency of the lower esophageal sphincter--cause of reflux esophagitis. PMID- 3972623 TI - [The clinical evaluation of patients with stomach surgery]. PMID- 3972624 TI - [Metabolic disorders following stomach bypass operations for extreme obesity. Animal experiment study]. PMID- 3972625 TI - [Injury close to the papilla following choledochus revision and stomach resection]. PMID- 3972626 TI - [Traumatic duodenal rupture]. PMID- 3972627 TI - [Traumatic rupture of the duodenum with multiple associated abdominal injuries]. PMID- 3972628 TI - [The place of surgery in the treatment of primary bronchiectasis]. PMID- 3972629 TI - [Surgical treatment of thoracic duct lesions]. PMID- 3972630 TI - [Thymomas]. PMID- 3972631 TI - [The treatment of painful infraclavicular brachial plexus paralysis following axillary management and roentgen therapy]. PMID- 3972632 TI - [Significance of the surgical technic for the long-term prognosis of crural artery reconstruction]. PMID- 3972633 TI - [Arterial and venous injuries in traumatology: angiographic follow-up studies]. PMID- 3972634 TI - [Complicated knee injuries with associated vascular lesions]. PMID- 3972635 TI - [Early complications following aortoiliac reconstruction]. PMID- 3972636 TI - [Is leg bypass justified?]. PMID- 3972637 TI - [Iliac endofibrosis in 2 cycling racers]. PMID- 3972638 TI - [Vascular access for chronic hemodialysis. Experience with 171 patients]. PMID- 3972640 TI - [Trends in vascular surgery]. PMID- 3972639 TI - Thoracic outlet syndrome: treatment of vascular complications. PMID- 3972641 TI - [Dilatation of the common bile duct: a pitfall in biliary surgery]. PMID- 3972642 TI - [Angiomatous malformation of the inner auditory canal with the leading symptoms of vertigo and tinnitus]. AB - A case of a rare arteriovenous malformation in the internal auditory canal is reported. It caused unilateral tinnitus, facial weakness, trigeminal hypesthesia, and vertigo with lateropulsion. The audiological and otoneurological findings together with air-cisternography a CT scan had indicated an intrameatal tumor. An extended trans-temporal exposure of the internal auditory canal demonstrated an angiomatous lesion compressing the adjacent seventh and eighth cranial nerves. It could be removed safely by a second-stage lateral suboccipital approach to the cerebello-pontine angle. PMID- 3972643 TI - [Hearing in advanced age: critical view of so-called presbycusis]. AB - Presbycusis cannot be defined nosologically as an uniform disease. The computed threshold curves of the age dependent high-frequency hearing loss should not conceal the fact that the degree and form of the hearing loss vary greatly within the age groups. The pathological appearances also vary; degenerative changes vary in site and extent and are not limited to the cochlear structures, but are also found in all parts of the auditory system. The etiology of presbycusis can scarcely be attributed to the physiological senile degeneration of cochlear or central nervous structures alone because epidemiological studies suggest that without additional endogenous and exogenous noxious effects the hearing loss progresses more slowly than under the influence of these effects. Therefore, presbycusis, in the sense of a socially handicapping hearing loss, is not an invariable lesion of the auditory system (mainly of the inner ear) due to a combination of different etiological factors. There are only two possible treatments: (1) elimination of exogenous and endogenous noxious effects in the hope of delaying the progress of the hearing loss and (2) fitting of a hearing aid. The open high-tone CROS-aid seems to provide a sufficient discrimination gain which is especially valuable for the typical high tone hearing loss in aged people. The necessity for a careful follow-up is emphasised. PMID- 3972644 TI - [Otoneurologic findings in multiple sclerosis. Stapedius reflex, vestibular evaluation, early acoustic evoked potentials]. AB - Symptoms such as tinnitus, hearing and taste disorders and facial palsy seldom occur in multiple sclerosis. Although ENT symptoms are few, vestibular and acoustic stapedius reflex tests combined with brainstem auditory evoked potentials (BAEPs) are available, and may give very useful evidence of the existence of MS. 52 patients with definite MS, and 13 patients with probable MS were examined (classified according to the McAlpine criteria). The vestibular and acoustic stapedius reflex tests were abnormal in 51%/61% and 61%/53% respectively of both groups. The corresponding figures for BAEP were 69% and 63%. The combination of the three tests on all patients showed at least one pathological finding. PMID- 3972645 TI - [Damage to inner ear function caused by the effect of ionizing rays]. AB - In the literature the inner ear is claimed to be resistent to the effects of ionizing irradiation. We therefore studied the inner ear function in a group of 49 patients who had undergone radiotherapy for malignant tumors of the head in which the irradiated field included at least one inner ear. 67 ears had been irradiated, 46 of them showed a sensorineural hearing loss of 10 dB or more. The frequency and the degree of the inner ear damage was correlated with the dosage of the irradiation and with the time elapsed after the end of radiotherapy. PMID- 3972646 TI - [Tachistophony, a measuring method for time threshold in hearing. A contribution to hearing theory]. AB - Tachistophony is presented as a method of measuring time-thresholds for understanding spoken signals and for recognising sound levels. The minimum total time of periodically interrupted sound-events per second is assessed. The pause total can reach a value between 4 and 9 times (in extreme cases up to 14 times) the sound flow period. The total of sound-pulses is measured only at 250 to 100 ms, with the recognition of values still operative. Due to the low information content of numerical words their time-threshold is the lowest. The time-threshold lies considerably higher for one-syllable words and sentences with a higher information-content. The superiority of the left ear with dichotic stimulation is confirmed with monaural tachistophonic stimulation. These values are related to phase-frequencies of between 13 and 40 Hz. When the phase-frequency is lowered, comprehension below 8 Hz falls considerably. This is less apparent with phase frequencies between 40 and 110 Hz. PMID- 3972648 TI - [Early detection of hearing disorders. A simple method of mass screening in newborn infants]. AB - The necessity of early detection and rehabilitation of hearing impaired children is accepted worldwide, but there are still different opinions about the earliest possible time and the kind of examinations in the Federal Republic of Germany. We report our method of examination of neonates, our results and our conclusions. We think that our method is very simple, easy, quick and can be done by well trained personnel. It is reliable enough to filter out suspicious cases, allowing audiological investigation and treatment, if necessary. PMID- 3972647 TI - [Sudden deafness--on the age dependence of therapy results with reference to naftidrofuryl (Dusodril)]. AB - The results of treatment of 100 patients with sudden sensorineural hearing loss were analysed in three age groups (under 30, 30-60, over 60 years). The basic therapy consisted of Dextran, Diazepam and Vitamins. One half of the patients in each age group was treated with Naftidrofuryl (Dusodril) too. Sudden hearing loss was more profound in the elderly patients than in the younger ones, and the hearing gain (%) decreased with increasing age. The absolute (dB) hearing gain was more or less independent of age and Dusodril, and for all patients averaged 21 dB. Only the hearing gain (%) of the 30-60 year old patients treated with Dusodril was significantly greater than that of the control group treated without Dusodril. PMID- 3972649 TI - [Objective tinnitus caused by myoclonus of the musculus tensor veli palitini]. AB - Objective tinnitus is often caused by palatal myoclonus. We report a 15 years old boy with objective tinnitus in both ears and palatal myoclonus. He had myorhythmic movements of both tensor veli palatini muscles asynchronous with the objective tinnitus. The frequency of the clonus was 120 contractions a minute. The myoclonus and the objective tinnitus disappeared after division of the bilateral tensor veli palatini muscles. PMID- 3972650 TI - Comparison of the effect of two and six week exposure to 80% and 100% oxygen on the lung of the newborn mouse: a quantitative SEM and TEM correlative study. AB - Prolonged inhalation of 80% oxygen, in contrast to 100% oxygen, has generally been assumed not to lead to significant pulmonary impairment. Two and six week old C57BL mice were systematically assessed by transmission and scanning electron microscopy for structural changes in the lung caused by inhalation of 80% and 100% oxygen from the first day of life, and the injury was quantitated morphometrically. Six weeks of continuous inhalation of 80% oxygen resulted in diffuse fibrosis of the gas exchanging parts of the lung superimposed on which were, in the 100% oxygen exposed mice, foci of coarse scarring. Lowering the inspired oxygen concentration from 100% to 80% appeared to reduce the mucosal injury more than the interstitial fibrotic response. This suggests that the most persistent alteration caused by chronic supplemental oxygen exposure below 80% will be interstitial fibrosis. PMID- 3972651 TI - Magnetic resonance imaging of primary intracranial tumors: a review. AB - The experience in magnetic resonance (MR) imaging of primary intracranial neoplasia at University of California, San Francisco is reviewed. Seventy patients have been evaluated by MR and computerized tomography (CT). MR scans were performed using a multi-slice spin echo technique with a long pulse repetition time (TR = 2000 msec), and long echo sampling delay (TE = 56 msec). This method was most sensitive in differentiating normal gray and white matter and in detecting both cerebral edema and abnormal tissue with prolonged T2 characteristics. More sensitive to slight alterations in normal tissue, MR may detect a focal lesion in cases in which CT shows only mass effect. Moreover, MR may demonstrate more thoroughly the extent of tumor infiltration and broaden the characterization of abnormal tissue. Posterior fossa and brainstem anatomy are invariably better depicted by MR. The major limitations of MR include its inability to detect foci of tumor calcification, demonstrate the severity of bone destruction, or reliably distinguish tumor nidus from surrounding edema. PMID- 3972652 TI - Benznidazole with CCNU: a clinical phase I toxicity study. AB - It has been shown in a variety of model systems that benznidazole (BENZO) is capable of enhancing the cytotoxicity of a number of drugs, including nitrosoureas. We report an escalating dose toxicity study of the combination of BENZO and CCNU on 34 patients in whom the usual clinical dose of CCNU (130 mg/m2) was given together with escalating doses of BENZO (up to a maximum dose of 40 mg/kg). We have observed no BENZO-related toxicity and no evidence that, in the dose range studied, BENZO enhances the gastrointestinal or hematological toxicity of CCNU. It is possible to administer the usual dose of CCNU together with doses of BENZO that can be shown to have a clear effect on the pharmacokinetics of CCNU and which might be expected, from the results of animal experiments, to produce enhancement of its cytotoxicity. A Phase III study of the combination is in progress. PMID- 3972653 TI - The management of stage II Hodgkin's disease with a large mediastinal mass: a prospective program emphasizing irradiation. AB - Between October 1980 and July 1983, 13 patients with clinical Stage II Hodgkin's disease who had a large mediastinal mass (mediastinal mass ratio, MMR greater than 1/3) were entered into a prospective treatment program emphasizing irradiation. Careful clinical staging, including CT scanning, was completed in order to define precisely the extent of disease in the chest. All patients had a negative lymphogram. The range of MMR was .34 to .56 (median .39). By the time mantle irradiation was completed the MMR ranged from .21 to .35. One patient had such extensive pulmonary parenchymal extension that treatment with combined modality therapy was necessary. Twelve patients underwent laparotomy after adequate reduction of the mediastinal mass size, but only two had subdiaphragmatic disease detected. One patient had disease extension into the lung during mantle irradiation and one patient failed in a rib six months after completion of irradiation. Both have been treated successfully with salvage chemotherapy. All the remaining patients received prophylactic irradiation below the diaphragm and all are doing well with a median follow up of 21 months. The 2 year actuarial freedom from relapse of the entire group of 13 patients is 83%. These early results are very encouraging for this unfavorable group of patients with large mediastinal masses. This may be due to the routine use of CT scans to determine tumor volume and aggressive mantle irradiation, which often includes prophylactic treatment to the lungs. Careful monitoring of tumor response and use of a shrinking field technique has helped to keep complications to a minimum. PMID- 3972654 TI - Psychological effects of breast conserving therapy in comparison with radical mastectomy. AB - Psychosocial sequelae of breast conserving therapy (BCT) and radical mastectomy (RM) have been compared. Also, in the BCT group, the cosmetic results were judged by the patients themselves and two plastic surgeons. Body image in the BCT group (n = 114) was significantly more positive than in the RM group (n = 58). Patients treated with BCT had even less fear of recurrence of the cancer and would, if necessary, choose the same treatment again. Cosmetic results were good to excellent in 75% of the cases as judged by the two plastic surgeons. Most of the patients with a bad grading by the surgeons were happy with the results. PMID- 3972655 TI - Radiotherapy in the treatment of vertebral hemangiomas. AB - Symptomatic vertebral hemangiomas are not common. Although radiotherapy has been used as treatment, the data are sparse concerning total dose, fractionation and results. We report nine patients with vertebral hemangioma treated with 3000-4000 rad, 200 rad/day, 5 fractions per week, followed from 6 to 62 months. Seventy seven percent had complete or almost complete disappearance of the symptoms. Radiotherapy schedules are discussed. PMID- 3972656 TI - 125I vicryl suture implants as a surgical adjuvant in cancer of the head and neck. AB - Sixty-four intraoperative 125I seed implants using absorbable suture (Vicryl) carriers were performed in 53 patients with head and neck cancers at Stanford between 1975 and 1980. In previously untreated patients, local control in the implanted volume or in all head and neck sites was obtained in 79 and 71%, respectively. Five of these patients (40%) remained NED. Of 34 patients with recurrent carcinomas, local control was obtained in the implant volume in 20 (59%), while 38% had no recurrence post-implantation in any head and neck site. The incidence of complications is correlated with 125I radiation doses, total millicuries inserted, seed strength used, and tissue volume implanted for both untreated patients and those with local recurrences. Guidelines for the optimal use of the above 4 parameters are also presented. We conclude that 125I seed Vicryl intraoperative suture implants are an effective surgical adjuvant in the treatment of advanced, previously untreated or recurrent head and neck cancers. PMID- 3972657 TI - A comparison between low dose rate radiotherapy and conventionally fractionated irradiation in moderately extensive cancers of the oropharynx. AB - We report the comparative results for local tumor control between two groups of patients treated by radiotherapy fractionated in a conventional manner at normal high dose rate (29 patients with 2 years minimum follow-up and 24 patients with 3 years minimum follow-up) and by low dose rate radiotherapy (19 patients with 2 years minimum follow-up, 14 patients with 3 years minimum follow-up) with moderately extensive cancers of the oropharynx (T2b-T3a, 3-5 cm in diameter). At 2 and 3 years follow-up, the number of local recurrences in the patients treated with low dose rate radiotherapy is half (26 and 21%) that for those treated with conventionally fractionated radiation at normal high dose rates (52 and 54%). These results require more rigorous confirmation. PMID- 3972658 TI - Californium-252 interstitial implants in carcinoma of the tongue. AB - A clinical study using 252Cf sources in brachytherapy of tumors began in the Research Institute of Medical Radiology of the Academy of Medical Sciences of the USSR in 1973. 252Cf afterloading cells were utilized by the method of simple afterloading. Dosimetry and radiation protection of medical personnel were developed. To substantiate optimal therapeutic doses of 252Cf neutrons, a correlation of dose, time, and treatment volume factors with clinical results of 252Cf interstitial implants in carcinoma of the tongue for 47 patients with a minimum follow-up period of 1 year was studied. Forty-nine interstitial implants have been performed. Seventeen patients received 252Cf implants alone (Group I), 17 other patients received 252Cf implants in combination with external radiation (Group II), and 15 patients were treated with interstitial implants for recurrent or residual tumors (Group III). Complete regression of carcinoma of the tongue was obtained in 48 patients (98%). Recurrences occurred in 1 patient (6%) in Group I, 6 patients (35%) in Group II, and 5 patients (33%) in Group III. Thirteen patients (27%) developed radiation necrosis. The therapeutic dose of neutron radiation from 252Cf sources in interstitial radiotherapy of primary tongue carcinomas (Group I) was found to be 7 to 9 Gy. Optimal therapeutic neutron dose in combined interstitial and external radiotherapy of primary tumors (Group II) was 5 to 6 Gy with an external radiation dose of 40 Gy. For recurrent and residual tumors (Group III), favorable results were obtained with tumor doses of 6.5 to 7 Gy. PMID- 3972659 TI - Postoperative vaginal radiation in endometrial cancer using a remote afterloading technique. AB - Carcinoma of the endometrium is the most common malignancy of the female genital tract. In early stage endometrial cancer, surgery remains the primary mode of treatment while radiation therapy plays an adjuvant role. Prophylactic vaginal radiation has been shown to reduce significantly the incidence of vaginal recurrences. Between the years 1969-1976, 330 patients with FIGO Stages I and II endometrial cancer were treated according to a standard departmental policy in which 40 Gy of external radiation was given to high risk Stage I and all Stage II patients in combination with surgery and intravaginal radiation. Stage I was considered high risk if the tumor was of high grade or exhibited deep myometrial invasion. Vault radiation was delivered with a remote afterloading technique to a point .5 cm from the surface of the applicator; a total dose of 21 Gy was delivered in three fractions spaced two weeks apart over four elapsed weeks. With this regimen, the mucosal surface received a total equivalent dose of 40 Gy. These treatments were given on an outpatient basis without the need for any sedation or analgesics. All patients, regardless of stage, grade, or depth of myometrial invasion received adjuvant post-operative vaginal radiation. The minimum follow-up was 5 years, with a median follow-up of 8.5 years. The overall pelvic and/or vaginal recurrence rate was 2.7%. The incidence of vaginal complications was 3.7%. It appears that the remote afterloading treatment (RAT) for vaginal radiation is a very cost-effective therapeutic alternative, which produces minimal early or late complications and gives complete protection from radiation exposure to the medical staff. The advantages of a remote afterloading technique in delivering vaginal vault radiation in endometrial cancer are discussed in this paper. PMID- 3972660 TI - Excisional biopsy, axillary node dissection and definitive radiotherapy for Stages I and II breast cancer. AB - From 1977 to 1982, 189 patients with clinical Stage I and II breast cancer underwent excisional biopsy and axillary node dissection followed by definitive radiotherapy at the University of Pennsylvania. One hundred and nine patients had T1 lesions and 80 had T2 lesions. Histologically negative nodes were found in 136 patients (72%) and histologically positive nodes in 53 patients. Seventy-four percent of those with positive nodes had 1-3 positive nodes. Median follow-up from the completion of radiotherapy was 26 months. The cumulative probability of local-regional failure only at 48 months is 5%. The incidence of local recurrence was unrelated to T stage or nodal status. Regional failure was unrelated to T stage, but appeared more frequently in node positive patients. Three patients have died, two of disease and one of an unrelated cause. Ten patients are alive with disease. The four year actuarial disease free survival is 82% for pathologic Stage I (T1, pathologic N0) and 70% for pathologic Stage II (T1 pathologic N1, T2 pathologic N0 or N1). Cosmesis was judged to be good to excellent in 90% and fair in 9%. Complications included arm edema (7%), symptomatic pneumonitis (1%), rib fractures (1%), pericarditis (1%) and pleural effusion (1%). No patient experienced a brachial plexus injury. Primary radiotherapy for Stages I and II breast cancer produces a local-regional control rate of 95% and good to excellent cosmesis in 90% of the patients. While these results are preliminary, they compare favorably with other reported series. PMID- 3972661 TI - Dose to the contralateral breast due to primary breast irradiation. AB - The radiation dose received by the contralateral breast during primary breast irradiation is of concern because breast tissue is subject to cancer induction from low to moderate doses of radiation. In this paper the dose to the opposite breast has been studied in detail for common breast treatment techniques. Measurements have been made on 16 patients, a water phantom, a polystyrene phantom with cork inserts to simulate lung tissue, and a body-shaped phantom with wax breasts. Thermoluminescent dosimeters (TLD), ion chambers, diodes, and film have been used in the various configurations. The patient measurements have shown that there is a wide variation in the opposite breast dose received by patients, even when all are treated with, for example, tangential fields alone. Addition of more radiation fields, such as supraclavicular/axillary and internal mammary fields, may increase the dose to the opposite breast for a particular patient. Variations in the details of the technique such as what wedges are used, the use of blocks, and the orientation of the field edges are all important to the final dose received by the patient's contralateral breast. With the phantom measurements, it has been possible to determine the contributions to the opposite breast dose from each of the relevant factors. This makes it possible to explain the wide variation in patient dose measurements, and to make some relatively simple recommendations that will allow the reduction of the dose to the opposite breast from several hundred cGy to about 50 cGy for a typical treatment course dose of 5000 cGy. PMID- 3972662 TI - Combined surgery and postoperative radiation therapy for advanced laryngeal and hypopharyngeal carcinomas. AB - The survival, pattern of failure and complications in 47 patients with Stage III and IV cancers of the glottis, supraglottis and hypopharynx treated with surgery and postoperative radiotherapy using a new treatment technique referred to as "mini-mantle" were analyzed. The absolute survival probability of the entire group was 53 and 31% at 3 and 5 years. The local control probability at 3 and 5 years was 63 and 58%, and was higher for the supraglottic/hypopharyngeal than for glottic carcinomas. Advanced lesions, lymph node metastases and positive resection margins were significantly related to a worse local control. Five patients developed complications requiring surgical correction, but none experienced mortality. Moderate complications were treated conservatively without lasting sequelae. This technique is a reasonably safe and efficient procedure and can be effectively employed for the management of advanced laryngeal and hypopharyngeal carcinomas after definitive surgery. PMID- 3972663 TI - Comparison of single, fractionated and hyperfractionated irradiation on the development of normal tissue damage in rat lung. AB - The effect of fractionated thoracic irradiation on the development of normal tissue damage in rats was compared to that produced by single doses. Animals received a single dose of 15 Gy, 30 Gy in 10 daily fractions of 3 Gy each (fractionation), or 30 Gy in 30 fractions of 1 Gy each 3 times a day (hyperfractionation). The treatments produced minimal lethality since a total of only 6 animals died between days 273 and 475 after the initiation of treatment, with no difference in survival observed between the control and any of the 3 treated groups. Despite the lack of lethality, evidence of lung damage was obtained by histological examination. At times less than 180 days after treatment, the lungs of animals receiving a single dose of 15 Gy displayed more severe changes than did animals from either fractionation group. At longer times after treatment (days 261 and 475), the histological appearances within each group were changed, collagen deposits and fibrosis being the most significant observations. Animals that had received either single doses or fractionated doses had more of the pulmonary parenchyma involved than did animals that had received hyperfractionated doses. We conclude that, in the rat lung model, a total radiation dose of 30 Gy fractionated over 14 days produces no more acute lethality nor damage to lung tissue than does 15 Gy delivered as a single dose. However, long-term effects as evidenced by deposits of collagen and development of fibrosis are significantly reduced by hyperfractionation when compared to single doses and daily fractionation. PMID- 3972664 TI - Practical thermal dosimetry. AB - A relatively simple means of thermal dose documentation is presented. It has the advantage of greatly condensing the vast amount of data collected during a course of hyperthermia treatments. The formulation incorporates both temporal and spatial temperature transients and is applicable when comparing hyperthermia devices and in quality control for prospective hyperthermia treatment protocols. PMID- 3972665 TI - Transient microwave induced neurosensory reactions during superficial hyperthermia treatment. AB - A pattern of neural anomaly has emerged in 10 of the 200 patients treated with ionizing external beam radiation and 915 MHz microwave induced hyperthermia for superficial malignancies. Patients report various sensations in parts of the body which not only are far removed from the treated area, but also are not generated through pathways in the treated areas. The most common sensation was a numbness and tingling in the ipsilateral arm when the chest was being treated. In each case, the applicator was at least three aperture widths from the axilla; the angle with the axilla was approximately 90 degrees, and the applicator was angled from 90-180 degrees to the affected arm. In each case, the sensation was only appreciated when the microwave energy was present. There was no correlation of sensation with level of power application. The sensation would saturate at power densities far below those used to achieve therapeutic heating. One patient reported such a severe "burning" sensation in the arm at the lowest measurable power from the generator that further treatment was discontinued. Only one patient had a demonstrable motor deficit. These effects were patient specific and repeated from treatment to treatment in at least two-thirds of the treatment sessions. Sensitive patients were sporadically distributed throughout the patient population. PMID- 3972666 TI - Hyperthermia and radiation in vivo: effect of 2-deoxy-D-glucose. AB - Since hypoxic cells rely heavily on glucose metabolism for energy, 2-deoxy-D glucose (2-DG), an inhibitor of anaerobic glycolysis, would be expected to increase tumor cell killing by heat and thus enhance the effect of concurrent radiation. In order to test this hypothesis two types of BALB/c mouse tumors, one induced by subcutaneous injection of 10(6) herpes virus Type 2-transformed (H238) cells and the other by injection of 1.6 X 10(5) 1,2-dimethylhydrazine-transformed (#51) cells in the right thigh, were subjected to radiation, 2-DG, and heat used singly and in various combinations. Control mice were injected with saline. Three to four weeks after inoculation the mice were assigned to one of eight treatment groups (28 mice/group) so that average tumor volume/group before treatment would be equivalent. A single 2000 rad dose of radiation 3 hr prior to heat and 2-DG injected intraperitoneally at 1 g/kg 30 min before heating were given to some of the groups. Localized heat at 43.5 +/- 0.1 degrees C for 30 min, when used, was administered by means of a water bath. Rectal temperatures were kept below 39 degrees C, whereas intratumor temperatures reached a maximum of 42 degrees C. After treatment, tumor volume, mouse weight, and mortality were noted twice a week for four weeks. In both tumor models, mice receiving radiation plus heat, and radiation plus heat plus 2-DG, had significantly smaller tumors over the entire 4 to 28 day range after treatment than saline-injected control mice. In addition, in the H238 tumor model, addition of 2-DG to treatment with radiation and heat resulted in significantly smaller tumors at 25 days. 2-DG alone or in combination with heat (without radiation) resulted in significantly smaller H238 cell-induced tumors at day 28 post-treatment when compared to the saline controls. The H238 tumor-bearing mice experienced a significant (4.7%) loss in total body weight after heating. It could be that heating trauma produced dehydration and possibly also decreased caloric intake to an extent which could be measured in weight loss. This observation, however, was not made in the heated mice in the #51 tumor model. PMID- 3972667 TI - Breast retraction assessment: an objective evaluation of cosmetic results of patients treated conservatively for breast cancer. AB - Breast Retraction Assessment (BRA) is an objective evaluation of the amount of cosmetic retraction of the treated breast in comparison to the untreated breast in patients who receive conservative treatment for breast cancer. A clear acrylic sheet supported vertically and marked as a grid at 1 cm intervals is employed to perform the measurements. Average BRA value (+/- standard deviation) in 29 control patients without breast cancer was 1.2 cm (+/- 0.7 cm). Average BRA value in 27 patients treated conservatively for clinical Stage I or II unilateral breast cancer was 3.7 cm (+/- 2.1 cm). BRA values in breast cancer patients ranged from 0.0 to 8.5 cm. Statistical analysis revealed that tumor size, employment of adjuvant chemotherapy and use of separate radiation lymph node fields were not factors in breast retraction. Patients who received a local radiation boost to the primary tumor bed site had statistically significantly less retraction than those who did not receive a boost. Patients who had an extensive primary tumor resection had statistically significantly more retraction than those who underwent a more limited resection. In comparison to qualitative forms of cosmetic analysis, BRA is an objective test that can quantitatively evaluate factors which may be related to cosmetic retraction in patients treated conservatively for breast cancer. PMID- 3972668 TI - Fallopian tube carcinoma. AB - Twenty-one patients with fallopian tube carcinoma from Yale-New Haven Medical Center are reviewed. Most patients who died of disease did so in the first two years after diagnosis, even following complete resection, clearly indicating the need for adjuvant therapy. Negative second-look surgery did not provide assurance of permanent remission. There was a high recurrence rate with Stage I and completely resected Stage II and III disease (8 of 14 patients). Some recurrences occurred late, up to nine years after initial diagnosis. We recommend whole abdomino-pelvic radiation if no disease greater than 2 cm3 bulk exists after surgery. Chemotherapy may be an alternative to radiation as primary adjuvant treatment in early stage disease. Chemotherapy for unresectable disease or recurrent disease has shown palliation with occasional prolonged survival but no patient with recurrent disease survived longer than two years. PMID- 3972669 TI - Is cancer treatment toxicity accurately reported? AB - To assess current documentation of treatment-related toxicity, 46 out-patients attending the Ottawa Civic Hospital Cancer Clinic were randomly selected. Physician's charting of toxicities was compared to patient's perception of toxicity, as recorded on a brief questionnaire. As a group, patients reported significantly more toxicities than had been recorded by their physician. The greatest disparity was observed for the following categories: nausea, vomiting, alopecia, and decreased performance status. The best-documented toxicities were: skin and mucosal reactions, and urinary symptoms. To the question concerning their most bothersome symptoms, patients described nausea, vomiting, mucosal reaction, and decreased performance status as the most common. In 46% of cases, the physician's notes failed to identify the patient's worst symptom. From our study; toxicity is probably under-reported, and unrecognized by oncologists. A self-administered questionnaire appears to be a better way of accurately identifying and reporting treatment toxicities, when compared to the oncologist's evaluation, as recorded in the patient's permanent record. PMID- 3972670 TI - Peripheral dose to the testes: the design and clinical use of a practical and effective gonadal shield. AB - A simple and practical gonadal shield has been developed for use near megavoltage radiation fields. The lead shield encloses only the testes, allowing its use with nearly any radiation field that does not include the testes. The dose to the testes with and without the shield has been measured extensively both in phantoms and on patients. The gonadal shield allows a 3 to 10-fold reduction in dose to the testes depending primarily on the distance from the field edge to the gonads. When the shield is used, the gonadal dose is always less than 1% of the patient's prescription dose. Based on our patient studies of testicular injury following conventionally-fractionated irradiation, a dose of less than 50 cGy (1% of a typical 5000 cGy treatment regimen) should preserve normal testicular function. PMID- 3972672 TI - A basis for blocking the spinal cord in opposed field irradiation. AB - The concept of partial tolerance is applied to the equivalent dose formula for spinal cord tolerance to allow for the change in dose when open and blocked fields are used in a course of radiotherapy. The field arrangement considered is parallel opposed irradiation. Certain assumptions are made regarding the contribution of dose to the spinal cord from open and blocked fields, which allows for the development of an equation to calculate the number of fractions that require spinal cord shielding in the posterior field. The use of a form to facilitate these calculations is described. PMID- 3972671 TI - Combining backscattered electrons and low energy photons to improve the dose distribution to an eyelid. AB - In electron beam therapy, backscattered electrons from metal shields result in a high dose to tissue in the vicinity of the shield. Data are now available which enable both the magnitude of the dose enhancement at the interface and the fall off in dose 'up stream' to be determined. With the aid of these data, a combined modality therapy (5 MeV electrons, 1.1 mm A1 HVL X rays) was given to an eyelid during which the lens was protected with a superficial X ray lead eye shield. The eyelid was treated to a mid lid dose of 45 Gy in 28 days, and the dose gradient on the beam central axis was more uniform (+/- 3%) than that obtainable with superficial X rays alone. The lens dose from the combined therapy was estimated to be less than 0.25 Gy. PMID- 3972673 TI - Chronic hypertrophic pyloric gastropathy as a cause of pyloric obstruction in the dog. AB - Six small-breed, middle-age dogs with a history of chronic intermittent vomiting had benign pyloric lesions causing gastric outlet obstruction. Marked similarities were found in clinical signs, pathologic changes, and treatment results. The condition was classified as a syndrome and was named chronic hypertrophic pyloric gastropathy. The appearance of the obstructive lesions at surgery were various forms of mucosal hypertrophy. Microscopically, the syndrome was characterized by mucosal foveolar and glandular hyperplasia, cystic glandular dilatation, superficial mucosal ulcerations, and various cellular infiltrates. The affected dogs were successfully treated by surgical correction of the gastric outlet obstruction. PMID- 3972674 TI - Efficacy of digoxin administration in dogs with idiopathic congestive cardiomyopathy. AB - Digoxin administration (0.22 mg/m2 of body surface BID) to 10 large-breed dogs with congestive cardiomyopathy increased shortening fraction more than 5.5% in 4 of the dogs. This group of dogs lived longer than the group that did not have a positive inotropic response to digoxin. Heart rate decreased in both groups of dogs. Base-line jugular PVO2 were low in all dogs. Jugular PVO2 decreased significantly in the group that did not respond to digoxin, presumably because of decreased cardiac output. Jugular PVO2 consistently increased in dogs that had a positive inotropic response to digoxin. Base-line shortening fraction, heart rate, and PVO2 did not predict which dogs would respond to digoxin. Serum digoxin concentrations were consistently between 1.5 and 2.5 ng/ml. It was concluded that digoxin administration is not efficacious in all dogs with congestive cardiomyopathy and that the positive inotropic response is not predicted by base line shortening fraction, heart rate, or jugular PVO2. Dogs that do respond to digoxin usually live longer than those that do not. Jugular PVO2 can be used to separate dogs that do respond from dogs that do not respond to digoxin as long as the base-line PVO2 is low. The negative chronotropic effects of digoxin may be detrimental to dogs that do not have a positive inotropic effect from digoxin. PMID- 3972675 TI - Radial agenesis and ulnar hypoplasia in two caprine kids. AB - Two of three caprine triplets caused dystocia due to malformed forelimbs. This malformity was caused by radial agenesis and ulnar hypoplasia. Other congenital anomalies were also present. The influence of diet versus genetics could not be ascertained. Bilateral ulnar fractures in one kid revealed histologically rounded fracture ends with prominent periosteal new bone formation. PMID- 3972676 TI - Submandibular and disseminated zygomycosis (mucormycosis) in feeder pigs. AB - Submandibular and/or disseminated zygomycosis (mucormycosis) was diagnosed in 3 feeder pigs from 2 farrow-to-finish farms. Affected pigs were stunted and unthrifty. Each pig had a large unilateral submandibular granuloma replacing the mandibular lymph node on the affected side. Two pigs had disseminated lesions. One had an abscess on the serosa of the stomach; another had abscesses scattered throughout the liver and mesenteric lymph nodes. Impression smears were made of several masses and stained with blue-black ink. Examination of smears by light microscopy revealed coarse, infrequently septate, irregularly branching, mucoraceous fungi typical of a Zygomycete. Histologic examination of the submandibular masses revealed granulomas containing large numbers of mixed inflammatory cells, including giant cells. Mesenteric lymph nodes and liver abscesses had necrotic cores surrounded by fibrous capsules infiltrated by mixed inflammatory cells. Hyphae of a mucoraceous fungus were scattered throughout all masses. The 2 pigs submitted alive had marked serum hypoproteinemia, including hypoglobulinemia. PMID- 3972677 TI - Cholelithiasis in a cat. AB - A 4-year-old cat was examined because of anorexia and lethargy. The cat became icteric within 3 days of admission. Values for aspartate transaminase, alanine transaminase, total bilirubin, alkaline phosphatase, and cholesterol were higher than normal. Radiography revealed hepatomegaly, with loss of detail in the cranioventral portion of the abdomen. Further diagnostic procedures were not permitted, and the cat was euthanatized. At necropsy, cholecystitis, cholangitis, and numerous choleliths were found. Cholelithiasis is a rare cause of obstructive jaundice in the cat. PMID- 3972678 TI - Compound odontoma in a dog. AB - A compound odontoma was diagnosed in the mandible of a 6-month-old dog. Histologically the tumor consisted primarily of mesenchymal tissue resembling dental pulp, odontoblasts, and areas of dentin. Smaller numbers of ameloblasts were associated with minimal enamel production. Odontomas are benign odontogenic tumors which must be differentiated from malignant bone tumors such as ameloblastic odontoma and ameloblastoma. PMID- 3972679 TI - Segmental aplasia of the uterine horn in a cat. AB - A 4.5-year-old female domestic longhair cat with a history of intermittent abdominal distention following estrus and infertility was admitted for routine vaccinations. Radiographs revealed 2 large blunt-ended tubular structures overlapping each other in the abdomen. Segmental aplasia of the right uterine horn was diagnosed following exploratory laparotomy and ovariohysterectomy. PMID- 3972680 TI - Lymphocytic-plasmacytic enteritis in a cat. AB - A cat with severe weight loss and small bowel diarrhea was diagnosed as having lymphocytic-plasmacytic enteritis. Treatment with medium chain triglycerides and glucocorticoids was palliative. This disease appears similar to that reported in Basenji dogs. In retrospect, dietary therapy should also have been attempted since cats with a similar infiltration of the colon responded well to such therapy. PMID- 3972681 TI - Veterinary ethics and ecologic concerns. PMID- 3972682 TI - Dissolution of a partnership. PMID- 3972683 TI - Benefits derived from research on food animals. PMID- 3972684 TI - Potential impact of on-farm microcomputers on livestock management and veterinary practice. PMID- 3972685 TI - Uterine involution in mares treated with progesterone and estradiol-17 beta. AB - Bacteriology, histology, and scanning electron microscopy were used to evaluate uterine involution in 27 mares treated with daily injections of 150 mg of progesterone and 10 mg of estradiol-17 beta, commencing within 18 hours of parturition. These findings were compared with those for 24 untreated mares at postpartum day 10 or 11. The treatment resulted in significantly (P less than 0.05) greater uterine gland proliferation. Gland density was significantly (P less than 0.05) greater in mares treated for 6 to 10 days than in those treated 2 to 5 days. The proportion of ciliated cells to secretory cells lining the endometrial surface was significantly (P less than 0.05) greater in mares during delayed foal estrus than in those at postpartum days 10 to 11. The proportion of ciliated to secretory cells increased with increasing duration of treatment. It was concluded that treatment with progesterone and estradiol-17 beta allowed additional time for uterine involution in the early postpartum period. PMID- 3972686 TI - Evaluation of fluorescein dye as an indicator of small intestinal viability in the horse. AB - In 6 horses, 2 types of ischemic lesions were created in small intestinal segments by selective ligation of vessels and intestinal wall for 1, 2, or 3 hours. After confirming the ischemia by IV injection of sodium fluorescein, the ligatures were released. Five minutes later, the fluorescent patterns were documented photographically. Observed patterns ranged from normal (identical to that observed in unaffected bowel) to a patchy distribution of non-fluorescence (indicating incomplete perfusion). None of the experimental segments was normal when reevaluated 1 month later. The typical appearance included fibrosis, adhesions, and thickening of the bowel wall. It was concluded that IV injection of fluorescein can be used to indicate perfusion of the intestine, but that this is not the only criterion for determining clinical outcome in cases of intestinal ischemia in horses. PMID- 3972687 TI - Evaluation of febantel used concurrently with piperazine citrate in horses. AB - Fifty horses from a herd known to have benzimidazole-resistant small strongyles were treated with febantel (6 mg/kg), combinations of febantel (6 mg/kg) and piperazine citrate (25 or 55 mg base/kg), thiabendazole (44 mg/kg), or placebo (0.6 ml of water/kg). Pretreatment and 7-day posttreatment fecal examinations were done. Fecal cultures, strongyle egg per gram (epg) counts, sugar flotation fecal examinations, and in vitro testing for benzimidazole resistance were performed. Results of fecal examinations before treatment were similar in all horses, and results of testing were positive for benzimidazole resistance. Horses treated with febantel and piperazine at all dosages had significantly lower mean strongyle epg counts and greater percentage reduction in mean strongyle epg counts (99.7% to 99.9%) 7 days after treatment, compared with those determined for horses treated with febantel, thiabendazole, or placebo. Adverse reactions to treatment were not observed. PMID- 3972688 TI - Diskospondylitis in five horses. AB - Diskospondylitis was diagnosed in 5 horses admitted to the Purdue University Large Animal Clinic during a 3-year period. Each horse had evidence of cervical pain. Clinical signs and radiography were useful for identifying the diskospondylitis. Cerebrospinal fluid was normal. PMID- 3972689 TI - Axial sesamoid injuries associated with lateral condylar fractures in horses. AB - Axial sesamoid injuries were found in 4 of 18 horses with lateral condylar fractures of the metacarpus or metatarsus. The injuries appeared as axial sesamoid fractures or progressive demineralization of the axial border of one of the sesamoids. None of the horses with axial sesamoid injuries returned to performance soundness. Axial sesamoid injury appeared to be an indication of severe fetlock trauma due to condylar fracture. Such injuries appeared to indicate a poor prognosis for return to performance soundness. PMID- 3972690 TI - Exsanguination due to gastric ulceration in a foal. AB - An Arabian foal with a congenital heart disease died due to hemorrhage secondary to a large gastric ulcer. Previously, death of foals with gastric ulcers has been due to diffuse peritonitis resulting from gastric ulcer perforation. The foal in this case report died due to hemorrhage secondary to a large gastric ulcer. PMID- 3972691 TI - Congenital aniridia in a pony. PMID- 3972692 TI - Tracheal compression secondary to abscessation of cranial mediastinal lymph nodes in a horse. AB - Respiratory distress and laryngeal paralysis were found to be caused by a Streptococcus equi abscess of cranial mediastinal lymph nodes, putting pressure on the trachea at the thoracic inlet. Surgical drainage was required to relieve the compression, and long-term antibiotic therapy was used to treat the bacterial infection. The trachea returned to normal diameter but left laryngeal hemiplegia persisted. Peritracheal abscesses should be considered in the differential diagnosis of inspiratory dyspnea of the horse. PMID- 3972693 TI - Bilateral degenerative coxofemoral joint disease in a foal. AB - Bilateral degenerative coxofemoral joint disease and noninflammatory osteonecrosis in the femoral heads were diagnosed in a 5-month-old Standardbred colt. Cytologic evaluation and bacterial cultures of coxofemoral synovial fluid, and radiographic and pathologic examination of the coxofemoral joints were conducted. The cause was not determined; however, a thrombus found in association with 1 focus of osteonecrosis was suspected as an etiologic factor. PMID- 3972694 TI - Clinical and hematologic findings in canine ehrlichiosis. AB - The clinical and hematologic findings for 56 dogs with ehrlichiosis were studied retrospectively. All dogs had a high serum antibody titer to Ehrlichia canis. The frequency of bleeding disorders, thrombocytopenia, and pancytopenia in these dogs was lower than previously described for dogs so affected. A bleeding disorder caused by a suspected qualitative platelet defect was found in some dogs that did not have thrombocytopenia. Megakaryocytic hyperplasia and high numbers of plasma cells were observed frequently on marrow aspirate smears. The clinical and laboratory findings of dogs were variable and were considered nonspecific for ehrlichiosis. PMID- 3972695 TI - Trochlear recession for correction of luxating patella in the dog. AB - Trochlear recession is a surgical technique for stabilizing luxating patellas by recessing the trochlear sulcus 1 to 2 mm. The smooth hyaline cartilage of the articulating trochlear surface is preserved. This technique has provided excellent results in 41 stifles of 28 dogs, as determined by a 6-month to 6-year follow-up, with an average follow-up period of 3.2 years. PMID- 3972696 TI - Laryngeal paralysis in dogs: a review of 23 cases. AB - The medical records of 23 dogs with laryngeal paralysis were reviewed. Although the condition developed mainly in old, large- or giant-breed dogs, a wide range of breeds was involved. The age of affected animals ranged from 7 months to 14 years. Respiratory distress, exercise intolerance, noisy breathing, and hoarse bark were common signs of the paralysis. Laboratory evaluations for hypothyroidism were performed on 11 dogs; only 3 were judged to have primary hypothyroidism. Males, particularly if castrated, were more frequently affected than females. A neurologic examination was performed on 6 dogs; 4 of them were found to have generalized neuromuscular disease. PMID- 3972697 TI - Psychogenic colic in a horse. AB - A 4-year-old mixed-breed gelding was presented with colic-type behavior of 5 days' duration that included pawing, looking at the flank area, and kicking and biting at the abdomen and flank when it was eating hay or grain. Medical evaluation did not reveal the cause of the "colic." During its stay in the hospital, the horse improved as regarded the colic-type behavior while eating, but resumed this behavior when it was able to see hay that it was not allowed to eat. It was determined that the persistent colic-type behavior developed as a result of the horse having been repeatedly displaced from its food by other horses. When the horse performed the colic-type behavior, the owner would remain with it and effectively protect it from competitors. The initial bout of colic may have been a result of true colic, psychosomatic colic secondary to stress, redirected aggression, or displacement activity. PMID- 3972698 TI - Chronic intestinal intussusception in two horses. AB - In 2 cases of chronic intestinal intussusception in horses, one involved jejunum and the other, ileum. The only clinical signs observed were intermittent colic. Surgery was performed on both horses, with successful outcomes. PMID- 3972699 TI - Vertebral fracture, extensor hypertonia of thoracic limbs, and paralysis of pelvic limbs (Schiff-Sherrington syndrome) in an Arabian foal. AB - An Arabian foal, which was recumbent for 4 days, had signs of extensor rigidity of the thoracic limbs and hypotonic paralysis of the pelvic limbs. Survey radiography revealed a lesion at T15, with radiographic impression of a compression fracture or a hemivertebra. Postmortem examination revealed a fracture at T15. Clinical and pathologic findings in this case were compatible with the Schiff-Sherrington syndrome, which is characterized by thoracic limb extensor hypertonia associated with paraplegia from acute thoracolumbar trauma. PMID- 3972700 TI - California serogroup virus infection in a horse with encephalitis. AB - A 4-fold or greater seroconversion to the snowshoe hare serotype of the California serogroup of viruses in a horse with acute encephalitis was demonstrated by hemagglutination-inhibition, complement-fixation, and neutralization tests. The horse had a mild fever, was ataxic, had a head tilt, and was observed to circle. Chloramphenicol, dexamethasone, and B complex vitamins were administered and the horse recovered. The snowshoe hare virus is a recognized human pathogen, but it has not been associated with disease in horses. It is unknown whether horses play a role as amplification hosts for the snowshoe hare virus in nature, and further studies appear indicated. PMID- 3972701 TI - Firm udder in periparturient ewes with lymphocytic accumulations, retrovirus infection, and milk unavailable at the teat. AB - A condition of firm udders in periparturient ewes, with little or no milk available at the teat, was associated with negative bacterial cultures of mammary tissue, isolation of ovine progressive pneumonia virus from mammary tissue, lymphocytic accumulations in mammary tissue, especially around ducts, and antibody to ovine progressive pneumonia virus in sera. Milk was present in the glands, but was not adequately transported through the duct system. The cull rate of ewes with this condition was reported by producers and veterinarians to be less than 5% in flocks where the condition was recognized, but approximately 10% of ewes were apparently affected in at least 1 flock. PMID- 3972702 TI - Gastric zygomycosis (mucormycosis) in 4 suckling pigs. AB - Acute gastric zygomycosis (mucormycosis) was diagnosed in four 6- to 7-day-old pigs with large venous infarcts in the gastric fundus. Two pigs were from one farm where several dams had developed fever at parturition and most of their litters had died. The other 2 pigs, from separate farms, had diarrhea that was unresponsive to broad-spectrum antibiotic therapy. Histologically there was severe hemorrhagic, ulcerative gastritis associated with numerous transmurally invading, mucoraceous fungi. The discussion includes speculation on the pathogenesis of this lesion in neonatal pigs. PMID- 3972703 TI - 1983 incomes of US veterinarians. PMID- 3972704 TI - Canine stress syndrome. PMID- 3972705 TI - Animal technicians and the practice of veterinary medicine. PMID- 3972706 TI - Rocky Mountain spotted fever in dogs and its differentiation from canine ehrlichiosis. AB - Rocky Mountain spotted fever (RMSF) or ehrlichiosis was diagnosed in dogs on the basis of specific immunofluorescent testing for each disease. Comparisons between clinical and laboratory findings were made between the 2 diseases. The incidence of RMSF tended to be more seasonal and it affected younger dogs. Purebred dogs appeared to be more susceptible to both diseases. In general, RMSF had a more rapid and severe course of clinical illness than did ehrlichiosis, but acute ehrlichiosis was difficult to differentiate from RMSF. Both diseases were characterized by fever, depression, lymphadenopathy, and signs of neurologic dysfunction; petechial hemorrhages or other signs of hemorrhagic diathesis were evident only in a small proportion of cases. Anemia, leukopenia, and thrombocytopenia were more common in dogs with ehrlichiosis, whereas those with RMSF more often had leukocytosis and thrombocytopenia. Hypoalbuminemia was found in dogs with both diseases, but those with ehrlichiosis usually had concurrent hyperglobulinemia. High serum alkaline phosphatase activity and serum cholesterol concentration, and low serum calcium concentration were more common in dogs with RMSF than with ehrlichiosis. Rising serum titers or positive direct immunofluorescence for Rickettsia rickettsii in skin biopsy specimens were used to confirm RMSF, whereas a single serum titer for Ehrlichia canis enabled detection of ehrlichiosis. In the absence of neurologic deficits and when dogs were treated with tetracycline, dogs with RMSF made a more rapid and consistent recovery than did dogs with ehrlichiosis. PMID- 3972707 TI - Gastrointestinal phycomycosis in 63 dogs. AB - In a study of 63 cases of canine gastrointestinal phycomycosis, 60 were determined to have pythiosis and 3 to have entomophthoromycosis. In pythiosis, male, large-breed dogs less than or equal to 3 years old were most commonly affected. Clinical signs usually included vomiting and weight loss and these were associated with lesions of the stomach and small intestine. Histologically, the causative organisms were found in necrotic regions of diffuse or discrete granulomas in the submucosa or muscularis mucosae. Entomophthoromycosis was diagnosed by finding wide eosinophilic sleeves intimately surrounding thin-walled hyphae. Less than 5% of the dogs were alive 3 months following diagnosis. PMID- 3972708 TI - Sulfadiazine-induced allergy in six Doberman pinschers. AB - Treatment with sulfadiazine-trimethoprim caused serious, but reversible, allergic drug reactions in 6 Doberman Pinschers 10 to 21 days after the first drug exposure and/or within 1 hour to 10 days after reexposure. Nonseptic polyarthritis was found in all dogs. Glomerulonephropathy, focal retinitis, polymyositis, skin rash, fever, anemia, leukopenia, and thrombocytopenia were found in some dogs. These clinical abnormalities were typical of an immune mediated vasculitis and mimicked other immune-mediated disorders. In a drug challenge study, 1 dog was given sulfadiazine and trimethoprim separately. Administration of trimethoprim alone did not result in any abnormalities; however, exposure to sulfadiazine caused recurrence of the polyarthritis, glomerulonephropathy, and focal retinitis within 5 days, suggesting that sulfadiazine likely was the offending agent in all cases. In addition, during the sulfadiazine reexposure, marked complement activation was documented at the time clinical signs were apparent, supporting the suggestion that sulfadiazine caused an immune complex disease (type-III hypersensitivity reaction). Since all dogs were of the same breed, a genetic predisposition of some Doberman Pinschers to react adversely to sulfadiazine was suspected. PMID- 3972709 TI - Orbital neoplasia in 23 dogs. AB - Medical records of 23 dogs with histologically documented orbital neoplasia and admitted to the New York State College of Veterinary Medicine between 1975 and 1984 were reviewed. Almost all (91%) of the tumors were classified as malignant; 74% of the tumors arose as primary neoplasms within the orbit. Eleven tumor types of connective tissue, bone, epithelial, and hemolymphatic origin were represented. The typically afflicted dog was purebred, female, and middle-aged. Review of this series confirmed the clinical impression that orbital neoplasms in dogs are aggressive malignancies with poor long-term prognosis. PMID- 3972710 TI - Calcium chloride for treatment of subcutaneous lipomas in dogs. AB - Ten dogs were selected for treatment of SC lipomas (n = 18) with intratumor injection of 10% calcium chloride. At 6-month follow-up, 4 tumors had regressed completely and 14 were less than 50% of their original size. Skin necrosis overlying treated tumors developed in 3 dogs. PMID- 3972711 TI - Myotonic dystrophy-like disease in a dog. AB - A mature female Rhodesian Ridgeback was determined to have a progressive, degenerative myopathy associated with myotonia, dysphagia, and marked muscle wasting. Clinical findings revealed a diffuse muscular disease with percussion dimpling, dysphagia, and creatine kinase elevation. A paroxysmal atrial tachycardia was found. Electromyography revealed a diffuse myopathy with high frequency bizarre waves, myotonic discharges especially in the masticatory, laryngeal, and pharyngeal muscles. A few positive sharp waves were found in some of the appendicular muscles. Histopathologic and histochemical stains on skeletal muscle biopsy specimens demonstrated moderate fiber-size variation, myofiber architectural changes, muscle-fiber splitting, focal necrosis and phagocytosis, high percentage of internal nuclei, and atrophy of type-2 muscle fibers. A review of myotonic myopathies in the dog is presented. The clinical, electrophysiologic, and histochemical findings are similar to those for myotonic muscular dystrophy in man. PMID- 3972712 TI - Thallium intoxication in a dog. AB - A fatal case of thallium poisoning was described in a dog. Clinical signs included vomiting, gastroenteritis, and dermal lesions. Chemical analysis of urine, liver, and kidney from the dog revealed 98, 7, and 34 ppm thallium, respectively, on a wet-weight basis. PMID- 3972713 TI - Neurologic manifestations of cerebrovascular atherosclerosis associated with primary hypothyroidism in a dog. AB - A 6-year-old, obese, spayed female Doberman pinscher dog was presented for clinical examination with a 1-day history of repeated seizures and a long-term history of periodic bouts of ataxia, circling, and head tilt. The seizures were controlled with phenobarbital, but the dog died 2 days after presentation. Necropsy revealed severe, diffuse, follicular atrophy of the thyroid gland (primary hypothyroidism), severe generalized atherosclerosis, severe pseudolaminar cortical necrosis and acute vasculitis in the cerebrum, and congestive heart failure. The neurologic signs were explained by the pseudolaminar necrosis and associated cerebrovascular atherosclerosis. The cerebrocortical necrosis was believed to be caused by tissue hypoxia secondary to progressive vascular occlusion. Cerebrovascular atherosclerosis, secondary to primary hypothyroidism, was considered the most important cause of the hypoxia. PMID- 3972714 TI - Laminectomy for treatment of cauda equina syndrome in a cat. AB - A 16-year-old spayed female Siamese cat was presented with a history of paraparesis and obstipation. The cat's impaired function was attributed to malalignment of the L7-S1 spine (cauda equina syndrome) and to traumatic fracture of the left femoral neck, with severe degenerative arthritis. Laminectomy resolved the cauda equina problem, and the hip joint was not treated. PMID- 3972715 TI - Malignant melanoma of the conjunctiva in a cat. AB - A conjunctival melanoma was diagnosed in an adult domestic cat. The neoplasm was excised without further complications. It is important to differentiate conjunctival melanoma from other types of pigmented ocular neoplasia. In man, conjunctival melanomas are often malignant tumors with potential for metastatic behavior. Although this neoplasm had histologic features of malignancy, no evidence of local recurrence or metastasis has been apparent during the 11-month follow-up period. PMID- 3972716 TI - Induced hypoprolactinemia and testicular steroidogenesis in man. AB - The effects of short-term hypoprolactinemia on the pituitary-gonadal axis were evaluated in a group of patients with untreated prostatic carcinoma. Each patient was studied prior to and during 7-day oral administrations of bromocriptine (2.5 mg q.i.d.). Serum LH, prolactin (PRL), androst-4-ene-3,17 dione (androstenedione), testosterone, and 5 alpha-androstane-3 alpha, 17 beta-diol (5 alpha-Diol) levels, as well as intra-testicular testosterone, dihydrotestosterone (DHT), 5 alpha-Diol and zinc (Zn) concentrations, were determined. Daily administration of bromocriptine caused a marked suppression of serum PRL (mean +/ SEM, 23.8 +/- 2.5 vs. 6.4 +/- 1.0 ng/ml) without concomitant changes in serum LH levels (mean +/- SEM, 8.3 +/- 1.6 vs. 8.9 +/- 2.1 ng/ml). Hypoprolactinemia induced a significant decrease (P less than 0.05) in the mean peripheral testosterone levels; but 5 alpha-Diol and androstenedione remained unchanged. However, in testicular tissues, bromocriptine treatment resulted in significant increases in mean concentrations of total androgens (P less than 0.001), testosterone (P less than 0.001) and DHT (P less than 0.02). Testicular levels of 5 alpha-Diol were not significantly altered. There was no change in Zn levels in basal conditions and during bromocriptine administration. These results indicate that short-term suppression of serum PRL levels in man affects basal testicular function without altering serum LH. However, a direct action of bromocriptine on the human gonad cannot be excluded. PMID- 3972717 TI - Regional differences in luminal fluid polypeptides of the rat testis and epididymis revealed by two-dimensional gel electrophoresis. AB - Luminal fluid samples were collected by micropuncture of the seminiferous tubule, rete testis, and defined levels of the epididymal tubule. After removal of spermatozoa by centrifugation, the supernatant fluids were analyzed by two dimensional polyacrylamide gel electrophoresis (2-D PAGE) and an ultrasensitive silver staining procedure to define the sequential change in protein composition along the excurrent duct system. Fluid from each segment displayed a characteristic 2-D PAGE map composed of numerous polypeptides. Seminiferous tubule fluid contained a wide array of polypeptides, with most concentrated in the 45 Kd to 90 Kd range, but, in contrast, rete testis fluid lacked most of these polypeptides. The major complex of rete testis fluid comigrated with serum albumin and was present in all distal segments. Other major rete testis components were not noted distally. Fluid from the caput was characterized by new major components of 30 to 37 Kd, 28 to 30 Kd, 24 Kd, and 23 Kd, each of which consisted of multiple spots of apparent isoelectric variants; all except the 30 to 37 Kd complex were present in the fluid from more distal segments. Proceeding distally, there was a temporal appearance of new polypeptides, especially in the molecular weight range below 30 Kd. Two-dimensional PAGE analysis of detergent extracts of washed spermatozoa indicate that a specific subset of these fluid polypeptides are sperm associated. PMID- 3972718 TI - Linear and nonlinear mouse sperm motility patterns. A quantitative classification. AB - A quantitative method is described for distinguishing two types of mouse sperm motility using a new parameter, the Linear Index. One hundred spermatozoa from C57BL/6-+/+ and 100 spermatozoa from C57BL/6-tw32/ + mice were used to evaluate this parameter. Spermatozoa were tracked by videomicrography, and the following calculated: net displacement velocity, Vn; curvilinear velocity of the sperm head, Vc; the "average" velocity, Va (a 5-point moving average of the track); the progressiveness ratio, (Vn/Vc); the curvilinear progressiveness ratio, (Va/Vc); and a linear index, (Vn/Va). Frequency histograms of linear index values were bimodal for both groups and each had a clear antimode at 0.5, separating two discrete subpopulations of spermatozoa. Within each group, "linear" (greater than 0.5) and "nonlinear" (less than 0.5) tracks differed in all characteristics; between groups, linear spermatozoa were similar and nonlinear spermatozoa differed only in the curvilinear velocity of the sperm head. PMID- 3972720 TI - Acute experimental testicular torsion. No effect on the contralateral testis. AB - Other investigators have shown that chronic unilateral testicular torsion produces negative effects on the contralateral testis in experimental animals. In the present study, bilateral testicular weight and histology, and concentrations and motility of spermatozoa from the cauda epididymidis were studied after 0 to 4 hours of acute unilateral testicular torsion in the rat. The obstruction of blood flow by torsion was documented, as well as the presence or absence of return blood flow after the relief of torsion. The above mentioned parameters of testicular function were studied at 7, 30, and 60 days after relief of torsion. Ipsilateral testis weights and epididymal sperm concentrations and motility were significantly reduced by 1, 2, and 4 hours of torsion. The histology of torsioned testes was also severely altered, and no seminiferous epithelial repair was evident 60 days after torsion. Contralateral testicles were not affected by ipsilateral torsion of 1, 2, or 4 hours duration, despite the fact that the ipsilateral testis function was completely compromised by 2 and 4 hours of torsion. These results indicate that there would be no clinical benefit in removing the acutely torsioned testis of Sprague-Dawley rats since it poses no threat to the contralateral testis. PMID- 3972719 TI - Effect of gossypol acetate on guinea pig epididymal spermatozoa in vivo and their susceptibility to capacitation in vitro. AB - To determine the effects of gossypol acetate on guinea pig epididymal and vas deferens sperm maturity and in vivo susceptibility to in vitro capacitation and the acrosome reaction, we examined spermatozoa removed from 37 animals fed gossypol acetate (10-15 mg/kg/day) for 5 to 9 weeks, and 15 vegetable oil-fed, age-paired control animals. In gossypol-treated, reproductively immature guinea pigs, the number of spermatozoa in the epididymis was markedly reduced (P less than 0.01) compared to controls, whereas the presence of spermatids and spermatocytes increased in the epididymis with the duration of gossypol administration. In sexually mature guinea pigs (given 15 mg/kg/day for 5 weeks), the epididymal sperm survival and forward motility were decreased significantly (P less than 0.025 and P less than 0.01, respectively), although the density of mature spermatozoa was the same as in control animals. The percentage of induced acrosome reactions (26.4 +/- 12%) was almost three-fold lower than that of control animals (72.8 +/- 4.6%). Also, in 31.5 +/- 3.8% of spermatozoa from gossypol-treated animals, as compared to only 2.4 +/- 0.7% of controls, the cytoplasmic droplet failed to migrate to its proper position in the midpiece and was retained in the neck region. With a few exceptions, spermatozoa from both experimental and control groups had comparable patterns of freeze-fractured membrane differentiations. Susceptibility to the induced acrosome reactions and the position of the retained cytoplasmic droplet reversed within 3 weeks after the end of gossypol feeding. This study helps establish the suitability of the guinea pig for studies on gossypol-induced infertility. PMID- 3972721 TI - Two thiolactones from Streptomyces Tu 2476. PMID- 3972722 TI - Acetylation of astromicin by the aminoglycoside 6'-N-acetyltransferase of a gentamicin-resistant S. aureus. PMID- 3972723 TI - The generation of additional antibiotic resistance by protoplast regeneration of a Streptomyces griseus strain. PMID- 3972724 TI - Identification of a red pigment from Streptomyces coelicolor A3(2) as a mixture of prodigiosin derivatives. PMID- 3972725 TI - Structure of the quinone antibiotic EM5519 and the behavior of quinones in fast atom bombardment mass spectrometry. AB - Fast atom bombardment (FAB) mass and MS/MS spectra of a novel quinone antibiotic are presented. Their interpretation is based upon the examination of reductive behavior of model quinones in FAB solvents. PMID- 3972726 TI - Vanoxonin, a new inhibitor of thymidylate synthetase. II. Structure determination and total synthesis. AB - Acid hydrolysis of vanoxonin yielded one mol each of 2,3-dihydroxybenzoic acid, L threonine, L-N omega-hydroxyornithine. Presence of acetyl group in vanoxonin was suggested by the 1H NMR. Periodate oxidation of vanoxonin liberated one mol of acetic acid suggesting that the acetyl group bound to the omega-nitrogen of N omega-hydroxyornithine. The sequence of three components was determined to be L-N (2,3-dihydroxybenzoyl)threonyl-L-(N omega-acetyl-N omega-hydroxy)ornithine by mass spectrometric analysis. This structure was confirmed by the total synthesis of vanoxonin. PMID- 3972727 TI - Vanoxonin, a new inhibitor of thymidylate synthetase. III. Inhibition of thymidylate synthetase by vanoxonin-vanadium complex. AB - Quinquevalent vanadium complex with two mol of vanoxonin ligated by the two catechols was shown to be the active structure for inhibition of thymidylate synthetase. The catechol group of vanoxonin as the essential moiety for the inhibition of enzyme was further confirmed by studies of structure-activity relationships using the enzyme obtained from Ehrlich ascites carcinoma cells of mice. Vanoxonin-vanadium complex showed competitive inhibition with respect to deoxyuridylic acid but uncompetitive to 5,10-methylenetetrahydrofolate. PMID- 3972729 TI - New antibiotic-producing streptomycetes, selected by antibiotic resistance as a marker. I. New antibiotic production generated by protoplast fusion treatment between Streptomyces griseus and S. tenjimariensis. AB - A novel antibiotic was found after performing an interspecific fusion treatment between Streptomyces griseus and S. tenjimariensis by the selection of clones with a unique antibiotic resistance. Nonantibiotic-producing mutants of streptomycin (SM)-producing S. griseus SS-1198 with resistance to SM and istamycin (IS)-producing S. tenjimariensis SS-939 with resistance to kanamycin (KM) were protoplasted, mixed with polyethyleneglycol and regenerated. Resistant clones to both SM and KM were found among spores of the regenerated culture at a frequency of 10(-6). Their growth appearance was identical with that of S. griseus. Antibiotic productivity was found only in clones resistant to both 20 approximately 50 micrograms/ml of KM and 400 micrograms/ml of SM. The antibiotic produced by a selected strain, SK2-52, proved to be different from SM and IS. PMID- 3972728 TI - The stabilization of vancomycin by peptidoglycan analogs. AB - The glycopeptide antibiotic vancomycin is unstable in solution. It undergoes a rearrangement involving the conversion of an asparagine residue to isoaspartate to give an antibiotically inactive species, CDP-I. Peptide analogs of bacterial peptidoglycan, such as Ac-D-Ala-D-Ala and di-Ac-L-Lys-D-Ala-D-Ala bind to vancomycin and stabilize the antibiotic against degradation and consequent loss of activity. Protection by peptide is effective even under prolonged heating at 80 degrees C or steam sterilization (30 minutes, 10(4) kg/m2). PMID- 3972730 TI - New antibiotic-producing streptomycetes, selected by antibiotic resistance as a marker. II. Features of a new antibiotic-producing clone obtained after fusion treatment. AB - A new antibiotic-producing Streptomyces strain SK2-52 obtained by a protoplast fusion treatment between Streptomyces griseus NP1-1 and S. tenjimariensis NM16 showed taxonomical features identical with those of S. griseus. The strain resistant to wider range of aminoglycoside antibiotics than the parental strains. This multiple resistance corresponded to the activities of streptomycin kinase and acetyltransferase which were probably derived from S. griseus NP1-1. Clones with fast-growth and reduced antibiotic productivity frequently segregated from strain SK2-52, while their antibiotic resistance was stable. The results suggest that the fusion treatment caused a genetic change in S. griseus which enhanced the expression of genes for unique multiple resistance to aminoglycoside antibiotics and also induced new antibiotic production. PMID- 3972731 TI - Metabolic products of microorganisms. 228. New nikkomycins produced by mutants of Streptomyces tendae. AB - Four new dipeptidyl nikkomycins of the Z- and the X-series with a variation in the amino acid moiety of the molecule were isolated from the mutant Streptomyces tendae 901/395 and characterized. Nikkomycins Kz and Kx contain 2-amino-4-hydroxy 4-(2-pyridyl)butyric acid, and nikkomycins Oz and Ox 2-amino-4-hydroxy-4-(5 hydroxy-2-pyridyl)butyric acid. In contrast to nikkomycins Z and X, nikkomycins Kx and Ox are quite stable at alkaline pH and exhibit a lower biological activity against various test organisms. From the mutant S. tendae 901/C37, which is auxotrophic for methionine and threonine, enhanced amounts of two tripeptidyl nikkomycins, Qz and Qx, were produced which are analogues of nikkomycins J and I and contain a homoserine residue instead of glutamic acid. These nikkomycins exhibit a high pH instability. PMID- 3972732 TI - The effect of artificial rearing on the growth of foals. AB - Fourteen Quarter Horse foals were used to evaluate the effects of artificial rearing on growth. Seven foals were removed from their dams at 3 d of age and fed a reconstituted 26% crude protein (CP) milk replacer free choice for 1 mo, at which time ad libitum solid feeding began. Controls were weaned from their dams at 2 mo of age and fed a 21% CP concentrate ad libitum until the end of the trial. Variables measured during the 26-wk trial were live body weight, height at the withers and length of body from point of shoulder to point of hip. No significant differences were found between the two groups, except during wk 8 where 2-mo weaned foals were slightly heavier (P less than .10). Average daily gains for artificially reared and 2-mo weaned foals were .95 and .98 kg, respectively. PMID- 3972733 TI - Adipose tissue lipolytic rate in genetically obese and lean swine. AB - In vitro lipolytic rate was determined in adipose tissue from genetically obese and lean pigs. There were about 20 pigs/genetic strain at 25 and 80 kg and 10 pigs/strain at 50 kg body weight. When expressed on a cellular basis, the in vitro adipose tissue basal (no exogenous hormone) lipolytic rate was similar in obese and lean pigs at 25 and 50 kg body weight. At 80 kg body weight the basal rate was greater in obese than in lean pigs. The in vitro adipose tissue epinephrine-stimulated lipolytic rate expressed on a cell basis was greater at 25 kg, was similar at 50 kg body weight and tended (P less than or equal to .1) to be greater at 80 kg in obese compared with lean pigs. The in vitro sensitivity of lipolysis to epinephrine was slightly greater in lean compared with obese pigs. The data obtained in vitro indicate that obese pigs do not have low adipose tissue lipolytic rates compared with lean pigs. Consequently, adipose tissue lipolysis does not appear to be a major metabolic factor leading to the excessive fat accretion in these obese pigs. PMID- 3972734 TI - Supplemental biotin for swine. I. Influence on feedlot performance, plasma biotin and toe lesions in developing gilts. AB - Three trials, utilizing a total of 240 crossbred gilts, were conducted to study the influence of 0 (NB) or 220 (SB) microgram supplemental biotin/kg of diet on feedlot performance, plasma biotin and development of toe lesions in developing gilts. Corn-soybean meal diets were fed from weaning to 92 kg body weight. Gilts were housed on expanded-metal floors to 50 kg body weight and on partially slatted concrete floors until completion of the trials. Feedlot performance, hair and structural soundness scores were not different (P greater than .10) between NB and SB gilts. Plasma biotin (PB) levels were elevated (P less than .01) when supplemental biotin was included in the diet. Gilts consuming SB diets had fewer (P less than .01) toe lesions/gilt and lower (P less than .01) toe lesion severity scores/gilt compared with gilts fed NB diets. Heel-horn erosion and heel cracks were the most frequent toe lesions observed. Fewer gilts (P less than .01) developed side-wall toe cracks when fed SB diets. Supplemental biotin reduced the frequency of individual toes containing heel-horn erosion (P less than .10), heel cracks (P less than .05) and side-wall toe cracks (P less than .05) with the severity of these lesions not affected (P greater than .10) by supplemental biotin. These results suggest that biotin levels in corn-soybean meal diets are adequate for feedlot performance, and that supplemental biotin can improve hoof integrity, but will not prevent toe lesions. PMID- 3972735 TI - Efficacy of tiamulin as a growth promotant for growing swine. AB - A study involving 244 pigs initially averaging 13 kg was conducted at two stations to evaluate tiamulin as a growth promotant for growing swine. In each experiment, four replicate pens of five (Exp. 1) or six (Exp. 2) pigs/pen were used to evaluate each treatment. In Exp. 1, pigs were fed 0, 11, 22 or 44 ppm tiamulin from 15 to 58 kg, then fed a nonmedicated control diet for the remainder of the experiment (to 95 kg). In Exp. 2, pigs were fed 0, 2.75, 5.5, 11 or 22 ppm tiamulin from 11 to 56 kg, followed by the nonmedicated control diet (to 95 kg). In each experiment, carbadox (55 ppm) was included as a positive control and was fed to an average weight of 35 kg, followed by the control diet. Averaged across all dietary levels, tiamulin resulted in a 14.1% improvement in gain and a 5.7% improvement in feed:gain ratio during the first 28 to 35 d of the experiment (to 30 kg). These improvements were slightly less than those resulting from the feeding of carbadox during the same period (21.5 and 6.9%, respectively). From 13 to 57 kg, pigs fed tiamulin gained 11.6% faster and 3.1% more efficiently than did controls. Over the entire experiment (13 to 95 kg), tiamulin-fed pigs gained 5.7% faster than did controls, even though the tiamulin was withdrawn at 57 kg body weight. Growth rate from 13 to 57 kg plateaued at the 11-ppm dietary level of tiamulin; whereas, feed:gain ratio plateaued at the 22-ppm level. The results indicate that tiamulin is an effective growth promotant for growing swine. PMID- 3972736 TI - Supplemental biotin for swine. II. Influence of supplementation to corn- and wheat-based diets on reproductive performance and various biochemical criteria of sows during four parities. AB - Data from 116 females previously fed a corn-soybean basal diet with 0 or 220 micrograms supplemental biotin/kg during growth and development were used to study the influence of 0 (NB) or 440 (SB) micrograms of supplemental biotin/kg to corn-(C) or wheat-(W) based diets for gilts and sows housed in total confinement. Reproductive performance through four parities (total of 245 litters) and various sow and pig biochemical criteria were evaluated. Females fed W diets were older (P less than .07) at first estrus, farrowed litters that were lighter weight (P less than .01) at birth and that contained fewer (P less than .05) total and live pigs compared with females fed C diets. Biotin supplementation did not significantly influence (P greater than .10) farrowing and lactation performance; however, after the first parity, total and live pigs/litter at farrowing tended to be larger for SB females. Conception rate at first estrus postpartum was increased (P less than .07) by 9% and the average weaning to estrus interval was reduced (P less than .05) from 14.5 to 10.2 d with SB. Biotin supplementation increased (P less than .001) the biotin content of sow plasma, milk and liver, while sow liver pyruvate carboxylase activity was not altered (P greater than .10). Pigs farrowed by SB females had three- and fivefold higher (P less than .001) levels of plasma biotin at birth and 14 d of age, respectively; however, liver biotin levels at birth were not different (P greater than .10) for pigs from NB and SB females.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972737 TI - Supplemental biotin for swine. III. Influence of supplementation to corn- and wheat-based diets on the incidence and severity of toe lesions, hair and skin characteristics and structural soundness of sows housed in confinement during four parities. AB - The influence of supplementing 0 (NB) or 440 (SB) micrograms biotin/kg to corn- or wheat-based diets on toe lesions, hair characteristics and structural soundness in 116 crossbred female swine was studied from selection (100 kg) until completion of four parities. Gilts that had been previously fed corn-soybean meal diets with 0 or 220 micrograms supplemental biotin/kg diet during growth and development, remained on either the biotin unsupplemented or supplemented diet. Females were housed in buildings containing partially slatted and solid concrete floors. Toe, hair and soundness evaluations were made at a mean age of 240, 521, 732, 916 and 1,090 d. Type of grain fed did not influence (P greater than .10) any response criteria evaluated. Six types of toe lesions were observed across all dietary treatments and varied in severity from minor to very severe. The percentage of females with heel cracks, heel-horn junction cracks and side-wall horn cracks was reduced (P less than .01) when females were fed SB diets. Females fed SB diets had fewer (P less than .001) total lesions, heel cracks, heel-horn junction cracks, side-wall horn cracks and white-line horn cracks (P less than .03) compared with females consuming NB diets. In general, biotin supplementation was more effective in reducing the number and percentage of toe lesions in multiparous sows compared with gilts and primiparous sows. Biotin supplementation increased (P less than .001) the number of hairs/cm2 skin and improved (P less than .001) hair scores. Histological evaluation and soundness scores were not affected (P greater than .10) by level of biotin fed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972738 TI - Effect of source of dietary energy and energy restriction during lactation on sow and litter performance. AB - The effects of source of energy and energy restriction during lactation on sow and litter performance were investigated in an experiment with 90 primiparous sows. At parturition, the sows were randomly assigned to diets containing either tallow or cornstarch as a major energy source. Energy intake was restricted to 8 Mcal of metabolizable energy X sow-1 X d-1 during a 28-d lactation. All sows received equal amounts of crude protein, vitamins and minerals daily, which met or exceeded standard recommendations. Sows fed the diet with tallow lost more weight (P less than .05) during lactation than those fed the diet with cornstarch. Litter size at d 28 was greater (P less than .07) for sows fed cornstarch than for sows fed tallow. However, pig and litter weights on d 14 and 28 of lactation were similar between dietary treatments. Sows were bled on d 110 of gestation and d 14 and 28 of lactation and blood plasma was analyzed for urea. A significant treatment X time interaction was found for plasma urea. Sows fed the diet with tallow appeared to catabolize more protein than those fed the diet with cornstarch. Energy digestibility was lower (P less than .01) in the diet containing tallow, but protein digestibility was not affected by source of energy. Percentages of sows in estrus by 7, 14 and 70 d post-weaning were not different between treatments. PMID- 3972739 TI - Effect of dietary gestation and lactation protein levels on reproductive performance and body composition of first-litter female swine. AB - A 2 X 3 factorial split-plot experiment was conducted to determine the effect of dietary protein on the performance and calculated body compositions of 45 first litter sows using the D2O dilution technique at various reproductive stages. Animals were initially fed 1.82 kg daily of a 14% protein diet to 14 d post coitum. Subsequently, two gestation protein levels (5 or 14%) were daily fed at 1.82 kg from 15 d postcoitum to parturition with three dietary lactation protein levels (5, 14 or 23%) fed from parturition to 28 d postpartum. Maternal body compositions were determined at 17, 35, 70, 85 and 105 d postcoitum and 7, 14 and 28 d postpartum using prediction equations reported previously. Gravid sows demonstrated higher maternal tissue accretion of all body chemical components from 14 to 70 d than from 70 to 105 d postcoitum. Sows fed the 5% protein gestation diet had more maternal fat but less protein accretion than those fed the 14% protein at each measurement interval. During the last trimester, those sows fed the 5% protein diet catabolized body protein reserves. Gravid sows fed the 14% protein gestation diet catabolized more maternal protein and water between 105 d postcoitum and 7 d postpartum than those fed the 5% protein diet. Litter and pig birth weights were lower and postpartum mortality higher for sows fed the 5% rather than the 14% protein gestation diet. Sows fed the 5% protein lactation diet mobilized more maternal tissue, particularly fat, between 7 and 28 d postpartum than those fed 14 or 23% protein lactation diets. These results suggest that labile maternal body protein reserves are used by gravid and nursing dams to fulfill reproductive needs and that dietary protein sequence affects the dam's performance and body composition. PMID- 3972740 TI - Effect of swine weaning age on body fat and lipogenic activity in liver and adipose tissue. AB - Two experiments were conducted to evaluate the effects of weaning swine at 2 or 5 wk of age on postweaning performance and fat metabolism. In the first experiment, 52 pigs were weaned at 2 or 5 wk of age with body weights determined from birth to 8 wk. The early weaned group was fed a 20% protein corn-soybean meal-oat diet containing 25% dried whey from 2 to 5 wk while both groups were fed a 20% protein cereal grain-based diet from 5 to 8 wk of age. In a second experiment, a total of 90 pigs weaned at similar ages and fed the same diet sequences were killed at weekly intervals from 2 to 8 wk of age to evaluate body fat content and lipogenesis in liver and adipose tissue. Lipogenic capacity was measured by incorporation of acetate-1 14C into the total lipid fraction in liver slices and adipose tissue minces or by monitoring liver ATP citrate lyase activity. The results demonstrate that pigs weaned at 2 wk experience a slower postweaning growth rate with lower empty body weights than those either concurrently nursing the dam or weaned at 5 wk of age. Both groups had similar body weights from 6 to 8 wk of age. The body fat content of nursing pigs increased from 2 to 5 wk of age. Pigs weaned at 2 wk lost approximately 25% of their body fat the first week postweaning while later-weaned pigs did not lose body fat postweaning. Body fat composition of both groups was similar by 8 wk of age. Lipogenic activity was higher in liver than in adipose tissue from 2 to 5 wk of age and remained relatively constant throughout the trial. Adipose tissue lipogenic activity was lower in the nursing pig but increased dramatically at 5 wk in the early-weaned group and 7 wk of age in the late weaned group. These results suggest that weaning age can affect postweaning body fat composition and that adipose contributes a greater lipogenic capacity than liver tissue as the pig matures. PMID- 3972741 TI - Genetic predisposition of pigs to hypo- and hyperselenemia. AB - A continuing, sporadic incidence of vitamin E-selenium (Se) responsive disease among confinement-reared pigs believed to be fed complete and adequately supplemented diets prompted these studies on the potential genetic influence over vitamin E and Se metabolism in pigs. The initial study revealed a wide range of serum Se and vitamin E concentrations among age-matched, commonly housed and commonly fed growing pigs. Pigs found relatively hyposelenemic (hypo-Se) or hyperselenemic (hyper-Se) early in life retained their relative Se status while commonly reared. The persistence of vitamin E status was poor. Selected matings between identified, relatively hypo-Se gilts and boars and between relatively hyper-Se gilts and boars produced similarly affected baby pigs. In Exp. 2, representative hypo-Se (20) and hyper-Se (20) pigs were identified from a total of 107 baby pigs by 30 d of age. These pigs were allotted to an experiment to compare the responses of these two populations to .1 and .3 ppm supplemental dietary Se through 150 d of age. The difference in mean serum Se of the selected hypo- and hyper-Se pigs fed .1 ppm Se was significant at each sampling time. This difference approximated that observed between pigs (either hypo- or hyperselenemic) fed .1 and .3 ppm Se. The increase in serum Se due to .3 ppm supplemental dietary Se was greater among the selected hypo-Se pigs than among the hyper-Se pigs. Plasma Se-dependent glutathione peroxidase (GSH-Px) was a better indicator of dietary or serum Se status than was erythrocyte GSH-Px. The selected hyper-Se pigs maintained a more rapid rate of growth than did the hypo Se pigs and were approximately 10 kg heavier at 150 d than the hypo-Se pigs. PMID- 3972742 TI - Influence of an experimental infection of Ascaris suum on performance of pigs. AB - Thirty-two pigs (average 26.6 kg live weight) were individually housed and fed to study the effect of an infection of Ascaris suum (either 0, 600, 6,000 or 60,000 A. suum eggs/pig) on performance of growing-finishing pigs. Increasing the level of A. suum infection produced linear (P less than .07) and quadratic (P less than .09) effects on final weight, weight gain and average daily gain. Feed to gain ratio and number of A. suum worms recovered from the intestines of pigs at slaughter increased linearly (P less than .01) with increasing doses of A. suum eggs. Pigs receiving 60,000 A. suum eggs were 13% less (P less than .01) efficient than the noninfected controls. In each of two trials, eight crossbred barrows (15.7 kg in trial 1 and 16.1 kg body weight in trial 2) were examined for the effects of two levels of A. suum infection (0 and 20,000 eggs/pig) on digestibility coefficients for dry matter, crude protein and gross energy. The infection did not affect (P greater than .05) digestibility coefficients during the first two collection periods (d 6 through 10 and 19 through 23). However, digestion coefficients for dry matter, crude protein and gross energy obtained from the total collection period on d 33 through 37 postinfection were greater (P less than .01) for control pigs than for pigs given 20,000 A. suum eggs each. Also, N retention was greater (P less than .05) for control pigs than for infected pigs. PMID- 3972743 TI - Duration of inhibition of 3-methylindole production by monensin. AB - A series of in vitro and in vivo trials was conducted to determine if continuous monensin feeding for up to 56 d would reduce ruminal conversion of L-tryptophan (TRP) to 3-methylindole (3MI). Fourteen mature beef cows were adapted to a maintenance diet for 3 wk. In trial I, the sampling time to optimize 3MI production was determined. Trials II through IV were to determine the duration of efficacy of monensin on reducing 3MI concentrations in vitro and in vivo. During trials II, III and IV one-half of the cows were fed 200 mg monensin X head-1 X d 1 for 21, 36 and 55 d, respectively, while the remaining cows served as controls. All cows were fed the control diet for 21 d between each trial. Volatile fatty acid (VFA) concentrations and in vitro conversion of TRP to 3MI were determined in ruminal fluid samples collected during trials I through IV. On d 28 of trial IV, all cows were given an oral dose of .35 g TRP/kg of body weight to induce acute bovine pulmonary edema and emphysema (ABPE). Ruminal concentrations of 3MI and indole were measured at intervals for 96 h. Results of trial I demonstrated that ruminal fluid collected 15 h postfeeding produced the highest in vitro conversion of TRP to 3MI. Therefore, ruminal fluid samples were collected at that time in trials II, III and IV. In vitro conversion of TRP to 3MI was lower (P less than .01) in samples from monensin-treated cows (12.1%) compared with controls (25.6%). Monensin reduced 3MI production for 55 d, the longest time tested in these experiments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972744 TI - Reduction of 3-methylindole production and prevention of acute bovine pulmonary edema and emphysema with lasalocid. AB - A study was conducted to determine the dose of lasalocid that would effectively reduce ruminal conversion of tryptophan (TRP) to 3-methylindole (3MI) and prevent the development of acute bovine pulmonary edema and emphysema (ABPE). After adaptation to a maintenance diet for 3 wk, 20 mature beef cows were randomly divided into four groups of five cows each and fed 0, 200, 400 or 600 mg lasalocid X head-1 X d-1 in .5 kg ground barley for the 12-d experimental period. In vitro conversion of TRP to 3MI and indole by ruminal fluid and volatile fatty acid (VFA) concentrations were determined on d 0, 2, 4, 6 and 12. On d 6, an oral dose of .35 g TRP/kg body weight was given to induce ABPE, and ruminal production of 3MI and indole was determined at intervals thereafter. Formation of 3MI was sharply reduced (P less than .01) both in vitro and in vivo by lasalocid treatment at 200 mg X head-1 X d-1. Further suppression of 3MI production occurred as the lasalocid dose was increased (P less than .05). Linear (P less than .0001) and quadratic (P less than .002) components were determined for the relationship between lasalocid dose and 3MI production. Indole formation was variable, but tended to increase (P less than .05) with increasing lasalocid dose. Cows that received no lasalocid developed moderate to severe clinical signs of ABPE and three cows died of acute lung disease. Lasalocid treatment at all levels prevented ABPE. Lasalocid decreased ruminal acetate and butyrate, and increased propionate concentration (P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972745 TI - Deoxynivalenol-contaminated wheat in swine diets. AB - Two studies were conducted using Fusarium graminearum-infected (scabby) wheat containing 6.8 ppm deoxynivalenol (DON), commonly called vomitoxin, substituted for normal wheat in starter pig diets to give varying levels of DON. After 3 wk on experimental treatments, one-half of the pigs in trial one were sacrificed to evaluate the effects of DON on heart, kidney, spleen and liver. Analyses for DON residues in these tissues were also performed. The remaining 16 pigs were placed on a conventional diet for 4 wk to evaluate effects of DON on subsequent animal performance. A different sample of scabby wheat containing 4.9 ppm of DON was substituted for sorghum grain in growing-finishing pig diets to give varying concentrations of DON. At the end of the 42-d feeding period, eight pigs were slaughtered to evaluate the effects of DON on selected tissues. Results of the three trials suggest that feed intake was reduced when DON concentrations in the swine diets neared or exceeded 1 ppm. No apparent signs of disease, including vomiting, were observed in experimental animals. Histological evaluation revealed no significant lesions or abnormalities related to DON ingestion in tissues examined. Traces of DON (8 to 28 ppb, wet weight) were found in kidney, liver, spleen and heart of starter pigs consuming the diets containing DON up to time of slaughter. No DON was found in tissues of growing-finishing pigs that were withdrawn from feed about 12 h before slaughter. PMID- 3972746 TI - Species susceptibility to the pulmonary toxicity of 3-furyl isoamyl ketone (perilla ketone): in vivo support for involvement of the lung monooxygenase system. AB - To explore a possible relationship between metabolism and lethality, the acute toxicity of naturally occurring perilla ketone (PK), 1-(3-furyl)-4-methyl-pentan 1-one, was examined in the uninduced mouse, hamster, rabbit, dog and pig. The LD50 (+/- SE), determined using intraperitoneal (ip) injection, for the mouse and hamster were low at 5.0 +/- .3 and 13.7 +/- .9 mg/kg, respectively. The rabbit died from an ip dosage of near 14 mg/kg and estimated ip LD50 dosages were quite high for the dog and pig, being 106 +/- 25 mg/kg and over 158 mg/kg, respectively. Dogs and the pig that died from ip injections of PK displayed varying degrees of midzonal and centrilobular liver damage and dogs also had elevated serum alkaline phosphatase and glutamic-pyruvic transaminase activities. In contrast, rodents and rabbits display only pulmonary toxicity from this agent. Cytochromes P-450 and b5 concentrations and NADPH-cytochrome c reductase activity were determined for the lung, liver and kidney of mice, hamsters, rabbits, dogs, swine, sheep and cattle. High correlation between lethality and enzyme concentration further supports the hypothesis that enzymatic bioactivation of PK is required for toxicity in all species. PMID- 3972747 TI - Reproductive performance and profitability of heifers fed to weigh 272 or 318 kg at the start of the first breeding season. AB - Reproductive performance and weaning weight of the first calf was determined in 221 Brahman crossbred heifers fed to weigh either 272 (TW1) or 318 kg (TW2) at the start of their first breeding season (target weight). Heifers were divided into light- (below average) and heavyweight (above average) groups on the basis of initial weight. Within each target weight, heifers were fed in three lots. One lot contained lightweight heifers, the second contained heavy heifers and the third was composed of one-half heavy- and one-half lightweight heifers. Heifers were fed for 200 d before the start of the first breeding season. More heifers in TW2 showed estrus and became pregnant in the first 20 d of the breeding season and more were pregnant at the end of the first breeding season. These same differences in reproductive performance were also noted the second year. Each heifer exposed in TW2 weaned 43.4 kg more calf than those in TW1. An average heifer in TW2 was fed 220 kg more corn and 100 kg less hay than a corresponding heifer in TW1. Estrus and pregnancy rate for lightweight heifers in TW1 and TW2 were not improved by sorting and feeding them separately. PMID- 3972748 TI - Effect of age of equine embryos and method of transfer on pregnancy rate. AB - A 2 X 2 cross-classified experiment was conducted to investigate the effect of age of equine embryo (7 vs 8 d postovulation) and method of transfer (surgical vs nonsurgical) on pregnancy rates at 50 d of gestation. Embryos were recovered 7 or 8 d postovulation using a Foley catheter and 3 liters of modified Dulbecco's phosphate-buffered saline (PBS). Upon identification, the embryos were placed in millipore-filtered PBS containing 20% heat-inactivated steer serum and maintained at room temperature until transferred. At the time of recovery, embryos were randomly assigned to be transferred either nonsurgically using a sterile insemination pipette or surgically via a flank incision. For nonsurgical transfer, the embryo was deposited into the uterine body; whereas, in surgical transfer, the embryo was placed in the uterine horn ipsilateral to the corpus luteum. Recovery rates for embryos collected on d 7 (75.5%) or 8 (81.9%) were similar (P greater than .05). Age of embryo did not affect (P greater than .05) pregnancy rate. At 50 d, pregnancy rates were 60 and 57% for mares receiving d 7 or 8 embryos. However, more (P less than .05) pregnancies were obtained after transfer of embryos surgically (72%) than nonsurgically (45%). More (P less than .05) pregnancies were obtained after transfer of d 8 embryos surgically (75%) compared with nonsurgically (40%). Within method of transfer, pregnancy rates were similar (P less than .05) for surgical transfer of d 7 and 8 embryos (69 and 75%), but tended (P less than .25) to be higher for nonsurgical transfer of d 7 embryos (50%) compared with d 8 embryos (40%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972749 TI - Estrogen receptor in bovine skeletal muscle. AB - In connection with investigations of the anabolic action of estrogens, we examined skeletal muscle of veal calves for estradiol receptors. The high speed supernatant of muscle homogenate was incubated with .5 nM 3H-estradiol and for the determination of nonspecific binding with .5 nM 3H-estradiol plus 13 nM estradiol at 0 C overnight. After treatment with charcoal two times, the supernatant was analyzed by agar gel electrophoresis. Specific binding was found in the typical position of cytosolic estradiol receptor. Ninety percent of 3H estradiol binding was suppressed by estradiol-17 beta, zeranol, estrone or diethylstilbestrol, but was not affected by testosterone, dihydrotestosterone, trenbolone or progesterone. The specific binding activity varied between .3 and 2.0 fmol/mg protein and the dissociation constant of the receptor was Kd = 60 pM. After an enrichment up to 42 fmol/mg cytosolic protein using heparin sepharose, the receptor remained unchanged as determined by agar gel electrophoresis. Although uterine tissue generally contains 1,000 times more estradiol receptors, these results clearly demonstrate that skeletal muscle also contains estradiol receptors with identical properties. This indicates that one possible component of the anabolic action of estrogens may be the direct stimulation of the muscle via the estradiol receptor. PMID- 3972750 TI - Temporal patterns of growth hormone in blood and seminal plasma of mature dairy bulls. AB - This study was conducted to determine if growth hormone (GH) concentration in bovine seminal plasma would be proportional to but less variable than blood plasma GH. The relationship between GH in blood and seminal plasma was also examined critically. Blood samples were collected at 15-min intervals for 5.75 h, while semen was collected at 30-min intervals over the same time period. Average seminal plasma GH concentrations were 3.2 times higher (P less than .05) than blood plasma GH concentrations (40.4 +/- 15.8 ng/ml vs 12.6 +/- 1.2 ng/ml, respectively). The within animal correlation between blood and seminal plasma was consistently low and nonsignificant (P greater than .05). Overall blood plasma GH and seminal plasma GH concentrations were weakly correlated (r = .418; P greater than .05) among bulls. A predictable relationship between blood and seminal plasma GH concentration does not exist under the conditions of this study. PMID- 3972751 TI - Effects of number of lambs suckled and supplemental protein source on lactating ewe performance. AB - Effects of number of lambs suckled and supplemental protein source on ewe performance were determined. Lactation performance of ewes nursing twin or triplet lambs was compared in Exp. 1 and 2. In Exp. 1, ewes giving birth to and nursing triplets produced 21% (P less than .05) more milk/unit metabolic body weight, were 10% more efficient in the conversion of feed to milk and produced 26% (P less than .05) more kg of lamb/ewe on d 42 of lactation than did ewes giving birth to and nursing twins. In Exp. 2, lactation performance of ewes giving birth to triplets and rearing only two lambs was compared with performance of ewes giving birth to triplets and rearing three lambs. Ewes rearing three lambs produced 28% (P less than .08) more milk and were 26% (P less than .05) more efficient in converting feed to milk than were those rearing two lambs. This suggests that direct nursing stimulation of the mammary gland is responsible for the improvement in milk production observed when ewes nurse additional lambs. The efficacy of slowly degradable protein sources for improved lactation was studied in Exp. 3 and 4. When blood meal was fed to twin-rearing ewes at 3.30% of the diet (25% of total dietary protein), milk production was greater (3,176 vs. 2,506 g/d, P less than .05) and efficiency of milk production was greater (1.05 vs .79 g milk/g feed, P less than .05) than when ewes were fed supplemental soybean meal. Ewes in this experiment fed supplemental meat and bone meal also tended to produce more milk than those fed soybean meal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972752 TI - Estimates of genetic correlations between testicular measurements and female reproductive traits in cattle. AB - Data from 528 male and 645 female progeny of 63 sires were used to estimate genetic correlations between female and male reproductive traits. Data were from two Hereford herds involved in a long-term selection program of the North Carolina Agricultural Experiment Service. Testicular measurements of circumference, diameter, length and volume were obtained on bulls at 205 and 365 d. Testicular growth measures were defined as differences between 205-and 365-d measurements. Heifers were placed in the breeding herd as yearlings and given two breeding seasons to produce a calf. Traits utilized from females were three age at-first-breeding traits, two age-at-first-calving traits, two pregnancy rate traits, rebreeding interval and calving interval. Genetic correlations were estimated from half-sib and from sire-daughter analyses. Seventy-five percent or more of the correlations of testicular measurements with pregnancy rats, age at first breeding and age at first calving were in the favorable direction. Average correlations were .62, -.55 and -.66, respectively. For each of the remaining female traits, approximately 50% of the correlations were favorable and the average correlations were small. Correlations were summarized by testicular measurement with favorable correlations given a negative sign. Testicular diameter had more favorable correlations (80%) than length, volume or circumference (70%). However, average correlations were similar (-.31, -.30, -.34 and -.26, respectively). Testicular measurements taken at either 205 or 365 d had the same percentage of favorable correlations (72%), while testicular growth measurements had a slightly higher percentage of favorable correlations (78%). Average correlations of 365-d measures were higher (-.38) than either 205-d or growth measures (-.25 and -.28, respectively). Heritabilities for testicular measurements tended to be moderate to high, while those for female reproduction tended to be low to moderate. These results suggest that selection for increased testicular size would lead to improvement in female reproduction, particularly an increase in calving rate and a decrease in age at first breeding. PMID- 3972753 TI - Inhibitory effects of gentamicin and ethacrynic acid on mammalian microsomal protein synthesis. AB - The ototoxic antibiotic gentamicin, and the ototoxic diuretic ethacrynic acid, both produce inhibitory effects on protein synthesis in microsomes isolated from rat brain. Inhibitory effects appear to be essentially independent of each other. The inhibitory dose-response curve for gentamicin is logarithmic, while that for ethacrynic acid is linear. The dose-response curves make gentamicin the predominant inhibitor when the drugs are combined at low concentrations and ethacrynic acid the predominant inhibitor when the drugs are combined at high concentrations. Accumulation of aminoglycoside by tissues of the inner ear may result in inhibition of protein synthesis in spite of low and transient plasma levels of the drug. Further inhibition of translation by ethacrynic acid could account, in part, for the ototoxic interaction of aminoglycosides and high ceiling diuretics. PMID- 3972754 TI - Meningeal penetration of apalcillin in man. AB - We have used high performance liquid chromatography to evaluate the meningeal penetration of apalcillin. In subjects without meningitis the penetration was poor and the levels obtained did not exceed 1.75 mg/l. In cases of meningitis, when the spinal fluid albumin level was greater than 0.60 g/l, the levels varied from 5 to 30 mg/l. These figures are in accord with those obtained in cases of experimental meningitis. A dosage of 200 mg/kg/day should allow the treatment of meningitis due to sensitive bacteria and in particular due to Pseudomonas aeruginosa. PMID- 3972755 TI - Antimicrobial susceptibility of Staphylococcus epidermidis and Staph. aureus. PMID- 3972756 TI - Determination of the activity on Legionella of eight macrolides and related agents by comparative testing on three media. AB - It has proved difficult to develop a standard method for the determination of minimum inhibitory concentrations (MICs) of antibiotics against the Legionellaceae. A major obstacle has been the inactivation of certain antibiotics by components of Charcoal Yeast Extract agar, especially charcoal. To determine the MICs of eight macrolides and related agents (erythromycin, spiramycin, oleandomycin, josamycin, midecamycin, lincomycin, clindamycin and pristinamycin) for 36 strains of Legionella, we used two charcoal-free media: Buffered Yeast Extract agar and Buffered Antibiotic Medium no. 1 (BAM1), the latter having been developed in our own laboratory. The inhibitory effect of charcoal was most marked on josamycin and pristinamycin. This effect was absent on the charcoal free media, which both, however, inhibited spiramycin. BAM1 agar seemed the better of the two charcoal-free media as it gave more consistent growth. The most active agents were josamycin (0.06-0.25 mg/l), pristinamycin (0.06-0.5 mg/l) and erythromycin (0.12-0.5 mg/l). Midecamycin (0.12-1 mg/l) and spiramycin (1-5 mg/l) also had useful activity. PMID- 3972757 TI - Interaction between penicillin, clindamycin or metronidazole and gentamicin against species of clostridia and anaerobic and facultatively anaerobic gram positive cocci. AB - Seven anaerobic and facultative Gram-positive cocci and 12 clostridial species were tested for in-vitro and in-vivo susceptibilities to penicillin, clindamycin, and metronidazole, used singly or in combination with gentamicin. The in-vitro tests consisted of determination of minimal inhibitory concentration (MIC), done without or with constant amounts of gentamicin. When used alone or in combination with penicillin or metronidazole, gentamicin had negligible effects on the bacteria. When used with clindamycin, gentamicin significantly reduced the MIC for one strain each of Peptococcus magnus and Clostridium difficile. The in-vivo tests were carried out in mice and consisted of studying the bacterial contents of abscesses induced by subcutaneous injection of bacterial suspensions. Synergy between gentamicin and penicillin, clindamycin or metronidazole was shown respectively in five, three and one strain. Consistency between in-vitro and in vivo findings was present in the above mentioned strains only between gentamicin and clindamycin. The synergy between penicillin, clindamycin or metronidazole and gentamicin in Gram-positive anaerobic and facultative organisms may have clinical implications. PMID- 3972758 TI - A replicator method for the combined determination of minimum inhibitory concentration and minimum bactericidal concentration. AB - Minimal bactericidal concentrations (MBCs) of nine antimicrobial agents were determined for clinical isolates by a replica plating method. Membranes were placed on the antibiotic-containing plates and the organisms replicated onto the membranes. After 18 h incubation the minimal inhibitory concentrations (MICs) were determined, the membranes were transferred to antibiotic-free plates and incubated a further 18 h and the MBCs determined. MICs and MBCs were also determined in broth. The reproducibility of the 'membrane' method and the agreement of these results for MIC and MBC with the agar and/or broth methods was satisfactory for most antibiotics, within one two-fold dilution. With sulphamethoxazole, trimethoprim and co-trimoxazole the results were less satisfactory, especially with Gram-negative rods, but agreement within two dilutions could be achieved. PMID- 3972759 TI - New azole compounds: vibunazole (Bay n7133) and Bay L9139, compared with ketoconazole in the therapy of systemic candidosis and in pharmacokinetic studies, in mice. AB - Ketoconazole, a new imidazole: Bay L9139, and a new triazole: vibunazole (Bay n7133) were compared in therapy of systemic candidosis. CD-1 male mice were challenged with Candida albicans intravenously (greater than LD80), and treated twice a day, orally, for one month. The isolate of Can. albicans used, and isolates obtained after treatment with the antifungals, were susceptible to all three drugs (MICs less than or equal to 0.5 mg/l). No drug was lethal to uninfected mice in doses of 200 mg/kg/day for one month. With therapy started on the day after infection, all three drugs at 50 or 100 mg/kg/day prolonged survival, compared with controls (P less than 0.05), with ketoconazole slightly superior to the other two drugs, but none did so at 25 mg/kg/day. At 200 mg/kg/day ketoconazole and vibunazole were protective, but L9139 was not, and this suggested synergistic toxicity of L9139 with Can. albicans infection, at this dose. With treatment begun on day 4, ketoconazole prolonged survival (P less than 0.005) at 200 or 100 mg/kg/day compared with controls, but ketoconazole at 10-50 mg/kg/day, and vibunazole and L9139 at 10-200 mg/kg/day were ineffective. Survivors had renal lesions and culture-proven residual infection. Pharmacokinetic studies indicated lower peak vibunazole and 9139 serum concentrations, and reduced area-under-curve (AUC), after 26 days of treatment, as against single dose administration. The relative inefficacy of vibunazole and L9139 appears to be related to unfavourable pharmacokinetic properties with continued administration. PMID- 3972760 TI - Cefotaxime: single agent therapy for infections in cancer patients with adequate granulocyte counts. AB - Seventy-eight infectious episodes in 75 cancer patients with adequate granulocyte counts were treated with cefotaxime. Sixty-six episodes were evaluable. The overall cure rate was 77% (51/66). The response rate in 46 episodes where an organism was identified was 72% (33/46). Gram-positive and Gram-negative infections responded equally with rates of 81% and 80% respectively. Pneumonia, septicaemia and urinary tract infections occurred most frequently and had response rates of 62% (18/29), 90% (9/10) and 91% (10/11) respectively. Polymicrobial infections were associated with a poor response--40% (4/10). No serious adverse effects occurred. Cefotaxime as a single agent was effective therapy for most Gram-positive and Gram-negative infections in cancer patients with adequate granulocyte counts. Polymicrobial infections and Gram-negative pneumonias might require additional agents. PMID- 3972762 TI - Effects of physical countermeasures on the physiological detection of deception. PMID- 3972761 TI - Using biodata to predict job choice among college graduates. PMID- 3972763 TI - Behavioral and physiological consequences of stress and its antecedent factors. PMID- 3972764 TI - Personal and environmental predictors of patient disturbance due to hospital noise. PMID- 3972766 TI - Processing litho films with a modified Kodak X-Omat. PMID- 3972765 TI - Evaluation of the Medical-Dental-Bio-Macro-Bracket for small object photography. PMID- 3972767 TI - Development of an imaging system for ophthalmic photography. PMID- 3972768 TI - Pyrimidine deoxyribonucleotide metabolism in Acholeplasma laidlawii B-PG9. AB - Extracts of Acholeplasma laidlawii B-PG9 were examined for the enzymes associated with the interconversion of the pyrimidine deoxyribonucleotides and the biosynthesis of thymidine nucleotides. A. laidlawii B-PG9 possessed deaminases for deoxycytidine and dCMP, pyrophosphatases for dUTP, phosphorylases for thymidine and uridine, and a membrane-associated pyrimidine deoxyribonucleoside monophosphate phosphatase activity. The role these enzyme activities have in the generation of deoxyribose-1-phosphate during growth may explain the ability of A. laidlawii B-PG9 to utilize either thymine or thymidine for biosynthesis. PMID- 3972769 TI - Analysis of Agrobacterium tumefaciens plasmid pTiC58 replication region with a novel high-copy-number derivative. AB - The origin of replication, ori, of the nopaline tumor-inducing plasmid, pTiC58, mapped in a region that shares sequence homology with octopine plasmids pTiAch5 and pTiB6. Within this region, the minimum amount of DNA necessary for maintaining autonomous replication was a 2.6-kilobase region, which also comprised the incompatibility function inc. pTiC58 derivatives containing inc were incompatible with Agrobacterium tumefaciens plasmids pTiC58, pTiD1439, pTiAch5, pTi15955, and pTiA5 and were compatible with A. rhizogenes plasmid pRi12. Situated adjacent to the origin region was a 1.5-kilobase par segment involved in stable inheritance of pTiC58 under nonselective growth conditions. When par was present, plasmid maintenance approached that of the wild-type pTiC58. Rapid loss from the cell population was observed for plasmids not containing this locus. Another 1.5-kilobase region, cop, positively regulated pTiC58 copy number, enabling certain pTiC58 derivatives to exist at a copy number up to 80 times higher than that of wild-type pTiC58. Deletions within the cop locus resulted in reduced copy number. The ori/inc regions were flanked on either side by the par and cop loci. PMID- 3972770 TI - Protein export by a gram-negative bacterium: production of aerolysin by Aeromonas hydrophila. AB - The synthesis and export of aerolysin, an extracellular protein toxin released by the gram-negative bacterium Aeromonas hydrophila, was studied by pulse-labeling with [35S]methionine. The toxin was synthesized as a higher-molecular-weight precursor. This was processed cotranslationally, resulting in the appearance within the cell of the mature protein, which was then exported to the supernatant. Precursor aerolysin accumulated in cells incubated in the presence of carbonyl cyanide m-chlorophenyl hydrazone, a substance which also inhibited the export of mature aerolysin from the cell. The entrapped mature toxin could not be shocked from the cells, although it could be digested by protease applied to shocked cells. The toxin was processed and translocated across the inner membrane of pleiotropic export mutants and accumulated in the periplasm. The results indicate that more than one step is required for the export of the protein and that aerolysin does not cross the inner and outer membranes simultaneously. PMID- 3972771 TI - Electron microscopic observations of structures associated with the flagella of Spirillum volutans. AB - Electron microscopy of thin-sectioned Spirillum volutans (ATCC 19554) showed that at the insertion site of the flagellum there was a cylindrical structure with a diameter of ca. 36 nm which extended ca. 19 nm into the cytoplasm. This structure, termed a cytoplasmic flagellar base, enclosed a central rod which was continuous with the hook. There was a continuation of the flagellar base into the peptidoglycan layer, enclosing ringlike structures and the central rod. The flagellar hook and proximal part of the flagellar filament contained a central channel which was large enough to accommodate the flagellin subunit. The flagella of fixed cells may project perpendicularly from the outer membrane in a position corresponding to a trailing, swimming orientation or may bend almost parallel to the membrane in a leading orientation. Maximum bending occurred in the hook region, which may be the structure responsible for executing changes in swimming direction. PMID- 3972772 TI - Purification of bromoperoxidase from Pseudomonas aureofaciens. AB - A Bromoperoxidase has been isolated and purified from Pseudomonas aureofaciens ATCC 15926 mutant strain ACN. The purified enzyme was homogeneous as determined by polyacrylamide gel electrophoresis and ultracentrifugation. This bromoperoxidase can utilize bromide ions in the presence of hydrogen peroxide and a halogen acceptor for the catalytic formation of carbon-halogen bonds. The homogeneous enzyme also has peroxidase and catalase activity. Based on the results from gel filtration and ultracentrifugation, the molecular weight of this procaryotic bromoperoxidase is 155,000 to 158,000. Sodium dodecyl sulfate polyacrylamide gel electrophoresis shows a single band having the mobility of a 77,000-molecular-weight species. We thus conclude that this bromoperoxidase exists in solution as a dimeric species. The heme prosthetic group of bromoperoxidase is ferriprotoporphyrin IX. The spectral properties of the native and reduced enzyme are reported. This bromoperoxidase is the first halogenating enzyme purified from procaryotic sources. PMID- 3972773 TI - Structure of the core oligosaccharide from lipopolysaccharide of Erwinia carotovora. AB - The lipopolysaccharide of Erwinia carotovora was analyzed by quantitative sugar analysis, methylation analysis, and chromic oxide oxidation. This led to the following structure of the core oligosaccharide: (Formula; see text). PMID- 3972774 TI - Modes of integration of heterologous plasmid DNA into the chromosome of Streptococcus pneumoniae. AB - We compared the efficiencies of two different processes that can direct integration of plasmids into chromosomes of recipient cells during transformation. A donor-recipient system was constructed to allow a single donor plasmid to use either flanking homology, involving an apparent double crossover, or the insertion duplication process that has been described as due to a "Campbell-like" single crossover between the chromosome and a circular duplex. The latter process gave 600-fold fewer insertions that did the former, confirming expectations from prior work showing that insertion of heterologous DNA by use of flanking homology is highly efficient. It has some advantages for cloning and mapping purposes and can be exploited once it is recognized. PMID- 3972775 TI - Pigment-protein complexes from Rhodopseudomonas palustris: isolation, characterization, and reconstitution into liposomes. AB - We have employed detergent solubilization and sucrose density gradient centrifugation to obtain pigment-protein complexes from Rhodopseudomonas palustris. Two types of detergent buffers were used, containing either octyl-beta glucopyranoside (OG) plus sodium dodecyl sulfate (SDS) or OG alone. The fractions thus obtained were analyzed spectrophotometrically and by polyacrylamide gel electrophoresis to determine their pigment and protein composition. OG-SDS solubilization yields four fractions. The least dense of these fractions (OG-SDS a and b) are nonspecific mixtures of peptides and pigments. The next fraction, OG SDS c, is an accessory light-harvesting complex, LHII, called B800-850. The largest particle, OG-SDS d, is a combination of reaction center (RC) and primary light-harvesting complex (LHI), B880. Solubilization using OG alone yields one fraction, a single large complex consisting of RC, LHI, and LHII. We have inserted the two large OG-SDS complexes and the OG complex into phospholipid liposomes to determine the size of such complexes in freeze-fractured membranes. On the basis of morphological, biochemical, and available biophysical data, we propose the following models for pigment-protein complexes in R. palustris membranes: 5-nm particles as free RC or LHI tetramers, 7.5-nm particles as LHI or LHII octamers (or both); 10-nm particles as RC-LHI core complexes (1 RC plus 12 LHI) or large LHII oligomers (or both), and large particles of 12.5 and 15 nm and LHII associated with the RC-LHI core complex. PMID- 3972776 TI - Intravenous chlorimipramine in the treatment of obsessional disorder in adolescence: case report. AB - The treatment of obsessive-compulsive disorder in adolescence with intravenous chlorimipramine chemotherapy and response prevention is discussed, with a brief review of recent literature. A case is described of severe obsessional disorder beginning in childhood that was successfully treated in adolescence. PMID- 3972777 TI - Acute organic psychosis caused by thyrotoxicosis and vitamin B12 deficiency: case report. AB - A 64-year-old woman developed an acute organic psychosis secondary to thyrotoxicosis and B12 deficiency, without the overt clinical features of pernicious anemia. The psychosis resolved with B12 and thyroid hormone replacement. The patient relapsed after an erroneous iatrogenic tripling of the levothyroxine dosage, but her condition normalized after dosage correction. PMID- 3972778 TI - The validity of the DST. PMID- 3972779 TI - Methylphenidate in diagnosing conversion symptoms. PMID- 3972780 TI - Age, medical illness, and the DST in depressed general hospital inpatients. AB - A dexamethasone suppression test (DST) was administered to 89 general hospital inpatients as part of an evaluation of depressed mood. Among the 55 patients with major depressive disorder (MDD), age was positively correlated with postdexamethasone cortisol (r=.317, p=.002 at 4 p.m.). The patients without MDD did not show this effect. Postdexamethasone cortisol concentrations of 15 micrograms/dl or greater were seen in 31% of 32 patients over 60 with MDD; they did not occur in 23 patients under 60 with MDD. The results suggest a clinically relevant effect of age on the DST in patients with MDD. PMID- 3972781 TI - The use of ECT in children: case report. AB - A case is presented in which electroconvulsive therapy (ECT) was successfully used to treat childhood depression. In addition, the literature of ECT use in childhood disorders is briefly reviewed. It is proposed that ECT is a valid therapy for children only in depression, mania, or acute schizophreniform psychoses, refractory to pharmacotherapy. PMID- 3972782 TI - The resonance Raman frequencies of the Fe-CO stretching and bending modes in the CO complex of cytochrome P-450cam. AB - Resonance Raman spectra of the ferrous CO complex of cytochrome P-450cam have been observed both in its camphor-bound and free states. Upon excitation at 457.9 nm, near the absorption maximum of the Soret band, the ferrous CO complex of the camphor-bound enzyme showed an anomalously intense Raman line at 481 cm-1 besides the strong Raman lines at 1366 and 674 cm-1 for the porphyrin vibrations. The Raman line at 481 cm-1 (of the 12C16O complex) shifted to 478 cm-1 upon the substitution by 13C16O and to 473 cm-1 by 12C18O without any detectable shift in porphyrin Raman lines. This shows that the line at 481 cm-1 is assignable to Fe CO stretching vibration. By the excitation at 457.9 nm, a weak Raman line was also observed at 558 cm-1, which was assigned to the Fe-C-O bending vibration, because it was found to shift by -14 cm-1 on 13C16O substitution while only -3 cm 1 on 12C18O substitution. These stretching and bending vibrations of the Fe-CO bond were not detected with the excitation at 413.1 nm, though the porphyrin Raman lines at 1366 and 674 cm-1 were clearly observed. When the substrate, camphor, was removed from the enzyme, the Fe-CO stretching vibration was found to shift to 464 cm-1 from 481 cm-1, while no detectable changes were found in porphyrin Raman lines. This means that the bound substrate interacts predominantly with the Fe-CO portion of the enzyme molecule. PMID- 3972783 TI - Human prothrombinase complex assembly and function on isolated peripheral blood cell populations. 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. Analyses of the kinetics of prothrombin activation permit calculation of the stoichiometry and binding parameters governing the functional interactions of Factor Va and Factor Xa with isolated thrombin-activated human platelets and isolated leukocyte subpopulations. Our kinetic approach indicates that Factor Xa binds to approximately 2700 +/- 1000 (n = 8) functional sites on the surface of thrombin activated platelets with an apparent dissociation constant (Kd) equal to 1.18 +/- 0.53 X 10(-10) M and kcat equal to 19 +/- 7 mol of thrombin/s/mol of Factor Xa bound. The store of Factor V in normal platelets prevents an analogous determination of the functional Factor Va platelet binding sites. Factor Va and Factor Xa titrations performed using platelets from a Factor V antigen-deficient individual indicate that Factor Va and Factor Xa form a 1:1 stoichiometric complex on the surface of thrombin-activated platelets. Both binding isotherms are governed by the same apparent Kd (approximately equal to 10(-10) M) and expressed the same kcat/site (14-17 s-1. Factor Xa-platelet binding parameters are not altered by the use of different platelet agonists, the choice of anticoagulant, or platelet washing procedure. Kinetics of prothrombin activation indicate also that monocytes, lymphocytes, and neutrophils possess, respectively, 16,000, 45,000, and 8,000 Factor Va-Factor Xa receptor sites/cell, which are all governed by apparent KdS approximately equal to 10(-10) M. Enzymatic complexes bound to monocytes or neutrophils exhibit kcat values similar to the platelet bound complex. Complexes bound to lymphocytes are only 25% as active. PMID- 3972784 TI - Activation of the rat liver cytosol glucocorticoid receptor by sephacryl S-300 filtration in the presence and absence of molybdate. Physical properties of the receptor and evidence for an activation inhibitor. AB - The DNA-binding and physical properties of the rat liver cytosol glucocorticoid receptor were determined before and after Sephacryl S-300 filtration in the presence or absence of molybdate. Cytosol was prepared and labeled with [3H]triamcinolone acetonide in buffer containing molybdate. Prior to gel filtration, only 5 +/- 3% (mean +/- S.E.) of labeled receptors bound to DNA cellulose. After gel filtration in the presence and absence of molybdate, the per cent of labeled receptors binding to DNA-cellulose was 57 +/- 10% and 83 +/- 1%, respectively. Nonreceptor fractions from the Sephacryl S-300 column contained a heat-stable factor which blocked receptor activation but did not block the binding of activated receptors to DNA-cellulose. The activation inhibitor eluted from the column in the region of the albumin standard, but after heating its size was considerably reduced (Mr less than 3500). Receptors activated by Sephacryl S 300 filtration underwent the same size changes in the presence or absence of molybdate. Prior to gel filtration, the S20,w of labeled receptors in the presence of molybdate was 9.2 +/- 0.2 S. After filtration in the presence and absence of molybdate, the S20,w of labeled receptors was 4.2 +/- 0.2 and 4.4 +/- 0.1 S, respectively. The Stokes radius (Rs) of labeled receptors after gel filtration in either the presence or absence of molybdate was 65 +/- 1 A. From the Rs and S20,w values, the molecular weight (Mr) of activated receptors was calculated to be 115,000 to 121,000, which was in close agreement with the Mr of affinity-labeled receptors determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. PMID- 3972785 TI - Kinetics of oxygen and carbon monoxide binding to liver fluke (Dicrocoelium dendriticum) hemoglobin. An extreme case? AB - The kinetics of oxygen and carbon monoxide binding to the monomeric liver fluke (Dicrocoelium dendriticum) hemoglobin have been studied. The ligand association rates are approximately 1 X 10(8) and approximately 3 X 10(8) M-1 s-1, respectively, for CO and O2 and show no pH dependence. On the contrary the ligand dissociation rates decrease by lowering the pH below 7, the pK of the transition being around 5.5. These findings, together with spectroscopic properties of the protein, are discussed in relation to the fact that, in this hemoglobin, the distal histidine is replaced by a glycine. PMID- 3972786 TI - Developmental changes of the lipidic part of the neutral glycosphingolipids of the rat stomach. AB - Neutral glycolipids were purified from the glandular part of the stomach of rats of different ages from 20 days of gestation to 60 days after birth. The two major glycolipids were identified as glucosylceramide and isogloboside. Free ceramide was also detected. The concentrations of these sphingolipids remained almost stable with development. Monohexosylceramide contained 55 and 68% of 2 hydroxylated fatty acids at 20 and 22 days of gestation, respectively, and 82% in the adult. Its three major bases, C18-sphingenine, C18- and C20-4D hydroxysphinganine were characterized by gas-liquid chromatography and mass spectrometry of their N-acetyl-O-trimethylsilyl derivatives. The occurrence of the bases changed with development. C18-sphingenine contributed for 26% of the bases at birth and 65% in the adult. Conversely, C18-4D-hydroxysphinganine contributed for 35% of the bases at birth and 9% in the adult. The ceramide part of isogloboside consisted of nonhydroxylated fatty acids and mainly C18 sphingenine throughout development. The percentage of long-chain fatty acids was higher in older animals. These results stressed the specificity of the lipidic part of the rat gastric glycolipids and their specific evolution during the development. PMID- 3972787 TI - Effect of phytyl side chain of vitamin E on its antioxidant activity. AB - Inhibition of the oxidation of methyl linoleate and soybean phosphatidylcholine in homogeneous solution and in aqueous dispersion by four chain-breaking antioxidants, vitamin E (alpha-tocopherol), 2,2,5,7,8-pentamethyl-6-chromanol, 2,6-di-tert-butyl-4-methylphenol, and stearyl 3-(3,5-di-tert-butyl-4 hydroxyphenyl)propionate, was studied to examine the effect of the phytyl side chain of vitamin E on its antioxidant activity. These four antioxidants exerted similar antioxidative activities. They were also effective as antioxidants in protecting the oxidation of soybean phosphatidylcholine liposomes in water dispersion. However, when they were incorporated into dimyristoyl phosphatidylcholine liposomes, only 2,2,5,7,8-pentamethyl-6-chromanol and 2,6-di tert-butyl-4-methylphenol could suppress the oxidation of soybean phosphatidylcholine liposomes dispersed in the same aqueous system. It was concluded that the antioxidative properties of vitamin E and its model without the phytyl side chain are quite similar within micelles and liposomes as well as in homogeneous solution but that the phytyl side chain enhances the retainment of vitamin E in liposomes and suppresses the transfer of vitamin E between liposomal membranes. PMID- 3972788 TI - Rat superoxide dismutases. Purification, labeling, immunoassay, and tissue concentration. AB - This study determines the validity of utilizing radioimmunoassay of CuZn and Mn superoxide dismutase in the rat for defining mechanism of control over mammalian tissue superoxide dismutase concentrations. To accomplish this, rat Mn and CuZn superoxide dismutase were purified. The CuZn superoxide dismutase dimer had a specific activity of 3600 units/mg of protein and a subunit Mr of 17,000. The Mn superoxide dismutase tetramer had a specific activity of 3700 units/mg of protein and a subunit Mr of 22,000. Both enzymes provided a single discrete protein band on disc gel electrophoresis. The purified enzymes were utilized to develop sensitive (less than 2.5 ng/ml Mn superoxide dismutase and less than 3.12 ng/ml CuZn superoxide dismutase) reproducible immunoassays the specificity of which was confirmed by tissue homogenate dilution and column chromatography. Immunoassay of these enzymes in rat tissues permitted clarification of existing data based on activity assays and demonstrated a trend for higher Mn superoxide dismutase concentrations in tissues of high mitochondrial content (with relative tissue concentrations comparable to man) and low superoxide dismutase concentrations in islets (providing an explanation for their sensitivity to free radical damage). This represents the first report of a radioimmunoassay for rat Mn superoxide dismutase, and the second report of successful purification of rat Mn superoxide dismutase (with higher specific activity and apparent purity and stability). The data support the proposition that these radioimmunoassays in rats will provide a useful system for investigation of mechanisms of control over tissue superoxide dismutase concentrations in mammalian tissues. PMID- 3972789 TI - Glucocorticoids affect the synthesis of pulmonary fibroblast-pneumonocyte factor at a pretranslational level. AB - Glucocorticoids accelerate fetal lung maturation by acting on the fetal lung fibroblast to induce the synthesis of fibroblast-pneumonocyte factor which in turn stimulates pulmonary surfactant synthesis by the alveolar type II cell. We have studied the site of glucocorticoid regulation of fibroblast-pneumonocyte factor synthesis in primary cultures of fetal rat lung fibroblasts. Conditioned media from fetal rat lung fibroblasts exposed to cortisol stimulate [Me 3H]choline incorporation into saturated phosphatidylcholine by primary cultures of fetal rat lung alveolar type II cells. This effect is blocked by the presence of actinomycin D during the first, but not the second, 24 h of incubation of the fibroblasts with cortisol. Cycloheximide blocks this effect if present during either the first or second 24 h of incubation. We fractionated mRNA from fetal rat lung fibroblasts incubated in the presence or absence of dexamethasone and observed that cell-free translation products from a fraction of approximately 500 bases possess biological activity in the bioassay. Such activity is only present in cell-free translation products of mRNA isolated from fibroblasts treated with dexamethasone. These results suggest that glucocorticoids act at a pretranslational level to induce production of fibroblast-pneumonocyte factor and that the primary translation products are biologically active. PMID- 3972790 TI - Skeletal muscle myosin subfragment-1 induces bundle formation by actin filaments. AB - As is well known, the light scattering intensity of F-actin solutions increases immediately upon formation of the rigor complex with subfragment-1 (S-1). We have found that after the initial rise in scattering, there is a further gradual increase in scattering (we call it "super-opalescence"). Fluorescence and electron microscopic observations of acto-S-1 solutions showed that super opalescence results from formation of actin filament bundles once S-1 binds to F actin. The actin bundles possessed transverse stripes with a periodicity of about 350 A, which suggested that in the bundles actin filaments are arranged in parallel register. The rate of the initial process of bundle formation (i.e. side by-side dimerization) could be approximately estimated by measuring the initial rate of super-opalescence (V0). V0 had a maximum (V0m) at a molar ratio of S-1 to actin of 1;6-1;7, regardless of the actin concentration, pH (6-8.5), Mg2+ concentration (up to 5 mM), or ionic strength (up to 0.3 M KC1). Lower pH, higher Mg2+ concentration, and higher ionic strength increased V0m; V0 was proportional to the square of the actin concentration, regardless of the solution conditions. PMID- 3972791 TI - Iron-sulfur cluster in aconitase. Crystallographic evidence for a three-iron center. AB - Native x-ray diffraction data from single crystals of inactive aconitase from pig heart (Mr 80,000) have been collected on oscillation films to 2.7 A. Analysis shows that significant measurements of the anomalous scattering signal from the Fe-S cluster in the enzyme are available in the film data. The 5.0-A resolution anomalous difference Patterson function contains vectors for one Fe-S cluster (one aconitase molecule) per asymmetric unit in space group P2(1)2(1)2 with a = 173.6, b = 72.0, and c = 72.7 A. At 2.7-A resolution, the vector map is best interpreted by three Fe sites separated from each other by less than 3 A. The single-crystal diffraction data thus confirm the presence of a 3Fe center in the inactive form of aconitase. Furthermore, the data provide crystallographic evidence that 3Fe clusters exhibit structural heterogeneity. The Fe-Fe vectors cannot be interpreted in terms of 4-A distances as observed for the [3Fe-3S] cluster in Azotobacter ferrodoxin (Ghosh, D., O'Donnell, S., Furey, W., Robbins, A. H., and Stout, C. D. (1982) J. Mol. Biol. 158, 73-109). The results are therefore in agreement with a [3Fe-4S] cluster having 2.7-A Fe-Fe distances (Beinert, H., Emptage, M. H., Dreyer, J.-L., Scott, R. A., Hahn, J. E., Hodgson, K. O., and Thomson, A. J. (1983) Proc. Natl. Acad. Sci. U. S. A. 80, 393-396). However, the data do not unambiguously discriminate between this model and other 3Fe clusters having short Fe-Fe distances. PMID- 3972792 TI - Stimulation by glucocorticoid of the synthesis of cartilage-matrix proteoglycans produced by rabbit costal chondrocytes in vitro. AB - The effect of glucocorticoids on sulfated proteoglycan synthesis by rabbit costal chondrocyte cultures exposed to serum-free conditions has been examined. Low density cultures of rabbit costal chondrocytes were maintained on dishes coated with extracellular matrix produced by bovine corneal endothelial cells and exposed to a 9:1 mixture (v/v) of Dulbecco's modified Eagle's medium and Ham's F 12 medium supplemented with transferrin, high density lipoproteins, fibroblast growth factor, and insulin (Medium A). Chondrocytes maintained in the presence of Medium A supplemented with 10(-7) M hydrocortisone reorganized, at confluence, into a homogeneous cartilage-like tissue composed of round cells surrounded by a refractile matrix in which abundant thin collagen fibrils characteristic of type II collagen were observed. The cell ultrastructure and fibrils of the pericellular matrix were similar to those seen in vivo. In contrast, cells maintained in the presence of Medium A alone, once they reached confluence, formed a fibroblastic multilayer and produced thick collagen bundles. The level of 35SO4(2-) incorporated into large cartilage-specific proteoglycans in glucocorticoid-supplemented cultures was 33-fold higher than that of glucocorticoid-free cultures. The level of 35SO4(2-) incorporated into small ubiquitous proteoglycans was only 4-fold higher than that of glucocorticoid-free cultures. On the other hand, the level of [3H]glucosamine incorporated into hyaluronate in glucocorticoid-supplemented cultures was 4.5-fold lower than that of glucocorticoid-free cultures. Within 24 h of their addition to confluent cultures, hydrocortisone or dexamethasone markedly stimulated proteoglycan synthesis. This effect was not mimicked by androgens, estrogens, progesterone, or an inactive form of glucocorticoids such as deoxycorticosterone. This suggests that glucocorticoids have a direct and specific stimulatory effect on cartilage specific proteoglycan synthesis and are essential for the maintenance of this synthesis in low density chondrocyte cultures. PMID- 3972793 TI - Enzymes of vitamin B6 degradation. Purification and properties of two N acetylamidohydrolases. AB - alpha-(N-Acetylaminomethylene)succinic acid hydrolase (Compound A hydrolase, EC 3.5.1-) and alpha-hydroxymethyl-alpha'-(N-acetylaminomethylene)succinic acid hydrolase (Compound B hydrolase, EC 3.5.1-) were purified to homogeneity from Pseudomonas MA-1 and Arthrobacter Cr-7, respectively. The two inducible enzymes catalyze Reactions 1 and 2, respectively, which release the first generally useful anabolic intermediates during growth of these organisms with (formula; see text) pyridoxine as a sole source of carbon and nitrogen. Compound A hydrolase is a monomeric protein of Mr 32,500 with aspartic acid as its NH2-terminal residue. Compound B hydrolase (Mr congruent to 205,000) is a multimer containing probably six identical subunits with glycine as the NH2 terminus. The two enzymes have quite different amino acid analyses, although both are high in Asx and Glx, lack tryptophan, and show similar stabilities to pH and temperature. Compound A hydrolase has a pI of 4.4, a Km of 3.3 microM, and a Vmax of 3.1 mumol X min-1 X mg-1 at pH 6.5 and 25 degrees C; no analogue substrates were found. Compound B hydrolase has a pI of 4.2, a Km of 25 microM, and a Vmax of 3.8 mumol X min-1 X mg-1 at 25 degrees C and pH 7.0; it also hydrolyzes Compound A slowly. Both enzymes are inhibited competitively by di- and tricarboxylic acids, itaconic acid being among the most effective. Sulfite inhibits both enzymes by a time-dependent mechanism not yet understood. The two amidases appear to differ greatly in architecture despite the similarity in properties and in the overall reactions they catalyze. PMID- 3972794 TI - The molecular shape of dopamine beta-hydroxylase from chromaffin granules of bovine adrenal medulla. AB - The structural features of the soluble dopamine beta-hydroxylase from chromaffin granules of bovine adrenal medulla were studied using negative staining and platinum shadowing electron microscopic methods. The enzyme was shown to be highly asymmetric as suggested in earlier hydrodynamic studies. The tetramer of the enzyme appeared as four subunits arranged in the shape of a planar rose with an estimated width of 15 nm. A minimum thickness of 3.0 nm for the enzyme monomer was calculated from the shadow length of unidirectionally shadowed molecules. A model composed of four oblate ellipsoid monomers in a tetrameric rose arrangement is proposed for the shape of the dopamine beta-hydroxylase molecule. Two monomers associate edge to edge to form an in-plane dimer and two dimers associate side-by side with their respective long axes at a slight angle to form a tetramer. Theoretical calculations based on the model are consistent with previous hydrodynamic studies. PMID- 3972795 TI - Formation and stability of the 5 S RNA transcription complex. AB - 5 S ribosomal RNA in Xenopus has been shown to be transcribed in vitro from 5 S RNA genes that remain stably associated with required transcription factors through multiple rounds of transcription (Bogenhagen, D. F., Wormington, W. M., and Brown, D. D. (1982) Cell 28, 413-421). We have studied the formation and stability of these "transcription complexes" by using cloned 5 S RNA genes immobilized on cellulose as templates for the assembly of complexes in crude extracts. RNA polymerase III is the least tightly bound component required for transcription of 5 S RNA genes. All other factors remain bound in 1 M NaCl, even though transcription complexes do not form at salt concentrations as low as 0.25 M. RNA polymerase III dissociates from transcription complexes as a result of RNA synthesis and is capable of reassociating with complexes to support additional rounds of transcription. A 5 S-specific positive transcription factor (factor A) and two crude phosphocellulose column fractions (B and C) are also required for 5 S RNA synthesis in vitro (Engelke, D. R., Ng, S.-Y., Shastry, B. S., and Roeder, R. G. (1980) Cell 19, 717-728; Segall, J., Matsui, T., and Roeder, R. G. (1980) J. Biol. Chem. 255, 11986-11991; Shastry, B. S., Ng, S.-Y., and Roeder, R. G. (1982) J. Biol. Chem. 257, 12979-12986). Fraction B stably interacts with 5 S RNA genes to form a stable, active complex only after the template has first been incubated with factor A and fraction C. In contrast, either factor A or fraction C can stably associate with 5 S RNA genes in the absence of other factors. The activities of fractions B and C are removed from solution as a result of transcription complex formation, suggesting the factors in these fractions act stoichiometrically. The rate-limiting step in complex formation is carried out by fraction B, which accounts for the lag in transcription activity observed in crude extracts. PMID- 3972796 TI - Adenosine 5'-diphosphate as an allosteric effector of phosphorylase kinase from rabbit skeletal muscle. AB - Equilibrium binding and activity studies indicate that adenosine 5'-diphosphate binds to phosphorylase kinase with high affinity at a site, or sites, distinct from the catalytic site. Equilibrium dialysis at pH 6.8 and 8.2, with and without Mg2+, and with phosphorylated and nonphosphorylated enzyme preparations revealed approximately 8 ADP binding sites per alpha 4 beta 4 gamma 4 delta 4 hexadecamer, with Kd values ranging from 0.26 to 17 microM. Decreasing the pH from 8.2 to 6.8 or removing the Mg2+ enhanced the affinity for ADP. At pH 6.8, ADP stimulated the phosphorylase conversion and autophosphorylation activities of the nonactivated enzyme. Analogs of ADP with modifications at the 2'-, 3'-, and 5'-positions allowed determination of structural requirements for the stimulation of activity. ADP seems to alter the conformation of the beta subunit because addition of the nucleotide inhibits its dephosphorylation by phosphoprotein phosphatase and its chemical cross-linking by 1,5-difluoro-2,4-dinitrobenzene. The binding affinities and effects of ADP suggest that it may function physiologically as an allosteric effector of phosphorylase kinase. PMID- 3972797 TI - Combined lipase deficiency (cld/cld) in mice. Demonstration that an inactive form of lipoprotein lipase is synthesized. AB - Combined lipase deficiency, cld, is a recessive mutation within the T/t complex of mouse chromosome 17. Mice homozygous for this defect display severe functional deficiencies of lipoprotein lipase and the related hepatic lipase. They develop massive hyperchylomicronemia and die within 3 days when allowed to suckle. Heart, diaphragm muscle, and brown adipose tissue of 1-day-old cld/cld and unaffected mice incorporated in vivo [35S]methionine into a protein that could be immunoprecipitated by antilipoprotein lipase serum. The immunoprecipitated protein in all tissues had the same Mr as bovine lipoprotein lipase as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The proportion of radioactivity in the lipoprotein lipase band to that in total protein was 0.02% in tissues of cld/cld mice and 0.01% in tissues of unaffected mice. There was 2-6 times more lipoprotein lipase-like protein (determined by immunoassay) in tissues of defective mice than in those of unaffected mice. These findings indicate that the cld mutation did not cause deletion of the structural gene for lipoprotein lipase. Lipoprotein lipase activity in heart, diaphragm muscle, brown adipose tissue, and lung of cld/cld mice was less than 5% of that in tissues of unaffected mice. This low activity could be inhibited more than 85% by antilipoprotein lipase serum, but not by nonimmune serum. It is concluded that tissues in cld/cld mice synthesize a lipoprotein lipase-like protein which has subnormal catalytic activity. PMID- 3972798 TI - Evidence for a role of the amino-terminal region in the biological activity of the classical anaphylatoxin, porcine C5a des-Arg-74. AB - The presence of methionyl residues at positions 1 and 17 in porcine classical anaphylatoxin (e.g. C5a des-Arg-74) permits chemical cleavage of the factor with cyanogen bromide to generate two defined fragments. Peptides corresponding to the amino-terminal fragment, CN-I, and the carboxyl-terminal peptide, CN-II, were purified from the CNBr digest of C5a des-Arg-74 by reverse-phase high performance liquid chromatography. The isolated derivatives were assessed for their abilities to cause contraction of isolated guinea pig ileal smooth muscle, guinea pig lung parenchymal strips, and degranulation of guinea pig polymorphonuclear neutrophils. In each assay, CN-I was devoid of biological activity at concentrations greater than 10(-6) M. In contrast, the carboxyl-terminal 56 residue fragment, CN-II, possessed weak (10(-6) versus 10(-9) M for classical anaphylatoxin) agonist activity in each of the assay systems. Our data suggest that structural information contained in the amino-terminal 17 residues of the C5a des-Arg-74 molecule contributes to the biological potency of the intact factor, but is not an essential component of the active site. Whether the structural information in residues 1-17 relates to receptor binding directly or serves to stabilize the conformation of the 18-73-fragment containing the active center of the molecule is yet to be determined. PMID- 3972799 TI - Balanced contribution of glycolytic and adenylate pool in supply of metabolic energy in platelets. AB - When platelets are treated with H2O2 the metabolic ATP content decreases sharply (Holmsen, H., and Robkin, L. (1977) J. Biol. Chem. 252, 1752-1757). Here we report that the loss of metabolic energy is fully recovered in phosphorylated glycolytic intermediates. A mixture of antimycin A/2-deoxy-D-glucose/D-gluconic acid-1,5-lactone blocks mitochondrial ATP resynthesis and prevents the entry of sugars into the glycolytic sequence. The energy-rich phosphates in the adenylate and the glycolytic pool are then consumed in a specific order. First, the glycolytic pool is consumed at a rate of 4.5 mumol of ATP equivalents/min/10(11) cells, and metabolic ATP and ADP are kept stable; then the consumption of the glycolytic pool decreases and metabolic ATP and ADP are consumed, together keeping up with the same rate of energy consumption. Thrombin stimulation increases the energy consumption to about 17 mumol of ATPeq/min/10(11) cells which is now furnished by both the glycolytic and the adenylate pool, again with a preferential consumption of the former. The results show that H2O2 triggers a shift of energy-rich phosphates from the adenylate to the glycolytic pool and that the latter remains rapidly accessible to energy consumption thereby stabilizing the level of metabolic ATP. The adenylate energy charge is independent of the distribution of energy among the two pools, which extends its importance to the regulation of energy supply and demand beyond the adenylate pool. PMID- 3972800 TI - Quantal entry of diphtheria toxin to the cytosol. AB - The rate-limiting step in diphtheria toxin (DT) intoxication of Vero cells has been determined utilizing cycloheximide as an inhibitor of the intoxication process. Cycloheximide is shown to inhibit the toxin catalyzed ADP-ribosylation of elongation factor 2 (EF-2). The inhibition is blocked by puromycin thus establishing the ribosome as the location of cycloheximide protection. Washing cells free of cycloheximide rapidly reverses the protective effect. The initial rates of protein synthesis inhibition observed after removal of cycloheximide from DT-intoxicated cells are 5 to 12-fold greater than rates observed in unprotected cells and are shown to reflect ADP-ribosylation of EF-2 by cytosolic DT. Ten to thirty minutes after cycloheximide removal, the rate of protein synthesis inhibition abruptly changes to values identical to those of unprotected cells. Both the initial rates and extent of the initial rapid inactivation are directly related to toxin concentration and time of incubation with DT in the presence of cycloheximide. We concluded that: the rate-limiting step in protein synthesis inhibition by DT is not the ADP-ribosylation of EF-2 by cytosolic toxin but rather the earlier entry step of DT into the cytosol. DT enters the cytosol as a bolus of sufficient size to rapidly inactivate all EF-2 in that cell. It is inferred from 1 and 2 that the first order inactivation rate exhibited by DT is the result of the probability of the release of a bolus of toxin to the cytosol of any cell in the population per unit time. Autoradiographic analysis of intoxicated cell populations support this two-population state model. The size of a single bolus or quantum of DT is calculated from data over the range of 10(-11) to 10(-9) M DT and is found to remain constant. We suggest that the cytosolic entry mechanism of DT results from a unique ability of the internalized toxin molecules to destabilize the vesicular membrane resulting in a random release of a bolus of toxin into the cytosol. Because the bolus size remains constant over a 50-fold change in receptor occupancy the possibility is raised that DT undergoes a post-receptor packaging process, package size remaining a constant and package number increasing with receptor occupancy. PMID- 3972801 TI - Purification of the Mr 80,000 and Mr 210,000 proteins of the sea urchin sperm plasma membrane. Evidence that the Mr 210,000 protein interacts with egg jelly. AB - Two immunologically cross-reactive plasma membrane proteins, of Mr 80,000 and Mr 210,000, have been purified to apparent homogeneity from sperm of the sea urchin Strongylocentrotus purpuratus. Purification includes a combination of antibody and wheat germ agglutinin affinity chromatography. The two proteins have similar but not identical amino acid compositions; however, their carbohydrate composition differs substantially. After purification, the Mr 210,000 protein binds to both living eggs and isolated egg jelly in a species-specific manner, but the Mr 80,000 protein does not. The inactivity of the Mr 80,000 protein could be due to denaturation during purification. The data are consistent with a model in which the Mr 210,000 protein acts as a jelly receptor in the sperm membrane, promoting the ion movements necessary to initiate the sperm acrosome reaction. PMID- 3972802 TI - Geminate recombination of CO in rabbit, opossum, and adult hemoglobins. AB - The geminate recombination of CO with Hb following dissociation by a 10-ns laser pulse has been studied as a function of pH (9.2 and 7.0 without inositol hexaphosphate and 6.0 with inositol hexaphosphate) and temperature (5-35 degrees C). The hemoglobins studied included adult, Rothschild, rabbit, opossum, and carp. Despite significant differences in their structural and functional properties, the first four of these hemoglobins show similar trends in the yields, rates, and activation energies of the geminate recombination. The nature of the "cage recombination" in hemoglobin is discussed in the light of such findings. Neither a slow diffusion model nor a model based upon a specific non heme binding site accounts for the observations. PMID- 3972803 TI - Solid-state 13C and 15N nuclear magnetic resonance studies of alanine metabolism in Aerococcus viridans (Gaffkya homari). AB - Transport and metabolism of D- and L-alanine by Aerococcus viridans (Gaffkya homari) have been studied using cross-polarization magic-angle spinning 13C and 15N NMR spectroscopy of lyophilized whole cells, isolated cell walls, and crude extracts. For equimolar concentrations in the growth medium, about 10 times more D-alanine than L-alanine is transported into the cells. Examination of cells labeled with D-[13C]alanine and L-[epsilon-15N]lysine by double cross polarization magic-angle spinning 15N NMR indicates that only about 20% of the D alanine present in cell-wall peptidoglycan comes directly from the growth medium. The rest is produced by de novo synthesis. Most of the labeled D-alanine is found within peptidoglycan precursors or inverted to L-alanyl residues of soluble proteins. PMID- 3972804 TI - S-Adenosylhomocysteinase from rat liver. Evidence for structurally identical and catalytically equivalent subunits. AB - Lines of evidence are presented which indicate that rat liver S adenosylhomocysteinase consists of four identical or nearly identical subunits. Cross-linking of the enzyme with dimethyl suberimidate followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis yields four distinct protein bands with molecular weights of 47,000, 93,000, 145,000, and 190,000. The molecular weight of the largest protein is in excellent agreement with that of the native enzyme. Carboxypeptidase A liberates 4 mol of COOH-terminal tyrosine/mol of enzyme, and the number of arginine-containing peptides in a tryptic digest of the enzyme is one-fourth of that arginine residues present in the enzyme. The enzyme reversibly binds 4 mol of the substrate adenosine in a noninteracting manner, and the binding is associated with the reduction of 3.2 mol of enzyme-bound NAD+. However, in the presence of dithiothreitol, the same compound causes a time dependent irreversible loss of enzyme activity concomitant with the formation of 3.6 mol of enzyme-bound NADH/mol of enzyme. Studies with adenine-labeled adenosine shows that radioactivity corresponding to 3.8 mol of substrate is tightly bound to the inactivated enzyme. Since the inactivation is apparently the consequence of reaction of dithiothreitol with an enzyme-bound intermediate as revealed by the kinetics of inactivation, these results support the conclusion that the four subunits of rat liver S-adenosylhomocysteinase are functionally equivalent. PMID- 3972805 TI - Salvage of circulating pyrimidine nucleosides by tissues of the mouse. AB - The metabolism of pyrimidine nucleosides present in the plasma of the mouse has been examined. Uridine and cytidine are rapidly cleared from the circulation with t1/2 of less than 5 min. Uracil, deoxycytidine, deoxyuridine, and thymidine are cleared more slowly with t1/2 of 9 to 13 min. Various tissues differed markedly in the extent of nucleotide formation from circulating nucleosides. Cytidine and uridine are predominantly converted to nucleotides (greater than 50%) rather than catabolized, whereas uracil is almost entirely degraded. Thymidine, deoxyuridine, and deoxycytidine are intermediate in the extent of their conversion to nucleotides: 8.9 to 21% of these nucleosides are salvaged in the mouse. Both anabolic and catabolic routes are important in the metabolism of pyrimidine nucleosides in vivo. PMID- 3972806 TI - 4',6-Diamidino-2-phenylindole, a fluorescent probe for tubulin and microtubules. AB - A new fluorophor for tubulin which has permitted the monitoring of microtubule assembly in vitro is reported. DAPI (4',6-diamidino-2-phenylindole), a fluorophor already known as a DNA intercalator, was shown to bind specifically to a unique tubulin site as a dimer (KD(app) = 43 +/- 5 microM at 37 degrees C) or to tubulin associated in microtubules (KD(app) = 6 +/- 2 microM at 37 degrees C) with the same maximum enhancement in fluorescence. When tubulin polymerization was induced with GTP, the change in DAPI affinity for tubulin resulted in an enhancement of DAPI binding and, consequently, of fluorescence intensity. DAPI, whose binding site is different from that of colchicine, vinblastine, or taxol, did not interfere greatly with microtubule polymerization. It induced a slight diminution of the critical concentration for tubulin assembly due to a decrease in the depolymerizing rate constant. Moreover, DAPI did not interfere with GTP hydrolysis correlated with tubulin polymerization, but it decreased the GTPase activity at the steady state of tubulin assembly. Even at substoichiometric levels DAPI can be used to follow the kinetics of microtubule assembly. PMID- 3972807 TI - The relationship between valinomycin-induced alterations in membrane phospholipid fatty acid turnover, membrane potential, and cell volume in the human erythrocyte. AB - The relationship between alterations in transmembrane potential, cell volume, and phospholipid fatty acid turnover has been examined in human erythrocytes by treating the cells with the monovalent cation ionophore valinomycin. Valinomycin increases the cellular uptake of tetra[3H]phenylphosphonium ion by erythrocytes, indicating membrane hyperpolarization, and causes net loss of potassium chloride and water from the cells leading to a decrease in cell volume. Treatment of erythrocytes with valinomycin also enhances incorporation of [9, 10-(3)H]oleic acid into phospholipids, primarily diacylphosphatidylethanolamine. After replacing intracellular chloride with sulfate and treating cells with the anion transport inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonate, exposure to valinomycin results in uptake of tetra[3H]phenylphosphonium ion and stimulation of [9, 10-(3)H]oleic acid incorporation, but, because anion efflux is prevented, no decrease in cell volume occurs. When tetra[3H]phenylphosphonium ion uptake is also prevented by suspending these cells in 125 mM KCl to dissipate the transmembrane potassium gradient, valinomycin still enhances [9, 10-(3)H] oleic acid incorporation into phospholipid. These results suggest that the presence of valinomycin in the membrane directly alters phospholipid fatty acid turnover and that some of the effects of this ionophore on cellular function previously attributed to alterations in transmembrane potential or cellular potassium content may instead be due to altered phospholipid turnover. Since it is possible that valinomycin may directly perturb phospholipid fatty acid turnover in other cells, the possibility that valinomycin-induced alterations in cellular function are due to altered phospholipid turnover rather than membrane hyperpolarization or altered potassium content should be considered in the interpretation of studies employing this ionophore. PMID- 3972808 TI - Rates of amphotericin B and filipin association with sterols. A study of changes in sterol structure and phospholipid composition of vesicles. AB - The influence of structural modifications in sterols and phospholipids on the rate of polyene antibiotic-sterol interaction was studied. For filipin and amphotericin B association with sterols in vesicles, a preferential interaction was found with sterols whose side chain length is close to that of cholesterol. Introduction of trans double bonds into the sterol side chain did not alter the rate of interaction in vesicles. The delta 7-bond of the sterol appears to be of critical importance in amphotericin B-sterol interaction, whereas the delta 5 bond is not essential. These observations are relevant to the well-known effects of amphotericin B on cell membranes containing ergosterol compared with those containing cholesterol. The dependence of the rates of sterol-polyene antibiotic interaction on the phospholipid composition of the vesicles indicates that phospholipid vesicles may be an inadequate model for reaching a comprehensive understanding of the effects exerted on biological membranes by these agents. PMID- 3972809 TI - Transcriptional regulation of the thyrotropin subunit genes by thyroid hormone. AB - Thyrotropin (TSH), a pituitary glycoprotein, consists of two subunits (alpha and beta), and regulates thyroid hormone production by the thyroid gland. The thyroid hormones, in turn, feedback negatively on TSH production. We have investigated the effect of triiodothyronine (T3) on the transcription of the TSH subunit genes. Hypothyroid LAF1 mice bearing TtT 97 thyrotropic tumors were injected daily with T3 (5 micrograms/100 g of body weight, intraperitoneal) and killed after 0, 0.5, 1, 4, or 120 h. Nuclei were isolated from the tumors and allowed to continue RNA synthesis in the presence of [alpha-32P]UTP. Newly synthesized mRNA sequences were quantitated by hybridization to immobilized cloned cDNA containing sequences specific for either alpha subunit or TSH-beta mRNA. Basal levels of mRNA synthesis were similar for alpha subunit and TSH-beta. After only 30 min of T3 treatment in vivo, mRNA synthesis was decreased for both alpha subunit (by 28%) and TSH-beta (by 61%). These decreases were maximum after 4 h, (75% for alpha subunit, greater than 95% for TSH-beta mRNA synthesis), and were maintained for the 5 days of T3 treatment. Decreases in mRNA synthesis precede decreases in tissue mRNA concentrations. Our studies suggest that T3 rapidly decreases the transcription of both the alpha subunit and TSH-beta genes, and that the transcription of the TSH-beta gene is affected to a greater extent than the alpha subunit gene. PMID- 3972810 TI - Sterol and squalene carrier protein interactions with fluorescent delta 5,7,9(11) cholestatrien-3 beta-ol. AB - The fluorescent sterol delta 5,7,9(11)-cholestatrien-3 beta-ol (cholestatrienol) was used as an analogue of cholesterol to determine the properties of the sterol in aqueous buffer and the interaction of cholesterol with sterol and squalene carrier protein (SCP). Cholestatrienol was synthesized and purified to a stable product by reverse phase high performance liquid chromatography. The critical micelle concentration of cholestatrienol in aqueous buffer was 1 nM while its maximum solubility was 1.15 microM as ascertained from fluorescence polarization and light scattering properties, respectively. Several lines of evidence indicated a close molecular interaction of cholestatrienol with purified rat liver SCP. The fluorescence emission spectrum of monomeric cholestatrienol in aqueous buffer was blue shifted upon addition of SCP. The fluorescence lifetime of monomeric cholestatrienol in aqueous buffer was increased by SCP from 5 to 12 ns. The SCP increased the fluorescence polarization of monomeric cholestatrienol from 0.002 to 0.38 in aqueous buffer. The close molecular interaction of cholestatrienol with SCP was also demonstrated by energy transfer experiments. Fluorescence energy transfer from tyrosine residues of SCP to the conjugated triene fluorophore in cholestatrienol had a transfer efficiency of 59%. R, the apparent distance between the tyrosine energy donor and the cholestatrienol energy acceptor, was 16.3 A. Binding analysis indicated that cholestatrienol interacted with SCP with an apparent KD = 0.5 microM and a Bmax = 3.54 microM. One mol of cholestatrienol was bound per mol of SCP. These results demonstrate the utility of cholestatrienol not only as a membrane sterol probe molecule but also as a probe for sterol-protein interactions. PMID- 3972811 TI - Biosynthesis of mammalian DNA ligase. AB - A monospecific antibody against calf thymus DNA ligase composed of a single polypeptide with Mr = 130,000 cross-reacts with rodent and calf thymus DNA ligases. The antibody precipitates a single Mr = 200,000 polypeptide from detergent lysates of [3H] leucine-labeled mouse Ehrlich tumor cells and calf thymocytes. Pulse-chase experiments show that the Mr = 200,000 polypeptide in Ehrlich tumor cells has a half-life of about 0.5 h. In addition to the Mr = 200,000 polypeptide, a Mr = 130,000 polypeptide is detected in the partially purified enzyme preparations from radiolabeled Ehrlich tumor cells. These results suggest that DNA ligase is synthesized in mammalian cells as a Mr = 200,000 polypeptide and that the Mr = 200,000 polypeptide is degraded to a Mr = 130,000 polypeptide by a limited proteolysis in vitro. PMID- 3972812 TI - Membrane fusion activity of the influenza virus hemagglutinin. The low pH-induced conformational change. AB - The hemagglutinin (HA) spike glycoprotein of influenza virus catalyzes a low pH induced membrane fusion event which releases the viral genome into the host cell cytoplasm. To study the fusion mechanism in more detail, we have prepared the ectodomain of HA in water-soluble form by treating virus particles with bromelain. Under mildly acidic conditions (pH less than or equal to 5.8), the ectodomain undergoes a conformational change which we found to be biochemically and immunologically equivalent to that in native viral HA. It became sensitive to proteinase K, it exposed new antigenic epitopes in its HA1 chain, and it acquired amphiphilic properties, notably the ability to bind to liposomes. The attachment to liposomes exhibited the same pH dependence and rapid kinetics as the conformational change and was mediated by HA2. The nature of the attachment resembled that of an integral membrane protein except that the bound HA was partially removed by base. As observed for virus fusion, attachment is independent of divalent cations and lipid composition. Temperature was found to be a critical parameter only with dimyristoylphosphatidycholine vesicles where attachment was partially blocked below the major phase transition. These and other results obtained indicated that the low pH-induced conformational change in the isolated ectodomain is equivalent to that occurring in intact viral HA, and that its attachment to liposomes can serve as a model for the initial stages in the HA-induced membrane fusion reaction. PMID- 3972813 TI - The amine transporter from bovine chromaffin granules. Partial purification. AB - We have partially purified the amine transporter from bovine adrenal chromaffin granules in a single step utilizing affinity chromatography. A 5 hydroxytryptamine moiety has been coupled to a Sepharose 4B matrix in a position ortho to the hydroxyl group. When membranes solubilized with sodium cholate are chromatographed on the above matrix a 45,000 Mr polypeptide is highly enriched. The enrichment is dependent on the presence of the proper ligand on the matrix and is inhibited if the column is previously equilibrated with a soluble ligand. Enrichment of the above polypeptide is accompanied by an increase in the specific activity of the transporter as measured by its labeling by 4-azido-3 nitrophenylazo(5-hydroxytryptamine). The ability of reserpine, a competitive inhibitor of binding and transport, to inhibit labeling of the purified transporter correlates well with its known kinetic constants in the native membranes. The polypeptide purified is identical to the one previously identified as the putative transporter based on specific labeling by a photoaffinity label (Gabizon, R., Yetinzon, T., and Schuldiner, S. (1982) J. Biol. Chem. 257, 15145 15150). The results clearly support the contention that the 45,000 Mr peptide is the amine transporter or one of its subunits. PMID- 3972814 TI - Effects of 5-fluorouracil on dihydrofolate reductase and dihydrofolate reductase mRNA from methotrexate-resistant KB cells. AB - Growth of methotrexate-resistant dihydrofolate reductase gene-amplified KB cells in the presence of 5-fluorouracil results in an increase in dihydrofolate reductase mRNA. This increase can be solely attributed to a species of RNA of approximately 3.5 kilobase pairs in size. Although dihydrofolate reductase enzyme activity increases per cell with increasing 5-fluorouracil, there is a decrease of enzyme activity per mg of protein (Dolnick, B. J., and Pink, J. J. (1983) J. Biol. Chem. 258, 13299-13306). The rate of in vivo enzyme synthesis, as assayed by immunoprecipitation and supported by gel electrophoresis, does not decrease and may in fact increase with increasing 5-fluorouracil. Translation of purified dihydrofolate reductase mRNA in vitro shows that the rate of translation is unaffected by 5-fluorouracil incorporation into mRNA. The inhibition of dihydrofolate reductase by a monospecific polyclonal antiserum is reduced with extracts from 5-fluorouracil-treated cells. Inhibition of dihydrofolate reductase by methotrexate is significantly reduced in extracts from 5-fluorouracil-treated cells compared to control extracts. Tight binding of [3H]methotrexate is also different in extracts from 5-fluorouracil-treated cells. This data supports the hypothesis of translational miscoding during protein synthesis as a major mechanism of 5-fluorouracil-mediated cytotoxicity and suggests a new mechanism of 5-fluorouracil-methotrexate antagonism. PMID- 3972815 TI - The effects of colchicine analogues on the reaction of tubulin with iodo[14C]acetamide and N,N'-ethylenebis(iodoacetamide). AB - We have previously found (Luduena, R. F., and Roach, M. C. (1981b) Biochemistry 20, 4444-4450) that colchicine and podophyllotoxin inhibit the alkylation of tubulin by iodo[14C]acetamide and the formation of an intrachain cross-link in the beta-tubulin subunit by N,N'-ethylenebis(iodoacetamide) (EBI). It was not clear whether these effects were due to conformational changes in tubulin induced by drugs or to direct steric blockage of the sulfhydryl groups involved. In an effort to characterize further these phenomena, we have examined the effects of single-ring and bicyclic analogues of colchicine on the reaction of tubulin with iodo[14C]acetamide and EBI. We have found that neither the A-ring analogues, 3,4,5-trimethoxybenzyl alcohol, 3,4,5-trimethoxybenzaldehyde, 2,3,4 trimethoxybenzaldehyde, and benzaldehyde, nor the C-ring analogues, tropolone and tropolone methyl ether, inhibited alkylation. In contrast, colchicine, podophyllotoxin, and nocodazole and the bicyclic analogues, 5-(2',3',4' trimethoxyphenyl)-2-methoxytropone and combretastatin, inhibited tubulin alkylation. Since the presence of a bond joining the A and C rings seems to be the determining factor in the suppression of alkylation, it is likely that inhibition by colchicine of the reaction with iodo[14C] acetamide is due largely to a conformational change induced by colchicine. A different pattern was obtained when the effects on cross-link formation by EBI were examined. Here, all the A-ring analogues, the bicyclic analogues, and colchicine, podophyllotoxin, and nocodazole all inhibited formation of the cross-link, whereas the C-ring analogue tropolone methyl ether did not inhibit cross-link formation. Since compounds whose effect on alkylation is markedly different have the same effect on cross-link formation, it is possible that this effect is a steric one and that perhaps the A-ring of colchicine binds to tubulin very close to one of the sulfhydryls involved in the intrachain cross-link formed by EBI in beta-tubulin. PMID- 3972817 TI - The expression and chromatin structure of the chicken glyceraldehyde-3-phosphate dehydrogenase gene in mouse cells. AB - Chicken glyceraldehyde-3-phosphate dehydrogenase gene (GAPD) and thymidine kinase gene (TK) were co-transfected into mouse LMTK- cells by the calcium phosphate precipitation technique. Four of the eight hypoxanthine/aminopterin/thymidine containing medium-resistant, TK+ transfectants were shown to produce different amounts of chicken glyceraldehyde-3-phosphate dehydrogenase by zymogram analysis. Subcloning and further analysis revealed that the chicken GAPD was stably inherited and that its enzyme subunits randomly combined with mouse subunits in heterotetramers. Although the contribution of chicken enzyme varied from approximately 30 to approximately 90% of the total glyceraldehyde-3-phosphate dehydrogenase activity with a proportional increase in total activity in the different subclones, it did not appear to affect the expression of mouse endogenous glycolytic enzymes since there was no distinct change in the levels of either mouse glyceraldehyde-3-phosphate dehydrogenase mRNA nor mouse phosphoglycerate kinase enzyme activity. The levels of chicken GAPD copy number, mRNA, and enzyme apparently were generally correlated in the different subclones, suggesting that the chicken GAPD in the mouse cells were expressed constitutively. In situ hybridization revealed that the transfected genes were integrated into mouse chromosomes in one cluster, and the locations of these clusters were different in different clones. Chromatin structure analyses of the chicken GAPD in four different transfectants revealed three DNase I hypersensitive sites located around 0.2, 2.0, and 3.4 kilobases upstream from the 5' side of the gene. These sites are also present in the same locations in chicken lymphoblastoid cells (Kuo, M. T., Iyer, B., and Schwartz, R. J. (1982) Nucleic Acids Res 10, 4565-4579), indicating the dominant transmission of DNase I hypersensitive cleavage sites in the transfected gene. PMID- 3972816 TI - Procollagen secretion meets the minimum requirements for the rate-controlling step in the ascorbate induction of procollagen synthesis. AB - Ascorbate addition to primary avian tendon cells has been shown previously to cause a approximately 6-fold increase in procollagen translation that is first observable after 4 h and reaches a maximum level after 48 h. Similarly, procollagen mRNA has been shown to increase after ascorbate addition by approximately 6-fold starting at 12 h and reaching a maximum level by 72 h. The rate constant for procollagen secretion is now shown to also react to ascorbate by a 6-fold change. This results in a drop in the half-life of procollagen within the cell from 120 to 20 min. In sharp contrast to the other steps in the procollagen pathway, the change in the secretion rate constant is extremely fast occurring in less than 30 min. Moreover, after ascorbate addition, greater than 80% of the internal procollagen can be secreted at the fast rate. Since this change results from an increase in hydroxylation of proline residues and since the hydroxylation reaction has been localized to the endoplasmic reticulum, this evidence strongly supports the model that the slow step in the secretion pathway is transport out of the endoplasmic reticulum. Further support for this comes from electron microscope autoradiography of [3H]proline-labeled cells where the labeled procollagen pool within the cells was highly localized to the endoplasmic reticulum. PMID- 3972820 TI - Subunit structure of extracellular hemoglobin from the polychaete Tylorrhynchus heterochaetus and amino acid sequence of the constituent polypeptide chain (IIC). AB - Tylorrhynchus cyanomethemoglobin reduced with dithiothreitol was separated by chromatofocusing into four heme-containing polypeptide chains (I, IIA, IIB, and IIC) and a non-heme chain (N). The molecular weights of chains IIA-C and N were confirmed to be the same by polyacrylamide gel electrophoresis in sodium dodecyl sulfate on a 10-20% gradient gel. The molecular weight of chain IIC was determined to be 17,415 (including heme) from the amino acid sequence. Chain N constitutes less than 5% of the total protein and has the same NH2-terminal sequence, suggesting that it is derived from chain IIA during the isolation procedure. Tylorrhynchus hemoglobin consists of two types of subunit with molecular weights of 16,327 (chain I) and approximately 50,000, and the latter splits into chains IIA-C in the presence of a reducing agent. On the basis of the accurate value obtained for the molecular mass of chain IIC, it was concluded that the subunit of approximately 50,000 daltons is a trimer of heme-containing chains IIA, IIB, and IIC linked by disulfide bonds. The cysteine residue at position 5 and the arginine at position 10 are conserved in the four heme containing chains of Tylorrhynchus hemoglobin. The complete sequence of 149 residues of Tylorrhynchus chain IIC was determined. This sequence shows high homology with Tylorrhynchus chain I (Suzuki, T., Takagi, T., and Gotoh, T. (1982) Biochem. Biophys. Acta 708, 253-258) and Lumbricus chain AIII (Garlick, R. L., and Riggs, A. F. (1982) J. Biol. Chem. 257, 9005-9015). PMID- 3972819 TI - Influence of template primary and secondary structure on the rate and fidelity of DNA synthesis. AB - High resolution gel electrophoresis was used to monitor the successive addition of dNMP residues onto the 3'-OH ends of discrete 5'-32P-primers, during DNA synthesis on natural templates. Resulting autoradiographic banding patterns revealed considerable variation in the relative rates of incorporation at different positions along the template. The pattern of "pause sites" along the template was unique for each of three different DNA polymerases (polymerase I (the "large fragment" form of Escherichia coli), T4 polymerase (encoded by bacteriophage T4), and AMV polymerase (DNA polymerase of avian myeloblastosis virus]. Most pause sites were not caused by attenuation of polymerization at regions of local secondary structure in the template. Assays of the accuracy of incorporation at different positions along the template (in which elongation was monitored in the presence of only 3 of the 4 2'-deoxynucleoside 5'-triphosphates) strongly suggested that the relative fidelity of DNA synthesis catalyzed by different polymerases depends on the position on the template at which the comparison is made. Primer-templates were constructed that permitted comparison of elongation during synthesis on a single-stranded template with that during polymerization through a double-stranded region (wherein elongation required concomitant displacement of a strand annealed adjacent to the 5'-32P-primer). Although strand displacement DNA synthesis catalyzed by polymerase I occurred approximately ten times more slowly than synthesis in the same region of a single stranded viral template, most of the pause sites were the same in the presence or absence of "tandem" primer. Electrophoretic assays of the fidelity of DNA synthesis suggested that an increased tendency toward misincorporational "hotspots" occurred when elongation required concomitant strand displacement. PMID- 3972818 TI - Turnover of plasma membrane proteins in rat hepatoma cells and primary cultures of rat hepatocytes. AB - The half-lives of turnover of plasma membrane proteins in rat hepatoma tissue, culture cells, and in primary cultures of rat hepatocytes have been analyzed after resolution by two-dimensional gel electrophoresis. Cell membranes were externally labeled via iodination catalyzed by lactoperoxidase and glucose oxidase. A bimodal pattern of turnover was found for the externally oriented plasma membrane proteins of rat hepatoma cells. Three glycoproteins analyzed in these cells had an average t 1/2 of 22 h while eight proteins which did not bind to concanavalin A had an average t 1/2 of 80 h. In contrast, more heterogeneous rates of turnover were found for the externally oriented plasma membrane proteins of primary cultures of hepatocytes. Most, if not all, of the membrane proteins accessible to iodination in these cells were glycoproteins. Among the glycoproteins resolved by two-dimensional polyacrylamide electrophoresis, the receptors for asialoglycoproteins had the shortest half-lives (18 h). Other glycoproteins, mostly with higher molecular weights and different isoelectric points, showed a spectrum of half-lives ranging from 16 to 99 h. The turnover rates of membrane proteins of primary cultures of rat hepatocytes were also determined with [3H]- and [35S]methionine labeling of cells. Heterogeneous rates of turnover again were found among the labeled glycoproteins and nonglycoproteins. Among the 10 glycoproteins individually analyzed, the half lives range from 17 to 67 h. Among the 21 proteins which do not bind to concanavalin A, the half-lives range from 18 h to more than 100 h. Three proteins analyzed showed an apparent biphasic pattern of turnover, having a fast phase with a half-life of 4-6 h and a slow phase with a half-life of 15-29 h. Several nonglycoproteins, including clathrin and actin associated with membrane vesicles had extremely long half-lives. The more than 5-fold difference in the half-life between clathrin and the receptors for asialoglycoproteins, which coexist in coated pits indicates that intrinsic proteins of the coated pits turn over at a different rate than peripheral components. PMID- 3972821 TI - An endonuclease specific for single-stranded DNA selectively damages the genomic DNA and induces the SOS response. AB - A plasmid carrying the bacteriophage T7.3 endonuclease gene under the control of the lacUV5 promoter could be maintained in the transcriptionally active state only in recA+ strains. In recA- strains, endonuclease induction resulted in extensive degradation of the genomic DNA and cell death. In sharp contrast, the plasmid DNA remained intact in the supercoiled form. In recA+ strains, the recA protein levels were increased and the SOS functions of the host were activated, as shown by measurements of recA protein synthesis and prophage induction. These results indicate that in normal undisrupted and non-irradiated cells, enzymatic nucleolytic damage can induce the SOS response and can be controlled by the DNA repair system of the host. In addition, the higher sensitivity of the genomic DNA to the single-strand-specific endonuclease relative to the plasmid suggests that the two molecules differ in their physiological states and most likely in their degree of single-stranded content. PMID- 3972822 TI - Processing of human cathepsin D in lysosomes in vitro. AB - The proteolytic maturation of cathepsin D polypeptides was studied in lysosomes isolated from metabolically labeled fibroblasts. In lysosomes isolated from fibroblasts labeled with [35S]methionine, 70-95% of labeled cathepsin D polypeptides were represented by a Mr = 47,000 polypeptide after a 20-min pulse and 75-min chase. When these lysosomes were incubated in vitro, up to 70% of the Mr = 47,000 polypeptide was processed to mature cathepsin D polypeptides. The processing was dependent on the integrity of the lysosomes, had an optimum between pH 6 and 7, and could be stimulated by dithiothreitol and ATP. The noncleavable ATP analogue, adenosine 5'-(beta, gamma-imido)triphosphate, and GTP, CTP, and UTP could not substitute for ATP. The ATP-dependent stimulation was associated with an acidification of lysosomes. It was inhibited by agents that dissipate the lysosomal pH gradient (carbonyl cyanide p trifluoromethoxyphenylhydrazone, N,N'-dicyclohexylcarbodiimide, nigericin, NH4Cl). A stimulatory effect of ATP was observed also at pH 5.5. The stimulation at pH 5.5 was not associated with acidification of lysosomes and was resistant to protonophores. Inhibitors of lysosomal cysteine proteinases and N-ethylmaleimide inhibited the processing. In the presence of ATP the processing activity was partially protected from inhibition by N-ethylmaleimide. In conclusion, the maturation of cathepsin D in lysosomes depends on cysteine proteinases and is stimulated by the ATP-driven acidification of lysosomes. In addition, ATP stimulates maturation at pH 5.5 by a mechanism not involving the proton pump. PMID- 3972823 TI - Isolation and characterization of a tropomyosin binding protein from human blood platelets. AB - We have isolated a tropomyosin binding protein (TMBP) from human platelets using isoelectric fractionation, hydroxylapatite chromatography, and affinity chromatography on skeletal muscle tropomyosin-Affi-Gel 15. TMBP is a 67,000-Da monomeric protein that binds to muscle and nonmuscle tropomyosin affinity resins. Its affinity for platelet tropomyosin is greater than for rabbit skeletal or chicken gizzard tropomyosin, and greater than that of troponin for all tropomyosin affinity resins tested. TMBP forms a complex with platelet tropomyosin that can be isolated on G-150. The approximate molar stoichiometry is 1:1. Troponin and TMBP have distinct binding sites on skeletal tropomyosin since binding of TMBP to tropomyosin-Affi-Gel 15 is not affected by previous saturation of the column with troponin (or vice versa). The amino acid composition of TMBP is virtually identical with that of human serum albumin, and is similar to those of beta-actinin (Heizmann, C. W., Muller, G., Jenny, E., Wilson, K. J., Landon, F., and Olomucki, A. (1981) Proc. Natl. Acad. Sci. U.S.A. 78, 74-77) and acumentin (Southwick, F. S., and Stossel, T. P. (1981) J. Biol. Chem. 256, 3030 3036). The protein we have isolated is the first nonmuscle protein other than actin that has been shown to bind to tropomyosin. Results in an accompanying paper show that this tropomyosin binding protein is identical with human serum albumin (Hitchcock-DeGregori, S. E., Gerhard, M. D., and Brown, W. E. (1985) J. Biol. Chem. 260, 3228-3231). PMID- 3972824 TI - Phenobarbital induction of rat liver cytochromes P-450b and P-450e. Quantitation of specific RNAs by hybridization to synthetic oligodeoxyribonucleotide probes. AB - Cytochromes P-450b and P-450e are extremely homologous and immunochemically indistinguishable proteins that are coordinately induced by phenobarbital in rat liver. To assess the effect of phenobarbital on mRNA levels for each of these hemoproteins we performed solution hybridization and Northern blot experiments with synthetic oligodeoxynucleotide probes of defined sequence. Our data demonstrate that phenobarbital administration to rats resulted in marked increases in levels of hepatic mRNA for both cytochrome P-450b and cytochrome P 450e, with a 4- to 5-fold greater accumulation of P-450b mRNA vis a vis P-450e mRNA. The level of hepatic mRNA increased from less than 3 molecules/cell of each mRNA in untreated rats, to 630 and 130 molecules/cell for P-450b and P-450e, respectively, in phenobarbital-treated rats. Data obtained in Northern blot hybridization experiments demonstrated that the size of the mRNAs for each protein were identical, being approximately 1800 bases in length. PMID- 3972825 TI - Streptomyces beta-alanine:alpha-ketoglutarate aminotransferase, a novel omega amino acid transaminase. Purification, crystallization, and enzymologic properties. AB - An enzyme which catalyzes the transamination of beta-alanine with alpha ketoglutarate was purified to homogeneity from Streptomyces griseus IFO 3102 and crystallized. Molecular weight of the enzyme was found to be 185,000 +/- 10,000 by a gel-filtration method. The enzyme consists of four subunits identical in molecular weight (51,000 +/- 1,000). The transaminase is composed of 483 amino acids/subunit containing 7 and 8 residues of half-cystine and methionine, respectively. The enzyme exhibits absorption maxima at 278 and 415 nm. The pyridoxal 5'-phosphate content was determined to be 4 mol/mol of enzyme. The enzyme catalyzes transamination of omega-amino acids including taurine and hypotaurine. beta-Alanine and DL-beta-aminoisobutyrate served as a good amino donor; the Michaelis constants are 8.0 and 12.5 mM, respectively. alpha Ketoglutarate is the only amino acceptor (Km = 4.0 mM); pyruvate and oxalacetate are inactive. Based on the substrate specificity, the terminology of beta alanine:alpha-ketoglutarate transaminase is proposed for the enzyme. Carbonyl reagents, HgCl2,DL-gabaculine, and alpha-fluoro-beta-alanine strongly inhibited the enzyme. PMID- 3972826 TI - In vivo glycolytic equilibria in dog gracilis muscle. AB - While the equilibrium assumption and the validity of using total measured concentrations for near equilibrium indicator reactions have been widely tested in liver, these have not been systematically evaluated in skeletal muscle. Vascularly isolated dog gracilis muscles were stimulated via the nerve at 4 Hz, and tissue was sampled by quick freezing at rest and after 10, 15, 30, 60, and 180 s of stimulation or after stimulation in the presence of glycolytic blockade by iodoacetate. Phosphocreatine, creatine, and several glycolytic intermediates were measured in tissue extracts. The in vivo mass action ratios for triosephosphate isomerase and aldolase were evaluated relative to substrate concentrations and compared with equilibrium constants determined in vitro. Although there was evidence of substrate binding at low substrate levels for the triosephosphate isomerase reaction, the in vivo mass action ratios for both reactions stabilized at a constant value at moderate substrate levels and in glycolytically blocked muscles. It was concluded that both enzymes are in apparent equilibrium in vivo, but the equilibrium constants are lower than those determined in vitro. The mass action ratios of the combined creatine kinase, lactate dehydrogenase, glyceraldehyde-phosphate dehydrogenase and phosphoglycerate kinase reactions were determined for resting muscles. These reactions are also at equilibrium and the equilibrium constants are consistent with in vitro values. PMID- 3972827 TI - Evidence for a role of taurine in the in vitro oxidative toxicity of neutrophils toward erythrocytes. AB - Production of hydrogen peroxide and secretion of myeloperoxidase by stimulated neutrophils resulted in myeloperoxidase-catalyzed oxidation of chloride to hypochlorous acid (HOCl), the reaction of HOCl with taurine to yield taurine monochloramine (TauNHCl), and accumulation of TauNHCl in the extracellular medium. When erythrocytes were present, the yield of TauNHCl was lower as the result of uptake of TauNHCl into erythrocytes. The zwitterion taurine was not taken up, but the anion TauNHCl and other anionic oxidants including taurine dichloramine (TauNCl2) and L-alanine chloramines were transported into erythrocytes by the anion-transport system. Oxidation of intracellular components such as glutathione (GSH) by taurine chloramines resulted in reduction of the chloramines and trapping of taurine within erythrocytes. At high oxidant:erythrocyte ratios, TauNHCl also oxidized hemoglobin (Hb) and depleted ATP, but caused little lysis. TauNCl2 was much more effective as a lytic agent. At low oxidant:erythrocyte ratios, the chloramines caused net loss of GSH when no glucose was provided, but Hb was not oxidized and GSH content returned to normal when glucose was added. Therefore, anionic chloramines may mediate oxidative toxicity when the neutrophil:erythrocyte ratio is high. Under more physiologic conditions, chlorination of taurine by neutrophils and the uptake and reduction of TauNHCl by erythrocytes prevents accumulation of oxidants and may protect blood cells, plasma components, and tissues against oxidative toxicity. PMID- 3972828 TI - Branchpoint for heme alkylation and metabolite formation in the oxidation of arylacetylenes by cytochrome P-450. AB - Phenylacetylene and biphenylacetylene are oxidized by cytochrome P-450 to the corresponding arylacetic acids. The acetylenic hydrogen shifts to the adjacent carbon and one atom of molecular oxygen is incorporated into the carboxylic acid group in these transformations, which are subject to a large kinetic isotope effect when the acetylenic hydrogen is replaced by deuterium. The same products and isotope effects are observed when the two arylacetylenes are oxidized by m chloroperbenzoic acid rather than by the enzyme. In contrast, the inactivation of cytochrome P-450 that occurs during the oxidation of phenylacetylene is insensitive to deuterium substitution. The partition ratio between metabolite formation and enzyme inactivation consequently changes from 26 to 15 in going from phenylacetylene to the deuterated analogue. Metabolite formation therefore diverges from heme alkylation very early in the catalytic process. PMID- 3972829 TI - The ATP dependence of the degradation of short- and long-lived proteins in growing fibroblasts. AB - To characterize the system(s) responsible for degradation of short-lived and long lived proteins in mammalian cells, we compared the concentrations of ATP required for the degradation of these classes of proteins in growing hamster fibroblasts. By treating CHEF-18 cells with increasing concentrations of dinitrophenol and 2 deoxyglucose, it was possible to reduce their steady-state ATP content by different amounts (up to 98%). These treatments caused a rapid decrease in the degradation of both short- and long-lived proteins. Removal of the inhibitors led to a prompt restoration of ATP and proteolysis. As ATP content fell below normal levels (about 3.1 mM), rates of proteolysis decreased in a graded biphasic fashion. Reduction in ATP by up to 90% (as may occur in anoxia or injury) decreased proteolysis up to 50%; and with further loss of ATP, protein breakdown fell more sharply. Degradation of both classes of proteins was inhibited by 80% when ATP levels were reduced by 98%. The levels of ATP required for the breakdown of short- and long-lived proteins were indistinguishable. Protein synthesis was much more sensitive to a decrease in ATP content than protein breakdown and fell by 50% when ATP was reduced by only 15%. Chloroquine, an inhibitor of lysosome function, did not reduce the degradation of either class of proteins in growing cells, but it did inhibit the enhanced degradation of long-lived proteins upon removal of serum (in accord with previous studies). Thus, in growing fibroblasts, an ATP-dependent nonlysosomal process appears responsible for the hydrolysis of both short- and long-lived proteins. PMID- 3972830 TI - The pH-dependent subunit dissociation and catalytic activity of bovine dopamine beta-hydroxylase. AB - The soluble form of dopamine beta-hydroxylase from bovine adrenal medulla has previously been shown to exist as a tetrameric species of Mr = 290,000 composed of two disulfide-linked dimers. Here we report that this enzyme can also undergo a reversible tetramerdimer dissociation which is dependent on pH. Gel permeation chromatography of dopamine beta-hydroxylase at pH 5.0 demonstrates a Stokes radius of 5.8 nm. When the pH is shifted to 5.7, the Stokes radius changes to 6.9 nm. Sedimentation equilibrium analysis of the purified enzyme demonstrates that this change in molecular size is due to a change in molecular weight. At low protein concentration, the estimated Mr of the enzyme is 145,000 at pH 5.0 and at high protein concentration approaches 290,000 at pH 5.7. This change in Mr is consistent with the existence of a tetramer-dimer dissociation and a change in the equilibrium constant from 1.8 X 10(-6) M to 1.16 X 10(-9) M when the pH is increased from 5.0 to 5.7. This pH-dependent subunit dissociation is correlated with pH-dependent changes in enzyme activity. Purified bovine-soluble dopamine beta-hydroxylase activity is a hyperbolic function of tyramine concentration at pH 5.0. However, the hydroxylase activity displays non-hyperbolic kinetics at pH 6.0. The kinetic data obtained at pH 6.0 can be accounted for by fitting to a model containing two nonidentical catalytic forms of enzyme generated by the pH dependent partial dissociation of tetrameric enzyme to dimeric subunits. The two catalytic forms have apparently identical maximal velocities; however, they differ in their Michaelis constants for the substrate; the dimeric form having a low Km and the tetrameric form having a high Km. Since the pH inside bovine adrenal medullary chromaffin granules is approximately 5.5, we conclude that the subunits of dopamine beta-hydroxylase are in dynamic dissociation in a physiologically important pH range. PMID- 3972831 TI - Translocation of proteins into rat liver mitochondria. Existence of two different precursor polypeptides of liver fumarase and import of the precursor into mitochondria. AB - Two different putative precursor polypeptides of rat liver fumarase were synthesized when RNA prepared from rat liver were translated in vitro using the rabbit reticulocyte lysate system. One of these putative precursor polypeptides (P1) was synthesized as a larger molecular mass than the mature subunit of fumarase (45,000 daltons) by about 5,000 daltons and the other (P2) had the same molecular mass as the mature enzyme. When the 35S-labeled cell-free translation products were incubated with rat liver mitochondria at 30 degrees C, P1 and the 35S-labeled mature size fumarase were associated with the mitochondria. Of these, the 35S-labeled mature size fumarase was resistant to externally added protease, but P1 was not, indicating that the 35S-labeled mature size fumarase was located in the mitochondrial matrix. The following observations strongly suggested that the 35S-labeled mature size fumarase in mitochondria was derived from P1, which was energy-dependently imported and concomitantly processed to the mature size. 1) The amount of the 35S-labeled mature size fumarase recovered from the mitochondria increased proportionally to the duration of incubation, while the amount of P1 recovered from the post-mitochondrial and mitochondrial fractions decreased with the duration of the incubation. 2) Only P1 could bind with the mitochondrial outer membrane at 0 degrees C even in the presence of an uncoupler of the oxidative phosphorylation but P2 did not. 3) P1 bound to the mitochondrial outer membrane was imported into the matrix, when the mitochondria binding only P1 at 0 degrees C was reisolated and incubated at 30 degrees C in the presence of an energy-generating system. The specific receptor was involved in the binding of P1 to mitochondria, since a high concentration of NaCl did not interfere with the binding of P1 to the membrane and did not discharge P1 bound onto the membrane. It was shown that P1 formed an aggregate composed of 6 to 8 molecules and P2 was a dimer in the cell-free translation mixture and that P1 and P2 were enzymatically inactive. These results suggest that the precursor for the mitochondrial enzyme has a larger molecular weight than that of the mature enzyme, whereas the precursor for the cytosolic enzyme has the same molecular weight as the mature enzyme. PMID- 3972832 TI - The amino acid sequence and stability predictions of the hinge region in myosin subfragment 2. AB - From an NH2-terminal sequence analysis of the long and short form of myosin subfragment 2 we have suggested that the putative hinge region in the myosin rod is located in the COOH-terminal portion of the long subfragment 2 (Lu, R. C. (1980) Proc. Natl. Acad. Sci. U.S.A. 77, 2010-2013). The amino acid sequence of this hinge region has now been determined: ASRA KAEKQRSDLSRELEEISERLEEAGGATSAQIEMNK KREAEFEKMRRDLEEATLQHEATAAALRKKHAD SVAELGEQIDNLQRVKQKLEKEKSELKMEIDDLA GNMETVSKAKGNLEKMCRTLEDQ(L/V)SE(V/L)KT KEEEHQRLIN(D/E)L(S/G)AQ(K/R)AR. Comparison of the sequence with that of other portions of the rod, viz. short subfragment 2 and light meromyosin, and of tropomyosin shows that the hinge region shares some feature of a coiled-coil helical structure, but it has somewhat fewer hydrophobic coil-coil interactions and there is a significant number of charged residues in the hydrophobic core region. This suggests that the stability of the putative hinge region would be reduced in comparison with other coiled-coil structures. PMID- 3972833 TI - Fluorescent phosphonate labels for serine hydrolases. Kinetic and spectroscopic properties of (7-nitrobenz-2-oxa-1,3-diazole)aminoalkyl methylphosphonofluoridates and their conjugates with acetylcholinesterase molecular forms. AB - The synthesis, kinetic, and spectral characterization of (7-nitrobenz-2-oxa-1,3 diazole)aminoethyl and (7-nitrobenz-2-oxa-1,3-diazole)aminopentyl methylphosphonofluoridate are described. These homologous organophosphorous agents contain the environmentally sensitive 7-nitrobenz-2-oxa-1,3-diazole chromophore. They inhibit acetylcholinesterase from Torpedo at rates exceeding 10(7) M-1 min-1 to form long-lived conjugates with one chromophore/80-kilodalton subunit. The intensity, position, and line width of the absorption spectra of the conjugates and reactivation kinetics in the presence and absence of the bisquaternary oxime 1,1'-trimethylene-bis(4-formylpyridinium bromide) dioxime indicate that these agents form conjugates in which the NBD-aminoalkyl moieties experience distinctive microscopic environments within the active center. NBD aminoethyl methylphosphono-acetylcholinesterase undergoes oxime-induced as well as spontaneous reactivation at rates that are 3.6 and 35 times faster, respectively, than the corresponding rates measured for the NBD-aminopentyl conjugate. Hence, reactivation exhibits a marked dependence on structure of the methylphosphonate. Fluorescence emission at wavelengths greater than 520 nm is highly quenched and exhibits quantum efficiencies of less than 5%. Absorption maxima for the covalent NBD-aminoethyl methylphosphono-acetylcholinesterase appear at 475-480 nm while those for the corresponding NBD-aminopentyl methylphosphono-acetylcholinesterase appear at 485-490 nm. Bandwidths of the absorption maxima are substantially broader for the acetylcholinesterase adduct with NBD-aminoethyl methylphosphonofluoridate (3870 cm-1) than for the enzyme adduct with NBD-aminopentyl methylphosphonofluoridate (2870 cm-1). The CD spectrum of NBD-aminopentyl methylphosphono-acetylcholinesterase shows optical activity coincident with the shape and position of the absorption spectrum. In contrast, in addition to optically active transitions at the absorption maxima, the CD spectrum of NBD-aminoethyl methylphosphono-acetylcholinesterase shows intense optical activity at 430 nm, a wavelength region coincident with the region of spectral broadening. The spectral properties of alpha-chymotrypsin conjugates formed by reaction with the two probes are different, and the respective spectra differ also from those observed for the acetylcholinesterase conjugates. These results indicate that there is a reciprocal relationship between the structure of the probe and the structure of the active center.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3972834 TI - Reconstitution studies of the human erythrocyte nucleoside transporter. AB - The human erythrocyte nucleoside transporter has been identified as a band 4.5 polypeptide (Mr 45,000-66,000) on the basis of reversible binding and photoaffinity labeling experiments with the nucleoside transport inhibitor, nitrobenzylthioinosine (NBMPR). In the present study, the NBMPR-binding protein was extracted from protein-depleted human erythrocyte "ghosts" with Triton X-100 and reconstituted into soybean phospholipid vesicles by a freeze-thaw-sonication procedure. The reconstituted proteoliposomes exhibited nitrobenzylthioguanosine (NBTGR)-sensitive [14C]uridine transport. A partially purified preparation of the NBMPR-binding protein, consisting largely of band 4.5 polypeptides, was also shown to have nucleoside transport activity. This band 4.5 preparation exhibited a 10-fold increase in uridine transport activity and a 7-fold increase in NBMPR binding activity relative to the crude membrane extract. Uridine transport by the reconstituted band 4.5 preparation was saturable (apparent Km = 0.21 mM; Vmax = 9 nmol/mg of protein/5 s) and was inhibited by dipyridamole, dilazep, adenosine, and inosine. The vesicles reconstituted with the band 4.5 preparation also exhibited stereospecific glucose transport which was inhibited by cytochalasin B, but unaffected by NBTGR. In contrast, cytochalasin B was a poor inhibitor of NBTGR-sensitive uridine transport. These experiments implicate band 4.5 polypeptides in both nucleoside and sugar permeation. PMID- 3972835 TI - Reaction rates of creatine kinase and ATP synthesis in the isolated rat heart. A 31P NMR magnetization transfer study. AB - The NMR technique of magnetization transfer can be used to define intracellular reaction kinetics. In order to determine the relationship between ATP synthesis and flux through the creatine kinase reaction in the intact heart, we used this technique to measure flux through the creatine kinase reaction in the isolated, isovolumic rat heart at five levels of cardiac performance and oxygen consumption. The unidirectional reaction rate constants (s-1) calculated from a two-site exchange model for both the forward and reverse creatine kinase reactions increased with cardiac performance and oxygen consumption. As the rate pressure product varied from 0 to 44.7 X 10(3) mm Hg/min and oxygen consumption rose from 5.9 to 45.8 mumol of O2/g dry weight/min, kforward increased from 0.27 to 1.30 and kreverse increased from 0.31 to 1.14. The relationship between creatine kinase flux and oxygen consumption, and thus ATP synthesis, took the form of the Michaelis-Menten equation. Rates of ATP synthesis estimated from magnetization transfer were similar to values calculated from oxygen consumption. The longitudinal relaxation time of creatine phosphate (2.06 s), the gamma phosphorus atom of ATP (0.75 s), and inorganic phosphate (0.81 s) did not change with cardiac performance. These results show that myocardial energy transfer via the creatine kinase reaction is closely coupled to energy production. PMID- 3972836 TI - Investigations of cyanide as an infrared probe of hemeprotein ligand binding sites. AB - The measurement of infrared spectra for cyanide liganded to hemeproteins and hemins has been investigated. The hemeproteins included human methemoglobin A, lamprey methemoglobin, metchlorocruorin, horse metmyoglobin, and horseradish peroxidase. The hemins were dicyanide and monopyridine monocyanide species of deuteroporphyrin IX iron(III) and its 2,4-divinyl(proto) and 2,4-diacetyl derivatives. C-N stretch bands of low intensity detected near 2100 cm-1 exhibit changes in frequency, width, intensity, and isotope shift with changes in cyanide compound structure. Infrared band parameters are particularly sensitive to a change in oxidation state (Fe2+ versus Fe3+) and are affected to a lesser extent by changes in porphyrin ring substituent, ligand trans to the cyanide, and protein structure. Evidence of multiple conformers (i.e. multiple C-N stretch bands) was found for several hemeproteins. The cyanide infrared spectra provide direct evidence for cyanide binding as a metal cyanide (Fe--C identical to N) and against HCN being the ligand in nitrile-like bonding (Fe--N identical to C--H) in all the hemeprotein and hemin cyanides studied. With the reduced horseradish peroxidase cyanide, differences between infrared spectra for D2O and H2O solutions can result from hydrogen bonding between a protein amino acid residue and the distal atom of the cyanide (Fe--C identical to N...H+--R). The binding of cyanide to reduced iron (Fe2+) of a hemeprotein was only observed in the case of the reduced peroxidase. These findings demonstrate that cyanide infrared spectra can not only determine when cyanide is bound to a metalloprotein but can also provide information on how the cyanide is bonded to metal and on characteristics of the ligand binding site. PMID- 3972837 TI - A phosphorus-31 nuclear magnetic resonance study of phosphate uptake and storage in cultured Catharanthus roseus and Daucus carota plant cells. AB - High resolution 31P NMR spectra (103.2 MHz) of oxygenated Catharanthus roseus and Daucus carota cells grown in suspension cultures were obtained using a solenoidal perfusion probe. The spectra showed resonances for various phosphorylated metabolites such as ATP, ADP, NAD(P)(H), nucleoside diphosphoglucose, and sugar phosphates. The relative levels of the phosphorylated metabolites remained constant throughout the growth curve. No resonances for storage compounds such as polyphosphates, pyrophosphate, or phytates were observed. Two resolved resonances for Pi indicated an intracellular pH of 7.3 and 5.7 (or below) for the cytoplasm and vacuoles, respectively. The time course of Pi uptake and storage during growth in fresh culture medium was followed by studying the level of vacuolar Pi with 31P NMR (145.7 MHz). Simultaneously, the level of Pi in the culture medium was followed with radioactive 32P. C. roseus quickly takes up all the Pi from the culture medium (maximum rate 1.7 mumol min-1 g-1 (dry weight of cells]. The Pi is first stored in the vacuoles; subsequently, one part of this pool is used to keep a constant cytoplasmic Pi level while another part is apparently accumulated as an NMR invisible Pi store, probably in another cell organelle. In contrast, D. carota does not accumulate Pi in the vacuoles and consequently it takes up Pi from the medium at a much slower rate (0.05 mumol min-1 g-1 (dry weight of cells]. PMID- 3972838 TI - Lipid mobility in the assembly and expression of the activity of the prothrombinase complex. AB - A phospholipid or membrane surface is a required component of the prothrombinase complex, yet little is known about the influence of the lipid on the assembly and expression of this complex. Vesicles composed of synthetic phospholipids were used to investigate the effects of membrane "fluidity" on the prothrombinase complex. All vesicle types studied were capable of supporting the prothrombinase reaction which in each case was characterized by a similar apparent Km. The binding constants for the interaction of Factor Va and prothrombin with synthetic phospholipid vesicles were not significantly affected by temperature. The rate of thrombin production, however, increased with increasing temperature. The fluidity of the vesicles was assessed by measuring the fluorescence lifetimes, steady state anisotropies, and differential phase fluorometry of diphenylhexatriene embedded in the vesicles. No correlation was observed between the fluidity of the vesicles and the steady-state rate of thrombin production, even when the enzymatic activity was monitored below and above the phase transition temperature of the lipid vesicles. A distinct correlation, however, was found between the fluidity of the vesicle and the time required to reach the maximum rate of thrombin production (pre-steady-state interval). We believe that this "lag" time corresponds to the time required for the assembly of the prothrombinase complex. Thus, although lipid fluidity does affect the assembly of the prothrombinase complex, after the complex is assembled, this property has little effect on the catalytic process itself. PMID- 3972839 TI - Chloroplast biogenesis. Molecular structure of chlorophyll b (E489 F666). AB - Nuclear magnetic resonance analysis established the presence of two vinyl groups/macrocycle of chlorophyll b (E489 F666). The latter is the only chlorophyll b that accumulates in a corn mutant (ON 8147). On the other hand the presence of only one vinyl group/macrocycle of authentic monovinyl chlorophyll b (E475 F660) was confirmed. PMID- 3972840 TI - The carbohydrate structure of porcine uteroferrin and the role of the high mannose chains in promoting uptake by the reticuloendothelial cells of the fetal liver. AB - Uteroferrin, the iron-containing, progesterone-induced phosphatase of the porcine uterus, is a glycoprotein carrying a single oligosaccharide chain. Most of the uteroferrin isolated from either uterine secretions or allantoic fluid has endoglycosidase H-sensitive carbohydrate chains with either five or six mannose residues. As determined by 1H-NMR spectroscopy, the Man6 oligosaccharide has the following structure. (Formula: see text) The Man5 species lacks the terminal alpha 1,2-linked residue. Uteroferrin is transported across the pig placenta and has been proposed to be involved in iron transfer to the fetus (see Buhi, W. C., Ducsay, C. A., Bazer, F. W., and Roberts, R. M. (1982) J. Biol. Chem. 257, 1712 1721). Injection of 125I-labeled uteroferrin into the umbilical vein of midpregnant fetuses resulted in incorporation of label into the liver, the major site of fetal erythropoiesis. Light and electron microscope autoradiography revealed that the primary sites of uteroferrin uptake were the reticuloendothelial cells lining the liver sinusoids. Reticuloendothelial cells isolated from either fetal pig or adult rat livers were shown to accumulate uteroferrin when cultured in vitro. Uptake was inhibited by yeast mannan and by glycopeptides isolated from either ovalbumin or uteroferrin. Rat cells did not accumulate uteroferrin whose high mannose chains had been removed using endoglycosidase H. Moreover, the K uptake values (3 X 10(-7) M), specific competition by D-mannose and L-fucose bovine serum albumin, and inhibition by EDTA are consistent with an uptake mechanism involving a receptor for high mannose oligosaccharides on the liver sinusoidal cells. It is suggested that one function of this receptor in the fetal pig is to remove maternally derived uterine glycoproteins from the fetal circulation. In the case of uteroferrin this process provides iron to the fetal liver. PMID- 3972841 TI - Cordycepin analogs of ppp5'A2'p5'A2'p5'A (2-5A) inhibit protein synthesis through activation of the 2-5A-dependent endonuclease. AB - Analogs of the triphosphate 2'-5'-linked adenylate trimer (ppp5'A2'p5'A2'p5'A, called 2-5A) which contain 3'-deoxyadenosine (cordycepin) instead of adenosine either in positions one and two, or in all three positions, are 10-100-fold less potent than is parent 2-5A in inhibition of protein synthesis in intact cells, when utilizing calcium co-precipitation techniques to introduce the 5' triphosphate oligonucleotides into the cells. That the inhibition of protein synthesis was a consequence of activation of the 2-5A-dependent endonuclease by the 3'-deoxyadenosine analogs of 2-5A was demonstrated in obtaining the ribosomal RNA cleavage pattern that is characteristic of endonuclease activation by parent 2-5A. Additional results (i.e. lack of activity by the dimer species ppp5'(3'dA)2'p5'-(3'dA) or the monomer 3'dA) as well as kinetic analysis both in intact cells and in cell-free extracts provided further evidence that the inhibition of protein synthesis observed with these 3'-deoxyadenosine 2-5A analogs was not due to their degradation to the antimetabolite monomer unit 3' deoxyadenosine. PMID- 3972842 TI - Evidence for more than two metallothionein isoforms in primates. AB - Two isoforms of metallothionein (MT) have in general been identified in mammalian cells. We have analyzed Cd2+-induced MTs of primate origin and demonstrated the presence of more than two isoforms. Four low molecular weight Cd2+-binding proteins were separated from Cd2+-exposed HeLa cells by gel filtration and ion exchange chromatography and identified as MTs by amino acid analysis. These were carboxymethylated and analyzed by electrophoresis under denaturing conditions. Three of these proteins were found to be distinct molecules. We also analyzed hepatic MTs from Cd2+-exposed rhesus monkeys, which have previously been partially separated. In this case, five distinct isomers were detected. PMID- 3972843 TI - Interactions between protein 4.1 and band 3. An alternative binding site for an element of the membrane skeleton. AB - Protein 4.1 from human erythrocytes formed a complex with band 3 in inside-out erythrocyte membrane vesicles and with soluble peptides derived from the cytoplasmic domain of band 3. Protein 4.1 labeled metabolically with 32P bound saturably to vesicles depleted of endogenous protein 4.1. The soluble cytoplasmic domain of band 3 (43K) competitively displaced approximately 60% of bound 32P protein 4.1 from reconstituted membrane vesicles. Pretreatment of vesicles with anti-43K similarly inhibited the rebinding of protein 4.1. In solution, 125I-43K formed a complex with protein 4.1 that saturated at 1:1 stoichiometry and migrated as a discrete band when analyzed by nondenaturing polyacrylamide gel electrophoresis. In rate-zonal sedimentation in isotonic salt solutions, protein 4.1 and 43K sedimented as a sharp peak at 4.4 S. In experiments aimed at exploring the role of the protein 4.1-band 3 interaction in the organization of the membrane skeleton, the effect of spectrin was investigated. Spectrin and protein 4.1 formed a complex which co-sedimented in sucrose gradients, but the addition of 43K to preformed spectrin-protein 4.1 complexes resulted in disruption of the complex and co-sedimentation of most of the protein 4.1 with 43K. These results suggest that protein 4.1 can associate with band 3 in the erythrocyte membrane and that this association may modulate the attachment of the membrane skeleton to the membrane. PMID- 3972844 TI - Phosphorylation of rat liver glucocorticoid receptor. AB - Rat liver glucocorticoid-receptor complex (GRc) was purified 2000-fold by a combination of methods including (NH4)2SO4-fractionation and phosphocellulose and DNA-cellulose chromatography. The purified glucocorticoid receptor preparation contained a major peptide of Mr = 90,000 and the GRc sedimented as 4 S in 5-20% sucrose gradients. An additional peptide of Mr = 45,000 (45K) was also observed. Some preparations yielded only the Mr = 90,000 (90K) peptide suggesting that the 45K peptide may be a proteolyzed portion of the 90K protein. The purified GRc was incubated with [gamma-32P]ATP in the presence of cAMP-dependent kinase. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the above preparation revealed the presence of two 32P-containing bands with apparent Mr = 90,000 and 45,000. The 32P incorporation was dependent on the availability of divalent cation (Mg2+). GRc in cytosol labeled with [3H]dexamethasone mesylate and purified as above co-migrated with 32P-containing bands. GRc was also purified from cytosol obtained from livers of rats injected with [32P]orthophosphate. Both 32P and 3H bands were associated with 90K and 45K peptides. Our results indicate that rat liver glucocorticoid receptor is a phosphoprotein and that both the phosphorylated peptides 90K and 45K also contain the steroid and the DNA binding regions of the glucocorticoid receptor. PMID- 3972845 TI - The elasticity of spectrin-actin gels at high protein concentration. AB - Human erythrocyte spectrin of high purity was studied alone and mixed with rabbit skeletal actin by dynamic rheometry as a function of protein concentration at pH 7.4 and 24 degrees C. Pure spectrin had a very low storage modulus, G', increasing slightly with increase in protein concentration (approximately 3 dynes/cm at 25 mg/ml). In contrast, unpurified cytoskeletal extracts containing spectrin, actin, and band 4.1 showed a marked concentration dependence for G', increasing to 150 dynes/cm at 20 mg/ml. Mixtures of purified spectrin and skeletal actin at a weight ratio of 4:1 also showed G' markedly dependent on concentration (approximately 150-200 dynes/cm at 20 mg/ml). Maximum elasticity of spectrin-actin gels occurred at a molar ratio of actin monomers to spectrin tetramers of 14:1. We conclude that the reconstituted in vitro spectrin-actin network consists of actin fibers cross-linked by spectrin tetramers at regular intervals. The gel is rapidly reformed after mechanical disruption or thermal collapse, indicating that the polymer fibers are in equilibrium with the constituent monomers. PMID- 3972846 TI - Isolation and characterization of a Mr = 38,000 protein from differentiating smooth muscle cells. AB - In culture, vascular smooth muscle cells grow and form a confluent monolayer of cells. Under appropriate conditions, regions of the monolayer can be induced to draw away from the substrate and form multicellular nodules. The ultrastructure of the cells in the nodules appears to be similar to that of differentiated smooth muscle cells. The process of nodulation is associated with the synthesis of a unique protein whose molecular weight is estimated from gradient gel electrophoresis to be 38,000 (38-kDa Protein). The protein is secreted into the culture medium and can be detected either by metabolic labeling or by staining with Coomassie Blue. Partial purification of 38-kDa Protein was achieved using affinity chromatography. The protein is adsorbed to heparin-agarose, but not to gelatin-agarose. The concentration of 38-kDa Protein in nodular conditioned medium is estimated at 1.9 micrograms/ml and less than 0.01 microgram/ml in conditioned medium made from monolayer cells. The presence of 5% fetal bovine serum in the labeling medium does not affect 38-kDa Protein synthesis. Cross reactivity with fibronectin was evaluated using polyvalent antibodies to 38-kDa Protein. The 38-kDa Protein is not antigenically related to fibronectin. Furthermore, we establish that the protein is not qualitatively influenced by the presence of ascorbate (50 micrograms/ml), beta-aminoproprionitrile fumarate (50 micrograms/ml) heparin (10 ng/ml), or fibronectin (20 micrograms/ml) in the culture medium. We find that the added components neither suppress 38-kDa Protein synthesis in nodular cultures nor enhance 38-kDa Protein synthesis in monolayer cultures. The 38-kDa Protein is not detected in either monolayer or nodular cell layers and appears to be a secreted protein. Its appearance in nodular conditioned medium during nodulation suggests a relationship with that process. PMID- 3972847 TI - Identification of the promoter and first exon of the mouse alpha 1 (III) collagen gene. AB - We have identified the promoter-proximal exon of the mouse alpha 1 (III) collagen gene using a synthetic oligonucleotide as a hybridization probe and have determined the DNA sequence of this exon and 380 base pairs 5' to it. The exact start site of transcription was localized with a primer extension experiment. The region upstream of the start of transcription shows only scattered homologies with the analogous sequences in the alpha 1(I) and alpha 2(I) mouse collagen genes although these genes are often co-expressed and co-regulated. The most striking homology with the type I gene is seen around the start of translation. This region contains an inverted repeat which could form a stem-loop structure with a calculated delta G of -30 kcal in the type III collagen mRNA. When compared to the alpha 1(I) and alpha 2(I) signal peptides, the signal peptide of mouse alpha 1(III) collagen presents less homology than when these segments are compared to each other. PMID- 3972848 TI - Specificity of fatty acid acylation of cellular proteins. AB - Labeling of the BC3H1 muscle cell line with [3H] palmitate and [3H]myristate results in the incorporation of these fatty acids into a broad spectrum of different proteins. The patterns of proteins which are labeled with palmitate and myristate are distinct, indicating a high degree of specificity of fatty acylation with respect to acyl chain length. The protein-linked [3H]palmitate is released by treatment with neutral hydroxylamine or by alkaline methanolysis consistent with a thioester linkage or a very reactive ester linkage. In contrast, only a small fraction of the [3H]myristate which is attached to proteins is released by treatment with hydroxylamine or alkaline methanolysis, suggesting that myristate is linked to proteins primarily through amide bonds. The specificity of fatty acid acylation has also been examined in 3T3 mouse fibroblasts and in PC12 cells, a rat pheochromacytoma cell line. In both cells, palmitate is primarily linked to proteins by a hydroxylamine-labile linkage while the major fraction of the myristic acid (60-70%) is linked to protein via amide linkage and the remainder via an ester linkage. Major differences were noted in the rate of fatty acid metabolism in these cells; in particular in 3T3 cells only 33% of the radioactivity incorporated from myristic acid into proteins is in the form of fatty acids. The remainder is presumably the result of conversion of label to amino acids. In BC3H1 cells, palmitate- and myristate-containing proteins also exhibit differences in subcellular localization. [3H]Palmitate labeled proteins are found almost exclusively in membranes, whereas [3H]myristate labeled proteins are distributed in both the soluble and membrane fractions. These results demonstrate that fatty acid acylation is a covalent modification common to a wide range of cellular proteins and is not restricted solely to membrane-associated proteins. The major acylated proteins in the various cell lines examined appear to be different, suggesting that the acylated proteins are concerned with specialized cell functions. The linkages through which fatty acids are attached to proteins also appear to be highly specific with respect to the fatty acid chain length. PMID- 3972850 TI - Intermediates in the replication of kinetoplast DNA minicircles. AB - Kinetoplast DNA of Crithidia fasciculata and other trypanosomatids is in the form of a network of thousands of minicircles and a few dozen maxicircles. Minicircles replicate as free molecules after release from the network, and their progeny subsequently reattach to the network (Englund, P. T. (1979) J. Biol. Chem. 254, 4895-4900). The minicircles just released from the network are covalently closed and apparently completely relaxed. After Cairns-type (theta) replication, the two minicircle progeny have different structures. One has a nascent H (heavy) strand which initially is in the form of 20-110 nucleotide fragments that are separated by gaps (Kitchin, P. A., Klein, V. A., Fein, B. I., and Englund, P. T. (1984) J. Biol. Chem. 259, 15532-15539). The other initially has a full-size (2.5 kilobase) nascent L (light) strand. During the time between formation of these progeny molecules and network reattachment, the nascent L strand is nicked (or gapped) and nascent H strand is partially repaired. Therefore, both progeny, at the time of reattachment, have several nicks (or gaps) in their nascent strand. Minicircle progeny with a nascent L strand reattach to the network quickly, whereas those with a nascent H strand reattach more slowly. Once reattached to the network, the nicks or gaps in the minicircles are repaired until finally covalent closure occurs. PMID- 3972849 TI - Cardiolipin is the membrane receptor for mitochondrial creatine phosphokinase. AB - Treatment of rat heart mitochondria with phosphate or mersalyl releases a number of proteins, including the mitochondrial creatine kinase (mt-CK). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the released proteins showed that phosphate is more selective than mersalyl in releasing mt-CK. The rebinding of mt CK to mitochondria was selectively inhibited by adriamycin, which complexes membrane-bound cardiolipin. mt-CK activity and binding experiments have shown that intact mitochondria are able to bind approximately twice the amount of mt-CK they originally contain. Liver mitochondria bound heart mitochondria mt-CK to the same extent as creatine kinase-depleted heart mitochondria. mt-CK was bound by liposomes but only if they contained cardiolipin. The binding of mt-CK to cardiolipin-containing liposomes was inhibited by adriamycin. Phosphatidylcholine liposomes reconstituted with the purified ADP/ATP translocator failed to bind mt CK. PMID- 3972851 TI - Mental health and female sterilization: a follow-up. Report of a WHO Collaborative prospective study. PMID- 3972852 TI - A survey of a Cambridge suburb: familial resemblances and IQ components. PMID- 3972853 TI - Comparison of ante-natal hospital records with retrospective interviewing. PMID- 3972854 TI - The effects on menstruation of elective tubal sterilization: a prospective controlled study. A report from the UK Field Research Centre of a WHO collaborative project. PMID- 3972855 TI - Birth intervals and women's economic activity. PMID- 3972856 TI - Parental age, parity and sex ratio in births in England and Wales, 1968-77. PMID- 3972857 TI - Demographic and endocrinological aspects of low natural fertility in Highland New Guinea. PMID- 3972858 TI - Socioeconomic status and fertility in rural Bangladesh. PMID- 3972859 TI - Abridged life tables for Pakistan based on the 1971 Population Growth Survey. PMID- 3972860 TI - Examination of the relationship between inbreeding and population size. PMID- 3972861 TI - Chronic posterolateral rotatory instability of the knee. AB - Posterolateral rotatory instability of the knee, usually accompanied by other instabilities, is easily missed, misdiagnosed, and mistreated. The correct diagnosis requires a complete examination of the knee, including both the external rotation-recurvatum and posterolateral drawer tests. The most effective operative approach when the lesion is interstitial or at the site of the femoral attachment consists of advancing the arcuate ligament complex and its osseous attachment anteriorly and distally on the femur to support the arcuate ligament repair. When the lesion is distal and the arcuate ligament attachment to the tibia and fibula is loose, this area must be stabilized. In a consecutive series of 140 patients, 141 knees were reconstructed with this procedure. Ninety-five patients (ninety-six knees), with a follow-up of two to thirteen years, form the basis for this report. Seventy-one of the patients had undergone a combined total of 112 prior operations on the knee without functional recovery. After surgery directed at the arcuate ligament complex, eighty-two knees (85 per cent) were objectively rated as good; thirteen (14 per cent), as fair; and one, as poor. Subjectively, seventy-five (78 per cent) of the patients considered the result to be good; twenty-one (22 per cent), fair; and none, poor. Functionally, seventy seven (80 per cent) of the knees were rated by the patient as good; sixteen (16 per cent), as fair; and three (4 per cent), as poor. This is the first report on the long-term results of reconstruction of the arcuate ligament complex for the correction of chronic posterolateral rotatory instability. The results demonstrate the effectiveness of the procedure. PMID- 3972862 TI - The results of treatment of acute injuries of the upper thoracic spine with paralysis. AB - We studied the cases of 218 patients who had had trauma to the upper region of the thoracic spine (first to tenth thoracic vertebra) that resulted in paralysis. Of these, 184 patients had a complete and thirty-four had an incomplete lesion of the spinal cord. Of the 184 patients who had a complete lesion of the spinal cord, none of the 149 patients who were followed for two to fifteen years recovered any significant neurological function, regardless of the type of operative or non-operative treatment. Thirty of the patients with an incomplete lesion of the spinal cord were followed for two to twenty years. Three others were lost to follow-up, and one died with ascending necrosis of the spinal cord and pulmonary failure three months after the laminectomy. Of the remaining thirty patients, twenty-three had an anterior cord syndrome, four had a central cord syndrome, and three had a Brown-Sequard syndrome. Five patients with an incomplete lesion were treated without surgery. Three of these patients recovered the ability to walk while two recovered some function but were still not able to walk. Seventeen patients with an incomplete lesion of the spinal cord were treated by laminectomy. Of these patients, two also had cord-cooling, two had a posterior fusion, and one had cord-cooling, spine fusion, and posterior instrumentation with Harrington rods. Five patients recovered partial ability to walk with braces, four did not, and eight lost neurological function or became completely paraplegic after surgery and did not recover. Eight patients with an incomplete lesion of the spinal cord were treated with anterior transthoracic decompression and fusion, three of whom had had a previous laminectomy that had not improved their status. Five patients recovered the ability to walk without aids, two walked with braces, and one recovered some motor function but was not able to walk. From this study, we concluded that laminectomy is contraindicated for incomplete lesions of the upper region of the thoracic spinal cord and that anterior transthoracic decompression and fusion offers the best chance of recovery of neurological function. PMID- 3972863 TI - The coracoid transfer for recurrent anterior instability of the shoulder in adolescents. AB - Thirty-six shoulders with recurrent anterior dislocation or subluxation in thirty four adolescent patients were treated with a modified Bristow procedure. The average length of follow-up was five years and ten months. Postoperatively, two patients had recurrent anterior subluxation on one occasion and none had recurrent anterior dislocation. The average loss of external rotation was 10 degrees. Despite the fact that young patients have a high rate of recurrence after anterior dislocation or subluxation of the shoulder, the modified Bristow procedure is an effective method of treating recurrent anterior instability of the shoulder in adolescents. PMID- 3972864 TI - Aseptic loosening in metal-backed acetabular components for total hip replacement. A minimum five-year follow-up. AB - We reviewed the cases of thirty-six patients who had forty cemented total hip replacements with the Harris metal-backed acetabular component. The operations were done between 1972 and 1977, and the duration of follow-up averaged 7.6 years (range, five to 10.8 years). The average age of the patients was forty-four years (range, sixteen to sixty-two years). Aseptic loosening of the acetabular component occurred in three hips (7.5 per cent), and three more sockets were revised for other reasons. Two of the three sockets with aseptic loosening were in the fifteen patients (seventeen hips) who were forty-five years old or younger. The remaining loose cup was in one of the twenty-one patients (twenty three hips) who were forty-six years old or older. The reduction in the rate of aseptic loosening of the socket in our series, compared with the higher rates reported in similar long-term studies in which other acetabular components were used, supports the conclusion that there is enhanced longevity of acetabular fixation when a metal-backed acetabular component is used in cemented total hip arthroplasty. PMID- 3972865 TI - Rupture of the distal tendon of the biceps brachii. Operative versus non operative treatment. AB - We did Cybex testing of thirteen patients who had had a rupture of the distal tendon of the biceps brachii. The tests were performed fifteen months to six years after injury. The ten patients who had had a surgical repair through the two-incision technique showed a return to normal levels of strength and endurance with regard to both flexion of the elbow and supination of the forearm. The three patients who had had conservative treatment showed a remaining deficit in those parameters which was clinically evident in several activities, such as use of a screwdriver or baseball bat. PMID- 3972866 TI - Rupture of the distal tendon of the biceps brachii. A biomechanical study. AB - In biomechanical studies on ten patients who had had a rupture of the distal tendon of the biceps brachii, we compared the results of immediate anatomical reattachment, delayed reattachment, and conservative treatment. When the tendon was simply attached to the brachialis muscle (one patient), there was nearly normal strength in elbow flexion but about 50 per cent loss of forearm supination. Late reinsertion (one patient) improved strength of both flexion and supination, but not to normal. Immediate reattachment (four patients) restored normal strength in flexion and supination at one year but not at four months (one patient). With conservative treatment (three patients) there was a mean loss of 40 per cent of supination strength and variable loss of flexion strength, averaging 30 per cent. These data suggest that immediate surgical reinsertion of the biceps tendon into the radial tuberosity, compared with other modes of treatment, restores more strength of flexion and supination. PMID- 3972867 TI - Complications of scaphoid silicone arthroplasty. AB - Between 1971 and 1982, thirty-three patients underwent scaphoid silicone arthroplasty, and twenty-three of them were available for review after an average of three years of follow-up. Radiographically, there was evidence of carpal collapse with a progressive decrease in carpal height and a progressive increase in the scapholunate angle in thirteen wrists. Subluxation of the spacer occurred in thirteen patients, and nine of them also had dislocation of the trapezial stem. Clinically, grip strength did not improve and wrist motion increased only slightly. There were complaints of pain associated with subluxation of the spacer in more than half of the patients. Ten patients, eight of whom had a subluxated spacer, underwent thirteen secondary surgical procedures. PMID- 3972868 TI - The natural history of scaphoid non-union. A review of fifty-five cases. AB - We reviewed the cases of fifty-six scaphoid non-unions in fifty-five patients, none of whom had received treatment of any kind before examination. In the thirty two patients who had been injured five years or more earlier, arthritis developed in thirty-one (97 per cent). The one patient in whom osteoarthritis developed less than four years after injury also had avascular necrosis of the scaphoid. The incidence of osteoarthritis increased with time after injury. We concluded that patients with established scaphoid non-union should be advised that osteoarthritis will most likely develop. PMID- 3972869 TI - The pressure distribution under tourniquets. AB - We measured the detailed pressure distribution under pneumatic tourniquets and Esmarch bandages in canine limbs. The results showed that pressure concentration can occur in the tissue under the tourniquet. The Esmarch-bandage tourniquet was shown to be capable of producing pressures in excess of 1000 millimeters of mercury immediately beneath the tourniquet. There is a wide variation between cuff pressure and the pressures in the underlying tissues. PMID- 3972870 TI - The use of Ender nails in fractures of the tibial shaft. AB - Between November 1979 and January 1983, we treated fifty-one severe fractures of the tibial shaft with multiple intramedullary Ender nails. Thirty-six fractures were treated within two weeks after injury. Forty-one fractures united in less than four months and eight, in four to eight months. Only two were not united after eight months. An anatomical reduction was maintained in all but three of the fractures, in which the tibia shortened. Two tibiae united with an angulation of 7 degrees and one with 6 degrees, as measured in two planes. There were two infections, both after an open fracture. It has been our experience that Ender nails provide excellent rotational stability, allow early full weight-bearing, and markedly decrease the duration of need for immobilization. Ender nailing was of value both for the acute management of complicated high-energy fractures of the tibial shaft with extensive soft-tissue damage and as a salvage procedure to maintain reduction of a fracture when other techniques had failed. PMID- 3972871 TI - Ultrastructural modifications of proteoglycans coincident with mineralization in local regions of rat growth plate. AB - We carried out histochemical and electron-microscopic studies to examine the relationship between mineral deposition and changes in the organization of proteoglycans during mineralization in the cartilaginous growth plate of the rat. To preserve the distribution and organization of proteoglycans in the extracellular matrix and to stain proteoglycans, acridine orange was included in the solutions that were used for fixation and demineralization. In undecalcified sections, mineral crystals that initially appeared at the level of the penultimate hypertrophic chondrocyte grew into dense, spherical mineral clusters, roughly one micrometer in diameter, in the longitudinal septa of the lowermost hypertrophic zone. Following the removal of mineral with EDTA in the presence of acridine orange, proteoglycan structures with a characteristic rosette-like architecture were revealed within the matrix of the longitudinal septa of the lower hypertrophic zone. The location of these rosette-like proteoglycan structures was identical to that of the dense, spherical mineral clusters in the undemineralized controls, and they were remarkably similar in morphology and size. In the electron micrographs stained with uranyl acetate and lead citrate, the greatly increased density of the rosette-like structures and large diameter of the proteoglycan structures located in mineral clusters contrasted sharply with the slender strands of more faintly stained proteoglycan that was diffusely distributed throughout most of the extracellular matrix. X-ray microprobe analysis for sulphur confirmed the existence of proteoglycans in the rosette-like structures and demonstrated that the concentration of proteoglycans was selectively increased in these regions. The cores of the metaphyseal calcified cartilage also exhibited rosette-like proteoglycan structures, which before demineralization were totally obscured by the diffuse, dense homogeneous deposition of mineral. Without stabilization of the proteoglycans in the extracellular matrix with acridine orange, the rosette-like proteoglycan structures could not be demonstrated. These results clearly indicate that there is a selective increase in the concentration of proteoglycans in exactly the same regions where mineral clusters are formed in the hypertrophic zone of the cartilaginous growth plate. PMID- 3972872 TI - Fractures of long bones previously treated for Ewing's sarcoma. AB - Patients with Ewing's sarcoma of a long bone who survive for two years from the time of diagnosis and have been treated with irradiation and chemotherapy have a significant risk of fracture of the involved segment of bone. In our experience, this risk is especially high when the humerus or femur is involved. Healing of these fractures is not normal, and our data suggest that early or even prophylactic internal fixation and bone-grafting may be indicated. PMID- 3972873 TI - Giant metacarpal osteoma. A case report. PMID- 3972874 TI - Transient osteoporosis of the hip. A case report and review of the literature. PMID- 3972875 TI - Little League shoulder syndrome: proximal humeral epiphyseolysis in adolescent baseball pitchers. A case report. PMID- 3972876 TI - Neck fractures of femoral prostheses. A report of two cases. PMID- 3972877 TI - Management of the upper extremity in cerebral palsy. PMID- 3972878 TI - Postoperative toxic shock syndrome following osteoplasty of the hip. A case report. PMID- 3972879 TI - Spontaneous rupture of the extensor mechanism causing ulnar dislocation of the long extensor tendon of the long finger. Two case reports. PMID- 3972880 TI - Carcinogenesis by oxygenated nitrosomethylpropylamines in Syrian hamsters. AB - Three oxygenated propylnitrosomethylamines were administered to female Syrian hamsters at doses similar to those which had induced high incidences of esophageal neoplasms in rats. Nitrosomethyl-2-oxopropylamine (NMOP) given at the rate of 2 mg/animal/week, whether as one application of 2 mg or two applications of 1 mg, led to early death of the animals, mostly with liver neoplasms; administration of 1 mg/animal/week led to longer survival, but most animals died with both liver neoplasms and neoplasms of the nasal mucosa. Only one hamster treated with NMOP had a neoplasm of the pancreatic duct. Of the 14 hamsters treated with the higher dose of nitrosomethyl-2-hydroxypropylamine (NMHP) and surviving beyond 6 weeks, most had liver neoplasms and nine had neoplasms of the pancreatic ducts. At the lower dose of NMHP, most hamsters developed neoplasms of the nasal mucosa, as did those receiving the same dose of NMOP, and seven animals had hemangioendothelial tumors of the liver, but only one animal had a carcinoma of the pancreatic duct. Nitrosomethyldihydroxypropylamine (NMDHP) was a much weaker carcinogen than the other two compounds and induced mainly neoplasms of the nasal mucosa, with little shortening of life. PMID- 3972881 TI - Influence of a prolonged treatment with disulfiram and D-penicillamine on nitrosodiethylamine-induced biological and biochemical effects. II. Investigations on trace elements in the liver. AB - The influence of a 28-week treatment with disulfiram (DSF), D-penicillamine (PA), and nitrosodiethylamine (NDEA), as well as with a combination of DSF or PA with NDEA on the concentrations of eight essential trace elements in the whole liver tissue of rats was measured by means of neutron activation analysis. While NDEA treatment lowered the Zn content of the liver, DSF alone or in combination with NDEA enhanced the Zn and Se concentration by 50%-80%. Co, Cu, and Cd levels were increased by factors of 10, 60, and 110, respectively. The Mo concentration was decreased by 50% after DSF administration. PA reduced Cu, Co, and Zn in the liver. PA/NDEA treatment also lowered Cu, Co, and Zn content, but there was no strengthening effect of PA on the decrease in Zn observed with NDEA. The change of trace element concentrations, especially of Cu, is discussed with regard to the observed tumor induction in the liver, which tended to be increased by a combined NDEA/PA administration compared with NDEA treatment alone, whereas a protective action of DSF against NDEA induced liver tumors could not be established. PMID- 3972883 TI - Blockage of the hepatic-artery blood flow by biodegradable microspheres (Spherex) combined with local hyperthermia in the treatment of experimental liver tumors in rats. AB - The effect of local hyperthermia and a simultaneous blockage of the hepatic artery blood flow by degradable starch microspheres (Spherex) was studied in a model of liver cancer in Wistar rats. Six days after each rat was inoculated with a cell suspension (NGW) in the central liver lobe, the rats were randomly allocated into four groups. The first group served as control, the second was treated with hyperthermia, the third by degradable starch microspheres (DSM) intraarterially, and the fourth with a combination of hyperthermia and DSM intraarterially. Tumor volumes were measured at laparotomy on days 0, 7, and 14. Temperature fluctuations in the tumor correlated well with those in the liver tissue, but were 2 degrees-4 degrees higher. The infusion of DSM did not change the pattern significantly. The tumor volumes were homogeneous between the groups at the start of treatment. The tumor growth was significantly reduced compared with the control group at day 7 in group III (P less than 0.05) and group IV (P less than 0.01) but only in group IV at day 14 (P less than 0.05). No differences in survival were found. Local hyperthermia concurrent with a blockage of the nutritional tumor blood flow seems to offer a more prominent and lasting tumor growth inhibition. PMID- 3972882 TI - Some properties of Bomirski Ab amelanotic melanoma cells, which underwent spontaneous melanization in primary cell culture. Growth kinetics, cell morphology, melanin content and tumorigenicity. AB - Four types of the Bomirski Ab amelanotic melanoma primary cell culture, differing in the presence of calf serum in the medium and in the cell number used for starting the culture, were employed in the study. In all types of cell culture, rapid melanization occurred in the cytoplasm of the cultured cells. Calf serum in the culture medium stimulated both melanization and proliferation of the Ab melanoma cells. The process of melanin synthesis occurred during the logarithmic phase of growth and was over when the cells reached the plateau phase. Heavily melanized cells changed their adhesive properties, lost the ability to divide in vitro, and showed decreasing tumorigenicity down to complete absence, though they retained some parameters of viability. The rate of melanin synthesis was lower in the cells cultured at high cell density than in those at low cell density. Highly melanized cells that did not divide in vitro but were still tumorigenic in vivo caused the growth of tumors whose morphology was typical for the amelanotic melanoma, melanin being absent. In conclusion, it may be stated that the present findings suggest the persistence of a highly anaplastic and malignant phenotype of Bomirski amelanotic melanoma, being a result of the regulatory action of the host, while the change in the phenotype in vitro does not rule out autoregulatory influences of the tumor itself on its differentiation level and malignancy. PMID- 3972884 TI - Sodium intake and gastric cancer. AB - To test the hypothesis that excessive intake of sodium chloride is a factor in gastric carcinogenesis, urinary excretion of sodium and creatinine was measured in Colombian subjects. Age, sex, weight, and height regression slopes for creatinine excretion were more similar in Colombia than in other countries. Sodium/creatinine (S/C) ratios correlated with 24-h urinary excretion of sodium revealed higher sodium excretion in populations with higher gastric cancer rates. The S/C ratios were not affected by circadial rhythms, making it possible to use single urine samples to investigate interpopulation differences in sodium excretion. PMID- 3972885 TI - Proliferative pattern of urothelial bladder cancer and urothelial atypias. AB - For early diagnosis of urinary bladder tumors, autoradiographic, cytological, and impulse cytophotometric examinations were performed on fresh bladder tissue with carcinomas of different grades of malignancy and various depths of infiltration, and also on tissues with concomitant urothelial atypias. Cell kinetic examinations of urothelial atypias of mild, moderate, and severe grade revealed labeling indices comparable to those of urothelial carcinomas grade I, II, and III, respectively. The labeling indices of the carcinomas increased with both the grades of malignancy and the depth of invasion up to factor 5. Cytophotometrically mild atypias showed euploidy, while moderate to severe atypias revealed aneuploidy. By means of cytologic, cytophotometric, and cell kinetic analyses, two subgroups of G I urothelial carcinomas were distinguished. Subgroup I a corresponded to highly differentiated papillary urothelial carcinomas with low labeling indices, pap I-III differentiation, and euploidy. Subgroup I b, on the other hand, revealed pap differentiations of IV-V, aneuploidy, and higher labeling indices. This subgroup seems to be more prone to recurrences and apparently indicates higher grades of malignancy and depths of infiltration. The data presented provide evidence that a combination of these methods is helpful for early recognition of precursors of bladder cancer atypias as well as for exact evaluation of the biological potential of carcinomas. PMID- 3972886 TI - Selective induction of nasal cavity tumors in rats by diallylnitrosamine. AB - Weekly intragastric administration of 20, 40, and 80 mg/kg body weight diallylnitrosamine to BD IX rats selectively induced nasal and paranasal cavity tumors with incidences of 30%, 85%, and 65% in females and of 0%, 75%, and 80% in males, respectively. All tumors were carcinomas of the olfactory region, and 95% were invasive. Only a few papillomas in the anterior region were found simultaneously with the carcinomas. PMID- 3972887 TI - Alcohol and cancer in male Japanese physicians. AB - The relationship between alcohol and site-specific cancers was investigated in a follow-up study of 5,139 male Japanese physicians. Information on drinking habits was obtained by mail questionnaire in 1965, and cancer deaths over 12.7 years were analyzed with drinking habits classified into five categories; nondrinker, ex-drinker, occasional drinker, and daily drinker whose intake of alcohol was equivalent to less than 2 or 2 and more go of sake (1 go sake congruent to 27 ml alcohol). Both age and smoking habits were taken into account in the calculation of death rates based on man-years at risk. Logistic regression analysis was also performed on cummulative mortality data. Upper aerodigestive cancer was strongly associated with alcohol consumption, giving some confidence in the validity of the present study. Excluding ex-drinkers, the risk of stomach cancer and liver cancer was gradually increased from nondrinkers to daily drinkers with lower intake of alcohol, but no further increase was noted for daily drinkers with larger consumption. Logistic regression did not show any significant associations between drinking habits and these two cancers, but the number of deaths from liver cancer was still small. Not particular patterns were observed for cancers of the large bowel and lung. PMID- 3972888 TI - Influence of a prolonged treatment with disulfiram and D(-)penicillamine on nitrosodiethylamine-induced biological and biochemical effects in rats. I. Investigations on the drug metabolizing system. AB - The influence of a prolonged treatment with disulfiram (DSF) and D( )penicillamine (PA) on biological and biochemical effects induced by nitrosodiethylamine (NDEA) was studied in rats. The combination of NDEA and DSF led to a massive and early development of esophageal tumors, which were fatal to the animals. No liver tumors were observed in this group, whereas PA in combination with NDEA led to an increased development of liver tumors compared with NDEA alone. In the last two groups, only incidental tumors of the esophagus were observed. Nasal cavity tumors also appeared earlier in the animals treated with DSF and NDEA than in animals treated with NDEA alone or with NDEA plus PA. At a biochemical level, DSF led to a significant inhibition of hepatic anilinehydroxylase and nitroso-dimethylaminedemethylase in contrast to PA, which had no influence on these enzymes. The reduced activities of these drug metabolizing enzymes did not appear to be related to gross cytochrome P450 content. Highly significant increases in glutathione content and glutathione-S transferase activity (GSH/GST) were induced by DSF but not by PA. Because N nitrosodiethylamine requires enzymatic activation to form the ultimate carcinogen, it is suggested that the observed inhibition of nitrosamine transforming enzymes in the liver during DSF treatment leads to an increased amount of intact nitrosamines in other organs, e.g., in the esophagus, where it could be transformed to the ultimate carcinogen. DSF treatment alone or in combination with NDEA leads to an accumulation of trace elements in the liver, whereas PA eliminated copper and cobalt. The possible influence of these elements on tumor development is discussed in part II of this study. PMID- 3972889 TI - Immunochemical demonstration that amino acids 360-377 of the acetylcholine receptor gamma-subunit are cytoplasmic. AB - Two monoclonal antibodies (mabs) previously prepared against Torpedo acetylcholine receptor are shown to recognize a synthetic nonadecapeptide corresponding to lys360-glu377 of the gamma subunit. The reaction was demonstrated by solid-phase enzyme-linked immunoabsorbent assays, by inhibition of binding of the mabs to receptor, and by immunoprecipitation of the peptide conjugated to bovine serum albumin. Immunogold electron microscopy on isolated postsynaptic membranes from Torpedo showed that both mabs bind to intracellular epitopes on the receptor. These results establish that amino acid residues 360 377 of the receptor gamma-subunit, and probably the analogous region of the delta subunit, reside on the cytoplasmic side of the membrane. Since the primary structures of all four subunits suggest a common transmembrane arrangement, the corresponding domains of the alpha- and beta-subunits are probably also cytoplasmic. PMID- 3972890 TI - Mutations in the cytoplasmic domain of the influenza virus hemagglutinin affect different stages of intracellular transport. AB - Mutations have been introduced into the cloned DNA sequences coding for influenza virus hemagglutinin (HA), and the resulting mutant genes have been expressed in simian cells by the use of SV40-HA recombinant viral vectors. In this study we analyzed the effect of specific alterations in the cytoplasmic domain of the HA molecule on its rate of biosynthesis and transport, cellular localization, and biological activity. Several of the mutants displayed abnormalities in the pathway of transport from the endoplasmic reticulum to the cell surface. One mutant HA remained within the endoplasmic reticulum; others were delayed in reaching the Golgi apparatus after core glycosylation had been completed in the endoplasmic reticulum, but then progressed at a normal rate from the Golgi apparatus to the cell surface; another was delayed in transport from the Golgi apparatus to the plasma membrane. However, two mutants were indistinguishable from wild-type HA in their rate of movement from the endoplasmic reticulum through the Golgi apparatus to the cell surface. We conclude that changes in the cytoplasmic domain can powerfully influence the rate of intracellular transport and the efficiency with which HA reaches the cell surface. Nevertheless, absolute conservation of this region of the molecule is not required for maturation and efficient expression of a biologically active HA on the surface of infected cells. PMID- 3972892 TI - Rates of diffusion of fluorescent molecules via cell-to-cell membrane channels in a developing tissue. AB - Diffusion coefficients for the intercellular movement of fluorescent tracers have been measured in the epidermis of a larval beetle. Fluorescent tracer was injected into a cell and the spread of tracer from cell to cell in this monolayer was recorded by a TV camera. Fluorescence intensities were digitized from the TV images at successive times after the start of injection at various distances from the source by a microcomputer interfaced with a video analyzer. From the relationship between concentration (measured as light intensity), time and distance, an effective diffusion coefficient (De) is calculated for the tracer in the tissue. In newly ecdysed epidermis, De for carboxyfluorescein (CF) is 2.7 X 10(-7) cm2/s, and De for lissamine rhodamine B (LRB) is 1.2 X 10(-7) cm2/s, whereas in intermolt epidermis the De's for CF and LRB are 3.7 X 10(-7) and 1.2 X 10(-7) cm2/s, respectively. These diffusion coefficients are only an order of magnitude lower than their values in water. The ratio of De for the two tracers at these two stages of development differs from the ratio predicted in cytoplasm alone, with the movement of the slightly larger molecule (LRB) being impeded relative to that of the smaller molecule (CF). This suggests that the properties of the membrane channels amplify differences in the rates of movement of molecules of similar size. This may be important during cell patterning in development. De for CF was also monitored as junctional resistance was increased in the epidermis. During 30 min of exposure to 0.25 mM chlorpromazine, De dropped to 20% of its initial value of 5 X 10(-7) cm2/s, implying that the junctional membrane, rather than cytoplasm, is the major barrier to molecular diffusion among the cells. PMID- 3972891 TI - Isolation of an actin-binding protein from membranes of Dictyostelium discoideum. AB - We prepared a probe of radiolabeled, glutaraldehyde cross-linked filamentous actin (F-actin) to study binding of actin to membranes of Dictyostelium discoideum. The probe bound to membranes or detergent extracts of membranes with a high affinity and in a saturable manner. The binding could be reduced by boiling of either the actin probe or the membranes, or by addition of excess native F-actin, but not by addition of an equivalent amount of bovine serum albumin, to the assay. The probe labeled several proteins when used to overlay sodium dodecyl sulfate gels of Dictyostelium membranes. One of these labeled proteins was a 24,000-mol-wt protein (p24), which was soluble only in the presence of a high concentration of sodium deoxycholate (5%, wt/vol) at room temperature or above. The p24 was purified by selective detergent extraction and column chromatography. When tested in a novel two-phase binding assay, p24 bound both native monomeric actin (G-actin) and F-actin in a specific manner. In this assay, G-actin bound p24 with a submicromolar affinity. PMID- 3972893 TI - Effect upon mitogenic stimulation of calcium-dependent phosphorylation of cytoskeleton-associated 350,000- and 80,000-mol-wt polypeptides in quiescent 3Y1 cells. AB - Rabbit antiserum raised against highest molecular weight microtubule-associated protein (MAP-1) of brain immunoprecipitated 350,000-, 300,000-, and 80,000-mol-wt phosphoproteins of rat embryo fibroblasts (3Y1-B). The 350,000-mol-wt protein was sensitive to heat as was brain MAP-1, but the 300,000- and 80,000-mol-wt proteins were not. These polypeptides were hardly phosphorylated in cells in the quiescent G0 phase but were rapidly phosphorylated after addition of serum, epidermal growth factor, phorbol ester, insulin, or transferrin in the presence of calcium ions. All these agents also induced incorporation of [3H]-thymidine into DNA. These polypeptides were detected in isolated microtubules and cold-resistant filaments by immunoblotting. Since the 350,000-mol-wt polypeptide was detected in the membrane, the cytoskeletons, and the nucleus, and has been suggested to function as a linker, its rapid phosphorylation might represent an early process in transduction of the signal of mitogenic stimulation to the nucleus. PMID- 3972894 TI - Antibodies against a lysosomal membrane antigen recognize a prelysosomal compartment involved in the endocytic pathway in cultured prolactin cells. AB - Antibodies against a lysosomal membrane antigen (A-Ly-M) have recently been obtained and characterized (Reggio, H., D. Bainton, E. Harms, E. Coudrier, and D. Louvard, 1984, J. Cell Biol., 99:1511-1526). They recognize a 100,000-mol-wt antigen immunologically related to a purified [H+,K+]ATPase from pig gastric mucosa. In the present study, we have localized this antigen during adsorptive endocytosis in rat prolactin cells in culture using cationized ferritin (CF) as a tracer. CF was rapidly internalized (after 5 min) in coated pits and vesicles that were labeled by antibodies against clathrin. The tracer was then delivered (after 15 min) to vacuoles and multivesicular bodies. These structures were labeled with A-Ly-M. These organelles were devoid of acid phosphatase activity. At later stages (after 30 min) CF was observed within larger structures that were strongly stained by A-Ly-M and displayed a strong acid phosphatase activity. These findings clearly indicate that A-Ly-M react with prelysosomal and lysosomal compartments involved in the endocytic pathway in cultured prolactin cells. The membrane of these structures therefore contains antigenic determinant(s) related to the 100,000-mol-wt polypeptide. Our results suggest that the prelysosomal structure stained by A-Ly-M may represent in GH3 cells the acidic prelysosomal compartment recently described in the early steps of endocytosis in other cell types (Tycko, B., and F. R. Maxfield, 1982, Cell, 28:643-651). PMID- 3972895 TI - Interaction of the sperm adhesive protein, bindin, with phospholipid vesicles. I. Specific association of bindin with gel-phase phospholipid vesicles. AB - Bindin is a 30,000-mol-wt protein of sea urchin sperm that is responsible for the specific adhesion of the sperm acrosomal process to the vitelline layer covering the egg plasma membrane during fertilization. Sulfated glycoconjugates are believed to be the egg surface receptors for bindin, but the mechanism by which bindin associates with the sperm acrosomal membrane is unknown. Here I report that bindin specifically associates with phospholipid vesicles in vitro. Interaction of the bindin polypeptide with liposomes was found to cause an increase in the density of the liposomes and induce the aggregation of the vesicles. A novel property of this association of bindin with membranes was that it required phospholipids in a gel phase. The interaction of bindin with liposomes was greatly reduced at temperatures above the phase transition temperature. The interaction of bindin with gel-phase vesicles appeared to be reversible, since the aggregated vesicles dissaggregated as the temperature was raised above the phase transition temperature. Association of bindin with the bilayer did not alter the accessibility of the polypeptide to cleavage by trypsin, which suggests that most of the polypeptide chain remains exposed at the surface of the membrane. PMID- 3972896 TI - Interaction of the sperm adhesive protein, bindin, with phospholipid vesicles. II. Bindin induces the fusion of mixed-phase vesicles that contain phosphatidylcholine and phosphatidylserine in vitro. AB - Bindin from sea urchin sperm associates with gel-phase phospholipid bilayers (Glabe, C. G., 1985, J. Cell Biol., 100:794-799). Bindin also interacts with phospholipid vesicles containing both gel-phase and fluid-phase domains and thereby induces their aggregation. Association of bindin with vesicles containing gel-phase domains of dipalmitoylphosphatidylcholine (DPPC) and fluid-phase domains of brain phosphatidylserine (PS) was found to result in the fusion of the vesicles. After incubation with bindin, these mixed-phase vesicles were much larger as determined by gel filtration chromatography and electron microscopic observations of negatively stained samples. The average diameter of the vesicles after incubation was 190 +/- 109 nm compared with 39 +/- 20 nm for vesicles incubated in the absence of bindin. Resonance energy transfer studies also indicated that bindin induces the fusion of vesicle bilayers. Two fluorescent probes (NBD-PE and Rh-PE) were incorporated into the membrane of mixed-phase DPPC:PS vesicles at a density of 0.5 mol%, where efficient energy transfer occurs between the probes. The efficiency of energy transfer was proportional to the concentration of the fluorescence energy acceptor in the bilayer. The fluorescent vesicles were mixed with an excess of unlabeled target vesicles to quantify fusion. After bindin addition, there was a significant decrease in the efficiency of energy transfer compared with controls incubated in the absence of bindin. Although bindin induced the fusion of vesicles in the absence of calcium, the rate of fusion in the presence of 2 mM calcium was three-fourfold higher. In the presence of calcium, approximately half of the vesicles in the population had fused with another vesicle after incubation with bindin for 20 min. Bindin did not induce the fusion of gel-phase DPPC vesicles or mixed-phase vesicles of DPPC and dioleoylphosphatidylcholine, which suggests that the fusagenic activity of bindin requires specific phospholipids. Electron microscopic observations of DPPC:PS vesicles incubated in the presence of bindin suggest that the outer leaflets of bindin-aggregated vesicles are in close apposition. This is believed to be an important initial event for membrane fusion. These observations suggest that bindin may play a dual role in fertilization: Bindin mediates the attachment of sperm to glycoconjugate receptors of the egg surface and may also participate in the fusion of the sperm and egg plasma membranes. PMID- 3972897 TI - A smooth muscle-specific monoclonal antibody recognizes smooth muscle actin isozymes. AB - Injection of chicken gizzard actin into BALB/c mice resulted in the isolation of a smooth muscle-specific monoclonal antibody designated CGA7. When assayed on methanol-Carnoy's fixed, paraffin-embedded tissue, it bound to smooth muscle cells and myoepithelial cells, but failed to decorate striated muscle, endothelium, connective tissue, epithelium, or nerve. CGA7 recognized microfilament bundles in early passage cultures of rat aortic smooth muscle cells and human leiomyosarcoma cells but did not react with human fibroblasts. In Western blot experiments, CGA7 detected actin from chicken gizzard and monkey ileum, but not skeletal muscle or fibroblast actin. Immunoblots performed on two dimensional gels demonstrated that CGA7 recognizes gamma-actin from chicken gizzard and alpha- and gamma-actin from rat colon muscularis. This antibody was an excellent tissue-specific smooth muscle marker. PMID- 3972898 TI - Phorbol esters and horseradish peroxidase stimulate pinocytosis and redirect the flow of pinocytosed fluid in macrophages. AB - Lucifer Yellow CH (LY) is an excellent probe for fluid-phase pinocytosis. It accumulates within the macrophage vacuolar system, is not degraded, and is not toxic at concentrations of 6.0 mg/ml. Its uptake is inhibited at 0 degree C. Thioglycollate-elicited mouse peritoneal macrophages were found to exhibit curvilinear uptake kinetics of LY. Upon addition of LY to the medium, there was a brief period of very rapid cellular accumulation of the dye (1,400 ng of LY/mg protein per h at 1 mg/ml LY). This rate of accumulation most closely approximates the rate of fluid influx by pinocytosis. Within 60 min, the rate of LY accumulation slowed to a steady-state rate of 250 ng/mg protein per h which then continued for up to 18 h. Pulse-chase experiments revealed that the reduced rate of accumulation under steady-state conditions was due to efflux of LY. Only 20% of LY taken into the cells was retained; the remainder was released back into the medium. Efflux has two components, rapid and slow; each can be characterized kinetically as a first-order reaction. The kinetics are similar to those described by Besterman et al. (Besterman, J. M., J. A. Airhart, R. C. Woodworth, and R. B. Low, 1981, J. Cell Biol. 91:716-727) who interpret fluid-phase pinocytosis as involving at least two compartments, one small, rapidly turning over compartment and another apparently larger one which fills and empties slowly. To search for processes that control intracellular fluid traffic, we studied pinocytosis after treatment of macrophages with horseradish peroxidase (HRP) or with the tumor promoter phorbol myristate acetate (PMA). HRP, often used as a marker for fluid-phase pinocytosis, was observed to stimulate the rate of LY accumulation in macrophages. PMA caused an immediate four- to sevenfold increase in the rate of LY accumulation. Both HRP and PMA increased LY accumulation by stimulating influx and reducing the percentage of internalized fluid that is rapidly recycled. A greater proportion of endocytosed fluid passes into the slowly emptying compartment (presumed lysosomes). These experiments demonstrate that because of the considerable efflux by cells, measurement of marker accumulation inaccurately estimates the rate of fluid pinocytosis. Moreover, pinocytic flow of water and solutes through cytoplasm is subject to regulation at points beyond the formation of pinosomes. PMID- 3972899 TI - Centriole number and the reproductive capacity of spindle poles. AB - The reproduction of spindle poles is a key event in the cell's preparation for mitosis. To gain further insight into how this process is controlled, we systematically characterized the ultrastructure of spindle poles whose reproductive capacity had been experimentally altered. In particular, we wanted to determine if the ability of a pole to reproduce before the next division is related to the number of centrioles it contains. We used mercaptoethanol to indirectly induce the formation of monopolar spindles in sea urchin eggs. We followed individually treated eggs in vivo with a polarizing microscope during the induction and development of monopolar spindles. We then fixed each egg at one of three predetermined key stages and serially semithick sectioned it for observation in a high-voltage electron microscope. We thus know the history of each egg before fixation and, from earlier studies, what that cell would have done had it not been fixed. We found that spindle poles that would have given rise to monopolar spindles at the next mitosis have only one centriole whereas spindle poles that would have formed bipolar spindles at the next division have two centrioles. By serially sectioning each egg, we were able to count all centrioles present. In the twelve cells examined, we found no cases of acentriolar spindle poles or centriole reduplication. Thus, the reproductive capacity of a spindle pole is linked to the number of centrioles it contains. Our experimental results also show, contrary to existing reports, that the daughter centriole of a centrosome can acquire pericentriolar material without first becoming a parent. Furthermore, our results demonstrate that the splitting apart of mother and daughter centrioles is an event that is distinct from, and not dependent on, centriole duplication. PMID- 3972900 TI - Experimental separation of pronuclei in fertilized sea urchin eggs: chromosomes do not organize a spindle in the absence of centrosomes. AB - We tested the ability of chromosomes in a mitotic cytoplasm to organize a bipolar spindle in the absence of centrosomes. Sea urchin eggs were treated with 5 X 10( 6) colcemid for 7-9 min before fertilization to block future microtubule assembly. Fertilization events were normal except that a sperm aster was not formed and the pronuclei remained up to 70 microns apart. After nuclear envelope breakdown, individual eggs were irradiated with 366-nm light to inactivate photochemically the colcemid. A functional haploid bipolar spindle was immediately assembled in association with the male chromosomes. In contrast to the male pronucleus, the female pronucleus in most of these eggs remained as a small nonbirefringent hyaline area throughout mitosis. High-voltage electron microscopy of serial semithick sections from individual eggs, previously followed in vivo, revealed that the female chromosomes were randomly distributed within the remnants of the nuclear envelope. No microtubules were found in these pronuclear areas even though the chromosomes were well-condensed and had prominent kinetochores with well-developed coronas. In the remaining eggs, a weakly birefringent monaster was assembled in the female pronuclear area. These observations demonstrate that chromosomes in a mitotic cytoplasm cannot organize a bipolar spindle in the absence of a spindle pole or even in the presence of a monaster. In fact, chromosomes do not even assemble kinetochore microtubules in the absence of a spindle pole, and kinetochore microtubules form only on kinetochores facing the pole when a monaster is present. This study also provides direct experimental proof for the longstanding paradigm that the sperm provides the centrosomes used in the development of the sea urchin zygote. PMID- 3972901 TI - Myosin and paramyosin are organized about a newly identified core structure. AB - Myosin isoforms A and B are differentially localized to the central and polar regions, respectively, of thick filaments in body wall muscle cells of Caenorhabditis elegans (Miller, D. M. III, I. Ortiz, G. C. Berliner, and H. F. Epstein, 1983, Cell, 34:477-490). Biochemical and electron microscope studies of KCl-dissociated filaments show that the myosin isoforms occupy a surface domain, paramyosin constitutes an intermediate domain, and a newly identified core structure exists. The diameters of the thick filaments vary significantly from 33.4 nm centrally to 14.0 nm near the ends. The latter value is comparable to the 15.2 nm diameter of the core structures. The internal density of the filament core appears solid medially and hollow at the poles. The differentiation of thick filament structure into supramolecular domains possessing specific substructures of characteristic stabilities suggests a sequential mode for thick filament assembly. In this model, the two myosin isoforms have distinct roles in assembly. The behavior of the myosins, including nucleation of assembly and determination of filament length, depend upon paramyosin and the core structure as well as their intrinsic molecular properties. PMID- 3972902 TI - The major tyrosine-sulfated protein of the bovine anterior pituitary is a secretory protein present in gonadotrophs, thyrotrophs, mammotrophs, and corticotrophs. AB - The anterior pituitary is a complex secretory tissue known to contain several sulfated macromolecules. In the present study, we identified the major tyrosine sulfated protein of the bovine anterior pituitary and investigated its cellular and subcellular localization. This protein consisted of two tyrosine-sulfated polypeptides of molecular weight 86,000 and 84,000 that were highly homologous to each other. In agreement with previous biochemical studies, the tyrosine-sulfated protein of Mr 86,000/84,000 was found to be secretory, as it was observed in the matrix of secretory granules by immunoelectron microscopy. Immunofluorescence studies indicated that the tyrosine-sulfated, secretory protein of Mr 86,000/84,000, referred to as TSP 86/84, was present in all endocrine cells except for some somatotrophic cells. Higher levels of immunoreactivity for TSP 86/84 were observed in gonadotrophic and thyrotrophic than in mammotrophic and corticotrophic cells. This appeared to result from the occurrence of TSP 86/84 in all secretory granules of the former cells and in only some secretory granules of the latter cells. We discuss the possibility that TSP 86/84 may have a role in the packaging of several distinct peptides hormones into secretory granules. One, though not the only, possible function of tyrosine sulfation may concern the sorting of this protein in the Golgi complex. PMID- 3972903 TI - Assembly of the sea urchin fertilization membrane: isolation of proteoliaisin, a calcium-dependent ovoperoxidase binding protein. AB - Fertilization of the sea urchin egg is accompanied by the assembly of an extracellular glycoprotein coat, the fertilization membrane. Assembly of the fertilization membrane involves exocytosis of egg cortical granules, divalent cation-mediated association of exudate proteins with the egg glycocalyx (the vitelline layer), and cross-linking of the assembled structure by ovoperoxidase, a fertilization membrane component derived from the cortical granules. We have identified and isolated a new protein, which we call proteoliaisin, that appears to be responsible for inserting ovoperoxidase into the fertilization membrane. Proteoliaisin is a 250,000-Mr protein that binds ovoperoxidase in a Ca2+ dependent manner, with half-maximal binding at 50 microM Ca2+. Other divalent cations are less effective (Ba2+, Mn2+, and Sr2+) or ineffective (Mg2+ and Cd2+) in mediating the binding interaction. Binding is optimal over the physiological pH range of fertilization membrane assembly (pH 5.5-7.5). Both proteoliaisin and ovoperoxidase are found in isolated, uncross-linked fertilization membranes. We have identified several macromolecular aggregates that are released from uncross linked fertilization membranes after dilution into divalent cation-free buffer. One of these is an ovoperoxidase-proteoliaisin complex that is further disrupted only upon the addition of EGTA. These results suggest that a Ca2+-stabilized complex of ovoperoxidase and proteoliaisin forms one structural subunit of the fertilization membrane. PMID- 3972904 TI - Cytosolic free calcium-ion concentration in cleaving embryonic cells of Oryzias latipes measured with calcium-selective microelectrodes. AB - Calcium-selective microelectrodes were used to measure the free calcium-ion concentration ([Ca2+]i) in early-cleaving embryonic cells of the golden medaka, Oryzias latipes, a fresh water teleost fish. Embryos could be dechorionated as early as the four-cell stage using a three-step technique consisting of removal of some yolk to enlarge the perivitelline space, partial digestion of the chorion with pancreatin, and removal of the weakened chorion with forceps. Dechorionated embryos underwent cleavage at a normal rate. Intracellular cytosolic [Ca2+]i was monitored by impaling blastomeres first with a microelectrode filled with 5 M potassium acetate to measure membrane potential, and a few minutes later with a calcium-selective microelectrode. During nine rounds of cytokinesis from a total of six different embryos, cytosolic [Ca2+]i remained constant (with apparently random fluctuations of less than +/- 0.1 microM). During two successive cleavages in one embryo, however, [Ca2+]i rose transiently fourfold above the original resting level to 1.32 and 1.20 microM in synchrony with each period of cytokinesis and returned after each rise to submicromolar levels. Because a calcium-selective microelectrode can detect [Ca2+]i changes only in the immediate vicinity of its 2-microns tip, we interpreted these data to suggest that, although [Ca2+]i in most areas of the cytosol remains between 0.01 and 0.40 microM (mean of 0.14 microM), there may be small regions of the cell in which [Ca2+]i undergoes a substantial increase at the time of cleavage. Evidence also is presented to suggest that the membrane potential in these blastomeres undergoes a slow net hyperpolarization during early cleavage stages. PMID- 3972905 TI - Defective temporal and spatial control of flagellar assembly in a mutant of Chlamydomonas reinhardtii with variable flagellar number. AB - Wild-type Chlamydomonas reinhardtii carry two flagella per cell that are used for both motility and mating. We describe a mutant, vfl-1, in which the biflagellate state is disrupted such that the number of flagella per cell ranges from 0 to as many as 10. vfl-1 cells possess the novel ability to assemble new flagella throughout the G1 portion of the cell cycle, resulting in an average increase of about 0.05 flagella per cell per hour. Such uncoupling of the flagellar assembly cycle from the cell cycle is not observed in other mutants with abnormal flagellar number. Rather than being located in an exclusively apical position characteristic of the wild type, vfl-1 flagella can be at virtually any location on the cell surface. vfl-1 cells display abnormally wide variations in cell size, probably owing to extremely unequal cell divisions. Various ultrastructural abnormalities in the flagellar apparatus are also present, including missing or defective striated fibers and reduced numbers of rootlet microtubules. The pleiotropic defects observed in vfl-1 result from a recessive Mendelian mutation mapped to Chromosome VIII. PMID- 3972906 TI - Nile red: a selective fluorescent stain for intracellular lipid droplets. AB - We report that the dye nile red, 9-diethylamino-5H-benzo[alpha]phenoxazine-5-one, is an excellent vital stain for the detection of intracellular lipid droplets by fluorescence microscopy and flow cytofluorometry. The specificity of the dye for lipid droplets was assessed on cultured aortic smooth muscle cells and on cultured peritoneal macrophages that were incubated with acetylated low density lipoprotein to induce cytoplasmic lipid overloading. Better selectivity for cytoplasmic lipid droplets was obtained when the cells were viewed for yellow gold fluorescence (excitation, 450-500 nm; emission, greater than 528 nm) rather than red fluorescence (excitation, 515-560 nm; emission, greater than 590 nm). Nile red-stained, lipid droplet-filled macrophages exhibited greater fluorescence intensity than did nile red-stained control macrophages, and the two cell populations could be differentiated and analyzed by flow cytofluorometry. Such analyses could be performed with either yellow-gold or red fluorescence, but when few lipid droplets per cell were present, the yellow-gold fluorescence was more discriminating. Nile red exhibits properties of a near-ideal lysochrome. It is strongly fluorescent, but only in the presence of a hydrophobic environment. The dye is very soluble in the lipids it is intended to show, and it does not interact with any tissue constituent except by solution. Nile red can be applied to cells in an aqueous medium, and it does not dissolve the lipids it is supposed to reveal. PMID- 3972907 TI - Modulation of the platelet-derived growth factor induced replicative response. AB - Quiescent cultures of density arrested BALB/c-3T3 cells have been sensitized to the growth stimulatory action of the platelet-derived growth factor (PDGF). Sensitization was achieved by depriving the cultures of PDGF prior to growth stimulation and was noted after transfer of cultures from medium supplemented with 10% serum to medium containing either an equivalent concentration of platelet-poor plasma or a low concentration (0.5%) of serum. Sensitized cultures required less pure PDGF for growth stimulation than nonsensitized ones. In addition such cultures required less mitogen to synthesize a PDGF modulated major excreted protein (MEP). The mechanism of sensitization was investigated. Sensitized cultures did not bind more PDGF than non-sensitized ones. Rather, sensitization appeared to result from the loss of cells that occurred when cultures were deprived of PDGF. Such a loss increased the amount of PDGF available per cell, causing a higher percentage of cells to enter the S phase. Similarly, the amount of PDGF per cell regulated MEP synthesis. Furthermore, in non-sensitized cultures (containing the same number of cells), the absolute quantity rather than the concentration of PDGF regulated DNA synthesis. It appears that the amount of PDGF per cell modulates mitogenesis. PMID- 3972908 TI - The deoxyglucose method adapted for studies of glucose metabolism in the early chick embryo. AB - 14C-2-deoxyglucose (DG), currently employed in in vivo studies of brain glucose metabolism, has been used for determination of glucose consumption in the in vitro developing chick embryo. DG, presented in traces, accumulates in the embryo in proportion with incubation time. Analysis of tissue homogenates shows that the accumulated radioactivity is due to both phosphorylated (DGP) and nonphosphorylated DG. As it is only the radioactivity originating from the DGP that is proportional to glucose utilization, the nonphosphorylated DG must be washed out. The washout shows two distinct kinetics: a fast one corresponding to DG that has entered the cells but has not yet been phosphorylated and a slow one that is probably due to a dephosphorylated DGP coming from a different cellular compartment. On the basis of these results the optimal experimental conditions have been defined, allowing quantitative studies of glucose metabolism during the first day of development of the chicken embryo. From 18 to 24 hr of incubation (end of gastrulation), total glucose consumption increases from 50 nmol X h-1 at stage 3-4 to 90 nmol X h-1 at stage 6-7. This increase mainly reflects the growth of the blastodisc. Comparison with the values of O2 uptake measured at the same period of development suggests that only a fraction of the glucose consumed is oxidized, the major part being converted aerobically to lactate. PMID- 3972909 TI - Differential effects of abrin on normal and tumor cells. AB - The effects of the plant toxin abrin on normal mouse embryonic fibroblasts (MEF), an untransformed mouse cell line (NIH 3T3), and two mouse tumor cell lines (LMTK- and S-180) were studied. Measurements of cell growth and colony formation showed that MEF and S-180 cells were more sensitive to abrin intoxication than NIH 3T3 and LMTK- cells. Also, the effects of abrin on the inhibition of [3H]leucine and [3H]thymidine incorporation were more evident in MEF and S-180 cells. The basis for these varying responses to abrin by the four different cells was examined. The number of abrin binding sites per cell was determined from [125I]abrin binding studies: NIH 3T3 and LMTK- cells had significantly fewer abrin binding sites than MEF and S-180 cells. The fate of the [125I]abrin after internalization was examined by gel electrophoresis and autoradiography. A pattern of time dependent degradation was observed, degradation being more rapid in NIH 3T3 and S 180 cells than in LMTK- and MEF cells. We conclude that the varying responses of different cells to the toxin abrin may be due to several factors, including the relative number of abrin binding sites on the cell surface and the rate of degradation of the toxin once internalized. The results also show that the sensitivities of the cells to abrin do not necessarily correlate with their normal or neoplastic state. PMID- 3972910 TI - Selenium deficiency in cultured adrenocortical cells: restoration of glutathione peroxidase and resistance to hydroperoxides on addition of selenium. AB - Cultured bovine adrenocortical cells were previously shown to be functionally deficient in selenium and vitamin E when grown in medium supplemented with fetal bovine serum. In the present experiments, the lack of significant bioavailable amounts of selenium in the medium was demonstrated by the finding of only low levels of glutathione peroxidase in the cultured cells (0.008 U/mg protein compared with 0.045 U/mg protein in fresh adrenocortical tissue). When 20 nM selenium as selenite was added to the cultured adrenocortical cells, glutathione peroxidase activity increased continuously over 72 h, with a total increase of about eightfold over this period. Over the same time-course, the highest concentration of cumene hydroperoxide tolerated by the cells without cell death increased progressively from 10 microM to 50 microM. Addition of 1 microM alpha tocopherol also increased the amount of cumene hydroperoxide tolerated to 50 microM. Cell death was measured by cloning efficiency after removal of cumene hydroperoxide. Addition of either selenium or alpha-tocopherol had little effect on the growth rate of the cells over six passages, even when residual vitamin E was removed from the serum by extraction with ether and residual low molecular weight selenium compounds were removed by dialysis. It is concluded that combined deficiency of selenium and vitamin E, at least in the presence of other components of fetal bovine serum, has little effect on the ability of the cells to survive under normal conditions, as evidenced by continued long-term proliferation. However, the low levels of glutathione peroxidase resulting from selenium deficiency cause an increase susceptibility to peroxide-mediated toxicity. The combined deficiency of selenium and vitamin E impairs the ability of cells to survive under adverse conditions, as well as altering mitochondrial functions, as previously demonstrated. PMID- 3972911 TI - Cell volume regulation of cerebrovascular endothelium in vitro. AB - Regulation of cell volume as a fundamental cellular function of high biological priority was studied in cultured cerebrovascular endothelium. The use of a multiparameter flow cytometric system allowed simultaneous measurements of cell volume, viability, and membrane potential or intracellular pH. Endothelium, the cellular constituent of the blood-brain barrier (BBB), swells immediately on exposure to low osmolality. This is associated with membrane depolarization and a fall of intracellular pH. Within 30-60 min, cell volume and membrane potential recover completely, although the extracellular osmolality is kept low. Intracellular pH does not normalize fully. Measurements of intracellular K+ and Na+ concentrations reveal their involvement in the regulatory process. The findings strongly suggest that the cerebrovascular endothelium has a highly effective built-in capacity for homeostatic control essential for normal BBB function. PMID- 3972912 TI - Stochastic branching model for hemopoietic progenitor cell differentiation. AB - We present algebraic expressions describing the predictions of a stochastic branching model for differentiation of hemopoietic progenitor cells. The model assumes that there is a fixed probability, p (0 less than or equal to p less than or equal to 1), that commitment to a differentiative event occurs per progenitor cell division for each daughter cell. The model describes properties of in vitro hemopoietic cell differentiation including the population structure at the time the first progenitor cell becomes committed, the number of committed progenitor cells engendered by a single progenitor cell, and the probability of eventual commitment of all daughter cells derived from a single progenitor or stem cell. Application of the model to experimental data obtained from erythroid cultures suggests that the observed data can be explained by the stochastic branching model alone without making the deterministic assumption that there is a differentiative hierarchy in the lineage of the progenitors of erythropoiesis (BFU-E). The qualitative and quantitative aspects of the proposed stochastic model are discussed in conjunction with other analogous stochastic branching models. PMID- 3972913 TI - Utilization and formation of amino acids by chicken epiphyseal chondrocytes: comparative studies with cultured cells and native cartilage tissue. AB - Utilization and production of amino acids by primary cultures of chicken growth plate epiphyseal chondrocytes grown in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum were investigated in both short-term (6 72 h) and long-term (3-24 day) cultures. Comparative studies were made on levels of free amino acids in chicken blood plasma and serum, and in extracellular fluids from different regions of growth plate cartilage and from two types of muscle. Chondrocytes rapidly consumed glutamine from the medium, and to lesser extents, various other amino acids. In contrast, free ammonia, alanine, glycine, glutamate, proline, and aspartate were released into the medium. The utilization of certain amino acids changed, depending on the stage of culture. Initially glutamate was released into the medium but after confluency was consumed. Conversely, histidine, lysine, and phenylalanine were initially utilized but later were released into the medium. Levels of total free amino acids in extracellular fluids of cartilage and muscle were higher than those in plasma and serum, while in cartilage the levels increased progressively from the resting to the hypertrophic zones. In these sequential regions certain amino acids increased proportionally, whereas others decreased. These interrelationships generally correlated closely with metabolism of amino acids by the cultured chondrocytes. They indicate that significant differences in amino acid metabolism exist between tissue areas and are reflected in the extracellular fluid composition. Accordingly, adjustment of specific amino acids may optimize culture conditions, enabling more normal phenotypic expression in vitro. PMID- 3972914 TI - Cerebral blood flow and metabolism in normal human aging, pathological aging, and senile dementia. AB - A review and a reappraisal are presented of earlier data on cerebral circulatory and metabolic studies in normal active elderly men (Group I) of mean age 71 years, compared with normal young subjects of mean age 21 years, conducted at the National Institutes of Health, Bethesda, MD, U.S.A., during 1956-1958. There was no significant difference in the mean CBF and cerebral metabolic rate for oxygen (CMRO2) values between the two populations; i.e., these important parameters did not fall with chronological aging per se. There was significant depression in the mean cerebral metabolic rate for glucose (CMRG) value (by approximately 23%) in the aged compared with the young. Newer methods using positron emission tomography and appropriate isotopes have confirmed these findings in normal aging in human subjects and experimental animals. As expected, MABP and cerebral vascular resistance (CVR) were significantly elevated in the normal aged. MABP was even more elevated in elderly hypertensive subjects, and the CVR more elevated in the subjects with arteriosclerosis (Group II), who also showed a small but significant fall in CBF and in internal jugular venous PO2. The CBF showed a more pronounced fall in senile aged patients with chronic brain syndrome (Group III), in whom the CMRO2 also showed a marked drop (by approximately 22%); the CMRG fell still further (approximately 40% of that in the young). Of the few aged subjects followed up after a lapse of 11 years by a repeat estimation of the same physiological and psychological parameters and of the EEG, most showed clear worsening, together with a fall in overall physical and intellectual performance, probably related to a rise in CVR and an increase in atherosclerosis with aging.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3972915 TI - Regional blood-brain barrier permeability changes after restoration of blood flow in postischemic gerbil brains: a quantitative study. AB - A quantitative technique utilising [14C]alpha-aminoisobutyric acid as a tracer was used to study cerebrovascular permeability in 22 Mongolian gerbils. Seven other animals were used to measure cerebral blood volumes. Global cerebral ischaemia was produced by temporary bilateral carotid artery occlusion (60 min) in 16 gerbils that were sacrificed at 1, 2, and 3 h following reperfusion. The blood-to-brain transfer constant was significantly increased after 2 h of reperfusion in the ischaemic zones and also in structures, like the cerebellum, not supplied by the carotid artery and not ischaemic during the vessel occlusion. The blood-brain barrier (BBB) alterations were coincident with the onset of ischaemia--induced seizures that were accompanied by sudden "spikes" of systemic blood pressure. Epilepsy may play an important role in the development of BBB damage in this ischaemic model, and this factor must be considered in the interpretation of BBB damage data in gerbils. PMID- 3972916 TI - Quantification of glucose utilization in an experimental brain tumor model by the deoxyglucose method. AB - Reevaluation of lumped and rate constants is necessary when Sokoloff's 2 deoxyglucose (DG) method is used to measure glucose utilization in pathological tissue. We describe here a modification of Sokoloff's lumped constant measurement that permits simultaneous estimation of both lumped and rate constants from a single animal experiment. A subcutaneous tumor model (AA ascites tumor) was used for measurement of these constants with a procedure similar to Sokoloff's that kept the plasma tracer concentration constant. Measured constants were as follows: lumped constant, 0.654 +/- 0.081; k1, 0.196 +/- 0.038 min-1; k2, 0.262 +/- 0.067 min-1; k3, 0.117 +/- 0.044 min-1. These constants were used to quantify glucose utilization in the implanted brain tumor. To test the validity of this method, we compared a fraction of the free DG pool calculated using the tumor constants with a fraction measured directly by chromatographic analysis of tissue samples from both subcutaneous tumor and implanted brain tumor. The values derived by chemical analysis agreed well with those predicted by the calculations. The value of k4 varied from 0.0031 +/- 0.0018 min-1 for the tumor tissue to 0.0214 +/- 0.0024 min-1 for tumors with a large necrotic center. This method would be especially useful when applied to xenograft human gliomas in nude mice for quantification of glucose utilization in human gliomas by means of positron emission tomography. PMID- 3972917 TI - Effects of xenon and krypton on regional cerebral blood flow in the rat. AB - The effects of high inspired concentrations of xenon and krypton on regional CBF (rCBF) were assessed in the rat using [14C]iodoantipyrine and quantitative autoradiography. Inhalation of 80% xenon for 1 or 2 min and inhalation of 40% xenon for 2 min were found to have significant effects on rCBF, including average increases of 75-96% in cerebral neocortical regions. Inhalation of 40% xenon for 1 min and of 80% krypton for 2 min had no significant effect on rCBF in most brain regions studied. If xenon inhalation produces effects on rCBF in humans similar to those observed in the rat, such effects could be an important source of error in xenon computed tomography rCBF studies. PMID- 3972918 TI - Rapid amino acid uptake in rat pituitary neural lobe during functional stimulation by chronic dehydration. AB - We studied the transfer of a small neutral amino acid, alpha-aminoisobutyric acid, from arterial blood into the pituitary neural lobe in normal rats and in rats deprived of water for 5 days. A threefold increase in the neural lobe uptake of the amino acid was found in the chronically dehydrated rats. Possible causes for this effect include enlargement of the capillary and pituicyte membrane surface areas available for solute flux and increased permeability of these membranes. Such functional and structural alterations may be associated with an increase in protein turnover in the neural lobe during dehydration. PMID- 3972919 TI - Role of prostaglandins in modulating sympathetic vasoconstriction in the cerebral circulation in anesthetized rabbits. AB - The effects of the interaction between sympathetic nerves and prostaglandins in the cerebral circulation were examined. The hypothesis tested was that inhibition of prostaglandin synthesis by indomethacin would potentiate decreases in CBF caused by sympathetic nerve stimulation. In anesthetized rabbits, following administration of either indomethacin (10 mg/kg) or vehicle, CBF was measured with 15-micron microspheres prior to stimulation and following 3-5 min of electrical stimulation (4, 8, 16 Hz) of both superior cervical ganglia. In the vehicle group, CBF was 33-42 ml/min/100 g prior to stimulation. Bilateral sympathetic stimulation reduced blood flow to the cerebrum by 12 +/- 6% (mean +/- SEM) (p less than 0.05) at 4 Hz (n = 8), by 20 +/- 4% (p less than 0.05) at 8 Hz (n = 12), and 21 +/- 6% (p less than 0.05) at 16 Hz (n = 11). In the indomethacin group, CBF was 37-48 ml/min/100 g prior to stimulation. Bilateral stimulation decreased blood flow to the cerebrum by 7 +/- 5% (NS) at 4 Hz (n = 8), by 25 +/- 3% (p less than 0.05) at 8 Hz (n = 6), and by 20 +/- 6% (NS) at 16 Hz (n = 6). Decreases in CBF during nerve stimulation were blocked by prazosin, an alpha adrenergic antagonist. In additional experiments, cerebral vascular constrictor responses to hypocapnia were found to be similar in the vehicle and indomethacin groups. This study provides evidence that sympathetic nerves can decrease CBF substantially even at low stimulation frequencies. Further, results of this study indicate that prostaglandins do not attenuate the effects of sympathetic stimulation on the cerebral circulation. PMID- 3972920 TI - Effect of the calcium antagonist nimodipine on local cerebral blood flow and metabolic coupling. AB - The effects of a continuous infusion of the calcium antagonist nimodipine (1 microgram kg-1 min-1) on local CBF (LCBF) and local cerebral glucose utilisation (LCGU) were studied, using the quantitative autoradiographic [14C]iodoantipyrine and [14C]2-deoxyglucose techniques in 34 anatomically discrete regions of the brain in lightly restrained, conscious rats. The infusion of nimodipine at this concentration produced only a small (8%) reduction in the MABP. The administration of nimodipine did not alter the rate of glucose utilisation in any of the regions examined. By contrast, in 24 regions, CBF was increased significantly by 39-84% from control levels (for example, cerebral cortices, hippocampus, hypothalamus, and most thalamic nuclei). In vehicle-treated animals, there was an excellent correlation (p less than 0.01) between the local levels of CBF and glucose utilisation, with the ratio of flow to glucose use being approximately 1.5 ml mumol-1 in each brain region. During nimodipine treatment, there was a similarly excellent correlation (p less than 0.01) between LCBF and LCGU, but the median ratio between local flow and glucose use increased to 2.5 ml mumol-1. PMID- 3972921 TI - Effects of (D-Met2,Pro5)-enkephalinamide and naloxone on pial vessels in cats. AB - To elucidate the fundamental actions of endogenous opioids and naloxone on the cerebral circulation, the effects of (D-Met2,Pro5)-enkephalinamide and naloxone on pial vessels were investigated in cats. Pial arteries (165.7 +/- 24.9 microns) were found to dilate after the intravenous administration of 1 mg/kg of (D Met2,Pro5)-enkephalinamide, and a definite dilatation of 7.1-7.6% persisted for 15 min. Pial veins (100.6 +/- 20.2 microns) also dilated but to a lesser degree. The MABP (118.7 +/- 10.5 mm Hg) decreased by 20 mm Hg immediately after the injection, but gradually returned to the initial value 15 min later. The observed cerebral vasodilatation may be attributable to sympathetic inhibition mediated either by the presynaptic opiate receptors of the cerebral vessels or by the opiate receptors in the brainstem. After the intravenous administration of 1 mg/kg of naloxone, pial arteries (122.0 +/- 17.2 microns) showed a slight but significant dilatation of 2.3-5.3%. There were no significant changes in pial veins (87.0 +/- 12.4 microns). MABP (130.4 +/- 12.3 mm Hg) was slightly increased after the injection. Although the mechanism involved was unclear, the cerebral vasodilatation occurring after the administration of naloxone may contribute to its ameliorating effect on the neurological symptoms following cerebral ischemia. PMID- 3972922 TI - Two-day starvation does not alter the kinetics of blood--brain barrier transport and phosphorylation of glucose in rat brain. AB - The blood-brain barrier (BBB) transport and brain phosphorylation of glucose were assessed in conscious rats subjected to 2 days of starvation. Although plasma glucose decreased, no significant changes in brain blood flow, BBB glucose transport, or 2-deoxy-D-glucose phosphorylation were observed. The data suggest that adaptive changes of brain glucose metabolism previously observed in starvation are located beyond the initial steps of brain entry and phosphorylation. PMID- 3972923 TI - Extra- and intracellular pH in the brain during seizures and in the recovery period following the arrest of seizure activity. AB - The objective of the study was to estimate changes in extracellular pH (pHe) and intracellular pH (pHi) during seizures and in the recovery period following the arrest of seizure activity. Seizures of 5- and 20-min duration were induced in rats by fluorothyl added to the insufflated gas mixture, and recovery for 5, 15, and 45 min was instituted by withdrawal of the fluorothyl supply following 20 min of continuous seizures. Changes in pHe were measured by double-barreled, liquid ion-exchange pH microelectrodes, and in pHi by the CO2 method, following estimation of tissue PCO2 and extracellular fluid (ECF) volume. The animals were either normoxic or rendered moderately hypoxic (arterial PO2 40-50 mm Hg). Upon induction of seizures in normoxic animals, pHe decreased by a mean of 0.36 unit, the values being identical at 5 and 20 min. In moderate hypoxia, seizures sustained for 20 min were accompanied by a further fall in pHe (mean decrease 0.51 unit). The changes in pHe seemed mainly to reflect the nonionic diffusion of lactic acid from cells to the ECF (tissue lactate levels approximately 10 and 15 mumol g-1 during seizures in normoxic and hypoxic animals, respectively). However, the gradual fall in pHe attributable able to lactic acid production was preceded by rapid acidification, sometimes exceeding the steady-state values subsequently attained. This acidification was interpreted to reflect spreading depression and fast transcellular Na+/H+ exchange. Following cessation of seizure discharge, pHe normalized at a surprisingly slow rate, with some acidosis persisting even after 45 min. The difference between cerebrovenous and arterial PCO2 was reduced during seizures and increased in the recovery period, probably reflecting alterations in the blood flow/metabolic rate coupling. Impedance changes were slight, indicating only minor changes in ECF volume. Changes in pHi after 5 min of seizures ranged from 0.20 (normoxic animals) to 0.32 (hypoxic animals) unit, the pHi values after 20 min being 0.07-0.08 unit higher. The results suggest the regulation of pHi during ongoing seizures. Upon arrest of seizure activity, pHi rapidly increased to normal and subsequently to supranormal values. Postepileptic intracellular alkalosis occurred at a time when pHe was still reduced and in spite of the fact that tissue lactate values had not normalized. It is concluded that the rapid normalization of pHi and overt alkalosis were caused by the simultaneously occurring oxidation of lactate, with the removal of a stoichiometrical amount of H+, and the extrusion of H+ from cells, possibly via a Na+/H+ exchanger, the latter probably delaying normalization of pHe. PMID- 3972924 TI - Influence of gamma-hydroxybutyrate on the relationship between local cerebral glucose utilization and local cerebral blood flow in the rat brain. AB - The relationship between local cerebral glucose utilization (LCGU) and local CBF (LCBF) was examined during the action of gamma-hydroxybutyrate (GHB) (900 mg/kg i.v.) in conscious rats. GHB induced discrepant effects on blood flow and metabolism. LCGU was markedly depressed in all structures examined, whereas LCBF was differently affected in that no related changes were observed. Global glucose utilization was markedly depressed (-51%), whereas global blood flow was not significantly altered. The marked dissociation between the changes in global glucose utilization and global blood flow induced by GHB is reflected only to a minor degree in the local values inasmuch as the correlation between LCGU and LCBF was only slightly weakened and its heterogeneity was increased. PMID- 3972925 TI - Multiparametric imaging of blood flow and metabolism after middle cerebral artery occlusion in cats. AB - In anesthetized adult cats, acute stroke was produced by transorbital occlusion of the left middle cerebral artery. A battery of imaging techniques was used for simultaneous evaluation of regional blood flow, glucose utilization, protein synthesis, pH, and the regional tissue content of glucose, ATP, and potassium. The electrophysiological impact of stroke was monitored by EEG frequency analysis and recording of somatosensory evoked potentials. Two hours after vascular occlusion, a close correlation existed between the degree of electrophysiological changes and biochemical alterations, in particular with the extent of tissue acidosis, ATP depletion, decrease of tissue potassium content, and suppression of protein synthesis. However, there was only a poor correlation with blood flow and glucose utilization. Both of these exhibited a greatly inhomogeneous pattern with regions of reduced, normal, or increased rates. In areas remote from the infarct, the content of biochemical substrates was normal but blood flow was reduced globally by approximately 50% and glucose utilization by approximately 20%. An anatomically defined regional pattern of cerebral or cerebellar diaschisis was not observed. It is concluded that during the acute phase of stroke, imaging of blood flow and glucose utilization does not provide an accurate estimate of the actual functional or metabolic disturbance. For the clinical evaluation of the development or treatment of stroke, in consequence, alternative noninvasive techniques such as imaging of protein synthesis and/or pH may be more relevant. PMID- 3972926 TI - ICD 9 & DSM III classification for the clinician. PMID- 3972927 TI - On data limitations in hyperactivity. AB - Three groups of children rated firstly as overactive and distractible, secondly as distractible and thirdly as low on both activity and distractibility were examined in a visual search task with three levels of display load: two, three and four items. The children were tested twice in two conditions of stimulus visibility to examine the encoding stage of the model used here. The experimental results reject the hypothesis that an encoding deficit or data limitation may explain the attentional performance of either hyperactive or somewhat hyperactive subjects. They suggest, rather, that a trade-off in speed and accuracy may be evident in (the) hyperactives. PMID- 3972929 TI - Hypnotherapy as a treatment for enuresis. AB - The main objective of this study was to provide an adequately controlled experimental and clinical study to assess the efficacy of hypnotherapy in the treatment of nocturnal enuresis. Subjects were 48 nocturnal enuretic boys, aged 8 13 yr. Treatment consisted of six standardized sessions, one hourly session per subject per week. Results indicated that hypnotherapy was significantly effective over 6 months in decreasing nocturnal enuresis, compared with both pretreatment baseline enuresis frequency and no-treatment controls. It also suggested that trance induction was not a necessary prerequisite for success. Comparison with other methods of treatment provided evidence that hypnotherapy was an effective alternative or adjunctive form of treatment for enuresis. PMID- 3972928 TI - Temperament and elementary school children's actual and rated academic performance: a test of a 'goodness-of-fit' model. AB - To test a goodness-of-fit model of temperament, 194 Pennsylvania fourth-grade students were studied. It was predicted that children whose temperament fitted or exceeded demands or expectations of their teachers would show more positive functioning than children whose temperament fell below expectations. Children responded to the Dimensions of Temperament Survey (DOTS), which assesses 5 temperamental attributes. Teachers specified demands/expectations for their students for each of the DOTS attributes and rated students' academic ability and adjustment. Objective measures of academic achievement were also obtained. Results indicated that for 2 of the 3 temperament attributes for which directional predictions were made some support was obtained for the model. PMID- 3972930 TI - Temperamental characteristics of three- to four-year-old boys and girls and child family interactions. AB - Mothers interviewed in their homes provided information concerning their child's temperamental characteristics, mild behaviour problems and family interactions. The characteristics active, shy (approach/withdrawal; not settling in) and moody/intense were consistent from 42 to 50 months of age for both sexes. No simple sex differences appeared in these three characteristics. There was little evidence for an association between active and either mild behaviour problems or family interactions. For both girls and boys, moody/intense scores were associated with mild behaviour problems and 'negative' family interactions. However, while shy scores of boys were associated with negative family interactions, shy scores of girls were associated with positive interactions, especially at the later age of 50 months. PMID- 3972931 TI - Psychiatric epidemiology in a sample of 1510 ten-year-old children--I. Prevalence. AB - Prevalence estimates of psychiatric disorder in 10-yr-old rural Norwegian children were based on responses to symptom checklists for parents and teachers. The parents' index showed highest validity, and was used as a basis for prevalence estimates. Properties of the index were shown to be sample specific, and a validity test should consequently always be administered to representative subsamples in psychiatric epidemiological studies based on symptom checklists. Prevalence of functional problems of a primarily psychological nature was calculated by proportional extrapolations from the validity test results. The prevalence rate for the total sample was 5%, and corrected prevalence when emigrants were excluded was 4.6%. PMID- 3972932 TI - Prevention of adolescent tobacco smoking: the social pressure resistance training approach. PMID- 3972933 TI - Interactions of language-delayed and normal preschool boys with their peers. AB - This study examined the impact of specific language delay (LD) on peer interactions in preschool children. Three groups of dyads were studied: normal children interacting with normal children, normals interacting with LD children and LD children with each other. The normal children were more likely to initiate interaction when the partner was non-responsive and to attempt to dominate the interaction. The results of this study illustrate reciprocity in the social interactions of young children, the significant role of dominance and control in interaction and the sensitivity of preschool children to the characteristics of their peers. PMID- 3972934 TI - Maltreated infants: vulnerability and resilience. AB - This study of maltreated infants offers evidence supporting a model of bidirectional effects in which the mother initiates the maltreatment but both mother and infant behave so as to maintain the situation. Maltreated infants were found not to differ from control infants in congenital characteristics. They did, however, display deviance in learned behavior patterns. After intervention with the mother the infants showed behavioral improvement. These results suggested that maltreated infants were not inherently different from other children and that they were resilient in response to environmental improvement. Their earlier behavior may, however, have functioned to maintain their mothers' maltreating responses. PMID- 3972935 TI - On resource strategy limitations in hyperactivity: cognitive impulsivity reconsidered. AB - Overactive and distractible (hyperactives), normoactive and distractible, and normoactive and attentive (controls) children were administered a high-speed visual search task. The display load was manipulated and all subjects were administered the task in three instruction conditions: speed, 'normal' and accuracy. Speed-accuracy trade-off curves indicated that the controls and distractibles conformed to the fast guess model, which relates speed and accuracy. Hyperactives partially conformed to this model. It is concluded that a structural process deficit is not indicated by these data in hyperactivity. Rather, the evidence suggests that a resource strategy defect may be characteristic of hyperactivity. PMID- 3972936 TI - Calculation of retention indices by molecular topology. Chlorinated benzenes. AB - A comparative study was undertaken to test the ability of several different topological indices to predict the retention indices of chlorinated benzenes on polar and non-polar stationary phases using both correlation coefficients and correctly predicted elution sequences as criteria of fit. The test was performed on three topological indices: connectivity indices, Wiener numbers, and Balaban indices. The regression analyses showed that the molecular connectivity model predicted the retention indices of chlorinated benzenes more successfully than either Wiener numbers or Balaban indices. The results also demonstrated that the major structural property controlling chromatographic behavior was the size of the chlorinated benzene. In addition, the use of the new non-empirical heteroatom parameterization scheme in the calculation of Wiener numbers and Balaban indices was successfully tested for the first time. PMID- 3972937 TI - One-step procedure for the rapid isolation of mouse monoclonal antibodies and their antigen binding fragments by fast protein liquid chromatography on a mono Q anion-exchange column. AB - A one-step chromatographic procedure was used to isolate rapidly mouse IgG monoclonal antibodies (mAbs) (IgG1, IgG2a, IgG2b) contained in ascites fluids and Fab fragments contained in papain-treated mAb suspensions. Chromatographic separations were performed on an anion-exchange Mono Q column connected to a fast protein liquid chromatographic (FPLC) system. Detection of mAb or their antigen binding fragments (Fab) in eluted peaks was performed using sodium dodecyl sulphate-polyacrylamide gel electrophoresis together with a silver or a Coomassie Brillant Blue R 250 staining technique and solid phase radioimmunoassay with 125I labelled sheep anti-mouse antibodies directed against total immunoglobulins. Rapid assessment of the purity of isolated mAbs and their Fab fragments was performed by gel permeation chromatography on a TSK G 3000 SW column. Mouse mAbs and their Fab fragments were rapidly isolated (25 min), in a functionally active state, to a high degree of purity on the FPLC-Mono Q system compared to the time taken by other techniques. PMID- 3972938 TI - Determination of protein spots separated by two-dimensional polyacrylamide gel electrophoresis. AB - A simple method for quantitating proteins in the spots on two-dimensional polyacrylamide gel electropherograms is described. The system consists in three steps: (1) O'Farrell's two-dimensional gel electrophoresis of the proteins to be analysed; (2) staining of the gels with Coomassie brilliant blue; and (3) determination of the area and integrated density of the stained spots by the Joyce Loebl Magiscan-1 image analysis system. The method can be used for the determination of proteins in the range 0.5-100 micrograms/cm2; the amount of protein involved in most spots detected by the staining method actually falls within this range. As the minimum spot diameter that can easily be handled by the method is about 2 mm, as much as 30 ng of protein in such a spot can be determined. The method can also be applied to autoradiograms. PMID- 3972939 TI - Identification of food thickeners by monitoring of their pyrolytic products. PMID- 3972940 TI - Dynamic headspace analyses of residual volatiles in pharmaceuticals. AB - Pharmaceutical preparations may be assayed for volatile organic compounds by purging them with a stream of inert carrier gas and collecting the organics onto a suitable sorbent material, from which they may be backflushed to a gas chromatograph. Compared to solvent extraction, the process offers advantages of increased sensitivity, ease of automation, and elimination of the solvent peak. Examples are given of three major sources of volatiles in pharmaceuticals, with the development of a method for quantitating the volatiles using an internal standard. PMID- 3972941 TI - Application of indirect photometric chromatography to pharmaceutical analysis. AB - Indirect photometric chromatography, which couples analyte separation by ion exchange with indirect photometric detection, is applied to the analysis of complex solutions encountered in the pharmaceutical industry. Applications of primary interest include simultaneous acetate, lactate, chloride, or phosphate determinations, a bisulfite/sulfate assay, and quantitation of trace levels of chloride in deionized water. Three commercially available ion chromatography columns are studied for their suitability in these applications. Due primarily to (A) the acid-base chemistry of the phosphate and bisulfite ions, (B) the need to stabilize the readily oxidized bisulfite, and (C) resin stability at high pH, the column packed with a polymer-based resin is capable of producing analytically superior separations of Cl-, HPO4-2, and matrix components and of SO3-2/SO4-2 in the samples of interest. Under rigid relative concentration conditions, the columns packed with a silica backbone resin are capable of separating acetate, lactate, Cl-, and H2PO4- with baseline resolution and are effective for determining Cl- levels at concentrations of less than one part-per-million. PMID- 3972942 TI - A simple and rapid method for typing adenoviruses 40 and 41 without cultivation. AB - Fastidious adenovirus DNA in faecal samples obtained from children with acute gastroenteritis was extracted by a simple and rapid method. The extracted viral DNA was characterized by restriction endonuclease SmaI treatment. Fastidious adenovirus DNA was detected in 58 of 65 cases. If faecal samples were too small it was not always possible to identify virus DNA. PMID- 3972943 TI - Assessment of sequence relatedness of double-stranded RNA genes by RNA-RNA blot hybridization. AB - Three well-characterized reovirus serotypes were used to investigate the usefulness of RNA-RNA blot hybridization as a means to assess the genetic relatedness of double-stranded RNA (dsRNA) viruses. [5'-32P]pCp-labeled genomic dsRNAs from reovirus 1, 2 and 3 were used as probes in hybridization experiments in which segments of the three serotypes were separated in 10% polyacrylamide gels and transferred electrophoretically to membranes. Nine of the 10 reovirus genes cross-hybridized between the serotypes. The S1 gene was serotype specific. The L2 gene of reovirus 2 showed a lower level of cross-hybridization with types 1 and 3 when compared to the hybridization signal observed for L2 when types 1 and 3 were hybridized to each other. The data were consistent with previous studies on the relatedness of the three virus serotypes. Since RNA-RNA blot hybridization allows the number and identity of conserved genes to be determined, this approach may prove useful for assessing the genetic relatedness among other viruses in the family Reoviridae. PMID- 3972944 TI - Detection of avocado sunblotch viroid by hybridization with synthetic oligonucleotide probes. AB - Two short (20 and 17 nucleotides) DNA hybridization probes, complementary to avocado sunblotch viroid (ASBV) RNA nucleotides 68-87 and 88-104 respectively (Symons, R.H., Nucleic Acid Res. 9, 6527, 1981) were synthesized. The sensitivity and specificity of these radioactively labelled probes for hybridization with RNA of several ASBV isolates are demonstrated. PMID- 3972945 TI - A comparison of the logistic risk function and the proportional hazards model in prospective epidemiologic studies. PMID- 3972946 TI - Psychosocial characteristics of adolescent smokers before they started smoking: evidence of self-selection. A prospective study. AB - Evidence of noncomparability of self-formed smoker and nonsmoker groups of adolescents from the Child Health and Development Studies of the University of California, Berkeley, was found in a study of antecedent psychosocial characteristics (observed at age 10) before the adoption of the smoking habit. With possible confounding factors controlled, eventual smokers showed significantly greater prevalence than nonsmokers of Type A personality traits, extraversion, psychoticism, anger, and restless sleep. Eventual smokers were lower in socioeconomic status than nonsmokers, and also exhibited significantly lower mean scores for the Raven Progressive Matrices and Peabody Picture Vocabulary tests. For each trait, the trends of the data were consistent in boys and girls. Since many of these traits are shown to "track" into adult life, where they are then related to coronary heart disease, the role of self-selection requires further consideration in causal inferences about smoking and coronary heart disease. PMID- 3972947 TI - A methodological framework for assessing health indices. AB - Tests or measures in clinical medicine or the social sciences can be used for three purposes: discriminating between subjects, predicting either prognosis or the results of some other test, and evaluating change over time. The choices made at each stage of constructing a quality of life index will differ depending on the purpose of the instrument. We explore the implications of index purpose for each stage of instrument development: selection of the item pool, item scaling, item reduction, determination of reliability, of validity, and of responsiveness. At many of these stages, not only are the requirements for discriminative, predictive, and evaluative instruments not complementary, they are actually competing. Attention to instrument purpose will clarify the choices both for those developing quality of life measures and for those selecting an appropriate instrument for clinical studies. PMID- 3972948 TI - Alterations in health perception and lifestyle in treated hypertensives. AB - The effect of being treated for hypertension on health perception and life-style and the duration of any alterations after first diagnosis were assessed by administering a standardized interview schedule to employed treated hypertensive men and women, aged 40-64 years, who were either newly diagnosed (ND) (within 6 months of the interview) or previously diagnosed (PD) (1-3 years before the interview) and who were otherwise healthy. In both groups of 50 hypertensives, indices of health status and ability to participate in enjoyable activities were significantly lower while symptom score and index of worry about health were significantly higher compared with a group of 50 age and sex-matched normotensive controls (C) (p less than 0.001). The hypertensive groups did not differ from each other. Both hypertensive groups reported significant reductions in the time spent at work (p less than 0.005). Self-reported weight loss in the 2 months preceding the interview was significantly greater in ND hypertensives compared with PD and C individuals (p less than 0.01). Our data indicate that the diagnosis and treatment of hypertension had a significant and sustained negative impact on health perception and activities of daily living even among actively employed, relatively healthy, medicated hypertensives for whom there were no medical indications to restrict their life-style. PMID- 3972949 TI - The causal sequence on death certificates: errors affecting the reliability of mortality statistics for rheumatoid arthritis. AB - Physicians' amount of diagnostic information and the adequacy of the causal sequence(s) on death certificates involving rheumatoid arthritis (RA) were investigated. Physicians' reporting was compared with the Swedish National Central Bureau of Statistics' (NCBS) registration of the causal conditions, particularly the underlying cause of death. All Swedish RA death certificates for the years 1971 and 1975 were studied. A total of 1224 such certificates were identified. The causal sequences were inadequate in 35% of the certificates, 37% in 1971 and 33% in 1975. Ten types of inadequate sequences were identified. The NCBS rejected the underlying cause of death in 56% of the inadequate sequences and in 52% of the adequate sequences. When the whole sequence leading directly to death was described by only a single diagnosis, 374 (31%) of the cases, this diagnosis was rejected by the NCBS in 54% of the certificates from 1971 and 75% from 1975. More than one diagnosis on each line of the causal-sequence description appeared on 28% of the certificates. The total number of diagnoses on each certificate did not, however, exceed the NCBS' registration capacity (up to seven diagnoses) in more than 1.6% of the 1224 cases. Thus, the major problem in the NCBS' data collecting process was not how to sort out excessive diagnostic information, but to record properly the causal classification of the conditions, and to interpret the physicians' account of the underlying cause of death. PMID- 3972950 TI - Evidence of bimodality of two hour plasma glucose concentrations in Mexican Americans: results from the San Antonio Heart study. AB - Evidence for bimodality in the distribution of two hour post oral glucose challenge plasma glucose concentrations has come previously primarily from native American and Pacific Island populations having high non-insulin dependent diabetes mellitus (NIDDM) prevalence. Because the National Diabetes Data Group (NDDG) criteria for diagnosing NIDDM rely in part upon the assumption of bimodality, it is important to determine the generality of this phenomenon. We looked for bimodality among Mexican Americans in San Antonio, a population having greater than 50% Caucasian admixture. By fitting both a single normal distribution model and a mixture model of two normal distributions, for each age decade, we found that the mixture model was preferred to the single normal model (p less than 0.001) and that this model fit the data well. The proportion in the upper component (hyperglycemics) increased with each successive age decade. The minimum misclassification cutpoints decreased with age, but all were higher than the 200 mg/dl cutpoint recommended by the NDDG. Use of the NDDG cutpoint, however, improved sensitivity with only a minimal deterioration of specificity. Our findings further generalize the bimodality phenomenon and support the NDDG criteria. PMID- 3972951 TI - Impairment and disability in the aged. AB - Data on 776 survivors of the Massachusetts Health Care Panel Study are used to examine the relationship between impairment and disability among noninstitutionalized aged. Using multiple regression we examined the relationship of sight, hearing, and musculoskeletal impairments with physical and social disability, controlling for age, gender, income, and living situation. Findings suggest that impairments do not inevitably lead to disability. Musculoskeletal and visual impairments are strongly related to physical disability. None of the impairments studied in this sample are related to increasing social disability. These results suggest that physical and social disabilities may be distinct concepts with quite different determinants. PMID- 3972952 TI - Leaving a cardiology service against medical advice. AB - In an exploratory retrospective study of 64 hospitalized patients, we examined the demographic, medical, and psychologic correlates in patients who left our Cardiology Service against medical advice (AMA). Based on a medical chart review, the AMA and control groups were found to be significantly different regarding prior cardiac disability level, physical signs of chronic alcohol abuse on admission, cardiac complications, and requirement of antihypertensive/diuretic medications while hospitalized. The two groups were also significantly different with regard to somatic complaints, apparent anxiety and use of psychotropic medication on the day before leaving against medical advice. This study indicates that a multifactorial assessment of patients hospitalized on a cardiology service can enhance identification of those at risk to leave the hospital against medical advice. PMID- 3972953 TI - Outpatient pediatric diabetes--I. Current practices. AB - A survey of pediatric diabetologists in the U.S. was made in an attempt to define current outpatient practices in diabetes subspecialty clinics. Survey questions addressed clinic organization, health care team members, content of histories and physical examinations, use of laboratory studies, patient education, therapeutic recommendations, self-management practices and screening procedures used to identify early diabetes-related complications. The results of the survey suggested similar clinic organization and operation in most settings; a high degree of reliance on glycosylated hemoglobin determinations; a preference for the use of NPH insulin; and a lack of credence given urinary glucose determinations. Additionally, screening tests for the development of complications are not performed with regularity. PMID- 3972954 TI - Systematic bias in recording the history in patients with chest pain. AB - Because of its central importance in medical diagnosis, sources of bias in the patient history must be identified. We report here a study of interobserver agreement in chest pain histories. Histories were obtained by physicians, nurse practitioners, and self-administered questionnaires. We used a discriminant rule to classify the histories as being more or less typical of angina pectoris. A sub group of the subjects underwent coronary arteriography after the histories were obtained. In subjects with positive coronary arteriograms, physicians consistently obtained histories typical of angina pectoris more often than a self administered questionnaire. There was no significant systematic bias when comparing physician interviews to the questionnaire among subjects with negative arteriograms nor when comparing two physicians' interviews or a nurse practitioner interview to a questionnaire. When compared to physician interviews, nurse practitioner interviews produced histories less typical of angina pectoris. We conclude that there are systematic differences between the histories obtained by physicians, nurse practitioners, and self-administered questionnaires. Questionnaires can produce biased patient histories and should be carefully validated before being used in patient care activities or health care research. PMID- 3972955 TI - Experimental requirements and scientific principles in case-control studies. PMID- 3972956 TI - The participant effect: mortality in a community-based study compared to vital statistics. AB - The 20-year mortality experience of the community-based Evans County Heart Study population is compared to local, regional and national vital statistics. Deficit mortality occurred in the study population at younger ages while at older ages mortality was similar to or greater than vital statistics. This was particularly true for white and nonwhite males, whose mortality patterns were statistically significantly different from Evans Co. vital statistics (P less than 0.005). Nonwhite/white mortality ratios in the study were close to those observed in local vital statistics, particularly for males. Sex mortality ratios in the study population were lower than in vital statistics due to a stronger participant effect (lower mortality) in males. Evans Co. was an area of particularly high mortality for whites in the period 1960-1980 compared to other parts of Georgia and the U.S. Results of this study are similar to other reports of participant effects in epidemiologic follow-up studies; implications for bias in estimates of population levels of disease and of disease/exposure relationships are discussed. PMID- 3972957 TI - Screening for geographic heterogeneity of disease rates: application to cancer incidence in Allegheny County, Pennsylvania, 1969-71. AB - A statistical technique for analyzing heterogeneity in rates proposed by Gail is potentially well-suited to the analysis of geographic patterns in disease incidence data. This was applied to 1969-71 cancer incidence in whites in 30 census tract aggregates within Allegheny County, Pennsylvania to ascertain its usefulness and to search for patterns. A product model, in which each area's risks are a constant multiple of one another across age groups, was found to adequately fit the observed data. The test for geographic heterogeneity indicated that 19 of 30 sex-site groupings manifested greater than chance variation across the county subunits, generally consistent with the number of outliers based on 95% confidence limits. Partitioning the heterogeneity in these sites by median income quintiles suggested a positive risk gradient with breast cancer (F) and negative risk gradients with rectal (M), pancreatic (F), lung (M), cervical (F), and bladder cancer (F). Percent foreign stock was positively associated with total cancer (M, F), colon (M, F), pancreatic (F), lung (M), and bladder cancer (M, F). The technique successfully demonstrated the accuracy of a product model, screened cancer sites meriting detailed study, and suggested several associations of median income and percent foreign stock with cancer risk. PMID- 3972958 TI - Changes in the prevalence distribution of hypertension: Connecticut adults 1978 79 to 1982. AB - In the Spring and Summer of 1982 the Second Connecticut Blood Pressure Survey (CBPS-II) was completed. This survey is independent of, but essentially identical in design and implementation to the First Connecticut Blood Pressure Survey reported on by Freeman et al. [1]. This paper compares the results of the two surveys using the same analytic techniques as reported previously [2]. In addition, a model for analyzing the components of hypertension control is utilized in the analysis. Finally, the implications of the survey comparison are discussed in the context of the Connecticut High Blood Pressure Program (CHBP) [3]. PMID- 3972959 TI - Personality, behavior, family environment, family social status and hypertension risk factors in children. The Minneapolis Children's Blood Pressure Study. AB - To assess the relationship of psychosocial variables to risk factors for hypertension in children, we administered instruments designed to measure aspects of children's personality, behavior, family environment and family social status to 1505 school children aged 7-10 years. Children's blood pressure was significantly related only to mother's occupation, the children of unskilled employees having higher blood pressure than children of higher status workers. Children's body mass index was directly related to scores on the conformity scale of the personality inventory and inversely related to scores on the intellectual cultural orientation scale of the family environment instrument and to social class. Social status but not measured dimensions of children's personality, behavior and family environment may influence the risk of hypertension in children. PMID- 3972960 TI - Self-reports predictive of mortality from ischemic heart disease: a nine-year follow-up of the Human Population Laboratory cohort. AB - In order to assess the validity of self-reports of physical conditions, symptoms, and ailments, the nine-year mortality experience of a random population sample of 4590 adults, aged 35-94, in Alameda County, California, was examined. Consistently, increased risks of death from any cause and from ischemic heart disease were found for several self-reports. Multiple logistic analyses of deaths from ischemic heart disease showed that the best predictors for men were reports of "high blood pressure," "heart trouble," and "shortness of breath" and for women were "heart trouble," "swollen ankles," and "chest pain." The strength and consistency of the relationships between these self-reports and risk of death from all causes and from ischemic heart disease argues for the validity of such reports as measures of underlying disease state. PMID- 3972961 TI - Insulin binding to human ovaries. AB - Human ovarian tissue samples were obtained at the time of laparotomy, and plasma membrane fractions were prepared and used in receptor assays. Incubations of the membrane fraction were performed with [125I]insulin (porcine), and Scatchard analysis of binding showed biphasic curves. The high affinity sites had an average concentration of 57.4 +/- 7.9 (+/- SEM) fmol/mg protein and a dissociation constant of 3.5 +/- 0.9 nM (n = 9). Neither affinity nor number of binding sites changed significantly during the menstrual cycle. We conclude that there is high affinity binding of [125I]insulin to human ovarian plasma membranes. PMID- 3972962 TI - Effects of aging on catecholamine metabolism. AB - To determine the cause of the high plasma norepinephrine (NE) concentrations in elderly subjects, we measured apparent NE secretion, NE plasma clearance, and NE production in 14 young and 13 elderly normal subjects. Apparent NE secretion, estimated by isotope dilution analysis, was higher (P less than 0.01) in the elderly subjects [3.08 +/- 0.45 (+/- SEM) nmol/m2 X min] than in the young subjects (1.84 +/- 0.12 nmol/m2 X min). Plasma clearance of NE did not differ between the young (1470 +/- 120 ml/m2 X min) and the elderly (1295 +/- 153) subjects. NE production, estimated from NE metabolite excretion, was 9.66 +/- 0.8 nmol/m2 X min in the elderly subjects, not significantly different from that in the young subjects, who produced NE at a rate of 11.7 +/- 1.1 nmol/m2 X min. Excretion of the O-methyl derivative of NE normetanephrine was increased (P less than 0.01) in the aged, whereas excretion of the deaminated metabolites vanillylmandelic acid and dihydroxmandelic acid was decreased. Our data indicate that the rate at which NE enters the circulation is increased in the elderly, but NE production is normal. Taken together, these results suggest that in aging, there is an alteration in the local disposition of sympathetic neuronal NE. PMID- 3972963 TI - The role of prolactin in the regulation of the primate corpus luteum. AB - The role of PRL in the control of corpus luteum (CL) function was examined in hyperprolactinemic and euprolactinemic female rhesus monkeys with hypothalamic lesions in which ovulatory menstrual cycles were induced by the pulsatile administration of GnRH, in intact postpartum monkeys nursing their infants, as well as in animals treated with bromocriptine. In the lesioned monkeys, neither markedly elevated nor undetectable (bromocriptine-suppressed) PRL levels influenced the time courses of postovulatory plasma progesterone concentrations compared to those in monkeys with normal PRL concentrations. Plasma progesterone concentrations in the hyperprolactinemic monkeys, however, did not decline to undetectable levels at the end of the luteal phase, as is the case in normal animals, but remained slightly elevated for extended periods, a pattern characteristic of lactating animals. In both lesioned and postpartum animals, bromocriptine administration or removal of suckling infants from the latter resulted in complete functional luteolysis. These observations suggest that PRL does not play a significant role in the control of the CL of the menstrual cycle, but that in high concentrations, this hormone can partially maintain previously established CL. PMID- 3972964 TI - The influence of age on the 24-hour integrated concentration of growth hormone in normal individuals. AB - We examined changes in spontaneously secreted growth hormone with aging by studying the 24-h integrated concentration of GH (IC-GH) of 173 nonobese subjects (height, greater than or equal to 5%; 7-65 yr of age). There was no significant difference in IC-GH on repeat testing of 13 men or in 23 women studied in the follicular and again in the luteal phase of the menstrual cycle. The level of IC GH was strongly effected by age; children had the highest mean IC-GH, and there was a decline in IC-GH with increasing age after the second decade of life. The correlation of IC-GH with age was highly significant (r = 0.73; P less than 0.0001). There was no difference in IC-GH between males and females when matched for age. The mean IC-GH at Tanner stage 5 of puberty (7.4 +/- 2.0 ng/ml) was higher than that at stages 2-4 (5.7 +/- 1.4; P less than 0.0005) or that in prepubertal children (5.8 +/- 1.4; P less than 0.001). Thus, age and pubertal status must be carefully considered when interpreting the IC-GH for patients suspected of having deficient or excessive secretion of GH. PMID- 3972965 TI - Effect of postpartum lactation on lipoprotein lipids and apoproteins. AB - To determine if postpartum lactation alters plasma lipoprotein lipid and apoprotein concentrations and composition, we studied 56 overnight fasting lactating and 16 nonlactating women approximately 6 weeks postpartum. Postpartum results are presented as absolute concentrations and as the difference from antepartum values determined at 36 weeks gestation. Antepartum lipoprotein lipid and apoprotein concentrations were generally not different in the 2 groups, with the single exception of whole plasma and low density lipoprotein (LDL) apoprotein (apo) B (probably a chance difference). When expressed as the antepartum and postpartum difference, the lactating and nonlactating groups were indistinguishable in very low density lipoprotein (VLDL) and LDL triglyceride, cholesterol, phospholipid, and apo B concentrations. However, lactating women had higher high density lipoprotein (HDL) cholesterol, phospholipid, apo A-I, and apo A-II concentrations than nonlactating women when results were expressed as differences from antepartum values or as absolute values. HDL triglyceride concentrations were not significantly different between lactating and nonlactating women by either analysis. There was no significant effect of lactation on VLDL or LDL composition, but there was a significant increase in the percent cholesterol content in HDL. We hypothesize that the increase in HDL constituents in lactation is generated in part by increased catabolism of triglyceride-rich lipoproteins by the lactating breast. PMID- 3972966 TI - Decreased urinary C19 and C21 steroid 5 alpha-metabolites in parents of male pseudohermaphrodites with 5 alpha-reductase deficiency: detection of carriers. AB - The urinary 5 beta/5 alpha ring A-reduced metabolites of C19 and C21 steroids from obligate carrier parents of male pseudohermaphrodites with 5 alpha-reductase deficiency were analyzed by gas chromatography. Etiocholanolone/androsterone, 11 beta-hydroxyetiocholanolone/11 beta-hydroxyandrosterone, tetrahydrocortisol/allotetrahydrocortisol, and tetrahydrocorticosterone/allotetrahydrocorticosterone were the paired 5 beta/5 alpha-metabolite ratios measured. Increased mean 5 beta/5 alpha ratios were found for all paired metabolites compared to mean ratios in normal subjects. In men, the highest index of discrimination of the carrier state was the tetrahydrocorticosterone/allotetrahydrocorticosterone ratio, while in women, the etiocholanolone/androsterone ratio was more diagnostic. In obligate carrier men, plasma testosterone, dihydrotestosterone, androstenedione, and 17 alpha hydroxyprogesterone levels were normal, as were testosterone/dihydrotestosterone ratios. These studies demonstrate a generalized defect in 5 alpha-reductase activity involving C19 and C21 steroid metabolism in obligate carrier parents and provide further confirmation of an autosomal recessive mode of inheritance in this condition. The data from parents of sporadic cases of male pseudohermaphrodites with primary 5 alpha-reductase deficiency suggest that there is a carrier rate within the general population, although the exact frequency remains unknown. PMID- 3972968 TI - Beer-induced prolactin secretion: a clinical and laboratory study of the role of salsolinol. AB - Salsolinol is a tetrahydroisoquinoline compound with opiate agonist and dopamine antagonist properties. The role of salsolinol, a minor constituent of beer, in beer-induced PRL secretion was investigated in humans and rats. Beer-stimulated PRL release was greater in women than in men; the PRL-stimulating effect of beer was not blocked by naloxone pretreatment. Administration of a solution of salsolinol or cocoa (another salsolinol-containing beverage) did not stimulate PRL secretion in normal women. In rats, administration of large doses of salsolinol ip or iv was required to raise serum PRL levels, and high concentrations of salsolinol were needed to antagonize the PRL-suppressive effects of dopamine in vitro. We conclude that salsolinol is not responsible for PRL secretion induced by beer ingestion. PMID- 3972967 TI - High pressure liquid chromatographic separation of an oxytocin/arginine vasotocin like peptide from the plasma of patients with chronic renal failure. AB - Levels of a novel oxytocin (OT)- and arginine vasotocin (AVT)-like peptide detected by one antiserum to OT (Pitt Ab-1) and one antiserum to AVT (Tor AVT) were recently found to rise in human plasma in response to administration of estrogen. The novel peptide rose in parallel with the estrogen-stimulated neurophysin (ESN). The mean level (+/- SEM) of ESN in plasma of 11 individuals with altered renal function (nondialyzed) was significantly higher than the level in individuals with normal renal function (4.2 +/- 0.9 vs. 1.1 +/- 0.04 ng/ml; P less than 0.01). In patients treated with hemo- or peritoneal dialysis, mean (+/- SEM) levels of ESN were 18.1 +/- 3.2 and 16.8 +/- 3.7 ng/ml, respectively. Levels of estradiol and estrone were not elevated and did not correlate with high levels of ESN. Levels of OT Pitt Ab-1, AVT, and ESN immunoreactivity were measured in plasma form nine patients undergoing hemodialysis and eight patients undergoing peritoneal dialysis. Mean (+/- SEM) levels of all three peptides were elevated (12.9 +/- 1.5 microU/ml, 32.1 +/- 6.7 pg/ml, and 13.5 +/- 4.0 ng/ml, respectively). ESN was significantly correlated with OT Pitt Ab-1 and AVT (R2 = 0.80; P less than 0.001). Plasma samples from the same patients were pooled, treated, and separated by reverse phase HPLC. The plasma contained a peak of immunoreactivity detected by Pitt Ab-1 and Tor AVT Ab. The position of the material was distinct from that of synthetic OT, AVT, or AVP and corresponded to the position of the novel OT-like peptide found in plasma of individuals given estrogen. The findings support parallel secretion of the OT-like peptide with ESN and represent the first disease state characterized by high levels of this OT- and AVT-like peptide. PMID- 3972969 TI - RU486, a progestin and glucocorticoid antagonist, inhibits the growth of breast cancer cells via the progesterone receptor. AB - The progestin and glucocorticoid antagonist RU486 was tested on the growth of several cell lines in culture. RU486 inhibited the growth of two progesterone receptor (RP) positive human breast cancer cell lines (MCF7 and T47D). The antiproliferative effect was dose dependent and its magnitude correlated with the RP content of the tested cells (T47D greater than estradiol-primed MCF7 greater than withdrawn MCF7). Cell growth inhibition was not prevented by the addition of dexamethasone, dihydrotestosterone, or estradiol, but the cells were rescued by low concentrations of the progestin R5020. RU486 had no effect on the growth of two RP negative human breast cancer cell lines and a rat fibroblast cell line. Moreover, RU486 had no progestin agonist activity in T47D cells when evaluated by measuring the 35S-labeling of two progestin-regulated proteins with mol wts of 48,000 and 250,000, but it totally prevented the induction of these two proteins by R5020. In conclusion, RU486 selectively inhibited the growth of human breast cancer cell lines with unoccupied RP sites and its effect was correlated with the RP concentration of these cells. We propose that RU486 is a RP-targeted drug of potential utility in breast cancer treatment. PMID- 3972970 TI - Amobarbital interactions with 25-hydroxycholecalciferol: effects on the extraction, quantification, and competitive protein binding in vitro. AB - Amobarbital has been found to coelute with 25-hydroxycholecalciferol (25OHD3) on a normal phase high performance liquid chromatographic system and cause subsequent interference in the UV detection and plasma transport competitive protein binding assay for this vitamin D metabolite. Concentrations of 25OHD3 were overestimated by 95% in the presence of 0.4 mg amobarbital in the competitive protein binding assay; as little as 0.1 mg amobarbital caused a 22% overestimation in the concentration of 25OHD3 in the assay. Separation of 25OHD3 from amobarbital on a reverse phase high performance liquid chromatographic system allowed for proper quantification without interference. Because of the similarity of chemical structures, other barbital-based compounds may cause similar interactions with 25OHD3 or other vitamin D metabolites as well. PMID- 3972972 TI - Episodic secretion of melatonin in pre- and postpubertal girls and boys. AB - The concentration of melatonin was determined in serum samples obtained at 15-min intervals during a 4-h period from seven normal girls, 9.5-16.5 yr of age, and eight normal boys, 9.0-16.8 yr of age. All samples were obtained between 0800 and 1300 h. An episodic pattern of melatonin secretion was found in all subjects. There was no significant (P greater than 0.1) difference between girls and boys as to number of episodes [3.1 +/- 0.4 (+/- SD) vs. 3.4 +/- 0.5 per 4 h), absolute melatonin increase (49.0 +/- 6.7 vs. 50.4 +/- 4.1 pg/ml), or apparent melatonin half-life (20.3 +/- 0.8 vs. 20.8 +/- 1.0 min). The mean absolute increase during secretory episodes correlated (r = 0.843; P less than 0.005) with the mean melatonin concentration per 4 h, and a significant (P less than 0.05) inverse correlation (r = -0.508) was found between the mean percent increment of the melatonin secretory episode and the mean apparent melatonin half-life. A significant correlation between melatonin secretion and previously reported (22) episodic LH secretion was not found. In girls and boys, the mean melatonin concentration increased with advancing puberty. The increase in melatonin concentration was due to an increase in the amplitude of secretory episodes. These data are consistent with an influence of gonadal function on melatonin secretion. PMID- 3972971 TI - Effects of an antiprogesterone agent, RU-486, on the menstrual cycle of the rhesus monkey. AB - RU-486 (RU), a synthetic steroid with antiprogesterone receptor activity, was used to study the role of progesterone in the normal menstrual cycle of rhesus monkeys. The drug, at dosages of 2, 4, or 12 mg/kg, was administered as a single im injection during the luteal phase (days 5-8) in 16 experiments in 8 monkeys. RU had acute effects on the endometrium, as it induced menstruation within 3 days in spite of persistant progesterone elevations, thereby shortening the cycle length by about 5 days. Long term effects on menstrual cyclicity were also found with the higher RU doses. The intermenstrual interval after RU treatment increased from 31.8 +/- 2.4 (+/- SE) days after a 2 mg/kg dose of RU to 82.4 +/- 6.8 days after a 12 mg/kg dose of RU, with a control cycle length of 29.4 +/- 0.7 days. This prolonged interval was related to a delay in the completion of the follicular maturation process and, therefore, a delay in ovulation, as judged by estrogen and progesterone concentrations. Subsequent menstrual cycles were regular and ovulatory. Our results suggest that RU binds to the endometrial progesterone receptor, thereby inducing premature menstruation in the presence of elevated progesterone levels. RU also exerts long term effects on the hypothalamo hypophyseal axis, since it significantly alters menstrual cyclicity. PMID- 3972973 TI - Defects in pulsatile LH release in normally menstruating runners. AB - Intense physical exercise has been associated with reproductive dysfunction and menstrual cycles may be abnormal in a majority of women with a heavy training load. To determine whether training influenced pulsatile LH release, we measured LH pulse frequency, LH pulse amplitude and area under the curve over six hours during the early follicular phase of the menstrual cycle in four sedentary women and six eumenorrheic women runners with a training volume of at least 32 km per week. All three LH variables were significantly lower in runners than in controls. These data suggest that there is a central inhibition of the hypothalamic-pituitary-gonadal axis in eumenorrheic runners. PMID- 3972974 TI - [Clinical significance of the glutamate dehydrogenase activity in serum with special reference to liver damage induced by hypoxia]. PMID- 3972976 TI - [Studies on influenza in Tokyo in 1983-1984 epidemic period. Analysis of occurrence under unusual meteorological conditions]. PMID- 3972975 TI - Epidemiological survey of hepatitis B virus infection in Chiang Mai, 1981-1982. PMID- 3972977 TI - [Pathogenesis of impaired glucose tolerance and its relationship to hemodynamics in patients with acute myocardial infarction]. PMID- 3972978 TI - [Scanning electron microscopic observations on the parasitic forms of fungi in tinea cruris]. PMID- 3972979 TI - [On the bactericidal effectiveness of various disinfectants (IV)]. PMID- 3972980 TI - [Statistical analysis on the postoperative survivals of cancer patients in the treatment of SSM (an extract from human tubercle bacilli, so called Maruyama vaccine)]. PMID- 3972981 TI - [Intermittent self-catheterization in a child]. PMID- 3972982 TI - Lack of utility of a Limulus amoebocyte lysate assay in the diagnosis of urethral discharges in men. AB - We evaluated a Limulus amoebocyte lysate assay (LALA) test kit for the diagnosis of gonorrhea in 883 unselected men with urethral discharge. Results were compared with those of Gram-stained smears and Martin-Lewis cultures. Of 331 men with gonococcal urethritis and 552 men with nongonoccal urethritis, 125 (37.8%) and 503 (91.1%), respectively, could not be evaluated by LALA owing either to insufficient discharge specimen to perform the test (569 or 64.4%) or to other exclusion criteria (59 or 6.7%). Of 255 LALA-evaluable discharges, LALA correctly diagnosed 252 (98.8%), compared with 244 (95.7%) for the Gram-stained smear. However, the Gram-stained smear also correctly diagnosed 96.5% of 456 men with insufficient discharge for LALA testing. The clinical utility of the LALA test kit is severely limited by performance criteria that exclude the majority of unselected men with urethritis. In addition, it is more technically cumbersome, time consuming, and costly than Gram-stained smears. Further test modifications are unlikely to overcome these inherent disadvantages of LALA. PMID- 3972983 TI - Comparative evaluation of commercial rubella virus antibody kits. AB - Comparative evaluation of six commercial rubella virus antibody kits is described. A set of serum samples skewed toward nonreactive and low-positive rubella antibody levels was used because the goal of an immunity screening test is the detection of susceptible individuals. The M. A. Bioproducts Rubastat and the Hynson, Westcott and Dunning Rubascan were superior in achieving high sensitivity, specificity, and reproducibility. They also were the easiest and fastest tests to perform, and they require equipment available in most laboratories. PMID- 3972984 TI - Campylobacter jejuni-specific serum antibodies are elevated in healthy Bangladeshi children. AB - In Bangladesh and other developing countries, isolation of Campylobacter jejuni is common in healthy children, and the illness/infection ratio falls with age. To determine whether specific serum antibodies correlate with this phenomenon, using an enzyme-linked immunosorbent assay, we studied sera from 93 healthy Bangladeshi children and 121 healthy U.S. children under 15 years of age. For each age group (less than 1, 2 to 4, and 5 to 14 years) studied, specific serum antibody levels were significantly higher in the Bangladeshi children. Among Bangladeshi children, for each of the three immunoglobulin subclasses, the change in antibody levels with age was different. Specific immunoglobulin A antibody levels rose linearly with age, immunoglobulin G levels peaked in the 2- to 4-year age group and then fell, and immunoglobulin M levels peaked in the 2- to 4-year age group and then plateaued. Elevated serum antibody levels to C. jejuni in Bangladeshi children may be protective in themselves or may reflect other protective phenomena. PMID- 3972985 TI - Infections caused by Mycobacterium avium complex in immunocompromised patients: diagnosis by blood culture and fecal examination, antimicrobial susceptibility tests, and morphological and seroagglutination characteristics. AB - The Mycobacterium avium complex, only rarely described as an invasive pathogen in humans, has recently been reported to frequently cause disseminated disease in patients with the acquired immune deficiency syndrome. Between February 1981 and February 1984 at Memorial Sloan-Kettering Cancer Center, 30 patients with acquired immune deficiency syndrome, 3 patients with leukemia, and 2 patients with congenital severe combined immunodeficiency syndrome developed disseminated M. avium complex infection. Mycobacteria were often found in multiple sites both antemortem and postmortem. Blood cultures were a reliable method for detecting disseminated infection, and the new lysis blood culture systems provided an efficient technique for determining the number of organisms per milliliter of blood. Acid-fast stains and cultures of fecal specimens were also helpful in diagnosing infection. Most of the mycobacteria were serovar 4 (77%), and most (86%) produced a deep yellow pigment. All isolates were susceptible to standard concentrations of clofazimine, cycloserine, and ansamycin, but tended to be resistant to isoniazid, streptomycin, ethambutol, ethionamide, and rifampin. PMID- 3972986 TI - Improvement of two toluidine blue O-mediated techniques for DNase detection. AB - Two DNase detection techniques in which the metachromatic dye toluidine blue O (TBO) is used have been improved, and a potential source of difficulty for personnel attempting to use TBO-related methods has been identified. Reducing the concentration of TBO in the Streitfeld plate-flooding method from 0.1 to 0.05% resulted in easier control of staining intensity, less masking of DNase-positive reactions due to overstaining, sharper delineation of zones of DNase activity, and more sensitive detection of weak DNase reactions. Incorporation of 0.005% TBO in DNase agar, rather than the recommended 0.01%, allowed growth and expression of DNase activity by gram-positive as well as gram-negative bacteria. The reduced dye content in the agar also enhanced expression of DNase activity by some organisms and provided sharper delineation of DNase-positive reactions. Because optimum expression of DNase activity depends upon exact TBO concentrations in both the flooding and agar incorporation techniques, strict attention must be paid to the dye content of commercially available TBO dye powders. TBO concentrations must reflect actual dye content; therefore, calculations must include a conversion factor that accounts for the true dye content of the commercial preparation. The conversion factor that we developed is determined by dividing 100 by the percentage of dye in the commercial powder. The grams of commercial dye powder required per 100 ml of dye mixture is calculated by multiplying the percentage of dye required in the dye mixture by the conversion factor. PMID- 3972987 TI - Radiometric method for testing susceptibility of mycobacteria to pyrazinamide in 7H12 broth. AB - The test of susceptibility to pyrazinamide requires an acid environment (pH less than or equal to 5.5). This, however, is not favorable to the growth of Mycobacterium tuberculosis, especially in solid agar media. To obviate this difficulty, we developed a testing method with 7H12 broth medium and based on radiometric readings of the growth. The radiometric method employed in this study (BACTEC system) provides an opportunity to detect the dynamics of growth by daily recording of the growth index, which reflects the metabolic activity of the multiplying bacteria. In our technique, M. tuberculosis isolates were initially cultivated at pH 6.8. After logarithmic growth had begun, phosphoric acid solution was added to obtain pH 5.5. When pyrazinamide was added simultaneously with the acid, the growth index of susceptible cultures decreased, whereas it continued to increase in pH 5.5 control vials and in tests with pyrazinamide resistant strains. PMID- 3972988 TI - Turbidimetric method for quantifying serum inhibition of Limulus amoebocyte lysate. AB - This study describes a method to quantify the inhibition of lipopolysaccharide (LPS) activity by serum with a turbidimetric Limulus amoebocyte lysate assay. Assays were performed in multiwell microplates, and turbidity was measured as the optical density at 380 nm with a microplate spectrophotometer. LPS potency was measured as the 50% maximal Limulus amoebocyte response (LR50) of LPS diluted with saline. By comparing LR50s in saline, LPSs from various species of bacteria were standardized against the U.S. Reference Standard Endotoxin, lot EC-5. The potency of Escherichia coli O113 and O18 and Serratia marcescens LPSs was found to be equal to that of the reference standard EC-5, whereas LPSs from two salmonella species were half as potent. The least potent LPSs tested, obtained from Klebsiella pneumoniae and E. coli rough mutant J5, were 5- and 10-fold less potent, respectively, than EC-5. As a measure of inhibition, the LR50 of LPS in serum was compared to the LR50 of LPS in saline. Serum inhibited the potency of LPS 103- to 6,400-fold compared with saline. A positive correlation was found between standardized potency in saline and serum inhibition of the various LPSs tested. Thus, LPSs from E. coli O113, O18, and EC-5 and S. marcescens, which exhibited the highest potency in saline, were inhibited the most by serum. Likewise, E. coli J5 and K. pneumoniae LPSs, which were the least potent tested, were the least inhibited. The degree of inhibition of all types of LPS tested increased with increasing serum concentration. PMID- 3972989 TI - Illness associated with Campylobacter laridis, a newly recognized Campylobacter species. AB - Campylobacter laridis, a recently described thermophilic Campylobacter species found principally in seagulls, has not previously been linked to illness in humans. Six clinical isolates of this species were referred to the national campylobacter reference laboratory in 1982 and 1983. Each isolate was confirmed by biochemical characterization and by DNA relatedness studies. The six isolates were obtained during an illness: enteritis in four, severe crampy abdominal pain in one, and terminal bacteremia in an immunocompromised host in one. The infections occurred in persons 8 months to 71 years old. Neither the geographic distribution nor the reports of the patients suggest that seagulls played a direct role in the epidemiology of these infections. This potential human enteric pathogen appears to be clinically, epidemiologically, and microbiologically similar to Campylobacter jejuni and may be mistaken for it if nalidixic acid susceptibility screening is not routinely performed. PMID- 3972990 TI - Comparison of basal media for culturing Campylobacter jejuni and Campylobacter coli. AB - Four strains of Campylobacter jejuni and four strains of Campylobacter coli were used to compare the quantitative growth of Campylobacter cells on blood agar base no. 2 (Oxoid), brucella agar (BBL Microbiology Systems and Difco Laboratories), campylobacter agar base (Difco), Columbia blood agar base (Difco and Oxoid), and Mueller-Hinton agar (Difco and Oxoid). Columbia blood agar base and blood agar base no. 2 were inhibitory to most of the strains tested, as evidenced by reduced (10- to 1,000-fold) colony counts compared with other basal media. One of the brucella agars was inhibitory to two of the C. coli strains. The inhibitory effect of these media could be eliminated by addition of FBP (0.05% each ferrous sulfate hydrate, sodium metabisulfite, and sodium pyruvate) or 7% defibrinated sheep blood. However, addition of FBP or blood to brucella agar, campylobacter agar base, or Mueller-Hinton agar did not significantly affect the count, indicating that supplements are not required in these media for growth of Campylobacter in pure culture. PMID- 3972991 TI - Leminorella, a new genus of Enterobacteriaceae: identification of Leminorella grimontii sp. nov. and Leminorella richardii sp. nov. found in clinical specimens. AB - Leminorella is proposed as a new genus for the group of Enterobacteriaceae formerly known as Enteric Group 57. Strains of Leminorella gave positive tests for H2S production, acid production from L-arabinose and D-xylose, and tyrosine clearing; they were negative for indole production, Voges-Proskauer, urea hydrolysis, phenylalanine deaminase, motility, gelatin liquefaction, lysine and ornithine decarboxylases, arginine dihydrolase, growth in KCN, and acid production from adonitol, D-arabitol, cellobiose, erythritol, D-galactose, myo inositol, lactose, maltose, D-mannitol, D-mannose, melibiose, alpha-CH3 glucoside, raffinose, L-rhamnose, salicin, D-sorbitol, sucrose, and trehalose. By DNA hybridization, strains of Leminorella were only 3 to 16% related to other Enterobacteriaceae and were divided into three groups. Leminorella grimontii is proposed as the type species for the genus and strain CDC 1944-81, ATCC 33999, is designated as the type strain. There were four strains of L. grimontii from stool specimens and two from urine specimens. L. richardii is proposed as the name for the second species (type strain, CDC 0978-82, ATCC 33998). All four L. richardii strains were from stool specimens. L. grimontii can be distinguished from L. richardii because it produces gas from glucose (100%) and acid from dulcitol (83%) and is methyl red positive (100%). One strain, CDC 3346-72, was more related to L. grimontii by DNA hybridization than to L. richardii, but the lower relatedness to both of these species indicated that it may be a third species. Biochemically it could not be distinguished from L. grimontii. All Leminorella strains were resistant (no zone of inhibition) to ampicillin, carbenicillin, and cephalothin. Some of the Leminorella strains were sent to us for Salmonella serotyping, and two reacted weakly in Salmonella antisera. The clinical significance of Leminorella is unknown. PMID- 3972993 TI - Radioenzymatic assay for trimethoprim in very small serum samples. AB - A modification of the methotrexate radioassay kit (supplied by New England Enzyme Center) enabled determination of trimethoprim levels in 5-microliter serum samples. An excellent correlation between this assay and high-pressure liquid chromatography assay was found. These preliminary results suggest that with this method rapid determination of trimethoprim levels in very small samples (5 to 10 microliters) can be achieved. PMID- 3972992 TI - Effect of fibronectin on adherence of neutrophils from newborn infants. AB - Neutrophils (polymorphonuclear leukocytes [PMNs]) from infants and adults increased in adherence over a 20-min incubation as measured in a morphological assay. At each time point, PMNs from healthy infants had significantly diminished adherence when compared with those of adults; PMNs from sick newborn infants showed intermediate adherence values. Moreover, PMNs from healthy infants had significantly diminished membrane fluorescence for fibronectin when compared with those of adults. Preincubation with exogenous fibronectin did not augment the adherence of PMNs from infants or adults. Deficient adherence of PMNs from newborns may be related to decreased membrane fibronectin. PMID- 3972994 TI - Two bacteriophages of Clostridium difficile. AB - Two temperate bacteriophages of differing morphology and host range were isolated by screening 94 isolates of Clostridium difficile. Phage 41 had a 300-nm flexible tail, whereas phage 56 had a shorter tail with a contractile sheath. Electron microscopy of phage 56 lysates exposed to elevated magnesium concentrations showed small virus-like particles which were 21 nm in diameter. The addition of MgCl2 to semisolid agar overlays enhanced both the titer and plaque size of phage 56. Phage 56 was more temperature labile than phage 41 and demonstrated unusual lability in buffer at pH 7.0. One-step growth and adsorption experiments revealed that both phages had latent periods of about 60 min, but phage 56 adsorbed to its indicator strain more efficiently. Phage 56, which was obtained from a toxigenic strain of C. difficile, was used to lysogenize its nontoxigenic indicator strain, but no conversion to toxigenicity was observed in this strain. PMID- 3972995 TI - Staphylococcus simulans septicemia in a patient with chronic osteomyelitis and pyarthrosis. AB - Staphylococcus simulans was identified as the etiological agent of osteomyelitis and septic arthritis in an adult male who had sustained a fracture of the fibula and syndesmosis separation which required the installation of orthopedic hardware. Identifying characteristics and antibiograms for this organism, recovered from blood, wound exudate, and deep tissue samples, were determined. Recent evidence has linked slime production (adherence to smooth surfaces) by coagulase-negative staphylococci to infections by these organisms at sites where foreign bodies had been inserted. Tests for adherence showed this S. simulans strain to be a strong slime producer. This is the first reported case of osteomyelitis and septicemia due to S. simulans. PMID- 3972996 TI - Isolation of Campylobacter fetus from a pet turtle. AB - During the course of a Salmonella agona case investigation, Campylobacter fetus was isolated from a pet turtle. This is the first reported isolation of C. fetus from a turtle and suggests that turtles, in addition to being reservoirs for Salmonella species, may also be reservoirs for C. fetus. PMID- 3972997 TI - Antibacterial activity in blood cultures. AB - A total of 2,010 blood samples inoculated into tryptic soy broth were examined for antibacterial activity by means of a bioassay plate seeded with Bacillus subtilis spores. The size of the zone of inhibition on this plate was indicative of the degree of antibacterial activity. Current antibiotic therapy was confirmed by examination of chart records. Of the 2,010 blood cultures tested, 147 (7.3%) contained detectable levels of antibiotics; of these 147, 14 (9.5%) yielded growth of bacteria, and 133 (90.5%) remained negative. When the Antibiotic Removal Device (Marion Scientific, Div. Marion Laboratories, Inc., Kansas City, Mo.) was used, it eliminated the antibacterial activity but did not improve the recovery of bacteria from these cultures. Only bacteria resistant to the respective antibiotic were recovered from blood cultures that showed high levels of antibacterial activity (beta-lactam antibiotics, greater than 0.60 micrograms/ml; aminoglycosides, greater than 2 micrograms/ml; and tetracycline, greater than 4 micrograms/ml). Blood cultures showing low levels of antibacterial activity yielded both resistant and susceptible bacteria. PMID- 3972998 TI - Performance of the prompt system in identification and antimicrobial susceptibility testing of clinical isolates. AB - The rapid 3M Prompt inoculation system was compared with the traditional log phase system for Autoscan identification and antibiotic susceptibility testing (MIC) of 188 recent clinical isolates. The two systems were equally effective for gram-negative rods; the Prompt system was slightly superior for the determination of MICs for gram-positive organisms. PMID- 3972999 TI - Evaluation of broth microdilution susceptibility results for anaerobic organisms by use of a rapid direct colony inoculum. AB - A direct colony inoculum suspension procedure was compared with the overnight suspension procedure recommended for the broth microdilution anaerobic commercial system (Micro-Media Systems, Inc., Potomac, Md.). Six National Committee for Clinical Laboratory Standards-recommended quality control organisms, Bacteroides fragilis ATCC 25285, Clostridium perfringens ATCC 13124, Bacteroides thetaiotaomicron ATCC 29741, Bacteroides vulgatus ATCC 29327, Peptococcus magnus ATCC 29328, Peptococcus asaccharolyticus ATCC 29743, and 50 anaerobic clinical isolates were tested against seven commonly tested antimicrobial agents. The minimum inhibitory concentration results from each suspension method (using the quality control organisms) were identical in 18 (78%) instances, and within +/- 1 log2 dilution in 96% of the comparisons. Results with the fresh clinical isolates also compared satisfactorily with the overnight procedure (97% were identical or within one dilution). The Wilkins-Chalgren test medium failed to support the growth of most anaerobic gram-positive cocci and Bacteroides melaninogenicus strains. PMID- 3973001 TI - Isolation and detection of multiple yeasts from a single clinical sample by use of Pagano-Levin agar medium. AB - A total of 15,234 clinical samples were tested on modified Pagano-Levin agar medium to detect multiple yeast species within a single sample. Samples containing more than one yeast species were estimated to be 8.0% of the total. The most frequent combination of different yeasts was Candida albicans and Torulopsis glabrata. PMID- 3973000 TI - Actinomyces naeslundii as an agent of pelvic actinomycosis in the presence of an intrauterine device. AB - Actinomyces naeslundii is a saprophyte, sometimes a pathogen, of the human oral cavity. Very few extra-oral infections related to this agent have been described. We report the first instance of A. naeslundii as an etiological agent of pelvic actinomycosis in a user of an intrauterine device, an infection so far exclusively attributed to Actinomyces israelii. PMID- 3973002 TI - Pseudomonas pickettii as a cause of pseudobacteremia. AB - An outbreak of pseudobacteremia caused by Pseudomonas pickettii biovariant 1 is reported. The common source was the aqueous chlorhexidine solution prepared by the hospital pharmacy. The contamination problem caused by the antiseptic solution was eventually solved by a series of preventive measures. PMID- 3973003 TI - Lactic acid levels in pleural fluid from patients with bacterial pleuritis. AB - Pleural fluid lactic acid estimations were carried out on 60 samples by gas liquid chromatography. Lactic acid levels in 12 patients with bacterial pleural infection were statistically significantly higher (mean, 287 mg/dl; range, 135 to 482 mg/dl) than in 18 patients with malignancy (mean, 71 mg/dl; range, 24 to 157 mg/dl) and 30 other patients with pleural effusions (mean, 19 mg/dl; range, 10 to 57 mg/dl). The determination of pleural fluid lactic acid may help in differentiating between empyema and nonbacterial pleural effusions in most cases. It is of particular value when antibiotic therapy has commenced before specimen collection and may be useful for monitoring therapy. PMID- 3973004 TI - Bacteroides fragilis meningitis. AB - A fatal case of pyogenic meningitis due to Bacteroides fragilis in a 6-year-old boy is reported. The need for processing cerebrospinal fluid of patients with underlying conditions such as chronic otitis media for recovery of both aerobes and anaerobes is discussed. PMID- 3973005 TI - Non-O1 Vibrio cholerae in Thailand: homology with cloned cholera toxin genes. AB - We examined 281 non-O1 Vibrio cholerae isolates from Thailand for homology with genes coding for cholera toxin. Five isolates from environmental sources were homologous with the cholera toxin gene probe and produced both the A and B subunits of cholera toxin. PMID- 3973006 TI - Autoimmune encephalomyelitis and hemorrhagic retinal disease in neonatal, infant, juvenile, and adult monkeys. AB - Severe (24/24) and lethal (22/24) autoimmune encephalomyelitis was regularly induced in rhesus monkeys of all age groups from newborns to adults by a single injection of guinea pig spinal cord in complete Freund's adjuvant. Age dependency of the encephalomyelitis was manifested by a delayed onset and prolonged course in newborn monkeys. A hemorrhagic retinopathy usually accompanying the earliest CNS symptoms was observed in most of these monkeys. The most severe lesions were predominant in the cerebellum and brainstem of neonates, and in the cerebral hemispheres of older animals. PMID- 3973007 TI - Muscle acetylcholine receptor loss in murine experimental autoimmune myasthenia gravis: correlated with cellular, humoral and clinical responses. AB - An extensive analysis of the relationship between immunological parameters and clinical responses and biochemical loss of muscle acetylcholine receptors (AChR) was performed in murine experimental autoimmune myasthenia gravis. The onset of clinical muscle weakness correlated strongly with the onset of significant muscle AChR loss. Mice with clinical muscle weakness had greater amount of muscle AChR loss. There was no correlation between the concentration of anti-AChR antibodies and the presence of clinical muscle weakness or amount of muscle AChR loss. However, the kinetics of autoantibody response correlated well with that of muscle AChR loss. PMID- 3973008 TI - Biosynthesis of factor V in isolated guinea pig megakaryocytes. AB - Although platelets contain Factor V, localized primarily in the alpha-granules, the origin of this coagulation cofactor in these cells is not known. We therefore explored whether isolated megakaryocytes could biosynthesize Factor V. Guinea pig plasma Factor V coagulant activity was demonstrated to be neutralized by human monoclonal and rabbit polyclonal antibodies directed monospecifically against human Factor V. These antibodies had been used earlier to purify human Factor V. These antibodies had been used earlier to purify human Factor V and to quantify Factor V antigen concentration, respectively (1983. Chiu, H. C., E. Whitaker, and R. W. Colman. J. Clin. Invest. 72:493-503). As determined by a competitive enzyme linked immunosorbent assay with guinea pig plasma as a standard, Factor V solubilized from guinea pig megakaryocytes was present at 0.098 +/- 0.018 micrograms/10(5) cells. Each megakaryocyte contained about 500 times as much Factor V as is in a platelet (0.234 +/- 0.180 micrograms/10(8) platelets). The content of Factor V antigen in guinea pig plasma was greater (27.0 +/- 3.0 micrograms/ml) than that of Factor V antigen in human plasma (11.1 +/- 0.4 micrograms/ml). In contrast, human platelets contain ninefold more Factor V antigen (2.01 +/- 1.09 micrograms/10(8) platelets) than do guinea pig were 2.85 +/- 0.30 U/ml plasma, 0.022 +/- 0.012 U/10(8) platelets, and 0.032 +/- 0.03 U/10(5) megakaryocytes, compared with human values of 0.98 +/- 0.02 U/ml plasma and 0.124 +/- 0.064 U/10(8) platelets. Isolated megakaryocytes were found to contain Factor V by cytoimmunofluorescence. The megakaryocytes were incubated with [35S]methionine, and radiolabeled intracellular proteins purified were on a human anti-Factor V immunoaffinity column. The purified protein exhibited Factor V coagulant activity and neutralized the inhibitory activity of a rabbit antihuman Factor V antibody, which suggests that megakaryocyte Factor V is functionally and antigenically intact. These results indicate that Factor V is synthesized by guinea pig megakaryocytes. Nonetheless, megakaryocyte Factor V was more slowly activated by thrombin and in the absence of calcium was more stable after activation than was plasma Factor Va. Electrophoresis in sodium dodecyl sulfate and autoradiography of the purified molecule showed a major band of Mr 380,000 and a minor band of Mr 350,000, as compared with guinea pig and human plasma Factor V, where the protein had an Mr of 350,000. Both forms of Factor V were substrates for thrombin. Possible explanations for the higher molecular weight and different thrombin sensitivity and stability observed are that a precursor of Factor V was isolated or that the megakaryocyte Factor V had not been fully processed before isolation. PMID- 3973010 TI - Inhibitors of protein synthesis also inhibit lysosomal proteolysis. Studies using cystinotic fibroblasts. AB - Cystine depleted cystinotic fibroblasts incubated in cystine-free medium accumulate lysosomal-free cystine from the degradation of cystine-containing intracellular and extracellular proteins. In this report we have used this characteristic of these cells to study lysosomal proteolysis. We find that inhibitors of protein synthesis (cycloheximide, emetine, and puromycin) inhibit cystine accumulation from endogenous proteins and therefore act to inhibit lysosomal proteolysis of these proteins. However, cycloheximide does not inhibit cystine accumulation derived from the degradation of the extracellular disulfide rich proteins, albumin and RNase, but lysosomal cystine accumulation derived from insulin is inhibited by cycloheximide. We conclude that a rapidly turning over protein may be required for the lysosomal degradation of intracellular and some extracellular proteins. PMID- 3973009 TI - Roles of apolipoproteins B and E in the cellular binding of very low density lipoproteins. AB - Apoproteins B and E both interact with cellular low density lipoprotein (LDL) apolipoprotein B and E (apo B,E)-receptors, and very low density lipoproteins (VLDL) contain both apo B and apo E. Our aim was to study the relative importance of apo B and apo E in the binding of VLDL subfractions to cells. Two monoclonal anti-LDL-apo B antibodies (464B1B3 and 464B1B6, 2a and 2b, respectively) and two anti-apo E antibodies (1506 A1.4 and 1907 F6.4) were used to inhibit lipoprotein cell interactions. In confirmation of previous findings, the binding and degradation of 125I-LDL by human fibroblasts were inhibited approximately 90% by antibodies 2a or 2b or the antigen-binding fragments of 2a, whereas the cellular processing of 125I-VLDL3 (Sf20-60), 125I-VLDL2 (Sf60-120), and 125I-VLDL1 (Sf greater than 120) were inhibited by only approximately 50%, approximately 25%, and less than 10%, respectively. The VLDL1-3 and LDL-dependent intracellular esterification of cholesterol with [3H]oleate were inhibited to a similar extent. Other monoclonal anti-human apo B antibodies inhibited lipoprotein-cell interactions much less effectively and nonimmune IgG isolated from mouse serum did not inhibit at all. 20-fold excesses of LDL produced about the same patterns of inhibition of degradation of 125I-VLDL1-3 and LDL by cells as did antibodies 2a and 2b, whereas homologous unlabeled VLDL1-3 in like amounts inhibited the matched 125I-VLDL subfraction more effectively. Two anti-apo E monoclonal antibodies and a polyclonal anti-apo E antibody inhibited cell-mediated degradation of and lipoprotein-dependent cholesterol esterification by VLDL1 but not VLDL3 or LDL. The results suggest that receptor recognition sites on apo E in preference to sites on apo B mediate the cellular binding of hypertriglyceridemic VLDL1. However, the proportion of particles bound via apo B seems to increase as VLDL decreases in size toward LDL, and virtually all of LDL binding is mediated by apo B. PMID- 3973011 TI - Modulation of lipoprotein lipase activity by apolipoproteins. Effect of apolipoprotein C-III. AB - From a total of 22 hypertriglyceridemic subjects tested, 14 subjects were selected on the basis of normal postheparin plasma lipoprotein lipase (LPL) levels and the presence of LPL inhibitory activity in their fasting plasma. The inhibitory activity was detected in both the lipoprotein fraction (d less than 1.25 g/ml) and the lipoprotein-deficient fraction (d greater than 1.25 g/ml). Correlational analyses of LPL inhibitory activity and apolipoprotein levels present in the lipoprotein fraction (d less than 1.25 g/ml) indicated that only apolipoprotein C-III (ApoC-III) was significantly correlated (r = 0.602, P less than 0.05) with the inhibition activity of the lipoprotein fraction. Furthermore, it was found that LPL-inhibitory activities of the plasma lipoprotein fraction and lipoprotein-deficient fraction were also correlated (r = 0.745, P less than 0.005), though the activity in the lipoprotein-deficient plasma was not related to the ApoC-III or apolipoprotein E levels. Additional correlational analyses indicated that the LPL levels in the postheparin plasma of these subjects were inversely related to the levels of plasma apolipoproteins C-II, C-III, and E. To explain some of these observations, we directly examined the in vitro effect of ApoC-III on LPL activity. The addition of ApoC-III-2 resulted in a decreased rate of lipolysis of human very low density lipoproteins by LPL. Kinetic analyses indicated that ApoC-III-2 was a noncompetitive inhibitor of LPL suggesting a direct interaction of the inhibitor with LPL. Results of these studies suggest that ApoC-III may represent a physiologic modulator of LPL activity levels and that the incidence of LPL inhibitory activity in the plasma of hypertriglyceridemic subjects is more common than previously recognized. PMID- 3973012 TI - Defective peroxisomal cleavage of the C27-steroid side chain in the cerebro hepato-renal syndrome of Zellweger. AB - Based on in vitro work with rat liver, we recently suggested that the peroxisomal fraction is most important for the oxidation of 3 alpha, 7 alpha, 12 alpha trihydroxy-5 beta-cholestanoic acid (THCA) into cholic acid. The cerebro-hepato renal syndrome of Zellweger is a fatal recessive autosomal disorder, the most characteristic histological feature of which is a virtual absence of peroxisomes in liver and kidneys. This disease offers a unique opportunity to evaluate the relative importance of peroxisomes in bile acid biosynthesis. A child with Zellweger syndrome was studied in the present work. In accordance with previous work, there was a considerable accumulation of THCA, 3 alpha, 7 alpha, 12 alpha, 24-tetrahydroxy-5 beta-cholestanoic acid (24-OH-THCA), 3 alpha, 7 alpha, 12 alpha trihydroxy-27-carboxymethyl-5 beta-cholestan-26-oic acid (C29-dicarboxylic acid), and 3 alpha, 7 alpha-dihydroxy-5 beta-cholestanoic acid in serum. In addition, a tetrahydroxylated 5 beta-cholestanoic acid with all the hydroxyl groups in the steroid nucleus was found. 3H-Labeled 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha-triol was administered intravenously together with 14C-labeled cholic acid. There was a rapid incorporation of 3H in THCA and a slow incorporation into cholic acid. The specific radioactivity of 3H in THCA was about one magnitude higher than that in cholic acid. The conversion was evaluated by following the increasing ratio between 3H and 14C in biliary cholic acid. The rate of incorporation of 3H in cholic acid was considerably less than previously reported in experiments with healthy subjects, and the maximal conversion of the triol into cholic acid was only 15-20%. About the same rate of conversion was found after oral administration of 3H-THCA. Both in the experiment with 3H-5 beta cholestane-3 alpha, 7 alpha, 12 alpha-triol and with 3H-THCA, there was an efficient incorporation of 3H in the above unidentified tetrahydroxylated 5 beta cholestanoic acid. There was only slow incorporation of radioactivity into 24-OH THCA and into the C29-dicarboxylic acid. From the specific activity decay curve of 14C in cholic acid obtained after intravenous injection of 14C-cholic acid, the pool size of cholic acid was calculated to be 24 mg/m2 and the daily production rate to 9 mg/m2 per d. This corresponds to a reduction of approximately 85 and 90%, respectively, when compared with normal infants. It is concluded that liver peroxisomes are essential in the normal conversion of THCA to cholic acid. In the Zellweger syndrome this conversion is defective and as a consequence the accumulated THCA is either excreted as such or transformed into other metabolites by hydroxylation or side chain elongation. The accumulation of THCA, as well as the similar rate of conversion of 5 beta-cholestane-3 alpha,7 alpha.12 alpha-triol and THCA into cholic acid, support the contention that the 26-hydroxylase pathway with intermediate formation of THCA is the most important pathway for formation of cholic acid in man. PMID- 3973014 TI - Transport of ammonia in the rabbit cortical collecting tubule. AB - Nonionic diffusion and diffusion equilibrium of ammonia have been generally accepted as the mechanism of urinary ammonium excretion. However, these characteristics have not been examined directly in vitro. In the present studies, nonionic diffusion and diffusion equilibrium of ammonia were examined in rabbit cortical collecting tubules perfused in vitro. Collected fluid ammonium and pH were measured in tubules exposed to chemical gradients of NH3/NH+4. In tubules perfused with an acid perfusate free of ammonia and bathed with solutions containing NH4Cl, collected fluid ammonia failed to equilibrate across the epithelium except at slow flow rates. The estimated apparent permeability coefficient to NH3 was approximately 5 X 10(-3) cm/s. Predominant nonionic diffusion of NH3, rather than transport of NH+4, was indicated by alkalinization of luminal fluid in tubules exposed to peritubular NH4Cl and by the relative influence of peritubular NH+4 and NH3 on ammonia entry. In tubules perfused with an acid solution containing NH4Cl, little loss of ammonium was detectable, indicating a low permeability to NH+4. In contrast to the restricted diffusion of NH3 in cortical collecting tubules, proximal convoluted tubules exhibited a much higher apparent permeability to NH3. In conclusion, nonionic diffusion of NH3 accounted for most ammonium transport in the proximal convoluted tubule and in the cortical collecting tubule. However, there was relatively restricted diffusion in the collecting tubules; this may account for the failure of whole kidney ammonium excretion to obey quantitatively the predictions of nonionic diffusion and diffusion equilibrium of ammonia. PMID- 3973013 TI - Functional compartmentation of glycolytic versus oxidative metabolism in isolated rabbit heart. AB - To investigate whether energy derived from glycolytic and oxidative metabolism are preferentially used for different functions in heart, tension, intracellular potential, and extracellular [K+] and pH (using triple barrel K/pH electrodes, tip diameter 0.5 mm) were monitored in isolated arterially perfused rabbit interventricular septa during exposure to hypoxia and metabolic inhibitors. Myocardial content of high energy phosphates, lactate, and glycogen were determined under the same conditions. Inhibiting oxidative metabolism with hypoxia, dinitrophenol (10(-5)M), or Na-azide (10(-3)M) caused marked suppression of tension (by 73 +/- 5, 65 +/- 8, and 50 +/- 14%, respectively) and a small increase in [K+]0 (0.8 +/- 0.4, 0.5 +/- 0.25, and 0.4 +/- 0.2 mM, respectively) after 10 min. Inhibiting glycolysis with iodoacetate (IAA) (10(-3)M) had a much smaller suppressant effect on tension (28 +/- 24%) but markedly increased [K+]0 accumulation (by 1.8 +/- 1.1 mM) at 10 min. These differences, when IAA was compared individually to the other interventions, were highly significant. The shortening of action potential duration was not significantly different for the four interventions. pH0 increased slightly during IAA (+0.04-+0.06 U) and fell during the other interventions (-0.10--0.16 U), but this did not account for the differences in [K+]0 accumulation and tension between inhibition of glycolytic vs. oxidative metabolism. Except for hypoxia, total cellular content of high energy phosphates was not significantly depressed under the various conditions. This data suggests that energy from glycolysis is preferentially used to support sarcolemmal function (as manifested by K+ loss), whereas oxidatively derived energy preferentially supports contractile function. Indexing terms: cardiac metabolism, extracellular pH, metabolic inhibitors, hypoxia, extracellular K+ accumulation, and glycolysis. PMID- 3973015 TI - Structural and functional evolution of jejunal allograft rejection in rats and the ameliorating effects of cyclosporine therapy. AB - We assessed the structural and functional evolution of small intestinal transplant rejection in a rat model by use of 1-micron section, electron microscopic, and in vitro electrophysiologic techniques to study jejunal mucosa 3, 6, and 9 d posttransplantation. The earliest structural abnormalities detected in jejunal loops transplanted from Lewis X Brown Norway F1 hybrids into Lewis rats occurred within 3 d posttransplantation and consisted of focal endothelial cell injury of the microvasculature and focal injury of crypt epithelial cells. Both alterations were associated with adjacent infiltration of large lymphoid cells, and both markedly progressed and became rather diffuse over the following 6 d. In contrast, villus absorptive cells were not markedly altered in structure until the 9th postoperative day. As compared with host jejuna, allograft jejunal epithelium demonstrated multiple functional abnormalities. Transepithelial resistance declined progressively by days 6 and 9 (both P less than 0.05), although baseline transepithelial spontaneous potential difference was only affected at day 9 (P less than 0.01). Stimulated absorption by allograft jejuna, as assessed by measuring electrical response to mucosal glucose, was not significantly diminished until day 9 (P less than 0.05). In contrast, stimulated secretion assessed by measurement of electrical response to serosal theophylline was diminished by day 6 (P less than .01). These data suggest that the earliest epithelial injury during rejection, as judged both structurally and functionally, occurs in the crypt and is paralleled by endothelial injury at the level of the microvasculature. Thus, the primary targets for rejection are most likely endothelial cells and crypt epithelial cells. In contrast, structural and functional impairment of villus epithelium is detectable only at substantially later times during rejection and are most likely secondary processes related to either ischemia produced by microvascular injury or decreased epithelial regenerative ability secondary to crypt injury. Last, we show that the detrimental structural and functional sequellae of jejunal transplantation across the major histocompatibility complex in this model is strikingly ameliorated with cyclosporine therapy. PMID- 3973016 TI - Presence of the Tn antigen on hematopoietic progenitors from patients with the Tn syndrome. AB - The Tn syndrome is an acquired clonal disorder characterized by the exposure of a normally hidden determinant, the Tn antigen, on the surface of human erythrocytes, platelets, granulocytes, and lymphocytes. Two distinct populations, Tn positive (Tn+) and Tn negative (Tn-), of mature hemopoietic cells are present in Tn patients. To determine whether the Tn antigen is already expressed on erythroid, myeloid, and pluripotent progenitors, light-density mononuclear blood cells from two patients with this syndrome were separated by fluorescent activated cell sorting and by affinity chromatography into Tn+ and Tn- fractions, using their binding properties to Helix pomatia agglutinin (HPA). Burst-forming unit erythroid (BFU-E), colony-forming-unit granulocyte/macrophage (CFU-GM), cells were assayed in plasma clot cultures. After 12-14 d of culture, colonies were studied by a double fluorescent labeling procedure. First, a fluorescein conjugated HPA permitted evaluation of the presence or absence of the Tn antigen at the surface of the cells composing each colony, and second, the binding of a murine monoclonal antibody against either glycophorin A (LICR-LON-R10) or against a myeloid antigen (80H5), revealed by an indirect fluorescent procedure, was used to establish the erythroid or myeloid origin of each cell. The Tn+ fraction obtained by cell sorting gave rise to nearly 100% Tn+ colonies composed exclusively of cells bearing this antigen. The reverse was observed for the Tn- cell fraction. These results demonstrate that in the Tn syndrome, BFU-E, CFU-GM, and CFU-GEMM of the Tn+ clone express the Tn antigen at this early stage of differentiation. PMID- 3973017 TI - Dietary protein suppresses feedback control of glomerular filtration in rats. AB - We have examined the possibility that changes in glomerular filtration rate (GFR) after changes in dietary protein intake may depend on altered function of the tubuloglomerular (TG) feedback system. We studied male Sprague-Dawley rats after dietary pretreatment for 9.6 +/- 3.6 (SD) d with isocaloric diets containing either 6% or 40% casein. We found that GFR in rats fed the high protein diet was 24-29% higher than in rats fed the low protein diet. Simultaneous measurements of single nephron GFR (SNGFR) in the distal tubule were 6.3 nl/min or 21% higher in the rats fed the high protein diet whereas proximally measured SNGFR was not statistically different in the two groups. The higher distally measured SNGFR of rats receiving the high protein diet was associated with a 4.2 nl/min or 50% smaller suppression of SNGFR by TG feedback (-4.3 vs. -8.5 nl/min, P less than 0.001). Loop perfusion experiments demonstrated that in rats fed the high protein diet the TG feedback mechanism was less sensitive than in rats fed the low protein diet. The TG feedback response in rats fed the low protein diet, as assessed by reductions in stop-flow pressure and SNGFR, was half-maximal at flows of 14-15 nl/min. In contrast, the TG feedback response in rats fed the high protein diet was half-maximal at 22-24 nl/min. Maximal suppression of stop-flow pressure and SNGFR and the slope of the TG feedback response to increasing loop flow rates were not different in the two groups. We conclude that the sensing mechanism of the TG feedback system is rendered less responsive by a high protein intake, and that this change permits GFR to increase. PMID- 3973018 TI - Transfer and expression of the gene encoding a human myeloid membrane antigen (gp150). AB - DNA from the human myeloid cell line HL-60 was cotransfected with the cloned thymidine kinase (tk) gene of herpes simplex virus into tk-deficient mouse L cells. tk-positive recipients expressing antigens detected on HL-60 cells were isolated with a fluorescence-activated cell sorter by use of a panel of monoclonal antibodies that detect epitopes on both normal and malignant myeloid cells. Independently sorted populations of transformed mouse cells showed concordant reactivities with four of the monoclonal antibodies in the panel (DU HL60-4, MY7, MCS.2, and SJ-D1), which suggested that these antibodies reacted to products of a single human gene. A second round of DNA transfection and cell sorting was performed with donor DNA from primary transformants. Two different dominant selection systems were used to isolate secondary mouse L cell and NIH/3T3 cell transformants that coexpressed the same epitopes. Analysis of cellular DNA from secondary mouse cell subclones with a probe specific for human repetitive DNA sequences revealed a minimal human DNA complement containing a characteristic set of restriction fragments common to independently derived subclones. Two glycoproteins, of 130,000 (gp130) and 150,000 (gp150) mol wt, were specifically immunoprecipitated from metabolically labeled lysates of mouse cell transformants and were shown to contain [35S]methionine-labeled tryptic peptides identical to those of analogous glycoproteins expressed in the donor human myeloid cell line. Kinetic and biochemical analyses established that gp130 is a precursor that differs in its carbohydrate moiety from gp150, the mature form of the glycoprotein detected on the cell surface. The isolation of human gene sequences encoding gp150 in a mouse cell genetic background provides the possibility of molecularly cloning the gene and represents a general strategy for isolating human genes encoding differentiation-specific cell surface antigens. PMID- 3973019 TI - Autoimmune sera reactive with Sm antigen contain high levels of RNP-like antibodies. AB - Ribonucleoprotein particles containing Sm antigen were separated from particles containing both Sm and RNP antigens by ion-exchange chromatography to study the recognition of these antigens by autoimmune sera. By using the separated antigens, anti-Sm and/or anti-RNP antibodies were detected in approximately 60% of sera from systemic lupus erythematosus patients by both enzyme-linked immunosorbent assay and immunoprecipitation of radiolabeled antigens followed by analysis on sodium dodecyl sulfate-polyacrylamide gels. These antibodies were detected in 30% of the same sera using the standard passive hemagglutination technique. Competition experiments demonstrated that all of the sera tested that contained anti-Sm antibodies also had anti-RNP-like reactivity. This latter reactivity usually represented 80% or more of the total Sm and RNP binding activity in lupus sera. The binding to RNP-like determinants by several of the sera was uniquely resistant to treatment of the antigen with snake venom exonuclease. These studies indicate that humoral immunity against Sm and RNP antigens in systemic lupus erythematosus is directed primarily against a single type of ribonucleoprotein particle in which the two antigens are physically associated. The specific binding to a single type of ribonucleoprotein particle suggests that this particle may be especially immunogenic and that it might play an important role in induction of the humoral immune response to Sm and RNP. PMID- 3973020 TI - Influence of chronic lactulose ingestion on the colonic metabolism of lactulose in man (an in vivo study). AB - The effects of a chronic load of nonabsorbable sugars on intracolonic bacterial metabolism of carbohydrates and on H2 breath excretion are disputed. However, most of the discussion relies on indirect evidence or on results of in vitro studies. Thus, we attempted to assess directly and in vivo the effects on intracolonic metabolism of lactulose of a chronic oral load of this nonabsorbable disaccharide. 20 g of lactulose was given orally twice daily during 8 d to eight normal volunteers. In all, breath H2 concentration was measured on days 1 and 8 after ingestion of the morning lactulose dose. In four subjects, stools were collected during 2 d at the beginning and at the end of the lactulose maintenance period to measure fecal pH and daily outputs of carbohydrates and beta galactosidase. The four other subjects were intubated on days 1 and 8 to measure the pH and the concentrations of carbohydrates, lactic acid, and volatile fatty acids (VFA) in the distal ileum and cecal contents. Moreover, 14C-lactulose was added to cold lactulose and 14CO2 breath outputs determined. Pulmonary H2 excretion fell from day 1 to day 8 (P less than 0.05), whereas 14CO2 excretion increased (P less than 0.01). Fecal water pH, lactic acid, and VFA concentrations did not vary between the two stool collection periods. 24-h fecal weight, fecal water, and carbohydrate outputs showed a trend to decrease between days 1 and 2 and days 7-8, whereas beta-galactosidase activity rose markedly (P less than 0.01). No significant variations were observed for all parameters measured in ileal fluid. In the cecum, areas under the concentration curves decreased from day 1 to day 8 for lactulose, galactose, and fructose (P less than 0.01), while an increase was found for lactic acid (P less than 0.001), acetic acid (P less than 0.0001), and total VFA (P less than 0.001). Cecal fluid pH dropped faster (P less than 0.05) and to a lower level (P less than 0.05) on day 8 than on day 1. These data clearly show that a chronic load of a nonabsorbable sugar induces changes in colonic bacterial metabolic pathways resulting in a better efficiency of the flora to digest the carbohydrate. PMID- 3973022 TI - Positive inotropic and vasodilator actions of milrinone in patients with severe congestive heart failure. Dose-response relationships and comparison to nitroprusside. AB - Milrinone is a potent positive inotropic and vascular smooth muscle-relaxing agent in vitro, and therefore, it is not known to what extent each of these actions contributes to the drug's hemodynamic effects in patients with heart failure. In 11 patients with New York Heart Association class III or IV congestive heart failure, incremental intravenous doses of milrinone were administered to determine the dose-response relationships for heart rate, systemic vascular resistance, and inotropic state, the latter measured by peak positive left ventricular derivative of pressure with respect to time (dP/dt). To clarify further the role of a positive inotropic action, the relative effects of milrinone and nitroprusside on left ventricular stroke work and dP/dt were compared in each patient at doses matched to cause equivalent reductions in mean arterial pressure or systemic vascular resistance, indices of left ventricular afterload. Milrinone caused heart rate, stroke volume, and dP/dt to increase, and systemic vascular resistance to decrease in a concentration-related manner. At the two lowest milrinone doses resulting in serum concentrations of 63 +/- 4 and 156 +/- 5 ng/ml, respectively, milrinone caused significant increases in stroke volume and dP/dt, but no changes in systemic vascular resistance or heart rate. At the maximum milrinone dose administered (mean serum concentration, 427 +/- 11 ng/ml), heart rate increased from 92 +/- 4 to 99 +/- 4 bpm (P less than 0.01), mean aortic pressure fell from 82 +/- 3 to 71 +/- 3 mmHg (P less than 0.01), right atrial pressure fell from 15 +/- 2 to 7 +/- 1 mmHg (P less than 0.005), left ventricular end-diastolic pressure fell from 26 +/- 3 to 18 +/- 3 (P less than 0.005), stroke volume index increased from 20 +/- 2 to 30 +/- 2 ml/m2 (P less than 0.005), stroke work index increased from 14 +/- 2 to 21 +/- 2 g X m/m2 (P less than 0.01), and dP/dt increased from 858 +/- 54 to 1,130 +/- 108 mmHg/s (P less than 0.005). When compared with nitroprusside for a matched reduction in mean aortic pressure or systemic vascular resistance, milrinone caused a significantly greater increase in stroke work index at the same or lower left ventricular end-diastolic pressure. Milrinone caused a concentration-related increase in dP/dt (32% increase at maximum milrinone dose), whereas nitroprusside had no effect. These data in patients with severe heart failure indicate that in addition to a vasodilating effect, milrinone exerts a concentration-related positive inotropic action that contributes significantly to the drug's overall hemodynamic effects. The positive inotropic action occurs at drug levels that do not exert significant chronotropic or vasodilator effects. PMID- 3973021 TI - Regulation of the production and catabolism of plasma low density lipoproteins in hypertriglyceridemic subjects. Effect of weight loss. AB - In subjects with hypertriglyceridemia, plasma concentrations of low density lipoprotein (LDL) cholesterol are often normal or reduced. Perturbations that alter plasma very low density lipoprotein (VLDL) concentrations are associated with opposite changes in plasma LDL levels. To determine the mechanisms regulating plasma LDL levels, we used 131I-VLDL and 125I-LDL to measure the fractional catabolic rates (FCR), production rates (PR), and rates of interconversion of apoprotein B (apo B) in VLDL, intermediate density lipoprotein, and LDL in six hypertriglyceridemic subjects pre- and post-weight reduction. [2-3H]glycerol was used to quantitate VLDL triglyceride PR. All data are presented as mean +/- SD. Percent ideal body weight fell from 132 +/- 17.9 to 119 +/- 15.9% in the group, P less than 0.05. After weight loss, plasma VLDL triglyceride (486.0 +/- 364.1 vs. 191.3 +/- 65.4 mg/dl, P less than 0.05) and VLDL apo B (32.2 +/- 12.0 vs. 14.8 +/- 6.8 mg/dl, P less than 0.05) concentrations were reduced. VLDL triglyceride PR also fell after weight reduction (56.6 +/- 39.0 vs. 28.6 +/- 23.1 mg/kg per h, P less than 0.05), as did VLDL apo B PR (47.9 +/- 41.4 vs. 19.0 +/- 14.1 mg/kg per d, P less than 0.05). Pre-weight loss, plasma LDL cholesterol and apo B levels were low-normal or reduced (64.0 +/- 12.6 and 58.4 +/- 11.9 mg/dl, respectively) despite normal or elevated LDL apo B PR (17.4 +/- 7.2 mg/kg per d). The reduced cholesterol and apo B levels were associated with increased FCRs (0.68 +/- 0.29 d-1) and reduced cholesterol/protein ratios (1.01 +/- 0.18) in LDL. The plasma levels of LDL cholesterol and apo B rose after weight reduction (84.8 +/- 24.9, P less than 0.05; and 69.5 +/- 14.3 mg/dl, P less than 0.05, respectively, vs. base line). These increased concentrations resulted from a combination of events. First, the FCR for LDL apo B fell in five of six subjects with a significant reduction for the group as a whole (0.48 +/- 0.11 d-1, P less than 0.05 vs. base line). Second, the cholesterol/protein ratio increased in all six subjects with a significantly greater mean after weight loss (1.25 +/- 0.27, P less than 0.05 vs. base line). In contrast, the LDL apo B PR fell or was essentially unchanged in the six subjects after weight loss (mean, 14.4 +/- 2.8 mg/kg per d; NS vs. pre-weight loss). The changes in LDL catabolism and composition were associated with changes in the source of LDL apo B. Pre-weight loss, 73.3% of LDL was derived from VLDL, while 26.7% was directly secreted into plasma. Post-weight reduction, VLDL derived LDL fell to 46.8% of total, while direct secretion accounted for 53.2% of LDL production. These changes were significant; P < 0.95. Thus, all subjects had direct secretion of LDL apo B and the magnitude of this source of VLDL triglyceride secretion. These results indicate that the regulation of plasma LDL levels in hypertriglyceridemic subjects is quite complex and that the rise in LDL levels after weight loss results from reduction in the fractional catabolism of this lipoprotein. The fall in the FCR is associated with changes in the source of LDL and in its composition. PMID- 3973023 TI - Demonstration of elastin gene expression in human skin fibroblast cultures and reduced tropoelastin production by cells from a patient with atrophoderma. AB - Atrophoderma is a rare dermal disorder characterized by a patchy distribution of areas apparently devoid of elastic fibers. Skin fibroblast cultures were established from the normal and affected dermis of a patient with this disorder. Human tropoelastin was identified in culture medium by use of electroblotting and anti-elastin antisera. An enzyme-linked immunosorbent assay was used to establish that significantly less elastin accumulated in the media of cultured cells from lesional fibroblasts over a 3-d period. Since elastin biosynthesis in most tissues is under pretranslational control, molecular hybridization to a nick translated genomic elastin probe was performed; however, elastin messenger RNA levels were equivalent in both cell strains. Both strains produced less elastin than did normal skin fibroblasts. Extracellular proteolysis of elastin was evaluated as a possible mechanism. Elastase activity was increased and porcine tropoelastin was degraded four times faster, on a per-cell basis, in lesional fibroblast cultures than in cells derived from an unaffected site. The two cell strains exhibited no significant differences in collagen production or collagenase activity. These results are the first demonstration of elastin production by cultured human skin fibroblasts, and they suggest that the primary defect in atrophoderma may be a result of enhanced degradation of newly synthesized elastin precursors. PMID- 3973024 TI - A new hemoglobin variant, hemoglobin Nunobiki [alpha 141 (HC3) Arg----Cys]. Notable influence of the carboxy-terminal cysteine upon various physico-chemical characteristics of hemoglobin. AB - A new hemoglobin variant, hemoglobin (Hb) Nunobiki, was detected in a Japanese male with marginal erythrocytosis. The Hb Nunobiki component amounted to 13.1% of the total hemoglobin. Structural analysis of this variant established the substitution of a cysteine for an arginine at the carboxy terminus of the alpha chain (alpha 141). The oxygen equilibrium curves of Hb Nunobiki revealed extremely high oxygen affinity with a reduced Hill coefficient n, a decreased alkaline Bohr effect, and a decreased 2,3-diphosphoglyceric acid effect. The isoelectric point of the Hb Nunobiki changed during storage, although the oxyhemoglobin state was maintained. These findings could be accounted for by the specific characteristics of a newly introduced cysteinyl residue. Cysteinyl residue at alpha 141 in Hb Nunobiki did not seem to be involved in the formation of either intermolecular or intramolecular disulfide bonds under physiologic conditions. The low proportion of Hb Nunobiki (13.1%) in the propositus was also discussed after it was verified that he exhibited four alpha-globin genes per diploid cell. PMID- 3973027 TI - The impact of training in behavioral pediatrics: a study of 24 residency programs. AB - Three groups of residency programs were compared: 11 externally funded to provide mandatory behavioral training, seven not externally funded but providing mandatory training, and six controls not requiring training. At the beginning and end of 1980-1981, 569 residents (70%) completed questionnaires assessing attitudes regarding behavioral disorders, physical disorders, and "mixed" disorders (with physical and behavioral aspects). Behavioral knowledge was tested by 60 multiple-choice questions. Virtually all significant effects of program type occurred in the PL-2 year. For three attitudinal measures, "competence in management," "ability to advise parents," and "future relevance," only Funded residents demonstrated higher change scores for both behavioral and mixed disorders, relative to physical disorders; Funded and Not Funded residents were superior to Controls regarding behavioral disorders. For "knowledge of resources" and "facility interest," Not Funded change was superior to Control. Given higher Funded ratings initially, Not Funded ratings approximated Funded ratings by the end of the year. Regarding knowledge, Funded and Not Funded residents showed greater improvement than Controls. These data suggest that: changes in attitudes and knowledge are related to mandatory training; Funded programs generate the most consistent changes in both behavioral and "mixed" disorders; and the impact of training is most evident in the PL-2 year. PMID- 3973025 TI - Effect of heparin-induced lipolysis on the distribution of apolipoprotein e among lipoprotein subclasses. Studies with patients deficient in hepatic triglyceride lipase and lipoprotein lipase. AB - In normal subjects, apolipoprotein E (apo E) is present on very low density lipoproteins (VLDL) (fraction I) and on particles of a size intermediate between VLDL and low density lipoproteins (LDL) (fraction II). The major portion of apo E is, however, on particles smaller than LDL but larger than the average high density lipoproteins (HDL) (fraction III). To investigate the possible role of the vascular lipases in determining this distribution of apo E among the plasma lipoproteins, we studied subjects with primary deficiency of either hepatic lipase or of lipoprotein lipase and compared them with normal subjects. Subjects with familial hepatic triglyceride lipase deficiency (n = 2) differ markedly from normal in that fraction II is the dominant apo E-containing group of lipoproteins. When lipolysis of VLDL was enhanced in these subjects upon release of lipoprotein lipase by intravenous heparin, a shift of the apo E from VLDL into fractions II and III was observed. In contrast, apolipoproteins CII and CIII (apo CII and CIII, respectively) did not accumulate in intermediate-sized particles but were shifted markedly from triglyceride rich lipoproteins to HDL after treatment with heparin. In subjects with primary lipoprotein lipase deficiency (n = 4), apo E was confined to fractions I and III. Release of hepatic triglyceride lipase by heparin injection in these subjects produced a shift of apo E from fraction I to III with no significant increase in fraction II. This movement of apo E from large VLDL and chylomicron-sized particles occurred with little hydrolysis of triglyceride and no significant shift of apo CII or CIII into HDL from triglyceride rich lipoproteins. When both lipoprotein lipase and hepatic triglyceride lipase were released by intravenous heparin injection into normal subjects (n = 3), fraction I declined and the apo E content of fraction III increased by an equivalent amount. Either moderate or no change was noted in the intermediate sized particles (fraction II). These data strongly support the hypothesis that fraction II is the product of the action of lipoprotein lipase upon triglyceride rich lipoproteins and is highly dependent on hepatic triglyceride lipase for its further catabolism. In addition, the hydrolysis by hepatic triglyceride lipase of triglyceride rich lipoproteins in general results in a preferential loss of apo E and its transfer to a specific group of large HDL. PMID- 3973026 TI - A monokine stimulates production of human erythroid burst-promoting activity by endothelial cells in vitro. AB - Conditioned media were prepared from human peripheral blood monocytes and human umbilical vein endothelial cells. These media were assayed for erythroid burst promoting activity (BPA) using human peripheral blood monocyte-depleted mononuclear cells as targets and assessing the stimulatory effect of the conditioned media on growth of early erythroid progenitor cells. Both monocytes and endothelial cells produced modest amounts of detectable BPA. Addition of varying concentrations of media conditioned by monocytes to plateau concentrations (5-10%) of media conditioned by endothelial cells had no additive effect. Endothelial cells incubated in the presence of 50% monocyte-conditioned medium produced 2.5- to 6.6-fold more BPA than did endothelial cells incubated only in control tissue culture medium. In contrast, endothelial cell conditioned medium did not stimulate increased BPA production by monocytes. Neither neutrophil- nor marrow fibroblastoid cell-conditioned medium stimulated BPA production by endothelial cells. Therefore, both monocytes and endothelial cells produce BPA. Moreover, monocytes produce a monokine that, in turn, stimulates the production of BPA by endothelial cells. Inasmuch as a monokine also has been shown to stimulate production of granulocyte-macrophage colony-stimulating activity, we propose that monocytes play a critical role in regulating the production of humoral regulators of the very early stages of hemopoietic cell differentiation. PMID- 3973028 TI - The treatment of nocturnal enuresis: a controlled comparison of two models of urine alarm. AB - This study examined the effectiveness of two models of urine alarm that are commercially available for the treatment of nocturnal enuresis. A total of 39 children who exhibited primary nocturnal enuresis was assigned to one of three experimental groups: behavioral conditioning with a contiguous model of alarm, behavioral treatment with a delayed model of alarm, or a clinical waiting list. Results for the 12-week program indicate that after the second week of treatment, the contiguous and delayed models of alarm produced comparable reductions in weekly wetting frequency that were significantly better than no treatment at all. Results indicated a significantly higher rate of apparatus malfunction for the delayed model of alarm. It is proposed that the contiguous alarm is the treatment of choice at the present time because of its significantly lower rate of malfunction. PMID- 3973029 TI - Rett's syndrome: a progressive developmental disability in girls. AB - Two girls are described who had normal physical and mental development during the first few months of life, documented on home movies in one. Gross motor development slowed during the second half of the first year followed by loss of acquired vocabulary and deterioration of fine motor skills. Linear growth and head growth decelerated. Stereotyped hand movements appeared around 2 to 3 years of age. Early appropriate social responses faded into a vacant stare. Neurological development was characterized by early hypotonia followed by ataxia and finally spasticity. One girl has been followed through adolescence. Additional symptoms in later childhood and adolescence included scoliosis, episodes of hyperpnea, vasomotor disturbances of the legs, and precocious puberty. The patients fit the criteria for a progressive neurological disorder called Rett's syndrome, which results in profound developmental disability and occurs only in girls. Etiology remains unknown. PMID- 3973030 TI - Accuracy of the Satz-Mogel procedure in estimating WAIS-R IQs that are in the normal range. AB - WAIS-R protocols from 81 normal adults were rescored using the Satz-Mogel short form procedure. Although correlations were high between short form and actual WAIS-R scores for Verbal, Performance and Full Scale IQ (over .90), short form estimated FSIQs exceeded +/- 5 points from obtained scores in 55% of cases. At the subtest level, correlations were especially low between the short form and complete subtests for Similarities, Picture Arrangement, Picture Completion and Object Assembly. In those cases, estimated scaled scores exceeded the range of +/ 2 scaled score points from obtained subtest scores in over 25% of cases. Users of the Satz-Mogel procedure with normal range IQ groups are cautioned against employing it for other than a very gross screening device. Interpretations of individual subtests should be avoided. PMID- 3973031 TI - The Child Abuse Potential Inventory: a study of concurrent validity. AB - Forty-four subjects were assigned to a High or Low Abuse Potential Group based upon their Child Abuse Potential (CAP) Inventory's abuse scale scores. Each subject's heart rate (HR) and skin conductance (SC) were monitored while the subject was viewing videotape presentations of an infant smiling, crying, or quiescent. The High Abuse Potential Group had a faster peak HR throughout the videotape presentations with no significant differences among videotape segments. The Low Abuse Potential Group had a slower peak HR and had a significantly lower HR during the Smile and Cry segments than in the second Quiescent segment. The males accounted for most of the significant SC variability among tape segments. The pattern of SC responses revealed that the males were less aroused than the females, the Low Abuse Potential Group was less aroused than the High Abuse Potential group, and all four groups showed a decrease in arousal toward the end of the videotape presentations. The results provide support for the concurrent validity of the CAP inventory. PMID- 3973032 TI - Factor analysis of the aftereffects of drinking in alcoholics. AB - Research that deals with the causes of alcoholism has been hampered by the absence of factor analyses that deal specifically with ethanol's aftereffects. We factor analyzed 100 alcoholics' reports of the effects that they experience after alcohol consumption. Five factors emerged--Hangover, Euphoria, Flushing, Seizures, and Sleepiness. They are described and discussed. Future investigators may find them helpful in assessing theories on the etiology of alcoholism and in studies of ethanol's effects on subsets of alcohol abusers. PMID- 3973033 TI - Symptomatic correlates of alcohol abuse as a presenting problem. AB - This investigation examined a large number of self-reported symptoms of psychopathology. Its specific purpose was to assess their relationship to alcohol abuse as a self-indicated problem behavior. Participants in the study were 72 adults of both sexes who sought mental health services at a Veterans Administration outpatient Mental Hygiene Clinic. The self-reporting instrument was a behavioral problem checklist that was administered as part of a routine psychological test battery given at the time of each client's intake assessment at the Clinic. A correlational analysis of these data revealed that several broad areas of psychopathology were related significantly to alcohol abuse: Social/interpersonal skill deficits, anxiety, addiction proneness, impulse dyscontrol, and self-destructive ideation. These findings support a social learning theory of alcohol abuse. The results also imply that future treatment approaches to excessive drinking should include social skill and relaxation training as well as attention to traditional clinical concerns with self destructive thinking and impulse control. PMID- 3973034 TI - Sources of anxiety in drug addiction. AB - A sample of drug addicts (N = 60) in treatment were interviewed, and their descriptions of their lives were elicited and recorded. Their scores on a measure of anxiety based on content analysis of these descriptions were compared with those of two other groups of people matched for sex and age. The chief element in the pattern of anxiety that differentiated the groups was shame. Addicts also expressed more guilt, loneliness, fear of death, and vague worries than the other groups. This pattern was found to vary with the criminal history of the addicts and their counselors' assessment of them. Implications were discussed. PMID- 3973035 TI - Adjustment and psychosocial problems of Iranian and Filipino physicians in the U.S. AB - A questionnaire was mailed to 2,521 Iranian and 2,938 Filipino physicians who were practicing medicine in the U.S. Six hundred ninety-five Iranians and 898 Filipinos responded. Data of a section of the questionnaire on perceived adjustment and psychosocial problems were analyzed in this study. Statistical analyses of the data (bivariate correlations, multiple regression, and factor analysis) indicated that the reported adjustment problem was related closely to psychopathological measures such as loneliness, anxiety, depression, homesickness, and low self-esteem in both nationality groups. Participation in social activities with Americans was inversely related to perceived adjustment problems. In both groups, those who had become naturalized U.S. citizens and those who planned to stay permanently in the U.S. were less likely to report adjustment problems. The relationships between perceived adjustment problems and age and total years in the U.S. were not significant for Iranian physicians; however, they were correlated significantly for the Filipinos, which indicates that older physicians in this group and those who had been in the U.S. for a longer period of time were less likely to report adjustment problems. Other differences and similarities between the two nationality groups also were identified. PMID- 3973036 TI - Situational influences on social behaviors of depression-prone individuals. AB - Depressed (N = 20) and nondepressed outpatients (N = 20) and normal controls (N = 20) rated the frequency with which they used various interpersonal behaviors in different social roles and emotional circumstances. The results indicated considerable situational specificity in subjects' reports of how they actually behave; the three subject groups displayed similar patterns. Most notable were findings that subjects report relatively frequent use of sadness displays when stressed by intimates, but not when similar stresses are imposed by strangers. In the latter case, social withdrawal is reported as a relatively frequent response. The results are discussed as contradicting an invariant, trait-like interpersonal style among depressed individuals. PMID- 3973037 TI - Depression and the wish to be held. AB - The relation between aspects of depression and the wish to be held was studied in 72 male and 57 female college students. Females reported higher levels of depressive experiences associated with issues of dependency as well as more intense wishes to be held. In both sexes the intensity of the wish to be held was related to dependency; however, it was the correlations of these variables with level of depression that revealed differences between males and females. In males, the wish to be held covaried positively with the overall level of depression, Whereas in females it remained invariant across levels of depression. Thus, males who describe themselves as more depressed, relative to other males, expressed more feelings associated with dependency and more intense wishes to be held. PMID- 3973038 TI - Effectiveness of hypnosis as an adjunct to behavioral weight management. AB - This study examined the effect of adding hypnosis to a behavioral weight management program on short- and long-term weight change. One hundred nine subjects, who ranged in age from 17 to 67, completed a behavioral treatment either with or without the addition of hypnosis. At the end of the 9-week program, both interventions resulted in significant weight reduction. However, at the 8-month and 2-year follow-ups, the hypnosis clients showed significant additional weight loss, while those in the behavioral treatment exhibited little further change. More of the subjects who used hypnosis also achieved and maintained their personal weight goals. The utility of employing hypnosis as an adjunct to a behavioral weight-management program is discussed. PMID- 3973039 TI - The Harris-Lingoes subscales: fact or fiction? AB - The subjectivity of the Harris-Lingoes MMPI content subscales was examined by asking expert judges (N = 13) to group items from appropriate clinical scales that represented similar content, attitudes or traits. The mean subgroups were compared to the Harris-Lingoes subscales, and item groupings were consensually validated and replicated. Judges developed more content categories per scale than Harris and Lingoes, but showed relatively little agreement on item groupings. Nine consensually validated and replicated subscales were highly similar to nine Harris-Lingoes subscales, while nine other replicated subscales were moderately similar to seven Harris-Lingoes subscales. Twelve Harris-Lingoes subscales were unrelated to the replicated subscales. PMID- 3973040 TI - An assertiveness scale for adolescents. AB - This study developed a situation-specific instrument that measures assertiveness of adolescents. The Assertiveness Scale for Adolescents (ASA), which contains 33 items, was constructed using a multiple-choice format with three response alternatives. Based on data from 682 elementary and secondary school students, adequate reliability and validity of the ASA were obtained when tested against several variables about which predictions could be made. Potential use of the instrument in clinical diagnosis and research was discussed. PMID- 3973041 TI - Naive versus sophisticated item-writers for the assessment of anxiety. AB - This study reported data from a comparison of items from psychologically naive vs. psychologically sophisticated item-writers vs. a standardized test (Self rating Anxiety Scale; Zung, 1971) (N = 552). Results supported Jackson's (1971) challenge with regard to non-empirically-produced items as equally valid as those generated by more traditional methods. Of major interest is the finding that, unlike previous studies, nonpsychologists with no formal definition of the construct they were to measure were able to write items that were as valid as those elicited from psychologists. PMID- 3973042 TI - Meaning of the Repression-Sensitization scale: defensive style or self-report of symptoms of psychopathology. AB - Two studies were conducted to test the hypothesis that the Repression Sensitization (R-S) scale assesses self-reported symptoms of psychopathology. In Study 1, 42 subjects were assigned randomly to groups that received differing instructions on the extent to which they should report experiencing distress and reveal personal problems. This manipulation produced highly significant group differences and accounted for most of the variability in R-S scale scores. In Study 2, R-S scale scores and scores of the Health Opinion Survey were correlated in a sample of 100 subjects. The high correlation obtained for these two measures suggests that both measures assess the same dimension, i.e., self-report of symptoms of psychopathology. The results of these studies indicate that the R-S scale is influenced so powerfully by self-report of symptoms of psychopathology that its usefulness in assessing repression-sensitization is questionable. PMID- 3973043 TI - Comparison of the TPT 10 and 6 hole form board. AB - The 10 hole (Adult Version) Tactile Performance Test (TPT) or Form Board is too difficult for patients with moderate to severe brain damage. A series of studies were done to enable an examiner to substitute the simpler 6 hole board (TPT 6 - Child's Version) for such patients. Eighty subjects (61 brain damaged and 19 controls) were given both boards in a counter-balanced order. It was found that: (1) the TPT 10 was inadequate for severe damage; (2) the TPT 6 can be used with severe impairment; (3) a method of prorating blocks into time was developed; (4) the TPT 10 and TPT 6 are strongly correlated; (5) there were no order effects when both boards were given; (6) both boards significantly separated controls from brain-damaged subjects; (7) criteria for substitution of the TPT 6 were established; and (8) comparable scales were established for both boards so that an examiner can substitute either TPT for the other. PMID- 3973044 TI - Word Finding Test performance: effects of localization of cerebral damage, level of neuropsychological impairment, age, and education. AB - The Word Finding Test (WFT; Reitan, 1972) was developed as a measure of verbal problem solving ability. It has been shown to be sensitive to the presence of brain damage, and to be more sensitive in this regard than several other verbal tests. The present study explored the relationships between WFT performances and lesion localization, level of general neuropsychological impairment, age, and education. The results from 165 brain-damaged and 129 normal control Ss indicated that the WFT is sensitive to cerebral damage, regardless of lesion localization. However, this test is not helpful in making localization inferences. WFT scores also were correlated significantly with level of impairment, age, and education. PMID- 3973045 TI - Continuous norming: implications for the WAIS-R. AB - Following Gorsuch (1983, 1984), a method for generating continuously adjusted age norms is illustrated using the normative data for the Wechsler Adult Intelligence Scale-Revised (WAIS-R) (Wechsler, 1981). Specific procedures for calculating age adjusted Verbal, Performance, and Full Scale IQ scores also are demonstrated, with a worked example. Compared to the original tabled norms for the WAIS-R, IQ scores based on continuous norming are more accurate because they involve an analytic smoothing procedure that eliminates the inaccuracies introduced by traditional tabled norms and because people are compared against their exact age groups. PMID- 3973046 TI - A study of post traumatic stress disorder in Vietnam veterans. AB - Three groups of Vietnam-era veterans were compared on the frequency of symptoms typical of the diagnostic criteria for Post Traumatic Stress Disorder (PTSD), a diagnostic category introduced in DSM III (N = 90). The three groups consisted of veterans who had experienced (a) a war-related traumatic event; (b) a non-war related traumatic event; or (c) no traumatic event. The results indicated that the two groups who experienced a traumatic event reported significantly more symptoms than the group who never experienced a traumatic event. Furthermore, the group who experienced a war-related traumatic event reported more symptoms than the group who experienced a non-war-related traumatic event. These results support the validity of PTSD. PMID- 3973047 TI - Two- and four-subtest short forms of the WAIS-R: a closer look at validity and reliability. AB - Vocabulary and Block Design were proposed previously as a two-subtest short form of the Wechsler Adult Intelligence Scale-Revised; the addition of Arithmetic and Picture Arrangement was suggested to provide a four-subtest short form of the scale. The present article reports the validities (correlations with the Full Scale) and reliabilities of these two short forms for each of the nine age groups in the standardization sample, together with standard errors of estimate and standard errors of measurement. The results are judged to support the use of these particular short forms for the purposes for which they were intended. PMID- 3973048 TI - Cluster analysis of the Wechsler Adult Intelligence Scale-Revised. AB - The intercorrelations among the 11 subtests of the WAIS-R were analyzed for each of the nine age groups in the standardization sample. The cluster analytic results were far more consistent with a three-factor solution than with a two factor solution. However, other evidence suggests that a single-factor solution may be at least as adequate as any of the multifactor solutions that have been offered for these data. PMID- 3973049 TI - Incidence of intraglomerular platelets in steroid sensitive nephrotic syndrome. AB - Renal biopsies from 44 patients with steroid sensitive nephrotic syndrome were examined with respect to the content of their intraglomerular platelets and compared with 18 normal control patients and with 51 patients with membranous glomerulonephritis and the nephrotic syndrome. The results suggested that platelet activity was not involved in the pathogenesis of steroid sensitive nephrotic syndrome; in the active phase of the number of platelets in glomeruli is lower than that of normal controls, and this may be associated with increased sensitivity to aggregating agents as part of the nephrotic syndrome. After steroid treatment and disappearance of proteinuria, the number of intraglomerular platelets rises to normal values. PMID- 3973050 TI - The Cronkhite-Canada syndrome: an ultrastructural study of pathogenesis. AB - Electron microscopical and cytochemical studies of intestinal biopsies from a patient with typical features of the Cronkhite-Canada syndrome show that the primary process affects the crypts. This results in cystic dilatation associated with expansion and focal degeneration of the crypt compartment of the intestinal epithelium. The villous epithelium compartment is reduced but ultrastructurally normal. Inflammation and oedema of the lamina propria follows from leakage of mucin through breaks in the abnormal crypts. PMID- 3973051 TI - Mucin producing microfollicular adenoma of the thyroid. AB - An unusual case of a mucin secreting benign microfollicular adenoma of the thyroid in a 30 year old euthyroid woman is reported. Histologically, the lesion was characterised by follicular cells with the appearance of signet ring cells. Histochemistry showed the mucin content of these cells to consist uniformly of sulphated acid mucins; positive thyroglobulin immunostaining was also shown. The published work on primary mucin secreting tumours of the thyroid gland is reviewed. Dual differentiation is thought to be responsible for combined mucin secretion and hormone production in this type of neoplasm. PMID- 3973052 TI - Morphometric studies of age related changes in normal human breast and their significance for evolution of mammary cancer. AB - Ageing changes in the normal human female breast were studied to determine their significance for the evolution of mammary cancer. Employing the morphometric techniques of point counting and planimetry, objective quantitative measurements were made of the structure of the normal female breast in 58 subjects from the prepubertal to late postreproductive period. The relative amounts of epithelial and connective tissue varied with age, and the epithelial elements (combined lobular and extralobular) were unevenly distributed within the gland, with lower containing more than upper quadrants. The upper outer quadrant, however, usually contained the largest proportion of lobular units, which may relate to the higher incidence of lobular carcinoma found in this quadrant. Involution was shown to be a premenopausal rather than postmenopausal phenomenon. Mammary dysplastic changes were uncommon in all age groups. PMID- 3973053 TI - Subcutaneous phaeohyphomycosis: a histopathological study of nine cases from Malawi. AB - The clinical and histopathological features of subcutaneous phaeohyphomycosis in nine patients from Malawi are presented. The patients had varied clinical presentations and microscopically, in each case, there was a subcutaneous abscess or cystic granuloma. In seven cases (78%) the causative fungal elements were easily identified in sections stained with haematoxylin and eosin. The fungal elements were easily identified in the other two cases with special fungus stains. The misleading terminology, which was used previously to cover this infection, is discussed. Even though this paper reports on this disease in a tropical country, subcutaneous phaeohyphomycosis occurs world wide, and these fungi should be looked for in otherwise unexplained subcutaneous abscesses or cystic granulomata. PMID- 3973054 TI - Gastro-oesophageal candidiasis: diagnosis by brush cytology. AB - The diagnosis of gastro-oesophageal candidiasis by brush cytology was studied in two groups. In eight immunosuppressed patients clinically suspected to have candidiasis, fungal infection was confirmed on six occasions, and a diagnosis of herpetic oesophagitis was established in the other two cases. Among 482 gastric and oesophageal brushings clinically unsuspected candidiasis was found on a further 12 occasions. Coexisting abnormalities including carcinoma, lymphoma, and postradiation oesophagitis were also identified by brushing. Of the 18 patients with cytologically confirmed candidiasis, endoscopic biopsies were available in 13, but histological diagnosis of fungal infection was possible in only two (15.5%). PMID- 3973055 TI - Evaluation of the common conditions associated with eosinophilia. AB - In an eosinophilic population of 47 boys of the same age, a large proportion (92%) were helminth infested or atopic, or both, compared with 36% of 36 controls. The methods used to detect these conditions were not costly or elaborate, except for the radioallergosorbent test, which was used to measure concentrations of circulating IgE antibodies to atopic allergens. It is suggested that an economical approach to detect helminthiasis and atopy in cases of eosinophilia is adopted using the methods employed here, with skin prick tests replacing the radioallergosorbent test. PMID- 3973056 TI - Postsplenectomy sepsis 10 years or more after operation. AB - Three new cases (two fatal) of postsplenectomy sepsis occurring 14, 25, and 26 years after operation for hereditary spherocytosis are described. There are now 25 cases in the published work in which this complication occurred 10 or more years after operation, 14 of which were fatal. The mean age of onset is 37 years. The features of the disease are similar to those seen in other postsplenectomy infections, and pneumococcal infection was responsible in 19 cases (76%). The major predisposing illnesses were trauma, hereditary spherocytosis, and idiopathic thrombocytopenia. PMID- 3973057 TI - Acute phase response of serum amyloid A protein and C reactive protein to the common cold and influenza. AB - C reactive protein (CRP) and serum amyloid A protein (SAA) are sensitive and rapid acute phase reactants, and their measurement for monitoring inflammatory disease and assessing the prognosis in secondary amyloidosis is gaining widespread acceptance. The changes in these proteins in eight subjects suffering from natural colds, 15 subjects with experimentally induced colds (rhinoviruses E1, 3, 9, 14, or 31), and eight with experimentally induced influenza (A/Eng/40/83) were studied. SAA concentration increased in 21 of the 23 subjects with natural or experimental rhinovirus colds (mean increase 95 mg/l); CRP concentration increased in 11 (mean increase 11 mg/l). All subjects with influenza showed pronounced increases in SAA concentrations (mean increase 642 mg/l) while six showed increases in CRP concentration (mean increase 22 mg/l). All these increases were highly significant (p less than 0.001). Asymptomatic excretors of both rhinovirus and influenza virus showed significant increases in SAA concentration (p = 0.015 for rhinovirus and p less than 0.001 for influenza virus) but not in CRP concentration. No changes in SAA or CRP values were seen in 12 volunteers after challenge with saline. These observations suggest that caution is required in the interpretation of estimations of SAA concentration and that it may be too sensitive an acute phase protein for clinical use as its concentration may be raised in both trivial and asymptomatic viral infections. PMID- 3973058 TI - Effects of media, working practice, and automation on the rapid detection of bacteraemia. AB - Advances in the treatment of disease have resulted in an increasing number of blood cultures being processed by microbiology departments. The effect of media, revision of working hours, and automation on the time taken to detect positive cultures are reported. A 9.5% detection rate at 24 h with broth systems examined manually increased to 76.0% with a semi-automated radiometric technique (BACTEC). The use of radiometry in a restructured working day--that is, 9.00 am to 7.00 pm- resulted in optimum conditions for reducing the reporting time. The efficacy of modern equipment, designed to detect micro-organisms rapidly, can be considerably enhanced by reorganisation of traditional working hours to suit microbial growth rather than the current availability of staff. PMID- 3973059 TI - Assessment of rapid methods of pneumococcal antigen detection in routine sputum bacteriology. AB - Sputum specimens from 480 patients were examined for the presence of pneumococci by Gram film and culture and for pneumococcal antigen by counterimmunoelectrophoresis, coagglutination, and latex agglutination. Ninety six positive specimens were detected. Gram film and culture provided the most reliable techniques in well taken specimens collected early in the illness before antibiotic treatment had started. More than 70% of the specimens examined were submitted after starting antibiotics, however, and in these specimens, methods of antigen detection proved of greater value than either Gram film or culture. Counterimmunoelectrophoresis, coagglutination, and latex agglutination were similar in sensitivity and specificity, but coagglutination and latex agglutination were much easier to perform and to read. PMID- 3973060 TI - High incidence of group C streptococci isolated from throat swabs. PMID- 3973061 TI - Antihypertensive action of nifedipine: effects on arteries and veins. AB - Nifedipine is a calcium-channel antagonist with effective antihypertensive activity and has been suggested for the treatment of high blood pressure as an alternative to vasodilators. The aim of this study was to define the acute effect of nifedipine and in particular the dose-effect relationship, effects on veins, influence on adrenergic reflexes, and effectiveness on hypertension according to severity and etiologic type. The effects of nifedipine on blood pressure, heart rate, forearm blood flow, peripheral vascular resistance, orthostatic and cold reflexes, and venous tone were examined in 45 patients with hypertension of different etiologies (essential, renovascular, and renal parenchymal) and different World Health Organization grades. The antihypertensive effect was dose dependent, but a dose of 20 mg has nearly maximal activity with acceptable side effects. The drug acts by lowering peripheral vascular resistance, and this lowering is directly related to baseline values; therefore, the antihypertensive effect increases with severity of the hypertension. Nifedipine had the same effect in all three etiologic groups of hypertension studied. The drug seems to increase venous tone, since it caused venoconstriction when locally injected in hand veins. Nifedipine did not alter adrenergic reflexes induced by both cold application and standing and was well tolerated. In conclusion, the calcium antagonist nifedipine for its characteristics of action, at least in acute administration, seems to be a useful alternative in the treatment of various forms of hypertension. PMID- 3973062 TI - Academic-industrial clinical pharmacology: a working model. PMID- 3973064 TI - Studies with stable isotopes II: Phenobarbital pharmacokinetics during monotherapy. AB - Six healthy adults receiving no other medications were given tracer doses of 90 mg of stable isotope-labeled phenobarbital (PB) intravenously before, and four weeks after, and 12 weeks after beginning therapy. Serum samples were collected for 96 hours after each injection, and the concentration of stable isotope labeled PB in each sample was determined by gas chromatographic mass spectrometry. The volume of distribution, elimination half-life, and total clearance of PB did not differ significantly on any of the three occasions measured. Phenobarbital clearance did not correlate significantly with total PB serum concentration. Clearances determined from single-dose studies before beginning PB therapy accurately predicted steady-state PB serum concentrations. Therefore, it is not necessary to adjust PB dosage for time-dependent or dose dependent changes in clearance during monotherapy. In addition, clearance or serum concentration determined at one dosing rate directly predicts serum concentration at another dosing rate. PMID- 3973063 TI - Studies with stable isotopes I: Changes in phenytoin pharmacokinetics and biotransformation during monotherapy. AB - Six patients were given tracer doses of 13C15N2-phenytoin (PHT) before and four and 12 weeks after beginning monotherapy. The following significant (P less than .05) changes occurred during monotherapy: (1) Apparent (from tracer doses) PHT total clearance by linear method decreased; (2) apparent PHT elimination half life increased; (3) apparent mean PHT serum concentration per unit dose increased; (4) apparent rate of excretion of p-hydroxyphenyl-phenylhydantoin (p HPPH) decreased; (5) apparent rate of excretion of PHT dihydrodiol increased; and (6) apparent PHT total clearance and elimination half-life and apparent p-HPPH rate of excretion were dose dependent. Phenytoin apparent pharmacokinetic and biotransformation values undergo a typical series of changes after beginning monotherapy at typical dosing rates, because PHT's dose-dependent pharmacokinetics result in differing apparent values as the serum concentration rises to steady state. Stable isotope methods are particularly suitable for investigating such phenomena. PMID- 3973066 TI - Alcoholism and acetaminophen. PMID- 3973065 TI - Studies with stable isotopes III: Pharmacokinetics of tracer doses of drug. AB - Stable isotope labeled tracer doses of phenytoin (PHT) and phenobarbital (PB) were given intravenously before and four and 12 weeks after beginning monotherapy in two groups of six patients. Phenytoin demonstrated nonlinear pharmacokinetics, while PB demonstrated linear pharmacokinetics. Each of the 36 sets of tracer dose serum concentration versus time data points appeared linear during the elimination phase on semilog plots, and each demonstrated a high degree of linearity using semilog regression analysis (r2 = .977-.999, P less than .001, for PHT; r2 = .791-.996, P less than .005, for PB). We conclude tracer doses administered at steady-state serum concentration will exhibit linear serum concentration versus time relationships on semilog plots regardless of whether the steady-state serum concentration is in the linear or the nonlinear portion of a drug's dose versus steady-state serum concentration relationship. The mechanism and implications of this conclusion are discussed. PMID- 3973067 TI - Amitriptyline in the treatment of anorexia nervosa: a double-blind, placebo controlled study. AB - The tricyclic antidepressant drug amitriptyline was evaluated as a short-term treatment of anorexia nervosa patients. In a 5-week double-blind, placebo controlled study 11 patients were given amitriptyline and 14 received placebo. In addition, 18 patients who refused to participate in the drug trial and received only psychosocial treatment were used as an additional comparison group. Overall, patients in the three groups showed little improvement. No statistically significant differences favoring amitriptyline were found in any of the outcome variables. Plasma levels varied widely among patients receiving similar doses. No association was found between plasma levels and improvement in either psychiatric symptomatology or weight. Amitriptyline patients did not manifest any tendency for a reduction of depressive symptomatology. In addition, amitriptyline treatment was associated with substantial discomfort and adverse affects. PMID- 3973068 TI - Adverse reactions to monoamine oxidase inhibitors. Part II. Treatment correlates and clinical management. AB - From a review of the clinical charts of 198 depressed outpatients, information was extracted on common major treatment emergent side effects associated with phenelzine, tranylcypromine, and imipramine. These included hypertensive reactions, severe orthostatic hypotension, hypomania, significant weight gain, sexual dysfunction, and a residual category of multiple side effects which together culminated in drug discontinuation. In this report, frequency of their occurrence for each drug, level of severity, relation to dose and treatment duration, and physician response at the time the side effect was recorded are described. In addition, procedures found useful in the clinical management of these side effects are discussed. PMID- 3973069 TI - The use of antidepressants in a psychiatric emergency department. AB - This article is the result of a pilot program at Sinai Hospital of Detroit's psychiatric emergency department (crisis clinic). Eight patients diagnosed as having a major depression and having met six proposed criteria were placed on antidepressant therapy. This approach contradicts traditional thinking regarding the initiation of antidepressant therapy in an emergency department or crisis clinic. Such use of antidepressants has, in the past, been considered unsafe and therefore contraindicated. This article suggests a protocol for the initiation of antidepressant therapy in an emergency department. PMID- 3973070 TI - Alprazolam in the treatment of obsessive symptoms. AB - Four patients with obsessive-compulsive disorder (DSM-III and RDC) were treated in an open trial with alprazolam. Moderate to marked improvement was noted in the degree of obsessionality, anxiety with motor tension, and secondary affective changes. The mixed anxiolytic-antidepressant properties of alprazolam are theorized as the basis for the clinical remissions. PMID- 3973071 TI - Nonlinear desipramine pharmacokinetics: a case study. AB - A case of nonlinear desipramine pharmacokinetics is described. During routine clinical monitoring serum desipramine concentrations appeared to change disproportionately with dose. Following a series of controlled dosage decreases, from 400 to 50 mg/day, the patient's steady state serum concentrations fit a nonlinear pharmacokinetic model. This curvilinear serum concentration-dose relationship suggests saturation of hepatic metabolism and signals the need for caution when predicting or titrating doses against serum drug concentrations. The implications of this new finding are discussed. PMID- 3973073 TI - View from the nation's courts. Electroconvulsive therapy: no ban in Berkeley. PMID- 3973074 TI - Measurement of haloperidol and metabolites. PMID- 3973072 TI - Acute psychosis following phenelzine discontinuation. AB - Most concern over the untoward effects of monoamine oxidase inhibitors (MAOIs) has concentrated on the hypertensive crises and recently on orthostatic hypotension, hypomania, and sexual dysfunction. However, little has been written about withdrawal effects when MAOIs are discontinued. This article reports an acute organic psychosis marked by visual, auditory, and tactile hallucinations after abrupt discontinuation of phenelzine in two young women without previous history of psychotic symptoms. PMID- 3973075 TI - PSOP for response to imipramine and doxepin. PMID- 3973076 TI - MAOIs, the "cheese" reaction, and sleep apnea. PMID- 3973077 TI - TCA and in vivo methylation. PMID- 3973078 TI - The effect of diazepam on patients' memory. PMID- 3973079 TI - Quantitative studies of auditory hair cells and nerves in lizards. AB - Because the lizard cochlear duct is anatomically accessible as well as relatively simple in structure it is an excellent model in which to study auditory hair cells, nerve fibers, and innervational patterns. The objectives of this study were to determine the intra- and interspecific variations of auditory hair cell and nerve fiber numbers, nerve fiber/hair cell ratios, and nerve fiber sizes in a varied of lizard species and to relate these to auditory function and phylogeny. Hair cell numbers were determined by SEM and serial frontal sections of the papilla basilaris and nerve fiber numbers and diameters by use of a Zeiss TGZ3 particle counter. The coefficient of variation of hair cell numbers varied from 3.2 to 16.6 (171 specimens, 15 species) and of nerve fiber numbers from 1.2 to 14.4 (381 specimens, 35 species). There was no correlation between hair cell or nerve fiber number and age or sex. The nerve fiber number/hair cell number ratio was 3.5-11.1/1 in small papillae basilares of the iguanid-agamid-anguid type, 2.4 3.2/1 in the teiid type, and 0.6-1.5/1 in the larger specialized papillae of the scincid and gekkonid types. Nerve fibers varied in diameter from 0.8 to 6.0 microns (largest percentage were 2-4 microns) and were unimodally distributed. Larger nerve fibers usually supplied the unidirectionally oriented hair cells of the papilla basilaris. Variations in hair cell and nerve fiber numbers in other vertebrate classes and the functional and phylogenetic aspects of lizard papilla basilaris structure and innervation are discussed. PMID- 3973080 TI - A qualitative and quantitative light microscopic study of the inferior olivary complex of normal, reeler, and weaver mutant mice. AB - In the normal mouse (+/+; +/rl) cerebellar Purkinje cells (PCs) are aligned in a monolayer and provide the main targets for incoming olivocerebellar climbing fibers (CF). In the neurological mutants, homozygous reeler (rl/rl), homozygous weaver (wv/wv) and heterozygous weaver (wv/+), cerebellar abnormalities exist in which many PCs are either missing or displaced. Therefore, it is of interest of determine if the inferior olivary complex (IO) in these mutants is also abnormal. This report concerns results obtained from a light microscopic study of the inferior olivary complex. Counts of IO cells revealed apparent differences in the IO in homozygous reeler when compared to normal littermates. Whereas in the normal mouse there are approximately 37,000 IO cells and clearly defined olivary subdivisions, the IO of the homozygous reeler has a 22.6% reduction in IO cells (mean = 28,770) and indistinct borders between the major olivary subdivisions. With regard to the heterozygous and homozygous weaver, surprisingly the IO morphology and cell numbers are similar to that of the wildtype mouse even though the animals have only 86% (wv/+, mean = 158,155) and 72% (wv/wv, mean = 131,882), respectively, of the normal numbers of PCs (+/+, mean = 183,857). Purkinje cell counts revealed that the midline vermal region is the most affected area in the cerebellum in wv/+ and wv/wv whereas counts in the lateral hemisphere are near normal. The PC/IO ratio in the homozygous weaver is approximately 3:1 as compared to 5:1 in the wildtype mouse. Recent electrophysiological findings in wv/wv indicate that PCs are multiply innervated by CFs. Since a transient phase of multiple innervation is normal in the immature rat, the situation in the adult homozygous weaver may represent a retention of this immature state. A factor which may play a role in this is the loss of parallel fiber (PF)-PC synapses resulting from massive postnatal granule cell death. An hypothesis suggesting an intrinsic PC time-dependent mutant gene effect is presented to account for the differences in the loss of Purkinje cells between wv/wv and wv/+ and between different regions of the cerebellum. PMID- 3973081 TI - The development of the nucleus isthmi in Xenopus laevis. I. Cell genesis and the formation of connections with the tectum. AB - The nucleus isthmi (NI) of the amphibian relays visual input from one tectum to the other tectum and thus brings a visual map from the eye to the ipsilateral tectum. This isthmotectal visual map develops slowly; it is first detected electrophysiologically at stages 60-62, the age at which the eyes begin their dorsalward migration and the region of binocular overlap beings to increase in extent. During this critical period of life, normal binocular visual input is required for establishment of normal topographic isthmotectal projections. In this study, we have used anatomical methods to trace cell birth, cell death, and formation of connections by the nucleus isthmi during the critical period. Tritiated thymidine labelling demonstrates that cells in the nucleus isthmi are generated throughout most of tadpole life (stages 29-62). Most cells conform to an orderly ventrodorsal gradient starting from stage 29 and extending to stages 56; later cells are inserted at apparently random locations in the nucleus. We have re-examined the hypothesis of Tay and Straznicky ('80) that the order of cell genesis in the NI and tectum could help establish proper isthmotectal connections, and we find that a timing mechanisms does not explain the two dimensional topography of the isthmotectal map but that timing may aid in proper mediolateral positioning of isthmotectal axons at the points where they first enter the tectum. Horseradish peroxidase labelling was used to investigate whether anatomical projections from tectum to NI and from NI to tectum are present prior to the onset of eye migration. The results show that there are tectoisthmotectal projections by stage 52. Moreover, isthmotectal axons grow into as yet monocular tectal regions prior to the onset of eye migration. At stage 60, when binocular overlap begins, isthmotectal axons are visible throughout the tectum but are densely branched only at the rostral tectal margin, the location where they are predicted to occur on the basis of electrophysiological maps. PMID- 3973082 TI - Number and distribution of stapedius motoneurons in cats. AB - Cell bodies of stapedius motoneurons were identified by retrograde transport of horseradish peroxidase (HRP) following injections into the stapedius muscle. Large injections were made in an attempt to label all stapedius motoneurons. To control for labeling of non-stapedial neurons resulting from spread of HRP, we determined the locations of brainstem neurons labeled by HRP applied to the facial nerve, the chorda tympani nerve, the auricular branch of the vagus nerve, the tensor tympani muscle, and the cochlea. In three cats analyzed in detail, 1,133-1,178 neurons projecting to the stapedius muscle were identified. Arguments are given which suggest that in these three cats all stapedius motoneurons were labeled. The labeled stapedius neurons may all be motoneurons because they all stain positively for acetylcholinesterase and have medium-coarse Nissl bodies. Most stapedius motoneurons were located around the motor nucleus of the facial nerve. Staphedius motoneurons were also found near the descending limb of the facial-nerve root, in the peri-olivary neuropil, and in the reticular formation with the ascending fibers of the facial-nerve root. PMID- 3973083 TI - Representation of whisker follicle intrinsic musculature in the facial motor nucleus of the rat. AB - Retrograde transport of wheatgerm-agglutinin horseradish peroxidase (WGA-HRP) and fluorescent tracers (true blue-TB, nuclear yellow-NY, and diamidino yellow-DY) from isolated whisker follicles was used to define the somatotopic organization of the facial (VII) motoneurons which innervate the intrinsic follicle muscles. Motoneurons supplying these muscles were restricted almost completely to the lateral (Martin and Lodge, '77) facial subnucleus and the motoneurons which innervated a given follicle were distributed over the entire length of this subnucleus. Cells projecting to dorsal (A-row) follicles were located in the most lateral part of the lateral subnucleus, while those supplying ventral (E-row) follicles were restricted to the medial part of the subnucleus. Injections of different tracers into rostral and caudal follicles within a given row revealed no somatotopic representation of the rostrocaudal axis of the whiskerpad. Additional control experiments demonstrated that some of the labelling obtained with WGA-HRP resulted from spread of this tracer to extrinsic muscles. This was not the case with the fluorescent tracers. The results of the control experiments suggested further that a significant percentage of the motoneurons in the lateral facial subnucleus innervate only intrinsic follicle muscles. PMID- 3973084 TI - Studies of innervation patterns in grafted chick wings. AB - The pattern of innervation of 12 day embryonic chick wings was studied by morphological and electrophysiological techniques. Several types of chick wing grafts were performed to investigate the rules governing nerve pattern formation: whether the motor neurons actively seek out and connect with specific muscles or are passively guided and whether cell death plays any role in pattern formation. In each type of graft the outgrowing neurons were confronted with extra targets distal to the elbow. Two grafts replicated lower arm parts in series (proximodistal graft) or in parallel (forearm and hand replicated in the same pattern of asymmetry in a split limb graft); a third produced a mirror image limb. The flexor carpi ulnaris muscle (F.C.U.) was studied in these limbs. The innervation of the most distal f.c.u. muscle in proximodistal grafted limbs varied with the extent of host f.c.u. muscle present. The f.c.u. muscles in the split limb graft were always innervated. In both limb grafts the f.c.u. muscles were innervated by the appropriate neurons, as determined by retrograde HRP technique and electrophysiological recordings. This strongly suggests that the motor neurons are able to seek out and connect with their appropriate muscle. Results of the mirror image limb graft suggest that other factors may be involved. In addition, motor neuron cell counts were performed. From this one can infer that the normally occurring pattern of cell death was not affected by the grafts. Cell death is therefore excluded as a major factor in nerve pattern formation. PMID- 3973085 TI - Distribution and morphology of callosal commissural neurons within the motor cortex of normal and reeler mice. AB - Retrograde transport of horseradish peroxidase was used to examine the cells of origin of the callosal commissural fibers (CC neurons) in the primary motor cortex of normal and reeler mice. Quantitative analysis of the intracortical, laminar distribution, and dendritic orientation of CC neurons was performed in conjunction with qualitative observation of their morphology. For comparison, similar quantitative data were obtained for the cells of origin of the corticospinal tract (CST) of normal and reeler mice from materials described previously by Terashima et al. ('83). In the normal mouse, CC neurons are distributed in a bilaminar pattern such that the largest number of cells are located in supragranular layers II and III and in infragranular layer V. The majority of CC neurons are normal (upright) pyramids, although a few in the upper zone of layer VI are inverted pyramidal cells. In the reeler mutant, CC neurons are found in all cortical layers, but two-thirds are situated in the lower half of the cortex. On the basis of the celL shape and orientation of the apical dendrite, CC neurons of the reeler were classified into six morphological types: (1) typical pyramidal, (2) inverted pyramidal, (3) tumbled, (4) hook-shaped, (5) polymorphic, and (6) simple. The apical dendrites of the CC neurons in all layers of the cortex of the reeler mouse are randomly oriented; no direct relationship between the intracortical position of the soma and orientation of the apical dendrite was found. In contrast, CST neurons in the reeler mutant are concentrated in the outer third of the cortex, and there is a relationship between the laminar distribution of these cells and the alignment of their dendrites with respect to the pial surface: the apical dendrites of CST neurons lie in superficial layers tend to be oriented obliquely, whereas those of CST neurons in the deeper of cortex most often are oriented vertically, i.e, toward the pial surface. Quantitative analysis revealed that the relative intracortical positions of CC and CST neurons are reversed in the reeler mutant although both populations exhibited greater laminar disposition, and as a consequence, there is more intermingling of the two cell groups in the reeler than in the normal mouse. Thus, the present study suggests that the normal cytoarchitectonics of the primary motor cortex are inverted in the reeler mutant mouse. PMID- 3973086 TI - Projections of medial terminal accessory optic nucleus, ventral tegmental nuclei, and substantia nigra of rabbit and rat as studied by retrograde axonal transport of horseradish peroxidase. AB - Projections of the medial terminal nucleus (MTN) of the accessory optic system, the ventral tegmental area of Tsai, and the substantia nigra of the rabbit and the rat have been studied by the method of retrograde axonal transport of horseradish peroxidase. The data show that MTN projections are remarkably similar in the rabbit and rat. The MTN projects heavily to the ipsilateral nucleus of the optic tract and dorsal terminal nucleus of the accessory optic system and to a portion of the contralateral ventral tegmental area of Tsai that we have termed the visual tegmental relay zone (VTRZ). Further, the MTN sends projections to the ipsilateral mesencephalic (deep mesencephalic nucleus, pars medialis) and pontine (nucleus reticularis pontis oralis) reticular formations; the contralateral dorsolateral division of the basal pontine complex; the superior and lateral vestibular nuclei (contralateral in rat; bilateral in rabbit); and the ipsi- and contralateral interstitial nucleus of Cajal, nucleus of Darkschewitsch, and supraoculomotor-periaqueductal gray. The findings also indicate that the MTN has a small bilateral, but mainly ipsilateral, projection to the dorsal cap, its ventrolateral outgrowth, and the B division of the inferior olivary complex. This study further reveals that ventral tegmental nuclei (n. parabrachialis pigmentosus and n. paranigralis) and subdivisions of the substantia nigra (pars compacta and pars reticulata) project to many brain stem targets of the MTN. Thus, the VTRZ projections are similar to those of the MTN in both distribution and density except that the VTRZ projection to the inferior olive is substantially stronger. The nucleus parabrachialis pigmentosus sends a small contralateral projection to the VTRZ and a moderate-sized bilateral projection to the supraoculomotor-periaqueductal gray. The nucleus paranigralis sends a moderate number of axons to the ipsilateral deep mesencephalic nucleus, pars medialis, and the nucleus reticularis pontis oralis and provides a strong bilateral projection to the supraoculomotor-periaqueductal gray. The pars compacta of the substantia nigra provides a sparse input to the ipsilateral deep mesencephalic nucleus, pars medialis, and nucleus reticularis pontis oralis, and to the contralateral VTRZ and sends a moderate number of axons, bilaterally, to the supraoculomotor-periaqueductal gray. The pars reticulata of the substantia nigra sends an ipsiateral projection of moderate size to the intermediate and deep layers of the superior colliculus, sparse ipsilateral projections to the deep mesencephalic nucleus, pars medialis, and nucleus reticularis pontis oralis, and a sparse bilateral projection to PMID- 3973087 TI - The onset and development of descending pathways to the spinal cord in the chick embryo. AB - The ontogenetic development of afferent (supraspinal and propriospinal) as well as efferent (ascending) fiber connections of the spinal cord was examined following the injection of horseradish peroxidase (HRP) or wheat germ agglutinin HRP (WGA-HRP) into the cervical and lumbar spinal cords (or brains) of embryos ranging in age from 4 to 14 days of incubation. A few cells were first reliably retrogradely labelled in the pontine reticular formation on embryonic day (E) 4 and E5 following the injection of WGA-HRP into the cervical and lumbar spinal cord, respectively. Propriospinal projections to the lumbar spinal cord, originating from brachial spinal cord, were found by E5, and from the cervical spinal cord by E5.5. Ascending fibers arising from neurons in the lumbar spinal cord could be followed to rostral mesencephalic levels in E5 embryos. Thus, the earliest supraspinal, propriospinal, and ascending fiber connections appear to be formed almost simultaneously. Retrogradely labelled cells were found in the raphe, reticular, vestibular, interstitial, and hypothalamic nuclei in E5.5 embryos following lumbar injections of WGA-HRP. Except for neurons in cerebellar nuclei, all the cell groups of origin that project to the cervical spinal cord of posthatching chicks were also retrogradely labelled by E8. There was a delay in the time of appearance of the projections from various regions of the brain stem to the lumbar versus the cervical spinal cord, ranging from 0.5 to 7 days, but typically of about 3 days duration. A large number of cells located in the ventral hypothalamic region, just dorsal to the optic chiasma, were found to be labelled following cervical HRP injection between E6 and E10. These cells may represent transient projections that are present only during embryonic stages since no labelled cells were found in this region in the newly-hatched chick. PMID- 3973088 TI - Novel sources of descending input to the spinal cord of the hatching chick. AB - Nuclear groups contributing supraspinal input to the spinal cord of the hatching chick (Gallus domesticus) were determined by using the enzyme tracer horseradish peroxidase processed with tetramethylbenzidine histochemistry. Five sources of projections to the spinal cord were found which have not been previously described in any species. All are probably related to autonomic function. They include ipsilateral hypothalamic projections from the lateral mamillary n., suprachiasmatic n., and n. of the lateral tubercle. There is a bilateral projection from the large interstitial cells of the mesencephalic posterior commissure, and in the myelencephalon, a mainly contralateral projection from interstitial cells of the vagus-glossopharyngeal nerve. Two other projections observed here have not been described in other avian species, one from the accessory vestibular n., the other, from the n. ambiguus. In the cerebellum, projections arise from the main and ventrolateral divisions of the fastigial n., and from "border cells" between the fastigial and interpositus n. The large celled submedial vestibular n. projects bilaterally. Several projections previously described only in the pigeon, were confirmed here: the hypothalamic nucleus over the supramammilary decussation, the n. intercollicularis, the tangential n., and the n. alatus, a cell group between the hypoglossal and vagal nuclei. Four sources of input projected only as far as mid-cervical cord. These are n. intercollicularis, fastigial n., accessory vestibular n., and tangential n. All remaining projections reached to lower lumbosacral cord. Sources of descending input are remarkably similar in mammals and avians. Where homologous nuclei exist, virtually identical projections to the cord are present. PMID- 3973089 TI - Innervation of the complexus ("hatching") muscle of the chick. AB - The complexus muscle of avians, also known as the "hatching" muscle, is notable for the dramatic, transient pseudohypertrophy which it undergoes around the time of hatching. The muscle is believed to be involved in specific dorsal and lateral head movements used for hatching. Innervation of the complexus muscle was studied in the hatchling chick by using horseradish peroxidase (HRP). HRP injections of the muscle showed that motor innervation arose, as expected, from the cervical motor column (C1-C6). However, additional innervation was also discovered; the spinal accessory nucleus (column of von Lenhossek), the nucleus supraspinalis, and the dorsal and ventral facial motor nuclei all contributed efferents to the hatching muscle. This observation constitutes the first description of dual innervation of a neck muscle by nuclei in both the brain and spinal cord. In addition, transganglionic transport of HRP revealed labelled primary afferent fibers from the hatching muscle ascending in the dorsal columns and terminating extensively within the vestibular complex, especially on the principal cells of the tangential nucleus. The tangential nucleus itself undergoes synaptic changes at the time of hatching. Possible functional relations between the tangential nucleus and the hatching muscle are discussed. PMID- 3973090 TI - Mapping and ultrastructure of serotonin-immunoreactive neurons in the optic lobes of three insect species. AB - With antibodies to serotonin (5-HT) we have mapped immunoreactive neurons in the optic lobes of three species, the blowfly Calliphora, the desert ant Cataglyphis, and the worker bee Apis. The main emphasis in this investigation is on a system of 5-HT-positive neurons connecting the most peripheral neuropil of the optic lobes, the lamina, to more central neuropil regions. To aid in electron microscopical identification of these neurons we used immunocytochemistry at the EM-level and Golgi-EM for Calliphora and horseradish peroxidase (HRP) labelling for the other two insects. The immunoreactive terminals in Calliphora and the HRP labelled ones in the other insects contain large (c. 100 nm) granular vesicles and smaller (c.60 nm) clear vesicles. In Cataglyphis and Apis the profiles with granular vesicles are presynaptic to second order neurons of the lamina, whereas in Calliphora no synaptic contacts were found. In this animal the 5-HT-positive terminals are situated distal to the synaptic layer of the lamina, in a region of retinal photoreceptor axons and perikarya of the lamina monopolar neurons. In Catagylphis and Apis the interactions of the 5-HT-neurons with the laminar neurons might occur through chemical synapses, whereas in Calliphora neuroactive substance could be released non-synaptically from varicosities distal to the synaptic layer. The possible involvement of 5-HT in control of neuronal activity in the optic lobes is discussed. PMID- 3973091 TI - Anatomical evidence for medial pulvinar connections with the posterior cingulate cortex, the retrosplenial area, and the posterior parahippocampal gyrus in monkeys. AB - Reciprocal connections between the medial pulvinar and the limbic neocortex in monkeys were demonstrated by means of tritiated amino acid injections in the medial pulvinar and the cingulate cortex, and HRP injections in the medial pulvinar. It appears that the medial nucleus of the pulvinar sends projection fibres to the posterior cingulate gyrus (area 23), the retrosplenial area, and the posterior parahippocampal gyrus (areas TH and TF). The labeled terminals were concentrated in two bands, one in the deeper part of layer III and in layer IV, and the other in layer I. These projections were observed to be reciprocal, and the cortical afferent fibers to the medial pulvinar were found to originate from the deep layers of the cortex. The medial nucleus of the pulvinar was already known to be connected with the prefrontal cortex and with the inferior parietal lobule. Since this nucleus is now demonstrated to be connected with the posterior limbic neocortex, it is envisaged as being the thalamic counterpart of a cortical triad (prefrontal, parietal, and limbic) involved in modulating directed attention. PMID- 3973092 TI - An electron microscopic study of terminals of rapidly adapting mechanoreceptive afferent fibers in the cat spinal cord. AB - The intra-axonal horseradish peroxidase technique was used to examine the central terminals of 7 A beta primary afferent fibers from rapidly adapting (RA) mechanoreceptors in the glabrous skin of the cat's hindpaw. At the light microscopic level, labelled collaterals were seen to bear occasional boutonlike swellings, mostly (75-82%) of the en passant type. These swellings were distributed more or less uniformly from lamina III to a dorsal part of lamina VI in the dorsal horn, over a maximum longitudinal extent of about 4 mm. At the electron microscopic level, we observed that labelled boutons of RA afferent fibers were 1.0 to 3.3 micrometers in longest sectional dimension, and contained clear, round synaptic vesicles. They frequently formed asymmetric axospinous and axodendritic synapses and commonly appeared to receive contacts from unlabelled structures containing flattened or pleomorphic vesicles plus occasional large dense-cored vesicles. The examination of synaptic connectivity over the entire surface of individual boutons indicated that RA afferent boutons each made contacts with an average of one spine and one dendrite and, in addition, appeared to be postsynaptic to an average of two unlabelled vesicle-containing structures. This synaptic organization was, in general, more complex than that we had seen previously in Pacinian corpuscle (PC) and slowly adapting (SA) type I mechanoreceptive afferent fibers. Our findings indicate that RA, SA, and PC afferent terminals, while displaying some differential synaptic organizations, have many morphological and synaptological characteristics in common. These afferent terminals, in turn, seem to be generally distinguishable from the terminals of muscle spindle Ia afferents or unmyelinated primary afferents. PMID- 3973093 TI - Acoustic chiasm II: Anatomical basis of binaurality in lateral superior olive of cat. AB - The afferent projections to the lateral superior olive (LSO) were examined with horseradish peroxidase, horseradish peroxidase-wheat germ agglutinin conjugate, 125I-wheat germ agglutinin and tritiated leucine autoradiograhy, anterograde axonal degeneration, and 14C-2-deoxyglucose methods. The pathway to the ipsilateral LSO orginates in the spherical cells in anteroventral cochlear nucleus. Although some of the fibers pass above the lateral nucleus of the trapezoid body, most pass below it and turn at right angles to enter the LSO either directly through its ventral, lateral, or dorsal borders, or through its ventral or dorsal hilus. They end in unpolarized terminal fields throughout the LSO. Most if not all of these fibers are true collaterals of axons continuing across the midline in the trapezoid body. Verifying Held's (1893) finding of a major direct projection from the cochlear nucleus to the contralateral medial nucleus of the trapezoid body (MTB) and Rasmussen's ('46) finding of a major projection from the MTB to the LSO, the present results illustrate that this two neuron pathway probably supplies all but a very small component of the relatively direct input to the LSO from the contralateral ear. This pathway originates in the globular cells of the ventral cochlear nucleus and relays mostly though not exclusively through the "principal cells" in the more rostral parts of the MTB. It terminates mostly in perisomal endings in unpolarized fields throughout the LSO, though most heavily within the (high frequency) medial and middle limbs and less heavily in the LSO's (low frequency) lateral limb. In addition to this indirect pathway, there is a small direct pathway to the contralateral LSO as suggested by Goldberg and Brown ('69) and Warr ('72, '82). This direct pathway to the contralateral LSO, like the direct ipsilateral pathway, probably originates in the spherical cell region of the ventral cochlear nucleus, crosses the midline in the trapezoid body, and terminates in a small circumscribed area within the LSO's ventromedial (high frequency) area. The 2-deoxyglucose method applied to cats in which the ipsilateral and contralateral pathways have been surgically isolated shows that each of the pathways converging on the LSO is topographically and tonotopically organized with the ipsilateral and the combined contralateral terminations in strict tonotopic register. PMID- 3973094 TI - Regulation of neuron numbers in Xenopus laevis: effects of hormonal manipulation altering size at metamorphosis. AB - Xenopus laevis tadpoles reared in a 0.01% solution of 6-n-propyl-2-thiouracil (PTU) are blocked in their development at larval stage 54 but continue to increase in size. When released from the effects of PTU they metamorphose into frogs of sizes significantly larger than those of their untreated siblings. Using this size difference to examine the hypothesis that neuron numbers are matched to the size of their postsynaptic targets during neuronal cell death, we measured the following on stage 66 frogs metamorphosing from PTU-treated and untreated tadpoles: lumbar lateral motor column (L-LMC) motoneuron number and mean nuclear cross-sectional area; thoracic and lumbar dorsal root ganglion (DRG) cell number and mean nuclear cross-sectional area; and muscle fiber number in two representative thigh muscles. A few measurements of neuron number and cell size were also made on untreated and PTU-treated stage 54 tadpoles. The most striking correlations observed were not between peripheral size and neuron numbers but between peripheral size and neuron size. Motoneuron numbers were not increased in the PTU-treated animals, perhaps because the increase in peripheral size involved an increase in muscle fiber diameter rather than an increase in muscle fiber number. Thoracic DRG cell number, but not the sum of thoracic and lumbar DRG cell numbers, was increased. In general, our findings do not support the hypothesis that neuron numbers are matched to peripheral size by a process regulating the amount of cell death that occurs during metamorphic stages in Xenopus laevis. PMID- 3973095 TI - Neuronal death and synapse elimination in the olivocerebellar system. I. Cell counts in the inferior olive of developing rats. AB - A transient multiple innervation of cerebellar Purkinje cells by climbing fibers has been described during postnatal development of the rat. The aim of the present study was to determine if the regression of redundant synapses is related to the loss of presynaptic cells in the inferior olivary nucleus (ION), which is the sole source of climbing fibers in rodents. To this end, the population size of the ION was evaluated by counting healthy cells of the four main subnuclei in rats from birth to adulthood. The cell population at birth was found to be very similar to that of the adult animal (27,655 versus 28,385), but a loss of 25% of the cells occurred in the first five days, presumably through their death since degenerating cells were observed over the same period. Although cell loss was found throughout the whole nucleus, it was more pronounced in the medial accessory olive. A subsequent apparent increase of the cell population was observed so that the adult value was again reached at 15 days. The evolution of the ION population is then characterized by a period of moderate cell death which takes place before the peak of polyneuronal innervation of Purkinje cells by olivary axons is attained. This strongly suggests that the removal of the redundant synaptic contacts established by climbing fibers onto Purkinje cells during development is caused by a progressive reduction of the branching of olivary axons rather than by degeneration of the presynaptic cells. PMID- 3973096 TI - Neuronal death and synapse elimination in the olivocerebellar system. II. Cell counts in the inferior olive of adult x-irradiated rats and weaver and reeler mutant mice. AB - Cell death in the developing rat inferior olive precedes the regression of the polyneuronal innervation of Purkinje cells by olivary axons (i.e., climbing fibers), suggesting that the involution of the redundant olivocerebellar contacts is caused by a withdrawal of supernumerary axonal collaterals rather than by degeneration of the parent cell. However, a subsequent apparent increase of the olivary population occurs, which could eventually mask a residual presynaptic cell death taking place at the same time. Therefore, cell counts were performed in the inferior olive of adult rodents in which the multiple innervation of Purkinje cells by olivary axons is maintained, with the idea that if cell death plays a role in the regression of supernumerary climbing fibers, the number of olivary cells should be higher in these animals than in their controls. The results show that the size of the cell population in the inferior olive of weaver and reeler mutant mice and rats degranulated by early postnatal x-irradiation does not differ significantly from that of their controls. Similarly, the distribution of the cells in the four main olivary subnuclei is not modified in weaver mice and x-irradiated rats. The present data further support the assumption that the regression of the polyneuronal innervation of Purkinje cells occurs independently of cell death in the presynaptic population. PMID- 3973097 TI - Selective retinal reinnervation of a surgically created tectal island in goldfish. I. Light microscopic analysis. AB - Through anatomical and physiological studies of the regenerating retinotectal projection of goldfish, we sought to determine whether the establishment of a topographic projection is attained through a refinement of an initially less precise pattern of innervation. A 1-mm-wide mediolateral strip of caudal tectum was removed so that a small island of tectal tissue was spared at the caudal pole, and the contralateral nerve was either crushed (TIX) or left intact (TI). The presence of regenerated axons in the ablated zone and the reinnervation of the caudal island were assessed with anterograde and retrograde labeling methods in the following postoperative intervals: early, 20-50 days; middle, 50-110 days; and late, more than 170 days. The anterograde radioautographic method revealed that the appropriate layers of the tectal island became reinnervated by optic axons during the early period. During the middle and late periods, one to several large, discrete bundles bridging the lesion zone along the surface of exposed subtectal structures were readily identified both by radioautography and by anterograde or retrograde labeling following application of horseradish peroxidase to the transected optic nerve or tectal island, respectively. In contrast, the anterograde horseradish peroxidase method did not reveal axon bundles extending caudal to the half-tectum in the absence of a tectal island. Among TIX cases, retrograde horseradish peroxidase labeling of the contralateral nasal retina was more widespread in the middle period than in the late period, a result we interpret as reflecting an improvement in topographical precision with time. The area of retinal labeling among TIX cases in the late period was similar to that following caudal tectal injection in cases with simple nerve crush, although it was still elevated above normal control values. Physiological maps indicated a focal representation of the nasal retina in the tectal island in both periods and did not reveal a transient extreme convergence of retinal input. These findings are discussed in relation to Sperry's chemoaffinity theory. PMID- 3973098 TI - Selective retinal reinnervation of a surgically created tectal island in goldfish. II. Electron microscopic analysis. AB - In the preceding study (Edwards et al., '85), we showed that regenerating optic axons reestablish a topographically restricted projection to a caudal tectal island created by surgical removal of a 1-mm-wide strip of caudal tectum in goldfish. In the present ultrastructural study, we evaluated the dependence of this axonal outgrowth on the presence of tectal target tissue caudal to the gap. Axon counts in the lesion zone were compared between cases with complete caudal tectal ablation and cases with ablation sparing a caudal tectal island (with and without optic nerve crush). During the postoperative interval of 20-50 days (early period), up to about 1,000 unmyelinated axons with features characteristic of optic axons were present in numerous small subpial bundles in both preparations. In the subsequent interval of 50-110 days (middle period), less than 200 axons were counted caudal to simple half-tecta, whereas 4,000-14,000 myelinated and unmyelinated axons were present in a few large bundles which crossed the lesion zone of tectal island cases. In this period, optic terminals could be demonstrated in the tectal island using the anterograde horseradish peroxidase method. At 170-300 days after surgery (late period), bridging bundles contained between 2,000 and 6,000 largely myelinated axons. We conclude that caudal tectal tissue is not necessary for the initial outgrowth of a small number of axons beyond a rostral half-tectum. The target is essential, however, for the maintenance of these axon fascicles and for the subsequent massive outgrowth of axons to the island. The contributions of glial guidance, diffuse exploratory outgrowth, and target-produced trophic factors to the formation of an initially exuberant projection to the island are discussed. A process of selective axon collateral withdrawal is proposed to account for the decrease in axon numbers within bridging bundles in the late period and for the late restriction in the retinal origin of the island projection indicated by results in the preceding study (Edwards et al., '85). PMID- 3973099 TI - Aging in the rat medial nucleus of the trapezoid body. II. Electron microscopy. AB - The medial nucleus of the trapezoid body (MTB), the largest cell group of the rat superior olivary complex, was studied ultrastructurally in five groups of rats ranging in age from 2 to 33 months. Relatively little aging pigment (lipofuscin) accumulates intraneuronally, even in rats aged 33 months. The heaviest accumulation of age pigment is in glial and perivascular cells of the MTB. In rats aged 24-33 months, there is evidence of axonal and dendritic degeneration in the MTB neuropil. Aged rats also show evidence of degeneration of nerve endings. This includes the loss of calycine axosomatic terminals synapsing with MTB principal cells. All of the ultrastructural changes observed in the MTB gradually increase in frequency with advancing age. PMID- 3973100 TI - Projection patterns of individual X- and Y-cell axons from the lateral geniculate nucleus to cortical area 17 in the cat. AB - Horseradish peroxidase was injected intracellularly into single, physiologically identified X- and Y-cell geniculocortical axons projecting to area 17 of the cat. This injection anterogradely labeled the axon terminal fields in cortex and retrogradely labeled the somata of these same axons in laminae A and A1 of the lateral geniculate nucleus (LGN). The laminar projections of 21 X- and 15 Y-cell axons were analyzed. For these, the laminar terminations of ten X- and seven Y cell axons were also related to their cells' positions in the A-laminae. The terminal fields of X- and Y-cell axons overlapped substantially in layers IV and VI of area 17. Some X-cells terminated mainly in IVb, others mainly in IVa, and still others throughout IVa and IVb. The latter two groups also projected up to 100 micron into lower layer III. Y-cells terminated primarily in layer IVa and projected up to 200 microns into lower layer III. Some also arborized throughout the depth of layer IVb. Both X- and Y-cell axons terminated throughout the depth of layer VI, although more so in the upper half. We found no relationship between the diameter of the parent axon and its sublaminar projection within layer IV. Within layer IV, X-cell axons generally terminated within a single, continuous clump and had surface areas of 0.6 to 0.9 mm2. Axons of Y-cells often terminated in two to three separate clumps, separated by terminal free gaps 400 to 600 micron wide. Their total surface areas, including gaps, were 1.0 to 1.8 mm2, roughly 1.6 times the surface areas of X-cell axons. Despite considerable overlap, Y-cell arbors contained significantly more boutons than did X-cell arbors. The sublaminar projections of the X- and Y-cell axons within layer IV reflected the locations of the cells' somata within the depth of the A-laminae. X cells located in the dorsal or ventral thirds of the depths of the laminae projected mainly to layer IVa or throughout layer IV in cortex. Those located in the central thirds projected mainly to layer IVb. Y-cells showed a similar positional relationship, but they appeared to follow different rules. Y-cells in the outer thirds of the A-laminae projected mainly to layer IVa; those in the central thirds, in addition, expanded their projections to include layer IVb. In general, larger sized somata in the LGN gave rise to more widely spreading terminal arbors and greater numbers of boutons in cortex than did smaller somata.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973101 TI - Termination patterns of individual X- and Y-cell axons in the visual cortex of the cat: projections to area 18, to the 17/18 border region, and to both areas 17 and 18. AB - Horseradish peroxidase was injected intracellularly into single, physiologically identified X- and Y-cell geniculocortical axons that projected to area 18, to the 17/18 border region, or to both areas 17 and 18 via branching axons. The axon terminal fields in cortex were labeled anterogradely, and the cell bodies of the axons in the A-laminae, lamina C, and the medial interlaminar nucleus (MIN) of the dorsal lateral geniculate nucleus (LGN) were labeled retrogradely. The laminar projections in area 18 of eight Y-cells and one geniculate, non-Y-cell were analyzed. Most of the cells arborized densely within layer IVa and the lower 200 to 400 microns of layer III. Most provided little or no input to layer IVb or layer VI. Thus, the laminar projections of Y-cells to layer IV of area 18 were similar to those of their area 17 counterparts, although the input to layer III was greater and rose much higher in area 18 than in area 17. The terminal arbors in area 18 were two to three times larger in lateral extent than those in area 17. They spread over 2.0 to 2.8 mm2 of layer IV and occupied proportionately much greater regions of area 18 than the Y-cell arbors in area 17. This may partially account for the large receptive fields of cortical cells in area 18, and it indicates that a small region of area 18 may receive converging inputs from a relatively wide retinotopic region of the LGN. The terminal arbors were also highly asymmetric, generally being two to four times longer anteroposteriorly than mediolaterally. These asymmetric arbors may form the structural basis for the anisotropic organization of the retinotopic map in area 18. We recovered three cells (two Y, one X) whose axons arborized in the border zone between areas 17 and 18. One Y-cell axon had a receptive field located in the ipsilateral visual hemifield and it arborized in a small region restricted almost exclusively to the border zone. The other two cells had receptive fields on or adjacent to the vertical meridian, and they terminated on either side of the 17/18 border region as well as within it. Thus, geniculate afferents representing the ipsilateral hemifield or the vertical meridian appear to have different patterns of termination on and adjacent to the 17/18 border zone. Also, some X-cell input may invade area 18 in the region immediately adjacent to the border zone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973102 TI - The morphology and synaptic connections of spiny stellate neurons in monkey visual cortex (area 17): a Golgi-electron microscopic study. AB - Based on a gold-toning, Golgi-electron microscope examination of 12 small and medium-sized spiny stellate neurons in laminae 4A, 4B, and 4C of the monkey visual cortex (area 17), the ultrastructure of the cell somata, dendrites, and axons of these neurons is described. Particular attention is paid to the synapses involving the surface of different parts of these neurons. Only symmetric synapses occur on the somata of spiny stellate neurons, and these occur with a frequency of 11.0-15.9 synapses/100 microns2 perikaryal surface. Symmetric synapses also occur on dendritic shafts and, occasionally, on dendritic spines. Asymmetric synapses are occasionally present along the dendritic shafts of spiny stellate neurons, but the majority of asymmetric synapses (75-95%) occur on their dendritic spines. The initial axon segments of the smallest spiny stellate neurons possess no axo-axonal synapses, but several symmetric synapses are present along the initial segment of a medium-sized, spiny stellate neuron in layer 4B. Fifty-three synapses made by boutons of the axons of these spiny stellate neurons have been identified, and all are asymmetric. Sixty per cent of the synapses are formed by boutons en passant and the remainder by the terminal swellings of spine-like axonal appendages, boutons terminaux. Of the synapses formed by the axons of spiny stellate cells, axo-spinous synapses outnumber axo dendritic synapses two to one, and axo-dendritic synapses involve both spinous and aspinous dendrites. Evidence is presented which suggests that many of the axon terminals forming asymmetric synapses with the dendritic shafts and spines of spiny stellate neurons are derived from other spiny stellate neurons. PMID- 3973103 TI - Synaptic connections between the hindwing stretch receptor and flight motor neurones in the locust revealed by double cobalt labelling for electron microscopy. AB - Synaptic interactions between sensory and motor neurones in the locust flight system have been investigated by using intracellular labelling with cobalt and nickel for electron microscopy. Simultaneous axonal filling of two neurones with different concentrations of metal ions produces differential labelling, so that contacts between them in the central nervous system can be recognized. We have investigated the connectivity of the hindwing stretch receptor neurone (SR) with a direct hindwing depressor motor neurone (MN 127) known from physiological experiments to receive monosynaptic input from the SR, and an indirect hindwing depressor motor neurone (MN 112/1), for which no monosynaptic connection with the SR has been reported. We have found no direct synapses between the SR and MN 112/1, although some of their branches lie close together in the neuropile. We have, however, found some evidence for polysynaptic connections between them. There are many synapses of conventional dyadic morphology from both the lateral and mediolateral branches of the SR to MN 127; the medial branch was not examined. Those from the lateral branch contact the motor neurone on branches close to the neuropilar segment, while those from the mediolateral branch contact long, thin distal twigs. We estimate that there are about 600 anatomical synapses between these two neurones. Our results suggest that a large number of widely distributed anatomical synapses constitute the physiological synaptic connection between the SR and MN 127. The dyadic arrangement of these synapses provides an anatomical correlate for the physiologically established divergence of SR outputs onto interneurones and motor neurones. PMID- 3973104 TI - Amyloid plaques in spongiform encephalopathy of mule deer. AB - Amyloid plaques were demonstrable in central nervous system tissues of adult captive mule deer affected with chronic wasting disease, a transmissible primary spongiform encephalopathy. Plaques were detected in tissues of 13 of 21 (62 per cent) spontaneously affected animals from 2 to 4 years of age or older, but were not found in 16 unaffected deer of from a few months to 12 years of age. PMID- 3973105 TI - Further studies of degenerative hip disease; antitrochanteric degeneration in turkeys and broiler type chickens. AB - Postmortem examination revealed antitrochanteric degeneration in turkeys (8 male, 2 female) and broiler type chickens (5 male, 1 female). Antitrochanteric degeneration was detected in birds aged 20 weeks or older but histological examination identified lesions in others with grossly normal antitrochanters. Normal and abnormal antitrochanteric development was studied in male, skeletally immature, turkeys and broilers. Differential subchondral bone growth occurred, with relatively delayed ilial bone development. As a result, hyaline cartilage was retained dorsally and persisted even in adult birds. Retained hyaline, and in younger birds growth plate, cartilage was prone to osteochondrosis. When cartilage flap formation involved fissures traversing retained hyaline cartilage, the term osteochondrosis dissecans was appropriate. In other cases of antitrochanteric degeneration, changes typical of osteoarthrosis were present with, in some instances, no evidence of pre-existing osteochondrosis. Certain sites of antitrochanteric cartilage may be susceptible to fatigue failure in these cases. PMID- 3973106 TI - Hodgkin's disease-like lesion in a rat. PMID- 3973107 TI - Spontaneous craniofacial malformations and central nervous system defects in an aborted equine foetus. AB - Developmental defects are rarely reported in the horse. Severe craniofacial and central nervous system defects in an equine foetus are described and their possible causation and pathogenesis are suggested. PMID- 3973108 TI - Histopathological evaluation of disseminated intravascular coagulation in Haemophilus somnus infection in cattle. AB - The frequency and distribution of fibrin thrombi (microthrombi) in the main organs of spontaneously infected cattle were investigated to evaluate disseminated intravascular coagulation (DIC) in Haemophilus somnus infection. This infection is well known as infectious thrombo-embolic meningo-encephalitis (ITEME) and is characterized histopathologically by formation of thrombi, necrosis of blood vessels and neutrophil infiltration. The precise pathogenic mechanism of this disease has not yet been fully elucidated. The liver, spleen, kidney, lung, heart and brain of 11 cattle showing thromboembolic meningo encephalitis were examined histopathologically and special attention was paid to fibrin thrombi. PTAH staining showed a high frequency of fibrin thrombi in the small vessels and capillaries in more than 3 organs and all the cases were regarded as falling within the histopathological criterion of DIC. The results of the present study indicate that the pathogenesis of the infection is closely related to the DIC. PMID- 3973110 TI - Spontaneous adenocarcinoma of the ascending colon in Wistar rats: the intracytoplasmic presence of a Campylobacter-like bacterium. AB - Campylobacter-like bacteria were demonstrated in the neoplastic cells in 15 of 17 naturally occurring endophytic adenocarcinomas of the ascending colon in Wistar rats. These bacteria were also present in the cytoplasm in metastases in the regional lymph nodes. The microorganisms penetrated the epithelial layer and their presence was associated with a chronic productive inflammatory reaction. A possible causal association of Campylobacter-like organisms in carcinoma of the colon in man and in the Wistar rat is discussed. PMID- 3973109 TI - The role of lysosomes in the pathogenesis of copper-induced hepatotoxicity: morphological studies. AB - Copper-induced hepatotoxicity was evaluated in beige and conventional mice which were injected intraperitoneally with aqueous copper chloride (8 mg per kg body weight per day). Hepatic lesions developed more quickly and were more severe in beige mice and consisted of karyomegaly, progressive accumulation of lipofuscin within hepatocytes and Kupffer cells, acute necrosis of random hepatocytes, and aggregation of leukocytes within the sinusoids. In both groups of mice the hepatic lesion had a centrilobular distribution and closely paralleled the appearance and distribution of copper within hepatocytes. Overall, beige mice had more severe copper-mediated hepatotoxicity, suggesting that normal lysosomes have protective effects for hepatocytes by sequestering copper from other cytoplasmic constituents. PMID- 3973111 TI - Topography and enterocyte morphology of the small bowel mucosal surface in equine granulomatous enteritis. AB - The jejunal mucosa of 4 cases of equine granulomatous enteritis and 2 control horses was investigated by light microscopy and by scanning and transmission electron microscopy. Attention was focused upon changes in mucosal topography and enterocyte morphology in the inflamed mucosa. Structural changes ranged in severity from only a slight thickening and shortening of villi to the appearance of a virtually flat mucosa, upon which crypts opened directly or through shallow cavities encircled by collars of epithelial cells. Between these extremes, the mucosa showed a variety of patterns, all characterized by distinctly abnormal villus projections. These were often united by epithelial bridges and were commonly markedly short, broad and irregular. Enterocytes of mildly changed mucosae showed a normal histology and fine structure, whereas more severely changed specimens displayed a flattened surface epithelium with ultrastructural abnormalities, the most consistent being a pronounced shortening of microvilli. In particular, greatly flattened cells showed evidence of cellular injury, such as prominence of cytolysosomes and degenerative changes of the rough endoplasmic reticulum, while other cells were chiefly characterized by an abundance of non membrane-bound ribosomes and other features signifying an immature state. Cell membrane-tight junctions of the surface epithelium appeared to be intact. No intracellular micro-organisms were detected. It is suggested that several factors are involved in the creation of the abnormal mucosal topography in this disease, including excessive enterocyte loss, crypt cell destruction, inflammatory distension of villi and villus fusions. PMID- 3973112 TI - Systemic malacoplakia in a breeding pig. AB - An adult breeding pig had multiple disseminated lesions in several organs of the thoracic and abdominal cavities. Histopathologically, the lesions consisted of accumulated histiocytic cells with a few giant cells and a mild infiltration of lymphocytes and plasma cells associated with concentric laminated spherical Michaelis-Gutmann bodies which stained strongly with haematoxylin and varied in diameter. The histological features of the lesions were similar to those of malacoplakia reported in man. The present case seems to be unique because the characteristic lesions were found in many organs including kidneys, liver, spleen, lungs, gall bladder, small intestine and several lymph nodes. The possibility of the haematogenous spread of malacoplakia was suggested by the frequent formation of the lesions in perivascular areas. The present case should be described as "systemic malacoplakia in a breeding pig". PMID- 3973113 TI - Prurigo pigmentosa. Case report with an electron microscopic observation. AB - Prurigo pigmentosa is an inflammatory dermatosis characterized by pruritic, reddish, papular lesions and gross reticular pigmentation that occurs mainly on the trunk. Nearly 100 cases have been reported in Japan to date. We describe a patient with this condition who responded well to dapsone. An electron microscopic study of the reddish papular lesion showed marked intercellular edema and evidence of cellular injury of the basal cells. Direct immunofluorescence was negative. We stress that this condition is a distinct clinical entity, histologically characterized by a lichenoid tissue reaction as proposed by Pinkus, although it is little known outside Japan. PMID- 3973114 TI - Calcinosis cutis resulting from percutaneous penetration and deposition of calcium. AB - A case of localized calcinosis cutis of the hands and fingers is described in an oil field worker with normal serum calcium and phosphorus levels. The proposed mechanism consists of percutaneous penetration and subsequent deposition of calcium from the daily exposure to industrial drilling fluids containing calcium salts. PMID- 3973115 TI - Alopecia in meralgia paresthetica. AB - Meralgia paresthetica has been described as a common affliction of the lateral femoral cutaneous nerve, creating the symptoms of numbness, tingling, and paresthesias in the overlying areas of the lateral and anterior thigh. It is second only to sciatica in peripheral nerve diseases of the lower extremity. We present two patients with classic symptoms of meralgia paresthetica and nonscarring alopecia overlying and demarcating the areas of paresthesias. Meralgia paresthetica should be included in the differential diagnosis of localized alopecia of the anterior or lateral thigh. PMID- 3973116 TI - Phenytoin hypersensitivity reaction presenting with toxic epidermal necrolysis and severe hepatitis. Report of a patient treated with corticosteroid "pulse therapy". AB - In this report we describe the successful outcome following the use of corticosteroid pulse therapy in a patient with a severe phenytoin hypersensitivity reaction presenting with toxic epidermal necrolysis and severe hepatitis. Steroid pulse therapy may be lifesaving in a severe dermatosis, such as toxic epidermal necrolysis. PMID- 3973117 TI - Nevus comedonicus of the palm and wrist. Case report with review of five previously reported cases. AB - Nevus comedonicus (NC) is an uncommon condition consisting of grouped comedo-like papules. Rarely, NC is associated with other structural abnormalities and diseases. Lesions of the palms or soles are distinctly unusual. Histopathologic findings support the concept of a developmental abnormality of the dermal components of the pilosebaceous apparatus with subsequent imperfect differentiation of the epidermal components. Therapy is often unrewarding, although topical tretinoin may be of value. PMID- 3973118 TI - Postoperative (pressure) alopecia. AB - Postoperative localized alopecia has been reported most commonly after certain gynecologic and open heart surgery procedures, the likelihood of hair loss and the chance of permanence correlating with the length of the anesthesia and the intubation. Some cases of pressure-induced alopecia have been described after prolonged coma from other causes. Coma blisters have been reported after drug overdoses, but clinically similar blisters (not tested by biopsy) have been seen in other cases of coma. We present three cases of postoperative (pressure) alopecia and propose that both coma blisters and postoperative alopecia arise from the same phenomenon--probably pressure-induced ischemia. PMID- 3973119 TI - Partial (localized) lipodystrophy. Report of a case with muscle and skin abnormalities. AB - The light and electron microscopic myopathologic and dermatopathologic features in one patient with the partial (localized) type of lipodystrophy are described. The myopathologic changes involve both the contractile elements and the intracellular organelles, especially mitochondria that show hyperplasia and structural alterations of cristae. The dermatopathologic changes consist of a reduction in subcutaneous fat, intercellular edema, and the presence of intracytoplasmic lipid droplets. This is the first report in the literature in which the myopathologic features and detailed electron microscopy of skin in this condition are described. The myopathologic features of partial lipodystrophy are compared with those of congenital generalized lipodystrophy. It is proposed that a myopathy may be one of the manifestations of partial lipodystrophy. PMID- 3973120 TI - Pili torti in association with citrullinemia. AB - A 2 1/2-year-old white girl with citrullinemia accompanied by neurologic symptoms presented with 2- to 3-week loss of scalp hair. Examination of the scalp revealed 90% of the hairs to be broken off, leaving a stubble of hairs less than 1 mm in length. Microscopically, plucked hairs demonstrated flattening, twisting through 180 degrees on its own axis, and breakage at the point of twisting. A diagnosis of pili torti was established. Pili torti is a rare disorder that may be seen with some genetic syndromes. Its association with citrullinemia has not been reported previously. PMID- 3973121 TI - Phaeohyphomycotic cyst of the skin caused by Exophiala jeanselmei. AB - A dermosubcutaneous nodule presenting with a superficial papular vascular component occurred in a man receiving long-term prednisone therapy. The histologic findings were characteristic of a phaeohyphomycotic cyst, and a black mold, Exophiala jeanselmei, was isolated. Despite treatment with ketoconazole and local heat, the lesion persisted and was excised. The fungus could be seen in the excised tissue, but cultures were sterile. Subcutaneous phaeohyphomycosis is a relatively uncommon, but recently more frequently recognized type of opportunistic fungus infection. PMID- 3973122 TI - Plantar fibromatosis responds to intralesional steroids. AB - A case of plantar fibromatosis that responded to five monthly intralesional steroid injections is reported. Improvement was noted after 3 to 4 months of therapy. Intralesional steroid injections may represent an alternative to surgery in patients with plantar fibromatosis or Dupuytren's contractures. PMID- 3973123 TI - Allergic contact dermatitis to dyclonine hydrochloride simulating extensive herpes simplex labialis. AB - Two patients developed allergic contact dermatitis to 1% dyclonine hydrochloride gel, a nonprescription topical anesthetic widely marketed for the symptomatic treatment of herpes simplex labialis. Both patients mistakenly believed that the eruption was expanding herpes simplex labialis, which resulted in their more frequent application of the dyclonine hydrochloride and a delay in diagnosis. Dermatologists should recognize that 1% dyclonine hydrochloride gel can cause allergic contact dermatitis that can masquerade as widespread herpes simplex labialis. PMID- 3973124 TI - Oral Crohn's disease: report of two cases in brothers with metallic dysgeusia and a review of the literature. AB - Between 4% and 14% of patients with intestinal Crohn's disease (CD) may manifest the typical oral changes of this disorder. These changes include labial and intraoral inflammatory tissue hyperplasia with fissuring ("cobblestoning") and swelling. In addition, angular cheilitis and regional lymphadenopathy may be present. We report two cases of oral CD in brothers, in whom the unusual symptoms of metallic dysguesia and gingival bleeding were prominent features. Despite the well-recognized familiar incidence of CD, a review of the literature shows that in no previous case reports has familial oral CD been noted. Successful symptomatic and objective treatment results were obtained with a mouthwash preparation of triamcinolone acetonide, tetracycline, and lidocaine. PMID- 3973125 TI - Cerebral cysticercosis: diagnostic value of subcutaneous nodules. Report of two cases. AB - In North America cysticercosis is a rare disease and may cause serious diagnostic difficulties. We report two patients with cysticercosis with neurologic involvement and subcutaneous nodules. In both cases the nodules were small and few in number. Histologic examination showed the diagnostic scolex of the parasite only after subserial sections of the biopsy specimen. The presence of subcutaneous nodules in patients who have lived in endemic areas should raise the possibility of cysticercosis, particularly if neurologic signs or symptoms are present. We stress the importance of careful histologic examination of subcutaneous nodules when cysticercosis is suspected. PMID- 3973126 TI - Bronze baby syndrome. Report of a case. AB - A newborn female infant suddenly developed a generalized gray-brown discoloration of her skin while receiving phototherapy for hyperbilirubinemia. The discoloration waned over the succeeding weeks. Her serum contained an unknown pigment that had a characteristic absorbance on spectrophotometry. The distinctive findings and some possible causes of the bronze baby syndrome are discussed. The findings are compared to other causes of dusky-hued skin in the neonate. The bronze baby syndrome is usually innocuous but can signal life threatening disease. PMID- 3973127 TI - Benign cephalic histiocytosis. A case report and ultrastructural study. AB - A 4-year-old Hispanic boy had an asymptomatic eruption of red-brown macules and papules on the face, neck, trunk, and upper extremities. Examination of the skin lesions by light microscopy revealed a diffuse infiltrate of histiocytes in the upper dermis. Examination by electron microscopy showed wormlike inclusion bodies within the histiocytes. A diagnosis of benign cephalic histiocytosis was made on the basis of these distinct clinical, histologic, and ultrastructural features. PMID- 3973128 TI - Periodic synopsis on pigmentation. PMID- 3973129 TI - Follicular cysts: how should we name them? PMID- 3973130 TI - Acquired, bilateral nevus of Ota-like macules. PMID- 3973131 TI - Letterer-Siwe disease in the ninth decade. PMID- 3973132 TI - PIBIDS: Tay's syndrome and xeroderma pigmentosum. PMID- 3973133 TI - Piroxicam-induced photosensitivity. PMID- 3973134 TI - Papular urticaria and immune complexes. PMID- 3973136 TI - Multiple keratoacanthomas. PMID- 3973135 TI - Skin cancer detection clinics. PMID- 3973137 TI - Lichen aureus. PMID- 3973138 TI - Risks and benefits from high-intensity ultraviolet a sources used for cosmetic purposes. Photobiology Task Force of the American Academy of Dermatology. PMID- 3973139 TI - Biopsy and survival of malignant melanoma. AB - Primary excisional biopsy is recommended as the procedure of choice whenever there is any suspicion of malignant melanoma. Evaluation of the total architecture of the lesion is necessary to make a satisfactory pathologic diagnosis and prognosis. Moreover, the risk of local tumor recurrence and metastatic potential can be increased by incisional procedures. Awareness of these potential hazards should provoke reappraisal of management of primary melanomas. PMID- 3973140 TI - Chronic cutaneous ulcerations and impaired healing in human skin. AB - Chronic skin ulcers, which are frequently located on the lower legs, are a common cause of patient morbidity and incur significant direct and indirect costs in their treatment. The most important process for their development is probably impairment of blood flow to the capillaries and small vessels. Examples of such ulcers are illustrated and some of their causes discussed. The milieu in which chronic skin ulcers develop is usually very different from those conditions in which biosynthetic dressings have been more extensively tested; nonetheless, the use of these dressings to treat such lesions is currently being evaluated. The successful treatment of chronic skin ulcers rests on four basic principles: (1) treatment of pathogenetic mechanisms, (2) correction of physiologic alterations, (3) treatment of contributing factors, such as infection, and (4) additional treatment to promote healing. The use of biosynthetic dressings on chronic skin lesions appears to result in a more rapid epithelialization and a reduction of pain, thereby satisfying the fourth principle. The management of the other principles, as well, is necessary to achieve a maximal rate of healing with chronic skin ulcers. PMID- 3973141 TI - Regeneration of epidermis by cells grown in tissue culture. AB - Pig epidermal cells were grown in vitro for 21 to 180 days, forming multilayered sheets of epidermis varying from thirteen to forty layers. For an evaluation of their use in wound coverage, they were transplanted onto surgically prepared full thickness wound beds on domestic swine. Autologous epidermal cells were studied on twenty-five of the animals, and allogeneic epidermal cells were studied on thirteen. Autologous epidermal cells grown in vitro provided functional wound coverage 10 to 15 days post transplantation and inhibited scar formation. Allogeneic epidermal cells "melted" 15 days post transplantation. There was a 7 day prolongation of allograft survival with cultured, as compared with noncultured, epidermal allografts. Results obtained are related to other advances made in this field. PMID- 3973142 TI - Dermal wound repair: role of collagen matrix implants and synthetic polymer dressings. AB - The effects of two different polymeric wound dressings and a new collagen matrix (CM) implant on the healing and scarring of full-thickness excision wounds were studied in swine. The synthetic polymers comprised an occlusive O2-impermeable hydrocolloid dressing (HCD) and an occlusive O2-permeable polyurethane film (PUF). The CM implant consisted of an acellular collagen sponge fabricated from purified bovine tendon type I collagen. Wounds were evaluated for granulation tissue--production capacity by measuring 14C proline incorporation into collagenase-sensitive protein. Epidermal resurfacing and wound contraction were measured by computerized morphometric image analysis of wounds made on a tattooed grid. In comparison with air-exposed wounds, the relative collagen synthetic capacity was greater in the granulation tissue of wounds treated with HCD, PUF, or CM with occlusion. Both HCD and PUF accelerated by 40% the epidermal resurfacing over the granulating wound bed. Wound contraction was significantly reduced by CM but was not altered by the occlusive dressings. PMID- 3973143 TI - Experiences with biosynthetic dressings. AB - Almost all documented clinical experience shows that occlusively dressed wounds heal more quickly and with less pain, tenderness, and swelling than undressed wounds. Clinical experience with occlusive skin dressings on acute and chronic wounds, on diseased skin, and on normal skin is reviewed. This report presents the effects of some of the newest oxygen-permeable and oxygen-nonpermeable occlusive dressings: three polyurethane adhesive films (Bioclusive, Op-Site, and Tegaderm), a polyethylene oxide hydrogel dressing (Vigilon), and a hydroactive polymer dressing (DuoDerm). PMID- 3973144 TI - Low field (0.02 T) nuclear magnetic resonance imaging of the brain. AB - Many technical and instrumental alternatives are available to obtain good spatial and contrast resolution in magnetic resonance (MR) imaging. Optimum field strength remains a controversial question. In spite of its inherent low signal-to noise ratio, low field imaging exhibits some advantages. It is well established that the relaxation times are dependent on the magnetic field strength. In low fields the relaxation times, especially T1, are shorter and the relative differences of T1 between different tissues are larger. Other benefits are the ease of installation of the device, its cost effectiveness, and the obvious avoidance of hazards caused by the magnetic field. In this report we describe six cases of cerebral lesions studied with an MR imager operating at a field strength of 0.02 T (200 G). This is the lowest field strength reported in clinical MR imaging. The information obtained was equal to that of the CT studies performed on the same patients. PMID- 3973145 TI - Gadolinium-DTPA as a contrast agent in MR imaging--theoretical projections and practical observations. AB - The theoretical basis for the use of paramagnetic agents to enhance proton relaxation is described. Factors of importance in the design of contrast agents are considered. Measurements of changes in T1 and T2 in vitro due to Gd3+ diethylenetriamine pentaacetic acid (DTPA) are used to predict changes in the intensity of transverse magnetisation seen with different sequences in magnetic resonance imaging. The use of Gd3+-DTPA in clinical cases is illustrated. PMID- 3973146 TI - Edge artifacts in MR images: chemical shift effect. AB - The boundaries of some organs as seen in clinical magnetic resonance images appear to be asymmetric. This effect is caused by chemical shift differences between the resonant frequencies of the hydrogen nuclei of water and fat. The zeugmatographic technique maps resonant frequencies to unique spatial locations. These differences in resonant frequencies can appear as artifactual misplacement of information as this one-to-one correspondence is lost. Various phantoms are used to demonstrate that the boundary artifact appears only in the direction of the read (frequency-encoding) gradient when media of two different chemical shifts are separated by an interface. When the relative shift is less than the width of the interface, the boundary appears to be asymmetric; when the relative shift is greater than the width of the interface, a bright band is seen along one edge with a dark band along the other. This artifact is more pronounced in low resolution images than in high resolution images, and these effects are seen even when the relative chemical shift is smaller than a pixel bandwidth. These effects are explained both conceptually and analytically. The clinician should be aware of the potential presence of this artifact at boundary interfaces that bear diagnostic significance. PMID- 3973147 TI - Utilization characteristics of a superconductive MR system undergoing initial clinical trial. AB - The authors describe their initial 7 month experience with magnetic resonance (MR) imaging using a superconductive MR system. Factors affecting system utilization were scheduled and unscheduled downtime, specific system characteristics, and physician experience with the new technology. Technical improvements that reduced the duty cycle and radiologist experience in tailoring examinations have improved patient throughput by reducing the average patient study time by approximately 40% during the 7 month survey. These considerations have important economic consequences for patients and operators of MR equipment. PMID- 3973148 TI - MR imaging of brain stem gliomas. AB - Magnetic resonance (MR) and CT examinations of 26 patients with the established or clinically suspected diagnosis of brain stem glioma were reviewed. Eleven tumors were seen on both MR and CT. The entire extent of the abnormality was better outlined on MR, although CT was more advantageous in demonstrating cystic components and calcium deposition. Magnetic resonance and CT depicted focal intratumoral hemorrhage equally. Magnetic resonance was found to be particularly suitable to follow up the progression or regression of the disease. Of particular interest were two patients with evidence of aqueductal obstruction but normal CT appearance of the midbrain; the causative abnormality, believed to be a glioma, was clearly shown by MR imaging. In nine patients the normal appearance was helpful to exclude the possibility of a brain stem glioma. Thus far, results have shown 100% sensitivity (true positive ratio) and specificity (true negative ratio) with MR in the evaluation of brain stem gliomas. It is concluded that MR imaging should be the examination of choice and could be the definitive screening procedure in patients with suspected brain stem glioma. PMID- 3973149 TI - CT demonstration of calcification within old cerebral infarcts. AB - Calcifications within old cerebral infarcts were demonstrated by CT in three patients who had suffered strokes probably due to emboli from a carotid or cardiac source. In two of them, calcifications were not shown on CT at onset but were first noted on follow-up CT approximately 2 years later in one, and 5 years later in the other. In the third case a large solitary calcification was found on the first CT carried out 13 years after onset. To our knowledge, these findings have not been described previously. PMID- 3973150 TI - Hemorrhagic nerve sheath tumors (plexiform neurofibromas) of the scalp: CT findings. AB - Three cases of hemorrhagic nerve sheath tumors of the scalp are presented with emphasis on CT findings. Each mass produced a mixed pattern of CT density due to the combination of tumor and hemorrhage within it. The CT findings were remarkably similar in the three patients and included a calvarial abnormality underlying the mass in each. PMID- 3973151 TI - CT myelography in cervical nerve root avulsion. AB - Computed tomographic myelography (CTM) with metrizamide was performed in six patients to delineate the CTM appearance of avulsed cervical nerve roots. Twelve cervical nerve root avulsions were found and confirmed by cervical myelography and physical examination. The CTM findings in cervical nerve root avulsion closely matched those found myelographically: outpouchings of metrizamide extending ventrolaterally from the thecal sac into the neural foramen in an expanding or "mushroom-like" manner and separated from the thecal sac proximally by a 1-2 mm thick dural plane. This CTM appearance differs from that seen in such normal variants as dilated nerve root sleeves or root diverticula. We conclude that CTM is as sensitive as myelography. In addition, it can provide useful information regarding bony fragments or contiguous soft tissue injury. PMID- 3973152 TI - Computed tomography of cervical infections. AB - Computed tomography of 31 patients with infections of the face and neck was reviewed and correlated with the clinical and surgical results. Computed tomography was found to be valuable for (a) distinguishing cellulitis from abscess, (b) defining the precise location and extent of complex infections, (c) demonstrating secondary complications, and (d) occasionally suggesting the etiology of infection. Based on this review, we concluded that CT provides important diagnostic information that aids clinical assessment and guides medical and surgical management of cervical infections. The anatomic relationships of selected cervical spaces are reviewed with respect to pathways of spread and potential complications of cervical infections. PMID- 3973153 TI - Mediastinal cystic hygromas: CT characteristics and pathogenetic consideration. AB - Two cases of asymptomatic primary mediastinal cystic hygroma in adults are reported. The CT findings, including: paratracheal and paravertebral location; round, smooth, and sharp outline; homogeneous density with low attenuation number; compression of surrounding tissue without gross invasion; and lack of calcification, together with the superior mediastinal location are sufficiently characteristic to suggest the diagnosis. PMID- 3973154 TI - CT diagnosis of acquired tracheoesophageal fistula in adults. AB - Two cases of acquired tracheoesophageal fistula (TEF) diagnosed by CT are presented. In one case TEF was clinically suspected; in the other it was incidentally discovered. Because of its noninvasive nature and because it can be performed without discomfort to the patient, CT should be a preferred diagnostic method for demonstration of TEF. PMID- 3973155 TI - Compression of the right pulmonary artery by aortic aneurysms: CT demonstration. AB - Two cases are presented in which compression of the right pulmonary artery by thoracic aortic aneurysm was demonstrated using dynamic CT. The patients initially presented with symptoms suggestive of pulmonary embolus and were found to have unilateral absence of perfusion on isotope lung scan. Computed tomography was useful in demonstrating pulmonary artery compression by aortic aneurysm as the cause in both cases, and in demonstrating an aortic dissection in one case. PMID- 3973156 TI - Relative intensity of abdominal organs in MR images. AB - Knowledge of the normal relative intensity of organs and tissues is a valuable aid to clinical interpretation of magnetic resonance images. In this study the in vivo spin echo image intensities of normal parenchymal organs and other structures in the upper abdomen were evaluated for eight parameter combinations. The examinations of 40 patients were used. Image intensity and calculated T1, T2, and spin density values were obtained for liver, spleen, pancreas, renal cortex, renal medulla, bone marrow, skeletal muscle, and fat. Repetition times (TR) of 500, 1,000, 1,500, and 2,000 ms and echo times of 28 and 56 ms were used. The T1 and T2 values and relative spin density were calculated using a new algorithm. Liver had the smallest relative standard deviation of T1 of all the tissues studied. For comparison purposes, relative image intensities were calculated by normalizing them to the intensity of liver in the same image. The resulting compiled data show the normal ranks and ranges for relative intensity for the tissues in each of eight types of spin echo images. Although images with short TR and echo time (TE) are known to display the greatest T1 contrast, the mean relative intensities of all tissues except muscle and fat in the TR = 500 and TE = 28 ms images were within 20% of liver. A much larger spread in the normal relative intensities was observed with longer TE and TR. PMID- 3973157 TI - Gastric leiomyosarcoma: CT observations. AB - The abdominal CT examinations of seven patients with gastric leiomyosarcoma (GLMS), proven by surgical or endoscopic biopsy or both in five patients and percutaneous aspiration biopsy in two, are reviewed. In the six patients studied prior to therapy, CT demonstrated that each of the primary gastric tumors was spherical or ellipsoidal, large (mean diameter 15 cm), and predominantly exogastric in location. Additional CT features of the primary tumor included necrosis in all six masses, a distinct gastric mural attachment in four, bubbles of gas or an air-fluid level or both in three, and mucosal ulceration in two. Direct tumor invasion of nearby organs was suggested by CT in four of the six patients, the spleen and pancreas representing the most frequent sites. Intraperitoneal spread of tumor was present in two patients; necrotic liver metastases accompanied three of the six primary tumors and were found in an additional patient examined 4 years after gastric resection. By accurately reflecting the biological behavior of GLMS, CT is an ideal imaging modality for studying this unusual neoplasm. Differential diagnosis and specificity of the CT findings are discussed. PMID- 3973158 TI - Computed tomography of emphysematous cholecystitis. AB - Two patients with emphysematous cholecystitis confirmed by CT are described. The use of CT in this diagnosis is discussed in relation to the use of sonography and plain radiography. Computed tomography can make a specific diagnosis of emphysematous cholecystitis in a rapid fashion on an emergent basis. PMID- 3973159 TI - The retrorenal colon on computed tomography: a normal variant. AB - In a review of 200 patients, the position of the colon in relation to the posterior aspect of the kidneys on CT was studied. A small part of the colon was found in the left retrorenal position in 1.0% of the patients. An illustrative case report of an unusual colonic variation in which the colon coursed directly behind the kidneys is described. The anatomy of the retroperitoneal fascia and the significance of the retrorenal colon are discussed. PMID- 3973160 TI - CT appearance of sacroiliac joint trauma in children. AB - Subchondral fractures in association with an intact joint space and narrowing of the joint space have not previously been reported with sacroiliac joint trauma in children. The subchondral fractures are thought to occur through the zones of cartilage proliferation and provisional calcification in the growing cartilage of the opposing sacroiliac joint surfaces and the zone of cambium layer of the periosteum in the areas of ligamental insertion, as these may represent structurally weak areas. This type of injury may explain the good long-term results in children with trauma to this region. Widening of the sacroiliac joint space in association with trauma as suggested on plain radiographs may thus not be as common as was previously thought. PMID- 3973161 TI - MR imaging of a choledochal cyst. AB - The preoperative magnetic resonance (MR) appearance of a choledochal cyst using the saturation recovery-spin echo technique is presented along with the CT and ultrasound images. Although CT suggested the correct diagnosis of choledochal cyst, the "solid" characteristics depicted by sonography led to confusion. The MR image demonstrated a mass, similar to the CT image with both a long T1 and T2, thus substantiating the cystic nature of the mass. Hepatoscintigraphy confirmed the obstructive nature of the lesion. PMID- 3973162 TI - Computed tomography of choledochocele. AB - One case of choledochocele is reported, and the findings on CT, endoscopic retrograde cholangiopancreatography, and surgery are described. At surgery, in addition to choledochocele, a large choledochal cyst in the proximal common bile duct was discovered. Choledochocele can be diagnosed by CT and can be recognized by the finding of a cystic mass contiguous with the distal common bile duct that invaginates into the contrast-filled duodenum. PMID- 3973163 TI - CT detection of typhlitis. AB - A case of typhlitis (neutropenic colitis) is reported in which the initial diagnosis was suggested by CT. Radiologists performing CT should be aware of this potentially lethal complication of leukemia, which may appear as a clinically unsuspected finding on CT. PMID- 3973164 TI - Torsion of lipoma of appendix epiploica: CT evaluation. AB - We present a case of a large abdominal mass of fat density on CT, which proved at surgery to be a lipoma arising in an appendix epiploica. The clinical, pathological, and radiological aspects of appendices epiploicae are discussed. PMID- 3973165 TI - Concurrent dissection and intracaval rupture of an abdominal aortic aneurysm: CT findings. AB - The CT findings of a concurrent dissection and intracaval fistula of an arteriosclerotic aortic aneurysm are reported. Recognition of the CT features of this severe and unusual complication is important for planning effective surgical treatment. PMID- 3973166 TI - Calcified pulmonary sequestration: CT demonstration. AB - A case of a calcified pulmonary sequestration is presented. Computed tomography demonstrated an unsuspected calcified pulmonary mass in an asymptomatic patient. PMID- 3973167 TI - Computed tomography of amiodarone pulmonary toxicity. AB - Amiodarone, an antiarrhythmic agent, is known to induce pulmonary toxicity in some patients. Previously described radiographic findings include alveolar and interstitial infiltrates. We report a patient who developed biapical infiltrates on chest X-ray film and demonstrated an unusual, symmetric appearance on CT. Correlative postmortem histologic findings are presented. Amiodarone-induced pulmonary toxicity should be considered in the differential diagnosis of pulmonary parenchymal infiltrates seen on CT of patients receiving this medication. PMID- 3973168 TI - Giant intracranial aneurysm in a child with tuberous sclerosis: CT demonstration. AB - The authors describe the first case of giant intracranial aneurysm in a child with tuberous sclerosis. The subject of vascular disease in this condition is reviewed. PMID- 3973169 TI - A unique case of neurosarcoidosis with pineal and suprasellar involvement: CT and pathological demonstration. PMID- 3973170 TI - An unusual CT presentation of cerebral toxoplasmosis. AB - Intracranial opportunistic infections have been widely reported in patients with acquired immune deficiency syndrome (AIDS). We report an unusual presentation of Toxoplasma gondii infection in a patient with AIDS. PMID- 3973171 TI - Metastatic renal cell carcinoma manifesting as a nasal mass: CT findings. AB - The clinical and radiological findings in a 71-year-old woman with a metastatic renal cell carcinoma to the right nasal cavity are presented. The kidney tumor manifested clinically as epistaxis. Computed tomography revealed an expansile lesion in the right nasal cavity with extension to the right antrum, right ethmoid sinus, and left nasal cavity. There was no lytic bone destruction, but there was displacement of bone caused by the expansile tumor mass. PMID- 3973172 TI - Internal jugular vein phlebectasia and duplication: CT features. AB - Phlebectasia of the internal jugular vein (IJV) is a rare entity with only 25 cases having been reported. Clinically this condition presents with enlargement with a Valsalva maneuver and decrease at rest. Venography, anteriography, and ultrasound have previously been used to diagnose this unusual cause of neck mass. We present a case in which CT confirmed the clinical diagnosis and in which there was an incomplete ipsilateral duplication of the IJV. This is only the second case reported of IJV phlebectasia and duplication. PMID- 3973173 TI - CT myelography of spontaneous spinal epidural hematoma. AB - A case of so-called spontaneous epidural hematoma is presented. A new constellation of myelographic and CT myelographic signs are described that may assist in localizing a mass within the spinal epidural space. PMID- 3973174 TI - Computed tomography in acquired absence of thoracic pedicle. AB - A patient with an acquired absence of a thoracic pedicle is presented, and the contribution of CT examination is demonstrated. A brief anatomical and radiographic review of congenital and acquired absence of pedicles is provided. PMID- 3973175 TI - MR imaging in spinal echinococcosis. AB - A case of spinal echinococcosis with dorsal spinal cord compression is presented and the findings on plain radiography, polytomography, myelography, CT, and magnetic resonance (MR) imaging are discussed. Although CT and MR are complementary studies for the diagnosis of spinal echinococcosis, MR is the study of choice for prolonged follow-up of complicated cases. PMID- 3973176 TI - CT features of reactive periostitis in the humerus: a lesion resembling myositis ossificans. AB - A 5-year-old boy with a painful lesion in the proximal humerus is reported. Plain radiographs suggested the presence of a malignant bone lesion, and CT showed features similar to stress fractures. Pathologically, the changes were that of reactive periostitis. PMID- 3973177 TI - Loose body within the glenohumeral joint in recurrent anterior dislocation: CT demonstration. AB - A loose body within the glenohumeral joint in a patient with chronic anterior dislocation and recent trauma that prevented successful reduction of the dislocated shoulder was demonstrated by CT. Although the use of CT with arthrography has been reported in patients with recurrent dislocations and unstable shoulders, this is the first such reported demonstration using CT without contrast medium of a loose body preventing reduction. PMID- 3973178 TI - Costal chondrosarcoma with pleural seeding: CT findings. PMID- 3973179 TI - The whirl sign: a CT finding in volvulus of the large bowel. PMID- 3973180 TI - CT diagnosis of hernia through iliac bone-graft donor site. PMID- 3973181 TI - Use of spherical receiver coils in MR imaging of the brain. AB - Spherical receiver coils suitable for magnetic resonance (MR) imaging of the brain are described. Spherical geometry permits high field uniformity with close proximity of the coil to the patient's head giving a good filling factor. Patient acceptability has been good in more than 800 examinations of the brain. Spherical receiver coils of appropriate size can provide a simple and worthwhile improvement over conventional saddle designs for low field MR imaging. PMID- 3973182 TI - Delayed iodine scanning of the liver: a promising CT technique. AB - Various techniques for contrast enhanced CT scanning have been proposed to maximize detection of hepatic abnormalities. A new method that uses the secondary excretion of water-soluble contrast media by the liver is described, and an example is provided. PMID- 3973183 TI - Direct sagittal computed tomography of the temporal bone. AB - A technique of obtaining direct sagittal (lateral) CT images of the temporal bone is described, and the normal sagittal CT landmarks are illustrated. Using this technique, structures seen to advantage by lateral polytomography may now be imaged by CT. The ability to scan the temporal bone in the sagittal plane should be a useful adjunct to coronal and axial images. PMID- 3973184 TI - Eosinophils in the cellular infiltrate of granuloma annulare. AB - Eosinophils have been described in the infiltrates of granuloma annulare, but their frequency, distribution and extent are not well documented. We found eosinophils in 18/45 (40%) cases of granuloma annulare, without significant variation relating to histologic sub-pattern. Eosinophils were seen in over half the cases of deep granuloma annulare and in over one-third of the cases of superficial granuloma annulare. This study demonstrates the lack of specificity of eosinophils in differentiating superficial granuloma annulare from deep granuloma annulare, granuloma annulare from necrobiosis lipoidica, and granuloma annulare from occasional clinical simulants which histologically show eosinophils, such as arthropod bite reactions. PMID- 3973185 TI - Gross pathology and scanning electron microscopy of pilomatricoma. AB - We have examined gross specimens of pilomatricomas, divided in half after surgical excision and have found a peculiar gross appearance that has enabled us to arrive at a correct diagnosis. The macroscopic structure of the tumor appears to conform to the scanning electron microscopic picture. PMID- 3973186 TI - Basaloid follicular hamartoma: three cases with localized and systematized unilateral lesions. AB - Two patients having a localized plaque of alopecia on the scalp, and one with a systematized unilateral epithelial nevus exhibited a histologically distinctive form of follicular hamartoma. In the affected areas individual hair follicles were replaced, or were associated with solid strands and branching cords of undifferentiated basaloid cells, filled in between by fibrous stroma resembling either a miniature premalignant fibroepithelial tumor of Pinkus, a small trichoepithelioma, or a basal cell epithelioma. The relation between these 3 patients and cases reported as linear unilateral basal cell nevus with comedones and generalized hair follicle hamartoma associated with myasthenia gravis is discussed. PMID- 3973187 TI - A decade of accomplishment. The Journal of Dermatologic Surgery and Oncology. PMID- 3973188 TI - A decade of dermatologic surgery. PMID- 3973189 TI - Tumor conference #55. Lymphangioma of the lip. PMID- 3973190 TI - The corneal shield. PMID- 3973191 TI - Stump the experts. PMID- 3973192 TI - Injections made easier. PMID- 3973193 TI - What's new in equipment for medical photography (2). PMID- 3973194 TI - Clear-cut definitions. PMID- 3973195 TI - Capsule dermatopathology: nevomelanocytic lesions with spindle cell differentiation. PMID- 3973196 TI - Cryosurgery for carcinoma of the eyelids: a 12-year experience. PMID- 3973197 TI - Ophthalmologic oncology: sebaceous carcinomas of the eyelids. AB - Sebaceous carcinomas are rare, and deadly, adnexal tumors with a distinct predilection for eyelid skin. A chronic blepharoconjunctivitis and/or a recurrent chalazion are the most common clinical presentations that should alert the clinician to the diagnosis. Great care and skill are needed in interpreting these lesions histopathologically as they can be easily confused with basal- and squamous-cell carcinomas. PMID- 3973198 TI - Chemosurgical reports: myxoid dermatofibrosarcoma protuberans. AB - Dermatofibrosarcoma protuberans (DFSP) is a fibroblastic tumor characterized by a high rate of recurrence following conventional surgical treatment. Several different histopathologic patterns exist, with the "cartwheel" pattern the most common. In this report, a patient with the unusual myxoid histopathologic pattern was successfully treated with Mohs surgery. PMID- 3973199 TI - Congenital-nevus-like nevi, nevi spili, and cafe-au-lait spots in patients with malignant melanoma. AB - The prevalence of congenital-nevus-like nevi (CNLN) in a group of 105 adults who had malignant melanoma (MM) was compared with that in a control group of 601 adults not afflicted by MM. Total cutaneous examinations were performed on both groups. The control group presented with complaints other than pigmented lesions. In this series, 10 (9.5%) of the group with MM had clinically diagnosed CNLN 1.5 cm or larger in diameter. These CNLN were not in contiguity with the MM sites. The 9.5% prevalence of CNLN in the group with MM was significantly higher (p less than 0.005) than the 2.5% CNLN observed in the control population. None of the patients in either group had large congenital nevocytic nevi (greater than or equal to 20 cm). In addition, in the group with MM, 5 patients (4.8%) had nevi spili (NS) and 13 (12.4%) had cafe-au-lait spots (CLS). The prevalence rates for these two types of pigmented lesions were not significantly different from those observed in the nonmelanoma control group (2.3% for NS; 13.8% for CLS). The relative risk for developing MM is 4.1 in people with CNLN compared with those without CNLN, which indicates that these nevi may be markers for individuals prone to develop malignant melanoma. PMID- 3973200 TI - Microscopically controlled surgery for periorbital melanoma: fixed-tissue and fresh-tissue techniques. AB - In the treatment of periorbital melanoma, microscopically controlled surgery not only provides great assurance of eradicating the primary melanoma and managing possible satellites, but it also permits maximal sparing of adjacent normal tissues, a benefit of particular value around such important structures as the eyes. The fixed-tissue technique is employed when there is no involvement of the lid margins or bulbar conjunctiva, but if these structures are invaded the fresh tissue technique with chemical cauterization of the incisional surface is used. PMID- 3973201 TI - Cutaneous cryosurgery: current state of the art. PMID- 3973202 TI - Dermabrasion: state of the art. AB - Dermabrasion was developed to remove acne scars but has now been utilized for other cosmetic and therapeutic problems. New instruments, anesthesia, and postoperative dressings have given rise to improved results. Complications and contraindications are emphasized. There is an increased popularity in dermabrasion. PMID- 3973203 TI - Substances for soft tissue augmentation: collagen and silicone. AB - Zyderm injectable collagen and silicone are both used for soft tissue augmentation. Neither is perfect. Critical factors associated with their use include lesion selection and injection technique. Both may have immediate and delayed adverse reactions. PMID- 3973204 TI - Relationship between numbers of face flies (Diptera: Muscidae) and nearest neighbor distance among Holstein cows. PMID- 3973205 TI - Synthesis and evaluation of the naturally occurring phototoxin, alpha-terthienyl, as a control agent for larvae of Aedes intrudens, Aedes atropalpus (Diptera: Culicidae) and Simulium verecundum (Diptera: Simuliidae). PMID- 3973206 TI - Fenvalerate cross-resistance in a resmethrin-selected strain of the house fly (Diptera: Muscidae). PMID- 3973207 TI - Resistance stability and coadaptation in diazinon-resistant house flies (Diptera: Muscidae). PMID- 3973208 TI - Field method for evaluating the effectiveness of acaricides against lone star ticks (Acari: Ixodidae) on domestic dogs. PMID- 3973209 TI - Morphometric analysis of hair cells in the chinchilla cochlea. AB - Ten chinchilla cochleas which ranged in length from 16.00 to 19.71 m were used for this study. The cross-sectional area and perimeter of the inner and outer hair cells and their nuclei were determined at two locations per cochlear turn and at the junction between each of the turns (11 locations from apex to base). Some interanimal variation in hair cell dimensions was noted. However, none of these size variations could be attributed to any known differences among the animals. It was concluded that the data reported here represent the natural variation in hair cell size in chinchillas. The data establish a baseline to which the dimensions of cells from abnormal cochleas can be compared, regardless of the length of the cochlea or the base-to-apex location of the cells. PMID- 3973210 TI - Frequency characteristics of the middle ear. AB - For 68 temporal bones, frequency curves for the round window volume displacement have been measured for a constant sound pressure at the eardrum. Phase curves were measured for 33 of the specimens. The levels averaged amplitude curve is approximately flat below 1 kHz, where the round window volume displacement per unit sound pressure at the eardrum is 6.8 X 10(-5) mm3/Pa, and falls off by about 15 dB/oct at higher frequencies. For the 20 ears having the largest sound transmission magnitude at low frequencies, the corresponding amplitude curve is displaced about 5 dB towards higher levels. The phase of the round window volume displacement lags the eardrum sound pressure phase. In average for 33 temporal bones, the phase lag increases from zero at the lowest frequencies to pi near 2 kHz and to about 1.5 pi at 10 kHz. PMID- 3973211 TI - Influence of direct current on dc receptor potentials from cochlear inner hair cells in the guinea pig. AB - Inner hair cell responses to sound were monitored while direct current was applied across the membranous labyrinth in the first turn of the guinea pig cochlea. The current injection electrodes were positioned in the scala vestibuli and on the round window membrane. Positive and negative current (less than 100 microA) caused changes in the sound-evoked dc receptor potentials which were dependent on the sound frequency and intensity. The frequencies most affected by this extracellular current were those comprising the "tip" portion of the inner hair cell frequency tuning characteristic (FTC). The influence of current increased with increasing frequency. Positive current increased the amount of dc receptor potential for the affected frequencies while negative current decreased the potential. Current-induced changes (on a percentage basis) were greater for low intensity sounds and the negative current direction. These frequency specific changes are evidenced as a loss in sensitivity for the tip area of the FTC and a downward shift of the inner hair cell characteristic frequency. Larger current levels (greater than 160 microA) cause more complex changes including unrecoverable loss of cell performance. In separate experiments positive and negative currents (less than 1.1 microA) were injected into the inner hair cell from the recording electrode during simultaneous measurement of the sound-evoked dc receptor potential. This condition caused a shift in IHC sensitivity that was independent of sound frequency and intensity. Positive current decreased the sensitivity of the level of the cell while negative current increased the responses. The effect of current level on sound-evoked dc receptor potential was nonlinear, as comparatively greater increases in cell response were observed for negative than decreases for positive current. The intracellular current injection results are accounted for by the mechano-resistive model of hair cell transduction, where nonlinear responses with current level may reflect outward rectification. Response changes induced by extracellular current are evidence of current effects on both inner and outer hair cells. The frequency and intensity dependences are hypothesized to represent voltage mediated control of inner hair cell response by the outer hair cells. PMID- 3973212 TI - Thresholds for discrimination between pure and tempered intervals: the relevance of nearly coinciding harmonics. AB - Thresholds for discrimination between pure and tempered musical intervals consisting of simultaneous complex tones (fundamental frequencies f1 and f2) were investigated. For these tones the main clue for the discrimination of pure intervals (f1:f2 = p:q; p and q small integers) from moderately tempered intervals (f1:f2 approximately p:q) is absence versus presence of beats. The strength of the beats (level difference between envelope maximum and minimum or level-variation depth D) was manipulated by introduction of differences in level (delta L) between the two tones. In each of three experiments the discrimination thresholds (DTs) were determined for 13 intervals with different values for p and/or q. Experiment 1 showed that there is a simple relation between frequency ratio complexity and discriminability: DTs gradually increased (smaller values of delta L) with increasing p + q. Experiment 2, in which tones with harmonics of equal amplitude were used, indicated that level of the interfering harmonics was not responsible for the relation between DT and p + q. Yet, Experiment 3, in which the spectral content of the tones was varied, clearly showed that for all intervals DT had been determined by the interference between nearly coinciding harmonics. Detailed analysis of the results revealed that the relation between DT and ratio complexity might have been the result of masking. PMID- 3973213 TI - Pitch shift of pure and complex tones induced by masking noise. AB - Psychoacoustic experiments were performed to measure the pitch-shift effects of pure and complex tones resulting from the addition of a masking noise to the tonal stimuli. Harmonic residue tones with either two or three harmonics and a fundamental frequency of 200 Hz were chosen as test tones. The pitch shifts of virtual and spectral pitches of the residue tones were measured as a function of the intensity of a low-pass noise with 600-Hz cutoff frequency. The SPL of this noise varied between 30 and 70 dB. In another experiment, the pitch shifts of single pure tones corresponding to the frequencies and SPLs of the harmonics of the residue tones were measured using the same masking noise. The results from five subjects for the harmonic residue tones show only a weak dependence of pitch shift on masking noise intensity. This dependence exists for both spectral and virtual pitches. In the case of single pure tones, pitch shift depends more distinctly on noise intensity. Pitch shifts of up to 5% were found in the range of noise intensity investigated. The magnitude of pitch shift shows pronounced interindividual differences, but the direction of the shift effect is always the same. In all cases pitch increases with higher masking noise levels. PMID- 3973214 TI - Penalty for impulse noise, derived from annoyance ratings for impulse and road traffic sounds. AB - In the laboratory, four groups of 16 subjects rated the annoyance caused by three types of impulse sounds (regular and irregular gunfire noise and metal construction noise) and by road-traffic sounds, all presented in background noise. The subjects were presented with the sounds for 5-min periods. The annoyance ratings were related to the A-weighted equivalent level (Leq) of the sounds. From these annoyance ratings a correction term or penalty was derived, which, added to the Leq of the impulse sounds, gives the level of equally annoying traffic noise. The correction was determined for conditions in which (1) only the annoyance caused by specific sources, or (2) the annoyance caused by the total sound (specific source plus background) had to be rated. In addition, the indoor Leq of the constantly present background noise was 35 or 55 dB(A) by and large, the results showed that for lower levels of the sounds an impulse-noise correction of at least 10 dB was required, whereas for higher levels the derived correction was about equal to the ISO/R 1996 penalty of 5 dB. This conclusion, based on the relation between Leq and annoyance ratings, is consistent with the correction based on Leq and the percentage of subjects who reported to be "very much annoyed." For equivalent levels of the impulse sounds at which 33% of the subjects claimed to be very much annoyed, the correction was 10 dB for the conditions in which the indoor Leq of the background noise was 35 dB(A), and 5 dB when this Leq was 55 dB(A).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973215 TI - Influence of monaural spectral cues on binaural localization. AB - Seven subjects located, monaurally and binaurally, narrow bands of noise originating in the horizontal plane. The stimuli were 1.0 kHz wide and centered at 4.0-14.0 kHz in steps of 0.5 kHz. The loudspeakers, 15 deg apart, were arranged in a semicircle (0-270-180 deg, azimuth). In the first part of the experiment all sounds emanated from the loudspeaker at 270 deg, but their apparent locations varied widely as a function of their center frequency. For each subject, the pattern of location judgments under the binaural listening condition corresponded to that recorded for the monaural condition. In the second part of the experiment the loudspeaker from which each of the same narrow bands of noise emanated was varied in irregular order. Again, monaural location judgments were governed by the frequency content of the noise bands. Binaural location judgments were strongly influenced by the sounds' frequency composition when the stimuli originated from 315-225 deg, notwithstanding the presence of interaural differences in time and intensity. For narrow bands of noise emanating off midline, monaural spectral cues significantly override binaural difference cues, and they also determine the resolution of front-back ambiguities. PMID- 3973216 TI - Touch as a communicative sense: introduction. AB - A brief survey is made of some of the threads of research and theory that have converged upon the problems of application of the touch sense to the task of substituting for the hearing process. PMID- 3973217 TI - The mutability of time and space on the skin. AB - Radical shifts in perceived spatial relations can occur through the operation of the principle of sensory saltation. In the realm of cutaneous sensation, where it was first encountered, and also in some auditory and visual situations, any brief stimulus preceding a second one by no more than about 300 ms will show apparent spatial displacement from its veridical position. The degree of deviation is determined primarily by temporal relations between the two stimuli but, secondarily, by intensive ones as well. Limits of the operation of the saltatory effect on the skin have been ascertained by employing a campimetric technique on representative body areas. From the results of such measurement, taken together with consideration of some aspects of the known neural substrate, it is possible to decide among several competing hypotheses concerning the essential seat of the phenomenon. The relation of the saltatory effect to the earlier tau and kappa effects is discussed, as are the possibilities offered by all three to the solution of tactual communication problems and the allied problem of tactile displays. PMID- 3973218 TI - Research on the Tadoma method of speech communication. AB - In Tadoma, speech is received by placing a hand on the talker's face and monitoring actions associated with speech production. Our initial research has documented the speech perception, speech production, and linguistic abilities of deaf-blind individuals highly trained in Tadoma. This research has demonstrated that good speech reception can be achieved through the tactile sense: Performance is roughly equivalent to that of normals listening in noise or babble with a signal-to-noise ratio in the range 0-6 dB. It appears that the principal cues employed are lip movement, jaw movement, oral airflow, and laryngeal vibration, and that the errors which occur are caused primarily by inadequate information on tongue position. Our current research includes (1) learning of Tadoma by normal subjects with simulated deafness and blindness, (2) augmenting Tadoma with a supplemental tactile display of tongue position, and (3) developing a synthetic Tadoma system in which signals recorded from a talker's face are used to drive an artificial face. This research is expected to increase our understanding of Tadoma and its relation to other tactile communication methods, show that performance obtained through Tadoma does not represent the ultimate limits of the tactile sense, and provide a research tool for studying transformations of Tadoma. PMID- 3973219 TI - A qualitative dynamic analysis of reiterant speech production: phase portraits, kinematics, and dynamic modeling. AB - The departure point of the present paper is our effort to characterize and understand the spatiotemporal structure of articulatory patterns in speech. To do so, we removed segmental variation as much as possible while retaining the spoken act's stress and prosodic structure. Subjects produced two sentences from the "rainbow passage" using reiterant speech in which normal syllables were replaced by /ba/ or /ma/. This task was performed at two self-selected rates, conversational and fast. Infrared LEDs were placed on the jaw and lips and monitored using a modified SELSPOT optical tracking system. As expected, when pauses marking major syntactic boundaries were removed, a high degree of rhythmicity within rate was observed, characterized by well-defined periodicities and small coefficients of variation. When articulatory gestures were examined geometrically on the phase plane, the trajectories revealed a scaling relation between a gesture's peak velocity and displacement. Further quantitative analysis of articulator movement as a function of stress and speaking rate was indicative of a language-modulated dynamical system with linear stiffness and equilibrium (or rest) position as key control parameters. Preliminary modeling was consonant with this dynamical perspective which, importantly, does not require that time per se be a controlled variable. PMID- 3973220 TI - Speech recognition and the Articulation Index for normal and hearing-impaired listeners. AB - The purpose of this experiment was to determine the applicability of the Articulation Index (AI) model for characterizing the speech recognition performance of listeners with mild-to-moderate hearing loss. Performance intensity functions were obtained from five normal-hearing listeners and 11 hearing-impaired listeners using a closed-set nonsense syllable test for two frequency responses (uniform and high-frequency emphasis). For each listener, the fitting constant Q of the nonlinear transfer function relating AI and speech recognition was estimated. Results indicated that the function mapping AI onto performance was approximately the same for normal and hearing-impaired listeners with mild-to-moderate hearing loss and high speech recognition scores. For a hearing-impaired listener with poor speech recognition ability, the AI procedure was a poor predictor of performance. The AI procedure as presently used is inadequate for predicting performance of individuals with reduced speech recognition ability and should be used conservatively in applications predicting optimal or acceptable frequency response characteristics for hearing-aid amplification systems. PMID- 3973221 TI - Infants' discrimination of final syllable fundamental frequency in multisyllabic stimuli. AB - Two groups of nine, 5- to 11-month-old infants were tested for discrimination of a change in peak fundamental frequency (F0) within the final syllable of multisyllabic speechlike stimuli. A visually reinforced headturn discrimination procedure was used to determine sensitivity to increments in peak F0 in synthetic speech in both bisyllabic (CVCVC) and trisyllabic (CVCVCVC) contexts. Discrimination performance was above chance expectation for increments of 10, 20, and 30 Hz relative to a 150-Hz standard. There were no differences in performance attributable to syllable-number context. In a second experiment reassessing two syllable stimuli, performance was above chance for increments of 5, 10, and 30 Hz relative to the same 150-Hz standard. Both experiments indicated a relatively flat function relating discrimination score and F0 increment. Overall, infant and adult absolute thresholds for a change in F0 appear similar. Effects of threshold, increment, and syllable number are contrasted with earlier results for infant discrimination of both peak-intensity changes and vowel duration increments in the same multisyllabic stimuli. PMID- 3973222 TI - Linguistic and acoustic correlates of the perceptual structure found in an individual differences scaling study of vowels. AB - Subjects judged the similarities among a set of American English vowels (See Text) presented in isolation or in a/dVd/ consonantal frame. Individual differences scaling was employed to analyze these similarities data for each of the conditions separately and for the two conditions combined. In all cases, perceptual dimensions corresponding to the advancement, height, and tenseness vowel features were recovered. Given the determinacy of individual differences scaling, this finding is taken to provide strong evidence for the perceptual significance of those features. The perceptual dimensions are considered in relation to various acoustic parameters of the stimuli employed in this study. They are also considered in relation to perceptual dimensions that have been observed in other vowel scaling studies. PMID- 3973223 TI - Evidence for ultrasonic finite-amplitude distortion in muscle using medical equipment. AB - Finite-amplitude distortion of ultrasonic waves from medical equipment has been observed to occur following transmission through calf muscle in human volunteers. Measurements were made using both dynamic pulse-echo imaging equipment and physiotherapy equipment. In both cases irradiation was carried out under operating conditions commonly used clinically. Pressure waveforms were measured at the skin surface using a broadband polyvinylidene difluoride membrane hydrophone. Using a pulsed, weakly focused 2.5-MHz beam with input peak pressure of 0.8 MPa and a pressure gain of 5.3 at the focus, the mean second harmonic peak magnitude (16 measurements) was 17 dB below the fundamental peak. A 1.1-MHz continuous wave therapy set with input peak pressure of 0.5 MPa showed mean second harmonic magnitude 23 dB below the fundamental. PMID- 3973224 TI - Ultrasonic attenuation and velocity properties in rat liver as a function of fat concentration: a study at 100 MHz using a scanning laser acoustic microscope. AB - This study examines the extent to which ultrasonic attenuation coefficients and velocity properties change between normal and fatty rat liver. The view of this problem is toward the application in clinical medicine in the future. Fatty livers were produced in rats by feeding them alcohol diets in liquid form. The animals were sacrificed and the fat concentration of the liver specimens determined. The fat concentration varied from 2.5% to 16.8% wet weight. The ultrasonic attenuation coefficient and velocity properties in 28 specimens were measured at 100 MHz with the scanning laser acoustic microscope (SLAM). Regression analysis was applied to the liver's ultrasonic propagation properties as a function of fat concentration. The results show that the attenuation coefficient increases at a rate of 1.08 dB/mm/% fat and the velocity decreases at a rate of 2.3 m/s/% fat as the fat concentration increases. PMID- 3973225 TI - Speechreading supplemented with formant-frequency information from voiced speech. AB - The benefit of supplementing speechreading with information about the frequencies of the first and second formants from the voiced sections of the speech signal was studied by presenting short sentences to 18 normal-hearing listeners under the following three conditions: (a) speechreading combined with listening to the formant-frequency information, (b) speechreading only, and (c) formant-frequency information only. The formant frequencies were presented either as pure tones or as a complex speechlike signal, obtained by filtering a periodic pulse sequence of 250 Hz by a cascade of four second-order bandpass filters (with constant bandwidth); the center frequencies of two of these filters followed the frequencies of the first and second formants, whereas the frequencies of the others remained constant. The percentage of correctly identified syllables increased from 22.8 in the case of speechreading only to 82.0 in the case of speechreading while listening to the complex speechlike signal. Listening to the formant information only scored 33.2% correct. However, comparison with the best scoring condition of our previous study [Breeuwer and Plomp, J. Acoust. Soc. Am. 76, 686-691 (1984)] indicates that information about the sound-pressure levels in two one-octave filter bands with center frequencies of 500 and 3160 Hz is a more effective supplement to speechreading than the formant-frequency information. PMID- 3973226 TI - Assessment of community response to impulsive noise. AB - The U.S. Army Construction Engineering Research Laboratory has completed community attitudinal surveys at two major Army installations. The main purpose of these surveys was to better understand community response to the impulsive noise generated by large Army weapons such as tanks, artillery, or demolition. The results show that an energy type of model such as the C-weighted day/night average sound level (CDNL) is the best available descriptor for community response for these types of impulsive sound. Growth in annoyance to all noises increases monotonically with both sound amplitude and frequency of occurrence. This descriptor should incorporate a nighttime adjustment on the order of 10 decibels (dB). The exact function for relating the percentage of a community highly annoyed to CDNL remains in question. It appears that the present National Academy of Science Committee on Hearing, Bioacoustics and Biomechanics (CHABA) recommendation may underestimate actual annoyance, and that the functional relation between annoyance and CDNL should be shifted by 3-4 dB. However, more research on the percentage of a community highly annoyed versus CDNL and the existence and value of community rise- and decay-time constants is required to clarify this issue. PMID- 3973227 TI - Studies of parallel barrier performance by acoustical modeling. AB - An investigation is presented into the performance of parallel barrier configurations, using acoustical scale modeling. A realistic geometry is investigated, with the source being positioned over a paved roadway and the receiver over grass-covered ground. The grass-covered ground surface was properly modeled in terms of its impedance. Results were obtained for a range of barrier types, and demonstrate that frequency dependent effects are evident in barrier insertion loss data. In most cases, the barrier on the far side of the source did not significantly affect sound levels at the receiver. The most effective barrier design was found to be that of a gradual grass-covered slope up to an upright, thin barrier. PMID- 3973228 TI - The possible role of the cochlear frequency-position map in auditory signal coding. AB - The frequency-position map in the cochlea is considered as part of a signal decomposition mechanism whose purpose is redundancy reduction and information compression of auditory stimuli. A logarithmic-type frequency distribution is analytically derived from a heuristic model of the autocorrelation function of auditory signals and confronted with empirical data from the cat cochlea. It is argued that the logarithmic organization of frequency along the cochlea is designed to extract the maximum amount of information with the minimum number of hair cells. PMID- 3973229 TI - Specification of the acoustical input to the ear at high frequencies. AB - The sound fields that arise in the auditory canals of cats have been examined both experimentally and theoretically. Of particular interest was the spatial variation of sound pressure near the eardrum, where reference probes are typically located. Using a computer controlled data acquisition system, sound pressure was measured between 100 Hz and 33 kHz for constant driver input at 14 different locations in the ear canal of a cat, and the standing wave patterns formed. The shape of the patterns could be predicted quite well above 12 kHz using a theory that requires specification of only the geometry of the ear canal. This theory, an extension of the one-dimensional horn equation, applies to three dimensional, rigid-walled tubes that have both variable cross section and curvature along their lengths. Large variations of sound pressure along the ear canal and over the surface of the eardrum are found above about 10 kHz. As a consequence it is not possible to define the acoustical input to the ear from sound pressure level measured at any single location. Even in comparative experiments, in which only the constancy of the acoustical input is important, any uncertainty in reference probe location would lead to an uncertainty in sound pressure level when different sets of measurements are compared. This error, calculated for various probe locations and frequencies, is especially large when the probe is near a minimum of the sound field. Spatial variations in pressure can also introduce anomalous features into the measured frequency response of other auditory quantities when eardrum sound pressure is used as a reference. This is illustrated with measurements of the round window cochlear microphonic. PMID- 3973230 TI - The effects of cochlear hypothermia on compound action potential tuning. AB - The effects of lowered cochlear temperature on eighth-nerve tuning were assessed by using forward masking of whole nerve action potential (AP) responses to generate AP tuning curves (APTCs) at cochlear temperatures ranging from 38.5 degrees to 30 degrees C for probe frequencies from 8 to 36 kHz. The data indicate that subnormal cochlear temperatures result in: broadened APTCs for probe frequencies above 10 kHz which are interpreted as resulting from reduced hair cell frequency selectivity, lowered or more sensitive APTC tips where tone-burst thresholds are unchanged, and raised or less sensitive tips where thresholds to tone bursts were elevated. Increased tip sensitivity is explained in terms of enhanced eighth-nerve adaptation which occurred during hypothermia. Experiments directly addressing adaptation were performed, in which the masker-probe interval (delta t) was systematically lengthened. The normalized AP decrement versus delta t functions indicate an enhancement of both the amount and duration of adaptation during hypothermia. Functions relating the growth of response to the masker (AP decrement versus masker intensity functions) were reduced at low temperatures. PMID- 3973231 TI - Nonlinear phenomena as observed in the ear canal and at the auditory nerve. AB - We report here several measures of nonlinear effects in the mammalian ear made in the external auditory meatus and in single neurons of the auditory nerve. We have measured the 2f1-f2 and the f2-f1 distortion products and we have found that the neural distortion product threshold curve for 2f1-f2 mirrors the low-frequency side of the frequency threshold curve, when the neural distortion product threshold curve of 2f1-f2 is plotted versus log(f2/f1) its slope is about 50 dB/oct and its intercept is 10-20 dB above the frequency threshold at the characteristic frequency CF, substantial 2f1-f2 distortion was seen in all animals studied while the f2-f1 distortion product was only rarely found at substantial levels, and the distortion product pressure observed in the ear canal was at a level equal to that detected at threshold by the neural units under study. We have also made measurements of two-tone rate suppression thresholds using two new and consistent threshold paradigms. We find that for high and intermediate characteristic frequency neural units the suppression threshold is independent of frequency and at a level of about 70 dB SPL, the suppression above CF is much less than below CF, and the tip of the frequency tuning curve can be suppressed by up to 40 dB by a low-frequency suppressor. PMID- 3973232 TI - Extension of a temporal model of frequency discrimination: intensity effects in normal and hearing-impaired listeners. AB - The effects of intensity on the difference limen for frequency (DLF) in normal hearing and in hearing-impaired listeners are incorporated into the temporal model of frequency discrimination proposed by Goldstein and Srulovicz [Psychophysics and Physiology of Hearing, edited by E. F. Evans and J.P. Wilson (Academic, New York, 1977)]. A simple extension of the temporal mode, which includes the dependence of phase locking on intensity, is sufficient to predict the effects of intensity on the DLF in normal-hearing listeners. To account for elevated DLFs in hearing-impaired listeners the impairment is modeled as a reduction in the synchrony of the discharge from VIIIth-nerve fibers that innervate the region of hearing loss. Constraints on the optimal processor and the validity of the temporal model at high frequencies are discussed. PMID- 3973233 TI - Speech perception ability and psychophysical tuning curves in hearing-impaired listeners. AB - Performance-intensity functions for monosyllabic words were obtained as a function of signal-to-noise ratio for broadband and low-pass filtered noise. Subjects were 11 normal-hearing listeners and 13 hearing-impaired listeners with flat, moderate sensorineural hearing losses and good speech-discrimination ability (at least 86%) in quiet. In the broadband-noise condition, only small differences in speech perception were noted between the two groups. In low-pass noise, however, large differences in performance were observed. These findings were correlated with various aspects of psychophysical tuning curves (PTCs) obtained from the same individuals. Results of a multivariate analysis suggest that performance in broadband noise is correlated with filter bandwidth (Q10), while performance in low-pass noise is correlated with changes on the low frequency side of the PTC. PMID- 3973234 TI - Spectral sharpness and vowel dissimilarity. AB - The effect of sharpening or smoothing the spectral envelopes of synthetic vowel like sounds on the dissimilarities perceived among these sounds was investigated by means of triadic comparisons. When a spectral envelope (dB on a log-frequency scale) is considered the sum of a series of sinusoidal spectral modulations (or ripples) of different densities (the ripple spectrum), spectral sharpening or smoothing can be described as an amplification or attenuation of a part of the original ripple spectrum. For a set of nine sounds comprising different degrees of spectral sharpening of a single vowel, the perceived dissimilarities were found to be dominated by a specific part of the ripple spectrum, i.e., by spectral modulations with a density of about 2 ripples/oct. The possible role of lateral suppression in relation to this dominant region is discussed. For a set of 18 sounds comprising six vowels, each in three different versions (sharpened, normal, or smoothed), the dissimilarities were found to be determined mainly by the global shape of the spectral envelopes, i.e., by spectral modulations up to about 1.5-2 ripples/oct. Details of the spectral envelope (including the region of 2 ripples/oct where lateral suppression is effective) appear to be of minor influence on vowel dissimilarities. PMID- 3973235 TI - Detection of temporal gaps in bandlimited noise: effects of variations in bandwidth and signal-to-masker ratio. AB - Thresholds were measured for the detection of a temporal gap in a bandlimited noise signal presented in a continuous wideband masker, using an adaptive forced choice procedure. In experiment I the ratio of signal spectrum level to masker spectrum level (the SMR) was fixed at 10 dB and gap thresholds were measured as a function of signal bandwidth at three center frequencies: 0.4, 1.0, and 6.5 kHz. Performance improved with increasing bandwidth and increasing center frequency. For a subset of conditions, gap threshold was also measured as bandwidth was varied keeping the upper cutoff frequency of the signal constant. In this case the variation of gap threshold with bandwidth was more gradual, suggesting that subjects detect the gap using primarily the highest frequency region available in the signal. At low center frequencies, however, subjects may have a limited ability to combine information in different frequency regions. In experiment II gap thresholds were measured as a function of SMR for several signal bandwidths at each of three center frequencies: 0.5, 1.0, and 6.5 kHz. Gap thresholds improved with increasing SMR, but the improvement was minimal for SMRs greater than 12-15 dB. The results are used to evaluate the relative importance of factors influencing gap threshold. PMID- 3973236 TI - Measures of the sentence intonation of read and spontaneous speech in American English. AB - The visual abstraction procedure used in previous studies of declination was tested using 12 subjects who each fit the F0 contours of 19 spoken short simple sentences with baselines. These baselines were found to be poorly replicated the fitters. An objective all-points least-squares best-fit procedure was tested on this corpus and on a set of sentences that had been produced in both spontaneous and read speech by six speakers. The all-points linear regression line was a better descriptor of the F0 contours than either baselines or toplines. Declination did not always occur in these simple declarative sentences; there was more variation present in the F0 contours of sentences that had been uttered during spontaneous speech; 35% of the spontaneous sentences did not show declination; 45% of these sentences better fit the breath-group model. Their F0 contours could be described by a level all-points linear regression line followed by a falling terminal segment. PMID- 3973237 TI - Phonetic identification by elderly normal and hearing-impaired listeners. AB - Young normal-hearing listeners, elderly normal-hearing listeners, and elderly hearing-impaired listeners were tested on a variety of phonetic identification tasks. Where identity was cued by stimulus duration, the elderly hearing-impaired listeners evidenced normal identification functions. On a task in which there were multiple cues to vowel identity, performance was also normal. On a/b d g/identification task in which the starting frequency of the second formant was varied, performance was abnormal for both the elderly hearing-impaired listeners and the elderly normal-hearing listeners. We conclude that errors in phonetic identification among elderly hearing-impaired listeners with mild to moderate, sloping hearing impairment do not stem from abnormalities in processing stimulus duration. The results with the /b d g/continuum suggest that one factor underlying errors may be an inability to base identification on dynamic spectral information when relatively static information, which is normally characteristic of a phonetic segment, is unavailable. PMID- 3973238 TI - The contribution of fundamental frequency, amplitude envelope, and voicing duration cues to speechreading in normal-hearing subjects. AB - The ability to combine speechreading (i.e., lipreading) with prosodic information extracted from the low-frequency regions of speech was evaluated with three normally hearing subjects. The subjects were tested in a connected discourse tracking procedure which measures the rate at which spoken text can be repeated back without any errors. Receptive conditions included speechreading alone (SA), speechreading plus amplitude envelope cues (AM), speechreading plus fundamental frequency cues (FM), and speechreading plus intensity-modulated fundamental frequency cues (AM + FM). In a second experiment, one subject was further tested in a speechreading plus voicing duration cue condition (DUR). Speechreading performance was best in the AM + FM condition (83.6 words per minute,) and worst in the SA condition (41.1 words per minute). Tracking levels in the AM, FM, and DUR conditions were 73.7, 73.6, and 65.4 words per minute, respectively. The average tracking rate obtained when subjects were allowed to listen to the talker's normal (unfiltered) speech (NS condition) was 108.3 words per minute. These results demonstrate that speechreaders can use information related to the rhythm, stress, and intonation patterns of speech to improve their speechreading performance. PMID- 3973239 TI - Intermodal timing relations and audio-visual speech recognition by normal-hearing adults. AB - Audio-visual identification of sentences was measured as a function of audio delay in untrained observers with normal hearing; the soundtrack was replaced by rectangular pulses originally synchronized to the closing of the talker's vocal folds and then subjected to delay. When the soundtrack was delayed by 160 ms, identification scores were no better than when no acoustical information at all was provided. Delays of up to 80 ms had little effect on group-mean performance, but a separate analysis of a subgroup of better lipreaders showed a significant trend of reduced scores with increased delay in the range from 0-80 ms. A second experiment tested the interpretation that, although the main disruptive effect of the delay occurred on a syllabic time scale, better lipreaders might be attempting to use intermodal timing cues at a phonemic level. Normal-hearing observers determined whether a 120-Hz complex tone started before or after the opening of a pair of liplike Lissajou figures. Group-mean difference limens (70.7% correct DLs) were - 79 ms (sound leading) and + 138 ms (sound lagging), with no significant correlation between DLs and sentence lipreading scores. It was concluded that most observers, whether good lipreaders or not, possess insufficient sensitivity to intermodal timing cues in audio-visual speech for them to be used analogously to voice onset time in auditory speech perception. The results of both experiments imply that delays of up to about 40 ms introduced by signal-processing algorithms in aids to lipreading should not materially affect audio-visual speech understanding. PMID- 3973240 TI - An approach to normalization of coarticulation effects for vowels in connected speech. AB - A method is proposed to reduce the ambiguity of vowels in connected speech by normalizing the coarticulation effects. The method is applied to vowels in phonetic environments where great ambiguity would be likely to occur, taking as their features the first and second formant trajectories. The separability between vowel clusters is found to be greatly improved for the vowel samples. In addition, distribution of the vowels on a feature plane characterized by this method seems to reflect their perceptual nature when presented to listeners without isolation from their phonetic environments. The results suggest that the method proposed here is useful for automatic speech recognition and help infer some possible mechanisms underlying dynamic aspects of human speech recognition. PMID- 3973241 TI - Effects of heat conduction and sample size on ultrasonic absorption measurements. AB - The absorption coefficient of a material can be determined by measuring the heating which occurs as a result of ultrasonic irradiation. When narrow focused beams are used to heat a sample, or when the available volume of a material is restricted to small dimensions, then the effect of heat conduction to surrounding unheated regions becomes significant, complicating the relation between measured temperatures and acoustic parameters. In this paper new analytical expressions, which account for radial and axial heat flow in a medium, are derived for the case of Gaussian-shaped ultrasonic beam patterns in thin or semi-infinite absorbing materials. Solutions are given for temperature histories resulting from an ultrasonic impulse (pulse decay method) or a step input (rate of heating method). The use of these equations in absorption measurements is discussed, and experimental results are given. These expressions provide flexibility in choice of laboratory ultrasonic parameters, and the results are especially useful for many biomedical measurements where the volume of tissue available is restricted. PMID- 3973242 TI - Demonstration of adaptation in beluga whale echolocation signals. AB - The echolocation signals of the same beluga whale (Delphinapterus leucas) were measured first in San Diego Bay, and later in Kaneohe Bay, Oahu, Hawaii. The ambient noise level in Kaneohe Bay is typically 12-17 dB greater than in San Diego Bay. The whale demonstrated the adaptiveness of its biosonar by shifting to higher frequencies and intensities after it was moved to Kaneohe. In San Diego, the animal emitted echolocation signals with peak frequencies between 40 and 60 kHz, and bandwidths between 15 and 25 kHz. In Kaneohe, the whale shifted its signals approximately an octave higher in frequencies with peak frequencies between 100 and 120 kHz, and bandwidths between 20 and 40 kHz. Signal intensities measured in Kaneohe were up to 18 dB higher than in San Diego. The data collected represent the first quantitative evidence of the adaptive capability of a cetacean biosonar system. PMID- 3973243 TI - Lateral-position-based models of interaural discrimination. AB - This letter investigates the hypothesis that lateral position is the only cue available for interaural discrimination experiments using 500-Hz stimuli. The discussion of this hypothesis is in the context of comparisons of the experimental data to predictions of the "position-variable" model of binaural interaction. The model predicts the mean and variance of the subjective lateral position of stimuli used in the discrimination experiments, assuming that discrimination performance is based on optimal processing of this subjective position. To the extent that the laterality predictions of the model are accurate, data that are inconsistent with its predictions would also be problematical for any model based on the subjective laterality of a single binaural image. The predictions (at least qualitatively) describe much of the observed experimental data, including a number of results that have not been addressed by any previous theory. Nevertheless, the observed performance is significantly better than the corresponding predictions for three types of experiments in which the utility of the position cue has been eliminated by experimental design. We believe that our results indicate that changes in lateral position are the primary cue in most interaural discrimination experiments, but that secondary attributes of the perceptual images can be useful when performance based on position alone would be poor. PMID- 3973244 TI - Use of resonating cavity to measure body volume. AB - A technique to estimate the body volume of newborns has been developed using the principle of the Helmholtz resonator. The change in the resonance frequency of a small cavity after an infant is placed inside can be used to determine the body volume of the infant. A prototype system, termed an acoustic plethysmograph, was built and used to measure the volume of newborn miniature pigs. Results of the animal body volume measurements compare favorably (within an average of 1.1%) with body volumes measured by hydrostatic weighing. PMID- 3973245 TI - Indiscriminate mothering as a contextual factor in aggressive-oppositional child behavior: "damned if you do and damned if you don't". AB - Fifty-two mother-child dyads took part in a parent training program to modify coercive, antisocial child behavior. Prior to intervention, scores on 14 measures of mother-child interaction and on an index of maternal community contacts (known as "insularity") were obtained for each dyad. This index was used to divide the sample into two groups (noninsular n = 21; insular n = 31). The interactional measures were then compared between the groups. Insular mothers were more aversive and indiscriminate than noninsular mothers in their use of aversive behavior toward their children, while their children were more aversive than noninsular children, especially in response to aversive maternal behavior. It was concluded that research and therapeutic work with deviant families should focus not only on immediate family interactions but also on the extrafamily environment in which these interactions take place. PMID- 3973246 TI - A comparison of the effects of child management and planned activities training in five parenting environments. AB - This study compared the effects of two procedures designed to enhance the extratraining effects of behavioral parent training. Twenty parents of oppositional children were randomly assigned to either a child management training condition or a combined child management plus planned activities condition. A further 10 nonproblem children and their parents served as a social validation group. Observations of both parent and child behavior were conducted in each of five home observation settings (breakfast time, kindy (kindergarten) or school exit, a structured playtime, bathtime, and bedtime). Both training procedures resulted in changes in both child oppositional and parent aversive behavior in all observation settings. In addition, desired positive parenting behaviors also improved in all settings. Treatment effects were maintained in all settings at 3-month follow-up. Comparisons between oppositional children following treatment and children in the social validation group showed that they each displayed similarly low levels of oppositional behavior in all settings. The implications of the results for facilitating generalized changes in behavioral parent training are discussed. PMID- 3973247 TI - A multitrait-multimethod analysis of the Preschool Behavior Questionnaire. AB - The Preschool Behavior Questionnaire is a teacher rating instrument yielding a total score reflecting overall level of adjustment and three subscale scores labeled Hostile/Aggressive, Anxious/Fearful, and Hyperactive/Distractible. This study assessed the convergent and discriminant validity of this teacher rating measure against two alternative measures within a multitrait-multimethod analysis. The results supported the construct validity of the Hostile/Aggressive and Anxious/Fearful scores as well as the overall score. There was, however, no support for the validity of the Hyperactive/Distractible score. PMID- 3973248 TI - Qualitative influence on the perception of movement: an experimental study. AB - One of the most puzzling features of "hyperactivity" in children is the importance of activity itself. Generalized overactivity has not been found to be a valid diagnostic marker. Could some qualitative features of activity be important determinants of the perceived quantity of activity? The analogue study reported here derives from a social-psychological hypothesis that anything that makes a behavior more noticeable or distracting can create an illusion of increased movement. Subjects performed a simple cognitive task while watching short films of adult actors. Two variables were manipulated: (a) The sound level was either loud or quiet, and (b) instructions to subjects were varied so that the behaviors shown were perceived as either appropriate or inappropriate. Results strongly supported the hypothesis. Loudness and contextual inappropriateness made the films more distracting, produced higher ratings of the amount of movement observed, and led to more negative evaluations of the behaviors seen. Implications for assessment and intervention are discussed. PMID- 3973249 TI - A comparison of objective classroom measures and teacher ratings of Attention Deficit Disorder. AB - Children identified as Attention Deficit Disorder (ADD) on the basis of teacher ratings using the SNAP Rating Scale were compared to non-ADD children on objective classroom measures including observations of classroom behavior, examination of the organization of children's desks, and scoring of daily academic work. Analyses provided some support for the ability of the objective measures to differentiate between teacher-identified ADD and non-ADD children, though there was considerable overlap on the distributions of most variables between groups. Six measures chosen by a discriminant analysis combined to predict teacher ratings in 83% of the cases. The inclusion of academic, observational, and desk measures in the discriminant function indicates the importance of a multivariate assessment of this construct. PMID- 3973250 TI - Attentional deficits of learning-disabled children: effects of rewards and practice. AB - This study investigated the effects of rewards and practice on the attentional task performance of learning-disabled (LD) and normally achieving children. Contingent feedback and rewards resulted in faster but less accurate performance by the LD children. Despite the speed-accuracy trade-off, the LD children still responded more slowly than the controls. However, limited practice on the tasks resulted in significantly improved performance, such that the groups performed similarly. Poorer performance of LD children on their first encounter with laboratory measures of attention may be due to inefficient strategies rather than to actual deficits in ability to attend. PMID- 3973252 TI - Acceptability of reductive interventions for the control of inappropriate child behavior. AB - Teacher attitudes about the acceptability of classroom intervention strategies were evaluated in two experiments. In both, teachers read descriptions of an intervention that was applied to a child with a behavior problem. In Experiment 1, an evaluation of six interventions for reducing inappropriate behavior suggested that one was highly acceptable (DRO), one was highly unacceptable (corporal punishment), and four ranged from mildly acceptable to mildly unacceptable (DRL, reprimands, time-out, and staying after school). In Experiment 2, the acceptability of the same intervention (staying after school) was evaluated as a function of who implemented it (teacher vs. principal). Analyses suggested that the teacher-implemented intervention was perceived as more acceptable. In both experiments, interventions were rated as less acceptable by highly experienced teachers versus those newer to the teaching profession. In addition, there was a trend for the acceptability of an intervention to vary as a function of the severity of the behavior problem to which it was applied. PMID- 3973251 TI - The normalizing effects of methylphenidate on the classroom behavior of ADDH children. AB - This study examined whether methylphenidate normalizes the behavior of hyperactive children (ADDH). Twenty-eight ADDH children were treated for 8 weeks with a mean dose of 41.5 mg/d of methylphenidate. Their classroom behavior and that of normal children was recorded by observers who were blind to diagnosis and treatment. Before treatment, all measures significantly differentiated the ADDH and normal children. After treatment, the two groups were indistinguishable on measures of gross and minor motor movement, noncompliance, interference, and overall hyperactivity. ADDH children were significantly improved on measures of attention but continued to be significantly less attentive. In many ways, the ADDH children were not only improved but indistinguishable from their normal peers. PMID- 3973253 TI - Methylphenidate and cognitive therapy: a comparison of treatment approaches with hyperactive boys. AB - This study of hyperactive boys evaluated the effects of three modes of treatment in relation to an untreated group. The treatments were administered over a 3 month period and included cognitive training, stimulant drug therapy (methylphenidate), and the two treatments combined. A follow-up assessment was conducted approximately 3 months after contact between the training staff and the child had ceased. Analyses of attentional deployment and cognitive style measures, tests of academic achievement, and behavioral ratings showed that only those children in the two medication treatment conditions demonstrated improvement in attentional deployment and behavioral ratings. In the cognitive therapy condition, there were changes only on measures of attentional deployment. The data did not provide evidence indicating that the combined medication and cognitive therapy condition was any more effective than that condition involving medication alone. Discussion provides future guidelines for evaluation of the relative effectiveness of stimulant drug therapy and other psychological treatment modalities. PMID- 3973254 TI - Peer relationships in ADDH and normal children: a developmental analysis of peer and teacher ratings. AB - Peer and teacher perceptions of younger and older ADDH and normal children were compared. Peer nominations on the Pupil Evaluation Inventory revealed that ADDH children received more nominations on the Aggression factor and fewer on the Likability factor. ADDH boys received more nominations on the Withdrawal factor. Generally, older children received fewer nominations, but age did not interact with diagnosis; that is, younger and older ADDH children were perceived by peers as equally deviant. Discriminant analyses showed that peer ratings were useful in discriminating between ADDH and normal boys, but not between ADDH and normal girls. Teacher ratings of peer behavior suggested that older ADDH girls were perceived as less disturbed than younger girls. However, teacher ratings of boys revealed no age by diagnosis interactions. Low to moderate correlations were found between peer and teacher ratings of ADDH boys, and the pattern of relationship varied with age. PMID- 3973255 TI - Scintigraphic evidence of the "no reflow" phenomenon in human beings after coronary thrombolysis. AB - To assess whether the absence of new thallium-201 uptake after successful intracoronary thrombolysis reflects a disturbance of myocardial cell function or lack of capillary reperfusion, dual isotope scintigraphic studies with thallium 201 and technetium-99m micro-albumin aggregates were performed in 16 patients with acute anterior myocardial infarction. Intracoronary thallium-201 and technetium-99m scintigraphy performed before intracoronary thrombolysis in 12 of the 16 patients resulted in identical thallium-201 and technetium-99m defect sizes. Immediately after intracoronary thrombolysis, thallium-201 and technetium 99m scintigraphy was repeated in 11 of the 12 patients. In 4 of the 11, the initial thallium and technetium scintigraphic defects were significantly reduced, and in 6 of the 11, they were only slightly reduced; there was no difference in the size of the residual defect as assessed with both radionuclides in all 10 of the 11 patients. In the eleventh patient, there was a significant reduction of the initial technetium-99m scintigraphic defect but no change in the size of the thallium-201 defect. In four other patients, scintigrams were obtained only after intracoronary thrombolysis; these revealed no difference in thallium-201 and technetium-99m defect size. In seven of eight patients restudied 2 to 4 weeks after intracoronary thrombolysis, thallium-201 and technetium-99m defect sizes were identical with those immediately after intracoronary thrombolysis; in the eighth patient there was no difference in thallium-201 and technetium-99m defect size, although such a difference had been present immediately after intracoronary thrombolysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973256 TI - Changes in diastolic properties of the regional myocardium during pacing-induced ischemia in human subjects. AB - Mechanisms related to alterations in the diastolic properties of the left ventricle during angina were studied in seven patients with coronary artery disease. Single plane left ventriculograms were obtained using a high fidelity micromanometer-tipped catheter in both the resting state and immediately after rapid cardiac pacing. In all patients, typical anginal pain developed with pacing stress. After atrial pacing, the left ventricular end-diastolic pressure increased from 10 +/- 3 to 21 +/- 7 mm Hg (+/- standard deviation) (p less than 0.005) regardless of the changes in the end-diastolic volume. The ejection fraction was reduced from 59 +/- 10 to 48 +/- 13% (p less than 0.05). The diastolic pressure-volume curves shifted upward in post-pacing beats in four patients, while in three the curves shifted more to the right. The regional myocardial function was expressed in quantitative terms by a radial coordinate system with the origin at the center of gravity of the end-diastolic silhouette. Two representative radial grids for normal and ischemic segments were selected. In the normal segment, the end-diastolic length was augmented by 15% (p less than 0.005) and was associated with a 24% increase in stroke excursion with pacing stress (p less than 0.05). The increase in diastolic pressure was accompanied by comparable increases in end-diastolic length, and the diastolic pressure-length relation moved up to the higher portion of the single curve. In the ischemic segment, the end-diastolic length remained unchanged in the post-pacing beat, but segment shortening was significantly reduced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973257 TI - Angiographic morphology and the pathogenesis of unstable angina pectoris. AB - In 110 patients with either stable or unstable angina, the morphology of coronary artery lesions was qualitatively assessed at angiography. Each obstruction reducing the luminal diameter of the vessel by 50% or greater was categorized into one of the following morphologic groups: concentric (symmetric narrowing); type I eccentric (asymmetric narrowing with smooth borders and a broad neck); type II eccentric (asymmetric with a narrow neck or irregular borders, or both); and multiple irregular coronary narrowings in series. For the entire group, type II eccentric lesions were significantly more frequent in the 63 patients with unstable angina (p less than 0.001), whereas concentric and type I eccentric lesions were seen more frequently in the 47 patients with stable angina (p less than 0.05). Type II eccentric lesions were also present in 29 of 41 arteries in patients with unstable angina compared with 4 of 25 arteries in those with stable angina (p less than 0.0001) in whom an "angina-producing" artery could be identified. Therefore, type II eccentric lesions are frequent in patients with unstable angina and probably represent ruptured atherosclerotic plaques or partially occlusive thrombi, or both. A temporary decrease in coronary perfusion secondary to these plaques with or without superimposed transient platelet thrombi or altered vasomotor tone may be responsible for chest pain in some of these patients with unstable angina. PMID- 3973258 TI - Left ventricular function after myocardial infarction: clinical and angiographic correlations. AB - There is a paucity of information correlating the angiographic findings immediately after myocardial infarction with the clinical status before infarction. Therefore, the coronary anatomy, collateral circulation and quantitative left ventricular function were studied in 39 patients who underwent angiography within 3 weeks of a first transmural myocardial infarction. In all patients, the vessel supplying the infarct was totally occluded at the time of angiography. Patients without angina before infarction (Group I) had fewer coronary obstructions than did patients with a long history of angina before infarction (Group II) (1.5 +/- 0.5 versus 2.5 +/- 0.5, respectively, p less than 0.001) but worse overall and regional left ventricular function. These paradoxical differences between Groups I and II were evident in patients with anterior as well as inferior infarction. Patients in Group I had significantly lower collateral scores than did patients in Group II (0.6 +/- 0.8 versus 1.9 +/- 0.9, respectively, p less than 0.0001) and 13 of 22 patients in Group I had no collateral vessels compared with only 1 of 17 in Group II (p less than 0.001). Partial preservation of anterior wall function in Group II patients with anterior infarction was related both to the presence of collateral vessels and to the more distal obstruction of the left anterior descending coronary artery in these patients as compared with patients with anterior infarction in Group I. In contrast, in patients with inferior wall infarction, no relation could be found between the presence of collateral vessels and regional left ventricular function, although only two patients in this series with inferior infarction did not have collateral vessels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973259 TI - Spatial variation of QT intervals in normal persons and patients with acute myocardial infarction. AB - The QT interval is a clinically important electrocardiographic measurement. This study attempted to determine 1) whether this interval was spatially distributed in a physiologically meaningful way on the torso of normal subjects, and 2) if these spatial patterns were altered in patients with acute myocardial infarction. To do so, 30 patients were studied within 72 hours of the onset of acute myocardial infarction (15 with an anterior and 15 with a posterior lesion) along with 50 normal control subjects. Electrocardiographic signals were registered from 150 torso electrodes; the QT interval in each lead was determined by a combined automated-manual method, and the durations displayed as "isointerval maps." In the normal subjects, the difference between the longest and shortest interval in each case was 59.4 +/- 12.9 ms. Long QT intervals were spatially located over the left lateral torso and short QT intervals were found over the right inferior chest. Acute infarction modified this distribution in relation to lesion location; the longest QT intervals were centrally positioned in anterior infarction and caudally located in inferior infarction. Thus, QT intervals in normal and abnormal states have distinctive spatial distributions that are consistent with known regional myocardial electrophysiology. PMID- 3973260 TI - Fascicular conduction disturbances and ischemic heart disease: adverse prognosis despite coronary revascularization. AB - In patients with ischemic heart disease, fascicular conduction disturbances are associated with increased mortality. This study reveals that increased mortality also exists for certain types of fascicular conduction disturbances after myocardial revascularization. In 227 consecutive patients undergoing bypass surgery, 24 had preoperative and an additional 52 developed at surgery a fascicular conduction disturbance. At 66 +/- 14 months of follow-up, 6 (4%) of 148 control patients without pre- or postoperative fascicular conduction disturbances had died from cardiac causes. Although right bundle branch block and left hemifascicular block were the most common form of fascicular conduction disturbance, only 1 of 55 of these patients died (p = NS). Mortality rates were much higher for patients with left bundle branch block or an intraventricular conduction defect; 8 (38%) of 21 died from cardiac causes (p less than 0.05). A high risk subgroup was identified by comparing 14 consecutive patients with left bundle branch block or an intraventricular conduction defect who survived more than 1 year postoperatively with 21 consecutive patients with these same conduction defects who died within 1 year of surgery. The following variables were significantly (p less than 0.05) different (survivors versus nonsurvivors): age (58 +/- 7 versus 65 +/- 9 years); class IV angina (2 of 14 versus 16 of 21), prior myocardial infarction (9 of 14 versus 21 of 21), left ventricular ejection fraction (53 +/- 18 versus 41 +/- 15%), three vessel disease (9 of 14 versus 20 of 21) and left ventricular aneurysm (2 of 14 versus 13 of 21).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973261 TI - Coexistent posteroseptal and right-sided atrioventricular bypass tracts. AB - Twelve patients with a posteroseptal accessory pathway underwent complete electrophysiologic studies, and four were found to have a second atrioventricular (AV) bypass tract that was right anterior, right anteromedial or right anterolateral in location. In two of these four patients, the presence of the right-sided AV bypass tract was confirmed by intraoperative epicardial mapping or after catheter-induced abolition of retrograde conduction through the posteroseptal bypass tract. In three of the four patients with a dual AV bypass tract, the delta wave pattern was clearly atypical of the pattern seen with an isolated posteroseptal accessory pathway. Instead of a transition from an isoelectric or slightly positive delta wave in lead V1 to markedly positive delta waves in leads V2 to V6, the delta waves were negative or only slightly positive in leads V2 to V5. However, in a fourth patient with dual AV bypass tracts, the only atypical electrocardiographic finding was an intermittently positive delta wave in lead II; at times this patient's electrocardiogram was consistent with an isolated posteroseptal bypass tract, with negative delta waves in the inferior leads. There appears to be an association between posteroseptal and right-sided accessory pathways. In patients with a posteroseptal accessory pathway who are candidates for catheter or surgical bypass tract ablation, a complete mapping study of the tricuspid anulus is mandatory, even when the electrocardiogram is typical of an isolated posteroseptal bypass tract. PMID- 3973262 TI - Detection of endocarditis-associated perivalvular abscesses by two-dimensional echocardiography. AB - The development of a perivalvular abscess as a complication of infective endocarditis adds appreciably to the expected morbidity and mortality of patients, but such abscesses are seldom recognized by available noninvasive techniques. Therefore, two-dimensional echocardiographic findings in 22 patients with perivalvular abscess found at surgery or necropsy were compared with those in 24 patients without abscess in a retrospective but blinded study. Forty-six valves were examined (31 aortic and 15 mitral, 35 prosthetic and 11 native); 4.0 +/- 2.4 days (range 0 to 7) elapsed between echocardiography and surgery or necropsy. Patients with perivalvular abscess had a somewhat higher incidence of serious complications (emergency repeat valve replacement or death) than did patients with endocarditis alone (63 versus 35%, respectively, p less than 0.05). No single echocardiographic finding was frequently seen with a perivalvular abscess. A "typical" echo-free abscess was noted in only one patient; however, the presence of one or more of the following had a positive predictive value of 86% and a negative predictive value of 87% for the presence of perivalvular abscess: prosthetic valve rocking; sinus of Valsalva aneurysm, anterior aortic root thickness of 10 mm or greater, posterior aortic root thickness of 10 mm or greater or perivalvular density in a septum of 14 mm or greater. These predictive values, of course, apply only to patients with infective endocarditis going to surgery, and may assist the surgeon in knowing whether or not to expect an abscess.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973263 TI - Synchronized coronary venous retroperfusion: prompt improvement of left ventricular function in experimental myocardial ischemia. AB - The effect of synchronized coronary venous retroperfusion of arterial blood on cardiac function after experimental coronary occlusion was examined by two dimensional echocardiography. In 18 closed chest anesthetized dogs, the proximal left anterior descending coronary artery was occluded for 6 hours with an intracoronary balloon catheter. Eight of these animals served as untreated controls. Ten were treated with synchronized retroperfusion initiated 30 minutes after occlusion, and treatment was interrupted for 5 minutes at 1 hour after occlusion for study of the rapidity of retroperfusion response. Quantitative echographic analysis yielded global ejection fraction and regional indexes of contraction in a low left ventricular short-axis section, including segmental systolic area change, systolic wall thickening and end-diastolic wall thickness. At 6 hours after occlusion, ejection fraction had decreased from 50.7 +/- 4.9% to 28.1 +/- 7.7% (mean +/- standard deviation) in control dogs, but was significantly (p less than 0.01) less depressed in treated dogs (from 55.9 +/- 5.2 to 41.8 +/- 9.3%). The ischemic zone fractional area change at 30 minutes of occlusion exhibited a marked depression in both groups, after which the dysfunction persisted in the control dogs, but was largely reversed with retroperfusion from 6.0 +/- 6.5 to 35.9 +/- 15.9% at 6 hours of occlusion (p less than 0.01). Brief interruption of retroperfusion 1 hour after occlusion reduced ischemic zone fractional area change from 33.0 +/- 14.9 to 12.2 +/- 9.5% (p less than 0.01). This depression was promptly reversed to 33.6 +/- 12.2% when retroperfusion was resumed. Segmental wall thickening followed a similar trend.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973264 TI - Relation of coronary blood flow and reactive hyperemia to regional dysfunction induced by dopamine infusion in dogs: limitations in detecting subcritical coronary stenoses. AB - Sympathomimetic agents have been used clinically to elicit regional dysfunction or heterogeneity of coronary blood flow to detect coronary artery lesions. However, the usefulness of this procedure in detecting mild to moderate coronary stenoses has not been defined previously. This was investigated in 10 open chest anesthetized dogs using subendocardial ultrasonic crystals to measure segment lengths. An electromagnetic flow probe was placed on the proximal left anterior descending artery, and graded coronary stenoses were created using a cuff occluder. In the first phase of the study, subcritical coronary stenoses were created which impaired maximal postocclusion reactive hyperemia, but not coronary blood flow at rest. A constant infusion of dopamine (average 15 micrograms/kg per min) was then administered. Regional dysfunction during dopamine infusion was not consistently observed despite production of coronary stenoses resulting in total loss of reactive hyperemia at rest. Regional function during dopamine treatment was, however, critically related to the actual changes in coronary blood flow during the infusion. In the second phase of the study, regional function during dopamine challenge was investigated during progressive impairments of coronary blood flow. Regional function was maintained until coronary blood flow during the infusion was reduced to near rest levels below which regional function deteriorated rapidly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973265 TI - Enhancement of triggered activity in ischemic Purkinje fibers by ouabain: a mechanism of increased susceptibility to digitalis toxicity in myocardial infarction. AB - Enhanced susceptibility to toxic arrhythmias by digitalis administration has been reported in clinical and experimental myocardial infarction. To investigate the mechanism responsible for this phenomenon, the effects of superfusion with normal Tyrode's solution and superfusion with Tyrode's solution containing 4 X 10(-8)M of ouabain in ischemic Purkinje fibers were compared. Ischemic Purkinje fibers of small endocardial preparations from 1 day old myocardial infarcts in 18 dogs were used for the study. During control conditions, these endocardial preparations demonstrated delayed afterdepolarizations and triggered activity. Superfusion with normal Tyrode's solution resulted in a gradual increase in maximal diastolic potential and action potential amplitude, a decrease in delayed afterdepolarizations amplitude and slowing and termination of triggered activity. Superfusion for 90 minutes with Tyrode's solution containing ouabain resulted in: 1) an increase in the magnitude of delayed afterdepolarizations in preparations demonstrating subthreshold delayed afterdepolarizations, 2) sustainment of triggered activity in preparations showing nonsustained triggered activity, and 3) shortening of cycle lengths of the triggered activity in preparations demonstrating sustained triggered activity before superfusion with ouabain. These effects occurred despite the gradual increase in maximal diastolic potential and action potential amplitude. Superfusion of normal Purkinje fibers with Tyrode's solution containing 4 X 10(-8)M of ouabain for 90 minutes did not result in delayed afterdepolarizations or triggered activity. Thus, ouabain at a concentration that has no toxic effect on normal Purkinje fibers may enhance arrhythmias in ischemic Purkinje fibers by increasing the magnitude of delayed afterdepolarizations and enhancing triggered activity. PMID- 3973266 TI - Tissue digoxin concentrations and digoxin effect during the quinidine-digoxin interaction. AB - Quinidine elevates serum digoxin concentration in part by reducing the volume of distribution of digoxin, which implies that quinidine displaces digoxin from tissues. The purposes of this study were to: 1) measure the effect of quinidine on tissue digoxin concentrations, and 2) determine if quinidine alters the relation between myocardial digoxin concentration and digoxin effect on myocardial monovalent cation transport. Eighteen dogs were treated with tritiated digoxin until the steady-state serum digoxin concentration was between 1.0 and 1.5 ng/ml. All dogs continued receiving the same dose of digoxin while nine dogs were given quinidine as well. Quinidine was continued until the serum digoxin concentration had increased by at least 25%. At the end of treatment, the serum digoxin concentration in dogs treated with digoxin was 1.2 +/- 0.1 ng/ml compared with 2.1 +/- 0.5 ng/ml in dogs treated with digoxin and quinidine in combination (p less than 0.001). Digoxin concentration in myocardium, skeletal muscle, liver, kidney, stellate ganglion, vagus nerve, femoral nerve, brain and brainstem medulla was higher in dogs treated with a combination of digoxin and quinidine than in dogs treated with digoxin alone, but remained proportional to the serum digoxin concentration in all tissues except the brainstem medulla. Myocardial monovalent cation transport was measured using rubidium-86. The effect of digoxin on myocardial monovalent cation transport did not increase as the serum and myocardial digoxin concentrations increased after quinidine administration. PMID- 3973267 TI - Clinical use of ultrashort-lived radionuclide krypton-81m for noninvasive analysis of right ventricular performance in normal subjects and patients with right ventricular dysfunction. AB - The ultrashort-lived radionuclide krypton-81m, eluted in 5% dextrose from a bedside rubidium-81m generator, was intravenously infused for rapid imaging of the right-sided heart chambers in the right anterior oblique projection adjusted for optimal right atrioventricular separation. Left-sided heart and lung background was minimized by rapid decay and efficient exhalation of krypton-81m, requiring no algorithm for background correction. A double region of interest method decreased the variability in the assessment of ejection fraction to 5%. In 10 normal subjects, 11 patients with pulmonary hypertension, 4 patients with right ventricular outflow tract obstruction and 4 patients with right ventricular infarction, right ventricular ejection fraction determined by krypton-81m equilibrium blood pool imaging ranged from 14 to 76%. The correlation between these values and those determined by cineangiography according to Simpson's rule was close: r = 0.93 for all data points (p less than 0.001), r = 0.92 for studies at rest (p less than 0.001) and r = 0.93 for exercise studies (p less than 0.001). Exercise-related changes in right ventricular function revealed a disturbed functional reserve with pulmonary hypertension and right ventricular infarction, whereas in compensated right ventricular outflow tract obstruction there was a physiologic increase in ejection fraction with exercise (p less than 0.001). Thus, equilibrium-gated right ventricular imaging using ultrashort-lived krypton-81m is a simple, accurate and reproducible method with potential for serial assessment of right ventricular ejection fraction in a variety of right ventricular anatomic and functional abnormalities, both at rest and during exercise. Advantages of this method include an extremely low radiation dose to patients and clear right atrioventricular separation without the need to correct for background activity. PMID- 3973268 TI - Errors in the visual determination of corrected QT (QTc) interval during acute myocardial infarction. AB - To estimate variations in intra- and interindividual measurements of the corrected QT (QTc) interval, duplicates of 50 twelve lead electrocardiograms (100 photocopies, paper speed 50 mm/s) were given to each of nine investigators in random order. The electrocardiograms were recorded from patients with acute myocardial infarction consecutively admitted to a coronary care unit. Patients receiving drug therapy and those manifesting various arrhythmias were included. Two-way analysis of variance was used to evaluate the results from all 900 QTc measurements. Significant differences in these measurements were registered among investigators and were of major importance (p less than 0.001). This finding illustrates the difficulty in comparing mean values from different studies and emphasizes the difficulties in applying limits for a normal QTc interval to data obtained by different observers. Of less but still significant importance was the interaction between the investigator and electrocardiogram (p less than 0.001). Finally, the random error was calculated and proven to be of no importance (less than 0.5 mm) when more than 11 measurements were performed. PMID- 3973269 TI - Cardiac lesions in acquired immune deficiency syndrome (AIDS). AB - Autopsy findings in 41 patients with acquired immune deficiency syndrome (AIDS) were reviewed. Major pathologic findings in the heart were demonstrated in 10 cases, and metastatic Kaposi's sarcoma in either the epicardium or myocardium was revealed in 4 cases, including 1 with additional fibrinous pericarditis. Nonbacterial thrombotic endocarditis with embolization to major organs was found in three cases, isolated fibrinous pericarditis of unknown origin was found in two and Cryptococcus neoformans myocarditis was found in one case. The primary cause of death in eight cases was pulmonary or systemic infection. Two patients died of thromboembolic disease. These findings suggest that cardiac lesions in AIDS relate to both morbidity and mortality. PMID- 3973270 TI - Intraaortic balloon counterpulsation as a temporary support measure in decompensated critical aortic stenosis. AB - Intraaortic balloon counterpulsation was instituted in two adult patients whose condition was rapidly deteriorating because of critical decompensated valvular aortic stenosis. The acute hemodynamic effect of counterpulsation in these patients was compared with the effect of counterpulsation in three control patients with unstable angina and no aortic valve disease. Augmentation of aortic diastolic pressure was similar in both groups; however, in contrast to the patients with unstable angina, the patients with aortic stenosis had no decrease in left ventricular systolic pressure. Counterpulsation resulted in an increase in the transvalvular pressure gradient, which was associated with a slight increase in stroke volume. In both patients with aortic stenosis, the institution of counterpulsation resulted in marked clinical improvement, which facilitated successful valve replacement surgery. The benefit from counterpulsation in critically decompensated aortic stenosis appears to be derived almost entirely from augmentation of the diastolic coronary filling gradient. The improvement that results from counterpulsation suggests that ischemia is the major cause of decompensation. PMID- 3973271 TI - Left ventricular function before and after diltiazem in patients with coronary artery disease. AB - Left ventricular contraction, relaxation and diastolic mechanics were investigated before and after intravenous administration of 15 mg of diltiazem in 15 patients with coronary artery disease. High fidelity left ventricular pressure measurements were performed in all 15 patients, with simultaneous biplane cineangiography in 13. The time constant of left ventricular isovolumic pressure decay was calculated from the linear relation of left ventricular pressure and its rate of change with time (negative dP/dt). Frame by frame volume analysis through one cardiac cycle was completed to construct volume-time and pressure volume curves before and after the administration of diltiazem. After diltiazem, left ventricular peak systolic pressure decreased from 124 to 113 mm Hg (p less than 0.001), while left ventricular end-diastolic pressure and heart rate were not altered. Maximal positive dP/dt also remained unchanged. End-diastolic volume was not changed after diltiazem, but end-systolic volume increased from 48 to 52 ml/m2 (p less than 0.025); as a result, ejection fraction decreased slightly from 57 to 55% (p less than 0.025). The time constant of left ventricular pressure decay and maximal negative dP/dt decreased from 58 to 54 ms (p less than 0.025) and from -1,404 to -1,321 mm Hg/s (p less than 0.025), respectively. Peak early diastolic filling rate increased from 621 to 752 ml/s (p less than 0.01) in association with an increase in filling volume during the first half of diastole from 60 to 68% (p less than 0.005). No consistent displacement of the diastolic pressure-volume curve was observed after diltiazem.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973272 TI - Inotropic, vascular and neuroendocrine effects of nifedipine in heart failure: comparison with nitroprusside. AB - To evaluate the short-term hemodynamic and neuroendocrine effects of nifedipine in heart failure, it was compared with nitroprusside, a balanced vasodilator without known inotropic effect, in equihypotensive doses during right and left heart catheterization in nine patients with heart failure. Mean arterial pressure decreased from 89 +/- 12 to 76 +/- 14 mm Hg with nitroprusside, and from 90 +/- 12 to 75 +/- 13 mm Hg with sublingual nifedipine. Right atrial, pulmonary artery, pulmonary capillary wedge and left ventricular end-diastolic pressures decreased significantly with nitroprusside, but not with nifedipine. Cardiac index and stroke volume index increased to a similar extent with both drugs; in contrast, stroke work index increased significantly with nitroprusside, but not with nifedipine. Peak rate of left ventricular pressure development (dP/dt) (measured with a micromanometer-tipped catheter in seven patients) was unchanged with nitroprusside, but decreased significantly with nifedipine (747 +/- 292 to 639 +/ 238 mm Hg/s; p less than 0.002). There was no change in heart rate with either medication. Plasma norepinephrine and epinephrine concentrations were not altered significantly by either drug. Plasma renin activity was not changed by nitroprusside infusion, but was increased after the administration of nifedipine. Thus, in contrast to the balanced vasodilator action of nitroprusside, the effect of nifedipine is predominantly on the arterial circulation. In these patients with heart failure, reflex sympathetic stimulation did not occur in response to a decrease in systemic arterial pressure by either vasodilator. A negative inotropic effect occurred after the administration of nifedipine, but not nitroprusside. PMID- 3973273 TI - The utility of aprindine blood levels in the management of ventricular arrhythmias. AB - Sixty-four patients with a history of ventricular tachycardia and ventricular fibrillation refractory to conventional therapy received aprindine to abolish recurrent episodes of symptomatic ventricular tachycardia. Fifty-six patients became asymptomatic and were followed up for a mean period of 23 months. Aprindine dose was adjusted to minimize adverse reactions but still control arrhythmia. Survival analysis was performed for the group with aprindine levels greater than 1.5 micrograms/ml and the group with levels of 1.5 micrograms/ml or less. At the end of the study, 65% of the patients with a high level were alive and asymptomatic as compared with only 35% of the patients with a low level (p less than 0.036). In patients at risk of recurrent sudden cardiac death, high aprindine levels maintained after abolition of symptomatic ventricular tachycardia were associated with improved survival. PMID- 3973274 TI - Aortico-left ventricular tunnel with ventricular septal defect: two dimensional/Doppler echocardiographic diagnosis. AB - Aortico-left ventricular tunnel is a rare congenital anomaly that presents as aortic regurgitation and congestive heart failure in childhood. Its association with a ventricular septal defect is even more rare. Because of the distortion of the normal anatomy around the aortic valve and the rarity of this combination of defects, the diagnosis of aortico-left ventricular tunnel with ventricular septal defect may be difficult. The two-dimensional and Doppler echocardiographic findings of aortico-left ventricular tunnel are described. PMID- 3973275 TI - Variant angina in an 11 year old boy. AB - Variant angina is a syndrome in which ischemic cardiac pain occurs with ST segment elevation. The syndrome is due at least in part to coronary vasospasm. Although well documented in adults, there are no known reports of this syndrome in children. The clinical, electrocardiographic and echocardiographic findings in an 11 year old boy with variant angina are reported. PMID- 3973276 TI - Two-dimensional echocardiographic recognition and repair of subvalvular mitral aneurysm of the left ventricle in an infant. AB - The clinical features, diagnostic studies and surgical treatment of a subvalvular mitral aneurysm of the left ventricle are described. The infant presented at 9 weeks of age with large apical ventricular septal defects and pulmonary hypertension. The subvalvular aneurysm was an incidental finding. Both lesions were treated surgically. PMID- 3973277 TI - Function of the atrioventricular node considered on the basis of observed histology and fine structure. AB - From the hearts of 20 young dogs, the region of the atrioventricular (AV) node was studied in vitro utilizing direct perfusion of the AV node artery. Intracellular impalement with microelectrodes provided records of local transmembrane action potentials in all 20 dogs. These were correlated with serial section histologic studies in 7 of the 20 dogs to characterize a smaller region that served as an anatomic guide for electron microscopic examination in 4 other dog hearts. This report describes the variety of specific cells found, including their intracellular content and organization, as well as the nature of their intercellular junctions. On the basis of these findings, AV nodal cells were arbitrarily divided into two types, transitional cells and P cells, although three somewhat different groups of transitional cells were identified. The first group, found principally at the outer margin of the AV node, has long and slender cells that exhibit large profiles of gap junctions or nexuses. The second and third groups of transitional cells, which constitute most of the body of the AV node, are oblong or oval and contain fewer and smaller gap junctions. P cells of the AV node resemble those more abundantly present in the sinus node; they are found principally at the junction of the AV node and His bundle. On the basis of these fine structural features and the histologic organization and transmembrane action potentials observed, clinical and experimental aspects of the local electrophysiologic events are discussed. PMID- 3973278 TI - Importance of pacing site in entrainment of ventricular tachycardia. AB - Transient entrainment by pacing has been demonstrated during various tachyarrhythmias, including ventricular tachycardia. A patient is described who had two morphologically distinct forms of sustained ventricular tachycardia induced by programmed stimulation. Entrainment of both configurations of ventricular tachycardia was demonstrated. Evidence for entrainment included the presence of different degrees of fusion between paced and ventricular tachycardia complexes at different pacing cycle lengths, and the observation that the last entrained beat was always unfused and identical in configuration to the ventricular tachycardia complexes. Termination of ventricular tachycardia only occurred at pacing cycle lengths at which there was loss of fusion. Catheter endocardial mapping suggested a septal origin of both configurations of ventricular tachycardia. Demonstration of entrainment was dependent on pacing site, being seen only during pacing in the ventricle opposite from that showing earliest activation during ventricular tachycardia. Thus, when attempting to entrain ventricular tachycardia, multiple pacing sites in both ventricles should be used. PMID- 3973279 TI - Left recurrent laryngeal nerve palsy associated with primary pulmonary hypertension and patent ductus arteriosus. AB - Two patients with left recurrent laryngeal nerve paralysis in association with pulmonary artery hypertension are described. One had primary pulmonary hypertension and the other had patent ductus arteriosus. The greatly dilated pulmonary artery in these patients resulted in compression of the left recurrent laryngeal nerve and produced a cardiovocal (Ortner's) syndrome. The pathogenesis of the vocal cord palsy was documented by cross-sectional computed tomography. In conclusion, computed tomography is of great help in differentiating this syndrome from other diseases such as mediastinal mass or lymphadenopathy whenever hoarseness is complicated by pulmonary hypertension. PMID- 3973280 TI - Late systolic click from isolated tricuspid valve prolapse simulating paradoxical splitting of the second heart sound. AB - A 72 year old woman was thought to have a paradoxically split second heart sound. Echocardiography with simultaneous phonocardiography revealed a late systolic click resulting from isolated tricuspid valve prolapse. Respiratory variation of the click in relation to the second heart sound resulted in an auscultatory phenomenon simulating paradoxical splitting of the second heart sound. PMID- 3973281 TI - Report of the policy conference on pacemaker reuse sponsored by the North American Society of Pacing and Electrophysiology. PMID- 3973282 TI - Impending paradoxical embolism from atrial thrombus: correct diagnosis by transesophageal echocardiography and prevention by surgery. AB - During recovery from a posterolateral myocardial infarction, a 56 year old patient developed signs of deep vein thrombophlebitis and subsequently of pulmonary embolism. After conventional echocardiography showed masses in both atria, transesophageal two-dimensional echocardiography clearly revealed an elongated mass overriding an atrial septal defect. Impending paradoxical embolism was confirmed at surgery. PMID- 3973283 TI - Rupture of left sinus of Valsalva aneurysm into the pulmonary artery. AB - Congenital sinus of Valsalva aneurysm is an uncommon lesion that frequently presents after rupture in adult life. This report describes a patient with a left sinus of Valsalva aneurysm that ruptured into the main pulmonary artery, a previously unreported anatomic variant. Anatomic and clinical features of previously reported cases of ruptured sinus of Valsalva aneurysm are reviewed. PMID- 3973284 TI - Paroxysmal fascicular tachycardia: electrophysiologic characteristics and treatment by catheter ablation. AB - A 69 year old man with ischemic heart disease underwent electrophysiologic evaluation for paroxysmal wide QRS tachycardia, the configuration of which was identical to that recorded during sinus rhythm, that is, right bundle branch block, left anterior fascicular block and anterior myocardial infarction. Electrocardiographic recordings during tachycardia showed atrioventricular dissociation and His bundle activation occurring 5 ms after the onset of the QRS complex recorded on the surface electrocardiogram, consistent with a left posterior fascicular tachycardia. All traditional therapeutic attempts failed to prevent frequent recurrences of tachycardia, which was finally ablated by three 300 J shocks delivered through an electrode catheter positioned in the posterobasal region of the left ventricular septum. PMID- 3973285 TI - Pigtail catheter for extraction of pacemaker lead. PMID- 3973286 TI - "Atrial systolic notch" and "early diastolic notch" on the interventricular septal echogram in constrictive pericarditis. PMID- 3973287 TI - Prevalence and significance of residual flow to the infarct zone during the acute phase of myocardial infarction. AB - Residual flow to the infarct zone was assessed by coronary angiography during the acute phase of myocardial infarction in 130 patients. In 36 patients, the infarct related coronary artery was not completely obstructed, thereby providing residual anterograde flow to the infarct area (Group I). Complete obstruction of the infarct vessel with residual flow to the infarct zone by means of collateral circulation was observed in 56 patients (Group II). Complete obstruction of the infarct vessel without residual flow was seen in 38 patients (Group III). Ejection fraction during the acute phase of infarction was found to be significantly higher in Group I (55 +/- 13%) than in either Group II (48 +/- 13%) or Group III (50 +/- 10%) (p less than 0.05). Group II patients had a longer history of angina pectoris (14.2 +/- 21.4 months) than did Group III patients (0.7 +/- 3.1 months) (p less than 0.01). Patients in Group I and Group II were more likely to be taking antianginal medication (56 and 54%, respectively) than were the patients in Group III (16%) (p less than 0.01). Thirty-seven patients in whom reperfusion techniques were not employed had repeat angiography in the chronic phase of infarction, enabling assessment of spontaneous changes in left ventricular function and coronary morphology.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973288 TI - Relative attenuation of sympathetic drive during exercise in patients with congestive heart failure. AB - Patients with congestive heart failure have been considered to have augmented sympathetic drive both at rest and during dynamic exercise. The augmentation observed during exercise may be related to the state of near exhaustion experienced by patients with heart failure at relatively low work loads. To compare the response of the sympathetic nervous system to exercise in normal subjects and patients with heart failure when they are working in a comparable physiologic frame of reference, the data for both groups can be expressed as percent peak oxygen consumption achieved (percent peak VO2) rather than as a function of absolute oxygen consumption (VO2). Ten healthy control subjects and 31 patients with chronic clinical class II and III heart failure were studied during upright maximal bicycle exercise. Eighteen of the 31 patients had primary cardiomyopathy and 13 had ischemic cardiomyopathy. The average ejection fraction at rest was 24 +/- 10% (+/- SD) in the group with heart failure. Heart rate, systolic blood pressure, VO2 and plasma norepinephrine levels were measured at rest and throughout exercise. When the data were expressed as a function of percent peak VO2 achieved, patients with heart failure demonstrated a flatter slope (p = 0.004) than normal in the response of plasma norepinephrine to exercise, indicating a relative blunting of sympathetic drive. This was accompanied by attenuated heart rate (p = 0.001) and blood pressure (p less than 0.001) responses. These differences were not apparent when the data are expressed as a function of absolute VO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973289 TI - Ejection fraction response to supine exercise in asymptomatic aortic regurgitation: relation to simultaneous hemodynamic measurements. AB - The change in ejection fraction during exercise is frequently employed as a measure of left ventricular functional reserve in patients with aortic regurgitation. However, little information is available about its relation to invasive measurements of cardiac performance. Therefore, simultaneous hemodynamic measurements and supine exercise blood pool scintigraphy were performed in 14 patients with severe, asymptomatic or minimally symptomatic aortic regurgitation associated with cardiomegaly but preserved left ventricular function at rest. Their hemodynamic measurements at rest were normal and their exercise capacity was excellent. When the patients were categorized into those patients whose ejection fraction increased or did not decrease by more than 0.05 (Group 1) and those whose ejection fraction decreased by more than 0.05 (Group 2), important differences were apparent. Echocardiographic, radionuclide and hemodynamic measurements at rest in the two patient groups were similar, but Group 1 exhibited a greater increase in cardiac index during supine exercise (2.8 +/- 0.4 to 10.0 +/- 1.8 versus 2.7 +/- 0.5 to 6.9 +/- 1.0 liters/min per m2; p less than 0.005) and a lesser increase in pulmonary capillary wedge pressure (13 +/- 4 to 19 +/- 7 versus 12 +/- 4 to 31 +/- 8 mm Hg; p less than 0.01). The severity of regurgitation decreased during exercise in all patients, but end-diastolic volume decreased and end-systolic volume decreased or was unchanged in Group 1, whereas end-diastolic volume was unchanged and end-systolic volume increased in Group 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973290 TI - Absence of cardioversion-induced ventricular arrhythmias in patients with therapeutic digoxin levels. AB - To determine the incidence of cardioversion-induced ventricular arrhythmias in patients with therapeutic serum levels of digoxin, 19 patients (average age [+/- standard deviation] 61 +/- 12 years) undergoing elective direct current cardioversion for atrial fibrillation were studied. Only patients with therapeutic serum digoxin levels (range 0.5 to 1.9 ng/ml; mean 1.1 +/- 0.5) at the time of cardioversion were included. Patients with acute myocardial ischemia or unstable angina, serious electrolyte disturbance or those requiring class I antiarrhythmic agents for control of ventricular or supraventricular arrhythmias were excluded. Ambulatory electrocardiograms were recorded for 24 hours before and 6 hours after cardioversion. No patient developed malignant ventricular arrhythmias (ventricular triplets or tachycardia) in the immediate 3 hour period after cardioversion. Furthermore, there were no significant (p less than 0.05) differences in the frequency of ventricular premature beats or couplets before and after cardioversion. To determine whether the level of serum digoxin or the strength of the applied shock had a significant effect on the development of postcardioversion arrhythmias, the change in frequency of single premature ventricular beats after cardioversion was compared with the serum digoxin level (ng/ml) and the applied energy level (joules) by means of linear regression analysis. There was no significant (p less than 0.05) relation between these variables. These findings suggest that patients with therapeutic serum levels of digoxin may safely undergo cardioversion without the concomitant use of class I antiarrhythmic agents. PMID- 3973291 TI - Electrophysiologic demonstration of concealed conduction in anomalous atrioventricular bypass tracts. AB - To demonstrate the occurrence of concealed conduction in anomalous atrioventricular (AV) bypass tracts, 11 patients were selected for study. Two had a right-sided and nine had a left-sided bypass tract. Electrode catheters were placed in the right atrium, coronary sinus, AV junction and right ventricle. After every eighth atrial or ventricular driving beat (A1 or V1) at a constant cycle length, two successive atrial or ventricular premature beats (A2 and A3 or V2 and V3) were delivered. The A1A2 or V1V2 interval was fixed at 30 ms greater than the effective refractory period of the atrium or right ventricle, but less than the effective refractory period of the bypass tract in the anterograde or retrograde direction. This allows A2 or V2 to capture the atrium or ventricle, but not conduct in the bypass tract. The A3 or V3 was delivered from late diastole with a progressively shorter A2A3 or V2V3 interval until atrial or ventricular refractoriness was encountered. In the anterograde direction, the presence of A2 prevented A3 conduction in the bypass tract despite A1A3 intervals being longer than the anterograde effective refractory period of the bypass tract in 8 of the 11 patients. In the retrograde direction, the presence of V2 prevented V3 conduction in the bypass tract despite V1V3 intervals being longer than the retrograde effective refractory period of the bypass tract in 3 of the 11 patients. Thus, using the technique of programmed electrical stimulation, concealed conduction in anomalous AV bypass tracts can be demonstrated in both anterograde and retrograde directions. PMID- 3973292 TI - Modified technique of transseptal left heart catheterization. AB - Transseptal left heart catheterization was performed in 106 instances in 101 patients using right anterior oblique fluoroscopy to define septal boundaries during interatrial septal puncture, and using a preshaped guide wire to catheterize the left ventricle. By using these two modifications of the classic transseptal technique, the left atrium was entered in 105 instances (99%) and the left ventricle was catheterized in all 87 attempts (100%), including attempts in eight patients with mitral stenosis (valve area 1.29 +/- 0.39 cm2 [mean +/- standard deviation] ). No deaths occurred as a direct result of transseptal catheterization; nonfatal complications occurred in 2.8% of patients (hemopericardium in one patient, ventricular fibrillation in one patient and transient vagal reaction in one patient). The use of the right anterior oblique projection to adequately visualize both the interatrial septum and the intended point of puncture, the use of a pigtail catheter positioned in the ascending aorta to define the relation of the puncture site to the aorta in this projection and the utilization of a flexible preshaped guide wire to catheterize the left ventricle are the major factors contributing toward this improved success rate and low incidence of complications. PMID- 3973293 TI - Value of two-dimensional echocardiography in evaluating coronary artery disease: a randomized blinded analysis. AB - Two-dimensional echocardiography at rest was used to analyze segmental wall motion abnormalities for detecting coronary artery disease in patients with and without a history of myocardial infarction. One hundred twenty-five echocardiograms were analyzed in a randomized, blinded fashion. They were obtained from 55 consecutive patients found to have significant coronary artery disease at angiography, 59 consecutive normal subjects and 11 patients with dilated cardiomyopathy. The overall sensitivity of two-dimensional echocardiography was relatively low at 67%. However, specificity was 99%. The sensitivity was higher in patients with past myocardial infarction than in those without myocardial infarction (81 versus 42%), as expected. Echocardiography can detect segmental wall motion abnormalities in some patients with coronary artery disease and no overt prior myocardial infarction. This was highlighted by nine such patients with coronary artery disease and no prior myocardial infarction or electrocardiographic Q waves who were found to have segmental wall motion abnormalities. A semiquantitative, two-dimensional echocardiographic segmental wall motion score was derived for 47 patients and was correlated with angiographic left ventricular ejection fraction (r = 0.71). This score differentiated patients with a normal ejection fraction (greater than 50%) from those with a depressed ejection fraction (less than 50%): 1.1 +/- 1.6 versus 6.9 +/- 3.1 (p less than 0.001). Almost all patients (92%) with an echocardiographic score of five or more had an abnormal ejection fraction of less than 50%. In patients with chronic congestive heart failure, the echocardiogram separated those with dilated cardiomyopathy from those with coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973294 TI - An echocardiographic index for separation of right ventricular volume and pressure overload. AB - Abnormal motion of the interventricular septum has been described as an echocardiographic feature of both right ventricular volume and pressure overload. To determine if two-dimensional echocardiography can separate these two entities and distinguish them from normal, geometry and motion of the interventricular septum in short-axis views of the left ventricle were evaluated in 12 normal subjects and 35 patients undergoing cardiac catheterization. Thirteen of the 35 patients had uncomplicated atrial septal defect with associated right ventricular volume overload, but no elevation in pulmonary artery pressure. The 22 remaining patients had a pulmonary artery systolic pressure greater than 40 mm Hg and, thus, constituted the group with right ventricular pressure overload. An eccentricity index, defined as the ratio of the length of two perpendicular minor axis diameters, one of which bisected and was perpendicular to the interventricular septum, was obtained at end-systole and end-diastole. In all normal subjects, the eccentricity index at both end-systole and end-diastole was essentially 1.0, as would be expected if the left ventricular cavity was circular in the short-axis view. In patients with right ventricular volume overload, the eccentricity index was approximately 1.0 at end-systole, but was significantly increased at end-diastole (mean eccentricity index = 1.26 +/- 0.12) (p less than 0.001). In patients with right ventricular pressure overload, the eccentricity index was significantly greater than 1.0 at both end-systole and end-diastole (1.44 +/- 0.16 and 1.26 +/- 0.11, respectively) (p less than 0.001). These results suggest that an index of eccentric left ventricular shape which reflects abnormal motion of the interventricular septum can be defined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973295 TI - Experimental angioplasty: circumferential distribution of laser thermal energy with a laser probe. AB - A new laser probe that converts argon laser energy to heat in a metallic cap on a fiberoptic fiber was compared with a bare argon laser fiberoptic catheter system for the dissolution of atherosclerotic obstructions under fluoroscopic guidance in 24 atherosclerotic rabbits. Twelve animals were randomly assigned to receive treatment with either a bare fiberoptic system or a laser probe coupled to an argon laser. Both fibers had similar outer (0.9 mm) and core (400 mu) diameters. Pulses of 1 watt for 1 second's duration were delivered from the tip of the fiberoptic system, while pulses of 6 watts for 2 seconds' duration were delivered to the laser probe. The results of angiography indicated that widening of luminal stenosis was seen in only 2 of 12 animals treated with the fiberoptic system compared with 8 of 12 animals treated with the laser probe. Perforation of the vessel wall occurred more frequently with the fiberoptic fiber (9 of 12 animals) as compared with the laser probe (1 of 12 animals). Histologic examination of direct laser radiation with the fiberoptic fiber revealed a small localized laser defect along one side of the vessel wall associated with charring, a gradient of thermal injury and considerable thrombus formation. In contrast, those vessels treated with the laser probe showed histologic evidence of thermal injury distributed evenly around the entire luminal circumference. This was associated with minimal charring, a gradient of thermal injury and thinner, flatter thrombus formation. Carbonization of the metallic tip and adherence of atherosclerotic debris with secondary vessel tearing were potential adverse effects of the laser probe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973297 TI - Regional myocardial function is not affected by severe coronary depressurization provided coronary blood flow is maintained. AB - It has been suggested that vasodilation distal to a stenosis may cause a profound decrease in perfusion pressure and adversely affect regional left ventricular function. This phenomenon could explain the clinical concept of reversal of regional dysfunction by coronary revascularization. To evaluate the hypothesis that regional myocardial function parallels regional coronary blood pressure in the absence of changes in coronary flow, dogs chronically instrumented with left circumflex coronary artery flow probes, cuff occluders, pressure catheters and segmental function sonomicrometers were studied. By decreasing regional coronary vascular resistance with selective intracoronary dipyridamole and controlling blood flow with a proximal coronary cuff occluder, the mean left circumflex artery pressure was reduced from 83 +/- 3 to 38 +/- 2 mm Hg while circumflex coronary blood flow was maintained constant. Regional contractile function as measured by circumflex sonomicrometers was unchanged at constant circumflex subendocardial blood flow as measured by radioactive microspheres. These findings suggest that regional contractile function is dependent on subendocardial blood flow and is independent of coronary perfusion pressure. PMID- 3973296 TI - Effects of pressure-controlled intermittent coronary sinus occlusion on regional ischemic myocardial function. AB - Pressure-controlled intermittent coronary sinus occlusion has been reported to reduce infarct size in dogs with coronary artery occlusion, possibly because of increased ischemic zone perfusion and washout of toxic metabolites. The influence of this intervention on regional myocardial function was investigated in open and closed chest dogs. In six open chest dogs with severe stenosis of the left anterior descending coronary artery and subsequent total occlusion, a 10 minute application of intermittent coronary sinus occlusion increased ischemic myocardial segment shortening from 5.5 +/- 1.2 to 8.2 +/- 2.6% (NS) and from -0.1 +/- 2.1 to 2.3 +/- 1.2% (NS), respectively. In eight closed chest anesthetized dogs, intermittent coronary sinus occlusion was applied for 2.5 hours between 30 minutes and 3 hours of intravascular balloon occlusion of the proximal left anterior descending coronary artery. Standardized two-dimensional echocardiographic measurements of left ventricular function were performed to derive systolic sectional and segmental fractional area changes in five short axis cross sections of the left ventricle. Fractional area change in all the severely ischemic segments (less than 5% systolic wall thickening) was -4.0 +/- 4.7% at 30 minutes after occlusion, and increased with subsequent 60 and 150 minutes of treatment to 13.1 +/- 3.3 and 7.0 +/- 3.3%, respectively (p less than 0.05). At the most extensively involved low papillary muscle level of the ventricle, regional ischemic fractional area change was increased by intermittent coronary sinus occlusion between 30 and 180 minutes of coronary occlusion from 0.4 +/- 0.1 to 14.4 +/- 4% (p less than 0.05), whereas a further deterioration was noted in untreated dogs with coronary occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973298 TI - Sequelae of left ventricular electrical endocardial ablation. AB - The endomyocardial residual effects of left ventricular endocardial electrical ablation utilizing unipolar and bipolar electrode catheters were studied in 15 dogs. Histopathologic techniques specific for contraction band necrosis revealed that the mean maximal depth and breadth of necrosis was 0.63 +/- 0.44 and 1.23 +/ 0.82 cm, respectively. The dimensions of necrosis were significantly increased when utilizing larger energy discharges, especially through unipolar electrodes. Four dogs died during the procedure, three from ventricular fibrillation and one from asystole, and two died suddenly within the succeeding 24 hours. Endocardial thrombi were noted at necropsy in two dogs. In conclusion, transcatheter endocardial electrical ablation may destroy a sufficient mass of myocardium to interrupt arrhythmogenic conduction tissue, especially when larger currents are delivered through unipolar electrodes. However, serious ventricular arrhythmias and endocardial thrombi should be anticipated. PMID- 3973299 TI - Count-based scintigraphic method to calculate ventricular volumes in children: in vitro and clinical validation. AB - A "phantom" was used to validate 1) estimates of different depths of a constant radioactivity source, and 2) the calculation of different volumes using a constant depth and different attenuation coefficients. Using data from this in vitro study, scintigraphic estimates of right ventricular volume and ejection fraction were compared with those obtained by cineangiography in 36 children with either a normal right ventricle or various right ventricular diseases. The static program accurately estimates the distance from the radiation source to the collimator surface (r = 0.99). Radionuclide count methods best predict "phantom" volumes using attenuation coefficients between 0.11(-1) and 0.13(-1) cm. A coefficient of 0.10(-1) underestimates, whereas 0.15(-1) cm grossly overestimates actual volumes. In vivo data were therefore analyzed using an attenuation coefficient of 0.11(-1) with right ventricular counts corrected using either right ventricular or left ventricular background. Closest agreement between scintigraphic and cineangiographic volumes was obtained using right ventricular background, although end-diastolic volumes larger than 100 ml were substantially underestimated. On the basis of this study, the use of two different attenuation coefficients is suggested: the smaller 0.11(-1) cm to calculate end-systolic and end-diastolic volumes and the larger 0.15(-1) cm for volumes greater than 100 ml. PMID- 3973301 TI - Generating precision microbubbles for use as an echocardiographic contrast agent. AB - To investigate whether precision microbubbles can be simply generated and used for quantitative contrast echocardiographic studies, precision microbubbles were fabricated in gelatin using a simple generator. The generator consisted of a fluid pump, a generating site containing a narrow bore tube and a bubble stream output port. Up to 5,000 microbubbles/s were generated with a controllable radius of 80 to 150 mu. No detectable interbubble size variation was observed under high power microscopy. To examine whether these bubbles could be used for quantitative contrast echocardiographic studies, they were then infused into a tube with a known flow of degassed water during ultrasonic imaging. The resulting ultrasonic contrast effect in the tube lumen at steady state was recorded and subsequently measured by videodensitometry. The precision microbubbles were visually and microscopically stable during the experimental run. Correlations between microbubble infusion rate and luminal videodensitometry on individual runs were r = 0.89, 0.83, 0.73 and 0.71. It is concluded that precision microbubbles can be generated in sufficient quantities on site to serve as an echocardiographic contrast agent for quantitative studies in vitro and at a very modest cost. These precision microbubbles are sufficiently stable to be collected and stored for short periods of time. PMID- 3973300 TI - Assessment of the ductus arteriosus in preterm infants utilizing suprasternal two dimensional/Doppler echocardiography. AB - Evaluation for patent ductus arteriosus by both Doppler examination and direct two-dimensional echocardiographic visualization has been reported in infants and children. However, visualization of a patent ductus arteriosus in preterm infants with lung disease has been difficult. Using a recently developed 7.5 MHz mechanical scanner with interfaced two-dimensional directed pulsed Doppler ultrasonography, 36 examinations were performed from a suprasternal approach in 27 patients (age range 1 day to 3 months, mean 18 days; weight range 490 to 2,500 g, mean 1,260). Complete imaging for evaluation of patency of the ductus arteriosus was successful in 33 (92%) of 36 examinations, and imaging of the pulmonary end of the ductus arteriosus was successful in all. In 18 examinations, the ductus arteriosus was closed by both two-dimensional echocardiography and Doppler examination. In four cases the ductus arteriosus was widely patent by both two-dimensional echocardiography and Doppler examination. Eleven echocardiographic examinations revealed a narrowed ductus arteriosus, and of these, 10 (91%) showed Doppler findings of patent ductus arteriosus. It is concluded that combined two-dimensional/Doppler echocardiographic assessment allows confident detection of both a large unrestrictive and a small, stenotic patent ductus arteriosus in preterm infants with lung disease. PMID- 3973302 TI - Endomyocardial fibrosis: report of eight cases. AB - Endomyocardial fibrosis is a disease of unknown origin which has not previously been described in detail from the Middle East. The clinical, echocardiographic, hemodynamic and angiocardiographic findings in eight patients (five men and three women, mean age 38 years) are presented. Two patients had right-sided involvement, two had left-sided involvement and four had biventricular involvement. The presence of a small ventricle with obliteration of the apex and a large atrium is a two-dimensional echocardiographic finding highly suggestive of endomyocardial fibrosis. Hemodynamic characteristics of dip and plateau on ventricular pressure curves were present in six patients. Ventricular angiography was diagnostic in all cases. Endomyocardial biopsy yielded positive findings in three of six patients and is not essential for diagnosis. PMID- 3973303 TI - Tumor of the heart diagnosed by magnetic resonance imaging. AB - A case of liposarcoma metastatic to the heart is presented. This is a very rare entity and only three prior case reports could be found. Magnetic resonance imaging was successfully used to visualize the tumor. These images compared favorably with a two-dimensional echocardiographic study and postmortem examination. PMID- 3973304 TI - Diaphragmatic hernia mimicking an atrial mass: a two-dimensional echocardiographic pitfall. AB - Two-dimensional echocardiography has become the diagnostic method of choice for identifying intracardiac masses. However, adjacent extracardiac structures may closely mimic intracardiac masses on the two-dimensional echocardiogram. Five cases of a previously unrecognized phenomenon in which a diaphragmatic hernia mimicked an intraatrial mass are reported. Techniques to identify a diaphragmatic hernia properly on two-dimensional echocardiographic examination and distinguish it from intracardiac masses are discussed. PMID- 3973305 TI - Automaticity of the Kent bundle: confirmation by phase 3 and phase 4 block. AB - Automaticity in the Kent anomalous atrioventricular bundle has been postulated to occur on the basis of electrocardiographic recordings. This hypothesis was confirmed using intracardiac recordings and programmed stimulation in a patient with pre-excitation. It was supported, in part, by demonstrating the presence of phase 3 and phase 4 block in the Kent bundle during decremental atrial pacing. The existence of automaticity in the Kent bundle may explain the manifestation of intermittent pre-excitation in certain patients. Furthermore, the presence of phase 3 and phase 4 block makes the likelihood of rapid antidromic conduction over the Kent bundle pathway unlikely within this subgroup. PMID- 3973306 TI - Transvenous catheter ablation of a right atrial automatic ectopic tachycardia. AB - A 10 year old patient with right atrial automatic ectopic tachycardia underwent successful transvenous catheter ablation after endocardial mapping. Tachycardia had been present for 7 years before ablation and associated with development of dilated cardiomyopathy. A single 50 J discharge at the point of earliest atrial activation was followed by the establishment of sinus rhythm that remains at 10 months' follow-up. This case represents the first reported successful catheter ablation of an atrial automatic ectopic tachycardia. Specific anatomic factors favoring successful ablation and improvement in technique are discussed. PMID- 3973307 TI - Are confusion and controversy about food hypersensitivity really necessary? PMID- 3973308 TI - Recertification in allergy and immunology: an historical review with special emphasis on the 1983 examination. AB - Recertification offers a method of evaluating a diplomate's cognitive knowledge of allergy and immunology. In 1983 candidates for the American Board of Allergy and Immunology recertification examination were offered the entire certifying examination but were informed that they would, for recertification purposes, be held responsible only for a subset of questions judged to be particularly clinically relevant. All 40 candidates elected to take the entire certifying examination. Differences between the performance of certifying and recertifying candidates on the recertifying questions were small. Except for the five-choice questions, the differences in performance between the two groups on the remaining questions were also small in an absolute sense. Recertification performance was not related to the time of original certification. Ninety-eight percent of the candidates completed a questionnaire after the examination. Ninety percent stated that they would encourage their colleagues to participate in the recertification process. PMID- 3973309 TI - Evaluation of immediate adverse reactions to foods in adult patients. I. Correlation of demographic, laboratory, and prick skin test data with response to controlled oral food challenge. AB - Forty-five adult patients, referred to here as the index population, with a history of immediate adverse reactions after food ingestion were evaluated by history, physical examination, laboratory studies, and skin testing. Fifty-six percent of these patients reported adverse reactions to only one food, whereas 84% of the patients reported up to three foods as being capable of eliciting reactions. The average age obtained by history at which adverse reactions began to occur was 19 4/5 yr. The occurrence of these reactions persisted over an average of 14 4/5 yr. Most reactions involved the gastrointestinal tract alone or in combination with the skin or respiratory tract. The most frequently involved foods were shellfish, peanuts, eggs, fish, tomatoes, and walnuts. Twenty-five of the patients participated in oral challenge with the suspected food. The food challenge was positive in 10 patients. Comparison of information obtained by history including personal or family history of any other allergic disease, age of onset of sensitivity, the length of time of suspected sensitivity in years, and the number of foods to which the sensitivity was believed to exist revealed no significant differences between food challenge-positive (FC+) and food challenge-negative (FC-) patients. However, a significant difference in the reaction patterns reported by history in the FC+ and FC- patients was noted in that FC+ patients more often described reactions in which a combination of gastrointestinal, respiratory, and dermatologic symptoms occurred. The complete blood count with differential, blood chemistries, and serum immunoglobulin levels were similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973311 TI - Histamine sensitivity influences reactivity to allergens. AB - The ability to mount an IgE response to allergens is a prerequisite for the development of positive allergen skin tests, and this is reflected to some extent by the observation that allergen-responsive subjects tend to have higher total serum IgE concentrations. To determine whether histamine sensitivity also contributes to allergen responsiveness, 893 subjects in a rural community were prick tested with 14 allergens and tenfold dilutions of histamine phosphate beginning at 1 mg/ml-1. IgE was measured in a subset of 400 subjects. Three-way contingency table analysis confirmed previous reports of an association between allergen responsiveness and IgE (p less than 0.001) and also demonstrated that allergen responsiveness is associated with sensitivity to histamine (p less than 0.001). This association is independent of IgE so that the additive effect of IgE and histamine sensitivity allows more nearly accurate prediction of allergen responsiveness than either measurement alone. PMID- 3973310 TI - Evaluation of immediate adverse reactions to foods in adult patients. II. A detailed analysis of reaction patterns during oral food challenge. AB - Eighty-three oral food challenges were performed on 25 patients with a history of immediate adverse reaction to foods. Seventy-one food challenges were performed in 24 patients, whereas 12 placebos were administered to nine patients. Of the 71 food challenges observed, 12 were positive in 10 patients. All challenges with placebo were negative. Doses of challenge foods provoking observable reactions ranged from 5 to 100 gm. The clinical signs and symptoms noted on food challenge reproduced those reported by history. Reactions were mild, generally self limited, and were not accompanied by elevations in urinary histamine. A plasma histamine elevation was observed in one patient. A 10- to 12-mo follow-up survey of nine patients with negative food challenges revealed that six patients had resumed eating the challenge food on a regular basis without experiencing adverse reactions, whereas three patients continued to avoid the challenge food. All 10 patients with positive food challenges continued to avoid the challenge food. PMID- 3973312 TI - Pharmacokinetics of a sustained-release theophylline preparation in infants and preschool children with asthma. AB - Sustained-release theophylline formulations should be most useful in young children who have rapid clearance and long sleep intervals. Somophyllin-12 is a recently introduced, newly designed, bead-filled capsule. We tested its ability to provide adequate serum concentrations at steady state in 16 children ages 0.9 to 5.1 yr. On a 12 hourly dosing schedule, mean dose was 25.9 mg/kg per day, and mean fluctuation was 138%. Seven children (43.8%) had fluctuations less than 100%, whereas four children (25%) had fluctuations more than 200%. Six patients with excessive fluctuation (greater than 100%) were restudied on an eight hourly dosing schedule. Mean dose was 28.7 mg/kg per day, and fluctuation was 59%. Because of the excessive fluctuation (greater than 100%) experienced by half these young children, therapy with this product should be initiated with an eight hourly dosing schedule. However, when dose and dosing interval are subsequently individualized, many young children can be switched to twice daily dosing with its improved compliance and convenience. PMID- 3973313 TI - Polymerized soluble venom--human serum albumin. AB - Extensive previous studies have demonstrated that attempts to produce polymers of Hymenoptera venoms for human immunotherapy resulted in insoluble precipitates that could be injected with safety but with very limited immunogenicity in allergic patients. We now report soluble polymers prepared by conjugating bee venom with human serum albumin with glutaraldehyde. The bee venom-albumin polymer (BVAP) preparation was fractionated on Sephacryl S-300 to have a molecular weight range higher than catalase. 125I-labeled bee venom phospholipase A was almost completely incorporated into BVAP. Rabbit antibody responses to bee venom and bee venom phospholipase A were induced by BVAP. Human antisera against bee venom were absorbed by BVAP. No new antigenic determinants on BVAP were present as evidenced by absorption of antisera against BVAP by bee venom and albumin. BVAP has potential immunotherapeutic value in patients with anaphylactic sensitivity to bee venom. PMID- 3973314 TI - Allergy grand rounds. Anaphylactoid reactions to radiocontrast material. PMID- 3973316 TI - Localized cold-reflex urticaria. PMID- 3973315 TI - Grand rounds: adverse reactions to wine. PMID- 3973317 TI - Improving estimates of food and nutrient intake: applications to individuals and groups. PMID- 3973318 TI - Consequences of utilizing reduced nutrient data bases for estimating dietary adequacy. AB - The USDA Nutrient Data Base (NDB) used to calculate dietary intake in the Nationwide Food Consumption Survey of Individuals 1977-1978 (NFCS) was reduced to two levels. Both reduced data bases were used in analysis of 3-day dietary records collected on 7,914 individuals during the first quarter of that survey. Baseline nutrient intake values for energy and 14 nutrients for 22 sex-age groups were calculated prior to NDB reduction. After reduction, nutrient intake values were again calculated. The magnitude of variation was determined, and ANOVA was used to evaluate those variations at both substitution levels. The NDB reductions resulted in significant alterations in calculated nutrient intake and interactions between NDB type and various sex-age groups. However, the magnitude of the differences in calculated nutrient levels between the original and reduced data bases was, generally, quite small. The notable exception was in the under-1 year sex-age group. On the basis of this study, predictions of nutritional adequacy for the NFCS using the smaller data bases would show essentially the same trends as obtained from the original data base. PMID- 3973319 TI - A comparative study of two nutrient data bases. AB - Reported dietary intake records of 18 infants, 22 young children, and 20 women were analyzed using the nutrient data base systems of the Second National Health and Nutrition Examination Survey (NHANES II) and the Nutrient Dietary Data Analysis (NDDA) System. Significant differences between the nutrient data bases were found in the calculations of potassium and niacin for infants and of energy and nine nutrients for women and children. The energy and nutrient composition of many commonly consumed food items in the two nutrient data base systems was different, even though the systems shared common data sources. Differences in the nutrient data bases were primarily due to the timing of data base updates, as well as to the differential use of industry, private, and government food analysis sources, procedural differences in data base updating, and random data entry error. Resolution of differences among nutrient data base systems may depend upon comprehensive reviews of all data base systems or the establishment of a national nutrient data base to serve as a standard for the professional. PMID- 3973320 TI - One-day and 3-day nutrient intakes by individuals--Nationwide Food Consumption Survey findings, Spring 1977. AB - With the use of data from the Spring 1977 sample of the USDA Nationwide Food Consumption Survey 1977-78, 1- and 3-day nutrient intakes for 8,779 individuals in 22 sex-age groups in the 48 conterminous states were compared. For most nutrients studied, 3-day mean intakes and day 1 mean intakes showed little difference. Mean intakes for day 1 and for days 2 and 3 combined were not significantly different for most sex-age groups for most nutrients. The few statistically significant differences observed for energy, fat, and carbohydrate could have been the result of chance and therefore have little practical significance. Regression analysis indicated that day 1 intake was strongest as a predictor of intake on subsequent days for energy, carbohydrate, calcium, magnesium, and phosphorus; less strong for protein, fat, iron, thiamin, riboflavin, niacin, vitamin B-6, and vitamin C; and poorest for vitamin A. PMID- 3973321 TI - Variability of nutrient intake over a 3-day period. AB - This study was designed to assess the magnitude of variation in nutrient intake of individuals over a 3-day period. It is based on an analysis of 3-day food intake records of 21,867 participants in the Nationwide Food Consumption Study (NFCS), 1977-78. Results from a subsample of 7,287 subjects showed a significantly greater variation from the median than from the mean for protein, vitamin A, and iron. Fewer than 30% of the respondents had intakes of any of the 11 nutrients studied within +/- 15% of the mean on all days. For all nutrients except energy and magnesium, less than 50% of the respondents had intakes within +/- 25% of the mean. Variability in intake was greatest for vitamins A and C, with 85% and 82% of respondents, respectively, having low and high daily intakes deviating by more than 25% from the mean. These findings document that 1-day food records alone are of limited value in assessing nutrient adequacy of an individual and quantify the magnitude of the variation over a 3-day period. The more adequate the mean nutrient intake, the less variability in intake from day to day. Similarly, the more consistent the meal pattern, the less the variability in intake. PMID- 3973322 TI - A comparison of methods for plate waste determinations. AB - Plate waste studies have traditionally been used to evaluate behavior change in nutrition education programs. Identical menus are served both before and after the implementation of curriculum. Theoretically, students will internalize nutrition information, and there will be less waste in the post-test phase. In this study, two methods for determining plate waste were compared using 343 students from six schools in a pretest/post-test treatment vs. control group design. One method consisted of actual weighing of waste using gram scales. The second method utilized visual estimation of the waste expressed on a 6-point scale. Correlations between the two methods were high. However, when statistical analysis was done to determine differences between groups, it was found that the visual estimation method was not always so sensitive in detecting differences as was the weighed food method. The visual method was also found to be more difficult to interpret. It is suggested that while there are advantages to the visual estimation method, its use be limited to informal studies in which broad generalizations will not be made as to the effectiveness of nutrition education programs. PMID- 3973323 TI - A simple nutrition screening procedure for hospital patients. AB - Nutrition screening is the process of identifying hospital patients with a high risk for nutrition problems who may require comprehensive nutrition assessment. Dietitians at a 700-bed teaching hospital recently implemented a nutrition screening program remarkable for efficient use of existing personnel resources. The three-step procedure includes a nutrition questionnaire completed by the patient in the hospital admissions office, measurement of each patient's height and weight by an admissions nurse, and addition of the patient's serum albumin concentration plus summary and recommendations for nutrition intervention by a registered dietitian. The procedure reduces the time needed for individual evaluation from 25 to 5 minutes and results in 1 1/2-hour time saving per day per clinical dietitian. Patients designated as "high risk" by this method appear to be more seriously ill, as shown by significantly longer hospitalization. The nutrition screening procedure described is simple, efficient, and applicable to a wide variety of institutional settings. PMID- 3973324 TI - Nutrient interaction with drugs and other xenobiotics. AB - Drugs and other xenobiotics (foreign compounds) are consumed with food, presenting the potential for interactions that may modify the biological activity of both nutrients and xenobiotics. The complexities associated with the biological fate of both classes of compounds yield a multitude of potential interactions, making the prediction of specific interactions a complicated task. However, the similarities between the biological processes involved in the biological fate of both xenobiotics and nutrients allow a logical approach to the understanding and prediction of interactions. For example, for either a xenobiotic or nutrient to produce a systemic effect, it must be absorbed. There are similarities between the factors that influence the availability and absorption of both xenobiotics and nutrients. It is at these points of similarity that interactions are most likely to occur. This is also true for the other major processes involved with the biological fate of both xenobiotics and nutrients, such as distribution, metabolism, and excretion. An understanding of these processes and the most likely points of interaction is the first step in understanding and acquiring predictive ability of the potential interactions between nutrients and drugs, as well as other xenobiotics. PMID- 3973325 TI - Model utilization in evaluation of a Dial-A-Dietitian system. AB - The purpose of this study was to determine the effectiveness of selected factors of performance of a telephone delivery system, Dial-A-Dietitian, which was established to provide nutrition information to the public. A model, developed for this use, entailed a systems approach with five phases, which included enabling factors (inputs), the interaction process, effort factors (outputs), performance (outcome), and feedback (reporting). The data analysis indicated that the Dial-A-Dietitian program was effective as measured by this model. PMID- 3973326 TI - Promoting dietary change: demonstrating reduction of dietary fat. AB - This short demonstration accomplishes several goals. People see where fat comes from and learn amounts needed to be removed. They practice substituting complex carbohydrate foods for fat. Most important, they learn that changing is not an "all-or-nothing" proposition. They can reduce dietary fat and still eat many of their favorite foods. This demonstration is a useful tool for nutrition educators who want to promote dietary change. PMID- 3973327 TI - Computer-planned menus: a prospective diet assessment method. PMID- 3973328 TI - An assessment of factors affecting consumption of entree items by hospital patients. AB - Seventy-one hospitalized patients completed surveys pertaining to their attitudes toward factors affecting food consumption and food preferences. Patients were divided into two groups, those who finished the entree and those who did not. Appetite and aroma were found to be the principal factors affecting food consumption. Mood, length of hospitalization, education level, appearance of the food, cleanliness of the service, foodservice ratings, health care ratings, and temperature of the food did not affect consumption. PMID- 3973329 TI - Soft drink consumption patterns of the U.S. population. PMID- 3973330 TI - Effect of egg supplements on serum lipids in uremic patients. PMID- 3973332 TI - Position paper of the American Dietetic Association on diet and criminal behavior. PMID- 3973331 TI - President's page: long-range planning. PMID- 3973333 TI - A perspective on training for academic leadership in geriatrics. PMID- 3973334 TI - A case-control study of maternal age in Alzheimer's disease. AB - A case-control study of maternal age as a risk factor for Alzheimer's disease was conducted in Washington state. Clinically diagnosed cases of Alzheimer's disease (n = 64) were identified from two sources, an outpatient clinic at the University of Washington and an organization of relatives of patients with Alzheimer's disease. Controls were spouses of the Alzheimer's disease cases and spouses of 87 patients with Parkinson's disease, also identified at the University of Washington. Mail questionnaires were sent to all subjects; responses were received for 90 cases and 96 controls, although nine of those cases, whose medical records of diagnostic evaluations were incomplete, were excluded. Among the 69 cases and 94 controls whose mothers' ages were known, there was no evidence that the mothers of cases were significantly older than the mothers of controls (chi-square test for trend, P = 0.82). These findings do not support the theory that persons born to older mothers are at increased risk of developing Alzheimer's disease. PMID- 3973335 TI - Septic arthritis in the elderly. AB - The clinical and microbiologic features of septic arthritis in 23 elderly patients are reviewed. Fifteen patients had pre-existing joint diseases, predominantly osteoarthritis and rheumatoid arthritis. Eight patients had underlying systemic illnesses, and eight patients were receiving systemic corticosteroid therapy prior to the development of septic arthritis. The knee was the joint most commonly infected. Although Staphylococcus aureus was the major pathogen (52.2 per cent of patients), enteric gram-negative bacilli were found in seven of 23 patients (30.4 per cent). Five patients died (21.7 per cent mortality), two as a result of their infection and three of nosocomial Pseudomonas sepsis. Eight of the 18 survivors (44.4 per cent) developed osteomyelitis in the contiguous bone. Return of joint function was slow in all patients. Septic arthritis in the elderly is difficult to treat and has a poor outcome, possibly because pre-existing joint disease is very common and enteric gram-negative bacilli are often the causative organisms. PMID- 3973336 TI - Increasing the pneumococcal vaccination rate of elderly patients in a general internal medicine clinic. AB - To improve the pneumococcal vaccination status of an elderly patients group, those older than 64 years of age were identified from a computer file of all continuing care patients in a general internal medicine clinic. In a randomly chosen study group (N = 163), 91 elderly patients (56 per cent) had received the pneumococcal vaccine. Factors associated with a higher rate of pneumococcal vaccination included receiving the previous year's influenza vaccine, a medical problem list attached to the patient's chart, active clinic status (i.e., seen in the year before the study began), and more than two problems listed in the computer record. Letters encouraging pneumococcal vaccination were then sent to patients who had not been vaccinated. Twenty of 72 patients (28 per cent) who received the letter were vaccinated during the next year; 8 per cent of control patients (three of 39) who did not receive the letter were vaccinated. The 95 per cent confidence limit for the relative difference between the study and control group is 6 to 53 per cent. The relative difference was also significant for influenza vaccination between the intervention group and the portion of the control group that had not been vaccinated at the first chart review. Factors associated with pneumococcal vaccination rate following the mailing of the reminder letter were active clinic status and being up to date for either influenza or tetanus vaccination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973337 TI - Legal and ethical standards in geriatric medicine. AB - Several examples of physicians' ethical and legal responsibilities toward older individuals desiring medical care are discussed. The focus is on the older person's ethical and legal right to access to medical services, and on the extent of corresponding obligations of physicians to actuate and fulfill the older person's access rights. The impact of current cost constraints in carrying out these obligations is also discussed. PMID- 3973338 TI - Teaching nursing homes: their impact on public policy, patient care, and medical education. AB - In summary, teaching nursing homes can be expected to have an impact on public policy development, patient care, and physician training. It is anticipated that research into the important public policy issues regarding relationships between costs and proprietary status and quality of care will be enhanced by developing teaching nursing homes. It will be important to coordinate efforts and evaluations between pilot projects with different funding bases in order to provide research projects with adequate controls. Many results regarding cost quality comparisons may be of limited applicability to community institutions because of the higher costs inherent to teaching facilities. Nursing home patients living in teaching facilities can expect to be directly benefitted in terms of receiving increased medical attention. They will reside in model facilities providing what is hoped to be the optimal services in all aspects of nursing home care. Possible detrimental aspects for such patients include increased exposure to heroic interventions and possibly poorer care as a result of medical interference with established nursing home team approaches to patient care. As a result of living in a research environment, patients also may be pressured to participate in protocols to which they are not normally exposed. In addition, because many of the geriatric fellowships are based in Veterans Administration facilities (with their predominantly male patient population), it will be important to ensure that current research adequately studies the common problems of elderly women, who represent 70 per cent of those who are in nursing homes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973339 TI - Four cases of "Milwaukee shoulder," with a description of clinical presentation and long-term treatment. PMID- 3973340 TI - Anorexia nervosa in the elderly. PMID- 3973341 TI - Advantages of growing older. PMID- 3973342 TI - Computer graphics: the state of the art. PMID- 3973343 TI - Skin cancer comic book: evaluation of a public educational vehicle. PMID- 3973344 TI - A glossary of computer terminology. PMID- 3973346 TI - The modified McBride bunionectomy utilizing the adductor tendon transfer. AB - A modification of the McBride bunionectomy utilizing the adductor tendon transfer is described. It includes transposition of the adductor hallucis tendon into the medial capsular flap via a pulley suture, and derotation of the sesamoidal apparatus. This is accomplished by torque placed on the medial capsular flap. It is transferred to the medial sesamoid through the tibial sesamoid ligament and then to the fibular sesamoid by the intersesamoidal ligament. The contracted fibular sesamoid ligament is sacrificed. The procedure helps to maintain reduction of an increased intermetatarsal angle, with hypermobile first ray. Another advantage is the ability to perform a concomitant metatarsal neck osteotomy, when necessary. This was not possible in the original McBride bunionectomy in which the adductor tendon was transposed to the head of the first metatarsal through a drill hole. Short-term results have been encouraging. PMID- 3973345 TI - Intravenous digital subtraction angiography and its use in amputation level consideration in the ischemic forefoot. AB - This case report utilizes a recently popularized method of radiologic examination for peripheral vascular disease. In a diabetic foot with osteomyelitis, ischemia, and gangrene we have assessed patent arterial supply in the distal arterial tree. This examination has allowed the authors to accurately predict wound healing potential preoperatively at a specific anatomic level. PMID- 3973347 TI - Tuberculous arthritis: a case study and review of the literature. AB - Tuberculosis of the bones and joints is a rare but treatable disease. This curable condition is frequently overlooked in the differential diagnosis, and often serious cases are not diagnosed until after severe joint destruction has already taken place. The literature on tuberculosis of the bones and joints is reviewed and the incidence, etiology, pathogenesis, diagnosis, and treatment of this condition are discussed. A case history of ankle joint involvement is presented in which antibiotic treatment before clinically significant joint destruction had occurred might have prevented surgery. Tuberculous involvement should thus be considered in any patient with chronic and subacute monoarticular arthritis. PMID- 3973348 TI - Congenital convex pes valgus. AB - Congenital convex pes valgus is a rigid flatfoot deformity that may or may not be symptomatic. The authors describe the anatomical, clinical, and radiographic appearance and various methods of treatment. It may be asymptomatic in children, but early detection is important because delay in reduction can adversely affect results. Failure to diagnose and treat properly may lead to disabling deformity. PMID- 3973349 TI - Reduction of a fracture-dislocation of Lisfranc's joint by endoprosthetic implantation. AB - The medical literature demonstrates numerous documented cases of post-traumatic arthrosis following comminuted fracture-dislocations at the tarsometatarsal joint(s). Conventionally described reductions and methods of fixation, therefore, lend themselves to less than acceptable results. A newly devised, alternative method of approach to this disabling injury was indicated, and is presented by the authors in the hope of preventing the long-term sequelae commonly seen with this type of injury. After open reduction and remodeling of a severely comminuted fracture-dislocation at the second metatarsal-cuneiform articulation, a modified, double-stemmed Swanson Silastic implant was utilized in order to maintain second ray length and attempt prevention of the usual postinjury osseous consequences, i.e., fusion and arthritic changes. The case presented demonstrates that, after her last clinical evaluation 19 months postoperatively, the patient returned to her normal occupation, and at that time her foot was normal in appearance with no sign of traumatic arthritic change. This procedure thus far has proved to be very rewarding to the patient, and the authors believe it should be considered as an alternative approach in patients who present with injuries of this magnitude. PMID- 3973350 TI - Nodular pigmented villonodular tenosynovitis. AB - Pigmented villonodular tenosynovitis is a proliferative disorder of the synovium that can involve the joints, tendon sheaths, and bursae. There are two histologically similar lesions of pigmented villonodular tenosynovitis--nodular pigmented villonodular tenosynovitis and diffuse pigmented villonodular tenosynovitis. The authors present a case involving nodular pigmented villonodular tenosynovitis, which is the more rare form of these two lesions. PMID- 3973351 TI - Leiomyoma of the foot. AB - A case involving a 68-year-old female with a leiomyoma of the heel is presented. Leiomyoma, a benign tumor of smooth muscle origin, is relatively rare in the foot. Pathologic, clinical, and histologic findings are included. PMID- 3973352 TI - Closed wound suction drainage. AB - Closed wound suction drainage may have application to certain podiatric surgical procedures. It can be used to reduce postoperative edema and hematoma formation, decrease the possibility of infection, and minimize the chance of external contamination of the surgical site. Certain conditions that may occur after podiatric surgical procedures and that are detrimental to the healing and rehabilitation of the patient but can be obviated by the use of closed suction drainage are illustrated. Drains should be considered in any podiatric surgical procedure that results in the creation of large voids or causes substantial bleeding as occurs in large resections of bone. Included in this would be any plastic surgical procedures or amputations of the foot. PMID- 3973353 TI - Age-related changes in venous catecholamines basally and during epinephrine infusion in man. AB - Plasma epinephrine (EPI) and norepinephrine (NE) levels were examined among healthy men aged 20 to 25 and 60 to 65 years basally and during EPI infusions. On separate days, 14.3 and 42.9 ng/kg/min EPI was administered intravenously for 45 min. Although there was no age difference in venous EPI levels basally, the old had less increase during the EPI infusions. The plasma metabolic clearance rate of EPI was greater among the old men. Plasma NE levels were elevated among the elderly men, but both age groups had an increase in NE during the EPI 42.9 ng/kg/min infusion rate. During EPI infusions, the old men had less increase in systolic but not diastolic blood pressure or heart rate compared with the young men. The different pattern of change in venous EPI levels and increased metabolic clearance rate of EPI observed among the old men could, in part, explain diminished end-organ responsivity. PMID- 3973355 TI - Effects of age and respiratory efforts on the perception of resistive ventilatory loads. AB - The present study examined the effects of age on the ability to quantitate changes in inspiratory resistive loads using signals related to the size of the load, per se. Magnitude scaling of inspiratory resistive loads was performed in different trials during breathing at small, large, and varied size tidal volumes. Subjects were specifically instructed to scale the magnitude of the airflow resistance. In both young and older adults, the perceived magnitude of a given resistance was the same in the small-, large-, and varied-sized breath trials despite substantial differences in inspiratory duration and peak inspiratory airway pressure. The change in sensation for a given change in resistance, however, was less in the older than in the younger adults. These results indicate that airflow resistance can be scaled independently of the effort used in breathing. The perception of airflow resistance is blunted in elderly adults probably as a result of an impairment in the central nervous system processing of separate signals of pressure and flow. PMID- 3973354 TI - Age-related changes in cardiac muscarinic receptors: decreased ability of the receptor to form a high affinity agonist binding state. AB - Cardiac ventricular muscarinic cholinergic receptors and agonist binding properties were determined in Fischer 344 rats at 3, 12, and 24 months of age. Muscarinic receptors were determined by specific (-)-[3H]quinuclidinyl benzilate (QNB) binding, and the agonist binding properties were determined by competition assays. There were no differences in the concentration of the receptor or the dissociation constant of [3H]QNB binding among the three age groups. In cardiac membranes from 3- and 12-month-old animals, 5'-guanylyl-imidodiphosphate (Gpp(NH)p) increased by 16- to 18-fold (p less than .01) the concentration of carbachol required to inhibit [3H]QNB binding by 50% (IC50). At 24 months, however, Gpp(NH)p induced only a 2.7-fold shift in the carbachol IC50 value (p less than .01). The reduced shift was due to an increase in the carbachol IC50 value determined in the absence of Gpp(NH)p (p less than .01). There was no significant differences among the 3-, 12-, and 24-month-old animals in the half maximal concentration of Gpp(NH)p required to produce the carbachol IC50 shift. The data indicated that with age there is a reduced ability of the muscarinic receptor to form a high affinity agonist binding state. PMID- 3973356 TI - Age-related brain atrophy: a study with computed tomography. AB - Brain atrophy in 176 men and 205 women without neurologic disturbances was studied using x-ray computed tomography. The ages ranged from 21 to 79 years. We measured cerebrospinal fluid (CSF) space volume above the level of the tentorium cerebelli and calculated brain atrophy index (BAI): BAI (%) = (CSF space volume/cranial cavity volume). Both the CSF space volume and BAI decreased from the 20s to the 30s only in men (p less than .001), and both were minimal in the 30s in men and in the 20s in women. Although both the CSF space volume and BAI started to increase in the 40s in both sexes (p less than .001, .002), considerable atrophy of the brain started to occur in the 40s in men and in the 50s in women. Both the CSF space volume and BAI increased exponentially with age after the 30s in both sexes (p less than .001). PMID- 3973357 TI - A system of classifying leisure activities in terms of the psychological benefits of participation reported by older persons. AB - The psychological benefits of 18 commonly chosen leisure activities were investigated using the Paragraphs About Leisure-Form E (PAL-E), which measures the psychological benefits of participation in leisure activities. The data were cluster analyzed using Ward's heirarchical grouping procedure, and a conceptual framework was developed for understanding the psychological benefits derived from participation in leisure activities by persons in the 55 to 75 age range. The data support the conclusions that leisure activities may be grouped into meaningful families or clusters on the basis of their psychological benefits. PMID- 3973358 TI - Effects of aging on sex differences in psychomotor reminiscence and tracking proficiency. AB - The influence of aging on sex differences in psychomotor reminiscence and practice distribution effects was investigated in young (18 to 22 year) and elderly (57 to 86 year) participants within the context of reactive inhibition theory. As predicted by the theory in conjunction with hormonal considerations, aging eliminated the sex differences typically found in young adults, reduced the absolute amount of reminiscence, and diminished the gains in task proficiency arising from practice distribution, progressively so as practice increased. Significant age effects on task proficiency were detectable even within the age span of the elderly adults. PMID- 3973359 TI - Effectiveness of attentional cueing in older and younger adults. AB - It has been proposed that aging selectively affects cognitive processes that are effortful rather than automatic and that active, memory-driven attentional selectivity is impaired in old adults. The present study evaluated attentional selectivity in two groups of healthy adults: a younger group with mean age 19.4 years and an older group with mean age 63.6 years. A visual simple reaction time task was used in which a warning cue appearing at the beginning of each trial indicated the probable location of the target signal. Response times of both groups were shortest when the stimulus appeared at the expected location and longest when it appeared at the unexpected location; responses of both groups were also faster on trials with a 3-s warning interval compared with a 2-s warning interval. These effects of spatial and temporal expectancy were as substantial in older adults as in younger adults. Reasons for the difference between these findings and earlier results are discussed. PMID- 3973360 TI - Prediction and evaluation of memory performance by young and old adults. AB - Does the poorer performance of older people in laboratory tests of episodic memory result from metamemory problems? Memory of 20 young and 20 old adults for 60 "unrelated" paired associates was measured by an associative matching task. Two metamemory measures also were taken: Each pair was rated at the time of study for the likelihood that the person would recall it (prediction measure) and on the matching task each response pairing was judged as to its correctness (response evaluation measure). Young adults were correct on 50% of the associative matches, old only 30%. The two groups did not differ in the predictive metamemory measure: Both were able to predict relative memorability. Old persons, however, underestimated task difficulty (i.e., they overestimated the number of correct associative matches they would make, whereas the young did not). Both groups were quite accurate in the response evaluation measure. PMID- 3973361 TI - Older adults' memory for the color of pictures and words. AB - Young and older adults were presented line drawings or matched words for study that were colored either red, green, yellow, or blue. Half of the research participants were instructed to remember the item and its color (intentional condition), whereas the other half studied only the item (incidental condition). Participants indicated their recognition of items and the color they believed positively recognized items were, regardless of their initial encoding instructions. Data analyses yielded evidence for a decline in color memory in old compared with young adults, particularly with respect to pictures. The color of pictures was generally better remembered than the color of words, particularly in the incidental memory conditions. The discussion suggests the effort required to remember color varies as a function of the stimulus with which it is associated. PMID- 3973362 TI - Memory for self-generated stimuli in young and old adults. AB - Young and elderly adults were required to generate or study synonyms or rhymes of stimulus words. In one experiment, multiple-trial free recall was used to assess possible developmental differences in the generation effect, a 48-hr delayed recognition task was used in the second experiment. There was a significant generation effect for young and old adults on both retention tasks. The effect, however, did not emerge for the elderly participants in free recall until the second or third trial. The implications of utilizing internal stimulus generation as a potent mnemonic device were discussed. PMID- 3973363 TI - Age-related slowing in the retrieval of information from long-term memory. AB - The present experiment investigated adult age differences in the retrieval of information from long-term memory. Each trial required a decision regarding the synonymy of two visually presented words. On the yes-response trials, the two words were either identical, differed only in case, or were synonyms that differed in case. Age differences in absolute decision time were greater for the synonyms than for the other word pairs, but the proportional slowing of decision time exhibited by the older adults was constant across word-pair type. A generalized age-related slowing in the speed of information processing can currently account for age differences in the retrieval of letter-identity and semantic information from long-term memory. PMID- 3973364 TI - Retirement communities and their life stages. AB - A developmental theoretical orientation is used to study age-dense environments for mature adults--retirement communities. By focusing on the community itself, we discovered two basic patterns of life-stage models that describe and explain the formation, development, and maturity stages of communities. Thirty-six communities in four states were visited by the researchers, who interviewed a variety of key insider and outsider informants. Retirement communities are both social and economic units. The development and viability of the community are related to two models based on residential ownership (Type I) versus rental (Type II) of land upon which their dwellings are located. Residents in both types of communities express satisfaction. In Type I, some communities may experience problems in self-government and community formation. In Type II communities, there is sometimes a threat of sale of the community by the owner--an event that is unanticipated by the residents and has profound repercussions. PMID- 3973365 TI - Predicting the retirement intentions and attitudes of professional workers. AB - The purpose of this study was to examine the intentions about and attitudes toward retirement of professional workers, one of the more neglected groups in the retirement literature. Four types of professionals were represented: attorneys, social workers, high school teachers, and college professors. Intentions were defined in terms of projections regarding when respondents planned to retire, consideration of early retirement, and thinking about life after retirement. Attitudes were measured by using a set of three previously developed attitude scales. Six kinds of independent variables were controlled: (a) certain social factors (gender, age, and profession), (b) alienation from work and everyday life, (c) work history, (d) life-long habits of using free time constructively, (e) extensiveness of financial preparation, and plans for second careers and new involvements were the most consistent predictors of both intentions and attitudes. Alienation and certain types of financial preparation were by far the major variables. PMID- 3973366 TI - Consanguinity and kin level: their relative importance to the helping network of older adults. AB - The purpose of this research was to examine the help received by older rural transitional adults from seven levels of consanguineous and affinal kin and to determine the correlates of help received according to kin type. The sample consisted of 321 working class adults, aged 65 to 96 years, selected by a compact cluster sampling procedure. The data showed that kin beyond the child, child-in law levels was of little functional importance in the helping network of older adults. Proximity to kin was the only common denominator of help received across all levels of kin. Results of the study appear to support, in part, the kin selection theory in that helping behaviors were usually based upon degree of consanguinity (and associated marriage tie) and extent of dependency of older adults as measured by their health status or age. PMID- 3973367 TI - Predictors of function among the old-old: a 10-year follow-up. AB - A 10-year follow-up of 297 survivors from a community study of the aged found there was little or no decline in social and economic function and only moderate declines in mental, physical, and activities-of-daily-living function; demographic and socioeconomic characteristics were usually strong predictors of decline in function; and impairment in one type of function often predicted greater decline in other types of function. Mental impairment was an especially strong predictor of social decline, but not vice versa. PMID- 3973369 TI - Pediatric critical care medicine. PMID- 3973368 TI - Power and cost containment in a Danish public hospital. AB - The assumption that hospital decision-making is hierarchical in character underpins the policy formulation process in public as well as pluralist national health care systems. This article's analysis of decision-making in a Danish public hospital reinforces the contrary assertion: that effective authority in acute-care hospitals rests in an amorphous power relationship among the hospital's several occupational groups, in which physicians clearly have the upper hand. After a brief introduction to this Danish hospital, the article develops a detailed portrait of its informal power structure and of the different occupational groups' permanent power-maximizing strategies. Subsequently, the article assesses the impact of these strategies upon two recent efforts to contain the hospital's costs: a decision to close an expensive specialty clinic, and an attempt to shrink the hospital's size by transferring less sick elderly patients to a newly created rehabilitation facility. The study's findings suggest that efforts to impose hospital cost containment by exclusively political means are unlikely to succeed. PMID- 3973371 TI - Maternalism: a sound concept in medicine. PMID- 3973370 TI - Adult respiratory distress syndrome in a pediatric patient. PMID- 3973372 TI - Continuous monitoring of blood gases in the intensive care unit and operating room. Part 2: Invasive monitoring of oxygenation. PMID- 3973374 TI - You'd better bring your own meat sauce. PMID- 3973373 TI - Prophylactic antibiotics in surgery. PMID- 3973375 TI - Marketing and your 4 PR pressure points. PMID- 3973376 TI - Chronic diverticular disease of the colon. PMID- 3973377 TI - Quantitative electron probe x-ray microanalysis and densitometric mass determination of individual rat blood platelets. AB - An improved method for quantitative electron probe X-ray microanalysis of thin biological specimens, introduced recently, has been applied to the elemental analysis of rat blood platelets. The method uses the X-ray signal to quantify the elemental content of an object and electron scattering to determine the total dry mass of the object. Along with the dry mass distribution, data were obtained on the content and mass fraction of calcium, magnesium, and sulfur in 31 individual platelets. The mean platelet dry mass was found to be 985 fg. The mean Ca, Mg, and S contents were 1.80, 3.41, and 18.3 fg, with mean dry mass fractions of 0.195, 0.396, and 1.96%, respectively. Furthermore, these elements appear to be unevenly distributed among the platelet population. PMID- 3973378 TI - Antisera to gamma-aminobutyric acid. I. Production and characterization using a new model system. AB - Antisera to the amino acid gamma-aminobutyric acid (GABA) have been developed with the aim of immunohistochemical visualization of neurons that use it as a neurotransmitter. GABA bound to bovine serum albumin was the immunogen. The reactivities of the sera to GABA and a variety of structurally related compounds were tested by coupling these compounds to nitrocellulose paper activated with polylysine and glutaraldehyde and incubating the paper with the unlabeled antibody enzyme method, thus simulating immunohistochemistry of tissue sections. The antisera did not react with L-glutamate, L-aspartate, D-aspartate, glycine, taurine, L-glutamine, L-lysine, L-threonine, L-alanine, alpha-aminobutyrate, beta aminobutyrate, putrescine, or delta-aminolevulinate. There was cross-reaction with gamma-amino-beta-hydroxybutyrate, 1-10%, and the homologues of GABA: beta alanine, 1-10%, delta-aminovalerate, approximately 10%, and epsilon-amino caproate, approximately 10%. The antisera reacted slightly with the dipeptide gamma-aminobutyrylleucine, but not carnosine or homocarnosine. Immunostaining of GABA was completely abolished by adsorption of the sera to GABA coupled to polyacrylamide beads by glutaraldehyde. The immunohistochemical model is simple, amino acids and peptides are bound in the same way as in aldehyde-fixed tissue and, in contrast to radioimmunoassay, it uses an immunohistochemical detection system. This method has enabled us to define the high specificity of anti-GABA sera and to use them in some novel ways. The model should prove useful in assessing the specificity of other antisera. PMID- 3973380 TI - The virulence of clinical and environmental isolates of Campylobacter jejuni. AB - The virulence of Campylobacter jejuni and C. coli isolated from various water sources was compared with that of clinical strains by in vitro assays of adhesion, invasion and cytotoxicity to HeLa cells. Variation in degree of attachment was observed, but this did not appear to be related to strain source, However, water strains were less invasive and less cytotoxic to HeLa cells than clinical strains as shown by immunofluorescence and electron microscopy. These differences were particularly evident between clinical and water isolates of the same serotype and biotype implicated in an outbreak of campylobacter enteritis in a school. The enhanced virulence of the clinical isolates, possibly induced by passage, was confirmed by colonization tests on infant mice. PMID- 3973379 TI - Studies on staphylococci from toxic shock syndrome in France, 1981-1983. AB - Staphylococci from 22 cases of toxic shock syndrome with onsets between 1981 and March 1983 have been studied. Another four cases were detected by abstract surveillance. Three of these patients died. The case histories show that the syndrome occurs in women during menstruation as well as in males and in children, and is associated with Staphylococcus aureus infections. The production of enterotoxins (A, B, C) and toxic shock toxin by S. aureus isolates from toxic shock syndrome was investigated. Twenty-two of the 23 isolates were found to be toxigenic: 7 produced enterotoxin A, 8 produced enterotoxin B, 3 produced enterotoxin C and 13 produced toxic shock toxin. The latter was found with enterotoxin A in five cases, and with enterotoxins A and B in only one case. Sixty-three percent of 46 S. aureus strains isolated from the vagina of patients with diseases other than toxic shock syndrome produced toxin; eight of these strains produced toxic shock toxin. PMID- 3973381 TI - A one-year survey of campylobacter enteritis and other forms of bacterial diarrhoea in Hong Kong. AB - The following enteropathogens were isolated from the faeces of 769 (10.2%) of 7,545 patients of whom 5,704 had diarrhoea or abdominal pain, attending a teaching hospital in Hong Kong during one year: salmonellae 458 (6.1%); Vibrio parahaemolyticus 125 (1.7%); campylobacters 108 (1.4%); shigellae 83 (1.1%); others 19 (0.3%). Further identification of the campylobacter isolates showed that 63 (58%) were Campylobacter jejuni biotype 1, 44 (41%) were C. coli and only one was C. jejuni biotype 2. Seventy-five (69%) of the 108 campylobacters were isolated from children under two years of age, mostly during the second year of life. Faecal specimens from 1,841 children under the age of two years without gastrointestinal symptoms yielded almost the same percentages of salmonellae, campylobacters and shigellae as children with diarrhoea. Salmonellae, shigellae and vibrios were isolated most often in the hot late summer months (August to October), but, contrary to the pattern in Europe and North America, both C. jejuni and C. coli were most prevalent in the coolest months of the year (January to March). The reasons for this "reversed' trend are unknown. PMID- 3973382 TI - The risk of leptospirosis in United Kingdom fish farm workers. Results from a 1981 serological survey. AB - Less than one per cent of serum samples taken from 257 fish farmers in 1981 had agglutinating antibodies to strains of Leptospira interrogans of serogroup Icterohaemorrhagiae at a titre of 30 or greater. Compared with the results from other serological surveys, this agglutinating antibody prevalence suggests that fish farming does not have a high occupational risk for leptospirosis. Between 1961 and 1981 the incidence in fish farmers was about 33 per 100000 person years at risk. During the same period the incidence in the general adult male population was 0.137 per 100000 person years at risk, so that fish farming had a moderately increased risk of Icterohaemorrhagiae serogroup infection (relative risk = 243). No one particular risk factor within fish farming could be reliably identified and therefore recommendations to reduce the risk can only be general. PMID- 3973383 TI - Antibody response and persistence in volunteers following immunization with varying dosages of a trivalent surface antigen influenza virus vaccine. AB - The serum antibody responses and 50% protective levels (PL50) of antibody were determined, using the SRH test, at one and twelve months post-vaccination in a group of student volunteers immunized with one of three dosages of a trivalent surface-antigen influenza virus vaccine, or with placebo. It was found that, for the H3, H1 and B haemagglutinin components present in the vaccine, a dose of 6 micrograms HA elicited high serum antibody responses at one month post immunization. High mean antibody levels and a high incidence of volunteers with PL50 values of antibody against each of the HA components of the vaccine remained in the volunteer group twelve months later. The results are discussed in relation to the vaccine dosage used and the nature of the population immunized. PMID- 3973385 TI - Relationships between terminal transferase expression, stem cell colonization, and thymic maturation in the avian embryo: studies in thymic chimeras resulting from homospecific and heterospecific grafts. AB - Terminal deoxynucleotidyl transferase (TdT) can be detected in 11- to 12-day-old embryonic chick thymuses 5 to 6 days after the first influx of lymphoid stem cells into the thymic rudiment. To identify the main factors of TdT induction, grafting experiments were devised in such a way that the age of the grafted thymus and that of the host were different. Uncolonized embryonic chick thymuses were grafted into chick hosts of different ages. Under these conditions, lymphoid differentiation arose from host lymphoid stem cells (LSC) invading the thymic rudiment. TdT immunofluorescent detection in the first wave of thymocytes showed that the percentages of TdT+ cells were related to the total age of the explant and not to the age of the host (11 to 17 days). Similar results were obtained when the chick thymic rudiment was transplanted into quail embryos, showing that quail LSC have TdT inducibility similar to that of chick LSC while developing in a chick thymic environment. Colonized chick thymuses were also grafted into quail embryos to compare the TdT inducibility of the first lymphoid generation (of chick type) and of the second (of quail origin), taking advantage of the different chromatin structure of quail and chick cells. In these experiments, the majority of chick cells remained TdT negative for as long as 10 days, whereas most lymphocytes of the second generation became TdT+ soon after their arrival in the grafted thymus. Therefore, during embryonic life, most TdT+ cells were derived from the second wave of stem cells, but some early stem cells were also able to acquire the enzyme. In a final series of experiments, early thymic rudiments were cultured in vitro with 14- to 16-day-old bone marrow and then grafted into 3-day-old host embryos. Under these conditions, bone marrow LSC contributed to a variable proportion of the first generation of thymocytes. The percentage of TdT+ cells among the progeny of these bone marrow stem cells was found to be two times higher than that of thymocytes derived from host LSC. These results suggest that, in addition to intrathymic environmental factors, the origin of LSC influences the frequency of TdT expression in their progeny. PMID- 3973384 TI - Antigenic heterogeneity among influenza A(H3N2) field isolates during an outbreak in 1982/83, estimated by methods of numerical taxonomy. AB - Fourteen influenza A(H3N2) field isolates, mainly obtained during the first weeks of the 1982/83 influenza epidemic in The Netherlands, and nine influenza A(H3N2) reference strains were examined by means of haemagglutination inhibition (HI) tests with 23 polyclonal ferret sera. The resulting HI patterns were subjected to various methods of numerical taxonomy using, among others, taxonomic distance and correlation between strains for resemblance coefficients. Marked differences between distance and correlation coefficients were found in strains which differed in avidity only. The field isolates could be divided into four groups in respect of their taxonomic resemblance to the reference strains. The same grouping was found for five of the field isolates by testing these against 200 human sera. PMID- 3973386 TI - Specificity of oligoclonal IgG bands in sera from chronic relapsing experimental allergic encephalomyelitis guinea pigs. AB - The specificity of oligoclonal IgG in sera from chronic relapsing EAE guinea pigs was determined by using imprint electroimmunofixation. The response of oligoclonal IgG to spinal cord and Mycobacterium tuberculosis appeared to be equal in animals sacrificed during first remission and in those sacrificed after recovery from acute EAE. In contrast, in animals sacrificed during or after the first relapse, the oligoclonal IgG seems to be directed predominantly against spinal cord. In imprint electroimmunofixation, the oligoclonal IgG specific to spinal cord did not react with guinea pig liver and kidney. In addition, activity to spinal cord could be removed from sera by absorption with spinal cord but not with kidney or liver. PMID- 3973387 TI - Role of the main immunogenic region of acetylcholine receptor in myasthenia gravis. An Fab monoclonal antibody protects against antigenic modulation by human sera. AB - Antigenic modulation of acetylcholine receptor (AChR), i.e., acceleration of its internalization and degradation rate by antibody-cross-linking, is considered to be one of the two main causes of AChR loss in myasthenia gravis (MG). The majority of the antibodies to AChR are directed to the main immunogenic region (MIR) on the alpha-subunit of the receptor. We here examine the relative contribution of the anti-MIR antibody fraction (as well as of another fraction) to the antigenic modulation caused by MG patients' sera. Fab fragments of an anti MIR monoclonal antibody (mAb) or a mAb to the beta-subunit (neither of which causes antigenic modulation) were allowed to shield their corresponding regions on the AChR on the mouse muscle cell line BC3H1. The 27 MG sera subsequently added thus bound to all other regions except to the protected one, and the resulting antigenic modulation was measured. The anti-MIR mAb protected the AChR by 68 +/- 16%. This is interpreted as the contribution to antigenic modulation of the anti-MIR antibody fraction in the human sera. This percentage correlated very well with the occurrence of the anti-MIR antibodies in the same sera. The anti beta mAb gave only small protection of the AChR. No significant pattern differences were observed between sexes, early and recent onset of the disease, or high and low antibody titers. It is concluded that as far as it concerns the one of the pathogenic mechanisms in MG, i.e., the antigenic modulation, the MIR seems to be the main pathogenic region. The observation that a single mAb can efficiently protect the AChR in this system may prove to be of therapeutic interest. PMID- 3973388 TI - Demonstration of the interaction of native C1 with monomeric immunoglobulins and C1 inhibitor. AB - The association of native C1 with physiologically relevant proteins was studied by ultracentrifugation. 125I-C1 was centrifuged through numerous sucrose density gradients, each of which contained a different concentration of monomeric (19S) IgM throughout the gradient. The s-rate of C1 (16S) increased with increasing IgM input to a maximum of 32S. In the absence of C1q, the C1r2s2 subunit did not bind to the Ig. In gradients containing physiologic concentrations of IgM (1.3 mg/ml) at 0.14 M ionic strength, the observed s-rate of C1 was 21S. In the presence of 13 mg/ml IgG, C1 sedimented with an s-rate of 19S. Thus, under physiologic conditions, a significant fraction of native C1 is reversibly bound to monomeric Ig. SDS-PAGE analyses show that this interaction does not lead to C1 activation. The interaction of native C1 with C1 inhibitor (C1-In) was studied by ultracentrifugation at physiologic ionic strength. Purified 125I-C1-In alone sedimented with an s-rate of 4S. However in the presence of excess native C1, one third of the C1-In co-sedimented with C1 at a 16S position. For these studies, 100 microM nitrophenylguanidinobenzoate (NPGB) was present throughout the sucrose density gradient to prevent C1 activation during centrifugation. As the concentration of NPGB was increased, the percent of 125I-C1-In at 16S decreased, indicating that C1-In was binding (reversibly) to the C1 active site region(s), which is at least partially accessible in uncleaved C1. In controls, when NPGB was omitted or activated C1 was used, the s-rate of 125I-C1-In was only 12S due to the release of C1rC1s(C1-In)2 from activated C1. Thus, under physiologic conditions native C1 is reversibly bound to C1-In. PMID- 3973389 TI - Genetic deficiency of the alpha-gamma-subunit of the eighth complement component in the rabbit. AB - Genetic deficiency of the alpha-gamma-subunit of the eighth complement component (C8 alpha-gamma) was found in a strain of the New Zealand White rabbit. The serum of this deficient rabbit lacked the immunochemical and functional alpha-gamma subunit of C8. Mating tests indicate that the C8 alpha-gamma deficiency is transmitted as a simple autosomal recessive trait with the following physiologic characteristics. The body weight at the first week of life, mature weight, and litter size of the deficient animals were smaller than those of heterozygous and normal ones. In addition, survival rates for the first 3 mo of life of the deficient animals tended to be lower than those of heterozygous and normal littermates. PMID- 3973390 TI - Growth cycle-dependent generation of complement-resistant Leishmania promastigotes. AB - The ability of in vitro grown Leishmania promastigotes to resist lysis by complement and survive in undiluted human serum was related to the species of Leishmania and the growth phase in culture. Promastigotes from log phase cultures were always killed in undiluted serum, whereas survival of stationary phase promastigotes varied among species. All L. major and L. m. amazonensis were killed, while up to 30% of L.b. panamensis and 10% of L. donovani survived. Lysis of promastigotes by human serum was inhibited in heat-inactivated serum and EDTA chelated serum, indicating that activation of complement was responsible for killing. Therefore, during growth in vitro, some strains of Leishmania promastigotes can undergo development from a complement-susceptible to -resistant stage. Stationary phase promastigotes of L.b. panamensis which survived in undiluted human serum were capable of subsequent growth in culture, and were also able to initiate infection in Mystromys albicaudatus. Organisms selected on the basis of complement resistance were more infective for M. albicaudatus than either log phase promastigotes or unselected promastigotes from stationary cultures. These data support the notion that the life cycle of Leishmania includes an infective stage promastigote which is generated during growth within the sandfly and which, on inoculation, is able to survive the potentially lethal effect of normal serum before uptake by host macrophages. PMID- 3973391 TI - A statistical approach to determine monoclonality after limiting cell plating of a hybridoma clone. AB - One of the standard methods to isolate a hybridoma clone producing a monoclonal antibody requires successive steps of limiting dilution. The probability of obtaining a monoclonal antibody increases with the number of limiting dilution steps. However, without meticulous visual screening monoclonality is hard to prove. Here we describe a statistical analysis, based on Poisson's approximation, which allows one to calculate the number of hybridoma cells at a given plating efficiency so that when seeded a predictable number of mono-, bi-, etc.-clonal cultures are obtained after the first step of limiting cell plating. PMID- 3973392 TI - A simple two-step procedure for the preparation of the first component of human complement (C1) in its native form. AB - Native human C1 was purified from fresh human serum by affinity chromatography on protein A-bound Sepharose in the presence of 4-nitrophenyl-4-guanidinobenzoate hydrochloride (NPGB) taking advantage of the successive binding of IgG to protein A followed by C1 binding to IgG. After elution the C1 preparation contained IgG as a major contaminant as shown by SDS-PAGE. C1 was further purified by gel filtration. The yield of C1 was 12% and less than 4% of this C1 was activated during purification as assessed by a C4 consumption assay. PMID- 3973393 TI - A simple in vitro method of screening panels of monoclonal antibodies for tumor binding. AB - We have developed a simple in vitro method of evaluating the relative binding properties of anti-tumor antibodies to human tumor and normal tissues. Cryopreserved surgical explants of tissues as 1 mm cubes are incubated in microtiter plate wells containing media and radiolabeled antibody. We show that the accumulation of antibody in tumor tissue is a specific process which may be reduced by preincubation with saturating levels of unlabeled specific antibody. Evaluation of 7 anti-breast and 4 anti-colorectal tumor antibodies against their respective tumor tissues showed good reproducibility of repeat measurements and up to a 100-fold difference in accumulation among different antibodies to the same tissue. Equivalent results were obtained with the same tissues employed fresh and after cryopreservation. Because of the simplicity of the assay, panels of antibodies may be screened against the large numbers of tumor and normal tissues required to identify superior antibodies for human trials. PMID- 3973394 TI - A simple technique for evaluation of methods of cell separation. AB - A simple method is described for labelling cells with fluorescein and using them in artificial mixtures to assess cell separation procedures. The method facilitates the examination of the variables in a separation procedure. It is thus possible to tailor a separation procedure (for example panning with monoclonal antibody) to suit the specific requirements of the experiment. PMID- 3973395 TI - Enzyme amplification--a general method applied to provide an immunoassisted assay for placental alkaline phosphatase. AB - A method is described in which enzyme amplification is used for the quantitative determination of placental alkaline phosphatase. In this particular application, placental alkaline phosphatase is captured on a solid surface by means of a monoclonal antibody. The enzyme is then determined by dephosphorylation of NADP to NAD which activates a strictly NAD-dependent redox cycle leading to the formation of a coloured product. PMID- 3973396 TI - Re.: Selective binding of heat- and antigen-aggregated IgG to Blue Sepharose. Radioimmunoassay of circulating immune complexes. PMID- 3973397 TI - An ELISA for the detection of maternal anti-trophoblast antibodies in human pregnancy. AB - An ELISA has been developed which is able to detect antibodies directed against determinants present on the plasma membrane of the outer layer, the syncytiotrophoblast, of term placentae. The IgG and IgM anti-trophoblast antibodies are present in the sera of women during the course of a normal pregnancy. The ELISA was based on the use of syncytiotrophoblast plasma membranes as the antigenic targets and utilised a developing antiserum conjugated to the bacterial enzyme urease. Although the assay was simple and reproducible, its viability was dependent on several factors including the stability of the antibodies and the proper preparative techniques for the production of the plasma membranes. Failure to adhere to the correct procedures resulted in an inferior non-viable assay. PMID- 3973398 TI - Spectroscopic interference of hemoglobin with neutrophil cytochrome b-245 and its elimination by carbon monoxide. AB - A cytochrome b, designated as cytochrome b-245, exists in neutrophils and is probably involved in their stimulated oxidative burst. As a rule, its concentration is spectroscopically measured by the height of its alpha-peak at 558-559 nm (dithionite-reduced minus oxidized). Hemoglobin (Hb), which usually contaminates neutrophils isolated from blood, interferes with the spectroscopic measurement of the cytochrome. Hb contamination from less than 0.4 red blood cells per 100 neutrophils leads to over-estimation of the cytochrome by approximately 50%. This interference can be overcome by bubbling CO through neutrophil homogenates heavily contaminated by Hb, prior to the conventional spectroscopic procedure. The cytochrome B-245 concentration obtained in neutrophils by CO bubbling is 7.2 +/- 1.28 pmoles per 10(6) polymorphonuclear neutrophils. PMID- 3973399 TI - Direct measurement of phagosomal reactive oxygen by luminol-binding microspheres. AB - A new method, utilizing microsphere-bound luminol, which makes possible the direct measurement of highly reactive oxygen within phagosomes, was studied. When Freund's complete adjuvant-elicited mouse peritoneal macrophages and luminol binding microspheres were mixed, the microspheres were engulfed in macrophages and enclosed in phagosomes, where chemiluminescence (CL) was generated, showing the generation of highly reactive oxygen. The reactive oxygen could be quantitatively assayed by measuring the intensity of CL. The addition of cytochalasin B inhibited the CL. CL production by the thioglycollate-elicited macrophages was found to be only a ninth of that by Freund's complete adjuvant elicited macrophages, though the phagocytic activities were almost equivalent in both cases. PMID- 3973400 TI - Detection of circulating immune complexes by PEG precipitation combined with ELISA. AB - An assay to detect circulating immune complexes is described and exemplified with serum from SLE and RA patients. The method is based on selective precipitation of immune complexes with PEG followed by a specific ELISA assay to detect the immunoglobulins present in the precipitate. The immunoglobulins of the precipitate were then monitored by their capacity to bind protein A and dDNA. With the PEG-protein A-ELISA procedure immune complexes were detected in 46% of the sera from SLE patients compared with 68% when using the PEG-DNA-ELISA. PMID- 3973401 TI - Covalent coupling of proteins to erythrocytes by isocyanide. A new, sensitive and mild technique for identification and estimation of antibodies by passive hemagglutination. AB - A mild method for covalent coupling of protein-antigens to the surface of red blood cells (RBC) is described. The method is based on the formation of covalent bonds between aldehyde groups of oxidized RBC and amino or carboxyl groups of proteins in the presence of isocyanide. Very low concentrations of antibodies (8 30 ng/ml) could be detected in antisera with the specifically sensitized RBC as reagents in passive hemagglutination with no or very low non-specific agglutination. PMID- 3973402 TI - Pharmacokinetics of topically applied radiolabeled retinoids in hairless mouse epidermis and dermis after single applications. AB - The retention of tritium-labeled all-trans-retinoic acid (RA), 13-cis-retinoic acid (13-cis-RA), aromatic retinoid, and arotinoid ethyl ester in the epidermis and dermis of hairless mice was measured up to 24 h following a single topical application in an acetone vehicle. The radioactivity in the tissues was extractable with chloroform:methanol, and the identities of the radioactive species extracted were confirmed as retinoids using thin-layer chromatography. All the retinoids were absorbed into the skin rapidly. After an initial period of distribution and penetration (lasting for about 1 h) the amount of the applied retinoid remaining in the epidermis and dermis decreased more slowly, obeying first order (exponential) decay kinetics. Both the arotinoid and the aromatic retinoid persisted for longer in the epidermis than equivalent doses of RA or 13 cis-RA. The half-lives of the retinoids in the dermis tended to be longer than in the epidermis, except for the arotinoid. Aromatic retinoid persisted for longest in the dermis with a half-life of 11 h. PMID- 3973403 TI - Subcutaneous blood flow in psoriasis. AB - The simultaneously recorded disappearance rates of 133Xe from subcutaneous adipose tissue in the crus were studied in 10 patients with psoriasis vulgaris using atraumatic labeling of the tissue in lesional skin (LS) areas and symmetrical, nonlesional skin (NLS) areas. Control experiments were performed bilaterally in 10 younger, healthy subjects. The subcutaneous washout rate constant was significantly higher in LS, 0.79 +/- 0.05 min-1 X 10(2) compared to the washout rate constant of NLS, 0.56 +/- 0.07 min-1. 10(2) (p less than 0.05), or the washout rate constant in the normal subjects, 0.46 +/- 0.17 min-1 X 10(2) (p less than 0.01). The mean washout rate constant in NLS was 25% higher than the mean washout rate constant in the normal subjects. The difference was, however, not statistically significant. Differences in the washout rate constants might be due to abnormal subcutaneous tissue-to-blood partition (lambda) in the LS--and therefore not reflecting the real differences in the subcutaneous blood flow (SBF). The lambda for 133Xe was therefore measured--using a double isotope washout method (133Xe and [131I]antipyrine)--in symmetrical sites of the lateral crus in LS and NLS of 10 patients with psoriasis vulgaris and in 10 legs of normal subjects. In LS the lambda was 4.52 +/- 1.67 ml/g, which was not statistically different from that of NLS, 5.25 +/- 2.19 ml/g (p less than 0.05), nor from that of normal subcutaneous tissue, 4.98 +/- 1.04 ml/g (p less than 0.05). Calculations of the SBF using the obtained lambda values gave a significantly higher SBF in LS, 3.57 +/- 0.23 ml/100 g/min, compared to SBF in the NLS, 2.94 +/- 0.37 ml/100 g/min (p less than 0.05). There was no statistically significant difference between SBF in NLS and SBF in the normal subjects. The increased SBF in LS of psoriatics might be a secondary phenomenon to an increased heat loss in the lesional skin. PMID- 3973404 TI - Characterization of adenosine deaminase from normal human epidermis and squamous cell carcinoma of the skin. AB - We compared the characteristics of adenosine deaminases (ADs) (E.C. 3.5.4.4.) in squamous cell carcinoma and normal human epidermis. Increased specific activity (per mg protein) of AD was observed in squamous cell carcinoma compared with that of the normal epidermis. In normal human epidermis most of the AD existed as a large form (Mr 300,000-350,000, type A). Squamous cell carcinoma of the skin was characterized by a high proportion of small-form (Mr 30,000-40,000, type C) AD. The proportion of the small-form enzyme varied from tumor to tumor. Comparison of the large-form AD from squamous cell carcinoma to that from normal epidermis revealed that both enzymes were similar in relative substrate specificity, Km values for adenosine, pH optima, heat stability pattern, isoelectric point, and sensitivity to inhibition by coformycin, a tight binding inhibitor of AD. However, the low molecular weight of AD from squamous cell carcinoma was less heat stable than that from the large-molecular-weight form. Increased AD activity and the high proportion of the small form of AD might be significant features of squamous cell carcinoma of the skin. PMID- 3973405 TI - Antimicrobial agents and Clostridium difficile in acute enteric disease: epidemiological data from Sweden, 1980-1982. AB - The carrier rate of Clostridium difficile in an adult Swedish population was found to be 11 (1.9%) of 594. All isolates were toxigenic in vitro, but no healthy individual harbored free cytotoxin in stool. Of 398 patients with acute diarrhea not associated with antibiotic use, cytotoxin was found in stool filtrates of four (1%). In 4,793 patients with antibiotic-associated diarrhea from all parts of Sweden during 1980-1982, C. difficile cytotoxin was demonstrated in 873 (18%). The tissue culture assay was found to be more specific than cultivation for the bacterium. By weighted analysis, in the age group greater than 70 years more women than men were infected. In the age group 21-50 years there was an even greater preponderance of infection in women than in men. Cephalosporins and lincosamides were 10-70 times more often implicated in C. difficile colitis than were narrow-spectrum penicillins. PMID- 3973406 TI - Effects of ampicillin and corticosteroids on brain water content, cerebrospinal fluid pressure, and cerebrospinal fluid lactate levels in experimental pneumococcal meningitis. AB - A study was made of the effects of antibiotics and corticosteroids on parameters that reflect brain dysfunction and potential neurological damage in experimental pneumococcal meningitis in rabbits. Brain water content was 398 +/- 10 g/100 g dry weight in normal rabbits and 410 +/- 11 g in rabbits after 24 hr of infection (P less than .001). Cerebrospinal fluid (CSF) lactate levels increased from 16.3 +/- 3.4 mg/dl to 69.5 +/- 28.2 mg/dl (P less than .001), and CSF pressure increased by +8.3 +/- 3.6 mm Hg (P less than .005) over the same interval. Antibiotic therapy with ampicillin sterilized CSF and normalized CSF pressure and brain water content in all animals within 24 hr, while CSF lactate levels remained elevated. Administration of methyl prednisolone, 30 mg/kg, or dexamethasone, 1 mg/kg, 15 and 22 hr after infection completely reversed the development of brain edema, but only dexamethasone also significantly reduced the increase in CSF lactate level (43.8 +/- 12.3 mg/dl) and CSF pressure (+1.8 +/- 2.7 mm Hg). Methyl prednisolone did not significantly affect pressure or lactate levels. PMID- 3973407 TI - The relative role of bacterial cell wall and capsule in the induction of inflammation in pneumococcal meningitis. AB - The relative contribution of bacterial components to the induction of inflammation during Streptococcus pneumoniae meningitis is unknown. Several strains of pneumococci with differences in cell surface characteristics (capsule or cell wall) were compared for the effect on the inflammatory response evoked during infection of the cerebrospinal fluid (CSF) in vivo. The presence of bacterial capsular polysaccharide was not necessary for bacterial growth in CSF in vivo but correlated with greater CSF bacterial density. CSF inflammatory changes began to appear when the bacterial concentration exceeded 10(5) cfu/ml, regardless of the pneumococcal strain. CSF inflammatory changes could be invoked by cisternal instillation of 10(5)-10(6) cell equivalents of whole, heat-killed unencapsulated strains or their isolated cell walls but not by similar concentrations of heat-killed encapsulated strains or isolated capsular polysaccharide. Hypoglycorrhachia was observed only during inflammation caused by live bacteria. The inflammatory response characteristic of naturally acquired pneumococcal meningitis can be reproduced by challenge with both encapsulated and uncapsulated bacteria. The bacterial cell wall appears to be the most potent pneumococcal surface component in inducing CSF inflammation. PMID- 3973409 TI - Phagocytic and fungicidal activity of monocytes from patients with acquired immunodeficiency syndrome. PMID- 3973408 TI - Visceral botryomycosis caused by Neisseria mucosa in a patient with chronic granulomatous disease. PMID- 3973410 TI - Disseminated cryptococcosis with muscular involvement. PMID- 3973411 TI - Rotaviruses and immunobiological failures. PMID- 3973412 TI - Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. AB - Yupik Eskimos of southwestern Alaska have the highest known prevalence of hepatitis B virus infection of any general population in the United States. Prospective serological surveys of 1,280 seronegative Yupik Eskimos, performed between 1971 and 1976, identified 189 (14.8%) who developed serological evidence of hepatitis B virus infection. Twenty-six (13.8%) developed clinical hepatitis during the interval when seroconversion occurred. The proportion of patients with clinically apparent hepatitis increased with age (P less than .01), ranging from 9.5% of infections in patients who were four years of age or less to 33.3% of infections in patients who were 30 years of age or older. Twenty-five (13.3%) of the 188 individuals who were studied became chronic carriers of hepatitis B surface antigen. The risk of becoming a carrier was inversely related to the age of the patient at the time of infection (P = .02). Among patients who were four years of age or less when infected, 28.8% became chronic carriers of hepatitis B, as compared with 7.7% of those who were 30 years of age or older. PMID- 3973413 TI - Hepatitis B virus DNA in Dane particles: evidence for the presence of replicative intermediates. AB - Half the Dane particle concentrates isolated from 84 serum samples of patients infected with hepatitis B virus (HBV) contained more than one HBV DNA species. At most, six HBV DNA molecules migrated on hybridization blots. The fastest migrating species was single minus-strand DNA, and the five slower species all were double-stranded relaxed circular DNA. One of the latter forms corresponded to the full-length HBV genome; the four others contained shorter plus strands of different lengths and might represent replicative intermediates. These results indicate that the replicative forms of HBV previously found in infected liver cells might be coated and exported as early as the step of single minus-strand synthesis. PMID- 3973414 TI - Persistent rubella virus infection of human synovial cells cultured in vitro. AB - Primary and passaged human synovial cell cultures inoculated with wild-type and vaccine strains of rubella virus were incubated at 32 C and 37 C. At 32 C, the temperature close to that in human peripheral joints, infection persisted with extracellular virus titers of approximately 10(4) fluorescent focus-forming units/ml. Extracellular titers at 37 C first stabilized at one-tenth the level of the titers at 32 C and then declined after 20 days to undetectable levels. Cellular expression of viral antigen rose at 32 C and fell at 37 C. Infection was noncytocidal at all stages. Virus yields reflected the temperature in the subsequent incubation rather than during virus adsorption. Interferon was found only in cultures held at 37 C and was mainly alpha with a minor beta fraction, a result suggesting retention of functional characteristics of the type A macrophage-like synovial cell. We conclude that persistent infection of synovial tissue in vivo is a feasible explanation for the presence of rubella virus in peripheral joints of patients with chronic arthritis. PMID- 3973415 TI - Induction of increased antibody responses to pneumococcal type 19F polysaccharide by Klebsiella polysaccharide. AB - The level of antibody to pneumococcal 19F polysaccharide (PS) was studied in the serum of mice inoculated with klebsiella K2 PS or pneumococcal 19F PS or both. The serum antibody levels and the IgM plaque-forming-cell (PFC) response after immunization were higher in mice given both K2 PS and 19F PS than in mice of a control group given 19F PS alone. This immune response was also higher than the sum of PFC production in mice given 19F PS or K2 PS separately. Thus, K2 PS produced the cross-reactive antibody to 19F PS and also enhanced the magnitude of the antibody response to 19F PS. This response appeared to be specific for the 19F PS. The resulting high levels of antibody to pneumococcal 19F persisted for eight weeks after the administration of K2 PS and 19F PS. Animals immunized with both type 3 PS and K2 PS did not show an increased antibody response to pneumococcal type 3 PS. Klebsiella K-O3 antigen also stimulated the immune response to 19F PS. Higher immunologic responses to 19F PS were also induced in nude mice injected with the cross-reacting K2 PS or K47 PS and 19F PS. The ability to stimulate an antibody response to 19F PS by administering both K2 PS and 19F PS could not be transferred with spleen cells obtained from mice given both K2 PS and 19F PS. PMID- 3973416 TI - Antileishmanial activity of human red blood cells containing formycin A. AB - Formycin B is the most active antileishmanial agent in vitro because it is metabolized by the parasites to formycin A phosphates. The in vivo use of formycin B may be limited by its toxicity to humans due to the slight similar metabolism of the drug in human cells. The obligatory intramacrophage localization of Leishmania in man suggests that encapsulation of drugs within macrophage-directed carriers, such as human red blood cells (RBCs), might enhance the therapeutic-toxic ratio. Since uncharged formycin B would be poorly metabolized by the RBC and would diffuse from the carrier, RBCs were incubated with formycin A so that approximately 90% of the formycin A was taken up by the cells, phosphorylated by RBC enzymes to charged formycin A triphosphate, and retained in the cells. In vitro, 81% of Leishmania-infected macrophages phagocytized IgG-coated RBCs containing this active form of formycin B, and multiplication of organisms within macrophages could be suppressed by approximately 80%. The 50% effective dose of the formycin A-RBC formulation was 0.02 microM, whereas the 50% effective dose of unencapsulated drug was 0.84 microM. This report of in vitro activity of human RBCs containing formycin A and coated with IgG indicates that this formulation should be tested for antileishmanial activity in vivo. PMID- 3973417 TI - Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer: a preliminary study. AB - Twelve patients with hematologic malignancies complicated by fungal infections were treated with liposomal amphotericin B (L-AmpB). Nine patients were granulocytopenic; the three additional patients with normal granulocyte counts were immunosuppressed. All patients had biopsy findings or cultural evidence of the progression of their fungal infection while being treated with conventional amphotericin B. Doses of 0.8-1.0 mg/kg of L-AmpB were administered intravenously every 24-72 hr. Three patients had a complete remission, five had a partial remission, and four showed no improvements. A total of 161 doses of L-AmpB were administered. Fever and chills occurred on seven occasions. No hematologic or blood chemistry abnormalities related to L-AmpB treatment were observed. PMID- 3973418 TI - Stereoisomeric configuration of arabinitol in serum, urine, and tissues in invasive candidiasis. AB - Because routine analytical methods cannot differentiate D- from L-arabinitol, a combined microbiological and gas chromatographic method was developed to study the stereoisomeric configuration of the arabinitol in humans and rats with invasive candidiasis. D-Arabinitol was defined as the difference between arabinitol concentrations measured with and without incubation with 5.0 X 10(5) blastospores of Candida tropicalis strain CT 12 at 37 C for 24 hr. The yeast consumed at least 95% of the D-arabinitol and none of the L-arabinitol added to normal serum and urine. D-Arabinitol as a fraction of D,L-arabinitol was 0.43 +/- 0.15 (mean +/- SD) in the urine of 10 normal humans, 0.82 +/- 0.12 in the serum or urine of five patients with cancer and invasive candidiasis (P less than .001), and 1.0 in the kidneys of rats with candidiasis. Because most or all of the excess arabinitol in body fluids or tissues in candidiasis was the D isomer, which is produced by fungal metabolism, stereospecific quantitation of arabinitol should improve the sensitivity of this approach to diagnosis of candidiasis. PMID- 3973419 TI - H-2 complex-linked resistance in murine toxoplasmosis. PMID- 3973420 TI - Appearance in patients' sera of antibodies against purified antigen of Campylobacter jejuni and its relation to the bacterium-excreting period. PMID- 3973421 TI - The prevalence of Campylobacter jejuni in random-source cats used in biomedical research. PMID- 3973422 TI - Resistance to challenge with influenza A/Hong Kong/123/77 (H1N1) wild-type virus induced by live attenuated A/Hong Kong/123/77 (H1N1) cold-adapted reassortant virus. PMID- 3973423 TI - Interferon treatment of poliomyelitis. PMID- 3973424 TI - Type-specific antibody responses of volunteers immunized with 23-valent pneumococcal polysaccharide vaccine. PMID- 3973425 TI - Enzyme-linked immunosorbent assay (ELISA) for the diagnosis of visceral leishmaniasis in Kenya. PMID- 3973426 TI - Expression of tumor-associated surface membrane antigens on marrow CFU-s, CFC-gm, BFU-e, and brain CFU-s. AB - Antiserum raised against a mouse mast cell line (FMP1) reacts with 90% to 100% of spleen colony-forming units (CFU-s), granulocyte/macrophage colony-forming cells (CFC-gm), erythroid burst-forming units (BFU-e), and 15% of nucleated marrow cells, using a complement-dependent cytotoxicity assay. We demonstrated that bone marrow, spleen, or thymus cells are able to absorb this activity from the antiserum. Although mouse brain cells have low reactivity with anti-FMP1 serum, the cytolysis level was reduced to background when antiserum was absorbed with brain cells. In addition, colony formation by marrow CFU-s, CFC-gm, and BFU-e was no longer prevented when the cells were incubated with brain-absorbed anti-FMP1 serum and complement. These findings suggest the presence of brain-associated antigens on CFU-s, CFC-gm, and BFU-e. To test whether a CFU-s accessory cell population in marrow is affected by treatment with anti-FMP1 serum and complement, antibody-treated marrow cells were mixed with large numbers of thymocytes and injected into recipient mice. Colony formation was not altered, indicating that the antiserum reacted directly with antigens on CFU-s and not on CFU-s accessory cells. PMID- 3973427 TI - Benign mediastinal teratoma with immature elements exhibited clonal growth and motility in the human tumor clonogenic assay. AB - The human tumor clonogenic assay has been used to study the growth and drug sensitivity of a wide variety of malignant and a limited number of benign tumors. We conducted detailed studies on a multipotential benign teratoma from a young child that gave rise to colonies in soft agar culture. The colonies separated themselves from the surrounding agar and exhibited rapid rotary movement (15 r/min). Morphologic, ultrastructural, and immunologic studies showed the colonies to be comprised exclusively of ciliated respiratory epithelium. The uniform beating of the cilia resulted in a constant rolling motion of the colonies in a single direction. PMID- 3973428 TI - [Acting point of placental coagulation inhibitor]. AB - In the previous paper, the methods of purification of placental coagulation inhibitor (PCI) were reported. This paper deals with the acting point of the PCI on the coagulation process. Prothrombin time, activated partial thromboplastin time, Russell's viper venom time, and recalcification time were all prolonged by PCI. Neither thrombin time nor Echis carinatus venom time was affected by PCI. Factors XII, XI, X, IX, VIII, VII and V were not inactivated by the incubation with PCI. PCI had no activities of fibrinolysis, antifibrinolysis and protein Ca. In the intrinsic pathways, activity of phospholipid seemed to be inhibited by PCI. The tissue thromboplastin activity was completely inactivated by incubation with PCI. PMID- 3973429 TI - [Suture material in vaginal hysterectomy]. AB - In order to find the best suture material to use for vaginal hysterectomies, we examined the tensile strength, stretchability and contractibilty of suture materials such as silk, chromic and plain catgut, and dexon under both wet and dry conditions. We also observed the incidence of postoperative hemorrhage, granulation and healing of the vaginal stump. Under dry conditions, the tensile strength, stretchability and contractibility was greatest in No. 3 plain catgut. (plain catgut greater than chromic catgut greater than dexon or silk) Under wet conditions, the tensile strength was not so changed, but the stretchability of catgut and silk was increased and that of dexon was low and unchanged. The contractibility of all types of suture material was increased. Silk had low tensile strength, was not absorbable and became an infectious foreign body. Dexon had low stretchability and tended to result in postoperative hemorrhage. Chromic catgut was frequently found to cause infectious granulation and postoperative hemorrhage in the vaginal stump. Plain catgut was easily absorbed and had the greatest tensile strength and stretchability. Plain catgut was considered to be the most suitable suture material for vaginal hysterectomy. PMID- 3973430 TI - HLA antigens-antibodies system and its association with severe toxemia of pregnancy. AB - HLA antigens and antibodies were investigated in order to study the relationship between severe toxemia of pregnancy (toxemia) and the HLA system, which is in a close relationship with the immune response. The frequencies of 8 HLA-A antigens, 21 HLA-B antigens, 10 HLA-DR antigens and 4 HLA-MT antigens were determined in 21 patients with toxemia and their husbands and some of their children, 45 fertile couples without a history of abnormal pregnancy and 206 healthy adult controls (DR were in 106 controls). Sera from toxemias and normal pregnant women in the 3rd. trimester and postpartum intra-uterine blood in women with normal deliveries were tested for Warm-T and Warm-B cell antibody against 30 panel lymphocytes. Results obtained were as follows: In toxemic couples there is a much higher incidence of HLA-DR and MT sharing between wives and husbands, mothers and children. In those sera with toxemias, there is a higher incidence of Warm-T antibody and a lower incidence of Warm-B antibody compared with those with a normal pregnancy. From the immunogenetic point of view, when the HLA-DR X MT locus of a certain fetus is homozygous, the mother tends to manifest toxemia. These results indicated that matching of HLA-DR X MT loci in parents possibly plays a role in causing severe toxemia, and genetic prediction of its onset and prognosis can be carried out through HLA typing. PMID- 3973431 TI - The uptake of [3H]estradiol by mouse preimplantation embryos in vitro. AB - Mouse blastocysts collected on day 4 were cultured for 20 hours in media containing various concentrations of [3H]estradiol with/without 10(-6) M unlabelled estradiol. There was a significant reduction in the radioactivity of embryos cultured at 4 degrees C compared with that of embryos cultured at 37 degrees C. The radioactivity of embryos kept in the washing solution after washing was slight lower but showed no significant difference when it was compared with that of embryos not kept in this way. There was no significant difference between the radioactivity of embryos cultured in 2 X 10(-8) M [3H]estradiol and that of embryos cultured in 2 X 10(-8)M [3H]estradiol plus 10( 6)M non-labelled estradiol. Furthermore the radioactivity of embryos incubated in 2.5 X 10(-8)M [3H]estradiol is more than twice that of embryos incubated in 10( 8)M [3H]estradiol. These results demonstrate that preimplantation mouse embryos are capable of uptake and retaining of estrogen and that the mechanism of uptake is neither selective nor receptor mediated. PMID- 3973432 TI - Type and screen system for elective surgery in obstetrics and gynecology. AB - In June, 1983, a preoperative blood ordering policy of "type and screen" was introduced in our department for elective surgery. Using this system, sera are preoperatively tested for unexpected antibodies and ABO/Rh typing is done. If the antibody screen result is negative, crossmatching is not done preoperatively. This paper reports our experience with the type and screen system in obstetrical and gynecological practice, and documents its safety, usefulness and efficiency. By adopting this system, the overall ratio of crossmatch to transfusion (C/T) declined from 8.96 to 1.84. There were 3 patients in this series of 80 (3.75%) with a positive antibody screen result. No untoward reactions were observed following transfusion. Based on these results, the type and screen system for preoperative blood ordering is recommended for most of routine obstetrical and gynecological procedures. PMID- 3973433 TI - [The responses of isolated uterine arteries from pregnant sows to vasoconstrictive agents]. AB - Isometric contractions of isolated uterine arteries, mesenteric arteries and the thoracic aortae of nonpregnant and pregnant sows were measured in a modified Krebs-Henseleit solution in order to investigate the characteristics of the uterine artery responsiveness to vasopressor substances during pregnancy. Contractile response (delta T) of the uterine artery from pregnant sow to angiotensin II(A II) was significantly smaller than that from nonpregnant animal. On the other hand, delta T of uterine artery from pregnant sow to norepinephrine (NE) was greater than that from nonpregnant animal. NE-induced delta T of preparations from both pregnant and nonpregnant sow were suppressed nearly to the same level following the treatment of phentolamine, or verapamil in the incubation medium of 2.5mM Ca2+. In the Ca2+-free (EDTA 1mM) incubation medium, the responses decreased to the minimum degree. These results imply that conspicuous refractoriness of the uterine artery to A II during pregnancy is due to the changes in the characteristics of the uterine vascular wall, and the enhanced responsiveness to NE of the uterine artery may be due to the increased sensitivity in alpha-adrenergic receptor on the vasculature with the increase in Ca ion influx. PMID- 3973434 TI - [Assessment of uterine contraction with special reference to the management of threatened preterm labor]. PMID- 3973435 TI - [Chemotherapy of cervical tuberculosis--a case report]. PMID- 3973436 TI - [Ammonia metabolism of liver of the fetus induced experimental IUGR in rats--in respect of the enzymes in pyrimidin biosynthesis and urea cycle system]. AB - Experimental intrauterine growth retarded fetuses (IUGR) were produced in rats. A cesarean section was performed on the 20th day of pregnancy. The enzymes and intermediate metabolite of pyrimidine biosynthesis (de novo pathway) and ammonia metabolism were studied in the fetal rat liver of IUGR and control group. The level of activity of carbamyl phosphate synthetase I(CPS I) in IUGR's liver was significantly lower than that of the control group. The activities of carbamyl phosphate synthetase II(CPS II) and aspartate transcarbamylase (ATC) in IUGR's liver were significantly higher than those of the control group. The content of orotate in IUGR's liver was significantly lower than that of control group, though the activities of CPS II and ATC were increased. PMID- 3973437 TI - [Treatment of stage I and II ovarian cancer (interim report of intraperitoneal chemotherapeutic perfusion and postoperative prophylactic intracavitary irradiation)]. AB - 74 cases of primary ovarian cancer treated here previously were classified into three groups, no residual (corresponding to Stage Ia, Ib), cell residual (Ic-IIc) and mass residual (III, IV), and prognoses were compared. The 5 year survival rates were 83.3%, 29.4% and 12.6% respectively. In Stage I and II cases, almost all of the tumor mass would be removed by operation. Therefore the target of postoperative treatment should be the residual cancer as cell units spread widely throughout the abdominal cavity. For this purpose, IPCP has been performed on 35 cases of Stage I and II since 1977. The 3 year survival rate for this series is as good as 88.6%, and the sites of recurrence were localized in the small pelvic cavity adjacent to the Douglas pouch in 5 out of 6 relapsed cases. This fact suggests that IPCP is capable of controlling the cancer cells in the upper abdominal cavity, but still insufficient to control them in the pelvic cavity where deeper invasion is suspected. In order to improve the local control ability, utilization of the uterus as the applicator for prophylactic intracavitary irradiation came to be considered. The spread of cancer to the uterus was found in 5 out of 38 cases in Stage I and II(13.2%), but silent invasion was found in only one case. These results suggests that the utilization of the uterus as the applicator for prophylactic intracavitary irradiation would be feasible if no macroscopical cancer extention to the uterus exists and the uterus is suitable for application. Several combinations with Tandem and Ovoid have been tested and an adequate method has been proposed. PMID- 3973438 TI - [The short-term variability index from abdominal fetal electrocardiogram]. AB - Fetal heart rate monitoring was carried out on 37 patients between 34 and 42 weeks gestation, in 21 patients with direct fetal electrocardiogram (dFECG), and in 16 patients with abdominal fetal electrocardiogram (aFECG). The mean of the absolute beat by beat differences (MABB) and the percentage of beat by beat differences below 1 millisecond (1 msec%) and below 2 milliseconds (2 msec%) were measured from true fetal R-R intervals by a computerized technique. With dFECG, a significant inverse correlation was found between the MABB and the 1 msec% or the 2 msec%. The standard deviation of fetal R-R intervals as the LTV index showed a higher correlation to the MABB than to the 1 msec% or the 2 msec%. These results were similar to those with aFECG. In addition, with aFECG, the effect of fetal rest and activity on the MABB was significant, but the 1 msec% and the 2 msec% were not altered with periods of fetal rest and activity. The influence of the artifact in aFECG signals on the 1 msec% and the 2 msec% was less than on the MABB. The 1 msec% and the 2 msec% were reliable indices of the STV assessment from aFECG. PMID- 3973439 TI - [Intrauterine treatment of nonimmunologic hydrops fetalis associated with pleural effusion]. AB - Four fetuses with nonimmunologic hydrops fetalis were treated in utero. The initial diagnosis was made between 27 and 32 weeks of gestation. All fetuses had generalized edema and pleural effusion at the time of diagnosis. In order to maintain plasma colloid osmotic pressure in the fetus, fetal transfusion of albumin was carried out. Because pleural effusion may inhibit fetal lung development, serial in utero thoracocentesis guided by ultrasonic tomography was carried out. In three of four fetuses, cord blood albumin concentration were within normal range. Urine volume in fetuses significantly increased after fetal transfusion of albumin. These results suggested that this procedure was useful in maintaining plasma colloid osmotic pressure in the fetus. Although pleural effusion was removed completely by in utero thoracocentesis, pleural effusion appeared within 1 hour after the procedure and rapidly increased thereafter until the 24th hour. There were no fatal trauma from the procedure. In all infants, generalized edema, ascites and pleural effusion were presented at birth, and Apgar scores at one minute were less than 7. All died of pulmonary insufficiency within 16 hours after delivery. At autopsy, their lungs were smaller than those of the other infants. PMID- 3973440 TI - [Experimental studies on the mechanism of implantation observed from PGF levels]. AB - We have studied the synthesis and release of prostaglandin F by the rabbit blastocyst and endometrium coitum 144 hrs (day 6), 168 hrs (day 7) using RIA and a conversion experiment. The results obtained were as follows: Content of PGF in the blastocyst increased significantly (p less than 0.01) from day 6 to day 7. There was no significant difference in the content of PGF in the endometrium between the day 6 pregnant group, day 6 pseudopregnant group, day 7 pregnant non implantation sites and day 7 pseudo-pregnant group. The value was significantly higher (p less than 0.05) on day 7 implantation sites compared to the others. A surge-like increase in PGF was observed in one hour incubation of day 6 blastocyst. On the other hand, an abrupt increase was observed after 3 hour incubation of day 6 pregnant endometrium. It was strongly suggested that day 6 blastocyst can convert 14C-arachidonic acid to PGF2 alpha in vitro. These results suggest that both the endometrium and the blastocyst are the sources of PGs involved in the process of implantation and that PGF emanating from blastocyst may play an important role in the beginning of implantation. PMID- 3973441 TI - [Granulosa-cell growth factor in oocyte and its transport systems]. AB - The possible existence of granulosa-cell growth factor (GGF) in the oocyte has been investigated using the labelling index (LI) with 3H-Thymidine and the mitotic index (MI) of granulosa cells (G-cells) in mice. The following results were obtained. In preantral follicles the LI increased with the development of the oocyte until its diameter reached the maximum (approximately 90 mu). In preantral follicles with the oocyte diameter below 69 mu, the LI was low and the follicular diameter was small. As the oocyte developed, the LI increased and reached the maximum value when the follicular diameter was approximately 200 mu. Then it decreased a little but maintained a high value. The antrum formation was seen when the follicular diameter was about 300 mu showing no change in LI. In preantral follicles with the oocyte diameter over 80 mu the G-cell near the oocyte had a much higher LI than the distant one. After the antrum formation, the LI and MI of cumulus layers adjacent to the oocyte were three times as great as those of the mural layers. Among the mural cell layers in the antral follicle the layer adjacent to the antrum showed remarkably high LI in comparison with the distant layers. These results suggest that GGF which seems to play a role in the formation of cumulus is secreted with the development of the oocyte. The GGF is transported through two systems the preantral follicle and cumulus layer through the G-cell gap junction and mural layers through the follicular fluid. PMID- 3973442 TI - [Differential responses of tumor and normal skin tissue to low dose rate radiations]. AB - HeLa S-3 cells in nude mice and the parabasal and basal cells of nude mouse skins were exposed to graded dose rates (37 or 55 rad/hour and 200 rad/minute) and doses of radiation and analyzed in terms of their cell cycle distribution using flow microfluorimetry. Standard procedures were HeLa cells, and the parabasal and basal cells were harvested from the skin using dispase and trypsin. In the case of the tumor cells, in vivo, 37 rad/hour proved to be the most effective in producing G2/M accumulation, which is the sensitive phase of the cell cycle. The same dose rate proved to be the most efficient in producing G2/M accumulation in the parabasal and basal cells of the skin, but sensitivity to this effect of radiation was far less than in the tumor. This differential sensitivity of normal and malignant cells to chronic radiation-induced accumulation in a radiosensitive phase of the cells might play an important role in increasing the therapeutic ratio. PMID- 3973443 TI - [Effects of the addition of serum albumin on penetration of human spermatozoa into zona-free hamster eggs]. AB - Since Yanagimachi et al. (1976) suggested that human spermatozoa were capable of penetrating into zona-free hamster eggs, this in vitro assay has been used to analyse the fertilizing ability of human spermatozoa. Serum albumin is an important constituent of the medium used for the assay. However, a great variation in the rate of sperm penetration was observed in the use of different albumin preparations at different concentrations. Therefore we examined the effects of three different kinds of albumin preparations on the rate of human sperm penetration into zona-free hamster eggs. The results obtained were as follows. The percentages of eggs being penetrated by spermatozoa from three fertile donors A,B, and C, were assessed. When Fraction V, Globulin Free and Fatty Acid Free albumin preparations were tested at a concentration of 3.5% (W/V) by the assay using sperm from donor A, penetration rates were 13.3%, 97.4%, and 8.7% respectively. Dilution of the albumin concentration to 0.3% considerably changed the penetration rates to 64.4%, 78.8% and 12.1% in that order. In cases B and C, penetration rates showed the same tendency as in case A. alpha 1 and alpha 2 globulin fractions contaminated in the Fraction V preparation possibly inhibit the human sperm penetration into zona-free hamster eggs. An appropriate quantity of fatty acid is necessary for human spermatozoa to penetrate into zona-free hamster eggs, because penetration rates were low in the percentage of Fatty Acid Free albumin regardless of the concentration added. It is concluded that use of the same preparation of good quality is mandatory for human sperm penetration tests using zona-free hamster eggs to evaluate the results with reproducibility and accuracy. PMID- 3973444 TI - [Studies on L-glutamate transport mechanism in human placental trophoblast microvilli membrane vesicles]. AB - The uptake of L-glutamate in brush border (microvilli) vesicles prepared from human term placenta was studied using the rapid filtration technique. The uptake of L-glutamate into the vesicles occurred osmotically, and preincubation with L glutamate increased the uptake of amino acid. These findings indicate that the uptake of L-glutamate by placental trophoblast brush border membranes represents the transport into membrane vesicles. A Na+ electrochemical gradient (extravesicular greater than intravesicular) stimulated the initial rate of L glutamate uptake about three times. The initial rate of transport exhibited saturation kinetics with respect to the L-glutamate concentration; an apparent Km of 0.15 mM and V max of 70 pmol/mg protein in 20 seconds were calculated. The uptake of L-glutamate into the vesicles was competitively inhibited by L glutamate and L-cysteate (acidic amino acid). These results indicate that a Na dependent acidic amino acid specific transport system exists in the placental trophoblast microvilli membrane. These results indicate that the transport of L glutamate across the placental microvilli membrane is sodium-dependent and carrier mediated. PMID- 3973445 TI - [Assessment of cases with ovarian cancer stage I]. AB - In the therapy of primary ovarian cancer in which the tumor is located in one ovary, radical operation including the uterus and contralateral ovary is performed in principle even in the case of young patients. However, there have been only a few results reported on the primary cases in our country, and the radical operation is adopted at present in line with western policy. In the present study, the authors examined mainly the prognosis of 49 patients with primary ovarian cancer (stage Ia, 25 cases; stage Ib, 2 cases; stage Ic, 22 cases), and the following results were obtained. Among 25 cases at stage Ia, the radical operation was performed on 14 cases, and only the conservative operation was performed on the remaining 11 cases. All of the latter are still well. Only one died among patients at stage Ia. Therefore, in these cases, complete treatments were done, including radical operation, postoperative irradiation and chemotherapy, and second look operation. The prognosis of the patients at Ic was worse than that at IIa + b. Therefore, it was felt to be necessary to treat them as progressive cancer. There was no difference between the prognoses of the conservative and radical operations even at stage Ic. Thus, problems such as functional maintenance were thought to be taken into consideration. Risk factors considered were tissue type, amount of ascites, capsular rhexis, and advanced age, etc. Since the prognosis after the second look operation was good, it was considered to be a treatment which should be introduced actively, even at stage I. PMID- 3973446 TI - [Nuclear DNA content and chromosomal counts of cultured cells derived from human cervix with normal and abnormal epithelia]. AB - In order to examine the cellular properties of each cultured cell derived from normal and abnormal epitheliums of the cervix, we measured the nuclear DNA content and chromosomal counts of these cultured cells. The following results were obtained. The nuclear DNA content of cultured cells derived from normal, mild, moderate, severe dysplasia, carcinoma in situ (cis) and invasive carcinoma was distributed among low 2c-high 4c, low 2c-6c, low 2c-7c, low 2c-10c, low 2c 11c and low 2c-13c respectively. A number of the cells exceeding 4c apparently increased from lesions of moderate dysplasia. In the chromosomal counts, approximately 90% of the primary and subcultured normal cells showed diploid cells and 3-6% of these cells showed tetraploidy. The chromosomal counts of the invasive carcinoma were widely distributed, but the number with diploid to hypotriploid was larger than those of cis. From these results, mild dysplasia cannot be considered to be a precancerous lesion. Cis and invasive carcinoma have different cellular patterns. PMID- 3973447 TI - [The effect of the uterine contraction on the fetal heart rate pattern]. AB - The relationship between uterine contraction and the change in the FHR pattern was investigated in term deliveries with cephalic presentation in the first stage of labor and immediately before fetal expulsion and the following results were obtained. In the first stage of labor, when the increase in the planimetric value over the value in the preceding period was defined as the increment ratio of uterine contraction (IRUC), its upper rejection limit was 22%. When IRUC was higher than the upper rejection limit, late deceleration was more frequently found than when it was within the normal range. Even in the presence of late deceleration, the fetal outcome was fairly good when IRUC was above the upper rejection limit. Melchoir's classification of the terminal bradycardia pattern immediately before fetal delivery was modified by the author and the UApH and Apgar scores were studied in accordance with the newly modified contraction types. The significance of the new classification of fetal outcome is discussed. PMID- 3973448 TI - [Effect of danazol on serum prolactin and cortisol levels]. AB - In order to investigate the effect of Danazol (D) on serum prolactin (PRL) and cortisol levels, D was given orally in a daily dose of 400 mg for 2 weeks to 4 women (400 mg group) and 600 mg to 5 women (600 mg group) at one month and more after menopause and oophorectomy. The blood samples were taken through an indwelling catheter into the cubital vein every 20 minutes for 2 hours before and after the administration of D. Serum hormone levels were determined by each specific RIA. In a comparison in each individual of mean hormone levels of 7 serum samples before and after D, (1) serum PRL levels were significantly lowered in 2 women after D of 400 mg (p less than 0.001) and in one woman after D of 600 mg (p less than 0.001), but increased in one woman after D of 600 mg (p less than 0.001), (2) serum cortisol levels were significantly lowered in one woman after D of 400 mg (p less than 0.01) and in 4 women after D of 600 mg (p less than 0.001). When the mean hormone levels in the 400 and 600 mg group (an average of the mean hormone levels of 7 samples in each group) were compared before and after D, (1) the mean serum PRL levels were not significantly affected by D in either group, (2) the mean serum cortisol levels were significantly lowered by D in the 600 mg group, but not in the 400 mg group. The present study demonstrated that serum PRL levels were not consistently affected by D in the condition without ovarian hormones, and serum cortisol levels were lowered after a relatively larger dose of D. PMID- 3973449 TI - [Some properties of a vasopressor substance generated in human plasma by incubation and its clinical significance in pregnancy-induced hypertension]. AB - A study to measure the pressor substance, called active pressor principle (APP), which is generated in incubated human plasma was performed using anesthetized and ganglion blocked rats. It was found that APP has properties characteristic of protein. APP was not extractable with mixtures of chloroform: methanol. APP was present at 50 to 70% saturation with ammonium sulfate. By treating the plasma with Pronase, the pressor activity of the plasma was almost completely abolished. The molecular weight of APP as determined by gel filtration was about 68,000. By adding diisopropyl fluorophosphate before incubation of the plasma, the generation of vasopressor substance was prevented. Treatment of the rat with captopril was ineffective in inhibiting the pressor effect of incubated plasma. It was found that the plasma of normal pregnant women generated significantly higher amounts of APP than the plasma of nonpregnant women. The plasma obtained from patients with pregnancy-induced hypertension generated significantly lower amounts of APP than the plasma of normal pregnant women. These findings suggest that a vasoactive protein (APP) is generated during simple incubation of plasma, and a serine protease is involved in the formation of this substance. Concerning the relevance of these results to blood pressure regulation in pregnancy-induced hypertension, probably APP is involved in blood pressure regulation via a compensatory mechanism. PMID- 3973450 TI - Alterations of polyamines in body fluids during pregnancy in rats. AB - Polyamines in plasma, urine, and amniotic fluid during pregnancy in rats were measured using high performance liquid chromatography (HPLC). Putrescine and spermidine in the plasma, and putrescine and spermine in the urine were elevated during pregnancy. The sharp increase in putrescine in the late stage of pregnancy in body fluids was particularly characteristic. Slight increases in plasma and urinary spermine levels were observed in the early stage of pregnancy. It was found that the administration of the steroid hormones, progesterone, estradiol-17 beta, and estriol, to virgin rats did not influence the concentrations of urinary polyamines, and that urinary putrescine levels did not rise in experimental IUGR rats, but they rose in the urine of the sham operation group. These data suggest that changes in polyamines in plasma, urine, and amniotic fluid were possibly subject to fetal growth and/or functional differentiation more than hormonal regulation during rat pregnancy. PMID- 3973451 TI - Origin of lysozyme in amniotic fluid. AB - We reported in a previous paper that the pattern of change in the lysozyme content of normal amniotic fluid during pregnancy resembles indices of fetal maturity such as L/S ratio, creatinine concentration and amylase activity. In order to clarify the origin of amniotic fluid lysozyme and to determine whether or not the amniotic fluid lysozyme concentration indicates the maturity of some specific fetal organ, we measured the lysozyme content of samples of materials considered to be possible sources of amniotic fluid lysozyme. These materials were amnion and--taken immediately after birth--saliva, urine and cord serum. Lysozyme content was 36.5 +/- 6.7 micrograms/ml in the saliva samples, 5.3 +/- 0.9 micrograms/ml in the urine samples, and 17.4 +/- 4.4 micrograms/ml in the cord serum samples. It is unclear, however, which material was the most important source of amniotic fluid lysozyme. The results suggested that homogenized amnion samples contained lysozyme, although the content was low, and that amnion tissue produced lysozyme in vivo. Lysozyme is an enzyme found in the lysozymes of cells. The results of this study provide evidence that amniotic fluid lysozyme originates from many sources. PMID- 3973452 TI - [Therapy of vaginal malformations with a functional uterus]. PMID- 3973453 TI - [Retention of the pelvic nerve plexus in total hysterectomy]. PMID- 3973454 TI - [Placenta praevia and neonatal outcome]. PMID- 3973455 TI - Perfusion studies on the formation of mural thrombi with cholesterol-modified and hypercholesterolemic platelets. AB - Using the Baumgartner apparatus, perfusion studies have been carried out with blood from patients with hypercholesterolemia type IIa (n = 5) and IIb (n = 9) and with reconstituted blood containing platelets in which the cholesterol/phospholipid ratio had been modified by incubation with liposomes. With cholesterol-enriched platelets (C/PL 0.869), both platelet adherence and thrombus size were doubled with respect to cholesterol-normal platelets (C/PL 0.587), which in turn had values approximately twice that in cholesterol-depleted platelets (C/PL 0.494), differences statistically significant at p less than 0.02. With blood from patients with hypercholesterolemia, statistically significant values (p less than 0.03) were seen only for increase in adherence of platelets from type IIb patients as compared with controls. These results demonstrate that changes in platelet membrane cholesterol levels can affect interaction with subendothelium in cholesterol-modified platelets but suggest that more restricted differences may occur with platelets from patients with hypercholesterolemia. PMID- 3973456 TI - Effect of a transported ligand on the binding of albumin to rat liver cells. AB - Organic anions destined for hepatic uptake often bind to albumin in the circulation. Because albumin binds to liver cells but is not transported, we suggest that sites on the hepatocyte surface catalyze the dissociation of albumin anion complexes, thus making more free anion available for transport than would otherwise occur. To learn whether liver cells distinguish between free albumin and albumin-anion complexes, we measured the binding of 125I-albumin to isolated rat hepatocytes in the presence and absence of rose bengal, a transported anion that binds extensively to albumin. Albumin binding to hepatocytes is reported as the albumin space corrected for extracellular fluid (14C-inulin space). Corrected albumin spaces are 2.95 and 2.83 microliter/mg cell protein with and without rose bengal, respectively. The mean difference and its 95% confidence interval computed from four comparisons in each of six rats is 0.12 +/- 0.67 microliter/mg cell protein. Inulin space is 32% of the uncorrected albumin space. Thus the affinities of albumin-rose bengal complexes and of free albumin for the hepatocyte surface differ by at most 28%. Accordingly, free albumin can compete with albumin-rose bengal complexes for cell surface sites, impairing the surface mediated generation of free rose bengal for uptake. This finding explains the otherwise paradoxical observation that adding albumin to liver perfusate inhibits the uptake of rose bengal even when sufficient albumin is already present to bind 99.9% of this dye. PMID- 3973457 TI - Origin of plasma lysophosphatidylcholine: evidence for direct hepatic secretion in the rat. AB - In the plasma, lysophosphatidylcholine (LPC) is formed by the action of lecithin cholesterol acyltransferase (LCAT) when a fatty acid is removed from plasma phosphatidylcholine (PC) and transferred to cholesterol. To determine whether plasma LPC might also be generated by the hydrolysis of hepatic PC, we assessed phospholipid production by the isolated perfused rat liver. Bile duct-cannulated livers were perfused with bile salt and a recirculating, lipid-free medium containing albumin. We found that LPC accumulated in the perfusate to a greater extent than any other phospholipid, exceeding the accumulation of PC (the second most prevalent phospholipid) twofold. We further found that perfusate LPC was not formed by hydrolysis of PC in the perfusate and was not dependent on the presence of infused bile salt. LPC that accumulated in the perfusate was highly unsaturated and markedly dissimilar to the more saturated LPC that results from the activity of LCAT. Results thus indicate that the isolated liver directly secretes LPC, which is presumably generated from hydrolysis of hepatic PC. Because plasma LPC is to a great extent unsaturated in the live rat, these findings suggest that direct hepatic secretion is a quantitatively important source of plasma LPC. PMID- 3973458 TI - A simple model for estimating the hemolytic rate in patients with sickle cell anemia. AB - The pathophysiologic processes of hemolysis in sickle cell anemia were formulated by a simple mathematical model that assumed a unimodal bone marrow erythrocyte population and a finite probability of random destruction of red blood cells (RBCs) in the circulation. Recognizing that the hemolytic rate of marrow RBCs is likely to be distributed normally around a mean hemolytic rate, we simplified the model by using the mean hemolytic rate as representative of the entire marrow RBC population. The model thus constructed allows an easy estimation of the mean steady-state hemolytic rate simply by measurement of reticulocyte counts and hematocrit levels. When the model was applied to data from 43 patients with sickle cell anemia, the estimated mean hemolytic rates based on the model correlated significantly with the published hemolytic rates obtained by diisopropylphosphofluoridate-RBC survival studies of the peripheral blood, but were generally greater than the published rates. This discrepancy was postulated to be the result of an enrichment of RBCs with smaller hemolytic rate in the circulation. The results of computer simulation studies were consistent with this hypothesis and suggest that the variation in the hemolytic rate for marrow RBCs is on the order of 10%. This simplified model may serve as a close approximation of this pathophysiologic system. The estimates of the steady-state hemolytic rate provided by the model should be clinically useful, especially when repeated estimations are required. The method of calculation is illustrated. PMID- 3973459 TI - Does an unfavorable metabolic environment for red cells develop within the cat spleen when abnormal cells become trapped? AB - Intrasplenic pH, blood gas tensions, and glucose concentration were deduced from measurements of blood drained from cat spleen during contraction with the inflow occluded. During this procedure the hematocrit of the outflow rises gradually from 35% to 40% (arterial) to 75% to 80%, the last fraction representing a pure sample of blood from the splenic pulp. In normoxic animals no evidence was found of an unfavorable metabolic environment for red cells within the spleen on account of low pH, low O2 tension, and substrate deprivation, as is generally believed. However, red cell flow through the red pulp can be impeded rheologically after sequestration of 10(9) heat-treated (HT) autologous red cells, and we have tested the hypothesis that under these conditions the availability of O2 and glucose might be reduced and a decline in pH might occur. One hour after injection of the HT cells into the splenic artery, splenic contraction was induced with the arterial inflow occluded; the blood expelled from the splenic vein was collected anaerobically as successive 1 ml fractions. Values of pH, O2 tension, and glucose concentration in the final samples expelled were not significantly different from those in corresponding samples from control spleens. Thus, even when stasis of 50% of intrasplenic red cells occurs, caused by the sequestration of 10(9) abnormal cells, no hostile metabolic environment develops within the red pulp. Presumably the residual plasma flow through the pulp is sufficient to maintain a normal metabolic environment. PMID- 3973460 TI - Dopaminergic mediation of the natriuretic response to volume expansion. AB - Previous studies have shown a direct relationship between urinary sodium excretion and both urinary dopamine excretion and plasma dopamine levels. The significance of this relationship is unclear. We therefore studied the effect of dopaminergic blockade on the renal response to volume expansion produced by the infusion of 2 L 0.9% saline solution intravenously over 4 hours in a group of six healthy adult volunteers previously shown to have appropriate sodium balance. The dopamine receptor antagonist metoclopramide was administered intravenously at a dose of 10 mg/hr throughout the study period; a separate group of control subjects received saline infusion without metoclopramide. During saline infusion urinary sodium excretion increased steadily in controls, from a basal level of 127 +/- 25 mu Eq/min to a peak value of 451 +/- 83 mu Eq/min (p less than 0.005) during the fourth hour of infusion. The study group receiving saline solution along with metoclopramide failed to show any significant increase in urinary sodium excretion over the basal levels. Cumulative sodium excretion during saline loading was significantly less in those receiving saline solution with metoclopramide (55 +/- 14 mEq) than in controls (101 +/- 15 mEq)(p less than 0.05). The plasma aldosterone levels in the control group receiving saline solution alone fell steadily from a preinfusion level of 11.0 +/- 0.9 ng/dl to the nadir of 6.5 +/- 0.9 ng/dl (p less than 0.02), reached during the third hour of infusion. In contrast, in the study group receiving saline solution with metoclopramide, the plasma aldosterone levels remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973461 TI - Catalytic activity and platelet reactivity of heparin covalently bonded to surfaces. AB - Heparin was covalently bound to solid substrate surfaces by means of four different chemistries. It was coupled to polymethylacrylate (PMA) beads with glutaraldehyde, carbodiimide, or radical polymerization initiated by Ce4+, or to agarose beads with cyanogen bromide. Each of these chemistries produced measurable amounts of surface-bound heparin, which was minimally elutable in contact with plasma. Antithrombin (AT) binding by heparinized PMA materials (compared with PMA control beads) ranged from no AT binding for the material heparinized with carbodiimide (PMA-Alb-Hep(EDC] to 3.6 micrograms/ml packed beads for the material heparinized by radical polymerization (PMA-MA-Hep). Heparin-like catalytic activity of these materials (assayed by measuring the generation of thrombin-antithrombin complex in plasma) correlated well with the amount of heparin bound, but not as well with AT binding capacity. Heparinized agarose, which exhibited a large AT binding capacity (2.2 mg AT per milliliter of packed gel), had virtually no catalytic activity because of its inability to release thrombin-antithrombin complex from the surface. Platelet interaction with heparinized materials that exhibit high AT binding capacity was reduced by pretreatment with normal plasma but not by pretreatment with AT-depleted plasma. Platelet interaction with heparinized materials with low AT binding capacities was not reduced by pretreatment with normal plasma. We conclude that AT binding by heparin reduces the platelet reactivity of heparinized surfaces. PMID- 3973462 TI - The compartmentalization and metabolism of aluminum in uremic rats. AB - Aluminum levels in bone are significantly higher and those in the liver are significantly lower in uremic rats than in control rats receiving similar amounts of parenterally administered aluminum. We evaluated the possibility that the hyperparathyroidism present in uremia might affect aluminum metabolism and toxicity. Uremia was induced by establishing the remnant kidney and hypoparathyroidism was induced by selective parathyroidectomy. Aluminum loading was accomplished by intraperitoneal aluminum injection. Bone aluminum concentration in the uremic group was 113 +/- 16 mg/kg, compared with 80 +/- 7 mg/kg in the uremic parathyroidectomy group and 55 +/- 9 mg/kg in controls (p less than 0.001 between all groups) and 52 +/- 16 mg/kg in parathyroidectomy controls. When parathyroidectomy was performed after the uremic animals were already loaded with aluminum, bone aluminum levels did not change, suggesting that the parathyroidectomy prevented some of the excess bone aluminum levels in uremia by decreasing bone uptake of aluminum rather than enhancing mobilization of bone aluminum. The only other effect the parathyroidectomy procedure had on tissue aluminum was to slightly decrease brain aluminum levels in uremic animals and kidney aluminum levels in control rats. Uremic rats with parathyroidectomy were found to have a significantly greater trabecular bone osteoid area than uremic rats (45.9% +/- 9.7% and 13.4% +/- 10.6%). We conclude that parathyroidectomy, especially in the uremic state, has a major influence on the compartmentalization of aluminum in bone and intensifies aluminum-induced osteomalacia. PMID- 3973463 TI - Relationship between urine flow rate and prostaglandin E excretion in human beings. AB - Although an increase in urine flow rate has been shown to augment urinary prostaglandin E (PGE) excretion, the relationship between these two variables has not been quantitated. Because we have previously shown that water immersion to the neck induces diuresis and augmentation of PGE excretion, we utilized water immersion to the neck to assess kinetically the relationship between changes in flow rate and PGE excretion. Fourteen normal male subjects were studied twice during 4 hours of water immersion to the neck, once after 11 hours of fluid deprivation and again during moderate hydration. PGE excretion as determined by radioreceptor assay was measured each hour. When subjects deprived of fluids underwent immersion to the neck, flow rate increased from 0.5 ml/min (control) to 1.5 ml/min, and PGE excretion rose from 1.4 to 2.6 ng/min (both p less than 0.01). In contrast, when subjects were studied during hydration, flow rate increased from 4.1 to 7.2 ml/min and PGE excretion increased from 8.1 to 13.0 ng/min at the same time intervals (both p less than 0.01). There was a significant positive correlation between flow rate and PGE excretion during both fluid deprivation and hydration. Were there an effect, independent of flow rate, of hydration on PGE, the slope of these two regression lines would differ. When the regression line slopes of these relationships were analyzed by the F test, there was a statistically significant (p less than 0.01) difference between the two regression coefficients. Our data suggest that, in addition to the previously characterized relationship between flow rate and PGE excretion, there is also a direct effect of hydration on PGE excretion. PMID- 3973464 TI - Elevated fasting cholecystokinin levels in pancreatic exocrine impairment: evidence to support feedback regulation. AB - Previous studies have suggested that intraduodenal protease suppression of pancreatic exocrine secretion may be mediated through cholecystokinin (CCK) release. Our study compares basal plasma immunoreactive CCK concentrations in normal human subjects with those obtained in patients with chronic pancreatitis. Fasting plasma samples were collected from 18 normal subjects and from 18 patients with chronic pancreatitis. Eight patients had mild to moderate pancreatic exocrine impairment, and 10 had severe exocrine insufficiency. Venous plasma immunoreactive CCK concentrations were measured with two distinct peptide region-specific antibodies. Basal plasma CCK concentration in controls was 14.3 +/- 1.3 fmol/ml (mean +/- SEM), a value significantly less than that obtained in all patients with chronic pancreatitis, 30.1 +/- 4.0 fmol/ml (p less than 0.001). Patients with mild to moderate impairment had a fasting plasma CCK concentration of 32.8 +/- 7.9 fmol/ml (vs. control p less than 0.01), and those with severe disease 27.9 +/- 3.6 fmol/ml (vs. control p less than 0.001). In five patients with mild to moderate impairment of exocrine function and pancreatic extract responsive abdominal pain, there was a 39 +/- 11% decrease in basal CCK levels during extract therapy (p less than 0.05). Results of this study indicate that pancreatic exocrine impairment is associated with elevated basal CCK levels, which may reflect a failure to provide feedback downmodulation of CCK release. PMID- 3973465 TI - Microplate solid-phase radioimmunoassay for rat prolactin. AB - A rat prolactin solid-phase radioimmunoassay has been developed that uses 96-well microtiter plates with removable wells to which the antibody is firmly adsorbed, resulting in a solid-phase antibody. Antigen as either reference or unknown competes with radioactivity labeled antigen for binding sites on the solid-phase antibody. After immunoreaction, free antigen is removed by washing the wells with phosphosaline solution. The solid-phase antibody-antigen complex is counted for quantitation with data reduction methods currently used in routine radioimmunoassay procedures. This microplate solid-phase radioimmunoassay has several advantages over conventional methods without sacrificing specificity, sensitivity, or accuracy. This method is rapid, compact, economical, easily automated, and could be readily established in other laboratories. PMID- 3973466 TI - Assessment of cellular mass and lean body mass by noninvasive nuclear techniques. AB - With the nuclear techniques employed in this study, it has been possible to measure total body potassium (TBK), lean body mass (LBM), and body cell mass (BCM). The latter two are derived independently of TBK. LBM is derived from the sum of total body water (TBW), total body protein, and bone mineral ash measurements. The BCM value is, in turn, based on the difference between the LBM (as measured above) and the sum of the extracellular water and extracellular solids. It was demonstrated in 123 normal individuals that, although the TBK/LBM ratio decreases with age, the TBK/BCM ratio does not change significantly with age. It can be deduced that the ratio of TBK to intracellular water should be relatively constant with age. This relative constancy with age was demonstrated independently with the absolute measurements of TBK and intracellular water in normal individuals. Because the BCM is physiologically and chemically more homogeneous than LBM and because it reflects the actively metabolizing cellular compartment more accurately than LBM, it is the preferred parameter to be used for reference or normalization in body composition studies. For most applications, BCM is readily derived from TBK measurement by either whole body counting or isotope dilution techniques. PMID- 3973467 TI - Analysis of immunoglobulin G kinetics in the non-steady state. AB - The effect of specific intravascular IgG depletion on IgG catabolism, generation, and intrabody transfer has been studied in rabbits. In contrast to previous studies, the radiolabeled IgG kinetics were analyzed in the non-steady state. A two-pool model was used to determine IgG distribution, catabolism, generation, and intrabody mass transfer after intravenous injection of 125I-IgG. Circulating IgG was then specifically removed by plasma perfusion through a Protein-A Sepharose column in an extracorporeal circuit. Based on the two-pool analysis, IgG catabolic clearance fell after IgG removal (1.0 ml/hr vs. 0.7 ml/hr), and mean generation rate was unchanged. Plasma levels rose 20 hours after IgG removal as a result equally of contributions from intrabody transfer and of generation. Model parameters from plasma 125I decay analysis overestimated plasma 125I levels in the first 24 hours after removal, although predicted endogenous levels corresponded well with experimental results over a 7-day period. Rapid intravenous infusion of a 7% body weight volume of saline solution during IgG removal resulted in 50% greater plasma levels of 125I-IgG 24 hours after removal. This indicated that an increased lymphatic flow had occurred, resulting in increased IgG transfer from the extravascular to the intravascular space. The two pool model adequately describes circulating IgG levels after specific IgG removal. Catabolic clearance was found to be a function of IgG level, whereas generation does not appear to be similarly dependent. Both the two-pool model and saline infusion procedure may be applied directly to the planning and optimization of plasma exchange therapy regimens in human autoimmune disease. PMID- 3973468 TI - Quantitative analysis of abnormal hemoglobins by agar gel electrophoresis. AB - Measurement of the proportion of abnormal hemoglobin in a hemolysate is essential for differentiation of simple and compound heterozygotes (e.g., sickle cell trait vs. sickle thalassemia), for differential of alpha- and beta-thalassemia in compound heterozygotes, and for differentiation of various types of beta thalassemia in such persons. Utilization of such measurements is hampered by the imprecision and inconvenience of current methods. We have adapted a readily available agar electrophoresis method for this purpose, scanning unstained gels at 420 nm. The new method is particularly valuable for rapid estimation of percent of HbS after partial exchange transfusion in patients with sickle cell anemia. It cannot be used for quantitation of HbF or for quantitation of hemoglobins that comigrate with HbA; contrariwise, it can be used for hemoglobins that only separate from HbA on agar (e.g., HbBethesda). PMID- 3973469 TI - Course of hepatic regeneration after 80% to 90% resection of normal rat liver. Comparison with two-lobe and one-lobe hepatectomy. AB - After subtotal (80% to 90%) hepatectomy of the normal rat liver, thymidine kinase activity began to increase after 24 hours and reached a maximum at 36 hours. This persisted for another 60 hours before it declined to reach the baseline by 7 to 8 days. The maximal increase was 30- to 50-fold. After two-lobe (67% to 78%) hepatectomy, the maximal increase was similar, but the onset and the maximum each occurred 12 hours earlier, and the maximum only persisted for another 24 hours. The important first peak of ornithine decarboxylase activity occurred earlier and rose higher after 67% to 78% hepatectomy. The distributions with time of histologic mitosis counts were similar to the distributions of thymidine kinase activity (reflects DNA synthesis) at each of the three levels of hepatectomy, 80% to 90%, 67% to 78% and 37% +/- 0.5%. Thus the initiation of regeneration was delayed after subtotal resection, but the regenerative response as reflected by DNA synthesis and cell multiplication was prolonged. PMID- 3973470 TI - Elevation of a calcium fraction tightly bound to serum proteins in maternal blood at delivery and in cord blood from newborn infants. AB - The intimate mechanisms for calcium transport and accumulation in bone cells are complex. We have previously observed that calcium tightly bound to serum proteins is taken up by bone cells preferentially over ionized calcium. To explore the significance of this phenomenon as a potential mechanism for calcium transport in vivo, we studied the distribution of calcium in sera from normal individuals, pregnant women, cord blood from newborn infants, and patients with disorders of calcium homeostasis. Tightly bound calcium was defined as the fraction that remained bound to serum proteins after six consecutive ultrafiltration cycles. Cord blood from newborn infants showed striking elevations of total serum calcium, 11.2 +/- 0.3 mg/dl (+/- SEM), and of the fraction tightly bound to serum proteins, 25.1% +/- 1.7%, compared to normal control values of 9.5 +/- 0.1 mg/dl, and 18.9% +/- 1.1%, respectively (p less than 0.01). Maternal blood at delivery also exhibited an increase of the tightly bound calcium fraction, 27.1% +/- 0.7% (p less than 0.01), but normal total serum calcium concentration, 9.4 +/- 0.2 mg/dl. There was no correlation between the simultaneous fractional concentrations of tightly bound calcium in the maternal and fetal blood compartments (r = -0.03; p = 0.92; n = 12 sets of paired samples). The high concentrations of calcium tightly bound to serum proteins in cord blood suggests that this fraction could play a role in the mineralization of fetal bone. PMID- 3973471 TI - alpha 2-Plasmin inhibitor metabolism in patients with liver cirrhosis. AB - We describe the metabolism of purified human alpha 2-plasmin inhibitor in patients with liver cirrhosis to determine whether low plasma concentrations of alpha 2-plasmin inhibitor are the result of impaired synthesis or increased catabolism or both. A kinetic study was performed with 131I-alpha 2-plasmin inhibitor as a sensitive parameter of fibrinolysis in 14 patients with histologically proved liver cirrhosis compared with six healthy control subjects. Eight patients had macronodular cirrhosis (with positive hepatitis B surface antigen), and six had micronodular cirrhosis as a result of alcohol abuse. None of the patients had clinical signs of ascites, and in all the disease was stabilized. alpha 2-Plasmin inhibitor levels biologically and immunologically measured were decreased in all patients. Ten microCi 131I-alpha 2PI was injected intravenously, the disappearance of plasma radioactivity was measured, and turnover data were calculated according to the function x(t) = A1e-alpha 1t + A2e alpha 2t + Be-beta t. Mean (+/- SD) turnover data in the control subjects were plasma radioactivity half-life 60.1 +/- 5.3 hours, fractional catabolic rate constant of the plasma pool 0.0318 +/- 0.0106 hr-1, and absolute catabolic (synthetic) rate constant 2.10 +/- 0.60 mg/kg/day. The alpha 1-phase was 1.26 +/- 0.23, and the transcapillary influx constant (k2,1) was 0.974 +/- 0.109 hr-1. In the patients, plasma radioactivity half-life was 58.7 +/- 12.09 hr, and fractional catabolic rate constant of the plasma pool 0.0283 +/- 0.0043 hr-1. The alpha 1-phase 4.74 +/- 6.48 and the transcapillary influx (k2,1) 3.08 +/- 3.9 hr 1 were both significantly increased compared with control values (p less than 0.05 and p less than 0.05, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973472 TI - Distribution of pneumococcus-induced augmentation of tissue leukostasis in rabbits: specificity for the pulmonary vascular bed. AB - We studied whether pneumococcal (PNC) sonicate-induced leukostasis is specific for the lung or whether it occurs in extrapulmonary foci as well. Indium 111 radiolabeled rabbit granulocytes were infused into rabbits that were then challenged with nonviable PNC or normal saline solution. Animals were killed at either 3 or 24 hours after infusion and washed tissue sections from lung, liver, spleen, brain, heart, and kidney were weighed. Tissue 111In radioactivities from each PNC sonicate-challenged animal were compared with those from a control simultaneously injected with saline solution. At both 3 and 24 hours after injection, 111In radioactivity was significantly (p less than 0.01) increased in the lungs of animals challenged with PNC compared with controls injected with saline solution. There were no significant differences between experimental and control animals in liver, spleen, heart, kidney, or brain radioactivities. Animals in another group were injected with PNC through catheters placed in either the right atrium or left ventricle. Significantly (p less than 0.03) increased 111In radioactivity was found after either route of administration only in the lung. PMID- 3973473 TI - Hospital admissions for pneumonia. A Kentucky Peer Review Organization study. PMID- 3973474 TI - Tuberculosis of the female genital tract. PMID- 3973475 TI - North American blastomycosis. A review. PMID- 3973476 TI - Physician surplus: boon or boondogggle. PMID- 3973478 TI - Reconstruction after temporal bone resection. PMID- 3973477 TI - Autologous fitted incus versus Plastipore PORP in ossicular chain reconstruction. AB - Hearing results and causes of failure with three types of ossicular reconstruction techniques over an intact stapes, during second-stage intact canal wall tympanoplasty, are reported herein. The three types of reconstruction are: fitted autologous incus (38 cases); Plastipore PORP with cartilage (41 cases); Plastipore PORP without cartilage (32 cases). A residual air-bone gap within 15 dB. was found in 63.2 per cent of fitted includes, in 41.5 per cent of PORPs with cartilage, and in only 37 per cent of PORPs without cartilage. Eighty-four per cent fitted incudes, 63 per cent PORPs with cartilage and 44 per cent PORPs without cartilage yielded a residual air-bone gap within 25 dB. Extrusion has been the main cause of failure among Plastipore prostheses. PMID- 3973479 TI - Acoustic brainstem electrical responses in congenital nystagmus. PMID- 3973480 TI - Aqueductal stenosis--results of vestibular function tests. AB - A case of aqueductal stenosis is reported. The patient was a 14-year-old Japanese girl who was suffering from bilateral tinnitus and unsteadiness of gait. A series of neuro-otological tests revealed prolonged acoustically evoked brain stem response (ABR) latency, disturbed standing reflex, inhibited optokinetic nystagmus (OKN) and ataxic eye tracking test (ETT). Marked distension of the lateral and third ventricles was noticed on CT examination of the brain. A positive contrast ventriculogram using iotalamic acid showed occlusion of the cerebral (Sylvian) aqueduct. All of these results are suggestive of benign, non neoplastic aqueductal stenosis with associated hydrocephalus. The patient underwent ventriculo-peritoneal shunt and, following the surgery, the results of neuro-otological, including radiological, re-examination indicated a remarkable recovery. PMID- 3973481 TI - Septoplasty in unilateral atrophic rhinitis with deviated nasal septum. AB - Eight cases of atrophic rhinitis with DNS towards the opposite side were treated by septoplasty with reversal of the DNS. All the cases showed satisfactory results. PMID- 3973482 TI - Blood flow in nasal polyps. PMID- 3973484 TI - Tonsillectomy: home after 24 hours? PMID- 3973483 TI - Lactate dehydrogenase in human maxillary adenocarcinoma and in experimental adenocarcinoma in mice. AB - Total lactate dehydrogenase (LDH) activity and isoenzyme pattern were studied in tumour tissue from eight patients with maxillary adenocarcinoma, chronic inflammatory mucosa from 12 patients, normal maxillary mucosa from 12 patients, and an experimental lung adenocarcinoma and normal lung tissue from 12 mice. An increase in the total LDH activity and cathodic shift in LDH isoenzyme pattern was found in human maxillary adenocarcinoma as compared to normal and inflammatory mucosa. The inflammatory mucosa showed an increase in the total LDH activity and a normal isoenzyme pattern. The LDH alterations in the experimental lung adenocarcinoma in mice were similar to those in the human tumours but they were much more marked. PMID- 3973485 TI - Antibiotic prophylaxis--a survey. PMID- 3973486 TI - Tactile neurofibroma of the stapedial nerve. PMID- 3973487 TI - Juvenile Meniere's disease. AB - The authors report their experience in the diagnosis and treatment of Meniere's disease in childhood. They believe it to be essential to carry out a complete battery of audio-vestibular tests, with particular reference to dehydration procedures, which in this age group are considered to be more significant for a correct diagnosis than in adults. After stressing the importance of eliminating other forms of disease which manifest themselves with vertigo, the authors conclude by asserting the efficacy of medical treatment with diuretics and they support the surgical procedure of endolymphatic-mastoid drainage as a valid means of contending with the hydrops. PMID- 3973488 TI - Leiomyoma of the nasal cavity (report of a case). PMID- 3973489 TI - The larynx in pulmonary tuberculosis. AB - Pulmonary tuberculosis is still a common disease in the developing countries of the world. One hundred patients with pulmonary tuberculosis showed laryngeal involvement in 37 patients. The posterior part of the larynx followed by the epiglottis are the commonest sites to be involved in the larynx. Ulcerative lesions and perichondritis, so common in pre-chemotherapeutic days, were not seen. PMID- 3973490 TI - Primary cervical neuroblastoma in infants. AB - We describe three cases of cervical neuroblastoma, each occurring in an infant less than one year old, and discuss the investigation and treatment of these patients. The prognosis of patients with advanced neuroblastoma is poor. By contrast, patients with stage I and II tumours often do well and it therefore seems appropriate for otolaryngologists to be familiar with the clinical features and management of localized cervical neuroblastoma. A history of upper aerodigestive compromise is typical, and in the evaluation of this complaint, the possibility of a cervical neuroblastoma must be borne in mind. A retropharyngeal firm, smooth mass is consistent with this diagnosis and supportive evidence can be obtained from ancillary studies. A biopsy is required for tissue diagnosis and, if possible, the entire tumour and sample local nodes should be excised. This will also relieve airway and pharyngeal obstruction. Complete tumour removal at the expense of major nerves and vessels is not necessary in view of the tendency to tumour regression. We conclude that prolonged disease-free survival can be achieved in infants by the use of limited surgery, with chemotherapy in some instances, and without the use of radiation therapy. Management decisions should be made jointly by paediatric otolaryngology and paediatric oncology teams. PMID- 3973491 TI - Fenestration: a twenty-five-year evaluation. AB - A review was made at least 25 years after surgery on a series of patients who had been fenestrated for otosclerosis. Adequate follow-up information was obtained on 28 of the original 58 subjects. Of these three still had hearing above the social adequacy level of 30 db. HL. One half of the subjects had hearing that was still significantly better than it had been prior to surgery. Twenty-five years post operatively more than half the patients were using hearing aids, generally with a high degree of satisfaction. Four out of five patients indicated that with hindsight they would still have gone ahead and had the operation. The small residual conductive impairment in a fenestrated ear appears to act as a protection against the effects of acoustic insult, in that the rate of decline of hearing with age in male subjects is less than the average for a normal population of adult males. The rate of decline approximates more closely with the assumed non-noise exposed female population. PMID- 3973492 TI - Hemifacial spasm: operative treatment. AB - This paper describes experience with a transtympanic facial nerve needling operation in 62 patients with hemifacial spasm, over a 15-year period. The procedure is simple and effective, but unfortunately it is usually marred by recurrence of the spasm. Repeat operations are easy to perform, and usually valuable the first time. Despite recurrence, most patients are finally less troubled than before operation. A small number have proved very resistant to treatment, and the aetiological implications of this are presented. Other operative options are also discussed, together with our experience in a small number treated by facial nerve needling at other sites. PMID- 3973493 TI - Nasal glioma. PMID- 3973494 TI - The value of X-ray examination of the paranasal sinuses after epistaxis. AB - In a number of Danish ENT departments, X-ray examination of the paranasal sinuses has been a routine procedure in cases of severe epistaxis of uncertain genesis, two to four weeks after its treatment has been completed. The object has been to rule out cancer of the nose and/or paranasal sinuses. In the present study, the value of this procedure was assessed. PMID- 3973495 TI - Radiological findings in lipoid proteinosis. AB - The radiological findings in six patients suffering from lipoid proteinosis have been described and discussed. Laryngeal examination showed thickened epiglottis, swollen arytenoids and aryepiglottic folds, thickened irregular false and true vocal cords, and increased stiffness of the vocal cords. The ventricles and subglottic region were free. Bean-shaped suprasellar calcifications were found in two cases who were free of neurological symptoms. The chest and upper gastro intestinal tract were radiologically free. PMID- 3973496 TI - Remediastinoscopy. AB - The experiences and results of four re-mediastinoscopies are presented. All the patients had to some degree developed mediastinal fibrosis but not to a degree seriously interfering with the procedure. It is concluded that re-mediastinoscopy should be done if it can contribute to the diagnosis. PMID- 3973497 TI - Pseudotumoral mycobacterial infection in the head and neck: a clinical study. AB - The clinical aspects of mycobacterial infection of the head and neck are considered as presenting in patients at a cancer hospital over the last 15 years. Some difficulties in diagnosis with respect to the evolution of tuberculosis in this region are discussed. A total of 32 patients with evidence of infection were identified. Twenty-six of these with cervical lymphadenopathy are considered as a group; their clinical features and diagnosis are summarized and a note made of the recent change in the macroscopic quality of the nodes removed. Six cases are given particular attention: two with laryngeal tuberculosis, two with nasal or adenoidal infection and two with atypical mycobacterial infection diagnosed on clinical grounds. PMID- 3973498 TI - Congenital absence of the palatine tonsil associated with congenital malformation of the external ear. A congenital anomaly. PMID- 3973499 TI - Ear involvement in human brucellosis. AB - A case report of mixed-type hearing loss following brucella infection is presented. Damage to the ear in brucellosis is well documented in the Polish literature whereas, surprisingly, it is not mentioned in the otolaryngologic and microbiologic English literature. Otolaryngologists should be aware of possible ear damage in brucellosis, in order to be helpful in the diagnostic process, with the aim of starting antibiotic treatment as soon as possible, in order to prevent irreversible ear damage. PMID- 3973500 TI - Congenital neural hearing-loss due to inner ear malformation. PMID- 3973501 TI - In praise of elementary teachers. PMID- 3973502 TI - Deficient eye-movement patterns in achieving high school students: three case histories. PMID- 3973503 TI - School readiness and the Draw-A-Man Test: an empirically derived alternative to Harris' scoring system. PMID- 3973504 TI - Cooperative group tasks and their relationship to peer acceptance and cooperation. PMID- 3973505 TI - Program evaluation in special education: from policy to practice in California. PMID- 3973506 TI - Use of haptic training to modify impulse and attention control deficits of learning disabled children. PMID- 3973507 TI - Mnemonic strategy instruction with learning disabled adolescents. PMID- 3973508 TI - Low density lipoprotein metabolism in hypertriglyceridemic and normolipidemic patients with coronary heart disease. AB - The turnover rates of low density lipoprotein-apolipoprotein B (LDL-apoB) were determined in 32 men with coronary heart disease (CHD) and 11 control men with normal plasma lipids. Thirty patients with CHD had normal levels of LDL cholesterol (LDL-C); of these patients, 9 had hypertriglyceridemia and 21 had normal plasma lipids. Mean concentrations of total cholesterol and LDL-C were similar among the control subjects and CHD patients, although the latter had significantly lower HDL-C. In control subjects, transport rates and fractional catabolic rates (FCR) of LDL-B were 10.6 +/- 0.5 (SEM) mg/kg-day and 0.31 +/- 0.01 pools/day, respectively. In 10 hypertriglyceridemic patients with CHD, transport rates were 21.7 +/- 1.7 mg/kg-day, and FCRs averaged 0.56 +/- 0.06 pools/day; both were significantly higher than normal (P less than 0.05). Six normolipidemic patients also had abnormally high transport rates of LDL-apoB (19.4 +/- 2.8 mg/kg-day) and FCRs (0.51 +/- 0.03 pools/day); again both were higher than normal. The remaining 16 normolipidemic patients with CHD had normal transport rates (9.9 +/- 0.6 mg/kg-day) and FCRs (0.28 +/- 0.01 pools/day). Thus, hypertriglyceridemic patients with CHD and a portion of normolipidemic patients with CHD were characterized by increases in both transport and fractional catabolic rate of LDL-apoB; these abnormalities in LDL metabolism may have contributed to their coronary heart disease. However, the majority of normolipidemic patients with CHD did not show a distinct defect in their LDL metabolism. PMID- 3973509 TI - Rapid separation of lipid classes in high yield and purity using bonded phase columns. AB - A method utilizing aminopropyl bonded phase (Bond Elut) columns has been developed to separate lipid mixtures into individual classes in high yield and purity. Up to ten lipid mixtures can be processed in 1 hr and the columns are reusable after suitable washing. Although the method was developed with standard lipid mixtures, it was shown that it is also applicable to biological extracts. Due to the rapidity and high yields (greater than 95%) of this procedure, it is superior to preparative HPLC or TLC, or other chromatographic methods for the separation of lipid mixtures for subsequent analysis. PMID- 3973510 TI - Pre-packed reverse phase columns for isolation of complex lipids synthesized from radioactive precursors. AB - Pre-packed reverse phase columns (Bond Elut) were used for the separation of complex lipids, such as phosphatidylcholine, cerebrosides, sulfatides, and gangliosides, from their respective water-soluble radioactive precursors after their in vitro biosynthesis. After an incubation in vitro, the entire reaction mixture is passed through the column, where complex lipids are retained and the hydrophilic radioactive precursors are washed away from the column. The retained lipids are then eluted with a more nonpolar organic solvent. The procedure is shown to be simpler and more efficient than the normally used Folch partitioning method or other procedures. PMID- 3973511 TI - Human apolipoprotein A-IV: displacement from the surface of triglyceride-rich particles by HDL2-associated C-apoproteins. AB - Human apolipoprotein A-IV rapidly dissociates from the surface of lymph chylomicrons following their entry into circulation by an unknown mechanism. We have therefore investigated the binding of human apoA-IV to triglyceride-rich particles and the interaction of these apoA-IV/lipid complexes with human HDL2. Human apoA-IV was purified from lipoprotein depleted serum (J. Lipid Res. 1983. 24:52-59). Triglyceride-rich particles of well-defined properties were isolated from Intralipid, a commercially available phospholipid-triglyceride emulsion. Various concentrations of radiolabeled human apoA-IV were incubated at 24 degrees C with a fixed quantity of lipid particles; the particles were reisolated by centrifugation, and bound and free apoA-IV were quantitated. In 50 mM Tris, pH 7.4, apoA-IV bound to the triglyceride-rich particles in a non-cooperative manner, with a Kd of 2.0 microM. The calculated maximal binding was 4.96 X 10(-4) mol of apoA-IV bound per mol of phospholipid. The addition of increasing amounts of human HDL2 to the incubations caused the progressive dissociation of apoA-IV from the triglyceride-rich particles. Analysis of the reisolated particles by isoelectric focusing demonstrated the presence of C-apoproteins, suggesting their transfer from HDL2. Addition of purified apoC-III-1 to the incubations at concentrations equivalent to those present in HDL2 caused a similar dissociation of apoA-IV. HDL2 was modified to selectively remove C-apoproteins, without alteration of other physical characteristics. This modified HDL2 was four times less effective in causing apoA-IV dissociation. These results demonstrate that the lipid binding properties of human apoA-IV may be quantitatively examined using triglyceride-rich particles as model chylomicrons. This approach reproduces in vitro the dissociation of apoA-IV that occurs in vivo when mesenteric lymph chylomicrons enter the circulation, and suggests that the primary mechanism for this phenomenon is the transfer of C-apoproteins from high density lipoproteins to the triglyceride-rich particle surface. We hypothesize that this mechanism may play an important role in the modulation of chylomicron apoA-IV content in man. PMID- 3973512 TI - Conformational properties of human and rat apolipoprotein A-IV. AB - Apolipoprotein A-IV has been isolated from four sources: human and rat lymph and plasma. Conformational properties of the rat and human apoA-IV in solution and denaturation changes induced by guanidine hydrochloride (Gnd X HCl) were studied using circular dichroic and fluorescence spectroscopy, and analytical sedimentation equilibrium ultracentrifugation. We have shown that both rat and human apoA-IV have similar secondary structure with negative maxima in the circular dichroic spectra at 222 nm and 207 nm. Furthermore, we have found no significant difference in the alpha-helical content of the apoA-IV from rat plasma (33%), rat lymph (37%), human plasma (35%), or human lymph (35%). Our denaturation studies with Gnd X HCl demonstrated reversibility and the fact that each apoA-IV had a tendency to self-associate in solution and the self association could be disrupted by low concentrations of Gnd X HCl (less than or equal to 0.4 M). Unfolding of the secondary structure of each apoA-IV occurred at higher concentrations of Gnd X HCl (midpoint less than or equal to 1.0 M). The apparent free energy of denaturation of the four apoA-IV proteins calculated from changes in the circular dichroic spectra upon addition of increasing concentrations of Gnd X HCl varied in a range from 3.0 to 4.2 kcal/mol. The fluorescence experiments revealed that apoA-IV from all sources had a maximum fluorescence emission at 342.5 nm, which shifted to the red region upon addition of increasing concentrations of Gnd X HCl.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973513 TI - 3-Hydroxy-3-methylglutaryl coenzyme A reductase activity in the human gastrointestinal tract. AB - Activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (EC 1.1.1.34) was measured in intestinal mucosa of the human gastrointestinal tract. Activity was highest in gastric mucosa (18.2 pmol per mg per min) and there was a constant low level in the small bowel and colon (approximately 10 pmol per mg per min). Phosphorylation/dephosphorylation modulation of intestinal reductase activity was demonstrated in normal mucosa. Expressed jejunal reductase activity was significantly higher in celiac sprue mucosa and mucosa from defunctionalized intestine of jejunoileal bypass patients. Enzyme activity also increased during 24-hr mucosal organ culture in the absence of exogenous cholesterol. Addition to the culture medium of pure cholesterol or 25-hydroxycholesterol dissolved in a small volume of ethanol suppressed the culture-induced increase to 86 +/- 3% and 69 +/- 5% of paired controls, respectively. This evidence suggests that a moderate degree of feedback regulation of intestinal cholesterol synthesis by luminal sterol occurs in man. Mucosal HMG-CoA reductase activity was also measured in patients with hyperlipoproteinemia. Patients with either predominant hypercholesterolemia or predominant hypertriglyceridemia lipid profiles had "normal" expressed reductase activity, but feedback regulation by free cholesterol could not be demonstrated in either group under these conditions. PMID- 3973514 TI - Regulated biosynthesis and divergent metabolism of three forms of hepatic apolipoprotein B in the rat. AB - Studies using rat livers perfused with recycled, serum-containing medium plus [3H]leucine revealed that secreted VLDL contain three forms of apolipoprotein B (apoB), B-48, B-95, and B-100, all synthesized by the liver. The B-48/(B-95 + B 100) [3H]leucine incorporation ratio ranged from 0.22 to 3.25 with livers of rats fed different diets, and the ratio was positively correlated with the triglyceride secretion rate in most of the livers. Generally, as more triglyceride was secreted, a greater proportion was packaged with B-48, which is the apoB form most rapidly cleared from the circulation. Together, these findings suggest a mechanism for regulating plasma triglyceride levels. [3H]Leucine incorporation into apoA-I also was positively correlated with the triglyceride secretion rate. Secretion of newly synthesized B-48 was delayed relative to all other apolipoproteins. There was little segregation of any of the three apoB forms into any of five subfractions of secreted VLDL separated on the basis of Sf value; only the smallest VLDL (Sf 20-100) were slightly enriched in B-95 and B 100. Less than 5% of newly synthesized apoB appeared in perfusate LDL. The B 100/B-95 [3H]leucine incorporation ratio was 3.3 with perfused livers of fed rats but only 1.6 in post-surgical, relatively fasted rats in vivo, suggesting physiologic regulation also of the relative amounts of the two large apoBs produced. With recycled serum-free perfusate, as opposed to serum-containing medium, there was hepatic reuptake of nascent VLDL, indicated by the reuptake of newly synthesized apoE and all three forms of apoB, and not other apolipoproteins. Divergent metabolism of B-100 and B-95 in the rat was evident from the following results: a) B-95 disappeared more rapidly from recycled, serum free liver perfusate; b) B-100 disappeared more rapidly from the circulation in vivo; c) plasma lipoprotein fractions of increasing density between d less than 1.019 and d 1.072 g/ml contained increasing proportions of B-95 over B-100. In summary, these results show that hepatic VLDL production in the rat involves the biosynthesis of three forms of apoB, that the relative amounts produced are regulated by physiologic variables, and that there is divergent metabolism of the VLDL particles into which these different apoB forms, either individually or in combination, become incorporated. PMID- 3973515 TI - Cholestyramine-induced changes in low density lipoprotein composition and metabolism. I. Studies in the guinea pig. AB - In previous animal studies, bile acid sequestrant resins have been shown to increase the fractional catabolic rate (FCR) of a low density lipoprotein (LDL) tracer isolated from a normal donor animal and to increase hepatic LDL-receptor activity. In addition, in man, these resins are known to alter LDL composition such that low density lipoproteins are smaller, more dense, and have a decreased cholesterol:protein ratio. To determine whether metabolic consequences resulted from these changes in LDL composition, we fed cholestyramine chow (2% resin by weight) to guinea pigs, which lowered LDL cholesterol levels by 55%. LDL was isolated from control donors (C-LDL) and from cholestyramine-treated donors (CH LDL). Compared to the C-LDL, the CH-LDL were smaller in size, depleted of cholesteryl ester and phospholipid, and had a marked decrease in their cholesterol:protein ratio. To determine whether the clearance of the altered CH LDL was different from that of C-LDL, we labeled the two LDL preparations with 125I or 131I and simultaneously injected them into control and cholestyramine treated guinea pigs. In 27/29 animals studied, the FCR of the CH-LDL was slower than that of C-LDL, demonstrating that the compositional changes alter the metabolism of CH-LDL. When C-LDL was used as the sole tracer in both control and treated animals, cholestyramine treatment increased the FCR by 41%; when CH-LDL was used as sole tracer, the increase in FCR on treatment was only 26%. This suggested that C-LDL was cleared more rapidly by the LDL-receptor pathway than was CH-LDL. Further support for this idea came from observations that C-LDL was degraded more readily by cultured fibroblasts and that nonenzymatic glucosylation abolished the difference in FCR between C-LDL and CH-LDL. These studies show that the effects of bile sequestration are complex and that the compositional changes produced have profound metabolic consequences. The implications of these observations for interpretation of LDL turnover studies are discussed. PMID- 3973516 TI - Brain functioning and addiction: what neuropsychologic studies reveal. PMID- 3973517 TI - Hanging in the balance: the scales of justice and forensic evidence. PMID- 3973518 TI - Nutrition for athletes. PMID- 3973519 TI - Non-transmural infarction: clinical distinction between patients with ST depression and those with T wave inversion. AB - The electrocardiograms and clinical characteristics of 152 patients with chest pain, who had changes only in their ST or T waves, were evaluated. The increase in ST depression was significantly greater (p less than 0.01) in infarction patients than in those without infarction; this was not the case with T wave inversion (p greater than 0.5). Infarction patients with ST depression had a higher incidence of previous myocardial infarction and prior digitalis usage (74% versus 35%, p less than 0.01) and a significantly greater short term (37% versus 12%, p less than 0.05) and long term (52% versus 19%, p less than 0.02) mortality than infarction patients who had T wave inversion alone. This difference was unrelated to infarct size as determined by peak enzyme levels. These two groups, therefore, appear to be clinically distinct, perhaps related to differences in ventricular function and/or extent of coronary artery disease. PMID- 3973520 TI - Dilated cardiomyopathy: utility of the transverse: frontal plane QRS voltage ratio. AB - Dilated cardiomyopathy is associated with an increase in transverse plane QRS voltage but a decrease in frontal plane QRS voltage. To study this paradoxical relationship further, electrocardiograms (ECGs) were retrospectively analyzed from five groups of men. Frontal plane QRS voltage was computed as the sum of peak-to-trough QRS amplitudes in the two limb leads with highest QRS voltage; transverse QRS voltage as the maximum peak-to-trough QRS voltage in leads [V1 or V2] + [V5 or V6]. The transverse:frontal plane QRS voltage ratio was significantly (p less than 0.01) greater in 26 patients with idiopathic dilated cardiomyopathy (3.0 +/- 1.3) compared to 29 patients with compensated aortic valve disease (2.0 +/- 0.6), 30 healthy men (2.0 +/- 0.6) and 20 patients with ischemic heart disease and relatively normal left ventricular function (1.9 +/- 0.8), but not significantly different from the ratio for patients with ischemic cardiomyopathy (2.3 +/- 1.1). This differential effect of dilated cardiomyopathy on transverse and frontal plane QRS voltages, which probably relates to a combination of mechanical and vectorial factors, may be the basis of a useful new ECG sign. PMID- 3973521 TI - Time course alterations of QTC interval due to hypaque 76. AB - Sequential measurement of QT interval during left ventricular angiography was made 30 seconds and one, three, five and ten minutes after injection of hypaque 76. The subjects were ten patients found to have normal left ventricles and coronary arteries. Significant QTC prolongation occurred in 30 seconds to one minute in association with marked hypotension and elevation of cardiac output. PMID- 3973522 TI - Effect of brief bursts of carotid sinus stimuli on heart rate and atrioventricular conduction. AB - The effect of a single brief stimulus burst applied simultaneously to both carotid sinus nerves on atrioventricular conduction (PR) was examined in paced and unpaced preparations of anesthetized open-chest dogs. The relative timing of the stimulus burst was varied to encompass the complete cardiac cycle. Carotid sinus/vagal effect curves were constructed to identify the time course of the response. In paced preparations the maximum increase in PR was 20.3 +/- 2.7 msec and this occurred 458.0 +/- 22.8 msec after the stimulus. There was a latency of 246.0 +/- 12.4 msec after the electrical stimulus before the PR began to increase. In unpaced heart preparations the effect of single carotid sinus nerve stimuli on heart period (PP) and PR was also determined. PP was maximally lengthened by 251.4 +/- 49.4 msec at 644.2 +/- 50.9 msec after the stimulus. There was a latency of 251.4 +/- 10.5 msec before the first noticeable change in PP occurred. The PR response was biphasic. The maximum lengthening of the PR interval was 16.2 +/- 4.2 msec. This response occurred at 361 +/- 22.0 msec after the electrical stimulus. The PR decreased to a minimum value of 13.6 +/- 2.2 msec below control values at 767.1 +/- 44.0 msec after the stimulus. The overall effect of carotid sinus activity on atrioventricular conduction depends not only on the direct nodal effect of acetylcholine but also on the indirect heart rate changes. We conclude that brief bursts of carotid sinus nerve stimulation produce cardiac electrophysiological effects qualitatively similar to the effects of direct vagal stimulation, differing only in having a lower amplitude, a longer latency and a somewhat wider time dispersion. PMID- 3973523 TI - The Brody effect and change of volume of the heart. AB - A simple model study2 is used to compare the relative contributions to the surface ECG of the "Brody effect"1 and positional changes of the heart when the heart volume changes. In certain studies, such as exercise, it is the change in heart volume and its effect on the surface ECG which is of interest. This paper suggests that when the heart volume changes the extent to which it is accompanied by positional change will strongly influence the surface voltage change; the surface voltage may in fact increase or decrease with volume increase. This may explain some of the controversy surrounding the influence of volume change on the surface signal. PMID- 3973524 TI - Ability of standard ECG parameters to detect the body surface isopotential abnormalities of pacing induced myocardial ischemia in the dog. AB - The ability of parameters derived from standard, scalar ECG leads to predict abnormal body surface isopotential distributions was tested in 25 dogs. Atrial pacing to rates of 170 beats per minute or greater, two weeks after implantation of an ameroid constrictor on the left circumflex coronary artery, resulted in abnormal isopotential patterns due to subendocardial ischemia. A total of 96 scalar ECG variables (potential and slope measurements at 20, 40, 60 and 80 msec into the ST-segment in each of 12 leads) were computed. Ability of each variable and potential-slope pairs to distinguish normal from ischemic map forms was tested using discriminant function analysis and simple classification procedures. Results demonstrated that accuracy of prediction was lead-dependent, and time dependent, with different sensitivities, specificities and boundary values in different leads and at different instants during the ST-segment. These new concepts may have direct relevance to the selection of clinical exercise ECG diagnostic criteria. PMID- 3973526 TI - The passage of 5 alpha-dihydrotestosterone from serum into cerebrospinal fluid and LH negative feedback in castrated rhesus monkeys. AB - Seven castrated monkeys were given either 50 or 100 micrograms 5 alpha dihydrotestosterone (DHT) propionate/kg per day. There was no correlation between serum and cerebrospinal fluid (CSF) levels of DHT, which remained very low in the CSF (0.3-0.6% of blood levels) despite the presence of high, supraphysiological amounts in the circulation. There was also no relation between unbound DHT in the blood and the CSF, in which all DHT is unbound. These results differ from previous work on testosterone, the metabolic precursor of DHT. 5 alpha Dihydrotestosterone propionate at the higher dose maintained suppressed levels of serum LH; LH in two out of four monkeys treated at the lower dose increased to levels observed in castrated, untreated rhesus monkeys. There was no predictable relationship between the amount of DHT in the CSF and levels of LH in the blood: by contrast, DHT in the blood was correlated with serum levels of LH. Levels of LH rose in monkeys in which total blood DHT fell below about 68 nmol/l and, even more obviously, if unbound DHT decreased to less than about 2 nmol/l. Differences between the distribution of testosterone and DHT between blood and CSF cannot be explained by serum binding, lipid solubility or clearance from the brain, and suggest that there may be some mechanism for excluding DHT from the CSF. Though DHT reaches the CSF from the blood in small amounts, levels there do not relate predictably to those in the vascular compartment. It seems unlikely, therefore, that levels of intracerebral DHT are controlled by changes in those of the blood. PMID- 3973525 TI - Effect of higenamine on action potential of ventricular myocardial cells. AB - Action potentials of isolated ventricular myocardial fibers of pigs and the electrophysiological actions of dl-demethylcoclaurine (DMC) or higenamine on the porcine myocardial cells were studied by glass microelectrodes. The action potentials of porcine ventricular myocardial fibers were similar to those of other mammalian hearts. Amplitude of the action potential was 115 +/- 9 mV, duration of action potential 242 +/- 30 ms, resting membrane potential -85 +/- 5 mV and the maximum rise of depolarization of action potential 151 +/- 27 V/s. After perfusion with normal Tyrode's solution containing DMC 5 micrograms/ml, the amplitude of action potential was increased and the duration of action potential was prolonged, the amplitude and duration of the plateau of action potential were increased and the slope of phase 2 of action potential was reduced (p less than 0.05). The resting potential, the slope of phase 3 and the maximum depolarization rate of phase 0 of action potential did not change. In Tyrode's solution containing Mn++ 3 mM, these electrophysiological actions of DMC disappeared. DMC may abolish the conduction block induced by K+-rich solution. In Tyrode's solution containing K+ 32 mM, the upstroke of action potential showed 2 phases under influence of DMC. The second phase disappeared when Mn++ was added. All findings indicate that DMC can be considered as an activator of the slow channel. The electrophysiological mechanism and clinical significance of DMC were discussed. PMID- 3973527 TI - Thyroid function in pyridoxine-deficient young rats. AB - In pyridoxine-deficient young rats hypothalamic serotonin was decreased with no changes in the dopamine and noradrenaline content. Serum thyroxine and tri iodothyronine concentrations were much lower in the deficient rats as compared to pyridoxine-supplemented controls. No significant difference between deficient and control groups in the serum TSH concentration was detected. Highly significant decreases in the content of pituitary TSH and in the number of pituitary thyrotroph secretory granules were found. These results suggest that the hypothyroidism of pyridoxine-deficient young rats might be of hypothalamic origin. PMID- 3973528 TI - Effect of a single injection of prolactin on the serum concentrations of thyroid hormones and corticosterone and liver monodeiodinase in the domestic fowl before and after hatching. AB - The influence of an intravenous injection of ovine prolactin on the liver monodeiodinase activity and serum concentrations of thyroid hormones and corticosterone was studied in Hisex embryos and chicks after hatching. An injection of 1 and 10 micrograms ovine prolactin into 18-day-old chick embryos increased serum concentrations of tri-iodothyronine (T3) five- and eightfold respectively after 2 h. At the same time serum concentrations of thyroxine (T4) and reverse T3 (rT3) were decreased in the chick embryo, but only with 10 micrograms prolactin. This was accompanied by a doubling of the liver monodeiodinase activity. Serum concentrations of corticosterone, however, were not influenced by the prolactin injections. In the 5-day-old chicken, serum concentrations of T3, rT3, T4 and liver T4-5'-monodeiodinase activity were not influenced by 1 or 10 micrograms prolactin. Serum concentrations of corticosterone after injection of 1 or 10 micrograms prolactin were doubled compared with controls. These results are compatible with a prolactin-induced shift from a T4-5-monodeiodination into a T4-5'-monodeiodination in the liver at the end of incubation. This effect, however, is not mediated through a prolactin induced corticosterone release. PMID- 3973529 TI - The Second International Reference Preparation of Thyroid-Stimulating Hormone, Human, for Immunoassay: calibration by bioassay and immunoassay in an international collaborative study. AB - Four batches of ampouled materials in ampoules coded 80/558, 81/502, 81/565 and 81/615 were evaluated by 22 laboratories in nine countries in an international collaborative study for their suitability to serve as a replacement for the First International Reference Preparation (IRP) of TSH, Human, for Immunoassay. The ampouled preparations were calibrated by immunoassay and bioassay. The preparation coded 80/558 had satisfactory stability and contained acceptably low levels of contamination with FSH and LH. Estimates of the immunoreactive TSH content of a set of specimens of serum in terms of 80/558 showed agreement in ranking order and no increase in variability compared with estimates made by assay against the First IRP. On the basis of these results, with the agreement of the participants in the study, and with the authorization of the Expert Committee on Biological Standardization of the World Health Organization, the preparation coded 80/558 was established in 1983 as the Second International Reference Preparation of TSH, Human, for Immunoassay, with a defined potency of 37 mi.u./ampoule. Preparations coded 81/502, 81/565 and 81/615 were found suitable to serve as working standards. PMID- 3973530 TI - Corticosterone storage within the adrenal cortex: evidence for a sulphate conjugate. AB - Incubation of homogenized rat adrenal glands with sulphatase for 18 h resulted in a significant increase in the amount of unconjugated corticosterone that could be extracted from the gland and which could not be attributed to de-novo synthesis of corticosterone during the incubation. Therefore corticosterone may be stored within the adrenal gland as a sulphate conjugate rather than as unconjugated hormone. Exposure of animals to footshock stress resulted in an increase in the amount of unconjugated corticosterone in the gland and a disappearance of the conjugate form. The rapid disappearance of the sulphate conjugate may reflect the activation of a steroid sulphatase by ACTH. However, the release of corticosterone from a storage form such as corticosterone sulphate could not explain entirely the initial increase in plasma corticosterone concentration following the stress. It was calculated that a pair of adrenal glands would have to store up to 20 nmole corticosterone in order to account for the initial increase in plasma corticosterone. This level was much greater than that extracted from a pair of glands (4.8 nmol) even after sulphatase pretreatment. PMID- 3973531 TI - Effects of pup sucking behaviour on inhibition of sexual behaviour and ovulatory secretion of LH in lactating rats. AB - The time-interval between parturition and the display of sexual receptivity varied between 13.5 +/- 0.7 and 35.9 +/- 2.5 days in rats with litters of between 1 and 24 pups. Body weight gain decreased and the avidity of pup sucking behaviour, measured by the latency before the pups, placed on the ventrum of an anaesthetized mother, attached to a nipple of the mother, increased as litter size increased. Litter-shifting procedures, which introduced asynchrony between the lactational age of the mother and the age of the pups, produced deficiencies in sucking behaviour and did not prolong the time-interval between parturition and the display of sexual receptivity by the mother. By keeping the lactational age of the mother in synchrony with the age of the pups and depriving the pups of maternal contact and nutrition every alternate day, the time-interval between parturition and the display of sexual receptivity by the mother was prolonged by 17 days, the avidity of pup sucking behaviour markedly enhanced and the body weight gain of the pups retarded in comparison with mothers and pups continuously living together. The results show that the display of the first postlactational behavioural oestrus and surge of pituitary LH secretion can be greatly delayed by an increase in the avidity of pup sucking behaviour. PMID- 3973532 TI - 4th joint meeting of British endocrine societies. 25-28 March 1985. Oxford. Abstracts. PMID- 3973533 TI - In situ analysis of antigens on malignant and benign cells of the melanocyte lineage. Differential expression of two surface molecules, gp75 and p89. AB - Monoclonal antibodies (mAb) were selected for differential binding to sections of freshly frozen biopsy material of human malignant melanomas and their precursor lesions, the melanocytic nevi. Both melanomas and normal nevi expressed human Ia like antigens, transferrin receptor and the transferrin-related molecule p97. In contrast, only 1 nevus of 21 tested expressed both glycoprotein gp75, defined by mAb 15.75, and protein p89, defined by mAb P3.58, whereas 12 of 15 melanomas tested expressed both antigens. mAb P3.58 reacted with one additional melanoma and one nevus. The expression of these two molecules therefore appears to be correlated with the appearance of the malignant phenotype of melanocytes. PMID- 3973534 TI - Pyrimidine salvage in Giardia lamblia. AB - We have found that the anaerobic protozoan parasite Giardia lamblia is incapable of de novo pyrimidine metabolism, as shown by its inability to incorporate orotate, bicarbonate, and aspartate into the pyrimidine nucleotide pool. Results from high performance liquid chromatography of pyrimidine and pyrimidine nucleoside pulse-labeled nucleotide pools and enzyme assays suggest that the parasite satisfies its pyrimidine nucleotide needs predominantly through salvage of uracil by a cytoplasmic uracil phosphoribosyltransferase. Exogenous uridine and cytidine are primarily converted to uracil by the action of uridine hydrolase and cytidine deaminase before incorporation into nucleotide pools. Direct salvage of cytosine occurs to a relatively limited extent via cytosine phosphoribosyltransferase. G. lamblia relies on salvage of exogenous thymidine for ribosylthymine monophosphate (TMP) synthesis, accomplished primarily through the action of a 100,000 g-pelletable thymidine phosphotransferase. PMID- 3973536 TI - Quantitative analysis of total macrophage content in adult mouse tissues. Immunochemical studies with monoclonal antibody F4/80. AB - We have estimated the macrophage content of different tissues of the normal adult mouse using F4/80, a highly specific antigen marker for mature mouse macrophages. An absorption indirect binding assay was used to quantitate F4/80 antigen against a calibration standard made from the J774.2 macrophage-like cell line. The richest sources of tissue F4/80 antigen were found to be bone marrow, spleen, cervical and mesenteric lymph nodes, large bowel, liver, kidneys, and small bowel. The organs that have the highest total F4/80 antigen content are the liver, large bowel, small bowel, bone marrow, spleen, cervical and mesenteric lymph nodes, and kidney. We conclude that the mononuclear phagocyte system is mainly distributed in the gastrointestinal tract and liver, followed by hemopoietic and lymphoid tissues. PMID- 3973537 TI - Malpractice liability risk and the physician-patient relationship. PMID- 3973538 TI - Throat cultures. PMID- 3973535 TI - Human megakaryocytes. V. Changes in the phenotypic profile of differentiating megakaryocytes. AB - Human megakaryocytes were studied for phenotypic changes occurring throughout differentiation using a panel of monoclonal antibodies raised against marrow megakaryocytes and blood platelets. 11 monoclonal antibody preparations were selected for restricted specificity against megakaryocytes and/or platelets after screening by immunofluorescence, complement-mediated cytolysis, and solid phase enzyme-linked immunosorbent assay. The expression of the cellular epitopes recognized by these reagents enabled the identification of three levels of megakaryocyte maturation characterized by distinct immunologic phenotypes. Based upon their reactivities against megakaryocytic cells at different ontogenetic levels, monoclonal antibodies were operationally categorized into three groups. Group A consisted of six different monoclonal antibodies that recognized antigens on the colony-forming unit-megakaryocyte (CFU-Mk), in vitro grown colony megakaryocytes, and early immature marrow megakaryocytes, only, and did not detect their respective epitopes on either mature megakaryocytes or platelets. A monoclonal antibody categorized in group B detected a cell antigen expressed by megakaryocytic cells at all maturational levels, but which is lost or suppressed during terminal differentiation and is not expressed on blood platelets. Group C included four different monoclonal antibodies raised against platelets that recognized antigenic determinants expressed on the CFU-Mk, colony megakaryocytes, early and mature megakaryocytes, and platelets. Three group C monoclonal antibodies (PC-1, PC-3, and PC-4) were specific for platelet glycoprotein IIb/IIIa. Additionally, group C monoclonal antibody PC-2 was unique in that it showed partial reactivity against the clonable progenitor for the erythroid series (BFU-E). Recognition of discrete phenotypic changes in differentiating megakaryocytes will enable multiparameter analyses of these cells as well as the study of factors regulating the dynamics of megakaryocytopoiesis in health and disease. PMID- 3973539 TI - Diagnosis of Candida vaginitis. PMID- 3973540 TI - Family practice grand rounds. Functional bowel syndrome, pheochromocytoma, or demonio? PMID- 3973541 TI - Papanicolaou smear adequacy: effect of different techniques in specific fertility states. AB - Six hundred fifty-four Papanicolaou smears were studied prospectively to determine the yield of endocervical cells within specific fertility states by technique used. Smears from postmenopausal women had the lowest yield of endocervical cells (32 percent, P less than 0.01). Smears from postpartum women had a higher yield of endocervical cells than those from pregnant women (69 percent vs 59 percent, P greater than .05). Swabbing excess mucus from the cervix prior to scraping uniformly improved the yield of endocervical cells (70 percent vs 62 percent, P less than .02). In swabbed postmenopausal women, use of a Milex spatula had a significantly higher yield than the use of a wooden spatula and a cotton-tipped applicator (43 percent vs 27 percent, P less than .03). PMID- 3973542 TI - Temperature and fever in the full-term newborn. AB - In order to establish temperature norms during the first nine days of life, a retrospective analysis of 501 neonates was completed. After norms were derived, charts of all infants born at the UCLA Medical Center in 1979 were reviewed. Data were analyzed on every infant who had a recorded temperature greater than two standard deviations above the mean high. Sustained fever was unusual but highly predictive of infection. Infants rarely had fever, however, as the only sign of infection. Single elevated temperature readings were not associated with infection. PMID- 3973543 TI - Physician compliance with colorectal cancer screening (1978-1983): the impact of flexible sigmoidoscopy. AB - Physician compliance with widely recommended colorectal cancer screening methods was studied over a five-year period in a university-based family medicine residency program. Indicated examinations were being avoided in symptomatic as well as asymptomatic patients aged over 50 years. The introduction of flexible sigmoidoscopy created significant change in previously documented poor resident and faculty compliance. Baseline measurement of outcomes was noted by audit of 189 adult medical records (year 1). Educational reemphasis by lecture and intragroup commitment produced no change by the end of year 2 (n = 189). Introduction of the flexible sigmoidoscope yielded a sevenfold increase in physician compliance in year 3 (n = 192). This compliance increased as measured by chart audit in years 4 (n = 166) and 5 (n = 190). All audited groups were mutually exclusive. The documented diagnostic superiority of this instrument was readily obtainable by family physician faculty and residents in training. With Papanicolaou smear activity serving as a control group, the findings indicated a significant and sustained effect. Two additional primary care training programs were audited during the final year of the study period. These control audits revealed continued poor compliance with rigid sigmoidoscopy. The flexible sigmoidoscope is an important addition to the diagnostic and screening armamentarium of a family medicine residency program. PMID- 3973544 TI - Family awareness demonstrated by family practice residents: physician behavior and patient opinions. AB - Audiotapes of the visits of 50 new patients with 20 family practice residents were analyzed to determine how aware the residents were of their patients' families. The same patients' opinions about family awareness were elicited by interviews. Residents exhibited only limited family awareness. Despite this, patients thought that the residents showed more interest in family matters than they usually expected from a family physician. Patients thought the physicians were most interested in their family situations when they asked more questions about family matters. Physicians were seen as least interested when they asked few family questions and when they were absent from the examination room for a relatively high proportion of the visit. Physicians were much less likely to discuss family matters with a patient during a short visit for an acute problem than during a longer visit for a chronic problem or for health maintenance. Most patients identified physician attitudes and behaviors as more important obstacles to the discussion of family matters than patient attitudes. Patients generally wanted substantially more help from their family physician for family problems than they expected to receive. PMID- 3973545 TI - The cost and funding of family practice graduate education in the United States. AB - This paper reports the findings of a national cost survey of 369 nonmilitary family practice graduate education programs in the United States, 1981-82. The purpose of the study was to develop a reliable revenue and cost information data base to enable an understanding of current family practice education costs and funding. The availability of this information will be of assistance in the development of future budgetary plans for family practice graduate education. The results presented are based on 147 programs associated with hospitals using a non cost center accounting protocol. These programs provided 100 percent complete revenue and cost data (40 percent of the targeted programs). Major sources of income were hospital support (35 percent), patient income (31 percent), and public dollars (28 percent). The mean cost per accredited position was $57,471. Expenses, each at approximately one third of the total, were resident stipends, faculty salaries, and clinic expenses. Statistically significant differences were found only for source of income when program structure, program size, and geographic location were examined. Recommendations for future family practice funding include modification of present reimbursement formulas and other third party payment mechanisms, increasing hospital support, maintenance of public subsidies, and development of a uniform system of monitoring and evaluating costs of residency programs operated under both cost center and non-cost center accounting protocols. PMID- 3973546 TI - Malpractice risk and patient relations. PMID- 3973547 TI - The early diagnosis of Campylobacter enteritis by wet-mount examination. PMID- 3973548 TI - Differentiation of mouse ectopic germinal cells in intra- and perigonadal locations. AB - Four hundred and thirteen ectopic germinal cells in the testicular and extratesticular stroma and in the rete testis of mouse fetuses from day 13 of uterine development to term were studied together with 161 ectopic germinal cells in the rete ovarii and periovarian stroma of female fetuses at days 17 and 18 of intrauterine life. The morphology and the differentiation of these ectopic germinal cells were compared to those of germinal cells within seminiferous and ovigerous cords. While the ectopic germinal cells in the testis and in the rete testis followed patterns of differentiation identical with those in the seminiferous cords throughout the period included in the study, those in the extratesticular stroma behaved like entopic germinal cells only through day 17, since at days 18 and 19 many of them entered meiotic prophase just like XX germinal cells in the ovigerous cords. No differences were noted between ectopic and entopic ovarian germinal cells. The results of this study show that the factors responsible for the male differentiation of XY germinal cells are not limited to the seminiferous cords but operate throughout the testicular territory, and confirm that outside the testis, XY germinal cells differentiate as female; our study also corroborates the thesis that the differentiation of XX germinal cells is an autonomous and ubiquitous process. PMID- 3973549 TI - Structural and functional development of cricket ring muscles. AB - The sizes of the unifunctional dorsal longitudinal (DLM) and bifunctional subalar (SA) metathoracic flight muscles of the cricket Teleogryllus oceanicus increase by more than an order of magnitude between the second instar before the terminal molt and the tenth day of adult life. During the same developmental period isometric twitch duration (onset to 50% relaxation, 25 degrees C) varies little, while muscle mitochondrial content increased by a factor of ten as measured by stereological analysis of electron micrographs and citrate synthase activity (mumoles citrate . min-1 . gm protein-1, 25 degrees C). The wing muscles of adults have abundant sarcoplasmic reticulum (SR), narrow myofibrils, and a high volume density of mitochondria. At two molts from adulthood muscles that will later be used in flight behavior also have narrow myofibrils and abundant SR, but unlike muscles at later stages, nymphal muscles have a low volume density of mitochondria. At the terminal molt muscles have at least as much SR as is seen in muscles at the tenth day of adult life, and the myofibrils are also more narrow at the earlier stage. Since there is significant variation in muscle structure and little change in twitch duration during late development, the efficacy of the SR in releasing and resequestering CA2+ is seemingly lower in muscles at the terminal molt, a time of rapid muscle growth. PMID- 3973550 TI - Effects of polyamines upon capacitation and fertilization in the guinea pig. AB - The effects of polyamines upon the ability of guinea pig spermatozoa to undergo the acrosome reaction and upon sperm-egg fusion were investigated. All of the polyamines (polyarginines and compound 48/80) stimulated the occurrence of the acrosome reaction, although differences in the duration of the preincubation period required were noted. The stimulatory effect of the polyarginines could not be reversed by washing, while that of 48/80 was abolished by its removal prior to induction of the acrosome reaction. Polyarginine-treated spermatozoa were fully capable of fertilizing intact guinea pig eggs. In contrast, 48/80 completely blocked sperm-egg fusion at only 5-10 micrograms/ml. This inhibition was reversible by washing either treated gamete. The ability of polyamines which may also be present at the time and site of fertilization, in vivo, to inhibit or stimulate gamete functions or interactions is discussed. PMID- 3973551 TI - Light flashes of different durations (0.063-3.33 msec) phase shift the circadian flight activity of a bat. AB - The phase-response curve (PRC) for the circadian rhythm in the flight activity of a cave-dwelling bat, Hipposideros speoris, constructed with 0.063-msec light flashes, reported here is the first of its kind for any circadian system and is unlike any other phase-response curves constructed for other nocturnal animals. The phase responding with maximal advances (90 degrees) and the phase responding with maximal delays (0 degree) of this PRC were exposed to light flashes of systematically varying durations from 0.083 to 3.33-msec. For 0 degree phase, the flashes of 0.063-3.33 msec effected delay phase shifts of comparable magnitude. For 90 degrees phase, the flashes of 0.063-1.0 msec effected advance phase shifts, whereas 3.33-msec flashes effected unmistakable delay phase shifts with advancing transients. Phase shifts evoked with such light flashes are further compared with phase shifts evoked with pulses of longer durations (15 min to 2.8 hr) for H. speoris. PMID- 3973552 TI - Muscle function studies in amputated lathyritic rats. AB - This study is presented to compare two methods of evaluating changes in muscle function after amputation of the left leg at the knee. Rats were fed a 50% Lathyrus odoratus diet, which causes exostoses to develop at sites of attachment of certain muscles. The rats were on the experiment for 3, 6, or 9 weeks. Muscles of rats killed at 6 weeks were weighed to determine whether atrophy or hypertrophy had occurred. Sizes of exostoses were evaluated subjectively at each time period. The left adductor longus and quadratus femoris muscles underwent considerable atrophy and their exostoses were smaller than on the right side. The left iliopsoas increased in weight and had the larger exostosis. However, the left pectineus increased in weight but had the smaller exostosis. It is concluded that changes in muscle weights and changes in sizes of exostoses both reflect changes in muscle function, but because the two methods respond by different mechanisms, the results do not always agree. PMID- 3973553 TI - Steroidal enhancement of growth in parasitic larvae of Ascaris suum: validation of a bioassay. AB - Third-stage larvae of the swine parasitic roundworm, Ascaris suum, were grown in stationary multiwell cultures in the presence of synthetic steroid hormones or the HPLC fractions of a steroid extract of adult female reproductive tracts to determine the subsequent effect of these compounds on length of 4th-stage larvae. Log doses of ecdysone, 20-hydroxyecdysone, progesterone, and makisterone standards, from 50 pg/ml to 500 ng/ml, were incubated with larvae for 1 day in RPMI-1640 supplemented with cholesterol. Length measurements were made on 4th stage larvae after an additional 6 days of incubation. All compounds and extracts had a dose-dependent enhancement on length of these larvae; the partially purified extracts were more potent than their synthetic analogs. All standards and extracts except makisterone showed reduced or no response at higher dose levels. In contrast, makisterone continued to have maximal effect from 500 pg/ml to 500 ng/ml. Short exposure period to the steroid and low concentration were critical to demonstrate enhanced growth in this homologous bioassay. PMID- 3973554 TI - Effect of absorbed and nonabsorbed anti-H-2 antiserum on mouse blastocysts. AB - Conventional antisera and monoclonal antibodies have been used to demonstrate the presence of H-2 antigens on preimplantation mouse embryos. In this study, the specificity of previously used anti-H-2 conventional antisera was tested by absorption of the antisera on spleen lymphocytes. It was found that absorption of the anti-H-2 antisera removed all of the antibody reactive with lymphocytes, but only about half of the antibody reactive with embryos. The effect of absorbed and nonabsorbed anti-H-2 antisera on mouse blastocysts was tested both by cytotoxicity assays and by electron microscopy. The results suggest that conventional antisera do indeed detect H-2 antigens on mouse embryos, but they may detect other, as yet undefined, antigens as well. PMID- 3973555 TI - Protein synthesis by isolated pachytene spermatocytes in the absence of Sertoli cells. AB - Isolated rat pachytene spermatocytes were incubated in chemically defined medium supplemented with pyruvate and lactate, which are known to be essential energy substrates for these germ cells. Protein synthesis by the isolated cells was investigated by means of two-dimensional polyacrylamide gel electrophoresis. The electrophoretic patterns of (35S)-labeled proteins, synthesized by the pachytene spermatocytes during incubation in the presence of (35S)methionine either from 0 2 h or from 24-26 h after isolation, were almost completely identical. The patterns of newly synthesized proteins of freshly isolated spermatocytes and spermatids, however, showed several stage-specific proteins in addition to many proteins common to both spermatogenic cell types. Hence, it was concluded that a stage-specific pattern of protein synthesis can be maintained by pachytene spermatocytes during incubation for a period of 24 h in the absence of Sertoli cells but in the presence of a proper energy source. PMID- 3973556 TI - Growth and aging in the rat: changes in total protein, cellularity, and polyploidy in various organs. AB - The objectives of this study were to determine the influence of growth and aging on ploidy, cell number, and protein content of various organs. Tissue homogenates were prepared at 3, 8, 25, 50, and 100 weeks of age. Samples were analyzed for DNA per nucleus (by flow cytofluorometry), nuclei number, and protein content. Livers of 8- and 100-week-old animals were also perfused with collagenase and the released cells separated into parenchymal and nonparenchymal populations by unit gravity sedimentation. Nuclei of these cells were also analyzed for DNA. In all four zones of the kidney and in thyroid, 4n nuclei diminished in percentage between 3 and 50 weeks and increased at 100 weeks. In the growth phase these probably are cycling cells and after 50 weeks represent an increasing population of nuclei arrested after synthesis of DNA. Constant levels of ploidy were found in brain, heart, rectus abdominis, and adrenal throughout the 3-100 weeks. A dramatic increase in 4n nuclei occurred between 3 and 8 weeks in liver with little change occurring thereafter. Ploidy is a property of only parenchymal cells in liver and this probably is also true in other organs. The 4n nuclei that remain in constant proportion to the total population are established early in life and are not related to aging. They are probably tetraploid and replicate into 4n daughter cells during growth. Cerebrum shows no changes in nuclei number but exhibits a 70% increase in protein between 3 and 100 weeks. Although kidney, liver and adrenal show large increases in number of nuclei (approximately equal to fourfold) with growth, these are not as great as increases in body weight (approximately equal to 11-fold). With regard to organ protein, only liver shows increases approximating those in body weight. Increases in organ nuclei appear to occur in concert for adrenal, kidney, and liver whereas increases in organ protein bear no relationship to each other. Protein content remains at stable levels in organs of 100-week-old animals and little (adrenal, liver) or no (brain, kidney) diminution occurs in nuclei numbers. PMID- 3973557 TI - Effects of temperature upon capacitation of guinea pig spermatozoa. AB - Spermatogenesis in many mammalian species requires a temperature a few degrees below body core temperature. Upon ascent through the male tract and deposition in the female tract, the temperature of spermatozoa is increased to body core temperature. This report investigates the effects of temperatures above or below normal body core temperature, which is also the usual temperature of in vitro gamete incubations and fertilization, upon sperm acrosome reacting ability and fertility. Epididymal guinea pig spermatozoa were preincubated in a Ca2+-free medium at temperatures of 15 degrees C, 25 degrees C, 37 degrees C, or 44 degrees C for increasing periods of time. At 15 degrees C or 25 degrees C, no or very few spermatozoa acquired the ability to acrosome react upon exposure to Ca2+ even after 18 hr of culture or warming up to 37 degrees C. A known stimulator of acrosome-reacting ability, lysophosphatidylcholine, was ineffective in promoting acrosome-reacting ability in spermatozoa incubated at 15 degrees C or 25 degrees C. At 37 degrees C the percentage of acrosome reaction increased steadily over time, reaching about 65% after 18 hr. At 44 degrees C the time course of acquisition of acrosome-reacting ability was greatly accelerated with a percentage at 2 hr comparable to that achieved at 37 degrees C only after 18 hr of preincubation. This effect of incubation at 44 degrees C could be reversed by cooling the spermatozoa to 37 degrees C before they were exposed to Ca2+. Spermatozoa induced to undergo the acrosome reaction after preincubation at 44 degrees C were fully capable of fertilizing intact guinea pig eggs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973558 TI - Developmental mutants isolated from wild-caught Xenopus laevis by gynogenesis and inbreeding. AB - Xenopus laevis obtained from indigenous African populations are a rich source of mutants affecting development. Gynogenesis and inbreeding were used to isolate mutants affecting development from wild-caught Xenopus laevis females. Fourteen mutants were recovered from eight females tested. One mutant was recovered from each of two females. This load of 1.875 developmental mutants per female is similar to that found in the axolotl (Ambystoma mexicanum), a urodele amphibian, and is only slightly less than the load of mutants with major developmental effects found in Drosophila and man. These results suggest that the anuran amphibian Xenopus laevis, an ancestrally tetraploid species, has undergone extensive diploidization of developmentally important loci and that gynogenesis and inbreeding of wild-caught animals can provide adequate mutants at diploid loci for developmental genetic studies. PMID- 3973559 TI - Relative developmental success of interspecific Lepomis hybrids as an estimate of gene regulatory divergence between species. AB - The developmental success of interspecific Lepomis hybrids is used as an index of gene regulatory divergence between the green sunfish, L. cyanellus, and each of three other parental species, longear sunfish, L. megalotis, warmouth, L. gulosus, and bluegill, L. macrochirus. This gene regulatory divergence is compared to the degree of structural gene divergence among these four species (genetic distance [Nei, '78], D, ranged from 0.206 to 0.586). The developmental success of the hybrid embryos at the level of morphogenesis was higher than expected from the genetic distance between the parental species. The rates of morphogenesis of the hybrid embryos were the same as that for the green sunfish embryos. The percentage of embryos that hatched was relatively high in all crosses. However, two of the hybrid crosses resulted in enhanced percentages of hatched embryos. Slight increases in the extent of morphological abnormalities were observed in hybrids from crosses between more distantly related parental species. The schedules and levels of enzyme locus expression of the hybrids, assessed spectrophotometrically and electrophoretically for nine enzyme systems (encoded in a total of 14 loci), were different from each other and from those of the green sunfish embryos. Alterations in the time of first enzyme appearance and in the time of first increase in enzyme activity in the developing hybrid embryos were not correlated with genetic distance between parental species. However, the extents of alteration of enzyme activities over the entire period of hybrid embryogenesis were correlated with the genetic distance. We attribute the morphological and molecular anomalies observed in the hybrids to gene regulatory incompatibilities between species. Although the exact number of mutational differences and their relative developmental impacts are not known, some inferences can be drawn about the degree of divergence in gene regulation between species. It appears that an uncoupling of the rates of structural and regulatory gene evolution can occur between species of some taxa, an observation that has implications for the roles of gene regulatory differences in organismic evolution. PMID- 3973561 TI - Synthesis of bunyavirus-specific proteins in a continuous cell line (XTC-2) derived from Xenopus laevis. AB - The XTC-2 cell line, derived from Xenopus laevis, supported the replication of representative viruses from each of the four genera in the family Bunyaviridae. Generally, viral titres were higher in XTC-2 cells than in other susceptible cell lines, and for some viruses plaques were detected earlier in XTC-2 cells. The XTC 2 cell line permitted comparative analyses of bunyavirus-specific protein synthesis. The patterns of synthesis of viral proteins, characteristic of each of the genera, were observed with representative viruses. These studies provided biochemical characterization of two Scottish isolates, which support the inclusion of Clo Mor virus in the Nairovirus genus and St Abb's Head (M349) virus in the Uukuvirus genus. PMID- 3973560 TI - Amino acid sequences of haemagglutinins of influenza viruses of the H3 subtype isolated from horses. AB - The amino acid sequence of the haemagglutinin of A/equine/Miami/63 (H3N8), the prototype influenza virus of the H3 subtype from horses, is deduced from the nucleotide sequence of virus RNA and compared with the sequences of haemagglutinins of viruses of this subtype isolated from humans [X-31 (H3N2)] and from birds [A/duck/Ukraine/63 (H3N8)] and with the sequence of the haemagglutinin of A/equine/Fontainebleau/79 (H3N8) a virus isolated from a recent outbreak of equine influenza. The amino acid sequence differences detected are discussed with reference to the structure of the molecules, their antigenicity and antigenic drift in influenza viruses viruses isolated from horses. PMID- 3973562 TI - Mouse interferon alpha and beta genes are linked at the centromere proximal region of chromosome 4. AB - In order to determine the chromosomal localization of the murine interferon-alpha (MuIFN-alpha) and murine interferon-beta (MuIFN-beta) genes the DNAs of a panel of somatic cell hybrids were analysed by Southern blot hybridization. The hybrid cells were derived from E36 Chinese hamster cells and GRSL or GR MaTu mouse cells and retained all hamster chromosomes but segregated mouse chromosomes. The MuIFN alpha probe used was a 0.7 kb HindIII-EcoRI fragment derived from the MuIFN-alpha 1 gene which hybridized with both mouse and hamster DNA. However, four fragments present in EcoRI digests of mouse DNA were clearly absent from the hybridization profile of EcoRI-digested hamster DNA and could be used for detection of MuIFN alpha sequences in the hybrid cells. The MuIFN-beta probe, a 0.5 kb BglII-BamHI fragment derived from the MuIFN-beta gene, hybridized with a 2.6 kb EcoRI fragment of mouse DNA and only weakly cross-hybridized with a 4.8 kb EcoRI fragment in hamster DNA. Southern blot analysis of DNA from mouse/hamster hybrids compared with the analysis of chromosome markers showed that both the MuIFN-alpha and the MuIFN-beta genes are located on chromosome 4. Analysis of DNA from hybrids that contained only part of chromosome 4 indicated that the MuIFN-alpha gene family and the MuIFN-beta gene are situated at the centromere-proximal region of the chromosome. PMID- 3973563 TI - Synthesis of proteins and glycoproteins in dengue type 2 virus-infected vero and Aedes albopictus cells. AB - Fifteen proteins were detected in Vero cells infected by dengue type 2 (DEN-2) virus that were not observed in mock-infected cells, namely P98, p82, P67, GP60, gp54, GP46, p30, p28, gp22, GP20, p18, gp16, p15, p14 and gp13. With the exceptions of gp54 and gp13, polypeptides corresponding to those listed above were also observed in DEN-2 virus-infected Aedes albopictus C6/36 cells. Pulse chase labelling experiments suggested a possible precursor-product relationship between p30 and p28, and between gp22 and GP20. Peptide mapping and immunoprecipitation experiments showed that the major glycoproteins GP60, GP46 and GP20 were unrelated. Immunoprecipitations of infected cells with antiserum prepared against the DEN-2 soluble complement-fixing (SCF) antigen demonstrated that this antigen is equivalent to the non-structural glycoprotein GP46. The envelope glycoprotein (E) from virus grown in C6/36 cells migrated faster through polyacrylamide gels containing SDS than E from virus grown in Vero cells. [3H]Mannose-labelled glycopeptides of GP60, GP46 and GP20 were separated by gel filtration and by electrophoresis in Tris-borate gels; in addition, the polypeptides synthesized in infected cells in the presence of tunicamycin were analysed. The results revealed heterogeneity among the glycan units of GP60 and GP46. PMID- 3973564 TI - Coding sequence of coronavirus MHV-JHM mRNA 4. AB - A coding sequence at the 5' end of mRNA 4 of the coronavirus MHV-JHM was determined by M13/chain-terminator sequencing of cloned cDNA. An open reading frame of 417 bases with the potential to encode a polypeptide of mol. wt. 15 200 (139 residues) was identified. The 3' end of the open reading frame overlapped by 16 bases the start of an open reading frame found in mRNA 5. The translation product of mRNA 4 was predicted to be a basic polypeptide rich in threonine. It had a large hydrophobic region near the amino terminus and a basic carboxy terminus. An intracellular, virus-specific polypeptide, which has been previously described having a mol. wt. of 14 000 to 14 500 has the size and charge characteristics of such a translation product. PMID- 3973565 TI - Comparative electrophoretic study of polypeptides of influenza A/H3N2 viruses isolated in circumscribed geographical areas. AB - Two distinct groups of influenza A/H3N2 viruses, closely related to A/Bangkok/1/79 and to A/Belgium/2/81, have been chosen from viruses isolated in Italy during 1981 to 1983 with the aim of analysing the biochemical composition of their polypeptides. The strains of each group have shown differences in electrophoretic migration rates in one or more proteins in comparison to the prototype viruses. Polypeptide mobility variations among isolates from circumscribed geographical areas and from single outbreaks have also been observed. In particular, there was a high degree of variability in the NS1 protein. The detection of biochemical differences among identical antigenic variants, probably the result of point mutations in polypeptide sequences or of genetic reassortment among different co-circulating human viruses, is a further expression of the peculiar ability of the influenza A virus to exhibit variation in internal proteins during its circulation. PMID- 3973566 TI - Extracellular release of enveloped vaccinia virus from mouse nasal epithelial cells in vivo. AB - The release of vaccinia virus from mouse nasal epithelial cells infected in vivo was studied by electron microscopy. Intracellular naked vaccinia virus was enwrapped by Golgi membranes to form a double membrane intermediate. The outer membrane of the intermediate presumably fused with the plasma membrane, releasing extracellular enveloped virus. No signs of simple naked virus budding at the plasma membrane were observed. The majority of extracellular virus was enveloped and not naked. PMID- 3973567 TI - Horizontal transmission of hepatitis B virus among children and adults in five rural villages in Zambia. AB - To determine whether horizontal transmission of the hepatitis B virus contributes to the high prevalence of infection with this virus in an endemic region, residents of five villages in Zambia were tested for hepatitis B serologic markers. The prevalence of hepatitis B was determined by testing samples from 620 residents. By examining paired serum samples from 79 children and 80 adults, it was determined that new infections occurred during the five years of this study in at least 14 children (18%) (aged 4-17 years) and ten adults (12%) (aged 23-65 years). These 24 new infections were distributed among 20 households and were not associated with active HBV infections in the mother or, in most cases, other family members. Intervention to prevent hepatitis B in regions such as rural Zambia will require vaccination of susceptible children and adults as well as newborn infants. PMID- 3973568 TI - Hepatitis B virus infection in upper and lower Egypt. AB - The relative prevalence of hepatitis B surface antigen (HBsAg), anti-HBs, and anti-hepatitis B virus core antigen (HBc), as markers of hepatitis B virus infection, among 1,866 apparently healthy residents of two Egyptian provinces representing Upper and Lower Egypt populations was determined using solid-phase radioimmunoassay (SPRIA). The prevalence rate of HBsAg in the Egyptian population was moderately high (10.1%); it was higher in the Upper Egypt (11.7%) than the Lower Egypt (8.0%) population and more frequent in young adults--especially those of Upper Egypt--and males than females in both populations. The prevalence of anti-HBs gradually increased with age; it was higher in the Lower Egypt (51.1%) than the Upper Egypt (41.7%) population, and it was higher in females than males. A remarkably high infection rate, as shown by the prevalence of anti-HBc, was found in both populations (88.0%), with minor variations depending on age, sex, and geographic area. PMID- 3973569 TI - Detection of human parvovirus using a molecularly cloned probe. AB - Half of the genomic DNA of the human parvovirus (B19) was cloned in the plasmid pBR322. The cloned DNA was used as a molecular probe for the detection of parvovirus in serum by means of a dot hybridization test. In an assay of 26 samples, the dot hybridization test was found to be of comparable sensitivity and to be as rapid as radioimmunoassay for viral antigen detection; it is potentially useful as a diagnostic test. PMID- 3973570 TI - Adenoviruses in faeces of children with acute gastroenteritis in Rio de Janeiro, Brazil. AB - Faeces from 746 children less than 5 years old with acute gastroenteritis were screened for the presence of adenovirus particles or antigens by immunoelectron microscopy (IEM) and enzyme immunoassay (EIA). Thirty-five samples were positive by both IEM and EIA, two only by IEM, and two only by EIA, giving a total of 39 (5.2%) samples with positive results. Of these, 25 could be propagated in HEp2 cells and were neutralized by one of the antisera to adenovirus types 1 to 18. The remaining 14 samples could be propagated only in the 293 permanent line of human cells transformed by adenovirus type 5 DNA [Graham et al, 1977] and were not neutralized by antisera to adenovirus types 1 to 31. An EIA carried out by the antibody-capture technique, using antiserum specific for "enteric" adenoviruses [Johansson et al, 1979], gave positive results with all isolates that could be propagated only in 293 cells and with none of those capable of growing in HEp2 cells. PMID- 3973571 TI - A difficult chest pain. PMID- 3973572 TI - Student section of impaired physician program established. PMID- 3973573 TI - The 1984 legislative experience: revision of the Medical Malpractice Act (1). PMID- 3973574 TI - The effects of mother-infant bonding. PMID- 3973575 TI - Self-report of the frequency and phenomenology of verbal hallucinations. AB - This study was an assessment of several parameters of verbal hallucinations ("voices") based on the self-report of 52 hallucinating psychiatric patients. These subjects were asked to estimate the frequency of their hallucinations and to rate phenomenological aspects (loudness, clarity, location, reality) of their most recent hallucination. Each parameter was assessed with two visual analogue scales which differed in their wording of the dimension. Results showed that the reliability of the subjects' estimates on the parameters differed greatly. Clarity was most reliably reported and reality was least reliably reported. Historical notions that schizophrenics characteristically perceive external "voices" and that such "voices" are perceived as more real were not supported. There was a significant negative correlation between the perceived location and the perceived clarity of hallucinations. No significant differences in mean parameter scores were found between two groups of subjects, schizophrenics and affective psychotics. PMID- 3973576 TI - Cognitive impairment in patients with tardive dyskinesia. AB - Schizophrenic patients with (N = 17) and without (N = 14) tardive dyskinesia performed several neuropsychological tests. Most patients (88%) showed complete lack of concern or anosognosia with regard to their involuntary movement. A marginally significant difference was found in recall of pictures presented in the right hemispace. It is suggested that when patients with organic brain disorder and a low Mini-Mental State score are excluded, neuropsychological tests do not differentiate between tardive dyskinesia patients and nonhyperkinetic controls. The results are discussed in relation to hemispheric asymmetries in schizophrenia. PMID- 3973577 TI - Death from self-induced water intoxication among patients with schizophrenic disorders. AB - Review of 60 consecutive records of patients who died before the age of 53 years in a state mental hospital revealed that 27 of those patients (45%) had a schizophrenic disorder. Of those 27 patients, five (18.5%) died of the complications of self-induced water intoxication and schizophrenic disorders (SIWIS). Clinical, laboratory, and autopsy features of those five SIWIS patients and of an additional five SIWIS cases obtained from the literature include psychosis, polydipsia, polyuria, severe hyposthenuria (specific gravity 1.003 or less), hyponatremia, seizures, coma, and cerebral and visceral edema. SIWIS characteristically develops during Arieti's third or "preterminal" stage (5 to 15 years after onset of psychosis) of schizophrenic disorders and it must be included in the differential diagnosis of unexplained death among psychiatric patients. As there are no pathognomonic SIWIS tissue changes, the pathologist must carefully integrate clinical, laboratory, and autopsy findings to arrive at the proper diagnosis. When premortem findings of polydipsia and hyponatremia are not available, evidence of antecedent severe hyposthenuria and postmortem vitreous humor hyponatremia of less than 120 mEq/1 are strongly supportive of the diagnosis of death due to SIWIS. PMID- 3973578 TI - Association of alcoholism with antisocial personality in urban men. AB - The association of alcoholism with antisocial personality is important from a research and a therapeutic standpoint. In a sample of urban black men, it was found that those with antisocial personality had a higher rate of alcoholism than those without. In addition, a family history of problem drinking, low educational level, and excessive irritability were also closely associated with alcoholism. The clinical, genetic, and neurophysiological implications of these findings are discussed. PMID- 3973579 TI - A family study of familial positive vs. familial negative alcoholics. AB - Of 259 alcoholics studied, 173 were primary alcoholics. Familial positive primary alcoholics tended to have earlier onset of alcoholism and males seemed to have more complications from drinking. Family study data indicated that the familial positive group had family pedigrees more likely to contain relatives with antisocial personality disorder. This relationship to antisocial personality may help in explaining previous research findings in familial positive alcoholics. PMID- 3973580 TI - Learning deficits in adolescents with anorexia nervosa. AB - Learning ability was examined in a group of female adolescents hospitalized with anorexia nervosa, and in groups of demographically similar depressed inpatients, diabetic outpatients, and healthy normal subjects. Results showed that the group of anorectic females was significantly impaired on a difficult symbol-digit paired-associate learning test, but did not differ from control subjects on measures of attention, immediate or delayed visual memory, and psychomotor ability. Whereas performance on the Symbol-Digit Learning Test was found to be independent of acute weight loss at the time of testing, a significant relationship was obtained between learning ability and duration of illness. PMID- 3973581 TI - Stereotyped movement disorder of rocking. AB - Despite the relatively common occurrence of rocking behavior in children, the literature contains little information on the diagnosis, management, and treatment of this condition. The authors report a case of body rocking in an 8 year-old girl, for which they discuss possible etiological factors and therapeutic strategy. PMID- 3973582 TI - Calorimetric studies of oxyhemoglobin dissociation. II. Erythrocytic oxygen depletion by sodium dithionite. AB - Dithionite causes the depletion of dioxygen from suspensions of erythrocytes by reduction of the external dioxygen and not by diffusion into the cell. The molar enthalpy for the reduction shows a small difference with respect to the values found for free hemoglobin; and the normal stoichiometry of 2 moles dithionite/mole dioxygen found there is not observed with erythrocytes. At low hematocrit, the stoichiometry is 2.6:1 and decreases to 1.5:1 at high hematocrit. The change is not due to differences in the hemoglobin saturation or to an inability of dithionite to reduce all dioxygen present at the higher hematocrit. Neither catalase nor peroxidase added to the extracellular volume significantly alters the stoichiometry or the enthalpy of dioxygen reduction by dithionite. Addition of superoxide dismutase, however, restores the normal stoichiometry at high hematocrit and further increases the stoichiometry at low hematocrit. The calorimetrical signal of hydrogen peroxide, clearly seen with free dioxygen, is not present with erythrocytes. In all these cases the total heat evolved is the same. PMID- 3973583 TI - Formate dehydrogenase molybdenum and tungsten sites--observation by EXAFS of structural differences. AB - Preliminary EXAFS data has been collected on the molybdenum (K-edge) in C. pasteurianum formate dehydrogenase and the tungsten (LIII-edge) in C. thermoaceticum formate dehydrogenase. In the presence of dithionite, the tungsten enzyme was devoid of W = O bonds, and exhibited average W-(O, N) and W-S bond lengths of 2.13 +/- 0.03 A and 2.39 +/- 0.03 A, respectively. In sharp contrast, the C. pasteurianum molybdenum site has three Mo = O bonds with an average bond length of 1.74 +/- 0.03 A. It is also the first molybdenum enzyme found lacking Mo-S bonds, and does not appear to be redox active in the presence of formate or dithionite. Model compounds WO2(8-hydroxyquinoline)2 = WO2(ox)2, and WO2(8 mercaptoquinoline)2 = WO2(tox)2, were also examined. Respective predicted bond lengths for WO2(ox)2 and WO2(tox)2 were W = O of 1.71, 1.73 A; W-N of 2.31, 2.29 A; W-O or W-S of 1.92 or 2.40 A, with estimated uncertainties of +/- 0.03 A. PMID- 3973584 TI - Structural, motional, and kinetic features of the Cu(II)-(L-His)2 complex in aqueous solution. AB - A careful analysis by 1H and 13C FT-NMR on the Cu(II) (L-histidine)2 complex was carried out which allows delineation of structure and dynamics in solution. A mixture of complexes was shown such that 24% of the Cu(II) (L-histidine)2 complex contains both histidines bound in the histaminelike way, while the remaining 76% contains one L-His molecule bound in the histaminelike way and the other L-His molecule bound in the glycinelike way. The motional correlation time and relevant features of the exchange process were also delineated. PMID- 3973585 TI - Posttranslational incorporation of [14C]arginine into rat brain proteins. Acceptor changes during development. AB - Many of the cytosolic proteins of the rat brain appear to have the capacity to incorporate L-[14C]arginine posttranslationally. Scanning of the electrophoretic pattern of the labeled proteins showed two main radioactive peaks: peak A, found in the region of proteins of MW above 200 kD, and peak B, found in the region of 33 kD. The ratio of peaks A/B tends to decrease with the age of the rats. Another zone of radioactivity has an apparent MW similar to that of albumin (approximately 66 kD). No differences were found between the effects of ionic strength and of inhibitors on the arginyl transferase of brain and those described for the transferases of other organs. PMID- 3973586 TI - Choline acetyltransferase activities in single motor neurons from vertebrate spinal cords. AB - Single cell bodies of spinal motor neurons were isolated from freeze-dried sections of fresh spinal cords from six species of vertebrates. Single human neurons were also isolated from the spinal cords of three autopsy cases without neurological diseases. Choline acetyltransferase activity of these single neurons was determined by measuring acetyl-CoA formation from CoASH and acetylcholine by use of the enzymatic amplification reactions, CoA and NADP cyclings. The enzyme activity was unevenly distributed in the cytosol of spinal motor neurons of all species, but not measurable in rabbit dorsal root ganglion cells. The specific activity on a dry weight basis varied widely among the individual neurons from the species studied. The average activity was highest with rat neurons and lowest with yellowtail neurons. The neurons from cold-blooded animals (bullfrog and yellowtail) had about one-tenth the activity compared with the warm-blooded animals (cat, rabbit, rat, and hen). Human neurons, obtained under different morbid and post-mortem conditions with three autopsy cases, had very low activities corresponding to those of cold-blooded animals. Since the choline acetyltransferase activity lost from mouse brain after 11 h at 38 degrees C was 50%, the activity in human neurons was believed to actually be low in vivo. PMID- 3973587 TI - Molecular forms of acetylcholinesterase from human caudate nucleus: comparison of salt-soluble and detergent-soluble tetrameric enzyme species. AB - Extraction of human caudate nucleus under high-ionic-strength conditions solubilized 20-30% of total acetylcholinesterase (AChE) activity. Density gradient centrifugation revealed monomeric (5.0 S) and tetrameric (11.0 S) enzyme species. The purified, tetrameric salt-soluble (SS) AChE sedimented at 10.6 S and did not bind detergents. It showed an immunochemical reaction of identity with the detergent-soluble (DS) AChE species from human caudate nucleus and human erythrocytes, but did not cross-react with antibodies raised against human serum cholinesterase. The remaining activity was solubilized under low-ionic-strength conditions in the presence of 1.0% Triton X-100. The purified tetrameric, DS-AChE sedimented at 10.0 S as detergent-protein mixed micelle and on extensive removal of the detergent this enzyme formed defined aggregates by self-micellarization. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions revealed that the salt-soluble and detergent-soluble tetrameric enzyme species both contained a heavy and a light dimer; under reducing conditions mainly one band corresponding to the light subunit was seen. Molecular weights of 300,000 dalton and 280,000 dalton were calculated for SS-AChE and DS-AChE, respectively. Limited digestion of DS-AChE with proteinase K led to isolation of an enzyme that no longer bound detergents and lacked the intersubunit disulfide bridges. PMID- 3973588 TI - Cell-free synthesis of the D2-cell adhesion molecule: evidence for three primary translation products. AB - The D2-cell adhesion molecule (D2-CAM) is a membrane glycoprotein that is involved in cell-cell adhesion in the nervous system. To study the biosynthesis of D2-CAM we have translated free and membrane-bound polysomes from rat brain in vitro in the rabbit reticulocyte lysate system. D2-CAM was exclusively synthesized on membrane-bound polysomes. The primary translation products of D2 CAM were three polypeptides of apparent molecular weights 187,000, 134,000, and 112,000. No interconversion between these polypeptides was detected. In contrast to previous suggestions, we conclude that all three D2-CAM polypeptides are primary translation products. When translating polysomes from embryonic and postnatal rat brain, we found that the relative amounts of the three polypeptides synthesized varied with age. Their molecular weights, however, were not age dependent. PMID- 3973589 TI - Effects of neuronal activity on inositol phospholipid metabolism in the rat autonomic nervous system. AB - The effect of nerve stimulation on inositol phospholipid hydrolysis in autonomic tissue was assessed by direct measurement of [3H]inositol phosphate production in ganglia that had been preincubated with [3H]inositol. Within minutes, stimulation of the preganglionic nerve increased the [3H]inositol phosphate content of the superior cervical sympathetic ganglion indicating increased hydrolysis of inositol phospholipids. This effect was blocked in a low Ca2+, high Mg2+ medium. It was also greatly reduced when nicotinic and muscarinic antagonists were present together in normal medium. However, neither the nicotinic antagonist nor the muscarinic antagonist alone appeared to be as effective as both in combination. In other experiments, stimulation of the vagus nerve caused dramatic increases in [3H]inositol phosphate in the nodose ganglion but did not increase [3H]inositol phosphate in the nerve itself. This effect was insensitive to the cholinergic antagonists. Thus, neuronal activity increased inositol phospholipid hydrolysis in a sympathetic ganglion rich in synapses, as well as in a sensory ganglion that contains few synapses. In the sympathetic ganglion, synaptic stimulation activated inositol phospholipid hydrolysis and this was primarily due to cholinergic transmission; both nicotinic and muscarinic pathways appeared to be involved. PMID- 3973590 TI - Phospholipid-induced changes of gamma-aminobutyric acid transport in cortex grey matter in culture. AB - The function of membrane phospholipids (PL) in the regulation of gamma aminobutyric acid (GABA) transport and GABA carrier binding has been investigated in organized cultures of rat cerebral cortex. The cellular lipid composition has been changed by growing the cells in a delipidated nutrient solution or by short term exposure of the cells to PL emulsions. Introduction of PL into the cellular matrix was monitored by analysis of biologically active fluorescently labeled phosphatidylcholine (PC) or phosphatidylethanolamine (PE). Parinaroyl and dansyl derivatives were used. Conditions of maintenance as well as exogenously given PL affected the transport of GABA. Two transport systems were observed, one first order system and one cooperative system. Saturated species of PC or PE reduced first-order GABA uptake with increase in chain length of the fatty acid residues. The effects of unsaturated PL were dependent upon the polar head. Unsaturated PC enhanced the capacity of the first-order transport of the amino acid. In comparison to cultures grown in lipid-free medium, introduction of diarachinoyl PC into the cells increased the density of the first-order active transport sites by a factor of 8 and the affinity constant by a factor of 17. Diarachinoyl-PE reduced both kinetic parameters. GABA uptake via the cooperative system was enhanced by the unsaturated PE, not by PC. The role of endogenous PL and their asymmetric distribution was studied by application of phospholipase A2, C, and D. Stimulation of carrier activity was induced by hydrolysis of PL on the external leaflet. Inhibition occurred upon enzymatic degradation of external and cytoplasmic PL. Lipolysis also affected GABA receptor binding, suggesting that the effects observed represent the activity of both classes of binding sites, the carrier and the receptor. However the latter accounted for a small fraction of the binding. Transport of the amino acid was temperature sensitive. The temperature curve was shifted within two discontinuities, appearing in the Arrhenius plot as a function of membrane lipids. The results suggest a partitioning of the proteins between fluid and ordered lipid domains. Displacement of the protein may govern the rate constants and/or the effective protein concentration. PMID- 3973591 TI - Glutamyl-taurine is the predominant synaptic taurine peptide. AB - Several taurine-containing peptides have been identified from trichloracetic acid extracts of synaptosomes and their subcellular vesicles prepared from calf brain. These peptides contain aspartic and glutamic acids, serine and taurine, and are often present in an N-acetylated form. The peptides were isolated as single spots by TLC. Glutamyl-taurine was found to be the predominant structure when analyzed by fast atom bombardment (FAB) mass spectrometry. PMID- 3973592 TI - Incorporation of intracisternally administered L-[methyl-3H]methionine and S adenosyl-L-[methyl-3H]-methionine into rat brain phospholipids. AB - The incorporation of intracisternally injected L-[methyl-3H]methionine [( 3H]Met) or S-adenosyl-L-[methyl-3H]methionine (Ado[3H]Met) into rat brain AdoMet and phospholipid pools was examined. When [3H]Met was administered, both AdoMet and phospholipid pools were labeled. However, exogenously injected Ado[3H]Met did not serve as a substrate for phospholipid-N-methyltransferases. It was concluded that only Ado[3H]Met formed in situ was utilized to methylate phospholipids and that this process was initiated on the cytoplasmic side of the membrane. The apparent biological half-life in brainstem of phosphatidyl-N-monomethylethanolamine and phosphatidyl-N,N-dimethylethanolamine formed from [3H]Met was 1.4 and 1.7 days, respectively. The half-life of phosphatidylcholine could not be determined due to interference from peripheral sources. PMID- 3973593 TI - Reconstitution of calmodulin-sensitive adenylate cyclase from bovine brain with phosphatidylcholine liposomes. AB - A partially purified calmodulin (CaM)-sensitive adenylate cyclase from bovine cerebral cortex was reconstituted with a series of phosphatidylcholine liposomes having variable fatty acid composition. The enzyme was successfully associated with dimyristoyl, dipalmitoyl, distearoyl, and dioleoylphosphatidylcholine liposomes. The specific activity of the enzyme in the various liposomes varied over a 4.6-fold range indicating some degree of specificity for fatty acid composition. The adenylate cyclase-liposome preparation retained sensitivity to both CaM and 5'-guanylylimidodiphosphate (GppNHp). Arrhenius plots of enzyme activity in the four different liposome preparations all exhibited a pronounced discontinuity at 30 degrees C +/- 2, even though the bulk-phase thermal transition points for the liposomes varied from -20 to 54 degrees C. Fluorescence anisotropy studies of reconstituted liposome systems illustrated that incorporation of protein did not alter the normal-phase transition point of these lipids. Since Arrhenius plots of the enzyme in Lubrol PX, prior to reconstitution with lipids, were strictly linear, it is concluded that the breaks at 30 degrees C may be the effect of a local enzyme-phospholipid environment. It appears that this adenylate cyclase is not particularly sensitive to phase transitions of the bulk lipid phase. The phospholipid reconstituted enzyme system appears suitable for examination of the influence of lipids on the CaM-sensitive adenylate cyclase. PMID- 3973594 TI - Elemental composition and water content of neuron and glial cells in the central nervous system of the North American medicinal leech (Macrobdella decora). AB - Elemental (Na, P, S, Cl, K, Ca, Mg) composition and water content of neurons and glial cells of the leech (Macrobdella decora) were determined by x-ray microanalysis of frozen hydrated and dried section techniques. Results are reported as elemental mass fractions (mass/mass) and water content as percent mass. Specific cell compartments and cell types had distinct elemental patterns and water content which suggests that chemical composition of specific cell types is unique and may represent an expression of cell differentiation analogous to morphological specialization. Water content of cells was also cell specific and ranged from 55% (neurons) to 90% (vacuolated zone of glial cells). K and Na were present in concentrations greater than predicted by ion-selective microelectrode measurements, indicating that not all the K and Na were simultaneously accessible to such electrodes. PMID- 3973595 TI - Purification and kinetic mechanism of human brain soluble catechol-O methyltransferase. AB - The soluble form of human brain catechol-O-methyltransferase (EC 2.1.1.6, COMT) has been purified approximately 4,000-fold from a 250,000 X g supernatant solution. The purified enzyme exhibits a molecular weight near 27,500 and a pI value equal to approximately pH 5.0. Initial velocity and product inhibition studies are consistent with an ordered reaction mechanism for soluble COMT. Tropolone, a dead-end inhibitor, exhibited a competitive pattern of inhibition when dopamine (DA) was the varied substrate and an uncompetitive pattern when S adenosyl-L-methionine (SAM) was the varied substrate. These observations strongly suggest that the soluble form of COMT from human brain catalyzes the O methylation of catecholamines via an ordered reaction mechanism in which SAM is the leading substrate. Since the membrane-bound form of COMT catalyzes the O methylation of catecholamines through an identical reaction mechanism, these data provide further evidence that two forms of COMT, while being localized in distinct subcellular compartments, are quite similar in their molecular structure. PMID- 3973596 TI - Glycosaminoglycans of rat cerebellum: II. A developmental study. AB - Total and individual glycosaminoglycans (GAGs) were determined in rat cerebellum in tissue explants at various postnatal ages. The major constituents of GAGs were chondroitin sulfate (CS), hyaluronic acid (HA), and heparan sulfate (HS). Dermatan sulfate (DS) and keratan sulfate (KS) could not be detected and therefore each amounts to less than 5% of all GAGs at all ages studied. HA was the prominent GAG during postnatal development and only a minor constituent at adult ages, whereas CS was the predominant GAG in adulthood. HS remained relatively constant throughout development. The incorporation of [3H]glucosamine into individual GAGs was highest for HS at postnatal day 6, whereas HA showed intermediate and CS the lowest levels of incorporation during the first postnatal week. All major GAGs showed the lowest incorporation values at adult ages. PMID- 3973597 TI - Kinetics of regional blood-brain barrier glucose transport and cerebral blood flow determined with the carotid injection technique in conscious rats. AB - Anesthetics, particularly barbiturates, have depressive effects on cerebral blood flow and metabolism and likely have similar effects on blood-brain barrier (BBB) transport. In previous studies utilizing the carotid injection technique, it was necessary to anesthetize the animals prior to performing the experiment. The carotid injection technique was modified by catheter implantation in the external carotid artery at the bifurcation of the common carotid artery. The technique was used to determine cerebral blood flow, the Km, Vmax, and KD of glucose transport in hippocampus, caudate, cortex, and thalamus-hypothalamus in conscious rats. Blood flow increased two to three times from that seen in the anesthetized rat. The Km in the four regions ranged between 6.5 and 9.2 mM, the Vmax ranged between 1.15 and 2.07 mumol/min/g, and the KD ranged between 0.015 and 0.035 ml/min/g. The Km and KD in the conscious rat did not differ from the values seen in the barbiturate anesthetized rat. The Vmax, on the other hand, increased two- to three-fold from that seen in the anesthetized rat and was nearly proportional to the increase in blood flow seen in the conscious rat. The development of the external carotid catheter technique now allows for determination of BBB substrate transport in conscious animals. PMID- 3973598 TI - Methionine sulfoximine prevents the accumulation of large neutral amino acids in brain of portacaval-shunted rats. AB - Portal-systemic shunting and hyperammonemia lead to an accumulation of the large neutral amino acids in brain and apparently alter transport of neutral amino acids across the blood-brain barrier. It has been proposed that portal-systemic shunting leads to a high brain concentration of glutamine, a product of cerebral ammonia detoxification, and thereby affects the transport of other neutral amino acids across the blood-brain barrier. To test this hypothesis, rats with a portacaval shunt were treated with L-methionine-dl-sulfoximine (MSO), an inhibitor of glutamine synthesis. Treatment with MSO resulted in lower concentrations of the neutral amino acids in brain of portacaval-shunted rats and a higher brain ammonia concentration, compared with untreated shunted rats. These results suggest that the accumulation of neutral amino acids in brain after portacaval shunt depends on the increased synthesis of glutamine in brain. PMID- 3973599 TI - Evidence for the presence of a ganglioside transfer protein in brain. AB - An extract from rat brain has been shown to catalyze the transfer of ganglioside GM1 from sonicated vesicles to erythrocyte ghosts. It also enhanced the transfer of GM1 to a crude neuronal membrane preparation, whereas myelin took up only a very limited amount. The transfer activity was heat-labile. Similar transfer activities were found in extracts from bovine gray and white matter, that of the former being comparable to rat brain whereas the latter was greater per milligram protein. PMID- 3973600 TI - Aminobutyric acid greatly increases the in vivo extracellular taurine in the rat hippocampus. AB - The effects of gamma-aminobutyric acid (GABA) on the extracellular levels of taurine and on excitability in the dentate gyrus were studied in anesthetized rats by the dialytrode technique. The dentate gyrus was perfused by means of a dialytrode with Krebs-Ringer-bicarbonate or GABA solutions. Amino acid contents in perfusates and dentate field potentials evoked by electrical stimulation of the perforant pathway were evaluated. GABA drastically elevated the levels of extracellular taurine in a dose-dependent manner, decreasing the amplitude of the population spike. This result indicates that GABA stimulates taurine release, probably by a counter-transport process. It is suggested that in physiological conditions an increase in extracellular taurine may be produced by synaptically released GABA. PMID- 3973601 TI - Decline of GABA uptake in the hamster preoptic area following light offset. AB - The uptake of gamma-aminobutyric acid (GABA) was studied in homogenates of the accumbens-preoptic region (APR) of the hamster brain. Aggressive and non aggressive female hamsters, maintained under a reversed 10-h dark and 14-h light cycle were sacrificed at various times after light offset. Aliquots of the APR homogenates were incubated with a series of [3H]GABA concentrations to obtain values for Vmax and Km. In both groups Vmax values declined sharply after light offset. The reduction in GABA uptake from early to later dark phase parallels the routine diminution in the aggressive activity of rodents from its peak in the early dark phase; the increase in GABAergic inhibition which presumably results from the reduced uptake may contribute to this change in aggressive activity. PMID- 3973602 TI - Effect of passive avoidance training on in vitro protein synthesis in forebrain slices of day-old chicks. AB - Slices from the forebrains of day-old chicks represent a highly active in vitro protein-synthesising system. The in vitro incorporation of L-[14C]leucine into protein of slices was estimated to be 2.5 mmol/mg protein/h. Incorporation was linear over 90 min of incubation and was suppressed by 92% by 1 mM cycloheximide. The highest incorporation was into microsomal and cell-soluble fractions. Under the electron microscope, slices appeared vacuolated near the cut surfaces, but well preserved internally (greater than 40 micron from the edge). Autoradiography showed that radioactivity was incorporated evenly across the slice with no decrease in label in the central part of the tissue. The rate of incorporation was only weakly dependent on leucine concentration in the medium (0.04-1 mM). Addition of a mixture of unlabelled amino acids (1 mM) produced a 20-50% inhibition of incorporation of radioactive L-leucine depending on the amino acids involved. In slices prepared from chicks 1 h after training on a one-trial passive avoidance paradigm, L-[14C]leucine incorporation was 23% higher (p less than 0.01) in the forebrain roof than in slices from control chicks. This figure is comparable to the one previously reported in vivo. Subcellular fractionation of incubated slices from the forebrain roof of trained and control birds revealed that the increased protein synthesis was due mainly to an elevated leucine incorporation into the soluble fraction. PMID- 3973603 TI - Purine nucleotide synthesis in adrenal chromaffin cells. AB - The synthesis of purine nucleotides from the salvage precursors adenine and adenosine, and from the de novo precursors formate and glycine, was studied in isolated adrenal chromaffin cells. Both [8-14C]adenine and [8-14C]adenosine from extracellular medium are effectively incorporated into intracellular nucleotides. [14C]Formate and [U-14C]glycine are also incorporated, but de novo synthesis is clearly lower than synthesis from salvage precursors, although similar to de novo synthesis in liver. The enzymes responsible for adenine and adenosine salvage, adenine phosphoribosyltransferase and adenosine kinase, were purified about 1,500 fold. Both enzymes are mainly cytosolic and exhibit a similar molecular weight of around 42,000. The results suggest that chromaffin cells can replenish their intracellular nucleotides lost during the secretory event by an active synthesis from salvage and de novo precursors. PMID- 3973605 TI - Metabolism of catecholamines in the developing spinal cord of the rat. AB - The metabolism of 3,4-dihydroxyphenylethylamine (DA, dopamine) and norepinephrine (NE) both normally, and after the administration of levo-3,4 dihydroxyphenylalanine (L-DOPA), has been studied in several regions of the developing spinal cord of the rat from fetal day (FD) 16 to the young adult stage. During late fetal (from FD 16) and most of neonatal life [to neonatal day (ND) 20], dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were either just detectable or present in very low concentration in all regions in the untreated developing rat. However, the developing spinal cord possesses an enormous capacity to metabolize the large amounts of DA synthesized from injected L-DOPA. At the end of 1 h after 100 mg/kg i.p. of L-DOPA, DOPAC and HVA are 54 +/ 14 (n = 5) and 16 +/- 5 (n = 5) nmol/g, respectively, in the thoracic zona intermedia in the 12-h-old (ND 0.5) rat. This metabolic capability is already highly developed as early as FD 16, peaks during the first half of neonatal life (ND 4 for DOPAC, and ND 15 for HVA), and is considerably reduced toward the end of neonatal life (approximately ND 28) and in the young adult. Control experiments suggest that a substantial part of this synthesis (from L-DOPA) and metabolism of DA occurs in elements other than the descending monoaminergic nerve fibers. By comparison, the synthesis and metabolism of NE develop more slowly, peak in the latter half of neonatal life, and then decline to the level found in the young adult.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973604 TI - Limited blood-brain barrier transport of polyamines. AB - Transport of polyamines across the blood-brain barrier of adult rats was examined by measuring the amount of radioactivity that reached the forebrain 5 s after a "bolus" intracarotid injection. The values were expressed by the brain uptake index (BUI), which is the percentage of material transported in relation to freely diffusible water in a single passage through the brain. Transport was restricted as indicated by the respective BUI values, presented as means +/- SD (number of animals): putrescine, 5.3 +/- 0.8 (11); spermidine, 6.1 +/- 1.3 (7); and spermine, 5.8 +/- 0.5 (4). A kinetic study of the transport of [14C]putrescine showed that transport due to passive diffusion accounted for the majority of the observed influx (66% at 1 mM putrescine). However, a small saturable component exists with a Km value of 4-5 mM and a Vmax of 30 nmol X min 1 X g-1. This Km value is considerably higher than the circulating levels of the polyamine in the normal mature animal, and thus is unlikely to be of physiological significance. Competition studies indicated that putrescine does not interact with carriers for adenosine, arginine, choline, or leucine. PMID- 3973606 TI - Laminar distributions of choline acetyltransferase and acetylcholinesterase activities in the inner plexiform layer of rat retina. AB - Choline acetyltransferase and acetylcholinesterase activities were measured in samples taken at 7-micron increments through the inner plexiform layer of rat retina. These enzyme activities were not uniformly distributed through the depth of the inner plexiform layer. Peaks of choline acetyltransferase activity occurred at about one-third and peaks of acetylcholinesterase activity at about one-fifth of the depth into the inner plexiform layer from either side. The positions of the two peaks of choline acetyltransferase activity most likely correspond to the locations of processes from cholinergic amacrine somata in the inner nuclear layer, which spread in sublamina a, and processes from cholinergic amacrine somata "displaced" in the ganglion cell layer which spread in sublamina b of the inner plexiform layer. The peaks of acetylcholinesterase activity may in addition correspond to the processes of cholinoceptive amacrine and ganglion cells. The magnitudes of choline acetyltransferase and acetylcholinesterase activities are as high as found anywhere in rat brain, emphasizing the important role of cholinergic mechanisms in visual processing through the rat inner plexiform layer. PMID- 3973607 TI - Large-scale purification of Torpedo electric organ synaptosomes. AB - A procedure for the large-scale purification of Torpedo electric organ synaptosomes is described. The synaptosomal fraction obtained is very pure as judged from biochemical and morphological data. In addition, acetylcholine (ACh) release was demonstrated after KCl depolarization of synaptosomes in the presence of calcium. Two hundred grams of electric organ can be fractionated in a single run, allowing biochemical studies on presynaptic membrane constituents. PMID- 3973608 TI - Assay of brain calmodulin levels using high-performance liquid chromatography. AB - A simple, sensitive, and efficient HPLC method for the determination of calmodulin levels in brain tissue extracts is described. The assay is linear with respect to both calmodulin and protein concentrations. The specificity and validity of this assay for calmodulin is demonstrated by parallel radioimmunoassay determinations which give equivalent results. Determination of calmodulin levels in various brain regions revealed a high concentration of this protein in the hypothalamus, by comparison to other areas examined. PMID- 3973609 TI - Neonatal steroid treatment reduces catecholamine-induced increases in pineal serotonin N-acetyltransferase activity. AB - Hydrocortisone acetate given to the neonatal rat diminishes subsequent elevations in pineal serotonin N-acetyltransferase (acetyl-coenzyme A:arylamine N acetyltransferase; EC 2.3.1.5; NAT) activity produced by administration of catecholamines to the intact animal or to pineals in organ culture. The time required for development of this decrease in sensitivity varies inversely with age at treatment. A minimal dose of 200 micrograms of hydrocortisone acetate/rat is required to elicit this decreased response to agonist. Other glucocorticoids have qualitative effects similar to hydrocortisone acetate, but cholesterol and the gonadal steroids testosterone, estradiol, and progesterone are without effect. In addition to showing a smaller rise in NAT activity on stimulation, pineals from steroid-treated neonates also synthesize less N-acetylserotonin and melatonin from tryptophan. The decrease in NAT response to stimulation after steroid treatment appears due to actions beyond cyclic AMP generation and may involve inhibition of protein synthesis. PMID- 3973610 TI - Cystathionine accumulation in various regions of brain of DL-propargylglycine treated rats. AB - The contents of cystathionine and taurine, as well as cystathionine beta-synthase activity in various regions of the brains of normal and DL-propargylglycine treated rats, were measured. The content of cystathionine in each region of brain increased gradually from 0.5 mg to 20 mg/200 g body weight in relation to the dose of DL-propargylglycine. Cystathionine was found to be unevenly distributed in brains of both normal and DL-propargylglycine-treated rats. On the other hand, the activity of cystathionine beta-synthase was evenly distributed in various regions of normal rat brain, and was unaltered following treatment of rats with DL-propargylglycine. The concentration of taurine was similarly unaffected by DL propargylglycine injection. PMID- 3973611 TI - Two acidic proteins associated with brain development in chick embryo. AB - The developmental changes in protein composition of the chick optic tectum were analyzed by two-dimensional gel electrophoresis. Staining with Coomassie Brilliant Blue R revealed 54 major proteins, eight of which remarkably changed their abundance during development: Four of these proteins (S8, S14, S30, and S54) increased and two of them (S7 and S37) decreased in the course of the brain development. The other two proteins (S5 and S6) appeared at specific embryonic stages and were not detected in the adult. The abundance of S5 protein was highest at day 7, and that of S6 protein at days 9-18. The two proteins were present in other regions of the embryonic brain but were not detected in the embryonic liver. The proteins were purified from the soluble fraction of embryonic chick brains by pH 5.5 precipitation, DEAE-Sepharose column chromatography, ammonium sulfate precipitation, and sodium dodecyl sulfate polyacrylamide gel electrophoresis. The molecular weights of S5 and S6 proteins were 95,000 and 100,000, respectively, and their isoelectric points were about 4.5. They were compared by peptide mapping using V8 protease and found to share 11 common peptides out of 17 distinct ones. This indicates a strong degree of structural homology between these two proteins. PMID- 3973612 TI - Effects of repeated administration of estradiol benzoate on tubero-infundibular GABAergic activity in male rats. AB - Repeated (once a day for 8 days) but not single administration of estradiol benzoate (10 micrograms/kg, s.c.) induced a sevenfold increase in anterior pituitary gamma-aminobutyric acid (GABA) concentration in male rats. GABA concentration also increased in the median eminence whereas no changes or decreases were observed in other brain regions including hypothalamic arcuate nucleus, lateral septum, hippocampus, caudate nucleus, and substantia nigra. Eight-day estradiol benzoate injection also enhanced the Vmax of median eminence glutamate decarboxylase activity without affecting the Km of the enzyme for glutamic acid. Taken together, these results suggest that repeated administration of estradiol benzoate increases the activity of the tubero-infundibular GABAergic system in male rats. PMID- 3973613 TI - Identification, purification, and characterization of two forms of serotonin binding protein from rat brain. AB - Serotonin binding protein (SBP) is found in synaptic vesicles of mammalian central and peripheral serotonergic neurons. 5-Hydroxytryptamine (5-HT, serotonin) is physiologically stored as a complex with SBP in vivo. Two forms of SBP have been detected with apparent molecular weights of 45,000 and 56,000 (45K and 56K). To understand the relationship between the two forms more fully, we purified the two proteins to homogeneity and partially characterized them. Purification steps included (NH4)2SO4 fractionation and chromatography on Sepharose 4-B, Affi-Gel-Blue, hydroxylapatite, and phosphocellulose. The 45K from of SBP was obtained pure, whereas the 56K form of SBP was obtained about 90% pure by these methods. To isolate pure 56K SBP for induction of antibodies, the protein was further purified by sodium dodecyl sulfate-gel electrophoresis followed by electroelution. The 56K form of SBP was thus isolated, but in a denatured state; its purity was established by two-dimensional gel electrophoresis. The two forms of SBP (pure 45K and 90% pure undenatured 56K SBP) were similar in their 5-HT binding capacity; the enhancement of 5-HT binding by Fe2+; and inhibition by--SH reagents, chelators, and sodium salts. Antibodies raised against the pure 56K form of SBP cross-reacted with the 45K SBP. The two forms of SBP differed in the following properties: (1) dissociation constants- 56K form showed higher affinity for 5-HT (KD1 = 0.4 nM; KD2 = 32 nM), whereas the 45K form showed lower affinity (KD1 = 9.7 nM; KD2 = 120 nM); (2) ratio of number of 5-HT binding sites with low affinity to those with high affinity--56K (19:1), 45K (10:1); (3) isoelectric point--the 56K form of SBP is more acidic (5.6 and 5.9) than the 45K form (6.1); (4) binding enhancement by gangliosides and bicarbonate. To establish whether the 45K form of SBP is found in vivo or is produced by proteolysis during isolation, two additional experiments were carried out. (1) We added a mixture of proteolytic enzyme inhibitors to our homogenization buffer; this addition did not change the ratio of the two forms of SBP. (2) We mixed regions of the CNS enriched in the 45K form of SBP (spinal cord) with regions rich in the 56K form of SBP (raphe nuclei) and homogenized them together. Again, this procedure failed to change the ratio of the two forms of SBP as judged by polyacrylamide gel electrophoresis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973614 TI - A histochemical study of the distribution of beta-hydroxybutyrate dehydrogenase in developing rat cerebellum. AB - The distribution of beta-hydroxybutyrate dehydrogenase (3-hydroxybutyrate dehydrogenase, EC 1.1.1.30) in the developing rat cerebellum has been determined using a histochemical method. Staining of Purkinje cells, particularly the soma, was seen at all ages examined. Intense staining of the proximal portions of Purkinje dendrites was noted at 8-11 days postnatally, with less prominent staining of Purkinje dendrites and surrounding structures of the molecular layer seen at later times. Development of glomeruli in the granule cell layer could also be observed due to the intense staining of these structures. (Although noncerebellar structures were not the focus of this study, intense staining of the choroid plexus of the fourth ventricle was also noted.) the transient external germinal layer of the cerebellum did not show appreciable staining. Since beta-hydroxybutyrate dehydrogenase is required for ketone body metabolism, the apparent low level of this enzyme in the external germinal layer suggests that the cells of this layer are not particularly well adapted for utilization of ketone bodies. Thus these results do not provide support for the suggestion that ketone bodies may serve as major substrates for energy metabolism in the external germinal layer of the developing cerebellum. Indeed, the rather restricted distribution of this enzyme in both developing and mature cerebellum (and presumably elsewhere in brain) suggests that ketone body metabolism may be largely confined to relatively few specific cellular compartments. PMID- 3973615 TI - Effect of intraventricular putrescine on adenosylmethionine decarboxylase in rat hypothalamus and caudate nucleus. AB - Effects of intracerebroventricularly injected putrescine on adenosylmethionine decarboxylase activity in rat hypothalamus and caudate nucleus were studied. Doses that lacked the capacity to produce behavioral and electrocortical epileptogenic disorder caused a significant activation of enzyme occurring between 10 and 15 min after injection. The changes in hypothalamic and caudate nucleus enzyme activity after putrescine administration were dose-dependent, and they supported the assumption that limiting putrescine concentration in vivo may play a role in adenosylmethionine decarboxylase regulation. PMID- 3973616 TI - Role of hyperthermia in effects of electroconvulsive shock on protein synthesis in the rabbit. AB - The effects of electroconvulsive shock (ECS) on rectal temperature (TR) and on protein synthesis in brain and liver were compared in rabbit, rat, and mouse. Protein synthesis status was assessed using an in vitro amino acid incorporation method which provides information equivalent to polyribosome profiles. In the rabbit, TR rose from 39.5 +/- 0.4 degrees C to 40.4 +/- 0.2 degrees C within 10 min following a single ECS, and significant hyperthermia persisted for at least 60 min. This effect was markedly attenuated in animals housed at 4 degrees C. In vitro protein synthesis activities of rabbit brain and liver preparations were significantly reduced following ECS only in those animals whose TR exceeded 40 degrees C. In the rat, ECS gave rise to a significant hyperthermia, but in no case did TR exceed 40 degrees C, and protein synthesis activity of brain supernatants was not affected. In the mouse, ECS reduced TR and had no effect on in vitro protein synthesis activity. These results demonstrate that the unique sensitivity of protein synthesis in rabbit tissues to electroconvulsive shock is a direct consequence of the hyperthermia that arises following ECS in this species. PMID- 3973617 TI - Who goes home? Predictive factors in stroke recovery. AB - One hundred and seventy two stroke patients were assessed two weeks post-stroke by a multi-disciplinary team. The predictive ability of a number of variables, including social, psychological and physical factors, was estimated for four outcome groups. Highly significant factors for good and bad outcome for one year were identified. PMID- 3973618 TI - Residual complaints of patients two years after severe head injury. AB - In a follow up study of 57 patients who had sustained a severe closed head injury, 84% still reported some residual deficit in their psychological functioning after two years, with forgetfulness being the most common complaint. Expressing the severity of the injury in terms of both the duration of post traumatic amnesia (PTA) and the extent to which previous work could be resumed (RTW), principal components analyses showed that the occurrence of "impairment complaints"--viz forgetfulness, slowness, poor concentration and inability to divide attention over two simultaneous activities--was positively related to severity. The other complaints, which in the main could be labelled as "intolerances" were not. The same pattern was found when the analyses were based on deficits of the patients as they were reported by relatives. Severity was not appreciably related to the total number of complaints. The correlation between PTA and RTW was 0.52, indicating that with longer PTA duration, work is likely to be resumed at a lower level, or not at all. Though Russell's cut-off of one week PTA to differentiate between severe and very severe concussion appeared useful, in the present study a further cut-off point at the unlucky number of 13 days was considered. PMID- 3973619 TI - Complex visual hallucinations in the hemianopic field. AB - From 120 patients with an homonymous hemianopia 16 experienced complex visual hallucinations in the hemianopic field. The brain lesion was located in the occipital lobe, though damage was not limited to this area. Complex hallucinations appeared after a latent period. They were weak in colour and stereotypical in appearance, which allowed differentiation from visual hallucinations of other causes. Different behaviour after saccadic eye movement differentiated between complex visual hallucinations in the hemianopic field and visual auras of an epileptic origin. PMID- 3973620 TI - Presentation and management of parasellar and suprasellar metastatic mass lesions. AB - Ten patients with parasellar metastatic lesions presented with insidious painful or painless ophthalmoplegia. Visual loss secondary to a chiasmal syndrome was identified in three of them. A mass lesion was demonstrated by CT scan with precise outlining of the location and size of the lesion. Symptomatic relief was achieved with local radiotherapy in those patients who had early diagnosis. PMID- 3973622 TI - Correlation between plasma fibrin-fibrinogen degradation product values and CT findings in head injury. AB - Plasma fibrin/fibrinogen degradation product (FDP) determinations and CT scans were performed in 26 patients on the first, third, and seventh day after head injury. Plasma FDP concentrations were increased in the patients with cerebral contusion shown on CT scans, while the plasma FDP values were normal in the patients with various sized epidural haematomas. Furthermore, the plasma FDP elevation appeared to be more marked and more prolonged in the patients with severe contusion than in those with mild contusion. These findings suggest that the degree of the increase in plasma FDP is proportional to the amount of brain tissue destruction. PMID- 3973621 TI - Cerebrospinal fluid vasopressin in neurological and psychiatric disorders. AB - Vasopressin was determined in CSF and plasma of 243 patients with different neurological and psychiatric disorders, including control patients. CSF vasopressin was significantly higher in patients with high pressure hydrocephalus, intracranial tumour, benign intracranial hypertension, intracranial haemorrhage, ischaemic stroke, and craniocerebral trauma. In patients with primary degenerative dementia, CSF vasopressin was lower than in control patients. Among patients with psychiatric disorders, CSF vasopressin was increased in manic patients, while in patients with depression CSF concentration of this hormone did not differ from that found in controls. However, an increase in CSF vasopressin level was found in patients recovering from a depression. The clinical significance of changes in CSF vasopressin concentrations in groups of patients with neurological and psychiatric disorders is still unknown. PMID- 3973623 TI - Recovery after stroke--the first 3 months. AB - Ninety-nine patients had their function recorded regularly over the first 13 weeks after their stroke. Five functional areas were studied: urinary continence, mobility, the ability to dress, feeding, and the ability to transfer from bed to chair. Thirty-two patients died before 13 weeks. Forty-five of the 67 survivors had assessments twice weekly from within 4 days of their stroke. Recovery in these 45 patients occurred fastest in the first 2 weeks, by which time at least 50% of recovery had occurred, but it was still continuing at 13 weeks. Urinary incontinence present between 7 and 10 days after stroke was the most important adverse prognostic factor both for survival and for recovery of function. Age was the second most important factor. Hospital discharge seemed to occur once recovery had stopped, although four of the 49 patients discharged had been fully independent for at least 12 days prior to discharge. It is suggested that rehabilitative therapy should concentrate less on physical function and more on cognitive ability. PMID- 3973624 TI - Mitochondrial malic enzyme in Friedreich's ataxia: failure to demonstrate reduced activity in cultured fibroblasts. AB - Mitochondrial and cytosolic malic enzymes were assayed radiochemically in fibroblasts from six patients suffering from Friedreich's ataxia in order to verify earlier reports of abnormalities in these enzymes. No abnormalities could be detected in the activities of either enzyme. On cellulose acetate electrophoresis a band of enzyme activity corresponding to the mitochondrial isoenzyme was detectable contrary to earlier reports. Possible explanations for the disparity of results between different laboratories are discussed. PMID- 3973625 TI - A relationship between claudication of the cauda equina and the small aorta syndrome. AB - Two cases of claudication of the cauda equina due to ischaemia secondary to distal aortic disease in the Small Aorta syndrome are reported. The association has not been previously reported and the appropriate management is discussed. PMID- 3973626 TI - Unusual EEG patterns in coma, and their evolution. AB - A 23-year-old chronic asthmatic patient is reported who showed successively four different EEG patterns within a 7 day period of unconsciousness following cardio respiratory arrest. The initial record was dominated by alpha activity, then beta activity supervened, to be followed by spindle components. Finally an isoelectric tracing occurred before death. A computer file search for all cases of unusual EEG coma patterns was carried out. It failed to reveal any other patient with a similar sequence, but various types of evolution were noted. Such features are seen in only a very small percentage of comatose patients, and in the context of cardio-respiratory arrest are almost invariably fatal. PMID- 3973627 TI - Denervation in wasted hand muscles in a case of primary cerebellar ectopia without syringomyelia. AB - Wasting of hand muscles and electromyographic changes of denervation in a case of primary cerebellar ectopia without evidence of syringomyelia is described. It is suggested that the wasting is due to anterior horn cell damage secondary to grey matter venous obstruction at high cervical cord levels. PMID- 3973628 TI - Contralateral gaze deviation after frontal lobe haemorrhage. AB - Contralateral deviation of the eyes was sustained for a week in a patient with discrete subcortical frontal lobe haematoma. When deviation recovered, ipsilateral saccades were hypo-metric and saccadic latencies were prolonged in both horizontal directions. Smooth pursuit was paretic during tracking toward the side of the haematoma. Pursuit gain was higher during tracking to the contralateral side. Smooth eye movement imbalance may explain the unusual finding of contralateral gaze deviation with frontal lobe damage. PMID- 3973629 TI - Central cord syndrome in an infant complicating inadvertent intraoperative stretching of the neck. PMID- 3973630 TI - Left temporal lobe abscess presenting with an acute amnesic syndrome 28 years after contralateral temporal lobe abscess. PMID- 3973631 TI - Exteroceptive reflexes abnormalities in stiff-man syndrome. PMID- 3973632 TI - Neurological findings in Miller-Fisher syndrome. PMID- 3973633 TI - Pyridoxine megavitaminosis: an analysis of the early changes induced with massive doses of vitamin B6 in rat primary sensory neurons. AB - The early effects of high toxic doses of vitamin B6 (pyridoxine) on the peripheral sensory neurons were studied in laboratory rats. The animals were treated with 600 mg/kg of pyridoxine hydrochloride by intraperitoneal injection twice daily. Thereafter they were killed by perfusion-fixation at periods ranging from one to 14 days and the tissues were examined by light and electron microscopy. The primary change consisted of the formation of swollen membranous profiles in both the axon hillock and the initial axonal segment of the large dorsal root cytons. This change occurred within 24 hours of exposure, and was followed by an axonal reaction of the nerve cell bodies and by secondary degeneration of their processes. These findings identify the probable target site for pyridoxine toxicity, and establish a simple animal model for studying not only sensory denervation, but also the axonal reaction and secondary degeneration. PMID- 3973634 TI - Ultrastructural appearance of intentionally frustrated axonal regeneration in rat sciatic nerve. AB - The ultrastructural appearance of axons regenerating after crush injury was examined in rat sciatic nerves in which proximodistal growth was interrupted (frustrated regeneration) by placement of a tight ligature 1 cm distal to the original crush injury, and in nerves lacking a distal tie (unimpeded regeneration). Examination of unimpeded regenerating axons four and seven days after injury showed minute axonal sprouts as well as scattered dilated (2-10 microns) axonal profiles containing large numbers of anastomosing tubulovesicular elements and vacuoles. These dilated profiles were consistent with the appearance of growth cones, the motile tips of regenerating axons, as described in various in vivo and in vitro systems. The ultrastructural appearance of regenerating axons accumulating proximal to a frustrating tie was a function of time after arrival at the ligature. At the earliest time examined (one week) large numbers of axonal profiles accumulated at the ligature which were qualitatively similar to growth cones seen in unimpeded regeneration, although slightly larger in diameter. With time, the uniform population of growth cones proximal to the frustrating ligature was replaced by dilated axons containing large numbers of neurofilaments, dense collections of heterogeneous membranous organelles, or delicate to coarse tubulovesicular elements admixed with a variety of subcellular organelles. Rare examples of axonal dystrophy were demonstrated after chronic frustration of regeneration; however, they represented only a small percentage (less than 1%) of frustrated axons. Frustrated regeneration was accompanied by scattered examples of demyelination/remyelination of large axons proximal to the ligature as well as transperineurial growth of axons as microfascicles to escape the site of ligation. PMID- 3973635 TI - Freeze-fracture studies of denervated and tenotomized rat muscle. AB - We studied the effects of denervation and tenotomy on the freeze-fracture ultrastructure of rat extensor digitorum longus muscle. The muscle plasma membrane was analyzed for the density of orthogonal arrays and caveolae. A period was found up to 30 days of age where innervation is required for the development and maintenance of orthogonal arrays. Denervation of older animals had no effect on the density of orthogonal arrays. The caveolar density increased after denervation at all ages. Tenotomy delayed the development of normal arrays, but had no significant effect on caveolar density. The results obtained for neonatally denervated rat muscles are similar to those seen in the muscles of patients with Duchenne muscular dystrophy. PMID- 3973636 TI - Cell death in Clarke's column after spinal cord transection. AB - The death of embryonic central nervous system (CNS) neurons deprived of a target is well established. In adult rats, similar cell death of corticospinal and rubrospinal motor neurons occurs as a delayed response to spinal cord transection. We document the loss of neurons in Clarke's column, secondary ascending spinocerebellar neurons in adult rats, after complete spinal cord transection at T-9. Twenty-five weeks after spinal cord transection, horseradish peroxidase (HRP) studies showed a dramatic loss of labeled cells in rats with transected spinal cords as compared to matched control rats. Cresyl echt violet stained sections failed to support the hypothesis that unlabeled cells persist in a shrunken, inactive state; instead we found far fewer identifiable neurons in Clarke's column. Although we saw little gliosis in the area of cell loss, gliosis was evident in the adjacent corticospinal tract which was severed in the original surgical injury. Amputation of the right hind limb resulted in a paradoxical increase in labeled Clarke's column cells on the right. Total cells stained with cresyl echt violet in amputated animals were not different from right to left. The increase in labeled cells on the amputated side may have been caused by an increase in metabolic activity of these deafferentated neurons which resulted in more effective axoplasmic transport of the HRP label. PMID- 3973637 TI - Canine inherited ataxia: ultrastructural observations. AB - Canine Inherited Ataxia is inherited as an autosomal recessive trait in Gordon Setters. This animal model shares features with certain human cerebellar degenerations and offers the opportunity to examine brain tissue at various stages during the evolution of disease. The present investigation focuses on the morphometric and ultrastructural changes of cerebellar neurons. Purkinje and granule cells are the principal intrinsic neurons at risk. The size of Purkinje cells decreases, axonal degeneration is an important feature of the pathology, and synaptic abnormalities occur in the cerebellar glomeruli and deep nuclei of the cerebellum. The sequence and nature of synaptic changes in the molecular layer suggest that the degenerative process begins in Purkinje cells and that granule cells may be secondarily affected. PMID- 3973638 TI - Familial myopathies with restricted distribution, facial weakness and inflammatory changes in affected muscles. AB - A myopathy characterized by restricted involvement of few muscles and inflammatory cell infiltration was observed in three families. In the first family, clinical features, hereditary transmission and biopsy findings were consistent with the diagnosis of facioscapulohumeral dystrophy. However in three of the four affected members, the occurrence of atrophies was specifically initiated by severe muscular pain. In the second family two 8-year-old identical twins had both marked facial weakness and atrophy limited to the right quadriceps femoris. In the third family, marked asymmetry of muscular wasting in the upper limbs was found in the 17-year-old daughter of a man suffering from facial and axial weakness. The indication of corticotherapy in such cases is discussed. PMID- 3973639 TI - Foveal interocular time thresholds and latency differences in multiple sclerosis. AB - Nineteen patients with suspected multiple sclerosis (MS) and 28 control subjects were foveally stimulated by a small cross formed by rectangular red-light emitting diodes. By means of crossed polarizers one eye was exposed only to the horizontal bar of the cross, the other to the vertical. Stimulus onset asynchrony ranged from 0 to +/- 300 ms (the horizontal bar preceding or following the vertical). The task was to indicate whether the horizontal or vertical bar had appeared first. Compared with normal subjects, MS patients exhibited much higher time thresholds (ranging from -150 to +130 ms) and had considerable interocular latency differences (up to 29 ms), indicating unilateral or asymmetrical impairment of the visual pathways. The psychophysical latency differences of the patients were compared to monocular latencies and interocular latency differences of the visually evoked cortical potential (VEP) obtained by foveal stimulation. Under the stimulus conditions chosen in this study, the diagnostic value of the psychophysical measurements was equal to or, for McAlpine's classes I and II of definite and probable MS patients, better than that based on VEP recordings. PMID- 3973640 TI - An unusual association of dentato-rubral degeneration with spinal ataxia, ophthalmoplegia and multiple cranial nerve palsies. AB - Clinical and neuropathological data of a 50-year-old woman with an unusual multisystem degeneration are presented. Clinically the illness was characterized by progressive ataxia with ophthalmoplegia and multiple cranial nerve palsies. Neuropathological investigation showed a severe and selective degeneration of the dentato-rubral system, of the posterior columns and of several cranial nerve nuclei. The problems of differential diagnosis and classification are discussed. PMID- 3973641 TI - Cerebrovascular lesions and livedo reticularis (Sneddon's syndrome)--a progressive cerebrovascular disorder? AB - Four cases are described in which livedo reticularis was associated with repeated cerebrovascular accidents, which eventually resulted in severe disability in two cases. Patients with severe disability had a history of many years, whereas two patients with little or moderate residual disability had a follow-up of 3 years each. CT scan revealed multifocal cerebral infarctions and cortical atrophy in all cases. Repeated cerebral angiograms, done in three cases, showed no signs of a vascular disease. There were no parameters that pointed to active immunological or inflammatory disorder. Neither clinical evidence of heart or large vessel disease was found. Observations suggest that a so-far unknown progressive cerebral vessel disease associated with livedo is the cause of a steady increase in multiple small cerebral infarctions. Because of the progressive character of the disease the search for effective therapy is needed. PMID- 3973642 TI - Acute spinal epidural abscess. AB - An anterolateral cervical epidural abscess occurred in the course of a septicaemia caused by Staphylococcus aureus. Early diagnosis, before permanent neurological signs developed, was provided by CT scan without myelography. Total recovery occurred with antibiotic therapy alone. PMID- 3973643 TI - Brachial diplegia in central pontine myelinolysis. AB - A patient developed weakness in the upper limbs, eventually causing brachial diplegia with only slight paresis of the legs after rapid correction of severe hyponatraemia. Pseudobulbar palsy, mental confusion and urinary incontinence were also present. CT scan showed a zone of lucency in the pons. Clinical recovery occurred and the zone of lucency had disappeared 12 months after the appearance of the neurological signs. PMID- 3973644 TI - Acute polyradiculoneuritis during toxoplasmosis. PMID- 3973645 TI - Pilot trial of murine monoclonal antibodies in patients with advanced melanoma. AB - We have performed a pilot trial with two murine monoclonal antibodies (MAbs) directed against two surface membrane antigens, p97 (MAb 96.5) and a proteoglycan antigen (MAb 48.7) primarily expressed in human melanoma. Five patients with disseminated melanoma were studied, all of whom had multiple cutaneous metastases. Four patients received 212 mg each of antibodies 96.5 and 48.7, and one patient received 424 mg of antibody 96.5 alone. MAbs were administered in escalating doses over ten days in four patients and over six days in one patient. There was no clear treatment-related toxicity. Immunohistologic studies on biopsies taken two to 240 hours after treatment showed extensive binding of murine immunoglobulin to melanoma cells, but not to normal cells in the same section. The intensity of antibody binding was uniform across the diameter of the tumor nodules. In two patients, no murine immunoglobulin was detected in biopsies taken ten days after the last treatment. The mean initial elimination half-life (T1/2) of infused MAbs was 40.5 hours in two patients who received a combination of both antibodies and 53.0 hours in a third patient who received only antibody 96.5; none of these patients had previously been exposed to mouse immunoglobulin. The elimination T1/2 was 21 hours in a fourth patient, who three months previously had tumor imaging with 2-mg radiolabeled antigen-binding fragments (Fab) prepared from antibody 48.7. Serum from this patient appeared to contain anti-idiotypic antibodies which specifically bound Fabs of antibody 48.7. Three other patients also developed human anti-mouse antibodies. There were no objective tumor regressions, and no histologic changes were noted on biopsy. PMID- 3973646 TI - Patterns of recurrence in patients with high-grade soft-tissue sarcomas. AB - From July 1975 to December 1982, 563 patients were referred to the Surgery Branch of the National Cancer Institute with the diagnosis of soft-tissue sarcoma. Three hundred and seven of these patients had fully resectable, localized high-grade soft-tissue sarcomas and were treated at the National Cancer Institute using standard protocols with surgery alone, or in combination with chemotherapy and/or radiotherapy. An aggressive surgical approach was undertaken in the management of patients who subsequently developed recurrent disease. These 307 cases have been reviewed, with a median duration of follow-up of 30 months, to determine the frequency of recurrent disease, the patterns of recurrence, and the impact of surgery on the survival of patients who developed recurrent disease. Disease recurred in one hundred seven patients (107/307, 35%), with a median disease-free interval of 18 months (range, 0.5 to 72.0 months). The frequency of recurrence by site of primary sarcoma was extremity, 31% (65/211); head and neck, 33% (4/12); trunk, 40% (17/42); retroperitoneum, 47% (17/36); and breast, 67% (4/6). Isolated pulmonary metastatic disease was the most common pattern of initial recurrence (56/107, 52%) followed by isolated local recurrence (21/107, 20%). Single other sites of recurrence and multiple concurrent sites of recurrence each accounted for 14% (15/107) of all initial recurrences. The relative frequency of each of these four patterns of recurrence varied with the site of the primary sarcoma. The outcome for patients with recurrent disease depended on the site of recurrence, rather than on the site of the primary sarcoma. Sixty-six patients (66/107, 62%) with recurrent disease were rendered surgically disease-free with the first recurrence, including 40 (40/56, 72%) patients with isolated pulmonary metastases, 20 patients (20/21, 96%) with isolated local recurrences, five patients (5/15, 33%), with isolated other sites of recurrence and one patient (1/15, 7%) with multiple sites of initial recurrence. Following surgical resection, the actuarial three-year survival for the 66 patients rendered disease free was 51%. The median survival for the 41 patients not rendered surgically disease-free with the first recurrence was only 7.4 months. Thirty of the sixty six patients (30/66, 45%) rendered disease-free with the first recurrence remained disease-free at follow-up, with a median follow-up of 28 months from the time of resection of the first recurrence. The remaining 36 patients (36/66, 55%) subsequently recurred, with a median disease-free interval of 7.3 months.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973647 TI - Ifosfamide: an active drug in the treatment of adenocarcinoma of the pancreas. AB - From April 1982, until February 1984, 29 patients with biopsy-proven and measurable adenocarcinoma of the pancreas were treated with ifosfamide. Ifosfamide was administered at a dose of 1.25 to 1.5 g/m2 daily for five consecutive days with courses repeated every three weeks. If no serious toxicity was noted, subsequent dosages were escalated to a maximum of 2.0 g/m2/d. In addition, N-acetylcysteine (NAC) (8 to 12 g/d) was administered (in divided daily doses days 1 through 7) as a urothelial protective agent. Nausea and vomiting occurred in the majority of the treated patients. Other toxicities noted were mild myelo-suppression, CNS toxicity, and one case of acute renal failure. One complete response (CR) and five partial responses (PR) were observed in 27 evaluable patients (CRs and PRs = 22%). Ifosfamide has definite activity against pancreatic adenocarcinoma. Doses greater than 1.2 g/m2 for days 1 through 5 can be administered without significant toxicity in the majority of patients. Further trials with ifosfamide alone and/or with other agents are warranted. PMID- 3973649 TI - Obstructive and perforative colonic carcinoma: patterns of failure. AB - Carcinoma of the colon complicated by obstruction or perforation has been recognized as having a poorer prognosis than tumors without obstruction or perforation. To clarify the natural history, failure patterns, and implications for adjuvant treatment after resection with curative intent, a review of the recent Massachusetts General Hospital (MGH) experience was undertaken. From 1970 to 1977, 77 patients with obstructive colonic carcinoma and 34 patients with localized perforation at the tumor site were identified and compared with a control group of 400 patients without obstruction or perforation undergoing curative resection. All patients were observed for a minimum of five years or until the patient's death. The actuarial five-year survival and disease-free survival rates in patients with obstruction was 31% and 44%, respectively, in contrast to 59% and 75% in control patients. For patients with localized perforation, the five-year actuarial survival and disease-free survival rates were 44% and 35%, respectively. Of the 77 patients with obstructing tumors, 32 patients (42%) developed local failure--nine with local failure only and 23 patients with local failure and distant metastases. Thirty-four patients (44%) developed distant metastases. Fifteen (44%) patients of 34 with perforative colonic carcinoma had local failure. Distant metastases occurred in 15 patients (44%). The incidence of local failure and distant metastases in the control group was 14% and 21%, respectively. The rate of local failure and distant metastases increased with stage and was generally higher stage for stage than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973648 TI - Treatment of locally unresectable cancer of the stomach and pancreas: a randomized comparison of 5-fluorouracil alone with radiation plus concurrent and maintenance 5-fluorouracil--an Eastern Cooperative Oncology Group study. AB - One hundred ninety-one patients with pathologically confirmed, locally unresectable adenocarcinoma of the stomach (57 patients) and pancreas (91 patients), were randomly allocated to therapy with 5-fluorouracil (5-FU) alone, 600 mg/m2 intravenously (IV) once weekly, or radiation therapy, 4,000 rad, plus adjuvant 5-FU, 600 mg/m2 IV, the first three days of radiotherapy, then follow-up maintenance 5-FU, 600 mg/m2, weekly. Forty-three patients (22%) could not be analyzed because of ineligibility or cancellation, thus 148 patients were evaluable. The median survival time was similar for both treatment programs and for both types of primary carcinoma, and was as follows: gastric primary carcinoma, 5-FU, 9.3 months; 5-FU plus radiotherapy, 8.2 months; pancreatic primary carcinoma, 5-FU, 8.2 months; 5-FU plus radiotherapy, 8.3 months. Substantially more toxicity was experienced by patients treated with the combined modality arm than by those patients receiving 5-FU alone. Severe or worse toxicity experienced by patients with gastric primary carcinoma treated by 5-FU was 19%, and the combined modality arm was 31%. The toxicity experienced by patients with pancreatic primary carcinoma treated with 5-FU was 27%, and the combined modality arm was 51%. Significant prognostic variables included: weight loss in stomach-cancer patients; and performance status, degree of anaplasia, and reduced appetite in pancreas-cancer patients. PMID- 3973651 TI - A pilot study of protracted venous infusion of 5-fluorouracil and concomitant radiation therapy. AB - A method to potentially increase the effectiveness of combination 5-fluorouracil (5-FU) and radiation therapy (XRT) using protracted (more than 30 days) venous infusion (PVI) of 5-FU with conventionally fractionated XRT (180 to 200 cGy per day) (100 cGy = 100 rad) is described. Forty-one patients were treated with this combination with acceptable acute toxicity. In 95% of patients, the toxicity was mild or moderate and symptom control was achieved with medications or a short treatment interruption. In two patients (5%), severe gastrointestinal side effects resulted in cessation of all therapy. This method of administration of 5 FU is feasible, and we have demonstrated that it can be safely used with a course of conventionally fractionated, high-dose (approximately to 6,500 cGy) radiation therapy. PMID- 3973650 TI - Prognostic groups for management of localized Hodgkin's disease. AB - Two hundred fifty-two patients receiving radical irradiation for clinical stages I and II Hodgkin's disease between 1968 to 1977 had an actuarial ten-year survival rate of 78% and a relapse-free rate of 61%. Sixty-seven patients receiving chemotherapy followed by radiation had a 78% survival rate and a 63% relapse-free rate. Independent prognostic factors for survival and relapse were age, stage, and histology. Disease bulk was predictive only of relapse. Neither site of presentation above or below the diaphragm nor presence of mediastinal involvement was predictive for survival or relapse; however, patients with large mediastinal masses (greater than or equal to 10 cm absolute diameter) had a significantly higher intrathoracic failure rate with conventional mantle irradiation. Analysis of failure, according to age, clinical stage, and histologic type, showed three groups of patients defined according to the risk of relapse with radiation therapy: those with isolated upper cervical stage IA disease (group 1, relapse rate 8%), younger patients with localized stages I and II disease of favorable histologic type (group 2, relapse rate 35%), and older patients with extensive or symptomatic stages I and II disease of less favorable histologic type (group 3, relapse rate 70%). Subsequent analysis of radiation treatment volume indicates that the use of upper abdominal irradiation for patients in group No. 2 could yield results equivalent to those achieved with radiation therapy for surgically staged patients. PMID- 3973652 TI - Phase I trial of an implanted battery-powered, programmable drug delivery system for continuous doxorubicin administration. AB - A second generation, implantable drug administration device (DAD, Medtronic, Inc, Minneapolis) which contains a 20-mL drug reservoir, a lithium-thionyl-chloride battery, a peristaltic roller pump, a microprocessor circuit, and an acoustic transducer has entered clinical trials. After surgical placement, drug is entered into and removed from the DAD percutaneously through a Silastic "fill port" using a standard gauge needle and syringe. The pump is noninvasively programmed using a hand-held telemetry wand to administer the drug in a continuous infusion, bolus, or bolus-delay mode. Because of the apparent improved therapeutic index of continuous-infusion doxorubicin (CID), a phase I trial of the Medtronic DAD with CID was begun. Thirteen pumps in 13 patients have functioned for a median of 153 days (range, 11 to 395 days) with one pump still functioning. Four pumps ceased function at 170, 278, 331, and 370 days, respectively; there was a catheter-tip clot on one of the pumps that later malfunctioned. All other pumps functioned until the death of the respective patients. In 84 pump refills, without drug extravasation, the median drug delivery error (actual residual volume--calculated residual volume/calculated residual volume X 100%) was 14%. Doxorubicin was compatible with all components of the drug pathway and did not significantly decompose during two weeks in the drug reservoir. The starting dose of CID was 2.0 mg/m2/d and the maximum tolerated dose was 4.1 mg/m2/d (range, 3.5 to 5.5). A median cumulative doxorubicin dose of 244 mg/m2 per patient (range, 10 to 583 mg/m2) has been infused.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973653 TI - The effect of chemotherapeutic agents on chemotaxis and random migration of human leukocytes. AB - Chemotherapeutic agents (CTAs) used for treatment of neoplastic and other diseases may influence defense mechanisms of the patient, altering various humoral and cellular immunologic functions. Herein we report the influence of 16 CTAs on random migration and chemotaxis of human polymorphonuclear cells (PMNCs), using two methods, under-agarose migration and double-filter Boyden chambers with 51Cr-PMNCs. Random migration was inhibited by vinblastine only (P less than .01). BCNU and daunorubicin inhibited random migration only when used in high concentrations. In under-agarose migration, only BCNU and vinblastine inhibited chemotaxis (P less than .01) in therapeutic concentrations. Inhibition was also observed when higher concentrations of vincristine were tested. In the Boyden method, marked inhibition of chemotaxis (P less than .01) was caused by BCNU, vinblastine, vincristine, daunorubicin, and doxorubicin. Inhibition of chemotaxis could not be reversed by washing the cells after preincubation. CTAs per se did not have chemoattractant activity. This study shows that some chemotherapeutic agents inhibit random and directed migration of human PMNCs. It also supports the evidence that Boyden chamber method may detect chemotactic abnormalities that escape recognition by the under-agarose migration method. Suppression of locomotion of PMNCs should be taken into consideration in patients treated with CTAs. PMID- 3973654 TI - Contrasting neuronal activity in supplementary and precentral motor cortex of monkeys. I. Responses to instructions determining motor responses to forthcoming signals of different modalities. AB - The present report contrasts neuronal activity in two motor cortical fields after instructions that determine which of two sensory signals will trigger a movement and which will not. The goal of the study was to determine possible differential roles of the two cortical fields in the process of preparing to move in response to one external cue and to ignore another. Single-cell recordings were made from the supplementary motor area (SMA) and the precentral motor area (PCM) of monkeys trained to perform key-press movements in two different modes. In the auditory mode, an instruction signal warned the animal to prepare to start the movement promptly in response to a forthcoming 1,000-Hz tone burst (trigger signal), but to remain motionless if the signal was vibrotactile (nontrigger signal). In the tactile mode, the trigger and nontrigger signals were reversed: a different instruction signal warned the animal to prepare to perform the key-press movement in response to the vibrotactile cue, but to withhold it in response to the 1,000 Hz tone. The instruction signals were auditory tones of 300 Hz for the auditory mode and 100 Hz for the tactile mode. Out of 259 task-related SMA neurons, 128 (49%) responded to instructions. Three types of instruction responses were observed: 1) 95 neurons showed continuous instruction-induced activity changes lasting until the occurrence of the movement-triggering signal, regardless of whether an intervening nontrigger signal occurred. 2) 24 neurons showed increased activity until the occurrence of the nontriggering signal, after which the activity subsided. When there was no nontrigger signal, the activity increased during a period when the nontrigger signal might have been given. 3) Nine neurons responded with a transient, short-latency discharge after the instruction. The responses of SMA neurons to two instructions were often different. Forty-four SMA neurons exhibited a selective response to only one of the two instructions. In 43 neurons the response was differential, with the magnitude of activity increase or decrease being at least three times greater after one instruction than the other. In the remaining 41 neurons the response was nondifferential. Out of 112 task related PCM neurons, 25 (22%) responded to the instructions. In the majority of them (21 neurons), the instruction response was nondifferential.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973655 TI - Contrasting neuronal activity in supplementary and precentral motor cortex of monkeys. II. Responses to movement triggering vs. nontriggering sensory signals. AB - This report compares neuronal activity in the supplementary motor area (SMA) and the precentral motor cortex (PCM) in response to auditory and vibrotactile signals that required a monkey either to start a key-press movement or to refrain from initiating such a movement. Confirming previous reports (3, 9), a vibrotactile stimulus that triggered movement gave rise to two phases of neuronal activity in PCM neurons: a short-latency response time-locked to the occurrence of the vibrotactile stimulus, and a response related to the time of onset of the movement. When the animal was required to refrain from moving in response to the vibrotactile signal, the short-latency response was often attenuated and there was rarely any later activity. There was no attenuation of the short-latency response to the nontriggering vibrotactile stimulus in the anterior part of the postcentral somatosensory cortex. As reported previously (23), short-latency stimulus-locked responses of SMA neurons to a vibrotactile signals were less frequent and the magnitude of the responses was smaller than in the PCM. However, the properties of the later-occurring responses of SMA neurons were often different from those of PCM neurons. Many SMA neurons responded to both the triggering and nontriggering vibrotactile signals. Twenty-nine SMA neurons responded to the nontriggering signal only and not to the movement-triggering signal. Most of the PCM neurons were active after the auditory signal only when the signal was a trigger to start the key-press movement; three neurons exhibited a slight activity increase after the nontriggering auditory signal. In contrast, a number of SMA neurons responded to the nontriggering auditory signal as well as the movement-triggering auditory signal. Twenty-three neurons responded exclusively to the nontriggering auditory signal. These results indicate the extent to which SMA neuronal activity, in contrast to that of the PCM, is related to factors other than the execution of movement. PMID- 3973657 TI - Projection from dorsal column nuclei to dorsal mesencephalon. AB - This study investigated the projection from the dorsal column nuclei (DCN) to the dorsal mesencephalon. Single-unit extracellular recordings were obtained from the DCN of alpha-chloralose anesthetized cats. Neurons were identified by standard antidromic stimulation criteria as projecting to the dorsal mesencephalon (M neurons), the diencephalon (D neurons), or to both regions (MD neurons). Fifty two neurons could be antidromically activated from the dorsal mesencephalon. Of these, 31 could also be antidromically activated by stimulation in the diencephalon. An additional 34 neurons were studied that could be antidromically activated only from the diencephalon. Stimulation sites within the dorsal mesencephalon effective in antidromically activating M and MD neurons were in the caudal ventrolateral superior colliculus, the intercollicular area, and external nucleus of the inferior colliculus. Effective diencephalic stimulation sites were in the ventroposterolateral nucleus, the zona incerta, and the magnocellular division of the medial geniculate. The antidromic latencies to stimulation in the dorsal mesencephalon of M and MD neurons spanned a similar but wide range of values in contrast to the latencies to stimulation in the diencephalon of D neurons which were all short. Conduction velocities along the mesencephalic and diencephalic collaterals of MD neurons were similar. Many of the neurons projecting to the mesencephalon had receptive fields located proximally on the body. Most of the neurons had rapidly adapting responses to low-intensity mechanical stimulation of the skin. The major difference between the mesencephalic M and MD projection neurons and diencephalic projection D neurons was the larger percentage of neurons having proximal receptive fields in the former group. These findings are the first electrophysiological demonstration of a direct somatosensory input to the dorsal mesencephalon arising in the DCN. This input is probably responsible for providing some of the somatosensory input to the deeper layers of the superior colliculus, the external nucleus of the inferior colliculus, and the intercollicular area, regions known to have neurons responding to somatosensory stimuli. PMID- 3973656 TI - Selective inhibition of glucose-sensitive neurons in rat lateral hypothalamus by noxious stimuli and morphine. AB - On the basis of their responsiveness to electrophoretically applied glucose, neurons in the lateral hypothalamic area (LHA) have been characterized as either glucose sensitive or glucose nonsensitive. Glucose-sensitive neurons are important in feeding control (4, 36-38, 44, 54). The aim of this study was to increase understanding of the neurophysiological mechanisms involved in the disturbance of feeding by pain. Radiant heating of the scrotum, strong tail pinch, and immersion of the tail in hot water were used as noxious stimuli. In order to correlate the responses of LHA neurons to noxious inputs with possible local release of endogenous opiates, effects of electrophoretically applied morphine and naloxone were also tested. The effects of glucose, morphine, and noxious stimulation were studied in a total of 165 neurons recorded from 75 adult male urethane-chloralose-anesthetized rats. Of 52 neurons determined to be glucose sensitive, 36 (69%) were inhibited by both noxious stimulation and morphine. A majority of the glucose-nonsensitive neurons did not respond to either morphine or noxious stimulation (87/113, 74%). The relation of glucose sensitivity to inhibition by pain and/or morphine was statistically significant (Fisher's exact probability test, P less than 0.01). Naloxone attenuated the inhibitory effects of both pain and morphine, thus suggesting mediation of both by the same neuronal mechanism. From this evidence we conclude that LHA glucose sensitive neurons are involved in the suppression of feeding by noxious stimulation. PMID- 3973658 TI - Classification of response patterns in cochlear nucleus of barn owl: correlation with functional response properties. AB - Response patterns of neurons in the cochlear nuclei of the barn owl (Tyto alba) were studied by obtaining poststimulus time histograms (PSTHs) and interspike interval histograms for the response to short tone bursts at the neuron's characteristic frequency. The observed response patterns can be classified according to the scheme developed for neurons of the mammalian cochlear nuclear complex (22). Neurons of the magnocellular cochlear nucleus (n. magnocellularis), which respond in a phase-locked manner to sinusoidal signals and do not show large increases in spike discharge rate with changes in stimulus intensity (26), have "primarylike" (PSTH) discharge patterns and broad interspike interval histograms. This indicates that magnocellular neurons have irregular firing patterns, with the timing of individual spikes being dependent on the phase of the stimulus waveform. Neurons of the angular cochlear nucleus (n. angularis), which show little or no phase-locking and large increases in spike rate with increasing intensity (26), had almost exclusively "transient chopper" discharge patterns. The interspike interval histograms of these angular units are sharp, indicating that their discharge is very regular. At the onset of the response where the chopper pattern is observed, both discharge regularity and rate intensity sensitivity are at their maximum levels. Several "onset" units were isolated in the angular cochlear nucleus, but no "pauser" or "buildup" units were seen. Also, all of the units in the angular nucleus had monotonic rate-intensity functions. Thus no neural response patterns typical of mammalian dorsal cochlear nucleus units were observed. The relationship of response pattern type to neural function is discussed in relation to the acoustic cues used by the owl for two dimensional sound localization. The primarylike, phase-locked discharge of magnocellular units is undoubtedly involved in the analysis of interaural differences in stimulus phase, which the owl uses for horizontal localization. There is strong evidence suggesting that the angular nucleus is involved in processing stimulus intensity information, which is important for determining sound elevation (due to asymmetries in vertical directionality of the owl's external ears). The predominant chopper patterns seen in the angular nucleus suggest that in the owl, this response type is correlated with stimulus intensity processing. Similarities in both anatomy and physiology suggest that the magnocellular nucleus is analogous to the spherical cell or bushy cell population of the anterior division of the mammalian anteroventral cochlear nucleus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973659 TI - Activity of neurons in putamen during active and passive movements of wrist. AB - Recent studies have shown that many neurons in the basal ganglia have patterns of activity that are closely related to various parameters of active movements of the arm. The topographical distribution of these cells suggests that they are influenced by afferents from primary motor and sensory areas of the cerebral cortex. Although there is abundant evidence that information from peripheral receptors is relayed to the basal ganglia, relatively little information is available on whether neurons related to active movement are influenced by peripheral inputs. The present study was undertaken to provide information on this problem by comparing responses of putamen neurons to active and passive movements of the wrist. Two monkeys were trained to place their hand in a manipulandum and actively extend and flex their wrist against opposing torque loads. Additionally, they were trained to accept 1) passive step displacements of the wrist by the experimenter, which were comparable in amplitude, duration, and velocity to active movements, and 2) brief rapid displacements generated by a pulse of torque applied to the manipulandum by a motor. An extensive electromyographic (EMG) study was made prior to unit recording to characterize patterns of muscle activity during active and passive movements. A sample of 82 neurons was isolated in the putamen on the basis of a phasic burst of spikes associated with active movement of the wrist. Most (80%) of these cells showed directionally specific responses. The onset latency of unit firing in 91% of the cells lagged behind the onset of EMG activity in forearm agonist muscles. Phasic unit discharge during active movement increased with increasing opposing torque loads in 59% of the sample. The rate-torque curves for most of these cells were curvilinear (plateau occurred at heavy torque loads), although some cells showed a linear relationship. A comparison of these neuronal activity patterns with EMG activity-torque curves suggests that most of the cells were related to activity in forearm muscles and not to activity in proximal or axial muscles. The functional significance of these findings is interpreted in light of recent physiological and anatomic studies of the basal ganglia. A substantial proportion (44%) of the units that were related to active wrist movements showed an excitatory response during passive step displacements of the wrist in the absence of phasic EMG activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973660 TI - Segmental differences in pathways between crayfish giant axons and fast flexor motoneurons. AB - We have used electrophysiological techniques to document segmental differences in the pathways between the giant, escape command axons, lateral giants (LG) and medial giants (MG), and the nongiant, fast flexor (FF) motoneurons. We found no difference in the input from LG and MG axons to FF motoneurons in the posterior (4th and 5th) ganglia. Since flexor motor output in these segments would be inconsistent with the LG-evoked behavior pattern, this finding was puzzling. Electromyographic (EMG) recordings during escape responses by intact unrestrained animals confirm that the FF muscles innervated by the posterior ganglia are not excited during LG-mediated tailflips, but are excited during MG-mediated tailflips. In the 2nd and 3rd ganglia, the command axons fire the FF motoneurons with high probability, in part via electrical excitatory postsynaptic potentials (EPSPs) from premotor neurons, the segmental giants (SG). In the 4th and 5th ganglia, the equivalent pathway is much less effective. Single, directly elicited impulses in SGs in ganglia 2 and 3 fire their respective FF motoneurons with high probability, while those in ganglia 4 and 5 rarely fire FF motoneurons. The command axons fire the SGs reliably in all segments. The amplitude of the SG evoked EPSP in FF motoneurons is significantly smaller in posterior vs. anterior ganglia. For technical reasons, we are unable to present conclusive evidence on ganglionic variations in FF-motoneuron thresholds. The FF motoneurons receive additional excitatory input from intersegmental interneurons recruited by the command neurons. Motoneurons in ganglia 4 and 5 are excited by large interneurons that do not synapse on motoneurons in ganglia 2 and 3, but this additional input is not sufficient to compensate for the weaker effect of SG input. Unlike the all or-none segmental differences demonstrated previously for the LG-to-motor giant pathway (24), the SG-to-FF pathway changes gradually, retains significant though subthreshold strength in posterior ganglia, and is common to both LGs and MGs. These features provide opportunities for variation in the spatial patterning of flexion and in the resulting escape trajectories. PMID- 3973661 TI - Tonotopic organization in ventral nucleus of medial geniculate body in the cat. AB - Responses of single units and clusters of units to tone burst stimulation were recorded at 100-micron intervals along vertical electrode penetrations through the medial geniculate bodies of eight barbiturate-anesthetized cats. Marking lesions were placed at two or three locations along most penetrations to aid in histological reconstruction of electrode tracks. Best frequencies and suprathreshold-response latencies were studied at each location along a penetration. The ventral nucleus is physiologically characterized as a region containing narrowly tuned, short-latency (less than or equal to 40 ms) responses and an orderly tonotopic organization. Best frequencies were plotted as a function of depth along single electrode penetrations, and the sequences from different locations in the ventral nucleus were compared. Two-dimensional best frequency maps were obtained at different rostrocaudal levels. Each map was constructed from best frequencies encountered along several electrode penetrations in the same transverse plane in one brain. We divided the ventral nucleus into seven different rostrocaudal levels, each characterized by a different pattern of tonotopy. Caudolaterally, isofrequency contours parallel the ventrolateral border of the medial geniculate body. At middle levels, low- and mid-frequency contours course ventromedially from the dorsal border of the ventral nucleus toward its medial border, then turn sharply and continue ventrolaterally. Higher-frequency contours parallel this course, but consist of discontinuous dorsal and ventral segments. Rostrally, isofrequency contours are vertically oriented. A model of the three-dimensional tonotopic organization of the ventral nucleus is described that is consistent with the two-dimensional best frequency maps obtained at different rostrocaudal levels and with locations of ventral nucleus neurons labeled by horseradish peroxidase injections into low-, mid-, and high-frequency representations in auditory cortex. The model includes a planar component and a concentric component. Within the planar component, low frequencies are represented laterally and high frequencies are represented rostromedially. Within the concentric component, low frequencies are represented in a central column that extends mediolaterally through a hole in the mid frequency representation. The mid-frequency representation in turn is partially surrounded by the high-frequency representation. There is a continuous representation of a "single" frequency in both the planar and concentric components of the model.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973662 TI - Responses of tendon organs to unfused contractions of single motor units. AB - The discharges of individual tendon organs of peroneus longus and tertius muscles were examined in anesthetized cats during stimulation of single motor units at frequencies that elicit unfused contraction (5-50/s). At these frequencies nearly all the fast-contracting motor units activating a tendon organ elicited responses whose discharge rates reproduced the stimulation frequency ("1:1 driving"), whereas slow-contracting motor units elicited responses in which the discharge rate was higher than the stimulation frequency. When a motor unit stimulated at 40/s developed a gradually potentiating tension, the tendon organ discharge could remain locked on stimulation frequency over an appreciable range of the increasing tension as if the receptor responded to the tension oscillations rather than to the mean level of tension. The only visible effect of the gradual increase in mean tension on the tendon organ response was a gradual decrease of the delay between each stimulus and the corresponding impulse. Driving of tendon organ discharge at the stimulation frequency occurred not only when relatively large oscillations were superimposed on a low level of static tension but also when the static component of the tension was quantitatively preponderant. These observations suggest that during unfused contractions the dynamic component of the stimulus (i.e., oscillation of tension) exerts a prevailing influence on the discharge pattern of tendon organs. Computed simulations of tendon organ responses confirmed that a relatively strong dynamic sensitivity could account for the observed behavior of the receptor. PMID- 3973663 TI - Representation of stimulus azimuth by low-frequency neurons in inferior colliculus of the cat. AB - The responses to changes in stimulus azimuth of 204 neurons in the inferior colliculus of the cat with best frequencies of less than 3 kHz were studied. Three main unit classes were identified: omnidirectional units uninfluenced by speaker azimuth (39%); multipeaked units with several azimuthal regions at which peak firing occurred (9%); and azimuth-selective units that showed clear preferences for a discrete range of sound-source azimuths (52%). Alterations in stimulus intensity produced little change in the shapes of profiles relating firing rate to stimulus azimuth (azimuth functions), but the peaks of these functions could shift by up to 20 degrees. Similar observations were made for a small sample of units, each of which was examined with a variety of stimulus frequencies. The pinnae were removed bilaterally in 11 cats, and azimuth functions for 35 units were measured both binaurally and with the ipsilateral or contralateral ear occluded. Evidence was found for facilitative or suppressive interactions, as a function of stimulus azimuth, between monaural inputs. The sharpness of an azimuth function was expressed by the half-width of the function, i.e., the number of degrees of azimuth between the peak of the function and the point at which 50% of maximum firing occurred on the medial side of the peak. When half-widths were plotted as a function of best frequency, it was found that the sharpest azimuth functions occurred for units with best frequencies between 1.1 and 1.5 kHz. Most units in the lowest two octaves (0.1-0.4 kHz) or having best frequencies between 2 and 3 kHz were omnidirectional. The relationship between half-width and the azimuth at which peak firing occurred (best azimuth) revealed that a range of best azimuths between 10 and 40 degrees contralateral contained the sharpest azimuth functions. When best frequency was plotted against best azimuth, it was observed that the majority of units (93%) had best azimuths in the contralateral hemifield. For frequencies between 0.7 and 1.7 kHz, best azimuths occurred relatively evenly between 10 and 60 degrees contralateral. These data suggested that for frequencies between 1.2 and 1.4 kHz, at least, the best azimuths of different units with the same best frequency collectively provide information about stimulus location across much of the contralateral hemifield.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973664 TI - Interaural time and intensity coding in superior olivary complex and inferior colliculus of the echolocating bat Molossus ater. AB - Single-unit responses to tonal stimulation with interaural disparities were recorded in the nuclei of the superior olivary complex (SOC) and the central nucleus of the inferior colliculus (ICC) of the echolocating bat, Molossus ater. Seventy-six units were recorded from the ICC and 74 from the SOC; of the SOC units, 31 were histologically verified in the medial superior olive (MSO), 10 in the lateral superior olive (LSO), and 33 in unidentified areas of the SOC. Best frequencies (BFs) of the units ranged from 10.3 to 89.6 kHz, and Q10 dB values ranged from 2 to 70 dB. Most ICC neurons responded phasically to stimulus onset and were either inhibitory/excitatory [I/E; (53)] or excitatory/excitatory [E/E; (21)] units. In the MSO, 23 units responded tonically and 7 phasically on, 18 were E/E or E/OF (facilitatory for other input) units, and 11 were I/E neurons. All LSO neurons responded in a "chopper" fashion, and the binaural neurons were E/I units. In E/E units the excitatory response to binaural stimulation was frequently larger than the sum of the monaurally evoked responses. Many neurons with E/I or I/E inputs had very steep binaural impulse-count functions and were sensitive to small interaural intensity differences. Twenty-eight units (24%) responded with a change in firing rate of at least 20% to interaural time differences of +/- 500 microseconds. Within this sample, 11 units (8 from ICC, 2 from MSO, and 1 from SOC) were sensitive to interaural time differences of only +/- 50 microseconds. Of these 11 units, 10 were I/E units responding phasically only to stimulus onset and were also sensitive to intensity differences (delta I), being suppressed completely by the inhibitory input over a delta I range of 20 dB or less. Of 117 units tested in the ICC and SOC nuclei, 86 units (76%) were not sensitive to interaural time disparities within +/- 500 microseconds. Because the BFs of these units sensitive to interaural transient time differences (delta t) ranged between 18 and 90 kHz, responses were elicited by pure tones, and responses did not change periodically with the period equal to that of the stimulus frequency, we conclude that the neurons reacted to interaural differences of stimulus-onset time (transient time difference) but not to phase differences (ongoing time difference). Sensitivity to interaural time differences was also correlated with interaural intensity differences.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973665 TI - Maturation of visual callosal connections in visually deprived kittens: a challenging critical period. AB - The number of callosally projecting neurons (callosal neurons) which can be labeled in cortical areas 17 and 18 by horseradish peroxidase (HRP), injected in the contralateral visual cortex, is reduced to about 50% of normal in cats reared with their eyelids bilaterally sutured. In the same animals the density of HRP anterogradely transported to areas 17 and 18 is also decreased. The apparent loss of callosal neurons is limited to layers III and IV (subzone a), whereas layer VI (subzone c) is unaffected. The effect is obtained after 3 months or more but not after 1 month of deprivation. Two months of visual experience following deprivation do not restitute a normal number of callosal neurons. However, 10 days of normal visual experience preceding the deprivation are sufficient to prevent the effects of the latter. Animals deprived of vision after a short period of normal visual experience and animals allowed normal vision after 1 month of visual deprivation have a more widespread distribution of callosal neurons than do normal animals; in this way they are similar to previously described cats reared with convergent or divergent strabismus, monocular enucleation, or monocular eyelid suture. The results suggest that: vision is actively responsible for both the maintenance and the elimination of fractions of the juvenile callosal connections; the elimination which normally takes place during the second postnatal month requires normal binocular vision; and activity dependent competition between callosal and other axons can explain the role of vision. PMID- 3973666 TI - Androgen and estrogen receptors in perinatal ferret brain. AB - Using DNA-cellulose affinity chromatography and either 3H-labeled dihydrotestosterone, testosterone, or estradiol, we qualitatively and quantitatively analyzed the androgen- and estrogen-binding activities present in four regions of male and female ferret brain at prenatal, early and late neonatal, and adult ages. The cytosolic androgen- and estrogen-binding activities in ferret brain at all ages studied were qualitatively similar in both sexes and in all brain regions and exhibited characteristics which resemble those of androgen and estrogen receptors from other species, including rodents and nonhuman primates. A developmental analysis indicated that high levels of both androgen and estrogen receptors were present in the hypothalamus-preoptic area as early as 5 days before birth. A significant, transient decline in concentrations of estrogen receptors (approximately 5-fold) occurred in anterior hypothalamus preoptic area and mediobasal hypothalamus at 12 days of age in both males and females; this phenomenon has not been observed in any other species studied to date. The observed ontogeny of androgen receptors correlates with the known ability of testosterone, acting over postnatal days 5 to 20, to cause coital masculinization in ferrets, whereas the observed postnatal dip in estradiol receptor concentrations correlates with the inability of estradiol to cause coital masculinization or defeminization of receptive behavior in this species. PMID- 3973667 TI - Postnatal development of the phase-locked response to low frequency tones of auditory nerve fibers in the cat. AB - The maturation of the auditory nerve's ability to encode temporal information in an acoustic signal was studied in young kittens, 7 to 23 days old, and in adult cats by measuring the degree to which auditory nerve fiber responses are synchronized (phase locked) to low frequency tones. The major findings include the following. In 7- to 10-day-old kittens thresholds are high (around 100 dB), and secure phase locking is observed only at frequencies below about 600 Hz. The upper frequency limit for phase locking in the adult, around 4 kHz, is reached gradually toward the end of the third postnatal week, a time when thresholds also reach their adult levels. The time course of development of the phase-locked response is similar for fibers with different characteristic frequencies (CFs). At all ages studied, the maximal phase synchrony at any given low frequency is generally obtained at stimulus intensities less than 20 dB above the rate threshold and some 10 to 30 dB below the saturation firing level of the fiber. Time delays, estimated from phase-versus-frequency plots, were similar across ages, although they tended to be longer and more variable at lower CFs during the first 2 postnatal weeks. Comparing the phase-locked response of auditory nerve fibers with that of the anteroventral cochlear nucleus neurons from a previous study suggested that the upper frequency limit for phase synchrony was reached later in the nucleus than in the nerve. PMID- 3973668 TI - Functional postnatal changes in avian brain regions responsive to retinal slip: a 2-deoxy-D-glucose study. AB - The postnatal development of two avian brain areas, the nucleus of the basal optic root (nBOR) and the lentiform nucleus of the mesencephalon (LM), was studied using the 2-deoxy-D-glucose (2-DG) method. Previous studies have shown that these nuclei respond to whole field visual motion, which is used for optokinetic eye movements. In the present study vertical whole field visual motion presented to one eye resulted in the accumulation of 2-DG label in the contralateral nBOR in both hatchlings and 3-week or older chicks. In hatchlings the nBOR was diffusely labeled whether upward or downward motion was used as the test stimulus, whereas in older birds the label was localized within different subdivisions of the nBOR depending on the direction of vertical motion: upward motion resulted in concentration of 2-DG label in the dorsal nBOR, whereas downward motion resulted in label in the ventral nBOR. Horizontal whole field visual motion presented to one eye resulted in 2-DG label in the contralateral LM and in the lateral portion of the contralateral nBOR in animals of both ages. In hatchlings, visual motion in both temporal-to-nasal and nasal-to-temporal directions resulted in labeling of both subdivisions of the LM, LM magnocellularis (LMmc) and LM parvocellularis. In older birds, temporal-to-nasal motion resulted in labeling of only the LMmc, whereas nasal-to-temporal motion produced labeling in both subdivisions. These results strongly suggest that the nBOR and LM continue to develop their response properties postnatally and that different functional units become separated within particular subdivisions of the nuclei. Conceivably, the functional segregation within the nBOR is due to an intrinsic reorganization, whereas functional changes in the LM may be due to the postnatal development of a projection from the telencephalon. PMID- 3973669 TI - Nerve growth factor-treated, neurite-bearing PC12 cells continue to synthesize DNA. AB - Cultures of rat pheochromocytoma (PC12) cells treated with beta-nerve growth factor (NGF) for up to 15 days continue to synthesize DNA. The present study compares the extent of maintained DNA synthesis in cells with and without processes and asks whether the observed DNA synthesis in differentiated PC12 cells reflects either the continued division of the cells or the formation of polyploid cells, or both. PC12 cells were grown on tissue coverslips for various lengths of time with or without 50 ng/ml of beta-NGF and then assayed for DNA synthesis by [3H]thymidine labeling and autoradiography. In 8-day-old control cultures (no NGF), 30% of the cells had labeled nuclei after a 2-hr [3H]thymidine pulse. In contrast, in cultures treated for 8 days with NGF, only 7% of the cells were labeled (i.e., still synthesizing DNA). The fractions of process-bearing and non-process-bearing cells with labeled nuclei were identical. Even after 14 days in NGF, 7% of the cells with neurites were still synthesizing DNA during any 2-hr period. With continuous [3H]thymidine labeling in the presence of NGF from 8 to 13 days, nearly 70% of the cells with neurites were labeled. The presence of neurites induced by NGF does not preclude continued (albeit reduced) DNA synthesis in these PC12 cells. To determine the fate of this newly synthesized DNA, nuclei extracted from NGF-treated PC12 cells were analyzed for the cellular distribution of DNA by combined propidium iodine staining and flow microfluorimetry. NGF treatment resulted in a 3-fold increase in the number of G2+M/4N cells along with the appearance of 8N cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973670 TI - alpha-Bungarotoxin receptors on neurons isolated from turtle retina: molecular heterogeneity of bipolar cells. AB - We studied localization of specific [125I]-alpha-bungarotoxin (alpha-BTX) receptors on neurons dissociated from the adult turtle retina. Cells isolated from papain-treated retinas retained complex morphologies and were readily identifiable with cell classes (photoreceptors, Muller cells, multipolar and bipolar cells). Levels of alpha-BTX receptors, measured by filtration assays, averaged 120 fmol/mg of protein whether or not retinas were treated with papain. Light microscope autoradiographs of isolated cells showed that only bipolar neurons had receptors for alpha-BTX. In the presence of d-tubocurarine, no cells were labeled above background. Receptors were localized both close to and far from known sites of synaptic contacts. Highly labeled bipolar cells had grains over Landolt clubs, cell bodies, and axons as well as over dendrites, but lightly labeled cells had few grains over axons and cell bodies. Overall, most receptors occurred on dendrites, suggesting the activity of cellular mechanisms capable of directing receptor molecules to specific subcellular positions. The receptor phenotype was not expressed all or none, as autoradiographs of individual bipolar cells showed a wide spectrum of receptor levels. A maximum level of about 30,000 receptors/cell was seen. Unlabeled bipolar cells also were prevalent (70%), and this group included virtually all "displaced" type bipolar cells. The data show molecular heterogeneity both between and within retina cell classes. PMID- 3973671 TI - Neuron-specific interactions with two neurite-promoting fragments of fibronectin. AB - Proteolytic fragments of fibronectin were used to identify regions of the molecule that support neurite extension and to investigate further the differential behavior of central and peripheral nervous system neurons in response to fibronectin (Rogers, S. L., P. C. Letourneau, S. L. Palm, J. B. McCarthy, and L. T. Furcht (1983) Dev. Biol. 98: 212-220). Fibronectin fragments with differing biological activities were produced by proteolytic digestion with trypsin and cathepsin D and sequential affinity chromatography on gelatin-agarose and heparin-Sepharose. The resulting fragments (described by Smith, D. E., D. F. Mosher, R. B. Johnson, and L. T. Furcht (1982) J. Biol. Chem. 257: 5831-5838; Smith, D. E., and L. T. Furcht (1982) J. Biol. Chem. 257: 6518-6523 included an NH2-terminal 27,000-dalton peptide that weakly binds heparin, a 46,000-dalton gelatin-binding fragment, a series of fragments (80,000 to 125,000 daltons) from the center of the molecule containing previously described cell-binding activity, two major peptides of Mr = 33,000 and 66,000 that bind heparin strongly and are thought to originate from the A and B chains, respectively, of plasma fibronectin, and a 31,000-dalton COOH-terminal peptide containing a free sulfhydryl from the A chain of the molecule. Tissue culture dishes were treated with these proteolytic preparations, and dissociated embryonic chick peripheral (PNS) and central nervous system (CNS) cells were cultured on each experimental substratum in serum-free medium. The fibronectin fragments were evaluated for ability to promote cell attachment, neurite initiation, and maintenance of neurite growth. The 27,000-, 46,000-, and 31,000-dalton preparations did not promote cell attachment or neurite extension. Both PNS and CNS neurons attached to and extended stable neurites upon the COOH-terminal heparin-binding preparation containing the 33,000- and 66,000-dalton peptides. A differential response of the neurons to the 80,000- to 125,000-dalton "cell-binding" peptides was observed: whereas PNS neurons maintained neuritic growth on this preparation for at least 48 hr, CNS neurons extended neurites during the first 24 hr of culture but, by 48 hr, withdrew these neurites and became increasingly clumped. On the basis of (1) the observed neuronal responses to the heparin binding and "cell binding" regions, and (2) the different ligand-binding properties of these regions, we propose that cell attachment and neurite extension can be mediated and/or modulated by two separate regions of fibronectin and that cellular response to the intact molecule may involve multivalent interactions. PMID- 3973672 TI - Adhesion of axolemmal fragments to Schwann cells: a signal- and target-specific process closely linked to axolemmal induction of Schwann cell mitosis. AB - Radioiodinated rat CNS axolemmal fragments adhered to cultured rat Schwann cells by a time-, temperature-, and concentration-dependent process independent of extracellular ionized calcium. Adhesion showed target and signal specificity; axolemmal fragments adhered to endoneurial or dermal fibroblasts to a much lesser extent than to Schwann cells, and plasma membrane fragments from skeletal muscle, erythrocytes, or PNS myelin adhered to Schwann cells to a lesser extent than did axolemmal fragments. Brief trypsinization removed 94 to 97% of bound radioactivity from Schwann cells previously incubated with 125I-axolemmal fragments for up to 24 hr, indicating that adhesion was largely a surface phenomenon rather than the result of rapid internalization of axolemmal fragments by the Schwann cells. When adhesion was compared to the axolemmal mitogenic response of Schwann cells, the concentration of axolemmal fragments yielding half maximal adhesion was the same as the concentration producing half-maximal stimulation of Schwann cell mitosis. Trypsin digestion, homogenization, or heating of axolemmal fragments before application to cultured Schwann cells diminished adhesion and axolemmal fragment-induced stimulation of Schwann cell mitosis in a parallel fashion. Whereas adhesion of axolemmal fragments to the surfaces of the cultured Schwann cells reached completion within 4 hr in this assay system, induction of Schwann cell mitosis by the fragments required contact with Schwann cells for a minimum of 6 to 8 hr and reached a maximum when the axolemmal fragments had adhered to the Schwann cells for 24 hr or more. PMID- 3973673 TI - Developmental neural kinship groups in the leech. AB - We have traced the developmental origins of various CNS neurons and glial cells of a leech to 10 clonally related groups of cells, the bilaterally paired M, N, O, P, and Q kinship groups. Each kinship group is descended from one of 10 identifiable blastomeres of the early embryo, the teloblasts. Of the approximately 200 neurons in each side of a segmental ganglion, 130 to 160 are in the ipsilateral N, 20 to 50 in the O, 8 to 12 in the P, 6 to 9 in the Q, and 3 to 6 in the M kinship group. A given identified neuron or glial cell was invariably found to belong to a particular kinship group, indicating that in leech development neuronal lineage is highly stereotyped. But cells of related function and morphology do not necessarily belong to the same neuronal kinship group: of the mechanosensory neurons, the T and N neurons belong to the N, the Pv neuron belongs to the P and the PD neuron belongs to the O kinship group. Similarly, glial cells arise from all four ectodermal teloblasts. Conversely, neurons within a kinship group are not obviously related in structure or function: the N kinship group includes sensory, motor, and effector neurons and interneurons: the O and P kinship groups each include sensory neurons and interneurons; both the P and Q groups contain representatives of three distinct morphological classes of interneurons. Consequently, in early development, the determinants of neuronal identity in the leech CNS are not segregated in any obvious thematic way in the cleavages that give rise to the five bilateral pairs of teloblasts. Rather, the neural kinship groups may be merely the evolutionary vestige of a primordial distributed nervous system, each quadrant of which was derived from one teloblast. PMID- 3973674 TI - Knife cuts of entorhinal cortex: effects on development of amygdaloid kindling and seizure-induced decrease of muscarinic cholinergic receptors. AB - This report examines the effect of transection of the entorhinal hippocampal projection on amygdaloid kindling. We found that: bilateral knife cuts of entorhinal cortex but not of dorsal neocortex antagonize the development of amygdaloid kindling; and bilateral knife cuts of entorhinal cortex eliminate the seizure-induced decrease in number of muscarinic receptors of dentate granule cells. We suggest the following interpretations of these data: the hippocampal formation circuitry facilitates the development of amygdaloid kindling; and the decline of muscarinic receptors after kindled seizures is due to excessive activation of granule cells by axons from entorhinal cortex, a noncholinergic afferent. PMID- 3973675 TI - Direct electrical stimulation promotes growth and enhances survival of aneurogenic muscles of the chick embryo. AB - Analyses of embryonic aneurogenic muscles indicate that several processes associated with early myogenesis in vivo proceed in the absence of peripheral nerves. However, aneurogenic muscles demonstrate impaired growth and limited survival. To investigate whether neurally mediated activity is responsible for these phenomena, aneurogenic muscles of the chick embryo were directly stimulated in vivo via implanted electrodes. Volumetric analyses of stimulated aneurogenic brachial (latissimus dorsi) muscles from Stage (St) 33 (7.5 to 8 days) through St 37 (11 days) demonstrated that growth was enhanced significantly beyond the level characteristic of unstimulated aneurogenic muscles. Moreover, for the majority of embryos, the stimulation regimen actually rescued the posterior latissimus dorsi muscle which characteristically does not survive beyond St 32 (7.5 days) in the aneurogenic state. Thus, our results implicate activity per se as an important factor necessary for the proper growth and survival of brachial muscles during early embryogenesis. The stimulation regimen, however, did not alter myosin ATPase profiles. PMID- 3973676 TI - Quantitative in vivo receptor binding. I. Theory and application to the muscarinic cholinergic receptor. AB - A novel approach to in vivo receptor binding experiments is presented which allows direct quantitation of binding site densities. The method is based on an equilibrium model of tracer uptake and is designed to produce a static distribution proportional to receptor density and to minimize possible confounding influences of regional blood flow, blood-brain barrier permeability, and nonspecific binding. This technique was applied to the measurement of regional muscarinic cholinergic receptor densities in rat brain using [3H]scopolamine. Specific in vivo binding of scopolamine demonstrated saturability, a pharmacologic profile, and regional densities which are consistent with interaction of the tracer with the muscarinic receptor. Estimates of receptor density obtained with the in vivo method and in vitro measurements in homogenates were highly correlated. Furthermore, reduction in striatal muscarinic receptors following ibotenic acid lesions resulted in a significant decrease in tracer uptake in vivo, indicating that the correlation between scopolamine distribution and receptor density may be used to demonstrate pathologic conditions. We propose that the general method presented here is directly applicable to investigation of high affinity binding sites for a variety of radioligands. PMID- 3973677 TI - Autoradiographic localization of (125I-Tyr4)bombesin-binding sites in rat brain. AB - The binding of (125I-Tyr4)bombesin to rat brain slices was investigated. Radiolabeled (Tyr4)bombesin bound with high affinity (Kd = 4 nM) to a single class of sites (Bmax = 130 fmol/mg of protein); the ratio of specific to nonspecific binding was 6/1. Also, pharmacology studies indicated that the C terminal of bombesin was important for the high affinity binding activity. Autoradiographic studies indicated that the (125I-Tyr4)bombesin-binding sites were discretely distributed in certain gray but not white matter regions of rat brain. Highest grain densities were present in the olfactory bulb and tubercle, nucleus accumbens, suprachiasmatic and periventricular nuclei of the hypothalamus, central medial thalamic nucleus, medial amygdaloid nucleus, hippocampus, dentate gyrus, subiculum, nucleus of the solitary tract, and substantia gelatinosa. Moderate grain densities were present in the parietal cortex, deep layers of the neocortex, rhinal cortex, caudate putamen, stria terminalis, locus ceruleus, parabrachial nucleus, and facial nucleus. Low grain densities were present in the globus pallidus, lateral thalamus, and midbrain. Negligible grain densities were present in the cerebellum, corpus callosum, and all regions treated with 1 microM unlabeled bombesin. The discrete regional distribution of binding suggests that endogenous bombesin-like peptides may function as important regulatory agents in certain brain loci. PMID- 3973678 TI - Age-dependent long-term adaptation of crayfish phasic motor axon synapses to altered activity. AB - Crustacean tonic and phasic motoneurons have neuromuscular synaptic properties corresponding with their functional requirements. Phasic axon synapses produce large excitatory postsynaptic potentials (EPSPs) which depress rapidly during repetitive activation. Tonic axon synapses generally produce smaller EPSPs which are more resistant to fatigue. To test whether nerve impulse activity of the motoneuron plays a role in the establishment of these synaptic properties, a phasic axon was tonically stimulated in vivo. The "fast" closer excitor of the crayfish claw, which normally fires few impulses, was stimulated for 2 hr/day at 5 Hz, through implanted electrodes. In young crayfish, this stimulation produced an 11-fold decrease in synaptic fatigue at the fast axon's neuromuscular synapses, as determined from measurements of EPSPs during 5 Hz stimulation of the fast axon for 30 min. In comparison with EPSPs of the contralateral control claw, the initial EPSP amplitude was 44% smaller and the final EPSP amplitude was 4.3 times larger for the chronically stimulated fast axon. These changes in EPSP amplitude are due to changes in transmitter release. This long-term adaptation of the fast axon to imposed tonic activity persists for at least 10 days after the effect has been established. The same chronic stimulation regimen produces significant, although less dramatic, results in adult crayfish. Compared to the contralateral control, the chronically stimulated fast axon showed no change in initial EPSP amplitude and only a 2-fold increase in the EPSP amplitude after 30 min of stimulation at 5 Hz. Thus, the decrease in synaptic fatigue was only 2- to 3-fold, much less than in young crayfish.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973679 TI - The complete pattern of ocular dominance stripes in the striate cortex and visual field of the macaque monkey. AB - Ocular dominance stripes in the striate cortex of a macaque monkey were labeled by autoradiography after injection of [3H]proline into one eye. The stripes were reconstructed on a representation of the flattened cortical surface by two independent techniques: one used computer graphics, and the other was the manual unfolding procedure of Van Essen and Maunsell (VanEssen, D. C., and J. H. R. Maunsell (1980) J. Comp. Neurol. 191: 255-281). The two reconstructions differed in many details of the pattern but were in agreement on its general features. As described in earlier studies, the stripes formed a system of parallel bands, with numerous branches and islands. They were roughly orthogonal to the V1/V2 border throughout the binocular segment of the cortex. In the lateral part of the operculum, where the fovea is represented, the stripes were less orderly than elsewhere. In the calcarine fissure the stripes ran directly across the striate cortex from its dorsal to its ventral margin. In the far periphery the stripes for the ipsilateral eye became progressively narrower, eventually fragmenting into small islands at the edge of the monocular segment. The overall periodicity (width of a left- plus right-eye pair of stripes) averaged 0.88 mm but decreased by a factor of about 2 from center to periphery. This decrease was not accounted for solely by shrinkage of the ipsilateral eye stripes. The flattened cortical reconstruction was transformed back into visual field coordinates, using information about visual field topography obtained from the detailed mapping study of Van Essen et al. (Van Essen, D.C., W.T. Newsome, and J.H.R. Maunsell (1984) Vision Res. 24: 429-448), as well as from more limited mapping done in the same monkey that was used for the reconstruction. In the transformed map, the stripes increased in width about 40-fold from the fovea to the far periphery. As deduced previously (LeVay, S., D. H. Hubel, and T. N. Wiesel (1975) J. Comp. Neurol. 159: 559-576; Hubel, D. H., and D. C., Freeman (1977) Brain Res. 122: 336 343), there were portions of the map in which the stripes followed curves approximating isoeccentricity lines, but this relationship was not very exact or consistent. The pattern of stripes appears to be more meaningfully related to the geometry of the cortical surface. This has significant implications for understanding the developmental mechanisms involved in stripe formation. PMID- 3973680 TI - Phase and amplitude computations in the midbrain of an electric fish: intracellular studies of neurons participating in the jamming avoidance response of Eigenmannia. AB - Electric fish monitor modulations in sensory feedback from their own electric organ discharges (EODs) to locate moving objects and to detect interfering EODs of their neighbors. The gymnotoid genus Eigenmannia minimizes detrimental effects of jamming by EODs of its neighbors by shifting its own EOD frequency away from a neighbor's EOD frequency that is too close to its own. Since the animal lowers its own frequency if its neighbor's frequency is higher and raises its frequency if its neighbor's frequency is lower, this jamming avoidance response (JAR) requires that the animal determine the sign of the difference frequency, Df, between the interfering EODs. Eigenmannia obtains this information by evaluating modulations in the amplitude and phase which its nearly sinusoidal EOD signal experiences due to the interference with the neighbor's EODs. The necessary logical operations are executed in the dorsal torus semicircularis, an analogue of the inferior colliculus of higher vertebrates, and are similar to operations underlying directional hearing. By intracellular labeling of physiologically identified cells we have identified the anatomy and functional characteristics of neurons involved in the processing of amplitude and phase information. The JAR is controlled by hierarchical and parallel processing of information in several laminae of somatotopically ordered neurons. Phase differences between signals received by electroreceptors in different parts of the body surface are computed in lamina 6. Information about differential phase is then relayed to multipolar cells in the deeper laminae 8, b and c, which also receive information about modulations in local signal amplitude. These cells are excited by a rise or fall of amplitude as well as by a lead or lag of phase. According to their responses to either of these two variables, these neurons can be divided into four classes. These classes encode all information necessary for the control of the JAR and project to the optic tectum. Dynamic properties and sensory specificities of the JAR are not found in individual, properly tuned neurons but rather emerge statistically from the joint effects of a large population of imprecisely tuned neurons. This system is characterized by a distributed pattern of organization and by the absence of a small number of key neurons whose malfunction would jeopardize the behavioral response. The complexity of this neural machinery appears unnecessary for the logically simple task of the JAR, and it suggests that this behavior was acquired later in evolution by being derived from more general motor responses to moving objects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973681 TI - Activity-dependent shrinkage of extracellular space in rat optic nerve: a developmental study. AB - Activity-dependent shrinkage of extracellular space (ECS) is described in a simple model of the mammalian central nervous system, the rat optic nerve. In response to neural activation, the ECS of the mature nerve rapidly and reversibly decreases by as much as 20%. Activity-dependent ECS shrinkage is not present in neonatal nerves but develops over the first 2 weeks of life, roughly coincident with the appearance of glial cells in this structure. These and other observations suggest that activity-dependent ECS shrinkage results from fluid and electrolyte movements into glial cells. PMID- 3973682 TI - Input and output changes of an identified neural pathway are correlated with associative learning in Hermissenda. AB - The effect of associative training on an identified putative motoneuron (MN1) in an identified visual input-output neural pathway was studied in Hermissenda crassicornis. The increased impulse frequency of the MN1 cell in response to a light step (MN1-LR) was found to be smaller up to 54 hr after associative training with paired light and rotation stimuli. No change was found in animals which received these training stimuli randomly. The MN1 activity in darkness, namely, baseline impulse frequency, spike amplitude, input resistance, and resting potential, did not change after training. The MN1-LR was positively correlated on retention days with the behavioral latency of the animal to enter the illuminated area of a light intensity gradient. However, the input resistance of the type B photoreceptor was inversely correlated with this behavioral latency as well as with MN1-LR. These findings suggest that the reduction of MN1-LR may be caused by the biophysical changes which have been found in the type B photoreceptor membrane. Furthermore, these findings support several other studies which indicate that specific biophysical changes in the type B photoreceptor membrane play a causal role in the observed behavioral modifications after associative training in Hermissenda. PMID- 3973683 TI - Autoradiographic localization of adenosine uptake sites in rat brain using [3H]nitrobenzylthioinosine. AB - The adenosine uptake site has been localized in rat brain by an in vitro light microscopic autoradiographic method, using [3H]nitrobenzylthioinosine ( [3H]NBI) as the probe. The binding characteristics of [3H]NBI on slide-mounted sections are comparable to those seen in studies performed on brain homogenates. A very high density of uptake sites occurs in the nucleus tractus solitarius, in the superficial layer of the superior colliculus, in several thalamic nuclei, and also in geniculate body nuclei. A high density of sites are also observed in the nucleus accumbens, the caudate putamen, the dorsal tegmentum area, the substantia nigra, and the central gray. The localization of the adenosine uptake site in brain may provide information on the functional activity of the site and suggests the involvement of the adenosine system in the central regulation of cardiovascular function. PMID- 3973686 TI - How straight do axons grow? AB - Detailed growth paths of embryonic frog and chick axons were measured as the axons elongated in dispersed cultures on acid-rinsed glass surfaces. Mathematical analyses demonstrate that, under these conditions, axons do not grow randomly but tend to grow straight. Growth cones appear to actively alternate sides--right and left from the straight line of growth--and the growth cone neck exhibits all possible angles, but the axon itself maintains a fairly constant orientation. It appears that an axonal resistance to bending may be the cause of the intrinsic tendency for relatively straight axonal growth. The natural straightness of axonal growth may be an important developmental determinant of certain in vivo axon patterns. PMID- 3973685 TI - Proprioceptive influences on auditory and visual spatial localization. AB - We evaluated the influence of proprioceptive information about arm position on the perceptual localization of auditory and visual targets attached to the hand. Our approach was to distort the perceived position of the restrained arm by means of mechanical vibration of the biceps brachii muscle; such vibration elicits compelling apparent extension of the stationary forearm (Goodwin, G. M., D. I. McCloskey, and P. B. C. Matthews (1972) Science 175: 1382-1384, Brain 95: 705 748), and subjects report changes in the apparent directions of the auditory and visual targets attached to their hand. These changes are in the same direction and plane as apparent arm motion and their onsets are coincident with or lag slightly behind the experienced displacement of the arm. While visual motion is being experienced, a subject's eyes remain steadily fixating the target light. The pattern of findings demonstrates that proprioceptive information about limb position can influence the central representation of gaze and auditory localization can be similarly influenced. The biasing of auditory localization indicates that identical patterns of arrival time and intensity cues at the two ears can give rise to the perception of sounds in widely disparate spatial positions in relation to the head and body, depending on the proprioceptive representation of the direction of the sound source. PMID- 3973684 TI - Starburst amacrine cells: morphological constancy and systematic variation in the anisotropic field of rabbit retinal neurons. AB - Starburst amacrine cells of rabbit retina have been characterized previously in terms of their highly distinctive and regular dendritic geometry. They have been identified as probable cholinergic neurons of the retina and have been shown to direct output solely to ganglion cells. The objectives of this paper are to chart the variation of starburst amacrine cells across the retina, to register the morphological features which are held constant for individual cells, and to examine factors which may remain invariant for the population with change in retinal position. Starburst amacrine cells occur as two completely segregated mirror-symmetrical populations, type a and type b cells, separately serving OFF and ON pathways, respectively. They are treated here as two distinct subpopulations with very similar features. A characteristic morphological feature of both types, related to branching pattern and best seen in flat view, is the location of boutons in the distal annular zone. This is the effective zone of synaptic output, which is constant at 50 to 60% of dendritic field area, regardless of the cell's retinal location. Both type a and type b cells exhibit systematic increase in cell body size and dendritic field diameter, and systematic decrease in frequency of branching and of synaptic boutons with perpendicular distance from the visual streak. These rates of increase or decrease fall off considerably at distances greater than about 1.5 mm dorsal and ventral to the visual streak, but at this distance, the dendritic field diameters of cells in dorsal retina are about 65% larger than the diameters of cells in ventral retina. When type a and type b cells are closely compared, they are seen to differ in several respects. Branching patterns of type a and type b cells differ slightly, the latter being more highly branched, and the normalized branching frequency histograms, characteristic for each type, remain constant with changing retinal position. At the same retinal location type a cells always have larger dendritic field diameters than type b cells. This difference is significant in ventral retina, out to a distance of at least 4.5 mm from the streak. The maximum percentage difference in size occurs not at mid-visual streak, but about 1.5 mm ventral to the streak. The population statistics of dendritic field overlap and areal dendritic coverage have been calculated using published data on cell densities. It is concluded that overlap is extraordinarily high (k greater than 25), more than 10 times that calculated for retinal ganglion cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3973687 TI - Relationship between heterosynaptic reflex facilitation and acquisition of the nictitating membrane response in control and scopolamine-injected rabbits. AB - Classical conditioning of the rabbit nictitating membrane response was accomplished by presenting a 100-msec tone conditioned stimulus at intervals of 0, 100, 200, 400, and 800 msec before the presentation of a 100-msec shock unconditioned stimulus. In addition, tone-alone and shock-alone trials were interspersed during conditioning. On the first day of conditioning, during which there was no evidence of acquisition of conditioned responses to the tone conditioned stimulus, the amplitudes of the nictitating membrane response evoked on paired tone-shock trials were compared with the amplitudes obtained on shock alone trials to provide a measure of reflex facilitation. There was a significant correlation (+0.86) in control animals between the degree of reflex facilitation and the degree of learning demonstrated at the various tone-shock intervals. Both reflex facilitation and learning were absent at the 0-msec tone-shock interval, increased at the 100-msec interval, reached a maximum at the 200-msec interval, and then declined at the longer intervals. Scopolamine (0.4 mg/kg) did not affect the amplitude of the nictitating membrane response elicited on shock-alone trials but eliminated any evidence of reflex facilitation or learning at the 100- and 800-msec intervals and significantly reduced both reflex facilitation and learning at the 200- and 400-msec intervals. The comparable effects of scopolamine on both reflex facilitation and learning were reflected by a significant correlation (+0.95) between these two measures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973688 TI - Morphology and serotonergic innervation of physiologically identified cells of the guinea pig's myenteric plexus. AB - Ganglion cells of the myenteric plexus of the guinea pig were physiologically classified as to cell type using intracellular microelectrodes containing horseradish peroxidase (HRP). Interganglionic fiber tracts were then stimulated in an attempt to elicit slow excitatory postsynaptic potentials (EPSPs) in the impaled cells. The presence or absence of a slow EPSP was noted, following which the cells were injected with HRP through the recording micropipette and finally were incubated with tritiated 5-hydroxytryptamine ([3H]-5-HT; 0.5 microM) and desmethylimipramine (10 nM). The preparations were examined by light and electron microscopy (EM) for which the physiologically identified, HRP-injected neurons were demonstrated histochemically and serotonergic nerve terminals were simultaneously demonstrated radioautographically. Forty-seven cells were physiologically identified, injected with HRP, and studied by light microscopy. Of these, 22 were also fully analyzed by electron microscopy. The sample included 13 type I/S cells (6 analyzed by electron microscopic radioautography), 16 type II/AH cells (10 analyzed by electron microscopic radioautography), and 18 nonspiking (NS) cells (6 analyzed by electron microscopic radioautography). Slow EPSPs were only observed in type II/AH cells. All five of the fully analyzed subset of type II/AH cells that manifested a slow EPSP were contacted by serotonergic terminals. These terminals were found on 7 of 10 type II/AH cells, 2 of 6 type I/S cells, and 0 of 6 NS cells. Serotonergic terminals, therefore, contacted type II/AH cells (p less than 0.05) and especially those that showed a slow EPSP (p less than 0.005) more frequently than other types of ganglion cells. Morphologically, cells with short, stubby dendrites were reproducibly found to be type I/S cells, and glia could be recognized by their astrocytic appearance; however, cell shape did not otherwise correlate with physiological cell type. These data are compatible with and provide support for the hypothesis that 5-HT is one of the mediators of slow EPSPs in the myenteric plexus. PMID- 3973689 TI - Non-quantal release of acetylcholine at a developing neuromuscular synapse in culture. AB - Local, pulsed application of d-tubocurarine at neuromuscular synapses in embryonic Xenopus nerve-muscle culture resulted in a transient hyperpolarization of muscle membrane potential. Miniature endplate potentials (MEPPs) were abolished during the hyperpolarization and recovered after the return of resting membrane potential. The magnitude of hyperpolarization was independent of the frequency of MEPPs before curarization, and it had an average peak value of 4.3 mV in medium containing physiological levels of Ca2+. Prolonged application of curare or alpha-bungarotoxin led to sustained hyperpolarizations up to 8 mV in magnitude. Denervation produced by mechanically removing the neurite from the muscle cell also produced similar hyperpolarization, and curarization after denervation was without significant hyperpolarizing effect. Increasing the extracellular Ca2+ concentration to about 8 mM abolished the curare-induced hyperpolarization response, in sharp contrast to its effect in elevating the frequency of MEPPs. Taken together, our results indicate that innervated embryonic muscle cells were maintained at a depolarized state relative to that of uninnervated muscle cells by a steady, spontaneous release of acetylcholine (ACh) from the innervating neurite. The cellular mechanism underlying this mode of ACh release appears to be different from that of the quantal ACh release responsible for MEPPs. PMID- 3973690 TI - Dorsal and ventral myotome motoneurons and their input during fictive locomotion in lamprey. AB - Motoneurons supplying the dorsal and ventral parts of the myotome in the lamprey are shown to have different morphological characteristics; furthermore, their pattern of activation during fictive locomotion may differ considerably. Intracellular recordings from motoneurons were performed in an in vitro spinal cord-myotome preparation from segments rostral to the fins. The location of the contracting muscle fibers in the myotome could be observed directly in the dissection microscope during intracellular stimulation of the motoneuron. The motoneurons were injected with Lucifer Yellow, an intracellular dye, and were subsequently reconstructed, sometimes in both a horizontal and a transverse plane. Motoneurons supplying the ventral third of the myotome had a dense, fan like, dendritic tree and ramifications near the midline. In contrast, motoneurons supplying the dorsal third of the myotome had a more widespread and less dense dendritic tree, with few ramifications near the midline. Some motoneurons supplying the most ventral or dorsal part of the myotome had contralateral dendrites crossing in the ventral commissure and ramifying near contralateral large, reticulospinal Muller fibers. The differences in morphology may indicate that these motoneurons receive different descending inputs. This may be related to the need for an effective control in the dorsoventral plane during righting and steering responses. During fictive locomotion elicited in the isolated spinal cord by bath-applied N-methyl-aspartate, pairs of motoneurons were recorded which subsequently were identified and characterized by intracellular injections of Lucifer Yellow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973691 TI - Long-term enhancement produced by activity-dependent modulation of Aplysia sensory neurons. AB - We have investigated long-lasting enhancement of signaling effectiveness in the tail sensory neurons of Aplysia using both intracellular and extracellular stimulation. The pairing of high frequency homosynaptic activation with heterosynaptic modulation produced significantly greater enhancement of monosynaptic connections to identified motor neurons than did homosynaptic activity, heterosynaptic modulation, or test stimuli alone. Enhancement of the monosynaptic excitatory postsynaptic potential produced by pairing persisted for at least 4 hr, and the kinetics of decay of this potentiation indicated a time constant of about 5 hr. Although unpaired stimulation produced much weaker enhancement, both homosynaptic activity and heterosynaptic modulation alone produced enhancement lasting more than 90 min. The results are consistent with the possibility that intrinsic electrical activity can amplify the modulatory effects of a paired extrinsic chemical signal to produce long-term changes in synaptic strength. Paired stimulation also produced a relative enhancement of the excitability of the sensory neuron soma as judged by changes in action potential threshold. The lack of generalized changes in the postsynaptic cell and the observation of pairing-induced long-term changes in action potential threshold in the presynaptic cell soma suggest that long-term enhancement produced by pairing has a presynaptic locus in this system. Since pairing-specific enhancement can encode associations between sensory and motivational events in these cells, this form of plasticity may function as a form of associative memory. Similarities between long-term paired enhancement in this system and associative long-term potentiation in other systems suggest that activity-dependent neuromodulation might be involved in cellular memory in other systems as well. PMID- 3973692 TI - Rapid mobility of motile varicosities and inclusions containing alpha-spectrin, actin, and calmodulin in regenerating axons in vitro. AB - Time-lapse video recording was used to investigate the bidirectional movements of motile varicosities and intervening phase-dense (IPD) inclusions associated with axons of goldfish retinal ganglion cells regenerating in vitro. In addition, analyses of fine structure and immunocytochemical distributions of alpha-spectrin (fodrin), actin, and calmodulin in axonal fields were undertaken. Varicosities and IPD inclusions undergo saltations in a random manner at mean rates of 0.218 and 3.33 micron/sec, respectively. Experiments involving calcium antagonists or depletion of internal calcium stores resulted in an arrest of all intra-axonal movement, indicating that saltations of the two mobile structures are dependent on intra-axonal calcium. The predominant structure in varicosities is a large aggregation of an anastomosing, tubular, smooth endoplasmic reticulum embedded in an amorphous matrix, suggesting a form of "packaged" cytomembranes undergoing bulk transport. IPD inclusions, presumably carrying membranes, appear to shuttle between varicosities and growth cones during axon elongation, and between growth cones and varicosities during axon retraction. alpha-Spectrin, actin, and calmodulin were shown by immunocytochemistry to be preferentially distributed to varicosities and IPD inclusions. The co-transport of spectrin, actin, and calmodulin with cytomembranes undergoing rapid saltations departs from reported results of radioactive labeling experiments insofar as spectrin, actin, and calmodulin are not normally associated with rapidly transported membrane components in the latter studies. Possible reasons for the discrepancy are discussed. Our results suggest that spectrin and actin may play a role in the packaging and axoplasmic transport of cytomembranes concerned with plasmalemma recycling. PMID- 3973694 TI - The topography of ganglion cell production in the cat's retina. AB - The ganglion cells of the cat's retina form several classes distinguishable in terms of soma size, axon diameter, dendritic morphology, physiological properties, and central connections. Labeling with [3H]thymidine shows that the ganglion cells which survive in the adult are produced as several temporally shifted, overlapping waves: medium-sized cells are produced before large cells, whereas the smallest ganglion cells are produced throughout the period of ganglion cell generation (Walsh, C., E. H. Polley, T. L. Hickey, and R. W. Guillery (1983) Nature 302: 611-614). Large cells and medium-sized cells show the same distinctive pattern of production, forming rough spirals around the area centralis. The oldest cells tend to lie superior and nasal to the area centralis, whereas cells in the inferior nasal retina and inferior temporal retina are, in general, progressively younger. Within each retinal quadrant, cells nearer the area centralis tend to be older than cells in the periphery, but there is substantial overlap. The retinal raphe divides the superior temporal quadrant into two zones with different patterns of cell addition. Superior temporal retina near the vertical meridian adds cells only slightly later than superior nasal retina, whereas superior temporal retina near the horizontal meridian adds cells very late, contemporaneously with inferior temporal retina. The broader wave of production of smaller ganglion cells seems to follow this same spiral pattern at its beginning and end. The presence of the area centralis as a nodal point about which ganglion cell production in the retinal quadrants pivots suggests that the area centralis is already an important retinal landmark even at the earliest stages of retinal development. This sequence of ganglion cell production differs markedly from that seen in the retinae of nonmammalian vertebrates, where new ganglion cells are added as concentric rings to the retinal periphery, and also bears no simple relationship to the cat's retinal decussation line. However, it can be related in a straightforward manner to the organization of axons in the cat's optic tract, suggesting that the fiber order in the tract represents a grouping of fibers by age. PMID- 3973693 TI - A postnatal change in the immunological properties of the acetylcholine receptor at rat muscle endplates. AB - We have used a myasthenic serum that in adult rat muscle is specific for acetylcholine receptors (AChRs) in the extra-junctional membrane to characterize the AChRs at developing endplates. Immunocytochemical experiments show that AChRs at endplates in the rat diaphragm bind the myasthenic antibodies during the first week after birth but lose their reactivity during the second and third postnatal weeks. AChRs at endplates in adult rat diaphragm do not bind the antibodies even after denervation; in contrast, AChRs at endplates in an adult chicken muscle (anterior latissimus dorsi) are recognized by the antibodies. The loss of immunological reactivity thus may be correlated with a change in the channel properties of the AChR and with the appearance of synaptic folds, two postnatal developmental changes that occur at the endplates of rats, but not of chickens. PMID- 3973695 TI - Developmental arborization of sensory neurons in the leech Haementeria ghilianii. I. Origin of natural variations in the branching pattern. AB - The overall sizes, contours, and positions of the receptive fields maintained by different individual cells of the T, P, and N types of mechanosensory neurons in the segmental skin of the leech Haementeria ghilianii are not subject to wide variation. However, the locations and contours of the boundaries which separate the various compartments of the sensory field, namely, the major and minor fields, as well as their component subfields, do vary significantly. These variations are reflected in differences in the detailed pattern of arborization of the mechanosensory axon branches that innervate different parts of the receptive field. The appreciable variation in the kinetics of embryonic outgrowth of sensory axon branches, in conjunction with a mechanism of neuronal self avoidance, is a probable source of this variability in adult receptive field structure. Thus, establishment of these sensory field components would seem to entail a first-come-first-served territorial exclusion between different axon branches extended by the same neuron. PMID- 3973696 TI - Developmental arborization of sensory neurons in the leech Haementeria ghilianii. II. Experimentally induced variations in the branching pattern. AB - The sharp, nonoverlapping boundaries of the major and minor receptive fields of the mechanosensory neuron Pv of the leech, as well as the mutual exclusion during embryonic development of growing axon branches belonging to the same Pv cell, have suggested that peripheral axon arborization of these neurons is constrained by a process of neuronal self-avoidance. To provide a direct experimental test of this proposal, the development of the major and minor receptive fields of the Pv neuron was studied in embryos of the leech, Haementeria ghilianii, after surgically preventing or delaying the outgrowth of the axon branches which establish only a minor or only the major field of that neuron. As predicted by the proposal of self-avoidance, interference with the outgrowth of a minor field axon branch resulted in the spread of the major field axon branch into what is normally minor field territory. Conversely, similar interference with the establishment of the major field resulted in the spread of the minor field axon branches into what is normally major field territory. The findings presented here indicate that neuronal self-avoidance does play a significant role in the development of mechanosensory receptive field structure but suggest also that the detailed pattern of arborization of the sensory axons is guided by prespecified pathways of only ephemeral availability or recognizability. PMID- 3973697 TI - Temperature dependence of intrinsic membrane properties and synaptic potentials in hippocampal CA1 neurons in vitro. AB - The temperature dependence of intrinsic membrane conductances and synaptic potentials in guinea pig hippocampal CA1 pyramidal neurons were examined in vitro as they were cooled from 37 degrees C to between 33 and 27 degrees C. Cooling reversibly increased resting input resistance in a voltage-independent manner (Q10 = 0.58 to 0.75). The amplitude and duration of orthodromically evoked action potentials were increased by cooling (Q10 = 0.87 and 0.52 to 0.53, respectively), whereas the maximum rates of rise and fall were reduced (Q10 = 1.27 to 1.49 and 2.19 to 2.44, respectively). The amplitude and duration of the afterhyperpolarization which follows a directly evoked train of action potentials were substantially increased at low temperatures. It is possible to attribute this increase to an augmentation of Ca2+ influx during the train and also to a slowing of Ca2+ removal from the cytoplasm. Spike frequency adaptation during prolonged depolarizing pulses was enhanced at low temperatures. In addition, there was a decrement in spike amplitude during the train of action potentials. These observations all suggest an increase in Ca2+-activated K+ conductance at low temperature. A late, slow, hyperpolarizing synaptic potential in response to orthodromic stimulation became apparent at low temperature. This potential had an apparent reversal potential more negative than the early inhibitory postsynaptic potential, suggesting that it was mediated by a K+ conductance, possibly activated by Ca2+ influx. We conclude that reductions in temperature of as little as 5 to 10 degrees C from normal can significantly alter the intrinsic and synaptic physiology of hippocampal neurons and should, therefore, be considered an important variable in in vitro brain slice experiments. PMID- 3973698 TI - Deficits in visual motion processing following ibotenic acid lesions of the middle temporal visual area of the macaque monkey. AB - Physiological experiments have produced evidence that the middle temporal visual area (MT) of the monkey is selectively involved in the analysis of visual motion. We tested this hypothesis by studying the effects of small chemical lesions of MT on eye movements made in response to moving as opposed to stationary visual targets. We observed two deficits for eye movements made to moving targets: a monkey's ability to match the speed of his smooth pursuit eye movements to the speed of the moving target was impaired, and a monkey's ability to adjust the amplitude of a saccadic eye movement to compensate for target motion was impaired. In contrast, saccades to stationary targets were unaffected by the MT lesions, suggesting that monkeys with MT lesions had more difficulty responding to moving than to stationary stimuli. These results provide the first behavioral evidence that neural processing in MT contributes to the cortical analysis of visual motion. PMID- 3973699 TI - The natural history of aneurysms and arteriovenous malformations. AB - The authors summarize the findings of previous studies relating to the natural history of aneurysms and arteriovenous malformations (AVM's). Ruptured aneurysms have their highest rate of rebleeding on Day 1, and at least 50% will rebleed during the 6 months after the first hemorrhage. Thereafter, the rate drops to at least 3% a year. This is the same rate as seen in anterior and posterior communicating artery aneurysms treated by anterior cerebral artery clipping and carotid ligation; these operations provide immediate protection but do not result in long-term diminution of the risk of rebleeding. Patients with unruptured incidental and unruptured multiple aneurysms rebleed at a rate of 1% per year, as do patients with subarachnoid hemorrhage of unknown etiology. The risk of rebleeding for AVM's is 3% a year. PMID- 3973700 TI - Revascularization of the extracranial vertebral artery at any level without cross clamping. AB - Hemodynamic insufficiency resulting from extracranial vertebral artery stenosis or occlusion is believed to be the major cause of vertebrobasilar transient ischemic attacks. The major difficulties in treating this disorder have been exposure of the vertebral artery distal to the stenosis and the risk of vertebral artery cross-clamping for vein grafting or carotid artery transposition. The authors describe a new technique for vertebral artery reconstruction at any level by the use of an intraluminal shunt, thus avoiding the necessity to cross-clamp the artery. This procedure was successfully performed at all three levels of the extracranial vertebral artery: C7-4, C3-1, and C-1 to the foramen magnum. The technique of exposure of the vertebral artery at these three levels and the method of vein grafting without cross-clamping are described. The initial results of the procedure are presented. PMID- 3973701 TI - Zygomatic approach for lesions in the interpeduncular cistern. AB - Lesions in the interpeduncular cistern include basilar tip aneurysms, craniopharyngiomas, and chordomas. The surgical approach to these lesions presents a special technical problem, particularly when they are located high in the interpeduncular fossa. For the purpose of minimizing brain retraction and achieving excellent exposure within the interpeduncular cistern, the authors have developed a new surgical technique which involves detachment of the zygomatic arch. The patient is placed in the supine position with the head rotated 45 degrees to the contralateral side and tilted down 30 degrees so that the surgeon can see into the interpeduncular cistern obliquely from below. The zygomatic arch of the temporal bone as well as a portion of the lateral orbital rim (the posterior ridge of the frontal process of the zygomatic bone) is removed to expose the anterior temporal base. With posterior retraction of the temporal lobe, the arachnoid membranes covering the Sylvian stem are opened in a retrograde fashion until the tentorial edge is sufficiently exposed. The posterior communicating artery and the optic tract are elevated to enter the interpeduncular cistern, after which the oculomotor nerve is dissected free of its surrounding arachnoid membranes and displaced posteroinferiorly. Two patients with basilar tip aneurysms were operated on with this zygomatic approach, and a subtemporal modification of the zygomatic approach was used to treat a craniopharyngioma and a chordoma in two other patients. The procedure is described and a short description of its clinical use is given. PMID- 3973702 TI - Anterolateral decompression for metastatic epidural spinal cord tumors. Results of a modified costotransversectomy approach. AB - Since 1981, 12 patients with epidural spinal cord compression from metastatic carcinoma have been treated surgically by a modified costotransversectomy approach for anterolateral decompression. Before surgery, all patients had received dexamethasone, and had deteriorated neurologically despite radiation therapy, chemotherapy, or steroid therapy. Postoperatively, nine patients (75%) improved neurologically and were ambulatory, two (17%) had no change in neurological status, and one patient was unchanged initially but deteriorated and died 8 weeks later. Anterolateral decompression by a modified costotransversectomy approach should be considered for management of ventrally located tumors or when posterior stabilization is considered a possible requirement following a proposed anterior decompression. PMID- 3973703 TI - Complications of carpal tunnel surgery. AB - During a 12-year period, the authors treated 25 patients with 26 complications of previous carpal tunnel surgery. Twenty-four of these patients were referred following initial surgery elsewhere. The most frequent complication identified was neuroma of the palmar cutaneous branch of the median nerve in 14 of the cases. Other complications were hypertrophic scars, dysesthesias after multiple procedures to release the carpal tunnel, joint stiffness, failure to relieve symptoms, and neuromas of the dorsal sensory branch of the radial nerve. All of these complications are potentially preventable. With a properly placed incision, exposure carried out under magnification, and surgery under direct vision the majority of these complications may be prevented. It is further noted that the technique of transverse incision at the wrist for release of the carpal tunnel is potentially dangerous and should be abandoned. PMID- 3973704 TI - Isolated ventricles following intraventricular hemorrhage. AB - Panventricular enlargement often follows intraventricular hemorrhage in the premature neonate. During a recent 12-month period, the authors identified five infants who required shunting because of symptomatic post-hemorrhagic hydrocephalus, which was progressive despite serial lumbar punctures and the use of indwelling subcutaneous ventricular reservoirs. In the first 6 months following placement of the initial shunt, four of the infants required an additional shunt for isolated ventricles. Two children had isolation of the lateral ventricles and required bilateral shunts. Two other children had isolation of the fourth ventricle from the lateral ventricular system and required posterior fossa shunts. All of the children were treated successfully using multiple shunts. In all cases, progressive dilation of the isolated ventricle was unaccompanied by the usual clinical signs of shunt malfunction. It appears that isolated ventricular systems are common following post-hemorrhagic hydrocephalus and these children must be followed closely with ultrasound and computerized tomography scanning. PMID- 3973705 TI - Thermosensitive determination of obstructed sites in ventriculoperitoneal shunts. AB - A simple method is described for checking the patency of ventriculoperitoneal shunts by using a pair of small disc thermistors. With this technique, shunt patency is shown by a downward deflection of the recording trace, blockage of the ventricular catheter is indicated by a flat-line recording, and obstruction of the distal end of the abdominal catheter is demonstrated by an upward deflection. These observations were confirmed in a study of 32 hydrocephalic patients with obstructed shunts who subsequently underwent shuntography and operation. An experimental model was also devised to study the mechanism of the recording changes. PMID- 3973706 TI - Progressive spasticity and scoliosis in children with myelomeningocele. Radiological investigation and surgical treatment. AB - Seventeen myelodysplastic patients with progressive extremity spasticity and scoliosis underwent radiological evaluation and surgical treatment. All but one were under 18 years of age at the time of surgical treatment. Duration of the clinical presentation ranged from 1 1/2 to 7 years. Metrizamide was instilled into the subarachnoid space in 12 patients, the lateral ventricle in two, and the hydromyelic cavity in three. Sequential computerized tomography scanning after intrathecal instillation of the contrast material clearly demonstrated hydromyelia in nine patients and compression of the brain stem in five. Posterior fossa decompression with plugging of the obex was performed in 12 patients, posterior fossa decompression alone in three, and ventriculoperitoneal (VP) shunting procedures in two. Of the 12 patients who underwent the obex plugging procedures, eight have shown partial or complete resolution of spasticity and an increase in motor strength with no significant postoperative complications. In contrast, posterior fossa decompression or VP shunting procedures alone have not led to a favorable neurological outcome. Hydromyelia may occur more commonly among myelodysplastic patients than previously recognized and may be treated most effectively by the obex plugging procedure. PMID- 3973707 TI - Spontaneous activity of ventral root axons following peripheral nerve injury. AB - In 18 Sprague-Dawley rats, the left sciatic nerve was divided at the mid-femur level. Seven to 9 days later, microfilament recordings were made from the ipsilateral L-5 ventral root. Spontaneous activity in the ventral root, ranging from 0.1 to 6.1 Hz, was recorded in 12 of the 18 animals. Conduction velocity determinations showed this activity to be in A-beta and A-delta fibers. Recordings in 10 normal L-5 ventral roots from five control rats showed no spontaneous activity. In the rats with sciatic nerve division, the ongoing discharge appeared to originate in the cut end of the nerve since mechanical stimulation of the neuroma produced synchronous ventral root activity. Furthermore, cooling of the neuroma inhibited the spontaneous discharge, whereas with rewarming it returned. Spontaneous ventral root activity was also increased by systemic application of epinephrine. This activity was qualitatively similar to spontaneous activity that has been recorded in dorsal root microfilaments after peripheral nerve injury. The observation of an ongoing discharge in potentially nociceptive ventral root axons subsequent to nerve injury may be relevant to the mechanism of chronic pain of peripheral origin. PMID- 3973708 TI - Immunohistochemical study of metastatic brain tumors with astroprotein (GFAP), a glia-specific protein. Tissue architecture and the origin of blood vessels. AB - Tissues from 12 metastatic tumors of the brain were studied immunohistochemically with an antiserum to a glia-specific protein, astroprotein (glial fibrillary acidic protein, GFAP). Emphasis was laid on demonstrating the tissue architecture of metastatic lesions incorporating brain-derived components (astrocytes and glial fibers). Of 12 samples, 11 manifested a number of irregular indentations at the tumor surface. These indentations, which contained astrocytic elements, extended into the tumor tissue in a tapering fashion. In seven cases, the deeper stromal portions of the tumor also contained astroprotein (GFAP)-positive elements. The presence of this glia-specific protein suggests that the stroma of the tumor tissue may in part be derived from preexisting brain tissue. This peculiar tissue architecture of the tumor supports the hypothesis that some of the blood vessels that are located in the stroma of the tumor tissue are also derived from the brain. These observations may be important in understanding the partial preservation of the blood-brain barrier in metastatic brain tumors and the mode of growth of the metastatic lesion, and in selecting the type of chemotherapy that will be most effective in controlling this central nervous system complication of systemic malignancies. PMID- 3973709 TI - Histopathological study of major intracranial arteries in premature infants related to intracranial hemorrhage. AB - The incidence of various types of intracranial hemorrhage (ICH) and the microscopic appearance of the major intracranial arteries were investigated in 112 premature infants, and related to birth weight. In none of the premature newborns, regardless of the presence of ICH, did the intracranial arteries contain true elastic elements. The wall of the basilar artery was significantly thinner in all premature infants with any kind of ICH. Within each body-weight group those with ICH had intracranial arteries with fewer reticular fibers than did those without ICH. The density of the reticular fibers in the cerebral arteries of premature neonates without ICH did not seem to depend on maturity. The authors believe that the hypoplasia of the major intracranial arteries and the reticular fiber deficiency most probably involve the whole vascular system of the brain and may predispose to hemorrhage. PMID- 3973710 TI - Hemiparesis caused by vertebral artery compression of the medulla oblongata. Case report. AB - The case is reported of a patient with progressive left hemiparesis due to vascular compression of the medulla oblongata. Metrizamide computerized tomography cisternography revealed that the left vertebral artery was compressing and distorting the left lateral surface of the medulla. Compression was surgically relieved and symptoms improved postoperatively. Neurological and symptomatic considerations are discussed in relation to the topographical anatomy of the lateral corticospinal tract. PMID- 3973711 TI - Multiple intracranial aneurysms in sickle cell anemia. Report of two cases. AB - Neurological complications of sickle cell anemia occur in 18% to 29% of patients with homozygous hemoglobin S disease. A review of the literature yielded reports of two cases, both treated conservatively, of multiple intracranial aneurysms occurring in patients with sickle cell anemia. The authors report two cases of subarachnoid hemorrhage secondary to multiple intracranial aneurysms in patients with sickle cell anemia. One of the two patients underwent three craniotomies for ablation of six intracranial aneurysms. The techniques used in the treatment of these patients are presented. PMID- 3973712 TI - Positional intermittent occlusion of the internal carotid artery. Case report. AB - A case of angiographically verified positional occlusion of the internal carotid artery is presented. A small web-like atherosclerotic plaque was found to be responsible for producing the intermittent occlusion. Endarterectomy was curative. The clinical implications of the case are discussed. PMID- 3973713 TI - Bitemporal compression injury caused by static loading mechanism. Report of two cases. AB - The authors report two cases of bitemporal compression injury caused by a static loading mechanism. These head injuries resulted from gradual bitemporal compression of the head. Plain skull films showed multiple skull fractures, and carotid angiography revealed internal carotid artery obstruction at the base of the skull. Neurological examination disclosed a slight disturbance of consciousness, hemiparesis, multiple cranial nerve injuries, and Horner's syndrome. In comparison with impact head injury, the energy from this type of trauma tends to be transmitted to the foramina and hiati of the middle cranial fossa and results in multiple injuries to the cranial nerves, sympathetic nerves, and blood vessels. PMID- 3973714 TI - Giant intradiploic epidermoid cysts of the skull. Report of two cases. AB - The authors describe two cases of giant intradiploic epidermoid cysts of the cranial vault in which there was massive intracranial extension causing signs of neurological involvement. The very slow growth and the benign histological nature of these tumors explain their long preoperative evolution and the mild neurological signs in some cases. Roentgenographic and computerized tomography findings permit a correct diagnosis. Complete removal of these cysts and their capsules can be easily accomplished, despite their large size. Total removal of these cysts is associated with a very good long-term prognosis. PMID- 3973715 TI - Cervical diastematomyelia presenting in adulthood. Case report. AB - A case of cervical diastematomyelia in an adult is reported. The patient first noted sensory and motor symptoms at 34 years of age after two episodes of cervical trauma. Metrizamide computerized tomography myelography of the cervical spine and cord showed the region of diastematomyelia and revealed a spur containing both bone and fat tissue projecting into the spinal canal and cord. The spur arose from the laminae and spinous processes of C-2 and C-3, and was successfully excised. Postoperatively, the patient's deficits gradually improved. The literature concerning adult cervical diastematomyelia is reviewed. PMID- 3973716 TI - Intra-arterial BCNU chemotherapy for malignant gliomas. PMID- 3973717 TI - AIDS with central nervous system toxoplasmosis. PMID- 3973718 TI - Treatment of craniopharyngiomas in children: 1972-1981. AB - Between 1972 and 1981, 37 children with craniopharyngioma were cared for at Children's Hospital, Boston. In this paper, the results of treatment with radiation therapy after conservative operations are compared with those following an initial attempt to excise the tumor. Radiation therapy was equally, if not more, effective than attempted excision in controlling subsequent tumor growth. Although this was not a controlled study, the complications of each approach are indicated, and it is inferred that conservative operations combined with radiation therapy offer less risk for psychosocial impairment than does attempted tumor excision when patients are considered as a group. The ultimate effect that either approach might have on quality of life remains to be defined, and therapy must still be individualized to the particular clinical problem. PMID- 3973719 TI - Radiation therapy for incompletely resected meningiomas. AB - Twelve patients with incompletely resected meningiomas were treated with postoperative radiation therapy. Nine of these patients had previously undergone incomplete surgical resection, and three had suffered one or more postoperative recurrences. The median dose of irradiation was 5490 rads in 6 weeks (range 4800 to 6080 rads). All patients were followed with serial neurological examinations and computerized tomography (CT) scans. Median follow-up period was 54 1/2 months (range 20 to 120 months); 10 of the 12 patients were followed for longer than 42 months posttreatment. Nine patients had no clinical evidence of recurrent disease after radiation therapy, and CT scans confirmed lack of progression or a gradual decrease in tumor size. Three patients had tumor recurrences; two of these lesions appeared at 70 and 112 months after irradiation as extracranial extensions beyond the margin of the irradiation field, and one has exhibited recurrence within the field at 48 months. Three patients who were treated after prior recurrences have demonstrated prolonged progression-free intervals in comparison to the intervals between recurrences prior to irradiation. No significant complications attributable to treatment have been found in any of the patients. These results are discussed in relation to previous reports of the incidence of meningioma recurrence after incomplete resection. PMID- 3973720 TI - Subependymomas of the fourth ventricle. Surgical treatment in 12 cases. AB - Subependymomas of the fourth ventricle are generally considered incidental postmortem findings, and have received scant attention from neurosurgeons. The authors present a surgical series of 12 cases of this disorder diagnosed over a 13-year period. The clinical and radiological findings were reviewed and correlations made with pathological studies. The subependymoma is a histologically benign tumor that tends to be calcified. It has a predilection for the fourth ventricle and a peak incidence in the fifth decade of life. It is usually of considerable size with extensive attachment at the time of its detection, and is associated with significant surgical morbidity. The authors believe that magnetic resonance imaging may be the best method of investigation. Intraoperative disturbance of circulatory or respiratory control should suggest to the surgeon that the operation be abandoned. A laser or ultrasonic aspirator may be very helpful in removing these tumors. Postoperative care must include monitoring for apnea. PMID- 3973721 TI - Evaluation of treatment of normal-pressure hydrocephalus. AB - Ten patients with dementia due to normal-pressure hydrocephalus were evaluated prospectively according to a planned, longitudinal protocol for 4 to 12 months. Information recorded at each visit included clinical history, medical and neurological examination, psychometric scoring by Mini-Mental Status Questionnaire, measurement of ventricular size and local cerebral blood flow, and partition coefficients (local lambda changes) (1 lambda) by xenon contrast computerized tomography scanning. Cerebrospinal fluid shunting was carried out in eight cases. Serial evaluations were repeated at intervals up to 8 months after shunting, and demonstrated that the ventricles decreased in size and periventricular hypodensities decreased. White matter 1 lambda values and blood flows and cortical gray matter flows progressively increased for 3 months after shunting, and remained increased except for one case complicated by chronic alcoholism. Clinical recovery correlated with improved cerebral perfusion. There were returns of urinary continence and improvements in gait and usually in activities of daily living. Mentation was the last factor to improve. Factors negatively influencing cerebral perfusion and clinical recovery were shunt failures and various contributing causes of dementia. PMID- 3973722 TI - Cause of decline in head-injury mortality rate in San Diego County, California. AB - Even with an increasing population, there were 100 fewer deaths due to head injury in San Diego County, California, in 1982 compared to 1980. During the 5 years from 1976 to 1980 there was nearly a constant death rate from head injuries, followed in the next 2 years by a decline of 24%. The number of deaths at the scene of injury declined 28%, and the number of individuals listed as dead on arrival at the hospital declined 68%. Mortality rates in the emergency room increased slightly and later death rates declined slightly. Mortality rates of hospitalized patients, adjusted for severity of injury, did not vary materially by year. This decline in deaths due to head injury followed a marked improvement in the county's emergency ground and prehospital air evacuation services. The data strongly suggest that advanced prehospital emergency medical services can substantially reduce mortality rates in head-injured patients. The authors postulate that some patients who ordinarily "would die now talk" because of early airway and circulatory management by highly trained paramedical personnel and airborne trauma specialists. Despite a search for other factors that might explain these observations, no satisfactory alternatives could be identified. PMID- 3973723 TI - Bypass surgery in patients with intracranial stenotic lesions. Postoperative morbidity and angiographic findings. AB - Postoperative morbidity in patients with intracranial stenotic lesions following extracranial-intracranial arterial (EC-IC) bypass is not well defined. A high rate of neurological complications associated with occlusion of the stenotic arteries after surgery has recently been reported. In the period June, 1976, to March, 1984, the authors performed EC-IC bypass procedures in 19 patients with intracranial stenotic arteries. Most of the patients were initially treated pharmacologically (usually by anticoagulant therapy). Surgery was performed if the symptoms recurred while the patients were under pharmacological treatment and if angiography confirmed arterial stenosis. Antiplatelet therapy was given until the day of surgery and during the entire follow-up period. No permanent postoperative morbidity was observed in the series. One patient, with stenosis of the left siphon, the A1 segment of the anterior cerebral artery, and the M1 segment of the middle cerebral artery, had a transient dysphasia and right hemiparesis (lasting 3 days) in the presence of an unchanged arterial stenosis. In five patients early postoperative angiography (at 5 to 21 days) revealed occlusion of previously stenotic arteries. In one patient the occlusion was disclosed only on a later angiographic study, 2 months after surgery. Although EC IC bypass is generally not a very high-risk operation in patients with intracranial arterial stenosis, there is a high percentage of immediate postoperative occlusion, and the authors suggest caution in determining indication for surgical treatment. PMID- 3973724 TI - Early operation and overall outcome in aneurysmal subarachnoid hemorrhage. AB - Over a 3-year period, 251 individuals in a population of 1.46 million were known to have suffered an aneurysmal subarachnoid hemorrhage (SAH). Forty-three individuals (17%) were either found dead or were dead on arrival at a hospital or forensic department. Forty-nine patients (20%) were at no stage in their clinical course considered to be surgical candidates. Six patients (2% of the total series) were initially in good condition, but subsequently deteriorated during the acute phase and were not treated surgically. Nineteen poor-risk patients (8% of the total series) underwent emergency surgery because of a life-threatening intracerebral hematoma; 105 patients (42% of the total series or 69% of the surgically treated patients) were operated on at the acute stage, and 29 patients (11% of the total series or 19% of the surgically treated patients) underwent late surgery. Of the total series, 107 patients (42%) recovered without neurological deficits; the overall morbidity rate was 19%, and the mortality rate was 39%. Of 99 Grade I to III patients who were operated on at the acute stage, 76% recovered without neurological deficits, and 4% died. It is concluded that the overall outcome in aneurysmal SAH remains poor, mainly because of the large group of patients who are permanently devastated by their initial bleed. PMID- 3973725 TI - Intraoperative brain-stem auditory evoked potentials during posterior fossa microvascular decompression. AB - Recent technological advances have led to increased interest in intraoperative evoked potential monitoring. Although theoretically valuable, its precise role remains to be defined, and useful criteria for predicting neurological deficit are not well established. The authors used brain-stem auditory evoked potential (BAEP) monitoring during 21 posterior fossa microvascular decompression procedures to assess the value of this technique in predicting postoperative deficit. The surgeon was notified only if there was complete disappearance of wave V. Although no patients had postoperative deafness, BAEP latencies changed significantly in all cases. In four patients, wave V totally disappeared during cerebellar retraction. The BAEP appears to be a very sensitive monitor of auditory function, such that "false positive" results will be frequent if latency criteria alone are used to trigger alterations in surgical technique. PMID- 3973726 TI - Beagle puppy model of intraventricular hemorrhage. Effect of superoxide dismutase on cerebral blood flow and prostaglandins. AB - Intraventricular hemorrhage (IVH) represents a major problem for preterm neonates and is thought to occur secondary to alterations in cerebral blood flow (CBF) to damaged germinal matrix tissues. Many investigators believe that both local CBF and changes in capillary morphology and permeability may be partially controlled by prostaglandins. To evaluate this hypothesis, the authors have studied the effects of superoxide dismutase (SOD), a known free-radical scavenger, on newborn beagle pups that were randomly assigned by computer to four groups consisting of either SOD- or saline-pretreated animals that underwent either insult by hemorrhagic hypotension/volume reexpansion or no insult. Prostaglandin levels were determined prior to and 60 minutes following the administration of the solutions, and carbon-14 iodoantipyrine autoradiography was performed for determination of CBF. It was demonstrated that, although SOD significantly decreased the incidence of IVH in this model (p less than 0.05), it caused no alterations in baseline CBF or prostaglandin levels. In addition, SOD did not prevent either the systemic blood pressure changes or the alterations in CBF found in response to a hemorrhagic hypotensive insult. The authors propose that neonatal IVH results from a combination of factors, one of which is prostaglandin mediated alterations in CBF to a damaged capillary matrix. PMID- 3973727 TI - Heparin reduces proliferative angiopathy following subarachnoid hemorrhage in cats. AB - Subarachnoid hemorrhage (SAH) was produced in cats by transorbital rupture of the right middle cerebral artery (MCA). In untreated cats, widespread proliferative angiopathy occurred in both MCA's by 16 days after SAH. In cats that received systemic heparin, the pathological events following SAH were clearly reduced in the ruptured artery, and were not present in the contralateral left MCA. Platelets are known to adhere to the subintimal surface of cerebral arteries after SAH. The authors suggest that platelet-derived growth factor released from the intimal platelet carpet following SAH may be the stimulus for the development of proliferative angiopathy, and that this platelet factor is inhibited by heparin. PMID- 3973728 TI - Aspiration of blood from the jugular vein during intracarotid drug infusion in monkeys. Implications for extracorporeal drug removal. AB - Circulation of blood in the ipsilateral jugular vein through an extracorporeal circuit for drug removal during intracarotid chemotherapy has recently been reported to decrease the systemic drug exposure. The reduced systemic exposure achieved by the use of this technique should permit a several-fold increase of the intracarotid dose of chemotherapy without increasing systemic toxicity. To determine the influence of the rate of blood removal from the jugular vein on the fraction of the blood flowing through the ipsilateral internal carotid artery (ICA) collected for extracorporeal drug removal, the authors aspirated blood from the jugular bulb into an extracorporeal circuit at varying rates during a constant infusion of the indicator dye, indocyanine green (ICG), into the ICA of rhesus monkeys. The fraction of the ipsilateral carotid blood channeled into the extracorporeal circuit increased linearly with the rate of aspiration of jugular blood. This suggests that the absence of valves in the intracranial venous system should permit increasing fractions of drug removal during intracarotid infusion by increasing the rate of collection of venous blood from the ipsilateral jugular bulb. The measurement of ICG concentrations in a similar manner in patients undergoing isolated perfusion may prove to be a clinically useful method for estimating the maximum safe dose in high-dose intra-arterial chemotherapy. PMID- 3973729 TI - Lysis of intracranial hematomas with urokinase in a rabbit model. AB - Urokinase (UK), a potent thrombolytic agent, was tested in a rabbit model for safety and efficacy in lysing intracranial hematomas. Intracerebral intraventricular (IC-IV) hematomas were created by stereotaxically injecting 0.2 ml of clotted human blood into the frontal lobe and lateral ventricle of a total of 57 anesthetized adult New Zealand White rabbits (weighing 1.6 to 2.5 kg). Control animals received 0.2 ml of normal saline injected into the clot, and the experimental group received an equal volume of UK solution (50,000 units/ml) immediately after the clot injection. Some animals were sacrificed at 3 hours and others at 24 hours postinjection. At 3 hours, clot lysis had been achieved in nine (90%) of 10 UK-treated animals as compared to one (14%) of seven controls. By 24 hours, clots had been lysed in 10 (83%) of 12 UK-treated animals and in two (33%) of six controls. Overall, clot lysis was demonstrated in 19 (86%) of the 22 UK-treated animals and in only three (23%) of the 13 controls (p less than 0.001). There was no significant difference in results between these animals and a further set of 22 rabbits that were treated with UK or saline 24 hours after clot injection. There was no histological evidence of damage or inflammation noted on careful light microscopic examination of three to five sections from each brain, although findings consistent with encephalitozoonosis, an incidental protozoan infestation, were encountered in four animals. These studies suggest that UK may be safely and effectively employed for the lysis of intracranial hematomas in this animal model, and that a delay in therapy of up to 24 hours does not significantly compromise its efficacy. PMID- 3973731 TI - Familial arteriovenous malformations. Report of four cases in one family. AB - Familial arteriovenous malformations (AVM's) are uncommon entities, with only seven reported cases in the English literature. Some have been associated with hereditary telangiectasia. A family in which AVM's were found in four male members of two generations is reported. In addition, one patient had a large cyst associated with his AVM without previous evidence of acute hemorrhage, which is an uncommon presentation. The family is discussed and a brief review of the literature is presented. PMID- 3973730 TI - A comparison of physiological responses to percussive brain trauma in dogs and sheep. AB - Physiological variables were monitored in dogs and sheep after exposure of the brain to a pressure wave produced by a fluid-percussion device. Mean systemic arterial pressure (SAP), mean pulmonary arterial pressure (PAP), and pulmonary wedge pressure (PWP) were recorded prior to and following trauma. Lung lymph flows (QLYM) were measured prior to and for 2 hours after trauma. Plasma catecholamine levels were quantitated prior to and at 30 seconds following trauma. In 16 dogs, SAP increased from 123 +/- 14.6 to 254 +/- 60.8 mm Hg (p less than 0.0001), PAP increased from 17 +/- 4.4 to 27 +/- 10.8 mm Hg (p less than 0.05), and PWP increased from 4 +/- 2.4 to 15 +/- 8.8 mm Hg (p less than 0.0001), all at 30 seconds posttrauma. All pressures returned to near baseline values within 6 minutes. The QLYM from the right lymph duct in 12 dogs increased from 0.82 +/- 0.77 to 2.7 +/- 2.1 and 1.88 +/- 1.82 ml/30 min, respectively, at 30 and 120 minutes. In five dogs the plasma concentrations of dopamine, epinephrine, and norepinephrine increased from 234 +/- 98 to 1906 +/- 1384, 609 +/- 641 to 19,813 +/- 10,234, and 388 +/- 194 to 3223 +/- 992 pg/ml, respectively (all p less than 0.01). In sheep there were no changes in SAP, PAP, PWP, QLYM, or catecholamine levels in response to percussive wave trauma up to 10 atm. Ratios of lung tissue water to dry weight were not significantly different from control animals in either species. The authors conclude that in dogs there is a profound sympathetic discharge resulting in dramatic elevations in plasma catecholamines, systemic and pulmonary artery hypertension, and an increase in pulmonary lymph flow. Sheep fail to demonstrate changes in any of these variables after severe percussive wave brain trauma. PMID- 3973732 TI - Enlargement of an intracranial aneurysm in the eighth decade of life. Case report. AB - The management of intracranial aneurysms in elderly patients remains controversial, since the natural history of these lesions is not well understood. The authors describe the case of a 76-year-old woman with documented enlargement of an internal carotid artery aneurysm over 3 years. The management of intracranial aneurysms in elderly patients is discussed. PMID- 3973733 TI - Revascularization of the anterior cerebral artery. Report of two cases. AB - Intracranial anastomosis between the distal anterior cerebral arteries (ACA's) was performed on two patients. One patient had isolated occlusion of the proximal ACA on one side causing monoparesis in the leg, and the other patient suffered from occlusion of the internal carotid artery and a small anterior communicating artery. The weakness of the legs improved immediately after surgery and cerebral angiography revealed a good filling of the bilateral ACA's. Technical aspects and indications for the procedure are discussed. PMID- 3973735 TI - Stereoscopic television system for use with the operating microscope. Technical note. AB - A new and simple method of stereoscopic television imaging of surgical procedures performed under an operating microscope has been developed. Two television cameras of the same type, two television monitors of the same size, and a mirror box for fusion of the two visual objects on the two television monitors are used. No significant modifications of available components are necessary. The method can be applied to all operating microscopes with a beam splitter. PMID- 3973734 TI - Cranioplasty with inner table of bone flap. Technical note. AB - A new method of cranioplasty is described in which the inner table of the bone flap obtained during craniotomy is used for grafting. The method was used in 10 cases to repair bone defects caused by a growing skull fracture in two, created during removal of an invasive skull tumor in two, during the approach to intraorbital tumors in two, and secondary to craniectomy for additional exposure in four. The method has the advantage that a piece of the inner table for grafting can be obtained from the craniotomy bone flap, without the need for an additional skin incision or taking a graft from another part of the body, and foreign-body reaction is minimal. PMID- 3973736 TI - Clip with enclosed spring for aneurysm surgery. Technical note. AB - A clip for aneurysm surgery has been designed with several unique features. The coil spring is fully hidden and protected within two hub sections so that it cannot be handled or become entrapped in tissue. The clip is milled from a piece of solid stock of nonmagnetic stainless steel to the desired size and shape by a computer milling process, thus avoiding the stresses and structural weaknesses caused by the bending, curling, and milling needed to prepare clips made from wire or sheet metal. The only means of opening the clip is by applying pressure to the solid milled surfaces, thus the spring cannot be weakened or bent by squeezing it or by trauma applied to the clip. The clip may be grasped in either a clip applier that holds the clip in one fixed position or in an applier that allows the clip to be rotated through an arc of 180 degrees. PMID- 3973737 TI - Constant-current versus constant-voltage stimulation. PMID- 3973738 TI - Selection of patients for ICP monitoring. PMID- 3973739 TI - Anticoagulant therapy for radiation necrosis. PMID- 3973741 TI - Practical gamma camera quality control with a four-point phantom. AB - A gamma camera QC phantom for practical assessment of resolution (average FWHM), spatial calibration (pixels/mm), nonhomogeneity of spatial calibration, and average point-source sensitivity (cpm/muCi) was developed and evaluated. The phantom consists of four 57Co-point sources mounted on a Plexiglas base at corners of a square 10 cm on each side. Computer acquisition and processing are fully automated and require less than 1 min for point sources totaling 100 muCi (3.7 MBq) activity. The normal range of variability of measured QC parameters from a 12 wk evaluation period with four different gamma cameras (assumed to be operating normally) yielded coefficients of variation ranging from 0.3% for spatial calibration (pixels/mm) to 2.3% for sensitivity (cpm/muCi) assessments. From the normal range of variability a minimum detectable difference (MDD) was determined for each measured parameter and each gamma camera. The range of acceptable operation of a gamma camera system was set as the measured value +/- MDD for each QC parameter. The ability to detect and track small changes in the measured QC parameters was evaluated. PMID- 3973740 TI - Technetium-99m HIDA hepatic lobar distribution and retention ratios in detection of intrahepatic lithiasis. AB - Technetium-99m HIDA hepatic lobar distribution and retention ratios were developed to evaluate patients with intrahepatic lithiasis. The data of 57 cases were analyzed. Results reveal a highly significant difference in these ratios between the patients and normal individuals. They are simple, objective, and easily obtainable. Thus, the determination of these ratios may replace [99mTc]HIDA sequential scintiphotography, which is qualitative and time consuming, for screening intrahepatic lithiasis. PMID- 3973742 TI - Bone scintigraphy current trends and future prospects. PMID- 3973743 TI - Indium-111 leukocyte imaging in colitis induced by Clostridium difficile. PMID- 3973744 TI - Usefulness of serum thyroglobulin at replacement withdrawal after thyroidectomy for differentiated thyroid cancer. PMID- 3973745 TI - Oxygen consumption in mice (I strain) after feeding. AB - To determine if excess heat production can account for the lower fat accumulation in I strain mice, oxygen consumption, a measure of energy expenditure, was measured in I mice and C57BL mice (a control strain) to determine basal metabolic rate (BMR) and resting metabolic rate (RMR) and response to food consumption and acute cold exposure. Oxygen consumption was higher in the I strain than in the C57BL mice only after the dark cycle (feeding period). No difference between I and C57BL mice in spontaneous activity was found during the dark or light cycle. Body temperature was also not different in I and C57BL mice. Oxygen consumption in response to norepinephrine was similar in the two strains. These results indicate oxygen consumption is greater in I than C57BL mice only in response to feeding. Differences in glucose utilization by I and C57BL mice, including a lower glucose tolerance curve, greater deposition of glucose to muscle glycogen and lactate production in I mice also indicate differences in nutrient processing. Higher oxygen consumption after feeding in I mice than in C57BL mice indicates inefficient food utilization and accounts for their lower ability to store energy as fat. PMID- 3973746 TI - Effect of Eimeria acervulina infection in chicks fed excess dietary cobalt and/or manganese. AB - Two trials were conducted with male Cobb chicks to investigate the interaction between experimental Eimeria acervulina infection and dietary excesses of Co and Mn. Eimeria acervulina infection depressed rate and efficiency of weight gain, increased bone mineral retention and exacerbated Co toxicity. A significant Co X Mn interaction was observed in growth rate and efficiency of gain and in Co and Mn concentration in some tissues as well. This interaction was present both in uninfected chicks and in coccidiosis-infected chicks. Excesses of dietary Co and Mn increased tissue Co and Mn concentrations, respectively. Excess Co also increased Mn accumulation in kidney, bile and the tibia. PMID- 3973747 TI - Different effects of zinc and copper deficiency on composition of plasma high density lipoproteins in rats. AB - Male Sprague-Dawley rats (six per group) were fed an egg white-based diet containing 0 or 5 micrograms/g Cu with 1, 10, 100 or 1000 micrograms/g Zn. After 6 wk of feeding, the rats were killed, and the tissues were processed for trace element, lipid and lipoprotein analysis. Copper deficiency was associated with a higher concentration of plasma free cholesterol, high density lipoprotein (HDL) cholesterol and HDL apolipoproteins. Plasma total cholesterol was not significantly affected. No significant differences were noted in HDL lipid composition. However, HDL apo E and apo A-I concentrations were higher with copper deficiency. Lecithin:cholesterol acyltransferase (LCAT) was not affected in a consistent manner by copper status. Varying the amount of zinc in the diet did not produce significant changes in plasma total cholesterol, plasma free cholesterol, HDL cholesterol, or HDL apolipoprotein concentrations. However, HDL from zinc-deficient rats were enriched in free cholesterol and depleted in triglycerides. Furthermore, the concentration of HDL apo C increased as the level of dietary zinc increased. PMID- 3973748 TI - Influence of iron on in vivo proliferation and lethality of L1210 cells. AB - The ability of iron to stimulate the growth of L1210 cells both in DBA-2 mice and in cell culture is evaluated. Although in vitro stimulation is absent, in vivo studies clearly indicate higher numbers of tumor cells in the presence of supplemental iron. When mice were given iron i.p., at levels comparable to clinical doses for humans (24 mg/kg body weight), the tumor load recovered from their peritoneum was substantially greater than from controls without iron supplements. Furthermore, at higher levels of supplemental iron (250 mg Fe/kg body weight), the pretreated animals inoculated with L1210 cells died in 9.7 d whereas controls died in 12.2 d (i.e., 25% faster). As expected, the lower iron dose (24 mg/kg) also resulted in shorter life spans, although the effects were less striking. It is the belief of these authors that these data support the opinion that "anemia of chronic disease" associated with leukemia and possibly other malignancies may represent a host defense mechanism as has been postulated by others (1, 8). PMID- 3973749 TI - Quantitative aspects of glycine and alanine nitrogen metabolism in postabsorptive young men: effects of level of nitrogen and dispensable amino acid intake. AB - The nutritionally indispensable amino acids (IAA) alone do not maintain body nitrogen (N) balance; a source of "nonspecific" nitrogen from dispensable amino acids (DAA), such as from glycine and alanine or other N compounds, is required. However, the in vivo regulation of the metabolism of these amino acids in humans with varying nutritional states has received little study. Hence, the effects of N intake and the IAA:DAA ratio on kinetic aspects of whole-body alanine and glycine metabolism were examined in eight healthy young adult male subjects. They received an L-amino acid diet supplying N equivalent to about 1.5 g and 0.6 g protein (N X 6.25) per kilogram body weight per day. All were studies at each N level with the IAA:DAA ratio (wt/wt) of 1:1 and 1:0, each for a 7-d diet period. Constant primed, intravenous infusions of L-[1-13C]leucine together with either L [15N]alanine (four subjects) or [15N]glycine (four subjects) were given to each subject at the end of the diet period, after an overnight fast, to determine rates of de novo whole-body alanine and glycine N synthesis. The rate of alanine synthesis was similar (P greater than 0.05) for all four diets. Glycine de novo N synthesis declined (P less than 0.01) with removal of dietary DAA, especially at the lower intake, where the mean rates [micromoles/(kilogram X hour)] were 59 and 20 for 1:1 and 1:0 ratios, respectively. The possible significance of reduced rates of glycine N synthesis for maintenance of protein nutritional status in the healthy adult is discussed. PMID- 3973750 TI - Oral iron, dietary ligands and zinc absorption. AB - The effect of iron on zinc absorption in humans was investigated by using 65Zn and whole-body counting after 2 wk. Increasing the molar ratio of ferrous iron (with ascorbic acid) to zinc from 1:1 to 2.5:1 did not affect absorption of zinc from water when given in a fasting state; 59 and 58% was absorbed, respectively. However, at an Fe:Zn ratio of 25:1, zinc absorption from water decreased significantly to 34%. When oral iron in the same ratio to zinc was given with a meal, no inhibitory effect was observed (25, 23 and 22%, respectively). Addition of the zinc ligand, histidine, to the water solution decreased the inhibitory effect of the higher dose of iron, resulting in a zinc absorption of 47%. Two weeks of iron preloading did not affect zinc absorption from water. The results demonstrate that when a multimineral supplement is taken on an empty stomach, excessive iron levels can negatively affect zinc absorption. Intake of the supplement with a meal or with a zinc ligand (such as histidine) may overcome this inhibitory effect. PMID- 3973751 TI - Spatial-frequency discrimination at low frequencies: evidence for position quantization by receptive fields. AB - In a recent study of spatial-frequency discrimination [J. Opt. Soc. Am. 72, 1367 (1982)], we reported evidence for the quantization of position in the human visual system with the fundamental unit of quantization being the photoreceptor spacing for spatial frequencies greater than 2 cycles per degree (c/deg). In this paper we extend our measurements to lower spatial frequencies, between 0.3 and 2, which we call the mid-spatial-frequency band, and find that this band of spatial frequencies shows similar evidence for spatial quantization. However, the spacing of the fundamental unit is about 0.056 deg or approximately seven or eight times the spacing of the foveal photoreceptor instead of about 0.008 deg or approximately equal to the spacing of foveal cones. We interpret this as evidence for a class of retinal receptive fields that we call spatial-sampling fields that perform a dual function of neural blurring and spatial sampling. We propose a scaled lattice model of spatial vision that allows apparently scale-free spatial processing while retaining the advantages of linear maps. The model generalizes the notion of hyperacuity to low-resolution tasks for which neural interpolation occurs not only on the photoreceptor sampling lattice to achieve hyperacuity but also on receptive-field sampling lattices to achieve lower resolutions. PMID- 3973752 TI - Postadaptation orientation discrimination. AB - An orientational difference of only 0.3-0.5 deg can be discriminated between two gratings or two lines, although psychophysical channels and cortical cells both have comparatively broad orientation bandwidths of 10-25 deg. One proposed explanation for the fineness of orientation discrimination is that, while detection is determined by the most excited orientation-tuned neural elements, superthreshold orientation discrimination is determined by difference signals between these elements [Westheimer et al., J. Opt. Soc. Am. 66, 332 (1976)]. This implies that, if stimulus orientation is changed slightly, the most important elements for discriminating this change will be those whose relative activity changes most, even though the excitation of these elements may be comparatively weak. In accord with this prediction, we found that adapting to a high-contrast grating degraded discrimination for test gratings inclined at about 10-20 deg to the adapting grating while having little effect on the detection of these inclined gratings. For test gratings parallel to the adapting grating, discrimination was improved, but detection was degraded. Either an opponent process or a line-element model can account for these effects of adaptation. An opponent model can also explain our findings that subjects do not confound orientation change with contrast change and that suprathreshold orientation discrimination is almost independent of contrast, varying by only +/- 10% from about 3 to about 25 times contrast threshold. A discrimination model must incorporate reliable storage of spatial frequency, because discrimination was not affected by increasing the interval between grating presentations from 1 to 10 sec.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973753 TI - Site of the accelerating nonlinearity underlying luminance-change detection. AB - The visual psychometric function for luminance-increment detectability (d') is known to be an accelerating function of stimulus energy. Two different models have been suggested to explain this fact and also why a luminance-increment pedestal linearizes the psychometric function. In the present experiment it is shown that a dichoptically presented increment linearizes the psychometric function and facilitates detection of weak signals. Since the dichoptic pedestal combines with the signal centrally, the nonlinearity must then originate more centrally. This result is compatible with the uncertainty model of the nonlinear psychometric function but not with a model that requires a nonlinear transducer. PMID- 3973754 TI - Vision in the presence of known natural retinal image motion. AB - Previously we reported that failures of compensatory eye movements led to appreciable binocular retinal image motion during head rotation. Subjectively, the visual world appeared clear, fused, and stable under these conditions. The present experiments examined these impressions psychophysically. The spatial modulation transfer function of subjects with known retinal image motion was measured during head rotation. We found that contrast sensitivity was reduced for gratings over 6 cycles/degree and was increased for lower spatial frequencies. Our results, when compared with Kelly's [J. Opt. Soc. Am. 69, 1340-1349 (1979)] measurements made with artificially moving stabilized gratings, show that natural retinal image motion is less harmful to contrast sensitivity at high spatial frequencies and more beneficial at low spatial frequencies. Furthermore, we had previously found that natural retinal image motion was different in each eye during head movement but no diplopia was noticed. We confirmed this subjective impression by measuring forced-choice stereoacuity thresholds concurrent with binocular head and eye recordings. Stereoacuity was not disturbed by large fixation disparities or high vergence velocities. Recordings also were made while a fused Julesz stereogram was viewed during attempts to break fusion with violent head movements. Fusion could not be broken. Stereograms turned on during violent head movement fused rapidly. We conclude that vision is better with natural retinal image motion than expected from experiments done with stabilized heads. PMID- 3973755 TI - Smooth pursuit of small-amplitude sinusoidal motion. AB - Subjects used smooth eye movements to track small-amplitude sinusoidal target motions. Target frequencies (0.05 to 5 Hz) and amplitudes (1.9 to 30 min of arc) were in the range of those found in the retinal image during fixation of a stationary target while the head is not artificially supported. Smooth pursuit was poor at high target frequencies in several ways: Large uncompensated drifts were observed for target frequencies between 1 and 4 Hz. The drifts were superimposed upon oscillations of the eye in response to the target motion. Mean retinal-image speeds were higher than retinal-image speeds during slow control (smooth eye movements with stationary targets) for target frequencies above 0.5 Hz. Mean retinal-image speeds were as high as target speed for target frequencies above 3 Hz. The ratio of eye speed to target speed decreased as target frequency and amplitude increased. The dependence on amplitude could be reduced and often eliminated by computing an adjusted ratio in which a constant (approximately equal to the mean speed of slow control) was subtracted from eye speed before dividing by target speed. Adjusted ratios declined for frequencies above 0.5 to 1 Hz and did not depend on amplitude. These results show that the response of the smooth-pursuit subsystem to target motion above 0.5 Hz is poor, even though the velocity and the acceleration of th motions are low. Models of smooth pursuit in which the response of the eye depends exclusively on the velocity, acceleration, or position of the target do not account for our results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973756 TI - Sequential recruitment in the discrimination of velocity. AB - Human observers can discriminate a 5% difference in velocity for a wide range of velocities. Using an apparent-motion stimulus, we demonstrated that velocity discrimination depends on the detection of small changes in asynchrony, changes of the order of 1 msec or less. The simplest component of an apparent-motion stimulus is a pair of spatially separate lines presented asynchronously. Generally the incremental asynchrony threshold for a single pair of lines is much too large to account for velocity discrimination. A sequence of five to eight asynchronously presented targets, equivalent to continuous motion viewed for a duration of 80-100 msec is required to reach asymptotic velocity discrimination. Our experiments rule out probability summation as the explanation for the enhanced temporal sensitivity observed with the sequential presentation of multiple asynchronous targets. Sequential recruitment, a descriptive term for this enhanced temporal sensitivity, depends on the summation of a velocity specific signal within the physiological network responding to motion. PMID- 3973757 TI - Spatial and temporal parameters of motion detection in the peripheral visual field. AB - We present evidence that motion detectors in the peripheral visual field react to spatiotemporal structure in moving spatial white-noise patterns in a qualitatively similar fashion to those located near the center of gaze. Reichardt type correlator mechanisms provide a simple theoretical framework in which all observed phenomena can be discussed. Two basic parameters of the correlator model are the time lag and the span. We have devised paradigms in which these parameters may be measured as a function of velocity and position in the visual field. Our results indicate that these parameters are primarily a function of the magnitude of the velocity (the span increasing and the lag decreasing as the velocity is increased) rather than of the retinal eccentricity. In another experiment, we determined the spatial resolution for apparent segregation of the visual image that is due to differential motion of detail in stationary rectangular gratings in which the pixels moved one way in the even bars and the other way in the odd bars. The limit of resolution occurs when the pixels traverse a bar of the grating in a given time, irrespective of the velocity or the retinal eccentricity. For higher velocities, the resolution is uniform over the entire visual field. For slower motion, the region of uniform (and relatively high) resolution shrinks to a region around the center of gaze. Resolution for segregation due to differential movement is at least 10 times worse than typical contrast-grating acuity. PMID- 3973758 TI - Discontinuity limits for the generation of visual motion aftereffects with sine- and square-wave gratings. AB - Visual motion aftereffects (MAE's) were produced with adapting gratings that underwent repeated, abrupt displacements in a uniform direction. MAE's could be generated with sine-wave gratings even when the magnitude of each displacement approached a phase angle as large as 1/2 cycle. The maximum spatial step for generating a MAE with a square-wave grating was less than 1/4 cycle. If a dark pause was introduced between the successive positions (phases) of the adapting grating, MAE's disappeared when the pause was longer than 60-70 msec. The results can be used to define the spatiotemporal-response limits of a short-range motion process (or system of directionally selective motion sensors), and the results also suggest that the individual Fourier components of complex spatial patterns are capable of producing independent signals for direction of motion. PMID- 3973759 TI - Detection and discrimination of sinusoidal grating displacements. AB - Vertical sine-wave gratings of varying spatial frequency were stepped instantaneously to the right or to the left at differing phase angles (theta). Separate paradigms measured the contrast threshold for the detection of such a step and for the discrimination of the direction of the same step. By considering the grating before and after its displacement as a rotating phasor, we made the following predictions: (1) Contrast sensitivity for the detection of a displacement should rise as sin(theta). (2) Contrast sensitivity for the discrimination of the direction of the displacement should rise as sin(theta/2). Both predictions were confirmed using a range of spatial frequencies and phase angles. From the results of additional experiments, by measuring the discrimination of the direction thresholds as a function of contrast, we derived a nonlinear contrast response function for the motion system. This function appears to saturate fully at fairly low levels, in the neighborhood of 2 to 3% under the conditions examined. Our results suggest a direct connection among the contrast sensitivity, the contrast response function, and motion-hyperacuity thresholds. PMID- 3973760 TI - Receptive-field symmetry probed using converging gratings. AB - Contrast-sensitivity functions (CSF's) for converging and diverging gratings were obtained under voluntary fixation at several field widths and under retinal stabilization at one field width. In general, these types of gratings had similar CSF's at all temporal frequencies tested, a result that can be explained by plausible spatiotemporal receptive-field models possessing spatial antisymmetry but not by models possessing pure (even) spatial symmetry. Phase condition at the central line in converging and diverging gratings affected grating detectability at high spatial frequencies, as expected. PMID- 3973761 TI - Visual responses to vorticity and the neural analysis of optic flow. AB - While an observer is moving forward, his retinal image of the outside world contains a flow field. This optical flow field carries information both about external objects and about where the observer is going relative to these objects. Mathematically, the flow pattern can be analyzed into elements that include the curl of local velocity (i.e., vorticity), and it has been suggested that the visual pathway might contain independent neural mechanisms sensitive to these mathematical elements [H. C. Longuet-Higgins and K. Prazdny, Proc. R. Soc. London Ser. B 208, 385-397 (1980)]. To test this suggestion we compared visual responses to two circular areas of random dots, A and B. These two stimuli were identical in that all dots oscillated along a straight line in one of two possible directions. However, the relative phases of dot oscillations were different for A and B, causing A to have a rotary component of motion that B did not have. We found that rotary motion thresholds for a rotary test stimulus were more elevated after adapting to A than after adapting to B, a difference that cannot be explained in terms of visual responses to linear motion, since linear motion components were the same for A and B. This finding is consistent with the idea of a neural mechanism sensitive to the curl of velocity (i.e., vorticity). Adding this to previous evidence for a mechanism specifically sensitive to the divergence of velocity (i.e., dilatation), we suggest that one role of these postulated mechanisms might be to parallel vector calculus by analyzing each small patch of the visual flow field into neural representations of the mathematically independent quantities curl and divergence of velocity. PMID- 3973762 TI - Spatiotemporal energy models for the perception of motion. AB - A motion sequence may be represented as a single pattern in x-y-t space; a velocity of motion corresponds to a three-dimensional orientation in this space. Motion sinformation can be extracted by a system that responds to the oriented spatiotemporal energy. We discuss a class of models for human motion mechanisms in which the first stage consists of linear filters that are oriented in space time and tuned in spatial frequency. The outputs of quadrature pairs of such filters are squared and summed to give a measure of motion energy. These responses are then fed into an opponent stage. Energy models can be built from elements that are consistent with known physiology and psychophysics, and they permit a qualitative understanding of a variety of motion phenomena. PMID- 3973763 TI - Elaborated Reichardt detectors. AB - The elaborated Reichardt detector (ERD) proposed by van Santen and Sperling [J. Opt. Soc. Am. A 1, 451 (1984)], based on Reichardt's motion detector [Z. Naturforsch. Teil B 12, 447 (1957)], is an opponent system of two mirror-image subunits. Each subunit receives inputs from two spatiotemporal filters (receptive fields), multiplies the filter outputs, and temporally integrates the product. Subunit outputs are algebraically subtracted to yield ERD output. ERD's can correctly indicate direction of motion of drifting sine waves of any spatial and temporal frequency. Here we prove that with a careful choice of either temporal or spatial filters, the subunits can themselves become quite similar or equivalent to the whole ERD; with suitably chosen filters, the ERD is equivalent to an elaborated version of a motion detector proposed by Watson and Ahumada [NASA Tech. Memo. 84352 (1983)]; and for every choice of filters, the ERD is fully equivalent to the detector proposed by Adelson and Bergen [J. Opt. Soc. Am. A 2, 284-299 (1985)]. Some equivalences between the motion detection (in x, t) by ERD's and spatial pattern detection (in x, y) are demonstrated. The responses of the ERD and its variants to drifting sinusoidal gratings, to other sinusoidally modulated stimuli (on-off gratings, counterphase flicker), and to combinations of sinusoids are derived and compared with data. ERD responses to two-frame motion displays are derived, and several new experimental predictions are tested experimentally.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973764 TI - Model of human visual-motion sensing. AB - We propose a model of how humans sense the velocity of moving images. The model exploits constraints provided by human psychophysics, notably that motion-sensing elements appear tuned for two-dimensional spatial frequency, and by the frequency spectrum of a moving image, namely, that its support lies in the plane in which the temporal frequency equals the dot product of the spatial frequency and the image velocity. The first stage of the model is a set of spatial-frequency-tuned, direction-selective linear sensors. The temporal frequency of the response of each sensor is shown to encode the component of the image velocity in the sensor direction. At the second stage, these components are resolved in order to measure the velocity of image motion at each of a number of spatial locations and spatial frequencies. The model has been applied to several illustrative examples, including apparent motion, coherent gratings, and natural image sequences. The model agrees qualitatively with human perception. PMID- 3973765 TI - Structure from stereo and motion. AB - Stereopsis and motion parallax are two methods for recovering three-dimensional (3D) shapes. Theoretical analyses of each method show that neither alone can recover rigid 3D shapes correctly unless other information, such as perspective and vertical disparity, is included. The solutions for recovering rigid structure from motion have a reflection ambiguity; the depth scale of the stereoscopic solution will not be known unless the fixation distance is specified in units of interpupil separation. (Hence the configuration will appear distorted.) However, the correct configuration and disposition of a rigid 3D shape can be recovered if stereopsis and motion are integrated, for then a unique solution follows from a set of linear equations. The correct interpretation requires only three points and two stereo views. PMID- 3973766 TI - Inferring the relative three-dimensional positions of two moving points. AB - We show that four orthographic projections of two rigidly linked points are compatible with at most four interpretations of the relative three-dimensional positions of the points if the points rotate about a fixed axis--even when the points as a system undergo arbitrary rigid translations. A fifth view (projection) yields a unique interpretation and makes zero the probability that randomly chosen image points will receive a three-dimensional interpretation. Assuming that the points rotate at a constant angular velocity, instead of adding a fifth view, also yields a unique interpretation and makes zero the probability that randomly chosen image points will receive a three-dimensional interpretation. PMID- 3973767 TI - Processing differential image motion. AB - The inference of three-dimensional camera motion parameters and the layout of a scene from image flows becomes particularly simple from a computational point of view if the scene contains depth variations. Under this condition, the differential image motion yields a simple estimate of the translation field lines at image locations corresponding to depth discontinuities in the scene. This in turn facilitates closed-form solutions of camera motion parameters and environmental depth. Our results may have relevance to human motion perception, which also seems to rely on depth variation in processing image motion. PMID- 3973768 TI - Copper toxicosis and tolerance in the rat. I--Changes in copper content of the liver and kidney. AB - Rats can tolerate toxic copper diets; the extent of this adaptation and the changes that take place in the liver and kidney with respect to copper are studied. Rats were fed diets containing 3000-6000 mg/kg copper for 15 weeks and groups were killed at regular intervals. Their livers and kidneys were examined for pathological changes and for their copper content. Liver copper rose rapidly in the 3000 mg/kg trial to 4780 +/- 636 micrograms/g copper between 4 and 5 weeks with marked liver damage. Stainable copper protein was present at 2 weeks in the hepatocytes but had disappeared by 5 weeks. Liver copper subsequently fell with recovery by 15 weeks. Kidney copper rose to plateau from 4 weeks. Stainable copper protein was present from 2 weeks in the cells of the proximal tubules and was apparently excreted. Tubular necrosis occurred at 4-5 weeks followed by regeneration. In the 6000 mg/kg trial the toxicosis was prolonged. Copper toxicosis in the rat can be a temporary phenomenon during the transformation of copper protein synthesis in the liver from a stainable to a non stainable form. Adaptation occurs after the removal of excess liver copper, facilitated probably by renal excretion, and the animals become tolerant. PMID- 3973769 TI - Mesothelial healing: morphological and kinetic investigations. AB - By using structural, kinetic and irradiation techniques it is possible to show that mesothelial healing is a local event. Initially, macrophages occupy the surface of a wound on the injured visceral layer, while mesothelial proliferation proceeds at the edge of the wound and the opposing parietal surface. Fibrin is formed on the wound surface within 24 h, even in the absence of much haemorrhage. Mesothelial ingrowth begins with isolated cells migrating from the wound edge as well as from the serosal surface apposing the wound where mesothelial cells are actively replicating. The cells presumably slide over a bridge of fibrin and macrophages, a process likely to be enhanced by the serosal fluid. Early colonization by macrophages results in the removal of debris and probably prevents the formation of adhesions during mesothelial restoration. PMID- 3973770 TI - The distribution of ceroid in human atherosclerosis. AB - It has been suggested that macrophages in atherosclerotic plaques oxidize the lipid they contain, leading to necrosis in the plaque. Over 200 human aortic and coronary atherosclerotic plaques from 102 human necropsy subjects aged between 5 and 88 were, therefore, examined histologically for the presence of insoluble lipid (ceroid), thought to be a product of lipid oxidation. Ceroid was present in all the plaques but not in areas of diffuse intimal thickening. In early lesions the insoluble lipid was within membrane-bound vesicles in macrophage-like cells, many showing characteristic ring structures suggesting that membrane-associated oxidative systems might be responsible for rendering the lipid insoluble. Staining was increased by an oxidizing agent and abolished by a reducing agent. It is suggested that this distribution supports the concept of lipid oxidation by macrophages within the plaque. PMID- 3973771 TI - Paraganglioma of the cauda equina: a histological, ultrastructural and immunocytochemical study of two cases with a review of the literature. AB - The clinical and pathological features of two paragangliomas arising in the cauda equina are described and compared with 14 previous reports. The light microscopic features were similar to those of paragangliomas from other sites, with a 'Zellballen' pattern of cells containing argyrophil granules. Electron microscopy showed densely staining membrane-bound granules, cilia and fibrous bodies in the cytoplasm. The last two features only occur in paragangliomas from this site. gamma-Enolase was demonstrated by the peroxidase-antiperoxidase technique for the first time in these neoplasms. This technique was also used to demonstrate cytokeratins, which appear to be associated with the presence of fibrous bodies. The pathological findings suggest that paragangliomas in this site arise from pre existing paraganglia, possibly of the visceral autonomic group. The prognosis in cases treated by complete excision appears to be good. PMID- 3973772 TI - Vitamin K in infancy. PMID- 3973773 TI - Prospective study of antecedents for nonorganic failure to thrive. AB - The cause of nonorganic failure to thrive (NFT) was studied prospectively in 274 low-income pregnant mothers by interviewing them for characteristics that retrospective studies indicated were associated with child maltreatment. After delivery, medical charts of mothers and infants were reviewed for complications of pregnancy, delivery, and postdelivery hospitalization, and the infants were observed for growth failure. The characteristics of 15 families with infants who developed NFT were compared with those of 86 selected randomly from the remaining families. Interview results suggest that NFT correlates significantly with aberrant nurture during the mother's childhood and with conflicts between the parents of the infants. Perinatal events correlating significantly with NFT include complications of pregnancy, short gestation, and residual minor medical problems at discharge from the nursery. We speculate that these events predispose to NFT by disturbing the development of the mother-infant relationship. PMID- 3973774 TI - Gastrointestinal transit time, frequency of defecation, and anorectal manometry in healthy and constipated children. AB - Total gastrointestinal transit time (TGITT), frequency of defecation, and anorectal manometry were evaluated in 63 pediatric patients referred for chronic nonorganic constipation; in 39, segmental transit times of the right and left colon and rectum were also measured. TGITT was significantly longer in chronically constipated children than in matched normal controls. Although bowel frequency was highly significantly correlated with TGITT in patients with prolonged transit time, not all children with prolonged TGITT had reduced bowel frequency. Moreover, not all children with constipation had prolonged TGITT. In children with idiopathic chronic constipation, slowing of intestinal transit occurred most frequently at the level of the distal colon and rectum. Anorectal motility variables were not significantly different in children with functional chronic constipation and in normal children. Maximal resting and pressure and mean intrarectal distending volume causing threshold inhibition in constipated patients did not significantly differ from the control values. Therefore, anorectal manometry did not detect relevant motor abnormalities in constipated children. PMID- 3973775 TI - Oral hydration solutions: experimental optimization of water and sodium absorption. AB - Eight solutions of potential efficacy for hydration orally, which differed in composition, osmolality, and pH, were tested in an in vivo perfusion system on rat jejunum to assess the rate of water and sodium absorption or secretion. Optimal results were obtained with a preparation of the type recommended by the World Health Organization, containing 60 mEq/L sodium and 111 mM glucose; there was a maximum influx of both water and sodium, which may be ideal for rehydration. It appeared that the critical factor was the molar relationship between glucose and sodium at a 2:1 ratio. Sodium absorption was inversely correlated with glucose concentration in the perfusates. Osmolality and pH may also have a role in the regulation of fluxes across the mucosa. Citrate at concentrations up to 30 mEq/L did not interfere with water absorption. The data presented may thus contribute to a better rationale for the use of orally administered hydration solutions and guidelines for the preparation of more effective ready-to-use solutions. PMID- 3973776 TI - Infantile multisystem inflammatory disease: a specific syndrome? AB - We report two patients with infantile onset of evanescent rash, fever, arthropathy with severe deformities, periosteal changes, chronic meningitis, hydrocephalus, convulsions, developmental delay, papilledema, unusual uveitis, and lymphadenopathy. A few patients with similar findings have been previously reported. Although some similarity exists between findings in these patients and in others with systemic juvenile rheumatoid arthritis, they appear to differ both in regard to the nature and severity of the clinical and pathologic features. We suggest that this group of patients has a separate rheumatic disorder not yet included in the standard classifications of the childhood rheumatic diseases. PMID- 3973777 TI - Otologic features of bacterial meningitis of childhood. AB - Sixteen temporal bones from eight children who had died of meningitis were histopathologically evaluated. Concurrent acute otitis media was demonstrated in 14 bones. In no case could a pathway of infection from the tympanomastoid compartment to the intracranial cavity be located. Further, inner ear infection appeared to be the result of retrograde bacterial invasion from the meninges rather than from an inoculation via the middle ear or mastoid. Should surgical drainage be required, the histopathologic findings indicate that mastoidectomy would have little advantage over myringotomy. We infer that a child with normal temporal bone anatomy is probably not at enhanced risk for development of bacterial meningitis from acute otitis media via a route of direct extension. PMID- 3973778 TI - Upper airway lesions in children after accidental ingestion of caustic substances. AB - Of 33 children admitted within 24 hours after accidental ingestion of a caustic substance, 14 (42.5%) had evidence of upper airway lesions on direct laryngoscopy. Three patients, 10 to 12 months old, needed endotracheal intubation for acute respiratory obstruction; four patients younger than 2 years had severe dyspnea without obstruction; seven patients had mild or no respiratory symptoms. All were discharged without respiratory sequelae, although esophageal stenosis developed in six patients. Nine of 13 patients younger than 2 years, compared to five of 20 patients older than 2 years, had upper airway lesions (P less than 0.01). The frequency of respiratory tract lesions was higher in patients with severe esophagitis. Eleven of 17 patients with severe esophagitis, compared to three of 16 with mild inflammation, had respiratory tract lesions (P less than 0.025). No specific caustic substance predisposed to upper airway lesions. PMID- 3973779 TI - Triose phosphate isomerase deficiency: prenatal diagnosis. AB - A child with triose phosphate isomerase deficiency has congenital nonspherocytic hemolytic anemia, mental subnormality, motor impairment, growth failure, and cardiac failure. The deficiency state is characterized by moderately reduced red cell triose phosphate isomerase activity and marked instability of the abnormal enzyme to heat. The stability characteristics of triose phosphate isomerase in cultured fibroblasts define the homozygous and heterozygous states with sufficient precision to allow prenatal diagnosis of the disorder. Successful prenatal identification of a heterozygote and an unaffected fetus in utero is described. PMID- 3973780 TI - Carcinoma in situ of the testis in children with 45,X/46,XY gonadal dysgenesis. AB - The frequency of gonadal tumors in intersex patients with a karyotype including a Y chromosome is very high. In other at-risk groups, testicular germ cell tumors have been shown to be preceded by carcinoma in situ (CIS) changes. We investigated gonadal tissue from four children, aged 1 month to 18 years, with 45,X/46,XY gonadal dysgenesis, and with male or ambiguous genitalia, for the presence of CIS germ cells. Twelve gonadal biopsies and gonadectomy specimens were analyzed by means of conventional histology and densitometric DNA measurements. CIS changes were detected in specimens from all four patients, and aneuploid DNA distributions of the CIS germ cells confirmed the malignant potential of these cells. In one case, electron microscopic analysis revealed the same ultrastructural features of the CIS germ cells as previously described in seminoma cells. These observations indicate that in all patients with 45,X/46XY gonadal dysgenesis and a male phenotype, gonadal biopsies should be considered as soon as the syndrome is diagnosed. We believe that the finding of CIS warrants gonadectomy. PMID- 3973781 TI - The right stuff for a new syndrome. PMID- 3973782 TI - Fulminant pneumonia caused by concomitant infection with influenza B virus and Staphylococcus aureus. PMID- 3973783 TI - Hyperzincemia in a patient with pyoderma gangrenosum. PMID- 3973784 TI - Screening for rubella IgG and IgM using an ELISA test applied to dried blood on filter paper. AB - IgG and IgM rubella antibodies were measured in dried blood samples from the neonatal metabolic screening program. Of 6613 samples from four central screening laboratories, 289 did not contain rubella IgG antibodies, indicating that only 4.3% of the mothers at term were not immune to the rubella virus in the spring of 1984. The proportion of women at term who were not immune was 9.3% in 1979. Rubella IgM was detected in nine of 37,000 samples; congenital rubella infection was confirmed serologically in eight infants. Of the infected babies, three showed severe clinical findings. We suggest that rubella IgG and IgM should be determined regularly in the surplus material of metabolic screening centers, thus giving the opportunity to detect infected infants. The screening procedure is also useful as a serologic tool for monitoring immunity patterns in women, and thus the effectiveness of vaccination programs. PMID- 3973785 TI - Cesarean delivery of full-term infants: identification of those at high risk for requiring resuscitation. PMID- 3973786 TI - Effective short-term diazepam prophylaxis in febrile convulsions. AB - The efficacy of short-term diazepam prophylaxis in febrile convulsions was evaluated in a prospective, controlled study. A total of 289 consecutive children admitted with their first febrile seizure were randomized into two groups. One group received short-term prophylaxis for 18 months with rectally administered diazepam in solution whenever the temperature was greater than or equal to 38.5 degrees C. The control group received no prophylaxis, but diazepam rectally in the event of new seizures. The short-term prophylaxis, a mean of five doses of diazepam per child per year, afforded effective seizure control; the 18-month recurrence rate was reduced from 39% to 12% (P less than 0.001), the total number of recurrences from 77 to 23 (P less than 0.001), the long-lasting recurrences from 5.0% to 0.7% (P less than 0.05). The risk of subsequent epilepsy within the first 2 years was the same, regardless of receiving prophylaxis (3%) or not (3%); it was low after simple febrile convulsions (no cases of epilepsy in 230 children) but considerable after complex febrile seizures (20%) or seizures associated with severe interictal EEG abnormalities (50%). PMID- 3973787 TI - Carbamazepine and carbamazepine-10,11-epoxide serum concentrations in epileptic children. AB - Carbamazepine (CBZ) and carbamazepine-10,11-epoxide (CBZ-epox) steady-state serum concentrations were measured in 82 children who had generalized tonic-clonic, or partial seizures. There was no correlation between a given dose and serum concentrations, whether other anticonvulsant drugs were used or not. Epileptic children receiving polytherapy (CBZ associated with one or more of the following drugs: phenobarbital, primidone, phenytoin, ethosuximide) had significantly different CBZ clearance values and percent CBZ-epox than did patients given CBZ alone. Even though given lower doses, girls had higher CBZ concentrations and lower CBZ clearance values than did boys. Older girls had lower serum concentrations of CBZ-epox than did younger girls. Seizure-free children had higher CBZ serum levels and lower CBZ clearance values than did those with uncontrolled seizures. The percentage of CBZ-epox in children with uncontrolled seizures was significantly higher than in children without seizures. These data indicate that serum levels of CBZ and CBZ-epox correlate more with factors such as associated drugs, age, and sex than with administered dose. Therefore, CBZ serum level monitoring represents an essential means of individualization of anticonvulsant drug therapy. PMID- 3973788 TI - Inconsistent absorption from a sustained-release theophylline preparation during continuous therapy in asthmatic children. AB - During routine monitoring of hospitalized children with asthma receiving a sustained-release theophylline formulation, we frequently observe unpredictable fluctuations in serum theophylline concentration (STC). We evaluated eight asthmatic patients (ages 4 to 17 years) with inconsistent STCs to determine the cause of this phenomenon. Only minimal variation in STC and therefore theophylline clearance was noted during a 24-hour period of continuous intravenous aminophylline infusion. However, marked variability in STC was observed when measured every 2 hours for 48 hours after 6 days of continuous therapy orally. In addition, the time required to reach peak and trough STCs varied from dose to dose. Inasmuch as clearance was shown to be constant, the variability was attributed to inconsistent theophylline absorption. Unpredictable fluctuations of STC secondary to variable absorption from this sustained-release theophylline preparation may occur in certain patients. Appreciation of this potential variability is necessary for the proper interpretation of STC measurements and subsequent dosage adjustment. PMID- 3973789 TI - Postconceptional age and gentamicin elimination half-life. AB - We examined the correlation between the elimination half-life of gentamicin and postnatal or postconceptional age in 104 infants greater than 24 weeks to less than or equal to 48 weeks postconceptional age. A weak correlation was observed between half-life and postnatal age (R = -0.353). A better correlation existed between postconceptional age and half-life (R = -0.572). A plot of the log of the mean half-life against postconceptional age was virtually linear. We conclude that postconceptional age is a major determinant of an infant's ability to excrete gentamicin, and speculate that the relationship between half-life and decreasing postconceptional age is exponential. PMID- 3973790 TI - Possible indomethacin-aminoglycoside interaction in preterm infants. PMID- 3973791 TI - Central nervous system depression from chlorpromazine poisoning: successful treatment with naloxone. PMID- 3973792 TI - Physician attitudes toward confidential care for adolescents. AB - We examined factors that determine whether pediatricians will grant confidential care to adolescents. Through four vignettes, in which adolescents of different ages and maturity requested confidential care, we assessed the willingness of physicians to give such care for four problems: request for contraceptive, diagnosis of gonorrhea, intrauterine device found incidentally on x-ray study, and illicit drug use. A random sample of 932 physicians responded to the vignettes. Overall, physicians agreed to give confidential care to adolescents in 75% of the vignettes. They were more likely to give confidentiality in cases involving sexual activity. They supported confidential care for 87% of patients requesting contraceptives, but for only 54% reporting illicit drug use. The proportion of physicians supporting confidentiality increased with age and maturity of the minors. Seventeen-year-old mature adolescents seeking contraceptives were given confidentiality by 97% of physicians. Thus physician responses to vignettes indicated that they strongly support confidential care for adolescents as represented in the clinical vignettes. PMID- 3973793 TI - A simple estimate of glomerular filtration rate in adolescent boys. AB - We reexamined the relationship between creatinine clearance (Ccr) and body habitus in 212 girls and 356 boys, including 181 boys and 69 girls between 13 and 21 years of age. The use of formula Ccr = k L/Pcr, where k = 0.55 for the calculation of GFR, resulted in a significant underestimation of GFR in adolescent boys but was suitable for girls. In 51 adolescent boys the equation Ccr = 0.7 L/Pcr resulted in an accurate estimate of GFR. Regression analysis in 133 boys aged 3 to 21 years showed that the constant k increased gradually and linearly with age (r = 0.35, P less than 0.01). GFR could be better estimated for boys of any age by the linear bivariate equation Ccr = 1.5 (age) + 0.5 (L/Pcr), where age is given in years (r = 0.82, P less than 0.001). This equation yielded slightly better results than did 0.7 L/Pcr in 91 additional clearance studies performed in adolescent boys with native kidneys or functioning renal transplants. The larger value for the constant k (0.7) and the age correction for GFR reflect the greater rate of urinary creatine excretion (and thus muscle mass) per unit of body mass in adolescent boys. PMID- 3973794 TI - Screening for cystic fibrosis. PMID- 3973795 TI - Chronic lung disease following hypocapneic alkalosis for persistent pulmonary hypertension. PMID- 3973796 TI - Calcium therapy in the sick premature infant with hypocalcemia. PMID- 3973797 TI - Prognosis of chronic active hepatitis. PMID- 3973798 TI - Anotia, facial paralysis, and heart disease. PMID- 3973799 TI - Management of neonatal hypothermia. PMID- 3973800 TI - Advances in control of production freeze dryers. PMID- 3973801 TI - Microwave coupled plasma sterilization and depyrogenation I. System characteristics. PMID- 3973802 TI - Glass and rubber closure effects on the pH of water II. A proposed mechanism of interaction. PMID- 3973804 TI - Reduction of microbial dispersion by clothing. PMID- 3973803 TI - Development of haloperidol in oil injection formulations. PMID- 3973806 TI - Streptokinase dissolution of a right atrial thrombus. AB - A critically ill 20-month-old white male with severe bronchopulmonary dysplasia, cor pulmonale, and intolerance to enteral feeds, required a left percutaneous subclavian Broviac catheter. Echocardiogram showed a right atrial thrombus, resolution of which was demonstrated after infusion of streptokinase through the Broviac catheter for 16 hours. The catheter remained in place, functioning well, for a further 4 months. The patient suffered no bleeding complications, and was spared the prohibitive risk of right atrial thrombectomy. This use of streptokinase has not previously been reported. PMID- 3973805 TI - Microwave coupled plasma sterilization and depyrogenation II. Mechanisms of action. PMID- 3973807 TI - Multiple gastrointestinal atresias in three consecutive siblings: observations on pathogenesis. AB - Three consecutive siblings with innumerable membranous gastrointestinal atresias, beginning at the prepyloric region and ending in the rectum, are reported. Microscopic examination of the small and large intestine showed multiple, tiny lumina each surrounded by a separate mucosa and muscularis mucosae but by a single muscular layer at the periphery. The pathological findings and hereditary character of these atresias suggest that a defect in recanalization during a solid stage of development involving the whole of the gastrointestinal tract may be the cause of these atresias. PMID- 3973808 TI - Nodular lymphoid hyperplasia of the intestinal tract in infancy and childhood. AB - Over an 18-year period we have diagnosed nodular lymphoid polyposis of the intestinal tract in 6 patients. The site of the polyposis, which was due to prominent lymphoid hyperplasia, was ileal (3), colonic (2), and rectal (1). The diagnosis was made following complications arising from the polyps, which included recurrent intussusception (2), rectal prolapse (1), intestinal or pseudointestinal obstruction (2), and rectal bleeding (1). Immunoglobulin staining was performed on all the bowel specimens and in every case secretory IgA was present on the mucosal surfaces and IgG and IgA were seen in the lamina propria, thus excluding immunodeficiency in these patients. Viral studies were performed in 3 patients and all were positive. In one patient Echovirus II was seen in tissue homogenate from a mesenteric lymph node and in another, adenovirus type II was cultured from lymphoid polyps of the rectum. A further patient had positive serological tests for adenovirus. Thus it appears that nodular lymphoid hyperplasia is part of the generalized lymphoid hyperplasia associated with viral infections in infancy and childhood. Immunodeficiency states as a cause of the lymphoid hyperplasia should always be excluded by estimation of serum immunoglobulins. PMID- 3973809 TI - Prediction of outcome following necrotizing enterocolitis in a neonatal surgical unit. AB - Retrospective analysis of 27 factors in 80 neonates with necrotizing enterocolitis has enabled us to identify three factors that appear to be of prognostic statistical significance, namely blood pH, platelet count, and the presence of congenital defects. All three factors may be assessed objectively at the time of admission of the patient. Using these factors we have estimated a "probability of death" score for each patient and a high-risk group of neonates has been identified. PMID- 3973810 TI - Failure of autotransplantation of the spleen in dogs: an anatomic, radionuclide imaging, and pathologic study. AB - Although splenic autotransplantation is successful in mice and rats, with regeneration occurring in any location, no extensive study had been performed on dogs. We transplanted the spleen into subcutaneous and intraperitoneal locations on 40 dogs. Four to six months later, splenic scanning and reexploration was carried out. Spleens were removed, weighed, and microscopic sections were made. Months later, no uptake was present on scanning, weight was less than 6% of original weight, and little identifiable splenic tissue was present on microscopic sections. When 15 small sections were transplanted to the omentum in a "necklace" fashion, good uptake and preservation were seen after six months. The small amount of spleen transplanted by this method, however, makes this an unsatisfactory option. We conclude, therefore that our large-animal experiments do not provide a basis on which to recommend autotransplantation of the spleen in humans. Preservation of splenic tissue by splenorrhaphy is still the treatment of choice. PMID- 3973811 TI - The absorptive function of colonic aganglionic intestine: are the Duhamel and Martin procedures rational? AB - The Lester Martin modification of the Duhamel procedure is an accepted definitive operation for long-segment Hirschsprung's disease, in which considerable use is made of aganglionic bowel. Whether the aganglionic segment contributes to fluid and electrolyte reabsorption is not known. We have modified the technique of nonequilibrium dialysis of the rectum in order to obtain simultaneous measurements of electrolyte transport and transmural potential difference (PD) in 9 infants with Hirschsprung's disease (HD), prior to operation. Six age-matched infants were studied as controls. In the control group Na+ was absorbed electrogenically while K+ secretion was passive and greater than HCO3- secretion. In HD, both NA+ absorption and Cl- absorption were greater than in control children, with Cl- absorption exceeding Na+ absorption. PD was higher in HD infants than in controls, with an associated increase in K+ secretion. HCO3- secretion accounted for the difference between Na+ and Cl- absorption. These data clearly show that aganglionic colon transports electrolytes, and that in the Lester Martin modification of the Duhamel procedure the refashioned colorectum contributes to overall colonic salvage of electrolytes. PMID- 3973813 TI - Streptococcus milleri in appendicitis in children. AB - A retrospective survey of 253 appendectomies performed on children over a period of one year was carried out. Streptococcus milleri was isolated from pus in 11 (29%) of the 38 children who developed postoperative infections; it was the most commonly identified pathogen in these children. It is concluded that S milleri is a significant pathogen in childhood appendicitis, and that this fact should be taken into account when antibiotic therapy is being planned. PMID- 3973812 TI - Can the human neonate mount an endocrine and metabolic response to surgery? AB - Little is known of the ability of the human newborn infant to mount an endocrine and metabolic response to surgical trauma. Blood concentrations of glucose, lactate, pyruvate, alanine, hydroxybutyrate, acetoacetate, and glycerol together with plasma concentrations of insulin, glucagon, adrenaline, and nonadrenaline were measured in 33 infants (26 term, 7 preterm) subjected to surgery during the neonatal period. The results show that newborn infants can indeed mount a substantial endocrine and metabolic stress response, the main features of which are hyperglycemia and hyperlactatemia associated with the release of catecholamines and the inhibition of insulin secretion. There are specific differences between preterm and term neonates and between neonates anesthetised by different anesthetic techniques in the pattern of this response. PMID- 3973814 TI - The importance of surgical evaluation of patients with "Turner-like" sex chromosomal abnormalities. AB - Children with "pure" gonadal dysgenesis do not require abdominal explorations to remove their gonads, because the risk of development of malignancy is minimal. Children with "mixed" gonadal dysgenesis, who usually present with sexual ambiguity, need to have gonadectomy because of the high incidence of malignancy in these gonads. We present four children (three adolescents and one two year old) who presented with minimal somatic anomalies, who did not have sexual ambiguity. The prominent features were primary amenorrhea and short stature in the adolescents, and minor dysmorphic features in the small child. On the basis of these physical features, complete genetic evaluation was carried out, and a Y chromosome or an unidentifiable fragment was identified in all four cases. At exploration, bilateral genital streaks were found, and were removed. In addition to the usual microscopic features of the streaks, Leydig cells and tubular structures resembling rete testis were seen in all the gonads. In one gonad, a gonadoblastoma was found. Since this type of gonad is "at risk" for the development of gonadoblastoma, the need for complete genetic evaluation of all females with "Turner-like" chromosomal abnormalities, although phenotypically female, is emphasized. If a Y chromosome or any unusual fragment is identified, exploration should be carried out, and any gonad that is not a normal ovary should be removed. PMID- 3973815 TI - The management of chylous ascites in children. AB - The results of surgical treatment of four children with chylous ascites unresponsive to medical management are presented. Peritoneovenous shunts were inserted in three patients, two of whom had the ascites resolved. The third patient was a 4-year-old girl with widespread mucin-secreting carcinomatosis, the first reported case in the literature combined with chylous ascites, whose shunt failed to relieve the ascites. A review of the literature comprising 92 cases of chylous ascites in children and a proposed scheme of management is presented. PMID- 3973816 TI - Pulmonary sequestration complicated by anomalies of pulmonary venous return. AB - Five anomalies of pulmonary venous drainage were seen among 12 children operated for lung sequestration. In two children, venous drainage from the sequestrated lobe and the rest of the right lung was via a single channel into the inferior vena cava ("scimitar syndrome"). In one of these children, the sequestrated lobe was resected and repair of the scimitar syndrome was delayed; in the second patient, the anomalous pulmonary venous drainage was not recognized preoperatively and the vein was ligated, resulting in acute hemorrhagic infarction of the right lung and death of the patient. Three patients had less severe anomalies of pulmonary venous drainage. We recommend very careful evaluation of patients with lung sequestration with special reference to pulmonary venous drainage. PMID- 3973817 TI - One-year experience in a regional pediatric trauma center. AB - During 1982, 267 children with life-threatening injuries were admitted to the Maryland Regional Pediatric Trauma Center at the Johns Hopkins Hospital. Seventy three percent of patients arrived directly from the injury scene by helicopter (46%), ambulance (50%), or other (4%). Mechanisms of injury included motor vehicle accidents (MVA; 55%), falls (27%), assaults (8%), and sports and other injuries (10%). In 75% of MVA the child was a pedestrian. Fifty-one percent of injuries were single organ system, 29% involved two systems, and 20% involved three or more systems. Remarkably, the mortality of 6.7% was not affected by the number of organ systems involved, but was directly related to the presence or absence of head injury. Fourteen of seventeen deaths resulted from head injury. Eighty percent of documented liver and spleen injuries were managed nonoperatively. This nonoperative plan of management simplified the optimal treatment of head injury. The high frequency of head injury has mandated a more aggressive approach to the management of brain trauma including intracranial monitoring to facilitate control of cerebral edema. Our data demonstrate that an excellent quality of life may be anticipated even in children with severe head injury. PMID- 3973818 TI - Bronchial laceration in a newborn with persistent posterior pneumomediastinum. AB - A large posterior pneumomediastinum that compromised the respiratory status and reaccumulated promptly after needle aspiration, aroused the suspicion of airway laceration. Tracheogram was consistent with laceration of the right bronchus. Evacuation of air with chest tube resulted in complete resolution of pneumomediastinum and healing of bronchial tear with no recurrence following removal of chest tube after seven days. PMID- 3973819 TI - Hypoganglionosis of the myenteric plexus with normal Meissner's plexus: a new variant of colonic ganglion cell disorders. AB - A 16-year-old girl with a history of achalasia of the lower esophagus was investigated for progressive constipation since the age of five years. Normal ganglion cells of the Meissner's plexus were found in a mucosal rectal biopsy. Manometric studies showed absence of the normal rectosphincteric relaxation reflex. A long posterior rectal myectomy was performed in which no ganglion cells were found between the muscular layers. The patient underwent a rectosigmoid resection with a low anastomosis according to Duhamel. In the resected bowel, a normal Meissner's plexus was again found while marked hypoganglionosis of the myenteric plexus was evident. Intranuclear inclusion bodies in Schwann cells and scattered inflammatory cells were noteworthy. This case may be an example of an acquired hypoganglionosis localized to the myenteric plexus. PMID- 3973820 TI - Opioid effects on hepatic disposition of dyes in mice. AB - Morphine administration acutely reduced plasma clearance of sulfobromophthalein (BSP) in mice and increased hepatic retention of this dye. Increasing morphine doses from 5 to 40 mg/kg s.c. progressively raised plasma and liver BSP levels. Morphine-treated mice, warmed to reverse hypothermia, still had higher plasma and liver BSP levels. The narcotic also raised plasma levels of two dyes which are not conjugated, indocyanine green and dibromosulfophthalein. Naloxone reversed morphine-induced elevation of plasma BSP levels. In bile duct-ligated mice, plasma BSP levels were very high but hepatic BSP levels remained low, both after saline or morphine. Thus, the effects of morphine on BSP disposition differed from those of biliary occlusion. BSP content in bile was reduced by morphine, as dye levels were raised in plasma and hepatic parenchyma. In bile duct-cannulated mice morphine increased BSP levels in plasma and liver whereas reducing the amount of dye eliminated in bile. PMID- 3973821 TI - Ibuprofen stereoisomer hepatic clearance and distribution in normal and fatty in situ perfused rat liver. AB - Ibuprofen is a 2-arylpropionic acid anti-inflammatory agent that undergoes stereoselective chiral inversion (R to S configuration) as well as oxidative metabolism in humans and rats. The present study was undertaken to define more clearly the role of the liver in ibuprofen stereoisomer clearance in both normal and disease states. Liver perfusion experiments were conducted with normal and fatty rat liver; chronic fatty liver was induced by nutritional deficiency and was used as a model of hepatotoxin-induced fatty liver in humans. Total (R) ibuprofen clearance (ClRtot), chiral inversion-related clearance (ClRinv), (S) ibuprofen clearance (ClS) and hepatic distribution coefficients for each stereoisomer (KR and KS) were calculated with a model that corrected for perfusate reservoir sampling. In both normal and fatty liver, ClRinv accounted for 60% of ClRtot, but ClRtot was 30% lower in fatty liver than in normal liver (P less than .001). ClS was 40% of ClRtot in normal liver and was not significantly different from the noninversion clearance of (R)-ibuprofen. ClS was unchanged between normal and fatty liver and KS was greater than KR in normal liver (P = .01) but not in fatty liver. The results indicate that the fatty liver condition stereoselectively affects (R)-ibuprofen clearance and eliminates preferential (S)-isomer hepatic distribution. Based on model simulations, these effects are predicted to have minimal impact on total ibuprofen plasma levels or area-under-curve measurements following a dose of rac-ibuprofen unless ClRtot is reduced by more than 50%. PMID- 3973822 TI - Evaluation of polymeric hydroxamic acid iron chelators for treatment of iron overload. AB - A series of polymers bearing hydroxamic acid-terminated side chains were prepared for the purpose of developing new iron chelators for treating iron overload in beta-thalassemia (Cooley's anemia) and other iron diseases. The polymers are for the most part amino acid amide derivatives of acrylic and methacrylic acid with the terminal carboxyl group converted to the hydroxamic acid. The polymers are generally water soluble and sequester iron(III) avidly. The polymeric iron chelators were assayed via a mouse screen for activity in removing iron. Iron overloaded mice were administered i.p. the iron chelator over a 7-day period. Urine and feces were collected and the iron content measured by atomic absorption. At the end of the treatment period the mice were sacrificed and the livers and spleens were homogenized and examined for iron content. The results were compared with similar data obtained for the iron chelator drug desferrioxamine as a standard. Four of the polymers prepared exhibited strong activity, as good or better than desferrioxamine in iron removal capability. The four polymers are the polyacroloyl and polymethacryloyl derivatives of beta alanine with the side chain carboxyls converted to the N'--H or N'--CH3 hydroxamic acids. Of these four the polyacryloyl N'--CH3 derivative exhibited superior behavior, being 3 to 5 times as effective as desferrioxamine at the lower dose level. None of the four polymers produced toxic signs and the administration was accompanied by little or no pain response. PMID- 3973823 TI - Endogenous opiate peptides may limit norepinephrine release during hemorrhage. AB - The involvement of the sympathetic nervous system in the cardiovascular response to hemorrhage and subsequent opiate receptor blockade was studied in conscious rabbits. Plasma catecholamines were measured by high-pressure liquid chromatography to indirectly assess sympathetic activity. Arterial blood samples were drawn at four times during the experiment: 1) before hemorrhage; 2) after a 15% blood loss; 3) after mean arterial blood pressure decreased to less than 40 mm Hg; and 4) 2 min after an i.v. injection of naloxone (3 mg/kg) or saline. Rapid removal of 15% of the total blood volume (approximately equal to 8 ml/kg) increased heart rate and plasma norepinephrine. Plasma epinephrine and blood pressure remained at control levels. Further hemorrhage (approximately equal to 16 ml/kg) produced a sudden decrease in blood pressure and a large increase in plasma epinephrine. Plasma norepinephrine was not significantly different from the previous sample. Subsequent injection of naloxone significantly increased plasma norepinephrine and blood pressure compared to the saline-treated group. Plasma epinephrine was similar in the two groups. These studies suggest that naloxone may exert its pressor effect during hemorrhagic hypotension in the conscious rabbit by blocking a naturally occurring, opiate peptide-mediated inhibition of norepinephrine release. The results are consistent with a peptidergic limit on sympathetic activity being responsible for the decrease in blood pressure seen during acute hemorrhage. PMID- 3973824 TI - Vasoactive intestinal peptide which coexists with acetylcholine decreases acetylcholine turnover in mouse salivary glands. AB - Acetylcholine (ACh) and vasoactive intestinal peptide (VIP) probably coexist in cholinergic neurons of rodent salivary glands. In this tissue, cholinergic drugs regulate release of both ACh and VIP from postganglionic cholinergic neurons. In the present study we investigated whether VIP could modulate the metabolism of ACh in mouse submandibular gland cholinergic neurons using ACh turnover rate (TRACh) as a parameter. The TRACh was estimated via measurement of the formation of [3H]ACh during constant rate infusion of [3H]choline. Choline and ACh were separated by reverse phase high-performance liquid chromatography and were detected electrochemically after enzymatic postcolumn reaction. We calculated that the TRACh was about 3 nmol/mg of protein per hr. Pilocarpine, a muscarinic agonist decreased the TRACh about 5-fold whereas atropine methyl Br, a muscarinic antagonist, caused a large increase in turnover. Turnover, therefore, appears to be regulated by a feedback mechanism triggered by occupancy of postsynaptic receptors. VIP infused i.v. (40 micrograms/kg/min) decreased the TRACh by about 50%. Atropine completely prevented the inhibition of the TRACh induced by VIP. These results suggest that, by changing postsynaptic or presynaptic muscarinic receptor function, VIP may participate in the control of ACh metabolism. Parasympathetic decentralization of salivary glands did not prevent the effect of either atropine or VIP on TRACh. This finding suggests that the central afferent input to the ganglionic cells is not required for the regulation of ACh metabolism and, therefore, the feedback loop probably acts via a postganglionic mechanism which is not elucidated by present experiments. PMID- 3973825 TI - Modulation of reflex renal vasoconstriction by increased endogenous renal prostaglandin synthesis. AB - The effect of increased endogenous renal prostaglandin synthesis on the reflex renal vasoconstrictor response to stimulation of skeletal muscle somatic receptors and their afferents was examined in anesthetized dogs with bilateral carotid artery occlusion and vagotomy. Acute ureteral occlusion and indomethacin were used to acutely increase and decrease, respectively, endogenous renal prostaglandin synthesis. Graded electrical stimulation of the afferent sciatic nerve or antegrade femoral arterial injection of capsaicin elicited a frequency dependent reduction in renal blood flow accompanied by increases in mean arterial pressure and heart rate. Acute ureteral occlusion attenuated (circa 50%) the renal vasoconstrictor response but did not affect the increases in mean arterial pressure or heart rate. Administration of indomethacin during continued ureteral occlusion restored the renal vasoconstrictor responses to the preureteral occlusion level. These results indicate that the increase in endogenous renal prostaglandin synthesis during acute ureteral occlusion specifically attenuates the reflex renal vasoconstrictor response to stimulation of skeletal muscle somatic receptors and their afferents. PMID- 3973826 TI - Role of 5-HT2 receptors in serotonin-induced contractions of nonvascular smooth muscle. AB - Vascular receptors responsible for serotonin-induced contractions are of the 5 HT2 subtype (site in brain cortical membranes that is preferentially radiolabeled by [3H]spiperone) whereas serotonin receptors mediating contraction in nonvascular smooth muscle have not been extensively studied. The present in vitro studies using the 5-HT2 receptor antagonists ketanserin, LY53857 and 1-(1 naphthyl)piperazine show that serotonin-induced contractions in the rat uterus and guinea-pig trachea are also mediated by interaction with 5-HT2 receptors. Prazosin, but not the serotonin receptor antagonists, blocked serotonin-induced contractions in the rat vas deferens, indicating that alpha adrenergic and not 5 HT1 or 5-HT2 receptors mediate the contractile response to serotonin in this tissue. Because selective 5-HT2 receptor antagonists did not block contractions to serotonin in the rat fundus or guinea-pig ileum, receptors in these gastrointestinal tissues are clearly not 5-HT2. However, contractions to serotonin in the fundus but not in the ileum were blocked by certain antagonists [metergoline and 1-(1-naphthyl)piperazine] demonstrating that the receptors involved in serotonin-induced contractions in the fundus are different from the ileum. Other differences between the fundus and ileum in serotonin-induced contractions include: 1) the potency of serotonin is greater in the fundus than in the ileum; and 2) the primary action of serotonin in the fundus is activation of a postsynaptic receptor on the smooth muscle whereas, in the ileum, serotonin exerts an indirect neuronal action to effect acetylcholine release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973827 TI - Cardiorespiratory, sympathetic and biochemical responses to T-2 toxin in the guinea pig and rat. AB - The cardiorespiratory, sympathetic and biochemical effects of T-2 toxin were examined in conscious rats and guinea pigs. The pithed rat preparation was also used to evaluate possible direct effects of T-2 on the heart and vasculature. Injection of T-2 (0.5-2.0 mg/kg i.v.) into conscious rats produced prolonged (6-8 hr) hypertension and tachycardia, followed by hypotension. Total peripheral resistance was increased and cardiac output decreased. In guinea pigs, a steady decrease in pressure and rate occurred. Intravenous administration of T-2 to pithed rats did not alter blood pressure or heart rate at a time when, in conscious rats, both blood pressure and heart rate were increased. Significant elevations of arterial plasma norepinephrine, epinephrine and dopamine occurred after T-2, with metabolic acidosis, hypocarbia and hyperoxemia in both conscious rats and guinea pigs. In the rat, increase in plasma vasopressin and prostacyclin were elevated, but thromboxane and leukotriene C4-immunoreactivity were not changed. In pithed rats, T-2 did not increase basal or stimulated plasma catecholamines but produced the same changes in blood gases, pH and lactate. The LD50 values for i.v. T-2 in the rat and guinea pig were 0.74 and 1.30 mg/kg, respectively. The data are consistent with the hypothesis that T-2 toxin disrupts cellular aerobic metabolism, resulting in lactic acidosis, sympathoadrenomedullary activation, variable initial circulatory responses and eventual cardiovascular collapse. PMID- 3973828 TI - Differences in the properties of muscarinic cholinergic receptors in the developing chick myocardium. AB - The number of muscarinic cholinergic receptors detected with [3H]quinuclidinyl benzilate (QNB) was constant in embryonic chick heart membranes but increased 2.5 fold by 3 days posthatching; the KD for [3H]QNB did not change. The affinities of the muscarinic receptors for agonists, as determined in in vitro [3H]QNB competition experiments, differed during development. The IC50 values were lowest for 10- to 14-day embryonic heart receptors, intermediate for 18- to 20-day embryonic receptors and highest for 3- to 7-day newborn heart receptors. These apparent differences in agonist affinity were not overcome by guanine nucleotides or monovalent cations alone, but were greatly diminished in the presence of a combination of guanylylimidodiphosphate plus NH4+. Modeling of [3H]QNB/oxotremorine competition curves indicated the presence of three agonist affinity states in membranes from embryonic heart and two in newborn hearts. The KD values for oxotremorine increased during development. The proportion of receptors displaying the highest affinity for oxotremorine was constant at all ages tested whereas the proportion displaying the lowest affinity decreased from 16% in membranes from 12-day embryonic hearts to zero in newborn hearts. The physiological significance of the differences in the properties of the receptors was investigated by assessing their ability to attenuate adenylate cyclase. The efficacy of agonists to attenuate basal adenylate cyclase increased 1.5-fold after birth, whereas the potency of agonists to produce this effect was similar at all ages tested. PMID- 3973829 TI - Guinea-pig model of halothane-associated hepatotoxicity in the absence of enzyme induction and hypoxia. AB - Halothane anesthesia (1%) administered in 21% oxygen for 4 hr to an outbred strain of guinea pig in the absence of enzyme induction resulted in liver damage in 40 of the 65 animals studied. Necrosis was either confluent around the central veins or in scattered foci throughout the lobules. Damage was present on the second and third days after anesthesia. By day 7 the livers had recovered, evidenced by lack of histological changes and normal serum alanine aminotransferase activity. Administration of halothane in 14 or 80% inspired oxygen did not alter the extent or incidence of liver damage. Major end metabolites of halothane biotransformation (2-chloro-1,1-difluoroethylene, 2 chloro-1,1,1-trifluoroethane, inorganic fluoride and trifluoroacetic acid) were identified at each oxygen concentration. The metabolic inhibitor SKF-525A significantly decreased the amounts of the volatile metabolites 2-chloro-1,1,1 trifluoroethane and 2-chloro-1,1-difluoroethylene. SKF-525A also decreased the incidence and severity of hepatic damage. Both halothane (1%) and isoflurane (1.1%) anesthesia caused similar reductions in mean arterial blood pressure. However, in contrast to halothane, isoflurane was not hepatotoxic. The results indicate that liver necrosis is unlikely to be caused by anesthesia per se, but rather by hepatotoxic metabolites of halothane. This model offers the opportunity to study the pathogenesis of halothane hepatotoxicity after the administration of halothane alone. PMID- 3973830 TI - Electrophysiologic and voltage clamp analysis of the effects of sotalol on isolated cardiac muscle and Purkinje fibers. AB - The effect of dl-, d- and I-sotalol on electrophysiologic characteristics of guinea-pig papillary muscles, sheep and rabbit Purkinje fibers was studied. Standard electrophysiologic and voltage clamp techniques were used. At concentrations between 10(-6) and 10(-4) M, the main effect of sotalol consisted of prolongation of the action potential duration. In voltage clamp experiments this effect correlated with a substantial reduction of the time-dependent K current activated during the plateau of the action potential and a small reduction of the background K current. At concentrations above 10(-4) M, a secondary shortening of the action potential concomitant with a fall in maximal rate of depolarization was seen. In voltage clamp experiments this effect correlated with a decrease of a slowly inactivating Na current. In the absence of catecholamines d- and I-sotalol exerted identical effects on action potentials and voltage clamp currents. PMID- 3973831 TI - CGP 22979A, a renal vasodilator with natriuretic properties. AB - Renal vasodilation might be an interesting new antihypertensive principle. In the present study, the prodrug approach was adopted to synthesize a preferential renal vasodilator. A hydralazine-like compound, CGP 18137A (2-hydrazino-5-n-butyl pyridine), was substituted with an N-acetyl-gamma-glutamyl residue. The resulting derivative, CGP 22979A [N-acetyl-L-glutamic acid-N[N2-(5-n-butyl-2 pyridyl)hydrazide]], was inactive in the isolated perfused mesenteric artery, whereas the parent compound induced a dose-dependent inhibition of vasoconstrictor stimuli. When administered i.v. to anesthetized rats in doses between 1.0 and 10.0 mg/kg, CGP 22979A increased renal blood flow significantly, by up to 31% without affecting blood pressure. A dose of 4.0 mg/kg lowered renal vascular resistance by 25% but did not alter total systemic, mesenteric and iliac vascular resistance. A dose of 10.0 mg/kg increased glomerular filtration rate by up to 42%. In conscious rats, the same dose increased sodium excretion by 200%. Because CGP 22979A induces renal vasodilation in rats and has a preferential action on the afferent arterioles, it might be a useful tool for studying the antihypertensive potential of renal vasodilation. PMID- 3973832 TI - Preferential renal vasodilator effects of CGP 22979A in conscious spontaneously hypertensive rats. AB - CGP 18137A (2-hydrazino-5-n-butyl-pyridine) and its prodrug CGP 22979A [N-acetyl L-glutamic acid-N-[N2-(5-n-butyl-2-pyridyl)hydrazide]] were evaluated for their blood pressure-lowering potency and regional hemodynamic actions in conscious spontaneously hypertensive rats. The effects were compared to those of hydralazine. Animals were instrumented with miniaturized pulsed Doppler flowprobes to allow continuous simultaneous measurement of renal, mesenteric and hindquarter blood flow. From changes in mean arterial pressure and the respective flows, changes in renal, mesenteric and hindquarter resistance were calculated. After i.v. administration, hydralazine and CGP 18137A were equally potent with regard to their blood pressure-lowering effect in a dose range of 0.1 to 1 mg/kg. Hydralazine was more effective than CGP 18137A in lowering renal and hindquarter resistance. Neither of the two drugs, however, caused preferential dilation in any of the three beds studied. CGP 22979A in doses of 1 to 30 mg/kg caused a much smaller acute blood pressure-lowering response. However, already at low doses (1 10 mg/kg) it caused a significant reduction of renal resistance, without affecting either hindquarter or mesenteric resistance. At the highest dose (30 mg/kg), selectivity was no longer retained, which is probably due to excessive leakage of the active vasodilator into the peripheral circulation. These findings suggest that CGP 22979A is a renal-selective prodrug for CGP 18137A and thereby is capable of preferentially dilating the renal vasculature in conscious unrestrained spontaneously hypertensive rats. PMID- 3973833 TI - Mechanism and metabolic disposition of verapamil-evoked overflow of radioactivity from isolated atria preloaded with [3H]norepinephrine. AB - In this study the mechanism and metabolic profile of verapamil-evoked release of radioactivity was investigated in the rat isolated atria preloaded with [3H]norepinephrine [( 3H]NE). Verapamil (10(-7) to 10(-3) M) caused a dose related increase in the outflow (or the fractional release) of 3H. The fractional 3H-release produced by verapamil was reduced markedly in tissues which had been preloaded with [3H]NE in the presence of cocaine (10 microM) or after pretreatment of animals with reserpine (5 mg/kg i.p., 24 hr before sacrifice). Verapamil-evoked fractional 3H-release was unchanged in the presence of tetrodotoxin (5 X 10(-6) M) or in Ca++-free Krebs' medium containing 2 mM ethylene glycol bis(beta-aminoethyl ether)N,N'-tetraacetic acid. Whereas greater than 90% of tissue 3H-content consisted of unchanged [3H]NE, 60 to 75% of the spontaneous outflow and the verapamil-evoked overflow consisted of [3H]-3,4 dihydroxyphenylglycol and 2 to 10% was unchanged [3H]NE. When both cocaine (10 microM) and hydrocortisone (28 microM) (uptake-1 and uptake-2 blockers, respectively) were present, although the spontaneous outflow, as well as verapamil-evoked overflow, of radioactivity was increased, the metabolic profiles remained essentially unchanged. The addition of pargyline (10 microM), a monoamine oxidase inhibitor, in addition to the uptake-1 and uptake-2 blockers to the Krebs' solution significantly depressed both the spontaneous outflow and verapamil-evoked overflow of 3H; the verapamil-evoked overflow under this condition, however, consisted of unchanged [3H]NE (greater than 90%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973834 TI - Effects of N-acetylcysteine on the disposition and metabolism of acetaminophen in mice. AB - N-acetylcysteine is the drug of choice for the treatment of acetaminophen poisoning, yet the mechanism of protection in vivo is unknown. Prevention of liver injury could result from decreased production of the toxic intermediate(s), from increased capacity to detoxify the toxic intermediate(s) or from increased ability of the tissue to withstand or even repair the molecular damage caused by the toxic species. Treatment of mice with N-acetylcysteine (1200 mg/kg p.o.) was found to prevent the hepatic damage caused by 1000 mg/kg p.o. of acetaminophen. Possible mechanisms for this hepatoprotective effect were examined by measurement at different time points of acetaminophen and its metabolites in plasma, urine, bile and whole-body homogenates and by evaluation of the changes in these parameters caused by treatment with N-acetylcysteine. A high-pressure liquid chromatographic method was developed to measure the majority urinary metabolites of acetaminophen and was validated by desorption chemical ionization mass spectral analysis of individual metabolites. Minimal differences in the concentration of unchanged acetaminophen and metabolites in whole-body homogenates at 4, 6 and 24 hr postdose were noted for N-acetylcysteine-treated vs. vehicle-treated mice. These results are incompatible with a decreased formation of the toxic species secondary to delayed acetaminophen absorption from the gastrointestinal tract or with an increased clearance of acetaminophen via nontoxic pathways such as sulfation as plausible mechanisms for the observed hepatoprotection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973835 TI - Effects of N-acetylcysteine on acetaminophen covalent binding and hepatic necrosis in mice. AB - Experiments were designed to test whether the protective effect of N acetylcysteine against acetaminophen hepatotoxicity precedes arylation of tissue or whether protection occurs after arylation of tissue. Investigation of potential postarylation actions showed that N-acetylcysteine was unable to attenuate the liver necrosis caused by acetaminophen or several other hepatotoxins that act through chemically reactive metabolites. Furthermore, varying the time and route of N-acetylcysteine treatment indicated that the late protection against acetaminophen mortality probably was a consequence of pharmacokinetic factors rather than postarylation intervention in the process of cell death. The antidote was found to inhibit covalent binding of acetaminophen by about 70% when N-acetylcysteine protected against liver necrosis. Treatment regimens that had no effect upon covalent binding also had no effect on acetaminophen hepatotoxicity. Previous failures to detect this relationship apparently occurred because of a failure to consider biological events important in the pathophysiology of acetaminophen-induced necrosis, particularly the marked intrahepatic hemorrhage and vascular congestion with liver engorgement by protein and fluid. These results support the hypothesis that sulfhydryl nucleophiles such as N-acetylcysteine act primarily through prearylation mechanisms to decrease the amount of reactive metabolite available for initiation of hepatic injury. PMID- 3973836 TI - The effect of factivity on lexical retrieval and postlexical processes during eye fixations in reading. AB - Subjects were required to read short passages of text while their eye movements were monitored. Each experimental passage contained a critical factive or nonfactive verb that was followed by a false complement. In half of the trials, subjects' reading was unimpaired; in the remainder of the trial, a central visual pattern mask, which moved in synchrony with the eyes, was applied. The results showed that (1) factive and nonfactive verbs did not receive different amounts of fixation time during the reading text. However, (2) false complements that followed nonfactive verbs. On the basis of this, it is concluded that individual word characteristics, such as factivity, are encoded automatically while sentence interpretation requires effort to be completed. PMID- 3973837 TI - Studying speech perception in adolescent school-age children by utilizing primary color perception. AB - Since both speech and color have perceptual ramifications in language, the present study was developed to study speech perception through color perception. With the recent advances in perception generally and color perception specifically, this nontraditional approach to studying speech perception appeared reasonable. The 12 consonants utilized in this study generated 144 pairs of nonsense CV-syllables. The consonant ensemble was selected because it accommodated a maximum number of phonological features with a minimum number of phonemes. The 46 subjects, who were in junior high school with an age range of 11 through 14 years, responded to each of the stimulus pairs by assigning (associating) to it one of the six primary colors. Because of the perceptual orderliness associated with subjects' judgments, the results indicated that color can be used to study speech perception. Specific findings included the retrieval of sameness, fronting (or place), and voicing. PMID- 3973838 TI - International epidemiology of cancer. PMID- 3973839 TI - Systemic sclerosis. The Watson Smith Lecture 1984. PMID- 3973840 TI - The medical career structure in 1985. PMID- 3973841 TI - The role of the pharmacist in the anticoagulant clinic. PMID- 3973842 TI - Use of hospital resources by acute stroke patients. PMID- 3973843 TI - Audit reviewed: medical audit in North America. PMID- 3973844 TI - Future consultant staffing in communicable and tropical diseases. A report of the Royal College of Physicians. AB - Infectious diseases and tropical medicine as clinically based specialties are in the decline, yet the importance of infection is as great as ever and advances in basic sciences have brought it once more to the forefront of academic medicine. A modest expansion in consultant posts in these specialties should be sought. Special expertise in dealing with infection could be offered by physicians or paediatricians within three categories: Specialists, including a small number with training in tropical medicine, appointed to regional centres linked to teaching hospitals who would be actively engaged in undergraduate and postgraduate teaching as well as research. General physicians with a major interest in infectious diseases appointed to teaching hospitals where they would also be involved in undergraduate training and research. General physicians with interest and training in infection working in District Hospitals (who might occasionally have a second interest, for example in chest diseases or gastroenterology). The general principles of training of infectious disease physicians are set out by the Joint Committee on Higher Medical Training. Perhaps a greater element of laboratory work or epidemiology than many trainees have undertaken in the past might be encouraged. For example, trainees could take an MSc in medical microbiology or epidemiology or receive laboratory training by local arrangement, perhaps as part of a project for an MD thesis. Regional and District Health Authorities should be encouraged to create new posts for physicians in infection in major District General Hospitals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973845 TI - Referral to consultants--the National Health Service versus private practice. AB - In a three-month audit of referrals to consultants by 18 general practitioners, a wide variation in individual doctor's referral rates was observed. The rate for private referral varied between doctors to a remarkable degree. Referrals made privately were twice as likely as NHS referrals to have been initiated by the patient. Private referrals were perceived by the doctors to have been no less worth-while than NHS referrals. The holding of private health insurance by patients was a factor in a third of private referrals. PMID- 3973846 TI - Defaulted appointments in general practice. AB - In a two-month study in an urban general practice of eight partners, 11.7 per cent of patients failed to attend for their appointments. Defaulters were younger than a control group of attenders, but the male to female ratio was almost identical. Annual consultation rates for defaulters were slightly lower than controls. Return visits had a default rate of 18 per cent and there was a strong statistical correlation between how and when an appointment was made and the default rate, with a maximum default rate of 19 per cent if the appointment was made between one to two weeks in advance. There was a significant difference in default rate between the partners (range 7.2-14.6 per cent) and the default rate was lowest on Mondays (9.7 per cent) and highest on Fridays (14.9 per cent). The majority of the defaulters had only defaulted once in the previous 12 months. These findings have important implications when planning an appointment system and asking patients to return for follow-up. PMID- 3973847 TI - Pruritus: a "coat of many colours'. AB - The symptom of pruritus was studied in one general practice. Approximately 2.8 per cent of consultations were found to involve pruritus. Information about site, duration, precipitating factors, relieving factors, and relationship of time of day to pruritus was obtained from 100 patients. Seventy-four of the patients were female, of whom one-third were in the age range 20-29 years. The cause of pruritus was classified into 29 categories. Only three patients had an underlying systemic disease causing their itch. Four patients were referred for a dermatologist's opinion. The importance of pruritus the symptom in relation to both disease and patient behaviour is considered. PMID- 3973848 TI - Evaluation of the experiences of trainees seeking employment after completion of their vocational training. AB - Two thousand questionnaires were sent to doctors receiving a certificate of prescribed or equivalent experience from the Joint Committee on Postgraduate Training for General Practice over a two-year period. More than 1,400 forms were returned.Seventeen per cent of respondents from 1982 experienced unemployment on completion of their vocational training and this figure had almost doubled by 1983. Some groups of people experienced more problems than others in finding employment but most respondents eventually found a post in which they were happy. Likewise, approval periods and parity varied considerably, and the majority of respondents appeared satisfied with what they achieved. PMID- 3973849 TI - A career in general practice. PMID- 3973850 TI - The detection of post-gastrectomy deficiency syndromes in general practice. AB - Post-gastrectomy deficiency syndromes were investigated in a rural practice. The main finding was a high prevalence of iron deficiency both with and without anaemia. Regular checks on iron level in the follow-up of these patients is suggested. PMID- 3973851 TI - A method of assessment during vocational training: report of a pilot study. AB - Problems arising from the present rate of failure of vocational trainees in the MRCGP examination are outlined; and the role of formative assessment during training in reducing this rate is considered. A study is described in which trainees in a number of centres were assessed by a method designed to measure specified cognitive abilities and areas of knowledge. The method, based on written papers, provides each candidate with a profile of performance and generates comparative standards. Reliability of marking, the distribution of candidate-scores within and between areas of assessment and techniques for monitoring the effectiveness of questions are reported. Use of the method by College as an educational service to trainees is considered, along with its potential as a Part I MRCGP examination. PMID- 3973852 TI - Deviation of humoral and cellular alloimmune reactions by placental extracts. AB - Modifications of the alloimmune response at both the humoral and the cellular levels by placental extracts (PE) syngeneic to the recipient were studied in the mouse using two different H-2 strain combinations. CBA (H-2k) or C57BL/Ks (H-2d), immunized with A/J (H-2a) spleen cells. The tests included in vivo tumor allograft evolution (accelerated rejection or enhancement reactions), and in vitro analysis of the involved immune agents, both cellular and humoral, using mixed lymphocyte reactions (MLR) and biological activity studies of serum samples. Animals from the recipient strains exhibited a delayed rejection of A/J tumor Sa 1 allografts if preimmunization was carried out with 10(6) A/J spleen cells combined with PE syngeneic to the recipients, as compared to controls immunized with A/J cells only or supplemented with isogeneic liver extracts (LE). The serological analysis revealed that PE treatment did not modify the overall hemagglutinating antibody production but resulted simultaneously in both a decreased production of cytotoxic complement fixing antibodies and an increase of specific anaphylactic mast cell degranulating antibodies, as compared to controls. The sera from PE-treated donors also demonstrated enhancing activity following passive transfer to isogeneic recipients. MLR regulatory activity was exhibited by spleen cells from PE- and immunogen-treated mice although the same or stronger activity was obtained from mice immunized without the addition of PE. However, in vivo transfer of these cells to syngeneic recipients showed that PE treatment erased the accelerated rejection caused by allogeneic immunization in the absence of PE and could even cause some degree of allografted tumor enhancement. The cells responsible for this inhibitory effect were mainly IJ+ lymphocytes, since their elimination with a relevant anti-IJ serum and complement restored a secondary type rejection pattern. These results show that PE present during the onset of immunization can promote the activation of regulatory agents such as enhancing antibodies and suppressor cells favoring allograft survival. PMID- 3973853 TI - Generation of mouse oocyte monoclonal isoantibodies: their effects and those of antisperm monoclonal antibodies on in vitro fertilization. AB - Monoclonal isoantibodies to mouse oocyte antigens were generated by modified hybridoma techniques similar to those described for mouse sperm monoclonals. Following isoimmunization with mouse oocytes and cell fusion, hybrid cells were cultured initially in a semi-solid medium containing methylcellulose. Seven to ten days after cell fusion about 350 hybrid clones were recovered for subculture. By an indirect immunofluorescence assay using frozen or fresh mouse oocytes, twenty hybridomas were shown to produce antibodies that bind to various oocyte components including antigens of the zona pellucida. However, they did not cross react with mouse spermatozoa or lymphocytes. A system was established to evaluate whether monoclonal antibodies to gamete-specific antigens have any inhibitory effects on the fertilization of mouse oocytes in vitro. A monoclonal antibody against zona antigen(s), ME 56, was shown to block fertilization of mouse oocytes via the inhibition of sperm binding to the zona pellucida. On the other hand, three out of four antibodies reacting with mouse sperm acrosomes were also inhibitory to mouse in vitro fertilization, perhaps mainly due to the inhibition of sperm acrosomal reactions. Using a sodium dodecylsulfate gel/protein blot radioimmunobinding method, the molecular weight of zona antigen(s) that react with ME 56 was determined to be in the range of 95,000, whereas that of the acrosomal antigen(s) reacting with the fertilization-inhibiting antibody, MS 207, was about 30.000. The results of this preliminary study suggest that monoclonal antibodies to certain gamete antigens can be a valuable tool for the analysis of sperm-egg interactions during the fertilization processes. PMID- 3973854 TI - Multifocal damage of the testis induced in rats by passive transfer of antibodies prepared against non-collagenous fraction of basement membrane. AB - Multifocal damage of the testis was induced in 70% of the rats injected with an antiserum against a non-collagenous fraction (D-STBM) obtained from a preparation enriched in basement membranes of seminiferous tubules. The damaged areas were characterized by perivascular and peritubular cell infiltrates, changes in the walls of small vessels and seminiferous tubules, and sloughing of the germinal epithelium. By electron microscopy, the most frequent changes observed in basement membrane of the seminiferous tubules were folding, focal thickening, and delamination. By immunofluorescence, discontinuous linear deposits of rabbit IgG were observed along the walls of the seminiferous tubules. In the same localization, faint immunofluorescence showing the presence of rat IgG was also detected. The same pattern was obtained when rabbit and rat IgG eluted from the testes of these rats were layered on sections of normal rat testis. Moreover, by immunoelectron microscopy, discontinuous deposits of rabbit IgG were detected along the basement membranes of the seminiferous tubules. Neither C3 deposits nor changes in the serum CH 50 were observed. By leucocyte migration inhibition reaction (LMIR) a cellular immune response to basement membrane antigens was detected. In the control group, 12% of the rats injected with normal rabbit serum presented mild interstitial cell infiltrates and occasional sloughing of the germinal epithelium. Neither deposits of rat IgG or rabbit IgG nor a cellular immune response were observed. PMID- 3973855 TI - The secretory immune system in the uterus of the pregnant rat: production of secretory component by uterine tissues. AB - Secretory component (SC) was measured in amniotic fluid, fetal serum, and maternal serum and compared with SC production during in vitro culture of uterine tissue segments from pregnant rats. The concentrations of SC in amniotic fluid did not change between days 14 and 20 of pregnancy. Similarly, there was no change in maternal or fetal serum during pregnancy, although, the levels of SC in sera were consistently higher than those in amniotic fluid. When uterine segments were incubated in vitro, release of SC was greater in the absence of cycloheximide than in the presence of cycloheximide at all stages of pregnancy. In contrast to SC values in amniotic fluid, however, SC production by uterine tissue changed markedly during pregnancy. SC levels were low during early pregnancy (day 7 post coitus) and increased to levels found in non-pregnant diestrous rats just prior to parturition (day 20). The findings suggest that the endocrine balance during pregnancy may play a central role in regulation of the uterus immune system. The pattern of SC release may reflect a need both to ensure protection of the fetus from the IgA immune system in early pregnancy and to prevent maternal infection during parturition by reactivation of this system. PMID- 3973856 TI - Dietary assessment of pregnant adolescents participating in a supplemental-food program. AB - We analyzed the energy-, nutrient- and food-intake patterns of pregnant adolescents before and during participation in a supplemental-food program. The dietary data on the pregnant adolescents were compared to those on older pregnant women and non-pregnant adolescents. Weight gain per trimester, hemoglobin and hematocrit values were reported. In general, the mean energy and nutrient values calculated from the diets of diet-supplemented, low-income pregnant adolescents as compared to other groups from the same area were not significantly different; however, the values calculated as a percentage of the recommended daily allowances (RDA) were significantly higher for the other groups. Mean weight gain per trimester for all the pregnant groups was within the recommended ranges. Mean hemoglobin and hematocrit values were within normal limits and comparable to values reported in other studies. The energy and nutrient values for the diets of the supplemented group were less than the RDA for several nutrients. However, when compared to the findings of most earlier studies, the mean values were greater. PMID- 3973857 TI - Perinatal outcome. Similarity and predictive value of antepartum and intrapartum assessment scales. AB - This study evaluated five risk-screening scales containing antepartum and intrapartum subscales. Two issues were addressed: (1) whether one scale is as good as another in screening obstetric patients for perinatal risk, and (2) whether intrapartum scores are more important predictors of perinatal outcome than are antepartum scores. Four of the five scales produced fairly similar total scores, but the overall value of these scores in predicting perinatal outcome was not as good as that shown by scores derived from the least similar scale. The major differences between scales were due to the specific antepartum items they contained. In general, the antepartum scores were found to influence the prediction of infant outcome more strongly, and intrapartum scores were more predictive of maternal outcome. PMID- 3973858 TI - Incidence, significance and remission of tubal spasm during attempted hysteroscopic tubal sterilization. AB - Four hundred three attempted hysteroscopic tubal sterilizations were performed. Tubal spasm was encountered in 37 cases (9.2%) and prevented bilateral placement of tubal plugs in 16 of those cases. There was some evidence that glucagon was associated with a higher rate of remission and that women using barrier birth control methods experienced a lower incidence of tubal spasm. A number of other factors were found to be unrelated to tubal spasm and its remission. PMID- 3973859 TI - Fetal heart rate tracings in fetuses with congenital malformations. AB - The fetal heart rate (FHR) tracings of 73 fetuses with gross congenital malformations were surveyed. Fifty-four percent of the tracings were pathologic. The most common pathologic tracing patterns were baseline bradycardia (30%), variable decelerations (25%), baseline tachycardia (22.5%) and decreased variability (20%). There was no characteristic tracing pattern for the whole group or any specific subgroup of malformations. The highest rates of pathologic FHR tracings were found in the groups with multiple malformations (83.3%), chromosomal aberrations (81.8%) and central nervous system lesions (71.4%). Twenty-three infants died neonatally, and 73.9% of them had pathologic FHR tracings. The rate of cesarean section was significantly higher in the group of malformed fetuses--17.8% as compared to 9.5% in the control group. Five of 13 malformed infants delivered by cesarean section died after delivery. Low birth weight and prematurity were more common in the group of malformed fetuses than in the control group. The fact that pathologic FHR tracing patterns occur both in the presence of a malformed fetus and as a result of fetal distress should suggest an early diagnosis of fetal malformation in order to avoid unnecessary obstetric interventions. PMID- 3973860 TI - Association of actinomyces and intrauterine contraceptive devices. AB - We analyzed the clinicopathologic aspects of 19 cases of actinomycosis associated with intrauterine devices (IUDs) seen and treated at hospitals affiliated with the State University of New York at Buffalo between 1972 and 1982. Clinical manifestations included the following: (1) asymptomatic IUD-associated Actinomyces colonization, (2) endocervicitis, (3) endometritis, (4) endometritis with salpingitis and/or tuboovarian abscesses and (5) abdominopelvic abscesses. No consistent relationship was found between the total peripheral lymphocyte count and/or degree of histologic lymphocytic reaction and the clinical picture. Abnormal uterine bleeding and/or discharge, pain, fever and abdominopelvic masses were among the symptoms and signs encountered. Patients with endocervicitis and/or endometritis responded to removal of the IUD, dilatation and curettage and antibiotic therapy for two to four weeks. Those who developed abscesses were treated successfully with surgical drainage and added antibiotic treatment. PMID- 3973861 TI - Umbilical cord cortisol in breech delivery. AB - Mixed umbilical cord blood samples were obtained in 31 cases immediately after vaginal breech delivery at term and in 31 cases immediately after vaginal vertex delivery at term. The total cortisol concentrations were determined using a direct radioimmunologic method (Amerlex cortisol kit). The mean umbilical cord total cortisol concentration was 790 +/- 363 nmol/liter in breech delivery as compared with 493 +/- 125 nmol/liter in vertex delivery. The difference was highly significant (p less than 0.0005). There was a highly positive correlation (r = 0.59, p less than 0.0005) between duration of labor and total cortisol concentrations in umbilical plasma after breech delivery. In contrast to that we found only a slightly positive correlation between duration of labor and total cortisol concentrations after vaginal vertex delivery (r = 0.23, p less than 0.10). Significant differences in pH values between breech and vertex deliveries (p less than 0.01) and a slight but significant correlation (r = 0.35, p less than 0.002) between umbilical vein pH values and umbilical total cortisol concentrations indicate that the increase in cortisol during vaginal breech delivery could be attributed partially to some hypoxic events. These results support the concept that the increase in cortisol in the umbilical cord plasma during labor reflects the fetal adrenal response secondary to stress in utero and contribute to our understanding of why an increased risk exists for the fetus during vaginal breech delivery of long duration. PMID- 3973862 TI - Testicular feminization syndrome. An unusual case with high estrogen levels. AB - In an unusual case of testicular feminization, the patient had a high estrogen and low testosterone level. The source of this female hormone excess may have been functioning gonadal stroma of either female or male derivation. All other aspects of the case were consistent with classic examples of the syndrome. PMID- 3973863 TI - Intrapartum pulmonary embolus. A case report. AB - Intrapartum pulmonary embolus is rare. In a case we encountered, both the mother and infant survived. The peripartum period is a relative contraindication to the use of thrombolytic therapy due to the risk of postpartum hemorrhage. The indications for embolectomy and vena caval interruption are the same as the ones generally accepted. PMID- 3973864 TI - Capnocytophaga isolated from the endometrium as a cause of neonatal sepsis. A case report. AB - Capnocytophaga, a genus of gram-negative, anaerobic organisms, was isolated from the endometrium of a postpartum woman and the blood of the neonate. This unusual organism, usually isolated from the oral cavity, is sensitive to most antibiotics except the aminoglycosides. PMID- 3973865 TI - Refractory status epilepticus in pregnancy. A case report. AB - Status epilepticus is an acute, life-threatening potential complication of pregnancy in the epileptic patient. It is important that obstetricians become familiar with the initial control of such seizure activity to decrease maternal and fetal morbidity and mortality. PMID- 3973866 TI - Obstetric significance of fetal craniofacial duplication. A case report. AB - Craniofacial duplication (diprosopus) is a rare form of conjoined twins. Whenever fetal hydrocephalus is diagnosed, a careful search for other anomalies, such as diprosopus, is mandatory. The obstetric management depends upon the time of the diagnosis. PMID- 3973867 TI - Morbidity of simple cholecystectomy and cholecystectomy with transduodenal sphincteroplasty. AB - Exploration of the common bile duct via transduodenal sphincteroplasty is thorough and provides an opportunity for the natural passage of retained calculi. However, this procedure destroys both the sphincter ampulla and sphincter choledochus, the sequelae of which are unknown. Fifty patients who had a transduodenal sphincteroplasty performed between 1970 and 1980 were randomly selected and compared with 50 patients who only had cholecystectomy. They were all seen in the outpatient department, assessed on a modified Visick scale and had liver function tests performed. There was no statistical difference in the subjective quality of result or in the liver function of the sphincteroplasty group when compared with the cholecystectomy patients, which suggests that destruction of the sphincters does not appear to be harmful to the patient. PMID- 3973868 TI - Teenage pregnancy and motherhood. AB - In a random sample of British-born women from a deprived inner London borough who were expecting their first baby, 31% were teenagers at the time they gave birth. The teenage mothers were compared with a group of older women randomly selected from the sample and both groups were followed up for 6 1/2 years after the birth. The teenage mothers were more likely to have had a deprived background and to have experienced material disadvantage. Despite this, they and their children did as well as the older women on a wide variety of measures of physical and mental health. A comparison of the teenagers with another sample of women who did poorly (those who had been brought up in care) suggests that the lack of an adverse result amongst the teenagers was at least in part due to support from the womens' own mothers. PMID- 3973869 TI - Vascular injuries to the extremities following blunt trauma: discussion paper. PMID- 3973870 TI - Acoustic impedance measurement as screening procedure in children: discussion paper. PMID- 3973871 TI - Hypnosis in terminal care: discussion paper. PMID- 3973872 TI - Whose file is it anyway? Discussion paper. PMID- 3973873 TI - Sclerotherapy--prevention of accidents: a review. PMID- 3973875 TI - Dissecting thoracic aortic aneurysm perforating the oesophagus and masquerading as peptic ulcer disease. PMID- 3973874 TI - Acquired immunodeficiency syndrome and Kaposi's sarcoma. PMID- 3973876 TI - Brucellosis as a rare cause of spondylitis. PMID- 3973878 TI - Filophilia. PMID- 3973877 TI - Overheating and the haemorrhagic shock and encephalopathy syndrome. PMID- 3973879 TI - Women and minor psychiatric morbidity. PMID- 3973880 TI - AIDS, Kaposi's sarcoma and the dermatologist. PMID- 3973881 TI - Monitoring and treatment of raised intracranial pressure in children. PMID- 3973882 TI - Counselling in general practice. PMID- 3973883 TI - Eight years' experience of Concorde operations: medical aspects. PMID- 3973885 TI - Surgical relief of obstructive jaundice in a district general hospital. AB - Fifty consecutive patients with obstructive jaundice treated by operation in Canterbury & Thanet Health District hospitals under the care of one surgeon (RECC) over a 6-year period have been studied. The pathology was found to be common bile duct (CBD) stone in 22 patients (44%); pancreatic carcinoma in 15 (30%), 3 of whom also had CBD stones; chronic pancreatitis in 4 (8%); extrahepatic CBD carcinoma in 4 (8%); ampulla of Vater carcinoma in 3 (6%); primary duodenal carcinoma in 1 (2%); and portahepatis obstruction in 4 (8%). The 8 postoperative deaths (16%) were found to be associated with high preoperative levels of serum bilirubin, but all occurred in patients with malignant disease. Complications occurred in 20 patients (40%) and bile culture state was found to be intimately related to the morbidity rather than operative mortality. The study represents a careful audit of the pathology distribution and the surgical management of obstructive jaundice as seen in district hospitals. PMID- 3973886 TI - Campylobacter colitis: differentiation from acute inflammatory bowel disease. AB - We describe 10 patients with campylobacter colitis who gave a characteristic history of an acute diarrhoeal illness, rectal bleeding and colicky abdominal pain. For the majority of patients the clinical and sigmoidoscopic features differentiated campylobacter colitis from acute inflammatory bowel disease. Where doubt remained, evidence of a specific antibody response to campylobacter enabled a presumptive clinical diagnosis to be confirmed. PMID- 3973884 TI - Primary carcinoma of the fallopian tube: favourable response to new chemotherapeutic agent, CHIP. AB - Two cases are reported of recurrent fallopian tube carcinoma treated with CHIP (cis-dichloro-transdihydroxy-bis-isopropylamine platinum IV), a new cis-platinum analogue, resulting in one complete (though transient) and one good partial remission. PMID- 3973887 TI - Minneapolis hip prosthesis in severe destructive lesions of the femur. AB - The use of the Minneapolis prosthesis was abandoned about 1955 by its originators, who had used it without acrylic for uncomplicated fractures of the femoral neck. This is the first report of its use with 'cement' fixation. It has been found to be very useful and reliable for arthroplasty of the hip in 57 patients with carcinomatous or other severe destructive lesions in the trochanteric region of the femur, being more convenient and easier to use than alternative prostheses and especially valuable in metastatic disease. Technical points relating to operative techniques are described, and postoperative Hamilton Russell traction is recommended. PMID- 3973888 TI - Protective role of faecal pH in experimental colon carcinogenesis. AB - There is epidemiological evidence that populations with alkaline stool pH are at greater risk for colon cancer than populations with acid stool pH. This association was investigated in the laboratory using the rat-dimethylhydrazine colon carcinogenesis model. Rats with acid stool pH, produced by consumption of lactulose or sodium sulphate or both, had significantly fewer colon tumours after injections of dimethylhydrazine (DMH) than rats treated with DMH alone. The results confirm the hypothesis that acidification of the stool can protect against the induction of colon cancer. PMID- 3973889 TI - Allergy to insect stings: a review. PMID- 3973890 TI - Gorlin's syndrome. PMID- 3973891 TI - Spontaneous rupture of the ureter proximal to ureteric stone. PMID- 3973892 TI - Phimosis of the prepuce of the clitoris: indication for female circumcision. PMID- 3973893 TI - Unusual presentation of Meckel's diverticulum. PMID- 3973894 TI - Elephantine sarcoidosis presenting as ulcerating lymphoedema. PMID- 3973895 TI - Dangers of Clinitest ingestion. PMID- 3973896 TI - The overworked or fraudulent diagnosis of food allergy and food intolerance in children. PMID- 3973897 TI - Food allergies and bowel disease. PMID- 3973898 TI - Skin disorders and food allergy. PMID- 3973899 TI - Structure-activity relationships of C-terminal tri- and tetrapeptide fragments that inhibit gastrin activity. AB - A series of tri- and tetrapeptide derivatives, analogues of the gastrin C terminal region with no phenylalanine residue, were synthesized. These peptides were tested for their ability to inhibit gastrin-stimulated acid secretion in vivo as well as binding of [125I]-(Nle11)-HG-13 to gastric mucosal cell receptors in vitro. Most of the peptides tested exhibited gastrin antagonist activity in vivo and in vitro. Most active derivatives were 20-30 times more potent than the well-known gastrin antagonist derivatives proglumide and benzotript and had 20 200 times more binding affinity. The smallest fragment exhibiting antagonist activity was the tripeptide Boc-L-tryptophyl-L-methionyl-L-aspartic acid amide. PMID- 3973900 TI - Alkyl esters of 3-adenin-9-yl-2-hydroxypropanoic acid: a new class of broad spectrum antiviral agents. AB - A new class of acyclic adenosine analogues is described which exhibit broad spectrum antiviral activity and are apparently targeted at S-adenosyl-L homocysteine hydrolase. The compounds are all alkyl (i.e., methyl, ethyl, 1 propyl, 2-propyl, 1-butyl, 2-butyl, 2-methylpropyl, tert-butyl, 1-pentyl, 3 methylbutyl, 1-octyl, 2-hydroxyethyl, 2-methoxyethyl, furylmethyl, cyclohexyl) esters of (RS)-3-adenin-9-yl-2-hydroxypropanoic acid. They are inhibitory to a broad variety of viruses, including vesicular stomatitis, vaccinia, reo, parainfluenza, and measles, and, with one exception (the furylmethyl ester), nontoxic to the host cell at antivirally active concentrations. It is postulated that the alkyl esters are as such taken up by the cells and hydrolyzed within the cells to release the parent compound, 3-adenin-9-yl-2-hydroxypropanoic acid. PMID- 3973901 TI - Synthesis and antiarrhythmic and parasympatholytic properties of substituted phenols. 3. Modifications to the linkage region (region 3). AB - As part of a continuing program of systematically modifying the structure of the class I antiarrhythmic drug changrolin, we synthesized 15 analogues in which the linkage between the two aromatic regions was altered. High antiarrhythmic activity and low parasympatholytic activity was found when the linkage region, designated region 3, contained a carbonyl moiety, including ketones, amides, and ureas. Secondary amides were superior to tertiary amides, while amide reversal resulted in no change in activities. One compound in this series, 7, 2,6-bis(1 pyrrolidinyl-methyl)-4-benzamidophenol (ACC-9358), is undergoing preclinical evaluations. PMID- 3973902 TI - Receptor-based design of dihydrofolate reductase inhibitors: comparison of crystallographically determined enzyme binding with enzyme affinity in a series of carboxy-substituted trimethoprim analogues. AB - By the use of molecular models of Escherichia coli dihydrofolate reductase (DHFR), analogues of trimethoprim (TMP) were designed which incorporated various 3'-carboxyalkoxy moieties in order to acquire ionic interactions with positively charged active-site residues. Certain of these compounds have shown exceptionally high affinity for this enzyme. For example, the 3'-(carboxypentyl)oxy analogue was found to be 55-fold more inhibitory than TMP toward E. coli DHFR (Ki = 0.024 nM vs. 1.32 nM for TMP). X-ray crystallographic studies of E. coli DHFR in binary complexes with TMP and two members of this acid-containing series of compounds defined the binding of these inhibitors and showed the carboxyl group of the latter two inhibitors to be ionically bound to Arg-57. These observations were in agreement with postulated binding modes that were based on receptor modeling. PMID- 3973904 TI - Octahydrobenzo[g]quinolines: potent dopamine agonists which show the relationship between ergolines and apomorphine. AB - A synthesis of all four diastereoisomeric 3-(tert-butoxycarbonyl)-1,6 dimethoxyoctahydrobenzo[g]quinolines 13a-d is presented. The two trans isomers 13b and 13c have been converted to tricyclic analogues 20 (CV 205-502) and 26 (205-503) of the potent dopaminomimetic ergolines CQ 32-084 and pergolide, respectively. These two compounds combine the essential moiety of apomorphine with the important 8-substituents of ergolines. Preliminary pharmacological evaluation of 20 and 26 suggests that these novel dopamine agonists combine the specificity of apomorphine with the potency, long duration of action, and good oral activity of the ergolines. PMID- 3973903 TI - 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors. 1. Structural modification of 5-substituted 3,5-dihydroxypentanoic acids and their lactone derivatives. AB - A series of 5-substituted 3,5-dihydroxypentanoic acids and their derivatives have been prepared and tested for inhibition of HMG-CoA reductase in vitro. In general, unless a carboxylate anion can be formed and the hydroxy groups remain unsubstituted in an erythro relationship, inhibitory activity is greatly reduced. Furthermore, only one enantiomer of the ring-opened form of lactone 6a(+/-) possesses the activity displayed by the racemate. Insertion of a bridging unit other than ethyl or (E)-ethenyl between the 5-carbinol moiety and an appropriate lipophilic moiety (e.g., 2,4-dichlorophenyl) attenuates activity. PMID- 3973905 TI - Bicyclic and tricyclic analogues of anthramycin. AB - As analogues of pyrrolo[2,1-c][1,4]benzodiazepine antitumor antibiotics, such as anthramycin and tomaymycin, several benzo[1,4]diazepine imines and carbinolamine ethers were prepared and tested in vivo against P388 leukemia. Two different synthetic approaches, namely, a reduction of an aromatic nitro group with a concomitant cyclization and a reduction of a lactam, were employed to generate an imine or a carbinolamine moiety. Bicyclic analogues 6a', 6f, and 6g were found to be active, indicating that the pyrroline ring of anthramycin is not an absolute necessity for the antitumor activity. Compound 6g, 3,4-dihydro-9-hydroxy-4 propargyl-5H-1,4-benzodiazepin-5-one, was at least as active as neothramycin although it was 5 times less potent. Among the tricyclic analogues, compounds 5, 7a, and 8b were active against P388 leukemia, and they generally appear to be more potent than bicyclic analogues. PMID- 3973906 TI - Career choice of 'fifth pathway' graduates from New York state medical schools. AB - Graduates of "fifth pathway" programs at medical schools in New York state between 1976 and 1978 were studied to determine their professional careers and choice of medical specialties. Of the 545 physicians participating in the program, 510 were able to be located. Of this latter cohort, 177 (34.7 percent) had entered primary care fields as of 1981. Of the physicians no longer in residency training, 19.1 percent had full-time salaried positions in academic institutions, and the remaining physicians were engaged in various clinical medical activities. Of the 545 fifth pathway graduates, 74 (13.6 percent) had not been able to pass the licensing examinations as of 1981, and an additional 54 (9.9 percent) had not taken those examinations. Comparisons with regular students graduating from a medical school in New York state showed that fifth pathway graduates were more likely to select nonprimary care specialties than primary care specialties (p less than 0.001). These data suggest that although a majority of graduates of fifth pathway programs in New York state are involved in the provision of health care, a small number are still unable to engage in the practice of medicine. PMID- 3973907 TI - Timing and motivation in pediatric career choices. AB - A total of 257 third-year residents in pediatrics, internal medicine, and family practice were asked about their career goals for the year following their residency and in five years, and information was obtained from them about their motives for career choices. The authors specifically examined the following: humanitarian interests; intellectual motivation; service motives; and practical, personal, and financial considerations. The characteristics of the residency training program which may have influenced their career choices were also examined. A majority of the 214 pediatric residents said they had not considered going into pediatrics on entry to medical school. Of these residents, 109 planned academic pursuits for the following year, while only 81 of the 109 anticipated an academic career within five years. Intellectual stimulation, geographic location, and an "opportunity to clarify goals" were the three most frequently mentioned factors in choosing positions for the following year. PMID- 3973908 TI - A model for teaching the brief psychosocial interview. AB - A technique to teach first-year medical students to conduct brief interviews that focus on how medical illness affects the daily life of patients is described. The technique includes a conceptual model of the interview and an explicit teaching method for instructors and students. With the conceptual model, the structure, goals, and techniques of interviewing are identified, and an operational definition of empathic interviewing is provided. The teaching methods include a manual and a seminar for faculty members, a syllabus for students, workshops for students using live patient volunteers, and evaluations of the students' interviews based on the conceptual model. PMID- 3973909 TI - Validity coefficients of clinical competence on NBME part III examination. PMID- 3973910 TI - Attitudes of internal medicine residents and staff physicians toward various patient characteristics. PMID- 3973911 TI - Use of a rotating 'minicourse' in clinical clerkships. PMID- 3973912 TI - Preceptorships in family medicine for second-year medical students. PMID- 3973913 TI - The 'preresidency syndrome': an incipient epidemic of educational disruption. PMID- 3973914 TI - Basic science studies. PMID- 3973915 TI - Association of American Medical Colleges. Annual meeting and annual report, 1984. PMID- 3973916 TI - Automated recognition of atypical nuclei in breast cancer cytology specimens by iterative image transformations. AB - In order to develop an objective grading system for nuclear atypia in breast cancer, an image analysis technique has been applied for the automated recognition of enlarged and hyperchromatic nuclei in cytology specimens. The image segmentation algorithm, based on the 'top hat' image transformation developed in mathematical morphology, is implemented on the LEYTAS automated microscope system. The performance of the segmentation algorithm has been evaluated for fifty malignant and eighty-five benign breast lesions by visual inspection of the displayed 'flagged' objects. The mean number of flagged objects per 1600 image fields for breast cancers was 887 (range 0-7920) of which 87% consisted of single, atypical nuclei. For benign lesions the mean number was 30 (range 0-307) of which 20% were single nuclei. By adaptation of the 'top hat' parameter values, a more extreme subpopulation of atypical nuclei could be discriminated. The large interspecimen variation in the breast cancer results was related to differences in DNA content distribution and mean nuclear area, determined independently with scanning cytophotometry, and to some extent with the histological type. PMID- 3973917 TI - A simple chamber for observing microscopic specimens in both top and side views. AB - A method is described which permits the observation of microscopic specimens in both top and side views, a rapid change between the two views being possible without disturbing the specimen. The system requires the introduction of simple optical components into a culture chamber, does not restrict the types of microscopy that may be used, and does not necessitate modification of the microscope itself. The technique is discussed in relation to the study of tissue cells in culture, but may find applications in other areas. PMID- 3973918 TI - A tannic acid based preparation procedure which enables leucocytes to be examined subsequently by either SEM or TEM. AB - A modification of the glutaraldehyde-osmium tetroxide-tannic acid-uranyl acetate (GOTU) fixation procedure is described which allows human leucocytes to be examined subsequently by either transmission electron microscopy (TEM) or scanning electron microscopy (SEM). PMID- 3973919 TI - Weighted least squares estimation of background in EELS imaging. AB - In quantitative Electron Energy Loss Spectrometry, a weighted least squares estimation should theoretically be used to estimate the background law below core edge energy, since the variances of the data vary. However, it is found that proper weighting makes the above edge signal-to-noise ratio decrease rather than increase. This result is discussed, and the influence of the bias introduced by the logarithmic transformation of the data is quantified. PMID- 3973920 TI - Does blood pressure cuff size make a difference in blood pressure readings? PMID- 3973921 TI - Tumor previa: a perinatal dilemma. PMID- 3973922 TI - Rotatory subluxation of the scaphoid. PMID- 3973923 TI - Emotional factors in the patient's illness. PMID- 3973924 TI - Form and function of the masticatory musculature in the tree sloths, Bradypus and Choloepus. AB - The tree sloths, Bradypus and Choloepus, show unusual masticatory specializations, compared to each other and to other mammals. Both have an incomplete zygomatic arch with descending jugal process, a complex superficial masseter, a large temporalis and medial pterygoid musculature, and a lateral pterygoid with two heads. In Choloepus the deep masseter and zygomaticomandibularis are typical when compared to other mammals. However, in Bradypus there is an ascending jugal process from which enlarged and vertically oriented deep masseter and zygomaticomandibularis muscles originate. Although both sloths are folivores, the anterior teeth in Choloepus are caniniform, while those of Bradypus have lost such elongation. In both sloths the glenoid cavity is similarly located; however, in Bradypus the craniomandibular joint is raised above the occlusal plane, and the pterygoid flanges are elongated. Prediction of the evolutionary sequence of cranial changes from Choloepus-like (primitive) to Bradypus-like (derived) morphology is based upon the most parsimonious model of masseter-medial pterygoid complex changes for masticatory efficiency improvement. The model proposes that the condylar neck in Bradypus was elongated and that this single change predicated a series of other structural changes. Mandibular movement patterns in both sloths showed anteromedially directed unilateral power strokes as in other mammals. Puncture-crushing, tooth-sharpening, and chewing cycles are distinct in Choloepus, less so in Bradypus. The masticatory rate is slow in sloths compared to other mammals of similar body size, averaging 590 ms per cycle for Choloepus and 510 ms for Bradypus. PMID- 3973925 TI - Anatomy of raccoon (Procyon lotor) and coati (Nasua narica and N. nasua) forearm and leg muscles: relations between fiber length, moment-arm length, and joint angle excursion. AB - Muscle architecture, moment arms, and locomotor movements in the distal limb segments of the procyonids Nasua (coati) and Procyon (raccoon) are analyzed with reference to patterns of muscle fiber length. This study addresses the hypothesis that relative fiber lengths among muscles in a muscle group can be predicted on the basis of correlates of muscle tension. The results include the following: consistent patterns of fiber length of muscles in a muscle group exist within and between the two genera. Differences in fiber length between muscles can be accounted for by two principal correlates of muscle excursion--length of a muscle's moment arm about a joint and joint-angle excursion. Muscle fiber pinnation permits increased tendon excursion, but this effect is relatively small in comparison to the effects of moment-arm length and joint-angle excursion. Corollary action between two or more joints (or lack thereof) is an important factor in determination of fiber lengths. PMID- 3973926 TI - A freeze-fracture study of postembryonic differentiation of latissimus dorsi muscles of the chicken. AB - The differentiation of fiber type characteristics in the anterior (ALD) and posterior (PLD) latissimus dorsi muscles is examined by the freeze-fracture technique in 1-, 7- and 30-day-old chicks. Several characteristics of plasma membrane (caveolae, rectilinear arrays, intramembranous particles) and sarcoplasmic reticulum which show fiber type differences in the adult ALD and PLD muscles are compared in the developmental stages. The caveolar density in the ALD fibers is about 20/microns2 at 1 day increasing to about 37/microns2 at 30 days, whereas in the PLD fibers it remains at about 20/microns2 during this period. The distribution of the caveolae in the two muscles is different from the beginning; in the ALD fibers the caveolae are distributed throughout the plasma membrane and in PLD fibers they are patterned into clusters overlying the I band regions. The density of intramembranous particles of 1-day ALD and PLD plasma membranes appears similar, but by 7 days the particle counts in the sarcolemma of the ALD muscle are about twice as numerous as those in the PLD muscle. The rectilinear arrays are virtually absent in the ALD muscle, whereas in the PLD muscle their density is about 10/microns2 at 1 day and about 20/microns2 at 7 days. Already at 1 day posthatching the SR in ALD and PLD fibers has the adult configuration, i.e., an open irregular network in ALD fibers and periodically arranged tubules with triadic expansions in the PLD fibers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3973927 TI - Facial morphology and vibrissal movement in the golden hamster. AB - The major cranial vibrissae in the golden hamster can be moved in complex ways that suggest they are served by a finely controlled motor system. Movements are hypothesized to be the products of differential blood flow and pressure regulation in the sinus surrounding each vibrissal follicle, contractions of the striated facial muscles, and elastic rebound in the connective tissues. The vasculature contributes hydrostatic forces that erect the vibrissae slightly and distort their connective tissue bedding, rigidify the vibrissal capsules, thus forming firm bases of attachment for certain facial muscles, and theoretically provide a pressure plate around the follicle, important in lowering the firing thresholds of receptor endings. The facial muscles supply the major forces in erection and protraction of the vibrissae by acting on both the capsules and the connective tissue bedding. The connective tissues are organized into capsular and extracapsular systems that serve to stabilize the vibrissae and return them to initial rest positions. The slight movements of the genal vibrissa are the effects of vascular and connective tissue dynamics, the musculature being uninvolved. Wide angle movements of the supraorbital vibrissae are products of the vasculature and connective tissues, plus contractions of the Mm. orbicularis oculi and frontalis. Mystacial vibrissal movement is quite complex. The vasculature supplies a small degree of capsular erection and mystacial pad distortion, but primarily rigidifies the capsules. The bulk of erection and protraction is produced by the M. nasolabialis profundus (NLP) and the vibrissal capsular muscles (VCM). The NLP distorts the mystacial pad; the VCM tilt the capsules relative to the pad. Retraction is mainly accomplished by elastic rebound in the pad, this being aided in its extreme degrees by the Mm. nasolabialis and maxillolabialis. The Mm. nasolabialis superficialis and buccinator pars orbicularis oris help to spread the vibrissae into a dorsoventral fan and stabilize the mystacial pad during whisking. PMID- 3973928 TI - Biology of the nerve growth cone. PMID- 3973929 TI - Neuron-specific growth cone properties as seen in identified neurons of Helisoma. AB - By using cell-cultured identified neurons of the snail Helisoma, we demonstrate that the growth cones of different neurons are intrinsically different from one another in terms of their structure, behavior, and response to environmental signals. Structurally neuron 5 has a greater number of filopodia per growth cone, has shorter filopodia, and has a smaller interfilopodial distance than neuron 19. Behaviorally, the growth cones of neuron 5 advance over the substratum at a faster rate than those of neuron 19; and the growth cones of neuron 19, but not of neuron 5, respond to the presence of serotonin in their environment by retracting their filopodia. In addition to such intrinsic differences between the growth cones of different neurons, we also demonstrate that the separate growth cones of a single neuron, while having identical properties, can act independently of one another. Focal application of serotonin to a growth cone causes only a localized retraction of that growth cones' filopodia. Other growth cones that are attached to the same neuron but that are not exposed to serotonin retain their normal structural features. PMID- 3973930 TI - A quantitative study of growth cone filopodial extension. AB - The extension of filopodia from growth cones of regenerating neurites from rat superior cervical ganglion neurons in tissue culture was studied. Cultures were grown on a thin layer of fibrous collagen and maintained in a medium containing serum and nerve growth factor. Time-lapse cinematography and computer-assisted morphometry were used to observe and measure the kinetics of extension of individual filopodia. Filopodia extended from the growth cone margin, trailing neurite, or from each other. Frequently, extension was preceded by the appearance at the cone margin of a nodule of cytoplasm which appeared dense in phase contrast optics. Branch points between adjacent extending filopodia remained fixed with respect to the growth cone while the filopodia lengthened. The rate of extension was maximum just after initiation (0.12 +/- 0.4 micron/sec; mean +/- SD; n = 36) and declined thereafter until the filopodium collapsed. This initial rate of extension was directly correlated with the eventual length of the filopodium (r = 0.67). Filopodia of growth cones arising from embryonic neurons exhibited higher initial extension rates (range: 0.07 to 0.20 micron/sec; mean = 0.13 micron/sec) than those of postnatal neurons (range: 0.01 to 0.13 micron/sec; mean = 0.09 micron/sec). These data are discussed in relation to a model proposed by Tilney and Inoue [1982] for the extension, by distal addition of G-actin to growing filaments, of another type of elongating process filled with microfilaments, the acrosomal process of Thyone sperm. PMID- 3973931 TI - Regulation of growth cone morphology by nerve growth factor: a comparative study by scanning electron microscopy. AB - The object of this study was to document and analyze local regulation by nerve growth factor (NGF) of neuronal growth cone properties and to explore the possible diversity of this effect in various NGF-responsive preparations. In particular, scanning electron microscopy was used to characterize the morphology of neuronal growth cones in cultures of dissociated chick embryo dorsal root ganglia (DRG) under conditions of continuous NGF exposure, withdrawal of NGF for 5-6 hr, and restoration of NGF for various times. Comparison was made with similarly manipulated cultures of dissociated newborn rat sympathetic ganglia and neurite-bearing PC12 pheochromocytoma cells. The growth cones of most of the continuously NGF-treated DRG neurons (cultured on poly-L-lysine or collagen coated glass coverslips) had relatively compact central flattened areas and numerous prominent filopodia. Withdrawal of NGF resulted in a marked spreading of the central growth cone area so that the average maximum width of this structure increased by about threefold as compared to nondeprived cultures. The mean number and lengths of filopodia were unaffected. Restoration of NGF brought about, over a time course of tens of minutes, a return of the original type of growth cone morphology. Rather different responses were observed for the sympathetic neuron and PC12 cultures. Here, surface ruffles, only rarely seen in the chick cultures, were a major feature of the growth cones, whereas filopodia, though present, were less prominent. Removal of NGF led to loss of ruffles and to rounding up of the growth cones; NGF readdition elicited a rapid (less than 30 sec) reinitiation of ruffling and a more gradual (over tens of minutes) respreading of growth cones. These findings illustrate not only that NGF can regulate growth cone properties, but also that there is a diversity as to how this is manifested. Possible mechanisms and biological roles for this regulation are discussed. PMID- 3973932 TI - Sensory neurite growth cone guidance by substrate adsorbed nerve growth factor. AB - The response of growth cones from embryonic chick dorsal root ganglia to a patterned substrate of adsorbed nerve growth factor (NGF) was studied. The patterned substrate presented growth cones with an adsorbed NGF pattern and NGF free substrate. NGF-responsive growth cones from 7 and 9 day ganglia could not proceed onto NGF-free substrate, reproducing the adsorbed NGF pattern. NGF unresponsive growth cones from 17 day ganglia did not display any preference for adsorbed NGF or NGF-free substrata, which resulted in neurites not reproducing the adsorbed NGF pattern. Neurite outgrowth from NGF responsive 7-day ganglia onto a patterned NGF substrate, in NGF-containing medium, was radially symmetrical, exhibiting no growth cone response to the patterned NGF substrate. The lack of NGF-responsive growth cone extension onto NGF-free substrate indicates that NGF is a requirement for neurite elongation. If NGF is withdrawn from growth cones by microperfusion, neurite elongation ceases. Thus, an adsorbed pattern of NGF may be duplicated because growth cones are not able to extend onto NGF-free substrate, since NGF is a requirement for neurite elongation. These results indicate that substrate adsorbed NGF can support neurite formation and elongation as well as guide the direction of neurite elongation. PMID- 3973933 TI - Guidance of neurite outgrowth by pathways of substratum-adsorbed laminin. AB - Neurite outgrowth is guided by narrow pathways of bioactive laminin. These pathways are created by ultraviolet light irradiation of laminin-coated coverslips masked with electron microscope grids. Patterned outgrowth of neurites is independent of gross mechanical guidance and guidance caused by substrate limitation. Cells on unirradiated laminin are less readily displaced by shear forces than cells on irradiated laminin. This study suggests that ultraviolet light alters the adhesive properties of laminin and that differential cell substratum adhesion may guide extending neurites on the purified naturally occurring substance, laminin. PMID- 3973934 TI - Electrical and ionic controls of tissue cell locomotion in DC electric fields. AB - The motility of fish epidermal cells (keratocytes) was examined in the presence and absence of DC electric fields. In fields of 0.5-15 V/cm, single epidermal cells, cell clusters, and cell sheets migrate toward the cathode. Cell clusters and sheets break apart into single migratory cells in the upper range of these field strengths. During locomotion, keratocytes extend broad lamellipodia, which contain a pervasive actomyosin network. The lamellipodial extension and locomotion of keratocytes are reversibly inhibited by a variety of calcium channel antagonists, whereas their motility is unaffected by hyperpolarizing and depolarizing (low and high K+) media. Microtubule disassembly has no effect on cell morphology, motility or the ability of the cells to be guided by a DC electric field. Using these results, the role that membrane-regulated Ca2+ influx may play in generating cytoskeletal and protrusive activity in keratocytes and other cells is discussed in some detail. Mechanisms by which an external electric field may bias transmembrane ion fluxes and thereby control cell locomotion are also examined. PMID- 3973935 TI - Response of nerve growth cone to focal electric currents. AB - Monopolar electric current pulses were focally applied through a micropipette to the growth cone of Xenopus embryonic neurons in culture. Application of the current directly in front of the growth cone modulated the rate of growth cone extension: Negative (sink) currents increased the growth rate, while positive (source) currents reduced the growth rate. When the currents were applied in a direction perpendicular to the direction of the neurite growth, both negative and positive currents produced inhibitory effects. Application of a negative focal current at a 45 degree angle with respect to the direction of neurite growth resulted in an oriented growth of the neurite toward the current sink. However, after the growth cone had been attracted to the vicinity of a current sink, further extension of the neurite was inhibited. These current effects occur rapidly after the onset of the current application, and are at least partially reversible within 1 hr after the termination of the current. The magnitude of current density required to induce a growth cone response was found to be in the order of a few pA per micron2. Such current density is close to that which may be generated at the muscle cell surface by the acetylcholine molecules released from the growth cone during the early phase of nerve-muscle contact. PMID- 3973936 TI - Polyribosomes under developing spine synapses: growth specializations of dendrites at sites of synaptogenesis. AB - We have previously reported that there is a dramatic increase in polyribosomes associated with dendritic spines during periods of synapse growth induced by denervating lesions. We suggested that polyribosomes at the postsynaptic site may somehow be involved in the growth of synapses. To evaluate this hypothesis further, the present study determines whether synapses which are growing in the developmental period also have accumulations of polyribosomes. We examined the dentate gyrus of the developing rat electron microscopically at 7, 10, 15, 20, and 28 days of age, which spans the major period of synaptogenesis in this structure. Qualitative observations revealed dramatic accumulations of polyribosomes under spine synapses in the youngest animals (7 and 10 days of age). With synapse development, the accumulations of polyribosomes became less dramatic, so that by 28 days of age, the neuropil of the dentate gyrus appeared qualitatively mature. To determine the relationship between polyribosomes under spine synapses and synapse development, quantitative electron microscopic methods were use to evaluate synapse density (number of synapses/100 micron 2), and the incidence of polyribosome-containing spines (proportion of spine synapses with underlying polyribosomes) in the neuropil of the dorsal blade of the dentate gyrus at each age. An inverse relationship was found between synapse density and the proportion of spines with polyribosomes. Synapse density increased in an almost linear fashion between 7 and 28 days of age to levels which were actually somewhat higher than in mature rats, whereas the incidence of polyribosome containing spines was highest at the youngest ages and decreased with development. Thus, polyribosomes were most prominent under spine synapses during the period of maximal synapse growth. These results, together with our previous observations of increased numbers of polyribosomes under spines during lesion induced growth, suggest that the polyribosomes represent a structural specialization of dendrites at sites of synapse construction. We propose that they produce protein(s) that are involved in synapse growth. PMID- 3973937 TI - Altered cell proliferation in burns. PMID- 3973938 TI - Definition of a burn injury-induced immunosuppressive serum component. AB - We and others have previously observed that immunologic activity can often be restored to both lymphocytes and neutrophils by removing them from the burn environment, leading to the conclusion that burn serum contains substances capable of suppressing immunologic function. The present studies were initiated to better define the serum component(s) responsible for this immunosuppression. The majority of immunosuppressive activity vs. both neutrophil chemotaxis and mixed lymphocyte cultures contained in large-volume serum samples obtained from three patients with greater than 40% body surface area flame burns was found to reside in a less than 25,000 mw fraction of serum obtained by Amicon ultrafiltration. A single suppressive serum component was isolated by precipitation and resuspension, followed by ion-exchange chromatography using an SP Sephadex C-25 column. Purity of the samples was verified by SDS slab-gel electrophoresis, and immunosuppressive activity was confirmed vs. both lymphocytes and neutrophils. Analysis of this isolated burn-associated suppressor indicates: a) a molecular weight of between 1,000 and 5,000 daltons; b) a complex composition containing a protein component, a lipid component, and a carbohydrate component; c) a structure which is heat stable, pH stable and unaffected by treatment with trypsin, proteinase K, DNAse, and RNAse; and d) a noncytotoxic immunosuppressive mode of action. It appears that the suppressive activity is dependent upon a prostaglandin portion of this low molecular weight complex. PMID- 3973939 TI - A prospective study of myocardial damage in electrical injuries. AB - A prospective study was undertaken to determine the incidence of possible myocardial damage following electrical injury. Sixteen patients with non-flash electrical injuries were assessed utilizing serial electrocardiograms (ECG), creatine kinase (CK) and MB creatinine kinase (MB-CK) determinations, technetium 99m stannous pyrophosphate scans, and 24-hour Holter monitors. Results showed that five patients (31%) had abnormal ECG, nine patients (56%) had elevations of the MB-CK isoenzyme, and one patient had a transiently abnormal Holter monitoring. No patient had an abnormal technetium pyrophosphate cardiac scan. Of the nine patients with elevated MB-CK levels, only two had abnormal ECG. None of the patients had clinical evidence of cardiac dysfunction. These results indicate a poor correlation of elevated MB-CK levels with ECG abnormalities, and demonstrate a relatively low incidence of myocardial damage in association with electrical injuries. PMID- 3973940 TI - Primary closure of wounds in burned tissue: experimental and clinical study. AB - Penetrating wounds in burn tissue may become infected, therefore primary closure of such wounds has only been recommended for lacerations of the face. To determine if wounds in burned areas can be closed primarily if seen early, we created partial- or full-thickness thermal burns in guinea pigs (n = 54) and made incisions through the burned tissue. One side was closed primarily at variable time intervals postburn. Infectious complications were determined by observation and the quantitative bacterial smear technique. All wounds closed primarily at 24 hours or longer postburn became infected. Wounds closed primarily at 4 hours postburn had fewer infectious complications than wounds left open (p less than 0.05). We also reviewed our experience with 23 multiply injured burn patients over an 11-year period who had peritoneal lavage or exploratory laparotomy. There were no wound infections in 12 patients with incisions closed primarily in unburned areas or in 11 patients with wounds through burned tissue. We conclude that lacerations or surgical incisions in burned tissues seen early (less than 12 hrs) postburn should be treated as wounds in unburned patients. Wounds in burned tissue seen late (greater than 24 hrs) postburn should be considered contaminated. PMID- 3973941 TI - Muscle devitalization in high-energy missile wounds, and its dependence on energy transfer. AB - Relations between the energy transferred by a high-velocity missile along a wound channel and the ensuing tissue destruction were studied in 25 live, anesthetized pigs. They were wounded in the muscular parts of the hind legs by an assault rifle bullet or by a spherical steel ball at about 1,000 m/s. The penetration of the assault rifle bullets was recorded by a stereo, multichannel flash X-ray arrangement. The energy transfer in the wound was evaluated from the X-rays. The wounds were surgically debrided in sections by a skilled surgeon. The energy transfer of the spherical steel bullets was measured. These animals had the thigh surrounded with a plaster of Paris cast, in order to suppress, as far as possible, the formation of the temporary cavity. The wounds were debrided. The amounts of tissue debrided were weighed and utilized as a measure of the extent of the injury. Good and consistent correlations between energy transfer and tissue debridement were obtained for the wound types studied. The amount of tissue debrided diminished by about 40% for the plaster-covered animals. Influence of boundary effects could be studied, and the results give indications of the mechanisms of missile wounding. PMID- 3973942 TI - The incidence of delayed traumatic intracerebral hematoma with extradural hemorrhages. AB - After introduction of computerized tomography (CT), we experienced 22 patients with traumatic extradural and intracerebral combined hematomas, of whom 15 underwent sequential CT scans. In 14 of the 22 patients or 13 of the 15 patients whose initial CT scans were performed early, within 6 hours after injury, intracerebral hematomas developed more slowly than extradural hematomas. In ten of the 13 patients, development of intracerebral hematomas was demonstrated only after removal of extradural hematomas, and in four patients acute brain swelling was observed during surgery. Therefore it is emphasized that the incidence of post-surgical intracerebral hematoma with extradural hemorrhages is high and that acute brain swelling during surgery for extradural hematomas is largely caused by the delayed intracerebral hematomas. PMID- 3973943 TI - The management of venous injuries in blunt extremity trauma. AB - Data on venous injury in blunt extremity trauma are scarce. The nature of injury and results of therapy in 22 patients presenting with blunt venous extremity injury at MIEMSS and KUMC in a 10-year period are presented. Comparisons of the outcome with venous ligation and repair, the use of anticoagulants, and the use of fasciotomy, led to the development of guidelines for the therapy of blunt venous injury in both upper and lower extremity trauma. PMID- 3973944 TI - Societal impact on surgical education in trauma. AB - Societal and demographic changes within Detroit have affected the incidence of trauma treated at the Detroit Medical Center. Using liver injury as an index, this phenomenon was studied by comparing 122 patients treated in 1972 with 38 patients treated in 1981. During 1972 76 patients had major injuries, compared to 13 patients in 1981. Intraoperative hemostasis of an actively bleeding liver in 1972 was achieved by liver suture (43 patients), resectional debridement through a nonanatomic plane (three patients), hepatic artery ligation (three patients), anatomic segmentectomy or lobectomy (four patients), and intrahepatic packing with later removal (one patient). During 1981, 13 patients had persistent bleeding requiring intraoperative hemostasis by liver suture (12 patients) or resectional debridement (one patient). This decline in trauma reflects a reduced city population, the dilutional effect of a four-quadrant emergency medical service begun in the mid 1970's, the implementation of a state gun law, and reduced citizen compliance to violence. These changes likely are not unique to Detroit and highlight the need for a National Trauma Registry which would not only help program directors design a meaningful trauma rotation but also help hospital planners accommodate to changes in patient exposure. PMID- 3973945 TI - Preparing the civilian surgeon for combat casualty management. PMID- 3973946 TI - Acute traumatic dislocations of the patella. AB - Twenty-three consecutive patients with acute traumatic dislocation of the patella were followed up for a mean period of 39 months. All patients had a medial capsulorrhaphy and in eight cases a supplementary lateral capsulotomy. Dislocation recurred in two cases, one of whom had had a supplementary lateral capsulotomy. Chondromalacia was demonstrated at followup in eight patients, six of whom belonged to the lateral capsulotomy group. We conclude that lateral capsulotomy confers no advantage in the operative repair of acute dislocation of the patella. PMID- 3973947 TI - Retreatment of previously treated hand infections. AB - Presenting patient profiles and bacteriologic culture and sensitivity data from 132 patients representing a 5-year experience with hand infections were examined. Patients were subdivided into those having no prior treatment and those having previously been treated with antibiotics. Presenting patient profiles showed the majority of patients to be young to middle-aged males. Temperature, pulse, and white blood cell counts, while usually mildly elevated, were usually not diagnostic. In comparison with patients not having been previously treated, patients having already received antibiotics with persistent or recurrent infections showed more of a tendency toward mixed infections. Anaerobic, mycobacterial, and fungal infections were also increased. Antibiotic susceptibility studies showed the cephalosporins and clindamycin maintain a reasonably good coverage (78% and 72%, respectively). Penicillinase-resistant antibiotics also provided some coverage in two thirds of patients. Proper antibiotic therapy may depend on several factors including previous treatment. Other measures of surgical drainage when appropriate, elevation, compresses, and splinting remain important. PMID- 3973948 TI - Air embolization during autotransfusion for abdominal trauma. AB - Autotransfusion is an accepted adjunct to the treatment of massive bleeding associated with intra-abdominal trauma. We describe a case of massive air embolism during autotransfusion for a gunshot wound to the vena cava. Treatment required thoracotomy and direct aspiration of air. The patient recovered without sequelae. PMID- 3973949 TI - Cold injury complicating burn therapy. AB - The immediate application of cool water to a burn provides prompt relief of pain; however, we must become aware of the complications associated with the use of ice and ice water in this regard. Two cases of extremity ischemia secondary to burn wound therapy are reported with a discussion of patient care. The most important aspect of this injury is prevention. PMID- 3973950 TI - Bilateral fracture of the hook of the hamate. AB - Bilateral hamate fractures in a physician sportsman were treated successfully by surgical excision of the fracture fragment. This case demonstrates the importance of carpal tunnel roentgenograms and of a high index of suspicion in making an accurate diagnosis in wrist injuries. PMID- 3973951 TI - Structural changes in the contractile apparatus of the myometrium during estrus and pregnancy. AB - The ultrastructure of the smooth muscle of the uterus of cats was studied at estrus and at several periods during pregnancy. For the pregnancy studies myometrium was observed at 10, 14, 17, 21, and 50 days postcoitus (PC) as well as in five animals close to term (60-63 days PC). Both thick and thin filaments are observed at estrus in five of the six animals studied and also in all of the animals up to 14 days PC. There is a variable occurrence of thick filaments between 14 and 21 days PC at which time thick filaments are not observed over the implantation site but are observed in myometrial tissue taken away from the nidus. Only thin filaments are observed in the myometrium of the pregnant cat after 21 and before 60 days PC. Prior to term there is again a variable occurrence of thick filaments with thick filaments observed in only one of the five animals studied between 60-63 days PC. These results may implicate the fetoplacental complex in the assembly and disassembly of the thick filaments of uterine smooth muscle. The relationship between thick filament assembly, phosphorylation and the parameters regulating uterine contractility are complex and the variable occurrence of thick filaments at the end of term may implicate factors other than hormonal fluctuations, such as stretch and oxytocics, in this process. PMID- 3973952 TI - Electron microscopic observations of endothelial junctions in perifocal human brain edema. An interpretative study. AB - Cortical biopsies of 12 patients with diagnosis of cerebral tumor or complicated brain trauma were studied with the electron microscope to analyse the alterations of endothelial junctions and their probable participation in the pathogenesis of human brain edema. Capillaries with increased vesicular and vacuolar transport from areas with moderate and severe edema were examined. Some endothelial tight junctions were structurally closed and intact while others showed openings and dehiscence of processes. Some accessory mechanisms of bypassing the endothelial junctions were found, such as: a) communicating micropinocytotic vesicles with the extracellular space at the basal segment of endothelial junction; b) chained micropinocytotic vesicles between endothelial luminal membrane and basal segment of endothelial junction and c) tubular structures connecting the extracellular pockets of endothelial junction with the basement membrane bifurcation. In severe brain edema a considerable enlargement of interjunctional pockets of extracellular space was seen, suggesting that in highly increased cerebrovascular permeability the endothelial junctions are partially opened and that an intercellular route through interendothelial clefts for transferring hematogenous edema fluid from blood to the capillary basement membrane is formed. PMID- 3973953 TI - An ultrastructural study of the contact between type I collagen assemblies and the induced human platelet aggregates. AB - Several type I collagen assemblies have been tested for their ability to induce platelet aggregation: a molecular solution, native and reconstituted native-type fibrils, segment long spacing aggregates (SLS) and an unordered collagen multimer. The ultrastructure of the inducer has been observed before its introduction into the platelet suspension as well as within the final aggregates. The following results have been obtained: 1) platelet aggregation was induced by the monomeric solution of collagen only after a long lag phase. While the original solution did not contain fibrillar elements, the platelet aggregates were in contact with collagen filaments showing a faint banding pattern. The results confirm that the longer lag time recorded is necessary for the collagen to polymerize and that the monomeric collagen actually does not induce platelet aggregation; 2) native and reconstituted native-type fibrils, SLS and unordered collagen multimer similarly induce platelet aggregation and were not modified during the course of this phenomenon; 3) although the general ultrastructure of the contacts between platelet and collagen assemblies were similar, a difference was noted in the extent of contact: a focal zone with native-type fibrils, numerous zones of contact with SLS and very extensive contact with unordered multimer. These results suggest that the combination of three factors are necessary to trigger platelet activation by collagen: the nature of the active sites on collagen, the density of these sites and the geometry of the collagen assembly. PMID- 3973954 TI - Permeability of external gill filaments in the embryonic shark. Electron microscopic observations using horseradish peroxidase as a macromolecular tracer. AB - External gill filaments of sharks are purely transient embryonic structures. They contain a single vascular sinusoidal loop that is continuous with the afferent and efferent branchial arteries. Each filament is comprised of a squamous epithelial bilayer that rests upon a prominent basal lamina. A collagenous stroma separates the epithelium from the underlying endothelium. The epithelium, from an embryo 4.5 cm in total length, is characterized by microvilli with smooth walled vesicles at their bases, a luminal glycocalyx, prominent tubular and vesicular elements, rough endoplasmic reticulum, a Golgi complex, a flattened nucleus, coated vesicles, lipid-like inclusion bodies and sparse cytoplasmic fibrils. Adjacent epithelial cells are joined by a zonula occludens, a zonula adherens and up to five maculae adherentes. The endothelium possesses mitochondria, rough endoplasmic reticulum, a Golgi complex, coated vesicles and many micropinocytotic vesicles on both the adluminal and abluminal surfaces. The endothelium has no basal lamina and is not associated with smooth muscle. After exposure to horseradish peroxidase (HRP) for 10 min, reaction product nearly occludes the cytoplasm of some surface epithelial cells. The deeper epithelial cells have reaction product in smooth walled vesicular and tubular elements. Reaction product is also present in smooth walled endothelial vesicles. Gill filaments from a 10 cm embryo show marked changes from earlier stages. In the epithelial cells, there is an increase in the number of cytoplasmic filaments and the formation of a dense terminal web. Fewer vesicles, tubules, rough endoplasmic reticulum and mitochondria, and a less elaborate Golgi complex characterize the epithelium. The endothelium remains unchanged. The amount of collagen increases and fibroblasts are observed in the stroma. These modifications contribute to the strength of the filaments and allow the gills to withstand increased abrasion by the developing skin denticles. These experiments establish the capability of external gill filaments to take up a macromolecular tracer in the form of horseradish peroxidase. Later in development, the yolk sac of R. terraenovae becomes modified as a yolk sac placenta which functions both in respiration and hematrophic nutrition. In viviparous sharks, the uterus elaborates nutrient-rich secretions. External gill filaments may thus serve as a nutrient absorptive membrane before the establishment of the yolk sac placenta as well as perform its respiratory function. PMID- 3973955 TI - A freeze-fracture study on epididymal and ejaculate spermatozoa of the monkey (Macaca fascicularis). AB - Spermatozoa from four epididymal regions and from the ejaculate of the monkey, Macaca fascicularis, always present the same particle organization for a given sample. The plasmalemma contains homogeneously distributed, 7-8 nm size, PF-face, particles throughout the head, midpiece and principal piece. A unique, particle arrangement occurs in the plasmalemmal, PF-face in spermatozoa from the proximal levels of the body of the epididymis only. Square arrays of 4-6 nm size, PF-face plasmalemmal particles occur in this region of the epididymis at the peripheral edge of the spermatozoon acrosomal region only. Throughout other regions of the epididymis the plasmalemma contains only the homogeneously distributed, 7-8 nm size, PF-face particles. Ejaculate spermatozoa exhibit a similar particle organization to that of spermatozoa found in the distal portions of the epididymis. However, ejaculate spermatozoa of one animal from the eight used in this study exhibited a series of 7-8 nm size, linearly arranged, plasmalemmal, PF face particles situated just proximal to the striated ring. This array of particles continued further rostral on the lateral aspect than on the flattened medial aspect of the spermatozoon. Spermatozoa from the tail of the epididymis and from ejaculates of the other seven animals lacked such specialization. The above data is discussed in terms of the population of particles generally, the significance of the presence of linearly arranged particles proximal to the striated ring, and the possible significance of the square arrays of particles present transiently in one region of the epididymis only. A correlation is made between these square arrays and similarly arrayed particles found in rat and boar epididymal spermatozoa. PMID- 3973956 TI - A quick-freeze, freeze-fracture study of mouse spermatozoa. AB - Rapid cryo-fixation of mouse spermatozoa followed by freeze substitution, thin section and freeze-fracture demonstrates the finer detail possible with quick freeze as compared to chemical fixation. As seen in thin sections the unit membrane is composed of 2-4 nm size particles and the cytoplasm, mitochondria, and axonemal filament components all appear rich in fine structure detail. The filamentous structure of the post-acrosomal sheath and its connection with the plasmalemma is presented and compared to previous studies on this structure. Freeze-fracture data demonstrates 7-9 nm size, plasmalemmal, PF-face particles most heavily concentrated in the region just ahead of the striated ring. The outer acrosomal EF-face contains linear arrays of 7-9 nm size EF-face particles. The inner acrosomal membrane contains scattered, 7-9 nm size PF-face particles. The inner and outer nuclear membranes also contain scattered, 7-9 nm size particles. The results of this study present data which supports and extends previous studies on mouse spermatozoa. The results are discussed in terms of the advantages of cryo-fixation and freeze-substitution compared to conventional fixation in the preservation of fine structure detail. PMID- 3973957 TI - Changes in the structure of somato-sensitive neurons in cat following retrograde uptake of HRP. AB - Neurons of cat cerebral cortex, area S1, labelled by retrograde transport of HRP, have been studied by electron microscopy; the animals were sacrificed 48 h after HRP injection. The cells studied are those in which the enzyme is found both in granular and in diffused form in the cytoplasm (diffuse-granular HRP neurons, DGN), or in diffused form in the cytoplasm (Golgi-like labelled neurons, GLN). The observations have shown that the certain recognition of DGN through electron microscopy, requires a comparison with a semithin section adjacent to the ultrathin section since the labelling granules are light-scattering in dark field. Instead the GLN are not light-scattering in dark field but are directly and unmistakably identifiable even by electron microscopy. The DGN are well preserved on the whole in all their organelles; the GLN show a highly damaged aspect in relation to both the Golgi apparatus and the smooth reticulum, to the cytoplasmic organelles and to the nucleus. Our hypothesis is that the latter neurons take on this appearance because of the combined action of: a) the peripheral mechanical lesions caused by the needle and b) the enormous amount of HRP that the cell is forced to take up (through these pathways) because of its lost integrity and because of the large quantity of marker around the axons. In conclusion intracellular HRP is identifiable by electron microscopy only when it is found in diffused form in the cytoplasm. PMID- 3973958 TI - Age changes in the ultrastructure and function of rat adrenal glands during stimulation of the hypothalamus. AB - Studies were undertaken on the ultrastructure and function of the adrenal cortex and the adrenal medulla three hours after an electric stimulation of the ventromedial nucleus area of the hypothalamus in the adult and old albino rats. The electron microscopic and biochemical findings revealed a significant decrease in the hypothalamic control over catecholamine and corticosteroid syntheses in the old rats. The regulatory influence of the hypothalamus on the secretory activity of the adrenocortical and adrenomedullar cells showed an irregular pattern of changes during aging, i.e. a more marked impairment of the adrenal medulla and a less marked impairment of the cortex. PMID- 3973959 TI - Ultrastructural basis of the vessel wall differentiation in the chick embryo optic tectum. AB - The mode and the temporal sequence of the growth and differentiation processes of the intraneural blood vessels have been ultrastructurally analyzed in optic tecta of 4, 8, 12, 16 and 19 incubation day chick embryos and of chicks 15 days after hatching. The findings suggest that the morphological maturation of the various components of the vascular wall and perivascular spaces, leading to the formation of the blood-brain barrier, unfold according to a spatio-temporal gradient, radially extending from the surface of the tectum rudiment. PMID- 3973960 TI - Neurofibrillary tangles of Alzheimer's disease: an immunohistochemical study. AB - The reactivity of neurofibrillary tangles (NFT) of Alzheimer's disease with several antisera has been studied by immunocytochemistry. They were heavily labelled by an antiserum prepared against isolated NFT; the latter also remained stainable by Bodian-silver method. Some NFT were labelled on vibratome sections by an antimicrotubular protein but remained able to be counterstained by Congo Red, suggesting this labelling could demonstrate material trapped in NFT. The immunoelectron labelling shows that the abnormal filaments, straight as well as 'twisted', are the only structures recognised by the anti-NFT serum. This labelling was prevented only by pre-incubation with fractions enriched in NFT, confirming the presence of unique antigenic determinants in the latter. PMID- 3973961 TI - Respiratory movements of the pancreas. PMID- 3973962 TI - Methylation pattern of fish lymphocystis disease virus DNA. AB - The content and distribution of 5-methylcytosine in DNA from fish lymphocystis disease virus was analyzed by high-pressure liquid chromatography, nearest neighbor analysis, and with restriction endonucleases. We found that 22% of all C residues were methylated, including methylation of the following dinucleotide sequences: CpG to 75%, CpC to ca. 1%, and CpA to 2 to 5%. Comparison of relative digestion of viral DNA with MspI and HpaII indicated that CCGG sequences were almost completely methylated at the inner C. The degree of methylation of GCGC was much lower. The methylation pattern of fish lymphocystis disease virus DNA differed from that of the host cell DNA. PMID- 3973963 TI - Differential susceptibility of cultured neural cells to the human coronavirus OC43. AB - By using cell-type-specific markers and neural cultures derived from various areas of the nervous system, it has been possible to identify various interactions between OC43 virus and mouse oligodendrocytes, neurons, astrocytes, and fibroblasts. Neurons derived from dorsal root ganglia produced viral antigen and infectious virus. Astrocytes and fibroblasts both produced viral antigen but not infectious virus. Oligodendrocytes produced neither infectious virus nor viral antigen. Human embryo brain cells, including astrocytes, were susceptible to OC43 infection but did not produce infectious virus. PMID- 3973964 TI - Protective effects of glycoprotein-specific monoclonal antibodies on the course of experimental mumps virus meningoencephalitis. AB - Newborn Syrian hamsters were challanged with an intracerebral inoculum containing 128 50% lethal doses of the Kilham strain of mumps virus and treated 24 h later with a single intraperitoneal injection of mouse monoclonal antibody. Monoclonal antibodies reactive with epitopes on the fusion glycoprotein of mumps virus could not inhibit hemagglutination or neutralize infectivity in vitro and failed to provide biologically important protection against the in vivo infection. In contrast, monoclonal antibodies reactive with epitopes on the hemagglutinin neuraminidase glycoprotein of mumps virus inhibited hemagglutination and neutralized infectivity in vitro and protected infected animals from the otherwise lethal central nervous system virus infection. Similar protection was provided by both purified immunoglobulin and F(ab')2 fragments. Immuno cytochemical and virological studies showed diminished virus antigen and virus titers in the brains of successfully treated animals. It appears that a topographically restricted region of the hemagglutinin-neuraminidase molecule of the Kilham strain of mumps virus is of critical importance for immune recognition by the infected host. PMID- 3973966 TI - Nucleoprotein and membrane protein genes are associated with restriction of replication of influenza A/Mallard/NY/78 virus and its reassortants in squirrel monkey respiratory tract. AB - An avian influenza A virus, A/Mallard/NY/6750/78(H2N2), was restricted in in replication in the respiratory tract of squirrel monkeys. Avian-human influenza A reassortant viruses possessing the six RNA segments coding for nonsurface proteins (i.e., internal genes) of this avian virus were as restricted in replication in squirrel monkeys as their avian influenza parent. These findings indicated that restriction of replication of the avian influenza virus is a function of one or more of its internal genes. For an investigation of which of the avian influenza genes was responsible for restricted replication in the respiratory tract of primates, reassortant viruses were produced that contained human influenza virus surface antigens from the A/Udorn/72(H3N2) virus and one or more of the internal genes derived from the avian influenza virus parent. Avian human reassortant influenza A viruses containing only the nucleoprotein or matrix protein RNA segment from the avian influenza virus parent were as restricted in their growth as an avian-human influenza reassortant virus containing each of the six avian influenza internal genes. In addition, an avian-human influenza reassortant virus possessing only the avian RNA 1 and nonstructural genes (which by themselves do not specify restricted replication) manifested a significant reduction of virus replication in squirrel monkey tracheas. Thus, the avian nucleoprotein and matrix genes appear to play a major role in the host range restriction exhibited by the A/Mallard/78 virus and its reassortants, but the combination of RNA 1 and nonstructural genes also contributes to restriction of replication. PMID- 3973965 TI - An adenovirus early region 1A protein is required for maximal viral DNA replication in growth-arrested human cells. AB - Two closely related adenovirus early region 1A proteins are expressed in transformed cells. The smaller of these, which is 243 amino acids in length, is required for the transformation of primary rat cells and for the transformation of immortalized rat cells to anchorage-independent growth. This protein is not required for productive infection of exponentially growing HeLa cells but is required for maximal replication in growth (G0)-arrested human lung fibroblasts (WI-38 cells). To determine the function of this protein in viral replication in these G0-arrested cells, we compared viral early mRNA, early protein, and late protein synthesis after infection with wild type or a mutant which does not express the protein. No differences were found. However, viral DNA synthesis by the mutant was delayed and decreased to 20 to 30% that of wild type in these cells. Viral DNA synthesis was much less defective in growing WI-38 cells, and in the transformed human HeLa cell line it occurred at wild-type levels. Furthermore, the mutant which can express only the 243-amino-acid early region 1A protein induced cellular DNA synthesis in G0-arrested rat cells to the same level as wild-type virus. A mutant which can express only the 289-amino-acid early region 1A protein induced less cellular DNA synthesis in G0-arrested rat cells. We propose that the early region 1A 243-amino-acid protein alters the physiology of arrested permissive cells to allow maximal viral DNA replication. In nonpermissive rodent cells, the 243-amino-acid protein drives G0-arrested cells into S phase. This activity is probably important for the immortalization of primary cells. PMID- 3973967 TI - In vitro transcription of a cloned vaccinia virus gene by a soluble extract prepared from vaccinia virus-infected HeLa cells. AB - Faithful transcription of a vaccinia virus gene was accomplished in vitro by using a soluble extract prepared from vaccinia virus-infected HeLa cells. Specific transcription of the cloned vaccinia virus gene was detected by using template DNA restricted within the transcribed region. The vaccinia virus gene was not transcribed by extracts prepared from uninfected HeLa cells even with supplementation by purified vaccinia virus RNA polymerase, nor was a clone of adenovirus 2 DNA bearing the major late promoter transcribed by the extract from vaccinia virus-infected HeLa cells. Thus, infection by vaccinia virus altered cellular transcriptional specificity to favor expression of vaccinia virus genes. RNA synthesis by the infected cell extract was resistant to alpha-amanitin but strongly inhibited by beta, gamma-imido ATP and novobiocin. PMID- 3973968 TI - Mutational mechanisms by which an inactive replication origin of bacteriophage M13 is turned on are similar to mechanisms of activation of ras proto-oncogenes. AB - M13 viral strand synthesis is initiated by nicking of the viral strand of the duplex replicative form by the M13 gene II initiator protein at a specific site within a sequence of about 40 base pairs having dyad symmetry. Efficient replication of the M13 viral strand also requires the presence of an adjacent sequence of ca. 100 base pairs. Together these sequences constitute the minimal origin for M13 viral strand synthesis. A pBR322 derivative having a 182-base-pair insert of M13 DNA contains a functional M13 viral strand origin and, when provided with M13 gene functions in trans, replicates under conditions nonpermissive for the parent plasmid. Chimeric plasmids containing deletions within the sequence flanking the viral strand origin are unable to replicate under these conditions. We isolated spontaneous mutants of M13 based on their ability to activate replication of such plasmids. The mutations found in these strains, as well as several produced by oligonucleotide-directed mutagenesis, all result in the substitution of any of at least four different amino acids for a specific glycine residue near the amino-terminal end of the initiator protein. Other studies have shown that overproduction of the wild-type initiator protein also restores replication. These alternate mechanisms are discussed in terms of their striking similarity to the mechanisms of activation of the ras proto oncogenes which can be activated either by increased expression of the wild-type protein or by substitution of any of several amino acids for a glycine residue near the amino terminus. PMID- 3973969 TI - A thermolabile mutant of adenovirus 5 resulting from a substitution mutation in the protein VIII gene. AB - The mutant adenoviruses H5sub304 and H5RIr were isolated sequentially from adenovirus 5 wild type by selection for the loss of EcoRI restriction endonuclease sites by Jones and Shenk (Cell 13:181-188, 1978). sub304 lacks the site at 84.0 map units (m.u.), and RIr lacks both that and the site at 75.9 m.u. A set of derivatives of RIr that lack the site at 75.9 m.u. accumulated virus more slowly at 38.8 or 39.5 degrees C than those with the site present, as measured by low-multiplicity passage or single-step replication cycles, respectively. Since the EcoRI site at 75.9 m.u. is predicted to lie in the gene encoding the precursor to virion polypeptide VIII (pVIII), the failure to accumulate virus rapidly could lie either in some step in processing and assembly of virions or in an increased virion thermolability. The latter possibility was shown to be the case, as all strains mutated at the EcoRI 75.9 m.u. site were extremely thermolabile in vitro, even at 37 degrees C. CsCl equilibrium density centrifugation of heated crude stocks of RIr and sub304 demonstrated that loss of infectivity in RIr was accompanied by physical disruption of virions. Polyacrylamide gel electrophoresis of infected cell extracts or of purified virions showed that pVIII of RIr had an apparent molecular weight that was slightly greater than that of sub304, and mature RIr and sub304 virions displayed polypeptide VIIIs which appeared to be of identical molecular weights. Nucleotide sequence analysis of RIr demonstrated that it contained a 9-base-pair (bp) substitution for 6 bp found in sub304, leading to a loss of the EcoRI site and a predicted insertion of a single amino acid. Comparison of the sequence of sub304 with the published sequence of adenovirus 2 revealed two changes, a single transversion at bp 1,722 and a bp deletion at 1,749, leading to the loss of a TaqI site. The predicted reading frame change would lead to a stop codon at bp 1,885. This raises the question of whether adenovirus 2 and adenovirus 5 use the same reading fame for pVIII. PMID- 3973970 TI - The S RNA segment of lymphocytic choriomeningitis virus codes for the nucleoprotein and glycoproteins 1 and 2. AB - The lymphocytic choriomeningitis virus (LCMV) genome consists of a large RNA segment and a small RNA segment. The three major structural proteins of this virus are an internal nucleoprotein and two surface glycoproteins. Intertypic reassortants between the Armstrong and WE strains of LCMV were made to map proteins encoded by the LCMV genome segments. Using monoclonal antibodies specific for the nucleoprotein and the glycoproteins of WE and Armstrong, we showed that the small RNA segment of LCMV codes for the three major structural polypeptides. PMID- 3973971 TI - Antibody response to respiratory syncytial virus structural proteins in children with acute respiratory syncytial virus infection. AB - The purified respiratory syncytial virus (RSV), Randall strain contained 10 polypeptides (72,000 molecular weight [72K], 66K, 48K, 42K, 40K, 36K, 30K, 23K, 18K, and 15K), 8 of which proved to be virus specific, and polypeptides 48K and 23K were glycosylated. In addition, a high-molecular-weight (150K), virus specific glycopolypeptide was immunoprecipitated from RSV-infected cell lysate. The antibody response in human sera serially collected from children with primary RSV infection was mainly directed against the polypeptides 30K, 48K, and 72K. The immune response against the other viral proteins was also already detectable in the acute-phase sera. These results indicate that the immune response in RSV infection differs significantly from those for other diseases caused by paramyxoviruses. PMID- 3973972 TI - Characterization of a porcine kidney cell line resistant to influenza virus infection. AB - A mutant cell line of porcine kidney cells that resists the cytopathic effect of influenza virus has been obtained and characterized. These cells, designated ESK R, were originally obtained by prolonged cultivation of cells surviving influenza B/Kanagawa/73 virus infection. No infectious virus was recovered from ESK-R cells, and no evidence for the presence of virus antigens in the cells was demonstrated by immunofluorescent staining. ESK-R cells also showed a distinct resistance to various other strains of both types A and B influenza viruses. The growth of mumps, Sendai, or Newcastle disease virus was considerably restricted, but the cell line normally supported the replication of vesicular stomatitis virus. ESK-R cells were found to lack specific receptors for influenza virus as determined by fluorescence-activated cell sorter analyses. The membrane barrier of ESK-R cells was successfully overcome by nonspecific endocytosis of calcium coprecipitated virus particles followed by production of an appreciable amount of progeny virus. PMID- 3973973 TI - A weakly pathogenic Rauscher spleen focus-forming virus mutant that lacks the carboxyl-terminal membrane anchor of its envelope glycoprotein. AB - A mutant Rauscher spleen focus-forming virus (mutant 4-3) that causes mild splenic erythroblastosis in mice has a 44-base-pair deletion in the 3' region of its envelope glycoprotein (env) gene. The encoded glycoprotein terminates prematurely, lacks a hydrophobic membrane anchor, and has a shortened intracellular lifespan. An active site for causing erythroblast proliferation may occur in the undamaged amino-terminal domain of the env glycoprotein. PMID- 3973974 TI - Hemagglutinin-neuraminidase protein of the paramyxovirus simian virus 5: nucleotide sequence of the mRNA predicts an N-terminal membrane anchor. AB - The nucleotide sequence of a cloned cDNA copy of the mRNA coding for the hemagglutinin-neuraminidase of the paramyxovirus SV5 was determined. There was a single large open reading frame on the mRNA which encoded a protein of 565 amino acids with a molecular weight of 62,134. The deduced amino acid sequence indicated that the only major hydrophobic region in the protein sufficiently long to anchor the protein in the membrane is located near the N terminus (amino acids 18 to 36). It is suggested that, like the influenza virus neuraminidase, hemagglutinin-neuraminidase of paramyxoviruses is oriented with its N terminus inserted into the membrane. PMID- 3973975 TI - Specific properties of two enteric adenovirus 41 clones mapped within early region 1A. AB - Enteric adenovirus type 40 (Ad40) and Ad41 form the sixth subgenus of human adenoviruses. They are associated with infantile diarrhea but cannot be isolated in conventional cell cultures. The genome of the fastidious enteric Ad41 has been cloned, and the cleavage sites of the genome produced by restriction endonucleases BamHI, EcoRI, HpaI, NruI, PvuI, and SalI have been mapped. To develop useful hybridization methods for direct detection of adenoviruses, a restriction fragment library containing Ad41 DNA, with plasmid pBR322 as vector, has been constructed. Clones have been isolated which contain 8 of 10 possible BamHI fragments of Ad41, inserted into the BamHI cleavage site of the vector. Two of these clones are particularly useful for the detection of adenoviruses. One clone detects members of all human adenovirus subgenera, and the second clone is specific for enteric adenoviruses, in particular Ad41. A conspicuous absence of detectable homology was noted at 1.5 to 3.3 map units of the Ad41 genome in hybridizations against other serotypes of adenoviruses, including the closely related enteric Ad40. This sequence corresponds to the 5' portion of early region Ia. PMID- 3973976 TI - Characterization of virulent and avirulent A/chicken/Pennsylvania/83 influenza A viruses: potential role of defective interfering RNAs in nature. AB - In April 1983, an influenza virus of low virulence appeared in chickens in Pennsylvania. Subsequently, in October 1983, the virus became virulent and caused high mortality in poultry. The causative agent has been identified as an influenza virus of the H5N2 serotype. The hemagglutinin is antigenically closely related to tern/South Africa/61 (H5N3) and the neuraminidase is similar to that from human H2N2 strains (e.g., A/Japan/305/57) and from some avian influenza virus strains (e.g., A/turkey/Mass/66 [H6N2]). Comparison of the genome RNAs of chicken/Penn with other influenza virus isolates by RNA-RNA hybridization indicated that all of the genes of this virus were closely related to those of various other influenza virus isolates from wild birds. Chickens infected with the virulent strain shed high concentrations of virus in their feces (10(7) 50% egg infective dose per g), and the virus was isolated from the albumin and yolk of eggs layed just before death. Virus was also isolated from house flies in chicken houses. Serological and virological studies showed that humans are not susceptible to infection with the virus, but can serve as short-term mechanical carriers. Analysis of the RNA of the viruses isolated in April and October by gel migration and RNA-RNA hybridization suggested that these strains were very closely related. Oligonucleotide mapping of the individual genes of virulent and avirulent strains showed a limited number of changes in the genome RNAs, but no consistent differences between the virulent and avirulent strains that could be correlated with pathogenicity were found. Polyacrylamide gel analysis of the early (avirulent) isolates demonstrated the presence of low-molecular-weight RNA bands which is indicative of defective-interfering particles. These RNAs were not present in the virulent isolates. Experimental infection of chickens with mixtures of the avirulent and virulent strains demonstrated that the avirulent virus interferes with the pathogenicity of the virulent virus. The results suggest that the original avirulent virus was probably derived from influenza viruses from wild birds and that the virulent strain was derived from the avirulent strain by selective adaptation rather than by recombination or the introduction of a new virus into the population. This adaptation may have involved the loss of defective RNAs, as well as mutations, and thus provides a possible model for a role of defective-interfering particles in nature. PMID- 3973977 TI - Sequence analysis of the termini of virion and replicative forms of minute virus of mice DNA suggests a modified rolling hairpin model for autonomous parvovirus DNA replication. AB - The nucleotide sequences of the terminal regions of monomer replicative form DNA, a pivotal intermediate species in the replication of minute virus of mice, were determined. The left (3') terminus had a unique sequence on both strands and in both 3'-hairpin configurations. In contrast, the right (5') terminus was sequence heterogeneous and extended an additional 18 base pairs beyond that expected from the known sequence of the virion DNA. These data unambiguously establish the sequence complexity at the termini of both the single-stranded viral genome and the pool of replicative DNA. A comparison of the combined sequence information leads us to propose a modified rolling hairpin model for the replication of autonomous parvoviruses which is compatible with all available data. PMID- 3973978 TI - Persistence of echovirus 6 in cloned human cells. AB - Establishment of a persistent infection by echovirus 6 in cloned human WISH cells (PI) was demonstrated. The cloned human WISH cells were maintained for 3.0 years (over 125 passages) and released virus continuously without cellular destruction. Neither temperature-sensitive virus mutants nor interferon appears to play a role in either establishment or maintenance of viral persistence. The majority of the virus produced by cloned human WISH cells is defective (2 X 10(6) particles per PFU) and differs from standard virus in its polypeptide profile and its inability to attach to parental WISH cells. PMID- 3973979 TI - Inhibitory effect of interferon on the genetic and oncogenic transformation by viral and cellular genes. AB - The rodent established cell lines LTk- and NIH 3T3 have been used as recipients in gene transfer experiments to study the effect of interferon treatment on the genetic and oncogenic transformation by several genes of viral and cellular origin. Our results show that interferon severely inhibits, to a similar extent, the stable transformation of Ltk- and NIH 3T3 cells by the chicken thymidine kinase (tk) gene, Ecogpt gene, simian virus 40, v-Ha-ras, and human c-Ha-ras and c-Ki-ras oncogenes. These results are consistent with an inhibition by interferon at the level of stabilization or integration, or both, of exogenous DNA sequences in the recipient cells, with an apparent effect on gene expression. PMID- 3973980 TI - Analysis of spontaneous deletion mutants of satellite bacteriophage P4. AB - Spontaneous deletion mutants of satellite bacteriophage P4 have been isolated and characterized. All of the deletions analyzed that were between 850 and 1,700 base pairs long are within the region nonessential for P4 lytic development; some of them cover the cII or the gop locus. PMID- 3973981 TI - Primer binding sites corresponding to several tRNA species are present in DNAs of different members of the same retrovirus-like gene family (VL30). AB - We analyzed the putative tRNA primer binding site (PBS) present in several cloned copies of the murine retrovirus-like VL30 family. In the five VL30 DNA clones analyzed, we identified PBS sequences corresponding to three different tRNA species: tRNAPro, tRNAGly, and tRNAGln. The latter two PBS sequences have not been previously encountered in other retroviral or retrovirus-like systems. A unique situation was observed in which PBS sequences complementary to two different tRNA species were flanked by otherwise identical VL30 sequences. In addition, we demonstrated the use of PBS-specific synthetic oligonucleotides for the identification of the tRNA primer and their potential utility in the direct cloning of PBS-containing DNA elements. PMID- 3973982 TI - In vitro mutagenesis of the promoter region for a vaccinia virus gene: evidence for tandem early and late regulatory signals. AB - A vaccinia virus gene that is expressed throughout the reproductive cycle was found to have two sets of RNA start sites approximately 55 nucleotides apart. The site nearest to the coding segment is used early in infection and the one further upstream is used after DNA replication. A series of 5' to 3' deletions were made in the promoter region, and the truncated DNA segments were then ligated to the coding portion of the procaryotic chloramphenicol acetyltransferase gene to measure expression. The effects of these mutations on chloramphenicol acetyltransferase synthesis were determined in a vaccinia virus helper-dependent transient expression system and by forming infectious vaccinia virus recombinants that contain the chimeric genes. Deletions extending up to 31 nucleotides before the late RNA start site had no effect on either early or late expression. Removal of an additional 15 nucleotides produced a dramatic decrease in late expression but had no effect on early expression. The latter was not diminished until the deletion was extended from 31 to 24 nucleotides before the early RNA start site. These results were confirmed by transcriptional analyses. We concluded that this vaccinia virus gene has two promoters and that the regulatory signals for each are located within 31 nucleotides of their sites of transcription. PMID- 3973983 TI - Studies of defective interfering RNAs of Sindbis virus with and without tRNAAsp sequences at their 5' termini. AB - Three of six independently derived defective interfering (DI) particles of Sindbis virus generated by high-multiplicity passaging in cultured cells have tRNAAsp sequences at the 5' terminus of their RNAs (Monroe and Schlesinger, J. Virol. 49:865-872, 1984). In the present work, we found that the 5'-terminal sequences of the three tRNAAsp-negative DI RNAs were all derived from viral genomic RNA. One DI RNA sample had the same 5'-terminal sequence as the standard genome. The DI RNAs from another DI particle preparation were heterogeneous at the 5' terminus, with the sequence being either that of the standard 5' end or rearrangements of regions near the 5' end. The sequence of the 5' terminus of the third DI RNA sample consisted of the 5' terminus of the subgenomic 26S mRNA with a deletion from nucleotides 24 to 67 of the 26S RNA sequence. These data showed that the 5'-terminal nucleotides can undergo extensive variations and that the RNA is still replicated by virus-specific enzymes. DI RNAs of Sindbis virus evolve from larger to smaller species. In the two cases in which we followed the evolution of DI RNAs, the appearance of tRNAAsp-positive molecules occurred at the same time as did the emergence of the smaller species of DI RNAs. In pairwise competition experiments, one of the tRNAAsp-positive DI RNAs proved to be the most effective DI RNA, but under identical conditions, a second tRNAAsp-positive DI RNA was unable to compete with the tRNAAsp-negative DIs. Therefore, the tRNAAsp sequence at the 5' terminus of a Sindbis DI RNA is not the primary factor in determining which DI RNA becomes the predominant species in a population of DI RNA molecules. PMID- 3973984 TI - Isolation and partial characterization of a bacteriophage T5 mutant unable to induce thymidylate synthetase and its use in studying the effect of uracil incorporation into DNA on early gene expression. AB - A mutant of phage T5 which is unable to induce thymidylate synthetase was isolated. T5 thy mutants synthesized less DNA than did wild-type T5, and the burst size of progeny phage was correspondingly reduced two- to threefold in thy+ Escherichia coli. No DNA or progeny phage were made in E. coli thy hosts grown in the absence of exogenous thymine. When the T5 thy mutation was recombined with a T5 dut mutation (unable to induce dUTPase), replication resulted in progeny which contained significant amounts of uracil in their DNA, and these phage failed to produce plaques unless the plating host was deficient in uracil-DNA glycosylase. T5 phage containing various amounts of uracil in their DNA were prepared and used to determine the effect of uracil on the induction of the early enzyme dTMP kinase. The presence of uracil in the parental DNA increased the rate of induction of this enzyme by about 2.5-fold. The T5 thy gene was mapped and is located near the T5 frd gene on the B region of the T5 genome. PMID- 3973985 TI - Virus-receptor interaction in the adenovirus system: characterization of the positive cooperative binding of virions on HeLa cells. AB - The established positive cooperativity of adenovirus 2 binding to HeLa cells revealed a strong temperature dependence. The degree of cooperativity, quantified by means of Hill coefficients, progressively increased from 10 degrees C to reach a maximum level, which was maintained between 20 and 37 degrees C. On the other hand, negative cooperativity of virion attachment was apparent at 3.0 degrees C and on glutaraldehyde-stabilized cells. The corresponding monovalent ligand of the system, the fiber antigen, demonstrated only weak-positive cooperativity of the binding at 37.0 degrees C, which was absent at 3.0 degrees C. Dithiothreitol and dansylcadaverine, reagents inhibiting clustering of ligand-receptor complexes in the plasma membrane, markedly reduced the degree of positive cooperative binding at 37.0 degrees C. Evidently, the positive cooperative binding of adenovirus to HeLa cells at 37.0 degrees C is a consequence of both the multivalency of virus attachment proteins, i.e., fibers, on the virion and of the capacity of the receptor sites to migrate in the plane of the plasma membrane, forming local aggregates of virus-receptor site complexes. PMID- 3973986 TI - Retrograde nephrostomy and percutaneous calculus removal in 30 patients. AB - We used a new technique, retrograde nephrostomy, to provide intrarenal access for percutaneous calculus removal in 30 consecutive patients. Under fluoroscopic control, we maneuvered cystoscopically a 5F and 9F coaxial catheter pair over a guide wire into the calix selected for nephrostomy. Then, a sheathed 20 to 21 gauge needle was passed through the 9F catheter into the flank to create the nephrostomy. Eight patients were given general and 22 intravenous sedation and local anesthesia for nephrostomy placement and calculus removal. Retrograde nephrostomy and subsequent calculus removal were completed successfully in 90 and 83 per cent of the 30 patients, respectively. There were 6 complications and 3 failures among the first few patients due to inferior equipment and inexperience with the technique. Over-all, we found that retrograde nephrostomy provided reliable, precise intrarenal access and we believe that it could become an alternative technique to aid in percutaneous calculus removal procedures. PMID- 3973987 TI - Improved allograft survival in nonidentical living related donor transplants using donor-specific blood transfusions. AB - A total of 78 consecutive HLA nonidentical living related donor transplant recipients with moderate to high stimulating mixed lymphocyte culture indexes underwent a deliberate donor-specific blood transfusion protocol. Of the patients 67 were first and 11 were second allograft recipients. Patients were monitored for immunological responses by cytotoxic B-cold, B-warm and T-warm antibody responses to a random panel of 30 donors, and by serial crossmatches to their donor subset B and T lymphocytes at 5C and 37C before beginning the protocol and after each donor-specific blood transfusion. Patients were followed from 3 months to 2 1/2 years, with allograft survival rates reported by the actuarial method. Survival rates of first allograft recipients were 96.0 plus or minus 2.77, 93.97 plus or minus 3.37, 93.97 plus or minus 3.37 and 90.68 plus or minus 4.50 per cent at 3 and 6 months, and 1 and 2 years, respectively. Of the patients entering the protocol for a primary transplant 20.18 per cent had persistently positive crossmatches. With increasing numbers of previous random blood transfusions a statistically significant sensitization rate was noted. Patient sensitization showed a general pattern of initial development of B-warm lymphocytotoxins resulting in positive B-warm crossmatches, which progressed to T-warm lymphocytotoxins and positive T-warm crossmatches if donor-specific blood transfusions continued. However, on development of B-warm positive crossmatches reversion to a negative crossmatch with successful transplantation was possible upon cessation of transfusions. No patient in the study was rendered nontransplantable due to donor-specific blood transfusions. All 5 patients who were completely disparate suffered amnestic type rejection episodes but following control of the rejection the course mimicked that of mixed lymphocyte culture identical living related donor transplants. Donor-specific blood transfusion is highly successful among first allograft recipients and success in extending the procedure to more disparate relatives is noted. PMID- 3973988 TI - Reoperative ureteroneocystostomy: review of 69 patients. AB - Reoperative ureteroneocystostomy in 69 patients with primary vesicoureteral reflux was reviewed. Of the renal units 49 were obstructed and 48 had reflux. Postoperative obstruction was caused by mechanical factors in 61 per cent of the renal units, distal ureteral scarring in 31 per cent and a previously unrecognized functionally neurogenic bladder (without a neurological lesion) in 8 per cent. Persistent postoperative reflux was secondary to a short submucosal tunnel in 94 per cent of the renal units and occult neurogenic bladder in 6 per cent. Reoperative ureteroneocystostomy was successful in 79 per cent of the renal units, with a mean followup of 33 months. The modified Paquin technique (omitting the ureteral cuff) yielded consistently superior results in children undergoing reoperation for ureterovesical junction obstruction. In patients with postoperative vesicoureteral reflux a variety of techniques produced similar and gratifying results. That 52 per cent of our patients had no symptoms indicates clearly the absolute necessity of careful followup after ureteral reimplantation. Furthermore, 20 per cent of our patients had late failure (4 to 10 years after initial ureteroneocystostomy), which suggests the need for careful monitoring of the reimplanted ureter past puberty. PMID- 3973989 TI - Urinary diversion: anastomosis of the ureters into a sigmoid pouch and end-to side sigmoidorectostomy. AB - From 1978 to 1982 bilateral ureterorectostomy and end-to-side sigmoidorectostomy were done following cystectomy for carcinoma of the bladder in 7 patients. No patient had recurrent pyelonephritis or ureterointestinal obstruction. Rectography showed the absence of rectoureteral reflux of contrast medium but rectosigmoid reflux appeared after injection of more than 150 ml. opaque solution. Adequate alkali therapy was performed in 2 patients with hyperchloremic acidosis. While there were some problems concerning the quality of urinary and fecal control achieved in our patients they were no worse than those of ordinary ureterosigmoidostomy. This operation might be recommended for patients in whom a collection appliance is unacceptable. However, before this surgical procedure can be performed the fact that the end result in terms of fecal urinary continence is unpredictable must be explained thoroughly to the patient. PMID- 3973990 TI - Significance of carcinoma in situ and dysplasia in association with bladder cancer. AB - Cystectomy specimens of 118 transitional cell carcinomas of the bladder were analyzed by step-sectioning. The carcinoma in situ and dysplasia adjacent to and remote from the visible bladder cancer were correlated with the tumor configuration on cystoscopy, and grade and stage of the disease. Results showed that a combination of papillary and nodular carcinomas in a single bladder was associated with a high incidence of mucosal involvement. Moreover, more than 50 per cent of all grade 3 carcinomas were associated with carcinoma in situ and dysplasia adjacent to and remote from the visible tumors. Carcinoma in situ and dysplasia were not related to the stage of disease. For management of bladder cancer, it appears important to assess the gross configuration of tumors by cystophotography and to determine the grade of tumors by biopsy, because mucosal involvement was found to be correlated closely with the tumor configuration and grade 3 disease. PMID- 3973991 TI - A technique for the correction of penoscrotal fusion. PMID- 3973992 TI - Idiopathic hypercalciuria of childhood: response to oral calcium loading in children with and without urolithiasis. AB - Fifteen children with episodes of painless hematuria without calculi and 8 others with calcareous urolithiasis were examined for hypercalciuria. All patients were normocalcemic and excreted excessive amounts of urinary calcium (greater than 4 mg. per kg. per day). A familial history for renal calculi was noted in 8 children with hematuria and in 5 with urolithiasis. Children with hematuria excreted greater amounts of calcium and presented at an earlier age compared to patients with renal calculi. After 7 days of a low calcium diet an oral calcium loading test was performed in children from both groups. Urinary calcium excretion and parathyroid activity were not different in the 2 clinical groups while fasting or after an oral calcium load. Absorptive and renal subtypes were found in patients with hematuria and urolithiasis. Treatment used to prevent the recurrence of calculi also was highly effective in resolving hematuria. Despite differences in age and clinical presentation, these children appeared metabolically similar and responded favorably to therapeutic regimens that reduce urinary calcium excretion. PMID- 3973993 TI - Learning to integrate systemic chemotherapy into a treatment plan for patients with advanced bladder cancer. PMID- 3973994 TI - Ureolytic Citrobacter freundii infection of the urine as a cause of dissolution of cystine renal calculi. AB - We report a case of cystinuria with staghorn renal lithiasis in a solitary right kidney and chronic renal failure. Right nephropyelolithotomy was performed and although 29 renal calculi were extracted many stones remained in situ. A permanent nephrostomy was left in the kidney. Several months later the urine was infected chronically with a ureolytic Citrobacter freundii bacteria and urinary pH oscillated between 8.0 and 9.2. Spontaneous dissolution of the cystine calculi was observed and many tiny fragments of cystine were expulsed through the nephrostomy, following which renal function improved. Despite the conditions favoring struvite calculi, formation did not occur. PMID- 3973995 TI - The etiology and treatment of delayed bleeding following percutaneous lithotripsy. AB - In 1,032 percutaneous stone manipulations the incidence of significant, documented or presumed vascular injuries was 0.9 per cent. Seven cases of pseudoaneurysm, arteriovenous fistula or vascular lacerations were found, all of which were diagnosed angiographically. The patients were treated successfully with transcatheter embolization techniques. Two additional patients experienced delayed bleeding, presumably from vascular injuries, which resolved spontaneously with conservative therapy. Arteriography should be performed in these patients with serious postoperative bleeding. Embolization of the peripheral vessel is preferable to flank exploration. PMID- 3973996 TI - Bilateral renal oncocytoma: report of 2 cases and review of literature. AB - We report 2 cases of synchronous bilateral renal oncocytoma treated by radical nephrectomy on 1 side and by partial nephrectomy on the other side. Long-term followup serves to confirm the noninvasive nature of this disease. We recommend conservative management based upon radiological and gross pathological findings. PMID- 3973997 TI - Endoscopic ureteropyelostomy: opening the obliterated ureteropelvic junction with nephroscopy and flexible ureteropyeloscopy. AB - Endoscopic re-establishment of a totally obstructed ureteropelvic junction was accomplished in 2 patients. The combined use of rigid percutaneous nephroscopy and flexible ureteropyeloscopy provided full visualization of the obliterated segment, and allowed accurate electroincision into the ureter and placement of a wire and catheter into the lumen. This technique demonstrates the potential therapeutic applications of flexible ureteropyeloscopy and should be considered for the initial treatment of the obliterated ureteropelvic junction. PMID- 3973998 TI - Condyloma acuminatum of the bladder and ureter: case report and review of the literature. AB - We report on a 56-year-old woman with extensive condyloma acuminatum of the external genitalia and vagina, with spread to and diffuse involvement of the urethra, bladder and distal ureters. A chronic course, failure to respond to conservative measures and evidence of malignant transformation led to radical surgical treatment. PMID- 3973999 TI - Upper urinary tract transitional cell carcinoma in patients with bladder carcinoma and associated vesicoureteral reflux. AB - Of 269 patients with bladder neoplasms treated during a 20-year period 47 had associated vesicoureteral reflux. All 47 patients were followed for 3 years or more, or until death. Upper urinary tract transitional cell cancer developed in 3, each of whom had recurrent bladder cancer. Among the 222 patients who had vesical cancer without reflux transitional cell carcinoma of the ureter developed in only 1, 11 years after transurethral resection for a bladder tumor. The incidences of upper tract transitional cell cancer in patients with and without vesicoureteral reflux were 6.4 and 0.44 per cent, respectively, which support the suggested role of reflux in disseminating or seeding of cancer cells from the bladder into the upper urinary tract. Patients with bladder cancer and associated vesicoureteral reflux have an approximately 15-fold greater risk of upper tract cancer developing compared with those without reflux. We recommend vigilant scrutiny of patients with recurrent bladder cancer and associated vesicoureteral reflux for early detection of upper urinary tract transitional cell carcinoma. PMID- 3974000 TI - Giant cell tumor of the bladder associated with transitional cell carcinoma. AB - We report in detail the first giant cell tumor associated with transitional cell carcinoma of the bladder. The giant cell tumor was composed of multinucleated giant and mononuclear stromal cells, and was morphologically indistinguishable from giant cell tumor of the bone. The giant and transitional cell carcinomas showed no evidence of recurrence or metastasis 8 months after transurethral resection. No histogenetic correlation between the cancers was found. PMID- 3974001 TI - Neonatal vesical necrosis and perforation secondary to posterior urethral valves. PMID- 3974002 TI - Cystic intra-abdominal testicular torsion in an infant. AB - We report on a 3-month-old infant with cystic intra-abdominal testicular torsion. He presented with abdominal distension and pain. Physical examination showed a movable, well delineated mass in the right iliac and lumbar fossae. Exploration revealed that the mass was connected to the abdominal aorta by a thin vascular cord that was twisted before reaching the mass. The histological study showed that the mass corresponded to a testis with cystic formations. The testicular parenchyma was necrotized, although isolated seminiferous tubules were found. The cystic cavities were filled by hematic and necrotic material, and exhibited no epithelial lining. A fibrous layer in continuity with interstitial hemorrhage surrounded the cysts. The twisted vascular cord corresponded to a spermatic cord with dilated pampiniform plexus veins. The differential diagnosis and the etiopathogenesis of the lesion are discussed. PMID- 3974003 TI - Polyorchidism: an unusual case. PMID- 3974004 TI - Prolactin. PMID- 3974005 TI - Papillary stones: calcified renal tubules in Randall's plaques. AB - Papillary stones are small, rounded concretions with one smooth convex face and one concave face which corresponds to its implantation on the papilla and in which a whitish Randall's plaque is often present. Eighty-seven papillary stones were studied with stereoscopic, scanning electron microscopic and x-ray dispersive energy analysis. Sixty-three stones had a plaque and 13 of these showed calcified renal tubules that demonstrated their intrapapillary origin and a link between partial papillary nephrocalcinosis and renal stones. PMID- 3974006 TI - Morphological observations on the epithelium of the developing urinary bladder of the mouse and rat. AB - Bladders from fetal and neonatal BALB/cStCrlfC3H/Nctr mice and Sprague-Dawley rats were studied to establish the sequence of events in their morphological development by using scanning electron, transmission electron and light microscopy. On fetal day 18 or 19 the epithelium from the mouse and the rat displayed 2 or 3 distinct cell layers. With transmission electron microscopy a star-like contraction of the cell surface of the mouse bladder occurred which was not seen in the developing rat bladder. In both the mouse and the rat, some of the superficial cells sloughed between fetal day 18 or 19 and the day of birth. On the day of birth, the epithelium was composed of only 2 layers. The nuclei of both the superficial and basal layers contained prominent euchromatin, and mitotic figures were often present in the basal layer. By the 5th postnatal day, some of the superficial cells contained autophagic vacuoles, and the epithelium was still 2 cell layers thick. One week after birth the epithelium consisted of 2 to 3 cell layers. Three weeks after birth the epithelium was 3 cell layers thick and appeared as the adult pattern with both transmission and scanning electron microscopy. The study demonstrated that the fetal and neonatal mouse and rat urinary bladders undergo a series of rapid developmental changes and suggest that the fetal and neonatal urinary bladder may be a target organ susceptible to toxic insult. PMID- 3974007 TI - Determination of renal function following urinary diversion through intestinal segments. AB - Serum concentrations of urea and creatinine, urinary clearances of urea and creatinine, and urine concentrating ability have been proposed as measures for determining renal function in patients with urinary diversion through intestinal segments. Intestinal segments reabsorb urinary solutes, including urea and creatinine, complicating these methods of assessing renal function. This study employs a canine model in which urinary clearances of urea, creatinine and inulin are determined through a normal renal unit and ureter and compared with the contralateral renal unit which has had its ureter replaced by a segment of ileum. Urea, creatinine and inulin are reabsorbed by the ileal segment. Reabsorption of each of these solutes is dependent on urinary flow. The clearance of these solutes through the renal unit with the interposed ileal ureter approaches that of the contralateral renal unit under maximal degrees of diuresis. Creatinine and inulin clearances obtained during diuretic states give the most accurate indication of true renal function. These solutes are reabsorbed to a lesser extent than urea. Diuresis minimizes reabsorption of all these solutes by the ileal segment. Urine concentration does not reflect distal tubule function since the ileal segment reabsorbs urinary solutes and is freely permeable to water. PMID- 3974009 TI - American Urological Association, Inc. Eightieth annual meeting, May 12-16, 1985, Atlanta, Georgia. Abstracts. PMID- 3974008 TI - Urease-induced crystallization in synthetic urine. AB - The urease-induced crystallization of magnesium ammonium phosphate and calcium phosphate was studied at different alkalinization degrees by incubating synthetic urine with increasing Jack Bean urease concentrations. The crystallization was studied as precipitation on glass rods immersed in synthetic urine. The calcium phosphate precipitation on the glass rods occurred when the pH reached 6.8. Magnesium ammonium phosphate precipitation occurred when the pH reached 7.0. The maximal crystallization occurred at a pH between 7.5 and 8.0; at higher pHs the precipitation was considerably lower. The possible mechanisms and clinical implications behind this narrow pH optimum for urease-induced crystallization, which also have important implications for future experimental studies, are discussed. PMID- 3974010 TI - Timing of carotid artery endarterectomy after stroke. AB - Carotid endarterectomy has been advocated to prevent further neurologic deterioration in patients who have had a stroke. Previous reports have shown that endarterectomy within 2 weeks of a stroke is associated with high morbidity and mortality rates presumably from hemorrhagic complications in the brain. Some recommend a 2- to 6-week waiting period after a stroke, but the safety of operation in the interval of time beyond 2 weeks has not been documented in the literature. The present study investigated the morbidity and mortality rates of 352 consecutive carotid endarterectomies. Three hundred three endarterectomies were performed on patients with symptoms other than stroke. Forty-nine endarterectomies were performed on patients with a deficit lasting more than 24 hours. Of these, 27 carotid endarterectomies were performed in an interval less than 5 weeks after initial stroke (early interval) and 22 operations were performed in a 5- to 20-week interval after stroke (late interval). Five strokes occurred in the 27 patients operated on within 5 weeks, an incidence of 18.5%; none of the patients operated on after 5 weeks exhibited worsening of their preoperative neurologic status. With the use of Fisher's exact test to compare these two intervals, the results were found to be significant (p less than 0.05). The cause of stroke in those operated on in the early interval was investigated by postoperative CT scans; in only one instance was there a hemorrhagic infarct of the ipsilateral hemisphere. The literature suggests that a variety of intracerebral vascular changes render the brain more susceptible to reinfarction soon after stroke. This study suggests an unstable situation in the 5-week interval following stroke that contraindicates carotid endarterectomy. PMID- 3974011 TI - The influence of inner wall filamentousness on the performance of small- and large-caliber arterial grafts. AB - Dacron prostheses with differing degrees of inner wall filamentousness were implanted in the canine descending thoracic aorta for 56 days (n = 14) and the carotid arteries for 21 days (n = 40). In the thoracic aorta the healed inner capsule of 8 mm internal velour grafts was approximately three times as thick as the inner capsule of external velour knitted prostheses. However, the early patency and rapidity of healing of these two types of prostheses were essentially the same. In the carotid arteries the patency of the 4 mm external velour prostheses was greater than that of the internal velour prostheses and the mean thrombus-free surface area of the external velour grafts was significantly greater than that of the internal velour grafts. These observations suggest that an internal velour surface is not deleterious to early patency in a large caliber, high-flow artery but that it may be in a small-caliber, low-flow artery. PMID- 3974012 TI - Structural details of boundary layer separation in a model human carotid bifurcation under steady and pulsatile flow conditions. AB - We have used a dye-flow visualization technique to analyze the substructure of flow separation in a plastic model of the human carotid bifurcation under steady and pulsatile flow. Under steady conditions at a physiologic flow split (Q external carotid/Q common carotid = 0.30) and Reynolds number (500), a large region of separated fluid developed along the outside wall of the sinus, opposite the flow divider. Yellow dye injected into the boundary layer upstream from the bifurcation traveled slowly along the wall of the common carotid and entered directly into the separation. Blue dye injected into the central, high-velocity streamlines in the common carotid impacted on the flow divider, then traveled circumferentially and entered the separation. Mixing of these two sources was documented by the appearance of green fluid, which lingered in the region of separation. Pulsatile flow resulted in a smaller region of separation; mixing still occurred. Flow separation at the carotid bifurcation is a site of mixing of fluids previously subjected to prolonged low-shear wall contact and brief high shear wall contact. Separation is itself a site of low shear, but this study reveals a mechanism whereby low and high shear may act independently or synergistically to explain the link between flow separation and atherogenesis. PMID- 3974013 TI - Rupture of surgically thrombosed abdominal aortic aneurysm. AB - A case of late rupture of an abdominal aortic aneurysm that had been successfully treated by surgically induced thrombosis is presented. After emergency surgery consisting of ligation of the neck of the aneurysm, the patient survived and is doing well. The literature on surgically induced thrombosis of abdominal aortic aneurysm is reviewed. It is stressed that complete thrombosis of aortic aneurysm induced by distal ligation does not preclude rupture, and if patients present with symptoms of expansion or rupture, they should undergo emergency surgery. PMID- 3974014 TI - Cerebral angioendotheliomatosis associated with hemispheric symptoms of carotid arterial origin. AB - Cerebral angioendotheliomatosis may mimic classic hemispheric and nonhemispheric carotid arterial symptomatology and may even result in carotid arteriography and endarterectomy prior to its recognition. Diagnosis requires brain biopsy and the prognosis is poor. PMID- 3974016 TI - Comparison of various oculoplethysmography modalities. AB - This article compares the accuracy of commonly used oculoplethysmography (OPG) equipments--OPG/Gee, OPG/Kartchner, and OPG/Zira--in the detection of significant carotid stenosis. The first 200 patients (400 carotid arteries) with readily available carotid arteriograms were selected from each of the following categories: OPG/Kartchner, OPG/Gee, and OPG/Zira, making a total of 600 patients. The radiologic findings were divided into two categories: the first included patients with normal carotid arteries or vessels with less than 50% stenosis, and the second included patients with carotid stenosis greater than or equal to 50%. The results of OPG/Zira, OPG/Kartchner, and OPG/Gee are listed respectively: diagnostic sensitivity of 88.88%, 92.6%, and 96.0%; diagnostic specificity of 86.77%, 90.7%, and 91.8%; false positive rate of 6.0%, 5.1%, and 3.6%; false negative rate of 22.7%, 13.0%, and 8.9%; overall diagnostic accuracy of 88.25%, 92.0%, and 94.8%; and accuracy in determining bilateral carotid stenosis of 66.0%, 79.0%, and 89.5%. We concluded that the three machines were valuable in the diagnosis of normal carotid arteries and significant unilateral carotid stenosis. However, the OPG/Gee had slightly better overall accuracy and was more valuable in the diagnosis of significant bilateral carotid stenosis. The OPG/Kartchner had the advantage of being applicable in patients with extreme hypertension and cardiac arrhythmias. The OPG/Zira was limited in the diagnosis of bilaterally significant carotid stenosis. PMID- 3974017 TI - Medial agenesis associated with multiple extracranial peripheral and visceral arterial aneurysms. AB - Developmental abnormalities consisting of focal absence of the arterial media have been implicated in the formation of the arterial aneurysms commonly observed in the intracranial cerebrovascular system. However, this observation has rarely been associated with visceral or peripheral arterial aneurysm formation. This article describes the experience with two patients having multiple peripheral and visceral arterial aneurysms with histologic findings previously observed only in intracranial, saccular berry aneurysms and in one patient with an isolated common carotid artery aneurysm. The two patients described herein had no clinical or angiographic evidence of cerebrovascular aneurysm formation. Light and electron microscopic histologic studies revealed complete focal absence of the arterial media in the region of aneurysm formation. No clinical or laboratory evidence of associated collagen-vascular disease was demonstrated. The patients were successfully managed with segmental resection and grafting of symptomatic, expanding, or large aneurysms. The necessity for an aggressive search for associated aneurysms as well as the need for long-term follow-up when histologic evidence of medial agenesis is demonstrated in association with arterial aneurysm formation are emphasized. PMID- 3974015 TI - Late axillary artery thrombosis in patients with occluded axillary-femoral bypass grafts. AB - The axillary-femoral bypass graft is an alternative to direct anatomic procedures for patients with aortoiliac occlusive disease. Touted for its low morbidity and mortality rates, with corresponding improved patency rates, this extra-anatomic procedure has been considered safe and effective. Noncompromising upper extremity ischemia and one case of upper extremity loss, associated with early graft thrombosis, have been reported previously. This article describes two cases of late axillary artery thrombosis, occurring 4 and 6 months after graft thrombosis, which severely jeopardized the viability of the ipsilateral upper extremity. Experience with these patients has shown that a thrombosed axillary-femoral bypass graft may jeopardize the viability of the ipsilateral upper extremity many months after its failure. The absence of information in the literature regarding this complication suggests this is a rare complication of thrombosed axillary femoral grafts. PMID- 3974018 TI - Extracranial carotid aneurysms: report of six cases and review of the literature. AB - Ligation of atherosclerotic extracranial carotid aneurysms was described nearly 200 years ago, but resection and direct reconstruction of these unusual lesions currently are associated with less risk for perioperative neurologic complications as well as with durable late results. During an interval in which carotid endarterectomy was performed in over 1500 patients at The Cleveland Clinic, only six patients underwent surgical management of cervical carotid aneurysms. Aneurysm resection was performed in conjunction with reanastomosis of the internal carotid artery in two patients but required saphenous vein interposition grafts in four others. A temporary carotid shunt was employed routinely and was threaded through the harvested vein before its insertion whenever graft replacement was necessary. Although one vein graft required revision because of early thrombosis, no operative deaths or permanent strokes occurred in this small series. Each patient has remained asymptomatic throughout a maximum follow-up period of 6 years postoperatively. PMID- 3974019 TI - Intraoperative fibrinolytic therapy: an adjunct to catheter thromboembolectomy. AB - This article describes our initial experience with intraoperative infusion of the fibrinolytic agent streptokinase. Five patients with various complications of atherosclerosis manifested by limb-threatening ischemia were treated by balloon catheter thromboembolectomy followed by intra-arterial streptokinase infusion. In each patient viability of the involved extremity was questionable after removal of all thrombus accessible to the balloon catheter. Fibrinolytic therapy was used when operative arteriography showed residual thrombus distal to the popliteal artery. All patients were systemically heparinized during the operation, and three patients were maintained on anticoagulants during the initial postoperative period. A streptokinase solution containing 750 U/ml was infused intra-arterially proximal to the residual thrombus. The total dosage ranged from 20,000 to 100,000 units per patient. This treatment was considered successful in all five patients, as documented by return of palpable pulses, audible Doppler flow signals where none was present prior to infusion, and operative arteriography. There were no complications related to intraoperative streptokinase infusion. We conclude that intraoperative fibrinolytic therapy is a safe adjunct to catheter thromboembolectomy. The observed improvement in limb perfusion can be attributed to lysis of thrombus in the distal arteries that could not be retrieved with the balloon catheter. Laboratory studies are in progress to establish precise indications for intraoperative streptokinase and to determine the most effective dosage and rate of administration. PMID- 3974020 TI - Popliteal entrapment syndrome: a report of tibial nerve entrapment. AB - A case of popliteal entrapment syndrome is reported, in which the patient experienced symptoms of tibial nerve entrapment. Exploratory surgery revealed an abnormal fibrous band between the heads of the gastrocnemius muscle that was compressing both the tibial nerve and popliteal artery. Division of this band provided immediate and lasting relief of the symptoms. This is believed to be the first report of a case of symptomatic entrapment of the tibial nerve. PMID- 3974021 TI - Use of a balloon-tipped perfusion catheter for renal preservation during suprarenal abdominal aortic operations. AB - Two cases are presented that illustrate the use of the Pruitt-Inahara vascular shunt to avoid renal failure during suprarenal aortic reconstruction. Previously reported methods of renal preservation are briefly reviewed, and the advantages of a balloon-tipped perfusion catheter over previously reported techniques are presented. PMID- 3974022 TI - Magnetic resonance imaging and spectroscopy in the study of cardiovascular disease. AB - Nuclear magnetic resonance (NMR) techniques are now being applied to clinical medicine. Magnetic resonance imaging has particular advantages in evaluating cardiovascular disease: it is noninvasive; it can estimate blood flow velocity; it does not require contrast medium; and it can image in several planes. The major current limitations are resolution and cost. There are also patient specific limitations involving implanted metal, pacemakers, metallic life support systems, and involuntary motion. NMR spectroscopy allows on-line analysis of important biochemical processes. 31P spectroscopy allows analysis of high-energy phosphate metabolism and is being used to study the effects of and recovery from ischemic cell injury. 13C can be used to monitor metabolism of carbon-containing compounds. The applications of these techniques are rapidly evolving. PMID- 3974023 TI - Carotid steal syndrome following carotid subclavian bypass. PMID- 3974024 TI - Conformational stress and anastomotic hyperplasia. PMID- 3974025 TI - Leads from the MMWR. Rabies postexposure prophylaxis with human diploid cell rabies vaccine: lower neutralizing antibody titers with Wyeth vaccine. PMID- 3974026 TI - Physicians for rural areas. PMID- 3974027 TI - Haloperidol and propranolol in combination. PMID- 3974028 TI - Symptoms and blood glucose levels in diabetics. PMID- 3974029 TI - Management of the asymptomatic patient with an abnormal exercise electrocardiogram. PMID- 3974030 TI - The radiological diagnosis of herniated lumbar disks. PMID- 3974031 TI - Preventing traffic fatalities. PMID- 3974032 TI - Registry of angiofollicular lymph node hyperplasia. PMID- 3974033 TI - Bar soap and liquid soap. PMID- 3974034 TI - Anisocoria from scopolamine patches. PMID- 3974035 TI - Alcohol, nutrient intake, and hypertension in US adults. AB - Data from the first Health and Nutrition Examination Survey were analyzed with multivariate statistical techniques to determine whether there was evidence for a contributory role of alcohol in hypertension and to provide a suitable perspective on the importance of nutrient variables compared with other established risk factors for hypertension. The results of these analyses reaffirm the importance of alcohol and sodium intakes on blood pressures among US adults. Potassium (inversely) and phosphorus (directly) were also identified as important nutrient predictors of higher systolic blood pressure. Calcium intake was significantly related to systolic blood pressure only among nonwhite men and was not a significant predictor of systolic pressure overall. In addition, the results of the study reemphasized the paramount importance of age, race, and obesity in determining hypertension. Current nutrient intakes, by comparison, are relatively less important. PMID- 3974036 TI - Airborne transmission of measles in a physician's office. AB - An unusual outbreak of measles occurred in 1982 in a pediatrician's office in Muskegon, Mich. Three children, who had arrived at the office 60 to 75 minutes after a child with measles had departed, developed measles. Using a model based on airborne transmission, it is estimated that the index patient was producing 144 units of infection (quanta) per minute while in the office. Characteristics such as coughing, increased warm air recirculation, and low relative humidity may have increased the likelihood of transmission. Adequate immunization of all patients and staff, respiratory isolation and prompt care of all suspected cases, and adequate fresh-air ventilation should decrease the risk of airborne transmission of measles in this setting. Airborne transmission may occur more often than previously suspected, a possibility that should be considered when evaluating current measles control strategies. PMID- 3974037 TI - Neonatal outcome in planned v unplanned out-of-hospital births in Kentucky. AB - We conducted a survey of 1,064 out-of-hospital Kentucky births during 1981 to 1983 in order to classify each by planning status (planned or unplanned to occur out of hospital) and attendant. Among the 809 births for which we obtained information, 575 (71.1%) were planned. We examined birth outcome by low birth weight (LBW) and neonatal mortality (NM). Compared with planned births, unplanned births were associated with increased risk of LBW (odds ratio = 6.6; 95% confidence limits [CL], 3.9 to 11.2, adjusted for maternal age). Furthermore, after adjusting for maternal age and parity, LBW births occurred at less than expected frequency among planned births (observed to expected [O:E] ratio = 0.48; 95% CL, 0.29 to 0.73), but at greater than expected frequency among unplanned births (O:E ratio = 2.9; 95% CL, 2.2 to 3.8). A similar, but nonsignificant, trend was seen for NM and NM was much greater in the unplanned group (72.7 per 1,000 live births) than in the planned group (3.5 per 1,000). PMID- 3974038 TI - Future directions in AMA programming. PMID- 3974039 TI - Guidelines for handling parenteral antineoplastics. Council on Scientific Affairs. PMID- 3974040 TI - Tibial lesion in a Laotian girl. PMID- 3974041 TI - 'Routine urinalysis'. Is the dipstick enough? AB - Results of this study indicated that a protein-negative, blood-negative dipstick result may be used to rule out the necessity for performing a microscopic examination in "routine urinalysis" only if one is willing to accept 13% false negative results. On the other hand, a protein-, blood-, and leukocyte esterase negative dipstick result was associated with 1.4% to 3.3% false-negative results. The high sensitivity of the leukocyte esterase-measuring dipstick for microscopically abnormal urine samples was dependent on its ability to detect small numbers of leukocytes only when interpreted five minutes after immersing it in the sample. Various approaches may be used by which these findings could be applied to produce cost savings and also protect the small number of patients who may have dipstick-negative, microscopically positive urine. PMID- 3974042 TI - Genital herpes infections in private practice in the United States, 1966 to 1981. AB - We analyzed data on genital herpes infections in the United States from 1966 to 1981 collected by the National Disease and Therapeutic Index survey. The number of private physician-patient consultations for genital herpes increased tenfold during this period. The number of patient visits for newly diagnosed infections increased 7.5-fold. Women aged 20 to 24 years and men aged 25 to 29 years were more likely to consult a private physician for genital herpes than were patients in other age brackets. Our analysis suggests an increasing national incidence of genital herpes infections and supports the concept that genital herpes infections are epidemic in the United States. PMID- 3974043 TI - Sudden death in adolescents resulting from the inhalation of typewriter correction fluid. AB - Inhalation abuse of various toxic agents continues to be a significant health problem among the younger segment of our society. We describe four cases of sudden death in adolescents associated with recreational sniffing of typewriter correction fluid occurring during the period 1979 through mid-1984. The solvents used in most of these fluids, 1,1,1-trichloroethane and trichloroethylene, are known to induce potentially fatal arrhythmias. Sniffing typewriter correction fluid poses a significant and underappreciated danger to the lives of these abusers. School health officials, public health departments, and law enforcement personnel should be alerted to the need for surveillance of this type of activity. PMID- 3974044 TI - Hyperosmolality induced by propylene glycol. A complication of silver sulfadiazine therapy. AB - An 8-month-old male infant was treated with topical silver sulfadiazine for a burn and complicating toxic epidermal necrolysis involving 78% of his total body surface area. Transdermal absorption of propylene glycol from the silver sulfadiazine produced hyperosmolality with an increased osmolal gap. A peak propylene glycol concentration of 1,059 mg/dL was documented, and its osmotic effect was that predicted from its concentration. Our data support either zero order elimination at a rate of 13.5 mg/dL/hr or first-order elimination with a half-life of 16.9 hours. Elevated concentrations of propylene glycol may have contributed to the patient's cardiorespiratory arrest. The osmolal gap may be used as a screen for suspected propylene glycol intoxication in selected clinical settings. PMID- 3974045 TI - The changing mole. PMID- 3974046 TI - Leads from the MMWR. Update: influenza activity--worldwide, United States. PMID- 3974047 TI - Leads from the MMWR. Update: Reye syndrome pilot study--United States, 1984. PMID- 3974048 TI - Patient education re: nuclear war. PMID- 3974049 TI - Vasectomy and health. PMID- 3974050 TI - The Rumpel-Leede sign associated with a noninvasive ambulatory blood pressure monitor. PMID- 3974051 TI - Assessment of double-blindness at the conclusion of the beta-Blocker Heart Attack Trial. AB - At the conclusion of a double-blinded, randomized clinical trial of propranolol hydrochloride, but before unblinding, the patients and clinic personnel were asked to guess the treatment group assignment of each patient. While 79.9% of the patients receiving propranolol correctly identified their treatment group assignment, 57.2% of the patients receiving placebo incorrectly guessed that they were also in the propranolol group. No specific mechanism was identified to explain why more patients receiving propranolol were better able to guess their group assignment. Clinic physicians correctly identified the group assignment of 69.9% of the patients receiving propranolol and 68.8% of the patients receiving placebo. Clinic coordinators correctly identified the group assignment of 67.1% of the patients receiving propranolol and 70.6% of the patients receiving placebo. For clinic personnel, heart rate level and heart rate change seem to be the mechanisms employed to identify their patients' treatment assignment. PMID- 3974052 TI - Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. AB - Among infants born to women in whom sera are positive for both the hepatitis B surface antigen and the e antigen, 85% to 90% are infected with hepatitis B virus and become chronic hepatitis B surface antigen carriers. In a study to assess the effectiveness of passive-active prophylaxis (hepatitis B immune globulin and hepatitis B vaccine) of such infants, we screened 18,842 pregnant Asian-American women: 8.7% were positive for hepatitis B surface antigen and 3.0% were also positive for hepatitis B e antigen. Thus far, 113 infants have received hepatitis B immune globulin (0.5 mL at birth) and hepatitis B vaccine (three 20-micrograms doses beginning at birth or at 1 month) and have been followed up for nine to 18 months. Among these infants, 16 have become chronic carriers, an incidence of only 14.2%. All of the uninfected infants have retained high levels of antibody to surface antigen, suggesting that they have had an active immune response to the vaccine and should have long-term protection against hepatitis B virus. PMID- 3974053 TI - Autoimmune hemolytic anemia with both cold and warm autoantibodies. AB - Of 144 patients with a positive direct antiglobulin test and having autoimmune hemolytic anemia (AIHA), 12 (8.3%) satisfied diagnostic criteria for both warm antibody AIHA and cold agglutinin syndrome. All 12 patients had IgG and C3d sensitizing their erythrocytes, and samples of their serum contained IgM cold autohemagglutinins optimally reactive at 4 degrees C, but with a high thermal amplitude to 37 degrees C, and IgG warm autoantibodies. All red blood cell eluates contained IgG warm autoantibodies. The 12 patients had severe hemolytic anemia that responded dramatically to corticosteroid therapy, with the mean hemoglobin level increasing from 6.3 to 12.9 g/dL. Five patients (42%) had systemic lupus erythematosus, one patient (8%) had a non-Hodgkin's lymphoma, and six patients (50%) had idiopathic AIHA; four patients (33%) had concomitant thrombocytopenia (Evans' syndrome). Nine patients (75%) were female. Four patients had unexpected alloantibodies potentially capable of in vivo hemolysis of transfused blood. Because of the severe hemolysis, the serologic findings, and the dramatic initial clinical response to corticosteroid therapy, these patients represent a distinct catagory of AIHA and should be given corticosteroid therapy quickly. PMID- 3974054 TI - Ocular manifestations of gravity inversion. AB - To determine the ocular manifestations of inverting the human body into a head down vertical position, we evaluated normal volunteers with applanation tonometry, fundus photography, fluorescein angiography, and ophthalmodynamometry. Compared with data obtained in the sitting position, the intraocular pressure more than doubled on inversion (35.6 +/- 4 v 14.1 +/- 2.8 mm Hg, n = 16), increasing to levels well within the glaucomatous range. Pressures in the central retinal artery underwent similar increases, while the caliber of the retinal arterioles decreased substantially. External ocular findings associated with gravity inversion included orbital congestion, conjunctival hyperemia, petechiae of the eyelids, excessive tearing (epiphora), and subconjunctival hemorrhage. We suggest that patients with retinal vascular abnormalities, macular degeneration, ocular hypertension, glaucoma, and similar disorders refrain from inversion altogether. Whether normal individuals will suffer irreversible damage from inversion is uncertain, but it seems prudent to recommend that prolonged periods of inverted posturing be avoided. PMID- 3974055 TI - The economic environment of resident physicians. AB - We examined the financial, working, and educational environment of resident physicians, using mail surveys of residents conducted in 1979 and 1983. Variables examined include annual residency salary, fringe benefits, educational debt, moonlighting income, hours and types of work, and perceived problems with the residency programs. Three conclusions are drawn from the surveys. First, the rapid increases in resident salaries prevalent in the late 1960s and early 1970s have been replaced by more modest advances. Second, resident physicians are not indicating great concern about their current financial status. Third, resident physicians work long hours, but teaching hospitals have not increased their use of residents. These findings illustrate the dual nature of residency training: residents are both students and employees. PMID- 3974056 TI - Community-oriented primary care in the United States. A status report. AB - Community-oriented primary care (COPC) is a variation on the primary care model, which is characterized by the complementary use of epidemiologic and primary care skills to systematically address the health care needs of a defined population. A study by the Institute of Medicine developed an operational model of COPC and examined its feasibility under differing organizational and financial arrangements. Although COPC is usually associated with publicly funded programs for underserved populations, the study demonstrated its presence in the private sector as well. However, the financial structure of the practice remains a critical factor determining the particular expression of the model. The study points to the need for data describing the marginal cost and health impact of COPC, if this promising innovation is to become an important form of primary care practice. PMID- 3974057 TI - The management of pneumonias in immunocompromised patients. PMID- 3974059 TI - Cerebrovascular complications of streptokinase infusion. AB - Ninety-one patients treated with streptokinase for vascular occlusion were studied retrospectively to document the incidence of cerebral hemorrhage. Three cerebrovascular complications occurred. Two patients had cerebral hemorrhage, one following limb ischemia, the other after acute myocardial infarction. The third patient received streptokinase for an occluded right subclavian bypass graft and suffered a right frontoparietal infarction, presumably secondary to retrograde embolization, but not angiographically proved. This incidence of cerebrovascular complications must be taken within the framework of the baseline incidence following systemic ischemia, but suggests that caution be exercised with this therapy. PMID- 3974058 TI - Persistence of improvement in antibiotic prescribing in office practice. AB - We evaluated persistence of the prescribing improvement seen in a previous statewide controlled trial, which measured improvement in the prescribing of contraindicated antibiotics and oral cephalosporins in the year after an educational intervention. Doctors visited by physician-counselors substantially improved their prescribing of both classes of drugs. The beneficial effect of the physician-counselors persisted throughout year 2, with attributable reductions in prescribing of 30% and savings of $950 for each doctor visited. The marked and lasting improvement in prescribing produced by the physician-counselors suggests using this model to develop ongoing programs to improve prescribing. PMID- 3974060 TI - Tuberculosis: when not to order roentgenograms. PMID- 3974062 TI - Opportunistic pneumonia: a stepped approach. PMID- 3974061 TI - Randomized clinical trials need to be more clinical. PMID- 3974063 TI - Laser may have uses in bladder tumors, esophageal blockages. PMID- 3974064 TI - For many, endemic goiter remains a baffling problem. PMID- 3974065 TI - Leads from the MMWR. Multiple measles outbreaks on college campuses--Ohio, Massachusetts, Illinois. PMID- 3974066 TI - Leads from the MMWR. Update: childhood poisonings--United States. PMID- 3974067 TI - Leads from the MMWR. Pseudo-outbreak of intestinal amebiasis--California. PMID- 3974068 TI - Ordering tests in the United States and England. PMID- 3974069 TI - Ethics and cost containment. PMID- 3974070 TI - Physician education and cost containment. PMID- 3974071 TI - Toxic shock syndrome associated with the use of the vaginal contraceptive sponge. PMID- 3974072 TI - Epileptics and scuba diving. PMID- 3974073 TI - Injuries from fireworks. PMID- 3974075 TI - Diagnosis of schistosomiasis. PMID- 3974074 TI - Bacteriuria: colonization or infection. PMID- 3974076 TI - Fatal case of necrotizing enterocolitis associated with feeding concentrated infant formula. PMID- 3974077 TI - Wonton, straight up. PMID- 3974079 TI - Recognition of mental distress and diagnosis of mental disorder in primary care. AB - Data from the National Ambulatory Medical Care Survey show that the majority of psychotropic drugs and "psychotherapy/therapeutic listening" provided to adults in office-based primary care are given in visits during which no diagnosis of mental disorder is recorded. This finding is not explained either by a general tendency of surveyed physicians to record drug treatment without an appropriate diagnosis or by management of specific nonmental disorders with mental treatments. Patients who receive treatment without diagnosis tend to be older, established patients with established diagnoses who see the physician for a shorter visit and are more likely to have a follow-up appointment. The data do not provide evidence as to whether mental treatment without mental diagnosis results from inadequacies in the current diagnostic system, inadequacies of physician knowledge and skills, or other factors. Further clarification of this issue will require new research models. PMID- 3974080 TI - Family history and the risk of breast cancer. AB - To investigate whether a family history of breast cancer increases a woman's risk of developing breast cancer, we analyzed data from the Centers for Disease Control's Cancer and Steroid Hormone Study. The 4,735 cases were women 20 to 54 years old with a first diagnosis of breast cancer ascertained from eight population-based cancer registries; the 4,688 controls were women selected at random from the general population of these eight areas. Compared with women without a family history of breast cancer, women who had an affected first-degree relative had a relative risk of 2.3; women with an affected second-degree relative had a relative risk of 1.5; and women with both an affected mother and sister had a relative risk of 14. The risk of breast cancer for a woman was higher if her first-degree relative had unilateral rather than bilateral breast cancer or had breast cancer detected at a younger rather than older age. For women aged 20 to 39, 40 to 44, and 45 to 54 years, the estimated annual incidence of breast cancer per 100,000 women attributable to a first-degree family history of breast cancer was 51.9, 115.1, and 138.6, respectively, and that attributable to a second-degree family history of breast cancer was 12.1, 19.2, and 92.4, respectively. PMID- 3974078 TI - Risk for bladder cancer. Psychological impact of notification. AB - Informing persons that they have been exposed to a carcinogenic chemical (beta naphthylamine) may adversely affect these persons and their families. The purpose of this study was to identify and assess the psychological impact of a bladder cancer notification and screening program on persons at risk and their families. Approximately 140 subjects were randomly selected from 850 workers exposed to beta-naphthylamine. The Family APGAR, Impact of Event Scale, and Improved Readability Form of the Minnesota Multiphasic Personality Inventory were administered within four weeks of the initial medical screening and readministered six months later. Results show no evidence of disruption to families or substantive psychopathology among these persons. While the actual acquisition of cancer is undoubtedly a psychological trauma, mere notification of risk may not be traumatic in every situation. PMID- 3974082 TI - Scientific status of refreshing recollection by the use of hypnosis. Council on Scientific Affairs. AB - The Council finds that recollections obtained during hypnosis can involve confabulations and pseudomemories and not only fail to be more accurate, but actually appear to be less reliable than nonhypnotic recall. The use of hypnosis with witnesses and victims may have serious consequences for the legal process when testimony is based on material that is elicited from a witness who has been hypnotized for the purposes of refreshing recollection. PMID- 3974081 TI - Are esophageal motility abnormalities produced during the intraesophageal acid perfusion test? AB - Many years ago, it was proposed that the symptoms of heartburn correlated more closely with acid-induced esophageal motility abnormalities than with the presence of inflammation. This concept, however, has not been evaluated by modern manometric techniques. We monitored intraesophageal pressures during acid perfusion (O.1N hydrochloric acid) in 17 reflux patients with gross esophagitis and positive pain response and 17 age-matched controls. Using a low-compliance infusion system, amplitude, duration, velocity, and the presence of simultaneous and repetitive contractions in the body of the esophagus were evaluated. Amplitude did not change in either group. Duration did increase significantly during acid perfusion in reflux patients, but not in controls. Mean duration between groups, however, was similar before and during acid perfusion. No simultaneous contractions were observed, while three patients and two controls had repetitive contractions. A significant decrease in velocity was observed in both groups during acid perfusion. These studies indicate that acid-induced motor abnormalities are neither a common accompaniment nor necessary for the production of acid-induced pain in the esophagus. PMID- 3974083 TI - Consequences of an oversupply of specialists. The case of neurology. PMID- 3974084 TI - News of risk as a potential stressor. PMID- 3974085 TI - Bhopal tragedy's repercussions may reach American physicians. PMID- 3974086 TI - After coping with crisis, medicine ponders sequelae. PMID- 3974087 TI - Leads from the MMWR. Update: acquired immunodeficiency syndrome--Europe. PMID- 3974088 TI - Leads from the MMWR. Occupational fatality associated with a robot--Michigan. PMID- 3974089 TI - Continuity of outpatient care in elderly men. PMID- 3974090 TI - Recurrent aphthous stomatitis. PMID- 3974091 TI - Preparation: sometimes good is not good enough. PMID- 3974092 TI - What's the beef? PMID- 3974093 TI - Neurotoxicity and vincristine. PMID- 3974094 TI - Communication between doctors and patients. PMID- 3974095 TI - Effects of nifedipine in achalasia and patients with high-amplitude peristaltic esophageal contractions. PMID- 3974096 TI - Breaks and other bad breaks for breakers. PMID- 3974097 TI - Comparison of the acute cardiopulmonary effects of oral albuterol, metaproterenol, and terbutaline in asthmatics. AB - The acute cardiopulmonary effects of oral albuterol, 4 mg, metaproterenol sulfate, 20 mg, and terbutaline sulfate, 5 mg, were compared over eight hours in 20 moderate to severe asthmatics. The magnitude and time course of bronchodilation following albuterol and terbutaline were comparable. Albuterol and terbutaline had a duration of action of at least eight hours and produced significantly greater bronchodilation than metaproterenol from six to eight hours. Metaproterenol produced a greater degree of bronchodilation than albuterol and terbutaline 30 minutes after drug dosing. Significantly fewer patients receiving albuterol experienced one or more central nervous system or musculoskeletal side effects than patients receiving terbutaline. These findings imply possible therapeutic advantages of oral albuterol and terbutaline with respect to dosing frequency, while the more rapid onset of oral metaproterenol suggests that it may have an advantage when used on an as-needed basis. PMID- 3974098 TI - Operational and financial outcomes of shared laboratory services in a consolidated hospital system. AB - The clinical laboratories of three hospitals were consolidated under a single directorship. Improvements in available services and substantial true cost savings were achieved. These results illustrate the theoretically anticipated but rarely documented advantages of a shared-hospital services model of health care provision. PMID- 3974099 TI - Consensus conference. Lowering blood cholesterol to prevent heart disease. PMID- 3974100 TI - An educational view of a national initiative to lower plasma lipid levels. AB - Two intervention trials have found significant reduction in coronary heart disease mortality and morbidity following reduction of plasma cholesterol levels by diet or drugs. The implications of these studies have been broadened to support a national effort directed to plasma lipid reduction. The evidence suggests that both a public health and medical approach can be effective and that each would be complementary in a national initiative. An important and critical dimension would be education, both of the public and of health professionals. The pertinent educational issues are identified in the categories of knowledge, attitudes, and skills. Economic considerations are an important factor in implementing a national initiative and require attention in development of a program. PMID- 3974101 TI - Cholesterol and coronary heart disease: a perspective. PMID- 3974102 TI - Effective medical treatment for hydatid disease? PMID- 3974103 TI - Cardioverters, proteins, receptors studied in cardiovascular disorders. PMID- 3974104 TI - Looking at vision problems in schoolchildren, infants. PMID- 3974105 TI - Leads from the MMWR. Botulism from fresh foods--California. PMID- 3974106 TI - Leads from the MMWR. Surveillance and assessment of alcohol-related mortality- United States. PMID- 3974107 TI - Compensation for vaccine injury. PMID- 3974109 TI - Atrophic gastritis. PMID- 3974108 TI - A case of stadol dependence. PMID- 3974110 TI - Management of TIAs. PMID- 3974111 TI - Leukopenia in Still's disease. PMID- 3974112 TI - Early detection of breast cancer. PMID- 3974113 TI - Postherpetic pudendal neuralgia. PMID- 3974114 TI - Physicians' abilities to detect lumps in silicone breast models. AB - Little is known about how well physicians detect breast lumps in clinical breast examinations. We studied 80 general medicine, family medicine, general surgery, and obstetrics/gynecology physicians to determine their abilities to detect lumps in manufactured breast models. The mean number of lumps detected was 8.0 (44%), with a range of three (17%) to 15 (83%). Detection varied significantly by size (87% of 1.0-cm and 14% of 0.3-cm lumps) and hardness (56% of hard and 40% of soft lumps), but not depth; by specialty (from 50% for general internists to 40% for obstetricians), but not by level of training or experience; and by search duration (r = .59). On multiple regression analysis, only search duration was consistently associated with increased detection. Modest detection rates and wide variation suggest breast lump detection can be improved among physicians. Adequate search duration may be important for high detection rates. PMID- 3974115 TI - The do-not-resuscitate order in teaching hospitals. AB - We studied the use of do-not-resuscitate (DNR) orders at three teaching hospitals that did not have official protocols for such orders to see whether their use meets the goals (decision making before a crisis and promoting patient autonomy) that have been identified for such orders. We found that 20% of all patients had or were being considered for DNR orders, that the patient and/or family was usually involved (83%) in the decision not to resuscitate, but rarely involved (25%) in decisions to resuscitate, or in cases of no decision, that a wide range of care was provided to patients with a DNR status, and that partial resuscitative efforts would be employed in some cases. Our main conclusion in light of our findings is that DNR orders are currently not fulfilling their major goals. We offer six proposals for improving future DNR protocols. PMID- 3974116 TI - Thermodilution cardiac output measurement. Effects of the respiratory cycle on its reproducibility. AB - Thermodilution cardiac output measurements are commonly employed in the management of critically ill patients. Serial measurements often show significant variation, and poor reproducibility limits their clinical utility. There are no clinical studies revealing when to perform thermodilution cardiac output measurements in relation to the respiratory cycle. We prospectively studied 32 patients in a randomized scheme comparing three thermodilution cardiac output measurements at peak-inspiration, at end-exhalation, or randomly in spontaneously breathing and mechanically ventilated patients. Saline injections initiated at peak-inspiration or end-exhalation resulted in cardiac output measurements with much smaller standard deviations than those seen with random injections. Thermodilution cardiac output measurements performed at random times in the respiratory cycle should be avoided, and we recommend initiating these measurements at end-exhalation. PMID- 3974117 TI - Oral contraceptives, Chlamydia trachomatis infection, and pelvic inflammatory disease. A word of caution about protection. AB - Management of pelvic inflammatory disease (PID) and decisions about contraception are being influenced by reports that oral contraceptives decrease the risk of PID. To evaluate the validity of this association, we have examined published epidemiologic evidence and reviewed relevant information from other disciplines. Current information does not permit the generalization that oral contraceptives protect against all forms of PID. Most studies conducted (1) have been limited to hospitalized women, who represent less than 25% of all PID cases and are likely to have relatively severe forms of the disease, and (2) have failed to distinguish between gonococcal and nongonococcal PID. While oral contraceptives may provide some protection against gonococcal PID, no basis exists for assuming similar protection is provided against chlamydial PID. In fact, epidemiologic and biologic evidence suggests that infection with Chlamydia trachomatis, the leading cause of nongonococcal PID, is enhanced by oral contraceptives. We judge the conclusion that oral contraceptives protect against all PID to be premature, and urge caution in its application in health policy and clinical decisions. PMID- 3974119 TI - Delayed diagnosis of disease. PMID- 3974118 TI - Splenic syndrome at mountain altitudes in sickle cell trait. Its occurrence in nonblack persons. AB - Six consecutive cases of splenic syndrome at mountain altitudes in persons with sickle cell trait are reported and the literature is reviewed. All six cases occurred in men who experienced the acute onset of severe left-upper-quadrant abdominal pain within 48 hours of arrival in Colorado from lower altitudes. All six patients were phenotypically nonblack. Three patients experienced their symptoms at moderate altitudes of 1,609 to 2,134 m (5,280 to 7,000 ft) above sea level. All recovered with medical management and none required splenectomy, although functional hyposplenia was a sequela in at least one patient. The possibility that nonblack persons with sickle cell trait may be at greater risk than black persons with sickle cell trait for the development of splenic syndrome at moderate altitude is discussed. PMID- 3974120 TI - The sickle cell gene in evolution: a solitary wanderer or a nomad in a caravan of interacting genes. PMID- 3974121 TI - Hypertension: some unanswered questions. PMID- 3974122 TI - Inhomogeneous contribution of late diastolic filling to filling volume in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography. AB - Contributions of late diastolic filling (slow filling and atrial systolic phases) to total filling volume in both global and regional left ventricle were analyzed using radionuclide techniques in 21 patients with isolated left anterior descending coronary artery disease without previous myocardial infarction. A computer program subdivided the image of the left ventricle into four regions at a geometric center of the area. The time-activity and its first-derivative curves of the global and regional left ventricles were computed. In the global left ventricle, the percent contributions of late diastolic filling to total filling volume were significantly increased in patients with one-vessel disease than in control subjects (20 +/- 5%, 28 +/- 4%; p less than 0.001). In the regional left ventricle, in patients with one-vessel disease, the percent contributions of late diastolic filling to total filling volume were significantly increased in the septal (25 +/- 5%, 34 +/- 8%; p less than 0.001) and in the apical regions (21 +/ 4%, 28 +/- 4%; p less than 0.001) which were perfused by stenosed vessel. In contrast, there were no significant differences in this value between the two groups in the normally perfused lateral region (22 +/- 6%, 25 +/- 5%; p = NS). These results indicate that the late diastolic filing makes a larger contribution to the left ventricular filling in the affected regions than in the normally perfused regions, and that the increased late diastolic filling in the affected regions are the cause for the increased late diastolic filling in the global left ventricle in patients with one-vessel disease. PMID- 3974123 TI - Calcium-binding of cardiac sarcoplasmic reticulum and diastolic hemodynamics in volume overloaded canine hearts. AB - The relationship between the active Ca2+-binding function of the cardiac sarcoplasmic reticulum (SR) and left ventricular (LV) relaxation was studied in various stages of chronically volume overloading canine hearts induced by complete atrio-ventricular (A-V) block. Rapid kinetic measurement of the Ca2+ binding activity of SR was made using a dual-beam spectrophotometric assay procedure. LV hemodynamics, especially diastolic indexes, were evaluated by the pressure-volume relationship using a trans-epicardial echo-cardiographic technique. In this study the maximum Ca2+-binding capacity and the initial Ca2+ binding rate of SR were impaired in eccentric hypertrophied hearts and failing hearts induced by volume overload. However, there was no significant difference of SR functional defect between the hypertrophied and the failing hearts. LV systolic properties were not influenced even by chronic volume overload. Its diastolic properties, however, were reduced with the progress of eccentric hypertrophy, and were estimated to respond more sensitively to the abnormalities of cardiac function compared with systolic properties. There was a close interrelation between the Ca2+-binding activity of SR on the molecular level and diastolic parameters, especially the time constant T, on the ventricular chamber level. In conclusion, the impairment of the Ca2+-binding activity of SR is a cause of depression of LV diastole. However, the role of SR in the occurrence of heart failure could not be clarified in this study. PMID- 3974125 TI - Quadricuspid aortic valve associated with severe aortic regurgitation. AB - A 57-year old man with severe aortic regurgitation was found to have a quadricuspid aortic valve. Aortic valve replacement was performed successfully with a St. Jude Medical prosthetic valve. On histological examination, the resected cusps showed fibrotic thickening with calcification. PMID- 3974124 TI - Beneficial effect of diltiazem on ischemia-reperfusion injury in the dog. AB - We determined the effect of the calcium antagonistic agent, diltiazem hydrochloride upon ischemia-reperfusion injury in the dog. Ischemia was produced by occluding the left anterior descending artery for 40 min. Subsequent reperfusion was accomplished for 120 min by virtue of removal of the occlusion. Sixteen of the dogs studied were randomly assigned to diltiazem (D)-treated group (n = 8) and saline (S)-treated group (n = 8). D in saline was intravenously infused at a concentration of 3 mcq/kg/min starting 15 min after the occlusion. Myocardial blood flow (MBF) was measured using hydrogen gas clearance method. Infarct size was quantified as percent myocardium at risk by triphenyltetrazolium chloride staining. D administration caused a slight decline in mean aortic pressure, heart rate, and heart rate X systolic blood pressure throughout the periods of occlusion and reperfusion. However, there was no significant difference observed in both groups of dogs. MBF to ischemic myocardium was not significantly enhanced by D during ischemia. After 5 min of reperfusion subepicardial MBF was increased in group S, indicating a tendency towards reactive hyperemia. After 120 min of reperfusion there was a significant reduction in subendocardial MBF in group S and the transmural blood flow ratio was 1.23 +/- 0.59 in group D as compared with 0.53 +/- 0.39 in group S (p less than 0.05). The infarcted area as a percentage of the risk area was considerably smaller in group D than in group S (27.5 +/- 3.0 vs 47.0 +/- 6.5%, p less than 0.05). D markedly reduced the elevation of tissue calcium especially in the subendocardium. These findings suggest that D reduces the ultimate infarct size through the beneficial effect on ischemia-reperfusion injury. PMID- 3974126 TI - Interaction between heart as a pump and artery as a load. AB - For a better understanding of the functional roles of the heart as a pump system, an analogy with an industrial fluid-pump system is beneficial. In this paper, the use of the ventricular pressure-volume relationship was shown to provide one of the most useful descriptions of the heart as a pump system. This description included the pump function of the ventricle as well as the interrelation between cardiac mechanics and energetics. In describing the heart only as a pump, Thevenin's network model consisting of a source of pressure with a series source resistance (or impedance) is useful in analysing the complex interactions of the equilibrium mechanism for determining cardiac output and arterial pressure, and the matching conditions under the ventriculo-arterial coupling during the ejection period for a given set of ventricular and arterial system parameters. The analytical results using this model explained previous experimental results by other investigators. It was also suggested that the ventriculo-arterial coupled system appears to be matched. From the engineering point of view, it is desirable also for the ventricle as a pump to behave under such an optimum matching condition for delivering a maximum power to the arterial load. PMID- 3974127 TI - Interaction of left ventricular contraction and aortic input impedance in experimental and clinical studies. AB - Implication of aortic input impedance and left ventricular coupling were investigated in three series of studies. In a clinical study, the ascending aortic flow velocity and pressure were simultaneously recorded from a multisensor catheter, and input impedance was calculated from 8 harmonics of aortic pressure and flow. Left ventricular wall stress was calculated from diameters and wall thickness of cineventriculogram and simultaneous recording of left ventricular pressure. In the experimental study, programmable artificial pulsatile pump was used to control pulsatile blood flow in dogs. The pressure-flow relationship in the arterial system had slightly convex curves toward the pressure axis with a critical turning pressure, so the arterial system had low output--high resistance and high output--low resistance characteristics. Therefore, the failed heart should inevitably eject the blood against stiffened vascular beds. Increased work load of the ventricle as expressed by sustained ventricular wall stress was determined mainly by the exaggerated late systolic pressure due to increased input resistance and increased low frequency pulsatile component of the input impedance. These findings are especially important for relieving additional work load of the ischemic heart, which have higher pressure wave reflection. PMID- 3974128 TI - Responses of left ventricle to changes in aortic input impedance. AB - In order to evaluate how pressure and flow at the outlet of a ventricle are determined by the interaction between the ventricle and an aortic input impedance, we examined the effects of independent changes in the peripheral resistance and in the aortic compliance using isolated canine left ventricle preparations. There was an inverse linear relationship of mean values between pressure and cardiac output under pure resistance changes when coronary flow was maintained constant. But, when the coronary perfusion pressure depended on mean aortic pressure, the relationship was no longer linear under a critical aortic pressure. When aortic compliance was increased, late systolic flow was enhanced and late systolic pressure decreased such that the stroke volume increased. The top part of the pressure-volume loop showed a configurational change from the right side down to the left side down. Changes in pressure and flow wave forms, and in the pressure-volume loop can be predicted by an electrical model in which time varying capacitance arranged in series with the internal resistance was used as a ventricular model. PMID- 3974129 TI - Roles of coronary circulation as a determinant of the left ventriculo-arterial interaction. AB - We investigated how coronary circulation influences the ventriculo-arterial interaction. For the quantitative analysis of this interaction, we proposed a simple framework where both ventricular property and vascular property were expressed as the end-systolic pressure-volume relationship. Combining this analysis with experimental data indicated the interactive nature of ventricular function that varied with loading condition through coronary circulation. Effects of regional ischemia on the ventriculo-arterial interaction was also analyzed. The loading condition insensitivity, simplicity and adequacy of the end-systolic pressure-volume relationship of ventricle made it possible to analytically couple the ventricle with arterial system providing a useful view in understanding the complex hydraulic interaction between the ventricle and arterial system. PMID- 3974130 TI - Altered loading sequence as an underlying mechanism of afterload dependency of ventricular relaxation in hearts in situ. AB - Underlying mechanisms of afterload dependency of ventricular relaxation rate were studied in nine isolated canine hearts and nine open chest dogs. In isolated hearts with isobaric contraction, peak LV pressure was increased by volume loading with stroke volume unchanged, and in anesthetized open chest dogs the afterload was altered by a manual clamp of the descending aorta to various extent under the pharmacological blockade of the autonomic nerve activity. Ventricular relaxation rate was assessed by the time constant (T) of isovolumic LV pressure decay. In hearts in situ of open chest dogs, T was progressively (p less than 0.01) increased as peak LV pressure increased, whereas in isolated hearts T was decreased as afterload increased (p less than 0.05), indicating that peak LV pressure is not a major determinant of ventricular relaxation rate. Between these two heart preparations loading sequence of the heart during contraction was characteristically different; in open chest dogs, as afterload increased ejection timing was accelerated and the time of peak LV pressure (TPmax) was prolonged, whereas TPmax in isolated hearts was decreased and ejection timing was progressively delayed as an increase in afterload. Consequently, TPmax showed a high correlation with T irrespective of peak LV pressure. These results indicate that T is directly dependent on loading sequence mainly regulated by ejection timing. This finding was also confirmed in open chest dog experiments in which 20 pairs of contractions with comparable peak LV pressures and LV dimensions (end systolic and end-diastolic lengths) but characteristically different loading conditions during contraction (early maximal loading vs late maximal loading) were obtained by the manual clamp of ascending aorta; in early maximal loading conditions (TPmax: 185 +/- 8 ms) T's (66 +/- 3 ms) were significantly (p less than 0.01) smaller than those (110 +/- 10 ms) in late maximal loading conditions (TPmax: 261 +/- 11 ms). A change in loading sequence associated with afterload interventions in hearts in situ may be due to a change in compliance in peripheral arterial system. We conclude that afterload dependency of ventricular relaxation rate observed in hearts in situ could be attributed to the accompanied changes in loading sequence of the heart probably due to a change in arterial compliance. The dependency of relaxation on loading sequence of the heart might be clinically important in evaluating the effect of cardiovascular agents on ventricular relaxation since these agents may largely affect the vascular compliance as well as muscular relaxation per se. PMID- 3974131 TI - Behavior of the right ventricle against pressure loading: on its plasticity. AB - The difference between the right (RV) and the left ventricle during progressive pressure loading is that the RV changes to cylindrical form without change in its enddiastolic pressure (EDP). We investigated this particular phase experimentally and clinically. In experimental animal studies (dogs), the gradual construction of the main pulmonary artery (PA) resulted in an elevation of RV systolic pressure (RVSP) without changes in RVEDP and PA flow (FPA). This was followed by an increase in RVEDP and a decrease in FPA. In this initial phase, the RV increased in its dimension from the free wall to the septum. In 155 clinical cases with RV pressure loading, the relationship between RVEDP and RVSP suggested that the RV compliance of the cases with chronic RV pressure loading was less than that with subacute loading. However, these studies did not supply the expected data on the phase we mentioned. In 2 patients with primary pulmonary hypertension who showed spontaneous remission during our observation, a decrease in RVSP without change in RVEDP occurred with a change in RV form detected by 2 dimensional echocardiography. These data suggested the existence of a phase in which the RV showed a character of plasticity during pressure loading, but direct documentation was not successful. PMID- 3974132 TI - [Extended pancreatectomy after a number of operations for pancreatic polycystosis]. PMID- 3974133 TI - [Surgical treatment of a cyst of the extrahepatic bile ducts]. PMID- 3974134 TI - [Recurrence of cholelithic intestinal obstruction]. PMID- 3974135 TI - [Surgical treatment of benign diseases of the biliary tract]. PMID- 3974136 TI - [Perforated cholecystitis]. PMID- 3974137 TI - [Use of a suspension of allogeneic liver cells in treating patients with acute liver and liver-kidney failure]. PMID- 3974138 TI - [Recurrent and residual echinococcosis of the abdominal organs]. PMID- 3974139 TI - [Use of penetrating transhepatic drainage in treating hepatic alveolar hydatid disease complicated by mechanical jaundice]. PMID- 3974140 TI - [Treatment of acute destructive pancreatitis by sealing the pancreatic duct system]. PMID- 3974141 TI - [Lactate dehydrogenase enzymes and isoenzymes in the diagnosis of forms of acute and postoperative pancreatitis]. PMID- 3974142 TI - [Diagnostic and therapeutic gastroduodenoscopy in acute pancreatitis]. PMID- 3974143 TI - [Diagnosis and treatment of internal pancreatic fistulae]. PMID- 3974145 TI - [Late results of the surgical treatment of pancreatic pseudocysts following acute pancreatitis]. PMID- 3974144 TI - [Diagnosis of calculi in the major bile ducts]. PMID- 3974146 TI - [Hepatic echinococcosis--ultrastructural pathogenetic aspects and clinico laboratory comparisons]. PMID- 3974147 TI - [Surgical treatment of congenital aneurysms of the internal jugular veins]. PMID- 3974148 TI - [Acute postoperative pancreatitis in stomach and duodenal surgery]. PMID- 3974149 TI - [Surgical treatment of intraoperative injuries to the common bile and pancreatic ducts]. PMID- 3974150 TI - [Errors and complications in the surgery of acute cholecystitis and the means for overcoming them]. PMID- 3974151 TI - [Thrombohemorrhagic complications in patients with mechanical jaundice]. PMID- 3974153 TI - [Time periods for surgical intervention in acute cholecystitis patients]. PMID- 3974152 TI - [Pure pancreatic juice in the diagnosis of chronic pancreatitis]. PMID- 3974154 TI - [Debatable problems in the treatment of acute cholecystitis]. PMID- 3974155 TI - [Treatment of retinal detachment with a macular hole using the Convers-Machemer method]. AB - Fourteen patients with retinal detachment and macular hole were treated by pars plana vitrectomy and air-gas injection, according to the method of Gonvers and Machemer. Neither scleral buckling procedures at the posterior pole nor coagulation of the macular hole were performed. Ten patients had not previously undergone detachment surgery, and the retinas were reattached in all of them at the follow-up examination 3 months later. In 2 patients the retina subsequently redetached, 7 and 14 months after surgery. Four patients had undergone detachment surgery previously; only in one of them was the retina still reattached after 3 months. The best postoperative visual acuity was 0.2, in 3 patients. PMID- 3974156 TI - [Botulism--observations on its course with emphasis on ophthalmologic symptoms]. AB - The natural history of a moderate intoxication with botulin (probably type B) in six patients is presented and discussed. All patients complained of a persistent and almost complete failure of accommodation, and marked dryness of the mouth. Reduced lacrimation was also noticeable. A disturbance of efferent pupillary reaction was noted only in four patients, and resolved relatively early. On testing with highly diluted pilocarpine solution, a denervation hypersensitivity reaction of the sphincter pupillae was seen. An optic nerve lesion could not be demonstrated in any of the cases. Manifest involvement of the striated musculature, such as a bilateral lateral rectus palsy and ptosis, was found in only one patient. In four patients the presenting symptom was gastroenteritis. Other systemic symptoms were dysphagia, persistent constipation, problems with micturition, general malaise and postural symptoms. All of the patients made a full recovery at the latest after 10 weeks. PMID- 3974157 TI - [Experience with the implantation of the Choyce Mark IX anterior chamber lens]. AB - Experience gathered so far in the implantation of the Choyce Mark IX anterior chamber lens in 140 cases is reported. The follow-up period was 1 year. The advantages of this lens compared to all other implantation lenses are its complete visibility, the fact that it is replaceable, and the ease and rapidity of implantation. The main problem lies in determining the correct length of the lens. A high percentage (56%) of distortion of the pupil has so far had no negative influence on ocular function. Hemorrhages into the chamber angle can be avoided by atraumatic surgery. PMID- 3974158 TI - [Vision disorders in insufficiency and occlusion of the basilar artery]. AB - The severe course of disease in a patient with stenosis of the basilar artery, who was initially an in-patient at the author's clinic, is described and compared with the courses in 15 patients with angiographically proven stenosis or insufficiency of the basilar artery. The difficulties of diagnosis and in particular of differentiating the condition from hysteria are discussed. PMID- 3974159 TI - [Bilateral retinal vein occlusions and general risk factors]. AB - A report on 12 patients with retinal vein occlusion in both eyes. In addition to advanced age (67 years on the average) the following risk factors were present, often in combination: hypertension, cardiac insufficiency, adiposity, hyperlipidemia, hyperuricemia, hypercholesterinemia, diabetes mellitus etc. The rate of retinal circulation was determined by video fluorescein angiography. A pronounced decrease in visual acuity was observed in all patients with a slower retinal circulation rate. The causes of the decrease in central visual acuity were macular edema, neovascularization with vitreal hemorrhage and rubeosis iridis with secondary glaucoma. PMID- 3974160 TI - [Results of 1-year use of local pindolol in open-angle glaucoma]. AB - In a randomized and controlled study (already published) the efficacy and safety of Pindolol eye drops 1% were compared with Timolol eye drops 0.5% in the treatment of open-angle glaucoma over a period of 6 months. With the exception of some allergic reactions there was no difference between the two with regard to IOP and the other parameters documented, such as pulse, blood pressure, visual acuity, refraction, diameter of pupils, tear production, visual field and biomicroscopic and ophthalmoscopic. In this article, the authors report on the results of prolongation of treatment in the 33 patients of the Pindolol group from month 7 to month 12 in an open-case study. The effect on IOP after 12 months was no different from that after month 6. There was no difference with regard to pulse and blood pressure, either. Four patients had to discontinue the treatment, in one case owing to drug-related side effects on the lids and conjunctiva. The other parameters documented (visual acuity, visual field, refraction, diameter of pupils, tear production, corneal sensitivity and biomicroscopic and ophthalmoscopic examination) revealed no difference between the first and the second 6 months. A diminution of the effect of the drug on the level and duration of IOP was ruled out. PMID- 3974161 TI - [Congruent corneal cap of metal foil as protection of the eye against light and heat from operation lamps]. AB - A protective cap of aluminum foil, covering the cornea, offers effective protection from the light and heat of surgical lamps. None of the 120 patients who underwent surgery in the course of a year, for implantation of Siensky-Kratz posterior chamber lenses (Intermedics), developed cystoid macular edema, the protective cap having been used whenever possible during the operation. The glare of the lamps, which is a torture for non-anesthetized patients, should alone be considered reason enough to cover the eye with a protective cap of this kind. PMID- 3974162 TI - [Myopia: causes and prevention]. AB - Myopia is the most common disorder of visual function in many literate populations, affecting 70% of some specific groups. The causes may lie in genetic or environmental factors. This article discusses the arguments put forward to support of the biological and environmental theories of the cause of myopia. It is argued that the biological theory has never been proven empirically and that the evidence clearly points to the role of close-range work in the prevalence of myopia as a massdisease. Primary prevention is difficult in this situation and compensatory strategies (relaxation, eye exercises) are rather ineffective. Prevention strategies are discussed and a research program to evaluate their effectiveness and efficiency is proposed. PMID- 3974163 TI - [Free-vision refraction determination]. AB - A refraction process is called free vision if the patient's visual field is not restricted at all, or at most by the same amount as when using normal spectacles. Free-vision refraction measurement is performed with the help of virtual lenses, which are real optical images of material lenses. In certain circumstances virtual lenses act as normal optical lenses. The advantage of free-vision refraction measurement lies above all in the fact that remote refraction measurement can also be performed from a distance of less than five meters. Moreover, it permits over-refraction, which enables the duration of the measuring procedure to be shortened considerably. PMID- 3974164 TI - [Magnifying vision aids and their use by vision-handicapped patients]. AB - Patients with visual acuities of below 0.4 at both long and short range cannot be sure of seeing well enough to read or watch TV. Low-vision aids improve vision to a such a degree that these activities can be performed once again. However, aside from this positive effect, low-vision aids have some disadvantages which sometimes prevent patients from actually using them. An investigation conducted among 150 patients revealed that 84% of them used their low-vision aids for about an hour or so a day. PMID- 3974165 TI - [Associated abnormalities in the VACTERL syndrome--case report with autopsy findings]. AB - We report on a male newborn with a VACTERL-association. Our patient had the characteristics of the syndrome: vertebral defects, anal atresia, cardiac anomalies, tracheal stenosis and radial dysplasia. In addition to this combination of malformations we have found a left pulmonary artery sling, cholecystaplasia and biliary dysplasia-not previously reported. Etiology, embryology, coincidence and differential diagnosis are discussed. PMID- 3974166 TI - [Vitamin D metabolism in children with malabsorption syndrome]. AB - In 16 children with malabsorption syndrome, out of which 5 had impaired lipid absorption or diarrhoea, and in 14 children in the control group the concentrations of vitamin D and 25 OH D3 were determined after oral administration of vitamin D in dose of 1200 U/kg.b.wt. or 12000 U/kg.b.wt. No decrease in initial 25 OH D3 concentrations was noted in children with malabsorption syndrome (40,5 +/- 0,7 ng/ml) in comparison with the control group (40,0 +/- 0,4 ng/ml). In children with impaired lipid absorption and diarrhoea the 25 OH D3 concentration was 33,6 +/- 2,4 ng/ml. After oral administration of vitamin D in small doses no differences were noted in the increase in vitamin D and 25 OH D3 concentrations in children with malabsorption syndrome or the control group. After administration of vitamin D in the dose 10 times higher no difference in the increase in vitamin D concentration was noted in children with malabsorption syndrome and the control group. However the increase in 25 OH D3 concentration in children with malabsorption syndrome was 49,8 +/- 1,2 ng/ml and 145,0 +/- 3,5 ng/ml in the control group. In the children with impaired lipid absorption and diarrhoea decreased vitamin D and 25 OH D3 concentrations were noted. This means that physiological doses of vitamin D in children with malabsorption syndrome are sufficient to supply vitamin D. Diarrhoea and impaired lipid absorption however, are indications for stimulation of skin synthesis of vitamin D. PMID- 3974167 TI - Vitamin B6- and protein concentrations in breast milk from mothers of preterm and term infants. AB - The vitamin B6 and protein composition of milk obtained during the first 75 days postpartum from 16 mothers delivering preterm and 24 mothers delivering at term was determined. Both groups of mothers had supplemental intake of 5 mg vitamin B6 beginning with the 2nd trimester of gestation but not during lactation. Milk from mothers delivering preterm contained significantly higher concentrations of vitamin B6 and protein than milk from mothers delivering at term. Vitamin B6 protein relationship, however, was significantly lower in milk from mothers delivering preterm than in milk from mothers delivering term. Both, concentrations of vitamin B6 and protein, and vitamin B6-protein ratio decreased with increasing time of lactation. Supplemental vitamin B6 intake during pregnancy is made responsible for this phenomenon. Milk of mothers with preterm infants is adequate to meet the maintainance requirements for vitamin B6 and protein for a premature infant. PMID- 3974168 TI - [Microbiology of streptococcal infections]. AB - Since the discovery of streptococci by the surgeon of Vienna, Theodor Billroth, more than 100 years ago, they have proved to be a bacterial group of great medical and epidemiological importance. The classification in growth characteristics on blood culture mediums (alpha-, beta- and gamma-hemolysis) has been detached by the evidence of group specific cell wall antigens. The antigene extraction described by Lancefield can distinguish at least 21 serogroups (A-T). They have also taken over the historical names (S. pyogenes, S. agalactiae etc.). In addition to group relationship the antigen structure of the streptococci cell wall (carbohydrates, peptidoglycanes, M-T-R-proteins and others) is responsible for antigenetic and pathogenetic conditions. Some species of streptococci do also excrete exotoxines (streptolysin, hyaluronidase, bacteriocines, erythrogenic toxins) with antigenetic and pathogenetic significance. Infections with streptococci of the serogroup A, B, D and H are numerously and medically significant. There is a great interest in infections due to A streptococci (pharygitis, impetigo, erysipel, scarlatin fever). The known non-purulent diseases following A streptococci infections (acute rheumatoid fever, acute glomerulonephritis) are streptococcal specific reactions for the individual. Some antigens of the cell wall and also some exotoxines react in human beings as autoantigenes. Human beings are the most important reservoir for streptococci. Nearly 20% of a population have A streptococci in their upper respiratory tract.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3974169 TI - [Spinous process osteomyelitis of the thoracic vertebrae 10 and 11 in a newborn infant]. AB - A case of a newborn with osteomyelitis of the spinous processes 10 and 11 is presented. The first clinical sign was a dorsothoracal abscess. Radiologically a destruction of the 10th, later also the 11th spinous process could be demonstrated. Staphylococcus aureus was isolated. The clinical course was mild. The pathogenesis of the disease is discussed. Such a case of newborn osteomyelitis has apparently not been described in the literature. PMID- 3974170 TI - [Transient erythroblastopenia]. AB - 5 patients 10 to 20 months old with severe normochromic, normocytic anemia and reticulocytopenia are reported. All patients recovered within 10 days to 5 weeks. No steroid therapy was given. Failure to recognize the clinical entity leads to unnecessary diagnostic and therapeutic procedures including the transfusion of blood. PMID- 3974171 TI - Iodine-induced thyrotoxicosis--a case for subtotal thyroidectomy in severely ill patients. AB - Iodine-induced thyrotoxicosis (IIT), due to iodine application in high amounts in patients with circumscript or disseminated thyroid autonomy, is complicated by a prolonged course, mainly due on the body's resistance to conservative therapy with thiourea derivates. Therefore, we decided to perform subtotal thyroidectomy in 16 thyrotoxic patients. This is in contrast to the common opinion that surgery should only be performed after normalization of thyroid hormones. In all 16 patients with severe IIT, including three patients with thyroid storm, hormone levels decreased within a few days after surgery to normal or subnormal values and the clinical picture of thyrotoxicosis disappeared. In the case of thyroid storm the signs of disorientation normalized within 1-3 days. One patient died 5 weeks after surgery due to severe concomitant diseases. One patient exhibited transitory respiration distress and another had postoperative hypocalcaemia. In nine patients L-thyroxine replacement became necessary because of subclinical or clinical hypothyroidism. Only by this procedure will the high intrathyroidal storage of iodine and performed hormone be extracted. Surgery as a treatment for thyrotoxicosis should be reserved for patients with severe IIT, where conservative treatment has been shown to be ineffective. Furthermore, in rare selected cases, when a rapid normalization is required, surgery without preoperative treatment seems to be justified. The effect of surgery was impressive in all our cases and there were only minor perioperative complications. Thus, it could be shown that subtotal thyroidectomy may be a rational and effective treatment in severe IIT which should be carefully considered and weighed against other types of therapy. PMID- 3974172 TI - Effects of the beta 2-adrenoceptor agonists fenoterol and salbutamol on force of contraction in isolated human ventricular myocardium. AB - The effects of fenoterol and salbutamol on isometric force of contraction were studied in isolated, electrically driven human papillary muscle preparations. Fenoterol increased force of contraction at concentrations of 1 mumol l-1 and higher. The maximally effective concentration of fenoterol (100 mumol l-1) increased force of contraction by about 130%. The positive inotropic effect of fenoterol was not influenced by 0.1 mumol l-1 prazosin. The beta 1-selective antagonist atenolol (2 mumol l-1) and the beta 2-selective antagonist ICI 118551 (1 mumol l-1) shifted the concentration-response curve of fenoterol to the right, indicating that beta 1- and beta 2-adrenoceptors may contribute to the positive inotropic effect of fenoterol. In contrast to fenoterol, salbutamol increased force of contraction only by about 11% at 100 mumol l-1. The results indicate that: (1) fenoterol exerts a direct positive inotropic effect in the human heart which may support the beneficial effects of the reduction of systemic vascular resistance in patients with congestive heart failure; (2) this positive inotropic effect of fenoterol is mediated by beta 1- and beta 2-adrenoceptors; (3) the clinically observed improvement of cardiac performance in the case of salbutamol is presumably not due to any direct positive inotropic effect. PMID- 3974173 TI - [Conjugated plasma catecholamines are lower in power athletes at rest and in physical work than in untrained probands]. AB - Lower levels of free plasma catecholamines, noradrenaline and adrenaline were recently described in statically trained athletes under identical work loads during incremental cycling as compared with untrained control subjects. These differences point to a control of sympathetic activity by static training. Theme of the presented investigation is the question of additional training-dependent alterations of the conjugated plasma catecholamines in statically trained athletes. Eight competition weight lifters (21 +/- 2 years of age; 73 +/- 10 kg body weight) and seven untrained healthy control subjects (26 +/- 6 years; 75 +/- 4 kg) were investigated. The conjugated catecholamines were radioenzymatically determined as the difference between total and free catecholamines. The investigated subjects performed an incremental, exhaustive bicycle ergometric test in an upright body position. Before exercise, the levels of conjugated plasma dopamine (P less than 0.10), of conjugated noradrenaline (P less than 0.001) and conjugated adrenaline (P less than 0.10) are 2-3 times lower in statically trained athletes than those of the control subjects. The conjugated catecholamines did not show any significant changes during exercise, the significant differences between both groups (P less than 0.05-P less than 0.01) were therefore also observed during exercise. In contrast to the free plasma catecholamine responses, the conjugated catecholamine fractions are seen as indicators of long term alterations of the sympathetic activity. PMID- 3974175 TI - Acute eosinophilic leukemia: characterization by cytochemistry, chromosomal analysis, and in vitro colony formation. AB - A pericentric inversion of chromosome 16 and acute myelomonocytic leukemia [AMMoL, M4 French-American-British (FAB)] with abnormal bone marrow eosinophils has recently been shown to form a new cytogenetic-clinicopathological entity. A patient otherwise undistinguishable from the more typical cases but lacking the FAB criteria for AMMoL is described. In such a situation, in vitro colony formation closely resembling that of acute myoblastic leukemia together with the clinical, morphological, cytochemical, and cytogenetic characteristics reported might serve as an indicator that these patients run an acute course justifying a diagnosis of acute eosinophilic leukemia and immediate institution of aggressive chemotherapy. The importance of the in vitro growth pattern regarding the differential diagnosis of disorders associated with predominant proliferation of eosinophils is discussed. PMID- 3974174 TI - [Effect of the Ca antagonist nimodipine on global and regional cerebrovascular circulation]. AB - The effects of Nimodipine on the global and regional cerebral blood flow were studied in 42 patients with cerebrovascular disorders. In 25 patients with focal deficits such as transitory ischemic attack (TIA), prolonged reversible ischemic neurological deficit (PRIND), and minor stroke due to arteriosclerosis, and in eleven patients with cerebral vasospasm after subarachnoid hemorrhage, the cerebral blood flow was measured by 133Xenon inhalation technique 60 min after oral administration of 40, 60, or 80 mg Nimodipine. In 6 patients with vasospasm the effects of Nimodipine i.v. were examined. The result in twelve patients with minor stroke who were only given placebo (lactose; "test-retest") was identical regional (rCBF) and global (CBF) cerebral blood flow before and 60 min after; placebo, blood pressure, and arterial pCO2 remained constant as well. After Nimodipine, however, the CBF increases, the increase after vasospasm being significant when taking the pCO2 in the Wilcoxon test into account. The rCBF increases much more in the regions with low perfusion rates than in well-perfused areas. This is also observed in the patients with TIA, PRIND, or minor stroke, most clearly after oral administration of 60 mg, whereas regions with normal perfusion rates show little reaction. The blood pressure was lowered, depending on the initial pressure. There was no evidence of a steal phenomenon. PMID- 3974177 TI - [Psychological adaptation and work capacity during simulated weightlessness]. AB - In two-head-down tilt studies of 7 and 8 days in duration variations in the work capacity of 24 test subjects were examined and the following stages were distinguished: habituation, stable work capacity, and unstable compensation. Among the test subjects two groups were discriminated: those with plastic and those with inert types of adaptation to a changed environment. It is concluded that the plastic-type people can better and faster adapt to head-down tilt and therefore can work more efficiently during an acute stage of adaptation to weightlessness. PMID- 3974178 TI - [Effect of rotation and vibration on orientation in man in relation to the gravitational vertical]. AB - The man's ability to get oriented in relation to the gravitational vector was investigated. The test subjects were exposed either to rotation in 1 m arm centrifuge or tilting in a chair. They were simultaneously exposed to total-body vertical vibration of 20 Hz. As the exposure continued, the ratio of the perceived vertical (in the absence of visual keys) and the apparent body position changed significantly. It is concluded that the tests used to evaluate the pilot ability for spatial orientation should include evaluations of the subjective vertical and body position relative to the gravitational vector. The tests should be performed during exposures to simulated dynamic flight factors. PMID- 3974176 TI - The role of bile acids in colonic carcinogenesis. AB - Several line of evidence suggest that bile acids may be implicated in the pathogenesis of colonic cancer. A high consumption of fat and animal protein and a low dietary intake of fiber have been shown to be related to the incidence of colonic cancer. From these epidemiologic observations the hypothesis was proposed that the correlation between diet and colon cancer might be explained by the involvement of bile acids. Populations at a high risk of developing cancer were shown to have an increased excretion both of total and bacterially modified bile acids in their feces. Animal studies demonstrated a cocarcinogenic effect of bile acids and experimental diets containing large amounts of fat did not only induce an increased bile acid excretion but also an enhanced tumor formation in the colon. Furthermore, microbial in vitro tests showed a comutagenic activity of secondary bile acids. However, case control studies comparing the fecal bile acid excretion pattern in colonic cancer patients and control subjects failed to show such a clear relationship, which might be explained by rather similar dietary habits within one population and individual differences in sensitivity to environmental factors contributing to the tumor development. Cholecystectomy, leading to an increased exposure of bile acids to the intestinal microflora, has been suggested as a predisposing factor for the development of colonic cancer, but the results of experimental and epidemiologic studies so far are rather inconsistent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3974179 TI - [Rheological blood indicators during motor activity of various degrees]. AB - Blood rheological parameters of essentially healthy people were examined during exercises of a maximal workload and 14-day head-down tilt. The results obtained indicate that in the people performing normal and increased motor activity some rheological parameters were different. Changes in the rheological parameters of blood after head-down tilt and exercises with a maximal workload suggest the existence of a blood viscosity threshold above which physical work capacity declines significantly. The capacity can be restored through a correction of blood viscosity in the recovery period. The basic rheological properties of blood can be improved by regular physical training. PMID- 3974180 TI - [Comparative characteristics of central hemodynamics and blood redistribution in active and passive orthostatic tests]. AB - Typological characteristics of central and peripheral (legs and viscera) circulation were identified in 90 clinically healthy people exposed to active and passive orthostatic tests. The following three hemodynamic states were distinguished: hypokinetic, hyperkinetic, and intermediate types of circulation. As compared to the passive tests, in the active states cardiac output decreased, leg blood flow increased, and viscera blood flow decreased. At the stage of stabilized hemodynamics inotropic cardiac stimulation was predominant during active orthostatic tests and chronotropic cardiac stimulation was predominant during passive orthostatic tests. In the former tests changes in cardiac output and blood redistribution between leg and viscera circulations were more distinct. Mechanisms of hemodynamic changes are discussed. PMID- 3974181 TI - [Amino acid composition of human blood serum during immersion hypokinesia]. AB - The content of free amino acids was measured in the blood serum of 6 male test subjects exposed to 7-day immersion. During the study the concentration of amino acids decreased in a different manner typical of a stress-effect. The results obtained can be used to develop a system of prevention and therapy of amino acid unbalance. PMID- 3974182 TI - [Factor analysis of reactions to lower body negative pressure on the earth and during space flight]. AB - The method of main components was used to examine separately the cosmonauts' responses to LBNP tests on the ground and in space flight. The factor structures of the ground- and flight data did not show significant differences. In both cases the first factor can be termed the factor of venous return and the second, the factor of the cardiac state. The first two factors were responsible for about 60%, and the first three factors for 76-78% of data scatter. The observation that the factor structure remains unchanged indicates that LBNP reactions in space flight can be evaluated using the criteria applied on the Earth. PMID- 3974183 TI - [Effect of long-term hypokinesia on the serum lipid spectrum]. AB - The effect of 120-day head-down tilt on the lipid spectrum of blood serum was investigated. By thin-layer and gas liquid chromatography lipids (total lipids, phospholipids, cholesterol and its esters, nonesterified fatty acids, triglycerides) and higher fatty acids were identified. It was found that cholesterolemia increased at the expense of the ester bound fraction, phospholipids decreased drastically, the ratio of phospholipids to total cholesterol decreased, and triglyceridemia diminished. Until bed rest day 70 saturated fatty acids were predominant, with linoleic acid being deficient, and thereafter the relative content of unsaturated fatty acids increased. The above changes in the lipid spectrum can be considered as risk factors with respect to preclinical stages of atherosclerosis. PMID- 3974184 TI - [Changes in regional hemodynamics and gas exchange in healthy males after moderate blood loss and blood reinfusion in response to antiorthostatic hypokinesia]. AB - Nine healthy male test subjects were exposed for 7 days to head-down tilting. Within 2 hours after exposure 500 ml of blood were withdrawn. This reduced pulse blood filling of all lung compartments, particularly upper (P less than 0.05) compartments, and decreased slightly finger circulation. The blood losses were then substituted but 2 hours after blood reinfusion the rheographic parameters of pulmonary circulation were still lower than before blood losses. In arterial blood pCO2 remained lower (P less than 0.05) and the deficiency of bases increased (P less than 0.05). It can be concluded that in the above situation blood reinfusion in the amount exceeding blood losses should be viewed adequate. On the basis of the results obtained increased blood content of the lungs in the course of head-down tilt can be interpreted as a reflex mechanism of blood pooling in the body. PMID- 3974185 TI - [Lens opacity in mice exposed to helium ions with energy of 4 GeV/nuclon and gamma-irradiation with Co-60]. AB - The cataractogenic effect of helium ions with the energy 4 GeV/nuclon and 60Co gamma-radiation was examined. In response to helium irradiation the cataract incidence and maturation rate was higher than in response to gamma-irradiation at the same doses. The RBE coefficients of helium ions were calculated from the equally effective doses of reference and helium irradiations. They depended on the exposure duration and amounted to 1.2 +/- 0.1, 2.2 +/- 0.1, and 2.6 +/- 0.1 by post-irradiation weeks 20, 30, and 40, respectively. PMID- 3974186 TI - [Effect of space flight aboard "Kosmos-1129" on thyroid hormone content of the blood and thyroid gland of rats]. AB - Thyrotrophin, thyroxine, triiodothyronine, and reverse triiodothyronine were measured in plasma and thyroxine and triiodothyronine in the thyroid gland of the rats flown for 18.5 days onboard Cosmos-1129. Postflight the plasma content of thyrotrophin and triiodothyronine increased and that of thyroxine decreased and the gland content of thyroxine and triiodothyronine diminished. It is postulated that in the flight animals the functional activity of the thyroid gland declined. PMID- 3974187 TI - [Study of the toxic properties of preservatives used in water reclamation systems]. AB - The comparative toxicity of halogen-containing oxidizing agents was investigated with the purpose of their utilization as urine preservatives in water reclamation systems. It was found that the high toxicity of the agents (LD50 of agent 1 was 15.7 +/- 1.1 mg/kg and LD50 of agent 2 was 23.0 +/- 1.2 mg/kg when injected i.p. to white mice) was distinctly related to their low pH in water solutions (pH 3 4). In neutral solutions the toxicity of agent 1 decreased 35 times and that of agent 2-12 times so that they can be classified as moderately toxic substances. Using an isolated frog heart according to Straub, it was shown that solution neutralization with 20% NaHCO3 also decreased the toxic effect of the above agents, making them similar to chloramine B, a well-known disinfectant. The above agents were found to be rapidly inactivated when stored in low concentrations and to remain highly stable when stored in concentrated solutions. PMID- 3974188 TI - [Study of water structure for evaluating the quality of reclaimed water]. AB - Among the physicochemical methods used to measure ion hydration in water solution, the most informative are those employed to evaluate the energetic state of the water molecule (swelling heat, gelatination, UV-spectrophotometry). These data may yield information about the water structure to be used in estimating the quality of potable water of different origin. IR-spectrophotometry and x-ray diffraction analysis are of lower informativity. A certain correlation has been found between the structure and biological action of water. PMID- 3974190 TI - [Prediction of X-ray phenomena of the M and X categories]. PMID- 3974189 TI - [Mathematical model of cyclic kinetics of granulocytopoiesis]. AB - A model of time-course variations of granulocytopoiesis which is a system of three non-linear differential equations has been developed. The model describes the basic stages of granulocyte development and includes the chalone mechanism regulating the proliferation of granulocyte precursors in bone marrow. Theoretical investigations applying the vibration theory and computer-aided calculations have shown that the model presents aperiodic and vibrational kinetics of reduction processes in the system of granulocytopoiesis as well as steady-state vibrations of concentrations of mature granulocytes and their precursors (limiting cycles). The variations of the model parameters within which the above dynamic modes occur have been identified. The conditions under which the limiting cycles arise have been examined. The fact that the model simulates various experimentally observed situations suggests that it can be used to predict changes in granulocytopoiesis induced by adverse effects responsible for hemopoietic abnormalities. PMID- 3974191 TI - A new mutant at the Dystrophia muscularis (dy) locus in the SM strain of mice. AB - Muscular dystrophy was found in the SM strain of mice. This defect was shown to be caused by a single autosomal recessive gene allelic with the genes at the dy locus. The dystrophic SM mice may provide a useful animal model for human muscular dystrophy, because SM strain has been selected for small body size and carries rare alleles at several loci. PMID- 3974192 TI - Intraperitoneal pentobarbitone anaesthesia of Mystromys albicaudatus. AB - Anaesthesia trials with intraperitoneal (i.p.) pentobarbitone sodium in Mystromys albicaudatus indicated that the optimum dose is between 4 and 5 mg/100 g bodyweight. No differences were detected in duration of anaesthesia associated with sex or time of day. PMID- 3974193 TI - Use and misuse of an imprecise concept: alternative methods in animal experiments. AB - The concept of inhumanity of Russell & Burch in 1959 with proposals for human procedures in experiments on animals by way of replacement, reduction and refinement (the 3 R's) and the revival of these by Smyth (1978) as alternatives to animal experiments are presented. Since then under the name 'alternative methods', replacement of in vivo by in vitro methods has found great public attention and promotion. It is argued that alternative methods are a fallacy, because in the progress of research a continual control and reinvestigation of findings on each system level is required until knowledge is complete, which makes in vivo experiments irreplaceable. True alternatives exist only for refinement within a system level. On the level of the organism, refinement would be in the care of animals and experimental procedure through alleviation of stress. The possibilities which refinement offers for animal welfare have been nearly forgotten and need promotion among researchers, animal technicians and attendants. PMID- 3974194 TI - A comparison of subcutaneous and intraperitoneal oxytetracycline injection methods for control of infectious disease in the rat. AB - After receiving once daily intraperitoneal (i.p.) or subcutaneous (s.c.) injections of oxytetracycline (15 mg/100 g bodyweight) for 7 days, laboratory rats had significantly different oxytetracycline serum levels depending on the method of injection. Regardless of injection method, the biological half-life of the antibiotic was 4.25 h and serum antibiotic levels never fell below therapeutic levels for certain rat pathogens during 24 h post-injection. Severe peritonitis and cellulitis were found in rats whether injected s.c. or i.p. and some animals lost bodyweight. It appeared that either injection method would be an effective treatment for certain infectious diseases of laboratory rats but tissue damage, probably from oxytetracycline's acidity, made both methods unattractive. PMID- 3974195 TI - Salmonella ochiogu: experimental infection of laboratory rabbits (Oryctolagus cuniculus). AB - Oral infection with Salmonella ochiogu resulted in the manifestation of clinical salmonellosis in laboratory rabbits. Infection was associated with septicaemia, anaemia and terminal pneumonia. Organisms were excreted in the faeces on the first day post-inoculation, and cultures of most visceral organs revealed widespread dissemination. This serotype appears to be highly pathogenic for rabbits. PMID- 3974196 TI - Biliary secretion in the conscious preruminant goat: use of a re-entrant cannula. AB - A double re-entrant bile cannula is described for use in conscious goats which permits study of bile flow and composition. PMID- 3974197 TI - Influence of housing conditions on pregnancy outcome in cynomolgus monkeys (Macaca fascicularis). AB - Female cynomolgus monkeys (Macaca fascicularis) were kept under 3 different housing conditions: individually in type A cages (45 X 45 X 60 cm), individually in type B cages (70 X 70 X 100 cm) and as couples in type B cages. Primigravida did not show early embryonic mortality, differing significantly from 11.5% early losses in multigravida. Early embryonic mortality was not affected by housing condition. Further reproductive failure rates did not differ significantly for primigravid (18.5%) and multigravid females (24.0%), though abortion tended to occur more frequently in primigravida. Perinatal mortality (16.1%) accounted for most of the losses under each housing condition. More successful pregnancies (90%) were recorded for females housed individually in type B cages than for females housed in type A cages (68%). About 50% of the couples originally established remained until weaning of their infants, yielding 77% viable offspring. For multigravid females statistical evaluation showed a significant effect of housing conditions on reproductive outcome (X2-test 0.01 less than P less than 0.05) that could be entirely attributed to low losses in females housed individually in type B cages. It is concluded that housing conditions can have a profound influence on reproductive success in cynomolgus monkeys. PMID- 3974198 TI - Gamma-subunit of the glycolytic enzyme enolase: nonspecific or neuron specific? PMID- 3974199 TI - Immunohistochemical localization of gamma-enolase in normal human tissues other than nervous and neuroendocrine tissues. AB - The neuron-specific enolase, gamma-enolase, is present at high concentrations in tissues of the nervous and neuroendocrine systems and at significant levels in other human tissues as detected by enzyme immunoassay. Its precise localization, however, has remained unclear. We report here the immunohistochemical localization of gamma-enolase in normal adult human tissues other than those of the nervous and neuroendocrine systems using direct and indirect enzyme-labeled antibody methods. The gamma-enolase was found in such smooth muscle cells as the media of aorta, fibromuscular tissue of the prostate, and the myometrium of the uterus, myoepithelial cells, the conducting system of heart, epithelial cells of loops of Henle, and macula densa cells of the kidney. It was also demonstrated in spermatogonia, lymphocytes, plasma cells, platelets, and megakaryocytes and in lesser amounts in bronchial epithelial cells and type II alveolar epithelial cells of the lung, and in secretory cells of the fallopian tube. The significance of its presence in these cells and the application of the gamma-enolase detection for diagnostic purposes in pathology are discussed. PMID- 3974200 TI - Biochemical and microscopic evidence for the internalization and degradation of heparin-containing mast cell granules by bovine endothelial cells. AB - Incubation of [35S]heparin-containing mast cell granules with cultured bovine endothelial cells was followed by the appearance of 35S-granule-associated radioactivity within the endothelial cells and a decrease in radioactivity in the extracellular fluid. These changes occurred during the first 24 hours of incubation and suggested ingestion of the mast cell granules by the endothelial cells. Periodic electron microscopic examination of the monolayers confirmed this hypothesis by demonstrating apposition of the granules to the plasmalemma of endothelial cells, which was followed by the engulfment of the granules by cytoplasmic projections. Under light microscopic examination, mast cell granules within endothelial cells then appeared to undergo degradation. The degradation of [35S]heparin in mast cell granules was demonstrated by a decrease in the amount of intracellular [35S]heparin proteoglycan after 24 hours and the appearance of free [35S]sulfate in the extracellular compartment. Intact endothelial cells were more efficient at degrading [35S]heparin than were cell lysates or cell supernatants. These data provide evidence of the ability of endothelial cells to ingest mast cell granules and degrade native heparin that is presented as a part of the mast cell granule. PMID- 3974201 TI - Curative intravenous adoptive immunotherapy of Meth A murine sarcoma. A histologic and immunohistochemical assessment. AB - Intravenous administration of 1.5 X 10(8) syngeneic spleen cells from immune animals resulted in the complete eradication of established Meth A soft tissue sarcomas in (C57BL/6 X BALB/c) F1 mice. In mice receiving a single injection of immune spleen cells 4 days after tumor implantation in the abdominal wall, the tumors continued to grow for approximately 1 week before undergoing regression. This delay before adoptive immunity is expressed is thought to represent the time needed for the passively transferred cells to give rise to a host response of sufficient magnitude to destroy the tumor. None of the mice receiving a similar number of control spleen cells were cured of their sarcomas. Successful therapy was dependent upon the transfer of viable, immune T lymphocytes and required prior irradiation of the tumor-bearing host in order to remove suppressor T cells. Utilizing sequential histologic and immunohistochemical techniques, we attempted to characterize the cellular events of tumor regression. The earliest histologic difference between animals treated with immune and nonimmune lymphocytes was in the number of lymphocytes detected at the perimeter of the tumor in specifically immunized mice on day 6. There was also a striking difference between animals treated with immune versus nonimmune lymphocytes in the intensity and timing of the acute inflammatory response beginning on day 8. The "front" of immunologically mediated tumor destruction appeared at the lateral and deep borders of the implanted sarcomas and progressed inward. During the period of active tumor regression T lymphocytes reactive with a biotinylated mouse anti-Thy 1.2 monoclonal antibody were increased in frozen sections of tumors in mice receiving immune cells relative to the controls. During the first 3 weeks following adoptive transfer of lymphocytes, T cells reactive with Lyt-1 biotinylated mouse monoclonal antibody (helper/inducer phenotype) outnumbered their Lyt-2 (suppressor/cytotoxic) counterparts in frozen sections of tumor from both specifically immunized and control mice. By the end of the 4th week of the experiment, the sarcomas were completely eradicated in all mice receiving immune cells. The previous tumor beds were occupied by collections of lipid-laden macrophages, lymphocytes, plasma cells, and fibroblasts. Despite vigorous but delayed acute and chronic inflammatory responses at the tumor perimeters in the control mice, these tumors all progressed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974202 TI - Effect of colchicine on experimental amyloidosis in two CBA/J mouse models. Chronic inflammatory stimulation and administration of amyloid-enhancing factor during acute inflammation. AB - To investigate the mechanism of action of colchicine in blocking amyloid deposition, two model systems of amyloidosis in CBA/J mice were studied. In experimental chronic inflammation, daily injection of silver nitrate (AgNO3) resulted in the deposition of 667 +/- 68 ng of amyloid A protein (AA)/mg of spleen after 25 days. Treatment with 10 micrograms of colchicine daily decreased AgNO3-induced AA deposition to 12 +/- 1 ng of AA/mg of spleen (p less than 0.001). Colchicine diminished the acute phase serum amyloid A protein (SAA) response after 24 hours. Over a 25-day period, SAA concentrations declined and approached baseline both in colchicine-treated and (unexpectedly) in control mice. This suggested that suppression of SAA levels was not the primary event inhibiting amyloid deposition. In a model of accelerated amyloid deposition, injection of preformed amyloid-enhancing factor along with AgNO3 induced the deposition of 974 +/- 46 ng of AA/mg of spleen 48 hours later. Colchicine only partially decreased amyloid-enhancing factor-induced amyloid deposition to 578 +/ 91 ng of AA/mg of spleen, while blunting the acute phase SAA response. These results suggest that colchicine inhibits amyloidosis in the predeposition phase, possibly by blocking formation of amyloid-enhancing factor. PMID- 3974203 TI - Radiographic imaging of lymph nodes in lymph node dissection specimens. AB - A new method of identifying and locating lymph nodes in lymph node dissection specimens using a radiographic imaging technique is described. The specimen is immersed in 96% ethyl alcohol which possesses a radiographic density similar to fat tissue. Even small immersed lymph nodes contrast well with 96% ethyl alcohol. Thus, a radiograph of a nodal dissection specimen, immersed in 96% ethyl alcohol, does not show the interfering projection of variations in thickness of the specimen. Simultaneously, lymph nodes are clearly imaged. Using this procedure, we could visualize 97% of all lymph nodes present in the fat tissue of lymph node dissection specimens, which were dissected free from large radiodense structures like muscle and submandibular glands. Thus, a simple method was established for radiographic documentation of lymph nodes in lymph node dissection specimens. PMID- 3974204 TI - Normally hearing children's responses to a nonsense syllable test (NST; Edgerton & Danhauer, 1979). PMID- 3974205 TI - Construction and use of a bite-block for the evaluation and treatment of speech disorders. PMID- 3974206 TI - A psychosocial perspective on the glossectomy experience. AB - This analysis of the glossectomy experience based on Goffman's concepts of the preservation of self and of stigma management suggests several helpful responses for speech-language pathologists and other clinicians. Attention to psychosocial dimensions of recovery. In the face of life-threatening illness and necessarily radical treatment, the patient and others may trivialize or overlook psychosocial needs. The importance of specific social behaviors--talking on a telephone or eating in a restaurant--can only be understood in terms of the patient's own self definition. The psychological impact is more than frustration at lost or inadequate functioning. It may be profound grief, a response to threats to aspects of self-definition most valued by the patient. Help in the presentation and preservation of self. While helping to improve speech intelligibility by reinforcing different compensatory mechanisms, clinicians can assist with other compensations in social performance. More attention to nonverbal cues, including dress and physical appearance, may be helpful. Increased use of written communication can facilitate social interactions and reinforce the sense of linguistic competence until intelligibility and fluency are regained. From the perspective of Goffman's analyses, the individual who selectively manipulates social cues to counteract a stigma need not feel "fake." The intent of more conscious manipulations is not to invent a new self or to fool others but to preserve the integrity of the self. More information about stereotypes may help the glossectomee cope with others' inappropriate reactions and evaluate the relative importance of stigmas in different social interactions (e.g., stereotypes expressed by one's employer or family members deserve more attention than those expressed by strangers).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3974207 TI - Acoustic-reflex dynamics and the loudness-discomfort level. AB - Acoustic-reflex growth functions and Loudness-Discomfort Level (LDL) measures were obtained for 15 normal-hearing subjects. The hypothesis that signals considered uncomfortably loud occur at intensity levels that produce proportionately equal acoustic-reflex magnitudes was evaluated. Individual reflex growth functions were measured as a function of activator SPL for a 1000-Hz tone, a 4000-Hz tone, and a broadband noise. These growth functions were measured within subjects (two trials) and across subjects in terms of (a) percentage acoustic-impedance change at LDL, (b) percentage acoustic-reactance change at LDL, (c) acoustic impedance at LDL, (d) relative change in acoustic impedance at LDL, and (e) ratio of static acoustic impedance to change in acoustic impedance at LDL. Although the loudness and acoustic-reflex measures demonstrated good reliability across trials, the data showed large variability across subjects and did not support the experimental hypothesis. It was concluded, therefore, that the use of acoustic-reflex measures in the estimation of an individual's LDL is unwarranted. PMID- 3974208 TI - Speech perception development in language-impaired children: a 4-year follow-up study. AB - A group of specifically language-impaired (SLI) children was compared with a matched group of non-SLI children (i.e., children displaying normal language) on tests of speech perception and language ability. The tests were administered longitudinally at times separated by an interval of 4 years. Initially (i.e., Time 1), the groups differed significantly in discrimination, sequencing, and rate processing of and serial memory for synthesized /ba/ and /da/ stimuli. At Time 1, age effects were also observed among both groups of children. That is, performance improved as a function of increased age. At follow-up (i.e., Time 2), performance was at or near ceiling for subjects in both groups, indicating that perceptual development occurred in both groups of children. Results are discussed in relation to the hypothesis that perceptual deficits play a causal role in specific language impairment. PMID- 3974209 TI - Facilitating word combination in language-impaired children through discourse structure. AB - The influence of an adult-child discourse structure on the production of early word combinations was examined in language-impaired children. The subjects were 10 children (2:8-3:4) at the single-word utterance level. Eight of the children were engaged in 10 experimental sessions utilizing vertical structures (e.g., Adult: "Who's this?" Child: "Daddy." Adult: "What's Daddy throwing?" Child: "Ball." Adult: "Yeah, Daddy's throwing the ball."), while the remaining children, serving as controls, were engaged in an alternate activity. Examination of pretest and posttest data as well as session data revealed a substantial increase in the number of multiword productions for most of the children in the experimental group but not for the children serving as controls. These findings indicate that vertical structures have a facilitating effect on the multiword productions of language-impaired children comparable to that found in an identical procedure with normally developing children. The use of a naturally occurring adult-child discourse structure as an intervention procedure is discussed. PMID- 3974210 TI - Unusual and subtle phonological behavior in the speech of phonologically disordered children. AB - Evidence is reviewed regarding three types of unusual and/or subtle phonological behaviors in the speech of phonologically disordered children. The models of child phonology that are compatible with these behaviors are then discussed. Considered are the nature of the child's stored forms for words, the types of rules operating on these forms as well as those responsible for the surface form of the words, and the nature of the phonological categories reflected in the child's usage. The paper concludes with the implications these considerations have for assessment and treatment. PMID- 3974211 TI - Rule invention in the acquisition of morphology by a language-impaired child. AB - This paper presents a case study of a language-impaired child who invented a unique morphophonologic rule for signaling the distinction between English singular and plural nouns. Conventional linguistic-phonetic analysis indicated that the child was producing the distinction suprasegmentally rather than segmentally. Acoustic-phonetic analysis of matched singular-plural noun pairs was performed in order to determine quantitatively which suprasegmental acoustic cues he used to signal the distinction. Results of a multivariate analysis of variance revealed that singular and plural productions were significantly different from one another on various fundamental frequency, duration, and intensity parameters. This example of a child's linguistic creativity is offered as further evidence in support of a model of language acquisition that emphasizes the cognitive aspects underlying linguistic regularities in child language. Clinical implications are also discussed. PMID- 3974212 TI - Misarticulating and normally articulating children's identification and discrimination of synthetic [r] and [w]. AB - In this study, 22 children, ages 6:0 to 6:11, who misarticulated word-initial [r] as [w], were compared to 13, age-matched normally articulating children for their ability to identify and discriminate seven synthetic stimuli representing an acoustic continuum between [we] and [re]. Discrimination was tested among 3-step continuum stimulus pairs using the 4IAX paradigm. All of the control children demonstrated a single, sharp phonemic boundary during identification and higher between-phoneme than within-phoneme discrimination ability. Most of the misarticulating children demonstrated abnormal identification functions, with many showing only chance-level responses. Discrimination ability of the misarticulating children was generally poorer than that of the normally articulating children. Furthermore, discrimination ability of children in both groups was largely predictable from their identification performance, assuming categorical perception of these stimuli. Results indicate that a majority of the 6-year-old [r]-misarticulating children have failed to phonemically distinguish /r/ from /w/. These results call into question the use of the liquid gliding process as a psychological processing description of the misarticulation of these children. PMID- 3974213 TI - Intrinsic laryngeal muscle activity in a spastic dysphonia patient. AB - EMG activity from four intrinsic laryngeal muscles (thyroarytenoid, posterior cricoarytenoid, interarytenoid, and cricothyroid) was obtained from one female spastic dysphonia patient while she performed a variety of speech and nonspeech tasks. These tasks were performed before and during a period of temporary unilateral laryngeal muscle paralysis. In the nonparalyzed condition, adductory muscle activity showed intermittent sudden increases that coincided with momentary voice arrests. These muscle patterns and accompanying voice interruptions were not present either when speech was produced in falsetto register or at anytime during the paralysis condition. The data suggest that individuals with this type of spastic dysphonia have normal morphology of recurrent laryngeal nerves and intrinsic laryngeal muscles, which means that the triggering mechanism(s) for spastic dysphonia symptoms must be located at some point neurologically upstream from the larynx. PMID- 3974214 TI - Alaryngeal speech intelligibility and the older listener. AB - Past investigations of alaryngeal speech intelligibility have focused on comparative intelligibility as perceived by young normally hearing adults. However, the spouses and social companions of laryngectomees may have significantly different auditory capabilities compared to young listeners. This report presents a comparison of alaryngeal and laryngeal speech identification performance for a group of young normally hearing listeners and a group of older adult listeners representative of the age of the laryngectomee's social companions. The speech signals investigated included normal laryngeal speech, artificial larynx speech, traditional esophageal speech, and tracheoesophageal speech. The results obtained reveal not only differences in speech signals but also a difference in the proficiency of speech perception for the two groups, favoring the younger listeners. The results of the speech identification measures in the presence of auditory competition revealed greatest intelligibility for the artificial larynx speech signal and poorest for the tracheoesophageal speech signal. PMID- 3974215 TI - Laterality differences in child stutterers: heterogeneity, severity levels, and statistical treatments. AB - The purpose of this study was to determine the relationship between stuttering severity and hemispheric dominance, as measured by a dichotic listening task. Subjects were 76 stutterers and 76 nonstutterers who were asked to respond to a series of dichotically presented synthetic syllables. Results revealed (a) a right ear preference for both stuttering and nonstuttering subjects; (b) right ear, no ear, and left ear preference subgroups among the stutterers; (c) differences in dichotic ear preferences for the 7- to 12-year-old stuttering and nonstuttering subjects; and (d) a relationship between stuttering severity and hemispheric dominance depending on the manner in which the data were analyzed. The discussion considers the earlier studies in the literature and reconsiders the idea of subgroups within the stuttering population. Also discussed is the use of certain statistical treatments and the need to determine the relationship between hemispheric dominance in stutterers and other variables. PMID- 3974216 TI - Correlates of language development in language-disordered children. AB - This study organized a large data archive gathered over 8 years on 718 children with language disorders. Descriptive data categorized by demographic/background, physical/development, social/personality, and language/academic characteristics were analyzed to provide a broad description of this group of children. Sets of descriptor variables in five domains were identified from program records and were used to predict language performance at program entry and relative language improvement over 2-3 years. Age was the strongest predictor for all analyses. In general, the primary research factors in the study (53 variables representing IQ, language history, socioeconomic status, physical/neurological, and social emotional background) failed to account very well for either language performance at program entry or for relative language gain. In prediction of pretest language performance, IQ and physical factors played the strongest role. The two factors contributing significantly to prediction of relative gain were IQ (although surprisingly weakly) and social-emotional status. Characteristics of those children who progressed most while in the program were identified. PMID- 3974217 TI - Effects of older siblings on the language young children hear and produce. AB - Mothers told stories to their children, inserting 30 questions about each story under two conditions. In one situation, mothers were alone with their younger child, and in the other condition, an older sibling was also present. During the question-answer interactions, older siblings responded to 60%-65% of all mothers' questions before younger children had a chance to respond and provided direct answers to the questions in 57%-65% of those instances. Mothers responded by producing fewer rephrased questions, fewer questions providing hints and answers, fewer questions functioning as repetitions and expansions, and more directly repeated questions when the older sibling was present. The effect of older siblings' first responses also reduced by half the number of younger children's utterances. The younger children produced fewer noncontent and content answers and more imitated answers in the presence of the older sibling. It is concluded that the presence of older siblings may influence the language young children hear and produce. PMID- 3974218 TI - Listening to your patients. PMID- 3974219 TI - The Nashville experience with scalene node biopsy--a procedure of limited application. PMID- 3974220 TI - Medical grand rounds. Cyanotic congenital heart disease in adults. PMID- 3974221 TI - Hepatic trauma. PMID- 3974222 TI - Loss prevention case of the month. Communication through the record. PMID- 3974223 TI - Studies on oestrogen-2/4-hydroxylase activity in mammalian brain, using a radioenzymatic assay method. AB - The activity of oestrogen-2/4-hydroxylase in brain tissue was studied using a radioenzymatic assay which controlled for non-specific formation of catechol oestrogen. The ontogeny of enzyme activity in male and female rat brain was examined between 1 and 70 days of age. Until 10 days of age, both sexes showed low enzyme activity. Between days 10 and 15 enzyme activity in the female significantly increased but was unchanged in the male. Male brain enzyme activity increased between days 15 and 20 whereas activity was unchanged in the female. Both males and females showed increases in enzyme activity between 20 and 25 days of age. Thereafter enzyme activity plateaued but at all ages between day 20 and day 70 male brain enzyme activity was significantly greater than in the female. A study of the distribution of the oestrogen-2/4-hydrolase in the sheep hypothalamus revealed that the stalk/median eminence had approx 10 times greater activity than either the anterior, medial or posterior hypothalamus. These findings are discussed in relation to sexual differentiation of the brain. PMID- 3974224 TI - 18-Substituted steroids: synthesis of 18-hydroxycortisol (11 beta,17 alpha,18,21 tetrahydroxy-4-pregnene-3,20-dione) and 18-hydroxycortisone (17 alpha,18,21 trihydroxy-4-pregnene-3,11,20-trione). AB - The isolation of 18-hydroxycortisol from the urine of patients with primary aldosteronism was recently described and no synthetic procedure was available for its preparation. The C-13 angular methyl group of prednisolone-17 alpha,21 acetonide-11 beta-nitrite was functionalized by photolysis in the presence of oxygen to give the product 18-hydroxy-prednisolone-17 alpha,21-acetonide-18 nitrate. The 18-nitrate was reduced with zinc and ammonium acetate to the corresponding 18-hydroxy compound, 18-hydroxy-prednisolone-17 alpha,21-acetonide. Homogeneous hydrogenation with Tris(triphenyl-phosphine)rhodium (I) chloride as catalyst resulted in the formation of 18-hydroxy-cortisol-17 alpha,21-acetonide. Acid hydrolysis of the latter compound gave 18-hydroxycortisol. Oxidation of 18 hydroxycortisol-17 alpha,21-acetonide with pyridinium dichromate followed by acid hydrolysis gave 18-hydroxycortisone. The 18-hydroxylated steroids exist as the 18,21-hemiacetals. Catalytic reduction with tritium gas with Tris(triphenyl phosphine)rhodium (I) chloride of 18-hydroxyprednisolone-17 alpha,21-acetonide and acid hydrolysis gave [1,2(3)H]18-hydroxycortisol. PMID- 3974225 TI - Presence of two types of estrogen binding sites in mouse testis. AB - The characteristics of cytosol estrogen binding sites in BALB/c mouse testis were investigated. The cytosol prepared from the whole testis contained two classes of the specific estrogen binding sites by Scatchard and Rosenthal plot analyses. The first binding site (first binder) had high affinity for 17 beta-estradiol (E2; Kd = 4.9 X 10(-9) M) and binding specificity as observed in the typical estrogen receptor. The second binding site (second binder) had lower affinity for E2 (Kd = 4.8 X 10(-8) M) and the binding was inhibited less vividly by diethylstilbestrol (DES) and antiestrogens in comparison with that for the first binder. Postlabeled sucrose density gradient analysis in a low salt medium revealed that the major radioactive peak of the first binder appeared at 7S region, while that of the second binder sedimented at 4S region. The 7S component showed an appreciable binding to the nuclei, while the 4S component did not show a significant binding ability to the nuclei. Much higher concentrations of the first and the second binders were found in Leydig cells preparations. These results demonstrate the presence of two types of the specific estrogen binding sites in the mouse testis especially in Leydig cells. PMID- 3974226 TI - Retention of estrogen receptors in vitro requires limited estradiol exposure in vivo. AB - Maintenance of functional estrogen receptors in culture has been accomplished in chick oviduct cells by manipulating the estrogen exposure before tissue dissociation. Tissue from chicks pre-treated with daily 17-beta-estradiol injections for 2 weeks or with 2 weekly diethylstilbestrol implants can be established in culture using a variety of enzymes. Tissue from animals with chronic estrogen stimulation must be withdrawn from hormone in culture at least 4 days before the digestion procedure. When tissue is digested using collagenase and pancreatin buffered by bovine serum albumin (Fraction V), large quantities of virtually fibroblast-free cultures can be established. The estrogen and progesterone receptors remain intact at normal levels using this procedure. The receptors have maintained biological function as evidenced by two hormone dependent measurements. The first was an increase in the amount of ovalbumin mRNA transcribed in response to estrogen supplementation of the cultures compared to cultures with no estrogen. The second function was an increase in ovalbumin protein secreted into the medium upon estrogen stimulation. The protein increment demonstrated that the hormone-induced levels of mRNA were functional and capable of being translated. PMID- 3974227 TI - Progesterone-mediated suppression of estradiol receptors in cynomolgus macaque cervix, endometrium and oviduct during sequential estradiol-progesterone treatment. AB - We used sequential treatment with implants of estradiol (E2) and progesterone (P) to create varied hormonal states in a group of spayed cynomolgus macaques. The reproductive tracts were removed, and nuclear and cytosolic estrogen receptors were analyzed in the cervical mucosa, endometrium, and oviducts. Nuclear receptor quantities were greater in tissues of E2-treated monkeys than in tissues of spayed animals. Sequential P treatment, even in the presence of continuous E2, decreased the amounts of nuclear and cytosolic E2 receptors. In the oviduct and endometrium, the P-mediated suppression of receptors occurred within 1 or 2 days. In the cervix, suppression occurred only if the serum P:E2 ratio was elevated to twice the amount (approximately 100:1) usually found during the luteal phase of the menstrual cycle (approximately 50:1) in this species. Of these three reproductive tract tissues, the cervix had the highest threshold for suppression by P of E2 receptors in the presence of E2. PMID- 3974228 TI - Aromatization of androstenedione by normal and neoplastic endometrium of the uterus. AB - The ability of human uterine endometrium to aromatize androstenedione to estrogens was investigated using 10 normal and neoplastic tissues. Normal and neoplastic endometrial homogenates were incubated with [6,7-3H]androstenedione (A) and NADPH. Estrone (E1) and estradiol (E2) were subsequently isolated in amounts ranging from 0-17600 fmol/h/g and 0-377 fmol/h/g, respectively, from the incubates after purifications by using Bio-Rad AG1-X2 column, thin layer chromatographies and co-crystallization. The conversion of A to E1 and E2 was significantly higher in neoplastic tissues. PMID- 3974229 TI - Synthesis of 7 alpha- and beta-carboxymethyl derivatives of cortisol, corticosterone, deoxycorticosterone and cortisone. Immunogenic properties of cortisol, corticosterone and deoxycorticosterone derivatives. AB - 7 alpha- and 7 beta-Carboxymethylderivatives of cortisol, corticosterone and deoxycorticosterone have been synthetized. After coupling to bovine serum albumin, they were used to elicit antibodies in rabbits. Highly specific antisera were obtained which may possibly be used for a direct radioimmunoassay of these steroids in human and rodent plasma. In the case of the derivatives of cortisol and corticosterone and stereoisomery of the coupling had an effect on the affinity and the specificity of the antisera. In all immunized rabbits the antisera obtained with the 7 alpha-derivative had a higher affinity and a narrower specificity than the antiserum obtained with the 7 beta-derivative. PMID- 3974230 TI - Lipoprotein augmentation of human chorionic gonadotropin and prolactin stimulated progesterone synthesis by rat luteal cells. AB - A collagenase dispersed cell suspension from PMSG-hCG primed immature rats responded to exogenously added hCG, cholera enteroxin, prolactin, and 8 Bromocyclic-AMP with increase in progesterone production in a dose dependent manner, and this stimulation was augmented by the plasma lipoprotein fractions hHDL and hLDL. The responsiveness to low doses of prolactin was not apparent when lipoprotein fractions were not included in the assay mixture. When the incubation mixture contained either LDL or HDL, the stimulatory effect of prolactin on progesterone production was evident at 5 and 10 micrograms prolactin/ml of the incubation mixture. Progesterone production, both basal and hormone stimulated, was maximum on day 7 of pseudopregnancy. Although the extent of hCG and prolactin stimulation of progesterone production and its potentiation by lipoprotein fractions was observed to be higher on days 3 and 5 than that seen on day 7, the net amount of progesterone produced was highest on day 7. The basal as well as hormone and lipoprotein stimulated progesterone production started to decline after day 7, reaching a nadir on day 14. These experiments show that prolactin is effective in stimulating progesterone production by rat luteal cells in vitro and that lipoprotein fractions, LDL and HDL further potentiate this response. This study further suggests that it is important to include LDL or HDL as a source of cholesterol for in vitro experiments in which the steroidogenic response of luteal cells to exogenous stimuli is tested. PMID- 3974231 TI - In vivo secretion of 3 alpha-hydroxy-5 alpha-pregnan-20-one, a potent anaesthetic steroid, by the adrenal gland of the rat. AB - 3 alpha OH-5 alpha-Pregnan-20-one (allo-THP), a steroid with strong anaesthetic properties, was found to be secreted by the adrenal gland of the rat in quantities similar to those secreted by the rat ovary. From the hypnotic potencies established for this and other endogenous steroids there can be little doubt that the total amount of steroids with anaesthetic properties produced in a female rat are sufficient to exert a depressant action on certain cells of the brain. In rats with intact adrenal glands a positive correlation existed between the adrenal secretion of allo-THP and pregnenolone or progesterone, whereas that between allo-THP and DOC was negative. This could be the result of a competition between the enzymes responsible for the oxidation and reduction of progesterone, the common precursor of allo-THP and DOC. The possibility that allo-THP could have hypotensive actions was suggested. PMID- 3974232 TI - Effects of intoxication on alcoholics' marital communication and problem solving. AB - The effects of intoxication on the marital interactions of treatment-motivated alcoholics and their nonalcoholic spouses were studied in eight couples (two of which had an alcoholic wife). In half of the sessions, the alcoholics were given enough alcohol to reach a blood level of 10 mg/dl. Couples engaged in three 10 min conflict-resolution discussions of varying intensity counterbalanced for alcohol and no-alcohol sessions. Couples expressed significantly more positive verbalizations in the alcohol sessions than in the no-alcohol sessions. This was true especially for the nonalcoholic spouses, who doubled their rate of positive verbal behavior when interacting with an intoxicated partner. Alcoholics spoke more and tended to make more problem-describing statements while intoxicated than while sober. The alcoholics made a greater number of problem-solving statements than did their spouses. Alcoholics were significantly more negative and less positive in nonverbal behaviors than were their spouses, but neither self-report of marital satisfaction nor observations of verbal behavior reflected this. The models of both social-learning theory and systems theory for the relationship of marital factors to the etiology and maintenance of alcoholism are supported. PMID- 3974233 TI - Relationship between subjective expected utility and behavior: a longitudinal study of adolescent drinking behavior. AB - The relationship between subjective expected utility (SEU) and the use of beer and distilled spirits by adolescents is examined. A panel design with 1339 subjects who began the study as seventh graders indicated that there were reciprocal relationships between SEU and behavior. It is concluded that SEU should be considered when attempts are made to explain adolescent drinking behavior. PMID- 3974234 TI - Self-image and social-image factors in adolescent alcohol use. AB - To investigate the social image of adolescent drinking, high-school students were asked to rate slides of drinking and nondrinking peer models. The image was ambivalent, with both social liabilities and possible social benefits (including toughness and precocity). This image was then related to adolescent drinking behavior. It was hypothesized that adolescents might be more likely to drink if their self-concepts were consistent with a drinking image (consistency theory), if their ideal self-concepts were consistent with a drinking image (self enhancement) or if their friends admired a drinking image (impression management). Analyses of subjects' current drinking behavior supported both the consistency and self-enhancement hypotheses. Moreover, boys' intentions to drink in the future were related to consistency and impression-management variables (controlling for current drinking). Girls' intentions were not related to any of these self-image and social-image factors. Implications for adolescent alcohol use and misuse are discussed. PMID- 3974235 TI - The substance abuse attitude survey: an instrument for measuring attitudes. AB - Although attitudinal objectives in medical education about alcohol and drug misuse are important, adequate instruments for measuring the achievement of such objectives have been lacking. The development of a standardized Substance Abuse Attitude Survey (SAAS) is described. Multiple administrations and factor analyses selected and refined the item pool of the final scale. Five factors were derived from tests completed by 324 noncriterion clinicians: Permissiveness, Treatment Intervention, Nonstereotypes, Treatment Optimism and Nonmoralism. The factor structure was found to be internally consistent over repeated administrations. Validation was obtained by scoring surveys completed by 116 criterion clinicians experienced in treating patients who misuse alcohol and other drugs. The criterion clinicians scored significantly higher than the noncriterion clinicians on the Treatment Intervention and Treatment Optimism factors. The SAAS has been well accepted by medical students and practicing physicians. It has proven useful in developing attitudinal objectives, measuring achievement of these objectives and modifying teaching approaches in both undergraduate and continuing medical education. PMID- 3974236 TI - Cognitive processes associated with "spontaneous" recovery from alcoholism. AB - Interviews were conducted with 29 alcoholics who claimed a "spontaneous" remission from alcoholism to elucidate the cognitive processes associated with the initiation and maintenance of absolute or relative abstinence. Factors associated with the initiation of abstinence included hitting a personal bottom, alcohol-induced physical problems, allergy or physical aversion, change in lifestyle and spiritual-mystical experiences. With respect to the maintenance of abstinence, the majority periodically resorted to willpower, some claimed the disappearance of craving and others were protected by their physical aversion to alcohol. Cognitive factors underlying the maintenance of abstinence overwhelmingly involved negative associations to the notion of drinking. The implications of these findings for psychotherapy are discussed. PMID- 3974237 TI - Alcoholism in men patients subtyped by family history and antisocial personality. AB - Alcoholism is known to be a familial disorder and the presence of a family history of alcoholism is recognized as an important variable in alcoholism research. The course and consequences of alcoholism in a group of men alcoholics are examined in relation to family pedigree for alcoholism. Consideration was also given to antisocial personality, a variable that may underlie and contribute to a positive family history of alcoholism. The presence of antisocial personality affected the course of alcoholism to a greater extent than having a positive pedigree for alcoholism. On the other hand, having a pedigree positive for alcoholism was more important in explaining the consequences of alcohol misuse than antisocial personality. The theoretical and methodological implications of these findings for future research are discussed. PMID- 3974238 TI - Alcohol misuse and depression in women criminals. AB - The interaction of alcohol misuse and major depressive syndromes was examined in 66 convicted women felons. At an initial (index) evaluation and during a 6-yr follow-up, alcohol misuse and depression, although both highly prevalent, were not significantly related. Alcohol misusing and nonmisusing depressives had similar rates of treatment for depression. Follow-up alcohol misuse, occurring in one-quarter of those reinterviewed, was not predicted by an index history of depression even among index alcohol misusers. Nonsignificant trends did suggest some association between the two symptom groups. Depressive subjects with a history of alcohol misuse had a greater rate of depression during follow-up than nonmisusing index depressives. Follow-up misusers had a greater rate of follow-up depression than nonmisusers. Alcohol-related depression could not be discounted simply as a consequence of alcohol misuse. Depression in the context of alcohol misuse was highly predictive of future depression and suicide attempts. The relative independence of alcohol misuse and depression in this group underscores the complexity of their interaction, especially in a population with multiple disorders such as women criminals. The contention that phenomenologically defined major depressive disorders are heterogeneous is supported. PMID- 3974239 TI - Stressful events, stressful conditions and alcohol problems in the United States: a partial test of Bales's theory. AB - Bales's theory that sociostructural factors that produce stress for members of a society increase the rate of alcoholism is examined to explain variations in the levels of alcoholism in the 50 states. Two types of social stress are conceptualized and measured at the state level: The first, the "life events" model, is based on life changes that require adaptation. An index is described in which (negative) personal life events in 15 categories (e.g., divorce and plant closings) are aggregated for each state using macro measures. The second model is based on the idea of chronic stressful conditions, and is measured through the Measure of Status Integration and the Index of Relative Opportunities. Alcohol related problems are measured by death rates for cirrhosis, alcoholism and alcoholic psychosis, and by per capita alcohol consumption. Both stressful events and stressful conditions are correlated with all indicators of alcoholism at the state level, 19 of 20 correlations being in the theoretically expected direction. Correlations are enhanced when age, urbanicity, the percentage of Blacks, low income and education are controlled for. The three macro measures of stress taken together explain 27% of the variation in cirrhosis death rates, 14% of the variation in alcoholism and alcoholic psychosis death rates and 47% of the variation in alcohol consumption rates. PMID- 3974240 TI - Basic aspects of blood platelet monoamine oxidase activity in hospitalized men alcoholics. AB - Platelet MAO activity (tryptamine as substrate) was assessed in 44 hospitalized men alcoholics to examine the relationships between MAO levels and variables related to alcohol misuse and physiological status. Mean MAO levels were lower in this population than in normal controls and hospitalized psychiatric patients. MAO activity correlated with age but was independent of variables derived from self-reported drinking histories and scales of alcohol dependence. Similarly, platelet MAO activity was not related to the misuse of other drugs. Of the variance in MAO activity, 38% could be accounted for by age, and the values of Mg++, low density lipoproteins and eosinophil combined. The significance of low platelet MAO activity in alcoholics is discussed. PMID- 3974241 TI - Reliability of retrospective estimates of alcohol consumption during pregnancy by recovering women alcoholics. AB - Twenty-six recovering women alcoholics were interviewed concerning their alcohol consumption during a pregnancy prior to their recovery. Several months later they were reinterviewed. Test-retest correlations were found to be high. Reliability was not related to the length of time since the pregnancy or to the test-retest interval. The frequency of consumption reported did not differ significantly from test to retest. However, the reported amount of consumption per occasion was significantly lower at the second interview. Reports of binge drinking were particularly unreliable. Results should be interpreted cautiously because the sample size was small. Although it may not be possible to estimate accurately actual alcohol consumption, it is possible to rank-order consumption reliably. It is not known whether these results may be generalized to other populations of pregnant women alcoholics, or to nonpregnant women and men. PMID- 3974242 TI - Plasmacytoma of the parotid gland. AB - Extramedullary plasmacytoma of the parotid gland is an extremely rare lesion of which there have been only four other reported cases. The importance of these lesions rests in the possibility of their being a harbinger of multiple myeloma or their subsequent transformation to multiple myeloma. Because of its extreme rarity, the proper management remains unclear. PMID- 3974243 TI - Surgical treatment of concurrent cancer of the esophagus and stomach. AB - Out of a total of 250 resections for carcinoma of the esophagus done in our department between 1965 and 1983, there were 11 patients with a concurrent esophageal cancer, nine being gastric cancer and seven of them early gastric cancer. In these nine, four underwent resection of the esophagus and lesser curvature of the stomach with gastric tube reconstruction. Two of the four patients are alive 10 and 3 yr postoperatively. We hold the view that detailed preoperative gastric examination is most important to plan the surgical repair and that the small gastric tube may serve as a substitute by resecting the lesser curvature of the stomach in cases of early proximal gastric cancer. PMID- 3974244 TI - Malignant smooth muscle tumors of the retroperitoneum and mesentery: a clinicopathologic analysis of 44 cases. AB - Forty-four cases of leiomyosarcoma arising in the retroperitoneum (33 cases) and mesentery (11 cases) were analyzed clinicopathologically, and four were examined ultrastructurally. These tumors were more common in women (61%) than in men (39%), and the median age of the patients was 59 years. Except for three tumors, most were large and over 10 cm in the greatest diameter. Twenty-seven tumors were classical leiomyosarcomas, while seven were composed predominantly of epithelioid cells and classified as malignant leiomyoblastoma (epithelioid leiomyosarcoma). In addition to the classical microscopic features, dedifferentiated areas resembling malignant fibrous histiocytoma were noted in three cases. Ultrastructurally, the tumors were characterized by smooth muscle tumor cells showing a spectrum of differentiation of varying degrees. Of the 42 patients for whom follow-up information could be obtained, 33 (79%) died within a period of five years after the initial treatment. Mitotic activity showed no significant correlation with biological behavior; ten of the 15 patients in whom the mitotic counts were less than five per 10 high-power fields (HPF), expired of the tumor. PMID- 3974245 TI - Bladder and urethral dysfunction after radical abdominal hysterectomy: rehabilitative treatment. AB - We studied bladder and urethral function prospectively in 64 patients before and after Wertheim's radical hysterectomy. Immediately after surgery, neurogenic bladder dysfunction of various degrees was found in 70% of all patients who presented difficulty of voiding, with high residual urine and/or stress incontinence. All the patients have received an early rehabilitative treatment with kinesitherapy and/or pharmacological therapy after the bladder catheter removal and the urodynamics' results. We have obtained a satisfactory functional recovery of the bladder activity in 91% of the symptomatic patients. PMID- 3974246 TI - High incidence of liver metastasis in gastric cancer with medullary growth pattern. AB - We studied the histology of resected specimens from 71 gastric cancer patients with synchronous and metachronous liver metastasis to assess the predominance of a particular histological pattern in gastric cancer with a tendency for liver metastasis. Poorly differentiated adenocarcinoma manifesting a medullary growth pattern was the most frequent histologic pattern (33%), followed by papillary adenocarcinoma (28%) in 39 patients with synchronous liver metastasis. In 32 patients who developed metachronous liver metastasis as the main pattern of recurrence, papillary adenocarcinoma was most frequent (47%), followed by poorly differentiated adenocarcinoma of the medullary type (28%). Scirrhous carcinoma was not encountered in patients manifesting metachronous liver metastasis. As most of the papillary adenocarcinomas exhibited a medullary growth pattern, we hypothesize that gastric cancer of the medullary type tends to metastasize to the liver, irrespective of the basic histologic pattern, and that poorly differentiated adenocarcinoma of the medullary type has a particularly high tendency for metastasizing to the liver. PMID- 3974247 TI - Carcinoma of the gallbladder: autopsy findings in 287 cases and review of the literature. AB - From 1950 to 1982, 287 patients with cancer of the gallbladder were autopsied. The ratio of men to women was 1:3.7. The average age of women was 70 years; that of men was 69.5 years. Most tumors (67.7%) had grown by diffuse infiltration and one-third (32.3%) were polypous-exophytic. Fundus and collum of the gallbladder showed an equal frequency (24%) of tumor localisation. The percentage of all gallbladder malignomas that were adenocarcinomas of various differentiation was 84.6, and 10.9% were anaplastic carcinomas, the rest consisted of squamous cell carcinomas (3.7%) and 0.8% sarcomas. Metastases were found in 265 cases (92.3%). Tumorous infiltration, lymph node metastases, and visceral metastases are discussed. A cholelithiasis was found in 78.4%. The results are compared with the literature. PMID- 3974248 TI - Adjuvant chemotherapy of gastric carcinoma: a pilot study of oral administration of injectable 5-fluorouracil. AB - During the past three years we have entered 54 patients with gastric adenocarcinoma into a clinical trial of oral administration of injectable 5 fluorouracil (5-Fu). Of the 20 unresectable advanced cases, the median survival was 6.2 months, and for 34 resectable ones, median survival was 22 months. These results were comparable to those reported in the literature. It is also safe, easy to administer, well tolerated, and does not have any apparent side effects. The author discovered for the first time that oral administration of 5-Fu could improve the liver function as manifested by a marked decrease of serum GPT level in advanced gastric cancer. PMID- 3974249 TI - Giant polypoid basal cell carcinoma. AB - A giant polypoid basal cell carcinoma occurring in the back of a 64-year-old man is reported. Three other such cases from the English literature are reviewed. PMID- 3974250 TI - Creatine kinase isoenzyme (CK-BB) by RIA as a follow-up marker in stage D cancer of the prostate: comparison with PAP RIA. AB - Fifty-nine patients with stage D carcinoma of the prostate under different modalities of treatment were studied for creatine phosphokinase isoenzyme BB (CK BB) and prostatic acid phosphatase (PAP) levels in serum by radioimmunoassay (RIA) technique, in order to study the possible use of CK-BB as a follow-up marker compared to PAP. Thirty-three patients were in stable, 19 in progressive, and seven in regressive clinical state. CK-BB was above normal level in 52 (88%) out of 59 patients with no statistically significant difference between the three clinical states. On the other hand, PAP was above normal level in only 23 patients (38.98%) with statistically significant difference between the three clinical states (P less than 0.001). The PAP/CK-BB index was below 1 in stable and regressive condition, while it was above 1 in eight out of 19 patients with progressive disease. The PAP/CK-BB index may be of prognostic importance. CK-BB by RIA was abnormal in more cases than PAP. In this way CK-BB reflects the presence of the tumor and may be used for diagnosis; however, it does not reflect the clinical response as PAP does. PMID- 3974251 TI - Assessment of the hot-plate antinociceptive test in mice. A new method for the statistical treatment of graded data. AB - The use of graded data from hot-plate antinociceptive tests is complicated by the problem of how to treat responses that are greater than the cut-off time. This paper describes a statistical procedure for analysis of antinociceptive data that circumvents this problem. The method is based upon the likelihood function and the data is assumed to follow a Weibull distribution. The technique can be implemented with the use of a computer and provides a more comprehensive assessment of antinociceptive data. PMID- 3974252 TI - Catecholamine, adenosine triphosphate, and P-creatine levels in decapitated whole mouse brain. AB - The levels of norepinephrine, epinephrine, dopamine, adenosine triphosphate, and P-creatine were measured in whole mouse brain collected under two conditions: 1) the decapitated head was immediately plunged into liquid nitrogen (nonanoxic tissue); or 2) the tissue was allowed to remain anoxic before the quick-freezing procedure. The substrate levels were significantly decreased in brain anoxic for only 30 sec. The catecholamine levels in nonanoxic mouse brain appear to be higher than levels previously reported in brains collected with microwave irradiation or by decapitation with rapid dissection of tissue before it was frozen. PMID- 3974253 TI - A method for the evaluation of calcitonin secretion using the isolated perfused porcine thyroid. AB - A method for the in vitro perfusion of isolated porcine thyroid glands was developed. The intact glands were placed in a chamber and perfused at a rate of 2.5 ml/min with an oxygenated Tris-balanced salt solution maintained at 37 degrees C. Perfusate fractions were collected at 5-min intervals and analyzed for immunoreactive porcine calcitonin (CT). Calcitonin secretion increased in a dose related manner with the level of calcium ion (2.5-6.25 mM) in the perfusion solution to a level of 7.5-fold greater than baseline levels. Other established CT secretagogues, such as theophylline (5 mM) and pentagastrin (4 microM), were found to stimulate calcitonin secretion. The CT secretory responsiveness of this system appears to mimic, both quantitatively and qualitatively, the secretory pattern observed in vivo in the pig. Therefore, this perfusion method should provide a valid in vitro model for the study of the process of CT secretion in the mammalian thyroid. PMID- 3974254 TI - The effect of heating on the functional activity of iota carrageenan. AB - Iota carrageenan is toxic to cells of the reticuloendothelial system. If carrageenan is dissolved at 40 degrees C and injected intraperitoneally, it will induce a significant reduction of alveolar macrophages. Heating the carrageenan preparation to 121 degrees C, however, results in a marked diminution of this in vivo cytotoxicity. This observation offers an explanation for the variability of effects previously attributed to carrageenan, and suggests that preparation methods should be standardized and carefully monitored. PMID- 3974255 TI - A quantitative method for assessing the extent of experimental gastric erosions and ulcers. AB - Evaluation of acute gastric erosions and ulcers induced by chemicals such as ethanol or aspirin is difficult because these lesions are predominantly multiple and irregularly shaped. A commercially available, relatively inexpensive microprocessor-linked planimeter (Micro-Plan II) with a stereomicroscope was used to measure the area of gastric mucosa damaged following intragastric administration of various doses of ethanol or aspirin. An enlarged image of rat glandular stomach was projected from the stereomicroscope onto a planimeter on which the perimeter of the entire glandular stomach and each lesion was traced with an electronic cursor. An attached printer recorded the area of stomach assessed, the number of lesions, the surface area of each lesion and the total area of mucosal damage. The technique was compared with semiquantitative methods used previously to assess experimentally induced gastric mucosal damage. The quantitative morphometric method was sufficiently sensitive to demonstrate a dose response effect of ethanol and aspirin. The stereomicroscope--planimeter combination provides a sensitive method to quantitate either a few small, or numerous large, regularly or irregularly shaped hemorrhagic and nonhemorrhagic gastric mucosal lesions. PMID- 3974256 TI - Continuous measurement of hindquarter resistance changes to nerve stimulation and intraarterial drug administration in rats. AB - Changes in vascular reactivity are thought to play an important role in the maintenance and/or pathogenesis of various disorders of the cardiovascular system including hypertension. In some animal models, results of studies examining reactivity of the hindquarters vasculature using different techniques are conflicting. The purpose of this study was to validate a new method for measuring vascular reactivity of the hindquarters: a method based on a modification of a technique used previously for renal autoperfusion. We tested the method in spontaneously hypertensive rats (SHR) in order to allow comparison of our results to those obtained previously using other techniques. We found that reactivity of the SHR hindquarters to norepinephrine was normal (compared to that of normotensive Wistar-Kyoto control rats, WKY), while reactivity to nerve stimulation was increased (when results were expressed as an absolute change in resistance). Dilator reactivity to acetylcholine and sympathetic nerve crush was greater in SHR. Resistance of the hindquarters at maximal dilation was 25% higher in SHR. Except for the resistance at maximal dilation, these results contrast with those obtained in earlier studies using an artificial pump to perfuse SHR hindquarters with blood or artificial media. However, the results agree with those reported in conscious, adult SHR. We conclude that: 1) our autoperfusion technique allows comparatively simple vascular reactivity testing to be performed in blood-perfused hindquarters of the rat, and 2) reactivity of the SHR hindquarters to dilator stimuli may be greater than in WKY rats. PMID- 3974257 TI - An all-glass apparatus for liver perfusion of lipophilic substrates. I. Construction and physical characteristics. AB - An all-glass apparatus for perfusing isolated rat livers was constructed for use in studies of the metabolism by, or action on, the liver of lipophilic substrates. Other designs, which generally include plastic connections or cannulae, can have unnecessarily complicated kinetics because of adsorption of the agent to the plastic parts. Two versions of an all-glass perfusion apparatus are described in detail. Both instruments operate on the same basic principle, but differ in size, total recirculating volume, pump rate, perfusion head pressures, maximum perfusate flow rate, maximum linear velocity in the perfusion head, and oxygenation efficiency. Although the maximum protein handling capacity differs for the two apparatuses, this capacity is so limited that it disallows the use of albumin in the perfusate. PMID- 3974258 TI - Quantitative determination of organ contribution to excretory metabolism. AB - A method for the quantitative determination of organ contribution to in vivo excretory metabolism is described. By excretory metabolism, we mean metabolism of a compound by an organ with direct excretion. The technique separately and simultaneously quantifies clearance of circulating metabolite and clearance of circulating precursor by excretory metabolism. For xenobiotics, the method involves the simultaneous infusion of radiolabeled precursor and unlabeled metabolite. The method is dependent upon the achievement of steady-state plasma concentrations of precursor and metabolite and on the ability to accurately analyze, both chemically and radioactively, the precursor in plasma, and the metabolite in both plasma and excretory fluid. The technique is not compromised by in vivo conversion of metabolite to precursor. This method is suitable for the simultaneous quantitative determination of the contribution of several organs to the formation of any number of metabolites present in excretory fluids. The simultaneous contribution of excretory metabolism to the urinary and biliary elimination of 1-naphthol in the rat is presented. PMID- 3974259 TI - The influence of multiple inseminations and multiple foundresses on social evolution. AB - The breeding biology of a population determines the way in which individuals are distributed within and between progeny groups and, thus, affects the genetic variation within and between these groups. The breeding biology of any organism can be characterized by the distribution of the numbers of mates of females, the apportionment of paternity among males, the distribution of the numbers of females reproducing in common nests, and the apportionment of total fecundity within a nest among founding females. In addition, the possibility of genetic correlations among mates or among founding females is an important consideration and will be addressed in a later paper. The influence of the breeding biology on social evolution was evaluated by deriving the necessary conditions for the spread of genes for social behaviors and the rate of spread of these genes for populations with different breeding biologies. The first step in this derivation is to demonstrate that selection for genes determining social behavior can be represented as the covariance between gene frequency and relative fitness. Secondly, it is shown that this covariance can be formally partitioned into within and between group components. Thirdly, each covariance component is shown to be equivalent to the product of a genetic variance and a coefficient of linear regression of relative fitness on gene frequency. Lastly, specific models for the genotype fitnesses and breeding biologies are assumed and the necessary conditions for the increase in the frequency of altruistic alleles are obtained. The theory illustrates that variation in the numbers of mates per female has less of an effect on the evolution of social behaviors than does variation in the numbers of reproductive females per nest. In addition, it points out that the harmonic mean number of mates per female or of females per nest is a more useful summary statistic for characterizing populations with respect to the expected degree of evolved sociality than is the arithmetic mean. PMID- 3974260 TI - Sensori-motor transformations in the brain (with a critique of the tensor theory of cerebellum). AB - Section 1 lists 12 points which must be addressed by neural models of sensorimotor coordination. Section 2 addresses the problem of extrapolating motor output from noisy data or from sensory input. The Pellionisz-Llinas cerebellar lookahead module addresses this problem for the noise-free case, and we suggest theoretical and experimental tests of the model; we then suggest the investigation of neural analogs of the Kalman-Bucy filter. Section 3 offers a brief exposition of mechanics in a tensor framework to provide the irreducible minimum of mathematical machinery to evaluate the Pellionisz-Llinas tensor theory of brain function and to suggest fruitful new hypotheses. Our critique of this theory in section 4 leads us to conclude that what they offer is based on metaphorical use of terminology from Euclidean tensors, not on rigorous application of the mathematics of tensor analysis. The central claim of their theory--that the input is a covariant intention vector transformed by a metric tensor encoded in the cerebellum to a contravariant execution vector--has not been substantiated and probably cannot be substantiated. However, we do point the way to further use of tensor analysis in the study of neural control of movement. The concluding section then returns to the points raised in section 1 with a highly selective survey of models of cerebellum and tectum. PMID- 3974261 TI - Calmodulin: calcium, potassium, and magnesium ion multiple equilibria and kinetics for interconversion, including the effect of repeated stimulation. AB - Using computer simulations, with realistic values for the intrinsic thermodynamic binding constants and kinetic on and off rate constants at the four metal-binding sites, the calmodulin molecule is shown to have been optimally adjusted by evolution for biological function. Despite a very large number of potential molecular states, depending upon occupation by potassium, calcium, or magnesium ions, the system restricts itself to a small number of physiologically significant equilibrium species. It appears to possess built-in triggers for biological processes, with rapid (approximately 20 ms time-scale), step-function shaped, changes of the populations of the CMKK, CMMK, CKKK, CMMM (and CCKK) states. The time-response of calmodulin to periodic changes in ionic levels (2 and 5 s-1) makes it quite adequate for repeated stimulations. In short, calmodulin appears as a very selective information transmitter at the molecular level. PMID- 3974262 TI - Equilibrium of apoproteins between high density lipoprotein and the aqueous phase: modelling of in vivo metabolism. AB - There is a growing body of evidence that apoproteins of the high density lipoproteins (HDL) exchange between lipoprotein particles through the aqueous phase and that there is always a finite but physiologically important quantity of lipid-free apoprotein in plasma. We have studied the theoretical consequences of this concept on the catabolism of apoproteins and developed a testable model for studying the in vivo metabolism of HDL apoproteins. This model describes the putative modification of the apparent tissue distribution spaces of the apoprotein that would result from a change in the partitioning of this apoprotein between HDL and the aqueous phase. The main parameters predicted by the model include the tissue distribution spaces of free monomeric apoprotein, those of HDL bound apoprotein and the partition coefficient of the apoprotein between HDL and the aqueous phase in blood. We have designed several ways of testing this model in vivo including the use of model synthetic apoproteins. This model can be generalized to a number of other binding systems. PMID- 3974263 TI - Compartmental analysis of the Na+ flux ratio with application to data on frog skin epidermis. AB - In this computer simulation study, the role of the topological factor on the Na+ influx/backflux (efflux) ratio in multicompartmental model membranes with active Na+ transport has been investigated. As in the classical "three compartment model", so also in multicompartment models with series order of compartments (series topology), the flux ratios are time-independent. By contrast, in models with series-parallel order of compartments (series-parallel topology), inclusive shunt pathways, the flux ratios are time-dependent. The values of the ratios can increase, or decrease with time, reaching steady state values, depending on the nature of the chosen topology. In a similar manner, the apparent value of the driving force, ENa, of the Na+-pumps, calculated from the Ussing-Teorell flux ratio equation and using global flux ratios, can vary in models with series parallel topology. This is not the case in models with series topology. On the other hand, the true value of the driving forces of the Na+ pumps, calculated from local flux ratios, are higher, and time-independent. In the absence of Na+ pumps (simulated ouabain effect) the flux ratios have in all cases the values of 1.0. These theoretical results are in good agreement with the theoretical results recently published by Sten-Knudsen & Ussing (1981) whose analysis utilized principles differing from those used here. In the design of the multicompartment model and the choice of kinetic parameters, frog skin epidermis served as a guide, such that simulated outputs closely agreed with experimental data in the literature. This includes the realization of a "fast" paracellular, and a "slow" cellular pathway for transepidermal flow of Na+. PMID- 3974264 TI - A model of bacterial DNA segregation based upon helical geometry. AB - A new mechanism to segregate daughter genomes in bacterial cells is suggested that is based upon the rules of geometry governing the helix clock (Mendelson, 1982a). The reorientation of cell surface string arrays used as a timing reference in the helix clock is capable of drawing apart the initial products of DNA replication. Physically linking the sister DNA replication origins to the ends of the initial cell surface string inserted into the cell surface at the start of a helix clock cycle, and linking the DNA terminus to a point along the length of the same string provides a means to mark the locations to which the genomes will segregate as well as the place where cell division will occur. The parallel packing of additional cell surface strings into an array which includes the string to which DNA is attached provides the necessary spatial rearrangements. The helical segregation model can account for the precise registration of cell divisions with the completion of replication forks in a multifork replication system, provides a basis for determining the relationship of sister cell sizes at division, and can also accommodate the asymmetrical divisions associated with minicell production and sporulation. Examination of the helical segregation theory under multifork DNA replication conditions moreover reveals that adjacent helical clocks are physically linked to one another although totally independent in terms of their progression through the clock cycle. A relationship between the initiation of DNA replication forks and the insertion of the first cell surface string associated with the start of a helix clock cycle is predicted by the model. PMID- 3974265 TI - Neuronal correlates of corticalization in mammals: a theory. AB - The cerebral cortex of mammals has been found to be uniformly organized, and to be composed of elementary processing units or modules having an essentially constant number of neurons. In the present paper the hypothesis is put forward that the relative proportion of local circuit neurons (LCNs) within a module reflects the evolutionary level of corticalization of a mammal. The modules, in turn, are interconnected so as to form basic neuronal networks or columns with a species-specific width varying from 90 to 310 microns. A mathematical formalism is presented from which the hypothetical ratio between LCNs and projection neurons, as well as the size of the cortical column and the number of modular units that it contains, can be calculated. PMID- 3974266 TI - Apparent stereochemical complementarity of estrogens and helical cavities between DNA base pairs: implications for the mechanism of action of steroids. AB - The shape of the space occupied by a model of the estrogenic steroid hormone estradiol-17 beta conforms closely to a helical cavity between neighboring base pairs in partially coiled B-DNA. The orientation of estradiol-17 beta when fitted into DNA allows stereochemically complementary hydrogen bonding of both the 3- and 17 beta-hydroxyl groups to phosphate oxygens of the deoxyribose-phosphate backbone on adjacent strands. Changes in the chirality (handedness) of the steroid skeleton or in the absolute stereochemistry of hydrogen bonding groups prevent formation of complementary fits in the DNA. Synthetic estrogens can also adopt conformations which are stereochemically complementary to the cavities between base pairs. The complementary relationships between active estrogens and nucleic acids may be related to constraints on the evolution of the structure and the biological function of steroids. PMID- 3974267 TI - Left ventricular aneurysmectomy. Resection or reconstruction. PMID- 3974268 TI - The changing spectrum of cystic pulmonary lesions requiring surgical resection in infants. AB - Congenital labor emphysema and cystic adenomatoid malformation have been the most common surgically treatable cystic lesions of the lung. With the successful treatment of newborn respiratory distress syndrome, an increased frequency of an acquired form of cystic disease, interstitial pulmonary emphysema, has been observed. Some degree of interstitial pulmonary emphysema is relatively common, and during the years 1980 to 1983 this disease was diagnosed in 372 infants. Seven of these infants, all premature, underwent resection of relatively localized areas of persistent cystic interstitial pulmonary emphysema. Lobectomy or wedge resection was performed in five patients because of their inability to be weaned from the ventilator. A sixth patient with this disease underwent lobectomy for recurrent pneumothoraces. A seventh patient underwent lobectomy because the cystic interstitial pulmonary emphysema produced atelectasis and recurrent infections. All seven patients were extubated by the fourth postoperative day, have been discharged, and are showing respiratory improvement. Within the same period, four infants had congenital lobar emphysema and two had congenital cystic adenomatoid malformation. They were gestational age 36 weeks or older and, although respiratory distress was present to some degree in all six, only one was ventilator dependent at operation. All underwent lobectomy and one infant had a left upper lobe resection and right middle lobectomy on separate occasions for bilateral congenital cystic adenomatoid malformation. All patients with congenital labor emphysema and congenital cystic adenomatoid malformation have been discharged and are doing well. Our results suggest the following conclusions: Persistent interstitial pulmonary emphysema is now the most common indication for pulmonary resection in the newborn period. The anatomic distribution of resected interstitial pulmonary emphysema is similar to that of congenital lobar emphysema. Although only a small fraction (less than 2%) of patients with interstitial pulmonary emphysema require operation, the development of relatively large discrete cystic areas that (1) significantly decrease effective lung volume and produce respirator dependence, (2) produce atelectasis and recurrent infections, or (3) lead to pneumothoraces may make pulmonary resection beneficial. Finally, despite the presence of generalized lung disease in patients with interstitial pulmonary emphysema, these patients can be expected to improve significantly after resection, and the long-term outcome is generally good. PMID- 3974269 TI - Early and late results of pericardiectomy for constrictive pericarditis. AB - Records of 231 patients (171 males, 60 females; aged 10 months to 83 years [median 45 years]) who underwent operation for constrictive pericarditis at the Mayo Clinic from 1936 through 1982 were reviewed. All had had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. Preoperatively, 69% were in New York Heart Association Class III or IV and 81% had peripheral edema or ascites. Pericardiectomy was performed through a left anterolateral thoracotomy (34%), a median sternotomy (27%), a U incision (Harrington) (21%), or a bilateral anterior thoracotomy (18%). Postoperatively, 28% of patients had evidence of low cardiac output; 70% of the 32 deaths within 30 days of operation were due to low cardiac output. Operative risk was significantly (p less than 0.001) related to preoperative disability (1% for Class I or II; 10% for class III; 46% for Class IV). Median postoperative follow-up was 9 years (longest was 43 years). Probability of survival for patients dismissed alive from the hospital was 84% at 5 years, 71% at 15 years, and 52% at 30 years. Long-term survival (excluding operative mortality) was not significantly influenced by the disability class preoperatively, the operative approach, or the development of low cardiac output in the immediate postoperative period. At the end of the follow-up interval, there were 141 patients in whom functional capacity could be assessed; 140 were in Class I or II. We conclude that a poor hemodynamic result after complete pericardiectomy relates to the preoperative degree of constriction and resultant cardiomyopathy. We recommend early pericardiectomy when pericardial constriction is diagnosed, and we continue to use a left anterolateral thoracotomy as the preferred approach for most patients. PMID- 3974270 TI - Cod-liver oil in the prevention of intimal hyperplasia in autogenous vein grafts used for arterial bypass. AB - Cod-liver oil, rich in eicosapentaenoic acid, an unsaturated fatty acid, was administered to 14 mongrel dogs to determine if this acid would prevent platelet mediated intimal hyperplasia. Twenty-eight 1 cm segments of undistended jugular vein were interposed between bilaterally divided femoral arteries. Seven control animals were fed a 2% cholesterol diet 1 week before and for 6 weeks after the operation. A further seven animals received cod-liver oil capsules containing 1.8 gm of eicosapentaenoic acid daily 1 week before and for 6 weeks after autogenous vein implantation, in addition to the lipid-supplemented diet. Baseline serum cholesterol was 4.6 +/- 0.4 mmol/L. The rise in serum cholesterol was similar in the two groups and increased to 7.4 +/- 0.6 mmol/L (control group) and to 6.8 +/- 0.2 mmol/L (eicosapentaenoic acid group) (p less than 0.001). Prothrombin time, partial thromboplastin time, bleeding time, and platelet counts were unchanged in the two groups. Vein grafts, harvested at 6 weeks, were fixed in formaldehyde. Mean intimal thickness was measured from multiple vein graft cross sections with a Zeiss computerized interactive image analyzing system. A mean of 140 +/- 11 measurements were computed from each graft. Marked intimal hyperplasia occurred in the control group and increased from 4.3 +/- 0.3 to 86.4 +/- 14 micron. In contrast, a high eicosapentaenoic acid diet inhibited intimal hyperplasia, with intimal thickness only increasing from 4.0 +/- 0.4 to 24.8 +/- 2.7 micron (p less than 0.001). These data indicate that eicosapentaenoic acid inhibits platelet mediated intimal hyperplasia and suggest that cod-liver oil could be used to prevent intimal hyperplasia in vein grafts used for myocardial revascularization. PMID- 3974271 TI - In vivo hemodynamic comparison of porcine and pericardial valves. AB - The bovine pericardial valve and the SupraAnnular valve have been developed to improve the hemodynamic function of tissue valves. Hemodynamic performances of the standard Carpentier-Edwards porcine valve, the Carpentier-Edwards SupraAnnular valve, and the Carpentier-Edwards bovine pericardial valve were compared in the aortic position. One hundred patients undergoing aortic valve replacement were studied intraoperatively. Mean gradient across the valve decreased for standard and pericardial valves as valve size increased. At the same flow rate, the 23 mm pericardial valve had larger valve orifice areas, higher performance indices, and lower gradients than the 23 mm SupraAnnular valve. The SupraAnnular valve is hemodynamically superior to the standard Carpentier-Edwards porcine bioprosthesis. The Carpentier-Edwards pericardial valve, however, is less obstructive in the aortic position than either of the porcine valves. PMID- 3974272 TI - Surgical management of refractory ventricular arrhythmias in patients with prior inferior myocardial infarction. A preliminary report. AB - Most reports of operations for ventricular arrhythmia have dealt with patients with anterior myocardial infarction. Patients with previous remote inferior myocardial infarction and recurrent ventricular tachycardia or fibrillation are a difficult subset of patients to treat with surgical ablative procedures. Over a 2 year period, 11 patients with prior inferior myocardial infarction and drug refractory ventricular tachycardia or fibrillation underwent elective operation to control the arrhythmia. Five patients had monomorphic ventricular tachycardia. Three of these five patients had localized endocardial resection and/or cryoablative procedures when the ventricular tachycardia was well localized intraoperatively. In the remaining two patients, ventricular tachycardia was noninducible intraoperatively, and the patients underwent extensive endocardial resection and mitral valve replacement because of sites suspected near the posterior papillary muscle from preoperative catheter mapping. None of these five patients had inducible ventricular tachycardia postoperatively, and all are clinically free of the arrhythmia over a 24 month follow-up period. One patient with two morphologies of ventricular tachycardia previously had an unsuccessful blind endocardial resection. She underwent map-directed cryoablation of both sites of ventricular tachycardia. Postoperatively, the patient was free of inducible arrhythmia and has been asymptomatic over 8 months. Five patients had pleomorphic ventricular tachycardia or fibrillation that could not be electrically localized. One patient with ventricular fibrillation underwent extensive endocardial resection, but the posterior papillary muscle was spared. Postoperative electrophysiological study was positive. The patient has had no clinical ventricular arrhythmias on a regimen of amiodarone, however. Two patients had extensive endocardial resection and mitral valve replacement. One died early in the postoperative course and the other is clinically well. The remaining two patients had an encircling endocardial ventriculotomy. Both are clinically stable although one had inducible ventricular fibrillation postoperatively. We conclude that well-defined monomorphic ventricular tachycardia in patients with a previous inferior myocardial infarction can be successfully treated with localized endocardial resection and/or cryoablation. However, patients with poorly localized monomorphic ventricular tachycardia or pleomorphic ventricular tachycardia or fibrillation may require more extensive procedures. The role of posterior papillary muscle sacrifice with mitral valve replacement remains undefined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974274 TI - Acute right ventricular failure is caused by inadequate right ventricular hypothermia. AB - The hypothesis of this study was that inadequate right ventricular hypothermia contributes to the right ventricular dysfunction occasionally observed after cardiac operations. Dogs were placed on cardiopulmonary bypass, and 60 minute periods of hypothermic myocardial ischemia were imposed. Left ventricular temperature was always maintained at 15 degrees C and right ventricular temperatures were maintained at 15 degrees C (Group I, n = 8), 25 degrees C (Group II, n = 8), and 35 degrees C (Group III, n = 8). These temperatures were produced by infusion of hypothermic crystalloid cardioplegic solution and appropriate topical cooling and heating of the left and right ventricles, respectively. Multiple indices of ventricular function were obtained 15, 30, 45, and 60 minutes after bypass and compared to prebypass control values. In all Group I animals (left ventricular temperature = 15 degrees C, right ventricular temperature = 15 degrees C), postischemic indices of right ventricular function were not different from control values (p = NS). In Group II (left ventricular temperature = 15 degrees C, right ventricular temperature = 25 degrees C), two animals died 30 and 45 minutes after bypass, respectively, of right ventricular failure. In the other six animals in Group II, all indices of right ventricular function were significantly reduced (p less than 0.05) except for right ventricular systolic pressure. In Group III (left ventricular temperature = 15 degrees C, right ventricular temperature = 35 degrees C), two animals could not be weaned from cardiopulmonary bypass because of right ventricular akinesia. Six animals were weaned from bypass, but two died 15 minutes, one died 30 minutes, and one 45 minutes after bypass. Two animals lived 60 minutes, but all indices of right ventricular function were decreased. Failure to maintain right ventricular temperatures below 25 degrees C during 1 hour of cardiac ischemia in the dog can result in fatal right ventricular failure. PMID- 3974273 TI - Diagnosis and management of synchronous lung cancers. AB - The findings in 28 patients with synchronous lung cancers are reviewed. Mediastinoscopy and systemic staging were performed to exclude the possibilities that one pulmonary lesion was metastatic from the other or that both represented systemic metastases from another tumor. Nineteen patients underwent resection of both tumors. Median survival was 25 months for four patients with definite Stage I synchronous cancers (no nodal involvement; different cell types, bronchoscopically separate endobronchial lesions or arising from separate foci of carcinoma in situ) and was 27 months for seven patients with possible synchronous Stage I cancers (no nodal involvement; similar cell types; located in separate lobes). Median survival was 11 months for 16 patients having Stage II or III lung cancer accompanied by a second synchronous lung cancer. In the absence of hilar or mediastinal nodal involvement and systemic metastases, synchronous tumors should be considered separate primaries when located in different lobes, even if they have similar histologic features. Prognosis of synchronous cancers is related to the presence or absence of nodal metastases. Pneumonectomy is the operation of choice for synchronous unilateral tumors. With bilateral tumors, sequential resection starting with the most advanced lesion is appropriate. Preservation of lung tissue without compromising the cancer operation is critical. PMID- 3974275 TI - Determinants of operative mortality for patients undergoing aortic valve replacement. Discriminant analysis of 1,479 operations. AB - The influence of 35 preoperative and intraoperative characteristics on operative mortality risk after 1,479 isolated aortic valve replacement procedures (1967 to 1981) was investigated utilizing univariate and multivariate logistic regression analyses. Mean age at operation was 58 +/- 13 years; 72% of patients were men. Physiology was classified as aortic stenosis (58%), regurgitation (30%), or both (9%). The overall operative mortality rate was 7% +/- 1%, but there were substantial differences in operative mortality rates among physiological subgroups (aortic regurgitation, 10% +/- 2%; aortic stenosis, 6% +/- 1%; stenosis/regurgitation, 5% +/- 2%). Independent determinants of operative mortality rate in the entire group were advanced New York Heart Association functional class, renal dysfunction, physiological subgroup, atrial fibrillation, and older age. In the aortic regurgitation subgroup, functional class, atrial fibrillation, and operative year were independent predictors. In the aortic stenosis subgroup, the significant determinants were functional class, renal dysfunction, age, prosthetic valve dysfunction, and absence of angina. Concomitant coronary bypass grafting, previous operation, endocarditis, and ascending aortic replacement had no independent predictive effect on operative mortality rate. Thus, the early results of aortic valve replacement can be related to several specific variables describing the functional and physiological status of the patient. Operative mortality rate is not independently related to previous operation or concomitant operative procedures. Specific differences in risk factors exist among the various physiological subgroups, probably reflecting the pathophysiology of the different hemodynamic lesions. This information should provide for a more rational approach to aortic valve replacement, at least in terms of early risk/benefit deliberations. PMID- 3974276 TI - Fifteen-year experience with surgical repair of truncus arteriosus. AB - From 1965 until March, 1982, 167 patients underwent surgical repair of truncus arteriosus. The age at operation ranged from 18 days to 33 years (mean 6 years). There were 48 hospital deaths (28.7%). The following factors had a positive correlation with the possibility of a surgical death: age at operation less than 2 years (p less than 0.001), a postrepair pulmonary arterial/left ventricular pressure ratio greater than 0.5 for patients with two pulmonary arteries (p less than 0.001) and greater than 0.6 for patients with unilateral absence of a pulmonary artery (p less than 0.02), and a postrepair right ventricular/left ventricular pressure ratio greater than 0.8 (p less than 0.008). The 119 hospital survivors were followed up for a total of 829 person-years. Late survival rate at 5 years was 84.4% and at 10 years, 68.8%. Preoperative factors that correlated with a reduced long-term survival rate were as follows: increasing age at operation (p = 0.004), the presence of moderate or severe truncal valve insufficiency (p = 0.008), lower pulmonary/systemic flow ratio (p = 0.04), and unilateral absence of a pulmonary artery (p less than 0.001). Thirty-six patients required reoperation during the follow-up period (30%) primarily for replacement of the right ventricular-pulmonary arterial conduit and/or for truncal valve replacement. The long-term results obtained in these patients support the need for early repair of the anomaly, improvement in the methods for control or repair of the truncal valve insufficiency, and the continued search for better extracardiac valved conduits. PMID- 3974277 TI - Pneumonectomy through an empyema. AB - In the 10 year period from May, 1973, to May, 1983, a total of 251 pneumonectomies were undertaken. Total unilateral bronchiectasis, the consequence of previous tuberculosis, occurred in 67.3% of cases and was the major indication for pneumonectomy. Of the 251 pneumonectomies, 14.7% were done through an empyema. The management of patients undergoing this procedure is discussed. There were two operative deaths among the 37 patients. Postpneumonectomy empyema developed in 16 patients (45.7%), and five of these patients required thoracoplasty, five left the hospital with an open drain or sinus, and in six the empyema was sterilized. PMID- 3974279 TI - A decade of experience with the Model 103 and 104 Beall valve prostheses. AB - Mitral or tricuspid valve replacement with the Beall Model 103 or 104 prosthesis has been associated with a high incidence of late prosthetic malfunction which has necessitated reoperation. Between 1972 and 1975, 57 patients underwent single valve replacement (55 mitral and two tricuspid) with Beall Model 103 or 104 valvular prostheses and survived at least 2 years. The mean follow-up time was 73.7 months (range 24 to 119 months). Of these patients, 22 required explantation of the prosthesis; there was an operative mortality of 27%. Major prosthetic malfunction occurred in four patients: Two occluders were embolized and two occluders were fixed in the open position. All four patients required urgent operation, and two of them died. The development of symptoms of congestive heart failure, systolic murmur, or hemolysis were the reasons for cardiac catheterizations and possible reoperation. Nineteen patients had cardiac catheterization. Fifteen of these subsequently underwent reoperation, with a mortality of 26%. Three patients were considered inoperable. Cardiac catheterization data revealed significant prosthetic regurgitation in all patients: pulmonary capillary pressure 29.9 mm Hg +/- 6.7 (standard deviation); V wave 31.5 mm Hg +/- 12.0; left ventricular end-diastolic pressure 18.0 mm Hg +/- 7.8. Comparison of hemolysis indicators in this group to those of asymptomatic patients revealed that the former had a significant elevation in lactic dehydrogenase (p = 0.038) and a lowered hematocrit value (p = 0.017). Waiting for severe symptomatic deterioration to justify reoperation risks the development of left ventricular dysfunction and possible emergency reoperation with a high operative mortality. PMID- 3974278 TI - Particle-induced coronary vasoconstriction during cardioplegic infusion. Characterization and possible mechanisms. AB - We have characterized an isolated rat heart preparation in which particles induce transient coronary vasoconstriction. Exploiting the fact that all commercially available intravenous solutions contain permissible levels of contaminant particles (usually 2 to 20 micron in diameter), we investigated whether these particles have any adverse effect upon coronary flow. A commercially available intravenous solution was modified to produce the St. Thomas' Hospital cardioplegic solution. Constant-pressure infusion of this solution over a 20 minute period caused a 46.2% +/- 5.1% reduction in coronary flow. This flow impairment could be limited to 13.3% +/- 3.5% by the incorporation of a 0.8 micron in-line filter. In hearts perfused with particle-containing solution followed by ultrafiltered solutions, the impairment of coronary flow was reversed within 1 minute. This quick reversal indicates that the particles were impairing flow not by physical occlusion of vessels but by triggering some form of transient vasoconstriction. In studies with filters of varying porosity (between 0.8 and 15.0 micron), the phenomenon was shown to be attributable to relatively small numbers of particles greater than 10.0 micron in diameter. In studies of myocardial protection, it was shown that the impairment of solution delivery and distribution caused by particles could severely reduce the protective properties of a chemical cardioplegic solution; hearts subjected to 180 minutes of hypothermic (20 degrees C) ischemic arrest with multidose (3 minutes every 30 minutes) cardioplegia recovered almost completely upon reperfusion if a filtered (0.8 micron) solution was used, but failed to recover when unfiltered, commercially prepared solutions were used. In an attempt to define the mechanisms underlying the particle-induced vasoconstriction, we conducted dose-response studies in which various vasoactive agents were used in an attempt to combat the effects of the particles. At their optimal concentrations, procaine (10.0 mmol/L), nifedipine (0.1 mumol/L), and adenosine triphosphate (1.0 mmol/L) completely prevented the problem; lidocaine and dipyridamole partially alleviated the effect; verapamil and isosorbide dinitrate were ineffective. These results indicate that several mechanisms acting at a small vessel level might contribute to the particle-induced vasoconstriction. PMID- 3974280 TI - A rare case of coronary artery obstruction. AB - A case of severe extrinsic compression of the left anterior descending coronary artery by an aneurysm of the left ventricular outflow tract is reported. PMID- 3974281 TI - Expanded polytetrafluoroethylene surgical membrane for pericardial closure. An experimental study. AB - This experimental study summarizes our experience with the use of a new polytetrafluoroethylene surgical membrane as a pericardial substitute in 24 dogs. Group I consists of 10 dogs who underwent simple pericardial closure with this membrane, and in Group II, 14 dogs had pericardial closure with this membrane after cardiac procedures. There were three early deaths. Two dogs that had undergone an associated right heart procedure developed endocarditis at 4 and 7 months, respectively. Postmortem examinations were performed in all 21 surviving dogs. The pericardial membranes were found to be acellular and to have maintained their initial characteristics. The epicardium was normal and the coronary arteries easily visible. Seven of the eight 0.2 mm thick membranes caused filmy pericardial adhesions. None of the 0.1 mm thick membranes formed adhesions or had any structural change. We conclude that this new 0.1 mm thick polytetrafluoroethylene surgical membrane should be clinically tested to see if it will reduce or eliminate pericardial adhesions and facilitate cardiac reoperation. PMID- 3974282 TI - Massive symptomatic cystic hygroma confined to the thorax in early childhood. AB - A case of massive symptomatic cystic hygroma confined to the left hemithorax and mediastinum in a 21-month-old boy is reported. The symptoms were of increasing respiratory distress and cough with fever. The mass surrounded all of the major vascular and nervous structures of the mediastinum and left hemithorax and was attached to the pericardium. It was excised, and the postoperative course was complicated by prolonged chylothorax and malfunction of the left hemidiaphragm. Seven other reported symptomatic cases of cystic hygroma confined to the thorax in early childhood are reviewed. The hygromas tend to be large and their care typically is complex and complicated. Hemorrhage into the cysts is a frequent finding and likely contributes to the acute and progressive symptoms. PMID- 3974283 TI - Intrathoracic vagus nerve tumors: a report of two cases and review of the literature. AB - We have observed 741 mediastinal tumors during the past 25 years. Among these tumors, two intrathoracic vagal tumors were found; one bilateral neurofibrosarcoma and one neurilemmoma. To date, 49 intrathoracic vagal tumors have been reported in the literature, and the neurofibrosarcoma described here is the fourth malignant vagal tumor reported. PMID- 3974284 TI - Hypoplastic aortic arch with aortic coarctation: surgical correction. AB - This report describes an alternative operation for hypoplastic aortic arch. The technique conserves the vascularization of the left arm and avoids the need of using flaps or free patches. The operative procedure is documented in three patients. PMID- 3974285 TI - Serous fluid leakage through PTFE grafts: a possible explanation. PMID- 3974286 TI - Limitations of blood conservation. PMID- 3974287 TI - Resolution of disseminated intravascular coagulation after valve replacement. PMID- 3974288 TI - Epidemiology of systemic lupus erythematosus and other connective tissue diseases in Rochester, Minnesota, 1950 through 1979. AB - The incidence and prevalence rates of connective tissue disease syndromes in Rochester, Minnesota, from 1950 through 1979 are reported. The incidence of definite systemic lupus erythematosus (SLE) has not increased since 1960. The incidence of SLE in the elderly population was higher than that in previous reports. Rates of SLE and discoid lupus erythematosus were approximately equal. Other diagnoses (in decreasing order of frequency) were suspected lupus erythematosus, scleroderma, drug-induced lupus, and overlapping connective tissue disease syndromes. The 10-year survival of patients with definite SLE was decreased, and the survival of patients with suspected SLE was the same as that of the general population. PMID- 3974289 TI - Argon laser treatment of port-wine stains. AB - Port-wine stains, especially of the face, are frequently a severely disfiguring lesion. Previous treatment modalities have not produced satisfactory results. The argon laser can be of benefit: in more than 70% of patients who undergo this treatment, the lesion becomes lighter. Three cases are presented to illustrate the range of clinical results. PMID- 3974290 TI - Thrombotic occlusion of a prosthetic heart valve: diagnosis and management. AB - Thromboembolic complications continue to be potential hazards in patients with prosthetic heart valves, and cerebral infarct and transient neurologic deficits as a result of embolism are the most common manifestations. Actual thrombotic obstruction of the valve occurs less frequently but is often fatal unless it is recognized and treated promptly. Tilting disk prostheses, such as the Bjork Shiley valve, seem to be associated with a higher incidence of thrombosis than other prosthetic designs. In this article, we review the important features of diagnosis and treatment of thrombotic occlusion of prosthetic valves. PMID- 3974291 TI - Hematopoietic cells in thyroid fine-needle aspirates for cytologic study: report of two cases. AB - In two patients, hematopoietic cells were found on cytologic study of fine-needle aspirates from the thyroid gland. The cells were thought to have been aspirated from ossified laryngeal tissues and to have no significance for hematologic disorders in these two patients. PMID- 3974292 TI - Magnetic resonance imaging: a time for assessment. PMID- 3974293 TI - Treatment of carotid sinus hypersensitivity. PMID- 3974294 TI - Diagnosis of giant cell arteritis. PMID- 3974295 TI - Magnetic resonance imaging in a routine clinical setting. AB - The results of magnetic resonance imaging (MRI) examinations in the first 1,000 consecutive patients who were studied by this technique at our institution were reviewed to determine the disease states encountered, the sensitivity and accuracy of results, and the value of the examination as compared with computed tomography and other imaging procedures. The MRI device was a 0.15-tesla resistive magnet that used a variety of saturation recovery, spin echo, and inversion recovery pulse sequences to produce images. MRI was found equal to or superior to other imaging techniques in most cases. Exceptions included organs or body regions that are prone to excessive respiratory or vascular motion, lesions that necessitate exquisite spatial resolution for diagnosis, and lesions in which angulation of the viewing plane is necessary for optimal depiction. Fresh blood and calcification within a lesion were also difficult to detect with use of MRI. PMID- 3974296 TI - Comparison of needle biopsy with cytologic analysis for the evaluation of pleural effusion: analysis of 414 cases. AB - We retrospectively studied the results from thoracenteses and needle biopsies of the pleura performed in 414 patients with pleural effusions between 1973 and 1982. The final causes of effusion were malignant disease in 281 patients (67.9%) and nonmalignant disease in 133 (32.1%). The presence of pleural malignant disease was established by cytologic study in 162 patients (57.6%), by needle biopsy in 123 (43%), and by either cytologic analysis or biopsy in 182 (64.7%). In only 7.1% of the 281 patients with malignant pleural effusions did biopsy reveal malignant disease when the results of cytologic study were negative for malignant disease. Nearly half of the patients with lymphoma had lymphocytosis of the pleural fluid, but neither this finding nor the lymphocytic pleuritis noted on biopsy was diagnostic of lymphomatous involvement of the pleura. Among the patients with malignant mesothelioma, thoracotomy was necessary to confirm the diagnosis in 60.9%. In the patients with nonmalignant diseases, with the exception of six with tuberculous pleurisy, pleural biopsy was nondiagnostic even though the causes of pleural effusion were apparent from the clinical features. The causes of pleural effusion remained unknown in 82 patients (19.8%). Pleural biopsy failed to provide adequate tissue in 55 patients (13.3%). This study shows that cytologic analysis has a higher sensitivity (P less than 0.001) than needle biopsy for diagnosing malignant pleural effusions. The value of needle biopsy is limited in establishing the cause of pleural effusion that results from either malignant or nonmalignant disease, with the exception of tuberculous pleurisy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3974297 TI - Energy expenditure in patients with low-, mid-, or high-thoracic paraplegia using Scott-Craig knee-ankle-foot orthoses. AB - Renewed interest in ambulation in patients with paraplegia prompted us to measure the energy expenditure (kcal/kg per min) during standing and ambulating with the Scott-Craig orthosis in nine patients who had low-, mid-, or high-thoracic paraplegia. Energy expenditure during standing and during ambulation with a walker was similar for patients with all levels of paraplegia. In patients with high-thoracic paraplegia, energy efficiency was significantly less (P less than 0.05) than that for patients with mid- or low-thoracic paraplegia, whose efficiency levels were similar. In patients with low-thoracic paraplegia, the only patients who could perform swing-through gait patterns, energy efficiency was increased because of increased velocity. Our data do not support the concept of denying, on the basis of the level of the lesion alone, young, otherwise healthy, well-motivated patients with thoracic paraplegia the opportunity of using Scott-Craig orthoses to supplement wheelchair mobility and activities of daily living. PMID- 3974298 TI - Refractory supraventricular tachycardia in the neonate: treatment with temporary antitachycardial pacing. AB - Although intracardiac antitachycardial pacing techniques are frequently used to terminate reentrant supraventricular tachycardia in adults, this approach has rarely been used in neonates. We describe two neonates, both of whom were in circulatory shock due to recurrent paroxysmal supraventricular tachycardia, who were treated with temporary antiatachycardial pacing. This approach allows repeated termination of the tachycardia at the bedside until an adequate therapeutic concentration of an effective drug regimen is achieved and obviates repeated direct-current cardioversion. PMID- 3974299 TI - Quantification of deposition of neutrophilic granulocytes on vascular grafts in dogs with 111In-labeled granulocytes. AB - A new radioisotopic technique has been developed for quantification of deposition of neutrophilic granulocytes on vascular grafts. Nine healthy mongrel dogs underwent bilateral femoral artery resection and reconstruction with grafts of femoral vein and Gore-Tex. Pure granulocytes that had been separated from whole blood by centrifugal elutriation were labeled with 111In-tropolone in plasma. The granulocyte harvesting efficiency was 25 +/- 12%, and the labeling efficiency was 87 +/- 7%. Three hours after injection of labeled granulocytes and 2 hours after reperfusion, the grafts were harvested and cut into several segments for study of areas of anastomoses and midsections. On the basis of the radioactivity in the blood and in anastomotic and graft sections, the area of graft sections, and the neutrophilic granulocyte and differential leukocyte counts, the number of neutrophilic granulocytes adherent to a unit area and the total number of neutrophilic granulocytes on graft sections were calculated. These quantifications of the deposition of neutrophilic granulocytes indicated that the midsections of Gore-Tex grafts retained more neutrophilic granulocytes than did the midsections of vein grafts. Although the anastomotic areas retained more neutrophilic granulocytes than did the midsections of vein grafts, the opposite finding prevailed for the Gore-Tex grafts. A major fraction of neutrophilic granulocytes on Gore-Tex grafts was incorporated into thrombus. Semiquantitative information obtained by scintigraphy of the deposition of neutrophilic granulocytes on vascular grafts also confirmed this observation. PMID- 3974300 TI - Left ventricular outflow tract obstruction related to a valve prosthesis: case caused by a low-profile mitral prosthesis. AB - Mechanical and bioprosthetic mitral prostheses may have many potential complications. In patients with isolated mitral stenosis and a small left ventricular cavity, low-profile prostheses are recommended to avoid myocardial impingement that can result from a high-profile valve and lead to possible left ventricular inflow or outflow obstruction or ventricular arrhythmias. This case report illustrates that left ventricular outflow obstruction may also result from a low-profile mitral valve prosthesis. This obstruction was not diagnosed before cardiac catheterization. Assessment of patients with suspected prosthetic valve dysfunction is difficult and may necessitate cardiac catheterization or even direct surgical inspection for conclusive information. PMID- 3974301 TI - Erythromycin: a microbial and clinical perspective after 30 years of clinical use (1). AB - Erythromycin is a macrolide that acts by inhibiting the translocation reaction during protein synthesis. Erythromycin is inactive against the Enterobacteriaceae and Pseudomonas aeruginosa except under alkaline conditions. Erythromycin is active against most gram-positive bacteria; some gram-negative bacteria, including Neisseria, Bordetella, Brucella, Campylobacter, and Legionella; and Treponema, Chlamydia, and Mycoplasma. The emergence of resistance to erythromycin is closely associated with its use and is often plasmid mediated. After its oral or parenteral administration, erythromycin diffuses readily into intracellular fluids and is actively concentrated intracellularly by polymorphonuclear leukocytes and alveolar macrophages. PMID- 3974302 TI - Biopsy of the temporal artery. PMID- 3974303 TI - Progressive neurologic disorder. PMID- 3974304 TI - Increase of size and dry mass of mouse erythrocytes depending on age of donors. AB - It was found that during aging of mice the size and the dry mass of their erythrocytes increased. Similarity of this phenomenon to that observed during aging in vitro and in vivo is suggested. PMID- 3974305 TI - Occurrence of anti-low density lipoprotein antibodies and circulating immune complexes in aged subjects. AB - The incidence of circulating immune complexes, anti-low density lipoprotein (LDL) autoantibodies and the anti-LDL activity of immune complexes was studied in healthy young and aged controls and in patients with vascular diseases. Circulating immune complexes (CIC) frequently occurred both in the young or old patient groups and in the aged healthy control groups, whereas they could not be found in the young controls. Marked differences were found in the incidence of anti-LDL antibodies between the groups tested. In both young and aged control groups such antibodies were very rarely observed (4-5%). In contrast anti-LDL antibodies were present in 35-45% in the aged, or young patients. Similarly, no anti-LDL activity was found in CIC of the controls, whereas in the patients with vascular diseases a significant CIC-associated anti-LDL activity was detected. These results suggest that the presence of anti-LDL antibodies are associated with the arteriosclerotic manifestations, while that of circulating immune complexes is connected by the ageing process itself. PMID- 3974306 TI - Translation fidelity in the aging mammal: studies with an accurate in vitro system on aged rats. AB - The accuracy of poly(U) translation was measured in the post-mitochondrial supernatant from whole brain of 7- and 33-month-old Fischer 344 rats. Measurements were made: under in vitro conditions in which translation fidelity was similar to what is known about the accuracy of translation in vivo; and under stresses of varying Mg2+ concentrations (3-12 mM), pH (6.6-8.4), temperature (26 42 degrees C) and in the presence or absence of 2.4% ethanol. No significant difference could be detected between the responses of old and young extracts, the activities of their Phe- and Leu-tRNA synthetases, and their endogenous amounts of Phe-tRNA and Leu-tRNA, despite the fact that the rats studied corresponded in age (by actuarial criteria) to 90-year-old human beings. The accuracy of poly(U) translation was also studied: in liver and hippocampus extracts from 7- and 33 month-old rats; and in brain extracts from 3- and 29-month-old rats. The results were similar to those obtained in brain extracts from 7-month-old rats. Explanations are provided for the inconsistencies which exist in the literature regarding the effect of aging on the accuracy of protein synthesis. It is shown that the inconsistencies are likely to reflect inadequate methodology in three previous studies rather than biological diversity in the control of translation fidelity in aged animals. PMID- 3974307 TI - Intramitotic variation in proliferative potential: stochastic events in cellular aging. AB - A series of mitotic pairs of cells were isolated and the proliferative potential of each cell determined. Although the proliferative potentials of the two cells of a single pair were similar for most pairs examined, in a significant proportion large differences were observed. These results suggest a strong stochastic component in the somatic inheritance of proliferative potential. This observation provides the basis for refinement of a mathematical model for in vitro cellular aging. PMID- 3974308 TI - Interaction of macrophages with "old" red blood cells from syngeneic mice in vitro and the independence of the recognition process on macrophage Fc receptors. AB - The interaction between peritoneal macrophages and "old" red blood cells (RBC) from syngeneic mice was studied in vitro. It seems that this interaction is not mediated directly via Fc receptors on the macrophage. (1) 2-deoxy-D-glucose did not inhibit the phagocytosis of "old" RBC, but did inhibit the phagocytosis of IgG-coated sheep RBC (SRBC). (2) Immobilization of Fc receptors by plating macrophages on coverslips coated with bovine serum albumin: anti-bovine serum albumin (BSA: anti-BSA) complexes had no effect on the phagocytosis of "old" RBC, but inhibited the phagocytosis of IgG-coated SRBC. The interaction between mouse macrophages and "old" RBC is temperature dependent. At 4 degrees C and 22 degrees C "old" RBC attach to macrophages but are not phagocytized; at 37 degrees C phagocytosis occurs. Fetal calf serum (FCS) is required for optimal phagocytosis. Sialic acid residues on the macrophage surface do not play a role in this recognition and phagocytosis process, as neuraminidase treatment of macrophages did not affect the interaction. PMID- 3974309 TI - Thyroxine deiodination, cytoplasmic distribution and nuclear binding of thyroxine and triiodothyronine in liver and brain of young and aged rats. AB - This study examines (a) the effects of aging on plasma thyroid hormone concentration and (b) in vivo binding and cytoplasmic distribution of thyroid hormones as well as the conversion of thyroxine (T4) to triiodothyronine (T3) in liver and cerebral hemispheric tissue. The results show that (a) in male Long Evans rats aging decreases plasma T4 concentration but does not affect plasma T3 concentration and (b) the in vivo nuclear T3 binding does not change significantly. However, nuclear T3 binding derived from T4 is decreased as a consequence of reduced T4 to T3 conversion in both tissues. The nuclear T4 binding is also depressed, perhaps due to the decrease in the T4 of the protein free cytoplasmic compartment. Aging was also found to change protein free and protein bound cytoplasmic distribution of T4. That is, an increase was observed in protein bound cytoplasmic T4 and a decrease in the protein free cytoplasmic T4 of both tissues. These results indicate an overall alteration in thyroid hormone production and peripheral tissue binding and processing of thyroid hormones with a consequent suboptimal thyroid state with aging. PMID- 3974310 TI - Ultraviolet light-induced DNA repair synthesis in hepatocytes from species of differing longevities. AB - The DNA repair capabilities of cultured hepatocytes derived from five mammalian species in response to a broad range of ultraviolet light exposures were measured. Differences in the induction of DNA repair synthesis and the proportion of responding cells were noted only for the lowest fluences. These differences appeared to be positively correlated with the potential lifespans of the species involved; mouse and rat hepatocytes displayed less repair than those from guinea pig or rabbit. At higher fluence levels, however, there were no differences in the amount of repair induced. Thus the maximal repair potential of hepatocytes derived from the rat, mouse, hamster, guinea pig and rabbit were the same. PMID- 3974311 TI - Changes in DNA and in nuclear and nucleolar dry mass and area in senescing parenchyma cells of corn cob and stalk tissues. AB - Corn (Zea mays L.) cob and stalk parenchyma tissues were used for a study of senescence using quantitative interference microscopy and quantitative Feulgen cytophotometry. In both parenchyma tissues, nuclear dry mass (NDM), nucleolar dry mass (NoDM), nuclear area (NA), and nucleolar area (NoA) increased during cell elongation and then decreased prior to cell death. These changes were more distinct in corn cob parenchyma tissue than in stalk parenchyma tissue. DNA content (determined for cob parenchyma, center section, only) decreased over the entire study period, slowly at first, them more rapidly. Because NoDM and NoA trends in cob parenchyma tissue were similar to those of NDM and NA but with earlier decreases, we conclude that nucleolar degeneration is an early event in corn parenchyma cell senescence. Loss of DNA also occurs earlier than loss of NDM in cob parenchyma tissue. It is further suggested that the increases in NDM as DNA content decreased represents nuclear protein and RNA content increases prior to senescence. However, no indication of nucleoli degeneration was found in stalk parenchyma cells even though NDM and NA decreased prior to cell death. PMID- 3974312 TI - Simplified electrode array for impedance cardiography. PMID- 3974313 TI - Compiled profile of respiration, heart beat and motility in newborn infants: a methodological approach. PMID- 3974314 TI - Real-time waveform analysis of multichannel nerve impulses with a multimicroprocessor system. PMID- 3974315 TI - Linear and nonlinear properties of platinum electrode polarisation III: Equivalence of frequency- and time-domain behaviour. PMID- 3974316 TI - A model of extracellular waveshape of the gastric electrical activity. PMID- 3974318 TI - Noninvasive measurement of beat-to-beat vascular viscoelastic properties in human fingers and forearms. PMID- 3974317 TI - Noninvasive measurement of pressure/volume characteristics in human limb veins by electrical admittance plethysmography. PMID- 3974319 TI - Computer graphics and numerical techniques in the measurement of movements within cells. PMID- 3974320 TI - Pulsatile blood flow in a stenosed artery--a theoretical model. PMID- 3974321 TI - 'Objective' algorithm for maximum frequency estimation in Doppler spectral analysers. PMID- 3974322 TI - Analysis of blood flow under time-dependent acceleration. PMID- 3974323 TI - VIPER: a powerful tool for the real-time calculation of inner products for biomedical signal processing. PMID- 3974324 TI - Fabrication techniques for thin-walled, kink-resistant tubular structures for use in medical devices. PMID- 3974325 TI - Adaptable myoelectric prosthetic control with functional visual feedback using microprocessor techniques. PMID- 3974326 TI - Life of Pt and Pt-Ir stimulating electrodes in neurological prostheses. PMID- 3974328 TI - Treadmill made of conducting rubber in gait analysis. PMID- 3974327 TI - Implantable myoelectric control system with sensory feedback. PMID- 3974329 TI - Relationship of the left ventricular and apical first sounds to the left ventricular pressure derivative. PMID- 3974330 TI - Inexpensive four-channel time-division multiplexer. PMID- 3974331 TI - Socioeconomic status and children's health. AB - This article explores the relationship between socioeconomic status and three common children's health problems: ear disease, hearing loss, and vision problems. Data are from a household survey and independent clinical examination of 1,063 black children in Washington, D.C. In the study sample, all three problems had a U-shaped relationship to income, with significantly higher prevalences among both upper- and lower-income children than the middle-income group, even controlling statistically for other socioeconomic factors. Except for past illness, income was generally the strongest determinant of children's health, followed by housing crowding and neighborhood income level. Some risk factors varied between upper- and lower-income children. Doctor contacts seemed to reduce illness among poor children but not among the more affluent, while the use of "private" rather than "public" settings did not appear to benefit either group. Policy implications are discussed. PMID- 3974332 TI - Medication usage in an elderly population. AB - One hundred eighty-three independently living elderly residents of two federally subsidized, urban high-rise apartment buildings were interviewed in their homes to determine the numbers and types of medications they used and stored and their utilization of pharmacy services. From these interviews and observations, the frequencies of use of medications and pharmacy services and the prevalence of potential problems were determined. Results showed that 75% of interviewees used a prescription drug regularly, and 82% used a nonprescription drug regularly. Fifty-one percent had stored noncurrent prescription drugs, while 67% had noncurrent nonprescription drugs in their homes. The most common problems encountered were discrepancies between labeled dosage and dosage actually used, potential drug interactions, and underuse of medication. Findings that may contribute to the risk of future medication problems were the prevalence of noncurrent medications stored in homes, the respondents' lack of knowledge about recognition and management of adverse drug reactions, and the underutilization of pharmacists as drug therapy consultants. PMID- 3974333 TI - The effects of drug counseling and other educational strategies on drug utilization of the elderly. AB - The medication behavior of 183 elderly apartment residents was assessed for problems in medication regimen compliance, regimen comprehension, drug interactions, and drug storage. Following an initial assessment, the residents were given instructions in drug utilization and access to drug counseling was provided intermittently for almost 2 years. Approximately 1 year after the educational intervention a final assessment of a sample of 39 residents, who initially were found to have the greatest numbers of problems, revealed a significant 11% decrease in the number of prescriptions taken and a significant 39% decrease in the number of medication behavior problems. The initial average was 3.7 prescriptions currently used and 2.7 problems per person that subsequently decreased to 3.3 prescriptions and 1.6 problems for the same residents at the end of the study. Results suggest that pharmacist consultation provides an effective health prevention strategy in elderly resident settings. Educational strategies used in this study appear to be well adapted for use with elderly home-based populations. PMID- 3974335 TI - [Indications for lumbar sympathectomy]. PMID- 3974334 TI - [Spectral analysis of tremor]. PMID- 3974336 TI - [Multiple endocrine deficiency syndrome. Presentation of 3 new cases]. PMID- 3974337 TI - [Factitious Bartter's syndrome induced by the surreptitious ingestion of diuretics]. PMID- 3974338 TI - [Bronchial asthma and broncho-alveolar lavage]. PMID- 3974339 TI - [Neuroarthropathy as the initial sign of syringomyelia]. PMID- 3974340 TI - [Negativity of gammagraphy using I131-labeled meta-iodobenzylguanidine in the diagnosis of pheochromocytoma]. PMID- 3974342 TI - [Respiratory morbidity and atmospheric pollution]. PMID- 3974341 TI - [Medical treatment of chronic subdural hematoma]. PMID- 3974343 TI - [Etiology of extrahospitallary pneumonia in an urban environment]. PMID- 3974344 TI - [Proteinuria in the nephrotic range as the initial manifestation of polycystic kidney]. PMID- 3974345 TI - [Toxic oil syndrome and autoimmunity]. PMID- 3974346 TI - [Celiac disease in the adult]. PMID- 3974348 TI - [Acute non-invasive test in the selection of anti-arrhythmic drugs. Preliminary study]. PMID- 3974347 TI - [Serum levels and spirometric response with sustained release theophylline]. PMID- 3974349 TI - [Clinical reflexions on celiac disease]. PMID- 3974351 TI - [Causes of failure of drug treatment]. PMID- 3974350 TI - [Lesch-Nyhan syndrome: a new variant with hypoxanthine-guanine phosphoriboxyl transferase activity higher than the classical disease and detection of the heterozygote trait in the erythrocytes of the carrier]. PMID- 3974352 TI - [Some comments about Sweet's syndrome]. PMID- 3974353 TI - [Enterobacter agglomerans bacteremia]. PMID- 3974354 TI - [Acute spontaneous subdural hematoma]. PMID- 3974355 TI - [Transient global amnesia associated with a meningioma of the frontal lobe]. PMID- 3974356 TI - [Osteoblastic metastasis and carcinoma of the pancreas]. PMID- 3974357 TI - [Pericardial window. Diagnostic and therapeutic effectiveness in chronic pericardial effusion and pericardial tamponade]. PMID- 3974358 TI - [Pellagra: a disease to re-evaluate?]. PMID- 3974359 TI - [Neurological manifestations of pellagra: description of 2 cases]. PMID- 3974360 TI - [Mechanisms regulating arterial hypoxemia during hemodialysis]. PMID- 3974361 TI - [Massive mesenteric necrosis in dermatopolymyositis of the adult]. PMID- 3974362 TI - [Toxic typhoid encephalopathy with mesencephalic and basal ganglia involvement]. PMID- 3974363 TI - [Sideroblastic anemia and tuberculosis]. PMID- 3974364 TI - [Pure aplasia of the red-cell series associated with thymoma]. PMID- 3974365 TI - [Infection by hepatitis B virus. Epidemiological study in a general hospital]. PMID- 3974366 TI - [Epidemiology of arterial hypertension in an industrial population]. PMID- 3974367 TI - Symposium on medical aspects of exercise. PMID- 3974368 TI - Injuries of exercise. AB - This article presents a brief overview of a few of the conditions that may affect the exercising individual. An accurate diagnosis and a positive attitude toward exercise on the part of the physician is stressed. PMID- 3974369 TI - Exercise during pregnancy. AB - Theoretical arguments suggest that cardiovascular fitness would be desirable during pregnancy but that high-intensity exercise should be avoided; both notions require rigorous testing. Moderate exercise, by normal women with uncomplicated pregnancy, does not appear to affect fetal health. Coexisting maternal medical or obstetrical complications may contraindicate exercise. PMID- 3974370 TI - [Digitalis poisoning--treatment with specific antibodies]. PMID- 3974371 TI - [Non-invasive heart diagnosis in a county region--the value of echocardiography and other methods]. PMID- 3974372 TI - [Endocrine cells and tumors of the gastrointestinal system and pancreas]. PMID- 3974373 TI - [Diagnosis, classification and treatment of endocrine intestinal tumors]. PMID- 3974375 TI - [WHO model for x-ray service is useful under Swedish primary health care]. PMID- 3974376 TI - [Polyneuropathy after long term treatment with metronidazole]. PMID- 3974374 TI - [Vasoactive intestinal polypeptide and sexual function: inhibition of motility in the fallopian tubes and uterus. Positive role in penile erection]. PMID- 3974377 TI - Basal lamina breaks in the histogenesis of cholesteatoma. AB - Aural cholesteatomas may arise in the middle ear by a variety of mechanisms; in some cases it appears that cholesteatomas arise within or behind an intact tympanic membrane. We have observed that microcholesteatomas arise within the tympanic membrane of mongolian gerbils which have keratin accumulations on the lateral surface of the tympanic membrane. An ultrastructural study of the keratinizing epithelium of these animals showed that breaks in the basal lamina allow pseudopods of epithelial cells to extend into the lamina propria and form epithelial cones. The basal lamina later reconstituted itself. Keratinization may occur within these ingrowing cones forming microcholesteatomas. This sequence of events may explain the occurrence of intratympanic cholesteatomas in humans in the absence of invagination or perforation. PMID- 3974378 TI - Nasopharyngeal carcinoma: an evaluation of 134 patients treated between 1971 1980. AB - An analysis is made of 134 patients with nasopharyngeal carcinoma treated from 1971-1980 at the Cancer Control Agency of British Columbia. Incidence rate for Chinese born in the Orient was 20.5 per 100,000 per year compared to 1.32 per 100,000 for Canadian born Chinese. The Caucasian rate was .19 per 100,000 per year. These figures confirm a 15 times greater incidence of the disease in Chinese born in the Orient over those born in North America. The 86 Chinese patients were noted to have a 10% poorer survival than the 48 Caucasian patients on long-term follow-up. The main factor affecting survival was initial staging. Overall survival rates were 46.3% three year, no evidence of disease (NED) and 38.3% five year NED survival, but when disease was limited to the nasopharynx (T1, T2, N0) they were 73.9% three year NED and 66.6% five year NED survival. One third of the patients ultimately developed distant metastases below the clavicle. Although lower T and N stage cases had fewer of these, the overall correlation with staging was poor. Female patients showed statistically significant better survival which was not related to better initial staging. They did, however, have 11% fewer eventual distant metastases. PMID- 3974379 TI - Acute epiglottitis in the adult. AB - Acute epiglottitis may be fatal when diagnosis is delayed. The literature stresses data that does not help to predict impending airway obstruction in patients who present with a sore throat, the most consistent presenting symptom among patients with acute epiglottitis. In this review of 80 cases of epiglottitis in adults, almost all patients who presented within eight hours from onset of symptoms required airway intervention, while the majority of those who presented more than eight hours after onset of symptoms never developed acute upper respiratory obstruction and were treated medically or had supportive treatment only. Artificial airway was indicated in all patients who had drooling. There were no fatalities in this series, however, we recommend keeping all patients with acute epiglottitis in an intensive care unit for at least 24 hours after admission. PMID- 3974380 TI - Sjogren's syndrome: a persistent clinical problem. AB - One hundred sixty patients with Sjogren's syndrome have been evaluated and managed at Scripps Clinic. Objective diagnosis has relied heavily on rose-bengal vital staining and corneal slit lamp examination to establish the presence of KCS and lip biopsy. The role of the head and neck surgeon in evaluating the patient with "dry mouth" is discussed. Usually Sjogren's syndrome is managed nonsurgically, but problems of abscess, recurrent infection, disfigurement, and malignant transformation may result in the need for total parotidectomy with nerve preservation. Radiation for Sjogren's syndrome is rarely, if ever, indicated. The etiology of Sjogren's syndrome may be closely tied to the homogeneous genetic background of its patients and the presence of a chronic immunogenic stimulus well recognized in the secondary form but less clear in the primary. PMID- 3974381 TI - Revision sphenoidethmoidectomy. AB - In 1981, a series of 236 intranasal ethmoidectomy (INE) procedures was reported with a complication rate of 1.8%. Special attention has subsequently been directed to the surgical failures; namely, recurrent nasal polyposis which accounted for approximately 17%. The reason for recurrence in most instances was felt due to failure to do a more thorough posterior ethmoidectomy and enter and clean out the sphenoid sinuses. Subsequently, in all revision cases where a more thorough sphenoidethmoidectomy (RSE) was performed, the overall long-term success rate raised to better than 90%. Attention to skeletonizing the middle turbinate by stripping mucosa and leaving a thin bony shell is an important technical factor. An attempt is made to leave some of this bony skeletonized medial wall of the middle turbinate as it represents the most crucial landmark in doing the surgery via the intranasal route. There still remains approximately 8% to 10% of this patient population with nasal polyposis and sinusitis of such severity that surgery has offered only a temporary measure of relief. In dealing with this group it may be necessary to see these patients postoperatively at four to six week intervals, carefully suctioning the ethmoid labyrinth and occasionally doing minor office "touch-up" ethmoidectomy-polypectomy procedures to clean off redundant mucosa or early polyposis. This paper is written to offer a compromise to the two schools of intranasal ethmoidectomy surgery as to the necessity of removing the middle turbinate in its entirety. PMID- 3974382 TI - Cranio-facial approach to ossifying fibromas. AB - A cranio-facial approach to ossifying fibromas of the orbit and the anterior cranial base is described. Ten patients with a documented ossifying fibroma were operated on utilizing this surgical modality. Eight tumors were completely removed and two were subtotally resected. The surgical defects were reconstructed either with an autogenous bone graft or an aluminum/acrylic cranioplasty. Our surgery for ossifying fibromas accomplished a significant reduction or an elimination of ocular displacement as well as the reestablishment of cranial symmetry. PMID- 3974383 TI - Oncogenes: their presence and significance in squamous cell cancer of the head and neck. AB - DNA extracted from squamous cell carcinomas of the larynx and tongue has been shown to contain cellular transforming genes characterized by their ability to transform mouse fibroblasts into malignant foci of cells which, when subsequently cloned and grown to volume, have been found to contain human DNA sequences. This DNA has been serially passaged through subsequent populations of NIH/3T3 mouse fibroblasts. Higher malignant transformation efficiencies have been observed and reported with serial passage. Of greater significance is the repeated identification of oncogenes of identical characteristics on electrophoretic radioisotope analysis. PMID- 3974385 TI - Auditory short, middle, and long latency responses in acutely comatose patients. AB - For assessing comatose patients, the combination of auditory short, middle, and long latency evoked potentials (auditory brain stem response [ABR], middle latency component [MLC], and slow vertex response [SVR] ) is more comprehensive than auditory brain stem response (ABR) only or ABR with slow vertex response (SVR). Fifty-four acutely comatose patients were studied. Thirty-four of the patients had severe head injury and others had coma of varied etiology. Within two months after admission, 25 patients survived, while 29 patients died. Auditory evoked response measurements were conducted usually within 48 to 72 hours after admission. For patients with normal SVR, MLC, and ABR, there was 100% survival; with absent SVR but normal MLC and ABR, survival was 91%; with absent SVR and MLC and normal ABR, it was 60%; with abnormal ABR, it was 10%; no patient survived whose ABR was absent. It is emphasized that a normal MLC is clearly a predictor of survival of comatose patients, but a normal ABR is not always a reliable indicator of survival. PMID- 3974386 TI - Surgery for correction of bilateral choanal atresia. AB - A transnasal approach was employed in 28 neonates (26 blacks and 2 whites) with bilateral choanal atresia. In each patient the atresia was perforated microsurgically with the drill, followed by insertion of a Portex endotracheal tube for a period of three months. By this method a satisfactory nasal respiration was established immediately. Removal of the posterior part of the vomer is crucial to the successful result. During the follow-up, one death was recorded in a microcephalic neonate, unrelated to the operation and another four patients required repositioning of the tube under general anesthesia. We feel that the above technique is simple and definitive with negligible complications. PMID- 3974384 TI - Safety of 125iodine and 192iridium implants to the canine carotid artery: preliminary report. AB - Thirty-nine healthy dogs underwent a simulated radical neck dissection followed by implantation of either 125Iodine (125I) or 192Iridium (192Ir) in various dose regimes randomized prospectively from 3,000 to 30,000 rad. Bilateral selective carotid angiography was performed immediately postoperatively and at six months and one year. No significant effects occurred to the animals who received 15,000 rad 125I or 6,000 rad 192Ir. In the higher dosed animals the 125I treated group fared better than the 192Ir treated group, probably due to the lower dose rate delivery. All surviving animals will be maintained an additional year to determine the late effects of brachytherapy irradiation to the carotid artery. PMID- 3974387 TI - Reconstruction of the Eustachian tube and the anterior tympanum: planned staged tubo-tympanoplasty. AB - A new technique is demonstrated in the management of chronic otitis media with inflammatory stenosis of the Eustachian tube. Bone exposure of the Eustachian tubal orifice and peritubal air cells was followed by placement of a long T shaped solid silicone plate in this area. Postoperative care was taken to ensure wound healing in the same way as after radical mastoidectomy. At the second stage surgery the Eustachian tube and pretympanum were found to have developed with an intact mucous membrane. A middle ear space with or without reconstruction of the posterior meatal wall and obliteration of mastoidectomy cavity could easily be rebuilt. A sound pressure transformer mechanism could be established at the second stage surgery. PMID- 3974388 TI - Arnold-Chiari malformation and the otolaryngologist: place of magnetic resonance imaging and electronystagmography. AB - The Arnold-Chiari malformation (ACM) is a rare congenital condition in which there is a downward displacement of the cerebellum through the foramen magnum. Patients with this condition frequently develop symptoms of ataxia, imbalance, or vertigo. As a result the patient is often referred to an otolaryngologist. Such a case is reported. A patient presented with imbalance, had downbeating nystagmus on down gaze, and had other eye movement abnormalities recorded on electronystagmography (ENG) which were strongly suggestive of central pathology. Although her computerized tomography (CT) scan was normal, the eye findings and neurological evaluation were strongly suggestive of an ACM. A repeat CT scan with intrathecal metrizamide was abnormal. A definite diagnosis of ACM was confirmed using the new investigative technique of magnetic resonance imaging (MRI). PMID- 3974389 TI - Swimming unprotected with long-shafted middle ear ventilation tubes. AB - Patients, parents, and physicians are all concerned about the risks of swimming unprotected with middle ear ventilation tubes. The risks have not previously been carefully quantified or correlated with the degree of swimming activity. In this study, 53 children with tympanometrically proven patent long-shafted tubes were allowed to swim unprotected. They suffered six middle ear infections that were clearly caused by swimming. Five of these infections occurred in divers. The rate of infections for divers was approximately one per 100 days of swimming activity. The rate for non-divers was approximately one per 600 days. Unprotected swimming was well accepted by almost all parents and patients. The need for earplugs for all children who swim with long-shafted ventilation tubes is questioned. PMID- 3974390 TI - Biologically aggressive papillomas of the nasal cavity: the role of radiation therapy. AB - Five patients were irradiated at the University of Florida for advanced and/or recurrent papillomas of the nasal cavity and paranasal sinuses from December 1969 through December 1981. Three patients were irradiated either before or after resection and two patients were treated with radiation therapy alone. Two patients had pure inverted papilloma, one patient had inverted papilloma associated with a focus of squamous cell carcinoma, and two patients had cylindrical cell papillomas. Four patients are alive and continuously disease free at 3, 3, 4, and 11 years following treatment. One patient died of intercurrent disease nine years following treatment without evidence of recurrent tumor. PMID- 3974391 TI - Simultaneous handling of the diathermy pen and scalpel. PMID- 3974392 TI - Prevention of facial burns during laser laryngoscopy. PMID- 3974393 TI - A simple technique for control of fistula secretion. PMID- 3974394 TI - Cerebrospinal fluid leak after translabyrinthine surgery for acoustic neuroma. PMID- 3974395 TI - [Risk findings of the gastric mucosa--a clinicopathologic discussion]. AB - Histological results of gastric biopsies necessitate a careful discussion between the gastroenterologist and pathologist in order evaluate the significance of the findings and to determine, what should be done next. Risk factors may be defined on the basis of clinical and endoscopic as well as of histological findings. Circumscript lesions of the gastric mucosa are such risk factors; histological examination of these lesions has to be done in quite a few cases repeatedly in order to confirm the diagnosis. Especially precancerous changes maybe considered as risk factors; according to WHO-definition they are subdivided in precancerous conditions and precancerous lesions. Precancerous conditions are type A gastritis, status after surgery of the stomach, hyperplasiogenic polyps of the stomach, increased familiar incidence of carcinoma, Menetrier's disease, and acanthosis nigricans. Precancerous lesions on the other side are circumscript, histologically definable tissue changes, like for instance adenoma of the stomach, where formation of carcinoma can be observed with higher than normal incidence. Chronic atrophic gastritis has been overestimated considerably as a precancerous lesion. Control biopsies are indicated only in large time intervals and if special, well defined histological conditions prevail. Carcinoma incidence after Billroth II-resection of the stomach is lower in Middle Europe and U.S.A. than has been assumed before. Regular gastroscopic check-ups seem only to be justified in persons over 50 years of age, or in persons who have been operated upon more than 15 years ago. The procedures to be taken if gastric polyps are present depend upon localisation and size of the tumor and histology of the forceps biopsy. If adenoma are found or borderline lesions, which are to be considered as real precancerous lesions total excision by endoscopy, or if necessary by surgery is indicated. PMID- 3974396 TI - [Alcohol consumption and chronic gastritis]. AB - History of alcohol intake was evaluated in 1,500 patients who had gastroscopy for different reasons. Alcohol intake was related to histological findings of antrum and corpus mucosa. No statistically significant correlation between lesions and alcohol intake could be found. There was a correlation between incidence and severity of gastritis on the one hand and increasing age on the other. The patients under investigation were beer drinkers in the first line. For this reason our findings do not allow any conclusions in regard to persons, who usually drink higher concentrated alcohol beverages. The conclusion can be drawn however that even excessive drinking of beer does not seem to cause chronic gastritis. PMID- 3974397 TI - [Indications and results of portal shunt surgery]. AB - Bleeding esophageal varices are treated in the first line as emergency by sclerosing procedures. Later on shunt surgery is still to be considered as an important definite procedure. Criteria to be met before surgery are discussed. In our experience the shunting procedure as described by Warren yields good results, low incidence of thrombosis and low lethality. In special cases subtotal esophagectomy can be performed, lethality being as low as after the Warren shunt. Repeating sclerosing over years in contrast carries a high risk of complications and death and does not prevent further bleeding safely enough. PMID- 3974398 TI - [Gastroscopy in the rat]. AB - A method is described for gastroscopic examination of the rat using a flexible bronchoscope. Endoscopy is performed under ether anesthesia and endotracheal intubation. Gastroscopies of 400 animals demonstrated, that this method is simple, highly sensitive and specific, and carries a low risk. It seems to be well suited for use in experimental gastroenterology. PMID- 3974399 TI - [Asymptomatic carcinoid in a Meckel's diverticulum as the incidental finding in the operation of an abdominal aortic aneurysm]. AB - A case report is given of a patient who had surgery because of an aneurysm of the abdominal aorta. During laparotomy a tumor in Meckel's diverticulum was found, which was removed by tangential incision without opening the intestine as to avoid an infection of the prosthesis. The tumor had a diameter of 1.5 cm and histology showed transmural spread of the carcinoid tissue; under these conditions further metastatic spread is possible. After the patient had recovered successfully from aneurysm surgery he was operated again and partial resection of the small intestine including the regional lymphatic system was performed. Carcinoid tissue was found during histological examination in the submucosal layer of the intestine in the area where surgery had been done before; no pathological changes however were found in the mesenterium. Thus the patient can be considered to be cured. PMID- 3974400 TI - Effects of castration and testosterone treatment on the hexobarbital sensitivity in male rats. AB - Castration increases the central nervous system (CNS) sensitivity to hexobarbital as measured by an EEG-threshold method. Testosterone treatment in doses from 1 to 5 mg/kg/day decreases CNS-sensitivity and restores threshold values in castrated rats to a level found in normal young adult male rats. PMID- 3974401 TI - Discriminative stimulus properties of methylxanthines and their metabolites in rats. AB - Rats were trained to discriminate methylxanthines from saline under a two-lever concurrent variable ratio schedule of reinforcement. One group was trained to discriminate between saline and 32 mg/kg caffeine. A second group was trained to discriminate between 56 mg/kg theophylline and saline. Rats reliably discriminated between saline and the training methylxanthine, displaying graded generalization curves across training-drug doses. Caffeine-trained rats demonstrated caffeine-appropriate responding when tested with theophylline, paraxanthine, and 3-methylxanthine. Theobromine failed to generalize to the caffeine cue at test doses up to 75 g/kg. In contrast to the caffeine group, rats trained to discriminate theophylline from saline were less sensitive (higher ED50) to the effects of caffeine and paraxanthine test doses. Only partial generalization to the theophylline cue occurred at paraxanthine doses up to 100 mg/kg. Based upon these data, it is suggested that the underlying substrate(s) for the caffeine cue is in some respects different from the substrate(s) for the theophylline cue. PMID- 3974402 TI - Reduced norepinephrine turnover in brown adipose tissue of pre-obese mice treated with monosodium-L-glutamate. AB - Norepinephrine (NE) turnover, an index of sympathetic nervous system (SNS) activity, was measured in interscapular brown adipose tissue (IBAT), heart and pancreas of 3-weeks-old pre-obese monosodium-L-glutamate (MSG) mice and at 6 weeks-old mildly obese MSG mice. In IBAT, rates of NE turnover were slower not only in 3-weeks-old MSG mice but also in older obese MSG mice than in their saline controls. In heart, rates of NE turnover were slower in 6-weeks-old mildly obese MSG mice, but not in pre-obese MSG mice. No significant difference in NE turnover in pancreas was observed at either age. The low NE turnover in IBAT of MSG-treated mice prior to the onset of gross obesity suggests that low SNS activity may be an initial contributor to their high energy efficiency and resultant obesity. PMID- 3974404 TI - Suppression of operant responding for food and water reinforcement following intraventricular injections of Bombesin in the rat. AB - The effects of injecting Bombesin (BBS) into the lateral cerebral ventricle on operant responding for food and water in the rat were investigated in two experiments. In the first experiment injections of BBS suppressed both operant responding for water and post-session water consumption. A combined treatment of water preloading and BBS injections produced greater suppression of post-session water consumption than either BBS injections or water preloading. This suggests that the peptide has a primary antidipsic effect. In the second experiment BBS produced a significant suppression of operant responding for food reward as well as lowered body temperature. This suggests that BBS may serve as a true satiety signal for food motivated behavior. PMID- 3974403 TI - Propane and propylene formation during the microsomal metabolism of iproniazid and isopropylhydrazine. AB - Both iproniazid and isopropylhydrazine were metabolized to the hydrocarbon products, propane and propylene, with nearly identical Michaelis constants and rates. This reaction appeared to be catalyzed by microsomal cytochrome P-450. Isonicotinic acid, a product of iproniazid hydrolysis by various amidases, was produced in only very small quantities, suggesting that the other amidase product, isopropylhydrazine, may not be an obligatory intermediate in the pathway of hydrocarbon formation from iproniazid. Hydrocarbon formation from iproniazid was more sensitive to inhibition in vitro by bis-p-nitrophenylphosphate (used in vivo as an amidase inhibitor) than was isopropylhydrazine. Iproniazid must be directly metabolized by cytochrome P-450 to yield propane and propylene, presumably via an azo ester intermediate which could give rise to an isopropyl radical, the chemical species presumed to be responsible for the hepatoxicity apparent after administration of large doses of iproniazid in vivo. PMID- 3974405 TI - Peroxidatic degradation and ether link cleavage of thyroxine in a particulate fraction of human thyroid. AB - The present study was undertaken to investigate degradation of thyroxine (T4) mediated by thyroid peroxidase in man. A particulate fraction (1,000-100,000 x g) of normal human thyroid tissue was prepared and used as crude enzyme. 125I-T4 and unlabeled T4 were incubated with the particulate fraction in buffer containing glucose and glucose oxidase for generation of H2O2. After incubation, iodoamino acids were extracted with ethanol and the products of T4 degradation were analyzed by thin layer chromatography. In this system, T4 was degraded in time-, temperature- and pH-dependent manners, but not in the absence of the H2O2 generating system. The rate of degradation was related to concentration of the particulate fraction. The reaction was inhibited by methimazole, propylthiouracil and catalase. When [3',5'-125I] T4 was used as a tracer, major labeled products of T4 degradation were inorganic iodide and ethanol-unextracted fraction and no detectable labeled 3,5,3'-triiodothyronine (T3) or 3,3',5'-triiodothyronine (rT3) was generated. From a kinetic study by adding various doses of unlabeled T4, the apparent Km value for T4 was 30 microM and the Vmax value was 230 pmol/mg protein/min. When [3,5-125I] T4 was incubated with enzyme preparation, one third of degraded T4 was recovered as diiodotyrosine (DIT) and half of 125I-DIT was degraded in parallel incubation. No formation of radiolabeled DIT was observed in incubation with Na- 125I done in tandem. These findings suggest that thyroid hormones can be metabolized by peroxidase in human thyroid by pathways that include cleavage of ether linkage. PMID- 3974406 TI - Interaction between warfarin and nonsteroidal anti-inflammatory drugs (NSAIDs) in rats. AB - In fed rats, the following NSAIDs were administered orally 24 hr before or 18 hr after the intraperitoneal administration of 1.34 mg/kg warfarin: phenylbutazone, 150 mg/kg; diflunisal, 75 mg/kg; ibuprofen, 150 mg/kg; acetylsalicylic acid, 300 mg/kg; indomethacin, 8 mg/kg; tolmetin sodium, 50 mg/kg; ketoprofen, 8 mg/kg; and amfenac sodium, 8 mg/kg. The elevation of the 24-hr prothrombin time was indicative of the effect of the warfarin. Warfarin-treated fasted rats showed a significantly higher prothrombin time than warfarin-treated fed rats. Interaction with phenylbutazone and warfarin occurred in fed and not in fasted rats when administered 18 hr after administration of the warfarin. At the 24-hr pretreatment time, only phenylbutazone significantly reduced the elevated prothrombin time. With the exception of amfenac sodium, all the NSAIDs significantly enhanced the elevated prothrombin time when administered 18 hr after warfarin. Their decreasing order of activity in enhancing the elevated prothrombin time was phenylbutazone, diflunisal, acetylsalicylic acid, ibuprofen, indomethacin, tolmetin sodium, and ketoprofen. The results indicate that the rat is more sensitive than the human to the interaction between warfarin and NSAIDs. PMID- 3974407 TI - Intensification of galactosamine hepatotoxicity by polyriboinosinic acid polyribocytidylic acid. AB - The effects of polyriboinosinic acid-polyribocytidylic acid (poly IC) on galactosamine-induced liver cell injury in rats were studied. Treatment of rats with D-galactosamine-HC1 (400 mg/kg) increased their serum glutamate-oxaloacetate transaminase (E.C.2.6.1.1, GOT) activities, indicating that hepatocyte injury was induced by galactosamine. Rapid and intense elevations of serum GOT activities were observed when galactosamine (200 mg/kg) was administered simultaneously with poly IC (10 mg/kg) but not with poly I or poly C. Acute increase in serum GOT activities caused by the simultaneous administration of poly IC and galactosamine was prevented by the simultaneous administration of uridine (1 g/kg), which is known to inhibit the early biochemical alterations caused by the amino sugar in the hepatocyte. These findings suggest that poly IC intensifies the hepatotoxic effect of galactosamine in rats. This poly IC-induced sensitization was inhibited by pretreatment with poly IC (10 mg/kg) itself, when injected 24 hr before the administration of the hepatotoxin together with poly IC. PMID- 3974408 TI - Caffeine-phenylethylamine combinations mimic the amphetamine discriminative cue. AB - Although caffeine-phenylethylamine combinations are widely available as over-the counter medications or as "legal" stimulants, little information is available concerning their behavioral pharmacology or abuse potential. In the present study, rats were trained in a food-reward, two-lever operant drug discrimination paradigm to differentially respond after saline or 0.5 mg/kg amphetamine injections. Tests for generalization to the amphetamine cue indicated only modest amphetamine-lever responding at various doses of caffeine alone or at various doses of ephedrine/phenylpropanolamine (PPA) combinations, but complete generalization to the training cue was found with higher doses of the triple combination (caffeine, ephedrine, and PPA) or with caffeine-ephedrine or caffeine PPA combinations. All drugs produced response rate decreases at higher doses. These data clearly indicate that certain "legal" stimulants mimic the amphetamine cue and suggest that caffeine may interact additively with phenylethylamines to produce the cue. PMID- 3974409 TI - Rat plasma levels of amino acids and related compounds during stress. AB - Forty-one amino acids and related compounds were measured (using an HPLC physiological amino acid analysis procedure fully validated for plasma studies) in rat plasma obtained through an indwelling jugular catheter before, during and following a 30 min period of immobilization. Taurine, phosphoethanolamine, aspartic acid, glutamic acid, alanine, cystine, tyrosine, beta-alanine and ethanolamine were increased during the period of stress; whereas, valine, tryptophan and arginine were decreased. Most of these alterations were restored toward normal during the 30 min of rest following the stress period. However, cystine, ethanolamine and beta-alanine remained significantly elevated, and valine, tryptophan and arginine remained significantly reduced. Serine, isoleucine, leucine and glutamine were not significantly altered during the stress period, but became significantly reduced during the 30 min following the stress period. While the patterns of amino acid alterations were generally consistent from animal to animal, the magnitude of the responses were variable with some rats demonstrating much larger responses than others. These results may implicate amino acids as important markers for stress related pathologies. The individual differences noticed may explain why some individuals show more stress effects than others. PMID- 3974410 TI - Imipramine treatment differentially affects platelet 3H-imipramine binding and serotonin uptake in depressed patients. AB - Uptake of serotonin and 3H-imipramine binding in platelets of depressed patients were investigated simultaneously with changes in clinical state. Both Vmax for serotonin uptake and Bmax for 3H-imipramine binding were significantly lower in unmedicated depressed patients with respect to normal subjects. Successful treatment with imipramine led to a significant increase in Bmax for 3H-imipramine binding, without significant change in Vmax for serotonin uptake. Bmax values increased to the normal range following complete, rather than partial clinical improvement. These data indicate that successful antidepressant treatment may increase the density of 3H-imipramine binding sites on platelets by a process which is independent of the uptake of serotonin. PMID- 3974411 TI - Quantitative autoradiography of 3H-nomifensine binding sites in rat brain. AB - The distribution of 3H-nomifensine binding sites in the rat brain has been studied by quantitative autoradiography. The binding of 3H-nomifensine to caudate putamen sections was saturable, specific, of a high affinity (Kd = 56 nM) and sodium-dependent. The dopamine uptake inhibitors benztropine, nomifensine, cocaine, bupropion and amfonelic acid were the most potent competitors of 3H nomifensine binding to striatal sections. The highest levels of (benztropine displaceable) 3H-nomifensine binding sites were found in the caudate-putamen, the olfactory tubercle and the nucleus accumbens. 6-Hydroxydopamine-induced lesion of the ascending dopaminergic bundle resulted in a marked decrease in the 3H-ligand binding in these areas. Moderately high concentrations of the 3H-ligand were observed in the bed nucleus of the stria terminalis, the anteroventral thalamic nucleus, the cingulate cortex, the lateral septum, the hippocampus, the amygdala, the zona incerta and some hypothalamic nuclei. There were low levels of the binding sites in the habenula, the dorsolateral geniculate body, the substantia nigra, the ventral tegmental area and the periaqueductal gray matter. These autoradiographic data are consistent with the hypothesis that 3H-nomifensine binds primarily to the presynaptic uptake site for dopamine but also labels the norepinephrine uptake site. PMID- 3974412 TI - Dexamethasone and zinc in combination inhibit the anchorage-independent growth of S-91 Cloudman murine melanoma. AB - Zinc inhibited the colony formation of Cloudman S-91 murine melanoma cells in a dose dependent manner with an ID50 of 3.4 ug/ml. Total inhibition of the melanoma colony-forming units occurred at a zinc concentration of 4.42 ug/ml. In the presence of dexamethasone the ID50 for zinc inhibition was reduced by 49% and total inhibition of anchorage-independent growth occurred at the achievable in vivo zinc concentration of 3.0 ug/ml. Dexamethasone and zinc in combination effected a greater than additive inhibition of the murine melanoma colony-forming units. Statistical evaluation of these results showed that zinc and dexamethasone interacted synergistically to inhibit the formation of murine melanoma colonies. PMID- 3974413 TI - Does phenobarbital protect against trimethyltin-induced neuropathology of limbic structures? AB - Because of the similarity in the pattern of limbic sites damaged by both compounds, it has been suggested that trimethyltin (TMT) may be an excitotoxin like kainic acid (KA). KA produces seizures which eventually result in neuronal damage similar to that found in epilepsy. Anticonvulsants reduce both the seizures and pathology associated with KA. Because TMT may also produce seizures, we undertook to determine whether or not some of the TMT-induced limbic neuropathology could result from seizure activity. To do this, a single dose of TMT chloride (either 7.5 or 15 mg/kg) was given per os to rats, and then phenobarbital (30 mg/kg) was administered subcutaneously in repeated doses. Treatment with phenobarbital did not prevent pathologic changes in the hippocampus, dentate gyrus, and pyriform or prepyriform cortex. Since phenobarbital did not protect against TMT-induced neuronal damage, as it has been reported by others to protect against KA-induced damage, the present findings suggest that these two toxicants probably produce hippocampal pathology via different mechanisms and that the TMT-induced pathologic changes do not require sustained electrical seizure activity. PMID- 3974414 TI - A method for very rapid determinations of catechols using ion-pairing reverse phase HPLC with electrochemical detection: effects of L-dopa treatment on the catechol content in various rat brain structures. AB - A simple and rapid method for determination of 12 catechols (9 endogenous and 3 internal standards, i.s.) using ion-pairing reverse phase HPLC with electrochemical detection is presented. This study basically concentrates on the importance of optimizing the mobile phase composition in isocratic systems where ordinary 25 cm X 4.6 mm i.d. columns are used. Mobile phase compositions for three different purposes are reported: 1) separation of 9 endogenous catechols, possibly occurring in the samples, and 3 i.s. in a moderately short retention time (tR) (L-DOPA, DOPEG, alpha-Methyldopa (alpha-MeDOPA, i.s.), Noradrenaline (NA), DOPAC, Adrenaline (A), Dihydroxybensylamine (DHBA, i.s.), Norsalsolinol (NS), Dopamine (DA), Epinine (EPI), Salsolinol (S) and Isoprenaline (ISO, i.s.) within 11 min), 2) ultra rapid separation of detectable endogenous catechols except L-DOPA (NA, DOPAC, A, DHBA (i.s.), NS and DA within 5.2 min and with S within 5.7 min) and 3) moderately fast separation of detectable endogenous catechols (L-DOPA, NA, A, DHBA (i.s.), NS, DOPAC and DA within 7.6 min and with S within 10 min). By balancing the pH, concentration of organic modifier (2 propanol) and pairing ion (1-heptanesulphonic acid) as well as preconditioning new columns with more packing material (Nucleosil 5 micron C18) and to high pressures (5000 psi) for 7 days, very fast separations with good baseline resolution between the peaks are possible. The method was applied on L-DOPA treated rats (100 mg/kg), where the catechol content was analysed in 7 different brain structures during the time course of synthesis and degradation (4 hours) of catechols from L-DOPA. PMID- 3974415 TI - Catecholamine binding by adrenal medullary protein can interfere with a sensitive radioenzymatic assay for norepinephrine. AB - Norepinephrine (NE) binds extensively to protein that copurifies with phenylethanolamine-N-methyltransferase (PNMT) prepared from bovine adrenal medulla. This binding interferes with a NE assay that employs PNMT to catalyze the transfer of a tritiated methyl group from S-adenosyl-L-methionine to the amine group of NE. It was discovered that the protein binding of endogenous NE is reversed by dialysis at pH 6.0. Preparations of PNMT intended for use in radioenzymatic assays should involve one or more purification steps at pH 6.0. PMID- 3974416 TI - Variations of prolactin content in human cerebrospinal fluid after metoclopramide and morphine. AB - Serum and cerebrospinal fluid (CSF) prolactin (PRL) concentrations were determined in fourteen patients of both sexes suffering from hydrocephalus, in basal conditions and after i.m. administration of 10 mg metoclopramide or 10 mg morphine. A significant increase in both serum and CSF hormone values was found after administration of both drugs. Serum and CSF PRL values after metoclopramide administration increased earlier and to a greater extent than after morphine. Furthermore, the metoclopramide induced CSF PRL increase immediately followed the serum peak, whereas after morphine administration an evident delay in the CSF hormone peak with respect to the serum increase was found. These data suggest that PRL entry in the CSF compartment is subject to a controlling mechanism which acts at the blood/brain barrier. PMID- 3974417 TI - Head injury--organic and psychogenic issues in compensation claims. PMID- 3974418 TI - Experience with drugs and driving in Queensland, Australia. PMID- 3974419 TI - Homicide in Singapore. PMID- 3974420 TI - Histopathological re-study of the human cardiac conduction system in coroners' autopsies. PMID- 3974422 TI - Man in space--ethical dilemmas. PMID- 3974421 TI - Defective newborns and government intermeddling. PMID- 3974423 TI - The psychology of the crowd--a social psychological analysis of British football 'hooliganism'. PMID- 3974424 TI - Alcohol and violent accidental and suicidal death. PMID- 3974425 TI - A subject for inquest--two cases of woodworkers' adenocarcinoma. PMID- 3974426 TI - The dissemination of fragments of cerebellar tissue into the spinal subarachnoid and subdural spaces following severe head injury--a report of two cases. PMID- 3974428 TI - [Classification of implantable electrodes intended for constant electrostimulation of the heart]. AB - The analysis is given of the currently used classifications for implantable electrodes with special reference to their disadvantages. Since manufacturers produce a great variety of electrode models with the intrinsic codes, certain difficulties are involved when decoding. So, the new, unique seven-alphabetic coding is proposed that may find extensive application. The coding was approved at the Second All-Union school-seminar held in Kaunas in September, 1983. Foreign specialists present there appreciated the proposed coding. PMID- 3974427 TI - Sudden death in a Nigerian due to rupture of an atherosclerotic abdominal aortic aneurysm. PMID- 3974429 TI - [Parameters of detectors for medical x-ray computed tomographs]. AB - Described in the paper are the techniques of testing parameters of detectors based on CdTe, HgI2, Si-photodiode + CsI (T1). The X-ray stand is especially designed to check the quality performance of detectors and to estimate their further possible use in computerized tomographic systems. PMID- 3974430 TI - [Laser mass-spectrometric medical microanalysis]. AB - Quantitative analyses of the whole microcomposition at a time without using the standards are shown to be realizable by the laser mass-spectrometry carried out on the domestic device EMAL-2. The techniques of sample preparation are simple and may be applied to analyze the wide range of medical and biological specimens. From the obtained results it is obvious that the mass-spectrometric method is useful in microanalyzing element compositions of medical and biological specimens. PMID- 3974431 TI - [Study of the statistical characteristics of latex suspensions using the Magiscan 2 image analyser]. AB - Characteristics of latex suspensions are studied in order to estimate their potential metrologic application. The study is carried out on the set "Magiscan 2" with the standard programs. Histograms for distribution of perimeters and particle diameters are determined, and the correlation between them is specified. Also presented are the histograms for distributing optical particle density. The correlation between optical parameters and the geometry of particles is found as well as the orientation and correlation between the optical density of particles and their location on the microscopic stage. PMID- 3974432 TI - [Automated roentgenography of the thoracic organs]. AB - A new device is developed to trigger automatically an X-ray unit at the instant of the extremum respiratory phase. The device is driven by a probe sensing the air stream. The serviceability of the unit has been tested in the course of pneumopolyradiographic and pneumotetraradiographic examinations in more than 5000 patients. The unit is recommended for clinical application in the X-ray departments. PMID- 3974433 TI - [Energy spectra of radiation from radiotherapeutic equipment]. AB - The X-ray photon spectra of a number of generally used radiotherapeutic systems have been studied by using a semiconductor Ge detector. The voltage ranges from 80 to 200 kV. The procedure of converting pulse-height distributions into photon spectra is described. The relation between the shape of the spectrum and the anode current is discussed. The data are useful for more precise calculations of the absorbed dose when planning radiotherapy. PMID- 3974434 TI - [Change in the properties of titanium alloys exposed to a stream of high frequency, low-pressure radiating plasma]. AB - The Nitrogen-Argon plasma of a high-frequency low-pressure discharge is proven to be very effective in machining pieces made of titanium alloys. The optimum operating modes are found that improve surface microhardness, reduce surface roughness, increase durability and endurance limits, and do not produce the effect on the residual stress. The operating modes have been tested with great success in machining microsurgical and ultrasonic surgical instruments. PMID- 3974435 TI - [Experience in the use of standard perfusion packings for hemosorption]. AB - A fixture for locking the perfusion packing to all types of the standard bottles with non-threaded neck is proposed. It consists of a metal ring, a yoke and two stop screws. The fixture has been clinically tested in the course of 45 hemosorption procedures. PMID- 3974436 TI - [Characteristics of x-ray intensifying screens for mammography]. PMID- 3974437 TI - [Oxygenators with polymeric sheet membranes]. PMID- 3974439 TI - [Urethral olive-tipped bougies constructed in one piece from polymeric materials]. AB - The development of urethral olive-shaped bougies of the integral design made of polymers will permit to make easier know-how processes, to raise their reliability under operating conditions, and to extend service life in comparison with olive-shaped bougies of the built-up construction. PMID- 3974438 TI - [Roentgen diagnostic complex for pediatrics with x-ray intensifying screens]. PMID- 3974440 TI - [The medical technology industry in the final year of the 11th 5-year plan]. PMID- 3974441 TI - Dermatologic manifestations of infections in immunocompromised patients. AB - Thirty-one immunocompromised patients (22 renal allograft recipients, 5 patients receiving chronic corticosteroid therapy, and 4 patients undergoing chemotherapy for acute leukemia) with significant dermatologic infection, excluding typical cellulitis and herpesvirus infections, were retrospectively identified over a 12 year period. Of these 31 patients, 15 (48%) had infection restricted to their skin, 6 (19%) appeared to have primary cutaneous infection that spread hematogenously to other parts of the body, 2 (6%) had infections of adjoining nasal tissue that spread to contiguous skin, and 8 (26%) appeared to have disseminated systemic infection that spread to the skin. In six of the eight patients with apparent secondary skin involvement, the development of the cutaneous lesion was the first clinical indication of disseminated infection. Eleven immunocompromised patients (35%) with bacterial infection of the skin or subcutaneous tissue were identified. These patients could be divided into three categories: leukemic patients with bacteremic gram-negative infection metastasizing to the skin (3 cases), renal transplant recipients with recurrent staphylococcal infection on and around the elbow ("transplant elbow") or streptococcal sepsis from a site of cellulitis (5 cases), and immunocompromised patients with opportunistic bacterial infection due to Nocardia asteroides or atypical mycobacteria (3 cases). Seventeen immunocompromised patients (55%) with fungal infection of the skin or subcutaneous tissue were identified. These included 12 patients with opportunistic fungal infection (Cryptococcus neoformans, 4 cases; Aspergillus species, 3 cases; Paecilomyces, 2 cases; Rhizopus species, 2 cases; and Candida tropicalis, 1 case) and 5 patients with extensive, confluent cutaneous dermatophyte infections. One patient with protothecosis and two patients with extensive papillomavirus infection were identified. Of these latter two cases, one had his immunosuppression discontinued, with clearing of his extensive warts; the other had confluent warts of the face and neck that subsequently underwent malignant degeneration to squamous cell carcinoma while chronic immunosuppressive therapy was continued.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974442 TI - Infections due to Lancefield group G streptococci. AB - The group G streptococcus has surfaced in the past 10 to 15 years as an important opportunistic and nosocomial pathogen. Although more precise organism recognition accounts for a portion of these cases, there can be little doubt that the group G streptococcus has become a more prevalent pathogen. Commercial kits, utilizing staphylococcal coagglutination or latex agglutination, are now available, affording all clinical laboratories the opportunity to identify this organism easily. Published reviews encompassing the experiences of a single institution or even several institutions affiliated with a single medical center, particularly as they were influenced by referral patterns, did not reflect the broad scope of infections that we discovered by extending our survey into the community, beyond the medical center complex and its immediate affiliated hospitals. Although malignancy is the single most obvious background factor, alcoholism and diabetes are also important host determinants of infection. Skin and soft-tissue infections (and surface sources of infection) are equally important among patients with or without the element of malignancy. Polymicrobial infection, including polymicrobial bacteremia, is an important feature, with S. aureus infections accounting for most of these cases, relating to the skin and soft tissue sources of infections so commonly seen. We saw a panorama of problems including endocarditis, septic arthritis, pleuropulmonary infections, bone and joint infections, puerperal sepsis and neonatal infection, peritonitis and ophthalmitis; we also saw a significant number of patients with bacteremia and no apparent primary source of infection. Response to antibiotic therapy was dictated by the nature of the underlying diseases, and individuals without a background of malignant disease did well, particularly those with skin and soft-tissue infections. While the literature suggests that patients with endocarditis and septic arthritis due to this organism respond poorly to antibiotic therapy, implying that such failures relate to in vitro antibiotic phenomena, we preferred to examine the problem from the viewpoint of the host(s) involved. Subacute endocarditis and acute endocarditis due to the group G streptococcus may be clinically separable, and thus require separate therapeutic approaches. In patients with septic arthritis, prosthetic devices, prior joint disease and immunosuppressive diseases and therapy often adversely influence the response to antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974443 TI - Proposal for information networks in mental retardation. PMID- 3974444 TI - The provision of information and referral services in the community. PMID- 3974445 TI - Fire safety training with adults who are profoundly mentally retarded. PMID- 3974446 TI - Administration of residential facilities: a literature documentation (1970-1982). PMID- 3974447 TI - The relationship between age and stereotyped behaviors. PMID- 3974448 TI - Models of service delivery: an assessment of some applications and implications for people who are mentally retarded. PMID- 3974449 TI - Familial associations of lipids and lipoproteins in a highly consanguineous population: the Limone sul Garda study. AB - The impact of genetic factors on the levels of plasma lipids and lipoproteins was evaluated in the total population of a small village. Limone sul Garda, separated up to recent years from neighboring communities, shows a high degree of consanguineity: major blood group phenotypes differ from nearby provinces for at least three gene frequencies. The absence of a difference in plasma lipid correlations between parent-pediatric offspring and parent-adult offspring, is consistent with the uniformity of living habits in the Limone community. Correlation coefficients proved highly significant only for plasma total cholesterol (range of r: 0.223 to 0.359). Differently from other reports, correlations for low density and high density cholesterolemias (LDL and HDL-C) were mostly nonsignificant in the parent-offspring comparisons. Similarly, only intersibling correlations for triglycerides (TG) were statistically significant. As indicated in other genetic studies on plasma lipoprotein levels (also in the Limone sul Garda study), TG and HDL-C were negatively correlated, whereas the correlation was positive between TG and LDL-C levels. The examined population does not, therefore, show a metabolic behavior at variance from other investigated groups. This study, offering a unique opportunity for enucleating genetic from environmental factors, suggests that most familial clusterings of lipoprotein concentrations are environmentally determined, whereas total cholesterolemia is controlled by autosomal mechanisms, without significant variations between sexes. PMID- 3974450 TI - The effect of apolipoprotein A on in vitro apolipoprotein C binding and in vivo removal of artificial triacylglycerol-rich particles. AB - Although the presence of apolipoprotein A on the surface of chylomicrons and its exchange for apolipoprotein C in the mesenteric lymph is known, the functional role of apolipoprotein A in triacylglycerol transport has not been elucidated. Mimicking the in vivo situation, artificial triacylglycerol rich particles (TGRP) with which apolipoprotein AI had been associated, were incubated with high density lipoproteins (HDL). It was found that apo AI-TGRP bound approximately twice as much apolipoprotein C from HDL as nonprotein-containing TGRP, losing 75% of the apolipoprotein AI originally present. To test whether an increased apolipoprotein C binding in vitro implicated an increased removal rate in vivo, boluses of apolipoprotein AI preincubated and control TGRP were given intravenously (IV) to six hypertriacylglycerolemic patients. The fractional catabolic rate was 35% (range 6% to 65%) higher for apolipoprotein AI preincubated TGRP than for control TGRP. In accordance with the in vitro incubations, the molar ratio of apolipoprotein C to phospholipid on TGRP reisolated 30 minutes after injection was 39% (range 12% to 115%) higher for apo AI triacylglycerol rich particles (TRP) than for control TGRP. The maximal removal capacity of apo AI-TRP, tested in one patient by constant infusion, was increased 53% as compared to control TGRP. Thus, the function of apolipoprotein AI in triacylglycerol transport may be to enhance apolipoprotein C binding to chylomicrons, which are comparable to TRP, and in doing so to enhance their removal from the plasma compartment. PMID- 3974451 TI - The effects of exercise and weight loss on plasma lipids in young obese men. AB - We studied the independent and combined effects of exercise training and weight loss on blood lipids under fixed diet and exercise conditions. Twenty-one obese sedentary men were randomly allocated to one of four treatment groups: (1) inactive and constant weight (control), (2) exercise training and constant weight, (3) inactive and weight loss, and (4) exercise training and weight loss. There were three study periods: a 3 week baseline period inactive and on an isocaloric diet, a 12 week treatment period, and a 3 week weight stabilization period. Exercise consisted of treadmill walking at an energy cost of 3500 kcal/wk for groups 2 and 4 with replacement caloric intake only in group 2. Group 3 reduced caloric intake by 3500 kcal/wk during the treatment period. Weight loss for groups 3 and 4 were 13.4 pounds and 13.7 pounds, respectively. Maximal oxygen uptake (mL/min) increased 6% in both exercise groups (2 and 4), and percent body fat decreased only in these groups. Regression analysis by group assignment on HDL cholesterol (HDL-C) showed that the inactivity-weight loss modality (group 3) and the exercise-constant weight modality (group 2) each significantly increased HDL-C, with an additive effect of exercise and weight loss (group 4). The rate of HDL-C change differed significantly between groups (P = 0.01). HDL-C increased 0.63, 0.61, and 1.89 mg/dL per 3 weeks or 2%, 2.4%, and 5.5% above baseline levels in groups 2, 3, and 4, respectively, while the control group decreased 0.11 mg/dL. Plasma triglycerides and very low-density lipoprotein (VLDL) cholesterol increased with exercise at constant weight (group 2) and decreased with exercise associated with weight loss (group 4). In conclusion, exercise and weight loss separately and independently increase HDL-C, and their effects are additive. PMID- 3974452 TI - Increased dopamine production in patients with carcinoid tumors. AB - Although both carcinoid tumors and pheochromocytomas arise from neural crest origin, they are thought to each secrete distinctive monoamines; carcinoid tumors, which contain tryptophan hydroxylase, secrete serotonin, and pheochromocytomas, which contain tyrosine hydroxylase, may secrete dopamine (DA), norepinephrine (NE), or epinephrine (E). The purpose of this study was to determine if patients with carcinoid tumors have evidence of increased DA production. Of patients with serotonin-producing carcinoid tumors, 18%, 27%, and 35%, respectively, had increased urinary homovanillic acid (HVA) excretion (the principal metabolite of DA), urinary DA excretion, and plasma DA concentration. In contrast, none of the patients with nonserotonin-producing carcinoid tumors had evidence of increased DA production. Only 4% of patients with miscellaneous tumors had increased excretion of homovanillic acid or DA; none of the patients with miscellaneous tumors had increased plasma DA concentration. This study suggests that DA and HVA measurements may be useful in the evaluation of some patients with suspected carcinoid tumors. PMID- 3974453 TI - Stereospecific determination and in vivo monodeiodination of thyroxine enantiomers in euthyroid man. AB - To compare in man the absorption, serum disappearance, and peripheral monodeiodination of the thyroxine enantiomers, we studied six euthyroid subjects who, on separate occasions, orally ingested 3 mg of either dextrothyroxine (DT4) or levothyroxine (LT4). We measured the serum concentrations of total T4 (TT4), total T3, and reverse T3 (rT3) by nonstereospecific radioimmunoassay and we determined serum DT4 and LT4 by stereospecific chromatography. Mean serum TT4 levels from 4 hours were significantly greater after LT4 administration. After DT4 administration, stereospecific analysis of serum revealed two T4 peaks that persisted from 2 to 48 hours. The mean serum LT4 level did not significantly change during the 48 hours after DT4 administration. Increases in serum T3 and rT3 were seen from 2 hours after administration of either enantiomer. From 12 hours the levels of both triiodothyronines after LT4 were significantly higher than after DT4. In this short term study we found no evidence that in man DT4 is converted to LT4, nor is it preferentially deiodinated to rT3. The greater and more persistent increases in serum T4 and T3 observed after LT4 probably contribute to the known higher bioactivity of that enantiomer. PMID- 3974454 TI - Norepinephrine kinetics during insulin-induced hypoglycemia. AB - Norepinephrine (NE) kinetics (plasma appearance rate, clearance, and forearm extraction) were measured during insulin-induced hypoglycemia in six healthy subjects. NE clearance did not change during hypoglycemia, indicating that the increase in plasma NE during hypoglycemia is due to an increased plasma appearance rate of NE. Forearm extraction of 3H-NE and of endogenous plasma epinephrine decreased significantly during hypoglycemia, probably due to an increase in regional blood flow. PMID- 3974455 TI - Plasma cell generation inhibition in lymphocyte cultures containing cerebrospinal fluid from children with central nervous system viral infections. AB - Plasma cell generation in pokeweed mitogen-pulsed lymphocyte cultures was markedly suppressed when the experiments were carried out by adding cell-depleted cerebrospinal fluid (CSF) from 5 acute aseptic meningitis or meningoencephalitis children known to have an overexpanded cell population with the suppressor cytotoxic T-cell surface phenotype in their CSF. In contrast, B-cell terminal differentiation was not affected by the addition of CSF from 5 control children with non-neurological diseases, thereby indicating that CSF from central nervous system virus-infected children contains soluble factors which are themselves capable of exerting regulatory influences on immunocompetent cells. PMID- 3974456 TI - Survey of some biochemical characteristics of Yersinia sp. strains. AB - One hundred and fifty five strains of Yersinia sp. isolated in Italy from 1981 through 1983 were studied for their ability to utilize esculin, D-lixose, L fucose and D-arabitol. All the strains belonging to biotype 4 serotype 3 isolated from humans failed to ferment such carbohydrates. The strains of other bioserotypes showed different biochemical reactions. PMID- 3974457 TI - Comparison of methods for the enumeration of fecal coliforms exposed to certain synfuel process waters. AB - Resuscitation methodology was found to give increased counts over the standard Membrane Filtration method in the enumeration of fecal coliforms exposed to a coal gasification and two oil shale process waters under certain but not all conditions studied. PMID- 3974458 TI - Prospects for teaching hospitals. PMID- 3974459 TI - Menarche--a major milestone to womanhood. PMID- 3974460 TI - Discretionary surgery. PMID- 3974461 TI - Menstruation, menstrual protection and menstrual cycle problems. The knowledge, attitudes and practices of young Australian women. AB - The results of a survey of 1377 young Australian women aged 14 to 19 years, conducted to determine their attitudes, state of knowledge and practices with regard to menstruation, are presented. The young women, as a group, lacked sufficient information about menstruation, about the time of ovulation, about menstrual discharge, and about the use of tampons. A high proportion (80%) considered menstruation to be inconvenient or embarrassing. Certain measures aimed at remedial action are suggested. PMID- 3974463 TI - Clonidine. Quo vadis? PMID- 3974464 TI - Colonic lavage with polyethylene glycol. PMID- 3974462 TI - NSW health care and discretionary surgery statistics. PMID- 3974465 TI - Prospects for teaching hospitals. The administrator's viewpoint. PMID- 3974466 TI - Prospects for teaching hospitals. The administrator's viewpoint. PMID- 3974467 TI - Prospects for teaching hospitals. The clinician's viewpoint. PMID- 3974468 TI - Prospects for teaching hospitals. The clinician's viewpoint. PMID- 3974469 TI - Prospects for teaching hospitals. The view of government. PMID- 3974470 TI - Prospects for teaching hospitals. The view of government. PMID- 3974471 TI - Mental health--potholes on the road from Richmond. PMID- 3974472 TI - Interventions to minimize AIDS. PMID- 3974473 TI - Privacy and medical research. PMID- 3974474 TI - Antenatal hepatitis B screening. PMID- 3974475 TI - Horse-riding accidents. PMID- 3974476 TI - Cytotoxics for breast cancer. PMID- 3974477 TI - Boxing: time for action. PMID- 3974478 TI - Sequelae of therapeutic abortion. PMID- 3974479 TI - Latrodectism as mimic. PMID- 3974480 TI - Random breath-testing. PMID- 3974481 TI - Herpes zoster and cimetidine. PMID- 3974483 TI - Theirs but to drink and die? PMID- 3974482 TI - Asthma education for all. PMID- 3974484 TI - Social correlates of advanced alcoholism and effect of counselling. A paired controlled analysis of 50 patients with a contrast group. AB - Fifty patients with advanced alcoholism and physical disease were investigated in a paired control study to determine some social indices particular to subjects with their condition. Also assessed was the usefulness of confrontation as a counseling procedure and whether patients with alcoholism in this study accepted referral to, or derived benefit from an outside agency specializing in the rehabilitation of subjects with alcoholism. Social indices which differed significantly between the experimental group and the control group were the number of siblings, marital history, the types of accommodation and a subjective estimate of pleasure derived from life. Indices which did not differ included country of origin, broken home, education, number of children and income. Confrontational counseling and attempts at referral seemed ineffective. It is suggested that the low success rate in the treatment of patients with alcoholism in this study may have been due to the selection of subjects with advanced alcohol-related physical diseases. PMID- 3974485 TI - Prenatal diagnosis. A preliminary study of first-trimester chorionic villous biopsy. AB - Biopsy of the developing placenta before the thirteenth gestational week was performed by transcervical cannula aspiration guided by real-time ultrasound in 21 consecutive patients. Chorionic villi were obtained in 20 patients and chromosomal analysis was possible in 19. One significant complication occurred: perforation of one gestational sac in the only patient in the series with a twin pregnancy. More studies are required in order to provide an adequate assessment of the risk--of fetal loss, culture failure and trophoblastic chromosomal abnormalities not representative of the mature fetus--associated with the technique. In practised hands, the procedure may provide a preferable and safe alternative to amino-centesis and fetoscopy for the prenatal diagnosis of genetic defects. PMID- 3974486 TI - Changes in tobacco advertising in Western Australian newspapers in response to proposed government legislation. AB - The number of cigarette and tobacco advertisements in the major Western Australian newspapers was counted for the six-month period June to November in the years 1981 and 1983. The latter period covered the introduction of the Western Australian Government's Tobacco (Promotion and Sales) Bill 1983 and the debate surrounding it. The change in the volume of cigarette advertising in Western Australia in those two years was compared with that which occurred in comparable Queensland papers in the same period. Three major factors emerged: (i) the volume of cigarette advertising was much higher in Western Australia in 1983 compared with 1981; (ii) the volume of advertising increased markedly in Western Australia when legislative action was threatened, and remained at very high levels until the Bill failed; and (iii) the number of cigarette advertisements placed in the Queensland papers surveyed fell between 1981 and 1983. The findings are presented in support of the view that the tobacco industry made a powerful and organized attack to defeat the proposed legislation; the means it adopted to do this are discussed. PMID- 3974487 TI - Reflections on the teaching of neurology. PMID- 3974488 TI - Abortion or premature delivery? PMID- 3974489 TI - Body-cavity searches. PMID- 3974490 TI - Snake in the grass roots. PMID- 3974491 TI - The budget and medical research. PMID- 3974492 TI - To drink but not to drive? PMID- 3974493 TI - Medical watershed. PMID- 3974494 TI - Funnel-web antivenom. PMID- 3974495 TI - Vitamins and neural tube defects. PMID- 3974496 TI - Digital examination for rectal carcinoma. PMID- 3974498 TI - Weather or not. PMID- 3974497 TI - Cryptosporidia detection. PMID- 3974499 TI - 131I-MIBG and phaeochromocytoma. PMID- 3974500 TI - Severe influenza myositis. PMID- 3974501 TI - Catheterization and pneumothorax. PMID- 3974502 TI - Neonatal intensive care. How much, and who decides. PMID- 3974503 TI - Institute evolving. PMID- 3974504 TI - Hydralazine--is there a safe dose? PMID- 3974505 TI - Professional and public education about bowel cancer. PMID- 3974506 TI - History of medicine--a phoenix rising. PMID- 3974507 TI - Characteristics of homosexual men who donate blood. AB - A number of demographic, psychological, medical, immunological and haematological indices, as well as sexual practices and partner numbers, were investigated in 97 homosexual men in Adelaide. A comparison of blood donors with non-donors among these men showed that the donors were younger, spent more time in the homosexual subculture, maintained a stable blood-donation pattern, and were significantly less likely to have had a sexually transmitted disease. Donors contacted their sexual partners in non-anonymous settings more frequently than did non-donors. PMID- 3974508 TI - Prevention of sepsis associated with the insertion of intravenous cannulae. The experience in a coronary care unit. AB - The effect of a strictly maintained treatment protocol on the incidence of bacteraemia associated with peripheral intravenous catheters was studied in a coronary care unit. This protocol was supervised and carried out by nursing staff members. Before the introduction of the protocol in October 1981, Staphylococcus aureus bacteraemia associated with peripheral intravenous catheters had developed in five patients and led to the deaths of four of these patients. During this time, 2364 patients were admitted to the unit. Since October 1981, there have been no further episodes of systemic sepsis associated with peripheral intravenous catheters in 2279 patients admitted to the unit (P = 0.03; Fisher's exact test). PMID- 3974511 TI - Driver education. PMID- 3974510 TI - Bee venom hyposensitization. PMID- 3974509 TI - Papillary adenocarcinoma of the gallbladder. AB - A case of papillary adenocarcinoma of the gallbladder in a 43-year-old woman is reported. Unusual features in this case were the lack of association of the tumour with gallstones and the presence of chronic ulcerative colitis. PMID- 3974512 TI - RSI, "kangaroo paw", or what? PMID- 3974513 TI - Krupinski on epidemiology. PMID- 3974514 TI - Comparison of MRSA. PMID- 3974515 TI - Humanism in health care. PMID- 3974516 TI - Nicotine-containing chewing gum. PMID- 3974517 TI - [Iron. Metabolism, deficiency, overdose]. PMID- 3974518 TI - [Can weather cause disease?]. PMID- 3974519 TI - Cancer chemotherapy. PMID- 3974520 TI - The determination of electron density by the dual-energy Compton scatter method. AB - The intensity of Compton scattered photons is directly proportional to the electron density of a substance; therefore it is possible to detect changes in electron density by this noninvasive method. The source-detector geometry has been varied to study the effects of geometry on the calculated electron density values, using a 90 degrees scattering angle. The dual-energy Compton scatter method provides a determination of electron density in known samples, with an uncertainty of less than 1% for the optimal geometry. The effective linear attenuation coefficient for Compton scatter has been determined with an uncertainty of 2.1%-3.6% for the optimal geometry used. The applications of the dual-energy Compton scattering technique in radiotherapy dosimetry and skeletal bone densitometry are being investigated. PMID- 3974521 TI - NMR imaging in the presence of magnetic field inhomogeneities and gradient field nonlinearities. AB - The relative merits of the spin-warp method and the multiple-angle projection reconstruction method are assessed for nuclear magnetic resonance imaging in the presence of magnetic field inhomogeneities. The results of computer modeling studies demonstrate the superiority of the spin-warp method under these conditions. Because the form of the point spread function for the spin-warp approach is insensitive to magnetic field irregularities, simple correction algorithms have been developed to reduce artifacts associated with bias field inhomogeneities. In addition, the formalism developed for magnetic field inhomogeneities can be easily extended to correct for gradient field nonlinearities. PMID- 3974522 TI - Tumor dose specification of I-125 seed implants. AB - A new calculation procedure for interstitial implants with I-125 seeds is presented. The total activity of I-125 seeds required to deliver a net minimum dose of 1 Gy is also given as a function of implant volume for various seed spacings. This will permit clinicians to prescribe a specific dose for patients as a primary or boost treatment. Elongation and shape corrections are studied. Discussions and comparisons with other dosimetric calculations such as "matched" peripheral dose, average minimum dose, and minimum peripheral dose are made. The results indicate that for a fixed total activity the net minimum dose is relatively insensitive to variations in seed spacing and individual seed activity. PMID- 3974523 TI - Signal-to-noise properties of mammographic film-screen systems. AB - The signal-to-noise ratio (SNR) and the detective quantum efficiency (DQE) have been experimentally determined as a function of spatial frequency for several mammographic film-screen systems. These two parameters were determined from our measurements of noise power spectra and sensitometric properties of each system along with modulation transfer function (MTF) data for the screens which were obtained from others. From the noise power spectra, it was found that film noise contributes significantly to the total noise of mammographic film-screen systems, comprising 30%-50% of the total noise at 1 cycle/mm and as much as 75% at 5 cycles/mm. All systems had approximately the same SNR below 1.5 cycles/mm, but differed at higher frequencies due to differences in screen MTF and in the gradient of the film's sensitometric curve. The DQE curves varied between systems at all frequencies, however, due to differences in system speed, MTF, and gradient. Generally, the DQE of mammographic film-screen systems is between 10% 30% at frequencies below 1 cycle/mm and decreases to about 1% between 8 and 12 cycles/mm. Compared to film-screen systems used in general radiography, mammographic systems have similar DQE values at low frequencies, but are superior at higher frequencies. PMID- 3974524 TI - Absolute neutron dosimetry: effects of ionization chamber wall thickness. AB - To assess the effect of ionization chamber wall thickness on absolute neutron absorbed dose determinations, measurements were made of the charge collected by an A-150 tissue-equivalent plastic ionization chamber irradiated by a p(66)Be(49) neutron therapy beam as a function of chamber wall thickness both in air and in four different media: tissue-equivalent solution, water, motor oil, and glycerin. Wall thicknesses ranged from 1 to 31 mm, where isolation of the chamber gas volume from protons originating outside the chamber wall was assured. The in-air measurements compare favorably with earlier buildup measurements performed with an A-150 extrapolation chamber in an A-150 phantom. The in-phantom results may be explained if the effect of charged particles reaching the gas volume from the medium and the wall as well as the differences in neutron attenuation by the wall and the medium displaced by the wall are taken into account. The errors in absolute absorbed dose determination caused by ignoring the above processes are assessed. PMID- 3974525 TI - An approach to specifying a minimum dose system for mammography using multiparameter optimization techniques. AB - Analytical expressions have been written for image quality in mammography. Multiparameter optimizations have been conducted to find mammography systems providing the lowest patient dose for a given image quality. The optimizations are subject to constraints imposed by technology, such as power limits on the tube focal spot, absorption efficiency related to detector resolution, and others. The optimizations permit system geometry, kVp, filtration, detector resolution, focal spot size, and grid characteristics to vary simultaneously and self-consistently subject to the constraints. A system configuration approaching a factor of 3 dose reduction has been found without assuming radical technological advances. The system satisfies image quality constraints for both large and small targets and would be possible to implement clinically. The sensitivity of the results to the assumptions made in the modeling has been investigated. PMID- 3974526 TI - NMR blood flow imaging using multiecho, phase contrast sequences. AB - Moving nuclei, in contrast to stationary nuclei, experience a phase shift in the presence of a balanced gradient. Monitoring of this phase shift can be used to measure the flow velocity of moving nuclei. A specific scan sequence for blood flow imaging is presented. This sequence uses multiple echoes as well as a phase contrast approach to generate both conventional anatomical images and blood flow images from the same data. Images of a phantom and a human volunteer demonstrating the accuracy of the method are presented. PMID- 3974527 TI - Selective plane removal in limited angle tomographic imaging. AB - A method of improving a planar image in limited angle tomography by removing blurred image information from selected out-of-focus planes is discussed. Focused tomosynthesized images rather than individual projections are used. The necessary equations for removing the information from either two or four adjacent planes, produced with a symmetrical, but otherwise arbitrary blurring function, are developed and specialized to the geometry of circular tomography. Results of a phantom experiment illustrating the technique are presented. PMID- 3974528 TI - Accurate T1 and spin density NMR images. AB - We present a method for producing accurate calculated T1 and spin density nuclear magnetic resonance images. A modified Carr-Purcell-Meiboom-Gill pulse sequence is used to obtain a series of images containing both T1 and T2 dependence. The image series is first analyzed to remove the T2 dependence. The resulting images are then analyzed, pixel by pixel, to generate an image containing T1 values and an image containing values proportional to spin density (SD). Tests performed on two phantoms containing solutions of various known T1's and H2O/D2O concentrations indicate that the T1 image values are accurate to better than 11% and the relative SD values agree to within one standard deviation. PMID- 3974529 TI - Two-film brachytherapy reconstruction algorithm. AB - We have developed a new isocentric two-film reconstruction algorithm for brachytherapy seed and needle implants. The algorithm has no requirements that the two films be orthogonal, symmetric, or even be taken in a transverse plane. In addition, there is no requirement that the two films even have the same number of images. We have found removal of these usual constraints useful for head and neck implants where images are often obscured by patient anatomy. The inherent image matching ambiguities associated with traditional two-film techniques are minimized by considering the image end points, rather than just the image centroids. For two films, the new algorithm, which considers all image combinations at one time, matches all the end-point images on one film with those on the other, and then reconstructs the end-point positions of the seeds. The algorithm minimizes the difference between the actual images and the projected images from the reconstructed seeds. The new two-film image matching problem is shown to be equivalent to the well-known assignment problem. For an implant of N seeds, this equivalence allows the two-film problem to be solved by an algorithm (ACM algorithm 548) that scales with a polynomial power of N, rather than N! as is usually assumed. An implant of N seeds can be matched and reconstructed in approximately (N/20)2s on a VAX 11/780. PMID- 3974530 TI - Calculation of the radiological depth. AB - The concept of the radiological depth is central to all algorithms which calculate radiation dose in a heterogeneous medium. For a discrete heterogeneous medium, consisting of regions of inhomogeneity, the radiological depth is usually presented as the sum over segments of the product of the segment length and the inhomogeneity density of the region corresponding to the segment. This paper illustrates that the usual formulation is inefficient because it requires the solution of the topological problem of which region corresponds to each segment. For simple heterogeneity problems involving just three regions of inhomogeneity, it is found that the topological problem constitutes at least 85% of the time required to calculate the radiological depth. It is shown in this paper that formulating the radiological depth as a sum over regions rather than as a sum over segments allows one to avoid this topological problem entirely. PMID- 3974531 TI - A general formula for computation of tissue-air ratios for radionuclides commonly used in brachytherapy. AB - Tissue-air ratio values for different radionuclides have been computed from first principles. The computed data have been used to derive a general formula applicable to most commonly used radionuclides in brachytherapy. There is good agreement between the values obtained from the present formulation and other reported values. For depths beyond 10 cm, no reported values are available for comparison, but on the basis of the self-consistency of the formalism it is reasonable to expect the accuracy of the computed values to be within +/- 2% at any depth up to 30 cm. PMID- 3974532 TI - A shaping device for irregular electron fields for the Therac-20 accelerator. AB - A device for shaping electron fields from a Therac-20 accelerator is described. The considerable advantage of continuously variable field sizes is enhanced when the shaping device is placed on the lower trimmer bars of the shorter set of electron trimmers, which remain fully adjustable. Cerrobend blocks of 1-cm thickness are sufficient for a 5% attenuation level with 20-MeV electrons and large field sizes. PMID- 3974534 TI - Echocardiographic assessment of left ventricular function in patients with hypokalemia. AB - Based on clinical and experimental data, a cardiomyopathic syndrome has been attributed to chronic hypokalemia. Analysis of the published data indicates the presence of numerous other complicating factors which might have compromised cardiac function. Echocardiographic studies on 5 children with lifelong (Bartter's syndrome, 3 cases; congenital renal alkalosis, 1 case) or prolonged (primary hyperaldosteronism, 1 case) hypokalemia did not reveal any abnormalities of myocardial performance, thus questioning the premise that hypokalemia causes cardiomyopathy. PMID- 3974533 TI - Lung density effect on 125I dose distribution. AB - Perturbations in 125I implant dose distribution due to lung tissue variations have been investigated. Dose correction factors for a point source, a planar, and a volume implant have been calculated using a model which accounts for the changes in primary photon attenuation and in buildup factor when the medium is lung rather than water. Results of our calculation show that the change in dose is about 9% and 20% in the core and the periphery, respectively, of a representative implanted volume whose density is 0.25 relative to water. PMID- 3974535 TI - Bone mineral content in idiopathic calcium nephrolithiasis. AB - The calcium content of the central one third of the skeleton was measured using neutron activation analysis in 109 patients with idiopathic calcium nephrolithiasis. The bone mineral content (calcium bone index or CaBI, corrected for body size) was significantly decreased by 5.2% in 20- to 60-year-old patients with calcium nephrolithiasis (p less than 0.01). Under age 50 the decrease was more marked in 64 males (7.1%; p less than 0.02) than in 21 females (4.1%; p = NS). There was a significant negative correlation of CaBI with fasting urine calcium/creatinine ratio (r = 0.39; p less than 0.01), but no correlation with age or indices of parathyroid function. The decrease in bone mineral content did not appear to be progressive. The decrease in CaBI indicates negative calcium balance, either in the past or at present, in patients with calcium nephrolithiasis and does not favour increased intestinal absorption as a primary cause. The lack of correlation of CaBI with parameters of parathyroid function does not support a primary renal loss of calcium. The results suggest that increased bone turnover may be an important component of disordered calcium metabolism in patients with calcium nephrolithiasis. PMID- 3974536 TI - Lead content of water and of reconstituted infant formula in Vienna. AB - Daily lead intake from infant formula was estimated for young infants living in Vienna based on determinations of the lead concentration of drinking water and powdered formulas. The lead concentration in water was higher in houses built before 1945 (median 15.6 micrograms/l) than in houses built between 1945 and 1965 (median 4.4 micrograms/l) and in houses built after 1965 (median 2.8 micrograms/l). Boiling water for 1 min substantially reduced (p less than 0.0005) the lead concentration in water from all houses, apparently because of the coprecipitation of lead with boiler scale. The mean lead concentration in infant formula powder (n = 36) was 161.8 (SD 103.7) micrograms/kg. The lead concentration of an 'average' reconstituted infant formula, calculated using the mean lead concentration of boiled water (5.4 micrograms/l) and of formula powder, was 27.5 micrograms/l. This corresponded to 4.1 micrograms/100 kcal, which was substantially below the FDA maximum value of 16 micrograms/100 kcal. The lead concentration in the fat-free mass of a hypothetical young infant was estimated, assuming formula as the only source of lead and average values for caloric intake and retention of ingested lead. Between 0 and 4 months the estimated lead concentration in the fat-free mass declined from the concentration present at birth, indicating that the lead intake from formula is not likely to cause lead accumulation in the body during early infancy. PMID- 3974537 TI - Effect of low doses of stable strontium on bone metabolism in rats. AB - The effects of low doses of oral stable strontium (0.19-0.40% of strontium chloride) on mineral and bone metabolism were examined in normal rats using biochemical and histomorphometrical methods. The strontium levels in serum and bone rose according to the intake of the element. Oral strontium supplementation did not produce deleterious effects on body growth or on mineral homeostasis except a transitory slight decrease in serum calcium. At the dosage level of 0.40% however, strontium induced a slight defective bone mineralization. At lower levels, treated rats showed stimulated bone formation evidenced by increased amount of osteoid and increased extent of tetracycline double-labelled surface while the mineralization lag time remained normal. The osteoclastic surface and the number of acid phosphatase-stained chondroclasts and osteoclasts remained unchanged. Stimulation of bone formation without apparent change in bone resorption resulted in a 10% increase in the trabecular calcified bone volume. The strontium-induced increased osteogenesis was not associated with changes in circulating levels of 1,25(OH)2 vitamin D or in parathyroid hormone effects. The results show that small doses of oral strontium may stimulate bone formation without altering bone resorption in the rat. PMID- 3974538 TI - Influence of alternate-day prednisolone administration on urinary electrolyte excretion. AB - The administration of 30 mg of prednisolone on an alternate-day schedule produced an increase in sodium and potassium excretion, followed by a compensatory decline on the succeeding nontreatment day. Water and electrolyte excretion in patients receiving a daily steroid treatment was intermediate between that on the treatment and nontreatment days in the patients on an alternate-day schedule. Fractional sodium and potassium excretion was significantly lower on the nontreatment days as compared to the treatment days. Body weight loss, elevated serum albumin, slightly reduced serum potassium and significantly decreased cortisol concentrations were found in the morning on the nontreatment days, while serum sodium and plasma aldosterone concentrations, and the creatinine clearance rate did not change significantly. Replacement of steroid-induced body fluid loss lessened a decline in water and electrolyte excretion on the nontreatment days. Reduced water and electrolyte excretion on the nontreatment days might have been associated with decreased extracellular fluid volume, suppressed cortisol secretion, or both. PMID- 3974539 TI - Cytosolic redox potential and phosphate transport in the proximal tubule of the rabbit. A study in the isolated perfused tubules. AB - Recently it has been proposed that cytosolic NAD+ may play a regulatory role in phosphate transport across the renal proximal tubules. To test this thesis, we have examined the effect of altering the cytosolic redox potential (NAD+/NADH) on phosphate flux across the isolated perfused rabbit proximal tubules. The cytosolic redox potential was shifted to a more oxidized state either by changing the substrate in the bathing medium from lactate to pyruvate or by adding methylene blue to the bath medium. On the other hand, cytosolic redox potential was shifted to a more reduced state by changing the substrate in the bath medium from pyruvate to lactate. In either case the phosphate flux across the proximal tubule was unaffected. It was concluded that cytosolic redox potential may not play a significant role in regulating the phosphate transport in renal proximal tubules. PMID- 3974540 TI - High incidence of sepsis in percutaneous liver abscess drainage. PMID- 3974541 TI - Delayed postoperative bloody pericardial effusion. PMID- 3974542 TI - Infectious disease complications of acute leukemia. Pathogenesis, therapy, and prevention. PMID- 3974543 TI - Severe hyponatremia in an eighty-one year old female. PMID- 3974545 TI - Alcoholism: a 117 billion dollar medical and societal embarrassment. PMID- 3974544 TI - Hypertensive pulmonary vascular disease. The point of no return. PMID- 3974546 TI - Smoke-free hospitals. Attitudes of patients, employees, and faculty. PMID- 3974547 TI - Twin cities consumers' attitudes on health care. PMID- 3974549 TI - Corporate transformation of medicine in Minnesota: how physicians think, or lessons learned from focus group discussions with 150 physicians. 8. PMID- 3974548 TI - As the competitive market unfolds: physician attitudes and actions toward fee disclosure and price information. PMID- 3974550 TI - Importance of proper radiography in acute shoulder trauma. PMID- 3974551 TI - MMIE malpractice claim review. Orthopedic surgery. MMIE Risk Management Committee. PMID- 3974552 TI - Policy of the Minnesota Medical Association on data collection and dissemination. PMID- 3974553 TI - The Minnesota Medical Association policy on physician payment. PMID- 3974554 TI - The price of life: ethics and economics. PMID- 3974555 TI - The price of life: ethics and economics. Critique of the report issued by the Minnesota Coalition on Health Care Costs. PMID- 3974556 TI - The corporate transformation of medicine in Minnesota: how hospital administrators think. Focus group findings. 8, part 2. PMID- 3974557 TI - Trauma prevention. The necessity of a seat belt restraint law in Minnesota. PMID- 3974558 TI - The myth of Homo gastronomicus: your child is not what he eats. PMID- 3974559 TI - Alcohol withdrawal syndromes. Part I: Recognition and pathogenesis. PMID- 3974560 TI - The relationship of chronic alcoholism and type I diabetes mellitus. A preliminary report. PMID- 3974561 TI - Mammary tuberculosis. A rare disease which may mimic carcinoma of the breast. PMID- 3974562 TI - Alcohol withdrawal syndromes. Part II: Management. PMID- 3974563 TI - Botulinum isn't just a poison anymore. Botulinum toxin in treatment of strabismus and essential blepharospasm. PMID- 3974564 TI - [Vagotomy for the treatment of peptic ulcer--from the beginning to the present]. PMID- 3974565 TI - [Pancreas head carcinoma associated with situs inversus viscerum totalis]. AB - The patient was a seventy seven years old male whose chief complaint was jaundice. Chest and abdomen roentgenogram showed situs inversus viscerum totalis. Echographically, pancreas head tumor was showed. Stenosis of inferior bile duct and dilatation of main pancreatic duct were showed by percutaneous transhepatic cholangiography and endoscopic retrograde cholangio pancreaticography. So, pancreas head carcinoma associated with situs inversus viscerum totalis was diagnosed. Pancreaticoduodenectomy and modified Child method was undergone. At the time of operation, liver was recognized left side of abdomen. The tumor was diagnosed well or moderately differentiated papillotubular adenocarcinoma by pathological study. This unusual combination of situs inversus viscerum totalis and pancreas head carcinoma was reported. PMID- 3974567 TI - [Treatment of post-infarction ventricular septal perforation]. AB - Recently clinical course of ventricular septal perforation following myocardial infarction is made clear. It is concluded that postinfarction ventricular septal perforation constitutes a surgical emergency. However, cardiac function of these patients are not fully evaluated, as full-cardiac catheterization including coronary angiography is hazardous. The timing of surgical intervention must be determined according to the non-invasive evaluation such as echocardiogram. In this report, we review our experience with postinfarction ventricular septal perforation and attempt to determine from this review the management of these patients. Our cases are classified into three categories. Group 1 showed cardiogenic shock state after onset of ventricular septal perforation. Group 2 had severe congestive heart failure and required inotropic support. Group 3 had moderate congestive heart failure. Group 1 need emergency operation. Group 2 need intraaortic balloon support and respiratory support after the onset. After then surgical intervention should be considered. Group 3 can be operated on more than 6 weeks after myocardial infarction on an elective basis. PMID- 3974566 TI - [Choice of appropriate surgical treatment of thyroid cancer: review of 2,244 malignant thyroid tumors]. AB - The aim of this study was to determine the appropriate surgical treatment of thyroid cancer. Follow-up results of 2,244 patients with malignant thyroid tumors were analyzed. As factors affecting the prognosis of thyroid cancer, histological type, sex, age, size of the primary tumors, extention of the primary tumor and the incidence of metastasis in excised lymphnodes were analyzed. Eight hundred and twenty-eight patients with papillary cancer were divided into 3 groups according to the combinations of the factors. Low-risk group (L group): Male under 30 years of age or female under 50 years of age, primary tumor less than 20 mm in maximum diameter, confined to one lobe and metastasis to the cervical lymphnodes less than 40%. High-risk group (H group): Male over 30 years of age or female over TP years of age, tumor more than 30 mm, primary lesion extended beyond isthmus and 40% or more metastasis to lymph nodes. Intermediate-ris group (I group): Other than the L and H groups. From the results of studies in each group on recurrence sites and recurrence rates, it was suggested that appropriate surgical treatment for L group was partial thyroidectomy or total lobectomy with local neck dissection, that for I group was total lobectomy with ipsilateral modified radical neck dissection and that for H group was subtotal thyroidectomy with bilateral modified radical neck dissections. PMID- 3974568 TI - [The clinical study of systemic hemodynamics after partial hepatectomy, with special reference to cirrhotic subjects]. AB - To elucidate the pathophysiological role of partial hepatectomy on systemic hemodynamics, general hemodynamics were investigated in 29 patients pre and postoperatively. Twenty-five patients with smooth postoperative course were divided into two groups, non-cirrhotic (n = 15) and cirrhotic (n = 10). On the first postoperative day (p.o.d.), cardiac index (CI) increased significantly but arteriovenous oxygen content difference (C(a-v)O2) didn't increase in non cirrhotics. While, increased in cirrhotics, CI increased only mildly and C(a-v)O2 increased. In both groups oxygen consumption (VO2) increased significantly. Since these characteristic pattern in cirrhotics were even clearer in patients with lower functional reserve of remnant liver, it was suggested that cardiac function was suppressed under decreased functional reserve of remnant liver. Four cirrhotics fell into hepatic failure during early postoperative period. On the first p.o.d., CI and C(a-v)O2 of these patients didn't increased, and VO2 decreased slightly. On the second p.o.d., CI increased but C(a-v)O2 and VO2 decreased extremely. It seemed likely that these disturbance of oxygen uptake and consumption affected function of remnant liver considerably. PMID- 3974569 TI - [An in vitro sensitivity assay of anti-cancer agents by measuring the inhibition rate of DNA synthesis (3H-thymidine uptake) of cancer cells--clinical study]. AB - In this paper, we demonstrated a selection system of anti-cancer agents (ACA) using discontinuous Ficoll density gradient method (DFDGM) for purification of tumor cells and 3H-Thymidine for evaluation of DNA synthesis of tumor cells. The tumor cells, purified to more than 80% by DFDGM, were contacted with ACAs for 3 days from the culture initiation and tumor suppression rate (TSR) by ACAs were calculated by following formula; TSR = ACA(-)cpm-ACA(+)cpm-background cpm divided by ACA(-)cpm-background cpm X 100% 7 ACAs; Mitomycin C (MMC), Adriamycin (ADM), 5 Fluorouracil (5-FU), Cytosine Arabinoside (Ara-C), Carbazilquinone (CQ), ACNU and Cis-platinum (CDDP) were examined in 106 cancers; 60 breast cancers, 18 gastric cancers, 23 colorectal cancers and 5 others. ADM and CQ showed high TSR against breast cancers, CQ against gastric cancers, and 5-FU and CQ against colorectal cancers, respectively. The reliability of this ACA selection system should be evaluated by future clinical studies, however, we stress that ACA should be selected by not only the effect on tumor cells but also the effect on immunity of the host, in future. PMID- 3974570 TI - [Serum lipids and lipoproteins in peripheral vascular disease]. AB - Serum lipids and lipoproteins were investigated in 102 cases with arteriosclerosis obliterans (ASO), 41 cases with Buerger's disease (TAO) and 133 normal controls. The following results were obtained. In ASO, triglyceride, beta lipoprotein, free fatty acid were higher than control, but total cholesterol and lipid peroxide were not increased. LDL and VLDL increased though LCAT decreased in ASO. ASO had lower HDL-cholesterol, HDL-phospholipid and apoprotein-A levels than control. HDL-cholesterol/HDL-phospholipid and HDL-cholesterol/Apoprotein-A ratios decreased also, indicating changes in quality in addition to quantity. In young patients with ASO, total cholesterol and LDL were higher than in old one. The same tendency was found in patients with proximal occlusion (aorto-iliac). In TAO, triglyceride, free fatty acid and VLDL increased and HDL-cholesterol, Apoprotein-A and LCAT decreased than that of control. These data may suggest that the change of lipids and lipoproteins in ASO are same in coronary heart disease. PMID- 3974571 TI - [Experimental and clinical studies on left ilio-femoral thrombosis, with reference to the significance of impaired venous return]. AB - One hundred and eleven patients with venous thrombosis were studied with pelvic phlebography and 99mTc-MAA venous scintigram. Based upon the degree of iliac venous compression, they were classified into 4 types: Normal type (I), slightly compressed type (II), moderately compressed type (III) and severely compressed type (IV). Left ilio-femoral venous thrombosis frequently occurred in type III and type IV, which suggests that left ilio-femoral venous thrombosis tends to develop with the advance of impaired venous return. The amount of serotonin, one of the substances released from platelets, was measured after the ligation of iliac veins in 31 mongrel dogs. Thrombus formation was observed 3 days after the ligation, while the decline of intra-platelet serotonin and the rise of extra platelet serotonin had already been seen 3 hours after the ligation. In all the 18 patients who had laparotomy, intra-platelet serotonin levels declined significantly 3 days after the operation, and left ilio-femoral venous thrombosis with iliac venous compression was detected in three of them without any symptoms. CONCLUSION: Iliac venous compression tends to produce left ilio-femoral venous thrombosis not only under impaired venous return but also from the releasing reaction of platelets, suggesting a strong possibility that platelets may play an important role in venous thrombogenesis. PMID- 3974572 TI - Comparison of the actions of carbamate anticholinesterases on the nicotinic acetylcholine receptor. AB - Neostigmine (Neo), pyridostigmine (Pyr), and physostigmine (Phy) at low concentrations inhibited acetylcholine (ACh) esterase, thereby indirectly potentiating ACh enhancement of [3H]perhydrohistrionicotoxin (H12-HTX) binding to the channel sites of the nicotinic ACh receptor of Torpedo membranes. However, at higher concentrations, they inhibited ACh action due to their direct binding to the ACh receptor. They displaced binding of [3H]ACh and 125I-alpha-bungarotoxin (alpha-BGT) to the receptor sites with the following order of decreasing potency: Neo greater than Phy greater than Pyr. Furthermore, Neo and Pyr potentiated [3H] H12-HTX binding to the receptor's channel sites. Preincubation of ACh receptors with any of the three carbamates reduced the rate of binding of 125I-alpha-BGT and increased the potency of carbamylcholine in inhibiting 125I-alpha-BGT binding, suggesting that the three carbamates act as partial agonists and potentiate receptor desensitization. Although none of the three carbamates inhibited [3H]H12-HTX binding to the receptor's closed channel conformation, only Phy was a potent inhibitor of [3H]H12-HTX binding to the carbamylcholine activated conformation. The potency of Phy was not due to the absence of positive charge since Phy methiodide acted similarly. The data suggest that the major action of the three carbamates at nicotinic cholinergic synapses is inhibition of ACh-esterase. Their interactions with the nicotinic ACh receptor are with its "receptor" as well as allosteric "channel" sites, but they differ in their effects. Neo and Pyr act mainly as partial agonists, while Phy is mostly an inhibitor of the channel in the activated receptor conformation. PMID- 3974573 TI - Reconstitution of functional mRNA-protein complexes in a rabbit reticulocyte cell free translation system. AB - A variety of evidence suggests that the cytoplasmic mRNA-associated proteins of eucaryotic cells are derived from the cytoplasm and function there, most likely in protein synthesis or some related process. Furthermore, the evidence suggests that protein-free mRNA added to a cell-free translation system should become associated with a set of proteins similar to those associated with mRNA in native polyribosomes. To test this hypothesis, we added deproteinized rabbit reticulocyte mRNA to a homologous cell-free translation system made dependent on exogenous mRNA by treatment with micrococcal nuclease. The resulting reconstituted complexes were irradiated with UV light to cross-link the proteins to mRNA, and the proteins were analyzed by gel electrophoresis. The proteins associated with polyribosomal mRNA in the reconstituted complexes were indistinguishable from those associated with polyribosomal mRNA in intact reticulocytes. Furthermore, reticulocyte mRNA-associated proteins were very similar to those of cultured mammalian cells. The composition of the complexes varied with the translational state of the mRNA; that is, certain proteins present in polyribosomal mRNA-protein complexes were absent or reduced in amount in 40S to 80S complexes and in complexes formed in the absence of translation. However, other proteins, including a 78-kilodalton protein associated with polyadenylate, were present irrespective of translational state, or else they were preferentially associated with untranslated mRNA. These findings are in agreement with previous data suggesting that proteins associated with cytoplasmic mRNA are derived from the cytoplasm and that they function in translation or some other cytoplasmic process, rather than transcription, RNA processing, or transport from the nucleus to the cytoplasm. PMID- 3974574 TI - Identification of promoter elements necessary for transcriptional regulation of a human histone H4 gene in vitro. AB - We have examined the nucleotide sequences necessary for transcription of a human histone H4 gene in vitro. Maximal transcription of the H4 promoter requires, in addition to the TATA box and cap site, promoter elements between 70 and 110 nucleotides upstream from the transcription initiation site. These distal promoter elements are recognized preferentially in extracts from synchronized S phase HeLa cells. The inability of non-S-phase nuclear extracts to recognize the H4 upstream sequences reflects a specific lack of a transcription factor which interacts with those sequences. These results indicate that the cell cycle regulation of human histone gene expression involves both a specific transcription factor and distal transcription signals in the H4 promoter. PMID- 3974575 TI - Specificity of gene expression in adipocytes. AB - During the differentiation of preadipose 3T3 cells into adipose cells, the mRNAs for three proteins increase strikingly in abundance. To determine the degree of cell-type specificity in the expression of these mRNAs, we estimated their abundances in several nonadipose tissues of the mouse. None of these mRNAs was strictly confined to adipocytes, but the ensemble of three mRNAs was rather specific to adipocytes. Insofar as is revealed by these three markers, the distinctive phenotype of adipocytes is the result of the enhanced expression of a number of genes, none of which is completely silent in all other cell types. PMID- 3974576 TI - Human c-fms proto-oncogene: comparative analysis with an abnormal allele. AB - The organization of the human c-fms proto-oncogene has been determined and compared with an abnormal allele. The human v-fms homologous genetic sequences are dispersed discontinuously and colinearly with the viral oncogene over a DNA region of ca. 32 kilobase pairs. The abnormal c-fms locus contains a small deletion in its 3' portion. DNA sequencing analysis indicated that it was 426 base pairs in size and located in close proximity to a putative c-fms exon. PMID- 3974577 TI - Identification of a mixture of two different monoclonal antibodies by nonlinear regression analysis after solid phase radioimmunoassay with labeled antigen. AB - The results of competitive solid phase radioimmunoassay with labeled antigen, when analyzed by nonlinear regression, may reveal the presence of two different monoclonal antibodies, occasionally produced in a hybridoma culture. In fact, a hybridoma-derived antihuman chorionic somatomammotropin antibody prepared in our laboratories showed an unsatisfactory curve fitting when the experimental data were elaborated on the basis of a monoclonal model. The antibody was subjected to recloning, and gave two separate homogeneous monoclonal antibodies with different affinity constants. PMID- 3974578 TI - Equilibrium in the protein-immobilized-ligand-soluble-ligand system: estimation of dissociation constants of protein-soluble-ligand complexes from binding inhibition data. AB - The equilibrium in the protein-immobilized-ligand-soluble-ligand system was examined theoretically and the equations found were used for determination of dissociation constants of protein-soluble-ligand complexes (K). These constants can be obtained from the s/b vs C plot [s/b = ratio of soluble and bound forms of the protein at equilibrium established in the presence of the soluble ligand (concn C)], which is linear if: (1) the concns of the complexes are much lower than the total concns of the immobilized and soluble ligands, and (2) if multiple interactions of an n-valent protein with the immobilized ligand essentially do not occur (i.e. the binding to the immobilized ligand is monovalent). The effect of violation of condition (1) is examined by computation simulation and is shown to be manifested as a non-linearity of the plot. Heterogeneity of the immobilized ligand (arising, for example, from the immobilization procedure) is predicted to have no effect on the K-values obtained. A more complex linear equation applicable principally for determination of K under more general conditions was also found. The conditions are defined under which the C50-values (i.e. concns of a series of ligands inhibiting the binding to an immobilized ligand by 50%) can be directly used for comparison of dissociation constants. The use of the s/b vs C plot was tested experimentally: transferrin, several glycoproteins or synthetic carbohydrate-containing copolymers were immobilized by adsorption in the wells of polystyrene microculture plates and thus served as immobilized ligands. Solutions of 125I-labelled ligand-binding proteins (lectins or monoclonal antibodies binding transferrin) were incubated in these ligand-coated wells in the presence of various amounts of soluble ligands (carbohydrates or transferrins): after equilibrium establishment the s/b values were determined and plotted against C and the values of K were obtained as the intercept of the plot with the abscissa. The method appears to be experimentally simple and the K-values of the lectin sugar and monoclonal antibody-antigen complexes agree well with those determined by other methods. PMID- 3974580 TI - [Development, structure and initial evaluation of a comprehensive psychosocial care program for children with cancer and their families]. AB - The development and trial of a model care program carried out by psychologists in close collaboration with oncologists aimed at the comprehensive in- and off-ward care of children with cancer and their families is reported. A structured psychosocial anamnesis in interview-form ("Aufnahmebogen") and an information list ("Checkliste") are used shortly after diagnosis to identify problems and to systematically inform on psychosocial support schemes. The procedure allows a comprehensive, early and preventative psychosocial care. An evaluation of 646 carefully documented contacts was carried out according to the criteria: number of contacts, initiator, person contacted, reason for contact and function of the psychologist. Various prerequisites important for the integration of psychologists into the oncological team are specified and discussed. PMID- 3974579 TI - Molecular weight diversity among murine class I antigens: both the mature cell surface forms and the unglycosylated polypeptides vary significantly in molecular weight. AB - The molecular weights of the fully glycosylated cell surface form and the unglycosylated polypeptide of five murine class I antigens (H-2Kb, Db, TL, Qa 1.1, and Qa-2) were compared by SDS-PAGE. Significant molecular weight diversity was observed for both forms among these molecules. The size of the fully glycosylated forms ranged from approximately 52,000 daltons (H-2Db) to 41,000 daltons (Qa-2), whereas the unglycosylated polypeptides ranged from 43,000 daltons (H-2Kb and TL) to 33,000 daltons (Qa-2). The magnitude of the size variation observed in the unglycosylated polypeptides implies that there are differences in the gene organization, RNA processing or post-translational modifications of various class I glycoproteins. PMID- 3974581 TI - [Preoperative risk assessment in pediatric surgery]. AB - The further development of the risk score presented by us in 1976 combined with Peter's score now permits a satisfactory preoperative risk estimation in pediatric surgery for all age groups. The score includes 18 lines for all significant preoperative parameters and the procedure planned. Each parameter is judged by a number of points according to its significance (1-4 points). An increasing number of points indicates an increasing operation risk. The evaluation of 533 cases using this core proved it to be a reliable preoperative risk estimation. PMID- 3974583 TI - [Clinical and computed tomographic observations on newborn infants with generalized brain edema due to perinatal asphyxia]. AB - We observed a sudden respiratory arrest in four term newborn infants after a clinically symptom-free period. There were no cardiac, pulmonary or metabolic changes responsible for these events. Signs of cerebral dysfunction existed (muscular hypotonia, jitterness, seizures). Cranial computerized tomographic scans were performed during the period of respirator treatment within the first week of life. The density of the brain structures was significantly decreased in all cases, three of the patients showed a complete compression of the lateral ventricles. These findings indicated severe brain swelling as a consequence of cerebral hypoxia. There was a history of umbilical cord occlusion in two cases. In the remaining patients we must assume an undetected hypoxic-ischemic episode prior to the onset of labor. We used hyperventilation, corticosteroids, phenobarbital, diuretics and fluid restriction for therapy. Later on the babies received special physiotherapy. Control CT-scans were performed during the fourth or fifth week of life. The findings were normal in one patient. Signs of mild focal brain atrophy developed in two babies. A more severe cortical atrophic lesion of both temporal lobes was found in one patient. He suffered from a slight cerebral palsy. No neurodevelopmental handicaps could be found in all the other patients on long term follow-up. The EEG examination was performed between the fifth and seventh month of life. No pathologic changes were observed. We conclude that severe generalized brain edema in the newborn is not necessarily followed by extensive brain damage. We think it important to develop more sensitive methods for detecting a hypoxic ischemic crisis preceding the birth. PMID- 3974582 TI - [Treatment of constitutionally tall girls with physiological estrogen doses in the prepuberty period. An alternative to high-dose estrogen therapy]. AB - The international literature shows that the constitutional tall stature of girls has so far been treated with high estrogen doses after the onset of puberty. But nowadays it is felt however, that the potential risks of high-dose estrogen therapy are considerable. While the hazards of persisting gonadotropine suppression were found to be less important, thrombo-embolic complications or severe changes in the liver cannot be excluded in young people. Epidemiological findings and animal experiments suggest that these complications are dose dependent. In search of an alternative to high-dose treatment, we--from 1966-1980 and basing on Whitelaw--administered approximately physiologic estrogen doses (80 micrograms of mestranol per day for 21 days, plus 2 mg of chlormadinonacetate per day for 10 days, cyclically) to a total of 86 tall girls ranging in age from 9 to 13 years. Only the group of the 20 girls with a skeletal age of 9-10 years, who were still prepubertal at the beginning of therapy, revealed a satisfactory mean height reduction of 7.6 cm. Serious side-effects of therapy did not occur. The possible drastic reduction of the estrogen dose to about 1/4 of the daily dose or about 1/3 of the overall dose as compared to the conventional method allows us to conclude that the early start of treatment offers a true alternative to the high dose estrogen therapy of the female tall stature. PMID- 3974584 TI - [Plasma separation in severe juvenile dermatomyositis]. AB - Because a seven year old boy with severe dermatomyositis failed to respond to a six week treatment course with prednisone (60 mg/m2) and azathioprine (2 mg/kg/d), five plasma separations were performed. Already after the second plasma separation an impressive reduction of skin ulcerations and an increase of muscle strength were noticed. So far there has been no relapse in spite of rapid reduction in the prednisone dosage. PMID- 3974585 TI - [Disinfection of incubators: Draeger-Aseptor or scrub-and-wipe disinfection?]. PMID- 3974586 TI - [Research on cystic fibrosis--1983]. PMID- 3974587 TI - [Changes in the rat aorta following ligation of the thoracic duct. II. Permeability studies]. PMID- 3974588 TI - [Nemaline bodies in striated muscles of animals with alloxan diabetes]. PMID- 3974590 TI - [Reorganization of homologous tendon grafts in man]. PMID- 3974589 TI - [Rare hair damage as a complication of hair care; a case of diffuse artificial trichorrhexia]. PMID- 3974591 TI - [Changes in the rat aorta following ligation of the thoracic duct. I. Morphologic studies]. PMID- 3974592 TI - [Solid ovarian teratoma]. PMID- 3974593 TI - [Diagnostic value of needle biopsy of the liver in visceral larva migrans]. PMID- 3974595 TI - [Injury of the basilar artery]. PMID- 3974594 TI - [Induced psychosis and the viewpoint of the forensic psychiatry expert]. PMID- 3974596 TI - Chromosome changes with time in lymphocytes after occupational exposure to toluene. AB - Chromosome analyses were carried out in peripheral lymphocytes of 27 workers exposed to toluene in a rotogravure plant. At the time of blood sampling all of them had not been exposed to toluene for at least 4 months up to 5 years. Up to 2 years after cessation of exposure to toluene a higher incidence of chromatid-type aberrations could be observed than in controls. After longer post-exposure periods the aberration yields can no longer be distinguished from background level. No differences were revealed in SCE frequencies of smoking or non-smoking workers post toluene exposure compared with the corresponding controls. PMID- 3974597 TI - Evidence of DNA repair in organ cultures of hamster tracheal epithelium following exposure to gas phase singlet oxygen. AB - Autoradiographic identification of unscheduled DNA synthesis (UDS) in short-term organ culture of hamster tracheal epithelium has been used as a predictive test for mutagenic and/or carcinogenic compounds. Tracheal explants were treated for 2 h with singlet delta oxygen plus [3H]thymidine. Silver grains over the nuclei of epithelial cells from the superficial layer of the mucosa were observed, indicating UDS. Control cultures, exposed to the gas phase without singlet oxygen, failed to elicit UDS. PMID- 3974598 TI - Correlation between unscheduled DNA synthesis and chromosome condensation in mitoses from human lymphocytes. AB - The correlation between chromosome condensation and amount of repair synthesis after UV irradiation was studied in PHA-stimulated human lymphocytes. The length of selected chromosomes and the number of autoradiographic grains were determined in cells from late prophase to middle metaphase. The statistical analysis of data indicates a highly significant correlation between the two variables and a positive linear regression of the number of grains on chromosome length. PMID- 3974599 TI - The interrelationship between SCE induction, cell survival, mutagenesis, aberration formation and DNA synthesis inhibition in V79 cells treated with N methyl-N-nitrosourea or N-methyl-N'-nitro-N-nitrosoguanidine. PMID- 3974600 TI - Analysis of mutagenic imidazo[4,5-f]quinolines and -quinoxalines (IQ compounds). Comparison of electrochemical and ultraviolet detection. AB - Two synthetic imidazoquinolin-2-amines (IQ and MeIQ) and two imidazoquinoxalin-2 amines (MeIQx and 4,8-DiMeIQx), all known potent mutagens, have been separated by reversed-phase HPLC and detected by two methods - UV detection and electrochemical (EC) detection. The limits of detection were found to be 2.5 pmoles for UV detection and 0.5-1.5 pmoles for electrochemical detection. PMID- 3974601 TI - In vitro fertilization rate of mouse eggs with sperm after X-irradiation at various spermatogenetic stages. AB - The frequency of in vitro fertilization of mouse eggs using sperm obtained weekly (for 1-9 weeks) from epididymis after testicular X-irradiation (200 rad) was observed. The sperm concentrations for insemination were 100, 200 and 300/mm3. The number of fertilized eggs seemed to remain constant almost at control level (90-98%) until the 4th week after X-irradiation. Thereafter, the number declined to reach a minimum level (about 30-50%) in the 6th week; they then recovered completely in the 8th week. This tendency was found at all sperm concentrations used. This result indicates that the most sensitive stage for the fertilization capacity of sperm to X-rays was the early spermatocytes or the late spermatogonia. The high radiosensitivity of the fertilization capacity of sperm irradiated during the early-spermatocyte to late-spermatogonial stage, corresponded well with the rate of induction of sperm abnormalities and spermatogenetic cell killing. The in vitro fertilization rate was not restored by an increase in sperm concentration at insemination; it is, therefore, likely that the in vitro fertilization frequency depends on the proportion of sperm with abnormal morphology and abnormal fertilization ability, and sperm number seems to have hardly any influence on the fertilization rate, as far as the in vitro fertilization experiment is concerned. PMID- 3974602 TI - Effects of post-irradiation interval on translocation frequency in male mice. AB - Hybrid male mice were given 5 Gy + 5 Gy acute X-rays 24 h apart, with cytological examination of testes 16-19, 39-42 and 64-66 weeks later. Mean testis weights were significantly lower in the youngest group than in the other two. However, translocation frequencies in spermatocytes of the youngest group (mean of 0.57 per cell) were significantly higher than in either of the other two groups, which gave similar values averaging 0.36 translocations per cell. There was highly significant heterogeneity in translocation yields within the youngest group. The decline in translocation yield with time after irradiation is in line with that reported by Leonard and Deknudt (1970) in inbred strain C57BL males. Analysis of all available data suggests that high translocation yields are found during late stages in the process of germ-cell repopulation of the testis after high radiation doses and may be connected with changing frequencies of radiosensitive and radioresistant stem cell populations as repopulation proceeds. PMID- 3974603 TI - Assignment of 2 patients with xeroderma pigmentosum to complementation group E. AB - Xeroderma pigmentosum (XP) fibroblast strains derived from XP24KO and XP26KO patients with mild clinical manifestations were similarly twice as sensitive to 254 nm UV killing as normal cells and had a reduced level of 30-55% unscheduled DNA synthesis (UDS) after irradiation with 10 J/m2. Complementation analysis in the hybridized heterodikaryons revealed that XP24KO and XP26KO cells were only unable to complement the reference XP2RO group E cells, despite sufficient complementation to give rise to the normal level of UV-induced UDS with cells of all the other reference XP groups. Nor did XP24KO cells complement XP26KO cells. Therefore, the above 2 unrelated XP patients were assigned to complementation group E. The present group E assignment is the first in Japan, and perhaps the second in the world, the first being the XP2RO/XP3RO second-cousin relationship in The Netherlands (now 4 patients in group E). PMID- 3974604 TI - Inhibition and recovery of DNA synthesis in human cells after exposure to ultraviolet light. AB - The inhibition of DNA synthesis in normal human cells by UV is a complex function of fluence because it has several causes. At low fluences, inhibition of replicon initiation is most important. This is made clear by the fact that it occurs to a lesser degree in cells from patients with ataxia telangiectasia (AT). Assuming that only leading strand synthesis is blocked by UV-induced lesions, single lesions between replicons in parental strands for leading strand synthesis inhibit DNA synthesis by acting as temporary blocks until they are replicated by extension of the lagging strand of the adjacent replicon. A more severe inhibition occurs when two lesions are induced between adjacent growing replicons, because one in four possible configurations may result in a long-lived unreplicated region (LLUR). In the absence of excision repair, these may eventually be replicated by activation of an otherwise unused origin within the LLUR. The frequency of LLURs increases steeply with fluence. Activation of normally unused origins to replicate LLURs may facilitate recovery from inhibition of DNA synthesis, but repair of lesions is probably more important. In excision-repair-defective cells, an LLUR without an origin to initiate its replication may be a lethal lesion. PMID- 3974605 TI - DNA-damaging properties and cytotoxicity in human fibroblasts of tetrachlorohydroquinone, a pentachlorophenol metabolite. AB - The DNA-damaging potential of pentachlorophenol (PCP) and its metabolite tetrachlorohydroquinone (TCH) was investigated. TCH was found to bind covalently to calf-thymus DNA and to cause single-strand breaks in PM2 DNA. No DNA-damaging effects were observed for PCP. Exposure of human fibroblasts to PCP and TCH showed that TCH is more toxic, when colony-forming ability after exposure to the agent is used as a measure of toxicity. In the evaluation of the mutagenic and carcinogenic potential of PCP the metabolite TCH should be taken into consideration. PMID- 3974606 TI - Split-dose exposure to N-methyl-N'-nitro-N-nitrosoguanidine in BALB/3T3 C1 a31-1 1 cells: evidence of DNA repair by alkaline elution without changes in cell survival, mutation and transformation rates. AB - Dose fractionation of a direct-acting chemical carcinogen, the alkylating agent N methyl-N'-nitro-N-nitrosoguanidine (MNNG), was studied for its concurrent effects on survival, DNA damage and repair, ouabain resistance (Ouar) mutations and neoplastic transformation, in the mouse embryo cell line BALB/3T3 C1A31-1-1. MNNG doses of 0.5, 1 and 2 micrograms/ml were added to the cells either as a single exposure or in two equal fractions separated by 1, 3 or 5 h intervals. No significant difference in cytotoxicity was found when single and split-dose treatments were compared. No recovery from sublethal damage was therefore found in this cell line by split-dose administration of MNNG, although such an effect was found when the same cell line was treated with single and split doses of X rays. Repair of DNA damage as measured by alkaline elution was studied up to 24 h after a single MNNG exposure (0.5 micrograms/ml). DNA repair was rapid during the first 5 h after treatment and slow thereafter. DNA damage detected after split doses of MNNG at 1 and 5 h intervals was significantly lower than after a corresponding single dose. With both single and split doses, rejoining of single strand breaks (ssb) was nearly complete after 24 h of repair time. Ouar mutation and neoplastic transformation frequencies were determined for single and split doses of MNNG with the second treatment being given during (1 h) or after (5 h) the period of rapid DNA repair. No significant differences in either effect were detected for dose splitting at any tested dose. PMID- 3974607 TI - Hypersensitivity of xeroderma pigmentosum cells to dietary carcinogens. AB - Xeroderma pigmentosum patients, in addition to ultraviolet-induced skin cancers, have an increased prevalence of neoplasms occurring in sites shielded from ultraviolet radiation. We postulated that these internal neoplasms might be related to ingestion of dietary carcinogens. As model dietary carcinogens, we studied the tryptophan pyrolysis products, 3-amino-1,4-dimethyl-5H-pyrido[4,3 b]indole (Trp-P-1) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2). These dietary compounds bind to DNA and are highly mutagenic and carcinogenic. Cytotoxicity of these compounds was examined in cultured lymphoblastoid cell lines from xeroderma pigmentosum patients in complementation groups A, B, C, D and E and the variant form and from normal donors. All xeroderma pigmentosum lymphoblastoid cell lines showed a greater reduction in viable cell concentration than the 2 normal lymphoblastoid cell lines following addition of Trp-P-1 or Trp P-2 (5 micrograms/ml) to the culture medium. Possible differences in cellular activation of these compounds were overcome by treating the cells with rat-liver microsome-activated Trp-P-2. There was a greater reduction in viable cell concentration in the xeroderma pigmentosum group A and D cells than in the normal lymphoblastoid cell lines after treatment with activated Trp-P-2. These data suggest that the xeroderma pigmentosum DNA-repair system is defective in repairing Trp-P-1 and Trp-P-2 induced DNA damage in addition to being defective in repairing ultraviolet-induced DNA damage. Thus xeroderma pigmentosum patients may be at increased risk of toxicity from some dietary carcinogens. PMID- 3974608 TI - Mechanism of UV-induced deoxynucleoside triphosphate pool imbalance in CHO-K1 cells. AB - Several laboratories have reported that exposure of cells to UV radiation results in a significant imbalance in deoxynucleoside triphosphate pool concentrations. In our CHO-K1 cells, a rapid drop in dCTP is accompanied by a rapid increase in dTTP. Examination of enzyme activities associated with synthesis/degradation of these molecules suggests that UV transiently enhances a putative dCTPase, dCMP deaminase and CdR kinase activities. This results in accumulation of excess dUMP which is probably converted to dTMP, then to dTTP. The absence of dCMP deaminase in V79 cells prohibits this rapid response in those cells. Moreover, significantly different dCMP deaminase activities were observed in CHO-K1 cells obtained from other laboratories, suggesting they, too, may respond differently to irradiation. PMID- 3974609 TI - A method for analysing sister-chromatid exchange in mouse preimplantation embryos. AB - Analysis of sister-chromatid exchange (SCE) has been shown to be a sensitive and reproducible method for detecting the action of mutagens and carcinogens. We have succeeded in establishing a reliable technique which allows to perform SCE in preimplantation embryos in order to make the pre-uterine stages of development accessible to routine detection of DNA damage. Using the mouse strain and technique described, approximately 30-40% of mice will mate successfully after synchronization and spontaneous ovulation. From 3 pregnant females, about 30 four to eight-cell embryos will be obtained, representing one experimental group providing approximately 50-80 two-S-phase labelled metaphases with a SCE frequency baseline below 6 exchanges. PMID- 3974610 TI - Measurement of micronuclei in lymphocytes. AB - The micronucleus technique has been proposed as a method for measurement of chromosomal damage in mitogen-stimulated human lymphocytes. Micronuclei require one cell division to be expressed and, consequently, the conventional micronucleus technique is very imprecise since the cells which have undergone only one division, and the micronuclei in them, cannot be identified separately from the total population of lymphocytes. To overcome this problem, two methods were developed to identify cells which have undergone their first mitosis. Using an autoradiographic technique, lymphocytes were pulse-labelled with [3H]thymidine at 48 h of culture, allowed to proceed through mitosis, identified by autoradiography between 72 and 84 h and micronuclei were scored in them. It was not possible to select a concentration of radiolabel which did not itself produce micronuclei and consequently the method was of no value for measuring pre existing chromosomal damage present in vivo. However, it was capable of quantitating micronuclei produced by irradiation of lymphocytes in vitro. In the second method, cytokinesis was blocked using cytochalasin B. Micronuclei were scored in cytokinesis-blocked cells. These were easily recognisable owing to their binucleate appearance and a large number could be accumulated by adding 3.0 micrograms/ml cytochalasin B at 44 h and scoring at 72 h. Cytochalasin B did not itself produce micronuclei. The cytokinesis-block method was simple to perform; the 'in vivo' micronucleus frequency in normal individuals was 4.4 +/- 2.6 micronuclei/500 cytokinesis-blocked cells; and for lymphocytes irradiated in vitro there was a linear relationship between dose of radiation and number of induced micronuclei. The cytokinesis-block method appears to be the procedure of choice for quantitating micronuclei in lymphocytes. PMID- 3974612 TI - A nonparametric approach to the statistical analysis of mutagenicity data. AB - A nonparametric statistical method for analysing count data from mutagenicity tests is proposed. This method does not make any stringent assumptions on the variation of the data. It requires only one ranking of the observations and the calculation of a resulting test statistic. The significance of this statistic can be assessed by approximation to the standard normal distribution or tables of critical values calculated by the authors. The method also includes a descriptive component through a series of K-1 estimates of a trend in a K group experiment. Several examples are discussed to illustrate the proposed method. PMID- 3974611 TI - Epidermal enzyme-mediated mutagenicity of the skin carcinogen, 2-aminoanthracene. AB - Using four Salmonella typhimurium tester strains (TA1537, TA1538, TA98 and TA100) and the promutagen 2-aminoanthracene, an epidermal S9-mediated mutagenicity assay was developed. Using an activation mixture derived from whole skin of the rat, mutagenicity was observed in tester strain TA98 whereas an activation mixture derived from the dermis resulted in mutagenicity in tester strains TA1538, TA98 and TA100. Activation mixtures from both the epidermis and the liver produced a positive response in all of the tester strains studied. Activation mixtures from liver were shown to have the highest specific activity followed in decreasing order of potency by epidermis, dermis and whole skin. These results indicate that the skin, a target tissue directly exposed to environmental chemicals, is capable of converting 2-aminoanthracene to mutagenic moieties. Since the skin of the rat is known to be susceptible to tumor induction by 2-aminoanthracene our findings re-emphasize that membrane-bound enzymes can influence toxic responses including mutagenicity to xenobiotics in cutaneous tissue. PMID- 3974613 TI - Plant tissue culture as a model system for mutagenicity testing of chemicals. AB - Two karyotypically stabilized callus strains of Crepis capillaris (2n = 7 and 2n greater than or equal to 12, respectively) were employed to illustrate the utility of plant tissue culture method for screening and analysis of cytogenetic effects of chemicals following long-term treatment. The cytogenetic analysis of callus cells revealed significant differences in the toxic and mutagenic effects of chemicals under study (2,4-D, MH, NMU and kinetin). A certain dose-response relationship (though not necessarily linear) was observed. The maximum cytogenetic activity of chemicals was associated with certain intermediate concentrations (4.5 X 10(-5) M-9 X 10(-5) M), whereas a further increase in the dose either gave rise to the opposite effects (i.e. decrease in the ana- and telo phase aberration rates and increase in the modal karyotype frequency) or the aberration rate remained unchanged. PMID- 3974614 TI - Report of the conference on DNA adducts: dosimeters to monitor human exposure to environmental mutagens and carcinogens. PMID- 3974615 TI - Mutagenesis at putative apurinic sites in alkylated single-stranded DNA of parvovirus H-1 propagated in human cells. AB - The treatment of parvovirus H-1, a single-stranded DNA virus, with ethylnitrosourea immediately prior to infection of human cells, resulted in both virus mutagenesis and lethality (immediate hits). The incubation of treated virus, prior to inoculation, under conditions promoting the release of alkylated bases, slightly reduced the mutagenicity of ethylnitrosourea but significantly increased its killing effect (delayed hits). In untreated cells, the appearance of one apurinic/apyrimidinic site in viral DNA correlated with the formation of approximately one delayed lethal hit per virus. Cells which had been sublethally UV irradiated prior to infection, were able to overcome about 20% of the delayed lethal hits inflicted to ethylnitrosourea-treated H-1. This UV-enhanced reactivation was accompanied by viral mutagenesis and was not observed for immediate lethal hits. Therefore, UV irradiation of human cells appears to trigger a conditioned recovery response which might alleviate a block to the replication of single-stranded DNA containing apurinic sites, allowing these noncoding lesions to direct mutagenesis. UV-irradiated cells also displayed a mutator phenotype towards untreated parvovirus H-1. In contrast, ethylnitrosourea failed to induce human cells to cause mutagenesis of undamaged viral DNA, although it enhanced their ability to reactivate damaged virus. PMID- 3974616 TI - The effect of temperature and cell cycle length on SCE frequency in Rat-1 cells. AB - The effects of temperature on sister-chromatid exchange (SCE) frequency in Rat-1 embryo fibroblasts was investigated by culturing cells at 35 degrees C and 39 degrees C. Cells routinely cultured at 35 degrees C had a significantly lower SCE rate (0.1903 SCE/chromosome) than those routinely cultured at 39 degrees C (2.657 SCE/chromosome). When cells routinely cultured at 35 degrees C were transferred to 39 degrees C, their SCE rate increased to that of the 39 degrees C cells. However, 39 degrees C cells transferred to 35 degrees C did not show a decrease after 24 h acclimatization but after 48 h acclimatization their SCE rate had dropped to that of the 35 degrees C cells. Cells cultured at 35 degrees C had a longer cell cycle time than cells cultured at 39 degrees C, indicating that in Rat-1 cells increased cell cycle time does not result in increased SCE. PMID- 3974617 TI - Specific-locus mutation response to unequal, 1 + 9 Gy X-ray fractionations at 24 h and 4-day fraction intervals. AB - The specific-locus mutation frequency obtained from mouse spermatogonial stem cells following unequal, 1 + 9 Gy X-ray fractionation with a 24-h fractionation interval is low, and consistent with the two fractions acting additively. The response is therefore markedly different from the augmented mutation frequencies obtained with 500 + 500 R and 100 + 500 R, 24-h fractionations. The lower yield compared with the 100 + 500 R response also indicates a clear difference from the translocation data which demonstrate increases in yield with increasing second dose over the same dose range. The decline in specific locus mutation yield with the increase in the second dose from 500 R to 9 Gy suggests that the stem cells surviving the first fraction are heterogeneous in their sensitivities to this class of genetic damage. A similar, additive specific locus mutation frequency is obtained with unequal, 1 + 9 Gy X-irradiation when the interval between fractions is 4 days. This is consistent with 500 + 500 R, 4-day and 7-day interval responses obtained previously but again differs from the sub-additive translocation responses obtained with such X-ray fractionation. Taken together with the data from previous studies the present results suggest that (1) 24 h after the first fraction, (a) the surviving stem cell have two components; survivors of the formerly radiosensitive, cycling component of the normal stem cell population and the formerly radioresistant, G0 or arrested G1 cells, which are being 'triggered' into a rapid cell cycle to achieve repopulation of the testis; (b) these two components are of near-equal sensitivity to translocation induction and cell killing, hence the additive translocation yields with equal X ray fractionations and yields consistent with those extrapolated from lower doses with higher, unequal fractionations, e.g. 1 + 7 Gy, 1 + 9 Gy; but (c) the formerly radioresistant, triggered component is much more sensitive than the surviving cycling component to specific locus mutation and cell killing, hence the augmented mutation response with 500 + 500 R fractionation and the drop in yield with 1 + 9 Gy compared with 100 + 500 R X-irradiation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974618 TI - Induction of 6-thioguanine-resistant mutants by hyperoxia and gamma-irradiation: effect of compromising cellular antioxidant systems. AB - Hyperoxia and gamma-irradiation were found to be mutagenic in a transformed Syrian hamster cell line in a dose-dependent manner. The frequency of resistance to 6-thioguanine increased from 10 per 10(6) survivors after 48 h of growth in 70% O2 to 32.6 (highly significant) after 75 h. Increasing the oxygen tension to 95% resulted in a significant mutagenic response in only 44 h. At equitoxic doses, gamma-irradiation was 4 times more mutagenic than 70% O2. After growth in hyperoxia, the cells showed an enhancement of catalase activity, glutathione peroxidase activity and glutathione levels but there was little effect on superoxide dismutase activity. Diethyldithiocarbamate (3 mM, 1.5 h) was mutagenic in normoxia and potentiated the mutagenic activity of both gamma-irradiation and hyperoxia. Cells thus treated showed an 855 reduction in superoxide dismutase activity. When diethyldithiocarbamate was used in conjunction with a direct acting alkylating agent, the mutagenic response was only additive. Depletion of cellular glutathione with buthionine sulfoximine (0.2 mM) or inhibition of catalase activity with aminotriazole (100 mM) was also effective in potentiating the mutagenic response of gamma-irradiation and hyperoxia. The data demonstrates that endogenously produced activated oxygen species are mutagenic to hamster cells in culture and suggest that aerobic organisms are subject to an unavoidable background risk due to living in an oxygen atmosphere. PMID- 3974619 TI - A deterministic approach for the estimation of mutation rates in cultured mammalian cells. AB - Unequal growth rates between mutant and wild-type cells in a large population constitute a problem for the estimation of mutation rate. Over a period of cell growth, a selective advantage of one cell type over the other might lead to considerable error in the estimation of mutation rate if equal growth rates are assumed. In this study, we propose a formula and apply it to the estimation of spontaneous mutation rate in a growing population of Chinese hamster V79 cells in which ouabain-resistant mutant cells exhibit a slower growth rate than the wild type cells. The formula is a generalization of that previously presented by Armitage (1953), and this is the first attempt to apply the deterministic approach for mutation rate estimation to cultured mammalian cells. The value of the estimated rate is compared with that derived from a parallel experiment using the fluctuation test of Luria and Delbruck (1943). The limitations and advantages of taking the deterministic approach to mutation rate estimation in mammalian cell systems are discussed. PMID- 3974620 TI - Codominant and recessive 9-beta-D-arabinofuranosyladenine-resistant mutations of baby hamster cells. AB - 9-beta-D-Arabinosyladenine (araA)-resistant mutants of baby hamster kidney (BHK) cells can be classified into 3 classes. In order to gain a better understanding of the mechanism(s) of resistance and the biochemical basis of cytotoxicity of various purine nucleosides, cell hybrids of the mutant and wild-type cells were made and analyzed. The class I araA-resistant, adenosine-kinase-deficient (AK-) allele was shown to be recessive to the wild-type araA-sensitive (AK+) gene. The class II mutant allele, which encodes an altered ribonucleoside diphosphate reductase, was shown to be codominant. The class III mutants show multiple phenotypes, araAr/dAdor/adenosine sensitive (Ados) and alteration in AK activity. The araA- and dAdo-resistant alleles of araS10d, ara-16c, and ara-19a in class III mutant/wild-type hybrid cells are all recessive to the wild-type allele, consistent with a common mechanism of resistance. In contrast the Ados allele of ara-S10d is dominant while those of ara-16c and ara-19a are recessive. The difference may be a reflection of two distinct mechanisms of enhanced Ado sensitivity or, alternatively, it suggests that the sensitivity of the hybrids to Ado is highly dependent on the level of AK activity. PMID- 3974621 TI - Confluent holding leads to a transient enhancement in mutagenesis in UV-light irradiated xeroderma pigmentosum, Gardner's syndrome and normal human diploid fibroblasts. AB - The influence of confluent holding periods of 0-24 h of UV-light-induced mutagenesis has been investigated in several human cell strains including xeroderma pigmentosum complementation group A (XPA), Gardner's syndrome (GS) and normal human diploid fibroblasts (NHDF). These cells strains were chosen for the variety of their responses in cytotoxicity experiments. Confluent cultures of NHDF exposed to UV light exhibited a time-dependent increase in survival when subculture was delayed up to 24 h after irradiation. GS and XPA fibroblasts showed no such increase. In dose-response experiments, GS cells from 3 kindreds were moderately hypersensitive to cell killing by UV light whereas XPA cells were strongly hypersensitive. Confluent cultures of GS cells were slightly and XPA markedly hypermutable to 6-thioguanine resistance (6-TGR) when the cells were subcultured immediately after UV exposure. When allowed confluent holding periods of 1.5-24 h, GS, XPA and NHDF all exhibited a transient enhancement of mutagenesis such that a 5-10-fold increase in mutation frequency was observed in cells subcultured at 6-9 h after irradiation as compared to cells subcultured at 3-6 h. A decline in mutation frequency prior to the mutagenesis peak was observed in GS and normal cells but not in XPA. After 24 h of confluent holding, the mutation frequency in irradiated GS and NHDF had returned to near background levels although XPA mutation frequencies remain similar to those observed in immediately subcultured cells. A model to explain these overall results is discussed. PMID- 3974622 TI - Diagrammatic representation for chromosomal mutagenesis studies. III. Radiation induced rearrangements in Pan troglodytes (chimpanzee). AB - A qualitative study is presented of chromosomal rearrangements induced by gamma irradiation at 2 Gy and 3 Gy in peripheral blood lymphocytes of the chimpanzee Pan troglodytes. From a sample of 460 cells, karyotyped after R-banding, 1047 rearrangements were detected. Each type of rearrangement is analyzed according to the diagrammatic method previously developed. The non-random nature of the induction of the rearrangements is clear. The chimpanzee seems highly sensitive to the induction of dicentrics. This may be related to the existence, in its karyotype, of sensitive juxta-telomeric heterochromatin, much more frequently affected in the case of formation of dicentrics than of other types of rearrangements. Thus, the evaluation of radiation sensitivity of a given species based only on the yield of dicentrics may not have a general value for chromosomal mutagenesis. PMID- 3974623 TI - Direct analysis of radiation-induced chromosome fragments and rings in unstimulated human peripheral blood lymphocytes by means of the premature chromosome condensation technique. AB - Development of the procedure to stimulate peripheral blood lymphocytes has greatly facilitated the understanding of chromosome aberration formation and repair mechanisms in human cells. Yet, because radiation induces far more initial chromosome breaks than are observed as aberrations in metaphase, it has not been possible to examine the kinetics of primary chromosome breakage and rejoining with this procedure. An improved method to induce premature chromosome condensation in unstimulated lymphocytes has been used to study primary chromosome breakage, rejoining, and ring formation at various times after irradiation with up to 800 rad of X-rays. The dose-response relations for chromosome fragments analyzed immediately or 1, 2, or 24 h after exposure were found to be linear. Rapid rejoining of chromosome fragments, which takes place in the first 3 h after X-ray exposure, was not correlated with a simultaneous increase in the formation of rings. The yield of rings per cell scored 24 h after irradiation, however, increased significantly and fit a linear quadratic equation. Both chromosome fragment rejoining and ring formation were completed about 6 h after irradiation. The frequency distributions of rings among cells followed a Poisson distribution, whereas chromosome fragments were overdispersed. PMID- 3974624 TI - Use of a human X mouse hybrid cell line to detect aneuploidy induced by environmental chemicals. AB - A short-term assay utilizing a human/mouse monochromosomal hybrid cell line R3-5, to detect chemically induced aneuploidy in mammalian cells is described. A single human chromosome transferred into mouse cells was used as a cytogenetic marker to quantitate abnormal chromosome segregation following chemical treatment. The human chromosome present in the mouse cells can be readily identified by differential staining procedures. The frequency of cells containing 0 or 2 human chromosomes in the progeny of chemically treated monochromosomal hybrid cells provided a direct measure of aneuploidy. We tested the sensitivity of the proposed system with 3 model chemicals (colcemid, cyclophosphamide and benomyl) known to induce numerical or structural changes in chromosomes. The frequency of an abnormal segregation of the human chromosome was found to be dose dependent and consistently higher than controls. This system has the capability to detect gain as well as loss of a chromosome resulting from nondisjunction or other mechanisms leading to aneuploidy. PMID- 3974625 TI - Developmental status of bioassays in genetic toxicology. A report of Phase II of the U.S. Environmental Protection Agency Gene-Tox Program. PMID- 3974626 TI - Chromosomal aberrations and micronuclei induced in rat and mouse bone marrow cells by sodium nitrate. PMID- 3974627 TI - Cytogenetic effects of epoxy resin in man: dependence on sex, age and period of exposure. AB - The cytogenetic analysis of 156 subjects occupationally exposed to epoxy resin has revealed sex-dependent differences: average frequencies of aberrant metaphases and chromosome breaks per cell were significantly higher in males than in females. No linear or other functional relationship between the frequency of aberrant metaphases and the period of exposure to the resin has been revealed. However, a significantly higher average frequency of aberrant metaphases was observed in the group of elderly workers with a long period of exposure. The distribution of individuals according to the frequency of aberrant metaphases in the control group does not differ significantly from Poisson's law, while in individuals exposed to epoxy resin it is closer to the normal distribution. PMID- 3974628 TI - Cytogenetic effects of pesticides. III. Induction of micronuclei in mouse bone marrow by the insecticides cypermethrin and rotenone. AB - The production of micronuclei in mouse bone marrow by the pyrethroid insecticide, cypermethrin and the botanical insecticide, rotenone was examined. Three routes of administration were used for the insecticides: intraperitoneal, oral and dermal. The different routes of treatment with cypermethrin and rotenone caused toxicity of marrow as indicated by a significant increase in the percentage of polychromatic erythrocytes (PEs) over that of the control. Cypermethrin showed mutagenic potential as evidenced by a positive response in the micronucleus assay. Oral administration of the insecticide at a dietary level of 900 ppm for 7 and 14 consecutive days as well as double and multiple (total 4) dermal treatments (360 mg/kg body wt.) induced a statistically significant increase in the frequency of PEs with micronuclei. The conducted intraperitoneal (i.p.) treatments with cypermethrin: single injection at 60 and 180 mg/kg body wt., double and multiple injections (total 3) at 60 mg/kg body wt. did not affect the percentage of PEs with micronuclei. The different treatments with rotenone: single, double and multiple (i.p.) injections (total 3) at 2 and 3 mg/kg body wt., oral administration for 14 consecutive days at dietary level of 225 ppm and multiple dermal treatments (total 4) with 135 mg/kg body wt. showed no effect on the frequency of micronuclei in PEs. PMID- 3974629 TI - Genetic monitoring of aluminum workers exposed to coal tar pitch volatiles. AB - A group of 50 workers exposed to coal tar pitch volatiles (CTPV) in an aluminum reduction plant and a group of 50 non-exposed workers were selected to evaluate the genotoxic effects of CTPV exposure. A battery of tests was performed on 3 different body fluids; urine, blood and semen. Urine samples were evaluated for mutagenic constituents using the Ames/Salmonella assay. Cultured lymphocytes from blood samples were used to perform cytogenetic analysis. Semen samples were used to measure sperm count, percent abnormal sperm morphology and frequency of sperm carrying double fluorescent bodies (2-F). 14 of 28 (50%) exposed workers and 7 of 36 (19.4%) non-exposed workers had mutagenic urine. This difference was significant (p less than 0.01). Among the non-smokers a significantly higher percentage of workers who were exposed had positive urine (36%) compared to the non-exposed workers (5%) (p less than 0.05). Among the exposed group, more mechanics had mutagenic urine than did other types of workers. Overall chromosome aberration rates were similar in both exposed and non-exposed workers. Among exposed workers a significant inverse correlation (p less than 0.05) between age and chromatid aberration rate was observed. Results of semen analysis failed to detect differences between exposed and non-exposed workers. Results of these tests lend support to a battery approach to genetic monitoring and suggest a link between exposure to CTPV and genotoxic effects. Detection of exposure to mutagens at an early time offers an opportunity for disease prevention by the reduction of exposure. PMID- 3974630 TI - [Yeast flora on healthy skin]. PMID- 3974631 TI - Simultaneous visualization of human epidermal immunocompetent cells and hyphae. PMID- 3974632 TI - Diabetic nephropathy. PMID- 3974633 TI - Bottom-line health care? PMID- 3974634 TI - Treatment of osteoporosis. PMID- 3974635 TI - Case 46-1984: AIDS associated with transfusion of blood products. PMID- 3974636 TI - Kaposi's sarcoma in transfusion-associated AIDS. PMID- 3974637 TI - Unsuccessful treatment of severe pain from bone metastasis with Sinemet 25/100. PMID- 3974639 TI - Case 44-1984: Wilson's disease. PMID- 3974638 TI - Cephradine-associated immune neutropenia. PMID- 3974640 TI - Psychotropic drug use in the elderly. PMID- 3974641 TI - The need for a research agenda. PMID- 3974642 TI - Reviewer status and review quality. Experience of the Journal of Clinical Investigation. PMID- 3974643 TI - The right to know about toxic exposures. Implications for physicians. PMID- 3974644 TI - Surgery for breast cancer. Less may be as good as more. PMID- 3974645 TI - Passive smoking. PMID- 3974646 TI - Diagnosis of pheochromocytoma. PMID- 3974647 TI - Removal of foreign bodies from the nose. PMID- 3974648 TI - What are we doing about AIDS? PMID- 3974649 TI - Scientific misconduct in investigational drug trials. PMID- 3974650 TI - Type A behavior and survival after acute myocardial infarction. AB - To ascertain the influence of personality factors on the course of coronary artery disease, we measured Type A behavior in 516 patients within two weeks after an acute myocardial infarction, using the Jenkins Activity Survey questionnaire. Over a follow-up period of one to three years, there was no relation between the Type A score and total mortality, cardiac mortality, time to death for nonsurvivors, left ventricular ejection fraction, or duration of the stay in the coronary care unit. These negative findings were not changed by restricting the analyses to men below 61 years of age or by comparing extreme score categories. The contributions of behavioral, demographic, and cardiac physiologic factors to postinfarction mortality were also evaluated by multivariate survivorship analyses. The physiologic factors were the only ones that contributed a significant and independent mortality risk; the Type A score did not enter the survivorship model (relative risk, 0.8; 95 per cent confidence interval, 0.5 to 1.5). Thus, we found no relation between Type A behavior and the long-term outcome of acute myocardial infarction. PMID- 3974651 TI - The long-term pulmonary sequelae of prematurity: the role of familial airway hyperreactivity and the respiratory distress syndrome. AB - Respiratory distress syndrome of the newborn, prematurity, and familial airway hyperreactivity may contribute to long-term pulmonary sequelae. We assessed the role of each by testing pulmonary function and airway reactivity in 11 prematurely born children who survived the respiratory distress syndrome and in 11 prematurely born children who had no neonatal respiratory disease, each of whom was paired with a sibling born at term. The subjects were between 7 and 12 years of age when studied. Airway reactivity was also assessed in their mothers. The group who had had the respiratory distress syndrome had higher ratios of residual volume to total lung capacity and lower values for forced expiratory volume in one second than did their siblings or normal controls (P less than 0.01). Expiratory flow was decreased in both groups born prematurely (P less than 0.02) and was related to neonatal exposure to oxygen (r = -0.71, P less than 0.02). The incidence of airway hyperreactivity was elevated in all groups, including the mothers. These data suggest that long-term pulmonary sequelae of the respiratory distress syndrome of the newborn are related to the disease, its treatment, or both, and to airway hyperreactivity. In prematurely born children without neonatal lung disease, the sequelae are related to airway hyperreactivity. The possibility of a relation between familial airway hyperreactivity and premature birth is suggested. PMID- 3974652 TI - Elastoderma--disease of elastin accumulation within the skin. PMID- 3974653 TI - Professional regulation and the state medical boards. PMID- 3974654 TI - Fending off the potassium pushers. PMID- 3974655 TI - Cysticercosis and taeniasis. PMID- 3974656 TI - Effect of rifampin on chloramphenicol levels. PMID- 3974657 TI - Intracoronary streptokinase for acute myocardial infarction. PMID- 3974658 TI - A possible association between maternal drinking and fetal clubfoot. PMID- 3974659 TI - Disulfiram reaction to organic solvents other than ethanol. PMID- 3974660 TI - Transitory spatial disorder with propranolol. PMID- 3974661 TI - The ethics of professional regulation. PMID- 3974662 TI - Diet, lipoproteins, and the progression of coronary atherosclerosis. The Leiden Intervention Trial. AB - We studied the relation between diet, serum lipoproteins, and the progression of coronary lesions in 39 patients with stable angina pectoris in whom coronary arteriography had shown at least one vessel with 50 per cent obstruction before intervention. Intervention consisted of a two-year vegetarian diet that had a ratio of polyunsaturated to saturated fatty acids of at least 2 and that contained less than 100 mg of cholesterol per day. Dietary changes were associated with a significant increase in linoleic acid content of cholesteryl esters and a significant lowering of body weight, systolic blood pressure, serum total cholesterol, and the ratio of total to high-density lipoprotein (total/HDL) cholesterol. Angiographic examination was performed after 24 months; angiograms were assessed visually (with blinding) and by computer-assisted image analysis. Both types of assessment indicated progression of disease in 21 of 39 patients but no lesion growth in 18. Coronary lesion growth correlated with total/HDL cholesterol (r = 0.50, P = 0.001) but not with blood pressure, smoking status, alcohol intake, weight, or drug treatment. Disease progression was significant in patients who had values for total/HDL cholesterol that were higher than the median (greater than 6.9) throughout the trial period. No coronary-lesion growth was observed in patients who had lower values for total/HDL cholesterol (less than 6.9) throughout the trial or who initially had higher values (greater than 6.9) that were significantly lowered by dietary intervention. PMID- 3974664 TI - Two new diet-heart studies. PMID- 3974663 TI - Hemolytic anemia after tetracycline therapy. PMID- 3974665 TI - Methotrexate in rheumatoid arthritis. PMID- 3974666 TI - Blood transfusion and athletics. Games people play. PMID- 3974667 TI - Eradication of resistant Staphylococcus aureus on a surgical unit. PMID- 3974668 TI - Does idoxuridine help herpes labialis? PMID- 3974669 TI - Phenelzine in the treatment of aphthous ulcers of the mouth. PMID- 3974670 TI - Failure to confirm muscarinic receptors on skin fibroblasts. PMID- 3974671 TI - Moonlighting house officers. PMID- 3974672 TI - Moonlighting medical students. PMID- 3974673 TI - Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. AB - Twenty of 89 consecutive patients with the acquired immunodeficiency syndrome (AIDS) in whom autopsies were performed over a 3 1/2-year period had a vacuolar myelopathy that was most severe in the lateral and posterior columns of the thoracic cord. Light and electron microscopy showed that vacuoles were surrounded by a thin myelin sheath and appeared to arise from swelling within myelin sheaths. Signs and symptoms referable to the spinal-cord lesions, including paraparesis, often accompanied by spasticity or ataxia (or both), were present in all five patients with marked pathological changes, in five of seven patients with moderate changes, and in two of eight patients with mild changes. Fourteen patients were demented. The clinical presentation was sufficiently distinctive to provide a guide for antemortem diagnosis. Possible causes of the vacuolar changes include uncharacterized viral infection or a metabolic derangement related to selective nutritional deficiency. PMID- 3974674 TI - Active myocarditis in the spectrum of acute dilated cardiomyopathies. Clinical features, histologic correlates, and clinical outcome. AB - We studied the clinical features and course (average follow-up time, 18 months) of 27 patients with acute dilated cardiomyopathy (symptoms for less than 6 months) who were referred for endomyocardial biopsy. Almost 40 per cent of the patients subsequently had a rise in left ventricular ejection fraction (on average, from 0.21 to 0.41) and substantial improvement in heart failure; the remainder died or had chronic dilated cardiomyopathy. Biopsy revealed myocarditis in 18 patients, and this finding was especially common (89 per cent) in patients who had been ill for less than four weeks. But the biopsy specimen was negative in four patients whose clinical features and later course were diagnostic of myocarditis. Nine patients received immunosuppressive drugs, and four improved--a rate that did not differ from the rate of spontaneous improvement. Neither the histologic features of the biopsy specimen nor the clinical features at presentation were clearly correlated with subsequent improvement, whether or not immunosuppressive drugs were given. We conclude that many cases of unexplained dilated cardiomyopathy result from myocarditis. Definitive histologic confirmation depends on the duration of illness. The efficacy of immunosuppressive treatment must still be established. PMID- 3974675 TI - Smokeless is not saltless. PMID- 3974677 TI - Immunosuppressive drugs plus prednisone versus prednisone alone in lupus nephritis. PMID- 3974676 TI - Reduction of bioavailability of verapamil by rifampin. PMID- 3974678 TI - Identification of human osteoclasts with monoclonal antibodies. PMID- 3974679 TI - Straw lung. PMID- 3974680 TI - Trade unionism for doctors. PMID- 3974681 TI - Psychiatric malpractice. PMID- 3974682 TI - Residencies for sale? PMID- 3974683 TI - Primary tubal infertility in relation to the use of an intrauterine device. AB - Women who use an intrauterine device (IUD) are at increased risk of acute pelvic inflammatory disease, but the relation of the IUD to subsequent infertility is not established. We interviewed 159 nulligravid women with tubal infertility to determine their prior use of an IUD. Their responses were compared with those of a matched group who conceived their first child at the time the infertile women started trying to become pregnant. The risk of primary tubal infertility in women who had ever used an IUD was 2.6 times that in women who had never used one (95 per cent confidence interval, 1.3 to 5.2). The observed difference between cases and controls was not uniform for different types of IUD. The relative risk associated with use of a Dalkon Shield was 6.8 (1.8 to 25.2), and that associated with use of either a Lippes Loop or Saf-T Coil IUD was 3.2 (0.9 to 12.0). The smallest elevation in risk was found among users of copper-containing IUDs (relative risk, 1.9 [0.9 to 4.0] for all women who had ever used a copper containing IUD). The relative risk for women who used only a copper-containing IUD was 1.3 (0.6 to 3.0). We conclude that use of the Dalkon Shield (and possibly of plastic IUDs other than those that contain copper) can lead to infertility in nulligravid women. PMID- 3974685 TI - Response to a physiologic dose of pyridoxine in type I primary hyperoxaluria. AB - We measured urinary oxalate and glycolate excretion before and during pyridoxine administration (2 to 200 mg per day) in four patients with primary hyperoxaluria. In two patients with type I primary hyperoxaluria, urinary oxalate and glycolate excretion fell markedly in response to a physiologic dose of pyridoxine of 2 mg per day and became completely normal when the dose was increased to 25 mg per day. In the other two patients, who had a different type of primary hyperoxaluria (normal urinary glycolate excretion), there was no response to 2 mg of pyridoxine per day. In one of these patients, doses of 25 and 50 mg per day were also ineffective, but a moderate reduction in oxalate excretion took place with 200 mg per day; in the other patient there was a moderate reduction in oxalate excretion with 25 mg of pyridoxine per day. Our findings suggest that the degree of hyperoxaluria in this disorder may be only slight or moderate if the patient has been ingesting a pyridoxine-rich diet or multivitamin tablets containing small amounts of pyridoxine. Our results also suggest that smaller doses of pyridoxine than those heretofore employed should be tried in patients with primary hyperoxaluria. PMID- 3974684 TI - Tubal infertility and the intrauterine device. AB - To study the association between intrauterine devices (IUDs) and pelvic inflammatory disease, we compared contraceptive histories in 4185 while women- 283 nulliparous women with primary tubal infertility, 69 women with secondary tubal infertility, and 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with IUD use was calculated by means of multivariate logistic regression to control for confounding factors, including region, year of menarche, religion, education, smoking, and reported number of sexual partners. The adjusted risk of primary tubal infertility associated with any IUD use before a first live birth was 2.0 (95 per cent confidence limits, 1.5 to 2.6) relative to nonuse. Users of the Dalkon Shield had an adjusted risk of 3.3 (1.7 to 6.1), users of the Lippes Loop or Saf-T-Coil had a risk of 2.9 (1.7 to 5.2), and users of copper IUDs had a risk of 1.6 (1.1 to 2.4). Women who reported having only one sexual partner had no increased risk of primary tubal infertility associated with IUD use. The adjusted risk of secondary tubal infertility associated with use of a copper IUD after a first live birth was not statistically significant (1.5; 95 per cent confidence limits, 0.8 to 3.0), whereas the risk from similar use of noncopper devices was significant (2.8; 1.3 to 5.9). We conclude that tubal infertility is associated with IUD use, but less so with copper IUDs. PMID- 3974687 TI - Current status of intrauterine devices. PMID- 3974686 TI - A comparison of the treatment of rheumatoid arthritis in health maintenance organizations and fee-for-service practices. AB - This study compares the use of health care services (hospital and ambulatory) by patients with rheumatoid arthritis who were under the care of rheumatologists in prepaid and fee-for-service arrangements. Participating physicians from a random sample of half the rheumatologists in northern California maintained a log of all their patients with well-established diagnoses of rheumatoid arthritis. We interviewed 822 of their patients, using a structured, validated phone survey to obtain information about health care use. Patients in prepaid plans had about the same number and type of hospitalizations and the same rate of surgery as those receiving fee-for-service care. However, fee-for-service patients made more ambulatory visits. We conclude that the use of expensive services (hospital admissions and surgery) for the care of patients with rheumatoid arthritis is not different in fee-for-service and prepaid settings. PMID- 3974688 TI - Estrogen treatment for victims of rape. PMID- 3974689 TI - Osteoporosis in anorexia nervosa. PMID- 3974690 TI - Possible association between rubella vaccination and the decline in rheumatic fever. PMID- 3974691 TI - Excretion of diltiazem in human milk. PMID- 3974692 TI - Glucagon in the cerebrospinal fluid. PMID- 3974693 TI - Embryos untouched. PMID- 3974694 TI - Tsukuba group murder charge? PMID- 3974695 TI - Nitrates, nitrites and gastric cancer in Great Britain. AB - Nitrate and nitrite were measured in the saliva of two populations who differed in their risk of developing gastric cancer. Surprisingly, the levels of both ions were significantly higher in the low-risk group. PMID- 3974696 TI - Molecular turnover and memory. PMID- 3974697 TI - The mitochondria and cellular calcium. PMID- 3974698 TI - Structure of the calcium regulatory muscle protein troponin-C at 2.8 A resolution. AB - Crystals of turkey skeletal muscle troponin-C reveal a molecule of two domains with an unusual structure. Two Ca2+ ions are bound to the C-terminal domain. The two cation-binding sites of the regulatory (N-terminal) domain are Ca2+ free; this domain adopts a markedly different conformation from the C-terminal domain. The two domains are connected by a long nine-turn alpha-helix; three of these turns are exposed fully to solvent. PMID- 3974699 TI - Redistribution of fallout radionuclides in Enewetak Atoll lagoon sediments by callianassid bioturbation. AB - The lagoon sediments of Enewetak Atoll in the Marshall Islands contain a large selection of fallout radionuclides as a result of 43 nuclear weapon tests conducted there between 1948 and 1958. Studies of the burial of fallout radionuclides have been conducted on the islands and in several of the large craters, but studies of their vertical distribution have been limited to about the upper 20 cm of the lagoon sediments. We have found elevated fallout radionuclide concentrations buried more deeply in the lagoon sediments and evidence of burrowing into the sediment by several species of callianassid ghost shrimp (Crustacea: Thalassinidea) which has displaced highly radioactive sediment. The burrowing activities of callianassids, which are ubiquitous on the lagoon floor, facilitate radionuclide redistribution and complicate the fallout radionuclide inventory of the lagoon. PMID- 3974700 TI - Independence of the circadian rhythm in alertness from the sleep/wake cycle. AB - It is common knowledge that our feelings of alertness or drowsiness vary throughout the day. Indeed, this diurnal variation is so widely accepted that it has been used to validate the drowsy/alert component of activation obtained from mood adjective checklists. There is, however, some evidence from sleep deprivation and shiftwork studies that this variation is not simply a reflection of our sleep/wake cycle, as might be expected, but is at least partially dependent on an endogenous circadian (approximately 24 h) oscillator such as that proposed to account for the circadian rhythm in body temperature and other physiological variables. Here we have tested this suggestion by separating the body-temperature rhythm from the sleep/wake cycle by progressively shortening artificial time cues (zeitgebers). Our results indicate that the circadian rhythm in alertness can become independent of both the sleep/wake cycle and the rhythm in body temperature. Further, and contrary to our expectations, the results suggest that the sleep/wake cycle exerts less influence on the alertness rhythm than it does on that of temperature. PMID- 3974701 TI - Depletion of unilateral striatal dopamine impairs initiation of contralateral actions and not sensory attention. AB - Although Parkinson's disease has traditionally been considered as a motor disorder, there has been much recent interest in the nature and the neural substrates of parkinsonian dementia and cognitive dysfunction. These disabilities, which can induce visuospatial impairment and visual 'neglect', may also have a bearing on the controversy about the normal functions of the nigrostriatal dopamine (DA) projection and the basal ganglia. The observations that neurones in both substantia nigra and striatum respond to sensory events in terms of neuronal firing or DA release, also suggest a role for striatum in sensorimotor integration. An important behavioural correlate of this integration is the 'sensorimotor neglect' syndrome in animals with unilateral lesions of the nigrostriatal projection who fail to orient to contralateral sensory events. However, this neglect may arise not from contralateral sensory inattention, but from an inability to express this sensory selection via motor output. We present here two lines of evidence that unilateral striatal DA depletion in the rat does not affect sensory attention to visual signals of reward, but rather impairs the initiation (though not the completion) of contralateral motor acts. These results not only help to clarify the function of the nigrostriatal DA projection, but also show that depletion in this system is linked specifically to a process of response initiation, which may be the fundamental impairment in Parkinson's disease. PMID- 3974702 TI - Interferon amplifies complement activation by Burkitt's lymphoma cells. AB - Interferon was originally described as an antiviral agent produced shortly after onset of infection with most viruses. However, in addition to inducing an antiviral state, interferon inhibits cell division, increases the expression of cell-surface antigens, boosts the cytotoxic activity of natural killer (NK) cells and modulates several immune functions of lymphocytes and macrophages. Moreover, a special class of interferon (immune interferon or IFN-gamma) is produced by T cells following stimulation with antigen or interaction with mitogens. The different methods by which interferon is induced and its multiple effects suggest that it may be part of a first-line defence system controlling the spread of virus infections and the proliferation of modified 'self' cells that have been affected by virus infection or neoplastic transformation. The ability of certain human lymphoma cells to activate the alternative pathway of complement is well established. Here we show that monoclonal antibody-purified interferon can amplify the ability of certain tumour cells to activate complement via the alternative pathway. This demonstration may reflect an additional, as yet unknown, role of interferon in inducing non-specific anti-tumour immunity. PMID- 3974703 TI - Derivation of mouse intestinal crypts from single progenitor cells. AB - Adult intestinal epithelium consists of a sheet of single-cell thickness which is morphologically highly organized into tubular invaginations (crypts) and finger like projections (villi). Proliferation of the cells is confined to the base of the crypts, from which cells migrate to the villi, where they are shed. The villi are formed during embryogenesis from a multilayered epithelium. In mice, crypts develop at about the time of birth from the epithelium between the villi, which by this stage is no longer multilayered. So far it has remained unknown how many progenitor cells contribute to each crypt, and whether they develop by the proliferation of already committed progenitors, or as a result of local inductive tissue interactions. Here, we have used mouse aggregation chimaeras as an experimental system to demonstrate immunohistochemically that the epithelium of individual crypts in small and large intestine of adult mice is always composed of cells of a single parental type. We have confirmed that this result is not an artefact of the chimaeric system by examining female mice that are mosaic for the X-linked alleles Pgk-1a and Pgk-1b. We conclude that the epithelium of each adult crypt is derived from a single progenitor cell. PMID- 3974704 TI - Generation of chick skeletal muscle cells in groups of 16 from stem cells. AB - The commonly accepted hypothesis explaining the control of skeletal muscle differentiation is that all myogenic precursor cells are equivalent and that they differentiate into post-mitotic muscle cells in response to exogenous signals, specifically low mitogen concentrations. Large clones derived from vertebrate myogenic cells, however, consist both of cycling precursors and of terminally differentiated, post-mitotic muscle cells. Here, we count the total number of cells and the number of terminally differentiated cells (or nuclei, in fused cells) in large myogenic clones. The number of terminally differentiated cells per clone was usually equal to or just below a multiple of 16. This finding is not expected from a model postulating a homogeneous population of muscle precursor cells. Rather, our results suggest that a self-renewing stem cell exists in the skeletal muscle lineage. This cell can generate committed precursors which then give rise to cohorts of 16 terminally differentiated muscle cells. This model of myogenesis provides a simple explanation for the protracted and asynchronous nature of muscle differentiation in vertebrate embryogenesis. PMID- 3974705 TI - US administration's parsimony criticized. PMID- 3974707 TI - Computer modelling of the behaviour of actin gels. PMID- 3974706 TI - France seeks policy in haste. PMID- 3974708 TI - Cell-surface proteins. At last the insulin receptor. PMID- 3974709 TI - Pinning down stem-cell populations. PMID- 3974710 TI - Microtubule assembly as a phase transition. PMID- 3974711 TI - Identification of DNA sequences required for activity of the cauliflower mosaic virus 35S promoter. AB - Although promoter regions for many plant nuclear genes have been sequenced, identification of the active promoter sequence has been carried out only for the octopine synthase promoter. That analysis was of callus tissue and made use of an enzyme assay. We have analysed the effects of 5' deletions in a plant viral promoter in tobacco callus as well as in regenerated plants, including different plant tissues. We assayed the RNA transcription product which allows a more direct assessment of deletion effects. The cauliflower mosaic virus (CaMV) 35S promoter provides a model plant nuclear promoter system, as its double-strand DNA genome is transcribed by host nuclear RNA polymerase II from a CaMV minichromosome. Sequences extending to -46 were sufficient for accurate transcription initiation whereas the region between -46 and -105 increased greatly the level of transcription. The 35S promoter showed no tissue-specificity of expression. PMID- 3974712 TI - Direct evidence that reverse cholesterol transport is mediated by high-density lipoprotein in rabbit. AB - Mammalian cells obtain cholesterol for membrane synthesis mostly via the receptor mediated endocytosis of low-density lipoprotein (LDL). Macrophages and vascular endothelium additionally have receptors that recognize certain modified forms of LDL (for example, acetyl-LDL). The process by which cholesterol returns from peripheral cells to hepatocytes (reverse cholesterol transport) has not been established; although tissue culture studies have favoured high-density lipoprotein (HDL) as the principal vehicle, the in vivo evidence for this is meagre. When cholesterol-loaded macrophages are incubated in medium containing plasma, cholesterol moves from the cells to HDL and is then esterified by lecithin/cholesterol acyltransferase. The accumulation of cholesteryl esters in the particles increases their size and decreases their density; enrichment with apoprotein E (apo E) also occurs, producing a decrease in electrophoretic mobility. We now report that similar changes occur in the circulating HDL of rabbits, when their peripheral tissues are loaded with cholesterol by intravenous (i.v.) injection of acetylated or native human LDL. This result suggests that HDL is involved in reverse cholesterol transport in vivo. PMID- 3974713 TI - An appeal to embryologists. PMID- 3974714 TI - Lysosomes and prohormone activation. PMID- 3974715 TI - British AIDS. New cases cause alarm. PMID- 3974716 TI - Status of IVF embryos. PMID- 3974717 TI - Unborn children (protection) bill. PMID- 3974718 TI - Diverged genetic codes in protozoans and a bacterium. PMID- 3974719 TI - Histidine-rich protein of Plasmodium lophurae. PMID- 3974720 TI - Firing patterns of motor units in normal rats. AB - Skeletal muscles consist of motor units which may differ considerably in contractile properties and types of usage. Some units participate mainly in relatively rare, quick movements and contract rapidly and are easily fatigued (type FF); others contribute to the maintenance of posture and hence contract slowly and are fatigue-resistant (type S), while others are both fast and fatigue resistant (type FR). Our understanding of motor control mechanisms and the dependence of contractile properties on usage would be enhanced if more quantitative information were available concerning the firing patterns of individual motor units during normal motor behaviour. Therefore, we have made continuous recordings for extended periods from single motor units in the fast extensor digitorum longus (edl) and the slow soleus (sol) muscle of freely moving adult rats. By counting the total number of discharges for each unit, and by determining the distributions of interspike intervals and the duration of the individual impulse trains, we have obtained information about firing rate, amount of use, modulation of muscle force and tonic and phasic behaviour for 16 motor units. We now report that these units fall into three classes apparently corresponding to type FF and FR in the edl muscle and type S in the soleus muscle. PMID- 3974721 TI - Does Paramecium primaurelia use a different genetic code in its macronucleus? AB - It has long been known that messenger RNAs (mRNAs) of ciliates and in particular of Paramecium are not translated well in heterologous in vitro translation systems. Recently, we have demonstrated for Paramecium primaurelia that this phenomenon results from the presence of well-defined blocking sites in the coding sequences of almost all mRNAs, and that these sites are an intrinsic feature of the primary as opposed to the secondary structure of the mRNAs. Here we show that both the gene and the mRNA for the G surface antigen of P. primaurelia contain numerous TAA and TAG codons scattered throughout their coding sequences. We propose that these codons do not represent termination codons in P. primaurelia but instead code for glutamic acid or glutamine and that the in vitro translation of Paramecium mRNAs is blocked by their presence. PMID- 3974722 TI - Deviation from the universal code shown by the gene for surface protein 51A in Paramecium. AB - The immobilization antigens (i-antigens) of Paramecium, large polypeptides of relative molecular mass approximately 300,000, are located on the cell surface. Each i-antigen is encoded by a different unlinked gene, and no more than one gene is expressed at a time. The proteins and the mRNAs and genes encoding them are readily isolated. Here we report the nucleotide sequence of three regions of the A i-antigen gene from stock 51 of Paramecium tetraurelia. Surprisingly, all reading frames contain TAA and TAG stop codons, even though there is evidence that one reading frame of these sequences codes for the i-antigen. We suggest that in Paramecium UAA and UAG code for amino acids, instead of serving as translational stops as they do in all other organisms. PMID- 3974723 TI - A bacterial repressor protein or a yeast transcriptional terminator can block upstream activation of a yeast gene. PMID- 3974724 TI - Unusual circulatory patterns in experimental neoplasms. PMID- 3974725 TI - Chemotherapy of tumours after synchronisation by induced hyperglycemia. PMID- 3974726 TI - [The final consultation]. PMID- 3974727 TI - [Scintigraphic possibilities for the localization of pheochromocytomas and parathyroid adenomas]. PMID- 3974728 TI - [Sensitization to Pix liquida (wood tar): a persistent problem]. PMID- 3974729 TI - [Hereditary lymphedema, a frequently unrecognized form of chronic edema; clinical study in 2 families with Meige's disease]. PMID- 3974730 TI - [Episodic psychoses, porphyria and amino acid metabolism]. PMID- 3974731 TI - [Acute intermittent porphyria with clinical symptoms of an atypical polyradiculoneuropathy]. PMID- 3974732 TI - [Health care institutions with a profit goal]. PMID- 3974733 TI - [Visit of an old friend, paranoid psychosis in chronic bromide poisoning]. PMID- 3974734 TI - [Obesity and the status of its knowledge]. PMID- 3974735 TI - [Toxicosis revisited]. PMID- 3974736 TI - [Hypertension in pregnancy]. PMID- 3974737 TI - [Disulfiram treatment of alcoholism]. PMID- 3974738 TI - [Computers in the hospital laboratory]. PMID- 3974739 TI - [Comparative clinical study of pyogenic granuloma and amelanotic melanoma of the skin]. PMID- 3974740 TI - [Cardiac arrhythmias in Guillain-Barre-Strohl syndrome]. PMID- 3974742 TI - [Knee symptoms in children]. PMID- 3974741 TI - [No beta blockers without a COPD anamnesis]. PMID- 3974743 TI - [Hepatitis B immunization in Dutch hospitals]. PMID- 3974744 TI - [Exercise-induced asthma]. PMID- 3974745 TI - [The family practitioner with a computer, a good business?]. PMID- 3974746 TI - Trends in cesarean section rates in Nebraska, 1979 through 1982. PMID- 3974747 TI - Familial and environmental factors involved in inflammatory bowel disease in rural Nebraska. PMID- 3974748 TI - Fibular head dislocation--another differential in the diagnosis of knee injury. PMID- 3974749 TI - The role of computed tomography in blunt trauma. PMID- 3974750 TI - Uvulopalatopharyngoplasty: a surgical procedure for obstructive sleep apnea and social snoring problems. PMID- 3974751 TI - [Direct connections between the hippocampus and the retrosplenial cortex in the rat]. AB - The connections of the retrosplenial field of the limbic cortex and hippocampal formation in the rat were studied by the horseradish peroxidase method. After dry horseradish peroxidase application into dorsocaudal part of the retrosplenial cortex labelled cells were found in the rostral pole of the hippocampal field Ca3 and in the presubiculum. After ionophoretic injection of HRP into the rostral pole of the hippocamp labelled cells were found in the layers V and VI of the retrosplenial field of the limbic cortex and in the prosubiculum. The data obtained show reciprocal direct connections between the rostral pole of the hippocamp and retrosplenial field of the limbic cortex, as well as direct efferent projections of the dorsal subiculum to the rostral pole of the hippocamp. PMID- 3974752 TI - [Formation of "caudate spindles" in the sensomotor cortex of the rabbit during ontogeny]. AB - The electrical activity elicited by electrical stimulation of the caudate nucleus in the sensorimotor and visual cortex was recorded in adult and 3-60-days old rabbits. It was shown that single stimuli applied to the caudate nucleus evoked bursts of synchronized rhythmical cortical waves similar in appearance to the so called "caudate spindles" described in cats and monkeys. The latency of the "caudate spindles" in adult rabbit was about 200 ms, the duration--1-3 s and the frequency--11-3 c/s. The most prominent area for obtaining "caudate spindles" was the ipsilateral sensorimotor cortex. In spite of repeated efforts we have never recorded "caudate spindles" in rabbits of the youngest group. Beginning from the 15th postnatal day caudate stimulation induced bursts of rhythmical activity in the sensorimotor cortex which was similar to "caudate spindle", but with lower frequency (about 8 c/s), longer latency (350 ms) and high threshold. The definite type of spindles appears by the end of the first month of life, in the period of complication of conditioned reflexes. PMID- 3974753 TI - [Depolarization of primary afferents of the lumbosacral division of the spinal cord during real locomotion]. AB - Changes of polarization of central afferent terminals during evoked locomotion of mesencephalic cats were studied in lumbar spinal cord. Significant part of primary afferent depolarization was shown to be evoked by afferent impulsation; intensity of such impulsation increased during limb flexion and decreased during extension. PMID- 3974754 TI - [Depolarization of primary afferents during real scratching in the cat]. AB - Changes in depolarization of primary afferents and their correlation with afferent impulsation and limb movement were studied in the lumbar spinal cord during real scratching of decerebrated cats. Two components in rhythmic dorsal root potential were observed. First--centrally evoked, retained during fictitive scratching after immobilization; second--evoked by afferent discharge, coming to the spinal cord during the scratching phase of the limb movement. PMID- 3974755 TI - [Low-threshold area of action potential generation in the somatic membrane of mollusk neurons]. AB - The excitability of somatic membrane of Helix lucorum neurons was studied by means of extracellular electric current of various direction (frequency 0.1 Hz). Inhomogenous excitability of somatic membrane was shown and the existence of the local low-threshold area of spike generation in the soma was demonstrated. PMID- 3974756 TI - [Variability of cortical evoked potentials in response to tooth pulp stimulation in the freely moving rat]. AB - Evoked potentials (EP) due to the stimulation of the upper incisor tooth pulp were recorded from the somatosensory cortex of the freely moving adult rats. Background EEG, motor activity of an animal and respiratory potentials of the olfactory bulb were recorded simultaneously. EP configurations and mean amplitudes of primary complex (P1 + N1) differed significantly during states of sleep, drowsiness, relaxed wakefulness, grooming and exploratory behaviour; primary complex amplitude during intensive motor activities was several times less than during periods without movements. Negative correlation of the EP amplitude and instant respiration rate was found during relaxed wakefulness: it was less pronounced during periods with motor activities. At the same time direct parallelism between changes in EP and respiration rate was absent: the EP depression was maximal during grooming, while the respiration rate was minimal during exploratory behaviour. PMID- 3974757 TI - ["Timers" and "scanners" among orientation detectors of the visual cortex in the cat]. AB - Acute experiments on immobilized cats were carried out to check the suggestion that a special class of neurons ("timers") which do not change time properties of responses with variations in light bar orientation exists in the visual cortex. Previously neurons of the visual cortex with a dynamic shift of preferable orientation ("scanners") were revealed. Among 76 neurons 27 (36%) showed different properties: stability of latencies in the orientation range, shorter initial and peak latencies, duration and time of the discharge frequency increase, wider orientational tuning and worse relations between magnitudes of responses to preferred and nonpreferred stimuli. They were considered as representatives of the suggested "timers". PMID- 3974758 TI - [Study of the afferent connections of the visual area of the lower bank of the cruciate sulcus of the cerebral cortex of the cat using the retrograde horseradish peroxidase axon transport technic]. AB - The possible visual inputs to the new visual area found in our experiments in the lower bank of cruciate sulcus of the cat cortex were studied with horseradish peroxidase technique. HRP was injected in the place preliminary identified as the visual area in physiological experiments with the same cats. Labelled neurons were found in the visual areas of the cortex (lateral suprasylvian and ectosylvian), in the parietal cortex (area 5 and 7) and in a small amount in the prefrontal and limbic cortex. In all experiments labelled neurons were found in the claustrum. In the thalamus labelled neurons were found in the nucleus medialis dorsalis, intralaminar nuclei (contralis lateralis, paracentralis and centralis medialis) and in the nuclei ventralis anterior, ventralis medialis, anteromedialis and reuniens. Some stained neurons were found in the midbrain in the stratum griseum centrale; the conclusion was made that the main sources of inputs to the studied area were different regions of the visual system or the structures of the brain closely connected with the latter. PMID- 3974759 TI - [Long-term reorganization of the neuronal activity in field 7 of the neocortex in the cat after unilateral section of the visual radiation]. AB - Changes in functional characteristics of area 7 cells were studied in cats under semichronic experimental conditions. The experiments were done in various periods of time after unilateral dissection of visual subcortic-cortical fibres. Neuronal responses to visual, auditory, somatic stimuli and electrical stimulation of primary cortical areas were studied in intact and impaired hemispheres. Reappearing of neuronal sensitivity to stimuli of various sensory modalities was found in the partially isolated neocortex. Both the number of cells with local visual receptive fields and averaged receptive field size of the cells increased slowly after the operation. Some suggestions about the nature of plastic changes developing in neuronal nets of the parietal cortex after impairment of subcortico cortical connections are made. PMID- 3974760 TI - [Spectral sensitivity of the visual cells of the complex eye of Blatta orientalis]. AB - Intracellular recordings were made from single photoreceptors of the frontal part in the compound eye of the cockroach Blatta orientalis. Two spectral types of cells were revealed: UV-receptors with lambda max = 361 +/- 8 nm and green receptors with lambda max = 503 +/- 12 nm. Spectral curve of the whole eye measured by ERG had two peaks (at lambda = 350-370 and 500 nm) and minimum in the range of 400-430 nm. The finding has been interpreted as an additional evidence for dichromatic vision of the cockroach. PMID- 3974762 TI - [Antidromic action potentials in the spinal cord motor neurons of the chick embryo]. AB - Antidromic action potentials of chick embryonic hindlimb motoneurons were studied intracellularly in the isolated perfused spinal cord during the second half of the incubation period. Although the microelectrode penetration produced damage of most of cells, some of them could restore their conditions. The amplitude and time-to-peak of action potentials and the presence of components reflecting activation of the initial axon segment and somadendritic membrane as well as values of resting potentials did not show any age dependence in these cells from the 11th to 18th day of the embryonic development and were similar to those in adult birds and mammals while impulse conduction velocities of motor axons increased from 0.3-0.5 m/s in 10-day embryos to 2-4 m/s in 18-day embryos. These results do not support the hypothesis based on the study of newborn mammalian neurons in situ, which points to rather late postnatal maturation of action potential mechanisms. The early onset and maturation of action potentials in the chick embryonic motoneurons is in agreement both with the phylogenetic anciency of this mechanism and with the recent studies performed on different isolated preparations of developing CNS of warm-blooded animals. PMID- 3974763 TI - [Comparative analysis of possible ways of activating depolarizing neurons in the system of flexor reflex afferents]. AB - Two schemes of activation of depolarizing neurons at the level of the first synaptic relay in the polysynaptic reflex arc were compared on an electronic model. It is shown that in the system without a feedback a long delay in the transition process of dorsal surface potentials must be observed during rhythmic stimulation of the afferent input. A decrease in the amplitude-frequency characteristics in this system must be observed as well. These findings contradict to neurophysiological data about changes in the N1-cord dorsum potential. The conclusion is made that a more acceptable scheme of activation of depolarizing neurons is the one with a negative feedback circuit formed by C interneurons. PMID- 3974761 TI - [Activity of septal and hippocampal neurons during isolated and combined growth in the anterior chamber of the eye in the rat]. AB - Neuronal activity of the septal and hippocampal grafts, developing in the anterior eye chamber of the rat for 3-6 months was recorded extracellularly in curarized or cerveau isole animals. While the units of isolated septum had background activity of regular, irregular and rhythmic burst type, the hippocampal units displayed no background discharges or produced very low frequency population spikes. In the paired septal-hippocampal grafts neurons of the hippocampus possessed the same types of activity, as that of the septum. Spontaneous epileptiform phenomena were observed in many paired grafts; such phenomena were easily provoked by mild electrical stimulation of one of the grafts. Superfusion with low Ca2+, high Mg2+ medium abolished spontaneous activity in most of hippocampal units but not in septal units. Epileptic discharges were also partly suppressed. PMID- 3974764 TI - [Analysis of the spike activity of the neuronal population of the motor cortex in the cat during a postural change conditioned reflex]. AB - In experiments on untrained and trained cats the impulse activity of cortical neurons (area 4) was studied in response to long (1s) acoustic stimulus (conditioned stimulus for trained animals) and to a fall of the platform under the studied limb (unconditioned stimulus). Only those neurons were studied which responded to the appearance of passive movement after the fall of the platform. In trained animals the number of neurons responding to conditioned stimuli in case of realization of the reflex was 100% and in the absence of conditioned movements--70%. This largely exceeded the number of neurons responding to the same sound in untrained animals (45%). In peristimulus histograms of neuronal reactions of the studied population in untrained and trained animals (in the absence of conditioned movements) only the initial impulse response was clearly seen with the latency less than 50 ms and duration up to 100 ms. In the presence of conditioned movements the impulse response consisted of many components: initial response, early and late after-responses. The early after-responses with latency of 100-150 ms and duration of 100-200 ms were associated with the start of the conditioned stimulus, and the pattern and duration of the late after responses was determined by the appearance of the conditioned movements. It is established that the value of neuronal response to reinforcement in trained animals does not depend on the appearance of the conditioned movement. PMID- 3974765 TI - [Structure of psychiatric services, exemplified by inpatient care in the area of Munster]. PMID- 3974766 TI - [Relation between degrees of vigilance and amnesia in the so-called clouded consciousness]. PMID- 3974767 TI - [Poisoning psychoses following suicide attempts with diphenhydramine]. PMID- 3974768 TI - Duodenogastric reflux quantification and the outcome of Roux-en-Y surgery in postgastrectomy gastritis. PMID- 3974769 TI - Diabetes prevalence in the three main ethnic groups in Surinam (South-America): a population survey. PMID- 3974770 TI - Reversible atrioventricular block due to Wegener's granulomatosis. PMID- 3974771 TI - Hypercalcaemic osteomalacia and encephalopathy due to aluminium intoxication in haemodialysis patients. Clinical aspects and treatment with desferrioxamine. PMID- 3974772 TI - Vitamin C intoxication and hyperoxalemia in chronic hemodialysis patients. AB - We studied vitamin C levels in 25 stable patients on chronic hemodialysis who were taking 0.5-1 g vitamin C orally daily and/or dialyzed against dialysate containing 33.3 micrograms/ml of vitamin C. We also studied the relationship between serum vitamin C and oxalate levels in 7 patients on chronic hemodialysis. All patients had markedly elevated pre- and postdialysis levels of vitamin C. The predialysis levels of vitamin C showed extremely good correlation to the serum oxalate levels. Overingestion of vitamin C in food or as supplementation may lead to excessive serum levels of vitamin C, resulting in hyperoxalemia that may contribute to vascular disease in patients on chronic hemodialysis. PMID- 3974773 TI - Tubular function disturbances in chronic glomerulonephritis and their significance for identifying tubulointerstitial lesions. AB - The tubular and tubulointerstitial renal functions of 237 patients with chronic glomerulonephritis and functional compensation corresponding to their plasma creatinine levels were investigated and the results were compared with the light microscopic findings obtained by examination of kidney interstices obtained by biopsy. Pronounced structural interstitial lesions (TiC) were found in 30% of the cases. Investigation of the predictive values of tubular function data in respect of the presence or exclusion of TiC showed that, although individual parameters of the renal function permit the exclusion of TiC disturbances with a high degree of certainty, the diagnostic value can be enhanced by considering pairs of such parameters. Five parameter combinations were found to have the highest predictive value regarding the diagnosis of TiC. These were disturbed concentration capacity accompanied by reduced ammonia excretion or total acid excretion, reduced water diuresis accompanied by disturbed ammonia excretion or total acid elimination; and, finally, the total acid excretion and maximum dilution capacity. The highest predictive values for the exclusion of TiC are shown by inconspicuous concentration capacity accompanied by normal ammonia excretion, total acid excretion, water diuresis, free water clearance or urine dilution capacity. PMID- 3974774 TI - Studies of bone morphology, bone densitometry and laboratory data in patients on maintenance hemodialysis treatment. AB - Bone morphological parameters of renal osteodystrophy such as abundance of osteoid surface, osteoid seam width index, calcification fronts, osteoclast activity and trabecular bone volume were studied in 71 patients on maintenance hemodialysis and compared with bone densitometry, laboratory and clinical data. Increased osteoclast activity (hyperparathyroidism) was by far the most common bone morphological finding. Patients with chronic pyelonephritis or polycystic kidney disease had more than double the amount of osteoid than patients with chronic glomerulonephritis. The trabecular bone volume seemed to be increased in most patients in contrast to the cortical bone volume which was decreased, judged from bone densitometry and previously from X-ray. Despite that patients with polycystic kidney disease were older, their trabecular volume was larger than in patients with glomerulonephritis. The bone mineral content evaluated by bone densitometry was low in most patients, and more associated with bone morphological signs of osteomalacia than with secondary hyperparathyroidism. Serum phosphate (S-PO4) and serum parathyroid hormone (S-PTH) seemed to discriminate better between osteomalacia and secondary hyperparathyroidism than serum alkaline phosphatase (S-Alk. phosph.), which was elevated in both groups. Patients who had been bilaterally nephrectomized were no more abnormal than other patients, and they had lower S-Alk. phosph. The abundance of osteoclasts was found to be a predictor of future development of clinical secondary hyperparathyroidism. PMID- 3974775 TI - Temperature and vascular stability in hemodialysis. AB - The temperature of the blood returning from an extracorporeal circuit may influence the vascular stability. Mean arterial blood pressure, heart rate and the temperature in the in-and outlet lines for blood and dialysis fluid of the dialyzer (TBa, TBv, TDi and TDo) were continuously measured in 8 patients suffering from vascular instability during standard dialysis. The TBv was adjusted to 37, 36 and 35 degrees C at the start of dialysis by manipulating TDi. The patients were studied two times at each temperature level during a 4-hour dialysis. At the start of dialysis TBa was 35.7 +/- 0.3 degrees C. The patient's mean arterial blood pressure and heart rate decreased and increased, respectively, continuously during TBv 37 and 36 degrees C experiments, but were fairly stable at an TBv of 35 degrees C. The standard TDi of 37 degrees C should be abandoned for a temperature which is similar to TBa (35.7 degrees C) to avoid the vascular effects of heating or cooling the blood in the extracorporeal system. PMID- 3974776 TI - Nonfamilial polycystic kidneys without enlargement. AB - 7 middle-aged males with bilateral, polycystic, nonfamilial kidneys without enlargement are described. The histological examination revealed multiple cysts of varying sizes and changes such as in interstitial nephritis. 6 of the patients had hematuria and/or calculi in the urinary tract. The etiology of the cysts is not clear. The picture does not conform to that of congenital cystic kidney. The cysts might possibly be a final phenomenon in contracted kidneys, so-called acquired cystic disease, but it should be noted that in 4 of the 7 cases the cystic degeneration was demonstrated log before the uremia appeared. Another possibility is that the cystic transformation described here might be attributed to a specific type of interstitial nephritis. PMID- 3974777 TI - On drug artifacts in middle molecule analysis. AB - In a retrospective study of 58 nondialyzed uremic patients, artifacts originating from furosemide, methyldopa, hydralazine, allopurinol and beta-blocking agents on determination of plasma middle molecules could not be substantiated. Furosemide administration did not have any influence on middle molecule determination in hemodialysis patients. The salicyclic acid administration in normal subjects resulted in increased urinary excretion of fraction 7c; the role of salicylic acid needs to be further investigated. PMID- 3974778 TI - Tubular dysfunctions in the diagnostic differentiation of glomerulonephritis, pyelonephritis, and diabetic nephropathy. AB - Concentration and acidification capability was tested in 41 patients with chronic pyelonephritis (PN), 14 patients with chronic glomerulonephritis (GN), 16 patients with diabetic nephropathy (DNP) and 12 healthy controls. Significant differences appeared between PN and GN, PN and DNP comparing a quotient between percent of normal osmolarity and percent of normal creatinine clearance. Similar results were obtained using a quotient creatinine clearance/ammonia excretion, which enabled the differentiation of PN from the other groups. The tubular functions of concentration and ammonia excretion in relation to creatinine are clinically useful in the differentiation of pyelonephritis from glomerular kidney diseases. PMID- 3974779 TI - Morphological transition in minimal change nephrotic syndrome. PMID- 3974780 TI - Mechanisms of hypouricemia in the syndrome of inappropriate secretion of antidiuretic hormone. AB - Hypouricemia seen with hyponatremia related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) results from an increase in uric acid renal clearance. We studied the mechanism of the increase of uric acid excretion in 6 SIADH patients through pyrazinamide (PZA), which decreases tubular secretion of uric acid, and sulfinpyrazone (SPZ) which decreases post-secretory reabsorption of uric acid. 3 g of PZA decreased the absolute uric acid excretion from 428 +/- 244 to 105 +/- 47 micrograms/min (mean +/- SD, p less than 0.01), and 300 mg of SPZ increased the uric acid to creatinine clearance ratio from 0.31 +/- 0.05 to 0.52 +/- 0.05 mg/dl glomerular filtration rate (mean +/- SEM, p less than 0.001), which represent an increment about half of that observed in the control group. The increase of uric acid clearance in SIADH seems to result from a decrease in the post-secretory reabsorption of uric acid. After SPZ, we saw a decrease of natriuresis from 5.6 +/- 1.4 to 1.8 +/- 0.3 mmol/h (p less than 0.001), without any change of urinary flow or urinary potassium excretion. PMID- 3974781 TI - Effect of hemodialysis on plasma and erythrocyte phenylalanine levels in end stage kidney patients. AB - Effect of hemodialysis on phenylalanine distribution between the intracellular water of erythrocytes and the plasma obtained from patients with end-stage kidney was studied by fluorimetric measurements of phenylalanine concentration according to the method of Mc Caman and Robins. The measurements were performed twice: before and after 4 h of hemodialysis. It was found that the nondialyzed patients with end-stage kidney had higher than normal phenylalanine concentrations both in plasma and in the intracellular water of erythrocytes. Hemodialysis brought about a decrease in plasma phenylalanine level without influencing the erythrocyte concentration of the studied amino acid and without altering the function of the erythrocyte cell membrane, as far as the phenylalanine transport was concerned. PMID- 3974782 TI - Renal retinal dysplasia with diffuse glomerular cysts. AB - A 32-year-old male with renal retinal dysplasia is presented. He also showed hearing loss and growth retardation. Laboratory data showed mild proteinuria, renal dysfunction and type-1 renal tubular acidosis. Computed tomography showed multiple cysts at the corticomedullary junction of both kidneys. Ocular examinations disclosed retinitis pigmentosa. On light microscopy of renal biopsy specimens, diffuse cystic dilatation of Bowman's space as well as dilated tubules with interstitial fibrosis and cellular infiltration were noted. Electron microscopy revealed a peculiar chromatin condensation of epithelial cell nuclei in Bowman's capsules, glomeruli and tubules. The association of renal retinal dysplasia with diffuse glomerular cysts has not, to our knowledge, been previously reported. PMID- 3974783 TI - Experimental studies on the hemolytic-uremic syndrome. AB - Ultrastructural studies of blood cells during the acute stage of the hemolytic uremic syndrome (HUS) revealed striking, but transient, changes in erythrocyte structure. These included membrane disruption, vacuolar degeneration, and Heinz body formation. There was also evidence of platelet injury, and there were peculiar tactile interactions between histiocytes and impaired red cells. These changes disappeared as the patients recovered. These changes were considered to be important in the pathogenesis of the hemolytic and thrombolytic features of HUS, and studies were directed at reproducing them in vitro and in vivo. Treatment of red cells with purified clostridial phospholipase C induced changes in red cells and platelets that were comparable to those encountered in HUS. Rats infused with phospholipase C developed hemolysis, thrombocytopenia, and hemoglobinuria. Their kidneys did not, however, reveal glomerular alterations similar to those seen in patients with HUS. It is proposed that HUS in some cases might be initiated by a nonspecific infectious injury to the intestinal mucosa thereby allowing increased absorption of toxins derived from indigenous gut flora and that these toxins could be responsible for the hemolysis, thrombolysis, and even the renal injury. PMID- 3974785 TI - Renotropic stimulation of DNA synthesis of proximal tubules and endothelial cells in the outer medulla. AB - We explored the effects of ovine pituitary-derived renotropin on renal DNA synthesis in castrated hypophysectomized mice. Administration of the preparation at a dose of 47 micrograms for 5 days was followed by significant increases in renal DNA (134% of controls), and in kidney dry weight, protein and RNA. A time course study showed that [3H]-thymidine incorporation into renal DNA peaked at 8 10 h after one injection (60 micrograms) 1.9 times higher than in controls. Autoradiographic studies indicated that labeling indices increased significantly in proximal tubules (17 times) and endothelial cells (4 times) in the outer renal medulla of treated mice compared to controls. Nuclear areas in these cells also increased significantly. Our studies demonstrated a time course of new DNA synthesis stimulated by a renotropin and identified renotropin target cells. PMID- 3974784 TI - Changes in glomerular basement membrane collagen caused by DOCA-NaCl treatment in rats. AB - The influence of hypertensive regime on collagen synthesis in glomerular basement membranes of rats was studied. Isolated glomeruli were incubated in a medium containing 14C-labeled proline. It was demonstrated that there was a higher proline incorporation and proline conversion to hydroxyproline in rats kept on the hypertensive regime. However, solubilization of the collagenous fraction by limited pepsin digestion did not reveal any qualitative changes in the collagen type deposited. It is concluded that the DOCA-NaCl treatment in rats results in an intensive accumulation of collagen, mainly of type IV, typical for basement membranes. PMID- 3974787 TI - Angioimmunoblastic lymphadenopathy and transient Fanconi syndrome. AB - A case of angioimmunoblastic lymphadenopathy (AIL) is presented in which the transient presence of a Fanconi syndrome was detected. Both the AIL and the Fanconi syndrome were ameliorated after steroid therapy. PMID- 3974786 TI - Monocyte escape through a glomerular capillary basement membrane gap. An ultrastructural observation in a case of acute glomerulonephritis. AB - A focal discontinuity of glomerular basement membrane (GBM) with extravasation of a monocyte is described in a case of acute postinfectious glomerulonephritis in a 2-year-old girl. It is proposed that also monocytes could play a role in causing disruption of glomerular capillary wall. Moreover, this finding gives morphologic support to the hypothesis that monocyte-forming crescents reach the urinary space through GBM gaps. PMID- 3974788 TI - [Course of the abducens nerve before the exit zone from the central nervous system to the lateral rectus muscle]. AB - The intracisternal, intrasinusoidal and intraorbital course of the sixth nerve is described, including the relative position in respect of the arachnoid membrane and the cerebral arteries. In addition, the relationships of the nerve in relation to possible injuries is considered. PMID- 3974789 TI - [Prognostic significance of perivascular round cell infiltrations in oligodendroglioma]. AB - In 175 cases of oligodendroglioma (all grades, partly operated on several times), histological sections of the surgical material--in all, 226 preparations--were examined with regard to the presence and extent of lymphocytic infiltrates which could be assessed as manifestation of an immune reaction, and correlated with the clinical course. In case of infiltrates, the course was not more favourable than expected. Development of a tumour depends first of all on the inherent dynamics of the tumour itself. Prognosis can be favourably influenced by operation and possibly also by radiation. PMID- 3974790 TI - Exacerbation of brain abscess during exclusive treatment with steroids, demonstrated by computerised tomography. AB - A case of acute brain abscess in a 59-year-old man is presented. The primary CT findings were misinterpreted as a brain infarct or possibly a tumour. Under steroid therapy an activation of the brain abscess was observed in only nine days and in spite of an immediate operation the patient died. PMID- 3974791 TI - [Spontaneous healing of a cavernous carotid sinus fistula caused by a gun shot injury]. AB - We report about a 22-year-old male with a carotid cavernous fistula after gunshot injury. A few weeks later the fistula turned into an intracavernous aneurysm of the internal carotid artery. After four years the aneurysm was no longer demonstrable; the ipsilateral internal carotid artery was spontaneously obliterated. According to the literature a carotid cavernous fistula is found in 0.4% to 1.7% of all cases with head trauma. Its spontaneous cure is a rare occurrence. PMID- 3974792 TI - Mucocele of the sphenoidal sinus. AB - Mucocele of the sphenoidal sinus is a rare lesion often mistaken for a pituitary tumour. A case first misdiagnosed as pituitary tumour is described. Additional radiography including CT findings led to the correct diagnosis. The treatment of sphenoidal mucoceles is surgical. The sublabial trans-septal route has proved to be an excellent approach. PMID- 3974793 TI - Reinnervation after microsurgical repair of transected cauda equina fibres. An electromyographic study. AB - Ventral nerve roots of the lumbar area in seven pigs were transected intradurally and resutured microsurgically immediately after transection. Four to seven months after repair electromyography was done via intradural electric stimulation of the resutured roots. Reinnervation was found. Patterns were compared with data from intact animals. PMID- 3974794 TI - [Thromboembolism complications in ventriculo-atrial drainage of cerebrospinal fluid in childhood]. AB - This report wants to call attention to the possible risks of thromboembolic complications of ventriculo-atrial shunts (Spitz-Holter valve). Among 126 children with ventriculo-atrial shunt we found four patients with severe thromboembolic complications. Two children died. The diagnostic and therapeutic possibilities are mentioned. Prophylaxis (prevention of infection, anticoagulation therapy and frequent followup investigation) is discussed; especially echocardiography is very useful for the early discovery of thrombotic deposits on the atrial catheter. PMID- 3974795 TI - Adrenal steroid modulation of vasoactive intestinal peptide effect on serotonin1 binding sites in the rat brain shown by in vitro quantitative autoradiography. AB - In the present work we demonstrate by means of quantitative in vitro autoradiography that the vasoactive intestinal peptide (VIP) is able to increase the number of serotonin1 (5-HT1) binding sites in the dorsal subiculum of the rat hippocampus and to decrease them in the suprachiasmatic nucleus (SCN). Bilateral adrenalectomy (ADX) for 6 days counteracted the stimulatory effect of VIP on 5 HT1 binding sites in the dorsal subiculum, but did not modify the inhibitory effect of the peptide in the SCN. Moreover, ADX increased 5-HT1 binding sites in response to VIP in various subfields of the hippocampus as well as in the superior colliculus and in the dorsal lateral septum, but this effect was not observed in normal or in ADX rats bearing a corticosterone implant. The present data are suggestive of a possible interaction between VIP and 5-HT in the regulation of the SCN and of a modulatory role of adrenal steroids in VIP activity in the hippocampal formation. PMID- 3974796 TI - Relation of gonadal hormones to differential LH response to naloxone in prepubertal male and female rats. AB - Naloxone (NAL) has been shown to induce LH release in female but not in male rats 10-25 days of age. The purpose of this study was to examine the role of neonatal gonadal hormones on NAL-induced LH release in male and female rats 15, 25, and 35 days of age. On each of these days rats received a s.c. injection of either NAL (5 mg/kg) or physiological saline, and blood was collected 30 min later by decapitation. At 15 days of age, NAL induced LH release in intact and ovariectomized (OVX) female rats, and in male rats castrated (CAST) on the 1st day of life (neonate CAST males). Injection of 10 micrograms estradiol benzoate (EB) 24 h prior to NAL administration blocked NAL-induced LH release in these rats. NAL had no effect on LH release in 15- or 25-day-old intact and CAST male rats or in female rats given 2 mg testosterone propionate at 3 days of age (androgenized female rats). At 35 days of age, NAL induced LH release in intact, OVX, and OVX-EB treated female rats, and in neonate CAST and neonate CAST-EB treated male rats. NAL had no effect on serum LH levels in androgenized female rats. NAL induced LH release in intact and CAST 35-day-old male rats, but pretreatment with estrogen prevented NAL from eliciting LH release. These results indicate that neonatal exposure to androgen is responsible for the sex difference in the LH response to NAL observed in prepubertal male and female rats before 30 days of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3974797 TI - Theophylline affects sleep-wake state development in premature infants. AB - This study investigated the prolonged effects on state behavior of theophylline administered to infants for apnea of prematurity. There were three groups: Four premature infants who had received theophylline in the preterm period, five premature infants who had not received theophylline, and twenty-eight normal fullterm infants. The Theophylline infants had been off the drug for at least one month prior to the beginning of the study. Sleep-wake states were observed in the home for seven-hour periods when all infants were the same corrected ages: two, three, four and five weeks post-term. Data from the portion of the day that the infants were alone were analysed for this study. The state organization of the Theophylline group differed significantly from those of the other groups. They exhibited more non-alert waking activity, more alert, more drowse or transition, and less active sleep than did the Non-Theophylline and Fullterm infants. The state distributions of the latter two groups did not differ. On the basis of similarities between the results of this study and of a previous animal study, it was concluded that theophylline altered the normal development of state organization in premature infants. These effects persisted long after the drug had cleared the body. PMID- 3974798 TI - Chronic hypoventilation and development of brain stem gliosis. AB - Chronic hypoventilation is important in the pathogenesis of congenital hypoventilation syndromes and sudden infant death syndrome. Cases of hypoventilation can be divided clinically into those with a defective respiratory drive and those with mechanical impairment of either the lungs or the chest wall. To determine the relationship between chronic hypoventilation and brain stem gliosis, the development of astrocytes in the brain stem of normal and abnormal cases with either type of chronic hypoventilation was studied morphometrically. The glial fibrillary acidic protein immunoperoxidase method of staining astrocytes showed a transient increase of astrocytes in some parts of the brain stem during early infancy in thirty-five normal cases. The astrocytosis was even greater in both types of chronic hypoventilation including subjects with myopathy, Ondine's curse, and sudden infant death syndrome. Gliosis in these subjects may have resulted from "asphyxia" of the brain stem, as seen in cases with myopathies involving respiratory muscles. However, the involvement of brain stem respiratory centers may suggest a failure of neural respiratory control that further compromises respiratory function. PMID- 3974799 TI - Infantile myasthenia. AB - A review of twelve Southern Chinese children whose myasthenic symptoms started within the first two years of life and followed up for one to sixteen years showed that, unlike some previous reports on non-Chinese children, the majority had only ocular myasthenia. Response to pyridostigmine was satisfactory and spontaneous remissions were frequent. Although more boys than girls were affected, familial myasthenia occurred in none. Serum acetylcholine receptor antibodies were not elevated in the majority. An association with HLA A11 and BW 46 needs further confirmation. PMID- 3974801 TI - Ophthalmoplegic neurolipidosis--storage cells in heterocygotes. AB - We describe two children with ophthalmoplegic neurolipidosis. Bone marrow specimens of the patients and their healthy relatives disclose typical storage cells. The literature is reviewed. The storage cells in healthy relatives are interpreted as a sign of heterocygosity. PMID- 3974800 TI - Cerebrovascular occlusive disease with and without the moyamoya vascular network in children. AB - Clinical features of cerebrovascular occlusive disease with the moyamoya network (group 1: twenty-nine children) and those without this network (group 2: nine children) are reported herein. Group 1 was characterized by female preponderance, recurrent and transient ischemic attacks, progression of mental deterioration, rebuild-up after hyperventilation on EEG and wide-spread lesions on CT scan. Group 2 had one or two attacks which led to a rather long-lasting hemiplegia but not to mental deterioration, rare rebuild-up findings on EEG and unilateral focal lesion on CT scan. Precipitating factors for ischemic attacks included deep breathing, changes in body temperature or sleep-waking transition were present in both groups. Etiology in some children was considered to be congenital. PMID- 3974802 TI - Pseudomonoventricle due to a malformation of the septum pellucidum. AB - Three children with complete absence of the frontal horns of the lateral ventricles and a single midline cavity on CT scan are reported. Two patients presented with adipsia, persistent serum hyperosmolarity and partial central diabetes insipidus. Another presented with congenital hemiplegia. The CT appearance was different from that of the known causes of monoventricle and was attributable to a malformation of the septum pellucidum, first described neuropathologically by Gross and Kaltenback (1957) who termed it frontal pseudomonoventricle. PMID- 3974803 TI - Variability of outcome in Joubert syndrome. AB - Two children with Joubert syndrome are reported. Patient one is the first case with Joubert syndrome where CT-findings are confirmed by autopsy. Until now only three cases with necropsy findings were reported. Patient two shows a remarkable clinical outcome not previously mentioned. PMID- 3974804 TI - Hemimegalencephaly--a case for hemispherectomy? AB - Two infants are described with intractable, drug-resistant seizures from birth associated with an enlarged cerebral hemisphere. The first died at sixteen months and demonstrated arrested head growth. Histology of the abnormal hemisphere showed disturbed cortical architecture, and subcortical heterotopias with multinucleate cells resembling tuberous sclerosis cells. Continuous fitting persisted in the second infant following callosal section. Hemispherectomy was undertaken in an attempt to preserve function of the "normal" hemisphere. Seizures ceased and head growth velocity accelerated. The neuropathology of the excised hemisphere is compared with the first case. From the literature this is the first report of a favourable outcome after hemispherectomy for hemimegalencephaly. The finding of an echodense enlarged hemisphere may allow presumption of this diagnosis in a neonate with unilateral seizures. After CT scan the diagnosis may be confirmed histologically providing that a precisely orientated frontal biopsy is submitted to the neuropathologist. We suggest that very early hemispherectomy may be the treatment of choice for this condition. PMID- 3974805 TI - Successful carnitine treatment in two siblings having lipid storage myopathy with hypertrophic cardiomyopathy. AB - Two Japanese siblings had lipid storage myopathy with hypertrophic cardiomyopathy (HCM). They had slowly progressive muscle weakness and ventricular hypertrophy of the heart evidenced by electrocardiography and echocardiography. Their developmental milestones were normal until three years of age when mild weakness in the lower limbs became evident. Laboratory examination showed transient high creatine kinase levels (CK) and hyperammonemia. Histochemical investigation on the muscles revealed abnormal accumulation of sudanophilic lipid droplets predominantly in type 1 fibers, type 2 A fiber atrophy and type 2 B fiber deficiency. In case 1, excessive lipid droplets were also observed in the biopsied cardiac muscle. Carnitine was decreased in the skeletal muscles and the serum. Treatment with DL-carnitine to both cases resulted in marked clinical improvement and decreased lipid droplets in the muscles. PMID- 3974806 TI - Thoracic chordoma in a patient with paraparesis and ivory vertebral body. AB - Chordoma arising in the thoracic region is uncommon. Its presentation roentgenographically as an ivory vertebra has not been previously reported. Such a case is described, and a brief review of the incidence and location of spinal chordomas is given. PMID- 3974807 TI - Tension pneumocephalus after evacuation of chronic subdural hematoma and subsequent treatment with continuous lumbar subarachnoid infusion and craniostomy drainage. AB - We present a case of tension pneumocephalus after burr hole evacuation of bilateral chronic subdural hematomas. Subsequent treatment was effected with combined twist drill closed system drainage and continuous intrathecal infusion of a physiological solution. The clinical entity, tension pneumocephalus, and the use of continuous subarachnoid infusion and drainage as a method of cerebral reexpansion are discussed. PMID- 3974808 TI - Chemotherapy for brain stem gliomas. PMID- 3974809 TI - Experimental carotid aneurysms: Part 2. Endovascular treatment with cyanoacrylate. AB - Using our modification of the vein patch technique, we created 16 aneurysms in the common carotid arteries of dogs. After a stabilizing and healing period, these aneurysms were treated using percutaneous catheter techniques. Coaxial microcatheters were placed into the aneurysms, and a mixture of isobutyl 2 cyanoacrylate and tantalum dust was infused through the microcatheter using real time fluoroscopic control. Fifteen of the 16 aneurysms were successfully occluded; 1 was a failure because of total occlusion of the carotid artery. One human facial artery aneurysm was similarly treated. The ease and technical details of the treatment are discussed. Although the results are encouraging, we believe that it would be prudent to broaden the animal experimentation rather than to begin human use. Because no experimental aneurysm models are yet physiological, our results must be applied with caution to human intracranial aneurysms. PMID- 3974810 TI - Treatment of acute focal cerebral ischemia and recirculation with d-propranolol. AB - The purpose of the investigation was to evaluate the effects of d-propranolol upon temporary cerebral ischemia followed by a period of reperfusion, that is, a situation analogous to major cerebral artery embolization. Twenty adult cats, lightly anesthesized with nitrous oxide, underwent 4 hours of right middle cerebral artery (MCA) occlusion and 2 hours of recirculation. Ten cats were untreated and 10 cats received d-propranolol, the weak beta-blocking isomer of racemic (d,l) propranolol. The d-propranolol was infused directly into the right carotid artery at doses of 2 mg/kg, given as a bolus immediately before MCA occlusion, and 0.33 mg/kg/hour, given continuously for 6 hours beginning immediately after MCA occlusion. Systemic arterial blood pressure was similar in both groups, but heart rate was transiently reduced in the treated group immediately after the bolus injection of d-propranolol and MCA occlusion. Regional cerebral blood flow (rCBF), measured by the xenon-133 clearance technique, was not significantly different in the ischemic, right hemisphere. Electroencephalographic (EEG) activity changes in the ischemic, right hemisphere were similar in both groups, but there was significant deterioration of EEG activity in the left, nonischemic hemisphere of untreated cats after MCA reopening. Swelling of the ischemic, right hemispheres was similar in both groups and more severe than in previous studies wherein there was no recirculation phase. Carbon perfusion and blood-brain barrier changes were also similar. The results of the study failed to show a protective effect despite theoretical beneficial actions of d-propranolol. Also, the study demonstrated that d propranolol does not have a detrimental effect upon rCBF in acute focal cerebral ischemia. PMID- 3974811 TI - Treatment of cerebrospinal fluid rhinorrhea by percutaneous lumboperitoneal shunting: review of 15 cases. AB - Fifteen patients with recalcitrant cerebrospinal fluid (CSF) fistula underwent the insertion of a lumboperitoneal shunt. The shunt consists of a two-piece Silastic tube and has been used in a population of 150 patients with communicating hydrocephalus, persistent postoperative meningocele, and benign intracranial hypertension. The spinal catheter is introduced subcutaneously and no flushing device is used. We studied three groups: 9 patients had a history of head trauma, and 7 of these had undergone one or several ineffective direct approaches to the dural leak. Four patients presented with a presumably congenital fistula. Two patients had persistent rhinorrhea due to previous intracranial procedures. Indium-111 cisternography was performed in 10 patients before lumboperitonel (LP) shunting and failed in 2 of those to document the site of leakage. Twelve patients showed cessation of rhinorrhea after LP shunting. In 4 of these, shunt-related complications responded to shunt removal with no further recurrence of rhinorrhea. Two patients underwent revision of the shunt. In 3 patients, the LP shunt failed to control the CSF leak and further intracranial procedures were indicated. The LP shunt provides an attractive and technically simple solution when direct methods of treatment have failed. Additionally, LP shunting should be considered as a primary mode of treatment in elderly patients or when impairment of CSF dynamics is documented by radionuclide cisternography and computed tomographic scanning. When an LP shunt is ineffective, shunt function should be checked by isotopic studies before additional surgery is performed. PMID- 3974812 TI - Brain stem auditory evoked potentials in Arnold-Chiari malformation: possible prognostic value and changes with surgical decompression. AB - Symptomatic Arnold-Chiari malformation (Chiari II) is a recently described clinical entity, the natural history and surgical management of which remain controversial. The brain stem auditory evoked potentials (BAEPs) have been described as abnormal in 50 to 86% of children with myelomeningocele. We present the case of a full-term infant with myelomeningocele, shunted hydrocephalus, and Chiari II malformation who was surgically treated by decompression when she was 3 weeks old. BAEPs recorded immediately after decompression showed dramatic improvement over BAEPs recorded immediately before decompression, an improvement that could not be attributed to maturation of the central nervous system. It is postulated that in further large series the degree of abnormality in BAEPs may be of value in predicting the clinical course of these patients. The current status of BAEPs as they apply to the evaluation of posterior fossa anomalies is reviewed. PMID- 3974813 TI - Evaluation of cerebrospinal fluid rhinorrhea by metrizamide computed tomographic cisternography. AB - Seven interesting and instructive cases of cerebrospinal fluid rhinorrhea evaluated by metrizamide computed tomographic cisternography are presented. The rhinorrhea was spontaneous in three patients and was related to previous head trauma or surgical procedures in four patients. The anatomical site and the extent of the fistula were demonstrated precisely by directly showing metrizamide passing through the bony defect. A combination of bone dehiscence and metrizamide within the adjacent paranasal sinuses or the nasal cavity is also useful in localization. Distortion of the interhemispheric fissure, sylvian fissure, or basal sulci indicates the probability of brain herniation through the defect. PMID- 3974814 TI - "Pseudotumoral" cystic cerebellar infarction with slow evolution. AB - A 63-year-old female patient presented with cerebellovestibular symptoms and posterior headaches. The onset of the symptoms was sudden, and the neurological condition slowly worsened over a 5-month period. It was found that she suffered from a cystic infarction of the cerebellar lobe, with subsequent hydrocephalus. This case and two others discovered in the literature argue for the recognition of a slowly evolving, cystic form of cerebellar infarction that calls for a direct surgical approach. PMID- 3974815 TI - Sylvian lipoma causing auditory hallucinations: case report. AB - A sylvian fissure lipoma that caused auditory hallucinations, frequent olfactory auras, and occasional visual hallucinations is reported. The patient had been diagnosed as suffering from a functional psychosis for more than a decade, with symptoms severe enough to warrant frequent psychiatric attention, including institutional care. The computed tomographic findings are discussed. The literature is reviewed and therapeutic options are proposed. PMID- 3974816 TI - Traumatic decerebracy with preserved consciousness and voluntary movement. AB - Decerebrate rigidity is a frequent occurrence in cases of craniocerebral trauma. It is almost always accompanied by coma and usually denotes a poor prognosis. Primary focal brain stem lesions due to trauma are uncommon and may be accompanied by other diffuse cerebral lesions. This report reviews the anatomical basis and clinical findings of a unilateral brain stem lesion in a patient with traumatic decerebracy and preserved consciousness. The anatomical pathways and possible physiological mechanism are discussed, and a few comments on the prognosis of such lesions are given. PMID- 3974817 TI - Malignant melanoma of the spinal epidural space metastasized from the enucleated left eye after nine years without symptoms: report of a case. AB - A case of flaccid paraplegia due to a metastatic spinal epidural melanoma is reported. Symptoms occurred approximately 9 years after the enucleation of the left eye. A solid melanotic mass was removed almost totally. Three years after the operation, the patient had not regained the motility of the lower limbs. The need for long term follow-up and management of patients with such problems is discussed, and the pertinent literature is reviewed. PMID- 3974818 TI - Intracranial mucocele mimicking arachnoid cyst: case report. AB - We describe a patient presenting with adult onset seizures whose computed tomographic scan was highly suggestive of arachnoid cyst. The cyst was removed by craniotomy and was found to be a mucocele on histological examination. During operation, no connection to the frontal sinus had been found. The very unusual combination of findings and their clinical implications are discussed. PMID- 3974819 TI - Cystic meningiomas: report of two cases. AB - Cyst formation with meningioma is extremely rare. Two cases of large peritumoral cystic lesions associated with intracranial meningiomas that simulated astrocytomas are presented. In each of these young patients, the cyst caused misdiagnosis pre- and intraoperatively. However, total excision was accomplished in each case. The pertinent literature is reviewed. PMID- 3974820 TI - Primary pituitary carcinoma: a clinical pathological study. AB - A 60-year-old woman presented with a history of headache and rapidly progressive complete bilateral ophthalmoplegia. Her endocrine function was normal. Radiographic studies revealed signs of diffuse destruction of the sella turcica by a tumor without suprasellar extension. Biopsies of the lesion within the sphenoid sinus demonstrated the presence of a primary pituitary carcinoma; autopsy findings revealed metastatic deposits in the liver, kidney, and lung. The histological characteristics of these cells and the electron microscopic findings confirmed that the tumor can first manifest themselves by the rapid development of unilateral or bilateral ophthalmoplegia; this diagnosis should be considered in all individuals with such a syndrome. PMID- 3974821 TI - Ependymal cyst of the quadrigeminal plate: case report. AB - A patient with an ependymal cyst of the quadrigeminal plate is reported. The patient presented with headache, diplopia, and evidence of increased intracranial pressure. A nonenhancing cyst with hydrocephalus was demonstrated by computed tomographic scan. The cyst was subtotally resected using a transtentorial approach. The causes, clinical presentation, and treatment of quadrigeminal plate ependymal cysts are discussed, together with a review of the literature. PMID- 3974822 TI - Nimodipine and chronic vasospasm in monkeys: Part 1. Clinical and radiological findings. AB - The efficacy of the calcium channel blocker nimodipine in the prevention of chronic cerebral vasospasm (VSP) and delayed ischemia after subarachnoid hemorrhage (SAH) in monkeys was examined in a blind, randomized, placebo controlled trial. The primate model developed in this laboratory reliably induces chronic cerebral vasospasm and can induce pathologically proven delayed ischemic neurological deficits (DINDs). With standard microsurgical procedures, an average 6.4-ml autologous hematoma was placed directly against the major anterior cerebral vessels in the right basal subarachnoid spaces of 24 monkeys. The monkeys were randomized to one of four groups and were treated orally q8h for 7 days with nimodipine (3, 6, or 12mg/kg)or placebo. An additional 2 monkeys underwent the surgical procedure without clot placement. Drug administration began between 14 and 20 hours after clot placement. Indices monitored before and after SAH included neurological status, angiographic cerebral vessel caliber, and cerebral blood flow. Significant VSP (25 to 100% reduction in vessel caliber) was present on Day 7 on the clot side in 83% of the animals (P less than or equal to 0.001). There was no significant difference (P greater than 0.05) in the incidence of VSP among the four groups. Similarly, there was no significant difference (P greater than 0.05) in the mean vessel caliber reduction after SAH among the four treatment groups. There was no VSP present on Day 7 in the sham operated animals. One animal receiving high dose nimodipine (12 mg/kg p.o. q8h) developed a DIND on Day 5 after SAH. A second animal in the 12-mg/kg group developed a transient neurological deficit between Days 4 and 7. PMID- 3974824 TI - Percutaneous discectomy: an anatomical study. AB - Percutaneous discectomy is a viable alternative in the treatment of herniated intervertebral discs of the lumbar spine. Anatomical analysis of the retroperitoneal surgical path utilizing computed tomography suggests that the risk of vascular injury is negligible at the L-4, L-5 level, but substantial at the L-5, S-1 level. In addition, one-third of patients otherwise suitable for percutaneous discectomy have segments of bowel obstructing the surgical path. Obtaining an abdominal computed tomographic scan with the patient in the surgical position seems to be a valuable screening technique in the evaluation of candidates for this procedure. PMID- 3974823 TI - Nimodipine and chronic vasospasm in monkeys: Part 2. Pharmacological studies of vessels in spasm. AB - The effect of nimodipine on the in vitro reactivity of cerebral vessels after subarachnoid hemorrhage (SAH) was studied. With the use of a primate model of chronic cerebral vasospasm, 12 female cynomolgous monkeys underwent the induction of a SAH by the direct placement of an average 6.4-ml autologous hematoma against the major anterior cerebral vessels in the right basal subarachnoid spaces (Day 0). The animals were then randomized to one of four groups and within 14 to 20 hours after clot placement were started on oral q8h therapy with nimodipine (3, 6, or 12 mg/kg) or placebo. On Day 7, the animals were killed and the right and left middle cerebral arteries (MCAs) were immediately resected and placed in oxygenated Krebs' solution. Ring preparations from the arteries were suspended in organ baths, and dose-effect curves to varying concentrations of norepinephrine, 5-hydroxytryptamine, and potassium chloride were obtained. There was a highly significant reduction in the response of the MCA on the clot side (right) relative to the nonclot side (left) to all three agonists. The clot side contractility was not influenced by nimodipine treatment at any of the four doses tested. The nonclot side arteries of the 12-mg/kg treatment group demonstrated significantly enhanced reactivity for all three agonists. Oral treatment with high dose nimodipine enhances the reactivity of normal cerebral vessels to the agonists tested, but it does not seem to affect the reactivity of arteries in chronic spasm at any of the four doses tested. PMID- 3974825 TI - Intracranial space-occupying lesions in acquired immune deficiency syndrome patients. AB - The recent description of the acquired immune deficiency syndrome (AIDS) followed the observation of an increased incidence of unusual neoplasms and opportunistic infections in previously healthy homosexual men, intravenous drug abusers, Haitians, hemophiliacs, and certain infants. Active research efforts on this group of patients established a defect in cellular immunity. Six patients with AIDS who underwent neurosurgical procedures for intracranial space-occupying lesions are presented. Two of the patients had toxoplasmosis brain abscesses, one had primary central nervous system lymphoma, one had cytomegalovirus encephalitis, one had progressive multifocal leukoencephalopathy, and one patient remained undiagnosed despite pathological examination of the brain tissue specimen. We recommend brain biopsy in AIDS patients with space-occupying lesions because the regimen for the various conditions differs. Although the central nervous system diseases found in AIDS patients are associated with a high mortality rate, four of the six patients responded favorably to specific treatment. PMID- 3974826 TI - Plasma fibronectin in patients with brain tumors. AB - Fibronectin, a large molecular weight glycoprotein normally found on the surface of many cells, was measured in the plasma of 15 normal volunteers and 75 patients with various kinds of brain tumors or other kinds of neurological disorders. The mean plasma fibronectin in the control group was 253 micrograms/ml. Statistically significant elevations in fibronectin levels were found in patients with progressive high grade astrocytomas (mean = 413 micrograms/ml). The majority of patients with high grade astrocytomas in remission had normal levels of fibronectin (mean = 273 micrograms/ml). Elevations were noted in patients with low grade astrocytomas, meningiomas, and benign nonneoplastic neurological disorders. Plasma fibronectin may be useful diagnostically and therapeutically in identifying and managing some patients with high grade gliomas. However, of greater importance is the observation that fibronectin elevation is the result of a tumor-host interaction. PMID- 3974827 TI - Fifty years of experience with chordomas in southeast Scotland. AB - We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches. PMID- 3974828 TI - Rupture of previously unruptured giant carotid aneurysm after superficial temporal-middle cerebral artery bypass and internal carotid occlusion. AB - A 51-year-old woman with an unruptured giant aneurysm of the internal carotid artery was treated by gradual occlusion of the internal carotid artery in the neck combined with a superficial temporal artery to middle cerebral artery bypass graft. Visual field defects improved after the operation, and thrombosis of the aneurysm was confirmed by angiography and computed tomography. Nevertheless, a fatal hemorrhage occurred 34 days after the final turn of the Selverstone clamp. The possible mechanism of rupture of the apparently thrombosed aneurysm is discussed. There is a risk of rupture of the aneurysm as long as the aneurysmal lumen remains after proximal ligation, no matter how small it may be. PMID- 3974829 TI - Chronic subdural hematomas: to drain or not to drain? AB - A consecutive series of 21 adult patients with chronic subdural hematoma was studied in respect to postoperative resolution of subdural collections and clinical improvement after burr hole evacuation without subdural drainage. This series was compared to a previously studied series of patients with chronic subdural hematoma in whom postoperative closed system drainage had been installed. Using the identical protocol for treatment and postoperative follow up, we obtained identical results with respect to time-related neurological improvement and persistence of subdural collections in the undrained and drained series, except that the steadily progressive clinical improvement during the early postoperative phase (24 hours) in all cases of the drained series was not universal in the undrained cases. Our study suggests that, to avoid the possibility of early postoperative clinical deterioration, burr hole craniostomy and closed system drainage is advisable. We think that subdural drainage is not necessary when the installation of the drainage system seems to be technically difficult, as it may be in cases with considerable perioperative cortical expansion. PMID- 3974830 TI - Intraventricular cavernous hemangioma: report of three cases and review of the literature. AB - The clinical and radiographic presentations of 3 patients with intraventricular cavernous hemangioma are described. The accumulated total of 19 cases from the literature are compared to determine whether there is a common clinical and radiographic presentation for this benign intraventricular lesion. The differential diagnosis of intraventricular cavernous hemangioma includes intraventricular meningioma, choroid plexus papilloma, arteriovenous malformation, low grade astrocytoma, and ependymoma. PMID- 3974831 TI - Hypothalamic hamartoma: report of two cases. AB - Two histologically confirmed hypothalamic hamartomas, one in a 7-year-old boy and another in a 10-year-old boy, are reported. One patient had precocious puberty, epileptic laughter, and abnormal behavior; the other had cerebral seizures. Partial removal of the tumors had no effect on precocious puberty; however, behavior improved in the first patient, and seizure control improved in the second patient. PMID- 3974832 TI - Modified prone position for cranial remodeling procedures in children with craniofacial dysmorphism: a technical note. AB - A new head position for use during operation on young children with cranial deformities is described. The position allows exposure of the entire calvarium from the supraorbital ridges to the posterior rim of the foramen magnum. It is a modification of the conventional prone position involving hyperextension of the neck. The authors have safely used this position to perform one-stage radical cranial remodeling procedures that previously required two stages. The advantages of this position and the methods for achieving it are discussed. PMID- 3974833 TI - Giant posttraumatic aneurysm of the intracranial carotid artery: evolution and regression documented by computed tomography. AB - Posttraumatic aneurysms of the proximal intracranial internal carotid artery are rare. A case is presented in which the evolution and regression of such an aneurysm is documented by computed tomography as well as by arteriography. The coexistence of a proximal dissection of the cervical carotid artery probably contributed to the growth of the aneurysm. PMID- 3974834 TI - Fracture of the sella turcica. AB - We report the cases of three patients with fracture of the sella turcica. All three patients developed vascular complications. Patient 1 had a traumatic aneurysm, Patient 2 had stenosis of the intracranial internal carotid artery, and Patient 3 had bilateral carotid-cavernous fistulas. We emphasize that, when fracture of the sella turcica is demonstrated, cerebral angiography is still the method of choice for the detection of intracranial vascular injury. PMID- 3974835 TI - Bilateral traumatic abducens nerve palsy without skull fracture and with cervical spine fracture: case report and review of the literature. AB - Bilateral traumatic abducens nerve palsy is a rare condition. Here a case without skull fracture and associated with cervical spine fracture is reported. Only two cases like this were found in a review of the literature. The mechanism of the lesion is discussed in light of the two main theories proposed thus far. When the injury is acute, as happens in the majority of cases, the nerve lesion probably is due to contusion and stretch of the nerve trunk against the ridge of the petrous bone and the rigid dural hole of entrance in the extradural space at the basilar process. PMID- 3974836 TI - Simplified technique for subdural pressure monitoring: technical note. AB - A simplified technique for monitoring intracranial pressure via a subdural catheter is presented. It utilizes a commercially available Silastic catheter inserted through a frontal twist drill approach. Twenty patients have been treated thus far without complication. Advantages over other extraventricular monitoring techniques are presented. PMID- 3974837 TI - Intracranial pressure monitoring by a subdurally placed silicone catheter: technical note. AB - A silicone catheter manufactured originally for ventricular fluid drainage was used for continuous monitoring of intracranial pressure. It can be placed under the dura mater immediately before replacing the craniotomy flap or by introduction through an ordinary burr hole. Pressure is monitored isovolumetrically by connecting the catheter to a pressure transducer mounted at the bedside. This technique has been used in 34 neurosurgical patients for periods of up to 12 days without any untoward effects. This monitoring system by a subdurally placed silicone catheter is simple, safe, inexpensive, and acceptably reliable. It has a place in clinical practice, particularly when the lateral ventricle cannot be tapped because of its deviation or collapse. PMID- 3974838 TI - Spontaneous intratumoral hemorrhage after ventriculoperitoneal shunting. AB - We report a 1 1/2-year-old child with an ependymoma in the posterior cranial fossa. As the computed tomographic scan showed evidence of marked triventricular hydrocephalus, the patient underwent ventriculoperitoneal shunting. Two hours after operation, he developed a fatal intratumoral hemorrhage. The indications and contraindications of ventricular external or internal drainage before posterior cranial fossa tumor removal are briefly discussed. PMID- 3974839 TI - Occipital interhemispheric acute subdural hematoma treated by lambdoid suture tap. AB - We present the case of a 6-week-old infant with acute subdural hematoma secondary to hemorrhagic disease of the newborn. Computed tomographic scan localization of the collection in the posterior portion of the supratentorial compartment allowed for its removal by lambdoid suture taps. The procedure is described. PMID- 3974840 TI - Malignant change in an intradiploic epidermoid: report of a case and review of the literature. AB - An unusual case of intradiploic epidermoid tumor is reported. In this case, a soft mass located over the parietal bone was noted shortly after birth. The mass gradually enlarged. The tumor underwent malignant change after several excisions and repeated inflammations. The patient was successfully treated with extensive excision, radiotherapy, and chemotherapy. Compiling a summary of reported cases with a tabulation of pertinent information, we discuss the incidence, pathogenesis, prognosis, and therapy of malignant intradiploic epidermoid. PMID- 3974841 TI - Currently available shunt systems: a review. AB - Many different types of shunt equipment have become available as shunting procedures have become commonplace. Variations among different systems can be subtle, and the choice between them is somewhat arbitrary. The author reviews some of the devices currently in use for the purposes of clarification and comparison. PMID- 3974842 TI - Role of defective dopaminergic inhibition of prolactin secretion in the pathogenesis of prolactinoma. AB - Prolactinomas pose an increasingly frequent therapeutic dilemma for the clinician. The neurosurgeon caring for the prolactinoma-bearing patient must stay abreast of the most current basic research concerning the pathogenesis of these often difficult tumors. A fascinating and dynamic line of research involves the possibility that prolactinomas arise secondary to a flaw in the normally inhibitory dopaminergic neurohypophyseal axis. The details of this hypothesis are presented, the current literature surrounding this topic is reviewed, and a brief synthesis of the available theoretical models of prolactinoma pathogenesis is provided. PMID- 3974843 TI - Stroke after EC-IC bypass. PMID- 3974845 TI - Lateral organization and aesthetic preference: the importance of peripheral visual asymmetries. AB - The observation that right-handers prefer pictures with the important content to the right was examined. In the first experiment, subjects manipulated the two elements of the composition. They showed a bias to place the principal object to the right and, with a central principal object, the secondary object was placed to the left. In a further experiment, eye movements were recorded while subjects scanned the pictures used in the first experiment and a rightward lateral bias in gaze direction was observed. It is argued that lateral asymmetry in preferred picture arrangements is not the result of a counterbalancing of content against perceptual bias, but a consequence of gaze being directed to informative content on the right, leaving more of the secondary content within the left visual field and associated with attentional bias or processes of the right hemisphere. PMID- 3974844 TI - Visual agnosia contrasted with visual-verbal disconnection. AB - Serial neuropsychological findings are contrasted in two cases: one with a syndrome of visual agnosia, the other with a disorder resulting from visual verbal disconnection. Both patients were impaired in confrontation naming of objects and pictures, but the patient with visual-verbal disconnection was able to perform tasks of color-object matching and pantomime recognition, whereas the patient with visual agnosia could not do so, demonstrating a failure to establish meaningful nonverbal visual-visual association. Additionally, the performance of the patient with visual agnosia reflected an evolution from the apperceptive to associative forms of the disorder, suggesting that the various impairments of visual identification form a continuum of related disorders. PMID- 3974846 TI - A left hemisphere basis for visual mental imagery? AB - The lateralization of visual mental imagery was investigated by presenting each hemisphere of a commissurotomy patient with a letter classification task known to require imagery and with a pair of control tasks designed to require all of the same processes as the imagery task except for the imagery processing itself. Whereas both hemispheres performed well on the control tasks, only the left hemisphere performed the imagery task. PMID- 3974847 TI - Asymmetry of speech actions. PMID- 3974848 TI - On the interpretation of mouth asymmetry. AB - Greater right-side mouth opening during propositional speech has now been observed in at least eight studies. All current data are consistent with the interpretation that left-hemisphere control of articulation of propositional speech results in greater activity of the right-side lip opening muscles. In addition, expression of automatic speech such as singing, emotion, and possibly prosody can also influence mouth asymmetry, but in the opposite direction, suggesting a relatively greater right-hemisphere role for these types of expression. Further work is needed to confirm these interpretations and to elaborate on the exact neuro-muscular mechanisms and task dependencies responsible for mouth asymmetry. PMID- 3974849 TI - Pain measurements in right-left cerebral lesions. AB - Left- and right-brain damaged (BD) subjects were examined to ascertain whether psychophysical parameters of pain-pain threshold (P), tolerance threshold (T), and pain endurance (E)-were modified by brain damage and whether differences exist between LBD and RBD. Noxious stimulus was provided by electrical stimulation. Results showed that P and T scores for the paralysed arms were consistently higher than those of the contralateral side. This was not simply due to modified sensitivity alone; in the RBD group hemi-inattention and aphasia in the LBD group also played a role. A significantly hightened value of pain endurance was found only in the healthy arm in the RBD group. PMID- 3974850 TI - Ear differences in children at two years of age. AB - Twenty-six children (13 boys and 13 girls) aged from 21 to 35.5 months were presented with a dichotic test of recognition of familiar words. There was no significant ear difference on average, however, a clear right-ear preference did emerge in children of right-handed parents. This contrasted with the tendency toward a left-ear preference that was exhibited by children with at least one left-handed parent. PMID- 3974851 TI - Visual and phonological factors in acquired dysgraphia. AB - The written spelling behaviour of a severely aphasic patient, whose many errors suggested a strong influence of visuo-spatial representations, is described. An experiment was carried out to confirm or refute the importance of visual factors in spelling to dictation. The strongest confirmatory evidence was the patient's propensity for writing the individual letters of a word in nonlinear order, i.e. not left to right, sometimes even beginning in the middle of a word. The influence of whole visual word-contours was also examined. Analysis of the results suggested that, in addition to the visual element, certain phonological factors played a small part in the patient's repertoire of strategies and this was confirmed in a second experiment. The patient's multi-strategy approach to written spelling is discussed on the basis of an information-flow model. This leads on to consideration of the possibility of consolidating the residual phonological system as part of a re-education plan. PMID- 3974852 TI - Cross-cultural differences in hemisphericity: EEG asymmetry discriminates between Japanese and Westerners. AB - This study was designed to test the hypothesis that Japanese subjects exhibit different patterns of resting EEG asymmetry compared with Westerners. EEG was recorded from the left and right temporal and parietal scalp regions in bilingual Japanese and Western subjects during eyes-open and eyes-closed rest periods before and after the performance of a series of cognitive tasks. Alpha activity was integrated and digitized. Japanese subjects were found to exhibit greater relative right-sided parietal activation during the eyes closed condition. This difference was found to be a function of greater left hemisphere activation among the Westerners. Various possible contributors to this cross-cultural differences are discussed. PMID- 3974853 TI - Discrimination and recognition of tonal melodies after unilateral cerebral excisions. AB - Groups of surgical patients with unilateral temporal- or frontal-lobe lesions and normal control subjects were tested in melodic discrimination and recognition tasks. The discrimination task required detection of a single-note change in a pair of short unfamiliar tonal melodies. The altered note either violated or preserved the contour, the scale, or both, of the original melody. Recognition required that the melodies used in the discrimination task be recognized from among a set of similar foils. Right temporal-lobe patients performed most poorly in discrimination. Further analysis showed that excision of the primary auditory receiving area. Heschl's gyri from either side resulted in a deficit which was independent from, but additive with, the deficit caused by right temporal lobectomy. In the recognition task, both temporal-lobe groups were impaired as compared to control. The use of scale and contour cues was similar for all groups, indicating that the deficits observed are not attributable to failure to process one of these cues. Right frontal-lobe lesioned patients differed from the others in response bias, but performed as well as controls on both tasks. The results are interpreted as evidence for two processes in melodic discrimination, one due to short-term memory mechanisms, the other attributable to a deficit in processing complex auditory patterns. PMID- 3974854 TI - An ear asymmetry for gap detection following anterior temporal lobectomy. AB - A threshold elevation in the performance of auditory temporal order judgment in man has been reported in the ear contralateral to the side of an anterior temporal lobectomy. On the basis of temporal order judgments alone it is not possible to determine whether the deficit is attributable to an impairment of recognition, identification, or temporal resolution. The present monaural experiments compared the performance of the two ears in the detection of a gap in a broad-band noise burst in normal and temporal lobectomized subjects. The results revealed a right-left symmetry in gap detection performance by normal subjects but a significant deficit in gap detection in the ear contralateral to the side of an anterior temporal lobectomy--a finding interpreted as revealing the existence of a bonafide deficit in auditory temporal resolution induced by such resection. PMID- 3974855 TI - Different basic components in the performance of Broca's and Wernicke's aphasics on the Colour-Figure Matching Test. AB - It is known that focal damage of the left hemisphere causes poor performances in a number of tasks devoid of overt verbal connotation, often referred to as "non verbal intelligence", "association" or "abstract attitude" tasks. However, it is not clear whether the existence of a unitary basic functional defect to account for the faulty performances outlined above can be supposed. In this investigation we have compared the behaviour of left-hemisphere damaged patients grouped according to aphasia type and have studied the extent to which two different, widely used tests of this supposed "non-verbal basic ability" (i.e. the Weigl Sorting Test and the Raven Progressive Matrices) overlap in their predictive power of the performance of a non-verbal association task, i.e. the Colour-Figure Matching Test. Notwithstanding the identical level of performance in the three tests between groups having different aphasia types, a clear-cut dissociation was found between Broca's and Wernicke's aphasics; in the former group the Colour Figure Matching Test was highly correlated only with Weigl Sorting Test and in the latter only with Progressive Matrices. The conclusions are that in this case the breakdown of non-verbal basic resources does not coincide in patients with different types of aphasia, and the hypothesis of the existence of a unitary basic defect caused by left hemisphere damage is not in line with our findings. PMID- 3974856 TI - Greater brain response of left-handers to drugs. AB - Among subjects participating in 14 placebo-controlled drug cross-over studies, left-handers showed a greater drug-related change in their electroencephalograms (EEGs) than did right-handers. Response differences between left- and right handers were not hemisphere-specific. Further, the magnitude of EEG changes correlated with handedness scores. A greater effect of centrally active substances in left-handers may, in part, explain the high incidence of left handers among those with certain brain-related pathologies and the evolution of right-hander predominance in the general population. PMID- 3974858 TI - Electrophysiological correlates of handedness and speech perception contrasts. AB - Auditory evoked responses (AERs) were recorded from left- and right-handed subjects who listened to consonant sounds from different phonetic categories. AERs recorded at parietal scalp regions indicated both groups differentiated categorical differences between speech sounds. However, hand preferences did not affect hemisphere responses to speech sounds. PMID- 3974857 TI - The effect of alcohol abuse on perceptual reference frames. AB - Visuospatial processing in alcoholics was investigated by aligning two elements along different axes of an equilateral triangle and asking subjects to report the direction the triangle appeared to point when first observed. Alcoholics were not as affected as controls by alignment of the elements. The implications of these findings are discussed. PMID- 3974859 TI - Event-related potentials associated with the discrimination of acoustic and semantic aspects of speech. AB - Analysis of a word's acoustic structure must precede identification of its meaning. Therefore, these aspects of speech processing could be associated with event-related potential (ERP) components that differed in their timing. To identify electrophysiologic indices of the cortical processing of acoustic and semantic features of speech, we recorded ERPs to the random presentation of nonsense or real words in four conditions designed to manipulate the extent to which the speech sounds were processed. In one condition subjects responded to all stimuli; in a second and third, to a designated nonsense or real word; and in the final condition to words within a specified semantic category. To define the cortical activity associated with acoustic processing, ERPs obtained when no discrimination was required were subtracted from those recorded during the identification of a specified speech target. The difference waveforms exhibited a negative potential that began about 50 msec after stimulus onset and lasted about 200 msec. Difference waveforms obtained by subtracting the non-discrimination ERP from those obtained during semantic discrimination exhibited a negative potential with similar onset timing. We concluded that the early negative potential indexed acoustic processes necessary for stimulus identification. To identify potentials associated with determination of a word's meaning, we subtracted the verbal discrimination from the semantic discrimination ERPs. This difference waveform exhibited a later negativity beginning at 150 msec and lasting about 250 msec. This potential may be related to the semantic processing of speech. PMID- 3974860 TI - Resistive NMR of intracranial hematomas. AB - Comparison between computed tomography and nuclear magnetic resonance imaging in 17 patients with intracranial hematomas indicates a distinct role for NMR in evaluating the stable patient with hematoma. NMR is useful for delineating the extent of the hematoma, the relationship of the hematoma to brain anatomy, and the presence of hematoma at a time when the hematoma is isodense on CT. PMID- 3974861 TI - Resistive NMR of brain stem gliomas. AB - The NMR and CT findings in 22 patients with primary brain stem tumors were compared to determine the value of each study in identifying, and delineating the extent and relationships of the tumor to brain anatomy. NMR was found to be distinctly superior to CT in showing involvement of the medulla and upper cervical cord. NMR eliminates the need for intrathecal enhanced metrizamide CT, and in the future should be the only initial diagnostic test needed for the evaluation of intrinsic brain stem tumors. PMID- 3974862 TI - High resolution O2 computed meatocisternography in the differential diagnosis of internal auditory canal pathology. AB - Recent introduction of O2 computed tomography cisternography and imaging with high resolution program have greatly improved the detection and preoperative evaluation of acoustic neuromas and other possible pathologies of the internal auditory canal. Sixty patients have been evaluated following the diagnostic protocol given in the text. Based on our results and on the experience as reported in literature HRO2CTC proved to be the most reliable method for detection and exclusion of intracanalicular and small extracanalicular acoustic neuromas and other pathologies at the internal auditory canal level. PMID- 3974863 TI - Magnetic resonance imaging and characterization of normal and abnormal intracranial cerebrospinal fluid (CSF) spaces. AB - A retrospective review of twenty-five normal MRI brain studies performed with the spin-echo technique focused special attention on the ventricular and extraventricular cerebrospinal fluid (CSF) and revealed unique signal intensity characteristics in the two locations. In addition, MRI studies of ten patients with abnormal extraaxial fluid collections either missed with CT or indistinguishable from CSF on CT images were also analyzed. MRI is more sensitive when compared to CT in evaluating the composition of CSF. Unique signal intensity characterizes the two major CSF compartments and presumably reflects their known but subtle difference in protein concentration (10-15 mg%). Normal variant or abnormal developmental fluid collections can be better characterized with MRI than with CT. These preliminary observations are offered in view of their implications for patient management and suggest further investigation. PMID- 3974864 TI - Prevalences of CT-detected calcification in the basal ganglia in idiopathic hypoparathyroidism and pseudohypoparathyroidism. AB - Sixteen patients with idiopathic hypoparathyroidism (IHP) and eight patients with pseudohypoparathyroidism (PHP) were examined by CT scan of the brain. Calcification in the basal ganglia was observed in 11 patients with IHP (69%) and in all eight patients with PHP. Of the 19 patients with basal ganglia calcification, nine had calcification in the cerebral cortex (47%), and four had calcification in the cerebellum (21%). Observation of basal ganglia calcification on CT gave rise to suspicion of IHP or PHP in three patients (12%). The remaining patients were examined at varying time after diagnosis. Since arrest in growth of calcification after institution of treatment has never been proven, the reported prevalences of calcification may not be valid to the situation at the time of diagnosis. PMID- 3974865 TI - Diagnosis of intracranial haemangiopericytomas with angiography and CT scanning. AB - Twenty-one primary intracranial haemangiopericytomas (HPC) were operated on from 1953 to 1983. The mean age of the 12 male and nine female patients was 38 years (17-64). Plain skull films showed well-defined bone destruction in two patients. Angiograms of 18 tumours (14 primary and four recurrent) showed the following when analysed according to the criteria of Marc et al. [4]: dual arterial supply (17/18), one-three main feeders giving rise to many irregular corkscrewlike vessels (16/18), dense, well-defined and long-lasting tumour strain (17/18), but early venous drainage rarely (1/18). The overall impression was that eight tumours appeared to be typical HPCs on angiogram. Five tumours had suggestive features, though not enough to justify specific angiographic diagnosis, and five were more like classical meningiomas. The larger tumours were more typical of HPCs, the smaller ones resembled meningiomas. CT scans of eight tumours (three primary and five recurrent) were available. The tumours were attached with a broad base to the convexity or other dural surfaces, often bilaterally. No calcifications were seen. There was little, if any, surrounding oedema. Contrast enhancement was strong and homogeneous. Four of the tumours were ring like, but the ring was thick and regular, in contrast to that in glioblastomas. The tumour margin was well-defined and smooth in three tumours, and nodular margins were seen in five; two of the latter grew extensively along dural surfaces. This sign may suggest aggressive biological behaviour. If both angiograms and CT scans are available, HPCs can be differentiated from glioblastomas and classical meningiomas, but perhaps not from anaplastic meningiomas. PMID- 3974866 TI - Radiation necrosis of the brain: time of onset and incidence related to total dose and fractionation of radiation. AB - Clinical deterioration during or after brain irradiation may be due to progression of neoplasm or radiation induced necrosis of the neoplasm and/or of normal brain tissues, or a combination of all. Eight patients with histologically documented radiation induced lesions of the brain are included in this study. The radiation therapy included the fractional schedule, group A, who received 280 to 300 rads daily, to a total dose of 4500 to 5000 rads and weekly exposure did not exceed 900 rads. Group B patients were exposed to 850 rads, daily dose on day 1, 3, 21 and 23 to a total dose of 3400 rads. The incidence of radiation induced lesions of brain was 3.4% in patients group A and 8.7% in group B patients (without statistical significance). The median time of onset of these lesions after completion of radiation therapy was significantly shorter in group B patients (8.5 months) as opposed to group A patients (21 months). PMID- 3974867 TI - Post-traumatic cystic and non-cystic myelopathy. AB - Sixty-four patients with suspected cystic myelopathy following spinal cord trauma were examined radiologically. In twenty-seven of these, spinal cord cysts were confirmed at surgery; in five, cysts were excluded by surgery and/or autopsy; the rest were unconfirmed. In water soluble myelography the most frequent sign in those with confirmed cysts was distention of the involved segments of the spinal cord. A less frequent but reliable sign was variation in cord size with position in a paradoxical fashion to the well established changes which occur with air myelography. Focal concentrations of contrast medium were visible within cord substance at CT in two of the patients in whom no cyst was found at surgery or autopsy. Some correlations between clinical features, including rate of progression and results of surgery, and radiological findings are unexpected on the basis of existing theories on pathogenesis. PMID- 3974869 TI - A new neuroradiologic method for therapy of spinal epidural hematomas. AB - A simple method was described with which spinal epidural hematomas in the cervical region can be rapidly decompressed when appropriate facilities for emergency surgery are not available. PMID- 3974868 TI - Pitfalls of computed tomography in diagnosis of discitis. AB - Sixteen patients with discitis from January 1980 through December 1983 underwent 18 CT scans for initial evaluation. In six scans the study produced a false negative result (sensitivity 63%, 11/16). In three of these six the scan was performed at the wrong disc level, and in three the error was interpretive. During the same time period 6 patients had a CT diagnosis of discitis which proved incorrect (positive predictive value 63%), three of which had fractures, two had normal post discectomy changes, and one had a neuropathic arthropathy. These studies were reviewed in a blinded fashion along with 30 CT scans of post operative patients without clinical or laboratory evidence of discitis. The CT findings in the discitis patients were: (a) anterior paravertebral soft tissue swelling with obliteration of paravertebral fat planes, (b) fragmentation or erosions of vertebral end plates, and (c) paravertebral fluid collection (abscess). Both (a) and (b) were seen in 13/15 patients, (a) alone in 1/15, (b) alone in 1/15, and all three (a, b, c) in 2/15. The CT scan is diagnostic of discitis in those with all three findings. In those patients with only (a) or both (a) and (b), the CT can be suggestive of discitis in the proper clinical setting when correlated with plain film findings: however, these CT findings are also observed in other conditions. Involvement of the spinal canal by inflammatory mass was seen in 6/16 patients with discitis. Low attenuation (hypodensity) of the affected disc was not observed. PMID- 3974870 TI - Accidental introduction of contrast medium into the cervical spinal cord. A case report. AB - The density of metrizamide injected accidentally into the spinal cord during cervical CT myelography was measured with CT scanning and compared with a series of dilutions of metrizamide scanned with a special phantom. The test suggests that the metrizamide is diluted rapidly in the spinal canal, and in an accidental intraspinal injection of metrizamide, it is not the contrast medium itself but the mechanical effect of the introduction of a volume of fluid that causes the neurological symptoms. PMID- 3974872 TI - Calcification of the transverse ligament in calcium dihydrate deposition disease (CPPD). PMID- 3974871 TI - Cerebral toxoplasmosis in acquired immuno deficiency syndrome. A comparative assisted tomographic and neuropathological study of a case. AB - Authors report a case of fatal CNS toxoplasmosis in a young homosexual man suffering from Kaposi angio-sarcoma. This paper is principally concerned with CT scan and neuropathological correlations. PMID- 3974873 TI - Orbito-facial extension of intracranial medulloblastoma. PMID- 3974874 TI - Cerebral NMR: diagnostic evaluation of brain tumors by partial saturation technique with resistive NMR. AB - One hundred and forty patients with cerebral neoplasms were examined in a 0.12 Tesla prototype resistive NMR proton imaging device by partial saturation technique. NMR was superior to CT in tumor and edema localization and equal to CT in tumor and edema detection. NMR, however, was not able to clearly separate tumor from edema, a separation that contrast enhanced CT achieved. PMID- 3974875 TI - Neuronal loss in different parts of the nucleus basalis is related to neuritic plaque formation in cortical target areas in Alzheimer's disease. AB - In order to substantiate the hypothesis of a cholinergic pathogenesis of neuritic plaques in Alzheimer's disease the relationship between the loss of cholinergic neurons in six subdivisions of the nucleus basalis of Meynert and density of neuritic plaques in five neocortical target areas and hippocampus was studied in five cases with Alzheimer's disease. Distribution of plaques in different cortical areas as well as degeneration pattern of neurons within the subpopulations of the nucleus basalis were markedly different in the cases of Alzheimer's disease. Quantitative evaluation of the number of neuritic plaques in the five cortical areas revealed a strong correlation with the loss of neurons in those subpopulations of the nucleus basalis which give rise to the cholinergic innervation of the affected cortical areas. The nonlinearity of this correlation may reflect two different modes of plaque formation. Either plaque formation is a self-perpetuating process with an increasing rate depending on the number of plaques already formed or additional mechanisms, with an increasing rate of influence during plaque formation are induced. The shape of the regression function is different for the various cortical regions and their corresponding subpopulations of the nucleus basalis suggesting a different dependency of neuritic plaque formation on the neuronal loss in the nucleus basalis. This might reflect a different density of cholinergic fibers within these areas, a different degree of collateralization of the fibers or other factors not yet known. The findings indicate that degeneration of cortical cholinergic afferents from the neurons of the nucleus basalis is an important feature in the pathogenesis of neuritic plaques. PMID- 3974876 TI - Organization of the cerebellar cortex viewed by scanning electron microscopy. AB - An improved method of preparing central nervous system tissue for examination in a scanning electron microscope is described. In cerebellar cortex, the precise distribution of synaptic junctions on Purkinje cell bodies, as well as complex arrangements of neurites in the glomeruli of the granule cell layer, are directly visualized. The method also provides views of glial cell processes investing brain surfaces, blood vessels and neurons. The principal advantage of a scanning electron microscopic study is that relationships between cells in the brain can be seen directly instead of inferred from laborious serial reconstructions or other more complex and indirect anatomical methods. PMID- 3974877 TI - Homotypical ipsilateral cortical projections between somatosensory areas I and II in the cat. AB - In 11 cats, small quantities of horseradish peroxidase conjugated to wheat germ agglutinin were placed into cortical zones of somatosensory area I representing the distal digits (n = 3), distal toes (n = 2), toes and digits (n = 1), proximal forelimb (n = 1), proximal hindlimb (n = 1), trunk (n = 2), and the face and nose (n = 1). Reconstruction of the pattern of retrograde labeling in somatosensory area II revealed dense, heavily labeled patches of cells in regions that were precisely homotypical to the injection site as determined by electrophysiological recordings. This dense, homotypical patch of labeled cells was usually surrounded by a less densely populated fringe of labeled cells that bordered, but did not appear to enter, heterotypical zones. In two animals, however, some retrogradely labeled cells were found in the cortex representing somatotopic zones adjacent to the sites injected with horseradish peroxidase. These results indicated that somatosensory area II primarily sends homotypical projections to somatosensory area I. In a few cases, however, some retrogradely labeled cells may represent either homo-or heterotypical projections depending on how receptive field sizes and the areal extent of labeling in somatosensory areas I and II are interpreted. PMID- 3974878 TI - Climbing fiber projection to the turtle cerebellum: longitudinally oriented terminal zones within the basal third of the molecular layer. AB - Injections of various radiolabeled amino acids were made into the caudal rhombencephalic tegmentum in the turtle, Pseudemys scripta elegans. In animals in which injections encompassed the entire area previously identified as the possible source of cerebellar climbing fibers, the basal portion of the molecular layer was labeled almost throughout the contralateral cerebellum. In cases of restricted injections, labeled climbing fibers terminated in quite distinct longitudinally oriented zones. Control injections immediately caudal and rostral to the mentioned rhombencephalic region resulted in labeling of only the granular layer. The organization of the climbing fiber projection in the turtle is compared with the organization of the climbing fiber projection in representatives of birds and mammals as described in the literature. Reptiles, birds and mammals appear to be similar to each other in that they all have climbing fiber projections organized in longitudinal zones; whereas they differ with respect to the extent of climbing fiber penetration into the superficial portions of the molecular layer, mammals having climbing fibers that project significantly more superficially than those of birds or reptiles. PMID- 3974879 TI - Light-induced potassium fluxes in the skate retina. AB - Changes in the extracellular concentration of potassium [K+]0 in response to photic stimulation were studied in the skate retina with the aid of ion-selective electrodes. The results confirm earlier studies in demonstrating that the light evoked changes originate at three intraretinal sites; an efflux of K+ was recorded in the regions of the two plexiform (synaptic) layers, whereas a decrease in [K+]0 occurred in the extracellular space surrounding the photoreceptors. Prolonged illumination induced long-term alterations in the levels of [K+]0 which, depending upon the retinal depth of the recording electrode, contained contributions from the various sinks and sources of [K+]0. In addition, the marked undershoot of the baseline level of [K+]0 that followed termination of the stimulus suggested the activity of a metabolically driven process for the uptake of extracellular potassium. PMID- 3974880 TI - Specialized neuroglial arrangement may explain the capacity of vomeronasal axons to reinnervate central neurons. AB - The neurosensory cells of the primary olfactory and vomeronasal projections are in a state of continuous replacement throughout adult life. Since their axons form synaptic terminals with neurons in the olfactory and accessory olfactory bulbs, this system is an apparent exception to the rule that peripheral axons cannot grow into the central nervous system of adult mammals. Electron microscopy of sections (especially in a plane tangential to the surface of the accessory olfactory bulb) shows a unique glial arrangement. By virtue of their greater electron density and "secretory-type" organelle content (Golgi apparatus and dense-core vesicles) the glial cells of the superficial layers of the accessory olfactory bulb are distinguished both from the glia of the vomeronasal nerves and from the astrocytes of the deeper bulbar layers. The synapses between the vomeronasal axons and the postsynaptic elements are formed in glomeruli which are encapsulated by an inner layer of glial cytoplasm derived from the superficial glia, and an outer layer derived from the astrocytes. The principle of the organization is that the superficial glial processes are reflected off the axons before they reach the synaptic terminal zone. Conversely, for the postsynaptic elements, the astrocytic processes are reflected off the dendrites of the accessory olfactory bulb neurons before they enter the core of the glomeruli. In effect, the synapses are formed in a "no-man's-land" between the two glial cell types. This peculiar glial arrangement may be important for the unique regenerative capacity of this system. PMID- 3974881 TI - The development of innervation patterns in the avian cochlea. AB - The sequence of developmental events leading to the innervation of the cochlea and the differentiation of its receptor cells has been studied in chick embryos with Golgi methods. We describe the morphogenesis of cochlear ganglion cell peripheral processes from their appearance in early embryos to the formation of their mature endings on hair cells in the basilar papilla (organ of Corti) of prehatching chicks. In the stage of peripheral fiber outgrowth, embryonic days 3 5, the fibers emerge from the ganglion cell bodies and grow, in a uniform fashion, toward the undifferentiated receptor epithelium of the otocyst. In the stage of the invasion of the otocyst by the peripheral fibers, embryonic days 6 7, some fibers enter the epithelium directly after reaching it, others enter after traveling some distance longitudinally beneath its basal lamina. The invading fibers appear to encounter resistance at the basal lamina, but, once within the epithelium, at embryonic days 8-9, they form a surfeit of branches in columnar zones oriented radially toward the surface. In early synaptogenesis (embryonic days 8-9) hair cells first become apparent. They differentiate from primitive epithelial cells. These cells withdraw their basal processes, which appear to accompany the growing fibers into the superficial epithelium. At embryonic days 11-13, the stage of mid-synaptogenesis, the fibers develop large, bulbous, preterminal and terminal swellings, which are located below the bases of the hair cells; the surplus branches atrophy or withdraw. Efferent axons are first seen in the epithelium at this time. In late synaptogenesis (embryonic days 14-17), the preterminal swellings disappear and the endings transform into mature foot-shapes at the bases of the hair cells. These morphological changes during the development of the peripheral endings are comparable to those of cochlear axons in nucleus magnocellularis (cochlear nucleus). During mid-synaptogenesis, when the ganglion cells develop swellings in the periphery, their central axons ramify extensively. Late in synaptogenesis, while the peripheral swellings disappear, there is a corresponding condensation of the central terminals to form the end-bulbs of Held. Thus, specific connections of the cochlear ganglion cells and their target cells in the ear and brain may result from two sequential developmental phases: (1) loosely organized and overabundant initial growth of branches from the fibers entering their target tissue; (2) reorganization of these fibers with the disappearance or resorption of the surplus branches during the transformation of their endings into mature synaptic arrangements.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974882 TI - The growth of cochlear fibers and the formation of their synaptic endings in the avian inner ear: a study with the electron microscope. AB - The developmental sequence of nerve-epithelial cell contacts, leading up to the formation of the mature receptoneuronal synapse, has been studied in the basilar papilla of chick embryos with electron microscopy. The receptor epithelium before innervation, on embryonic days 3-4, consists of a homogeneous population of primitive cells; hair cells and supporting cells cannot be distinguished. During innervation of the epithelium (embryonic days 5-7), the invading peripheral fibers of cochlear ganglion cells penetrate the basal lamina and form nerve epithelial attachments with the epithelial cell bases. Once within the epithelium some fibers turn and spread in the transverse dimension across the basilar papilla through channels formed between the basal epithelial processes. Subsequently, nerve-epithelial attachments are observed more superficially within the epithelium. Hair cells and supporting cells differentiate during early synaptogenesis (embryonic days 8-9). Receptoneural synapses, possibly derived from the nerve-epithelial attachments formed during the innervation stage, are first seen during this period. They are characterized by symmetrical or asymmetrical membrane densities, separated by a cleft containing a dense material. At many of these junctions synaptic bodies, as well as dense-cored and coated vesicles, gather in the hair cells. During mid-synaptogenesis (embryonic days 11-13) the hair cells proliferate synaptic bodies, many of which are not located at receptoneural junctions. The preterminal portions of the sensory endings form large swellings, containing flocculent material, endoplasmic reticulum and vesicles. Late in synaptogenesis (embryonic days 15-17) the swellings disappear, while synaptic endings are transformed to foot-shaped terminals. In the hair cells, synaptic bodies not associated with junctions disappear. Efferent synapses are first seen during this period. This sequence of ultrastructural changes, which the developing sensory nerve endings and their target cells undergo in parallel, can be correlated with observations of Golgi preparations from a companion study. These correlations suggest that the innervation of the cochlea involves the following developmental processes. Initially the peripheral fibers of the ganglion cells grow directly toward the otocyst in fascicles. Having reached the base of the primitive receptor epithelium, the axonal endings, including some with growth cones, encounter a barrier in the basal lamina. When they enter some of the fibers attach to the basal end-feet of the primitive epithelial cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974883 TI - Microinjection of calmodulin antibodies into cultured chromaffin cells blocks catecholamine release in response to stimulation. AB - Polyclonal monospecific antibodies raised in sheep against rat testis calmodulin demonstrated cross-reactivity with bovine adrenal medullary chromaffin cell calmodulin. This antibody immunoprecipitated a [35S]methionine-labelled protein from chromaffin cell extracts prepared from [35S]methionine prelabelled cells that comigrated on a sodium dodecylsulfate gel electrophoresis system with calmodulin. In addition, an excess of non-radioactive exogenous calmodulin was shown to readily compete with this labelled endogenous protein for the antibodies' binding sites. Erythrocyte ghosts were used as vehicles for microinjecting either preimmune immunoglobulin G or anti-calmodulin immunoglobulin G into chromaffin cells following a polyethylene glycol-induced cell fusion procedure. The efficiency of ghost cell fusion was monitored and found to be 43.6 +/- 1% (n = 33). Cell morbidity subsequent to fusion and microinjection was negligible (87.8 +/- 0.6% of the total cell population were viable cells; n = 33) as determined by the Trypan Blue exclusion test. The delivery of intact antibodies raised against calmodulin directly into the cytoplasm of cultured chromaffin cells by erythrocyte ghost-mediated microinjection, inhibited catecholamine output in response to stimulation by either acetylcholine (10(-4) M) or a depolarizing concentration of potassium (56 mM). However, under these conditions, the chromaffin cell's ability to accumulate exogenous catecholamines through a high affinity uptake system, as well as the kinetic parameters that characterize this uptake mechanism remained unaltered. Furthermore, microinjection of preimmune immunoglobulin G did not modify either catecholamine uptake or stimulation-induced amine release from chromaffin cells. It therefore appears that calmodulin may play a role in the process of stimulus secretion coupling in the chromaffin cell in culture while it is of little significance to the high affinity amine uptake mechanism. PMID- 3974885 TI - Nerve growth factor increases choline acetyltransferase but not survival or fiber outgrowth of cultured fetal septal cholinergic neurons. AB - Neurons dissociated from the septal area of fetal rat brains were grown in culture. Cholinergic neurons were identified by immunocytochemical visualization of choline acetyltransferase and cytochemical demonstration of acetyl cholinesterase. Choline acetyltransferase immunocytochemistry stained cell bodies and proximal processes while acetylcholinesterase cytochemistry visualized the entire neuron. Choline acetyltransferase-positive neurons could only be identified in cultures grown under conditions that produced the maximal choline acetyltransferase activity, measured biochemically. All of the choline acetyltransferase-positive neurons were double stained for acetylcholinesterase while only 6% of the acetylcholinesterase-positive cells were choline acetyltransferase negative in these cultures. These results indicate that acetylcholinesterase is a reliable marker for cholinergic cells in cultures of dissociated septal neurons. Being the more sensitive method, acetylcholinesterase staining was therefore used to identify cholinergic cells in cultures with choline acetyltransferase levels insufficient for immunocytochemical visualization of this enzyme. Addition of nerve growth factor or antibodies to nerve growth factor to the medium did not affect the number of cholinergic neurons surviving in culture. Furthermore, nerve growth factor and anti-nerve growth factor failed to influence the general morphological appearance and the number of processes of these neurons. However, nerve growth factor elevated the biochemically measured activity of choline acetyltransferase up to two-fold. The nerve growth factor-mediated increase in choline acetyltransferase activity was dose dependent with an ED50 of 10 ng/ml (4 X 10(-10) M). The increase was highly specific for nerve growth factor. It was blocked by anti-nerve growth factor, and epidermal growth factor, insulin and other control proteins failed to exert a similar effect. Nerve growth factor had to be present for at least 3 days in the culture medium to increase choline acetyltransferase activity, suggesting that the increase was due to an elevated choline acetyltransferase synthesis rather than to an activation of the enzyme. PMID- 3974884 TI - Injections of picrotoxin and bicuculline into the amygdaloid complex of the rat: an electroencephalographic, behavioural and morphological analysis. AB - Bicuculline methiodide (0.5-3 nmol) and picrotoxin (0.5-4 nmol) were injected uni or bilaterally into the rat amygdala and the resulting behavioural, electroencephalographic and morphological alterations were studied. In rats treated unilaterally with lowest doses of either bicuculline or picrotoxin (0.5 and 1 nmol) increase in the locomotor activity, occasional myoclonus of the hindlimbs and wet dog shakes were observed. At doses of 2-3 nmol, both gamma aminobutyrate antagonists produced a sequence of repetitively occurring behavioural alterations including limbic gustatory automatisms, tremor and myoclonus of the forelimbs, head nodding and rearing, that developed over 15-30 min and built up progressively into the recurrent motor limbic seizures lasting for 1-6 h. In animals injected bilaterally with either bicuculline (0.5-3 nmol) or picrotoxin (0.5-3 nmol) motor limbic seizures rapidly developed into the status epilepticus lasting for several hours. Bicuculline and picrotoxin produced both ictal and interictal epileptiform activity in the electroencephalogram. A spectrum of electroencephalographic changes consisted of high voltage fast activity, slow and fast voltage spiking, paraoxysmal bursts and periods of postictal depression. The earliest electrographic alterations appeared in the amygdala and then rapidly spread to cortical areas. Electrographic seizures started 1-10 min after unilateral injections of large doses of bicuculline and pictrotoxin (2-4 nmol). Ictal periods lasted for 1-2 min, recurred every 5-10 min and were followed by periods of depression of the electrographic activity. Bilateral injections of large doses of both gamma-aminobutyrate antagonists (2-3 nmol) resulted in the status epilepticus. Morphological examination of frontal forebrain sections with light microscopy revealed a widespread damage to the amygdala, olfactory cortex, substantia nigra, thalamus, hippocampus and neocortex. Pretreatment of animals with diazepam prevented the build-up of convulsive activity and brain damage produced by bicuculline or picrotoxin. Muscimol retarded the appearance and shortened the duration of convulsive activity, but did not alter the sequence and intensity of seizures. The results indicate that gamma-aminobutyrate antagonists, bicuculline and picrotoxin when directly applied to the amygdala can elicit in rats motor limbic seizures, epileptic changes in the electroencephalogram indicative of repetitive limbic seizures, and status epilepticus accompanied by seizure-related brain damage.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974886 TI - Evidence for exocytotic release of dopamine beta-hydroxylase from rabbit heart and of vasopressin from rat neurohypophyses during homogenization and fractionation. Effects of gadolinium ions, cytochalasin B, gallopamil and different temperatures. AB - Isolated rabbit hearts were perfused according to a modified Langendorff method for 1 h (unstimulated hearts). In different hearts, release of dopamine beta hydroxylase activity into the transmyocardial fluid draining the interstitium was evoked by electrical field stimulation for six periods of 1 min at 30 min intervals (stimulated hearts). The hearts were then homogenized and fractionated into 100,000 g supernatant and sedimented at 4 degrees C. In homogenates from unstimulated hearts, the soluble dopamine beta-hydroxylase (determined in the supernatant) accounted for 17% of the total dopamine beta-hydroxylase (determined in the homogenate). In stimulated hearts the soluble fraction of dopamine beta hydroxylase was reduced by 65%. The dopamine beta-hydroxylase released into the transmyocardial fluid by electrical stimulation, expressed as fraction of the total activity, corresponded well to the loss of enzyme from the supernatant demonstrating that the soluble dopamine beta-hydroxylase determined from the supernatant represents the releasable pool. Gadolinium ions (Gd3+) added to the homogenization medium of unstimulated hearts reduced the soluble fraction of dopamine beta-hydroxylase up to 63%, with the maximum effect at 200 microM. Similarly, when neurohypophyses were homogenized and spun at 0-4 degrees C, the fraction of vasopressin in the soluble phase was about 50% of the total. Gd3+ reduced this fraction by maximally 60%, an effect which was accompanied by an increase of vasopressin in the sedimentable fraction. When cytochalasin B (10 microM) was present during the homogenization of the hearts the soluble fraction of dopamine beta-hydroxylase was reduced to the same extent as in the presence of Gd3+. However, cytochalasin B had no effect on the distribution of vasopressin in the soluble and sedimentable fractions of homogenates of neurohypophyses. Gallopamil, when present during the homogenization of the hearts at a maximum effective concentration of 1 microM, reduced the soluble fraction of dopamine beta-hydroxylase by only 40%. However, the electrically evoked noradrenaline release from perfused hearts was completely blocked at 100-300 microM gallopamil. When neurohypophyses were homogenized and fractionated at room temperature only 13% of the total vasopressin was found in the soluble fraction and Gd3+ did not further reduce this fraction. When unstimulated hearts were homogenized and fractionated at room temperature the fraction of soluble dopamine beta hydroxylase was reduced by 40% compared to the experiments at 0-4 degrees C.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3974887 TI - Long-term study of pergolide in Parkinson's disease. AB - In 18 patients with Parkinson's disease, the effects of pergolide after 28 months of treatment were compared with the response after the initial 10-week therapy. At a mean 3.2-mg daily dose of pergolide, the daily dose of levodopa was still 33% lower than at the onset of pergolide therapy. The mean motor disability score, which decreased by 65% during the first 10 weeks of pergolide, was still decreased by 42% after 28 months. In the 12 patients with on-off effect, the percent time on increased 117% during the first phase of the study and was still increased 63% after more than 2 years of pergolide therapy. Sudden freezing episodes became the most disabling problem in the majority of patients. "Down regulation" of dopamine receptors may contribute, but it is not the only cause of loss of responsiveness to pergolide. PMID- 3974888 TI - Surgical treatment of idiopathic hydrocephalus in elderly patients. AB - We studied 45 adult patients with idiopathic hydrocephalus who had undergone a shunting procedure at the Mayo Clinic during a 16-year period. The follow-up period extended up to 157 months. Thirty-four of the 45 patients (75%) improved at some time after the operation, and 19 (42%) experienced continuous improvement. The median duration of improvement was 24 months. Patients who had symptoms for less than 2 years were most likely to improve. CT played an important role in the diagnosis and follow-up, but ventricular size or degree of atrophy did not correlate with response. PMID- 3974889 TI - Chronic progressive multiple sclerosis: double-blind controlled study of plasmapheresis in patients taking immunosuppressive drugs. AB - Fifty-four patients with chronic progressive multiple sclerosis received prednisone plus oral low-dose cyclophosphamide and either true plasmapheresis (PP) or "sham" PP weekly for 20 weeks in a double-blind controlled study. Immunosuppressive drug therapy alone (sham PP group, n = 29) was associated with improvement (greater than or equal to one step in Kurtzke Disability Status Scale [DSS]; mean change of 1.5) in 8 and stabilization of MS in 18 patients, with this status sustained in 23 patients at follow-up, 11 months after entry. In contrast, 14 of 26 patients who received "true" PP improved (greater than or equal to one step in DSS; mean change of 2.6), and 11 more were stable, with these changes sustained in 23 of 26 patients at follow-up. These differences, overall, between the PP and sham PP groups were significant at p less than 0.007. PMID- 3974890 TI - Long-latency event-related potentials in the evaluation of cognitive function in children. AB - The endogenous auditory P300 event-related potential (P3) has been used to differentiate functional and organic cognitive disorders in adults. We found that children with organic cognitive impairments (as determined by the Halstead-Reitan [HR] test) had greater P3 latencies than children with normal HR evaluations. The P3 and HR showed 85% agreement in independent assessments of functional or organically based cognitive impairment in children. Mini-Mental-State, IQ, EEG evaluations, and clinical suspicions of "organicity" with respect to cognitive function were similarly associated with P3 latency. PMID- 3974891 TI - Isometric muscle contraction in endocrine myopathies. AB - Isometric contraction of the adductor pollicis muscle of the thumb was evoked by stimulating the ulnar nerve in 20 normal adults and 58 patients with endocrine disorders. We evaluated mechanical latency, electromechanical latency, contraction time, half relaxation time, isometric twitch force, compound muscle action potential, nerve conduction velocity, and relative refractory period. Mechanical characteristics were altered in diseases of the pituitary, thyroid, and parathyroid glands. The close relationship between thyroid hormone and contractile properties discriminated between hypo- and hyperthyroidism. PMID- 3974892 TI - Blind loop syndrome, vitamin E malabsorption, and spinocerebellar degeneration. AB - A 72-year-old man had severe malabsorption, progressive retinopathy, and spinocerebellar degeneration 32 years after gastric surgery, blind loop formation, and intestinal bacterial overgrowth. Clinical and pathologic features were typical of vitamin E deficiency; vitamin E was nearly undetectable in serum and profoundly low in adipose tissue. Vitamin E blood levels initially improved on treatment with antibiotics; after additional vitamin E supplementation, there was clinical improvement. PMID- 3974893 TI - Clinical correlations of serial somatosensory evoked potentials in multiple sclerosis. AB - Serial median nerve somatosensory evoked potentials (SEPs) were recorded in 12 patients with definite MS. On the initial tests, there was no clear association between the severity of clinical disease activity and SEP findings. The cervical response was most frequently affected and, when present, was often abnormal in configuration, suggesting absence or delay in the far field P14 component with preservation of cervical N11 and N13 components. Clinical motor and sensory findings in the corresponding limb frequently correlated with abnormalities of the cervical response. When new motor and sensory findings developed in the arms during the study, the SEP deteriorated in some patients but improved in others. Most SEP changes were not accompanied by clinical changes. Overall disability sometimes increased during the study despite improvements in the SEP. PMID- 3974894 TI - Familial tic disorder, parkinsonism, motor neuron disease, and acanthocytosis: a new syndrome. AB - We report two brothers who were of consanguineous parents and who displayed a unique association of motor and vocal tics, parkinsonism, distal muscular atrophy, and acanthocytosis. In the older brother, leg weakness and muscle wasting started at age 13, and he became wheelchair bound at 40. Electrophysiologic studies and muscle biopsy confirmed diffuse denervation. Involuntary vocalizations and facial tics began at age 36, but within 5 years the tics were replaced by progressive parkinsonism with supranuclear ophthalmoparesis. CSF studies implied impaired central dopamine and serotonin turnover. In the younger brother, orofacial tics started at age 36, vocalizations and fasciculations in the legs began 1 year later, and parkinsonian findings were present at age 40. This is the first report of an association of Tourettism, parkinsonism, motor neuron disease, and acanthocytosis occurring as an autosomal recessive syndrome. PMID- 3974896 TI - Task-dependent hemisphere asymmetries of the visual evoked potential. AB - Stimulus-related and event-related components of the visual evoked potential were recorded in three separate tasks that required language comprehension or spatial discrimination. Task-dependent asymmetries in the evoked potential were found for both the language task and one of the tasks involving spatial discrimination. Moreover, an identical stimulus presented in two different contexts elicited potentials with a significantly different distribution over the two sides of the head. These asymmetries were largely confined to the event-related components and presumably reflect task-dependent differences in neural processing. Reaction-time studies for these tasks, however, indicated that these asymmetries occurred too late to arise from neural structures responsible for language comprehension or spatial discrimination per se, and must therefore reflect subsequent neural events. PMID- 3974895 TI - Improvement of abnormal pyruvate metabolism and cardiac conduction defect with coenzyme Q10 in Kearns-Sayre syndrome. AB - In a patient with Kearns-Sayre syndrome, concentration of coenzyme Q10, a component of the mitochondrial electron transport system, was decreased in serum and in the mitochondrial fraction of skeletal muscle. Serum concentrations of lactate and pyruvate were abnormally high, especially after exercise or oral glucose loading. Levels of folic acid in plasma and CSF were decreased. ECG showed a first-degree atrioventricular block. After administration of coenzyme Q10 60 to 120 mg daily for 3 months, serum levels of lactate and pyruvate became normal, with improvement of atrioventricular block and ocular movements. PMID- 3974897 TI - Aphasia in dementia of the Alzheimer type. AB - Speech and language assessment in 30 patients with dementia of the Alzheimer type and in 70 normal controls revealed that all Alzheimer patients were aphasic. Throughout most of the course, the language disorder resembled transcortical sensory aphasia, and increasing language impairment correlated with increasing severity of dementia. Aphasia was present regardless of age of onset or family history of dementia. Aphasia is an important diagnostic criterion of dementia of the Alzheimer type. PMID- 3974898 TI - Brainstem gliomas of childhood: magnetic resonance imaging. AB - We compared magnetic resonance imaging (MRI) and CT on 16 children with brainstem gliomas. MRI demonstrated masses of decreased signal intensity, which enlarged and distorted brainstems in all patients with active disease and showed brainstem abnormalities in 21 of 23 studies (91%). In one-half of the patients, MRI showed more extensive disease than did CT. Exophytic portions of tumors were shown well on MRI. MRI was more sensitive than CT in demonstrating disease relapse. PMID- 3974899 TI - Sjogren-Larsson syndrome: delta 5-and delta 6-fatty acid desaturases in skin fibroblasts. AB - Cultured skin fibroblasts from two patients with Sjogren-Larsson syndrome (SLS) and from a normal control were analyzed for trienoic and tetraenoic fatty acids. In addition, we assayed desaturation of [1-14C]linoleic acid in cells from four patients and four controls. There was no significant effect of the disease on the composition of polyunsaturated fatty acids or on the rate of linoleic acid desaturation in fibroblasts. The results indicate the presence of delta 5- and delta 6-fatty acid desaturases in cells from SLS patients. PMID- 3974900 TI - Cerebral vasculitis and hemorrhage associated with phenylpropanolamine. AB - A 20-year-old woman using an oral diet aid preparation containing phenylpropanolamine presented with an intracerebral hemorrhage and angiographic evidence of cerebral vasculitis. Gas chromatography demonstrated phenylpropanolamine in the urine. Even when used within recommended guidelines, phenylpropanolamine usage should be included in the differential diagnosis of patients presenting with intracranial hemorrhage. PMID- 3974901 TI - Periodic leg movements in sleep: effect of clonazepam treatment. AB - Periodic leg movements in sleep were diagnosed in 8 patients with insomnia and in 12 patients with hypersomnia. Polysomnography did not reveal any difference in the number of leg movements in these groups, the mean duration of a leg movement, or the number of activity epochs. Those with insomnia, however, had a shorter intermovement interval than those with hypersomnia, with more leg movements in each activity epoch. Treatment with 0.5 to 2 mg clonazepam improved subjective complaints and decreased the number of leg movements without affecting the intermovement interval or movement duration. PMID- 3974902 TI - Reversible ischemic attacks with normal angiogram: risk factors, clinical findings, and prognosis. AB - One hundred seventeen patients with reversible ischemic attacks were divided into two groups according to the presence of atheromatous lesions on angiography. Female sex, vertebrobasilar territory involvement, and younger age were related to normal angiograms. Among risk factors, only hypertension was associated with atheroma. However, the number of risk factors in each patient was related linearly to angiographic abnormality. Later stroke and myocardial infarction were significantly more common in patients with atheromatous lesions. PMID- 3974903 TI - Marinesco-Sjogren syndrome: evidence for a lysosomal storage disorder. AB - The inherited abnormality of the Marinesco-Sjogren syndrome is not known. We studied four patients from two different families and ethnic groups. Electron microscopic studies revealed numerous, abnormally enlarged lysosomes that contained whorled lamellar or amorphous inclusion bodies. Enzyme studies excluded previously described lysosomal storage disorders. PMID- 3974904 TI - "Apraxia" of eyelid opening: an involuntary levator inhibition. AB - Apraxia of lid opening was described by Goldstein and Cogan as "a non paralytic motor abnormality characterized by the patient's difficulty in initiating the act of lid elevation." We studied six such patients with this finding accompanied by vigorous frontalis contraction and no evidence of ongoing orbicularis oculi contraction, dysfunction of the oculomotor nerve, or loss of ocular sympathetic innervation. Four patients had Parkinson's disease or atypical parkinsonism, one had progressive supranuclear palsy, and one had Shy-Drager syndrome. At onset of ocular symptoms, mean age was 64 years, and the mean duration of extrapyramidal symptoms was 9.7 years. By definition, the motor system must be intact in any apraxia. Therefore, this disorder of lid opening in patients with extrapyramidal motor dysfunction is not an apraxia, but rather involuntary levator palpebrae inhibition of supranuclear origin. PMID- 3974905 TI - Accidental hypothermia in a healthy quadriplegic patient. AB - An otherwise healthy 28-year-old quadriplegic patient was admitted to the hospital with a core temperature of 76 degrees F secondary to accidental hypothermia. Her neurologic disability was detrimental to thermoregulation by decreasing her ability to shiver actively and to vasoconstrict. The relationship between shivering and thermoregulation is discussed. PMID- 3974907 TI - Pure word deafness: CT localization of the pathology. PMID- 3974906 TI - Metoclopramide-induced phantom dyskinesia. AB - A 58-year-old woman was receiving chemotherapy for carcinoma of the breast. She was given 1,700 mg metoclopramide IV for 2 months to prevent nausea and vomiting. Within hours after metoclopramide was given, she had hand tremor, akathisia, and truncal and orofacial dyskinesia. These symptoms resolved, but she was left with persistent shoulder stump chorea, the perception of the phantom left arm involuntarily adducted at the shoulder and flexed at the elbow, and dystonic pronation and extension of the hand away from her body. The motor aspects of the phantom dyskinesia will be emphasized. PMID- 3974908 TI - CT follow-up in central pontine myelinolysis. PMID- 3974909 TI - Ocular dipping. PMID- 3974910 TI - Transient dyskinesia and cerebral ischemia. PMID- 3974911 TI - Propranolol in essential tremor. PMID- 3974913 TI - Dementia of the Alzheimer type. PMID- 3974912 TI - Progressive supranuclear palsy: paraneoplastic effect of bronchial carcinoma. PMID- 3974914 TI - Lumbosacral plexus neuropathy and paraspinal muscle denervation. PMID- 3974915 TI - [Immuno-oncologic monitoring of patients with bronchial carcinoma. I. Carcinoembryonic antigen (CEA)]. AB - Plasma levels of carcinoembryonic antigen (CEA) were determined in 82 lung cancer patients before surgery and during the clinical course of the disease. Results were compared to those obtained in normal controls and in patients with lung inflammatory diseases. Furthermore, relationships between plasma CEA levels and survival were carried out. While CEA levels were not useful to make differential diagnosis, in our study, we hypothized the possibility to use CEA in prognostic evaluations. PMID- 3974916 TI - [Clinical and radiological diagnosis considerations on 2 cases of achalasia]. AB - Two cases of achalasia of the lower third of the oesophagus are presented. Leucoplakia was encountered in one of the cases. The clinical, aetiopathogenic and x-ray diagnostic aspects of achalasia are described in relation to the possibility that it may be associated with neoplasia or pre-cancerous alterations. In both the above cases, early dysphagia was encountered. PMID- 3974918 TI - [Chest pain]. AB - After a thorough description of the physiological background, the problem of chest pain is examined with extensive documentation including pictures. It is suggested that meticulous clinical assessment is of even greater value than laboratory tests or instrumental explorations for the accurate diagnosis and appropriate treatment of the condition causing the pain. In other words laboratory and instrumental assessments should be based on and used to confirm an approximate diagnosis formed on clinical data. PMID- 3974919 TI - [Clinical value of serum concentration of total bile acids in chronic hepatopathies]. AB - Total bile acid concentrations were estimated in fasting serum samples from 251 patients with chronic liver disease and 108 controls without liver disease, together with conventional liver tests. Serum bile acids level was significantly higher in patients with liver disease than in control group. Fasting serum bile acid concentration was raised in 172 of the 251 patients with impaired hepatic function (68.5%). Only gamma-glutamyltranspeptidase and transaminase tests exhibited a higher abnormality frequency. Two-hour postprandial serum bile acid concentrations were measured in 78 patients: the meal test shows a rise in sensitivity (+26.9%). Our results confirm that serum bile acids concentration represent a sensitive and reproducible test for hepatobiliary disorders. PMID- 3974917 TI - [Chronic gastritis: classification, etiopathogenesis and clinical course]. AB - The Authors show and discuss the classification proposed till now for dividing chronic atrophic gastritis into subtypes different in hystological, functional or immunological aspects. In accordance with the more recent reports, the classification into type A, type B and type AB is accepted. Genetical (factor A) and environmental agents (alcohol, smoke, drugs) as well as immunological (parietal and gastrin cell antibodies) and functional abnormalities (duodenogastric reflux), suggested to play a role in the aetiopathogenesis of chronic atrophic gastritis, are also re-examined. Finally, dynamic aspects of chronic atrophic gastritis and its association with anemia and gastric carcinoma are widely reviewed. PMID- 3974920 TI - [Typology and etiopathogenesis of breast pain]. AB - Although mammary pain is the most common reason prompting women to seek breast examination, it is considered to unimportant to be fully investigated and often treatment is extremely superficial. A projected investigation of the natural history of mammary pain through examination of the symptomatology of the commonest forms is considered to be necessary for accurate diagnosis, itself indispensable for effective treatment. PMID- 3974921 TI - [Radiographic diagnosis in the early recognition and evaluation of incapacitating sequelae of advanced rheumatoid arthritis]. AB - Two observed cases of rheumatoid arthritis, one at an initial, the other at a very advanced stage, form the basis for a detailed report on the radiographic signs of the disease. Particular emphasis is placed on the possibilities offered by the various radiographic techniques for the evaluation of the sequelae of rheumatoid arthritis and for the early diagnosis of the disease. PMID- 3974923 TI - [The Biomedical Publishing House in Italy]. PMID- 3974922 TI - [Serologic methods in the diagnosis of toxoplasmosis]. AB - The data revealed on the same subject by the indirect agglutination test and the immunoenzyme test for IgG and IgM anti-toxoplasma antibodies were compared. The analysis shows that neither the indirect agglutination test nor the antibody count is sufficient for the diagnosis of the disease and that both are more appropriately employed in statistical epidemiological surveys. PMID- 3974924 TI - [Infusion and transfusion therapy in polytraumatized patients]. AB - Considerations of a physiopathological nature are expressed with regard to haemorrhagic multiple-injury patients in the light of the experience acquired in first-aid practice at the University of Turin department of emergency surgery. While treatment of the basic injury is the key to therapy, sufficient infusion management and careful monitoring of coagulation parameters before and during transfusion may be of fundamental importance in survival. By the same token, not all blood products available can be used indiscriminately. A treatment and monitoring protocol for the reinstatement of volaemia and corpuscle mass, and for the correction of coagulopathy due to loss, consumption and wash-out is proposed. PMID- 3974925 TI - [Immuno-oncologic monitoring of patients with bronchial carcinoma. II. Plasma fibronectin determination]. AB - Recent attempts implicating glycoproteins have been focused on the study of fibronectin. This glycoprotein was observed especially in cellular adhesivity processes. Some works were direct to detect the fibronectin concentration in plasma and in other biological fluids to relate increased or decreased levels in pathological features. In this paper we describe a study on plasma fibronectin in lung cancer patients during the course of the disease. PMID- 3974926 TI - [Partial and multiple correlations between 4 types of enzymuria in 2 groups of chronic nephropathic patients]. AB - The urinary activity of four enzymes (NAG, GLU, GRS and GAL) was studied in two groups of patients suffering respectively from interstitial nephritis and chronic glomerulonephritis with the aim of further investigating enzyme variability through the theory of partial and multiple correlation. This study permitted the effects of two enzymes on the known correlations between the remaining two enzyme types to be studied. It was established that very stable relationships exist between each enzyme and the group composed of the remaining three. In particular, in patients with interstizial nephritis, correlations with GAL were all highly significant even if the effect of the other two enzymes was ignored. Similarly, correlations with GRS were strongly significant in patients with chronic glomerulonephritis. In the two groups studied, each enzyme appears to have a highly stable relationship with the other three. Accurate estimates may probably be achieved for GAL and GRS in both groups and for NAG in the glomerulonephritis sufferers. This is further evidence that the enzyme procedure may be used to differentiate between interstitial and glomerular nephritis. PMID- 3974927 TI - [Delayed rehabilitation of colostomized patients. Our experience]. AB - Rehabilitation by means of periodic irrigation is an easy-to-use method that is generally well accepted by the patient. By "giving up" an hour less a day, or better still every 48 hours, the patient can avoid the inconvenience of numerous, continual and uncontrollable evacuations. In confirmation of previous experiments, no significant differences were observed concerning early rehabilitation (up to 10 years after the operation). Irrigation has also been shown to have few negative aspects. PMID- 3974928 TI - [Postoperative thromboembolism: preventive use of calcium heparin in low doses]. AB - The problem of post-operative thromboembolism is re-examined and the progress made in the prevention of venous stasis and hypercoagulability reviewed. The high incidence of asymptomatic phlebitic phenomena is noted and personal experience of the use of low doses of Calcium heparin in 415 patients undergoing various types of operation is reported. Eight patients had chronic duodenal ulcers. A notable reduction in the incidence of post-operative thromboembolism was confirmed. The value of this preventive method is thus demonstrated, as is the usefulness of analysing haemostatic balance in patients with one or more risk factors for thromboembolism in order to "personalize" the dosage and duration of treatment with Calcium heparin. PMID- 3974929 TI - [Postoperative pain and methods for its control]. AB - Research was conducted into post-operative pain and possible means for its control. A total of 66 patients subdivided into 3 groups were studied. In order to document analgesic effectiveness, pain was measured by two subjective methods- Huskisson's Visual Analogue and the "SCORE" index. Patients' anxiety was assessed pre-operatively by a suitably modified tourniquet test. The groups of patients were subdivided according to the analgesic agent used: 1st group (herniectomies, appendicectomies) Baralgina f. 1; 2nd group (cholecystectomies, hysterectomies) Talwin f. 1; 3rd group (cholecystectomies, hysterectomies) Baralgina f. 1 + Talwin f. 1. The latter combination proved to be satisfactory and guaranteed a sufficiently calm post-operative period. On the basis of the data obtained, it is recommended that anaesthesiological procedures include analgesic cover that exploits the action of Phentanyl as an analgesic agent and neurovegetative stabilizer and is to be used at the start of the operation. For operations lasting more than 60 minutes, a combination of Baralgina and Talwin or Buprenorfina may be administered during the post-operative period. PMID- 3974930 TI - [Bone biopsy in hematology]. AB - The importance of bone marrow biopsy in haematology lies in the fact that it puts relatively little stress on the patient and can reliably diagnose numerous blood diseases involving the bone marrow. It also provides information on the state of the bone marrow after treatment, and is essential for restaging in cases of lympho-proliferative diseases. A total of 116 personally conducted bone marrow biopsies proved to be a basic test for certain pathologies (medullary hypoplasia, myelofibrosis, N. H. lymphomas); while for others (leukaemia, plasmocytoma, polycythaemia), it was revealed to be a valuable back-up to clinical examination and other diagnostic procedures. PMID- 3974931 TI - [Malignant tumors preceding or following breast cancer]. AB - Using the records of the Cancer Clinic of Biella Hospital that date back more than 25 years, a retrospective survey was conducted into 65 patients suffering from two primary malignant neoplasms one of which affected the breast. Graphs and tables illustrate; the frequency, location, histological type, staging, the age of the patient and the date of the onset of the first neoplasia, any previous family history of cancer, the interval between the two neoplasias and the type of treatment given during this interval. Particular attention is paid to cases in which both neoplasias were breast tumours, and brief remarks on certain aspects of such cases are presented. PMID- 3974932 TI - [Analysis of the activities of the Biella Mental Health Service during the 3-year period 1980-1982]. AB - An account is presented of the work of the Biella local health unit in the province of Vercelli, Piedmont. Attention is drawn to the difficulties met with in applying the latest enactments concerning psychiatry. Delay in application of the health reforms is having an adverse effect on the operation of the new psychiatric care structures. Psychiatry is finding it difficult to become an integral part of the other health services. This is clear from the requests for consultation made to department psychiatrists at Biella Hospital. There has been an increase in applications for admission and compulsory treatment in the three year period under review. In particular, there is the difficulty of taking on a small number of patients from the previous structures. By contrast, there has been a change for the better in the relationship between the community and the outpatient service. This relationship is becoming stable and is beginning to acquire a psychotherapeutic structure. PMID- 3974933 TI - [Assistance for the thalassemic child in a child care center]. AB - Problems associated with running a new thalassaemic child care center are described. In addition to well documented treatment problems, the search for new diagnostic approaches and psychological support for the rest of the family are also important factors. PMID- 3974934 TI - [Cranial injuries in childhood and a radiologic study]. AB - 527 patients with cranial traumas aged between 15 days and 13 years 10 months old were examined. All the subjects were treated at the Paediatric Division of Biella Hospital in 1972-1982, and were given cranial radiography. The most frequent types of trauma for the different age groups were noted, together with any correspondence between clinical signs and the presence of a cranial fracture. The study seeks to make a practical contribution to the problem of the principles on which radiological examinations should be based in order to haven a clear prognosis and indications for treatment. PMID- 3974935 TI - [A case of primary adenocarcinoma of the cervix of probable origin from an area of endometriosis]. AB - A case of primary adenocarcinoma of the cervix of probable endometrial origin is described in a 37 year-old woman. PMID- 3974936 TI - [Method of carrying out a vaginal delivery after cesarean section]. AB - 51 cases of successful vaginal childbirth after caesarean section are reported. An assessment of the various methods used for vaginal parturition showed the spontaneous eutocic type to be the most frequent (66,6%). The incidence of instrumental parturition was only 33,33%. Foetal condition was good, both in terms of weight and the A.P.G.A.R. index: no maternal complications were reported. PMID- 3974937 TI - [Effects of long-term treatment with L-carnitine on dyslipemia in hemodialysis patients]. AB - The effect of long-term intravenous administration of L-carnitine on the lipid pattern of 18 patients on intermittent haemodialysis has been evaluated. Serum levels of carnitine were assayed at the beginning and after 4 months of treatment: no significant change was observed. At the end of our investigation, we found a significant reduction of HDL-cholesterol and a significant increase of triglyceride levels, compared with basal values. On the contrary cholesterol levels did not change. Five of the patients though behaved as responders to the treatment: their triglyceride levels decrease while their carnitine values rose significantly. The Authors discuss the therapeutic importance of L-carnitine and its possible influence on dyslipaemia of uremic haemodialysed patients. PMID- 3974938 TI - [Therapy of lymphedemas: a study trip to Shanghai in search of the Chinese cure. The second Medical School in Shanghai (11-25 November 1984)]. PMID- 3974939 TI - [Exogenous infections and environmental flora. Criteria for the characterization of bacteria and parameters influencing their spread]. AB - An assessment was made of environmental micro-organisms isolated in the University of Turin Intensive Surgical Care Unit and Emergency Surgery Department to determine the possible exogenous origin of post-operative infections. The enzymatic characters and antibiotypes were determined for some species, and subsequently compared with similar characters of the "in vivo" isolated flora. A monthly disinfection method based on comparison among three antiseptic agents (chlorexidine, formaldehyde and formotetronium) considerably reduced the flora. The data obtained, while showing that most of the infections observed were endogenous, also provided indications on the way in which the spread of certain Gram-negative germs, often involved in post-operative and post-traumatic infections, could be contained. PMID- 3974940 TI - [Flowmetric, thermometric and rheologic studies in obliterating arterial diseases of the lower extremities treated with buflomedil]. AB - Ten subjects with peripheral arterial occlusive disease were treated with buflomedil, analysing the effect of every single intravenous administration of the drug, and the effect of the administration repeated for a period of 5 days. This controlled study was aimed at evaluating the state of the peripheral blood flow, not just relating to the flowmetric parameters, but also to those more directly connected to the metabolic and functional conditions of the microcirculation. During every single administration, blood flow, skin and muscular temperatures were recorded. As concerned the drug's chronic effect, endurance limit, skin and muscular temperatures, whole blood viscosity, plasma viscosity and red cell filterability were recorded before beginning the treatment and after 15 days. The results of this study show that during a single buflomedil infusion no modifications have been observed in blood flow and muscular temperature, whereas skin temperature showed a slight increase. On the contrary, after a 15 days treatment, muscular temperature and endurance limit significantly increased, without flowmetric changes. A significant decrease in values of blood viscosity at high shear-rate was recorded too. The overall results seem to indicate that after treatment with buflomedil there is an improvement of the metabolic muscular conditions, probably due to a stimulant effect of the drug on microcirculatory blood flow. PMID- 3974942 TI - Comparative localization of Cajal-Retzius cells in the neocortex of normal and reeler mutant mice fetuses. AB - The Cajal-Retzius cells (CRc) appear as an histochemically advanced subpopulation, since they are the only neocortical neurons able to express an acetylcholinesterase activity at an early stage of corticogenesis. Thus a comparative study of the CRc population was carried out on normal and reeler mice fetuses. The use of an appropriate cytochemical technique to reveal this endogenous cell marker, in conjunction with coronal and tangential sections show that: the Cajal-Retzius cells form a sheet in the more superficial layer of the embryonic cortex, with a relative cell density giving the same value in both phenotypes; a difference is observed in the relative depth position of these cells with regard to the pial basal lamina and in the pattern of cell grouping between the heterozygous and homozygous mutant littermates. This technique appears of great interest for a further analysis of the CRc population during cortical ontogenesis. PMID- 3974941 TI - [Immuno-oncologic monitoring of patients with bronchial carcinoma. III. Plasma glycoproteins]. AB - Alpha and beta serum glycoprotein levels were determined in lung cancer patients at time of diagnosis and during the natural course of the disease. The results do not suggest that these glycoproteins can be used as tumour markers. Moreover, some glycoproteins, which have activity in cell-mediated processes and macrophage functions, can suggest prognosis. PMID- 3974943 TI - Chronic arthritis in the rat: differential changes in discrete brain pools of vasopressin as compared to oxytocin. AB - Rats inoculated in the tail-base with killed Mycobacterium butyricum developed an arthritic swelling and inflammation of the limbs accompanied by a hyperalgesia to noxious pressure applied thereto. These changes were maximal at 3 weeks and had subsided by 10 weeks post-inoculation. At 3 weeks, arthritic rats manifested an elevation in levels of immunoreactive (ir)-vasopressin (VP) but not ir-oxytocin (OT) in the midbrain. In contrast, ir-OT was increased in the medulla-pons while ir-VP was unaltered therein. These changes had disappeared by 10 weeks. No other brain region displayed changes. Thus, chronic arthritis is associated with selective and reversible effects upon discrete brain pools of ir-VP and ir-OT. The data clearly demonstrate that pools of ir-VP and ir-OT can be modulated independently of each other in particular brain tissues. Whether the changes are produced by, or reflect a functional response to, the pain rather than other characteristic of the arthritis, remains to be determined. PMID- 3974945 TI - Differences in direction specificity of receptive fields in upper and lower layers of the cat's prestriate area 18. AB - Direction specificity was measured for neurons in area 18 (A18) in penetrations approximately perpendicular to the layers in awake cats. A majority of lower layer cells (below 1.0 mm) preferred stimuli moving at rather orthogonal directions with respect to the preferred directions of the neurons in the upper layers (0-1.0 mm). The results suggest more functional autonomy of the corresponding cortical layers. PMID- 3974944 TI - Cholinergic and non-cholinergic septohippocampal pathways. AB - Cholinergic innervation of the hippocampus was examined in the rat by immunocytochemical localization of choline acetyltransferase immunoreactivity combined with retrograde transport of horseradish peroxidase-conjugated wheatgerm agglutinin. It was found that at least 50% of hippocampal afferents arising in the septal-diagonal band region consisted of non-cholinergic projection neurons. In addition, scattered choline acetyltransferase-immunoreactive neurons were localized to the hippocampal formation. These results indicate that: (1) the septohippocampal pathway is neither uniformly nor predominantly cholinergic; and (2) confirm that cholinergic innervation of the hippocampal formation of the rat is derived in part from intrinsic neurons. PMID- 3974946 TI - Regional heterogeneity of muscarinic acetylcholine receptors from rat brain is retained after detergent solubilization. AB - Muscarinic acetylcholine receptors were extracted from rat cerebral cortex, hippocampus and brainstem membranes with 1% digitonin. Solubilized receptors retained both multiple receptor affinities and their regional selectivity in agonist binding (in terms of their affinity for carbamylcholine, brainstem greater than cortex greater than hippocampus). The affinity for carbamylcholine was increased 2-8-fold by solubilization; this increase was largely accounted for by an increase in the proportion of receptors displaying high affinity binding. No differences were observed in the size of receptor-detergent complexes from cortex or brainstem in gel filtration chromatography using a variety of gels and solubilizing agents. These findings indicate that not all of the factors underlying receptor heterogeneity and conformational state are removed or disrupted by solubilization. PMID- 3974947 TI - Speed discrimination and its relation to involuntary eye movements in human vision. AB - In addition to a selective response to a narrow range of motion directions, a neural mechanism specialized for motion detection must also be able to discriminate between different speeds of target movement. Many psychophysical and electrophysiological investigations of motion perception have largely been concerned with identifying possible schemes or mechanisms capable of discriminating motion direction, but the ability to discriminate faster or slower movement in the same direction has so far received comparatively little attention. Two schemes capable of motion detection and speed discrimination are reported here, together with experimental data which show that the visual system employs both schemes, one for the slow speed range (i.e. less than 3 degrees/s) and the other for larger speeds of target movement. It is also shown that the use of both schemes ensures that retinal image displacements due to involuntary eye movements (i.e. slow drifts and microsaccades) are not detected as target movement. PMID- 3974948 TI - Cyclosporin A enhances the survivability of mouse cerebral cortex grafted into the third ventricle of rat brain. AB - The effect of the immunosuppressant cyclosporin A on the survivability of newborn mouse cerebral cortex transplanted into the third ventricle of adult rats was investigated. Hematoxylin staining revealed that the transplanted mouse brain tissue was rejected by 4 weeks after the transplantation in the control group. In contrast, a large mass of grafted tissue was clearly detected in the third ventricle even 4 weeks after the transplantation in the cyclosporin A-treated group, and the grafted tissue was heavily stained with Thy-1.2 mouse monoclonal antibody. The results indicate that cyclosporin A is an effective immunosuppressant in neuronal transplantation as well as in transplantation of other organs. PMID- 3974949 TI - Gonadal steroid actions on the paraventricular magnocellular neurosecretory cells of the male rat. AB - One-hundred and ten paraventricular (PV) neurosecretory cells were identified antidromically in castrated male rats anesthetized with urethane. After classifying the antidromically driven units into tonically and phasically firing groups, the latency, threshold, relative refractory period and wave form of the antidromic response were studied. Estradiol and testosterone had no effect on these parameters or on the wave form of antidromic responses in both cell groups. Testosterone caused a significant acceleration of the mean firing rate of the tonically firing cells (from 2.9 +/- 0.6 to 5.1 +/- 0.5 Hz) but estradiol did not affect it. These observations suggest that testosterone modulates the basal firing activity of the tonically firing PV neurosecretory cells in the male rat. PMID- 3974950 TI - Capsaicin impairs preoptic serotonin-sensitive structures mediating hypothermia in rats. AB - In an attempt to elucidate the possible mechanisms involved in the development of the thermoregulatory disturbances induced by systemic capsaicin treatment, the effects of 5-HT injected into the preoptic region or into the cisterna magna on the body temperature and on tail skin vasodilation were studied in control and capsaicin-treated rats. Intracisternal 5-HT elicited a comparable decrease in body temperature in both groups of animals. In contrast, intrapreoptic injection of different doses of 5-HT-induced tail skin vasodilation and hypothermia in the controls, but not in the capsaicin-treated rats. It is suggested that changes in the sensitivity of preoptic warm-responsive structures to 5-HT may contribute essentially to the specific thermoregulatory impairment brought about by systemic capsaicin treatment. PMID- 3974951 TI - An approach to infertility investigation. AB - Infertility has been described as a major developmental crisis. It affects one out of every six couples of childbearing age in the United States. With infertility rates increasing, it is likely that nurse practitioners will encounter patients seeking help for this problem. Although eventual management of these patients requires specialists, nurse practitioners can initiate the workup and provide patient support and education. This article describes the first-level approach to infertility investigation. It provides guidelines for taking the history, doing the physical and ordering laboratory tests. A discussion of infertility as a crisis is included in order to help practitioners provide empathetic support to couples facing fertility problems. PMID- 3974952 TI - Achieving compliance to a reduced sodium diet. AB - Hypertension affects at least 40 million people in the United States today. Nonpharmacological treatment of hypertension relies on modifications in the diet and lifestyle. In refractory cases, the initiation of drug treatment is necessary. Although dietary sodium restriction is widely advocated, assessment of compliance to a reduced sodium diet has been difficult. This article discusses the use of a urinary chloride titrator stick to enable patients to monitor their dietary sodium intake at home. This tool increased compliance to a low sodium diet in the test population. PMID- 3974954 TI - Asbestos-related lung disease. PMID- 3974953 TI - Kegel's exercises with biofeedback therapy for treatment of stress incontinence. AB - True stress incontinence due to a weakened pelvic floor is one of the most frequently cited urologic complaints of multiparous women past age 40. One treatment modality currently used to treat stress incontinence is exercising the pubococcygeus muscle. Combining biofeedback therapy with a vaginal probe (perineometer) helps patients identify the muscle, provides immediate feedback and assists the nurse and patient in assessing problem resolution. This article describes an intervention program using biofeedback, and measured Kegel's exercises on a small number of women with symptoms of stress incontinence. The lessening of symptoms became a major factor in continued compliance with the exercise program. PMID- 3974955 TI - Legislatures act on reimbursement. PMID- 3974956 TI - Antithrombin III activity in women with hypertension during pregnancy. AB - Antithrombin III activity was measured prospectively in 127 pregnant women within four weeks of delivery, and the results were tabulated with respect to the clinical diagnosis of their hypertensive disorder. Plasma antithrombin III activity was significantly lower than controls in women with preeclampsia and in women with chronic hypertension and superimposed preeclampsia (P less than .001). In contrast, women with chronic hypertension alone had antithrombin III activities similar to controls. Based on discriminant analysis, an antithrombin III activity of less than 70% was selected as indicative of the preeclampsia eclampsia syndrome. The sensitivity and specificity of plasma antithrombin III for preeclampsia was 76 and 91%, respectively. Importantly, an antithrombin III activity in excess of 70% accurately predicted the absence of preeclampsia in 89% of study patients. Although gestational ages at delivery were similar in preeclamptic women with antithrombin III activity above and below 70%, women with antithrombin III activity above 70% delivered larger infants and experienced less fetal distress during labor. These findings suggest antithrombin III measurement may be useful in the management of hypertensive pregnant patients who are unresponsive to bedrest. PMID- 3974957 TI - Prenatal child safety education. AB - In a prospective trial at two hospitals, 78 of 136 couples received a special 30 minute curriculum consisting of a lecture, a motion picture demonstrating the consequences of not using child car safety seats, and a question-and-answer session. Four to six months postpartum all parents were interviewed by telephone. When asked how their child rode during the most recent car trip, 96% of parents who received the special curriculum said they used a crash-tested child car safety seat, compared with 78% of those who had not received the curriculum. At hospital B, where parents reported demographic factors often associated with low compliance (eg, lower income, low use of seat belts, lower educational level), compliance rose from 60% before curriculum to 94% after curriculum (P less than .01). A car safety curriculum added to prenatal classes will increase parents' use of child car safety seats. Obstetricians and those managing prenatal care should assume a role in educating expectant parents about child passenger safety. PMID- 3974958 TI - Placental function studies in low birth weight infants with and without dysmaturity. AB - Maternal blood levels of human placental lactogen and schwangerschaftsprotein 1 were measured in 51 women who delivered a growth-retarded infant. The levels were substantially lower in the 27 women whose infants were clinically dysmature than in the 24 women whose infants were small but of normal appearance. About one-half (44%) the cases of true dysmaturity had abnormal concentrations of human placental lactogen (less than 4 mg/L), whereas none of the small but normal group had values in this zone. It is concluded that biochemical tests of this type reflect dynamic aspects of placental function and not simply the overall size of the fetus and placenta. PMID- 3974959 TI - Prenatal care and perinatal mortality in a black population. AB - Using three-year cumulative data relative to perinatal mortality, the present study examines the relationship of prenatal care and birth weight to pregnancy outcome. The results support the hypothesis that links prenatal care to pregnancy outcome and the relationship between birth weight and pregnancy outcome is found to be strong. The study indicates that the knowledge of birth weight would reduce the number of errors in predicting the chances of survival of the newborn by 37.0%. PMID- 3974960 TI - Thermoregulation during aerobic exercise in pregnancy. AB - To characterize maternal thermal balance during pregnancy, the authors recorded the thermal response to moderate weight bearing exercise stress in four aerobically conditioned pregnant women. Studies were performed in a climate controlled environment in each trimester of pregnancy and postpartum after modifying the exercise protocol for changes in maternal exercise condition. Core, vaginal, and mean skin temperatures were recorded at rest and during maximum exercise. Mean resting skin temperature increased during pregnancy; mean resting core and vaginal temperatures did not change. Core temperatures did not exceed 39C during exercise. Heat storage (heat content/kg) was not increased as a result of exercise with advancing pregnancy. According to these findings, thermal balance can be maintained with advancing gestation when exercise prescriptions are appropriately modified for conditioned women. PMID- 3974961 TI - Meconium aspiration and fetal acidosis. AB - Meconium in labor is associated with increased perinatal morbidity and mortality. To identify the infants at risk, 53 women with moderate-to-thick meconium were followed in labor after obtaining baseline fetal scalp blood pH levels. Although 28 of the newborns (53%) exhibited an arterial cord pH of less than 7.25 at delivery, there were no significant predictive variables found in the electronic fetal monitoring score, Apgar score, or mode of delivery. Nine of the infants with a pH value of less than 7.25 had meconium below the vocal cords at delivery, but none in the infants with pH levels greater than or equal to 7.25. The P50 value for cumulative acidosis is 55 minutes, indicating a more rapid deterioration than an average-for-gestational-age fetus without meconium. Therefore, the presence of thick meconium implies that fetal stress must be avoided during labor, and early intervention is warranted when there is deviation from normal labor progress or fetal heart rate pattern. PMID- 3974962 TI - Peripartum hysterectomy: a review of cesarean and postpartum hysterectomy. AB - A retrospective review of 117 women who underwent peripartum hysterectomy at Duke University Medical Center during the past 21 years was conducted. Seventy-three cesarean hysterectomies were performed electively; 44 cesarean or postpartum hysterectomies were performed as emergencies. Statistically significant differences were noted between these groups in surgical technique, operative time, estimated blood loss, intraoperative hypotension, and intraoperative and total blood replacement. Additional significant differences were noted in postoperative febrile morbidity, use of therapeutic antibiotics, incidence of thromboembolic phenomena, and length of postoperative hospital stay. Separate analysis of elective cesarean hysterectomy patients revealed statistically significant decreases in operative time, estimated blood loss, intraoperative and total blood replacement, and postoperative hospital stay in the group having an experienced surgeon when compared with the group with less experienced surgeons. PMID- 3974963 TI - Chromosome studies of 500 couples with two or more abortions. AB - Chromosome studies of 500 couples with recurrent (two or more) spontaneous abortions revealed abnormal karyotypes in 50 partners (10%). There was no apparent relation with the number of abortions. The abnormalities were translocations (44%), mosaicisms (48%), and deletions or inversions (8%). In 20 cases the translocations were reciprocal and mainly maternal. Most mosaicisms involved the maternal X-chromosome. Studies of 78 relatives of the index patients identified another 24 carriers of a balanced translocation. Prenatal diagnosis was performed on 13 carriers of a balanced translocation and 16 carriers of a mosaicism because of their risk of an abnormal fetal karyotype causing serious congenital anomalies. These results illustrate the impact on the families. It is concluded that couples should have chromosome studies after two abortions and that maternal X-chromosomal mosaicism occurs as frequently as a balanced parental translocation. PMID- 3974964 TI - Chlamydia trachomatis as a cause of prepubertal vaginitis. AB - Chlamydia trachomatis was encountered in four cases during the evaluation of 29 premenarchal girls with gynecologic complaints during 1983. Only one of the patients had antecedent infection with Neisseria gonorrhoeae. The importance of using specific tests to actively establish a definite diagnosis of chlamydia is stressed. The susceptibility of the thin premenarchal vaginal mucosa to chlamydial infection is discussed as is the role of chlamydia as a marker for sexual abuse. Once a diagnosis of chlamydial rectogenital infection is established in a child, it is mandatory to investigate for child abuse and sexual molestation as the source of the infection. PMID- 3974965 TI - Preoperative crossmatch ordering and blood use in elective hysterectomy. AB - Preoperative crossmatch guidelines have been shown to improve crossmatch ordering practices. To refine crossmatch ordering, specific characteristics of 258 patients who underwent abdominal hysterectomy and 277 patients who underwent vaginal hysterectomy were correlated with blood transfusion by univariate and multivariate analyses. Abdominal hysterectomy patients with pelvic inflammatory disease with adhesions and/or abscess were significantly more likely to require blood transfusion. Specimen weight correlated significantly with blood transfusion only for patients with ovarian pathology. Blood use was independently correlated with reduced preoperative hemoglobin and with estimated blood loss. Vaginal hysterectomy patients who had a colporrhaphy were more likely to require blood transfusion. Preoperative crossmatch recommendations made on the basis of these results reduce costs and increase the efficiency of predeposit autologous transfusion programs and preoperative crossmatch ordering practices. PMID- 3974966 TI - Role of endocervical curettage in colposcopy. AB - Two-thousand three-hundred and four patients with abnormal cervical cytology were evaluated by colposcopy, cervical biopsy, and endocervical curettage. The endocervical curettage was more accurate than the cervical biopsy in 1.2% of patients with satisfactory colposcopic examinations, 15.7% of patients with unsatisfactory examinations, and 30.5% of patients with no lesions observed. The endocervical curettage contained neoplastic epithelium in all 15 of the patients with invasive cancer and in seven patients it was the only diagnostic parameter that indicated invasion. The information from the endocervical curettage, when correlated with the cervical cytology, colposcopic findings, and cervical biopsy, eliminated the need to do a diagnostic conization in 76% of patients with unsatisfactory examinations and 79% of patients with no lesion identified. It is recommended that the endocervical curettage be a part of every colposcopic examination. PMID- 3974967 TI - Poor prognosis in patients with adenosquamous cell carcinoma of the cervix. AB - From 1 July 1974 to 31 December 1982, 127 patients with primary carcinoma of the cervix were assessed to determine the prognosis of patients with adenosquamous cell carcinoma. Of all patients, 34 are dead of disease for an overall corrected survival rate of 73.2%. The survival of 20 patients with adenosquamous cell carcinoma is 20%. Seventy-five percent of the adenosquamous cell patients had stage IB lesions. When patients with adenosquamous cell carcinoma were compared with patients with squamous cell carcinoma or adenocarcinoma, there was a statistically significant decrease in survival. Patients with adenosquamous cell carcinoma were relatively young with a mean age of 41.1 years. A normal appearing cervix was noted in 30% of all patients with adenosquamous cell carcinoma. The majority of adenosquamous cell patients (87.5%) dead from cancer had distant metastases. This report emphasizes that, independent of stage, adenosquamous cell cervical carcinoma is an extremely aggressive neoplasm and carries a poor prognosis. PMID- 3974968 TI - A tubal plug and clip method for female sterilization. AB - Animal studies using rabbits, stumptailed macaques monkeys, and baboons demonstrate that the tubal plug and clip device is an effective and safe method for female sterilization in these animal models. The devices were placed in 18 baboons that were bred regularly for six to 18 months without conception. Ten of these 18 animals conceived within 12 months after removal of the devices and carried normal pregnancies without any other surgical procedure. Six of the ten animals conceived and carried a second pregnancy for a total of 16 successful pregnancies. The expected pregnancy rate for baboons is 64.9% per year so that the 55.6% success rate of reversal and 16 total pregnancies clearly represents a high degree of reversibility for the method in this animal species. PMID- 3974969 TI - Noncontraceptive estrogens and progestins: use patterns over time. AB - The use of noncontraceptive estrogens and progestins, particularly in menopausal women, has been a subject of considerable controversy during the past decade. Reported is a review of overall trends in the use of these drugs from 1966 to 1983 and a more indepth qualitative and quantitative description of their use during 1983. The use of these estrogens and progestins appears to be increasing again. The estrogens are apparently being used at lower doses than in the past, and there is a trend toward using estrogens and progestins concomitantly. Exclusive of oral contraceptives, enough oral estrogen was purchased during 1983 to treat an average of 2.3 million people each day, while oral progestin purchases could have supplied 129,000 people daily. PMID- 3974970 TI - Fetal heart rate patterns and premature rupture of membranes. PMID- 3974972 TI - Cervical conization. PMID- 3974971 TI - Fetal heart rate W-sign. PMID- 3974973 TI - Idiopathic thrombocythemia and pregnancy: report of a case. AB - Pregnancy and delivery in patients with idiopathic thrombocythemia have not been reported elsewhere, to the knowledge of the authors. Such a case is presented herein. The platelet count decreased with progression of pregnancy, falling to a normal level near term. It was, however, again increased in the puerperium, reaching a level of 1570 X 10(3) per mm3 eight months after delivery. Aspirin was continuously administered throughout pregnancy to prevent thrombus formation, but no adverse effects on the delivery or the infant were observed. PMID- 3974974 TI - Self-inflicted gunshot wound to the pregnant uterus: report of two cases. AB - Attempts to terminate a pregnancy by self-inflicted gunshot-wounds is a new mechanism whereby women sustain gunshot wounds of the pregnant uterus. Two patients with self-inflicted gunshot wounds of the gravid uterus in an attempt to induce abortion are presented. The conservative management of such wounds is discussed. PMID- 3974975 TI - Maternal death secondary to a dissecting aneurysm of the pulmonary artery. AB - True aneurysms of the pulmonary artery are most frequently associated with congenital heart lesions that have lead to sustained high pulmonary artery flow rates and pulmonary hypertension. A maternal death secondary to a dissecting aneurysm of the pulmonary artery is presented. Death occurred 17 hours postpartum, and the acute dissection may have been precipitated by the high flow rates accompanying parturition or, alternatively, by the Valsalva maneuver. The authors suggest a baseline chest radiograph and electrocardiogram in all women with known or suspected congenital heart disease to evaluate for pulmonary hypertension and pulmonary artery aneurysms. The occurrence of symptoms such as dyspnea or chest pain warrants repeat evaluation with strong consideration being given to right heart catheterization and pulmonary angiography. If a dissecting aneurysm is diagnosed, then emergency surgical repair seems warranted in view of the rapidity with which this condition progresses to death. PMID- 3974976 TI - Severe preeclampsia with persistent postpartum hemolysis and thrombocytopenia treated by plasmapheresis. AB - A case of severe preeclampsia in which hemolysis and rapid platelet consumption persisted after delivery, but in which the blood urea nitrogen and serum glutamic oxaloacetic acid transaminase levels returned to normal is presented. Antiplatelet aggregating medications and exchange plasmapheresis with fresh frozen plasma were begun on the eighth postpartum day, but the hemolysis and rapid platelet consumption did not begin to improve until the 12th postpartum day. The use of plasmapheresis in highly selected cases of severe preeclampsia with hemolysis and thrombocytopenia that do not resolve after delivery is discussed. PMID- 3974977 TI - Postpartum cervical myofascial pain syndrome: review of four patients. AB - Four postpartum patients with complaints of headache and neck pain were examined. All had received epidural analgesia and had a long second stage associated with prolonged pushing. Many similarities to postdural puncture headache were noted. The headache started the day after delivery and involved the occipital region primarily, along with the neck and shoulder girdle areas. However, the pain did not change with positional changes and was associated with marked tenderness of muscles at specific anatomic points. A diagnosis of cervical myofascial pain was made. All patients responded quickly to physical therapy. The authors suggest that many patients initially considered to have postdural puncture headache may actually have postpartum cervical myofascial pain. PMID- 3974978 TI - Endometriosis causing ureteral obstruction. AB - Although endometriosis accounts for 15 to 20% of all gynecologic laparotomies, ureteral obstruction secondary to this disease has received little attention. This may be partly the result of diagnostic difficulties secondary to the unusual symptoms and atypical age groups of the patients. Five cases of obstructive uropathy caused by endometriosis are reported. Each case was documented by urologic evaluation as well as excretory urograms, surgical exploration, and histologic confirmation. All patients had significant radiographic and laboratory renal compromise, including marked degrees of hydronephrosis. Follow-up included excretory urograms obtained in all cases, which showed cure of original symptoms with radiographic improvement in four of five patients, whereas one patient developed chronic renal failure and hypertension. The present report suggests that with thorough preoperative assessment of the urinary tract, including contrast radiography in select cases of pelvic pathology, curative gynecologic and urologic surgery can be performed. PMID- 3974979 TI - Incisional bladder hernia and urinary incontinence: report of three cases. AB - Herniation of the bladder has been primarily described in association with inguinal and femoral hernias. Review of the literature yielded only one case report of incisional bladder hernia. The authors report three cases of herniation of the bladder through a postoperative fascial defect. All patients presented with nonspecific sensory lower urinary tract symptoms, pelvic discomfort, and urinary incontinence. Involuntary urine loss as related to bladder hernia has been mentioned only circumstantially. Although urodynamic evaluations were performed, the mechanism of urinary incontinence could not be clarified. Cystography was essential in arriving at a definitive diagnosis. PMID- 3974980 TI - Blood transfusion complications: leukoagglutinin reactions. AB - Blood transfusions performed earlier in the 20th century were often accompanied by significant complications. Today, with an increased knowledge of blood type compatibility, the majority of risks have been eliminated. However, hazards still remain. The authors report on a potentially fatal pulmonary disorder caused by transfusions involving leukoagglutinins. This phenomenon apparently occurs with an increased risk in parous women and patients who have had multiple transfusions. PMID- 3974981 TI - [Does DNA alone determine the development of the organism? (the information aspect of the problem)]. AB - Two closely related controversial problems are discussed: whether the developmental processes can be reduced to the synthesis of polypeptides encoded in DNA, and whether the information in DNA is equivalent to that in the adult organism. Critically considered are the ideas that DNA is only responsible for the protein synthesis, whereas morphogenesis proceeds independently and according to epigenetic regularities of its own. It is stated that development is the realization of genetic information in which more elementary (molecular) processes unambiguously determine a more complex cellular level which in its turn determines morphogenesis of tissues and organs. Various mechanisms of the appearance of new information in the course of development are considered. The statement is made that new information concerns only some individual characters of the organism, whereas most of information that determines the process of development and the structure of the adult organism is created in the course of evolution, is stored in DNA and inherited. PMID- 3974982 TI - [Cultivation of the retinal pigment epithelium in the cavity of the lentectomized eye of newts]. AB - A study was made of proliferative activity and transdifferentiation of the cells of retinal pigment epithelium (RPE) cultivated in the cavity of the lensectomized eye of adult newt. Implantation of the newt RPE together with vascular membrane and scleral coat resulted in the regeneration of retina. In this process the character of changes in the proliferative activity of RPE and differentiation of retinal cells were the same as in the regeneration of retina in situ. RPE implanted with the vascular membrane alone, despite a high level of proliferation during the first ten days of cultivation, no differentiated retina was formed. Possible causes of these differences are discussed, and the comparison is made of the data obtained with those on RPE cultivation in vitro. After lens removal, with RPE implants present in the eye cavity, in addition to the regenerated lens, 2-3 extra lenses and retina were formed from the cells of the inner layer of the recipient's dorsal iris. Also some cases were revealed of lens formation from the cells of ventral iris. With a complete detachment of the recipient's retina (an after-effect of transplantation) a second differentiated retina regenerated in situ from the recipient's RPE cells. PMID- 3974983 TI - [Model of epithelial morphogenesis based on elastic forces and cell contact polarization]. AB - It is well known that in embryonic tissues at the key stages of morphogenesis there arise stable, stage--specific tension fields. These fields occur due to particular pattern of morphologically polarized cells. Some basic properties have been understood previously. 1. Morphologically polarized and isotropic shapes correspond to the alternative stable states of embryonic cells. 2. Polarization can be transmitted between the adjacent cells via intercellular contacts. 3. The tension fields at particular stage of development determine the pattern of morphogenetic movements. In this paper the physical model is suggested which interprets the selforganization of tension fields in embryonic tissues. The polarization in some region of tissue is assumed to generate the elastic tension in the surrounding cells thus restricting the propagation of cell polarization. It is shown that the properties underlined are sufficient to provide spontaneous subdivision of the cellular layer into the domains of polarized and unpolarized stretched cells. The proportion of polarized and unpolarized areas is determined and size--invariant. PMID- 3974984 TI - [Mouse oocyte maturation in vitro at a low concentration of pyruvate in the culture medium]. AB - Mouse oocytes isolated from antrum--containing follicles were cultivated for 17 19 hours in the media with different concentrations of pyruvate. Decrease of pyruvate concentration down to 0.03 mM significantly increased the number of oocytes with intact germinal vesicles. However, in 50% of oocytes desintegration of nuclear membrane and condensation of chromosomes occurred even at a concentration of 0.02 mM. PMID- 3974985 TI - Use of a short wavelength filter in an operating microscope. AB - There is growing concern over the potential phototoxic effect on the patient's retina from the coaxial illumination of the operating microscope. By replacing the existing red-free filter in the body of a Zeiss operating microscope, with a 470-nm filter, the ultraviolet and low wavelength blue light can be easily and effectively filtered from the transmitted white light. In this location, the filter can be quickly and safely rotated into or out of line with the transmitted light depending on the preference of the ophthalmologist. PMID- 3974986 TI - A new system of intraocular instruments: III. Guillotine scissors. AB - The development of a new manual 20-gauge intraocular scissors provides several distinct advantages over prior models. They are compatible with standard vitrectomy systems and useful in applications in both the anterior and posterior segments of the eye particularly for resection of epiretinal and pupillary membranes. PMID- 3974987 TI - Diversionary grooves for filtering procedures. PMID- 3974988 TI - Anterior segment fluorescein angiography in the diagnosis of scleral inflammation. AB - Anterior segment fluorescein angiography was performed on 135 patients with scleritis and episcleritis and on several normal subjects. It was confirmed that the coats of the eye anterior to the extraocular muscles derive their blood supply from perforating ciliary vessels. Characteristic patterns were detected which could distinguish the various forms of scleritis and episcleritis. Fluorescein angiography was found to be particularly useful in the detection of those patients who have early, but not clinically recognisable, necrotizing scleritis. The fluorescein angiographic appearances have been used to help to determine whether treatment should be given with nonsteroidal anti-inflammatory drugs, with systemic steroids or other immunosuppressive agents. PMID- 3974989 TI - Conjunctival involvement with mycosis fungoides in a patient receiving PUVA therapy. AB - A 40-year-old woman had documented mycosis fungoides of the skin. Over a period of five years, she had undergone intermittent treatment with psoralen long-wave ultraviolet light (PUVA) therapy. Despite regression of the skin lesions, tumor plaques developed in her eyelid and conjunctiva within the area shielded by dark glasses. Light and electron microscopic examination of a biopsy from the conjunctival plaque confirmed that the lesion was a deposit of mycosis fungoides. Local radiotherapy resulted in complete regression of these ocular lesions. The conjunctiva may well be an iatrogenic "sanctuary site" when this disease is treated with PUVA therapy. PMID- 3974990 TI - Metastatic eyelid carcinoma. AB - Two cases of carcinoma metastatic to the eyelid are described. The first was derived from a lung primary diagnosed two months prior and presented as a solitary tender mass mimicking an acutely inflamed recurrent chalazion. The second case was the initial manifestation of a stomach carcinoma, presenting as a solitary painless nodule. Both were part of generalized metastatic disease; survival was six weeks and five months, respectively, after eyelid tumor presentation. Excisional biopsy was effective palliation in the first case, but multiple operations were required in the second. The clinicopathologic features are discussed and the prior reported cases reviewed. PMID- 3974991 TI - Fibrous dysplasia of the orbit in childhood. Clinical features and management. AB - In 16 children with orbitocranial fibrous dysplasia confirmed histopathologically, facial asymmetry, orbital dystopia, and unilateral proptosis were the main presenting problems. Five children had radiological evidence of narrowing of the optic canal but only two developed optic atrophy and visual loss. One patient had persistent epiphora due to involvement of the bony nasolacrimal duct. Sixteen patients were treated by excision of the dysplastic bone and 15 had immediate craniofacial reconstruction. A good cosmetic and functional result was achieved in the majority of cases although transient vertical diplopia and minor degrees of ptosis occurred postoperatively in about a third. Fibrous dysplasia of the orbit is progressive in childhood and is best managed by radical surgery and reconstruction in a specialized craniofacial unit. PMID- 3974992 TI - Psammomatoid (juvenile) ossifying fibroma of the orbit. AB - The clinical and pathologic features in 21 cases of a distinctive solitary fibro osseous lesion affecting the orbit distinguished histologically by the dominance of numerous small round "psammoma-like" ossicles embedded in a cellular benign spindle cell stroma were studied. The patients were predominantly young, and 19 of the lesions were centered on the orbital plate of the frontal bone or ethmoid. A clinical course of slowly progressive symptoms over several years was typical but not uniform. The most common clinical diagnosis was fibrous dysplasia and mucocele. At least nine patients underwent two or more surgical operations; one patient had six recurrences over a 15-year period. There were no known deaths from the tumor, but its potentially massive size can result in considerable morbidity and cosmetic deformity. Although previously referred to as active juvenile ossifying fibroma, the term psammomatoid ossifying fibroma for this lesion is more descriptive and has historical precedence. PMID- 3974993 TI - Bimanual endoscopic orbital biopsy. An emerging technique. AB - Diagnostic biopsy specimens from six posterior orbital lesions have been obtained under direct endoscopic view with either a fine needle aspiration or an intracannular microbiopsy forcep. This method is comparable to earlier fine needle aspiration techniques, but has the decided advantage of providing a specimen from visually indentified abnormal tissue. In those cases where inadequate specimens are obtained by fine needle aspiration, a microforcep is used to obtain a substantial specimen. The microinvasive endoscopic biopsy technique of the Orbital Unit at Pacific Medical Center is described with an analysis of six cases. The emerging technology of fiberoptic illumination, minified color video cameras, sophisticated imaging, efficient microsurgical instruments and laser delivery methods make the potential for deep orbital endoscopic microinvasive surgery exciting. PMID- 3974995 TI - Isolated pupil-sparing third nerve palsy. AB - The challenge in managing patients with pupil-sparing third nerve palsies is met most efficiently by dividing such patients into three groups according to the relative deficits in pupillomotor and extraocular muscle function: (1) patients with a normal pupillary sphincter and completely palsied extraocular muscles. Such patients should not have cerebral angiography if they are aged 50 or more; (2) patients with a normal pupillary sphincter and incompletely palsied extraocular muscles. Such patients should have angiography, particularly if the inferior oculomotor division is spared; (3) patients with a subnormal pupillary sphincter and completely palsied extraocular muscles ("relative pupil-sparing"). Such patients should have angiography unless they have clear-cut vasculopathic findings. PMID- 3974996 TI - Large druse-like lesions on the surface of choroidal nevi. AB - Three patients had choroidal nevi with a single, large, overlying, hypopigmented lesion. In one case, this lesion was observed to enlarge for seven years, although the nevus, itself, did not. All of the hypopigmented lesions showed mild hyperfluorescence early in the fluorescein angiogram and intense staining in the later phases. These lesions were probably large drusen that developed on the surface of the nevi. PMID- 3974994 TI - Fine needle aspiration biopsy in the diagnosis of intraocular cancer. Cytologic histologic correlations. AB - Fine needle aspiration biopsy was used as an investigational procedure in the evaluation of 71 eyes harboring a suspected intraocular malignancy between January 8, 1981, and January 21, 1983. Twenty-seven of these 71 biopsies were performed prior to any treatment as a diagnostic procedure and the others were performed following enucleation or tumor excision to provide specimens for cytologic-histologic correlation. The histologic findings confirmed the cytologic diagnosis of malignancy or benignancy in 94.3% of the 53 cases in which a corresponding tissue specimen was available for histologic evaluation. None of the eight eyes with a cytologically confirmed diagnosis of malignancy that were managed conservatively following the biopsy has experienced visual loss attributable to the biopsy. There have been no instances of documented needle tract seeding by tumor cells or orbital tumor recurrence to date in the 27 cases in which diagnostic fine needle aspiration biopsy had been performed prior to treatment. PMID- 3974997 TI - A clinical comparison of visual field testing with a new automated perimeter, the Humphrey Field Analyzer, and the Goldmann perimeter. AB - Automated threshold static perimetry with the Humphrey field analyzer and kinetic and suprathreshold static perimetry with the Goldmann perimeter were performed on 171 eyes: 69 with glaucoma or ocular hypertension, 69 with "neurologic" disorders, and 33 normal. The two fields were similar or differed only slightly in 78% of eyes overall and in 88% when both fields appeared reliable. In general, defects were slightly more extensive using the Humphrey than the Goldmann perimeter. In 21% of the eyes with glaucoma or ocular hypertension, defects were found with the Humphrey perimeter that were not present with the Goldmann perimeter. Patient fixation was more difficult to maintain on the Humphrey than Goldmann perimeter. Poor fixation accounted for 9% of the automated fields being inadequate whereas only 2% of the manual fields were inadequate. The results indicate that the Humphrey Field Analyzer is capable of reliably detecting and quantitating visual field defects. PMID- 3974998 TI - Computer-assisted spectral electroretinography in vitrectomy patients. AB - Computer-assisted spectral electroretinography (CASE), using full field stimulation in the presence of a rod saturating background light, has been found to be a useful means of evaluating retinal function in patients with vitreal opacities. By this means, cone electroretinograms (ERGs) to white as well as spectrally selective stimuli could easily be detected in 22 of 24 eyes with vitreal opacities obscuring any view of the fundus and with minimal or no detectable ERGs to standard single flash stimuli. The responses to spectral stimuli in the presence of a rod saturating background light provides a means of estimating the optical density of the opacity. The results indicate that most patients undergoing vitrectomy for such opacities have considerable superimposed retinal damage and that the opacities themselves are seldom sufficiently dense to decrease the ERG to any great extent. Five eyes studied before and after vitrectomy indicate that successful vitrectomy has no effect on the ERG. The results suggest that CASE may be a useful substitute to the bright flash ERG for evaluating global retinal function behind an opaque media. PMID- 3975000 TI - The effect of therapeutic soft contact lenses on antibiotic delivery to the cornea. AB - The effects of high (71%) and low (38.6%) water content lenses on antibiotic delivery to the cornea were studied in rabbits by measuring corneal tobramycin concentrations 1, 2, 4 and 6 hours after topical application at intervals of 15 minutes. In the presence of the low water content lens corneal drug levels were higher than in control corneas for every time point assayed. This difference was only significant at 4 hours (P less than 0.05). In eyes wearing the high water content contact lens corneal drug concentration was also higher at every time point tested except one hour. The difference was significant only at 4 hours (P less than 0.01). The data suggest that in the normal, noninflammed eye, the presence of a therapeutic soft contact lens will not compromise aminoglycoside delivery to the cornea. PMID- 3974999 TI - Clearance of intravitreal fluorouracil. Normal and aphakic vitrectomized eyes. AB - The ocular pharmacokinetics of 5-fluorouracil (5-FU) after intravitreal administration in the rabbit are described for the first time. Following a 1 mg intravitreal injection of C-14 labeled 5-FU in the phakic nonvitrectomized eye, a peak level of 664 micrograms/ml is achieved which declines to 7.8 micrograms/ml at 24 hours. For the aphakic vitrectomized eye comparable values are 669 micrograms/ml at 0.1 hour and 0.21 micrograms/ml at 24 hours. 5-FU is cleared more than two times more rapidly in aphakic vitrectomized eyes than normal eyes during the first 12 hours following injection. Following this, when the actual concentrations are relatively low, the rate of clearance appears relatively similar for both groups of eyes. Although it is difficult to extrapolate from previous in vitro results, potentially therapeutic vitreous concentrations are present in normal rabbit eyes for up to 72 hours following a single intravitreal injection. PMID- 3975001 TI - [Features of the treatment of patients with 2-segment adjacent fractures of the femur and crural bones]. PMID- 3975002 TI - [Role of intra-arterial infusion of antibiotics and extrafocal osteosynthesis in the treatment of open fractures of the crural bones]. PMID- 3975003 TI - [Causes of complications during intramedullary osteosynthesis of the femur and their prevention]. PMID- 3975004 TI - [Problems of the orthopedo-traumatology service during the transition to dispensarization of the entire population]. PMID- 3975005 TI - [Effect of the main injury on circulatory status in severe combined trauma]. PMID- 3975006 TI - [Analysis of different means of surgical treatment of radicular syndromes in hernias and protrusions of the lumbar intervertebral disks]. PMID- 3975007 TI - [Recurrences of congenital clubfoot]. PMID- 3975008 TI - [Bone mineral concentration according to the results of photon absorptiometry during treatment of fractures by the transosseous technic]. PMID- 3975010 TI - [Use of bone matrix to stimulate osteogenesis in the presence of wound infection]. PMID- 3975011 TI - [Outcome of surgical treatment of frostbite of the extremities]. PMID- 3975009 TI - [Pathogenesis of traumatic arthritis]. PMID- 3975013 TI - [Surgical treatment of dysplasia of the dorsal artery of the foot]. PMID- 3975012 TI - [Physiotherapy in the complex treatment of post-burn keloid scars]. PMID- 3975014 TI - [Surgical treatment of congenital dislocation of the hip in preschool children]. PMID- 3975015 TI - [Evaluation of the status of orthopedic-traumatology patients during rehabilitation by the expert method]. PMID- 3975016 TI - [Thermographic diagnosis of injuries of the tendons and nerves of the hand]. PMID- 3975017 TI - [Method of studying the friction properties of the joints of living organisms]. PMID- 3975018 TI - [Method of fixation for avulsions of the distal tendon of the biceps brachii]. PMID- 3975019 TI - [Scheuermann-May disease and its treatment]. PMID- 3975020 TI - [Anti-ischemic measures in severe injuries of the extremities at stages of medical evacuation]. PMID- 3975021 TI - [Cardiac changes found in patients with ankylosing spondylarthritis]. PMID- 3975022 TI - [Changes in the permeability of the vascular wall in hyperlipoproteinemia and diabetes mellitus]. PMID- 3975023 TI - [Role of undiagnosed inflammation of the embryonic structures in the mortality of premature infants]. PMID- 3975024 TI - [Follow-up studies in a family with ichthyosis vulgaris]. PMID- 3975025 TI - [Congenital aorto-left ventricular tunnel]. PMID- 3975026 TI - [A new variant of sigmoid anus praeternaturalis]. PMID- 3975027 TI - [Cerebrovascular diseases in the practice of the district physician]. PMID- 3975028 TI - [Subclavian puncture--a routine procedure (?) Results and complications]. PMID- 3975030 TI - [Changes in gastric juice secretion in the 1st year after proximal selective vagotomy]. PMID- 3975029 TI - [A simple method for the diagnosis of water metabolism disorders in childhood]. PMID- 3975031 TI - [Experience with adjuvant chemotherapy of patients with bladder tumors]. PMID- 3975032 TI - [Lead content in the blood of infants and children]. PMID- 3975033 TI - [Pseudoaneurysm of the internal carotid artery caused by injury]. PMID- 3975034 TI - [Distortion of the orthography of Hungarian medical terminology. From esophagus to anus pre (praeternaturalis)]. PMID- 3975035 TI - [Replantation of the upper limbs]. PMID- 3975037 TI - [Urodynamic measurement of micturition with special reference to the diagnosis of subvesical obstruction]. PMID- 3975036 TI - [Enzyme induction study in children treated with anticonvulsants]. PMID- 3975038 TI - [Neonatal chylothorax after Bochdalek herniorrhaphy]. PMID- 3975039 TI - [Treatment of acute pancreatitis]. PMID- 3975040 TI - The measurement of contrast sensitivity function. PMID- 3975041 TI - Critical fusion frequency in the central visual field. AB - The critical fusion frequency (CFF) was measured across the central visual field. Stimulus parameters were adjusted to ensure an increase in CFF at the fovea. Comparison was made between the foveal and extra-foveal CFF values. The study showed that, while the CFF may be highest at the fovea when the CFF values are generally low, stimulus parameter changes that increase the CFF result in a greater increase extra-foveally. Ultimately, then, the CFF maximum shifts from the fovea to an extra-foveal area. Under the experimental conditions used in the study, the maximum occurred approximately 10 degrees from fixation. PMID- 3975042 TI - Measurement of the axial wavefront aberration of the human eye. AB - An objective variation of Howland and Howland's subjective crossed-cylinder aberroscope method of estimating ocular aberration is described. An ophthalmoscopic arrangement allows the distorted retinal image of the aberroscope grid to be directly photographed for later analysis. Results for 10 subjects show that the ocular wavefront aberration near the visual axis is rarely symmetrical about the pupil centre and that, as a result, the phase transfer function is generally non-zero. Calculated modulation transfer functions at various pupil diameters broadly agree with those of earlier authors but suggest that marked differences occur between individual eyes when the pupil diameter exceeds about 3 mm. PMID- 3975043 TI - The relationship between tonic vergence and oculomotor stress induced by ethanol. AB - Previous investigations have demonstrated an ethanol-induced increase in distance esophoria and an increase in near exophoria, together with a decrease in negative fusional ability, the AC/A ratio and near point of convergence. The present study (N = 10) was designed to test the hypothesis that these effects are due to a biasing of vergence towards its tonic resting state when under conditions of oculomotor stress. Measurements of the parameters before and 1 hr after imbibition of a moderate dose of ethanol supported the previous findings. Darkroom measures of tonic vergence (vernier alignment) and tonic accommodation (laser optometry) were unaffected by ethanol. The study indicates that the changes in oculomotor function induced by the central inhibitory action of ethanol represent a shift towards the tonic vergence position. PMID- 3975044 TI - Displacement thresholds for motion detection under conditions of chromatic adaptation. AB - The smallest, continuous target displacement which is sufficient to cause a sensation of movement was measured under conditions of chromatic adaptation. The experiments were carried out for test target and background field wavelengths which selectively isolate the activity of the colour mechanisms of the human eye. The results show that, when target detection is largely mediated by the red or green colour mechanism, a target displacement of 2-3' in the foveal region is sufficient to cause a reliable sensation of movement. These displacement thresholds show only a small change as a function of target contrast or background retinal illuminance level. Similar results were obtained when the colour of the test target was the same as that of the background field (e.g. green, yellow or red), when no attempt was made to isolate a single colour mechanism. Test target and background wavelengths which isolate the activity of the blue colour mechanism yield displacement thresholds in the range 5-7' and show a stronger dependence on target contrast and background retinal illuminance level. The experiments were repeated at several eccentricities and the results show that, for a test target and background field of the same colour and under conditions which isolate the green or red spectral response mechanism, the minimum target displacement required for motion detection appears to increase in a manner similar to the centre-width receptive-field size of broad-band, centre- surround transient neurons in the rhesus monkey retina [De Monasterio and Gouras (1975) J. Physiol., Lond. 251, 167-195].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975045 TI - An analysis of visual performance with soft contact lens and spectacle correction. AB - This study compares, under controlled conditions and by rigorous statistical analysis, the contrast sensitivity function (CSF) measured with soft-lens and spectacle correction, attempting to resolve the conflicting reports in the literature. Ten non-astigmatic ametropic subjects had the CSF measured at eight spatial frequencies with the two types of visual correction. Analysis of variance revealed statistically significant effects for subjects, stimuli and type of visual correction, statistically superior performance being obtained with soft lenses. However, the actual difference in the CSF for the two forms of correction was small (0.14 log units) and not clinically significant. Comparison of the average CSF for the three highest and lowest spatial frequencies tested revealed a significant advantage in using higher spatial frequencies in the determination of statistical differences in the CSF obtained with different types of visual correction. PMID- 3975047 TI - Some statistical concepts in the analysis of vision and visual acuity. AB - As conventionally recorded, visual acuity data constitute an ordinal scale of measurement. An investigation of four different clinical samples shows that visual acuity is not normally distributed amongst these populations. Furthermore, acuity is often measured on charts which, by the inherent restriction of the stimulus size, have the effect of truncating the upper limit of the scale producing, in statistical terms, an incomplete distribution. The distribution of acuity for each sample is found to be adequately described in terms of the equation: F(x) = Ax alpha (T - x) beta, where F(x) is the cumulative distribution of the statistical population, T is the truncation level (known), x is the Snellen decimal acuity (known) and A, alpha and beta are parameters. Alternative analytical procedures based upon this model, which overcome these limitations, are discussed. PMID- 3975046 TI - Fresnel prism correction for trauma-induced diplopia. AB - Fresnel prisms placed on the spectacle lenses of a patient with optic atrophy resulting from an accident eliminated constant diplopia in the remaining visual field. A reduction in vision due to Fresnel prisms was found to be more tolerable than diplopia. PMID- 3975048 TI - The employment and education of the partially sighted in the period immediately after leaving special school. AB - Initial results are reported of a major study undertaken to determine factors which could be used to predict employment success of partially-sighted school leavers. The sample involved 355 individuals from 13 schools for the partially sighted taken from three successive final academic years and followed up 1 year after leaving school. Questionnaire techniques were used, the response rate being 85.6%. Analysis revealed that 55.6% sought or experienced employment and 44.4% undertook further education. Eighty-seven per cent of those seeking employment obtained jobs alongside the normally sighted. Only 12 leavers remained totally unemployed. Forty-seven per cent were still in their initial employment. PMID- 3975049 TI - The role of the sympathetic nervous system in ocular accommodation and ametropia. PMID- 3975050 TI - The impossibility of squaring the sphero-cylinder. PMID- 3975051 TI - How your practice can cope with change. PMID- 3975052 TI - Judging causality in environmental cancer. PMID- 3975053 TI - Asbestosis: inhalation disease of the lungs. PMID- 3975054 TI - For completeness' sake. PMID- 3975055 TI - Checking references important in hiring. PMID- 3975056 TI - Changes in Pennsylvania's physician supply. PMID- 3975057 TI - Hearing aids for the very elderly. PMID- 3975058 TI - [New pediatric splint for fixation of the upper or lower extremities during venous infusion therapy]. AB - It is not an easy task to fix the frightened child's arm or leg for intravenous infusion therapy. With the splints available still a lot of improvisation is needed--and yet not always sufficient fixation of the limb is achieved. A new kind of pediatric splint for infusion therapy has been developed and proved service for 16 months in daily pediatric hospital needs. PMID- 3975059 TI - [Anti-T in children]. AB - In the serum of 245 newborn children, 165 elder children, and 50 grown-up persons, the antibody against the antigen T (Thomsen-Friedenreich-antigen, Transformation-antigen, T-receptor) has been determined. In 24,8% of the newborn, it was possible to find anti-T, which might be a cause of so far unclear hemolysis in this age. The investigation of sera from children between 1 and 17 years has shown, that anti-T is already present in children aged one year and reaches the level it usually has in grown-up people at the age of 4. PMID- 3975060 TI - [Conservative and surgical treatment of hip dysplasia and dislocation]. AB - Almost in any case of hip dislocation and dysplasia, diagnosed within the first 3 months of live conservative treatment is successful. Very instable hips have to be treated with plasters. Because of the danger of necrosis of the femoral epiphysis the Lorenz position of hip plasters is no more longer accepted. The only way to avoid this complication is to use the human position (110 Grad flexion, 60 Grad abduction) for hip spikas. Surgical methods are necessary in cases of late diagnosis, or of neglected conservative therapy. PMID- 3975061 TI - [Cerebrospinal fluid and plasma levels of vitamin C in children]. AB - Vitamin C (ascorbic acid) levels in cerebrospinal fluid (CSF) and plasma from 67 children, in whom lumbar puncture had to be performed for medical reasons, are reported in this preliminary paper. 14 children of this group show normal CSF laboratory values and serve as controls. Vitamin C concentrations in CSF of controls are on average 2.5-3-times higher (30.1 +/- 6.3 mg/l) than the pertaining values in their plasma (12.2 +/- 4.9 mg/l). Significant differences are exhibited by premature and term babies, which have up to 16-times higher values of vitamin C in CSF than in plasma. Furthermore CSF vitamin C is 4-5 times higher in premature babies than in schoolchildren of our group (118.2 +/- 65.9 versus 28.3 +/- 3.0 mg/l). Another interesting finding in this study is a significant decrease of CSF vitamin C in cases of acute purulent meningitis (12.3 +/- 4.8 versus 30.1 +/- 6.3 mg/l, p less than 0.05). These results, in connection with reports about high vitamin C concentrations in brain tissue, particularly in prematures, make one suspect important functions of this vitamin in physiological and pathological mechanisms in the central nervous system. PMID- 3975062 TI - [Flaccid paralysis following oral poliomyelitis vaccination]. AB - This is the report of a four months old boy who developed a serous meningitis and flaccid paralysis of the left upper and lower extremity 17 days following the first immunisation with a trivalent life poliomyelitis vaccine. The patient recovered well within 2 months. Presently a mild functional disturbance and muscle wasting of the left leg can still be observed. An acute poliomyelitis can be due to a wild virus infection in an unimmunized child. Secondly an acute poliomyelitis can occur as vaccine associated poliomyelitis as it is reported in the immunocompromised host. As a third possibility the remutation of a poliomyelitis vaccine virus in a patient concomitantly infected with cytomegalovirus can be discussed. Our patient showed a normal humoral and cellular immunity. Virologic studies in our patient disclosed a wild poliomyelitis virus type III which was isolated from the stool. It cannot be clearly distinguished at the present time whether this wild virus is due to a remutation in the presence of a recent cytomegalovirus infection in our patient or due to a newly acquired wild virus infection. PMID- 3975063 TI - [Clonidine poisoning]. AB - Accidental clonidine poisoning of infants has been more frequently observed during the last years. The early onset of sedation together with miosis, hypotension, bradycardia and sometimes respiratory depression should draw our attention to clonidine poisoning. Treatment of cardiac and circulatory symptoms with atropine sulfate, epinephrine chloride, dopamine hydrochloride and intravenous fluids should start early. Ventilatory support must be available for children in case of apnoe. We report our experience with the treatment of five infants. PMID- 3975064 TI - [Oral pertussis vaccination]. PMID- 3975065 TI - [Fauna of dust-dwelling mites in the Maritime Territory]. AB - The specific composition of acarid mites occurring in dust of rural dwellings in the Far East of the USSR has been first studied and characters of their fauna have been revealed. 3 species are most frequently encountered of which Dermatophagoides pteronyssinus accounts for 56% of all finds. 6 species happened to be new for the fauna of dwellings. The typical synanthropic species Glycyphagus domesticus is totally absent from dwellings but occurs in 90% of honey-bee hives. PMID- 3975066 TI - [Theory of the relationship of the types of feeding and digestion in blood sucking arthropods and their ability to be specific vectors of the causative agents of transmissible infections]. AB - An attempt has been made to relate the ability of bloodsucking arthropods to be specific vectors of different groups of agents to such properties of digestive system of blood-suckers as the type of food consumption on larval and imaginal phases, composition of food consumed by larva and imago, structure of intestinal epithelium in adult arthropods and speed of blood digestion process. PMID- 3975068 TI - [Wohlfahrtiasis in wild ungulates in the Askaniia-Nova Zoo]. AB - The paper presents data on the sick rate with volfartiosis in different species of wild ruminents. The animals were maintained in spacious enclosures (up to 1550 hectare). This disease was recorded in 24 species of animals, african eland (33.5%) and american bison (9.4%) being infected mostly often. The morbidity dinamics within years and its dependence on weather conditions is given. The methods of prophylaxis and medical treatment of wild animals are discussed. PMID- 3975067 TI - [Adaptibility of Diplostomum cercariae in carp and the effect of a prior infestation]. AB - Experiments on the infection of carp fry with cercariae of Diplostomum have shown that cercariae of Diplostomum spathaceum can penetrate crystalline lens of larvae of these fishes in three days after their hatching and that the adaptability of cercariae of D. paracaudum to carp is much higher than that of cercariae of D. spathaceum. After the first infection with cercariae a relative postinfectious immunity against infection with cercariae of this or close species of this genus arises in carp fry. PMID- 3975069 TI - [Development of the trypanosomes (Trypanosoma) and cryptobians (Cryptobia) of carp and tench in the leech Piscicola geometra]. AB - The paper presents the results of studies of the development of trypanosomes and cryptobiae of carp and tench in Piscicola geometra. The paper describes an unknown way of reproduction by means of fusion of individuals and formation of cystlike bodies, the subsequent development of which results in a special form schizogony with a formation of rosettes. PMID- 3975070 TI - [Ultrafine structure of the malpighian tubules of hematophagous Diptera]. AB - The ultrastructure of Malpighian tubes of 5 species of bloodsucking Diptera was studied: Culicoides pulicaris, Tabanus bromius, Hybomitra schineri, Haematopota pluvialis and Stomoxys calcitrans. The Malpighian tubes of the above species include the cells of two types. The most abundant cells of the 1st type contain many spherical inclusions which represent deposits of mineral compounds. The microvilli of the 1st type cells always contain mitochondria. Cells of the 2nd type are characterized by a smaller size, their microvilli lack mitochondria and no sphere crystals are observed in cytoplasm. Differences in the ultrastructure of epithelial cells of Malpighian tubes were found out. PMID- 3975071 TI - [Distribution of the thorny-headed worm Acanthocephalus lucii (Palaeacanthocephala, Echinorhynchidae) in the digestive tract of the perch]. AB - The distribution of Acanthocephalus lucii in the intestinal tract of perch was investigated. It has been established that host's sex and age do not affect the parasite's localisation. At the same time different age groups of A. lucii migrate to different parts of the host's intestine. With age females of A. lucii migrate in the direction of the hind department of the Gut while males remain in its anterior part. PMID- 3975072 TI - [Correlation between various lipid and apolipoprotein parameters and clinical severity in arteriopathy of the lower limbs]. AB - We have compared the serum levels of lipids (cholesterol, triglycerides, high density lipoprotein cholesterol), apolipoproteins (Apo Al and Apo B) and two ratios (HDL cholesterol/VLDL + LDL cholesterol and Apo Al/Apo B) between a population of 180 patients with atheromatous member lesions, divided into four sub-groups with respect to clinical severity, and one of 121 controls without lesions. It seems that the most discriminative values linking to the severity of atherosclerotic manifestations are levels of Apo B, ratio Apo Al/Apo B and with a lower efficiency ratio HDL cholesterol/VLDL + LDL cholesterol. PMID- 3975073 TI - [Comparative study of urine immunoelectrophoresis and 4 indexes of glomerular selectivity in chronic glomerulopathies]. AB - Glomerular selectivity has been evaluated in a group of 89 patients, using renal clearances of orosomucoid (Cl O), transferrin (cl T) and immunoglobulin G (Cl IgG). In all cases, protein excretion was found above 0,30 g/24 h and urinary immunoelectrophoresis (IEP) showed a glomerular pattern. Clearance ratios Cl IgG/Cl T and Cl T/Cl O as well as Joachim's and Sabot's indexes were correlated to IEP patterns, protein daily excretion, creatinin clearance and pathological findings. The ratio Cl T/Cl O and Joachim's and Sabot's indexes correlated significantly with IEP patterns while Cameron's ratio (Cl IgG/Cl T) did not. Criteria other than Cameron and Joachim's indexes were found to be related to protein excretion; all indexes, Cameron's excluded, were influenced by renal functional status. Progress may be expected from the simultaneous serum and urine determinations of 5 proteins in the range 40 000-1 000 000 molecular weight with more accurate techniques such as laser nephelometry. PMID- 3975074 TI - [Thyroid hormones during a hypocaloric diet in obese patients]. AB - The levels of T3, RT3, T3/RT3, T4, FT4 index or T4/TBG, TSH, at days 1, 4, 8, 15 of a 800-1 000 diet with 60-80 g of carbohydrates, were studied in 45 subjects. Statistical analysis was performed using parametric and non parametric tests for comparison of the mean levels between days 1 and 4, 1 and 8, 1 and 15, 4 and 8, 4 and 15, 8 and 15. We observed no difference between men and women. We noted no modification in the evolution of T4, FT4 or T4/TBG and TSH levels. A significant T3 decrease and a RT3 increase with a clear cut decrease of the T3/RT3 ratio from day 1 to 15 principally marked from day 4 to 15 were found. These hormonal modifications correlate well with the weight fall. PMID- 3975075 TI - [Migration of polynuclear neutrophils in vivo. Standardization of the technic]. AB - The migration of neutrophils across a skin barrier is a commonly employed method for the study of the inflammatory response. This report aims at comparing the leukocyte migration in the presence of two different chemoattractants : autologous serum and pool of serum. The reproducibility of this method has proved to be increasing by using duplicate skin chambers in 30 healty volunteers. The neutrophil migration with the pool of serum appears more homogeneous than with autologous serum. These results permit to obtain a standard curve of the neutrophil migration using a pool of serum. PMID- 3975078 TI - [Pseudomonas pickettii septicemia]. AB - A case of bacteremia caused by Pseudomonas pickettii in an insulin dependent diabetic patient is reported, the portal of entry was unknown. After a failure of cefotaxime therapy whereas the strain was found susceptible by disk assay to this antibiotic, the patient became afebrile with doxycycline treatment. The bacteriological findings as well as the clinical problems are reported in the present paper. PMID- 3975076 TI - [Estrogen and progesterone receptors in malignant melanoma, benign pigmented nevi and basocellular epithelioma]. AB - 45 malignant melanomas, 10 benign nevi and 17 basal cell carcinomas were investigated for estradiol (ER) and progesterone (PR) receptor activity by a single saturating-dose method (5 nM for ER and 10 nM for PR) using DCC. ER were found respectively in 7%, 10% and 24% of the studied samples and PR in 18%, 40% and 29% of the same samples. The low rates of ER+ and PR+ samples were discussed according to the data of the literature, more specially to the weak results obtained with anti-estrogenic therapy and to the possibility of tyrosinase to mimic the estrogen binding detected in melanomas. PMID- 3975077 TI - [Evaluation of the diagnostic power of 3 methods for assaying free T4. Results in the diagnostic strategy of hyperthyroidism]. AB - The free thyroxin (FT4) tests of Amersham, Clinical Assay and Corning Medical were evaluated in 240 patients who were suspected of hyperthyroidism. The diagnostic performances of the Corning method were of less value while those of the other methods were equivalent to that obtained with the free thyroxin index for an average cost reduced. Furthermore our results show that T3 determination is better than T4 determination in patients who remained doubtful after FT4. However the development of ultra-short methods of measurement of total thyroid hormone blood levels using fluorescence polarization could lead to reconsider the diagnostic strategy of hyperthyroidism. PMID- 3975079 TI - [Fluorimetric assay of serum 5-fluorocytosine]. AB - A manual and fast procedure for the fluorimetric determination of 5 fluorocytosine in the serum, after extraction by chloroform is described. The intra-assay variation was between 3,1 and 4,1%; the inter-assay variation was 4,8%. The results obtained are in good agreement with those obtained by the microbiological method. The determination of 5-fluorocytosine by this method is not possible if the sample contains ketoconazole or 5-fluorouracil. PMID- 3975080 TI - Viral diarrhea. PMID- 3975081 TI - Symposium on injuries and injury prevention. PMID- 3975082 TI - Submersion injury. Epidemiology, prevention, and management. AB - The epidemiology of injuries resulting from submersion in water and their prevention are reviewed and the management of submersion injury is detailed. PMID- 3975083 TI - Injuries at play. AB - The problem of toy-related injuries is a complicated one. The authors detail specific hazards related to toys, playgrounds, skateboards, and baby walkers. Guidelines are provided for toy suitability for children of all ages. PMID- 3975084 TI - The epidemiology of injuries to bicycle riders. AB - Over half a million injuries related to bicycle crashes were seen in U.S. hospital emergency rooms in 1982. The data reviewed show a strong link between bicycle/motor vehicle collisions, head injury, and serious morbidity and mortality. PMID- 3975085 TI - Falls in children and youth. AB - Falls account for considerable morbidity in childhood. The importance of the surface that the child strikes is highlighted as well as the parents' perceptions of the seriousness of the fall. Recommendations for prevention are made. PMID- 3975086 TI - Pedestrian injuries to children and youth. AB - Prevention of pedestrian injuries constitutes a most difficult problem, involving not only driver and pedestrian behavior, but also the design of streets, highways, and automobiles. The epidemiology of these injuries is assessed, using the host-agent-environment model, and approaches to prevention are presented, from child behavior modification to engineering. PMID- 3975087 TI - Developmental approach to injury prevention. AB - Children's developmentally diverse temperament, motivation, and competencies, when viewed through the lens of the agent-host-environment model, help us understand the child's contribution to the occurrence of injury. Pediatricians can use this information to individualize their safety counseling. PMID- 3975088 TI - Management of multiple trauma. AB - The first 20 minutes of medical treatment are crucial in determining the outcome for the multiple injured child. The author chronicles management procedures and their sequence, emphasizing the systemic approach and preparation as important tools. PMID- 3975089 TI - Management of the choking child. AB - There is controversy regarding the best maneuver to expel a completely obstructing foreign body from the upper airway of a patient. Further study and research are needed. However, we recommend that no change in the present recommendations be made until these studies are accomplished. We have attempted to outline the major aspects of the controversy and give the rationale for the present recommendations. PMID- 3975090 TI - Legal approaches to injury prevention. AB - Injury prevention can be achieved, but it will require a fundamental reexamination of our approach to injury causation. We must learn to examine the manufacturing and marketing practices of companies that produce the products associated with children's injuries, for these are the real culprits in our national childhood injury plague. Most importantly, we must learn to demand from industry that it take injury prevention seriously. If it refuses to do so it must face the consequences before the American system of justice. Legal advocacy can be a valuable tool in this effort. The legal system provides the means to pierce the corporate veil of secrecy and to learn how and why products are made of hazardous design. Under the light of public scrutiny, culprit companies can be made to pay the price for producing hazardous products. Only in this manner will industry be given the incentive to increase product safety. PMID- 3975091 TI - Effects of Massachusetts raising its legal drinking age from 18 to 20 on deaths from teenage homicide, suicide, and nontraffic accidents. AB - In this study, contrary to expectations, no significant decline in violent deaths (excluding traffic accidents) was found among Massachusetts 15 to 19 year olds after the state raised its drinking age from 18 to 20. The authors also review the epidemiology of alcohol-related injuries. PMID- 3975092 TI - Educating parents about injury prevention. AB - Pediatricians usually spend very little time counseling parents about childhood safety. The Framingham Safety Surveys (FSS) were developed for pediatricians to use in counseling on childhood injury prevention. The use of FSS and supplemental safety instruction are reviewed. This study found increased preventive behaviors in homes after safety counseling by pediatricians using FSS. PMID- 3975093 TI - The pediatrician as advocate. AB - Pediatricians' success in the role of advocate can be associated with fewer injuries to children. The authors emphasize the importance of pediatrician advocacy for injury prevention, including preventive health maintenance, education, community organization, professional education, development of emergency medical services, and legislation and regulation. PMID- 3975094 TI - Injury prevention in the community: a systems approach. AB - Injury prevention requires a coordinated political, medical, individual, and community effort. Comprehensive strategies for planning, implementing, and evaluating injury prevention programs are set forth by the authors. PMID- 3975095 TI - Injuries to adolescents and young adults. AB - Death rates in adolescents are on the rise--the only age group for which this is true. Unintentional injuries, homicide, and suicide account for 80 per cent of all deaths in this group. The authors summarize the available morbidity and mortality data. PMID- 3975096 TI - Recognition of nonaccidental injury. AB - Intentional injuries may be grossly underrecognized and underreported. The authors review the literature, provide guidelines for recognizing intentional injuries, and address the problem of identifying intentional injuries. Prevention of these injuries is also addressed and the need for further study is stressed. PMID- 3975097 TI - An approach to the epidemiology of childhood injuries. AB - Injury epidemiology is summarized and important concepts such as injury versus accident, the agent-host-environment model, level of severity, morbidity versus mortality, and definitions of rates are considered. The authors suggest steps needed to improve the understanding of injury epidemiology and to remove barriers to the acceptance of injury prevention as a recognized field of study and clinical practice. PMID- 3975099 TI - Poisonings. AB - While the three demonstration programs failed to document a major impact on prevention of poisoning, they do provide a rationale for selected strategies that may have wide application. Future efforts and successes in poison prevention will involve both the primary care physician and the poison center, using primary and passive interventions. The primary physician can be a source of information and counseling, while the poison center, having succeeded in secondary prevention, can expand its role into primary prevention. PMID- 3975098 TI - Burns. AB - The authors present an extensive review of burn epidemiology. They review sources of burns, preventive tools, emergency behaviors to reduce severity, and rehabilitation. Ways are sketched in which the pediatrician can be an effective advocate against burn injuries. PMID- 3975100 TI - Motor vehicles. AB - The author discusses the epidemiology of injuries from motor vehicles, the leading killer of children. Type and mechanism of trauma, restrain use, children's relative risk, and issues for advocacy are presented in this article on the occupants of motor vehicles. PMID- 3975101 TI - A home injury prevention program for children. AB - Most injuries to children under age five occur in the home. This article recounts the experience of an injury prevention project in developing and implementing an approach combining educational, regulatory, and technologic methods to reduce home injuries. PMID- 3975102 TI - International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. AB - The classification of grading of vesicoureteric reflux (VUR) agreed to by the participants in the International Reflux Study in Children is described. It combines two earlier classifications and is based upon the extent of filling and dilatation by VUR of the ureter, the renal pelvis and the calyces. A standardised technique of voiding cystography is also described to ensure comparability of results. PMID- 3975103 TI - Heel pain due to retrocalcaneal bursitis-radiographic diagnosis (with an historical footnote on Sever's disease). AB - Retrocalcaneal bursitis is a distinct condition causing posterior heel pain in active, healthy children. It appears to result from post-traumatic inflammation of the soft tissues of the posterior heel, and is unrelated to avascular necrosis of the calcaneal apophysis. The diagnosis may be confirmed radiographically by the loss of the lucent retrocalcaneal recess, with a normal Achilles tendon and superficial soft tissue contour, and intact cortex of the underlying os calcis. PMID- 3975104 TI - Tuberculous mediastinal lymphadenitis with a chest wall mass. AB - A 14-year-old black female was found to have massive lymphadenopathy and osteomyelitis of the sternum in association with a parasternal mass. Diagnostic studies revealed tuberculosis as the etiology of this patient's skeletal and mediastinal disease. The differential diagnosis of chest wall lesions accompanied by mediastinal disease is discussed. PMID- 3975105 TI - Infra-azygous pneumomediastinum versus pulmonary ligament air collection: CT evaluation. AB - A full-term infant developed a large collection of air posteriorly in the thorax. Computed tomography showed the anatomical distribution of this extraventilatory air and although, it did not conclusively differentiate between infra-azygous pneumomediastinum and a pulmonary ligament air collection, inappropriate needle aspiration of the air was avoided. PMID- 3975107 TI - Tracheoesophageal fistula: diagnosis with CT. AB - A baby with two lower cervical tracheoesophageal fistulas was evaluated with a barium esophagram and computerized tomography (CT). The esophagram identified both fistulas. Axial CT demonstrated the esophageal attachment of the upper fistula and completely displayed the lower fistula. A change in caliber of the esophagus from a collapsed to a distended state marked the site of the fistulas. PMID- 3975106 TI - Intrathoracic desmoid tumor in a child. AB - The case history of a child with an intrathoracic desmoid tumor is presented. The insidious nature of the tumor's development and its possible relationship to previous surgery are noted. Desmoid tumors are rare in the childhood population and an intrathoracic site as the origin of one has not been reported previously. PMID- 3975108 TI - Focal foveolar hyperplasia presenting as an antral-pyloric mass in a young infant. AB - A young infant with vomiting associated with a gastric polyp is presented. The polyp proved to be focal foveolar hyperplasia. These non-neoplastic polyps of unknown etiology are usually found in adults. PMID- 3975109 TI - Sacral chondromyxoid fibroma. AB - A 15-year-old girl with a limp and weakness and wasting of the left leg, was found to have a large chondromyxoid fibroma of the sacrum. The lesion presented difficulties in diagnosis because of its unusual site, neurological presentation, large size and extensive extension into the soft tissues of the pelvis and buttock. PMID- 3975110 TI - A case of lethal congenital dwarfism with accelerated skeletal maturation. AB - Details of a female infant, who was born after 29 weeks gestation and who died within minutes of birth, are presented. The infant was hydropic, showed macroglossia and had very short limbs with normal sized hands and feet. Apart from a preductal aortic coarctation the pathological findings were confined to the skeleton. The radiographical and histological findings are described in detail; they differ from those of previous studies of similar conditions. PMID- 3975111 TI - Early echographic findings in non-hemorrhagic periventricular leukomalacia of the premature infant. AB - The ultrasonic detection of periventricular leukomalacia is described in two neonatal patients. Confirmation of this condition by CT and post mortem was obtained in one case. CT scan and further echography was positive in the other. Neither patient had evidence of an intracranial hemorrhage. It is suggested that echography is of value in the early diagnosis of this lesion which may be similar to intraparenchymal hemorrhage in its mechanism and prognosis. PMID- 3975112 TI - Unilateral dilatation of the internal mammary artery as a sign of an intrathoracic lesion. AB - Nineteen children had unilateral dilatation of the internal mammary artery associated with an intrathoracic lesion on the same side. Dilatation of one internal mammary artery to a calibre more than twice that of the artery on the other side is a sign of an intrathoracic pathological finding on the same side. However, when the arteries have the same calibre an intrathoracic pathological process is not excluded. Dilatation occurs independently of the vascular supply of the pathological process by systemic collaterals. A share in the collateral supply from the pulmonary circulation is specially characteristic. PMID- 3975113 TI - A comparison of the Shwachman, Chrispin-Norman and Brasfield methods for scoring of chest radiographs of patients with cystic fibrosis. AB - Three systems are described for chest radiograph scoring in cystic fibrosis patients: the Shwachman-Kulczycki, the Chrispin-Norman and the Brasfield method. Sixty chest radiographs of 39 patients of different ages have been independently scored by two radiologists according to the three methods. No statistical differences between the methods could be demonstrated. The Chrispin-Norman method is recommended as the best choice because differences in scoring appeared better interpretable. A significant increase in precision could be achieved by combining the scores of the three methods. PMID- 3975114 TI - Traumatic deaths of children in the United States: currently available prevention strategies. AB - The causes of traumatic deaths of children 14 years of age and younger in the United States are presented. Available prevention strategies to decrease injury fatalities due to various causes are described, and the number of preventable deaths is calculated. With the implementation of only 12 currently available prevention strategies, childhood deaths from trauma could be reduced by 29% in the United States. The implications of these strategies are discussed, as well as the area for which no effective countermeasures exist and which require further epidemiologic and investigative research. PMID- 3975115 TI - Epidemiology of trauma in a population of incarcerated youth. AB - This study assessed the types, circumstances, frequency, and health consequences of trauma suffered by juvenile delinquents at a secure residential training school. A review of 369 medical records of 387 teenagers, aged 10 to 17 years, admitted to one such facility between 1978 and 1982 was made. Of the 369 students, 191 students (52%) suffered 391 separate trauma incidents serious enough to require a health care provider's attention. Circumstances surrounding the injuries included sports (36%), fights (20%), self-inflicted injuries (13%), suicide attempts (9%), incidents related to vocational studies (8%), and horseplay (3%). The most common types of injuries were musculoskeletal trauma, scratches, bruises and lacerations, and fractures. The usual sites of injury were the extremities, head, or neck. More than 50% of trauma incidents required a physician's attention initially or in follow-up; 28% of the injured were referred to an off-campus facility; 21% necessitated radiologic or laboratory studies; 4% required hospitalization; and one student died. The average trauma rate for teenagers in this setting was 1.2 injuries per person per year; the average rate of hospitalizations for trauma was 0.04 hospitalizations per person per year. These data call for further studies of trauma morbidity among adolescents in this and other settings and for innovative trauma prevention strategies. PMID- 3975116 TI - Sleep problems seen in pediatric practice. AB - To determine whether sleep problems commonly seen in pediatric practice, such as conflicts at bedtime and night waking, are associated with more pervasive disturbances in the child or family, two groups of healthy children were studied. Interview data from a pilot sample were examined to identify factors that might be important in sleep problems, and then the results were validated with data from the second sample. The two samples included 96 white children between 6 months and 4 years of age. In each group, approximately 30% had a sleep problem by the criteria that night waking involving parents or bedtime struggles occurred three or more nights a week for the month preceding the interview, accompanied by conflict or distress. Five experiences distinguished children with sleep problems from those without: an accident or illness in the family, unaccustomed absence of the mother during the day, maternal depressed mood(s), sleeping in the parental bed, and maternal attitude of ambivalence toward the child. These experiences correctly classified 100% of pilot and 83% of validation sample children as having a sleep problem or not. The similarity of findings in the two samples attests to the potential importance of sleep problems as an early childhood symptom. Bedtime conflicts and night waking seem to be quantifiable, easily ascertainable behavior patterns that could alert pediatric health professionals to the existence of more pervasive disturbances in child and family. PMID- 3975117 TI - Normal cerebrospinal fluid values in children: another look. AB - Cerebrospinal fluid samples sterile for virus and bacteria from 371 patients who had no evidence of CNS pathology were examined. The patients were divided into five age categories. The white blood cell polymorphonuclear, and mononuclear cell counts were evaluated. The frequency distributions for these cell counts were markedly skewed, so values were calculated as percentiles for each age group. WBC values were highest for CSF obtained from patients in younger age categories, but 25% of patients from all age categories had two or three WBCs in their CSF. Patients from all but the 3- to 6-month category had three polymorphonuclear cells in their CSF 5% of the time. There was no significant difference in CSF WBC count between patients who had seizures and those who did not. Knowledge of normal values in different age groups is needed for the interpretation of CSF findings, but it should be used in conjunction with other clinical and laboratory findings. PMID- 3975118 TI - Intracerebral hemorrhage in the full-term neonatal infant. AB - Supratentorial intracerebral hemorrhage was diagnosed in 18 full-term neonates, including six with primarily intraparenchymal hemorrhage and 12 with primarily intraventricular hemorrhage. Precipitating or associated factors were hypoxic ischemic injury in five patients, polycythemia in two, and cranial birth trauma in two. Nine other infants had no identifiable medical risk events. The pathogenesis of intraparenchymal hemorrhage was probably related to hemorrhagic infarction, but the pathogenesis of intraventricular hemorrhage was often unknown. All 17 survivors returned for neurologic and developmental examinations between 1 and 7 years of age. Follow-up assessments were normal in nine children and abnormal in eight. Two had perceptual difficulties, three had moderate-to severe cognitive deficiencies (two of the three had hemiplegia), and three had severe mental and neurologic handicaps. Eight of nine children with known or suspected hypoxic-ischemic or traumatic insults suffered moderate-to-severe disabilities whereas eight of nine children with no known precipitating cause for their hemorrhage developed normally. PMID- 3975119 TI - Early termination of breast-feeding: identifying those at risk. AB - In a private pediatric practice, 94 infants who were breast-feeding were followed for the first 2 months of life in order to define the frequency of cessation of breast-feeding and to identify factors that would predict mothers and infants at risk for early cessation. At 8 weeks, 30% of the mothers had stopped nursing. Factors associated with cessation were: maternal lack of confidence in breast feeding (P less than .001); anticipated duration of nursing less than 6 months (P = .002); ratings by the nursery staff of infant's excessive crying (P = .007), infant's demanding personality (P = .007), trouble with feeding (P = .001), and future trouble with feeding (P = .004). Together, these factors predicted 77% of the mothers who terminated breast-feeding. Supplementing with formula before the 2-week office visit also led to termination of breast-feeding by 8 weeks (P = .006). This decision was frequently made without medical advice. Nearly 64% (14/22) of the mothers who added formula within the first 2 weeks did so without contacting the pediatric practice. PMID- 3975121 TI - Munchausen syndrome by proxy: an outpatient challenge. AB - Primary health care providers are well aware of the physical findings that suggest a child has been intentionally maltreated. Practitioners must also be aware of a more subtle form of child abuse in which the parent victimizes the child by presenting fictitious medical history that initiates a sequence of unnecessary diagnostic and therapeutic interventions. A 4 1/2-year saga of such a case, an example of Munchausen syndrome by proxy in the outpatient setting, is reported. PMID- 3975120 TI - Bilirubin photoisomerization in premature neonates under low- and high-dose phototherapy. AB - Photoisomerization of native bilirubin to more polar configurational isomers (Z,E bilirubin) and structural isomers (lumirubin) was studied in 20 premature infants with physiologic jaundice to determine the effect of low-dose (6 microW/cm2/nm) v high-dose (12 microW/cm2/nm) phototherapy. Patients were assigned prospectively to receive either low- or high-dose treatment. Study groups were comparable with regard to birth weight, gestational age, and total bilirubin prior to the initiation of phototherapy. Treatment was administered with white light produced by a commercially available halogen-tungsten lamp. Dose was measured periodically during the study to ensure a uniform distribution of irradiance and constant exposure. Sera for photoisomers were obtained before initiation of treatment and at two, four, and eight hours. Photoisomers expressed as a percent of total bilirubin were determined using high-pressure liquid chromatography. Serum proportion of both configurational and structural isomers increased with the duration of phototherapy in both treatment groups. There was no significant difference between the percent of configurational isomers in low- and high-dose phototherapy groups. However, high-dose treatment produced a significantly higher proportion of the structural isomer lumirubin after four hours (0.7% low dose v 1.3% high dose, P less than .05). These data confirm that phototherapy results in both configurational and structural isomerization of bilirubin in vivo. Furthermore, the previously described "dose" effect of phototherapy may be attributed to the production of the structural isomer, lumirubin. PMID- 3975122 TI - When pediatricians become parents. PMID- 3975123 TI - Incarcerated youths: urgent needs. PMID- 3975124 TI - Normotriglyceridemic abetalipoproteinemia in infancy: an isolated apolipoprotein B-100 deficiency. AB - The plasma lipoproteins of a 1-year-old Japanese infant were studied because of malnutrition, severe decrease in plasma lipid level, and acanthocytosis. Plasma lipoprotein analysis revealed that low-density lipoproteins were deficient; however, low levels of triglyceride-rich lipoproteins were found in the plasma. On sodium dodecylsulfate (SDS) polyacrylamide gel electrophoresis, apoprotein B 48 and a faint band corresponding to apoprotein B-100 were detected in the lipoprotein fraction of density less than 1.006 g/mL when the infant was 6 months old. Apoprotein B-48 was more clearly detected after 1 year, but the band corresponding to apoprotein B-100 on the sodium dodecylsulfate gel electrophoresis had disappeared. The apoprotein B-48 content of the fraction with density less than 1.006 g/mL was about 0.05 to 0.3 mg/dL. The patient's lipoproteins consisted mainly of high-density lipoproteins. These results suggest that the disorder in this patient is caused by apoprotein B-100 deficiency. PMID- 3975126 TI - Morphologic significance of bifid uvula. AB - Bifid uvula is often regarded as a marker for submucous cleft palate although this relationship has not been fully confirmed. The reason for the tacitly assumed connection between these two anomalies has, in part, been perpetuated by the generally accepted definition of submucous cleft palate as the triad of bifid uvula, notching of the hard palate, and muscular diastasis of the soft palate. Recently, investigations have provided evidence of more subtle manifestations of submucous cleft palate by the use of nasopharyngoscopic examination of the palate and pharynx. It has been determined that submucous cleft palate can occur even when a peroral examination shows an intact uvula. This finding places the "marker" relationship in question. In order to determine the frequency of association between bifid uvula and submucous clefting, a total ascertainment of children with bifid uvula from a suburban pediatric practice was examined nasopharyngoscopically. It was determined that in all but two cases, children with bifid uvula had some or all of the landmarks of submucous cleft palate. Several of the children were found to have velopharyngeal insufficiency and mildly hypernasal speech. This finding prompts caution in the recommendation of adenoidectomy in the presence of bifid uvula. PMID- 3975125 TI - Anticipatory nausea and vomiting in pediatric cancer patients. AB - The purpose of this study was to determine the prevalence and correlates of anticipatory nausea and vomiting in a sample of pediatric patients with cancer who were receiving outpatient chemotherapy. Forty male and female patients representing a broad range of diagnoses were interviewed with their parents concerning nausea and vomiting before and after chemotherapy. Anticipatory nausea was reported by 28.8% of the sample; anticipatory vomiting was present in 20% of the sample. An additional 9% had experienced anticipatory nausea and vomiting in the past but not currently. Anticipatory nausea and vomiting was positively correlated with the emetic potential of chemotherapeutic regimens and the severity of nausea and vomiting after chemotherapy; anticipatory nausea and vomiting most often developed within the first 4 months of treatment. Onset of anticipatory nausea and vomiting usually occurred two to four hours before treatment and was most severe at the actual time of drug administration. Considerable interpatient variability was observed, with treatment-related factors accounting for only 22% of the variance in the occurrence of anticipatory nausea and vomiting. These findings are considered within a behavioral framework for understanding conditioned aversions in pediatric patients with cancer. Implications for patient education, future research on the prediction of children at risk, and intervention are discussed. PMID- 3975127 TI - Foster care for child maltreatment: impact on delinquent behavior. AB - Previous reports of child maltreatment sequelae have not systematically examined the effects of societal intervention. A historical cohort study has been undertaken to examine the impact of one intervention, foster care, on the subsequent development of juvenile delinquency among child victims. One hundred fourteen foster children, aged 11 to 18 years, in foster care for three or more years, and who were in foster care as a result of maltreatment were studied. A comparison cohort was composed of 106 victims of maltreatment who were left in their family home; these children were similar to the children in foster care with regard to age, race, sex, and year of diagnosis. Cohort differences in maternal education, type of abuse, history of prior maltreatment, sex, and race were controlled in the analysis. Foster children committed 0.050 crimes per person-year after age 11 years; home care children committed 0.059 crimes per person-year after age 11 years (P greater than .2). Foster children were more likely to have committed criminal assault. Among foster children, increased number of foster home placements correlated with increased number of delinquency convictions. Overall, there appears to be no support for the idea that foster care is responsible for a significant portion of later problems encountered by victims of maltreatment. PMID- 3975128 TI - Renal clearance of fluoride in children and adolescents. AB - Renal function and fluoride excretion have been studied in 38 children. The children were divided into three groups according to their glomerular filtration rate: normal (92 to 136 mL/min/1.73 m2 of body surface area [BSA]), low (less than 92 mL/min/1.73 m2 BSA, and super-normal (greater than 136 mL/min/1.73 m2 BSA). Standard clearance technique with infusion of inulin and p-aminohippuric acid during water diuresis was used. Mean renal fluoride clearance was 45.0 +/- 9.8 (SD) mL/min in the group of children with normal glomerular filtration rates and 31.4 +/- 8.8 mL/min in the group with low glomerular filtration rates. This difference was statistically significant. There was a close linear relationship between renal fluoride clearance and glomerular filtration rate, urinary flow, and free water clearance. The fractional fluoride excretion did not differ between the groups. About 60% of the filtered fluoride was reabsorbed. No evidence for tubular secretion exceeding the reabsorption could be found. The results suggest that children have lower renal fluoride clearance rates than adults and indicate that a moderate impairment of the renal function could lead to increased retention of fluoride. PMID- 3975129 TI - Symptoms of respiratory illness in young children and the use of wood-burning stoves for indoor heating. AB - The occurrence of symptoms of respiratory illness among preschool children living in homes heated by wood-burning stoves was examined by conducting an historical prospective study (n = 62) with an internal control group (matched for age, sex, and town of residence). Exposures of subjects were not significantly different (P greater than .05) with respect to parental smoking, urea-formaldehyde foam insulation, and use of humidifiers. The control group made significantly greater use of gas stoves for cooking whereas the study group made greater use of electric stoves for cooking and of air filters (P less than .05). Only one home used a kerosene space heater. During the winter of 1982, moderate and severe symptoms in all categories were significantly greater for the study group compared with the control group (P less than .001). These differences could not be accounted for by medical histories (eg, allergies, asthma), demographic or socioeconomic characteristics, or by exposure to sources of indoor air pollution other than wood-burning stoves. Present findings suggest that indoor heating with wood-burning stoves may be a significant etiologic factor in the occurrence of symptoms of respiratory illness in young children. PMID- 3975130 TI - Involuntary smoking and incidence of respiratory illness during the first year of life. AB - A prospective study of 1,144 infants and their families was performed. Smoking and family histories were evaluated with respect to the incidence of lower respiratory disease during the first year of life. It was found that (1) tracheitis and bronchitis occurred significantly more frequently in infants exposed to cigarette smoke in the home, (2) maternal smoking imposed greater risks upon the infant than paternal smoking, (3) occurrence of neither tracheitis nor bronchitis showed a consistent relationship to the number of cigarettes smoked, (4) a family history that was positive for respiratory illness (chronic cough or bronchitis) significantly influenced the incidence of bronchitis, (5) too few cases of laryngitis and pneumonia were seen to warrant any opinions regarding the adverse influence of either smoking or a family history that was positive for respiratory illness, and (6) occurrence of bronchiolitis was not affected by the presence of a smoker nor influenced by a family history that was positive for respiratory illness. It is concluded that passive smoking is dangerous to the health of infants and that infants born to families with a history that is positive for respiratory illness (chronic cough or bronchitis) are at risk of developing bronchitis. PMID- 3975131 TI - Unusual syndrome among premature infants: association with a new intravenous vitamin E product. AB - Eight small, premature infants developed an unusual symptom complex of pulmonary deterioration, thrombocytopenia, liver failure, ascites, and renal failure. Five infants died; the health of the other three infants improved and they were discharged from the hospital. This unusual syndrome occurred after introduction of a new intravenous vitamin E product (E-Ferol, alpha-tocopherol acetate) for routine use in the intensive care nursery. Even though no definite conclusion was reached as to its cause, the administration of this intravenous vitamin E product appears to be a significant risk factor. PMID- 3975132 TI - Prevention of bacterial endocarditis. Committee on Rheumatic Fever and Bacterial Endocarditis of the Council on Cardiovascular Diseases in the Young, American Academy of Pediatrics. PMID- 3975133 TI - The 'dynamic transcutaneous PO2 histogram' or how to deal with immense quantities of monitoring data. PMID- 3975134 TI - Adolescents and ritalin. PMID- 3975135 TI - Bronchiolitis and recurrent wheezing. PMID- 3975136 TI - Balloons as a cause of suffocation. PMID- 3975137 TI - Breaker's back. PMID- 3975138 TI - Rock in the nose. PMID- 3975139 TI - Pertussis vaccine and neurologic disease. PMID- 3975140 TI - Breast-feeding and hyperbilirubinemia in full-term newborn infants. PMID- 3975141 TI - [Importance of immunodeficiency syndromes in pediatrics]. PMID- 3975142 TI - [Clinico-immunological polymorphism of the hyperimmunoglobulinemia E syndrome]. PMID- 3975143 TI - [Secretory immune system of the breast in mothers and their newborn infants]. PMID- 3975144 TI - [Immune system in acute, protracted and chronic infectious and inflammatory diseases of the respiratory organs in children]. PMID- 3975145 TI - [Local cellular mechanisms of protection in lung diseases in children]. PMID- 3975146 TI - [Immunological reactivity of children with an allergy-aggravated family history]. PMID- 3975147 TI - [Mechanisms of the development of allergic diathesis in children]. PMID- 3975148 TI - [Determination of the individual values of venous circulatory indices for healthy children and adolescents]. PMID- 3975149 TI - [The status of pediatric care in the USSR and tasks for its improvement]. PMID- 3975150 TI - [Features of conducting practical classes with pediatric department interns]. PMID- 3975151 TI - [Cardiogenic shock in children]. PMID- 3975152 TI - [Combined congenital cysts of the lungs, kidneys and thyroid]. PMID- 3975153 TI - [Late result of the surgical treatment of a malignant tumor developing in the cavity of a congenital lung cyst in a 2-year-old child]. PMID- 3975155 TI - Policy issues concerning antimicrobials: controls on antimicrobial usage. PMID- 3975156 TI - The purchase of regression. PMID- 3975154 TI - Bioethical essentialism and scientific population thinking. PMID- 3975157 TI - Molecular genetics and the foundations of evolution. PMID- 3975158 TI - Factitious illness: an exploration in ethics. PMID- 3975159 TI - Medicine, technology, and lived relations. PMID- 3975160 TI - [Experiences from the diphtheria outbreak in Gothenburg. Basic vaccination data should be computerized]. PMID- 3975162 TI - [Skin symptoms as a sign of internal organ diseases]. PMID- 3975161 TI - [Treatment of infection in patients with malignant diseases]. PMID- 3975163 TI - [Preventive treatment of renal calculi]. PMID- 3975165 TI - [Methodology of research: Bias II. Occurrence in other types of studies]. PMID- 3975164 TI - [Aboard ship--an occupation and a life style in transition]. PMID- 3975166 TI - [Carcinoembryonic antigen (CEA) in patients' blood serum]. PMID- 3975167 TI - [Pathophysiological basis of anti-aggregation treatment in migraine]. PMID- 3975168 TI - [The expected and real role of a physician in the opinion of patients with chronic respiratory tract diseases]. PMID- 3975169 TI - [Etiology of exudative pleurisy]. PMID- 3975170 TI - [Picolinic acid concentration in human milk]. PMID- 3975171 TI - [Membranoproliferative glomerulonephritis in pregnancy]. PMID- 3975172 TI - [Familial form of Parry-Romberg syndrome]. PMID- 3975173 TI - [Peculiarities of pediatric dermatology in Africa]. PMID- 3975174 TI - Familial factors affecting prostatic cancer risk and plasma sex-steroid levels. AB - Whether familial factors affect the frequency of prostatic cancer and the plasma content of sex-steroids was investigated. Brothers (n = 257) of probands (n = 150) diagnosed with prostatic cancer before age 62 years had a fourfold higher risk for developing the disease than men in the general population in the State of Utah and their brothers-in-law (n = 202). Familial factors markedly affected the plasma content of sex steroids (testosterone, dihydrotestosterone, the ratio of testosterone to DHT, sex-hormone binding globulin, and the free fraction of testosterone) in nonendocrinologically treated probands and their brothers and sons and in normal men in the general populations. Index cases and their brothers and sons had a significantly lower mean plasma testosterone content than controls of comparable age. Preliminary data suggest that the metabolic clearance rate of testosterone and the conversion ratio of testosterone to estradiol are relatively high in probands. The observations indicate that familial factors are potent risk factors for the development of prostatic cancer. They also suggest that plasma androgen values in families with prostatic cancer cluster in the lower range of normal and that plasma sex-steroid content is more similar in each brothers with or without prostatic cancer than among nonbrothers. PMID- 3975175 TI - Approaches to prostatic cancer chemotherapy using the Dunning R3327H prostatic adenocarcinoma. AB - Androgen-responsive cells: To determine if testosterone or dihydrotestosterone is the main trophic hormone of prostatic adenocarcinoma, we have treated Dunning R3327H prostatic adenocarcinoma-bearing rats with 6-methylene progesterone, which blocks conversion of testosterone to dihydrotestosterone. Copenhagen-Fisher rats were treated with steroid (20 mg/Kg daily) immediately following implantation of tumor and thereafter for 117 days. There was a 92% inhibition of growth of tumors and a lesser effect upon prostate and seminal vesicles. Tumor-free body weights remained unchanged. Both treated and untreated tumors had equivalent DNA content on a per weight basis. This result supports the thesis that prostatic adenocarcinoma requires dihydrotestosterone for growth. Androgen-insensitive cells: Advanced prostate cancer does not respond to endocrine therapy but is temporarily controlled by the cytotoxic steroid estramustine. The latter shows significant selective binding to prostatic protein. To develop chemotherapeutic agents that will control androgen-insensitive cells and possess improved selectivity for prostatic protein, we have studied a number of steroids for their ability to displace 3H-labeled estramustine from prostatic cytosolic proteins. Surprisingly, a carbamido substituent at the C17 position was found to confer significant binding affinity for prostatic estramustine-binding protein. Extension of this structural characteristic to the estramustine type of molecule is being studied. PMID- 3975176 TI - Secretion of bromide by the canine prostate. AB - Four dogs with surgically produced prostatic fistulas were given single oral doses of 1.13 gm of sodium bromide daily for five consecutive days. Two days later the mean (+/- SE) serum level of bromide was 28.0 +/- 4.0 meq/L and the serum chloride level had decreased from a pretreatment value of 112.5 +/- 1.0 meq/L to 86.5 +/- 3.7 meq/L; in the basal prostatic secretion, the mean prostatic fluid to serum (PF/S) ratios for bromide and chloride were 0.56 +/- 0.15 and 0.53 +/- 0.11, respectively, and were not different (P greater than 0.05, paired t test); at higher rates of secretion provoked by intravenous pilocarpine the corresponding PF/S ratios of 1.48 +/- 0.04 and 1.32 +/- 0.01 were significantly different (P less than 0.05, paired t-test). It is concluded that the processes involved in forming the basal and pilocarpine-induced prostatic secretions must differ and that the ability of the chloride-transporting system to transport bromide is slightly greater than that for chloride. Because it may impair sperm motility, bromide secreted in prostatic fluid potentially could adversely affect reproduction. PMID- 3975177 TI - Amifloxacin distribution in the dog prostate. AB - Constant infusion experiments with amifloxacin, a quinoline carboxylic acid derivative, were performed in five anesthetized dogs to determine the drug concentrations in prostatic secretion (PS), prostatic interstitial fluid (PIF), prostatic tissue, and plasma (P). The experiments were carried out under steady state conditions. Amifloxacin concentrations in PS and PIF were lower than the corresponding P concentrations, as might be expected for an acid compound. There was no significant difference between the PS/P and PIF/P concentration ratios of the drug, and none exceeded 1.0. The concentrations of amifloxacin in PS, PIF, and prostatic tissue were above the minimal inhibitory concentration values of most gram-positive bacteria causing chronic bacterial prostatitis. Clinical trials of amifloxacin seem justified. PMID- 3975179 TI - Future directions in medical care. The heightening need for physicians as patient advocates. PMID- 3975178 TI - Fluctuations in prostatic glycosaminoglycans during fetal and pubertal growth. AB - Mesenchymal glycosaminoglycans have been shown to fluctuate during the development of various organs. Prostatic development is an interesting example of organogenesis as it is only at puberty, under androgen influence, that differentiation is completed. We have extracted and quantitated the glycosaminoglycans of human prostates obtained from fetuses, prepubertal, and adult males to determine the changes that occur during prostatic differentiation. The total glycosaminoglycan content per prostate followed the wet weight growth curve. The percentages of heparan sulfate and heparan sulfate sulfation seemed to correlate with prostatic epithelial differentiation. After 25 years of age prostatic glycosaminoglycan concentrations tend toward the glycosaminoglycan ratios typical of benign prostatic hyperplasia. PMID- 3975181 TI - Contemporary medical ethics. Would Hippocrates approve--or even understand? PMID- 3975180 TI - Chronic neck and shoulder pain. Focusing on myofascial origins. AB - Chronic neck and shoulder pain is a complex, multifactorial problem. Often many months have passed since its onset. During this time the patient may have seen many physicians and tried many medications, some with abuse potential. Most patients are depressed and have lost their ability to cope with the stresses of daily life. The goals of therapy are to enable patients to deal with the problem and to bring them to the point where pain is no longer the dominant factor in their lives. For patients with chronic neck and shoulder pain of myofascial origin, this is accomplished with a multi-disciplinary approach that incorporates use of psychotherapeutic techniques, nonsteroidal antiinflammatory medications, antidepressant drugs, trigger-point injection, and several physical therapy modalities. PMID- 3975182 TI - Prevention of extravasation injuries secondary to doxorubicin. AB - Intravenously administered drugs with potentially devastating consequences should be given only by personnel highly knowledgeable regarding the side effects and skilled in intravenous cannulation. A strict protocol should be followed. The earliest signs heralding extravasation should be recognized and infusion discontinued immediately. If extravasation occurs, prompt surgical consultation is necessary. Injection into the volar wrist, dorsum of the hand, and antecubital fossa should always be avoided. Polyethylene catheters are preferable to butterfly needles for administering chemotherapeutic agents. A careful history of the venous problems of patients who require long-term therapy should be maintained in their chart. Ideally, vascular access should avoid these problems. PMID- 3975183 TI - Hazardous waste sites. Will the community call on you to assess their effect? PMID- 3975184 TI - How--and why--to request an autopsy. AB - Autopsy remains the touch-stone of diagnosis, but clinicians are often reluctant to request the procedure because of their discomfort in approaching the family. Fundamental to a successful autopsy request is sensitivity for the family's feelings, which bespeaks respect for the deceased and the family. For example, in announcing the death and requesting autopsy, the clinician should bring the family to the hospital and talk with them privately. If they have questions or reservations about autopsy, the clinician should answer honestly and simply, stressing the benefits of the procedure to the family and society as a whole. Since the manner of request influences the family's decision in about one third of cases, efforts at overcoming personal reluctance in requesting autopsy are worthwhile. Clinical excellence develops through effort and practice in this activity as in any other. PMID- 3975185 TI - Human infections derived from dogs. AB - Infected dogs, including those that appear healthy, have been implicated in the genesis of certain infectious disorders in humans. Failure to appreciate the epidemiologic features of these infections can result in delayed diagnosis and therapy, with occasional fatal results. Efforts directed toward patient education, frequent veterinarian examinations of household pets, and thorough hand washing after animal contact will reduce the incidence of dog-related infections in humans. PMID- 3975186 TI - Choosing an antiepileptic drug. The case for individualized treatment. AB - The range of drugs available for seizure control is broad, but selection of the drug and the dosage most likely to be effective for an individual patient is complex. In general, drug choice is determined by type of seizures involved and total daily dosage is based on milligrams per kilogram, so that plasma levels for all patients can be easily interpreted. Optimal seizure control is often possible with use of a single drug; in fact, in most patients with epilepsy, single-drug therapy is more effective than multiple-drug therapy and more desirable. PMID- 3975187 TI - Anxiety within the Aesculapian shrine. The high priests of medicine tighten their cinctures. PMID- 3975188 TI - Preparing the medically compromised patient for surgery. AB - Preparing the medically compromised patient for surgery requires identifying and treating preoperative risk factors and anticipating postoperative complications. Preoperative evaluation of all patients should include careful screening for bleeding disorders and prior anesthetic complications and assessment of nutritional status. In addition, patients with preexisting cardiac, pulmonary, and endocrine problems must be identified, since these problems represent the greatest risk factors for postoperative complications. Perioperative care is more effective when directed at specific organ systems. Communication among internists, anesthesiologists, and surgeons promotes optimal treatment for surgical patients with medical illness. PMID- 3975189 TI - Sexual dysfunction. A guide to evaluation and intervention. PMID- 3975190 TI - Market research in medical practice. A case study of one practice's site survey. PMID- 3975191 TI - Stroke. A guide to differential diagnosis and prevention. PMID- 3975192 TI - Energy and protein relationships in the broiler. 1. Effect of protein levels and feeding regimens on growth, body composition, and in vitro lipogenesis of broiler chicks. AB - Male broiler chicks were fed ad libitum diets containing 18, 23, or 30% protein for 3 weeks. In addition, chicks were fed diets containing 12, 23, or 30% protein on a 3-day rotation. Finally, chicks were fed either the 23 or 30% protein on a schedule of 2 days on feed and 1 day off feed. These feeding schemes allowed chicks to consume low to excess protein coupled with either adequate or inadequate energy intake. Feed intakes were equal for the 18, 23, and rotational percent protein dietary groups and lower (P less than .05) for the 30% ad libitum group. Chicks fed the 18% protein diet ad libitum were the least efficient (P less than .05) at utilizing feed and the most efficient (P less than .05) at utilizing protein for weight gain. Compared to the ad libitum situation, restricted feeding improved feed and protein efficiency of chicks fed 30% protein diets but not of chicks fed 23% protein diets. Body composition data on a dry matter basis supported a positive relationship between dietary protein and percent lean tissue. Conversely, expressing data on a whole bird basis indicated that lean body mass was favored by feeding the diet containing 23% protein. In vitro lipogenesis was greatest (P less than .05) in chicks fed a 18% protein diet ad libitum and least (P less than .05) in chicks fed a 30% protein diets ad libitum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975194 TI - The reliability and efficiency of various methods for estimating spermatozoa concentration. AB - A study was conducted of the reliability and the efficiency of four methods to estimate concentration of spermatozoa in chicken semen. The methods used were hemocytometer, Coulter counter, optical density, and spermatocrit. Twenty-four samples of pooled semen (5 males per sample) were used in this experiment. Sperm concentration estimates were determined on each of three subsamples: pure semen, semen diluted 1:1, and semen diluted 1:3. The average time to prepare and evaluate 6 replications of each subsample with the hemocytometer, Coulter counter, optical density, and spermatocrit methods was 9.0, 2.6, 2.3, and 4.4 min, respectively. Correlation coefficients ranged from .78 to .93 between the hemocytometer and either optical density or Coulter counter in both pure and diluted 1:1 and 1:3 samples. However, no significant correlation was observed between the hemocytometer and spermatocrit in the 1:3 dilution. The reliability expressed as coefficient of variation for each technique was: hemocytometer 17.9%, Coulter counter 1.57%, optical density 2.24%, and spermatocrit 9.95%. It is concluded from these results that the optical density and Coulter counter methods are more reliable and more efficient (less time consuming) than either hemocytometer or spermatocrit methods in estimating semen concentrations in chickens. PMID- 3975193 TI - Thyroid and adrenal response to heat stress in chickens and quail differing in heat tolerance. AB - Three experiments were conducted to evaluate the thyroid and adrenal response in groups of birds with altered heat tolerance. Groups of chickens that had been handled on each of 4 days and a nonhandled control group were bled on the 5th day with or without heating for 1 hr at 50 C. Handling did not affect the thyroid response as indicated by thyroxine (T4) or triiodothyronine (T3) levels. Corticosterone levels were lower in handled birds than nonhandled birds after heating. In a second experiment, groups of broilers were fed a diet containing .2% thiouracil or a control diet. After 2 weeks they were bled either with or without 1 hr of heating at 50 C. The T3 and T4 levels were reduced by thiouracil feeding both with and without heating, but adrenal function was not affected. In Experiment 3, T3 and T4 levels were compared for four lines of Japanese quail. The nongrowth-selected line had higher T3 and T4 levels than growth-selected lines but did not have elevated levels of T3 or T4 in response to heat stress. The growth-selected lines (T, S, and P) responded to heating with increased T3 and T4 levels. Levels of T4 in Line T (selected on a thiouracil diet) after heating were significantly higher than all other lines. PMID- 3975195 TI - Lymphocyte migration through the lymphatic sinuses of the chicken's lymph node. AB - We have described the lymphocyte migration through the sinus wall of the lymph node. The sinuses showing lymphocyte migration are located in a given area of the node that might be comparable with the T-dependent deep cortex of the mammalian lymph nodes. The lymphocyte migration takes place through the cytoplasm of the endothelial cell presumably by formation of the transendothelial channels, which are produced by vesicles of the endothelial cell. The intensive vesiculation preceding the formation of transendothelial channels might indicate the direction of the migration. The absence of vesicles in the endothelial cell and the dilated intercellular space between the lymphocyte and endothelial cell suggest that the lymphocyte in the sinus wall may be "resting". The presence of the multivesicular body in the pseudopod or in the vicinity of the pseudopod of the lymphocyte may contribute to the migration. PMID- 3975197 TI - Maternal and sex-linked genetic effects in broiler parent stocks. AB - Sire and dam populations of chickens were synthesized from commercial broiler parent stocks at the Animal Research Centre, Ottawa. The production of two-way and four-way crosses during synthesis permitted measurement of maternal and sex linked genetic effects on body weight and conformation traits. Sex-influenced effects were also measured. Reciprocal cross differences were minimal. Consequently, there was no evidence among stocks within parental type of maternal effect differences and only minimal evidence of sex-linked genetic effects. As expected, sex-influenced effects were large. Hence, it appears that breeders must work within strains or stocks to improve maternal and sex-linked genetic effects for body weight and conformation. PMID- 3975196 TI - Effect of cyclic sound cues on sexual development in nonphotostimulated Japanese quail. AB - The influence of cyclic ambient sound stimuli on sexual development was studied in nonphotostimulated [6 hr light:18 hr dark (16L:18D)] Japanese quail (Coturnix coturnix japonica). The incidence of accelerated gonadal development was reduced when ambient daily sound stimuli were attenuated by the presence of a white noise mask in the animal quarters. In a second experiment nonphotostimulated (9L:15D) male quail showed a phase-dependent testicular response to a daily 3-hr radio broadcast presented at different portions of the day. The radio sound stimulus induced a higher incidence of accelerated gonadal development when presented 6 hr prior to the photophase than when presented either 3 hr prior to the photophase or when presented coincidently with the photophase onset. In a third experiment locomotion was monitored in nonphotostimulated quail (9L:15D) with a 3-hr radio sound stimulus presented 6 hr prior to photophase onset. The onset of a daily locomotor activity pattern was associated with radio sound in some individuals, but sound-induced locomotion was not consistently associated with sound-induced accelerated gonadal development. PMID- 3975198 TI - Duration of exposure--histological effects on broiler lungs, performance, and house environment with Mt. St. Helens' volcanic ash dust. AB - Fourteen hundred broilers were exposed to Mt. St. Helens' volcanic ash (VA) dust (D) from 28 to 49 days of age to correlate the duration of exposure time to histological effect on lungs and to determine the effects on broiler performance and house environment. Histological examinations of the lungs from birds exposed each day for 4 days to either VAD for 60 min (VAD 60) in the morning and afternoon (3276 g VA/day), or VAD after one direct application (DiAp) (20 kg/m2) on wood shaving litter revealed mild lymphoid hyperplasia and granuloma formation accompanied by phagocytized crystalline material seen in some alveolar macrophages; however, no effect was observed in lung tissues from broilers exposed each day for 4 days to VAD for 15 min (VAD 15) in the morning and afternoon (82 g VAD/day). Birds exposed to all VAD treatments and examined after 7 days had histological changes in the lungs, including giant cell granuloma formation, similar to those seen at 4 days. No significant histopathological changes were found in the turbinates with any VAD treatments. Levels of mean body weight, ammonia concentration, mortality, and respiratory dust (particles ranging in size from .5 to 10 micron) levels were not significantly different among the treatments. Significantly poorer mean feed conversion was observed with broilers exposed to VAD 60 than the VA DiAp exposure. No difference in feed conversion was observed between the control and either VAD 15 or VAD 60 treatments. From this experiment, the observed histological changes in the lungs occurred with 4 days or less exposure to VAD 60 (3276 g/day). PMID- 3975199 TI - Effect of mixed organic acid administration on blood levels of chlortetracycline in broiler chicks. AB - Male broiler chicks, when administered mixed organic acids via the drinking water for 3 days prior to water administration of chlortetracycline (CTC), showed no significant increases in the blood levels of the antibiotic. However, if the organic acids were administered simultaneously with the antibiotic, either via drinking water administration or via oral dosing, significant increases in the blood levels of the antibiotic were noted. With simultaneous administration of the antibiotic and mixed organic acids via the drinking water, a significant decrease in water intake was observed; however, in spite of the decrease in water intake and a concomitant decrease in CTC intake, significant increases in the blood levels of the CTC were still present. These data suggest that mixed organic acids, commonly used in the poultry industry, can be utilized to elicit an increase in CTC blood levels to a greater degree than would be anticipated without the use of the organic acids. PMID- 3975200 TI - Genetic variation in body size, composition, temperature, and feed intake in mature chickens. AB - Genetic variation for more than 40 traits was assessed in 26 stocks of mature chickens reared together and fed ad libitum from hatching to slaughter at 507 days of age. There was greater genetic variation among males than among females. The intraclass correlation, t, was high (greater than .75) for measures of size and weight and moderate (.20 to .60) for most other traits (P less than .05) including a measure of lean distribution (.37). Three main categories of stocks were studied, viz. outbred Leghorns, medium-sized stocks, and contemporary heavy meat chickens. Differences in lean distribution were not associated with category, but differences of 40 to 50 g/kg lean in the breast of some stocks may be caused by a single gene. Lean:bone ratios were similar in medium and heavy stocks but were greater (P less than .05) in heavy meat-types compared with outbred Leghorns. Bone density was higher (P less than .01) in females compared with males and in outbred Leghorns compared with heavier stocks (P less than .01). Heavy meat-type males were leaner (P less than .01) and had proportionately less fat in the abdominal cavity than outbred Leghorns. Carcass fatness was similar among stocks of females, but abdominal fat was lower in Leghorns selected for high egg production compared with unselected Leghorns (P less than .05) and heavy stocks (P less than .001). One resistant and two Marek's disease susceptible stocks were replicated in a specific pathogen-free (SPF) environment. Spleen weight was larger (P less than .001) in the conventional environment. Females were relatively smaller (P less than .05) than males in the conventional environment. Body temperature (t = .25, P less than .05) and feed intake were assessed in males. Heavy meat birds had a lower (P less than .01) body temperature than outbred Leghorns and medium-sized stocks. Differences among stocks for feed intake (t = .77) were significant (P less than .05); however, they were greatly reduced when feed intake was expressed as g/kg liveweight (LW) (t = .49) or g/kg LW.75 (t = .25). Outbred Leghorns ate less in absolute terms but significantly more (P less than .01) as a proportion of LW or LW.75 than the medium and heavy lines. PMID- 3975202 TI - Coping with a diagnosis of breast cancer. PMID- 3975201 TI - Sports injuries: rugby league may be less dangerous than union. PMID- 3975203 TI - Pycnodysostosis referred as hydrocephalus. PMID- 3975204 TI - Breast screening. Part 1. Mammography. PMID- 3975205 TI - Breast screening. Part 2. Fine needle aspiration of breast lesions. PMID- 3975206 TI - Breast self-examination. PMID- 3975207 TI - Surgical options for the treatment of operable breast cancer. PMID- 3975208 TI - Radiotherapy in the management of breast cancer. PMID- 3975209 TI - Management of advanced carcinoma of the breast. PMID- 3975210 TI - The Mastectomy Association. PMID- 3975211 TI - The problems of people with severely restricted growth. PMID- 3975212 TI - Diuretic-induced gout: the beginnings of an epidemic? PMID- 3975214 TI - [Mediastinal tuberculosis with invasion of the esophagus]. PMID- 3975215 TI - [Tasks of general thoracic surgery]. PMID- 3975213 TI - [Pharmacokinetics of theophylline, proxyphylline and diprophylline in a combination preparation in healthy probands]. PMID- 3975216 TI - [Thoughts, measurements and comparisons of the usefulness of phase displaced pressure-flow diagrams in the evaluation of obstructive lung diseases. Measurement of respiratory air per liter]. PMID- 3975217 TI - [Stuttering as relation disorder. Psychotherapeutic intervention with parents of stuttering children]. PMID- 3975218 TI - [Following a terror attack on a school class]. PMID- 3975219 TI - [Integrated psychotherapy in inpatient child and adolescent psychiatry--the significance of group meetings]. PMID- 3975220 TI - Prenatal detection of rubella-specific IgM in fetal sera. AB - Serum specimens were obtained by fetoscopy at 19-25 weeks' gestation from four fetuses whose mothers had had confirmed rubella earlier in pregnancy. They were tested for rubella-specific IgM by antibody capture radioimmunoassay. No specific IgM was detected in one fetus and a healthy infant was delivered at term. Specific IgM was detected in the other three fetuses. In one case the level was low (1 unit) and this pregnancy went to term resulting in a neonate with clinical and laboratory evidence of congenital rubella infection. The remaining two fetuses had 2.8 and 2.4 units of specific IgM and the pregnancies were terminated. Blood obtained from these two fetuses after abortion showed levels of 5.4 and 2.9 units respectively. No specific IgM was detected in sera from eleven other fetuses aborted because of maternal rubella but five of these cases were terminated before 19 weeks and in five the interval between rash and abortion was three weeks or less. The results show that the human fetus can produce detectable specific IgM antibody by 19-20 weeks' gestation after exposure to rubella several weeks earlier. However, a larger study is required to define the reliability of fetoscopic blood sampling for the diagnosis of intrauterine infection. PMID- 3975221 TI - The prenatal diagnosis of the cerebro-hepato-renal syndrome of Zellweger. AB - The prenatal diagnosis of the cerebro-hepato-renal syndrome of Zellweger (CHRS) was made by assaying the levels of very long chain fatty acids (VLCFAs) in amniotic fluid cell cultures, obtained by amniocentesis at 16 1/2 weeks of pregnancy. The family-at-risk, because they had previously borne a child with CHRS, accepted these results as indications of an affected fetus, and chose to terminate the pregnancy at 20 1/2 weeks of gestation. The diagnosis was confirmed by the phenotype of the aborted fetus and the presence of markedly elevated levels of VLCFAs in fetal liver homogenates. The prenatal diagnosis of CHRS, which can now readily be determined from amniotic fluid cell cultures, is an important step in genetic counselling of families-at-risk for this disease. PMID- 3975222 TI - Utilization of prenatal cytogenetic diagnosis in women of advanced maternal age in Australia, 1979-1982. AB - This paper reports the results of a complete national survey to measure utilization rates of prenatal cytogenetic diagnosis (P.C.D.) in women of advanced maternal age in Australia. P.C.D. has been available throughout Australia for the last decade. Every laboratory in Australia providing a P.C.D. service for the years 1979-1982 took part in this study. Utilization rates (both National and State rates) by ages of mothers, are presented. Big interstate differences exist. The 1982 National P.C.D. utilization rate for pregnant women who were 40 years of age and over was 38.8 per cent, and this rate has shown an average annual increase of 9 per cent. In those four States which offered P.C.D. to pregnant women of 35 years or over the median utilization rate was 20 per cent. These Australian rates indicate an under-utilization of P.C.D. services with (in 1982) 50-80 per cent of 'at risk' women not being tested. Factors which influence this are discussed. PMID- 3975224 TI - Definition of true and pseudo-mosaicism. PMID- 3975223 TI - Evaluation of a prenatal screening procedure for beta-thalassaemia carriers in a Chinese population based on the mean corpuscular volume (MCV). AB - Haemoglobin A2 (HbA2) levels were determined on 25 beta-thalassaemia carriers by the microcolumn method and were found to range from 4.5-7.2 per cent (mean 5.2 +/ 0.82 S.D.). The haemoglobin level (Hb), mean corpuscular volume (MCV), plasma ferritin and HbA2 levels were measured on a further 299 consecutive Chinese pregnant women at a gestation of less than 24 weeks. 18 patients (6 per cent) had HbA2 level greater than 4.5 per cent and were diagnosed to be beta-thalassaemic carriers. It was observed that all these patients had a MCV below 75 fl. If this level is selected in a screening procedure based on measurement of MCV alone all beta-thalassaemia carriers could be detected and 11 per cent of the population screened would require HbA2 estimation. At a lower cut-off level of 70 fl, 8 per cent of the population screened would require HbA2 measurement (a decrease of 27 per cent) but the detection rate will be lowered considerably (83 per cent). The high false positive rate at all cut-off levels of MCV was largely due to the prevalence of iron deficiency anaemia in the population. Estimation of plasma ferritin level in patients with low MCV will reduce this false positive rate, but there will be a considerable delay in diagnosis in patients with concomitant iron deficiency and beta-thalassaemia. The presence of iron deficiency in beta thalassaemia carriers did not reduce their HbA2 level below the diagnostic range in this study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975225 TI - Effects of different dietary carbohydrates on hepatic enzymes of copper-deficient rats. AB - The present study was undertaken to measure the activities of several hepatic enzymes of regulatory importance in the pathways of lipogenesis and gluconeogenesis in rats fed diets marginally deficient in copper (1.2 micrograms Cu/g of diet) and containing either fructose, glucose, or starch as the carbohydrate sources. Although all copper-deficient rats exhibited the characteristic signs of copper deficiency, they were more pronounced in rats fed the diet containing fructose. Except for the activity of phosphoenolpyruvate carboxykinase which was unaffected either by copper deficiency or by the type of dietary carbohydrate, the hepatic activities of glucose-6-phosphate dehydrogenase, malic enzyme, L-alpha-glycerophosphate dehydrogenase and fructose 1,6-diphosphatase were unaffected by copper deficiency but were affected by the type of carbohydrate in the diet. Fructose produced the greatest increase in enzymatic activities, whereas starch produced the least activity and glucose induced an intermediate effect. These results indicate that the deleterious effects of a fructose diet deficient in copper on biochemical and physiological indices could not be due to an immediate metabolite of fructose. However, the involvement of a subsequent metabolite of fructose in the mechanism of copper utilization and/or requirement cannot be excluded. PMID- 3975227 TI - Heparin inhibition of human neutrophil and eosinophil-enriched leukocyte acid beta-glycerophosphatase. AB - Heparin inhibited acid beta-glycerophosphatase (EC 3.1.3.2) from human blood leukocytes, eosinophil-enriched leukocytes, and neutrophils. The inhibition interfered in the hydrolysis of phosphorus from glycerophosphate, not in the formation or detection of colored complexes of phosphomolybdate in the second or color development step in two conventional assays. Heparin inhibited human hypereosinophilic syndrome leukocyte homogenate enzyme activity according to the equation: activity equals 0.946 - 0.087 ln heparin (units/assay) when heparin was varied from 1 to 100 units per assay. At 100 units of heparin per assay, 51% of the original activity remained. Enzyme activity was less in neutrophils than in eosinophils; moreover, the inhibition of neutrophil homogenate by heparin was considerably less than that seen in the eosinophil-enriched leukocyte preparations. In neutrophil homogenates containing 100 units of heparin per assay, 77.1% of activity without heparin was retained. When neutrophil lysates were utilized, less inhibition was observed: e.g., at 1 unit of heparin per assay, 91.7% enzyme activity was retained and at 1000 units, 76.2%; here, activity equals 0.289 - 0.007 ln heparin. The data allowed more precise consideration of the inhibition of acid beta-glycerophosphatase by heparin, and, while confirming quantitatively the greater content of acid beta glycerophosphatase in eosinophil-enriched leukocyte preparations than in neutrophil preparations, provide experimental support for an acid beta glycerophosphatase in human eosinophils, which is different from that in human neutrophils. It is more highly susceptible to heparin inhibition than acid beta glycerophosphatase in human neutrophils from which it is apparently distinct. PMID- 3975226 TI - Effects of lead on the renal response to extracellular volume expansion. AB - Subacute lead exposure has been observed to inhibit the natriuretic response to isotonic saline expansion in adult female rats. Three-week exposure to 0.5% lead acetate in drinking water resulted in a moderately high blood lead concentration of 57 micrograms/100 ml and up to 60% inhibition of the natriuretic response to extracellular volume expansion. This ability of lead to inhibit natriuresis following volume expansion (an induced stress) may be a more sensitive index of lead poisoning than alterations of renal function in nonstressed animals. Lead exposure had no effect on GFR or plasma aldosterone concentrations, and in the presence of large doses of DOCA (a mineralocorticoid) this inhibitory effect of lead was still persistent. Amiloride completely blocked the antinatriuretic effect of lead in volume-expanded lead-poisoned animals, causing a twofold increase in water and electrolyte excretion while having minimal effects on volume-expanded controls. It is concluded that lead interferes with the action of a "third factor," controlling natriuresis. PMID- 3975228 TI - A new erythrocytic antigen of C57BL/10 (B10) mice. AB - A new antigen, detectable on murine erythrocytes by hemagglutination assay with a (BALB/cCrl X SWR/J)F1 anti-B10.D2n/Sn alloantiserum, is described. Among the inbred and congenic mouse strains tested for reactivity with the antiserum, only the immunizing strain, B10.D2, and its congenic resistant partner, C57BL/10 (B10), reacted. Three other C57 strains, C57BL/6J, C57BL/6By, and C57L, were negative for the antigen. F1 hybrids between B10 and BALB/c, an antigen-negative strain, were positive for the antigen indicating that its expression is dominant. Typing of 39 (BALB/c X (BALB/c X B10)F1) and 62 [BALB/c X B10)F1 X BALB/c) backcross mice revealed that a single gene controls expression of the antigen. The gene is autosomal and not linked to H-2, Ly-4, or the c (albino) or b coat color genes. PMID- 3975229 TI - Type B atrial receptor discharge increases on opening a nonhypotensive arteriovenous shunt in the dog. AB - A vagovagal cardioacceleratory reflex is activated when an arteriovenous (a-v) shunt is opened in the dog. However, the receptors which initiate this reflex have not been localized. Type B atrial receptor excitation was considered to be a major component of this reflex. The effect of opening a femoral nonhypotensive a v shunt (i.e., shunt open plus infusion of blood to compensate for the resultant fall in mean arterial and pulse pressure) on type B atrial receptor discharge and heart rate was therefore studied in seven anesthetized, artifically ventilated dogs with beta-adrenergic blockade. Right atrial and aortic blood pressures, heart rate, and type B atrial receptor discharge was studied before and after opening a femoral a-v shunt. On opening the a-v shunt there was a significant increase (44%) in the average activity of type B atrial receptors and a small, but significant (6.8%) increase in heart rate. A significant linear positive correlation was observed between the change in activity of type B atrial receptors and the shunt flow. The results suggest that type B atrial receptors may be one of the receptor groups that initiate this vagovagal reflex. PMID- 3975230 TI - The growth of individual seminal vesicle epithelial cells and their proliferation. AB - Histologically seminal vesicle epithelium (SVE) of the intact adult guinea pig is a discrete and segregated monolayer of highly specialized tall columnar cells. The epithelial layer is so sharply demarcated from its attached stroma (primarily smooth muscle), that blunt dissection alone is sufficient to separate epithelium from muscle. After castration the epithelial cells decrease in both size and number so that by the fifth day, the surviving cells are greatly involuted structurally and comprise only about 12% of the original numerical population normally present in one seminal vesicle. Injected testosterone leads to restructuring of individual cells followed by cell replenishment. The major goal of this effort was to elaborate upon the processes of individual cell growth and cell replenishment during restoration of the tissue to normal cell size and number. The two separate processes were studied using light and electron microscopy, [3H]thymidine incorporation, and Northern blots with labeled histone gene probes. By approximately 48 hr of hormone repletion, parenchymal cell size had returned to normal as the result of a dramatic anabolic process of individual cell growth while cell number remained unchanged. During the subsequent 48-hr period of hormone repletion, the cell population was restored to normal as cell replenishment became the predominant process. Microscopic analysis at intervals throughout the 96-hr period failed to disclose any mitotic events to account for cell replenishment even when Colcemid had been administered. Nor could the increase in cell numbers be correlated with a great increase in [3H]thymidine incorporation or in histone mRNA synthesis. Thus, we could provide no evidence that mitotic division of the parenchymal cells themselves is responsible for cell replenishment. During the 24- to 48-hr interval of hormone repletion, electron microscopic examination disclosed the presence of small epithelial cells lying in a basal position. Some of these cells were seen to insert themselves between the basal regions of parenchymal cells and to expand from the basement membrane into the parenchyma. Possible origins of the cells which replenish the tissue are discussed. PMID- 3975231 TI - Increase in pulsatile secretion of growth hormone during failure of catch-up growth following glucocorticoid-induced growth inhibition. AB - The pattern of growth hormone (GH) secretion was determined in rats injected with cortisone acetate, 5 mg/rat/day subcutaneously, or with an equivalent volume of saline for 4 days from age 40 days. Cortisone injections resulted in inhibition of growth of body weight and tail length. During recovery the rats resumed a normal rate of growth but failed to show catch-up growth acceleration. From 17 to 27 days of recovery, plasma was sampled at 15-min intervals through the lights-on period, 06:00 to 18:00, via a catheter chronically implanted in the superior vena cava. During sampling each rat was housed singly in an insulated chamber, unrestrained, and with food and water ad lib. Cortisone-treated animals had a normal periodicity of GH plasma concentration, but they showed a reduction in values in the range of 50 to 99 ng/ml (P less than 0.01) and an increase of values in the range of 200 to 499 ng/ml (P less than 0.025) and above 1000 ng/ml (P less than 0.05). The area under the GH concentration curve of the cortisone treated rats was significantly greater than that of the controls, 100.9 +/- 18.7 (mean +/- SE) units vs 55.3 +/- 7.4 (P less than 0.025). Thus, increased growth hormone secretion during the light phase persisted in spite of failure of catch up growth acceleration. The findings indicate that the mechanism involved in GH release is linked to the catch-up growth control. PMID- 3975232 TI - Ethanol induced alterations in low and high density lipoproteins. AB - Male squirrel monkeys fed ethanol (ETOH) at variable doses were used to determine whether alcohol modifies levels of plasma low density lipoproteins (LDL) in addition to increasing high density lipoproteins (HDL). Because we earlier showed that high alcohol consumption enhances lipoprotein cholesterol synthesis, experiments were also performed to further assess whether ETOH alters lipoprotein clearance and plasma transfer processes in vivo. Monkeys were divided into three groups: Controls fed isocaloric liquid diet; and Low and High ETOH animals fed liquid diet with vodka substituted isocalorically for carbohydrate at 12 and 24 of the calories, respectively. High ETOH primates had significantly more LDL lipid and protein while serum glutamate oxaloacetate transaminase was similar for the three groups. Although removal of 3H LDL cholesteryl ester (CE) from the plasma compartment was not affected by dietary ETOH, transfer of LDL CE to HDL was impaired in the High ETOH group suggesting a mechanism for the enlarged circulating pool of LDL. Transfer of 14C HDL CE to lower density lipoproteins was similar for the three groups. However, ETOH at both doses delayed clearance of radiolabeled HDL CE from circulation. Thus besides enhancing synthesis of lipoproteins, ETOH at a moderately high dose (24% of calories) influences lipoprotein levels in primates by modifying lipid transfer processes (LDL) as well as by altering clearance (HDL) without adversely affecting liver function. PMID- 3975233 TI - [Comparative study of availability of various extracts of Strychnos Ligustrina B. L]. PMID- 3975234 TI - [Galenic forms and availability of theophylline. II. Influence of the content of the active principle and parameters of tablet manufacture]. PMID- 3975235 TI - Effects of moderate stress storage conditions on the dissolution profile of enteric-coated aspirin tablets. PMID- 3975237 TI - [Aroma therapy]. PMID- 3975236 TI - [Calcium and calmodulin]. PMID- 3975238 TI - Alteration of the neurochemical effects of fenfluramine by previous treatment with d-amphetamine. AB - It was found in an earlier study that a 15-day IP subacute d-amphetamine treatment rendered an apparent "tolerance" to the food intake suppressant effects of fenfluramine. The purpose of the present study was to determine if the neuronal substrate on which fenfluramine supposedly acts to produce a decrement in food consumption was altered by the previous treatment with d-amphetamine. The time course effects (0-90 min) of a single IP injection of 10 mg/kg fenfluramine on brain monoamines in saline-treated rats included a significant lowering of serotonin in all brain regions examined. Although the serotonin depleting actions of fenfluramine in the d-amphetamine-treated rats generally paralleled those seen in the saline group (i.e., as in the hypothalamus), no such effects were noted in regions where baseline values (see below) were already lowered by d-amphetamine treatment (i.e., pons-medulla, thalamus, and substantia nigra). Norepinephrine and dopamine depletions were observed in the pons-medulla and hypothalamic areas after fenfluramine administration in the saline-treated rats, but fenfluramine caused no decreases in hypothalamic dopamine or in pons-medulla and hypothalamic norepinephrine content in rats previously treated with d-amphetamine. Analysis of the baseline amine levels (i.e., values in the d-amphetamine and saline-treated rats before fenfluramine was given) indicated that the repeated d-amphetamine treatment generally lowered norepinephrine in most brain regions, serotonin in the pons-medulla, substantia nigra and thalamus, and dopamine in the striatum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975239 TI - Hippocampal muscarinic receptor loss following trimethyl tin administration. AB - The effects of trimethyl tin on passive and active avoidance behavior, hippocampal muscarinic receptors and hippocampal cell destruction were examined in male rats. The animals were intubated with 18 mumoles/kg (3.5 mg/kg) of TMT hydrochloride or vehicle. When tested two weeks later treated animals exhibited marked deficits in retention of passive avoidance and extinction of active avoidance tasks. Receptor binding analysis, using 3H-QNB, revealed a significant decrease (21%) in muscarinic receptor density in the hippocampus. Histological examination of the hippocampus revealed a concomitant loss in pyramidal cells in these animals. These results suggest that muscarinic receptors reside on the hippocampal pyramidal cells and that these cells and receptors may be involved in retention of passive avoidance behavior. PMID- 3975240 TI - Enhancement of phenol-induced tremor caused by central monoamine depletion. AB - The effects of monoamine depletors and monoamine denervators on phenol-induced tremor were studied in mice. The tremor induced by phenol was enhanced by pretreatment with reserpine or tetrabenazine, but not with syrosingopine. However, alpha-methyl-p-tyrosine, p-chlorophenylalanine or 6-hydroxydopamine did not affect the tremor. These results suggest that the depletion of central monoamines as a whole contribute to the enhancement of the tremor induced by phenol. PMID- 3975241 TI - Morphine tolerance and sensitization in the hamster. AB - The effects of morphine on hamster locomotor activity were studied. Repeated administration of morphine in doses from 5 to 40 mg/kg produced systematic changes in morphine's biphasic time effect pattern: morphine's sedative effects decreased (tolerance) while morphine's excitatory effects increased (sensitization). These results extend findings of behavioral tolerance and sensitization in the hamster to a range of higher doses than those used previously. PMID- 3975242 TI - Local application of beta-phenylethylamine to the caudate nucleus of the rat elicits locomotor stimulation. AB - The behavioural effects of bilateral injections of beta-phenylethylamine (PEA) into the caudate nucleus of male rats were examined. PEA in doses of 200 and 300 micrograms increased locomotion with maximal stimulation being evident 15-25 min after injection. In addition 300 micrograms PEA increased rearing 20-25 min post injection and produced increases in sniffing. This is the first report of a behavioural stimulant effect of intracranially administered PEA without concurrent monoamine oxidase inhibition. The data suggest that the stimulant action of systemically administered PEA may be mediated, at least in part, by striatal mechanisms. PMID- 3975243 TI - A microgram dose of diazepam produces specific inhibition of ambulation in the rat. AB - There is considerable consistency in the experimental literature showing that non sedating doses of benzodiazepines can enhance the consumption of food, water and salt solutions. It is of great interest, therefore, that in a previous report low dose treatments with diazepam were found to significantly suppress the level of consumption of a palatable 0.005 M sodium saccharin solution in nondeprived male rats. The present study was designed to elucidate the behavioral characteristics of the inhibitory action of low dose diazepam treatments. Food consumption and general activity measures were chosen for analysis to examine the possibilities that low dose diazepam treatments might suppress ingestive behavior in a general way, or that the treatments might affect nonconsummatory responses including components of spontaneous motor activity. The results of two experiments succeeded in locating a highly specific inhibitory effect produced by 100 micrograms/kg diazepam. First, food consumption was not inhibited. Instead, 1.0 mg/kg diazepam produced significant elevations in food intake in both food deprived and nondeprived animals. Second, vertical activity (rearing) and fine body movements were unaffected over the dose-range 0.1-3.0 mg/kg diazepam. Hence, low dose treatments with diazepam did not produce a generalised nonspecific behavioral depression. However, 100 micrograms/mg diazepam significantly inhibited coarse activity (measured automatically) and the corresponding ambulation measure (recorded by direct observation). The effect was present throughout a 1 hr test period and did not interact with the declining baseline level of activity. The results therefore confirm the presence of low dose diazepam-induced behavioral inhibition in quite a different context from the saccharin solution consumption study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975245 TI - Effects of intracerebroventricular injection of naloxone on operant feeding and drinking in pigs. AB - Operant feeding and drinking to satiation were studied in prepubertal pigs deprived of food or water for 18 hours and then given intracerebroventricular (ICV) injections of a solution of naloxone hydrochloride. In feeding tests there was no difference in the amount of food consumed, or in the rate at which reinforcements were obtained, between pigs given ICV injections of 0.4 or 0.8 mg naloxone and those receiving a control injection of saline. However, in drinking tests, injection of both 0.2 and 0.4 mg naloxone significantly (p less than 0.01) reduced the quantity of water drunk and slowed the rate at which reinforcements were obtained. No significant effects on operant water intake were seen after intravenous injection of 0.4 mg naloxone. PMID- 3975244 TI - Association of spontaneous and dopaminergic-induced yawning and penile erections in the rat. AB - In a Sprague-Dawley-derived line of rats, selectively bred to establish a high incidence of spontaneous yawning behavior, the simultaneous and systematic monitoring of yawning and penile erections, during observation periods of one hour, demonstrates a linear correlation between these two behavioral patterns. Dose-effect curves of yawning and penile erections elicited by apomorphine and bromocriptine, and their inhibition by metoclopramide are quite similar. These results strongly suggest that yawning and penile erection are subject to some common regulating and modulating mechanisms, one of which seems to involve dopaminergic pathways. PMID- 3975246 TI - Effects of morphine and LSD on the classically conditioned nictitating membrane response. AB - Two experiments were carried out to determine the effects of LSD and morphine on the unconditioned nictitating membrane response of the rabbit elicited by 5 intensities of a 100 msec puff of air directed at the cornea, and on the acquisition of conditioned responses to a tone and light conditioned stimulus using the air-puff as an unconditioned stimulus. In Experiment 1, LSD tartrate (0.013 mg/kg) had no effect of the frequency, amplitude, magnitude or latency of the unconditioned response. However, LSD significantly enhanced the rate of acquisition of conditioned responses to both tone and light conditioned stimuli. In Experiment 2, morphine sulfate (5 mg/kg) had no effect on the frequency, amplitude, magnitude or latency of the unconditioned response, but significantly retarded the acquisition of conditioned responses to both tone and light conditioned stimuli. The results indicated that the enhancement of acquisition produced by LSD and the retardation of acquisition produced by morphine were not due to effects of the drugs on either the sensory processing of the air-puff unconditioned stimulus or on the motoric expression of the unconditioned response. PMID- 3975247 TI - Comparison of anticonvulsive properties of eboracin and phenytoin in mice. AB - The in vivo effects of phenytoin (diphenylhydantoin, Dilantin) and the experimental anticonvulsant, eboracin, a substituted indenopyrrole, were compared in mice. Pretreatment with varying dosages of either agent followed by challenge with the chemoconvulsant pentylenetetrazol (Metrazol) indicated that eboracin provided slightly less protection against seizures than phenytoin and was much less toxic. Intermediate doses of either agent led to a form of clonic status epilepticus which persisted for an average of 18 min in phenytoin-treated and 58 min in eboracin-treated mice. Pretreatment with higher or lower doses did not lead to these manifestations. Animals in which this syndrome had been induced should be of value in studies of the chemistry and physiology of the clonic state. PMID- 3975248 TI - Central and peripheral contributions to the enhancement of amphetamine anorexia by desmethylimipramine (DMI). AB - Intrahypothalamic administration of amphetamine to rats increased food intake, but pre-treatment with the alpha-receptor antagonist phentolamine unmasked an anorexic effect commensurate with that seen after peripheral amphetamine administration. Pretreatment with systemic DMI increased anorexia after peripheral or central amphetamine administration, but the enhancement of centrally-induced anorexia was small. It is concluded that enhancement of the anorexic effect of peripherally administered amphetamine by DMI is primarily a peripheral phenomenon, with interactions within the central nervous system making a relatively minor contribution. PMID- 3975249 TI - Intravenous self-administration of nicotine: with and without schedule-induction. AB - In Experiment I, rhesus monkeys were trained to lever press on a concurrent fixed interval 5-min (food pellets) fixed-ratio 1 (IV nicotine-injection) schedule of reinforcement. All three monkeys self-administered nicotine (0.1-100 micrograms/kg/injection) at two or more doses during the concurrent conditions (Concurrent I or II) at rates that exceeded saline control or rates of nicotine maintained responding on a simple fixed-ratio 1 schedule (No Food condition). At least one dose of nicotine did maintain FR 1 responding which was greater than saline rates on the single component schedule and these rates were not increased by the addition of a concurrent schedule of food reinforcement. During the concurrent schedule, nicotine-maintained responding occurred throughout the 60 min session in contrast to the No Food (FR 1) condition where most injections of nicotine were self-administered during the initial segments of the session. In general, nicotine injections occurred during the early portions of the interval, although this varied between individual animals. In Experiment II, rhesus monkeys were trained to lever press for intravenous injections of cocaine (50 micrograms/kg/injection) on a fixed-ratio 10 schedule of reinforcement. During testing, doses of nicotine (1-300 micrograms/kg/injection) or saline were substituted for cocaine. Nicotine maintained FR 10 responding at rates that exceeded saline self-administration at one or more doses in all four monkeys. These doses were similar to those that functioned as positive reinforcers in Experiment I. These two experiments demonstrate that nicotine can function as a positive reinforcer to maintain FR 1 or FR 10 responding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975250 TI - Oral ethanol self-administration in the rat: effect of naloxone. AB - Rats responding on a two lever concurrent for ethanol and water, were injected with 5, 10, or 20 mg/kg naloxone hydrochloride 30 min prior to a 30 min session. Only the 20 mg/kg dose had any effect, a decrease in responding for ethanol of up to 50% compared to saline control injection sessions. There were no systematic effects upon water responding. An additional study using sucrose and water as the fluid concurrently available failed to find any effects of naloxone on sucrose responding at the same doses. The effect upon ethanol responding was found not to resemble a pattern of extinction, but rather was best described as a general overall reduction in responding. The relation of these findings to the direct involvement of the endogenous opiate system in ethanol reinforcement is discussed. PMID- 3975251 TI - Regional variation in norepinephrine-stimulated calcium uptake in rabbit aorta. AB - This study was conducted to determine if there is a difference in the calcium handling mechanism of the thoracic and abdominal aortic regions of the rabbit aorta. Isolated segments of aorta from both regions were studied in HEPES buffer at 37 degrees C and bubbled with 100% oxygen using identical procedures. Intracellular calcium levels were determined after segments had been exposed to 45Ca-labeled buffer during experimental procedures and subsequently washed with a 'quench' solution of zero calcium, 2 mM EGTA, and HEPES buffer, maintained at 0 degree C. The results suggest that the thoracic region is capable of taking up more calcium under resting conditions compared to the abdominal aorta. During stimulation with norepinephrine, both regions show significantly increased calcium influx rates after 10 min of exposure to the agonist, but only in the abdominal region is this effect maintained after 60 min of norepinephrine stimulation. Net (summation of calcium influx and efflux) intracellular calcium levels are significantly increased by norepinephrine in the thoracic but not in the abdominal aorta. Taken together, these data suggest that, compared to the thoracic aorta, the abdominal aorta may possess a more effective calcium efflux mechanism which may be able to fully compensate for the norepinephrine-stimulated increase in calcium influx. PMID- 3975252 TI - Effects of ethanol ingestion on amino acid uptake in the dog liver in vivo. AB - The effect of ethanol ingestion on the uptake of labeled amino acids was studied in the in situ autoperfused dog liver. Ethanol was administered orally, as a 15% water solution, in a dose of 4 g/kg body weight/day as the only source of water for 2 days. Amino acid uptake was measured in anesthetized dogs by means of the single-passage, multiple-tracer dilution technique. In control animals, hepatic uptake of 14C-glycine, 3H-alpha-aminoisobutyric acid (3H-AIB) and 3H-L-leucine were 50, 15 and 66%, respectively. In the ethanol-treated dogs, glycine and AIB uptake was reduced by 70 and 63%, respectively. L-leucine uptake was reduced by only 23%. The plasma concentration of the naturally occurring amino acids was significantly increased after ethanol treatment, probably due to a reduced influx into hepatocytes. Simultaneous measurements of hemodynamic parameters showed a significant increase in the portal vein pressure of ethanol-treated animals, whereas the portal vein blood flow and hepatic extracellular volume were unaffected. PMID- 3975253 TI - Morphine potentiates the gastroulcerogenic effect of indometacin in rats. AB - Morphine potentiated the ulcerogenic activity of indometacin in a dose-dependent manner when administered subcutaneously (2.5-7.5 mg/kg). However, in the case of intracerebroventricular administration, morphine failed to exert any potentiating action. Atropine (0.5 mg/kg, s.c.) and cimetidine (12.5-25 mg/kg, s.c.) decreased the ulcerogenic activity of indometacin, and the combination of indometacin/morphine in about the same degree. However, the reduced ulcerogenic activity of indometacin after atropine or cimetidine treatment could still be enhanced by morphine if it was added to the combination of indometacin/atropine or indometacin/cimetidine. Since the potentiating action of morphine was completely blocked by naloxone (1 mg/kg), this action of morphine might be mediated via opiate receptors. PMID- 3975254 TI - Indometacin-induced gastrointestinal lesions in relation to tissue concentration, food intake and bacterial invasion in the rat. AB - The effect of food intake and gut bacterial flora on gastrointestinal lesions caused by oral indometacin (IND) was studied in rats. A dose of 10 mg/kg IND caused no intestinal lesions when the animals were starved before and after treatment; it produced moderate lesions when the animals were continuously fed and maximal lesions when the animals were fed in the postdrug period after starvation in the predrug period. Under germ-free conditions, 15 mg/kg IND induced significantly less intestinal lesions than under specific pathogen-free conditions. The differences in the magnitude of intestinal lesions under the varying feeding and maintenance conditions were not associated with different IND concentrations in the jejunal mucosa. The dose of 10 mg/kg IND produced most gastric lesions when the animals were previously starved for 24 h and subsequently fed, medium lesions in continuously starved animals and only a few lesions in animals fed before and after IND. The disposition of IND from the gastric mucosa did not differ under the different feeding conditions. As the dose of IND is high enough to inhibit prostaglandin synthesis, it was concluded that additional factors are important for the development of gastrointestinal lesions caused by IND. Secondary bile acids in conjunction with IND are important for the development of intestinal lesions, while gastric acid influences the intensity of gastric lesions. PMID- 3975255 TI - Minimization of gastric damage with enteric-coated aspirin granules compared to buffered aspirin. AB - This study involved a randomized parallel groups comparison of the effects of aspirin formulated as enteric-coated granules (25 subjects) or as buffered tablets (26 subjects) with that of a lactose placebo (5 subjects), on the gastric and duodenal mucosa, as determined by endoscopic examination 2 h after a fasting single 975-mg dose. A grading scale of 0 (no damage) to 4 (severe damage) was used. The granule formulation produced a statistically significant (p less than 0.05) lower severity (mean 0.40 +/- 0.58 vs. 3.00 +/- 0.94) and incidence (36% of subjects vs. 100%) of gastric lesions than the buffered aspirin formulation. None of the lesions produced by the granule formulation or the placebo was considered clinically significant by the blinded endoscopist, whereas 17 subjects on the buffered formulation (65%) had clinically meaningful stomach damage. The incidence of duodenal lesions was minimal and comparable for the two formulations. PMID- 3975256 TI - Analytical and pharmacological studies on a new antineoplastic tripeptide, PTT.119. AB - The new synthetic tripeptide, p-fluoro-L-phenylalanyl-m-bis-(2-chloroethyl)-amino L-phenylalanyl-methi onine ethylester hydrochloride, PTT.119, an alkylating agent, is currently undergoing preclinical trials as an antineoplastic agent. The molecular composition, C29H39N4O4SCl2F, was confirmed by desorption chemical ionization mass spectrometry with accurate mass measurement. A high-performance liquid chromatographic technique was developed for the quantification of PTT.119 in cell culture medium and serum. Incubation of 5 X 10(5) mammary tumor cells (MJY-alpha)/ml tissue culture medium with 25 micrograms PTT.119/ml for 60 min (37 degrees C) removed 68% of the tripeptide from the medium. This corresponds to an uptake of 51 fmol PTT.119/tumor cell. Cell death, assessed 5 days after treatment, was directly proportional to the time-dependent removal of PTT.119 from the cell culture medium. PMID- 3975257 TI - Pre- and postsynaptic actions of tetraethylammonium at the chick neuromuscular junction. AB - The possible pre- and postsynaptic effects of tetraethylammonium (TEA; a potassium ion channel blocker) have been examined in the isolated chick neuromuscular junction. The presynaptic effect of TEA was studied by investigating its effect on the uptake of tritiated choline, 3H-methyl choline, which was taken as an index of acetylcholine (ACh) release. The postsynaptic effect of TEA was investigated using solutions containing no calcium ions and/or calcium antagonist lanthanum. TEA increased the uptake of tritiated choline by a factor of 10. Although the contracture produced by TEA was greatly reduced by lanthanum (0.1-1 microM), it still persisted in the calcium-free Krebs solution. PMID- 3975258 TI - Phenobarbital induction does not potentiate hepatotoxicity but accelerates liver cell necrosis from acetaminophen overdose in the rat. AB - Rats were pretreated with phenobarbital to induce hepatic cytochrome P-450. Compared to noninduced rats, a similar relation between the dose of acetaminophen and mortality, and between dose and changes in liver function (prothrombin index) and identical time courses, was found. The urinary excretion of acetaminophen mercapturate and acetaminophen cysteine was identical in induced and noninduced rats. The metabolism of acetaminophen in terms of blood levels and excreted metabolites was not influenced by phenobarbital induction. At the same dose level, hepatic necrosis was accelerated (maximum 24 h) compared to noninduced animals (maximum 72 h), but no difference in the maximum extent was found. These data cannot support the concept that induction of cytochrome P-450 leads to greater formation of the hypothetical toxic metabolite of acetaminophen, or that induction enhances its hepatotoxicity, in the rat. Several factors may contribute to accelerate the necrotic changes which make it possible to histologically identify cell damage and death. In that case, functional studies are more relevant than morphological evaluation in quantitative assessment of liver damage. PMID- 3975259 TI - Sodium balance and blood pressure during high sodium ingestion in spontaneously hypertensive and Wistar Kyoto normotensive rats. AB - Objectives of this study were to compare natriuretic capability and arterial pressure elevation at high Na+ ingestion in male spontaneously hypertensive (SH) and normotensive Wistar Kyoto (WKY) rats at the young adult age of 16-19 weeks. 10 SH and 10 WKY male rats at this age were surgically implanted with arterial catheters. After a period of 10 days on low nutritionally adequate Na+ intake they were fed a high Na+ diet for a period of 1 week. Na+ retention (intake output) on the high Na+ diet was substantial, but similar in both groups of rats. None of the animals displayed meaningful elevation of arterial pressure. Thus, the functional capacity of the young SH rat to excrete Na+ during excessive ingestion without elevation of blood pressure seems adequate as compared to normotensive rats, at least within the age range of 16-19 weeks. PMID- 3975260 TI - Does nitrous oxide induce release of brain opioid peptides? AB - Increased concentrations of immunoreactive methionine-enkephalin but not leucine enkephalin were measured in fractions of cerebrospinal fluid perfusate collected from ventricular-cisternally perfused, urethane-anesthetized rats exposed to a mixture of 75% nitrous oxide/25% oxygen for 60 min. These findings suggest that nitrous oxide might be capable of inducing the release of methionine-enkephalin in the central nervous system. PMID- 3975261 TI - Effects of phenobarbital and SKF-525A on in vitro hepatic metabolism of verapamil and nifedipine. AB - Both verapamil and nifedipine are first-generation calcium-entry antagonist drugs which are eliminated by hepatic metabolism. To evaluate the effects of enzyme induction and suppression on the biotransformation of these compounds, liver homogenate fractions were prepared from male Fisher (F344) rats, which were either untreated, or injected intraperitoneally with phenobarbital or with SKF 525A prior to sacrifice. Known concentrations of verapamil or nifedipine were incubated with the 9,000 g supernatant, and the quantity of unchanged drug remaining after 10 min was measured. SKF-525A pretreatment significantly decreased the elimination (disappearance) rate of both calcium-entry antagonist compounds. Phenobarbital increased the rate of disappearance of verapamil, but had no effect on that of nifedipine. Difference spectra of hepatic microsomes to which verapamil had been added revealed a concentration-dependent, saturable interaction between drug and enzymes with spectral changes characteristic of "type I' substrates for cytochrome P-450 monooxygenase(s). The spectral characteristic of microsomes to which nifedipine was added could not be determined because of drug absorption at 350-500 nm. These data imply that verapamil metabolism is mediated by the cytochrome P-450 monooxygenase(s), and that nifedipine metabolism likely involves hepatic enzyme systems other than those known to be induced by phenobarbital. PMID- 3975262 TI - Alterations in hepatic microsomal drug metabolism and cytochrome P-450 proteins in spontaneously hypertensive rats. AB - Experiments were conducted to determine if substrate-specific changes in microsomal metabolism and liver proteins occurred in young (12-13 weeks) spontaneously hypertensive rats (SHR) fed ad libitum compared to age-matched normotensive Wistar Kyoto (WKY) control rats. The hepatic microsomal protein content in SHR rats was significantly increased compared to WKY rats while cytosolic and total liver protein levels did not differ between the two groups. Liver microsomal ethylmorphine-N-demethylase activity was substantially enhanced in SHR rats with only slight increases in cytochrome P-450 content and aniline hydroxylase activity compared to WKY rats. The substrate-specific increases in the microsomal drug metabolism in SHR rats were accompanied by an increase in the prominence of a protein with molecular weight 55,000 in the cytochrome P-450 region. These preliminary observations may be clinically relevant in that alterations in hepatic drug metabolism may be associated with endogenous biochemical processes underlying the hypertensive state. PMID- 3975263 TI - Theophylline kinetics: dose dependency and single sample prediction of clearance. AB - Theophylline clearance was measured at 3 doses (2, 4 and 6 mg/kg) in 10 young, healthy adult subjects. Clearance decreased as the dose of theophylline increased going from 0.064 +/- 0.016 to 0.052 +/- 0.011 1.h-1.kg-1 at the 2 and 6 mg/kg doses, respectively (p less than 0.02). A simplified method for estimating theophylline clearance was tested using single plasma concentrations of theophylline and assuming a constant value (0.5 l/kg) for volume distribution of theophylline. This method gave the best results when samples were drawn at 12 or 24 h after a 2 or 4 mg/kg intravenous dose of theophylline, respectively, and was effectively applied in estimating the quantitative impact of cimetidine administration on theophylline clearance. PMID- 3975264 TI - Phenytoin as a probe of drug metabolism. Predicting clearance with a salivary sample. AB - Phenytoin (PHT) was administered in single 300-mg doses to each of 12 healthy, male subjects. Serial blood samples and salivary samples were collected for the next 48 h, and concentrations of plasma total PHT, unbound plasma PHT (plasma ultrafiltrates), and salivary PHT (salivary ultrafiltrates) were measured by immunofluorescence polarization. The following parameters were estimated: CLint/F, CL'int/F, V/F, and total and unbound PHT plasma disappearance half lives. Estimates of CL'int/F (CL'int/F) were calculated from single 48-hour salivary PHT measurements. Mean (+/- SD) values were 0.026 +/- 0.009 1 . h-1 . kg 1, 0.385 +/- 0.148 1 . h-1 . kg-1, 12.6 +/- 3.5 l/kg (referenced to unbound drug), 28.0 +/- 12.1 h, and 25.9 +/- 13.5 h, respectively. When V/F referenced to unbound PHT was set at 14 l/kg, CL'int/F estimates were good predictors of the actual CL'int/F values demonstrating a mean prediction error of -9.012 1.h-1.kg 1. These data demonstrate that under specified conditions, intrinsic unbound PHT clearance can be estimated from a single PHT measurement in saliva, thereby permitting PHT to be used safely and sampled simply and noninvasively as a probe of hepatic mixed function oxygenase activity in humans. PMID- 3975265 TI - Seeking alternative research funding: problems for the young academic physician. PMID- 3975266 TI - Aberrant medical humor: case histories, literary histories. PMID- 3975267 TI - Descent into the maelstrom: a postoperative experience. PMID- 3975268 TI - Monetary inducement to research participation. PMID- 3975269 TI - More on steroids for athletes. PMID- 3975270 TI - Past and present. Doing well or doing good? PMID- 3975271 TI - Two related works: Osler's "Aequanimitas" and Bernard's "An Introduction to the Study of Experimental Medicine". PMID- 3975272 TI - The component elements of physician compassion. PMID- 3975273 TI - A prototype digital ionographic imaging system. AB - A prototype digital ionographic imaging system is described. The process involves direct electrical reading of a latent electrostatic image which has been produced by an ionographic technique. The main design features of the system are outlined and their effect on its imaging performance highlighted. A preliminary assessment of the performance of the system in terms of resolution, noise, contrast and sensitivity is presented and compared with that of a conventional screen-film combination. PMID- 3975274 TI - Effect of additives on liposomes: an electric birefringence study. AB - Under the influence of an electric field, vesicles in suspension partially deform or orientate, rendering the medium optically birefringent. The amplitudes of the birefringence under fields of variable amplitude lead to evaluation of the anisotropy of the electrical delta alpha and optical delta G polarisabilities of the vesicles. By using pulsed fields, rates of establishment and decay of birefringence enable vesicle sizes d to be measured. Samples of 9:1 phosphatidylcholine-phosphatidylserine liposome suspension in water were studied in the presence of various additives, including sucrose, an antibiotic (streptomycin), a steroid (dexamethasone), an anaesthetic (lignocaine) and a fluidising agent (benzyl alcohol). The changes in the three parameters delta alpha, delta G and d were different for each additive and are thought to be indicative of the mode of interaction of each. Electric birefringence also appears to be a rapid means of detecting structure changes. PMID- 3975275 TI - Measurements of ionisation in water, polystyrene and a 'solid water' phantom material for electron beams. AB - Measurements of central axis depth ionisation curves and ionisation at ionisation maximum were carried out in water, clear polystyrene and a commercially available 'solid water' phantom material. Flat and cylindrical chambers were used for electron beams of 5-10 MeV. Displacements for the cylindrical chambers were determined, indicating a recommended value of 0.55 times cavity radius (without perturbation corrections). The use of a single scaling parameter is considered for converting depth ionisation curves obtained in plastic to those in water. This is shown to be valid within 2 mm at these energies and for these materials. Ionisation ratios between water and polystyrene are presented, i.e. correction factors for converting ionisation readings in the plastic to readings in water required for electron dosimetry determinations. These show 3% differences on average at these energies, ionisation in water being higher. Variations were observed with chamber wall material and chamber type. Measurements in the solid water material showed it to be a better water substitute than polystyrene for electron dosimetry in this energy range, although still significantly different from a true water phantom. Experiments at 10 MeV on the effect of charge storage on chamber reading in polystyrene, as a result of previous irradiation with electron beams, were carried out, indicating that such effects have negligible influence on the ionisation ratios reported. PMID- 3975276 TI - Scaling relative neutron depth-dose distributions from one phantom material to another: a comparison of experimental and theoretical results. AB - To correct percentage depth-dose data from one phantom material to another, experimental and theoretical scaling factors (SF) are compared for different neutron beam qualities. Differences of up to 10% were observed for different phantom materials relative to water. The ratio SF/rho was plotted as a function of H concentration by mass where rho is the mass density of the phantom material. A nearly linear relationship resulted at all energies for the theoretical scaling factors, while, for the experimental points, important deviations appeared at high energies for materials with relatively low H and high C concentrations. It can be shown that a single linear relationship for all compounds composed of H, C and O can only be valid if the ratio of total cross sections of carbon to oxygen is equal to 3/4. Experimental scaling factors will be more accurate than calculated values because of the uncertainty in the average total cross sections. If these factors for tissue equivalent (TE) liquid relative to water are converted to those of ICRU muscle by correcting to a mass density of 1.04 g cm-3, then the scaling factors are, within experimental uncertainty, equal to one. PMID- 3975277 TI - The effect of reversing projection data in fan-beam reconstruction tomography. PMID- 3975278 TI - Effects of a wrapping technique on passive range of motion in a spastic upper extremity. AB - Limited range of motion (ROM) and subsequent soft tissue contractures resulting from spasticity are common developments in patients with acquired hemiplegia from cerebrovascular accidents. The purpose of this study was to examine the effects of a wrapping technique on ROM in patients with a spastic upper extremity. Four adult patients, postcerebrovascular accident of less than one year, received wrapping of the upper extremity for three hours, three times a week on alternating days for a total of two to four weeks. Baseline passive range-of motion (PROM) measurements were established for shoulder flexion, shoulder abduction, shoulder external rotation, and wrist extension; these movements were commonly limited in all patients. The PROM was recorded after each wrapping session. The results showed a significant change in PROM for all motions in all patients (p = less than .01). In addition, all patients reported a decrease in pain in the upper extremity. Comparisons of videotapes of two patients at baseline and after 12 wrappings revealed an increase in ROM and a decrease in spasticity in the upper extremity during ambulation. These findings should encourage clinicians to experiment further with the wrapping technique and to report their findings. PMID- 3975279 TI - Effect of load and carrying position on the electromyographic activity of the gluteus medius muscle during walking. AB - Physical therapists often teach people with hip osteoarthritis ways to decrease gluteus medius muscle activity of the stance limb during gait. The rationale for decreasing this muscle activity is that hip muscle contraction needed for frontal plane hip stabilization is responsible for a large component of the hip joint compressive forces during stance. The magnitude and carrying position of external loads during walking are both variables that influence requirements of gluteus medius muscle force. Therefore, the purpose of this study was to determine through EMG, the relative amounts of gluteus medius muscle electrical activity produced during the stance phase of gait when subjects used varying combinations of load size (10 and 20% of body weight) and carrying position of the hands (contralateral or ipsilateral to a given hip, or anterior or posterior to the chest). We studied 24 healthy subjects and used their EMG activity during the stance phase of gait as an indication of the relative amount of myogenic hip compression force. Results indicated statistical differences in EMG according to carrying condition with the contralateral position (with loads of 10 and 20% of body weight) producing the highest levels of EMG. We discuss the kinesiologic reasons for results and the prevention of hip osteoarthritis in occupational settings. PMID- 3975280 TI - Effect of quadriceps femoris muscle stretch on knee extension torque. AB - Peak and angle specific knee extension torques produced after a quadriceps femoris muscle stretch and after a 15-second rest were compared to determine the effect of stretch on knee extension torque. Twenty healthy subjects performed eight maximum voluntary knee extensions at 90 degrees/sec under each condition. Although peak torque and torques at 15, 30, 45, and 60 degrees from full extension were measured, knee extension torque was only significantly greater (p less than .02) at 60 degrees of knee flexion after quadriceps femoris muscle stretch. The absolute difference, which was only a mean 4.9 N X m (3.6 ft-lb), was not substantial. When quadriceps femoris muscle stretch is a consequence of passive knee flexion at 90 degrees/sec, knee extension torque is apparently facilitated only during the initial part of the knee extension movement. Therefore, in healthy patients, a muscle stretch, such as used in this study, is probably of little therapeutic value. PMID- 3975281 TI - Contributions of behavior modification to cerebral palsy habilitation. AB - The application of behavior modification techniques to cerebral palsy habilitation combines behaviorist psychology and physical therapy. In working together, physical therapists and behaviorists have a great deal to offer children and adults with cerebral palsy. I present a behaviorist perspective on how cerebral palsy affects an individual's interactions with the environment and how the environment can be modified to teach and improve motor functioning. The usefulness of this perspective in guiding physical therapy is discussed and research in which behavior modification has been used in cerebral palsy habilitation is reviewed. PMID- 3975282 TI - Device for stretching the hamstring muscles. Suggestion from the field. PMID- 3975283 TI - Using feedback and evaluation effectively in clinical supervision. Model for interaction characteristics and strategies. AB - Feedback and evaluation are both integral parts of daily communications that supervisors and instructors use to help employees and students learn and grow. The purpose of this article is to provide guidelines for the effective use of feedback and evaluation in the supervision and performance assessment of students and staff therapists and assistants. I define feedback and evaluation and give examples of their uses. Reactions of students and staff to feedback and evaluation are identified. Carkhuff's phases of helping are described and integrated in a model with interaction characteristics and strategies that supervisors and instructors use when giving feedback and evaluation. I describe and suggest applications of the model for using feedback and evaluation to facilitate the development of independent and competent physical therapists and assistants. PMID- 3975284 TI - The blood supply of thigh skin. AB - The pattern of blood supply to the integument of the thigh is reported. A new technique is described for analyzing the length, direction, and number of arterioles in specimens of cadaver skin and deep fascia. The information obtained from these studies adds to existing knowledge of the anatomic vascular basis of direct cutaneous and musculocutaneous flaps in this region and provides a scientific basis for the elevation of fasciocutaneous flaps in such a way as to aid the achievement of maximum length-to-breadth ratios. PMID- 3975285 TI - Pharmacologic action of isoxsuprine in cutaneous and myocutaneous flaps. AB - The therapeutic effects of isoxsuprine on skin capillary blood flow and viability were studied in arterial buttock flaps, latissimus dorsi myocutaneous flaps, and random skin flaps in pigs. It was observed that parenteral isoxsuprine increased capillary blood flow to the skin of arterial buttock flaps and the skin and muscle of latissimus dorsi myocutaneous flaps in a dose-response manner, with a maximum vascular effect observed at 1.0 mg/kg. However, this maximum effective dose of isoxsuprine did not have any significant effect on skin viability in the cutaneous and myocutaneous flaps compared with the control. Examination of the distribution of capillary blood flow within the flaps at varying distances from the pedicle revealed that isoxsuprine did not increase capillary blood flow or perfusion distance in the distal portion of the skin of arterial buttock flaps, latissimus dorsi myocutaneous flaps, and random skin flaps. The increased capillary blood flow as a result of isoxsuprine treatment was limited only to the arterial portion of the arterial buttock flaps and latissimus dorsi flaps. Therefore, it is concluded that isoxsuprine alone is not effective in augmentation of skin viability in cutaneous and myocutaneous flaps. The pharmacologic action of isoxsuprine on the vasculature in the skin and muscle of flaps was also discussed. PMID- 3975286 TI - Early changes in dissected small vessels: experimental study on rat arteries and veins. AB - This study was undertaken to investigate the cause of the early endothelial damage that is seen at sites of microvascular anastomosis and in particular to study the possibility of a connection between damage to the vasa vasorum and subsequent endothelial denudation. Rat femoral vessels were subjected to a variety of experimental injuries, including simple dissection, clamping, and ligation. The vessels were examined in longitudinal section by light microscopy at intervals ranging from 5 minutes to 1 day. The endothelial cells were counted and the numbers were analyzed statistically. In addition, the anatomy of the vasa vasorum was studied using india ink perfusion. Simple dissection of the femoral vessels and excision of the vasa vasorum without interruption of blood flow were followed by ischemic lesions of the tunica media with subendothelial edema and ballooning and exfoliation of endothelial cells. Endothelial denudation reached a maximum level in 30 minutes. Adherence of leukocytes was found on damaged endothelial cells. Mural thrombi were seen in 13.6 percent of arteries and in 40 percent of veins following simple dissection. PMID- 3975287 TI - Cellular and bacterial toxicities of topical antimicrobials. AB - Cellular and bacterial toxicities of four commonly used topical antimicrobials (1% povidone-iodine, 3% hydrogen peroxide, 0.25% acetic acid, and 0.5% sodium hypochlorite) were assayed in vitro using cultures of human fibroblasts and Staphylococcus aureus. All agents tested at full strength killed 100 percent of exposed fibroblasts. Fibroblast toxicity exceeded bacterial toxicity with serial dilutions of hydrogen peroxide and acetic acid. Dilutions of povidone-iodine (1:1000) and sodium hypochlorite (1:100) were identified where no fibroblast toxicity occurred while full bactericidal activity persisted. PMID- 3975289 TI - Understanding case-control and prospective statistics. PMID- 3975288 TI - Dislocated intra-articular fracture of the base of the fifth metacarpal: a clinical study of 23 patients. AB - Twenty-three patients with dislocated intrarticular fractures of the base of the fifth metacarpal were treated during the last 3 years in our department. This fracture characteristically occurs in young, active males, and the most frequent mechanism of this injury is axial force striking the metacarpal head, mostly in fist fights. In 8 patients, the fracture was caused by direct force hitting the base of the fifth metacarpal. Four certain fracture patterns are described. Operative treatment by open reduction and fixation with two Kirschner wires generally gave good results. PMID- 3975290 TI - Congenital absence of flexor pollicis longus without hypoplasia of thenar muscles. AB - A 7-year-old girl who was unable to flex her left thumb at the interphalangeal joint proved to have an extremely hypoplastic flexor pollicis longus with normal thenar muscles, which is very rare. The flexor digitorum superficialis of the ring finger was transferred to the inserting portion of the flexor pollicis longus tendon with good results. The patient's cooperation seems to be a factor determining the prognosis. PMID- 3975291 TI - Lumbar hernia after latissimus dorsi flap. AB - The authors present what they believe to be the first recorded case of a lumbar hernia following latissimus dorsi myocutaneous flap procedure. The authors discuss the diagnosis by physical examination and x-ray confirmation, pointing out the importance of not mistaking the hernia for a seroma. Suggestions for avoiding the problem are given, relating primarily to preservation of the fascia underlying the distal latissimus aponeurosis. PMID- 3975293 TI - Aplasia cutis congenita of the scalp: delayed closure complicated by massive hemorrhage. AB - A case of aplasia cutis congenita involving the scalp, cranium, and dura is presented to illustrate the complication of major hemorrhage from the sagittal sinus that may occur if closure is delayed. Subsequent problems with scalp-flap cover eventually required split-skin grafting of the defect. The case for surgery as soon after birth as possible is reinforced. PMID- 3975292 TI - Implant arm: axillary compression from breast prostheses. AB - Abnormal pressure on the axillary contents can occur following subpectoral breast reconstruction when the pocket is surgically or traumatically extended superolaterally. Aside from the cosmetic deformity, this migration of the prosthesis may give the syndrome of "implant arm," manifested by edema and a dull pain extending distally along the medial arm. Functional and cosmetic improvement can best be achieved by the introduction of a row of sutures placed to close the superolateral extension of the pocket. Two case reports depicting traumatic dissection of the implant into the axilla are presented to illustrate the syndrome and its surgical correction. PMID- 3975295 TI - Method of bundling hair before alopecic surgery. PMID- 3975294 TI - Parotid fascia and face lifting. PMID- 3975296 TI - A simple technique for stabilizing mandibular segments. PMID- 3975298 TI - Tourniquet after suction lipectomy of the lower extremity. PMID- 3975297 TI - Hand and arm injuries following external capsulotomies. PMID- 3975299 TI - The helical opening in suction cannulas for lipolysis. PMID- 3975300 TI - Photography of the hand. PMID- 3975301 TI - Fasciocutaneous vessels of the upper arm. PMID- 3975303 TI - Cigarette smoking in face lift patients. PMID- 3975302 TI - The use of disposable cautery in blepharoplasty. PMID- 3975304 TI - Survivor guilt in the pathogenesis of anorexia nervosa. AB - The purposes of this paper are (1) to contribute to an understanding of the crucial role of unconscious guilt in the pathogenesis of anorexia nervosa and (2) to contribute to an appreciation of the importance of the concept of survivor guilt by demonstrating its usefulness in describing and explaining aspects of the pathogenesis, psychopathology and psychotherapy of anorexia. PMID- 3975305 TI - Gregory Bateson, Alcoholics Anonymous, and stoicism. AB - In 1971 Gregory Bateson put forward an "entirely new epistemology," or view of the world, that he described as cybernetic. In a very influential article, which appeared in this journal, Bateson claimed that his cybernetic epistemology "coincides closely" with the epistemology of Alcoholics Anonymous (AA), for which he claimed "the only outstanding record of success" in the treatment of alcoholism (1971, p. 310). However, Bateson's discussion of AA dealt with only four of the Twelve Steps of AA's program. Although the epistemology of cybernetics and AA congrue in some respects, they contradict each other in many others. Common ground is found in the ancient philosophical tradition of Stoicism. In Stoicism the contradictions between the two are sources for an ethics and psychology of great power. Stoicism offers the cybernetic epistemologist a solid base for theory. It offers the clinician who deals with chemical dependency practical insights into the process of recovery. PMID- 3975307 TI - On therapeutic wisdom: graduation address, Washington School of Psychiatry. PMID- 3975306 TI - Culture's influence in Japanese and American maternal role perception and confidence. AB - Japanese recognition of the importance of the mother in ensuring survival of the culture group is very old. This antiquity is spelled out dramatically in the ancient Chinese-Japanese ideographs (in Japan called kanji), which remain in use today. The kanji reflect the cultural isolation of Japan during 300 years of insularity preceding the Meiji period, and reveal the deep historical link to even greater antiquity in continental Asia. The historical development of kanji explicitly associates the concept of woman with passiveness, the home, and domesticity (see "woman," "peaceful," "to marry," and the concept "wife" in Figure 1) and attributes to the mother survival of the infant (see "mother" and "milk" in Figure 1). The dependence of this new member of the culture group on its mother also is conveyed in the kanji depiction of the "child" with its arms open and unable to walk. In contrast, diverse European progenitors of the comparatively recent "American" perception of the maternal role contributed an array of maternal role expectations; though often conflicting, each set of expectations was well-suited to the exigencies of the particular immigrant group's circumstances. Given the contrasting historical circumstances, substantial difference between present Japanese and American perceptions of the maternal role, and in the degree of a woman's confidence in taking the maternal role for the first time, could be expected. These hypotheses were tested using questionnaire responses and drawings made by 102 Japanese women and 104 American Caucasian women in the last trimester of their first pregnancy. The findings are examined in relation to achievement dynamics in the context of culture. PMID- 3975308 TI - Progression, regression, and child analytic technique. AB - A detailed example is presented of analytic work with a latency age youngster. The technical problems encountered in the analysis of such a child are discussed in order to consider how child analysis can help to elucidate what is involved in the psychoanalytic process. PMID- 3975310 TI - Neglected classics: Rapaport's "Metapsychological considerations concerning activity and passivity". PMID- 3975309 TI - "Natural termination": some comments on ending analysis without setting a date. AB - This paper is a re-examination of the rule of date setting in termination. It reviews the literature and presents an analytic case which was terminated in what the patient called a "natural" manner, i.e., without the setting of a date. Some ideas about the nature of the rules used in organizing analysis are discussed. PMID- 3975311 TI - Compulsive shopping as a derivative of a childhood seduction. PMID- 3975312 TI - Poor Rumpelstiltskin. PMID- 3975313 TI - Comparison of eye motion in wakefulness and REM sleep. PMID- 3975314 TI - Respiratory sinus arrhythmia predicts heart rate and visual responses during visual attention in 14 and 20 week old infants. PMID- 3975315 TI - Comparison of event-related potentials of young children and adults in a visual recognition and word reading task. PMID- 3975316 TI - Heart rate deceleration in REM sleep: an orienting reaction interpretation. PMID- 3975317 TI - Forty Hertz EEG activity in dementia of the Alzheimer type and multi-infarct dementia. PMID- 3975318 TI - Neurocognitive pattern analysis of a visuospatial task: rapidly-shifting foci of evoked correlations between electrodes. PMID- 3975319 TI - Engaging visual stimuli and reflex blink modification. PMID- 3975320 TI - Cardiopulmonary adjustments during exercise and an aversive reaction time task: effects of beta-adrenoceptor blockade. PMID- 3975321 TI - Chronic sleep reduction: daytime vigilance performance and EEG measures of sleepiness, with particular reference to "practice" effects. PMID- 3975322 TI - Psychophysiological response of breast- and bottle-feeding mothers to their infants' signals. PMID- 3975323 TI - Stability of pathway-hemisphere differences in the auditory event-related potential (ERP) to monaural stimulation. PMID- 3975324 TI - Physiological and subjective reactions to being touched. PMID- 3975326 TI - Menstrual cycle symptomatology: the role of social expectancy and experimental demand characteristics. AB - The purpose of this study was to examine the effects of experimental demand characteristics and social expectancies on the report and experience of presumed menstrual cycle-related moods and symptoms. Participating in the study were 18 healthy women with regular menstrual cycles who were randomly assigned to either a group told that menstrual cycle symptomatology was the focus of the study or a group to which no interest in menstrual cycle symptoms was communicated. Nine males were also included as a control group. Results indicated that women who were informed of the interest in menstrual cycle symptomatology reported significantly more negative psychologic and somatic symptoms at the premenstrual and menstrual phases than did the women and men not so informed. It appears, therefore, that the report of stereotypic menstrual cycle symptomatology is influenced by social expectancy and experimental demand characteristics. PMID- 3975325 TI - Relationship of pregnanediol level to cognitive behavior and mood. AB - This work examines data secured from a larger study relating cognitive behavior and mood in women to variation in estrogen level. The larger study noted that performance tended to be better during the luteal phase. The present analysis looks at the relationship of urinary pregnanediol levels with mood and cognitive behaviors. Thirty women with non-oral contraceptive-controlled menstrual cycles were tested during the luteal phase on a battery of cognitive tests and a variation of the Clyde Mood Scale. The cognitive tests were selected based upon the automatization versus perceptual restructuring dimensions described by Broverman and colleagues. Pregnanediol levels were measured in 24-hour urine specimens collected on the same day. Results show a significant relationship of pregnanediol level with mental subtraction and with time estimation. Perceptual restructuring tasks in general (perceptual restructuring index) showed a significant positive relationship with pregnanediol levels. Mood, however, was not found to be related to pregnanediol levels. PMID- 3975328 TI - Male infertility: relationships among gonadotropins, sex steroids, seminal parameters, and personality attitudes. AB - We investigated the relationship between objective psychologic test data and endocrine parameters as well as ejaculate characteristics in 117 husbands in barren couples. Data analysis suggests that test scores indicating high self confidence, extraversion, and social assertiveness correspond negatively with male fertility parameters. Our results show that levels of gonadotropins and sex steroids, as well as accessory gland functions, are not randomly related to personality attitudes in these patients, but support the idea that psychologic factors are relevant in male infertility. PMID- 3975327 TI - Pseudocyesis: psychologic and neuroendocrine interrelationships. AB - There is a paucity of information concerning the interrelationship of psychiatric and neuroendocrine abnormalities in pseudocyesis. We have studied two patients using a multimodal investigatory approach, with particular attention to the association of depression and alterations in endocrine secretory patterns. Both patients had abnormal growth hormone secretory patterns, as demonstrated by lack of sleep-associated peaks and the absence of a response to L-dopa administration. Both patients had elevated testosterone and estradiol levels and normal prolactin levels. Only the patient who met DSM III criteria for a major depressive episode had abnormally elevated luteinizing hormone (LH) levels and large LH pulse amplitudes. These findings, together with a review of cases reported in the literature, suggest that no single neuroendocrine profile is common to all patients with pseudocyesis. PMID- 3975329 TI - Grief and disease. PMID- 3975330 TI - Short-term dynamic psychotherapy. I. The Oslo group's form to score outcome, the reliability testing of this form and observer characteristics. AB - The aim of short-term dynamic psychotherapy is, through working with a central conflict and transference reactions, to obtain lasting changes based on cognitive and emotional understanding of the main dynamics of the central conflict, called insight. The aim of the present study was to construct a follow-up form that was easy to handle, could score different outcome of short-term dynamic psychotherapy, as for instance symptom relief, change in social functioning and better insight, and was reliable. Sufficient reliability was established with a reliability coefficient between 0.756 and 0.564 for eight result variables. Percentage agreement was estimated in addition. As a total only 10% of the scores differed more than +/- 1 from a consensus score on a scale from zero, no change, to 7, recovered. The therapist was a reliable observer of his/her own patients. The sex of the observer did not influence percentage agreement. High-formal training in psychotherapy tended to give higher percentage of agreement compared to low-formal training. PMID- 3975331 TI - Short-term dynamic psychotherapy. III. A 5-year follow-up of 36 neurotic patients. AB - 36 patients of 39 (92%) were followed up 2 years after the end of short-term dynamic psychotherapy. 33 of these 36 patients (92%) were again followed up 5 years after the end of treatment. Changes had occurred between the two follow-up times that to some extent might be due to spontaneous remission and further therapy, but this could not explain all changes. The same patient characteristics that were related to outcome at the 2-year follow-up were related to outcome at the 5-year follow-up. This replication of findings strengthens the results. PMID- 3975332 TI - Short-term dynamic psychotherapy. IV. Comparison of recorded changes in 33 neurotic patients 2 and 5 years after end of treatment. AB - Changes for 33 neurotic patients treated with short-term dynamic psychotherapy were compared as measured at 2 and 5 years after end of treatment. There were changes both in symptoms and in degree of insight as measured by a dynamic variable between the two follow-up points. Some of these changes could be due to spontaneous remission and further therapy, but this could not explain all changes. Dynamic changes measured at 2-year follow-up persisted throughout the whole follow-up period. Some patients with mere symptom relief at 2-year follow up got their symptoms back while others changed dynamically. Thus effect of short term dynamic psychotherapy may occur even after 2 years after the end of treatment. PMID- 3975333 TI - Short-term dynamic psychotherapy. V. Global assessment scale as an instrument for description and measurement of changes for 33 neurotic patients. AB - Global assessment scale (GAS) has not been tested out on a group of neurotic out patients earlier. The patients in this study were selected for short-term dynamic psychotherapy by defined selection criteria and were thus a fairly homogeneous group of patients. It could be demonstrated that GAS could be used as a supplement for describing patient characteristics both at the start of treatment and at the 5-year follow-up. GAS could further be used for measuring change for this patient population after short-term dynamic psychotherapy. GAS could not be used as a predictor for dynamic change at the 5-year follow-up. PMID- 3975334 TI - Verbal measures of alexithymia: what do they measure. AB - Previous studies have shown that measurement of verbal affective expression is influenced by the method used for obtaining speech samples, thereby supporting a situation-dependent, or state concept of alexithymia. In this study monadic speech samples obtained from 20 psychoneurotic and 20 psychosomatic patients, using selected thematic apperception test (TAT) cards, were examined using different methods of content analysis. Although no differences were found with the Gottschalk-Gleser anxiety, hostility outward and hope scales, the psychosomatic patients had a more limited emotional vocabulary than the psychoneurotic patients as measured by an 'affect vocabulary score' (AVS). In contrast to the Gottschalk-Gleser scores (GGS), the AVS correlated with measures of fantasizing ability and would appear to be a more valid method of measuring alexithymia. The findings also supported a trait concept rather than a state concept of alexithymia. PMID- 3975335 TI - Life stress and rheumatoid arthritis. A 15-year follow-up study. AB - A 15-year follow-up study of 74 female patients with definite or classic rheumatoid arthritis (RA) was performed with special focus on the association between life stress and clinical course of the illness. Two categories of RA could be classified: a disease form less connected with genetic factors and more influenced by major psychodynamic conflict situations ('major conflict group' MCG) and a second form more associated with hereditary predisposition and less influenced by environmental psychosocial changes ('non-conflict group', NCG). PMID- 3975336 TI - Cerebral hemisphere function and laterality of migraine. AB - We report preliminary findings of a study exploring the hypothesis that migraine is the experience of a protective cerebrovascular mechanism arising in response to unilateral cerebral information overload. The necessary population to be studied, namely those with exclusive one-sided migraine, proved to be rare. The measures of cerebral hemisphere function were the verbal and non-verbal scales of Wechsler's Adult Intelligence Scale. Preliminary results suggest that it is worthwhile continuing to explore the notion using additional and more sophisticated measures. PMID- 3975337 TI - Short-term dynamic psychotherapy. II. Prognostic value of characteristics of patients studied by a 2-year follow-up of 39 neurotic patients. AB - 39 out-patients, 19 men and 20 women with a neurotic personality structure, evaluated by at least 2 therapists, were treated with short-term dynamic psychotherapy. 33 patients were followed up 2 years after the end of treatment with a semi-structured, problem-oriented interview, scored by 3 therapists according to a follow-up form developed for the study. Sufficient reliability was demonstrated for the follow-up form. 11 of 36 patients (31%), followed up 2 years after the end of treatment, obtained a high score on the dynamic result variable, and 24 (67%) on symptom relief. It could be established that these changes were mostly due to the therapy given. Variables pertaining patients' ability to relate to another person correlated with outcome. This is consistent with what Malan found in his two studies. PMID- 3975339 TI - Reactive hypoglycemia: overlooked or overdiagnosed? PMID- 3975338 TI - Referral for medically unexplained somatic complaints: the role of histrionic traits. PMID- 3975340 TI - Ten commandments of medical etiquette for psychiatrists. PMID- 3975341 TI - An atypical eating disorder following cancer chemotherapy. PMID- 3975342 TI - Major depression in patients with cardiac disease: diagnosis and somatic treatment. PMID- 3975343 TI - Oro-facial granulomatosis--a clinical and pathological analysis. AB - A study of 60 patients with oro-facial granulomatosis has been conducted and the clinical presentation of this disorder defined. It encompasses the previously recognised clinical entities of Melkersson-Rosenthal syndrome and cheilitis granulomatosa. The pathological features of the disease are lymphoedema and the presence of multiple non-caseating giant cell granulomata. These granulomata are histologically indistinguishable from those found in both gastrointestinal Crohn's disease and systemic sarcoidosis. Within this series of patients, nine had evidence suggestive of gastrointestinal Crohn's disease, and in six this was confirmed. A diagnosis of sarcoidosis was made in a further two patients. The relationship of oro-facial granulomatosis to these systemic granulomatous diseases is not yet clear. Patients with oro-facial granulomatosis who have gastrointestinal symptoms should be investigated for the presence of gastrointestinal Crohn's disease. Those without symptoms should be investigated for evidence of malabsorption or serological evidence of Crohn's disease. Within the present study, the erythrocyte sedimentation rate, full blood count, corrected whole blood folate, serum albumin and calcium were the most sensitive markers of gastrointestinal involvement. Sarcoidosis should be considered in all patients with oro-facial granulomatosis. The absence of clinical signs suggestive of sarcoidosis, a normal chest radiograph and normal levels of serum angiotensin converting enzyme makes sarcoidosis unlikely. PMID- 3975344 TI - The nature and prognosis of thyrotoxic heart disease. AB - Thirty-two patients with uncomplicated hyperthyroidism were compared to 17 patients deemed to be suffering from pure thyrotoxic cardiac failure, other heart disease having been excluded. The thyrotoxic failure group were older and had clinically and biochemically milder endocrinal abnormalities for a longer time. Haemodynamic studies at rest and exercise showed that the thyrotoxic failure patients had no functional cardiac reserve. Their response to propranolol indicated that myocardial function was dependent on beta-adrenergic activity. Following specific anti-thyroid medication cardiac function returned to normal in the majority of cases with cardiac failure. This study shows that hyperthyroidism by itself can cause a reversible cardiomyopathy. PMID- 3975346 TI - Clinical and morphological aspects of the management of crescentic anti glomerular basement membrane antibody (anti-GBM) nephritis/Goodpasture's syndrome. AB - Twenty-two patients with crescentic anti-GBM nephritis or Goodpasture's syndrome with renal impairment were reviewed. All patients were treated with a combination of plasma exchange and immunosuppression. Sixteen patients (73 per cent) showed improvement in renal function (greater than 30 per cent reduction in serum creatinine level) apparently in response to treatment, and nine patients (41 per cent) made long-term recoveries in renal function. The most important features carrying a bad prognosis were total anuria, and/or a very high percentage of glomeruli showing crescents (greater than 85 per cent) in the initial renal biopsy. Some patients with other so-called 'bad' prognostic features, including severely impaired renal function at presentation, oliguria and the need to institute dialysis had unexpected marked improvement in renal function and/or recovered renal function in the long term provided treatment with plasma exchange was begun promptly and maintained for a sufficient period to allow resolution of the disease process. Renal biopsies at the beginning and later proved to be an extremely valuable guide for the progress and outcome of the disease. PMID- 3975345 TI - Renal osteodystrophy and metastatic calcification in long-term continuous ambulatory peritoneal dialysis. AB - The biochemical data and drug histories related to bone disease were extracted from the case records of 47 patients who had been treated by continuous ambulatory peritoneal dialysis (CAPD) for more than two years. These data were reviewed in conjunction with the skeletal surveys done over the same period in all patients, with particular reference to secondary hyperparathyroidism, osteomalacia and non-visceral metastatic calcification. Paired bone biopsies were available in 20 of these patients and the histology was quantitated. In the majority of our patients secondary hyperparathyroidism was controlled or improved on CAPD. Osteomalacia also improved in two of the three patients in whom it was initially present and did not develop in any patient whilst on CAPD. We did, however, note a high incidence of non-visceral metastatic calcification. Small vessel calcification developed in 19.6 per cent of patients, large vessel calcification developed in 23.9 per cent and soft tissue calcification developed in 21.7 per cent of patients. We conclude that CAPD, as a form of treatment for end-stage renal disease, satisfactorily controls the osteodystrophy associated with renal failure in the majority of patients. The significance of the high incidence of non-visceral metastatic calcification remains to be established. PMID- 3975347 TI - The clinical assessment of acute mountain sickness. AB - During three expeditions to high altitude the Birmingham Medical Research Expeditionary Society has studied the effects of the ascents on its members. The severity of acute mountain sickness (AMS) produced was assessed by three methods, interview, self assessment and peer review. Physical examination was unhelpful. The results of the three methods were closely correlated. Clinical interview permitted allowances to be made for individual factors such as fatigue. There was no tendency for self assessment to indicate effects consistently more or less than the other methods. Peer review revealed a wide spread of opinions but the large number of observers allowed the derivation of plausible mean values. Correlation of AMS with arterial pH and PaCO2 showed little relationship but correlation with PaO2 was good, particularly for self assessment. As all the methods are subjective a combination of techniques is recommended for future expeditions. PMID- 3975348 TI - Micronucleus induction in mammalian cell cultures treated with ionizing radiations. AB - Exponentially growing and plateau phase cultures of Ehrlich ascites tumor cells (suspension strain) were treated with either fast electrons, X-rays, fast neutrons or Am-241-alpha-particles in a dose range from about 0.02 Gy to 1 Gy and for comparison also at higher doses. After the first post-irradiation division, cells were scored for the presence of micronuclei and the micronucleus fraction as well as the number of micronuclei/cell was determined. Micronuclei were counted using the DNA specific stain H 33258 in a fluorescence microscope. A comparison with cytofluorometric measurements established that microscopic detection accounted for up to 90% of all micronuclei present within a sample, the rest probably being hidden in direct observation by the main nucleus. Dose response curves based on the micronucleus fraction as well as on the number of micronuclei/cell were found to be linear in the whole dose range tested at low and at high ionization density. Linearity was maintained also when repair of primary lesions was promoted or suppressed. The RBE of alpha-particles compared with X-rays was dependent on the time of fixation and was at a maximum immediately after the first division (RBE = 4.8 +/- 0.5). Micronucleus distribution showed overdispersion relative to Poissonian statistics with every radiation quality used, in accordance with earlier observations on the distribution of acentric fragments in irradiated cultures. PMID- 3975349 TI - The reversion phenomenon in irradiated fern prothalli: effects of acute or chronic anoxia and LET. AB - In several systems a paradoxical reduction of radiation damage with increasing dose, termed reversion, has been observed. In the fern Osmunda regalis the percentage of cells which does not die but stays alive, although reproductively sterile, increases with dose. The assumed mechanism of this effect is a continuation of cytoplasmic growth during radiation-induced mitotic delay which induces terminal differentiation (early differentiation) thus preventing mitosis and the expression of chromosomal injury. Suppression of cytoplasmic growth after irradiation should abrogate reversion. This was tested using anoxia. Reversion was suppressed by storage of the sporelings in nitrogen for 8 h or more after X rays, but was not suppressed by storage in 0.27 microM oxygen nor by a 60-min exposure to air after irradiation and before storage in nitrogen. Anoxia before irradiation in air had no effect. Anoxia only during irradiation showed an OER of about 2 for the reversion peak. The partial abrogation of reversion is consistent with the assumed mechanism. Marked reversion also was observed after 14.7 MeV neutrons. PMID- 3975351 TI - Study of a photo-induced lysozyme-riboflavin bond. AB - Irradiation of lysozyme in the presence of riboflavin results in the formation of a lysozyme-riboflavin adduct. Reduction and carboxymethylation of the four disulfide bonds as well as the chemical modification of the Tyr residues and the photochemical alteration of the His residue in lysozyme, do not affect the formation of the photo-induced lysozyme-riboflavin bond. When the lysozyme riboflavin adduct was subjected to mild acid hydrolysis and ion exchange chromatography, the retention of a compound containing 14C-riboflavin was observed. Free 14C-riboflavin, on the contrary is not retained by the column. The photo-oxidation of free Trp in the presence of 14C-riboflavin, gave a compound which bound to the ion exchange resin like the above-mentioned derivative. The photo-oxidation of the Trp residues in lysozyme and in peptides obtained from lysozyme showed very high quantum yields, and these values were directly related to the incorporation of 14C-riboflavin in these samples. PMID- 3975350 TI - The riboflavin-sensitized photooxidation of horseradish apoperoxidase. AB - Native horseradish peroxidase, as well as its reduced and carboxymethylated form, and the apoenzyme, showed resistance to photodynamic action. Sensitivity to this action was detected only in reduced and carboxymethylated apoenzyme, when the photooxidation of its histidine residues was observed. When analyzing the bulk hydrophobic character (Hf) and the accessibility coefficients (Br) in those amino acid residues which can be subjected to photooxidation in horseradish peroxidase, it was found that all of them are situated in hydrophobic zones with low accessibility coefficients. This could justify the high resistance of this enzyme to photodynamic action. The only exception is tryptophan-117, which has low values of Hf and Br, and therefore its resistance to photodynamic action can only be explained in terms of its location and environment. Tryptophan-117 would be situated in a zone of antiparallel beta-structure, according to Chou and Fasman's predictive method for protein conformation. PMID- 3975352 TI - Energy-dependent effect of iodized contrast medium on radiation-induced chromosome aberrations. PMID- 3975353 TI - Natural radioactivity in Indian tea. AB - The paper presents the results of measurements on tea samples collected during 1962 and 1973-1983 period for their natural radioactivity content. The radioisotopes studied under this programme are radium-226, thorium-228, and potassium-40. Tea was found to contain higher concentration of these radionuclides compared to other foodstuffs having vegetative origin. Interpretation for higher concentrations in tea compared to other foodstuffs is briefly given on the basis of agroclimatic conditions. PMID- 3975354 TI - Radiation induced formation of giant cells in Saccharomyces uvarum. II. Effect of X-rays on septum formation. AB - Thin sections of budding yeast cells and giant gells grown after X-irradiation have been examined by electron microscopy. The different steps of cross-wall formation during budding were documented with unirradiated cells. With X-ray induced giant cells cytokinesis was shown to be absent. Neither primary nor secondary septae appeared thus cell separation did not occur. Despite this fact both macromolecular synthesis and bud growth continued, giving rise to the formation of giant cells. PMID- 3975355 TI - Nuclear fragmentation of clinical silicon beam. AB - Heavy ions used for biomedical studies fragment when they pass through matter. It is known that different fragments cause different types of biological damage. In this paper, results pertaining to different kinds of secondary fragments produced by a 28Si beam at 463 MeV/nucleon in its interaction with nuclear emulsion are presented. It is observed that the production frequencies of secondary fragments are independent of the target. Partial production cross sections and fluences of the secondary fragments are also discussed. The partial production cross sections for different fragments at three lower energy ranges are practically the same within their statistical errors except for the cross section for Li fragments, which is larger by almost a factor of 1.5 at the lowest energy investigated. The dose contributions of the primary Si beam and its components at different points of the Bragg curve are presented for two different energy regions. PMID- 3975356 TI - Chemical and biological consequences of the radioactive decay of iodine-125 in plasmid DNA. AB - Doubly labeled [U-14C, 5-125I]iododeoxycytidine (IdC) triphosphate was synthesized and incorporated enzymatically into defined positions of the plasmid pBR322. After storage under various conditions, the stable end products were analyzed using radio-GC, radio-HPLC, and electron microscopy. In addition, solutions of 14C-IdC-labeled DNA containing Na125I as an internal radiation source were studied to investigate the influence of internal radiolysis. Transmutation of the covalently bound 125I leads to complete destruction of the labeled nucleotide, giving rise to 14CO2 and 14CO as major products. Fragmentation of the pyrimidine base is independent of solvent and DNA configuration. Internal radiolysis caused by Na125I leads to only minor damage. Electron microscopy studies reveal that decay-induced double strand breaks (dsb) occur both at the site of decay and in areas as far as hundreds of base pairs apart from that site. Number and distribution of the breaks is strongly dependent on solvent and DNA configuration. A direct correlation exists between the extent of fragmentation of the nucleotide and the mean number of dsb. PMID- 3975357 TI - In vitro transformation by bromodeoxyuridine and X irradiation in C3H 10T1/2 cells. AB - The effect of 10(-5) M bromodeoxyuridine (BrdUrd) substitution in C3H 10T1/2 cells was evaluated. Cellular toxicity increased rapidly for BrdUrd exposure times that were longer than the population doubling time. Radiosensitization by BrdUrd exposure was almost complete after one cell doubling time and was characterized by a decrease in D0 and the survival curve shoulder. Exposure to BrdUrd for one cell doubling time produced only very low transformation levels, but for prolonged BrdUrd exposure times, the transformation frequency per viable cell increased significantly. BrdUrd incorporation also enhanced radiation induction of transformation above the transformation levels resulting from the independent action of X rays or BrdUrd treatment. These results show that BrdUrd is a transforming agent in C3H 10T1/2 cells and thus may be a carcinogen and that BrdUrd can enhance radiation-induced transformation. PMID- 3975358 TI - Effect of hypothermia on cell kinetics and response to hyperthermia and X rays. AB - Hyperthermia is a potent radio enhancer. Studies using hypothermia in combination with irradiation have given confusing results due to lack of uniformity in experimental design. This report shows that hypothermia might have potential significance in the treatment of malignant cells with both thermo- and radiotherapy. Reuber H35 hepatoma cells, clone KRC-7 were used to study the effect of hypothermia on cell kinetics and subsequent response to hyperthermia and/or X rays. Cells were incubated at 8.5 degrees C or between 25 and 37 degrees C for 24 hr prior to hyperthermia or irradiation. Hypothermia caused sensitization to both hyperthermia and X rays. Maximum sensitization was observed between 25 and 30 degrees C and no sensitization was found at 8.5 degrees C. At 25 degrees C maximum sensitization was achieved in approximately 24 hr, cell proliferation was almost completely blocked, and cells gradually accumulated in the G2 phase of the cell cycle. In contrast to the effect of hypothermia on either hyperthermia or X rays alone, thermal radiosensitization was decreased in hypothermically pretreated cells (24 hr at 25 degrees C) compared to control cells (37 degrees C). The expression of thermotolerance and the rate of development at 37 degrees C after an initial heating at 42.5 degrees C were not influenced after preincubation at 25 degrees C for 24 hr. The expression of thermotolerance for heat or heat plus X rays during incubation at 41 degrees C occurred in a significantly smaller number of cells after 24 hr preincubation at 25 degrees C. The enhanced thermo- and radiosensitivity in hypothermically treated cells disappeared in approximately 6 hr after return to 37 degrees C. PMID- 3975359 TI - Effect of misonidazole on formation of thymine damage by gamma rays. AB - The effect of the radiosensitizer misonidazole (Ro-07-0582) on the formation of thymine base damage of the 5,6-dihydroxydihydrothymine-type by gamma rays was measured under aerobic and hypoxic conditions. HeLa cells, prelabeled with [methyl-3H]thymidine, were suspended in phosphate-buffered saline in the presence and absence of misonidazole. Concentrations of misonidazole up to 15 mM were used. The cell suspensions were irradiated at ice temperature with 60Co gamma rays. Dose-response curves under aerobic and hypoxic conditions showed a much depressed base damage formation under hypoxia, which was created by blowing a stream of nitrogen across the cell suspensions for 30 min on ice. The presence of misonidazole had little or no detectable effect under hypoxia. It is concluded that an effect on the level of formation of thymine base damage is not primarily responsible for the radiosensitization by misonidazole under hypoxic conditions. PMID- 3975360 TI - Effect of hypoxia on recovery from damage induced by heat and radiation in plateau-phase CHO cells. AB - The effect of hypoxia on the induction of and recovery from damage by radiation alone and in combination with heat has been investigated using plateau-phase Chinese hamster ovary (CHO) cells. Postirradiation hypoxia reduced the potentially lethal damage recovery (PLDR) in cells irradiated under an euoxic state and completely eliminated PLDR in cells irradiated under hypoxia. Cells which were maintained under hypoxia during both irradiation and a 4-hr recovery period and then incubated for a further period of 4 hr under euoxic conditions showed PLDR, suggesting that the inhibition of PLDR by hypoxia is reversible. Oligomycin, an inhibitor of energy metabolism, completely eliminated PLDR when present at a concentration of 1 microM during the postirradiation period. Pre- or postirradiation heat treatment at 42.5 degrees C for 30 min appreciably sensitized the cells to the induction of lethality. Thermal enhancement ratio (TER) was 1.7 for cells irradiated and heat treated under hypoxic conditions. The same heat treatment reduced the oxygen enhancement ratio (OER) associated with gamma radiation from 3.1 to 2.5. Cells subjected to this postirradiation heat treatment showed a small extent of PLDR, whereas the pre-heat-treated cells showed as much recovery as non-heat-treated cells. When hypoxic conditions prevailed during the post-treatment incubation period, PLDR was reduced in preheated cells and completely eliminated in postheated cells. The kinetics of interaction between heat and radiation damage were studied by introducing a time gap of 4 hr between the treatments. Cells maintained under euoxic conditions between the treatments showed an appreciable decrease in interaction, suggesting recovery from damage induced by the first treatment. Hypoxic conditions intervening the two treatments largely inhibited the loss of sensitization. Analysis of the results suggests that cells fail to recover from sublethal heat damage when held for 4 hr under hypoxic conditions. Cells held under hypoxic conditions partly recover from the radiation damage which subsequently interacts with sublethal heat damage, resulting in cell lethality. PMID- 3975361 TI - Correlation between cellular survival and potassium loss in mouse fibroblasts after hyperthermia alone and after a combined treatment with X rays. AB - Mouse fibroblast LM cells have been heated at 44 degrees C for different periods. Potassium content of the cells was measured at certain intervals during the postheating period at 37 degrees C for up to 24 hr. The level of K+ decreased gradually in time starting within some hours after the heat treatment. The rate of K+ loss as well as the ultimate level reached was heat-dose dependent. When the potassium content of the cell population was determined 16 hr after the heat treatment, a correlation was observed between the concentration of potassium and the level of cell survival. When X irradiation was applied immediately after hyperthermia, radiosensitization on the level of cell survival was obtained as expected, the extent being dependent on the severity of heat treatments. No added K+ loss was observed, however, when hyperthermia was combined with radiation. It is suggested that plasma membrane related functions are disturbed by the heat treatment. This points to membranes as possible candidates for primary targets in the case of cell inactivation by heat alone, and not with respect to the radiosensitization by hyperthermia. PMID- 3975362 TI - Dose fractionation effects in plateau-phase cultures of C3H 10T1/2 cells and their transformed counterparts. AB - A comparison of gamma-ray dose fractionation effects was made using plateau-phase cultures of C3H 10T1/2 cells and their transformed counterparts in an attempt to simulate basically similar populations of cells that differ primarily in their turnover rates. The status of cell populations with respect to their turnover rates may be an important factor influencing dose fractionation effects in early- and late-responding tissues. In this cell culture system, the rate of cell turnover was approximately three times higher for the plateau-phase transformed cultures. While the single acute dose survival curves for log-phase cells were indistinguishable, there were significant differences between the survival curves for plateau-phase cultures of the two cell types. These differences were qualitatively similar to the differences recently postulated for the survival of target cells governing early and late tissue responses. Both cell lines had a similar capacity for repair of sublethal damage, but untransformed cells had a much greater capacity to repair potentially lethal damage in plateau phase. Further, untransformed plateau-phase cultures were much more sensitive to a radiation-induced G1 (or G0 to G1) delay than transformed cultures. Multifraction survival curves were determined for both cell lines for doses per fraction ranging from 9.0 to 0.8 Gy, and from these isoeffect curves of log total dose versus dose per fraction were derived. The isoeffect curve for the slowly cycling, untransformed cells was found to be appreciably steeper than that for the more rapidly cycling transformed cells, a finding consistent with previously reported differences in dose fractionation isoeffect curves for early- and late responding tissues in vivo. PMID- 3975363 TI - [Use of meradin for normalizing catecholamine metabolism in the rat hypothalamus at late periods following irradiation]. AB - Meradine administered in a dose of 2 mg/kg during 10 days 10-12 months after irradiation with a dose of 4 Gy normalized the catecholamine metabolism in rat hypothalamus. The content of noradrenaline was restored as early as 24 h and that of DOPA and dopamine, 1 month after the cessation of meradine injection. PMID- 3975364 TI - [Modification of the action of ionizing radiation on cells of transplantable tumors by administering xanthobine]. AB - In experiments on mice it was established that the radiosensitizing effect of xanthobin was manifested by the enhancement of the inhibiting action of ionizing radiation on the growth of adenocarcinoma RL-67, diminution of the "shoulder" of the survival curve of Ehrlich ascites tumor cells, and increase in the average life of tumor-bearing animals. PMID- 3975365 TI - [Effect of continuous low-intensity microwave irradiation on the behavior of albino rats]. AB - A study was made of a single 10 min exposure of albino rats to microwaves (6 GHz, 0.2 MW/cm2) on their orientative-trying reaction. The locomotive activity, attentiveness and trying activity of the experimental animals were found to increase. PMID- 3975366 TI - [Behavior of cats following gamma-irradiation of the head: the induced pleasure test]. AB - A decrease in the degree of manifestation of the induced pleasure response of male cats to the administration of valerian tincture was observed during the first 1-2 h following gamma-irradiation of the head with a dose of 1.29 C/kg. It is suggested that the absence of the reaction during the first 10-15 min after exposure is indicative of the presence of the phase of a pronounced excitation in the C.N.S. of the exposed animals. PMID- 3975367 TI - [Inductive-resonance energy transfer between chromophores localized in different parts of irradiated and nonirradiated erythrocyte ghosts]. AB - A study was made of the inductive-resonance energy transfer between chromophore pairs, tryptophan--pyren, tryptophan--1.8-anilinonaphthalene sulfonate (ANS), puren--1.8-ANS, diphenylhexatrien--ethidium, and 1,8-ANS--ethidium, in irradiated (250 Gy) and nonirradiated preparations of erythrocytic membranes. The radiation- induced decrease in the energy transfer was noted in the pairs in which one of the chromophores was localized in a lipid phase. On the basis of the data obtained it is suggested that irradiation of membranes causes the lesions in them which lead to a reduction of the effective thickness of a hydrophobic part of the lipid bilayer. PMID- 3975369 TI - [Initiation of unscheduled synthesis on DNA sites associated with a nuclear matrix of irradiated hepatoma cells]. AB - A study was made of the distribution of unscheduled DNA synthesis (induced by UV- or gamma-radiation and resistant to hydroxyurea) between the DNA sites in the nuclear matrix and total nuclear DNA of Zajdela ascites hepatoma cells. It was shown that during the first 1.5 to 5 min of the postirradiation incubation the rate of the unscheduled synthesis of DNA was considerably higher in the DNA fraction, firmly associated with the nuclear matrix proteins, than in the total nuclear DNA. PMID- 3975368 TI - [Effect of low doses of internal irradiation resulting from the administration of 75Se- and 35S-labeled compounds on the cellular immune response]. AB - The administration to rats of radioactive preparations. 75Se- selenomethionine, 35S-methionine or sodium 75Se-selenite in the amounts creating the absorbed dose in the body of 0.5 Gy suppressed the delayed hypersensitivity reaction as was registered 1-12 months after the injection. The delayed hypersensitivity was tested in vitro by the method of inhibimacrophage spreding inhibition. The degree of suppression of the cellular immune response depended upon the type of the compound administered, of which the radionuclide was a component, and upon characteristics of radiation spectrum of the radionuclide. PMID- 3975370 TI - [Lipid transport activity of liver cell cytosol at early periods following gamma irradiation of rats]. AB - A study was made of the rate of the transfer of phospholipids and cholesterol between 14C-microsomes and mitochondria of gamma-irradiated rat liver. Cytosole and cell organelles of nonirradiated and irradiated rat liver were combined to reveal the increase in the cholesterol-transfer activity of liver cell cytosole 60 min following irradiation (12 Gy). Roughly purified lipid-transfer proteins from liver cytosole of control rats transported lipids, at an equal rate, between organelles isolated from liver cells of control and exposed rats. Radiation modification of cell organelle membranes was only detected upon the reaction with cytosole from the irradiated rat liver. PMID- 3975371 TI - [Quantitative assessments of synergism]. AB - The basic approaches to the assessment of the biological effects of combinations of different agents are briefly discussed. The situations of additivity, synergism and antagonism are defined with hetero- and isoaddition being taken into consideration. The practical application of the methods is illustrated by the analysis of the experimental data on the staphylococcus survival after the combined effect of gamma-irradiation and hydrogen peroxide or incubation at elevated temperature. PMID- 3975372 TI - [Effect of gamma-irradiation on the enzyme activity of cerebrospinal fluid lymphocytes in dogs]. AB - Cytochemical activity of succinate dehydrogenase (SDG), L-glycerophosphate dehydrogenase (L-GPDG), lactate dehydrogenase (LDG), and glutamate dehydrogenase (GDG) increased immediately after total-body irradiation with a dose of 129 mC/kg. After 2 h, LDG activity only returned to the control level. Irradiation of the head with the same dose caused less pronounced changes. Changes caused by lethal irradiation (1290 mC/kg) were different: there was an increase after exposure of the abdomen and a decrease in the activity of SDG and L-GPDG after irradiation of the head. PMID- 3975373 TI - [Determination of the optimal proportions as regards toxicity of AET, ATP and serotonin used in combination]. AB - In experiments on mice, a study was made of the quantitative dependence of toxicity of AET, ATP and serotonin applied in combinations. The toxicity decreased when ATP was combined with AET and increased when ATP of AET were combined with serotonin. The toxicity of a combination of all three substances was reduced by introducing high doses of ATP. PMID- 3975374 TI - [Radiomodifying effect of acute hypoxia in neutron-irradiated dogs]. AB - A pronounced protective effect of acute hypoxia was demonstrated on dogs exposed to fast neutrons (4.0 Gy). Breathing of 10% gas hypoxic mixture protected more than half of the exposed animals from death and provided the development of a light form of radiation sickness instead of a serious one. Possible mechanism of the effect observed are discussed. PMID- 3975375 TI - [Effect of preliminary chronic irradiation and alpha-tocopherol on the frequency of chromosome aberrations in mouse bone marrow cells, induced by exposure to acute gamma-irradiation]. AB - The incidence of chromosome aberrations in bone marrow cells of femur did not exceed the spontaneous one in CBA mice exposed, during 70 days, to gamma radiation at dose--rates of 33.7-35.8 nA/kg and cumulative dose of 2.75 Gy. A single acute exposure of intact animals to a dose of 2.98 Gy increased significantly the mutation level. Preirradiation with small doses increased the resistance of hereditary structures to sublethal radiation doses. Exogenous alpha tocopherol (0.06 mg/20 g mass) protected the genetic apparatus of cells from total-body irradiation and was an additional factor decreasing the mutation level after acute exposure of mice at the background of long-term irradiation with small doses. PMID- 3975376 TI - [Ability of locally irradiated bone marrow to form erythroid colonies in diffusion chambers]. AB - It was shown that mouse bone marrow locally exposed to ionizing radiation during the period of T-lymphocytes accumulation can form, int the diffusion chambers in the absence of exogenous erythropoietin, a large number of giant and small erythroid colonies. PMID- 3975377 TI - [Effect of the thymus on the capability of stromal progenitor cells for intracellular repair of radiation damage]. AB - Cells-precursors of haemopoietic microenvironment, as well as osteogenic cells precursors, indicated with heterotopic transplantation of mouse bone marrow, can repair sublethal radiation damages. Thymectomy of the bone-marrow donors does not influence this capacity of the stromal precursors. PMID- 3975379 TI - [Criteria for assessing the radioresistance of the Central Asiatic turtle]. AB - A study was made of a phenomenal radioresistance of Testudo horsfieldi. The authors described the features of the postirradiation death at different seasons. A threshold number of the affected systems in the turtles was one order lower than that of mammals. A positive correlation was found between specific affection of the systems and the degree of their radioresistance. PMID- 3975378 TI - [Change in the catecholamine balance of rat hypothalamus at late periods following local irradiation and its correction with etimizol]. AB - A local exposure (15 Gy) of chest caused a disturbance in the metabolism of adrenergic mediators of hypothalamus at later times (1-12 months) after irradiation: this was manifested by a decrease in the noradrenaline level 1 month following irradiation, and by phase changes in the dopamine content and considerable deficiency of deoxyphenylatanine throughout the entire period of observation. The treatment with etymisol normalized the catecholamine balance. PMID- 3975380 TI - [Stimulating effect of aminoethylisothiuronium on the immune response and interferonogenesis in irradiated mice]. AB - Aminoethylisothiuronium (AET) stimulated the formation of antibodies against sheep erythrocytes, not against E. coli, in X-irradiated (4 Gy) mice. The serum containing AET-induced interferon had the same effect. AET also promoted the rejection of the allogenic skin graft in mice irradiated with the same dose. In addition, AET and cystaphos stimulated the induction of interferon by the Newcastle disease virus in mice exposed to doses of 4, 5 or 6 Gy. PMID- 3975381 TI - [Effect of irradiation on proteins and phagocytic activity of rat blood leukocytes]. AB - The method of chromatography on DEAE-cellulose was used to study the effect of radiation (180.6 mC/kg) on the physicochemical properties of rat leukocyte proteins. The qualitative changes were noted in the protein spectrum of leukocytes which were indicative of the substantial changes in the cell proteins. A fraction was isolated which caused a 44% inhibition of the phagocytic activity of intact leukocytes in vitro. PMID- 3975382 TI - Beyond andragogy. AB - Radiologic technology educators must be aware of the adult learner's needs and of all the methods available to enhance the learning process. Synergogy goes beyond pedagogy and andragogy by avoiding their weaknesses and preserving their strengths. This article details the benefits and limitations, and explains the strategy, of this new teaching approach. PMID- 3975383 TI - Stress in clinical learning: a transactional approach. AB - After relevant literature regarding stress and clinical learning is reviewed, a model designed to reduce stress experienced by students in the clinical learning setting is presented. The application of the model is discussed, using a specific clinical example. PMID- 3975384 TI - [Morphology and roentgenology of asbestosis]. AB - The different sequelae of lung and pleura resulting from the inhalation of asbestos dust are discussed in detail, taking into consideration the improvements in dust-control measures. The use of Lung Dust Separation and Investigation and Radiological Classification of Pneumoconioses (ILO 1980) with regard to diagnostics is critically reviewed. Certain problems of compensation for asbestos induced neoplasms are pointed out with special reference to the regulations of the Federal Republic of Germany. PMID- 3975385 TI - Plate atelectasis. AB - Postmortem examination was performed in 15 patients who had plate atelectasis (PA) on their last antemortem radiograph. In 10 patients, corresponding abnormalities were found in the lungs. In all 10, there was peripheral subpleural linear collapse combined with invagination of the overlying pleura; prominent interlobular septa were observed within or bordering the linear atelectasis in nine. The atelectasis and the invaginated pleura both contributed to the linear radiographic density. The bronchi supplying the areas of PA showed no obstruction nor rearrangement. Despite a frequent association with pulmonary embolism (6/10), there was no evidence that PA directly represented thrombosed vessels or infarcts. The findings suggest that PA represents one (radiographically visible) form of peripheral atelectasis. In persisting low-volume states, the dependent subpleural lung appears to buckle and fold in. The frequent association of PA with congenital pleural clefts, indentations, scars, and incomplete fissures suggests that this process may preferentially occur at sites of pre-existing pleural invagination. PA frequently indicates more widespread peripheral atelectasis than is radiologically apparent; it also may indicate the presence of some other (more serious) abnormality in the chest or abdomen. PMID- 3975386 TI - Isolated left thoracic isomerism. AB - Left thoracic isomerism may present as an isolated anomaly without symptoms. The chest radiograph demonstrates characteristic right hilar findings that may be misinterpreted as a hilar mass. Computed tomography of the chest is recommended to confirm the correct diagnosis. PMID- 3975387 TI - Extravasation of contrast material from unused bladders during voiding cystourethrography. AB - Extravasation from unused bladders in three children during the voiding phase of voiding cystourethrography is described. In these cases, extravasation was not a clinically significant problem and did not indicate irreversible nondistensibility of the small-capacity bladders. PMID- 3975388 TI - Computed tomography of cerebral infarction along the distribution of the basal perforating arteries. Part I: Striate arterial group. AB - Computed tomographic (CT) manifestations of cerebral infarction along the distribution of the basal perforating arteries were reviewed in correlation with cerebral angiography. Infarcts in the territories of perforators were demonstrated individually based on knowledge of their three-dimensional distribution as demonstrated by microangiography of cadavers. In Part I of the study, the areas supplied by the medial (MSA) and lateral striate arteries (LSA) were examined. Infarction along the branches of the MSA usually involved the antero-inferior portion of the corpus striatum, immediately posterolateral to the most inferior part of the frontal horn of the lateral ventricle. Infarcts along the branches of the LSA abutted the territory of the MSA posteriorly and superiorly and involved the posterolateral region of the corpus striatum. Clinical and neuroradiological correlations are discussed. PMID- 3975389 TI - Computed tomography of cerebral infarction along the distribution of the basal perforating arteries. Part II: Thalamic arterial group. AB - Computed tomographic (CT) manifestations of cerebral infarction along the distribution of the basal perforating arteries were reviewed and correlated with cerebral angiography. Infarcts in the territories of perforators were demonstrated individually based on knowledge of their three-dimensional distribution as shown by microangiography of cadavers. In Part II of the study, the posterior areas supplied by the thalamic arteries were examined. Infarcts in the area supplied by the thalamotuberal arteries involved the anterior pole of the thalamus; those in the area of the thalamoperforate arteries involved the medial portion of the thalamus, along the lateral wall of the third ventricle; those in the area of the thalamogeniculate arteries involved the posterolateral portion of the thalamus; and those in the area of the choroidal arteries of the lateral ventricle involved the most posterolateral and dorsolateral portions of the thalamus. Clinical and neuroradiological correlations are discussed. PMID- 3975390 TI - Central nervous system tumors in children: detection by magnetic resonance imaging. AB - Fifty-one pediatric patients who were suspected of having central nervous system (CNS) tumors underwent magnetic resonance (MR) imaging using a 0.35 T Diasonics MT/S system. Pulse intervals (TR) ranged from 0.5 to 2.0 seconds with echo delays (TE) of 28 and 56 msec. The ability of MR and contrast-enhanced CT to detect focal lesions, determine lesion extent, and evaluate associated abnormalities was compared. In most patients in whom there was suspected spinal cord disease, comparison with myelography was made. Thirty-three intracranial lesions were detected with at least one imaging modality in 43 cranial examinations. MR was judged superior to CT in 14 of these cases and CT superior to MR in only one. Of eight spinal examinations, there were six that demonstrated abnormal findings. MR was superior to CT in all six cases and better than myelography in four of five cases where myelography was performed. Spin echo (SE) sequences with long pulse intervals were the most sensitive, but in some cases short pulse intervals permitted further characterization of the lesion. Patient motion was not a problem; sedation was routinely used in children younger than five years of age. MR imaging has rapidly become a valuable diagnostic modality in neuroradiology. The lack of ionizing radiation and the ability to evaluate the spinal cord noninvasively makes it particularly attractive in examination of children. PMID- 3975391 TI - The unprotected parasphenoidal carotid artery studied by high-resolution computed tomography. AB - A retrospective review was made of 500 consecutive thin-section axial CT scans of the adult sphenoid sinus using contrast enhancement and the bone algorithm to determine whether there was exposure of the cavernous sinus and the carotid arteries along their parasphenoidal course. At least one cavernous-carotid complex that could be considered at risk during sphenoid sinus surgery was seen in 31.4% of the patients. Of this group, 14.4% of the patients had no bony covering on one or both sides at some point along the parasphenoidal course. In 17% the bony covering was so thin it would give minimal, if any, protection from surgical trauma. A patient who had laceration of an unprotected carotid artery with development of post-traumatic aneurysm is discussed. PMID- 3975392 TI - The cervical neural foramina: correlation of microtomy and CT anatomy. AB - The CT appearance of the cervical neural foramina and contents is described in detail. Nineteen cervical spine specimens were studied with CT and corresponding cryomicrotomy in direct axial, sagittal, coronal, and oblique planes. Both ventral and dorsal nerve roots can be identified in the foramen's lower portion at or below the disk level. The dorsal nerve roots and ganglion contact the superior facet. The ventral nerve roots contact the uncinate process and bottom of the neural foramen. The ventral nerve roots, dorsal nerve roots and ganglion, and vertebral artery are resolved with current high-resolution CT. PMID- 3975393 TI - Cochlear otosclerosis (otospongiosis): CT analysis with audiometric correlation. AB - Ninety patients who had suspected or confirmed fenestral or cochlear otosclerosis underwent CT examination. Foci of demineralization in the otic capsule were discovered in 20 ears (12 patients). Audiometric studies of the 12 patients revealed sensorineural hearing loss (SNHL) with distinct correlation of CT findings with progressivity and with involvement of the frequency level subtended by the specific area of the cochlea involved. Foci of abnormal increased density, presumably representing the healed phase of this disorder, were found less frequently than expected. There was a predilection for the basilar turn. All patients had static SNHL in the higher frequencies. The healed phase of this disorder is probably not consistently diagnosable with CT. PMID- 3975394 TI - Pulmonary hamartoma: diagnosis by transthoracic needle-aspiration biopsy. AB - Hamartomas of the lung often present as asymptomatic, noncharacteristic masses that can seldom be differentiated from other lung masses such as primary cancer or metastases by conventional radiography. Transthoracic needle-aspiration biopsy (TNAB) has become a popular and reliable method for the diagnosis of a lung lesion, and it offers a valuable alternative to diagnostic thoracotomy. In our study, TNAB established the diagnosis of pulmonary hamartoma in 12 of 14 (86%) patients. In eight patients, one procedure (using one to three punctures) was sufficient to establish the diagnosis, and, in four patients, two procedures (using one to two punctures) were necessary. In two patients, the lesion was missed on second and/or third biopsy procedures, and the correct diagnosis was obtained at surgery. Cytologic examination of the material was diagnostic in five of the 14 patients. Tissue specimens were sent in 13/14 patients, and findings of histologic examination established the correct diagnosis in 11 of these patients. One of the 12 patients in whom hamartoma was correctly diagnosed by TNAB underwent resection of his lesion, and histologic examination confirmed the diagnosis. In the remaining 11 patients, the lesions have been stable on follow up chest examinations. PMID- 3975395 TI - The oral cavity and tongue: magnetic resonance imaging. AB - Magnetic resonance images of the oral cavity were obtained in the sagittal, coronal, and axial planes on normal volunteers. Although judgment regarding the current capabilities of magnetic resonance in imaging of the oral cavity remains guarded, expectations are that it could eventually surpass other diagnostic modalities in providing useful information about the oral cavity and tongue. PMID- 3975396 TI - The intranuclear cleft of the intervertebral disk: magnetic resonance imaging. AB - Three cadaver spines, 40 patients who were symptomatic for lumbar disk disease, and ten healthy subjects were examined by MR. T2 weighted spin echo images were used to evaluate the character of an intranuclear cleft. This cleft appears identical to annular tissue both on T2 weighted images and histologically. A 120 msec TE, 3 sec TR image was used to delimit the normal nucleus pulposus from the annulus. The incidence and age distribution of the cleft were calculated. An intranuclear cleft was present in all normal disks in both control and symptomatic subjects who were 30 years of age and older. If present in one disk, it was also present in 94% of the other disks in the same subject. This cleft represents a normal anatomic structure and appears to be a constant feature in subjects 30 years of age or older. Its absence, in the presence of an increased signal intensity within the disk, suggests a pathological process with a long T2 value, such as inflammation. PMID- 3975397 TI - Multi-section multi-echo pulse magnetic resonance techniques: optimization in a clinical setting. AB - The user-selectable magnetic resonance imaging parameters involved in a multi section multi-echo pulse sequence are described and their interrelationships explained. These parameters include repetition time (TR), echo delay time (TE), the number of sections (S), the number of echoes (E'), the time from the center of the last echo to the end of data acquisition (15 msec on the authors' system), and the time for T1 recovery. A simple mathematical relationship among these quantities, permitting easy calculation of the remaining parameters once a sufficient number have been specified, is given. In addition, a nomogram that permits rapid visual estimation of these parameters is presented. The effects of these choices and others is explained with respect to imaging time, region covered, and image contrast. Finally, the inherent trade-offs are illustrated in a clinical example involving the pelvis. PMID- 3975398 TI - Esophageal carcinoma: CT findings. AB - Preoperative CT scans of 33 patients with esophageal cancer were reviewed to assess staging accuracy and define the role of CT in patients being considered for transhiatal blunt esophagectomy. Surgical and pathological verification was obtained in all cases. Only 13 tumors were staged correctly according to the TNM classification. In addition, CT was not useful in assessing resectability because of its low accuracy in evaluating aortic invasion and the fact that few patients had tracheobronchial or aortic invasion or hepatic metastases at presentation. PMID- 3975399 TI - Gastric interposition following transhiatal esophagectomy: CT evaluation. AB - Transhiatal esophagectomy without thoracotomy (THE) but with gastric interposition results in less morbidity and mortality than standard transpleural esophagectomy with thoracotomy. Barium examination has been the primary radiographic study following THE for detecting postoperative complications. We reviewed computed tomography (CT) scans of 21 patients who had undergone THE and correlated CT appearance with clinical status and with findings of the barium studies. Local mediastinal recurrent neoplasm was detected by CT in seven patients; barium study within 2 weeks of the CT scan failed to detect tumor recurrence in three of these patients. A mediastinal abscess well delineated by CT was percutaneously drained under CT guidance. Water-soluble contrast medium/barium study is preferable for the evaluation of certain postoperative complications such as anastomotic leak. However, CT is the modality of choice for detecting locally recurrent neoplasm and distant metastases following THE and may also be helpful in patients with postoperative mediastinal abscess. Normal mediastinal CT anatomy after esophagectomy is reviewed in order to warn against pitfalls in scan interpretation. PMID- 3975400 TI - Adrenal glands in patients with congenital renal anomalies: CT appearance. AB - The CT appearance of the adrenal glands was investigated in 30 patients with congenital renal anomalies (17 cases of unilateral renal agenesis, 11 of inferior ectopy, and 2 of crossed fused ectopy). The ipsilateral adrenal was clearly identified in 83% of these patients; in all of them, the adrenal was a paraspinal disk-shaped organ, which appeared linear on CT. Conversely, the adrenals retained their normal shape in a control group of 20 patients with acquired renal atrophy or prior simple nephrectomy. PMID- 3975401 TI - Three-dimensional computed tomography of acetabular fractures. AB - Computer programs that produce 3D surface reformations from sets of contiguous axial CT scans were used in evaluating a variety of acetabular fractures in 20 patients. The 3D images were easily correlated with plain radiographs, and new views were produced that provided a unique perspective not obtainable by conventional radiography. The 3D images were useful in complex displaced fractures in cases in which the interpretation of plain radiographs was difficult. Plain radiographs and conventional CT scans were more sensitive than the 3D images in detecting undisplaced fractures. PMID- 3975402 TI - Accessory lateral segmental branch of the portal vein. AB - An accessory lateral segmental branch of the protal vein was found in a patient with esophageal varices. This rare anomalous branch should not be mistaken for a coronary vein supplying varices. PMID- 3975403 TI - Simultaneous MR imaging of both breasts using a dedicated receiver coil. AB - We have designed and built a dedicated magnetic resonance (MR) coil that images both breasts simultaneously with the patient in a prone position, incorporates imaging advantages of surface coils, and benefits from having separate transmitter and receiver coils. This coil is compatible with a 0.15-T (6.3 MHz) resistive-magnet unit. It works as a simple plug-in replacement for the standard receiver coil. The unit's triple-coil structure consists of two outer coils that lie close to the lateral surface of the right and left breast and a central coil positioned between the breasts. A two-chambered box supports the coils. Breast coil image-reception sensitivity is three to seven times greater than values obtained with a whole-body coil and shows a smooth spatial variation without oscillatory or sharply breaking behaviors. Increased sensitivity for breast tissue allows us, with a given imaging time, to use thinner sections (5 mm thick) than are possible with the whole-body coil. Since the coil is insensitive to organs such as heart and lung, motion artifact is eliminated, and image quality and resolution are further increased. Simultaneous imaging of both breasts allows direct comparison and increases patient throughput. PMID- 3975404 TI - The quick aortic turn: a rapid method for reformation of the Simmons sidewinder catheter. AB - The Simmons sidewinder catheter is frequently used, but reforming its unique curve may be a problem. In our original description, we used the left subclavian artery to reform the catheter's curve. We no longer use this as our primary method of reformation. Our current method, which is simpler, quicker, and more reliably successful, is described. PMID- 3975405 TI - Transhepatic transcatheter puncture of an occluded biliary intestinal anastomosis for recanalization. AB - A new technique to recanalize a stenosis following hepaticojejunostomy is described. Transhepatic transcatheter puncture of the jejunum is performed followed by dilatation and electroincision of the new track. PMID- 3975406 TI - Early gastric cancer. Recent experience. AB - Early gastric cancer (EGC) is defined as carcinoma in which malignant invasion is limited to the mucosa or submucosa. Records of pathologic examinations from the Hospital of the University of Pennsylvania show that EGC comprised 6% of all gastric carcinomas diagnosed between 1977 and 1983 (7/118 cases) compared with 8.2% of gastric carcinomas diagnosed between 1965 and 1977 (12/147 cases). Double contrast radiographic techniques and fiberoptic endoscopy became widely available at our institution in 1976. Thus, the application of these techniques to symptomatic patients has not improved our ability to diagnose EGC. In contrast, the incidence of EGC in Japan has risen from 5% to 35% with the widespread use of these diagnostic techniques. This discrepancy can be attributed to mass screening of asymptomatic patients in Japan because of the unusually high prevalence of gastric carcinoma in that country. American radiologists and endoscopists should therefore recognize that they are unlikely to experience a significant increase in the detection of EGC as long as these examinations are performed predominantly on symptomatic patients. PMID- 3975407 TI - Percutaneous lumbar diskectomy using a new aspiration probe: porcine and cadaver model. AB - A method of percutaneous aspiration of the nucleus pulposus of lumbar disks is described as performed in four pigs and three cadavers. Through a lateral oblique percutaneous approach, 80-100% of the nucleus pulposus was removed in each of the pigs; approximately 30% of the cadaver disk was removed. A unique aspiration probe and the introducing set as well as the technique are described. The implications for clinical use in patients are discussed. We believe this technique may be an alternative to both surgical diskectomies and chymopapain injection in the treatment of herniated disk disease of the lumbar spine. PMID- 3975408 TI - The empty sella: air-enhanced CT. AB - Two patients who had histories of allergy to iodine compounds underwent air enhanced CT of the sellar cisterns. In both patients, the basal cisterns and empty sella were well demonstrated. The technique, results of which compared favorably with those of metrizamide cisternography, is described. PMID- 3975409 TI - Aspiration biopsy: use of a curved needle. AB - We advocate use of a curved needle to perform biopsies where underlying skeletal or visceral structures may prevent easy passage of a straight needle. PMID- 3975410 TI - Re: Early gastric cancer: radiographic experience. PMID- 3975411 TI - Re: Obtaining informed consent for intravenous contrast-enhanced radiography: pros and cons. PMID- 3975412 TI - Clinical radiographs of the cadaver as a teaching aid in anatomy. AB - The use of clinical histories and radiographs of cadavers as a method for teaching anatomy was explored. This method was found to generate student interest in both anatomy and radiology, to make anatomy clinically relevant, and to supplement the laboratory manual by guiding the student through the dissection of medically or surgically complicated cases. It is an effective and workable method that is easily implemented and virtually cost free. PMID- 3975413 TI - Detailed per-oral small bowel examination vs. enteroclysis. Part I: Expenditures and radiation exposure. AB - Time involved, patient reaction, and radiation exposure were compared for 25 patients undergoing a per-oral small bowel series and 18 having enteroclysis. For the per-oral study, mean room time was 17 minutes and fluoroscopy time was 4 minutes; for enteroclysis, mean room time was 44 minutes and fluoroscopy time was 22 minutes. Side effects were categorized as mild to moderate in two thirds of patients having enteroclysis, whereas they were minimal in 20% of those having the per-oral examination. Radiation exposure was five times greater for enteroclysis. These factors should be considered along with the age of the patient, indications for the examination, and the accuracy of the technique when planning a study of the small bowel. PMID- 3975414 TI - Detailed per-oral small bowel examination vs. enteroclysis. Part II: Radiographic accuracy. AB - Accuracy of the detailed per-oral small bowel series and enteroclysis was compared in 134 patients known to have (or not have) disease of the small bowel. Overall sensitivity of the per-oral examination was 92% and specificity 94%, compared to 94% and 89%, respectively, for enteroclysis. There was no difference between the two in Crohn disease, adhesions, and metastatic disease; however, enteroclysis was thought to be more effective in delineating peritoneal adhesions in patients with obstruction. The authors conclude that while the per-oral study and enteroclysis are equally valid methods of examining the small bowel, the per oral study is preferable as a screening examination because it requires less time, has fewer side effects, and involves a lower radiation exposure. PMID- 3975415 TI - Distribution of colonic polyps: increased incidence of proximal lesions in older patients. AB - Several recent studies have shown a proximal shift in the distribution of colonic carcinoma compared to older studies. Because of the association between polyps and cancer, the authors evaluated the distribution of colonic polyps in 3,664 consecutive patients who had a colon examination over a period of 14 months. A total of 967 colorectal polyps were found in 633 patients. In all, 502 polyps (52%) were proximal to the rectosigmoid. Older patients had significantly more right-sided polyps and fewer rectosigmoid lesions. Large polyps occurred more frequently in the right colon, and this was also statistically significant. Gender has no effect on polyp distribution. The authors conclude that the importance of screening for polyps, particularly on the right side of the colon, increases with age. PMID- 3975416 TI - Idiopathic chronic ulcerative enteritis: a report of two cases. AB - Idiopathic chronic ulcerative enteritis (ICUE) is considered by some physicians to be a variant of sprue. Two patients being treated at our hospital for nonspecific abdominal symptoms had abnormal findings from a small-bowel series; at surgery, an ulcerating process involving the jejunum was found. Clinical, radiological, and pathological findings in these cases suggest that ICUE is a distinct entity. PMID- 3975417 TI - Coiled-spring sign of appendiceal intussusception. AB - Appendiceal intussusception has been considered a rare entity that is difficult to diagnose radiographically. However, a characteristic coiled-spring appearance in the cecum with nonfilling of the appendix has been observed on double-contrast barium enema (DCE) examinations in 11 cases of apparent or proved appendiceal intussusception. In two surgically proved cases, the intussusception was precipitated by an appendiceal mucocele and by endometriosis implants in the appendix. In four other cases, the intussusception was transient and the coiled spring defect in the cecum disappeared with filling of the appendix on the DCE examination (three cases) or on a subsequent barium enema study (one case). The remaining five cases were unproved, although two patients had undergone prior appendectomy and the coiled-spring finding presumably resulted from an intussuscepted appendiceal stump. Only one patient was found to have appendiceal related symptoms. It appears that appendiceal intussusception often occurs as a transient phenomenon in asymptomatic patients, and that it can be diagnosed on the routine DCE examination by a characteristic coiled-spring defect in the cecum. PMID- 3975418 TI - Defecography. AB - Defecography is a technique of examining the rectum and anal canal in which the patient is studied while sitting down rather than recumbent and recordings are obtained both at rest and during straining. The authors describe their findings in 83 patients with dyschezia. Defecation was normal in 28 patients. Prolapse of the anal mucosa was seen in 13 patients and internal procidentia in 23, 12 of whom also had intussusception manifested as rectal prolapse. A deep rectogenital fossa associated with an enterocele was seen in 16 patients; 13 had a proctocele, while fecal retention was seen in 5. Descent of the pelvic floor and changes in the angle between the rectum and anal canal were assessed. The authors recommend defecography as a more physiological means of assessing rectal dysfunction. PMID- 3975419 TI - Bacteremia during double-contrast barium enema examination. AB - Forty-five patients undergoing double-contrast barium enema examinations were studied to identify the incidence of transient bacteremia associated with the examination. Blood cultures were obtained immediately prior to the examination and at 5, 10, and 20 minutes after the start of the examination. Blood samples were cultured in both aerobic and anaerobic media, and four of these cultures were positive for organisms that are common skin contaminants. No bacteremia was identified from enteric pathogens. The data herein suggest that patients with cardiac valvular disease are not at greater risk of bacteremia during double contrast barium enema examinations. PMID- 3975420 TI - Pressure erosions of bone in rheumatoid arthritis: a subject review. AB - Pressure, or compressive, erosions of bone in various locations in patients with rheumatoid arthritis are described. Possible pathophysiologic mechanisms that account for the appearance and distribution of these erosions include osteopenia, soft-tissue laxity, soft-tissue pressure on bone, bone pressure on bone, and muscular forces. PMID- 3975421 TI - Growth arrest recovery lines in hypoparathyroidism. AB - Dense lines paralleling vertebral end plates with a "bone-in-bone" appearance were seen on radiographs of five patients with idiopathic hypoparathyroidism. The lines are similar to those seen in cases in which there is recovery from a growth arrest. The cause of the lines is unclear and may be related not only to the metabolic process itself, but also to its complications and treatment. The finding, although nonspecific, should bring the possibility of idiopathic hypoparathyroidism to mind. PMID- 3975422 TI - Indurative mastopathy: a cause of false-positive mammograms. AB - Indurative mastopathy is a benign, elastotic lesion of the breast characterized by a stellate appearance, with surrounding compressed and distorted ducts causing a pseudo-infiltrative pattern. In previously reported cases of benign sclerosing lesions of the breast there has been no evidence of local recurrence of metastasis following excisional biopsy. The significance of identifying indurative mastopathy lies in recognizing its benign nature despite clinical, radiographic, and gross histologic features that are indistinguishable from malignancy, thereby saving the patient additional surgery or radiotherapy once an excisional biopsy has been performed. PMID- 3975423 TI - Abdominal abscess with low-output fistula: successful percutaneous drainage. AB - Abdominal abscesses in 72 patients were drained percutaneously. Sinograms were obtained at the time of drainage and repeated three to six days later. In 32 patients, a low-output fistulous communication to the alimentary canal, biliary tract, or pancreatic duct was demonstrated. Percutaneously placed drainage catheters provided successful treatment in 27 of these 32 patients. We conclude that low-output fistulous communications to abdominal cavities occur frequently, but can be managed successfully with percutaneous techniques in the majority of patients. PMID- 3975424 TI - Colon perforation following percutaneous nephrostomy and renal calculus removal. AB - Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal. PMID- 3975425 TI - Electrolysis for recanalization of urinary collecting system obstructions: a percutaneous approach. AB - Nine recent endourologic cases are presented that evidence percutaneous electrolysis and electrocautery as new and safe techniques for incising the urothelium. Electrolysis with balloon dilation was employed to remove stones sequestered behind infundibular and/or diverticular neck stenoses, to correct uretero-pelvic junction (UPJ) stenoses and strictures, and to recanalize a totally obstructed fibrotic UPJ. PMID- 3975426 TI - Artificial urinary sphincters in children: radiographic evaluation. AB - Use of the artificial urinary sphincter to treat incontinence in children has increased over the past decade. The hydraulic fluid used in this device is radiopaque, and the radiologist is directly involved in its evaluation. Despite advances in design and surgical technique, mechanical failures and other complications occur. Our experience with 34 artificial sphincters implanted in 31 children during 1973-1983 is reviewed, giving a method of radiographic evaluation, diagnostic errors to avoid, examples of sphincter malfunction, and common complications. PMID- 3975427 TI - Aortic arch in neonates with esophageal atresia: preoperative assessment using CT. AB - Preoperative localization of the aortic arch is important in infants with esophageal atresia to prevent morbidity and death from an ipsilateral surgical approach. Computed tomography is an accurate, noninvasive technique for determining the position of the aortic arch. PMID- 3975428 TI - The cardiomyopathy of obesity. PMID- 3975429 TI - Synthesis and LTD4-antagonist activity of desamino-2-nor-leukotriene analogs. AB - A series of desamino-2-nor-leukotriene analogs has been prepared by the reaction of various thiols with several methyl trans-4,5-epoxy-6Z-alkenoates, followed by deprotection. The products were assessed for their ability to antagonize the LTD4 induced contraction of the isolated guinea pig trachea. Several compounds displayed potent leukotriene antagonist activity, i.e., KB values in the sub micromolar range, while only minimally affecting basal airway tone. The most potent analog, 4-hydroxy-5-(2-carboxyethylthio)-6Z-nonadecenoic acid, antagonized both LTD4- and LTE4-induced contractions of the trachea in an apparently competitive fashion. These agents possess increased potency relative to SK&F 101132, the first leukotriene analog identified as having LT-antagonist activity. Thus, these results demonstrate that deletion of the peptide amino group can produce leukotriene analogs which have minimal intrinsic contractile activity on the isolated guinea pig trachea, yet possess potent leukotriene-antagonistic effects. PMID- 3975430 TI - Effect of a hydantoin prostaglandin analogue, BW245C, during oral dosing in man. AB - Following an open pilot study, the effects of repeated oral doses of BW245C, a hydantoin prostaglandin analogue, were studied in man. Six healthy volunteers received 150 micrograms BW245C or placebo 6-hourly for 5 days according to a double blind randomised balanced design with 7 days interval between treatments. Measurements of headache, facial flushing, heart rate, blood pressure, systolic time intervals, ECG, platelet aggregation responses to ADP and of subjective effects were made before and 1 and 3 h after the first dose of BW245C/placebo on days 1, 3 and 5 of dosing. BW245C produced significantly (p less than 0.05) higher headache scores than placebo on days 3 and 5; facial flushing, nasal stuffiness and abdominal discomfort were more frequent on BW245C than placebo. Heart rate, derived from the ECG, was significantly (p less than 0.05) higher and pre-ejection period significantly (p less than 0.05) shorter on BW245C at 1 h after dosing on each day. Left ventricular ejection time index, QS2 index, PR interval, QRS duration and T wave height were unchanged. Heart rate, counted at the radial pulse, and systolic and diastolic blood pressure, all measured lying and standing, were similar for BW245C and placebo. Platelet aggregation responses were not significantly different between the two treatments. The results indicate that repeated oral doses of BW245C, sufficient to cause moderately uncomfortable subjective effects, do not inhibit platelet aggregation. PMID- 3975431 TI - [The collapsing house of cards. On Bernd Nitzschke's essay on the origin of the id]. PMID- 3975432 TI - [The rediscovered id. On Bernd Nitzschke's essay on the origin of the id]. PMID- 3975433 TI - [Large id or small id? Remarks on the article by Bernd Nitzschke on the origin of the id]. PMID- 3975434 TI - [Georg Groddeck's philosophy of the id]. PMID- 3975435 TI - [Genealogy of the id]. PMID- 3975436 TI - What is known about tumour proliferation rates to choose between accelerated fractionation or hyperfractionation? AB - Repopulation of surviving clonogenic tumour cells during fractionated radiotherapy is one of the crucial factors determining cure probability in radiotherapy. Clinical and experimental data suggest that repopulation rates vary considerably between different tumours but may be similar to the cell production rates in the untreated tumour. For those tumours which repopulate fast, such as squamous cell carcinomas, bladder cancer and colorectal carcinomas, accelerated fractionation may be indicated. PMID- 3975437 TI - Hemibody irradiation in multiple myeloma. AB - Eighteen patients with multiple myeloma were treated by hemibody irradiation using large single fractions, usually to a dose of 10 Gy (lower half) and 7.5 Gy (upper half). All except one patient had previously been treated by multiple courses of conventional chemotherapy with melphalan and prednisone, and were considered to be resistant to further chemotherapy. In most cases, local field irradiation had also been given for symptomatic bone pain. Of the 13 patients who had symptoms at the start of hemibody irradiation, 11 improved sufficiently for their analgesia requirement to be reduced. In eight patients, there was a significant fall in circulating immunoglobulin but no patient with Bence-Jones proteinuria had complete resolution of this biochemical abnormality. Although thrombocytopenia and neutropenia were common, only two patients required platelet transfusion and the treatment was in general extremely well tolerated. Survival following hemibody irradiation was similar to the survival reported from the use of "second-line" chemotherapy and we feel that hemibody irradiation is a more acceptable alternative for most patients. PMID- 3975438 TI - Conservative treatment of early carcinoma of the breast: significance of axillary dissection and iridium implant. AB - One hundred and ninety five patients with T1T2 less than 3 cm N0 infiltrating carcinomas of the breast have been treated between 1973 and 1982 with local excision followed by cobalt irradiation and iridium boost. One hundred and sixty five underwent an elective axillary dissection. The overall survival at 5 years is 87% and the NED survival 81%. The size of the tumor on the mammogram and on the operative specimen is of significant prognostic value. At 5 years the probability of local relapse in the breast is 4% and the probability of axillary recurrence is 1.2% after axillary dissection. Comparison of these results with those of an historical group of 300 patients treated between 1950 and 1973 indicates an improvement in the local control with good cosmetic results and no obvious change in axillary recurrence and overall survival. PMID- 3975439 TI - Reirradiation of head and neck cancers. Presentation of 35 cases treated at the Gustave Roussy Institute. AB - Thirty-five patients with head and neck carcinoma who were treated with a second course of radiotherapy for relapse or second malignancy at the Gustave Roussy Institute between 1973 and 1981 were studied. Immediate tolerance for total doses greater than 80 Gy was good but 37% of patients suffered from delayed necrosis or bleeding. Thirty-seven per cent of lesions were locally controlled at 3 months and 97% of patients showed a subjective improvement to reirradiation. Local control was obtained in 53% of patients aged between 40 and 60 as compared to 19% in other age groups, and was obtained in 55% of patients who were irradiated a second time with a dose greater than 60 Gy as compared to 8% for doses less than 60 Gy. Complications following treatment are related to failure to achieve local control and area of second treatment fields greater than 70 cm2. Survival was worse for those patients having an interval less than 12 months between the two courses of irradiation and those in whom local control was not achieved. PMID- 3975440 TI - Human tumour xenografts in radiotherapeutic research. AB - The radiation response of human tumour xenografts has been shown to vary considerably among tumours of different histological types, tumours of the same histological type and cell subpopulations of single tumours. There is encouraging evidence that the radiation response correlates with clinical responsiveness when xenografts are exposed to single radiation doses and single cell survival in vitro or growth delay in vivo is used as endpoint. If subsequent research supports this conclusion, human tumour xenografts may be useful in studies aimed at (a) elucidating the underlying mechanisms for intertumour differences in radiation response and (b) developing short-term in vitro assays for clinical radiosensitivity testing. However, there are at least three main disadvantages with xenografts as models for human cancer. Firstly, the volume-doubling time is usually shorter than for tumours in man. Secondly, the vascular system and the supporting stromal elements originate from the host. Thirdly, host defence mechanisms may be active against xenografts. The radiation response of xenografts may be influenced by these three aspects and hence fail to reflect clinical responsiveness, especially when exposed to fractionated irradiation or when local tumour control is used as endpoint. PMID- 3975441 TI - Scanning electron microscopy and transmission electron microscopy of the ciliated cells of the trachea of the rabbit treated with misonidazole alone and in combination with ionizing radiation. AB - The trachea is often located in the treatment volume when irradiating malignant tumours in the thorax. In order to evaluate possible synergism between misonidazole and irradiation on this tissue, the following studies were made. Fifty rabbits were treated with daily injections of 100 mg misonidazole given i.p. on consecutive days from 1 to 10 days. Morphological investigations of the trachea were made with scanning electron microscopy (SEM), transmission electron microscopy (TEM) and light microscopy (LM). Physiological examinations were performed with recording of the ciliary beat frequency. The results were compared with those from a group of 100 rabbits given misonidazole in a similar manner and exposed to irradiation (2 Gy) 15-30 min after each injection. Ten rabbits were used as controls. The results are compared to the effect of fractionated irradiation alone with 2 Gy/day. Fractionated irradiation of the ciliary epithelium in the trachea of the rabbit has shown dose-dependent physiological and morphological effects. Misonidazole potentiates these effects of radiation with a more pronounced change of the ciliary beat frequency and an increased metabolic activity as could be visualized on TEM. The combination of drug and irradiation also induced a hyperplasia of the ciliary epithelium. Misonidazole itself had no effect on the ciliary beat frequency, but caused a hypoplasia of the ciliary epithelium. PMID- 3975442 TI - Screens in ovoids of a Selectron cervix applicator. AB - The addition of screens in the vaginal source holders of a cervix applicator for intracavitary brachytherapy reduces the dose to rectum and bladder and therefore diminishes the number of rectal and vesical complications. Shielding properties of tungsten rectal and bladder screens of a Selectron cervix applicator, loaded with spherical cesium sources, were determined for verification of dose calculations. Transmission characteristics of half-disk shaped tungsten screen segments in a single ovoid were measured in a water phantom. The minimum transmission ratios are 60, 70 and 80% for segment thickness of 5.0, 3.5 and 2.0 mm, respectively. The accuracy of the new screen correction algorithm of the Selectron Planning System was assessed by comparing measured and calculated dose rates and was found to be better than +/- 4%. The correction algorithm provides a method to analyse the efficacy of screens in the ovoids for various segment geometries and orientations without extensive phantom measurements. Isotransmission and isodose calculations were made for a typical clinical applicator set-up and source distribution. The dose reduction to rectum and bladder, near the bottom and top of the ovoids was analysed in detail. A 3.5 mm thick rectum and bladder screen in each ovoid reduces the dose approximately by 20% to the rectum and by 15% to the bladder. A distance enlargement of about 5 mm between ovoid and rectum or bladder, e.g. by packing, results in a comparable dose reduction. Shielding properties of a Selectron cervix applicator, provided with screens, were compared with those of some Fletcher-type applicators. Significant differences between the transmission ratios and shielded areas of the screens of both systems near rectum and bladder were observed. PMID- 3975443 TI - The effects of ionizing radiation on eight cardiac pacemakers and the influence of electromagnetic interference from two linear accelerators. AB - Eight cardiac pacemakers were irradiated in a cobalt-60 beam. Two out of six demand-type pacemakers showed an alarming decrease in pulse repetition frequency when irradiated to dose levels that are used in radiotherapy (less than 100 Gy). Two modern programmable pacemakers showed a failure at a dose of 97 and 147 Gy, respectively. The dose levels at which these failures occurred were low enough to recommend that cardiac pacemakers should always be kept outside the radiation beam. The signals induced by electromagnetic interference (EMI) from two linear accelerators were measured using a simulation model of a pacemaker. In the laboratory, 22 modern-type pacemakers were tested with these signals to determine the sensitivity for the electromagnetic fields in the treatment rooms. It was observed that an inhibition of one pacemaker pulse was to be expected on one of the two linear accelerators when switching the machine on and off. No permanent effects were found. These findings resulted in the recommendation in our department not to use this treatment machine for radiation therapy of pacemaker bearing patients. PMID- 3975444 TI - A method for consistent precision radiation therapy. AB - Using a meticulous setup procedure in which repeated portal films were taken before each treatment until satisfactory portal verifications were obtained, a high degree of precision in patient positioning was achieved. A fluctuation from treatment to treatment, over 11 treatments, of less than +/- 0.10 cm (S.D.) for anatomical points inside the treatment field was obtained. This, however, only applies to specific anatomical points selected for this positioning procedure and does not apply to all points within the portal. We have generalized this procedure and have suggested a means by which any target volume can be consistently positioned which may approach this degree of precision. PMID- 3975446 TI - [Plasma levels of bupivacaine following inadvertent intravascular injection via a peridural catheter]. AB - We report on a 57 year old woman, who suffered from an inadvertent intravascular injection of bupivacaine via a perforating epidural catheter. At the end of the epidural injection she showed symptoms of toxicity caused by the local anaesthetic. Venous blood dripping out of the epidural catheter and central venous blood were sampled simultaneously and analysis of plasma levels of bupivacaine were performed. PMID- 3975445 TI - [Early postoperative mobilization of the knee joint following arthrolysis with continuous catheter peridural anesthesia]. AB - 21 patients with stiffness of the knee were operated on, for mobilisation under epidural analgesia. As soon as the patients returned to the ward the leg was placed on a mobilisation-splint driven by an electric motor. Epidural analgesia was continued by infusion of 0.25 ml/kg . h of 0.125% bupivacaine via epidural catheter for a period of four to six days whereafter the catheter was removed. Analgesia during mobilisation was complete or almost complete in 15 patients. In 5 cases loss of sensitivity was present predominantly or selectively in the contralateral extremity, in one patient segmental extension of epidural analgesia did not include the knee. The bladder had to be catheterized in 9 patients, three suffered from decubital ulcers which disappeared after removal of the epidural catheter. In spite of the frequency of side effects, which can be diminished by further experience, continuous epidural analgesia is advantageous for early mobilisation of the knee after arthrolysis. The patients must be informed about side effects and possible complications before giving their consent for this method of long lasting analgesia. PMID- 3975447 TI - [A clinical study of circulatory depression and pharmacokinetics following peridural anesthesia with bupivacaine 0.75%. Preoperative phase]. AB - In previous study it was demonstrated that the clinical use of bupivacaine 0.75% for peridural anesthesia appears to be without risk. There was seen no toxicity (bradycardia, convulsion, respiratory depression etc) at the measured plasma levels. Very important is the early onset of action of this drug contrary to the other used concentrations. It is useful for a major surgery. Hypotension can be avoided by applying volume transfusion. PMID- 3975448 TI - Behavioral effects of alcohol in sons of alcoholics. AB - This paper describes a search for genetically mediated biological factors that contribute to a predisposition toward alcoholism. Healthy, nonalcoholic, drinking men aged 21 to 25 who have a close alcoholic relative were selected as the family history positive (FHP) or higher risk subjects and matched with lower risk controls (family history negative, or FHN) on demography, drinking and smoking history, and height to weight ratio. Comparisons of this higher and lower risk population revealed no significant differences in selected personality attributes, and an alcohol challenge resulted in identical patterns of blood alcohol over time. However, the FHP men developed higher levels of the first breakdown product of ethanol, acetaldehyde, after drinking, demonstrated a less intense intoxication than the FHN controls despite identical blood alcohol concentrations, and tended to show a lower amplitude of a positive brain wave sent at about 300 msec in an event-related potential paradigm. These results may be clues to help investigators identify genetic markers of a predisposition toward alcoholism. PMID- 3975449 TI - Alcohol, coronary heart disease, and total mortality. AB - The dose-response relationship between alcohol consumption, coronary heart disease, and total mortality was examined. The results indicated that moderate consumers (1 to 2 drinks/day) were at a lower risk of coronary heart disease than nonconsumers or heavy consumers. Evaluation of total mortality in relationship to alcohol consumption reveals that a similar U-shaped relationship to longevity exists. PMID- 3975450 TI - The EEG in persons at risk for alcoholism. AB - Alcoholics tend to have a relatively small amount of alpha and a large amount of beta activity in their EEG. This pattern may be a consequence or an antecedent of alcoholism. Attempts to demonstrate this EEG pattern in subjects who were at high risk (HR) for alcoholism (because they had alcoholic fathers) have yielded equivocal results. However, electrophysiological changes elicited by a single dose of alcohol differentiated HR subjects from controls. The HR subjects exhibited greater increases of slow-alpha energy and greater decreases of fast alpha energy after alcohol administration than controls. In another study, the HR subjects showed a greater decrease of a late positive component of the auditory evoked potential after alcohol than controls. Thus the HR subjects show greater electrophysiological responses to alcohol than controls. These effects are not related to differences in alcohol metabolism, and they may reflect a biologic marker for CNS sensitivity to alcohol. Alternative interpretations of these findings are discussed and suggestions for further research are offered. PMID- 3975451 TI - Alcohol use and cognitive functioning in men and women college students. AB - Two studies of the relationship between alcohol consumption and cognitive functioning in men and women college students are presented. Study 1 showed several predicted relationships of decreased cognitive performance on various tests with increased quantity of alcohol per occasion and total lifetime consumption in both women and men. Study 2a was designed to replicate study 1, but the pattern of relationship of cognitive and consumption variables was quite different, e.g., increased cognitive performance was associated with increased quantity per occasion for several tests in males. Study 2b was designed to demonstrate reversibility of the negative effects of consumption on cognition by randomly assigning half of the subjects to abstain for two weeks. Reversibility was not demonstrated. Difficulties in studying these effects in college students are discussed. PMID- 3975452 TI - CT demonstration of the early effects of alcohol on the brain. AB - CT evidence of brain damage has been sought in subjects consuming alcohol between 10 g/day to over 200 g/day. Dietary contributing factors have been evaluated. The level of atrophy (shrinkage) has been correlated with intellectual performance. To establish a relationship between alcohol intake and brain structure and function, re-examination of subjects over a 6- to 12-month period of abstinence has been undertaken to examine any reversibility features. A record of liver function showed that brain damage always precedes liver damage. Subjects were re examined a second time, who had initially abstained for six months and then had returned either to their original level of consumption or to one that was somewhat reduced. A regression in initial improvement was considered evidence of reversible brain damage that had originally been related to alcohol. The threshold consumption for CT damage was 40 g/day, but the level of CT atrophy at which cognitive dysfunction appeared has still to be established. PMID- 3975454 TI - Brain damage in social drinkers? Reasons for caution. PMID- 3975453 TI - Cognitive deficits and morphological cerebral changes in a random sample of social drinkers. AB - A random sample of 200 men and 200 women taken from the general population as well as subsamples of 31 male and 17 female excessive social drinkers were investigated with neuropsychological tests and computed tomography of the brain. Relatively high alcohol intake per drinking occasion did not give evidence of cognitive deficits or morphological cerebral changes. However, in males, mild cognitive deficits and morphological cerebral changes as a result of high recent alcohol intake, particularly during the 24-hr period prior to the investigation, were observed. When excluding acute effects of recent alcohol intake, mild cognitive deficits but not morphological cerebral changes that are apparently due to long-term excessive social drinking were observed in males. In females there was no association between the drinking variables and cognitive deficits or morphological cerebral changes, probably due to their less advanced drinking habits. It is suggested that future risk evaluations and estimations of safe alcohol intake should take into consideration the potential risk for brain damage due to excessive social drinking. However, it is premature to make any definite statements about safe alcohol intake and the risk for brain damage in social drinkers from the general population. PMID- 3975455 TI - Statistical issues for research on social drinkers. AB - The crucial problem in alcohol research is the large amount of inherently uncontrolled variation in the dependent variables. Because randomization with respect to key independent variables is frequently impractical or impossible, quasi-experimental and survey methods are being used to control residual variation statistically. For various reasons, however, the methods have often not been properly applied in alcohol research, endangering the replicability of true findings and prolonging the life of false claims. Ill-advised practices found in alcohol research that are discussed here are the use of partial correlations and standardized regression coefficients, of categorization or truncation of independent variables, and of available or convenient samples. It is recommended that researchers use unstandardized regression models, avoid categorizing independent variables, and scale them either to agreed on units of measure or use natural units (e.g., ounces or deciliters of alcohol consumed per occasion), and employ randomization or random sampling. PMID- 3975456 TI - Psychopathology in adopted-out children of alcoholics. The Stockholm Adoption Study. AB - The inheritance of alcohol abuse and other psychopathology was studied in 862 men and 913 women adopted by nonrelatives at an early age in Sweden. Both male and female adoptees had a greater risk of alcohol abuse if their biologic, but not adoptive, parents were alcoholic. We distinguished two types of alcoholism that have distinct genetic and environmental causes and that differ in frequency of alcohol abuse and somatoform disorders in women. The combination of both genetic and environmental risk factors is required for development of alcoholism in the most common type. In contrast, in families with the less common type of susceptibility, alcohol abuse is highly heritable in the men, but the women have multiple somatic complaints without alcohol abuse. The implications of these findings of genetic heterogeneity and gene-environment interaction are discussed in relation to research, prevention, and treatment. PMID- 3975457 TI - Premorbid assessment of young men at high risk for alcoholism. AB - The high-risk paradigm has been applied to a group of sons of alcoholic fathers and a control group without parental alcoholism. The sample is selected from a Danish birth cohort (1959 to 1961) including 8949 consecutive deliveries. A multidisciplinary assessment was undertaken when the subjects were 18 to 19 years old. The over-all results from this premorbid phase of the longitudinal study are presented. Items such as impulsivity, restlessness, and specific school problems are characteristic for the high-risk group and may be of predictive importance. A follow-up assessment of the sample is planned during the next five to ten years. PMID- 3975458 TI - Minimal brain dysfunction and neuropsychological test performance in offspring of alcoholics. AB - Previous studies have indicated that alcoholics report a high frequency of problem behaviors in childhood. Additionally, certain neuropsychological deficits are often evident. Both childhood problem behavior and antecedent neuropsychological deficits have been suggested as risk factors for the later development of alcoholism. However, neither set of variables nor their interrelationship have been previously investigated in a sample at high risk for the development of alcoholism. In this study, unaffected offspring of an alcoholic parent and unaffected offspring of nonalcoholic parents were examined. Although attention deficit disorder/hyperactivity and conduct disorder prior to age twelve predicted the onset of drinking, the frequency of childhood behaviors was similar in both groups. Further, the neuropsychological performances of the high-risk and low-risk samples were also similar and within normal limits. The theoretical and methodological implications of these findings for future research are discussed. PMID- 3975459 TI - [Form of presentation and clinical manifestations of Crohn disease in our environment]. PMID- 3975460 TI - [Optical study using ultrastructural time-lapse microcinematography of liver parenchymal and sinusoidal cells maintained in co-cultivation. 1]. PMID- 3975461 TI - [Solvent effects on cholesterol calculi: an in vitro study using octanoic acid, glycerol monooctanate, sodium cholate, heparin and ursodeoxycholic acid]. PMID- 3975462 TI - [Comparative study between the Lundh test and fecal chymotrypsin in chronic pancreatitis]. PMID- 3975463 TI - [Hepatic form of Q fever. Apropos of a case]. PMID- 3975464 TI - [Presentation of a new case of pure Caroli's disease]. PMID- 3975465 TI - [Double pylorus]. PMID- 3975466 TI - [Primary ano-rectal melanoma, a new case]. PMID- 3975467 TI - The emperor's new clothes: a preppy pilot. PMID- 3975468 TI - The role of the discharge planner. PMID- 3975469 TI - Eulogy for a dead survivor. PMID- 3975470 TI - Strategies for the enhancement of visual function in individuals with fixed visual deficits: an interdisciplinary model. PMID- 3975471 TI - [Influence of the photoperiod on the production and fecundity of spermatozoa in the adult Ile-de-France ram]. AB - Two groups, A and B, of 5 adult Ile-de-France rams each of the same age were exposed for 52 weeks (October 1975 to October 1976) to an artificial light regime reproducing natural variations of daylength (DL). In group A, DL increased from 8 to 16 h during the first 26 weeks and then decreased. In group B, DL varied in an opposite manner. Light intensity was constant (300 lux/m2) and ambient temperature was controlled (20 +/- 4 degrees C). The rams were collected using an artificial vagina twice weekly (2 X 2 ejaculates/male/week) during the whole experimental period (EP). The volume and concentration of each ejaculate were recorded. The pH of the raw semen was also measured on the first ejaculate once a week or every two weeks, according to material possibilities. The unselected ejaculates of all rams were used for artificial insemination (AI) on the same days in the same flocks between January and October 1976. AI (980 ewes) was always carried out after oestrus synchronization (FGA + PMSG). Amongst these ejaculates, some (3 ejaculates/male/group/period) could be used for both in vitro (pH) and in vivo (AI) measurements: - Weekly sperm production (SP) varied in an opposite manner in both groups during the whole EP. In group A, minimal (10.6 +/- 4.0.10(9) and maximal (25.5 +/- 5.1.10(9] levels were reached from weeks 12 to 28 and weeks 38 to 52, respectively. In group B, SP was maximal (21.8 +/- 2.3.10(9] from weeks 9 to 24 and minimal (12.7 +/- 5.2.10(9] from weeks 36 to 49. The differences between rams were significant within periods of high and low production. - The sperm pH was somewhat higher in both groups when DL increased and vice-versa. Fertility after AI was higher with rams exposed to short days than with rams exposed to long days (65.7 vs 56.7%; P less than 0.01). The season of AI had no effect on mean fertility (61.0 vs 62.3% for ewes inseminated from January to June and from July to October, respectively), whatever the DL. No correlation was found between the pH of the sperm and its fertilizing ability. From January to April, a highly significant correlation existed between fertility and prolificacy in the 10 rams (r = + 0.607). These results show that photoperiodism has an important effect on both ejaculated sperm production and fertility in rams.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3975472 TI - [Effect of genotype, age and season on preovulatory follicles in the rabbit 8 hours after mating]. AB - The purpose of this study was to compare the population of preovulatory follicles in two INRA strains of rabbits of different natural ovulation rates. The two strains chosen were the Californian (A1066) with an ovulation rate of 13 and the New Zealand (A1077) with an ovulation rate of 11. Nulliparous, primiparous and multiparous does were followed during the four seasons. Eight hours after mating the right ovaries of 154 of these animals were collected. The following data were recorded : the number of follicles with an area equal to or more than 5.10(5) micron 2 (diameter : 0.8 mm), the area of that section of the follicle containing the oocyte, and the presence of pyknotic cells with granulosa. The higher ovulation rate of Californian does was due to a significantly higher number of healthy follicles. The mean size of these follicles, their area (between 5.10(5) micron 2 and 3.10(6) micron 2) distribution and rate of atresia were similar in the two strains. Environmental factors led to changes in the number and size of healthy follicles which were responsible for the number of ovulations, while the rate of atresia remained constant. The seasonal effect was most marked in November by a definite reduction in follicle size, particularly in multiparous does. Follicle number and size increased with parity number; this seemed to be due to an acceleration of the growth rate and to the increasing number of large sized follicles. As there were no interactions between genotype and environmental factors, it can be concluded that the latter modified follicular growth parameters in the same way in both strains and that these strains can be identified in all cases on the basis of their ovarian characteristics. About 1/3 of the does exhibited almost exclusively healthy follicles, while in the remaining 2/3 both healthy and atretic follicles were seen. These proportions were the same in both female genotypes. Those possessing only healthy follicles also had the largest ones. It is suggested that atresia could be a regulatory factor of ovulation rate along with the preovulatory level of FSH. 23% of the does accepting the buck showed no oocytes in meiosis, even though their follicle size exceeded 5.10(5) micron 2. Th mean number of these follicles was the same as that of does with oocytes in meiosis, but they were half as large. It is suggested that the follicle oestrogen secretion of these does was not high enough to induce ovulatory release of LH at mating. PMID- 3975473 TI - Influence of photoperiod on the time of birth in the rat. IV. Effects of an imposed feeding rhythm. AB - In order to study the respective effects of photoperiod and feeding rhythm on the time of birth in rats, the onset of fetus expulsion was determined in six experimental groups. Under the standard light regime (14L-10D; lights-on at 6 a.m.), rats caged alone or in threes and fed ad libitum (groups C and 3C) gave birth over two preferential periods, the first during the late light phase of day 22 of gestation and the second during the early light phase of day 23. Under the same conditions, rats fed during a restricted period (from 9 a.m. to 11 a.m.) from day 8 of gestation (groups PF and 3PF) gave birth during a single period, starting just before and spreading over the first half of the night separating the last two days of gestation. The number of rats per cage affected birth distribution slightly, but an inverse effect was observed between the feeding regime and the social group constituted by mating (group 3C vs 3PF). Most births occurred after lights-on at day 23 of gestation when the rats were caged alone, fed ad libitum and submitted to a progressive shift in the light phase (group BC). This shift was realized by daily advancing dawn and dusk every day by 15 min from day 8 of gestation. Under these conditions, food restriction from 9 a.m. to 11 a.m. (group BC-PF) resulted in an intermediate distribution between groups BC and PF. The data show that time of birth in rats can be modulated by two different biological entrainers, photoperiod and feeding rhythm and that time of birth, in a given case, is determined by the interactions between these two factors. PMID- 3975474 TI - Assessment of renal blood flow in dogs: analysis of 131I-hippuran blood clearance in healthy dogs and in dogs with proteinuria. AB - In 30 clinically healthy dogs (weights 7.5 to 57 kg) and in 41 proteinuric dogs the 131I-hippuran blood disappearance curve after single injection was determined (0 to 90 minutes), described by a bi-exponential function and analysed according to a two compartment model. The dependence of the blood clearance (C), representing an effective renal blood flow, on the bodyweight (W) (kg) could be described with both a linear function (C = 61 + 13.2 W ml min-1) and a power function (C = 30.56 W0.79 ml min-1) in the healthy dogs. The results of the regression between blood clearance and bodyweight were reproducible (r = 0.92, n = 10 residual error 12 per cent, P less than 0.01). PMID- 3975475 TI - Neutrophilic nodules in the intestinal walls of Japanese monkeys associated with the neutrophil chemotactic activity of larval extracts and secretions of Oesophagostomum aculeatum. AB - High neutrophil chemotactic activity was detected in the culture medium from Oesophagostomum aculeatum larvae in vitro using blind-well chambers with Millipore filters, and guinea pig leucocytes as indicator cells. Neutrophil chemotactic activity was also detected in the extract from larval worms in a dose dependent fashion. This activity was detected in the low molecular weight fractions adjacent to a sodium chloride marker by gel filtration on Sephadex G200. These results were further confirmed with monkey neutrophils. The possible role of this activity in the formation of granulomatous lesions rich in neutrophils found in O aculeatum infections in the Japanese monkey is discussed. PMID- 3975476 TI - Myometrial electrical activity during pregnancy and parturition in the pygmy goat. AB - To quantify the pattern of myometrial activity during gestation and parturition, one bipolar electrode was implanted on each uterine horn of four bilaterally pregnant pygmy goats between days 102 and 120 of gestation. After a recovery period, electromyographic recordings were made for at least six hours per day and continuously when parturition was judged to be imminent. During late gestation myometrial activity occurred as discrete episodes of myometrial electrical activity (EMEA) with a mean duration ranging from 6.2 +/- 2.07 to 8.3 +/- 1.60 minutes. The mean interval between two successive EMEAs ranged from 45.8 +/- 19.95 to 74.7 +/- 42.27 minutes. In three of the four goats these characteristics were not significantly different from the two uterine horns. Parturition was preceded by a prolonged period (eight to 12 hours) of myometrial quiescence. It was only from 19 to 15 hours before expulsion of the first kid that total duration of EMG activity increased. This finally resulted in the regular occurrence of bursts which occupied 25 to 30 per cent of the recording time. The results demonstrate that, as in the sheep, cow and pig, the myometrium is active during late pregnancy. It is postulated that luteolysis coincides with the prolonged period of myometrial quiescence which precedes the onset of the parturient pattern of uterine activity. PMID- 3975477 TI - In vitro activity of tiamulin against porcine mycoplasmas. AB - The activity of tiamulin against Mycoplasma hyopneumoniae, M flocculare, M hyorhinis and M hyosynoviae grown in liquid medium was assessed in vitro. With the first three of these mycoplasmas, the activity of tylosin and oxytetracycline was observed in parallel. Tiamulin was more active against M hyopneumoniae and M flocculare, but there was less disparity between the three antibiotics with the strain of M hyorhinis tested. Tiamulin was notably more active against M hyosynoviae than against M hyopneumoniae. It was more difficult to suppress M hyopneumoniae than the other mycoplasmas with tiamulin. This persistence of M hyopneumoniae was more striking when M hyopneumoniae and M hyosynoviae were tested in parallel. PMID- 3975478 TI - Cardiopulmonary effects of a xylazine and ketamine combination in pigs. AB - The carotid and pulmonary arteries were catheterised in six pigs anaesthetised with thiopentone sodium and halothane. A minimum of five days was allowed to elapse before the investigation. The carotid artery pressure, pulmonary artery pressure, cardiac output, arterial pH, PO2, PCO2, plasma glucose and lactate were measured before and after intravenous injection of xylazine (1 mg kg-1) and ketamine 10 mg kg-1). Complete analgesia was produced for 10 minutes in all pigs but by 25 minutes all animals responded to a painful stimulus. The cardiac output and arterial PO2 were significantly decreased for 30 minutes and 10 minutes, respectively. The total vascular resistance was significantly increased. No statistically significant changes occurred in the other variables measured. PMID- 3975479 TI - Use of phage for the identification of Brucella canis and Brucella ovis cultures. AB - The brucella phage strains R, R/O and R/C standardised at routine test dilution on their propagating strains were effective in identifying cultures of Brucella ovis and B canis and in differentiating these from other non-smooth brucella isolates. PMID- 3975480 TI - Enzyme-linked immunosorbent assay for antibodies to Campylobacter fetus in bovine vaginal mucus. AB - An enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies to Campylobacter fetus subspecies venerealis in bovine vaginal mucus. The results of testing 168 samples from experimentally infected, field cases and control cows showed that the ELISA was more sensitive than the vaginal mucus agglutination test and also detected antibodies in earlier stages of infection. PMID- 3975481 TI - Effect of oestrogen and progesterone on sodium, potassium and water balance in sheep. AB - The effects of oestrogen and progesterone, injected alone or during successive periods, were studied in mature ovariectomised ewes on sodium intakes ranging from 1 to 4 mmol kg-1 d-1. Progesterone had no effect on fluid and electrolyte balance. Oestrogen (17 beta oestradiol) inhibited drinking but had little effect on water excretion whereas it reduced both food intake and urinary potassium concentration. Since the resulting changes in potassium intake and excretion were very similar, oestrogen had little net effect on potassium balance; neither change lasted beyond the treatment period. Oestrogen had a biphasic effect on urinary and faecal sodium excretion, an initial enhancement of salt loss being followed by sodium retention. Faecal sodium retention and the biphasic effect on renal sodium excretion were independent of changes in food intake. These observations are discussed in relation to the pattern of change of electrolyte balance during the reproductive cycle and the influence of changes in food intake and factors affecting sodium preference. The fact that a variety of responses is involved in a coordinated change of sodium balance is emphasised and its possible importance is considered. PMID- 3975482 TI - Influence of dietary protein on the pathophysiology of ovine haemonchosis in Finn Dorset and Scottish Blackface lambs given a single moderate infection. AB - Two experiments were conducted to examine the influence of dietary protein on the pathophysiology of Haemonchus contortus in lambs of two breeds, namely Finn Dorset and Scottish Blackface. Erythrokinetic and metabolic studies using 51Cr red cells, 59Fe-transferrin and 125I-albumin, and digestive efficiency and nitrogen balance measurements were conducted between four and six weeks after infection. Identical radioisotopic and nutritional studies were also conducted on pair-fed control lambs of both breeds. The results demonstrated that in normal control animals, there were no significant effects of diet or breed on any of the erythrokinetic, metabolic or nutritional parameters, with the possible exception of red cell survival which was considerably longer in the Finn Dorset lambs. However, in the infected animals diet and breed did influence those parameters. The severest effects were seen in the infected Finn Dorset lambs given the low protein diet. These animals had the highest level of abomasal blood loss and this was associated with low red cell volumes and high levels of both albumin catabolism and plasma iron turnover. These animals were also in negative nitrogen balance which was partly accounted for by a significantly greater urinary nitrogen loss compared with their pair-fed controls and partly due to the poorer digestibility of the crude protein fraction of the diet. In contrast, although the infected Scottish Blackface lambs had high levels of blood loss and associated pathophysiological changes, these did not differ between dietary treatments and were similar to the changes in the infected Finn Dorset lambs given the high protein diet. PMID- 3975483 TI - Influence of dietary protein on parasite establishment and pathogenesis in Finn Dorset and Scottish Blackface lambs given a single moderate infection of Haemonchus contortus. AB - An experiment was conducted to examine the influence of dietary protein on parasite establishment and pathogenesis of Haemonchus contortus in lambs of two breeds. Finn Dorset and Scottish Blackface. The lambs were introduced to high protein (170 g crude protein (CP) kg-1 dry matter (DM) or low protein (88 g CP kg 1 DM) diets at three months old and infected one month later with 125 larvae (kg bodyweight)-1. Blood and faecal samples were collected for analysis and bodyweights recorded weekly. The lambs were killed 20 weeks after infection. A second experiment was conducted in Blackface lambs solely to determine the influence on parasite establishment of the high and low protein diets following infection with 125 larvae kg-1. These lambs were killed five or 14 weeks after infection. Results showed that in Scottish Blackface lambs dietary protein did not significantly influence the establishment of H contortus. However, in Finn Dorset lambs dietary protein may have influenced parasite establishment since lambs on the low protein diet had a higher faecal egg output four weeks after infection and more severe clinical signs than infected lambs of the same breed on a high protein diet. PMID- 3975484 TI - Magnesium concentrations in the ventricular and lumbar cerebrospinal fluid of hypomagnesaemic cows. AB - Samples of ventricular and lumbar cerebrospinal fluid (CSF) were taken at intervals from six lactating dairy cows, made hypomagnesaemic by feeding a magnesium-deficient diet. Initially the ventricular CSF had a higher magnesium concentration than lumbar CSF but as the cows became hypomagnesaemic the magnesium concentration in ventricular CSF decreased more rapidly than that in lumbar CSF. Tetany occurred when the concentration of magnesium in ventricular CSF fell below about 0.5 mmol litre-1. Intravenous infusion of magnesium into two hypomagnesaemic cows increased the concentration of magnesium in ventricular CSF before there was any change in the lumbar CSF. Newly formed CSF from the ventricles appeared to be more sensitive to changes in the concentration of magnesium in plasma than lumbar CSF which equilibrates with the diffusible magnesium of the central nervous system. PMID- 3975485 TI - Upper airway resistance in healthy Friesian cattle. AB - Total pulmonary resistance (RL) and upper airway resistance (Ruaw) were measured in nine healthy unsedated Friesian cattle divided into three age groups. Mean values for these three groups of animals aged four, 188 and 1157 days were 0.32, 0.13 and 0.06 kPa litre-1 s for RL; 0.14, 0.09 and 0.05 kPa litre-1 s for Ruaw; and 0.45, 0.68 and 0.79 for the ratio Ruaw/RL respectively. Ruaw, measured with the head in the normal position, did not significantly differ from values obtained with the head in the horizontal position. Ruaw, measured with the head in the vertical position, was approximately three times greater than when measured in the two other positions. PMID- 3975487 TI - Prenatal occurrence and mode of inheritance of neuraxial oedema in Poll Hereford calves. AB - Breeding experiments were conducted in 1981, 1982 and 1983 using bulls and cows that were obligatory heterozygotes for neuraxial oedema. Fifty-six calves were born in the herd, 14 of which were diagnosed as cases of neuraxial oedema. The mean gestation length for affected calves born in 1983 was nine days shorter than that for unaffected calves. Observations were made of the birth of three affected calves. In one calf spasms of the forelimbs were observed during an unassisted delivery, and in this and two others, typical clinical signs were observed within two minutes of birth. Radiological and, or, pathological examination of each of the eight affected calves born in 1983 revealed lesions in the coxae, some of which predated parturition. These observations are consistent with the calves being affected with neuraxial oedema while in utero. PMID- 3975486 TI - Scanning electron microscopic study of the lower respiratory tract in calves and adult cattle. AB - The surface characteristics of the lower respiratory tract of two groups of cattle were studied with the scanning electron microscope. Group A comprised six one-week-old calves and group B four adult cows. None of the animals had overt respiratory disease or gross morphological evidence of pulmonary lesions. The trachea, bronchi, bronchioles and alveoli of the cranial and the caudal lobes of the right lung were examined. In both groups the luminal surface of the trachea and large bronchi were completely covered by cilia, apparently forming an efficient mucociliary escalator. In the adult animals there were some patchy areas in the trachea and large bronchi devoid of ciliated cells; these were considered abnormal. In the bronchi, non-ciliated cells, mainly mucus-secreting, were not easily identified unless they were discharging secretion. In small bronchi, non-ciliated cells were more evident and easily seen. The bronchioles had many non-ciliated cells and very few ciliated cells capable of forming a complete carpet for a mucociliary escalator. Types 1 and 2 alveolar epithelial cells and alveolar macrophages were identified in both groups. Pores of Kohn were found in the alveolar walls in all animals. PMID- 3975488 TI - Bronchial hyperreactivity and arterial carboxyhemoglobin as detectors of air pollution in Milan: a study on normal subjects. AB - Research has been carried out in the town area of Milan on 275 subjects. For each patient the following data have been measured: ventilatory profile, aspecific bronchial reactivity, arterial concentration in CO and acid-base balance. The results obtained have been divided into four groups, according to the level of SO2 in the area of residence of the subjects, who have also been studied with reference to the habit of smoking. The data obtained have shown (1) an alteration of the ventilatory function, with decrease of oxygen tension in arterial blood in all subjects. (2) Increase of bronchial irritability and CO concentration in arterial blood have been found in these subjects, with rates higher than those established by the WHO (1.5-1.7). (3) The division of our results according to the level of SO2 pollution in the areas of residence of the patients showed the presence, in the most polluted areas of Milan (NE and SW), of higher levels of bronchial irritability and higher CO rates in arterial blood. (4) Cigarette smoking does not seem to play a major role in causing bronchial irritability. It certainly increases CO concentration: smokers have HbCO concentration higher than nonsmokers in all four areas. (5) Air pollution is more important than cigarette smoking in determining CO saturation of blood. Nonsmokers living in the most polluted areas of Milan (NE) show a higher concentration of CO in arterial blood than smokers living in the less polluted areas (SW). PMID- 3975489 TI - Airway responsiveness after antigen inhalation challenge in hypersensitive pneumonia. AB - We performed pulmonary function tests after antigen inhalation challenge in 6 patients with hypersensitive pneumonia. 2 patients showed a reduction in maximal expiratory flow at 25% vital capacity (V25) within the first 1-3 h (early reaction) followed by a decrease in vital capacity, forced expiratory volume at 1 s and increased respiratory resistance in the next 4-7 h (late reaction). In the other 4 patients, only V25 decreased within the first 1-3 h. Diffusion capacity did not change significantly. It is suggested that the small airway is the most sensitive site of reaction to an antigen inhalation challenge in hypersensitive pneumonia and that the obstructive change of the small airway could occur as the early reaction. PMID- 3975490 TI - Effect of Zaditen on serum neutrophil chemotactic activity in exercise-induced asthma. AB - Zaditen has a partial blocking effect in exercise-induced asthma, but the mechanism of this effect is unknown. In our study we investigated the effect of Zaditen on one of the mediators released by mast cells. We measured the serum neutrophil chemotactic activity - by using a modified Boyden chamber assay - after 2 week's treatment with Zaditen or placebo. The airway parameters (SGaw) were recorded with a wholebody plethysmograph. Our studies on 10 patients show that Zaditen has a protective effect on the release of the neutrophil chemotactic factor during an exercise challenge test. A direct effect of Zaditen on the mast cell degranulation process is postulated. PMID- 3975492 TI - Effect of low hemoglobin levels on the diffusing capacity of the lungs for CO. Investigations in persons with healthy lungs and in patients with interstitial pulmonary fibrosis. AB - The influence of the hemoglobin concentration in the peripheral venous blood on the diffusing capacity of the lungs for CO (DLCO) was tested with the single breath method. 9 patients with histologically verified interstitial pulmonary fibrosis of varying etiology and 26 persons with healthy lungs with anemia requiring transfusions were investigated before and after compensation of the anemia. It was found that the true maximum diffusing capacity of the lungs measured in anemia patients was too low. In the test subjects with healthy lungs, there was a positive linear correlation between the hemoglobin content of the blood and DLCO. A correction factor to calculate the true DLCO in patients with healthy lungs but with anemia is specified. In the patients with interstitial pulmonary fibrosis, the influence of the reduced diffusing capacity of the alveolocapillary membrane on the extent of the diffusion disorder was in each case greater than the effects due to the anemia. PMID- 3975491 TI - Enflurane and isoflurane inhibit the oxidative activity of pulmonary alveolar macrophages. AB - Enflurane and isoflurane, widely used general anesthetic agents, were shown to significantly inhibit the microbicidal oxidative activity of pulmonary alveolar macrophages (PAM) at clinically relevant concentrations. This inhibition was reversible, as exposing the anesthetic-treated PAM to air for 30 min completely removed any depression of oxidative activity. Using chemoluminigenic probes to analyze the generation of oxidative metabolites, a significant reduction in superoxide anion (O-2) production was found in PAM exposed to enflurane or isoflurane. PMID- 3975493 TI - Effects of breathing pattern and oxygen upon the alveolar arterial oxygen pressure difference in lung disease. AB - It was suggested by analysis of theoretical lung models that low V/Q units are unstable and can be converted into shunt by breathing O2. We tested this theory in 21 subjects with various lung diseases (mostly chronic obstructive pulmonary disease) by having them breathe O2. We also increased the tidal volumes in these patients to see whether this maneuver could prevent the development of shunt. We found that mean P(A-a)O2 increased from 30 +/- 2.8 (mean +/- SEM) Torr breathing room air to 135 +/- 20.7 Torr breathing O2 for 10 min (p less than 0.0001), to 124 +/- 20.4 Torr breathing O2 for 20 min (p less than 0.0001), and to 125 +/- 19.0 Torr breathing oxygen with inspiratory capacity breaths (p less than 0.0001). The corresponding shunt increased from about 2.8% of the cardiac output to 7.9 +/- 1.01, 7.3 +/- 1.03 and 7.3 +/- 0.98%, respectively. We conclude that: (1) breathing pure oxygen can convert low V/Q units to shunt, hence measurement of P(A-a)O2 and shunt by oxygen technique will overestimate the actual values; (2) 10 min of oxygen breathing will cause complete atelectasis of low V/Q units, and (3) increased tidal volume does not prevent absorptive atelectasis. PMID- 3975494 TI - Elementary complex number analysis of lung models. AB - Formulae from the complex number method of network analysis are used by respiratory physiologists with increasing frequency. As yet, however, no elementary derivation of these has been found in physiological journals, the reader usually being referred to electronic texts: the derivations in these texts are not directed to respiratory problems and are generally more involved than required for respiratory purposes. The present presentation of the complex number analysis method is elementary, the necessary grounding in the field of complex numbers being given in an Appendix. The analysis is directed first to a one compartment lung, then to a simple two-compartment lung (effectively the same method applying also to simple multiple-compartment lungs), and finally an indication is given of the analysis of more complex models that include air compression effects. By gaining an understanding of the underlying principles the respiratory physiologist will improve the extent and depth of application of this powerful method of analysis. In particular, he will be in a position to analyse the body plethysmographic measurement of the non-uniform lung. PMID- 3975495 TI - Prognosis of patients with adenocarcinoma of the lung and mediastinal lymph node metastases undergoing pulmonary resection. AB - Of 57 patients who were operated on for adenocarcinoma of the lung during the period 1966-1970, 18 with mediastinal lymph node metastases successfully underwent potentially curative pulmonary resection combined with complete mediastinal lymph node dissection. The 5-year survival rate was nil. In light of this poor outlook, we do not recommend surgery as the primary treatment of choice in patients with adenocarcinoma of the lung and known mediastinal lymph node metastases. PMID- 3975496 TI - Unilateral chest wall edema in carcinomatous pleurisy. AB - 21 patients with protracted unilateral pleural effusion were studied with respect to the etiology of their pleurisy. 13 presented with unilateral chest wall edema (UCE). These were classified as group A patients. 8 group B patients suffered from unilateral pleural effusion without UCE. A malignant cause of the effusion was established in 8 out of the 13 patients in group A, and in 2 patients from group B. Empyema was present in 4 additional patients, all of them belonging to group A. The diagnosis of purulent pleural effusion could be made promptly by microscopic examination of the pleural fluid. If excluding the empyema patients, the presence of UCE was significantly associated (p less than 0.025) with a malignant etiology of the pleural effusion. It seems that careful examination of the chest wall skin texture can be a simple and useful method in the initial evaluation of patients with pleurisy. PMID- 3975497 TI - [Unresolved questions on the use of bronchial hypersensitivity as a test for asthma]. PMID- 3975498 TI - Gas exchange during exercise in hypoxic ducks. AB - We quantitatively assessed pulmonary gas exchange in Pekin ducks (Anas platyrhynchos) during running exercise (1.44 km X h-1 at 3 degrees incline) while the ducks spontaneously breathed either air (FIO2 = 0.21) or a hypoxic gas mixture (FIO2 = 0.12). During exercise, oxygen consumption increased 3 times above the resting value in normoxia and 3.6 times above rest in hypoxia. The convection requirement rose 34% and 20% in running normoxic and hypoxic ducks, respectively. The O2 extraction coefficient was the same in resting normoxic and hypoxic ducks (0.19 vs 0.18) and decreased by the same amount under exercise conditions (0.14 vs 0.15). Arterial PO2 was maintained during exercise in normoxia but increased slightly during exercise in hypoxia. Cardiac output increased by 73% and 111% during exercise in normoxic and hypoxic ducks, respectively. Calculations indicate that both the O2-diffusing capacity and the total conductance for O2 of the gas exchange system increased markedly during exercise in normoxia and hypoxia. We conclude that at this level of exercise, there was no apparent limitation to gas exchange in either the normoxic or hypoxic Pekin duck. PMID- 3975499 TI - Lung volume changes during respiration in ducks. AB - The avian lung has been considered to be rigid and to remain isovolumetric during the respiratory cycle. We tested this hypothesis by implanting radiopaque markers of tantalum on the dorsal pulmonary surfaces and ventral pulmonary aponeuroses of Pekin ducks (Anas platyrhynchos) and measuring changes in lung thickness during the respiratory cycle using high speed cineradiography. We found small but regular changes in lung thickness that were synchronous with respiratory phase. Lung thickness was greatest at mid-inspiration (0.6% greater than mean) and least at mid-expiration (0.8% less than mean). Measurements made on ostrich (Struthio camelus) respiratory structures suggest that the maximal force that could be generated by the muscles (Mm. costopulmonales) at the margins of the ventral pulmonary aponeurosis is more than two orders of magnitude greater than would be required to resist pressure-induced changes in lung volume during respiration at rest. The action of these muscles could account for the very small magnitude of the volume changes measured during the respiratory cycle. PMID- 3975500 TI - Mechanical coupling between the ribs and sternum in the dog. AB - We measured the axial (cranio-caudal) displacements of the sternum and the second and seventh bony ribs using linear displacement transducers in five supine anesthetized dogs during passive inflation and deflation, during quiet breathing and static inspiratory efforts before and after bilateral phrenicotomy, and during tetanic stimulation of either the sternocleidomastoids or the sternal fibers of the rectus abdominis. Quiet inspiration before and after phrenicotomy was always associated with a caudal displacement of the sternum and a cranial displacement of the seventh rib; the second rib, however, was either motionless or also showed an inspiratory caudal displacement. During static inspiratory efforts, the second rib was always moving in concert with the sternum in the caudal direction, while the seventh rib, in particular after phrenicotomy, usually moved in the cranial direction. Finally, for any given axial (cranial or caudal) displacement of the sternum, stimulation of the sternocleidomastoid or rectus abdominis muscles invariably caused the second rib to move disproportionately more than the seventh. These results indicate that the upper ribs are more tightly linked to the sternum than the lower ribs. This presumably results from the fact that the costal cartilages increase in length from above downwards, and it implies that the upper portion of the rib cage behaves more as a unit with the sternum than the lower portion. PMID- 3975501 TI - Laryngeal cold receptors. AB - We have previously demonstrated the presence of specific laryngeal 'flow' receptors activated independently of transmural pressure. This study considers the operational characteristics of these endings. In 15 anesthetized dogs we recorded single unit action potentials from the peripheral cut end of the internal branch of the superior laryngeal nerve. All the 30 laryngeal 'flow' receptors studied showed an inspiratory modulation when the dog was breathing room air at 26 degrees C and 55% relative humidity (laryngeal temperature approximately equal to 34 degrees C) through the upper airway. All the receptors became silent when the temperature of the inspired air was raised to 36-40 degrees C, 100% relative humidity (laryngeal temperature between 35 and 38 degrees C) and increased their activity when the temperature in the larynx was decreased either by lowering the temperature or the humidity of the inspired air. Fourteen laryngeal 'flow' receptors were tested with a steady flow of air, directed through the isolated in vivo larynx, at different temperatures and saturated with water vapor. Their discharge rate was found to be inversely related to laryngeal temperature (from 35 to 25 degrees C) and independent of airflow. Their rate of adaptation indicates a high dynamic sensitivity. In the isolated larynx preparation these receptors were activated by airflow in both inspiratory and expiratory directions provided that laryngeal temperature was lower than 35 degrees C. We conclude that the previously described laryngeal 'flow' receptors operate as thermoreceptors activated by cooling. PMID- 3975502 TI - Electrophysiological aspects of reflexogenic area in the chelonian, Geoclemmys reevesii. AB - Electrophysiological and anatomical experiments were performed to determine the baro- and chemoreceptive area of the turtle, Geoclemmys reevesii. The baro- and chemoreceptive sites are located in the aortic and pulmonary arches and the truncal region. The aortic arch is innervated by both the superior truncal nerve (aortic nerve) and a branch of the inferior truncal nerve arising from the ganglion trunci of the vagus. The pulmonary arch is innervated by a fine branch of the inferior truncal nerve, a branch containing mainly barosensitive and a few chemosensory fibers. On the peripheral cut end of these nerves, afferent electrical baro- and chemosensory activities were induced by NaCN and hyperoxia. Fluorescence microscopy revealed that the glomus cells are located in these regions. PMID- 3975503 TI - The effect of potassium on carotid chemoreceptor activity and ventilation in the cat. AB - Intravenous injections of potassium chloride were given to anaesthetised cats to produce rises in arterial plasma potassium within the range of those occurring in man during exercise. Carotid chemoreceptor activity was recorded as action potentials from a single or few fibre preparation of the right sinus nerve. Arterial potassium was recorded continuously using a potassium electrode placed in the abdominal aorta. In response to the potassium injections there was an increase in carotid chemoreceptor activity, which closely followed the arterial potassium concentration, and an increase in ventilation. It is suggested that potassium released from muscle may be an important drive to ventilation in exercise. PMID- 3975504 TI - Kinetics of O2 uptake and release by red cells in stopped-flow apparatus: effects of unstirred layer. AB - Using a stopped-flow apparatus, measurements were made of the velocity of uptake and release of oxygen by red cells of man, sheep and goat, three species of widely differing red cell size. The results were used to calculate resistances to O2 uptake provided by: (1) any unstirred layer (USL) outside the cells; (2) the cell membrane; and (3) the cell substance, in which the process of simultaneous diffusion and chemical reaction occurs. For O2 release, the USL was virtually abolished by using sufficient dithionite in the reactant buffer for it to diffuse up to the cell membrane and mop up O2 as it passes out of the cell. Hence, differences in the rate of O2 uptake and release allowed estimation of the resistance and thickness of the USL. Its thickness in the three species was between 0.7 and 0.9 micron; it provided at least 70% of the resistance to O2 uptake located outside the cell interior (cell membrane plus USL). Existence of the USL slows the uptake of O2 in the stopped-flow apparatus by a factor of at least 1.8 to 2.0. PMID- 3975505 TI - [Dermatoses specific to pregnancy]. PMID- 3975506 TI - [Hepatic toxicity of mianserin]. PMID- 3975507 TI - [Hypercapnia caused by oxygen therapy]. PMID- 3975508 TI - [Epidemiological study of cancers of the digestive system in Belgium. Interuniversity study: nutrition and health]. PMID- 3975509 TI - [Recurrent pancreatitis and pancreas divisum: surgical treatment using double sphincteroplasty]. PMID- 3975510 TI - [The place of endoscopic sphincterotomy in the treatment of biliary calculi]. PMID- 3975511 TI - [Clinical aspects of osteoarticular pathology. Arthritic and algodystrophic manifestations in a case of akineto-rigid Parkinson syndrome]. PMID- 3975513 TI - [Cytogenetics and hematology]. PMID- 3975512 TI - [Cardiac tamponade as the initial symptom of a cardiothoracic neoplasm. Study of 10 cases, role of radiotherapy]. PMID- 3975514 TI - [Description and treatment of hirsutism]. PMID- 3975516 TI - [Hemorrhages due to anticoagulants]. PMID- 3975515 TI - [Obesity in children: the pitfalls of dieting]. PMID- 3975517 TI - [Primary hyperparathyroidism. Apropos of 76 observations]. PMID- 3975519 TI - [Early results following loco classico radius fractures]. PMID- 3975520 TI - [Divisible tablets--source of error in therapeutic drug dosages]. PMID- 3975518 TI - [Acute schistosomiasis]. PMID- 3975522 TI - [Clubfoot and sickle foot from the current viewpoint]. PMID- 3975521 TI - [Perspectives of immunopharmacology]. PMID- 3975523 TI - [Help in coping with breast cancer--experiences with affected females]. PMID- 3975524 TI - [Retrospective analysis of the efficacy of hospitalizations for anorexia nervosa]. PMID- 3975525 TI - [Fever, sore throat]. PMID- 3975526 TI - [Fluorides and pregnancy]. PMID- 3975527 TI - [Coumarin necrosis. A rare severe complication of oral anticoagulation]. PMID- 3975528 TI - [Carcinoma surgery today: analysis of complication rates and mortality in 1000 consecutive cases]. PMID- 3975530 TI - [A case from practice (32). Female patient: M.E., born 10-13-1939, annuitant]. PMID- 3975529 TI - [Distribution of dithranol therapy in dermatologic clinics and specialty practice in Switzerland]. PMID- 3975531 TI - [Medical ethics and the expert physician]. PMID- 3975533 TI - [The physician facing dangerous behavior]. PMID- 3975532 TI - [Psychiatric expertise of the partner murderer: when can one infer a "crime of passion"?]. PMID- 3975534 TI - [The training of medicolegal psychiatrists]. PMID- 3975535 TI - [The medical secret and delinquent patients]. PMID- 3975536 TI - [Treatment and security in psychiatric hospitals: the model of the Bethlem Royal Hospital]. PMID- 3975537 TI - [Penal responsibility, always and again]. PMID- 3975538 TI - [Treatment and justice]. PMID- 3975539 TI - [Violence and aggression: treatment and the therapeutic community at Grendon Prison (England)]. PMID- 3975540 TI - [Treatment of personality disorders? The sociotherapy workshop of the medical department of the Champ-Dollon prison (Geneva): 5-year survey]. PMID- 3975541 TI - [Physicians and patient-prisoners. Sociological aspects of penitentiary medicine at the Champ-Dollon prison in Geneva]. PMID- 3975542 TI - [Driving aptitude examination in the Traffic Medicine and Psychology Unit of the University Institute of Legal Medicine]. PMID- 3975544 TI - [The concept of responsibility]. PMID- 3975543 TI - [Toxoplasmosis. Immunohistochemical study of a case of acquired toxoplasmosis in a patient with AIDS and of a case of congenital toxoplasmosis]. PMID- 3975545 TI - [Diagnosis of etiology and complications of recurring urinary tract infections using imaging procedures]. AB - The indication and efficiency of various radiological examination methods in relapsing infections of the urinary tract, as well as the complications of such infections, are described, and characteristic and pathognomical findings are demonstrated. The diagnostic accuracy of the individual imaging methods depends on the site, size, and density of the pathological process. Accurate diagnosis also requires the incorporation of clinical findings including those established by means of clinical pathology setups. PMID- 3975546 TI - [CT findings and CT-guided puncture of a perineal cyst]. AB - CT findings and treatment results after CT-monitored surgery of a large perineal cyst are described. This was identified as a Mullerian duct cyst which is considered--according to world literature--to be a great rarity. The high rate of relapses even on instillation of sclerosing solutions, as well as differential diagnosis in relation to other perineal cystic space-occupying growths, are discussed. PMID- 3975547 TI - [Complications arising from a Cimino hemodialysis fistula]. AB - Authors report on the possible complications with arteriovenous fistulas created for haemodialysis. Attention is drawn to the importance of angiography in demonstrating these complications. PMID- 3975548 TI - [Adrenal cyst--a rare finding]. PMID- 3975549 TI - [Contusions of the spleen]. PMID- 3975550 TI - [Contusions of the liver]. PMID- 3975552 TI - [Evaluation of protein nutritional status: its practical importance]. PMID- 3975551 TI - [Epidemiology and prognosis of abdominal contusions]. PMID- 3975553 TI - [Nutritional factors and carcinogenesis, excluding alcohol]. PMID- 3975554 TI - [Ambulatory monitoring of restrictive diets]. PMID- 3975555 TI - [Sugar for diabetic patients? Dietetic counselling for the diabetic]. PMID- 3975556 TI - [Muscular exertion and nutrition]. PMID- 3975557 TI - [Food habits and public health]. PMID- 3975558 TI - [Impotence and psychological disorders]. PMID- 3975559 TI - [Endocrine evaluation of sexual impotence]. PMID- 3975560 TI - [Sexual impotence of arterial origin]. PMID- 3975561 TI - [Impotence of neurologic origin]. PMID- 3975562 TI - [Iatrogenic impotence]. PMID- 3975563 TI - [Behavioral sex therapy for erectile dysfunctions (impotence)]. PMID- 3975564 TI - [What can be expected from the surgical treatment of impotence?]. PMID- 3975566 TI - Evaluation of microtitre plates for the routine assay of oestrogen and progesterone receptors in tissue extracts. AB - A time- and material-saving assay of oestrogen and progesterone receptors in tissue extracts using enzyme-linked immunosorbent assay quality microtitre plates and microtitre-compatible equipment is described. The results from simultaneous determinations in microtitre plates and in conventional tubes show the former to yield higher receptor values. Furthermore, the results of a large series of measurements in microtitre plates compare favourably with previously obtained results from assays in tubes. PMID- 3975567 TI - Human marrow stromal cells in short-term semi-solid bone marrow culture in aplastic anaemia. AB - A short-term methylcellulose technique was used to study the proliferation of marrow-derived stromal, erythroid and myeloid colonies from normal controls and from patients with aplastic anaemia. There was a significant reduction in all colony types in patients with aplastic anaemia when compared with normal controls. In 4 patients who achieved remission following treatment with ATG + oxymetholone or with oxymetholone alone there was a return to normal range of stromal colonies and also of CFU-E. There was no change in the numbers of BFU-E's and only a slight increase in the numbers of CFU-C's. PMID- 3975565 TI - Seasonal variations in UVR-induced DNA synthesis and in UVR inhibition of phytohaemagglutinin-stimulated proliferation of human lymphocytes. AB - Two years of sequential studies of the UVR (254 nm) response in normal human lymphocytes showed pronounced seasonal variations. In the winters of 1981-82 and 1982-83 the UVR-induced DNA synthesis in the lymphocytes in vitro (the DNA-repair synthesis) was very stable with inter- and intra-individual variations below 14 and 10%, respectively (15 individuals). In the summers 1982 and 1983 the inter individual variations was 2-3-fold higher. Closer analysis revealed that this was due to a pronounced intra-individual variation with sharp fluctuations in the single individual. Also the UVR tolerance of the lymphocytes estimated by alterations of the phytohaemagglutinin (PHA) stimulated lymphocyte proliferation showed seasonal variations, being 1.5-fold higher in the winter than in the summer (P less than 0.0001, 12 individuals). The observed seasonal variations emphasize the importance of considering chronobiological variations when working with long term projects. The UVR-induced DNA synthesis was determined as the increase in incorporation of [3H]-thymidine in irradiated cells compared to non irradiated cells after incubation for 2 h at 37 degrees C in phosphate buffered saline. The UVR tolerance was measured by the UV dose necessary for 50% reduction in PHA stimulated lymphocyte proliferation assessed after 7 days of growth. PMID- 3975568 TI - Quantification of the distribution of the marginating granulocyte pool in man. AB - The kinetics of autologous granulocytes, separated from whole blood and labelled with 111In-tropolonate with continuous maintenance in plasma, have been studied in man, using a gamma camera and computer, with the aim of quantifying the distribution of the marginating granulocyte pool (MGP). We have used 3 approaches: dynamic gamma camera imaging immediately following i.v. injection of labelled cells, comparison of the activity signal from 111In-granulocytes with that from previously injected 111In-labelled red cells and absolute quantification of 111In present in liver, spleen and blood. Deconvolution analysis of the hepatic and peripheral blood time activity curves indicated that hepatic granulocyte transit time was 2.5 +/- SE 0.14 min. By comparison with 111In red cells, hepatic transit time was calculated to be 7.4 +/- SE 0.82 that of red cells, which, assuming an hepatic red cell content of 6% that of the total red cell mass, is equivalent to a transit time of 1.8 min. By comparison with 111In red cells, lung granulocyte transit time as a factor of red cel transit time was 5.4 +/- SE 0.7 at 5 min and 2.5 +/- SE 0.13 at 40 min after granulocyte injection. Using these kinetic data, in combination with previously published values for splenic granulocyte transit time, it was calculated that, 5 min after injection, the MGP accounted for 54% of the total blood granulocyte pool (TBGP), was 90% filled, and was distributed between spleen (19%), liver (26%), lung (33%) and the remainder of the body (22%). At 40 min, the MGP accounted for 60% of the TBGP, had equilibrated with the circulating granulocyte pool (CGP), and was distributed between the spleen, liver, lung and remainder of the body according to the following respective percentages: 35, 25, 10 and 30. The total granulocyte contents of the spleen and liver calculated on the basis of the kinetic data were 21% and 22% respectively and in broad agreement with the values, 34 and 23% respectively, calculated from quantitative scanning. It was concluded that about 70% of the body's MGP was present in the spleen, liver and lung. If the MGP is itself 60% of the TBGP then only about 18% of the TBGP marginates in extra hepatosplenopulmonary sites. PMID- 3975569 TI - Iron absorption from red and white wines. AB - Iron (3 mg) was added as ferrous sulphate to 2 dl red wine, white wine and 7% alcohol and its absorption was then measured in 38 fasting male subjects. (The original concentrations of iron in the two wines were low, being 1.01-1.08 mg/l (red wine) and 0.13-0.20 (white wine]. The geometric mean absorption from red wine was only 20% of that from the alcohol solution whilst more than 4 times as much was absorbed from white wine as from the alcohol. Direct comparison showed greater absorption from white wine (10.4%) than from red wine (4.4%). Removal of about 80% of the polyphenols in red wine increased the geometric mean iron absorption from 1.9% to 3.6%. In vitro experiments indicated that iron was less soluble and less dialysable in red wines than in white wines. This was possibly due to the binding of iron to polyphenols in red wines. Electrophoretic studies suggested that the iron in white wines was complexed to hydroxycarboxylic acids. PMID- 3975570 TI - Procoagulant cellular activity and disseminated intravascular coagulation in acute non-lymphoid leukaemia. AB - The procoagulant cellular activity (PCA) of intact and lysed leukaemic cells was evaluated at diagnosis in 23 patients with acute non-lymphoid leukaemia (ANLL). The leukaemic cells of all 13 patients having DIC feature (excess of fibrin monomers, serum FDP and plasma fibrino-peptide A) showed a significant (P less than 0.0001) increase of PCA, while a pattern similar to that of normal granulocytes and lymphomonocytes was observed in the remaining 10 patients without evidence of DIC. When the patients were subdivided according to the FAB cytological classification, features of DIC and increased PCA were demonstrated in 3/3 M3 patients, 5/6 M5 patients and only in 5/14 remaining patients. These findings indicate that in ANLL patients: (1) the increased PCA of leukaemic cells is closely related to the occurrence of DIC; (2) the increased PCA seems related to the differentiation line and maturation level of the leukaemic cells. PMID- 3975571 TI - The lymphocyte acid phosphatase-positive lysosomes in patients with malignancies. AB - Patients with various malignancies are characterized by decreased numbers of intact acid phosphatase-positive lysosomes within the peripheral blood lymphocytes as compared to the control groups of healthy subjects. PMID- 3975572 TI - Plasma cobalamin-binding and serum cobalamin in patients with folate deficiency. AB - Plasma unsaturated R-binder and transcobalamin 2 (TC 2) levels were measured in 62 patients with folate deficiency and compared with 80 control subjects and 52 patients with pernicious anaemia. An increase in unsaturated R-binder concentration was found in the majority of patients with folate deficiency and with PA. In folate deficiency, however, the unsaturated R-binder was often elevated whether the serum cobalamin (Cbl) was low or normal, more frequently when the serum Cbl was normal. Results of a separate in vivo study of plasma retention of injected 57Co cyanocobalamin were consistent with these findings. An elevated TC2 was found in a small number of patients with folate deficiency and with PA. The serum Cbl appears to the maintained at a normal level in some patients with folate deficiency by an increase in R-binder, which is caused by folate deficiency itself. PMID- 3975573 TI - Ferrochelatase deficiency of the bone marrow in a syndrome of congenital microcytic anaemia with iron overload of the liver and hyperferraemia. AB - Ferrochelatase deficiency of the bone marrow was found in 2 sisters with a syndrome of congenital hypochromic anaemia, hyperferraemia and heavy iron deposits in the liver. PMID- 3975574 TI - Adherence of lysostaphin to and penetration into human monocytes. AB - The effect of lysostaphin on Staphylococcus aureus phagocytosed by monocytes was investigated. The results showed that lysostaphin adheres to monocytes by a temperature-independent mechanism, is not adequately removed from monocytes by washing, and penetrates by means of a temperature-dependent mechanism. In in vitro assays of monocyte function, phagocytosed S. aureus can be killed by lysostaphin after penetration of the cells during incubation or by adhering lysostaphin when the monocytes are disrupted. PMID- 3975575 TI - [Special infections of the respiratory tract in children]. AB - Inspiratory or exspiratory stridor associated with dyspnea represents a common pediatric symptomatology compatible with various diseases which usually are of infectious etiology. The causative obstruction of the infantile airways may lead to life-threatening respiratory failure. A review is conducted of the most important emergencies characterized by stridor and dyspnea in early childhood: croup syndromes (acute viral laryngotracheitis, spasmodic croup, bacterial tracheitis), epiglottitis and bronchiolitis. PMID- 3975576 TI - [Antibiotic therapy in bronchopulmonary infections]. AB - The causative agent of lower respiratory tract infection cannot always be determined even with invasive techniques. In most clinical situations an empirical choice of antibiotics is indicated, if only for early institution of therapy. Next to the often misleading clinical picture, consideration of the epidemiological setting and specific risk of underlying diseases is of value in selecting empirical therapy. PMID- 3975577 TI - [Aminoglycoside levels in bronchial secretions]. AB - Aminoglycosides are of limited clinical efficacy in gram-negative bacillary pneumonia, although they are commonly employed to treat this infection. This poor efficacy has been related in part to host factors (abnormalities in the lung, immunocompromise) and in part to pharmacologic factors. In particular, aminoglycoside levels in bronchial secretions are often borderline or inadequate in relation to the minimal inhibitory concentrations for most gram-negative strains. The low aminoglycoside concentrations result from poor penetrance into the respiratory tract or from local inactivation of these drugs, but basically reflect their low therapeutic-to-toxic ratio. The endotracheal injection of aminoglycosides resulted in high bactericidal activity within the bronchial lumen and in increased clinical efficacy, without increasing systemic toxicity. In view of the potential dangers of topical antibiotics, however, endotracheal treatment should be confined to selected patients. PMID- 3975578 TI - [Residual lung function changes following adult respiratory distress syndrome (ARDS) in children]. AB - Residual lung function abnormalities have been investigated in 9 children (4 boys and 5 girls) a mean 2.7 years after surviving severe adult respiratory distress syndrome (ARDS). All patients had been artificially ventilated for an average of 9.4 days with a FiO2 greater than 0.5 for 34 hours and maximal PEEP levels in the range of 8-20 cm H2O. Since the ARDS, 3 children had presented recurrent respiratory symptoms (moderate exertional dyspnea and cough) and 2 had had evidence of fibrosis on chest radiographs. In all patients abnormal lung functions were found, i.e. ventilation inequalities (8), hypoxemia (7), and obstructive (2) and restrictive (1) lung disease. A significant correlation between respirator therapy and residual lung function was found (duration of FiO2 greater than 0.5 in hours and inspiratory plateau pressure during respirator therapy vs. ventilation inequalities and hypoxemia). PMID- 3975579 TI - [Hemodynamic and respiratory effects of phentolamine in pulmonary hypertension secondary to chronic obstructive syndrome]. AB - The hemodynamic and respiratory effects of phentolamine i.v. (15-30 mg/h) on pulmonary hypertension following chronic obstructive pulmonary disease (COPD) have been studied in 13 patients under stable conditions. Phentolamine produced a significant reduction in mean pulmonary arterial pressure, right and left ventricular filling pressures and right ventricular stroke work index. Cardiac index and oxygen delivery increased significantly. Individual analysis showed that in 7 patients the driving pressure decreased across the pulmonary circulation with concomitant increase in cardiac output, suggesting a direct vasodilating effect of phentolamine on the pulmonary circulation. Pulmonary gas exchange did not change significantly. In conclusion, in patients with pulmonary hypertension following COPD phentolamine given i.v. may have beneficial effects on right ventricular function and peripheral oxygen delivery without detrimental effect on gas exchange. PMID- 3975581 TI - [Medullary sponge kidney. Diagnosis and course in 12 cases]. AB - 12 adult patients with medullary sponge kidney (MSK), followed up for 1 to 14 years (mean 7 years) are presented. MSK was initially diagnosed in 4 cases. In 8 cases the initial diagnosis included pyelonephritis, nephrocalcinosis, and nephrolithiasis. Renal calculi (4 patients), urinary tract infection (8) and hematuria (5) were the most frequent symptoms. Renal tubular acidosis was documented in 2 patients and hypercalciuria without hyperparathyroidism in 2. Over the years renal calculi increased in size in 4 patients. Renal function was stable in 11. In one patient with associated, well controlled hypertension, serum creatinin rose from 141 to 298 mumol/l over 14 years. PMID- 3975580 TI - [Candida endophthalmitis: diagnosis, course and therapy in 8 patients]. AB - Over a two-year period 8 patients were hospitalized with a presumptive diagnosis of Candida endophthalmitis. 6 patients were heroin addicts, while in the 2 other patients no risk factor could be identified. The presumptive diagnosis was based on the typical findings of retinohyalitic exudate and exclusion of other factors causing endophthalmitis. Intravenous therapy with amphotericin-B and flucytosin resulted in definitive scar healing. In 1 patient vitrectomy was necessitated by recurrence of endophthalmitis resistant to antifungal therapy. PMID- 3975582 TI - [Recurrent pulmonary hemorrhage with normal kidney function]. AB - A case of Goodpasture's syndrome with normal renal function is described. Clinical, morphological and prognostic features of the diagnosis are compared with the findings in Goodpasture's syndrome with progressive renal failure and with the findings in idiopathic pulmonary hemosiderosis. PMID- 3975583 TI - [Therapy of differentiated thyroid carcinomas. Prospective study]. AB - During an 11-year period (1973-1984) a consecutive series of papillary (n = 30) and follicular (n = 38) thyroid carcinomas was prospectively selected, on the basis of a clinico-pathologic and prognostic classification, for 1) non-total thyroidectomy (n = 20), 2) total thyroidectomy (n = 13), or 3) total thyroidectomy and radioiodine (n = 35), together with exogenous suppressive thyroxine therapy in most patients. Patients with an occult papillary carcinoma and patients under 40-50 years of age with an intrathyroidal, single papillary carcinoma without nodes, and microangioinvasive follicular carcinoma were often treated by non-total thyroidectomy or without radioiodine. Some patients refused adequately radical therapy (completion of thyroidectomy or radioiodine). RESULTS: a half-year to 11 (5 +/- 3) years following treatment no recurrences or deaths occurred in occult papillary and in microangioinvasive follicular tumors (treated by total thyroidectomy and radioiodine in 1 of 9 and in 2 of 9 patients respectively); 1 death and 1 curable recurrence occurred in the intrathyroidal papillary carcinoma group (treated by total thyroidectomy and radioiodine in 7 of the 15 patients); 3 patients died and there were 4 recurrences (3 locoregional, 1 systemic) in the patients suffering from extrathyroidal papillary or angioinvasive follicular carcinoma (treated by total thyroidectomy and radioiodine in all of the 6 and in 19 of 29 patients respectively). Patients who died (all had pulmonary metastases at the time of diagnosis) and those with a recurrence had total thyroidectomy with radioiodine as the primary treatment. In lethal papillary carcinomas, large follicular and solid areas, squamous cell metaplasia or anaplastic transformation were observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975584 TI - [Does self-measurement of blood pressure improve compliance in hypertensive patients?]. AB - To increase compliance in antihypertensive therapy, adherence was measured before and after distribution of non-automatic blood pressure devices. After 2 weeks of taking placebo, 37 essential hypertensive patients, both male and female, were treated over a period of 8 months with an antihypertensive combination drug containing triamterene. At each follow-up, compliance was checked by triamterene urine fluorescence. In the third month of therapy all patients were given a non automatic blood pressure device. The results showed that self-recording of blood pressure increased the compliance rate of the group from 65% at the beginning of the trial to 81% at the end. Patients who showed poor adherence and consistently insufficient blood pressure values increased their compliance rate from 0% before to 70% after self-measuring of blood pressure. In the light of these findings, self-recording of blood pressure can be recommended in cases where compliance is suspected to be poor and blood pressure is inadequately controlled. PMID- 3975586 TI - [Mechanical ventilation in acute decompensation in chronic obstructive bronchopneumopathy]. AB - Acute respiratory failure in chronic obstructive lung disease (COPD) is characterized by abnormal gas exchange and respiratory muscle fatigue; mechanical ventilation would appear to be particularly well suited to the management of COPD patients, because the respirator is a reliable oxygenator and a mechanical power supplier. However, many clinicians are reluctant to prescribe this therapy. The author discusses the indications and practical use of mechanical ventilation in COPD patients. Data are presented which show no correlation between the duration of mechanical ventilation, the age of the patients and pulmonary function tests. During acute respiratory failure, COPD patients require active management in an intensive care unit. PMID- 3975585 TI - [Rounded atelectasis and persistent pleural effusion on top of fibrothorax. Report of a case]. AB - The autopsy findings are reported in an 84-year-old woman who presented with a six-year history of right and left heart failure. A right-sided sterile transsudate persisted for 5 years despite medical treatment and repeated thoracenteses. Three years before death, a rounded density appeared in the right lung field, followed by a second 2 years later. At autopsy the pleural effusion was found to be related to fibrothorax, and the rounded densities consisted of two foci of atelectasis. PMID- 3975587 TI - [Current problems in weaning from the respirator]. AB - Weaning from the respirator is obviously the most time-consuming phase in mechanically ventilated patients. Major problems still arise in the early detection and elimination of risk factors which may impair adequate spontaneous breathing. Detailed physiological consideration of the respiratory disability should distinguish between defects in lung mechanics and inspiratory muscle failure. Thus, proper mechanical ventilation can be established in order to restore or to train the respiratory muscles (IPPB versus IMV/CPAP principle) during the weaning period. Prior to any extubation, the data on clinical state, results of blood gas analysis and pulmonary mechanics, as well as special tests for estimation of inspiratory muscle strength, are of definite value. PMID- 3975588 TI - [Function of the respiratory muscles in acute cardiac decompensation]. AB - In anesthetized dogs the performance of the respiratory muscles during cardiogenic shock and their influence on its outcome was studied. Shock was induced by cardiac tamponade. Cardiac output during shock amounted to 25-35% of control and was kept constant. Minute ventilation (VE) initially increased and then progressively decreased until respiratory arrest. The latter was due to impairment of respiratory muscle contractility, the pressure generated by the diaphragm (Pdi) decreasing despite a marked increase in the diaphragmatic electromyogram and of the phrenogram. Mechanical ventilation during shock prolonged survival for the same decrease in cardiac output, and also decreased substantially the severity of lactic acidosis. Furthermore, blood flow to the respiratory muscles during shock was different in the animals breathing spontaneously (SB) from that in mechanically ventilated animals (MV). The fraction of cardiac output distributed to the respiratory muscles during control amounted to 1.85% in MV and 2.79% in SB. With shock this decreased to 1.55% in MV while in SB it decreased by 21%, which suggests that mechanical ventilation during shock preserves a large portion of cardiac output used by the respiratory muscles during spontaneous breathing, thus making it available to other organs. PMID- 3975589 TI - [Injury to the larynx and trachea following artificial respiration]. AB - A general interdisciplinary survey of trends within intensive care units is necessary in order to further reduce the risk of laryngo-tracheal injury requiring treatment after prolonged intubation. Endoscopic controls of the larynx and cervical trachea should be recommended as urgent during long intubations, to ensure that a secondary tracheotomy does not ultimately occur too late. Only a perfectly performed tracheotomy minimises complications (stenoses). Repeated laryngoscopy and endoscopy of the trachea with a fibreoptic system (a few days after extubation) is recommended after every prolonged intubation. PMID- 3975591 TI - [What does the history of veterinary medicine mean and to what purpose do we study it?]. PMID- 3975590 TI - [Sudden death outside the hospital: evaluation of the activities of an intensive care mobile unit in Geneva]. AB - A prospective study on the treatment of out-of-hospital cardiac arrest by a mobile intensive care unit was conducted in Geneva for 1 year. 76 attempts at cardiopulmonary resuscitation (CPR) were made: 25 patients were admitted to the intensive care unit (33%) and 13 lived to be discharged from hospital (17%). Age, initial arrhythmia and duration of cardiopulmonary arrest (CPA) were important factors in determining the initial success of CPR. Long-term survival was associated with CPA of less than 4 minutes duration, with bystander-initiated CPR and with CPR lasting less than 30 minutes. Better education of the public and more direct access to the system should make it possible to treat more patients in more favourable conditions and improve overall results. A more determined effort to educate the public in CPR would also improve the prognosis in out-of hospital cardiac arrest. PMID- 3975592 TI - [Hypomagnesemia in dairy cows and the quick urine test for control of the cow's magnesium supply]. PMID- 3975593 TI - The chemistry of garlic and onions. PMID- 3975594 TI - Chromosome translocations and human cancer. PMID- 3975595 TI - Blood flow in prosthetic devices. PMID- 3975597 TI - The vexing problems of vaccine compensation. PMID- 3975596 TI - A surfeit of fluoride? PMID- 3975598 TI - OMB raid on NIH budget called "outrageous". PMID- 3975599 TI - Obesity declared a disease. PMID- 3975600 TI - Electrical sources in human somatosensory cortex: identification by combined magnetic and potential recordings. AB - Magnetic fields and electrical potentials produced by neuronal activity have different properties that can be used for the identification of electrical sources in the human brain. Fields and potentials occurring 20 to 30 milliseconds after median nerve stimulation in human subjects were compared in order to investigate the sources of evoked potential components that have been attributed by different investigators to the thalamus or thalamocortical afferents, to separate radial sources in somatosensory cortex and motor cortex, or to a tangential source in somatosensory cortex. The magnetic and potential wave forms were highly similar in morphology, and their spatial distributions were centered over sensorimotor cortex, were dipolar in shape, and differed in orientation by approximately 90 degrees; distances between the minimum and maximum of the magnetic distributions were about 60 percent of those of the potential distributions. These results cannot be accounted for by thalamic sources or radial cortical sources alone, but are consistent with a tangential source in somatosensory cortex, with an additional smaller contribution from radial sources. PMID- 3975601 TI - Limits of neurogenesis in primates. AB - Systematic analysis of autoradiograms prepared from postpubertal rhesus monkeys given single and multiple injections of tritium-labeled thymidine and killed 3 days to 6 years later displayed a slow turnover of glial cells but failed to reveal any radiolabeled neurons. Therefore, unlike neurons of some nonprimate species, all neurons of the rhesus monkey brain are generated during prenatal and early postnatal life. A stable population of neurons in primates, including humans, may be important for the continuity of learning and memory over a lifetime. PMID- 3975603 TI - Visual flow and direction of locomotion. PMID- 3975602 TI - Regulation of extravascular coagulation by microvascular permeability. AB - Extravascular coagulation is a prominent feature of such important pathological processes as cellular immunity and neoplasia and has been thought to result from procoagulants associated with the inflammatory or tumor cells peculiar to these entities. It was found that increased microvascular permeability alone is sufficient to induce equivalent extravascular coagulation in several normal tissues. The results indicate that saturating levels of procoagulant are present even in normal tissues and that microvascular permeability is a rate-limiting step in extravascular coagulation. PMID- 3975605 TI - Criminality and adoption. PMID- 3975604 TI - On the mathematical structure of the visuotopic mapping of macaque striate cortex. PMID- 3975606 TI - Dietary fat recommendations. PMID- 3975608 TI - OTA critical of AIDS initiative. PMID- 3975607 TI - Transformation of human bronchial epithelial cells transfected by Harvey ras oncogene. AB - Transfection of normal human bronchial epithelial (NHBE) cells with a plasmid carrying the ras oncogene of Harvey murine sarcoma virus (v-Ha ras) changed the growth requirements, terminal differentiation, and tumorigenicity of the recipient cells. One of the cell lines isolated after transfection (TBE-1) was studied extensively and shown to contain v-Ha ras DNA. Total cellular RNA from TBE-1 cells hybridized to v-Ha ras structural gene fragment probes five to eight times more than RNA from parental NHBE cells. The TBE-1 cells expressed phosphorylated v-Ha ras polypeptide p21, showed a reduced requirement for growth factor supplements, and became aneuploid as an early cellular response to v-Ha ras expression. As the transfectants acquire an indefinite life-span and anchorage independence they became transplantable tumor cells and showed many phenotypic changes suggesting a pleiotropic mechanism for the role of Ha ras in human carcinogenesis. PMID- 3975609 TI - IOM's future under review. PMID- 3975610 TI - The immune system "belongs in the body". PMID- 3975611 TI - Phagocytes as carcinogens: malignant transformation produced by human neutrophils. AB - In a study of the relation between chronic inflammation and carcinogenesis, C3H mouse fibroblasts of the 10T 1/2 clone 8 line (10T 1/2 cells) were exposed to human neutrophils stimulated to synthesize reactive oxygen intermediates or to a cell-free enzymatic system generating superoxide (xanthine oxidase plus hypoxanthine). After exposure, the 10T 1/2 cells were either placed in tissue culture or immediately injected into athymic nude mice. Both malignant and benign tumors developed in the mice injected with treated cells, but not in those injected with control cells; in one instance cells grown from one of the benign tumors subsequently developed a malignant phenotype. Malignant transformation was also observed in treated cells in the experiments in vitro. PMID- 3975612 TI - Platelet-mediated cholesterol accumulation in cultured aortic smooth muscle cells. AB - Cholesterol accumulates within smooth muscle cells and macrophages in atherosclerotic lesions, thereby contributing to the progressive enlargement of these lesions. The mechanism of this cellular accumulation of cholesterol is not known. The possibility that platelets may have a role in the cellular cholesterol accumulation that occurs during atherogenesis was investigated. Incubation of thrombin-activated washed rat platelets (or platelet-free supernatants prepared from thrombin-activated platelets) with cultured rat aortic smooth muscle cells induced cholesteryl ester lipid droplet accumulation within the smooth muscle cells. No cholesteryl ester lipid droplets accumulated when smooth muscle cells were incubated with unactivated platelets. Smooth muscle cell lipid droplet accumulation occurred in the absence of serum lipoproteins and was not inhibited by mevinolin, a drug that blocks cholesterol synthesis. These findings suggest that activated platelets may release cholesterol, which can be accumulated by cells and stored as lipid droplets. PMID- 3975613 TI - Auditory midbrain responses parallel spectral integration phenomena. AB - Resolving the frequency components of complex sound spectra including speech is an inherent, important accomplishment of the auditory nervous systems of vertebrates. The critical perceptual unit in the frequency domain, the critical bandwidth, has a simple functional equivalent within the principal midbrain auditory nucleus--the central nucleus of the inferior colliculus. PMID- 3975614 TI - Benefits, risks, vaccines, and the courts. PMID- 3975615 TI - Molecular models for DNA damaged by photoreaction. AB - Structural models of a DNA molecule containing a radiation-induced psoralen cross link and of a DNA containing a thymine photodimer were constructed by applying energy-minimization techniques and model-building procedures to data from x-ray crystallographic studies. The helical axes of the models show substantial kinking and unwinding at the sites of the damage, which may have long-range as well as local effects arising from the concomitant changes in the supercoiling and overall structure of the DNA. The damaged areas may also serve as recognition sites for repair enzymes. These results should help in understanding the biologic effects of radiation-induced damage on cells. PMID- 3975616 TI - Dynamics and conformational energetics of a peptide hormone: vasopressin. AB - A theoretical methodology for use in conjunction with experiment was applied to the neurohypophyseal hormone lysine vasopressin for elucidation of its accessible molecular conformations and associated flexibility, conformational transitions, and dynamics. Molecular dynamics and energy minimization techniques make possible a description of the conformational properties of a peptide in terms of the precise positions of atoms, their fluctuations in time, and the interatomic forces acting on them. Analysis of the dynamic trajectory of lysine vasopressin shows the ability of a flexible peptide hormone to undergo spontaneous conformational transitions. The excursions of an individual phenylalanine residue exemplify the dynamic flexibility and multiple conformational states available to small peptide hormones and their component residues, even within constraints imposed by a cyclic hexapeptide ring. PMID- 3975617 TI - Clinical trial stirs legal battles. PMID- 3975618 TI - AID tightens antiabortion measures. PMID- 3975619 TI - Why do people get fat? PMID- 3975620 TI - A renal countercurrent system in marine elasmobranch fish: a computer-assisted reconstruction. AB - Computer-aided techniques were used to reconstruct the complex renal tubular system in the dorsal kidney region of a marine elasmobranch fish, the little skate (Raja erinacea), from a series of light micrographs of serial sections. It was established that five individual segments of one nephron, consisting of two loops and a distal tubule, are arranged in parallel within an elongated closed tissue sac. Capillaries, which form a network around these nephron segments, enter and exit this sac at the same end. This anatomical arrangement suggests that a complex renal countercurrent multiplier system may be important in fluid regulation in these fish. PMID- 3975621 TI - Hormonal control of the anatomical specificity of motoneuron-to-muscle innervation in rats. AB - Motoneurons of the spinal nucleus of the bulbocavernosus innervate bulbocavernosus muscles in male rats. Adult female rats normally lack both the spinal nucleus and its target muscles. Prenatal treatment of females with testosterone propionate resulted in adults having, like males, both the spinal nucleus and its target muscles. However, prenatal treatment with dihydrotestosterone propionate preserves the muscles but not the motoneurons. This paradoxical condition might result from (i) bulbocavernosus muscles without innervation; (ii) muscles innervated by morphologically unrecognizable motoneurons; (iii) muscles innervated by a very few spinal nucleus cells, each innervating many bulbocavernosus fibers; or (iv) muscles innervated by motoneurons outside their normal anatomical locus in the spinal nucleus. The results of retrograde marker injections into the bulbocavernosus muscles of females treated with androgen refute the first three possibilities and confirm the last: the different androgen treatments result in anatomically distinct spinal motor nuclei innervating bulbocavernosus muscles. PMID- 3975622 TI - Response to ethanol reduced by past thiamine deficiency. AB - Ethanol-induced intoxication and hypothermia were studied in rats approximately 7 months after severe thiamine deficiency, when treated rats appeared to have recovered their physical health. Previously induced thiamine deficiency without prior ethanol exposure significantly decreased the area under the curve plotted for the concentration of ethanol in blood and also decreased behavioral impairment and hypothermia due to ethanol exposure. Pathophysiologic changes resulting from thiamine deficiency may contribute to both the pharmacodynamic and pharmacokinetic tolerance to ethanol in chronic alcoholics. PMID- 3975623 TI - Regional myocardial substrate uptake in hypertensive rats: a quantitative autoradiographic measurement. AB - Severe hypertension causes global and regional changes in myocardial perfusion and substrate utilization. Regional perfusion and fatty acid utilization were evaluated by dual-tracer autoradiography in normotensive and hypertensive rats of the Dahl strain. The regional distributions of perfusion and fatty acid utilization were homogeneous in normotensive rats. Severe hypertension was associated with a homogeneous pattern of regional perfusion, but fatty acid utilization was focally decreased in the free wall of the left ventricle. The decrease in fatty acid uptake was associated with a concomitant increase in glucose utilization. These findings suggest that severe hypertension is associated with uniform myocardial perfusion and focal alterations in the substrates used for the performance of myocardial work. PMID- 3975624 TI - Promoting functional plasticity in the damaged nervous system. AB - Damage to the central and peripheral nervous system often produces lasting functional deficits. A major focus of neuroscience research has been to enhance functional restitution of the damaged nervous system and thereby produce recovery of behavioral or physiological processes. Promising procedures include surgical, physical, and chemical manipulations to reduce scar formation and minimize the disruption of support elements, administration of growth-stimulating substances, tissue grafts to bridge gaps in fiber pathways, and embryonic brain tissue grafts to provide new cells with the potential to generate fiber systems. Two elements are required for functional nervous system repair: (i) neurons with the capacity to extend processes must be present, and (ii) the regenerating neurites must find a continuous, unbroken pathway to appropriate targets through a supportive milieu. PMID- 3975626 TI - Who runs NIH? PMID- 3975625 TI - Jury clears Bendectin. PMID- 3975627 TI - Blood-brain barrier: endogenous modulation by adrenal-cortical function. AB - The blood-brain barrier restricts the passage of molecules from the blood to the brain. The permeability of the barrier to iodine-125-labeled bovine serum albumin was examined in rats that had undergone adrenalectomy, adrenal demedullation, and corticosterone replacement. Adrenalectomy, but not adrenal demedullation, increased the permeability of brain tissue to the isotopically labeled macromolecule; corticosterone replacement reversed this effect. These results indicate that the blood-brain barrier may be hormonally regulated; that is, the pituitary-adrenal axis may physiologically modulate the permeability of the brain microvasculature to macromolecules. PMID- 3975628 TI - On the nature of a defect in cells from individuals with ataxia-telangiectasia. AB - The cells and tissues of patients with ataxia-telangiectasia (A-T), an inherited disease characterized by a high degree of proneness to cancer, are abnormally sensitive to ionizing radiation. Noncycling cultures of normal human and A-T fibroblasts were exposed to x-rays so that the breakage and rejoining of prematurely condensed chromosomes in the G1 phase could be compared. After a dose of 6.0 grays, both cell types had the same initial frequency of breaks and the same rate for rejoining of the breaks, but the fraction of breaks that did not rejoin was five to six times greater for the A-T cells. The results also show that progression of cells into the S phase is not a prerequisite for the increased frequency of chromosome fragments that appear in mitosis after A-T cells are irradiated in the G1 or G0 phase. PMID- 3975629 TI - Developmentally controlled expression of immunoglobulin VH genes. AB - Although antibody diversity arises mainly from apparently random combinatorial and somatic mutational mechanisms acting upon a limited number of germline antibody genes, the antibody repertoire develops in an ordered fashion during mammalian ontogeny. A series of early pre-B and B-lymphocyte cell lines were examined to determine whether an ordered rearrangement of gene families of the variable region of immunoglobulin heavy chains (VH) may be the basis for the programmed development of the antibody response. The results indicated that the VH repertoire of fetal B-lineage cells is largely restricted to the VH 7183 gene family and that subsequent recruitment of additional VH gene families occurs during neonatal development. These results have important implications in understanding the ontogeny of immune function. PMID- 3975630 TI - Plasma homovanillic acid concentration and the severity of schizophrenic illness. AB - Concentrations of plasma homovanillic acid before treatment were highly correlated with global severity of illness in schizophrenic patients, both before and after treatment. In contrast, a fixed dose of haloperidol did not affect those concentrations. Thus, in patients with a diagnosis of schizophrenia, plasma homovanillic acid may reflect the severity of illness, but not be influenced by short-term pharmacological perturbations by neuroleptics. PMID- 3975631 TI - Reversal of oncogenesis by the expression of a major histocompatibility complex class I gene. AB - The classical transplantation antigens (the major histocompatibility complex class I antigens) play a key role in host defense against cells expressing foreign antigens. Several naturally occurring tumors and virally transformed cells show an overall suppression of these surface antigens. Since the class I molecules are required in the presentation of neoantigens on tumor cells to the cytotoxic T lymphocytes, their absence from the cell surface may lead to the escape of these tumors from immunosurveillance. To test this possibility, a functional class I gene was transfected into human adenovirus 12-transformed mouse cells that do not express detectable levels of class I antigens; the transformants were tested for expression of the transfected gene and for changes in oncogenicity. The expression of a single class I gene, introduced by DNA mediated gene transfer into highly tumorigenic adenovirus 12-transformed cells, was sufficient to abrogate the oncogenicity of these cells. This finding has important implications for the regulation of the malignant phenotype in certain tumors and for the potential modulation of oncogenicity through derepression of the endogenous class I genes. PMID- 3975632 TI - NIH gaining in grants battle. PMID- 3975633 TI - Genotoxicity of formaldehyde in cultured human bronchial fibroblasts. AB - Formaldehyde, a common environmental pollutant, inhibits repair of O6 methylguanine and potentiates the mutagenicity of an alkylating agent, N-methyl-N nitrosourea, in normal human fibroblasts. Because formaldehyde alone also causes mutations in human cells, the compound may cause genotoxicity by a dual mechanism of directly damaging DNA and inhibiting repair of mutagenic and carcinogenic DNA lesions caused by other chemical and physical carcinogens. PMID- 3975634 TI - NIH budget. PMID- 3975635 TI - Neurobiological bases of rhythmic motor acts in vertebrates. AB - The general principles governing the nervous control of innate motor acts in vertebrates are discussed. Particular consideration is given to the control of locomotion in both mammals and lower vertebrates. One in vitro model of the lamprey central nervous system has been developed. It can be maintained in vitro for several days and the motor pattern underlying locomotion can be elicited in isolated sections of the spinal cord. These findings now allow a detailed analysis of the underlying neural mechanisms. The hypothesis that different parts of the network controlling locomotion can be used in a variety of other motor acts, including learned ones, is reviewed. PMID- 3975636 TI - Computerized pattern recognition: a new technique for the analysis of chemical communication. AB - Computerized pattern recognition techniques can be applied to the study of complex chemical communication systems. Analysis of high resolution gas chromatographic concentration patterns of the major volatile components of the scent marks of a South American primate, Saguinus fuscicollis, demonstrates that the concentration patterns can be used to predict the gender and subspecies of unknown donors. PMID- 3975637 TI - Synaptic morphology and differences in sensitivity. AB - A relation between synaptic morphology and physiology was observed in an in vitro preparation of a sense organ (the ampulla of Lorenzini), in which activity was monitored from the primary afferent neurons before electron microscopic examination of the afferent synapses. The depth of the postsynaptic trough decreased as prefixation sensitivity of the sense organ decreased. This relation and other ultrastructural differences suggest that physiological properties of synapses are influenced by morphological features. Thus, synapses might be morphologically dynamic to modulate synaptic efficacy in relatively long-term phenomena. PMID- 3975638 TI - Digestive adaptations for fueling the cost of endothermy. AB - Little is known about the digestive adaptations that enable mammals to sustain metabolic rates an order of magnitude higher than those of reptiles. Comparison of several features of digestion in mammals and lizards of similar size eating the same diet revealed that mammals processed food ten times faster and with the same or greater extraction efficiency. Transport kinetics and rates of nutrient absorption normalized to the quantity of intestinal tissue were similar in these two classes of vertebrates. The main basis for faster absorption in mammals is their much greater intestinal surface area. PMID- 3975639 TI - The determination of molecular weight distributions on heparin samples. PMID- 3975640 TI - An investigation of the functional role of the carboxylic groups of heparin. Affinity for antithrombin III and anti-Xa activity of selectively carboxyl esterified heparin. PMID- 3975641 TI - The diagnosis of gastric cancer. PMID- 3975642 TI - Staging of gastric cancer. PMID- 3975644 TI - Evaluation of AJC stomach cancer staging using the SEER population. PMID- 3975643 TI - Clinical implications of recent developments in gastric cancer pathology and epidemiology. AB - Recent developments in the epidemiology of gastric cancer have direct clinical implications: It is important to classify patients as belonging to communities with high or low gastric cancer risk. Most native white Americans are at low risk. American Indians, blacks, and Hispanics, as well as immigrants from Russia, Scandinavia, Japan, and some Latin American countries, are at high risk. In high risk populations the predominant histologic type of gastric carcinoma is "intestinal" or "expansive" which tends to form discrete masses, predominates in males and older people, and has a relative better prognosis. In low-risk populations the tumors tend to be "diffuse" or "infiltrative," are frequent in females and younger people, and tend to have a worse prognosis. The intestinal type of gastric cancer is probably related to diet, characterized by low fat and animal protein intake, high ingestion of grains and tubercular roots, high salt intake, and low intake of fresh fruits and fresh vegetables. Some foods such as fava beans and Japanese fish are suspected of yielding gastric carcinogens after nitrosation. Populations at high risk in which the intestinal type predominates have a high prevalence of atrophic gastritis and intestinal metaplasia. Some of these precursor lesions reach the precancerous stage of dysplasia. The management of these lesions needs further clinical research. Some gastrectomy techniques facilitate the reflux of bile acids into the stomach where they may react with nitrite to produce mutagens and possibly carcinogens. The risk of "stump carcinoma" increases with time after gastrectomy. Billroth II operations should be replaced with techniques that minimize duodenal reflux. PMID- 3975645 TI - Role of progesterone receptors in breast cancer. AB - It has been demonstrated that progesterone receptor (PR) is at least as valuable as estrogen receptor (ER) for predicting the outcome in breast cancer patients. Retrospective analysis indicates that presence of PR may be the second most critical factor, after the number of positive nodes, in predicting for disease free survival, with a correlation between length of survival and number of tumor PR. The presence of PR has been shown to be of value for predicting response in both early and advanced breast cancer patients. In studies of assay consistency, major discordance rates were minimal in simultaneous assays but extremely high in sequential assays of tumors that were PR positive in initial assay. The responsible factor was interim endocrine therapy, and it was subsequently determined that prognosis was worse for those patients whose tumors lost PR between assays. PMID- 3975646 TI - Bioequivalence evaluation of new megestrol acetate formulations in humans. AB - The bioequivalence of two new investigational 160 mg tablets, one containing the regular form and the other a micronized form of megestrol acetate, was determined relative to a commercially available 40 mg tablet. The tablets were administered to 24 male subjects in a three-way crossover study, balanced for sequence, with 1 week between administrations. The 40 mg tablets were administered qid at 8 AM, 12 PM, 6 PM, and 10 PM, while the 160 mg tablets were administered once at 8 AM. Plasma samples were collected at appropriate times up to 96 hours after administration and were analyzed for megestrol acetate with a validated high performance liquid chromatographic procedure. Based on the times to maximum plasma concentrations (2.5 to 2.8 h) the rate of absorption was the same for each of the tablets. Relative to the 40 mg qid dose, the 160 mg regular and the 160 mg micronized tablets had mean relative bioavailabilities of 97% and 118%, respectively. PMID- 3975647 TI - The use of high-dose megestrol acetate in the treatment of ovarian adenocarcinoma. AB - This study investigated the use of a progestin, megestrol acetate, in high doses for 34 patients with ovarian adenocarcinoma and related gynecologic tumors. Megestrol acetate was administered in doses of 800 mg/d orally for one month, followed by 400 mg/d until the first signs of progression of disease. Of 23 evaluable patients, seven patients showed a complete response and four patients a partial response. Ten of the responders had ovarian adenocarcinoma, and one, who is alive and free of disease 96 months after treatment, had a mesothelioma. The remaining six patients achieving complete response survived from 5 to 36 months, and those achieving partial response survived from 4 to 10 months. In contrast, studies of progestins administered in conventional doses to ovarian carcinoma patients have yielded minimal response at best. Our results confirm the benefits of high-dose progestins for ovarian carcinomas and related gynecologic tumors and warrant further investigation of hormonal therapy for this patient group. PMID- 3975648 TI - Progestin therapy in lesions of the endometrium. AB - This paper details several studies of the effect of a single progestin, megestrol acetate, in patients with persistent endometrial hyperplasia and recurrent or persistent endometrial adenocarcinoma. Results of these studies indicate that megestrol acetate inhibits recurrence of adenomatous and atypical hyperplasia as well as adenocarcinoma in situ. These diseases when left untreated often progress to invasive adenocarcinoma. Additional studies presented here show that megestrol acetate is effective in the treatment of endometrial adenocarcinoma in inoperable patients and increases survival in patients with recurrent endometrial cancer. PMID- 3975649 TI - Mechanisms of action of progestational agents. AB - An in vitro tissue culture system utilizing human breast cancer cells in long term culture was employed to examine mechanisms of action of progestational agents such as progesterone and megestrol acetate. Growth experiments were performed under various defined media conditions. Concentrations of both progesterone and megestrol acetate (10(-5) mol/L), which are attainable in patients, led to direct cytotoxicity of hormone-dependent cells and also to a modification of the known estrogen stimulation of growth in these cells. PMID- 3975650 TI - Megestrol acetate used as primary hormonal therapy in stage D prostatic cancer. AB - The majority of patients with advanced prostatic cancer respond either to castration or estrogen therapy. In an attempt to identify an alternative hormonal therapy, 25 symptomatic stage D prostate cancer patients were treated with megestrol acetate as initial hormonal therapy. Thirty-three patients were evaluable for response as defined by the National Prostatic Cancer Project criteria. Partial remission was observed in 11 patients and stable disease in 5, with an overall response rate of 70%. The projected median duration of response and survival were 10 and 20 months, respectively. Weight gain was common, but only two patients showed evidence of fluid retention. Gynecomastia, thromboembolic episodes, and gastrointestinal side effects were not observed in this group of patients, though two patients had increased pain shortly after therapy was initiated. Thus, in advanced prostatic cancer, megestrol acetate is effective primary therapy with minimal side effects. PMID- 3975651 TI - Use of megestrol acetate in advanced breast cancer on a single-daily-dose schedule. AB - Twenty patients with metastatic breast carcinoma received megestrol acetate following additive or ablative therapy. The drug was given in a single oral dose of 160 mg daily to all patients. Side effects and response to therapy appeared comparable to those obtained when the drug is given on a multiple-daily-dose schedule. This small series suggests that megestrol acetate can be used as a single daily dose with comparable therapeutic efficacy and no change in the expected side effects. PMID- 3975652 TI - Megestrol acetate v tamoxifen in advanced breast cancer in postmenopausal patients. AB - One hundred six postmenopausal patients with advanced breast cancer received megestrol acetate or tamoxifen as primary therapy. Response to therapy was comparable for the two agents, with no organ site preference observed for either agent. The median duration of remission was also comparable for the two agents. Both treatments were well tolerated, with weight gain being the most common side effect observed. Initial results of another ongoing study suggest that megestrol acetate is as effective as tamoxifen in hormone-sensitive breast cancer in which receptors have been identified. PMID- 3975653 TI - Primary hormonal therapy of advanced breast cancer with megestrol acetate: predictive value of estrogen receptor and progesterone receptor levels. AB - Estrogen (ER) and progesterone receptor (PR) levels in human breast cancer have been shown to have value in predicting response to a variety of hormonal therapies. However, the relationships between steroid receptor levels and tumor response and survival in patients treated with progestational agents for primary hormonal therapy have not been clearly defined. Forty-three advanced breast cancer patients, whose tumors had been assayed for ER and PR were treated with megestrol acetate as initial hormonal therapy. Twenty-five patients had ER and PR levels greater than 10 femtomole/mg cytosol protein, and the median ER and PR levels for the entire group were 114 fmol/mg and 100 fmol/mg, respectively. The overall response rate (complete and partial) was 46%, with a median duration of response of 66 weeks. Seventy percent of patients whose ER and PR were greater than 10 fmol/mg responded: Step-wise discriminant analysis showed that ER and PR were significantly related to response and that PR was the best predictor of response (P = .0034). Similarly, both ER and PR were significantly related to survival (P = .0001 for PR and P = .021 for ER). These data indicate that megestrol acetate is effective primary hormonal therapy in advanced breast cancer patients, and that ER and PR levels were significantly related to response and to survival duration. PR proved to be the best predictor of response in this group of patients. PMID- 3975654 TI - Progestin modulation of estrogen-dependent marker protein synthesis in the endometrium. AB - While it is well known that progestins have significant effects on estrogen dependent processes in the uterus, very little is known about the molecular details of these effects. To understand these processes we have developed an immunocytochemical staining technique to help clarify the progestin regulation of estrogen receptor (ER), and we have also studied the effects of progestins on estrogen-dependent specific protein synthesis and secretion in the immature rat uterus. The immunocytochemical method for identifying estrogen receptor in tissue sections uses biotinylated monoclonal antibody to the estrogen receptor protein and shows a largely nuclear localization of the receptor protein in the rat uterine endometrium and myometrium. This method can be used to explore changes in the intercellular and intracellular localization of the uterine ER during progestin action. In an effort to correlate these changes with specific biological responses in the uterus we have been studying the effects of the administration of estrogens and progestins in vivo on the synthesis of specific proteins in uterine target cells in vitro. We previously reported that one dimensional SDS-PAGE analysis of labeled secreted uterine proteins and cellular proteins extracted from the luminal epithelium and from the stroma plus myometrial fractions of the uterus revealed that estradiol-17 beta preferentially stimulated the synthesis of 110,000, 74,000, and 66,000 dalton secreted proteins, and 180,000 and 110,000 dalton epithelial proteins. We found that while progestins administered alone in vivo did not have any stimulatory effect on the synthesis of these secreted or cellular uterine proteins, concomitant administration of either progesterone or megestrol acetate and estradiol in vivo substantially reduced the estrogen-stimulated increase in labeling of the 110,000, 74,000, and 66,000 dalton secreted uterine proteins in vitro. In animals first primed with the progestin prior to combined estrogen/progestin treatment, the progestins were even more effective antagonists of estrogen. In addition, progestins alone given 24 hours after estradiol substantially inhibited the estrogen-stimulated synthesis of these proteins. These results suggest that progestins can both modulate the initial level of estrogen stimulation of synthesis of specific proteins and selectively terminate their synthesis, by affecting the continued transcription of their estrogen-regulated genes, altering the processing, half-life, or translation of their mRNAs, or by modulating the translation or the posttranslational processing of the nascent peptide chains. PMID- 3975656 TI - VP-16 in the treatment of malignant lymphomas: a report from the Swiss Group for Clinical Cancer Research (SAKK). AB - In a pilot study, researchers at The Swiss Group for Clinical Cancer Research (SAKK) treated advanced lymphoma patients with a combination of DDP/VP 16/prednisone. Overall response rate was 34%. Currently, the new platinum derivatives are being studied. Meanwhile, various pilot studies are being conducted in non-Hodgkin's lymphoma (NHL) patients to evaluate the combination, VP-16/bleomycin/procarbazine/ARA-C. Preliminary results are encouraging. It is hoped that this will be an effective salvage regimen for NHL patients and also for use in an alternating regimen along with a well-established first-line treatment. PMID- 3975655 TI - Vindesine, etoposide (VP-16), and prednisolone (VEP) in relapsed patients with grade II non-Hodgkin's lymphoma. AB - Vindesine, etoposide (VePesid), and prednisolone (VEP) have been evaluated as a second-line combination regimen in 20 patients with grade II non-Hodgkin's lymphoma (NHL) who relapsed during or after first-line intensive therapy. The overall response rate was 40% (20% complete, of 9 to 13+ months' duration, and 20% partial, of 1.5 to 5 months' duration). The main toxicities were alopecia and myelosuppression (with two nonfatal cases of septicemia); nausea, vomiting, neurotoxicity, and skin and mucosal problems were relatively uncommon. VEP appears to be an active second-line regimen with acceptable toxicity in relapsed high-grade NHL patients. PMID- 3975657 TI - Bioavailability and pharmacokinetics of etoposide (VP-16). AB - The absolute oral bioavailability of etoposide (VePesid) was determined in cancer patients based on a comparison of intravenous and oral administration. The oral dosage unit was etoposide solubilized in a polyethylene glycol-based vehicle in a soft gelatin capsule formulation. The intravenous dose was 80 mg/m2 as a one-hour infusion and the oral dose was 160 mg/m2. The absolute bioavailability based on plasma concentrations or urinary excretion of etoposide was 48% to 57%. The plasma elimination half-life was 5.3 hours, total body clearance 21.4 mL/min/m2, and renal clearance 7.7 mL/min/m2. Significant intersubject and intrasubject variation was observed in intravenous and oral pharmacokinetics and oral bioavailability. This variability could be related to intrapatient and interpatient differences in nonrenal clearance and the inherent patient and disease status problems in evaluating the pharmacokinetics of anticancer drugs. This variability is characteristic of many classes of cytotoxic drugs and indicative of the requirements of individual dose optimization. PMID- 3975659 TI - Magnetic resonance imaging of bone and soft tissue tumors: early experience in 31 patients compared with computed tomography. AB - In 31 patients with 21 soft tissue and 10 bone tumors, magnetic resonance imaging (MRI) and computed tomography (CT) were equally effective in delineating the margins of most soft tissue tumors, and the margins of bone tumors from fat and adjacent normal bone. However, MRI was superior to CT in delineating bone tumors from adjacent muscle, and in showing the relationships to bone of the deep margins of some soft tissue tumors. This was true because the quality of CT images around thick cortical bone often was severely degraded by streak artifact, which does not occur in MRI. Excellent anatomic detail was achieved on MRI by spin echo pulse sequences with short repetition times. Bone tumors were delineated best by spin echo 1000/30 images, and soft tissue tumors by spin echo 1000/30 or inversion recovery images. PMID- 3975658 TI - Radiologic study of 42 cases of Wilson disease. AB - This paper reports 42 cases of bone and joint radiographic changes in hepatolenticular degeneration. The cases were proven clinically by ophthalmologic and laboratory study, and their radiographic and joint changes were divided into five groups: no abnormal findings, osteoporosis, osteomalacia (rickets), distinct changes, and miscellaneous. Distinct changes include marginal bone fragments, angulation of carpal bones, squaring of metacarpal heads, and calcification of the joint capsule or tendon insertion. The mechanism causing the bone changes in hepatolenticular degeneration is also discussed. PMID- 3975660 TI - Case report 295. Metastatic disease of the carpus (primary site: bronchogenic carcinoma). PMID- 3975661 TI - Case report 302. Desmoplastic fibroma of the proximal end of the left femur. PMID- 3975662 TI - Case report 303. A complete plica synovialis suprapatellaris, with diffuse pigmented villonodular synovitis limited to an isolated non-communicating suprapatellar bursa. PMID- 3975663 TI - Case report 304. Florid reactive periostitis proximal phalange of the left 5th finger. PMID- 3975664 TI - Case report 305. Dysplasia epiphysealis hemimelica (Trevor disease) of left ankle with an associated osteochondral (post-traumatic) fracture fragment, probably arising from talus. PMID- 3975665 TI - Populism and health policy: the case of community health volunteers in India. AB - The Indian Community Health Volunteer (CHV) Scheme is a major large scale experiment in people's participation into primary health care. This study intended to elicit the origins, the formulation and decision making process and the implementation of this programme. The evolution of the CHV programme is a particularly striking example of the contradictions of participation policies in a populist regime. Political awakening of the rural masses makes it absolutely necessary to take action so as to re-direct a portion of state interventions for their benefit. But the determining influence of the dominant classes, in both political and intermediate level bureaucracy of the state apparatus, tends to divert most of the resources made available by the State from their initial object, while inevitable reforms are constantly delayed. Thus the development of a popular participation policy would seem to be the necessary complement to the centre's reform policies. Yet the implementation of this participation policy can be realized only through the intermediary apparatus which must be verified and reoriented. Participation policy is thus distorted in order to reinforce the patronage capacities of existing political apparatus. In its present configuration, the CHV programme would appear first as an effort to constitute a poor-people's medicine circuit, answering the aspirations awakened by a populist political system, and much less the springboard for collective mobilization of communities in order to master their own development. As a whole, the order of priorities has been deeply altered in the course of implementation. The curative action took precedence over preventive action; individual action over collective action. This distortion could be explained both by the nature of people's demand and by the prevalence of clientelism and patronage as mode of political control. PMID- 3975666 TI - Using the health belief model to predict initial drug therapy defaulting. AB - In a study of HMO patients, a Health Belief Model (HBM) questionnaire was tested to determine whether initially drug defaulting patients could be differentiated from initially compliant patients. The results of discriminant analysis indicated that individuals in the two groups could be correctly classified at a level of 68.7%. The variables on which the initially defaulting sample collectively scored less on, and which produced the most discrimination between the two groups, were: feedback from physicians on how to take a newly prescribed drug: belief in benefits of medical care for symptoms or illnesses; convenience factors including travel, need for day care and time off from work without pay needed for medical services; length of HMO membership; and education. A total of 20% of the variance in the derived discriminant function could be accounted for by the two groups. The results indicate the utility of the HBM as a tool of prediction for this form of noncompliance, and suggest possible other patient behaviors that may be able to be predicted by the model. The results further suggest the need for increased communication between providers and patients in the health care setting. PMID- 3975667 TI - Maintenance of psychosocial attitudes in medical students. AB - Attitudes of medical students towards the psychosocial aspects of illness is of serious concern to medical educators. It is thought that medical students are overwhelmingly disease-oriented and not sufficiently sensitive to the role of the psychological, emotional, sociological and economic factors in the etiology and management of illness. In the present study the ATSIM (Attitudes Towards Social Issues in Medicine) was presented to third year medical students and compared with their responses obtained 2 years previously when they were first year students. The data suggest that third year medical students have positive attitudes towards certain psychosocial issues (the importance of social factors as determinants of health or illness, the role of preventive medicine in maintaining health, the role of physician-patient interactions in patient care). These attitudes were positive during the students' first year and have been maintained during the course of medical school. These finding are contrary to previous studies which indicate a deterioration in attitudes during the course of medical school. PMID- 3975668 TI - The meaning of medications: another look at compliance. AB - Most research on compliance with medical regimens takes a doctor-centered perspective and proceeds from certain assumptions. This paper presents an alternative, patient-centered approach to managing medications, using data from 80 in-depth interviews of people with epilepsy. This approach focuses on the meanings of medication in people's everyday lives and looks at why people take their medications as well as why they do not. I argue that from a patient's perspective the issue is more one of self-regulation than compliance. When we examine 'noncompliance' beyond difficulties with 'side effects' and drug efficacy, the meanings of self-regulation include testing, controlling dependence, destigmatization and creating a practical practice. What appears to be noncompliance from a medical perspective may actually be a form of asserting control over one's disorder. PMID- 3975669 TI - Patient reactions to doctors' computer use in general practice consultations. AB - This paper describes an experimental field study of patient reactions to computer use by doctors during general practice consultations. The computer system offered facilities for the review of medical histories and the entry of individual encounter notes. Questionnaire assessments of patient reactions were obtained from 127 patients who had just consulted a doctor who was using the computer and from 216 control patients for whom conventional procedures had been retained. Contrary to many doctors' concerns no overall negative effects were recorded for patient reactions. There were no differences between the experimental and control conditions with respect to patients' perceptions of the doctors' attentiveness and rapport, patients' satisfaction with information received, their confidence in the treatment received, their expected compliance or post-consultation stress. A relation was however apparent between post-consultation stress and attitudes to the idea of doctors using computers in the consulting room, in which unfavourable attitudes were associated with reports of higher stress, and conversely. The results suggest that patient reactions to the consultation are more affected by which doctor they see than by whether or not the doctor is using a computer. However, the findings relate to only a short period of computer use in an experimental context and the effects of more established computer use remain a matter for further enquiry. PMID- 3975670 TI - A survey of traditional medical practices used for the treatment of malignant tumors in an East African population. AB - A group of 119 Tanzanians with cancer were interviewed regarding previous traditional medical experiences prior to evaluation for radiation treatment. Forty-nine (49.1%) percent of the females and 40.6% of the males had been treated with traditional medicines. Seventy-four percent of the traditionally-treated patients had consulted a traditional doctor prior to being seen by a Western trained doctor. The most common given treatment was a combination of several traditional methods. More than half of all traditionally-treated patients reported progression of their diseases after treatment. Only one patient had any subjective improvement. These patients tended to have less formal education and a lower standard of living than untreated patients. Problems associated with the diagnosis of cancer are addressed. PMID- 3975671 TI - The association between health and retirement: self-health assessment of Israeli retirees. AB - Self-health evaluation and health behavior after retirement were compared with the retrospectively self-assessed health state of the pre-retirement period. The data of 310 former industrial and service workers were examined within the context of the 'Health, Stress and Coping' mechanism, with retirement representing the potential psychological stress. The findings negate the hypothesis that retirement is responsible for worsening health conditions leading to over-utilization of medical services. The decline in the perceived health state, that had already started 6 to 1 year before retirement is not ascribable to this life change event per se, but rather to the normal biological ageing processes. PMID- 3975672 TI - Mobilizing indigenous resource for primary health care in Nigeria: a note on the place of traditional medicine. AB - Noting the challenges posed by the goal of health For All by the Year 2000, this paper re-echoes the need to mobilize traditional medicine for Primary Health Care in Nigeria. The paper points to the inadequacy of modern health facilities and the obstacles that stand in the way of providing enough modern health facilities to meet the demand of Nigeria's population by the year 2000. It is observed that traditional medicine offers an alternative model not only because it is relatively inexpensive both to the practitioners and patients who often settle their bills in kind or cash but also because of its acceptability among Nigerians. Finally, it is suggested that government and traditional medical practitioners should cooperate for it is in this way that the practice of traditional medicine can be improved and the practitioners encouraged to add Primary Health Care activities to the repertoire. PMID- 3975673 TI - The persistence of high fertility in Kenya. AB - Like many underdeveloped countries, Kenya's demographic structure is in a state of flux. Its annual population growth rate is now about 4% and half of the population is under 15 years of age. This rapid growth has put additional pressure on regional development in a country which is struggling to transform its predominantly agrarian economy into a modern one. Rural poverty is a persistent problem, life expectancy is depressed, and malnutrition is endemic in many parts of the country. Despite a national fertility control programme, contraceptive use in Kenya is almost negligible. The current family planning programme emphasizing maternal and child health care will have little impact on family size in the long term. The programme's basically coital contraception aimed at women runs against the complex individual and societal norms which control fertility in African communities. The paper presents one view of fertility differentials in Kenya and its relationship with the incidence of poverty. It posits that in the absence of broad-based socio-economic changes current efforts at fertility control will have few short-term benefits and hold little long-term promise. PMID- 3975674 TI - Pharmacy patronage among the elderly: selected racial and geographical patterns. AB - In the United States the number of elderly and their percentage of the total population continues to increase. The large majority will never require care in an institution, yet they are faced with increasing health problems and decreased mobility, and almost half require prescription drugs to pursue activities of daily living. In this paper selected patterns of pharmacy patronage among a sample of elderly are presented. Overall, the percentage of elderly requiring prescriptions reflects national estimates and no significant difference is found in the expressed need for prescriptions between black and respondents. 'Neighborhood' pharmacies are perceived as being very important, but relatively few use the most geographically convenient. Nevertheless, the large majority of elderly are satisfied with distances they presently have to travel to purchase prescriptions. The observed travel patterns for prescription purchases suggest that conventional wisdom pertaining to the nature of the pharmacy journey, the notion of convenience and the traditional concept of neighborhood among the elderly should be reexamined. PMID- 3975675 TI - Personality indicators of psychosocial adjustment in first-year medical students. AB - One aspect of the Rush Medical College Longitudinal Study is concerned with the identification of personality traits that predict various kinds of psychosocial adjustments and impairments among medical students and physicians. Two orthogonal traits, masculinity and femininity, were selected for study as independent variables because of their implications for mental health and their relevance to the work of physicians. Ninety percent (N = 106) of a class of first-year medical students completed measures of masculinity and femininity during orientation and, 8 months later, completed a broad array of dependent measures of psychological well-being, interpersonal satisfaction, humanistic attitudes and alcohol consumption. Analyses of the data revealed strong and consistent main effects of masculinity on depression, confidence, pleasure capacity, extraversion, locus of control, neuroticism and interpersonal satisfaction. Femininity was associated with depression, pleasure capacity, extraversion, neuroticism, interpersonal satisfaction, concern for the opinion of others and humane attitudes toward patient care. Low femininity was also associated with high alcohol consumption. These results suggest that masculinity and femininity scores may help to identify at the outset medical students at risk for impairment, and that androgynous individuals (who are high in both masculinity and femininity) may be especially well-suited to assume the demanding and varied roles that physicians are called on to play. PMID- 3975676 TI - Sociology of health and illness in France, retrospectively and prospectively. PMID- 3975677 TI - Social uses of illness at the workplace: sick leave and moral evaluation. AB - From interviews with 25 white-collar employees in France, the processes are analysed through which fellow workers and superiors morally evaluate persons who are ill. The differences between this lay interpretation and the medical one are highlighted along with the criteria (the 'sick leave' and 'morbidity' scales) used to form judgments. A person's illness can be used as a pretext to justify measures that are related to other aspects of his life at the workplace. These uses of illness lead us to raise new questions about the legitimation of symptoms by the physician. They also throw light upon the pervasive means of social control that lie outside medical institutions. PMID- 3975678 TI - A protest movement in a private clinic: an analysis of a patients' strike. AB - Behind this protest movement among chronic patients on dialysis was a dispute between the specialist who headed the service and the director of the clinic. This dispute eventually involved the patients, who felt that the quality of care was at stake. Their 'therapy strike', as exceptional as it is in the world of illness, brings to mind forms of action used by the consumer movement or by labour unions. The reasons that this small group of patients interrupted treatment are analysed in terms of their relations to medicine and their conceptions of illness. PMID- 3975679 TI - Professional socialization and social control: from medical students to general practitioners. AB - Most American research considers the assimilation of the norms and values of a given profession to be the most important way in which that profession controls the socialization of its future members. This view of social control is based on a problematic pattern of socialization. Using the results of a research into the socialization of general practitioners, a different approach to this problem of social control is suggested that takes into account the specific manner of integration into the university-hospital structures and the ways in which future doctors gain access to the professional world. The hospital with its scientific logic is thus the chief instrument of social control, even though this control is limited by the very nature of the hospital: hospital training only partly controls the application of this scientific knowledge by general practitioners. PMID- 3975680 TI - Hospital system management in France and Canada: national pluralism and provincial centralism. AB - Since the mid-1960s, France and Canada have developed different ways of managing their hospital systems. In Canada, each provincial government has gradually imposed technocratic control with the aim of planning the allocation of health care resources. In spite of attempts to do the same in France, the hospital system has grown with few restrictions other than those set by the medical profession itself. Consequently, health expenditures have risen at one of the fastest paces in Europe. The provincial monopoly over hospital care in Canada contrasts with the juxtaposition of local 'cartels' throughout France resulting, for the latter, in a much more uncoordinated system. After a description of each country's hospital system and its historical origins, the advantages and disadvantages of each system are assessed so as to understand current public debate in each country. PMID- 3975681 TI - Managerial procedures and hospital practices: a case study of the development of a new medical discipline. AB - In anesthesie-reanimation, a discipline that brings together anaesthesiology and emergency as well as intensive care, the managerial methods of evaluation and control of needs in personnel, were not adequate for describing medical practices. Around four managerial standards that were used by the Paris public hospital administration, new situations have crystalized. The historical analysis of how these standards have been put into use, used and put in question throws light upon the way organizations function. The present day situation in this speciality seems to be mainly determined by the strategies of specialists for obtaining professional recognition of their discipline and for advancing their careers. PMID- 3975682 TI - An economic approach to the daily activities of private general practitioners. AB - The present crisis in general medicine centres around the contents of the health care services provided by general practitioners. These services were examined in a survey, carried out in 1975, of GP's daily activities. Collected data have been used to describe the characteristics of the daily activities of a typical general practitioner. Variations from this model have been interpreted in terms of three factors that characterize the local situation under which primary medical care is delivered: the nature of the health-care market, GPs' relationships with potential clients and their relationships with the local medical profession and environment. PMID- 3975683 TI - The Primary Health Care Project in Belgium: a survey on the utilization of health services. AB - The article consists of two major parts. In the Introduction a general overview is given of the Primary Health Care Project, carried out in Belgium from 1975 to 1978 in the broader framework of a large National Project in the Social Sciences. An explanation is given of the scope of the study, its method and sampling. Since the very broad study design, it was decided to make a selection of interesting results. An overview is given of the most relevant data with respect to the utilization of health care services and of medicines. After a short clarification of the concept of utilization behaviour, some data are presented in order to describe the use of medical services and the consumption of medicines. Secondly an attempt is made to explain utilization behaviour. For the explanatory model used in this project, the WHO-model functioned as an important source of inspiration. In this way it surmounted the limitations of much previous research. This model included variables on the level of the individual-perceived morbidity, predisposing factors and enabling factors-as well as system variables--such as degree of urbanization, proximity and the way of functioning of the medical supply. The research results have successfully shown that: there is a strong relationship between perceived presence and perceived seriousness of morbidity on the one hand, utilization behaviour on the other hand; the health perspective (including medical knowledge, values and attitudes) seems to have a differential influence on utilization behaviour, depending on age and social background of the respondent; the inclusion of socio-structural variables is an innovation in the Belgian health care research. The hypothetical character of the relationships found here is largely supported by the research simultaneously conducted in the French-speaking region of Belgium; accessibility and socialization are factors having a clear influence on the use of general practice services. The importance of the presence and the organization of the supply in the explanation of utilization behaviour is partly confirmed. PMID- 3975684 TI - Prescription drug advertising: trends and implications. AB - Prescription drug advertisements which appeared in two leading American medical journals in 1972, 1977 and 1982 were analyzed to discover possible trends in advertising. The 5016 ads examined showed that ads for the diuretic cardiovasculars, especially the beta-adrenergic blocking agents and the slow channel inhibitors, as well as the analgesics, had increased, while ads for the anti-infectives and tranquilizers had diminished. The average amount of space allocated for each ad had increased. On the average, most ads (69%) depicted neither male nor female patients in their graphics, and a trend of increased neutrality was observed. When the hormones were excluded, an average of 21% of the ads showed male patients and 10% showed females. Since a relationship was discerned between the leading drugs advertised and the leading prescriptions filled, it was concluded that advertising does have some effect on the prescribing behavior of practitioners. The findings suggest that great investment in advertising is necessary in order to achieve high levels of sales for such drugs as Valium (diazepam) which do not have a clear-cut ameliorative effect on a specific physiological condition. On the other hand, it was suggested that saturation advertising would not significantly enhance the sales of such drugs as Dyazide (triamterene and hydrochlorothiazide) because of its well established therapeutic value in the control of hypertension. Ten advertising companies, on the average, had purchased 67% of all advertising space and five had purchased almost half (47%). The same two pharmaceutical companies were among the top five advertisers and the same five were among the top ten for the three years studied. PMID- 3975686 TI - An assessment of community health workers in Nicaragua. AB - In 1981, the Ministry of Health of Nicaragua began a series of health campaigns whose front-line workers were volunteers from the community called 'brigadistas.' These volunteers have since evolved into a type of community health worker with a multi-disciplinary role and are now called 'primary health care brigadistas'. These brigadistas were formed with the intention of encouraging local community involvement in health and as a means of overcoming rural health manpower shortages. However, in field research at two sites, these primary health care brigadistas were found to have rather limited roles and were dependent upon the nurse auxiliary for direction. A current debate in the Ministry of Health centers around the future role of the brigadistas and their degree of accountability to the Ministry of Health and the Popular Organizations. This article suggests that the brigadistas may be underutilized at present and that increasing their training and expanding their role may be necessary to adequately meet rural health care needs. PMID- 3975685 TI - What is unnecessary surgery? Who shall decide? Issues of consumer sovereignty, conflict and self-regulation. AB - This paper presents the results of a study of selected surgical procedures in Queensland, Australia. The data are compared to trends in the U.S.A. and England and Wales. Attention is drawn to the limitations of such epidemiological data as the basis for inferences about the necessity (or otherwise) of particular operations. This leads to a discussion of unnecessary surgery in the light of arguments for and against consumer sovereignty and the self-regulation of the medical profession. Faced with differences of opinion, and the problems of reconciling expert and consumer views about necessity, we argue that claims and counter-claims about unnecessary surgery should be opened to closer scrutiny. A review committee format based on medical and non-medical participation is proposed to achieve this end. PMID- 3975687 TI - Sterilization in the northeast of Brazil. AB - Results of household surveys carried out in four states in the Northeast of Brazil showed that female sterilization is the most prevalent method among women who want no more children. Many women who indicated an interest in tubal ligation, however, had not been sterilized. Access to sterilization depends on the type of hospital in which the child was delivered and the type of delivery the woman had. Over 60% of the sterilized women reported that they had a tubal ligation at the time they were hospitalized for a cesarean delivery. Compared with unsterilized women, the sterilized women are characterized by relatively higher education levels and a greater likelihood of urban residence and were far more likely to have had cesarean deliveries and, therefore, to have qualified for postpartum sterilization on medical grounds. PMID- 3975688 TI - Dietary beliefs in health and illness among a Hong Kong community. AB - Dietary adjustment for health promotion and maintenance and for helping the body to expedite its recovery from illness conditions has been part and parcel of the Chinese medical culture. The paper reports on the extent traditional dietary beliefs in health and illness persist in a fast changing Hong Kong community. It explores the community interpretation of the role of diet therapy; and the relationship of social demographic variables with peoples' tendency to give traditional dietary suggestions. Traditional beliefs were found to be quite prevalent. Differentiation in responses was seen for different types of belief concepts. Over 80% of respondents had strong belief in the role of diet expediting recovery during illnesses. Measles and anaemia were used as indicators to look at the types of foods suggested for consumption or avoidance and the rationale behind the suggestions. Explanations of diet therapy for measles were in general traditionally based and that for anaemia were based on a mix of traditional and modern concepts. While there is a tendency for the more Chinese culturally affiliated in this study population to have stronger traditional food beliefs, the relationship of social demographic factors with the tendency to give dietary suggestions for specific diseases are not clear. Diet therapy is a form of self-care and is an inseparable part of the total health care system in the community. The efficacy of traditional food remedies and the role of diet therapy in self-care should be further explored. PMID- 3975689 TI - Clinical clerkships in professional education: a study in pharmacy and other ancillary professions. AB - An empirical study of the dynamics of clinical clerkships in professional education is offered, with particular attention to ancillary professions. For students to eventually establish innovative practices within professional organizations, they need skills in the technical aspects of their fields, as well as in role-making and interprofessional negotiation. In examining a clinical clerkship in pharmacy, it was found that faculty overwhelmingly focus on technical matters, and assume that technical competence alone is enough to attain role expansion. The experiences of students, simulating participation in a complex organization as members of clinical teams, give good reason to question this and other assumptions constituting the structure of clerkships. Several recommendations issue from the analysis for strengthening the objectives of professional training. PMID- 3975690 TI - Factors which differentiate smokers from ex-smokers among cardiovascular patients: a discriminant analysis. AB - A retrospective analysis of smoking behavior among hospitalized, cardiovascular patients was conducted in order to describe factors which differentiate smokers from ex-smokers. Ex-smokers were defined as smokers who abstained from smoking for at least 6 months prior to admission to the hospital. A multifactor model of variables related to smoking cessation was tested utilizing a survey instrument which measured health beliefs, health locus of control, a standardized measure of stress (habits of nervous tension), social supports and tendency to utilize social and over-the-counter medication. Social support for cessation measured as the degree of disapproval of smoking by the respondents social network and belief in susceptibility to the smoking--disease linkage were the factors which most highly differentiated smokers and ex-smokers among the respondents. The standardized measure of stress did not differentiate the groups. The efficacy of routine health counselling concerning negative effects of smoking by health professionals and the encouragement and structuring of social supports for smoking cessation among high risk populations should be further investigated as an alternative or adjunct to more elaborate and formal programs of smoking cessation. PMID- 3975691 TI - A physician role typology: colleague and client dependence in an HMO. AB - This paper reports on physicians' role definitions in one prepaid group practice, a health maintenance organization (HMO). Colleague and client dependence are reviewed and analyzed as separable dimensions of physician role definitions. Data are derived from documents, interviews, and staff questionnaires collected in 1979-1980. The evidence reported suggests widespread colleague dependence in the HMO. Physicians consulted with one another about patient care and engaged in informal referral and review, developing practice standards; and some of these physicians relied on colleagues for handling their patient visits when needed. In relation to their patients, some physicians viewed themselves as bureaucratic officials relatively dependent on client approval in carrying out their health care activities, while others saw themselves as trusted medical experts in a setting free of nonmedical constraints in patient care. The relationship of organizational structure to these different role definitions is discussed. Classifying these HMO physicians according to a fourfold typology of professional dependence shows that most are Organizational Physicians (Type I), who are both colleague and client dependent. Collegial Physicians (Type II) are colleague dependent and, at the same time, do not perceive clients as demanding. Implications for quality of care and physician satisfaction and turnover are considered. PMID- 3975692 TI - Patterns in preventive behaviour: a study of women in middle age. AB - There has been little comparative research to discover if the same people take part in different preventive health programmes. The study described here examines if the same women carry out seven different types of preventive health behaviour and attempts to identify ways of characterising participants or non-participants in the various forms of behaviour. The results show that the probability of women who carry out one type of preventive health behaviour carrying out another was low. However, the one factor that distinguished between participation and non participation in various forms of preventive health behaviour was social class. The need to develop a model of health behaviour which accommodates both general structural factors and specific beliefs and circumstances is recommended. PMID- 3975693 TI - Lay workers in primary health care: victims in the process of social transformation. AB - The training and utilization of non-professional Primary Health Care Workers (PHCW's) is currently a major strategy for meeting the minimal health needs of the four-fifths of the world's population without permanent access to care. Increasingly, however, in countries where the wealth is in the hands of the few, PHCW's are become victims of political violence. Because the implementation of the Primary Health Care Model in these Third World countries requires a major transformation of the existing socioeconomic structures, the PHCW may be knowingly or unknowingly placed in a vulnerable situation. This relates to the various functions--both latent and manifest--of the PHCW's role as well as to the way they have been trained and utilized. That PHCW's may be utilized as vehicles of a nation's overall political strategy is demonstrated by the role of the 'barefoot' doctors during the cultural revolution in China. In contradistinction, they may be trained and utilized as part of a government's strategy to 'take over' struggling liberation groups and to 'cool out' potentially explosive situations. In addition, they may be used as spies as may their foreign counterparts and trainers. PHCW's trained in programs which encourage health workers to participate with the community in a critical analysis of the root causes of their ill health may be subject to reprisals if, in fact, they actually participate with the community in the development and implementation of strategies designed to combat the underlying social causes of their problems.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975694 TI - Traditional healers, mothers and childhood diarrheal disease in Swaziland: the interface of anthropology and health education. AB - A study of beliefs and practices relating to childhood diarrhea, relying primarily on traditional healers as informants and survey respondents, revealed an indigenous classification of childhood diarrhea into three main types. Enemas are used as a treatment in two types of more serious diarrhea regarded as due to unnatural causes. Most children with diarrhea are taken to clinics only after home treatments and those of traditional healers have failed, by which time a child may be severely dehydrated. The role of oral rehydration and strategies for health education are discussed in the context of Swazi culture. PMID- 3975695 TI - Obstetrical choice among urban women in Benin. PMID- 3975696 TI - Clean water provision in rural areas of less developed countries. AB - The decade of the 1980s is declared as a time to solve global domestic water supply problems. By 1990 international goals include the provision of adequate quantities of clean water to every person on earth. Such goals are justified on the basis of human health, economic well being, political development and equity and public safety. Drawing upon observations from Ethiopia, Malaysia and Liberia, cases where attempts to provide domestic water to villagers and rural town dwellers are presented. In all cited cases attempts to provide safe water have failed or are in jeopardy. Conclusions drawn from these cases include acknowledgement that global goals will best be achieved by approaching local problems one-by-one and recognizing the technical, environmental and human constraints upon safe water provision interact differently from one site to another. To properly plan, implement and maintain safe water systems the current technical solutions must be combined with the contributions of social and environmental scientists on a case-by-case basis. PMID- 3975697 TI - Police, social work and medical responses to battered women. PMID- 3975698 TI - Doing his best to sustain the sanctity of marriage. PMID- 3975699 TI - Women-battering, child abuse and social heredity: what is the relationship? PMID- 3975700 TI - Making the break. PMID- 3975701 TI - Domestic violence and the law: the 1976 Act and its aftermath. PMID- 3975702 TI - Refuges and self-help. PMID- 3975703 TI - Constructing images of deviance: a look at state intervention into the problem of wife-battery. PMID- 3975704 TI - The burden of dependency. PMID- 3975705 TI - Personal relationships: help and hindrance. PMID- 3975706 TI - Medical care in the 1980s. PMID- 3975708 TI - Percutaneous transhepatic catheterization in reconstructive surgery of the biliary ducts. AB - Preoperative placement of a No. 9 percutaneous transhepatic drainage catheter for two to three weeks greatly improves the condition of the patient who has suffered operative damage to the hepatic bile ducts. At operation the previously placed catheter serves to identify the proximal portion of the damaged bile duct, even in dense scar tissue, and then serves to pull a Silastic tube stent in a retrograde manner into the bile duct and out through the right hepatic lobe and skin. This stent is left across the hepaticojejunostomy anastomosis for 12 months, or even permanently, in cases in which the anastomosis can be made only to scar tissue rather than biliary mucosa. PMID- 3975707 TI - Surgically correctable fecal incontinence. AB - A significant percentage of children who are fecally incontinent are so from improper operation or failure to recognize a surgically correctable problem. Over the past five years, we have managed ten children who had operations for anorectal problems and two with anterior anus. Seven were seen after poorly positioned pull-through procedures for imperforate anus and had anal repositioning, four successfully. Gracilis sling was successful in two of the other three. In two children overflow after a Duhamel operation for Hirschsprung's disease was corrected by division of a persistent anorectal septum. The third child with a disrupted Duhamel procedure was cured by anolevatorplasty. In two children an anterior ectopic anus was made continent by posterior anoplasty. Primary and secondary deviations from proper anatomy of the anorectal region will result in incontinence, which may be recognized by physical examination and defecograms. Proper operation usually produces acceptable continence. PMID- 3975709 TI - Inadequate tetanus protection among the rural elderly. AB - Three cases of tetanus occurring in a community in southern West Virginia in five years prompted a survey of the immunization status of the population of this region. An immunization history was obtained from 540 consecutive patients seen at three different health care facilities. Of these, 386 (71.5%) had received prior tetanus protection, 65 (12%) had never been immunized, and 89 (16.5%) were uncertain or had received incomplete immunization. Of the 65 nonimmunized patients, 54 (83%) were older than 50 and only 11 (17%) were younger. Compared to the total group sampled, significantly more nonimmunized patients (both male and female) were older than 50 (P less than .001). Also, significantly more of these never immunized individuals lived in rural areas (P less than .001). In a group of 222 patients identified as being at increased risk of having tetanus, 65 (29%) had never been immunized, 89 (40%) were of uncertain or incomplete status, and 68 (30.5%) had been immunized more than ten years previously. One hundred twenty (54%) high-risk patients were older than 50 and 103 (46%) were younger. Compared to the entire population sampled, high-risk patients included significantly more who were older than 50 (P less than .001). Also, significantly more high-risk patients lived in rural areas (P less than .007). When treating injured patients, it is important to recall that many older adults living in rural areas are not adequately immunized against tetanus. Such patients should receive human tetanus immunoglobulin, as well as tetanus toxoid. PMID- 3975710 TI - Hand infections in the elderly. AB - Diagnosis and management of hand infections in the elderly can be challenging. The general principles of rest, elevation, compresses, and drainage when appropriate apply. Antibiotics are important to therapy. Review of data from elderly patients and comparison with a younger population having identical infections show a number of important differences. Temperature, pulse, and white blood cell and differential counts were not elevated significantly enough to be useful. Culture data show fewer pure Staphylococcus aureus infections (20%) and fewer pure gram-positive infections (20%) than the 34% and 56% respectively in a younger population. On the other hand, there were significantly more mixed gram positive and gram-negative infections (60%). Significantly, the average number of organisms per infection is increased (2.4 vs 1.9 per infection). Antibiotic susceptibility is significantly worse. The cephalosporins and the penicillinase resistant antibiotics remain good choices. PMID- 3975712 TI - Health beliefs, compliance, and control of diabetes mellitus. AB - The problem of compliance and control in the treatment of diabetic patients is widely recognized. However, compliance research is contradictory and impractical as a basis for intervention to improve the patient's adherence to his medical regimen. Health beliefs may provide an opportunity to intervene to improve compliance and control of the disease. In this study we examined the health beliefs of 93 male diabetic patients and correlated their beliefs with behavioral and physiologic measures of compliance gathered at a follow-up interview. The belief in severity of illness related to compliance. Health beliefs were better predictors of metabolic control than compliance itself. The study suggests that improving attitudes about care may be a means of directly influencing control of the disease. PMID- 3975711 TI - Type 8 pneumococcal pneumonia: an outbreak on an oncology ward. AB - An outbreak of four cases of type 8 Streptococcus pneumoniae pneumonia occurred on an Oncology Ward during a five-day period. All four patients had underlying malignancy and were in close proximity to each other on an open ward. No other patients or hospital personnel had type 8 S pneumoniae on throat or nasopharyngeal cultures. The implications of the outbreak with respect to transmission of this disease and role of pneumococcal vaccination are discussed. PMID- 3975714 TI - Brain metastasis: analysis of patients without known cancer. AB - Our retrospective review of the charts of patients receiving radiation therapy for brain metastasis revealed that one third presented neurologic symptoms without prior diagnosis of cancer. Lung cancer was detected in two thirds of this group, and in one third, the primary site remained unknown. There was good clinical and CT correlation. PMID- 3975713 TI - Initial experience with a new prosthetic angioaccess device. AB - Long-term vascular access has increased longevity for many patients with end stage renal disease. Much of the hospitalization in this group of patients continues to be for maintenance of reliable vascular access. Thrombosis, infection, aneurysm, and stenosis lead to serious morbidity. The Hemasite angioaccess system has been introduced in an attempt to circumvent some of these problems. We reviewed our initial experience with 90 of these devices placed in 77 patients during the past 24 months. Thirty-five devices (39%) were placed under emergency conditions when the primary access site had failed, 34 (38%) were used as the initial access procedure, and simple patient convenience was the indication 21 times (23%). Twelve patients have died, with no deaths related to the device. Twenty-eight infections and 18 thromboses accounted for the failures. Fourteen thromboses were seen with the graftless device where collateral flow existed around it. One-year patency was 46% for all devices, 38% for 34 graftless devices placed in the upper arm, and 50% for the grafted model in the upper arm position. Overall patency is not comparable to other access methods yet patient acceptance is high. Placement in the upper arm offers the highest rate of success. PMID- 3975715 TI - Defense against nuclear weapons: a decision analysis. AB - Response to the public health threat posed by nuclear weapons is a medical imperative. The United States, in contrast to other nations, has chosen a course that assures maximal casualties in the event of a nuclear attack, on the theory that prevention of the attack is incompatible with preventive measures against its consequences, such as blast injuries and radiation sickness. A decision analysis approach clarifies the risks and benefits of a change to a strategy of preparedness. PMID- 3975717 TI - Familial infantile myasthenia gravis: a preventable cause of sudden death. AB - We have described an infant with familial infantile myasthenia gravis, the rarest of the myasthenic syndromes, which occurs in infants of nonmyasthenic mothers. Recurrent apnea and respiratory depression with an absence of ophthalmoplegia are features of this syndrome, which if untreated can lead to sudden death. PMID- 3975716 TI - Response of tularemic meningitis to antimicrobial therapy. AB - A 60-year-old man had pyogenic meningitis due to Francisella tularensis acquired by tick bite. His disease initially improved but later relapsed after a standard course of streptomycin. Complete resolution resulted from prolonged combined therapy with streptomycin and tetracycline. Successful treatment of acute tularemic meningitis has not previously been reported. Our experience suggests that therapy should include agents that reliably penetrate the CSF, that is, tetracycline or chloramphenicol, for optimal treatment of this rare form of tularemia. PMID- 3975718 TI - Fetal hydrocephalus: a case of ventricular-amniotic shunting. AB - The case we have reported describes the management of fetal hydrocephalus using an intrauterine ventricular-amniotic shunt, which unfortunately was not recovered after delivery. To prevent this potential complication, we suggest such shunts be made radiopaque. The encouraging results in this case are attributed to the efforts of an interdisciplinary team and suggest that vascular accidents may well prove to be amenable to treatment by this new procedure. PMID- 3975719 TI - Influenza and mania: a possible connection with the locus ceruleus. AB - I have presented a possible case of mania induced by influenza B. Some epidemic influenza viruses may be neurovirulent. These epidemics seem to be associated with postencephalitic Parkinson's disease, mania, and depression. Viral, neuroanatomic, neurophysiologic, neurochemical, pharmacologic, clinical, and epidemiologic evidence can be found to suggest a connection between the locus ceruleus, the influenza virus, and the induction of a manic psychosis. PMID- 3975720 TI - Five cranial nerve palsies in a diabetic man. AB - A patient with stable non-insulin-dependent diabetes mellitus had five successive cranial nerve palsies, all of which resolved. This syndrome is rarely encountered in patients with diabetes and in otherwise healthy individuals. PMID- 3975721 TI - Postpartum osteitis pubis. AB - We have presented a rarely described case of osteitis pubis occurring in a postpartum period. This rapidly progressive, nonsuppurative osteonecrosis of the symphysis pubis is frequently confused with other entities. Because the prognosis for recovery is invariably good, acute intervention is directed at relieving pain by immobility and anti-inflammatory agents. PMID- 3975722 TI - Massive hydrothorax complicating occult cirrhosis. AB - This case emphasizes that absence of ascites does not rule out cirrhosis as the cause of a massive pleural effusion. Consideration of hemochromatosis as a cause of cirrhosis is worthwhile both for the patient and his family, as the course of the cirrhosis may be benefited by periodic phlebotomy to reduce the iron overload, and disease may be prevented in asymptomatic relatives. PMID- 3975723 TI - Late development of electrocardiographic abnormalities after a stroke. PMID- 3975724 TI - Ventricular tachycardia due to a transvenous catheter pacemaker. AB - Ventricular tachycardia may be caused by temporary cardiac pacing, especially when there is acute inferior myocardial infarction with significant right ventricular extension. Correction of hypoxemia, electrolyte imbalance, and drug excess, and the use of a unipolar lead with proper sensing and pacing settings may prevent this complication. PMID- 3975725 TI - Cyclophosphamide-associated hepatotoxicity. AB - Cyclophosphamide, a potent alkylating agent, is effective therapy for some rheumatic diseases. Despite primary hepatic activation of the drug, hepatic toxicity has been reported only in one case. We have reported two episodes of hepatic dysfunction associated with oral cyclophosphamide administration in patients with systemic rheumatic diseases. PMID- 3975726 TI - Oral antibiotic therapy for osteomyelitis of the foot in diabetic patients. AB - Although osteomyelitis of the foot in diabetic patients is generally considered a difficult infection to cure, the literature contains few reports comparing various treatment regimens. We have described two diabetic patients with osteomyelitis of the foot treated with oral antibiotics chosen on the basis of their broad activity against the pathogens commonly found in such infections. Both patients responded well to therapy and have shown no evidence of active osteomyelitis for 11 and four months, respectively. PMID- 3975727 TI - Nasal papillomas: successful treatment with podophyllin. AB - We have described a 20-year-old man with recurrent intranasal papillomas that were successfully treated by twice-weekly applications of 25% podophyllin in tincture of benzoin. PMID- 3975728 TI - Ventricular premature complexes and diagnosis of acute MI. PMID- 3975729 TI - Hyperbaric oxygen therapy in clostridial infection. PMID- 3975730 TI - Acupuncture update, 1984. PMID- 3975731 TI - Psychiatric disorders in geriatric medical/surgical patients. Part I: Report of 195 consecutive consultations. AB - We reviewed psychiatric consultations (N = 195) for patients aged 60 years or more from a consecutive series of 1,000 psychiatric consultation requests. Consultations for geriatric patients were requested disproportionately less frequently than for nongeriatric patients and significantly more frequently for elderly women than for elderly men. The most frequent primary psychiatric diagnoses were organic psychiatric and depressive spectrum disorders. The referring primary care physician had either misdiagnosed or failed to recognize an underlying organic psychiatric disorder in more than half the patients with organic psychiatric illness. The study highlights the prevalent psychiatric disorders of the elderly medical/surgical patient, and opines that psychiatric consultants can be of significant assistance in the medical care of these patients. PMID- 3975732 TI - Use of hypnosis for improving medication compliance in psychiatric patients. AB - Factors involved in failure to comply with medication regimens may be divided into four categories: patient characteristics, physician-patient relationship, psychosocial environment, and treatment regimen features. Although several methods aimed at improving medication compliance have been described in the literature, hypnosis was not among them. Three cases in which hypnosis was effective for improving compliance are presented, suggesting that hypnotherapy for compliance problems has potential clinical applications. PMID- 3975733 TI - Medical interview of sexually abused children. AB - Physicians seeing sexually abused children in their practices often fail to recognize the abuse. Recognizing the frequency of child sexual abuse and variety of presentations will alert physicians to seek explanation. Physicians should know the common behavior of perpetrators and how to encourage children to reveal and describe the abuse. Information gained through effective interviewing can be used to plan appropriate medical investigations, to form the basis of a protective service report, and as a sound introduction to counseling for sexual assault. Improved medical support to protective service agencies will improve their capacity to protect victims of sexual abuse, and competent educational support by physicians will improve their immediate and long-term emotional adjustment. PMID- 3975734 TI - Retrograde endoscopy of the bypassed stomach segment after gastric bypass surgery: unexpected lesions. AB - Surgical measures for the treatment of morbid obesity include gastric bypass of the stomach and duodenum. We endoscopically evaluated the bypassed segments in 51 patients three to 24 months after a standard gastric bypass procedure. Retrograde endoscopy was successful in 33 of the patients (65%). There was significantly more gastritis by endoscopic grading in the distal bypassed segment than in the proximal part of the stomach. The gastritis in the bypassed segment was associated with pooled bile in 97% of the patients. The severity of gastritis did not appear to be related to the time after surgery and was as severe three months after surgery as it was at 24 months. Histologically, the gastritis was nonconfluent, and often the histologic and endoscopic findings were at variance. There was intestinal metaplasia in biopsy specimens from the distal pouch in four of the 33 patients. The mechanism for the high incidence of gastritis is unknown, but may be related to decreased antral motility due to distention of the proximal pouch with food. These patients require close observation for changes in the bypassed segment of stomach that may occur as a consequence of chronic inflammation. PMID- 3975735 TI - Hepatic trauma: evaluation of routine drainage. AB - Routine drainage of liver wounds created by trauma has recently been challenged, prompting a prospective, randomized trial of drainage via a Penrose dam versus no drain in patients having emergency laparotomy for abdominal trauma. We excluded cases in which definite bile leak was noted at operation. Of 167 patients studied, six had obligatory drainage because of obvious bile leak. Among the remaining 161 patients, there was no significant difference as to demographics, mode of injury, volume of blood lost or used for resuscitation, incidence and severity of shock, number and types of associated injuries, or magnitude of liver wound between the 78 allocated to drainage and the 83 left without a drain. Resultant mortality, duration of hospitalization, incidence of wound and/or intra abdominal infection, and likelihood of subsequent bile fistula were not different. Such data support the routine use of a drain only if bile leakage from the liver wound is found at laparotomy. Without obvious bile leak, drainage of a specific liver injury does not appear to be necessary. PMID- 3975736 TI - Treatment of the ruptured or exposed carotid artery: a rational approach. AB - Review of 15 cases of carotid artery exposure or rupture in patients with no recurrent tumor demonstrated several important principles. Irradiation was a risk factor in 90% of cases of carotid blowout. Only one of five patients (20%) with carotid exposure who had not had irradiation had carotid perforation. Immediate death occurred in two of 15 (13%), and delayed death in five of 15 (33%). The neck wound was successfully controlled in 11 of 15 cases, requiring extracervical vascularized muscle or skin in eight of the 11 cases. Only one of seven pectoralis major flaps failed to control infection in the neck. This review reaffirms the importance of irradiation and orocutaneous fistula as risk factors. A rationale for prophylaxis, treatment of carotid exposure, and treatment of carotid rupture is presented. PMID- 3975737 TI - Effect of nasal surgery on snoring. AB - When 113 patients who had had nasal surgery for chronic obstruction were questioned about their snoring habits before and after operation, 42% said they had snored before nasal surgery. Of that group, 77% had either elimination or improvement of snoring after nasal surgery. Nasal obstruction is one of several factors contributing to snoring; surgery that relieves nasal airway impairment may also relieve or decrease the severity of snoring. PMID- 3975738 TI - Management of the chronically draining ear. AB - Management of the chronically draining ear requires careful assessment as to the source and predisposing factors leading to recurrent infections. Surgery should be planned to remove all irreversible disease and to seal the middle ear in a single operation, whether this requires a simple myringoplasty or extensive mastoidectomy, ossicular chain reconstruction, and tympanoplasty. Before surgery, every effort should be made to control the infection medically. After surgery, periodic irrigation with acetic acid alcohol will help to keep the ear clean and trouble-free. This paper will describe an approach to the assessment and management of the chronically draining ear in a single operation. PMID- 3975739 TI - Esthesioneuroblastoma: diagnosis and management. AB - Esthesioneuroblastoma is an uncommon nasal tumor originating from cells of neural crest origin. An increased awareness of this neoplasm by clinicians and pathologists has led to an increase in its diagnosis. In the Department of Otolaryngology--Head and Neck Surgery at the University of Virginia Medical Center, 22 cases have been treated. A review of the biologic course of these cases has allowed us to make certain recommendations for therapy. Patients with stage A and B disease are best treated with preoperative radiation therapy followed by craniofacial resection. Patients with stage C disease are treated with cyclophosphamide and vincristine before irradiation and craniofacial resection. If a significant response occurs these patients receive postoperative chemotherapy. We believe this treatment should result in five-year survivals in excess of 50%. PMID- 3975740 TI - Do brown recluse spider bites induce pyoderma gangrenosum? AB - Brown recluse spider bites are usually self-limited skin lesions that infrequently progress to bullae, ulceration, and scarring. We treated a patient with a documented brown recluse bite who had recurring lesions resembling pyoderma gangrenosum (PG) that persisted for months. Three other patients referred to Vanderbilt University because of probable brown recluse bite also had pyoderma for the first time after a suspected arthropod bite. The persistent and recurrent pyodermas in these four patients indicate that (1) brown recluse spider bites may not be self-limited but induce PG or PG-like lesions; (2) arthropod bites in general may induce PG in susceptible people; and (3) treatment of the PG like lesions in these patients may be difficult. PMID- 3975741 TI - Laser iridotomy for management of angle-closure glaucoma. AB - In this series, laser iridotomies were produced in 112 eyes, with a minimum of six months' follow-up. Despite the need to reopen some laser-produced iridotomies, it has proved to be safe and effective therapy. When the cornea is clear, laser iridotomy is an alternative to surgical iridectomy and can be used on outpatients without the risks of intraocular surgery. This alternative is especially beneficial to patients with combined-mechanism glaucoma and to patients in whom incisional surgery is contraindicated. There appears to be a definable curve of increased proficiency in producing patent laser iridotomies as the surgeon's experience increases. PMID- 3975742 TI - Chest wall masses in children. AB - A hard, fixed mass on the chest wall is usually considered to be malignant. Of 24 such lesions we have evaluated in children, only eight (33%) were malignant. Six of the eight children with malignant masses died of the disease. Benign lesions were often indistinguishable from malignant lesions by physical or roentgenographic examination, and histologic diagnosis was often difficult. Small lesions could be excised en bloc without significant deformity. Seven masses were the product of indolent infection, indicating that cultures should be obtained. Larger lesions should have adequate biopsy to direct the proper sequence of subsequent radical operation, irradiation, and chemotherapy. The defect created by radical operation is closed with polypropylene mesh and/or flap coverage. With this graded approach, the majority of children with chest wall lesions will survive with minimal deformity. PMID- 3975743 TI - Computerized tomographic evaluation of aortic prosthetic graft complications. AB - Computerized tomography has been found to be an accurate and sensitive method of diagnosing complications of synthetic aortic grafts. Complications in our series of four cases included aortoesophageal fistula, aortoduodenal fistula, pseudoaneurysm, and retroperitoneal hematoma. PMID- 3975745 TI - Segmental spinal instrumentation. AB - Over a 2 1/2-year period, I have treated 25 patients with segmental spinal instrumentation (SSI), using paired-wired Luque rods. Of 13 patients with unstable spinal fractures, seven were paraplegic. Nine had idiopathic scoliosis, and three had neurogenic scoliosis. Significant loss of correction after SSI occurred in five of the nine patients with idiopathic scoliosis and in two of the three with neurogenic scoliosis. In vitro testing of Harrington distraction rods and paired-wired L-shaped rods showed the Harrington rod to resist shortening and lateral bending due to axial compression forces better than the Luque system. From the study I conclude that postoperative brace protection is as necessary to the success of SSI as with the more traditional Harrington technique. Segmental spinal instrumentation is a powerful corrective device, but appears to be deficient in maintaining correction. PMID- 3975744 TI - Diagnosis of bacterial meningitis in previously treated children. AB - We reviewed the charts of 115 children with the clinical diagnosis of bacterial meningitis admitted to our hospital over a period of eight years. Of these, 47 patients had received antimicrobial agents before hospitalization and eight (17%) of them had negative cerebrospinal fluid (CSF) cultures. These eight children, however, had CSF features suggestive of bacterial meningitis. We conclude that prior antimicrobial therapy does not alter the chemical properties of CSF, the response to pharmacologic agents, or the ultimate outcome, even though previously treated children may have lower rates of positive CSF and blood cultures. PMID- 3975746 TI - Intestinal Salmonella carriage in patients with major sickle cell hemoglobinopathies. AB - The increased incidence of Salmonella osteomyelitis in patients with sickle cell disease has never been entirely explained. Problems such as cholelithiasis, intestinal infarction, and frequent antibiotic use in this population could possibly result in prolonged or chronic intestinal carriage of Salmonella after acute gastroenteritis. If prolonged carriage were a factor in the pathogenesis of osteomyelitis, attempts to eliminate the Salmonella with antibiotics would be indicated. We did a stool culture survey of 71 patients attending our pediatric sickle cell clinic to determine the incidence of asymptomatic Salmonella carriage. At least two rectal swab cultures were obtained from each patient; 69% of patients also mailed in a stool sample for culture. No Salmonella was isolated. It therefore appears unlikely that prolonged intestinal Salmonella carriage is an important mechanism in the development of Salmonella osteomyelitis in patients with major sickle hemoglobinopathies. PMID- 3975748 TI - Essential vocal tremor: clinical characteristics and response to therapy. AB - We evaluated four patients with an initial and predominant voice tremor. All were referred for evaluation for suspected parkinsonism, though vocal tremor was the only symptom. These three women and one man ranged in age from 37 to 59 years. Neurologic evaluation and laryngeal examination were unremarkable. No signs of parkinsonism were present. All patients had a family history of tremor, though in only one family was vocal tremor the sole manifestation. Tremor was suppressed by alcohol ingestion in all patients and with whisper in two. Duration of tremor before evaluation ranged from eight months to six years. Visual representation of tremor was obtained in three, with frequencies ranging from 4 to 10 cps. Three patients responded to treatment with propranolol (Inderal), and one did well with voice training. Follow-up was six months to ten years. Although previous cases of essential vocal tremor with concurrent tremor elsewhere have been noted, only six cases of isolated voice tremor had been reported and response to therapy was not mentioned. Essential tremor may also be isolated to the head, chin, and hands. PMID- 3975747 TI - Primary esophageal motor disorders: clinical response to nifedipine. AB - The effect of nifedipine on esophageal symptoms was evaluated in 20 patients with primary esophageal motor disorders. The patients were randomized to receive nifedipine (10 mg t.i.d.) or placebo for two weeks, and then crossed over to receive the other medication. Ten patients had hypertensive lower esophageal sphincter, four had diffuse esophageal spasm, three had vigorous achalasia, two had "nutcracker esophagus," and one patient had achalasia. The score of chest pain or dysphagia was recorded on a scale of 0 to 10 during each study. The patients who received nifedipine improved significantly compared to those who received placebo. This improvement was most marked in patients with hypertensive lower esophageal sphincter. No significant side effects or changes in blood pressure were encountered in any of the study groups. Our results indicate that patients with primary esophageal motor disorders have a good clinical response to nifedipine therapy. PMID- 3975749 TI - Nephrotoxicity from nonsteroidal anti-inflammatory drugs. AB - We categorize the three types of renal dysfunction associated with the use of nonsteroidal anti-inflammatory drugs (NSAID): acute renal failure, acute interstitial nephritis, and hyperkalemia. The paper provides clinical examples of each type, discusses pathophysiology, and describes response to therapy, in addition to outlining the usefulness of labeled leukocyte nuclear studies and kidney biopsy. We conclude that these drugs are relatively common causes of renal dysfunction, particularly in selected subpopulations. PMID- 3975750 TI - Contraceptive use in Georgia: estimation by telephone survey. AB - Because household surveys are expensive and time consuming, determination of state or local family planning needs is based on national household survey estimates of contraceptive use rather than state-specific estimates. In June 1982, the University of Georgia Survey Research Center invited the Georgia Department of Human Resources (DHR) to add questions to a Statewide Omnibus Telephone Survey to obtain information on contraceptive use, source of contraception, and reasons for not using contraception. The survey used two-stage random digit dialing to select 1,737 households. From these households, we have complete information on 332 women aged 18 to 44. The definition of contraception included use by either the respondent or partner. Fifty-six percent of female respondents were using contraception; oral contraceptives (22%) and contraceptive sterilization (21%) were the primary methods used. Private sources provided 78% of nonpermanent contraceptive methods. The majority of women not using contraception reported a noncontraceptive sterilization or infertility (31%) or were pregnant, desiring a pregnancy, or not sexually active (29%). The advantages of this method over household surveys are rapid turnaround of data and relatively low cost. PMID- 3975751 TI - Multiple systems organ failure: is it a specific entity? AB - Multiple systems organ failure (MSOF) is a relatively new clinical syndrome that should be considered as a unified and identifiable clinical condition. In many ways it is a product of the technologic advances developed in the last few years to treat seriously ill patients. Failing respiratory, renal, and cardiovascular systems are the most frequently encountered combinations, with sepsis, faulty nutrition, and metabolic derangements often present. However, other systems of organs that support vital functions (eg, gastrointestinal, hepatic, neurologic, and coagulation) become additional important components of the MSOF syndrome. The etiology of this entity is multifactorial and difficult to clearly determine. The patients at risk are usually in an intensive care unit and are easy to identify. Because there is no specific treatment, prevention is of utmost importance. When MSOF occurs, correction of the obvious deficits, active support of the failing systems, and prevention of failure of other still functioning systems are the key to survival. PMID- 3975753 TI - Foreign medical graduates: The door should never close. PMID- 3975752 TI - Health precautions for travelers to Mexico. AB - After Canada, Mexico is the most popular destination for Americans traveling outside the United States. As a developing country, Mexico presents numerous health hazards to American visitors, including the prevalent travelers' diarrhea (turista), from which 40% will suffer, and the less common typhoid, dengue, rabies, malaria, taeniasis, cysticercosis, and trichinosis. Environmental hazards, including sun, heat, high altitude, motion sickness, and accidents, also threaten the unwary traveler. In the event of illness or injury, Americans may find medical facilities unfamiliar and less well equipped than those in the United States. Utilizing both an individualized risk assessment for each traveler and readily available references, physicians, in partnership with local public health agencies, can develop comprehensive preventive health plans for their patients traveling to Mexico. PMID- 3975754 TI - Familial trigeminal neuralgia. PMID- 3975755 TI - Bacterial endocarditis in pregnancy associated with septic renal embolization. PMID- 3975756 TI - Bone marrow failure and pancytopenia in two patients with hypothermia. AB - Two patients with hypothermia were noted to have pancytopenia. Bone marrow examination showed failure of all marrow elements in both patients. Although a wide variety of hematologic abnormalities have been found in patients with hypothermia, bone marrow failure has not been previously reported. PMID- 3975757 TI - Hazard of a postendarterectomy intimal flap in carotid artery surgery. AB - A patient with severe bilateral carotid artery stenosis had an intimal flap after removal of the carotid plaque using the plaque cracker. Because use of the plaque cracker in the carotid artery surgery offers no significant advantages and allows the possibility of an intimal flap occurring in the carotid artery, this instrument should not be used in carotid artery surgery. The plaque cracker has been established as a useful instrument in peripheral vascular surgery in selected cases. PMID- 3975758 TI - Peptococcus magnus endocarditis. AB - An 18-year-old man had an eventually fatal case of Peptococcus magnus endocarditis. Multiple emboli and continued valve destruction occurred during appropriate therapy. Penicillin therapy was associated with fever and neutropenia, thought to be due to an immunologic mechanism. PMID- 3975759 TI - Elevated bleeding time and epistaxis associated with piperacillin therapy. PMID- 3975760 TI - Simple method to predict digoxin serum concentrations. PMID- 3975761 TI - Extreme hyperkalemia associated with amiloride. PMID- 3975762 TI - Osteomyelitis of the femur due to Fusobacterium mortifereum. PMID- 3975763 TI - Emerald-green urine associated with Cuprex therapy. PMID- 3975764 TI - Peritonitis due to Pseudomonas paucimobilis during ambulatory peritoneal dialysis. PMID- 3975765 TI - Research in geriatric psychiatry: a view from the United States. PMID- 3975766 TI - Psychiatric disorders in children and family dysfunction. A study of migrant workers' families. PMID- 3975767 TI - The psychiatrist in the 1980s. Societal pressures and coping strategies. PMID- 3975768 TI - Community psychiatric services in England and Finland. PMID- 3975769 TI - Are life events which cause each other additive in their effects? PMID- 3975771 TI - [Automation of the planning of public health resources based on the use of mathematical models and computers]. PMID- 3975770 TI - The relationship between social functioning and psychiatric symptomatology in primary care. PMID- 3975773 TI - [Prevention--the general trend in socialist public health]. PMID- 3975772 TI - [Use of microcomputers for processing the information used in public health management]. PMID- 3975774 TI - [Organizational and economic problems of polyclinic care]. PMID- 3975775 TI - [Detection of arterial hypertension in female workers employed in the ship repair industry]. PMID- 3975776 TI - [Morbidity with temporary loss of work in the workers and employees of light industry enterprises]. PMID- 3975777 TI - [Protection of the environment and health]. PMID- 3975778 TI - [Deontology of a public health organizer]. PMID- 3975779 TI - [Efficiency of automation and overall mechanization of the laboratory process]. PMID- 3975780 TI - [Chief directives of the section "Protection of the Health of the Population" of regional comprehensive programs of the scientific-technological revolution]. PMID- 3975781 TI - [Work of a republic hospital in the transition to annual dispensarization of the entire population]. PMID- 3975783 TI - [Ways of improving the training of nurses]. PMID- 3975782 TI - [Team form of organization and stimulation of the work of middle and junior medical personnel of a regional hospital]. PMID- 3975784 TI - [Program for the prevention of chronic non-infectious diseases]. PMID- 3975785 TI - [Venous digital subtraction angiography of the thoracic aorta]. PMID- 3975786 TI - [Normal anatomic structures of the body in the MR-tomogram: studies with a 0.35 superconducting magnet. 2. Abdomen, pelvis, musculoskeletal system]. PMID- 3975787 TI - [A constancy test for quality assurance of x-ray film including film processing]. PMID- 3975788 TI - [Intra-arterial DSA of the mesenterico-spleno-portal vessels]. PMID- 3975789 TI - Distribution of income sources of recent retirees: findings from the New Beneficiary Survey. AB - Using data from the New Beneficiary Survey, this article examines income received by the newly retired from assets, employer-provided pensions, and social security. Today's retirees commonly possess pension or asset income to supplement social security. The proportions with asset income were 83 percent for married men and their wives and 69 percent for the unmarried. The proportions with pension income were 56 percent for the married couples and 42 percent for the unmarried. The article finds that up through the middle of the income distribution, social security remains the main income component. In addition to these traditional income sources of the retired, the data also highlight the important role of earnings among many of the new beneficiaries--44 percent of the married couples and 27 percent of the unmarried had current earnings. PMID- 3975790 TI - The trauma center: what it is, what it is not, what it can accomplish. PMID- 3975791 TI - Sclerotherapy for the treatment of fissure in ano. AB - Sclerotherapy has a useful part in the conservative management of anal fissure. When compared with results obtained with routine forms of local treatment, it leads to a higher incidence of successful outcome and reduced number of patients coming to operation. The complication rate was almost nonexistent and in no instance led to any permanent effects. It is an outpatient procedure and can be done with a minimum amount of equipment, technical skill and expertise, resulting in immediate relief. It does not lead to accelerated healing; this is of no consequence since the patient is asymptomatic. We recommend this procedure for acute anal fissures which cause moderate to marked symptoms, particularly when other conservative methods have failed. PMID- 3975792 TI - Utilization and wide clinical implementation using the wick catheter for compartment pressure measurement. AB - A series of 71 patients was identified and studied over a period of 30 months. Twenty-five patients underwent fasciotomy, all but one patient had a compartment pressure finding of more than 30 millimeters of mercury. Sixteen patients underwent fasciotomy on the basis of pressure measurement alone. Patients with a pressure measurement of less than or equal to 30 millimeters of mercury and those with an absence of clinical findings were spared fasciotomy. Continued accumulation of data in various patient groups should yield specific comments and observations using this important adjunctive technique. PMID- 3975793 TI - Changes of cell population in the antrum after selective proximal vagotomy and pyloroplasty in gastroduodenal ulcer. AB - A marked increase in the number and size of the antral gastrin cells and parietal cells could be shown in long term examinations of the antrum mucosa after SPV and pyloroplasty. Twenty-five patients with UD, 12 with UV and five with Dragstedt combination (UV and UD) were examined over a period of five to seven years. A significant correlation of parietal cell increase and a positive reaction to insulin was found. The findings were compared with the changes in the fundic mucosa, where a marked decrease of parietal cells occur after SPV. PMID- 3975794 TI - Splenectomy is contraindicated for thrombocytopenia secondary to portal hypertension. AB - We believe that splenectomy is contraindicated in patients with portal hypertension and secondary hypersplenism. The greatest threat to life in this group of patients is variceal bleeding, and the primary consideration in the management of these patients should be to control this bleeding. Concomitant improvement in the hematologic indices of hypersplenism is achieved by DSRS. PMID- 3975796 TI - Postoperative changes in serum bromine value. AB - The changes in bromine levels in the blood serum of 40 patients who were operated upon are discussed herein. The results of this study demonstrate that all patients who received anesthetics rich in bromine (halothane and Fluothane) have an increase in serum bromine levels postoperatively. Eight of ten patients with high serum bromine levels postoperatively had intense symptomatologic findings which could be attributed to an instance of acute brominism. PMID- 3975795 TI - Patency of autogenous saphenous vein versus polytetrafluoroethylene grafts in femoropopliteal bypass for advanced ischemia of the extremity. AB - Eighty-six femoropopliteal bypass operations were performed for ischemic ulceration, gangrene or rest pain in 77 patients whose mean preoperative ABI was 0.35. In this homogeneous patient sample, we compared prospectively a trial of saphenous vein versus PTFE grafts. During the follow-up period amputations were required in 30 per cent of the patients with a vein graft and in 31 per cent of patients with a PTFE graft. However, the presence of gangrene significantly decreased the interval to first occlusion (p less than 0.001). Over-all, autogenous saphenous vein grafts had longer patency than PTFE grafts in both the femoropopliteal and distal bypass positions. This advantage prevailed when 45 of the patients were randomized, although not at statistically significant levels. In patients without gangrene who underwent limb salvage, bypassing the diseased femoropopliteal segment with either of the graft materials increased graft patency and limb salvage compared with patients who had ischemic tissue necrosis. PMID- 3975797 TI - Clinical behavior and results of current therapeutic modalities for squamous cell carcinoma of the buccal mucosa. AB - A retrospective analysis of 28 patients who received therapy for squamous cell carcinoma of the buccal mucosa at the Massachusetts General Hospital from January 1962 through December 1976 is presented. The patients ranged in age from 42 to 78 years; the majority of patients presented with disease at 50 years or more. The proportion of females in this series (43 per cent) represented a dramatic increase compared with previous reports from other large centers. The 29 per cent rate of metachronous or synchronous second primary malignant disease is increased significantly over that expected for the general population. Uncontrolled disease above the clavicle continues to be the major site of therapeutic failure. The development of co-operative multicenter randomized prospective protocols to evaluate the efficacy of various combinations of current therapy methods in order to improve patient survival from this devastating disease are encouraged. PMID- 3975798 TI - Prophylactic antibiotics and closed tube thoracostomy. AB - A prospective randomized study of 85 patients who had sustained trauma to the chest requiring closed tube thoracostomy is reported. They were segregated into two groups, one of which did not receive prophylactic cephapirin sodium. Although the series is somewhat abbreviated, it would appear that the use of prophylactic antibiotics merely for the presence of a chest tube is an unsettled issue and of no definitely proved benefit. PMID- 3975799 TI - A new vascular clamp. AB - A new vascular clamp called the occluder pad is described. It has significant utility when used in a variety of anatomic sites in either normal or diseased vessels. It possesses suitable tractive and occlusive forces while minimizing the mechanical forces applied to the vessel walls. PMID- 3975800 TI - Intraoperative communication. AB - Superior technique necessitates effective intraoperative communication. Hand signals can convey most of the wishes of the surgeon. Pragmatic execution calls for mixing hand signals with anticipation and verbal commands. PMID- 3975801 TI - Small tube peritoneovenous shunting for the management of neonatal intractable ascites. AB - A ventriculoperitoneal shunt for infants has been successfully adapted to function in a reversed manner by sending ascitic fluid back into the circulation of the premature infant. This technique permits successful peritoneovenous shunting in the smallest infant. PMID- 3975802 TI - Anterior approach for resection of the first rib and total scalenotomy. AB - We have found the technique described herein to be advantageous to previously described techniques for resection of the first rib. The vital structures--the brachial plexus, subclavian artery and vein--are all readily visualized with the anterior approach and, therefore, subject to less risk of injury intraoperatively. PMID- 3975803 TI - Intracranial hemangiopericytoma: radiology, surgery, radiotherapy, and outcome in 21 patients. AB - At operation, 21 meningeal intracranial hemangiopericytomas resembled meningiomas, but differed histologically. They were frequently attached to sinuses, occipitally located, bled profusely at operation, and had a higher risk of recurrence and metastasis. Specific preoperative diagnosis is possible: computed tomography scan showed a meningiomalike tumor, which on the angiogram looked malignant and highly vascular. Two tumors showed a malignant growth pattern on computed tomography scan, "mushrooming." After a radical removal, three patients have lived for more than 10 years without recurrence; two of them were irradiated postoperatively. Three recurrent tumors were treated with radiotherapy only; one responded favorably. PMID- 3975804 TI - Intracranial aneurysm associated with moyamoya disease in childhood. AB - We report a 6-year-old girl with an intracranial aneurysm associated with moyamoya disease. The patient did not have a subarachnoid hemorrhage but had an ischemic attack. The aneurysm, located on the proximal portion of the lateral posterior choroidal artery, disappeared after external carotid-internal carotid anastomosis. The characteristics of the aneurysms associated with moyamoya disease are briefly reviewed. We emphasize that the treatment of choice in moyamoya disease is cerebral revascularization, because it reduces the increased blood flow through the moyamoya vessels, basilar artery and other uninvolved cerebral arteries, the sites where the aneurysms in this disease frequently develop, as the blood flow through the external carotid system is increased by such an operation. PMID- 3975805 TI - Transoral anterior decompression for treatment of unreducible atlantoaxial dislocations. AB - Three cases of nonreducible atlantoaxial dislocation are reported. Transoral anterior decompression followed by posterior fusion was done with good results in all three cases. PMID- 3975806 TI - Cavernous angioma in the fourth ventricle. AB - A cavernous angioma in the fourth ventricle of a 47-year-old man is reported. Because of a progressive clinical course and a ring-like enhancement on computed tomography, a brain tumor, rather than a vascular disease, was suspected. The lesion was removed totally and verified histologically as a cavernous angioma. PMID- 3975807 TI - Spinal cord and root injuries due to glass fragments and acupuncture needles. AB - The authors report four cases of extremely rare spinal cord injuries due to foreign bodies. These include one case of injury to the spinal cord caused by glass splinters from a shattered automobile windshield, two cases of spinal cord injury resulting from acupuncture needles, and one case of spinal nerve root injury by acupuncture treatment. The mechanism of occurrence of delayed myelopathy or progressive symptoms, which appeared after acupuncture treatments in two cases, are discussed. PMID- 3975808 TI - Posttraumatic hydrocephalus--a retrospective review. AB - The authors retrospectively reviewed all cases of acquired hydrocephalus admitted to the Institute of Neurological Sciences, Glasgow, Scotland, within a 5-year period and encountered 17 cases of posttraumatic hydrocephalus. These represented 0.7% of 2374 cases of severe head injury. Hydrocephalus became symptomatic within 1 year from the time of injury in 16 of 17 cases. Meningitis, traumatic subarachnoid hemorrhage, posterior fossa mass, supratentorial clot with contralateral ventricular dilatation, and craniotomy contributed to the development of posttraumatic hydrocephalus. After shunting, eight patients (50%) improved markedly and four (25%) slightly. PMID- 3975809 TI - Intrasacral perineurial cyst. AB - A rare case of intrasacral perineurial cyst is presented. Findings on metrizamide myelography and computed tomography scan are described, and their usefulness in the diagnosis of this rare condition is emphasized. The literature is reviewed, and the clinical and pathological features of the 17 reported cases including our own are summarized. Indication for operation and surgical approach are briefly discussed. PMID- 3975810 TI - Treatment of moyamoya disease by cerebroarteriosynangiosis. AB - The case of a child with multiple strokes secondary to moyamoya disease and a surgical technique to maximize cerebral revascularization, cerebroarteriosynangiosis, are presented in detail. PMID- 3975811 TI - Distal ulnar neuropathy. Clinical and electrophysiologic aspects. AB - Nine patients with distal ulnar neuropathy were studied. Weakness of the hand muscles was the only abnormality in six patients; abnormal sensation was present in two patients. The cause was known in seven patients: chronic "occupational" nerve compression occurred in three meat packers and two long-distance bicyclists -acute blunt trauma to the palm of the hand in two patients. Our study indicates that electromyographic abnormalities in distal ulnar neuropathy are more variable than reported. The electromyographic findings indicated predominant axonal degeneration of motor nerve fibers, contrasting also to electromyographic abnormalities seen in entrapment neuropathies. The reasons for these differences are discussed. PMID- 3975812 TI - Postoperative lumbar arachnoidal diverticula. AB - Five patients with arachnoidal diverticula after lumbar operations are reported. Myelography was performed in all cases, spinal computed tomography scanning in three; three patients underwent surgical treatment with good clinical results. Arachnoidal diverticula are a rare complication of operations on the lumbar spine. Spinal computed tomography scanning is very useful, especially in the investigation of large diverticula and in the radiologic visualization of the arachnoidal stalk. Surgical treatment, which is required in symptomatic cases, results in remission of pain and prevents neurological complications. PMID- 3975813 TI - Syringomyelia associated with a foramen magnum meningioma. AB - In a 14-year-old boy with a meningioma at the foramen magnum extending to C-2, cervical syringomyelia was found on metrizamide computed tomographic myelography. The mechanism of syrinx enhancement on delayed computed tomographic scanning was considered to be due to transneural passage of metrizamide into the spinal cord. Long-standing spinal block may be responsible for development of syringomyelia. Syringomyelia associated with spinal extramedullary tumors was reviewed in the literature. PMID- 3975814 TI - Closed reduction of lumbosacral fracture dislocations. AB - A unique method for closed reduction of lumbosacral fracture dislocations that uses a circle-electric bed is described. Fine radiological description of the injury with computed tomography scanning allows the application of appropriate forces to facilitate the reduction, while having the patient awake during the procedure greatly reduces the chance of introducing further neurological deficit. PMID- 3975815 TI - Fatal rupture of a thrombosed giant basilar artery aneurysm. AB - The case of a patient who died from rupture of an aneurysm that had previously been demonstrated to be essentially completely thrombosed is presented. The patient initially presented with sudden clinical deterioration as a result of brainstem compression. A computed tomographic scan showed a giant basilar aneurysm with recent thrombus filling the lumen. Angiography showed only a small irregularity at the top of the basilar artery which may have represented a tiny remnant of the aneurysmal neck. The patient was treated conservatively, and over the next few weeks he improved clinically. Four months later the aneurysm ruptured fatally. PMID- 3975816 TI - Deep Sylvian meningiomas. AB - A case of deep Sylvian meningioma in a 35-year-old woman was precisely diagnosed preoperatively with the aid of computed tomography and stereoscopic cerebral angiography. On reviewing the literature, it appears to be the first case that has been accurately diagnosed preoperatively and successfully treated by a total excision without serious complication. We report this case in detail together with another, similar case which we had encountered previously. PMID- 3975817 TI - Ruptured median and paramedian lumbar disk. A review of 243 cases. AB - Ruptured median and paramedian lumbar disks present special problems for the surgeon, not the least of which is adequate laminectomy to provide satisfactory decompression and release of the disk fragment without trauma to the cauda equina. The surgical technique described was used over a 10-year period in a series of 243 patients and emphasized the principles of sufficient removal of bone and posterolateral approach. Although 72% of patients had complete or partial myelographic block, unilateral symptoms and neurologic signs predominated. Full recovery with minimal or no neurologic deficit was recorded in 85% of patients, with a recurrence rate of 6%. In no patient was neurologic deficit greater than before operation. PMID- 3975819 TI - Is hypothermia dead? PMID- 3975820 TI - Are intracranial aneurysms rare in some parts of the world? PMID- 3975818 TI - Neurosurgical residency programs. PMID- 3975821 TI - Selection methods and entry criteria for graduate medical education in neurological surgery. PMID- 3975822 TI - Thoracic disc herniation. Improved diagnosis with computed tomographic scanning and a review of the literature. AB - Thoracic disc herniation is uncommon. One of the main problems in the treatment of thoracic disc herniation has been the lack of accuracy of diagnostic tests. Now, with the use of computed tomographic scanning with and without metrizamide in the subarachnoid space, this accuracy has greatly improved. Computed tomography scanning can demonstrate the type and level of the lesion even when the myelographic study is negative. We have reviewed 280 cases; a peak incidence was noted in the fourth decade with 75% of the protruded discs occurring below T 8. Back pain was the most common presenting symptom followed by sensory disturbances. By the time of diagnosis, 70% of the patients had signs of spinal cord compression. A small group of patients could be identified that invariably had a good prognosis. They had a history of trauma, symptoms lasting less than a month, and soft disc herniation. Regarding the results of surgical treatment, there was a success rate ranging from 57% for decompressive laminectomy to over 80% for the posterolateral, lateral, and transthoracic approaches. PMID- 3975823 TI - Prognosis for arteriovenous malformations of the brain in adults based on 150 cases. AB - Arteriovenous malformations of the brain generally make their presence felt before the age of 40 through cerebromeningeal hemorrhage (83 cases) or epilepsy (47 cases). In our series, 128 patients were operated upon and total resection of the malformation was performed on 119 occasions. The operative mortality rate was 12.5% and there were 70.3% good results from a long-term point of view. The essential benefit from surgical treatment is the elimination of the risk of hemorrhage. The effect on epilepsy is much less, and the natural development of nonhemorrhagic forms is not unfavorable over the long term. The prognosis for surgical treatment is linked to the size and the topography of the malformation, the number and the origin of the arterial afferent vessels, and, above all, to the mode of drainage into the venous system that may be malformed. PMID- 3975824 TI - Spinal subdural hematoma, neurilemmoma, and acute transverse myelopathy. AB - A 74-year-old woman had acute cervical transverse myelopathy from a neurilemmoma. Although extremely rare, the possibility of tumor should be recognized in patients with apparently spontaneous spinal subdural hematoma. As in other cases of compressive myelopathy, early operation is essential for recovery of neurological deficit. PMID- 3975825 TI - Posterolateral approach to thoracic disk herniations through transversoarthropediculectomy. AB - The authors describe an approach by transversoarthropediculectomy in three cases of herniation of thoracic disks. The technique permits the initial approach to locate the vasculoneural elements and leaves these intact. We underline certain rules: osteotomy of the vertebral bodies located above and below, possible laminectomy after excision of the herniated disk fragment, and posterior osteosynthesis. PMID- 3975826 TI - Coarctation of the descending aorta with aneurysm of the anterior communicating artery. AB - A case of a 19-year-old woman who had coarctation of the descending aorta associated with an aneurysm of the anterior communicating artery is reported. The aneurysm was successfully clipped during the acute phase of subarachnoid hemorrhage. PMID- 3975827 TI - Syndrome of inappropriate secretion of antidiuretic hormone after severe head injury. AB - This study is based on 109 patients with severe head injury who had a Glasgow coma score equal to or less than 7 and a Liege coma score equal to or less than 12 in the first 24 hours. The syndrome of inappropriate secretion of antidiuretic hormone seems to us to be a frequent complication of severe craniocerebral trauma. It has been discovered in 33% of our patients. On the other hand, diabetes insipidus was rarely diagnosed (2.8%). We propose, in cranial trauma, to subdivide the syndrome of inappropriate secretion of antidiuretic hormone into two clinical forms: an early syndrome (5%) that becomes apparent towards the second day and is significantly associated with lesions at the base of the skull; and a delayed syndrome that occurs at the end of the first week and is related to different factors inherent in intensive care procedures. Surgical intervention, in the case of acute craniocerebral trauma, does not result in a higher frequency of inappropriate secretion of antidiuretic hormone. PMID- 3975828 TI - Solitary osteochondroma with spinal cord compression. AB - Osteochondromas are unusual in the spine, and they are very rarely present with compression of the spinal cord. Two cases are reported with delineation of the tumor by metrizamide myelography and computed tomography. PMID- 3975829 TI - Fenestration of the internal carotid artery. AB - Fenestration of the internal carotid artery is very rare. The authors describe two cases of fenestration at the cervical portion of the internal carotid artery that were revealed by angiography. The embryological basis and clinical significance of this anomalous condition are discussed. PMID- 3975830 TI - Unusual craniocerebral penetrating injury by a chopstick. AB - The case of a 53-year-old man who attempted suicide by introducing a wooden chopstick through his nostril into his brain is reported. The importance of computed tomography is stressed in the diagnosis of intracranial wooden foreign bodies. PMID- 3975831 TI - Mixed teratoma and meningioma in the temporoparietal region. AB - A case of a teratoma mixed with meningioma in the left temporoparietal region in a patient with progressive memory impairment, bradyphasia, loss of visual acuity of the left eye, and left leg weakness is presented. Histological findings showed fibroadipose tissue containing gland-like structures and lymphocytoid cells alongside a meningothelial meningioma. It is unusual for a teratoma to occur in the temporoparietal region; even more unusual is its proximity to an unrelated tumor in the same location. PMID- 3975832 TI - Fibrous dysplasia of the skull with increased vascularity in the angiogram. AB - The case of a 12-year-old girl with fibrous dysplasia involving the cranial vault is presented. The external carotid angiogram demonstrated a dilated and beaded zygomatico-orbital branch of the superficial temporal artery, a faint tumor stain, and an early filling vein. The mass was moderately vascular at the operation and histological examination demonstrated no malignancy. PMID- 3975833 TI - Acute simultaneous bilateral extradural hematoma. AB - A patient with acute simultaneous bilateral extradural hematomas is presented and the mechanism of formation and the sequence of operations necessary to reduce the risk of disability are discussed. The recent literature is reviewed and it is suggested that two types of bilateral extradural hematoma may be found, depending upon whether venous or arterial bleeding is responsible. PMID- 3975834 TI - Dementia due to meningioma: outcome after surgical removal. AB - The outcome of operations in nine patients with meningiomas who presented with dementia was studied. Two patients died within 6 months of their operations. Six out of the remaining seven patients improved; two of these patients had normal intellectual function confirmed by psychometry. Our results show that recovery can be expected in most patients who present with dementia due to a meningioma. PMID- 3975835 TI - Acute spontaneous subdural hematoma of arterial origin. AB - A patient is described who had a history of sudden vomiting and rapidly becoming deeply unconscious. There was no history of head trauma. The cause turned out to be an acute spontaneous subdural hematoma from arterial rupture. Comparable cases in the literature are reviewed and the etiological possibilities are discussed. PMID- 3975836 TI - Hemolysate-induced release of prostaglandinlike substances from the canine cerebral arteries. AB - The release of prostaglandinlike substances from canine pial arteries that was induced by exposure of the pial arteries to red blood cell hemolysate was estimated by using a superfusion technique for prostaglandin bioassay. The assay organs used were strips of rat stomach for prostaglandin E2- or prostaglandin F2 alpha-like substances, strips of dog coronary artery for prostaglandin I2-like substance, and strips of dog ileum for prostaglandin F2 alpha-like substance. The substances released from the canine pial arteries induced contractions in rat stomach strips and relaxations in canine coronary arterial strips, whereas they did not induce any response in canine ileal strips. The equivalent prostaglandin E2 doses for the contractions of the rat stomach strips and the equivalent prostaglandin I2 doses for the relaxations of the canine coronary arterial strips were 125.2 +/- 19.4 (n = 8) and 59.5 +/- 16.4 (n = 6) pmol/g wet wt +/- SEM, respectively. PMID- 3975837 TI - Multiple meningiomas in the posterior fossa. AB - A case of multiple meningiomas in the posterior fossa is reported. Computed tomography scans clearly demonstrated the tumors. They were removed completely and the patient was discharged without any neurological deficits. The clinical features are discussed and the pertinent literature is reviewed. PMID- 3975838 TI - Communicating spinal arachnoid cysts: diagnosis by delayed metrizamide computed tomography. AB - A case of an extradural spinal arachnoid cyst is presented with emphasis on the neuroradiologic characteristics of this lesion. The cyst was definitely diagnosed by delayed metrizamide spinal computed tomography. Extradural spinal arachnoid cysts, or diverticula, have been the subject of much discussion in the neuroradiologic and neurosurgical literature. However, the appearance of a communicating arachnoid cyst on delayed spinal computed tomography after metrizamide myelography is heretofore undescribed in the English language neurosurgical literature. PMID- 3975839 TI - Angiographically occult arteriovenous malformations. AB - Angiographically occult arteriovenous malformations not associated with clinically recognizable intracranial hemorrhage appear to be rare. We are reporting three cases of histologically proven arteriovenous malformations of the brain that were angiographically occult. These cases presented with seizures or attacks of dizziness, and were detected by computed tomography scan, radionuclide scan, or both. The preoperative diagnosis was granuloma in the first case and meningioma in the other two. After surgical exploration, biopsy revealed an arteriovenous malformation in each case. A review of 47 cases in the literature is tabulated and etiologies of the angiographically occult arteriovenous malformations are discussed. The routine use of computed tomography scan and timely, appropriate surgical intervention with the operating microscope for the removal of these deeply situated lesions is necessary for the diagnosis and therapy. PMID- 3975840 TI - Effect of naloxone on functional recovery after experimental spinal cord injury in the rat. AB - The effect of the opiate antagonist naloxone on the functional recovery of rats injured with a 10 g-cm impact to the spinal cord at the T-3 level is studied. Sixteen rats were treated with 0.8 mg of naloxone in an intraperitoneal bolus 45 and 120 minutes after injury, 16 rats were given 4 mL of saline instead of naloxone, and 16 rats were neither injured nor treated. To asses weekly the motor recovery of the injured animals, the inclined plane method was employed. After the 10-week assessment period, naloxone-treated animals showed a significantly better performance on the inclined plane than saline-treated animals. Naloxone may be useful for the treatment of spinal cord injury although its mechanism of action remains unknown. PMID- 3975842 TI - On the use of nonphysician associate residents. PMID- 3975841 TI - Stroke-in-evolution--an indication for an emergency extracranial-intracranial bypass. AB - The role of the emergency extracranial-intracranial bypass in the management of the stroke-in-evolution is controversial. A case is presented in which the patient's fluctuating clinical picture was influenced by hemodynamic factors. The site of occlusion was inaccessible and an emergency extracranial-intracranial bypass was made to restore cerebral blood flow. The patient made a dramatic recovery after the operation. An emergency extracranial-intracranial bypass may be indicated in carefully selected cases. PMID- 3975843 TI - Cervical spine injuries: a few easy rules. PMID- 3975844 TI - Research and training. PMID- 3975845 TI - Brain transplantation. PMID- 3975846 TI - Meningioma of the lesser sphenoid wing presenting like Parkinson's disease. PMID- 3975847 TI - Traumatic aneurysms. PMID- 3975848 TI - Isolated hindlimb perfusion in dogs: the effect of perfusion pressures on the oxygen supply (ptO2 histogram) to the skeletal muscle. AB - During regional isolated perfusion, neoplasms in extremities are treated with high doses of chemotherapeutic drugs by means of an extracorporeal circuit. The question is whether optimal tissue perfusion, which is essential for the therapy, is obtained by regulation of the extracorporeal circuit on an adequate perfusion flow or on an adequate perfusion pressure. To determine which perfusion pressure is needed to maintain adequate tissue perfusion, hindlimbs of six dogs were perfused at perfusion pressures 0, 15, 25, and 50 mm Hg below systemic mean arterial pressure. A multiwire polarographic oxygen electrode placed on the sartorius muscle permitted quantitative evaluation of tissue oxygenation by means of ptO2 histograms. Our results indicated that the perfusion pressure must be equal to or within 15 mm Hg below systemic mean arterial pressure to obtain optimal tissue perfusion. To maintain this perfusion pressure, high perfusion flows of about five to 10 times control femoral flows were needed. At a perfusion pressure 50 mm Hg below systemic mean arterial pressure, perfusion flow was normal, but tissue perfusion was severely impaired. PMID- 3975849 TI - Extensive colonic necrosis complicating acute pancreatitis. AB - Segmental ischemic gangrene of the colon is a rare complication of acute pancreatitis. Three patients with long-segment colonic necrosis complicating acute pancreatitis are reported. At operation all three patients had extensive retromesocolic necrolysis associated with colonic arterial thrombosis. Colonic resection and intestinal exteriorization with peripancreatic drainage were performed, with survival of two patients. Although diagnosis of colonic ischemia in the presence of acute pancreatitis is difficult, operative therapy affords reasonable cure when this severe problem is recognized. PMID- 3975850 TI - Umbilical vein bypass in patients with severe lower limb ischemia: a report of 121 consecutive cases. AB - In 112 patients with severe ischemia of the lower limb and without a suitable saphenous vein, 99 femoropopliteal and 22 femorodistal bypass procedures were performed with the modified human umbilical vein (Biograft, Meadox Medicals Inc., Oakland, N.J.). Seventy-eight percent of the operations were performed for limb salvage. In the remaining 22% the indication was severe disabling claudication. Forty-nine percent of the patients had previously undergone arterial reconstruction of the extremity in question. In 36% the distal anastomosis was to the popliteal artery above the knee, in 46% to the popliteal artery below the knee, and in 18% to one of the crural arteries. It was mandatory to perform an additional proximal reconstruction in 38% of the extremities. The observation time ranged from 6 to 60 months, with a mean of 24 months. Two patients died within the first month. The overall cumulative patency rate calculated by the life table method was 67.7% at 1 year, 61.2% at 2 years, and an unchanged 56.6% at 3 to 5 years. The cumulative patency rate in the limb salvage group was higher (58.6%) than the patency rate of the grafts implanted for claudication (46.5%, not significant). Graft patency decreased the more peripherally the distal anastomosis was situated, but we could demonstrate neither a significant relationship between graft patency and runoff nor any prognostic significance in the peroperatively measured flow values. Limb salvage calculated by the life table method was 86% at 1 year and 75.4% at 5 years. It is concluded that the umbilical vein graft is an acceptable alternative for bypass grafting in patients without a suitable autogenous vein. PMID- 3975851 TI - Results of multimodality therapy of resectable soft-tissue sarcomas of the retroperitoneum. AB - Thirty-seven patients with resectable retroperitoneal sarcomas were studied prospectively to determine the efficacy of aggressive multimodality treatments. No patients was lost to follow-up, which ranged from 11 to 85 months (median 29 months). All patients received radiotherapy and some received postoperative chemotherapy (doxorubicin, cyclophosphamide, and high-dose methotrexate). A subset of 15 patients were entered into a prospective, randomized study testing the efficacy of adjuvant chemotherapy (eight received chemotherapy; seven did not). Two-year actuarial survival rates were inferior in the chemotherapy arm (100% versus 47%; p = 0.06), but the small number of patients precluded drawing definitive conclusions from this randomized study alone. Among the entire 37 patients (21 received chemotherapy; 16 did not) the actuarial 3-year survival rate was 43% and appeared unaffected by chemotherapy. Two patients suffered doxorubicin infiltration, three sustained cardiac toxicity, two developed cyclophosphamide-induced cystitis, and three withstood transient, severe bone marrow suppression. Eight patients suffered severe radiation enteritis, and one patient died after bowel resection for this problem. Thus the chemotherapy regimen we administered did not appear to improve survival but was associated with major morbidity. Radiotherapy was also associated with major complications, and since all patients received radiotherapy, it remains to be established if this modality is beneficial in improving survival. PMID- 3975852 TI - Primary hyperparathyroidism in pregnancy. AB - The history of a pregnant woman with primary hyperparathyroidism is presented. The patient underwent successful operation during the second trimester and the subsequent pregnancy and delivery were completely normal. Previously, 72 women with an established diagnosis of hyperparathyroidism in pregnancy are reported in the English literature. Twenty-three women underwent operation during pregnancy and 18 normal children were born. Fifty women with a total of 79 pregnancies during a hyperparathyroid state bore 35 normal children while 40 births had different kinds of complications. It is thus clearly documented that the risk of severe fetal complications is much higher if the hyperparathyroidism is left untreated than if the mother undergoes operation during the pregnancy. Therefore when the diagnosis is established the mother should undergo operation, if possible during the second trimester, which minimizes the complication rate significantly in both mother and child. Correction of the hypercalcemic state enables the development of adequate parathyroid gland function in the baby. PMID- 3975853 TI - The effect of metronidazole on wound healing in rats. AB - Metronidazole is gaining increasing acceptance as a perioperative antimicrobial agent. We studied the effect of metronidazole on wound healing in Sprague-Dawley rats, which received seven daily intraperitoneal injections of either metronidazole, 20 mg/kg/day, (simulating a therapeutic course) or equivalent volumes of physiologic saline solution. On the second day of treatment 25 treated rats and 20 control rats had full-thickness circular skin defects created on the back and standardized midline celiotomy incisions. The fascial incisions were closed with staples, and the abdominal skin was closed with silk sutures. On the seventh postoperative day all rats were put to death. The breaking strength of 1 cm wide segments of skin and fascial celiotomy wounds was measured, and the contraction of the open back wounds was computed. There was no significant difference in wound contraction or skin wound breaking strength, but fascial wound breaking strength was lower in treated rats than in control rats (283 versus 548 gm mean; 2 p less than 0.001). To determine whether metronidazole permanently altered or only temporarily delayed fascial wound healing, 39 additional rats treated with metronidazole and 40 control rats underwent celiotomies as described above on the second day of a 7-day course of treatment. Fascial wound breaking strength was measured 2, 3, and 5 weeks after operation. The wound breaking strength in rats treated with metronidazole remained significantly lower than that of control rats at 2 and 3 weeks (860 versus 1005 gm at 2 weeks and 1071 versus 1369 gm at 3 weeks; both 2 p less than 0.05), but at 5 weeks there was no significant difference between treated and control groups (1358 versus 1399 gm). Metronidazole apparently interferes with early fascial wound healing, but the wounds of treated rats ultimately attain the same strength as untreated controls. PMID- 3975854 TI - Distribution of neurotensin in the canine gastrointestinal tract. AB - The distribution of immunoreactive neurotensin in the canine gastrointestinal tract from the esophagus to the rectum, as well as in the pancreas, was determined by a specific neurotensin radioimmunoassay. Immunoreactive neurotensin was found throughout the gastrointestinal tract and in the pancreas. The highest concentrations of immunoreactive neurotensin were found in the mucosal extracts of the jejunum (422 +/- 68 ng/gm) and ileum (3025 +/- 289 ng/gm). Small but substantial amounts of immunoreactive neurotensin were found in the esophagus, fundus (includes fundus and corpus), antrum, duodenum, colon, and pancreas. The concentrations of neurotensin in the mucosal extracts of the jejunum and ileum increased in a graded fashion from the proximal jejunum to the distal ileum. The neurotensin concentration in extracts of the seromuscular layers of jejunum (73 +/- 14 ng/gm) and ileum (187 +/- 38 ng/gm) were statistically higher in comparison with other gut loci. PMID- 3975855 TI - A new method for correlating pancreatic and biliary duct pressures and sphincter of Oddi electromyography. AB - Myoelectric activity of the sphincter of Oddi and duodenum was correlated with pancreatic and biliary duct pressures in eight opossums, in both the fasted and fed states. Four bipolar electrode pairs were implanted in the sphincter of Oddi and duodenum. A polyethylene T tube was placed in the pancreatic duct. The common duct was cannulated through a small bile duct. This method allowed pressure recording for several weeks and avoided interference with the flow of bile or pancreatic juice into the duodenum. The frequency of slow waves was the same in the sphincter of Oddi and duodenum (19 per minute). The variation in the frequency of spike potentials in the sphincter of Oddi correlated to that of the migrating myoelectric complex in the duodenum. The average frequency of slow waves that have superimposed spike potentials in the sphincter of Oddi and duodenum was 3.0 and 0 in phase 1, 4.7, and 6.2 in phase II, 6.1 and 15.1 in phase III, and 3.4 and 6.3 in phase IV, respectively. The average duration of a migrating myoelectric complex cycle was 92 minutes. After feeding, the interdigestive phases of the migrating myoelectric complex were abolished and substituted by a feeding activity pattern that was characterized by an average number of sphincter of Oddi and duodenum spikes of 6.6 and 10.7, respectively. The mean fasting pressure in the pancreatic and biliary duct was 15 and 13 mmHg, respectively. Pressure changes were of two types--synchronous with respiratory movements and with each sphincter of Oddi spike potential. There was no variation in the baseline pressure during the migrating myoelectric complex phases and the fed state. It is concluded that the sphincter of Oddi of the fasting opossum exhibits cyclic changes in the number of spike potentials that correlate with the migrating myoelectric complex in the duodenum. However, the number and amplitude of spike potentials are different in the sphincter of Oddi and duodenum. There is no change in the baseline pressure during fasting and feeding states, and a temporary pressure elevation synchronic with each sphincter of Oddi spike potential was observed. PMID- 3975857 TI - A simplified method for controlled left hepatectomy. AB - Left hepatectomy consists of the removal of the area supplied by the left portal pedicle, separated from the right lobe of the liver by the main portal fissure running from the middle of the gallbladder bed to the left anterior surface of the inferior vena cava; removal of the caudate lobe is optional. During the first step in conventional hepatectomy, the elements of the left portal pedicle are usually dissected in the hilum, and many surgeons remove the gallbladder. The procedure is not always easy to perform and death and morbidity are not negligible. A recent case gave me the opportunity to elaborate on a simple technique: ligation without interruption of the left pedicle in the left end of the hilum, providing immediate hemostasis of the left liver and making resection as easy as that for a cholecystectomy or hysterectomy. PMID- 3975856 TI - Hypothesis: neonatal necrotizing enterocolitis is caused by the acquisition of a pathogenic organism by a susceptible host infant. AB - The following hypothesis is offered for the etiology of neonatal necrotizing enterocolitis (NEC): that NEC is caused by the acquisition of a potentially pathogenic organism by a susceptible host infant. To test this hypothesis, serum IgM, IgG, IgA, C3, and C4, were measured in 11 neonates with NEC and 11 control infants matched for age and birth weight. Mean initial serum IgA was found to be significantly greater (p less than 0.05) in patients with NEC (8.4 mg/dl) than in control subjects (0.6 mg/dl). This difference persisted during a subsequent period of observation. There were no significant differences in initial concentrations of the other immunoglobulins or complement components. Serum IgM was noted to increase and serum IgG to decrease in both study groups during the period of observation. C3 rose minimally and C4 fell in patients with NEC. An explanation for this alteration in serum IgA concentration in infants with NEC is, at this time, speculative. However, this association, suggests that further evaluation of host susceptibility in this patient group may lead to a better understanding of this disorder. PMID- 3975859 TI - Ruptured mesenteric varices in hepatic cirrhosis: a rare cause of intraperitoneal hemorrhage. AB - We report a case of massive and fatal intraperitoneal hemorrhage from ruptured superior mesenteric varices secondary to portal hypertension and hepatic cirrhosis and proved by postmortem angioradiography. To our knowledge, this is the second case in the English language literature. Although very rare, this possibility should be borne in mind when one attempts to locate hemorrhagic complications of portal hypertension. PMID- 3975858 TI - Bright-light amaurosis fugax: an unusual symptom of retinal hypoperfusion corrected by external carotid revascularization. AB - The eye often serves as an important monitor of carotid artery disease by manifesting visual disturbances before cerebral events. The most typical ocular symptom complex is amaurosis fugax characterized by loss of vision in one eye that occurs suddenly and clears within seconds to minutes. This symptom is a hallmark of carotid artery disease and is usually caused by an embolic event. Although monocular visual disturbance on a hemodynamic basis is a more unusual manifestation of carotid artery disease, significant stenosis in combination with a low-flow state can cause transient, unilateral telescoping of vision. This report describes another visual disturbance associated with carotid artery disease in which unilateral visual loss occurred upon exposure to bright light. We term this syndrome bright-light amaurosis fugax and document successful treatment by external carotid artery revascularization in two patients. PMID- 3975860 TI - Haemodialysis and haemofiltration on cardiopulmonary bypass. AB - Over a three year period we have used haemodialysis and haemofiltration in parallel with cardiopulmonary bypass in 26 patients. Impaired renal function and excessive fluid retention have been the main indications. Patients on haemodialysis programmes for end stage renal failure did not require further dialysis until at least the third postoperative day, when they could tolerate the haemodynamic disturbance of dialysis. In the other patients these techniques proved valuable in reversing the effects of haemodilution and in controlling the concentration of serum potassium. Our experience has confirmed that haemodialysis and haemofiltration in parallel with cardiopulmonary bypass are useful adjuncts in the perioperative management of patients with impaired renal function undergoing open heart surgery. The techniques are also effective in correcting the fluid retention and biochemical imbalance in patients with congestive cardiac failure, including those with heart transplants. PMID- 3975861 TI - Effects of mitral valve surgery on static lung function and exercise performance. AB - Lung function at rest was assessed in 50 patients before and six months after mitral valve surgery. There were small increases in spirometric volumes (FEV1 and vital capacity) with decreases in total lung capacity and residual volume, but no change in carbon monoxide transfer factor or transfer coefficient (KCO). Progressive exercise tests performed before and after operation in 19 of the patients confirmed an improved exercise capacity after surgery. The patients with the greatest symptomatic improvement in breathlessness were also those who achieved the greatest increase in maximum work load and the greatest decrease in ventilation for a given oxygen consumption. Depression of the ST segment of the electrocardiogram and frequent ventricular ectopic beats on exercise remained common after surgery and may have been due to digoxin treatment. PMID- 3975862 TI - Treatment of pulmonary tuberculosis in patients notified in England and Wales in 1978-9: chemotherapy and hospital admission. Medical Research Council Tuberculosis and Chest Diseases Unit. AB - The treatment of adult patients, both white and of Indian, Pakistani, or Bangladeshi ethnic origin, with previously untreated pulmonary tuberculosis who were notified in England and Wales from 1 October 1978 to 31 March 1979 has been surveyed. Chemotherapy was completed as planned by the physician in charge in 820 (65%) of the 1253 patients. Eleven per cent of patients died before chemotherapy could be completed, 8% defaulted, and 6% had chemotherapy modified because of drug toxicity, and for 8% there were miscellaneous reasons for failure to complete chemotherapy. Of the 1003 patients who completed chemotherapy, 804 (80%) were prescribed isoniazid and rifampicin throughout, 667 (67%) receiving ethambutol in addition, either in the initial phase (550) or throughout chemotherapy (117). A further 129 (13%) had a regimen based on isoniazid and ethambutol throughout, and the remaining 70 had miscellaneous combinations of drugs. For the 544 patients who received a two phase regimen of isoniazid and rifampicin throughout with one or two additional drugs initially and who completed chemotherapy as planned, the median duration of chemotherapy was 10.8 months, 122 (22%) patients being treated for more than 12 months. For all 1001 patients who completed chemotherapy (whether or not as planned) and for whom the duration was known, the median duration was 11.8 months and 311 (31%) had more than 12 months' treatment. The great majority (79%) of the patients were admitted to hospital initially, the commonest reason being for investigation and diagnosis. PMID- 3975863 TI - Thoracic lymphadenopathy in Asians resident in the United Kingdom: role of mediastinoscopy in initial diagnosis. AB - Although the incidence of superficial glandular tuberculosis is high in Asian immigrants, a clinical diagnosis without biopsy has previously been shown to be inaccurate in 22% of cases. The role of diagnostic mediastinoscopy and biopsy in thoracic lymphadenopathy was therefore evaluated in 41 consecutive Asian patients. Tuberculosis was diagnosed by histological examination or culture (or both) of gland biopsy material in 24 (59%). A further 12 patients, however, also received antituberculous chemotherapy, with a response in 10 cases. If these are included, 34 (83%) were finally considered to have tuberculosis. The symptoms and ages of the patients with tuberculosis were similar to those typically seen in caucasians with sarcoidosis. Six had tuberculous bilateral hilar lymphadenopathy. In only four cases (10%) was a positive diagnosis other than tuberculosis established; in two (lymphoma and thymoma) mediastinoscopy confirmed preoperative suspicions, and saved only two more (with sarcoidosis and vascular anomaly) from unnecessary antituberculous treatment. Complications included severe haemorrhage (1) and chronic tuberculous sinus in the endoscopy tract (2). Mediastinoscopy is unlikely to change management in most patients, produces an appreciable amount of morbidity, and should be reserved for cases in which there is additional clinical doubt. Any future decline in the prevalence of tuberculosis in Asians may, however, require its further evaluation. PMID- 3975864 TI - Longitudinal decline in FEV1 in United States coalminers. AB - Changes in ventilatory function measurements of United States miners who had participated in two surveys held nine years apart were analysed in relation to smoking habits, dust exposure, and other factors. The results showed trends similar to those reported among British miners. Loss of FEV1 over time and found to be related to smoking (0.1 litre excess decline in current smokers compared with those who had never smoked over 11 years) and to occupational exposure (0.036-0.084 litres over 11 years, depending on the index used). The results offer confirmation of the relationship between work in coal mines and loss in ventilatory function observed in British miners, and also seen in cross sectional studies. PMID- 3975865 TI - Acute pleural effusions in inactive ankylosing spondylitis. PMID- 3975866 TI - Aberrant origin of the left coronary artery with associated aortic stenosis. PMID- 3975867 TI - Bronchial lavage and transbronchial lung biopsy in the diagnosis of Legionnaires' disease. PMID- 3975868 TI - Simultaneous aortic and pulmonary artery aneurysms due to giant cell arteritis. PMID- 3975869 TI - Disc and strut embolisation after minor strut fracture in a Bjork-Shiley mitral valve prosthesis. PMID- 3975870 TI - Funding respiratory research. PMID- 3975871 TI - Inhibition of antithrombin III by lipid peroxides. AB - A study was made of the inhibition of antithrombin III (At III) activity by lipid peroxides prepared from autoxidation of unsaturated fatty acids. Lipid peroxides markedly reduced the thrombin neutralising activity of plasma and purified At III with or without albumin carrier. Heparin Sepharose chromatography and heparin cofactor assays suggested that the primary target of lipid peroxides on the At III molecule may be the heparin binding site. Results from electrophoretic studies suggested that interaction between lipid peroxides and At III increased the negative charge of the At III molecule; however, no aggregation of the At III molecule was observed. Lipid peroxidation is being increasingly recognised as a factor in the pathogenesis of several disease states, and it is possible that local inhibition of At III by lipid peroxides could contribute towards the development of a thrombotic event. PMID- 3975872 TI - Antithrombotic effect of ticlopidine in a platelet-independent model of venous thrombosis. AB - The antithrombotic activity of ticlopidine demonstrated in a variety of experimental models of thrombosis has been explained by its antiaggregating properties. This study describes the antithrombotic effect of ticlopidine in a platelet independent model of venous thrombosis. In the rat, ligature of the inferior vena cava induces thrombosis. Antiaggregating drugs (acetylsalicylic acid, dipyridamole, sulfinpyrazone) are inactive while anticoagulants (heparin, acenocoumarol) are highly antithrombotic. Ticlopidine reduces thrombus weight significantly and dose-dependently (ED 50 = 150 mg/kg/day X 3 days). Thrombocytopenia induced by injection of anti-platelet anti-serum was found not to modify thrombus formation. Yet, even in these conditions, ticlopidine remains active. Acetylsalicylic acid treatment does not prevent the antithrombotic effect of ticlopidine, indicating that its action is independent of PGI2 synthesis. These results demonstrate that ticlopidine acts as an antithrombotic agent in a venous thrombosis model in which platelets play a minor role. PMID- 3975874 TI - Purification and characterization of platelet aggregating activity from tumor cells: copurification with procoagulant activity. AB - The platelet aggregating component from murine 15091A mammary adenocarcinoma cells was purified by solubilization of activity with CHAPS (3-[(3 cholidamidopropyl)-dimethylammonio]-1-propane sulfonate), fractionation with ammonium sulfate, ion exchange chromatography on DEAE cellulose, and hydrophobic interaction chromatography on dodecyl agarose. A purification of 90-100 fold over the initial cell homogenate was achieved. SDS-PAGE of the purified material resulted in a single major band with a molecular weight of 51,000 +/- 2,000. Procoagulant activity was found to copurify with platelet aggregating activity. Reconstitution with phospholipids was necessary to obtain platelet aggregating activity and procoagulant activity. Trypsin abolished both platelet aggregating and procoagulant activities. The irreversible proteinase inhibitors phenylmethylsulfonyl fluoride, N alpha-p-tosyl-L-lysine chloromethyl ketone, iodoacetamide or phenanthroline had no effect on platelet aggregating or procoagulant activities. Platelet aggregation induced by this material was inhibited by low concentrations of the specific irreversible thrombin inhibitors, dansylarginine N-(3-ethyl-1, 5-pentanediyl) amide and D-phenylalanyl-L-prolyl-L arginine chloromethyl ketone. This is the first report of copurification of tumor cell platelet aggregating and coagulating activities. PMID- 3975873 TI - alpha 2 Antiplasmin and disseminated intravascular coagulation in liver cirrhosis. AB - Subnormal concentrations of alpha 2 Antiplasmin (alpha 2 AP) in liver cirrhosis may be due to an impaired hepatic synthesis and/or to a fibrinolysis activation in disseminated intravascular coagulation (DIC). In order to clarify this problem, in 26 cirrhotic patients (15 compensated and 11 decompensated) alpha 2 AP plasma activity and plasma Fibrinopeptide A (FPA) were measured. Serum albumin, p-Cholinesterase (p-CHE), Fibrinogen and Fibrinogen Degradation Products (FDP) were also carried out. Our data show that alpha 2 AP and FPA were equally abnormal in compensated and decompensated cirrhosis. The significant negative correlation obtained between alpha 2 AP and FPA as well as the lack of correlation between alpha 2 AP and albumin, alpha 2 AP and p-CHE in both groups suggests that, in our patients, alpha 2 AP decrease may be due to a fibrinolysis activation induced by a DIC which appears chronic since Fibrinogen and FDP were normal. These findings are in agreement with the results obtained in the four subgroups a posteriori selected on the basis of FPA levels: alpha 2 AP in subgroups with high FPA was significantly different from controls while it did not differ in subgroups with normal FPA. PMID- 3975875 TI - Kinetic study on the initial stage of the fibrinogen-fibrin conversion by thrombin. (III) Effects of competitive inhibitors. AB - By using the turbidimetrical procedure, the inhibition constants, Kip, of competitive inhibitors of thrombin were estimated in systems of fibrinogen thrombin-inhibitor. In the presence of a competitive inhibitor such as benzamidine, p-aminobenzamidine, tosylarginine methyl ester, MD-805, and antithrombin III-heparin, the turbidity change of reaction mixture was traced on the initial stage of the fibrinogen-fibrin conversion catalyzed by thrombin. The formation rate of the smallest polymer as detectable by turbidimetry was measured from evaluating the induction period of turbidity-time curves. The Kip values thus obtained were a little less than or agreed well with the inhibition constants, Ki, reported on systems of synthetic substrate-thrombin-inhibitor. PMID- 3975876 TI - Inhibition of platelet aggregation and thromboxane B2 production during aspirin treatment: dependence on the dose of the aggregating agent. PMID- 3975877 TI - Assay of hirudin in plasma using a chromogenic thrombin substrate. PMID- 3975878 TI - [Suicide in adolescents. Development in Scandinavia. 7-year case material from Oslo]. PMID- 3975880 TI - [Should chronic bronchitis be considered a clinical concept?]. PMID- 3975879 TI - [The reliability of suicide statistics in Norway]. PMID- 3975882 TI - [Training in practical procedures in undergraduate medical education]. PMID- 3975883 TI - [The first surgical term. Practical procedures--medical students' experiences]. PMID- 3975881 TI - [Bladder paralysis in spinal injuries. Primary therapeutic results in 1-year case material]. PMID- 3975884 TI - [Experiences from American medical education. Is there something to learn?]. PMID- 3975885 TI - [Misuse of hospital beds]. PMID- 3975886 TI - [Pain, perception and expression: an ethological perspective]. AB - To better understand the pain phenomenon, its occurrence and its functional significance, pain should be considered as a part of a behaviour system which activates two functions: defensive and aversive behaviour on the one hand, and recuperative behaviour on the other. In the former especially the more short lasting primary pain plays a role, in recuperative behaviour more chronic secondary pain is of importance. Pain should not be seen primarily as the unconditioned stimulus in the fear system, but as one of the independent behaviour systems. Within the framework of this ethological model both the facilitative and inhibitive influences which 'pain' and 'fear' exert on each other can be more satisfactorily explained. We assume that animals feel pain on the grounds of the so-called 'analogy decision'. The only objective measure, of course, is the behaviour which is observable as a consequence of harmful influences. This behaviour varies greatly with the nature and localisation of the harmful effects; the variation is dependent on the degree to which behavioural responses can be effective in avoiding damage and promoting recovery, and also on the animal species considered. In some species expressions of pain have been selected for and adapted as social signals which elicit consideration, help and care of conspecifics. In other species social and other factors have precluded stimulation of such a development. All this means that the extent to which spontaneous behavioural expressions can serve as valid pain measures is a complicated question; it leads to consideration of the feasibility of more meaningful experimental measurement methods. PMID- 3975888 TI - [The organized control of paratuberculosis in cattle and the possibilities of using vaccination for this]. PMID- 3975887 TI - [One man's meat is another man's poison]. AB - A case of rumen acidosis in non-lactating cattle is reported. This was due to the fact that stale bread was fed ad lib, rather than concentrates. Of seventy animals, fourteen died or were slaughtered. The meat was declared unfit for human consumption in every case. PMID- 3975889 TI - [Abnormal behavior in farm animals]. PMID- 3975890 TI - [Current insights into an old problem: BVD (bovine virus diarrhea)]. AB - A number of recent papers on the epidemiology of bovine virus diarrhoea and the pathogenesis of mucosal disease resulted in new insights, but also gave rise to several questions. Prior to dealing with these questions the new views are discussed, and the possible damaging effects of BVD infection are briefly reviewed. PMID- 3975891 TI - [Autochthonous babesiosis in dogs in the Netherlands?]. AB - For the first time cases of babesiosis have been diagnosed in dogs that had not been abroad. Three cases were seen in the province of Gelderland (Bennekom, Elspeet), two in North-Holland (Koog aan de Zaan). A female Dermacentor reticulatus tick, the main vector of the disease in Europe, was found on one of the dogs at Koog; previously specimens of this tick species had only occasionally been seen on dogs returning from abroad. Serological evidence was obtained that in at least four of the cases European Babesia canis, transmitted by Dermacentor ticks, was involved. PMID- 3975892 TI - [A case of cystic ovarian follicles in the cat]. PMID- 3975893 TI - [Extrahepatic cholestasis due to pancreas fibrosis in a trotter]. AB - A trotter stallion showing symptoms of emaciation was suspected of disease of the liver associated with cholestasis in view of clinical symptoms (poor appetite, sluggishness, jaundice and oedema) and the results of examination of the blood (increased concentrations of gamma-glutamyl, transpeptidase, sorbitol dehydrogenase, alkaline phosphatase, aspartate aminotransferase and markedly increased conjugated bilirubin). A specimen removed at biopsy of the liver revealed the presence of portal fibrosis and severe cholestasis. At autopsy, it was found that very extensive fibrosis of the pancreas (probably due to migrating larvae of parasites) had caused extrahepatic cholestasis accompanied by fibrosis of the liver. The lesions of the coronary border, which were also present in this horse, could not be accounted for. PMID- 3975894 TI - [Chloramphenicol, contraindicated for topical use on the eye?]. AB - It was calculated in the Dutch bulletin for drugs, that chloramphenicol--even in topical treatment--should only be used in human bacterial infections in which the bacteria are solely susceptible to chloramphenicol. Information is supplied stating that these conclusions are based on wrongly chosen patients. It is concluded that the indications for use of topical chloramphenicol in dogs or cats continue to be unchanged. PMID- 3975895 TI - [A brief review of the literature for deep-freezing cattle embryos]. AB - Low temperature preservation of bovine embryos is briefly reviewed. The following subjects are discussed: the desired developmental stage of the embryo, the packaging system during freezing, the cryoprotective agents, the freezing and thawing methods and the results made possible by freezing bovine embryos. PMID- 3975896 TI - [From the Veterinary Chief Inspection for Public Health and the Board of the Veterinary Service. Revised vaccination regimen in immunization areas--practical guidelines for performing immunization]. PMID- 3975897 TI - Acute toxicity and recovery in the hemopoietic system of rats after treatment with ethylene glycol monomethyl and monobutyl ethers. AB - Male rats were given ethylene glycol monomethyl ether (EGM) or ethylene glycol monobutyl ether (EGB) po for 4 consecutive days at doses of 100 or 500 mg/kg body wt/day for EGM, and 500 or 1000 mg/kg body wt/day for EGB. Animals were killed on Days 1, 4, 8, and 22 after the final treatment. Both EGM and EGB produced thymic atrophy and lymphocytopenia and, in the case of EGM, neutropenia also. Hemolytic anemia induced by EGB resulted in splenic extramedullary hemopoiesis, hyperplasia of both spleen and bone marrow, and reticulocytosis. Apart from residual slight increases in spleen weight, mean red cell volume, and mean corpuscular hemoglobin at the end of the recovery period, other effects were reversible. With EGM, reduction in the numbers of circulating red cells was only slight. Treatment with EGM also abolished splenic extramedullary hemopoiesis which partially recovered on Day 4, followed by a marked response on Day 8, and return to the moderate control values on Day 22. Femoral bone marrow was hemorrhagic 1 day after treatment with EGM which appeared to be associated with sinus endothelial cell damage. By Day 4 the histologic appearance of the marrow was normal. Testicular atrophy was also produced in EGM-treated animals which persisted for the duration of the experiment. It is concluded that EGM and EGB differ considerably in the spectrum of toxic changes induced, and apart from testicular atrophy, these changes were largely reversible within a short time of the end of treatment. PMID- 3975898 TI - Concentration-time-response relationship under conditions of single inhalation of carbon tetrachloride. AB - An attempt was made to establish a concentration-time-response relationship for a single inhalation of CCl4 in rats. Rats were exposed to CCl4 under conditions of various combinations of concentration (C = 1350, 2500, 3400, and 6900 ppm) and time (t = 1, 2, 3, and 6 hr). As a parameter of toxicity, glutamic-oxaloacetic transaminase (GOT) activity was measured. The concentration-time-response relationship obtained by graphic analysis of the data could be described by the equation: log g = nCmlog t + gamma C + log delta, where g is the GOT activity 24 hr after the end of exposure, and n, m, gamma, and delta are empirical parameters. It was found from this relationship that concentration has more influence on toxic effect than time does. The concentration-time relationship, furthermore, suggested that the time-weighted average of the concentration of CCl4 (and presumably also other atmospheric contaminants), which can be applied only under the condition of C X t = constant, does not correctly reflect the "toxicity value" of exposures. Quantitative expression of the concentration-time response relationship makes it possible to predict the "no observable effect level" (NOEL) of CCl4 for various exposure times. PMID- 3975899 TI - Acute renal failure and glucosuria induced by ferric nitrilotriacetate in rats. AB - Nitrilotriacetate (NTA), an effective metal-chelating agent, has been used as a substitute for polyphosphates in household laundry detergents. Nephrotoxicity and renal tumorigenicity have been reported in experimental animals that received high doses of NTA po for 4 weeks to 2 years. Since NTA exists in water as a variety of NTA-metal complexes, it was important to investigate the biological effects of NTA in a complexed form. In this study, acute and subchronic toxicity of a ferric iron chelate of NTA (Fe-NTA) was investigated in rats. When Fe-NTA was given ip, acute tubular necrosis and renal failure occurred following a single injection of 15 mg iron/kg. Repeated injections of sublethal doses produced degeneration and necrosis of the proximal tubular epithelium and was associated with polyuria, glucosuria, aminoaciduria, and azotemia. After 9 days of treatment, regeneration of the tubular epithelium with atypical cells was observed. Except for a parenchymal iron deposit, no marked changes were observed in other organs. None of these effects were observed in animals given noncomplexed NTA. In conclusion, the toxicity observed following high doses of NTA given po may be the result of an absorbed metal-NTA chelate. PMID- 3975900 TI - Biodisposition of [3H]diisopropylfluorophosphate in mice. AB - The disposition of [3H]diisopropylfluorophosphate (DFP) and its metabolites was studied in mice after iv treatment. In addition, disposition of [3H]DFP in selected tissues was correlated with cholinesterase activity and spontaneous activity following DFP treatment. Within 1 min of administration [3H]DFP had penetrated tissues and was already irreversibly bound. The tissue concentrations of [3H]DFP declined in a rapid fashion so that after 2 hr all concentrations were below 50 pg/mg tissue. The major portion of radioactivity was bound to tissue in the form of [3H]diisopropylphosphoric acid (DIP). There was a decline in [3H]DIP with time in all tissues except liver, kidneys, and fat, which reached a maximum at 30 min before declining. The only appreciable quantities of [3H]DIP remaining after 3 days were in liver and kidneys. There was also evidence that [3H]DFP was rapidly hydrolyzed to free [3H]DIP which was found in all tissues within 1 min of [3H]DFP administration. [3H]DIP concentrations were equivalent to or exceeded those of [3H]DFP in all tissues, except brain. Cholinesterase inhibition in plasma, diaphragm, and brain following DFP treatment (1 mg/kg, iv) was temporarily correlated with the concentrations of bound [3H]DIP in these same tissues between 1 hr and 3 days. Cholinesterase inhibition in brain and diaphragm did not correlate well with bound [3H]DIP at earlier time points which suggested the presence of noncholinesterase binding. DFP treatment (1 mg/kg) also induced motor hypoactivity which lasted up to 6 hr after iv injection. The time course of motor hypoactivity was not correlated with free [3H]DFP, bound [3H]DIP concentrations in the brain, or with cholinesterase inhibition in the brain, which suggested that noncholinesterase bound [3H]DIP was responsible for this CNS depression. PMID- 3975901 TI - Acute motor and lethal effects of inhaled toluene, 1,1,1-trichloroethane, halothane, and ethanol in mice: effects of exposure duration. AB - Some acute effects of inhalation exposure to toluene, 1,1,1-trichloroethane (1,1,1-TCE), halothane, and ethanol were examined in mice. Lethality and performance on an inverted screen test of motor performance were measured following 10-, 30-, and 60-min exposures. Concentration-dependent effects were obtained on both measures for all solvents except that lethal concentrations of ethanol could not be produced under these exposure conditions. Lethality increased with longer exposures for toluene, 1,1,1-TCE, and halothane. Sensitivity to the motor effects of 1,1,1-TCE, halothane, and ethanol increased when exposure duration was increased from 10 to 30 min, with no further change with 60-min exposures. In contrast, behavioral sensitivity to toluene increased over the entire range of exposure durations. The relative lipid solubilities of the solvents correlate with potency for behavioral activity but not as well with potency for lethality. The ratio of potency for motor and lethal effects depended on the chemical studied and in some cases exposure duration. These results demonstrate that both concentration and exposure duration determine the effects of inhaled compounds, but a simple linear relationship does not exist and it depends upon the effect measured. PMID- 3975902 TI - Cardiovascular dysfunction and hypersensitivity to sodium pentobarbital induced by chronic barium chloride ingestion. AB - Barium-supplemented Long-Evans hooded rats were characterized by a persistent hypertension that was evident after 1 month of barium (100 micrograms/ml mineral fortified water) treatment. Analysis of in vivo myocardial excitability, contractility, and metabolic characteristics at 16 months revealed other significant barium-induced disturbances within the cardiovascular system. The most distinctive aspect of the barium effect was a demonstrated hypersensitivity of the cardiovascular system to sodium pentobarbital. Under barbiturate anesthesia, virtually all of the myocardial contractile indices were depressed significantly in barium-exposed rats relative to the corresponding control-fed rats. The lack of a similar response to ketamine and xylazine anesthesia revealed that the cardiovascular actions of sodium pentobarbital in barium-treated rats were linked specifically to this anesthetic, and were not representative of a generalized anesthetic response. Other myocardial pathophysiologic and metabolic changes induced by barium were manifest, irrespective of the anesthetic employed. The contractile element shortening velocity of the cardiac muscle fibers was significantly slower in both groups of barium-treated rats relative to the control groups, irrespective of the anesthetic regimen. Similarly, significant disturbances in myocardial energy metabolism were detected in the barium-exposed rats which were consistent with the reduced contractile element shortening velocity. In addition, the excitability of the cardiac conduction system was depressed preferentially in the atrioventricular nodal region of hearts from barium-exposed rats. Overall, the altered cardiac contractility and excitability characteristics, the myocardial metabolic disturbances, and the hypersensitivity of the cardiovascular system to sodium pentobarbital suggest the existence of a heretofore undescribed cardiomyopathic disorder induced by chronic barium exposure. These experimental findings represent the first indication that life long barium ingestion may have significant adverse effects on the mammalian cardiovascular system. PMID- 3975903 TI - Temperature-dependent disposition of [14C]benzo(a)pyrene in the spiny lobster, Panulirus argus. AB - [14C]Benzo(a)pyrene (BP) (1 mg/kg) was administered by intracardiac injection to groups of spiny lobsters which were killed at various times up to 7 weeks after dosing. Tissues and fluids were evaluated for BP-derived radioactivity. Two studies were conducted in successive summer and winter seasons, when seawater temperatures throughout were 26.5 to 29.0 and 13.5 to 16.5 degrees C, respectively. Highest concentrations of BP-derived radioactivity were found in the hepatopancreas, stomach, intestine, intestinal contents, and the green gland. After an initial distribution phase, the dose was lost from the lobsters in a log linear manner. The elimination half-lives for overall elimination of BP-derived radioactivity were 1.11 weeks in the warmer (summer) and 2.25 weeks in the colder (winter) water. Similarly, for individual organs, elimination was more rapid in the warmer water. For the hepatopancreas, green gland, intestine, and tail muscle, respective t1/2 values (week) were 1.02, 1.26, 1.71, and 1.42 in the summer and 2.50, 1.50, 5.04, and 2.11 in the winter. There was no suggestion of tissue accumulation of BP-derived radioactivity. HPLC analysis of hepatopancreas samples showed that, in summer, unmetabolized BP concentrations fell rapidly, accounting for only 5% of the total label in the hepatopancreas by 3 days. The fall in unmetabolized BP was accompanied by approximately equal increases in the percentages of both polar metabolites and conjugates. Although the time curve for metabolism of BP in the hepatopancreas was not studied in winter, the metabolic capacity was such that, by 3 days after the dose, only 5% of the 14C present in hepatopancreas was unmetabolized BP. Thus, it appears that, for this dose of BP, the more rapid elimination of 14C in summer was due to a more rapid excretion of metabolites, and not to increased metabolism of BP. PMID- 3975904 TI - Aluminum bioavailability and disposition in adult and immature rabbits. AB - Prolonged aluminum (Al) exposure produces neurobehavioral and skeletal toxicity. To further characterize the risk from Al exposure, lactating rabbits were administered iv (40 or 80 mumol/kg), po (4 or 20 mmol/kg), and sc (400 mumol/kg) doses of Al lactate on Days 10, 15, and 20 of lactation. Baseline pretreatment Al concentration averaged 138 ng/ml in serum and 710 ng/ml in milk. Individual baseline values were subtracted from posttreatment samples, and pharmacokinetic analysis was performed on these residual values. The high and low doses did not produce statistically significant differences in systemic clearance, half-life, or the apparent volume of distribution. The amount of aluminum in milk 24 hr after injection was estimated to be 2.4% of the iv and 3.3% of the absorbed sc dose. Systemic bioavailability of Al after low- (0.7 +/- 0.5% means +/- SD) and high-dose po Al (1.9 +/- 1.7%) was not significantly different. Bioavailability of sc Al was 27 +/- 7%. Rabbits receiving daily sc Al injections (400 mumol/kg) for 28 consecutive days demonstrated nonlinear kinetics. Preinjection serum Al concentrations and the area under the curves associated with the 7th dose were considerably greater than with the 1st dose. Further increases were seen with the 28th dose. Seven days after the last Al injection, 12% of the total Al injected was still in the region of the injections, indicating prolonged absorption. The bioavailability and disposition of Al were determined in 17- to 24-day old suckling rabbit offspring after iv (40 mumol/kg) and po (4 mmol/kg in water or milk) doses of Al lactate. Baseline pretreatment serum Al concentration averaged 119 ng/ml. Mean systemic clearance was comparable in offspring and adults, although the apparent volume of distribution was greater in offspring producing a longer half-life in the offspring. The limited distribution of Al into milk and poor GI absorption of Al support the observation that there is little risk of Al toxicity in suckling offspring of Al exposed nursing females. PMID- 3975905 TI - Nonlinear association between covalent binding of formaldehyde to DNA and administered formaldehyde concentration. PMID- 3975906 TI - Buthionine sulfoximine inhibition of cystine uptake and glutathione biosynthesis in human lung carcinoma cells. AB - Intracellular glutathione (GSH) content of human lung carcinoma cells, A549, in log phase was 25 +/- 5 nmol/10(6) cells, which is considerably higher than that reported in other tumor cells. After partial depletion of GSH with diethyl maleate (DEM), addition of cystine to the medium allowed full resynthesis of GSH in 4 hr, cysteine in the same time period led to less resynthesis, and methionine provided minimal resynthesis. Using cystine as the sole sulfur source and with buthionine sulfoximine (BSO, 5 mM) included in the medium after cells were depleted with DEM, inhibition of both cystine uptake and resynthesis of GSH occurred. BSO inhibited [35S]cystine uptake (as early as 10 min) in a concentration-dependent process, ranging from a 28% decrease for 1 microM BSO to an 85% decrease for 100 microM BSO compared to the control cells after 240 min of incubation. In addition, GSH resynthesis from [35S]cystine for 240 min was inhibited in a parallel dose-dependent manner, in that 1 microM BSO caused a 27% decrease and 100 microM BSO provided a 75% decrease from control values. BSO did not inhibit the uptake of [35S]methionine, but inhibited the low amount of resynthesis of GSH when methionine was the sole sulfur source. BSO did not inhibit the uptake of arginine, phenylalanine, and leucine. DL-, L-, and methyl ester-BSO each inhibited [35S]cystine uptake and incorporation into GSH to a similar extent. The half-life of GSH was 3.5 +/- 0.4 hr in A549 cells that were grown in complete medium with GSH synthesis occurring. PMID- 3975907 TI - Glutathione S-sulfonate, a sulfur dioxide metabolite, as a competitive inhibitor of glutathione S-transferase, and its reduction by glutathione reductase. AB - Glutathione S-sulfonate (GSSO3H) is a reaction product of glutathione disulfide (GSSG) and sulfite, the hydrated form of sulfur dioxide. In the present study, GSSO3H was found to be a potent competitive inhibitor of the glutathione S transferases (GST) in the rat liver (Ki = 14 microM) and lung (Ki = 9 microM), and in human lung tumor-derived A549 cells (Ki = 4 microM). GSSO3H was also reduced by a cytosolic enzyme in the rat liver (Km = 313 microM) and lung (Km = 200 microM), and human lung A549 cells (Km = 400 microM). These results suggest that SO2 may affect the detoxification of xenobiotic compounds by inhibiting, via formation of GSSO3H, the enzymatic conjugation of glutathione (GSH) and reactive electrophiles. Although GSSO3H can be enzymatically degraded, the high substrate Km value suggests that this compound may not be readily reduced at low concentrations. PMID- 3975908 TI - Brain cholinergic, behavioral, and morphological development in rats exposed in utero to methylparathion. AB - The purpose of this study was to determine the effects of subchronic administration of the organophosphate methylparathion (MPTH) during gestation on behavior and development of brain cholinergic neurons in the offspring. Pregnant rats received daily po doses of MPTH from Day 6 through Day 20 of gestation at doses causing no (1.0 mg/kg) or minimal (1.5 mg/kg) visible signs of maternal toxicity. Acetylcholinesterase (AChE) and choline acetyltransferase (CAT) activities, and [3H]quinuclidinyl benzilate (QNB) binding to muscarinic receptors, were determined in several brain regions at 1, 7, 14, 21, and 28 days postnatal age and in maternal brain at Day 19 of gestation. Prenatal exposure to 1.5 mg MPTH/kg reduced AChE and increased CAT activity in all brain regions at each developmental period and in maternal brain. Similar exposure to 1.0 mg MPTH/kg caused a significant but smaller and less persistent reduction in AChE activity but no change in brain CAT activity of the offspring. Both doses of MPTH decreased the Bmax of 3H-QNB binding in maternal frontal cortex but did not alter the postnatal pattern of 3H-QNB binding. In parallel studies, prenatal exposure to MPTH did not affect a variety of behaviors. However, cage emergence, accommodated locomotor activity, and operant behavior in a mixed paradigm were impaired in rats exposed to 1.0 but not to 1.5 mg/kg MPTH. No morphological changes were observed in hippocampal or cerebellar tissue. Thus, subchronic prenatal exposure to MPTH altered postnatal development of cholinergic neurons and caused subtle alterations in selected behaviors of the offspring. PMID- 3975909 TI - Cadmium-induced hepatic and renal injury in chronically exposed rats: likely role of hepatic cadmium-metallothionein in nephrotoxicity. AB - Rats were injected sc with 0.5 mg Cd/kg, 6 days/week, for up to 26 weeks. Hepatic and renal function and tissue Cd and metallothionein (MT) content were determined in tissues and plasma at various times after Cd injection. Cd in liver and kidney increased linearly for the first 10 weeks of treatment, but thereafter hepatic concentrations of Cd decreased by 33% whereas the content of Cd in kidney remained constant. MT in liver and kidney increased linearly during the first 12 weeks of Cd treatment to 4400 and 2300 micrograms MT/g, respectively, but rose only slightly thereafter. Circulating concentrations of MT progressively increased beginning 2 weeks after Cd treatment and were approximately 10 times control values in rats dosed with Cd for 12 or more weeks. Plasma activities of alanine and aspartate aminotransferase exhibited a time course similar to that observed with MT, and were elevated as early as the sixth week of Cd exposure. Sharp increases in activities of these enzymes also occurred after 10 to 12 weeks of dosing. Hepatic microsomal metabolism of benzo[a]pyrene and ethylmorphine was severely attenuated beginning 4 weeks after Cd. Renal injury occurred after hepatic damage, as evidenced by decreased in vitro p-aminohippuric acid uptake beginning 8 weeks after exposure. Urine outflow increased threefold 11 weeks after Cd exposure began, while urinary protein and Cd excretion increased beginning at Week 9. These data indicate the liver is a major target organ of chronic Cd poisoning, and suggest that Cd-induced hepatic injury, via release of Cd-MT, may play an important role in the nephrotoxicity observed in response to long-term exposure to Cd. PMID- 3975910 TI - Pulmonary and sensory irritation of diphenylmethane-4,4'- and dicyclohexylmethane 4,4'-diisocyanate. AB - The use of isocyanates in industry has been increasing and, therefore, the potential for human exposure has also increased. Two such isocyanates are diphenylmethane-4,4'-diisocyanate (MDI) and dicyclohexylmethane-4,4'-diisocyanate (SMDI). Furthermore, there are only a few reports describing the toxicity of these diisocyanates. The pulmonary irritation of the aromatic isocyanate MDI and the sensory and pulmonary irritation of the cycloaliphatic isocyanate SMDI were studied in an animal bioassay. Groups of male, Swiss-Webster mice were exposed to aerosol concentrations of MDI varying from 17 to 67 mg/m3. The total exposure time for both isocyanates was 240 min, and the respiratory patterns and frequency of four mice were recorded during each exposure. Concentrations of MDI and SMDI in the exposure chamber were determined gravimetrically. The mass median aerodynamic diameter (MMAD) and geometric standard deviation for the MDI aerosol were 0.7 micron and 1.6 and for the SMDI aerosol were 0.9 micron and 1.5, respectively. The inhalation responses during the 4-hr exposures to aerosols of MDI and SMDI were investigated, and the animal model was used to determine time response and concentration-response relationships for all exposures. From these results it was determined that the level of effect was dependent on both the duration of exposure and the exposure concentration. Unlike many other isocyanates tested with this animal model, MDI and SMDI acted primarily as pulmonary irritants, evoking little or no sensory irritation. The concentrations required to reduce the respiratory rate 50% (RD50) due to pulmonary irritation was 32 mg/m3 for MDI and 40 mg/m3 for SMDI. Increases in lung weight were found in groups of animals killed 24 hr following all exposures to MDI and SMDI. Using the animal model, which has been calibrated to human responses with nitrogen dioxide and other pulmonary irritants, the recommended TLV-TWAs for MDI and SMDI in industry should be no higher than 0.3 and 0.4 mg/m3, respectively. PMID- 3975911 TI - Accumulation of cadmium by the eye with special reference to the lens. AB - Subcutaneously administered Cd2+ (in vivo) was accumulated in the eyes of rabbits. The concentration was greatest in the iris-ciliary body, followed by the retina, cornea, and lens. It was also present in the vitreous humor, but was not detectable in the aqueous humor. Cd2+ in the bathing medium in vitro was toxic to the lens (tissues gained Na and lost K) at 10(-3) M, for 24 hr incubation, or 10( 5) M, for 7 days. Cadmium-109 was gradually accumulated by the lens in vitro (the process may be saturable), but with 10(-7) M Cd in the medium (similar to the vitreous in Cd-treated rabbits) 100 times less was taken up in 24 hr than in the 28-day in vivo experiments. Cadmium-109 in vitro was almost confined to the outer 30 to 50% of the lens tissue. Cadmium-109 was able to reenter the bathing medium, and its efflux was not changed by the presence of external Cd, suggesting that substantial specific binding was not occurring. Efflux could be reduced by lanthanum so that it may follow pathways similar to those used by Ca and Zn. PMID- 3975912 TI - An apparent acceleration of age-related changes of rat red blood cells by cadmium. AB - The effect of cadmium at nonhemolytic concentrations on rat red blood cells was examined in vitro and compared with that of mercury. When rat red blood cells were incubated at 37 degrees C with 0.5 to 2.0 mM CdCl2 for 60 min, age-related changes of red blood cells occurred. These changes developed in a dose-dependent manner and included increases in cell density and in the number of echinocytes and a decrease in filterability. The incubation of red blood cells with 0.5 and 1.0 mM CdCl2 resulted in their shortened in vivo survival. Neither metabolic blockade, such as a fall in the adenosine triphosphate and glutathione contents, nor potassium leakage occurred at nonhemolytic concentrations of Cd. The effect of HgCl2 on age-related changes of red blood cells occurred at 5- to 20-fold lower concentrations than those of CdCl2. These results show that age-related changes were apparently accelerated by nonhemolytic concentrations of Cd and may be, at least in part, due to the interaction of Cd with thiol residues of cell membranes. PMID- 3975913 TI - The effect of lead toxicity and milk deprivation of myelination in the rat. AB - During a defined postnatal developmental period, the 2nd through the 28th postnatal day, rats were exposed daily to either an oral administration of 200 mg lead (as lead acetate) per kilogram of body weight, an 8-hr maternal milk deprivation schedule, or a combination of the two insults. On the 29th day the rats were killed. Either lead exposure or milk deprivation alone decreased brain (10%) and body (15%) weights, and an additive effect was observed in rats exposed to both lead and milk deprivation (brain: 20%; body: 35%). Neither the lead nor the deprivation insult alone produced a perturbation in the process of myelination. However, when the two conditions were combined an interaction was evident as a 25% decrease in myelin accumulation in females. No effect was seen in males. The myelination deficit in females was specific in that neither accumulation of glial fibrillary acidic protein (a marker for astroglial cells) nor neurofilament protein (a marker for neurons, especially axons) was perturbed. Tissue lead concentrations did not suggest that this increased sensitivity in females was due to a selective increase in their body burden of lead. PMID- 3975914 TI - Teratologic and postnatal evaluation of aniline hydrochloride in the Fischer 344 rat. AB - Timed-pregnant Fischer 344 rats were dosed by gavage with aniline hydrochloride (10, 30, or 100 mg/kg/day), a positive control agent (hydroxyurea, 200 mg/kg/day), or vehicle (distilled water) on gestational days (gd) 7 through 20 or gd 7 through parturition. At termination on gd 20 confirmed-pregnant dams exhibited characteristic signs of aniline HCl toxicity, i.e., methemoglobinemia, increased relative spleen weight, decreased red blood cell (RBC) count, and hematological changes indicative of increased hematopoietic activity. High-dose dams exhibited mild methemoglobinemia, increased relative spleen weight, and increased RBC size at termination on postnatal day (pnd) 30. At termination on gd 20, fetuses from aniline-treated dams exhibited increased relative liver weight and enhanced hematopoietic activity, but no evidence of an embryolethal or teratogenic effect was observed. Postnatal signs of toxicity in litters from aniline-treated dams (i.e., decreased body weight, elevated relative liver weight, and elevated relative spleen weight) were transient, and no evidence of toxicity was observed in pups surviving to pnd 60. Hydroxyurea (200 mg/kg/day) administered by gavage proved to be an excellent positive control for embryotoxicity, maternal toxicity, teratogenicity, and postnatal maturational deficits in the Fischer 344 rat. In conclusion, aniline hydrochloride was not teratogenic to Fischer 344 rats, even at maternally toxic doses; transient signs of toxicity were observed postnatally in the offspring in conjunction with mild, but persistent signs of maternal toxicity through pnd 30. PMID- 3975915 TI - Comparative ototoxicity of netilmicin, gentamicin, and tobramycin in cats. AB - Netilmicin, a semisynthetic aminoglycoside antibiotic, is less ototoxic in a variety of species than other aminoglycosides currently in therapeutic use. In this study, mixed-breed cats (four/group) were given daily sc injections of netilmicin (20, 40, and 80 mg/kg), gentamicin (20 and 40 mg/kg), or tobramycin (20, 40, and 80 mg/kg) for up to 30 weeks or until ototoxicity was observed. The animals were examined throughout the study for effects on cochlear and vestibular function. Hematologic, serum chemical, and drug-serum (24-hr postdose) assays were performed at approximate monthly intervals during the dosing period. The cochleae, kidneys, and liver were examined microscopically. The mean number of dose days required to produce vestibulotoxic effects, demonstrated by impaired righting reflex or locomotor ataxia, was from 41 to 61 in cats dosed with tobramycin (40 and 80 mg/kg) or gentamicin. No vestibular dysfunction was observed in any of the netilmicin 20-mg/kg-dosed cats, in two cats each of the tobramycin 20-mg/kg and netilmicin 40-mg/kg groups, and in one netilmicin 80 mg/kg-dosed animal. Histologic examination of the cochleae revealed degeneration of the hair cells and supporting sensory structures in the majority of cats dosed with gentamicin at 20 and 40 mg/kg and tobramycin at 40 and 80 mg/kg. Less than 50% of the tissues from cats of the tobramycin 20-mg/kg and netilmicin 40- and 80 mg/kg-dosed groups had similar degenerative cochlear changes. No cochlear damage was noted in any of the cats given netilmicin at 20 mg/kg. Results of the clinical laboratory determinations were generally unremarkable. Proximal tubular degeneration was the principal finding observed in the kidneys of the animals. Under the conditions of this study, at least a twofold (vestibular) to fourfold (cochlear) relative safety margin for ototoxicity was established in favor of netilmicin over tobramycin and gentamicin. PMID- 3975916 TI - Comparative toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in four (sub)strains of adult male rats. AB - Four (sub)strains of adult male rats were given single oral doses of various concentrations of TCDD to establish and compare the oral 30-day LD50 values. The strains of rats were Fischer (F/334N) supplied by Harlan Industries, Frederick Cancer Research Center, and Charles River Breeding Laboratories; and CD supplied by Charles River Breeding Laboratories. The Charles River/Fischer rats were most sensitive to TCDD (LD50 = 164, 95% confidence limits 104-217 micrograms/kg), the Frederick/Fischer and Charles River/CD rats were moderately sensitive to TCDD (LD50 = 303, 250-360; and 297, 240-360 micrograms/kg, respectively), and the Harlan/Fischer rats were most resistant to TCDD (LD50 = 340, 281-409 micrograms/kg). The mean times of death were from 24.5 +/- 1.0 to 28.3 +/- 0.5 days and the percentage body weight loss at death was 37.4 +/- 1.2 to 42.7 +/- 1.3%. One week after exposure of the Charles River/Fischer animal to 45 micrograms TCDD/kg (1/4 the established 30-day LD50 dose), the same serum profile was induced as previously observed in the Harlan/Fischer rat, which includes hypoglycemia, hypertriglyceridemia, and hypercholesterolemia. These results emphasize the importance of indicating the precise dose, strain of rat, and time after dosing before termination in reporting the effects of TCDD on a particular biological response. PMID- 3975917 TI - Measurement of solid feed consumption patterns in neonatal rats by 141Ce radiolabeled microspheres. AB - Dams nursing litters of Fischer 344 rats were allowed access to feed containing nonabsorbable 141Ce-labeled NEN-TRAC microspheres for 24-hr intervals during the later half of a 28-day nursing period. Neonatal solid feed consumption began during the third week of nursing and rose to peak amounts as high as 2.1 times normal adult levels on a gram consumed per kilogram body weight per day basis at 28 days of age, with an average daily feed consumption (g kg-1 day-1) of approximately 1.5 times that normally eaten by adults. Feed consumption in lactating females peaked at concentrations as high as 3.2 times and averaged approximately 2.5 times the amount normally consumed by nonpregnant adult females of comparable age. These results should be considered when interpreting the results observed in reproduction studies when exposure is via feed. Effects which could be attributed to "enhanced neonatal sensitivity" may, in fact, merely reflect the toxicity resulting from increased chemical exposure. It is thus clear that, if reproduction studies are to be conducted at or near the MTD, adjustment of dietary concentration of test agents during lactation is necessary to maintain target dose levels and to prevent overexposure. PMID- 3975918 TI - Cholestasis and increased biliary excretion of inulin in rats given 1,1 dichloroethylene. AB - Bile flow and biliary excretion of the inert solute [3H]inulin were monitored in unanesthetized, freely moving male rats for 4 h after oral administration of 1,1 dichloroethylene (1,1-DCE) at a dose of 200 mg/kg. Comparisons were made between 4 groups: fed-controls, fed-1,1-DCE treated, fasted-controls, and fasted-1,1-DCE treated. Biliary inulin excretion was assessed at 30-min intervals as total excretion and as bile/plasma ratio. 1,1-DCE treatment was consistently associated with at least a 2-fold increase in both parameters of inulin excretion within 2 h after toxin administration. In contrast, 1,1-DCE treatment was not associated with changes in plasma inulin values at any time or in liver/plasma inulin ratios at 4 h. Bile flow decreased in all groups: gradually by 30% in the fed and fasted controls, by 40% in the fed-1,1-DCE treated group, and markedly by 65% in the fasted-1,1-DCE treated group. Liver damage at 4 h as reflected by elevated plasma activities of liver-derived enzymes was found only in fasted-1,1-DCE treated rats. Thus the cholestatic effect of 1,1-DCE appears related to the development of liver damage whereas other aspects of the hepatic response to 1,1-DCE may enhanced biliary excretion of inulin. PMID- 3975919 TI - Quantitating exposure to chemical carcinogens: in vivo alkylation of hemoglobin by benzo[a]pyrene. AB - Mild acid hydrolysis of globin preparations from erythrocytes of mice, previously exposed topically to benzo[a]pyrene (BaP), releases tetrols which are detectable by HPLC/fluorescence analysis. If the mouse is exposed to radiolabelled BaP, radioactivity can be found in the acid-releasable tetrols. Treatment of the globin preparations prior to acid hydrolysis with proteolytic enzymes, but not enzymes that degrade nucleic acids, followed by dialysis, reduces the amount of tetrols that can be detected. Because the procedure used for the isolation of globin preparations from mouse blood precludes the presence of non-covalently bound BaP or its cellular metabolites, it is concluded that prior to acid hydrolysis, the tetrols were covalently attached to the hemoglobin, most probably as a result of the metabolic conversion of the applied carcinogen to the chemically reactive anti-diol epoxide. There is a dose response relationship between the amount of BaP applied to the skin of the mouse and the occurrence, 24 h later, of BaP adducts to hemoglobin, while the adduct, once formed, disappears with a half-life of 6 days. The amount of anti-benzo[a]pyrene diol epoxide (anti BaPDE) binding to DNA and hemoglobin at various doses of BaP appears to be qualitatively similar. PMID- 3975920 TI - Effects of calcium and magnesium acetates on tissue distribution of carcinogenic doses of cadmium chloride in Wistar rats. AB - Previous studies have shown that magnesium, unlike calcium, prevents cadmium carcinogenesis at the subcutaneous injection site, and that neither magnesium nor calcium has any significant influence on the production of testicular tumors by cadmium in rats. The present investigation attempts to disclose the nature of those different effects by comparing the results of administration of both physiological metals on the uptake and distribution of carcinogenic doses of cadmium in rats. Male Wistar rats received a single subcutaneous (s.c.) injection of 109CdCl2 (0.02 mmol/kg or 0.04 mmol/kg) and s.c. injections (one daily) of calcium acetate (CaAcet; 0.16 mmol/kg), or magnesium acetate (MgAcet; 4 mmol/kg), or saline on the day before, the day of and the day after the 109CdCl2 dosing. The concentration of cadmium in tissues was determined by gamma-counting on the 4th, the 15th and the 45th day after the 109CdCl2 injection. The concentration of cadmium in tissues on day 4 was ranked as follows: liver greater than kidney greater than the injection site skin greater than pancreas greater than spleen greater than heart greater than lung greater than distant skin greater than testes greater than blood. Administration of CaAcet increased by over 20% and that of MgAcet decreased by over 30% the initial uptake of both cadmium doses at the injection site. Thus MgAcet may prevent cadmium carcinogenesis by inhibiting the uptake of cadmium by the injection site tissues. In the testis and in all other tissues investigated, except kidney, the effects of the physiological metals were reversed, CaAcet tended to decrease and MgAcet tended to increase the uptake of cadmium. CaAcet and MgAcet exerted no noticeable effects on the uptake of cadmium by the kidney. The observed results of CaAcet and MgAcet administration on the concentration of cadmium in distal tissues seem to depend on the alterations in cadmium uptake at the injection site. PMID- 3975921 TI - Methods for measuring mutagenicity in urine of rats dosed with [14C]di(2 ethylhexyl)phthalate. AB - Di(2-ethylhexyl)phthalate (DEHP) is extensively used as a plasticizer for vinyl plastic articles. It has been found to be positive in an NCI rodent bioassay but has generally given negative results in in vitro genotoxicity tests. We therefore decided to test the urine of rats fed [14C]DEHP for mutagenic activity in the Ames Salmonella test. The recovery of radioactivity from the urine of rats dosed with [14C]DEHP was examined by solvent extraction and XAD-2 resin absorption procedures. Both of these procedures were inadequate for quantitative recovery of urinary metabolites required for subsequent mutagenicity testing using the Ames Salmonella/microsome procedure. Recoveries of less than 5% were observed using standard solvent extraction techniques whereas the XAD-2 adsorption technique gave about 67% at high resin/urine ratios. Treatment of the urine with beta glucuronidase/aryl sulfatase did not affect these recoveries. The direct urine plating procedure represents a viable alternative to the above concentration procedures for this phthalate ester. The effects of L-histidine and the beta glucuronidase/aryl sulfatase preparation on the background reversion frequencies of the Ames tester strains is discussed. PMID- 3975922 TI - Preliminary studies on the differential removal of products formed in the DNA of various rat organs after chronic administration of a low dose of zinc. AB - Metals can bind to various sites on the bases, the phosphate groups and/or sugars in DNA, depending on the physico-chemical characteristics of the metal ion. Up till now most studies concerned with the interaction of metal ions with DNA and polynucleotides have been carried out in vitro. In the present study, 23 ppm Zn2+ was administered chronically to rats in the drinking water for periods up to 1 week, after which the DNA was isolated from liver, kidney, ileum, colon and brain. The DNA was subsequently hydrolysed and the purine bases separated on Sephadex G-10. Three products of metalation were eluted. There were differences in the overall levels of metalation and in the capacity of the different organs to remove the major product of metalation from the DNA: after 7 days the Zn2+ content of this adduct in brain and kidney was 2 and 4 times respectively that of the controls, but in colon and ileum it had returned to control values, despite the continued administration of Zn2+. PMID- 3975923 TI - Photochemical binding of photoallergens to human serum albumin: a simple in vitro method for screening potential photoallergens. AB - A simple procedure employing UV spectroscopy is described for testing the ability of chemicals to form covalent conjugates with proteins after irradiation with the appropriate wavelength of light. A range of known photoallergens of widely differing structure has been tested using this procedure; results of these experiments, together with evidence from the scientific literature, provide a correlation between compounds known to be photoallergens and their ability to form covalent conjugates with proteins on irradiation with the appropriate wavelength of light. The method is proposed as an in vitro screening procedure for potential photoallergens. PMID- 3975924 TI - Absence of embryotoxic effects of formaldehyde after percutaneous exposure in hamsters. AB - Pregnant hamsters were treated by topical application of formaldehyde solution on day 8, 9, 10 or 11 of gestation. Fetuses recovered on day 15 were weighed, measured, and examined for teratogenic effects of formaldehyde exposure. The resorption rate was increased in the treated groups, but formaldehyde treatment did not significantly affect weight or length, nor did any malformations which could be related to treatment appear. It was concluded that fetal risk due to maternal topical exposure to formaldehyde is minimal in this model system. PMID- 3975926 TI - In vitro effect of cadmium on primary antibody response to T-cell independent antigen (DNP-Ficoll). AB - The effect of various concentrations of cadmium on the in vitro primary antibody response to T-cell independent antigen (DNP-Ficoll) was investigated. Anti DNP Ficoll antibody response in mice was significantly enhanced by 8 microM cadmium, but suppressed by 20 and 40 microM cadmium. However, cell viabilities were decreased by cadmium exposure with dose-dependent relationships. The results suggest that in vitro exposure to cadmium produces different effects on antibody responses. PMID- 3975925 TI - Induction and detection of a third isometallothionein (metallothionein-II') in rat liver. AB - A third isometallothionein was shown to be present during metallothionein synthesis, particularly following induction by zinc (Zn). It appeared to be closely related to metallothionein-II and the relative amount decreased with time, with only a minor peak after repeated cadmium (Cd) loading. On-line column switching by high-performance liquid chromatography (HPLC)-atomic absorption spectrophotometry (AAS) is effective in analysing and characterizing isometallothioneins. PMID- 3975927 TI - Alkylation of bronchiolar epithelial cells by 3-methylindole metabolites in the horse. AB - Autoradiographs of horse-lung explants incubated with [3H]3-methylindole (3MI) showed 8 times greater labeling per area to bronchiolar epithelial cells than to the interalveolar septa. Incubations of horse-lung microsomes with [14C]3MI resulted in alkylation of microsomal proteins, which could be reduced by exogenous glutathione. An apparent covalent adduct of glutathione and 3MI was isolated from these incubations. These results suggest that the target cells of 3MI-induced injury in the horse, the bronchiolar epithelial cells, are alkylated by an electrophilic 3MI intermediate. PMID- 3975928 TI - Protein-bound iodine levels in the blood plasma of freshwater teleost, Channa punctatus (Bl.) exposed to subtoxic pesticide concentrations. AB - The effect of subtoxic concentrations (SC) of carbofuran 3% granules (G), a carbamate (5 ppm) and fenitrothion 50% emulsifiable concentrate (EC), an organophosphate (1.5 ppm) on protein-bound iodine (PBI) levels in the blood plasma of Channa punctatus were studied. Exposure to fenitrothion caused more decline in PBI levels than did carbofuran exposure. PMID- 3975929 TI - Quinuronium induced hepatotoxicity in rats. AB - Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity. PMID- 3975930 TI - Organophosphorus insecticide induced decrease in plasma luteinizing hormone concentration in white-footed mice. AB - Oral intubation of 50 and 100 mg/kg acephate inhibited brain acetylcholinesterase (AChE) activity by 45% and 56%, and reduced basal luteinizing hormone (LH) concentration by 29% and 25% after 4 h in white-footed mice (Peromyscus leucopus noveboracensis). Dietary exposure to 25, 100, and 400 ppm acephate for 5 days substantially inhibited brain AChE activity, but did not affect plasma LH concentration. These preliminary findings suggest that acute exposure to organophosphorus insecticides may affect LH secretion and possibly reproductive function. PMID- 3975931 TI - Methylmercury stimulates the exhalation of volatile selenium and potentiates the toxicity of selenite. AB - The aim of the present experiments was to investigate whether a single dose of 24 mumol/kg methylmercuric chloride (MeHgCl) in rats can influence the effect of an equimolar dose of sodium selenite (Na2SeO3) on body weight or the exhalation of dimethylselenide, a volatile metabolic product of selenium. Due to the difference in their single-dose toxicities, only selenite depressed body weight gain, when given alone. The experiments indicated that methylmercury, irrespective of whether it was given 1-2 h before, or at the same time as sodium selenite, potentiated the effect of the latter on body weight. Methylmercury also increased the exhalation of volatile selenium, but this effect decreased when the administration of selenite was delayed. PMID- 3975932 TI - Carbon tetrachloride depresses hepatic phospholipid synthesis in rats. AB - 40 h after an acute dose of CCl4 (11.3 mmol/kg), the incorporation of [1 3H]ethanolamine into rat hepatic microsomal phospholipids was inhibited to 70% of control. Incorporation into phospholipids of the inner and outer mitochondrial membranes was 30-35% of control. Rates of incorporation were equal to or above normal rates in all membranes 65 h after dosage. The activity of methyltransferase in microsomal fractions isolated from rats 10 to 66 h after dosage was depressed. These data suggest that the alteration of mitochondrial phospholipids that parallels mitochondrial dysfunction after acute CCl4 dosage could be attributed to a CCl4-induced inhibition of the microsomal phospholipid biosynthetic pathways. PMID- 3975933 TI - Effect of cobaltous chloride on butylated hydroxytoluene-induced hepatic necrosis in rats. AB - Although a single dose of butylated hydroxytoluene (BHT); 1000 mg/kg to rats induced a hepatic injury accompanying centrilobular necrosis, the pretreatment with cobaltous chloride, an inhibitor of cytochrome P-450 synthesis, could inhibit the damage. The marked elevations of serum transaminase activities and bile acid content induced by BHT were diminished to nearly the control level by pretreatment with cobaltous chloride. The protective effect of cobaltous chloride on BHT-induced hepatotoxicity is discussed. PMID- 3975934 TI - Methyldopa: effects on the murine immune system. AB - Mice were treated for 7 weeks with doses of methyldopa somewhat exceeding those given to man, and mixed immunotoxic effects were observed. Daily subcutaneous injections of 5 mg (in 0.1 ml) methyldopa or saline (0.1 ml) did not generally alter body weights, except on day 19, when the methyldopa-treated mice weighed significantly less. During treatment, all mice were immunized twice with sheep red blood cells (SRBC) and bled four times. Anti-SRBC titers were not affected by methyldopa treatment, but leukocyte counts were dramatically decreased, and hematocrits to a lesser degree. Although in methyldopa-treated mice spleen and kidneys were increased in size, liver, lung, heart, and thymus size was not affected. These results are discussed in the context of other studies on the mode of action of methyldopa in eliciting an autoimmune anemia in man treated therapeutically with this drug. PMID- 3975936 TI - A procedure for splitting human teeth to obtain intact pulp tissue, enamel and dentin. AB - Calcified human permanent and primary teeth are often split to obtain pulp tissue for histochemical studies as well as unaltered dentin and surfaces for scanning electron microscopy. Various procedures have been used to cleave teeth, with different degrees of consistency. For rapid and fairly consistent splitting, a vise to the jaws of which triangular metal files have been welded has been found useful. The apices of the files were ground by an electric drill to the shape of typical teeth. Teeth to be split were grooved on their opposing external surfaces and were then cracked open between the file blades upon application of pressure by the vise. Teeth usually split lengthwise, exposing the entire pulp organ in one section and an empty pulp chamber-root canal in the other. This facilitated rapid penetration of fixative into pulp, and easier removal of pulp tissue in toto, as well as providing fresh enamel and dentin surfaces suitable for scanning electron microscopy. PMID- 3975935 TI - N-(3,5-Dichlorophenyl)succinimide nephrotoxicity in the Fischer-344 rat. AB - The nephrotoxic potential of N-(3,5-dichlorophenyl)succinimide (NDPS) was examined, in male Fischer-344 rats. Rats were administered NDPS (0.1, 0.2, 0.4 or 1.0 mmol/kg intraperitoneally (i.p.) or sesame oil (2.5 ml/kg, i.p.), and renal function was monitored at 24 and 48 h. NDPS (0.1 mmol/kg) stimulated organic ion uptake at 48 h. NDPS (0.2 mmol/kg) produced diuresis but did not alter blood urea nitrogen (BUN), kidney weight or organic ion uptake by renal cortical slices at 48 h. High-dose NDPS (0.4 and 1.0 mmol/kg) administration produced diuresis, decreased accumulation of p-aminohippurate (PAH) and tetraethylammonium (TEA), increased BUN and kidney weight and caused acute tubular necrosis. At 24 h, NDPS (0.2 mmol/kg) decreased uptake of PAH and TEA and tended to increase BUN. These results are similar to previous reports of NDPS-induced nephrotoxicity in Sprague Dawley rats and suggest that either rat model would be suitable for future studies on the mechanism(s) of NDPS-induced nephropathy. PMID- 3975937 TI - A simple microcentrifugation tube for electron microscopy. PMID- 3975938 TI - [Digital recording of glow curves of the TLD-300 thermoluminescent dosimetry detector by adaptation of a sum of Gauss function to the measured values]. AB - Calciumfluoride doped with Thulium (TLD-300) can be used to measure simultaneously with one detector neutron and photon absorbed dose in mixed neutron-photon beams. The accuracy in dose measurements can be increased by use of a computer. Additionally the number of data needed to store a glow curve can be reduced from 240 to 24 by fitting a sum of Gauss functions to the measured glow curve. PMID- 3975939 TI - [Introduction to thermoluminescence--simple models]. AB - Thermoluminescence comprises two fundamental processes, one proceeding at a constant temperature during the stimulation of the solid body by electromagnetic radiation or particle radiation, the other when the specimen is heated. The light emission during the rise of temperature can show several maxima and is called thermoluminescence glow curve. In some cases a thermally stimulated conductivity and a thermally stimulated emission of exoelectrons can be observed and correlated with thermoluminescence. The observations can be phenomenologically analyzed, not considering the physical processes of thermal activation and radiative recombination as well as the atomistic structure of the centres involved. Cinetic balance equations based on the energy band model are described. Some glow curves of thermoluminescence can be calculated in simple models, where the concentration of the charge carriers in traps, in permitted energy bands and in activators during the heat input are approximately determined. PMID- 3975940 TI - [The theory of thermoluminescence]. AB - The interaction of stimulating radiation with matter produces defects which can be divided into two groups: 1. electronic defects, 2. ionic defects. The formation of defects is essentially determined by electronic processes and elastic impacts. The supply of energy in the form of heat makes possible a thermal stimulation the probability of which is characterized by a Boltzmann factor. Whereas the classical explications are based on thermodynamic or statistical considerations, the quantum mechanical calculation relates to non radiative transitions from traps. For the radiating recombination a selective rule is valid which guarantees the conservation of energy and impulse. The phenomenological description of thermoluminescence makes use of the kinetic processes in the non-stationary case and allows in simple models the determination of trap parameters, such as activation energy or pre-exponential factor. The simple models can be extended by introducing thermally separated trap levels. If the kinetic balance equations are solved exactly with the aid of an analogic computer, the simulated Glow curves show a good correspondence with experimental curves. PMID- 3975941 TI - [Comments on the current state of thermoluminescent dosimetry instrumentation]. AB - Due to the essential improvement of evaluation equipment, thermoluminescent dosimetry has found more and more practical use during the last decades. This study describes the measuring technique of TL dosimetry, presents some individual components of modern measuring units and indicates some further amelioration possibilities. PMID- 3975942 TI - [Properties, effectiveness and thermal processing of thermoluminescent dosimetry material]. AB - Under dosimetric terms, TLD materials are part of the TLD system. A rating of their dosimetric properties and of effects of influence quanties cannot solely be based on their physical properties but requires the consideration of influences also of the other components of the respective TLD system, TLD evaluation programme and TLD operator. Taking into account all criteria, coefficients of variation of around 0.1% were achieved for reproducibility measurements with individual TLDs. A fast method for pre and post annealing is proposed. PMID- 3975943 TI - [The use of thermoluminescent dosimetry systems in individual dosimetry and environmental monitoring]. AB - A brief survey is given of the application of TLD systems, above all in neutron dosimetry, dosimetry in the irradiation of body parts and beta-radiation as well as in the environment monitoring. Recent communications of literature are mentioned, also concerning the practical application of thermoluminescent dosimetry in the cited fields. PMID- 3975944 TI - [Review of other solid-body dosimetry methods in comparison with thermoluminescent dosimetry]. PMID- 3975945 TI - [Introduction to the tasks of clinical dosimetry and its requirements in dosimetric methods]. AB - Requirements for clinical dosimetry procedures are derived from the radiotherapeutical necessities especially for the exceptionally suitable thermoluminescence dosimetry. With regard to the following papers discussing problems of the ambitious two-peak TLD method typical features of this method are compared with those of the classical method, respectively. PMID- 3975946 TI - Clinical applications of thermoluminescent dosimetry. AB - The clinical applications of continuous cylindrical TL dosemeters, readout by linear motion through a heated oven, are presented in this work. The applications extend over high energy electron and photon therapy as well as diagnostic X-ray radiology. PMID- 3975947 TI - [Clinical dosimetric properties of the TLD-300 thermoluminescent dosimetry detector and its use for measuring spatial dose distribution in patient radiation planning]. AB - Thermoluminescence dosimetry is often used to verify the calculation of dose distribution of treatment techniques and treatment planning by using a phantom. However, a quality assurance of therapy by comparison between treatment planning and actual dose values measured with TL-detectors on the patient, is only sporadically realized. The use of a single detector offers a solution for the measurement of both the neutron and gamma ray absorbed doses in mixed neutron photon fields in fast neutron tumour therapy. The knowledge of both gamma ray and neutron absorbed doses is important because of the considerable difference in biological efficiency of these two types of radiation. PMID- 3975948 TI - [Radiotherapy of paraplegia caused by extramedullary hematopoietic tissue]. AB - The presentation by computed tomography of an extramedullar epidural intraspinal hemopoisis has only been described sporadically. It has been possible to visualize by CT-scans the regression under radiotherapy of a sensory and motor paraplegia in a 17 years old patient with beta-thalassemia major. The central nervous system (thoracic and lumbar zone as well as os sacrum) was exposed to a total reference dose of 30 Gy which was administered within twenty days by a 60Co unit in single doses of 2 Gy each. From 4 Gy on, the paraplegic symptoms regressed continuously. The control CT taken after 26 Gy- the paraplegia had completely disappeared at this time-showed a significant regression of the intraspinal soft tissue masses. Radiotherapy is very important in the treatment of this disease. A direct correlation is found between clinical symptoms and CT presentation. PMID- 3975949 TI - [Dupuytren's contracture. Radiotherapy in the early stages]. AB - Conventional radiotherapy is the treatment of choice for the early stages of the Dupuytren contracture. The conventional semi-deep therapy is more favorable than the soft ray technique and the moulage technique. 62 patients have been treated at Erlangen; 33 out of them (46 irradiated hands) with a minimum observation time of 18 months have been evaluated. The pathologic process was stopped in 98% of the cases. 85% of the patients showed an improvement of troubles by regression of tubercules and cords, pains and sensation of pressure. A recurrence was observed only in one patient at the edge of the irradiated volume. PMID- 3975950 TI - [Representation of tumor and organ contours by projection radiography--an important supplement to radiotherapeutic treatment planning]. AB - A special program developed in collaboration with the manufacturer ot the computer tomograph Somatom DR3 allows to transfer organ or tumor shapes from the transverse computed tomography scan to the localization radiograph (projection radiography). Some typical examples are presented in order to describe the possibilities offered for radiotherapy planning by this method. The procedure may be applied in all cases where neoplasms have to be irradiated or to spared and where this is of a decisive importance for simulator planning. PMID- 3975951 TI - Normal tissue reactions to high dose-rate intracavitary irradiation of the vagina with different fractionation schedules and dose levels. AB - The radiation reactions in the normal tissues of the vagina, rectum and bladder were studied in 166 patients receiving prophylactic vaginal high dose-rate intracavitary irradiation. Most reactions were observed in the vaginal mucosa included in the intracavitary target and only a few in the rectum and bladder in close proximity to the same target. The influence of the total dose, the dose per fraction and the overall treatment time, summarized as the Cumulative Radiation Effect (CRE), correlated well to the rate of reactions after a correction of the formula for late effects. PMID- 3975952 TI - [Efficacy of the paramunity inducers PIND-AVI and PIND-ORF as radioprotective agents]. AB - A significant reduction of mortality after lethal irradiation (7,8 and 9 Gy X-ray total-body irradiation) was achieved by continuous therapeutic subcutaneous application of the biologic inducers PIND-AVI and PIND-ORF. This was obtained by a stimulation of the investigated spleen parameters and a stimulation of leucocytes and phagocytosis. The inducers had no significant influence on the radiogenic reduction of blood cells and bone marrow cells, of the relative spleen and thymus weight and of the DNA and protein level of spleen and thymus. The regeneration of blood leucocytes (preponderantly by PIND-AVI) and of the spleen (preponderantly by PIND-ORF) was accelerated, but not the thymus regeneration which was already rather low. The leucocyte phagocytosis which increased generally after irradiation was markedly stimulated by paramunization. This stimulation was also observed after a latent time in animals submitted to sham irradiation. Its temporal appearance and its quantitative and qualitative properties corresponded to the effects of inducers after X-ray irradiation. Both inducers were found to be harmless in all experiments. PMID- 3975953 TI - On the problem of time, dose and fractionation (TDF) in the linear-quadratic model. AB - In many problems of modern radiotherapy such as multifractionation, interstitial and intracavitary therapy with implanats the NSD-formula is hardly applicable. Serious difficulties arise, when this formula is used for an estimation of late responses of tissues, because it mainly appreciates acute effects. On the basis of the linear-quadratic survival model S = exp (-alpha D - beta D2) the TDF problem is investigated with the help of kinetic principles. PMID- 3975954 TI - Non-rheumatic atrial fibrillation as a risk factor for stroke. AB - The association between non-rheumatic atrial fibrillation (AF) and stroke has been studied in 402 patients consecutively admitted to a stroke unit. Brain infarction patients with sinus rhythm (n = 196) and non-rheumatic AF (n = 92) were further compared. Some findings supported an embolic origin of the stroke: half of the deceased AF patients (n = 24) at autopsy either had left atrial thrombosis or arterial embolism compared to none of the ten with sinus rhythm. Patients with AF also had a higher mortality and more severe brain lesions, findings compatible with a sudden occlusion of blood flow. However, these differences might also be explained by an atherothrombotic occlusion with impaired autoregulation in the ischaemic region in conjunction with heart failure, which was more common in the AF patients. Other findings supporting an atherothrombotic mechanism were: the prevalence of AF was higher (19-29%) in all kinds of stroke, including haemorrhage, than in age-matched controls (3-9%). Also patients with previous AF and no present embolic source resembled the whole AF group and differed from patients with sinus rhythm. Thus embolism is a plausible cause of stroke in many AF patients, whereas an atherothrombotic origin is more likely in others. Characteristics identifying the mechanism in an individual case were not found. PMID- 3975955 TI - The incidence of stroke in the Kuopio area of East Finland. AB - During a 20-month study period there were 373 strokes in a geographically defined population (235/100,000/year). When age and sex were adjusted to the mean population of Finland in 1979, the annual incidence of stroke was 270/100,000 persons. The distribution of incident cases by diagnostic category was as follows: cerebral infarction 80%, ICH 9%, SAH 8% and NOS 3%. Case fatality of stroke within one year was 37%. The recurrence rate was 6% during the first year after any stroke. PMID- 3975956 TI - Fibrinogen, blood viscosity, and cerebral ischemia. AB - This study examines the effect of fibrinogen and consequent blood viscosity reduction on cerebral blood flow and cellular injury following severe cerebral ischemia for 30 minutes in 78 Wistar rats. In half of these rats 10 to 15 cc's of blood was removed and replaced with a mixture of 5% albumin and autologous red blood cells maintaining a constant hematocrit but resulting in a 30% decrease in fibrinogen and corresponding reduction in viscosity. Fibrinogen reduction in a slight increase in baseline CBF and the elimination of post-ischemic hyperemia at 24 hours. Both study and control animals showed a similar decrease in CBF at 30 minutes and 2 hours. There was no significant difference in the severity of ischemic cellular change between the fibrinogen reduction group and controls, although there was a significant inverse relationship between the amount of viscosity change and severity of cellular injury within the treatment group. Fibrinogen reduction alone cannot significantly ameliorate ischemic injury in this model. Viscosity reduction therapy should include reduction of hematocrit and alteration of red cell deformability. PMID- 3975957 TI - Cerebral venous thrombosis--a review of 38 cases. AB - A series of 38 patients with angiographically proven cerebral venous thrombosis (CVT) affecting dural sinuses is reported. This study shows that CVT is not rare, that the clinical diagnosis is extremely difficult because of the variable modes of onset and groupings of symptoms, that most CT findings are non specific and that angiography remains the best diagnostic tool. Only 4 patients died, which suggests a more benign outcome than classically described. None of the 23 heparin treated patients died, which indicates that anticoagulants were not harmful in this series. PMID- 3975958 TI - Effect of chronic middle cerebral artery stenosis on the local cerebral hemodynamics. AB - In 36 patients with angiographically proven middle cerebral artery (MCA) stenosis, local cerebral hemodynamics were studied employing angiography, 133Xe inhalation regional cerebral blood flow (rCBF) measurements and CT scans. They had transient ischemic attacks in 8 and completed stroke in 28. The patients with less than 50% stenosis (n = 16) had no hemodynamic abnormality in angiographical and rCBF examinations. The infarction in this group was small and located in the basal ganglia area. The patients with 50 to 74% stenosis (n = 9) often revealed a delayed filling of MCA branches in the angiography, however, they showed no significant rCBF reduction. The infarction in this group was also small and located in the basal ganglia area. The patients with 75 to 99% stenosis (n = 11) exhibited a significant flow depression both in angiographical and rCBF examinations. Three of them had large cerebral infarction in the watershed zone or the cerebral cortex. The results of the present study suggest that the hemodynamic effect of MCA stenosis begins to manifest at 50% in grade and becomes apparent at 75%. The danger of hemodynamic crisis as well as the risk of large cerebral infarction may increase when MCA stenosis exceeds 75% in grade. PMID- 3975959 TI - Cerebral ischemic attacks as a complication of aortic and mitral valve prolapse. AB - The high incidence of mitral valve prolapse (MVP) in patients with ischemic attacks is puzzling when compared with the very low incidence of cerebrovascular attacks observed in individuals known to have MVP. Our aim was to determine if it is possible to identify a patient subset with MVP at the highest risk of embolization on the basis of 2D-echocardiographic findings. We compared the echocardiographic picture of a group of 39 patients with MVP and cerebral ischemic attacks (29 TIAs, 10 strokes) in the carotid territory, without any pathological lesions at angiography, with that of a control group of 111 patients with MVP without neurological complications. The two groups were not different for age or sex. Patients with MVP and neurological complications showed a higher prevalence of aortic valve prolapse (62% vs 34%, p less than 0.01), of an association between valvular diffuse thickening and aortic valve prolapse (54% vs 23%, p = 0.001), and of multiple valve prolapse with valvular diffuse thickening (26% vs 7%, p less than 0.01) than those of the control group. This study suggests that in young people cerebral ischemic events could be related to the presence of a combined valve prolapse and to an echocardiographic picture of valve diffuse thickening. These data suggest that in this selected group with multiple valve prolapse and valvar diffuse thickening prophylaxis against embolic events by pharmacological preventive measures should be considered. PMID- 3975960 TI - Platelet accumulation in regions of low blood flow during the postischemic period. AB - Various studies indicate that after a latent interval, a progressive focal deterioration of microvascular perfusion can develop in zones of acute damage to the central nervous system (CNS). In order to obtain reliable information concerning the possibility of platelet participation in this phenomenon, platelet deposition was investigated by means of 111Indium-labeled platelets, and compared with local cerebral blood flow (CBF) and cortical sensory evoked response (CSER). Studies were performed with a model of focal ischemia in which small volumes of air were injected selectively into one internal carotid artery of dogs anesthetized with alpha chloralose throughout the experiment. The ischemic period was followed by a 10-min, 60-min or 4-hr recovery period. The main result was a prominent and diffuse accumulation of platelets in zones of low CBF in dogs subjected to 4 hr recovery. PMID- 3975961 TI - Effects of indomethacin on rCBF during and after focal cerebral ischemia in the cat. AB - The effect of indomethacin on rCBF was studied in cats anesthetized with Nembutal either under resting conditions or with temporary middle cerebral artery (MCA) occlusion. RCBF was measured by the microsphere method. In control animals (n = 3), indomethacin (4 mg/kg, i.v.) significantly reduced rCBF by about 25% in both cortex (from 44 +/- 6 to 32 +/- 3 ml/100 g/min, p less than 0.001) and white matter (from 36 +/- 4 to 26 +/- 2 ml/100 g/min, p less than 0.001). After MCA occlusion rCBF was markedly decreased in the sylvian region ipsilateral to occlusion (ischemic core) (from 38 +/- 4 to 14 +/- 2 ml/100 g/min in cortex, 4 animals). Although pretreatment with indomethacin (4 mg/kg) (4 animals) 30 min prior to occlusion did not alter rCBF during ischemia, a marked enhancement of reactive hyperemia was observed in the ischemic core immediately upon reperfusion following 2 h occlusion (54 +/- 11 untreated vs 95 +/- 13 treated, p less than 0.05). In the delayed postischemic period, namely 2 h after recirculation, rCBF still remained to be higher in the animals treated with indomethacin (40 +/- 6 untreated vs 96 +/- 9 treated, p less than 0.001). Such an effect of indomethacin for ameliorating postischemic blood flow in both the immediate and delayed period was less prominent in the adjacent area (penumbra) ipsilateral to occlusion. In the contralateral hemisphere, indomethacin caused slight reduction in rCBF during ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3975962 TI - Cerebrovascular injuries induced by activation of platelets in vivo. AB - Intravascular platelet aggregation induced by ADP injection into the carotid artery of rabbits caused ipsilateral cerebrovascular injuries. We have observed the details of these in vivo vascular changes under the electron microscope. Intracytoplasmic vacuole (1.0-2.0 micron in diameter) formation and partial deendothelialization followed by platelet thrombus formation were characteristic changes in the middle cerebral artery. These vacuoles did not contain horseradish peroxidase (HRP) which was used as a marker of vascular permeability change. Compared with these phenomenon, increased vesicular (0.05-0.2 micron in diameter) transport was prominent, and vacuole formation was rarely seen in small vessels, namely, capillaries and arterioles in the cortex. Endothelial cell damage seemed to be more prominent in large arteries, but only the smaller vessels show marked extravasation of HRP-reaction product and perivascular edema. Blood levels of TXB2 and 6-keto PGF1 alpha were significantly increased 3 min after the ADP injection and returned to pre-injection levels at 60 min after. These results suggest that vasoactive substances resulting from platelet activation may play an important role in producing cerebrovascular injuries caused by platelet aggregation induced with ADP. PMID- 3975963 TI - Imaging of leukocytic infiltration in human cerebral infarcts. AB - The circulating white blood cells of patients with brain infarction were labelled in vitro with Indium-111 tropolonate; the cells were reinjected to study the inflammatory process by gamma camera imaging. Eight patients with acute cerebral ischemic infarct were studied during the first two weeks after the onset of neurological symptoms. In seven cases a well defined area of increased radioactivity was revealed in the infarcted hemisphere indicating active migration and tracking of labelled leukocytes in cerebral infarct. This method allows monitoring of the cellular inflammatory response in human cerebral infarcts and adds another imaging technique. PMID- 3975964 TI - Fibromuscular dysplasia of cervico-cephalic arteries with multiple dissections and a carotid-cavernous fistula. A pathological study. AB - A rare case of widespread fibromuscular dysplasia (F.M.D.) is reported, involving the cervico-cephalic arteries associated with multiple dissections, saccular aneurysms and a carotid-cavernous fistula. A detailed post-mortem examination revealed FMD involvement of the intracranial vessels, not demonstrated by arteriography. PMID- 3975965 TI - CT contrast enhancement on brain scans and blood-CSF barrier disturbances in cerebral ischemic infarction. AB - CT contrast enhancement of the ischemic infarction, blood-CSF barrier function for albumin, and severity of neurological symptoms were evaluated at predefined intervals in 41 patients with supratentorial ischemic infarctions. Contrast enhancement was most frequently observed in the 2nd and 3rd week after the stroke. This late CT enhancement was not related to infarction size and severity of blood-CSF barrier disturbance. The rare appearance of CT enhancement in the 1st week was usually associated with extensive infarctions and accompanied by blood-CSF barrier disturbances. These barrier disturbances, which occurred with higher frequency and greater severity in extensive infarctions (peak 3rd day), generally persisted for several weeks. We suggest that contrast enhancement in the 1st week after an ischemic stroke is due to diapedesis from necrotic capillaries; the more frequently observed late enhancement might be the result of a blood-brain barrier disturbance which in turn is hypothetically attributed to increased pinocytotic activity of regenerated endothelial cells. PMID- 3975966 TI - Measurement of activated rCBF by the 133Xe inhalation technique: a comparison of total versus partial curve analysis. AB - An initial assessment of the differential sensitivity of total versus partial curve analysis in estimating task related focal changes in cortical blood flow measured by the 133Xe inhalation technique was accomplished by comparing the patterns during the performance of two sensorimotor tasks by normal subjects. The validity of these patterns was evaluated by comparing them to the activation patterns expected from activation studies with the intra-arterial technique and the patterns expected from neuropsychological research literature. Subjects were 10 young adult nonsmoking healthy male volunteers. They were administered two tasks having identical sensory and cognitive components but different response requirements (oral versus manual). The regional activation patterns produced by the tasks varied with the method of curve analysis. The activation produced by the two tasks was very similar to that predicted from the research literature only for total curve analysis. To the extent that the predictions are correct, these data suggest that the 133Xe inhalation technique is more sensitive to regional flow changes when flow parameters are estimated from the total head curve. The utility of the total head curve analysis will be strengthened if similar sensitivity is demonstrated in future studies assessing normal subjects and patients with neurological and psychiatric disorders. PMID- 3975967 TI - Prognosis in middle cerebral artery occlusion. AB - The natural history of MCA occlusion has become increasingly important since the surgical option of EC/IC bypass surgery has been available. The clinical course of 24 patients with angiographically-demonstrated occlusion of the MCA artery was reviewed. Eight patients presented with a major disabling stroke and five of these died during the acute phase of this ischemic event. The remaining 19 patients were followed for a mean of 54.2 months. There were five deaths in follow-up and two of these were due to subsequent strokes. Fourteen patients manifested a benign course: one of these had a further minor stroke and four had TIAs. Altogether, 3 strokes occurred during the follow-up period (2 fatal, 1 minor) and all were in the territory of the artery known to be occluded. Of those patients who survived their presenting ischemic event, 12 (63%) remained completely functional in terms of activities of daily living. MCA occlusion does not necessarily carry a poor prognosis with medial therapy alone and the role of bypass surgery hopefully will be clarified by the ongoing clinically randomized trial. PMID- 3975969 TI - Effect of recirculation and regional counting rate on reliability of noninvasive bicompartmental CBF measurements. AB - Based on data from routine intravenous Xe133-rCBF studies in 50 patients, using Obrist's algorithm the effect of counting rate statistics and amount of recirculating activity on reproducibility of results was investigated at five simulated counting rate levels. Dependence of the standard deviation of compartmental and noncompartmental flow parameters on recirculation and counting rate was determined by multiple linear regression analysis. Those regression equations permit determination of the optimum accuracy that may be expected from individual flow measurements. Mainly due to a delay of the start-of-fit time an exponential increase in standard deviation of flow measurements was observed as recirculation increased. At constant start-of-fit, however, a linear increase in standard deviation of compartmental flow parameters only was found, while noncompartmental results remained constant. Therefore, and in regard to other studies of potential sources of error, an upper limit of 2.5 min for the start-of fit time and usage of noncompartmental flow parameters for measurements affected by high recirculation are suggested. PMID- 3975968 TI - Innervation of brain intraparenchymal vessels in subhuman primates: ultrastructural observations. AB - Sympathetic innervation of intraparenchymal blood vessels in the basal ganglia was demonstrated by transmission electron microscopy in arteries, arterioles, and capillaries of the subhuman primate brain. Small arteries (40-120 micron) and some arterioles (12-40 micron) are innervated only at branching sites. However, arterioles occasionally may be innervated at points distal to their origin. Capillary innervation was very infrequently observed. PMID- 3975970 TI - The morphometry of consecutive segments in cerebral arteries of normotensive and spontaneously hypertensive rats. AB - The media cross-sectional area, the media thickness, the internal radius and the ratio between media thickness and internal radius were determined in consecutive sections of extraparenchymal cerebral arteries of 7- and 12-month-old normotensive and spontaneously hypertensive rats. The study included intracranial pial and basal arteries as well as extracranial cervical arteries. In the chronically hypertensive rats the media to radius ratio was consistently higher than in normotensive rats over the entire calibre spectrum investigated (radius 5 400 micron). The increase of the ratio in the extracranial arteries of the hypertensive rats was exclusively due to a thicker media. In the basal intracranial arteries the increase of ratio was due to a thicker media and/or a smaller internal radius in 7- and 12-month-old rats with moderate hypertension (mean arterial pressure, MAP 171 +/- 8 and 177 +/- 7 mm Hg respectively). In 7 month-old rats with severe hypertension (MAP 204 +/- 11 mm Hg) the increase of ratio was mainly due to a smaller internal radius. The observed structural alterations are likely to be of hemodynamic importance. PMID- 3975971 TI - Reaction of pial arteries and veins to hypercapnia in hypertensive and normotensive rats. AB - The lumen diameters of the main cortical surface arteries were continuously monitored through a closed cranial window in spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY). The arterial diameter was significantly smaller in SHR (55 +/- 1 micron) than in WKY (87 +/- 1 micron) during resting conditions as well as during hypercapnic dilatation (87 +/- 2 micron compared to 117 +/- 5 micron). The per cent increase in diameter induced by hypercapnia was larger in SHR (54%) than in WKY (36%), presumably a consequence of the altered vascular wall to lumen ratio. Alpha-adrenoreceptor blockade with yohimbine and phenoxybenzamine had no significant effect on arterial diameter during hypercapnia. The diameters of the largest pial surface veins increased to the same extent in SHR and WKY during hypercapnia (about 10%). PMID- 3975972 TI - A 1-4 year follow-up study of 306 cases of stroke. AB - To study the long-term prognosis of stroke, we performed annual follow-up examinations on 306 patients who had survived cerebrovascular accidents. All patients had been admitted to the Neurology Service, First Teaching Hospital, Beijing Medical College from January 1, 1976, to December 31, 1978, and were followed up for 1 to 4 years. The series included 217 cases of cerebral thrombosis, 54 of cerebral hemorrhage, and 35 of TIA. The life-table method was used to determine the cumulative survival rate (CSR), cumulative marked improvement rate (CMIR), and cumulative recurrence rate (CRR), for each of these three types of stroke. The main results were the following: 1. The prognosis was not significantly influenced by sex, BP level on admission, or type of cerebrovascular accident. 2. Age was an important prognostic factor. The survival rate decreased significantly in each successive age group. However, age was not a risk factor for recurrence or poor improvement. 3. The cumulative survival rate, cumulative marked improvement rate, and cumulative recurrence rate did not differ significantly among cerebral thrombosis, cerebral hemorrhage, and TIA. PMID- 3975974 TI - Middle cerebral artery stenosis. PMID- 3975973 TI - Cerebral infarction in a young female following snake bite. AB - We present a normal 13-year old female who developed left cerebral infarction following envenomation by the carpet viper (Echis carinatus). We have read of only one other case of cerebral infarction following viper envenomation (Viperi russelli). Possible mechanisms for cerebral infarction in these circumstances are discussed. It is believed that this complication may be more common than is reported in the literature. PMID- 3975975 TI - Anticoagulation-related hemorrhage in acute cerebral embolism. PMID- 3975976 TI - Mitral valve prolapse and embolic stroke. PMID- 3975977 TI - Heterogeneity and age dependency of human thymus reticulo-epithelium in production of thymosin components. AB - The specific compartmentalization of intrathymic lymphoid cells in different steps of T-cell maturation and the involvement of thymosin components in these steps prompted us to evaluate the localization of epithelial cells synthesizing various thymosin components. Thymosin fractions 5 and 6 were found in epithelial cells throughout the thymus cortex and medulla. Thymosin alpha 1 and beta 4 were observed in subcapsular and perivascular epithelial cells, and thymosin alpha 1 was observed in the medullary epithelium. Thymosin alpha 7 was exclusively found in Hassall's corpuscles and adjacent epithelial cells. We conclude that the organ localization of epithelium synthesizing different thymosin components is associated with the organ localization of intrathymic T-cell maturation steps. The involution of the human thymus, starting during the third decade of life, has been related to the age-dependency of thymus humoral factors in the circulation. However, quantitative data on humoral factor synthesizing epithelial cells are lacking. We found a strong intensity of thymosin fraction 6 expression by epithelium in thymus tissue from donors in the early postnatal period (2-4 months of age) and from all four donors aged 20-30 years. This phenomenon was paralleled by a high number of thymosin fraction 6 positive cells per unit area. PMID- 3975978 TI - Radiation abrogation of myelopoietic inhibitors found in thymus-conditioned medium. AB - We have previously reported conditioned medium from cultures of murine 'nonlymphoid' adherent thymus cells to be a source of myelopoietic inhibitor substance(s). The inhibitor has a molecular weight of less than 1000 daltons. It is dialyzable. and its effects are reversible with washing, but it is not significantly cytotoxic. The inhibitor(s) abrogate both the 10-day granulocyte macrophage colony-forming cell (GM-CFC) and the 25-day monocyte-macrophage colony forming cell (M-CFC). Morphologically, cultures appear to be lymphocyte-free after 10-12 days, and consist primarily (80%) of nonspecific esterase positive cells and epitheloid appearing (20%), nonspecific esterase negative cells. Radiation of thymic cultures at 12 days reduces levels of inhibitor(s) found in the medium. Inhibitor levels from pooled samples collected over 4 days demonstrate reductions of 10% at 100 rads 15% at 200 rads, 25% at 300 rads, and 85% at 400 rads. The steepest area of radiation reduction occurs between 300 and 400 rads, with the interpolated 50% radiation reduction level at 342 rads. Analysis of once-harvested radiated culture supernates showed no significant inhibitors present when medium was examined 5-10 days postradiation. PMID- 3975980 TI - Symposium on the laser in ophthalmology and glaucoma update. PMID- 3975979 TI - Effects of ovariectomy and androgen treatment on the thymic pathology of NZB X SJL mice. AB - Aging (NZB X SJL)F1 (NS) mice provide a unique model of thymic pathology occurring in females but not in males and characterized by the intrathymic accumulation of mature T cells and B cells. Here, we studied the basis for the sex-related difference in the development of this thymic pathology. In the reverse (SJL X NZB)F1 hybrids, a similar pathology was also observed only in females which suggests that its sex-dependency does not involve sex-linked gene(s) but rather hormonal influences. Ovariectomy of NS females reduced but did not prevent the accumulation of T and B cells in the thymus indicating that estrogens play a minimal role in this thymic pathology. In contrast, chronic dihydrotestosterone (DHT)-treatment of females, started at 4 weeks of age, inhibited the development of thymic lesions. Consistently, orchidectomy of NS males induced the appearance of 'female-like' thymic lesions that could be prevented by DHT-treatment. This demonstrates that the absence of thymic disease in NS males primarily reflects an inhibitory action of androgens. Evidence was obtained that androgens also decrease the production of anti-ds DNA antibodies in NS mice. PMID- 3975981 TI - The challenge of when to treat in glaucoma. PMID- 3975982 TI - Problems and prognosis of the developmental glaucomas. PMID- 3975983 TI - Pigmentary glaucoma. PMID- 3975984 TI - Nerve fiber loss and disparity of disc and field changes in glaucoma. PMID- 3975985 TI - Complications of laser trabeculoplasty. PMID- 3975986 TI - New concepts in angle-closure glaucoma. PMID- 3975987 TI - Technical considerations in laser trabeculoplasty. PMID- 3975988 TI - The future of glaucoma filtering operations. PMID- 3975989 TI - Special features and modifications of laser trabeculoplasty: where are we today? PMID- 3975990 TI - The glaucomas and extracapsular cataract surgery with posterior chamber lens implantation. PMID- 3975991 TI - Chronic open-angle glaucoma: new findings and possible new treatments. PMID- 3975992 TI - Laser trabeculoplasty before and after aphakia and pseudophakia. PMID- 3975993 TI - Current applications of the dye laser. PMID- 3975994 TI - Ophthalmic laser surgery: principles, technology, and technique. PMID- 3975996 TI - Acquired immunodeficiency syndrome (AIDS) PMID- 3975995 TI - Calculation of a predictive value for transplantation. PMID- 3975997 TI - Dietetic control of maturity-onset diabetes in Nigeria. PMID- 3975998 TI - Alcohol-related problems and primary health care. PMID- 3975999 TI - Primary health care with refugees: between the idea and the reality. PMID- 3976000 TI - Cataract surgery in developing countries. PMID- 3976001 TI - Traumatic paraplegia in northern Tanzania. PMID- 3976002 TI - Oxygen concentrator in a remote hospital in Zaire. PMID- 3976003 TI - Inflammatory conditions and semen quality among subfertile Sudanese males. AB - Fifty-nine subfertile males were investigated to assess seminal quality, inflammatory conditions and spermatogenic picture in relation to their subfertility. Defects in semen analysis were found associated with an old gonococcal infection (42.4%), schistosomiasis (13.6%) and chronic prostatitis (5.1%). Varicocele was observed in a few patients (3.4%). Azoospermia was found in 40.7%, of whom 33.3% were found to suffer from spermatogenic arrest. PMID- 3976004 TI - Radiology in a rural hospital. PMID- 3976005 TI - Pregnancy-associated hypertension in Papua New Guinea. PMID- 3976007 TI - Food groups in cultural perspective. PMID- 3976006 TI - Prevention of deafness in rural tropical areas. PMID- 3976008 TI - Problems of rural health workers. PMID- 3976009 TI - Coagulant property of an indigenous seed: home water treatment in Tamil Nadu. AB - Use of some vegetable substances as coagulant has been recorded in historical literature. A seed from the tree known as tettan cottai is used today in South Indian villages to purify water. The scrapings of the seed were shown in laboratory experiments to have coagulant properties. It would be extremely valuable to have additional measurements made in South India, where the practice is employed in removal of turbidity, and also to have evidence of the extent of removal microorganisms. PMID- 3976010 TI - [Composition and metabolism of low-density lipoproteins in rabbits of various ages]. AB - It is shown that in old (aged 48-54 months) rabbits the percentage of low-density lipoproteins in the blood serum increases as compared to that in young (aged 6-10 months) animals. The age accumulation of the mentioned lipoproteins is combined with their slow removal from the blood. A decrease in the income of lipoproteins of the given class and their slow removal in the vascular wall of old rabbits is observed. PMID- 3976011 TI - [Lipoprotein metabolism in rabbits with cholesterol-induced hyperlipoproteinemia during physical conditioning]. AB - Moderate exercises of rabbits inhibit the development of their cholesterol induced hyperlipoproteinemia and accelerate normalization of higher lipid and lipoprotein concentrations after cessation of cholesterol delivery to the organism. Physical training of rabbits under hyperlipoproteinemia increases the activity of the blood plasma lipoproteinlipase and liver cholesterol-7-alpha hydroxylase increases. PMID- 3976012 TI - [Complexes of the N-terminal disulfide branch point of fibrin with fibrinogen]. AB - Investigation of fibrin N-terminal disulphide knot (N-DSK) binding with fibrinogen (F) showed, that the F-N-DSK-complex represents growing polymer structure which is soluble at early polymerization stage and forms a solid phase during the further growth. This complex is characterized by constant stoichiometry expressed by formula F (N-DSK)2. A model of the complex structure as a regular copolymer of fibrinogen and N-DSK is proposed, in which neighbouring fibrinogen molecules are clamped with two N-DSK molecules. Such copolymer was never described. Since its formation is caused by specific D-E interdomain binding, it may be considered as a peculiar analogue of fibrin polymer. PMID- 3976013 TI - [The role of vitamin E in the biosynthesis of the isoprenoid region of the ubiquinone molecule in the rat liver]. AB - A decrease in the CoA and acetyl-CoA amount in the rat liver tissue by 34.8 and 29.4%, respectively, as well as inhibition of the biosynthesis rate of mevalonic acid from [I-14C] acetyl-CoA in the postmitochondrial liver fraction by 17.9% as compared to the control are found against a background of E-hypovitaminosis. The last change is not associated with the inhibition of the 3-oxy-3-methylglutaryl CoA-reductase activity and may not be one of reasons which cause the biosynthesis disturbances in the isoprenoid part of the ubiquinone molecule in this organ. alpha-Tocopherol activates the ubiquinone biosynthesis from [2-14C] sodium acetate in the liver of rats with E-hypovitaminosis under conditions of 30 min preincubation and is not efficient when added in combination with actinomycin D. Probably, such an effect of alpha-tocopherol is realized at the level of RNA synthesis and is associated with the biosynthesis activation of short-living RNA. PMID- 3976015 TI - [Effect of metal ions on the glucose isomerase activity of Streptomyces robeus S 606]. AB - The intracellular glucose isomerase produced by Str. robeus S-606 refers to the group of isomerases activated most effectively by Mg2+. Besides, an activating effect of Fe3+, Co2+ and Mn2+ is observed. The optimal Mg2+ concentration for the D-glucose isomerization to D-fructose is 10(-2) M, and that of Co2+ is 100 times as low. Addition of Ca2+ (above 10% of the Mg2+ content) to the reaction mixture with the optimal Mg concentration inhibits the enzyme. At the same time Co2+ increases thermostability of glucose isomerase to a greater extent than Mg2+. PMID- 3976014 TI - [Levels and intracellular distribution of calcium and magnesium in the myometrium]. AB - Atom-absorption spectrophotometry have shown that the content of Ca2+ in the rabbit and cow myometrium amounts to 4.54 +/- 0.47 and 2.57 +/- 0.30 and that of Mg2+--3.89 +/- 0.15 and 1.35 +/- 0.17 mmol per 1 kg of wet tissue weight, respectively, The content of Mg2+ in the myometrium is two times lower than in the myocardium and three times lower than in the skeletal muscle. During pregnancy (the day before delivery), delivery and postdelivery period the Ca2+ content in the rabbit myometrium is 1.5-2 times lower than in the state of functional rest, and its specific content in fractions of nuclei, mitochondria, microsomal and plasma membranes is practically the same (100-140 nmol per 1 mg of fraction protein). Distribution of the total Ca content calculated per fraction protein satisfies the following series: soluble fraction (56.4%) greater than nuclei (23.6% greater than mitochondria (7.4%) greater than microsomes (1.9%) greater than or equal to plasma membranes (1.3%). The highest specific content of Mg2+ is observed in the fraction of: plasma membranes--52, then mitochondria--40, microsomes--27 and nuclei--19 nmol per 1 mg of protein. The distribution of the total content of this element is described by a series: soluble fraction (71.8%) greater than nuclei (8.3%) greater than mitochondria (4.6%) greater than plasma membranes (1.7%) greater than microsomes (0.4%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976016 TI - [Dehydrogenase activity of pentose and glucuronate pathways of glucose utilization in the rat brain during single and repeated cooling]. AB - Repeated supercoolings down to rectal temperatures (19-20 degrees C) results in the different changes in the dehydrogenase activity of pentose and glucuronate pathways in the rat brain: the activity of the pentose cycle oxidative enzymes (glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase) lowers considerably and that of VDP-glucose dehydrogenase rises. The dehydrogenase activity in the pentose cycle is found to be inhibited in rats cooled for the first time, the UDP-glucose dehydrogenase activity being preserved at the control level. In the adapted rats the cooling causes mobilization of the pentose cycle, the UDP-glucose dehydrogenase activity remains unchanged. PMID- 3976017 TI - [Changes in the levels of glycolysis and tricarboxylic acid cycle metabolites in cat tissues during periodontosis]. AB - The predominance of restored substrates in the bone system and liver of cats under chronic parodontosis evidence for intensification of reproduction properties of NAD-pairs and causes inhibition of glycolysis and activation of gluconeogenesis. A high content of alpha-ketoglutarate and isocitrate in tissues in a result of lipogenesis inhibition. Under the lower rate of glycolysis, activation of proteolysis and transamination reactions amino acids are the major contributors to pyruvate. Under the acute course of the disease with the development of the inflammatory process the quantity of pyruvate grows sharply in the parodont tissue, as well as oxidative properties of NAD-pairs intensify and lipogenesis accelerates. This is confirmed by a decrease in the alpha ketoglutarate and isocitrate content in the tissues. PMID- 3976018 TI - [In vitro incorporation of [14CH3]methionine into liver phosphatidylcholine in rats with vitamin E deficiency]. AB - The content of phosphatidyl choline, a terminal product of phosphatidyl ethanolamine methylation as well as in intensity in vitro incorporation of [14CH3]methionine into phosphatidyl choline of rat liver with E-hypovitaminosis are found to considerably decrease as compared to the norm. In this case the total content of phospholipids is practically the same. PMID- 3976019 TI - [Correction of lipid peroxidation disorders in experimental traumatic shock using the antioxidant ionol]. AB - The level of certain parameters of lipid peroxidation and the activity of lysosome hydrolases were studied on the shock model in rats. It was established that the traumatic shock in the experiment is accompanied by the growth of the level of over-oxidation products (malonic dialdehyde, diene conjugates), the rate of erythrocyte hemolysis as well as by an increase in the hydrolase activity. Administration of ionol (60 mg/kg) inhibits the higher activity of radical-free lipid oxidation, decreases the damage of membrane structure and the metabolism disturbance. PMID- 3976021 TI - [Medical education in the 1985 spring semester. Course catalog]. PMID- 3976020 TI - [Effect of naphthoquinones and tocopherols on the changes in mitochondrial volume]. AB - Experiments with albino mice show that a long deficiency of natural tocopherols and naphthoquinones in the organism causes a change in the mitochondrial volume of the liver, myocardium and skeletal muscles. Addition of ADP (5 mM) to the mitochondrial suspension does not lead to adequate changes in the optic density that evidences for inability of mitochondria to regulate actively their volume under a long K- and E-hypovitaminosis. Due to the treatment of intact mitochondria with 1% acetone solution the volume of mitochondria changes significantly, whereas addition of vitamin KI (2-4 mM) prevents partially these changes. PMID- 3976022 TI - [Flow cytometric analysis and sorting of human metaphase chromosomes. A new field of research]. PMID- 3976023 TI - [Dietary treatment of women with Folling's disease. A review of current experiences and future perspectives]. PMID- 3976024 TI - [A new view on Hodgkin's disease. A review of the literature]. PMID- 3976025 TI - [Experimental allergic encephalomyelitis]. PMID- 3976026 TI - [Plasma concentrations of C-peptide and glucose during glucose tolerance tests. The effects of running]. PMID- 3976028 TI - [Poliomyelitis vaccination in Denmark]. PMID- 3976027 TI - [The acute course of spontaneous intracerebral hematoma. A report of 53 patients not treated surgically]. PMID- 3976029 TI - [The effect of massage on muscle infiltrations as assessed by myoglobin in the blood]. PMID- 3976030 TI - [The long-term prognosis in ulcerative colitis. Results from a regional patient group in the county of Copenhagen]. PMID- 3976032 TI - [Gynecological examination of women aged 45 in Glostrup. An epidemiological study]. PMID- 3976031 TI - [The prognosis in Crohn's disease. Results from a regional patient group in the county of Copenhagen]. PMID- 3976033 TI - [Chromosome study in repeated abortions]. PMID- 3976034 TI - [Anorexia nervosa. Pregnancies occurring before, during and after anorexia nervosa]. PMID- 3976036 TI - [Utilization of beds in psychiatric departments and the development in alternative forms of treatment]. PMID- 3976035 TI - [Two generations--what is happening to them? Women physicians and their working conditions. Susanne Helweg-Larsen and Viveke Binder interviewed by Birgit Petersson and Ulla Christensen]. PMID- 3976037 TI - [Psychiatric supervision in Fredriksberg Hospital. An analysis over a 3-month period]. PMID- 3976038 TI - [Contraceptive habits in women born in 1936. Results of a health survey at the ages of 40 and 45]. PMID- 3976039 TI - [The psychiatric problems in a birth cohort in relation to socio-demographic background]. PMID- 3976040 TI - [Study of children whose parents have both been hospitalized for psychiatric disorders]. PMID- 3976041 TI - [The Long-term social medicine prognosis in spontaneous intracerebral hematoma. A report of 32 patients not treated surgically]. PMID- 3976042 TI - [85-year-old people in Glostrup. Description and survey method and the social conditions of the population]. PMID- 3976043 TI - [Emergency psychiatry. I. A study of the function of the emergency psychiatric admission and the activity involved in a population of first referrals]. PMID- 3976044 TI - [Emergency psychiatry. II. A study of the problems associated with referral and the prevailing psychological factors in a population of first referrals to an acute psychiatric department]. PMID- 3976045 TI - [Women and torture]. PMID- 3976046 TI - [Sarcoidosis of the central nervous system]. PMID- 3976047 TI - [Research on prophase and prometaphase chromosomes]. PMID- 3976048 TI - [Romanus and Andersson injuries in ankylosing spondylitis]. PMID- 3976049 TI - [Slaughterhouse injuries. A retrospective study of 109 slaughterhouse injuries treated at casualty departments, with special emphasis on the type of injury and occurrence of infections]. PMID- 3976050 TI - [Manometry of the esophagus in generalized scleroderma]. PMID- 3976051 TI - [Stenosis of the subclavian artery]. PMID- 3976052 TI - [Blood viscosity in patients receiving continuous treatment with bendroflumethiazide (Centyl with potassium chloride)]. PMID- 3976053 TI - [Transphincteric rectotomy of tumors and fistulae in the rectum]. PMID- 3976054 TI - [Meningitis following epidural treatment of pain]. PMID- 3976055 TI - [Candida infection and meningitis as a complication of a central venous catheter in a premature infant]. PMID- 3976056 TI - [Renal oncocytoma]. PMID- 3976057 TI - [Drugs used by narcotic addicts]. PMID- 3976058 TI - [Patterns of injury and socioeconomic consequences of injuries sustained in slalom and long-distance skiing]. PMID- 3976059 TI - [Treatment of oral dextropropoxyphene poisoning]. PMID- 3976060 TI - [Peroperative fine needle biopsy of the pancreas]. PMID- 3976061 TI - [Colonic diverticulosis. Symptoms in patients referred for out-patient barium enema]. PMID- 3976062 TI - [The Miller Fisher syndrome: ophthalmoplegia, ataxia and areflexia]. PMID- 3976063 TI - [Fractures of the zygoma. A retrospective study of 109 patients]. PMID- 3976064 TI - [Congenital synostosis between the carpal scaphoid and trapezium bones with recurrent fractures]. PMID- 3976065 TI - [Retropancreatic abscess. Intermittent lumbar hernia]. PMID- 3976066 TI - [Cavernous hemangioma originating from a tendon sheath at the wrist]. PMID- 3976067 TI - [Occlusion of the carotid artery following blunt injury to the neck. A case of matrimonial violence with an unrecognized complication]. PMID- 3976068 TI - [Postoperative and posttraumatic non-calculous cholecystitis]. PMID- 3976069 TI - [Dextropropoxyphene]. PMID- 3976070 TI - [Follow-up study of a clientele receiving sick-leave maintenance allowances for limited periods]. PMID- 3976071 TI - [The casualty department study in the western part of Fredriksborg. V. Closing of the casualty department]. PMID- 3976072 TI - [Changes in plasma lipids and lipoproteins in patients receiving long-term antihypertensive treatment]. PMID- 3976073 TI - [Adult metachromatic leukodystrophy]. PMID- 3976075 TI - [Villous adenoma of the duodenum]. PMID- 3976074 TI - [Exogenous allergic asthma in children]. PMID- 3976077 TI - [The stability of filters for epidural catheters]. PMID- 3976076 TI - [Symphysis/fundus measurements. A study of the method]. PMID- 3976078 TI - [Pseudo-pseudohypoparathyroidism. Familial occurrence of Albright's hereditary osteodystrophy]. PMID- 3976079 TI - [Pseudo-pseudohypoparathyroidism and hypothyroidism in a 3-year-old child]. PMID- 3976080 TI - [ECG changes developing during clozapine treatment]. PMID- 3976081 TI - [A cerebral tumor simulating apoplexy]. PMID- 3976082 TI - [Simultaneous occurrence of celiac disease and chronic pancreatitis]. PMID- 3976083 TI - [Is the use of Fansidar as an antimalarial justified?]. PMID- 3976084 TI - [The clientele of an institution for alcoholics. Social background and subsequent course]. PMID- 3976085 TI - Volvulus of cecum following simple nephrectomy. AB - We report a case of intestinal obstruction secondary to cecal volvulus following a palliative nephrectomy. Cecal volvulus and other causes of acute abdomen should be considered in postoperative patients who develop adynamic ileus undergoing retroperitoneal surgery. PMID- 3976086 TI - [Effect of calcium antagonists (nifedipine) on nephrocalcinosis and calcium excretion in the rat]. AB - An animal model was established to test the effect of a calcium antagonist on nephrocalcinosis, which was induced by an atherogenous diet, and its effect on the excretion of calcium and other parameters relevant for stone formation. With the administration of nifedipine (Adalat), the grade of nephrocalcinosis could be significantly reduced. Furthermore, with nifedipine the excretion of calcium and sodium in the urine was raised, while phosphate and potassium levels were lowered. The excretion of magnesium and citrate, reduced by an atherogenous diet, could be raised significantly with the administration of nifedipine. The pathophysiological mechanisms underlying the effect of nifedipine on nephrocalcinosis and on the excretion of the urine parameters are discussed. Apparently hypercalciuria is the result of a reduced reabsorption of calcium in the tubulus. The inhibitory effect on the genesis of nephrocalcinosis is possibly due to the lower calcium influx into the tubular cells. PMID- 3976087 TI - The Rosen prosthesis: a bad experience. AB - Between September 1977 and September 1980 we implanted 4 Rosen inflatable incontinence prostheses in 4 men with urinary incontinence. Twelve operations were necessary on these 4 patients to assure them to be continent during a total of 43 months. Because of the great number of complications we no longer use the Rosen prosthesis. PMID- 3976088 TI - Ureteroduodenal fistula. AB - A 73-year-old man presented with pain in the right flank and fever. A ureteroduodenal fistula was demonstrated by intravenous pyelography and excised with nephroureterectomy. This seems to be the 8th case of such a lesion. PMID- 3976089 TI - Leiomyoma of the urinary bladder. AB - We report a case of urinary retention in a women caused by a leiomyoma of the bladder. The intramural form often causes obstruction, as it is usually located near the bladder base. Treatment is surgical, and the prognosis is excellent. Therefore, cystoscopy is recommended in women with urinary retention. PMID- 3976090 TI - Electrostimulation and penile erection. AB - Electrostimulation was used to study the neuroanatomy and physiology of penile erection in dogs and monkeys. The canine spinal nuclei responsible for penile erection, identified by the retrograde horseradish peroxidase transport technique after verification of the cavernous nerves with neurostimulation, were mediolateral autonomic neurons at T12-L3 and S1-S3. The erection induced by electrostimulation of the cavernous nerves is the result of increased arterial flow, relaxation of cavernous muscles, and venous outflow restriction. Study of electrostimulation in dogs and monkeys is invaluable for the understanding of the complex neurophysiology of human penile erection. PMID- 3976091 TI - Symposium on advances in pediatric urology. PMID- 3976092 TI - The artificial urinary sphincter in children. Experience with the AS800 series and bowel reconstruction. AB - Recent reports have shown that the artificial urinary sphincter is a reliable means of achieving urinary continence in both adults and children who have urinary incontinence of various etiologies. Although complications may occur, currently the artificial urinary sphincter is the most efficient means of obtaining urinary continence. The author discusses the features of the device, how to trouble-shoot when problems occur, and the role of the device in patients who have undergone partial or total reconstruction of the bladder with bowel. PMID- 3976094 TI - Nerve-sparing radical retropubic prostatectomy. AB - A newly developed technique for radical retropubic prostatectomy that allows for preservation of sexual potency in the majority of patients is described. This technique involves removal of the prostate medial to both neurovascular bundles containing the pelvic parasympathetic nervierigentes. This technique can also be adapted to the performance of radical cystectomy. PMID- 3976093 TI - Nuances of distal hypospadias. AB - The MAGPI procedure should be the procedure of choice and is applicable for most boys with coronal/subcoronal hypospadias. The excellent results of the MAGPI are reliable and reproducible. However, careful evaluation of meatal configurations is essential, as is assessing for the existence of fibrous chordee. Should subcoronal meatal variation or possible chordee exist, the creation of a vascularized meatal-based flap provides excellent flexibility as well as many options to the surgeon. PMID- 3976095 TI - Neurogenic voiding: function and dysfunction. AB - Normal bladder function is dependent upon neural components for storage and coordinated, controlled evacuation. Maturation of these nervous system functions is acquired in childhood to allow a transition from the reflex voiding of infancy to the inhibitable, controlled voiding required for adult living. Alterations in this transition may manifest themselves in benign forms such as nocturnal enuresis or more severe forms that threaten urinary anatomy and function. Understanding these characteristics may involve the application of urodynamic concepts and techniques. Therapy may be chosen to counter these disturbances. This may subsequently require revision of earlier traditional approaches to recurrent cystitis and reflux. PMID- 3976097 TI - [Correction of disorders of central and renal hemodynamics in patients with chronic calculous pyelonephritis with obzidan]. PMID- 3976096 TI - [Errors in the diagnosis of kidney cancer and their prevention]. PMID- 3976098 TI - [Morphologic features of lesions of the kidney and ureter in the presence of doubled upper urinary tracts in children]. PMID- 3976099 TI - [Ureteral instability in women with stress incontinence]. PMID- 3976100 TI - [Prospects for improving urologic medical services to the population]. PMID- 3976101 TI - [Causes of male sterility according to biopsy findings]. PMID- 3976102 TI - [Concentration of polyamines in the semen of healthy subjects and patients with chronic nonspecific prostatitis]. PMID- 3976103 TI - [Effect of hemodialysis on the state of water metabolism in patients with renal insufficiency]. PMID- 3976105 TI - [Clinico-morphologic features of nephropathies with a tubulointerstitial component]. PMID- 3976104 TI - [Hazards and complications of specific ultrafiltration]. PMID- 3976106 TI - [Plastic surgery of a retrocaval ureter and carbuncle of the right kidney]. PMID- 3976107 TI - [Formation of a urinary receptacle in a patient with a vesico-rectovaginal fistula]. PMID- 3976108 TI - [Pregnancy and natural labor after replacement of the urinary bladder with an intestinal graft]. PMID- 3976109 TI - [Isolated traumatic rupture of the renal pelvis with formation of a pararenal pseudocyst]. PMID- 3976111 TI - [Lipoma of the scrotum]. PMID- 3976110 TI - [Bilateral involvement of the testes with seminoma]. PMID- 3976112 TI - Gleason grading of prostate cancer: a predictor of survival. AB - The Gleason grading system was employed in the pathologic assessment of 82 patients with carcinoma of the prostate diagnosed between 1962-1965 and subsequently followed to death. The data suggest that the Gleason grade gives long-term prognostic information independent of stage with a direct correlation between increasing Gleason grade and cancer death rate index. Furthermore, the sum of clinical stage plus Gleason grade is a more significant prognostic factor than either stage or grade alone. PMID- 3976113 TI - Acute toxicity and preliminary therapeutic results of pelvic lymphadenectomy combined with transperineal interstitial implantation of 192IR and external beam radiotherapy for locally advanced prostate cancer. AB - We have developed a combined modality approach for treatment of locally advanced prostate cancer consisting of: surgical staging with lymphadenectomy; transperineal placement of afterloading needles for a course of 192Ir brachytherapy; and a course of moderate-dose external beam irradiation to tight prostatic fields. The flexibility of the treatment permits adaptation of the dose to any tumor configuration. A total of 23 patients have been treated to date; 18 are available for treatment review and 14 for acute toxicity analysis. Significant morbidity has occurred in only 2 patients, 1 with a pelvic hematoma and 1 with hematoma in the wound. Local tumor response has been excellent in all but 1 patient. A good degree of symptomatic improvement was observed at the three month follow-up. This approach appears to be safe and effective at this time. A brief review of the technique and the rationale for its use are also presented. PMID- 3976115 TI - Pressure volume relationships in human hydronephrosis. AB - Pressure volume curves were obtained in 8 children with ureteropelvic junction obstruction prior to pyeloplasty after totally obstructing the ureteropelvic junction. All human renal pelves displayed a similar shape pressure volume curve. The human renal pelvis is able to accommodate to increasing volumes by maintaining a relatively low intrapelvic pressure Once its capacity is reached, pressures rise to pathologically high levels at a much faster rate. These findings suggest that hydronephrosis can be viewed as a compensatory mechanism which protects some kidneys from further overdistention, high intrapelvic pressures, and progressive renal deterioration by virtue of acquired changes in compliance, pelvic size, and renal function which limit the rate of pressure rise within the hydronephrotic kidney. PMID- 3976114 TI - Controlled continuous flow (CCF) resectoscope. Report of 200 cases. AB - Controlled continuous flow (CCF) is a new balanced pumping system which has been designed for the resectoscope. The system is controlled by an intravesical pressure sensor. Upper limits of pressure are set, and the input flow is shut off electronically if it is attained. Flow rates of up to 1,000 ml/minute can be achieved for maximum clarity of vision. Two hundred cases have been performed with the CCF resectoscope. Various parameters were measured and are presented. The results indicate that TURP can be performed safely and more efficiently with the CCF resectoscope. PMID- 3976117 TI - Evaluation of new nonadhesive urostomy system. AB - The new Vance nonadhesive urostomy system has several advantages over established systems, including ease of assembly, cleanliness, large and less visible storage capacity, and security from leakage. We studied 44 patients using this system, including those who were previously satisfied with more established ostomy systems and those with stomal problems. We found the new system to be superior in most of the patients. PMID- 3976116 TI - Effect of abdominal perineal resection on genitourinary tract. AB - One hundred ten patients at the UCLA Medical Center underwent abdominal resection from 1974 to 1980. The following effects on the urinary tract are discussed: surgical complications, anatomic changes, and functional complications. Urologic investigation and management of incontinence will be presented. PMID- 3976118 TI - Use of retrograde occlusion balloon catheters in percutaneous removal of renal calculi. AB - The best results in percutaneous renal calculus removal are in patients with solitary pelvic stones and dilated collecting systems. Calyceal and/or infundibular calculi and ureteral calculi constitute more complex problems and are less successfully removed. Placement failure of the nephrostomy tube, and inability to gain access to calyceal calculi, and to engage impacted stones are the usual causes for unsuccessful procedures. To try to improve overall success we inserted occlusion balloon catheters prior to nephrostomy insertion in 60 of 71 patients. In a select group of 23 patients with a small renal pelvis and large calculi or infundibular calculi or patients with ureteral calculi, overnight application of 20 cm of hydrostatic pressure through the ureteric catheter led to marked dilatation in all instances. In all other patients the occlusion balloon catheter was placed immediately prior to the definitive nephrostolithotomy procedure. These ureteral catheters allow for better opacification and for dilatation of a small collecting system thereby facilitating the placement of the nephrostomy tube. They permit manipulation of calyceal and especially ureteral calculi. Placement of ureteral occlusion catheters is a safe adjunct to nephrostolithotomies and, in our experience, resulted in increased overall success. PMID- 3976119 TI - A general ureteral dilator-sheathing system. PMID- 3976120 TI - Bilateral emphysematous pyelonephritis. AB - Emphysematous pyelonephritis is a severe infection found almost exclusively in diabetics, characterized by the presence of gas within the renal parenchyma. The diagnosis is established radiographically. An additional case is added to the 52 cases reported in the literature; we believe this is the fifth reported case with bilateral emphysematous pyelonephritis. If appropriate diagnostic studies demonstrate no evidence of either perinephric abscess or urinary obstruction, intensive medical management should be the initial therapy for this condition. Surgical intervention is necessary in patients without prompt response to medical therapy. PMID- 3976121 TI - Large renal hemangioma necessitating nephrectomy. AB - An unusually large renal hemangioma with nonfunction on an excretory urogram is reported. Preoperative angiography revealed typical early draining veins in the kidney. Contrary to the previously reported cases preoperative angiography precluded renal salvage procedure. The resected kidney was nearly completely replaced with cavernous hemangioma. To the best of our knowledge this is the largest renal hemangioma on record. PMID- 3976122 TI - Transitional cell carcinoma of kidney extending into renal vein and inferior vena cava. AB - A case involving transitional cell carcinoma of the renal pelvis with extension to the main renal vein and inferior vena cava as well as massive involvement of the kidney and ureter is reported. A review of the literature on renal pelvic tumors and patterns of tumor growth is presented. PMID- 3976123 TI - Triple synchronous genitourinary malignancies of dissimilar histogenesis. PMID- 3976125 TI - Multicentric basal cell carcinoma of penile skin. AB - A multicentric basal cell carcinoma of the penile skin is reported. The skin adjacent to the tumor showed changes similar to those observed in sun-damaged skin. Inasmuch as the patient denied sunbathing in the nude, causation is unclear, but sun may have played a role in the genesis of the tumor. PMID- 3976124 TI - Acute digitalis toxicity during TURP. AB - Water entrainment into opened prostate venous sinuses during transurethral resection of the prostate (TURP) may lead to dilution of serum electrolytes. Dilutional hypokalemia may precipitate digitalis toxicity in the digitalized patient. Successful resuscitation of such a patient is reported. PMID- 3976126 TI - Sarcoma of renal capsule. PMID- 3976127 TI - Cystic pheochromocytoma. AB - Computed tomography is the preferred imaging modality for adrenal lesions, particularly pheochromocytoma. Central hemorrhagic degeneration of a pheochromocytoma can cause the mass to resemble a benign adrenal cyst. Such a case is illustrated and the preoperative evaluation discussed. PMID- 3976128 TI - ABO(H) isoantigens and urine. PMID- 3976129 TI - Reduction of paraphimosis. PMID- 3976130 TI - Lesions in bovine progressive degenerative myeloencephalopathy ("Weaver") of Brown Swiss cattle. AB - Gross changes and other necropsy findings in 36 purebred Brown Swiss cattle affected with bovine progressive degenerative myeloencephalopathy were nonspecific. Primary microscopic lesions were confined to the central nervous system, specifically the white matter of the spinal cord, axons in some brainstem nuclei, and Purkinje cells of the cerebellar cortex. Spinal cord lesions involved only the white matter and consisted of axonal degeneration, loss of axons and myelin, and status spongiosus. Axonal degeneration was characterized by swelling and fragmentation of the axoplasm or formation of large, discontinuous swellings referred to as spheroids. Lesions were qualitatively similar at all levels, but quantitatively dissimilar in the same funiculi at different levels. Both ascending and descending fibers were involved but correlation to specific fasciculi was not evident. Lesions always were most severe in thoracic spinal cord segments. Little or no astroglial response, no inflammatory response, and no involvement of gray matter were observed in the spinal cord. Cerebellar lesions were limited to selective degeneration and loss of Purkinje cells and occasional swelling of Purkinje cell axons (torpedos) in the granular layer of the cerebellar cortex. Brainstem lesions were inconsistent and limited to occasional axonal swelling in brainstem nuclei. The pathogenesis of bovine progressive degenerative myeloencephalopathy is unknown and possible mechanisms were discussed. The disease exhibits a familial pattern in Brown Swiss cattle and may be hereditary. Extraneural lesions were considered secondary to central nervous system lesions. PMID- 3976132 TI - Lesions of articular, sternal and growth plate cartilage in rats. AB - Degenerative osteoarthritis was observed in the femur and sternum in specific pathogen free Fisher 344 rats at 13 and 19 months of age. Histological changes consisted of degeneration of the matrix and erosion in the articular cartilage of the femur. In the sternal cartilage, degeneration and necrosis of the matrix, formation of cysts, and cleft-like fractures were observed. In addition, degeneration of the matrix, appearance of eosinophilic streaking, and necrosis and fissure between the growth plate and epiphyseal trabeculae were seen in the femur. The changes in the sternum were essentially the same as the femur. PMID- 3976131 TI - Variability in limb malformations and possible significance in the pathogenesis of an inherited congenital neuromuscular disease of Charolais cattle (syndrome of arthrogryposis and palatoschisis). AB - Limb abnormalities in 30 calves with an inherited congenital neuromuscular disorder known as syndrome of arthrogryposis and palatoschisis were classified according to the range of severity of joint deformity in either flexion or extension, and restricted joint movement. Joint movement was variably affected; it was either normal, lax, restricted in the range of mobility, or occasionally, fixed. The characteristic findings were: bilateral hyperextension of the hind fetlock, flexion deformity of the forelimb that particularly involved the fetlock and the carpus, with restricted articular movement and complete rigidity in some cases. One-third of calves also had medial deviation of the forelimb due to angular deformity of articular surfaces in the carpus. All nine live calves were floppy due to marked generalized muscular hypotonia. Birth weight of deformed calves was reduced. In some calves muscle development was impaired as judged by muscle weight, and histological examination. In some calves the gross appearance, muscle weight and histological examination revealed no abnormal development and indicated that the effects on skeletal muscle were secondary. No lesions were found in the spinal cord of 23 of 24 calves examined histologically. The remaining calf had a localized cavitation in the dorsal white matter at T2-3. Based on the observations in calves in this study it is proposed that both primary and secondary factors contribute to the phenotypic expression of this congenital deformity. The primary lesion is considered to be a neurogenic abnormality of differentiation in the central nervous system. Cytogenetic analysis of 16 carrier cows and two deformed calves showed normal karyotypes. Serology for Akabane virus in 16 carrier cows was negative. PMID- 3976133 TI - Necrosis and rupture of the aorta and pulmonary trunk in four horses. AB - Four horses are described with rupture of the aortic arch and pulmonary trunk which resulted in a fistula between these vessels. Ruptures were located near the ligamentum arteriosum. Histological examination of the vessel walls revealed media necrosis which was probably due to intimal thickening and/or medial fibrosis of the vasa vasorum. PMID- 3976134 TI - Lesions of experimental flea bite hypersensitivity in the dog. AB - Hypersensitivity to fleas was induced in flea-naive dogs by controlled challenge exposure to virgin fleas. By week 10 of the investigation, immediate (15 minute) and delayed (24-48 hours) responses could be elicited in the skin by flea bites. Histologically, the immediate response consisted of edema and eosinophils which sometimes overlapped with a delayed inflammatory response comprised of perivascular lymphocytes and fewer histiocytes. These inflammatory patterns correlated with type I or immediate, and type IV or cellular, allergic reactions. The combined immediate and delayed responses to fleas in the dog are as observed by other investigators in man and guinea pigs. PMID- 3976135 TI - Fine structural changes during reparative phase of canine drug-induced arthropathy. PMID- 3976136 TI - Prostatic carcinoma in a rhesus monkey (Macaca mulatta). PMID- 3976137 TI - Bone marrow necrosis associated with pancytopenia in a cow. PMID- 3976138 TI - Energy requirements for the penetration of heads of domestic stock and the development of a multiple projectile. AB - The forces and kinetic energy required to penetrate the isolated heads of calves, adult beef cattle, sheep and red deer with a metal probe the same diameter as the bore of an experimental pistol were determined. Approximately 16 and 127 Joules were required to penetrate the heads of adult sheep and cattle, respectively. Using these data a 10 g projectile, consisting of 49 lead pellets and a lead disc in a polyethylene sleeve, was constructed. This projectile, when fired by a charge sufficient to produce a muzzle velocity of 165 m/second, had sufficient kinetic energy to penetrate the heads and brains of cattle, sheep, horses and deer. The projectile was fired from a new design of humane killer with a spring loaded barrel and fitted with a silencer. After penetration of the frontal bones the projectile fragmented and the kinetic energy of its individual particles were insufficient for them to penetrate the opposite side of the head of any of the animals, including one-week-old calves. Fragmentation also caused more brain damage and inhibition of spinal reflexes than a solid free bullet or captive bolt. It is suggested that the use of such a projectile for the emergency slaughter of animals is less hazardous than a solid free bullet and is easier to use and more effective than either a solid free bullet or captive bolt. The projectile was not suitable for killing adult pigs because of problems associated with the frontal sinus. PMID- 3976139 TI - Dyschondroplasias of growth cartilages (osteochondrosis) in crossbred commercial pigs at one and 15 days of age: radiological, angiomicrographical and histological findings. AB - The age of onset and morphology of the earliest lesions of dyschondroplasias in pigs have not been established. Bones and growth cartilages from pigs were examined for the presence of lesions using radiological, angiomicrographical and histological techniques. Lesions were in 10 of 11 pigs at 15 days of age and 12 of 21 pigs at one day of age, indicating that the condition was congenital. The simplest and apparently earliest lesion was an area of persistent hypertrophied chondrocytes and matrix which extended from the articular-epiphyseal complex or physis into the epiphysis or metaphysis, respectively. Since the prevalence of lesions was high it was considered that the dyschondroplasia may be part of the usual growth pattern of cartilages in contemporary pigs. PMID- 3976140 TI - Manpower situation of the veterinary profession in the UK, 1985-1990. Comments by the British Veterinary Association. PMID- 3976141 TI - Entropion in the sharpei. PMID- 3976142 TI - Anaesthesia of wildlife. PMID- 3976143 TI - Avian anaesthesia. PMID- 3976144 TI - Sex determination of monomorphic birds. PMID- 3976145 TI - Epidemiological study of wastage among racehorses 1982 and 1983. AB - An epidemiological study of wastage among racehorses was conducted in 1982 and 1983 among six stables, five of which were in Newmarket. The basis of the survey was the inability of horses to take part in cantering exercise as a result of injury or disease. The greatest number of days lost to training was caused by lameness (67.6 per cent) and respiratory problems (20.5 per cent). Conditions of the foot (19 pe cent), muscle (18 per cent), carpus (14 per cent), fetlock joints (14 per cent), tendons (10 per cent) and sore shins (9 per cent) were the major reasons for training days being lost in 198 cases in which a positive diagnosis of the site of lameness was made. The results confirm a previous investigation by Jeffcott and others (1982) and suggest that the diagnosis, therapy and prophylaxis of lameness merit a high priority in research efforts to reduce wastage among young racehorses. PMID- 3976146 TI - Cryptosporidiosis in the domestic cat. PMID- 3976147 TI - Urinary incontinence in a bitch caused by vaginal fibroma. PMID- 3976148 TI - Hypothermia in calves. PMID- 3976149 TI - Acorn poisoning. PMID- 3976150 TI - Aujeszky's disease: control strategies. PMID- 3976151 TI - Campylobacter jejuni mastitis in a cow: a zoonosis-related incident. PMID- 3976152 TI - Addison's disease in a puppy. AB - Low serum cortisol levels in a young puppy, following adrenocorticotrophic hormone (ACTH) stimulation, were used to establish a clinical diagnosis of Addison's disease. This was likely to have been congenital although studies of adrenocortical function in close relatives showed no evidence of a genetic origin for the condition. Autoantibody to canine adrenal tissue was not present. Further investigations are necessary to establish the role of autoantibody in canine hypoadrenocorticism. The diagnosis of primary adrenocortical hypoplasia was confirmed at post mortem examination. PMID- 3976153 TI - Ataxia/paresis syndrome of sheep in West Africa associated with bilateral multifocal cerebrospinal poliomalacia. AB - Between 1976 and 1981 a specific neurological disorder of sheep was observed in Ghana. It was encountered on eight properties on some of which it was responsible for losses of up to 72 per cent of the sheep stock in some years. The condition affected mainly adult ewes, and was characterised clinically by a brief period of ataxia, followed by paresis prostration and death in four to five days. Morphological examination of nine affected animals revealed significant lesions only in the central nervous system. These consisted of oedema of the intracellular glial compartment and bilateral, sometimes symmetrical, foci of spongy transformation, malacia and haemorrhage in the grey matter of the brain stem, cerebellum and spinal cord. The aetiology of ataxia/paresis syndrome was not determined but some possibilities are discussed in the context of other naturally occurring and experimental focal malacic disorders in animals. PMID- 3976154 TI - Index Lists provided by the VAMPP computer programme for dairy herd health and production control. III. Interpretation and analysis of data on Index List 3. AB - In a series of four papers computerized herd reports for dairy herd health and production control purposes, the Index Lists, are presented. This third paper deals with Index List 3 on youngstock rearing and cow culling. The information from this list is suitable for monitoring rearing efficiency and culling policy in a veterinary herd health and production control programme, especially when used in combination with information from the other index lists. Methods for interpretation and evaluation of the data are provided. It is demonstrated how prompt computerized analysis of current information is used to detect deviations in index figures and to advise the farmer. PMID- 3976155 TI - Index Lists provided by the VAMPP computer programme for dairy herd health and production control. IV. Interpretation and analysis of data on Index List 4. AB - In a series of 4 papers computerized herd reports on various aspects of dairy farming, the Index Lists, are presented for herd health and production control purposes. This fourth paper regards Index List 4 on nutritional disorders, body condition and ration composition. The information from this list is suitable to monitor nutritional efficiency and feeding management, especially when used in combination with information from the other index lists. Methods for interpretation and evaluation of the data listed are provided. Evaluations should take into account the aspects related to nutrition. It is demonstrated how deviations of index figures are detected and how advice to farm management is built up by means of actual information and prompt computerized analysis. PMID- 3976156 TI - Index Lists provided by the VAMPP computer programme for dairy herd health and production control. I. Interpretation and analysis of data on Index List 1. AB - In a series of 4 papers the Index Lists as provided by the VAMPP computer programme are presented. The information on Index List 1, covering milk production, milk quality and udder health, is suitable to monitor actual herd performance, especially when used in connection with the other index lists. With computer programmes becoming available to veterinary control programmes, proper interpretation and prompt analysis of data is more critical. This paper outlines how deviations of index figures from reference values are detected, how analysis may be performed and how advice is built-up. PMID- 3976157 TI - Prevalence of Campylobacter jejuni and Salmonella during pig slaughtering. AB - It was found that 79% of healthy pigs, slaughtered in three different slaughterhouses in the Netherlands, were intestinal carriers of Campylobacter jejuni (mean number 4000 cfu per g), and 21% of the same pigs had Salmonella in the intestinal tract (mean number 10 cfu per g). Immediately after slaughter, Campylobacter was swabbed from 9% of the carcasses and Salmonella from 13%. It is concluded from these data that most of the contamination on carcasses does not originate directly from the intestinal tracts of the animals but rather from surfaces, equipment, and utensils in the slaughter hall. It was demonstrated that Salmonella could survive in the slaughter hall, whereas Campylobacter died off, probably due to its vulnerability to drying conditions and its inability to grow at temperatures below 30 degrees C. Campylobacter was not isolated from the carcasses after cooling. It had been shown earlier that this again was caused by dry conditions, brought about by the use of forced ventilation in the cooling rooms. In an additional investigation, Campylobacter was not isolated from 248 samples of minced pork (10 g each), whereas Salmonella was found in 13% of these samples. PMID- 3976158 TI - Effective control for diethylstilbestrol in cattle in the Netherlands. AB - In the period from August 1981 to April 1983, 10243 random samples of urine from slaughtered cattle were inspected for the presence of the stilbene derivatives diethylstilbestrol (DES), dienestrol (DE), and hexestrol (HEX). Fast screening of all samples was performed by radioimmunoassay (RIA) with prior clean-up column chromatography. In this screening, 216 samples were indicated for confirmatory analyses by combined high performance liquid chromatography-gas chromatography mass spectrometry (HPLC-GCMS) on account of an immunochemical response equivalent to 1 microgram/1 DES or more. The presence of DES was confirmed in 184 samples, DE in 5 samples and HEX in 14 samples. In the remaining 13 samples no stilbene derivative could be confirmed. From the results in 1984, after the introduction of the Meat Inspection Act, it is concluded that the use of stilbene derivatives in cattle in the Netherlands has dropped almost to zero. Of 4558 samples investigated, only 6 (0.13%) were indicated as 'stilbene' positive. The presence of DES was confirmed in 2 samples and DE in 4 samples. PMID- 3976159 TI - A study of the effects of replacing monensin ionophore with lasalocid ionophore in the field control of coccidiosis in broilers. AB - The following conclusions are made from an introductory investigation on the use of the coccidiostat lasalocid on 11 production farms of an integrated broiler production organisation. In terms of the incidence of sub-clinical coccidiosis, no significant difference was found between the previous use of monensin and the use of lasalocid during the investigation. However, the incidence of coccidiosis decreased with the introduction of lasalocid. Despite the fact that on some farms sub-clinical coccidiosis was diagnosed, the production performance clearly improved with lasalocid. EBI figures significantly increased from 163.6 to 172.5. During the investigation, in which approximately 220,000 broilers were involved, litter quality did not differ from that of previous crops in which monensin had been used. Feathering of the broilers in the trial crops in which lasalocid was used was similar to that of previous crops. PMID- 3976160 TI - An improved bioassay for the qualitative detection of sulphonamide and dapsone residues. AB - An improved method of bioassay has been described for qualitative detection of sulphonamide and dapsone residues in kidney, muscle, urine, and milk. The sensitivity to the sulphonamides tested ranged from 0.01 to 0.3 micrograms/ml or g of tissue and from 0.003 to 0.0006 micrograms/ml for dapsone. No extraction procedures are needed. PMID- 3976161 TI - Cholinesterase activity in Thysaniezia giardi (Cestoda, Anoplocephalidae). AB - The activity of cholinesterase was determined separately in the mature and gravid proglottids of Thysaniezia giardi and its significance is discussed. The mean values of the enzyme in mature and gravid proglottids were respectively 225.60 +/ 28.55 and 75.00 +/- 11.64 units per gram of wet weight. PMID- 3976162 TI - Effects of SKF 525-A, phenobarbital and 3-methylcholanthrene on the toxicity of lobeline sulfate. AB - Pretreatment of mice with the microsomal enzyme inducers and inhibitors modified the toxicity of lobeline sulfate. The intraperitoneal LD50 of lobeline sulfate following SKF 525-A (75 mg/kg), phenobarbital (PB), and 3-methylcholanthrene (3 MC) were 18.3, 85.5 and 82.1 mg/kg, respectively, as compared to that of saline treated controls, 55.3 mg/kg. Pretreatment of mice with disulfiram (DSF), diethylmaleate (DEM), or ethoxyquin hydrochloride (EQ-HC1) exhibited a very slight effect on the toxicity of lobeline sulfate. These results suggest that the hepatic microsomal monooxygenase system, but not glutathione (GSH), is involved in the detoxication of lobeline sulfate. PMID- 3976163 TI - Toxic ducks--1080 residues in game birds. An exercise in applied toxicology. PMID- 3976164 TI - The availability of fluoride from NaF and phosphorus supplements. AB - The availability of fluoride (F) from dicalcium phosphate (DCP), defluorinated phosphate (DFP), and raw rock phosphate (RRP) has been assessed and compared to the availability of F as NaF. Diets containing 50-55 ppm F were fed to lambs and rats and skeletal F retention determined. The relative availability of F in the different phosphate sources measured by this technique compared to that of NaF was about 50% (DCP), 20% (DFP), and 65% (RRP). Digestibility of F in goats fed similar diets was determined in a 4 x 4 Latin Square design experiment and found to be 38% (DCP), 34% (DFP), 65% (RRP), and 75% (NaF). PMID- 3976165 TI - Lead concentrations in fresh, frozen and formalin fixed tissues from lead poisoned calves: guidelines for diagnosis. PMID- 3976166 TI - Stimulatory effects of selenium on mitogen responses in lambs. AB - Separated lymphocytes from untreated and selenium-supplemented lambs were tested in culture against phytolectins (phytohaemagglutinin and pokeweed mitogen). Levels of response varied considerably among individuals, and this tended to mask the effects of selenium. However, cells from both groups were more active in the presence of serum from supplemented animals, and a similar stimulatory effect was achieved by adding sodium selenite in vitro. Thus selenium could exert a direct influence on the performance of immunocompetent cells. PMID- 3976167 TI - Quantitation of sheep IgG1, IgG2, IgA, IgM and albumin by radioimmunoassay. AB - A solid phase radioimmunoassay procedure for the measurement of immunoglobulins (IgG1, IgG2, IgA and IgM) and albumin in sheep body fluids (serum, intestinal lymph, caudal mediastinal lymph, bile, mammary secretions and intestinal secretions) is described. This method was found to be easy to perform, rapid, sensitive and reproducible. Results obtained were consistent with those previously reported using radial immunodiffusion and nephelometric techniques. PMID- 3976168 TI - Immunochemical behaviour of a tumour-associated antigen obtained from an AKR mouse lymphoma. AB - A soluble tumour-associated antigen was prepared by homogenizing AKR lymphoma cells (L15) followed by treatment with acetone and glycine-HCl buffer pH 3. It was analyzed by immunoelectrophoresis, rocket electrophoresis in the presence of Concanavalin A and SDS-PAGE. It showed rapid electrophoretic mobility, and the major component had an estimated molecular weight of 70,000 daltons. The molecular composition of the antigen included a glycoprotein. Specific antibodies against this antigen were demonstrated in BALB/c mice in which the AKR lymphoma was conditioned to grow by introducing the L15 cells into a subcutaneously implanted glass cylinder. In this model antibodies were found in both tumour bearing (progressor) and tumour-rejecting (regressor) animals. In vivo experiments showed that pretreatment of BALB/c mice with L15 acellular extracts, 10 days before tumour challenge, led to a significant increase in allogeneic tumour growth. A rabbit anti-tumour extract serum was prepared and was rendered tumour -specific by exhaustive absorption with normal AKR serum and tissues. It shared the same epitopic specificity with tumour progressor or regressor mouse sera since indirect immunofluorescence using L15 cells could be reciprocally inhibited. PMID- 3976169 TI - A new surface marker on equine peripheral blood lymphocytes. I. Subpopulations of lymphocytes with receptors for Helix pomatia A hemagglutinin (HP). AB - Untreated and neuraminidase-treated equine peripheral blood lymphocytes were analysed for binding of the A hemagglutinin of the snail Helix pomatia (HP). For optimal staining by direct immunofluorescence, the concentration of neuraminidase had to be increased as compared to that needed for other species. Moreover, higher concentrations of HP were required for optimal staining of equine lymphocytes as compared to lymphocytes from other species. Even so, the maximal number of equine lymphocytes exhibiting positive staining was only about 20%. No, or very few, HP-positive lymphocytes were seen when neuraminidase treatment was omitted. However, when the more sensitive method of indirect immunofluorescence was used, approximately 60% of the lymphocytes were HP positive without prior treatment with this enzyme. Neuraminidase treatment significantly increased this figure to about 75%. In all instances, HP binding was specific since it was inhibited by the competitive sugar hapten N-acetyl-D-galactosamine (D-GalNAc) while addition of D-glucose (D-Glc) gave no inhibition. HP binding to neuraminidase-treated lymphocytes was also investigated quantitatively by means of 125I-labeled HP. The number of HP molecules bound per HP-positive cell was approximately 3 X 10(5) and the apparent association constant for the binding of HP to its cellular receptors was approximately 8 X 10(7) 1/mol. No binding of HP to untreated lymphocytes could be recorded in these experiments. PMID- 3976170 TI - A new surface marker on equine peripheral blood lymphocytes. II. Characterization and separation of purified blood lymphocytes with receptors for Helix pomatia A hemagglutinin (HP). AB - In a preceding report we have shown that the lectin Helix pomatia A hemagglutinin (HP) binds to two subpopulations of neuraminidase-treated equine peripheral blood lymphocytes (PBL), constituting about 20% and 75% of PBL, respectively. The aim of the present study was to further characterize these HP+ cells in regard to other surface markers such as receptors for guinea pig erythrocytes (GPR+ cells), membrane-bound immunoglobulins (sIg+ cells), receptors for activated complement (C3R+ cells) and receptors for IgG (Fc alpha R+ cells). This was done by double marker analysis and by lymphocyte fractionation either on columns charged with HP coupled to Sepharose beads or by rosetting with guinea pig erythrocytes. The fractions were also analysed for their proliferative response in the mixed lymphocyte tumor cell interaction (MLTC) assay and to the mitogens leucoagglutinin (La) and concanavalin A (Con A). The results revealed that the majority of GPR+ cells also expressed high avidity receptors for HP, as defined by means of direct immunofluorescence. These cells constituted a subpopulation of GPR+/HP+ cells T cells comprising approximately 20% of PBL. In contrast, about 75% of the HP+ cells in indirect immunofluorescence were GPR-. The fractionation experiments showed that HP+ and GPR+ cells were probably not B cells since they were sIg-. The C3R+ and Fc alpha R+ lymphocytes were heterogeneous in regard to HP receptors but the majority of these cells was also found in the fractions depleted of HP+ and GPR+ lymphocytes. The fractions eluted from HP columns gave a strong proliferative response in MLTC, whereas fractions depleted of HP+ cells responded poorly. However, in contrast to the GPR+-depleted fractions, those enriched in GPR+ lymphocytes responded poorly to the T cell mitogens La and Con A. The mitogenic response of the HP-column fractions to La and to Con A was variable. The results are discussed in relation to HP being a surface marker for a heterogeneous population of equine T cells. PMID- 3976171 TI - Pharmacokinetics of chloramphenicol in cows after intramuscular application. AB - The concentrations of chloramphenicol and its water-soluble metabolites in the plasma of six clinically healthy heifers were measured at intervals during five days after intramuscular administration of free chloramphenicol (20 mg/kg) in a vehicle containing 40% of an organic solvent. Estimations were carried out by a colorimetric method and by high pressure liquid chromatography (for the very low values beyond the second day). For free chloramphenicol a peak concentration of 1.7 micrograms/ml at 7.3 h after injection was found (MIC: 5 micrograms/ml). Bioavailability was calculated to be 63%. It is shown that absorption was apparently not a uniform process but occurred rather slowly (t 1/2 (ab) = 10.2 h) for the main part of the available dose, whereas one sixth was quickly absorbed (t'1/2 (ab) = 0.7 h). The apparent half-time of elimination was 10.2 h for the unchanged drug. At the fifth day after administration the plasma concentration was below the limit of detectability (10 ng/ml) in all animals. PMID- 3976172 TI - Experimental intrauterine inoculation of pregnant ewes with ureaplasmas. AB - The pregnancies of 13 ewes which were inoculated intrauterine with one of two strains of ovine ureaplasmas resulted in 9 normal and 3 abnormal births, and one ewe was found to be no longer pregnant on postmortem examination. Vaginal ureaplasma infection was detected in the majority of ewes only after lambing. Of the 12 ewes examined at postmortem, ureaplasmas were isolated from the uterus of 5 out of the 6 necropsied up to 21 days post-partum. The vulvar/preputial areas of the majority of lambs that survived were infected with ureaplasmas for the duration of the experiment, but infections of the nasal cavity and eye areas, detected at birth in 4 lambs, were resolved within 8 days post-partum. The only pathological effects detected that could possibly be attributed to ureaplasma infection were a placentitis in an ewe that aborted, and the resorption of the foetus in another. PMID- 3976173 TI - A study of the pregnant uterus of the ewe and the goat using real-time ultrasound scanning and electromyography. AB - In this study of the pregnant uterus of the ewe and the pygmy goat, the simultaneous use of real-time ultrasound scanning and electromyography is introduced. In unanaesthetized animals it was possible to visualize the uterine wall, the placentomes, parts of the fetal skeleton, the fetal kidneys, different parts of the fetal stomach and several structures of the fetal heart and vascular system. From these features the intra-abdominal position of the fetus could be determined. It was observed that Episodes of Myometrial Electrical Activity (EMEA's), as registered by chronically implanted uterine surface electrodes, coincided with passive displacements of the fetus in the direction of the maternal pelvis. These passive displacements could clearly be discerned from active fetal body movements. In both species the number of active fetal movements was significantly reduced during and/or shortly after an EMEA. In one of the pygmy goats, in which three different types of movement were discerned, this reduction of fetal movements could be studied in more detail. It is concluded that real-time ultrasound scanning of the fetus in small ruminants might contribute to studies of the complex maternal-fetal interactions that exist during late gestation. PMID- 3976175 TI - Neuraminic acid is involved in the binding of influenza C virus to erythrocytes. AB - Neuraminidases of both viral and bacterial origin have been reported to be unable to destroy the cellular receptor for influenza C virus on chicken erythrocytes, in contrast to the receptors for influenza A and B virus. However, under appropriate conditions neuraminidases from both Vibrio cholerae and Clostridium perfringens were able (i) to make chicken red blood cells resistant against agglutination by influenza C virus and (ii) to reduce the hemagglutination inhibiting activity of rat serum. Both effects were abolished in the presence of the neuraminidase inhibitor 2,3-dehydro-2-deoxyneuraminic acid (DDN). These results indicate that contrary to previous assumptions sialic acid may very well be an essential component of the receptor for influenza C virus. PMID- 3976176 TI - Electron microscopic and solution X-ray scattering observations on the structure of hepatitis B surface antigen. AB - The structure of the small, spherical hepatitis B surface antigen was studied by negative staining, freeze-fracture and freeze-etching electron microscopy and solution X-ray scattering techniques. The protein appears to be organized at the surface into a small number of morphological subunits which display two- and threefold axes of symmetry. The mean particle size was 18.3 nm by negative staining and 19.6 nm by freeze-fracture electron microscopy. The diameter of the individual subunits was about 7.5 nm with an intersubunit distance of about 10.0 nm. The lipid is distributed more homogeneously. Some heterogeneity of the particle structure is apparent which may be due to a slightly variable lipid protein composition or incomplete or defective particle formation. PMID- 3976174 TI - Susceptibility of North Ronaldsay sheep to copper from cupric oxide needles. AB - Three housed North Ronaldsay sheep were treated with copper in the form of cupric oxide "needles", two at the manufacturer's recommended dosage rate and the third at twice this level. Sheep of this breed are especially sensitive to high dietary intake of copper. Pre- and post-dosing blood samples were monitored for changes in packed cell volume and changes in content of plasma copper, bilirubin, AST and SDH. Weight changes were also recorded. The animal dosed at twice the recommended level died on day 19 post-dosing of acute copper poisoning. The two dosed at the standard rate remained healthy and put on weight steadily throughout the six months following treatment. Two Welsh Mountain sheep dosed at the standard rate and maintained and examined in the same way likewise showed no signs of copper toxicity. PMID- 3976177 TI - Protein coding assignment of the S genes of the avian reovirus S1133. AB - The protein coding assignments for each of the S genes of the avian reovirus S1133 have been determined. In vitro translation of RNA derived from individual S dsRNA genome segments demonstrated that the largest S gene, S1, codes for the smallest protein, sigma C; the S2 for sigma A; the S3 gene for sigma C; and the S4 gene for sigma NS. No other gene products could be identified. By examination of appropriate reassortant viruses, these assignments were confirmed. PMID- 3976178 TI - 1H, 13C, and 31P nuclear magnetic resonance studies of cowpea mosaic virus: detection and exchange of polyamines and dynamics of the RNA. AB - 1H and 13C NMR studies on cowpea mosaic virus (CpMV) revealed that polyamines are present in the middle (M) and upper bottom (BU) components obtained by CsCl density gradient centrifugation but not in the top (T) component; the lower bottom (BL) component contains trace amounts of polyamine. Dialysis of the BL component against spermidine led to incorporation of spermidine which gave rise to NMR peaks very similar to those observed with the natural M and BU components. NMR results conclusively demonstrate that polyamines in the M and BU components of CpMV are exchangeable with cesium ions and the exchange process is pH dependent. They also provide experimental support for the hypothesis that the BU to BL conversion results from the displacement of polyamines and possibly other natural counter ions of the RNA by cesium ions [G. Bruening, (1977), In "Comprehensive Virology" (H. Fraenkel-Conrat and R. R. Wagner, eds.), Vol. 11, pp. 55-141. Plenum, New York]. No sharp peaks, attributable to mobile amino acid side chains, were seen in spectra of an intact CpMV particle or its empty protein shell (T component). 31P NMR spin-lattice relaxation time and nuclear Overhauser effect parameters, which are sensitive to high-frequency motions, suggest that the RNA and, when present, the bound polyamine undergo internal motions with correlation times in the nanosecond range. PMID- 3976180 TI - [Medical services in the Armed Forces in 1984 and objectives for 1985]. PMID- 3976179 TI - [Improving the services of military pharmacies]. PMID- 3976181 TI - [Effect of severe trauma on decompression sickness]. PMID- 3976182 TI - [Pathological changes in internal organs after burns]. PMID- 3976183 TI - [Psychological classification of military specialties]. PMID- 3976184 TI - [Psychophysiological indicators in students during training]. PMID- 3976185 TI - [Medical control of microclimate in ship's cabins]. PMID- 3976186 TI - [Use of low-energy laser irradiation in the complex treatment of non-healing wounds of soft tissues]. PMID- 3976187 TI - [Use of film-forming polymers in wounds and burns]. PMID- 3976188 TI - [Autologous blood transfusion for replenishing blood loss during surgery]. PMID- 3976189 TI - [Treatment of patients with primary facial neuritis]. PMID- 3976190 TI - [Prevention of acoustic trauma among military personnel]. PMID- 3976191 TI - [Pathogenetic mechanisms of shock in napalm burns]. PMID- 3976192 TI - [Multiple primary tumors complicating prostatic cancer]. AB - Postmortem examination of 600 cases of prostatic cancer established concomitant malignancies at other sites in 3.5%, the latter being mostly gastrointestinal carcinomas. Most tumors were synchronous, whereas only 4 out of 21 were metachronous ones. Among the 17 cases of synchronous tumors, prostatic carcinoma was the main pathology in 11, competing-2 and a concomitant one in 4 cases. Out of 17 cases, both tumors were diagnosed intravitally only in 4, one tumor-8 and none-in 5 cases. Among 32 (5.3%) cases of concomitant benign lesions, there was one in which bleeding from an ulcerated glomus tumor of the stomach was the immediate cause of death. PMID- 3976193 TI - [Meaning of the concept "local recurrence" following surgical treatment of malignant melanoma of the skin]. AB - The paper deals with a retrospective clinico-morphological analysis of the data on 161 cases of secondary tumors developing in the zone of postoperative scar or transplanted skin flap. The results of the study showed lesions traditionally referred to as "local recurrence" of skin melanoma to be pathogenetically different. The data obtained suggest that this term should cover secondary tumors arising in the postoperative scar or transplanted skin flap that develop either from the remnants of primary melanoma or from tumor cells which are brought from anabrotic primary melanoma of surgical wound during excision. PMID- 3976195 TI - [Change in the level of steroid hormone receptors in the tumors of patients with breast cancer complicated by liver and bile duct diseases]. AB - Estrogen, progesterone and glucocorticoid receptor levels were assayed in cytosols of primary tumor in 132 patients with breast cancer. Concomitant diseases of the liver and bile ducts were detected in 13 of them. Patients with concomitant hepatic pathology showed a relatively lower percentage of tumors bearing receptors of the above steroid hormones. This was matched by a significant reduction in the level of progesterone receptors. The frequency of identification of receptors of both estrogens and progesterone in tumor in cases of concomitant hepatic pathology was three times less than in those free from it. PMID- 3976194 TI - [Use of protamine sulfate in a method for determining the hormonal sensitivity of breast cancer]. AB - A new procedure for estrogen receptor assay in breast cancer tissue is discussed. According to the method cytosol receptor level is interpreted as the estradiol binding capacity of protein which is precipitated by protamine sulfate from the cytosol fraction of tumor. PMID- 3976196 TI - [Relation of spontaneous chemiluminescence, electrochemiluminescence and resistance of blood serum in patients with cancer of the proximal part of the stomach and esophagus]. AB - The levels of spontaneous chemoluminescence of serum in patients with cancer of the proximal part of the stomach and the esophagus were found to be 2-6 times the age-connected norm. The said concentrations decreased by half following radiation treatment, to rise by 75% after surgery. At later periods after surgery, chemoluminescence levels dropped almost to normal unless complications developed. However, in patients with gastroesophageal cancer, the level of spontaneous chemoluminescence remained high over a long period of time. Variation patterns were identical, with an amplitude being significantly lower. Changes in blood serum resistance were insignificant. Scale factor K varied in the range of 6-66. In cases of purulent complications, spontaneous chemoluminescence levels showed a sharp rise, the values of K exceeding 75. This pattern made it easier to differentiate between inflammatory lesions and neoplasia. PMID- 3976197 TI - [Treatment tactics and prognosis in gallbladder cancer in relation to the degree of spread of the tumor]. AB - The experience of treatment of 88 cases of gallbladder cancer was used in developing a TNM staging classification of the lesion. The extent and procedure of radical surgery versus tumor stage as well as long-term results of treatment are discussed. PMID- 3976198 TI - [Clinico-morphologic comparisons in villous and adenovillous tumors of the colon]. AB - The data on 330 cases of villous and tubular-villous adenoma of the colon were analysed. The results of histological examination of resected material were compared with the evidence provided by clinico-endoscopic examination as well as preoperative bioptic findings. Since none of the above procedures proved to be of diagnostic value in detective invasive growth of villous tumor, it makes the case for total biopsy as the only reliable diagnostic procedure. PMID- 3976199 TI - [Means of improving the active diagnosis of breast cancer]. AB - The paper is concerned with an analysis of case histories of 1,873 breast cancer patients treated at the Center. Cancer was diagnosed by medical check-ups in 208 (11%) only, while 1,665 (89%) females detected the lesion themselves. In the former group, the frequency of stage I cancer was twice that of tumors at other stages. However, nearly all patients in that group had the same stage of tumor as the patients who consulted the doctor. Early stage malignancies were detected by mass screenings in as few as 1.5% of the total number of those admitted to the Center clinics for breast cancer treatment. Well-organized follow-up aimed at an early diagnosis of breast cancer proved to be more effective than mass screenings. Many measures aimed at an early diagnosis of breast cancer still fall short of their target and fail to detect many malignancies. PMID- 3976200 TI - [Experience in the organization of ambulatory chemotherapy at the All-Union Oncologic Research Center of the USSR Academy of Medical Sciences]. AB - The recent advances have made it possible for chemotherapy to be used for cancer control under the conditions of out-patient clinics. Within 5 years, 9,000 out patients had received at the Center 10-day courses of chemotherapy which was free from toxic complications and produced a therapeutic effect similar to that observed in in-patients. The out-patient chemotherapy service saved 177,140 in patient/days which is an equivalent of running a 500 bed specialized cancer hospital during 12 months. PMID- 3976201 TI - [Role of the attitude to work in the rehabilitation of patients with breast cancer]. AB - The nature and changes of motivation for work as well as occupational rehabilitation planning were studied in 50 cases of radical mastectomy for breast cancer. The approach was based on the general principles of psychology and some methods of pathopsychology. Patient's motivation for work was found to be one of the major factors leading to occupational rehabilitation, the latter being less dependent on the stage of disease and surgical procedure in patients with stable motivation. The role of the immediate social environment and its beneficial effect on rehabilitation are also discussed. PMID- 3976202 TI - [Calculation of the index of relative survival and the median of observed survival in oncological patients]. PMID- 3976203 TI - [Multiple primary cancer in 1 lung]. AB - The experience gained in the treatment of 29 cases of primary multiple carcinomas of one lung (synchronous--20 and metachronous--9) was analysed. Criteria for diagnosis of primary multiple neoplasms as well as choice of treatment are discussed. Surgical excision of both tumors was performed in 27 cases (synchronous--19 and metachronous--8). Surgery proved to offer considerable advantage in treatment of the lesion. PMID- 3976205 TI - [Development of criteria for assessing the individual risk of breast cancer]. AB - The results of clinico-epidemiological examination of breast cancer patients and controls were used in prognostic tables designed for evaluation of individual risk for breast cancer on the basis of a case history. Practical experience with the said tables showed the percentage of breast tumors detected in patients at high risk selected with the aid of the tables to be several times that of routine mass screenings. PMID- 3976204 TI - [Change in zinc metabolism in malignant neoplasms]. AB - Changes in the zinc metabolism indexes (levels in blood serum, leukocytes, erythrocytes, diurnal urine and liver tissue) were assayed colorimetrically in 116 patients (52 with primary and metastatic cancer of liver, 20 with neoplasms of extrahepatic localizations and 44 with acute and chronic leukemia). Normal or elevated concentration of zinc in blood serum identifiable only in cases of primary cancer of the liver (matched by a decrease in blood serum zinc level in the remaining cases) provides a differential diagnosis sign suggesting transformation of hepatocirrhosis into primary cancer of the liver. Zinc levels in blood serum and leukocytes are relatively low in cases of different types and sites of tumors, this being characteristic of the initial stages of the disease. PMID- 3976206 TI - [Radionuclide visualization of the thoracic lymphatic duct in patients with stomach cancer]. AB - Lymphoductoscintigraphy with colloid 113mIn was carried out in 24 gastric cancer patients prior to catheterization of the thoracic duct. The procedure provided perfect scintigraphic images of the duct in 15 cases, failed completely in 7 cases and terminal part of the duct was not visualized in 2 cases. During surgery, clinically undetectable involvement of lymph nodes in the left supraclavicular region was found in patients of the latter groups (4 and 1 cases, respectively). The results of radionuclide examination were confirmed by surgery in 23 out of 24 patients (95.8%). PMID- 3976207 TI - [Ligation and prolonged catheterization of the internal iliac arteries in hemorrhaging bladder cancer]. AB - Internal iliac arteries were ligated in 15 cases of extensive cancer of the urinary bladder to arrest persistent bleeding. A stable effect was obtained in 8 cases only. The procedure of maintenance of a permanent catheter in the visceral part of internal iliac artery suggested by the authors was successively used to stimulate hemostatic effect in the remaining 5 cases. The procedure was carried out in conjunction with intraarterial injection of hemostatic agents. PMID- 3976208 TI - [Short- and long-term results of cystectomy in localized bladder cancer]. AB - Long-term results of cystectomy involving formation of ureterosigmoid anastomosis and ureterocutaneostomy were studied in 51 cases of cancer of the urinary bladder. Half the patients with T2 tumors and 23%--with T3 tumors survived for 3 years and longer. Tumor process generalization caused death long after operation in 64.2%, while renal failure--in 32.1%. During 1-2 years of follow-up, such pathological changes in uretero-intestinal anastomoses as abnormally large diameter of ostium ureteris and cicatricial stricture were identified in 14 cases and stricture of uretero-cutaneous stoma--in 2 cases. The best results in formation of ureterosigmoid anastomosis were obtained by application of transsigmoid procedures which assured reflux prevention, retention change-free ureters alone being eligible for use in anastomosis. PMID- 3976209 TI - [Complications and causes of fatal outcomes in prostatic cancer]. AB - An analysis of post-mortem examination data on 600 cases of cancer of the prostate showed that among the most frequent complications were ascending pyelonephritis (51.7%), focal pneumonia (42.8%) and cachexia (36.7%). Deaths were caused mainly by progression of cachexia (24.3%), uremia (24.3%) and focal pneumonia (19.5%). Only a small percentage of patients died from postoperative complications and concomitant pathology. PMID- 3976210 TI - [Lymphographic picture of malignant lymphomas in children]. AB - The paper deals with a study of lymphographic data on 204 cases of pediatric malignant lymphomas: primary Hodgkin's disease--150 and non-Hodgkin's lymphomas- 54. The frequency of retroperitoneal lymph node involvement was nearly identical in both study groups (68.0 and 68.5%, respectively). In Hodgkin's disease, lymph node lesions developed gradually and were asymmetric; a total involvement of lymph nodes was more frequent in non-Hodgkin's lymphomas, the X-ray patterns of affected nodes being identical. The study failed to establish any lymphographic signs pathognomonic for certain histologic types characteristic of Hodgkin's disease and non-Hodgkin's lymphomas. Lymphography should be carried out in all cases of stage I--II Hodgkin's disease, while in stages III and IV its role is limited to determining the size of irradiation fields. PMID- 3976211 TI - [Combination electroanesthesia in oncological patients during surgery and in the early postoperative period]. AB - Pelan and Elnar type electric stimulators were used to produce analgesia in 178 cancer patients in the course of surgery and in early postoperative period. The results of a complex study using rhythmography, acid-base balance, blood-sugar level, arterial and central venous pressure measurements and psychophysiologic examination with the Neuron type installation showed that joint application of electric stimulation and local anesthesia as well as the use of electric stimulation in combination with intravenous injection of hydroxybutyric acid, seduxen and ketalar provide adequate intraoperative anesthesia in 85% of cases. Postoperative application of electroanesthesia in cancer patients was followed by a significantly lower requirement of narcotic analgetics. Moreover, the procedure did not involve depressive or hyperkinetic complications, characteristic of morphine and promedol treatment. The results of the study suggest that electroanesthesia be used in cancer treatment. PMID- 3976212 TI - [Comparative quantitative assessment of a carcinogenic effect taking intercurrent mortality into account]. AB - The paper discusses the advantages offered by the statistical evaluation of experimental carcinogenic effect with due regard to mortality from concomitant pathology. The method used complex tables of contingents and analysis was carried out separately in 3 groups of tumors--independent of mortality, fatal and incidental ones. The method was compared with standard procedures which do not take care of the said mortality rate (table of contingents 2 X 2 and precise procedure of Fisher). The data on development of 1,2-dimethylhydrazine-induced tumors of the skin, uterus and ovaries in 5 strains of mice were used in the study. PMID- 3976213 TI - Premarital screening for syphilis. PMID- 3976214 TI - Break dancer's fracture of the fifth metatarsal. PMID- 3976215 TI - More on pains cured by examination. PMID- 3976217 TI - Neonatal hyperviscosity syndrome. PMID- 3976216 TI - Hyperuricemia and gout. PMID- 3976218 TI - Management of community-acquired pneumonia in outpatients. AB - The medical records of 94 patients with pneumonia who were not admitted to hospital were reviewed and compared with those of 25 patients admitted to hospital for treatment of pneumonia. In all, 93% of the outpatients in whom follow-up could be obtained did not require modification of treatment. This included patients older than 50 years of age without important underlying illness, patients with leukocyte counts of more than 14,000 per mu and patients with multilobular pneumonia. A properly obtained Gram-stained sputum specimen showing a predominant organism was the best method for determining the antimicrobial regimen. If sputum cannot be obtained for Gram's staining, erythromycin should be the drug of choice for patients younger than 40 years and ampicillin or erythromycin should be given to those patients older than 40 years who are managed outside of the hospital. Patients who are critically ill with tachypnea or hypoxia and those with severe underlying illness and pneumonia should be admitted to hospital. PMID- 3976219 TI - The variable hyponatremic response to hyperglycemia. AB - Hyperglycemia may lower the plasma sodium concentration. Theoretical analyses have suggested that elevations in glucose concentration produce an invariant hyponatremic response. We propose, however, that change in plasma sodium concentration in response to hyperglycemia is variable and depends on (1) the distribution of total body water and solute, (2) the relationship between the gain of extracellular glucose and the loss of intracellular solute and (3) the intake and loss of solute and water. These factors are incorporated into a formulation of the relationship between the plasma sodium and glucose concentrations. PMID- 3976220 TI - Magnetic resonance imaging of the central nervous system--an update. AB - Magnetic resonance imaging has developed rapidly and now has superior ability to detect and to characterize disease in the central nervous system without any significant biologic hazard. It is becoming the screening method of choice in the diagnosis of neoplasm, ischemia, hemorrhage, infection and degenerative and demyelinating diseases involving the central nervous system. PMID- 3976221 TI - Polyamines in clinical disorders. AB - An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine, Los Angeles. The Director of Conferences is William M. Pardridge, MD, Associate Professor of Medicine.Polyamines, necessary for cell growth, influence many cell functions. As small polyvalent cations they can change the configuration of large polyvalent anions, such as DNA, and alter their sensitivity to other molecules including chemotherapeutic agents. By altering polyamine content in a cell, we can change its growth, its susceptibility to drugs and change other cellular functions. Malignant conditions, other proliferative diseases and infections are the most apparent clinical conditions likely to improve by depleting polyamines and suppressing cell growth. Proliferative disorders of the skin respond to many agents that suppress polyamine metabolism. Hyperoxia may suppress cell growth in the lung by suppressing polyamine metabolism. PMID- 3976223 TI - Magnetic resonance in medicine. PMID- 3976224 TI - Polyamines in biology and medicine. PMID- 3976222 TI - Controversies in the medical management of stroke. PMID- 3976225 TI - Acromegaly with 'normal' growth hormone levels. PMID- 3976226 TI - Treatment of mild hypertension. PMID- 3976227 TI - Patient compliance in drug therapy for hypertension. PMID- 3976228 TI - [Possibilities of 2-dimensional echocardiography in childhood. I. Study technic, section planes, normal findings]. AB - Two-dimensional echocardiography is a superb method for non-invasive investigation of cardiac anatomy and cardiac function in infancy and childhood. It supplements and often replaces invasive investigations. This paper presents the standardized imaging planes and transducer locations and shows the normal cross-sectional cardiac anatomy. PMID- 3976229 TI - [2-dimensional echoencephalography in childhood: method, indications and personal results]. AB - Two-dimensional echoencephalography has become an important diagnostic tool in paediatric neurology. The clinical value of two-dimensional echoencephalography in children is discussed on the basis of the results of 669 own ultrasonic examinations. Improvements in equipment and handling, as well as increasing experience enabled a firm diagnosis in most cases. However knowledge of ultrasound morphology and correlation of these pictures with clinical findings and prognosis are necessary for the successful application of this new method. PMID- 3976230 TI - [Possibilities of 2-dimensional echocardiography in childhood. II. Possibilities for use]. AB - Two-dimensional echocardiography has been shown to be equal, or even superior, to cardiac catheterization in the diagnosis of congenital heart disease. On the basis of clinical and non-invasive investigations alone many cardiac malformations can be diagnosed correctly and an operation carried out without previous catheterization. This paper reports our findings with cross-sectional echocardiography in common and rare cardiac malformations using standardized imaging planes and typical transducer locations. PMID- 3976231 TI - [Psychological changes in multiple sclerosis]. AB - In dealing with our multiple sclerosis (MS) patients concomitant and consecutive symptoms of a psychical nature also deserve appropriate consideration in addition to the variety of somatic symptoms. In the following synopsis, numerous and in part divergent findings - observations, hospital statistics as well as psychodiagnostic test results - concerning the psychopathology of MS are presented. A multiplicity of mental changes, depending upon the variability of the disease process and its course, can be noticed. Over the past century euphoria was long regarded as the psychopathological trait of MS. Along with transitions in patient populations in the meantime hardly more euphoric than depressive moods are registered. Euphoric mood aberrations are to be regarded as substrate dependent disturbances, which deteriorate parallel to disease duration and severity. Intellectual dysfunctions as well as topical brain symptoms (so called "instrumental disabilities"), obsessive laughing and crying also reflect the basic organic process. Concerning other symptoms such as depression or dysphoria, emotional lability or lack of drive, at its extreme apathy, one cannot definitely determine to what extent - in view of a multidimensional approach - these are to be regarded as mental correlates of the disease process, or as individual reactions to the disease along with considerable social consequences. Psychoses, rarely occurring in MS, can be classified either as organic, or, in seldom cases, as a fortuitous coincidence of MS and endogenous psychosis. PMID- 3976232 TI - [Cranial CT changes in multiple sclerosis patients]. AB - The CCT changes in multiple sclerosis patients were described, 60 patients of them with a clinically certain illness of more than 5 years. The indication for the CCT of the etiologically still unknown disease is discussed. PMID- 3976233 TI - [Metabolic aspects of multiple sclerosis]. AB - According to the present opinion multiple sclerosis (MS) is caused by a concurreance of various factors. This predisposing factor seem to be related to a disturbance of the lipid- and fatty acid metabolism, characterized by decreased concentrations of polyunsaturated fatty acids (PUFA) and essential fatty acids (EFA) in the plasma, the blood cells, the cerebrospinal fluid (CSF) and white matter of the brain in patients with MS. A disturbed absorption of EFA could be excluded. Now the question arises whether there is a disturbed utilisation of EFA with the consequence of biochemical changes in myelin and blood cells. According to lipid-chemical and lipolytic enzymological studies a disturbance of the fatty acid elongation system as well as primary increased activation of the phospholipase A1 is conceivable. According to the demonstrated results the conception of a metabolic immunological caused generalised defect of the biological membranes - especially those of the myelin sheath and platelets - as predisposing factor for the increased platelet aggregation is possible. Even though these ideas do not yet allow a concrete pathogenetic conclusion, the prostaglandins (PG) might be of importance because their precursors are fatty acids and influence the immune mechanisms. Possibly, new approaches follow from the synopsis of present working hypotheses for an extended biochemical immunological model of multiple sclerosis. Further immunological and laboratory methods should concentrate on differentiating MS from other diseases of the central nervous system and on diagnosing the disease in its early stage. The results of this work are fully discussed in other publications. Separate prints can be requested from the author. PMID- 3976234 TI - [Cerebrospinal fluid and multiple sclerosis]. AB - A survey of the relevant diagnostic methods in the cerebrospinal fluid in multiple sclerosis is given. In over 90% positive results are obtained, showing the inflammatory CNS-process or myelin break down. Personal findings demonstrate the relevance of lymphocytic transformation in CNS inflammatory diseases. In 73% of definitive MS cases transformed lymphocytes occurred, commonly associated with a pathological IgG/Albumin ratio, but in 23% of chronic progressive cases in isolation. Under unselected cerebrospinal fluids with transformed lymphocytes and a cell count under 16 per micro 1 multiple sclerosis was suspected clinically in 70%, in further 20% other inflammatory diseases were present while only 10% unspecific cases occurred. PMID- 3976235 TI - [Otoneurologic testing in multiple sclerosis]. AB - The values of the individual audiological and vestibular examination methods in multiple sclerosis (MS) diagnosis are discussed. Our experience shows that the most accurate indications are provided by acoustic stapedius reflex, brainstem auditory evoked potentials (BAEPs) and vestibular investigation. Other testing processes play only a minor part. Using the three methods mentioned, brainstem injuries can be shown to be present at an early stage. Hence one should always include them in MS-diagnosis as a matter of routine. Of the 85 patients we examined, 72 had definite MS and 13 probable (sub-division according to Mc Alpine criteria): all of them underwent acoustic stapedius reflex test and vestibular investigation (nystagmogram, caloric vestibular test according to Hallpike Frenzel. The stapedius reflex measurements showed pathological findings of 64/54% and the vestibular test findings of 53/61%. PMID- 3976236 TI - [Multiple sclerosis and electronystagmography]. AB - The electronystagmography (ENG) is a valuable auxiliary measure in the neurological diagnosis of diseases of the optic-vestibular system. ENG-results may also contribute to lesion localization of brainstem affections resulting from brain trauma, of vascular processes or tumours of the posterior cranial fossa, in spite of the EEG lacking any lesion signs. Therefore, the ENG constitutes a useful complement to the EEG-examination in the diagnosis of brainstem lesions. PMID- 3976237 TI - [Visual and acoustic evoked potentials in multiple sclerosis]. AB - A central topic of recent research on multiple sclerosis (MS) concerns the development of sensitive neurophysiological techniques with the ability to detect lesions at the earliest possible stage. Specifically, the recording of evoked potentials has during the past decade demonstrated its diagnostic value by disclosing clinically silent lesions especially of the optic nerve and brainstem region. The visual evoked potential (VEP) was registered in 177 patients with definite, probable and possible MS (McAlpine). Abnormal latencies were obtained in 86/46/34% of these three patient groups, respectively. 44% of all MS-patients without clinical or anamnestic evidence of optic nerve dysfunction showed delayed VEPs. The brainstem auditory evoked potential (BAEP) enables topodiagnostic statements to be made regarding brainstem lesion site. This is very valuable, since the brainstem region is especially prone to demyelination, which clinically as well as morphologically often evades detection. 74/60/48% of our definite, probable and possible MS-patients had pathological BAEPs. 50% of asymptomatic patients had an abnormal BAEP-result. Computer tomography yielded brainstem pathology in only 10% of all MS-patients. PMID- 3976238 TI - [Multiple sclerosis and the electroencephalogram (computer EEG studies)]. AB - A computerized analysis of EEg-records from 96 multiple sclerosis (MS) patients yielded about twice as many abnormal results (79%) in comparison to the usual visual EEG-evaluation (39%). The statistically significant (p less than 0.05) increase in slow frequencies in addition to beta frequencies to the cost of alpha, but especially the reduction in total percentage of alpha contribution to overall EEG-power discriminated most efficiently between MS-patients and our normal population. Thus, alpha index alone allowed for 87% correct classification of the normal population, and 73% of patients with normal visual EEG-records were correctly classified as belonging to the MS-population. Extending the patient group to include pathological visual EEG-records as well, the corresponding figures were 95% and 89%, respectively. The computerized EEG-analysis was thus clearly superior to the usual visual inspection. PMID- 3976239 TI - [Micturition disorders in multiple sclerosis]. AB - 103 patients with multiple sclerosis (MS) were investigated, of which 53% complained of micturition difficulties. Since these symptoms frequently are the main cause for social withdrawal of the multiple sclerosis patient, the investigation and therapy of micturition dysfunction should play a central role in the management of these patients. PMID- 3976240 TI - [Psychosocial aspects of multiple sclerosis--course and coping with a chronic disease]. AB - The analysis was elaborated in an epidemiological area. 92 patients with multiple sclerosis were researched and interviewed under biographical and psychosocial aspects. The most limiting factor in the organic view was the motoric deficit provoking negative social coping of the disease. The family members usually supported their patient in coming out with the different handicaps; but psychosocial disturbances often were to be seen. Only one third of the patients held their job or were managing the household. One half of the sample suffered on pathological coping with the disease, showed signs of isolation and resignation. A quarter of them lived in psychosocial extrem conditions. A sufficient income had nearly half of the patients. The medical care was optimal in all cases. For women a help in the household often failed. The study enlighted the necessity of a therapeutic program involving a normalisation of the disease. PMID- 3976241 TI - [Pathology and pathogenesis of multiple sclerosis from the viewpoint of neurologic disease research]. AB - The pathology of multiple sclerosis (MS) is characterized by the trias: inflammation, primary demyelination and reactive gliosis. However, besides these obligatory alterations a high inter- and intraindividual variability of structural aspects is found in MS lesions. Recent experimental studies in a model disease for MS, in chronic relapsing experimental allergic encephalomyelitis, provide a better understanding of the dynamics of lesions development in MS brains. PMID- 3976242 TI - [Clinical findings in multiple sclerosis]. AB - The mean interval between first and last clinical interview in 170 patients with multiple sclerosis was 8.8 years. The main initial symptoms were sensory disturbances and paresis of the cranial nerves. An uncharacteristic symptomatology was found in 6%, psychiatric symptoms in 6%. In the last investigation psychiatric symptoms were found in 2%, uncharacteristic symptoms were seen in 4%. A normal neurological status was found in 9%. Apart from the clinical well defined typical MS patient, also benign forms of the diseases have been found. PMID- 3976243 TI - Child abuse and neglect. PMID- 3976244 TI - A case of listeriosis in Bayfield County. PMID- 3976245 TI - Epidemic typhus acquired in Wisconsin. PMID- 3976246 TI - Is high too low? A commentary by the Wisconsin State High Blood Pressure Advisory Committee. PMID- 3976247 TI - [Interpretation of a vitality model from the clinico-experimental viewpoint]. AB - The vitality model conceived by Beier from a theoretical point of view is corroborated by clinical and experimental investigations of the authors. From a randomized study on the biological age of a statistically representative population group it can be concluded that the speed of ageing of this group is not linear in its course and hardly displays any differences between the sexes. Besides, distinct selection effects in advanced age suggest that the human population might consist of two sub-populations (the potentially long-lived and the potentially short-lived) who differ from one another with regard to the speed of ageing, morbidity and to the duration of life. Furthermore, similarities of the sex-specific change in vitality as occurs in the course of life, and the significance of this change for a possible reduction of male over-mortality are pointed out. PMID- 3976248 TI - [Use of the labyrinth test in gerontologic functional diagnosis]. AB - The authors inform on the basic application possibilities of the labyrinth-test in gerontological functional diagnoses. They are able to refer to experiences gained from their investigations with 365 subjects from 18 to 75 years of age (197 female, 168 male ones). They recommend this psychological procedure as a practicable and economical method to assess age-dynamics of over-lapping sub aspects of intelligence (orientational capacity, transitional ability, problem solutional attitude, memory performance). PMID- 3976249 TI - [Social medicine sequelae of femoral fractures near the hip in elderly patients]. AB - On the basis of uni- and multivariant statistic analyses on 1700 old-age patients suffering from hip-joint near femur fractures, socio-medical initial and final parameters of treatment are shown the correlations between the quality of osteosynthesis, psycho-physical ability to walk at the time of discharge and subjective assessment of the personal living circumstances being pointed to. With the help of a long-term study covering a period of 13 years after the accident, it is established that the further posttraumatic life expectancy of old people decidedly depends on the development of their ability to walk after their discharge from the hospital. PMID- 3976250 TI - [Morphometric findings of a peculiarity in the aging of the lymphatic system]. AB - The size of sections of lymph follicles in the pharyngeal tonsils of sixty-four children and juveniles between two and twenty-one years of age was determined histomorphometrically. The measurements were followed by linear regression and correlation analyses and determinations of mean differences by Student's t-test. It was possible to show that lymph follicles start decreasing in size already from the third year of life onward. Moreover, lymph follicle size decreases with the frequency of infections, and there is a positive correlation between the histomorphometrically determinable follicle size and the macroscopic size of the organ. PMID- 3976252 TI - [Diabetes mellitus in advanced age. 5: Longevity of senile diabetes patients examined in the Neustrelitz district 1962/63]. AB - For all diabetics who were discovered in the Neustrelitz District in 1962/63 and who were aged between 62 and 81 when the disease manifested itself, reduction of expectation of life as compared with an age- and sex-adapted normal population could be calculated within the frame of a mortality follow-up. For the 62- to under 65-year-olds reduction in lifespan was 6.8 years; for the 65- to under 70 year-olds it was 5.6 years; for the 70- to under 75-year-old it was 4.1 years, and it was still detectable even in the group of the very old (75-81 years; 2.5 years). Only 15.6 per cent of the patients still reached, or even surpassed, a normal further expectation of life after the disease had become manifest. The much favourable prognosis established by renowned representatives of social medicine according to which the expectation of life of diabetics in the GDR corresponds to that of non-diabetics could not be confirmed by us. PMID- 3976251 TI - Study of blood lipid content and occurrence of hyperlipoproteinemias in hypertensive patients of various age. AB - The level of serum lipids and HLP occurrence were investigated in apparently healthy subjects and in patients with arterial hypertension (essential and systolic forms) aged 20-30, 60-74 and 75-89 years. The increase of total cholesterol and atherogeneity coefficient, HLP occurrence and decrease of alpha cholesterol content were noted in the control group during aging. The essential hypertension is accompanied by the increased HLP occurrence mainly in 20-30 and 60-74 year-old patients, as compared with the corresponding control groups. The content of serum lipids and HLP occurrence were found to be higher in 75-89-year old patients within systolic hypertension group. PMID- 3976253 TI - [Evaluation of social activity in aging using the Leningrad Assessment Scale]. AB - Some results are presented on social activities of a group of subjects living in the City of Leipzig, selected at random from its population. There are some interesting sex differences as well as a revealing age characteristic/concerning/their social engagement. The authors describe a psycho social measurement procedure (Leningrad Assessment Scale) which has shown to be useful-as well from its practicability as its test-theoretical capacities-to register reliable data on social activities in professional and family's every day-life as in leisure-time areas. PMID- 3976255 TI - [Experimental sleep induction: controlled acceleration of falling asleep and delay of falling asleep by monotone acoustic stimulation]. PMID- 3976254 TI - [Problems in the definition of biologic aging--methodologic and method positions]. AB - The author presents the actual cognitive-theoretical and methodological positions for the assessment of the biological age, reviewing the most essential contents and usual definitions of this term. She points, furthermore, to the methodical and interpretational conclusions (selection and evaluation of age-indicators) resulting from the actual theoretical level of knowledge for corresponding diagnostical procedures. PMID- 3976256 TI - [Value of the levels of processing approach--text learning in an age cross section of psychotic patients and normal probands]. PMID- 3976257 TI - [Aftereffect of longer fixations on distance perception: an evaluation of motor interpretations]. PMID- 3976258 TI - [Acoustic discrimination in musical and non-musical persons]. PMID- 3976259 TI - [Heart and skeletal muscle scintigraphy with thallium 201]. AB - The regional uptake of Thallium-201 is correlated with the regional distribution of cardiac output in the myocardium as well as in skeletal muscle. Thallium-201 perfusion scans will detect peripheral occlusive arterial disease (POAD) as well as coronary heart disease (CHD). In a prospective study we examined POAD patients and CHD patients by both myocardial and leg stress scintigraphy. In normals the uptake ratio of both calves was 1.03 +/- 0.05 (mean +/- SD), while in all patients with proven POAD the ratio was higher than 1.2. In 12 of 16 patients with myocardial infarction the high ratio indicated a coincidence of POAD and CAD, confirmed by other techniques in all but one patient. In patients with suspected CHD there was an increased ratio in 8 of 21;6 of these patients also had an abnormal myocardial stress scan, while there were only 4 abnormal scans in the 13 patients with normal leg uptake. In 19 of 26 patients with known POAD the myocardial stress scan was abnormal, indicating CHD in 75% of this group. This was confirmed in most patients by coronary angiography. The combination of myocardial and leg stress scan can be carried out without further radiation exposure to the patient and in a few minutes. It is a new approach to determine the possible coincidence between POAD and CHD; it should be performed in all patients referred for TI-201 myocardial stress scintigraphy. PMID- 3976261 TI - [Familial occurrence of cardiac myxomas]. AB - A report is given on the occurrence of left atrial myxoma in both mother and daughter. A successful operation for a local recurrence was performed on the mother 4 years later. Sudden death of unknown cause occurred at young age in other siblings and was accompanied in one by arterial embolism, suggesting an even higher incidence. The potential accumulation of cardiac myxomas in a family was confirmed by a literature survey of 8 "myxoma families". Observation of these cases calls for the following Careful surgical excision because of the danger of a local recurrence. Echocardiographic follow-up for at least 5 years. Investigation of relatives. PMID- 3976260 TI - [Doppler sonographic determination of the degree of severity of mitral valve stenoses]. AB - Using combined two-dimensional echocardiography and Doppler technique in 30 patients with pure mitral valve stenosis or combined valve disease with prevailing mitral stenosis, the mitral valve area and diastolic pressure gradient were determined, and compared to the invasively recorded values obtained during heart catheterization. Four patients were examined by Doppler ultrasound before and after mitral valve replacement. The determination of the mitral valve area was performed 1) invasively by means of the formula derived by Gorlin (and measured between 0.5 and 2.9 cm2), 2) by means of planimetry by integration of the two-dimensional echo in the short-axis view (between 0.7 and 2.8 cm2), and 3) by Doppler ultrasound based on the formula 220/t1/2, whereby the pressure half time was obtained by dividing maximum flow velocity by square root 2. Here, the mitral valve area was between 0.5 and 2.8 cm2. The correlation between values obtained invasively and by means of Doppler ultrasound was good (r = 0.86), and compared well to the correlation between two-dimensional echocardiography and heart catheterization (r = 0.88). The best correlation of r = 0.89 was found between the mitral valve areas obtained by Doppler ultrasound and two-dimensional echocardiography. The diastolic pressure gradient was calculated by means of the formula derived from the Bernoulli equation, which is: delta P = 4Vmax2, whereby Vmax equals the maximum transmitral flow velocity. The invasively measured pressure gradients were between 2 and 30 mm Hg, the values obtained by Doppler ultrasound were between 6 and 29 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976262 TI - [Hormonal growth control and its justification. II. Limits of psychological indication]. PMID- 3976263 TI - [Body height determination of male individuals using femoral, tibial and humeral fragments]. PMID- 3976264 TI - [A deductive model of historic anthropology. Contribution to an ecosystemic interpretation]. PMID- 3976266 TI - Casual observations on the philtrum of the lowland gorilla. PMID- 3976265 TI - [Human remains from the Coupe-Gorge cavern at Montmaurin (High Garonne)]. PMID- 3976267 TI - Retired. Return to sender. PMID- 3976268 TI - Management of gastric polyps: case reports. PMID- 3976269 TI - Somatopsychic aspects of medicated Addison's disease: case report. PMID- 3976270 TI - Boxing: the intent is wrong. PMID- 3976271 TI - Medicine and the law. Review panels in Virginia 1972-1982. PMID- 3976272 TI - Glutaraldehyde-processed human veins as small vessel substitutes. PMID- 3976273 TI - [Metabolic changes in muscle and blood caused by ergometric stress in chronic arterial occlusive disease (I)]. PMID- 3976274 TI - [Muscle metabolism and blood circulation under ergometric stress in arterial occlusive disease (II)]. PMID- 3976275 TI - Circulating platelet aggregates in patients with coronary heart disease and lower limb ischaemia. PMID- 3976277 TI - Thoracic outlet syndrome: treatment of vascular complications. PMID- 3976276 TI - [Diagnosis of thromboangiitis obliterans (Winiwarter-Buerger disease) by detection of anti-elastin antibodies]. PMID- 3976278 TI - [Endoscopic subfascial discussion of perforating veins--preliminary report]. PMID- 3976280 TI - Constriction of varicose veins and improvement of venous pumping by dihydroergotamine. PMID- 3976279 TI - [Antibiotic prevention in vascular surgery]. PMID- 3976281 TI - [Postthrombotic status and its modification by dihydroergotamine]. PMID- 3976283 TI - [Problems with current enzyme tests]. PMID- 3976282 TI - [Roentgen aspect of the left superior intercostal vein]. PMID- 3976284 TI - [Experimental substantiation of the clinical use of the enzymatic blood preparation, ceruloplasmin]. PMID- 3976285 TI - [Reactivity, safety and immunogenicity of trivalent subunit highly purified 'Grippovak SE-AZh' influenza vaccine tested on young children in children's homes in Moscow]. PMID- 3976286 TI - [Thymidine kinase activity and its isoenzymes in breast tumors]. PMID- 3976287 TI - [Modified effect of the induction of the mixed function oxidase system on the cytogenetic action of cyclophosphamide]. PMID- 3976289 TI - [Diagnosis of paraneoplastic dermatoses]. PMID- 3976288 TI - [Electron microscopic and histochemical research on lysosomes and acid phosphatase of epithelial cells of the normal oral mucosa and in lichen ruber planus]. PMID- 3976290 TI - [Classification and clinical uniqueness of chronic generalized (granulomatous) candidiasis]. PMID- 3976291 TI - [New data on the membrane ultrastructure of Trichophyton rubrum]. PMID- 3976292 TI - [Ultrastructure of the microcirculatory bed of the vascular layer of human dermis]. PMID- 3976293 TI - [Practical results of modeling the dynamics of syphilis morbidity]. PMID- 3976294 TI - [Assessment of the incidence of psoriasis based on data from office visits and medical examinations]. PMID- 3976295 TI - [Catamnesis of vitiligo patients]. PMID- 3976296 TI - [Acquired epidermolysis bullosa combined with thrombocytopenia]. PMID- 3976297 TI - [Photochemotherapy combined with low-dose methotrexate in severe forms of psoriasis]. PMID- 3976298 TI - [Early symptoms of Pringle-Bourneville disease]. PMID- 3976299 TI - [Pseudomonas paronychia and onychia]. PMID- 3976300 TI - [Skin lesion in trichomoniasis]. PMID- 3976302 TI - [Histamine and serotonin participation in the genesis of diseases with connective and epithelial tissue lesions]. PMID- 3976303 TI - [Determination of chloramphenicol with electrochemical detection]. AB - The simple conditions of a reductive electrochemical detection are described, which allows to determine the content of chloramphenicol (CAP) in trout down to 0.5 micrograms/kg. PMID- 3976301 TI - [Syphilitic aortic aneurysm]. PMID- 3976304 TI - [Etiology and pathogenesis of congenital physical and mental handicaps]. AB - Two to five percent of newborn infants present with congenital structural defects. This incidence contains mostly rare to extremely rare conditions. Aetiologically, these consist of defects secondary to genetic and environmental causes, with a third group of defects which are presumed to be due to an unfavorable combination of genetic and environmental factors. In many individual patients, however, allocation into one of these groups is difficult or even impossible. The following clinical and epidemiologic observations may help in some cases to arrive at a classification; pedigree, pregnancy history (infections, teratogens, bleeding, foetal movements etc.), clinical picture and various complementary investigations. Pathogenetically, we may classify congenital structural defects into primary defects (malformations) and secondary ones, if a primarily correctly formed structure has secondarily been deformed (deformation) or destroyed (disruption). In many cases, these clinical observations will then allow a classification into one of the groups. The importance of the determination of the aetiology and pathogenesis of structural defects for the individual family is in the subsequent implications for determination of the risk of recurrence. PMID- 3976305 TI - [Individual and familial characteristics in the etiology of cancer: epidemiologic approach]. AB - The present report discusses the main constraints influencing the choice in the method in the epidemiological approach of host factors and family factors. It briefly describes 3 of the usual methods in this field, i.e. the migrant studies, the twin studies and the family studies. The practical problems and the conceptual limitations met by each of these 3 methods are reviewed. A brief review of the literature provides an opportunity for examining the main misunderstandings between geneticists and epidemiologists in their study of human groups when analysing the role of such factors in the etiology of cancer. PMID- 3976306 TI - [Industrial hygiene: dusts and fibers as hazards in the industrial milieu]. PMID- 3976307 TI - [Indications for antirefluxplasty in childhood]. AB - By own experiences on 336 children, 212 of whom were operated on, and a critical review of the relevant literature, the indication to the antireflux plastic in childhood is derived. It is tried to establish certain principles which shall facilitate the treatment. It is referred to the extraordinarily complex character of the diagnosis and the individual techniques are valuated. PMID- 3976308 TI - [Chronic prostatitis]. AB - By own experiences on 2,850 patients with chronic prostatitis the problems of classification, diagnosis and therapy are demonstrated. In clinical practice should be most exactly differentiated between a chronic prostatitis and a neuro vegetative prostatopathy. The prostatitis itself can be subdivided into a bacterial and abacterial one. Symptoms, diagnostics and therapy of these two different form of prostatitis are demonstrated. PMID- 3976310 TI - [Migration and distribution of Toxocara canis Werner 1782 (Anisakidae) larvae in the definitive host (beagle) following primary infection and reinfection]. PMID- 3976309 TI - [Results of immunosuppressive therapy of chronic glomerulonephritis in 400 patients]. AB - For the judgment of the success of the immunosuppressive therapy of chronic glomerulonephritis 400 patients (242 males and 158 females) at an average age of 31.2 years were examined after an average duration of treatment of 31.9 months. Apart from the renal function (serum creatinine), the histological and immunohistological form of the glomerulonephritis for the valuation further clinico-paraclinical data were taken into consideration: proteinuria, nephrotic syndrome, arterial hypertension and the combination of nephrotic syndrome and arterial hypertension. At the beginning of the treatment 293 of 400 patients (73.2%) had a normal renal function, 107 of 400 patients (26.8%) were initially renal-insufficient. 16 of 400 patients (4.0%) had additionally a pyelonephritis and 12 of 400 patients (3.0%) had a lupus nephritis. 27 of 400 patients (6.9%) developed a terminal renal insufficiency after an average duration of observation of 40.5 months. Complications caused by therapy were registered in 104 of 400 patients (26.0%). Recommendations for the present therapy of chronic glomerulonephritis are formulated. PMID- 3976311 TI - [Isolation of Campylobacter jejuni and Campylobacter coli in fecal samples of healthy slaughter swine depending on the season]. PMID- 3976313 TI - Metacercariae of Diplostomum spathaceum in freshwater fish of the lake system Koronia and Volvi (Macedonia, Greece). PMID- 3976312 TI - The isolation of organisms resembling rickettsiae from respiratory tracts of horses. PMID- 3976314 TI - Isolation of Acinetobacter calcoaceticus from a cow with mastitis. PMID- 3976315 TI - Occurrence of VHS virus in wild white fish (Coregonus sp.). PMID- 3976317 TI - Education for leadership in anaesthesiology. The sixteenth Husfeldt lecture, Copenhagen, 11 May, 1984. AB - A description of the genesis of the Anaesthesiology Centre in Copenhagen after World War II is presented. The major contribution of Professor Husfeldt in organizing is described. The need for leadership in anaesthesiology is discussed in detail. The characteristics of leadership and leaders are presented, and their importance in the future development of anaesthesiology is pointed out. PMID- 3976316 TI - Coronary haemodynamic effects of surgery during enflurane-nitrous oxide anaesthesia in patients with ischaemic heart disease. AB - The systemic and coronary haemodynamic effects of 1.5 MAC enflurane-nitrous oxide anaesthesia and abdominal surgery were investigated in nine patients with ischaemic heart disease. Anaesthesia decreased systemic blood pressure (-56%) by a combination of cardiodepression and peripheral vasodilation. A marked fall in myocardial oxygen extraction suggested a moderate coronary vasodilation. Surgery markedly increased the circulating levels of adrenaline and noradrenaline, manifested by increases in blood pressure (+76%) and systemic vascular resistance (+83%). Pulmonary capillary wedge pressure increased by 70% without any change in cardiac or stroke volume index, suggesting that the patients were performing at the horizontal part of their left ventricular function curve. Despite the marked rise in coronary perfusion pressure and a 62% increase in myocardial oxygen demand, coronary blood flow remained unaltered. This could be due either to coronary vasoconstriction overriding the normal coronary autoregulation or to an increase in coronary back pressure opposing the diastolic aortic pressure. When coronary blood flow could not increase to meet the demand for oxygen, the myocardium had to extract more oxygen to ensure appropriate oxygenation, demonstrating interference with coronary autoregulation. Surgery markedly increased myocardial extraction of adrenaline and noradrenaline. We could not find any relationship between myocardial adrenaline extraction and heart rate response to surgery or between myocardial noradrenaline extraction and changes in coronary blood flow, calculated coronary vascular resistance, incidence of myocardial ischaemia or cardiac dysrhythmias. PMID- 3976318 TI - A method for epiduroscopy and spinaloscopy. Presentation of preliminary results. AB - A method for endoscopic observation of the epidural space, epiduroscopy, and the subarachnoid space, spinaloscopy, in the lumbar region is described using the Olympus Selfoscope SES 1711 S. The preliminary results of 30 consecutive attempts at epiduroscopy on randomly chosen autopsy cases, with 28 successes, are presented. Five spinaloscopies were performed on the same material. The results justify the conclusion that epiduroscopy and spinaloscopy are methods that can be used for study of individual variation of the contents of the lumbar epidural and subarachnoid spaces. PMID- 3976319 TI - Circulatory shock following intravenous propoxyphene poisoning. An experimental study of cardiac function and metabolism in pentobarbital-anesthetized pigs. AB - The effects of continuously administered intravenous propoxyphene chloride (15 mg X min-1) on ECG, systemic, pulmonary and coronary circulations and myocardial oxygenation were investigated in eight pentobarbital-anesthetized pigs. Circulatory shock, defined as a systolic blood pressure below 60 mmHg (8.0 kPa) and a cardiac output of approximately 2.0 l X min-1 X m-2, occurred after 675 to 2025 mg propoxyphene chloride. At the time when shock occurred plasma concentrations of propoxyphene ranged from 9.6 to 15.3 micrograms X ml-1 which is within the range of the lethal concentration observed in man. Statistically significant decreases were observed for the following variables: maximum rate of rise of left ventricular pressure dP/dt (-90%), mean arterial pressure (-73%), heart rate (-46%), cardiac index (-58%), stroke volume index (-22%), left ventricular stroke work index (-85%), right ventricular stroke work index (-63%) and systemic vascular resistance (-50%). Mean pulmonary arteriolar occlusion pressure increased (+42%), whereas mean right atrial pressure and pulmonary vascular resistance remained unchanged. The arteriovenous oxygen difference increased (+53%) and total body oxygen consumption decreased (-35%). The following coronary variables decreased: coronary sinus blood flow (-57%), coronary vascular resistance (-65%), myocardial oxygen consumption (-68%), myocardial oxygen extraction (-26%) and myocardial lactate extraction (-28%). Prolongation of the ECG PQ and QRS intervals were recorded shortly before shock appeared, and all animals were in sinus rhythm till the last minute before death. The results indicate that intravenously administered propoxyphene besides being a powerful negative inotropic and chronotropic agent, is also a potent systemic and coronary vasodilator. PMID- 3976320 TI - Effects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients. AB - Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. In the general anaesthesia group, there was a rise in either systolic or diastolic arterial pressure of over 30% of the control value in 8/15 patients. In the spinal anaesthesia patients, there was a transient rise above 30% in only one patient out of 15 and no rise in the 15 epidural group patients. On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated. PMID- 3976321 TI - Epidural morphine for postoperative pain: experience with 1085 patients. AB - A prospective study of the effect and side-effects of epidural morphine for pain relief in 1085 patients after thoracic, abdominal, urologic, or orthopaedic surgery was performed. Morphine chloride was diluted in saline or bupivacaine and administered through an epidural catheter placed at a segmental level appropriate for the type of surgery. The initial dose was 4 or 6 mg morphine and supplementary doses were given when needed to obtain complete freedom from pain during deep breathing or nursing care. The total dose of epidural morphine from end of surgery until the next morning varied from 4 to 18 mg. 97% of hip arthroplasty patients, 91% of prostatectomy patients and thoracotomy patients, 90% of patients after major lower extremity surgery and 88% of patients after laparotomy were completely satisfied with the postoperative course. For hip arthroplasty and major extremity surgery, an initial dose of 4 mg of epidural morphine was as effective as 6 mg. After prostatectomy, laparotomy, and thoracotomy, an initial dose of 6 mg gave significantly better effect than 4 mg. Pruritus occurred in 11%, nausea or vomiting in 34%, and respiratory depression in 0.9% of the total patient population. Urinary retention occurred in 42% of patients not having urinary catheters in place. Postoperative nausea or vomiting was more frequent in women than in men (P less than 0.001). There was a higher incidence of nausea or vomiting in men experiencing pain than in men who were completely pain-free after abdominal surgery (P less than 0.001). Respiratory depression was rare and occurred as a gradually decreasing respiratory rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976322 TI - Effect of anaesthesia on respiratory function after major lower extremity surgery. A comparison between bupivacaine spinal analgesia with low-dose morphine and general anaesthesia. AB - Postoperative pulmonary function was studied in 16 patients undergoing total hip or knee arthroplasty. Their mean age was 65 years. Half of them received spinal analgesia (22.5 mg bupivacaine + 0.3 mg morphine) and the other half underwent general anaesthesia with halothane-nitrous oxide. Four hours postoperatively, the forced expirogram was maintained in the spinal analgesia group, compared with preanaesthesia measurements. Functional residual capacity (FRC) measured by multiple breath nitrogen washout was reduced by 0.51, as was closing capacity (CC) measured by the bolus technique. The gas distribution index (nitrogen washout delay) was unaltered. The alveolar-arterial oxygen tension difference (PA ao2) was not significantly altered, but arterial oxygen tension (Pao2) was reduced by 1.7 kPa, and arterial carbon dioxide tension (PaCo2) was increased. No respiratory measurements could be made in the general anaesthesia group 4 h postoperatively, but arterial blood gases were unaltered compared with preanaesthesia values. Eighteen hours postoperatively, forced vital capacity (FVC) was reduced in the spinal analgesia group, FRC and CC remained diminished and the gas distribution index was increased, indicating less efficient gas mixing. Simultaneously, PA-ao2 was increased, and Pao2 remained reduced despite increased alveolar ventilation (lowered PaCo2). In the general anaesthesia group FVC, FRC and CC were also reduced, but the gas distribution index remained at the awake level and blood gases were unaltered. It is suggested that the slight hypoventilation in the spinal analgesia group early after surgery may have contributed to impaired gas distribution and ventilation-perfusion matching later postoperatively. PMID- 3976323 TI - Skin conductance responses during spinal analgesia. AB - Skin conductance responses (SCR, "sympatho-galvanic reflex") were measured before and during spinal analgesia in 17 patients scheduled for transurethral surgery. Responses were provoked by standardized electrical stimulation over the clavicle opposite to the recording side; alternatively, a short deep breath, pinching, verbal stimuli or sharp sounds were used. Measuring sites (two electrodes 6 cm apart) were the hand, levels T5, T9, T12-L1 and the foot. Spinal analgesia reached a median cephalad level of T4 (mean T4, range +/- 3 segments) 20-25 min after injection. SCR was markedly depressed in the foot in 15 of 17 patients, at T12-L1 in 12 of 17, at T9 in 10 of 17, at T5 in 9 of 16 and in the hand in 6 of 17. Total abolition of the SCR in the foot was accomplished in only seven cases and sympathetic activity reappeared long before regression of analgesia or motor blockade was observed. In four cases of five with an analgesic level T1-T2, the SCR was preserved in the hand. No consistent correlation between blood pressure change and SCR-change was seen. The conclusion from this study is that preganglionic sympathetic B-fibres are more difficult to block than A-fibres during spinal analgesia. The duration of sympathetic blockade was far shorter than analgesia and motor blockade. Thus, sympathetic blockade during spinal analgesia seems to be far less extensive than that described in the literature. PMID- 3976325 TI - A comparison of bupivacaine and tetracaine in spinal anaesthesia with special reference to motor block. AB - Thirty-six patients received spinal anesthesia with either glucose-free bupivacaine (22.5 mg) or glucose-containing solutions of bupivacaine (20 mg) or tetracaine (15 mg). The duration of analgesia in the lower thoracic and lumbar segments was significantly longer with glucose-free bupivacaine than with the other solutions. Using a quantitative method for measuring muscle strength, the motor block was recorded for three types of movements: hip flexion, knee extension and plantar flexion of the big toe. Movements of the lower part of the thoracic cage were recorded at the same time. The length of time from spinal injection to complete motor block was short and without notable difference between all three groups. Regression of the motor block tended to start earlier for hip flexion and knee extension than for plantar flexion of the big toe. For all three movements the regression of the motor block began significantly later in the glucose-free bupivacaine group than in the other groups. During the regression phase, muscle strength returned significantly later in the glucose free bupivacaine group than in the bupivacaine group containing glucose and knee extension returned significantly later in the glucose-free bupivacaine group than in the tetracaine group. No difference in motor block was found between the hyperbaric solutions of bupivacaine and tetracaine. For hip flexion (L1-L3), there was no noteworthy difference between the level of analgesia and the motor block segments, whereas for plantar flexion of the big toe (L5-S2) the level of analgesia lay 2-3 segments higher than the motor block segments. In seven patients, during spinal anaesthesia there was a reduction in respiratory deflections corresponding to the lower thorax.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976324 TI - A new method for measuring motor block in the lower extremities. AB - A method for determining muscle strength in the lower extremities was developed and its clinical application evaluated in ten elderly, healthy subjects, and also subsequently in one of them during spinal anaesthesia. With the subject lying in the lithotomy position on a modified operating table, muscle strength measurements were made during flexion of the hip, extension of the knee and plantar flexion of the big toe. The electromechanical performance of the apparatus was stable, and the maximum measurement errors observed at loads of 245 and 49 N were 4 and 11% of the deflections, respectively. The subjects underwent repeated muscle strength measurements during a 4-h period without any difficulty. No signs of muscular fatigue were observed. The variation of the measured isometric muscle strength was small and the average coefficient of variation roughly 10%. In the patient receiving spinal anaesthesia, the degree of motor block was determined, and the results are presented graphically. This new method for evaluation of motor block in the lower extremities is a reliable quantitative method for bilateral, three-joint muscle strength measurements, which is also applicable during regional anaesthesia. PMID- 3976326 TI - Adrenergic hyperactivity and epidural block in severe tetanus. A case report. AB - In a 69-year-old man with severe tetanus, sympatho-adrenal overactivity was successfully treated with a lumbar epidural block. Cardiovascular disturbances were reduced and fluctuations in plasma catecholamines were decreased. The duration of other manifestations of tetanus was, however, not influenced by the epidural block in this case. PMID- 3976327 TI - Cardiovascular studies during controlled baroreflex activation in the dog: I. Effects of enflurane. AB - In chloralose-anaesthetized dogs the carotid sinuses were bilaterally perfused with blood from a femoral artery, either at systemic arterial pressure through a direct by-pass or with a pump in order to control the sinus pressure. Influences from cardiac receptors and aortic baroreceptors were eliminated by denervation. Administration of enflurane (1.6% end-tidal concentration) with the presence of barostatic modulation, i.e. the carotid sinuses were perfused at prevailing systemic arterial pressure, reduced cardiac performance (cardiac output, cardiac contractility, heart rate and left ventricular stroke work) and mean arterial pressure. When barostatic compensation of enflurane-induced circulatory changes was prevented by maintaining sinus perfusion pressure constant at the pre enflurane level, these haemodynamic alterations, with the exception of cardiac output, were significantly more pronounced. Furthermore, systemic vascular resistance decreased. We conclude that barostatic reflexes significantly modify cardiovascular depressive effects of enflurane. PMID- 3976328 TI - Maternal haemodynamic changes during caesarean section: a comparison of epidural and general anaesthesia. AB - Haemodynamic measurements were performed on 20 healthy women before and during elective caesarean section under epidural (10 women) or general anaesthesia (10 women). The influence of the two anaesthetic techniques on the haemodynamic changes associated with operative delivery was compared. The following haemodynamic variables were studied: cardiac output (CO), stroke volume (SV) determined non-invasively with impedance cardiography, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure, mean arterial pressure (MAP) and total peripheral vascular resistance (TPR). During epidural anaesthesia, SV was largely unchanged before delivery but increased (P less than 0.05) following delivery. However, CO increased (P less than 0.05) prior to delivery due to an increase (P less than 0.01) in HR. A further increase (P less than 0.05) in CO was recorded following delivery. SBP, DBP, MAP and TPR decreased (P less than 0.01) during epidural anaesthesia. In the patients undergoing general anaesthesia, SV decreased (P less than 0.05) prior to delivery. However, CO remained largely unchanged due to an increase (P less than 0.01) in HR. Following delivery, CO (P less than 0.05) and SV (P less than 0.01) increased whereas HR decreased (P less than 0.01). SBP, DBP and MAP increased (P less than 0.01) prior to delivery, returning to the same level as prior to induction of anaesthesia following delivery. TPR was largely unchanged prior to delivery but decreased (P less than 0.01) following delivery. PMID- 3976329 TI - Caudal or dorsal nerve block? A comparison of two local anaesthetic techniques for postoperative analgesia following day case circumcision. AB - Fifty boys presenting for day case circumcision were allocated randomly to receive either caudal analgesia or dorsal nerve block (DNB) to provide postoperative pain relief. Analgesia was assessed by a single, unbiased observer utilising a three-point scale. Subsequently, parents completed a simple questionnaire. Subjects in the DNB group micturated earlier (P less than 0.05) and stood unaided earlier (P less than 0.025) than patients in the caudal group. The incidence of vomiting was significantly lower in the DNB group (P less than 0.05). There was no significant difference in the duration of analgesia, although that produced in the DNB group tended to wane sooner. It is concluded that DNB provides satisfactory analgesia following circumcision and has specific advantages when compared with caudal analgesia. PMID- 3976330 TI - Sublingual buprenorphine for premedication and postoperative pain relief in orthopaedic surgery. AB - The effect of sublingual buprenorphine (Temgesic) as a premedicant and for postoperative pain relief compared with morphine/pethidine was studied in 50 patients scheduled for elective surgery of the knee joint. Twenty-five patients received buprenorphine 0.4 mg sublingually 1 h before surgery and the same dose on demand postoperatively. Twenty-five patients were given morphine intramuscularly (7.5 mg or 10 mg to females and males respectively) 1 h preoperatively. This group received pethidine (75 mg) intramuscularly on demand postoperatively. All the patients were anaesthetized with halothane N2O/O2 after induction with thiopentone. No significant differences were found with regard to sedation, dizziness, nausea and vomiting during the study period. Emergence shivering, confusion and restlessness just after termination of the operation were equal in the two groups. In the recovery room, however, there was a higher frequency of shivering (P less than 0.05) in the morphine group. During the first 24 h postoperatively the buprenorphine group was given an average of 3.8 doses compared with 2.3 in the pethidine group (P greater than 0.05). It is concluded, that buprenorphine sublingually is as good as morphine intramuscularly for premedication and therefore should be recommended to patients who wish to avoid injections. For postoperative pain relief the initial dose of buprenorphine should be given intravenously. Only minor and unimportant side effects were seen. PMID- 3976331 TI - Effect of postoperative extradural morphine on lower urinary tract function. AB - The effect of postoperative extradurally administered morphine on lower urinary tract function was studied in female patients undergoing uterine surgery. Urodynamic measurements were made on the day before and on the day after the operation, using a DISA 2-channel carbon dioxide (CO2) cystomictrograph. In ten patients without postoperative urinary retention no changes in cystometry were found during morphine administration, while two patients who developed acute urinary retention had a marked increase in bladder capacity and of detrusor pressure. In contrast, the urethral pressure profile was unchanged in both groups of patients. Intravenously administered naloxone tended to normalize the bladder capacity in the patients with urinary retention. These findings seem to indicate a marked effect in some patients of extradurally administered morphine and the acute urinary retention, following morphine administration, may be treated with naloxone. PMID- 3976332 TI - Postoperative respiratory complications in non-idiopathic scoliosis. AB - The medical records of 303 patients undergoing fusions for scoliosis correction were retrospectively reviewed. The frequency and type of postoperative respiratory complications were compared in idiopathic versus non-idiopathic scoliosis patients in relation to age, type of spinal fusion procedure, pulmonary function test (PFT) results and preoperative diagnoses. The following factors were found to increase the incidence of problems in the postoperative period: a non-idiopathic type of scoliosis, mental retardation, anterior spinal fusion procedures, age of 20 or more years, a relative arterial hypoxemia and an obstructive component to the PFT's. Topics for further investigation are suggested. PMID- 3976333 TI - Analysis of 13 800 subclavian vein catheterizations. AB - During the period 1974-1983, 13 857 subclavian or internal jugular vein catheterizations were analysed in the same hospital. The data on the catheterizations have been collected prospectively in the hospital computer. In 93% of the cases, catheterization was subclavian vein cannulation performed through the infraclavicular route. In 15% of the cases the catheter position was not ideal, verified with x-ray; e.g. the catheter tip was turned into the internal jugular vein. Of the catheters 70% were kept in place for less than 7 days, and only 6% for over 2 weeks. More than one catheterization was required in 26% of the cases during the same hospitalization. Recatheterization is an important prophylactic measure for preventing septic complications, if suspicion of infection arises. In 5% of the cases, some complications occurred, but they were mostly minor, such as haematoma at the puncture site. More serious complications were 19 pneumothoraces (0.1%). The results suggest that subclavian vein catheterization is a fairly safe method for large-scale use in a hospital, if only a limited group of physicians perform it. Certain precautions should, however, be taken. PMID- 3976334 TI - Nitrous oxide exposure during routine anaesthetic work. Measurement of biologic exposure from urine samples and technical exposure by bag sampling. AB - Nitrous oxide exposure in a modern hospital during routine anaesthetic work was measured using a technical exposure measurement technique and compared to measurement of biologic exposure from urine samples. The study included different anaesthetic situations and also a study of the efficiency of close scavenging and general air-conditioning in reducing nitrous oxide exposure. Exposure to nitrous oxide varied greatly. The mean nitrous oxide exposure in the total material was 53 ppm corresponding to approximately half the Swedish control limit (100 ppm) for 8 h time-weighted average (TWA). The only anaesthetic situation regularly resulting in 8 h TWA exposure exceeding the control limit was paediatric anaesthesia (92 +/- 67 ppm, mean +/- s.d.). The use of close scavenging significantly reduced the 8 h TWA nitrous oxide exposure in paediatric anaesthesia. The reduction of exposure was not significant during other forms of anaesthesia where low levels were found when anaesthetic equipment with excess gas scavenging was used in theatres with non-recirculating air-conditioning. The correlation between conventional technical exposure measurement and urine headspace nitrous oxide measurement was good. Both theoretical arguments and practical experience indicate that this method can be used for assessing nitrous oxide exposure during routine anaesthetic work. PMID- 3976335 TI - Sublingual flunitrazepam for premedication. AB - The clinical effects of a standard 2 mg flunitrazepam tablet given sublingually for premedication were evaluated in a group of 50 patients undergoing otorhinolaryngologic surgery. A comparable group of 49 patients received 10 mg of diazepam orally. The degree of sedation and anxiety was assessed objectively and subjectively before induction of anaesthesia. Flunitrazepam produced better sedation judged by the observer as well as by the patients. There was less anxiety in the flunitrazepam group but this was not statistically significant. Side effects were few and patient acceptability high. Sublingual premedication using flunitrazepam could be a useful alternative to other forms of premedication. PMID- 3976336 TI - Naloxone does not reverse the pain-reducing effect of vibratory stimulation. AB - Fifteen patients suffering from chronic epicondylitis pain who obtained alleviation of pain with vibratory stimulation were studied to investigate the possible role of endogenous opioids in the mediation of pain alleviation of vibratory stimulation. The patients' subjective pain intensity was rated using a graphic rating scale. In five patients the changes in peripheral blood flow before, during and after vibratory stimulation were also studied. After 30 min of mechanical vibratory stimulation at 100 Hz, patients were given a double-blind intravenous injection of naloxone or saline (placebo). Twelve patients did not experience reversal of pain relief from naloxone (0.4 mg). Reversal of the pain alleviation induced by vibratory stimulation was seen in two patients after i.v. injections of naloxone and in one patient after i.v. injections of naloxone or saline. When an i.m. injection of naloxone 0.01 mg/kg was administered before and during vibratory stimulation, none of the patients experienced an antagonistic effect of the pain-reducing effect of vibratory stimulation. The results suggest that the pain relief obtained with vibratory stimulation at 100 Hz is not associated with release of endogenous opioids. PMID- 3976337 TI - Hemorrheological effects of colloidal plasma substitutes infusion. A comparative study. AB - Our objective was to investigate experimentally the easily overlooked effect of the clinical use of colloidal plasma substitutes on tissue perfusion. The experimental animals were dogs, and the study was carried out using several independent rheological experimental methods. The following are the principal findings: 1) Based on the observations made under a microscope, the stability of blood suspensions was best maintained by dextran-40 (Dex 40) and hydroxyethyl starch (HES0.55; Hespander), both of which cause little rouleaux formation by erythrocytes. In addition, the electronegativity of the erythrocyte membrane was simultaneously elevated. 2) The blood viscosity was greatly affected by the hematocrit and the serum protein concentration. 3) At a high shear rate, the blood viscosity among these colloidal plasma substitutes showed no great difference after infusion; in contrast, at a low shear rate, the blood viscosity after infusion of Dex 40 or HES0.55 was lower than after other substitutes. 4) The ratio of the viscosity at a low shear rate to the viscosity at a high shear rate is more significant and useful as a clinical indicator. On the basis of the preceding findings, Dex 40 and HES0.55 were generally superior to the other substitutes, especially HES0.55. PMID- 3976338 TI - The role of polymorphonuclear leucocytes in the pulmonary dysfunction induced by complement activation. AB - To determine the role of polymorphonuclear leucocytes (PMNs) in the pulmonary reaction induced by complement activation, pigs were infused with complement activated plasma (CAP), cell-free supernatant from PMNs activated in vitro, or washed PMN aggregates produced in vitro. Infusion of CAP resulted in transient peripheral leucopenia, a reversible rise in pulmonary vascular resistance (PVR) and decreased arterial oxygen tension (PaO2). Indomethacin did not influence the CAP-induced drop in PMN count or the accumulation of PMNs in the lung, but significantly counteracted the rise in PVR and fall in PaO2. Antihistamines did not prevent the cellular or pulmonary reactions to CAP infusion. Methylprednisolone did not inhibit the decrease in PMN count, but modified the pulmonary reaction to CAP, although it did not prevent the rise in PVR to the same extent as indomethacin; it counteracted the fall in PaO2. Infusion of supernatant from activated PMNs did not influence the PMN count, but caused a reversible increase in PVR and a drop in PaO2. Indomethacin counteracted the pulmonary reaction to this infusion. Infusion of washed PMN aggregates did not result in any cellular or physiological changes. These findings suggest that the pulmonary reaction induced by complement activation is mediated by humoral components generated and/or released during activation of PMNs. Arachidonic acid metabolites play an important role and it is likely that substance(s) released from activated PMNs trigger prostanoid synthesis in other cells. It is conceivable, however, that PMNs exposed to activated complement factors also directly synthesize and release arachidonic acid metabolites. PMID- 3976339 TI - Left ventricular function during anaesthesia induction and sternotomy in patients with ischaemic heart disease. A comparison of six anaesthetic techniques. AB - A comparison between five anaesthetic procedures, fentanyl (FE), morphine (MO), halothane (HAL), fentanyl/droperidol (NLA) and thiopenthone (two dose levels: PE 3 and PE 6), all supplemented with nitrous oxide, was performed with respect to the left ventricular function (LVF) during anaesthesia induction and sternotomy in 47 patients with good preoperative LVF and maintained beta-blockers. Peroperative LVF was characterized by left ventricular stroke volume (stroke index) and external pressure volume stroke work (left ventricular stroke work index) in relation to filling pressure (pulmonary capillary wedge pressure) and outflow resistance (systemic vascular resistance). The individual patient patterns in each group indicated normal LVF in the awake state. Anaesthesia induction was followed by a moderate depression of LVF in the HAL, MO, PE 3 and PE 6 groups at full dose of anaesthetic agent. After addition of nitrous oxide, there was also a decrease of preload in all groups, masking any additional depressions of LVF. The response to external stimuli, endotracheal intubation and sternotomy was that of mildly depressed LVF in the majority of the patients. The haemodynamic reactions in the FE and NLA groups were more varied. In all groups some patients (approximately 30%) showed signs of left ventricular failing in response to external stimuli. With the exception of the more variable haemodynamic reactions in the FE and NLA groups, the differences between the anaesthesia groups with respect to LVF depended mainly on extracardiac factors. PMID- 3976340 TI - Macrophages in Pacinian corpuscles. AB - The presence of macrophages in the outer bulb region of mouse, monkey and human Pacinian corpuscles was demonstrated by light and electron microscopy. In the normal, nontreated, Pacinian corpuscles, a few particular cells were located in the spaces between lamellae of the outer bulb. These cells contained numerous vesicles and vacuoles, and various cytoplasmic processes. When horseradish peroxidase (HRP) was injected locally or systemically, many HRP-positive cells, which were considered to be similar to the particular cells described above, were found in the outer bulb region of the corpuscles. Electron microscopy revealed that these cells contained HRP in vesicles and vacuoles, suggesting that they were macrophages vigorously taking up exogenous HRP. Macrophages in the Pacinian corpuscles are considered to work as scavengers to keep the inner environment of the corpuscles clear and constant with regard to its macromolecular content. PMID- 3976341 TI - [Arterial vascularization of the tail of the pancreas with special reference to the relation of the tail and body vessels]. AB - The cauda pancreatis has a characteristic pattern of vascularization. Among the big arterial stems surrounding it, up to 4 arteries, 'caudal arteries', nourish the arterial system of the cauda. These stems originate especially in the Arteria gastroepiploica sinistra and in the lower main splenic branch of the Arteria lienalis. The vascular relations between corpus and cauda can be of different kinds. Five basic types of relations can be identified: type I: the cauda is supplied exclusively by caudal arteries; type II: at least one caudal artery anastomoses with the vessels of the corpus; type III: the cauda is supplied both by the caudal arteries and by vessels of the corpus (non-anastomosing); type IV: combined forms of blood supply by caudal arteries and corpus arteries by way of anastomoses and non-anastomosing vessels are found; type V: the cauda is supplied exclusively be vessels stemming from the corpus. In each of these five types, individual vessels supplying the cauda can assume the function of a terminal vessel. PMID- 3976342 TI - [Light and electron microscopic studies on the development of the spiral prominence of the cochlear duct of the fetal guinea pig]. AB - The anlage of the spiral prominence can be seen on the 37th day of development as a small protrusion of the epithelium towards the lumen of the cochlear duct. During the further progress, the spiral prominence more distinctly protrudes by augmentation of the vascularized connective tissue. In the epithelial cells pinocytotic vesicles near the plasmalemma are seen earliest lateral and basal on the 37th day, apical on the 39th day. The epithelial cells send basal cytoplasmic extensions towards the connective tissue. Starting on the 44th day, small invaginations of connective tissue extend into the epithelium, remaining separated from the epithelial cells by the basal lamina. Until the 48th day, the monostratified epithelium remains columnar, thereafter it changes to cuboidal or flat. Towards the end of the development, the invaginations of the connective tissue nearly reach the surface of the epithelium, being separated from the endolymph by a small epithelial area. PMID- 3976343 TI - Sympathetic pathways through the petrosal nerves in monkeys. AB - Light and electron microscope observations of tiny nerve branchlets attached to the nerve of the pterygoid canal suggests that the source of sympathetic autonomic fibres in the greater petrosal nerve may not be solely confined to fibres 'recurrent' from the deep petrosal nerve, as hitherto believed. PMID- 3976344 TI - Morphological and histochemical study of the submandibular gland in Praomys (Mastomys) natalensis. AB - The submandibular gland in female and male Praomys (Mastomys) natalensis (a South African multimammate rodent) was studied using light microscopy and techniques for the demonstration of carbohydrates. Hematoxylin and eosin stain revealed the presence of a single secreting component that gave a strongly positive PAS reaction. Limiting elements of the granular tubules gave a weakly positive PAS reaction. Acidic glycoproteins were evidenced only in granules of the acinar component. PMID- 3976345 TI - Modification of bone formation rate by growth hormone, melanocyte-stimulating hormone, and cortisone in the normal rat. AB - Bone growth and remodelling was studied in rats after injection of growth hormone, melanocyte-stimulating hormone (alpha-MSH), and cortisone daily for 20 days with tetracycline as intravital marker. An increase of both longitudinal and periosteal growth with growth hormone was found. A decrease of both was found after a high cortisone dose. Lower cortisone doses seem to have stimulated periosteal growth. No effect of alpha-MSH was found. PMID- 3976346 TI - Fibre number and sizes of mouse soleus muscle in early postnatal protein malnutrition. AB - The effect of early postnatal protein malnutrition on the development of soleus muscle was investigated in 26 mice (13 males, 13 females). The control group received a balanced diet containing 18% lactalbumin while the protein malnourished group received protein deficient diet containing 0.5% lactalbumin. The body weight was determined both at 3 weeks (weaning age) and 12 weeks of age. The soleus muscle weight, total number and sizes of muscle fibres were also determined at 12 weeks of age for each mouse. There was considerable retardation of body weight and soleus muscle weight. The smaller soleus muscle of protein malnourished mice resulted from loss of muscle fibres and hypotrophy of the remaining fibres. Permanent retardation of body weight after recovery from early postnatal protein malnutrition may be as a result of loss of muscle fibres during that period. PMID- 3976347 TI - An ultrastructural study on muciparous microcysts of the human adenohypophysis. AB - The microcysts found in two adenohypophyses removed from patients with nonsecreting adenomas of this gland have been studied. In one case the cysts were completely surrounded by neoplastic tissue, whereas in the second they were located within the normal parenchyma. The cysts were surrounded by a basement membrane, and appeared to contain a finely granular weakly electron-dense substance. Their walls were lined by mostly cubic cells with microvilli, joined by junctional complexes. Intracytoplasmic microlumina could be seen in some of these cells. Cells showing cilia with a 9 + 2 fibrillar pattern and cells with mucosecretory differentiation were also present. Furthermore endocrine cells were also found in the cyst-lining epithelium. The ultrastructural aspects of the cyst cells lead to reject the hypothesis that these are derived from folliculostellate cells. Besides, intermediate aspects between cyst cells and tumor cells were never visible. Therefore it seems likely that a relationship between adenoma and cyst cells does not exist and that cyst cells originate from remnants of Rathke's pouch with a ciliate or mucosecretory differentiation. The presence of endocrine cells in the cyst-lining epithelium deserves further study, for it seems to indicate that an endocrine differentiation may occur in the adult, too. To our knowledge this is the first ultrastructural study of these structures in adult human pituitary gland. PMID- 3976348 TI - Reaction time and brain disease: relations to location, etiology and progression of cerebral dysfunction. AB - Using the results from 485 patients with various forms of cerebral dysfunctions and from 60 hospitalized controls, it was shown that measurement of continuous reaction times (CRT) is sensitive to cerebral lesions. Reaction times were more impaired by progressive than by non-progressive brain diseases. The test did not distinguish between patients with right- or left-hemisphere lesions and was not influenced either by etiology, chronicity, age or sex. Our conclusion is that CRT is useful as a "screening" test for the presence of cerebral dysfunction and is especially sensitive to progressive diseases. Its discrimination power is equivalent to more sophisticated and complex psychological tests. PMID- 3976349 TI - Central nervous dysfunction associated with deep-sea diving. AB - A group of 23 professional divers was investigated before and after dives to 300 and 350 metres of sea water. 12 divers were also studied during the actual dive. All divers presented neurological symptoms and signs during compression. Intention tremor, ataxia, motor weakness, sensory symptoms, vertigo, nausea and reduced memory were the most prominent features of the High Pressure Nervous Syndrome (HPNS). There were considerable individual differences. Neuropsychological and neurophysiological investigations performed after one dive showed no significant changes in any of the divers, while there was a clear-cut impairment in a group of 6 divers who had performed 2 dives 3 months apart. These changes indicate that there may be pressure-induced brain dysfunction which persists for a transient post-dive period. Loss of short-term memory is a prominent part of this dysfunction. Transitory neurological signs indicating focal cerebral dysfunction were found immediately post-dive in 4 divers, presumably reflecting the unmasking of pre-existing subclinical minimal CNS lesions. PMID- 3976351 TI - Autonomic cardiovascular responses in parkinsonism: effect of levodopa with dopa decarboxylase inhibition. AB - Autonomically mediated cardiovascular responses to certain manoeuvres were studied in 20 parkinson patients, 24 h off levodopa-decarboxylase inhibitor medication and again one h after medication. Results were compared with 15 healthy control subjects. The heart rate at rest was higher in parkinson, the respiratory sinus arrhythmia was lower, while the Valsalva ratio, the heart rate and blood pressure responses during an orthostatic test and the heart rate response to a dive reflex test were normal. These findings indicate a normal function of peripheral autonomic nerves and a possible central parasympathetic dysfunction. There were significantly attenuated responses of heart rate, blood pressure and contralateral forearm blood flow to an isometric handgrip. Since the peripheral autonomic nerves seemed to be normal, these results could be related to a reduced central command and/or diminished stimulation of postulated peripheral ergoreceptors in parkinsonism. There was no major effect on the cardiovascular responses by the acutely administered medication. PMID- 3976350 TI - N20 and P40 somatosensory evoked potentials: thalamic lesions and subcortical origin. AB - Three patients with well-defined clinical and radiographic lesions have been studied with somatosensory evoked potentials (SSEPs). The data indicate that the primary scalp potentials from stimulation of both the arm and leg (N20 and P40) can be lost with thalamic lesions and would be consistent with these potentials being generated in either the thalamus or thalamocortical radiations. PMID- 3976352 TI - The value of somatosensory-evoked potentials and bulbocavernosus reflex in patients with impotence. AB - In 14 normal male adults and 97 male patients having impotence alone or together with systematic and/or neuro-psychiatric symptoms and signs, the somatosensory cerebral-evoked potentials were obtained by glans penis stimulation (penile SEP); by peroneal nerve stimulation (peroneal SEP) and by electrically-induced bulbocavernous (BC) reflex. In normal subjects, the configurations of both SEPs were basically similar, except that the onset of latency was 10-15 msec longer and the amplitude in the P1-N1 component was higher in penile SEP. BC-reflex latency was abnormally prolonged, especially in diabetic impotence and in patients with cauda/conus lesions, while the abnormalities on the penile and peroneal SEP were more frequent in patients with spinal cord injuries. MS and parkinsonism. In impotent patients with epilepsy, chronic prostatis and psychogenic problems, all the tests were generally normal. PMID- 3976353 TI - Brainstem involvement in multiple sclerosis: a clinical and electrophysiological study. AB - A major aim of this study was to determine the diagnostic value of 4 electrophysiological tests in MS, and particularly their effectiveness in detecting signs of brainstem involvement. Therefore, auditory brainstem evoked response (ABER), somatosensory evoked response (SSER), blink reflex and electronystagmographic (ENG) investigative methods were applied to a group of 89 patients with definite, probable or possible multiple sclerosis (MS). The 4 methods yielded interdependent data, especially where the brainstem function was concerned, thus it can be concluded that a single demyelinating lesion may cause a combination of electrophysiological disorders within a small structure such as the brainstem. ENG recordings were found to reveal the highest number of asymptomatic abnormalities. The combination of ABER and ENG tests revealed electrophysiological disorders in 81% of all patients. The blink reflex and the SSER tests gave hardly supplementary information. PMID- 3976354 TI - Skeletal muscle in paramyotonia congenita: biochemistry, histochemistry and morphology. AB - In 12 patients with paramyotonia congenita, percutaneous needle biopsies from the brachial biceps muscle were performed. Muscle fibre area, distribution of muscle fibre types I, II-A and II-B and capillarization were not different from healthy controls. Signs of myopathy with central nuclei in the muscle cells were noted in 9 of the patients. 4 of these patients also had small areas with degeneration and, in one, vacuoles were observed. Quantitative determination of muscle glycogen, water and protein content were within normal range as were enzyme activities for hexokinase, lactate dehydrogenase, citrate synthetase and 3 hydroxy-acyl-CoA dehydrogenase. PMID- 3976356 TI - Abstracts: annual meeting of Scandinavian Neuropathological Society, Stockholm, May 18-20, 1984. PMID- 3976355 TI - Myoglobin, creatine kinase and creatine kinase subunit-beta in serum from patients and relatives with hypokaliaemic familial periodic paralysis. AB - Increased levels of serum myoglobin (S-myoglobin) were found in 6 investigated patients with hypokaliaemic familial periodic paralysis (hypoKPP) in their habitual condition. Furthermore, in 3 of the 6, increased levels of serum creatine kinase (S-CK) were found. These findings support the hypothesis that hypoKPP is a permanent myopathy, which is aggravated during attacks. It was found that 1 definite carrier had elevated S-myoglobin and among healthy relatives 6/11 had elevated S-myoglobin and 3/11 elevated S-CK. The use of S-myoglobin and S-CK for carrier detection is discussed. PMID- 3976358 TI - Communicating hydrocephalus in rodents treated with beta,beta' iminodipropionitrile (IDPN). AB - Beta,beta'-Iminodipropionitrile (IDPN), a neurotoxic compound known to induce swellings in the proximal internodes of sensory and motor axons in several parts of the central nervous system (CNS), was also found to cause hydrocephalus in rats and guinea pigs. In both species, ventricular dilatation was observed within 1 week following a single i.p. injection of IDPN. While in rats the severity of hydrocephalus correlated with dose and duration of IDPN exposure, in guinea pigs studies with high doses yielded inconclusive results, and no significant temporal correlation was noted. Parallel investigations with another neurotoxic agent, acrylamide, in rats, and with IDPN in cats failed to demonstrate any change in size and shape of the cerebrospinal fluid (CSF) pathways. No signs of spontaneously occurring hydrocephalus were found in control animals. In both rats and guinea pigs intoxicated with IDPN, macroscopic and microscopic findings were consistent with the diagnosis of communicating hydrocephalus. Treatment of hydrocephalic rats with acetazolamide (500 mg/kg) markedly attenuated ventricular distention, suggesting that an overproduction of CSF by the choroid plexus is responsible for the communicating hydrocephalus following IDPN intoxication. PMID- 3976357 TI - Basement membrane of hypothalamus and cortex capillaries from normotensive and spontaneously hypertensive rats with streptozotocin-induced diabetes. AB - Basement membrane (BM) thickness of hypothalamic arcuate nucleus capillaries was measured in normotensive (WKY) and hypertensive (SHR) rats 4 and 8 months after streptozotocin or saline injection. Three groups were studied: controls (C), diabetics (D), and animals with impaired glucose tolerance (L). For comparison, BM thickness of cortical capillaries of an occipital and a frontal area was measured in three different layers starting from the pial surface. Independently from strain, hypothalamic capillary BM was thicker in older than in younger animals. At both 4 and 8 months, BM thickness was lowest in C, highest in D, and intermediate (between C and D) in L. Hypertension combined with diabetes did not further increase BM thickness. In both C and D no difference was found between the two cortical areas. The BM thickness of C increased from the superficial to the deep layer. In C hypertension induced BM thickening in the superficial frontal and the deep occipital layer. In the intermediate and the deep layer of the frontal area BM was thicker in WKY-D than in WKY-C. In every layer BM was thicker in SHR-D than in corresponding controls. Hypertension combined with diabetes enhanced BM thickening in the intermediate and the deep layer of the frontal and in the intermediate layer of the occipital area. Degenerative changes occurred in hypothalamic and cortical pericytes. These changes were more frequent in hypertensive than in normotensive animals. In conclusion, a microangiopathy characterized by BM thickening and pericytic degeneration occurs in the brain of diabetic animals. Its intensity and enhancement by a concomitant hypertension vary from hypothalamus to cortex. PMID- 3976359 TI - Dystrophic axons in the nucleus gracilis of the normal rat containing cholecystokinin-like immunoreactivity. Light- and electron-microscopic observations. AB - Cholecystokinin immunoreactive (CCKI) axons in the nucleus gracilis of the normal rat were studied by light and electron microscopy using the peroxidase antiperoxidase (PAP) immunocytochemical method. Immunoreactivity was found in both normal and dystrophic axons at various ages. Slightly enlarged CCKI varicosities were first observed in 2-month-old rats, gradually increased in number (max. at 21 months) and in diameter (up to 20 micron at 21 months), and then decreased (at 27 and 36 months). Dilatated CCKI fibers continuous with dystrophic varicosities also tended to increase proportionally in diameter. The dystrophic CCKI axonal profiles, first identified at the light-microscopic level and then observed under electron microscopy, had consistently characteristic features. In addition, numerous dystrophic nonreactive axonal profiles had morphological features differing from those of dystrophic reactive ones at advanced ages. These findings suggest that CCK may be partly involved in the formation of dystrophic axons in the nucleus gracilis. PMID- 3976361 TI - Neuropathology of ornithine carbamyl transferase deficiency. AB - Neuropathologic findings in two cases of ornithine carbamyl transferase (OCT) deficiency are presented. In one, a boy 3 days old, the only abnormality related to the enzyme defect was metabolic gliosis which was unusual in distribution being present mainly in the brain stem. In the other case, a girl who died at the age of 2 3/12 years, the brain showed metabolic gliosis in typical location, widespread ulegyria, and moderate atrophy of the internal granular layer in the cerebellum accompanied by development of expansions of Purkinje cell dendrites. Case 2 demonstrates how rapidly changes previously demonstrated in the cerebral cortex after a few months of illness can proceed to massive hemispheric destruction. By now ulegyria has been observed in several disorders of the urea cycle. PMID- 3976360 TI - Tracer study on a paracellular route in experimental hydrocephalus. AB - Considering the possibility of a paracellular pathway for edema resolution, we studied the intracerebral movement of proteins and ionic lanthanum in rats with experimental hydrocephalus. Hydrocephalus was induced by injection of kaolin suspension into the cisterna magna. After induction of hydrocephalus, horseradish peroxidase (HRP), microperoxidase (MP), or lanthanum chloride (LaCl3) were perfused into the ventricle system. HRP and MP were localized mainly in the intercellular spaces between ependymal cells, glial cells, and in perivascular spaces and were restricted by endothelial tight junctions. Ionic lanthanum (La3+), however, penetrated these tight junctions and moved between the blood and CSF cavities by paracellular pathways. These findings indicate that in obstructive hydrocephalus, the tight junctions may constitute part of a paracellular pathway for the transendothelial movement of small solutes, although they prevent the movement of larger molecules. PMID- 3976362 TI - Evidence of subclinical extrapyramidal hemosiderosis in cystic fibrosis. AB - We are presenting evidence of subclinical extrapyramidal hemosiderosis in chronic cystic fibrosis (CF) by histological staining and quantitative analysis. Comparison was made between age-matched control (eight cases) and CF brains (14 cases). None of the CF patients had extrapyramidal or other focal CNS symptoms but showed an increased iron pigment, and four cases had a few dystrophic axons (DA) in pallidonigral areas. Histological stain revealed significantly increased iron pigment in pallidonigral and subthalamic nuclei (P less than 0.05, 0.01, 0.01, respectively). The pigment was located in astrocytes, macrophages, neuronal perikarya, and neuropils. The increase was directly proportional to age and numbers of DA in nucleus gracilis/cuneatus. As in previous reports [5, 22], the numbers of DA in nucleus gracilis/cuneatus were higher in CF (P less than 0.01) and varied directly with age (correlation coefficient 0.72). Quantitative analysis disclosed an upward trend of mean iron content in pallidonigral areas. Aluminum was detected in four cases of CF but not in the controls. PMID- 3976363 TI - Is Werdnig-Hoffmann disease a pure lower motor neuron disorder? AB - It is not widely recognized that the pathology of Werdnig-Hoffman disease (WHD) may include cells other than the lower motor neuron. In the early infantile (acute) forms of this degenerative disease, neuropathologic involvement may extend well beyond the lower motor neuron territory to include neurons in spinal sensory ganglion and thalamus. The present report describes the neuropathologic findings of four patients with early infantile degenerative motor neuron disease, compares them to other reported patients, and discusses the relationship of these patients to those with classic WHD. We found involvement of thalamic and primary sensory neurons, although mild, to be a common finding in classic WHD. We suggest that early infantile forms of degenerative lower motor neuron disease which show prominent involvement of thalamic, primary sensory, and other neurons are but one end of the spectrum of WHD. PMID- 3976364 TI - Age-related changes of pyramidal cell basal dendrites in layers III and V of human motor cortex: a quantitative Golgi study. AB - Age-related changes of pyramidal cell basal dendrites in layers III and V of human motor cortex (area 4) were analyzed quantitatively in Golgi-impregnated sections by Sholl's method of concentric circles (Sholl 1953). The present data suggested that basal dendrites of the pyramidal cells were decreased in number with advancing age, and that the decrease was more prominent in basal dendrites of layer V pyramidal cells than in those of layer III pyramidal cells. PMID- 3976365 TI - Intra-axonal polysaccharide deposits in the peripheral nerve seen in adult polysaccharide storage myopathy. AB - This is the first report of an adult polysaccharide storage myopathy demonstrating polysaccharide deposits within the axons of the peripheral nerve. Histochemical and electron-microscopic studies revealed that the intra-axonal deposits were basophilic, PAS-positive, diastase-resistant, and composed of filamentous and granular material. The structural similarity among the polysaccharide deposits in our case, amylopectin-like materials in type IV glycogenosis, Lafora bodies, corpora amylacea, and polyglucosan bodies is discussed. PMID- 3976366 TI - A new mutant strain of Syrian hamster with myelin deficiency. AB - A new disorder of central myelination was found in black mutant hamsters showing trembling. The condition was inherited in an autosomal recessive mode. Histologically, a marked myelin deficiency was distributed throughout the central nervous system (CNS), and it was closely related to clinical manifestations observed in the mutants Ultrastructurally, abnormally thin myelin sheaths were observed in all axons with different diameters, and most axons below 1 micron in diameter were unmyelinated in the white matter of the spinal cord. There was no overt evidence of demyelination, but some myelin sheaths showed an aberrant configuration. The numbers of glial cells were not reduced, and there were no striking morphological abnormalities in them. It was suggested that there may be a dysfunction of oligodendrocytes resulting in retarded or defective myelination. This trembling hamsters may be a suitable animal model for the study of normal and abnormal myelinogenesis. PMID- 3976367 TI - Congenital absence of pyramids and its significance in genetic diseases. AB - Bilateral absence of the pyramids, best assessed in transverse sections of the medulla oblongata, was found in 0.7% of 2,850 autopsies performed at the Royal Children's Hospital, Melbourne (Australia). A strong association with some forms of congenital aqueductal stenosis was observed and evaluated in further cases ascertained through other hospitals. The very strong association observed with X linked congenital aqueduct stenosis may be useful diagnostically but must be evaluated in other centres. At least, the presence of pyramids seems strong evidence against this diagnosis. Absence of the pyramids was also observed in several known or new genetic syndromes - Meckel's syndrome, the HARD syndrome, two sisters with congenital aqueductal stenosis and polydactyly and two families with microcephaly and arthrogryposis. PMID- 3976368 TI - A rabbit model of intracerebral hematoma. AB - The epiphenomena that seem to cause deterioration and death after spontaneous interacerebral hematoma (SICH) might best be studied in an animal model. Therefore, the principles for developing such a model and techniques to study these phenomena were evaluated. Animals will tolerate injection of 3%-5% of their brain volume with a high proportion of clots. Fluorescein can be used to study the blood-brain barrier, and gravimetry to study edema. Others have found that injection of a paraffin/oil mixture can be employed for a control model. Refinement of the fluorescein technique, development of a primate model, and directions for future research are suggested. PMID- 3976369 TI - The morphology of lipopigment granules in oligodendrocytes of the cerebellum and spinal cord and in Schwann cells of the N. ischiadicus of the cat, Japanese waltzing mouse, and albino mouse. AB - In the oligodendrocytes of cerebellum and spinal cord and in the Schwann cells of peripheral nerves of cat, albino mouse, and Japanese waltzing mouse lipopigment bodies of different size and shape are deposited, which exhibit a characteristic internal structure. The following three subtypes can be distinguished: (1) Granules completely surrounded by a membrane and consisting regularly spaced lamellae, (2) granules consisting of a granular matrix with elucidations, and (3) granules with bifurcating stacks of lamellae. Thus, their structure is distinct from that found in nerve cells and other glial cells and allows the diagnosis of oligodendrocyte or Schwann cell. The significance of these granules in relation to function and aging is briefly discussed. PMID- 3976370 TI - "Pink spots" in formalin-fixed brains--poor fixation or bacterial byproduct? AB - Circumscribed pink areas 0.3-1.0 cm in diameter seen in deeper parts of otherwise well-fixed brains are usually ascribed to inadequate fixation. Twenty-three patients with pink areas in their fixed brains had evidence of inflammation in at least one organ. Blood vessels in the pink areas contained bacteria. Postmortem cultures identified the organisms in 16 cases. Gram-negative bacteria were the most common. Sharply delineated pink areas in well-fixed brains correlate with postmortem intravascular growth of bacteria. PMID- 3976371 TI - Self-monitoring of blood glucose in pregnant diabetics. A comparative study of the blood glucose level and course of pregnancy in pregnant diabetics on an out patient regime before and after the introduction of methods for home analysis of blood glucose. AB - Sixty-one pregnant patients with insulin-dependent diabetes mellitus completed a self-monitoring program consisting of five daily blood glucose tests at least twice weekly during the ambulatory periods of their pregnancies. Either a reflectometer method, Eyetone, glucometer--reflectometer, or Haemoglucotest 1-44 test strips were used. Of 1 834 glucose profiles, 45% were optimal, with all blood glucose values between 3.9 and 8.3 mmol/l. The 61 pregnancies were compared with 62 pregnancies where the diabetic control and therapy principles were identical, but where self-monitoring blood glucose methods were not employed. The self-monitoring regime resulted in a significant drop in mean blood glucose levels, from 7.8 +/- 1.3 to 6.4 +/- 1.0 mmol/l, compared with the period before the self-monitoring program was introduced. Furthermore, a decline in the number of diabetes-conditioned extra hospitalizations during pregnancy in the self-test group could be registered. PMID- 3976372 TI - Advanced extra-uterine pregnancy. AB - Forty-three cases of advanced extra-uterine pregnancy of more than 34 weeks' gestation, seen and treated at Baragwanath Hospital between 1966 and 1978, are reviewed. The incidence in our unit was 1 per 6 389 deliveries. Abdominal pain and vaginal bleeding were the most common complaints. Simple vaginal examination is of great help in establishing the diagnosis, while the abdominal signs are found to be disappointing in this respect. The oxytocin test is a helpful diagnostic aid and various radiographic methods, such as plain X-ray abdomen, hysterosalpingography and ultrasonography have their merits. The placenta, although attached to rather critical areas in the majority of patients, was removed safely without damage to neighboring structures in 93% of the cases. Four patients, however, required hysterectomy. There were two maternal deaths. Of the 18 babies born alive, only 8 survived. All the surviving infants had congenital anomalies but only 5 had problematic defects. PMID- 3976373 TI - Contraction stress test by breast stimulation as part of antepartum monitoring. AB - Non-stress tests (NSTs) and oxytocin challenge tests (OCTs) are widely used in most prenatal units for the assessment and monitoring of patients with high risk pregnancies. The contraction stress test is considered to be one of the best tests for evaluating fetal wellbeing in indicated cases. For this purpose, the OCT is usually used. It is a time-consuming test. An intravenous i.v. and oxytocin are both required, and it is therefore relatively costly. In this study, a non-invasive technique--breast stimulation--was used to induce uterine contractions for the purpose of contraction stress testing. Sixty-six patients were studied, and a total of 95 breast stimulation tests (BSTs) were done. 91 tests were successful contraction stress tests (95.78%). The high success rate, the fact that this is a non-invasive method, its easy application and the fact that this test is less expensive and much less time consuming make it a good test for the assessment of fetuses at risk. PMID- 3976374 TI - Ectopic pregnancy and spontaneous abortions following in-vitro fertilization and embryo transfer. AB - In-vitro fertilization and embryo transfer was performed in 25 patients with diseased oviducts. Three pregnancies were achieved, but all ended in early abortion. One patient had ectopic pregnancy, one spontaneous abortion having a severe autosomal chromosome abnormality, and one had a rise in serum hCG but vaginal bleeding started 18 days after embryo transfer. We conclude that repeated ultrasonic examinations of all pregnancies following in-vitro fertilization and embryo transfer is recommendable until intra-uterine implantation has been confirmed and that amniocentesis should be offered to all these patients. PMID- 3976375 TI - Abruptio placentae and disseminated intravascular coagulation. AB - Several parameters of hemostasis have been studied in 19 patients suffering from abruptio placentae. In 10 of them severe hemostatic alterations were detected and in 5, disseminated intravascular coagulation was observed. The patients were divided into four groups according to the severity of their clinical picture. The degree of placental separation was related to the severity and course of the clinical history and to the alterations in hemostasis detected at the most critical clinical moment. The analytical parameters were evaluated after extraction of the thromboplastic material. A good correlation was observed between the severity of the clinical picture and the degree of placental separation and the greatest analytical alteration, especially with cross-linked soluble fibrin monomer complexes (SFMC). In 9 of the 19 patients who showed analytical and/or clinical alterations, an improvement was detected in these alterations after evacuation of the uterus. PMID- 3976376 TI - Effect of acute hypoxia on human fetal heart rate. The significance of increased heart rate variability. AB - The fetal heart rate response to acute hypoxemia was observed during an accidental drop in oxygen concentration inspired by the mother in labor. There was a marked increase in FHR variability in the early stage of hypoxia and also during the recovery phase. While an increase in fetal heart variability is generally considered to be a normal physiological event, it may also indicate a state of fetal hypoxemia associated with an intact fetal circulation, and should be treated with caution during labor. PMID- 3976377 TI - Mode of delivery in the low birth weight fetus. Delivery by cesarean section independent of fetal lie versus vaginal delivery in vertex presentation. A study with long-term follow-up. AB - In a paired controlled multicenter study of patients in preterm labor of unknown etiology without additional maternal or fetal complications, 59 low birth weight infants in vertex presentation born vaginally were compared with 59 infants delivered by cesarean section. In the early postpartum period, hypothermia and acidosis occurred more often in the vaginal delivery group. The rate of respiratory disorders and need for assisted ventilation did not differ between the groups. Persistent ductus arteriosus occurred in 19% in the vaginal delivery group and in 7% in the abdominal delivery group. At follow-up until 18-24 months of age the rate of cerebral palsy did not differ between the groups, whereas the rate of psychomotor retardation was significantly higher in the vaginal delivery group (p less than 0.05). The difference in percentage of total outcome, i.e. sum of mortality and neurodevelopmental sequelae, being 20.3% in the vaginal delivery group versus 8.5% in the cesarean section group, fails to reach a statistical significance, but the results suggest that for the low birth weight infants, vaginal delivery may be more hazardous than abdominal delivery. PMID- 3976378 TI - Oral contraceptives and the cobalamin (vitamin B12) metabolism. AB - The mean concentrations of serum (S)-cobalamin (vitamin B12) and S-unsaturated B12 binding capacity (UBBC) were significantly decreased in 101 women (mean age: 30.4 years) taking oral contraceptives (OC) of the combination type, compared to 113 controls. OC users more frequently showed decreased concentrations of S cobalamin (less than 200 pmol/l) than did their controls. However, the incidence of particularly low concentrations (less than 150 pmol/l) in OC users was not increased. To study a possible dose-dependent effect, 27 women (mean age: 50.5 years) given high-dose estrogen preparations (1-4 mg estrogen) were compared with 31 controls. The two groups showed no difference with regard to S-cobalamin, but the mean S- and plasma-UBBC levels were significantly decreased in the high-dose estrogen group. 12 OC users with decreased S-cobalamin (less than 200 pmol/l), 9 OC users with normal S-cobalamin and 10 controls were studied more intensively. The mean hemoglobin concentration was significantly decreased in those OC users having decreased S-cobalamin. On the contrary, the absorption and excretion of radiolabeled cobalamin and the concentrations of erythrocyte-folate, S-iron and transferrin did not show any difference between the groups, and all results were normal, by and large. No characteristic changes in plasma volume were found. It is concluded that routine measurement of S-cobalamin in women taking OC is not justified. PMID- 3976379 TI - Effects of electronic fetal monitoring on rates of early neonatal death, low Apgar score, and cesarean section. AB - Using data from the University Hospital in Odense, Denmark, we have studied the effects of electronic fetal monitoring on rates of early neonatal death (death of liveborn within first week of life), low five-minute Apgar score (less than 7), and cesarean section. Approximately 22 000 births occurring in 1974 - 82 were studied, of which 13% were electronically monitored. Monitoring was significantly associated with an elevated cesarean rate in low-risk labors and certain high risk labors, but appeared not to increase the cesarean rate in all high-risk labors. In high-risk labors, monitoring was associated with an approximate 40% reduction in rates of low Apgar score and early neonatal death, but neither reduction was statistically significant. The associations of monitoring with elevated cesarean rate declined significantly over the study period. These results accord closely with studies conducted in the United States, indicating that monitoring is of benefit in high-risk labors, but leads to excessive cesarean deliveries in low-risk labors. Our study additionally indicates that the effect of monitoring on the cesarean rate has been declining over time. PMID- 3976380 TI - Gynecological follow-up of parkinsonian patients on long-term bromocriptine treatment. AB - Bromocriptine given for prolonged times at high doses has been found to induce tumors in the uterus in aged rats. To elucidate the possible tumorigenic effect of long-term treatment with bromocriptine in humans, 35 women treated with this drug for chronic parkinsonism were studied. For each patient a gynecological anamnesis and examination were performed; one or several cervicovaginal smears and endometrial samples were also taken, by jetwash. No evidence of malignant changes was seen. Thus, in this respect bromocriptine would appear to be a safe drug, even for long-term use. PMID- 3976381 TI - Gynecologic presentation of pelvic lymphoma. AB - Advanced pelvic lymphoma is rarely encountered by the gynecologist. Two cases of pelvic lymphoma involving the reproductive tract are reported. Long-term survival is achieved by minimal surgical intervention, correct histologic examination and treatment with local radiation therapy and systemic chemotherapy. PMID- 3976382 TI - Malignant hemangiopericytoma of the ovary. AB - Tumors originating from the blood vessels seldom occur in the ovaries, and primary hemangiopericytoma localized to the ovaries has not previously been described. In the case reported here a bilateral ovarian tumor was found, with one metastasis to the terminal ileum. It was not possible to perform a radical operation, and the patient was after-treated with external irradiation therapy and chemotherapy. For 9 1/2 months the tumor receded, whereafter it appeared to be stationary for 13 months, to the death of the patient. At autopsy the tumor was in evident regression and there were no signs of metastases. PMID- 3976383 TI - Hearing preservation in acoustic neurinoma surgery. AB - In a series of 120 patients with acoustic neurinoma, hearing preservation at removal of the tumour via the suboccipital approach was attempted in 30 ears. Hearing was preserved in 13 ears (43%), but in two, hearing was lost entirely in 3 to 4 years; thus the success rate was 36%. In 9 of the remaining 11 ears useful speech discrimination was present. Audiological tests showed increased retrocochlear loss after surgery. A surgical team should master the methods of both translabyrinthine and suboccipital surgery in order to choose the best approach for each patient. PMID- 3976384 TI - Modulation of vestibulo-ocular reflex (VOR) by active stabilization of head to trunk. AB - Horizontal vestibulo-ocular reflex (VOR) with covered eyes was tested in 15 healthy subjects sitting on a rotation chair (40 degrees, 0.05, 0.1, 0.2, 0.33 Hz) under two conditions: (a) head fixed to chair by a neck support; (b) with instruction to turn the head together with the passively moved trunk. In situation (b), saccadic amplitudes/sec, nystagmus frequency, gain of nystagmus slow phase velocity and amplitudes of maximum eye shift were enhanced significantly. The phase of maximum eye shift changed from 180 degrees up to 270 degrees with respect to stimulus position. The distribution of nystagmus saccades over the stimulus period showed enhanced peak values and a slight phase shift. PMID- 3976385 TI - The vascular arrangement of the sinus mucosa. A study in rabbits. AB - Seventy-seven New Zealand White rabbits, with an average weight of 3 kg, were used in studies on the paranasal sinus. Replica moulds of the sinus revealed a sinus cavity composed of three compartments with a total volume of 2-3 ml. The sinus cavity was connected with the nasal cavity through an ostium. By intravascular injection of silicone rubber for dissection and of methacrylate for production of corrosion casts, the vascular bed and the vessels passing to and from the sinus cavity were studied. The main arterial supply and venous drainage takes place through the ostium, which is surrounded by a dense venous plexus. Compared with the nasal mucosa, the number of vessels per volume unit is about the same in the sinus mucosa. Many vessels perforating through the osseous walls, both arteries and veins, were found, however, indicating that the blood supply is not derived exclusively from vessels coming through the ostium. PMID- 3976386 TI - Nasal mucosal blood flow at rest and during exercise. AB - Nasal airway resistance increases at rest in the supine position and decreases during exercise due to changes of the thickness of the nasal mucosa regulated by the capacitance vessels. The resistance vessels regulating blood flow have not not been evaluated in these conditions before. In 15 healthy subjects the nasal mucosal blood flow was measured in rest and exercise with the 133Xe washout method. No change in blood flow was registered during exercise, which demonstrates that the blood flow and the blood content of the human nasal mucosa are not affected in the same way by exercise. PMID- 3976387 TI - Blood flow in the rabbit maxillary sinus mucosa. Measurement with a diffusible and a non-diffusible tracer. AB - The blood flow of the sinus mucosa was studied in 11 New Zealand White rabbits. Their body weight averaged 3.5 kg. The blood flow determinations were performed during neurolept anaesthesia with continuous blood pressure recording. The blood flow in the sinus mucosa and septum, as well as in other organs, was determined both with Sn113-labelled microspheres and with Rb86Cl. Cardiac output as determined with the microsphere method was 146 +/- 36 ml X min-1 X 1000 g-1 body weight. There was a good correlation between the blood flow values obtained with the two methods. The blood flow in the sinus mucosa was 0.58 +/- 0.41 ml X min-1 X g-1 when measured with microspheres and 0.43 +/- 0.34 ml X min-1 X g-1 with the Rb86Cl technique. In the septal mucosa the corresponding values were 0.42 +/- 0.20 ml X min-1 X g-1 and 0.49 +/- 0.43 ml X min-1 X g-1 respectively. PMID- 3976388 TI - Reciprocal changes in nasal resistance to airflow caused by pressure applied to the axilla. AB - The resistance to airflow of each nasal passage was measured using active, posterior, rhinomanometry. Application of pressure to the axilla for 15 min by means of a wooden crutch caused a reciprocal change in nasal resistance with an ipsilateral increase and a contralateral decrease in resistance. The results are discussed in terms of reflex changes in sympathetic tone to the nasal venous erectile tissue. PMID- 3976389 TI - Effects of wood dust exposure and diethylnitrosamine. A pilot study in Syrian golden hamsters. AB - Fine wood dust is epidemiologically associated with human nasal cancer. The aim of the present study was to elaborate an animal model for inhalation studies of the effects of fine wood dust on the upper and lower airways. Syrian golden hamsters were used. After 10 months one animal in the group which was exposed only to wood dust, had developed a malignant nasal tumour and another animal in the same group had nasal dysplasia. Spontaneous nasal tumours in this laboratory animal is not known. Many tumours of the nose, larynx and trachea arose in animals treated with a carcinogen (diethylnitrosamine). There was no increase in tumours in animals with combined exposure to diethylnitrosamine and wood dust. PMID- 3976390 TI - Sinonasal cancer and exposure to softwood. AB - In order to study the connection between occupation and sinonasal cancer we have reviewed the files and histological sections of 70 patients (24 females and 46 males) treated at the Department of Oto-rhino-laryngology, National Hospital of Norway. Detailed information concerning previous occupations was obtained by telephone interviews according to a standardized questionnaire. This pilot study revealed a strong association between wood dust exposure and sinonasal cancer. Of 12 wood dust exposed men, 11 had been exposed exclusively to softwood. While squamous cell carcinoma was the predominant type of cancer in joiners, carpenters and loggers, non-Hodgkin lymphomas appeared to be associated with employment in saw- and planingmill firms. A nationwide case-control study is under preparation for further substantiation of the health hazards connected with exposure to softwood and other possible occupational factors related to sinonasal cancer. PMID- 3976391 TI - The autogenous mucosal cyst procedure. Experimental reconstructive surgery of the airway with a new composite graft technique. AB - Autogenous buccal mucosa was transplanted to the pretracheal region in five beagles. Subsequently a cyst developed in which the graft constituted the main part of the cyst wall. After 4 to 13 weeks the cyst was explored and a perforated autogenous cortical bone plate was sutured to its vertex. After a further 5 to 7 weeks the resulting composite graft was sutured to an anterior tracheal window defect. All dogs survived. They did not lose weight. One dog had moderate breathing difficulties during exertion. At bronchoscopy, which was performed in all dogs, no contractions or granulations were seen but the stability of the airway wall in the grafted areas was reduced. These areas were removed after 8 to 15 months and studied by light microscopy, scanning electron microscopy and transmission electron microscopy. The mucosa survived in all cases. Total resorption of the bone graft occurred in all but two cases, in which remnants were found. PMID- 3976392 TI - Effect of glycerol on furosemide-caused EP decrease in guinea pig neonates. AB - Furosemide, a loop diuretic, reduces the endocochlear potential in guinea pigs. In our previous experiment using adult guinea pigs, glycerol was thought to open the blood-cochlea barrier and to help furosemide to reach its site of action in the stria vascularis. The present study was designed to determine whether or not the same potentiation by glycerol occurs in neonate guinea pigs. In one group, furosemide (10-30 mg/kg) was administered, while in another group, 50 v/v% glycerol (1 ml/kg) was administered 15 minutes prior to the injection of furosemide. Furosemide reduced the EP significantly more in neonates than in adults. This effect was not potentiated in the glycerol-pretreated group. From these findings, it seemed conceivable that the neonate blood-cochlea barrier still remains immature in some functions. PMID- 3976393 TI - Peptides of the otosclerotic perilymph examined by analytical isotachophoresis. AB - Perilymphs of normal and otosclerotic origin were separated chromatographically on a Sephadex G-25 microcolumn. Peptide composition of the perilymphs was compared by capillary analytical isotachophoresis in the molecular mass range 0.3 5 kD. Otosclerotic perilymph samples contain a heterogeneous, UV-absorbing peptide subfraction which is not detected in the normal perilymph. Normal and otosclerotic perilymph, furthermore, contain four common subfractions detected in twice the normal concentration in the otosclerotic perilymph. These ITP subfractions are degraded during acid hydrolysis (6 M HCI). On the contrary, otosclerosis is a deficient state compared with the normal, as the number of peptides or oligoglycopeptides is twice as high in normal as in otosclerotic perilymph, beside the otosclerosis specific peptides. PMID- 3976394 TI - Methyl mercury ototoxicity in mice determined by auditory brainstem responses. AB - Mice of the C57 B1/6 strain were used to assess auditory deficits due to methyl mercury chloride intoxication. Auditory Brainstem Responses were obtained to pure tone stimuli from 4 to 78 kHz. Physiologic thresholds were compared with behavioral methods for determining audibility in mice. Two dosage levels were studied; 4 and 8 mg/kg. Recordings were taken weekly, for each mouse, for 3 consecutive weeks after initial injection. Analysis of physiologic threshold and latency indicated that methyl mercury chloride causes auditory deficits at all frequencies tested with the greater effect in the higher frequencies. Additionally, latencies indicated nerve conduction hypersensitivity in the brainstem. PMID- 3976395 TI - Effects of intravenous glycerol injection on inner ear fluid electrolytes. AB - Under sodium pentrobarbital anesthesia (20-30 mg/kg, i.p.), normal guinea pigs received an intravenous injection of glycerol (1.0 ml/kg). Serum, cerebrospinal fluids (CSF) and inner ear fluids were collected from the scala tympani perilymph, scala vestibuli perilymph and the scala media endolymph. The sodium and potassium concentrations were assessed using microflame photometry. Increases in sodium concentration were found in the CSF and the scala tympani perilymph; no significant changes were observed in the serum, scala vestibuli perilymph or the scala media endolymph. These sodium increases were considered to be a result of the dehydration process caused by the osmotic agent glycerol. Increases in potassium concentration were found only in the scala vestibuli perilymph. PMID- 3976396 TI - Efficacy of Metronidazole in experimental Bacteroides fragilis otitis media. AB - The efficacy of metronidazole in otitis media due to Bacteroides fragilis was evaluated in a guinea pig model. Fifty-nine animals received an injection of 10(8) live B. fragilis bacteria through the tympanic membrane into the right middle ear cavity and metronidazole therapy was started 7 days later. On day 14 after challenge the animals were sacrificed and their middle ears analysed. Intraperitoneal injection of 6 mg metronidazole (about 20 mg per kg) once daily, 6 mg twice daily and 15 mg (50 mg per kg) once daily reduced the incidence of culture positive ears from 13/17 among untreated controls to 7/17 (p = 0.08), 3/10 (p = 0.05) and 2/15 (p = 0.001), respectively. The therapeutic efficacy of metronidazole in experimental otitis media was less than that expected from the concentrations of drug recorded in serum and the drug levels presumed to be achieved in the middle ear effusion. PMID- 3976397 TI - The effect of pressure change rate on the eustachian tube function in pressure chamber tests. AB - The capacity of the Eustachian tube to equilibrate pressure differences across the eardrum was tested repeatedly at different rates of pressure change with the aid of a quantitative impedance method in a pressure chamber. Three recordings of the active and passive pressure equilibration functions were made during chamber pressure changes of 0.3, 0.7 and 1.5 kPa-1s in 53 ears in 28 otologically healthy subjects. The middle ear pressures at which the active and passive equilibrations were achieved increased with increasing rates. The test-retest reliability was not rate dependent as regards the passive pressure equilibration functions, but tended to deteriorate with increasing rates for the active equilibration functions. Advantages and disadvantages of the different rates in such tests are discussed. PMID- 3976398 TI - Intrabeat relationship of postrotatory nystagmus in normal subjects. AB - Intrabeat relationships between duration, amplitude and velocity of the slow phase of nystagmus and between amplitudes of the fast and slow phase of nystagmus were analysed from postrotatory responses in 10 normal subjects, using linear regression analysis. For 5 subjects, the tests were repeated five times. Highly significant correlation was found between velocity and amplitude of the slow phase in 9 of 10 subjects, whereas in one subject it was less significant. All subjects exhibited a significant correlation between velocity and duration of the slow phases. These intrabeat relationships were repeatable and representative for each individual. Highly significant correlation was found between amplitudes of the slow and fast phases of nystagmus in all subjects. No interindividual differences in these variables could be observed. The results indicate that the end-point of the slow phase of vestibular nystagmus in darkness is controlled by positional and durational corollary circuitries. The positional signal in displacement circuitry is probably derived by integration of the velocity signals from the labyrinths. The durational circuitry is presumably more dominant at high nystagmus velocities in order to permit sufficient time for fixation. PMID- 3976399 TI - Ganglion cell counts in the cochleae of patients with normal audiograms. AB - Spiral ganglion cells were counted in the right cochleae of 16 patients with normal audiograms and without a history of hearing deficit or other auditory symptoms. Total counts ranged from 29 802 to 38 352, with a mean of 33 623. There was no relationship between total counts and patient age or between total counts and length of either the cochlea or the spiral ganglion. PMID- 3976401 TI - Kinetics of di-(2-ethylhexyl) phthalate in immature and mature rats and effect on testis. AB - The testicular response of di-(2-ethylhexyl) phthalate (DEHP), as well as the kinetics of DEHP and its primary metabolite mono-(2-ethylhexyl) phthalate (MEHP), were studied in immature and mature rats. After 14 daily oral doses of 1.0 g DEHP/kg body weight to 25, 40 and 60-day-old rats, testicular damage was observed in the youngest age group only. DEHP was not found to any significant extent in the peripheral plasma after an oral dose of 1.0 g DEHP/kg body weight. High plasma levels of MEHP were found, with maximal plasma concentrations ranging from 48 to 152 micrograms/ml. The in vitro plasma protein binding of MEHP was extensive, approximately 98%, in all age groups and no age-related difference in the elimination half-life was observed. The amount of DEHP-derived material excreted in urine was twice as high in 25 as in 60-day-old rats. The mean area under the plasma concentration-time curve of MEHP was also significantly larger in 25 than in 40 and 60-day-old rats. These observations suggest that the extent of absorption, and hence total exposure to MEHP and its metabolites, is higher in young than in more mature rats after oral administration of DEHP. It seems probable that this finding is relevant to the age-related difference in the toxic effects on the testis. PMID- 3976400 TI - Human optokinetic afternystagmus. Effects of repeated stimulation. AB - Normal human subjects were exposed to repeated optokinetic afternystagmus (OKAN) testing in either one direction or alternating directions of stripe movement. Sessions were conducted at intervals of either one week or several weeks. Repeated exposure to OKAN stimulation in one direction produced significant response decrements in cumulative displacement, short time constant, long time constant, and the coefficient of the long time constant component (C). The data suggest that the decrease in C and cumulative displacement occurred most noticeably between trials 3 and 4 of the first session. Retesting after 1 week, and up to 8 weeks later revealed no recovery. Repeated exposure to alternating leftward and rightward stimuli resulted in response decrement in both cumulative displacement and C. Responses to leftward stimuli were indistinguishable from responses to rightward stimuli. PMID- 3976402 TI - Morphine antidiuresis in conscious rats: contribution of vasopressin and blood pressure. AB - Intracerebroventricular injections of morphine (5-20 micrograms) produced a dose dependent antidiuresis in the conscious hydrated rat. Naloxone pretreatment completely abolished this antidiuretic effect, but pretreatment with a specific antidiuretic vasopressin antagonist did not change the morphine antidiuresis. The vasopressin concentration in the first voided urine after antidiuresis from morphine treated rats was found to be in the same range as the vasopressin concentration in urine from saline treated rats. Injections of 20 micrograms morphine intracerebroventricularly in conscious hydrated rats gave a short decrease in heart rate but not in mean arterial blood pressure. This indicates, that either liberation of vasopressin nor a fall in systemic blood pressure contribute to the morphine antidiuresis. PMID- 3976403 TI - Pitfalls in the interpretation of whole-body autoradiograms: long-time retention in brain and adrenal cortex caused by metabolic incorporation of 14C from various labelled xenobiotics. AB - The long-time retention of radioactivity in mice was studied by whole-body autoradiography after administration of 1-14C-alkanes (C12 and C16), 1-14C polychlorododecanes (56 and 68% Cl w/w), U-14C-polychlorohexadecane (23% Cl w/w), ethyl-14C-phenacetin and ring-3H-phenacetin. All the labelled xenobiotics, except the high-chlorinated (68% Cl) polychloroalkane and the ring-3H-phenacetin, gave rise to long-time (12-60 days) retention of radioactivity in the central nervous system and in the adrenal cortex; the distribution of radioactivity within the brain corresponded to the stain intensity of myelin stained sections. Administration of 1-14C-fatty acids (C12 and C16) and 1-14C-acetylcoenzyme A gave a similar distribution pattern. The lipophilic radioactivity in brain and adrenal tissue was extracted and separated with thin-layer chromatography. In the adrenal extracts, the label co-chromatography mainly with cholesteryl ester, and in the brain extracts with cholesterol and with more polar lipids (mainly phosphatidyl choline and -ethanolamine). The brain homogenate contained a non-extracted, probably proteinaceous, residue, with comparably high radioactivity. The results show that several 14C-labelled xenobiotics which give long time retention of radioactivity in the adrenal cortex and brain, are degraded to intermediates with the possibility to become incorporated into endogenous substances. The high chlorinated alkane (1) and ring-3H-phenacetin (2) did not give such long time retention due to its persistance towards degradation (1), and lack of labelling of the degradable part of the molecule (2). It is concluded that erroneous interpretations can be drawn from distribution studies if the routes of degradation and positions of label of the 14C-labelled compounds are not considered. PMID- 3976404 TI - Chlorpromazine increases the lowered response to antidiuretic hormone in rats with lithium-induced diabetes insipidus. AB - The interaction between chlorpromazine (CPZ) and lithium on renal concentrating ability was studied in rats fed a Li-containing diet for 8 weeks (plasma-Li 0.6 0.7 mmol/l). CPZ (15 mg/kg daily orally) reduced the polydipsia and increased the ability to concentrate the urine upon water deprivation in rats treated with lithium. CPZ also reduced systolic blood pressure, but had no effect on the glomerular filtration rate or plasma levels of arginine vasopressin (AVP) in hydrated rats treated with lithium. However, CPZ prevented the rise in plasma AVP levels observed in lithium-polyuric rats in response to dehydration. During anaesthesia CPZ partially restored the impaired anti-diuretic response to exogenous AVP in rats treated with lithium. CPZ had no influence on plasma-Li levels in rats treated with lithium. It is suggested that CPZ by unknown mechanisms interferes with the effects of lithium on the water permeability response to AVP. PMID- 3976405 TI - Anticholinergic activity in the serum of patients receiving maintenance amitriptyline or doxepin therapy. AB - The anticholinergic activity in serum of depressive patients receiving amitriptyline (50-300 mg/day) or doxepin (50-225 mg/day) was measured using a radioreceptor assay. In this method the membrane suspension prepared from rat brain was able to bind the potent muscarinic antagonist, quinuclidinyl benzilate. Using atropine as a standard, the antimuscarinic activity of several compounds can be measured in the serum of patients receiving drugs with anticholinergic effects or side-effects. The steady state serum levels of amitriptyline and doxepin and their desmethylated metabolites, nortriptyline and desmethyldoxepin were measured by radioimmunoassay in the same serum samples. The antimuscarinic activity in serum measured as atropine equivalents was 2.7 +/- 0.4 (S.E.M.) ng/ml in amitriptyline patients and 1.1 +/- 0.2 ng/ml in doxepin patients. There was a highly significant correlation (P less than 0.001) between amitriptyline (r = 0.92) and nortriptyline (r = 0.79) concentrations and serum antimuscarinic activity. The correlation was less clear, although statistically significant for doxepin (r = 0.42, P less than 0.05) and desmethyldoxepin (r = 0.58, P less than 0.01). The better correlation between serum drug levels and antimuscarinic activity in amitriptyline than in doxepin patients is probably due to the higher affinity of amitriptyline and its desmethylated metabolite to muscarinic receptors with the doses used in the present study. The method may have clinical applications e.g. in evaluation of excessive anticholinergic activity in patients. PMID- 3976406 TI - Dexamethasone suppression test and the levels of serum growth hormone, plasma vasopressin and plasma homovanillic acid in depressed in- and outpatients. AB - A total of 206 depressive patients (176 outpatients and 30 inpatients) underwent a dexamethasone suppression test (DST). Resting levels of serum growth hormone (GH), plasma vasopressin (AVP) and plasma homovanillic acid (HVA) were also measured in a proportion of the patients. Fifty-seven per cent of the endogenous patients showed nonsuppression of cortisol in the DST, while 92% in the nonendogenous group showed normal suppression. The diagnostic confidence of a positive test was 83%. The sensitivity and specificity of the test was slightly higher among inpatients than out-patients, and serum cortisol value at 4 p.m. was more useful than the morning value. No significant correlation was found between severity of the depression as measured by the Hamilton Rating Scale for Depression and serum cortisol. In single subjects there was, however, an obvious correlation. The levels of serum GH, plasma AVP and plasma HVA did not differ in the endogenous and nonendogenous groups, and there was no correlation between serum cortisol in the DST and the concentrations of the other hormones or HVA in plasma. PMID- 3976407 TI - Antidepressive therapy in depressed clinical suicides. AB - A total of 61 clinical suicides, all of them fulfilling the Research Diagnostic Criteria for a depressive disorder, were examined with regard to the psychopharmacological treatment they received at the time of their suicide. Scarcely half were treated with antidepressants, and only a small minority were optimally treated. One of the reasons for this therapeutic inadequacy lies in a discrepancy between the clinical and RDC diagnoses. An improvement in diagnostic practice, in the sense of paying more attention to the presence of a depressive syndrome, along with an improvement in psychopharmacological treatment, could contribute to a reduction in the clinical suicide rate, which has recently been observed to be increasing. PMID- 3976408 TI - Assaultive alcoholics 20 years later. AB - In a consecutive series of 257 alcoholics from an out-patient department 53 were judged as assaultive and 38 as suicidally inclined at the clinical examination 20 years ago. At the follow-up the assaultive alcoholics had a 3.3 times increased mortality rate, the suicidally inclined 1.9 times and the others 1.7 times compared with the general population. The assaultive alcoholics had an increased rate of suicides, intoxications and other alcohol-related deaths compared with other alcoholics. Repeated assaultive behaviour was uncommon. It is concluded that a skilled psychiatric evaluation of assaultive behaviour in alcoholism has an important predictive value. PMID- 3976409 TI - Prophylactic efficacy of lithium and its effective plasma levels in Chinese bipolar patients. AB - One hundred and one bipolar patients with at least two episodes during the 2 successive years prior to lithium received continuous lithium treatment for 2 years. The prophylactic efficacy of lithium increased from 60% to 73% when patients with individual standard deviations of plasma lithium of more than 0.2 mM/l were excluded. Most of the good responders showed individual mean plasma lithium levels from 0.5 mM/l to 0.79 mM/l. PMID- 3976410 TI - Adverse drug reactions--an epidemiological study at psychiatric hospitals. PMID- 3976411 TI - Partnership problems as causes of endogenous and neurotic depressions. AB - Content analysis of biographic interviews with endogenous and neurotic depressives shows that problems in a partnership carry particular weight as triggers of depression. In this respect, however, separations and the death of a partner play a comparatively less important role. Neurotic depressives become significantly more often depressive because of partnership-related events than endogenous depressives. Also in qualitative respects the causes for depression differ between the two groups: in endogenous depressives a threat of real loss often triggers depression, whereas neurotic depressives fall ill more frequently as a result of disappointments and injuries caused by the partner. Accompanying differences in the course of the partnership, the choice of partner and the premorbid personality are discussed. PMID- 3976412 TI - A comparison of some processing time measures based on eye movements. PMID- 3976413 TI - Subjects' assessment of the processing demands of a series of orienting tasks. PMID- 3976414 TI - Intersensory facilitation and inhibition: immediate arousal and location effects of auditory noise on visual choice reaction time. PMID- 3976415 TI - An attempt to distinguish between kinematic and motor memory components. PMID- 3976416 TI - Correlation of detrusor vesicae activity to radiologic findings in childhood myelodysplasia. AB - In selected cases of childhood myelodysplasia associated with incontinence oral anticholinergics, e.g. atropine, may significantly improve the results of continence training programs. At present, the differentiation of patients who may benefit from this kind of pharmacotherapy from those who do not respond calls for laborious recordings of the intravesical pressure. Urography and micturition cystourethrography routinely used for the morphologic evaluation of the urinary tract were compared with the pressure tracings. No useful correlation between findings was obtained, thus excluding the possibility to replace the pressure studies by the much simpler radiologic examinations. PMID- 3976417 TI - Radiographic changes in cortical bone after intramedullary nailing. An experimental investigation on rabbits. AB - Transverse osteotomies of the midshaft of the tibia in 75 rabbits were stabilized with intramedullary nails which prevented rotational instability. In a further 36 animals intramedullary nailing was performed without preceding osteotomy. The animals were able to move freely immediately after the operation without any supporting case or splint. The structural changes in the bones were analysed radiographically 3 to 24 weeks after the operation. Fracture repair was accompanied by moderate periosteal callus formation and remodelling of the callus was seen from 9 weeks on. A sleeve of new endosteal bone surrounding the nail was found after 12 weeks. Porotic transformation of the diaphyseal cortical bone was seen in both osteotomized and non-osteotomized bones from 12 weeks onwards. It is concluded that intramedullary nailing provides favourable conditions for fracture repair and enables accurate radiographic assessment of the healing. Attention is focused on the causes and features of secondary porotic transformation of the cortical bone after intramedullary nailing. PMID- 3976418 TI - Fatal thrombo-embolic complications at aorto-femoral angiography. AB - Fatal complications due to angiographic procedures are rare. An awareness of these complications is, however, mandatory in order to be able to prevent them. This report concerns three fatal cases with a deleterious complication of distal macro- and microembolization in connection with the angiographic procedure. In all cases the local circulation was surgically restored. The microcirculation was 'out of reach' and all three patients succumbed with profound tissue ischemia. PMID- 3976419 TI - Embolization of medullary carcinoma of the thyroid invading the trachea. Report of a case. AB - A case is presented of medullary thyroid carcinoma causing severe hemoptysis by invading the trachea. After embolization with polyvinyl alcohol there was marked diminution of tumor vascularity. The embolized portions were significantly revascularized two months later, however. PMID- 3976420 TI - Preliminary experience with mammography. Reliability of mammography in patients with a palpable tumour of the breast. AB - Radiologists with very limited practical experience in mammography initially achieved a low PVpos (0.50) and a high PVneg (0.95) in blind mammography of 80 patients with 85 excised and histologically examined breast tumours. After having read films from approximately 2500 patients the initial films were blindly reevaluated. PVneg was unchanged, whereas PVpos was elevated significantly (0.80). The intraobserver variation was 11.5 per cent. The actual interobserver variation was 3.2 per cent. These findings indicate that the reliability of blind mammography in patients with palpable tumours of the breast is considerable, also in case of only limited mammographic experience. PMID- 3976421 TI - Computed tomography in staging of rectal carcinoma. AB - Computed tomography (CT) was performed on 204 patients with rectal carcinoma in an attempt to determine the tumour stage preoperatively. In 154 patients CT and histopathology could be compared. Correct staging was achieved in 60 to 70 per cent of the patients, but considerable over- and understaging limit the use of CT in preoperative staging of rectal carcinoma. PMID- 3976422 TI - Endoscopically inserted endoprosthesis in inoperable biliary obstruction. AB - Attempts were made to introduce an endoprosthesis into the biliary tract using endoscopic technique in 13 patients with unresectable extrahepatic biliary obstruction. In all but one papillotomy was performed. Successful insertion of the prosthesis was achieved in 11 patients, 10 of whom had effective palliation of jaundice. Mean survival was 4 1/2 months (range one week-13 months). One patient developed pancreatitis following prosthesis insertion. No further complications occurred in the series. This method is an attractive alternative to biliodigestive bypass procedures in patients with inoperable pancreaticobiliary lesions. When compared with internal and/or external drainage by the percutaneous transhepatic technique the method to place an endoprosthesis endoscopically has several advantages. PMID- 3976423 TI - Pancreatography in a family with hereditary pancreatitis. AB - Endoscopic retrograde pancreatograms of five cases of hereditary pancreatitis in one family are presented. The appearance of the pancreatic duct was abnormal in all cases but no findings were specific to hereditary pancreatitis. In two of the cases the only abnormality was dilatation of the secondary pancreatic ducts or caudal area ducts. PMID- 3976424 TI - Unstable thoracolumbar fractures. A comparative radiologic study of conservative treatment and Harrington instrumentation. AB - Two comparable groups with unstable thoracolumbar fractures have been studied: one consisting of 23 patients treated conservatively and one consisting of 20 patients treated surgically with Harrington instrumentation. The vertebral injuries have been analysed radiologically at the time of injury as well as after completion of conservative and surgical treatment and at follow-up on average 6 years and 3 months after injury in the conservatively treated group and 2 years and 2 months after injury in the operated group. The vertebral fractures were often solitary at the L1 level with a characteristic radiologic appearance and mainly caused by flexion-rotation injuries. There were indirect signs of associated ligament injuries in most cases. Indirect signs of associated disc injury were found in 77 per cent of the cases, most of them related to the superior disc. The signs of disc injury were accentuated at the two follow-up examinations. In the operated group, the radiologic appearance of the vertebral body normalised after Harrington instrumentation. A preoperative gibbus angle of 19.4 degrees was reduced to 6.8 degrees on average postoperatively. In 13 of the operated cases the rods were removed. Among these patients the gibbus angle increased to 17.6 degrees at the final follow-up examination, compared with 11.9 degrees in the patients who had their rods retained. This difference in gibbus angle was significant. In the conservatively treated group, the initial gibbus angle of 19.5 degrees continuously increased to 27.6 degrees at the follow-up examination. All vertebral fractures had healed at the follow-up examination. PMID- 3976425 TI - Comparison of 99Tcm lymphoscintigraphy and lymphangiography in patients with malignant lymphomas. AB - Comparison of abdominal lymphoscintigraphy with 99Tcm microcolloid and conventional lymphangiography in 38 patients with malignant lymphomas showed 62 per cent agreement when the results were classified as normal, doubtful and abnormal. The present scintigraphic method seems to be sufficiently safe and accurate as a screening test, without significant side effects and associated with little patient discomfort. PMID- 3976426 TI - Detection of myocardial infarction in dogs by contrast enhanced sequential CT scans. AB - Surgically induced myocardial infarcts were studied in ten dogs by contrast enhanced computer transmission tomography at several stages of the infarct evolution. The hearts were scanned sequentially at 3.4 second intervals during intravenous bolus injection of contrast medium and every five minutes following the completion of a ten minute contrast medium infusion. Cardiac borders including those of the infarctions were defined by computer graphic techniques. Data from several consecutive scans were combined into one image; the ventricular chamber boundaries and those of the epicardium were reconstructed from images taken during the bolus injection. Images taken during the contrast medium washout phase were used for infarct area determination. A statistical definition of the boundary between normal tissue and infarcted myocardium was obtained which correlated well with autopsy measurements. Image analysis as described here may serve as a basis for infarct volume estimates as well as differentiation between acute and chronic infarctions. PMID- 3976427 TI - Prognosis in glomerulonephritis. A follow-up study of 395 consecutive, biopsy verified cases. I. Classification, renal histology and outcome. Report from a Copenhagen study group of renal diseases. AB - Between 1967 and 1977, 395 consecutive cases of glomerulonephritis (GN) were collected by a Copenhagen study group. The diagnosis was established by histological and biochemical criteria. Light microscopy investigations of thin silver-stained sections were applied. In a follow-up in 1980 all cases were categorized by one of the following end points: death without uremia, uremia, recovery, or censored cases. The course is presented in figures showing the cumulated distribution of outcomes in relation to observation time. Each histological subgroup of GN had its own characteristic course with respect to initial rates of changes in the renal state, as well as to frequency of recovery, uremia and death. The prognosis was good in minimal changes GN and proliferative GN, bad in unclassified GN and worst in extracapillary GN. When part of a connective tissue disease, GN carried a poor prognosis. We conclude that histological classification of GN based on light microscopy offers a reliable means of predicting the long-term prognosis. PMID- 3976428 TI - An evaluation of ultrafiltration as treatment of diuretic-resistant oedema in nephrotic syndrome. AB - Plasma volume, plasma colloid osmotic pressure, creatinine clearance and sodium excretion were measured before and after ultrafiltration treatment in six patients with diuretic-resistant nephrotic syndrome. The mean total ultrafiltrate volume in two sessions on two successive days was 7460 ml, the mean ultrafiltration rate was 22.0 ml/min and the calculated plasma refilling rate was 19.9 ml/min. Plasma volume and creatinine clearance were unchanged and sodium excretion was reduced after treatment. A short-lasting drop in blood pressure was seen in 3 of the 12 treatment sessions. No other complications were noted. Ultrafiltration is a safe and useful alternative in the treatment of the few patients with massive oedema due to nephrotic syndrome not responding to conventional therapy. PMID- 3976429 TI - A case of brucellosis complicated by endocarditis and disseminated intravascular coagulation. AB - Brucellosis, being eradicated among domestic animals in some countries, is still prevalent in some others where it poses a potential threat to the consumers of milk and cheese and those working with animals and meat. The patient presented below had contracted a severe and long-standing Brucella abortus infection by ingesting raw camel milk. She had signs of endocarditis and disseminated intravascular coagulation, but recovered when treated with tetracyclin and streptomycin. PMID- 3976430 TI - Platelet counts in myocardial infarction, angina pectoris and peripheral artery disease. AB - Serial determinations of peripheral venous platelet counts were performed in 43 consecutive patients with acute chest pain. On admission, patients with acute myocardial infarction (AMI) had a significantly lower mean platelet count (p less than 0.05). Thereafter a further reduction was seen with steadily reduced platelet counts by about 20%, both in comparison with healthy controls (p less than 0.001) (n = 113) and patients with peripheral artery disease (PAD) without heart symptoms (p less than 0.005) (n = 54). The platelet number increased one week after admission and even thrombocytosis was observed. The changes in platelet number during AMI seem to parallel the changes in platelet function. Patients with PAD had normal mean platelet counts. Female patients as well as healthy subjects had significantly higher values than men (p less than 0.01). PMID- 3976431 TI - Highly refractile myocardial echoes in familial amyloidosis with polyneuropathy. A correlative echocardiographic and histopathological study. AB - Two-dimensional echocardiography in systemic amyloidosis has in most cases shown highly refractile myocardial echoes. The morphological basis for this finding has so far been little examined. In the present study, echocardiographic examinations were performed in vitro on autopsied hearts from ten patients with familial amyloidosis with polyneuropathy (FAP). An ultrasonically visible needle was used to localize the abnormal echoes, and samples were taken for histological analysis of the region of the echocardiographic abnormality. Our results indicate that the highly refractile myocardial echoes in FAP are due to nodules composed of collagen and amyloid. PMID- 3976432 TI - Treatment of hyperthyroidism with standard doses of radioiodine aiming at ablation. AB - Sixty patients with hyperthyroidism were treated with standard doses of 131I during 1969-83 in our department. The doses were 10-25 mCi (370-920 MBq), mostly 15 mCi (550 MBq). 38 of the patients have become hypothyroid, mostly within one year after treatment. There were 3 early relapses of hyperthyroidism; these patients became hypothyroid within one year after an additional dose of radioiodine. All hypothyroid patients had early substitution with l-thyroxine before overt clinical symptoms and signs had developed. There were no late relapses of hyperthyroidism. 15 patients had died during the follow-up; all were euthyroid or hypothyroid with adequate substitution. 28 of the 60 patients have been followed for 5-14 years, 14 for 2-5 years, 7 for 1-2 years and 10 for less than one year. Standard dose 131I treatment offers certain advantages compared with attempted individualized treatment. Late hypothyroidism after individualized dosage may be difficult to anticipate and detect, whereas early hypothyroidism after ablative standard dose treatment is easy to detect and control. Generally speaking, hypothyroidism is not to be regarded as a complication of radioiodine treatment for hyperthyroidism, but as its natural end result. The fixed dose schedule is especially well suited for regions where hyperthyroidism with no goitre or a small goitre is common. PMID- 3976433 TI - Investigation of TSH dependency, circulating thyroid autoantibody, and morphological features of recurrent nontoxic goitre. AB - Pathogenetical factors possibly responsible for recurrence of nontoxic goitre in a nonendemic area are evaluated. A group of 22 female patients admitted for surgical treatment of recurrent nontoxic goitre was compared with a control group of 86 female nontoxic goitrous patients not operated upon before. Preoperative serum baseline thyrotrophin levels in the recurrent goitre group were low normal and did not differ significantly from those in the control group. Circulating thyroid microsomal autoantibodies, thyroglobulin antibody titers, and the densities of lymphocytic aggregation in goitrous tissue did not differ significantly in the two groups. Thus, none of the parameters studied were likely explanations of regrowth of goitre. PMID- 3976434 TI - Reversal of increased whole blood and plasma viscosity after treatment of hypothyroidism in man. AB - Blood and plasma viscosity was measured in 13 patients with hypothyroidism before and during replacement therapy with l-thyroxine. Blood viscosity was measured at natural hematocrit and after adjustment to 40%. The values were compared to those of 12 healthy subjects. Both blood viscosity at hematocrit 40% and plasma viscosity were increased in the hypothyroid state and decreased to the levels of the reference group after treatment. The therapy-induced changes in blood and plasma viscosity were intercorrelated at low but not at high shear rates. The changes in viscosity were not correlated to the reductions in lipoprotein concentrations resulting from therapy. The institution of l-thyroxine replacement therapy was also followed by reductions in erythrocyte sedimentation rate and diastolic blood pressure, both with significant correlations to the decrease in blood viscosity. It is concluded that in hypothyroidism there are changes in both plasma and erythrocytes that increase blood viscosity, with normalization upon treatment with l-thyroxine to euthyroidism. PMID- 3976435 TI - Positive correlation between urinary excretion of catecholamine metabolites and tumour mass in pheochromocytoma. Results in patients with sustained and paroxysmal hypertension and multiple endocrine neoplasia. AB - In a series of 53 pheochromocytoma patients operated on at Sahlgren's Hospital during 1956-82, a positive linear correlation is established between the 24-hour urinary excretion of vanilmandelic acid (mumol/24 h) and tumour mass (g). A similar correlation was found between the excretion of metanephrines and tumour mass in 33 subjects. The patients were subgrouped according to their type of hypertension. A statistically significant correlation between vanilmandelic acid excretion and tumour mass persisted in groups IA (sustained hypertension without attacks), IB (sustained hypertension with attacks), and II (paroxysmal hypertension) but not in group III (miscellaneous patients). There was also a correlation between metanephrine excretion and tumour mass in groups IB (n = 8) and II (n = 12). In 10 patients with the syndrome of multiple endocrine neoplasia, a positive correlation was found between tumour mass and the excretion of vanilmandelic acid, metanephrines and adrenaline. PMID- 3976436 TI - Liver affection in iron overload studied with serum ferritin and serum aminotransferases. AB - Liver dysfunction as measured by S-ALAT activity was present in 72% of patients over 40 years of age with HLA-related iron overload, mainly detected by laboratory screening. Liver dysfunction was correlated to the amount of iron stored (r = 0.54, p less than 0.001). When iron was removed by phlebotomy, liver function returned to normal. S-ALAT activity was closely correlated to serum ferritin concentration (r = 0.73, p less than 0.001). Even a mild iron excess can affect hepatocytes and result in increased levels of ferritin and aminotransferases in serum. Patients with "transaminitis" should be investigated for iron overload. PMID- 3976437 TI - ADP-induced platelet aggregation in young female survivors of acute myocardial infarction and their female controls. AB - Adenosine diphosphate (ADP)-induced platelet aggregation was studied in 35 young female survivors of acute myocardial infarction (AMI) 14-46 (median 30) months after the infarction. The results were compared to those obtained for 35 control females of comparable age. Five different final ADP concentrations (0.2-1.0 microM) were employed, and the object was to assess the slope for the primary wave of aggregation as well as the threshold ADP concentration for secondary aggregation. The results showed that AMI patients and control subjects did not differ with respect to the primary wave of aggregation. However, secondary platelet aggregation was recorded to a significantly higher extent (p less than 0.02) in AMI patients than in their controls. The results therefore support the concept that enhanced platelet reactivity is present in patients with documented ischemic heart disease. PMID- 3976438 TI - Prevention of recurrent life-threatening ventricular arrhythmias by temporary cardiac pacing. AB - Overdrive pacing has been applied in 26 patients to prevent frequent recurrent ventricular fibrillation (VF) and ventricular tachycardia (VT) occurring in the setting of ventricular extrasystole of 2-5 degrees graded by Lown. These patients had 3-47 recurrent attacks of VF and VT (11.4 +/- 2.4) which were not prevented with antiarrhythmic agents. Overdrive pacing was continued for 2-236 hours (21.3 +/- 3.7) and appeared to be effective in 23 (88.4%) of the 26 patients including those with prolonged QT intervals. Atrial pacing was more effective than ventricular overdriving and required stimulation at a slower rate. Antiarrhythmic therapy and overdrive pacing in combination were more effective than both used independently. Suppression of ventricular extrasystole and prevention of life threatening arrhythmias were achieved by increasing the heart rate by 23.2 +/- 4.5 beats/min. PMID- 3976439 TI - Deep vein thrombosis after aneurysm surgery. AB - In a prospective study of 100 consecutive patients who underwent operations for intracranial aneurysms, the incidence of deep vein thrombosis (DVT) was 14%. The diagnosis was based on contrast venography, which was carried out in any patient who showed clinical symptoms and signs of DVT. In the presence of DVT the patient was placed on bed rest and intravenous plus peroral anticoagulation was begun. No complications thought to be related to anticoagulation were observed. A programme of postoperative prophylaxis is suggested for a selected group of aneurysm patients with a high risk for thromboembolic disease. PMID- 3976440 TI - Epidural monitoring of the intracranial pressure in severe head injury characterized by non-localizing motor response. AB - Recent studies on prognostic variables and the intensive care of head injuries enabled us to select 64 patients and administer a standard treatment protocol to prevent secondary brain injury. All the patients were in coma with a flexor motor pattern as the best response between 6 and 24 hours after the accident and/or decompressive surgery. Continuous epidural intracranial pressure (ICP) monitoring was used in all patients to control the effect of positioning, analgetics, hyperventilation and osmotherapy. None of the patients with a normal initial ICP (15 mm Hg or less) developed an ICP increase leading to brain tamponade. A subsequent further rise to 40 mm Hg signified a very high risk of progression towards brain tamponade. The majority of the patients (71%) with a maximum ICP increase of less than 40 mm Hg had an acceptable recovery. After 6-12 months, the outcome in this series of patients was 48% with a good/moderate recovery, 14% with severe deficits and 38% dead/vegetative. PMID- 3976441 TI - The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. A series of 56 cases studied by the computerized tomography. AB - The authors report a series of 56 cases of craniocerebral lesions secondary to missile injuries studied by means of CT scan. CT scans demonstrate the track of the missile, destruction of deep cerebral parenchyma, dissection of the white matter (intracerebral air) and reactive oedema. The prognostic incidence of CT is discussed. The CT scan helps to choose the best therapeutic management with respect to each particular case. PMID- 3976442 TI - Cranio-cerebral injuries from Slaughterer's gun. AB - 3 patients attempted suicide by a powder-activated cattle skull impacting tool (Slauthterer's gun). While captive bolt pre-slaughter stunning in pigs and ruminants is safe, two of the patients remainded conscious after the shot and survived. Despite much lower impact velocity (less than 50 m/sec) these self inflicted brain lesions are as serious as "low velocity" (less than 300 m/sec) penetrating gunshot wounds, mainly because of impaction of bone fragments and the dynamic energy possessed by the bolt. PMID- 3976443 TI - The incidence and developmental process of delayed traumatic intracerebral haematomas. AB - Although delayed traumatic intracerebral haematomas (DTICH) have been frequently reported especially after the advent of computerized tomography (CT), the developmental processes of traumatic intracerebral haematomas and the incidence of DTICH have not been described precisely. Based on early sequential CT examinations of 84 intracerebral haematomas for which initial CT scans were performed as early as within 6 hours of injury, we could ascertain four types of the developmental processes: Type I (39%) included the haematomas which were already evident in the initial CT scans, Type II (11%) the haematomas which were small or medium initially and increased their sizes afterwards, Type III (24%) the haematomas of which admission CT scans could not demonstrate any changes at the sites of development of the haematomas, and Type IV (26%) the haematomas of which initial CT scans showed a salt and pepper or flecked high-density appearance. Types III and IV denoted the DTICH and accounted for 50% of all the haematomas. Therefore, DTICH are thought to be not as uncommon as previously reported. Aetiologies and changes in the concepts of the DTICH are discussed, and it is stressed that, in the cases with eventual extra- and intra-cerebral combined haematomas, any surgical treatment of an extracerebral haematoma plays an important role in the development of DTICH. PMID- 3976444 TI - The management of cerebral arteriovenous malformations. AB - The presentation of 129 cases of cerebral angioma is reviewed. There were 4 main methods of presentation: haemorrhage, epilepsy, deteriorating neurological signs and headache. The fifth common method of presentation, heart failure, almost exclusively confined to infants, was not seen in the current series which includes no paediatric cases. Standard techniques of investigation principly angiography and CT scanning were used in diagnosis and the current indication for surgery was haemorrhage. The mortality rate per haemorrhage in the series considered in natural terms was 3.6%, neurological deficit as a result of the haemorrhage, either major or minor, occurred in a total of 8%, 4% each. Complete excision of the angioma was performed in 69 cases, although in 3 of these it was necessary to reoperate following postoperative angiography which was then used again to confirm total removal. There was 1 death in this series of radical removals, a mortality rate of 1.5%. Six cases however, showed significant neurological deterioration postoperatively, a major morbidity of 8.7%. From the period of observation of these cases and the instance of haemorrhage the annual bleeding rate would appear to be 4.2%. From follow-up of our cases where the lesion was not completely removed the re-bleeding rate would appear to be 2.6%. PMID- 3976445 TI - Third ventricle gliomas. Report of 7 cases with benign clinical behaviour. AB - Neoplasms of the third ventricle are lesions arising within the ventricular cavity, often free but more often pedunculated. True third ventricle tumours are surgically removable. In a consecutive surgical series of 580 intracranial tumours the authors operated on 27 lesions of the third ventricle, 7 of which were benign gliomas. The histological diagnosis was polar spongioblastoma in 5 cases and fibrillar subependymal astrocytoma in 2 cases. The dominant clinical features were a slowly progressive or intermittently increased intracranial pressure syndrome, and mental and visual disturbances. CT and CSF contrastographic studies provided the essential diagnostic data for the therapeutic plan. CT scans at follow-up studies confirmed the successful removal of the lesions. A right trans-ventricular approach was employed in all cases. Depending on the size and position of the lesion, removal was performed through the foramen of Monro or through a sub-choroidal approach. In two patients a ventriculo-atrial shunt was necessary in spite of tumour removal. No surgical mortality occurred and patients are well at a follow-up time of from 2 to 6 years. PMID- 3976446 TI - Transient spontaneous regression of mass effect with glioma. AB - A spontaneous regression of the lesion seen in sequential computertomographic scans does not necessarily indicate a non-neoplastic nature of the pathological process. Two patients with pathologically verified glioma of the brain which showed a temporary regression of the mass effect are reported, and the mechanism of the regression of computertomographic mass signs is discussed. PMID- 3976447 TI - Supratentorial space occupying lesions following infratentorial surgery early diagnosis and treatment. AB - Supratentorial complications of infratentorial surgery are rare. In the last 3 years we have operated on 187 patients with infratentorial lesions and have observed an incidence of 3.7% of supratentorial haemorrhages. Postoperative intracranial air, as shown by early postoperative CT control, was encountered mainly in a subdural frontal location and within the interhemispheric fissure. We performed no surgical decompression of the air accumulation because of the lack of clinical symptoms. Predisposing factors for the development of supratentorial complications remote from the surgical area are hypertonia, female sex, brain atrophy and preoperative shunting procedures. Measures to avoid these complications are discussed. PMID- 3976448 TI - Long term sequelae of hemispheric abscesses as a function of the treatment. AB - The authors compared the clinical, electroencephalographic and CT evolution of 31 cases of brain hemispheric abscesses. The vital prognosis was largely improved by the introduction of the CT scan, as compared with previous series. The functional evolution was better in the group of patients receiving high dosage (15 cases) antibiotics and/or puncture (4 cases) in the case of a large lesion, than in patients whose abscesses were removed (12 cases). The CT scan confirmed this difference, with frequent atrophy after excision. PMID- 3976449 TI - The medial geniculate body of the cat. PMID- 3976450 TI - Excessive dispensing of controlled substances: a legal perspective. PMID- 3976451 TI - Health promotion challenges. PMID- 3976452 TI - Colorectal health check. PMID- 3976453 TI - Benzodiazepines. PMID- 3976454 TI - Sick sinus syndrome. AB - Disease in the sinus node may cause bradyarrhythmias or tachyarrhythmias. Bradyarrhythmias occur because of impaired automaticity (with or without sinus arrest) or because of sinus node exit block. Reentrant or automatic rhythms may produce tachyarrhythmias. Symptoms and signs of sick sinus syndrome include lightheadedness, palpitation, syncope and peripheral or cerebral emboli. After diagnosis by Holter monitoring, symptomatic patients usually improve with placement of a permanent cardiac pacemaker. PMID- 3976455 TI - Second-generation video sigmoidoscopy. AB - A newly developed 60-cm video sigmoidoscope has no image bundle or eyepiece. During scope manipulation, the instrument provides a real-time color endoscopic image on a video monitor as well as a permanent videotape record of the procedure. In a series of examinations performed by residents in family medicine, no complications occurred and patient acceptance was good. Consultations can be obtained using the videotapes. The video recording format overcomes many of the teaching limitations of conventional fiberoptic sigmoidoscopy and may play a role in documentation of procedures as well as certification of competence. PMID- 3976456 TI - Nocturnal enuresis: a review of treatment approaches. AB - Nocturnal enuresis, a common childhood problem, has several plausible etiologies: adverse environmental circumstances, psychologic disturbances and physiologic mechanisms. A wait-and-see approach is commonly adopted, since spontaneous resolution occurs in many children. Moderate success has been reported with the use of tricyclic antidepressants. Two behavioral conditioning approaches are reported to be highly successful in ameliorating enuretic episodes. PMID- 3976457 TI - Extravasation of chemotherapeutic agents. AB - Extravasation of vesicant agents into the soft tissues can lead to painful and indolent ulcerations. Precautions for avoiding extravasation include the use of fresh intravenous lines. The line should be placed in the forearm whenever possible. Hand veins, joint surfaces and extremities with impaired circulation should be avoided as infusion sites. If evidence of extravasation appears, the infusion must be stopped immediately and appropriate measures initiated. PMID- 3976458 TI - Helping children cope with death. AB - When confronted with the death of a loved one, children usually behave according to their developmental level. In the young child, death may be perceived as separation, as the result of magical thinking, or as punishment. Children over six can understand explanations about the cause of death. Parents may seek advice from their family physician about such issues as how the child will react to the death, what the child should be told about death, and whether the child should attend the funeral. PMID- 3976459 TI - Drugs for cough and cold symptoms in hypertensive patients. AB - Most cold preparations contain sympathomimetic decongestants in combination with antihistamines, anticholinergics or expectorants. All of the sympathomimetic decongestants have the potential to elevate blood pressure, yet little information has been reported on their use in patients with hypertension. Phenylephrine and phenylpropanolamine stimulate alpha-adrenergic receptors, causing elevation of blood pressure and a reflex decrease in heart rate. Ephedrine and pseudoephedrine stimulate both alpha and beta receptors, elevating blood pressure with an increase or no change in heart rate. Because little is clinically known, these agents should probably be avoided in hypertensives. PMID- 3976460 TI - Management of acute stroke. PMID- 3976461 TI - Cost of Tolectin. PMID- 3976462 TI - Necrotizing fasciitis. PMID- 3976463 TI - NIMH study measures prevalence of mental illness in U.S. PMID- 3976464 TI - Iatrogenesis of drug therapy. PMID- 3976465 TI - Treatment of hypertriglyceridemia. PMID- 3976466 TI - Difficult intubations: aids and alternatives. AB - Physicians who are likely to encounter emergency situations should know how to secure an airway with techniques other than the standard methods of oral and nasal intubation. The approach and the equipment used depend on the clinician's abilities and experience. Aids and alternative techniques include use of the fiberoptic laryngoscope, guided retrograde transcricoid intubation, esophageal devices, cricothyrotomy, tracheotomy and transtracheal jet ventilation. PMID- 3976467 TI - Mitral valve prolapse and bacterial endocarditis: when is antibiotic prophylaxis necessary? AB - We investigated the association between mitral valve prolapse (MVP) and bacterial endocarditis (BE) in a case-control study of 56 patients with BE and 168 age- and sex-matched controls who had had echocardiography. Cases and controls were selected from patients without other known cardiovascular risk factors for BE. Twenty percent of the BE cases (11 of 56) and 4% of the controls (7 of 168) had MVP; the odds ratio of 5.3 (95% confidence interval 2.0 to 14.4) indicated a significantly greater risk of BE in patients with MVP. This increased those who had preexisting systolic murmurs (9 of 11). Exposure to repeated vascular instrumentation also increased the risk of BE (odds ratio 6.2, 95% confidence interval 2.3 to 16.4); this was independent of the risk associated with MVP. Based upon these data and the incidence of BE in New South Wales, Australia, in 1980, we estimate that 14 of every 100,000 adult patients with MVP would develop BE over a 1-year period, compared with three people in every 100,000 without other known risk factors for BE in the general population. Thus, although the risk of BE is five times greater in patients with MVP, the absolute risk remains small. This indicates that antibiotic prophylaxis is unnecessary for the majority of patients with MVP. We suggest that for patients with MVP not otherwise known to be at high risk of BE, routine antibiotic prophylaxis should be advised only for those who have systolic murmurs. PMID- 3976468 TI - Flail mitral valve syndrome: comparison with chronic mitral regurgitation of other etiologies. AB - Thirty-nine patients with symptomatic severe mitral regurgitation (MR) were studied by cardiac catheterization and two-dimensional echocardiography (2DE) prior to mitral valve replacement. A flail mitral valve was found at surgery in 23 patients (group 1); 16 patients had intact chordae tendineae (chronic MR, group 2). No difference was found between groups 1 and 2 with regard to hemodynamic findings. Left atrial volumes in end systole (LAESV) and end diastole (LAEDV) were determined by 2DE from apical four- and two-chamber views with the use of a biplane area-length method and a light pen system. The LAESV and LAEDV measured 116 +/- 66 ml and 56 +/- 48 ml, respectively, in group 1, as compared with 185 +/- 101 ml and 105 +/- 62 ml in group 2 (p less than 0.025). Ten patients from group 1 with LAESV less than or equal to 100 ml (group 1A) were compared to the remaining 13 patients with LAESV greater than 100 ml (group 1B). Patients in group 1A had significantly smaller left ventricular volume and higher mean pulmonary wedge pressure, pulmonary artery, and left ventricular end diastolic pressure compared to patients in groups 1B and 2 (p less than 0.05). Thus, a subset group of patients with flail mitral leaflets and smaller LAESV has hemodynamic features of acute MR, whereas the remainder with larger LAESV are indistinguishable from patients with chronic MR. PMID- 3976469 TI - Age-related changes in cardiovascular performance in mitral regurgitation: analysis of 61 patients. AB - This study examines the cardiovascular performance in relation to age in 61 patients with moderate or severe chronic mitral regurgitation (MR). Coronary artery disease (CAD) (50% or more diameter narrowing of one or more major coronary arteries) was present in 20 patients (33%). Patients less than 60 years (n = 33) had lower pulmonary artery pressure, systolic arterial pressure, left ventricular (LV) end-diastolic pressure, and pulmonary artery wedge pressure than the patients greater than or equal to 60 years (n = 28) (p less than 0.05). In the 41 patients without associated CAD, the LV end-diastolic pressure and systemic arterial pressure were higher in patients greater than or equal to 60 years (n = 14) than patients less than 60 years (n = 27) (p less than 0.05). The LV end-diastolic pressure showed an age-related increase in the presence or absence of CAD. Thus, older patients with MR have higher LV end-diastolic pressure, probably because of an increase in myocardial stiffness. PMID- 3976470 TI - The influence of exercise training on the ventilatory threshold of patients with coronary heart disease. AB - Out of 156 patients with stable coronary heart disease randomized to either an exercise intervention group or a control group, 41 had complete gas analysis data. Continuous gas exchange data, including the ventilatory threshold, and selected heart rates were determined initially and at 1 year. The mean attendance for the exercise group was 2.2 +/- 0.7 days a week at an intensity of 60 +/- 9% of estimated peak oxygen uptake for 1 year of the study. Statistically significant differences (p less than 0.05) were observed between the exercise group (n = 19) and the control group (n = 22) for peak oxygen uptake (L/min), total treadmill time, and supine rest and submaximal heart rates after 1 year. The most remarkable change was a 16% increase in treadmill time. There was no difference between groups for the ventilatory threshold expressed either as an absolute oxygen uptake or as a percentage of peak oxygen uptake at 1 year. However, there was a significant correlation (r = 0.45; p less than 0.05) between the absolute change in peak oxygen uptake and the absolute change in the ventilatory threshold. These results indicate that a moderate exercise program is inadequate to alter the ventilatory threshold in patients with coronary heart disease and that changes in ventilatory threshold do not explain the increase in treadmill time that usually occurs. PMID- 3976471 TI - Noninvasive assessment of left ventricular wall motion abnormalities by QRS isointegral maps in previous anterior infarction. AB - In order to determine to what extent left ventriculographic abnormalities can be predicted from ECG changes in myocardial infarction (MI), 87 unipolar ECGs were simultaneously recorded in 22 patients with previous anterior MI with no conduction defects. We adopted a QRS isointegral mapping technique for analyzing body surface mapping data. Particular attention was given to the area where the QRS time-integral value was less than the lower limit (mean minus two standard deviations) of the normal, and this area was designated as the departure area. Left ventricular wall motion was assessed by left ventriculography and correlated with the departure area. The departure area demonstrated a close correlation with the left ventricular ejection fraction (r = -0.93) and the extent of asynergy (r = 0.74). It is suggested that the departure area reflects the loss of electromotive force due to MI. We conclude from this study that the QRS isointegral map is a useful method for evaluating left ventricular function in patients with anterior MI. PMID- 3976472 TI - The role of prehospital discharge two-dimensional echocardiography in determining the prognosis of survivors of first myocardial infarction. AB - Two-dimensional echocardiography (2DE) was performed in 47 consecutive survivors (mean age 47 years) of a first myocardial infarction (MI), to assess its value in predicting major cardiac complications (MCC) during the posthospital phase. 2DE was undertaken 1 day before hospital discharge (mean 15 days). A wall motion score was derived by analyzing endocardial motion in 11 left ventricular segments. During a mean 17-month follow-up, 17 patients had MCC: eight (47%) had significant angina; two (12%) reinfarcted, and seven (41%) died. Wall motion scores of patients with MCC (9.2 +/- 0.9) (+/- SEM) were significantly higher compared to those without MCC (3.7 +/- 0.4 (p less than 0.005). A wall motion score greater than or equal to 8 was present in 82% (14 of 17) of patients with MCC compared to 7% (2 of 30) who remained asymptomatic. Patients who died had significantly higher wall motion scores compared to those who survived (11.3 +/- 0.9 vs 4.7 +/- 0.5) (p less than 0.005). Stepwise logistic regression and discriminant analysis, by means of age, infarct site, maximal Killip class, cardiac enzymes, and wall motion score, identified wall motion score and Killip class as the most significant predictors of MCC. Thus predischarge 2DE is capable of identifying high-risk patients prone to developing MCC after a first MI. PMID- 3976473 TI - Clinical and hemodynamic effects of combined propranolol and nifedipine therapy versus propranolol alone in patients with angina pectoris. AB - To determine the comparative effectiveness and hemodynamic effects of long-term oral treatment with propranolol alone and combined with nifedipine in patients with stable angina pectoris, 20 patients with coronary disease were studied by equilibrium radionuclide ventriculography. Measurements were performed at rest and during supine bicycle exercise before treatment, after 4 weeks on propranolol, 1 hour after institution of combined propranolol and nifedipine treatment, and after 4 weeks on the combined treatment. The reduction in exercise rate-pressure product induced by the combination (17.2 +/- 2.6 X 10(3)) was significantly greater (p less than 0.001) than that attained by propranolol alone (19.3 +/- 2.8 X 10(3)). In patients at rest, neither propranolol nor the combined therapy altered global left ventricular (LV) ejection fraction (EF). Without drugs and on propranolol, exercise EF decreased significantly. On the combined therapy there was a significant improvement in exercise EF compared both with rest values (p less than 0.01) and with exercise EF on propranolol (p less than 0.001). Exercise tolerance, expressed as total work load, significantly increased on propranolol and further increased on combined therapy. Thus the combined propranolol/nifedipine therapy in patients with stable angina proved to be hemodynamically superior to therapy with propranolol alone and safe even in patients with moderately depressed LV function. PMID- 3976474 TI - Nuclear magnetic resonance analysis of acute myocardial infarction in dogs: the effects of transient coronary ischemia of varying duration and reperfusion on spin lattice relaxation times. AB - The purposes of this study were to evaluate the effects of acute myocardial ischemia with reperfusion on T1 (spin-lattice) nuclear magnetic resonance (NMR) relaxation times in a canine model and correlate these changes with bulk myocardial water content (%H2O). In 15 dogs the left anterior descending coronary artery was occluded for either 40 minutes (n = 5), 1 hour (n = 5), or 2 hours (n = 5). In 15 additional dogs, matched occlusion periods were followed by 3 hours of reperfusion. T1 of tissue from normal and ischemic myocardium was measured in vitro with a 2.5 kg NMR spectrometer. In the reperfusion animals, the 2-hour group showed significant increases in %H2O and T1 when the ischemic segment of myocardium was evaluated (both p less than 0.01). All but one animal in the 1 hour (reperfusion) group showed increases in both %H2O or T1 in the ischemic segment of myocardium when compared to control segments. The mean values from the ischemic myocardium in the 1-hour group were significantly higher than the values from the matched control segment for %H2O (p less than 0.05) and T1 (p less than 0.05). In the group undergoing 40 minutes of ischemia followed by 3 hours of reperfusion, neither %H2O nor T1 changed significantly. In the nonreperfused animals, neither T1 nor %H2O content increased significantly after 40 minutes. Significant increases were seen in the 1-hour (p less than 0.05) and 2-hour groups (without reperfusion) (p less than 0.01). In addition, the 2-hour occlusion followed by reperfusion animals had significantly greater T1 relaxation times and %H2O than control ischemic animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976475 TI - Failure of experimental atherosclerosis to sensitize coronary arteries to spasm in hypercholesterolemic rabbits. AB - Since hypercholesterolemia sensitizes isolated rabbit coronary arteries to vasoconstrictor stimuli, we assessed the possibility of reproducing occlusive coronary spasm both in vitro and in vivo in atherosclerotic rabbits. In Langendorff-perfused hearts from nine atherosclerotic rabbits (2% cholesterol diet for 18 weeks), despite a threefold increase of cholesterol concentration in the coronary wall compared with nine control rabbits, ergonovine and serotonin did not produce any increase of coronary vascular resistances; the increase produced by pitressin was significantly less in atherosclerotic than in normal hearts (56 +/- 13% vs 138 +/- 28%, p less than 0.05, respectively), whereas that produced by phenylephrine was similar (10.1 +/- 1.8% vs 8.5 +/- 2.4%, p = n.s.). In eight other unanesthetized rabbits we recorded the ECG during ergonovine administration (0.05 mg/kg) and during hypothalamic stimulation before and at regular intervals during the 2% cholesterol diet; rabbits survived for periods ranging from 1 to 22 weeks (mean 9.6 weeks). Only one animal had ST depression during episodes of marked tachycardia; no ischemic ECG changes were ever observed in the other rabbits despite the diffuse subintimal coronary deposition of cholesterol found postmortem. Thus, in atherosclerotic rabbits with chronic marked hypercholesterolemia, coronary arteries do not develop occlusive coronary spasm as observed in patients with variant angina. PMID- 3976476 TI - Ventricular arrhythmias in severe heart failure: incidence, significance, and effectiveness of antiarrhythmic therapy. AB - Forty-three patients receiving maximal medical therapy for severe chronic heart failure from dilated cardiomyopathies (28 ischemic, 15 idiopathic) and ventricular premature beats (VPBs) on the 12-lead ECG had baseline 24-hour ambulatory ECG monitoring. Complex VPBs (multiform, repetitive--couplets, R on T phenomenon) and asymptomatic, nonsustained ventricular tachycardia were present in 38 patients (88%) and 22 patients (51%), respectively. Twenty-three patients (group I) were placed on long-term antiarrhythmic therapy (20 patients received procainamide and the remaining quinidine). Twenty patients (group II) did not receive antiarrhythmic therapy. At baseline, no significant differences between the two groups were noted for age, functional class, type of cardiomyopathy, medical therapy for heart failure, cardiothoracic ratio, radionuclide ejection fraction, or rate and complexity of the ventricular arrhythmias on the 24-hour ambulatory ECG tracings. At a mean follow-up period of 16 months (range 1 to 37), there were 16 deaths, 10 (62%) of which were sudden and unexpected. No significant differences in the incidence of sudden death and overall mortality were noted between the two groups. Among patients with nonsustained ventricular tachycardia, those who died suddenly had a lower mean left ventricular ejection fraction (0.15 +/- 0.01) when compared to the survivors (0.23 +/- 0.02; p less than 0.01). It is concluded that patients with severe heart failure have a high mortality from both sudden and nonsudden cardiac death, incidence of complex VPBs is very high, sudden death is more common when the left ventricular function is severely compromised, and apparently, therapeutic plasma levels of conventional antiarrhythmic drugs do not protect this group of patients from dying. PMID- 3976477 TI - The electrocardiogram at extreme altitude: experience on Mt. Everest. AB - The American Medical Research Expedition to Mt. Everest provided a unique opportunity to record 12-lead resting ECGs in one of the largest groups studied to date at extreme altitude (19 men, aged 25 to 52 years). Twelve of the 19 subjects had four recordings breathing ambient air: May, 1981, at sea level; September at base camp (5400 meters); October at camp 2 (6300 meters); and January through May, 1982, after descent. Five subjects had no recording at camp 2 and two of them had no postdescent record. In the 12 subjects in whom all four recordings were obtained, data were analyzed by means of a two-way analysis of variance. Resting heart rate increased from 57 +/- 11 (SD) to 70 +/- 12 bpm at base camp and to 80 +/- 11 bpm at camp 2 (p less than 0.001). P wave amplitude in standard lead II increased from 0.09 +/- 0.06 to 0.13 +/- 0.045 mv at camp 2 (p less than 0.05); QTc decreased from 424 +/- 72 to 318 +/- 48 msec (p less than 0.001). Mean frontal plane QRS axis increased from +64 +/- 18 degrees to +78 +/- 20 degrees at base camp (p less than 0.001) and to +85 +/- 28 degrees at camp 2 (p less than 0.001). At extreme altitude, three subjects exhibited right bundle branch conduction disturbances and three others showed changes consistent with right ventricular hypertrophy. Seven developed flattened T waves and four developed T wave inversions. One developed premature ventricular beats and one developed premature atrial beats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976478 TI - Clinical and electrophysiologic course of sinus node disease: five-year follow-up study. AB - Thirty patients with symptomatic sinus node disease (SND) who 5 years previously had undergone a clinical investigation including intracardiac electrophysiologic studies with pharmacologic inhibition of autonomic tone were followed up with respect to development of arrhythmias and cardiac conduction abnormalities. In 17 of these patients a reinvestigation, including a second intracardiac study, was performed. Stable atrial fibrillation developed in five patients, paroxysmal supraventricular tachycardia occurred in one patient, and complete heart block appeared in another patient. Paroxysmal atrial arrhythmias and radiographic atrial enlargement were more common at the initial investigation in patients who during follow-up developed either stable atrial fibrillation or paroxysmal supraventricular tachycardia. Development of complete heart block was associated with signs of severe conduction defects at the initial study. General progression of conduction dysfunction as evaluated by intracardiac techniques was not a finding in this study. Conduction abnormalities limited to the atrioventricular (AV) node did not in this context predict a clinically important progression. The results indicate that those patients with SND who are predisposed to develop high grade AV block and atrial arrhythmias can be identified by Holter monitoring, chest x-ray examination, and an intracardiac electrophysiologic study. These possibilities improve the selection of patients suitable for pacing modes preserving atrial transport. PMID- 3976479 TI - The electrophysiologic effects of nisoldipine in the conscious dog. AB - The electrophysiologic effects of nisoldipine, 10 to 100 micrograms/kg, were studied in eight conscious nonsedated chronically instrumented dogs. No change in blood pressure or electrophysiologic measurements followed 10 micrograms/kg nisoldipine. Following 30 micrograms/kg, the mean arterial pressure was decreased from 116 +/- 9 to 105 +/- 10 mm Hg (means +/- SD) and the sinus cycle length decreased from 536 +/- 101 to 428 +/- 75 (msec) without changes in PR, AH, HV intervals, atrioventricular (AV) nodal conduction, or sinus node recovery times. After 100 micrograms/kg, the mean blood pressure was further reduced (87 +/- 17 mm Hg), the sinus cycle length further decreased (378 +/- 71 msec), and the AV nodal effective and functional refractory periods shortened (178 +/- 59 to 148 +/ 43 and 178 +/- 59 to 148 +/- 43 msec, respectively), as did the sinus node recovery time (corrected and uncorrected) and the QT and QTc intervals. No significant changes in atrial or ventricular pacing thresholds, atrial or ventricular refractory periods, or in the HV interval were observed. Nisoldipine, a nifedipine derivative, did not significantly change electrophysiologic parameters in intact conscious animals when given in doses which did not alter blood pressure. When nisoldipine produced significant vasodilatation, the enhancement of AV nodal conduction observed probably reflects a balance of the direct effect of nisoldipine and opposing autonomic activity. PMID- 3976480 TI - Prolongation of refractoriness and activation time in normal canine ventricular myocardium following bolus administration of lidocaine. AB - This study examines the electrophysiologic effects of an intravenous bolus of lidocaine in the normal canine ventricle. In 14 open-chest dogs, left ventricular effective refractory period, ventricular repolarization time, and activation time were measured continuously during ventricular pacing (150/min) before, during, and after intravenous lidocaine given over 4 minutes. Lidocaine doses of 1.25, 2.5, and 5.0 mg/kg transiently prolonged the ventricular effective refractory period from 177 +/- 4 (X +/- standard error of the mean) to 185 +/- 5 msec (p less than 0.05), 176 +/- 3 to 188 +/- 6 msec (p less than 0.05), and 176 +/- 5 to 197 +/- 5 msec, (p less than 0.05), respectively, at 6 +/- 1.5 minutes from the onset of the bolus. Serum lidocaine levels obtained at the peak of the effective refractory period prolongation averaged 4.3 +/- 1.0, 9.0 +/- 3.0, and 22.3 +/- 4.7 micrograms/ml, respectively. Ventricular repolarization time was not prolonged. Activation time also transiently increased from 43 to 45 msec (p less than 0.05) and from 47 to 52 msec with the 2.5 mg/kg and 5.0 mg/kg doses, respectively. Cardiac denervation and administration of propranolol, 1 mg/kg intravenously, did not influence these responses to lidocaine. We conclude that a bolus of lidocaine transiently prolongs the effective refractory period and activation time in the normal canine ventricle because of its direct membrane rather than autonomic effects. PMID- 3976481 TI - Unrecognized myocardial infarction and hypertension: the Framingham Study. PMID- 3976482 TI - Exercise-induced myocardial infarction due to coronary thrombosis. PMID- 3976483 TI - Thrombosis complicating transvenous pacemaker lead presenting as contralateral internal jugular vein occlusion. PMID- 3976484 TI - Prolapsing right atrial thrombus and deep venous thrombosis despite systemic coagulopathy. PMID- 3976485 TI - Two-dimensional echocardiographic identification of blood stasis in the left atrium. PMID- 3976486 TI - Prenatal death from acute myocardial infarction and cardiac tamponade due to embolus from the placenta. PMID- 3976487 TI - Hydatid cyst of the heart: diagnosis by two-dimensional echocardiography and computed tomography. PMID- 3976488 TI - Atherosclerotic plaque simulating aortic dissection by echocardiography and angiography. PMID- 3976489 TI - A pharmacist's guide to quack weight products. PMID- 3976491 TI - Pharmacy counseling services, Inc. A profile. PMID- 3976490 TI - The community pharmacist as poison expert. Documenting the standards of practice. PMID- 3976492 TI - Independent vs. chain store pharmacy practice in Massachusetts. PMID- 3976493 TI - The ADA's acceptance program: how it works and what it does. PMID- 3976494 TI - Physiological stresses in warehouse operations with special reference to lifting technique and gender: a case study. AB - A field study was conducted to evaluate the effects of lifting technique (free style vs. straight-back, bent-knee) on male workers' performances and physiological responses. A secondary objective was to study physiological stresses to female order selectors using the free-style lifting technique only. Six male and six female workers performed their routine work of grocery order selection in three different warehouses while their oxygen uptake and heart rates were measured. Workers' performances were determined using the traditional work measurement techniques (time study, methods time measurement and master standard data systems) employed by the warehouses. Total cases, weight, volume, actual and allowed time for each order were also determined. Statistical analysis showed that the performance levels of the male workers (allowed time per order * 100/actual time per order) were significantly lower and oxygen uptake and heart rates were higher for the straight-back, bent-knee method as compared to the free style lifting technique. Male workers lifted more cases, weight and volume/min with the free-style lifting technique than with the straight-back, bent-knee method. It is concluded that the traditionally recommended straight-back, bent knee method of lifting is slower and physiologically more demanding. It is practically impossible for a substantial number of workers to meet the existing time or performance standards based on traditional work measurement techniques- when using the straight-back, bent-knee method of lifting recommended by the warehouses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976495 TI - Site-specific whole glove chemical permeation. AB - This study explored chemical permeation of latex neoprene gloves by acetone. Twenty-three specific glove sites were monitored to determine the breakthrough time and the challenge liquid concentration at steady-state. In summation, the thinnest parts of the gloves, which are the backs, the palms, and the interstices between the fingers, exhibited the shortest breakthrough times and largest steady state concentrations. The thickest parts of the gloves, the fingertips, exhibited the longest breakthrough times and least steady-state concentrations. The backs or palms are appropriate specimens to use for chemical permeation testing. PMID- 3976496 TI - Seasonal formaldehyde concentrations in an office building. AB - The objective of this investigation was to determine if there was a seasonal effect on formaldehyde emissions from paneling and shelving in a one story office building. Measurement of formaldehyde was done by standard impinger sampling techniques using 1% bisulfate absorbing solution and by using a dry diffusional formaldehyde monitor. Results show a definite seasonal trend for formaldehyde concentrations by either monitoring method. The formaldehyde concentrations for warm weather are about twice as great as those in cold weather. In addition the dry diffusional monitor concentrations determined were consistently low compared to impinger sampling. PMID- 3976497 TI - Biological effects and toxicity assessment of titanium dioxides: anatase and rutile. AB - Anatase and rutile are titanium dioxides (TiO2) with different crystal lattices. The particles of TiO2 are considered a "nuisance" dust. It has been reported that rutile can be considered "inert". However, anatase, because of its hemolytic activity in vitro and slow lung clearance, should warrant further research regarding its toxicity. We exposed rats to an aerosol of either anatase or rutile and determined the TiO2 retention in the lung up to 132 days post exposure. Particle clearance from the lung, calculated from the retention data, was similar in both the anatase and the rutile groups with T1/2 of 51 or 53 days, respectively. In addition a pulmonary cell response test was performed on other rats. After intratracheal instillation of anatase and rutile in doses of 0.5 or 5.0 mg/rat, lung lavage was performed and the harvested cells counted. The counts of all cells, alveolar macrophages (AM), peroxidase positive AM, and polymorphonuclear leukocytes were compared. The pulmonary cell response test also yielded similar results for both types of TiO2. Thus there was no indication that the crystal lattices of TiO2 altered the biological effects of TiO2 particles. The evidence suggests that both anatase and rutile are "nuisance" dusts. PMID- 3976498 TI - Aerosol resuspension from fabric: implications for personal monitoring in the beryllium industry. AB - The fabric used for work clothing at an industrial site can significantly influence personal monitor (PM) exposure estimates because dust resuspension from clothing can increase the concentration at the sampler inlet. The magnitude of the effect depends on removal forces and on the interaction of the contaminant particles with work garments. Aerosol deposition and resuspension on cotton and Nomex aramid fabrics was evaluated at a beryllium refinery. Electrostatically charged cotton backdrops collected more beryllium than neutral controls, but electronegative Nomex backdrops did not. Moving fabrics collected more beryllium than did stationary controls. When contaminated fabrics were agitated, PMs mounted 2.5 cm in front of the fabric collected more beryllium than monitors above the fabric, positioned to simulate the nose or mouth. The difference between the air concentrations measured by these PMs increased with Be loading and tended to level off for highly contaminated fabric. Cotton resuspended a larger fraction of its contaminant load than Nomex. These results are consistent with current knowledge of the behavior of particles on fabric fibers. Aerosol resuspension from garments is an important consideration in assessing inhalation exposure to toxic dusts. A garment may attract and retain toxic particles. This contamination is then available for later resuspension. PMID- 3976499 TI - Emission of ink aerosol from ink-jet recorders. AB - As a follow-up of two patients found to be allergic to EKG*ink, a study was made, using spectrophotometric and light microscopic methods, of the factors influencing the emission of ink aerosol from ink-jet recorders used in electrocardiographs. Ink aerosol concentrations were only detectable by spectrophotometry under extreme conditions. However, the light microscopic method was sufficiently sensitive. At the slow paper speeds normally used (10-25 mm/sec) and under normal working conditions, the concentration of ink aerosol near the recorder was less than 0.1 microgram/m3; but aerosol emission increased exponentially with increasing ink pressure, i.e. increasing paper speed. At the highest paper speed studied (200 mm/sec), the aerosol concentration 36 cm from the ink nozzles was about 65 micrograms/m3. An increase in the distance from the ink nozzles to the chart paper resulted in a decrease in ink aerosol emissions. Aerosol dissipation was decreased by local exhaust ventilation of the ink-jet recorder. However, a protective shield designed to catch emitted ink aerosol only reduced the aerosol concentration at the measuring point at slow paper speeds. At higher paper speeds, the concentration increased. The average ink aerosol concentration near modern electrocardiographs is low, but some EKG operations may result in high peak concentrations. The formation of ink aerosol could be considerably reduced by changing the rheologic properties of the ink. PMID- 3976500 TI - A comparison of iron oxide fume inside and outside of welding helmets. AB - A study was conducted to compare the iron oxide fume concentrations inside and outside the helmets of welders. Airborne iron oxide fume concentrations were determined simultaneously at four body locations--the left front shoulder, right front shoulder, front chest, and inside the helmet--during welders' normal activity. Results indicate that the fume concentrations at the actual breathing zone inside helmets are reduced to 36%-71% of concentrations outside the helmets, depending on the type of welding and employees' postures. PMID- 3976501 TI - Effect of digitalis treatment on survival after acute myocardial infarction. AB - To determine whether treatment with digitalis is associated with decreased survival after acute myocardial infarction (AMI), data from 504 patients who were enrolled in a postinfarction natural history study were analyzed. At the time of discharge, 229 patients (45%) were taking digitalis. After 3 years of follow-up, the cumulative survival rate for patients discharged on a regimen of digitalis was 66%, compared with 87% for those not treated (p less than 0.001). Univariate analysis showed that statistically significant differences existed between the 2 groups with respect to age, previous AMI, left ventricular failure in the coronary care unit, atrial fibrillation in the coronary care unit, peak creatine kinase levels, enlarged heart and pulmonary vascular congestion on the discharge chest x-ray, ventricular arrhythmias and treatment with diuretic, antiarrhythmic and beta-blocking drugs. Survival analysis using Cox's regression model showed that the association between digitalis and decreased survival was of borderline significance after adjustment for atrial fibrillation and left ventricular failure. Serum digoxin concentration was measured in 83% of the patients who took digitalis. Survival was inversely and significantly related to serum digoxin, i.e., the higher the serum digoxin concentration, the lower the long-term survival rate. After adjusting for atrial fibrillation and left ventricular failure, serum digoxin was not significantly related to survival. Taken together with the results of 3 other large, nonrandomized studies of digitalis treatment after AMI, this study suggests that digitalis treatment may have adverse effects on survival during follow-up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976502 TI - Symptomatic coronary artery disease in patients aged 21 to 30 years. AB - One hundred one young people (88 men, 13 women) aged 30 years or younger with arteriographically proved obstructive coronary artery disease (CAD) were identified and reviewed for risk factor prevalence. The men were compared with an age and date-of-catheterization matched control group who were arteriographically normal. Significant risk factors were cigarette smoking (p = 0.001), familial CAD (p = 0.002) and familial CAD manifested by age 50 years or younger (p = 0.005). Serum cholesterol values were significantly higher in the CAD group (p = 0.0001), but in most (54%) were still less than 250 mg/dl. Arteriography showed a spectrum of CAD: 1-vessel in 57, 2-vessel in 21 and 3-vessel in 22. One patient had significant left main CAD. Follow-up was obtained for all of the 94 American subjects. One-year mortality was 3% and 5-year mortality was 20%. The causes of death were predominantly cardiac: myocardial infarction in 10 patients, congestive heart failure in 2 and sudden death in 6; 3 patients died of noncardiac causes. PMID- 3976503 TI - Exercise testing to enhance wives' confidence in their husbands' cardiac capability soon after clinically uncomplicated acute myocardial infarction. AB - The effects of wives' involvement in their husbands' performance of treadmill exercise testing 3 weeks after clinically uncomplicated acute myocardial infarction was compared in 10 wives who did not observe the test, 10 who observed the test, and 10 who observed and participated in the test themselves. In a counseling session after the treadmill test, couples were fully informed about the patient's capacity to perform various physical activities. Wives' final ratings of confidence (perceived efficacy) in their husbands' physical and cardiac capability were significantly (p less than 0.05) higher in those who also performed the test than in the other 2 groups. Only wives who walked on the treadmill increased their ratings of their husbands' physical and cardiac efficacy to a level equivalent to those of their husbands. Spouses' and patients' perceptions of patients' cardiac capability after treadmill testing and counseling at 3 weeks were significantly correlated with peak treadmill heart rate and workload at 11 and 26 weeks. Efficacy ratings at 3 weeks were slightly better than peak 3-week treadmill heart rate and workload as predictors of treadmill performance at 11 and 26 weeks. Participation in treadmill testing early after acute myocardial infarction is an effective means for reassuring spouses about the capacity of their partners to resume their customary physical activities with safety. PMID- 3976504 TI - Acute hemodynamic and antiischemic effects of intravenous amiodarone. AB - The acute hemodynamic and antiischemic properties of amiodarone were investigated in 16 patients with more than 70% diameter reduction of a left coronary artery. Two successive atrial pacing stress tests (APST I and II) were performed, with an interval of 40 minutes in between, and amiodarone, 5 mg/kg/5 min, was infused 30 minutes after APST I. Hemodynamic changes during amiodarone administration consisted of a 20% decrease in left ventricular (LV) systolic pressure, a 13% decrease in systemic vascular resistance and an 18% decrease in stroke work. Coronary vascular resistance was reduced 19% and coronary sinus flow increased 23%. Despite a secondary 14% increase in heart rate, contractility decreased 21%, accompanied by a 45% increase in LV end-diastolic pressure, which persisted until APST II. Although most hemodynamic changes were observed only during the infusion, contractility and LV systolic pressure were still diminished at the beginning of APST II and remained so during pacing, resulting in a reduction in myocardial oxygen demand compared to APST I. Although overall myocardial oxygen consumption and coronary flow were equal during both pacing tests, amiodarone significantly reduced pacing-induced myocardial ischemia. Lactate metabolism remained normal during APST II (lactate extraction 12 +/- 3% vs -28 +/- 8% (APST I) at maximal pacing rates [p less than 0.05]), while ST-segment depression, LV end-diastolic pressure postpacing and angina were also significantly reduced during APST II. Thus, in humans, intravenous amiodarone reduces vascular resistance and contractility and inhibits pacing-induced myocardial ischemia, presumably by reducing myocardial oxygen demand. PMID- 3976505 TI - Out-of-hospital sudden coronary death: rest and exercise radionuclide left ventricular function in survivors. AB - One hundred fifty-four survivors of out-of-hospital ventricular fibrillation (VF) with coronary artery disease underwent radionuclide ventriculography an average of 4.2 months after VF. All patients were studied at rest, and 91 of these patients were also studied during supine bicycle exercise. Clinical histories and 24-hour ambulatory electrocardiograms were also assessed, and patients were followed for an average of 3.1 years after ventriculography. The mean left ventricular (LV) ejection fraction (EF) at rest was 40 +/- 16%; in 34% of patients, it was 30% or less; in 37%, 31 to 50%; and in 29%, more than 50%. Regional LV wall motion was normal in 18%. The most severe segmental abnormality was hypokinesia in 22%, akinesia in 45% and dyskinesia in 14%. Wall motion abnormalities were usually located at the apex. During exercise, only 3% of patients (3 of 91) had a normal increase in EF of more than 5%, and the mean EF decreased from 42 to 38%. New exercise-induced wall motion abnormalities occurred in 30%. During the follow-up period, 54 patients died (35%): 48 from cardiac causes and 42 from unexpected and sudden causes. Predictors of death included EF at rest, presence of akinesia or dyskinesia on the ventriculogram at rest, the number of abnormal LV segments, history of congestive heart failure, history of acute myocardial infarction, absence of acute myocardial infarction at the time of VF and the presence of ventricular arrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976506 TI - Coronary and systemic hemodynamic effects of nicardipine. AB - Systemic and coronary hemodynamic effects of a new dihydropyridine calcium antagonist, nicardipine, were studied in 15 patients. Nicardipine was administered as a 2-mg bolus intravenously followed by an infusion titrated to maintain a 10 to 20-mm Hg decrease in systolic pressure. Nicardipine increased both heart rate from 69 +/- 3 to 81 +/- 3 beats/min and cardiac output from 7.3 +/- 0.5 to 9.9 +/- 0.5 liters/min (both p less than 0.001) as systemic vascular resistance decreased from 1,183 +/- 70 to 733 +/- 33 dynes s cm-5 (p less than 0.001). Left ventricular end-diastolic pressure remained constant, at 14 +/- 1 vs 14 +/- 1 mm Hg as stroke volume increased from 108 +/- 6 to 123 +/- 6 ml/m2 (p less than 0.001). Coronary blood flow increased from 102 +/- 9 to 147 +/- 13 ml/min, while coronary resistance decreased from 1.17 +/- 0.1 to 0.7 +/- 0.1 mm Hg/ml/min (both p less than 0.001). Heart rate-systolic blood pressure product did not change (104 +/- 5 vs 106 +/- 5 beats/min mm Hg X 10(-2), difference not significant) with drug administration. At the same heart rate before and during nicardipine administration (using atrial pacing in 6 patients), significant augmentation of coronary flow was still observed. Thirteen of 14 patients showed a greater percent decrease in coronary resistance than systemic vascular resistance. Nicardipine differs from other calcium antagonists with respect to consistent augmentation of coronary blood flow. This effect appears to be the result, in part, of increased potency in the coronary bed compared with the systemic vascular bed. PMID- 3976507 TI - Initial coronary air embolus in the differential diagnosis of coronary artery spasm. AB - Angiographic and electrocardiographic manifestations of initial coronary air embolism were seen in 4 patients and in a dog. All 4 patients had angina pectoris, 2 had ST elevation, 1 patient had ST depression and 1 had no electrocardiographic change after the air embolus. Although the initial diagnosis in these 4 patients was coronary artery spasm, a subsequent ergonovine test response for coronary artery spasm was negative in the 3 patients in whom it was performed. In a dog, initial injection of air in a coronary artery produced ST segment elevation and delayed clearance of contrast material. The angiographic appearance of initial air embolus was similar in the 4 patients and in the dog. The leading edge of contrast material that followed an air embolus stopped abruptly, appeared hazy and blunt, and pulsated back and forth. The air embolus produced temporary cessation of flow in the main artery and its branches. Initial injection of air during coronary arteriography mimics coronary artery spasm by producing a syndrome characterized by angina, ischemic changes on the electrocardiogram, and delayed flow of contrast material. An initial air embolus may be differentiated from true coronary spasm by several distinctive angiographic features. PMID- 3976508 TI - Mucocutaneous lymph node syndrome: clinical, hemodynamic and angiographic features of coronary obstructive disease. AB - Clinical, hemodynamic and angiographic features of coronary obstructive disease (greater than or equal to 90% diameter reduction) in Kawasaki disease were evaluated in 30 patients. The mean age at the onset of Kawasaki disease was 2.9 +/- 1.9 years and that at cardiac catheterization was 6.3 +/- 2.8 years. Obstructive lesions were observed in the right coronary artery in 12 patients (group 1), in the left anterior descending coronary artery (LAD) in 6 (group 2), in both right coronary artery and LAD in 10 (group 3) and in the left main coronary artery in 4 (group 4). Twenty-two patients (73%) had cardiac symptoms, including myocardial infarction in 10 (33%). Cardiac symptoms were observed in 41% in group 1, 100% in group 2, 80% in group 3 and 100% in group 4. Left ventricular (LV) end-diastolic pressure, end-diastolic volume and ejection fraction were abnormal in 32% of the patients in group 1, a frequency less than that in other groups (83% in group 2, 78% in group 3 and 100% in group 4). Fifty percent had mitral regurgitation and 73% had left ventricular wall motion abnormalities. No patient in groups 1 or 2 has died, but 8 of 14 patients in groups 3 and 4 have died. These observations indicate that coronary obstruction owing to Kawasaki disease can cause depressed LV function, mitral regurgitation and LV wall motion abnormalities in children.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976509 TI - Importance of total life consumption of cigarettes as a risk factor for coronary artery disease. AB - Cigarette smoking is an established risk factor for the occurrence of cardiovascular events and mortality. Whether recent smoking history or total life consumption best represents the increased risk due to smoking has not been previously established. Thus, stepwise logistic regression analysis was used to determine the relative contributions of these factors to the risk of having significant coronary artery disease in 1,349 patients who underwent cardiac catheterization. Six risk factors were analyzed: total pack-years, current packs smoked per day, age, gender, family history and symptomatic status. The results of this analysis showed that total pack-years, but not current packs per day, is a significant independent risk factor for the development of coronary artery disease. This was true in every age group up to but not older than age 70 years. Although the overall risk was lower in younger patients and in patients with less typical symptoms of angina, the relative risk in cigarette smokers relative to pack-years was consistently greater. The risk of total life consumption of cigarettes is thus greater than has heretofore been realized, particularly in persons who would otherwise be categorized as low risk. PMID- 3976510 TI - Day-to-day reproducibility of responses to right ventricular programmed electrical stimulation: implications for serial drug testing. AB - The day-to-day reproducibility of responses to right ventricular programmed electrical stimulation was analyzed in 77 patients studied in the baseline state twice within 72 hours. Of 66 in whom ventricular tachycardia (VT) was inducible at the first study (C1), VT was reproduced in 53 (80%) at the second control study (C2). Among 41 patients in whom VT was inducible using 1 or 2 programmed electrical stimuli (PES) at C1, VT remained inducible in 39 (95%) at C2, whereas only 14 of 25 patients (56%) who required 3 or more PES for VT induction at C1 had VT reproduced at C2. The difference in the reproducibility of VT induction in these 2 patient groups was highly significant (p less than 0.001). Although VT was inducible in 50% of patients using the identical stimulation mode at each study, 35% required a more intense mode for VT induction at C2; this included 11 of 35 patients (31%) in whom VT was initially inducible with 1 or 2 PES who required 3 or more PES for induction of VT at C2. Thus, patients in whom VT is initially inducible with 1 or 2 PES demonstrate reproducible day-to-day responses to programmed electrical stimulation and appear to be excellent candidates for electrophysiologically guided antiarrhythmic drug therapy. Because VT induction was significantly less reproducible in patients who required 3 or more PES at C1, day-to-day reproducibility of VT induction should be confirmed in such patients if electropharmacologic therapy is attempted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976511 TI - Suppression of arrhythmias within hours after a single oral dose of amiodarone and relation to plasma and myocardial concentrations. AB - In 65 patients a single oral dose of amiodarone (30 mg/kg) produced an antiarrhythmic effect on supraventricular or ventricular arrhythmias within 3 to 8 hours and lasted for 17 to 19 hours. On the second day a 15-mg/kg dose reproduced this effect within 3 to 9 hours. Plasma concentration of amiodarone increased to a maximum (2.2 +/- 1.7 mg/liter) mean +/- standard deviation) at 6 +/- 3.5 hours and plasma levels of N-desethylamiodarone (NDA) rose to 0.2 +/- 0.08 mg/liter at 12 +/- 6.4 hours. Sixty-one other patients were given a single 30-mg/kg dose 7 hours to 4 days before open heart surgery. Biopsies of the right atrial and left ventricular walls were taken during surgery. Myocardial concentration of amiodarone was maximal in the atrium after 7 hours (13 +/- 8 mg/kg) and in the ventricle after 24 hours (17 +/- 11 mg/kg). NDA myocardial concentration increased progressively until 24 hours and then remained stable over 4 days (1.5 mg/kg). The amiodarone myocardial to plasma concentration ratio was similar in the atrium and in the ventricle and averaged 22 and 10 for amiodarone and NDA, respectively. A significant relation existed between amiodarone concentration and the effect on ventricular premature complexes (r = 0.74, p less than 0.001) and between amiodarone plasma concentration and the effect on the atrioventricular conduction (r = 0.58, p less than 0.001). The plasma concentration of amiodarone corresponding to a 60% decrease in arrhythmias averaged 1.5 to 2 mg/liter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976512 TI - Electrophysiologic evaluation and follow-up characteristics of patients with recurrent unexplained syncope and presyncope. AB - One hundred nineteen patients with unexplained syncope (82%) or presyncope (18%) underwent complete electrophysiologic study (EPS). Symptoms were recurrent in 72% of the patients. Fifty-two percent of the patients had structural heart disease. Forty-one patients had normal EPS results and 78 had electrophysiologic abnormalities (ventricular tachycardia in 31, induced atrial flutter/fibrillation in 17, vasovagal syncope in 8, hypersensitive carotid sinus syndrome in 7, supraventricular tachycardia in 6, heart block in 5 and sick sinus syndrome in 4). The presence of structural heart disease (p = 0.0033) and previous myocardial infarction (p = 0.05) were the only clinical or electrocardiographic predictors of a positive EPS response. Therapy was guided by EPS and patients were followed for 27 +/- 20 months (mean +/- standard deviation). In the patients with negative EPS results, 76 +/- 11% (mean +/- standard error) were symptom-free at follow-up, compared to 68 +/- 10% in the group with positive EPS responses. No clinical variables helped to predict remission in the absence of therapy. One patient in the negative EPS response group and 2 patients in the EPS positive group died suddenly (cumulative survival 94 +/- 4%). Total cardiovascular mortality was 13% in the positive EPS response group, and 4% in the negative EPS response group. Thus, certain clinical characteristics are helpful in selecting patients for study. Electrophysiologically guided therapy is associated with a recurrence and sudden death rate similar to an untreated control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976513 TI - Value of Holter monitoring in identifying risk for sustained ventricular arrhythmia recurrence on amiodarone. AB - Seventy-four patients with sustained ventricular tachyarrhythmias had 22 +/- 3 hours of Holter monitoring before and after 11 +/- 6 days of amiodarone treatment. On control Holter recordings, 55 patients (group I) had frequent (more than 10 extrasystoles per hour) and/or complex (at least couplets) ventricular ectopic activity (VEA), and 19 patients (group II) had infrequent and simple VEA. A positive Holter monitor response to amiodarone was defined as a decrease in VEA by more than 85% and abolition of all complex VEA. In group I, 34 patients (62%) had a positive Holter monitor response. In group II, 16 patients (84%) had persistent, infrequent and simple VEA and 3 had frequent and/or complex VEA. During a mean follow-up of 13 +/- 12 months, 22 patients (30%) had ventricular tachycardia (VT) or sudden death. In group I, VT or sudden death occurred in 6 of 34 (18%) patients with a positive Holter monitor response and 11 of 21 (52%) with a negative Holter monitor response (p less than 0.01), and in group II, VT or sudden death occurred in 5 of 16 patients (31%) with persistent, infrequent and simple VEA. All episodes of VT or sudden death occurred after at least 2 weeks of amiodarone therapy (mean 5 +/- 6 months). The predictive accuracy of a positive Holter monitor response as an indicator for subsequent prevention of sustained ventricular tachyarrhythmias and sudden cardiac death was 82% and for a negative Holter monitor response as an indicator of tachyarrhythmia or sudden death recurrence on therapy it was 52%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976514 TI - Catheter mapping during sinus rhythm: relation of local electrogram duration to ventricular tachycardia cycle length. AB - Catheter mapping was performed during sinus rhythm in 52 patients with 102 morphologically distinct ventricular tachycardias (VT). Twenty patients had a single VT morphologic pattern. The cycle length of VT was correlated with the duration of all electrograms and various electrogram subgroups, including abnormal, fractionated, late, and longest electrograms, as well as the electrogram recorded at the site of origin of VT and at sites other than the site of origin using linear regression analysis. No correlation was found between local electrogram duration of any of these groups and VT cycle length. There was no relation regardless of whether the patient had a single or multiple morphologic patterns. Thus, the local electrogram duration measured with catheter mapping during sinus rhythm does not correlate with VT cycle length. This finding provides additional support that catheter mapping during sinus rhythm does not give sufficient information to guide localized endocardial resection for VT surgery. PMID- 3976515 TI - Value of preexisting bundle branch block in the electrocardiographic differentiation of supraventricular from ventricular origin of wide QRS tachycardia. AB - The relation between the morphologic configuration of QRS complexes during wide QRS tachycardia induced during electrophysiologic studies and sinus rhythm was examined in 18 patients who had preexisting left or right bundle branch block. Representative QRS complexes during sinus rhythm and during tachycardia were isolated from each patient and juxtaposed for comparison. The QRS complexes that constituted each pair were judged by 4 observers as being identical, different or, if the decision was equivocal, similar. Nine patients had supraventricular tachycardia (SVT). In 8 of the 9 patients, all 4 observers found the QRS complexes during sinus rhythm and SVT identical in morphologic configuration. In the other patient, 2 observers found the QRS complexes identical and 2 found them similar. In 12 patients ventricular tachycardia (VT) was induced. In 11 of these 12, all 4 observers found the QRS complexes during VT different from their respective sinus beats. In the other patient, 3 observers found the QRS complexes different, whereas the fourth found them similar. During SVT, the QRS duration was unchanged from the corresponding value during sinus rhythm, whereas in patients with VT, QRS width increased by a mean of 56 +/- 20 ms (p less than 0.001). The results of our study suggest that the electrocardiographic differentiation of wide QRS tachycardia in patients with preexisting bundle branch block can be accomplished easily and accurately by comparing the QRS complexes during tachycardia with those during sinus rhythm: If the complexes are identical, the tachycardia is supraventricular, but if they are different, the arrhythmia is ventricular in origin. PMID- 3976516 TI - Immediate hemodynamic effects of urapidil in patients with essential hypertension. AB - Systemic, renal and splanchnic hemodynamics and certain reflex and endocrine responses were determined in 10 patients with essential hypertension before and after intravenous administration of urapidil, a new antihypertensive agent that acts through both central and peripheral alpha-adrenergic inhibitory mechanisms. The reduction in mean arterial pressure by 12% (103 +/- 3 vs 91 +/- 6 mm Hg, p less than 0.05) was mediated through a decreased total peripheral resistance index (from 34 +/- 2 to 25 +/- 3 U/m2, p less than 0.01), which was associated with a significant reflexive increase in cardiac index, heart rate and serum norepinephrine level. This hypotensive effect was also associated with blunted Valsalva overshoot and orthostatic hypotension, suggesting peripheral arteriolar and venular dilation. Renal and splanchnic blood flows increased (p less than 0.05), resistances in these vascular beds decreased (p less than 0.01) and there were no changes in creatinine clearance or glomerular filtration fraction. Thus, intravenous urapidil reduced arterial pressure by decreasing total peripheral, renal and splanchnic resistances associated with maintained organ flows and increased heart rate and cardiac index. PMID- 3976517 TI - Acute dose range study of milrinone in congestive heart failure. AB - To determine the magnitude and time course of the optimal acute hemodynamic response to oral milrinone, an ascending dose range study was performed in 34 patients with severe chronic congestive heart failure (2.5 to 10 mg, n = 21; 7.5 to 15 mg, n = 13). With the 7.5- and 10-mg doses in both groups, cardiac index increased 26%, pulmonary capillary wedge pressure decreased 25% and systemic vascular resistance decreased 20%, with peak effect at 90 minutes. The hemodynamic improvement with 10 mg was sufficient to normalize cardiac index in 29% of patients. There was a clear dose-response relation, with the largest increases of cardiac index seen with the 15-mg dose (1.67 +/- 0.10 to 2.31 +/- 0.11; p less than 0.005). This dose-response relation was confirmed by the correlation of drug levels and change in cardiac index. However, some patients had significant hypotension and tachycardia with the 15-mg dose. Thus, although 10 mg appears to be optimal for most patients, the dose of milrinone should be individualized for all patients. PMID- 3976518 TI - Long-term results of open mitral valve reconstruction for mitral stenosis. AB - Open mitral reconstruction for rheumatic mitral stenosis (MS) was performed in 120 patients, 101 women and 19 men, aged 22 to 75 years (mean 49). Nine patients were functional class II, 106 class III, 5 class IV; 13 only underwent noninvasive studies, including echocardiography, before surgery, while 107 had preoperative cardiac catheterization studies. The latter showed a mean valve area of 1.09 cm2 and a pulmonary artery wedge to left ventricular mean diastolic gradient of 14 mm Hg. Cardiopulmonary bypass was used in all patients for open reconstruction under direct vision. Superior commissurotomy was done in 115 patients, inferior in 114, papillary muscles were incised and chordae lengthened in 39 and calcium was excised from valve leaflets in 23. Suture or ring anuloplasty was not required in any patient. The series was begun January 1972 and terminated in January 1984. Personal follow up was conducted in July 1984. There were no operative deaths in the 120 patients. There were 5 late deaths, all from noncardiac causes. The mean follow-up time was 53 months. The actuarial probability of survival at 10 years was 95 +/- 2%. Thromboemboli occurred in 9 patients; the probability of freedom from thromboemboli at 10 years was 91 +/- 3% and the linearized rate was 1.8%/patient-year of follow-up. Reoperation was required in 9 patients, an absolute incidence of 7.5% and an annual incidence of 1.7%/patient year. At 10 years the probability of freedom from reoperation was 84 +/- 5%. PMID- 3976519 TI - Results of valve reconstruction for mitral regurgitation secondary to mitral valve prolapse. AB - Mitral valve prolapse (MVP), often the result of myxomatous degeneration of the mitral valve, is the most commonly known pathologic entity leading to pure mitral regurgitation (MR). Reconstruction of the mitral valve rather than replacement is particularly applicable to this pathologic defect, but is not often used in the U.S. Experience with reconstruction of the mitral valve for MR secondary to MVP during the period January 1970 to January 1984 was reviewed. A total of 479 patients with mitral valve disease underwent operation during this period, 82 (17%) of whom had MR secondary to MVP. Thirty-one patients (6%) had valve reconstruction by a technique of leaflet plication and posteromedial anuloplasty. Eleven of these patients had associated cardiac disease requiring correction: 2 requiring aortic valve replacement and 9 requiring coronary artery bypass grafting procedures. One hospital death (3%) and 6 late deaths (19%) occurred, of which only 3 were related to cardiac factors. Major complications included recurrent MR in 5 patients and cerebral embolus in 1 patient. The adjusted 5-year survival rate was 89 +/- 6 (mean +/- standard error of the mean), and the overall survival rate of patients free of cardiac-related complications was 73 +/- 9%. Thus, reconstruction of the mitral valve is a highly effective surgical approach to the management of symptomatic patients with MR secondary to MVP, and its use is favored over replacement in the management of these patients. PMID- 3976520 TI - Multifactorial determinants of reduced coronary flow reserve after dipyridamole in dilated cardiomyopathy. AB - Coronary sinus blood flow (ml/100 g left ventricular [LV] mass/min) and coronary resistance (mean aortic minus LV mean diastolic pressures/coronary sinus blood flow, mm Hg/[ml/100 g/min]) were studied in 7 control patients and in 11 patients with severe dilated cardiomyopathy (DC) and normal coronary arteriograms. Basal coronary sinus blood flow was not different in the 2 groups. After intravenous administration of dipyridamole (0.14 mg/kg/min X 4 min), coronary sinus blood flow and dipyridamole/basal coronary sinus blood flow ratio were significantly (p less than 0.001) lower in the DC group than in the normal group (coronary sinus blood flow 188 +/- 48 vs 408 +/- 58, respectively; blood flow ratio 1.78 +/- 0.35 vs 4.01 +/- 0.56, respectively), and the coronary resistance was higher in the DC group than in the control group (0.39 +/- 0.15 vs 0.22 +/- 0.03, respectively, p less than 0.01). After administration of dipyridamole in patients with DC, no correlation could be found between coronary sinus blood flow and LV mean diastolic, mean aortic or coronary driving pressures, i.e., mean aortic minus LV mean diastolic pressures. Thus, in DC patients, neither an elevated LV diastolic pressure nor a low coronary perfusion pressure can totally account for the restriction of the coronary flow reserve after dipyridamole. PMID- 3976521 TI - Accuracy of prospective two-dimensional echocardiographic evaluation of left ventricular outflow tract in complete transposition of the great arteries. AB - Thirty-two consecutive infants with transposition of the great arteries (TGA) and ventricular septal defect underwent subxiphoid 2-dimensional echocardiography (2 D echo). Two independent observers prospectively evaluated each echocardiogram for the presence or absence of left ventricular (LV) outflow tract obstruction, whether outflow obstruction was dynamic or fixed, or both, and the precise anatomic type of fixed obstruction. Compared with the LV-to-pulmonary artery gradient determined at cardiac catheterization, 2-D echo yielded low false negative (7 to 13%) and false-positive (0 to 6%) rates for diagnosing the presence or absence of LV outflow tract obstruction. Moreover, the false-negative cases were only minor errors, because the measured LV-pulmonary artery gradients proved to be less than 25 mm Hg. Compared with the long-axial oblique LV angiogram, 2-D echo yielded no false-negative results in detection of outflow tract obstruction, which was at least partly fixed. Compared with autopsy/surgical observation, 2-D echo made no significant errors in delineating the exact anatomic type of fixed obstruction. The diagnostic accuracy of 2-D echo in detecting and characterizing LV outflow tract obstruction limits the need for "routine" cardiac catheterization before repair in infants with TGA and intact ventricular septum. Furthermore, because certain types of fixed LV outflow tract obstruction are difficult for the surgeon to visualize and alleviate, precise knowledge of the anatomic type of fixed obstruction influences the choice among Rastelli, intraatrial baffle and arterial switch procedures in patients with TGA and ventricular septal defect. PMID- 3976522 TI - Anomalous origin of the left main coronary artery from the right sinus of Valsalva. AB - The clinical and angiographic findings in 10 patients with anomalous origin of the left main (LM) coronary artery from the right sinus of Valsalva are presented. The initial course of the anomalous artery was between the aorta and the pulmonary trunk in 6 patients (5 men and 1 woman), and posterior to the aorta in 4 patients (3 women and 1 man). The best coronary angiographic projection to determine the course of the LM coronary artery in relation to the aorta and pulmonary trunk was the right anterior oblique and lateral projections, with a catheter in the pulmonary trunk as a guide. In the right anterior oblique projection left ventriculogram, an increased density at the base of the aorta was seen in all patients with posterior-to-aorta course of the anomalous artery. The blood supply to the first portion of the ventricular septum is provided by 1 or 2 descending septal branches from the anomalous LM artery, when the anomalous vessel is coursing between the aorta and pulmonary trunk. When the anomalous LM courses posteriorly to the aorta, it does not provide any septal branches. In patients with this anomaly, the blood supply to the first portion of the septum is usually provided by descending septal branches originating from the right sinus of Valsalva or from the first portion of the right coronary artery. Six of the 10 patients had severe obstructive coronary artery disease. Four of the 6 patients had significant LM coronary artery disease. PMID- 3976523 TI - Anomalous origin of the left main coronary artery from the right anterior aortic sinus: angiographic definition of anomalous course. AB - Five cases of anomalous origin of the left main (LM) coronary artery from the right anterior aortic sinus are presented. In 4 patients the anomalous artery ran a septal course through the floor of the right ventricular infundibulum and in 1 an interarterial course between the aorta and pulmonary trunk. The cineangiographic features of these courses are contrasted with arteries running anterior free wall and retro-aortic courses. A caudal anterior loop of the anomalous LM coronary artery indicates a septal course, a cranial posterior loop an interarterial course, a cranial anterior loop an anterior free wall course and a caudal posterior loop a retro-aortic course. Review of previously documented cases shows that the septal course is relatively common, although previously not recognized. PMID- 3976524 TI - Small left atrium and change in contour of the ventricular septum in total anomalous pulmonary venous connection: a morphometric analysis of 22 infant hearts. AB - Morphometric measurements of 22 hearts with total anomalous pulmonary venous connection (TAPVC) were compared with measurements of 8 matched control specimens without heart disease. Each of the TAPVC specimens had a shorter left atrium, smaller left atrial surface area and larger diameter of the fossa ovalis. In addition to increased length of the right ventricle and larger circumferences for tricuspid and pulmonary valve anuli, the left ventricular contour of the ventricular septum was flat or convex in 18 of the 22 hearts; the septum was significantly longer than normal in these specimens and wider at its midportion. Because mitral and aortic valve anuli were normal in circumference, the data suggest that left ventricular volume is not decreased despite change in ventricular shape. PMID- 3976525 TI - Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. AB - To determine cardiac chamber size, wall thickness and left ventricular (LV) systolic function in morbidly obese patients, M-mode and cross-sectional echocardiography was performed in 62 patients whose body weight was greater than or equal to twice their ideal weight but who were free from underlying organic heart disease and systemic hypertension. The initial clinical protocol consisted of a medical history, physical examination, electrocardiogram at rest, chest x ray and echocardiogram. Thereafter, each patient underwent gastric restriction. Thirty-four patients returned for follow-up echocardiography 4.3 +/- 0.3 months after substantial weight loss was achieved. For the whole group (n = 62) and LV internal dimension in diastole was enlarged in 24 (39%), the right ventricular internal dimension was enlarged in 20 (32%), the left atrial dimension was enlarged in 25 (40%) and the ventricular septal and LV posterior wall thickness was increased in 35 (56%). In the 34 patients who returned for follow-up, mean body weight decreased significantly, from 135 +/- 8 to 79 +/- 6 kg (73 +/- 4% of the amount over ideal body weight). In the subgroup with low preoperative LV fractional shortening (n = 13), mean LV fractional shortening increased from 22 +/- 2% to 31 +/- 2% (p less than 0.01). This was accompanied by a significant decrease in the mean LV internal dimension in diastole and mean blood pressure. The results indicate that cardiac chamber enlargement, LV hypertrophy and LV systolic dysfunction occur frequently in morbidly obese patients and that LV systolic dysfunction in such persons may improve following substantial weight loss. PMID- 3976526 TI - Mitral and tricuspid valve anular diameter in normal children determined by two dimensional echocardiography. AB - To establish normal values for atrioventricular valve anular diameter in children, we measured the diameter of the mitral and tricuspid valve anuli from 2 dimensional echocardiograms in 103 children aged 1 day to 15 years. Measurements of the mitral valve anulus were made from the parasternal long axis and the apical or subcostal 4-chamber views. The tricuspid valve was measured from the subcostal or apical 4-chamber view. Multiple regression analyses were performed comparing valve anular diameter to weight and body surface area and their respective square root, cube root and logarithmic functions. Mitral and tricuspid anular diameter increased in proportion to the logarithm of weight and body surface area. The best predictor of valve anular diameter was a logarithmic function of body surface area with a calculated correlation coefficient ranging from 0.90 to 0.93 for the 3 anular dimensions. Knowledge of the normal atrioventricular valve anular diameter should be useful in planning palliative or corrective surgery in children with congenital heart disease. PMID- 3976527 TI - Effects of training on systolic time intervals at rest and during isometric exercise in men and women 61 to 64 years old. AB - To determine whether regular exercise improves left ventricular (LV) contractile function in persons 60 years and older, systolic time intervals (STIs) were measured in 10 healthy men and women (mean age 62 +/- 1 year [+/- standard deviation]) before and after 6 months of intense endurance training. STIs, systolic and diastolic blood pressure (BP) and heart rate (HR) were determined at rest and in response to isometric handgrip exercise. Systolic BP, diastolic BP and HR increased acutely from rest in response to handgrip (p less than 0.002). The indexes of total electromechanical systole and LV ejection time (ET) index increased (p less than 0.01), preejection period (PEP) index increased (p less than 0.05) or remained unchanged and PEP/LVET did not change from values at rest in response to handgrip. Training resulted in an 18% increase in maximal oxygen uptake (p less than 0.01). After training, systolic and diastolic BP were reduced at rest (p less than 0.002) and, along with HR, were lower in response to handgrip (p less than 0.002). However, training did not alter STIs at rest or during handgrip. These findings indicate that healthy persons in their 60s have a normal LV response to isometric exercise. Prolonged, intense endurance training does not alter LV contractile function at rest or in response to isometric exercise. However, training can significantly reduce BP at rest, and markedly lower the HR-systolic BP product attained during acute isometric stress, even in normotensive older subjects. PMID- 3976528 TI - Blood pressure and heart rate responses during 24-hour ambulatory monitoring and exercise in men with diabetes mellitus. AB - The heart rate (HR) variation of 25 normotensive and asymptomatic men, mean age 58 +/- 7 years, with diabetes mellitus (group I) was studied during deep respiration. Thirteen subjects (52%) had a variation of 10 beats/min or less, consistent with an autonomic neuropathy (AN) (group IA); 12 had variation in HR of more than 10 beats/min and were considered to have no neuropathy (group IB). The 24-hour ambulatory HR and systolic blood pressure (BP) values of group I were compared with those of 13 healthy men, mean age 48 +/- 8 years (group II). The mean of 5 maximal HR measurements during the 24-hour period was higher for group IA (106 +/- 11 beats/min) than for group IB (100 +/- 13 beats/min) or for group II (92 +/- 9 beats/min) (p less than 0.01). The mean of 5 maximal BP measurements was greater for group I (149 +/- 28 mm Hg) than for group II (128 +/- 13 mm Hg) (p less than 0.01), but no difference was observed between groups IA and IB. Maximal treadmill exercise was performed with 22 of the patients (11 with and 11 without AN), and no difference in HR was observed between the 2 groups during all stages of exercise or at maximal exertion. The increase in systolic BP and duration of exercise in these 2 groups were also similar. Seventeen of 25 diabetic men had peripheral neuropathy (PN). Of 13 patients with AN, 10 had PN; of 12 without AN, 7 had PN and 5 did not.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976529 TI - Development of an endocardial-epicardial gradient of activation rate during electrically induced, sustained ventricular fibrillation in dogs. AB - Electrograms recorded with currently available electrodes become indistinct soon after the onset of ventricular fibrillation (VF), thus, little is known about transmural myocardial depolarization during VF. A plunge electrode system (plunge) was developed that registers discrete deflections during VF. These plunges were used to record for 20 minutes after inducing VF with a single premature shock in 20 open-chest dogs. In the first 6 dogs the epicardium was exposed to room temperature and in 14 dogs transmural temperature was maintained at 38 degrees C. Electrograms recorded with the transmural plunges contained sharp, discrete deflections during early VF in all dogs. Over the next 20 minutes of VF, the rate, regularity of cycle length and discreteness of the deflections in the electrograms decreased with time, first at the epicardial level, then deeper toward the endocardium. In all dogs, however, discrete, regular, rapid deflections persisted in the most subendocardial electrogram throughout the recording period. In 8 dogs, transmural myocardial biopsy samples were taken before fibrillation, and at intervals after the onset of fibrillation. The high energy phosphate content of the myocardium decreased during VF, with comparable decreases in the epicardial and endocardial halves. Coronary perfusion was maintained during the first 20 minutes of VF in 6 additional dogs by cardiopulmonary bypass. A gradient of activation rates did not develop on bypass, but did develop within 1 minute of halting bypass. Thus, the endocardial epicardial gradient of activation rates during VF is caused by ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976530 TI - Improved internal defibrillation with twin pulse sequential energy delivery to different lead orientations in pigs. AB - Internal cardiac defibrillation with an intravascular catheter was compared with a new method for internal cardiac defibrillation using 2 pulses delivered in sequence directly to the myocardium. For the sequential pulses, the first pulse was passed through an intravascular catheter (Medtronic 6880), between the anode in the superior vena cava-atrial junction region and the cathode in the apex of the right ventricle. The second pulse was delivered between the catheter tip in the right ventricular apex as cathode and an oval plaque electrode (Medtronic TX 7) secured on the epicardium of the left ventricular free wall as anode. Defibrillation pulses were of truncated, trapezoidal waveform (65% tilt), separated by 1, 10 and 100 ms. Using the catheter alone, 36 normal pig hearts could be defibrillated by 44 J. However, 22 pig hearts (60%) could not be defibrillated with energies below 35 J. Defibrillation threshold was improved with sequential twin pulses, the improvement being dependent on pulse separation (42, 34 and 19 J, at 100-, 10- and 1-ms separation, respectively; F = 14.6, df = 2.29, p less than 0.01). In conclusion, sequential twin pulse defibrillation provides a considerable reduction in energy necessary for defibrillation in comparison to single pulses using the catheter alone. In this study, the optimal separation was 1 ms. PMID- 3976531 TI - Limitations of fluorocarbons in reducing myocardial infarct size. AB - The effects of the oxygen-carrier fluorocarbons on myocardial infarct size were assessed in non-exchange-transfused dogs subjected either to a 3-hour occlusion of the left anterior descending coronary artery (LAD) followed by 2 hours of reperfusion (protocol I) or to a 5-hour permanent LAD occlusion (protocol II). Fluorocarbon administration was begun 30 minutes after LAD occlusion and was continued over the entire period of ischemia. After 5 hours, the hearts were excised and areas of necrosis were visualized by triphenyl tetrazolium chloride staining while risk regions were assessed by radiolabeled microspheres injected after coronary occlusion just before the onset of therapy, and further, in protocol I, by thallium-201 perfusion imaging performed at the end of fluorocarbon administration. In protocol I experiments, the ratio of necrotic area to area at risk was 81 +/- 35% (mean +/- standard deviation) in control saline-treated dogs (n = 6) and 67 +/- 27% in fluorocarbon-treated dogs (n = 6) (difference not significant). There was no significant difference between risk regions measured after and before fluorocarbon treatment. In protocol II, the ratio of necrotic area to area at risk was 47 +/- 30% in control dogs (n = 5) and 63 +/- 29% in fluorocarbon-treated dogs (n = 5) (difference not significant). However, in control dogs, the ratio of necrotic area to area at risk increased from 47 +/- 30% in the dogs that underwent permanent occlusion to 81 +/- 35% in the group that underwent reperfusion (p less than 0.001) while this ratio was similar in the corresponding subsets of fluorocarbon-treated animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976532 TI - Myocardial ischemia during intravenous nicardipine administration. PMID- 3976533 TI - Cocaine-induced angina pectoris and acute myocardial infarction in patients younger than 40 years. PMID- 3976534 TI - Effect of peripheral thyroid hormone metabolism on cardiac arrhythmias. PMID- 3976535 TI - Concomitant pulsus and U-wave alternans after head trauma. PMID- 3976536 TI - Study of Wolff-Parkinson-White syndrome by transesophageal pacing and assessment of long-term amiodarone therapy. PMID- 3976537 TI - Left atrial-pulmonary artery wedge pressure relation: effect of elevated pulmonary vascular resistance. PMID- 3976538 TI - Relation of body habitus to the severity of mitral stenosis in women. PMID- 3976539 TI - Patent ductus arteriosus, atrial septal defect and branch pulmonary artery stenosis: a possible new syndrome. PMID- 3976540 TI - Recanalization of a Blalock-Taussig anastomosis eight years after repair of tetralogy of Fallot. PMID- 3976541 TI - Hypoplasia of the apical trabecular component of the morphologically right ventricle. PMID- 3976542 TI - Single coronary artery from the right sinus. PMID- 3976543 TI - An attempt to differentiate further between microglia and fluorescent granular perithelial (FGP) cells by their capacity to incorporate exogenous protein. AB - It seems established that under pathological conditions, microglia and blood monocytes (invading the cerebral parenchyma) behave as histiocytic cells in the central nervous system. However, it has not been clear whether or not phagocytic cells are present in normal cerebral tissue. Recently, we found a new type of cell having an uptake capacity for exogenous substance at the bifurcations of small cerebral vessels except for capillaries. According to Imamoto et al. (1982), ameboid microglia, a kind of precursor of microglia, appear at a perinatal stage and can incorporate exogenous material. In the present paper, the developmental sequences of ameboid microglia and the unique cells laden with fluorescent granules are compared at a light and electron-microscopic level. From this study, it is clear that ameboid microglia are already present in the corpus callosum at 5 days after birth and are potent in their uptake capacity for horseradish peroxidase (HRP). However, at 2 weeks, they transform into star cells and the capacity for incorporation diminishes markedly. The finding is also supported by the quantitative analysis of transformation of ameboid microglia. At 3 months, glial cells do not take the administered HRP under the present conditions. On the other hand, fluorescent granular perithelial (FGP) cells arise from a leptomeningeal tissue (pia mater) and become situated in the perivascular spaces. They are not clearly defined at 5 days, and their uptake capacity for HRP has not yet developed. At 2 weeks, the FGP cells take definite forms with several inclusion bodies, and their uptake capacity for HRP attains a certain degree. Often, they are located at bifurcations of small blood vessels. At 3 months, the FGP cells differentiate completely in appearance, and their pinocytotic capacity reaches a high level. Consequently, the FGP cells belong to a different type of cell from that of ameboid microglia in their developmental sequences and assume a principal role of scavenging waste products in normal cerebral tissue. PMID- 3976544 TI - Morphological evidence of reduced bone resorption in the osteosclerotic (oc) mouse. AB - Osteopetrosis, a metabolic bone disease characterized by a generalized sclerosis of the skeleton, is inherited as an autosomal recessive in a number of mammalian species. The pathogenesis of congenital osteopetrosis is mediated by a reduction in bone resorption as a result of decreased osteoclast function. This hypothesis is based on both functional and structural evidence of reduced bone resorption in all mutations examined to date. The present study examined the histology of cartilage and bone, the ultrastructure of osteoclasts, and the morphology of mineralized bone surfaces in a lethal osteopetrotic mutation, the osteosclerotic (oc) mouse. Histologically, epiphyseal cartilage growth plates, especially the hypertrophic zone, are markedly thickened in oc mice and metaphyses contain excessive osteoid, features characteristic of rickets. Transmission electron microscopy revealed that less than one-quarter of osteoclasts in oc mice demonstrated evidence of ruffled border formation compared with three-quarters of the osteoclasts in normal littermates. In mutants, ruffled borders were less elaborate and cytoplasmic processes penetrated into bone surfaces, suggesting that bone may be removed by mechanical rather than by enzymatic means. There was little morphological evidence of cartilage degradation and broad laminae limitantes persisted in mutants. Mineralized surfaces that undergo resorption in normal mice showed no evidence of bone resorption by scanning EM in mutants. The presence of a rachitic condition, the observations of reduced bone resorption, and the possible contribution of undermineralized matrices to decreased bone resorption are characteristics of the osteosclerotic mutation which suggest that it is a unique osteopetrotic mutant in which to study both the development and regulation of skeletal metabolism. PMID- 3976545 TI - Hypnosis in Canadian criminal law. PMID- 3976546 TI - Metaphoric hypnotic imagery in the treatment of functional amenorrhea. PMID- 3976547 TI - Clinical hypnosis and recurring nightmares: a case report. PMID- 3976548 TI - Little people, images, and child health. PMID- 3976549 TI - Imagery for the treatment of obsessional behavior: a case study. PMID- 3976550 TI - A spontaneous catatonic-like reaction associated with hypnotic regression: a brief case report. PMID- 3976551 TI - Influence of dietary carbohydrate on skeletal muscle glucose uptake. AB - The effect of altering the percent of dietary carbohydrate on the rate of skeletal muscle glucose uptake was studied using the perfused rat hindlimb preparation. The rats received either a high carbohydrate (HC; 65%), mixed (M; 35%) or low carbohydrate (LC; 10%) isocaloric diet for 7 days. With 0.1 mU/ml of insulin in the perfusate, the muscle of rats on the HC diet had a 33% increase in the rate of glucose uptake and the muscle of rats fed the LC diet a 23% decrease in the rate of glucose uptake when compared to the muscle of rats fed the M diet (3.34 mumol/g/30 min). With 10.0 mU/ml of insulin in the perfusate, ie maximal insulin stimulation, the rate of glucose uptake showed a similar dietary effect as that obtained with 0.1 mU/ml insulin. Compared to the M diet (8.67 mumol/g/30 min), the rate of glucose uptake increased 26% in muscle of rats from the HC group and decreased by 20% in muscle of rats from the LC group. Diet had no effect on the rate of muscle glucose uptake in the absence of insulin. Under both maximal and submaximal insulin stimulation, glycogen accumulation was greatest in muscle from HC fed rats and least in muscle from LC fed rats. During perfusion muscle intracellular free glucose and glucose-6-phosphate accumulation for the three dietary groups was negligible. The groups did not differ significantly in their muscle hexokinase or beta-hydroxyl acyl CoA dehydrogenase activities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976552 TI - A comparison of two very-low-calorie diets: protein-sparing-modified fast versus protein-formula-liquid diet. AB - This study investigated the acceptability of two very-low-calorie diets in 16 moderately overweight persons participating in a weight reduction program. Subjects were prescribed a 1000-1200 kcal balanced diet the first month and asked to complete appetite and mood scales on a weekly basis. They were then randomly assigned to either a protein-sparing-modified fast (PSMF) or a protein-formula liquid diet, each of which provided about 400 kcal daily. Analysis of the appetite data showed that PSMF subjects reported significantly less hunger and preoccupation with eating than did liquid diet subjects during 2 of the 4 weeks on a very-low-calorie diet. Subjects in both conditions reported significant reductions in anxiety. Results are discussed in terms of possible advantages of PSMF. PMID- 3976553 TI - Anthropometric and calorimetric evidence for the protein sparing effects of a new protein supplemented low calorie preparation. AB - A commercial protein sparing modified fast (PSMF) preparation has been evaluated for the protein sparing effects in 15 morbidly obese patients. During a 500 kcal preparation, given during a 6-week period, mean body weight and BMI decreased significantly. Total body fat decreased from 55.8 to 41.4 kg and lean body mass and arm muscle circumference (AMC) remained unchanged. Using indirect calorimetry and under the same degree of energy expenditure, carbohydrate metabolic consumption was significantly diminished (166 to 61 g/24 hr; p less than 0.001) but fat consumption was increased (116 to 155 g/24 hr; p less than 0.05) while the metabolic turn-over of protein was unchanged. This new presented PSMF preparation seems to present the typical properties of a protein sparing modified fast. PMID- 3976554 TI - Lack of sustained increase in VO2 following exercise in fit and unfit subjects. AB - Thermogenesis after exercise was studied by measuring oxygen consumption in 23 subjects who were classified into three groups according to their routine level of physical activity. VO2 was first measured after a 30-minute rest period 4 hours after breakfast. Then each subject either exercised for 20 minutes at approximately the anaerobic threshold or on a separate non-exercise day remained recumbent. The subject then returned to, or remained, at rest. There was no significant difference in VO2 from the resting level from 40 minutes to 3 hours after exercise, between exercise and non-exercise days in any fitness group. Seven subjects also exercised for a longer period or at a higher intensity. Again, there was no significant difference in the time course of VO2 from 40 minutes to 220 minutes after exercise, between exercise and non-exercise days. Because no sustained effect of moderate or intense exercise on VO2 was demonstrated, we conclude that no appreciable caloric loss beyond that generated by the exercise period itself and the early recovery phase is found in either fit or unfit subjects. These data do not support claims for sustained increases in metabolic rate after exercise in weight-control programs. PMID- 3976555 TI - The effects of a dietary zinc supplement during lactation on longitudinal changes in maternal zinc status and milk zinc concentrations. AB - Dietary zinc intakes, selected biochemical indices of zinc status, and milk zinc concentrations were determined at monthly intervals throughout lactation for 53 middle-income lactating women, 14 of whom received a daily supplement of 15 mg zinc. Overall mean dietary zinc intake for the non-supplemented group (NZS) was 10.7 +/- 4.1 mg/day (mean +/- SD). The mean dietary zinc intake of the zinc supplemented group (ZS) was 12.2 +/- 3.5 mg/day, with an additional 12.8 +/- 1.5 mg/day from the supplement. For the NZS group, the highest mean plasma zinc concentration of 79 +/- 10 mu/dl, which occurred at month 4, was significantly less than the mean for non-lactating control women (86 +/- 10 micrograms/dl). ZS plasma zinc levels had a pattern similar to that of the NZS group for months 1-7. The rate of decline in milk zinc during lactation was significantly less for the ZS group compared to that of the NZS group (p = 0.02). It is concluded that milk zinc concentrations are influenced by maternal zinc intake within a physiological range and that the effects of low maternal intakes are most apparent with prolonged lactation. PMID- 3976556 TI - Serum chromium of human subjects: effects of chromium supplementation and glucose. AB - Seventy-six adult subjects, 48 males and 28 females, were given placebo or 200 micrograms Cr in the form of chromic chloride in a double-blind crossover study, with 3-month experimental periods, to determine basal serum Cr levels and the effects of Cr supplementation on serum Cr and related variables. Basal serum Cr determined by graphite furnace atomic absorption for all subjects was 0.13 +/- 0.02 ng/ml (mean +/- SEM), and increased significantly to 0.38 +/- 0.02 ng/ml following 3 months of Cr supplementation. There were no significant differences in the serum Cr values for males and females. Serum Cr 90 min following a glucose load (1 g per kg body wt) was not significantly different from fasting during either the placebo or Cr supplementation periods. These data demonstrate that serum Cr increased significantly following Cr supplementation and is a reflection of Cr intake, but serum Cr concentration, even that following a glucose load, does not appear to be a meaningful indicator of Cr status. PMID- 3976557 TI - Effects of supplemental pantothenic acid on wound healing: experimental study in rabbit. AB - The effect of pantothenic acid supplementation and deficiency on wound healing was investigated over a one month postoperative period in rabbits. The supplemented group was injected with pentothenate (20 mg/kg of body weight/24 h) for three weeks and compared to a placebo group (0.5 ml of distilled water). Deficient animals were fed with a pantothenate free diet also for three weeks. These three experimental groups were matched against a control group. The degree of wound healing was determined by the mean of postoperative breaking strength and wound fibroblast population changes. Pantothenic acid urinary excretion measured by gas chromatography served as control of pantothenate consumption. With regard to these three parameters no significant difference has been found between placebo and controls. The average urinary elimination in the pantothenic acid group was significantly higher as far as the pantothenate supplemented group was concerned, while the deficient group showed no significant decrease when compared to controls. Chronic pre- and postoperative pantothenic acid supplementation significantly increased aponeurosis strength after surgery; it improved slightly, but not significantly the strength of the skin. Furthermore, the fibroblast content of the scar became significantly greater during the fibroblast proliferation phase after pantothenic supplementation. These data suggest that pantothenic acid induces an accelerating effect of the normal healing process. The mechanism responsible for this improvement seems to be an increase in cellular multiplication during the first postoperative period. But the exact intimate mechanism of the beneficial effect of pantothenate remains unclear. PMID- 3976558 TI - Folate intake and blood concentrations of term infants. AB - Folate nutrition of 67 full-term infants was studied longitudinally from birth to 1 year. Infants were grouped according to type of milk consumed during early infancy: group I (n = 14) received human milk; group II (n = 31), a standard cow milk infant formula; and group III (n = 22), the same formula with added iron (12.3 mg/L). Solid foods were introduced after 3 months. Folate status, as indicated by serum and red blood cell folate concentrations, and folate intake were measured periodically. Blood folate concentrations of all groups were higher than or similar to adult control values. No differences in indices of folate status were observed between formula-fed groups at any time frame. At 6 weeks and 3 months formula-fed infants had folate intakes and blood concentrations significantly greater than human milk-fed infants. With the introduction of solid foods, decreases in blood folate concentrations paralleled decreases in milk folate intake within each group. Serum folate concentrations correlated with both total folate intake and milk folate intake, whereas RBC folate concentrations correlated with only milk folate intake. The results indicate that milk, regardless of type (human milk, formula, and cow milk), is an important dietary source of folate during the first year of life and that both human milk and proprietary formula feeding during early infancy provide more than sufficient folate to maintain blood folate concentrations well above acceptable limits. PMID- 3976559 TI - Short term effect of a low fat diet on plasma retinol and alpha-tocopherol and red cell alpha-tocopherol levels in hyperlipidemic men. AB - The effect of a low fat, low cholesterol diet on plasma alpha-tocopherol and retinol and erythrocyte alpha-tocopherol levels was studied in fourteen hyperlipidemic men for a period of 28 days. Plasma alpha-tocopherol decreased with decreasing plasma cholesterol levels while the ratio of plasma alpha tocopherol to cholesterol remained constant. There was a tendency for plasma retinol levels to decrease but the change was not significant. As plasma alpha tocopherol levels decreased there was a consistent and significant increase in alpha-tocopherol content of red cells (p less than 0.001). These findings indicate that fat soluble vitamin status is maintained with low fat diets during a short time period. PMID- 3976560 TI - Assessment in humans of hypolipidemia induced by orotic acid. AB - The hypolipidemia induced by oral orotic acid in rats but not in other experimental species was investigated in human adults. Twelve outpatients in a medically-supervised weight reduction program participated in the study. After adaptation to their restricted dietary regime for at least 8 weeks, all subjects were given placebos (1 g lactose/day) for 2 weeks, then orotic acid (1 g/day) for 4 weeks, followed by placebos for 2 more weeks. Pertinent dietary, urinary, and serum parameters were monitored biweekly and intake of calories, carbohydrate, protein and fat was similar throughout. The ingestion of orotic acid did not lower serum triglycerides or cholesterol in these subjects. Since the daily dose tested corresponds to the orotic acid in 12 liters of cow's milk, milk orotic acid at levels normally consumed should not be considered a hypolipidemic or hypocholesteremic agent for humans. PMID- 3976561 TI - Lactose malabsorption in Australian Aboriginal children. AB - The purpose of this study was to determine the prevalence of lactose malabsorption in healthy full-blood Australian Aboriginal children. Sixty-three Aboriginal subjects and forty-six non-Aboriginal controls ranging in age from six to 14 years were tested using the breath hydrogen method. Seventy percent of the Aboriginal subjects were found to be lactose malabsorbers and 9% of the controls. The results provide strong evidence that the majority of full-blood Aboriginal children are lactose malabsorbers and that the characteristic is well-established by 6-7 years of age, in common with most other non-Western populations. PMID- 3976562 TI - The relation of drinking and smoking habits to diet: the Lipid Research Clinics Prevalence Study. AB - The relation of cigarette smoking and alcohol use to diet was examined in a general population of adults ages 20-59 years enrolled in the Lipid Research Clinics (LRC) Prevalence Study. There was a positive association between cigarette and alcohol use, but little relation between these habits and the nutrient intake. The total energy from food was about the same whether or not a person drank or smoked; alcohol was simply added to food intake. However, persons who drank received slightly less of their food energy from carbohydrate than persons who did not drink and persons who smoked received slightly more of their food energy from fat than did nonsmokers. Both persons who drank and persons who smoked weighed less than would be expected from their total energy intake. While these relationships were similar for men and women, among women they were stronger for those using gonadal hormones than among those not using these hormones. PMID- 3976563 TI - Red blood cell tocopherol concentrations in a normal population of Japanese children and premature infants in relation to the assessment of vitamin E status. AB - To determine the normal range of red blood cell (RBC) tocopherol as an assessment of vitamin E nutritional status, 261 apparently healthy children, 3 to 16 years old, including 160 males and 101 females, were investigated and this population was compared with premature infants and adults. In the children, the mean plasma tocopherol was 682 micrograms/100 ml, ranging from 309 to 1,442 micrograms/100 ml. Plasma tocopherol expressed in terms of total lipids (tocopherol/lipid ratio) was generally within accepted value (greater than 0.8). Only one had a value below 0.8. The mean RBC tocopherol was 179 micrograms/100 ml packed cells ranging from 79 to 320 micrograms/100 ml. When the cumulative percentage frequency was examined, the value of 115 micrograms/100 ml corresponded to the fifth percentile of the population of RBC. Thirteen of 90 premature infants (14.4%) less than 24 hours-old and 9 of 48 at 7 days of age (18.8%) had values of less than 115 micrograms/100 ml packed RBCs, while on the basis of the tocopherol/lipid ratio, 44.8% of the infants less than 24-hours-old and 22.2% of those 7 days old had values below 0.8. No adult was below the accepted values of either RBC tocopherol or the tocopherol/lipid ratio. PMID- 3976564 TI - The prevalence of vitamin K deficiency in chronic gastrointestinal disorders. AB - Vitamin K deficiency results in the appearance of abnormal prothrombin, deficient in gamma-carboxyglutamic acid, in the blood. The presence of abnormal prothrombin can be eliminated or lowered by the administration of vitamin K. Since the abnormal prothrombin antigen assay is approximately 1000-fold more sensitive than the prothrombin time for the diagnosis of vitamin K deficiency, this assay was used to evaluate patients with intestinal abnormalities. Vitamin K deficiency was found in 18 of 58 patients (31%) with chronic gastrointestinal disease and/or resection. All patients with vitamin K deficiency had either Crohn's disease involving the ileum or ulcerative colitis treated with sulfasalazine or antibiotics. Abnormal prothrombin levels returned toward normal in patients treated with vitamin K but not in patients who were not treated with vitamin K. The mean plasma vitamin E level in patients with vitamin K deficiency was significantly lower than in vitamin-K sufficient patients (p less than 0.01). We conclude that certain chronic forms of gastrointestinal disorders are associated with vitamin K deficiency. PMID- 3976565 TI - A new chart to monitor weight gain during pregnancy. AB - A new chart to monitor maternal weight gain during pregnancy is presented. The chart is based on the adequacy of maternal weight for height, as suggested by a modified table of weight for average frame size, and the data were derived from a low-income racially-mixed population living in New York City. A nomogram accompanies the chart and is used to calculate values of percentage of "standard weight" at various gestational ages. The chart establishes a desirable weight near term which is equivalent to 120 percent of "standard weight" for women with a pre-pregnancy weight equal to or lower than 100 percent of "standard weight". For women with pre-pregnancy weight above 100% of "standard weight" the desirable weight near term varies according to the initial weight but includes a minimal weight gain of 7 kg for women with pre-pregnancy weight over 120% of standard. Women who attained or exceeded body weight near term equivalent to 120 percent of "standard weight" in low income populations in the US and Chile delivered infants with significantly higher mean birth weight than those from mothers who did not meet this goal. PMID- 3976566 TI - Carnitine concentration of red blood cells. AB - The presence of significant concentrations of carnitine in red blood cells is documented using an assay procedure that is described in detail. Red blood cells can be prepared for assay by simple techniques and stored frozen. The reproducibility of the assay procedure is within acceptable limits. Usefulness of the procedure in an experimental setting has been documented with an investigation of both plasma and red blood cell carnitine concentrations of rats of different ages. Earlier studies have demonstrated that plasma carnitine concentrations are two-fold higher in adult male rats than in adult female rats. In agreement with that data, the adult male rat has a red blood cell carnitine concentration which is two-fold higher than that of adult female rats. PMID- 3976567 TI - Predictions of plasma cholesterol responses to dietary cholesterol. PMID- 3976568 TI - Reply to letter by Bradfield and Staehling. Anthropometric data for Mexican American children. PMID- 3976569 TI - A quantitative ELISA procedure for the measurement of membrane-bound platelet associated IgG (PAIgG). AB - A quantitative ELISA assay for the measurement of in vivo bound platelet associated IgG (PAIgG) using intact patient platelets is presented. The assay requires quantitation and standardization of the number of platelets bound to microtiter plate wells and an absorbance curve using quantitated IgG standards. Platelet-bound IgG was measured using an F(ab')2 peroxidase labeled anti-human IgG and o-phenylenediamine dihydrochloride (OPD) as the substrate. Using this assay, PAIgG for normal individuals was 2.8 +/- 1.6 fg/platelet (mean +/- 1 SD; n = 30). Increased levels were found in 28 of 30 patients with clinical autoimmune thrombocytopenia (ATP) with a range of 7.0-80 fg/platelet. Normal PAIgG levels were found in 26 of 30 patients with nonimmune thrombocytopenia. In the sample population studied, the PAIgG assay showed a sensitivity of 93%, specificity of 90%, a positive predictive value of 0.90, and a negative predictive value of 0.93. The procedure is highly reproducible (CV = 6.8%) and useful in evaluating patients with suspected immune mediated thrombocytopenia. PMID- 3976570 TI - Quality control of multichannel hematology analyzers: evaluation of Bull's algorithm. AB - Bull's algorithm has been evaluated by computer simulation studies. Varying amounts of systematic analytic error were simulated in either hemoglobin (Hgb), red blood cell count (RBC), or mean corpuscular volume (MCV) with the resulting red blood cell indices averaged in batches of 20 using Bull's algorithm. The number of average indices outside the limits of 0.97 means and 1.03 means (means = stable patient mean index) was tabulated and plotted against the size of the systematic shift, expressed in multiples of the long-term analytic standard deviation (SD). The resulting plots, called power functions, show that Bull's algorithm can detect large shifts effectively and that its power increases with increasing batch number. Shifts less than 2 SD rarely are detected. The minimum error that is detected 50% of the time after nine consecutive batches is shown below: (Formula: see text) The simulation of populations with outlying indices, e.g., neonates and oncology patients, resulted in both decreased and increased power, depending on the proportion of outliers averaged, the index averaged, and the direction of the shift. PMID- 3976571 TI - Immunoglobulin G (IgG) levels in breast tumor cytosols. AB - Immunonephelometer investigation of specific proteins revealed a difference in levels of immunoglobulin G (IgG) found in the cytosol of estrogen receptor (ER) rich and estrogen receptor poor tumor tissue. Cytosols from estrogen receptor poor tumors had a significantly higher level of IgG than those from estrogen receptor rich tissues. The relationship between progesterone receptor levels and IgG was not as significant as that observed between ER levels and IgG. Other specific proteins did not correlate with either estrogen receptor levels or progesterone levels. PMID- 3976572 TI - Rapid method of MIC determinations utilizing tetrazolium reduction. AB - A rapid preliminary method of determining antibiotic susceptibilities of clinically isolated gram-negative fermentative organisms has been evaluated. The method utilizes tetrazolium dye reduction as a colorimetric indicator of bacterial growth. Tetrazolium dye reduction is incorporated into the standard Micro-Media MIC microdilution testing system and shortens the required incubation period from 15 to 18 hours to 4 hours. Parallel MIC determinations were made by the standard MIC method and by the rapid tetrazolium method. The test organisms included 218 gram-negative fermentative clinical isolates. The overall correlation between the standard and the rapid MIC methods was 93%. Of the 7% discordant results, 6.3% represented minor discrepancies and 0.7% represented major discrepancies. There were no very major discrepancies. The study concluded that the rapid tetrazolium MIC method is an accurate, low-cost, easily implemented method of preliminary antibiotic susceptibility testing for gram negative fermentative organisms. PMID- 3976573 TI - Heparin therapy adjusted for body weight. AB - A linear relation between heparin concentrations and the dosage of heparin/kg body weight (r = 0.91, N = 47) was found after bolus injections of 2,500, 5,000, or 10,000 U heparin; the heparin concentrations agreed with plasma distribution. The maintenance therapy showed linearity between heparin concentrations and the dosage of heparin/kg body weight and 24 hours; however, the sensitivity for maintenance therapy differed between patients. The mean dosage required for maintaining heparin at 0.5 U/mL was 400 but ranged between 250 and 600 U heparin/kg body weight and 24 hours. A bolus dose of 75 U heparin/kg body weight, followed by a maintenance dose of 400 U heparin/kg body weight and 24 hours, showed therapeutic heparin response in 78% of patients, however, heparin monitoring two times daily is necessary for adjustment of dosage. PMID- 3976574 TI - Psammoma bodies in malignant carcinoid tumor metastases. PMID- 3976575 TI - O.C.T. not a problem. PMID- 3976576 TI - On routine urine sediment examinations. PMID- 3976577 TI - Circumcision and the risk of cancer of the penis. PMID- 3976578 TI - Adolescent drug use. PMID- 3976579 TI - Mortality of persistent pulmonary hypertension of the newborn. PMID- 3976580 TI - The Martin-Bell syndrome: the physician's dilemma. PMID- 3976581 TI - Duplicate publication is boring. PMID- 3976582 TI - Risky business. Umbilical arterial catheterization. PMID- 3976583 TI - Publication of research presented at the pediatric meetings. Change in selection. AB - The adequacy of research presented in abstract form for presentation at scientific meetings remains a concern, as indicated by the proportion of such research appearing in scientific journals after peer review. This report examines the publication of research presented at the pediatrics meetings and the effect of a change in selection procedure for abstracts presented at the Ambulatory Pediatric Association meetings for the years 1979 and 1980. Throughout the period, about half of the presentations were published, usually in general pediatric journals, with an average time to publication of about 20 months. The change in selection procedure resulted in little change in the proportion published among either presentations or abstracts submitted but not selected for presentation, but it did lead to a reduction in time to publication. This experience suggests a mechanism for enhancing the timeliness of publication of research presented at scientific meetings without adversely affecting the process of selection. PMID- 3976584 TI - Illnesses in infants born to women with Chlamydia trachomatis infection. A prospective study. AB - Chlamydia trachomatis is known to cause infant pneumonitis and conjunctivitis and is a suspected cause of otitis media and gastroenteritis. To identify infections associated with exposure to C trachomatis, infant illnesses were studied through a "blinded" review of medical records of 244 infants born to women cultured antenatally for cervical C trachomatis, 25% of whom had C trachomatis-positive cultures. Compared with unexposed infants, infants exposed to C trachomatis had twice the rate of both pneumonitis and recurrent otitis media in the first six months. Infants who were exposed to C trachomatis and who had pneumonitis had higher subsequent rates of gastroenteritis than either unexposed infants or exposed infants without pneumonitis. These results suggest that appreciable outpatient infant morbidity may be associated with maternal infection with C trachomatis, and that it may either cause or promote the occurrence of early, recurrent otitis media and gastroenteritis. PMID- 3976585 TI - The sarcoma, breast cancer, lung cancer, and adrenocortical carcinoma syndrome revisited. Childhood cancer. AB - We studied two children who had rhabdomyosarcoma and glioblastoma and who were from a family with a hereditary cancer syndrome that was characterized by sarcoma, breast cancer, brain tumors, lung cancer, laryngeal carcinoma, leukemia, and adrenocortical carcinoma. The deleterious genotype has now been expressed through the fourth generation of this large kindred. The pedigree emphasizes the need for an extended history of several generations to arrive at a hereditary syndrome diagnosis. A limited pedigree may result in nonappreciation of the genetic component. The pedigree illustrates that, in certain circumstances, the highly specific varieties of cancer may occur in children before it is expressed in the parent who carries the putative gene. Pediatricians, in evaluating the causes of childhood cancer, must be cognizant of cancer among adult relatives, since this recognition may aid in the diagnosis of those hereditary cancer syndromes that are characterized by cancer occurrence in children as well as adults. PMID- 3976586 TI - Cell-mediated immunity in schoolchildren assessed by multitest skin testing. Normal values and proposed scoring system for healthy children. AB - Measurement of cutaneous delayed-type hypersensitivity (DTH) to a battery of ubiquitous antigens is an accepted means of assessing cell-mediated immunity (CMI). The recently introduced Multitest CMI system consists of a plastic multiple puncture device that simultaneously applies seven standardized recall antigens in a reproducible manner. A representative population of 448 healthy US schoolchildren was tested to determine incidence and size of DTH responses to each of the seven antigens. All responded to one or more antigens, the number and size of reactions generally increasing with age. Incidence of positive DTH tests was highest for tetanus and diphtheria toxoids, intermediate for streptococcal, Candida, and Proteus antigens, and lowest for tuberculin and Trichophyton antigens. These normal values, related to age and sex, can be a foundation for immunologic evaluation and are the basis of a proposed scoring system that distinguishes between normal DTH reactivity and diminished responsiveness. PMID- 3976587 TI - Counts, scales, and scores. Levels of observation. AB - Description, analysis, and interpretation of biomedical information are guided, in part, by the nature of the observations. Objects or events in categories, ie, nominal data, are simply counted. At a somewhat higher level, observations may have a "more than" character, so they can be ordered or ranked; the increments between the elements may be unknown or not measurable. Interval data have known and fixed increments, but no true zero; ratio scales are interval observations with a true zero. Some relationships between the levels of observation and the presentation and interpretation of biomedical information are discussed. PMID- 3976588 TI - Pediatricians and mental health professionals. Patterns of collaboration and utilization. AB - We surveyed 1,089 fellows of the American Academy of Pediatrics regarding (1) their experiences with child psychiatrists during training, (2) their current utilization preferences and practice with psychiatrists and other mental health professionals, and (3) differences in responses between pediatricians who completed ambulatory pediatric and related training and other pediatricians with respect to the aforementioned questions. Of those pediatricians who had contact with psychiatrists during training, more than 68% remembered the psychiatrist as being helpful. There was a strong preference on the part of all respondents for referral to a "behaviorally oriented pediatrician" for selected psychosocial problems. The pediatricians trained in ambulatory pediatrics believed they were more competent to treat the psychosocial problems of their patients than did other pediatricians and indicated more collaborative activities with psychiatrists than did other pediatricians. PMID- 3976589 TI - Growth patterns in children hospitalized because of caloric-deprivation failure to thrive. AB - Infants and children with suspected caloric-deprivation failure to thrive (CDFTT) are commonly hospitalized to confirm the diagnosis. In the hospital, weight gain at an accelerated rate is used as the primary diagnostic criterion. We evaluated how soon patients with CDFTT began to gain weight and if the speed with which the patients started to gain weight was age dependent. Of 476 patients with growth problems, 57 met the criteria for inclusion in the study. We developed the concept of the "growth quotient," which expresses the patient's rate of growth. We found that almost all 57 children started to grow in less than two weeks, and those less than 6 months old usually began to gain weight in only two to three days. Older infants and children with CDFTT often had initial corrective growth rates equal to or greater than those of young infants. PMID- 3976590 TI - Consequences of candidemia for pediatric patients. AB - The hospital records of 45 infants and children with one or more blood cultures positive for Candida species were studied retrospectively in an attempt to define the risk of Candida-related complications. Death of eight of the patients (18%) was related to Candida infection, and five additional patients (11%) had metastatic foci of infection but survived. No characteristics were identified that would predict patients who were at high risk for complications of candidemia. Eleven patients were treated with amphotericin B for longer than a week and were examined for evidence of nephrotoxicity. None had persistent abnormalities of blood urea nitrogen or serum creatinine concentrations develop during treatment; two patients had hypokalemia. PMID- 3976591 TI - Two-decade follow-up of fatness in early childhood. AB - As shown in our study of 383 infants and preschool children followed through early adulthood, there is some evidence that obese children are more likely to be obese as adults. Though skinfold correlations over a two-decade period were low, averaging 0.14 for both sexes, 26% of initially obese preschool children were still obese two decades later as against 15% that would be expected by chance. The risk ratio was thus 1.77. Examined in the context of the family, the fatness levels of siblings, parents and grandparents help to identify obese children for whom early intervention is indicated and the larger number of obese preschoolers who do not become obese adults. PMID- 3976592 TI - To report or not to report. Physicians' attitudes toward discipline and child abuse. AB - Interviews were conducted with 58 physicians to ascertain what factors influenced their reporting of child abuse. When physicians were presented with sample cases of injured children, factors that influenced their decision to report suspected abuse included their attitudes toward physical discipline, seriousness of the injury, presence of other injuries, their familiarity with the family, appropriate parental concern, compatibility of the history and physical examination findings, and the child's behavior. Results indicated that inappropriate discipline was usually not equated with reportable child abuse. Physicians believed that abuse is not often reported because of its low incidence in the private practice setting, the fear of losing patients, the need for certainty, and the lack of confidence in community agencies. These beliefs may conflict with the welfare of young patients. PMID- 3976593 TI - The education and evaluation of the pediatric resident. Whose responsibility? PMID- 3976594 TI - The premature infant goes home. Guidelines for primary care. PMID- 3976596 TI - Growth of breast-fed infants. PMID- 3976595 TI - Radiological case of the month. Intralobar pulmonary sequestration. PMID- 3976597 TI - Growth of healthy breast-fed infants in the first six months. PMID- 3976598 TI - Inheritance of pseudohypoparathyroidism. PMID- 3976599 TI - Zinc and copper in Indian infant formulas. PMID- 3976600 TI - Precocious pseudopuberty and ovarian follicular cysts. PMID- 3976601 TI - New recommendations for antibiotic prophylaxis of bacterial endocarditis. PMID- 3976602 TI - Statistics and the medical journal. PMID- 3976603 TI - Children and handguns. A public health concern. AB - Data on children who are killed by handguns each year are reported. Homicide, suicide, accidental death, as well as injuries by handguns, are reviewed. It is concluded that handguns are a major cause of death among children and adolescents. The medical profession is urged to take a more active role in finding solutions to this problem. PMID- 3976604 TI - Phytophotodermatitis simulating child abuse. AB - We explored the history in two children who had bizarre, hyperpigmented skin lesions suggestive of child abuse. A final diagnosis of phytophotodermatitis was established. The lesions resulted from inadvertent application of squeezed lime juice to the children's skin by their parents during the routine preparation of drinks, followed by sun exposure, which activated the applied plant psoralens (furocoumarins). Phytophotodermatitis can be induced by a number of plants, and, when unrecognized, may lead to inappropriate investigation of child abuse. PMID- 3976605 TI - Neonatal screening and genetic counseling for sickle cell trait. AB - In a newborn screening program for abnormal hemoglobins, 91 infants were found to have hemoglobin AS or AC. Their parents were informed and offered genetic counseling, but only 35% accepted. We tested parents' knowledge of sickle disorders before and after the session. The tests were repeated when their babies were 4 to 8 months old; parents of babies with normal hemoglobin and those with sickle trait who had not been counseled were also tested at this time. Parents who received counseling showed an increase in knowledge and retained it until the second interview although 27% did not recall the original session. Uncounseled parents of "trait families" also had knowledge of the condition; in general, trait families knew more about the condition than normals' families. Newborn hemoglobin screening programs prove helpful for certain families but not necessarily for all who may be eligible. PMID- 3976606 TI - Birth defects and psychosocial adjustment. AB - A one-year prospective study was conducted to examine the extent to which type of disability, severity, and family functioning serve to predict maladjustment. One hundred forty children, aged 4 to 13 years, born with cardiovascular disorders, cleft lip or palate, or hearing defects were assessed using the Child Behavior Checklist at two points in time. The results suggest that the type of disorder and severity are associated with remaining or becoming maladjusted. Deaf girls and boys with cardiac problems were most likely to be affected, followed by boys with clefts and boys with hearing problems. A direct relationship is found with severity assessed by the Functional Status Measure. Family functioning, however, is not significantly related to maladjustment. These findings provide a framework for better understanding factors contributing to the increased risk of maladjustment for some children with birth defects. PMID- 3976607 TI - Mothers' perceptions of problems of feeding and crying behaviors. A prospective study. AB - During early infancy, problems of crying, colic, spitting, and feeding difficulties often provoke anxiety and lack of self-confidence in parents. We studied prospectively what proportion of mothers felt that their infants had problems of this type and determined risk factors for perceived problems identified in the early postnatal period. The mothers of 189 breast-fed and 184 formula-fed infants completed questionnaires post partum and responded to a follow-up interview at four months. Thirty-five percent of mothers in each group reported that their infants had moderate or severe problems of feeding or crying behavior. Risk factors for perceived problems were identified using stepwise logistic regression analyses. Inquiry about, and early attention to, risk factors may alleviate the parents' concerns and possibly affect the development of these problems. PMID- 3976608 TI - Ventricular dysrhythmias in children with Marfan's syndrome. AB - A teenager with Marfan's syndrome required resuscitation and was found to have multiform premature ventricular contractions and ventricular tachycardia. Of 24 children with Marfan's syndrome, eight (33.3%) were found to have ventricular dysrhythmias, including three with ventricular tachycardia. Six of these eight patients had mitral valve prolapse, and five had prolonged QT or QTU intervals corrected for heart rate. However, only two patients had severe mitral regurgitation, five had only mild heart disease, and one had no detectable heart lesion. The role of mitral valve prolapse and/or delayed repolarization in the development of ventricular dysrhythmia was explored. Delayed repolarization, especially when combined with mitral valve prolapse, is associated with occurrence of ventricular dysrhythmia. Serious ventricular dysrhythmia can occur in children with Marfan's syndrome with or without substantial valve disease, and the dysrhythmia appears to progress with age. PMID- 3976609 TI - Kawasaki syndrome. A case-control study during an outbreak in Maryland. AB - An outbreak of 30 cases of Kawasaki syndrome (KS) occurred in Maryland from January through May 1983. The mean age of patients was 27 months; 60% were male. Rug shampoo exposure within one month and within six months of illness was not significantly greater in the 30 epidemic and seven sporadic cases than in their neighborhood and pediatric controls. These findings suggest that rug shampoo exposure may not be an important risk factor in the outbreak of KS in Maryland. PMID- 3976610 TI - Congenital tuberculosis. Review and diagnostic guidelines. AB - A review of congenital tuberculosis was prompted by the successful treatment of this disease in a unique patient. She was followed up for 27 years, and gave birth to two normal, uninfected newborns despite calcifications throughout her abdomen and elsewhere. Tuberculosis of the newborn, whether acquired congenitally or postnatally, is preventable. Recommendations for diagnosis of congenital tuberculosis are given. Determination of the mother's tuberculin status or suitable testing should be done early in pregnancy. Endometritis is cited as an unrecognized source of fetal infection. PMID- 3976611 TI - Transcutaneous oxygen monitoring. Its use in the treatment of outpatients with congenital heart disease. AB - To validate transcutaneous Po2 (TcPo2) monitoring for outpatient use in cyanotic congenital heart disease (CCHD), TcPo2 was compared with simultaneous arterial Po2 at cardiac catheterization and with arterial Po2 obtained by puncture. Over a 40-month period, 1,493 outpatient TcPo2 determinations were made in 461 patients to diagnose the presence or absence of hypoxemia in newly referred patients and to help assess oxygen delivery in patients with known CCHD. Clinical decisions regarding the need for further diagnostic study and the adequacy of oxygen delivery were made based on these determinations. PMID- 3976612 TI - Syndrome of inappropriate secretion of antidiuretic hormone in enteroviral meningitis. AB - In nine of 102 children admitted to the Montreal Children's Hospital with a diagnosis of aseptic meningitis, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) developed. Patients with and without SIADH were similar with respect to clinical symptoms, duration of illness, and CSF inflammatory response. The SIADH group differed in that the largest age group was 1 to 5 years. PMID- 3976613 TI - Neonatal characteristics of maltreated infants and children. AB - We compared selected neonatal characteristics of 40 children who were abused and neglected (34) or who failed to thrive (six) and 40 nonabused, thriving children individually matched by hospital of birth, gender, mother's welfare status, race, and age at which abuse or failure to thrive was manifested. The populations were preponderantly lower-class, black, and male. The following characteristics were overrepresented in the study population: birth order second or later, low birth weight, admitted to neonatal intensive care unit, and discharged from hospital after mother. The higher incidence of full-term infants who were small for gestational age for the study population (20%) than for the control population (3%) was of borderline significance. The lower distribution of birth weights in relation to expected birth weights for the full-term study subjects, however, was highly significant. PMID- 3976614 TI - Noncrash motor vehicle accidents. Injuries to children in the vehicle interior. AB - Injuries caused by hitting against the vehicle interior during a noncrash motor vehicle accident are noteworthy. Data on children 0 to 15 years of age involved in motor vehicle accidents were obtained from an ongoing multihospital monitoring system. Approximately 12% of the passengers were injured in a noncrash accident. One half of the noncrash injuries were caused by a child hitting against the vehicle interior during a sudden stop, turn, or swerve or after losing balance in a moving vehicle. Most of these accidents involved a child between 1 and 4 years of age who was traveling in the front passenger seat unrestrained. While most of the injuries were minor, some children sustained serious injuries. An analysis of the cases indicated that most of these injuries could have been avoided if the child had been restrained. Medical costs as well as use of medical resources could have been saved by preventing these noncrash injuries. PMID- 3976615 TI - Radiological case of the month. Pneumoretroperitoneum following blunt abdominal trauma. PMID- 3976616 TI - Picture of the month. Hemangioma and lymphangioma of the nose. PMID- 3976617 TI - Gastrointestinal and respiratory illnesses in breast-fed infants. PMID- 3976618 TI - Elimination diet therapy in allergic children--a word of caution. PMID- 3976619 TI - Phenylpropanolamine-associated headache. PMID- 3976621 TI - The new pediatrics. PMID- 3976620 TI - Pulmonary edema with upper airway obstruction. PMID- 3976622 TI - Is childhood appendicitis familial? AB - Family history of appendicitis was studied in 135 children with histologic confirmation of acute appendicitis and in 212 control children without appendicitis, matched by age, sex, and admission date. Parents of patients with appendicitis were approximately 10% more likely than parents of control children to have a positive history of this disease, a difference that could have easily arisen by chance. In contrast, seven patients with appendicitis had siblings with a history of appendicitis, whereas only 0.64 would have been expected on the basis of the proportion among the control group. A significant positive trend was also noted between the proportion of family members with a history of appendicitis and risk for this disease in children. These results indicate some familial tendency for appendicitis, although not to the extent suggested by previous studies. PMID- 3976623 TI - Assignment of follow-up appointments from an emergency room by pediatric residents. AB - A total of 2,028 visits to the pediatric emergency room (ER) in a teaching institution made by children enrolled in the institution's primary care clinic were analyzed to determine how residents assigned follow-up (FU) visits. Of the ER visits, 841 (41.5%) resulted in an FU appointment. Problems such as acute asthma, pneumonia, and otitis media, for which FU is usually advised by pediatric textbooks and by the faculty of our institution, did not automatically result in appointments for FU. Those illnesses for which FU may not have been indicated were appointed. Focused teaching about the FU management of problems for which care is provided in an ER is needed. PMID- 3976624 TI - Growth hormone therapy and tumor recurrence. Findings in children with brain neoplasms and hypopituitarism. AB - We report the outcome of growth hormone (GH) therapy in 34 children (17 boys and 17 girls) with brain tumors in whom hypopituitarism developed. The types of tumors included the following: craniopharyngiomas (18); germinomas (four); astrocytomas (three); chromophobe adenomas (three); medulloblastomas (two); glioma (one); dermoid (one); retinoblastoma (one); and metastatic rhabdomyosarcoma from the pelvis (one). Ninety-four percent of the patients were GH deficient post-tumor therapy, which consisted of surgery with and without radiotherapy. Twenty-four of 34 patients received GH. Eight of 24 patients receiving GH had recurrence of tumor; 16 were tumor free eight to 72 months after initial therapy. Eleven patients had 12 recurrences. Patients with tumor recurrence had a considerably lower growth rate during the first year of GH therapy than those without recurrence (mean, 3.5 +/- 1.3 cm/yr v 6.2 +/- 2.5 cm/yr). Three of 11 patients with recurrence had not received GH therapy; however, one was receiving testosterone intramuscularly monthly at the time of a second recurrence. Thus, 24 of 34 patients with brain tumors and hypopituitarism received GH therapy. Eight (33%) of 24 had tumor recurrence, compared with three (30%) of ten who did not receive GH. The data suggest that GH therapy is probably not associated with increased rate of tumor recurrence. PMID- 3976625 TI - Bronchopulmonary dysplasia and pulmonary insufficiency of prematurity. Lack of correlation of outcome with gas exchange abnormalities at 1 month of age. AB - A review of all infants admitted to the two intensive care nurseries in Seattle from July 1, 1980, through Dec 31, 1981, was performed to evaluate the outcome of infants still requiring supplemental oxygen and/or mechanical ventilation at 1 month of age. Sixty-three infants were identified. Fifty-six infants survived to at least 2 years of age, including 11 of 13 in the subgroup of infants requiring 40% or more oxygen at 1 month of age. Eight (14%) of the 56 survivors have required prolonged rehospitalization for pneumonia or other respiratory illnesses in the first two years following birth. We conclude that the degree of gas exchange impairment assessed at 1 month of age does not predict ultimate outcome from neonatal chronic lung disease. PMID- 3976626 TI - Congenital optic nerve hypoplasia with hypothalamic-pituitary dysplasia. A review of 16 cases. AB - Sixteen children had congenital optic nerve hypoplasia and hypothalamic-pituitary dysplasia. Investigation disclosed an extremely variable spectrum of neuroendocrinological findings that ranged from deficiency to hypersecretion of trophic hormone. Neuroendocrine abnormalities consisted mainly of trophic hormone deficiencies, the most common being growth hormone deficiency, but trophic hormone hypersecretion, including growth hormone, corticotropin, and prolactin was found as well. The extent of anterior pituitary hormone deficiency was variable. Anti-diuretic hormone deficiency was presented in two patients. Our findings support the concept of hypothalamic defect as the major cause for the pituitary dysfunction in this syndrome. Physicians should be aware of this syndrome as a common cause for growth failure and multiple pituitary hormone deficiencies in visually impaired children, which would facilitate the diagnosis and early institution of therapy for this treatable but potentially serious entity. PMID- 3976627 TI - Computed tomographic demonstration of brain changes in incontinentia pigmenti. AB - Incontinentia pigmenti is a rare condition, which may involve the central nervous system. Computed tomographic (CT) examination can supply important information about the dynamics and pathologic nature of this poorly understood syndrome. Two patients suffering from incontinentia pigmenti were examined by CT because of central nervous system symptoms. Large low-density areas in the brain were demonstrated in the CT examination of the first patient a few days after birth, suggesting a local edema. Diffuse brain atrophy was found two years later. Brain atrophy was also found in the second patient in a CT examination done at the age of 11 years. PMID- 3976628 TI - Maternal-fetal transfer of pneumococcal capsular polysaccharide antibodies. AB - Maternal-fetal transfer of IgG antibodies is an important host defense for newborns, who have an increased incidence of bacterial infections. To study the transfer of specific pneumococcal capsular polysaccharide (PPS) antibodies, we measured the concentrations, in 30 paired maternal and cord serum samples, of IgG and IgM by radial immunodiffusion, of serotype 7F Streptococcus pneumoniae PPS antibodies by radioimmunoassay and enzyme immunoassay, and of opsonic activity to that organism by a radiolabeled bacterial uptake assay. Cord serum had significantly greater total IgG, yet significantly less type 7F PPS IgG antibodies and opsonic activity than maternal serum. Cord serum had low concentrations of total IgM and no IgM type 7F-specific antibodies. Reduced transport of specific IgG antibodies and absent transfer of IgM may contribute to the susceptibility of newborns to bacterial infection. PMID- 3976629 TI - A method to maintain infant temperature. AB - A new insulating material (Thinsulate) was used to provide thermal protection for newborn infants. Infant core temperature was measured as part of a randomized study comparing the efficacy of an insulated bunting, an insulated hat, and routine management. The new bunting was superior in terms of its ability to maintain the infant's core temperature on arrival in the regular nursery. Nursing staff and parental acceptance was high, and further consideration should be given to defining the role of this new insulating material in the care of the newborn. PMID- 3976630 TI - Evaluation of child abuse reporting by physicians. AB - There is little information concerning child abuse reporting by physicians. The present study, a questionnaire survey, was therefore designed to examine several aspects of child abuse reporting by practicing physicians in Virginia. Physicians diagnosed few abused or neglected children in their practices. More than 90% saw five or fewer cases, and 26% encountered no abuse or neglect at all during the preceding year. Most physicians were inclined to report all diagnosed cases of physical abuse (91%) and sexual abuse (92%), but fewer reported all cases of physical neglect (58%), emotional abuse (45%), or medical neglect (43%). The two most frequently cited reasons for not reporting were (1) reluctance to report before you are certain of the diagnosis of abuse or neglect; (2) the belief that you can work with the family to solve the problem without outside intervention. PMID- 3976631 TI - Slipped capital femoral epiphysis in growth hormone-deficient patients. AB - Slipped capital femoral epiphysis (SCFE), a potentially disabling hip disorder, occurs primarily during the pubertal growth spurt. It has been reported in association with pituitary gigantism, growth hormone deficiency, hypothyroidism, hypogonadism, and panhypopituitarism. We estimated the frequency of SCFE among children with growth hormone deficiency (treated or untreated) and compared it with the reported frequency of SCFE among Connecticut residents under 25 years of age. Based on this comparison, the risk of developing SCFE is significantly greater in growth hormone-deficient children than in the general population. PMID- 3976632 TI - The late appearance of hypopigmented maculae in tuberous sclerosis. AB - Tuberous sclerosis (TS) is a dominantly inherited disorder characterized by seizures, developmental delay, and specific skin lesions. Hypopigmented maculae that occur in 80% of patients with TS have become important for the clinical diagnosis of TS in young children. These lesions are claimed to be present from birth, in contrast with other dermatologic manifestations of TS that usually appear much later. We studied seven children in whom hypopigmented maculae appeared months to years after repeated negative skin examinations. Our findings emphasized that the absence of hypopigmented maculae in young children does not preclude their later appearance nor rule out the diagnosis of TS. The need for repeated skin examinations in infants and children with suspected TS or with seizures and/or mental retardation of unknown cause is apparent. PMID- 3976633 TI - Radiological case of the month. Pneumoretroperitoneum and pulmonary interstitial emphysema. PMID- 3976634 TI - Chronic gastric volvulus: report of a case and review of literature. AB - A patient with chronic gastric volvulus is reported and the related literature reviewed. The clinical presentation, diagnosis, and treatment are discussed. Features of acute and chronic volvulus are compared. PMID- 3976635 TI - Villous adenocarcinoma arising in the bypassed duodenum 18 years after a Billroth II subtotal gastrectomy: report of a case and review of the literature. AB - Eighteen years after a Billroth II procedure for a duodenal ulcer, a 65-year-old man presented with a large epigastric mass which was clinically interpreted as a pancreatic carcinoma. Fourteen months later, reevaluation of the enlarging mass led to a diagnosis of a villous tumor of the afferent limb of the gastroenterostomy. Laparotomy revealed an advanced villous adenocarcinoma. We could find only one other similar case in a 50-year literature review. PMID- 3976636 TI - Golytely lavage--is metoclopramide necessary? AB - During Golytely cleansing for colonoscopy, two dose forms of oral metoclopramide were evaluated in separate studies for patient tolerance and adequacy of preparation. In study 1, patients were randomized to 10 mg metoclopramide (n = 21) or placebo (n = 27); in study 2, 20 mg metoclopramide (n = 21) was compared to placebo (n = 25). Ten milligrams metoclopramide was not significantly different from placebo in patient acceptance for any of the assessed symptoms. Patients taking 20 mg metoclopramide had less cramping (p = 0.02), but more nausea (p = 0.03) than placebo. Time for rectal effluent to clear was similar in all groups. The percentage of patients preferring Golytely was similar in both studies (70-79%, p = NS) and 85% of all patients were willing to repeat Golytely. Physician assessment of colon cleansing showed no difference between metoclopramide or placebo in either study, with adequate preparations in 97% and optimal cleansing in 80% of all patients. Neither 10 nor 20 mg oral metoclopramide improved adequacy of colon cleansing for colonoscopy or decreased symptoms associated with Golytely lavage. PMID- 3976637 TI - Transcatheter embolization of the dorsal pancreatic artery to control massive postoperative bleeding. AB - We report a severely traumatized patient who developed massive bleeding through surgical drains in the postoperative period. Superselective dorsal pancreatic arteriography demonstrated extravasation of contrast material in the pancreatic bed. Embolization with Gel-foam particles successfully controlled this severe bleeding. Transcatheter embolization is the procedure of choice for controlling pancreatic bleeding in acutely traumatized patients. PMID- 3976638 TI - Depression and gastrointestinal illness: the joint use of biological and clinical criteria. AB - Occurrence and characteristics of depression were investigated in 37 consecutive patients suffering from gastrointestinal illness. More than 40% of patients with an organic digestive disease and about a quarter of those with functional gastroenterological complaints were found to suffer from a major depressive disorder according to DSM-III criteria. The dexamethasone suppression test--a laboratory marker of the endogenous depressive state--supported clinical diagnosis in several cases, yet its routine use to screen depression is not warranted because of its poor specificity. The results should alert the physician to include clinical and biological criteria for depression in the diagnostic work up for gastrointestinal illness. PMID- 3976639 TI - Diphenylhydantoin-induced hepatotoxicity. PMID- 3976640 TI - Submucosal colonic edema--urticaria of the colon. AB - Radiographically, colonic urticaria presents a non-specific pattern of submucosal edema. Previously unreported diverticulitis with colonic distention resulting in the flat, polygonal, mosaic pattern typical of this entity is described. PMID- 3976641 TI - Surgeons and gastrointestinal endoscopy. PMID- 3976642 TI - Splenic infarction, splenic sequestration, and functional hyposplenism in hemoglobin S-C disease. AB - Splenic atrophy or evidence of hyposplenism occurs in as many as one third of all patients with S-C hemoglobinopathy. Yet there are few reports in the literature of clinically apparent splenic infarction in this disease. We describe four instances of acute splenic infarction in three patients with hemoglobin S-C disease which illustrate a wide spectrum of clinical manifestations and severity. Of particular interest were the observations of coincident occurrences of splenic sequestration and functional hyposplenism with splenic infarction, suggesting a close pathophysiological relationship among these syndromes. PMID- 3976643 TI - Effect of hyperoxia on the carbohydrate metabolism of human lymphocytes. AB - Lymphocytes incubated under high oxygen tensions have impaired lymphoblastic transformation to nonspecific mitogens. Since carbohydrate metabolism may be essential for an optimal proliferation of these cells following an antigenic stimulus, we have characterized the effect of hyperoxia on the glucose metabolism of human lymphocytes in vitro. The mean rates of glucose utilization, Krebs cycle activity, and hexose monophosphate shunt activity were determined for unstimulated and phytohemagglutinin (PHA)-stimulated cultures incubated for 3 days. In unstimulated cultures, hyperoxia stimulated glucose utilization and markedly impaired Krebs cycle activity but did not alter HMPS activity. These observations suggest that hyperoxia impairs the mitochondrial activity of lymphocytes and that increased glycolysis compensates for the loss of cellular energy normally produced by this organelle. Under high oxygen tension PHA stimulated cultures failed to show the burst in HMPS activity and increased Krebs cycle activity characteristic of cultures incubated under physiological oxygen tensions and consumed less glucose. Our results indicate that hyperoxia alters the glucose metabolism of lymphocytes. This metabolic alteration may be related to the impaired function of the cells under hyperoxic conditions. PMID- 3976644 TI - Diagnostic value of bone marrow imaging with 111indium-transferrin and 99m technetium-colloids in myelofibrosis. AB - 111Indium--transferrin (111In) and 99mTechnetium-colloids (99mTc) bone marrow imaging of 55 myelofibrosis (MF) cases has been compared with clinical, histological, and iron-kinetics data. The best correlations are seen between the splenic uptake of 111In with the spleen/sacrum ratio of 59Fe at the first hour (r = 0.69, P less than 0.001) and also with the splenic erythropoiesis histologically assessed in ten splenectomized patients (r = 0.75, P less than 0.01). Moreover, sacrum uptake of 111In, when compared with sacrum uptake of 59Fe (r = 0.51, P less than 0.001) and with hematopoietic cellularity of the bone marrow (r = 0.57, P less than 0.001) reflects faithfully the hematopoietic cell content of the marrow. Thus, 111In bone marrow imaging provides a noninvasive and useful tool for the diagnosis of myeloid metaplasia in MF. Ferrokinetic studies still appreciate with better insight the amount of ineffective erythropoiesis or hemolysis and remains therefore of great value when splenectomy is discussed. PMID- 3976645 TI - A microtiter method for long-term in vitro maintenance of human monocyte. AB - A microtiter method is described for long-term maintenance of human monocytes in culture with intact functional and morphological characteristics. This micromethod is the adaptation of our previously reported method which required large volume of blood. The micromethod relies on the use of microexudate plate (pregrown with BHK cells) and the two phases of adherence and maintenance culture. The purity of cultured cells approaches 100% and the yield is 50-70%. As many as 24 experiments and controls can be done on 20 ml of blood drawn. PMID- 3976646 TI - Pseudothrombocytopenia masking true thrombocytopenia. AB - Pseudothrombocytopenia owing to platelet clumping is usually associated with blood specimens anticoagulated with EDTA. It may also be seen if specimens possessing IgM cold agglutinins are processed at room temperature. A patient with a temperature-independent, EDTA-independent agglutinin is reported whose pseudothrombocytopenia was masking true thrombocytopenia. A technique for blood collection when evaluating similar cases is described. PMID- 3976647 TI - Platelet transfusion therapy in acute leukemia: lack of effect of splenomegaly on transfusion requirements and risk of hemorrhage. AB - Platelet transfusions are an important supportive measure during treatment for acute nonlymphocytic leukemia (ANLL). The presence of splenomegaly may produce decreased posttransfusion platelet increments leading some to recommend an increased dose of platelets per transfusion in this situation. Forty-nine newly diagnosed patients with ANLL were evaluated during 1980 and 1981, and 24% had palpable splenomegaly. Although treated with usual doses of platelets per transfusion, there was no detectable statistical increase in transfusion requirement or incidence of hemorrhage in patients with splenomegaly. Experimental evidence indicates that the splenic platelet pool enlarges with splenomegaly, but the life span of circulating platelets is not significantly changed. Furthermore, the splenic platelet pool is in dynamic equilibrium with the circulating platelet pool thus allowing these platelets to participate in hemostasis. Although posttransfusion increment in platelet count may be less, it appears that platelet transfusion therapy need not be altered solely because of splenomegaly. PMID- 3976648 TI - Concentration-dependent sedimentation properties of ferritin: implications for estimation of iron contents of serum ferritins. AB - Serum ferritins from various sources sedimented at lower densities than tissue ferritins in sucrose gradient centrifugation systems. The sedimentation patterns of ferritins, however, were shown to be dependent on the concentration of the protein; as the concentration decreased the protein appeared to sediment at lower densities. Thus, at the low concentration levels usually used for analysis of serum ferritin, tissue ferritins also sedimented in the same lower density regions. Iron labeling experiments indicated that the sedimentation changes upon dilution were not due to release of iron or was there any indication that the protein dissociated into subunits. The anomalous sedimentation behavior of serum ferritin should therefore not be interpreted in terms of its iron content. The disclosure that serum ferritins may have full complements of iron is counter to the prevalent view that serum ferritins are low iron forms and has potential implications with regard to the sources and possible function of this protein in the circulation. PMID- 3976649 TI - Simultaneous reticulocyte and platelet counting on a clinical flow cytometer. AB - Laser flow cytometric analysis is well suited to many clinical immunofluorescent and hematologic applications. One of these is automated reticulocyte and platelet enumerations. We have performed a clinical evaluation of a fluorescence laser flow cytometer reticulocyte and platelet enumeration method using the fluorochrome acridine orange. One hundred and thirty-two clinical specimens from inpatients in our comprehensive cancer center were analyzed for platelet counts and 101 samples from the same population were analyzed for reticulocyte counts by the flow cytometer and simultaneously by conventional techniques. Both the reticulocyte and platelet enumerations achieved a high degree of correlation with standard methods for the nonbone marrow-transplant patients studied (R = .989 for reticulocytes and R = .995 for platelets). Marrow transplant patients had a slightly poorer correlation coefficient for the reticulocyte enumeration (R = .923), but analysis of serial determinations of these patients' samples for reticulocyte counts revealed that results were more consistent over time with the automated method than with the traditional manual method. The laser flow cytometer fluorescence reticulocyte and platelet enumeration methods described are efficient, rapid, and reliable for platelet and reticulocyte counting. PMID- 3976650 TI - Increased numbers of marrow basophils may be associated with a t(6;9) in ANLL. AB - We have characterized another subset of acute nonlymphocytic leukemia (ANLL) based on the cytogenetic and morphologic findings in a group of nine patients. Five patients had chromosomal analyses performed at the University of Chicago, two patients were studied at the All-Union Cancer Research Center in Moscow, and one patient each was studied at the University of Maryland and at Fairfax Hospital in Fairfax, Virginia. All nine patients had a reciprocal translocation involving the short arm of chromosome 6 and the long arm of chromosome 9 [t(6;9)(p23;q34)]. The patients, four males and five females, ranged in age from 5 to 51 years; the median age of 38 years is lower than that typically seen in ANLL. Only two of eight treated patients entered a complete remission. Classification of bone marrow morphology according to FAB Cooperative Group criteria revealed AML-M1 in one patient, AML-M2 in four, and AMMoL-M4 in three. One patient had refractory anemia with excess blasts (RAEB) which evolved to AML M2. All bone marrow specimens showed severe myelodysplasia, with Auer rods present in seven of the nine cases. Of note was the particular prominence of bone marrow basophils (greater than 1%) in eight of the nine (89%) patients. Among 160 evaluable patients with ANLL de novo seen at the University of Chicago whose cells lacked a t(6;9), only five (3%) had greater than 1% basophils in the marrow aspirates. It is of interest that the breakpoint in 9q involves the same chromosomal band as that in the t(9;22) observed in chronic myelogenous leukemia (CML), in which increased basophils are a prominent feature. Thus, the association of the t(6;9) with increased bone marrow basophils in ANLL may provide additional insight into the chromosomal location of genes regulating the production and/or maturation of basophils. PMID- 3976651 TI - Hairy-cell leukemia associated with Hodgkin's disease: a case report. AB - A 56-year-old man who had easy bruising, an enlarged left supraclavicular lymph node, and splenomegaly was diagnosed as having hairy-cell leukemia. Treatment consisted of splenectomy. Because of progressive lymphadenopathy in the following months, the patient required reevaluation. Examination of a lymph node biopsy specimen now revealed Hodgkin's disease, nodular sclerosis. This is the first pathologically confirmed case of hairy-cell leukemia coexisting with Hodgkin's disease. PMID- 3976652 TI - Heparin-induced thrombocytopenia and recurrent thromboembolism in siblings. AB - Two brothers with heparin-induced thrombocytopenia and multiple arterial and venous thromboembolism affecting peripheral vessels are described. Heparin dependent antiplatelet antibody was detected using platelet aggregometry in both patients. Although these observations may be coincidental, the possibility of familial occurrence of this adverse reaction to heparin cannot be excluded with certainty. PMID- 3976653 TI - Association of IgA nephropathy with steroid-responsive nephrotic syndrome. A report of the Southwest Pediatric Nephrology Study Group. AB - In a multicenter study of 83 children with IgA nephropathy, we have encountered four patients (three female, one male) who presented with steroid-responsive nephrotic syndrome (NS) 1 to 12 years before the demonstration of IgA nephropathy. Renal biopsies performed within several months of the onset of NS in three of the patients showed changes consistent with minimal change glomerulonephropathy in two and diffuse mesangial hypercellularity in one patient. Immunofluorescence studies performed on two of the biopsies were negative for IgA. Corticosteroid therapy induced remission of NS in all four patients, but this was followed by frequent relapses. IgA nephropathy was diagnosed subsequently by renal biopsies that were performed because of the onset of gross hematuria in three patients and persistent, low-grade proteinuria in the other. Light microscopy studies on these biopsies showed minimal glomerular changes in three and focal proliferative and sclerosing glomerulonephritis in one patient. Subsequent follow-up evaluations have revealed normal serum creatinines and/or glomerular filtration rate (GFR) in all four patients with remission of NS in three and no further episodes of gross hematuria in any patient. These four patients represent either a variant of IgA nephropathy associated with long standing steroid-responsive NS or development of IgA nephropathy superimposed upon preceding minimal change disease. PMID- 3976654 TI - Chromosomal localization of several families of repetitive sequences by in situ hybridization. AB - Four recombinant DNA clones (H1, H7, H12, and H15) carrying low-repetitive human DNA were previously isolated from a human genomic library based on their specificity for chromosome 21 and were studied for their distribution as determined by in situ hybridization. Clone H7 hybridized to the satellite regions of chromosomes 13, 14, 15, 21, and 22 as well as to the centromere region of chromosome 1. Clone H12 hybridized strongly to chromosomes 11 and 17 and the centromere of the X. Clones H1 and H15 had a very widespread distribution throughout the genome. Clone H15 hybridized significantly more to the short arm of chromosome 18 than to any other chromosomal segment. Clone H1 hybridized strongly to the centromere of chromosome 19 and also showed random distribution on all the other human chromosomes. We conclude that these probes appear to represent four repetitive families that demonstrate in situ hybridization patterns that do not correspond with those of any other repetitive family. Further, the in situ hybridization patterns do not show the strong chromosome 21 specificity originally defined by Southern blot analysis. The nature and chromosomal localization of these repetitive families should be useful in regional mapping and evolutionary studies and give additional insight into chromosomal organization. PMID- 3976655 TI - Mother-child HLA compatibility ratios in children of Amerinidian parents who share common haplotypes. AB - Among 166 children whose parents share the HLA-A, -B, and -C antigens of at least one haplotype, there is a superficial concordance between observed and expected proportions of children whose mothers would recognize no foreign antigen in them. However, this balance is composed of fewer (64%) homozygous offspring than expected and more (147%) than the expected number of genotypes identical to the mother's. A homozygous child would be expected to recognize his or her mother as foreign, unless the mother was also homozygous, but an HLA-identical child would not. Thus, the number of children who might be immunologically tolerant of their mothers was greater than expected. No one of the three loci included in designating haplotypes was individually responsible for the divergences in haplotype frequency. PMID- 3976656 TI - Identification of human red cell glutamate-pyruvate transaminase (GPT) phenotypes by isoelectric focusing. AB - Isoenzymes of human red cell glutamate-pyruvate transaminase (GPT) were resolved by isoelectric focusing (IEF) of hemolysates in polyacrylamide gels at pH 5.0 7.0. The bands of enzyme activity required both alpha-ketoglutarate and L-alanine in the staining mixture for visualization, indicating that the bands were not lactate dehydrogenase or glutamate dehydrogenase. Phenotyping of 41 individuals by IEF, including types GPT 1, 2A, 1-2A, 1-2B, and 2A-2B, agreed with the typing results obtained by electrophoresis in starch gels and in polyacrylamide gels at acid and alkaline pH. Analysis of one kindred demonstrated autosomal codominant transmission of the rare GPT*2B gene through 3 generations. IEF facilitates phenotyping by permitting identification of the GPT types on a single gel with a considerable reduction in time and cost. Although no new variants were found in this investigation, IEF may be more powerful for the recognition of presently undetected variants of GPT. PMID- 3976657 TI - Family-size distribution and Ewens' equivalence theorem. AB - Segregation analysis of a data set containing nuclear families of more than one sibship size is considered, and two different formulations of the likelihood are examined. One is the "separate-multinomials" formulation, which treats each family size as representing a separate multinomial distribution; the other is the "grand-multinomial" formulation, which treats the entire data set as representing one distribution. It is shown that these two formulations are equivalent, if and only if the population distribution of family sizes is completely unknown. However, if anything is known about the family-size distribution, the grand multinomial formulation, although more cumbersome, makes more complete use of the data; moreover, it enables the use of one-child families in a segregation analysis. The relationship of this work to Ewens' equivalence theorem concerning "unconditional" and "conditional" likelihoods is discussed. The findings are illustrated with a simple example, and their practical relevance to real-life segregation analysis is discussed. PMID- 3976658 TI - Path analysis of family resemblance with temporal trends: applications to height, weight, and Quetelet index in northeastern Brazil. AB - A multifactorial model incorporating temporal trends in its parameters is discussed. The model is a generalization of the tau model of Rice et al. in which the parameters are assumed to be specific functions of time. A special case of this model is fit to data on height, weight, and Quetelet index in 1,067 nuclear families to demonstrate the utility of the approach. The results indicate that there is considerable temporal variation in family resemblance over time for all three traits. For height and Quetelet index, both the transmissibility, comparable to heritability, and residual sibling environmental correlation show temporal changes, while for weight, only the latter exhibits significant trends. Trends were not found in the marital correlation for any of the traits, and only limited evidence was found for trends in the maternal transmission parameter for height. This provides an objective method for evaluating the nature and sources of temporal trends in family resemblance, which can easily be incorporated into the framework of any model-based approach. PMID- 3976659 TI - Fra(10)(q25): the BrdU effect is substitution-dependent. AB - Expression in the majority of fra(10)(q25) cases is either induced or enhanced by the presence of bromodeoxyuridine (BrdU) in the culture medium. BrdU is known to exert its effects on cells via two primary mechanisms: substitution-dependent and concentration-dependent. BrdU incorporation into DNA and BrdU concentration in the culture medium can be resolved as independent variables. The results of such experiments indicate that at three fixed levels of BrdU substitution, 100-fold variation of BrdU concentration had little or no effect on fra(10)(q25) expression. At a fixed BrdU concentration, the level of fra(10)(q25) expression rises as a function of increased BrdU substitution, approaching 100% expression at 100% substitution. Thus, BrdU induction or enhancement of fra(10)(q25) expression is clearly substitution-dependent. Iododeoxyuridine, another halogenated pyrimidine, has a similar effect. The critical time of incorporation is between 8 and 9 hrs before mitosis. After this time, removal of BrdU (and fluorodeoxyuridine [FdU]) from the culture medium followed by addition of deoxythymidine does not reverse the BrdU effect on fra(10)(q25) expression. PMID- 3976660 TI - Chromosome translocations in fibroblast cultures derived from patients with Werner's syndrome. PMID- 3976661 TI - Mortality among a sample of chemical company employees. AB - A general mortality survey was done on a 5% random-start systematic sample (N = 1,666) of present and former white male employees of a Texas chemical plant. The purpose was to determine whether there were any unusual patterns of cause specific mortality that would require further research with case-control studies. Mortality risks were examined by duration of employment and year of hire as surrogates for more specific exposure data. Among all employees in the sample, there was significant excess mortality due to All Cancer, Ill-Defined Conditions, and All External Causes of Death, and a significant deficit from All Circulatory Diseases. The excess mortality from All Cancer was primarily attributable to excess cancers of the kidney, lung, and pancreas. The excesses for lung and kidney cancer were statistically significant. Those employed for 1 year or more experienced significantly lower mortality from All Causes than those employed for less than 1 year. PMID- 3976662 TI - A case-control study of renal cancer mortality at a Texas chemical plant. AB - An in-plant case-control study of 26 renal cancer deaths was conducted to determine whether an occupational exposure may be related to an apparent increase in mortality from this disease observed among a sample of employees at a multiple process chemical production facility. None was found that explained the excess. Elevated odds ratios were identified for employment in the cell maintenance area of chlorine production and with those presumptive exposures considered to occur in this job, asbestos and caustic, but not chlorine. While an association between renal cancer and asbestos has been previously reported, an association with caustic, per se, is not consistent with prior observations made by others. Diminished risk estimates were observed for employment in magnesium production and for exposures in this process to sulfur dioxide and heat. Both the increased and decreased risks, while statistically significant, are based on small numbers of exposed subjects and may be spurious owing to the problem of multiple comparisons. PMID- 3976663 TI - Epidemiologic and immunologic studies in processors of the king crab. AB - Following the report of ten cases of respiratory illness in processors of frozen king crab, we investigated the conditions of work and the pulmonary and immunologic status of the workers in three crab-processing and one fish-packing (control) plant. Pulmonary function was measured before and after work, and skin tests were performed in subgroups matched for age, sex, and duration of current employment. The antibody response to king crab antigens was examined in sera from the subgroups and another (unrelated) control group. Extracts of crab meat, shell, and processing dust were used for skin testing and precipitin detection. FEV1, FVC, and MEFR decreased during the day in two crab processors, and precipitins were evident in sera from nine, but findings were normal in the fish packers. Crab meat elicited the strongest response, with multiple precipitin bands in some cases. Control sera showed no reaction. There was correlation between serology, results of skin tests, and symptoms. It is concluded that the inhalation of aerosolized crab antigen(s) may cause respiratory symptoms and can cause immunologic effects similar to those caused by other occupational respiratory allergens. We recommend preplacement and periodic medical examination of workers in crab-processing plants, improved ventilation in processing areas, and programs to discourage smoking. PMID- 3976664 TI - Fertility of male workers exposed to mercury vapor or to manganese dust: a questionnaire study. AB - The fertility of male workers exposed to mercury vapor or to manganese dust was assessed with the use of the questionnaire developed by Levine et al [1980]. In the mercury group (concentration of mercury in urine ranging from 5.1 to 272.1 micrograms/g creatinine), no statistically significant difference was found between the observed number of children and that expected on the basis of the reproductive experience of a well-matched control group. On the contrary, by comparison with their corresponding controls, the manganese-exposed workers exhibited a statistically significant deficit in the number of children during their period of exposure to the metal. The airborne concentration of manganese dusts at the different workplaces ranged from 0.07 to 8.61 mg/m3 with a geometric mean of 0.94 mg/m3. PMID- 3976665 TI - Occupational health services in 1984: a prospective model. PMID- 3976666 TI - Medical and industrial hygiene characterization of the cotton waste utilization industry. AB - We studied 260 workers in the cotton waste utilization industry and 310 "blue collar" control workers from nondusty industries in the same geographic area of the United States by respiratory symptom questionnaire and by pre- and postshift spirometry. We excluded 75 cotton workers and 75 control workers from statistical analysis because of prior hazardous occupational exposures. Plant-wide, 8-hour time-weighted average exposures ranged from 0.28 mg/m3 to 7.80 mg/m3. The overall prevalence of symptoms compatible with byssinosis was 5.9% in cotton workers and 4.7% in the controls. Cotton workers with less than 2 years of employment had a significantly greater prevalence of bronchitis than their control counterparts. The cotton workers with 2 years or more of employment had significantly greater prevalences of bronchitis, shift decrement in forced expiratory volume in 1 second (FEV1) of greater than or equal to 10%, and FEV1/FEV1-predicted less than 80%, than their control counterparts. Regression analysis showed that for matched cotton and control workers, the percentage decrement in FEV1 over the shift was significantly greater for cotton workers; and that in all cotton workers, longevity in industry had a negative effect on the before-shift forced vital capacity (FVC). This study suggests that there are both acute and chronic effects of cotton exposure in the cotton waste utilization industry. PMID- 3976667 TI - Packaging requirements for investigational agents. PMID- 3976668 TI - Preparation of an oral lavage solution for bowel cleansing. PMID- 3976669 TI - Streptokinase flocculation in evacuated glass bottles. PMID- 3976670 TI - Good communication solves problems. PMID- 3976671 TI - Another look at prime-vendor cost savings. PMID- 3976673 TI - The career pharmacist. PMID- 3976672 TI - Certifying laminar-flow hoods properly. PMID- 3976674 TI - Career management: understanding the process. AB - This article is the first of a three-part series on career management for hospital pharmacists. Work attitudes, life cycles, needs, and career trends are discussed. Three basic work attitudes exist. Some see work as punishment. Others believe work in itself is good, i.e., they have a strong work ethic. Some view work as a means to satisfy, at least partially, a range of needs. Attitudinal transition points are likely to occur at specific times in the adult life cycle. The stages of the life cycle can be labeled as leaving, reaching out, questioning, midlife crisis, settling down, and mellowing. A progression through each of these stages is required for normal adult psychological development. Every individual exhibits a blend of needs that changes throughout life. Jobs can fulfill existence, relatedness, and growth needs. Relatedness needs include the need for love, affiliation, social esteem, and power, and growth needs include the need for self-esteem, competence, achievement, and autonomy. Three important career trends are the changing opportunities for advancement, women in careers, and dual-career couples. The number of women pharmacists is increasing as is the number of two-career couples. Tips for managing two-career relationships are presented. Pharmacists can manage their careers more effectively by understanding their needs, identifying their basic attitude toward work, and being aware of the trends occurring in pharmacy. PMID- 3976675 TI - Retrospective evaluation of a pharmacist-managed warfarin anticoagulation clinic. AB - The effectiveness of a pharmacist-managed warfarin anticoagulation clinic in maintaining therapeutic prothrombin times and preventing hospitalizations secondary to inadequate control of anticoagulation was evaluated. Patients who had received warfarin sodium for at least one year before being referred to the anticoagulation clinic were studied using retrospective chart reviews. Clinical pharmacists provided patient education, monitored patients for hemorrhagic and thromboembolic complications, and adjusted warfarin sodium dosage to maintain therapeutic prothrombin times. The patients' primary physicians retained responsibility for overall care and were consulted by pharmacists regarding complications of anticoagulation and patient unreliability. The percentage of patients requiring hospitalization (39% versus 4%) and the percentage of prothrombin times outside the therapeutic range (35.8% versus 14.4%) were significantly higher during the preclinic phase (before referral to the clinic) than during the clinic phase. Eight patients were hospitalized for hemorrhagic complications and four for thromboembolism during the preclinic phase; only one hospitalization for hemorrhage occurred during the clinic phase. The warfarin anticoagulation clinic staffed by specially trained pharmacists provided improved therapy compared with treatment received by patients before their referral to the clinic. PMID- 3976676 TI - Impact of computerization on dispensing time in an ambulatory-care pharmacy. AB - The effect of computerization on dispensing time in a hospital-affiliated ambulatory-care pharmacy was studied. Personnel time requirements for dispensing medications were measured by hospital systems-development personnel three months before and six months after implementation of computer-assisted dispensing. Times required for completion of all activities associated with dispensing new and refill medications were recorded. A varying number of random samples for each activity were timed on several different days in each dispensing system. The time recorded for each activity reflected time for completion of that activity for all of a patient's prescriptions. Based on mean times for each activity, prescription processing time per patient (average of 1.5 prescriptions) was 7.0 minutes for both new and refill prescriptions using manual dispensing, 6.28 minutes for new prescriptions using computer-assisted dispensing, and 4.61 minutes for refill prescriptions using computer-assisted dispensing. Computerization eliminated 78 minutes of time spent on miscellaneous activities each day and added 58.67 minutes of time for computer-related activities each day. A net time savings of 196.58 minutes was realized for a prescription volume of 176 prescriptions per day. Although implementation of computer-assisted dispensing involved economic costs and procedural changes, it increased the efficiency of this outpatient pharmacy operation. PMID- 3976677 TI - Management seminar miniseries for training pharmacy residents. AB - A management seminar miniseries for training hospital pharmacy residents is described. A series of lectures and workshops on the administrative aspects of hospital pharmacy practice are an integral part of a 2400-hour residency training program. Hospital pharmacy practice, clinical pharmacy practice, communication skills, and pharmacy administration and personnel management are the four major areas covered by the program. The section on pharmacy administration and personnel management is initiated in the middle of program after the residents have gained an appreciation of the intricacies of the department. The management workshops emphasize role playing and actual case-study analyses. The program's faculty members are members of the professional staff who have received formal training in the topics they teach. Twenty-two of this program's 53 graduates have assumed management positions. The management miniseries described can provide residents with the managerial skills they need to become effective pharmacy leaders. PMID- 3976678 TI - Cost comparison of two systems for intermittent intravenous administration of small-volume injections. AB - Pharmacy department costs for preparing and administering intermittent i.v. drug doses using a piggyback bottle system and a syringe pump system were predicted and compared. Centralized i.v. admixture service personnel time for preparation of small-volume injections in piggyback bottles was recorded for 14 days. After a four-week orientation of personnel to the syringe pump system, personnel time for preparation of doses in this system was recorded for 14 days. Material costs were itemized for each system and annual costs were predicted. Costs were calculated on the basis of the previous year's purchasing data, assuming that 80% of intermittent i.v. drug doses could be given by the syringe pump system. Syringe pump system costs were calculated for administration of one to eight drug doses through each secondary infusion set; 5-mL and 10-mL syringes were used. Preparation time was slightly longer for the syringe pump system than for the piggyback bottle system; the annualized personnel cost difference was $0.012 per dose. Based on one dose per secondary infusion set, material costs were higher for the syringe pump system. Based on administration of four doses through each secondary infusion set, overall costs were lower for the syringe pump system. Lower material acquisition costs for the syringe pump system could result in pharmacy department cost savings if at least four intermittent i.v. drug doses were administered through each secondary administration set. PMID- 3976679 TI - In vivo accuracy of gravity-flow i.v. infusion systems. AB - The accuracy of fluid delivery via gravity-flow i.v. infusion systems in hospitalized patients was evaluated. All adult patients on the medical-surgical wards of a university hospital who were receiving i.v. fluids via gravity-flow infusion sets were studied during a four-day period. Data collected approximately every two hours over a 15-hour period daily included the prescribed i.v. flow rate, type of i.v. set (microdrop or macrodrop), drop rate, and the approximate volume of fluid remaining in the i.v. container. Drop rates were measured with a photocell device placed around the drip chamber of the i.v. set. A total of 509 observations involving 86 patients were recorded during the study; drop rates were evaluated at flow rates for which there were 20 or more observations. For the majority of flow rates and set types, less than 15% of observations were within +/- 10% of desired drop rates, while only 21% of observations fell within +/- 20% of desired drop rates. Mean versus desired volume of fluid delivered between observations differed substantially but not as much as anticipated based on drop rate variability, reflecting nurses' attempt to adjust fluid therapy based on volume of fluid delivered. Intravenous fluid delivery via gravity-flow i.v. infusion systems is highly inaccurate. To ensure appropriate fluid delivery, better monitoring or improvement of i.v. fluid administration systems or the use of electronic infusion control devices is recommended. PMID- 3976680 TI - Stability and cost analysis of clindamycin-gentamicin admixtures given every eight hours. AB - Stability and costs of a mixture of clindamycin and gentamicin in a single carrier solution for every-eight-hour i.v. administration were analyzed. Duplicate solutions containing clindamycin 900 mg (as the phosphate salt) and gentamicin 100 mg (as the sulfate salt) in 5% dextrose injection 150 mL in flexible plastic containers were prepared. Samples withdrawn at 0-24 hours were visually inspected and assayed for content of both drugs. Clindamycin concentrations were determined by high-performance liquid chromatography and gentamicin concentrations by fluorescence-polarization immunoassay. Preparation and administration times were measured in two trials to determine cost differences between every-eight-hour administration of the two-antibiotic mixture and separate administration of the two drugs (four daily doses of clindamycin and three of gentamicin). No precipitate was seen. Concentrations of both drugs after 24 hours were greater than 90% of initial concentrations. Total daily costs (per patient) for labor, drug, and carrier solution were $3.08 less when the two drugs were mixed and administered every eight hours. At the concentrations studied, clindamycin and gentamicin mixed together in 5% dextrose injection are stable for 24 hours. Administration of this drug mixture every eight hours is safe and less costly than separate administration of the two drugs. PMID- 3976681 TI - Effect of a polyethylene-lined administration set on the availability of diazepam injection. AB - Delivery of diazepam through a polyethylene-lined i.v. administration set and through a polyvinyl chloride (PVC) set was compared. Diazepam was prepared in concentrations of 50 mg/500 mL and 100 mg/500 mL in 0.9% sodium chloride injection and 5% dextrose injection in glass containers. Diazepam concentrations were measured by high-performance liquid chromatography at 0 through 5 hours in samples collected simultaneously from the glass solution containers and from the distal ends of a PVC administration set and a polyethylene-lined (non-PVC) set. Flow rates of 50 and 100 mL/hr were tested. For the non-PVC sets, diazepam concentration in the infusate was not significantly different from concentration in the glass container at any sampling time. The overall percentage of diazepam recovered was 100.7 +/- 6.8%. For the PVC sets, diazepam concentration in the infusate was less than in the container at all sampling times, and the overall percentage of diazepam recovered was 65.4 +/- 13.3% (significantly different from delivery for the non-PVC sets). Delivery through the non-PVC sets was not affected by flow rate, type of solution, or concentration of diazepam. For infusion periods of up to five hours, delivery of diazepam through polyethylene lined i.v. administration sets was superior to delivery through polyvinyl chloride sets. PMID- 3976682 TI - Stability of an analgesic-sedative combination in glass and plastic single-dose syringes. AB - The stability of a combination of chlorpromazine hydrochloride (6.25 mg/mL), hydroxyzine hydrochloride (12.5 mg/mL), and meperidine hydrochloride (25 mg/mL) in glass and plastic syringes was studied. Syringes (glass 1.5 mL, plastic 3.0 mL) containing the combination drug solution were stored at 4, 25, and 44 degrees C. At 0,7,30,60,90,180, and 366 days after preparation, samples were visually inspected and tested for pH. Drug concentrations were determined by gas chromatography. No significant changes in drug concentration were apparent in any of the samples stored at 4 degrees C or 25 degrees C. Samples in both glass and plastic syringes stored at 44 degrees C turned yellow by day 30 and continued to darken throughout the study period. At the concentrations tested, chlorpromazine hydrochloride, hydroxyzine hydrochloride, and meperidine hydrochloride combined in glass or plastic syringes are stable for 366 days when stored at 4 degrees C and 25 degrees C. Degradation occurs at higher temperatures. PMID- 3976683 TI - Managing the inventory control system. AB - The four functions of management--planning, organizing, directing, and controlling--are described in relation to the hospital pharmacy inventory control system. Planning includes the development of inventory system objectives and identification of the resources needed to complete them. Organizing requires the manager to decide on the best method of grouping system activities and resources to complete the objectives in order of priority. Directing is a continual activity that involves obtaining optimal performance from the inventory system resources available. Controlling consists of regulation and verification of inventory system activities. The effective inventory system manager integrates planning, organizing, directing, and controlling in a continuous cycle. PMID- 3976685 TI - Source of papers contributed to ASHP Midyear Clinical Meetings, 1967-1982. PMID- 3976684 TI - Tax aspects of outpatient drug transactions in nonprofit hospitals. AB - Tax issues related to sales of medications to outpatients by pharmacies in nonprofit hospitals are described. Hospitals are increasing their emphasis on development of ambulatory-care programs. Two aspects of the tax implications of such services are (1) whether revenue from sales of medications to ambulatory patients constitutes "unrelated business income" for the nonprofit hospital and thus is taxable and (2) whether engaging in dispensing of medications to ambulatory patients might jeopardize the tax-exempt status of the hospital. Various rulings from the Internal Revenue Service and court cases are reviewed. Sales of medications to members of the general public who are unrelated to the hospital are taxable. Sales of medications for the convenience of hospital patients, and irregular and intermittent sales to the public by a pharmacy that normally serves only "patients," are tax exempt. Sales of medications to the public probably do not jeopardize the tax-exempt status of a hospital so long as the primary purpose of the hospital is consistent with permissible tax-exempt purposes. PMID- 3976687 TI - ASHP technical assistance bulletin on hospital formularies. PMID- 3976686 TI - ASHP guidelines: minimum standard for pharmacies in institutions. PMID- 3976688 TI - ASHP technical assistance bulletin on single unit and unit dose packages of drugs. PMID- 3976689 TI - Pharmacist-oriented drug distribution systems. PMID- 3976690 TI - New directions in the use of calcium channel blockers. PMID- 3976691 TI - Calcium channel blockers in hypoxic pulmonary hypertension. AB - Hypoxia is the major cause of pulmonary hypertension and right ventricular hypertrophy in chronic obstructive pulmonary disease, cystic fibrosis, kyphoscoliosis, chronic mountain sickness, and the obesity-hypoventilation and sleep apnea syndromes. Pulmonary hypertension develops in these patients because the long-standing vasoconstriction produced by hypoxia causes muscular hypertrophy of the pulmonary arteries and arterioles. These pathologic changes may regress if alveolar hypoxia is corrected and hypoxic pulmonary vasoconstriction is continuously inhibited. Intermittent inhibition of hypoxic pulmonary vasoconstriction does not reverse these pathologic changes. Since patient noncompliance with oxygen therapy makes it difficult to achieve continual relief of alveolar hypoxia, a drug that inhibits hypoxic vasoconstriction may be useful. Experimental findings indicate that hypoxic pulmonary vasoconstriction requires calcium influx and can be inhibited by certain slow-channel calcium blockers. Studies also demonstrate that slow-channel calcium antagonists can attenuate the pulmonary hypertension and right ventricular hypertrophy produced in rats by chronic hypoxia. Recently, two studies have shown that nifedipine inhibits hypoxic pulmonary vasoconstriction in patients with chronic obstructive pulmonary disease. If further studies demonstrate that these short-term effects are sustained, certain slow-channel calcium blockers may become a useful adjuvant to low-flow oxygen therapy in the treatment of hypoxic pulmonary hypertension. PMID- 3976692 TI - Calcium in the pathogenesis and therapy of human hypertension. AB - The contribution of calcium to normal regulation of blood pressure is reviewed. Epidemiologic data suggest that abnormal calcium homeostasis may play a role in dietary and environmental contributions to the risk of hypertension and cardiovascular disease. Recent studies in human and experimental hypertension point to one or more defects in cellular handling of calcium as contributing to the initiation and maintenance of increased vascular tone and, thereby, to abnormally elevated arterial blood pressure. By "correcting" some of these defects, calcium channel blockers may represent relatively specific therapy for hypertension. Data from human trials are still limited, but it is evident that, following oral administration of nifedipine and related compounds, an immediate decrease in peripheral vascular resistance and mean arterial pressure is produced. Cardiac output is not altered, and renal perfusion is maintained. In contrast to many currently used antihypertensive agents--including thiazide diuretics and beta blockers--which frequently induce alterations in the patient's serum chemical values, long-term administration of calcium channel blockers does not produce significant adverse metabolic effects or substantive changes in biochemical parameters. PMID- 3976693 TI - Calcium channel blocking agents in the prophylaxis of asthma. AB - Asthma is a state of reversible airway obstruction caused by the activation and response of different cell types (smooth muscle cells, mast cells, mucous gland secretory cells, and inflammatory cells) in various combinations. Recent evidence has demonstrated that all these cells require calcium-dependent reactions for their activation, which suggests that mobilization of calcium from extracellular and intraorganelle storage depots to the cytoplasmic matrix may be one possible underlying mechanism for asthma. Numerous agents have been developed to prevent this flow of calcium to the intracellular cytoplasmic matrix. Although their exact mechanism of action is not always clear, it has been shown that they can be effective in preventing muscle spasm and release of chemical mediators from mast cells following antigen and exercise challenges. Studies indicate that one calcium channel blocking agent, ketitofen, is effective as a prophylactic agent in the treatment of mild to moderate asthma. Other calcium channel blockers, including nifedipine, verapamil, and diltiazem, are now being actively investigated. PMID- 3976694 TI - Treatment of Raynaud's phenomenon with calcium channel blockers. AB - Raynaud's phenomenon may cause severe digital pain and functional disability, particularly in patients with underlying connective tissue diseases. The pathophysiology of Raynaud's phenomenon is varied, but digital ischemia is an essential element. Because calcium channel blockers cause arteriolar vasodilation and an increase in peripheral blood flow, they have been used to treat patients with Raynaud's phenomenon in several prospective, randomized, double-blind, placebo-controlled trials. Verapamil was ineffective in low doses, but both nifedipine and diltiazem produced subjective improvement. In placebo-controlled studies with nifedipine, the frequency of vasospastic episodes per two weeks decreased from 14.7 episodes during placebo therapy to 10.8 during nifedipine therapy (p less than 0.05). This response was more pronounced in patients without underlying vascular disease. Moderate or marked subjective improvement occurred in 60 percent of the patients receiving nifedipine and in only 13 percent of patients receiving placebo. Adverse effects were mild. It is concluded that nifedipine is an effective short-term therapy for most patients with Raynaud's phenomenon. PMID- 3976695 TI - Calcium channel blockers in congestive heart failure: theoretic considerations and clinical experience. AB - Although it has been suggested that calcium channel blocking agents may be utilized as vasodilators in patients with congestive heart failure, these agents also have the potential to cause a deterioration in cardiac function because of their negative inotropic actions. There is considerable variation among the available agents with regard to their relative effects on the vasculature, myocardial inotropy, and myocardial chronotropy. Thus, at clinically relevant dosages, nifedipine is a potent systemic and coronary vasodilator, but it has little or no direct effect on inotropy and chronotropy. In contrast, verapamil exerts significant negative inotropic and chronotropic effects at vasodilatory dosages, whereas diltiazem is a potent vasodilator with a negative chronotropic action at dosages that do not affect inotropy. In patients with heart failure, the largest experience so far has been with nifedipine. Data derived from over 100 patients with moderate to severe congestive heart failure indicate a generally beneficial net hemodynamic response to nifedipine, with substantial improvements in cardiac index (+24 percent) and left ventricular filling pressure (-15 percent). The major effect seems to be on arteriolar resistance vessels, resulting in a reduction in afterload, with relatively little effect on venous pressures. Limited data suggest that the initial effect is sustained during long term therapy. The clinical experience with verapamil and diltiazem in patients with heart failure is at present limited. In patients with normal or mildly impaired left ventricular function, verapamil's vasodilator and negative inotropic effects are counterbalanced. With severe left ventricular dysfunction, however, treatment with verapamil can result in abrupt decompensation and development of overt pulmonary edema and hypotension. Diltiazem's relative lack of negative inotropic effects may allow it to be used safely in patients with congestive heart failure, particularly when control of supraventricular tachyarrhythmia is required. PMID- 3976696 TI - Hyperestrogenemia, diet, and disorders of Western societies. PMID- 3976697 TI - The coronary care unit. A lack of consensus. PMID- 3976698 TI - Being a better house officer. PMID- 3976699 TI - Patterns of foot examination in a diabetes clinic. AB - Peripheral vascular disease is a well-known source of morbidity and potential mortality in diabetic patients. Sixty-five subjects with diabetes were studied in order to describe the contributions of the patient, the physician, and the health care system to the performance of a preventive foot examination. The incidences of foot examination on the day of study (12.3 percent) and during the previous year (49.2 percent) were similar to those found by other investigators. The feet of patients at higher risk for limb amputation were not examined with greater frequency at the clinic, although such patients were more often referred to a podiatrist. The most significant determinants of physician foot examination were patient recall of foot-related education received at the clinic and inter physician variability. These data suggest that the patient, physician, and clinic routine all play an important role in the success of a foot screening program for patients with diabetes. PMID- 3976700 TI - Tricuspid stenosis. Atrial systolic murmur, tricuspid opening snap, and right atrial pressure pulse. AB - Observations on the atrial systolic murmur, the tricuspid opening snap, and the right atrial pressure pulse of tricuspid stenosis are presented, based on catheter manometer intracardiac sound and pressure recordings in five patients with hemodynamically significant tricuspid stenosis. The manometer-recorded right atrial pressure pulse of tricuspid stenosis differed from the normal, with (1) elevation of right atrial pressure, (2) different morphologic features (tall, spiky A wave complete before C; small V wave with an interruption, the tricuspid opening snap notch at termination of the gradual Y descent; a diastolic plateau, the relatively flat diastolic segment of the right atrial pressure pulse following the tricuspid opening snap notch prior to the next A wave), and (3) the relative lack of right atrial pressure and right atrial pressure pulse response with normal respiration. The atrial systolic murmur, recorded in the right ventricular inflow tract, was complete by S1; the crescendo-decrescendo atrial systolic murmur configuration paralleled the right ventricular-right atrial diastolic pressure gradient at the time of the atrial A wave. The right atrial contraction-relaxation process, as reflected by the right atrial A wave ascent and descent, was complete at the onset of ventricular systole with P-R intervals of 170 to 200 msec. Thus, the timing and configuration of the atrial systolic murmur reflected the timing and completion of the right atrial contraction relaxation process prior to the onset of right ventricular systole and the configuration of the tricuspid diastolic pressure gradient. The tricuspid opening snap was recorded in the right ventricular inflow tract and occurred at the time of a notch at the termination of the Y descent of the right atrial pressure pulse V wave, while right atrial pressure exceeded right ventricular pressure. The sound-pressure events were consistent with angiographic and echocardiographic studies, which showed doming or ballooning of the mobile, fused, stenotic tricuspid valve into the right ventricle during the Y descent of the right atrial pressure pulse. The tricuspid opening snap occurred at the time of the termination of the diastolic movement of the fused tricuspid unit into the right ventricle. These observations are presented within the framework of previous studies in order to trace the development of medical ideas about the pathophysiologic basis for the sound and pressure events of tricuspid stenosis. PMID- 3976701 TI - Q wave, S-T segment, and T wave myocardial infarction. Useful clinical distinction. AB - Abundant experimental and clinical evidence now suggests that the presence or absence of Q waves on surface electrocardiography does not permit distinction between pathologic transmural and subendocardial myocardial infarction. It has been recommended, therefore, that use of certain electrocardiographic descriptors of myocardial infarction be avoided. One hundred fourteen consecutive patients with first myocardial infarction were studied. The lack of development of Q waves accompanying acute myocardial infarction delineated a group of patients with low in-hospital mortality. Left ventricular ejection fraction was less after Q wave (0.48 +/- 0.16) than after non-Q wave (0.67 +/- 0.10) infarction (p less than 0.0001). Left ventricular end-diastolic pressure was greater after Q wave (16.1 +/- 5.9 mm Hg) than after non-Q wave (11.7 +/- 2.7 mm Hg) infarction (p less than 0.02). Fixed thallium perfusion scintigraphic defects were more common in survivors of Q wave (98 percent [41 of 42]) than in survivors of non-Q wave (64 percent [seven of 11]) infarction (p less than 0.002). Objectively demonstrable myocardial ischemia was more common after non-Q wave (68 percent [13 of 19]) than after Q wave (32 percent [16 of 50]) infarction (p less than 0.01). The incidence of late cardiac events (sudden death plus reinfarction) did not differ after Q wave or non-Q wave infarction. Q wave, S-T segment, and T wave myocardial infarctions differ physiologically, clinically, and prognostically. It is of little consequence to the clinician managing patients whether such useful electrocardiographic descriptors also accurately define groups that differ anatomically with regard to the thickness of the injured myocardial wall. PMID- 3976702 TI - Effect of long-term amiodarone therapy on thyroid hormone levels and thyroid function. AB - Both hyperthyroidism and hypothyroidism have been noted to occur in some patients treated with amiodarone for cardiac arrhythmias. To determine the frequency of the development of thyroidal abnormalities in patients receiving amiodarone, 45 euthyroid patients were prospectively evaluated. Serum samples were obtained for measurement of thyroxine, thyrotropin, triiodothyronine, and triiodothyronine resin uptake prior to initiation of amiodarone treatment and serially over a 12- to 27-month period during which amiodarone was administered. The patients were divided into four subgroups as follows: Group I (n = 22) had elevated thyroxine levels, Group IIA (n = 13) had normal thyroxine levels and normal thyrotropin levels, Group IIB (n = 7) had normal thyroxine levels and elevated thyrotropin levels, and Group III (n = 3) had subnormal thyroxine levels. Demographic factors (such as route of administration, cardiac diagnosis, sex of the patient, or indication for amiodarone therapy) and amiodarone levels had no significant effect on the thyroid hormone parameters. However, Group I patients were statistically older than the patients in the other groups. Linear regression analysis revealed a negative correlation for thyroxine levels and a positive correlation with thyrotropin levels with age for the whole group. The various groups were not statistically affected by duration of therapy, but a positive trend existed for increasing thyroxine levels. Although virtually all patients showed changes in their thyroid hormone levels, chemical hyperthyroidism (elevated thyroxine and triiodothyronine levels without symptoms) developed in only two patients (4 percent), and clinical hyperthyroidism (elevated thyroxine and triiodothyronine levels with symptoms) developed in no patients. Four patients (9 percent) became biochemically and clinically hypothyroid. Thus, amiodarone frequently influences thyroid hormonal parameters, but less commonly causes a change in actual thyroid function. However, hyperthyroidism and hypothyroidism do occur in a significant number of patients. PMID- 3976703 TI - Ventricular arrhythmias during pulmonary artery catheterization in the intensive care unit. Prospective study. AB - The balloon-tipped, flotation pulmonary artery catheter is frequently utilized in the management of intensive care unit patients. Advanced ventricular arrhythmias (three or more consecutive premature ventricular contractions) have been reported in 25 to 68 percent of intensive care unit patients undergoing catheterizations. A group of 56 intensive care unit patients who received a pulmonary artery catheter were prospectively studied to determine the incidence of catheter induced arrhythmias and the time required for catheterization. The mean age of the patients was 69.8 +/- 11 years. Indications for catheterization included septic shock (n = 10), congestive heart failure (n = 8), hypovolemia (n = 12), respiratory failure (n = 2), preoperative cardiac evaluation (n = 20), and miscellaneous (n = 4). Advanced ventricular arrhythmias were recorded in seven of the 56 patients (12.5 percent), the longest arrhythmia being a run of seven consecutive premature ventricular contractions. No patient required treatment with lidocaine for their arrhythmias and all arrhythmias resolved with catheter movement. The mean time of catheterization for the 56 patients was 175.9 seconds (SD 263.2), and was not significantly different for patients with or without arrhythmias. There was no statistical difference in catheterization times or incidence of arrhythmias between critically ill patients and the preoperative patients. It is concluded that pulmonary artery catheterization can be performed in critically ill patients with a lower incidence of arrhythmias than has previously been reported. The decreased incidence of arrhythmias may be secondary to the decreased catheterization times. PMID- 3976704 TI - Endogenous catecholamine levels in chronic heart failure. Relation to the severity of hemodynamic abnormalities. AB - Plasma free epinephrine, norepinephrine, and dopamine concentrations were determined in 48, 63, and 45 patients, respectively, with overt congestive heart failure, and compared with those in 26 patients with stable angina but without heart failure. Systemic hemodynamic values were determined to assess the severity of heart failure. Arterial epinephrine levels were not different between patients with heart failure (73 +/- 92 pg/ml) and patients without heart failure (55 +/- 73 pg/ml). In patients with congestive heart failure, norepinephrine (665 +/- 510 pg/ml, mean +/- SD) and dopamine (407 +/- 405 pg/ml) levels were significantly higher than in patients with stable angina without heart failure (norepinephrine 184 +/- 136 pg/ml, p less than 0.001, and dopamine 197 +/- 259 pg/ml, p less than 0.02). However, in patients with congestive heart failure, the plasma norepinephrine levels did not correlate with cardiac index (r = 0.21, p = NS), pulmonary capillary wedge pressure (r = 0.11, p = NS), mean arterial pressure (r = 0.11, p = NS), or systemic vascular resistance (r = 0.18, p = NS). Similarly, there was no correlation between dopamine levels and the hemodynamic abnormalities in patients with congestive heart failure. These findings suggest that although endogenous norepinephrine and dopamine levels are frequently elevated in patients with heart failure, reflecting enhanced sympathetic activity, catecholamine levels do not reflect the severity of heart failure. PMID- 3976705 TI - Clinical clues to the cause of Addison's disease. AB - Tuberculosis and other potentially treatable diseases remain important causes of adrenal insufficiency. Knowledge of the cause of adrenal destruction, although often difficult to ascertain clinically, is necessary for appropriate management. Clinical data are reviewed in eight patients with Addison's disease who underwent computed tomographic scanning and in 31 additional patients with Addison's disease in whom autopsy was performed. Seven of eight patients (87 percent) with tuberculous Addison's disease of no greater than two years' duration had enlarged glands whereas patients with longer duration of disease had smaller or normal sized glands. Adrenal enlargement was also found in five of six (87 percent) subjects with carcinomatous replacement of the adrenal glands. The adrenal glands were small or undetectable in each of 16 patients with idiopathic Addison's disease. Adrenal calcification was found in nine of 17 (53 percent) tuberculous patients and was not found in any of the 22 other patients. Duration of adrenal disease, adrenal size on computed tomographic scanning, and presence of adrenal calcification were useful clues to the cause of Addison's disease. PMID- 3976706 TI - Post-marketing studies of drug efficacy: why? AB - In order to quantify the need for post-marketing studies of drug efficacy, the 100 drug uses (i.e., drug-indication pairs) that were most common in 1978 were reviewed. Of the 100 most common drug uses, 31 were not Food and Drug Administration (FDA)-approved at the time of initial marketing and 18 had not become FDA-approved, even subsequently. In 13, the use was based on the drug's secondary effect rather than on the primary effects investigated before marketing. The efficacy of all was subject to modification by incompletely explored factors, including other drugs, patient age, other illnesses, pregnancy, etc. Specific examples are provided of important modifiers of the efficacy of these drugs that were not investigated prior to marketing. Thus, despite the existence of sufficient data for the regulatory process to permit the marketing of these commonly used drugs, considerable gaps remain in the information needed for their optimal clinical use. Post-marketing studies of drug efficacy will be needed to fill these gaps. PMID- 3976707 TI - Are patients with hip fractures more osteoporotic? Review of the evidence. AB - This report critically reviews 15 case-control studies that disagree about whether patients who fracture their hip are significantly more osteoporotic than persons of similar age who do not. The most rigorously designed studies observed less bone mass in the hips of patients with fractures than in the hips of control subjects, but the differences were usually small and overlapping. Measurements at other sites in the skeleton did not consistently find differences. Those studies that protected against ascertainment bias generally found smaller differences than studies that did not. Patients with hip fractures do not appear to be distinctly more osteoporotic than persons of similar age. Therefore, factors besides bone mass, such as a tendency to fall, may be important determinants of which elderly persons will have fractures; thus, measurements of bone mass might not be a reliable way to identify those at greatest risk of hip fracture. PMID- 3976708 TI - Anaerobic myocardial abscess following myocardial infarction. AB - An anaerobic myocardial abscess due to Bacteroides fragilis developed in a 60 year-old man when he had an acute myocardial infarction while recuperating from surgery for a paracolonic abscess. Anaerobic bacteremia is a common event and may lead to infection in areas of low oxygen tension far removed from the original portal of entry. PMID- 3976709 TI - Epidural abscess, vertebral destruction, and paraplegia caused by extending infection from an aspergilloma. AB - An aspergilloma developed in a lung cyst in a 53-year-old man. Aspergillus infection then contiguously spread to the epidural space, causing an abscess, vertebral destruction, and paraplegia at the level of T4. Chronic alcoholism, liver cirrhosis, and corticosteroid treatment may have been predisposing factors in this patient. Although Aspergillus epidural abscess has been described infrequently, this complication has not been described in association with an aspergilloma. Symptoms, signs, or roentgenographic or laboratory findings suggestive of vertebral or meningeal pathologic lesions in patients with aspergilloma should alert the physician to the possibility of contiguous spread of infection. PMID- 3976710 TI - Polyostotic fibrous dysplasia with acromegaly. AB - A 26-year-old man was found to have incomplete polyostotic fibrous dysplasia of bone and elevated growth hormone and prolactin levels. There was roentgenographic evidence of a pituitary tumor. The natural history of fibrous dysplasia in relationship to excess growth hormone secretion since childhood is described. PMID- 3976711 TI - Steroid pretreatment does not prevent paraquat pneumonitis in rabbits. AB - Rabbits exposed to paraquat develop interstitial pneumonitis. A sublethal dose of paraquat (PQ) solution (250 mg/100 ml) was aerosolized by ultrasonic nebulization for one hour to rabbits in a closed vented chamber on two occasions with a five day interval between exposures. Groups studied included saline-exposed (N = 4); saline-exposed, methylprednisolone (MP) treated (1 mg/kg daily IM starting one day prior to the first exposure and then throughout the exposure period until sacrifice at day 8) (N = 4); PQ-exposed (N = 6); and PQ-exposed, MP treated (N = 6). Controls and MP controls gained weight and showed no abnormalities of respiratory rate. PQ and PQ-MP animals lost weight (average -0.35 kg) and had decreased breathing frequency (average decrease, 80-90 BPM). Blood gases showed minimal changes in all groups, although some individuals had hypoxemia and an increased alveolar-arterial oxygen pressure quotient [P (A-a) O2]. Bronchoalveolar lavage at sacrifice showed a marked increase in the percent of neutrophils in PQ and PQ-MP animals that correlated with pathology scores (R = 0.83). The P(A-a)O2 correlated with both the percent of neutrophils in lavage and the pathology score. Total cells recovered from a 100 ml lavage were comparable in all groups (approximately 3 X 10(7) cells). Steroid did not prevent the development of pathologic change. PMID- 3976712 TI - Nosocomial pulmonary mucormycosis with fatal massive hemoptysis. AB - We postulate that the previously healthy woman reported here developed abnormal host defense mechanisms because of acute renal failure, metabolic acidosis, hyperglycemia, and glucocorticosteroid administration. Pneumonia unresponsive to antibiotics terminated in massive fatal hemoptysis that was due to mucormycosis with rupture of the pulmonary artery into the tracheobronchial tree. PMID- 3976713 TI - Familial combined hyperlipidemia and otosclerosis--the occurrence in a large kindred. AB - The occurrence of otosclerosis and hyperlipidemia in four generations of a single family is described. The lipid abnormality fulfilled the characteristics of combined familial hyperlipidemia. Whereas a genetic linkage between combined hyperlipidemia and otosclerosis is feasible, our study indicates that both conditions are inherited through autosomal but unlinked genes. PMID- 3976714 TI - Amiodarone-associated hypothyroidism--a possible cause of digoxin intoxication. AB - The problem of a possible interaction between amiodarone and digoxin is still unsettled. We have recently treated two patients with digoxin intoxication who had received amiodarone for eight and 36 months respectively. Both developed extreme bradycardia requiring temporary pacemakers. The presence of hypothyroidism was confirmed in both cases by laboratory data. Judging by present knowledge concerning the interaction between amiodarone, thyroid function, and digoxin, it is suggested that digoxin intoxication was not the result of its direct interaction with amiodarone. The possibility that amiodarone-induced hypothyroidism precipitated digoxin intoxication seems to be more plausible. Prevention of digitalis toxicity in amiodarone-treated patients would therefore require monitoring of thyroid function every three to six months. Frequent monitoring of digitalis blood levels is also indicated in patients with amiodarone associated hypothyroidism. Early detection of hypothyroidism and digitalis intoxication is necessary in view of the severity of the course of the disease. PMID- 3976715 TI - Digoxin-amiodarone-hypothyroidism interaction. PMID- 3976716 TI - Paternity testing. 2: Likelihood ratio tests. AB - It is known that the so-called paternity index is also a likelihood ratio statistic for testing that an alleged father is the true father. Unfortunately the likelihood ratio test can sometimes lead to unsatisfactory results because of its dependence on the phenotype combinations of the mother and child. A new, conditional likelihood ratio test, which we call the ancillary test, is proposed in which statistical testing is carried out conditionally on the phenotypes of the mother and alleged father. An exact procedure is available which can be executed with reasonable facility on a microcomputer. PMID- 3976717 TI - Transmitting balanced translocation carrier information within families: a follow up study. AB - Approximately 1 of 500 individuals is a carrier of a balanced chromosome translocation. Since many translocations are inherited, many (but not all) relatives of carriers have a need to be informed of their potential carrier status. Presently, no data are available as to what extent individuals identified as balanced carriers inform at-risk relatives of the problem. We interviewed 12 balanced translocation carriers to learn whether such information had been transmitted to relatives. The 12 propositi had 36 surviving sibs and 21 surviving parents. Of the 36 sibs, 32 were informed of their risk. The four sibs not informed were from two families. Only 16 of the 32 informed sibs had subsequent carrier testing. Of the 21 surviving parents, 14 were told by their children of their carrier status; subsequently, three parent couples were tested. This survey provides data showing that individuals do not always disclose genetic risk information to relatives. Therefore, genetic professionals need to determine if they have a duty to transmit such information to at-risk relatives in light of the harm that may occur when information is withheld. PMID- 3976718 TI - Oto-palato-digital syndrome, type II--an X-linked skeletal dysplasia. AB - We report on two male infants with a lethal skeletal dysplasia characterized by cleft palate, midface hypoplasia, downward-slanting palpebral fissures, small thorax, and bowed limbs with absent fibulae. The clinical and radiographic changes are similar to those seen in the recently proposed oto-palato-digital syndrome, type II [Fitch et al, 1983]. The disorder is X-linked with heterozygous females being more mildly affected. PMID- 3976719 TI - Brief cytogenetic report on maternal translocation t(7;9) (p22:p13): two sibs with duplication 9p and one sib with the balanced translocation. AB - We report on a family in which a maternal translocation (7;9) (7qter--- 7p22::9p13----9pter; 9qter----9p13) resulted in 2 sibs with dup(9p) syndrome, one sib with the same balanced constitution as the mother, and one normal boy. PMID- 3976720 TI - Brief clinical report: non-mosaic partial tetrasomy and partial trisomy 9. AB - Partial tetrasomy 9 is a very rare chromosome abnormality. Of the reported cases, most have had tetrasomy only of 9p arising from the formation of an isochromosome. In addition, mosaicism was found in five of the 12 previous cases. We report on a case of non-mosaic partial tetrasomy 9 involving all of the short arms and asymmetrical segments of the long arms. PMID- 3976721 TI - The phenotypic and cytogenetic spectrum of partial trisomy 9. AB - A new patient with trisomy for the chromosome segment 9pter----q22 is compared to 19 previously reported cases of partial trisomy 9. Manifestations such as microcephaly, prominent nasal root, bulbous nose, and down-turned corners of the mouth are common to patients with trisomic segments extending from 9p21 to 9q13, while intra-uterine growth retardation, cleft lip/palate, skeletal anomalies, and heart defects are more common with trisomic segments extending through 9q22-9q32. A graphic method illustrates this progression in the partial trisomy 9 malformation spectrum as the triplicated chromosome region extends from bands 9p21 to 9q32. More severe and random defects are observed with complete trisomy 9 or tetrasomy 9p, suggesting an extreme excess of material greatly increases developmental variability. PMID- 3976722 TI - Distichiasis, congenital heart defects and mixed peripheral vascular anomalies. AB - We report on a previously apparently unreported syndrome of distichiasis with congenital heart defects and with mixed peripheral vascular anomalies in a mother and her four children. The mother had a ventricular septal defect; both daughters had surgery for patent ductus arteriosus. Sinus bradycardia alone (elder son), with stress induced asystole (younger son), and with wandering atrial pacemaker (both daughters) are documented electrocardiographically. Three of the five have edema, two have visible varicosities, three have symptoms consistent with chronic venous disease of the legs, and the older daughter has complaints consistent with arterial disease in the legs. Doppler flow studies demonstrated post-phlebitic syndrome in all but the younger daughter, and vasospastic disease in the mother, older daughter, and second son. PMID- 3976723 TI - Segregation and linkage analysis of alpha-N-acetyl-D-glucosaminidase (NAG) levels in a black family. AB - Alpha-N-acetyl-D-glucosaminidase (NAG) activities were evaluated on serum samples from 67 persons in a large black family. These data were analyzed in conjunction with those from 126 previously tested unrelated blacks [Vance et al, 1980]. After loge transformation, admixture analysis indicated a significantly better fit (P less than .01) of a mixture of 2 normal distributions for NAG activity versus a single normal distribution. Segregation analysis using the transmission probability model of Elston and Stewart [1971] demonstrated that a genetic model fits the data better than the random "environmental" model. Thus, the existence of a major gene is suggested in the family, although the possibility of polygenic or other familial effects cannot be ruled out. These results confirm the existence of a polymorphism for NAG reported earlier in a series of White half sib twin families [Vance et al, 1980]. However, the estimates of the means of the three genotypes (AA, AA', A'A') appear to differ in the two racial groups. Thus, the data suggest either a racial polygenic effect and/or different alleles segregating in the two populations. In fact, thermal stability data [Vance et al, 1981a] suggest that at least two alleles are structurally distinct. Linkage analysis of the pedigree with 20 marker loci gave no clear indication of linkage. A lod score of 1.44 was found at 0 recombination with orosomucoid (ORM). PMID- 3976724 TI - Fetal mortality in sibships with one or more affected members with oral clefts. AB - We investigated the fetal mortality in 903 sibships with at least one member having cleft lip with or without cleft palate [CL(P)] and 213 with at least one individual affected with cleft palate (CP) derived from three different data sources in Mexico. The frequency of fetal wastage (abortion and/or stillbirth) was not increased in sibships where the propositi had cleft lip and palate (CLP) as compared with cleft lip (CL) nor in those where index cases had a bilateral lesion as compared to a unilateral one, nor when the index cases with CL(P) were female rather than males, nor when the index case was a female with bilateral lesion as compared to males with a unilateral one. Similarly fetal mortality was not increased in sibships in which the propositus had CP compared to those in which the index case was a female. These findings are contrary to some reports that claim to support a two-threshold model according to which individuals reaching the first one would be born with an oral cleft, and those reaching the second would be aborted. Our results, together with others, suggest the possibility that liability to oral clefts is independent of liability to fetal wastage. PMID- 3976725 TI - Reproductive counselling for multiple sclerosis patients. AB - The diagnosis of multiple sclerosis (MS) is frequently made during the reproductive years, and there is increasing evidence that it has a genetic causal component. An increasing number of couples are concerned about recurrence and they request reproductive counselling at genetic clinics or from their physicians. Here we outline factors to be considered in the reproductive counselling of such individuals. These include empiric recurrence risks, the effect of pregnancy and delivery on maternal MS, overall pregnancy outcome, longterm prognosis for the affected parent, and the possibility of sexual dysfunction in couples trying to conceive a child. PMID- 3976726 TI - Computerized tomography of the foramen magnum: achondroplastic values compared to normal standards. AB - Computerized tomographic dimensions of the foramen magnum of 63 achondroplastic individuals were compared to standards established for nonachondroplastic individuals. The size of the foramen magnum in patients with achondroplasia was small at all ages, particularly in those with serious neurologic problems. The data suggest that measurement of the foramen magnum may identify achondroplastic individuals at high risk of developing neurologic complications. PMID- 3976727 TI - Deletion of the long arm of chromosome 11 and sex chromosome constitution. PMID- 3976728 TI - Transferrin polymorphism and malaria. PMID- 3976729 TI - In vivo alteration of a mutant human protein using the free thiol cysteamine. AB - Inborn errors of metabolism in which there is a mutant protein due to a cysteine for arginine substitution may be amenable to treatment with the free thiol cysteamine. Evidence for this derives from patients with type III hyperlipoproteinemia, who are homozygous for apolipoprotein E2, which differs in charge and in vitro function based on a single such amino acid substitution. The plasma of a type III hyperlipoproteinemic patient, when made at least 50 microM with respect to cysteamine in vitro, demonstrated a charge shift of the apolipoprotein E isoelectric focusing pattern from the E2 to the normal E3 and E4 positions. Two children treated for cystinosis with cysteamine each exhibited some charge alteration of their apoE3 to a form migrating in the apoE4 position. The use of thiol reagents such as cysteamine to specifically alter selected mutant human proteins, such as antithrombin III Toyama, may be added to our therapeutic armamentarium in the treatment of life-threatening metabolic disorders. PMID- 3976730 TI - Mental retardation in over half-a-million consecutive livebirths: an epidemiological study. AB - Prevalence and incidence of all levels of mental retardation were investigated in the population of British Columbia. Ascertainment was through the British Columbia Health Surveillance Registry. The minimum prevalence for all levels of retardation among the 15- to 29-year age group, where ascertainment was best, was 7.7 per 1,000 (8.8 per 1,000 males, 6.6 per 1,000 females). Minimum ascertainment (incidence) of retardation in the 1952 to 1966 birth cohort was 9.3 per 1,000 livebirths (9.9 per 1,000 males, 8.6 per 1,000 females). Data were also presented on lagtime (time from birth until a retarded person is identified in association with the level of functioning and the presence or absence of disabilities in addition to mental retardation. PMID- 3976731 TI - Psychosocial correlates of depression in mentally retarded adults: I. Minimal social support and stigmatization. AB - Two hypotheses were tested in a study with 28 mildly mentally retarded, emotionally disturbed adults and 17 mildly mentally retarded adults for whom an emotional disorder had not been diagnosed: depression is associated with (a) low levels of social support and (b) high levels of perceived stigmatization. Self report and informant measures of depression, social support, and perceived stigmatization were collected. The self-report and informant measures of the same construct were significantly correlated. Results revealed negative correlations between depression and social support ranging between -.25 and -.76 and positive correlations between depression and perceived stigmatization ranging from .11 to .44. After additional analyses comparing depressed subjects, disturbed/nondepressed subjects, and nondisturbed/nondepressed subjects, the results were interpreted as showing a powerful association between low levels of social support and depression. Convincing evidence of an association between perceived stigmatization and depression was not found. PMID- 3976732 TI - Behavioral disturbance in mentally retarded children in TMR and EMR classrooms. AB - The frequency with which disruptive behavior actually takes place in ongoing classroom settings was examined. Disruptive behavior of 646 subjects in TMR and EMR classrooms was observed over a 4-day period. Although mean disruptive behavior occurred at relatively low levels, considerable variability was evident with some differences observed in the nature of disruptive behavior between TMR and EMR subjects. This variability was further examined within a subsample of "high" and "low" disrupters. PMID- 3976733 TI - Conceptual systems and teacher attitudes toward regular classroom placement of mildly mentally retarded students. AB - The effects of a teacher personality construct (abstract vs. concrete conceptual system) and two pupil variables (race, school behavior) on 454 regular classroom teachers' attitudes toward mainstreaming were determined. Following administration of the Conceptual Systems Test, teachers were randomly assigned a profile of a mildly mentally retarded student that held pupil IQ and school achievement constant while varying pupil's race and school behavior. Subjects responded on an integration inventory comprised of three subscales: social psychological classroom environment, self-actualization, and classroom cohesiveness. Results revealed a significant main effect on the behavior variable and a significant Personality X Race interaction on all inventory dimensions, suggesting that these teachers perceived maladaptive behavior of mainstreamed retarded students as a significant threat to a conducive instructional atmosphere and the capability of nonretarded students to achieve to their potential. These results have implications for inservice training for teachers based on the pupil race and teacher conceptual system findings. PMID- 3976734 TI - Factors in family decision-making about placement for developmentally disabled individuals. AB - Variables that affect placement requests by families for their developmentally disabled members were examined. Results reaffirmed the importance of degree of disability, behavior problems, and external stressors for the decision-making process but also demonstrated that previous assumptions concerning their relative importance should be reexamined. Among younger disabled individuals (under 21), behavior problems were most important; for older individuals (over 21), disruption of family relations and perceived burden of care were more important. Different decision-making processes appeared to operate for younger and older disabled individuals. These results highlight the need for better specified theories that can explain placement requests among different types of individuals and families. PMID- 3976735 TI - Prediction of developmental attainments of institutionalized mentally retarded children. AB - Two regression equations using chronological age and either IQ or the Fisher and Zeaman K score were developed to predict Developmental Record ratings of institutionalized mentally retarded children over a 2-year interval (N = 200), a 4-year interval (N = 165), and an 8-year interval (N = 95). Although the correlations between predicted and obtained scores for both equations were quite high even over an 8-year interval, analysis of mean differences revealed that the equation using IQ yielded more accurate predictions. If future studies support the use of such equations with other subjects in other settings, they should be useful in estimating later developmental attainments of mentally retarded children. PMID- 3976736 TI - Assessment of mentally retarded children with the Kaufman Assessment Battery for Children. AB - The Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Kaufman Assessment Battery for Children (K-ABC) were compared using a sample of 37 mentally retarded children (mean age = 9.75 years). The predictive validity of these instruments was examined using the Peabody Individual Achievement Test, administered 7 months later, as a criterion measure of achievement. Results revealed that the WISC-R Full Scale IQ (57.8) was significantly lower, p less than .001, than the K-ABC Mental Processing Composite (65.1). The WISC-R Verbal and Full Scale IQs correlated highly with the K-ABC Achievement Scale, which was the best predictor of PIAT Total Test scores. Implications for use of the K-ABC and WISC-R were presented. PMID- 3976737 TI - Evidence of the similar-structure hypothesis controlling for organicity. AB - The similar-structure hypothesis and the two-group approach to mental retardation, proposed by Zigler (1967, 1969) and his colleagues, was investigated. Nonretarded, socioculturally mildly retarded, organically impaired retarded, and organically impaired moderately retarded children matched for MA were compared on moral and cognitive reasoning tasks. No differences were found between the nonretarded and socioculturally retarded subjects or between the two organically impaired groups. Differences were found between the organically impaired groups and the nonretarded and socioculturally retarded groups. When the effect of cognitive reasoning was partialled out of the moral reasoning scores, however, no differences were found among the four groups. The findings supported Ellis' (1963, 1969) difference theory as well as the similar-structure hypothesis but did not totally support Zigler's two-group position. PMID- 3976738 TI - Institutional reform, adaptive functioning of mentally retarded persons, and staff quality of work life. AB - In a previously reported, one-year field experiment of institutional reform, higher adaptive behavior among residents who lived in more normalizing residences was found (MacEachron, 1983). The main hypothesis of the present study was that staff quality of work life (job design, influence in decision-making, and leadership style of the immediate supervisor) may explain the effectiveness of institutional reform as well as staff satisfaction and motivation to perform effectively. Only greater staff influence in decision-making could explain the effectiveness of institutional reform, although all quality-of-work-life perspectives were associated with staff satisfaction and motivation to perform effectively. PMID- 3976739 TI - Attention in discrimination learning in relation to certain teacher-rated behavior anomalies. AB - Teacher ratings of the anomalous classroom behaviors hyperactivity, inattention, perceptual-motor impairment, perserveration, and stereotypy were examined as predictors of performance on a visual discrimination task. Weak but statistically reliable correlations were obtained. PMID- 3976740 TI - Structural memory deficits of mentally retarded persons. AB - Short-term memory of mentally retarded and nonretarded persons was compared in four experiments on the Brown-Peterson task in an attempt to relate short-term memory deficit to control or structural processes. Type of stimulus, pictures and letters, was varied along with encoding time. On pictures, with liberal encoding time, rate of forgetting did not differ. Retarded groups forgot letters more rapidly after limited encoding time. Increases in encoding time improved retention for retarded persons, but this variable did not normalize forgetting rate. In a direct comparison, retarded persons retained pictures better than letters. The converse was true for nonretarded persons. Evidence for both encoding and storage deficiencies of retarded persons was found. Differences in memory were found under conditions that precluded the use of voluntary cognitive strategies. These differences were interpreted as evidence for structural memory deficits of retarded persons. PMID- 3976741 TI - Note on the recruitment of subjects for mental retardation research. AB - Analysis of questionnaires mailed to 42 distinguished mental retardation researchers suggests that many of them feel handicapped by existing subject recruitment policies. Cited frequently as a major impediment was the time delay attending the securing of parental consent. PMID- 3976742 TI - Participation of professionals, paraprofessionals, and direct-care staff members in the interdisciplinary team meeting. AB - Results of a study of individual participation in interdisciplinary team meetings, with a focus on the participation behavior of professionals, paraprofessionals, and direct-care staff members, were reported. Several differences in observed and self-perceived participation were noted, with the general finding that professional staff members exhibited the highest levels of participation, whereas direct-care staff members exhibited the lowest levels of participation. PMID- 3976743 TI - Respiratory sinus arrhythmia in the human fetus. AB - This study explores the relationship between fetal heart rate variability and fetal breathing movements in the term fetus. Fourier analysis was applied to fetal heart rate variability during fetal breathing and nonbreathing episodes. A distinct component in the order of 0.7 to 0.95 Hz was demonstrated in fetal heart rate variability during breathing episodes. These frequencies have the same distribution as the corresponding rate of breathing and therefore indicate that respiratory sinus arrhythmia exists in the term fetus. PMID- 3976744 TI - Biochemical and morphologic effects of ethanol on fetuses from normally ovulating and superovulated mice. AB - To further our understanding about the teratogenicity of ethanol, we studied the changes produced by this compound in the incorporation of glucose 14C into several tissue fractions of 12-day mice fetuses and the morphologic alterations present at day 19 of gestation. Furthermore, to determine if the fetal toxicity of ethanol was modified by changes in the characteristics of the pregnancy, we performed similar biochemical and morphologic observations in fetuses from superovulated mice. Maternal ethanol administration caused biochemical alterations in the fetal tissues of both normally ovulating and superovulated mice, but it caused morphologic alterations predominantly in fetuses from superovulated animals. The prevalent morphologic alteration found in ethanol treated animals was a hemorrhagic lesion dorsal to the lumbar or dorsal vertebrae. These results suggest that superovulation increases the susceptibility of the fetal mice tissues to the teratogenic effects of ethanol. PMID- 3976745 TI - A comparison of sheep and human fetal oxygen delivery systems with use of a mathematical model. AB - Human fetal cardiac output measured with ultrasound is only about 60% of that found in the sheep. We modified a previously developed mathematical model of the fetal circulation and oxygen delivery in sheep for the human in order to study several differences. The model predicts that a human fetus can maintain its oxygen delivery with a relatively low cardiac output because of its relatively high fetal hemoglobin concentration, as compared with that of the sheep fetus. Thus an inverse relationship between fetal hemoglobin concentration and fetal cardiac output is suggested. This relationship may be mediated by the influence of red blood cell concentration on blood viscosity. Furthermore, it indicates that fetal anemia should be detectable by ultrasound measurements of increased cardiac output and/or umbilical blood flow. Dynamic responses of the model suggest that the mechanism of late and variable decelerations in the fetal heart rate pattern is mediated via a fall in arterial oxygen tension. PMID- 3976746 TI - Intrauterine growth retardation induced by thiamine deficiency and pyrithiamine during pregnancy in the rat. AB - The role of nutritional factors in the development of prenatal and postnatal growth retardation is not well understood. We tested if thiamine deficiency may cause intrauterine growth retardation in rats. From the second day of gestation Sprague-Dawley rats were freely fed either a nutritionally complete or a thiamine deficient diet. A similar group of rats was pair-fed with a complete or a thiamine-deficient diet and daily pyrithiamine injections (50 micrograms/100 gm of body weight) were given to precipitate thiamine deficiency during the short gestation of the rat. Maternal thiamine levels in blood and brain tissues, maternal erythrocyte transketolase activity with thiamine pyrophosphate effects, and fetal tissue thiamine levels were measured. The results indicate that feeding a thiamine-deficient diet in conjunction with pyrithiamine injections caused sufficient thiamine deficiency to induce intrauterine growth retardation in the progeny. We conclude that thiamine deficiency alone during in utero development in the rat may contribute to intrauterine growth retardation. PMID- 3976747 TI - Frequency of diabetes mellitus in mothers of probands with gestational diabetes: possible maternal influence on the predisposition to gestational diabetes. AB - Interviews for genetic histories were conducted prior to delivery in 166 pregnant diabetic probands and 83 control gravidas with normal carbohydrate metabolism throughout gestation. A significant association was observed between parental diabetic phenotypes and type of diabetes in the probands (chi 2(12)) = 32.413; p less than 0.001). In particular a higher than expected number of mothers with diabetes was encountered in 91 probands with gestational diabetes mellitus. The findings are examined in relationship to the hypothesis that vulnerability to gestational diabetes may be increased by exposure to an abnormal environment during intrauterine development. PMID- 3976748 TI - Catecholamine responses in fetal lambs subjected to hemorrhage. AB - We monitored plasma epinephrine and norepinephrine responses to hemorrhage of 20% of estimated blood volume in 11 chronically instrumented, unanesthetized fetal lambs. In addition, we performed control experiments--blood sampling but no hemorrhage--in five fetuses. Arterial blood gases, pH, mean arterial pressures, heart rates, and plasma norepinephrine and epinephrine levels were similar in both groups in the resting state. Arterial blood gases and pH did not change significantly during the experimental period in either group. Mean arterial pressure, heart rate, and plasma norepinephrine and epinephrine levels did not change in the control group during the experimental period. Hemorrhage was associated with a significant decrease in fetal mean arterial pressure, 39.8 +/- 1.2 to 29.6 +/- 2.1 mm Hg, and heart rate, 186 +/- 8 to 146 +/- 6 bpm (p less than 0.01 in both cases). There was a significant increase in plasma norepinephrine, 664.9 +/- 91.6 to 1384.8 +/- 216.7 pg/ml (p less than 0.02) and epinephrine, 224.6 +/- 43.6 to 681.7 +/- 199.0 pg/ml (p less than 0.01) with hemorrhage. These results demonstrate significant catecholamine responses to hypovolemia in the fetal lamb. PMID- 3976749 TI - An examination of vascular reactivity during pregnancy in the chronic ewe model. AB - The hind limb vascular responses to angiotensin II and phenylephrine, an alpha adrenergic agonist, were determined in chronically instrumented pregnant (n = 7) and castrated (n = 6) ewes. On any one day, five doses of one or the other drug were administered directly into the arterial femoral circulation while the perfusion pressure and external iliac blood flow were monitored. The steady-state resistance change (baseline resistance - the resistance calculated during the 3 to 5 minutes of drug infusion) showed a reduction in vascular response to angiotensin II in the pregnant ewes compared to the controls, with no significant differences in response to phenylephrine. When the dynamic (within 40 seconds) rather than the steady-state changes were analyzed, a hyperreactivity to phenylephrine was present in the pregnant animals. These data are an illustration of the complex interactions that are present in the whole-body pressor responses to vasoactive stimuli during pregnancy. PMID- 3976750 TI - Fetal heart rate response to maternal exercise. AB - Twenty-five pregnant women without complications underwent fetal heart rate evaluation during a program involving exercise at a relative intensity of 61% to 73% of maximal capacity during the course of the pregnancy. Assessment of the influence of gestational age on the fetal heart rate response to exercise and evaluation of the course of fetal heart rate recovery were the main goals of the study. The results of the study confirmed previous findings that fetal heart rate is accelerated after maternal exercise. However, contrary to other studies we found no effect of gestational age on the fetal heart rate response to exercise. Neonatal findings provided further evidence that quantitated maternal exercise up to 70% of maximal capacity does not interfere with normal fetal growth and development. PMID- 3976751 TI - Umbilical artery velocity waveforms and intrauterine growth retardation. AB - A continuous-wave Doppler unit was used to obtain umbilical artery velocity waveforms and to calculate the peak-systolic/diastolic ratio, a reflection of vascular resistance distal to the point of measurement. A total of 587 examinations were performed on 189 women between 18 to 42 weeks' gestation. The neonates were divided in four groups based on their centile birth weight: less than 25%, 25% to 50%, 51% to 75%, and greater than 75% for that gestational age. In all four groups the placental vascular resistance as reflected by the systolic/diastolic ratio fell progressively from the 24 weeks onward. In the lower weight group, placental vascular resistance between 31 to 39 weeks' gestation was higher than in the other three groups (p less than 0.05). For measurements taken between 31 and 39 weeks' gestation we calculated the predictive value of this test in identifying the small-for-gestational age fetus. A ratio of greater than or equal to 3 was defined as abnormal. For the entire population tested, sensitivity was 78% and the specificity was 83%. The predictive value of a positive test was 49%, but when hypertension was present, it was 66%. These findings may prove useful in identifying and managing pregnancies at risk for intrauterine growth retardation. PMID- 3976752 TI - Characteristics and analysis of uterine electromyographic activity in the pregnant sheep. AB - Myometrial electromyographic activity was recorded with electrodes placed on the uterus in seven pregnant sheep. Electromyographic recordings were made continuously in two groups of animals. One group of four animals was studied for the first 8 days after operation at 60 to 132 days' gestation. The second group of three animals was studied at least 8 days after operation. Myometrial electromyographic activity could be divided into epochs of varying duration. With the use of microprocessor-based data acquisition systems and computerized analysis it was demonstrated that (1) on the basis of an analysis of duration of electromyographic activity there were at least two populations of electromyographic epoch, (2) myometrial electromyographic activity increased in the first 3 to 4 days after operation, and (3) by 6 to 7 days after operation a relatively stable level of activity had been achieved. The separation of electromyographic activity into two populations was most marked in the animals observed in the immediate postsurgical period. In these animals the population of epochs with the longer-lasting activity had a median duration of 5.9 minutes in eight pairs of electromyographic electrodes from four animals. Curve-fitting techniques demonstrated that no more than 14% of uterine electromyographic activity had a duration less than 3 minutes. The longer-lasting group of myometrial electromyographic events corresponds to uterine contractures we have described previously; the other group of epochs of activity was of shorter duration. PMID- 3976753 TI - Fetal breathing movements and lung hypoplasia: preliminary human observations. AB - Hypoplasia of the fetal lung is found in association with long-standing oligohydramnios. In animal models, interference with fetal breathing activity has led to lung hypoplasia. It has been suggested that lung hypoplasia associated with oligohydramnios is due to inhibition of fetal breathing. Observations of seven patients with prolonged oligohydramnios, three of whom had lung hypoplasia, indicate that fetal breathing does occur in these cases and that is unlikely that lung hypoplasia is merely the result of absent fetal breathing activity. In fact, when compared to the four patients with oligohydramnios and presumably normal lungs, the three patients with oligohydramnios and lung hypoplasia spent more time breathing and did so at higher rates. PMID- 3976754 TI - The significance of C-reactive protein levels in women with premature rupture of membranes. AB - In a prospective study of 100 patients with preterm premature rupture of membranes, clinical chorioamnionitis was present in 18 and histologic chorioamnionitis was present in 63. Patients who were managed conservatively for premature rupture of membranes were monitored by C-reactive protein determination, white blood cell and differential counts, maternal temperature, and fetal heart tone. C-reactive protein was measured nephelometrically (Immuno chemistry Analyzer II, Beckman). Elevated C-reactive protein levels correlated well with both the pathologic and the clinical diagnosis of chorioamnionitis. Elevated C-reactive protein levels (at least 12 to 24 hours before delivery) were more sensitive than other standard laboratory or clinical tests in predicting chorioamnionitis both by clinical and pathologic criteria. When C-reactive protein values were normal, clinical chorioamnionitis was rarely found, whereas pathologically diagnosed chorioamnionitis was found half of the time. We conclude that although the C-reactive protein level is a very sensitive predictor of infectious morbidity in premature rupture of membranes, its specificity is not high. PMID- 3976755 TI - Previous cesarean section: the risks and benefits of oxytocin usage in a trial of labor. AB - Permitting a trial of labor in patients with a previous cesarean birth is rapidly becoming an accepted alternative to routine elective repeat cesarean section. As interest in this approach has grown and the risks associated with a trial of labor have been better defined, the use of oxytocin in these patients emerges as a pertinent issue. Our retrospective experience of oxytocin use in patients undergoing a trial of labor suggested no increased maternal or fetal risk compared to patients who did not receive oxytocin. On the basis of our prior experience, we set out to investigate prospectively the role of oxytocin in 732 patients with prior cesarean section who underwent a trial of labor. During the study period, 289 (40%) patients received oxytocin for either induction (32, 11%) or augmentation (257, 89%) of labor and 443 patients did not receive oxytocin. Successful vaginal delivery was achieved in 200 patients (69%) as opposed to 395 (89%) of the patients who did not receive oxytocin. The incidences of dehiscence in the oxytocin and no oxytocin groups were 3% and 2%, respectively. Further analysis of vaginal and cesarean delivery complications for the two groups were contrasted and no significant differences were found with respect to the incidence of hemorrhage, uterine atony, hysterectomy, or the requirement of transfusions. Neonatal outcome was also comparable for both groups. On the basis of our prospective experience, it appears that the use of oxytocin, when carefully monitored, is a safe and reasonable consideration in the patient undergoing a trial of labor. PMID- 3976756 TI - Labor risk assessment in a rural community hospital. AB - Unanticipated perinatal catastrophe in a rural community hospital is responsible for the deaths of many potentially salvageable infants. An intrapartum risk scoring system was designed to help anticipate infants needing skilled resuscitation at the rural community hospital. Thirty-three percent of infants whose mothers scored as high risk (greater than or equal to 10) required resuscitation while only 6% of infants whose mothers scored less than 10 required resuscitation. Sequential Apgar scores of infants in need of resuscitation attended by a skilled resuscitator showed significant improvement compared with Apgar scores of infants not attended by a skilled resuscitator, suggesting at least a short-term benefit for early identification of the infant at risk. PMID- 3976757 TI - Prevention of premature labor by 17 alpha-hydroxyprogesterone caproate. AB - Eighty pregnant women at high risk of giving birth prematurely were divided randomly into two groups. Treatment with either 17 alpha-hydroxyprogesterone caproate, 250 mg by intramuscular injection once a week, or a placebo was given in a double-blind fashion. Imminent premature labor occurred in 29.0% of the treated group and in 59.4% of the control group (p less than 0.025). The rate of premature deliveries was also significantly lower in the treated group (16.1%) than in the control group (37.82%) (p less than 0.05). There were no cases of perinatal death or fetal malformations in either group. The mean birth weight of all infants of the treated group was significantly higher than in those of the control group (3111.9 +/- 905 gm versus 2680 +/- 813.4 gm, p less than 0.05). The results support treatment with progesterone caproate for the prevention of premature labor. PMID- 3976758 TI - Radiation treatment of carcinoma of the vulva, 1950-1980. AB - A retrospective study of all patients with carcinoma of the vulva treated by radiation therapy at the A. Maxwell Evans Clinic of the Cancer Control Agency of British Columbia, between 1950 and 1980, is reported. Sixty-eight patients, representing 30% of all referred patients with vulvar cancer, were analyzed for survival, recurrence patterns, complications, and clinical features. This group is companion to a series of patients treated with operation reported in 1979. The data confirm a major role for radiation therapy both in palliation and in combined radiotherapy-operation. For 13 cases, radiotherapy with curative intent was used in combination with operation resulting in a 5-year actuarial survival of 92%, with acceptable posttreatment morbidity. The advantages of preoperative radiotherapy, particularly for posterior vulvar lesions, are suggested by the data, and the need for a reappraisal of the role of radiotherapy in vulvar carcinoma is stressed. PMID- 3976759 TI - Diabetes in pregnancy: a population-based study of incidence, referral for care, and perinatal mortality. AB - During 1979 and 1980 in Washington State, 260 infants (live births plus fetal deaths greater than or equal to 20 weeks' gestation) were born to women with preexisting diabetes mellitus, the equivalent to a population-based incidence of 2.1 per 1000 total births. One quarter of these women had non-insulin-dependent diabetes prior to pregnancy. The perinatal mortality rate for all infants of diabetic mothers in this series was 108 per 1000, which was eight times the state perinatal mortality rate. Only 45% of births occurred in the five tertiary centers in the state, whereas 39% occurred in hospitals that had fewer than six deliveries per year complicated by overt diabetes. The mortality rate was slightly, but not significantly, lower among infants born in referral hospitals than among those born in primary-level hospitals. Congenital malformations accounted for 43% of the 28 perinatal deaths, and fetal losses between 20 and 27 weeks' gestation accounted for another 21%. During the 2-year study period there were only three cases in which antepartum care in nonspecialty centers may have contributed to a perinatal loss. PMID- 3976760 TI - Neonatal mortality in infants born weighing 501 to 1000 grams. The influence of changes in birth weight distribution and birth weight-specific mortality rates on neonatal survival. AB - We analyzed changes over time in neonatal mortality rates for infants born weighing 501 to 1000 gm. The decline in total mortality in this weight group due to improved small-group, birth weight-specific mortality was contrasted to the increase in mortality caused by changes in the birth weight distribution resulting from the care of smaller infants. Had the birth weight distribution remained unchanged, the total improvement in neonatal mortality for the entire 501 to 1000 gm group would have been substantially greater. PMID- 3976761 TI - Cervical dysplasia: association with sexual behavior, smoking, and oral contraceptive use? AB - Information on possible risk factors of cervical dysplasia, including indices of sexual behavior, smoking habits, and the use of oral contraceptives was obtained from a case-control study in Ontario in which 250 cases of histologically proved cervical dysplasia and 500 age-matched neighborhood controls were interviewed. Initial analysis showed an increased risk associated with more than one sexual partner, an early age at first intercourse, current smoking, the use and duration of use of oral contraceptives, and education. However, the increased risk of use and duration of use of oral contraceptives and education was reduced after adjustment for indices of sexual behavior and smoking. This finding does not confirm previously reported large adverse effects of pill use. The relationship between smoking and cervical dysplasia might be explained by some agent in cigarette smoke which depresses the immune mechanism, thus permitting a sexually transmitted agent to result in abnormal cellular development that leads to the onset of cervical dysplasia. PMID- 3976762 TI - Hemodynamic alterations associated with amniotic fluid embolism: a reappraisal. AB - Experimental amniotic fluid embolism in animals produces profound pulmonary hypertension and acute cor pulmonale without evidence of left ventricular compromise. Authors reporting hemodynamic alterations associated with clinical amniotic fluid embolism have traditionally attempted to explain their findings within this experimental framework. A reanalysis of the five published cases of amniotic fluid embolism, which include hemodynamic data derived from pulmonary artery catheterization as well as a report of a sixth case suggests a hemodynamic interpretation different from the traditional one based on the animal model. Left ventricular failure is the only hemodynamic abnormality consistently observed in humans, and the published data are most readily explained on this basis alone. A theoretical model of hemodynamic changes accompanying amniotic fluid embolism that incorporates both experimental and clinical observations is presented. Therapeutic implications are discussed. PMID- 3976763 TI - Thyroid function in epileptic mothers and their infants at birth. AB - It has been suggested that patients receiving anticonvulsant therapy have depressed thyroid function. Thyroid function was studied in 16 pregnant epileptic women who were receiving various anticonvulsants; 20 nonepileptic pregnant women served as controls. Maternal and umbilical cord blood was collected at delivery and serum thyrotropin, total thyroxine, triiodothyronine, triiodothyronine resin uptake, and free thyroxine levels were measured. The free thyroxine index was calculated from the thyroxine and triiodothyronine resin uptake data. There were no significant differences in any of the maternal parameters. In cord serum, the thyroxine level was significantly lower (p less than 0.001) in the infants of the epileptic mothers. The triiodothyronine resin uptake was slightly increased in the epileptic group (p less than 0.05) so that the free thyroxine index largely compensated for this. The thyrotropin, free thyroxine, and triiodothyronine levels did not differ between the two groups. Thus the low thyroxine values in cord blood of infants of epileptic mothers receiving anticonvulsants probably reflect an alteration in protein binding rather than a true alteration in thyroid function. PMID- 3976764 TI - Physiologic concentrations of dopamine fail to suppress prolactin secretion in patients with idiopathic hyperprolactinemia or prolactinomas. AB - Several investigators have suggested that normal responsiveness to dopamine is exhibited by pituitary lactotrophs in patients with idiopathic hyperprolactinemia and prolactinomas. These studies, however, have employed dopamine infusion rates that produced supraphysiologic serum dopamine concentrations. In order to further examine this issue, we infused graded doses of dopamine to normal men and women as well as to patients with idiopathic hyperprolactinemia and prolactinomas. Dopamine infusion rates as low as 0.004 micrograms/kg/min, which were associated with physiologic serum dopamine levels, produced significant (p less than 0.01) suppression of prolactin in normal women and in normal males (p less than 0.05). In contrast, a 10-fold increase in the dopamine infusion rate, 0.04 micrograms/kg/min, was required in the hyperprolactinemic subjects to produce prolactin suppression similar to that found in the control subjects. Hence, prolactin secretion in both tumors and other hyperprolactinemic states is associated with a resistance to suppression by dopamine. PMID- 3976765 TI - Analysis of the human fetal skeleton and organs with xeroradiography. AB - We have used xeroradiography to study normal and abnormal fetuses including some with anencephaly, hydrocephalus, spina bifida, osteogenesis imperfecta (type IV), Jeune syndrome, radial aplasia, thanatophoric dysplasia, and Pena-Shokeir syndrome. Xeroradiography images the lines of ossification and epiphyses in great detail, shows ossification, and reveals abnormalities that alter bone modeling as seen in Jeune syndrome, osteogenesis imperfecta (type IV), and thanatophoric dysplasia. This technique can be used successfully to examine soft tissues and organs. It can also be used in combination with contrast materials to identify the lateral ventricles, the cardiovascular, gastrointestinal, urinary, and respiratory systems, and the cavities (pleural and peritoneal) of the fetal body. PMID- 3976766 TI - Reproductive tract abnormalities in female mice treated neonatally with tamoxifen. AB - Immature female mice of the NMRI strain were treated with 20 micrograms/day of tamoxifen or vehicle for the first 3 days after birth. At 90 days of age, vaginas, uteri, and ovaries were examined histologically. A benign epithelial change, vaginal adenosis characterized by abnormal growth of columnar epithelium with glandular structures, was found in all of the tamoxifen-treated mice. Anatomic anomalies such as hypospadias, cervical hypoplasia, uterine hypoplasia, and absence of corpora lutea also were commonly observed. Such abnormalities were not found in the control mice. PMID- 3976767 TI - Antibodies to the neutral glycolipid asialo ganglio-N-tetraosylceramide: association with gynecologic cancers. AB - As part of our efforts to define subpopulations at increased risk for gynecologic malignancies, sera from 145 women were obtained prior to diagnosis and analyzed for antibody to asialo ganglio-N-tetraosylceramide. This neutral glycolipid is present on the surface of thymocytes and natural killer cells, and asialo ganglio N-tetraosylceramide antibody has been shown in animals to block natural killer cell activity and promote tumor cell proliferation. With the use of an enzyme linked immunosorbent assay and with a value of 2 SD above the mean for healthy women designated as the boundary for a positive response, antibody to asialo ganglio-N-tetraosylceramide was detected in only one of 30 (3%) healthy women, none of 16 pregnant women, none of 18 women with benign masses, and two of 24 (8%) women with microbial infections. All of the above samples that contained antibodies were barely over the 2 SD limit. In marked contrast, 19 of 35 (54%) women with gynecologic malignancies had asialo ganglio-N-tetraosylceramide antibodies, with positive values ranging to greater than 10 SD above the control mean. Asialo ganglio-N-tetraosylceramide antibody was found in six of eight (75%) patients with cervical cancer, five of eight (63%) with endometrial cancer, and seven of 15 (47%) with ovarian cancer. Of the eight patients with Stage I gynecologic cancer at any site, five (62%) had asialo ganglio-N-tetraosylceramide antibodies. Four of 22 (18%) women with Hodgkin's disease also had antibodies, with values just exceeding 2 SD above control levels. The presence of these antibodies may contribute to an impaired immune surveillance system in these women and so increase their susceptibility to malignancy. PMID- 3976768 TI - Cardiac output distribution and uteroplacental blood flow in the pregnant rabbit: a comparative study. AB - This study presents data on cardiac output distribution and uterine and placental blood flows in pregnant rabbits under chronic steady-state conditions. Ten liters and 67 fetuses were studied at 29 days of gestation, by means of radioactive microspheres. Five nonpregnant female animals were also studied for comparison. Mean cardiac outputs were 747.16 +/- 55.7 and 613.80 +/- 63.76 ml/min in the pregnant and nonpregnant states, respectively. In the pregnant animals, uterine and mammary blood flows were 6.7% +/- 0.7% and 5.1% +/- 0.5% of cardiac output, respectively. Within litters, the highest placental blood flows occurred at the ovarian and vaginal ends of the uterine horn. Placental blood flow per gram of fetus was 0.106 +/- 0.008 ml X min-1 X gm-1. A comparison with analogous data in the guinea pig and sheep demonstrates that toward the end of pregnancy placental blood flow per gram of fetus is approximately 2.5-times higher in sheep than in rabbits and guinea pigs. Expressed as a percentage of cardiac output, near-term uterine blood flow is significantly less in rabbits than in guinea pigs and sheep, whereas mammary blood flow is significantly higher. These interspecies differences are related to differences in placental structure, fetal/maternal mass ratio, and maturity at birth. PMID- 3976769 TI - Management of placenta previa. PMID- 3976770 TI - The abdominal pelvic pain syndrome: fact or fiction. PMID- 3976771 TI - Abdominovaginal delivery in case of impacted head in cesarean section operation. PMID- 3976772 TI - Self-examination of the cervix in premature labor prevention. PMID- 3976773 TI - Use of Hickman catheter during pregnancy. PMID- 3976774 TI - Systemic absorption of metronidazole. PMID- 3976775 TI - Use of ritodrine in uterine inversion. PMID- 3976776 TI - Six myths about controlled trials in perinatal medicine. AB - Despite a historical commitment to evaluation of the results of practice, obstetrics has missed many opportunities to assess new therapies adequately prior to their widespread use. Although randomized controlled trials are generally recognized as the best method of evaluating therapy, a number of myths about these trials have impeded both their performance and the implementation of their results. The unscientific nature of these myths is discussed, and examples from the perinatal literature are presented. PMID- 3976777 TI - Long-term neurological morbidity in breech and vertex births. AB - Seventy frank breech fetuses delivered vaginally, alive at the onset of labor, and without major congenital anomalies were matched by birth weight and race with a breech infant born by cesarean section, a vertex infant born vaginally, and a vertex infant born by cesarean section. Long-term neurological abnormality was determined from time of hospital discharge through a minimum of 2 years of age. The results document the absence of significant differences with respect to major brain damage effected by birth route changes for breech fetuses and between the entire breech and vertex populations. PMID- 3976778 TI - Brain injury and intrauterine death. AB - Many of the stresses contributing to brain injury in the intrapartum or neonatal period may also exist prenatally. To define this problem, we reviewed the clinical features and neuropathologic findings in 433 consecutive stillbirth autopsies. Twenty-five had evidence of periventricular/intraventricular hemorrhage or gliosis. Twenty infants had died in utero before active labor and five during delivery. Nine stillbirths were infected. Ten cases had periventricular/intraventricular hemorrhage alone, five had the hemorrhage with parenchymal hemorrhage, five had parenchymal hemorrhage only, and five had gliosis. This group of 25 cases establishes that intrauterine brain injury is not rare. Separation of antepartum events occurring in utero from those imposed during labor, delivery, resuscitation, and the neonatal period is very important and has significant medical and legal implications. PMID- 3976779 TI - The role of external version in the intrapartum management of the transverse lie presentation. AB - External version under tocolysis was applied and studied prospectively as an alternative to routine cesarean delivery in the laboring patient with a transverse lie presentation. After sonographic confirmation and signing of informed consent, 12 patients with a transverse lie presentation and intact membranes agreed to participate in the current investigation. For these 12 patients, 10 (83%) presentations were successfully converted to a longitudinal lie (nine cephalic, one breech) and two (17%) remained transverse. Of the 10 patients with successful conversions, six (60%) delivered vaginally while four required cesarean delivery. In two (20%) patients external version was unsuccessful and both patients were delivered by cesarean. With the exception of one infant with congenital anomalies, neonatal outcome was excellent in the study population. Overall, the use of external version in the laboring patient with a transverse lie presentation was associated with a 50% reduction in the cesarean section rate. While these results are encouraging, further experience is still needed to more clearly define the maternal and fetal risks associated with this procedure. PMID- 3976780 TI - The effect of exercise on uterine activity in the last eight weeks of pregnancy. AB - In order to determine if moderate maternal exercise increased uterine activity, a prospective study was done during the last 8 weeks of pregnancy in 17 women. Two forms of exercise were chosen, weight-bearing (running) and non-weight-bearing (stationary bicycle), to study this hypothesis. The results show that with these types of exercise no increase in uterine activity was noted. This is useful information to convey to pregnant patients ready to engage in a physical fitness program. PMID- 3976781 TI - Fatal meconium aspiration syndrome occurring despite airway management considered appropriate. AB - A combined obstetric-pediatric approach to tracheal toilet is said to prevent serious cases of the potentially fatal meconium aspiration syndrome. After delivery of the head a DeLee trap is used to suction the oropharynx and nasopharynx. Immediately following delivery, endotracheal suction is performed in an effort to remove any remaining meconium-stained amniotic fluid. Although routinely using this approach, we continue to have occasional cases of fatal meconium aspiration syndrome. Therefore, we reviewed the outcome of infants born through meconium-stained fluid. During a 5-year period, 1420 (15%) of 9299 live born infants had meconium-stained fluid. Thirty (2.1%) of these 1420 developed meconium aspiration syndrome and 12 (40%) died; eight received a postmortem examination. Four had unequivocal evidence of meconium aspiration, two had large numbers of intra-alveolar squamous cells, and two had no evidence of aspiration. We conclude that aggressive airway management during and immediately after delivery does not always prevent fatal meconium aspiration syndrome. PMID- 3976782 TI - Factors involved in the interpretation of fetal monitor tracings. AB - In order to study how physicians choose to use electronic fetal monitoring and interpret tracings, we administered a questionnaire to which 107 practicing obstetricians and 11 experts in electronic fetal monitoring responded. Sixty-one (57%) of the respondents monitored more than half of their deliveries (high users). In comparison to the less frequent users of electronic fetal monitoring (low users), they showed more positive attitudes toward electronic fetal monitoring and were nearly always more likely to perform cesarean sections on hypothetical patients described in the questionnaire. These differences appeared to be due to the high users' higher estimate of danger to the fetus. We also found that most physicians were generally more likely to perform a cesarean section on a high-risk mother than a low-risk mother with the same tracing. The majority of high and low users and nearly all of the experts, however, felt that antepartum risk factors are not of value in deciding what to do about an abnormal tracing. We conclude that there is wide variation in the way in which obstetricians use, interpret, and act on electronic fetal monitoring tracings. Some of these differences may be due to differing attitudes toward electronic fetal monitoring, differences in interpretation of electronic fetal monitoring tracings, and differences in the way obstetricians incorporate maternal risk factors into their decision-making. PMID- 3976783 TI - Intrapartum fetal heart rate monitoring of the extremely premature fetus. AB - When cesarean section is not warranted because of extreme prematurity, continuous electronic fetal heart rate monitoring during the intrapartum period and in utero resuscitation of the distressed fetus are indicated, especially in cases of borderline fetal viability. Two cases are presented to illustrate the benefit of such measures when fetal distress occurs and the fetus is judged to be too small for operative intervention. PMID- 3976784 TI - Subfractions of high-density lipoprotein cholesterol during estrogen replacement therapy: a comparison between progestogens and natural progesterone. AB - Subfractions of high-density lipoprotein cholesterol and its apolipoproteins were followed up in 58 postmenopausal women during three cycles of unopposed estrogen replacement therapy with 2 mg of estradiol valerate daily. During the last 10 days of the following three cycles the women received sequential addition of either 250 micrograms of levonorgestrel, 10 mg of medroxyprogesterone acetate, or 200 mg of natural micronized progesterone. Both progestogens significantly decreased total high-density lipoprotein cholesterol as well as subfraction 2 of high-density lipoprotein. Data suggest that doses and relative biologic activity of 19-norsteroids and 17-hydroxyprogesterone derivatives are more important for their metabolic effects than are qualitative differences. Natural progesterone had no apparent influence on high-density lipoprotein cholesterol or its subfractions and may develop into an attractive alternative to synthetic progestogens. PMID- 3976785 TI - An unusual presentation of a case of staphylococcal pericarditis during pregnancy. PMID- 3976786 TI - Abruptio placentae following snake bite. AB - A case in which, besides the clinical complications that commonly follow snake biting, abruptio placentae occurred is reported here. None of the factors that are frequently associated with abruptio placentae were present. The laboratory tests performed showed that renal function was impaired and that a dramatic hypercoagulability was present. The relationship of the latter to the abruptio placentae is discussed. PMID- 3976787 TI - Oxytocin augmentation of dysfunctional labor. V. An alternative oxytocin regimen. AB - A regimen is described in which the time from the start of a large dose of oxytocin to a myometrial response was used for selection of a maintenance dose. The method is based on our experience that continuous intravenous doses of oxytocin in the therapeutic range for the augmentation of labor require about 40 minutes of intravenous infusion to achieve a steady-state plasma concentration of oxytocin. The method effectively identified the proper maintenance dose on the first attempt in 43 of 59 patients (73%) and on the second in 58 of 59. The doses selected effected cervical dilatation in 55 of 59 cases (93%). Comparison of the timed dose method with an arithmetic progression regimen revealed the former method to select the minimum effective dose more rapidly, but that method had no advantage in shortening the time from the start of oxytocin to complete cervical dilatation. Examination of the plasma concentration of oxytocin by radioimmunoassay demonstrates that the maintenance dose selected by the duration of the interval from the start of infusion to a myometrial response sustains the plasma oxytocin concentration obtained by the initial dose. These data lend additional evidence that any particular dose of oxytocin in the therapeutic range requires approximately 40 minutes to achieve a steady-state plasma concentration. PMID- 3976788 TI - Cardiovascular alterations in severe pregnancy-induced hypertension: relationship of central venous pressure to pulmonary capillary wedge pressure. AB - The relationship between central venous pressure and pulmonary capillary wedge pressure was studied in 18 patients with severe pregnancy-induced hypertension. Although statistically a linear relationship for the group as a whole could be identified, analysis on a case-by-case basis revealed different results. In 10 patients, a linear correlation between central venous pressure and pulmonary capillary wedge pressure was observed. However, accurate prediction of pulmonary capillary wedge pressure from central venous pressure was not possible even in this group because of large interindividual variations. In seven patients no correlation between central venous pressure and pulmonary capillary wedge pressure could be identified. In the last patient a curvilinear relationship existed between central venous pressure and pulmonary capillary wedge pressure. Additionally, in five cases of pulmonary edema, a negative gradient of colloid osmotic pressure to pulmonary capillary wedge pressure gradient was observed. Our data suggest that central venous pressure is not a clinically reliable predictor of pulmonary capillary wedge pressure. PMID- 3976789 TI - Chlamydial endocervical infections and cytologic findings in sexually active female adolescents. AB - The association of infection with Chlamydia trachomatis and cytologic changes on Papanicolaou smear was examined in 148 sexually active postmenarchial++ female subjects, aged 13 to 21 years (mean = 17.2) attending a teen clinic. Endocervical samples for micro-organisms (C. trachomatis and Neisseria gonorrhoeae) and a cervical sample for cytologic examination were taken. A detailed evaluation of the cytologic results was made independently of the C. trachomatis status. In 23 (15.5%) subjects tests for isolation of C. trachomatis were positive. Inflammatory changes in epithelial cells, nuclear changes in metaplastic cells, and lymphocytes in the inflammatory exudate were associated with C. trachomatis isolation but suspected "chlamydial inclusions" and cytoplasmic vacuoles in metaplastic cells were not. The results reported here do not support the use of cervical cytologic examination as a definitive diagnostic test for presence of an endocervical chlamydial infection. However, it may be possible to use the cytologic pattern described here to identify a population with a high prevalence of C. trachomatis. PMID- 3976790 TI - Factors affecting the sex differential in neonatal mortality: the role of respiratory distress syndrome. AB - We investigated factors affecting the sex differential in neonatal mortality rate using linked birth and death certificates of more than 300,000 infants born in Georgia between 1974 and 1977. The neonatal mortality rate was higher in male infants than in female infants (relative risk = 1.23, p less than 10(-8)) and was most pronounced for infants weighing between 1501 and 2500 gm (relative risk = 1.78, p less than 10(-8)). This differential persisted after adjustment was made for effects of several prenatal and labor-related factors. The male excess in neonatal mortality rate was most prominent during the first week of life and was found for several perinatal disorders. Respiratory distress syndrome-related mortality showed the largest male excess (relative risk = 1.57, p less than 10( 8)) and was most pronounced in infants weighing between 1501 and 2500 gm (relative risk = 2.78, p less than 10(-8)), in whom it accounted for roughly 60% of the excess. Since previous studies have shown that male infants have a higher incidence of respiratory distress syndrome but not a higher case-fatality rate, we suggest that slower lung maturation among male fetuses is a major contributing factor to the sex differential in neonatal mortality. PMID- 3976791 TI - Soft drug use after pregnancy compared to use before and during pregnancy. AB - With the use of information gathered through the course of pregnancy and data collected after delivery, the changing patterns of alcohol, nicotine, and marijuana use of 288 women participating in the Ottawa Prenatal Prospective Study were investigated. The time periods considered were the year before pregnancy, each trimester of pregnancy, and 1, 6, and 12 months post partum. Alcohol use showed the most marked reduction of the three drugs during pregnancy, but a year after delivery prepregnancy drinking patterns (including binging) had been reestablished. An exception to this was a continued reduction of alcohol consumption by those categorized as heavy social drinkers prior to pregnancy. Although not as marked as the alcohol reduction, nicotine use was reduced during pregnancy and continued to remain at the reduced level 1 year post partum. Heavy marijuana use was the least reduced of the drugs during pregnancy and consumption returned to prepregnancy levels a year after the birth of the baby. PMID- 3976792 TI - Prolactin production by explants of normal, luteal phase defective, and corrected luteal phase defective late secretory endometrium. AB - The production of prolactin by explants of late secretory endometrium has been correlated with the extent of decidual differentiation. This correlation is strengthened by the observation that luteal phase defective endometrium produces less prolactin than normal control endometrium in a 24-hour in vitro culture system. In the present study the prolactin production by explants of normal, luteal phase defective, progesterone-corrected luteal phase defective, and clomiphene- or follicle-stimulating hormone/luteinizing hormone-corrected luteal phase defective late secretory endometrium was measured over 96 hours at 24-hour intervals. Progesterone in physiologic concentrations was added to the culture medium to maintain tissue integrity and prolactin synthesis. The prolactin production of normal late secretory endometrium rose over 96 hours under progesterone stimulation. The luteal phase defective endometrium produced significantly less prolactin under the same conditions. Histologically proven corrected luteal phase defective endometrium, regardless of treatment method, produced prolactin not different from the normal controls of the same dates. From these results it is concluded that histologic correction of luteal phase defective endometrium is associated with a corresponding biochemical correction with use of prolactin as a metabolic marker. The findings also strongly support timed endometrial biopsy as the method of diagnosis and evaluation of treatment of luteal phase defect. PMID- 3976793 TI - Gap junctions and myometrial steroid hormone receptors in pregnant and postpartum rats: a possible cellular basis for the progesterone withdrawal hypothesis. AB - Myometrial gap junctions, levels of cytosol and nuclear estradiol and progesterone receptors, and serum estradiol and progesterone levels were determined simultaneously in pregnant and postpartum rats. Between days 15 to 20 after conception, levels of progesterone nuclear receptors decreased (776.8 +/- 88.5 versus 241.1 +/- 56.5 fmol/mg of DNA, p less than 0.05). The mean serum progesterone also fell by about 50% during this period, but variation in individual levels between days 15 to 20 did not allow for this group to achieve statistical significance until day 21. As the progesterone nuclear receptors decreased, estradiol remained stable, but estradiol nuclear receptors increased (day 21 versus 22: 1710.6 +/- 61.1 versus 3254.8 +/- 203.8 fmol/mg of DNA, p less than 0.05), preceding the increase in gap junctions observed at parturition (day 21 versus 22: 2.0 +/- 0.2 versus 8.0 +/- 3.2 [per 1000 micron plasma membrane], p less than 0.05). Gap junctions fell to prepartum levels by 12 hours, when progesterone nuclear receptors were markedly increasing (6 versus 12 hours post partum: 637.7 +/- 324.8 versus 1509.6 +/- 283.2 fmol/mg of DNA, p less than 0.05). Relationships between gap junctions and cellular estradiol and progesterone nuclear receptors are clearer than could be forecast by circulating hormone measurements alone, and may offer a cellular basis for the role of progesterone in controlling labor. PMID- 3976794 TI - Peripartum colloid osmotic pressure changes: effects of controlled fluid management. AB - A prospective, fluid-controlled study of serially measured colloid osmotic pressure changes in the peripartum period was undertaken. Seventeen patients with uncomplicated pregnancies undergoing elective cesarean section at term were administered a predelivery bolus of 15 ml/kg of lactated Ringer's solution prior to operation. Maintenance crystalloid fluids were infused at 125 to 150 ml/hr both intraoperatively and post partum without the addition of blood or other colloid solutions. Serial colloid osmotic pressure measurements were obtained before hydration, after hydration, after delivery, and at 6 and 24 hours post partum. The results demonstrated a 15.9% decline in colloid osmotic pressure immediately following the hydration bolus (20.7 +/- 1.5 to 17.4 +/- 1.8 mm Hg) (p less than 0.01). A further decline in colloid osmotic pressure to 16.6 +/- 1.7 mm Hg occurred after delivery and represented an overall 22% decrease from the baseline value (p less than 0.05). The lowest mean colloid osmotic pressure value occurred at 6 hours post partum (16.1 +/- 1.1 mm Hg). These data support previous observations that colloid osmotic pressure is uniformly lowered in the immediate postpartum period with peak reductions identified at 6 hours following delivery. In addition, intravenous crystalloid administration during the peripartum interval can substantially influence this decline in colloid osmotic pressure. Although no clinical evidence of cardiopulmonary compromise was observed in this set of normal gravid women, these data may be useful in the management of the parturient patient with established risk factors for pulmonary edema where alterations in the pulmonary capillary wedge pressure-colloid osmotic pressure gradient have been shown to correlate with the development of this complication. PMID- 3976795 TI - Ovine fetal urine production following maternal intravenous furosemide administration. AB - The response of the ovine fetus to maternal furosemide administration was studied in six chronically catheterized fetal lamb preparations. These studies indicate that in the chronic sheep model maternally administered diuretics do not augment fetal urine production. Additionally, passage of the drug from the maternal intravascular compartment to the fetal intravascular compartment could not be demonstrated. It is suggested that on the basis of these data, the results of the "Lasix challenge test" should be interpreted with caution when they are used to evaluate human fetal renal function. PMID- 3976796 TI - Long-term reversible contraception with levonorgestrel-releasing Silastic rods. PMID- 3976797 TI - Combined use of ritodrine and magnesium sulfate for tocolysis of preterm labor. PMID- 3976798 TI - Transplacental spread of influenza virus. PMID- 3976799 TI - Tubal ligation: a misnomer. PMID- 3976800 TI - Sound stimulation test and fetal well-being. PMID- 3976801 TI - Gestational age according to fetal sex in twins. PMID- 3976802 TI - Natural course of retinitis pigmentosa over a three-year interval. AB - Ninety-four patients, 6 to 49 years old, with progressive forms of retinitis pigmentosa were examined at baseline and annually for three consecutive years with respect to visual acuity, kinetic visual fields, dark-adaptation thresholds, computer-averaged electroretinograms, and fundus photographs. A subset was recalled within two months of a given visit to measure intervisit variability and to develop criteria for what constitutes significant (P less than .01) functional change. Over a three-year interval full-field electroretinograms declined significantly in 66 of 86 patients (77%) with detectable responses at baseline. Patients lost an average of 16% to 18.5% of remaining electroretinographic amplitude per year and 4.6% of remaining visual field area per year. Bone spicule pigmentation increased in 41 of 76 patients for whom we could make comparisons over a three-year interval (54%). Visual acuity and dark-adaptation thresholds remained relatively stable. PMID- 3976803 TI - Retinal tacks. AB - An improved retinal tack and applicator can be used to fix the retina to the wall of the eye mechanically. The system consists of a small (1 X 2.7 mm) stainless steel tack with a blade-like tip and a forked applicator that can grasp the tack securely from any position. Two eyes with complex detachments with fixed rolled retinas could not have been repaired without the help of retinal tacks. The advantages of the retinal tack system over other methods include ease of handling, insertion, and removal. PMID- 3976804 TI - Vitrectomy without scleral buckling for primary rhegmatogenous retinal detachment. AB - Trans pars plana vitrectomy with air-fluid exchange was performed on 29 selected cases of primary rhegmatogenous retinal detachment in which scleral buckling would be the usual surgical approach. The group contained 20 phakic eyes, two aphakic eyes, and seven pseudophakic eyes; the macula was detached preoperatively in 17 eyes (66%). The reattachment rate after one operation was 79% (23 of 29 eyes); after two operations this increased to 93% (27 of 29 eyes). Visual acuities of 20/50 or better were achieved in 22 of 27 successfully treated cases (81%). Vitrectomy without scleral buckling may allow retinal reattachment with excellent visual results in selected cases of primary rhegmatogenous retinal detachment. PMID- 3976805 TI - A clinicopathologic study of 21 cases of adenoid squamous cell carcinoma of the eyelid and periorbital region. AB - We conducted a clinicopathologic study of adenoid squamous cell carcinoma involving the eyelid (15 cases) and periorbital region (six cases). The mean age of the 17 men and four women was 64.5 years (range, 43 to 85 years). Histopathologically, the lesions were characterized by acantholysis and a pseudoglandular pattern with many alveolar and tubular structures. Solar keratosis was also a prominent histologic feature, suggesting that exposure to the sun was a predisposing factor. Local recurrences occurred in five of 16 patients for whom follow-up information was available (mean follow-up period, 8.8 years). There was no regional lymph node or distant metastasis, and none of these patients died of their neoplastic disease. Surgical excision appears to be the best treatment. PMID- 3976806 TI - Peripheral corneal edema after cataract extraction. AB - Twenty-six eyes in 16 patients with aphakic peripheral corneal edema showed most of the signs described in 1969 by Brown and McLean in a syndrome they called "peripheral corneal edema after cataract extraction," consisting mainly of aphakia, marginal corneal edema, and discrete orange punctate pigmentation of the endothelial surface of the edematous areas. The syndrome was observed in 21 eyes after intracapsular cataract extraction, in three eyes after extracapsular surgery, and in two eyes with spontaneous absorption of the lens. In one case the spontaneous absorption of the lens was attributable to trauma, and in the other it was seen in association with congenital rubella syndrome. There was a high incidence of myopia (61%) in the affected eyes in this series. PMID- 3976807 TI - Effects of intraocular irrigating solutions on the corneal endothelium after in vivo anterior chamber irrigation. AB - We used wide-field specular microscopy and corneal pachymetry to evaluate the effect of anterior chamber irrigation with BSS and BSS Plus on the corneal endothelium of cats. Endothelial changes were quantitated by computerized morphometric analysis of individual cells. After short-term (15 and 30 minutes) and long-term (one and two hours) irrigation, endothelial cell density remained unchanged. Corneal thickness increased significantly in the BSS group after one hour of irrigation. BSS Plus caused minimal changes in endothelial morphologic characteristics regardless of the irrigation time. By comparison, BSS caused a significant increase in the coefficient of variation of cell area (polymegethism) and a decrease in the percentage of hexagonal cells (pleomorphism). These changes were more prominent after prolonged irrigation. The morphologic changes caused by BSS irrigation are indicative of a stressed endothelial monolayer that may be more susceptible to additional surgical trauma. PMID- 3976808 TI - Loading doses and extended dosing intervals in topical gentamicin therapy. AB - Loading doses and extended dosing intervals were studied in a rabbit model using topically applied gentamicin in a concentration of 13.6 mg/ml. Loading doses consisting of one drop every minute for five minutes produced significantly higher gentamicin concentrations in the cornea during the early hours of treatment than regimens using one drop every hour and one drop every 30 minutes. Extended dosing intervals of two and four hours, when used in conjunction with an initial loading dose, produced peak gentamicin levels above 125 micrograms/g of cornea. However, trough levels with these extended dosing intervals were significantly lower than troughs during hourly gentamicin administration. An extended dosing interval regimen consisting of three drops every two hours maintained peak and trough levels equal to those produced by one drop an hour. PMID- 3976809 TI - Momentary fluctuations of intraocular pressure in normal and glaucomatous eyes. AB - To examine the range of momentary fluctuations of intraocular pressure caused by vascular pulsations in 42 glaucomatous and 18 normal eyes, we obtained consecutive intraocular pressure measurements at hourly intervals with a noncontact air tonometer. Glaucomatous eyes had a significantly (P less than .001) greater range of intraocular pressure measurements on consecutive readings than normal eyes (4.4 +/- 1.4 mm Hg vs 2.7 +/- 0.7 mm Hg). The frequency of consecutive intraocular pressure readings exceeding a spread of 4 mm Hg was significantly increased in glaucomatous eyes. The range of intraocular pressure measurements was greater even in those glaucomatous eyes with mean intraocular pressures within the normal range. There was a positive correlation between mean intraocular pressure and mean range in glaucomatous eyes, but not in normal eyes. In both glaucomatous and normal eyes, there was no significant correlation between age and mean range. PMID- 3976810 TI - Filtering iridocycloretraction in chronic closed-angle glaucoma. AB - In 98 patients, 112 eyes with chronic closed-angle or combined glaucoma were operated on using filtering iridocycloretraction, including preparation of two limbal-based scleral strips that were introduced through scleral incisions into the anterior chamber and the supraciliary space. The intraocular pressure was controlled (less than or equal to 21 mm Hg) in 107 eyes by surgery alone and in two eyes with medication by three to four weeks postoperatively. Ninety-one eyes were followed up for 12 to 30 months (mean, 19 months). The intraocular pressure was controlled in 78 eyes by surgery alone and in four eyes with medication. Three eyes were operated on repeatedly. PMID- 3976811 TI - Moraxella nonliquefaciens endophthalmitis after trabeculectomy. AB - Endophthalmitis caused by Moraxella nonliquefaciens developed five years after trabeculectomy in a 67-year-old man and 15 months after trabeculectomy in a 62 year-old women. Symptoms in both cases included pain, inflammation, and decreased visual acuity. Aggressive treatment with antibiotics and corticosteroids led to resolution within a few days. PMID- 3976812 TI - Visual function and academic performance. AB - Evaluation of 1,910 first-, second-, and third-grade students indicated that visual function and academic performance as measured by reading were not positively related. Visual function tests included visual acuity, muscle balance, preferred eye and hand, color vision, refraction, sensory and motor function, and a writing and drawing task. Academic tests included the Metropolitan Readiness Test, the Cognitive Abilities Test, the Iowa Test of Basic Skills, and the teacher's assessment of reading level. A simple test which can be completed during the office visit and interpreted by the ophthalmologist in the office included drawing, copying, and writing. A segment of this test, the "draw a bicycle test," can be used by an ophthalmologist to demonstrate the difference between vision and performance when examining a child up to third-grade level who is referred because of school failure. PMID- 3976813 TI - Scleral canal size and optic nerve head drusen. AB - From projected optic disk photographs we measured the size of the scleral canal in two samples of emmetropic patients: one of patients with unilateral pseudopapilledema and drusen and the other of the general normal population. Measurements on the non-drusen-containing optic disk of patients with unilateral drusen were taken to reflect the scleral canal size of the fellow, affected eye. For both trained (t = 6.642) and untrained (t = 4.274) observers, the average diameters of the non-drusen-containing optic disks of patients with unilateral drusen were significantly smaller than those of the optic disks of normal patients (P = .0005, one-tailed independent t-test). The association of a small scleral canal with vascular anomalies, frequently noted in optic disks of patients with drusen, indicates a mesodermal dysgenesis of the optic nerve head. PMID- 3976814 TI - Possible cardiovascular effects secondary to topical ophthalmic 2.5% phenylephrine. PMID- 3976815 TI - Sodium hyaluronate (Healon) as an adjunct to lacrimal surgery. PMID- 3976817 TI - Argon laser photomydriasis during vitrectomy surgery. PMID- 3976816 TI - Potential acuity meter for predicting postoperative visual acuity in cataract patients. PMID- 3976818 TI - Neodymium-YAG laser therapy to the anterior hyaloid in aphakic malignant (ciliovitreal block) glaucoma. PMID- 3976819 TI - Ocular effect of neodymium-YAG laser. PMID- 3976820 TI - The effectiveness of verbal versus activity groups in improving self-perceptions of interpersonal communication skills. AB - This study compares the efficacy of a verbal group with that of an activity group in an occupational therapy clinic during the treatment of interpersonal communication deficits at a psychiatric day treatment center. Outpatients were randomly assigned to the following groups: an experimental group, which received activity therapy (n = 7), an experimental group, which received verbal therapy (n = 6), and a control group, which was involved exclusively in the normal milieu therapy at the center (n = 6). The two experimental groups received one hour of treatment per week for eight weeks. The pretesting and posttesting of interpersonal communication skills were done with the Interpersonal Communication Inventory. The activity group used collages, problem-solving tasks, role-playing sessions, games, and drawing exercises. The verbal group used discussion exclusively. Both the activity and verbal groups were based on whether participants had the following: an adequate self-concept, the ability to be a good listener, the skill of expressing his or her thoughts and ideas clearly, the ability to cope with his or her emotions (particularly with angry feelings) and express them in a constructive way, and a willingness to disclose him- or herself to others freely and truthfully. A significantly higher level of interpersonal communication skills was attained by the activity group. Comparisons between both groups and the control group showed no significant differences. PMID- 3976821 TI - Purposeful activity in motor learning theory: an event approach to motor skill acquisition. AB - This paper presents the event approach to motor skill acquisition as a theoretical treatment of the learning and relearning of motor skills; the emphasis is toward rehabilitation of physical dysfunction. Purposeful activity is viewed as a necessary prerequisite for the formation of coordinative structures, which are the bases for skilled movement. Traditional approaches to motor learning, which focus primarily on the actor, are seen as inadequate to accurately describe motor skill acquisition. The event approach treats the actor and the environment as inseparable in the acquisition of skills. Using this approach, I hope to establish a common ground and collaborative relationships between the disciplines of occupational therapy and motor learning. PMID- 3976822 TI - Characteristics of students in occupational therapy educational programs. AB - This study used data from self-administered questionnaires to compare technical- and professional-level students from four occupational therapy educational programs in Illinois. Examination of the similarities and differences in biographic characteristics indicate that registered occupational therapy and certified occupational therapy assistant students come from different backgrounds. The reasons why students chose their levels of education, and the amount and character of contact with occupational therapy that they had prior to entering the program provide useful information for counselors, recruiters, and designers of informational materials. The students' intended roles, desired career goals, and work values furnish suggestions for curriculum developers. PMID- 3976823 TI - Brief or new: adapted cone-handled sander. PMID- 3976824 TI - The Foundation. Collaborative research. PMID- 3976825 TI - Performance of Japanese and Japanese-American children on the Motor Accuracy Revised and Design Copying Tests of the Southern California Sensory Integration Tests. AB - This study investigates whether cultural differences affect childrens' performances on the Design Copying (DC) and Motor Accuracy-Revised (MAC-R) Tests of the Southern California Sensory Integration Tests. The DC and the MAC-R were administered to 98 children who were born in Japan and lived there at least during the first year of life and to 82 children who were of Japanese descent but who were born in America. Average test scores of the Japanese and Japanese American children were compared with those of the American children, on whom the tests were standardized. Results of the tests requiring right-hand performance revealed that both groups of Japanese-descent children performed better than the standardization group of American children; the Japan-born children performed the best. We base these findings on the influence that culture has on the development of a child. PMID- 3976826 TI - The revised Fieldwork Performance Report: implementation and implications. PMID- 3976827 TI - Occupational therapy intervention for cancer patients with metastatic disease. AB - Very little information is available on the role of occupational therapy in the care of cancer patients who are being actively treated for metastatic disease. To gain information on occupational therapy assessment and treatment procedures, we reviewed the records of 54 adult inpatients who received occupational therapy services during a hospital admission. We found that assessment focused on independent living skills, sensorimotor components, and therapeutic adaptations. Treatment also focused on these areas but placed heavy emphasis on physical daily living skills, range of motion, assistive/adaptive equipment, and energy conservation. These findings indicate that occupational therapy has a unique role in the physical care of cancer patients with metastatic disease. PMID- 3976828 TI - Fieldwork performance and academic grades. AB - The literature examining the relationship between occupational therapy academic course work and fieldwork performance was reviewed. Responding to a recent suggestion calling for a reexamination of this relationship with a sample of significantly larger size, we initiated the present study. The results are similar to earlier studies, with little or no correlation found in most analyses. Further investigation of the results provides strong evidence supporting the conclusion that correlation analysis is inappropriate for this investigation; thus, it would be incorrect to assume that there is little or no relationship between occupational therapy academic course work and fieldwork performance. Suggestions of ways to study the relationship between course work and fieldwork are presented. PMID- 3976829 TI - Professional socialization: implications for occupational therapy education. AB - This article examines the implications that adult socialization theory can have on occupational therapy education. Sociological literature about professional socialization is reviewed and related to the preparation of occupational therapists. The discussion includes a description of the goals, processes, and participants in professional socialization. Consistency of socializing influences is presented as a critical factor in the formation of strong professional role identities. Finally, the article considers which values and attitudes may be transmitted during the socialization process for occupational therapists and other health professionals. PMID- 3976830 TI - Clinical factors in proximal vergence. AB - Using forced vergence fixation disparity curves, proximal vergence was analyzed in two asymptomatic patient samples; 20 young adults (average age 25.2 +/- 4.71 years) and 20 presbyopes (average age 61.6 +/- 7.8 years). Total proximal vergence was significantly larger when measured under binocular (closed loop) conditions than monocular (open loop) conditions for pre-presbyopes (binocular 10.51 delta +/- 4.7 vs. 6.4 delta +/- 3.84 monocular) and presbyopes (binocular 11.59 delta +/- 3.13 vs. 4.71 delta +/- 2.15 monocular). Associated proximal vergence was shown to predict associated phoria magnitude in presbyopes and in pre-presbyopes when vergence adaptation and convergence accommodation (CA/C) interactions with accommodative convergence (AC/A) are included. A vergence/accommodation model is presented which includes influences of proximal vergence. Clinical implications of the findings relating to diagnosis and therapy are discussed. PMID- 3976831 TI - Funduscopic systems: magnification in ametropia and aphakia. AB - The magnification of the fundus image with various forms of funduscopy in ametropia and aphakia is poorly understood. This paper investigates these relationships. Direct and indirect ophthalmoscopy and biomicroscopic funduscopy is included. The Gullstrand Simplified Schematic Eye is modified by changing either the axial length, the power of the cornea, or the index of refraction of the lens to produce ametropia. Aphakia is produced by considering these same eyes with the crystalline lens removed. The magnification of these various eye/funduscope systems is presented, along with general principles illustrated by the figures. PMID- 3976832 TI - Fixation disparity vs. binocular fixation misalignment. AB - Conventional fixation disparity was compared with the corresponding foveal fixation misalignment measured by a recently developed method based on the effect of retinal eccentricity on the width of the border enhancement band. Unlike procedures using binocular nonius alignment, the method is not subject to adaptive changes in perceived direction. Forced convergence and divergence stimulation served as the independent variable. It was found that conventional fixation disparity represents only a small, constant fraction of the misalignment through the greater portion of the vergence range. However, when the misalignment is restricted to a small, central portion of the foveola, this relation changes drastically, and the fixation disparity can then be much larger than the fixation misalignment. During perfect fixation alignment of the foveal centers, there is always a significant amount of fixation disparity present. It is suggested that the large differences between fixation disparity and fixation misalignment are due to a fundamental, perceptual mechanism that is always at work during binocular vision, changing the relation between retinal location and perceived visual direction. PMID- 3976833 TI - Flicker electroretinograms and visual evoked potentials in the evaluation of laser flash effects. AB - Electroretinograms (ERG's) and visual evoked potentials (VEP's) were recorded from four cynomolgus monkeys in response to a sinusoidally flickering argon laser beam (514 nm) producing a 50-micron spot on the fovea. Super-position of a 20-Hz train of six pulses of Q-switched (120 ns) frequency-doubled neodymium laser light (532 nm) at "safe" exposure energies in 250 ms had no significant effects on the ERG (p greater than 0.05). The VEP was disrupted significantly (p less than 0.001) but demonstrated recovery within 500 ms of the initial pulse. Therefore, flash effects of pulsed visible lasers at these doses on suprathreshold luminance processing are probably limited only to the exposure period. PMID- 3976834 TI - Are vitreous asteroid bodies associated with diabetes mellitus? AB - Twenty-seven subjects having vitreous asteroid bodies were matched for age and sex with control subjects. The results of random blood glucose analysis and 2-hr glucose tolerance tests were used to determine the presence of diabetes mellitus or impaired glucose tolerance. Five of the subjects having asteroid bodies were diabetic and four had impaired glucose tolerance. In the control group there were no diabetics; however, three subjects had impaired glucose tolerance. These results confirm that a relation exists between the occurrence of vitreous asteroid bodies and diabetes mellitus (p = 0.036). There was no statistically significant difference between random blood glucose levels of the two cohorts. Four of the five diabetics were excluded from the 2-hr glucose tolerance tests; however, for the remainder of the asteroid body group, there was no significant difference in the results of this test compared with the control group. These results suggest that the relation between asteroid bodies and diabetes may not be dependent on blood glucose levels. Diabetics having asteroid bodies may form a special subgroup of the disease in which there is accelerated degeneration and mineralization of collagen associated with increased intraocular vascular permeability. PMID- 3976835 TI - Clinical measures of visual function in familial retinitis pigmentosa. AB - Visual function and ocular structures were evaluated in a family with retinitis pigmentosa (RP) by dark adaptometry, electroretinography (ERG), perimetry, and fundus photography. All members examined showed gross rod dysfunction by dark adaptometry and ERG. The inferior and nasal segments of each patient's retina showed denser accumulations of pigment than the other segments. All patients showed superior field losses, the extent of which was correlated with the age and sex of the individual. The clinical impression formed from the assessment of visual fields in this sample was that males are more severely affected than females. PMID- 3976836 TI - Visual performance and reading capacity of partially sighted persons in a rehabilitation center. AB - Visual acuity and reading performance of 178 partially sighted patients from a rehabilitation center were measured using a TV text display device. A linear relation was demonstrated between visual acuity and reading speed for patients with visual acuity values below 15% of the normal value. With respect to reading performance, three groups of partially sighted patients could be distinguished: (1) 25% of the patients are unable to read visually and require tactile reading aids; (2) 50% are partially sighted and require high-magnification electronic reading aids; (3) 25% can read normal text by using optical magnifying devices. There is evidence that reading performance is related to the nature of the underlying ocular problem, such as refractive anomalies, macular degeneration, or other diseases. PMID- 3976837 TI - Intraocular pressure, ocular pulse pressure, and body position. AB - Intraocular pressures (IOP's) were measured using the Digilab Pneuma-tonometer with the subject in both the sitting and supine positions. The IOP with the Pneuma-tonometer was greater (17.03 mm Hg) in the supine position than in the sitting position (12.90 mm Hg). The IOP measured with the Pneuma-tonometer, with the subject sitting, was similar to the IOP measured with the Goldmann applanation tonometer (13.42 mm Hg). Inasmuch as IOP tends to be lower with the patient in a sitting position, the clinician should be alert to the possibility that some patients with borderline Goldmann IOP's may have pressures well above the normal range when they are lying down. Due to the continuous recording provided by the Pneuma-tonometer, the ocular pulse pressure can be measured. We found a mean ocular pulse pressure amplitude of 1.77 mm Hg. All values are shown plus or minus 1 SD. Comparison of the ocular pulse pressure amplitude for the two eyes could aid in detecting patients with suspected carotid artery stenosis. PMID- 3976838 TI - Three-way comparison of retinoscopy, subjective, and Dioptron Nova refractive findings. AB - On the basis of routine clinical findings taken on a group of 100 patients serving as subjects in the Houston Myopia Control study, a three-way comparison was made between retinoscopy, subjective, and Dioptron Nova refractive findings. Retinoscopy and subjective findings compared very favorably, mean differences being -0.01 D for spherical equivalent power and -0.05 D for cylinder power. Dioptron and retinoscopy findings differed by -0.30 D for spherical equivalent power and -0.13 D for cylinder power, whereas Dioptron and subjective findings differed by -0.33 D for spherical equivalent power and -0.18 D for cylinder power. PMID- 3976839 TI - An unusual ocular presentation of multiple sclerosis. AB - An unusual presentation of visual loss in multiple sclerosis is reported. The case is also noteworthy because the patient's presenting complaint appeared to be the result of insufficient or fatiguing accommodation. Had an unsuspected visual loss not been detected, the patient's management may have been inappropriate until more debilitating symptoms of the underlying cause became apparent. PMID- 3976840 TI - Reduced sialylation of podocalyxin--the major sialoprotein of the rat kidney glomerulus--in aminonucleoside nephrosis. AB - In this study the sugar composition of podocalyxin was determined in puromycin aminonucleoside-treated (PAN) rats and controls. Podocalyxin from both control and PAN rats bound 125I-WGA and 125I-peanut lectin (the latter only after neuraminidase treatment) on nitrocellulose transfers. Purified podocalyxin from both control and PAN rats was found to contain sialic acid, Gal, GlcNac, and Man but lacked Fuc and GalNac by gas-liquid chromatography. In PAN rats the sialic acid content of podocalyxin was reduced from 4.5% to 1.5%, whereas the concentration of the other sugars (with the possible exception of Gal) was similar to that of controls. The density of podocalyxin on the epithelial cell surface was estimated after immunogold labeling with anti-podocalyxin IgG, and no differences were found between PAN rats and controls. These data indicate that the reduced total glomerular sialic acid content found in PAN is due to the combined effects of the decreased podocyte plasmalemmal surface area and the reduced sialic acid content of podocalyxin. PMID- 3976841 TI - Diethylstilbestrol inhibits tumor growth and prolactin production in rat pituitary tumors. AB - Treatment of rats bearing transplantable MtT/W15 tumors with 10 mg of diethylstilbestrol (DES) for 3 weeks led to inhibition of tumor growth. The inhibition of tumor growth was reversible after removal of the DES. Histologic examination revealed decreased mitotic activity; however, DES did not produce cell necrosis. Concomitantly, the anterior pituitary glands of animals treated with DES became hyperplastic, with an increased number of prolactin (PRL) producing cells. DES resulted in a decreased number of PRL cells in the tumor and decreased serum PRL/tumor weight, compared with that of control rats. There was also an increase in the number of growth hormone (GH) tumor cells and an increased serum GH/tumor weight. 17 beta-Estradiol had an effect similar to that of DES, while progesterone did not inhibit tumor growth or cause pituitary cell hyperplasia. Ovariectomy resulted in a decrease in the tumor growth rate, compared with that of control animals, suggesting that the MtT/W 15 tumors are relatively dependent on estrogens for optimal growth. These results indicate that DES inhibition of MtT/W 15 tumor growth is an excellent model for study of the mechanism of the inhibition of tumor growth and the modification of GH and PRL expression by the tumor cells. PMID- 3976842 TI - The cytopathologic effects of specific aromatic hydrocarbons. AB - A heterogeneous mixture of the aromatic hydrocarbons benzene, toluene, and xylene is capable of inducing cellular lesions among selected organs of the fat-head minnow at the respective concentrations of 10.7, 7.4, and 2.7 mg/l. The gill, pseudobranch, liver, and nasal mucosa of experimental fish were exposed for a period of 6, 12, 24, or 48 hours to the hydrocarbons, whose source was the water soluble fraction of jet aviation fuel JP-4. While many of the initial cellular changes appeared reversible, the extent and magnitude of injury increased as the exposure period progressed, with an apparent concomitant development of irreversible lesions. Manifestations of cytotoxicity among cells of the gill included multivesiculated blebs, distended mitochondria, intercellular spaces between surface and underlying epithelial layers, and evaginations of the endothelial lining associated with capillaries of secondary lamellae. Cells comprising the pseudobranch were characterized by a significant increase in lipidlike droplets, proliferation of cytoplasmic vacuoles, and disruption of the normally ordered association of mitochondria and tubules. The nasal mucosa was characterized by a loss of cilia and cellular necrosis within the underlying epithelial layers. Cytotoxicity among hepatocytes was evident in the forms of vesiculated endoplasmic reticulum and both swollen and condensed mitochondria. PMID- 3976843 TI - Effects of the aminonucleoside of puromycin on glomerular epithelial cells in vitro. AB - Glomerular epithelial cells (GECs) in vitro provide a useful model for the study of the mechanism(s) underlying the nephrotic syndrome of rats induced by the aminonucleoside of puromycin (PAN). Some of the toxicities of PAN are nonspecific, in that the constituent molecules of PAN (adenosine and puromycin) cause similar effects in vitro. These include GEC blebbing and rounding, reduced uptake of precursors of protein (leucine) and glycoprotein (glucosamine) synthesis, and increased permeability of the GEC membrane to adenosine. Some of the effects of PAN are not reproduced by adenosine or puromycin and are inhibited by the simultaneous presence of N6-monomethyl adenosine (MMA), a PAN analog and an in vivo blocker of nephrosis due to PAN. These processes may be related to the nephrotic syndrome and include the loss of adhesion to plastic; a reduction in the incorporation of 14C-glucosamine and 35S-sulfate both into molecules removable from the GEC surface by neuraminidase and into those moieties precipitated from the culture media by TCA; a marked reduction in the "ordering" of the lipids of the rigid GEC membrane, which is possibly dependent upon cell surface proteins. These morphologic alterations in GECs and in the distribution of negatively charged molecules, which are either secreted or on the cell surface, correlate with observations made in PAN-induced nephrosis in rats in vivo. These include changes in the turnover and the array of sialic acid and heparan sulfate glycoprotein on the GECs and the glomerular basement membrane. The in vitro sensitivity of GECs to PAN and the effects of MMA suggest a role for these cells in in vivo aminonucleoside nephrotoxicity, where alterations in both the morphology and the anionic topology of GECs participate in the development of proteinuria. PMID- 3976844 TI - Streptococcus mutans-induced nephritis in rabbits. AB - Intravenous administration of disrupted Streptococcus mutans into rabbits over 23 76 weeks led to severe nephritis involving glomeruli, tubules, and interstitium. Light-microscopic observation of glomeruli documented diffuse endocapillary proliferative glomerulonephritis accompanied often (65%) by epithelial crescents. Electron-microscopic observation revealed humps in glomeruli of 70% of kidney specimens. In the glomeruli of some rabbits, extensive fibrin deposits and sclerosis were evident. Immunofluorescence showed linear, granular, often ribbonlike or patchy immune deposits encompassing, in order of decreasing frequency, C3, IgG, streptococcal antigen, IgA, and IgM. The histopathologic and immunohistologic features of the nephritis seen in rabbits given S mutans thus shows many features of Streptococcus-associated nephritides in man, in particular, the diffuse glomerular nephritis encountered in subacute bacterial endocarditis. Further, analysis of nephritis induced by administration of S mutans may have implications for the evaluation and purification of dental caries vaccines. PMID- 3976845 TI - Changes in the macrophage content of lung metastases at different stages in tumor growth. AB - The macrophage content of experimental B16 melanoma metastases at different stages of their growth has been quantified with the use of morphometry in conjunction with a recently developed histochemical method for selectively staining intratumoral macrophages. Data are presented from analyses of 954 sections of 155 individual lung metastases, showing that the macrophage content of individual B16 melanoma lung metastases not only varies significantly but also falls dramatically once metastases contain more than 700 tumor cells. In addition to providing new information on host response reactions of micrometastases, these experiments also indicate that conclusions on intratumoral macrophages derived from studies of large primary tumors and metastases in advanced stages of growth may have little or no relevance to events in micrometastases. PMID- 3976846 TI - Vesicular uptake of eosinophil peroxidase by guinea pig basophils and by cloned mouse mast cells and granule-containing lymphoid cells. AB - Guinea pig basophils, cloned mouse mast cells, and cloned mouse granule containing lymphoid cells were found to utilize a vesicular transport system to internalize eosinophil peroxidase (EPO) added in vitro. Kinetic analysis indicated that EPO internalization involved the binding of EPO to the plasma membrane, the formation of complex surface invaginations, and the movement of EPO laden vesicles, tubules, and vacuoles toward the center of the cells. EPO became associated with multivesicular bodies in granule-containing lymphoid cells and mast cells, with immature granules in mast cells, and with mature granules in basophils. In other cells, the endogenous production of granule peroxidases (neutrophils and eosinophils) or the prior uptake of exogenous peroxidatic substances (some basophils) precluded cytochemical analysis of granules for EPO. Vesicular transport of EPO provides a possible explanation for the variable detection of peroxidase activity in mast cells or basophils. It also provides a mechanism for sequestration of this potentially toxic material or for its storage for possible future use. PMID- 3976847 TI - Myocardial response to infarction in the rat. Morphometric measurement of infarct size and myocyte cellular hypertrophy. AB - For determination of the effects of myocardial infarction on the recovery potential of muscle mass in the surviving tissue, ligation of the left coronary artery was performed in 3-month-old rats, and the infarcted ventricles were analyzed morphometrically a month after surgery. Comparisons were made with 4 month-old control rats that underwent sham operations and with 3-month-old control rats that were not operated upon for evaluation of the magnitude of infarct size and discrimination of the relative contribution of tissue growth that occurred in the surviving myocardium solely as a result of the change in age, from 3 to 4 months (postoperative tissue growth, or POTG), from the additional growth induced by infarction (hypertrophic growth, or HG). Coronary occlusion induced a 276-cu mm loss of ventricular tissue volume that corresponded to 43% of the total left ventricular mass, 648 cu mm. Over a 30-day period the remaining 372 cu mm of viable tissue expanded by 90% with an overall volume gain of 334 cu mm. This tissue augmentation consisted of 20% POTG, 67 cu mm, and 80% HG, 267 cu mm. Total myocyte volume increased 89%, from 302 cu mm to 571 cu mm, and average myocyte cell volume per nucleus increased 92%, from 16,500 cu mu to 31,600 cu mu. The expansion of the myocyte mass was the result of a 21% POTG and a 79% HG. Corresponding values for the myocyte population were 19% and 81%. PMID- 3976848 TI - Idiopathic torticollis. Torticollis in white Pekin ducks. PMID- 3976849 TI - Canal wall for cholesteatoma: up or down? Long-term results. PMID- 3976850 TI - Vitamin D deficiency and deafness: 1984 update. AB - Vitamin D deficiency has been diagnosed in 27 patients with bilateral deafness in a period of just over 3 years. It should be considered in the differential diagnosis of unexplained bilateral cochlear deafness and may be important in the origin of some cases of otosclerosis, presbyacusis, and the deafness associated with chronic renal failure. Treatment should prevent progressive hearing loss, which may occasionally be partly reversible, and the development of clinical osteomalacia with more generalized skeletal symptoms. PMID- 3976851 TI - Surgical treatment of Meniere's disease. PMID- 3976852 TI - Zinc and presbycusis. PMID- 3976853 TI - Recurrent and residual cholesteatoma. PMID- 3976854 TI - Congenital cholesteatoma today. PMID- 3976855 TI - Intact canal wall for cholesteatoma. PMID- 3976856 TI - Homograft ossicles in middle ear surgery. PMID- 3976857 TI - Sodium fluoride as a treatment for otosclerotic hearing loss. PMID- 3976858 TI - Osteoplastic epitympanotomy. Tympanoplasty types I, II, III: a review of 15 years of experience. PMID- 3976859 TI - Current status of fluoride therapy for otosclerosis. PMID- 3976860 TI - Stapedectomy technique and results. PMID- 3976861 TI - "Stapedotomy" technique and results. PMID- 3976862 TI - Stapedotomy technique and results. PMID- 3976863 TI - Robinson stainless steel stapes prosthesis: technique and results. PMID- 3976864 TI - Repair of bony canal wall defects in tympanomastoid surgery. PMID- 3976866 TI - Reporting results in tympanoplasty. PMID- 3976865 TI - Personal experiences with TORPs and PORPs. A report on 455 operations. PMID- 3976867 TI - Obliterative procedures in cholesteatoma surgery. PMID- 3976868 TI - GM allotypes in Native Americans: evidence for three distinct migrations across the Bering land bridge. AB - We report the results of typings, for immunoglobulin G allotypes, of 5392 Native Americans from ten samples, the typings having been performed over the last 20 years. Four cultural groups are represented: the Pimans-Pima and Papago; the Puebloans-Zuni and Hopi; the Pai-Walapai; and the Athabascans-Apache and Navajo. The haplotype Gm1;21 has the highest frequency in each population while Gm1,2;21 is polymorphic in all except the Hopi. The Mongoloid marker Gm1;11,13 is found primarily in the Athabascans. The Caucasian haplotype Gm3;5,11,13 is found at polymorphic frequencies in several of the populations but its frequency is very low or absent among nonadmixed individuals. Although Nei's standard genetic distance analysis demonstrates genetic similarity at the Gm and Km loci, the heterogeneity that does exist is consistent both with what is known about the prehistory of Native Americans and traditional cultural categories. When the current Gm distributions are analyzed with respect to the three-migration hypothesis, there are three distinct Gm distributions for the postulated migrants: Gm1;21 and Gm1,2;21 for the Paleo-Indians 16,000 to 40,000 years ago; Gm1;21, Gm1,2;21, and Gm1;11,13 for the second wave of Na-Dene hunters 12,000 to 14,000 years ago; and Gm1;21 and Gm1;11,13 for the Eskimo-Aleut migration 9,000 years ago. The Pimans, Puebloans, and the Pai are descendents of the Paleo Indians while the Apache and Navajo are the contemporary populations related to the Na-Dene. Finally, the Gm distribution in Amerindians is found to be consistent with a hypothesis of one migration of Paleo-Indians to South American, while the most likely homeland for the three ancestral populations is found to be in northeastern Asia. PMID- 3976869 TI - Patterns of dental wear in the Lengua Indians of Paraguay. AB - Wear patterns were examined on dental casts of 202 living Lengua Indians from the Chaco area of Paraguay. Consideration was given to the development of the molar helicoidal plane, age-related changes in occlusal attrition, coalescence of dentine exposures, interproximal attrition, and erupted crown height. This study lends support to Osborn's theory of the helicoidal plane development by showing that attrition enhances rather than modifies posteruption molar occlusal planes. The rate of interproximal attrition was found to slow down with the eruption and functional initiation of the third molars. Sinuous and cavo-convex interproximal contact areas that are generated with age, however, appeared to be less abrasion resistant than straight surfaces, hence leading to an increase in interproximal attrition rates with advanced age. Maximum crown height reduction occurred between the ages of 20 and 40 years in central incisors, canines, and first molars. Kruskal-Wallis tests and log linera models failed to demonstrate significant sexually dimorphic or antimeric differences in wear patterns of Lengua teeth. PMID- 3976870 TI - A statistical test for differences in sexual dimorphism between populations. AB - Many studies involve comparison of measures of sexual dimorphism between two samples. This comparison is used to test a variety of hypotheses, such as changing environmental conditions. Methods for testing the significance of the difference between two populations tend to be complex, and/or require access to complete original data. We offer a simplified approach which is based on a linear regression model using dummy variables. Our method is computationally simple and can be used with summary statistics (sample size, means, standard deviations) instead of raw data. We present three examples of the application of our method to problems in physical anthropology. We also note that our method has a broader range of applications apart from that of sexual dimorphism. PMID- 3976871 TI - A population genetic study in the Ochamchir region, Abkhazia, SSR. AB - The reported longevity of residents of the Soviet Socialist Republic of the Caucasus has focused considerable attention on this population. However, little is known of the genetic composition of this population. With this in mind, several village populations of the Ochamchir Region, Abkhazia, SSR, were typed for 37 discrete genetic blood groups, erythrocyte and plasma protein loci. Gene and haplotype frequencies calculated for the polymorphic markers were determined and the results used in an analysis of intervillage heterogeneity and genetic distance analysis comparing the Abkhazians to European and Asian reference populations. The Abkhazians are approximately equal distance from European and West Asian populations in a genetic sense, and this is consistent with their geographical location. In addition to the usual genetic polymorphisms, rare electrophoretic variants were encountered at the lactate dehydrogenase A and phosphohexose isomerase loci. These results suggest that the population of the Ochamchir Region is relatively homogeneous and not distinctly different from its geographical neighbors. PMID- 3976872 TI - The skeleton of early Eocene Cantius, oldest lemuriform primate. AB - A recently discovered partial skeleton of the adapid Cantius trigonodus from the early Eocene Willwood Formation of the Bighorn Basin, Wyoming, documents substantial new information about the anatomy of the oldest lemuriform primates. It is very similar in all features to its descendant, middle Eocene Notharctus, and both exhibit numerous resemblances to certain extant Malagasy lemurs, particularly Lepilemur, Propithecus, Lemur, and Hapalemur griseus. Like these forms, Cantius had relatively long hind limbs and short forelimbs. Forelimb traits (prominent brachialis flange of the humerus, well-developed olecranon process of the ulna, and strong shafts of the ulna and radius) suggest active use of the forelimbs in progression. Specializations in the hind limb (e.g., expanded articular surface of the femoral head, narrow and elevated patellar trochlea and prominent lateral trochlear ridge, posteriorly oriented femoral and tibial condyles, narrow and elongate talus, and hallucal metatarsal with prominent peroneal tubercle) indicate capabilities for leaping and for powerful grasping with an opposable hallux. Cantius was presumably primitive in having a relatively long ischium and much more distal inferior tibial tuberosity than most extant lemurs--traits suggesting that powerful extension of the thigh and flexion at the knee were important in its locomotion and posture. We interpret Cantius as an active arboreal quadruped with a propensity for leaping. The existence of this skeletal structure in one of the oldest primates of modern aspect suggests that it represents the primitive lemuriform morphology. PMID- 3976873 TI - The design of a parallax-correcting anthropometer for replication in nonspecialized machine shops. AB - A fixed-rod, slider with a window, a double-scribed line for viewing a measuring tape affixed to the rod, and a sturdy footpiece are design features of an anthropometer for measuring projected lengths. The new instrument is designed to replace contemporary models which may be inaccessible to investigators with limited budgets or currency restrictions. None of the design features are beyond the ingenuity of local machinists to modify, find alternate materials, and use different machine procedures. The same principles of construction can be applied in making sliding calipers with straight and recurved branches. While there is some loss in portability of the fixed-length anthropometer, the improved stability and superior visual scale more than compensate for the disadvantages and make the new anthropometer a candidate for the instrument of choice in obtaining projected length measurements. PMID- 3976874 TI - The modeling methodology forum: an expanded department. PMID- 3976875 TI - Synthesis and binding of lactose-specific lectin by isolated lung cells. AB - Neonatal maturation of alveolar structure in rat lung temporally coincides with the peak activity of a beta-galactoside-specific endogenous lung lectin of the type that has been linked to developmental processes in other tissues. To learn more about the lung lectin we examined four cell types for their ability to synthesize and bind the lectin. Cultured lung fibroblasts and pulmonary artery endothelial cells synthesized and bound the lectin, alveolar macrophages bound but did not synthesize it, and alveolar epithelial type II cells neither bound nor synthesized it. Pulmonary macrophages made a different lactose-binding protein that did not agglutinate or bind trypsin-treated red blood cells, a property of lung lectin that is the means of its assay. PMID- 3976876 TI - Temperature-dependent physiological stability of rat skeletal muscle in vitro. AB - Stability of rat skeletal muscle contractile properties with time in vitro as a function of incubation temperature was characterized. Female Sprague-Dawley rats (8 wk, 148 g) were anesthetized with pentobarbital sodium (40 mg/kg, ip). Intact soleus (SOL) and extensor digitorum longus (EDL) muscles of 70- to 90-mg mass were removed and studied at incubation temperatures of 20, 25, 30, 35, and 40 degrees C. The average muscle thickness was 2.0 mm. Each muscle was studied at one temperature only. At 5, 15, 30, 45, and 60 min following immersion in an oxygenated Krebs-Ringer bicarbonate solution, isometric contractile properties were measured. Peak twitch tension, maximum tetanic tension, and rate of tension development of both SOL and EDL muscles were stable with time at 20 and 25 degrees C but decreased with time as a function of bath temperature above 25 degrees C. The calculated critical radius for O2 diffusion declined from 1.19 mm at 20 degrees C to 0.51 mm at 40 degrees C. For SOL and EDL muscles incubated at 25 degrees C, the histochemical demonstration of glycogen content was similar to that of fresh muscles, whereas muscles incubated at 40 degrees C showed staining for glycogen only in peripheral fibers. Observed and calculated results both infer a progressively larger hypoxic core at incubation temperatures above 25 degrees C. PMID- 3976877 TI - Comparison of isolated cells from liver, colon, and kidney of guinea pig. AB - Liver cells, colon epithelial cells, and kidney tubule fragments were isolated from guinea pig using methods previously employed in the rat. All three cell preparations exhibited well-preserved structure. Respiration was highest in kidney tubule fragments (25 nmol O2/mg protein X min) and was well coupled in all preparations. When cells were incubated at 37 degrees C, they accumulated K+ in a ouabain-sensitive manner. Incorporation of [3H]phenylalanine and [3H]uridine into acid-precipitable material proceeded linearly over at least 40 min. The cytochrome P-450 content (175 pmol/mg cell protein) and activity (aminopyrine demethylation) of liver cells exceeded that of the other two preparations 15- to 20-fold. The results indicate good maintenance of function in all three preparations. Because guinea pig epithelial cells exhibit some advantages over isolated cells from other species, the present preparations are well suited for comparing the cell physiology of the respective organs. PMID- 3976878 TI - Phosphorus nuclear magnetic resonance of fast- and slow-twitch muscle. AB - Phosphorus nuclear magnetic resonance (NMR) spectra were obtained at 109.3 MHz from isolated, arterially perfused cat biceps brachi (greater than 75% fast twitch, glycolytic fibers) and soleus (greater than 92% slow-twitch, oxidative) muscles at 30 degrees C. The perfused muscles were stable with respect to O2 consumption, twitch characteristics, and ATP and phosphocreatine (PC) levels for up to 10 h. NMR spectra showed a higher PC/Pi ratio in the biceps (11) than in the soleus (1.7). Relatively higher Pi levels were observed in extracts of clamp frozen muscles than in the intact muscles. This difference could be accounted for by artifactual hydrolysis of PC during muscle freezing. Based on the NMR and chemical data, the free cytosolic ADP level, calculated from the creatine kinase equilibrium, was 14 microM in the soleus and less than 1 microM in the biceps. Intracellular Pi concentration was 10 mM in the soleus and 3 mM in the biceps. Intracellular pH, estimated from the chemical shift of phosphate or 2 deoxyglucose 6-phosphate, was 7.0 in both muscles (perfusate pH 7.2). Both extracellular space and pH measurements were obtained from NMR spectra of muscles perfused with 10 mM sodium phenylphosphonate added to the perfusate. These results document larger differences in the phosphate metabolites in the two types of mammalian muscles than previously reported. PMID- 3976879 TI - Hormonal control of gap junctions in the myometrium. AB - Myometrial tissues from immature, ovariectomized mature, and pregnant rats were examined by thin-section or freeze-fracture electron microscopy for the presence of gap junctions following treatment with steroid hormones and inhibitors of prostaglandin synthesis. Gap junctions were present in the myometrium of immature rats after repeated injections of estradiol or diethylstilbestrol (500 micrograms/day). The frequency of gap junctions in immature rats after estradiol treatment was similar to that found during delivery. Concomitant administration of indomethacin or meclofenamate with estradiol (50 and 500 micrograms/day) for 3 or 4 days enhanced the effect of estradiol on gap junctions. Progesterone depressed the response of 500 micrograms/day estradiol and both 50 and 500 micrograms/day doses of estradiol when administered together with the inhibitors of prostaglandin synthesis. Gap junctions were also present in the myometria of ovariectomized mature rats after treatment with estradiol by itself or together with indomethacin, and these effects were suppressed by concomitant progesterone administration. These results indicate that the steroid hormones and prostaglandins may interact to modulate the presence of gap junctions in the myometrium. PMID- 3976880 TI - Phosphagens and intracellular pH in intact rabbit smooth muscle studied by 31P NMR. AB - Phosphorus-31 nuclear magnetic resonance (NMR) spectra (103.2 MHz) were obtained from rabbit portal vein, urinary bladder, and taenia coli smooth muscle. The muscles were mounted isometrically as strips in a horizontal probe and superfused with oxygenated medium at 23 degrees C. Under these conditions the preparations could remain in a stable metabolic state for at least 24 h. The resonances observed represented phosphocreatine (PC), adenosine triphosphate (ATP), and phosphomonoester. The PC-ATP ratio in relaxed preparations was approximately 1.9 (bladder) and 1.4 (taenia coli), approximately consistent with chemical analysis of tissue extracts by isotachophoresis. However, the levels of adenosine diphosphate (ADP) and inorganic phosphate (Pi) were considerably lower as estimated by NMR, suggesting intracellular compartmentalization. Contraction for 30 min in high-K+ medium caused a reversible 10-30% decline of PC but no change in ATP. Intracellular pH was 7.0 +/- 0.1 and was unchanged by contraction or inhibition of tissue respiration by cyanide. Treatment with 2-deoxyglucose resulted in accumulation of 2-deoxyglucose 6-phosphate, verifying the pH assignment. However, the phosphomonoester resonance of normal spectra is not glucose 6-phosphate. Treatment with Mg2+-free, high-Mg2+ (10 mM), or hyperosmotic media did not alter the Mg2+ saturation of ATP. The results obtained by the nontissue-destructive 31P-NMR measurements are consistent with the view that metabolic steady-state conditions are maintained during contraction in the smooth muscle. PMID- 3976881 TI - Effect of duration of stimulation and pH on energetics of rabbit rectococcygeus muscle. AB - The mechanical and energetic performance of the rabbit rectococcygeus preparation have been studied at 27 degrees C. Energy flux has been measured either myothermically (heat production) or by recording the O2 consumption and lactate production of the muscle. The maximal active-to-basal O2 consumption ratio was 2.42. The peak oxidative energy flux was 3.5 mW/g, and the peak initial rate was about 5.0 mW/g. We could find no evidence for an increment in lactate production associated with mechanical activity. The effects of increasing the stimulus duration on the "economy" of force maintenance was assessed by plotting the heat to-tension ratio against duration. For stimulus periods up to 20 s there was no evidence of a change in the economy: the slope of the relationship was similar in myothermic and O2 consumption experiments with split muscles. When total heat production was plotted against the stress-time integral for stimulus periods up to 60 s at both pH 7.4 and 6.7, there was no change in energy usage in the longer duration tetani (2-60 s). However, the reduction in pH, which had minimal mechanical effects other than prolonging relaxation, did slow the rate of evolution of recovery heat (time constant doubled) and reduced the rate of O2 consumption. It is concluded that the rectococcygeus preparation cannot make use of the energy-saving mechanisms that operate in arterial and several invertebrate smooth muscles. PMID- 3976882 TI - Androgens in male rat reproductive tract fluids: hypophysectomy and steroid replacement. AB - The control of androgen concentrations in the intraluminal fluids of the male reproductive tract is not well understood. The present experiments were performed to determine the effects of hypophysectomy, hypophysectomy plus testosterone (T), and hypophysectomy plus pregnenolone treatment on intraluminal androgen concentrations in the adult rat testis and epididymis. T and 5 alpha dihydrotestosterone (DHT) concentrations were determined in the vascular, interstitial, and intraluminal compartments of the epididymis. Testicular and epididymal morphology also were examined under light microscopy. Hypophysectomy of at least 5 days duration significantly reduced T and DHT concentrations in serum, tissues, and intraluminal fluids of the reproductive tract. T replacement for 14 days, which produced peripheral T concentrations of 5 ng/ml, did not support intraluminal androgen concentrations in the seminiferous tubules equivalent to controls; rete testis androgen concentrations were similar to controls, however. Pregnenolone administration at 2 mg X rat-1 X day-1 for 14 days did not maintain spermatogenesis nor intraluminal T concentrations in the seminiferous tubules equivalent to controls; however, a low level of spermatogenesis continued when intraluminal and tissue androgen concentrations were maintained at 10-20% of controls by either the testosterone and pregnenolone treatments. PMID- 3976884 TI - CSF vasopressin rhythm is effectively insulated from osmotic regulation of plasma vasopressin. AB - By using our method for continuous removal of cisternal cerebrospinal fluid (CSF) and intermittent sampling of blood from unanesthetized freely moving cats, we investigated the effect of osmotic-induced changes in plasma vasopressin on the daily rhythm of CSF vasopressin. Examination of the daily profiles of vasopressin and osmolality in the CSF and plasma of six euhydrated animals showed that CSF vasopressin concentrations exhibit a clear daily rhythm, whereas CSF osmolality and plasma vasopressin and osmolality do not exhibit such daily variation. A 48-h period of water deprivation caused marked sustained elevations in plasma vasopressin concentrations, which returned to basal levels on rehydration. In contrast, water deprivation had only a small effect on the CSF vasopressin rhythm. Although there was a significant elevation of the normally low nighttime CSF vasopressin levels during water deprivation in three of the four animals studied, high daytime vasopressin levels were unaltered and the daily rhythm was clearly evident before, during, and after the period of water removal in all animals. Changes between plasma vasopressin and osmolality were significantly correlated in all animals. Changes between plasma and CSF osmolality were significantly correlated in three of the four animals. The data indicate that the circadian regulation of the CSF vasopressin rhythm is effectively insulated from the osmotic regulation of plasma vasopressin. PMID- 3976883 TI - Carrier-mediated uptake of methylglyoxal bis(guanylhydrazone) by rat lungs perfused in situ. AB - Rat lungs perfused in situ were employed to begin investigations of the pathways by which the tissue takes up circulating polyamines (PA). Uptake kinetics were studied using [14C]methylglyoxal bis(guanylhydrazone) (MGBG), a nonmetabolized substrate analogue thought to enter cells via the PA carrier. Lungs concentrated MGBG from the perfusate at a linear rate for at least 60 min. Uptake was saturable with respect to perfusate MGBG concentration; it exhibited an apparent Km of 12.5 microM and Vmax of 0.6 nmol X g lung-1 X min-1. MGBG (1 microM) uptake was inhibited rapidly and to a similar extent (30-40%) by the naturally occurring PAs spermidine, spermine, or putrescine (50 microM); no additional inhibition of uptake was exerted when all three compounds were present simultaneously (total concentration, 150 microM). No inhibition by 5-hydroxytryptamine was evident. Spermidine produced a half-maximal inhibitory effect at a perfusate concentration of 1.9 microM (vs. 1 microM MGBG). The spermidine-insensitive component of MGBG uptake operated at a Vmax similar to that of the control (total), 1.2 nmol X g-1 X min-1, but the apparent Km was increased 3.5-fold to 44 microM. These observations indicate that MGBG is taken up from the pulmonary circulation by a high-affinity, carrier-mediated, concentrative uptake process that is inhibited, at least in part, by naturally occurring polyamines. PMID- 3976885 TI - Effects of glucocorticoid treatment on excitation-contraction coupling. AB - We studied the myofibrillar calcium affinity and mechanical threshold of single muscle fibers from the extensor digitorum longus (EDL) and soleus muscles of male Sprague-Dawley rats treated with daily intramuscular injections of dexamethasone, 1.5 mg/kg, for 14 days. The strength-duration and pCa-tension relationships of EDL fibers were not altered by glucocorticoid treatment. However, in soleus fibers the mechanical threshold was increased and the myofibrillar calcium sensitivity was reduced by dexamethasone treatment. Glucocorticoid treatment did not change the maximum tension per cross-sectional area of single-skinned EDL or soleus fibers. The glucocorticoid-induced atrophy and impaired force-generating capacity of fast-twitch muscle are probably not caused by impaired excitation contraction coupling. PMID- 3976886 TI - Effects of pancreatic polypeptide, caerulein, and bombesin on satiety in obese mice. AB - Congenitally obese mice are hyperphagic, suggesting that their obesity is secondary to defects in normal satiety mechanisms. The present study compares the effects of caerulein, bombesin, and pancreatic polypeptide (three equimolar doses each of 3, 9, and 27 nmol/kg) on food intake in 10 pairs of lean and obese mice. After the intraperitoneal injection of saline, obese mice eat 240% more of a liquid meal (Magnacal) than their lean littermates (P less than 0.01). All three doses of caerulein significantly inhibited food intake in both obese and lean mice. Although the highest dose of bombesin significantly decreased food intake in both obese and lean mice, the lowest dose was only effective in obese mice. In contrast, none of these doses of pancreatic polypeptide had a significant effect on food intake in either lean or obese mice. A dose of bovine pancreatic polypeptide of 200 nmol/kg was required to significantly reduce food intake in lean and obese mice. This study demonstrates that obese mice respond to satiety signals and may even be more sensitive than their lean littermates to some messengers. In addition, the previously described reversal of this obesity syndrome by pancreatic polypeptide in doses of approximately 2.5 and 25 nmol X kg 1 X day-1 is unlikely to be due to effects of this peptide on food intake. PMID- 3976887 TI - Gastrin-releasing peptide: effect on exocrine secretion and release from isolated perfused porcine pancreas. AB - The effect of gastrin-releasing peptide (GRP) on pancreatic exocrine secretion was studied by infusing it at four dose levels (0.01, 0.1, 1.0, and 10 nmol/l) into the arterial line of the isolated perfused porcine pancreas. At 1.0 nmol/l GRP stimulated protein (37-fold), fluid (13-fold), and bicarbonate secretion (12 fold). Atropine at 1 mumol/l diminished the protein secretion in response to infusion of GRP at a dose of 1 nmol/l to 45% of control. Fluid and bicarbonate responses were not affected by atropine treatment. Electrical stimulation of the vagus nerves resulted in an increase in pancreatic output of GRP and a concomitant stimulation of exocrine secretion. Infusions of acetylcholine, carbachol, pilocarpine, or dimethylphenylpiperazinium had no effect on the output of GRP, although hexamethonium abolished the response to vagal stimulation. It is concluded that GRP in conjunction with acetylcholine is likely to play a prominent part in parasympathetic regulation of pancreatic exocrine secretion. PMID- 3976888 TI - Localization of acid microclimate along intestinal villi of rat jejunum. AB - Considering the significance that pH value could have for digestive and absorptive processes, these investigations were aimed at precisely localizing the position of the acid microclimate, i.e., of proton accumulation along the surface of intestinal villi. The determinations were carried out under microscopic control on jejunal segments of rats incubated at 25 degrees C in O2-saturated phosphate buffer (pH 7.4). Specially manufactured antimony microelectrodes (tip diam 50 microns) and calomel reference electrodes were used for pH registration. Highest proton concentration (214-224 nmol/l not equal to pH 6.67-6.65) was found 10-100 microns below the tip of the villus in the zone of digestive and absorptive epithelial cells. Toward the crypt, a steep decrease of proton concentration was registered with alkaline values 200 microns below the villus tip. Toward the bulk phase, the decrease of the proton concentration was moderate due to the existence of the unstirred water layer as an effective diffusion barrier. The pH value of the bulk phase was reached 440 microns over the villus tip, a distance possibly identical to the thickness of the unstirred water layer. PMID- 3976889 TI - Opiate nerves mediate feline pyloric response to intraduodenal amino acids. AB - Intraluminal pressures and myoelectric activity were recorded from the feline antrum, pylorus, and duodenum in response to intraduodenal amino acid solutions. Mixed amino acids (0.02 mg/ml, 3.0 ml) increased the amplitude of pyloric contractions (59.7 +/- 7.9 mmHg) and pyloric spike activity (73.7 +/- 6.8% of slow waves with spike activity) compared with a saline control (P less than 0.001). The selectivity of these responses was determined with specific amino acids. L-Tryptophan (10 or 40 mM) produced a response similar to the mixed amino acid response, while L-phenylalanine or L-glycine (10 or 40 mM) had no effect. Intra-arterial tetrodotoxin, intraluminal ethyl aminobenzoate, or intravenous naloxone (1.0 mg/kg) abolished the pyloric responses to amino acids (P less than 0.02). Bilateral cervical vagotomy had no effect. Cholecystokinin octapeptide (CCK-OP) produced dose-dependent increases in the amplitude of pyloric contractions and in pyloric spike activity. The ED50 dose of CCK-OP (1.0 microgram/kg iv) gave an increase in pyloric pressure of 155.6 +/- 49.9 mmHg and in spike activity of 77.7 +/- 9.4%, similar to mixed amino acids or tryptophan. These effects of CCK-OP were not antagonized, however, by a dose of naloxone (1.0 mg/kg) that blocked the maximal pyloric response to leucine-enkephalin. We concluded intraduodenal mixed amino acids or tryptophan increase phasic, spike dependent pyloric contractions in the cat via nonvagal, naloxone-sensitive neural pathways, phenylalanine, a structurally similar essential amino acid, had no effect on the feline gastroduodenal junction, and the pyloric responses to exogenous CCK-OP are mediated by pathways distinct from the responses to tryptophan or mixed amino acids. PMID- 3976891 TI - Structure-activity relation among macrolide antibiotics in initiation of interdigestive migrating contractions in the canine gastrointestinal tract. AB - The relation between the chemical structure of commercially available macrolide antibiotics and their activity in inducing interdigestive migrating contractions (IMC) was studied in conscious dogs. It was found that the 14-membered macrolides erythromycin and oleandomycin are active in inducing IMC in the stomach in association with the endogenous release of motilin. These erythromycin- and oleandomycin-induced contractions in the stomach migrated through the small intestine in a caudad direction. Conversely, 16-membered macrolide antibiotics such as leucomycin, acetylspiramycin, and tylosin do not induce any contractions in the stomach or stimulate endogenous release of motilin. These findings suggest that the IMC-inducing activity in macrolides seems to be closely related to their chemical configuration, i.e., the structure of 14-membered macrolides with dimethylaminosugar (desosamine) bound at C-5 and neutralsugar at C-3 in glycosidic linkage in parallel is likely to be necessary for IMC-inducing activity. The mechanisms by which erythromycin and oleandomycin stimulate endogenous motilin release are not known. PMID- 3976890 TI - Studies of carnitine metabolism in relation to intestinal absorption. AB - We studied the postabsorptive fate of L-[3H]carnitine after intraluminal injection into the proximal intestine of anesthetized rats. Carnitine absorption was characterized by slow appearance in the circulation with blood levels still rising 2 h after administration. Absorption via the portal vein was followed by hepatic extraction and appearance in bile with reabsorption of a fraction, thus establishing an enterohepatic circulation. About half of the [3H]carnitine in blood obtained 4 h after administration was free, with the rest largely acetylcarnitine. In contrast the increase in blood carnitine content after intraluminal administration of unlabeled carnitine was almost exclusively limited to the esterified fraction. We hypothesize that release of esterified endogenous or stored carnitine from some other site accounted for the increase in esterified carnitine. The liver may be that site: although about 50% of hepatic [3H]carnitine was in ester form after administration of labeled carnitine, the increase after unlabeled carnitine was primarily in the free fraction, suggesting that a large amount of esterified carnitine had been released. Thus the liver appears to be an important storage and excretory site for exogenous as well as endogenous carnitine, which may be released with an appropriate signal from the intestine. PMID- 3976892 TI - Intestinal uptake and release of cobalamin complexed with rat intrinsic factor. AB - The mechanism of uptake of intrinsic factor (IF) and cobalamin (Cbl) by enterocytes and their subsequent fate have been uncertain. To examine this problem double-labeled IF X Cbl was added to small intestinal organ cultures. When 125I-IF X [57Co]Cbl was added to rabbit ileal explants, binding and internalization increased linearly for 24 h. After an 18-h chase with nonlabeled IF X Cbl, no 125I-IF returned to the cell surface. An amount of 35-45% of the internalized Cbl was found free, not bound to IF or any other protein. About 60% of both internalized ligands was bound to membranes but by a non-Ca2+-dependent bond, suggesting binding to a protein other than the brush-border receptor. Cobalamin was released from IF at pH 5.0 to the same degree (30%) as free Cbl was found inside the cell (35-45%). Neither pancreatic proteases nor ileal homogenates effected release of Cbl from IF. When cathepsins were added, the Cbl released was no greater than could be attributed to pH 5.0 alone. Chloroquine added to tissue explants did not alter the percentage of free intracellular Cbl. From these results we suggest that IF X Cbl is internalized and detached from the receptor within the enterocyte. The mechanism of release is not known but seems to require an acid pH (5.0). The Cbl is released in the mucosa, perhaps when the IF X Cbl complex enters a nonlysosomal cellular compartment with an acidic environment. There is no substantial recycling of IF to the brush-border membrane. PMID- 3976893 TI - Electrical properties of smooth muscle cell membrane of opossum esophagus. AB - The electrical properties of the circular smooth muscle layer from the North American opossum esophagus (body) were studied in vitro by microelectrode recording techniques, both at rest and during stimulation of intramural inhibitory nerves. All observations were made at 37 degrees C in an Abe-Tomita partitioned bath on muscle strips dissected 2 cm orad of the lower esophageal sphincter. At rest, the potential of the smooth muscle cell membrane was -49 +/- 4 mV (mean +/- SE); the length constant and the time constant were 2.0 +/- 0.6 mm and 120 +/- 16 ms, respectively. The inhibitory junction potential (IJP) elicited by stimulation of intramural nerves was followed by a "rebound" or "off" response, characterized by a membrane depolarization on which spikes were superimposed and concomitant mechanical activity of the preparation that usually caused dislocation of the recording microelectrode. The maximal IJP amplitude was 35 mV, and the response reversed at a membrane polarization to -90 mV, suggesting that the IJP was due to an increase of the permeability toward potassium ions. The invariability of the IJP latency at different distances from the stimulating electrodes (1.25-4 mm) suggests that the latency is largely due to diffusion of transmitter from nerve varicosities to postsynaptic receptor sites. Depending on the rate, prolonged stimulation caused fusion of IJP or a continuous hyperpolarization of the membrane. The hyperpolarization faded with time, but off responses were only observed after terminating stimulation. The passive electrical properties of the membrane are comparable with those of other gastrointestinal smooth muscles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976894 TI - Regional specificity of iron uptake by small intestinal brush-border membranes from normal and iron-deficient mice. AB - Fe(II)-ascorbate uptake by purified small intestinal brush-border membrane vesicles prepared from proximal and distal segments was studied in normal and iron-deficient mice. Iron was maintained in a reduced, soluble form by a 20-fold excess of ascorbate at a physiological pH of 7.2-7.4. In normal mice, iron uptake by proximal membrane vesicles was three- to fourfold greater (approximately 1,700 pmol/mg prot) than from distal segments (approximately 500 pmol/mg prot). In iron deficient mice, uptake of Fe(II) was also greater in proximal membranes (approximately 3,200 pmol/mg prot) than uptake from distal segments (approximately 350 pmol/mg prot), and the regional difference was almost 10-fold, without any change in distal segmental iron uptake. These results are consistent with the pattern of intestinal iron absorption in iron-replete and iron-deficient animals and indicate that regulatory changes in proximal intestinal brush-border membranes may account for the increased iron absorption known to occur in iron deficiency. PMID- 3976895 TI - How should we write multiple denominators? PMID- 3976896 TI - Weak electrolyte absorption modeling: comment on a contribution. PMID- 3976897 TI - Fluid uptake in the renal papilla by vasa recta estimated by two methods simultaneously. AB - Fluid uptake by vasa recta was determined by two independent methods, videomicroscopy and the micropuncture technique, in the exposed papilla of nine antidiuretic rats to reconcile differences in values previously obtained by the two techniques. Erythrocyte velocity (Vrbc) and diameter (D) in descending vasa recta (DVR) (n = 22) and ascending vasa recta (AVR) (n = 31) near the "base" of the papilla were measured. Using a conversion function determined in vitro, Vrbc was transformed into mean blood velocity (Vblood). From D and Vblood, mean blood flow (Q) in DVR and AVR was calculated. In DVR, mean Vrbc, D, and Q were 1.06 +/- 0.01 mm/s, 16.3 +/- 0.4 micron, and 10.6 +/- 1.4 nl/min, respectively. In AVR, each corresponding value differed significantly, 0.47 +/- 0.06 mm/s (P less than 0.001), 19.8 +/- 0.8 micron (P less than 0.001), and 5.65 +/- 1.3 nl/min (P less than 0.025), respectively. Blood samples from DVR and AVR were obtained by micropuncture from the same location. Plasma protein concentration (g/dl) was 5.1 +/- 0.6 in DVR, 4.0 +/- 0.4 (P less than 0.05) in AVR, and 3.6 +/- 0.3 (P less than 0.025) in the renal vein. Assuming no net transcapillary loss of protein, total plasma outflow exceeded inflow by 29%, the excess representing fluid uptake; and to reconcile the blood flow and plasma protein concentrations found, functioning AVR should outnumber functioning DVR by a ratio of 2.1-2.4 to 1, depending on local hematocrit. Given the total number of AVR + DVR = 2,944 (at the base), capillary fluid uptake was calculated to range between 1.5 and 2.6 microliter/min. PMID- 3976898 TI - Structural adaptation of the distal convoluted tubule to prolonged furosemide treatment. AB - Rats were treated with furosemide, continuously applied by implanted minipumps, for 6 days. As compensation for the salt lost with the urine the animals drank large amounts of a salt solution ad libitum. This procedure resulted in an enlargement of kidney cortex. Light and electron microscopic studies revealed a proliferation of the distal convoluted tubule (DCT). The proportion of the DCT in the cortical tissue increased from 5.98 +/- 1.3% in controls to 9.54 +/- 1.7% (P less than 0.01) in treated rats. Basolateral cell membrane amplification in DCT cells increased from 17.33 +/- 2.9 to 38.24 +/- 5.8 (P less than 0.0001) in treated rats, while luminal membrane area per unit tubular length did not change. The structural changes after furosemide treatment in the DCT suggest an increase in active transcellular transport capacity of this segment. It is assumed that the chronically altered Na load of the tubular fluid (due to transport inhibition in the thick ascending limb of Henle's loop) delivered to the DCT may specifically stimulate the transport capacity of this segment by augmentation of basolateral cell membrane area. The changes occurring in the segment situated downstream to the one in which the function is impaired by furosemide emphasize the role of tubular fluid composition in the regulation of transport function. PMID- 3976899 TI - Reabsorption and secretion of alpha-ketoglutarate along the rat nephron: a micropuncture study. AB - The transport of alpha-ketoglutarate (alpha-KG) across the luminal membrane of the rat nephron was studied by micropuncture and microassay techniques. In normal and acidotic rats, approximately 75% of the filtered alpha-KG was reabsorbed in the proximal tubule and 20% in the pars recta and/or loop of Henle at endogenous plasma concentration of alpha-KG. A progressive elevation to steady-state levels of plasma alpha-KG resulted in a progressive reduction of the fractional reabsorption of alpha-KG in the proximal tubule as well as in a progressive increase in the fractional reabsorption of alpha-KG in the pars recta and/or loop of Henle. At plasma alpha-KG concentration 20-40 times above normal, reabsorption of alpha-KG was found to be limited by a maximal tubular capacity. In alkalotic rats, net secretion of alpha-KG in the early proximal convoluted tubule, net reabsorption in the remainder of the proximal convoluted tubule, and net secretion in the pars recta and/or loop of Henle were observed. These micropuncture data indicate that, depending on the acid-base conditions, net reabsorption or net secretion of alpha-KG may occur in at least two distinct sites along the rat nephron. PMID- 3976900 TI - A distributed model of peritoneal-plasma transport: analysis of experimental data in the rat. AB - Transport of uncharged, water-soluble substances (ranging in molecular weight from 180 to 5,000) between the fluid in the peritoneal cavity and plasma was studied in anesthetized female Sprague-Dawley rats. In certain experiments the effect of fluid shifts on the transport was observed by manipulating the effective osmotic pressure or the hydrostatic pressure of the dialysis fluid. Parameters for the distributed model outlined in previous work were obtained from the experimental data for the substances tested. Capillary membrane transport was modeled by pore theory. A single pore radius of 40 A and a pore density of 600 cm 2 were satisfactory. Tissue diffusivities for these substances were found to correspond closely to those in the literature. Additional simulations were performed with a three-compartment model and the results were compared with those of the distributed model. PMID- 3976901 TI - An alternate method for estimating efferent arteriolar plasma colloid osmotic pressure. AB - The colloid osmotic pressure (COP) of efferent arteriolar plasma in glomerular dynamic studies generally is estimated from the measured protein concentration (CE) while the nephron filtration fraction (SNFF) is derived from CE and the systemic plasma protein concentration (CA) according to the equation SNFF = (1 - CA/CE). Estimates of both SNFF and COPE are quite sensitive to small errors in protein measurement, however, with a putative coefficient of variation of +/- 5% in protein measurement at a typical SNFF of 0.33, for example, providing an uncertainty (i.e., +/- SD) of +/- 14% in the SNFF estimate and +/- 2.4 mmHg in the estimated COPE value. In this study, we evaluated in vitro the precision with which the COP of plasma samples can be estimated after ultrafiltration by coupling direct oncometry of native plasma with isotopically measured filtration fractions derived employing nanoliter and microliter volumes and applying a modification of the equation of Ladegaard-Pedersen (Scand. J. Clin. Lab. Invest. 23: 153-158, 1969). The measured and estimated oncotic pressures were then compared. The mean differences between theoretic and measured COP values at filtration fractions of less than 0.1, 0.1-0.2, 0.2-0.3 and greater were: -0.4 +/ 0.8 (SE) (n = 22); 1.8 +/- 1.1; 3.9 +/- 1.0; and 6.0 +/- 1.7%, respectively. It is concluded that the coupling of direct oncometric measurement of arterial plasma colloid osmotic pressure with isotopically determined filtration fractions provides a satisfactory estimate of COPE that is suitable for studies of glomerular dynamics. PMID- 3976902 TI - Distribution of blood platelets flowing in arterioles. AB - The distribution of blood platelets flowing in arterioles (21-35 microns) of the mesentery of anesthetized rabbits was studied using intravital fluorescence microscopy. Sites were selected without upstream branch points within at least 10 vessel diameters. The distribution was determined by counting in flashed video frames the number of platelets present in each of six equal segments across the vessel. Only platelets were counted that could be localized objectively within a thin optical section around the median plane of the vessel. It could be shown that differences in counting volume between the six segments were negligible. Because of the use of flashed pictures (flash duration less than 0.1 ms; interval 180 ms), the method is independent of differences in velocity over the cross sectional area of the vessel. In all measurements (15 sites in 13 vessels in 10 animals) the distribution was nonuniform, the wall segments containing the highest platelet numbers. The general distribution as calculated from all measurements (total platelet number 6,571) and expressed in percentages was found to be 23.0, 14.6, 12.5, 12.1, 13.6, and 24.2. PMID- 3976903 TI - Negative chronotropic and parasympatholytic effects of alinidine on canine sinus node and AV junction. AB - The direct effects of alinidine (N-allyl-clonidine) on the sinus node and atrioventricular (AV) junction were studied in 18 anesthetized dogs. Stimulus frequency-response curves to right stellate ganglion and right cervical vagus stimulations as well as responses to norepinephrine or acetylcholine were determined before and after selective perfusion of alinidine into the sinus node artery. Alinidine (1 microgram/ml) had no effect on spontaneous sinus rate [148 +/- 5 (SE) beats/min]. However, alinidine concentrations of 5, 10, and 25 micrograms/ml produced significant (P less than 0.05) sinus slowing to 138, 127, and 121 beats/min, respectively. Recovery to control rate was dose dependent and took from 4 to 33 min. Sinus rate increases with right stellate stimulations were not affected by alinidine. However, sinus rate decreases with right vagal stimulations were significantly (P less than 0.01) attenuated by alinidine. The negative chronotropic effects of acetylcholine were not influenced by alinidine. Alinidine (1-100 micrograms/ml into AV node artery) had no effect on the A-H interval of the His bundle electrogram. However, alinidine (10 and 25 micrograms/ml) diminished the AV block produced by stimulation of the left vagus in electrically paced hearts but not the negative dromotropic actions of directly administered acetylcholine. Thus alinidine has direct negative chronotropic effects, no effect on sinus node responses to sympathetic stimulation, ability to diminish sinus node and AV junctional responses to vagal stimulations without interference at the cholinergic muscarinic receptor, and 4) no effect on AV nodal conduction. PMID- 3976904 TI - Creatine kinase and phosphorylase in cardiac lymph: coronary occlusion and reperfusion. AB - Cardiac lymph, collected from conscious dogs, was monitored for glycogen phosphorylase and creatine kinase (CK) enzymatic activity during control state, circumflex coronary artery (CFX) occlusion, and reperfusion. CFX occlusions, lasting for intervals as short as 10 min, initiated a release of phosphorylase and CK into the cardiac lymph, which was immediately observed during reperfusion of the ischemic tissue. Blood plasma levels did not appear for several hours. In the absence of reperfusion, the appearance of enzymes in cardiac lymph was delayed and peaked later. Glycogen phosphorylase and CK entered the lymph in greater quantities with reperfusion as the length of occlusion was increased. Histological examination of multiple sections of the reperfused hearts showed infarcts in hearts where CFX occlusions lasted 20 min or longer; occlusions of 10 15 min showed evidence of cell injury and death in two hearts and no definable infarct in the majority. Ischemic intervals of short duration release functionally active glycogen phosphorylase and CK, which reflect changes in myocardial cell egress of macromolecules and/or cell death. PMID- 3976905 TI - Effect of controlled ventilation on renal and splanchnic blood flows during nicotine. AB - The present study was undertaken to evaluate the influence of respiratory condition [free breathing (FB) vs. controlled ventilation (CV)] and of anesthetic [pentobarbital (PA) vs. chloralose (CA)] on nicotine-induced vasomotor responses in the renal cortex and splanchnic beds. Nicotine (36 micrograms . kg-1 . min-1 iv) was infused in four groups of dogs: group I, PA and CV; group II, PA and FB; group III, CA and CV; group IV, CA and FB. Regional vascular conductances (VC) were calculated from regional blood flows measured with 15-microns radioactive microspheres. In group I, VC fell in renal cortex (-22%) and pancreas (-52%), increased in liver (hepatic arterial bed +130%), and did not change significantly in duodenum and spleen. In group III, VC fell to a greater extent in renal cortex, pancreas, duodenum, and spleen than in group I; VC in hepatic arterial bed did not change. In FB dogs (groups II and IV), nicotine caused marked hyperventilation, but decreases in VC in renal cortex, pancreas, and duodenum were similar to those in CV dogs. Results indicate that during intravenous infusion of nicotine 1) hyperventilation does not attenuate or reverse vasoconstriction in renal cortex, pancreas, or duodenum under either PA or CA, although it does in spleen under CA; 2) vasodilator mechanisms predominate over vasoconstrictor mechanisms in the hepatic arterial bed; and 3) vasoconstrictor responses in renal cortex, pancreas, duodenum, spleen, and liver are more pronounced under CA than under PA. PMID- 3976906 TI - Changes in anatomy, glomerular filtration, and solute excretion in aging rat kidney. AB - Changes in kidney function were studied in anesthetized female WAG/Rij rats 6, 18, and 30 mo old. The growth in kidney size measured between 6 and 18 mo and 18 and 30 mo was due to enlargement of the glomeruli and lengthening of the proximal tubules, without significant changes in the number of nephrons. Glomerular filtration per gram kidney was unaffected between 6 and 18 mo but diminished 27% between 18 and 30 mo. This reduction was accompanied by an intrarenal redistribution of individual filtration rates for the superficial and deep nephrons. Fractional excretion of sodium, potassium, calcium, and magnesium declined sharply between 6 and 18 mo but did not change further between 18 and 30 mo, whereas the fractional excretion of amino acids and glucose remained constant between 6 and 18 mo but rose in the 30-mo group. Taken together, these observations indicate that, in the rat, kidney aging cannot be reduced to a loss in the number of functional nephrons but is the result of several differential and specific processes. PMID- 3976907 TI - Splenic red cell sequestration and blood volume measurements in conscious pigs. AB - When estimated by the dilution of 51Cr-labeled red blood cells under nearly basal conditions, immature splenectomized pigs (n = 20) had a circulating red cell volume of 17.8 +/- 1.64 (SD) ml/kg. At an assumed body-to-large vessel hematocrit (BH:LH) ratio of 0.9, plasma volume was 49.6 +/- 3.12 ml/kg and blood volume 67.3 +/- 3.67 ml/kg. Sham-operated pigs (n = 20) had a circulating red cell volume of 16.2 +/- 1.39 ml/kg, a plasma volume of 51.1 +/- 3.42 ml/kg, and blood volume of 67.2 +/- 4.12 ml/kg. Kinetic analysis of early 51Cr loss from the circulating blood of the sham-operated pigs indicated a splenic red cell sequestration of 4.5 +/- 0.89 ml/kg and a t1/2 of 9.76 +/- 1.93 min for splenic red cell turnover. Epinephrine injection (n = 6) and physical restraint (n = 8) caused rapid mobilization of splenic red blood cells in sham-operated pigs. Volume estimates in splenectomized pigs (n = 7) based on simultaneous dilutions of 51Cr-labeled red blood cells and 125I-labeled bovine albumin gave circulating red cell, plasma, and blood volumes of 18.4 +/- 2.46, 60.7 +/- 4.01, and 79.0 +/- 3.51 ml/kg, respectively, and a BH:LH ratio of 0.756 +/- 0.029. The latter value may have reflected an overestimation of plasma volume by the 125I-labeled albumin procedure. PMID- 3976908 TI - Survival of hypothermic dogs after 2-h circulatory arrest. AB - Adult mongrel dogs were rapidly cooled to a body temperature of 4-5 degrees C with a combination of internal (core) cooling and external surface cooling. All dogs survived profound cooling and 2-h circulatory arrest when profound hemodilution and drainage of the left ventricle were used during cooling and when preferential microwave chest rewarming and hypervolemia were employed during rewarming. After recovery no permanent neurological damage was observed. The histology of the brain and heart of animals killed 6 mo after the cooling indicated normal tissue. When during rewarming the selective microwave chest heating was not used, fewer dogs survived the 2-h circulatory arrest. PMID- 3976909 TI - Circadian sleep-wake cycle organization in squirrel monkeys. AB - To investigate the relationship between circadian rhythms of body temperature and sleep-wake stages, four squirrel monkeys were prepared for unrestrained monitoring of temperature, locomotor activity, electroencephalogram, electroculogram, and electromyogram. Continuous records for each animal were made for several 12-h light-dark (LD) cycles and then after a few days in constant illumination (LL). All animals maintained consolidated sleep-wake cycles and had a longer circadian period (mean 24.7 h) in LL than in LD (mean 24.1 h). The increased period reflected greater time per circadian cycle spent awake in LL (mean 14.0 h) than in LD (mean 12.8 h). Total night NREM sleep was less in LL (mean 6.5 h) than in LD (mean 8.2 h). Sleep onset occurred at later phases in LL (187 +/- 6 degrees) than in LD (170 +/- 2 degrees). Because the circadian phase measure of NREM sleep was unchanged between LD and LL conditions, the difference in sleep onsets reflected balanced changes in NREM circadian waveforms. Wake-up phases were the same in both conditions (mean 342 degrees). In summary, during free run squirrel monkeys maintain a stable consolidated circadian sleep-wake cycle with a period greater than 24 h, but they exhibit only minimal internal phase restructuring. PMID- 3976910 TI - Central role for angiotensin in control of adrenal catecholamine secretion. AB - Angiotensin II (ANG II) is required for unimpaired adrenal reflex secretion of catecholamines after hemorrhage in the dog. To test if ANG II acts centrally, experiments were performed under general anesthesia on bilaterally or sham nephrectomized dogs hemorrhaged at 25 ml/kg. Ventriculocisternal perfusion of ANG II or its antagonist saralasin was accomplished via needles inserted in the left lateral cerebral ventricle and cisterna magna. Mean arterial pressure and adrenal secretion of catecholamines were measured before and after hemorrhage. Nephrectomized dogs receiving only artificial cerebrospinal fluid (CSF) by ventriculocisternal perfusion had a very small adrenal response to hemorrhage compared with animals receiving ANG II intraventricularly (IVT) (at 10 and 100 pg . kg-1 . min-1). This effect of ANG II IVT also depended on the rate of IVT infusion. Peripheral infusion of ANG II (10 pg . kg-1 . min-1) had no effect on adrenal catecholamine secretion. Animals with intact kidneys given saralasin IVT (0.06 ng/min) responded similarly to nephrectomized dogs receiving only CSF IVT. Intravenous saralasin did not blunt the response to hemorrhage. Thus ANG II appears to support catecholamine secretion via a central mechanism. This mechanism is physiologically significant because either nephrectomy or functional elimination of ANG II by saralasin greatly attenuates the adrenal medullary response to hemorrhage in vivo. PMID- 3976911 TI - Thermal responses to central angiotensin II, SQ 20881, and dopamine infusions in sheep. AB - The thermoregulatory role of brain angiotensin II (ANG II) was tested by intracerebroventricular (IVT) infusion of ANG II or the converting enzyme inhibitor SQ 20881 (SQ) in 15 conscious sheep. Deep body temperature decreased 0.30 +/- 0.07 degree C (SE) during the 3-h period of IVT ANG II (25 ng/min) infusion (P less than 0.05) and increased 0.50 +/- 0.13 degree C during IVT SQ (1 microgram/min) infusion (P less than 0.01). To determine whether the rise in body temperature after IVT SQ infusion might be the result of a central renin angiotensin system (RAS), SQ was infused IVT in five conscious sheep 20 h after bilateral nephrectomy. This resulted in a significant rise in body temperature of 0.28 +/- 0.05 degree C (P less than 0.05). When vasopressin antidiuretic hormone (ADH) was infused intravenously at the same time of IVT SQ infusion, the rise in temperature was depressed, but ADH did not lower the temperature below basal. IVT dopamine (20 micrograms/min) increased body temperature by 0.40 +/- 0.04 degree C (P less than 0.01), which was qualitatively similar to the result with IVT SQ. These data support the hypothesis that endogenous brain ANG II may play a role in thermoregulation. Furthermore, plasma ADH level, regulated in part by brain ANG II, is probably not the mediator of that thermoregulation. The similar effects of IVT dopamine and SQ on body temperature strengthen the hypothesis that dopamine may be involved in the central action of brain ANG II. PMID- 3976912 TI - Multiple-objective criteria for optimal experimental design: application to ferrokinetics. AB - Optimal experimental design is used to predict the experimental conditions that will allow the "best" estimates of model parameters. A variety of criteria must be considered before an optimal design is chosen. Maximizing the determinant of the information matrix (D optimality), which tends to produce the most precise simultaneous estimates of all parameters, is commonly considered as the primary criterion. To complement this criterion, we present another whose effect is to reduce the interaction among the parameter estimates so that changes in any one parameter can be more distinct. This new criterion consists of maximizing the determinant of an appropriately scaled information matrix (M optimality). These criteria are applied jointly in a multiple-objective function. To illustrate the use of these concepts, we develop an optimal experimental design of blood sampling schedules using a detailed ferrokinetic model. PMID- 3976913 TI - Is gastric sham feeding really sham feeding? AB - Rats were fitted with gastric cannulas, food deprived, and allowed to drink a sugar solution that drained out of the opened cannula; i.e., the rats sham-fed. Although this procedure is thought to prevent absorption of ingested food, it was found that the sham feeding of a 32% glucose or sucrose solution significantly elevated blood glucose levels. The addition of acarbose, a drug that inhibits the digestion of sucrose, to the 32% sucrose solution blocked the blood glucose rise, as did closing the pylorus with an inflatable pyloric cuff. Neither the drug nor the cuff, however, reduced the amount of sucrose solution consumed. These findings indicate that gastric sham feeding does not necessarily prevent the digestion and absorption of food, although absorption is not essential for the appearance of a vigorous sham-feeding response. Nevertheless the possibility that neural or hormonal feedback from the stomach contributes to the sham-feeding response cannot be excluded, and until this issue is resolved the results of gastric sham-feeding studies should be interpreted with caution. PMID- 3976914 TI - Imagery and posttraumatic stress disorder: an overview. AB - A review of theories of traumatic neurosis or posttraumatic stress disorder reveals a relative neglect of the role of posttraumatic imagery. The broad range of imagery has not been recognized, nor its role in the disorder adequately formulated. A two-dimensional framework for understanding posttraumatic stress disorder based on 1) repetitions of trauma-related images, affects, somatic states, and actions and 2) defensive functioning puts into perspective the centrality of traumatic imagery, implies a reorganization of DSM-III criteria, points to new directions for research, and clarifies diagnostic and clinical confusion. PMID- 3976915 TI - Tarasoff and the clinician: problems in fulfilling the duty to protect. AB - The obligation to protect potential victims of one's patients, as first described in the California Tarasoff case, is being endorsed by an increasing number of jurisdictions. Although problematic in many respects, it has become a factor that must be dealt with in routine clinical interactions. The author presents a three part model of the Tarasoff obligation--identifying the requirements of assessment, selection of a course of action, and implementation--and illustrates with case examples the mistakes that clinicians commonly make at each of these stages. Guidelines are suggested for a reasonable approach to dealing with the Tarasoff doctrine. PMID- 3976916 TI - Sued and nonsued physicians' self-reported reactions to malpractice litigation. AB - To assess the impact of malpractice litigation on physicians' personal and professional lives, the authors surveyed a random sample of the Chicago Medical Society membership. Although both sued and nonsued physicians reported changes in professional behavior and emotional reactions to both the threat and actuality of litigation, sued physicians reported significantly more symptoms than nonsued physicians. Significantly more of them reported that they were likely to stop seeing certain types of patients, think of retiring early, and discourage their children from entering medicine. Malpractice litigation may affect not only physicians' personal and professional lives but also the delivery of health care. PMID- 3976917 TI - A family study of schizophrenic and normal control probands: implications for the spectrum concept of schizophrenia. AB - Morbidity risks for mental illness were determined in 750 first-degree relatives of chronic schizophrenic and normal control probands. Psychiatric disorders that were more frequent in relatives of schizophrenic probands than in relatives of normal control probands were chronic schizophrenia (5.8% versus 0.6%), schizotypal personality disorder (definite, 14.6% versus 2.1%; probable, 12.1% versus 6.5%), and paranoid personality disorder (7.3% versus 2.3%). The data suggest that schizotypal and paranoid personality disorders are genetically related to schizophrenia. The implications for schizophrenia research are discussed. PMID- 3976918 TI - State-dependent learning in hyperactive children receiving methylphenidate. AB - State-dependent learning refers to a failure of learning mastered under one drug condition to be remembered when tested under another drug condition. Previous studies of state-dependent learning in hyperactive children receiving stimulants have yielded conflicting results. The authors systematically evaluated learning and transfer of learning in children who were or were not receiving methylphenidate and included several design features intended to optimize the likelihood of demonstrating state-dependent learning. They found no evidence of state-dependent learning. These results diminish concern regarding state dependent effects in hyperactive children who are positive drug responders and who are clinically administered methylphenidate to control their hyperactivity. PMID- 3976919 TI - Past trauma and present functioning of patients attending a women's psychiatric clinic. AB - A women's psychiatric clinic, incorporated within a university teaching general hospital and staffed entirely by women, was opened in March of 1980. The authors studied a sample of 100 women who came to the clinic and characterized them by demographic variables, psychiatric diagnoses, health problems, chronic illness, death in the family, and traumatic incidents. Death in the family before she was 18 was found to predict a woman's subsequent request for or completion of sterilization. Physical or sexual abuse was significantly related to abortion, and abortion and trauma were significantly correlated. PMID- 3976920 TI - Fire-setting behavior in the histories of a state hospital population. AB - Review of the records of 191 nongeriatric state hospital inpatients showed that 50 (26%) of the patients had engaged in some form of fire-setting behavior; half of this group had engaged in a single episode. As a group, persons who had engaged in fire-setting behavior were significantly more likely to have a history of nonlethal self-injurious behavior and had a significantly greater number of admissions to the state hospital. The data suggest that fire setting by any patient cannot be accurately predicted and that fire-setting behavior may be an example of destructive operant behavior. PMID- 3976921 TI - NIMH/NIH Consensus Development Conference statement. Mood disorders: pharmacologic prevention of recurrences. Consensus Development Panel. AB - This report represents the consensus of a panel of representatives from psychiatry, psychology, pharmacology, epidemiology, internal medicine, and the general public regarding the use of pharmacologic agents to prevent recurrences of mood disorders. The panel concluded that recurrent mood disorders, which have a high prevalence and serious consequences, are underdiagnosed and undertreated. Applying appropriate strategies to the management and use of pharmacologic agents will enhance the likelihood of compliance and the prevention of recurrence with a minimum of bothersome side effects. Such strategies should be used within the context of a supportive relationship among doctor, patient, and family. PMID- 3976922 TI - Major depression with mood-congruent or mood-incongruent psychotic features: outcome after 40 years. AB - Using cross-sectional evaluations 40 years after index admissions, the authors compared depressed patients with mood-congruent and those with mood-incongruent psychotic features. These patients were then compared with patients with nonpsychotic major depression, schizophreniform disorder, or schizophrenia. Outcome in the mood-congruent group resembled that in the nonpsychotic group and was significantly better than that in the mood-incongruent group. Patients in this latter group, however, had significantly better follow-up scores than did schizophrenic patients. These findings are consistent with a short-term outcome and family history study and suggest that patients with major depression and mood incongruent psychotic features constitute a more diagnostically heterogeneous group than do those with mood-congruent psychotic features. PMID- 3976923 TI - Tolerance to therapeutic effects of antidepressants. PMID- 3976924 TI - Toxic reactions to the combination of monoamine oxidase inhibitors and tryptophan. AB - The combination of monoamine oxidase inhibitors and tryptophan--a recognized antidepressant regimen--has been reported to cause behavioral or neurologic toxicity. The authors present eight cases of delirious syndromes apparently attributable to this combination of agents. PMID- 3976925 TI - RBC choline and renal disorders during lithium treatment. AB - The authors measured RBC choline level, plasma choline level, and renal concentrating ability in 26 lithium-treated patients, seven psychiatric control subjects, and seven normal control subjects. An analysis of variance revealed no significant relationship between renal concentrating ability and either RBC choline level or RBC/plasma choline ratio. PMID- 3976926 TI - Psychopharmacologic and clinical correlates of attention in chronic schizophrenia. AB - Distractibility and reaction time were measured in 25 clinically stable chronic schizophrenic subjects receiving psychotropic medications. Higher serum neuroleptic levels were associated with lessened distractibility. Extrapyramidal side effects and level of symptoms were each related to slow and variable reaction times. PMID- 3976927 TI - Suicide attempts associated with akathisia. AB - The authors report two cases of impulsive suicide attempts associated with akathisia. In both cases, suicidal ideation appeared suddenly, concurrent with neuroleptic-induced akathisia, and disappeared when the akathisia was treated. PMID- 3976928 TI - Psychometric detection of fabricated symptoms of posttraumatic stress disorder. AB - Vietnam veterans with posttraumatic stress disorder and two groups instructed to fabricate its symptoms completed the MMPI. A discriminant function analysis of selected scale scores and an empirically derived decision rule successfully classified over 90% of the subjects. PMID- 3976929 TI - Regional cerebral blood flow in a patient with multiple personality. AB - Cerebral blood flow was measured in a patient with multiple personality during two different personalities, the same patient after recovery, and three control subjects. Personality change was associated with no significant alterations in cerebral blood flow except right temporal hyperperfusion. PMID- 3976930 TI - Malpractice data seem inconsistent. PMID- 3976931 TI - Arterial pH in provocation of panic. PMID- 3976932 TI - Ethics in epidemiologic studies. PMID- 3976933 TI - Was fever psychogenic in origin? PMID- 3976934 TI - Discontinuation of drugs and DST results. PMID- 3976935 TI - Possible dexamethasone influences on subsequent serial DST results. PMID- 3976936 TI - Genetic linkage in bipolar illness. PMID- 3976937 TI - The dexamethasone suppression test in dementia. PMID- 3976938 TI - ECT-induced hyperactive delirium and brain laterality. PMID- 3976939 TI - Reactions of psychiatric staff to an AIDS patient. PMID- 3976940 TI - Variation in suicide and homicide rates by latitude and longitude in the United States, Canada, and Australia. PMID- 3976941 TI - Can nicotine control panic attacks? PMID- 3976942 TI - Long-term dependence on antidepressants. PMID- 3976943 TI - Olfactory deficits and primary degenerative dementia. PMID- 3976944 TI - Missed diagnosis of organic mental syndromes in hospitalized medical patients. PMID- 3976945 TI - Studies of migrant populations. PMID- 3976946 TI - Good medical care in nursing homes. PMID- 3976947 TI - Patterns of site-specific displacement in cancer mortality among migrants: the Chinese in the United States. AB - Taking advantage of the information gathered for the 1975 National Mortality Survey in China, this paper compares the levels of cancer mortality among foreign born and United States-born Chinese around 1970 with those of the communities of origin of the majority of Chinese migrants to the US. Age-adjusted rates indicate two distinctive site-specific patterns among US Chinese: a downward trend for cancers of high risk among Guangdong and Hong Kong Chinese (nasopharynx, esophagus, liver, uterus, and perhaps stomach) and an upward trend for those sites of low risk among Chinese in Guangdong and Hong Kong (colon, lung, leukemia, and female breast). Further field studies are needed with emphasis on the birthplace of migrants and environmental changes in host countries. PMID- 3976948 TI - A controlled evaluation of rural regional perinatal care: impact on mortality and morbidity. AB - The impact of a rural regional perinatal care (RPC) program was assessed by a quasi-experimental, controlled, population-based design. Outcome measures included changes in five-year average fetal and neonatal mortality rates as well as short-term obstetric and newborn morbidity. Declines in fetal and neonatal as well as birthweight specific mortality rates were observed for both pilot and control regions, for both races, and especially for 1501-2500 g infants. However, comparisons of preprogram (1966-74) and postprogram (1975-80) average yearly changes showed no statistically significant differences between regions. While the incidence of prenatal morbidity was the same for both regions, intrapartum and newborn morbidity significantly favored the pilot region. These results were difficult to interpret. Program relevant implications of the findings in relation to rural RPC in North Carolina are discussed. Specific benefits appeared to be associated with the development of two high-risk maternity clinics and a Level II center capability in the pilot region. The importance of community support and public/private sector cooperation in relation to RPC is noted. PMID- 3976949 TI - Waterborne disease in Colorado: three years' surveillance and 18 outbreaks. AB - The Colorado Department of Health conducted intensive surveillance for waterborne diseases during the three-year period July 1, 1980-June 30, 1983. Eighteen outbreaks of waterborne illness were investigated. Outbreaks involved from 15 to 1,500 ill persons. Giardia lamblia was confirmed or suspected as the agent in nine outbreaks, rotavirus in one, and no agent could be identified in eight. Seventeen outbreaks occurred on surface-water systems; none of these had adequate chemical pretreatment and filtration. Investigation of water systems exhibiting positive coliform results during the first year detected no outbreaks. Activities important to effective surveillance included educational outreach programs to local health agencies, physicians and the public, and the designation of one individual to whom all water-related public complaints and health department inquiries were directed. PMID- 3976950 TI - Prescribing practices among nurse practitioners in adult and family health. AB - Data derived through log recordings of 89 nurse practitioners (NPs) in adult/family practice on 7,086 prescriptions issued during 890 clinical days were analyzed to describe prescribing practices of NPs who held prescriptive authority from the licensing regulatory boards of five western states. Results showed drug utilization to be similar to physician prescribing data, and intensity of prescribing to be less than that of physicians. The distributions of prescriptions by drug category and in relation to health problems underlying prescriptions are reported. Confidence with prescribing by type of drugs was parallel to incidence of prescriptions within drug category. Physician consultation prior to prescribing occurred with highest incidence for health problems treated with least frequently prescribed drugs. Physician consultation or referral was reported for 14.3 per cent of prescriptions. PMID- 3976951 TI - Does race affect hospital use? AB - Based on 1980 hospital discharges in areas in the State of Michigan, with substantial Black populations, Blacks use approximately 50 per cent more hospital care than Whites, but about half this difference is associated with use in specific communities which affects both White and Black use. Black use is not associated with community size, per cent of Blacks, or available beds and doctors. After controlling for mortality and socioeconomic status, a small statistically non-significant difference in race-specific use remains for 23 Michigan communities. The elimination of race as an explainer of hospital use suggests progress in assuring equal access to hospitals, but differences in poverty, mortality, and some specifics of use remain. PMID- 3976952 TI - Credentialing of diagnostic x-ray technologists: a question of public health impact. AB - This paper presents estimates of the number of diagnostic x-ray examinations performed in the United States, the population dose delivered, the percentage of that dose contributed by credentialed and noncredentialed operators, and one measure of performance: collimation of the x-ray beam. An estimated 82 per cent of medical x-ray examinations are performed by voluntarily certified (ARRT or ARCRT) operators. These procedures contribute 90 per cent of the radiation dose to the population. Data from the Nationwide Evaluation of X-Ray Trends (NEXT) program indicate that certified operators collimate the x-ray beam somewhat better than noncertified for chest examinations. They also indicate that differences in collimation practices may be attributed to the type of facility as well as to the credentials of the operators. One-third of the medical x-ray machines are in states presently requiring licensure of operators. It appears from these estimates that instituting operator licensure in the remaining states may reduce population dose by a maximum of one or two per cent. PMID- 3976953 TI - Psychiatric epidemiology and epidemiological psychiatry. PMID- 3976954 TI - Mortality patterns of New York State Vietnam Veterans. AB - Mortality odds ratios (MORs) comparing veterans with Vietnam service who died in New York State to veterans of the Vietnam era with no Vietnam service were estimated (N = 1,496). The most elevated MORs and their confidence intervals were non-motor vehicular injuries of transport (MOR = 2.18, (1.19, 3.96)), other accidents and burns (MOR = 1.37, (0.95, 1.98)), and homicide (MOR = 1.59, (0.86, 2.94). PMID- 3976955 TI - Physicians' attitudes and practices toward CPR training in family members of patients with coronary heart disease. AB - A survey of 482 physicians practicing in central and western Massachusetts was carried out to examine attitudes and reported practices toward cardiopulmonary resuscitation (CPR) training for family members of patients with coronary heart disease (CHD). Seventy-nine per cent of physicians felt that CPR training was important for the family members of patients with CHD yet only 6 per cent actually provided information about CPR to families. Further studies are indicated to determine why physician behavior is at odds with their stated beliefs and to guide appropriate remedial action. PMID- 3976956 TI - Drug product selection: the Florida experience revisited. AB - The comparison of drug product selection rates determined approximately one year and four years after passage of Florida's Drug Product Selection (DPS) Law indicates very little change in the product selection and brand interchange behaviors of Florida pharmacists. Lack of adequate guidelines from the state and the liability concerns of pharmacists appeared to limit an expected increase in the state DPS rate. PMID- 3976957 TI - Insuring preventive dental care: are sealants included? AB - Lack of third-party reimbursement for pit and fissure sealants has been cited as a barrier preventing increased adoption rates. The extent to which commercial insurance companies and Blue Cross/Blue Shield Associations provide reimbursement for dental sealants is examined with data from a telephone survey. Results indicate that the majority of such third-party payers did not provide reimbursement for sealants. PMID- 3976958 TI - Science and policy making. PMID- 3976959 TI - Prior publication, an ethical issue. PMID- 3976960 TI - Epidemiologic evidence and motor vehicle policy making. AB - After being randomly assigned to receive policy effectiveness information expressed as attributable benefit, attributable risk, or relative risk, 318 graduate students were asked to indicate their preferences for the current voluntary seat belt use policy, a mandatory seat belt policy, or mandatory passive restraints. A control group received no data. Exposure to effectiveness information (any type) was significantly associated with favoring either mandatory seat belts or passive restraints over the current policy. Those exposed to attributable benefit or risk data were more apt to make proregulatory choices than subjects exposed to relative risk data. Attitudes toward government regulation and specific views about personal freedom and policy effectiveness were also found to be significant predictors of policy preference. PMID- 3976961 TI - Driver licensing age and lifestyles of 16 year olds. AB - The relationship of driver licensure rate differences to 16 year old lifestyles was assessed by surveying 15 and 16 year olds in New York, Michigan, and New Jersey. Michigan 16 year olds reported the highest rates of licensure (56 per cent), whereas New York (14 per cent licensed) and New Jersey (2 per cent licensed) had much lower rates. Teenagers in Michigan reported greater decreases in use of bicycles and reliance on parents and relatives for transportation but, for the most part, the differences in 16 year old licensure and mobility were not reflected in lifestyle differences. PMID- 3976962 TI - Epidemiology of a tuberculosis outbreak in a South Carolina junior high school. AB - A 13-year-old, female, seventh-grade student (the index patient) was found to have smear-positive, cavitary, pulmonary tuberculosis. Epidemiologic and contact investigation, involving skin testing over 900 people, revealed a 40 per cent tuberculin reactor rate for persons in the junior high school she attended compared to a 2 per cent rate for control schools. Repeat skin testing of initial non-reactors identified an additional 3 per cent of infected school children. School teachers showed a seven-fold increase in the prevalence of positive skin test reactions following the outbreak. Tuberculin-reactor rates for seventh graders were substantially higher than for eighth graders. The more classes shared with the index patient, the higher the probability of being a reactor. Among students who shared no classes with the index patient, the highest rates of tuberculin reactions were found for those who had entered a classroom immediately after the index patient had left it. Evidence of transmission on the school bus and in the church choir was also suggested. Six secondary cases (three pulmonary) resulted from the outbreak. Identical phage types from the index and secondary patients suggest who had left school during the term proved useful in determining when transmission began. The index case was found to be a missed contact of a previously identified case of tuberculosis. Since household contacts are at high risk for developing active disease, there is a need for meticulous and complete investigation and preventive therapy for all such persons, especially children. PMID- 3976963 TI - Comparative risks and costs of male and female sterilization. AB - Couples who are considering elective sterilization should compare the risks and costs of male and female sterilization procedures as part of the decision process. Morbidity, mortality, failure rates, and short-term costs associated with male and female sterilization procedures were estimated from data available in previous case series. Male sterilization procedures were found to have zero attributable deaths and significantly less major complications when compared to female sterilization procedures. No less than 14 deaths a year can be attributed to female sterilization procedures in the US. Male and female sterilization procedures have efficacy rates that are not significantly different from each other. The short-term costs of female sterilization are 3.0 to 4.1 times that of vasectomy. PMID- 3976964 TI - The cost and effectiveness of school-based preventive dental care. AB - The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five nonfluoridated communities. These children were examined at baseline and assigned to one of six treatment regimens. Four years later, 9,566 members of this group were examined again. Analyses of their dental examination data showed that dental health lessons, brushing and flossing, fluoride tablets and mouthrinsing, and professionally applied topical fluorides were not effective in reducing a substantial amount of dental decay, even when all of these procedures were used together. Occlusal sealants prevented one to two carious surfaces in four years. Children who were especially susceptible to decay did not benefit appreciably more from any of the preventive measures than did children in general. Annual direct per capita costs were $23 for sealant or fluoride prophy/gel applications and $3.29 for fluoride mouthrinsing. Communal water fluoridation was reaffirmed as the most cost-effective means of reducing tooth decay in children. PMID- 3976965 TI - School-based preventive dental care: a different view. PMID- 3976966 TI - Medical examination of school entrants: later school problems and absenteeism of attenders and non-attenders. AB - Children who were scheduled for medical examination before entering school were followed in school one or two years later. Non-attenders had a two-fold risk of repeating grades, special class placement, referral for speech/language problems, teacher-reported learning or behavior problems, failure of vision or hearing screening, and transfer between schools. Absenteeism was also significantly more common. Children not brought in for preventive health care are at greater risk than others for difficulties in school. PMID- 3976967 TI - Imported measles outbreak in a university. AB - In 1981, a measles outbreak in an Arkansas university involved 16 students and four persons who were contacts of these students. The first two cases were in students who recently returned from Honduras. Of the 16 students with measles, 12 had significant gastrointestinal symptoms; five had elevated liver transaminase, and eight were hospitalized. Only two of the students were considered adequately immunized. A voluntary immunization clinic held on the university campus resulted in 67 per cent of 3,076 students being vaccinated. PMID- 3976968 TI - Community coverage in a rural, church-based, hypertension screening program in Edgecombe County, North Carolina. AB - In a rural, church-based hypertension program in Edgecombe County, North Carolina, screening of the congregations was complemented by a community outreach component targeted at 18-60 year old males, a group at higher risk for untreated hypertension. Compared with its estimated frequency in the community, untreated hypertension was as common in the church congregations and somewhat less prevalent than expected among outreach screenees. PMID- 3976969 TI - Home refinishing, lead paint, and infant blood lead levels. AB - We measured the blood lead levels of 249 infants semi-annually from birth to two years of age; we sampled the home paint and recorded any recent home refinishing activity. Mean blood lead from birth to age 2 years did not vary systematically with age but did correlate significantly with the amount of lead in the indoor paint (p less than .01). Refinishing activity in homes with high lead paint was associated with elevations of blood lead averaging 69 per cent. PMID- 3976970 TI - Contemporary table salt practices and blood pressure. AB - Salt intake of 978 subjects when compared to 1954 data demonstrated a trend toward the decreased use of table salt. When hypertensives in treatment were excluded, persons reporting low salt use had higher mean systolic and diastolic blood pressures than those reporting high salt use. These findings were the reverse of the relationships found in 1954. PMID- 3976971 TI - The emerging relevance of antitrust laws to the delivery of health care. AB - Until relatively recently, antitrust enforcement in the delivery of health care was virtually non-existent. Not even 15 years ago, many legal observers might have concluded that the professional services of medical care providers were exempted from the federal antitrust laws altogether; or that many providers were engaged in local activities beyond the reach of federal interstate commerce jurisdiction. Even 10 years ago, many providers were arguing that collective agreements among potential competitors were not only sound public policy, but also that such concerted activities were actively encouraged by various federal laws. Today, however, the enforcement of the federal antitrust is an integral part of the complicated legal environment of American health care delivery. PMID- 3976972 TI - Weighted regression analyses found incorrect. PMID- 3976973 TI - Impacting on drunk driving. PMID- 3976974 TI - Handbook: Radiation safety in shelters. PMID- 3976975 TI - Life expectancies recalculated. PMID- 3976976 TI - The surgical treatment of osteochondritis of the capitellum. AB - This paper reviews 14 patients who underwent elbow arthrotomy for osteochondritis of the capitellum. The etiology in 7 of the 14 cases appears to be the result of repeated trauma from throwing sports. Five of the 14 described a singular significant traumatic episode, and in 2 of the 14, a clear etiology is uncertain. The diagnostic features including signs, symptoms, and elbow range of motion are examined. The operative findings are correlated with plain x-ray films of the elbow in all cases and with an elbow arthrogram in 11 out of 14 cases. The average length of followup was 24 months. The postoperative range of motion was increased an average of 18 degrees. Eighty-six percent (12 out of 14) patients returned to organized, competitive athletic activity without restrictions. The Little League background of those patients with apparent repetitive microtrauma to the elbow is examined in terms of length of pitching experience and types of pitches thrown. In addition, the throwing mechanism of these patients is evaluated with respect to the type of delivery at possible risk for the development of osteochondritis. We conclude that after a failure of conservative therapy, surgical treatment, including removal of the intraarticular loose bodies, excision of capitellar lesions, and curettage to bleeding bone can be expected to produce pain relief and improvement in joint motion. A return to organized competitive sport activities can be expected. PMID- 3976977 TI - An in vivo strain gage study of elongation of the anterior cruciate ligament. AB - The purpose of this paper is to study the load-elongation characteristics of a Grade II sprain of the anterior cruciate ligament (ACL) at the time of local anesthesia arthroscopy. The data may be used to increase diagnostic and prognostic accuracy when evaluating Grade II ACL sprains and to structure properly a rehabilitation program following ACL injury. This report is based on the data from two in vivo strain gage studies of Grade II ACL sprains. Following instrumentation of the ligament, several events common to physical examination and rehabilitation programs were tested. The Lachman test produced greater elongation of the anteromedial fibers than did the anterior drawer or pivot shift test. A fairly high force of 80 pounds may be required by the examiner's hands to test satisfactorily the anteromedial fibers in the acutely injured large athlete. The proper order for a rehabilitation program should be crutch walking, cycling, walking, slow running, and faster running. Patients should be cautioned to run on a perfectly level surface. Cycling produced 7% as much elongation as an 80 pound Lachman test, and the one leg half squat 21% as much. Quadriceps rehabilitation can be done more safely using these exercises. Quadriceps exercises by knee extension against a 20 pound weight boot in the range of full extension to 22 degrees flexion created peak elongation of the anteromedial fibers ranging from 87 to 121% of that produced by an 80 pound Lachman test. We recommend that quadriceps exercises and testing by knee extension through a full range of motion not be done during the first year following ACL injury or reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3976978 TI - Hamstring control and the unstable anterior cruciate ligament-deficient knee. PMID- 3976980 TI - A comparison of acute anterior cruciate ligament examinations. Initial versus examination under anesthesia. AB - The preoperative examination, the examination under anesthesia, and the findings at surgery were compared for acutely injured knees that were found at surgery to have anterior cruciate ligament (ACL) tears. The pivot shift was initially positive in only 35% of the knees; however, under anesthesia 98% were positive. The Lachman test was initially positive in 99% of the knees, and under anesthesia, 100%. The anterior drawer sign was present initially in 70% of the knees, and under anesthesia this increased to 91%. Of the 37 patients with isolated ACL tears, only 20 (54%) had initially positive anterior drawer signs. In the knees in which secondary restraints to anterior-posterior motion were injured, this percentage increased to 69% in medial meniscus injury, 82% in lateral meniscus injury and 89.5% in rupture of the medial collateral ligament (MCL). The Lachman test seems relatively unaffected by associated ligamentous or meniscal injuries, but the end point in the Lachman test is absent in all complete ACL tears. The pivot shift phenomenon, which was demonstrable in 98% of patients when tested under anesthesia, may be diminished when there is a MCL injury or absent in partial ACL tears. Experience in performing the Lachman test and in appreciating the quality of the end point will give the examiner a high degree of accuracy in making the diagnosis of an ACL tear without resorting to anesthesia, arthroscopy, or arthrography in most patients. PMID- 3976979 TI - Comparative radiologic study of the influence of ankle joint bandages on ankle stability. AB - A comparative radiologic study was carried out to test the stabilizing value of ankle strapping and taping on unstable tibiotalar joints. Unstable ankle joints of 51 athletes were examined without bandages, with strapping, and with taping before and after an activity program. The use of taping proved to give the greatest decrease of the talar tilt (TT) angle. This improvement was greater, even after activity, than the stabilization obtained by strapping before any activity. PMID- 3976981 TI - Early hilar-type squamous cell carcinoma of the lung resected by bronchofiberscopy surviving 5 years. AB - We record a case of early squamous cell carcinoma located in the hilar region of the lung, which was completely resected by multiple tumor biopsies through the bronchofiberscope. In this case, there was concomitant contralateral pulmonary tuberculosis which was treated by right upper lobe lobectomy. The patient had a long history of smoking and had worked for 27 years in a factory that used chromate. Bronchoscopically, there were no abnormal findings in the visible branches of the right bronchial tree, but an early stage squamous cell carcinoma lesion was found at the bifurcation of left B8 and B9+10 bronchi. After bronchofiberscopic excision of the tumor, the patient was closely followed-up by repeated bronchoscopy at intervals of 4 weeks to 6 months. The patient is currently free of recurrence 5 years and 3 months following the initial bronchoscopic excision and is judged to have been cured. PMID- 3976982 TI - Focal lymphoid hyperplasia (pseudolymphoma) of the esophagus. AB - Focal lymphoid hyperplasia is an uncommon but ubiquitous lesion. It occurs most commonly in the gastrointestinal tract in association with chronic peptic ulcer disease of the stomach. We describe the hitherto unrecognized association of lymphoid hyperplasia in the esophagus with chronic stenosing ulcerating esophagitis and Barrett's mucosa. This association is considered to be analogous to the more prevalent coexistence of lymphoid hyperplasia and chronic peptic ulcer disease in the stomach. PMID- 3976983 TI - Clear cell myeloma. AB - We report a case of clear cell myeloma misinterpreted at initial biopsy as liposarcoma. The patient had lytic skeletal lesions and monoclonal IgA, kappa, serum immunoglobulin. The tumor cells contained cytoplasmic vacuoles that produced a clear histologic appearance. The light-microscopic and ultrastructural findings are compared with those of other cases of lymphoplasmacytic disorders with prominent cytoplasmic inclusions. PMID- 3976984 TI - Juvenile granulosa cell tumor of the infantile testis. A report of 14 cases. AB - Fourteen testicular tumors diagnosed in infants less than 6 months of age had a distinctive appearance resembling that of the juvenile granulosa cell tumor of the ovary. One of them was discovered at autopsy in an infant of 30 weeks' gestational age; seven were diagnosed during the first few days of life, and the remainder between 3 weeks and 4 1/2 months of age. Enlargement of a scrotal testis was the presenting manifestation in 10 cases and abdominal swelling in one case; one tumor was found in a descended testis that had undergone torsion and one was discovered in an inguinal testis at the time of inguinal herniorrhaphy. The tumors ranged from 0.8 to 5.0 cm in diameter and were cystic or partly cystic and partly solid. Microscopic examination disclosed both follicular and solid components. The follicles were of varying sizes and contained eosinophilic or basophilic fluid that stained positively for mucin in some of the cases. The solid foci typically had a nodular arrangement and occasionally were hyalinized or had a basophilic background due to the presence of intercellular mucin. The neoplastic cells contained moderate to large amounts of eosinophilic cytoplasm and round to oval hyperchromatic nuclei, which typically lacked grooves. The mitotic rate varied from less than 1-24/10 high-power fields. Limited follow-up examination revealed no evidence of recurrence. The microscopic features of these neoplasms warrant their designation as "juvenile granulosa cell tumor." PMID- 3976985 TI - Cost containment and survival of the teaching hospital. PMID- 3976986 TI - Contributions of pathologic margins and Dukes' stage to local recurrence in colorectal carcinoma. AB - Two hundred fourteen patients with colorectal carcinoma who underwent curative resection for biopsy-proved or autopsy-proved local recurrences with a minimum of 2 years follow-up were evaluated. The only predictive variables for anastomotic recurrence were Dukes' stage and tumor margins. There were 49 Dukes' A lesions with no observed recurrences. There were also 83 Dukes' B lesions and 84 Dukes' C lesions with a total of 18 local recurrences in 214 cases or 8.4 percent (of Duke's B lesions or 6 percent and 14 of Dukes' C lesions or 17 percent). When proximal or distal margins were less than 5 cm there were seven total recurrences (three Dukes' B lesions and four Dukes' C lesions). However, when margins were greater than 5 cm, 11 local recurrences were observed (1 Dukes' B and 10 Dukes' C lesions). It appears that margins are not as important in preventing local recurrences of Dukes' A lesions as they are of both Dukes' B and C lesions. Although the numbers are small in this study, it appears that Dukes' B lesions can be satisfactorily resected with a very low incidence of local recurrence if their margins are 5 cm or greater, whereas if the resected margins are less than 5 cm, the incidence of local recurrences increases from 9 percent (1 of 11 lesions) to 43 percent (3 of 7 lesions), or almost a fivefold increase. Therefore, it appears that good surgical technique and adequate margins of greater than 5 cm are very important in reducing local recurrences of Dukes' B lesions. However, when margins are greater than 5 cm, this does not guarantee freedom from local recurrence of Dukes' C lesions. This may merely reflect the difference in the biologic characteristics among Dukes' A, B, and C lesions and the fact that limited resection, particularly in the rectosigmoid region, cannot possibly remove all intralymphatic disease, which is the presumed culprit in locally recurrent Dukes' C lesions. PMID- 3976987 TI - Management of obstructing carcinoma of the left colon by extended right hemicolectomy. AB - In obstructing carcinomas of the left colon, primary resection with immediate colocolonic anastomosis is associated with a high risk of anastomotic dehiscence, and therefore, it has become traditional to manage such patients with staged resection. In obstructing carcinomas of the right colon, immediate resection of the lesion with ileocolonic anastomosis is acceptable. The scope of right hemicolectomy can be extended to encompass obstructing carcinomas of the left colon by performing subtotal or total colectomy with ileosigmoid or ileorectal anastomosis. Herein, we have reported the outcome in 16 patients treated in this manner. The operative mortality was 12.5 percent, which compared favorably the mortality of other methods of surgical management. Extended right hemicolectomy achieves in one operation relief of intestinal obstruction, tumor resection, restoration of gut continuity, elimination of the risks of synchronous or metachronous colonic tumors, and a possible increase in the 5 year survival rate. In our experience, the frequent passage of liquid stools is not a problem. This approach justifies further study. PMID- 3976988 TI - Effect of diverting colostomy on collagen metabolism in the colonic wall. Studies in the rat. AB - The effect of total bowel rest by colostomy on collagen metabolism was studied. Fecal diversion led to a marked decrease of collagen and protein synthesis in the excluded colon. These changes were accompanied by a decrease in the amount of collagen and noncollagenous components. In the colonic part proximal to the colostomy site, a less marked decrease in collagen content was observed. It was concluded that stimulation of intraluminal bulk might be important as a regulating factor for collagen turnover. It remains to be determined if the observed changes in collagen metabolism affect colonic healing. PMID- 3976989 TI - Does drainage of intraabdominal pus reverse multiple organ failure? AB - Intraabdominal abscess induced multiple organ failure in 21 patients. Sepsis was most often due to perforation of the colon and was located with almost equal frequency in the upper and lower abdomen. Four patients died after single laparotomy for drainage. Seventeen were drained operatively more than once (average 3.4 operations) at mean intervals of 10 days. Sixteen of the 21 patients (76 percent) died with multiple organ failure despite drainage. Organ function improved temporarily in only one patient. Autopsy showed that pus had persisted or recurred in three patients. No significant predictors of survival were identified, although the advantage appears to lie with the younger patient in whom multiple organ failure develops relatively late after sepsis (mean 13 days) and who needs ventilatory assistance for less than 1 week. The location, size, and bacteriologic characteristics of abscesses do not appear to influence outcome. This study shows that early and repeated drainage of intraabdominal pus will not reverse multiple organ failure in the majority of patients. PMID- 3976990 TI - Influence of gastric banding on stomach blood supply with or without concurrent splenectomy. AB - A lethal gastric perforation occurred after a gastric banding procedure, which was complicated with splenectomy. Prompted by this incident, an experimental study was undertaken in which regional blood flow in the stomach was measured in anesthetized cats after gastric banding or splenectomy or both. A fatal course with an extensive ischemic lesion of the stomach near the banding area was seen in all the cats with the combined procedure after 5 to 12 days. Banding alone reduced gastric blood flow within 24 hours, particularly on the greater curvature. Splenectomy also reduced blood flow along the greater curvature within 2 weeks. The combined procedure showed similar flow changes within 24 hours. The implication of these experimental results is that, if the spleen must be removed, the performance of gastric partitioning for morbid obesity should be reconsidered. PMID- 3976991 TI - Management of giant duodenal ulcer. AB - Giant duodenal ulcer is a variant of peptic ulcer that is 2 cm in diameter or greater and essentially replaces the duodenal bulb. Diagnosis by upper gastrointestinal series is often missed, due to the large size of the ulcer, which causes it to look like a scarred duodenal bulb or duodenal diverticulum. This study reviews our experience with 32 patients who presented with giant duodenal ulcer between 1963 and 1982. Seventy-five percent of the patients were men between 30 and 81 years of age (mean age 59 years). Gastrointestinal hemorrhage was a presenting symptom in 75 percent of the patients and free perforation in 9 percent. Diagnosis was made by upper gastrointestinal series (24 patients), and endoscopy (11 patients), alone or in combination. Three patients were diagnosed at surgery and one at necropsy. Mean size of the ulcer was 3.5 cm in diameter, range 2 to 6 cm. Twenty-four patients were initially managed medically (mean length of treatment 41 months), with 2 deaths (hemorrhage) and 20 recurrences (83 percent). Twenty-seven operations were required in 25 patients. In 17 of the 25, medical treatment had failed. Seven of these patients required emergency surgery. Eight patients were managed primarily by surgery, of whom five presented emergently. There were three deaths in the surgical group after emergency surgery. In two of these patients, medical treatment had failed. There were no deaths among the elective surgery group. Twenty-five of the 27 operative procedures were definitive, acid-reducing operations (15 vagotomy and antrectomy and 10 vagotomy and drainage). Two patients underwent emergency exploration and oversewing of a giant perforated ulcer alone, and both patients required subsequent surgery because of symptoms. The results indicate that giant duodenal ulcer should be primarily surgically managed and that an acid-reducing procedure should be performed during primary surgery. These patients do very poorly with medical therapy, and the mortality rate is increased if emergency surgery is required for hemorrhage. Medical treatment alone is associated with a high morbidity (92 percent). Should operation be required, a definitive acid reduction operation is the procedure of choice. PMID- 3976992 TI - Surgical and nonsurgical treatment of total carotid artery occlusion. AB - The natural history of totally occluded internal and common carotid arteries was studied in 102 patients (109 arteries) with a 97 percent follow-up (mean 39.7 months.) Symptomatic occlusions occurred in 72.6 percent of the patients, the reconstructed group (46 patients) having a greater number of symptomatic vessels than the nonreconstructed group (63 patients) (p less than 0.05). Contralateral disease was encountered in 46 percent. Initial mortality was 5 percent. Twenty patients (19.6 percent) were dead at the time of follow-up. Half of these deaths were from strokes and three fourths from atherosclerotic causes. Persisting neurologic symptoms were present in 14 percent of the patients and new events occurred in 5 percent. Fifteen percent of initially asymptomatic vessels were symptomatic at last follow-up. Twenty-one percent of the symptomatic occluded vessels were symptomatic on follow-up, 16 percent being in the reconstructed group and 26 percent in the nonreconstructed group. PMID- 3976993 TI - Hemodynamics of an anastomotic arteriovenous fistula. AB - Various vascular surgical techniques have been employed to increase both graft patency and limb survival when the prognosis for limb salvage in arteriosclerotic patients is especially poor due to a diseased outflow tract. Ibrahim et al described the creation of an anastomotic arteriovenous fistula in distal tibial bypasses as the reconstructive procedure of choice in severely ischemic extremities unsalvageable by more conventional methods. This study presents the hemodynamics of an anastomotic arteriovenous fistula under such circumstances. Four adult mongrel dogs were anesthesized, and a femoral artery and vein were exposed from the groin to the knee. The femoral artery was ligated in midthigh, and the ligated segment was than bypassed using an umbilical vein graft. The distal anastomosis included an arteriovenous fistula. Flow was measured electromagnetically, and pressure was measured with intravascular catheters attached to strain gauges. The creation of an anastomotic arteriovenous fistula rapidly leads to a reversal of flow in the distal artery, distal arterial hypotension, and distal venous hypertension. Its clinical use in contraindicated as a result of our experimental observations. PMID- 3976994 TI - Timing of surgery for acute biliary pancreatitis. AB - Twenty-five patients with acute biliary pancreatitis were classified according to the severity of disease as determined by Ranson's signs. A significant correlation was found between the severity of pancreatitis estimated in this way and the observed postoperative mortality. Early operation was performed in 15 patients, whereas 10 patients received conservative management for a certain period before operation. The choice of treatment was based on clinical considerations. No significant difference was found in mortality between the two groups. We conclude that early operation does not harm patients with mild pancreatitis whereas patients with severe pancreatitis may benefit from it. PMID- 3976995 TI - Nontraumatic perforations of the small intestine. AB - Nontraumatic perforation of the small intestine is very rarely found as a cause of acute abdominal disease. A series of 15 adult patients admitted to our hospital from 1973 to 1983 is reviewed. Underlying conditions were primary neoplasia (three patients), adhesions (three patients), intraluminal foreign bodies (two patients), metastases (two patients) and diverticulum (one patient). In four patients, the pathogenesis remained unclear (idiopathic perforations). As surgical therapy, resection and anastomosis is preferred in order to make a thorough histologic examination of the perforated bowel possible. A possible role of local drug toxicity in the pathogenesis of perforations has been discussed herein. No anastomotic leakage was observed. Four patients died (27 percent). PMID- 3976996 TI - Herniography in athletes with groin pain. AB - In the years 1974 to 1981, herniography was performed in 78 athletes with groin pain. The investigation comprised 101 painful groin sides in 23 athletes with bilateral symptoms. Before herniography, a hernia was palpated in only eight (7.9 percent) groins with pain. Hernias were found at herniography in 84.2 percent of the symptomatic groin sides and in 49.1 percent of the asymptomatic groin sides. Sixty-three hernia operations were performed. The herniographic and operative diagnoses corresponded well. Direct hernias dominated among the operated athletes, and were found in 55.6 percent of those below 30 years of age. Altogether 69.8 percent of the operated patients were cured by hernia repair and another 20.6 percent were improved. Tenoperiostitis of the adductor muscles was the most frequent diagnosis in those not cured by operation and among the nonoperated patients. Herniography was of great value in selecting those patients who needed a repair. A broad differential diagnostic approach when examining these patients is of the utmost importance. PMID- 3976997 TI - Relative value of glucose and amino acids in preserving exercise capacity in the postoperative period. AB - The value of crystalline amino acids compared with glucose in maintaining functional muscle mass (maximum exercise capacity) in the perioperative period was studied. Twelve surgical patients received 100 g of glucose (Group 1) for 7 to 10 days perioperatively, and 12 (Group 2) received 90 g of crystalline amino acids for a similar period. Maximum exercise capacity, nitrogen balance, and serum albumin were studied. The use of amino acids instead of glucose spared nitrogen. Net nitrogen loss was 64.7 +/- 6.7 g in Group 1 compared with 34.7 +/- 4 g in Group 2 (p less than or equal to 0.001). Exercise capacity decreased 13.8 +/- 4.5 percent in Group 1 and 13.3 +/- 2.9 percent in group 2. The serum albumin level decreased by 0.30 +/- 0.2 g/100 ml in Group 1 compared with 0.34 +/- 0.15 g/100 ml in Group 2. These differences were not significant. Changes in serum albumin were correlated with changes in exercise capacity (r = 0.7, p less than or equal to 0.002), but neither was significantly correlated with nitrogen loss. We concluded that the use of amino acids instead of glucose during moderate periods of semi-starvation associated with moderate trauma will not influence loss of exercise capacity significantly, although some nitrogen will be spared; patients undergoing moderately severe surgical procedures accompanied by moderate periods of semistarvation will lose approximately 14 percent of their exercise capacity; and loss of exercise capacity is not correlated with loss of nitrogen under these conditions but is loosely correlated with changes in serum albumin levels. PMID- 3976998 TI - Ease of suturing surgical fabrics. A quantitative evaluation. AB - Based on the definition that suturability is the amount of force required to puncture a graft using a surgical needle, a simple testing procedure was devised, using an Instron testing machine to measure the suturability of a number of vascular graft materials. The grafts tested, in order of preference were Cooley double velour, Weavenit, Sauvage filamentous, Cooley knitted, DeBakey woven, and Cooley woven. It has been shown that the suturability of a graft is directly related to its water porosity and the size of the needle used. PMID- 3976999 TI - The ParkS S ileal pouch and anal anastomosis after colectomy and mucosal proctectomy. AB - Attention to detail is crucial to the success of the operation described. Surgeons contemplating performing it should first be experts in pelvic surgery and are advised to personally observe and participate in the procedure performed by surgeons currently experienced in this technique. PMID- 3977000 TI - Placement of an implantable percutaneous permanent triple-lumen catheter. AB - A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. The three lumens allow multiple, simultaneous intravenous therapies to be administered in the long-term inpatient, as well as the outpatient. PMID- 3977001 TI - A new needle for biopsy of pleura. AB - A new pleural biopsy needle is hollow with a movable stylet. Three millimeters away from the tip of the needle, there is a hook-like notch for holding the biopsied pleural tissue. Its tip is not sharp enough to damage the lung tissue. As the tip is closed by solder, the specimen does not slip easily. Compared with the Cope needle, biopsy with this needle is easier to perform, and the size of the specimen is much larger. There were no complications in 21 patients. PMID- 3977002 TI - Intestinal obstruction due to schistosomiasis. AB - We have described a patient with intestinal obstruction caused by schistosomiasis but closely resembling colon carcinoma. The cause, demography, pathologic characteristics, and clinical management of the disease caused by Schistosoma mansoni are reviewed. PMID- 3977003 TI - Late sequelae of gastric acid injury. AB - The late sequelae of gastric acid injury follow a predictable pattern and often require operative correction. Pyloric and antral stenoses are the most commonly cited late complications of acid ingestion. Other late sequelae include intractable pain, achlorhydria, protein-losing gastroenteropathy, duodenal atonicity, radiographic abnormalities, mucosal metaplasia, and gastric carcinoma. Resection of the injured gastric segment appears to provide the most favorable long-term result. Diligent patient follow-up is required to ensure adequate restoration of gastrointestinal function and to correct late-appearing complications. The distinction between the expected sites of gastrointestinal injury in acid versus alkali ingestion has become less clear with the recent introduction of readily available concentrated liquid household alkaline products, and the incidence of late gastric sequelae of caustic injuries has increased accordingly. PMID- 3977004 TI - Subclavian vein catheterization. AB - Massive fluid replacement is occasionally useful for resuscitation of severely injured patients. The use of MAST garment and the inability to obtain peripheral intravenous access may necessitate the use of infraclavicular subclavian cannulation. Two modifications of the standard subclavian technique have been described which enable quick access for infusion of large fluid volume and autotransfusion. The first involves the placement of multiple catheters in the same vein. The second method utilizes a modified Seldinger technique to place an 8 F. Swan-Ganz introducer into the subclavian vein. Complications are similar to those encountered when the standard subclavian technique is utilized. PMID- 3977005 TI - Effect of diverting colostomy on collagen metabolism in the colonic wall. PMID- 3977006 TI - Recovery from multiple organ failure. PMID- 3977007 TI - Experimental motion sickness induced in squirrel monkeys by continuous off-axis horizontal rotation. AB - Under a variety of experimental conditions, nonrestrained adult male squirrel monkeys were subjected to continuous rotation in the horizontal plane at 33 rpm. Severity of motion-induced sickness was quantified by measuring latencies of three responses associated with sickness. Per- and postrotational nystagmus was recorded from a subsample of monkeys with permanent recording electrodes implanted in the bony orbits. Incidence of sickness depended on the time limits of stimulation imposed, and it occurred in a maximum of about 90 per cent of test sessions if rotation was continued for two hours. When subjected to ten once-per day rotation sessions, only a few monkeys showed evidence of developing transient habituation of onset of motion sickness. Mean frequency of emetic episodes, however, declined over the latter half of the rotation series. Restricting visual cues by blindfolding the monkeys prevented most subjects from vomiting. PMID- 3977008 TI - Dynamic computerized tomography in the assessment of hemangioma. AB - Three hemangiomas of the face and orbit are studied with dynamic computerized tomography (CT). This noninvasive technique has the advantage of simultaneous bone and soft tissue visualization at the time of peak contrast enhancement, and it precludes the potential complications of arteriography and biopsy. The hemangiomas are precisely delineated with intense contrast; the sharp peak and rapid uninterrupted runoff of the computer-generated plot of contrast concentration (CT number) versus time is characteristic of this lesion. It is suggested that the progress of hemangioma involution may be documented by the change in contrast distribution in sequential dynamic CT studies. Dynamic CT is recommended for the evaluation of head and neck vascular tumors. PMID- 3977009 TI - Mediastinitis and neck abscess following cervical spinal fracture. AB - Neck abscess and mediastinitis are rare complications of cervical spinal injury. Often there is a delay in diagnosis because the physical and laboratory signs of abscess are falsely attributed to the vertebral injury. Prognosis is directly related to the expediency of recognition of infection and surgical drainage. Three cases of neck abscess with mediastinitis that were seen over a four-year period at the spinal cord unit at Northwestern Memorial Hospital are reviewed. PMID- 3977010 TI - Carcinoma arising in monomorphic adenoma of the salivary gland. AB - A case of carcinoma arising in a membranous type of monomorphic adenoma of the parotid gland is reported, and the literature is reviewed. This may represent the first unequivocal case of carcinoma arising in a nonadenolymphomatous and nonsebaceous monomorphic adenoma of the salivary gland. PMID- 3977011 TI - Cervical abscess caused by Salmonella infection. AB - A 69-year-old man had an abscess in the neck caused by Salmonella hador (enteritidis) infection. Salmonella infection of the head and neck are rare, and often occur in association with Salmonella infection in other parts of the body. The patient described may have had seeding to the neck from previous gastrointestinal infection. Treatment by drainage of the abscess and oral administration of ampicillin was successful. To the authors' knowledge, this is the sixth case of pure Salmonella infection of the head and neck reported in the world literature. PMID- 3977013 TI - Surgical management of inflammatory bowel disease. PMID- 3977012 TI - Surgical treatment of pancreatitis. PMID- 3977014 TI - Magnetic resonance imaging of the abdomen. PMID- 3977015 TI - The clinical utility of cytogenetic analysis in acute leukemia. PMID- 3977016 TI - A question of priority or misunderstanding? PMID- 3977017 TI - Lee McCarthy and his Histopathology of Skin Diseases. PMID- 3977018 TI - And now a few words about sex. PMID- 3977019 TI - Doctors can't split fees--why should lawyers? PMID- 3977020 TI - Atypical fibroblasts as a clue to radiation injury. PMID- 3977021 TI - Atypical fibroxanthoma of the skin metastatic to a lung. Report of a case, features by conventional and electron microscopy, and a review of relevant literature. PMID- 3977022 TI - Cutaneous manifestations of drug abuse by parenteral injections. PMID- 3977023 TI - Isolation of the vascular plexuses from the dermis. AB - A technique for isolation of the blood vessels from the dermis is presented. A number of characteristics of the vessels may be visualized in this way. PMID- 3977024 TI - Doctors and executions. PMID- 3977025 TI - The lure of primitive art. PMID- 3977026 TI - International cooperation in dermatology and dermatopathology. Some personal experiences. PMID- 3977027 TI - Allergy to storage mites or cow dander as a cause of rhinitis among Finnish dairy farmers. AB - The role of storage mites Acarus siro, Lepidoglyphus destructor, and Tyrophagus putrescentiae, compared with that of cow dander, as a cause of allergic rhinitis was studied by nasal challenges in a population of 106 non-smoking dairy farmers. Thirty-six of the subjects were challenged with storage mites alone, each with only one of the three species in consecutive order, 43 with cow dander alone, and 27 with both. Thus mite challenges were performed on 63 farmers and cow dander challenges on 70. Challenges with any one of the storage mite species were positive in 18% and with cow dander in 20% of farmers with allergic rhinitis. All challenges to asymptomatic farmers were negative. Five of the eight positive reactions to storage mites were due to Lepidoglyphus destructor, and three to Tyrophagus putrescentiae. Acarus siro was not responsible for any of the positive reactions. The results indicate that, among dairy farmers, storage mites are as common as cow dander as a cause of allergic occupational rhinitis. PMID- 3977028 TI - High dose inhaled budesonide in the treatment of severe steroid-dependent asthmatics. A two-year study. AB - Thirty-eight patients with chronic asthma requiring continuous oral corticosteroid treatment took part in a 2-year study. Budesonide, a new inhalation steroid with high topical activity and low systemic effects, was given in stepwise increasing doses from 200 micrograms daily up to 800-1600 micrograms daily and prednisolone doses were decreased gradually on an individual basis. After 2 years, 18 patients had been able to cease oral prednisolone treatment, 11 had decreased the dose by greater than or equal to 50%, three by less than or equal to 50% and two patients had increased their dose. At the end of the study the majority of patients (26) were using 800 micrograms budesonide daily and seven, 1200 micrograms or more daily. There were two dropouts, one due to local side effects and one to a severe pulmonary eosinophilia. Ten patients had local side effects in the form of hoarseness and/or sore throat, and 13 patients had steroid withdrawal symptoms such as arthralgia and myalgia. The asthma condition in all patients was improved, as indicated by the reduced need for hospital admissions. The results indicate that high doses of budesonide should be tried before starting maintenance therapy with oral steroids. PMID- 3977030 TI - Althesin. PMID- 3977029 TI - Characterization of IgE and IgG antibody responses to Dermatophagoides farinae in rats. AB - Rats (Brown Norway/Wistar Fu) that were pretreated or not pretreated with cyclophosphamide were immunized with varying amounts of Dermatophagoides farinae allergen extract with alum as adjuvant. Sera were analysed by RAST and by crossed radioimmunoelectrophoresis (CRIE). The highest IgE antibody responses were recorded in animals pretreated with cyclophosphamide that had received low immunizing doses of antigen. The IgE antibody pattern in CRIE was, however, not influenced by the dose of antigen or by cyclophosphamide pretreatment. The IgG pattern in CRIE closely resembled the IgE pattern, demonstrating a similar specificity of the antibody responses of the two isotypes. This indicates non class specific control of the specificity of antibody responses. PMID- 3977032 TI - Patient monitoring in the operating theatre. A comparison of practice between 1976 and 1983. AB - The vital importance of patient monitoring during anaesthesia is well recognised. There is little information available, however, on the actual practice of instrumental monitoring in the operating theatre. This study examined present-day practice and compared it with that of 1976. The main findings were an increase in frequency of electrocardiographic monitoring, especially for non-major surgery, and a smaller increase in blood pressure recording. Monitoring of other variables remained essentially unchanged. Possible reasons for this are given and suggestions made for improvements. PMID- 3977031 TI - Peri-operative endocrine effects of etomidate. AB - This study investigated the effects of etomidate on endocrine responses to anaesthesia and surgery. Patients undergoing abdominal hysterectomy received standard anaesthetics of either etomidate for induction with etomidate infusion, or thiopentone and halothane. Etomidate suppressed the secretion of cortisol and aldosterone for between 8 and 22 hours after the end of the etomidate infusion; 11-deoxycortisol secretion was not suppressed during the etomidate infusion, but rose postoperatively; 17 alpha-hydroxyprogesterone suppression also lasted only as long as the etomidate infusion. There were no effects on plasma oestradiol, ACTH, or prolactin, but growth hormone concentrations were elevated in the etomidate group. Etomidate was concluded to have influenced adrenocortical function only, where it probably inhibits 11 beta-hydroxylation, 17 alpha hydroxylation and other intramitochondrial hydroxylation reactions. There were no clinical sequelae attributable to adrenocortical suppression. The relationship of chemical structure of etomidate and other phenylated imidazoles to inhibition of steroidogenesis is discussed. PMID- 3977033 TI - Asynchronous independent lung ventilation. Its use in the treatment of acute unilateral lung disease. AB - The use of asynchronous independent lung ventilation is described in a patient presenting with acute respiratory failure due to a severe unilateral pneumonia. A polyvinyl chloride (Portex) double-lumen tube was inserted through a tracheostomy and the lungs ventilated independently using a combination of a Cape ventilator and a Servo 900B ventilator. PMID- 3977034 TI - A rate pressure product meter. A new module for use with the Simonsen & Weel System 8000 monitors. AB - A prototype rate pressure product module has been constructed for use with Simonsen and Weel Series 8000 monitors. The importance of method of display of rate pressure product is stressed. PMID- 3977035 TI - Isoflurane: effect on the encephalogram during carotid endarterectomy. AB - The effect of isoflurane on the electroencephalogram was studied in patients monitored during carotid endarterectomy. Increasing concentrations of this agent cause changes, but did not affect the ability to detect the onset of cerebral ischaemia consequent upon temporary occlusion of the internal carotid artery. At 1.0% and 1.5% concentration isoflurane caused significant decreases in mean arterial pressure which is undesirable in patients undergoing vascular surgery. PMID- 3977037 TI - Difficulty in extubation. PMID- 3977036 TI - Electrocardiographical changes in the peri-operative period. A pilot study. AB - The value of continuous electrocardiogram recording in the peri-operative period has been examined. In a group of 15 patients, 14 developed changes two of which persisted into the postoperative period. Dysrhythmias, ST segment and T-wave changes occurred frequently. Continuous recording is of potential benefit in the study of cardiovascular disease and therapy in the peri-operative period. PMID- 3977039 TI - Sterility of disposable syringes. PMID- 3977038 TI - Inadvertent total spinal for Caesarean section. PMID- 3977040 TI - Domperidone--an acute dystonic reaction. PMID- 3977041 TI - Neurogenic pulmonary oedema. PMID- 3977042 TI - Use of plastic guides for vascular catheterisation. PMID- 3977043 TI - Difficult tracheal intubation. PMID- 3977044 TI - Marfan's syndrome. PMID- 3977045 TI - Anaesthesia and Still's disease. PMID- 3977046 TI - Hydrophobic versus hygroscopic heat and moisture exchangers. PMID- 3977047 TI - Tracheal rupture. PMID- 3977048 TI - [A new cricothyreotomy set for emergencies]. AB - Cardio respiratory emergencies in which intubation is by any reason not possible are rare. The traditional procedure of emergency tracheotomy can be complicated by tracheal esophageal perforation. There is now available a new emergency cricothyreotomy set "Nu-Trake" which is easy to handle even by the less experienced anaesthesiologist. As shown in our study the risk of tracheo esophageal perforation is very small with the new emergency coniotomy set. We believe the device should be part of the standard equipment of every emergency ambulance, after some improvements by the manufacturer. PMID- 3977049 TI - Pain of skin infiltration with local anaesthetics. PMID- 3977050 TI - Verapamil and epidural bupivacaine. PMID- 3977051 TI - Potential hazard of an injection port in an arterial flushing device. PMID- 3977052 TI - Pulmonary oedema associated with tocolytic therapy. PMID- 3977053 TI - Failure of endotracheal tube cuff deflation. PMID- 3977054 TI - Subclavian arteriovenous fistula from central venous catheterisation. PMID- 3977055 TI - Curare before pancuronium. PMID- 3977057 TI - Mera circuit. PMID- 3977056 TI - Atropine and obstetric anesthesia. PMID- 3977058 TI - Industrial gas hazard. PMID- 3977059 TI - A gas delivery system for use during regional anaesthesia. PMID- 3977060 TI - Dantrolene sodium intravenous--verapamil. PMID- 3977061 TI - Changes of body temperature and heat in cardiac surgical patients. AB - Changes in body temperature were assessed in ten adult patients undergoing surgery involving cardiopulmonary bypass (CPB) and induced hypothermia. Intraoperatively, in comparable time intervals before CPB and after rewarming, the patients lost body heat. Between the time of induction of anaesthesia and CPB, the temperature of blood in the pulmonary artery fell 1.46 (SD 0.28 degrees C); between CPB and the end of surgery the fall was 1.55 (SD 0.86 degrees C). The extent of spontaneous hypothermia did not correlate with the amount of subcutaneous fat. Hypothermia was induced to obtain a stable deep body temperature of 27.2 (SD 1.3) degrees C, when mean skin temperature averaged 2 degrees C higher. The CPB machine returned approximately 2000 kJ of heat in the rewarming period, to produce pulmonary artery and mean skin temperatures of 37.1 (SD 0.7) degrees C and 31.4 (SD 2.1) degrees C respectively. Intraoperative deep body temperatures demonstrated the expected exponential relationship with metabolic rate. Postoperatively, increase in metabolic rate was associated with rising deep body and skin temperatures. Low resistance to the flow of heat toward the skin surface was demonstrated by low postoperative values for thermal insulation, which may indicate good peripheral perfusion seen during continuing vasodilator therapy. PMID- 3977062 TI - Blood flow, sympathetic activity and pain relief following lumbar sympathetic blockade or surgical sympathectomy. AB - The physiological effects of local anaesthetic (bupivacaine), neurolytic (phenol) blockade and surgical ablation of the lumbar sympathetic chain were assessed in patients with peripheral vascular disease or sympathetic dystrophy. Local anaesthetic blockade in 49 patients resulted in significant decrease in pain, plantar sweating and in the vasoconstrictor ice response of the foot, as well as a significant increase in skin temperature and foot blood flow. Subsequent neurolytic blockade in 31 of these patients achieved an effective denervation as assessed by the same physiological measurements. The magnitude of changes in blood flow and sympathetic activity were similar for local anaesthetic and neurolytic blockade as well as in six patients who underwent surgical sympathectomy. PMID- 3977063 TI - Acute epiglottitis in children. AB - The records of one hundred and sixty-one children with acute epiglottitis admitted to the Royal Alexandra Hospital for Children between January 1975 and June 1984 were reviewed. Forty-five complications occurred in thirty-four patients, including five deaths. The preferred method of airway management is direct laryngoscopy and nasotracheal intubation under general anaesthesia in the presence of skilled assistance. There should be no attempt to lie the child down prior to this, nor should awake laryngoscopy be attempted, as this may precipitate a respiratory arrest. Chloramphenicol (with or without ampicillin) should be commenced after blood cultures are obtained, as 20% of the sensitivities available demonstrated resistance to ampicillin. PMID- 3977064 TI - Ranitidine prophylaxis before anaesthesia in early pregnancy. AB - Forty patients presenting for vaginal termination of pregnancy, divided randomly into four groups, received either no medication, sodium citrate 30 ml orally, ranitidine 150 mg orally or ranitidine 50 mg intravenously. During the procedure, gastric contents were removed by orogastric tube for volume and pH measurements. Ranitidine, orally and intravenously, significantly increased gastric pH and reduced gastric volume. In the control group only one pH was greater than 2.5. Sodium citrate raised the pH above 2.5 in 6 out of 10 patients. Fasting patients in the first months of pregnancy may be at risk of developing Mendelson's syndrome. Ranitidine is very effective in increasing gastric pH and at the same time reducing gastric volume in such patients. PMID- 3977065 TI - Intravascular monitoring via the axillary artery. AB - Axillary artery cannulation was performed in 31 patients in whom the radial arteries were unavailable or unsuitable for cannulation. The artery was first cannulated with an 18-gauge needle, after which a Seldinger guide wire (0.032 inch diameter) was passed, which was used to introduce a 6-inch, 18-gauge Teflon catheter. The mean duration of cannulation was 3.2 days (range 19 hours to 8 days). All patients were assessed for complications of the procedure up to 72 hours after decannulation. No serious complications were encountered. It is concluded that the axillary artery is a safe alternative in the absence of an available radial artery when arterial cannulation is indicated. PMID- 3977066 TI - Indications for and complications of temporary transvenous cardiac pacing. AB - A prospective survey was conducted of the indications for and complications of 153 temporary transvenous cardiac pacing lead insertions in 148 patients. Pacing for bradyarrhythmias or potential bradyarrhythmias (Group I) accounted for 105 insertions, wide complex tachycardia (Group II) 17, and narrow complex tachycardia (Group III) 31 pacing electrode insertions respectively. The infraclavicular subclavian vein approach was used in 73%. The median insertion time was 20 minutes. Group I: 77% were undertaken because of severe symptoms. On 64 occasions (61%) the patient had complete heart block or ventricular asystole. Group II: The lead was inserted to treat and often assist in the diagnosis of the wide complex tachycardia. Ventricular 'burst' pacing reverted ventricular tachycardia in 13 (76%). Group III: Rapid atrial 'burst' pacing was used to treat supraventricular tachyarrhythmias (paroxysmal supraventricular tachycardia and atrial flutter) resistant to medical therapy. Pacing was successful in reverting 28 (90%). A complication occurred in 27 (18%) of 153 lead insertions, 11 (7%) were serious. No complication resulted in the death of a patient. Temporary transvenous pacing is safe and effective for the treatment of bradyarrhythmias and certain tachyarrhythmias. PMID- 3977067 TI - A complication of circumcision and dorsal nerve block of the penis. PMID- 3977068 TI - Anaesthesia for separation of conjoined twins in the neonatal period. PMID- 3977069 TI - Phaeochromocytoma in a child. PMID- 3977071 TI - Electrochemical sensors in clinical chemistry: yesterday, today, tomorrow. PMID- 3977070 TI - Australian Society of Anaesthetists presidential address 1984. The winds of change. PMID- 3977072 TI - Fourier transform ion mobility spectrometry. PMID- 3977073 TI - Decomposition of marine biological tissues for determination of arsenic, selenium, and mercury using hydride-generation and cold-vapor atomic absorption spectrometries. PMID- 3977074 TI - Stable isotope ratio mass spectrometry for iron bioavailability studies. PMID- 3977075 TI - Study of the effect of decomposition methods on the accurate determination of zinc in biological samples by electrophoresis. PMID- 3977077 TI - Sensitive bioaffinity sensor with metastable molecular complex receptor and enzyme amplifier. PMID- 3977076 TI - Thermospray liquid chromatography/mass spectrometry determination of drugs and their metabolites in biological fluids. PMID- 3977078 TI - High mass analysis by laser desorption Fourier transform mass spectrometry. PMID- 3977079 TI - Electrochemical and electron spectroscopic studies of highly polished glassy carbon electrodes. PMID- 3977080 TI - Enzyme-based fiber optic sensor. PMID- 3977081 TI - The cellular distribution of calcium in freeze-dried rabbit vas deferens using EM autoradiography. AB - The role of calcium in initiating smooth muscle contraction is widely accepted. The sources of this calcium are thought to be located both intracellularly and extracellularly. We have recently developed a method by which the cellular localization of calcium in smooth muscle can be determined. This method involves exposing the tissue to 45Ca, rapidly freezing and vacuum dehydrating the tissue, and preparing the tissue for electron microscopic autoradiography (EM ARG). In the present study the distribution of calcium in control and potassium-contracted tissue of the rabbit vas deferens was compared. No significant differences in distribution were observed in the two treatments. This finding provides morphological support for the hypothesis that the calcium used in potassium induced contraction is primarily of extracellular origin. In addition, significant sequestration by intracellular organelles does not occur during a potassium contraction. In other experiments, the effect of rinsing tissue in cold calcium prior to freezing was investigated. From these data is appears that calcium is removed from the cytoplasmic matrix, plasma membrane, and organelles in a nonuniform manner. Further investigation into these findings should enable us to characterize more precisely the intracellular redistribution of calcium that occurs as a result of a variety of physiological manipulations. PMID- 3977082 TI - Muscle fiber necrosis and regeneration induced by prolonged weight-lifting exercise in the cat. AB - For periods ranging from 26 to 87 weeks, the morphological characteristics of the flexor carpi radialis (FCR) muscle were examined in four cats trained to perform weight-lifting exercise. Four untrained, sex and weight-matched cats served as controls. The right FCR from each cat was surgically isolated, attached to a tension transducer, and set at its optimal length. The forelimb was perfused with 2% glutaraldehyde in 0.1 M cacodylate buffer. Small bundles of fibers were teased from their origin and insertion tendons and embedded in Epon. Spaced serial sections were used to examine the morphological features of the fibers for trained and control animals. Ultrastructural examination revealed muscle fiber degenerative changes, such as pyknotic nuclei, disruption of the sarcolemma, vacuolation, and disorganization of myofilaments. Such changes were observed at a higher frequency in trained muscle than in control muscle. Spaced serial sections of fiber bundles showed that the degree of degeneration varied along the length of the fiber. Fiber area measurements showed that trained muscle had both larger and smaller fibers than control samples. The very small fibers observed in the trained muscle were considered to be regenerating or "new" fibers since they had not undergone degenerative changes. "Satellite-like" cells were observed in trained muscle. Such cells resembled satellite cells but also contained developing myofilaments. Since evidence of degeneration-regeneration was observed in control samples, but at a lower frequency, it was postulated that weight lifting exercise accelerates muscle fiber turnover in the cat FCR. PMID- 3977083 TI - Variation in basement membrane topography in human thick skin. AB - Samples of human plantar and palmar skin were excised and incubated in 20 mM EDTA after which the epidermis was gently separated from the dermis with the plane of separation occurring in the lamina lucida. Scanning electron microscopic examination of the dermal component revealed the classically described series of regularly spaced grooves and papillae that characterize the epidermal-dermal junction in thick skin. Primary dermal grooves exhibited evenly spaced tunnels that were originally occupied by sweat gland ducts. The basement membrane (basal lamina) in the primary grooves was relatively smooth but did exhibit a flattened, reticulated pattern at high magnifications. The basement membrane of secondary dermal grooves and papillae was in the form of numerous, elevated microridges off of which septae arose at roughly right angles. The surface appearance of the basement membrane in these areas was that of a honeycomb owing to the numerous compartments and recesses formed by the ridges and septae. Degradation of the basement membrane by trypsin demonstrated that the foundation for the highly folded and compartmentalized basement membrane was composed of dermal collagen fibrils, 60-70 nm in diameter, that were arranged in a series of variably sized, interconnected collagen bundles or walls. Epidermal basal cells extended cytoplasmic (foot) processes into two or more compartments, formed by the ridges and septae, which considerably amplified the basement membrane surface available for epidermal attachment. Scanning electron microscopic studies of the epidermal dermal junction confirm the variable surface character of this interface previously reported by others using sectioned material.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977084 TI - Bone healing after amputation of mouse digits and newt limbs: implications for induced regeneration in mammals. AB - Postamputational healing was compared in nonregenerating and regenerating animals to determine whether bone healing might interfere with a regenerative response in mice. More than 150 mouse toes and 100 newt limbs were examined at the light microscope level. Stages of normal bone healing with approximate times of occurrence were established. Major differences in healing of these two species were seen. The periosteum produced hyaline cartilage, woven bone, and chondroid bone in mice, but only hyaline cartilage in newts. The endosteum produced woven bone in mice but no new growth in newts. Dead bone persisted in mice but was removed in newts. The marrow cavity became sealed in mice but remained open in newts. Despite these differences both animals produced skeletal tissue distal to the amputation plane. Woven bone formed distal to the amputation plane of mice. Cartilage formed distal to the amputation plane of newts, but cartilage was never seen distal to the plane of mice. Results of previous studies reveal that cartilage can be formed distal to the amputation plane of experimentally treated mice. Thus, although it does not regenerate, mouse bone is capable of producing, distal to the amputation plane, the type of skeletal tissue which appears at that location during an epimorphic regenerative response. This observation, in combination with other experimental results, indicates that both skeletal and soft tissues at the amputation site of treated mammals can resemble comparable tissues of newt limbs at an early stage of regeneration. PMID- 3977085 TI - The allantois of the North American opossum (Didelphis virginiana) with preliminary observations on the yolk sac endoderm and trophectoderm. AB - During the middle of prenatal day 10, the opossum allantois forms as a ventral outgrowth of the hindgut. By day 11 it appears as a large, fluid filled sac and by the middle of day 12 (just prior to birth) it reaches its maximal development. The simple squamous epithelium lining the allantois consists of only one cell type that often contains numerous filaments in the apical cytoplasm. At the luminal surface, the apices of the cells are united by junctional complexes and desmosomes are present between adjacent cells. The luminal surface is irregular, whereas laterally and basally the cell membranes show few if any infoldings. Mitotic figures and presumptive degenerating cells occasionally occur in the allantoic epithelium which rests on a delicate basal lamina. The allantois is covered by a simple squamous mesothelium that lacks a distinct basal lamina. Between the two epithelial sheets lie mesenchymal cells, collagen fibers, and blood vessels. No specializations of cell membranes were noted in either of the epithelial layers. The yolk sac endoderm consists of a single layer of squamous cells whose cytoplasm contains scattered profiles of rough endoplasmic reticulum and mitochondria. Extensive lateral and basal infoldings of the plasmalemma were not observed in these endodermal cells. The morphology of the trophectodermal (trophoblastic) cells indicates a cell type that is active in the transport of materials. Since the endodermal cells that line the allantois lack morphological features that would suggest the presence of mechanisms for transport or exchange, and because they remain relatively unchanged throughout pregnancy, it is thought that the allantois functions primarily in the storage of urinary wastes during prenatal life.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977086 TI - Pit cells in extrahepatic organs of the rat. AB - Electron microscopic examination of the extrahepatic distribution of pit cells, a cell type found in the liver, revealed their existence in several other organs of the rat. They were relatively frequent in lungs, spleen (red pulp), small intestine, epididymis, trachea, and peripheral blood; much fewer in bone marrow and thymus (medulla); and nonexistent in lymph nodes, spleen (white pulp), and thymus (cortex). The pit cells in these organs, as well as in the liver, contained characteristic dense granules and rod-cored vesicles in the cytoplasm. Our observations suggest that pit cells circulating in the peripheral blood adhere to the endothelium of capillaries in the various organs and migrate into the tissue, where they have some special immunological function. PMID- 3977087 TI - A comparison of histopathologic changes following X-irradiation of mid-thoracic and lumbosacral levels of neonatal rat spinal cord. AB - Light microscopic changes were studied in the dorsal funiculi of spinal cords from rats irradiated (4000 R) at 3 days of age and killed from 9-60 days postirradiation (P-I). The irradiated site was limited to a 5-mm length of mid thoracic spinal cord (T only) in one group of rats, to a 5-mm length of lumbosacral spinal cord (L only) in a second group, and to 5-mm lengths of both mid-thoracic and lumbosacral spinal cord (T/L) in the third group. Changes in the lumbosacral regions were essentially the same in both L only and T/L irradiated groups. These changes included a decreased neuroglial population and a concurrent state of hypomyelination from 9-30 days P-I. In contrast, in the mid-thoracic regions of T only and T/L irradiated groups the decrease in the neuroglial population was obvious only through 13 days P-I, and by 30 days this population resembled that of the controls. The irradiated mid-thoracic areas were hypomyelinated, with the fasciculus gracilis showing a greater degree of hypomyelination than the fasciculus cuneatus. By 25 days P-I, myelination appeared to be normal in these areas. Scattered hemorrhages were noted in both lumbosacral and mid-thoracic regions, but necrotic areas occurred only at the lumbosacral level. In general, the mid-thoracic area appeared to be less sensitive to x-radiation at 3 days of age than the lumbosacral area. These data suggest that there may be marked differences in the developmental states of cells at these two levels at 3 days of age. PMID- 3977088 TI - Asymmetry of the human skull during fetal growth. AB - Asymmetry of the human skull in the frontal and basal views has been described previously as a normal feature in adults. However, no investigation has been performed during the fetal period to see when asymmetry first develops. Previous quantitative methods for measuring asymmetry have relied upon defining anatomical points and using geometrical constructions. In the present study image outlines and their centroids (centers of area) were related to each other via a rectangular coordinate reference grid using the technique of morphanalysis. The centroids were shifted to the left relative to the coordinate reference grid indicating a left side expansion. Also the signed area under the cyclical curve, which is zero for a perfectly symmetrical shape, showed a negative shift indicating asymmetry. The cranium was found to be the major site of asymmetry caused by unequal development of the cerebral hemispheres. The asymmetrical development of the temporal lobes caused a greater displacement of the nasomaxillary segment on the left leading to a rotation of the face on the cranium. PMID- 3977089 TI - The relation of nucleolus diameter to cell body diameter in mammalian dorsal root ganglion cells. AB - The present study correlates cell body and nucleolar sizes for dorsal root ganglion cells in the rat. To do this, we measured cell body areas and calculated their diameters and measured nucleolar diameters for 719 cells. These data indicate that there is a correlation in that increasing cell size is associated with increasing nucleolar size. However, there is considerable variability of cell body size for each nucleolar diameter and vice versa. Nevertheless, when nucleolar diameters are grouped, the function 1n D = 1.687 + 0.334 dr, where D is the diameter of the cell body and dr the rounded diameter of the nucleolus, produced an almost straight line. Thus this formula provides a good estimate of the relation of nucleolar and cell body sizes for dorsal root ganglion cells of the rat. In addition, estimates of the variances of cell body size at each nucleolar diameter are provided. PMID- 3977090 TI - Odontoblast turnover in the impeded and unimpeded rat incisor derived from computerized histomorphometry. AB - A computerized histomorphometric method was devised to estimate the kinetics of odontoblast turnover and dentinogenesis in rat incisors. The method was applied to two groups of rats: one group with lower incisors in impeded eruption and another group with the left lower incisor in the unimpeded state. The teeth were divided into six equal segments, from which consecutive ground sections were obtained. The distance of each ground section from the posterior border of the alveolar bone was calculated. Each section was magnified, traced, and the tracings fed into a computer by a sonic digitizer. The perimeters and areas of dentine and pulp in each ground section were calculated by the computer. The mean odontoblast density along the predentine was evaluated from histological sections taken both from the same tooth segments and from teeth sectioned midsagittally. These served for the estimation of the predentine area occupied by the average odontoblast. In the impeded group, this area was 11% larger than in the unimpeded one. Outer dimensions of teeth, namely the circumference of the dentine, the labiolingual width, and the mesiolateral width remained constant and equal for both groups. Daily rates of dentine apposition were computed and were found to vary according to the age of the odontoblasts. Odontoblasts of impeded teeth started to secrete matrix at a rate of 17 microns/day, which increased slightly to 19 microns/day and later declined to 7 microns/day on the 38th day. Dentine production of unimpeded odontoblasts, on the other hand, started at a rate of 16 microns/day and gradually increased to 34 microns/day on the 17th day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977091 TI - Comparison of the effects of 15 and 60 micrograms/kg fentanyl used for induction of anesthesia in patients with coronary artery disease. AB - We compared the effects of 15 and 60 micrograms/kg fentanyl used for induction in 40 patients, 50-72 yr old, with coronary artery disease and mildly impaired ventricular contractility. Morphine (0.1 mg/kg) and scopolamine (0.4 mg) were used for premedication. Crystalloid (500 ml) was administered before induction, and nitroglycerin (0.3 micrograms X kg-1 X min-1) was infused during the study. Fentanyl, 15 or 60 micrograms/kg, was administered at a rate of 1.2 micrograms X kg-1 X sec-1. Pancuronium (0.04 mg/kg) and metocurine (0.16 mg/kg) were used for muscle relaxation. Data were collected 2 min before induction (baseline), before intubation (3 min), at 6 min, and at 13 min. Responses to 15 and 60 micrograms/kg were similar. At 3 min the heart rate (HR) in patients given 15 micrograms/kg increased by 6; whereas the HR in those given 60 micrograms/kg increased by 14 (P less than 0.01). Subsequent differences in HR were not significant. There were no dose-related differences in mean arterial pressure, cardiac index, central venous pressure, or pulmonary capillary wedge pressure. The EEG showed high-voltage low frequency activity within 2 min in all patients. Arterial plasma fentanyl concentrations at 3 min averaged 25.9 +/- 3.8 ng/ml with 15 micrograms/kg and 89.9 +/- 15.2 ng/ml with 60 micrograms/kg. At 4 hr, plasma concentrations averaged 0.4 +/- 0.2 ng/ml and 3.6 +/- 0.7 ng/ml, respectively. We conclude that anesthesia for induction and intubation is achieved by the rapid administration of 15 micrograms/kg fentanyl and that 60 micrograms/kg has no substantially different effect on cardiovascular responses. PMID- 3977092 TI - Large volume crystalloid resuscitation does not increase extravascular lung water. AB - The purpose of this study was to determine whether Ringer's lactate solution increases extravascular lung water (EVLW) during resuscitation after hemorrhagic shock. Ten sheep anesthetized with thiamylal were bled to a mean arterial pressure (MAP) of 50 mm Hg; further bleeding maintained that pressure for 30 min. Resuscitation fluid consisted of Ringer's lactate solution in volumes necessary to restore and maintain for 1 hr MAP, pulmonary capillary wedge pressure (PCWP), and cardiac index at levels equal to those measured before bleeding. After volume replacement, the colloid oncotic pressure (COP) - PCWP gradient (COP - PCWP) decreased from 12 +/- 3 to 2 +/- 5 mm Hg (P less than 0.001). After volume restoration, COP decreased from 19 +/- 8 mm Hg to 12 +/- 2 mm Hg (P less than 0.001). Despite the large volume of fluid administered, EVLW did not increase. Crystalloid resuscitation does not necessarily increase EVLW despite significant decreases in COP and COP - PCWP gradient. PMID- 3977093 TI - Effects of low doses of meperidine on neonatal behavior. AB - After meperidine administration during labor, meperidine reaches its highest level in fetal tissues within 2-3 hr. The highest levels of normeperidine, the active metabolite of meperidine, are, on the other hand, determined in fetal tissues by the time between administration of meperidine to the mother and delivery: the greater the drug-to-delivery interval (DDI), the higher the fetal levels of normeperidine. Because of the different times to peak fetal levels of meperidine and normeperidine, it may be possible to partially separate the effects of meperidine and its metabolite on the neonate using the DDI. The purpose of this study was to determine whether low doses of meperidine affected performance on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS), and whether this performance is related to the DDI or to levels of meperidine or to normeperidine. Sixteen control neonates whose mothers received no meperidine and 41 study infants whose mothers received 25-100 mg meperidine intravenously (mean 39 +/- 19 mg) were studied. Comparisons of BNBAS scores of control and study infants measured at less than 12 hr, again at 3 days of age, and the effect of DDI were made using repeated measures analyses of variance (ANOVA). Correlation techniques were used to examine relationships between BNBAS performance and clinical and pharmacological variables related to drug administration. The BNBAS cluster scores representing regulation of state and number of abnormal reflexes were significantly different in study neonates from control neonates. Performance depended upon test day. Further analysis showed that longer DDIs resulted in less optimal BNBAS performance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977094 TI - Accumulation of methane, acetone, and nitrogen in the inspired gas during closed circuit anesthesia. AB - During closed-circuit anesthesia, the patient's inspired gas may become progressively contaminated by nonanesthetic gases. We studied the concentrations of methane, acetone, and nitrogen as nonanesthetic gas contaminants in the circuit gas of 16 cases during closed-circuit anesthesia. After a "short" period of denitrogenation (6-8 min), average nitrogen concentration in the closed circuit increased from 6.4 to 16.2%, methane from 4.3 to 22.4 ppm, and acetone from 0.3 to 2.2 ppm. After "long" denitrogenation (33 min), average nitrogen concentration in the closed circuit increased from 1.0 to 5.1%, methane from 3.7 to 17.9 ppm, and acetone from 1.3 to 5.9 ppm. It is concluded that gases stored in tissues or produced within the body can appear in the patient's expired gas during closed-circuit anesthesia. Intermittent flushing of the circuit with high flow gases is suggested to remove these contaminants. PMID- 3977095 TI - Subjective evaluation of anesthesia textbooks: relation to currency. PMID- 3977096 TI - Transient aphonia and quadriplegia during epidural anesthesia. PMID- 3977097 TI - Seizure activity during isoflurane anesthesia. PMID- 3977098 TI - Anesthetic management of a patient with Moebius syndrome. PMID- 3977099 TI - Shoulder block anesthesia for shoulder reconstruction surgery. PMID- 3977100 TI - Pulse oximetry during pulmonary artery surgery. PMID- 3977101 TI - Disulfiram-like reaction to moxalactam after celiac plexus alcohol block. PMID- 3977102 TI - Esophageal stethoscope amplifier. PMID- 3977103 TI - Capnographs: a new operating room pollution hazard? PMID- 3977104 TI - Counter-irritation reduces pain during cutaneous needle insertion. PMID- 3977105 TI - Vent stitch entrapment. PMID- 3977106 TI - Importance of anesthetic equivalence. PMID- 3977107 TI - Avoiding air infusion with pressurized infusion systems: a new hazard. PMID- 3977108 TI - The health of operating room personnel. PMID- 3977109 TI - The assessment of diaphragmatic contractility. PMID- 3977110 TI - New dimensions of the respiratory system. PMID- 3977111 TI - Effects of aminophylline on diaphragmatic dysfunction after upper abdominal surgery. AB - The effects of upper abdominal surgery on diaphragmatic function were studied in eight supine patients before and after administration of aminophylline. Changes in pleural (delta Ppl) and gastric pressure (delta Pga) swings were measured with balloon catheter systems. Transdiaphragmatic pressure change (delta Pdi) was calculated as the difference delta Pga-delta Ppl. The ratio delta Pga/delta Pdi, used as an index of the diaphragmatic contribution to the quiet breathing process, decreased significantly as early as 1 h after operation without any further change throughout the 6-h period studied. Administration of aminophylline (6 mg/kg), six hours postoperatively, produced a significant increase in this diaphragmatic index. These data indicate that the early reduced diaphragmatic activity, after upper abdominal surgery, partially may be reversed by administration of aminophylline. The mechanism of its action may involve central nervous stimulation and/or a direct inotropic effect on diaphragmatic muscle. Further studies are needed to evaluate if the correction of altered diaphragmatic motion by aminophylline improves postoperative lung function. PMID- 3977112 TI - Functional residual capacity, thoracoabdominal dimensions, and central blood volume during general anesthesia with muscle paralysis and mechanical ventilation. AB - Functional residual capacity (FRC), rib cage and abdominal dimensions (rc-ab), central blood volume (CBV), and extra vascular lung water (EVLW) were measured in six lung-healthy subjects awake and during halothane anesthesia, muscle paralysis, and mechanical ventilation. FRC was assessed by multiple breath nitrogen washout, rc-ab dimensions by computerized tomography, and CBV and EVLW by a double-indicator dilution technique (thermo-dye). During anesthesia, FRC decreased by 0.5 1 (17%). The cross-sectional chest area was reduced by 12-20 cm2, causing an approximate reduction in thoracic volume by 0.3 1. Concomitantly, the diaphragm was moved cranially by an average of 1.9 cm, diminishing the thoracic volume a further 0.5 1. The abdominal cross-sectional area did not alter significantly, despite the shift of the diaphragm. CBV decreased by 0.3 1. EVLW did not change significantly. It is concluded that the thoracic volume is reduced during halothane anesthesia, muscle paralysis, and mechanical ventilation as a result of cranial shift of the diaphragm and reduction in transverse area. The decrease in thoracic volume is accompanied by a reduction in FRC and a displacement of blood from the thorax to the abdomen, the transverse area of the latter thus being maintained despite the shift of the diaphragm. PMID- 3977113 TI - Continuous-plus-on-demand epidural infusion of morphine for postoperative pain relief by means of a small, externally worn infusion device. AB - In this study, 50 patients received an initial bolus epidural injection of 2 mg morphine-hydrochloride followed by a continuous-plus-on-demand epidural infusion of a 0.25% morphine-hydrochloride solution by means of a small, externally worn infusion device, for constant pain relief after abdominal operations. Mean morphine consumption on the operation day (until 8:00 AM on the first postoperative day) was 4.8 +/- 0.2 mg, on the first postoperative day (until 8:00 AM on the second postoperative day) 1.9 +/- 0.2 mg, and on a second postoperative day until 8:00 PM, 0.6 +/- 0.1 mg. The mean morphine consumption over 50 h was 7.1 +/- 0.3 mg; in the first 25 h and in the following 25 h after the operation, 5.44 +/- 0.3 mg and the significantly lower amount of 1.64 +/- 0.2 mg morphine, respectively, were consumed (P less than 0.001). There were no serious side effects. Serum levels of free, unmetabolized morphine immunoreactivity decreased during the treatment. The described method is recommended for treating postoperative pain, as it offers constant analgesia and the possibility of individualized treatment. PMID- 3977114 TI - Pulmonary and systemic hemodynamic responses to ketamine in infants with normal and elevated pulmonary vascular resistance. AB - Avoidance of ketamine has been recommended in children with pulmonary hypertension or with limited right ventricular reserve, despite absence of data about the effects of ketamine on pulmonary vascular resistance (PVR) in children. Ketamine has been associated with increased PVR in studies of adults; in these studies adults were spontaneously breathing through unprotected airways, despite ketamine's known effects of ventilatory depression and partial loss of airway. The authors measured pulmonary and systemic hemodynamic responses to ketamine during spontaneous ventilation in 14 intubated infants who were receiving minimal ventilatory support with an intermittent mandatory ventilation (IMV) of 4 at an FIO2 of 0.3-0.4. No significant changes were found in cardiac index (CI), pulmonary vascular resistance index (PVRI), or systemic vascular resistance index (SVRI) in a group of seven infants with normal PVRI or in another group of seven infants with preexisting increased PVRI. Results did not differ in infants receiving diazepam sedation. The authors conclude that ketamine has little effect on baseline hemodynamics in mildly sedated infants whose airway and ventilation are maintained; in particular, PVRI is little changed by ketamine administration in ventilated infants with either normal or increased baseline PVRI. PMID- 3977115 TI - Health experiences of operating room personnel. AB - In an attempt to evaluate health experiences of operating room personnel using previously published reports, the authors calculated summary relative risks (RRs) for each outcome under investigation by combining data from six studies. For each summary RR, they also calculated 95% confidence limits; when the range of the confidence interval excludes 1.0, the increased risk is statistically significant at the 0.05 level. The most consistent evidence was for spontaneous abortion among pregnant physicians and nurses who work in operating rooms, where the RR was 1.3 (95% confidence limits from 1.2 to 1.4). For liver disease there were statistically significant increased RRs among both men (1.6, 1.3-1.9) and women (1.5, 1.2-1.9), but these were based on smaller numbers of studies. Although the results of pooled analyses are suggestive, most studies of this issue have relied on voluntary responses and self-reported outcomes, so that response and/or recall bias could explain these findings. In addition, these investigations generally have examined working in operating rooms rather than actual exposure to anesthetic gases. Finally, there have been considerable improvements in operating room scavenging systems during the last decade. Thus, prospective cohort studies are needed to determine whether there is a relationship between current levels of occupational exposure to anesthetic gases and adverse outcomes, particularly spontaneous abortion and liver disease. PMID- 3977116 TI - Halothane, isoflurane, and enflurane MAC in pregnant and nonpregnant female and male mice and rats. AB - The MAC of halothane, isoflurane, and enflurane was determined using the tail clamp technique in pregnant female, nonpregnant female, and male Swiss Webster mice (n = 216) and Sprague-Dawley rats (n = 112). Mean MAC values (+/-SD) for halothane, isoflurane, and enflurane in mice were 0.95 +/- 0.07%, 1.34 +/- 0.10%, and 1.95 +/- 0.16%, respectively; values in rats were 1.03 +/- 0.04%, 1.46 +/- 0.06%, and 2.21 +/- 0.08%, respectively, all significantly higher than in mice. Neither the sex of the animals nor whether female animals were pregnant influenced the results. PMID- 3977117 TI - Effects of peripheral vasoconstriction on the blood pressure in the finger, measured continuously by a new noninvasive method (the Finapres). AB - The authors determined whether vasoconstriction alters the ability of a noninvasive method (Finapres) of continuously measuring arterial blood pressure in the finger to function accurately. They compared the response of the Finapres to blood pressures determined simultaneously by an oscillometric technique (Dinamap) in six anesthetized patients. Vasoconstriction was detected from a photoelectric plethysmogram, which was recorded continuously from an adjacent finger. Vasoconstriction was defined as a decrease in amplitude to less than half of its highest value in one and the same patient. From the 378 paired blood pressure readings obtained in this study, 51% took place in such a vasoconstricted state. The authors found that diastolic and mean blood pressures in the finger were, on the average, 9 mmHg below those in the upper arm and that the systolic pressure was 7 mmHg above that in the upper arm. The authors concluded that the Finapres keeps functioning well during peripheral vasoconstriction and is a recommendable method to monitor arterial blood pressure in the finger. PMID- 3977118 TI - The hemodynamic effects of nimodipine in patients anesthetized for cerebral aneurysm clipping. PMID- 3977119 TI - Epidural blockade for cesarean section comparing lidocaine hydrocarbonate and lidocaine hydrochloride. PMID- 3977120 TI - Preanesthetic evaluation of a patient with pathologic Q waves following subarachnoid hemorrhage. PMID- 3977121 TI - Intraoperative defibrillator failure. PMID- 3977122 TI - A new pressure-sensitive laryngoscope. PMID- 3977123 TI - Technique of avoiding esophageal burns. PMID- 3977124 TI - Delayed onset of laryngospasm-induced pulmonary edema in an adult outpatient. PMID- 3977125 TI - High oxygen saturation does not always indicate arterial placement of catheter during internal jugular venous cannulation. PMID- 3977126 TI - Securing the epidural catheter. PMID- 3977127 TI - Decreasing the incidence of upper airway bleeding when using a large-size nasotracheal tube. PMID- 3977128 TI - A technique for avoiding inadvertent intraarterial placement of large bore catheters. PMID- 3977129 TI - Oxygen- and suction-equipped laryngoscope blade. PMID- 3977130 TI - Ventricular fibrillation during thermodilution cardiac output determination. PMID- 3977131 TI - A complication of multipurpose pacing pulmonary artery catheterization via the external jugular vein approach. PMID- 3977132 TI - Eosinophilia, mental status changes, and renal failure in a 55-year-old woman. PMID- 3977133 TI - Central nervous system effects of antiasthma medication--an EEG study. AB - The relationship between electroencephalographic (EEG) abnormalities (in particular paroxysmal activity) and theophylline alone or in combination with corticosteroids and/or ephedrine was examined in 161 adult and 93 pediatric patients. For each patient, total theophylline dosage was calculated and a theophylline blood level was obtained at the time of EEG recording. The major findings indicated: The presence of EEG paroxysmal activity in a greater percentage of the population studied than that which has been reported in a group of nonhospitalized individuals of similar age in the general population. There is a greater probability of EEG paroxysmal activity among patients with higher theophylline blood levels or total dosages than among those with lower blood levels or total dosages. There is an increase in EEG abnormalities with the addition of ephedrine. There is a possible protective effect of steroids against theophylline-related central nervous system disturbances. PMID- 3977134 TI - Chronic cough, sinusitis, and hyperreactive airways in children: an often overlooked association. AB - Ten patients, aged 7 to 16 years, were prospectively evaluated for chronic cough of more than 4 months duration. All patients denied wheezing, but in addition to cough complained of chronic obstructive nasal symptoms. Sinus roentgenograms were consistent with sinusitis in 7/10 patients. Methacholine bronchial provocation was positive in 6/9 patients. The patients were recalled for a 2-year follow-up evaluation. Of seven follow-up patients, bronchial asthma had developed in three, two patients had chronic cough and exercise-induced bronchospasm, and two patients had chronic cough without wheezing. Methacholine bronchial provocation was positive in 6/6 patients. Sinus roentgenograms were compatible with sinusitis in 4/7 patients. Chronic cough in some children may be a complaint of diffuse hyperreactive airways complicated by sinusitis. In some of the children the clinical course evolved into a diffuse respiratory tract disorder including chronic obstructive eosinophilic rhinitis, recurrent or chronic sinusitis and bronchial asthma. An IgE-mediated mechanism usually could not be shown in the pathogenesis. PMID- 3977135 TI - Dissemination of dust by central and portable vacuum cleaners. AB - Determination of the number of particles greater than 0.5, 1, 2, 5, and 10 microM in the air before, during, and after cleaning of carpeting disclosed larger numbers of airborne particles during cleaning with portable vacuum cleaners than with central vacuum cleaners, and more airborne particles during cleaning of shag carpeting than shorter pile carpeting. PMID- 3977136 TI - Inhaled metabisulfite sensitivity. AB - Sensitivity to an inhaled sulfite-containing solution was evaluated in 13 asthmatics and ten nonasthmatic controls. Three of the 13 asthma patients were known to be sensitive to ingested sulfite and ten were not sensitive. All three sulfite-sensitive patients developed bronchospasm following sulfite inhalation challenges. Four of the ten asthmatics not sensitive to ingested sulfite developed bronchospasm following sulfite inhalation. The control subjects showed no reaction to inhaled sulfite. This study demonstrated that all asthmatics sensitive to ingested sulfite developed bronchoconstriction with inhaled sulfite. Furthermore, sensitivity to inhaled sulfite was more common than sensitivity to ingested sulfite in asthmatic patients. Possible reasons for this difference are discussed. PMID- 3977137 TI - Localized bronchomalacia presenting as worsening asthma. AB - A patient with longstanding mild asthma presented with a several month history of almost continuous wheezing. Pulmonary function tests suggested large airway variable intrathoracic obstruction. At bronchoscopy, she was found to have severe bronchomalacia limited to the left main bronchus. There was almost complete obstruction of that airway during forced expiration. PMID- 3977138 TI - Bisulfite sensitivity manifesting as an allergic reaction to aerosol therapy. PMID- 3977139 TI - Pulmonary hyalinizing granuloma. AB - We describe a recent case of pulmonary hyalinizing granuloma presenting classically in a young black American female. The diagnosis was made by histopathologic examination. The etiology of this entity remains elusive, however, an abnormal response involving the immune system to an undefined agent (or agents) is the most likely explanation. PMID- 3977140 TI - Immunochemical study of the venom from the hornet Vespa orientalis (hymenoptera:Vespinae). AB - Venom from young (0 to 48 hours after eclosion) Vespa orientalis should presumably be less allergenic and/or antigenic than venom from adult hornets. This point was confirmed by skin tests, by crossed immunoelectrophoresis and by radioallergosorbent test (RAST), using rabbit IgG antibodies and human IgE antibodies. It is suggested that the venom of young hornets could have therapeutic applications. PMID- 3977141 TI - A study of aeroallergens in Nanning, Guangxi, China. AB - There were 43 families of airborne pollen in Nanning, and the major sensitizing pollens were those of Gramineae, Artemisia (a genus of Compositae), Chenopodiaceae, and Moraceae. It was found that sensitization with pollens of the same genus is similar. This may be helpful in selecting the proper antigen for immunotherapy. PMID- 3977142 TI - Effects of chronic aspirin ingestion in aspirin-intolerant asthmatic patients. PMID- 3977143 TI - Dose-related response of centrally administered epinephrine on the change in aortic diastolic pressure during closed-chest massage in dogs. AB - The current recommendation of the American Heart Association is to give 0.5 to 1.0 mg (7.5 to 15 micrograms/kg in a 70-kg man) of epinephrine intravenously every five minutes during cardiac arrest. The optimal dose of epinephrine to augment the aortic diastolic pressure (ADP) is not known. The effect of various doses of central bolus epinephrine on the ADP during closed-chest massage was studied. A group of 25 large dogs was divided equally into five groups: control and 15, 45, 75, and 150 micrograms/kg. After three minutes of cardiac arrest, closed-chest massage was initiated, and the study drug was given two minutes later. The ADP and right atrial pressures were monitored for 15 minutes. Changes in ADP peaked at two minutes after injection in all groups receiving epinephrine, and the drop in ADP over time noted in the control group was prevented by increasing doses of epinephrine. Among the groups receiving epinephrine, however, there was no difference in the absolute ADP and diastolic coronary perfusion pressure. PMID- 3977144 TI - Comparison of deep and shallow endotracheal administration of dionosil in dogs and effect of manual hyperventilation. AB - The endotracheal route has been used as a second route of choice for administration of emergency drugs for several years; however, the optimal technique for administration of drugs by this route has not been clearly defined. One important aspect of technique involves the question of how distribution to the distal-most endobronchial tree is influenced by initial depth of endotracheally administered drug instillation and use of forced manual hyperventilation. This study demonstrates that depth of instillation of drugs administered by the endotracheal route may not be an important factor in the delivery of medications to absorptive sites in the lung. It appears, however, that forced manual hyperventilation is essential to assure bilateral and optimal distal delivery of endotracheally administered medications. PMID- 3977145 TI - Effect of antishock trousers on the trauma score: a prospective analysis in the urban setting. AB - This study was designed to determine the effect of military antishock trousers (MAST) use on the presenting emergency center trauma score (TS) in an urban prehospital setting. Sixty-eight patients were assigned randomly to study and control groups in a prospective investigation of the use of MAST on injured patients with hypotension. Thirty-two control patients, whose mean initial systolic BP was 59 +/- 32 mm Hg, and 36 MAST-treated patients, whose mean initial BP was 55 +/- 31 mm Hg, were found to be well matched for age; sex; type and location of injuries; initial field TS; response, field management, and transport times; and the total amount of intravenous crystalloid infused. Our results demonstrated no significant difference between the control and MAST-treated groups in the presenting emergency department TS (9.8 +/- 6.6 vs 10.6 +/- 5.9). These data conflict with the widely accepted belief that MAST will always enhance conventional support for improving the prehospital condition of injured patients with significant hypotension. PMID- 3977146 TI - Injuries associated with percutaneous placement of transthoracic pacemakers. AB - Injuries associated with the percutaneous placement of transthoracic pacemakers are poorly documented. We prospectively sought to determine any injuries associated with various placement routes. Six different approaches were used in each of 20 adult patients examined at autopsy. Three parasternal approaches utilized the fifth intercostal space (5ICS). One pacing wire was inserted immediately to the left of the sternum along the parasternal line (5ICS-PS), one pacing wire was inserted 4 cm to the left of the midsternal line (5ICS-4), and the third wire was inserted 6 cm from the midsternal line (5ICS-6). All parasternal needle insertions were directed medially, dorsally, and cephalad toward the right second costochondral junction at an angle of 30 degrees to the skin. Three subxiphoid approaches were inserted through the left xyphocostal notch at an angle of 30 degrees to the skin. One pacing wire was directed toward the right shoulder, one toward the sternal notch, and one toward the left shoulder (SXLS). Injuries were assessed by autopsy, postmortem coronary angiography, and stereoscopic radiography. The 5ICS-PS approach resulted in fewer injuries when compared to all other approaches. Because previous work has demonstrated that the 5ICS-PS, 5ICS-6, and SXLS approaches are more accurate than the other approaches for transthoracic pacemaker insertion, the 5ICS-PS represents an approach that combines reasonable accuracy with the least likelihood for injury in the placement of percutaneous transthoracic pacing wires. PMID- 3977147 TI - Safe and effective IV regional anesthesia for use in the emergency department. AB - The mini-dose Bier block, a technique of intravenous (IV) regional anesthesia that uses low-dose lidocaine and provides safe and effective anesthesia for outpatient closed reductions of upper extremity fractures and dislocations, is presented. This procedure was evaluated in two hospital emergency departments in 105 patients (ages 2 to 86). Ninety-five percent achieved adequate anesthesia (minimal or no pain on closed reduction). No significant complications were noted. Full neurologic function returned in ten minutes in all cases. Both patient and physician satisfaction with the procedure were high. The mini-dose Bier block creates the potential for significant cost savings in cases previously treated in the operating room by providing a safe, effective technique of IV regional anesthesia for outpatient use. PMID- 3977148 TI - Northeastern Ohio Trauma Study III: incidence of fractures. AB - To determine the frequency with which fractures are encountered in emergency care and to estimate the incidence of fractures in a well-defined population, a population-based sample of emergency department (ED) visits was examined. Eleven percent of ED visits for trauma involved fractures. The incidence of fractures was 21 per 1,000 persons per year and had two peaks, the first at ages 10 to 14 and the second at ages greater than 60. Among young people, falls (often related to sports or recreation), striking objects, motor vehicle injuries, and assaults were the major causes of fractures. Among the elderly, falls caused 87% of all fractures. PMID- 3977149 TI - Acute medical care for championship auto racing. AB - Auto racing is a diverse sport in terms of car design and sophistication, topography of race courses, speeds achieved, and driver experience. These factors relate directly to potential hazards of auto races and the approaches to safety utilized by the groups conducting these events. The evolution in recent years of technologically advanced racing machines capable of speeds exceeding 200 mph has mandated commensurate sophistication in acute medical care programs serving professional racing teams. A comprehensive team approach to the on-track evaluation and treatment of speed-sport-related trauma is described. PMID- 3977150 TI - Delayed treatment of serious decompression sickness. AB - We report the cases of three patients with residual symptoms from diving decompression sickness, each of whom presented to a recompression chamber three to seven days following original exposure. All three had complete resolution of symptomatology despite the delayed treatment. The late resolution of symptoms is evidence both of residual bubble effect and of distal tissue hypoxia responding to oxygen therapy with the recompression. We recommend that decompression sickness symptoms be treated whenever they are seen, even ten to 14 days postinjury. PMID- 3977151 TI - Spinal subdural hematoma. AB - Although spinal subdural hematoma is a rare condition, it has a higher incidence in persons with a bleeding diathesis and in those with a bleeding diathesis who have had a lumbar puncture. We report a case of a 65-year-old woman on oral anticoagulants presenting with atypical symptoms who developed a spinal subdural hematoma over a six-hour period. This resulted in complete paraplegia of her lower extremities with no improvement after surgical spinal cord decompression. PMID- 3977152 TI - Bilateral posterior fracture-dislocations of the shoulder after convulsive status epilepticus. AB - Presented is the case of a 30-year-old man who sustained bilateral posterior fracture-dislocations of the shoulder as an unusual complication of status epilepticus. Initial evaluation failed to reveal this unsuspected diagnosis. After improvement in the patient's mental status, his subjective complaints made the diagnosis evident. He subsequently underwent hemiarthroplasty for one shoulder and active assisted range of motion exercises for the other, with partial return of function in both arms. PMID- 3977153 TI - Trauma as a symptom of alcoholism. PMID- 3977154 TI - Fatal thrombosis of left internal carotid artery following diuretic abuse. PMID- 3977155 TI - Immediate reversal of severe laryngospasm by intranasally instilled lidocaine with epinephrine. PMID- 3977156 TI - Signs of endotracheal intubation in a field setting. PMID- 3977157 TI - Food injuries. PMID- 3977159 TI - Alcohol consumption by pilots. PMID- 3977160 TI - Diver's Alert Network. PMID- 3977158 TI - Microwave aids in external rewarming of hypothermia patients. PMID- 3977161 TI - Hand exposure to microwaves. PMID- 3977162 TI - Pulmonary barotrauma during CPR training. PMID- 3977163 TI - Empyema following blunt chest trauma. PMID- 3977165 TI - Executive summary. Final report of the APA Task Force on the Victims of Crime and Violence. PMID- 3977164 TI - Current legislation on victim assistance. PMID- 3977166 TI - Hypochondriasis, neuroticism, and aging. When are somatic complaints unfounded? PMID- 3977167 TI - Psychologist heal thyself. What is available for the impaired psychologist? PMID- 3977168 TI - Victims of crime. Their plight, our response. PMID- 3977169 TI - Experimental airway inflammation and hyperreactivity. Searching for cells and mediators. PMID- 3977170 TI - Sequence of pathologic changes in the airway mucosa of guinea pigs during ozone induced bronchial hyperreactivity. AB - We assessed the nature and progression of airway mucosal disease and muscarinic bronchial reactivity in guinea pigs studied in groups of 4 at 2 h, 6 h, 14 h, 1 day, 2 days, or 4 days after ozone exposure (3.0 ppm for 2 h), and in 1 control group. Muscarinic reactivity was determined by measuring specific airway resistance as a function of increasing doses of intravenous acetylcholine in 31 intact, unanesthetized, spontaneously breathing animals. After testing, each group was killed to obtain tracheal tissue for light microscopic examination. We found that airway hyperreactivity to acetylcholine occurred in 96% of the animals exposed to ozone. Its degree at 2 h was substantial. Complete remission was not observed until the fourth day. In association with the acute bronchial hyperreactivity found at 2 h, a marked decrease in airway mucosal goblet cells and an increase in mucosal mast cells occurred. Neutrophilic infiltration occurred later and lasted longer, despite remission of the hyperreactivity. Our results indicate that acute, ozone-induced bronchial hyperreactivity is related to signs of airway mucosal injury and mast cell infiltration. After this early phase of airway damage, neutrophilic infiltration occurs and persists, suggesting that it is a consequence of the damage rather than a cause of the increased airway reactivity after ozone exposure. PMID- 3977171 TI - Tissue factor in bronchoalveolar lavage fluids. Evidence for an alveolar macrophage source. AB - Local and systemic coagulation and fibrin deposition occur in many types of alveolar injury and inflammation, but clotting factors capable of initiating the coagulation cascade in the alveolus have not been thoroughly identified and characterized. In the present studies, BAL (bronchoalveolar lavage) fluids obtained from rabbits were found to have procoagulant activity detectable in dilutions containing as little as 1.3 ng of protein. The specific activity of the procoagulant in these fluids was within 1 order of magnitude of that found in brain thromboplastin. The BAL procoagulant was shown to be associated with particles having a molecular weight greater than 15 X 10(6) daltons by gel filtration chromatography, and was characterized as tissue factor by showing specific requirements for factors VII, X, and II. Further experiments were performed using membranes purified from alveolar macrophages by sucrose density gradients and characterized by studies of alkaline phosphodiesterase I, a cytoplasmic membrane marker, and electron microscopy. These studies demonstrate that alveolar macrophages, especially low-density subpopulations, generate and release membrane material that is a source of tissue factor in BAL fluids. PMID- 3977172 TI - Infants are not obligatory nasal breathers. AB - It is widely believed that infants are obligatory nasal breathers. We studied 19 infants, 1 to 230 days of age, for respiratory response to acute nasal occlusion. Lips were kept apart. Oropharyngeal structures were monitored by fluoroscopy, whereas respiratory movements and oral flow were recorded. We systematically observed before and during nasal occlusion tight apposition of the soft palate and the tongue, closing the oropharyngeal isthmus. After a variable time (mean 7.8 s, range 0.6 to 32 s), the soft palate rose and oral breathing was initiated. Time required to mouth-breathe was related to age and/or conscious state, older and/or awake infants responding faster than younger and/or asleep infants. In 9 others, when nasal occlusion was performed with the mouth closed, results were comparable to those obtained in infants with mouths open. In 3 infants, electroencephalograph (EEG) records showed quiet non-REM sleep. Nasal occlusion resulted in an immediate arousal reaction, followed after a variable time by mouth breathing. We conclude that infants are not obligatory nasal breathers. They can breathe through the mouth by detaching the soft palate from the tongue, thus opening the oropharyngeal isthmus. PMID- 3977173 TI - Effect of heat delivery and extraction on airway conductance in normal and in asthmatic subjects. AB - Ten asthmatic and 10 normal subjects were exposed to 7 air conditions varying in temperature (-2 to 49 degrees C) and relative humidity (10 or 100%). Normocapnic hyperventilation for 3 min at 40% maximal voluntary ventilation was performed for each condition. A constant-volume body plethysmograph measured functional residual capacity and specific airway conductance (SGaw). Three to five sets of functional residual capacity and SGaw measurements were taken before and 1, 5, and 10 min after each challenge. All conditions that extracted heat from the airway caused SGaw to fall in both subject groups. In normal subjects, this response was greatest immediately after challenge. In asthmatic subjects, the immediate response exceeded the normal response, and airway function worsened in the 5 to 10 min after exposure. The quantity of heat extracted correlated moderately well with change from baseline SGaw in both normal (r = 0.55 at 5 min) and asthmatic (r = 0.64) subjects. When heat was added to the airway by hyperventilation of warm, humid air, SGaw increased in normal subjects. However, marked bronchoconstriction followed the same challenge in asthmatic subjects. Changing osmolality of the respiratory mucosa rather than thermal exchange may be responsible for the bronchospasm consequent to heat delivery. PMID- 3977174 TI - Bronchoalveolar eosinophilia during allergen-induced late asthmatic reactions. AB - In order to obtain information about the nature of the local inflammatory process during late asthmatic reactions after house dust mite inhalation, bronchoalveolar lavage (BAL) was performed in 19 asthmatic patients and in 5 control subjects. In 16 of the patients and in all of the control subjects, BAL was performed 6 to 7 h after allergen inhalation. Six of the patients showed early and late asthmatic reactions (LAR), 5 showed early reactions, and 5 showed no reactions. Bronchoalveolar lavage was also performed shortly after the early reaction in 5 patients with documented combined early and late reactions. In the BAL fluid of the patients with LAR, a significant eosinophilia (0.01 less than p less than 0.05) was found compared with that in all other patient groups and with that in the control subjects. This bronchoalveolar eosinophilia was accompanied by elevated eosinophil cationic protein/albumin ratio in the BAL fluid (0.01 less than p less than 0.05). These observations suggest that eosinophils and their mediators might be involved in the development of LAR after allergen inhalation. PMID- 3977175 TI - Smoking pattern of smokers with and without tobacco-smoke-related lung diseases. AB - The number of cigarettes smoked, the duration of the smoking habit, and the tar content of the smoke influence the occurrence of tobacco-smoke-related lung diseases, as may also patterns of smoke inhalation. We therefore determined the smoking pattern, especially the time relation between cigarette puff and inhalation, in smokers with and without tobacco-smoke-related lung diseases. On the basis of clinical and radiologic findings as well as pulmonary function tests, 91 smokers were classified as smokers without lung disease, with small airway disease, with simple chronic bronchitis, with obstructive bronchitis, with pulmonary emphysema, and with lung cancer. Smoking and breathing patterns were recorded, using a smoke-flow machine and a strain-gauge belt while the subject smoked a cigarette. Blood levels of COHb were determined before and after smoking. Of the smoking characteristics assessed, puff-inhalation time, puff peak pressure, and the venous difference in COHb level before and after smoking varied significantly among the smoker groups. Puff-inhalation time, reflecting the duration of smoke retention in the mouth, was only 0.08 s (i.e., practically zero) in smokers with pulmonary emphysema and differed significantly from the time in the other groups. This puffing characteristic may be the consequence or the cause of emphysema. If the latter is true, smokers with emphysema may perhaps lack the acute airway response to smoke inhalation that normally protects most smokers from immediately inhaling tobacco smoke. PMID- 3977176 TI - The radiographic appearance of tuberculosis in patients with the acquired immune deficiency syndrome (AIDS) and pre-AIDS. AB - We reviewed the medical records and chest radiographs of 23 adult patients with culture-proved tuberculosis and verified acquired immune deficiency syndrome. Seventeen patients, including 8 with disseminated tuberculosis, had positive sputum or bronchial washing cultures for Mycobacterium tuberculosis. Their initial pretreatment radiographs revealed hilar and/or mediastinal adenopathy in 10 patients (59%), localized pulmonary infiltrates limited to the middle or lower lung fields in 5 patients (29%), localized pulmonary infiltrates involving an upper lobe in 3 patients (18%), diffuse miliary or interstitial infiltrates in 3 patients (18%), no pulmonary infiltrates in 6 patients (35%), and no abnormalities in 2 patients (12%). Pulmonary cavitation was not seen. Only 1 patient (6%) had a chest radiograph typical of adult onset reactivation tuberculosis (i.e., localized pulmonary infiltrate involving the upper lung fields without hilar or mediastinal adenopathy). Six patients (35%) had pulmonary infiltrates that may have been caused by concomitant nontuberculous infection. Six patients had positive cultures for M. tuberculosis from extrapulmonary sites only. Three (50%) of these patients had hilar and/or mediastinal adenopathy. None of them had pulmonary infiltrates on their initial chest radiograph. PMID- 3977177 TI - Comparison of computerized tomography with fiberoptic bronchoscopy in identifying endobronchial abnormalities in patients with known or suspected lung cancer. AB - Determining the presence and extent of endobronchial involvement is an important part of the evaluation of patients with known or suspected lung cancer. Bronchoscopy is accepted as the best technique for such an evaluation. We have studied the potential usefulness of computerized tomography (CT) for examining the airways by retrospectively comparing CT scans with fiberoptic bronchoscopy findings in 53 patients with known or suspected lung cancer undergoing both tests during the same hospitalization. We have found CT to be moderately accurate in predicting the presence of airway abnormalities (sensitivity from 63 to 85%, specificity form 61 to 77%) but inaccurate in defining the type of abnormality seen at bronchoscopy (localized mucosal abnormality, endobronchial mass, or extrinsic compression). We feel that CT, using standard techniques, should not be relied on for the identification of endobronchial abnormalities in patients with known or suspected lung cancer. PMID- 3977178 TI - Mechanical ventilation with 100% oxygen does not increase intrapulmonary shunt in patients with severe bacterial pneumonia. AB - Pure oxygen ventilation has been shown to increase the right to left shunt QS/QT in both normal and diseased lungs. Nitrogen absorption atelectasis, an explanation of the phenomenon, is likely to occur in lung units with low ventilation/perfusion ratio. In 11 patients with severe unilateral or bilateral bacterial pneumonia, we assessed the effects of increasing FlO2 from maintenance level (m = 0.44 +/- 0.11) to 1.0. Venous admixture (QVA/QT) was calculated using the O2 method, and the distribution of the VA/Q ratios were assessed with the 6 inert gas (IG) technique providing the distribution between the true shunt (QS/QT IG) and the low VA/Q units. Although a large part of perfusion was distributed preferentially to low VA/Q units, ranging from 2 to 43% of cardiac output, thus placing large zones of lung parenchyma at risk of absorption atelectasis, QVA/QT decreased from 31 +/- 13% to 25 +/- 10% and IG shunt did not increase after 30 min of O2 ventilation. In addition, QS/QT IG remained unaltered despite PVO2 increased from 32 to 43 mmHg, suggesting a poor level of hypoxic vasoconstriction in human bacterial pneumonia. PMID- 3977179 TI - Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure. AB - In 10 acutely ill patients mechanically ventilated for management of acute respiratory failure, respiratory system mechanics were determined with the interrupter technique as described recently (J Appl Physiol 1984; 56:681-690). Flow, volume, and tracheal pressure were measured throughout a series of brief expiratory interruptions. A plateau in tracheal pressure during interruption was observed in all patients, indicating respiratory muscle relaxation as well as equilibration between alveolar and tracheal pressure. Measurement of the plateau in postinterruption tracheal pressure, corresponding volume, and preceding flow enabled determination of the passive elastic and flow-resistive properties of the total respiratory system. In general, the volume-pressure relationship was linear over the expired volume examined and did not necessarily pass through the origin, indicating deviation of the end-expiratory lung volume during mechanical ventilation from the equilibrium position of the respiratory system. Elastance, or inverse slope of this relationship, averaged 16.88 +/- 1.90 (SE) cmH2O X 1( 1). The pressure-flow relationship of the respiratory system was curvilinear; resistance averaged 19.74 +/- 2.08 (SE) cmH2O X 1(-1) X s at a flow rate of 1.0 1 X s-1. In 6 patients the pressure-flow relationship was concave upward. An upward convexity, particularly towards end expiration, was present in the remaining patients. This was associated with characteristic "supramaximal" flow transients after expiratory interruptions, indicating the presence of dynamic airway compression and expiratory flow limitation. In conclusion, the interrupter technique enabled detailed examination of the passive elastic and flow-resistive properties of the total respiratory system in mechanically ventilated patients using simple, noninvasive equipment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977180 TI - Effect of vasodilator treatment on the resolution of oleic acid injury in dogs. AB - Diffuse pulmonary injury is accompanied by reduction of blood flow to injured areas because of local pulmonary vasoconstriction, vascular thrombosis, and vascular obliteration. To assess whether reduced pulmonary arterial blood flow might produce relative ischemia in injured areas and consequent potentiation of the injury, we studied the effects of vasodilator treatment in a dog model of diffuse alveolar damage. Twenty-five awake dogs with arterial and pulmonary arterial catheters in place were given 0.08 ml/kg oleic acid, a dose that produces a diffuse lung injury that largely resolves over a 1-wk period. Ten of the animals were treated with minoxidil, a potent vasodilator and inhibitor of hypoxic pulmonary vasoconstriction. Observations were made for a total of 96 h. At 24 h, treated animals had lower pulmonary vascular resistance (207 +/- 85 versus 348 +/- 136 dyne X s X cm-5, p less than 0.01) but higher venous admixture (30 +/- 10% versus 18 +/- 12%, p less than 0.05) and thermodilution-measured lung water (17 +/- 8 ml/kg versus 9 +/- 2 ml/kg, p less than 0.05). However, by 96 h, there were no differences between the 2 groups in any measured parameters of hemodynamic status, gas exchange, or histologic examination. We conclude that pulmonary vasodilation increased blood flow to injured areas but did not affect eventual resolution of the injury. PMID- 3977181 TI - The effects of systemic immunization of pulmonary clearance of Pseudomonas aeruginosa. AB - Systemic immunization with gram-negative organisms enhances the subsequent pulmonary clearance of these organisms. We studied the early time course of this phenomenon and related it to the time of appearance of polymorphonuclear leukocytes (PMN) and anti-Pseudomonas antibody in bronchoalveolar lavage (BAL). Mice were immunized intraperitoneally twice, separated by 1 wk, with 10(8) formalin-treated Pseudomonas aeruginosa. Two weeks later, they received an intrabronchial inoculum of 2.9 X 10(6) or 4.6 X 10(7) Pseudomonas organisms. Two, 4, and 6 h later, clearance and total PMN and anti-Pseudomonas antibody in the BAL were assessed. Clearance was enhanced in immunized mice at the lower inoculum. At the higher inoculum, bacteria were growing in lungs of both groups, although they were inhibited in immunized mice. Total PMN in the BAL increased progressively in both groups of mice, but net recruitment was diminished with the high inoculum. There were significant differences in the PMN in the BAL between control and immunized mice with high inoculum. Anti-Pseudomonas IgG first appeared in the BAL at 2 h, anti-Pseudomonas IgM at 6 h. These data suggest that anti-Pseudomonas IgG is an effective early pulmonary opsonin. Further, with high inoculums, immunization may aid pulmonary defenses by diminishing the magnitude of the decrement of PMN in the lung. PMID- 3977182 TI - An improved method of ammonia determination, applicable to amidases and other ammonia-producing enzyme systems of mycobacteria. AB - The colorimetric estimation of amidase activity, using both qualitative and quantitative determinations of ammonia, is widely used for the differentiation of mycobacteria. At present the generally used phenol-hypochlorite method requires heating of the test solution to 90 degrees C for 30 min or to boiling for 5 min. At room temperature at least 2 h are necessary to obtain a full and stable color. Heating is also disadvantageous because it increases the vaporization of toxic phenol vapors and it may lead to the formation of insoluble manganese dioxide, which interacts with the photometric determination. We found that the addition of ketones (preferably acetone) to the catalyst solution (MnSO4) accelerates the reaction in such a manner that heating is not necessary and the full color development can be obtained within 6 min. The proposed method is superior to the conventional ones because (1) the fully developed color can be obtained after 6 minutes without heating; (2) boiling, which increases the volatilization of phenol and creates dangers for the laboratory staff and the equipment, can now be reduced; and (3) the formation of manganese dioxide in the test solution is avoided. PMID- 3977183 TI - Reproducibility of VO2max in patients with chronic air-flow obstruction. AB - The purpose of this study was to determine the variability in maximal oxygen consumption (VO2 max) determined from repeated exercise tests in patients with chronic air-flow obstruction (CAO). Three incremental maximal cycle ergometer tests were performed in each of 11 CAO patients who were familiar with such testing. Two tests (Test 1, Test 2) were carried out on the same day, separated by a 60-min rest period, and 1 (Test 3) was performed on a consecutive day. Group mean values for VO2 max were: 1.313 +/- 0.259, 1.311 +/- 0.281, 1.306 +/- 0.288 L/min, for Tests 1 to 3, respectively. These nearly identical values did not differ significantly. There was no systematic "fatigue" or "learning" effect from test to test. Other mean measurements obtained at maximal exercise were likewise not significantly different among the 3 tests. For tests performed on the same day, the mean of the absolute values of the individual patient VO2 max differences (delta VO2 max) was 53 +/- 30 ml. The delta VO2 max was less than 6% in 10 of the 11 patients and less than 10% in the remaining patient. For tests performed on consecutive days, delta VO2 max was 93 +/- 81 ml; delta VO2 max was less than 6% in 6 patients and less than 10% in 9 patients. From this study we concluded that repeated maximal exercise testing is highly reproducible for groups of CAO patients, although some individual patient variability is seen. Individual patient differences in delta VO2 max are less when the 2 tests are performed on the same day than when duplicate testing is performed on consecutive days. PMID- 3977184 TI - Specific bronchoalveolar lavage IgG antibody in hypersensitivity pneumonitis from diphenylmethane diisocyanate. AB - We evaluated a patient for dyspnea, fever, malaise, and hypoxemia that developed after exposure to diphenylmethane diisocyanate (MDI). Specific inhalation challenge with MDI caused fever, leukocytosis, a restrictive decline in forced vital capacity, and a decrease in Pao2 several hours after challenge. Bronchoalveolar lavage 24 h after challenge showed lymphocytic alveolitis. Specific IgG antibodies to MDI human serum albumin (MDI-HSA) conjugate were demonstrated in serum and bronchial lavage fluid using the enzyme-linked immunoabsorbent (ELISA) technique. These findings suggest participation of both humoral and cellular immunity in the pathogenesis of hypersensitivity pneumonitis from isocyanate exposure. PMID- 3977185 TI - Recent experiences with duodenal trauma. AB - In a 10-year period ending December 1983, 56 patients with duodenal injuries were treated at Vanderbilt University and Metropolitan Nashville General Hospitals. Most injuries consisted of isolated duodenal lacerations or perforations (37), five patients had duodenal hematomas, and 14 patients had injuries involving the duodenum, pancreas, ampulla, and/or common bile duct. Most injuries were successfully managed with suture repair. The Whipple procedure was necessary in five cases. Overall morbidity was 39.2 per cent, but complications directly related to the duodenal injury occurred in only six patients (10.7%). Only three patients died (5.3%). Excellent results can be achieved even with extensive duodenal injuries by the use of careful debridement and primary closure. When injuries to the duodenum are associated with injury to the ampulla of Vater, the head of the pancreas, or the common bile duct, a Whipple procedure is usually necessary. It has not been necessary to employ duodenal bypass or diverticulization. PMID- 3977186 TI - Small bowel trauma in children and adolescents. AB - Fifty-five children and adolescents with blunt and penetrating small bowel injuries were treated during a 17-year period. Fourteen patients had blunt injuries, and there were no deaths in this group. The remaining 41 patients had penetrating small bowel injuries, with a mortality of 10 per cent. A decision to operate based on physical examination can be made in the pediatric age group without unduly delaying operation or increasing mortality. PMID- 3977187 TI - Emergency pneumonectomy for penetrating and blunt trauma. AB - Emergency pneumonectomy for penetrating and blunt trauma has an attendant high mortality. Patients with major lung injuries presenting with prolonged shock followed by control of bleeding, resuscitation with or without aortic cross clamping and pneumonectomy have had uniformly unsatisfactory results. From 1972 to 1982, eight patients at the University of Louisville Hospital underwent emergency pneumonectomy. All patients underwent expeditious evaluation, resuscitation, and thoracotomy with pneumonectomy. Three patients died of exsanguination (2 patients had major associated intra-abdominal injuries). Three other patients died due to pulmonary edema and right ventricular failure 2 to 3 hours after hemorrhage had been controlled and intravascular volume restored. Aortic cross-clamping was employed in four patients due to persistent hypovolemia with 100 per cent mortality. Of the two surviving patients, one presented with stable blood pressure and had pneumonectomy for tracheobronchial disruption, while the other had pneumonectomy for tangential laceration of the lung at the hilum. Pulmonary edema and right ventricular failure were responsible for mortality following emergency pneumonectomy and control of hemorrhage and restoration of blood volume. The addition of aortic cross-clamping did not seem to alter survival and may, indeed, hinder therapy due to increased vascular afterload and increased heart failure and pulmonary edema. PMID- 3977188 TI - Penetrating chest wall and thoracic injuries. AB - Two hundred seventy patients with penetrating chest wall and thoracic injuries were treated at the Metropolitan Nashville General Hospital in a 5.5-year period ending July 1982. Most (250) were males, and the average age was 29.3 years. One hundred thirty-four injuries were the result of gunshot wounds and 18 patients had sustained shotgun wounds. Stab wounds were the cause of injury in 117 patients. Most patients were successfully treated with closed tube thoracostomy. Twenty-five patients required emergency room thoracotomy, and 27 patients were stable enough to be transported to the operating room for thoracotomy and repair of injuries. Survival in the patients who had emergency room thoracotomy was 12 per cent and 78 percent in patients who had operating room thoracotomy. All but one of the patients who died following operating room thoracotomy died within 1 hour of admission. When thoracotomy is indicated, it frequently must be performed very soon after admission. The indications for emergency thoracotomy must be known and recognized early if it is to be an effective procedure. PMID- 3977189 TI - Reoperation for sepsis. AB - A retrospective study of 50 patients undergoing reoperation for sepsis was performed to evaluate the ability of commonly available clinical and laboratory tests to predict the findings at reoperation and the outcome after operation. The influence of multiple organ failure on these parameters was also studied. No laboratory finding helped to predict operative findings. Computed tomographic scanning (80% accurate) was the most helpful radiographic procedure. A low total lymphocyte count and a high serum creatinine level both predicted a fatal outcome. No single organ failure or combination predicted a positive reexploration. Infection was found in 75 per cent of patients with multiple organ failure and 79 per cent of patients who did not have this syndrome. Patients having three-organ failure did have a significantly higher mortality. The mortality of a negative reexploration was 18.2 per cent, slightly lower than the 28.2 per cent mortality of patients with a positive exploration. No patient without organ failure died. The authors conclude that laboratory tests are not helpful in predicting the presence of infection on reexploration, that the decision to reoperate is one based primarily on clinical judgment, and that if reoperation is performed before the development of organ failure, the risk associated with a negative exploration is worth taking. PMID- 3977190 TI - Choledochoscopy in common bile duct surgery for choledocholithiasis: A must: Eight years experience in 441 consecutive patients. AB - Between 1975 and 1983, 441 choledochoscopy were performed in a series of 451 consecutive patients undergoing surgical common biliary duct exploration for choledocholithiasis. In 127 patients (27.8%), no stones were found. Forty-five cases (10%) of choledocholithiasis missed by surgical and radiologic exploration methods were found by choledochoscopy. Therefore the retained stone rate decreased from 10 per cent to 2 per cent. Fourteen patients (3%) died at surgery, ten of whom (2%) were over 70. Postoperative biliary tract was drained in 98 patients (8%) using external drainage. Biliary tract patency was checked on the tenth postoperative day by the tube cholangiography. When retained stones were not found, T-tube was removed on the 20th day after surgery. When retained stones were found (11 patients, 2%) an endoscopic papillotomy was performed. Choledochoscopy is a significant addition in biliary surgery. It reduces operative mortality and morbidity, decreases retained stone rate, diminishes indications for biliary anastomosis and sphincterotomy, and is easy to perform without specific training. Its extensive and systematic use is advocated when- ever common bile duct patency has to be surgically demonstrated in choledocholithiasis. PMID- 3977191 TI - Cost containment with the use of "mini-cholecystectomy" and intraoperative cholangiography. AB - During an era when cost containment has become increasingly important, a new approach to elective cholecystectomies through a 4 to 5 cm incision is reported. Over an approximately 2-year period, 96 patients have undergone "mini cholecystectomies" with intraoperative cholangiograms. Six of these patients have had concomitant common bile duct explorations. The average postoperative stay was 2.5 days. The average procedure lasted 45 minutes. Pain medication postoperatively was required less frequently than with the routine subcostal incision. Time away from work was greatly reduced. No complications were encountered. When a more complicated cholecystectomy is discovered, which may place the patient in danger, the small incision can be easily lengthened in order to provide better exposure and thus aid in dissection. On the basis of almost 600,000 cholecystectomies performed per year, hospital costs ranging from $100 to $150 per day, and the procedure being acceptable in 80 per cent of the elective procedures, the potential yearly cost-savings could range up to $250,000,000 per year when this procedure is used. PMID- 3977192 TI - Corrosive injury to the stomach due to acid ingestion. AB - Ingestion of acid often causes severe damage to the stomach. Ingestion of alkali, however, usually injures the esophagus and spares the stomach. Early complications of acid ingestion, e.g., massive gastric hemorrhage or perforation, are unusual. The absence of severe symptoms in most patients soon after ingestion of acid is often misleading. Gastric outlet obstruction is a common late result and may develop following an asymptomatic interval. The authors' experience with three patients with severe complications following ingestion of acid is presented. The initial treatment, as well as the surgical management, are discussed. PMID- 3977193 TI - High risk of malignant melanoma in melanoma-prone families with dysplastic nevi. AB - The risk of hereditary cutaneous malignant melanoma was evaluated in 401 members of 14 families with an autosomal dominant form of melanoma. We documented 127 primary melanomas in 69 family members, including 39 new melanomas diagnosed in 22 study participants from the time of first examination through a maximum of 8 years of follow-up. The 39 newly diagnosed melanomas occurred only in family members with dysplastic nevi, a known precursor of familial melanoma. Of 77 patients with dysplastic nevus syndrome without prior melanomas, 4 developed their first melanoma during prospective follow-up, as compared with 0.03 cases expected. The prospective age-adjusted incidence for melanoma was 14.3/1000 patients with dysplastic nevus per year, with a cumulative melanoma risk (+/- SE) of 7.2% (+/- 3.6) at 8 years. The actuarial probability of melanoma developing in family members with dysplastic nevi was 56.0% (+/- 10.1) from age 20 to age 59. This study confirms that dysplastic nevi are clinical markers of high risk for, and precursors of, hereditary melanoma. PMID- 3977194 TI - Erythromelalgia caused by platelet-mediated arteriolar inflammation and thrombosis in thrombocythemia. AB - Erythromelalgia was the presenting symptom in 26 of 40 patients with thrombocythemia in its primary form or when associated with polycythemia vera. The localized painful burning, redness, and warm congestion in the extremities could be accurately documented with thermography. Skin punch biopsy samples taken from the affected areas showed typical arteriolar inflammation, fibromuscular intima proliferation, and thrombotic occlusions. Erythromelalgia often progressed to ischemic acrocyanosis or necrosis in toes or fingers. Complete relief of pain and restoration of microvascular circulation disturbances was obtained with the cyclo-oxygenase inhibitors aspirin and indomethacin, but not with sodium salicylate or the platelet inhibitors dipyridamole, sulfinpyrazone, ticlopidine, and dazoxiben. The erythromelalgia was alleviated during busulfan-induced remissions of thrombocythemia and its recurrence coincided with relapsing thrombocythemia. These observations suggest a causal relationship between erythromelalgia and thrombocythemia, in which platelet-mediated inflammatory and occlusive arteriolar changes play a part in the etiology of erythromelalgia. PMID- 3977195 TI - Kaposi's sarcoma causing pulmonary infiltrates and respiratory failure in the acquired immunodeficiency syndrome. AB - Although an aggressive form of Kaposi's sarcoma often develops in patients with the acquired immunodeficiency syndrome, most patients die due to opportunistic infections rather than the direct effects of this tumor. Because Kaposi's sarcoma has caused pulmonary dysfunction in a number of our patients, we attempted to characterize features of pulmonary dysfunction induced by Kaposi's sarcoma. In 66 patients with Kaposi's sarcoma treated between 1982 and 1984 there were 30 episodes of pulmonary dysfunction that resulted in a biopsy. Six episodes were due to pulmonary Kaposi's sarcoma alone, and 6 additional episodes were due to Kaposi's sarcoma and associated opportunistic infections. Clinical and radiologic features of pulmonary Kaposi's sarcoma an infection were indistinguishable. Pulmonary Kaposi's sarcoma could only be documented in large tissue sections available from open-lung biopsy or autopsy samples. Because chemotherapy or radiation therapy appears to provide palliation, clinicians should recognize Kaposi's sarcoma as a cause of pulmonary disease in patients with the acquired immunodeficiency syndrome. PMID- 3977196 TI - Acyclovir and suppression of frequently recurring herpetic whitlow. PMID- 3977198 TI - Expanding patient involvement in care. Effects on patient outcomes. AB - An intervention was developed to increase patient involvement in care. Using a treatment algorithm as a guide, patients were helped to read their medical record and coached to ask questions and negotiate medical decisions with their physicians during a 20-minute session before their regularly scheduled visit. In a randomized controlled trial we compared this intervention with a standard educational session of equal length in a clinic for patients with ulcer disease. Six to eight weeks after the trial, patients in the experimental group reported fewer limitations in physical and role-related activities (p less than 0.05), preferred a more active role in medical decision-making, and were as satisfied with their care as the control group. Analysis of audiotapes of physician-patient interactions showed that patients in the experimental group were twice as effective as control patients in obtaining information from physicians (p less than 0.05). Results of the intervention included increased involvement in the interaction with the physician, fewer limitations imposed by the disease on patients' functional ability, and increased preference for active involvement in medical decision-making. PMID- 3977197 TI - Familial benign hypercalcemia (hypocalciuric hypercalcemia). Clinical and pathogenetic studies in 21 families. AB - Familial benign hypercalcemia (hypocalciuric hypercalcemia) was diagnosed in 125 members of 21 families. The syndrome was generally characterized by autosomal dominant inheritance of symptomless, nonprogressive hypercalcemia with normal serum immunoreactive parathyroid hormone concentrations, parathyroid glands that had normal gross and histologic features, relatively low urinary excretion of calcium, and failure to achieve normocalcemia after subtotal parathyroidectomy. Affected persons had normal longevity and no discernible increase in other medical problems except gallstones. The parathyroid glands were not seen using high-resolution ultrasonography. Plasma calcitonin and calcitriol levels were normal or low. Skeletal mass was normal as assessed by photon absorptiometry of the radius and lumbar spine, and fractures were not more frequent. Familial benign hypercalcemia or hypocalciuric hypercalcemia is a distinctive heritable syndrome that should always be considered in the differential diagnosis of asymptomatic hypercalcemia. PMID- 3977199 TI - Acquired dysplastic melanocytic nevi and cutaneous melanoma: precursors and prevention. PMID- 3977200 TI - Niclosamide therapy for tapeworm infections. PMID- 3977201 TI - Atypical Hodgkin's disease and the acquired immunodeficiency syndrome. PMID- 3977202 TI - Combination chemotherapy for Hodgkin's disease. PMID- 3977204 TI - Palmar-plantar erythrodysesthesia and cytarabine. PMID- 3977203 TI - Metastatic renal cell carcinoma and carcinoembryonic antigen levels. PMID- 3977205 TI - Ranitidine and theophylline. PMID- 3977207 TI - Theophylline overdose and metabolic abnormalities. PMID- 3977206 TI - Cyclobenzaprine overdosage. PMID- 3977208 TI - Epstein-Barr virus infection and persistent fatigue. PMID- 3977209 TI - Rubella vaccine and facial paresthesias. PMID- 3977210 TI - Syndrome of inappropriate antidiuretic hormone secretion in advanced age. PMID- 3977211 TI - Amphotericin B resistance in Candida. PMID- 3977212 TI - Letters to the editor and informed consent. PMID- 3977213 TI - Prognosis in Behcet's disease. AB - A retrospective clinical study made to determine the course and prognosis of the disease in 51 cases of Behcet's disease, with a follow-up of at least one year (average five years, range 1 to 15 years), showed that 45% of the eyes kept visual acuities of 1/10 or less, and 44% 8/10 or better, four years after the onset of the ocular symptoms. Ten years later, some 50% of the eyes had visual acuities of 1/10 or less and 32% had acuities of 8/10 or better. In the group of patients who were treated early with chlorambucil, the eye prognosis was significantly improved. PMID- 3977214 TI - Corneal epithelial dysplasia. AB - Corneal epithelial dysplasia is a rare clinical problem. It is not known whether the corneal epithelial cells undergo dysplastic changes in situ or in the region of the limbal or conjunctival epithelium with subsequent centripetal migration onto the cornea. We obtained an intact, dysplastic corneal epithelial sheet and samples of conjunctival tissue from a 75-year-old patient. Light and transmission electron microscopic examination of the dysplastic corneal epithelium showed histologic evidence of conjunctival, limbal, and corneal epithelium. The adjacent conjunctiva appeared normal except for a possible slight decrease in goblet cells. The 3H-thymidine uptake indicated a normal mitotic index for the conjunctiva. Glycogen content of the dysplastic sheet showed high values seen with corneal and not conjunctival epithelium. The dysplasia recurred despite wide conjunctival resection. Although no final conclusions can be made, we feel our studies support the hypothesis that the dysplastic process in our patient arose de novo in the corneal epithelium. PMID- 3977215 TI - Open angle glaucoma in melanosis oculi: response to laser trabeculoplasty. AB - The case for an association between secondary open angle glaucoma and melanosis oculi is strengthened by our recent observation of a teenaged male with advanced glaucomatous damage in the eye with melanosis oculi. This report summarizes his clinical findings, his response to medical therapy and laser trabeculoplasty, and suggests the possibility that melanosis oculi causes secondary open angle glaucoma in patients who are predisposed to primary open angle glaucoma. PMID- 3977216 TI - Saccadic velocity studies in paralytic strabismus: fixation with the paretic vs the nonparetic eye. AB - Twenty-seven patients with monocular rectus muscle palsy had saccadic velocity studies. In each patient, both the paretic and the nonparetic eye were used for fixation. With the nonparetic eye fixating, the saccadic amplitude was invariably smaller. When equal amplitude saccades were compared, there was no difference in velocity with either eye fixating. It may be preferable to fixate with the paretic eye, since larger amplitude saccades are obtained and the recordings can be easier to interpret. PMID- 3977217 TI - A new lid sign in seventh nerve palsy. AB - This paper describes a new lid sign in two patients with facial nerve paralysis. The facial nerve palsy was secondary to a pontine abscess in the first case and a complication of acoustic neuroma resection in the second patient. Both patients were found to have absence of the normal nasal twist of the lower lid during eyelid closure. The nasal twist is felt to help pump tears into the lacrimal drainage system. This paper will describe the absence of an important eyelid function in a patient with facial nerve paralysis. By way of background, Doane's slow motion movies have shown that during a normal blink, the upper lid moves both down and nasally, while the lower lid moves from 2 to 5 mm nasally. As the upper lid descends, the lower lid normally moves 2 to 5 mm in a horizontal and nasal direction. This motion of the lower lid helps produce a partial vacuum in the lacrimal system and is responsible for moving the fluid and debris in the tear mentiscus across the eye and into the lacrimal drainage system. The two cases of facial nerve paralysis to be presented demonstrate absence of tear drainage on the side of the lesion and a build-up and overflow of the tears on that side. PMID- 3977218 TI - Tear lysozyme measurements in chronic blepharitis. AB - Tear lysozyme concentrations were measured on 47 patients with chronic blepharitis and 22 normal control patients. The patients consisted of 26 individuals with various types of chronic blepharitis alone and 21 individuals with chronic blepharitis and clinically-diagnosed keratoconjunctivitis sicca (KCS). The mean lysozyme concentration of blepharitis patients without KCS (4070 micrograms/ml) was not significantly different from normals (3760 micrograms/ml). However, mean lysozyme concentration of the blepharitis patients with KCS (2530 micrograms/ml) was significantly lower than normals or blepharitis patients without KCS (p less than 0.01). It was concluded that tear lysozyme deficiency does not play a significant role in the etiology of chronic blepharitis. However, a large percentage of patients with chronic blepharitis were found to have KCS. PMID- 3977219 TI - Experimental intravitreal 5-fluorocytosine. AB - The pyrimidine 5-fluorocytosine is a water soluble agent which may be suitable for intravitreal injection in the treatment of Candida endophthalmitis. Experimental ocular toxicity studies of intravitreal 5-fluorocytosine have been performed in rabbits with the aid of slit-lamp biomicroscopy, indirect ophthalmoscopy, electroretinography, and histologic examination. Intravitreal injection of 100 micrograms 5-fluorocytosine produced no detectable ocular injury. PMID- 3977220 TI - Polycythemia rubra vera and conjunctival vascular congestion. AB - A case of primary polycythemia is reported. The patient presented with bilateral, diffuse, painless engorgement of the palpebral and bulbar conjunctiva which improved dramatically following phlebotomy. Polycythemia, because of increased blood viscosity, can result in ocular, neurologic, and peripheral vascular disease. PMID- 3977221 TI - Transient ischemic attacks and amaurosis fugax from timolol. AB - A variety of neurological disturbances may occur in patients receiving ocular administration of timolol. Possible mechanisms include direct effects on neurons of the central nervous system, effects on peripheral vasculature, and cardiac arrhythmias. Interestingly, transient ischemic attacks have not been documented to occur synchronously with timolol-related arrhythmias. We report a case of recurrent dizziness and staggering gait occurring synchronously with timolol related arrhythmias. An attack of amaurosis fugax also occurred. Discontinuing timolol abolished all the symptoms. Pre-existing autonomic dysfunction in our patient may have been an important contributing factor in his symptomatology. PMID- 3977222 TI - The effect of a 550 nm cutoff filter on the vision of cataract patients. AB - The effect on visual function of an optical filter which absorbs essentially all visible wavelengths below 550 nm has been studied in a group of patients with moderate stage cataracts. Using a Snellen-type visual acuity chart with a blue background and orange letters, under both glare and non-glare conditions, the visual acuity of these patients was determined. Improvement in acuity was more striking under glare conditions than under standard (non-glare) conditions; in the former case it reached levels as high as 300% in a few patients. The level of the improvement seemed to be related both to cataract type and stage of cataract progression. PMID- 3977223 TI - Granuloma annulare of the eyelid. AB - A five-year-old patient presented with nodular lesions on the left upper lid, index finger and thigh. Biopsy revealed granuloma annulare. The lesions resolved without treatment. This entity should be considered in the differential diagnosis of eyelid nodules. PMID- 3977224 TI - Papiloedema: benign intracranial hypertension in menarche. AB - Benign intracranial hypertension has been described in association with hormonal imbalance. We hereby present a rare case of transient, severe swelling of the optic discs during menarche, diagnosed as BIH. PMID- 3977225 TI - Anterior subcapsular cataracts: a review of potential etiologies. AB - Photographs of amiodarone-induced anterior subcapsular lens opacities and axial punctate lens opacities are presented and compared for the first time. The similarities and differences between these lens opacities and phenothiazine induced lens opacities are discussed. Potential etiologies for anterior subcapsular cataracts are reviewed. The biomicroscopic techniques required to appreciate subtle lens opacities are mentioned. The importance of recognizing and recording subtle lens opacities is discussed. PMID- 3977226 TI - Patient use of low-vision aids after retinal detachment surgery. AB - Patient use of low-vision aids to improve postoperative vision was evaluated in 32 eyes after successful repair of retinal detachment that involved the macular area. Despite best-corrected postoperative visual acuity ranging from 5/155 to 10/38, both distance and near vision could be improved in all cases using telescopic and microscopic systems, respectively. Patient acceptance of the telescopic systems was 62%, and of the microscopic systems, 96%. PMID- 3977227 TI - Implantation of posterior chamber lenses in glaucoma patients. PMID- 3977228 TI - Pterygium: clinical classification and management in Virgin Islands. AB - Three hundred (300) patients from the Caribbean area and Southeast United States were classified and evaluated for pterygium surgery. Each subject had the surgical excision performed by the same surgeon (ALA). Each was followed for a period of one year postoperatively while receiving topical vasoconstrictors and artificial tears only without steroids, thiotepa, or beta-irradiation. Attempts were made to predict the probability, incidence, and type of recurrence, in relation to specific risk factors identified in each individual preoperatively. Those subjects exposed to highest number risk factors seemed to correlate best with ptergia recurrence. Recurrences, which consisted of pterygium regrowths onto the cornea, were classified as active or passive. Nineteen recurrences occurred in this series, the majority being in the secondary group where more than five risk factors were present. Of 270 eyes classified as primary ptergia that were operated upon by wide excision and suture closure, there were 13 recurrences (5.0%). PMID- 3977229 TI - [Platelet aggregation in nephroses in children]. PMID- 3977230 TI - [Deep catheterization in pediatric hemodialysis]. PMID- 3977231 TI - [Superficial cutaneous mycoses in children]. PMID- 3977232 TI - [So-called "essential" scolioses. Reflections presented as preliminary work]. PMID- 3977234 TI - [Treatment of pituitary nanism with human growth hormone. Indications, methods and results, perspectives]. PMID- 3977233 TI - [Hepatic abscess in children. Apropos of a case following yersiniosis]. PMID- 3977235 TI - [Investigation of somatotropin secretion. Comparative study of 8 stimulation tests in 599 children and results of somatotropin secretion during sleep]. PMID- 3977236 TI - Continuous plexus blockade for improved circulation in microvascular surgery. AB - Five patients are presented who were fitted with an axillary plexus catheter for postoperative sympathetic blockade: 1 finger replantation, 3 toe-finger transfers, and 1 finger-finger transfer. This catheter caused spasmolysis and an increase in the circulation and in the acral systolic blood pressure. Simultaneously an adequate analgesic effect was achieved through the administration of local anesthetic. The muscle relaxation helped immobilize the extremity. The improved circulation, the analgesic effect, and the suppression of muscular activity through continuous plexus anesthesia help healing in replanted or transferred digits. PMID- 3977237 TI - Retroauricular secondary island flap. AB - A new method consisting of conversion of the retroauricular skin into an axial flap is described. During the first stage the superficial temporal vessels are transposed under the skin of the retroauricular region. The second operative step consists of elevation of the retroauricular-mastoid skin on the dissected axial pedicle. The secondary island flaps proved to be efficient in the repair of small and medium-sized defects of the facial region. PMID- 3977238 TI - The use of Clinitron therapy unit in the immediate postoperative care of pressure ulcers. AB - The conventional postoperative care of patients undergoing pressure ulcer operations is complicated and unsatisfactory. In an effort to improve this care, we used the Clinitron therapy unit, which provides a true flotation environment for the patient. The surface pressure on the skin constantly remains below the capillary closure pressure of 32 mm Hg, and therefore no change in the patient's position is required as with the other beds currently used. Its special design creates a bactericidal fluid medium in which the temperature can be controlled. Our experience with 16 patients using the Clinitron in the immediate postoperative period has been encouraging. Comments from the patients and the nursing and medical staff, as well as advantages and disadvantages of this modality are discussed. PMID- 3977239 TI - Congenital facial anomalies among 4- through 7-year-olds: psychological effects and surgical decisions. AB - In children with congenital facial anomalies, body image and emotional indicators correlated with the timing and number of operations, rather than with the severity of the deformity. These data suggest that surgery should be performed at the earliest age possible and in the fewest number of stages. PMID- 3977240 TI - Craniofacial surgery for craniosynostosis improves facial growth: a personal case review. AB - An evaluation of 220 cases of frontocranial remodeling for craniosynostosis is reported. The follow-up period was 10 years for children, 7 years for infants. The principles of the craniofacial techniques described in 1974 [4] and 1978 [3] were not modified; only variations were added. The floating forehead [5] concept has also remained basically unchanged. Intracranial pressure recordings have been used continually to help evaluate borderline indications and to assess results [9]. Our results show that 14% of cases of craniosynostosis affecting only one suture, usually considered as merely aesthetic problems, in fact were accompanied by increased intracranial pressure. The postoperative recordings have shown a return to normal pressures. Growth has not deteriorated the initially satisfactory results at the level of the forehead. At the midface level, improvement has been observed after surgery, especially for plagiocephalics. Their orbitonasal asymmetry has nearly completely disappeared. Patients with bilateral faciocraniosynostosis show an improvement of midface development compared with non-operated patients, but in severe cases an inverted bite still develops and further facial osteotomies remain necessary. The Apert's patients remain the most difficult to improve. PMID- 3977241 TI - A flap for moderate-sized oral defects. AB - The use of a cervical musculocutaneous flap is described which is easily transferable to the oral cavity to cover an osseous and soft tissue operative defect, eliminating the need for a more distant and extensive musculocutaneous flap. PMID- 3977242 TI - Electrosurgical blepharoplasty: a technique that questions conventional concepts of fat compartmentalization. AB - Traditional teaching on blepharoplasty surgery emphasizes the existence of several discrete fat compartments in the upper and lower lids. Surgical techniques are based upon removal of fat from each of the two or three so-called compartments within the upper or lower lid. Anatomically, there is little basis for assuming the existence of such compartments. They usually represent areas of weakness or dehiscence within the overlying muscle or septum. A technique of blepharoplasty using electrosurgical dissection is described which emphasizes wide incision of the orbital septum with abundant presentation of the entire fat pad. Removal of fat is carried out without clamping and with great assurance that there will be no subsequent bleeding. Since it is not necessary to pull on the fat pads, retraction of open vessels is avoided. PMID- 3977243 TI - High division of the median nerve: unusual anatomical variation. AB - An unusually high division of the median nerve in the forearm is reported. Recognition of this anatomical variation can help plastic surgeons make the proper diagnosis when encountering an incomprehensible clinical sign in the vicinity of the median nerve. PMID- 3977244 TI - Postintubation croup in two consecutive patients undergoing cleft lip and/or palate repair. AB - Postintubation croup is not common, but it is potentially serious complication of surgery and anesthesia. We report 2 consecutive cases of postintubation croup in infants undergoing cleft lip and/or palate repair, each occurring after an uncomplicated postoperative course of 48 hours' duration. PMID- 3977245 TI - Cherubism. AB - Cherubism is a rare, hereditary fibroosseous lesion of the jaws that is thought to undergo spontaneous involution after puberty. Treatment is unnecessary unless functional or emotional disturbances develop. This article describes the 21-year follow-up of a patient with cherubism and briefly reviews the pertinent literature. PMID- 3977246 TI - Refined liposuction unit. AB - I present two innovations that may be helpful to anyone who is designing or purchasing a unit for suction lipectomy: dual use of the unit as an ordinary operating room sucker, and cannulas with hand control. PMID- 3977247 TI - Treatment of oesophageal perforation by intubation. AB - The mortality following oesophageal perforation ranges from 25% to 100% depending on the delay in diagnosis and treatment. Although the treatment recommended for thoracic perforations is emergency thoracotomy and suture of the perforation, the avoidance of this approach in elderly patients is desirable. We therefore describe 6 cases of oesophageal perforation which were treated by insertion of a Celestin tube at laparotomy. PMID- 3977248 TI - Early discharge following appendicectomy in children. AB - In a prospective study of 410 children who had a non-perforated appendix removed, the mean postoperative stay was 46 hours and 80% of patients were discharged within 48 hours. Twenty-two patients were readmitted, but neither the temperature of the patient, nor bowel motions passed prior to discharge were of any prognostic value in predicting those who would develop postoperative complications. The cost saving and the patient benefit of earlier return to home environment recommend this policy. PMID- 3977249 TI - Preserved dura and pericardium for closure of large abdominal wall and diaphragmatic defects in children. PMID- 3977251 TI - A simple method for closing fasciotomies. PMID- 3977250 TI - Analgesia by wound infiltration after surgical excision of benign breast lumps. AB - Wound infiltration with bupivacaine provided complete postoperative pain relief in 14 of 19 women undergoing excision biopsy of a benign breast lump under general anaesthesia. Fifteen patients formed a control group in whom the wound was infiltrated with saline. They had inadequate relief of pain despite receiving significantly more opioid analgesia than the bupivacaine group in the postoperative period. The analgesia from bupivacaine usually outlasted the postoperative pain. No adverse reactions were apparent. PMID- 3977252 TI - Breakage of Redivac suction drains. AB - An investigation is described which defines points of weakness in the design of Redivac suction drains. PMID- 3977253 TI - Cells of periodontium: their role in the healing of wounds. PMID- 3977254 TI - Surgical wound management with adhesive polyurethane membrane. PMID- 3977255 TI - The results of Ramstedt's operation: room for complacency? PMID- 3977256 TI - The surgical anatomy of the marginal artery. PMID- 3977257 TI - Subcutaneous left colon reconstruction following pharyngo-laryngectomy. PMID- 3977258 TI - Vertical banded gastroplasty: operation for morbid obesity. PMID- 3977259 TI - Replacement of the pharynx after pharyngolaryngectomy. PMID- 3977260 TI - Delayed recognition of an interspincteric abscess as the underlying cause of Fournier's scrotal gangrene. PMID- 3977261 TI - Penetrating injuries of the neck. AB - A review of 271 patients with penetrating wounds of the neck is presented. A policy of selective conservative management appears totally justified in view of the low mortality and morbidity in this series. Particular attention has been paid to the presentation and surgical approach to the injured vertebral artery. PMID- 3977263 TI - Hyperparathyroidism--patterns of presentation, symptoms and response to operation. AB - Forty-three patients operated upon for hyperparathyroidism over a 7-year period are reviewed with reference to modes of presentation, symptoms and symptomatic response following operation (76% of symptoms cured or improved). The patterns of presentation are discussed in relation to the increasing use of routine biochemical screening; emphasis is given to the symptoms admitted by 17 so-called 'asymptomatic' patients diagnosed in this way and to their improvement following surgery (75% of symptoms). Symptomatic improvement among a similar group of seventeen 'asymptomatic' patients undergoing operations for thyroid swellings was observed in only 9% of symptoms. In the light of such subjective improvement following parathyroidectomy, the theoretical prophylactic benefit of operation and its lack of morbidity, an aggressive surgical approach to the disease is considered justified. PMID- 3977262 TI - Biopsy procedures, primary wide excisional surgery and long term prognosis in primary clinical stage I invasive cutaneous malignant melanoma. AB - 281 patients managed for primary clinical Stage I invasive cutaneous malignant melanoma at one Plastic Surgery Unit were followed up to a minimum of 10 years after primary surgical treatment. Sixty-three (23%) had received an initial biopsy procedure prior to definitive wide margin excisional surgery. One third of all lesions initially treated by so called incisional biopsy were rendered histologically unassessable on current histopathological criteria. Incisional biopsy significantly interfered with the accurate histopathological staging of the tumours. Of the assessable incisional biopsy specimens the majority were greater than 4.0 mm thick. When the incidences of local tumour recurrence and mortality were related specifically to maximal tumour thickness of the primary lesion, prognosis at minimum follow up of 10 years was not significantly different between patients treated initially by either incisional biopsy, minimal margin excisional biopsy or primary wide excisional surgery. Whether or not incisional biopsy adversely affects prognosis in cutaneous malignant melanoma, the technique should be avoided since it compromises accurate histopathological microstaging which represents one of our most valuable prognostic guides. Clinical doubt over the diagnosis of cutaneous malignant melanoma should be resolved by a total excisional biopsy of the lesion in question. PMID- 3977264 TI - A convenient alternative to the Zachary Cope enterostomy clamp. PMID- 3977265 TI - Per-operative cholangiography and post-cholecystectomy biliary strictures. AB - A series of 78 patients with post-cholecystectomy biliary strictures have been examined. The majority (71%) did not have per-operative cholangiography at the time of initial cholecystectomy. Of the remainder, inadequate views were obtained in two patients and incomplete information was associated with subsequent common bile duct damage. In addition the study was performed after the common bile duct had been transected in a further two cases. The use of per-operative cholangiography in patients undergoing cholecystectomy is advocated, and the advantages and disadvantages of such an approach examined. PMID- 3977266 TI - An assessment of operative choledochoscopy--a worthwhile procedure or not? AB - The results of a nine year survey of biliary surgery are reported. The incidence of retained common bile duct stones prior to choledochoscopy was 4%. When choledochoscopy became available, the incidence of retained stones rose to 9%. This disappointing rise is probably due to inexperience with the technique and post-exploratory cholangiography is still considered mandatory. PMID- 3977267 TI - Choledochoscopy? Post-exploratory fluorocholangiography? Or both? AB - Per-operative, post-exploratory fluorocholangiography and choledochoscopy were evaluated prospectively in 59 consecutive patients undergoing bile duct exploration for calculus disease. Fluorocholangiography showed filling defects in 13 cases and was valuable in localisation of stones, assessment of ampullary patency and visualisation of intrahepatic radicles. Choledochoscopy confirmed stones in nine cases, gave immediate confirmation of four false positive X-rays, enabled removal of five residual stones and biopsy of one benign stricture. This study suggests that fluorocholangiography should be performed routinely after duct exploration. Choledochoscopy is a useful adjunct but need only be performed in patients with abnormal X-ray findings; to confirm residual stones and aid in their removal or to permit biopsy of strictures. PMID- 3977268 TI - [Prevention of bacterial endocarditis]. AB - Prevention of bacterial endocarditis is aimed at limiting the frequency, size, and duration of transient bacteremia with subsequent bacterial implantation on valvular endothelium in patients with cardiopathy. Any procedure involving mucosa rich in normal flora or an infectious site can result in bacteremia, which can be minimized by selecting diagnostic and therapeutic procedures which are least traumatic. In addition, proper antibiotic prophylaxis should be administered according to the most frequently encountered bacteria: Streptococcus viridans during dental manipulations, enterococci during urogenital or intestinal procedures, and staphylococcal species from skin lacerations or cardiac surgery. The different antibiotic prophylactic regimens suggested at the present time vary according to the patient and the particular circumstances surrounding his illness. These regimens should be modified according to future epidemiologic findings in bacterial endocarditis. PMID- 3977269 TI - [Surgical treatment of acute aortic dissection]. AB - The author initially describes the principal clinical, laboratory, and radiologic findings which confirm the diagnosis. A description of the operative technique demonstrates the important progress made possible through the use of G.R.F. biological glue. The results indicate a low mortality rate in hospitalized patients if the patient was less than 65 years of age and if surgery was performed in the first 24 hours. Long-term results are also satisfactory, with a mortality rate of 3.5% over an average follow-up period of 52 months. PMID- 3977271 TI - [Results of the intracardiac repair of tetralogy of Fallot and interventricular communication before the age of 2 years]. AB - The post-operative review of 81 patients operated for a large interventricular communication before the age of two years reveals excellent results: the mean age at operation was 7 months, extracorporeal circulation was performed in 25 patients for a mean duration of 77 minutes and profound hypothermia to 18 degrees C was induced in 56 patients. The atrial approach was used in 30% of cases. The mean follow-up period is 26 months. There was one case of complete bundle branch block, which was subsequently fitted with a pacemaker, 7 cases of bifascicular branch block and a right bundle branch block in the majority of cases. The pulmonary vascular resistance was virtually normal (a mean of 3.2 U.m-2 prior to the operation and a mean of 1.9 U.m-2 after the operation). The left ventricular volume, which was markedly increased in all patients preoperatively, returned to normal with maintenance of a normal ejection fraction. The neuro-psychomotor behaviour was abnormal in 13 of the 63 patients tested. These abnormalities are not related to the correction procedure, but to pre-existing pathology (small birth weight). 52 patients from a series of 63 cases operated for tetralogy of Fallot before the age of 2 years (median age 12 months) were also reviewed. Extracorporeal circulation lasting a mean of 115 minutes was performed in 31 patients, cardiac arrest under profound hypothermia was induced in the other cases, for a mean duration of 61 minutes. The mean follow-up period was 29 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977270 TI - [Outcome of children operated on for congenital cardiopathy before 2 years of age. Foreseeable sequelae at adulthood]. AB - A brief description is presented of the long-term follow-up of four commonly encountered cardiopathies undergoing early surgical correction. Sequelae are not increased and probably even less frequent when compared to children undergoing surgery after two years of age. It is still too early, however, to establish whether or not certain manifestations, such as rhythm or conduction disturbances and ventricular dysfunction will develop at a later date. The prognosis of coarctation of the aorta depends to a great extent on other associated lesions which can become serious over time and require additional surgical procedures. In the past, early surgery for large ventricular septal defects was poorly tolerated, but now the prognosis is particularly favorable. Persistent hemodynamic abnormalities such as stenoses of the pulmonary outflow tract can worsen the prognosis in tetralogy of Fallot. In addition, it is especially important to recognize subsequent ventricular dysrhythmias due to their potentially serious nature. The most common procedures for transposition of the great arteries consist of auricular transposition of the venous returns which may later cause rhythm disturbances or venous stenoses. The long-term functional capacity of the right ventricle as a pump for the systemic circulation is not known. A general outline of follow-up care is presented. PMID- 3977272 TI - [Median- and long-term results of Mustard and Senning operations in isolated transposition of great vessels]. AB - This study concerns 89 cases of isolated transposition with early surgical repair by auricular transposition of the venous returns. Fairly good results were obtained with an operative mortality rate less than 10%, few postoperative complications, and long-term follow-up without significant worsening of the functional capacities of these patients. From this study, the authors state precisely the present indications for treatment of isolated transposition. PMID- 3977273 TI - [Outcome of patients operated on for aortic coarctation during the 1st year of life]. AB - A coarctectomy performed on infants with congestive heart failure in the first year of life is an emergency procedure due to the "coarctation syndrome". An intracardiac anomaly is also present in the majority of cases. The surgical risk of coarctectomy in the newborn infant or during the first year of life is now low (7 percent in our study), but intermediate-term mortality rates were relatively significant (24 percent in our study), due to intracardiac anomalies and their surgical correction. Without treatment, however, the coarctation syndrome proves fatal in two out of three cases before one year of age. The principal long-term complication is recurrence of the coarctation resulting from the absence of growth at the anastomosis. It occurs in 20 to 50 percent of cases depending on the study, the diagnostic criteria, and length of time since the surgery. This complication is more frequent when the coarctectomy was performed in the first month of life. Another coarctectomy must be undertaken in these cases. Persistent arterial hypertension without recurring coarctation is rarely observed, but is frequently encountered following a coarctectomy in an older child or adult. It should be noted that the systolic arterial blood pressure in almost all infants in our study was between the 50th and 97th percentile for normal children of this age. Aside from the problem of recurring coarctation, the long-term follow-up depends principally on associated valvular lesions, particularly aortic (bicuspid valves are very frequent) and mitral valvular lesions. Even though surgery has greatly improved the prognosis of coarctation in children, these infants must have long-term postoperative surveillance. PMID- 3977274 TI - [Natural history of hepatic metastases. Morphological and physiopathological findings]. PMID- 3977275 TI - [Tertiary hepatic metastases]. PMID- 3977277 TI - [Localized intestinal lymphangiectases presenting as peritonitis]. AB - The authors report a case of localised intestinal lymphangiectases in a segment of jejunum with the unusual presentation of an acute perforation. The anatomical findings did not provide a satisfactory aetiopathogenic explanation, although the most likely hypothesis is a past history of abdominal irradiation. The mechanism of the perforation also remains unclear and the presence of microscopic lesions in the wall of the remaining small intestine raises the problem of the long-term prognosis. PMID- 3977276 TI - [Contribution and current limitations of computed tomography in the diagnosis of cavernous hemangioma of the liver]. AB - Based on findings for 30 patients, the authors assess the value of CT scans for the diagnosis of cavernous hemangiomas of the liver. Four images were retained, and were graded 0 (absence) or 1 (presence): hypodensity before injection of the contrast material, arteriolar halo after injection, progressive centripetal filling and late hyperdensity. A score of 3 or 4 after the CT scan allows diagnosis. Solitary lesions of at least 3 cm are correctly evaluated. When associated with other smaller lesions, or when smaller than 3 cm, CT scans are less helpful and arteriography is necessary. In all. CT scanning has four limiting parameters: lesion diameter, the number of images requiring exploration, the difficulty in obtaining exactly the same section in various sequences allowing effective scan analysis (thoraco-abdominal position of the liver) and problems specific to individual patients (poor circulation, iodine allergy or intolerance). These limiting factors explain the "wait-and-see" strategy suggested when confronted with solitary hyperechoic nodules smaller than 3 cm. PMID- 3977278 TI - [Fatal hepatitis from nitrofurantoin]. PMID- 3977279 TI - [1 year's use of alizapride for the prevention and treatment of nausea and vomiting secondary to anticancer agents]. PMID- 3977280 TI - The estimation of body density in men: are general equations general? AB - Regression equations for estimating body density and fatness from anthropometric measurements are usually specific to the populations from which they are derived, owing to methodological and biological factors. Some equations are, however, regarded as having general validity for subjects of different ages, levels of fatness and fitness. In this study, five such general equations were tested by comparing estimated body density (Dest) with measured body density (Dmeas) in 138 European men employed in an Italian shipyard. Body density was measured by underwater weighing with the simultaneous determination of lung residual volume. Measurements were also made of height, weight, eight skinfolds, four circumferences and seven diameters by standard techniques. Dest from the five general equations were significantly different from Dmeas (P less than 0.001). New prediction equations for estimating D were drawn up by simple and multiple regression of various combinations of skinfolds expressed as individual skinfolds, sums, log sums and the quadratic form. Equations were drawn up on a validation sample (N = 92) and tested on a cross-validation sample (N = 46). The form of skinfolds and the combination selected made little difference to the SEEs and R2 but the inclusion of age resulted in lower SEEs. Stepwise multiple regression produced an equation incorporating thorax and triceps skinfolds and age with an SEE of 6 kg/m3 and R2 of 79%. The derived equations were successfully cross-validated, Dmeas and Dest were not significantly different, ryy' and SEE were similar to those of the validation sample. When the cross-validation sample was divided into two according to age, density or VO2 max, the derived equations were applicable to the upper and lower groups for age or physical fitness but not to the groups differing in fatness. These equations should be validated further on other samples by studies performed with due regard to the methodological factors, both technical and statistical, that may result in specificity. However, the poor performance of the general equations tested and the specificity for fatness of the derived equations suggest that biological factors may preclude the development of general prediction equations for body density. PMID- 3977281 TI - Group-specific component (Gc) subtypes in Gambian and Transkeian populations: a description of a new variant. AB - A total of 270 serum specimens from Keneba and Manduar villages of The Gambia and 126 from Bantu of Transkei were examined for the group-specific component (Gc) phenotypes by isoelectric focusing. Only one individual showed phenotype 2-2 in the Bantu population, and the sub-allele frequencies showed a distribution very characteristic of African populations. A new rare mutation, Gc1C34, was found in heterozygous combination with Gc2 allele. The synthesis of the existing Gc sub type data was examined for its anthropological implications. PMID- 3977282 TI - Genetic studies in four tribal populations of the Surat District, Gujarat (India). AB - Four tribal populations (Chaudhuri, Vasava, Kotwalia and Gamit) of the Surat District in Gujarat (India) have been investigated for the distribution of 22 polymorphic systems of the blood. The main results of this study are as follows: The allele frequencies show considerable heterogeneity among these populations. From the genetic structure analysis it is seen that only a small fraction of the total gene diversity accounts for genetic differences among them, and the major portion of it is due to genetic variation within them. Analysis of genetic distance according to Nei (1972) reveals that the Vasava and Kotwalia show a rather close genetic relationship, while the Chaudhuri and Gamit differ from both the Vasava and Kotwalia. PMID- 3977283 TI - Infant feeding and growth--a longitudinal study in three Swedish communities. AB - In a prospective longitudinal study of 312 Swedish infants physical growth was analysed in relation to breast feeding, artificial feeding and some other possible determinants of growth. Weight and length at eight ages, from birth to 19.5 months as well as weight and length velocities for the corresponding intervals are reported. Almost all infants were breastfed during the first month of life and 50% were still breastfed at six months of age. The attained weights and lengths of these infants were generally above the national or international standards in early infancy and around the standard from six months of age. In a regression analysis the weight and length velocities are analysed in relation to feeding habits, birth weight, birth length and some other factors. Entirely breast-fed infants were shown to have a higher weight and length velocity than mixed- or formula-fed infants during the first three months of life. The artificially fed infants showed a catch-up in growth during the next three months and there was no difference in attained weight or length from six months of age due to previous feeding habits. The higher initial weight and length velocities of breast-fed infants were not caused by any catch-up due to unfavourable intra uterine factors. Entirely breast-fed infants were heavier at birth; a difference which could be explained by differences in smoking habits during pregnancy. The consequences for the interpretation of individual growth patterns in early infancy and the need of an appropriate growth standard for the first six months of life are discussed. PMID- 3977284 TI - Size and shape in dermatoglyphic analysis of palmar interdigital areas. AB - With very few exceptions, dermatoglyphic methodology either refers to shape (pattern) or to size (quantitative value). In this study, an attempt is made to consider simultaneously these two basic components of morphology in the analysis of the third palmar interdigital area. For this purpose, three criteria of shape and bc ridgecount (size) were studied in 150 male and 150 female Viennese pupils, and were each classified according to whether they could be interpreted as showing strong reduction, slight reduction or no reduction. Their frequencies alone and in combination were calculated. Their interrelation with the mean ridge counts and their comparison with the traditional reduction types of c-triradius or mainline C strongly suggest that the traditional notation is not sufficiently precise to evaluate criteria of reduction which are thought to indicate different embryonic growth patterns. PMID- 3977285 TI - Modernization, migration and obesity among Samoan adults. AB - Modernization and migration have biological as well as social effects on people. In this study, 2657 Samoan adults from Western Samoa, American Samoa and Hawaii were surveyed in an attempt to examine the relationships between modernization, migration and obesity. The Samoan men showed an increase in the frequency of obesity with increasing modernity of residence or occupation. While the women in American Samoa had the highest frequency of obesity of any subsample, Samoan women also demonstrated a pattern of higher adiposity in more modern jobs. Young women tended to show a negative relationship between obesity frequency and education, with college-educated women having the lowest average levels of adiposity. Time since migration to Hawaii was not found to exert a major effect on frequency of obesity. PMID- 3977286 TI - Growth of Wroclaw children aged 0-2 years born in 1964-65 and in 1973-75: longitudinal data. AB - One hundred boys and 100 girls born in Wroclaw, Poland in 1964-65 and the same number of children born in 1973-75 were measured every month during the first year of life and every three months during the second. The characters investigated were body length and weight, head circumference and Rohrer's index. Generally, it seems that during the decade considered body dimensions in girls have shown slight secular increases while in boys these dimensions have remained stable or have decreased. Consequently, sex differences have decreased. Values of Rohrer's index indicate that children born in the 1970s are slimmer than those born in the 1960s. This particularly concerns girls. It seems that the explanation of these changes should be sought in the lack of improvement of the socio-living conditions and the increase of harmful environmental influences, to which boys may react quicker. With girls, the secular changes may persist for some time, since their reaction to environmental stimuli is slower. PMID- 3977287 TI - Pregnancy loss in mothers of multiple births and in mothers of singletons only. AB - We compared pregnancy loss in mothers of multiple births and in mothers of singletons only. The index of pregnancy loss used for purposes of the present analysis is: the ratio of total pregnancies to total maternities consisting of live births. Mothers of one set of like-sexed twins and mothers of one set of unlike-sexed twins had greater pregnancy loss than did mothers of singletons only. Women who had higher-order multiple births comprised only 5% of our sample; in terms of their pregnancy loss these women were similar to mothers of singletons only. Data on whether women ever had difficulty becoming pregnant, and the type of therapy received to aid in conception showed that mothers of twins had greater difficulty becoming pregnant than did mothers of singletons. Among women with difficulty becoming pregnant, pregnancy loss was greater than among those who reported no difficulty. In our sample, 4.3% of mothers of multiple births and 3.4% of mothers of singletons only received hormonal therapy, some of which included FSH or clomiphene citrate. PMID- 3977288 TI - Variations of lactose and oligosaccharides in milk from women of blood types secretor A or H, secretor Lewis, and secretor H/nonsecretor Lewis during the course of lactation. AB - Variations of lactose and oligosaccharides in human milk were studied over a 3 month lactation period by dialysis, chromatography on Bio-gel P-2 column, paper chromatography, colorimetric analysis and gas chromatography. Milk samples were collected from donors of various blood and secretor types. An increase in the concentration of lactose was noted: 59.25 +/- 1.61 to 72.17 +/- 1.35 g/l for the group of secretor A secretor Lea Leb individuals, and from 62.25 +/- 1.35 to 73.15 +/- 3.45 g/l for the group of secretor H secretor Lea Leb individuals. A decrease in the concentration of oligosaccharides was also found: from 16.71 +/- 0.99 to 7.90 +/- 1.29 g/l and from 18.51 +/- 0.74 to 7.33 +/- 0.65 g/l, respectively, for these same groups. In secretor H nonsecretor Lewis individuals, the concentration of lactose increased from 67.97 +/- 3.09 to 77.42 +/- 1.88 g/l, and the concentration of oligosaccharides decreased from 13.27 +/- 0.40 to 3.47 +/- 0.33 g/l. Analysis of oligosaccharide composition by chromatography showed that variations are in relation to the secretor Lewis type. All oligosaccharides decreased equally throughout the lactation period, regardless of the blood group. The decrease was more rapid, however, in the nonsecretor Lewis individuals. In these individuals, the absence of certain oligosaccharides is not compensated by an overproduction of the other oligosaccharides present or by biosynthesis of structurally different oligosaccharides. The origin of these oligosaccharides is discussed. PMID- 3977289 TI - Lipids, lipoproteins and alpha-tocopherol: relationship and changes during adolescence. A longitudinal study. AB - From May 1976 until June 1982 a longitudinal study in 54 apparently healthy Austrian schoolchildren with a mean age of 11.2 years at their first visit was performed. The aim of this study was to determine if there are any age-related changes in serum lipids, lipoproteins and alpha-tocopherol concentrations during adolescence and whether a permanent relationship between lipoproteins and alpha tocopherol can be observed. Total cholesterol showed a significant decrease from age 11 to 14 years in boys (from 195.5 +/- 42.2 to 147.9 +/- 40.3 mg/dl) as well as in girls (from 181.9 +/- 29.7 to 144.1 +/- 23.4 mg/dl); thereafter, a slight increase could be shown. Similar changes could be observed for LDL cholesterol. No significant sex differences were found either in total or in LDL cholesterol, whereas in HDL cholesterol concentrations, a decrease in boys between 12 and 14 years (from 58.4 +/- 18.3 to 41.7 +/- 10.8 mg/dl) and an increase in girls from 13 years onwards led to significantly lower values in boys than in girls from the age of 16 years onwards. No consistent changes could be shown for alpha tocopherol blood levels. Nevertheless, a close relationship between total cholesterol and alpha-tocopherol could be observed during all our investigations (0.4695 less than or equal to 0.7300, p less than 0.05) and, to a lesser degree, between LDL cholesterol and alpha-tocopherol. Significant correlations between alpha-tocopherol and HDL cholesterol and between alpha-tocopherol and triglycerides occurred only occasionally. PMID- 3977290 TI - The effects of lactation on the relationship between metabolic rate and ambient temperature in the rat. AB - The oxygen consumption rates of virgin and lactating rats fed ad libitum were measured at temperatures ranging from 1 to 28 degrees C. The oxygen consumption rates of the virgin animals decreased progressively with increasing ambient temperature, but those of the lactating animals decreased slightly between 1 and 8 degrees C, remained approximately constant between 8 and 20 degrees C and fell rapidly above 20 degrees C. It is suggested that the fall in oxygen consumption rate above 20 degrees C in the lactating rats was due to a reduction in milk synthesis rate, and that the thermoneutral zone for normal lactation was 8-20 degrees C; this is a substantially cooler range than that of virgin rats (28-29 degrees C). The net energetic efficiency of milk production was calculated from the energy output in milk and the amount of energy used to produce milk (estimated from the oxygen consumption rates). The value obtained was 57.0%. PMID- 3977291 TI - [Energy balance trials with a diet rich in fats in the human]. AB - The effects of two diets equal in protein content (12% of energy) but different in carbohydrates (80% of energy) or in fat (68% of energy) were studied in a changeover trial with 6 healthy young subjects. Each person was 2 weeks on each diet. Under the conditions of slight undernutrition and neutral temperature the balances of nitrogen, carbon and energy were assessed in 7-day collection periods, and according to 48-hour measurements of gaseous exchange (carbon nitrogen balance method) by the procedures of indirect calorimetry. At isocaloric supply of metabolizable energy no differences were found in the retention of N, C and energy. The heat production calculated by indirect calorimetry was not significantly different with both diets. The lower body weight during the high fat diet was due to higher sodium and water excretion. The high-fat diet resulted in lower fecal and higher urine excretion of nitrogen, but because of a compensative response no difference in nitrogen retention was observed between the two dietary regimens. The plasma concentrations of cholesterol, glucose and uric acid were higher with fat-rich diet; those of triglycerides were higher with carbohydrate-rich diet. The results demonstrate that the composition of the diet did not influence the energy balance. PMID- 3977292 TI - Effects of severe caloric restriction on the degree of sialylation of apoprotein C-III in obese women. AB - Alterations in the relative proportions of very low density lipoprotein (VLDL) apoprotein C-III (apoC-III) isoforms have been previously observed under various dietary and metabolic states. This study was designed to evaluate the effects of a very high caloric restriction on plasma triglycerides and on the relative proportions of VLDL apoprotein C-II (apoC-II) and apoC-III isoforms in obese subjects. VLDL were isolated by preparative ultra-centrifugation from 12 obese women. ApoC-II and apoC-III subspecies were separated by analytical ultrathin layer isoelectrofocusing. The mean body weight decreased significantly from 96.2 +/- 8.7 to 90.6 +/- 7.6 kg (p less than 0.01). Mean total and VLDL triglycerides did not vary significantly. Apoprotein C-III2 (apoC-III2) as percentage of total apoprotein C increased (p less than 0.01) and apoprotein CIII0 (apoC-III0) decreased (p less than 0.01). Apoprotein C-III1 (apoC-III1) did not vary significantly. An inverse correlation was found between the percentage variation of apoC-III2 and that of apoC-III1 (r = -0.94; p less than 0.01). The variations of apoC-III2 correlated positively (r = 0.83; p less than 0.01), while those of apoC-III1 correlated inversely (r = -0.65, p less than 0.025) with the changes of VLDL triglycerides. The apoC-III1 to apoC-III2 ratio as well as the apoC-III0 to apoC-III2 and apo C-III1 ratios decreased after diet (p from less than 0.01 to less than 0.001). Total apoC-III as well as apoC-III2 and apoC-III1 to apoC-II ratios did not vary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977293 TI - Racial differences in the energy cost of standardised activities. AB - The assumption is currently made by international organisations that individuals of the same size living in the same environment and having the same mode of living will have the same energy requirements whatever their race. Reports of very low energy intakes are frequently doubted. To investigate possible racial differences the energy cost of standardised activities was measured in European, Asian, and African males under the same experimental conditions. Subjects were closely matched for height, weight and Quetelet index. The energy cost of each activity, lying, sitting and standing, was significantly higher, by 10-17%, in Europeans as compared to Asians and Africans, between whom no differences were found. Whether these differences are morphological or metabolic is discussed. It is concluded that differences in energy requirements do exist over and above those due to body size and activity. PMID- 3977294 TI - Relationship between dietary and plasma copper levels of pregnant Nigerian women. AB - Dietary copper intake as well as plasma copper levels were assessed in a group of pregnant Nigerian women during the third trimester of pregnancy. Intake of zinc, protein and energy was also measured. Dietary intake was assessed by cumulative 24-hour recalls while plasma copper was assessed by atomic absorption spectrophotometry. Dietary copper levels were relatively lower than those documented in the literature for other physiological groups. The intake of other nutrients was below recommended dietary allowances. When corrected for the effect of gestation and maternal age, one-way analysis of variance showed that plasma copper varied with the level of dietary copper intake. Correlation analysis seems to suggest that the influence of dietary copper on plasma levels during pregnancy is partially dependent on the relative amounts of copper and zinc as represented by the copper:zinc ratio in the diets consumed. PMID- 3977295 TI - [Nutritional status of the rat in refeeding following massive mobilization of DDT by fasting]. AB - Rats were subjected to fasting-induced mobilization of a quantity of DDT equivalent to 45% of the LD50. They were then fed for 1 week for a nutritional and toxicological study. Mobilization of DDT by starvation had no apparent effect on the activity of the various enzymes or the weight of the organs measured at the end of the refeeding period. The animals which had received DDT pretreatment showed higher protein efficiency than the control animals. Only the level of body lipids was lower in the animals pretreated with DDT, although the quantities of lipids stored during the study period were identical in both groups of animals. Overall, the results show that the nutritional state of the two groups of animals was very similar at the end of the refeeding period. PMID- 3977296 TI - Atypical presentations of pyridoxine-dependent seizures: a treatable cause of intractable epilepsy in infants. AB - We report on 3 patients with atypical pyridoxine-dependent seizures. Each had either late onset of convulsions (2 cases) or seizure-free intervals of up to several months' duration in the absence of pyridoxine supplementation. The findings, taken together with those in 9 previously reported cases, indicate that a trial of pyridoxine should be performed in all seizure disorders with onset before 18 months of age, regardless of type. PMID- 3977297 TI - Hyponatremia and cerebral infarction in patients with ruptured intracranial aneurysms: is fluid restriction harmful? AB - We studied retrospectively the relationship between hyponatremia and cerebral infarction in 134 consecutive patients with aneurysmal subarachnoid hemorrhage. In 44 patients sodium levels fell below 135 mmol/L on at least two consecutive days between the second and the tenth day after the hemorrhage. Twenty-five of these patients fulfilled the criteria for the syndrome of inappropriate secretion of antidiuretic hormone. Cerebral infarction developed in 27 of the 44 patients with hyponatremia and in 19 of the 90 patients with normal serum sodium levels (p less than 0.001). Cerebral infarctions were more often fatal in patients with hyponatremia (p less than 0.01). Twenty-six of the 44 patients had been treated with fluid restriction to correct the serum sodium levels, and infarctions developed in 21. Fluid restriction to correct hyponatremia appears to be potentially dangerous in patients with aneurysmal subarachnoid hemorrhage. PMID- 3977298 TI - Hemispheric lateralization of spatial contrast sensitivity. AB - Visuospatial contrast sensitivity was determined by the Arden grating chart in 23 patients with cerebral infarctions involving the primary visual cortex or visual association cortex. Subjects were classified into three groups according to their lesions: I, 6 patients with unilateral medial occipital or occipitotemporal lesions; II, 6 patients with left lateral parieto-occipital lesions; and III, 11 patients with right lateral parieto-occipital lesions. Contrast sensitivity was markedly reduced in Group III, especially in patients having hemispatial agnosia. Group I patients with hemispatial agnosia showed almost normal contrast sensitivity. Spatial contrast sensitivity appears to be more affected when the lesion has an influence on the nondominant lateral parieto-occipital cortex. PMID- 3977299 TI - The second sensory area in humans: evoked potential and electrical stimulation studies. AB - A patient with intractable seizures originating from a right frontal focus was evaluated for surgical treatment. This evaluation was carried out using a chronically implanted array of 96 stainless steel electrodes 1 cm apart and covering the perirolandic and frontal areas. Somatosensory evoked potentials and electrical stimulation of the subdural electrodes localized the primary sensory hand area. Evoked potentials of identical waveform but of lower amplitude and 2.4 ms longer latency were recorded in the inferior frontal gyrus immediately anterior to the face area of the motor strip. Electrical stimulation of that area elicited: (1) a "paralyzing" feeling in the left arm and face; (2) inhibition of rapid alternating movements of left fingers, left hand, and tongue; (3) inability to maintain a strong voluntary muscle contraction of the left hand or tongue; and (4) speech arrest. This appears to be the first report of a secondary sensory area in humans demonstrated by both electrical stimulation and evoked potential studies. Electrical stimulation showed that the secondary sensory area overlapped an area of complex motor control, suggesting that the secondary sensory area provides direct sensory feedback information for appropriate motor integration. PMID- 3977300 TI - Disturbance of smooth pursuit caused by infarction of occipitoparietal cortex. AB - Two distinct deficits of ocular smooth pursuit could be demonstrated using two types of visual stimulus motion in a patient who had suffered bilateral occipitoparietal lobe infarction. First, in response to constant-velocity (zero acceleration) target motion, smooth pursuit gain (eye velocity/target velocity) was mildly impaired for tracking to the right but near normal for tracking to the left. For example, for a target moving at 28.5 degrees/sec, gain was 0.65 to the right but 0.85 to the left. Second, in response to high-acceleration sinusoidal target motion, there was a deficit in maximum eye acceleration for targets moving right and left. The patient was unable to accelerate his eyes faster than 48 degrees/sec2 to the right and 95 degrees/sec2 to the left (normal is more than 300 degrees/sec2). It is suggested that smooth pursuit should be routinely tested using stimuli with a wide range of accelerations. PMID- 3977301 TI - Adoptive transfer of murine relapsing experimental allergic encephalomyelitis. AB - Relapsing experimental allergic encephalomyelitis (EAE), an autoimmune disorder resembling multiple sclerosis, has been produced by inoculating SJL/J mice with spinal cord or myelin basic protein in appropriate adjuvants. To determine whether initially sensitized lymphocytes or the persistence of antigen depots in the animal were responsible for the relapsing episodes of inflammatory demyelination, adoptive transfer studies were undertaken utilizing lymphocytes from relapsing EAE-immunized donors transferred directly or after in vitro culture. In direct-transfer studies donor lymphocytes produced clinical and pathological signs of relapsing EAE in 3 of 7 recipients of lymph node lymphocytes and 1 of 5 recipients of splenic lymphocytes. In vitro culture of lymphocytes in myelin basic protein or T cell growth factor prior to transfer increased both the incidence of disease and the number of animals having relapses, and allowed transfer with fewer lymphocytes. Because all animals had delayed onset of disease, this study demonstrates that the ability to develop relapsing inflammatory demyelination is transferable with lymphocytes and does not require the presence of antigen. PMID- 3977302 TI - Regional perfusion in normal and ischemic rat sciatic nerves. AB - We measured regional blood flow in rat sciatic-posterior tibial nerve using an iodo-[14C]antipyrine autoradiographic technique. Average flow was 12.1 +/- 3.3 ml/100 gm/min, considerably less than that of both gray and white matter structures in the cerebral hemispheres. Perfusion was homogeneous along the proximal-distal extent of this nerve and along its radial axis. Acute occlusion of the femoral artery reduced regional sciatic blood flow. Flow was especially depressed within the endoneurial core of the proximal posterior tibial branch, which lies in a watershed zone between adjacent segmental arterial fields. The topography of the arterial supply to nerves and their abundant collateral circulation may explain the centrifascicular distribution of nerve infarcts, and in part can account for the apparent resistance of peripheral nerves to ischemia. PMID- 3977304 TI - Cefazolin-induced encephalopathy in a uremic patient. PMID- 3977303 TI - Tetrabenazine induces acute dystonic reactions. AB - Four patients suffered acute dystonic reactions caused by tetrabenazine. Because dystonic reactions have previously been reported only after dopamine receptor blockade and not with dopamine depletion, it is likely that the ability of tetrabenazine to induce acute dystonia is due to its dopamine receptor blocking properties. Because tetrabenazine can induce acute dystonia even when combined with alpha-methyl-p-tyrosine, presynaptic dopamine stores may not be necessary for these reactions to occur. PMID- 3977305 TI - Worsening of myasthenia gravis with timolol maleate eyedrops. PMID- 3977306 TI - Growth of phenol-mineralizing microorganisms in fresh water. AB - A method was developed to enumerate the procaryotic and eucaryotic phenol mineralizing microorganisms present in samples of fresh water. Sixty-five percent or greater mineralization of [U-14C]phenol was considered a positive tube (contained phenol-mineralizing microorganisms) in the most-probable-number technique. Replicate most-probable-number tubes contained no microbial inhibitors, streptomycin and tetracycline, or cyclohexamide and nystatin plus 200 pg to 100 micrograms of phenol per ml. Phenol mineralization rates were obtained by measuring the amount of exogenous phenol that disappeared from solution over time in the presence or absence of the microbial inhibitors. Initially, less than 100 phenol-mineralizing bacteria per ml and 1 phenol-mineralizing fungus per ml were present at both 200 pg and 100 micrograms of phenol per ml. Phenol mineralization rates were 6.3 times greater for the mineralizing bacteria than for the fungi at 200 pg of phenol per ml. Phenol concentrations above 10 micrograms/ml were inhibitory to the microorganisms capable of mineralizing phenol. The phenol mineralizers grew in the water samples in the absence of phenol, indicating that there were sufficient indigenous nutrients in the lake water to support growth. There was no difference in the growth rate of these microorganisms in the presence or absence of 1 ng of phenol per ml, whereas the growth rate was more rapid at 1 microgram of phenol per ml than in its absence. There was a correlation between microbial growth and the amount of phenol mineralized at 1 microgram but not at 1 ng of phenol per ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977307 TI - Seasonal distribution of Vibrio parahaemolyticus in freshwater environs and in association with freshwater fishes in Calcutta. AB - The seasonal distribution of Vibrio parahaemolyticus in freshwater environs and in association with freshwater fishes was studied in 1982 and 1983. The occurrence of this organism in water and sediments at the three sites studied was very infrequent and was restricted to the summer months, although it was not always isolated during these months. The association of V. parahaemolyticus with plankton was chiefly confined to the summer months and progressively declined with the onset of monsoons, remaining below detectable levels during the postmonsoon and winter months. The incidence and counts of V. parahaemolyticus were consistently higher in association with plankton than with water and sediment samples. V. parahaemolyticus could be recovered throughout the period of investigation from freshly caught and market samples of freshwater fishes. The highest recovery rate of this halophile from fishes was invariably from fecal samples. Most of the strains isolated in this study were untypable, and those which could be typed were predominantly serotypes encountered in the environment. All the isolates were Kanagawa negative. From this study, it could be concluded that the survival of V. parahaemolyticus in freshwater ecosystems is transient and dependent on a biological host. PMID- 3977308 TI - Incorporation of phenol carbon at trace concentrations by phenol-mineralizing microorganisms in fresh water. AB - The fate of phenol carbon at phenol concentrations ranging from 1 ng/ml to 1 microgram/ml was determined in freshwater samples. Approximately 20% of the parent phenol was incorporated into trichloroacetic acid-precipitable material by the microorganisms capable of mineralizing phenol. There was no apparent lag period before phenol incorporation commenced, and incorporation was complete within 2 h at all concentrations tested. A direct relationship was found between the initial phenol concentrations and both phenol mineralization and incorporation rates, indicating that cometabolism of phenol does not occur at concentrations that are environmentally significant. At all concentrations, approximately 80% of the initial phenol concentration was mineralized. This percentage plus the percentage of phenol incorporated at the various concentrations equaled approximately 100%. Therefore, the parent phenol does not remain in fresh water; it is either incorporated into cellular biomass or mineralized. However, the incorporated phenol carbon is subject to bioaccumulation in nature. There was no apparent lag period before thymidine was incorporated into biomass, and incorporation was complete within 4 to 8 h at all of the phenol concentrations tested. Thymidine incorporation was independent of phenol concentration at all levels tested. This is probably due to the small amount of thymidine incorporated by the phenol-mineralizing microorganisms in comparison with the amount of thymidine incorporated by the total microbial population. PMID- 3977309 TI - Gibberella fujikuroi mutants obtained with UV radiation and N-methyl-N'-nitro-N nitrosoguanidine. AB - N-methyl-N'-nitro-N-nitrosoguanidine (nitrosoguanidine) and to a lesser extent UV radiation are very mutagenic for Gibberella microconidia. The recommended nitrosoguanidine doses lead to much higher frequencies of mutants than are found in other microorganisms. The frequency of mutants among the survivors increases linearly with the nitrosoguanidine dose (molar concentration X time); the absolute number of viable mutants in a given population reaches a maximum for a dose of ca. 0.7 M X s. The microconidia are uninucleate. The onset of germination brings about increased lethality of nitrosoguanidine, but it does not modify the action of UV radiation. Mycelia are more resistant than spores to both agents. Visible illumination effectively prevents lethality when given immediately after UV radiation. Auxotrophs and color mutants are very easily obtained. Pink adenine auxotrophs and several classes of color mutants are affected in the biosynthesis of the carotenoid pigment, neurosporaxanthin. PMID- 3977310 TI - Occurrence of Yersinia enterocolitica in wild-living birds and Japanese serows. AB - Yersinia spp. were isolated from 34 of 500 birds representing nine species. The highest isolation rate, 5 of 21 (23.8%), was found in blue magpies (Cyanopia cyanus), followed by pheasants (Phasianus colchicus tohkaidi), 5 of 33 (15.2%); gray starlings (Sturnus cineraceus), 6 of 57 (10.5%); tree sparrows (Passer montanus), 1 of 14 (7.1%); bulbuls (Hypsipetes amaurotis), 4 of 57 (7.0%); crows (Corvus levailantii or Corvus corone), 7 of 117 (6.0%); eastern turtledoves (Streptopelia orientalis), 4 of 118 (3.4%); Chinese bamboo pheasants (Bumbusicola thoracica thoracica), 1 of 36 (2.8%); and domestic pigeons (Columba livia domestica), 1 of 47 (2.1%). The isolates were identified as Yersinia enterocolitica O:3, O:4, O:4,32, O:5A, O:6,30, O:7,8, and O:14, Yersinia frederiksenii, Yersinia intermedia, and Yersinia kristensenii. Yersinia spp. were isolated from 35 of 157 wild-living Japanese serows (Capricornis cripus). The isolates were identified as Y. enterocolitica O:4, O:4,32, O:5A, O:7, O:7,8, O:9, O:14, O:18, and O:34, Y. frederiksenii, Y. intermedia, and Y. kristensenii. PMID- 3977311 TI - Ecology of Legionella pneumophila within water distribution systems. AB - The reservoir for hospital-acquired Legionnaires disease has been shown to be the potable water distribution system. We investigated the influence of the natural microbial population and sediment (scale and organic particulates) found in water systems as growth-promoting factors for Legionella pneumophila. Our in vitro experiments showed that: (i) water from hot-water storage tank readily supported the survival of L. pneumophila, (ii) the concentration of sediment was directly related to the survival of L. pneumophila, (iii) the presence of environmental bacteria improved the survival of L. pneumophila via nutritional symbiosis, (iv) the combination of sediment and environmental bacteria acted synergistically to improve the survival of L. pneumophila, and (v) the role of sediment in this synergistic effect was determined to be nutritional. Sediment was found to stimulate the growth of environmental microflora, which in turn stimulated the growth of L. pneumophila. These findings confirm the empiric observations of the predilection of L. pneumophila for growth in hot-water tanks and its localization to sediment. L. pneumophila occupies an ecological niche within the potable water system, with interrelationships between microflora, sediment, and temperature. PMID- 3977312 TI - Sterigmatocystin in dairy cattle feed contaminated with Aspergillus versicolor. AB - Sterigmatocystin (7.75 micrograms/g of feed) and a high-propagule-density of Aspergillus versicolor were detected in feed associated with acute clinical symptoms of bloody diarrhea and death in dairy cattle. Nine isolates of A. versicolor from the feed produced 13 to 89 micrograms of sterigmatocystin per g on cracked corn and lower amounts in liquid culture. This is the first report of sterigmatocystin in dairy cattle feed in the United States. PMID- 3977313 TI - Modulation of cytotoxin production by Clostridium difficile in the intestinal tracts of gnotobiotic mice inoculated with various human intestinal bacteria. AB - Gnotobiotic mice died 2 days after inoculation of a cytotoxigenic Clostridium difficile strain. Protection occurred when mice were previously inoculated with a strain of Escherichia coli or Bifidobacterium bifidum. Intestinal cytotoxin production was highly reduced in the surviving mice, whereas the C. difficile population level did not decrease to a great extent. PMID- 3977314 TI - Incidence of Acinetobacter spp. and other gram-negative, oxidase-negative bacteria in fresh and spoiled ground beef. AB - A total of 1,409 gram-negative bacterial colonies were randomly selected from 19 samples of fresh and spoiled ground beef plated on six media. Only 137 (9.7%) were oxidase negative, and 20 (14.6%) of these were Acinetobacter spp., all of which were recovered from fresh meat samples. The importance of this group in both fresh and spoiled beef is less than is generally believed. PMID- 3977315 TI - Kinetics of microbial growth on pentachlorophenol. AB - Batch and fed-batch experiments were conducted to examine the kinetics of pentachlorophenol utilization by an enrichment culture of pentachlorophenol degrading bacteria. The Haldane modification of the Monod equation was found to describe the relationship between the specific growth rate and substrate concentration. Analysis of the kinetic parameters indicated that the maximum specific growth rate and yield coefficients are low, with values of 0.074 h-1 and 0.136 g/g, respectively. The Monod constant (Ks) was estimated to be 60 micrograms/liter, indicating a high affinity of the microorganisms for the substrate. However, high concentrations (KI = 1,375 micrograms/liter) were shown to be inhibitory for metabolism and growth. These kinetic parameters can be used to define the optimal conditions for the removal of pentachlorophenol in biological treatment systems. PMID- 3977316 TI - Initiation of membranal lipid peroxidation by activated metmyoglobin and methemoglobin. AB - The interaction of hydrogen peroxide (H2O2) with metmyoglobin (MetMb) led very rapidly to the generation of an active species which could initiate lipid peroxidation. The activity of this prooxidant decreased rapidly during the first minutes, but 50% of its activity remained stable for more than 30 min. In this model system, it was found that small amounts of H2O2 (1-10 microM) could activate MetMb for significant lipid peroxidation. The incubation of the sarcosomal lipids with activated MetMb caused oxygen absorption. No absorption of oxygen was determined in the presence of membrane with MetMb or H2O2 alone. Methemoglobin (MetHb) was also found to be activated by H2O2 and to initiate lipid peroxidation. Membranal lipid peroxidation initiated by activated MetMb was inhibited by several reducing compounds and antioxidants. However, several hydroxyl radical scavengers and catalase failed to inhibit this reaction. PMID- 3977317 TI - Calmodulin-stimulated protein methylation in rat liver cytosol. AB - The in vitro methylation of three liver cytosolic proteins was found to be selectively stimulated by calmodulin. This effect was also seen, although to a much smaller degree, in kidney and lung, but not in testes, brain, or spleen. The three methylated proteins affected by calmodulin have apparent Mr = 29,000, 32,000, and 45,000. The stimulation of methylation by calmodulin was greatest for the Mr 29,000 protein; there was an equal degree of methylation of the other two proteins. Dialysis of liver cytosolic fractions also stimulated the methylation of these proteins; the methylation of the Mr 32,000 and 45,000 proteins was stimulated to a greater extent by dialysis than by calmodulin. The degree of stimulation of methylation of the Mr 29,000 protein by calmodulin and dialysis was equivalent, but the addition of calmodulin to dialyzed liver cytosolic fractions gave additive effects on the stimulation of methylation of the Mr 29,000 protein, but not of either the Mr 32,000 or 45,000 proteins. Troponin C stimulated the methylation of the Mr 29,000 protein, but not the Mr 32,000 or 45,000 proteins, whereas parvalbumin stimulated methylation of the Mr 32,000 protein, but not the Mr 29,000 or 45,000 proteins. The effects of calmodulin and dialysis on protein methylation are cation-dependent and substrate-specific; methylation of the Mr 29,000 was supported by Mn2+, Ca2+, and Co2+, and to a lesser degree by Mg2+, Ni2+, and Zn2+. Methylation of the Mr 32,000 protein was supported only by Mn2+ and Mg2+ and methylation of the Mr 45,000 protein by Mn2+, Mg2+, Ca2+, Ni2+, and Zn2+, and to a much smaller extent by Fe2+. In extracts of fetal liver, stimulation of protein methylation by calmodulin or dialysis was restricted to the Mr 45,000 protein. In regenerating liver, stimulation of the methylation of all three proteins was observed, but the stimulation provided by dialysis plus calmodulin was much less than that observed in preparations from intact adult liver, suggesting a possible negative correlation between the rate of cell division and calmodulin-dependent methylation of these hepatic proteins. These results are consistent with the presence in liver of a minimum of three distinct N-methyltransferases and a dialyzable inhibitor which antagonizes calmodulin-dependent protein methylation. PMID- 3977318 TI - Cyclopropyl oxiranes: reversible inhibitors of cytosolic and microsomal epoxide hydrolases. AB - A series of aryl- and alkyl-substituted cyclopropyl oxiranes were synthesized as potential suicide inhibitors of mouse liver epoxide hydrolase (EH). The inhibitory potency of each compound and its corresponding alkene precursor was determined with mouse liver EHs using [3H]-cis-stilbene oxide as substrate for microsomal EH (mEH) and for glutathione-S-transferase, and using [3H]-trans stilbene oxide for cytosolic EH (cEH). The cyclopropyl oxiranes all showed low (26-60% at 5 X 10(-4) M) inhibition of glutathione transferase and moderate inhibition (I50 = 5 X 10(-4) to 6 X 10(-6) M) for cEH and mEH. cis Phenylcyclopropyl oxirane had an I50 for mEH near that for a commonly used inhibitor, 1,1,1-trichloropropene oxide. Inhibition appeared competitive and reversible, and the cyclopropyl oxiranes appeared to function as alternate substrates. Absence of irreversible inhibition is evidence against a strongly electrophilic epoxide-opening mechanism involving a cyclopropyl carbinyl homoallyl cation rearrangement. Instead, a concerted mechanism is favored, in which electrophilic opening and hydroxide attack occur in a concerted fashion. PMID- 3977319 TI - Induction of intracellular acyl-CoA:cholesterol acyltransferase activity in glioblastoma cells by lidocaine. AB - The perturbation of cellular cholesteryl ester biosynthesis in glioblastoma C-6 cells by lidocaine was investigated. Lidocaine specifically inhibited the incorporation of radioactive oleic acid into cellular cholesteryl ester but had no significant effect on the incorporation of oleic acid into phosphatidylcholine. Oxygenated cholesterol-enhanced cholesteryl ester formation was less sensitive to lidocaine inhibition. Several other local anesthetics were compared. Lidocaine altered cholesteryl ester formation in time- and dose dependent manners. Lidocaine was a powerful inhibitor initially and its potency declined with time. Lidocaine was capable of directly inhibiting acyl CoA:cholesterol acyltransferase (ACAT) activity in broken cell homogenates. The lidocaine-mediated inhibition of cellular cholesteryl ester formation triggered an enhanced intracellular ACAT activity that was not fully expressed in the presence of lidocaine. The activation of ACAT activity by lidocaine might represent a compensatory mechanism by which the inhibitory effect of lidocaine was partially overcome with time. PMID- 3977320 TI - Effect of growth hormone on rat liver N-acetyl-L-glutamate. AB - Earlier studies have revealed, upon hypophysectomy, a specific increase in mitochondrial urea cycle enzymes, namely carbamyl phosphate synthetase and ornithine transcarbamylase. Administration of growth hormone to hypophysectomized rats brought these enzyme activities back to normal. Since growth hormone plays a role in the formation of citrulline and ultimately urea, in the present study its effect on the levels of N-acetyl-L-glutamate, an allosteric activator of carbamyl phosphate synthetase has been investigated. A significant increase in N-acetyl-L glutamate concentration in rat liver on hypophysectomy and its reversal back to normal levels on growth hormone administration was reported. These results suggest that the lack of growth hormone tends to amplify urea production by the liver. PMID- 3977321 TI - Enzymatic conversion of glutamate to delta-aminolevulinate in soluble extracts of the unicellular green alga, Chlorella vulgaris. AB - Cell-free preparations from the unicellular green alga, Chlorella vulgaris, catalyze the conversion of glutamate to delta-aminolevulinate, which is the first committed step in heme and chlorophyll biosynthesis. Most activity remains in the supernatant fraction after centrifugation at 264,000g. Additional activity can be solubilized from the high-speed pellet by treatment with 0.5 M NaCl. After gel filtration through Sephadex G-25, the reaction catalyzed by the high-speed supernatant requires glutamate, ATP, Mg2+, and NADPH. Boiled extract is inactive. The pH optimum is between 7.8 and 7.9 and the temperature optimum is 30 degrees C. Concentrations required for half-maximal activity are 0.05 mM glutamate, 0.4 mM ATP, 6 mM MgCl2, and 0.4 mM NADPH or 0.7 mM NADH. The reaction requires no additional amino donor. Involvement of pyridoxal phosphate in the catalytic mechanism is suggested by sensitivity to pyridoxal antagonists; 50% inhibition is achieved with 5 microM gabaculine or 0.4 mM aminooxyacetate. Involvement of two or more enzymes is suggested by the nonlinear reaction rate dependence on protein concentration. Evidence for the involvement of an activated glutamate intermediate was obtained by product formation after sequential addition and removal of substrates, and by inhibition (80%) with 1 mM hydroxylamine. Protoheme inhibits the activity by 50% at 1.2 microM. Preincubation of the extract with ATP causes stimulation and/or stabilization of the activity compared to preincubation without ATP or no preincubation. In preparations obtained from C. vulgaris strain C-10, which requires light for greening, dark-grown cells yield one-third as much activity as 4-h-greened cells. PMID- 3977322 TI - Solubilization and purification of hepatic microsomal trans-2-enoyl-CoA reductase: evidence for the existence of a second long-chain enoyl-CoA reductase. AB - The present study describes the solubilization and purification of a NADPH specific trans-2-enoyl-CoA reductase from rat liver microsomes. The final preparation was purified to near homogeneity and had a minimal molecular weight of 51,000 +/- 2,000, as judged by sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis. This enzyme specifically used NADPH, as cofactor, and was chromatographically (2',5'-ADP-agarose) separated from another trans-2-enoyl-CoA reductase which utilized either NADH or NADPH as cofactor. The NADPH-specific trans-2-enoyl-CoA reductase catalyzed the reduction of trans-2-enoyl-CoAs from 4 to 16 carbon units. The Km values for crotonyl-CoA, trans-2-hexenoyl-CoA, and trans-2-hexadecenoyl-CoA were 20, 0.5, and 1.0 microM, while the Km value for NADPH was 10 microM. Although N-ethylmaleimide, heat treatment, and limited proteolysis with trypsin affected the reduction of short-chain (C4) and long chain (C16) substrates equally, and in spite of the fact that a single protein band was observed on SDS-gels, at the present time one cannot state unequivocally that the purified preparation contained only one reductase. trans-2-Hexenoyl-CoA, for example, did not inhibit the reduction of trans-2-hexadecenoyl-CoA to palmitoyl-CoA and trans-2-decenoyl-CoA to decanoyl-CoA whereas it strongly inhibited the conversion of crotonyl-CoA to butyryl-CoA. The potential implications of this finding are discussed. Finally, the reductase preparation was shown not to contain either heme, nonheme iron, or a flavin prosthetic group. PMID- 3977323 TI - Association of splinters with chromomycosis and phaeomycotic cyst. PMID- 3977324 TI - Phenytoin and junctional epidermolysis bullosa. PMID- 3977325 TI - Alopecia areata. PMID- 3977326 TI - Fat cells in intradermal nevus do not contain S100 protein. PMID- 3977327 TI - Darier-White disease: a multifaceted immunodeficient state? PMID- 3977328 TI - Erythema gyratum repens. PMID- 3977329 TI - Extensive ichthyosiform sarcoidosis in a patient with juvenile rheumatoid arthritis. PMID- 3977330 TI - Chloracetamide: an unusual cause of cosmetic dermatitis. PMID- 3977331 TI - Topical minoxidil therapy and hair regrowth. PMID- 3977332 TI - Metabolic importance of acanthosis nigricans. PMID- 3977333 TI - The use and abuse of immunosuppressive agents in dermatology. PMID- 3977334 TI - Percutaneous absorption of minoxidil in man. AB - The percutaneous absorption and excretion of 1% and 5% solutions of minoxidil labeled with carbon 14 were measured in 12 adult male subjects. These subjects were randomly assigned to the 1% and 5% minoxidil testing groups, and all received nine topical applications to a bald area on the scalp, with the radioactive solutions applied on days 1 and 9. Urinary excretion of radioactivity was low, with mean values ranging from 1.6% to 3.9% of applied dose. No radioactivity could be detected in fecal samples. Recovery of radioactivity from the skin surface and from scalp and pillowcase washes was in the range of 41% to 45% of applied dose. No adverse reactions or notable abnormalities were noted in the subjects during the study. Although minoxidil is poorly absorbed through the skin, systemic doses in the range of 2.4 to 5.4 mg/day can be anticipated if application is made to entire scalp. PMID- 3977335 TI - Fluorouracil paste treatment of thin basal cell carcinomas. AB - Treatment of thin (superficial) basal cell carcinomas (BCCs) with topical fluorouracil is widely accepted despite the absence of published five-year cure rates. The published short-term data disclose treatment failure rates substantially higher than other modalities. In trials to improve and standardize topical fluorouracil therapy, thin BCCs were treated with 25% fluorouracil in petrolatum under occlusion for three weeks using weekly dressing changes. Of 44 thin BCCs treated only with 25% fluorouracil under occlusion for three weeks, the five-year cumulative recurrence rate was 21%. In a second series of 244 BCCs, light curettage preceded the 25% fluorouracil treatment to yield a five-year cumulative recurrence rate of 6%. Cosmetic results were good to excellent in more than 80% of both series. While fluorouracil by itself is not a satisfactory treatment for thin BCC, when combined with light curettage, topical fluorouracil therapy is capable of cure rates competitive with other modalities. PMID- 3977336 TI - Juvenile plantar dermatosis. A clinicopathologic study. AB - Fifty-six patients had juvenile plantar dermatosis (JPD). The plantar surface of the toes and the anterior third of the sole were the sites most commonly affected. Less commonly affected were the dorsal surface of the toes and the fingertips. No seasonal variation was found, and treatment was generally ineffective. Preventative measures had no influence on the course of the condition. Histopathologic features included psoriasiform acanthosis, with focal loss of granular cell layer, and uniform parakeratosis. Distinctive features included a tendency for the dermal infiltrate to localize around sweat ducts at their point of entry into the epidermis. In addition, inflammatory changes within the epidermis were localized mainly to the acrosyringium and included paranuclear vacuolization of epidermal keratinocytes, spongiosis, and slight spongiotic vesiculation. These changes are similar to those described in other eczematous conditions, and there is little evidence to suggest that disordered sweating plays a primary role in the pathogenesis of JPD. PMID- 3977337 TI - Acanthosis nigricans and insulin resistance associated with hypothyroidism. AB - An obese 15-year-old boy with a one-year history of acanthosis nigricans was found to have primary hypothyroidism, with a thyrotropin level in excess of 50 microU/mL. At the same time, he was found to have subclinical insulin resistance. Therapy with thyroxine resulted in weight loss, reversal of hyperinsulinemia, and resolution of the acanthosis nigricans. Hypothyroidism can be added to the list of endocrine diseases associated with acanthosis nigricans. This is unlikely to be a direct effect of the hypothyroid state, but may instead be an indirect action mediated through obesity and subsequent insulin resistance. Insulin resistance and hyperinsulinemia seem to be commonly associated with (and perhaps causative of) the acanthosis nigricans that is seen in many endocrine diseases. PMID- 3977338 TI - Acanthosis nigricans-like hyperpigmentation secondary to triazinate therapy. AB - Cutaneous hyperpigmentation resembling acanthosis nigricans developed in two patients with malignant brain tumors following chemotherapy with triazinate (Baker's Antifol), a folic acid antagonist. In both cases, the eruption resolved after the cessation of drug administration and reappeared after the reinstitution of triazinate therapy. A skin biopsy specimen from one patient showed microscopic changes consistent with those found in acanthosis nigricans. The other patient had a decreased serum folate level that returned to normal as the hyperpigmentation resolved. Folate may have a role in triazinate-induced acanthosislike hyperpigmentation. PMID- 3977339 TI - Sustained remission of generalized lichen planus induced by cyclophosphamide. AB - Three patients with generalized lichen planus, who were unresponsive or transiently responsive to conventional therapies, were successfully treated with low dosages of oral cyclophosphamide. PMID- 3977340 TI - Pustular contact hypersensitivity to fluorouracil with rosacealike sequelae. AB - A 51-year-old woman had a severe pustular contact hypersensitivity reaction to fluorouracil used to treat actinic keratoses on the face. The reaction was composed of long-lasting redness, facial flushing, exaggerated skin markings, and sensory changes. Physicians prescribing topical fluorouracil should be aware of its potential to produce such a severe reaction. PMID- 3977341 TI - Hypercalcemia in association with cutaneous squamous cell carcinoma. Occurrence as a late complication of hidradenitis suppurativa. AB - Squamous cell carcinoma of the skin is a rare complication of hidradenitis suppurativa. We treated a case of hidradenitis-associated squamous cel carcinoma with metastases to the inguinal lymph nodes. Hypercalcemia also occurred, possibly in relation to the secretion of a hormonelike substance by the tumor. Chemotherapy with bleomycin sulfate, methotrexate sodium, and cisplatin led to tumor regression and control of the hypercalcemia. PMID- 3977342 TI - Cutaneous Mycobacterium szulgai infection. AB - Multiple inflammatory skin lesions and osteomyelitis of the right ankle developed in a 51-year-old man who had been receiving prednisone therapy for several months. Cultures of both the skin and bone lesions yielded Mycobacterium szulgai, a scotochromogenic mycobacterium, which is an unusual human pathogen. The patient's condition responded to treatment with isoniazid, ethambutol hydrochloride, and rifampin. PMID- 3977343 TI - Granulomatous slack skin. AB - A 39-year-old man had a two-year history of three indurated plaques that progressively underwent a cutis laxa-like transformation. Histopathologically a granulomatous, deep, dermal infiltrate was observed. It was composed mainly of numerous histiocytes and many multinucleate cells and foam cells. The case has the clinical and microscopic features of granulomatous slack skin (GSS), which may be considered to be a peculiar form of localized elastolysis. To date, there is no effective therapy for GSS. PMID- 3977344 TI - A probable case of rotavirus exanthem. AB - A generalized maculopapular exanthem and signs of hepatitis developed in a 28 year-old man one week after his two sons had suffered from rotavirus gastroenteritis. The patient's serum contained rotavirus antibody at titers of 1:256 and 1:512. Other known causes of exanthemata were excluded by clinical and laboratory investigations. The epidemiologic evidence and the results of serological tests suggested that the rotavirus caused the patient's exanthem. PMID- 3977345 TI - Pellagra in a patient with anorexia nervosa. AB - A 20-year-old woman was seen with the associated disorders of pellagra and anorexia nervosa, both of which had been present for approximately six months. Treatment with niacin induced resolution of the pellagra skin changes. PMID- 3977346 TI - Delayed hypersensitivity to a corticosteroid suspension containing methylprednisolone. Two cases of conjunctival inflammation after retrobulbar injection. AB - Two patients with chronic iridocyclitis had a delayed hypersensitivity reaction, characterized by severe conjunctival inflammation, after retrobulbar injections with a commercial suspension of methylprednisolone acetate. Although patch test reactions to methylprednisolone at enhanced concentrations were negative, delayed hypersensitivity could be easily demonstrated by intradermal testing with this corticosteroid. Both patients also had concomitant delayed hypersensitivity to a proprietary preservative (myristyl gamma-picolinium chloride) in the commercial corticosteroid suspension, which was confirmed by intradermal testing. These observations (negative patch test reactions, positive intradermal test reactions) suggest that the route of administration may be an important determinant of antigenic hapten-protein complex formation and subsequent delayed hypersensitivity responses involving cutaneous or mucocutaneous tissue. PMID- 3977347 TI - Pemphigus vegetans limited to the lips and oral mucosa. PMID- 3977348 TI - Pemphigus vulgaris of esophageal mucosa. PMID- 3977349 TI - Treatment of eczema herpeticum with systemic acyclovir. PMID- 3977350 TI - Pterygium formation due to sarcoidosis. PMID- 3977351 TI - Granulocytes, lymphocytes, and toxic epidermal necrolysis. PMID- 3977352 TI - Treatment of alopecia areata. PMID- 3977353 TI - Nummular purpura. PMID- 3977354 TI - Immunobiological significance of the Ro/SSA antigen-antibody system. PMID- 3977355 TI - The potential hazards of dinitrochlorobenzene. PMID- 3977356 TI - A histopathologic evaluation of nevocellular nevi in pregnancy. AB - A detailed histopathologic study was performed on 128 nevi removed from 86 pregnant white patients. None of the patients had clinical evidence of the dysplastic nevus syndrome, and none of the excised nevi were clinically suspicious for melanoma. One third of patients reported some change in nevi during pregnancy. Nevi from an age-matched male control population (50 patients) had a spectrum of histologic features essentially identical to the pregnant patients, while nevi from a female control population (51 patients) showed slightly less atypia according to our criteria. The differences found between the nevi from pregnant and control women suggest that a mild degree of histopathologic atypia or "activation" is associated with pregnancy. However, in the population studied, these changes were never of sufficient degree to result in diagnostic confusion. PMID- 3977357 TI - Masked type I wheat allergy. Relation to exercise-induced anaphylaxis. AB - Six patients had type I hypersensitivity to wheat. Three cases were exercise induced anaphylaxis to wheat, one was exercise-induced urticarial reaction to wheat (with angioedema), and the remaining two were exercise-accentuated urticarial reaction to wheat. Elimination of wheat from the diet completely cleared these symptoms. Allergens were prepared from wheat, gluten, gliadin, and glutenin by simple extraction and enzyme digestion, and these preparations were used in skin tests. The allergens obtained from gluten, gliadin, and glutenin by pepsin digestion were qualitatively different from wheat and gluten allergens obtained by simple extraction and were more related to exercise-induced anaphylaxis. Trypsin digestion showed no such effect and abolished all these allergens. These results indicate that wheat allergens are reinforced in the stomach and destroyed in the jejunum. PMID- 3977358 TI - Mule spinner's disease. AB - Mule spinner's disease represents the occurrence of scrotal cancer in cotton textile workers exposed to mineral oils on a long-term basis while working on a machine called "the mule." We describe a 66-year-old cotton textile worker who had frequent scrotal contact with mineral oils and later had multiple squamous cell carcinomas of the scrotum develop. He also had a variety of other keratotic lesions develop on the scrotum that histopathologically demonstrated features of verruca, lichenoid keratoses, and squamous cell carcinomas in situ. We have termed these lesions mule spinner's keratoses. PMID- 3977359 TI - Neonatal lupus erythematosus. A report of three cases associated with anti-Ro/SSA antibodies. AB - Three patients had neonatal lupus erythematosus syndrome. All three infants were girls who presented with characteristic skin lesions but without evidence of congenital heart block. All three mothers were asymptomatic at the time of delivery and have remained so until the present time. All mothers were positive for anti-Ro/SSA antibodies, as were the infants prior to 6 months of age. Anti La/SSB antibodies were not present in either the mothers or the infants. HLA typing revealed that two of the mothers were positive for B8 and DR3, while the third mother was positive for B8 and DR2. Two of the infants were positive for B8 and DR3, while the third infant was positive for DR2 only. PMID- 3977360 TI - Paraffinomas of the scalp. AB - Four cases of scalp paraffinoma were seen in our clinics within the past year. This unusual condition results from intradermal injection of substances containing paraffin. The presence of paraffin in excised tissue was confirmed by thin-layer chromatography and infrared absorption spectrophotometry. Our patients received their treatments 35 to 42 years ago after responding to radio or newspaper advertisements that promised a cure for baldness. Two patients were initially observed with severe scalp inflammation and two were completely asymptomatic other than having lumpy scalps. Although these cases were readily diagnosed by history, eliminating other possibilities was greatly aided by use of xeroradiography, obviating the need for biopsy in asymptomatic cases. PMID- 3977361 TI - Acquired fibrokeratoma of the heel. AB - We describe a patient with a 3-cm sessile tumor of the heel. Despite its large size and unusual location, it had the histologic characteristics of a fibrokeratoma. The essential microscopic feature of fibrokeratoma is its core of collagenous fibers with both interwoven and parallel arrangements. Epidermal hyperplasia and hyperkeratosis are often present, but probably represent secondary changes. Fibrokeratomas, therefore, have some of the clinical and pathologic features of collagenomas. PMID- 3977362 TI - Epithelioid sarcoma. Enzymatic histochemical and electron microscopic evidence of histiocytic differentiation. AB - A 63-year-old man had epithelioid sarcoma. Light microscopy showed the tumor to resemble granuloma annulare. Enzymatic histocytochemical and ultrastructural studies demonstrated the tumor's histiocytic features. Literature review of epithelioid sarcoma and granuloma annulare showed them to have a similar anatomic distribution. PMID- 3977363 TI - Epithelioid sarcoma. Report of a case. AB - Epithelioid sarcoma is familiar to orthopedic surgeons but not to dermatologists. Because this malignant neoplasm presents as a subcutaneous mass, often with overlying epidermal changes, the patient may be seen by a dermatologist for evaluation. The differential diagnosis often includes nodular fasciitis and tenosynovitis. The histopathologic interpretation of the biopsy specimen may be difficult, so it is helpful for the physician to suspect and consider epithelioid sarcoma in the differential diagnosis given to the pathologist. Early, accurate diagnosis can be achieved and can thus spare the patient significant morbidity or even death. PMID- 3977364 TI - Vesiculopustular eruption in a patient with ulcerative colitis. Pyoderma gangrenosum. PMID- 3977365 TI - Acquired intertriginous pigmentation: Dowling-disease or reticulated-pigmented anomaly of the flexures. PMID- 3977366 TI - Transepidermal elimination following the use of a topical adrenal steroid. PMID- 3977367 TI - Exaggerated physiologic speckled mottling of the limbs. PMID- 3977368 TI - Progressive cutaneous herpes simplex or postoperative progressive gangrene. PMID- 3977370 TI - Solar urticaria. PMID- 3977369 TI - PUVA therapy in the treatment of skin lesions of the hypereosinophilic syndrome. PMID- 3977371 TI - Heterogeneity in autosomal recessive ichthyosis. Clinical and biochemical differentiation of lamellar ichthyosis and nonbullous congenital ichthyosiform erythroderma. AB - Nonbullous congenital ichthyosiform erythroderma (CIE) and classic lamellar ichthyosis (LI) can be distinguished by clinical, histopathologic, and biochemical findings reported herein. Whereas all patients with CIE (n = 12) had fine white scales, they were heterogeneous with respect to degree of erythroderma, ectropion, and prognosis. In contrast, all patients with LI (n = 6) had large, dark, platelike scales, severe ectropion that showed no improvement with age, and minimal erythroderma. Although the stratum corneum of patients with LI was two to three times thicker than that of those with CIE, the latter group demonstrated more acanthosis, parakeratosis, hypergranulosis, and less prominent dermal capillaries. Studies of scale-lipid content have indicated biochemical correlates of this clinical heterogeneity. These clinical, histologic, and biochemical findings provide useful guidelines to differentiate CIE from LI and strongly suggest that autosomal recessive primary ichthyosis comprises two distinct diseases. PMID- 3977372 TI - Clinical, histologic, and cell kinetic discriminants between lamellar ichthyosis and nonbullous congenital ichthyosiform erythroderma. AB - Patients described as having lamellar ichthyosis (LI) may not all have the same disorder. We studied nine patients, four of whom had erythroderma and generalized fine scaling, while the remainder had more marked scaling and hyperkeratosis without erythema. The former group is referred to as having nonbullous congenital ichthyosiform erythroderma (CIE), and the other is said to have LI. The clinical differences were paralleled by cell kinetic and histologic differences. The mean tritiated thymidine autoradiographic labeling indices were 9.36 +/- 4.05 and 19.70 +/- 5.84 for the LI and CIE groups, respectively. The histologic differences were delineated using 10-cm analogue scales and showed statistically significant differences for hyperkeratosis and parakeratosis. These data support the hypothesis that LI and CIE are separate disorders. PMID- 3977373 TI - Genital herpes. A pervasive psychosocial disorder. AB - The reports of patients with genital herpes suggest that it is not an awesome physical disability; the more distressing consequences appear to be psychosocial. The symbolic meaning of the disease and its effects on self-esteem and body image have the greatest destructive impact. Patients move through a sequence of adaptational responses remarkably similar to those described for cancer. Of greatest importance is their growing sense of social isolation and their reluctance to initiate relationships with members of the opposite sex. PMID- 3977374 TI - Amyloid elastosis. A new cutaneous and systemic pattern of amyloidosis. AB - A patient with papulonodular cutaneous disease was studied until his death from progressive systemic disease. The elastic fibers in the skin, subcutaneous tissue, and serosae were coated with an amyloid-staining material in a unique pattern, as demonstrated by special stains and electron microscopy. Visceral and cutaneous blood vessels from autopsy tissue also showed amyloidosis, particularly in relation to the elastic fibers. These findings seem to represent a unique syndrome of amyloid disease. PMID- 3977375 TI - Solar urticaria. Further studies on the role of inhibition spectra. AB - A 27-year-old woman exhibited an urticaria only to monochromatic light in the range from 400 to 525 nm, but not to polychromatic light longer than 360-nm ultraviolet (UV) and visible light. An urticarial response induced by 475-nm monochromatic light was completely inhibited by preirradiation, simultaneous irradiation, and postirradiation with light having wave bands longer than 650 nm. Two other patients with sunlight-induced solar urticaria, who had an erythema-and wheal reaction during and after exposure to sunlight, had no suppressive wave bands in either the UV or visible-light range. These observations strongly indicate an important role for inhibition wave bands in the development of light induced immediate erythema and urticaria. In some cases of solar urticaria, preirradiation and postirradiation with longer visible light wavelengths could be useful in preventing the development of urticaria. PMID- 3977376 TI - Nodular cutaneous amyloidosis involving the vulva. Case report and literature review. AB - A case of localized nodular cutaneous amyloidosis involving the vulva occurred in a 53-year-old woman. This rare type of cutaneous amyloidosis has been reported in the female genitalia in two prior cases. The unusual aspects of our case were (1) recurrence after six years, (2) an ulcerative appearance clinically simulating a malignant neoplasm, and (3) the presence of numerous Russell bodies. Our histopathologic findings in hematoxylin-eosin-and peroxidase-antiperoxidase stained sections support the concept of immunoglobulin light chain derivation. PMID- 3977377 TI - Thiazide diuretic therapy and chronic photosensitivity. AB - Chronic photosensitivity associated with hydrochlorothiazide ingestion occurred in four patients. These patients developed a debilitating photosensitivity that persisted for months to years even after they stopped taking the diuretic. Their age range was 44 to 66 years. Phototesting with ultraviolet B (UV-B) and ultraviolet A (UV-A) radiation revealed decreased minimal erythemal doses for one or both wave bands in all patients tested. Histologic examination of skin biopsy specimens from the patients' UV-B and UV-A test sites and lesional skin revealed an acute eczematous dermatitis. Treatment with methoxsalen and UV-A radiation successfully cleared the photosensitive eruption in the patients. PMID- 3977378 TI - Quinidine photosensitivity. AB - A 55-year-old woman developed a dermatitis confined to light-exposed areas while taking quinidine gluconate, warfarin sodium, furosemide, spironolactone, and digoxin after cardiac surgery. Phototesting indicated a normal erythematous response to 290- to 320-nm ultraviolet radiation, but she developed erythema from 6 joules/sq cm of 320- to 400-nm radiation (ultraviolet A [UV-A]), a much lower dose than needed to produce a reaction in normal individuals. Two days after she discontinued quinidine and warfarin, phototesting showed no reaction to as much as 20 joules/sq cm of UV-A. One week after resuming quinidine (but not warfarin), she again reacted to 8 joules/sq cm of UV-A. No reactivity was elicited when the preparation was applied to the skin or injected into the dermis either with or without subsequent UV-A irradiation. PMID- 3977379 TI - Skin peeling syndrome in a Kurdish family. PMID- 3977380 TI - Stanozolol in the treatment of pityriasis rubra pilaris. PMID- 3977381 TI - Pott's puffy tumor. A clinical marker for osteomyelitis of the skull. PMID- 3977383 TI - Lupus nephritis. Collaborative study by the French Society of Paediatric Nephrology. AB - Sixty two children were included in a collaborative study to determine the prognosis for lupus nephritis. Renal involvement was confirmed by histologic study of renal biopsy specimens which were classified into five categories: minimal lesions (11 cases, 18%); focal segmental glomerulonephritis (15, 24%); diffuse proliferative glomerulonephritis (30, 48%); membranous nephropathy (5, 8%); and glomerular sclerosis (1,2%). That the predictive value of the early biopsy is limited was indicated by the most recent status of 37 patients five years after onset--total remission (13, 35%); urinary abnormalities or nephrotic syndrome (7, 19%); moderate renal failure (4, 11%); chronic renal failure (7, 19%); and hypertension (6, 16%). Treatment did not always prevent the development of severe renal failure; in particular, plasmapheresis failed to avert the death of one patient and the development of chronic renal failure in two others. PMID- 3977382 TI - Cytochemical bioassay of parathyroid hormone in maternal and cord blood. AB - Parathyroid hormone and calcium were measured in plasma taken from pregnant women at term and from the umbilical veins of their infants at birth. Three assays were used to measure parathyroid hormone, a cytochemical bioassay of bioactivity and two immunoradiometric assays, one specific for the amino terminus, the other specific for the carboxy terminus of the parathyroid hormone molecule. Plasma calcium was significantly higher in the infants than in the mothers. Maternal parathyroid hormone bioactivity and the amino terminus were both slightly raised, but the carboxy terminus value was normal; these findings supported the view that late pregnancy is a time of mild physiological hyperparathyroidism. In the infants, the amino terminus was undetectable and the carboxy terminus was either undetectable or towards the lower end of the normal range: bioactivity of parathyroid hormone was considerably raised and was related to the gradient of calcium across the placenta. This suggests that the parathyroid glands are not suppressed during fetal life and that they may play an important part in the maintenance of high fetal plasma calcium concentrations. PMID- 3977384 TI - Problems associated with indwelling central venous catheters. AB - Forty nine Broviac or Hickman indwelling central venous catheters were inserted in 36 patients with haematological and neoplastic diseases for indications including young age, intensity of treatment, and psychological attitude. Sixteen patients suffered 29 episodes of infection related to the catheter bacteraemia (0.68 episodes per 100 days of catheter use). Infections occurred much more commonly where there was intensive use of the catheter than with relatively light catheter use. Twenty episodes were caused by a single bacterial strain and nine by multiple strains; coagulase negative staphylococci accounted for 51% of the strains isolated. Altogether 72% of infections were cured by antibiotic treatment, which was more likely to be successful in eradicating single than multiple infections. Although infection was common, mechanical problems were a more usual reason for catheter removal. There were no deaths caused by catheter related infection. PMID- 3977385 TI - Congenital microvillous atrophy: specific diagnostic features. AB - Proximal small intestinal and colonoscopic mucosal biopsies from two children with the intractable diarrhea of infancy syndrome were examined by electron microscopy. Microvillous involutions were found in the small and large bowel of both patients. We suggest that this is a specific diagnostic finding for congenital microvillous atrophy, a distinct disorder within the intractable diarrhoea syndrome which has an extremely poor prognosis. PMID- 3977386 TI - Neonatal thyroid function: influence of perinatal factors. AB - Indices of thyroid function were measured in 229 healthy term neonates at birth and at 5, 10, and 15 days of age. Results were analysed to assess whether maternal diabetes mellitus, toxaemia of pregnancy, intrapartum fetal distress, duration of labour, method of delivery, asphyxia at birth, race, sex, birthweight, birth length, head circumference, or method of feeding influenced any index. Thyroxine, the free thyroxine index, and free thyroxine concentrations at birth correlated with birthweight. Method of delivery influenced mean thyroxine and free thyroxine index values at birth and at age 5 days. Mean values of triiodothyronine, reverse triiodothyronine, thyroxine binding globulin, and thyroid stimulating hormone were not affected by any of the perinatal factors studied. Birthweight and perhaps method of delivery should be taken into account when interpreting neonatal thyroxine parameters but determination of thyroid stimulating hormone as a screen for congenital hypothyroidism in healthy term neonates circumvents these considerations. PMID- 3977387 TI - Diaphragmatic paralysis due to spinal muscular atrophy. An unrecognised cause of respiratory failure in infancy? AB - An unusual form of spinal muscular atrophy presenting with respiratory failure was observed in four infants from two families. In one, whose death was attributed to pneumonia, the diagnosis was inferred retrospectively after two siblings died from an identical illness and were shown to have diaphragmatic paralysis and the typical electrophysiological and histological features of spinal muscular atrophy. Other signs of skeletal muscular weakness were absent or inconspicuous. The fourth, unrelated infant presented in an identical way but has survived for over a year on a ventilator. Two months after the onset of respiratory paralysis, more extensive skeletal muscular weakness was seen. Other infants, dying of unexplained respiratory illness, may have this disorder and some may be included in the miscellany of disorders that constitute the sudden infant death syndrome. PMID- 3977388 TI - Deaths in cots are not always cot deaths. AB - Agonal histories were traced for 1182 of 1782 postneonatal deaths in Sheffield between 1947 and 1979. Twenty eight per cent of these deaths were histologically inexplicable, 19% were from infections and 15% from malformations. These sudden infection and malformation deaths were explicable, yet by some definitions they would be considered as cot deaths. Varying definitions may lead to confusion, hindering the search for aetiological mechanisms. PMID- 3977389 TI - Successful treatment of fetal atrial flutter and congestive heart failure. AB - Fetal supraventricular tachycardia may cause congestive heart failure, hydrops fetalis, and intrauterine death. Tachycardia in a fetus of 34 weeks' gestation was diagnosed as atrial flutter by echocardiography, and was successfully treated by giving the mother digoxin. PMID- 3977390 TI - Henoch-Schonlein syndrome and selective IgA deficiency. AB - A 9 year old girl presented with clinical manifestations of Henoch-Schonlein syndrome and macroscopic haematuria. Laboratory investigations showed selective IgA deficiency and renal biopsy showed mesangial proliferative glomerulonephritis with diffuse granular deposits of C3 on immunofluorescence. IgA deposits were absent. PMID- 3977391 TI - Symptomatic vitamin E deficiency in cystic fibrosis. AB - A girl with cystic fibrosis who developed a neurological syndrome probably secondary to vitamin E deficiency at the age of 10 years is described. The severity of the deficiency and the early development of neurological features probably result from reduced intraluminal bile salt concentrations in addition to the pancreatic insufficiency. PMID- 3977392 TI - Treatment of severe coagulation disturbances as a condition of improved prognosis in fulminant liver failure. AB - A favourable outcome of fulminant liver failure by replacement treatment with antithrombin III, prothrombin concentrate, fresh frozen plasma, and plasminogen is reported. Haemostatic balance was maintained and no severe bleeding complications occurred during the 15 days of disturbed liver function. PMID- 3977393 TI - Elimination diets in eczema. PMID- 3977394 TI - Prevalence of glucose-6-phosphate-dehydrogenase deficiency. PMID- 3977395 TI - Hyperglycaemia in infantile gastroenteritis. PMID- 3977396 TI - Clinical significance of gastro-oesophageal reflux. PMID- 3977397 TI - Intensive care and neonatal mortality. PMID- 3977398 TI - Equating optimal temperatures for incubators. PMID- 3977399 TI - Coagulation defect of congenital tyrosinaemia. PMID- 3977400 TI - Role of aldosterone in late hyponatraemia. PMID- 3977401 TI - Haemoglobin concentration depends on protein intake in small preterm infants fed human milk. AB - Studies have shown that early anaemia of prematurity cannot be prevented by iron or vitamin supplementation. We studied 35 infants of birthweight less than 1520 g and mean gestational age 30.4 weeks who were fed either human milk alone or human milk supplemented with human milk protein. The vitamin and iron status were the same in both groups but the concentration of haemoglobin was significantly higher at the ages 4 to 10 weeks in the protein supplemented infants. Reticulocytosis occurred earlier in the protein supplemented infants. The findings on haemoglobin and reticulocytes were similar in 18 infants who received no blood transfusions. We conclude that human milk protein supplementation can increase the haemoglobin concentration of very low birthweight infants in the early weeks of life and that the protein content in human milk may be insufficient to satisfy their needs. PMID- 3977402 TI - Cytotoxicity of intratracheally administered coal fly ash: studies on liver and plasma lipids in rats. PMID- 3977403 TI - Acute oral toxicity and repellency of 933 chemicals to house and deer mice. PMID- 3977404 TI - Temporal patterns of brain cholinesterase activities of white-footed mice (Peromyscus leucopus) following dosing with diazinon or parathion. PMID- 3977405 TI - Time trends of organochlorine chemical residues in seven sedentary marine fish species from a Norwegian fjord during the period 1972-1982. PMID- 3977406 TI - Mirex residues in seven groups of aquatic and terrestrial mammals. PMID- 3977407 TI - Implantation disturbance studies with linear alkylbenzene sulphonate in mice. PMID- 3977408 TI - Cytotoxicity of intratracheally administered coal fly ash: studies on lipids in the lung of rats. PMID- 3977409 TI - Cryptococcal sacroiliitis. AB - Disseminated cryptococcal disease is known to occur in patients with altered immune status. We have reported an unusual case of cryptococcal disease manifested solely by sacroiliitis, which occurred in a patient on chronic steroid therapy for autoimmune haemolytic anaemia. This case stresses the importance of considering unusual organisms as a cause of sepsis in patients with altered immune status. PMID- 3977410 TI - Geode development and multiple fractures in rheumatoid arthritis. AB - The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described. PMID- 3977411 TI - Arthritis of the middle ear in ankylosing spondylitis. PMID- 3977412 TI - Diabetic cheiroarthropathy in adult non-insulin-dependent diabetes. PMID- 3977413 TI - Rupture of the spleen in rheumatoid arthritis. PMID- 3977414 TI - Prostaglandin E1 vasospastic disease and thermography. AB - This is the first study to show a quantitative thermographic difference between patients with Raynaud's syndrome and normal controls after cold stress testing. An improved thermographic response to cold stress testing after treatment of Raynaud's syndrome with PGE1 has also been shown for the first time. Discriminant analysis of the change in temperature of a finger after cold stress, and the mean thermal gradient along the finger during rewarming, clearly separated patients from controls. After treatment with PGE1 the patients' discriminant values moved into the normal range. Symptomatic improvement after PGE1 correlated well with thermographic improvement, and both persisted for up to 12 weeks. PMID- 3977416 TI - Chronic juvenile toxic epidemic syndrome. AB - The clinical manifestations in 21 children with chronic toxic epidemic syndrome (TES) and musculoskeletal manifestations were analysed and compared with those of the adult population. The sex ratio (2.5:1, F/M) was different from the one found in adults (6:1, F/M). The neuromuscular syndrome, the scleroderma-like picture, the pulmonary hypertension, and the Raynaud's phenomenon characteristic of TES were similar to those in adults but milder in children. The less severe vascular endothelial lesions found on microscopic examination might explain the better prognosis in this age group. PMID- 3977415 TI - Limited joint mobility in diabetes mellitus. AB - The relationship of limited joint mobility and finger joint contractures in diabetics to age of onset, duration, and control of diabetes has not been established. We measured the mobility of metacarpophalangeal, wrist, elbow, and ankle joints and assessed the prevalence of finger joint contractures in 254 young diabetics and 110 controls. The presence of microvascular disease was assessed by ophthalmoscopy and urine analysis for proteinuria. An estimate of long-term diabetic control was obtained from a postal questionnaire. A generalised reduction in joint mobility was present in diabetics of all ages two years after diagnosis. The reduction in joint mobility in controls between the ages of 12 and 13 was exaggerated in the diabetics. Diabetics diagnosed before puberty were more severely affected than those with a postpubertal onset, independent of duration of diabetes. Finger joint contractures were a significant feature of longstanding diabetics (nine years or more duration) only. PMID- 3977417 TI - Silicon-containing particles in synovial fluid: scanning electron microscopy coupled with analytical techniques allows an easy identification and differentiation from pathologically relevant crystals. AB - Silicon-containing particles were observed by scanning electron microscopy (SEM) in synovial fluid samples from patients with crystal-induced or inflammatory synovitis, or both. This material was an artefact produced by the technical procedures, but these particles could be easily differentiated from naturally occurring compounds by their morphology and their composition determined by analytical spectrometry. PMID- 3977418 TI - Selection of vasodilator therapy for severe Raynaud's phenomenon by sequential arterial infusion. AB - Two young adults with impending gangrene due to persistent Raynaud's vasospasm were studied by sequential intra-arterial (IA) infusion of three vasodilatory drugs while arterial pressure and plethysmographic digital pulse volume were continuously monitored. The results of the IA infusion accurately predicted relief from vasospastic symptoms by oral drugs of the same class. This method may be useful in selecting the most effective vasodilator for patients with severe vasospasm. PMID- 3977419 TI - Common IgA and IgM rheumatoid factor idiotypes in autoimmune diseases. AB - Anti-idiotypic antibodies to four monoclonal IgM, one polyclonal IgM, and one polyclonal IgA rheumatoid factors were produced in rabbits and tested for cross reactivity with rheumatoid factors from nine patients with essential mixed cryoglobulinaemia, three patients with rheumatoid arthritis, four patients with systemic sicca syndrome, and one patient with systemic lupus erythematosus. Variable (3/16 to 10/16) cross reactivity for each anti-idiotypic antibody was observed which was not restricted by disease category, clonality, or isotype of the rheumatoid factor. These findings suggest that rheumatoid factor genes are highly conserved from the germ-line antibody repertoire. PMID- 3977420 TI - Endothelial cell cytotoxicity in inflammatory vascular diseases--the possible role of oxidised lipoproteins. AB - One of the proposed mechanisms of vascular damage in connective tissue disease is the direct action of a cytotoxic serum factor inducing endothelial cell damage. The nature of this serum factor is unclear, but has been suggested to be a lipoprotein. Sera from patients with (1) systemic necrotising arteritis (polyarteritis nodosa, Wegener's granulomatosis, and necrotising arteritis associated with rheumatoid synovitis), (2) systemic or joint restricted rheumatoid disease, and (3) large vessel/giant cell arteritis have been examined for cytotoxicity to human cultured endothelial cells and azide-resistant ferroxidase-like activity (indicative of the oxidised lipoprotein content). Stored sera from patients with necrotising arteritis showed a significantly enhanced tendency to develop oxidised lipoprotein, which correlated closely with human endothelial cell cytotoxicity. Fresh sera also contained this factor, but to a lesser extent. It is argued that the cytotoxic factor detected in previous clinical studies is in part an in-vitro artefact, although its accelerated development in certain patient groups might suggest an excess of pro-oxidants that have developed in vivo. PMID- 3977421 TI - Effect of intravenous iron dextran on rheumatoid synovitis. AB - Eleven patients with rheumatoid arthritis received a total dose infusion of iron dextran for anaemia. Two of them had anaphylactic reactions and the remaining nine an exacerbation of synovitis. Quantitative infrared thermal imaging was used to assess the extent and distribution of joint involvement resulting from this therapy. In all eight patients examined the 'thermographic index' increased in two or more joint areas, indicating an increase in inflammation. Small joints of the hands were maximally affected, though larger joints when previously inflamed also worsened. Uninflamed joints were rarely affected. The exacerbation of synovitis occurred 24-48 h after completion of the iron dextran infusion and corresponded with a saturating of the serum iron binding capacity. Levels of immune complexes were unaltered, implying normal reticuloendothelial function. In one further patient, reported to have synovial flares when challenged with oral ferrous sulphate, iron dextran was infused at a lower dosage. All previously inflamed joints in this patient worsened 12 h after the infusion was discontinued. Concomitant with this was an increase of lipid peroxidation products in synovial fluid and to a less extent serum. Iron dextran in vitro stimulated lipid peroxidation, but dextran alone had no effect. It is therefore suggested that iron dextran worsens synovial inflammation by promoting lipid peroxidation. PMID- 3977422 TI - Recurrent rheumatic fever. AB - Although recurrent rheumatic fever in adults is uncommon and the recurrence rate declines with age and with the interval from the attack, we describe a patient who has had four attacks of rheumatic fever, two in childhood and two in adult life. PMID- 3977423 TI - Acute synovitis with intra-articular apatite deposits in an osteoarthritic metacarpophalangeal joint. AB - A patient was shown to have acute arthritis in a metacarpophalangeal joint, with local calcification indicated by x-rays. Surgical and pathological examinations showed strictly intra-articular apatite crystal deposits and an erosive osteoarthritis. These crystal deposits could account for the synovial inflammation; they are thought to be related to bone fragments embedded in the synovium. The predisposing role of previous local injections of corticosteroids is debatable. PMID- 3977424 TI - Non-steroidal anti-inflammatory drugs and adverse renal effects. PMID- 3977425 TI - Free thiomalate levels in rheumatoid arthritis. PMID- 3977426 TI - A surgeon's view of extracorporeal circulation. AB - Because this lecture series is named after Dr. John Gibbon, an examination of the remarkable developments that were set in motion by John and Maly Gibbon's work on extracorporeal circulation is not only appropriate to this forum but is, in fact, long overdue. Although John Gibbon and his wife have been honored in many countries for their basic contribution to medicine, it is my belief that the work was of Nobel stature, and I am sure that if the rules for selecting a Nobel prize winner had been different, John Gibbon would have certainly been the recipient. I feel particularly pleased to be speaking of them today because what may be the most important trip I ever took was a visit to their laboratory in Philadelphia in 1952 to watch their progress in developing the heart-lung machine. As we were doing research in the field and had no pump, he gave me one of his original circular pumps, which we subsequently used with our disc oxygenator in the first 300 open heart operations performed in our unit. PMID- 3977427 TI - A personal overview of causalgia and other reflex dystrophies. AB - This is a personal assessment of true major causalgia and the other reflex dystrophies, related but distinctly separate entities. The clinical picture of causalgia differs only in minor respects from that described by Mitchell over 120 years ago. Its management has, however, been clarified, largely through the extensive experiences of World War II. It is readily recognized and can be treated effectively by sympathetic blocks or sympathectomy together with active exercise. The other reflex dystrophies are far less understood. They appear to have a similar pattern in their early phase and to respond well to a program of exercise and control of edema--a regimen which, because of pain and paresis, cannot be carried out without sympathetic blocks or occasionally sympathectomy. When not recognized early and treated properly, the sympatomatology usually changes dramatically and treatment differs. Often control of edema and active use of the affected part are all that is necessary. Sometimes, in addition to these measures, sympathetic blocks or sympathectomy is required. Guidelines found useful in management are outlined. Puzzling features are discussed. PMID- 3977428 TI - Fundoplication enhances gastric emptying. AB - Fundoplication of the stomach is an established surgical treatment of gastroesophageal reflux. Its mechanism of action remains unclear. To assess its effect on gastric emptying, 21 patients (11 men, 10 women), median age 47 years (range 19-72), underwent a gastric emptying study before and 6 months after fundoplication. Gastric emptying studies were performed after an overnight fast using a dual isotope technic. Solid and liquid emptying rates were assessed over 120 minutes. The time taken for 50% of the liquid marker to leave the gastric region was a median of 22 minutes before surgery (range 9-35) and 13 minutes after surgery (range 9-27) (p less than 0.01). The percentage of solid remaining in the stomach 100 minutes after ingestion was 50% before surgery (range 19-90) and 44% after surgery (range 5-89) (p less than 0.01). We conclude that gastric emptying of both solids and liquids tends to be increased following fundoplication. This observation suggests a further mechanism for the efficacy of this operation in the treatment of gastroesophageal reflux. PMID- 3977429 TI - Release of secretin immunoreactivity from the ileum. AB - In the rat, about 80% of the intestinal content of secretin immunoreactivity is found distal to the duodenum with a peak in the ileum. This work therefore studied whether the secretin immunoreactivity in distal ileum could be released by substances normally found in the intestinal lumen. An isolated loop of ileum or duodenum was perfused with 100 mM HCl, 3 mM HCl, 50 mM taurocholate, 50 mM oleate, 308 mM glucose, 273 mM amino acids, or 308 mM NaCl in anesthetized rats. Release of secretin immunoreactivity was estimated by the integrated response above basal in portal blood. Substantial release of secretin immunoreactivity was seen after both ileal and duodenal perfusion with concentrated HCl and taurocholate, whereas perfusion with oleate was followed by a lesser response. The response to taurocholate was slower than that to HCl, but more likely represents a physiologic mechanism. The results show that the distal small intestine is capable of contributing to secretin immunoreactivity in the circulation and it is speculated that bile salts and secretin constitute parts of a negative feedback loop. PMID- 3977430 TI - Simultaneous and sequential determinations of steroid hormone receptors in human breast cancer. Influence of intervening therapy. AB - Estrogen (ER), progesterone (PgR), and androgen (AR) receptors were measured in two simultaneous or subsequent specimens taken each from 259 patients with breast cancer. We studied in 182 patients results from receptor assays, either from one tumor or from the primary tumor, and a lymph node metastasis, and in 77 sequential biopsies with or without intervening therapy. All assays were performed in a single laboratory, considering 10 fmol/mg cytosol protein bound ligand as receptor positive. The concordance rate in simultaneous ER assays was 85%; however, we found a considerable high discordance rate for PgR in primary tumor and lymph node metastasis (25%). The overall discordance rate in sequential biopsies for ER was 38% and for PgR 25%. This discordance rate was primarily dependent on the receptor quality of the first assay (ER+: 50%, ER-: 24%, PgR+: 68%, PgR-: 9%). Considering only the ER+ and PgR+ cases, we found the greatest discordance rate in the patients having endocrine treatment following the first biopsy (55% and 84%, respectively). We conclude that the receptor status of one tumor biopsy is highly representative for other tumor or lymph node biopsies. Because of the high discordance rate of primarily receptor + cases in subsequent recurrences, the receptor quality of these lesions should be analyzed whenever possible. PMID- 3977431 TI - What constitutes adequate study of axillary lymph nodes in breast cancer? AB - This study was undertaken to determine the value of the clearing technique and multilevel sectioning of lymph nodes to aid in optimally examining axillary dissections for lymph node metastases. One hundred consecutive mastectomy specimens with axillary dissections were initially examined by our routine technique: examination of fat for lymph nodes by inspection and palpation and examination of one microsection from each lymph node. The remaining axillary tissue was then cleared using the technique of Durkin and Haagensen and each of the originally examined lymph nodes was resectioned at two additional deeper levels. In our routine examination, 2203 lymph nodes were found with 211 lymph nodes containing metastatic tumor. Clearing disclosed 412 additional lymph nodes, of which 17 contained metastatic tumor. The two additional microsections of lymph nodes revealed tumor in only two lymph nodes which were initially free of tumor. The extended study of the axilla did not add significantly to our routine examination. PMID- 3977432 TI - Gallstone disease following antrectomy and gastroduodenostomy with or without vagotomy. AB - The incidence and prevalence of gallstones has been documented in 289 consecutive patients with peptic ulcer disease, at the time of antrectomy and gastroduodenostomy (with or without truncal or selective vagotomy) and again during a 5-year follow-up period. By comparing the preoperative prevalence of gallstone disease in one age group with the prevalence 5 years after the gastric operation in another group of patients who were 5 years younger at the operation, the incidence of gallstone production due to the gastric operation could be calculated independent of the age factor. Within 5 years of the gastric operation, 18% of the patients who were normal at the time of operation produced gallstones. The incidence of new gallstones during the 5-year postgastrectomy follow-up was the same in men and women, and was increased by 7 to 15% in each age group of men. The incidence of new gallstones was 30% after truncal and 12% after selective vagotomy (p less than 0.05). Gallstone formation seems to be a sequel of Billroth I gastric resection. Truncal vagotomy in addition to the gastrectomy increases the risk of gallstone disease; patients with selective vagotomy and antrectomy had an incidence of postoperative gallstones which was the same as patients with antrectomy alone. PMID- 3977433 TI - Cirrhosis and alcoholism as pathogenetic factors in pigment gallstone formation. AB - The association of cirrhosis with pigment gallstones has been noted in numerous autopsy studies. However a direct relationship between alcoholism and pigment cholelithiasis has not been previously demonstrated. We have classified 123 cholecystectomy patients according to stone type and correlated the resulting categories with hepatic morphology, drinking history, and hematological data. Pigment stones were found in 79% of biopsy-verified cirrhotic patients but in only 26% of noncirrhotics. In patients without cirrhosis a positive history of alcoholism was found associated with pigment gallstones more often than with cholesterol or mixed stones (36% vs. 10%). Similarly, the mean red cell volume (MCV), a sensitive marker of alcoholism, was significantly increased in patients with pigment stones (93.6 mu 3 vs. 89.6 mu 3). We conclude that both cirrhosis and alcoholism predispose to pigment gallstone formation and that the effect of alcoholism may occur independent of cirrhosis. This suggests that the apparent association of cirrhosis with pigment stones may, in fact, result from a direct effect of long-term ethanol ingestion on red blood cells, liver, or bile. PMID- 3977434 TI - A "nondislodgeable" endoprosthesis for nonsurgical drainage of the biliary tract. AB - In patients with obstructive jaundice, biliary decompression can be achieved by an endoprosthesis inserted by a percutaneous transhepatic approach. The prosthesis sometimes becomes dislodged and thus additional percutaneous transhepatic procedures may be required. To avoid this problem, a nondislodgeable endoprosthesis has been developed. The prosthesis is constructed with a layer of biocompatible material (hydrogel) on its surface. The hydrogel is located in grooves around the endoprosthesis and has the ability to absorb liquid, which increases its size. By placing the rings of hydrogel on either side of the obstruction, dislodgement of the prosthesis can be prevented. The nondislodgeable endoprosthesis has been inserted into 11 patients with biliary obstructions due to malignant strictures. No dislodgement has occurred and the established internal drainage reduced serum bilirubin levels without any major complications. PMID- 3977435 TI - Accidental lesions of the common bile duct at cholecystectomy. Pre- and perioperative factors of importance. AB - The 65 reports of accidental lesions of the choledochus at cholecystectomy from the records of the Patients' Insurance Syndicate in Stockholm, Sweden, 1975-1982, were studied in order to characterize avoidable factors and/or situations at cholecystectomy. Compared with control materials, there were significantly less men (28 vs. 34%) and the patients were younger (46 vs. 54 years). The patients were without significant other diseases and former operations, and were slim or of a normal weight. The patients had a short history of known biliary tract disease and there was seldom a suspicion of common duct stone. Most of the surgeons were under training and 80% of them had done 25 to 100 cholecystectomies before, seldom assisted by a more experienced surgeon. The inflammation was never severe, the bleeding insignificant, and an anomaly was found after the lesion was done in only 16 of 55 cases. The lesion was done before cholangiography in 27 cases and after the cholangiography, but before the films were available in 32 cases. The gallbladder was excised about as often from the fundus as from the pouch. We have found it probable that most of these accidental injuries of the choledochus could have been prevented with a policy that considers cholecystectomy as a major operation that requires well-trained surgeons with a humble and concentrated approach to their task. PMID- 3977436 TI - Amikacin concentrations in serum following intraoperative irrigation of the pleura and peritoneum. AB - Serum concentrations of amikacin following operative wound irrigation were studied in 17 patients having laporatomy and in eight patients having thoracotomy. Irrigation was done with 500 mg of amikacin in 200 ml of saline. The irrigant was reaspirated after 3 minutes. Measurement of amikacin in the irrigant allowed calculation of the retained dose. Serum levels were measured before surgery, and at 30 minutes, 60 minutes, 6 hours, and 12 hours following irrigation. Amikacin was assayed by a microbiological technique. The retained dose after peritoneal irrigation was 350 +/- 128 mg, and after pleural irrigation was 100 +/- 79 mg. The average maximum serum level in the peritoneal irrigation group was 9.4 +/- 6.7 gm/ml; in the thoracotomy group it was 3.5 +/- 1.7. Fourteen of the 17 laparotomy patients but only one of the eight thoracotomy patients had measurable plasma levels at 6 hours. Plasma half-life in the laparotomy group was 2.81 +/- 1.34 hours, and in the thoracotomy group 1.53 +/- 0.83 hours. Interoperative amikacin irrigation, even with immediate aspiration, results in significant absorption in both thoracotomy and laporatomy patients. There was less absorption and a shorter serum half-life in the thoracotomy patients. PMID- 3977437 TI - Isolation-perfusion of the liver with 5-fluorouracil. AB - Isolation-perfusion of the liver was performed in ten pigs using 5-fluorouracil administered in the perfusion circuit at doses of 100, 250, 500, and 1000 mg/kg body weight. Perfusion was performed for 60 minutes at normothermic (37 C) or hyperthermic (41 C) temperatures. One animal died shortly after perfusion. Incomplete isolation of the hepatic vasculature in two animals resulted in significant drug leakage into the systemic circulation with resulting hematologic toxicity. Perfusion with 5-fluorouracil at 1000 mg/kg produced hepatic necrosis. Perfusion with 5-fluorouracil at doses of 100, 250, or 500 mg/kg produced no hepatic toxicity except for transient elevations of hepatic enzymes and resulted in no systemic drug toxicity. Levels of 5-fluorouracil tolerated by the liver in the isolation-perfusion system were more than 1000-fold greater than the maximum drug levels achievable by routine systemic, intra-arterial, or intraperitoneal administration. PMID- 3977438 TI - Peritoneal approach to prosthetic mesh repair of paraostomy hernias. AB - A new method for repair of large hernias at stoma sites is presented. The old abdominal incision is reopened and prosthetic mesh is sutured in place aseptically. The bowel courses above the mesh to be secured to the lateral abdominal wall creating a flap valve. Seven paraostomy hernia repairs in six patients were performed with no recurrences in a 4- to 7-year follow-up. The peritoneal approach to insertion of prosthetic mesh into the hernia defect is recommended especially for recurrent paraostomy hernias. This technique is appropriate for a hernia that possesses a large fascial defect. PMID- 3977439 TI - Motility of the small intestine after proctocolectomy and ileal pouch-anal anastomosis. AB - Though the mechanisms of continence after proctocolectomy and ileal pouch-anal anastomosis have been studied, functions of the small intestine have received little attention. However, frequent stools and urgency plague some patients who are otherwise quite continent. Motility of the jejunum and ileum was assessed in eight patients with ulcerative colitis who were studied 4 to 24 months after proctocolectomy and ileal pouch-anal anastomosis; these findings were compared to those in six healthy volunteers. Continuous manometric recordings from the small bowel were obtained in both groups for 16 to 23 hours of fasting; postprandial recordings were made for 6 hours following a mixed meal (800 kcal, 20% protein, 40% fat, 40% carbohydrate) in the ileoanal patients. The duration, velocity of propagation, and periodicity of the migrating motor complex did not differ between the groups (P greater than 0.05). Discrete bursts of clustered contractions were recorded from all of the controls and in five of eight patients. Likewise, we recorded from all controls and five of eight patients large amplitude, prolonged waves of pressure which propagated distally. However, in controls these large amplitude waves were confined to the terminal ileum, but in patients these were detected in the jejunoileum, up to 125 cm proximal to the ileal pouch. We conclude that jejunoileal motility is not greatly altered by proctocolectomy with ileal pouch-anal anastomosis. However, the appearance of the large amplitude, rapidly propagating waves in the proximal jejunoileum after operation may be a response to increased storage within and distention of the distal bowel. PMID- 3977440 TI - Effects of superoxide dismutase and allopurinol on the survival of acute island skin flaps. AB - We have demonstrated previously that oxygen-derived free radicals are important mediators of tissue injury following ischemia (total venous occlusion) and reperfusion in small (3 cm X 6 cm) island skin flaps in rats. In this study, we evaluated extension of this concept to regional ischemia in large (8 cm X 8 cm) acute island skin flaps which were constructed to exceed their sole blood supply via unilateral inferior epigastric vessels. Under normal (control) circumstances, a significant portion of the flap would undergo necrosis at the periphery, mimicking the corresponding clinical situation. Blocking the generation of superoxide radicals from xanthine oxidase with a single dose of allopurinol prior to flap elevation significantly improved the area of flap viability from 34 +/- 12% to 57 +/- 6% (p less than 0.01) in the random portion of the flap, contralateral to the source of blood supply. Similarly, the detoxification of superoxide radicals with a single dose of superoxide dismutase improved viability from 41 +/- 6% to 58 +/- 7% (p less than 0.01). Similar results were obtained when either of these agents were administered 60 minutes after flap elevation. These findings suggest that oxygen-derived free radicals play an important role in the development of tissue necrosis in the critical transition zone between well-vascularized and devascularized skin. PMID- 3977441 TI - The effect of vasopressin on solute and water excretion during and after surgical operations. AB - The relationship between the concentration of plasma arginine vasopressin (AVP), urine volume, and osmolality during and after an abdominal operation was studied in nine patients. In all patients the AVP level rose well above that necessary for maximal antidiuresis (5 fmol ml-1) and then returned to within the normal range (0.5-5.0 fmol ml-1) usually over the next 24 hours. During this period of raised AVP concentration the urine volume, which varied considerably, was closely related to osmolar excretion. With the fall of AVP to normal levels, all but one of the patients eventually exhibited positive free water clearance. However, in most patients the urine remained hypertonic for some hours and its volume continued to be determined mainly by osmolar load which was itself apparently related to glomerular filtration rate. At no time was there a significant relationship between changes in plasma AVP concentration and urinary volume. PMID- 3977442 TI - Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients. AB - Although an extensive literature exists concerning essential arterial hypertension, the primary etiology has been unclear. Arterial compression of the left lateral medulla oblongata by looping arteries of the base of the brain was seen incidently in 51 of 53 hypertensive patients who underwent left retromastoid craniectomy and microvascular decompression for unrelated cranial nerve dysfunctions. Such compression was not noted in normotensive patients. Treatment by vascular decompression of the medulla was performed in 42 of the 53 patients. Relief in the hypertension was seen in 32 of the patients and improvement in four. Arteriosclerosis and arterial ectasia contribute to arterial elongation and looping. If pulsatile compression of the left lateral medulla occurs, hypertension may develop as a consequence of an imbalance in the neural control systems that normally regulate blood pressure. The hypertension may further contribute to arterial elongation, providing a vicious circle of pathophysiologic changes. PMID- 3977444 TI - Shock. A century of progress. AB - The word shock has been used for at least a century in all clinical disciplines to describe a progressive but gradual collapse of vital organ functions. Important initial steps in understanding the problem began at the turn of the century by two means: clear clinical descriptions and the initiation of research into etiology and treatment. The growth of shock treatment and its promising future are discussed. PMID- 3977443 TI - Experience with sphincteroplasty and sphincterotomy in pancreatobiliary surgery. AB - Review of a 26-year experience with transduodenal sphincteroplasty and sphincterotomy was undertaken (1) to analyze critically the indications for and results of these procedures and (2) to determine which preoperative factors correlate with a good or poor outcome. Of 109 patients, 78 underwent sphincteroplasty, whereas 31 had a transduodenal sphincterotomy. Surgical indications included: group 1, 53 patients with common duct stones; group 2, 28 patients with dyskinesia or stenosis of the sphincter of Oddi (without choledocholithiasis or recurrent pancreatitis); and group 3, 28 patients with recurrent pancreatitis. Three elderly group 1 patients who presented with cholangitis died after surgery (a hospital mortality of 2.7%). Seventy-nine of the 103 patients (77%) in whom follow-up was obtained achieved an excellent or good result. Results were almost identical with sphincteroplasty and sphincterotomy. Abnormal preoperative liver function tests were the only predictors of a good postoperative outcome (p less than 0.05). Group 3 patients (good results in 63%) had significantly poorer (p less than 0.05) outcome than group 1 and 2 patients. Results were worst in group 3 patients who had undergone previous abdominal or pelvic surgery (p less than 0.025) and in group 2 patients who were narcotic users (p less than 0.025). The authors conclude that transduodenal sphincteroplasty or sphincterotomy can be performed relatively safely, but caution that careful selection of patients is important when the indication for surgery is either ampullary stenosis or recurrent pancreatitis. PMID- 3977445 TI - Comparative studies of plasma secretin response after reconstructive surgery of the stomach and pancreas. AB - The postprandial plasma secretin response was examined in ten normal persons, seven patients with a Billroth I and seven with a Billroth II anastomosis after subtotal gastrectomy, seven with a Roux-en-Y anastomosis, two with an interposed jejunal anastomosis, and five with a modified Child's anastomosis after pancreatoduodenectomy. The postprandial plasma secretin response in patients with Billroth I anastomosis was better than that in patients with a Billroth II anastomosis but was less than that of normal subjects. Although no postprandial secretin response was noted in Roux-en-Y anastomosis after total gastrectomy, a response was seen in patients with the interposed jejunal anastomosis because the digested food passed through the duodenum, but it was less than that for Billroth I and II patients and normal controls. After a modified Child's reconstruction, the postprandial secretin response was similar to that of patients with the Billroth II, which preserved the duodenum. A patient with a modified Child's reconstruction was examined 12 years after surgery and had the same response as other patients with the modified Child's reconstruction and those with a Billroth II anastomosis within 2 months after surgery. After ingestion of hydrochloride solution, the plasma secretin release in patients with a Billroth I and II anastomosis after subtotal gastrectomy and Roux-en-Y anastomosis after total gastrectomy had a better response than after a meal, but this was less than in normal subjects. The authors suggest that careful selection of intestine for the gastrointestinal anastomosis, which contains many secretin secretory cells, is important to obtain endogenous secretin release. For gastrojejunostomy after pancreatoduodenectomy, a method preserving the pylorus is better than the usual gastrojejunostomy because it maintains gastric acid. The ingestion of secretin stimulants, such as hydrochloride, may help to prevent pancreatic dysfunction after gastrectomy and other surgical reconstructions. PMID- 3977446 TI - Accidental lesions of the common bile duct at cholecystectomy. II. Results of treatment. AB - Sixty-five cases of accidental lesion of the choledochus at cholecystectomy reported from 51 Swedish hospitals to the Patients' Insurance Syndicate in Stockholm 1975-1981 were studied. The results were evaluated as to the time of detection and the primary surgical repair done. Fifty-five of the 65 lesions were detected and repaired at the cholecystectomy and ten were detected and repaired the first 10 days after the primary operation. In 38 of 55 lesions detected before surgery, an end-to-end choledochostomy was performed. Good results without further surgical intervention were achieved in 22%. The 17 other preoperatively detected lesions were treated with choledocho/hepaticoenterostomy, and good results were achieved without further surgical intervention in 54%. Of the ten patients in whom the lesions were detected after surgery, three were reconstructed with an end-to-end choledochostomy; all of these developed obstruction that led into further reoperations. In the remaining seven patients the lesions were repaired within 10 days with a choledocho/hepaticoenterostomy; three of them did not require further surgical intervention and four had to be reoperated. There was no mortality at the first repair, but two cases of hospital mortality at reoperations. However, the morbidity have been substantial for patients with as well as without obvious further surgical complications. The results indicate that in this selected group choledocho/hepaticoenterostomy should be the procedure of choice. However, the accumulated rate of biliary strictures increased with time, which requires a considerably longer follow-up to know the end results of this of avoidable complication to "a straightforward cholecystectomy." PMID- 3977447 TI - Predicting the risk of abdominal disease in Hodgkin's lymphoma. A multifactorial analysis of staging laparotomy results in 255 patients. AB - There were 425 consecutive patients treated for Hodgkin's disease at this Medical Center from 1943 to 1983. Of these, 255 patients underwent a staging laparotomy and had complete preoperative clinical records. Overall, 35% had a change in stage (24% were upstaged, 11% downstaged). Twenty-nine per cent of clinical stage I patients were upstaged; 31% of stage II patients were upstaged, while less than 1% were downstaged; and four per cent of stage III patients were upstaged while 44% were downstaged. The diagnostic laparotomy yielded involvement in the spleen in 71% of patients with abdominal involvement, in the periaortic lymph nodes in 41%, in the liver in 11%, and the bone marrow in seven per cent. Only 12% of the 135 patients with negative laparotomies subsequently relapsed in the abdomen after a mean follow-up of 4.8 years. A multifactorial analysis was performed to identify dominant factors predicting the risk for abdominal disease. The factors best predicting abdominal involvement in stage I and II patients were: antecedent symptoms (greater than or equal to 2, 1, 0; p less than 0.00001), histological type [nodular sclerosing (NS) less than lymphocyte-predominant (LP) less than mixed cellularity (MC) less than lymphocyte-depleted (LD); p = 0.0009], and sex (females less than males, p = 0.01). The clinical stage (I vs. II), the site of lymphoma presentation, and the age and race of the patient did not have significant predictive value for the risk of abdominal disease after the other factors were accounted for. A mathematical model was derived for identifying dominant prognostic factors for predicting the risk of abdominal disease in an individual patient setting. The lowest risk patients were asymptomatic females with NS histology (6%) or LP histology (8%), while the highest risk patients were men with multiple symptoms and either MC histology (85%) or LD histology (93%). This information can be useful in making clinical decisions in Hodgkin's lymphoma patients, especially those at an increased risk for surgery. PMID- 3977448 TI - Surgical aspects of intestinal injury due to pelvic radiotherapy. AB - Seventy-one patients with intestinal injury secondary to pelvic irradiation had predominantly large bowel lesions. Seventeen cases were treated conservatively and 54 came to surgery, 28 patients having more than one operation. Following this essentially salvage surgery there were more ileal than colonic anastomotic leaks. Thirty-four patients died during the follow-up period (2-12 years), 19 from recurrent malignancy, and nine as a result of continuing radiation effects. Seventy per cent of the patients who had a radiation fistula died as a result of malignancy. Of 42000 cases of pelvic malignancy treated by irradiation over the decade 1972-1982, surgical referrals for complications constituted 1.7%, with an overall radiation-related mortality of 0.2%. It is our opinion that colostomy alone has little part to play in this condition, and a policy based on excisional surgery is suggested. PMID- 3977450 TI - The LeVeen shunt in the elective treatment of intractable ascites in cirrhosis. A prospective study on 140 patients. AB - One hundred and forty patients with an intractable ascites complicating a chronic liver disease received a peritoneovenous shunt (PVS) using the LeVeen valve. Operative mortality was ten per cent but was 25% in patients with severe liver failure. Intraoperative drainage of ascites sharply decreased postoperative complications and mortality. One-year actuarial survival rate was 81.4%, respectively 77.7%, 61.3%, and 24.7% in patients with good liver function and moderate or severe liver failure. Variceal hemorrhage occurred in 11 patients and late infection in another 11 patients. Thirty-eight patients (30.5%) had recurrence of ascites. This was mostly due to an obstruction on the venous side of the shunt. An elective portacaval shunt had to be done in 23 patients for recurrence of ascites or variceal bleeding. Among the 57 patients still alive at time of writing, 51 were free of ascites. These results suggest that PVS is an efficient operation. This procedure may be largely indicated in the selected and small group of cirrhotic patients with true intractable ascites and moderate or no liver insufficiency. PMID- 3977449 TI - Factors affecting immediate and long-term survival after emergent and elective splanchnic-systemic shunts. AB - The course of 121 shunted cirrhotic patients, managed according to a prospective protocol over a period of 10 years, was analyzed to determine predictors of 30 day and long-term survival. Forty-five per cent of the patients underwent emergent decompression within 12 hours of active bleeding, and 34% of the shunts were selective. Logistic regression linked early mortality to bilirubin and blood urea nitrogen (BUN) (p = 0.001), and long-term survival to the presence of preoperative ascites and higher levels of alkaline phosphatase (p = 0.027), but neither variable set was a more accurate predictor than Child Class. Emergency shunt patients had greater risk of early death, 44% vs. 17% for patients shunted electively (p = 0.001), but beyond 30 days, their Kaplan-Meier survival curves were identical. Independently, angiographic prograde portal flow was favorably associated with short-term (p = 0.003) but not prolonged survival. The presence of Mallory bodies, fatty metamorphosis, and acute periportal inflammation, alone or in combination, had no prognostic value. Continued post-operative alcohol ingestion jeopardized long-term survival (p = 0.017). Survival of nonalcoholics was enhanced by selective as opposed to total splanchnic decompression (p = 0.009). PMID- 3977451 TI - Early complications following surgical treatment for Crohn's disease. AB - One hundred thirty patients with Crohn's disease operated at the Mount Sinai Hospital were studied to determine the incidence of early postoperative complications. Thirty per cent of patients developed postoperative complications, while eight per cent had major complications requiring readmission to the hospital, reoperation, or suture of a bleeding vessel. Patients with a low preoperative serum albumin concentration had a significantly higher incidence of nonseptic and multiple complications. Septic complications were more common in patients having extensive resections and in those with multiple previous operations. There was also a significantly higher complication rate in patients requiring permanent or temporary ileostomy as opposed to those having intestinal anastomosis. The majority of complications in the patients with ileostomy were nonseptic in nature. There were no mortalities in this series. PMID- 3977453 TI - Venous gangrene of the upper extremity. AB - Gangrene of the hand associated with acute upper extremity venous insufficiency has been seen in four limbs in three patients treated at Vanderbilt University Medical Center. All three patients had life-threatening illnesses associated with diminished tissue perfusion, hypercoagulability, and venous injury. One patient progressed to above-elbow amputation, but venous thrombectomy in one limb and thrombolytic therapy in two others were successful in preventing major tissue loss. All three patients eventually died from their underlying illness. Thirteen previously reported patients with "venous gangrene" of the upper extremity have been analyzed. An underlying life-threatening illness was present in the majority of these patients (7/13, 54%) and, like the Vanderbilt series, amputations were frequent (7/13, 54%) and mortality (5/13, 38%) was high. This unusual form of ischemia appears to be produced by permutations of global circulatory stasis, subclavian or axillary vein occlusion, and peripheral venous thrombosis. Early, aggressive restoration of adequate cardiac output and thrombectomy and/or thrombolytic therapy may provide the best chance for tissue salvage and survival in this group of patients. PMID- 3977455 TI - Sarcoma of the breast. A study of 32 patients with reappraisal of classification and therapy. AB - A retrospective clinicopathologic review of 32 patients with mammary sarcoma exclusive of angiosarcoma or lymphoma was performed. For 25 patients with previously untreated lesions, the median tumor diameter was 4 cm and 14 patients had high or intermediate grade lesions. One of 22 patients treated by mastectomy and one of three patients treated by local excision died of sarcoma yielding an actuarial 5-year survival of 91%. None of the 25 patients had received adjuvant chemotherapy and only one treated by mastectomy had post-operative radiation therapy. Seven other patients were referred for treatment of recurrent mammary sarcoma. In this group, median size of the primary tumor was 6 cm and four had high or intermediate grade histology. Tumor control was achieved for only one of five patients with local recurrence and neither of the two with distant metastases. Median survival was 6 months following initiation of treatment for recurrence. Whenever possible breast sarcomas should be classified according to histologic cell type and grade. For lesions not readily classified, the terms unclassified or anaplastic sarcoma should be used. The diagnosis of stromal sarcoma is best reserved for those infrequent sarcomas that can be traced to the specialized periductal and perilobular stroma of the breast. Total mastectomy is recommended for most patients with postoperative radiation therapy indicated when the adequacy of the margin is in doubt. The role of adjuvant chemotherapy in the primary management of mammary sarcoma is yet to be determined. PMID- 3977452 TI - Thin (less than or equal to 1 mm) melanomas of the extremities are biologically favorable lesions not influenced by regression. AB - Although a thickness of less than or equal to 0.76 mm has been used to define biologically favorable (thin) melanoma, there is evidence that 1 mm may be a reasonable cutoff to categorize favorable extremity melanomas. This is tempered, however, by the claim that histologic regression in thin melanomas is associated with an increased metastatic rate. We have therefore addressed the following questions: Is 1 mm an appropriate cutoff point to define thin melanoma on the extremities? Does regression in a thin lesion truly signify a poor prognosis? Is the width of excision (narrow vs. wide) related to recurrence rates in these lesions? To address these issues we reviewed 48 patients with extremity melanomas, less than or equal to 1 mm in maximum thickness, treated at this institution during a 20-year period. Pathologic features included histologic type: superficial spreading (90%), nodular (6%), and not classified (4%); thickness: less than 0.76 mm (61%) and 0.76 to 1 mm (39%); and Clark's level: II (33%), III (63%), and IV (4%). A moderate or marked lymphoid infiltrate occurred in 75%, and histologic tumor regression was found in 50%. The median margin of excision, as stated by the surgeon, was 4 cm. The median margin measured by the pathologist in unfixed specimens was 3.5 cm. Although 13% had atypical melanocytic hyperplasia in the initial excisional biopsy margin, all reexcisions were clear. Of 21 patients having node dissections, none had nodal metastases. There were no recurrences or deaths due to melanoma (median follow-up: 90 months). We conclude that melanomas less than or equal to 1 mm in thickness on the extremities can be defined as biologically highly favorable, "thin" lesions. Foci of regression do not alter their behavior. Their favorable prognosis justifies conservative excision in most cases. PMID- 3977454 TI - Venovenous perfusion in ECMO for newborn respiratory insufficiency. A clinical comparison with venoarterial perfusion. AB - Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) has been successful in the treatment of newborns less than 1 week of age and greater than 2000 gm birthweight with respiratory failure resistant to current medical and surgical management. While VA ECMO supports the heart as well as the lungs, it has the disadvantage of requiring carotid artery ligation and the possibility of perfusing air bubbles or particles into the arterial tree. We have treated 11 newborns with respiratory failure with venovenous (VV) ECMO returning the oxygenated blood to a cannula in the distal iliac vein. We compared these patients with 16 patients treated during the same period of time with VA ECMO. Three of the 11 VV patients required conversion to VA ECMO because of inadequate oxygenation and unstable hemodynamic situations. Ten of the 11 VV patients survived. Eleven of the 16 VA patients survived. The better survival in these patients treated with VV ECMO is attributed to their more favorable initial condition compared to patients treated with VA ECMO. The disadvantages of VV ECMO include a longer operative time to place the cannulas, groin wound problems, and persistent leg swelling along with the necessity to convert some patients to VA ECMO. Although this experience demonstrates that newborns with severe respiratory failure can be supported with VV ECMO, the complications and lack of practical advantages over VA lead us to recommend VA ECMO for routine clinical use at present. PMID- 3977456 TI - Surgical management of cutaneous melanoma. PMID- 3977457 TI - The role of enzymes in acute pancreatitis. PMID- 3977458 TI - Laser photoablation for the treatment of refractory ventricular tachycardia and endocardial fibroelastosis. PMID- 3977460 TI - Cardiopulmonary bypass and host defense functions in human beings: II. Lymphocyte function. AB - In 47 patients undergoing open-heart surgical procedures, the influence of cardiopulmonary bypass (CPB) on lymphocyte function was investigated by studying in vitro the mitogen responses of lymphocytes in whole blood cultures. Subnormal mitogen responses before operation that likely resulted from dexamethasone medication were found in half of the patients studied. During operation, changes in phytohemagglutinin responses were uniform in a group of 23 patients. No significant effect of anesthesia and operation was observed until the patients were heparinized (i.e., before CPB). At the end of operation, the phytohemagglutinin response was below normal. In a group of 24 other patients, postoperative mitogen responses were studied. A tendency toward restoration of mitogen responses was observed in most patients the first morning after operation. However, no uniform pattern of normalization of mitogen responses was found. In an attempt to relate postoperative mitogen responses to trauma resulting from CPB, we observed that perioperative (in comparison with postoperative) administration of blood coincided with a significantly higher incidence of subnormal phytohemagglutinin and pokeweed mitogen responses on postoperative day 1. No correlation between laboratory data and clinical findings could be established. PMID- 3977459 TI - Cardiopulmonary bypass and host defense functions in human beings: I. Serum levels and role of immunoglobulins and complement in phagocytosis. AB - In patients undergoing open-heart surgical procedures, the serum levels of immunoglobulins and complement were determined as well as the functional capacity of these defense proteins as opsonins to facilitate phagocytosis by polymorphonuclear leukocytes. A considerable decrease in serum levels of the proteins studied was found after cardiopulmonary bypass (CPB). As a result, the opsonic capacity of post-CPB plasma was diminished. After correction for hemodilution, however, no difference between pre- and post-CPB plasma, as measured by the activity of thermolabile (e.g., complement C3) and thermostabile (e.g., immunoglobulin IgG) opsonins, could be demonstrated. It is concluded that CPB causes a quantitative but no functional decrease in levels of IgG and C3. PMID- 3977461 TI - Interactions between pharmacological cardioplegia and hypothermia for intraoperative myocardial protection. AB - Cold cardioplegia is currently the method of choice for providing myocardial protection during open-heart surgical procedures. Two components of protection, perfusion cooling and pharmacological cardiac arrest, were investigated in the guinea pig heart-lung model. The effects of two cardioplegic solutions, the University of Alabama Hospital solution and the St. Thomas' Hospital solution, and a control perfusate were compared. The results confirmed the efficacy of hypothermia as a protective agent and the additional protection afforded by pharmacological cardioplegia. Infusion temperature critically influenced the cardioprotective action of the Alabama solution: Striking protection was afforded only under hypothermic conditions, whereas myocardial damage was exacerbated by the infusion at 37 degrees C. The St. Thomas' Hospital solution provided substantial protection independent of infusion temperature. Thus, the safety margin of the Alabama solution was narrower than that of the St. Thomas' solution. It is suggested that the difference between the two cardioplegic solutions partially depends on their coronary vasoactivity, since the administration of the Alabama solution at 37 degrees C increased coronary perfusion pressure. It would seem worthwhile to use a temperature-independent cardioplegic solution devoid of coronary vasoconstricting action. PMID- 3977462 TI - Arch vessel injury during pulmonary artery catheter placement. AB - We have observed seven instances of unintentional cannulation of major arteries with 8F sheaths during preparation for open-heart operation. When the sheath was removed and the operation delayed, there were no complications; in the two instances in which the open-heart operation was performed immediately after arterial cannulation, there was 1 death due to hemorrhage and 1 false aneurysm of the carotid artery. Elective open-heart operations should be delayed if unintentional cannulation of a major artery occurs. PMID- 3977463 TI - A comparison of flow gradients across disposable arterial perfusion cannulas. AB - Five-hundred members of The Society of Thoracic Surgeons were canvassed to discover which cannulas are currently used for open-heart surgical procedures in adults; 120 surgeons responded. The mean arterial line pressure produced by 29 disposable arterial perfusion cannulas (size range, 16F to 30F) at flow rates of 1 to 5 liters per minute was compared. A roller pump with perfusion tubing 95 mm (0.75 inch) in diameter was used with water as the test solution. Line pressures in these cannulas ranged from 22.4 +/- 2.30 (standard deviation) to 271.0 +/- 6.60 mm Hg at 5 L/min. Four 24F cannulas had gradients of less than 55 mm Hg at a flow rate of 5 L/min, and 6 cannulas--4 of which were 22F and 2, 24F--had gradients higher than 150 mm Hg at 5 L/min. A number of cannulas kinked easily, and these showed marked increases in line pressure. The following results were obtained from this study: (1) a wide range of line pressures was observed in disposable arterial perfusion cannulas currently in clinical use; (2) some cannulas currently used for cardiopulmonary bypass in adults generated excessive line pressure; and (3) both material and design affect function, with some designs being safer than others. Cardiac surgeons should base the choice of an arterial perfusion cannula on the best performance and safest design available to avoid cannula-related problems at operation. PMID- 3977464 TI - Long-term assessment of aortic valve replacement with autologous pulmonary valve. AB - Two hundred two autologous pulmonary valves were transplanted into the aortic position between 1967 and 1982 at the National Heart Hospital in London. The indication for operation was congenital or acquired aortic valve disease, and the patients were followed for periods from 1 to 4 years. The patients were not anti coagulated, but the entire series has been completely free from thromboembolism or bleeding. The actuarial prediction of freedom from valve-related deaths was 82 +/- 6% at the end of the fourteenth year after operation; deaths were due to reoperations for technical failure and to infective endocarditis. Event-free survival of the autologous pulmonary valve in the aortic position was 73 +/- 6% after 14 years at risk. Valve failure resulted mainly from technical problems encountered during the early years of surgical experience. There was no macroscopic or histological evidence of calcification in any of the failed valves. The right ventricular outflow was reconstructed with an aortic homograft in the majority of patients; 81 +/- 5% of these homografts demonstrated event free performance over a 12-year follow-up period. It is concluded that the long term performance of a pulmonary autograft inserted for aortic valve disease is superior to that of any other valve substitute and that the operation offers an almost ideal means of aortic valve replacement in appropriate patients. PMID- 3977466 TI - Extraction of large tracheal foreign bodies through a tracheostoma under bronchoscopic control. AB - Despite various technical manipulations through contemporary endoscopic equipment, large tracheal foreign bodies may be lost during bronchoscopic extraction, with a 1 to 2% in-hospital mortality. Recently, emergency tracheostomy was performed during bronchoscopy after a tracheal foreign body had become dislodged in the subglottic region causing blockage of the airway, and the results of this procedure provoked its deliberate application in a second patient. In 3 additional infants, aspirated tracheal T tubes (Montgomery tubes), which were producing acute respiratory distress, were brought from the carina to the performed tracheostoma under bronchoscopic manipulation and were withdrawn. Elective application of this simultaneous approach--tracheostomy with bronchoscopy--may decrease morbidity and mortality from large tracheal foreign bodies. PMID- 3977465 TI - Porcine cardiac bioprostheses: evaluation of long-term results in 990 patients. AB - Clinical results with porcine bioprostheses were reviewed for 990 patients who underwent heart valve replacement from January, 1974, to December, 1980. Eight hundred and seventy-four Hancock, 283 Carpentier-Edwards, and 10 Liotta bioprostheses were used. In 23 patients, 26 mechanical prostheses were implanted as well. Overall operative mortality was 60 out of 990 (6.06%): 30 out of 506 (5.9%) for mitral valve replacement (MVR), 13 out of 287 (4.5%) for aortic valve replacement (AVR), 1 out of 4 (25%) for tricuspid valve replacement, 0 out of 2 for pulmonary valve replacement, and 16 out of 191 (8.4%) for multiple valve replacement. Cumulative follow-up covered 1,793 patient-years. (Actuarial survival at 7 years was 76.6 +/- 3% for MVR. At 6 years, it was 83.2 +/- 2.8% for AVR and 55 +/- 13.5% for multiple valve replacement.) Prosthesis-related survival at 7 years was 91.7 +/- 1.9% for MVR, and at 6 years, it was 96.6 +/- 1.5% for AVR and 95.1 +/- 2.2% for multiple valve replacement. Bioprosthesis survival, considering deaths or complications that led to reoperation as final events, was 84.2 +/- 3.7% at 7 years for mitral valves and 87.7 +/- 3.8% at 6 years for aortic valves. Emboli per 100 patient-years numbered 3.2 for MVR, 0.5 for AVR, and 1.6 for multiple valve replacement. Twenty-seven patients underwent reoperation, 12 for perivalvular leak, 5 for endocarditis, 6 for valve thrombosis, and 4 for primary tissue failure (linearized rates of 0.7, 0.3, 0.3, and 0.2% per patient-year, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977467 TI - Massive hemoptysis in patients with cystic fibrosis: three case reports and a protocol for clinical management. AB - The clinical management of massive hemoptysis in patients with cystic fibrosis proceeds according to the following paradigm. The site of bleeding is identified by bronchoscopy, ideally under general anesthesia. Then selective bronchial arteriography is performed. If collaterals to the spinal cord are visualized, arterial embolization is abandoned and pulmonary resection is undertaken within the limits of pulmonary function. PMID- 3977468 TI - A method for predicting postoperative lung function and its relation to postoperative complications in patients with lung cancer. AB - We predicted the postoperative forced expiratory volume in 1 second (FEV1) with a formula based on the premise that the total number of subsegments was 42: postop FEV1 = [1 - (b - n)/(42 - n)] (preop FEV1), where n and b are the number of obstructed subsegments and total subsegments, respectively, in the resected lobe. It was assumed that b was 6, 4, and 12 in the right upper, middle, and lower lobes, respectively, and 10 each in the left upper and the left lower lobes. The obstructed subsegments, n, were obtained from the findings on bronchography or bronchofiberscopy or both before operation. The linear regression line derived from the correlation between predicted (x) and measured (y) FEV1 was y = 0.850x + 0.286 +/- 0.296 (standard error) (N = 52; r = 0.821; p less than 0.001). We calculated the predicted postoperative FEV1 in 188 patients with primary lung cancer. The predicted values were corrected with the regression equation just mentioned and then normalized by the patient's height and sex (%FEV1(p,c). The correlation between %FEV1(p,c) and the surgical risk was studied. Postoperative respiratory complications were inversely related to %FEV1(p,c), and a significantly high incidence of complications (p less than 0.05) was observed in those whose %FEV1(p,c) was less than 60% of predicted normal. In aged patients (65 years old or more) without complications, %FEV1(p,c) was 67.3 +/- 18.0%; it was 52.2 +/- 12.8% in those with respiratory trouble and 53.3% +/- 9.6% in those with circulatory complications. The difference between groups with and without complications was significant (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977470 TI - Late false aneurysm following replacement of ascending aorta: the problem of the teflon graft in combination with a silk suture anastomosis. AB - Two patients underwent resection and replacement of the ascending aorta using a low-porosity Teflon graft anastomosed with silk suture. In both patients false aneurysms developed that required operation 13 and 23 years postoperatively. The clinical courses of these patients, along with data from the literature, suggest that the combination of a low-porosity Teflon graft and a silk suture anastomosis presents a major potential hazard for the development of anastomotic false aneurysm. PMID- 3977469 TI - Percutaneous tube drainage: the treatment of choice for refractory lung abscess. AB - During the years 1978 to 1982, 48 patients with primary lung abscess were seen in the Sheba Medical Center in Israel. Seven of them (14%) did not respond to conservative treatment and were candidates for operation. All were successfully treated by percutaneous tube drainage initiated under local anesthesia, and all recovered completely. There were no relapses after a follow-up period of 2 to 5 years. During this period, we did not perform pulmonary resection for primary lung abscess. Three patients with malignant abscesses were also treated initially by transthoracic drainage but eventually required surgical intervention. We conclude that percutaneous transthoracic drainage is an efficient and safe mode of treatment, and we recommend transthoracic drainage as the treatment of choice for long-standing, refractory primary lung abscesses. PMID- 3977471 TI - False aneurysm of the aorta secondary to an esophageal foreign body. AB - False aneurysm of the aorta developed in a 14-month-old child following endoscopic removal of an open safety pin from the esophagus. The diagnostic techniques and operative repair of this rare complication of foreign body ingestion are described. PMID- 3977472 TI - Late Mycobacterium chelonei bioprosthetic valve endocarditis: activation of implanted contaminant? AB - Mycobacterium chelonei contamination of the Hancock porcine heart valve prosthesis occurred in a few lots manufactured between October, 1975, and August, 1976. The unimplanted valves were recalled, but a number of valves in their cohort had already been implanted. This report describes a patient with Mycobacterium chelonei endocarditis of a Hancock bioprosthetic heart valve belonging to this cohort that occurred three years after implantation. We are aware of four similar instances of mycobacterial endocarditis and believe that these latent infections originated either from surgical inoculation or from implantation of a contaminated valve prosthesis. Other Hancock valves manufactured between October, 1975, and August, 1976, may harbor latent M. chelonei. We believe early valve replacement with aggressive combination antibacterial and antituberculosis therapy is essential for control of atypical mycobacterial valve endocarditis. PMID- 3977473 TI - Right ventricular myxoma. AB - This report describes a patient with right ventricular myxoma in whom two dimensional echocardiography was the sole means of diagnosis and provided sufficient justification for surgical intervention without further invasive workup. A review of the literature also is presented. PMID- 3977475 TI - Closure of patent ductus. PMID- 3977474 TI - Epidural hematoma as a cause of postpneumonectomy paraplegia. AB - Postpneumonectomy paraplegia developed in a woman admitted for resection of bronchogenic carcinoma. Postpneumonectomy paraplegia is an uncommon, but catastrophic, event that is thought to be caused primarily by ischemia to the spinal cord; in this instance an epidural hematoma was the cause. Recommendations for prevention are presented. PMID- 3977476 TI - Rebound vasospasm after coronary bypass grafting. PMID- 3977477 TI - Familial extra-adrenal pheochromocytoma. PMID- 3977478 TI - Psychiatric manifestations in patients with pheochromocytomas. PMID- 3977479 TI - Myxedema megacolon. PMID- 3977480 TI - Asymptomatic disordered breathing during sleep in older persons. Disease or not? PMID- 3977481 TI - Mechanically assisted ventilation in a community hospital. Immediate outcome, hospital charges, and follow-up of patients. AB - In 100 consecutive patients undergoing mechanically assisted ventilation, we prospectively determined immediate survival, hospitalization charges, and subsequent one-year outcome. Sixty percent of the patients survived the episode of assisted ventilation. This survival decreased to 50% at the time of hospital discharge and to 33% one year after hospitalization. There were no posthospitalization deaths in patients less than age 50 years. In those patients older than 70 years, however, 51% were dead by the time of hospital discharge and 73% died by one year following discharge. Comparison of features that reflect the magnitude of intensive respiratory care, such as hours of ventilation and intensive care unit (ICU) length of stay, disclosed no statistically significant differences between survivors and nonsurvivors at discharge. Hospitalization charges averaged $10,968 per patient. The total charge for respiratory therapy services (including arterial blood gas determinations) averaged $2,200. Respiratory care service charges were only marginally different between survivors and nonsurvivors. By contrast, total charges and total length of stay were greater for the survivors. Resource use in the intensive care setting as reflected by hours of mechanical ventilation and ICU length of stay was similar in both survivors and nonsurvivors, with the larger total cost for survivors relating primarily to care outside the ICU. Also, we confirm that prognosis is excellent in patients less than 50 years of age who survive mechanically assisted ventilation for acute respiratory failure and that extubation in elderly patients is not necessarily indicative of a good prognosis. PMID- 3977482 TI - Serum thyroglobulin levels in the diagnosis and follow-up of subacute 'painful' thyroiditis. A sequential study. AB - Serum thyroglobulin (Tg) levels were elevated in 92% of 38 patients with subacute "painful" thyroiditis in the early stage, independent of the extent of the disease and thyroid hormone concentrations. After two months of corticosteroid treatment, serum Tg levels were significantly decreased in 25 patients who could be rechecked, compared with the levels in the acute phase, although higher than those in our normal control subjects. Twelve of 25 patients underwent sequential measurements of Tg for three to four months, during the disease and after recovery. In ten the initially elevated values decreased rapidly to normal and were maintained for approximately 20 days. Then they rose gradually, peaked about 60 days after disease onset, then returned slowly and permanently to normal. In one patient who had a clinical relapse during the plateau phase, the Tg level also increased markedly and abruptly. Therefore, serial measurements of serum Tg can help in diagnosing and monitoring subacute "painful" thyroiditis. PMID- 3977483 TI - Anxiety in patients with pheochromocytomas. AB - Anxiety has been considered an important clinical feature of patients with pheochromocytomas. We studied 17 patients with active pheochromocytoma to determine whether they experienced anxiety that met criteria of the Diagnostic and Statistical Manual of Mental Disorders, third edition, for either panic disorder or generalized anxiety disorder. Fifty-two patients with primary anxiety disorders were used as a comparison group. Six patients with pheochromocytomas had norepinephrine-secreting tumors and 11 had mixed-secretion tumors, with elevated levels of both epinephrine and norepinephrine. None of the 17 patients described the severe apprehension or fear characteristic of panic attacks and none described agoraphobia. One patient received a diagnosis of possible panic disorder, two met criteria for generalized anxiety disorder, and two met criteria for major depressive episode. Thus, the elevated levels of catecholamines secreted by pheochromocytomas are not sufficient to elicit an anxiety disorder. PMID- 3977484 TI - Prognostic implications of normal exercise thallium 201 images. AB - We studied 455 patients (mean age, 51 years) in whom exercise thallium 201 scintigrams performed for suspected coronary artery disease were normal. Of those, 322 (71%) had typical or atypical angina pectoris and 68% achieved 85% or more maximal predicted heart rate. The exercise ECGs were abnormal in 68 patients (15%), normal in 229 (50%), and inconclusive in 158 (35%). Ventricular arrhythmias occurred during exercise in 194 patients (43%). After a mean follow up period of 14 months, four patients had had cardiac events, sudden cardiac death in one and nonfatal myocardial infarctions in three. None of the four patients had abnormal exercise ECGs. Two had typical and two had atypical angina pectoris. Normal exercise thallium 201 images identify patients at a low risk for future cardiac events (0.8% per year), patients with abnormal exercise ECGs but normal thallium images have good prognoses, and exercise thallium 201 imaging is a better prognostic predictor than treadmill exercise testing alone, because of the high incidence of inconclusive exercise ECGs and the good prognosis in patients with abnormal exercise ECGs. PMID- 3977486 TI - Systemic necrotizing vasculitis seen initially as hypertensive crisis. AB - Necrotizing vasculitis is not usually considered in the differential diagnosis of hypertensive crisis. Three cases are presented in which hypertensive crisis with encephalopathy was the principal initially seen manifestation of systemic necrotizing vasculitis. The correct diagnosis was suspected because of the patients' young age, elevated ESRs, and evidence of previous exposure to hepatitis B virus and was confirmed by renal angiography. All three patients had metabolic alkalosis, and two of the three patients had hyponatremia and hypokalemia. The literature presents a picture of hypertension in necrotizing vasculitis as insidious, relentless, and progressive. Our cases illustrate that it can be a dramatic, life-threatening initial manifestation. A renal angiogram can be justified in similar patients, since effective therapy for necrotizing vasculitis exists. In these patients control of BP ultimately depends on successful treatment of the underlying vasculitis. PMID- 3977485 TI - Familial extra-adrenal pheochromocytoma. A new syndrome. AB - Pheochromocytomas in the same anatomic site, the right renal hilum, occurred in a family over three successive generations. For two patients in the latter two generations, scintigraphy with iodine 131-tagged metaiodobenzylguanidine (MIBG) showed tumors only in the region of the right renal hilum, thus indicating that they were primary lesions. At surgery, except for lymph node metastases noted microscopically in one patient, tumors were found only near the right renal hilum. The adrenal glands seemed normal on inspection, palpation, and computed tomography. In another family, a mother and son had primary pheochromocytomas arising from the urinary bladder. We suggest that primary extra-adrenal pheochromocytoma is a syndrome in which specific genetic abnormalities determine sites of tumor development. PMID- 3977487 TI - Whole-day BP monitoring in ambulatory normotensive men. AB - Noninvasive automated ambulatory BP monitoring techniques were used to evaluate BP patterns in 34 healthy normotensive men. Daytime BPs (128 +/- 12/80 +/- 7 mm Hg) were significantly higher and nighttime BP averages (109 +/- 11/67 +/- 9 mm Hg) were significantly lower than the casual BPs (119 +/- 13/76 +/- 9 mm Hg) of the subjects studied. On the average, 15.6% of the readings in each tracing showed systolic BPs above 140 mm Hg, and more than 25% of these elevated readings were found in six of the 34 subjects. The average incidence of elevated diastolic BPs (greater than 90 mm Hg) observed during each monitoring period was 14.4%, but six subjects had incidences of more than 25%. The incidence of elevated BP readings was not age related. However, subjects with a family history of hypertension generally had more elevated systolic BPs than those with no family history of hypertension (24% v 9%). PMID- 3977488 TI - Depressive symptoms in medical house officers. Effects of level of training and work rotation. AB - To measure depressive symptoms in medical house officers, a self-report questionnaire was administered to 68 medical house officers each month for an academic year. Of 844 possible responses, 737 forms were completed (87.3%). Although the overall prevalence of depressive symptoms (21.4%) approximated that of the general population, subpopulations of residents with high prevalence rates of depressive symptoms could be identified. A 28.7% prevalence rate of depressive symptoms was noted for postgraduate year 1 (PGY-1) residents. Prevalence rates fell with each successive year of training. Depressive symptoms occurred in 34.8% of PGY-1 residents on ward rotations. Similarly, responses from PGY-1 and PGY-2 residents on intensive care rotations indicated prevalence rates of depressive symptoms for both groups of greater than 33%. The impact of these symptoms on resident function and patient care has yet to be determined. PMID- 3977489 TI - Campylobacter fetus subspecies fetus bacteremia. AB - Eight patients with Campylobacter fetus bacteremia, six of them with serious underlying diseases, were seen in a two-year period. Besides fever, which was observed in all cases, the most frequent clinical manifestation was lower extremity phlebitis and cellulitis (four patients). In one of these patients, it had the peculiar aspect of bilateral pretibial cellulitis. One patient had vertebral osteomyelitis, a complication, to our knowledge, not yet described. Two patients, both with advanced underlying diseases, died. The five patients who completed a two- to three-week course of erythromycin gluceptate, all had initial clinical improvement. However, one patient suffered a relapse at the end of treatment, and progression of vertebral osteomyelitis while on erythromycin therapy was observed in another patient. These clinical and bacteriologic failures occurred despite the in vitro sensitivity to erythromycin of the two strains. This suggests that erythromycin might not be adequate therapy for C fetus septicemia. PMID- 3977490 TI - Persistence of abnormal RBC and platelet phenotype during recovery from aplastic anemia. AB - Sixteen adults with chronic acquired aplastic anemia had abnormally large RBCs and abnormally small platelets before chemotherapy. During their therapy, transfusion initially obscured these macrocytic RBCs. In the eight who had erythropoietic recovery, endogenous RBCs again were macrocytic, and platelets remained small whether or not the platelet count increased. The percentage of cells containing hemoglobin F changed in only one of the eight subjects. In contrast, the eight who did not have erythropoietic recovery had no reappearance of macrocytes. Of 19 other previously treated patients whose hemoglobin level had recovered to normal for seven to 196 months, 16 had increased mean corpuscular volume (101 to 133 femtoliters) and abnormally small platelets. We conclude that in aplastic anemia the appearance of macrocytes reliably and easily predicts RBC recovery. Furthermore, even in treated, apparently recovered subjects, an abnormality of blood cell size remains. PMID- 3977492 TI - Persuasive communication and medical technology assessment. AB - Assessments of medical technologies with respect to their efficacy, safety, and cost-effectiveness are expected to influence clinical practice, but they are often lost in an avalanche of medical information. We developed a conceptual model that may aid understanding of the potential impact on clinical practice of new medical information in general and assessment information in particular. The model identifies aspects of medical communication that may influence an assessment's subsequent impact, including sources, messages, channels, audiences, and settings. We reviewed the literature on how medical information diffuses to physicians and highlighted those factors likely to heighten physicians' awareness and decisions to incorporate recommended medical advances. We outlined implications for educational interventions and promising research directions. PMID- 3977491 TI - Immune response to a heat-inactivated hepatitis B vaccine in patients undergoing hemodialysis. Enhancement of the response by increasing the dose of hepatitis B surface antigen from 3 to 27 micrograms. AB - In a randomized trial, 227 patients undergoing hemodialysis who were seronegative for all markers of hepatitis B virus were immunized at monthly intervals with three doses of either 3 micrograms or 27 micrograms of heat-inactivated hepatitis B HB-vaccine (CLB). Five months after the first injection, 77% of the patients in the 3-micrograms group and 94% in the 27-micrograms group manifested antibodies against hepatitis B surface antigen (anti-HBs). At month 12 the proportions of subjects with anti-HBs in the 3-micrograms and 27-micrograms groups had dropped to 68% and 87%, respectively. At all times, the differences in the anti-HBs conversion rate between the two treatment groups were significant. These results show that the impaired immune reactivity to hepatitis B vaccines of patients undergoing hemodialysis can be overcome by increasing the dose of the vaccine. PMID- 3977493 TI - The clinical assessment of severe asthma. AB - Thorough and ongoing clinical assessment is the foundation of modern asthma management. The history delineates the severity, circumstances, and time course of the present attack, placing it in the clinical context of the patient and his disease. A physical examination disclosing airflow obstruction, tissue hypoxia, respiratory muscle fatigue, and complications of therapy, in conjunction with simple objective measures of airflow obstruction and arterial gas tensions, allows the physician to make informed management decisions in the care of these severely ill patients. PMID- 3977494 TI - Persistent fever with aortic valve endocarditis. PMID- 3977496 TI - Poststreptococcal neprhitis and acute rheumatic fever in two adults. AB - In two adult subjects who suffered acute episodes of rheumatic fever, sever kidney involvement developed with proteinuria and renal insufficiency. The clinical and histologic picture was typical of poststreptococcal (infectious) glomerulonephritis. During a follow-up period of more than three years, no clinical or biochemical abnormalities have been detected; thus, it is likely that both patients have recovered from their renal diseases. The coexistence of rheumatic fever and acute glomerulonephritis, which is uncommon even in your age groups, may be observed in adult subjects. PMID- 3977495 TI - Gastroesophageal reflux. Pathophysiologic concepts. PMID- 3977497 TI - Pontine hemorrhage in a patient with pheochromocytoma. AB - A 24-year-old woman with a two-year history of hypertension was hospitalized for coma and quadriplegia secondary to pontine hemorrhage. A seven-year history of intermittent severe headaches, diaphoresis, and anxiety together with persistent severe hypertension led to the diagnosis of pheochromocytoma. This unusual but devastating manifestation of pheochromocytoma illustrates the importance of excluding remedial forms of hypertension in young patients before initiating antihypertensive therapy. PMID- 3977498 TI - Esophageal carcinoma masquerading as recurrent acute suppurative thyroiditis. AB - A 61-year-old woman had clinical features of acute suppurative thyroiditis that was recurrent and refractory to antibiotic therapy. The diagnosis of acute suppurative thyroiditis was established by a fine-needle aspiration biopsy procedure, yielding suppurative material from which anaerobic and aerobic bacteria grew. Subsequent investigation with a barium swallow study followed by esophagoscopy and biopsy confirmed extensive esophageal carcinoma with a fistulous tract extending into the perithyroidal region. PMID- 3977499 TI - Iodine-induced thyrotoxicosis in a woman with a multinodular goiter taking levothyroxine. AB - In a 63-year-old woman with a multinodular goiter who was receiving suppressive therapy with levothyroxine sodium, iodine-induced thyrotoxicosis developed after povidone-iodine was applied to the surface of a granulating hip wound. Signs and symptoms of apathetic thyrotoxicosis developed on two occasions, once within a week after exposure of the wound to povidone-iodine soaks and again following repeated Hubbard tank debridement with added povidone-iodine. Iodine-induced thyrotoxicosis was confirmed by markedly elevated serum thyroxine and serum and urine iodine levels. On eliminating the sources of exogenous iodine and inhibiting thyroxine biosynthesis with propylthiouracil, the process was gradually controlled. A year later the patient was taking no medication and was clinically and chemically euthyroid. Apparently, iodine-induced thyrotoxicosis can result from passive diffusion of iodine into autonomous thyroid tissue. Iodine-containing preparations given to patients with multinodular goiters may result in thyrotoxicosis even if thyrotropin is suppressed with exogenous thyroxine. PMID- 3977501 TI - Transient diabetes insipidus following "benign' febrile illness revisited. PMID- 3977500 TI - Thymic carcinoid with cutaneous hyperpigmentation. AB - Carcinoid tumors of the thymus gland have occasionally been associated with endocrine hyperfunction. A case of thymic carcinoid was initially observed as Cushing's syndrome and was also associated with marked hyperpigmentation. While the hyperpigmentation may be related to the excessively high levels of corticotropin, it is also possible that thymic carcinoids could produce melanocyte-stimulating hormone-like (or beta-lipotropin) material. PMID- 3977502 TI - Further comments on insect sting allergy. PMID- 3977503 TI - Antibiotic therapy based on stained peripheral blood smear. PMID- 3977504 TI - Failure of accessory spleens to prevent infection following splenectomy. PMID- 3977505 TI - Surgical management of splenic abscess in endocarditis. PMID- 3977507 TI - Bacteremic pneumococcal pneumonia. PMID- 3977506 TI - Kerosene-induced epidural abscesses. PMID- 3977508 TI - Meningitis. PMID- 3977509 TI - Artificial insemination in lesbians. Ethical considerations. PMID- 3977510 TI - The risk of bladder calculi in patients with spinal cord injuries. AB - A nonconcurrent prospective study of bladder calculi included 500 persons treated at the University of Alabama in Birmingham Spinal Cord Injury Care System between 1973 and 1981. Risk factors suspected of contributing to the development of bladder calculi were identified. Logistic regression analysis was used to estimate each risk factor's adjusted odds ratio and to develop a predictive model for bladder stone formation. Bladder calculi were most likely to develop within one year of injury. Patients developing bladder calculi prior to first definitive discharge were most likely to be white and have neurologically complete lesions and Klebsiella infections at admission. Patients developing bladder stones within two years of hospital discharge were most likely to be young and white and have indwelling urethral catheters and either Proteus or multiple-organism infections at discharge. The predictive model was 82% sensitive and 83% specific when applied to a validation sample of patients. PMID- 3977511 TI - Mitral valve prolapse in sickle cell disease. Presumptive evidence for a linked connective tissue disorder. AB - To determine the prevalence of mitral valve prolapse in sickle cell disease, M mode echocardiography was performed on 57 patients with sickle cell disease and 35 patients with chronic anemia of end-stage renal disease (anemic control group). In 25% (14/57) of patients with sickle cell disease, unequivocal mitral valve prolapse was diagnosed by echocardiography; all these patients had a mobile systolic click and/or late systolic murmur. This figure was significantly greater than the reported 5% to 6% prevalence in the general adult population, the 1% to 3% prevalence in the black population, and the 3.0% prevalence (1/35) in the anemic control group. The association of mitral valve prolapse and sickle cell disease cannot be explained on the basis of left ventricular size, systolic function, ischemic left ventricular or papillary muscle dysfunction, or chronic anemia. Therefore, a linked connective tissue defect in these two diseases is a hypothesis worthy of further investigation. PMID- 3977512 TI - Patterns of analgesic prescription and consumption in a university-affiliated community hospital. AB - To assess the patterns of prescription and consumption of analgesic and psychotropic medications, we reviewed the medication records of all 311 adult medical and surgical patients at a university-affiliated community hospital. Acetaminophen combinations and meperidine accounted for 85% of all analgesics prescribed. Analgesic use declined with advancing age. Two or more analgesics were prescribed to 18% of medical patients, compared with 44% in surgical patients. Less than one third of the patients with cancer received analgesics more frequently than every six hours. Nearly all psychotropic prescriptions were for sedative-hypnotics. Our data suggest that (1) physicians prescribe a limited number of analgesics, despite the variety available; (2) elderly patients receive fewer analgesics; (3) polypharmacy occurs often; (4) pain in patients with cancer is probably undertreated; and (5) psychotropic medications are used infrequently for analgesia. PMID- 3977513 TI - Neurocysticercosis: a new classification based on active and inactive forms. A study of 753 cases. AB - Cysticercosis of the central nervous system, because of the combination of inflammatory response, topography of lesions, degree of parasitic infestation, and sequelae of previous infestations produces a most variable clinical picture. The symptomatology may range from a discrete neurological disturbance to the most dramatic brain disorder. Severity of the disease, prognosis, and medical or surgical decision for treatment largely depend on the individual amalgam of the above-referred factors. An improved classification of neurocysticercosis (NCC) that delineates active from inactive forms of the disease will eventually be important in the research of immunodiagnosis and in therapeutic trials. In this report, a classification is presented that separates active from nonactive forms of NCC and is based on our experience with 735 patients studied. Characteristics of each form of NCC, frequency of principal signs and symptoms, and findings in cerebrospinal fluid analysis are discussed. PMID- 3977514 TI - Systemic lupus erythematosus (SLE) induced by quinidine. AB - Only two definite cases of quinidine-induced systemic lupus erythematosus (SLE) are reported in the English-language literature. We have treated five patients who had an SLE-like syndrome while receiving quinidine. Symptoms, signs, and abnormal laboratory values improved after quinidine therapy was discontinued and prednisone therapy was started. The disease did not return after steroids were withdrawn. These cases indicate that quinidine can indeed cause an SLE-like syndrome. PMID- 3977515 TI - Lumbar puncture in asymptomatic late syphilis. An analysis of the benefits and risks. AB - We evaluated the treatment of asymptomatic patients with untreated syphilis of more than one year's duration (asymptomatic late syphilis) using a decision analysis model. Two strategies were compared: treatment with 7.2 million units of penicillin G benzathine, or performing a lumbar puncture to test for asymptomatic neurosyphilis followed by penicillin and management based on cerebrospinal fluid analysis. Estimates of probabilities of disease prevalence, test sensitivity, and cure and complication rates were derived from published studies. Both strategies resulted in a cure rate of at least 99.7% using the best estimates. Although the strategy using lumbar puncture results in a 0.2% higher cure rate, its rate of complications (0.3%) exceeds its marginal benefit. We conclude that a lumbar puncture offers little additional benefit and may increase morbidity in patients with asymptomatic late syphilis. PMID- 3977516 TI - Hair and fingernail changes in acquired and congenital pernicious anemia. AB - Pigmentation changes limited to skin appendages accompanied pernicious anemia in four patients. Two Latin-American patients, one with congenital and one with acquired pernicious anemia, had reddish hair while they were cobalamin deficient. With treatment, the new hair growth assumed its normal premorbid dark brown color. Two black patients with pernicious anemia had blue fingernails. The new nail growth after treatment was of normal color. Pigmentation changes seem to be more frequent in nonwhite than in white patients with cobalamin deficiency and may have various expressions. PMID- 3977517 TI - Severe anaphylactoid reactions to cuprammonium cellulose hemodialyzers. AB - Twenty-one severe reactions to hemodialysis occurred in approximately 260,000 dialysis treatments at three centers within a 10 1/2-year period. Reactions typically appeared within minutes of initiating dialysis, and were characterized by cardiopulmonary, mucocutaneous, and/or gastrointestinal tract symptoms highly suggestive of anaphylaxis. Four respiratory arrests and one death resulted. Analysis of dialyzer use patterns and of each patient's dialyzer exposure history strongly implicated hollow-fiber dialyzers made of cuprammonium cellulose (CC) as a cause of these reactions. No obvious factors could be found to identify predisposed patients. Less than optimal rinsing of the CC hollow-fiber dialyzers prior to use may have been responsible for some, but not all, of these reactions. PMID- 3977518 TI - Hereditary warfarin resistance. Investigation of a rare phenomenon. AB - A 57-year-old black woman required a daily dosage of 50 mg of warfarin sodium to maintain her prothrombin time in a therapeutic range. The central volume of distribution and clearance of warfarin were normal for this patient. These findings, combined with the patient's requirement for plasma warfarin levels four times greater than those usually required to achieve adequate anticoagulation, indicated that the relative resistance was due to altered pharmacodynamics of warfarin. The only child of the propositus, a daughter, showed a similar relative resistance, confirming that this family is the third to be reported with hereditary resistance to warfarin. PMID- 3977519 TI - Palpitations in a patient with morbid obesity. Right atrial thrombus. PMID- 3977520 TI - Artificial insemination in a lesbian. A case analysis. PMID- 3977521 TI - Wolff-Parkinson-White syndrome. PMID- 3977522 TI - Water intoxication following moderate-dose intravenous cyclophosphamide. AB - Moderate-dose (15 to 20 mg/kg) bolus intravenous (IV) cyclophosphamide is increasingly being employed for the treatment of autoimmune diseases. High-dose (30 to 50 mg/kg) IV cyclophosphamide, which is used in transplantation and oncology, may cause water intolerance and water intoxication. Described herein is the first patient, to our knowledge, to develop water intoxication following administration of moderate-dose IV cyclophosphamide. A water challenge test demonstrated the absence of an underlying syndrome of inappropriate antidiuretic hormone secretion. Water intolerance was demonstrated in five additional patients receiving moderate-dose IV cyclophosphamide and hydration with hypotonic fluids. Thus, contrary to previous reports, water intoxication can occur following administration of moderate-dose IV cyclophosphamide. Patients with renal insufficiency who are receiving hypotonic fluids following moderate-dose IV cyclophosphamide administration may be at greatest risk for development of symptomatic water intoxication. PMID- 3977523 TI - IgA nephropathy associated with disseminated tuberculosis. AB - A 59-year-old man had disseminated tuberculosis and microscopic hematuria, red cell casts, and normal renal function. Renal biopsy revealed focal mesangial proliferation with exclusively IgA deposits, diagnostic of IgA nephropathy. After institution of antituberculous therapy, the urinary abnormalities resolved. There is evidence to suggest that tuberculosis, in addition to other conditions associated with mucosal exposure to antigens producing an IgA immune response, can result in IgA nephropathy. This glomerulopathy is reported as a potential renal complication of concurrent mycobacterial infection. PMID- 3977525 TI - Diaphragmatic paralysis following chiropractic manipulation of the cervical spine. AB - We present a case of phrenic nerve damage resulting in unilateral diaphragmatic paralysis following chiropractic manipulation of the neck. Related vascular and neurologic complications of spinal manipulation are reviewed. PMID- 3977524 TI - Septoplasty complicated by staphylococcal spinal osteomyelitis. AB - Surgery for correction of anatomic abnormalities of the nasal septum is usually free of major infectious complications. A case of staphylococcal spinal osteomyelitis as a consequence of bacteremia induced by nasal septoplasty is reported and the questions raised by this occurrence are discussed. PMID- 3977526 TI - Campylobacter jejuni-associated hemolytic-uremic syndrome: a possible role for endotoxin. PMID- 3977527 TI - Oral theophylline intoxication. PMID- 3977528 TI - Streptococcal infections following splenectomy for trauma. PMID- 3977529 TI - Neoplastic v reactive hematopoiesis in oxalosis. PMID- 3977530 TI - Radiation-induced breast cancer. PMID- 3977531 TI - Thyroid function tests in relapsing fever. PMID- 3977532 TI - Metoprolol-induced hyperkalemia in a diabetic with advanced renal failure. PMID- 3977533 TI - Toxic oil syndrome. PMID- 3977534 TI - Cold agglutinins and hypothermia. PMID- 3977535 TI - [Value of human lip lines and nail striations in identification]. AB - The pattern of the lips and the longitudinal striation of the lower concave surface of the nails of fingers and toes can be resource of identification. The types of the lip lines are individual and probably constant for some years. We demonstrated that the pattern of all of 20 human nails are over the space of one year the same and found no interindividual correspondence. The investigation rate for examination amount to 36% for the nails of the fingers and 55% for suchlike toes. PMID- 3977536 TI - [Use of the film impression procedure--a procedure for the detection of surface distribution of chemical elements in gunshot residues]. AB - A description of the principle, and practice, of "sheetprinting" patterns of gun powder residue as presently used in the Bundeskriminalamt. The various applications of the methods are presented by way of examples. PMID- 3977537 TI - [An unusual ability following a contact gunshot wound of the head]. PMID- 3977538 TI - [Status of disintegration and forensic value of empty fly pupae]. PMID- 3977539 TI - The dexamethasone suppression test and pituitary-adrenocortical function. AB - The dexamethasone suppression test (DST) as now commonly carried out in psychiatric settings yields "abnormal" results in many conditions including the healthy state. To determine whether the DST accurately identifies patients with physiologically meaningful increases in pituitary-adrenocortical activity, we compared DST results to baseline urinary cortisol level. Thirty-four psychiatric inpatients underwent a 24-hour urine collection and then a DST using 1 or 2 mg of dexamethasone. With the common 1-mg DST, 24-hour urinary cortisol levels in nonsuppressors and suppressors did not differ. With the 2-mg DST, however, nonsuppressors had significantly higher urinary cortisol levels than suppressors, and all nonsuppressors had urinary cortisol levels above the normal range. Thus, the 1-mg DST may not identify the heuristically important subgroup of psychiatric patients who have a pathophysiologically meaningful alteration in pituitary adrenal regulation. PMID- 3977540 TI - Immunoglobulin studies in patients with psychiatric diseases. AB - Autoimmune processes and viral infections have been proposed as causative factors in psychiatric diseases. To investigate this issue, we screened serum and CSF from schizophrenic and depressed patients for quantitative and qualitative immunoglobulin abnormalities. Qualitative immunoglobulin abnormalities were assessed by isoelectric focusing (IEF) since the presence of IEF oligoclonal immunoglobulin bands is a feature of viral and autoimmune diseases. We found no significant elevation of immunoglobulin levels or increased incidence of oligoclonal immunoglobulin bands, suggesting that viruses and autoimmunity are not involved in the major psychoses. PMID- 3977541 TI - Family history of alcoholism in borderline personality disorder. AB - The lifetime expectancy (morbid risk) of alcoholism was determined in the parents and siblings of 83 women with DSM-III borderline personality disorder and compared with that in the parents and siblings of 100 women with DSM-III schizophrenia and 100 women with DSM-III bipolar disorder. The relatives of the borderline probands had two to three times more alcoholism than the relatives of the bipolar and schizophrenic probands. The condition was most common in the fathers of the borderline probands, almost one third of whom were either alcoholics or heavy drinkers. When the three groups of probands were subdivided according to whether they, themselves, had occasionally abused alcohol, there were no longer any significant differences in alcoholism among their relatives. PMID- 3977542 TI - Alcoholism and antisocial personality. Interrelationships, genetic and environmental factors. AB - In a sample of 127 male and 87 female adult adoptees, antisocial personality and alcohol abuse were related to biologic backgrounds and to environmental factors. In the men, alcohol abuse was increased by a background of problem drinking in first-degree biologic relatives and by drinking problems in the adoptive home. Antisocial personality occurred more frequently in men whose first-degree biologic relatives had antisocial behavior problems. In the women, alcohol abuse was increased in adoptees whose first-degree relatives had problem drinking. Increased alcohol abuse in men and women was not predicted by biologic first degree relatives with antisocial problems, nor did increased frequency of antisocial personality occur in adoptees with biologic relatives with problem drinking. The results suggest specificity of inheritance of antisocial and alcoholic conditions and the importance of environmental factors. PMID- 3977543 TI - Alcoholism and genetics. The sins of the fathers. PMID- 3977544 TI - Limited utility of the 1-mg dexamethasone suppression test as a measure of hypercortisolism. PMID- 3977545 TI - Possible association between tardive dyskinesia and altered carbohydrate metabolism. PMID- 3977546 TI - Ambulatory monitoring of panic disorder. AB - Twelve patients with panic disorder and 11 control subjects received 24-hour ambulatory monitoring of heart rate, finger temperature, ambient temperature, and self-rated anxiety. No differences were found between groups in tonic levels of any measure or in their patterns of variation throughout the day. However, substantial heart rate increases and finger temperature changes did occur in panic attacks but not during control periods having equally high anxiety ratings. These measures may be useful in the diagnosis of panic disorder and in the assessment of treatment outcome. PMID- 3977547 TI - Evaluating prolactin response to dopamine agonists in schizophrenia. Methodological problems. AB - Serum prolactin (PRL) level was assessed after challenges with apomorphine hydrochloride, saline, dopamine hydrochloride, or levodopa-carbidopa (Sinemet) in 19 control and 38 chronic schizophrenic subjects. Baseline PRL level varied inversely with age. High correlations existed between baseline PRL level and any subsequent absolute measure of PRL after administration of a dopamine agonist or placebo. Percent decrease was not a function of baseline concentrations and was therefore the only independent measure of drug response. Baseline PRL level was generally lower during exacerbation than remission in patients studied during two states of illness. Percent PRL level decrease after apomorphine administration was significantly greater in normal subjects than in schizophrenics. Correction of apomorphine responses for corresponding placebo (saline) values abolished differences between groups. Prolactin responses after dopamine or levodopa carbidopa did not differ; however, placebo correction was not possible. PMID- 3977548 TI - Motor activity and affective illness. The relationship of amplitude and temporal distribution to changes in affective state. AB - We measured motor activity with a self-contained monitoring device worn on the wrists of affectively ill patients and volunteer normal control subjects. Decreases in the daytime motor activity level were observed in depressed patients, compared with their improved (euthymic) or manic mood states. Moreover, affectively ill patients, even during euthymic periods, showed lower daytime motor activity levels than the control group housed in the same ward. These data provide objective evidence for decreases in motor activity that occur concomitantly with the depressive phase of illness in patients with affective disorder, and fluctuate in patients in euthymic or manic phases. PMID- 3977549 TI - Infradian rhythms. A comparison of affective disorders and normal persons. AB - We matched patients with affective disorders by sex and age with a healthy control group. The two groups recorded daily measures of hours slept, energy, anxiety, and mood levels for 14 months. We analyzed the data using spectral analysis. We found that both groups had statistically significant infradian rhythms, with the majority having seasonal cycles, and that the patients with affective disorders differed from the control subjects in having a greater amplitude of their periodicities. PMID- 3977550 TI - Importance of diagnostic thresholds in familial classification. Dexamethasone suppression test and familial subtypes of depression. AB - A sample of 184 hospitalized primary unipolar depressives was used to examine the relationship between the dexamethasone suppression test (DST) and Winokur's familial typology as a function of the broadness of the criteria used to diagnose the patients' first-degree relatives. When a high threshold was used (ie, alcoholic relatives were treated, antisocial relatives had legal problems, and depressed relatives were hospitalized), the DST-familial subtype relationship was much stronger than when a low threshold was used (ie, relatives were diagnosed according to the Family History Research Diagnostic Criteria). The differences in diagnosing family members may be responsible for the inconsistent results reported by investigators examining the relationship between Winokur's typology and the DST. PMID- 3977551 TI - Neurological soft signs. Their relationship to psychiatric disorder and intelligence in childhood and adolescence. AB - Sixty-three male and 27 female adolescents known to have had neurological soft signs at the age of 7 years were compared with controls with no soft signs at age 7. Adolescents with early soft signs had significantly lower IQs and were more likely to have a psychiatric disorder characterized by anxiety, withdrawal, and depression. All the girls and 80% (12/15) of the boys with an anxiety-withdrawal diagnosis showed early soft signs. There was no relationship between early soft signs and attention deficit or conduct disorders. Examination of the relative contributions of anxiety at age 7, IQ, and social and family disadvantage to later diagnosis showed that most of the variance was accounted for by soft signs independently of IQ. Soft signs and anxious dependent behavior at age 7 were strongly predictive of persistent psychiatric disorder characterized by anxiety and withdrawal. PMID- 3977552 TI - Attention dysfunction and psychopathology in college men. AB - Four hundred college men were screened on a measure of vigilance, the Continuous Performance Test (CPT). The individuals with good and poor attention (the upper and lower 5% of the CPT score distribution) were compared on multiple measures of psychiatric disturbance, cognition, and psycho-physiologic function. The attention dysfunction group (lower 5%) had a higher incidence of symptoms of hyperactivity both in childhood and as adults, but had no higher incidence of other psychopathology as assessed with either the Research Diagnostic Criteria or the Minnesota Multiphasic Personality Inventory. Cognitive differences between the lower and upper CPT groups, including differences on Wechsler Adult Intelligence Scale subtests, the Stroop test, reaction time, and evoked potentials, substantiated an attention dysfunction syndrome. Thus, attentional dysfunction in young adults seems more closely linked to hyperactivity than to current psychopathology. PMID- 3977553 TI - Desipramine and 2-hydroxydesipramine plasma levels in endogenous depressed patients. Lack of correlation with therapeutic response. AB - Studies of the relationship between plasma concentrations of desipramine hydrochloride and clinical response have shown contradictory results, and only one prior study examined 2-hydroxydesipramine and its relationship to treatment. We therefore performed a study in a large, carefully diagnosed group of depressed patients taking fixed maintenance doses of desipramine to elucidate a potential relationship between clinical response and plasma concentrations of desipramine and 2-hydroxydesipramine. There was no significant correlation between clinical response and steady-state plasma levels of desipramine, 2-hydroxydesipramine, or the sum of desipramine plus 2-hydroxydesipramine. Although some commercial laboratories suggest a specific therapeutic plasma level "range" for desipramine, our data provide no support for such a range, nor for the routine measurement of plasma desipramine and 2-hydroxydesipramine concentrations in depressed patients. PMID- 3977554 TI - Familial transmission of depression and alcoholism. AB - The familial transmission of major depression and alcoholism among probands who had depression and alcoholism was examined. Our findings indicated that depressives without alcoholism did not transmit alcoholism, and probands with depression and alcoholism tended to transmit both depression and alcoholism. This confirms the observation that depression and alcoholism are not manifestations of the same underlying disorder. An increased risk of anxiety disorders in the relatives of probands with alcoholism, which could specifically be attributed to the presence of alcoholism in addition to an anxiety disorder in the proband, was also observed. This suggested that the alcoholism in these probands may result from self-medication of anxiety symptoms. The results of this study underscore the importance of examining combinations of diagnoses in patients in decreasing the heterogeneity of diagnostic categories. PMID- 3977555 TI - Ethanol-induced changes in body sway in men at high alcoholism risk. AB - This study measures the amount of body sway or static ataxia in 34 drinking but nonalcoholic men 21 to 25 years of age who have an alcoholic first-degree relative (the family-history-positive, or FHP, group). Results are compared with 34 control subjects matched pairwise on demographic characteristics and drinking histories, but who have no known alcoholic close relatives (the family-history negative, or FHN, group). Each man was tested on three occasions where he drank either placebo, or 0.75 mL/kg or 1.1 mL/kg of ethanol; the subjects were repeatedly tested during the subsequent four hours. At the baseline of each of the three test sessions, the level of body sway for the two family-history groups was virtually identical. However, following the 0.75-mL/kg dose, the increase in body sway was significantly less for the FHP than for FHN group, with similar but less dramatic group differences noted following the ingestion of 1.1 mL/kg of ethanol. These results are consistent with the significantly less intense subjective feelings of intoxication after drinking for the FHP men, and also parallel findings of less intense ethanol-related changes in biologic and cognitive test scores. A decreased intensity of reaction to ethanol should be explored further as a possible genetic trait marker of a predisposition toward alcoholism. PMID- 3977556 TI - Opioid regulation of hypothalamic-pituitary-adrenal function in depression. AB - A morphine infusion paradigm was used to investigate opioid mechanisms in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis in depression. The subjects were unmedicated psychiatric inpatients and healthy volunteers. Morphine suppressed cortisol secretion. Early resumption of cortisol secretion was associated with a diagnosis of major depression and abnormal dexamethasone suppression test results. Our data suggest that the hyperactivity of the HPA axis observed in depression is abnormally resistant to opioid inhibition as well as glucocorticoid feedback. PMID- 3977558 TI - Theories of origins of male homosexuality. A cross-cultural look. AB - In this report, we use data from an isolated Eastern Highlands New Guinea tribe to test psychoanalytic and learning theory explanations for origins of homoerotic behavior. Despite heavy reinforcing of unlimited fellatio in prepubertal boys and youths and powerful teaching that female bodies are poisonously dangerous, Sambia men are almost always heterosexual. We present the history of the one who is not. It shows that, as analytic theory predicts, he is homosexual. In the childhood of all the other boys are the kinds of preoedipal and oedipal experiences that analytic theory proposes for a heterosexual outcome. PMID- 3977557 TI - Clonidine in outpatient detoxification from methadone maintenance. AB - Inpatient narcotic detoxification with clonidine hydrochloride has been used since 1978. Outpatient withdrawal, potentially more useful, has not been adequately studied. This report describes a double-blind random assignment of 49 methadone hydrochloride-maintained patients whose dose had been lowered to 20 mg. Twenty-five were detoxified using methadone at 1-mg decrements, 24 by abrupt substitution with clonidine. Approximately 40% of both groups achieved successful detoxification, with one third maintaining abstinence over the subsequent six months. The groups were also largely equivalent on withdrawal symptoms, but the clonidine group experienced symptoms in the first half of the study and the methadone group in the second half. Clonidine appears to be a safe and efficacious outpatient treatment for opiate withdrawal, although the results were less favorable than those obtained in open or inpatient studies. PMID- 3977559 TI - Brain evolution relating to family, play, and the separation call. AB - Mammals stem from the mammal-like reptiles (therapsids) that were widely prevalent in Pangaea 250 million years ago. In the evolutionary transition from reptiles to mammals, three key developments were (1) nursing, in conjunction with maternal care; (2) audiovocal communication for maintaining maternal-offspring contact; and (3) play. The separation call perhaps ranks as the earliest and most basic mammalian vocalization, while play may have functioned originally to promote harmony in the nest. How did such family related behavior develop? In its evolution, the forebrain of advanced mammals has expanded as a triune structure that anatomically and chemically reflects ancestral commonalities with reptiles, early mammals, and late mammals. Recent findings suggest that the development of the behavioral triad in question may have depended on the evolution of the thalamocingulate division of the limbic system, a derivative from early mammals. The thalamocingulate division (which has no distinctive counterpart in the reptilian brain) is, in turn, geared in with the prefrontal neocortex that, in human beings, may be inferred to play a key role in familial acculturation. PMID- 3977560 TI - Brain function in psychiatric disorders reconsidered. PMID- 3977561 TI - The appropriate use of criteria for schizophrenia. PMID- 3977562 TI - Rapid atrial fibrillation associated with trazodone hydrochloride. PMID- 3977563 TI - The Walter J. Zeiter lecture. Inherited susceptibility to musculo-skeletal disorders. PMID- 3977564 TI - Temporal pulmonary function changes in cervical cord injury. AB - Temporal changes in pulmonary function (PF) in subjects with complete cervical cord transection occur in two stages. The first, extending from the acute to post acute periods, is characterized by relatively rapid increases in the following: vital, inspiratory, and total lung capacities (VC, IC, and TLC, respectively), and inspiratory and expiratory airflows coupled with decreases in functional residual capacity (FRC). Second stage changes--from the post-acute period on--are more gradual, with both VC increase and FRC decrease continuing while TLC and ventilatory indices remain unchanged. The initial stage appears to be caused in part by functional respiratory muscle return coincident with resolution of inflammation and edema above the injury level. Altered respiratory mechanics also contribute to these early changes and the continuing later changes. Mechanical changes in the lung are probably both decreased compliance (which decreases FRC) and increased airway resistance (which diminishes airflow). Chest wall changes, resulting from returning spinal cord reflexes, affect PF via: (1) increased rib cage stability, leading to a more effective transduction of diaphragmatic displacement into lung volume, and (2) abdominal and expiratory intercostal spasticity, which could limit maximum inspiration. The net effect of these changes, however, may eventually lead to chronic hypoventilation. PMID- 3977565 TI - Surgical treatment of lumbar spinal stenosis in the elderly. AB - Unrelenting sciatica or intermittent neurogenic claudication in the elderly may be caused by degenerative lumbar spinal stenosis. This rather common condition is produced by advanced multilevel disc degeneration leading to facet hypertrophy, infolding of ligamentum flavum, descent of the pedicles, and occasional disc herniation. The symptoms of lumbar spinal stenosis usually do not improve with time. Despite the advanced age of some patients, surgical decompression may offer significant relief. Of 19 patients who underwent lumbar decompressive laminectomy, 18 showed sufficient improvement to return to normal daily activities. PMID- 3977566 TI - Sensation-seeking behavior and the incidence of spinal cord injury. AB - Professionals in the rehabilitation field differ in their conceptualization of the role of premorbid personality factors as related to risk behavior and incidence of traumatic injury. Some hold that specific premorbid personality traits can be identified for the spinal cord injured population; others argue that no one personality trait or specific combination of traits is descriptive of this heterogeneous population. This study explores the relationship between the sensation-seeking behavioral patterns and incidence of traumatic spinal cord injury (SCI). The Sensation-Seeking Scale (SSS) was administered to 56 patients with spinal cord injury (50 males and 6 females) between the ages of 16 and 50. A description of the incident causing injury was obtained for all 56 patients and subsequently rated by non-medical judges on a dimension of prudence-imprudence. No significant correlations were found between sensation-seeking scores and rated prudence of onset of injury, and sensation-seeking scores were no higher for SCI patients than for a comparable normal population. These findings indicate that spinal cord injury is not related to sensation-seeking, and, more generally, support the view that no premorbid personality trait distinguishes the SCI population from the normal. PMID- 3977567 TI - Body sodium and potassium in men with spinal cord injury. AB - As part of a broad study on the body composition of patients with extensive muscular paralysis, total body water (TBW), extracellular fluid (ECF), exchangeable sodium (Nae), and exchangeable potassium (Ke) were measured in 22 paraplegic and 23 quadriplegic patients. These data were compared with similar measurements obtained on 12 healthy men. Patients with spinal cord injury (SCI) showed a drastic loss of K+, more pronounced in quadriplegic than in paraplegic patients. Sodium was retained and associated with a relatively increased ECF volume. The high correlation between TBW and total "exchangeable base" (Nae + Ke) reported in previous studies on healthy subjects and patients with varied diseases was also observed in SCI patients. Analysis of the present data suggests that the physiologic mechanism which maintains the tonicity of the body fluids is not affected in SCI. This analysis does not provide any clue as to the identification of the mechanism that might explain the relative expansion of the extracellular space in the presence of K+ depletion. PMID- 3977568 TI - Urodynamic evaluation of voluntary detrusor response in healthy subjects. AB - The ability of healthy subjects to voluntarily inhibit a bladder detrusor contraction was evaluated using standard urodynamic techniques. Ten healthy subjects (five men and five women) were appraised using trichannel techniques which included measuring bladder volume, bladder pressure, intraabdominal pressure, and electromyographic activity of the anal or external urethral sphincter. Each subject was first evaluated to determine normalcy of urine flow rate. All subjects were assessed in three positions: supine, sitting, and standing. All ten subjects were able to inhibit their detrusor responses without increasing external urethral or anal sphincter activity or raising the tonus pressure limb of the bladder. Three of the subjects were unable to void during any part of the urodynamic evaluation. In one subject, voiding was accomplished by Valsalva maneuver which mimicked detrusor contraction. At least two subjects did not demonstrate their first urge to void until 300 to 400 cc, and one of these individuals was unable to void until his bladder capacity reached 600cc. These results indicated that normal subjects can inhibit their detrusor response during urodynamic studies. Inability to inhibit this response would therefore appear to be an abnormal pattern. Conversely, inability to produce a detrusor response cannot be called an abnormal retention pattern. Bladder volumes in healthy subjects may be higher than the traditional norms, and this must be taken into account during urodynamic evaluations. PMID- 3977569 TI - Optokinetic nystagmus and upper extremity dressing independence after stroke. AB - Right hemisphere brain-damaged stroke patients demonstrate a variety of neurologic deficits which seem to impair their ability to regain self-care independence. Visual perceptual and visual search disorders have been implicated with persistent functional deficits. The objective of this study was to measure the extent to which defects of optokinetic nystagmus (OKN), an ocular movement reflex, may be associated with inability to regain independent function. Eighteen right hemisphere brain-damaged stroke patients suffering similar sensory-motor deficits were followed up from admission as they underwent self-care training in a comprehensive stroke rehabilitation center. Ten subjects demonstrated unilateral absence of OKN and eight subjects demonstrated bilaterally intact responses upon admission. Upper extremity (UE) dressing independence was used as an indicator of functional skill level at admission, during treatment, and at discharge. Subjects with unilateral loss of OKN were significantly less independent at admission and at discharge when compared to subjects with intact OKN. Although both groups of patients made statistically significant gains in UE dressing, those with defective OKN had a 40% greater inpatient length of stay and were more likely to be discharged to a nursing home or needed care by a significant other after rehabilitation. PMID- 3977570 TI - Isometric torque of the quadriceps femoris after concentric, eccentric and isometric training. AB - Twenty-seven normal, healthy women participated in this study, which investigated three methods of increasing the isometric strength of the quadriceps femoris through a six-week training program. Three experimental exercise groups were formed: A, eccentric, B, concentric, and C, isometric. The peak isometric torque of the quadriceps femoris was determined on the Cybex II Isokinetic Dynamometer before and after training. A total of 18 exercise sessions per subject were held. A two-way ANOVA with repeated measures revealed that while all three experimental groups significantly increased in isometric strength, no one method of training was superior. No interaction occurred in the population between the effects of pre- and posttraining scores and the type of training. The relationship between the experimental design and knee joint biomechanics may have precluded significant differences in strength gain among the experimental groups. PMID- 3977571 TI - Duration of stretching effect on range of motion in lower extremities. AB - The duration of the effect of contract-relax stretching on range of motion (ROM) in the lower extremities was measured on eight male volunteers. The stretching procedure was performed as one isometric contraction, followed by relaxation and then a passive extension of the muscle being stretched. The treated muscle groups were the adductors, hamstrings, rectus femoris, iliopsoas, gastrocnemius, and soleus. The total stretching time was 15min. Six ROMs were tested 0, 30, 60, and 90min after the stretching procedure. There was a significant increase in hip abduction (+17% +/- 3), knee flexion (+4% +/- 1), hip flexion (+4% +/- 2), ankle dorsiflexion with knee flexed (+18% +/- 7), and ankle dorsiflexion with knee straight (+16% +/- 5). The increase remained for 90min for all ROMs except for ankle dorsiflexion with the knee straight. PMID- 3977572 TI - Static rear stability of conventional and lightweight variable-axle-position wheelchairs. AB - Wheelchair users with high or posteriorly placed centers of mass often complain of rear tipping on inclines or when accelerating. In this study we compared the rear stability of occupied conventional and lightweight wheelchairs and determined the effect of various rear axle positions. Ten normal subjects were studied in both a conventional (22.6 kg) and a lightweight (12.3 kg) wheelchair. Twenty-one experienced wheelchair users were also studied in their own wheelchairs. Stability points were determined with brakes unlocked on a tilt platform. Inter- and intraobserver test-retest reliabilities were 0.97 and 0.974, respectively. For the normal subjects the mean (+/- 1SD) stability point in the conventional chair was 28.6 (+/- 2.7) degrees. In the lightweight chair their mean stability points ranged from 21.7 (+/- 2.6) degrees to 9.4 (+/- 2.9) degrees, depending upon axle position. The mean difference between the conventional chair and the lightweight chair in its most stable position was 6.9 (+/- 1.7) degrees (t = 13.04, p less than 0.0001) and in its least stable position 19.3 (+/- 2.4) degrees (t = 24.97, p less than 0.0001). Experienced wheelchair users in their own lightweight wheelchairs were less stable than users of conventional chairs (t = 2.16, p less than 0.05) or chairs with posteriorly offset axles (t = 3.64, p less than 0.01). PMID- 3977573 TI - Infection and pressure sores. AB - Pressure sores cause considerable morbidity and prolonged hospitalization in debilitated patients. Healing of pressure sores may be delayed if they are infected, although response to appropriate topical therapy is satisfactory. However, some pressure sores that appear uninfected may have associated infection of deeper tissues and require specific diagnosis and treatment to close the sores. Two hundred sixty-seven debilitated patients, mostly with spinal cord injury, are reviewed. Included in this group are 49 patients with pressure sores that did not appear to be infected but were associated with deep infections. Diagnosis of nonhealing sores associated with deep infection requires clinical suspicion and a variety of laboratory tests, such as sinograms, radionuclide studies, computed tomography, and biopsy. Treatment usually requires a combination of appropriate antibiotics and surgery. Prevention of pressure sores and infection by offering specialized care for nonambulatory patients should be the ultimate goal. PMID- 3977574 TI - Amitriptyline for agitation in head injury. AB - Agitated behavior is frequently associated with traumatic closed head injury. Proactive behavioral intervention is often not successful, and psychopharmacologic agents may result in increasing the targeted behavior through sedation. We describe a 32-year-old woman who developed severe agitation after frontal lobe closed head injury. After failing conservative behavioral management, a therapeutic trial of amitriptyline was initiated. Within two weeks, aggressive outbursts nearly ceased and attention span improved. Serial neuropsychologic assessment before and during amitriptyline therapy documented preservation of cognitive indices along with improvement in Trailmaking tasks. This case suggests that a trial of amitriptyline or other tricyclic antidepressant may be helpful in diminishing agitation associated with frontal lobe damage without impeding cognitive recovery. PMID- 3977575 TI - Dysgraphia after right hemisphere stroke. AB - Acquired dysgraphia has been described as a disorder of graphemic selection and spatial temporal disorganization which can exist in isolation or as a component of a broader language or cognitive syndrome. There is little agreement on the locus of writing centers, although select areas within the left hemisphere have been suggested. We describe a patient who had dysgraphia after a right hemispheric stroke. He had no demonstrable signs of limb apraxia or visual field deficit, and only subtle signs of language impairment other than the writing disturbance. Treatment emphasized progressively more complex writing tasks which included the following: (1) written responses to picture/word stimuli, (2) word and sentence dictation, and (3) self-generated sentences and functional writing tasks. At discharge from the hospital the patient's writing was within normal limits. Our findings were similar to those described for a patient with a left hemispheric stroke who was primarily dysgraphic. We conclude that our patient's dysgraphia was a component of a subtle aphasia as well as a spatial temporal disorganization disorder. PMID- 3977576 TI - Medically reversible quadriparesis in tophaceous gout. AB - This case report presents a successful nonoperative outcome of a type II odontoid fracture secondary to severe tophaceous gout. The patient presented with spastic quadriparesis and tophaceous involvement of the odontoid process with fracture and C1-C2 instability. He refused surgery. However, his odontoid process stabilized with the used of a collar, and he regained almost normal strength plus independence in self-care and ambulation, demonstrating that an unstable type II odontoid fracture secondary to tophaceous gout can stabilize with conservative management. PMID- 3977577 TI - Shoulder forearm support for the subluxed shoulder. AB - Subluxation of the shoulder is a common problem in patients who have had a stroke. Of the shoulder supports that are being used, many do not reduce the subluxation, and patients continue to complain of shoulder pain. The shoulder support designed for this study reduces subluxation, is custom fit, costs less, and is more comfortable than conventional slings. The sling is difficult to don but patients are able to perform self-ROM exercises without removing the sling. The sling consists of two parts: a shoulder support and forearm support. Both portions are worn when the patient is ambulating or standing. Only the shoulder support is worn when the patient is sitting with a lapboard. X-rays confirmed the reduction of subluxation, and patients reported decreased shoulder pain. PMID- 3977579 TI - Chronic pain and the physiatrist. PMID- 3977578 TI - Modular hand tiller system for joystick operation of powered wheelchairs. AB - A method has been developed for assembling a hand support tiller that mounts to the post of a joystick controller of an electrically powered wheelchair. The hand tiller can be custom-designed by the therapist to fit the size, shape, and position of the user's hand. This results in a functional hand grasp that is necessary for the safe operation of the powered wheelchair. The design of the modular hand tiller system consists of low-cost, commercially available plastic tubing and fittings. This allows for an efficient set-up, easy modification, and durability. PMID- 3977580 TI - Reflex sympathetic dystrophy. PMID- 3977581 TI - Defeminization and social class. AB - The hypothesis that there might occur selective defeminization by social class between childhood and adulthood among homosexual men was explored. Interview data on 686 homosexual men were employed. It was found that there is a greater tendency for cross-gender propensities to persist into adulthood among respondents from blue-collar backgrounds. Effeminate respondents from such backgrounds were found to be disproportionately involved in same-sex sexual activities during adolescence. They were also sexually responsive to same-sex persons earlier. The interpretation is offered that early homosexual experiences reinforce cross-gender propensities among blue-collar respondents because of the greater gender role dichotomization found in blue-collar culture. Such reinforcement may explain the tendency for there to be greater persistence of cross-gendering among blue-collar men. PMID- 3977582 TI - Voluntary vaginal musculature contractions as an enhancer of sexual arousal. AB - In a study of the effects of vaginal musculature contractions (Kegel's exercises) on both subjective and physiological measures of sexual arousal, 30 normal females were randomly assigned to one of three groups. The first group was informed about these exercises and was asked to practice them both during lab sessions and during the week intervening between sessions. The second group was informed concerning the effects of Kegel's exercises but did not practice contractions. A control group received no information regarding these exercises. Measures of vaginal vasocongestion and subjective ratings of sexual arousal were obtained during two 31-minute lab sessions. Vaginal contractions enhanced both subjective ratings and physiological measures of arousal. When combined with self generated fantasy, tensing further augmented arousal. These effects were not further enhanced after 1 week of practice. The present study provides empirical support for the prescription of Kegel's exercises to normal women as an enhancer of sexual arousal. Further study of the effects of Kegel's exercises on a sample of dysfunctional women is necessary to determine the applicability of these results to a clinical population. PMID- 3977583 TI - The dyadic adjustment of female-to-male transsexuals. AB - Dyadic adjustment, sexual activities, and marital stability in the relationships of female-to-male transsexuals and their spouses were examined. Participants were 22 female-to-male transsexuals who had undergone some form of surgery to alter their anatomical sex, their spouses, and a control group of married or cohabitating nontranssexual men and women. Participants were administered the Dyadic Adjustment Scale and additional items to assess quantitatively their marital relationships. The transsexuals and their spouses were also asked open ended interview questions concerning marital and life adjustments. Generally, the transsexuals and their spouses reported good and mutually satisfying interpersonal relationships that are in many ways comparable to those of the matched control group. These findings lend support to the previous clinical interview studies that have reported that female-to-male transsexuals form stable and enduring intimate relationships. PMID- 3977585 TI - Standards of care: the hormonal and surgical sex reassignment of gender dysphoric persons. Harry Benjamin International Gender Dysphonia Association. PMID- 3977584 TI - Sexual orientation after prenatal exposure to exogenous estrogen. AB - Thirty women aged 17 to 30 years with documented prenatal exposure to the nonsteroidal synthetic estrogen diethylstilbestrol (DES) were compared to thirty women of similar demographic characteristics from the same medical clinic who had a history of abnormal Pap smear findings. A subsample of the DES women were also compared to their DES-unexposed sisters. Sexual orientation in its multiple components was assessed by systematic semistructured interviews. In comparison to both control groups, the DES women showed increased bisexuality and homosexuality. However, about 75% of the DES women were exclusively or nearly exclusively heterosexual. Nonhormonal and hormonal interpretations of these findings are discussed. PMID- 3977586 TI - Comparison of indium 111-labeled platelets v leukocytes in a pyogenic abscess. AB - This study sought to determine which blood component, WBCs or platelets, is the more specific indicator of an abscess and where each localizes. An abscess was created using stool in the hind limb of dogs. After 24 hours, one group was given autologous indium 111-labeled platelets and another group was given autologous indium 111-labeled WBCs. Blood, abscess fluid, infected operative control muscle tissue, and nonoperative control muscle tissue were counted for radioactivity 24 hours after administration of the labeled cells. There was significantly (P less than .001) less WBC radioactivity in blood and more within abscess fluid compared with platelets. The highest platelet activity occurred in muscle tissue adjacent to the abscess (P less than .002) compared with platelet activity in abscess fluid or control muscle tissue. The unwanted high platelet blood background activity and the desirable high concentration of WBC radioactivity within the abscess fluid makes the latter the preferential radionuclide imaging agent. PMID- 3977587 TI - Severity of illness in intra-abdominal infection. A comparison of two indexes. AB - The severity of illness in 58 surgical patients with high-grade intra-abdominal infection was measured with two methods, an acute physiology score and a septic severity score. Both methods are the summed weight of derangements in physiologic factors representing the function of the major organ systems of the body. Sixteen patients died (28%). Score values with both methods were significantly higher for nonsurvivors than for survivors. There was good interrelation between the methods, and the scores correlated better with mortality than did age, chronic disease, anatomy, or cause. Three risk levels were recognized, low, high, and intermediate, with respective mortality rates of less than 10%, greater than 80%, and approximately 45%. Three-fourths of the patients were assigned to the same risk group with both methods. The severity of illness in patients with intra abdominal infection can suitably be measured with both methods. PMID- 3977588 TI - Modulation of hepatocyte protein synthesis during co-cultivation with macrophage rich peritoneal cells in vitro. AB - The etiology of hepatic failure associated with the multiple-system organ failure syndrome is poorly understood. Because of indirect evidence suggesting that macrophages or Kupffer's cells may play a role in this phenomenon, macrophage rich peritoneal cells were co-cultured with isolated rat hepatocytes. Following co-culture, the rate of hepatocyte protein synthesis, quantitated by counts per minute of tritiated leucine incorporated into protein, was significantly diminished. This modulation of hepatocyte function was not enhanced by prestimulation of macrophage-rich peritoneal cells in vivo by casein, thioglycolate, or Corynebacterium parvum. Addition of the macrophage secretory product lysozyme did not alter hepatocyte protein synthesis. This cell-mediated effect on hepatocytes could not be recreated by a macrophage-rich peritoneal cells supernatant transfer. These results support the idea that cells of macrophage lineage could mediate changes in hepatocyte function that may, in turn, play a role in the etiology of hepatic malfunction associated with the multiple-system organ failure syndrome. PMID- 3977589 TI - In vivo neutrophil delivery to inflammatory sites in surgical patients. Correlation with in vitro neutrophil chemotaxis and adherence. AB - We examined the interrelationships between leukocyte adherence (ADH), polymorphonuclear neutrophil (PMN) chemotaxis (CTX), and PMN delivery to an inflammatory focus in hospitalized patients. Patients included 25 men and 17 women, with a mean age of 62.8 years, who were admitted for major elective surgery. The patients were studied preoperatively and on the second and seventh postoperative days. Leukocyte adherence increased on the second postoperative day (82.3%, P less than .05) and remained elevated on the seventh postoperative day (81.6%). Polymorphonuclear neutrophil chemotaxis decreased significantly on the second postoperative day (3.4 to 2.9 cm, P less than .05), but returned to normal by the seventh postoperative day. The PMN delivery to skin-window chambers decreased markedly on the second postoperative day (1.28 million cells, P less than .05) with a further decrease on the seventh postoperative day (0.82 million cells). There was no correlation between in vitro PMN CTX and in vivo cell delivery. We conclude that major surgery leads to increased ADH, decreased PMN CTX, and diminished PMN delivery to areas of inflammation. However, a single measure of PMN function such as in vitro PMN CTX does not, alone, reflect in vivo PMN delivery to areas of inflammation. PMID- 3977590 TI - Expanded criteria for percutaneous abscess drainage. AB - The original criteria for percutaneous abscess drainage were limited to simple abscesses (well-defined, unilocular) with safe drainage routes. We expanded these entry criteria to include complex abscesses (loculated, ill-defined, or extensively dissecting abscesses), multiple abscesses, abscesses with enteric fistulas or whose drainage routes traversed normal organs, as well as complicated abscesses (appendiceal, splenic, interloop, and pelvic). Using these expanded criteria, cure was achieved nonoperatively in 92 (73.6%) of 125 abscesses with ten deaths (9%), and 11 complications (9%). Cure was achieved in 82% of simple abscesses, but only 45% of complex abscesses. There was no correlation between size, depth, drainage route, or etiology of the abscess (spontaneous v postoperative) with either cure or complications. We recommend a trial of percutaneous drainage in all simple abscesses and most complex abscesses with clinical response as the key determinant of the need for operative intervention. PMID- 3977591 TI - Choledochoduodenostomy for calculous biliary tract disease. AB - After the opening of the common bile duct, several controversial procedures may be used. In choledocholithiasis, our preference is to perform choledochoduodenostomy in older patients. We report the results in 77 consecutive patients with a mean age of 75 years. There were two hospital deaths (2.6%). Follow-up ranged from six months to 15 years, with an average of 6.7 years. Fifty patients are alive and well. Twenty-five patients have died. Only two patients were unavailable for follow-up. Expected mortality in the French population corresponding in age and sex was 29 deaths and the overall survival is not different, including the two postoperative deaths. Delicate technique allows anastomoses to ducts of any size, with no difference in long-term survival compared with a French population similar in age and sex. PMID- 3977592 TI - Heel-drop jarring test for appendicitis. PMID- 3977593 TI - Vaginal cuff dehiscence presenting as an acute abdomen. PMID- 3977594 TI - Embryotoxicity induced by alkylating agents: left-sided preponderance of paw malformations induced by acetoxymethyl-methylnitrosamine in mice. AB - The alkylating agent acetoxymethyl-methylnitrosamine (DMN-OAc) triggers preferential left-sided paw defects in mice following IP administration on either day 11 or 12 of pregnancy. Predominantly, ectrodactyly and hypoplasia of the left paws were found. In an organ culture system, using limb buds of 11-day-old mouse embryos, differentiation is severely impaired following addition of 2 microM DMN OAc to the culture medium. Left and right limbs are equally affected. In contrast, when DMN-OAc is administered in vivo to the dams with subsequent culturing of the limb buds, growth and differentiation of the left limb buds is more affected when compared to the right. Furthermore, DNA alkylation experiments were performed: in vitro, following addition of (14C)-DMN-OAc (2.3 microM) to the culture medium, the DNA alkylation rate of the limb bud DNA is determined. In vivo, following IP administration of 10 mg/kg DMN-OAc to the dams on day 11 of pregnancy, the extent of DNA alkylation of whole-embryo DNA is similar. However, the DNA alkylation rate of separately pooled left and right limb buds exhibits a two-fold difference according to the different teratogenic susceptibility. The results obtained with both in vivo and in vitro systems are consistent with the thesis that a certain amount of DNA alkylation in the tissue of the embryos is the initial step of alkylating agent-induced teratogenicity. PMID- 3977595 TI - Tissue specific, acute toxic effects of the carcinogen trans-4 dimethylaminostilbene. AB - The acute toxicity of the carcinogen trans-4-dimethylaminostilbene was studied in Wistar rats. The animals die after oral administration of 50 mg/kg (LD50) with a latency period of 11 days. Specific lesions of the stomach epithelium together with acute bone marrow incapacity and toxic effects on peripheral blood cells lead to acute anemia, which is considered to be the cause of death. Histological observations indicate that the stomach lesions develop in three phases. Firstly, necroses appear in the proliferative area predominantly in the antrum. This leads, secondly, to cystic transformation of the antrum, cardia, and Brunner's glands and further to peptic erosions and ulcerations. Thirdly, mitotic activity increases. With lethal doses, cell replacement remains incomplete. There ist a correlation between the proliferation rate of different cell types and their susceptibility; but this cannot entirely account for the tissue-specific, systemic effects of trans-4-dimethylaminostilbene. Metabolic activation is also involved, since enzyme induction with methylcholanthrene inhibits toxicity. The study disclosed a new target tissue which may now be used to investigate the mechanism of action of reactive metabolites of an aromatic amine in acute experiments. The same stomach lesions were also observed with adriamycin. With this compound, however, the intestine is also involved. PMID- 3977596 TI - Lack of evidence of increased lethality due to propoxyphene overdose in the presence of ethanol in male Wistar rats. AB - The primary purpose of the present investigation was to evaluate if the presence of ethanol increased lethality induced by propoxyphene. A secondary aim was to study the effect of naloxone on propoxyphene lethality alone, and on the concomitant administration of propoxyphene and ethanol. Male Wistar rats (210-330 g) were used as test animals. Propoxyphene (175 mg/kg) and ethanol (2 g/kg) were administered by gastric intubation, naloxone (2 mg/kg) by subcutaneous injection. Four groups, each consisting of 19 rats, received either of the following drug treatments: Propoxyphene, ethanol + propoxyphene, naloxone + propoxyphene, and naloxone + ethanol + propoxyphene respectively. The drugs were given in the sequence mentioned at the beginning of the experiment. Naloxone was also given 45 and 90 min later. Mortality was reduced to 42% in the group that received ethanol and propoxyphene compared to 73% in the group that received propoxyphene only. Naloxone protected against lethality in both groups. Some animals died despite naloxone administration, possibly due to a nonopioid cardiotoxic effect of propoxyphene or its metabolite. An increase in the propoxyphene/norpropoxyphene (P/N) ratio due to an increase in the absolute concentrations of propoxyphene and a decrease in the absolute levels of norpropoxyphene in blood, brain, and heart tissues was observed in the ethanol + propoxyphene group, compared to the propoxyphene group. In the animals which died, the highest P/N ratio was observed in brain tissue and the lowest in heart muscle. Despite the pharmacokinetic data obtained in this investigation indicating impaired propoxyphene metabolism in the presence of ethanol, ethanol did not enhance propoxyphene-induced lethality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977598 TI - Predicative calculation of the efficiency of hemodialysis or hemoperfusion for the removal of drugs from the body. AB - Formula are derived for the calculation of the amounts of drug which, during a defined time interval, are eliminated from the body with and without the help of hemodialysis or hemoperfusion (HD/HP). A programmable pocket calculator like the TI-59 suffices to perform all calculations. The pharmacokinetic system constants of the drug, the effective plasma flow, and the HD/HP plasma extraction rate are entered into the program. Additional information can be obtained if the plasma concentration of the drug at the onset of HD/HP is known. Worked examples are presented. PMID- 3977597 TI - Effects of inorganic lead in vitro on ion exchanges and respiratory metabolism of rat kidney cortex. AB - The effects of Pb2+ added in vitro to tissue slices, isolated tubules and isolated mitochondria of rat kidney cortex have been studied. Slices were depleted of K+ and loaded with Na+, Cl- and water by pre-incubation at 1 degree C, and reversal of these changes was then induced by incubation under metabolically favourable conditions. The net reaccumulation of K+ was reduced by a maximum of 30% when Pb2+ was present in the medium, the maximal effect being caused by 200 microM Pb2+. Lead also caused a reduction of Na+ extrusion which was approximately equimolar with its effect on K+, but it did not affect the extrusion of Cl- and water. The initial rates of the net, active movements of K+ and Na+ were not altered by Pb2+, divergence from control values only being noted after 15-30 min incubation. The O2 consumption and the ATP content were 25-30% lower in slices incubated with 200 microM Pb2+ than in control slices; the effect on ATP content was not observed until incubation had continued for 30 min. In tubules isolated from the renal cortex, the rate of respiration (50%) and ATP content (30%) were also partly reduced by 200 microM Pb2+. The consumption of O2 by mitochondria isolated from the cortex was much more sensitive to Pb2+ added in vitro than the respiration of intact cells; the rate of respiration in state 3 (presence of phosphate acceptor) and the respiratory control ratio were drastically reduced, with half-maximal inhibition at 30 and 20 microM Pb2+ respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977599 TI - Toxicokinetics of labeled amatoxins in the dog. AB - Radioactivities were measured in serum, urine, and bile of dogs at different times after intravenous injection of 14C-methyl-gamma-amanitin (14C-A) and 3H-O methyl-dehydroxymethyl-alpha-amanitin (3H-A). For either substance, the relation between the specific plasma activity C and the time t could be best described with the function C = C1 X e- lambda 1 X t + C2 X e- lambda 2 X t. Therefore the linear open two-compartment system was selected as an adequate toxicokinetic model. Most important, the distribution volumes (in the steady state) were in the range of the extracellular space, and the total body clearances were in the range of the dog creatinine clearance. In accordance with former findings for 3H-A, 14C A was not bound to plasma proteins. More than 80% of 14C-A was eliminated in the urine; less than 10% was found in the bile. From these data, two suggestions may be derived for the therapy of Amanita intoxication in man. First, detection in the urine of amatoxins 2 or 3 days after mushroom ingestion points to an ongoing amatoxin absorption or reabsorption from the intestine, and should lead to therapy with adsorbents and, in the absence of diarrhea, with laxatives. Second, hemoperfusion will remove significant amounts of amatoxins during the time of ongoing absorption or reabsorption and a few hours thereafter. PMID- 3977600 TI - Transfer of hexachlorobenzene (HCB) from mother to newborn baby through placenta and milk. AB - HCB was detected in all preparations of human placenta, maternal blood, milk, and cord blood. It was confirmed that HCB transferred from mother to fetus through the placenta. A significant linear correlation exists between the HCB concentration in placenta and that in cord blood. Therefore, the placental concentration of HCB is an accurate indicator of HCB contamination in pregnant women and in the newborn baby. It was decided that the commercial pesticides, PCNB and PCP, contained HCB at a concentration of about 0.7 and 0.4% of pesticides, respectively. The animals which consumed PCNB diet accumulated large amounts of HCB in lipid-rich tissues, especially in adipose tissue. On the other hand, PCNB was metabolized to methylthiopentachlorobenzene and bis(methylthio)tetrachlorobenzene. One of the main sources of HCB contamination in the general population in Japan may be derived from the commercial pesticides, PCNB and PCP. PMID- 3977601 TI - Accidental exposure to sarin: vision effects. AB - Two men were accidentally exposed to vapors of sarin, a cholinesterase inhibitor and extremely toxic nerve gas. Diagnosis was confirmed by depressed cholinesterase activity, and fixed extremely miotic pupils. No other signs or symptoms developed and neither man required treatment. Recovery to normal cholinesterase activity was gradual over a 90-day period. Pupillary reflexes were not detectable until 11 days after exposure; the miotic pupils dilated slowly over a 30-45 day-period. Eye pain and blurred vision did not occur; visual acuity and amplitude of accommodation were improved for several weeks. Other functions not affected significantly were intraocular pressure, visual fields, color vision, heterophorias, and vergences. PMID- 3977602 TI - Stimulatory and cytotoxic effects of beryllium on proliferation of mouse spleen lymphocytes in vitro. AB - Low concentrations (1-5 microM) of beryllium (Be) salts were weakly mitogenic to mouse spleen cells in vitro as measured by an hydroxyurea-sensitive 2-3fold increase in pulse labelled [3H]-thymidine incorporation into lymphocyte DNA. It is proposed the activation may be induced by a direct interaction of Be2+ with the lymphocyte membranes. Higher concentrations of Be2+ (5-20 microM) produced a gradual loss of the stimulatory response, possibly as the result of either a limited cytotoxic effect or by the established property of intracellularly accumulated Be2+ to inhibit cell division. In contrast, Concanavalin A-stimulated lymphocyte mitogenesis was markedly decreased by a 20-h preincubation of splenocytes with micromolar concentrations of Be2+, whereas similar pretreatment with lower concentrations (0.1 microM) actually enchanced the subsequent proliferative response. In both cases, supplementary addition of 0.1-1% peritoneal macrophages increased the level of Concanavalin A stimulation. It is concluded, therefore, that inhibition of the proliferative response to accessory cell-dependent mitogens may result from dose-dependent destruction by Be2+ of the macrophage/adherent cell population. PMID- 3977603 TI - Incidence of gastric ulcers by indomethacin and piroxicam in rats. AB - Comparative toxicity of indomethacin and piroxicam at low multiples of the human therapeutic dose was studied in inbred albino rats of both sexes. Using the drug induced model, the two drugs were used to produce gastric ulcers in the rat. Both showed significant evidence of gastric ulceration measured by the ulcer index. The incidence of ulceration increased with dose for both drugs. Piroxicam produced a lower incidence of gastric ulcers than equivalent doses of indomethacin. PMID- 3977604 TI - [Afferent connections of the basolateral division of the amygdaloid complex of the cat brain]. AB - Injection of horseradish peroxidase into the basal macrocellular and lateral nuclei of the amygdaloid complex (BLAC) in the cat brain has revealed their rich thalamic afferentation. On the BLAC there are massive projections of: a) nuclei of the middle line of the precommissural pole of the dorsal thalamus (anterior parts of the paratenial, interanteromedial and reunial nuclei), as well as the whole anterior paraventricular nucleus, medial part of the ventral posteromedial nucleus; b) postcommissural nuclei of the dorsal thalamus; some "nonacustical" nuclei of the internal geniculate body (ventrolateral nucleus, medial and macrocellular parts and the most caudal end of the internal geniculate body). Rather essential are projections of the "posterior group nuclei", those of the suprageniculate nucleus, of some parts of the ventral thalamus (subparafascicular nucleus, marginal and peripeduncular nuclei) and parabrachial nucleus. Scattered single projections are obtained from all hypothalamic parts (most of all the ventromedial nucleus), reticular nuclei of the septum, substantia innominata, substantia nigra, truncal nuclei of the raphe. Variety of the dorsal thalamic nuclei, sending their fibers to the BLAC reflects variety of sensory information, that gets here, according to its modality, degree of its differentiation and integrity. A number of the dorsal thalamus nuclei, owing to abundance of labelled neurons, can be considered as special relay thalamic nuclei for the BLAC resembling corresponding relay nuclei for the new cortex. PMID- 3977605 TI - [Ultrastructure of the capillaries of nerve tissue transplants growing in the anterior chamber of the eye]. AB - Blood capillaries have been studied electron microscopically in the areas of grafts (rat embryonal hippocamp and septal cerebral parts transplanted to mature rats) containing mainly nervous, glial or connective tissue cells. Certain differences in the capillary wall structure have been revealed. In areas with a great concentration of nervous cells, the blood capillaries are characterized by a dense arrangement of cellular elements in their walls, a continuous layer of the glial end-feet, this is specific for the CNS capillaries providing the blood- brain barrier. In peripheral area of the grafts, where glial elements predominate, the capillaries have loose arrangement of the mural cellular elements, great endotheliocyte activity, thick connective tissue tunic, lack of a dense glial surrounding. These characteristics make dubious the statement whether these capillaries possess the blood--brain barrier function. In places where connective tissue cells make aggregates, the capillaries do not possess the barrier properties because of perforations and fenestrae in endothelium and interruptions of the basal membrane, absence of pericapillary glial elements. All types of the capillaries demonstrate certain signs of a high functional activity. Formation of the capillary structure depends on the surrounding tissue. PMID- 3977606 TI - [Ultrastructure of the skeletal muscle fibers of athletes with various specializations and qualifications]. AB - An electron microscopic investigation of the skeletal muscle bioptates has been performed in 80 volunteer-sportsmen of different qualification specializing in race rowing and in skating. Common for all the sportsmen examined are those peculiarities in ultrastructural organization of the skeletal muscle fibers that demonstrate their adaptation to an increased muscle activity. Specificity of ultrastructural organization of the skeletal muscle fibers is revealed in connection with sportive specialization. Speed-force trainings in skater sprinters produce hypertrophy of myofibrils; more often than other sportsmen they demonstrate dilatation of cisterns in the sarcoplasmic reticulum, appearance of granular inclusions in mitochondrial matrix. In skater-statyers sarcoplasm of muscle fibers sharply increases in volume. Sometimes, loading for endurance in skater-stayers produces rather essential disturbances in structure of muscle fibers up to their necrosis. In muscles of these sportsmen processes of "intracellular" regeneration are most distinctly observed. PMID- 3977607 TI - [Adaptive structures of the arteries of the heart participating in the regulation of coronary circulation]. AB - By means of a complex of anatomical, histological and histochemical methods cardiac vessels have been studied in 20 control dogs and in 84 dogs with experimentally produced circulatory disturbances peculiar for congenital heart diseases presented as an open arterial duct, coarctation of the aorta and the pulmonary trunk stenosis. The experimental animals have been observed for 6-12 months. In the animals with experimentally produced disturbances of the general and coronary hemodynamics hyperplasy in the coronary branches of the arteries appears, it is more pronounced in functionally loaded cardiac parts, as well as thickening of their walls at the expense of new formations and hyperthrophy of smooth muscle cells. In both control and experimental dogs in the coronary vessels at various branching levels certain formations are revealed; they are of compensatory-adaptive value: intimal and adventitial musculature, polypoid pulvinars, muscular-elastic constrictors, muscular cuffs and precapillary sphincters. They differ in structure, sources of their origin and in their functional value. Degree of their manifestation increases significantly after reproduction of the hemodynamic disturbances in the heart vascular system. The active role of these formations in regulation of the coronary circulation is demonstrated owing to a high content of ribonucleinic acid and glycogene in their smooth muscle cells and also an elevated succinate dehydrogenase, cytochromoxydase, acid and alcaline phosphatase activities. PMID- 3977608 TI - [Histologic organization of the myocardium of the rat during hypokinesia (stereologic study)]. AB - For 30 days Wistar rats have been kept under conditions of hypokinesia. Using stereological methods, the volume and surface density of muscle fibers, microcirculatory bed and connective tissue components have been defined, and volumetric and surface--volume ratios of parenchymal and stromal structures have been calculated. Intracellular stereological parameters of the cardiac myocytes have been studied. Three-dimensional parameters in the parenchymatous-stromal interrelations of the atrophying myocardium accompanied with a deep rearrangement of the intracellular architectonics have been determined, as well as certain destructive changes of the cardiac myocyte ultrastructures. Such a treatment as a decreased functional loading is demonstrated to be the cause of cardiomyocytic lesions. PMID- 3977609 TI - [Cardiomyocytes of the left ventricle of the heart in experimental infarct and pharmacostimulation (histochemical study)]. AB - Contents and activity of lactate dehydrogenase and succinic dehydrogenase of cardiomyocytes have been studied histochemically and cytophotometrically in the left ventricle of the rabbit heart under conditions of myocardial infarction experimentally induced by alpha-tocoferol and sodium nucleinate. The substances mentioned produce a protective effect on the energic metabolism of cardiomyocytes. PMID- 3977610 TI - [Effect of prolonged restriction of overall motor activity on the hemomicrocirculatory bed of the retina of the rabbit]. AB - In 56 rabbits kept in tight cages for 4, 8, 12, 16 and 20 weeks, effect of hypokinesia on structure of hemomicrocirculatory bed of the retina has been studied. The retina is digested in tripsin and then it is exfoliated, and the vessels are stained after Shiff. Diameters of arterioles, capillaries and venules are measured, their relations to each other and number of vessels per square unit are taken into consideration. Restriction of the motor activity for 4 weeks results in narrowing of arterioles, capillaries and venules, in increasing venuloarteriolar coefficient, in decreasing number of vessels per square unit, as compared to the norm. In 8 weeks of hypokinesia the diameter of all links of the hemomicrocirculatory bed is evenly increasing, but it does not reach the normal value; the number of the vessels is keeping to decrease; the venuloarteriolar coefficient is at the same level. In 12, 16 and 20 weeks changes in the diameter and the number of the vessels are poorly pronounced, have a wavy character and diversily directed. The value of the venuloarteriolar coefficient is kept constant. As a whole, the data obtained demonstrate that at a long hypokinesia the animals adapt to the new conditions of existence, and the state of the reticular hemomicrocirculatory bed stabilizes. PMID- 3977611 TI - [Cellular composition and ultrastructure of the thymus of the newborn mouse after immunization of pregnant females with homologous brain antigens]. AB - Immunization is performed with 20% of water-saline extract of medulla oblongata on the 6th, 8th, 10th days of pregnancy (1 g per 200 g body mass). In the thymus cortical substance of newborn rats no statistically significant difference in content of small lympocytes, lymphoblasts and large lymphocytes, mitotically deviding cells is revealed as compared to the normal. The part of middle lymphocytes decreases up to 5.7 +/- 0.7% (control--10.0 +/- 1.7%). The content of distroying cells and fagocytic macrophages is increasing. In cytoplasm of one macrophage several fagocyted degenerating cells with pyknotic nuclei and destructively altered organells are often present. In the interlobular connective tissue an increased amount of degenerating forms of mast cells is noted. In the thymus medullary substance small lymphocytes are growing in number. Certain changes in vessels of the microcirculatory bed are revealed. PMID- 3977612 TI - [Secretion of organic acids and bases by the kidneys of marine teleosts]. AB - In the experiments performed on kidneys of 5 species of marine Teleostei, morphological peculiarities in secretion of 8 fluorescent organic acids (uranin, primulin, tripaphlavin, erythrosin etc.) and in 5 organic bases (rhodamin C, auramin etc.) have been studied. At a very low concentration in the incubation medium--about 0.005 mg/ml--the substances mentioned penetrate into the epithelial cell of the canaliculus; its weak fluorescence appears, and soon they begin to be excreted in great amount through the apical part of the plasmolemma and accumulated in the canalicular lumen. All the substances studied accumulate in the cell and only some of them (uranin, primulin, titanic yellow, etc.) are secreted into the canalicular lumen. Penicillinum and probenecide inhibit penetration of the organic acids into the cell through the basal membrane. Uranin secretion into the canalicular lumen is inhibited in the presence of furocemid; amilorid, magnium and sulfate ions do not influence secretion of the organic acids. Secretion of the organic bases does not change when paraaminohippuric acid and furocemid are added to the medium, but it decreases when concentration of magnium ions increases. PMID- 3977613 TI - Cancer-induced achalasia. PMID- 3977614 TI - Malignant histiocytosis: case report and review. PMID- 3977615 TI - Case report: perforation of the gallbladder diagnosed preoperatively by nuclear imaging. PMID- 3977616 TI - Medical cause versus legal cause. PMID- 3977617 TI - Medical practice, medical education and government: future trends in a troubled relationship. PMID- 3977618 TI - Lobular carcinoma in situ. PMID- 3977619 TI - Ophthalmic plastic and reconstructive surgery. PMID- 3977620 TI - Preservation of the lower extremity in the treatment of massive pressure ulcers. PMID- 3977621 TI - [Microcirculation in rheumatic mitral stenosis (clinico-morphological research by lung biopsies)]. AB - The study of the microcirculation in lung and visceral pleura biopsies from patients with rheumatic mitral stenosis showed the involvement of all parts of the microcirculatory system including intra- and extravascular alterations and changes of the vascular wall as well as its lymphatic part. As the pressure in the small circulation circle increased and arterial hypertension established enhancement of the vascular reconstruction, rheological disturbances and dyscoagulation in the pulmonary microvessels took place. All this resulted in hemodynamic and metabolic homeostasis disturbances in the pulmonary artery system and, consequently, in the establishment of lung hypertension. PMID- 3977622 TI - [Morphological characteristics of skeletal muscle after damage by a laser scalpel]. AB - Changes in the skeletal muscles provoked by carbon dioxide laser in white rats were studied histologically, biometrically and electron microscopically. The laser wound is characterized by coagulation necrosis, vacuolization, the absence of hemorrhages, decrease of edema and leukocytic infiltration. Laser hyperthermia produces local submicroscopic alterations in the muscle tissue. Histologically the borders of the zone affected are formed 3 days later. Preliminary administration of the liquid into the muscle results in a considerable decrease of the necrotic zone size. PMID- 3977623 TI - [Cytological characteristics of a malignantly degenerating stomach ulcer]. AB - On the material of 154 gastrobiopsies and 42 resected stomachs a pronounced dysplasia was revealed which cytologically was manifested by the hyperbasophilic cells (HBC), nucleolar atypia and hypertrophy of other cells, multinuclear pathological mitoses. Fragmentation of the nucleus and alterations of the nuclear apparatus were detected in the HBC in carcinoma in situ and in incipient carcinoma. PMID- 3977624 TI - [Ultrastructural changes in the CNS in amyotrophic leukospongiosis]. AB - Various types of cells in the human spinal cord and brain, status spongiosus of the white matter of the spinal cord were studied by electron microscopy; the comparison was made to the status spongiosus in monkeys with experimental amyotrophic leukospongiosis. The alterations in the motor neurons of the spinal cord, pyramidal neurons of the brain hemisphere cortex and cerebellum ganglious neurocytes were revealed. Changes in some cells (astrocytes, olygodendrocytes) were characterized. The possibility of a primary axon damage in this disease is discussed. PMID- 3977625 TI - [Morphological changes in the nervous system in acute peroral chlorophos poisoning]. AB - The nervous system of 14 patients who died from acute poisoning with chlorophos (Dipterex) taken orally was studied morphologically. Considerable vascular disorders, congestive plethora, perivascular edema, degeneration of collagenous and elastic fibers of vascular walls, as well as diffuse changes in brain and spinal cord cells, and in sensitive and vegetative ganglia were found. Acute swelling, severe ischemic changes were the most common forms of the cellular pathology. Pathomorphology of nervous fibers was manifested by moderate destruction of myelin sheaths of the spinal cord lateral columns, brain peduncles, and by structural changes in the axons of peripheral nerves. PMID- 3977626 TI - [Leukoplakia of the bladder]. AB - The urinary bladder leukoplakia from 42 patients was studied clinico morphologically, histochemically and electron microscopically. This precancerous condition is observed in 58,3 cases of chronic cystitis, more frequently in females. Three successive stages of the leukoplakia development under the conditions of the inflammatory process can be distinguished: squamous-cell modulation, squamous-cell metaplasia, squamous-cell metaplasia with keratinization. The formation of fissure-like intercellular bridges and the appearance of the long dense bundles of tonofibrils in the cytoplasm are the early ultrastructural signs of squamous-cell metaplasia of the transitional epithelium which are of the differential-diagnostic importance. PMID- 3977627 TI - [Metastasis of one tumor into another in multiple primary neoplasms]. AB - Eight patients had two tumours located in different organs: one of these tumours was carcinoma which metastasized into another, histologically benign neoplasm. Morphological characteristics of the two tumours, sources of metastases and metastasis "recipients", are described. The order of their clinical manifestations was followed up. PMID- 3977628 TI - [Pigment-free clear-cell sarcoma]. AB - Clear-cell sarcoma of tendons and aponeuroses is an infrequent soft tissue sarcoma. Although this sarcoma is now accepted as a clinico-pathological entity and is well-defined clinically, questions on the histogenesis are still under discussion. Because of the possible presence of melanin pigment the idea was put forward that these tumors may be soft tissue melanomas. The authors studied a clear-cell sarcoma without melanin pigment and found at the ultrastructural level that the tumor cells often showed a basal lamina-like material in the vicinity of their cell membranes and were inclined to wrap around extracellular structures. They were in part connected to another by desmosome-like junctions and occasionally contained membrane-bound dense bodies resembling neurosecretory-type granules. Pinocytosis and glycogen were lacking. The results of electron microscopic examination showed this tumour to be closer to the malignant schwannoma rather than melanoma: histogenetically it is obviously linked to the neural crest. PMID- 3977629 TI - [Case of epithelioid sarcoma]. AB - A case of recurring epithelioid sarcoma located in the subcutis of the palmar surface of the main phalanx of the second finger in a woman of 40 is presented. Metastasis of the inner organs 2 years after the amputation of the hand is not evident. PMID- 3977631 TI - [Method of microphoto exposure using the Sverdlovsk-4 photo exposure meter]. AB - The exposure meter "Sverdlovsk-4" equipped with an adapting ring is recommended for determining the exposure in microphotography. The eyepiece of the exposure meter light-receiver together with the adapter is adjusted to the ocular of the camera viewfinder. The exposure is determined according to the operating instruction manual. PMID- 3977630 TI - [Gaucher's disease combined with congenital developmental defects of the urinary system]. AB - Two cases of Gaucher's disease of the juvenile type are described, in a boy of 1 year and 7 months and in a girl of 8 years. The juvenile type of Gaucher's disease is documented by detection in the internal organs of typical Gaucher's cells formed mainly of histiocytes and macrophages, PAS-positive and weakly positive with Sudan III, and by the absence of the brain gangliocytes impairments. The peculiarity of these cases consists in the combination of glucocerebroside with congenital developmental defects of the urinary system: in one case with bilateral megaureter and hydronephrosis and in the second one with developmental defect of the renal arteries and bilateral cystic renal dysplasia. PMID- 3977633 TI - Spinal cord injury rehabilitation. PMID- 3977632 TI - Sleep in the Prader-Willi syndrome. PMID- 3977634 TI - A time for reassessment. Plasmapheresis at maturity. PMID- 3977635 TI - Rehabilitation outcome following spinal cord injury. AB - The rehabilitation outcome of 100 consecutive patients with a recent spinal cord injury was reviewed. On admission, 80% were predicted to become functionally independent; 70% had achieved this goal at discharge. Factors relating to success or failure of the rehabilitation effort were identified. Appropriate intervention to neutralized negative influences may increase the number of successfully rehabilitated patients who have spinal cord injuries. PMID- 3977636 TI - Seasonal incidence of phenytoin allergy unrelated to plasma levels. AB - In a three-year prospective study of patients to whom phenytoin was administered, 26 (8.5%) of 306 patients manifested an erythematous morbiliform rash within three weeks of onset of therapy. Occurrence of the rash was not related to the mode of administration of treatment (loading v maintenance) or initial phenytoin levels. A striking seasonal incidence of the rash was noted: None of the 79 persons who received the initial dose during December to February had a reaction, whereas 13 (20.6%) of 63 persons treated during June to August manifested the rash. For March to May, the rate was 10% (8/88), and for September to November, 6.7% (5/76). Monthly rates were significantly different by chi 2 test. PMID- 3977637 TI - Postictal serum creatine kinase in the diagnosis of seizure disorders. AB - We prospectively correlated daily serum creatine kinase (CK) levels with the occurrence of different types of epileptic and nonepileptic seizures documented by video EEG recording in 22 hospitalized patients. Prolonged postictal CK elevations, 8.0 to 19.2 times baseline, were seen following six (15%) of 41 generalized tonoclonic seizures. No CK elevations were seen following 147 complex partial, focal motor, absence, and tonic seizures or 55 psychogenic seizures, 89% of which involved vigorous muscular activity. Six of 12 patients with generalized tonoclonic seizures had postictal CK elevations compared with none of six patients with psychogenic seizures and none of 15 patients with complex partial, focal motor, absence, and tonic seizures. Thus, postictal CK determination can serve as an adjunctive test for differentiation between psychogenic and epileptic generalized tonoclonic seizures. PMID- 3977638 TI - Dissociated foveal and parafoveal visual evoked responses in subacute combined degeneration. AB - In four patients with subacute combined degeneration, clinically silent involvement of the visual pathways was demonstrated by visual evoked responses following selective foveal and parafoveal stimulation. The characteristic distribution of the lesion is different from that generally found in patients with multiple sclerosis, and affects slow- and fast-conducting fibers in an opposite manner. PMID- 3977639 TI - Intracerebral hemorrhage with rapid recovery. AB - Occasionally, patients with small supratentorial intracerebral hemorrhages exhibit the sudden onset of neurologic deficits, followed by rapid improvement during the next several days. We analyzed the computed tomographic (CT) and clinical features of a group of nine such patients, who were drawn from a series of 120 patients with intracerebral hemorrhage. The temporal pattern of illness was similar to that of a cerebral ischemic event, but the correct diagnosis of intracerebral hemorrhage was made on the basis of the CT findings. PMID- 3977640 TI - Progressive multifocal leukoencephalopathy in acquired immune deficiency syndrome. AB - Progressive multifocal leukoencephalopathy occurred in two homosexual men affected with acquired immune deficiency syndrome (AIDS). Both patients received HLA-matched platelet transfusions in an attempt to increase their immune status, but we were unsuccessful in altering their fatal clinical course. PMID- 3977641 TI - Familial infantile myasthenia gravis. Report of three cases with follow-up until adult life. AB - We describe three siblings with familial infantile myasthenia gravis (FIMG). Contrary to previous reports suggesting a benign course of FIMG beyond the infantile period, our two patients had severe respiratory exacerbations in early adult life. Thymectomy was performed in the two more affected siblings, with only brief beneficial effect in one and no improvement in the other. Steroid therapy, employed in two patients who underwent thymectomy, resulted in no long-term improvement. The third patient has not required therapy. Recognition of FIMG has important therapeutic implications, because this disease shows rather poor response to thymectomy and steroid therapy. PMID- 3977642 TI - Experimental trigeminal glycerol injection. Electrophysiologic and morphologic effects. AB - The mechanism by which glycerol abolishes the pain of tic douloureux with minimal trigeminal deafferentation remains unknown. To study the action of glycerol, ten cats underwent unilateral retrogasserian injection of anhydrous glycerol. The contralateral (control) side was injected with saline. Glycerol injection increased the average latencies and reduced the average amplitudes of trigeminal brain-stem evoked potentials. Histopathologic examination disclosed focal demyelination, axonal swelling, endoneurial fibrosis, and neuronal loss. Evoked potentials were severely altered or abolished in cats with axonal damage in the maxillary portion of the postganglionic nerve. Glycerol injection into the trigeminal nerve damages axons and myelin sheaths. We believe that relief of tic douloureux after glycerol injection most likely results from further destruction of the abnormally myelinated fibers implicated in the etiology of trigeminal neuralgia. PMID- 3977643 TI - Visual evoked potentials in pseudotumor cerebri. AB - Pattern reversal visual evoked potentials in 13 patients with pseudotumor cerebri were significantly delayed (99 +/- 7.3 ms [mean +/- SD]) compared with the findings in 20 normal subjects (94 +/- 2.7 ms), although only four patients had latencies outside the normal range. There was, however, a significant correlation between the intracranial pressure and the latency of visual evoked potentials. After medical treatment of the intracranial hypertension, visual evoked potential latencies decreased in patients who recovered and in whom the papilledema disappeared. In one patient with progressive visual failure, the visual evoked potentials were abnormal before disturbances of visual fields and visual acuity were evident. Repeated examinations of visual evoked potentials might be of value in patients with pseudotumor cerebri to ensure neurosurgical intervention in due time to prevent visual loss in patients with impending optic nerve atrophy. PMID- 3977644 TI - Acetylcholinesterase activity in patients with torsion dystonia. Measurement in erythrocyte membranes. AB - Anticholinergic therapy provides symptomatic relief in many patients with dystonia. The mechanism underlying this therapeutic action is poorly understood; however, one possibility is that the degradation of acetylcholine is perturbed in these conditions. To investigate this possibility, acetylcholinesterase activity was measured in erythrocyte membranes from healthy volunteers and patients with torsion dystonia. Enzyme activities in erythrocytes from 14 patients with adult onset, childhood-onset idiopathic, and childhood-onset familial dystonias did not differ significantly from activities measured in erythrocyte membranes from 17 healthy volunteers. Moreover, when blood samples from several members of a family with dominant inheritance of dystonia were assayed simultaneously, similar enzyme activities were found in the affected and unaffected individuals. The data suggest that a generalized acetylcholinesterase deficiency is not involved in the pathogenesis of torsion dystonia. PMID- 3977645 TI - Brain-stem auditory evoked potentials in children with brain-stem or cerebellar dysfunction. AB - Brain-stem auditory evoked potentials (BAEPs) were recorded in 23 children who had signs of brain-stem or cerebellar dysfunction. In patients with brain-stem gliomas, BAEPs were abnormal in all except one, in whom involvement of the brain stem auditory pathway was limited to the midbrain tectum. The BAEPs were normal in neuronal ceroid lipofuscinosis, but abnormal bilaterally in inheritable leukoencephalopathies. All patients with Leigh's encephalopathy had BAEP abnormalities; in two, abnormalities occurred before the appearance of lesions on computed tomographic scan. Patients with Friedreich's ataxia and giant axonal dystrophy had abnormal BAEPs, but the test was normal in a child with similar neurologic findings with vitamin E deficiency. Patients with diffuse metabolic encephalopathies had variable findings. Thus, BAEP abnormalities are nonspecific for various disease processes but are frequently seen in neoplastic and neurodegenerative diseases, with primary white matter or extensive brain-stem involvement. PMID- 3977646 TI - Kaposi's sarcoma metastatic to the CNS. AB - Metastatic lesions of the CNS developed in two male patients with disseminated Kaposi's sarcoma. One patient was a homosexual, but the second patient had no apparent risk factors for disseminated Kaposi's sarcoma. These cases indicate that CNS involvement by tumor should be suspected in patients with Kaposi's sarcoma who exhibit abnormal neurologic signs or symptoms. PMID- 3977647 TI - Carbamazepine toxicity induced by concurrent erythromycin therapy. AB - We describe a 41-year-old woman receiving carbamazepine for epilepsy, in whom concurrent erythromycin stearate administration led to carbamazepine toxicity, including inappropriate antidiuretic hormone syndrome. We review the literature on erythromycin-carbamazepine interaction and discuss the mechanism for such interaction. PMID- 3977648 TI - Cortical blindness following ictal nystagmus. AB - Both ictal nystagmus and cortical blindness may occur transiently in acute cerebral disorders and therefore escape clinical detection, particularly in confused, agitated patients. The following case report describes a young woman with chronic myelogenous leukemia who became progressively ill following bone marrow transplantation. During the course of her illness, acute ictal nystagmus developed from focal right occipital ischemia; postictally she remained cortically blind with possible visual hallucinations for 48 hours. PMID- 3977649 TI - Trauma and amyotrophic lateral sclerosis. PMID- 3977650 TI - The dexamethasone suppression test. An indicator of depression in stroke but not a predictor of rehabilitation outcome. AB - The dexamethasone suppression test (DST) result was found to be abnormal in 49% of patients who were an average of seven weeks post stroke. The DST response correlated with depressive symptoms as measured by both the Zung and modified Hamilton Depression scales. The specificity of the DST for clinically diagnosed depression reached 87% for the 8 AM cortisol determination, with a corresponding sensitivity of 47%. It was not related to the patient's final level of self-care function as measured by the Barthel score, need for nursing home placement following discharge, or duration of rehabilitation needed to achieve maximum benefit. Abnormal responses were more prevalent in cerebral hemisphere than in brain-stem or cerebellar strokes. The more extensive the stroke the more likely the possibility of an abnormal DST response. The DST response is stable, with test-retest replicability being 84% at two weeks and 74% at seven weeks. PMID- 3977651 TI - Long-term clinical and EEG changes in patients with epilepsy. AB - I studied changes during a 15- to 40-year period in EEG paroxysms and clinical seizures on 1,645 EEG tracings. The most common paroxysm before other patterns was the frontal focus and after other patterns was the temporal focus. Most patterns changed in six to eight years and these EEG changes accurately predicted the type of later clinical attacks. The majority of our patients manifested a temporal spike. The incidence of bilateral foci, as opposed to unilateral temporal foci, increased with age at a rate of almost 1% per year; the clinical expression of developing bilateral temporal foci was seen in 34% of the patients. Right-sided foci usually required more than twice as much time to manifest bilaterality than did left-sided foci; all changes from temporal areas required shorter development times than those from parasagittal areas. The most common intrahemispheric change was lateral; anterior migration was not statistically more common than posterior migration. PMID- 3977652 TI - Motor proficiency in dyslexic children with and without attentional disorders. AB - Motor proficiency, in terms of speed, rhythm and absence of overflow, has previously been shown to distinguish nonlearning disabled hyperactive boys from matched controls. Accepted screening methods for selecting children with dyslexia do not include assessments of hyperactivity or other attentional deficits. Dyslexic children selected in this customary manner were compared with an otherwise matched group that had been screened for attentional disorders, on a series of repetitive and alternating movements of the fingers, hands, and feet. The screened dyslexic group performed more rapidly on five of six movements and had fewer qualitative signs of dysrhythmia or overflow. PMID- 3977653 TI - Neurologic manifestations of the organoid nevus syndrome. AB - Prominent neurologic abnormalities were observed in six patients with epidermal or linear sebaceous nevi (organoid nevi). These cases were remarkable for unilateral facial nevi, cognitive impairment, seizures, and focal or lateralized epileptic EEG abnormalities. Additional manifestations included the onset of seizures in the neonatal period, unilateral hypsarrhythmia or Lennox-Gastaut EEG pattern, hemiparesis, asymmetric macrocephaly, and somatic growth disturbances. The full expression of this disorder was not apparent at birth, but emerged gradually during infancy. The neurologic abnormalities in these patients were attributed to unilateral or asymmetric malformations of the CNS as demonstrated by computed tomography. A lateralized disorder of neuroectodermal proliferation, differentiation, and migration could account for both the cutaneous and neurologic abnormalities in this disorder. The striking clinical similarities in these patients suggest a close link between epidermal and linear sebaceous nevi. PMID- 3977654 TI - Stroke due to vertebral artery injury. AB - Minimal neck injury produced vertebral artery damage in two women and three men, 20 to 57 years of age. Serious neurologic deterioration occurred in two patients when positioned for roentgenographic procedures. Dissection or thrombosis of one or both vertebral arteries while in the transverse foramina occurred in three, one at the site of an osteophyte. The arteriogram of one patient showed a traumatic aneurysm at C-7, and a second patient had segmental arterial stenosis with bilateral traumatic aneurysms at C-5. The location of the arterial injury is not restricted to the occipitoatlantoaxial level but includes the course through the transverse foramina. The use of anticoagulation appears to be important in the immediate management of this process. PMID- 3977655 TI - Hemispheric control of speech expression in aphasia. A mouth asymmetry study. AB - Clinical observation of aphasic patients often shows a dissociation between impaired propositional speech and preserved automatic speech. The question of differing hemispheric control between these speech tasks was examined by measuring asymmetry in facial muscle activity. In spite of right-sided facial palsy, greater opening of the right side of the mouth was seen for spontaneous speech, repetition, and word list generation, suggesting that the damaged left hemisphere still controlled motor output in these propositional tasks. However, greater opening of the left side of the mouth for serial speech and singing indicated at least a relatively greater role of the right hemisphere in these "automatic" tasks. PMID- 3977656 TI - Multimodal amnesic syndrome following bilateral temporal and basal forebrain damage. AB - A 55-year-old right-handed man (patient DRB) had a major amnesic syndrome following extensive bilateral damage to the temporal lobe and basal forebrain, caused by herpes simplex encephalitis. His amnesia was both anterograde and retrograde. The retrograde amnesia spanned the five decades of his life, sparing only generic (semantic) material and shreds of previous experiences devoid of appropriate temporal and spatial placement. The anterograde amnesia encompassed both generic (semantic) and contextual (episodic) material. With the exception of preserved learning of a visuomotor skill, the patient did not show acquisition of any new information since his illness in 1975. Elementary perceptual, intellectual, and linguistic abilities remained intact. Because several anatomic and behavioral characteristics of this case are different from those of previously reported cases of amnesia, they may provide new insight into the neuroanatomic substrate of human memory. PMID- 3977657 TI - Amnesia following basal forebrain lesions. AB - Of five patients with damage to the basal forebrain, four had lesions secondary to rupture of anterior cerebral or anterior communicating artery aneurysms, and one to the resection of an arteriovenous malformation. Computed tomographic scans and intraoperative reports confirmed damage to basal forebrain regions, which include septal nuclei, nucleus accumbens, substantia innominata, and related pathways. Behavioral disturbances featured a prominent amnesic syndrome and personality changes. The amnesia was distinguishable from that reported in patients HM and DRB and shared features with that seen in patients with Korsakoff's syndrome. We propose that the memory disorder can be explained by malfunctioning in the hippocampal system, secondary to damage in the basal forebrain structures with which it is strongly interconnected. The dysfunction might, in part, be caused by reduction of specific neurotransmitter innervation because the lesions are likely to damage cholinergic neurons and nearby catecholamine pathways within the basal forebrain. PMID- 3977659 TI - Common and classic migraine. One or two entities? PMID- 3977658 TI - The headache symptom. How many entities? PMID- 3977660 TI - Transient ipsilateral paresthesias (TIPs) with transient monocular blindness. PMID- 3977661 TI - Penetration of topical cyclosporine into the rabbit cornea, aqueous humor, and serum. AB - Systemic and ocular absorption of topically applied 10% cyclosporine ointment was determined in rabbit cornea, aqueous humor, and serum by radioimmunoassay. The concentration of the drug in the cornea reached a peak of 900 ng/mL three hours after application. Substantial levels were still present at 24 hours. Relatively low concentrations were measured in the aqueous humor and serum, suggesting corneal stromal pooling of this hydrophobic cyclic peptide. Topical ocular application of cyclosporine may reduce or eliminate the drug's systemic toxic effects while maintaining a therapeutic level of local immunosuppressive activity. PMID- 3977662 TI - In vitro measurement of contractile force of transvitreal membranes formed after penetrating ocular injury. AB - We adapted a preloaded isometric microstrain gauge force transducer system to measure in vitro the contractile strength of intravitreal fibrocellular membranes formed after reproducible posterior penetrating injury to the eye. We demonstrated that these intravitreal membranes reversibly contracted to serotonin, norepinephrine bitartrate, angiotensin II, prostaglandin F1 alpha, bradykinin, and vasopressin as well as when placed in a depolarizing solution or if electrically stimulated. The membranes could be subsequently relaxed with papaverine hydrochloride, cytochalasin B, and diltiazem hydrochloride. We further demonstrated adrenergic receptor sites on these membranes. We were unable, however, to demonstrate any response to histamine or acetylcholine. Based on these findings, we postulate that the intravitreal membranes formed after perforating ocular injuries bear a functional similarity to smooth muscle and the contractile tissue formed after injury elsewhere. These membranes are of basic importance in the pathogenesis of traction retinal detachment. PMID- 3977663 TI - Vascular casting and scanning electron microscopy of human ocular vascular abnormalities. AB - Plastic casts of ocular vessels were made from postmortem specimens obtained from patients who had had hypertension and arteriosclerosis, diabetes mellitus, and retinopathy of childhood. In conjunction with scanning electron microscopy, the casts serve as models of pathologic vascular changes, including arteriovenous crossing defects, microaneurysm, localized capillary nonperfusion, and rapidly growing peripheral choroidal vessels. These preliminary findings should serve to encourage further study of ocular vascular abnormalities with the use of plastic casting techniques. PMID- 3977664 TI - Pharmacokinetic analysis of intravitreal ceftriaxone in monkeys. AB - Ocular toxic effects of intravitreally injected ceftriaxone sodium and its rate of clearance after a single dose were studied in rhesus and cynomolgus monkeys. Doses of 2, 2.5, and 3 mg/0.1 mL were injected into the vitreous cavity. Electroretinograms performed 15 minutes, 24 hours, one week, and two weeks after injection were not significantly different from preinjection electroretinograms. Lens opacification occurred in one eye receiving 2.5 mg of ceftriaxone. Histopathologic findings in the retina were normal in all eyes injected intravitreally. Levels of ceftriaxone after a 2-mg intravitreal dose were 609 mg/L at 0 hours, 434 mg/L at 24 hours, and 19 mg/L at 100 hours in the vitreous; and 1 mg/L at 0 hours, 116 mg/L at 24 hours, and 9 mg/L at 100 hours in the aqueous. PMID- 3977665 TI - Sideways displacement and curved path of recti eye muscles. AB - We investigated the sideways displacement of recti muscles with the eye in various gaze-positions by making computed tomographic (CT) scans in a plane perpendicular to the muscle cone, posterior to the globe. We found no consistent sideways displacement of the horizontal recti in the up or down gaze or the vertical recti in the left or right gaze. We found a substantial displacement, however, of the contracting and relaxing muscles. Consequently, we made CT scans in a horizontal plane through medial and lateral recti and found that, with the eye in primary position, the recti muscles follow a curved path. The curvature of the path increased following muscle relaxation and decreased following muscle contraction. PMID- 3977666 TI - Q-switched neodymium-YAG laser trabeculopuncture in monkeys. AB - In nine cynomolgus monkeys, trabeculopuncture was performed with a Q-switched neodymium-YAG laser, using a pulse energy of 5 to 7 millijoules and an exposure time of 14 nanoseconds. A penetration into Schlemm's canal was successfully achieved with two to four pulses; this penetration was accompanied by intraocular pressure (IOP) reduction and blood reflux into the anterior chamber. However, after eight days, IOP returned to baseline level, while white tissue was observed gonioscopically to fill in the puncture sites. Histologically, one hour after laser treatment, a blasting effect on the trabecular meshwork was observed with no signs of necrosis. Ater eight days, a hypertrophic scar formed, with the corneal endothelium extending over the scarred surface. At eight weeks and at six months after laser treatment, further shrinkage of the scar and the formation of a membrane over it was evident. Attempts to control scar formation by preventing blood reflux or injecting fluorouracil subconjunctivally for two weeks were unsuccessful. Scar formation at the trabecular puncture site severely limits the applicability of this potentially simple glaucoma treatment. PMID- 3977667 TI - Bioptic telescopes. PMID- 3977668 TI - Ophthalmology in Canada. PMID- 3977669 TI - Bisulfite intolerance manifest as bronchospasm following topical dipivefrin hydrochloride therapy for glaucoma. PMID- 3977670 TI - Lincoff balloon catheter in the repair of posterior retinal tears. PMID- 3977671 TI - Outpatient surgery: back to the barbershop? PMID- 3977672 TI - Stereoacuity in patients with optic nerve disease. AB - Twenty-eight patients were given the Titmus stereoacuity test (TST). Seventeen patients had documented optic nerve disease, and 11 had no known optic nerve disease. Thirteen of 17 patients (76%) with known optic nerve disease failed to achieve their expected TST scores, while only three of 11 (27%) of the patients without optic nerve disease fell into this category. Patients with reduced visual acuity secondary to optic nerve disease showed a disproportionately greater reduction in their TST scores than would be expected, based on Snellen's visual acuities. PMID- 3977673 TI - Brightness-sense and optic nerve disease. AB - We describe a simple device used to compare the sense of brightness in the two eyes. An investigation of brightness-sense with this device in normal persons and patients with optic nerve disease, maculopathies, cataract, and factitious visual impairment shows that brightness testing can provide useful information supplementary and complementary to conventional clinical and laboratory investigations. Impairment of brightness-sense was a consistent finding among patients with optic neuropathies and, in some cases, brightness testing appeared to be more sensitive than other techniques in establishing the presence of disease. Brightness-sense was also used to monitor the course of the patient's illness. Abnormalities were also found among some patients with unilateral maculopathies, but significant intereye differences in brightness-sense were not encountered among normal persons or patients with cataracts. Patients with factitious visual loss gave variable responses, and the nature of their disorder could be identified by the inconsistency of their responses. PMID- 3977674 TI - A distance visual acuity chart incorporating some new design features. AB - Standardized visual acuity assessments are possible when consideration is given to legibility, acuity row legibility, letter spacing, optotype, row arrangement, and letter size gradation. The relative optotype legibilities reported by Sloan were verified experimentally under simulated conditions of optical defocus. Acuity row component letters were selected to equalize aggregate row legibilities and were arranged to minimize contaminative sequencing dependency. We describe a new acuity chart format with vertical acuity row presentations to eliminate bias from previous reading experience, and testing procedures using this chart. PMID- 3977675 TI - Contrast sensitivity in diabetics with and without background retinopathy. AB - Contrast sensitivity measurements were obtained from 64 patients with insulin dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes mellitus who had normal Snellen acuity and minimal or no visible diabetic retinopathy. Contrast thresholds were determined for stationary gratings at six spatial frequencies, ranging from 0.5 to 22.8 cycles/degree (c/deg), and for 1.0-c/deg gratings phase alternated at 15 Hz. Data from each group of diabetic patients were compared with data from age-matched normal subjects. We found that (1) patients with IDDM and no retinopathy had normal contrast sensitivity, (2) patients with NIDDM and no retinopathy had abnormal contrast sensitivity at only one spatial frequency (22.8 c/deg), and (3) patients with NIDDM and background retinopathy had abnormal contrast sensitivity at all spatial frequencies tested. We also found a dissociation of Snellen acuity and contrast sensitivity, indicating that contrast sensitivity can be used as an early index of changes in the retina not demonstrated by measurements of visual acuity. PMID- 3977676 TI - Eye-movement abnormalities in ophthalmoplegia, ataxia, and areflexia (Fisher's syndrome). AB - Ophthalmoplegia, ataxia, and areflexia are present in a distinctive syndrome called Fisher's syndrome. Eye-movement recordings were used to analyze ophthalmoplegia and other eye-movement abnormalities in three patients. Disorders of supranuclear ocular motor pathways (palsy of upward gaze and internuclear ophthalmoplegia) and peripheral cranial nerve palsies could account for the ophthalmoplegia. In one patient, computed tomography demonstrated a lucency in the midbrain that could be correlated with palsy of upward gaze and bilateral internuclear ophthalmoplegia. Eye-movement abnormalities characteristic of lesions of the midline structures of the cerebellum were documented in two patients. A review of reported cases of Fisher's syndrome and brain-stem encephalitis suggested that these syndromes comprise a spectrum of a reversible, parainfectious process affecting the peripheral cranial nerves and CNS. PMID- 3977677 TI - Evolution of optociliary veins in optic nerve sheath meningioma. Evolution. AB - Sequential fundus photographs, obtained during an eight-year period, documented the development of optociliary veins. Disc edema preceded their appearance by three years, and as optic atrophy became profound, the veins changed in number and in size. PMID- 3977678 TI - Carbon monoxide retinopathy. AB - We recently examined three family members with acute carbon monoxide intoxication resulting from a single accidental exposure--a stepfather with a normal fundus, a mother with scattered superficial retinal hemorrhages, and her child with multiple large subinternal limiting membrane hemorrhages, peripapillary hemorrhages, severe venous tortuosity, and disc edema. All three had comparable carboxyhemoglobin levels and no evidence of hypertension, diabetes, or anemia. The different fundus presentations illustrated the variable clinical manifestations of carbon monoxide retinopathy. Early detection could prevent a lethal outcome. PMID- 3977679 TI - Comparison of the corneal endothelium in an American and a Japanese population. AB - We compared the corneal endothelial morphology between an age-matched population of American and Japanese persons. Endothelial specular photographs were subjected to a computer-assisted morphometry of the area and shape of individual cells. The endothelium in the Japanese population showed a significantly higher cell density when compared with an age-matched American population. However, there was no difference in the degree of variations in cell area and cell shape between the two populations. The results suggest that higher endothelial cell density in the Japanese population could be related to the lower incidence of aphakic bullous keratopathy in the Japanese population. PMID- 3977680 TI - Ceftriaxone. A new cephalosporin with aqueous humor levels effective against enterobacteriaceae. AB - One- or two-gram doses of ceftriaxone were administered intravenously to 30 patients before cataract extraction. With the 1-g dose, mean aqueous humor concentrations of 0.93 and 0.88 microgram/mL were found at approximately 2 and 12 hours after administration, respectively. With the 2-g dose, a mean level of 2.47 micrograms/mL was observed at two hours; levels of more than 2 micrograms/mL were found in two patients 13 hours after administration. Both the 1- and 2-g doses thus produce aqueous humor levels many times higher than the minimum inhibitory concentration of ceftriaxone for 90% of most Enterobacteriaceae, excluding Pseudomonas. Concentrations adequate for Staphylococcus aureus and Staphylococcus epidermidis were not, however, obtained. PMID- 3977681 TI - The effect of silicone oil on the cornea. AB - Intraocular silicone oil tamponade is being used with increasing frequency as an adjunct to conventional vitrectomy techniques in the treatment of proliferative vitreoretinopathy. When used in patients with aphakia, corneal decompensation is a common long-term complication. In this study, we evaluated the clinical and morphologic changes that occurred in the corneas of 14 rabbits and seven cats when the anterior chamber was filled with silicone oil. Within six days, wide field specular microscopy showed a 40% reduction in endothelial density in the area of the silicone oil bubble in both groups. Progressive stromal thinning occurred in the rabbit cornea, with gradual development of a retrocorneal membrane at the junction of silicone-endothelial cell contact. In contrast, persistent stromal edema, peripheral vascularization, irregular plaques on the endothelium, and eventual epithelial ulceration and corneal thinning occurred in cat eyes. PMID- 3977682 TI - Effect of suprofen on corneal wound healing. AB - We studied the effect of suprofen, a new ophthalmic nonsteroidal anti inflammatory agent, on corneal wound healing. Nine-millimeter, central, perforating corneal wounds were made in albino rabbits and sutured with 10-0 nylon. The animals were randomly treated with balanced salt solution, suprofen vehicle, 1% suprofen, or 0.1% dexamethasone sodium phosphate administered topically for six days. On the seventh postoperative day, the sutures were removed and, in situ, the intraocular pressure was increased in a controlled manner until the wound burst. Dexamethasone applied four times a day significantly inhibited corneal wound healing, whereas suprofen given as often as hourly did not. Pretreatment with hourly administered suprofen for two days prior to surgery, in addition to the same postoperative hourly therapy, also did not significantly decrease stromal wound strength. PMID- 3977683 TI - Corneal epithelial wound healing in normal and diabetic rabbits treated with tretinoin. AB - The rate of corneal epithelial wound healing has been shown to be faster in diabetic than in normal rabbits when the epithelial cells are removed by scraping or freezing; both methods of epithelial removal, however, damage the basement membrane in corneas of diabetic but not normal rabbits. In this study, we compared the rate of wound healing and the increase in corneal thickness in normal and diabetic rabbits in which the epithelial cells were removed with heptanol, a method that does not damage the basement membrane in either group. In addition, the effect of tretinoin on the rate of wound healing was compared in both groups. There was no statistical difference between the rate of epithelial healing in the untreated control and in untreated diabetic eyes. Treatment with tretinoin resulted in a significant increase in the rate of healing in control but not in diabetic eyes. Corneal thickness increased in all groups after epithelial removal, but the increase was significantly less in the corneas of diabetic rabbits at 24 hours. These results indicate that tretinoin may be more effective in promoting epithelial healing in eyes of normal patients than in diabetic patients. PMID- 3977684 TI - Laser accidents. PMID- 3977685 TI - Inconsistency in Schirmer tear test strips. PMID- 3977687 TI - Evaluation of the Honey Bee Lens. PMID- 3977686 TI - Sickle cell eye disease. PMID- 3977688 TI - Better methods in glaucoma diagnosis. PMID- 3977689 TI - Characteristics of recession-resection and bimedial recession for childhood esotropia. AB - Of 367 unilateral medial rectus recessions-lateral rectus resections and bilateral medial rectus recessions performed for childhood esotropia from 1960 through 1980, a total of 206 met the requirements for a comparative study. Preoperative and postoperative amblyopia was more prevalent in the recession resection population and was attributed to the more common occurrence of monocular esotropia in patients undergoing recession-resection. Postoperative ocular alignment was better and the need for subsequent strabismus surgery was less in patients who initially underwent recession-resection. Because preoperative esotropia was found to be significantly greater in three of the four categories recorded among the bimedial recession population, we could not state that recession-resection was the "better" operation. Contrary to our previous recommendations for graded recessions, we now believe that maximal (5-mm) bimedial rectus recessions should be performed initially. PMID- 3977690 TI - Neuroretinal rim area and retinal nerve fiber layer in glaucoma. AB - Magnification corrected measurements of the neuroretinal rim area of the optic nerve head were correlated with semiquantitative scores of diffuse and localized loss of retinal nerve fibers. The study comprised 134 patients, including 33 normal control subjects, 50 patients with suspected glaucoma, and 51 patients with glaucoma. Both of these estimates of the amount of neural tissue in the eye were highly significantly correlated with the rim area, with the diffuse nerve fiber loss score having somewhat higher correlation coefficient than the localized nerve fiber loss score. PMID- 3977691 TI - Visual field and retinal nerve fiber layer comparisons in glaucoma. AB - Semiquantitative retinal nerve fiber layer (RNFL) scores given separately to diffuse and localized changes of the RNFL were correlated with the overall mean retinal sensitivity and visual field indexes calculated from 49 thresholds of the OCTOPUS program JO. The indexes have been developed to differentiate between generalized reduction and localized disturbances of the retinal sensitivity. The RNFL scores and visual field functions were highly correlated. Approximately 50% of the variation of the visual field functions could be accounted for by the RNFL loss scores. An adequate fit of visual field data on localized nerve fiber loss score was achieved by linear regression, whereas the diffuse nerve fiber loss score was improved by quadratic regression. This suggests that localized nerve fiber loss may be more directly associated with localized visual field disturbances than generalized fiber loss and that there may be a latency between the appearance of structural changes and generalized reduction of retinal sensitivity. PMID- 3977692 TI - Gentamicin, tobramycin, amikacin, and netilmicin levels in tears following intravenous administration. AB - Peak and trough tear and serum concentrations were determined in 27 human volunteers undergoing intravenous (IV) gentamicin sulfate, tobramycin sulfate, amikacin sulfate, and netilmicin sulfate therapy. Although effective serum concentrations were achieved, tear levels were subtherapeutic. The mean peak tear concentrations were 0.4 microgram/mL, 0.5 microgram/mL, 1.7 micrograms/mL, and 0.3 microgram/mL for gentamicin, tobramycin, amikacin, and netilmicin, respectively. These levels did not approach the minimum inhibitory concentrations for Pseudomonas and raise some concern regarding the risk-benefit ratio of IV antibiotics for bacterial keratitis. PMID- 3977693 TI - Effectiveness of a pinhole method for visual acuity screening. AB - Visual acuity screening was performed in the home in an adult population, using a standardized, retroilluminated chart. A pinhole disk was utilized to retest those subjects who initially failed the screening. All subjects failing the screening with the pinholes, and an equal number of age-matched subjects passing the screening (controls), were asked to have a complete ophthalmologic examination, including a protocol refraction in an eye clinic (clinic examination). Without use of the pinhole disk, 14.4% of subjects failed to read a 20/40 line. Use of the pinholes reduced the failure rate to 6.9%. Fifty-seven percent of those failing and 55% of controls had the clinic examination. Determination of best corrected visual acuity after protocol refraction in the clinic indicated that the false-positive rate (the percentage of subjects who failed the screening but had visual acuity of 20/40 or better on the clinic examination) for the screening was 26%, and the false-negative rate (the percentage of subjects who passed the screening but had visual acuity of worse than 20/40 on the clinic examination) was 1.5%. Use of a pinhole disk is highly effective for visual acuity screening, reducing the false-positive rate by more than half. PMID- 3977694 TI - Vibrio alginolyticus conjunctivitis. First reported case. AB - A gravely ill patient had Vibrio alginolyticus conjunctivitis develop, possibly from contact with seashell fragments. It is believed to be the first reported instance of ocular infection by this organism. Marine Vibrio organisms must be considered as potential sources of ocular infection in patients with direct or indirect exposure to salt water habitats, or in patients who are immunocompromised. PMID- 3977695 TI - Epithelioid cell nevus of the iris. AB - A 21-year-old woman had a progressively enlarging pigmented tumor of the iris and anterior chamber angle in the right eye. Because the lesion was suspected to be a malignant melanoma, it was removed by an iridocyclectomy. Histopathologic examination disclosed the tumor to be a benign epithelioid cell nevus. This article describes the clinical and pathologic features of this rare iris tumor. PMID- 3977696 TI - The histopathology of familial exudative vitreoretinopathy. A report of two cases. AB - Two eyes were enucleated for angle-closure associated with familial exudative vitreoretinopathy. Characteristic features included total retinal detachment, peripheral retinal vascular proliferation, and a fibrovascular preretinal membrane. Angle-closure glaucoma developed in one case when sudden massive subretinal hemorrhage, associated with abnormal intraretinal vessels, produced anterior displacement of the lens-iris diaphragm; in the second case, angle closure was associated with the development of rubeosis iridis. Intraretinal inflammatory cells and exudates were also seen in the enucleated eyes. PMID- 3977697 TI - Experimental retinal detachment. VIII. Retinochoroidal horseradish peroxidase diffusion across the blood-retinal barrier. AB - Unilateral rhegmatogenous retinal detachments in 13 cynomolgus monkeys were studied with horseradish peroxidase (HRP). When injected subretinally in six eyes, HRP did not diffuse anteriorly into the sensory retina and penetrated posteriorly through the zonulae occludentes of the retinal pigment epithelium (RPE) in only two eyes. In seven eyes, tracer was detected after intravitreal HRP injection throughout the sensory retina, the basal lamina of retinal blood vessels, and the subretinal space, but did not penetrate through the RPE. In 13 control eyes (with vitrectomy), intravitreal HRP penetrated the sensory retina and the basal lamina surrounding inner retinal blood vessels. These results confirm that the zonulae occludentes of the RPE and retinal blood vessels remain intact in most eyes after rhegmatogenous retinal detachment. Furthermore, the HRP staining patterns suggest a posteriorly directed movement of fluid across the RPE and possible fluid absorption by retinal blood vessels. PMID- 3977698 TI - Polymorphonuclear leukocyte kinetics in experimentally induced keratitis. AB - The movement of polymorphonuclear leukocytes (PMNLs) into inflamed corneas was studied using a quantitative technique to measure PMNL chemotaxis in vivo. Our studies suggested that, in this model, most PMNLs enter the cornea through limbal vessels. A variety of bacterial agents, including viable bacteria, killed bacteria, culture filtrates, and endotoxin, were found to induce a significant corneal inflammatory response. Of the agents tested, viable Pseudomonas aeruginosa produced greatest inflammation. Host factors (serum, PMNLs) also induced movement of PMNLs into corneas, but only after preincubation with activating agents. Normal serum, resting PMNLs, and PMNL lysates derived from resting cells did not promote PMNL corneal ingress. These studies provide further insight into the movement of PMNLs into the inflamed cornea and information that may be of use in developing techniques to inhibit the corneal inflammatory response. PMID- 3977700 TI - Retrobulbar anesthesia in strabismus surgery. PMID- 3977699 TI - Effects of topical epinephrine on experimental sickle cell hyphema. AB - Experimental sickle cell hyphemas were produced by injecting human sickle cell beta(0)-thalassemia blood into rabbit anterior chambers. Eyes treated with topical 2% epinephrine hydrochloride showed no significant difference in the duration of the hyphema or in the percentage of sickled cells in the anterior chamber compared with untreated eyes. Topical 2% epinephrine had no apparent sustained effect on intraocular pressure. PMID- 3977701 TI - Central serous retinopathy, the Farnsworth-Munsell 100-Hue Test, and prolactin. PMID- 3977702 TI - Central retinal artery occlusion following YAG synechialysis. PMID- 3977704 TI - Ophthalmology in service to the public. PMID- 3977703 TI - An improved negative-lens field expander for patients with concentric field constriction. PMID- 3977705 TI - Botulinum A toxin injection as a treatment for blepharospasm. AB - Thirty-nine patients with blepharospasm were treated with injections of botulinum A toxin into the lid and brow. The maximum number of injections in one patient was 16 over a period of 24 months. A reduction of abnormal movement occurred in all patients, lasting up to 170 days. Both the amount and the duration of effect were dose dependent. Reinjection for recurrence had effects similar to the original injection. Tearing, dry-eye symptoms, or transient ptosis occurred in 20% of injections, especially in patients who had had previous eyelid surgery. PMID- 3977706 TI - Intraoperative adjustment of eye muscle surgery. Correction based on eye position during general anesthesia. AB - During general anesthesia, the eye position of patients with strabismus, measured by Krimsky's test at 1 m, 30 minutes after induction, has a linear correlation with the eye position measured clinically preoperatively. A similar study was performed on 77 patients; however, Hirschberg's test was used for simplicity and was performed as soon as the patient was in a surgical plane of anesthesia. We confirmed that there was a linear correlation. We also adjusted the surgery performed in seven cases where the test was anomalous, ie, when the eye position under anesthesia was more than 15 prism diopters more or less than expected based on preoperative clinical measurements. We did approximately 1 mm more or less surgery than we had planned on each eye muscle. This significantly improved the final results in anomalous cases. Patients with anomalous tests who did not have such adjustments had significantly poorer results. PMID- 3977707 TI - Margin limbal distance to determine amount of levator resection. AB - In 68 consecutive patients with congenital blepharoptosis undergoing levator muscle resection, a formula derived from the preoperative margin limbal distance (MLD) was used to determine the amount of levator resection. Excellent results were achieved in 86% of 43 patients with unilateral blepharoptosis when this formula was followed. Of 25 patients with bilateral blepharoptosis, excellent results were achieved in 76% of eyelids. When compared with Berke's method, the MLD formula was superior in unilateral cases and almost equal in bilateral cases. The MLD formula gave the surgeon an excellent preoperative prediction of the amount of levator to resect and aided in the placement of the initial tarsal levator suture. In unilateral cases, little if any tarsal-levator adjustment was necessary. In bilateral cases, Berke's intraoperative values enabled the surgeon to refine the MLD determination. PMID- 3977708 TI - The use of a periosteal strip for eyelid reconstruction. AB - Strips of periosteum from the zygoma were used to reconstruct very extensive lateral canthal and temporal eyelid defects in 11 patients. The strips were reflected nasally, sutured to residual tarsal stumps, and covered anteriorly with myocutaneous flaps. After a minimum follow up of one year, cosmesis was excellent in five patients, satisfactory in five, and poor in one. Minor complications related to this procedure included ectropion and low lateral contour (one patient each), blunting of the lateral canthal angle (three patients), eyelid notching and dehiscence (one patient each), and symblepharon formation (one patient). However, only one patient had a complication that was significant enough to require a second surgery. This technique allows for one-stage reconstruction, an open palpebral fissure, and the ability to reconstruct extensive loss of the temporal portion of two adjacent eyelids when sharing techniques are not possible. PMID- 3977709 TI - Acute angle-closure glaucoma associated with surgical anesthesia. AB - We reviewed the records of all inpatients of the UCLA Medical Center from 1955 to 1980 with the discharge diagnosis of "glaucoma." Nine cases of acute angle closure glaucoma occurring after spinal or general anesthesia were identified among the 913 records reviewed. Of the nine cases, two were bilateral. Seven patients were female and two were male; the mean age was 63 years. Six of the nine surgical procedures were extraperitoneal and abdominal or pelvic. Parenteral atropine sulfate or scopolamine hydrobromide was administered to seven patients and ephedrine sulfate to four; drug-induced mydriasis may have contributed to this complication. Succinylcholine chloride, which causes contraction of the extraocular muscles, was administered to six patients. Additionally, psychological stress in the surgical patient may increase the risk of this disease by causing mydriasis. Our cases are compared with previous reports. PMID- 3977710 TI - Primary angle closure glaucoma in a myopic kinship. AB - Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients. PMID- 3977711 TI - Autosomal dominant retinitis pigmentosa. A method of classification. AB - Four types of autosomal dominant retinitis pigmentosa (RP) were discernible in 84 patients by clinical, electrophysiologic, and psychophysical criteria. Type 1 patients showed diffuse fundus pigmentary changes and nondetectable electroretinographic (ERG) cone and rod functions. Both type 2 and type 3 patients showed fundus pigmentary changes more apparent within the inferior retina. Type 2 patients showed marked loss in rod ERG function, with prolonged cone implicit times, whereas type 3 patients showed substantial rod function and normal cone implicit times. Type 4 patients had a funduscopically and functionally "delimited" disease, with substantial cone and rod ERG amplitudes and normal implicit times. The classification of dominantly inherited RP is important for studies of natural history in disease progression, for patient counseling, and for various laboratory investigations of patients with RP in which patient homogeneity should be maximized. PMID- 3977712 TI - Intrapapillary refractile bodies in optic nerve sheath meningioma. AB - Intrapapillary refractile bodies were observed in seven of 13 patients with chronic optic disc edema secondary to optic nerve sheath meningioma. The observation of refractile bodies preceded or coincided with decline in vision and disappeared as optic atrophy supervened. Intrapapillary refractile bodies appear to be a nonspecific sign of chronic optic disc edema. PMID- 3977713 TI - Medical management of self-enucleation. AB - Self-enucleation or oedipism is a specific manifestation of psychiatric illness distinct from the milder forms of self-inflicted ocular injury. In this article, we discuss the previously unreported medical complication of subarachnoid hemorrhage accompanying self-enucleation. The diagnosis was suspected from the patient's history and was confirmed by computed tomographic scan of the head. This complication may be easily missed in the overtly psychotic patient. Specific steps in the medical management of self-enucleation are discussed, and medical complications of self-enucleation are reviewed. PMID- 3977714 TI - Differentiation between recently resolved optic neuritis and central serous retinopathy. Use of tests of visual function. AB - A test battery was performed on 13 patients with resolved central serous retinopathy and on 13 patients with resolved optic neuritis to see whether the tests would help to distinguish between the two conditions. We found that the most useful discriminators were the relative afferent pupillary defect, followed by the visual evoked potential latency and the critical flicker frequency. The total error score on the Farnsworth-Munsell 100-Hue Test and the nature of the color vision defect were not helpful in separating the two diseases. PMID- 3977715 TI - A comparison of Peritest automated perimetry and Goldmann perimetry. AB - Both Peritest perimetry and Goldmann visual field testing were performed on three groups of eyes. Eighty-one eyes had glaucoma with elevated intraocular pressures and abnormal visual fields determined by Goldmann perimetry. There were 47 eyes with suspected glaucoma, based on elevated IOPs and normal Goldmann visual fields. Nineteen eyes were normal. All visual fields were evaluated in masked fashion, and the results were compared. The Peritest had a high sensitivity in both glaucomatous (98.8%) and normal (94.7%) eyes. One half of the eyes with suspected glaucoma had abnormal Peritest results but normal Goldmann visual fields. These eyes were examined prospectively with color stereo discs and monochromatic nerve fiber layer photographs. One half of the eyes with suspected glaucoma and abnormal Peritest results also had photographic evidence suggesting optic nerve damage. Thus, early field defects detected by the Peritest perimeter in eyes with suspected glaucoma are likely to be representative of glaucomatous damage. PMID- 3977716 TI - Spondyloepiphyseal dysplasia congenita. Light and electron microscopic studies of the eye. AB - A 5-month-old infant with spondyloepiphyseal dysplasia congenita (SEDC) died after an anoxic episode. Ophthalmologic examination one month before death revealed marked myopia and a normal ophthalmoscopic examination, without evidence of retinal detachment, lattice degeneration, or vitreoretinal changes. On postmortem histopathologic and electron microscopic examination of the eyes, we found the vitreous to have central liquefaction, to be detached in multifocal areas, and exerting traction on the retina. The internal limiting membrane of the retina was thin throughout and displayed many areas of discontinuity. There were multiple areas of preretinal cellular proliferation and a few small areas of retinoschisis. Our observation of extensive vitreoretinal degeneration with traction of the retina indicates that eyes of patients with SEDC are at an increased risk for the development of retinal detachment. PMID- 3977717 TI - Effect of nitrous oxide on gas bubble volume in the anterior chamber. AB - Nitrous oxide is often used as anesthesia during ophthalmic surgery that requires intraocular injection of sulfur hexafluoride gas or air. Ventilation with N2O is known to increase intraocular pressure in the presence of intraocular bubbles, but little is known about the effect of N2O on intraocular bubble volume. Accordingly, we have compared the effect of N2O:O2 ventilation (66% N2O, balance O2) with that of air ventilation and oxygen ventilation on intraocular bubbles of SF6 or air. Aspiration of anterior chamber gas after 180 minutes of N2O:O2 ventilation in cats showed an increase in bubble volume of more than threefold when the original intraocular bubble was SF6 and an increase of more than twofold when the original intraocular bubble was air. In contrast, during air ventilation, intraocular SF6 bubble volume increased by 50%, and intraocular air bubble volume increased by only 7.5%. During O2 ventilation, intraocular SF6 bubble volume increased by 35%, and intraocular air bubble volume decreased by 13%. Our results indicate that N2O is contraindicated when gas is injected into the closed eye. PMID- 3977718 TI - The Honan intraocular pressure reducer. An experimental study. AB - Although use of the Honan intraocular pressure reducer is believed to be clinically safe and effective in reducing IOP and the risk of vitreous loss, the IOPs achieved during application of the device have not been directly measured. Intraocular pressure dynamics in ten eyes of five patients were measured shortly after death, using a pressure transducer within the anterior chamber as the Honan device was applied. Pressures were measured again after enucleation. The peak IOPs produced in eyes in situ were much lower than in the same eyes after enucleation. The peak IOP increased as the initial IOP was raised. The Honan device would appear to be safe for eyes undergoing routine anterior segment surgery, but the pressures that may be generated in hypertensive eyes (IOP greater than or equal to 35 mm Hg) might put these eyes at risk for vascular occlusion. PMID- 3977719 TI - Cefsulodin levels in the human aqueous humor. AB - Subconjunctival administration of cefsulodin sodium (100 mg), but not systemic administration (500 mg), provided therapeutic concentrations in the primary aqueous humor of 22 patients who underwent cataract surgery. Therapeutic concentrations of cefsulodin persisted in the aqueous humor for at least five hours after subconjunctival administration of the agent. PMID- 3977720 TI - Cryotherapy enhances intravitreal dispersion of viable retinal pigment epithelial cells. AB - Proliferative vitreoretinopathy (PVR) is the most common cause of failure in retinal reattachment surgery. Giant retinal tears are associated with a particularly high incidence of PVR. It involves the formation of cellular membranes that contract and cause traction retinal detachments. Retinal pigment epithelial (RPE) cells are a major component of these cellular membranes. Displacement of viable RPE cells from their normal position into the vitreous cavity is necessary for membrane formation to occur. This study demonstrates that cryotherapy, but not diathermy, enhances intravitreal dispersion of viable RPE cells in bovine eyes in vitro. This suggests that in some circumstances, excessive cryotherapy may play an exacerbating role in the initiation of PVR. PMID- 3977722 TI - Argon laser choroidotomy for drainage of subretinal fluid. AB - We used the argon laser to perforate the choroid and drain subretinal fluid during retinal detachment surgery in 24 consecutive patients. The procedure was successful in 23 of 24 patients (95.8%). The laser settings required for perforation ranged from 0.02 to 0.2 s and from 200 mW to 2.0 W. Because it is not necessary to enter the subretinal space with a solid, pointed object, laser choroidotomy may reduce the incidence of retinal perforation. In addition, the laser has the advantage of cauterizing small vessels during choroidal puncture, which may reduce bleeding at the time of drainage. PMID- 3977721 TI - Corneal endothelium following immersion of eyes in water. AB - Eye banks are occasionally asked to retrieve corneal tissue from drowning victims. The ambient water surrounding the eyes before recovery of the victim has chemical, pH, and osmotic characteristics different from those of aqueous humor, thereby possibly making corneas recovered from these eyes unsuitable for transplantation. Corneal endothelial cell function and ultrastructure were maintained following soaking of rabbit eyes for three hours in either seawater, fresh lake water, or chlorinated swimming-pool water at 25 degrees C. The data suggest that physiological and ultrastructural integrity of the corneal endothelium is maintained under these conditions, and that if other, generally accepted criteria of donor suitability are met, such corneas are probably suitable for transplantation. PMID- 3977724 TI - Three-dimensional distribution of neuromuscular junctions in human cricothyroid. AB - Microinjections of myoneural blocking agents are effective in the treatment of strabismus and have been proposed as a possible technique to treat spastic dysphonia. The success of such a technique would rely on a precise knowledge of the neuromuscular junction distribution in the laryngeal muscle to be injected. In view of the possibility of an involvement of the cricothyroid muscle in spastic dysphonia or other neuromuscular disorders, we determined the three dimensional distribution of neuromuscular junctions in the human cricothyroid muscle. Cricothyroid muscles obtained from autopsy cases were fixed, sectioned, and processed for the histochemical localization of neuromuscular junction acetylcholinesterase. Using serial sections and a computer interfaced X-Y digitizer, the neuromuscular junctions were referenced to various anatomic landmarks and the neuromuscular junction distribution and reconstructed in three dimension using computer graphics. PMID- 3977723 TI - Long-term results of the Blom-Singer speech rehabilitation procedure. AB - We report a 64% long-term success rate in our series of 66 patients who have undergone the tracheoesophageal puncture (TEP) procedure with follow-up ranging from one to 3 1/2 years. Poor motivation and compliance were the most common factors noted in patients who failed to obtain or maintain tracheoesophageal speech. Other problems causing failure were technical problems relating to the TEP and medical problems. The success rate in the last 24 cases of our series has improved to 83%. The "collared" prosthesis, more careful patient selection, and emphasis on a team approach seem to be important factors for the higher success rate. The Blom-Singer TEP procedure is a safe, simple, and effective means of alaryngeal communication for selected patients. PMID- 3977725 TI - Temporal bone findings in a case of otopalatodigital syndrome. AB - The principal features of the otopalatodigital syndrome are hearing loss, cleft palate, and skeletal dysplasia of the hands and feet. The right temporal bone was acquired from a boy with this syndrome who died at the age of 2 1/2 years. Behavioral audiometry had indicated a conductive hearing loss, with probable near normal sensorineural function; brainstem evoked response audiometry indicated a mild sensorineural hearing loss. Histologic studies of the temporal bone revealed dysmorphic features in both the middle ear and the bony labyrinth. The ossicles were deformed, the stapes was fixed, and no round window was present. A defect of the modiolus resulted in a wide communication between the subarachnoid space of the internal auditory canal and the scala vestibuli. These anomalies would clearly have frustrated any attempt to improve the patient's hearing through reconstructive middle ear surgery. PMID- 3977726 TI - Electron microscopy of olfactory epithelia in two patients with anosmia. AB - Ultrastructural alterations were present in biopsy specimens of olfactory epithelia taken from two patients with anosmia. In both cases, the olfactory epithelia presented a disorganized appearance when viewed by transmission electron microscopy. The number of ciliated olfactory receptors was reduced; few olfactory vesicles were present at the epithelial surface. Where present, the olfactory vesicles usually lacked cilia. Since both patients had a history of head trauma, we speculate that the fila olfactoria may have been severed at the level of the cribriform plate. The histopathologic changes in the olfactory receptors that were revealed by electron microscopy may have resulted from the inability of regenerating axons to reach their normal site of synaptic contact- the second-order neurons (mitral cells) in the olfactory bulb of the brain. PMID- 3977727 TI - Complications of Venturi jet ventilation during microlaryngeal surgery. AB - Microlaryngoscopy for the diagnosis and treatment of laryngeal pathology is a commonly performed procedure in otolaryngology. The use of this technique continues to increase in frequency due to the availability of laser surgery for the management of laryngeal disease. Ventilation during microlaryngoscopy, however, poses a problem as the airway must be shared by the anesthesiologist and the otolaryngologist. Although many techniques of ventilation during microlaryngoscopy are used, the use of high-pressure Venturi jet ventilation, especially during laser surgery, is most frequent. Complications during high pressure Venturi jet ventilation are uncommon but may occur suddenly and present the surgeon with a life-threatening emergency. Hypoventilation, pneumomediastinum, pneumothorax, severe abdominal distention, and death (directly attributable to various methods of jet ventilation) have been described. PMID- 3977728 TI - Complete mandibular agenesis. Report of a case. AB - A child had complete mandibular agenesis, with associated anomalies of microstomia, left choanal stenosis, and a cleft soft palate. This child had evidence of disruption in development at about the four-week stage by the persistence of several developmental remnants, specifically, the buccopharyngeal membrane, tongue remnants, and the laryngotracheal groove. The etiology of this condition is unclear at this time. PMID- 3977729 TI - The auditory response to inverted posture. PMID- 3977730 TI - Electrocochleography and symptoms of inner ear dysfunction. AB - We examined the relationship between electrocochleographic test results and symptoms associated with Meniere's disease-endolymphatic hydrops (MD-ELH). Extratympanic electrocochleography (ECochG) was performed on 55 consecutive patients (110 ears) suspected of having MD-ELH, and the results compared with the clinical symptoms of the patients on the day of recording. Referring symptoms included sensorineural hearing loss, aural fullness or pressure, tinnitus, vertigo, and all combinations of these four. There was a statistically significant difference between ECochG findings when symptoms were absent compared with when one or more symptoms were present. Furthermore, the presence of hearing loss combined with aural fullness or pressure was the strongest predictor of a positive ECochG, as characterized by an enlarged summating potential action potential amplitude ratio. PMID- 3977731 TI - Pharyngeal wall cancer. A reappraisal after comparison of treatment methods. AB - We retrospectively examined 89 patients with pharyngeal wall cancer treated in our institution between 1964 and 1981, to compare the results of treatment after low-dose preoperative irradiation and surgery (R + S) with those achieved with radiation therapy alone (RA). Age, sex, and stage of tumor were comparable for the 41 patients who had R + S and the 34 who had RA. Treatment outcome, survival, and tumor and nodal control were better for the R + S treatment group than for the RA treatment group. Patterns of relapse differed for the two treatment methods and suggested that each might complement the other. Low-dose preoperative irradiation and surgery more often controlled the pharyngeal tumor than did RA, while high-dose irradiation more often controlled nodal disease than did low-dose irradiation and surgery. Our experience suggests that surgical treatment combined with high doses of radiation might improve treatment results for pharyngeal wall cancer. PMID- 3977732 TI - Total inferior turbinectomy for nasal airway obstruction. AB - A variety of surgical procedures are performed to open the nasal airway chronically obstructed by hypertrophic inferior turbinates. Because the results are universally unsatisfactory, we suggest bilateral total inferior turbinectomy to patients in whom medical therapy fails. One hundred fifty patients were followed up for one to seven years (mean, 2 1/2 years) and the results of the follow-up were assessed clinically via questionnaire and chart review. Patent nasal airway resulted in 91% of the patients. Eighty percent of the patients reported improvement in nasal breathing, and 14 (27%) of the 51 patients who suffered from nasal drainage preoperatively reported that it had stopped after the operation. Of the 39 patients who had anosmia preoperatively, 46% reported the restoration of their sense of smell. Postoperative complications are minimal, and no patient complained of crusts, dryness, or foul odor. PMID- 3977733 TI - Aesthetic facial surgery in the otolaryngology training program. PMID- 3977734 TI - Reconstruction of half of the face. AB - A 29-year-old man underwent a severe electrical burn involving the entire right side of the face, resulting in destruction of the temple, orbit, a portion of the nose, zygoma, and maxilla, through-and-through destruction of the cheek and lips, and a portion of the parotid gland and buccal mucosa. This massive and debilitating wound was an acute surgical emergency, as far as life-support measures were concerned. Gradually, the patient underwent debridement, and finally resurfacing of the entire right side of the face with a large deltopectoral flap. Over four years, this flap, the area of the orbit, and the area of the lips underwent rehabilitation and the transportation of residual regional muscles, and the debulking and repositioning of the flap was carried out. The orbit was finally rehabilitated with a prosthesis. PMID- 3977735 TI - Nasopharyngeal stenosis. AB - Nasopharyngeal stenosis in children is a serious problem. Formerly a result of syphilis, it is now more commonly seen as an unusual complication of tonsillectomy and adenoidectomy or pharyngoplasty. The surgical correction of this problem continues to be a challenge. Seven cases required surgical repair because of the severity of symptoms. A new method of repair, using a laterally based pharyngeal flap, was used with good results in six cases. PMID- 3977736 TI - Westernization of the Asian eyelid. AB - Westernization of the Asian eyelid has become a topic of considerable interest in the Western world in recent years due to the increasing number of surgeons being consulted to perform this procedure. This demand is attributable to the great influx of Asian immigrants who are influenced by Western culture, design, and esthetics. After performing over 2,000 cases of westernizing Asian eyelids, I have developed a method of surgically creating a "double eyelid" as well as a method for removing the epicanthal web. The techniques result in a marked improvement of the narrow, puffy Asian eye and greater patient satisfaction. With these two separate techniques, improved cosmetic results can be achieved over those techniques that are commonly performed today, either in the Western world or in the Orient. PMID- 3977737 TI - Porous polyethylene in reconstructive head and neck surgery. AB - Porous polyethylene is a thermoplastic synthetic with a pore size ranging from about 100 micron to 200 micron. In addition to other materials, it is used for alloplastic replacement of auditory ossicles. Experimental and clinical experience in our department in recent years has shown that porous polyethylene, due to its good formability, tissue tolerance, and stability is suitable for use in reconstruction of other cartilaginous and bony structures. Therefore, it has been used successfully in reconstruction of the outer ear, in repairing defects of the facial skull, and in rebasing paralyzed vocal folds. Its use in the inner nose to replace the cartilaginous septum or rebase the mucosa in ozena, however, cannot be recommended. The suitability of the material for alloplastic tracheal replacement is investigated experimentally. PMID- 3977738 TI - The wrestler's ear (acute auricular hematoma). AB - The wrestler's ear (acute auricular hematoma) is a common problem for physicians treating facial trauma. One method of treatment involves open drainage of the serum and excision of the newly formed fibroneocartilage. This technique provides an outstanding cosmetic result and allows the athlete continued wrestling competition. PMID- 3977739 TI - Use of temporalis fascia in eyelid reconstruction. AB - Full-thickness eyelid defects resulting from trauma, tumor destruction, surgical excision, or congenital anomalies present a dilemma to the reconstructive surgeon. Full-thickness eyelid replacement requires composite grafting of skin, muscle, tarsal support or its substitute, and mucosa. A temporalis fascia sling hammock can be used to support the reconstructed eyelid. This static suspension assists in maintaining proper globe apposition to the eyelid and in preventing sagging of the reconstructed structures. PMID- 3977740 TI - Temporalis muscle-galea flap in facial reanimation. AB - When substantial destruction of the facial nerve occurs as a result of trauma, measures to animate the face, such as transfer of masticatory muscles, must be considered. Unfortunately, these techniques have been limited by a difficult reeducation process for the patient and failure of these muscles to reach sufficiently large areas. A method of extending the temporalis muscle with galea allows rotation into important areas of the face. Case presentations illustrate specific indications, advantages, and disadvantages of this technique. PMID- 3977741 TI - Malar fractures associated with exophthalmos. AB - Although fracture of the malar bone is often associated with enlargement of the orbit and subsequent development of enophthalmos, occasionally, a blowin type of orbital floor fracture and exophthalmos occurs. The causes of the injury and the differential diagnosis of the blowin fracture are reviewed. An explanation is offered for the development of the symptoms. Early recognition, open reduction and fixation of the malar bone, and repair of the floor of the orbit defect are important for successful management of the injury. PMID- 3977742 TI - A computer-based method of filing photographs and procedures. AB - Careful preoperative and postoperative photographs are an essential part of facial plastic surgery for medical and legal documentation, publication, patient education, and lectures. Computers play an increasing role in many aspects of the medical practice. A method of filing photographs and procedures and a related data base system allows rapid access by multiple factors, including name, procedure, age, surgeon, assistants, anesthetic, complications, dates of all photographs, multiple procedure subheadings, and so on. Additional variables can be added as a date base for analysis of operation results and postoperative recall of patients. This system is based on a personal computer (IBM-PC Computer) and readily available software. The system allow simple entry and retrieval of photographs on any of the multiple variables. We found it to be a superb adjunct to photography in facial plastic and reconstructive surgery. PMID- 3977743 TI - Tracheal stoma reconstruction. AB - A simple surgical technique prevents or corrects tracheostoma stenosis. Forty eight (96%) of patients undergoing laryngectomy in whom this technique was used have maintained adequate stomal size for cleaning, ventilation, and tracheoesophageal fistula speech restoration. PMID- 3977744 TI - Reconstructive options for pharyngeal and/or cervical esophageal defects. AB - Reconstruction of the pharynx and or cervical esophagus continues to represent a formidable challenge for the head and neck oncologic surgeon. An analysis was made of 40 patients undergoing pharyngeal and/or esophageal reconstruction. The majority of these reconstructions were sometimes used in combination with skin grafts and even regional skin flaps. Those patients undergoing complete pharyngeal-esophageal reconstruction using a myocutaneous flap with soft Silastic stenting will be discussed as to the potential value of this technique. This article addresses the author's preference for particular reconstructive techniques (ie, skin graft v flap) as it relates to anatomic areas in the pharynx and esophagus. The study concludes that the myocutaneous flaps can be effectively and successfully used for the one-stage reconstruction of subtotal pharyngeal esophageal defects. However, the reconstruction of total pharyngeal-esophageal defects continues to be a problem area, with only moderate success achieved with the techniques described. PMID- 3977745 TI - Trapezius osteomyocutaneous flap for mandibular reconstruction. AB - The recent introduction of myocutaneous flaps has kindled the interest in including bone in the flap to reconstruct the anterior mandibular arch and floor of mouth--still one of the most challenging reconstructions in head and neck surgery. The trapezius osteomyocutaneous compound flap has certain advantages over other osteomyocutaneous flaps; the scapula, being a flat bone, receives relatively more blood supply from the periosteum. The absence of bone resorption at more than two years postoperatively has been encouraging, and it has been possible to reconstruct mandible from angle to angle. PMID- 3977746 TI - Intraparotid branchial cleft cyst. PMID- 3977747 TI - Osteoblastoma. PMID- 3977749 TI - Tracheoesophageal puncture prostheses. PMID- 3977748 TI - Pectoralis myocutaneous flap modifications. PMID- 3977750 TI - An improved esophageal insufflation test. AB - Previous investigations identified that insufflation of the esophagus may elicit reflex pharyngoesophageal closure, impeding airflow and subsequent voice production. A simplified method for esophageal insufflation consistently evaluates the capacity for alaryngeal speech acquisition. Although primarily a method for predicting tracheoesophageal speech, it may also be an important prognostic indicator for traditional esophageal speech development. PMID- 3977751 TI - Acceptability and intelligibility of tracheoesophageal speech. AB - The original Blom-Singer voice prosthesis, introduced in 1979, has been recently modified to provide lower airway resistance. A tracheostoma breathing valve, introduced in 1982, permits unrestricted two-way breathing, yet eliminates the need for manual occlusion of the stoma. To date, the acceptability and intelligibility of tracheoesophageal (TE) speakers, using these prostheses, has not been extensively studied. Forty-six naive listeners rated the acceptability and intelligibility of 15 TE speakers, all of whom were wearing the tracheostoma breathing valve and a prototype low-pressure prosthesis. Acceptability was judged on an equal-appearing interval scale. Intelligibility judgments were based on randomized word lists of 50 items. Results suggest a high level of acceptability and intelligibility among both male and female TE speakers. PMID- 3977752 TI - Differences in speaking proficiencies in three laryngectomee groups. AB - Speaking proficiencies of three groups of alaryngeal speakers were examined: (1) esophageal speakers (n = 12), (2) electrolarynx speakers (n = 11), and (3) tracheoesophageal puncture speakers (n = 10). Subjects were videotaped while engaged in a variety of speaking tasks. Three groups of judges, varying in their knowledge about laryngectomees, independently rated the speaking proficiency of each videotaped speaker. Specific variables rated included voice quality, pitch, loudness, intelligibility, rate of speaking, visual presentation during speech, extraneous speaking noise, and overall communicative effectiveness. Multivariate analyses of variance performed on the ratings made by each judge group disclosed significant differences in ratings for various speaking variables for the three laryngectomee groups. In addition, differences in proficiency ratings for the laryngectomees were found, depending on the expertise level of the judges. PMID- 3977753 TI - Mitomycin and fluorouracil with concomitant radiotherapy in head and neck cancer. AB - Forty-two previously untreated patients with predominantly stage IV (35) head and neck squamous cell carcinoma were treated preoperatively with mitomycin and fluorouracil and concomitant radiotherapy with 5,000 to 6,000 rad using a split course technique. Toxic reactions were acceptable. Five patients developed severe mucositis. The white blood cell count fell to 1,500/cu mm in two patients; the platelet count fell to 100,000/cu mm in three. Other complications occurred in three patients. Eighty-six percent of patients completed advised treatment. Complete response, assessed clinically and with histologic correlation, was 79% at primary sites and 69% at nodal sites. Twenty-seven patients had a complete response (64%). Follow-up currently is between ten and 24 months. Though analysis of disease-free intervals and survival data is premature, the high complete response rates in this study are encouraging. PMID- 3977754 TI - Oral cavity reconstruction using pectoralis major muscle and amnion. AB - The pectoralis major myocutaneous flap has become the mainstay of major oral cavity reconstruction. The flap provides excellent soft-tissue bulk and cavity or surface lining for major defects. There is a high rate of primary take. However, the flap has some deficiencies. A group of patients were identified that are likely to have less than ideal results with the pectoralis major myocutaneous flap technique. In these cases, the flap has been modified and amnion has been added. Initial results indicate enhancement of reconstruction with the modified technique. PMID- 3977755 TI - X-linked progressive mixed deafness with perilymphatic gusher during stapes surgery. AB - Stapes gusher is a rare and usually unexpected complication of stapes surgery. This complication will inevitably be encountered during stapes surgery in all affected males with the X-linked, progressive mixed deafness syndrome. The opportunity of studying eight affected males in a large Dutch family with audiometry, vestibulometry, and polytomography was used to identify specific features. Awareness of these features will assist the otologist in recognizing new cases preoperatively. PMID- 3977756 TI - Use of polytetrafluorinated ethylene compound in peripheral nerve grafting. An experimental study. AB - The suitability of polytetrafluorinated ethylene compound (Gore-tex) tubing in peripheral nerve grafting was studied using a rat sciatic nerve model. Thick walled (0.36 mm) tubing was compared with thin-walled tubing (17 mm). Thin-walled tubing gave a favorable functional and microscopic result in five of seven animals, while thick-walled tubing gave a favorable graft result in three of six animals. The results achieved with the thin-walled tubing were comparable to those achieved using nerve grafts and vein interposition grafts. PMID- 3977757 TI - Laser arytenoidectomy. AB - An endoscopic laser arytenoidectomy was performed on 20 patients for bilateral abductor vocal cord paralysis due to various causes. Ten patients had a previous tracheostomy prior to the laser arytenoidectomy and all were subsequently decannulated. One patient without a previous tracheostomy required an immediate tracheostomy after the completion of the laser arytenoidectomy due to a severe laryngeal edema and was also subsequently decannulated. All of these patients had a satisfactory voice and an adequate laryngeal airway. The advantages of the laser for endoscopic arytenoidectomy are facility of the operation, hemostasis, minimal postoperative edema, and absence of scarring. PMID- 3977758 TI - Posttraumatic pseudoaneurysm of the extracranial middle meningeal artery. AB - Pseudoaneurysms of the extracranial arterial tree are uncommon. To our knowledge, four cases of pseudoaneurysm of the internal maxillary artery have been reported, but there have been no reports of pseudoaneurysm of the extracranial segment of the middle meningeal artery. A 15-year-old girl, who suffered a gunshot wound in the right maxillary region, suffered a pseudoaneurysm of the proximal portion of the middle meningeal artery, as shown by carotid angiography six days after injury. The lesion was successfully treated with absorbable gelatin sponge embolization. Treatment of pseudoaneurysms reduces the risk of hemorrhage from subsequent rupture. Although these lesions are amenable to surgery, transvascular embolization or mechanical interruption appears to be simpler and equally effective. PMID- 3977759 TI - Oral features of Wegener's granulomatosis. AB - A review of the dental literature yielded ten cases of Wegener's granulomatosis manifesting in the oral cavity, but only one was found in the medical literature. The most common oral lesion is hyperplastic gingiva, which is red to purple, with many petechiae. Tooth mobility, loss of teeth, and failure of wounds to heal are also common manifestations. The disease may remain localized in the oral cavity for unusually long periods of time before multiorgan involvement occurs. Histologically, oral biopsy tissue does not exhibit the characteristic features of vasculitis and granulomas. There are, however, diagnostic histologic features that are consistently present, including pseudoepitheliomatous hyperplasia, epithelioid histiocytes, giant cells, and eosinophils. Failure to recognize these diagnostic clinical and histologic features resulted in a 24-month delay in the diagnosis and treatment of our patient. PMID- 3977760 TI - Unilocular cystic sebaceous lymphadenoma of the parotid gland. AB - A unique variant of the sebaceous lymphadenoma, so-called unilocular cystic sebaceous lymphadenoma or lymphoepithelial cyst with sebaceous differentiation, occurred in the parotid gland of a 38-year-old man. Morphologic evidence to support the lymph node-salivary gland inclusion derivation of this tumor is presented and its taxonomic relationship to the parotid lymphoepithelial cyst and Warthin's tumor is discussed. PMID- 3977761 TI - Pathologic quiz case 2: Cervical neurilemmoma (schwannoma). PMID- 3977762 TI - Pathologic quiz case 1: Rhinocerebral mucormycosis. PMID- 3977763 TI - Dangers of propranolol withdrawal prior to local anesthesia with epinephrine. PMID- 3977764 TI - Deterioration of voice prostheses caused by fungal vegetations. PMID- 3977765 TI - Proceedings of the 1984 annual meeting of the German Society for Otorhinolaryngology, Head and Neck Surgery. Abstracts. PMID- 3977766 TI - Dissociation of the cochlear microphonics and endocochlear potential after injection of ethacrynic acid. AB - The cochlear microphonics (CM), endocochlear potential (EP) and summating potential (SP) were simultaneously recorded for 60 min after injection of 30 mg/kg body weight of ethacrynic acid. The EP decreased parallel with the CM for about 20 min after injection, but they differed in the recovery stage. Even when the EP was still negative, the output of CM for 500 Hz acoustic stimulus recovered to its original level and was supernormal. A large SP observed in the recovery stage of CM and EP seemed to suggest that some functional change in the hair cells might be connected with the supernormal CM. Four minutes of anoxia during the supernormal CM decreased CM to only 68% of its level prior to anoxia. A cathodal polarization of the scala media, to change the polarity of the dc potential gradient, reversed the polarity of CM in the anoxic guinea-pig cochlea but not in the guinea-pig cochlea administered ethacrynic acid. These results suggest that supernormal CM observed in this experiment may not be dependent on the dc potential gradient, but due to some functional change in the hair cells after the injection of ethacrynic acid, although CM is essentially dependent on the dc potential gradient between the scala media and the inside of the hair cells. PMID- 3977767 TI - Clinical and histopathologic findings in a patient with Gorlin's syndrome. AB - An 18-year-old patient with Gorlin's syndrome is described, and the clinical findings associated with the syndrome are discussed. The management of keratocysts occurring in patients with the syndrome requires a follow-up period of more than 5 years. PMID- 3977768 TI - Analysis of fifty cases of facial palsy due to otitis media. AB - Fifty cases of facial palsy (FP) due to otitis media treated in our hospital during the 10-year period from 1972 to 1981 were analyzed. The averaged percentage of this incidence was 3.1% of all the FP occurring. FP due to otitis media acuta (OMA) was frequently seen in infants. FP due to otitis media chronica (OMC) tended to occur in combination with cholesteatoma or acute exacerbations of infection. Paralyses were generally mild and bacteria from the otorrhea were similar to those of OMC without FP. When present, sites of dehiscence of the facial canal were most frequently seen in its horizontal portion. Electromyographically, the posterior (mastoid) side of the horizontal portion of the facial nerve bundle seemed to be related to the branch to the orbicularis oculi muscle, while the anterior (stapes) side was directed to the orbicularis oris muscle. PMID- 3977770 TI - Terminal tubulus adenocarcinoma of the nasal seromucous glands. A specific entity. AB - A distinctive species of adenocarcinoma arising in the region of the middle turbinate and ethmoid is described. While these tumors generally behave rather benignly, some lesions are capable of invading the cranial cavity as well as metastasizing. Histologically the cells and the structure of these tubular papillary cystadenocarcinomas show such a striking similarity to the terminal tubules of the seromucous glands that the term "terminal tubulus adenocarcinoma" is proposed. As similar glands can be found in all portions of the upper and lower aerodigestive tracts, it is also possible that these tumors may occur throughout this entire area. PMID- 3977769 TI - Topical immunology of nasal allergy and mucosal IgE antibodies. AB - In the present study, the in vitro tissue-radioallergosorbent test (t-RAST) was performed in two groups of patients: one with perennial attacks of sneezing, serous hypersecretion and nasal congestion, the other with nasal congestion only. The results obtained were compared with those obtained by a series of conventional allergy tests. We then found that t-RAST provided objective data comparable to those obtained with serum-RAST and that the t-RAST is a reliable means of quantitatively detecting specific IgE antibodies in the nasal mucosa. t RAST is of special value to diagnosticians because it is able to discern unequivocally and easily those patients with localized nasal allergy. PMID- 3977771 TI - An ultrastructural analysis of abnormal otic development in exencephalic mutant mice. AB - Homozygous loop-tail (Lp/Lp) mice exhibit defects in the otocyst as well as extensive neural dysraphism. At 19 days of gestation, cells in the otic pit of abnormal embryos are flattened and lack the rounded luminal contours characteristic of otic cells in their normal littermates. Apical filaments also are not as prominent as in normal embryos, and there is an increase in densely stained globular material in cells at the ventral lip of the otic pit. With glutaraldehyde-tannic acid fixation, the basal lamina of the otic pit cells shows differences from that of the normal otic pit. In abnormal specimens, the lamina densa is irregular and clumped, and the adjacent less dense area is spotty and lacks the more uniformly arranged and delicate fibrils characteristic of the normal basal lamina. These defects may reflect faulty developmental interactions between the dysraphic neural tube, mesenchymal cells, and otic anlage. PMID- 3977772 TI - A comment on laryngeal cytology. AB - Cytology of the laryngeal mucosa proved to be a suitable method for diagnosing low-grade and intermediate dysplasia, but it did not allow any distinction between high-grade dysplasia and invasive cancer. In our experience, the use of this method should be restricted to a few conditions, such as the persistance of recurrent dysplasias and certain extended lesions from which biopsies give a high risk for scarring and permanent hoarseness. PMID- 3977773 TI - Role of the low density lipoprotein receptor in penetration of low density lipoprotein into rabbit aortic wall. AB - The present study was designed to determine whether binding of low density lipoprotein (LDL) to endothelial LDL receptors contributes significantly to the penetration of LDL into the normal rabbit aorta. Initial flux rate was used as a measure of uptake of LDL. Reductive methylation of LDL is known to block its recognition by the LDL receptor. Therefore, the difference in flux rates of native LDL and reductively methylated LDL (methyl-LDL) was assumed to represent the receptor-dependent uptake. Native LDL and methyl-LDL were labeled with different isotopes (125I or 131I) and both were injected simultaneously into the same rabbit. After 30 to 60 minutes, trichloroacetic acid-precipitable counts were determined in aortic specimens. The initial flux rates, expressed as plasma clearance (nl/g/hr), were 1787 for native LDL and 1924 for methyl-LDL. The difference was not significant, which suggests that the flux of LDL into the aorta is not significantly dependent upon, or regulated by, endothelial LDL receptors, but is mediated by other mechanisms. PMID- 3977774 TI - Reversible high affinity uptake of apo E-free high density lipoproteins in cultured pig hepatocytes. AB - We examined the high affinity binding, uptake, and degradation of apo E-free 125I high density lipoprotein (HDL) in cultured pig hepatocytes. At steady state, the cells degraded 9.4% of cell-associated 125I-HDL/hour, compared with 41.7%/hour for 125I-LDL. Pulse-chase experiments at 4 degrees C revealed that high affinity 125I-HDL binding was reversible. Similar experiments at 37 degrees C revealed that about 70% of the cell-associated 125I-HDL was released as a macromolecule; the remainder was degraded to acid-soluble products. In contrast, over 75% of the 125I-LDL that was released had been degraded to acid soluble products. The amount of macromolecular 125I-HDL released at 37 degrees C was similar to the amount that was bound to the cell surface, as estimated from measurements of trypsin releasable radioactivity. Density gradient ultracentrifugation and SDS polyacrylamide gel electrophoretic analysis of macromolecular 125I-HDL released to the medium revealed an increase in density, and the apparent partial proteolysis of apo A-I (Mr 25,000) to products of apparent Mr 12,000-14,000. The findings suggest that high affinity 125I-HDL uptake had a reversible component in which HDL was concentrated temporarily at the cell surface, modified, and then released as a somewhat denser lipoprotein particle. Measurement of 125I-HDL and 125I-LDL degradation in cell homogenates revealed no difference in the inherent susceptibility of the two lipoproteins to proteolysis by lysosomal enzymes. The overall slower rate of degradation of 125I-HDL compared to 125I-LDL was therefore due in part to the smaller fraction of HDL that was committed to irreversible catabolism. The rate of catabolism of this fraction, however, was considerable. Cells pulsed at 4 degrees C and subsequently warmed to 37 degrees C released one half the acid-soluble products from 125I-HDL within about 4 hours, compared with 2 hours for cells pulsed with 125I-LDL. These findings indicate that HDL was internalized, transported to lysosomes, and degraded at about one-half the rate of LDL. PMID- 3977775 TI - Comparison of clofibrate and caloric restriction on kinetics of very low density lipoprotein triglycerides. AB - This study of 12 patients with mild-to-moderate hypertriglyceridemia compares the mechanisms of triglyceride (TG) lowering by caloric restriction and by clofibrate. Turnover rates of very low density lipoprotein triglycerides (VLDL TG) were determined by using 3H-glycerol as a precursor. Radioactivity-time curves of VLDL-TG were analyzed with a multicompartmental model. Hypertriglyceridemia in these patients was due mainly to overproduction of VLDL TG. Clofibrate therapy for 1 month had a variable effect on VLDL-TG levels. A group of relatively poor responders to the drug had a mild increase in the fractional catabolic rate (FCR) of VLDL-TG, but no change in production rates. The remaining patients were relatively good responders; they had increased FCR and modest reductions in synthetic rates of VLDL-TG. However, clofibrate largely failed to correct the primary defect in this group of patients, namely, the overproduction of VLDL-TG. Almost all patients responded to 1 month of caloric restriction (1000 cal/day) with marked reductions in VLDL-TG levels. The major response to reduced caloric intake was a decrease in production of VLDL-TG, although FCR was also increased to some extent. Despite these differences in mechanisms for VLDL-TG lowering, both regimens tended to raise levels of LDL and HDL. PMID- 3977776 TI - Fenofibrate reduces low density lipoprotein catabolism in hypertriglyceridemic subjects. AB - This study examines the kinetic basis for the increment in plasma low density lipoprotein (LDL) levels that accompanies the fenofibrate treatment of severely hypertriglyceridemic (HTG) patients. Seven HTG men with a mean plasma triglyceride level of 1470 mg/dl were treated for 6 weeks. During treatment, their plasma triglyceride level fell by 77% and their cholesterol level by 41%. The fall in very low density lipoprotein (VLDL) cholesterol level was reciprocated by increments in the cholesterol level in both LDL and high density lipoproteins (HDL); the rise in HDL was confined to HDL3. LDL catabolism was examined before and during therapy using native and chemically modified tracers in an attempt to distinguish receptor-mediated from non-receptor-mediated clearance. In their basal state, the hypertriglyceridemic subjects overcatabolized both the native and the modified lipoprotein, implying that the non-receptor pathways were hyperactive. The mean fractional clearance rate of LDL via the receptor pathway was not significantly different from normal. Fenofibrate therapy corrected the patients' hypercatabolism, reducing the receptor independent fractional clearance of apo LDL by 50% (from 0.48 to 0.24 pools/day; p less than 0.05). The mean fractional catabolic activity of the receptor route did not change, but when the increment in the plasma apo LDL concentration was taken into account, it was clear that the drug treatment was associated with an increase in the net amount cleared by the receptor pathway and with a reduction of lipoprotein uptake into receptor-independent routes. PMID- 3977777 TI - Ovariectomy, social status, and atherosclerosis in cynomolgus monkeys. AB - Evidence is contradictory regarding the effects of natural or surgical menopause on "female protection" against coronary artery atherosclerosis. We evaluated atherosclerosis, plasma lipids, blood pressure, and carbohydrate tolerance in 21 ovariectomized and 23 intact female cynomolgus macaques fed a moderately atherogenic diet for 30 months. We also evaluated the influence of social dominance status, with particular emphasis on a possible relationship with ovarian endocrine function. Atherosclerosis was two to 10 times as extensive in coronary, carotid, and iliaco-femoral arteries of the ovariectomized females; this could be explained, in part, by 15% to 20% increases in total plasma and LDL cholesterol concentrations. Socially dominant intact females were protected against advanced atherosclerotic lesions (plaques) of the coronary arteries, while subordinate females and ovariectomized females were not. Increased susceptibility to advanced coronary artery atherosclerosis in subordinate intact females may have been related in some way to chronic ovarian dysfunction observed in seven of 12 of these individuals. As a group, subordinate intact females also had enlarged adrenal glands, suggestive of mechanisms that may influence atherogenesis independently. The results indicate that, in this species, ovariectomy and chronic ovarian dysfunction related to subordinate social status are associated with a more atherogenic plasma lipid pattern and abolish "female protection" against coronary artery atherosclerosis. PMID- 3977778 TI - Apolipoprotein B-48 and B-100 very low density lipoproteins. Comparison in dysbetalipoproteinemia (type III) and familial hypertriglyceridemia (type IV). AB - A protein band having the same migration as apolipoprotein (apo) B-48 was observed by SDS electrophoresis in the plasma very low density lipoprotein (VLDL) from 14 Type IV and three Type III hyperlipoproteinemic subjects and from six normal fasting subjects. The VLDL from five Type IV, three Type III, and one normal subject were separated into two subfractions, retained and nonretained, by immunoaffinity chromatography on monoclonal anti-apo B-100 Sepharose. Based on results of electrophoresis and radioimmunoassay, we have concluded that these two fractions represent apo B-48 and apo B-100 lipoproteins that we have named apo B 48 and apo B-100 VLDL. When compared to their respective apo B-100 VLDL, the apo B-48 VLDL from either Type III or Type IV was principally enriched in total lipids, in apo E, and had an electrophoretic migration similar to chylomicrons. This suggests that apo B-48 VLDL has the same origin (i.e., intestinal) in the two disorders. Both apo B-48 and apo B-100 VLDL were enriched in cholesteryl ester (CE) and depleted in triglyceride (TG) in Type III; however, both fractions were rich in TG and poor in CE in Type IV and in normal subjects. In addition, compared to their respective apo B-100 VLDL, the apo B-48 fraction was enriched in CE in Type III and in TG in Type IV. We conclude that, despite a possible similar origin for apo B-48 VLDL in Type III and in Type IV subjects, the composition of apo B-48 VLDL is variable and the CE/TG ratio is more characteristic of the type of hyperlipidemia than of the particular VLDL subfractions. PMID- 3977779 TI - Influence of interaural level differences on the speech recognition masking level difference. AB - This study was undertaken to determine the effect of interaural level differences on the magnitude of the speech recognition masking level differences obtained from younger and older subjects with normal hearing and from subjects with asymmetrical sensorineural hearing losses. A ten-word subgroup of CID W-1 spondaic words having the largest masking-level differences was used. Masking level differences decreased systematically with increasing interaural level differences for all three groups. At interaural level differences of 36 and 42 dB, the masking level difference persisted for the younger and older normal subjects (1.6 and 1.9 dB, respectively); similar results were obtained from the subjects with hearing losses at a 24-dB interaural level difference. For all subject groups, the S0N0 thresholds were unaffected by changes in the interaural level difference, whereas the S pi N0 thresholds were inversely related to the interaural level difference. PMID- 3977780 TI - Methods of analysis of large numbers of audiograms. AB - The analysis of large numbers of audiograms raises the question if and how we can reduce the amount of data without discarding essential information. The present paper compares two ways of data reduction: principal-component analysis and curve fitting. The methods are tested on the audiograms of a large family suffering from a dominant hereditary, progressive hearing loss, beginning in the high frequencies. It is shown that principal-component analysis rejects information on the shape of the audiogram, as do all methods generally referred to as factor analysis. The information concerned is essential for our understanding of the patient's ability to discriminate speech. Curve-fitting procedures are shown to be effective in data reduction. PMID- 3977781 TI - The binaural masking level difference as a function of frequency, masker level and masking bandwidth in normal-hearing and hearing-impaired listeners. AB - Binaural masking level differences (MLDs) were measured for 10 normal-hearing and 10 cochlear-impaired listeners, at 500 and 2 000 Hz. Maskers were either wide band (approximately 2 000 Hz), or narrow-band (50 Hz). For wide-band maskers the noise pressure spectrum level was 50 dB/Hz, and for the narrow-band maskers the noise levels were 50 and 60 dB/Hz. At 500 Hz the hearing-impaired listeners show abnormally low MLDs in wide-band noise, but not in narrow-band noise. At 2 000 Hz, the hearing-impaired subjects show abnormally low MLDs only in narrow-band noise at the 50 dB/Hz level. The clinical implications of the results are considered. PMID- 3977782 TI - Hearing aid quality judgments in reverberant and nonreverberant environments using a magnitude estimation procedure. AB - Speech discrimination performance utilizing CID W-22 word lists and patient preferences for hearing aids were investigated. Preference judgments were made using the magnitude estimation procedure. 10 experienced hearing aid users served as subjects. Results revealed that speech discrimination using CID W-22 words was unable to differentiate among hearing aids which possessed similar electroacoustic characteristics. In contrast, the magnitude estimation quality judgment procedure was quite effective and reliable at differentiating among the hearing aids. Further, the magnitude estimation quality judgment procedure is able to provide numerous preference judgments about each hearing aid in a relatively short time. In addition, the magnitude estimation procedure has a major advantage over the paired-comparison quality judgment procedure in that the patient is able to actually wear the hearing aid during the magnitude estimation procedure. PMID- 3977783 TI - Multifrequency tympanometry in normal ears. AB - Susceptance and conductance tympanograms were recorded from 10 normal subjects with probe frequencies ranging from 220 to 910 Hz. Tympanometric shapes progressed through an orderly sequence of patterns, becoming more complex with increasing probe frequency. When the direction of ear-canal air pressure change was from negative to positive values, more complicated tympanometric shapes occurred for all subjects, compared to the positive to negative direction. The results are discussed in relation to the Vanhuyse et al. [Scand. Audiol. 4:45-50, 1975] model of tympanometric shapes. In general, the model is a good first approximation to the distribution of tympanometric patterns from normal ears. PMID- 3977784 TI - Threshold sensitivity and frequency specificity in auditory brainstem response audiometry. AB - Frequency-specific electric response audiometry can be performed on difficult to test young children if the child is sedated and proper choices are made of acoustic stimuli and recording parameters, although certain compromises are necessary. A very satisfactory sedative is secobarbital, administered intramuscularly in doses related to the weight of the child. As stimuli we recommend '2-1-2' tone bursts at 500, 1 000, 2 000, and 4 000 Hz: i.e., with a rise and fall of two periods and a plateau of one period of the modulated tone. A very robust and sensitive response that is not significantly modified by the sedation and is effective for all four frequencies is the P6-SN10 of the early brainstem sequence. To record this complex favorably requires a bandpass input filter of the Butterworth type with pass-band (at -3 dB) from 50 to 1 700 Hz and rejection rates of 24 dB/octave. With this combination, polarity of stimulus is unimportant and sweep time, rate of stimulation and number of responses averaged may be selected for convenience and simplicity. A routine that requires about an hour of testing time is described and the necessary correction factors are given for estimating a child's behavioral pure-tone thresholds. We believe that our threshold estimates are generally correct within 10 dB, and are sufficiently frequency-specific for proper selection of a hearing aid. PMID- 3977785 TI - Nonlinear phenomena in click- and tone-burst-evoked otoacoustic emissions from human ears. AB - Otoacoustic emissions have been recorded from normally hearing subjects in response to clicks and 1-kHz tone bursts. Input-output relationships for response magnitudes and wave delays are presented. For the response magnitudes, two main effects are seen: (i) nonlinearities are maximal at moderate to high intensity levels (saturation), while deviations from linearity are minimal at the lowest levels (around the psychoacoustic threshold); (ii) the nonlinear behaviour is different at different time intervals (after stimulation): deviations from linearity are maximal for the latest parts of the response. Level- and time dependent phenomena are also observed in the delay of identifiable response waves. PMID- 3977786 TI - Bicultural conflict in families. PMID- 3977787 TI - Low birth weight in Tasmania 1975-1983: the effect of socioeconomic status. AB - An analysis of all births in Tasmania from 1975 to 1983 showed that social class differences in low birth weights were almost entirely restricted to infants between 1500 and 2500 g weight at birth. There was a marginal increase in very low birth weight infants (less than 1500 g) among women whose partners were unemployed or in unskilled work but extremely low birth weight infants (less than 1000 g) were evenly distributed across the whole social spectrum. PMID- 3977788 TI - Cord blood G-6-PD activity by quantitative enzyme assay and fluorescent spot test in Chinese neonates. AB - Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is a common X-linked recessive disorder among the Chinese population. Neonatal screening for this condition is important and with necessary precaution, enzyme deficient infants are less likely to develop severe haemolysis and subsequent kernicterus. Screening of G-6-PD deficiency by fluorescent spot test on cord blood samples of 1228 Chinese neonates revealed an incidence of 4.4% in males and 0.35% in females. Simultaneous direct enzyme assay confirmed the sensitivity and specificity of the spot test in the identification of male hemizygotes and female homozygotes. However, the spot test was unsatisfactory in detecting heterozygotes. Even quantitative enzyme assay could detect only 70% of the partially deficient subjects. PMID- 3977789 TI - Some factors influencing the stature of Dunedin 7 year old children: a report from the Dunedin Multidisciplinary Health and Development Research Unit. AB - The stature of 987 representative Dunedin 7 year olds was measured and some factors contributing to stature were studied in 666 children for whom complete data were available. Dunedin children were of similar stature to American children but were about 1 cm taller than British children. Socio-economic stature (SES), birth weight and maternal stature were significantly correlated with stature, while the sex of the child, gestational age, maternal age, ordinal position of the child in the family and number of children in the family were not significantly correlated. The effect of SES in Dunedin was much less than that reported for the United Kingdom. It was concluded that in this population SES and family structural factors are probably less important as determinants of child growth than they are in Britain and are of considerably less importance than the mother's stature and the child's birth weight. PMID- 3977791 TI - Injuries in the eighth and ninth years of life. AB - From a sample of 818 children, 211 were involved in 256 separate incidents which resulted in 283 injuries requiring medical attention. The most common injuries were lacerations, abrasions and contusions, fractures, concussion, and sprains. The majority of the injuries were minor. The most common incident resulting in injury was a fall, followed by incidents where the child struck against or was struck by an object or persons and incidents involving sharp objects. The nature and circumstances of the serious injuries is presented in detail. Methods of improving the description and the classification of childhood injuries and some incidents worthy of further investigation are discussed. PMID- 3977790 TI - Intestinal parasites and bacteria in Aboriginal children in South West Australia. AB - In a study of intestinal parasites in 697 Aboriginal children under the age of 6 years in South-west Australia, Giardia lamblia was recorded in 26% and Hymenolepis nana in 13.9%. G. lamblia infections occurred above 4 months of age, and H. nana infections above 18 months of age. There was a close correlation between infection with these two species (chi 2, P less than 0.001). Campylobacter jejuni, the predominant bacterial species recorded, was isolated in 2.3%, and was related to bowel symptoms in one child. G. lamblia was more prevalent in the country areas than in the Perth metropolitan area (chi 2, P less than 0.05. H. nana was more prevalent in children whose weight was below the third percentile (chi 2, P less than 0.02), and in those with diarrhoea (chi 2, P less than 0.01). There were strong correlations between low weight (below third percentile), a history of recent diarrhoea, and discharging ears. PMID- 3977792 TI - Mumps as a cause of admission to hospital: an estimate for Western Australia 1981. AB - Close to 40% of children admitted to Princess Margaret Hospital with mumps over the period 1979 to 1982 were diagnosed retrospectively as a result of virological tests and their illness was not coded as being due to mumps. This clinical underestimate of the incidence of mumps is due to the frequent absence of salivary gland enlargement, especially in preschool children. In such cases there is usually evidence of inflammation of the upper respiratory tract. The main clinical features leading to admission were neck stiffness, fits and high fever. An appropriate adjustment was made to the figures obtained from the computerised data on discharges with the diagnosis of mumps from Western Australian hospitals in 1981. This led to the estimate that 104 patients suffering from mumps were discharged from hospital during that year. It was also estimated that mumps was responsible for 379 in-patient days. Our findings show that the benefit cost ratios for mumps immunization of others are underestimates. PMID- 3977794 TI - Acute intussusception. PMID- 3977793 TI - Acute chromium poisoning in a 2 year old child. AB - Sodium dichromate ingestion in children is uncommon and potentially lethal. The most appropriate management is uncertain because of the lack of sound data contained in the few reports of successfully treated patients. Immediate treatment should include urgent induction of emesis, administration of ascorbic acid as an antidote, followed by supportive treatment. PMID- 3977795 TI - Rising tide of child abuse? PMID- 3977797 TI - ICAO: a forum for international civil aviation safety. PMID- 3977796 TI - Drug overdose in children. AB - This paper reviews epidemiological factors, drugs taken, management and outcome of 478 children admitted to the Royal Children's Hospital with drug poisoning during the 5 years 1978-82. Accidental ingestion in young children is still common whilst self poisoning is increasing in the age group 8-17 years. Suicide attempts and self destructive ingestion accounted for 11.5% of all cases with two deaths. A significant number in this group were less than 10 years of age. Iatrogenic poisoning accounted for 11% of all cases with metoclopramide or prochlorperazine frequently involved. Benzodiazepines, major tranquillizers and antihistamines were the most commonly taken groups of drugs whilst the greatest number of admissions to Intensive Care Unit were due to tricyclic poisoning. Principles of management are discussed. PMID- 3977798 TI - Exercise thermoregulation in men after 6 hours of immersion. AB - Rectal (Tre) and mean skin (Tsk) temperature, skin heat conductance (Ksk), heart rate, and total body sweat rate were measured in 6 men (20-35 years) during 70 min of supine leg exercise (Ta = 23.5 degrees C, rh = 40%) at 50% of their peak O2 uptake (VO2 peak); these data were taken after a 6-h control (C) period in air and after immersion to the neck (NI) in water (34.5 degrees C) for 6 h after overnight food and fluid restriction. After NI mean (+/- S.E.) water balance was 1,285 +/- 104 ml for the 6 h and plasma volume (delta Hb and Hct) decreased by 5.2%. End exercise heart rates after C (141 +/- 3 b X min-1) increased to 148 +/- 3 b X min-1 (p less than 0.05) after NI while Vo2 were both 2.2 L X min-1 Tre increased by 0.5 C degrees (p less than 0.05) between the end of NI and the start of exercise. During exercise following C and NI, delta Tre were +1.0 degrees C and +0.9 degrees C (NS), Ksk were 44 +/- 2 and 43 +/- 1 kcal X m-2 X hr-1 X degrees C-1 (NS), while sweat rates increased from 248 +/- 19 to 366 +/- 52 g X h 1 (p less than 0.05), respectively. Both the total integrated Tre and Tsk curves after NI were higher (p less than 0.05) than for C. These results suggest that, compared with control responses, the equilibrium level of core temperature during submaximal exercise is regulated at a higher level after immersion. PMID- 3977799 TI - Factors affecting human tolerance to sustained acceleration. AB - Linear increases in G tolerance with increases in anti-G suit (AGS) bladder inflation pressure occurred when relaxed subjects were exposed to acceleration plateaus while riding a centrifuge and were either seated upright, (15 degrees seat back angle or SBA) or supine (60 degrees SBA). Supine G tolerance with AGS bladder inflation decreased as G onset time was increased by factors of two and four. Changing the mode of operation of a new servo-controlled anti-G valve regulating AGS bladder pressure had no effect on G tolerance nor on AGS comfort scores. Comfort was unaffected by G onset time and reduced with high AGS bladder pressures. Results support the hypotheses that G protection provided by simultaneously applied anti-G techniques is additive and that the simple hydrostatic model of the circulatory system can adequately account for AGS bladder pressure changes required for G protection when body position is changed. PMID- 3977800 TI - Models to predict operational loads of flight schedules. AB - Several concepts have been presented in the literature which have the potential to predict the operational load on aircrews during long-distance flights. They are briefly described and applied to a flight duty pattern actually scheduled for an airline route. For each model relative and absolute difficulty grades for the different segments of the pattern are evaluated and compared. Relative ranking results in an excellent agreement between the various models. Absolute classification into "normal," "heavy," and "definitely severe" segments reveals less conformity. From our observations on this route, it is concluded that the index of Mohler's model reflects the most realistic load estimates. Finally, a new approach is introduced which considers duty period, night flying, number of transits, preceding layover time, and preceding time-zone transitions as those elements constituting a computable and essential part of the operational load. PMID- 3977801 TI - Knee ligament injury during lateral impact. AB - A volunteer woman subject incurred injury to her right knee consisting of a torn anterior cruciate ligament and stretched medial collateral ligament during a lateral (+Gy) impact test. Similar injury has not been reported in the English language literature an accidental sideward automotive crashes or lateral impact experimentation involving humans. The primary mechanism which produced this injury was external tibial rotation on the femur with the knee flexed. The factors contributing to the injury included extraordinarily forceful leg bracing by the subject, her knee joint laxity or hypermobility, and the absence of side supports to limit lower extremity flailing during the impact response. In future lateral impact tests, women subjects should be used with caution and any subject with abnormal joint mobility should be excluded from participation. PMID- 3977802 TI - The effects of moisture on molecular sieve oxygen concentrators. AB - Molecular sieve oxygen generating systems are receiving extensive laboratory and flight evaluation. Assessment of the molecular system has generally been conducted in the laboratory using clean dry air. In aircraft, however, the molecular sieve generator is supplied with engine bleed air which may not always be totally free of contaminants and water. Recent studies using bed washout technics have shown that the molecular sieve units, with 50% of the beds deactivated with water, still function normally with respect to product gas flow and O2 concentration. By utilizing the technics described in this paper, the moisture content or state of hydration of the molecular sieve can readily be determined. PMID- 3977803 TI - The flight acceptability of soft contact lenses: an environmental trial. AB - Seventeen officer aircrew, wearing soft contact lenses, were subjected to adverse conditions likely to be encountered in military aviation. The stresses included hypoxia, rapid decompression, pressure breathing, vibration, climatic extremes, G forces, and the prolonged wearing of an aircrew respirator. Their visual performance wearing contact lenses under stress did not differ significantly from the control values; either when wearing corrective flying spectacles or contact lenses when not under stress. It is considered that from the environmental standpoint soft contact lenses are suitable for aircrew. As contact lenses may not be tolerated by all, and may cause undesirable side-effects in some, their use should be restricted to the aircrew to whom they offer the maximum advantages. The group most likely to benefit are young, well motivated myopes flying fast jets. PMID- 3977804 TI - The influence of clothing on human intrathoracic pressure during airblast. AB - Exposure to airblast can result in injury to the lungs and other gas-containing organs. The mechanism of lung injury is not clearly understood, but may be related to the rapid increase in intrathoracic pressure (ITP) which is produced when the blast wave strikes the chest wall. The purpose of this study was to determine if ITP during airblast would be influenced by several different types of protective clothing. Ten healthy young male volunteers were exposed to airblast while standing face-on and wearing 1) military fatigues (control condition); 2) fatigues with field jacket; 3) fatigues with ballistic armor vest; 4) fatigues with ceramic vest; 5) fatigues with ceramic vest over the ballistic vest. The incident blast waves simulated artillery muzzle blast. In each subject, an esophageal strain-gauge pressure transducer measured ITP during the blast. The pressure signal was analyzed for ITPmax, and maximum rate of rise of ITP (dP X dt max-1). In addition, the power density spectra of each ITP wave was computed and the peak frequency (fp) and centroid frequency (fc) were calculated. When the subjects wore the ballistic vest, the mean ITPmax was higher (p less than 0.05) than when they were exposed to airblast in fatigues alone. ITPmax was not influenced by the other clothing ensembles. The mean dP X dtmax-1 was not significantly different with any protective clothing ensemble. Clothing had no significant effect of fp, but with the ballistic vest, the mean calculated fc was higher (p less than 0.05) than that for the fatigues alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977806 TI - An aviator with idiopathic dilated cardiomyopathy. AB - The clinical presentation, evaluation and diagnosis of an aviator with dilated cardiomyopathy of determined etiology are discussed. The aeromedical disposition and prognosis of this patient are also presented. PMID- 3977805 TI - A direct test for the survival of gaseous nuclei in vivo. AB - It has recently been demonstrated that bubble formation in the crab Pachygrapsus crassipes is induced by limb motions following decompression from nitrogen pressures as low as 2 atm. Preformed gaseous nuclei are not involved in this process and are absent from this animal. We further demonstrate here that nuclei do not remain in the body fluids when the motion-induced bubbles dissolve. This shows that gas phases do not become protected against dissolution in vivo as has been proposed by other workers. This may have important implications concerning the origin of bubbles causing decompression sickness in higher animals. PMID- 3977807 TI - Truth telling, placebos, and deception: ethical and legal issues in practice. AB - The issue of truth-telling is very complex. There is variance among patients in the amount of information they want to be told and variance among professionals in the amount of information they want to tell. Truth is conditioned by our knowledge limits and understanding. Technological advances in health care have made this arena even more complex. Placebos have been viewed traditionally as a kind of benign deception. Few studies have looked at treatments and tests as placebos. There are many myths associated with placebos and placebo therapy. There are five primary theories for withholding the truth or promoting deception with patients. Ethical and legal principles generally support veracity and the concept of a duty to tell the truth. One of the remaining issues is whether the placebo effect can be achieved without deception. PMID- 3977808 TI - Regulations and the air ambulance. PMID- 3977809 TI - Effect of physical training in cool and hot environments on +Gz acceleration tolerance in women. AB - Rectal temperature (Tre), sweat rate, plasma volume (PV), peak oxygen uptake (peak VO2), and relaxed +Gz acceleration tolerance (0.5 G X min-1 linear to grayout) were measured in 15 healthy women 21-41 years old before and after submaximal isotonic exercise training for 2 h X d-1 on a cycle ergometer. The women had 2 weeks of acceleration runs and Vo2 testing, followed by 8 d of exercise training, post-training acceleration runs on day 9, and peak Vo2 tests on day 10. They were divided into three groups: an exercise (heat) group, ambient temperature (Ta) 40.6 degrees C, relative humidity (rh) 42%, and a peak Vo2 of 52%; an exercise (cool) group, Ta = 18.7 degrees, rh = 48%, and Vo2 peak = 55%; and a sedentary control (cool) group. There was no change in peak ventilation, peak heart rate (HR), peak Vo2, or in resting PV in any group after training. Heart rate and Tre were significantly lower after training in both cool and hot environments; HR by 17 b X min-1 (p less than 0.05) and 27 b X min-1 (p less than 0.05), respectively, and Tre by 0.4 degrees C (p less than 0.05) and 0.4 degrees C (p less than 0.05), respectively. Sweat rates were not different in any group. In all groups, acceleration tolerances were not different after training; they ranged from 3.5 to 3.8 G (373 - 410 s). The loss (shift) in PV during acceleration ranged from -5.8% to -10.3% (nonsignificant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3977810 TI - Reinforcer displacement. A preliminary study of the clinical application of the CRF/EXT effect. PMID- 3977811 TI - Reduction of rapid eating by normal adults. PMID- 3977812 TI - Treatment of self-injurious behavior. Contingent versus noncontingent positive practice overcorrection. PMID- 3977813 TI - Combining behavioral treatments to reduce blood pressure. A controlled outcome study. PMID- 3977814 TI - Helping teachers increase student academic engagement rate. The evaluation of a minimal feedback procedure. PMID- 3977815 TI - Assessing cognitive aspects of anxiety. Stability over time and agreement between several methods. PMID- 3977816 TI - Physiological and cognitive assessment of a fire-setting child. PMID- 3977817 TI - [Stomach neoplasms in the dog]. PMID- 3977818 TI - [Oxygen supply and lactate utilization in the porcine heart]. PMID- 3977819 TI - [Definition of the principal deficiency, "laryngeal wheeze", based on laryngoscopic mass screening of warm-blooded horses]. PMID- 3977820 TI - [Mitraspora cyprini Fujita, 1912 (Protozoa Myxosporea Butschli, 1881) in the kidneys of carp from Lower Saxony pond farms]. PMID- 3977821 TI - The thiol groups of mouse immunoglobulin A. Incomplete formation of the C alpha 1 domain disulphide bridge. AB - The BALB/c IgA (immunoglobulin A) myeloma protein M167 contained on average 5.7 free SH groups per IgA dimer. These groups were preponderantly on the heavy chains and comprised two distinct populations: 3.3 exposed SH groups per dimer in the Fc region, and 2.4 buried SH groups per dimer in the Fd region, detectable o only after denaturation. To locate the cysteine residues involved, labelled peptides were purified from thermolysin digests of radioalkylated IgA by high performance liquid chromatography. From the amino acid compositions of the peptides, the exposed thiol groups were assigned to Cys-307 in the C alpha 2 domain, which thus existed in the reduced form to an extent exceeding 80%. This residue may allow attachment of secretory component to dimer IgA in the mouse to proceed via thiol-disulphide exchange. The buried thiol groups were assigned to Cys-150 and Cys-208, in the C alpha 1 domain, each being in the reduced form to the extent of approx. 30%. This pair of residues would normally give rise to the characteristic intradomain disulphide bridge. It appears that disulphide formation is not a crucial event during folding of the C alpha 1 domain in IgA biosynthesis. The sequence in the region 140-151 was re-investigated, and residue 142 was shown to be serine, not cysteine, helping explain the lack of heavy-chain light chain bonding in BALB/c mouse IgA. A disulphide-bond model for mouse IgA is proposed on the basis of these assignments and other features of the mouse alpha chain sequence. PMID- 3977822 TI - Studies on the mechanism of sheep liver cytosolic aldehyde dehydrogenase. AB - The dissociation of the aldehyde dehydrogenase X NADH complex was studied by displacement with NAD+. The association reaction of enzyme and NADH was also studied. These processes are biphasic, as shown by McGibbon, Buckley & Blackwell [(1977) Biochem. J. 165, 455-462], but the details of the dissociation reaction are significantly different from those given by those authors. Spectral and kinetic experiments provide evidence for the formation of abortive complexes of the type enzyme X NADH X aldehyde. Kinetic studies at different wavelengths with transcinnamaldehyde as substrate provide evidence for the formation of an enzyme X NADH X cinnamoyl complex. Hydrolysis of the thioester relieves a severe quenching effect on the fluorescence of enzyme-bound NADH. PMID- 3977823 TI - The molecular structure and lubricating activity of lubricin isolated from bovine and human synovial fluids. AB - Lubricin was isolated from bovine ankle, metacarpophalangeal and knee and human knee synovial fluids. The lubricins isolated from the bovine joint fluids had the same amino acid and carbohydrate compositions, but differences were observed in the relative molecular masses. The Mr values of bovine metacarpophalangeal and ankle lubricin determined by light-scattering measurements were about 200 000, whereas values of 132 000 and 143 000 were obtained for the bovine knee lubricin. The human knee lubricin had a similar carbohydrate composition to bovine knee lubricin except for the higher glucosamine content, and the amino acid composition differed slightly. The human sample had a lower glutamic acid content and a leucine/isoleucine ratio of 2:1 compared with 1:1 in the bovine. The Mr value of the human knee lubricin (166 000) was also lower than that of the bovine metacarpophalangeal and ankle samples. The Mr value of the bovine knee lubricin determined by sedimentation-equilibrium measurements was 171 000. The length measurements determined by electron microscopy and also the sedimentation measurements showed considerable polydispersity and indicate that the degree of extension of lubricin molecules can vary. Friction measurements showed that the human knee synovial-fluid lubricin had equivalent lubricating ability in a test system in vitro to that observed for lubricin isolated from normal bovine synovial fluids. The lubricating ability of lubricin was concentration-dependent, and each lubricin sample was able to act as a lubricant in vitro in an equivalent manner to whole synovial fluid at concentrations that are thought to occur in vivo. PMID- 3977824 TI - The influence of catabolic reactions on polyamine excretion. AB - Complete inhibition of polyamine catabolism is possible by combined administration of two compounds. Aminoguanidine (25 mg/kg body wt., intraperitoneally) inhibits all reactions that are catalysed by copper-containing amine oxidases (CuAO). The products of the CuAO-catalysed reactions cannot be reconverted into polyamines (terminal catabolism) and therefore usually escape observation. N1-Methyl-N2-(buta-2,3-dienyl)butane-1,4-diamine (MDL 72521) is a new inhibitor of polyamine oxidase. It inhibits completely the degradation of N1 acetylspermidine and N1-acetylspermine. The enhanced excretion of N1 acetylspermidine in urine after administration of 20 mg of MDL 72521/day per kg body wt. is a measure of the rate of spermidine degradation in vivo to putrescine, and thus of the quantitative significance of the interconversion pathway. From the enhancement of total polyamine excretion by aminoguanidine treated rats, one can calculate that only about 40% of the polyamines that are destined for elimination are usually observed in the urine, the other 60% being catabolized along the CuAO-catalysed pathways. The normally observed urinary polyamine pattern gives, therefore, an unsatisfactory picture of the actual polyamine elimination. Although aminoguanidine alone is sufficient to block terminal polyamine catabolism, rats that were treated with a combination of aminoguanidine and MDL 72521 excrete more polyamines than those that received aminoguanidine alone. The reason is that a certain proportion of putrescine, which is formed by degradation of spermidine, is normally reutilized for polyamine biosynthesis. In MDL 72521-treated animals this proportion appears in the urine in the form of N1-acetylspermidine. Thus it is possible to determine polyamine interconversion and re-utilization in vivo and to establish a polyamine balance in intact rats by using specific inhibitors of the CuAO and of polyamine oxidase. PMID- 3977825 TI - Oxidative metabolism of long-chain fatty acids in mitochondria from sheep and rat liver. Evidence that sheep conserve linoleate by limiting its oxidation. AB - Mitochondria isolated from the livers of sheep and rats were shown to oxidize palmitate, oleate and linoleate in a tightly coupled manner, by monitoring the oxygen consumption associated with the degradation of these acids in the presence of 2mM-L-malate. Rat liver mitochondria oxidized linoleate and oleate at a rate 1.2-1.8 times that of palmitate. Sheep liver mitochondria had a specific activity for the oxidation of palmitate that was 50-80% of that of rats and a specific activity for the oxidation of oleate and linoleate that was 30-40% that of rats. This would indicate that sheep conserved linoleate by limiting its oxidation. Carnitine acyltransferase I (CAT I) actively esterified palmitoyl-CoA and linoleate to carnitine in both rat and sheep liver mitochondria, and in both cases the rate for linoleate was faster than for palmitate. The CAT I reaction in both rat and sheep liver was inhibited by micromolar amounts of malonyl-CoA. With 90 microM-palmitoyl-CoA as substrate, CAT I was inhibited by 50% with 2.5 microM malonyl-CoA in rats, and in sheep, 50% inhibition was found with all malonyl-CoA concentrations tested (1-5 microM). With 90 microM-linoleate as substrate for CAT I, a much larger difference in response to malonyl-CoA was seen, the rat enzyme being 50% inhibited at 22 microM-malonyl-CoA, whereas sheep liver CAT I was 91% and 98% inhibited at 1 microM- and 5 microM-malonyl-CoA respectively. We propose that malonyl-CoA may act as an important regulator of beta-oxidation in sheep, discriminating against the use of linoleate as an energy-yielding substrate. PMID- 3977826 TI - Purification, properties and amino acid sequence of a low-Mr abundant seed protein from pea (Pisum sativum L.). AB - The seeds of pea (Pisum sativum L.) contain several proteins in the albumin solubility fraction that are significant components of total cotyledonary protein (5-10%) and are accumulated in developing seeds concurrently with storage-protein synthesis. One of these proteins, of low Mr and designated 'Psa LA', has been purified, characterized and sequenced. Psa LA has an Mr of 11000 and contains polypeptides of Mr 6000, suggesting that the protein molecules are dimeric. The amino acid sequence contains 54 residues, with a high content (10/54) of asparagine/aspartate. It has no inhibitory action towards trypsin or chymotrypsin, and is distinct from the inhibitors of those enzymes found in pea seeds, nor does it inhibit hog pancreatic alpha-amylase. The protein contains no methionine, but significant amounts of cysteine (four residues per polypeptide), suggesting a possible role as a sulphur storage protein. However, its sequence is not homologous with low-Mr (2S) storage proteins from castor bean (Ricinus communis) or rape (Brassica napus). Psa LA therefore represents a new type of low Mr seed protein. PMID- 3977827 TI - Glucocorticoids induce the expression of the uteroglobin gene in rabbit foetal lung explants cultured in vitro. AB - In 27-day-old rabbit foetal lung explants cultured in vitro, the synthesis of the protein uteroglobin decreased progressively during several days of culture. Addition of glucocorticoids to the medium progressively induced the synthesis of uteroglobin in a dose-dependent manner without affecting the synthesis of total proteins. The glucocorticoid-mediated induction of uteroglobin appears mainly due to increased amounts of uteroglobin mRNA and seems to be independent of simultaneous cell proliferation, suggesting a glucocorticoid-triggered differentiation of pre-existing cells. The results suggest a major role of glucocorticoids in the developmental regulation of the uteroglobin gene in the lung. PMID- 3977828 TI - Asbestos-catalysed lipid peroxidation and its inhibition by desferroxamine. AB - In an effort to understand the properties of asbestos fibres that might contribute to their being toxic, we incubated three different varieties of asbestos with phospholipid emulsions and looked for evidence of lipid peroxidation. Although all three types of asbestos were able to catalyse lipid peroxidation in the native state, this catalytic activity was inhibited by pre washing of the asbestos with the iron chelator desferroxamine. This suggests that: lipid peroxidation may be one of the mechanisms by which asbestos produces tissue injury, and treatment with iron chelators might diminish the potential to produce this injury. PMID- 3977829 TI - Substrate specificities of the enzymes of the oleate desaturase system from photosynthetic tissue. AB - In the microsomal fraction from young pea (Pisum sativum L.) leaves, the oleoyl moieties from oleoyl-CoA are principally transferred to the sn-2 position of phosphatidylcholine by oleoyl-CoA:1-acyl-lysophosphatidylcholine acyltransferase. The major product of this acyl transfer is 1-palmitoyl(stearoyl)-2-oleoyl phosphatidylcholine. The 1-palmitoyl(stearoyl)-2-oleoyl phosphatidylcholine is subsequently converted into 1-palmitoyl(stearoyl)-2-linoleoyl phosphatidylcholine by the oleate desaturase complex without equilibrating with the bulk membrane phosphatidylcholine pool. Hence, both the acyl transfer to phosphatidylcholine and the subsequent desaturation of oleoyl moieties occur on the sn-2 position of phosphatidylcholine, and there is also a functional coupling of the acyltransferase and oleate desaturase. PMID- 3977830 TI - Membrane insertion of the microvillar 110-kDa protein of the enterocyte. PMID- 3977831 TI - The role of ADP in the modulation of the calcium-efflux pathway in rat brain mitochondria. AB - The role of ADP in the regulation of Ca2+ efflux in rat brain mitochondria was investigated. ADP was shown to inhibit Ruthenium-Red-insensitive H+- and Na+ dependent Ca2+-efflux rates if Pi was present, but had no effect in the absence of Pi. The primary effect of ADP is an inhibition of Pi efflux, and therefore it allows the formation of a matrix Ca2+-Pi complex at concentrations above 0.2 mM Pi and 25 nmol of Ca2+/mg of protein, which maintains a constant free matrix Ca2+ concentration. ADP inhibition of Pi and Ca2+ efflux is nucleotide-specific, since in the presence of oligomycin and an inhibitor of adenylate kinase ATP does not substitute for ADP, is dependent on the amount of ADP present, and requires ADP concentrations in excess of the concentrations of translocase binding sites. Brain mitochondria incubated with 0.2 mM-Pi and ADP showed Ca2+-efflux rates dependent on Ca2+ loads at Ca2+ concentrations below those required for the formation of a Pi-Ca2+ complex, and behaved as perfect cytosolic buffers exclusively at high Ca2+ loads. The possible role of brain mitochondrial Ca2+ in the regulation of the tricarboxylic acid-cycle enzymes and in buffering cytosolic Ca2+ is discussed. PMID- 3977832 TI - Extracellular and cellular proteins of rat cells with O-glycosidically linked fucose. AB - Fucose-labelled proteins were examined for the release of low-Mr O-linked fucose substituents after mild alkaline-borohydride treatment. A component tentatively identified as glucosylfucitol (DS) and an apparently higher-Mr component (TS), which also contained fucitol, were observed to be released over a broad molecular size range of proteins. Approx. 90% of the DS-releasing proteins were in the particulate fraction, whereas only approx. 66% of the TS-releasing proteins were in that fraction. In addition to cell-associated proteins, a substantial proportion of DS-containing proteins were shed into the medium. For example, after 96 h of labelling there was 6-fold more of these components in the growth medium than were cell-associated. Moreover, the incorporation of labelled fucose into both the DS and TS appeared to be cell-population-density-dependent. Despite the apparent wide distribution of these novel fucose substituents in cellular proteins, it seems reasonable to suggest that they have not been routinely observed largely because each represents less than 0.5% of the fucose bound to protein. PMID- 3977833 TI - Separation and characterization of two populations of aggregating proteoglycans from cartilage. AB - Intermediary gel immunoelectrophoresis was used to show that purified aggregating cartilage proteoglycans from 2-year-old steers contain two distinct populations of molecules and that only one of these is immunologically related to non aggregating cartilage proteoglycans. The two types of aggregating proteoglycans were purified by density-gradient centrifugation in 3.5M-CsCl/4M-guanidinium chloride and separated by zonal rate centrifugation in sucrose gradients. The higher-buoyant-density faster-sedimenting proteoglycan represented 43% of the proteoglycans in the extract. It had a weight-average Mr of 3.5 X 10(6), did not contain a well-defined keratan sulphate-rich region, had a quantitatively dominant chondroitin sulphate-rich region and contained 5.9% protein and 23% hexosamine. The lower-buoyant-density, more slowly sedimenting, proteoglycan represented 15% of the proteoglycans in the extract. It had a weight-average Mr of 1.3 X 10(6), contained both the keratan sulphate-rich and the chondroitin sulphate-rich regions and contained 7.3% protein and 23% hexosamine. Each of the proteoglycan preparations showed only one band on agarose/polyacrylamide-gel electrophoresis. The larger proteoglycan had a lower mobility than the smaller. The distribution of chondroitin sulphate chains along the chondroitin sulphate rich region was similar for the two types of proteoglycans. The somewhat larger chondroitin sulphate chains of the larger proteoglycan could not alone account for the larger size of the proteoglycan. Peptide patterns after trypsin digestion of the proteoglycans showed great similarities, although the presence of a few peptides not shared by both populations indicates that the core proteins are partially different. PMID- 3977834 TI - Leucine and tryptophan metabolism in rats. AB - The rate of tryptophan metabolism in isolated liver cells from animals fed on a high-leucine diet was greater than for cells from control animals. Leucine inhibited tryptophan metabolism and tryptophan uptake in isolated liver cells, probably by competing for membrane transport. Leucine had no effect on tryptophan 2,3-dioxygenase in vitro. 4-Methyl-2-oxovalerate increased tryptophan oxidation in incubations containing albumin, by displacing bound tryptophan and increasing the availability of the amino acid to the cell. The results suggest that, under extreme conditions, when the availability of tryptophan is low, leucine may be pellagragenic. PMID- 3977835 TI - Chain-shortening of erucic acid and microperoxisomal beta-oxidation in rat small intestine. AB - The ability of rat small intestine to chain-shorten C22:1 fatty acids was investigated. Radioactive chain-shortened products, mainly C18:1, were demonstrated in intestinal-lymph lipids after intraluminal injection of [14 14C]erucic acid. Chain-elongation to C24:1 was also observed. Adaptation to a diet containing C22:1 fatty acids (partially hydrogenated-marine-oil diet) slightly increased the percentage of chain-shortened products. Microperoxisomal beta-oxidation activity, measured as CN(-)-insensitive palmitoyl-CoA-dependent NAD+ reduction, was detected in a microperoxisome-enriched fraction from mucosal scrapings. This activity was increased 1.9-fold by a soya-bean-oil diet, and 2.7 fold by a diet containing partially hydrogenated marine oil. PMID- 3977836 TI - Hepatic delta 6-desaturase activity in lean and genetically obese ob/ob mice. AB - Hepatic delta 6-desaturase activity is primarily located in the mitochondrial fraction in mice. Both delta 6- and delta 5-desaturase activities are increased in the liver of young (6-week-old) obese mice. The increase in hepatic delta 6 desaturase activity in obese mice does not occur until weaning. Neither restriction of food intake nor hyperinsulinaemia normalize hepatic delta 6 desaturase activity of obese mice. Both cold acclimation and tri-iodothyronine (30 micrograms/day per kg) decreased hepatic delta 6-desaturase activity of obese mice to levels observed in lean mice, whereas the increase in activity in obese mice was still maintained after the induction of hypothyroidism. PMID- 3977837 TI - The purification and steady-state kinetic behaviour of rabbit heart mitochondrial NAD(P)+ malic enzyme. AB - The mitochondrial NAD(P)+ malic enzyme [EC 1.1.1.39, L-malate:NAD+ oxidoreductase (decarboxylating)] was purified from rabbit heart to a specific activity of 7 units (mumol/min)/mg at 23 degrees C. A study of the reductive carboxylation reaction indicates that this enzymic reaction is reversible. The rate of the reductive carboxylation reaction appears to be completely inhibited at an NADH concentration of 0.92 mM. A substrate saturation curve of this reaction with NADH as the varied substrate describes this inhibition. The apparent kinetic parameters for this reaction are Ka(NADH) = 239 microM and Vr = 1.1 mumol/min per mg at 23 degrees C. The steady-state product-inhibition patterns for pyruvate and NADH indicate a sequential binding of the substrates: NAD+ followed by L-malate. These data also indicate that NADH is the last product released. A steady-state kinetic model is proposed that incorporates NADH-enzyme dead-end complexes. PMID- 3977838 TI - Isolation and characterization of the 1,4-beta-D-glucan glucanohydrolases of Talaromyces emersonii. AB - Culture filtrates of Talaromyces emersonii were found to contain four endocellulases termed I, II, III and IV, the last having the greatest electrophoretic mobility towards the anode in homogeneous 5%-(w/v)-polyacrylamide gels at pH 4.5. All four are glycoproteins, the carbohydrate contents being: I, 27.7%; II, 29.0%; III, 44.7%; IV, 50.8. Each form is eluted as a single peak corresponding to an Mr value of 68000 on gel filtration at pH 3.5 and as a single band corresponding to an Mr value of 35000 on reductive sodium dodecyl sulphate/polyacrylamide-gradient-gel electrophoresis. However, we believe that the latter represents the native Mr value. The pI values for each lie between pH 2.8 and 3.2. Activity in each case is optimal at pH 5.5-5.8 and at 75-80 degrees C. Half-life values at pH5 and 75 degrees C were from 2 to 4h. The specific activity with any individual substrate was much the same for each enzyme, as was the ratio of activity from one substrate to the next. Possible reasons for the observation that plots of velocity versus substrate concentration are sigmoidal are discussed. We believe that the finding of four endocellulases reflects differential glycosylation of a single enzyme form rather than genetically determined differences in primary structure. PMID- 3977839 TI - Glutathione S-transferases of human brain. Evidence for two immunologically distinct types of 26500-Mr subunits. AB - Human brain contains one cationic (pI8.3) and two anionic (pI5.5 and 4.6) forms of glutathione S-transferase. The cationic form (pI8.3) and the less-anionic form (pI5.5) do not correspond to any of the glutathione S-transferases previously characterized in human tissues. Both of these forms are dimers of 26500-Mr subunits; however, immunological and catalytic properties indicate that these two enzyme forms are different from each other. The cationic form (pI8.3) cross reacts with antibodies raised against cationic glutathione S-transferases of human liver, whereas the anionic form (pI5.5) does not. Additionally, only the cationic form expresses glutathione peroxidase activity. The other anionic form (pI4.6) is a dimer of 24500-Mr and 22500-Mr subunits. Two-dimensional gel electrophoresis demonstrates that there are three types of 26500-Mr subunits, two types of 24500-Mr subunits and two types of 22500-Mr subunits present in the glutathione S-transferases of human brain. PMID- 3977840 TI - Human bronchial leucocyte proteinase inhibitor. Rapid isolation and kinetic analysis with human leucocyte proteinases. AB - Bronchial leucocyte proteinase inhibitor (BLPI) is an 11 000 Mr protein found in human mucous secretions. This inhibitor apparently controls the serine proteinases elastase and cathepsin G, released from extravascular polymorphonuclear leucocytes. A simple, single-step chromatographic procedure for the isolation of BLPI based on its affinity for chymotrypsin was developed. The purified inhibitor was homogeneous by electrophoresis and gel filtration. Amino acid analyses were in close agreement with previous reports, and showed BLPI to be rich in proline and cystine, but lacking histidine. We have further characterized the role of BLPI with respect to human leucocyte elastase and cathepsin G by close examination of the kinetic parameters. Additionally, we have determined the kinetics of association (kon) and dissociation (koff) for BLPI with bovine trypsin and chymotrypsin. Equilibrium dissociation constants (Ki) of 1.87 X 10(-10) M, 4.18 X 10(-9) M, 8.28 X 10(-9) M and 2.63 X 10(-8) M were obtained for human leucocyte elastase, cathepsin G, bovine trypsin and chymotrypsin, respectively. These results are discussed with respect to BLPI's possible function in vivo and its role relative to other inhibitors in bronchial secretions. PMID- 3977841 TI - The rat liver vasoactive intestinal peptide binding site. Molecular characterization by covalent cross-linking and evidence for differences from the intestinal receptor. AB - To identify the molecular components of the vasoactive intestinal peptide (VIP) binding sites in the liver, 125I-labelled VIP was covalently linked to liver membranes by using the cleavable cross-linker dithiobis(succinimidylpropionate). Purified rat liver plasma membranes were incubated with 125I-VIP, washed and treated with 1 mM-cross-linker. Polyacrylamide-gel electrophoresis of membrane proteins followed by autoradiography revealed a major 125I-VIP-protein complex of Mr 51 000. A minor Mr 89 000 complex was also observed. An identical pattern of protein labelling was obtained using crude membranes from rat liver. Labelling of the Mr 51 000 and 89 000 species was specific in that it could be abolished by native VIP, but was unaffected by 1 microM-glucagon and cholecystokinin octapeptide. Densitometric scanning of autoradiographs indicated that the labelling of the two species was abolished by similar low VIP concentrations (0.1 100 nM). It was also reduced by two VIP agonists, peptide histidine isoleucine amide and secretin, with a potency that is 1/7 and 1/200 that of native VIP, respectively. The guanine nucleotide GTP in the concentration range between 10( 7) and 10(-3) M reduces the labelling of the major Mr 51 000 protein and that of the minor Mr 89 000 protein, but with a slightly higher potency. Assuming one molecule of 125I-VIP was bound per molecule of protein, a major Mr 48 000 protein and a minor Mr 86 000 protein were identified as components of the high-affinity VIP binding sites in liver. This contrasts markedly with the pattern of labelling of rat intestinal epithelial membranes, where a Mr 73 000 protein was identified as a high-affinity VIP receptor and a Mr 33 000 protein as a low-affinity VIP binding site [Laburthe, Breant & Rouyer-Fessard (1984) Eur. J. Biochem. 139, 181 187], suggesting structural differences between VIP binding sites in rat liver and intestinal epithelium. PMID- 3977842 TI - Purification and properties of a protein activator of phosphorylated branched chain 2-oxo acid dehydrogenase complex. AB - The protein activator of phosphorylated branched-chain 2-oxo acid dehydrogenase complex was purified greater than 1000-fold from extracts of rat liver mitochondria; the specific activity was greater than 1000 units/mg of protein (1 unit gives half-maximum re-activation of 10 munits of phosphorylated complex). Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis gave two bands (Mr 47700 and 35300) indistinguishable from the alpha- and beta-subunits of the branched-chain dehydrogenase component of the complex. On gel filtration (Sephacryl S-300), apparent Mr was 190000. This and other evidence suggests that activator protein is free branched-chain dehydrogenase; this conclusion is provisional until identical amino acid composition of the subunits has been demonstrated. Activator protein (i.e. free branched-chain dehydrogenase) was inhibited (up to 30%) by NaF, whereas branched-chain complex was not inhibited. There was no convincing evidence for interconvertible active and inactive forms of activator protein in rat liver mitochondria. Activator protein was detected in mitochondria from liver (ox, rabbit and rat) and kidney (ox and rat), but not in rat heart or skeletal-muscle mitochondria. In rat liver mitochondrial extracts, branched-chain complex sedimented with the mitochondrial membranes, whereas activator protein remained in the supernatant. Activator protein re-activated phosphorylated (inactive) particulate complex from rat liver mitochondria, but it did not activate dephosphorylated complex. Liver and kidney, but not muscle, mitochondria apparently contain surplus free branched-chain dehydrogenase, which is bound by the complex with lower affinity than is the branched-chain dehydrogenase intrinsic to the complex. It is suggested that this functions as a buffering mechanism to maintain branched-chain complex activity in liver and kidney mitochondria. PMID- 3977843 TI - Crystallization of cytoplasmic actin in complex with deoxyribonuclease I. AB - Crystals of cytoplasmic (porcine liver) actin in complex with deoxyribonuclease I (DNAase I) were prepared for structural determination by X-ray-diffraction analysis. The crystallization of porcine liver actin-DNAase I complex is preceded by a brief treatment with immobilized trypsin, whereby a C-terminal tri- or di peptide including cysteine-374 is removed from the actin without any noticeable degradation of both proteins as judged by sodium dodecyl-sulphate/polyacrylamide gel electrophoresis. Analysis of the crystals obtained does not reveal any differences in the three-dimensional structure of porcine liver actin from its skeletal compartment at up to 0.6 nm resolution. However, in contrast with crystalline skeletal-muscle actin-DNAase I complex, heavy-atom substitution of crystals of porcine liver actin-DNAase I complex could not be achieved with methyl mercuriacetate. Evidence is presented that, in porcine liver actin, the N terminal cysteine residue is not located at position no. 10, as in skeletal- and smooth-muscle actin, but most probably at position no. 17. Thus, because this site is covered by DNAase I, the cysteine becomes inaccessible to titration with 5,5'-dithiobis-(2-nitrobenzoic acid) after complex-formation with DNAase I. PMID- 3977844 TI - Deoxyribonuclease IV from rat liver chromatin and the excision of apurinic sites from depurinated DNA. AB - Deoxyribonuclease IV, a 5'-3' exonuclease degrading double-stranded DNA from intra-strand nicks, has been purified from the chromatin of rat liver cells. The enzyme, which has an Mr of 58000, excises the apurinic (AP) sites from a depurinated DNA nicked 5' to these AP sites with the chromatin AP endonuclease. The excision is not the result of hydrolysis of the phosphodiester bond 3' to the AP sites since the excision product does not behave as deoxyribose 5-phosphate but as its 2,3-unsaturated derivative. This result suggests that, to remove the AP sites from the DNA nicked by an AP endonuclease, the chromatin deoxyribonuclease IV rather acts as a catalyst of beta-elimination. PMID- 3977845 TI - Comparison of the structure of two cardiac troponin T isoforms. AB - Two isoforms of troponin T have been isolated from bovine cardiac muscle. One isoform has an Mr of 31000 and a pI at about 7.1, the corresponding values for the second isoform being 33000 and 6.5. Both isoforms have identical C- and N terminal sequences, and, according to the data from tryptic-peptide mapping, a similar structure of the central and C-terminal domains. The large N-terminal peptides of troponin T isoforms differ in the content of glutamine/glutamic acid and alanine. It is concluded that the isoform with Mr 33000 has an additional peptide enriched with glutamic acid and alanine that is inserted between the N terminal pentapeptide and the cysteine located 40-60 residues from the N terminus. PMID- 3977846 TI - Comparison of the behaviour in vivo of two molecular forms of antithrombin III. AB - The distribution and rates of catabolism were determined for rabbit antithrombin III (AT) isoforms differing in affinity for heparin-agarose. After isolation from rabbit plasma by heparin-affinity chromatography, the very-high-affinity form, ATvh, was labelled with 131I, and its high-affinity congener, ATh, with 125I. The two forms were separated from free iodine by heparin-affinity chromatography, and then injected simultaneously into young recipient rabbits. The disappearance-of plasma-AT-radioactivity data were fitted to three exponential equations, and the resulting constants were used to calculate fractional catabolic rates and the various pool sizes for ATh and ATvh. The fractions of plasma ATh and ATvh catabolized daily (j3) were 0.763 +/- 0.023 and 1.88 +/- 0.057 day-1 respectively. Average values of jT, the daily fractional catabolic rates for the total-body ATh and ATvh, were 0.2633 +/- 0.0113 and 0.3832 +/- 0.0211 day-1. The ratios, ATh/ATvh, of the sizes of the plasma, non-circulating vascular-associated and extra-vascular compartments were 0.593, 0.990 and 1.30. By using a previous estimate of a 9:1 ATh/ATvh ratio in rabbit plasma and the calculated compartment sizes, the calculated relative ratio of ATh to ATvh was 5.4:1 in the non circulating vascular-associated compartment. The data fit a model of antithrombin III distribution and catabolism in which a pool of endothelial-cell heparin-like receptors is seen to mediate the transfer of the inhibitor from plasma to interstitium with catabolism serving as an alternative to this transport. PMID- 3977847 TI - Increased loss and decreased synthesis of hepatic glutathione after acute ethanol administration. Turnover studies. AB - The effect of acute ethanol administration on rates of synthesis and utilization of hepatic glutathione (GSH) was studied in rats after a pulse of [35S]cysteine. A 35% decrease in hepatic GSH content 5h after administration of 4 g of ethanol/kg body wt. was accompanied by a 33% increase in the rate of GSH utilization. The decrease occurred without increases in hepatic oxidized glutathione (GSSG) or in the GSH/GSSG ratio. The rate of non-enzymic condensation of GSH with acetaldehyde could account for only 6% of the rate of hepatic GSH disappearance. The increased loss of [35S]GSH induced by ethanol was not accompanied by an increased turnover; rather, a 30% inhibition of GSH synthesis balanced the increased rate of loss, leaving the turnover rate unchanged. The rate of acetaldehyde condensation with cysteine in vitro occurred at about one third of the rate of GSH loss in ethanol-treated animals. However, ethanol induced only a minor decrease in liver cysteine content, which did not precede, but followed, the decrease in GSH. The characteristics of 2-methylthiazolidine-4 carboxylic acid, the condensation product between acetaldehyde and cysteine, were studied and methodologies were developed to determine its presence in tissues. It was not found in the liver of ethanol-treated animals. Ethanol administration led to a marked increase (47%) in plasma GSH in the post-hepatic inferior vena cava, but not in its pre-hepatic segment. Data suggest that an increased loss of GSH from the liver constitutes an important mechanism for the decrease in GSH induced by ethanol. In addition, an inhibition of GSH synthesis is observed. PMID- 3977848 TI - Investigation of the effect of metal ions on the reactivity of thiol groups in human 5-aminolaevulinate dehydratase. AB - The reaction of human 5-aminolaevulinate dehydratase with 5,5'-dithiobis-(2 nitrobenzoic acid) (Nbs2) results in the release of 4 molar equivalents of 5 mercapto-2-nitrobenzoic acid (Nbs) per subunit. Two of the thiol groups reacted very rapidly (groups I and II), and their rate constants were determined by stopped-flow spectrophotometry; the other two thiol groups (groups III and IV) were observed by conventional spectroscopy. Titration of the enzyme with a 1 molar equivalent concentration of Nbs2 resulted in the release of 2 molar equivalents of Nbs and the concomitant formation of an intramolecular disulphide bond between groups I and II. Removal of zinc from the holoenzyme increased the reactivity of groups I and II without significantly affecting the rate of reaction of the other groups. The reactions of the thiol groups in both the holoenzyme and apoenzyme were little affected by the presence of Pb2+ ions at concentrations that strongly inhibit the enzyme, suggesting that Zn2+ and Pb2+ ions may have independent binding sites. Protein fluorescence studies with Pb2+ and Zn2+ have shown that the binding of both metal ions results in perturbation of the protein fluorescence. PMID- 3977850 TI - Relations between high-affinity binding sites of markers for binding regions on human serum albumin. AB - Binding of warfarin, digitoxin, diazepam, salicylate and Phenol Red, individually or in different pair combinations, to defatted human serum albumin at ligand/protein molar ratios less than 1:1 was studied at pH 7.0. The binding was determined by ultrafiltration. Some of the experiments were repeated with the use of equilibrium dialysis in order to strengthen the results. Irrespective of the method used, all ligands bind to one high-affinity binding site with an association constant in the range 10(4)-10(6) M-1. High-affinity binding of the following pair of ligands took place independently: warfarin-Phenol Red, warfarin diazepam, warfarin-digitoxin and digitoxin-diazepam. Simultaneous binding of warfarin and salicylate led to a mutual decrease in binding of one another, as did simultaneous binding of digitoxin and Phenol Red. Both effects could be accounted for by a coupling constant. The coupling constant is the factor by which the primary association constants are affected; in these examples of anti co-operativity the factor has a value between 0 and 1. In the first example it was calculated to be 0.8 and in the latter 0.5. Finally, digitoxin and salicylate were found to compete for a common high-affinity binding site. The present findings support the proposal of four separate primary binding sites for warfarin, digitoxin (and salicylate), diazepam and Phenol Red. An attempt to correlate this partial binding model for serum albumin with other models in the literature is made. PMID- 3977849 TI - Calcium and calmodulin in the regulation of human thyroid adenylate cyclase activity. AB - TSH (thyrotropin)-stimulated human thyroid adenylate cyclase has a biphasic response to Ca2+, being activated by submicromolar Ca2+ (optimum 22nM), with inhibition at higher concentrations. Calmodulin antagonists caused an inhibition of TSH-stimulated adenylate cyclase in a dose-dependent manner. Inhibition of TSH and TSIg-(thyroid-stimulating immunoglobulins)-stimulated activity was more marked than that of basal, NaF- or forskolin-stimulated activity. This inhibition was not due to a decreased binding of TSH to its receptor. Addition of pure calmodulin to particulate preparations of human non-toxic goitre which had not been calmodulin-depleted had no effect on adenylate cyclase activity. EGTA was ineffective in removing calmodulin from particulate preparations, but treatment with the tervalent metal ion La3+ resulted in a loss of up to 98% of calmodulin activity from these preparations. Addition of La3+ directly to the adenylate cyclase assay resulted in a partial inhibition of TSH- and NaF-stimulated activity, with 50% inhibition produced by 5.1 microM and 4.0 microM-La3+ respectively. Particulate preparations with La3+ showed a decrease of TSH- and NaF-stimulated adenylate cyclase activity (approx. 40-60%). In La3+-treated preparations there was a decrease in sensitivity of TSH-stimulated adenylate cyclase to Ca2+ over a wide range of Ca2+ concentrations, but most markedly in the region of the optimal stimulatory Ca2+ concentration. In particulate preparations from which endogenous calmodulin had been removed by La3+ treatment, the addition of pure calmodulin caused an increase (73 +/- 22%; mean +/- S.E.M., n = 8) in TSH-stimulated thyroid adenylate cyclase activity. This was seen in 8 out of 13 experiments. PMID- 3977851 TI - Effect of glycyl-L-phenylalanine 2-naphthylamide on invertase endocytosed by rat liver. AB - The release by glycyl-L-phenylalanine 2-naphthylamide (Gly-L-Phe-2-NNap) of endocytosed invertase associated with the MLP fraction (sum of the M, L and P fractions [de Duve, Pressman, Gianetto, Wattiaux & Appelmans (1955) Biochem. J. 63, 604-617]) of rat liver was investigated and compared with the release of cathepsin C. The percentage of invertase released increases with time after the enzyme injection, whereas the release of cathepsin C is not influenced by this treatment and corresponds to 85-90% of the total activity of the enzyme. It takes about 2h to attain a similar release of both enzymes. The quantity of invertase releasable or not by Gly-L-Phe-2-NNap was plotted against the time after the injection. Results agree well with the hypothesis that unreleasable invertase is associated with a pre-lysosomal compartment, whereas releasable invertase is present in lysosomes. A kinetic analysis indicates that invertase enters the pre lysosomal compartment with a zero-order rate constant of 0.48 unit/min per g fresh wt., and leaves this compartment with a first-order rate constant of 0.042 min-1. PMID- 3977852 TI - The use of monoclonal antibodies to study the proteins specified by the transforming region of human adenoviruses. AB - Monoclonal antibodies against two of the proteins specified by one of the transforming genes (early region 1B) of human adenovirus type 2 have been produced and characterized. Two clones (RA1 and PA6), generated by fusion of mouse myeloma NSO cells with splenocytes from rats immunized with whole-cell lysates of an adenovirus-transformed rat cell line (F19), secreted antibodies against a 58 kDa protein. Another clone (DC1) produced antibodies against the same protein, and resulted from fusion of immune rat splenocytes with the rat myeloma Y3.Ag.1.2.3. Immunoprecipitation studies showed that all three antibodies recognized [35S]-methionine-labelled 58 kDa protein, and phosphorylated derivatives of the 58 kDa protein labelled with [32P]orthophosphate present in infected human cells. One clone (EC3) produced antibody against a 19 kDa protein also encoded by early region 1B, but not sharing sequence homology with 58 kDa. The identity of the 19 kDa protein recognized by the EC3 antibody was established by immunoprecipitation from lysates of labelled-infected cells and from products of cell-free translation directed by mRNA isolated from adenovirus 2-infected cells. Indirect immunofluorescent-antibody staining of infected human cells using the RA1 and EC3 antibodies revealed a nuclear location of the 58 kDa protein and a mainly cytoplasmic location of the 19 kDa protein. PMID- 3977853 TI - A mouse gene family associated with a major submaxillary-gland glycoprotein. AB - A gene family encoding msp36 (mouse submaxillary protein 36), a major product of the mouse submaxillary gland, was shown by Southern analysis and genomic cloning to contain approx. 10 related genes. Heteroduplex mapping has elucidated the structure of one of the genes. Close physical linkage of four of the genes in this family has been demonstrated by the use of specific oligonucleotide probes. PMID- 3977854 TI - Mechanism of depolarization of rat cortical synaptosomes at submicromolar external Ca2+ activity. The use of Ca2+ buffers to control the synaptosomal membrane potential. AB - Rat cortical synaptosomes responded to a reduction of external Ca2+ from pCa 3.5 to pCa 4.8 in the absence of MgCl2 with a slight decrease of internal K+ and an increase of Na+. The effects were prevented by tetrodotoxin or millimolar concentrations of MgCl2. Further lowering of external pCa to 7.7 with N hydroxyethylethylenediaminetriacetate evoked a rapid fall of internal K+, which was specifically blocked by Ruthenium Red; tetrodotoxin and nifedipine were ineffective. A linear relationship was established between K+ and methyltriphenylphosphonium cation distribution ratios by varying external pCa between 4.8 and 7.7, indicating that K+ efflux resulted from a depolarization of the plasma membrane. An increase of Na+ permeability was suggested by the synaptosomes' gain of Na+ and the disappearance of the depolarization in an Na+ free sucrose medium. According to the constant field equation, the permeability ratio PNa/PK increased from 0.029 at pCa4.8 to 0.090 at pCa 7.7 with plasma membrane potentials of -74mV and -47mV, respectively. Since the plasma membrane responded to variation of external Ca2+ activities in the micromolar range with a graded and sustained depolarization, the use of Ca2+ buffers to control membrane potentials is suggested. PMID- 3977856 TI - Resolution and reconstitution of bovine kidney branched-chain 2-oxo acid dehydrogenase complex. AB - Branched-chain 2-oxo acid dehydrogenase complex was resolved into component E1 and E2-kinase subcomplex by gel filtration in the presence of 1 M-NaC1. Essentially all the original activity of the complex can be regained after reconstitution of the component enzymes, reassociation being a rapid process. The specific activities of E1 and E2 were 25.1 and 19.0 units/mg respectively. Non phosphorylated active E1 has an approx. 6-fold higher affinity for E2 than does phosphorylated E1. The components of the branched-chain 2-oxo acid dehydrogenase complex do not crossreact with the respective components from the pyruvate dehydrogenase complex. The significance of these results and of the tight association of the kinase with E2 are discussed. PMID- 3977855 TI - The effects of 17 alpha-ethynyloestradiol and of acute inflammation on the plasma concentration of rat alpha 1-acid glycoprotein and on the induction of its hepatic mRNA. AB - We measured the serum concentration of alpha 1-acid glycoprotein (alpha 1-AGP) and we evaluated the content of its hepatic mRNA in rats after 17 alpha ethynyloestradiol treatment or after turpentine-induced acute inflammation, or after both treatments performed simultaneously. We have also studied the affinity of serum alpha 1-AGP for concanavalin A under these conditions. Both types of stimuli induce a marked retention of the glycoprotein on free concanavalin A. The serum concentration of alpha 1-AGP is increased about 14-fold compared with that in control rats when a single pharmacological dose (50 micrograms) or multiple injections of 17 alpha-ethynyloestradiol are administered. This increase is greater in turpentine-oil-injected rats (about 21-fold) and reaches a maximum (about 32-fold) in rats injected with 17 alpha-ethynyloestradiol plus turpentine oil; this increase in alpha 1-AGP corresponds to the addition of the effects of the two inducing agents. Similar changes are also observed either in the alpha 1 AGP mRNA content as estimated by using an alpha 1-AGP-specific cDNA probe, or in the amount of translatable alpha 1-AGP mRNA. The results indicate that: after a high dose of 17 alpha-ethynyloestradiol and after acute inflammation, the increase of the alpha 1-AGP serum concentration is due to an accumulation of the alpha 1-AGP mRNA; different mechanisms and/or pathways are probably involved in regulating the synthesis of alpha 1-AGP under various stimuli; 17 alpha ethynyloestradiol as well as acute inflammation seem to control the glycosylation process of alpha 1-AGP in an identical manner. PMID- 3977857 TI - Branched-chain amino acid metabolism and alanine formation in rat muscles in vitro. Mitochondrial-cytosolic interrelationships. AB - Muscle branched-chain amino acid metabolism is coupled to alanine formation via branched-chain amino acid aminotransferase and alanine aminotransferase, but the subcellular distributions of these and other associated enzymes are uncertain. Recovery of branched-chain aminotransferase in the cytosol fraction after differential centrifugation was shown to be accompanied by leakage of mitochondrial-matrix marker enzymes. By using a differential fractional extraction procedure, most of the branched-chain aminotransferase activity in rat muscle was located in the mitochondrial compartment, whereas alanine aminotransferase was predominantly in the cytosolic compartment. Phosphoenolpyruvate carboxykinase, like aspartate aminotransferase, was approximately equally distributed between these subcellular compartments. This arrangement necessitates a transfer of branched-chain amino nitrogen and carbon from the mitochondria to the cytosol for alanine synthesis de novo to occur. In incubations of hemidiaphragms from 48 h-starved rats with 3mM-valine or 3mM glutamate, the stimulation of alanine release was inhibited by 69% by 1 mM aminomethoxybut-3-enoate, a selective inhibitor of aspartate aminotransferase. Leucine-stimulated alanine release was unaffected. These data implicate aspartate aminotransferase in the transfer of amino acid carbon and nitrogen from the mitochondria to the cytosol, and suggest that oxaloacetate, via phosphoenolpyruvate carboxykinase, can serve as an intermediate on the route of pyruvate formation for muscle alanine synthesis. PMID- 3977858 TI - Determination of acetylcholinesterase activity by a new chemiluminescence assay with the natural substrate. AB - A chemiluminescence method for determining acetylcholinesterase activity is described. It is an adaptation of the chemiluminescence assay of acetylcholine described by Israel & Lesbats [(1981) Neurochem. Int. 3, 81-90; (1981) J. Neurochem. 37, 1475-1483]. The acetylcholinesterase activity is measured by monitoring the increase in light emission produced by the accumulation of choline or by determining the amount of choline generated after a short interval. The assay is rapid and sensitive, and uses the natural substrate of the enzyme. Kinetic data obtained with this procedure for acetylcholinesterase from Torpedo and Electrophorus electric organs were comparable with those obtained by using the method of Ellman, Courtney, Andres & Featherstone [(1961) Biochem. Pharmacol. 7, 88-95]. In addition, it was shown that sodium deoxycholate totally inactivated Torpedo acetylcholinesterase but not the Electrophorus enzyme. Competitive inhibitors of acetylcholinesterase protected the enzyme from inactivation. PMID- 3977859 TI - An inhibitor of ornithine decarboxylase in the thymus and spleen of dexamethasone treated rats. AB - A marked decrease in activity of ornithine decarboxylase in thymus and spleen occurs soon after treatment of rats with a glucocorticoid. In the present study, evidence was obtained that extracts of these tissues prepared 5 h after administration of dexamethasone, when the enzyme activity is very low, contain an inhibitor of ornithine decarboxylase. The inhibitor is also present at 12 h after treatment and, in lesser amount, at 2.5 h, but was not evident at 24 h. The inhibitory activity was destroyed by treatment with heat or with trypsin, and was not lost on dialysis of the extract. Preliminary experiments indicate that the Mr of the inhibitor is greater than 50 000, which differentiates it from antizyme, an inhibitor of ornithine decarboxylase found in several other cell types. The inhibitor seems to act by a non-catalytic and non-competitive mechanism. The inhibition is dependent on the amount of inhibitor and does not change with time. Since inhibition is not changed by dialysis of the inhibitory extract, its activity apparently does not require small-Mr substances. This differentiates it from inhibitors which inactivate ornithine decarboxylase by covalent modification, such as the polyamine-dependent protein kinase or transglutaminase. The formation of this inhibitor is an early event in lymphoid tissues in response to dexamethasone and may be important in causing the inhibition of cell division which precedes the destruction of lymphocytes. PMID- 3977860 TI - Evaluation of the extent of heterogeneity in the Glycera dibranchiata monomer haemoglobin fraction by the use of n.m.r. and ion-exchange chromatography. AB - The coelomic haemoglobin of Glycera dibranchiata is known to be separable into monomeric and higher-Mr fractions. Although exhibiting homogeneity with respect to Mr, the extent of haemoglobin heterogeneity for the monomer fraction has never been adequately assayed. In the present paper we demonstrate that there exists in the monomer haemoglobin fraction reproducibly detectable heterogeneity regardless of the presence or absence of proteinase inhibitors during the isolations. These results show that, considered on the same time scale as previous preparations used for amino acid sequencing, crystallography and kinetics, the monomer haemoglobin fraction is highly heterogeneous. Application of ion-exchange chromatography and ion-filtration methods resulted in the isolation of four resolvable haem protein components from the Glycera monomer haemoglobin fraction. Three of these components were isolated in sufficient quantity to employ proton n.m.r. as a successful analytical tool for discriminating the individual haemoglobins. These results are not surprising. Several previous studies indicated less extensive heterogeneity in the monomer fraction. Moreover, the ability of the Glycera monomer haemoglobin to bind oxygen at even quite low partial pressures has been attributed to functional diversity originating in multiple haemoglobin components. The present work reveals the extent of the haemoglobin heterogeneity. The results show that it is more extensive than previously believed. Examination of this monomer fraction is particularly important, since crystallography indicates that one of the components of the monomer fraction lacks the E-7 (distal) histidine residue. As a consequence, the identification of such extensive heterogeneity is important to many previously published ligand-binding studies. PMID- 3977861 TI - Purification and properties of S-adenosylmethionine: aldoxime O-methyltransferase from Pseudomonas sp. N.C.I.B. 11652. AB - An enzyme catalysing the O-methylation of isobutyraldoxime by S-adenosyl-L methionine was isolated from Pseudomonas sp. N.C.I.B. 11652. The enzyme was purified 220-fold by DEAE-cellulose chromatography, (NH4)2SO4 fractionation, gel filtration on Sephadex G-100 and chromatography on calcium phosphate gel. Homogeneity of the enzyme preparation was confirmed by isoelectric focusing on polyacrylamide gel and sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. The enzyme showed a narrow pH optimum at 10.25, required thiol protecting agents for activity and was rapidly denatured at temperatures above 35 degrees C. The Km values for isobutyraldoxime and S-adenosyl-L-methionine were respectively 0.24 mM and 0.15 mM. Studies on substrate specificity indicated that attack was mainly restricted to oximes of C4-C6 aldehydes, with preference being shown for those with branching in the 2- or 3-position. Ketoximes were not substrates for the enzyme. Gel filtration on Sephadex G-100 gave an Mr of 84 000 for the intact enzyme, and sodium dodecyl sulphate/polyacrylamide-gel electrophoresis indicated an Mr of 37 500, suggesting the presence of two subunits in the intact enzyme. S-Adenosylhomocysteine was a powerful competitive inhibitor of S-adenosylmethionine, with a Ki of 0.027 mM. The enzyme was also susceptible to inhibition by thiol-blocking reagents and heavy-metal ions. Mg2+ was not required for maximum activity. PMID- 3977862 TI - The metabolism of sialic acids in isolated rat colonic mucosal cells. AB - The activities of ten enzymes involved in sialic acid metabolism were measured in colonic mucosal cells from rats and compared with those in liver. A methodology was devised that enabled all ten enzyme activities to be evaluated in a single rat colon preparation. Enzyme assays with radioactively labelled substrates were developed for maximum sensitivity, and the identification of substrates and products was carefully checked to assess the contribution of contaminants to enzyme reactions with low activity. The activities of most enzymes involved in the biosynthesis of N-acetyl-D-neuraminic acid (NeuAc) from UDP-N-acetyl-D glucosamine were found to be more than 20-fold lower than those in liver. The activities of CMP-NeuAc synthase, N-acetyl-D-glucosamine 2-epimerase, N-acetyl-D glucosamine kinase, sialyltransferase and sialidase were similar to or 2-4-fold lower than in liver. The biosynthesis of NeuAc via its 9-phosphate was demonstrated in the 100 000 g supernatant of colonic-cell homogenates by enzymic assay and precursor experiments with N-acetyl[14C]-mannosamine. No alternative route for NeuAc formation could be detected. The 100 000g supernatant fractions of liver, kidney and colonic mucosal cells utilized N-acetyl[14C]mannosamine with differing efficiencies. Radioactive products identified as sialic acid biosynthetic intermediates amounted to 49%, 0.04% and 5.6% of added precursor in liver, kidney and colon respectively. Catabolism of labelled precursor to non hexosamine products was high in kidney and colonic mucosal-cell fractions. PMID- 3977863 TI - Intracellular DNA damage produced by a series of diacridines. AB - The intracellular DNA damage produced by a series of diacridines after a 2 h pulse treatment of L1210 cells in culture was investigated by using the alkaline elution technique. Like other intercalating agents, diacridines produce single strand breaks and protein-DNA links. There is a large increase in both types of damage as the alkane chain linking the two 9-aminoacridine residues is increased beyond five methylene groups, which is consistent with the previously observed change from monofunctional to bifunctional intercalation [Wakelin, Romanos, Chen, Glaubiger, Canellakis & Waring (1978) Biochemistry 17, 5057-5063]. For linker chains of less than six methylene groups these agents produce less DNA damage than does the parent 9-aminoacridine at the same drug concentration. Unlike the monofunctional intercalators previously investigated [Ross, Glaubiger & Kohn (1979) Biochim. Biophys. Acta 562, 41-50; Zwelling, Michaels, Erickson, Ungerleider, Nichols & Kohn (1981) Biochemistry 20, 6553-6563; Zwelling, Kerrigan & Michaels (1982) Cancer Res. 42, 2687-2691; Zwelling, Michaels, Kerrigan, Pommier & Kohn (1982) Biochem. Pharmacol. 31, 3261-3267], there is no correlation between the number of single-strand breaks and protein-DNA links produced by these diacridines. PMID- 3977864 TI - Effects of thyroid hormone on mitochondrial oxidative phosphorylation. AB - In order to locate sites of action of thyroid hormone on mitochondrial oxidative phosphorylation we have used an experimental application of control analysis as previously described [Groen, Wanders, Westerhoff, Van der Meer & Tager (1982) J. Biol. Chem. 257, 2754-2757]. Rat-liver mitochondria were isolated from hypothyroid rats or from hypothyroid rats 24 h after treatment with a single dose of 3,3',5-triiodothyronine (T3). The amount of control exerted by four different steps on State-3 respiration with succinate as respiratory substrate was quantified by using specific inhibitors. The hormone treatment resulted in an increase in the flux control coefficient of the adenine nucleotide translocator, the dicarboxylate carrier and cytochrome c oxidase and a decrease in the flux control coefficient of the bc1-complex. The results of this analysis indicate that thyroid hormone treatment results in an activation of the bc1-complex and of at least one other enzyme, possibly succinate dehydrogenase. Measurement of the extramitochondrial ATP/ADP ratio at different rates of respiration (induced by addition of different amounts of hexokinase in the presence of glucose and ATP) showed that the adenine nucleotide translocator operates at a higher (ATP/ADP)out after T3 treatment, which supports previous reports on stimulation of this step by thyroid hormone. PMID- 3977865 TI - Complement-subcomponent-C1-inhibitor synthesis by human monocytes. AB - By using a radioimmunoassay, C1-inhibitor was found to accumulate in the supernatants of human monocyte cultures. The production of this protein was inhibited reversibly by cycloheximide. When C1-inhibitor synthesis was compared with C2 synthesis, it was found that C1-inhibitor synthesis continued, whereas synthesis of C2 appeared to cease after about 7 days in culture. Immunoprecipitation of supernatants of monocyte cultures that had been pulsed with [35S]methionine showed a specific band with an Mr of 105 000. Immunoprecipitates of the lysates revealed a band of Mr 83 000; this was thought to represent a partially or non-glycosylated precursor of C1-inhibitor. C1 inhibitor produced by the monocytes was shown, by using a haemolytic assay, to be functionally active. However, the functional activity of C1-inhibitor was reduced by only 44% in the presence of cycloheximide, whereas the concentration of this protein in cycloheximide-treated culture supernatants fell by more than 93%. This finding suggests that monocytes secrete a second molecule, which inhibits C1 activity but is distinct from classical C1-inhibitor. PMID- 3977866 TI - Calcium efflux and cycling across the synaptosomal plasma membrane. AB - Ca2+ efflux from intact synaptosomes is investigated. Net efflux can be induced by returning synaptosomes from media with elevated Ca2+ or high pH to a normal medium. Net Ca2+ efflux is accelerated when the Na+ electrochemical potential gradient is collapsed by veratridine plus ouabain. Under steady-state conditions at 30 degrees C, Ca2+ cycles across the plasma membrane at 0.38 nmol . min-1 . mg 1 of protein. Exchange is increased by 145% by veratridine plus ouabain, both influx and efflux being increased. Increased influx is probably due to activation of voltage-dependent Ca2+ channels, since it is abolished by verapamil. The results indicate that, at least under conditions of low Na+ electrochemical gradient, some pathway other than a Na+/Ca2+ exchange must operate in the plasma membrane to expel Ca2+. PMID- 3977868 TI - Kinetic study of the photochemical changes of (ZZ)-bilirubin IX alpha bound to human serum albumin. Demonstration of (EZ)-bilirubin IX alpha as an intermediate in photochemical changes from (ZZ)-bilirubin IX alpha to (EZ)-cyclobilirubin IX alpha. AB - The present study was performed to elucidate why the photochemical reaction of (ZZ)-bilirubin bound to human serum albumin is singularly selective, and only one of the two (EZ)- and (ZE)-bilirubins, the (ZE)-isomer, is produced. In a kinetic study of the photochemical reaction in vitro, the sum of the relative rate constants of photochemical transformation of (EZ)-bilirubin into both (EZ) cyclobilirubin and (ZZ)-bilirubin, with a significant preference for the former, was proved to be considerably larger than that of the transformation of (ZZ) bilirubin into (EZ)-bilirubin. Therefore only one of the geometrical isomers, namely (ZE)-bilirubin, is apparently formed. It was concluded that (EZ)-bilirubin photochemically undergoes (EZ)-cyclization, i.e. structural photoisomerization, while bound to its high-affinity site on human serum albumin, and is an intermediate in the transformation of (ZZ)-bilirubin into (EZ)-cyclobilirubin. PMID- 3977867 TI - Human liver cathepsin L. AB - Cathepsin L was purified to apparent homogeneity from human liver obtained post mortem. It was necessary to treat the homogenate at pH 4.2 and 37 degrees C to release active enzyme. The purification procedure involved ion-exchange chromatography on carboxymethyl-Sephadex and the Mono S column of a Pharmacia fast-protein-liquid-chromatography system. The enzyme was found to consist of two polypeptide chains of Mr 25 000 and 5000. The larger chain was shown to contain the active-site cysteine residue. Human cathepsin L proved to be similar to the rat and rabbit enzymes in regard to kinetic constants for the substrate benzyloxycarbonylphenylalanylarginine 7-(4-methyl)coumarylamide and rates of inactivation by the active-site-directed reagents benzyloxycarbonylphenylalanylphenylalanyldiazomethane and benzyloxycarbonylphenylalanylalanyldiazomethane. Thus clear characteristics of cathepsin L are now emerging, and these should simplify the identification of the enzyme in other tissues and species. PMID- 3977869 TI - Macromolecules released into the culture medium during the vegetative cell cycle of the unicellular green alga Chlamydomonas reinhardii. AB - The culture medium of growing Chlamydomonas reinhardii cells contains hydroxyproline-rich glycoproteins, which are mainly liberated during release of the zoospores from the mother-cell wall. Pulse-labelling studies with [3H]proline and [35S]methionine have been performed in order to detect the protein components released by synchronously growing cells at different stages of the cell cycle. When either [3H]proline or [35S]methionine were applied during the phase of cell growth, radioactive label appeared in the released macromolecules after a lag period of 40 min, whereas incorporation into the insoluble part of the cell wall was delayed only by 20 min. When applied at the end of the growth phase, e.g. 13 h after beginning of the illumination period, the radioactive amino acids were incorporated into the cell wall, but radioactive labelling of macromolecules released into the culture medium could not be detected before the zoospores were liberated from the mother-cell wall. Maximal incorporation of [3H]proline and [35S]methionine into the insoluble part of the cell wall was observed during cell division, but essentially no radioactively-labelled macromolecules were released into the culture medium during this time period. Analysis of the macromolecules, which were liberated during cell enlargement, by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis revealed distinct radioactive bands, which were differentially labelled with [3H]proline and [35S]methionine. Among the macromolecules released into the culture medium during cell growth, a component of an apparent Mr 35 000 was preferentially labelled with [3H]proline. This component was also detected after labelling with [35S]methionine, but components of an apparently higher Mr were more prominent after labelling with [35S]methionine. Macromolecules released during the cell-enlargement period of synchronously growing cultures in the presence of [3H]proline contained radioactively-labelled hydroxyproline in addition to proline. These results show that, during cell-wall growth, specific protein components are released into the culture medium and that at least one of these components contains large amounts of proline and hydroxyproline. At least some of these macromolecules seem to be constituents of the cell wall, because during pulse-chase experiments radioactively-labelled macromolecules appeared in the culture medium mainly during the time period when the specific radioactivity of the insoluble inner cell-wall layer decreased. PMID- 3977870 TI - A kinetic study of glycerophosphate acyltransferase of rat adipocytes in relation to its control by noradrenaline. AB - Glycerophosphate acyltransferase present in an extract of rat adipocytes is strongly inhibited by excess palmitoyl-CoA. This inhibition is released by serum albumin but an excess of serum albumin is inhibitory, particularly at low palmitoyl-CoA concentrations. An optimal activity is reached when the ratio palmitoyl-CoA/albumin is in the range of 3-6. In the absence of albumin, oleic acid inhibits the activity at all palmitoyl-CoA concentrations. This inhibition is released by albumin and, inversely, oleic acid releases the inhibition by high concentrations of albumin. Another effect of fatty acids is to favour the inactivation of the glycerophosphate acyltransferase in extracts of adipocytes kept at 0 degree C. This inactivation is time-dependent and cannot be reversed by the addition of albumin to the assay mixture. Treatment of adipocytes with noradrenaline had no effect on the activity of the enzyme as long as the cells had been separated from fatty acids and albumin. With extracts of unwashed cells, the effect of noradrenaline on both the activity and stability of glycerophosphate acyltransferase could be explained by the presence of fatty acids in the extract. PMID- 3977872 TI - Integrated rate equations for irreversible enzyme-catalysed first-order and second-order reactions. AB - Integrated rate equations are presented that describe irreversible enzyme catalysed first-order and second-order reactions. The equations are independent of the detailed mechanism of the reaction, requiring only that it be hyperbolic and unbranched. The results should be directly applicable in the laboratory. PMID- 3977871 TI - Digitonin perfusion of rat liver. A new approach in the study of intra-acinar and intracellular compartmentation in the liver. AB - Perfusing a rat liver with digitonin in the concentration range 2-20 mg/ml results in complete decolorization of the organ within 45-250 s. Decolorization progresses with time in the direction of flow, and it is therefore possible, by collecting the eluate, to obtain material from specific intracellular compartments of hepatocytes in different zones in the microcirculatory unit of the liver. The results demonstrate that cytoplasmic marker enzymes from periportal or perivenous hepatocytes can be collected with as little contamination from the other compartment as is obtained in micro-dissection studies. Furthermore, a fraction enriched in mitochondrial marker enzymes can be achieved with only 10-20% contamination by cytoplasmic material. PMID- 3977873 TI - Starvation and feeding with a high-carbohydrate diet induce changes in the specific activity of rat hepatic pyruvate kinase. AB - A highly specific radiosandwich assay for hepatic type-L pyruvate kinase (PK) determinants was developed. This assay was used to evaluate changes in PK specific activity which occur on starvation or feeding with a high-carbohydrate diet. Despite a large increase in both catalytic activity and immunoreactive protein, the calculated specific activity falls on feeding, and the opposite effect occurs on starvation. These change can be attributed to disproportionate changes in immunoreactive protein compared with changes in catalytic activity. PMID- 3977874 TI - Synthesis of chain elongation-desaturation products of linoleic acid by liver and brain microsomes during development of the pig. AB - Microsomes isolated from liver and brain tissue were assayed to examine transitions in metabolic capability to synthesize chain elongation-desaturation products of C18:2(9,12) during the perinatal development of the pig. Microsomal synthesis of trienes, tetraenes and pentaenes was compared for fetal, neonatal and postnatal piglets. Rates of synthesis of tetraenes and pentaenes by chain elongation-desaturation of C18:2(9,12) were greatest in liver. During the later half of gestation, the capability to synthesize tetraenes increased 2-3-fold on a per mg of microsomal protein basis. Increase in the capacity to synthesize tetraenes suggests a significant transition in the activity of delta 5 desaturase during the last half of gestation. For brain, synthesis of C22:5(4,7,10,13,16) from C18:2(9,12) was greatest at term. These observations indicate that in liver and brain the capability to chain elongate-desaturate C18:2(9,12) to longer chain homologues increases significantly during early development. It is suggested that during gestation the activity of the delta 5 desaturase limits synthesis of C20 and C22 homologues of C18:2(9,12). The metabolic conversion of C20 and C22 fatty acids by chain elongation of C20:4(5,8,11,14) does not appear to limit the synthesis of very long chain homologues of linoleic acid in fetal liver or brain. PMID- 3977875 TI - Release of C-terminal tyrosine from tubulin and microtubules at steady state. AB - Microtubule protein preparations purified by cycles of assembly-disassembly contain the enzyme tubulinyltyrosine carboxypeptidase (TTCPase). Using these preparations, containing tubulinyl[14C]tyrosine, we studied the release of [14C]tyrosine from assembled and non-assembled tubulin under steady-state conditions. It was found that both states of aggregation were detyrosinated at similar rates by the action of the endogenous TTCPase. However, practically no release of [14C]tyrosine from the non-assembled tubulin pool was found when microtubules were previously eliminated from the incubation mixture. These results indicated that non-assembled tubulin requires to interact with microtubules to be detyrosinated. This interaction seems to occur through the incorporation of dimers into microtubules, since when the capability of tubulin to incorporate into microtubules was diminished by binding of colchicine a concomitant decrease in the rate of release of tyrosine was observed. When detyrosination was accelerated by increasing the concentration of TTCPase relative to the microtubule protein concentration, microtubules were found to be detyrosinated faster than was non-assembled tubulin. Using exogenous TTCPase in an incubation system in which the formation of microtubules was not allowed, tubulinyl[14C]tyrosine and tubulinyl[14C]tyrosine-colchicine complex were shown to have similar capabilities to act as substrates for this enzyme. Free colchicine was shown not to affect the activity of TTCPase. PMID- 3977876 TI - An alternative procedure for incorporating radiolabelled cholesteryl ester into human plasma lipoproteins in vitro. AB - A simple method has been developed for labelling human plasma lipoproteins to high specific radioactivity with radioactive cholesteryl esters in vitro. After isolation by preparative ultracentrifugation, the selected lipoprotein was incubated for 30 min at 4 degrees C in human serum (d greater than 1.215) that had been prelabelled with [4-14C]cholesteryl oleate or [1,2-3H]cholesteryl linoleate, and was then re-isolated by ultracentrifugation. All major lipoprotein classes were labelled by the procedure. Specific radioactivities of up to 18 d.p.m. . pmol-1 (46 d.p.m. . ng-1) were achieved. When radiolabelled high-density lipoprotein was infused intravenously, the radioactive cholesteryl ester behaved in vivo indistinguishably from endogenous cholesteryl esters produced by the lecithin (phosphatidylcholine): cholesterol acyltransferase reaction. PMID- 3977878 TI - Purification and properties of plant cytochrome b5. AB - Microsomal cytochrome b5 was 352-fold purified from potato tubers with a yield of 10.4%. To our knowledge, this is the first report relating the purification of higher-plant cytochrome b5. Its Mr (16 700) and absorption spectrum are similar to those of animal and yeast cytochrome b5. PMID- 3977877 TI - Carnitine acyltransferase activities in rat brain mitochondria. Bimodal distribution, kinetic constants, regulation by malonyl-CoA and developmental pattern. AB - Carnitine palmitoyltransferase and carnitine octanoyltransferase activities in brain mitochondrial fractions were approx. 3-4-fold lower than activities in liver. Estimated Km values of CPT1 and CPT2 (the overt and latent forms respectively of carnitine palmitoyltransferase) for L-carnitine were 80 microM and 326 microM, respectively, and K0.5 values for palmitoyl-CoA were 18.5 microM and 12 microM respectively. CPT1 activity was strongly inhibited by malonyl-CoA, with I50 values (concn. giving 50% of maximum inhibition) of approx. 1.5 microM. In the absence of other ligands, [2-14C]malonyl-CoA bound to intact brain mitochondria in a manner consistent with the presence of two independent classes of binding sites. Estimated values for KD(1), KD(2), N1 and N2 were 18 nM, 27 microM, 1.3 pmol/mg of protein and 168 pmol/mg of protein respectively. Neither CPT1 activity, nor its sensitivity towards malonyl-CoA, was affected by 72 h starvation. Rates of oxidation of palmitoyl-CoA (in the presence of L-carnitine) or of palmitoylcarnitine by non-synaptic mitochondria were extremely low, indicating that neither CPT1 nor CPT2 was likely to be rate-limiting for beta oxidation in brain. CPT1 activity relative to mitochondrial protein increased slightly from birth to weaning (20 days) and thereafter decreased by approx. 50%. PMID- 3977879 TI - Comparison of different techniques for estimating rates of protein synthesis in vivo in healthy and bacteraemic rats. AB - Previous studies have reported that use of a flooding dose of radiolabelled amino acid is a more precise technique than the constant infusion of tracer quantities for determining rates of protein synthesis in rapidly turning-over tissues in the rat. However, there has been little direct investigation comparing different methods under comparable conditions. Initially, 12 healthy male Sprague-Dawley rats, weighing approx. 100 g, were randomized to receive either a bolus intravenous injection of 100 mumol of L-leucine (containing 30 microCi of [1 14C]leucine)/100 g body wt., or a continuous 2 h tracer infusion of [14C]leucine. In the second phase of the experiment, 12 additional rats were intravenously injected with 1 X 10(8) colony-forming units of Pseudomonas aeruginosa and 16 h later randomized to receive one of two infusions described above. Total protein synthesis as well as fractional synthesis rates were determined in liver, rectus muscle and whole body. Synthesis rates measured in liver, muscle and whole body were significantly higher in bacteraemic rats than in healthy rats. The flooding dose methodology gave significantly higher estimates of protein synthesis in the liver, skeletal muscle and whole body than did the continuous-infusion method using direct measurement of the acid-soluble fraction from the respective tissue. Indirect estimates of whole-body protein synthesis based on plasma enrichments and stochastic modelling gave the lowest values. PMID- 3977880 TI - Monoacetoacetin and protein metabolism during parenteral nutrition in burned rats. AB - The effect of intravenous infusion of monoacetoacetin (glycerol monoacetoacetate) as a non-protein energy source was evaluated in burned rats. During 3 days of parenteral nutrition, in which animals received 14 g of amino acids/kg body wt. per day exclusively (group I) or with the addition of isoenergetic amounts (523 kJ/kg per day) of dextrose (group II), a 1:1 mixture of dextrose and monoacetoacetin (group III) or monoacetoacetin (group IV), significant decreases in urinary nitrogen excretion and whole-body leucine oxidation were observed in the three groups given additional non-protein energy as compared with group I. Serum ketone bodies (acetoacetate and 3-hydroxybutyrate) were decreased in rats given dextrose, whereas glucose and insulin increased significantly. Monoacetoacetin-infused animals (group IV) had high concentrations of ketone bodies without changes in glucose and insulin, whereas animals infused with both monoacetoacetin and glucose (group III) showed intermediate values. On day 4 of nutritional support, whole-body L-leucine kinetics were measured by using a constant infusion of L-[1-14C]leucine. In comparison with group I, the addition of dextrose or monoacetoacetin produced a significant decrease in plasma leucine appearance and release from whole-body protein breakdown. Gastrocnemius-muscle protein-synthesis rates were also higher in the three groups receiving additional non-protein energy. These findings suggest that monoacetoacetin can effectively replace dextrose as an intravenous energy source in stressed rats. Both fuels are similar in decreasing weight loss, nitrogen excretion, leucine release from whole body protein breakdown and oxidation, in spite of differences in energy substrate and insulin concentrations. PMID- 3977882 TI - The squash family of serine proteinase inhibitors. Amino acid sequences and association equilibrium constants of inhibitors from squash, summer squash, zucchini, and cucumber seeds. AB - Six amino acid sequences for trypsin inhibitors isolated from squash, summer squash, zucchini, and cucumber seeds were determined. All these inhibitors along with the two previously sequenced squash inhibitors (1) form the squash inhibitor family. The striking characteristic of the family is that its member inhibitors are very small (29-32 residues, 3 disulfide bridges). The association equilibrium constants with bovine beta trypsin for 6 squash family inhibitors were determined and range from 5.9 X 10(10) to 9.5 X 10(11) M-1. PMID- 3977881 TI - Properties and activities of aminopeptidases in normal and mitogen-stimulated human lymphocytes. AB - Human peripheral lymphocytes were found to contain at least two distinct aminopeptidases, designated cytosol aminopeptidase and microsomal aminopeptidase, which differed from one another with respect to intracellular localization, substrate specificity, metal-ion activation, Km value and electrophoretic mobility. No change in these aminopeptidase activities was observed in cultured lymphocytes in the absence of mitogen throughout the cultivation period. The addition of phytohaemagglutinin or concanavalin A to the culture medium caused, in dose-dependent manner, a significant increase in cytosol aminopeptidase activity in lymphocytes. On the other hand, no increase in microsomal aminopeptidase activity was observed under the same conditions. The biochemical properties of aminopeptidases in stimulated cultured lymphocytes were identical with those of the enzymes in peripheral lymphocytes and unstimulated cultured lymphocyte. The phytohaemagglutinin dose-response curves for lymphocyte activation as measured by the DNA synthesis rate and for cytosol aminopeptidase activity were observed to be similar. However, when DNA synthesis was temporarily blocked by hydroxyurea, the rate of increase of aminopeptidase activity was unaffected. Pokeweed mitogen only slightly increased the cytosol aminopeptidase activity in cultured lymphocytes, although the lymphocytes were highly activated. PMID- 3977883 TI - Human breast milk stimulates low density lipoprotein (LDL) binding to human skin fibroblasts in culture. AB - Human breast milk incorporated at 1% concentration into the culture medium significantly (p less than 0.05) increased the binding of 125I-LDL to receptors of human skin fibroblasts in culture. Homogenized cows milk and infant formula (Similac) also possessed this stimulating property. The stimulating activity of milk persisted after dialysis and extraction with cold acetone. These preliminary studies suggest that milk might contain potent factor(s) influencing cholesterol metabolic process in early life. PMID- 3977884 TI - Antibody to a synthetic peptide detects a conserved region of retrovirus transmembrane proteins. AB - N-terminal amino acid sequence analysis of the transmembrane protein of baboon endogenous virus revealed an internal 13 residue identity with the transmembrane homolog of murine leukemia virus. A tridecapeptide Glu-Val-Val-Leu-Gln-Asn-Arg Arg-Gly-Leu-Asp-Leu-Leu corresponding to this region was chemically synthesized and antibody to the peptide was raised in rabbits. The rabbit antisera recognized the protein in Western blots. The specificity of the antisera was tested against a panel of retroviruses. Transmembrane proteins of type C retroviruses as well as type D were identified. PMID- 3977885 TI - 2-Chloroadenosine inhibits complement-induced reactive oxygen metabolite production and recovery of human polymorphonuclear leucocytes attacked by complement. AB - Luminol-enhanced chemiluminescence demonstrated that 2-chloroadenosine inhibited complement-induced reactive oxygen metabolite production in human polymorphonuclear leucocytes. This inhibition was reversed by 8 phenyltheophylline. Binding of a [125I]-labelled monoclonal antibody against C9 to human PMN demonstrated removal of membrane attack complexes from the cell membranes, and in addition indicated inhibition of this process by 2 chloroadenosine. This compound also increased the percentage of complement induced cell lysis of polymorphonuclear leucocytes. PMID- 3977886 TI - Induction of proliferation of human circulating monocytes in vitro by lectin induced factor(s) from lymphocytes. AB - Human peripheral blood monocytes, which have been considered to be non-dividing cells, were induced to proliferate in vitro by soluble mediator(s) from lectin activated human lymphocytes. The lectin-induced factor from lymphocytes increased both the number of nuclei of cultured monocytes and [3H]-thymidine incorporation into the monocytes. The molecular weights of the soluble factor(s) that promote growth of monocytes were in the range of 20,000-70,000 daltons with two peaks. PMID- 3977887 TI - Inhibitory effect of the flavonoid silymarin on the erythrocyte hemolysis induced by phenylhydrazine. AB - The flavonoid silymarin, which is used as a therapeutical agent in the treatment of liver diseases, can inhibit the hemolysis and lipid peroxidation induced by phenylhydrazine on erythrocytes obtained from rats treated with the flavonoid. This effect is ascribed to the antioxidant properties as a free radical scavenger exhibited by the flavonoid. Silymarin failed to inhibit the glutathione depletion induced by phenylhydrazine on erythrocytes. It is proposed that the flavonoid acts at the membrane level of the cell avoiding the lipid peroxidative and fluidizing effect of phenylhydrazine. PMID- 3977888 TI - The recognition domain for the low density lipoprotein cellular receptor is expressed once on each lipoprotein particle. AB - The stoichiometry of binding of monoclonal antibodies and Fab fragments to LDL was assessed. Increasing amounts of two [125I]-labelled antibodies which define epitopes at or near the LDL-receptor recognition domains of apoB were incubated with fixed amounts of LDL and antibody-LDL complexes were separated from free antibodies by heparin-MnCl2 precipitation. Saturation kinetics were obtained and data were analyzed according to Scatchard. One antibody or Fab fragment was bound per LDL particle. Homogeneity of binding was indicated by straight Scatchard lines and by the binding of virtually all LDL particles by an antibody affinity chromatographic column. PMID- 3977890 TI - Variations in ADP-ribosylation of nuclear scaffold proteins during the HeLa cell cycle. AB - Cell cycle variations in ADP-ribosylation of nuclear scaffold proteins were determined. Nuclei of synchronized cells were isolated and labeled with [32P]NAD before nuclear scaffolds were obtained by digestion of DNA with DNase I and extraction of proteins with 2M NaCl. Autoradiograms revealed the three groups of "lamins" and a species identified as poly (ADP-ribose) polymerase to be the primary ADP-ribosylated proteins. The patterns of modification of nuclear scaffold proteins displayed similar features through the cell cycle. Radioactivity in the lamins increased from 20% in early-S phase to 40% in G1 phase of the next cell cycle. PMID- 3977889 TI - Synthesis and release of sulfated glycoproteins by cultured glial cells. AB - Both primary cultured glial cells and cloned (C-6) glioma cells have been shown to synthesize and release sulfated glycoproteins. It was found that N-linked tri- and tetra-antennary glycopeptides recovered from the glycoproteins contained most of the (35S) sulfate label. C-6 glial cells showed a higher rate of oligosaccharide sulfation than the primary glial cultures. Both cell types exhibited a high rate of release of sulfated glycoproteins into the medium. The ratio of 35S/3H incorporated from (35S) sulfate and (3H) glucosamine in the released material was higher than that of the glycoproteins associated with the cell, indicating an enrichment of sulfated glycoproteins in the secreted materials. Monensin inhibited both the synthesis and the release of sulfated glycoproteins. PMID- 3977891 TI - Methylation of the serum albumin gene as compared to the Kirsten-ras oncogene in hepatocytes and non-parenchymal cells of rat liver. AB - The extent of methylation of a gene, i.e. percent of cytosine present as 5 methylcytosine, is correlated with its activity. Hypermethylation is associated with non-expression, whereas hypomethylation is a necessary but not sufficient condition for expression. In this study, the methylation state of the serum albumin gene as compared to the Kirsten-ras (Ki-ras) oncogene was assessed in hepatocytes and non-parenchymal cells (NPC) isolated from rat liver. The results of this investigation indicate that the serum albumin gene is hypomethylated in hepatocytes and hypermethylated in NPC. This is consistent with expression of the gene in the former cell type, and non-expression in the latter. In contrast, the Ki-ras oncogene is hypermethylated in both hepatocytes and NPC, suggesting that it is, at most, minimally expressed in normal rat liver. PMID- 3977892 TI - Cloning of sequences induced and suppressed by administration of PSK, antitumor protein-bound polysaccharide. AB - To elucidate the effects of PSK, a protein-bound polysaccharide from Coriolus versicolor, on gene expression in tumor cells, we prepared cDNA clone libraries from PSK-treated and untreated cells of a rat ascites hepatoma line, AH66, which was previously shown to be susceptible to the antitumor action of this compound. Two PSK-induced and one suppressed cDNA clones were selected from these libraries by using a differential colony hybridization and RNA blot hybridization. PSK was thus shown to have a direct effect on the transcription and consequently on the translation of tumor cells. PMID- 3977893 TI - Calcium exposure required for full expression of injury in the calcium paradox. AB - Isolated hearts repleted with calcium after a short period of perfusion with a calcium-free medium undergo the injury of the calcium paradox and release cellular protein. In the present experiments, 15 min perfusion with a calcium containing HEPES solution subsequent to 10 min calcium-free perfusion resulted in the loss of 42.7 +/- 3.9 mg of protein/g heart. If hearts were repleted with calcium for 30 s only, then returned to calcium-free perfusion, resultant protein loss was the same. When calcium repletion was further decreased to 20 s, 23.9 +/- 1.3 mg/g of protein was lost. This critical period coincided with the onset of contracture but was prior to major ion movements. It is concluded that the transition to irreversible injury occurs within 30 s of calcium repletion and that subsequent removal of extra-cellular calcium does not alter the course of events leading to cell death. PMID- 3977894 TI - Studies on the primary structure of rat liver phenylalanine hydroxylase. AB - The primary structure of phenylalanine hydroxylase purified from rat liver was investigated with high speed gel filtration chromatography, cyanogen bromide cleavage and end group analyses of polypeptides derived from the enzyme. On gel filtration in the presence of 6M guanidine hydrochloride, the enzyme gave a single peak corresponding to a molecular weight of 52,000. In the same system the enzyme that had been cleaved with cyanogen bromide gave two peptides (CB1, Mr = 32,800 and CB2, Mr = 20,400). Sequence studies showed that the alignment of these two peptides was CB1 - CB2. Furthermore, in experiments using 32P phosphorylated enzyme, the site of phosphorylation by cAMP-dependent protein kinase was found to be located on the CB1 peptide. The NH2-terminus of this enzyme, which was found to be blocked, was shown to be N-acetylalanine. By both carboxypeptidase A digestion and hydrazinolysis, the carboxyl terminus was identified as serine. These data indicate that the phenylalanine hydroxylase molecule from rat liver is composed of subunits which are homogenous or, at least, very similar in their primary structure. PMID- 3977895 TI - Acylpeptide hydrolase activity from erythrocytes. AB - Acylpeptide hydrolase, which cleaves the NH2-terminal acetylated or formylated amino acid from a blocked peptide, has been purified to apparent homogeneity from human erythrocytes. The enzyme catalyzes the hydrolysis of a diverse number of peptides and displays different pH optima for certain substrates in doing so. Zinc inhibits to the same extent the hydrolysis of both the most efficient and the least efficient substrates. This enzyme may play a pivotal role in the processing of polypeptide chains during biosynthesis. PMID- 3977896 TI - Androgen regulated genes from prostate and seminal vesicle share upstream sequence homologies. AB - The genes for seminal vesicle secretory protein IV and prostate steroid binding protein component 3 of the rat share upstream homologies of which the most striking is a 30 nucleotide sequence located between position -190 and -330 relative to the major transcriptional initiation sites. This sequence does not appear to be a common repetitive element and deserves consideration as a potential site involved in the androgen regulated expression of these genes. PMID- 3977897 TI - Synthetic study on the structure-activity relationship of sperm activating peptides from the jelly coat of sea urchin eggs. AB - Various analogue peptides with substitution and deletion of amino acid residues have been synthesized by liquid phase method for Sperm Activating Peptides from the jelly coat of sea urchin eggs. The deletion of C-terminal Gly reduced the activity to about 1/3000, while removal of N-terminal Gly reduced the activity to 1/10. The residues Ser5 and Asp3 were replaced by Lys without significant loss of activity. Substitution of Phe2 by Gly, Ala or Pro markedly reduced the activity by the factor of 10(4)-10(6), in contrast to Tyr-substitution retaining almost full activity, indicating the essential role of the aromatic residue in exerting the activity. Substitutions, Asp3 to Glu and Gly10 to Pro, increased the activity 5-fold and 500-fold, respectively. PMID- 3977898 TI - Solid-state 15N NMR studies of the effects of penicillin on cell-wall metabolism of Aerococcus viridans (Gaffkya homari). AB - Lyophilized whole cells and isolated cell walls from Aerococcus viridans (Gaffkya homari) grown on a synthetic medium containing benzylpenicillin, and either L [epsilon-15N]lysine or 15N-ammonium ion as the only source of label, have been studied using cross-polarization magic-angle spinning 15N nuclear magnetic resonance. The lysine is incorporated directly into protein and cell-wall peptidoglycan and was used to measure cell-wall cross-links. The ammonium ion acts as a non-specific label monitoring general metabolism. Inhibition of cell wall cross linking by penicillin occurs, but may not be the exclusive cause of cell death and lysis in this microorganism. Instead, the disruption of the mechanism for control of peptidoglycan synthesis probably is a contributing factor. PMID- 3977899 TI - Stereoselective and regioselective hydroxylation of warfarin and selective O dealkylation of phenoxazone ethers in human placenta. AB - The oxidative metabolism of warfarin and a series of phenoxazone ethers was studied in two groups of human placentas which exhibited high or low levels of aryl hydrocarbon hydroxylase (AHH). Warfarin metabolism was stereoselective (mean R/S = 2.48) for the R-enantiomer and regioselective for the 6- and 8- positions in the high AHH group whereas warfarin metabolism in the low AHH group displayed no significant overall stereoselectivity (mean R/S = 1.24) and was regioselective for the 7- position. The high AHH group metabolized the methyl, ethyl, propyl and butyl ethers of phenoxazone rapidly, while the low AHH group catalyzed their biotransformation at very low or negligible rates. Neither group detectably metabolized phenoxazone or pentyloxyphenoxazone whereas both groups metabolized benzyloxyphenoxazone at low but similar rates. Rates of warfarin R-6 and R-8 hydroxylation were highly correlated with metabolism of benzo(alpha)pyrene (r = 0.99) and the C1-C4 phenoxazone ethers (r greater than 0.87), but poorly correlated with metabolism of benzyloxyphenoxazone (r less than 0.50). These data support the use of warfarin and the phenoxazone ethers as sensitive biochemical probes for P-450 isozymes in human extrahepatic tissues. They indicate the presence of a multiplicity of xenobiotic metabolizing P-450's in placental tissue which has not been exposed to inducing agents that elevate AHH. PMID- 3977900 TI - Conformational states of Leu5- and Met5-enkephalins in solution. AB - The molecular conformations of Leu5- and Met5-enkephalins in aqueous and DMSO solutions were investigated by FT-IR and laser Raman spectroscopic methods. The amide I, II, and III regions in the FT-IR spectra of Leu5- and Met5-enkephalins in aqueous solution were analyzed by performing Fourier self-deconvolution of the bands. Leu5-enkephalin in aqueous solution is found to exist in both type II beta turn and beta-sheet structures, whereas Met5-enkephalin has a lesser tendency to form beta-turn structure in aqueous solution. It is likely that these different conformers of enkephalins might bind to different receptor types. PMID- 3977901 TI - Phosphorylation of the rat hepatocyte asialoglycoprotein receptor. AB - Phosphorylation of asialoglycoprotein receptor was investigated by using rat hepatocytes. Analysis of the purified receptor by SDS-PAGE and autoradiogram revealed that the 64 and 54 Kd polypeptides of the receptor were phosphorylated but the 43 Kd one was not and that phosphorylation took place at the cell surface. These results are compatible with the fact that the 64 and 54 Kd species exist predominantly at the cell surface. The sites of phosphorylation were identified as Ser and Thr with no detectable radioactivity in phosphotyrosine. PMID- 3977903 TI - Increased content of cytochrome P-450 and 4-methylpyrazole binding spectrum after 4-methylpyrazole treatment. AB - 4-Methylpyrazole is a potent inhibitor of alcohol dehydrogenase and of ethanol metabolism. In vitro, 4-methylpyrazole was shown to inhibit microsomal oxidation of drugs and alcohols. Treatment of rats with 4-methylpyrazole at doses ranging from 0 to 300 mg per kg body wt per day for three days resulted in a dose dependent increase in the content of liver microsomal cytochrome P-450. There was no change in the activity of NADPH-cytochrome P-450 reductase. 4-Methylpyrazole interacted with control microsomes to produce a type II binding spectrum, with a peak at 429 nm, and a trough at 392 nm. The magnitude of this spectral change was increased after 4-methylpyrazole treatment. Kinetic experiments indicated that the 4-methylpyrazole treatment lowered the dissociation constant (Ks) for 4 methylpyrazole. The maximal binding (Vs) was increased when expressed per mg microsomal protein, but not per nmol cytochrome P-450. Therefore, 4 methylpyrazole treatment can affect the microsomal mixed-function oxidase system in several ways, including binding to P-450 as well as inducing P-450. PMID- 3977902 TI - Autophosphorylation of the insulin receptor in rat adipocytes is modulated by thyroid hormone status. AB - The effect of thyroid status on the in vitro autophosphorylation of the insulin receptors was studied in triton-solubilized adipocyte plasma membranes obtained from normal and thyroidectomized rats. Thyroidectomy results in an increase (two to three times) of the in vitro insulin-dependent phosphorylation of the insulin beta-subunit receptor. Phosphorylation occurred on tyrosine residues. In vivo injection of triiodothyronine to thyroidectomized rats restored plasma membranes autophosphorylation of the beta-subunit to the values obtained for control euthyroid rats. This effect was independent of the number and affinity of the insulin receptors, which were not modified regardless of thyroid status. PMID- 3977904 TI - Endogenous free radical generation may influence proteolysis in mitochondria. AB - Isolated Mitochondria were allowed to incorporate radioactive amino acids into protein and proteolysis was then measured. In State 4 free radical generation was manipulated by means of respiratory chain blockers and uncouplers. Conditions of enhanced radical flux resulted in accelerated protein breakdown. We suggest that radicals influence proteolysis in cells both directly (by fragmenting proteins) and indirectly (by rendering proteins more susceptible to proteinases). PMID- 3977905 TI - On the metabolism of epoxyeicosatrienoic acids by ram seminal vesicles: isolation of 5(6)epoxy-prostaglandin F1 alpha. AB - cis-5(6)Epoxy- and cis-14(15)epoxyeicosatrienoic acid are formed from arachidonic acid by monooxygenases. 5(6)Epoxyeicosatrienoic acid is metabolized by fatty acid cyclooxygenase of ram seminal vesicles and the major products were recently identified as 5(6)epoxy-PGE1 and two stereoisomers of 5-hydroxy-PGI1. The two isomers were likely formed from an unstable intermediate, 5(6)epoxy-PGF1 alpha. The isolation of 5(6)epoxy-PGF1 alpha is described here and 14(15)epoxyeicosatrienoic acid is shown to inhibit fatty acid cyclooxygenase of ram seminal vesicles, albeit less potently than eicosatetraynoic acid (IC50 0.18 and 0.05 mM, respectively). PMID- 3977906 TI - Evidence that 1-naphthol is not an obligate intermediate in the covalent binding and the pulmonary bronchiolar necrosis by naphthalene. AB - Recent studies of a number of volatile aromatic hydrocarbons have suggested that the formation of covalently bound metabolites arises solely through the intermediate formation of phenols. This study further examines the involvement of 1-naphthol in the in vivo and in vitro formation of covalently bound metabolites and pulmonary bronchiolar necrosis by naphthalene. Marked differences were observed in the rate of 1-naphthol formation in lung and liver microsomal incubations without correspondingly large differences between the rates of formation of covalently bound metabolites from naphthalene and 1-naphthol. Glutathione decreased covalent binding in hepatic microsomal incubations containing 14[C]1-naphthol but did not result in the formation of any of the glutathione adducts isolated from identical incubations containing 14[C]naphthalene. Tissue levels of covalently bound radioactivity in mice treated with 14[C]1-naphthol or 14[C]naphthalene were similar; however, in contrast to studies with naphthalene, 1-naphthol administration did not deplete tissue glutathione nor result in detectable tissue injury. These studies indicate that 1 naphthol is not an obligate intermediate in the formation of covalently bound metabolites from naphthalene nor does it appear to be a more proximate lung toxic metabolite. PMID- 3977908 TI - Loss of glucagon control of gluconeogenesis in liver cells from rats with bile duct obstruction. AB - Bile acids induce membrane alterations including reduced response to peptide hormones in vitro. Isolated liver cells from rats with bile duct obstruction were studied regarding gluconeogenesis and its hormonal control. While cells from shamoperated animals showed an 63% increase of glucose release in the presence of glucagon (1 microM), cells from cholestatic livers did not response regardless of the duration of obstruction. Cholestatic cells also showed other signs of membrane alterations, such as an increased enzyme leakage while redoxstatus and other metabolic responses were unchanged. These results suggest that a loss of hormonal control in the liver could contribute to disturbations of glucose homeostasis in cholestatic conditions. PMID- 3977907 TI - Oxygen-mediated cell injury in the killing of cultured hepatocytes by acetaminophen. AB - Sensitivity of cultured hepatocytes to acetaminophen was induced by pretreatment of the rat with 3-methylcholanthrene. Under these conditions, 10 uM B naphthoflavone but not SKF-525A prevented the cell killing, indicating dependence on metabolism. Inhibition of glutathione reductase by 50 uM bis-chloro nitrosourea, shown previously to increase the sensitivity of hepatocytes to an oxidative stress, potentiated the toxicity of acetaminophen without increasing the covalent binding of acetaminophen metabolites. Pretreatment of the hepatocytes with the ferric iron chelator deferoxamine, known to reduce the sensitivity of hepatocytes to an oxidative stress, prevented the cell killing without reducing covalent binding. Addition of ferric chloride to the culture medium restored the sensitivity of the cells to acetaminophen, again without effect on the extent of covalent binding. These data demonstrate that the toxicity of acetaminophen can be dissociated from the covalent binding of its metabolites and support the conclusion that the hepatocytes were lethally injured by an oxidative stress accompanying the mixed function oxidase-dependent biotransformation of acetaminophen. PMID- 3977909 TI - Analysis of neuraminidase isozyme phenotypes in mammalian tissues: an electrophoretic approach. AB - A simple cellulose acetate electrophoretic method for visualizing mammalian neuraminidase isozymes has been developed. Application of the method with rat and mouse liver extracts reveals the presence of two distinct isozymes in each species. Each isozyme exhibits tremendous variation in activity between inbred strains. The two isozymes vary independently of one another suggesting that their activities are controlled by different genes. The neuraminidase phenotypes detected in these inbred strains via electrophoresis are consistent with published accounts of neuraminidase phenotypes determined fluorometrically in whole liver homogenates, but also indicate the presence of a second isozyme not perceived by this other procedure. PMID- 3977910 TI - Retinoic acid treatment of human neuroblastoma cells is associated with decreased N-myc expression. AB - Cells from human neuroectodermal tumors (retinoblastoma and neuroblastoma) and from neuroblastoma cell lines express a gene, N-myc, which is frequently amplified in these tumors. We report here that N-myc mRNA content is markedly decreased in cells of a neuroblastoma cell line (LA-N-5) following differentiation induced with retinoic acid. Exposure of the cells to retinoic acid induced morphologic changes consistent with neuronal differentiation, and led to a 75% decrease in expression of N-myc mRNA. These results suggest that N myc expression is intimately related to an undifferentiated phenotype in neuroblastoma cells, and support other studies which relate N-myc expression to the malignant phenotype in neuroblastoma tumors. PMID- 3977911 TI - Glutathione: an endogenous substrate for thiopurine methyltransferase? AB - An investigation was initiated to determine if glutathione is an endogenous substrate for thiopurine methyltransferase. Glutathione, as well as S methylglutathione, were each capable of inhibiting the enzyme in a concentration dependent manner, which suggested competitive and product inhibition, respectively. However, radiochromatography revealed that S-methylation of glutathione is not a catalytic activity of this sulfhydryl transmethylase. Subsequent experiments indicated that the inhibitory effects of both glutathione and S-methylglutathione on thiopurine methyltransferase may be due to their acidic natures, changing the reaction mixture pH away from the optimal range for the enzyme. PMID- 3977912 TI - Partial characteristics of an analog of pyridinoline isolated from human skin. AB - The most abundant amine in acid hydrolysates of human skin, eluting in the crosslink region of a reversed-phase HPLC chromatogram, has the same retention time as pyridinoline standard. This amine is not pyridinoline, since it is a weak fluorophore and its U/V spectrum does not agree with that of pyridinoline. The unknown amine was isolated and characterized by fast atom bombardment mass spectrometry and its structure is consistent with a deoxy-analogue of pyridinoline. It may be a crosslink component of some biological importance, since it is not detectable in skin from a patient with Marfan's Syndrome. PMID- 3977913 TI - Primary structure of the variable region of an amyloidogenic Bence Jones protein NIG-77. AB - The complete amino acid sequence of the variable region of a Bence Jones protein NIG-77 from an individual with myeloma-associated systemic amyloidosis has been determined. This protein represents a complete light chain consisting of 216 residues and it has a sequence characteristic of V lambda I subgroup, which is closely homologous to that of another amyloidogenic V lambda I Bence Jones protein NIG-51, differing by 20 of 111 residues (82% homology). In contrast, it differs by 29 residues (74% homology) to that of non-amyloidogenic V lambda I light chain NIG-64. This finding shows that, in accordance with our previous report(1), the V lambda I-related light chains can further be divided into two distinct subsubgroups, V lambda I-1 and V lambda I-2, and the latter property seems to be more prone in association with the amyloid process. PMID- 3977914 TI - Quaternary forms of classical muscarinic antagonists distinguish subpopulations of muscarinic receptors: correlation with gallamine-defined subpopulations. AB - Atropine and scopolamine inhibit the binding of [3H] quinuclidinyl benzilate (QNB) to muscarinic receptors of rat forebrain in a manner that suggests homogeneity of the binding sites. Under the same conditions, the inhibition by N methylatropine (NMA) and N-methylscopolamine (NMS) of the binding of [3H]QNB is consistent with the presence of subpopulations of receptors that differ greatly in affinities toward these quaternary ligands. The subpopulations that are defined according to the affinities of NMA and NMS correlate very well with those that are defined by the use of gallamine. It is suggested that the heterogeneity in the binding of NMS explains some of the anomalous interactions between NMS and gallamine that have been reported previously. PMID- 3977915 TI - Interaction of O,O,S-trimethyl phosphorothioate and O,S,S-trimethyl phosphorodithioate, the impurities of malathion with supercoiled PM2 DNA. AB - The interaction of O,O,S-trimethyl phosphorothioate and O,S,S-trimethyl phosphorodithioate, the impurities found in malathion, with DNA at pH 8.0, was investigated. Supercoiled PM2 DNA was incubated with these compounds at pH 8.0 at 37 degrees C and then the superhelicity of the modified DNA was determined by gel electrophoresis. Both compounds caused unwinding of supercoiled DNA in dose- and incubation time-dependent manner. O,S,S-trimethyl phosphorodithioate was a more potent agent than O,O,S-trimethyl phosphorothioate. At 37 degrees C following 2.0 hours incubation, 100 mM O,S,S-trimethyl phosphorodithioate produced fully unwound DNA, whereas at 200 mM O,O,S-trimethyl phosphorothioate produced 80% unwound DNA following 12 hours' incubation. At the same condition, 5 mM methyl methanesulfonate, a potent alkylating mutagen, produced fully unwound DNA following 1 hour incubation at 5 mM. These results indicated that there were chemical interactions between these agents and DNA. The possibility of the interaction of OOS-TMP being as a covalent intercalation as well as strand nicking was discussed. PMID- 3977917 TI - Opiate binding in rat hearts: modulation of binding after hemorrhagic shock. AB - [3H] Diprenorphine was used to measure binding in sectioned rat hearts. Saturable binding for concentrations up to about 20 nM was obtained in the right atrium and ventricle. Unlabeled diprenorphine displaced bound [3H] diprenorphine most effectively in the right atrium (up to 55%), as compared to less than 27% in the right ventricle and the remaining parts of the heart. Scatchard analysis of the binding in the right atrium revealed cooperative binding. The delta agonist [D Ala2,D-Leu3] enkephalin, the kappa agonist ethylketocyclazocine, and levorphanol, but not the mu agonist [D-ala2,MePhe4,Gly-(ol)5] enkephalin or dextrophan competed variably with [3H]diprenorphine for the binding in the right atrium and ventricle. A significant decrease in binding was observed in the right atrium ( 66%) and ventricle (-45%) of hearts removed from rats 2 h after hemorrhagic shock; 24 h after shock, recovery of binding was found. This novel observation suggests that the diprenorphine binding sites in the heart may be physiologically active receptors, involved in regulation of peripheral cardiovascular processes. PMID- 3977916 TI - Peroxisomal beta-oxidation enzyme proteins in the Zellweger syndrome. AB - The absence of peroxisomes in patients with the cerebro-hepato-renal (Zellweger) syndrome is accompanied by a number of biochemical abnormalities, including an accumulation of very long-chain fatty acids. We show by immunoblotting that there is a marked deficiency in livers from patients with the Zellweger syndrome of the peroxisomal beta-oxidation enzyme proteins acyl-CoA oxidase, the bifunctional protein with enoyl-CoA hydratase and 3-hydroxyacyl-CoA dehydrogenase activities and 3-oxoacyl-CoA thiolase. Using anti-(acyl-CoA oxidase), increased amounts of cross-reactive material of low Mr were seen in the patients. With anti-(oxoacyl CoA thiolase), high Mr cross-reactive material, presumably representing precursor forms of 3-oxoacyl-CoA thiolase, was detected in the patients. Catalase protein was not deficient, in accordance with the finding that catalase activity is not diminished in the patients. Thus in contrast to the situation with catalase functional peroxisomes are required for the stability and normal activity of peroxisomal beta-oxidation enzymes. PMID- 3977919 TI - Raman study of effect of phospholipid chain unsaturation on bilayer phase transitions. AB - Raman scattering has been used to study the gel to liquid-crystalline transition in several unsaturated mixed-chain, saturated mixed-chain, and unsaturated symmetric phospholipids. The results show that the large transition temperature widths in membranes containing unsaturated mixed-chain phospholipids in which the two acyl chains do not differ significantly in length are due mainly to the presence of the double bond and not to the asymmetry in the chains. PMID- 3977918 TI - Superior resolution of gamma-crystallins from microdissected eye lens by cation exchange high-performance liquid chromatography. AB - A novel procedure is presented for the rapid quantitative analysis of eye lens gamma-crystallins and beta s-crystallin by ion-exchange high-performance liquid chromatography on Synchropak CM300. At least six different gamma-crystallin gene products can be resolved from the soluble fraction of calf lens extract. This method is applicable to the analysis of microsections from individual lenses, and can be used to rapidly characterize spatial variations in gamma-crystallin composition which occur with aging and cataractogenesis. PMID- 3977920 TI - Desensitization of human platelets by platelet activating factor. AB - Human platelets are less responsive to PAF at 37 degrees than at 25 degrees. They can be desensitized to the effects of PAF by pre-exposure to small concentrations. In both cases desensitization appears to be accompanied by a decreased affinity of the high affinity site for PAF rather than loss of binding sites. Alteration of a metabolic step subsequent to binding cannot be excluded, but platelets show normal response to a variety of other agents under the conditions resulting in desensitization of platelets to PAF. PMID- 3977921 TI - Location of the inter-chain disulfide bonds of the third component of human complement. AB - Location of the disulfide bonds connecting three polypeptide chains (alpha 3, 27kd; 2, 43kd; beta, 75kd) of C3c has been investigated by partial reduction with cysteine followed by alkylation with 14C-monoiodoacetic acid. Treatment of C3c with cysteine produced a partially reduced fragment, composed of disulfide-linked beta and alpha 3 chains. A single thiol residue was detected on the alpha 3 chain but not on the beta chain of the fragment, suggesting that the alpha 2 chain in C3c is linked through a single disulfide bond to the alpha 3 chain but not to the beta chain. PMID- 3977922 TI - Enhancement of intracellular glutathione protects endothelial cells against oxidant damage. AB - We studied the role of glutathione in the endothelial cell defense against H2O2 damage. Treatment of endothelial cells with buthionine sulfoximine, an irreversible inhibitor of gamma-glutamylcysteine synthetase, depleted the cells of GSH, while L-2-oxothiazolidine-4-carboxylate, an effective intracellular cysteine delivery agent, markedly enhanced endothelial cell GSH concentration. Depletion of intracellular GSH sensitized the endothelial cells to injury by H2O2 either preformed or generated by the glucose-glucose oxidase system. In contrast, an increase of intracellular GSH protected the cells from H2O2 damage. There was an inverse, linear relationship between the intracellular GSH concentrations and killing of endothelial cells by H2O2. Our results suggest that enhancement of endothelial cell GSH may be an alternative approach toward the prevention of oxidant-induced endothelial damage such as adult respiratory distress syndrome. PMID- 3977923 TI - The neurohypophysial hormones of the egg-laying mammals: identification of arginine vasopressin in the platypus (Ornithorhynchus anatinus). AB - Two neurohypophysial peptides have been purified from acetone desiccated posterior pituitary glands of the platypus (Ornithorhynchus anatinus) by molecular sieving and high-pressure liquid chromatography. A single pressor peptide, having an amino acid composition and a chromatographic retention time identical to those of arginine vasopressin, has been identified. A single oxytocic peptide has been isolated that ressembles oxytocin by its chromatographic retention time, but lack of material has prevented to obtain a correct amino acid composition. The pressor peptide is roughly four times more abundant than the oxytocic peptide. Neurohypophysial hormones of platypus seem similar to those of echidna, the other living prototherian, and to those of most placental mammals. PMID- 3977925 TI - The primary structure of the nonspecific lipid transfer protein (sterol carrier protein 2) from bovine liver. AB - The primary structure of the nonspecific lipid transfer protein (sterol carrier protein 2) from bovine liver has been determined. The protein consists of a single polypeptide chain of 121 amino acid residues with serine as the amino terminal and alanine as the carboxy-terminal residue. The protein contains one single cysteine and tryptophan residue and lacks tyrosine, histidine and arginine. PMID- 3977924 TI - Interactions of quinidine and lidocaine with rat brain and heart muscarinic receptors. AB - We have studied the effect of quinidine and lidocaine on binding to rat brain and cardiac muscarinic receptors. Both drugs had a higher affinity to brain stem and cardiac receptors, as compared with cerebral cortex, coinciding with the distribution of high-affinity agonist binding sites in the above tissues. The effects of the drugs on muscarinic antagonist and agonist binding did not fit simple competition to one receptor site, suggesting either preferential binding to high affinity agonist binding sites, or allosteric interactions. Batrachotoxin, which opens voltage sensitive sodium channels, had an opposite effect on agonist binding. The possibility of allosteric interactions between the muscarinic receptors and a site analogous to the sodium channel is discussed. PMID- 3977926 TI - Cross-linking with dimethylsuberimidate to study thyroglobulin conformation. AB - The present investigation demonstrates that the cross-linking agent, dimethylsuberimidate, is an usefull tool to study thyroglobulin structure. In fact, while reproducible and discrete polymerization products are obtained in strictly controlled conditions, valuable information on the native assemblage of thyroglobulin subunits and the effects of its major post-translational modification (iodination) on its structure, are reported. PMID- 3977927 TI - The amino terminal sequences of bovine and human chromogranin A and secretory protein I are identical. AB - The amino terminal sequences of bovine and human adrenal medullary chromogranin A have been determined. Their sequences are identical and also identical to the published sequence of secretory protein I from the parathyroid gland. This data indicates that the previously published sequence of chromogranin A is incorrect at residues 2 and 19. These data confirm earlier observations of a substantial similarity between secretory protein I and chromogranin A and, in fact, strongly suggest that they are identical. PMID- 3977928 TI - Purification of thyroid peroxidase by monoclonal antibody-assisted immunoaffinity chromatography. AB - A rapid method was developed for purification of hog thyroid peroxidase by immunoaffinity chromatography on a column of Sepharose 4B coupled to a monoclonal antibody to the peroxidase. The purified enzyme had a specific activity of 194 units/mg and showed the same absorption spectrum in the Soret and visible regions as that of the enzyme purified after trypsin treatment. The ratio of A413 nm to A280 nm was 0.24, being much less than that for the trypsinized enzymes. Upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis, it gave a broad protein band in the 100,000-dalton region. It is concluded that the preparation purified in this study represents a native form of thyroid peroxidase. PMID- 3977929 TI - Differences in the occurrence of glutathione transferase isoenzymes in rat lung and liver. AB - Cytosolic GSH transferases have been purified from rat lung by affinity chromatography followed by chromatofocusing. On the criteria of order of elution, substrate specificity, apparent subunit Mr, sensitivity to inhibitors, and reaction with antibodies, transferase subunits equivalent to subunits 2, 3, and 4, in the binary combinations occurring in liver, were identified. However, subunit 1 (and therefore transferases 1-1 and 1-2) was not detected. The most conspicuous difference is the presence in lung of a new form, eluting at pH 8.7, which is not detected in rat liver. This isoenzyme (transferase "pH 8.7") is characterized by its low apparent subunit Mr and high efficiency in the conjugation of glutathione with anti-benzo(a)pyrene-7,8-dihydrodiol-9,10-epoxide, considered the ultimate carcinogen of benzo(a)-pyrene. PMID- 3977930 TI - Evidence that the long-lifetime photointermediate of s-rhodopsin is a receptor for negative phototaxis in Halobacterium halobium. AB - The effect of blue background light on behavioral response of Halobacterium halobium to step-like stimulation with green-orange attractant light was examined. The results strongly support the previously proposed hypothesis that a long-lifetime photointermediate of s-rhodopsin is the photoreceptor for repellent light: the step-like increase in green-orange light was convertible from attractant stimulus to repellent one, when the cells were constantly illuminated with blue light. No difference of the threshold intensity of the blue background light was observed between the mutant strain that lacks both bacteriorhodopsin and halorhodopsin and the wild type strain, suggesting that the two light-driven ion pumps are not participant in sensing attractant light. PMID- 3977931 TI - Temperature dependent redistribution among the multiple forms of rat Yb glutathione-S-transferase. AB - Anionic (Yb) rat liver glutathione-S-transferases are susceptible to temperature or pH dependent transitions to more basic forms of this class of proteins. At elevated temperatures (25-30 degrees) or at pH values above 9.0 the protein is rapidly and irreversibly converted to forms that are no longer retained by anion exchange resins and display basic components in chromatofocusing systems, because bound glutathione is removed at the higher temperatures or pH. Sharp increases in enzymatic activity with 1,2-dichloro-4-nitrobenzene as a substrate, accompany the temperature induced changes. Microheterogeneity patterns for this protein are contingent upon these interconversions, and the results explain apparent variations in relative amounts of the multiple forms under different conditions in terms of glutathione binding. PMID- 3977932 TI - Release of thioltransferase from rabbit polymorphonuclear leucocytes by immune complex in vitro and inhibition of the enzyme by chloramphenicol. AB - Immune complex induced the release of thioltransferase from rabbit peritoneal exudates polymorphonuclear leucocytes in vitro. The release of thioltransferase occurs from viable cells and does not depend on a cytolysis. The catalytic activity of the released enzyme with S-sulfocysteine and glutathione as substrates had a distinct optimum pH at 7.6. On the contrary, opsonized zymosan was not effective as a stimulus for the liberation of thioltransferase from polymorphonuclear leucocytes. Thioltransferase liberated by the stimulation with immune complex was inhibited by chloramphenicol, but not by bacitracin. The inhibition was non-competitive (apparent Ki of 0.2 mM). PMID- 3977933 TI - Influence of anion flux upon mitochondrial oxidative phosphorylation. AB - We have measured mitochondrial ATP synthesis during passive anion influx and find that influx of phosphate leads to diminished efficiency (as reflected in the ATP:0 ratio) whereas influx of acetate produced enhanced efficiency. The anions, sulfate, propionate, and thiocyanate, are without influence on the ATP:0 ratio. It is likely that the opposite effects of phosphate and acetate on the ATP:0 ratio reflect phosphate-acetate exchange, and that acetate influx produces its positive effect on ATP synthesis by promoting phosphate efflux. Thus, phosphate efflux may be associated with increased, and phosphate influx, with decreased energy conservation. PMID- 3977934 TI - A new protein of the brain myelin: isolation and chemical characterization. AB - An unknown protein has been isolated from bovine brain myelin. This protein, purified in the nonionic detergent n-octylpolydisperse oligooxyethylene, reveals on SDS gel electrophoresis a large number of bands in the higher MW region. However, chemical analysis and gel chromatography indicate the presence of a single, small protein containing large amounts of bound phosphatidylserine. N terminal and C-terminal sequences, aminoacid composition, and the anomalous electrophoretic behaviour led us to exclude the protein as a fragment of other already known myelin proteins. PMID- 3977935 TI - Reduced substrate affinity for human erythrocyte uroporphyrinogen decarboxylase constitutes the inherent biochemical defect in porphyria cutanea tarda. AB - The pathogenesis of human porphyria cutanea tarda (PCT) is associated with an intrinsic abnormality of the uroporphyrinogen decarboxylase enzyme. To characterize this, we studied the kinetic properties of the red cell enzyme procured from patients with various forms of PCT and non-porphyric controls. The enzyme activity (units/mg hemoglobin) in the red cell hemolysate was close to normal in sporadic PCT but about 75% diminished in the familial PCT. The Michaelis constants (Km) of 200-fold purified red cell enzyme preparations, determined by using pentacarboxylic porphyrinogen I and uroporphyrinogen I as substrates, were more than 3.8-4.0 times higher, and the maximum velocity (Vmax) was about 70% diminished in familial PCT, whereas the Km was about 1.7-1.9 times higher and the Vmax was more or less normal for sporadic PCT. These observations suggest for the first time that the primary lesion in familial PCT is a genetically determined kinetic abnormality of uroporphyrinogen decarboxylase which appears to be different from the sporadic form of the disease. PMID- 3977936 TI - One- and two- dimensional 15N/1H NMR of filamentous phage coat proteins in solution. AB - High resolution 15N NMR studies of proteins in solution can be performed efficiently by combining the use of isotopically enriched proteins and pulse sequences that generate polarization transfer from protons and result in two dimensional heteronuclear chemical shift correlation spectra. The coat proteins of the filamentous bacteriophages fd and Pf1 solubilized in detergent micelles give one- and two- dimensional NMR spectra with resolved resonances for nearly all of the nitrogen sites in the proteins. The resonances from the amide sites with slowly exchanging protons can be obtained as a subset of the resonances of all amide sites by comparing the spectra of proteins in D2O and H2O solutions at pH = 4.0. PMID- 3977937 TI - Ammonium inhibition of fatty acid oxidation in rat liver mitochondria. A possible cause of fatty liver in Reye's syndrome and urea cycle defects. AB - NH4C1 inhibited oxygen consumption (State 3, ADP induced) by rat liver mitochondria respiring on palmitoyl-L-carnitine or octanoic acid but not on succinate or malate + glutamate. The inhibition became apparent at 0.02 mM reaching a plateau (40%) at 2 mM NH4C1. Similar inhibition was observed with uncoupled (in the presence of 2, 4-dinitrophenol) mitochondria. The inhibition of uncoupled mitochondria was reversible as the rate of respiration with palmitoyl-L carnitine was further increased by succinate and the total rate was unaffected by NH4C1. Therefore, NH+4 inhibition of mitochondrial respiration may lead to fatty infiltration and be one of the causes of the pathophysiology in children with Reye's syndrome and disorders of urea cycle enzymes. PMID- 3977938 TI - Direct measurement of phagolysosomal esterase activity. AB - A new method of directly measuring esterase activity within phagolysosomes has been developed. Decanoyl fluorescein- binding microspheres were prepared and phagocytosed by human peripheral neutrophils. Within phagolysosomes lysosomal esterase hydrolyzed decanoyl fluorescein on the microspheres, causing the conversion of decanoyl fluorescein- binding microspheres (non-fluorescent) into fluorescein- binding microspheres (fluorescent). The activity of phagolysosomal esterase in intact neutrophils was assayed by the measurement of the fluorescence intensity without rupturing cells. By use of a flow cytometer, esterase activity within phagolysosomes in single cells was measured. PMID- 3977939 TI - Generation of acetyl glyceryl ether phosphorylcholine from the rat skin and muscle tissues stimulated by moxibustion. AB - Platelet-activating factor was obtained from the rat skin and muscle tissues which were stimulated by moxibustion. It showed a typical aggregation pattern on interaction with washed rabbit platelets but when it was treated with phospholipases A2 and C, and CV 3988 the aggregation activity was lost. Platelet activating factor was hydrolysed with phospholipase C and the resulting lipid product was converted to the tert-butyldimethylsilyl derivative. After purification by thin layer chromatography, the ether type of derivative was analysed by a selected ion monitoring technique of gas chromatography-mass spectrometry. 1-0-Hexadecyl-2-acetyl-sn-glyceryl-3-phosphorylcholine only was identified. PMID- 3977940 TI - Structural and functional assembly of rat intestinal cytochrome P-450 isozymes. Effects of dietary iron and selenium. AB - We have reported previously that both dietary iron and selenium regulate intestinal cytochrome P-450 content by modulating the synthesis of its prosthetic heme moiety. Whether these elements are required for synthesis and/or viability of its apocytochrome moiety is unknown. We have examined the effects of intraluminal deprivation of these elements on the apocytochrome moieties of the constitutive (P-450) and the beta-naphthoflavone inducible (P-448) intestinal isozymes. The relative content of intestinal apocytochrome P-450 moieties generated by dietary deprivation of iron and/or selenium was assessed indirectly by complexing with exogenous heme in vitro, to reassemble the holocytochromes which could be monitored spectrally and catalytically. We now report that, whereas both intraluminal iron and selenium are required for maintenance of the prosthetic apocytochrome moiety of the constitutive intestinal isozyme, only intraluminal selenium is required for the viability of apocytochrome P-448. The latter apparently survives in the absence of intraluminal iron and can be assembled to the holocytochrome, with exogenously added heme. The mechanistic basis of the critical requirement of intestinal apocytochromes for intraluminal selenium is unclear. It is intriguing, however, that the deleterious effects of selenium deprivation are principally exerted in cell systems actively synthesizing protein and inexorably dependent on their extracellular milieu for their nutriment. PMID- 3977941 TI - Inhibition of p-nitroanisole O-demethylation in perfused rat liver by oleate. AB - p-Nitroanisole O-demethylation in perfused livers from fasted, phenobarbital treated rats was rapidly and reversibly inhibited by sodium oleate (0.3 to 0.6 mM). Xylitol partially reversed this inhibitory effect. The inhibition was not mediated by a direct effect of oleate on microsomal components since concentrations of oleate ranging up to 1.0 mM did not affect p-nitroanisole O demethylation by isolated microsomes. Infusion of 0.6 mM oleate did not alter the measured intracellular NAD+/NADH ratio but did cause a significant increase in the intracellular NADP+/NADPH ratio. A significant decrease in the ATP/ADP ratio was also observed. Oleoyl CoA inhibited p-nitroanisole O-demethylation in microsomes (Ki about 30 microM), and both oleoyl CoA and palmitoyl CoA inhibited the energy-linked nicotinamide nucleotide transhydrogenase in submitochondrial particles (Ki about 1 microM). Thus, inhibition of mixed-function oxidation in the intact liver by oleate is most likely mediated by oleoyl CoA. Oleoyl CoA inhibits mixed-function oxidation in the intact liver by acting directly on cytochrome P-450 and by decreasing generation of NADPH via inhibition of key enzymes of the citric acid cycle and the energy-linked transhydrogenase. PMID- 3977943 TI - Difference circular dichroism studies of copper and nickel binding to D penicillamine in the presence of human serum albumin. AB - The binding of copper and nickel to D-penicillamine in the presence of human serum albumin (HSA) has been studied using difference circular dichroism (CD). The difference CD spectra due to penicillamine in HSA-Cu2+-penicillamine systems at pH 6 are indicative of ternary complexes between HSA, copper and penicillamine. On the other hand, the difference spectra due to penicillamine in HSA-Ni2+-penicillamine systems resemble that due to the Ni2+-penicillamine complex, indicating that mostly binary complexes are formed. The formation of stable complexes between penicillamine and copper or nickel (whether they are of the binary or mixed ligand type) may be important in the therapeutic action of this drug. PMID- 3977945 TI - 1-Naphthol conjugation in isolated cells from liver, jejunum, ileum, colon and kidney of the guinea pig. AB - Cells from liver, jejunum, ileum, colon and kidney of the guinea pig were freshly prepared by standard isolation procedures. Cells were incubated in the presence of several concentrations of 1(14C)-naphthol, and formation of 1-naphthol glucuronide and 1-naphthol sulphate was assessed at various times by thin layer chromatography. Cells from all five tissues conjugated 1-naphthol. The velocity of conjugation was fastest in jejunals cells (2.9 nmole/mg prot X min) followed by cells from liver, ileum, colon and kidney (0.2 nmole/mg prot X min). The apparent Km-values for glucuronidation ranged from 17 microM to 32 microM, and those for sulphation from 15 microM to 35 microM. Each tissue had a specific conjugation pattern. The two extremes were kidney cells, which had a glucuronidation/sulphation ratio in excess of 10, and colon cells which had a ratio of 0.38. The data suggest that these tissues possess different levels of 1 naphthol-conjugating enzymes, which resemble with regard to their apparent substrate affinities. PMID- 3977944 TI - Demonstration of a functional blood-testis barrier to acetaldehyde. Evidence for lack of acetaldehyde effect on ethanol-induced depression of testosterone in vivo. AB - In vitro studies have shown that acetaldehyde is a more potent inhibitor of testicular steroidogenesis than ethanol. The present study examined the in vivo role of acetaldehyde in ethanol-induced reduction of testosterone by (1) determining the levels of acetaldehyde to which the testes were exposed subsequent to acute ethanol administration to mice; and (2) examining the effect of ethanol on testosterone in animals subsequent to drug pretreatment which decreased or increased ethanol-derived acetaldehyde. Ethanol-induced (3 g/kg) depression of testosterone was dependent upon gonadotropin stimulation. The increase in hCG-induced testosterone was suppressed (P less than 0.01) in ethanol as compared to saline-treated animals [39.8 +/- 2.6 (S.E.M.) vs 28.1 +/- 2.3 ng/ml]. Pargyline (100 mg/kg) or cyanamide (8.4 mg/kg) increased (P less than 0.05) plasma and testicular acetaldehyde, while having no effect on the testosterone response to ethanol. Similarly, 4-methylpyrazole (25 mg/kg) reduced blood and testicular acetaldehyde to nondetectable levels, while having no effect on testosterone. Testicular acetaldehyde was lower (P less than 0.001) than plasma levels (14 +/- 2 vs 2.0 +/- 0.2 microM). This functional blood-testis barrier to acetaldehyde could be explained by testicular aldehyde dehydrogenases in the mitochondria (Km for acetaldehyde = 1.5 microM) and in the cytosol (Km = 123 microM) whose maximal activities totaled to more than 25-fold greater than that of testicular alcohol dehydrogenase (ADH). ADH was concentrated in the Leydig cells, while aldehyde dehydrogenase was evenly distributed in the testis. Ethanol prevented further hCG-induced rises in testosterone rather than inhibiting testosterone production to below pre-ethanol values. The above data argue against a significant role of acetaldehyde in the in vivo response of testosterone to ethanol. Ethanol appears to impair gonadotropin-testicular receptor interaction in vivo. PMID- 3977947 TI - Effect of uncharged anesthetics on ion binding to liposome surfaces. PMID- 3977946 TI - Tricyclic antidepressant drug effects on liposomal membranes. PMID- 3977942 TI - Inhibition of rabbit nasal and hepatic cytochrome P-450-dependent hexamethylphosphoramide (HMPA) N-demethylase by methylenedioxyphenyl compounds. AB - Eighteen methylenedioxyphenyl (MDP) compounds, including some commonly inhaled by people, were tested for the ability to inhibit rabbit nasal microsomal cytochrome P-450-dependent hexamethylphosphoramide (HMPA) N-demethylase. For comparison, liver microsomes were also used. Nasal cytochrome P-450 from rabbits metabolized MDP compounds to form cytochrome P-450-metabolite (P-450-MI) complexes as indicated by difference spectra in the Soret region. Several of the MDP compounds were potent inhibitors of nasal P-450-dependent N-demethylase. If inhibition of nasal P-450 also occurs in vivo after inhibiting MDP compounds are inhaled, the metabolism of concurrently or subsequently inhaled compounds may be altered. PMID- 3977948 TI - Localization of diethylstilbestrol metabolites in the mouse genital tract. PMID- 3977949 TI - Synaptosomal calcium uptake unaltered by adenosine and 2-chloroadenosine. PMID- 3977950 TI - Potentiated hepatotoxicity from concurrent administration of acetaminophen and allyl alcohol to rats. AB - Female Wistar rats were treated with acetaminophen 3.0 g/kg BW and allyl alcohol 75 microliter/kg BW by gastric tube. Hepatic function, measured as galactose elimination capacity and prothrombin index, was reduced to about 0.40 times control value. Plasma alanine transferase activity was elevated more and earlier after treatment with acetaminophen and allyl alcohol compared to administration of acetaminophen alone. Also prothrombin index was reduced more and earlier from the combination. Hepatic glutathione was depleted to a lower level 3 hr after administration of the combination of toxins, compared to administration of acetaminophen alone, after 6 hr there was no difference. Excretion of acetaminophen metabolites, especially the acetaminophen mercapturate, into urine was not changed from the combination. After administration of the toxic combination histological changes in the liver were minor. The results indicate that the two toxins potentiate each other's action. The potentiation is proposed to be due to prevention of compensatory hyperfunction of non-necrotic liver cells rather than to direct metabolic interaction of the toxins. PMID- 3977951 TI - Protein binding as a component of drug interaction in cellular pharmacokinetic studies. Effects of probenecid on transport and accumulation of methotrexate in Ehrlich ascites tumor cells in vitro. AB - The organic acid probenecid has been shown to interfere with the active extrusion of methotrexate (MTX) from L1210 tumor cells in vitro leading to enhanced MTX accumulation and increased formation of MTX polyglutamate derivatives. In the presence of serum albumin (4 g/100 ml), to which probenecid is bound, the inhibition by probenecid of [3H]MTX efflux from the Ehrlich ascites tumor cell was reduced markedly. While half-maximal inhibition of MTX efflux occurred with 0.12 mM probenecid in the absence of albumin, 1.45 mM probenecid was required in its presence. The presence of albumin also modified the probenecid-induced elevation of steady-state MTX levels in the tumor cell. Maximal elevation of cellular MTX levels occurred with 0.5 mM probenecid in the absence of albumin, and 3 mM probenecid in its presence. Serum albumin further reversed the effects of probenecid on MTX influx. While probenecid inhibited influx of 1 microM [3H]MTX in the absence of albumin (half-maximal inhibition at approximately 1 mM probenecid), probenecid stimulated MTX influx in its presence (half-maximal effect at 0.5 to 1 mM). Equilibrium dialysis studies demonstrated that probenecid displaced MTX from albumin, increasing the effective free concentration of MTX in the incubation medium, and hence the rate of MTX influx. Therefore, probenecid may enhance the accumulation of MTX in the tumor cells by increasing the level of free (as opposed to albumin bound) MTX in the extracellular medium as well as by direct inhibition of MTX efflux. These observations may provide an additional explanation for probenecid enhancement of the therapeutic efficacy of MTX in tumor bearing mice and highlight the importance of assessing drug-protein interactions in an in vitro experimental model. PMID- 3977952 TI - Effect of benzo[a]pyrene on DNA synthesis and DNA polymerase activity of rat liver nuclei. AB - When benzo[a]pyrene (B[a]P) was administered intraperitoneally to rats 48 hr before they were killed, the DNA-synthesizing capability of isolated rat liver nuclei was decreased as compared with control animals. B[a]P also inhibited in vitro DNA synthesis in nuclei purified from control animals; this effect was enhanced by NADPH. DNA polymerases solubilized from purified nuclei of B[a]P treated animals were less active than those of control animals. DNA polymerase alpha was more inhibited than DNA polymerase beta. Purified rat liver nuclei devoid of cytoplasmic contamination possess an NADPH-dependent B[a]P hydroxylase activity. The observed inhibition of DNA synthesis in nuclei isolated from B[a]P treated rats was increased by NADPH. Moreover, there was an increased inhibition of DNA polymerase activity by nuclear membranes obtained from B[a]P-treated animals when the incubations were performed in the presence of NADPH. Also, the derivative B[a]P-trans-9,10-dihydrodiol was a potent inhibitor of DNA polymerase alpha under conditions where DNA polymerase beta was less affected. These results suggest that nuclear B[a]P hydroxylase might be involved in the inhibition of DNA synthesis probably at the level of DNA polymerase alpha. As in the in vivo studies, the nuclear polymerase most affected by the hydrocarbon in vitro was DNA polymerase alpha. PMID- 3977953 TI - Antagonism of the cytocidal activity and uptake of melphalan by tamoxifen in human breast cancer cells in vitro. AB - The effect of the antiestrogen tamoxifen on the cytocidal activity and uptake of melphalan in human breast cancer cells was investigated. A clonogenic assay was used to obtain dose-survival curves of estrogen receptor-positive MCF-7 cells and of estrogen receptor-negative Evsa T cells following treatment with melphalan and/or tamoxifen. Isobolograms derived from these dose-survival curves were concave downward, suggesting that the drug interaction was antagonistic. The effect of tamoxifen on melphalan uptake by breast cancer cells was evaluated at steady-state conditions. Thin-layer chromatography revealed that the intracellular level of free intact melphalan (mean +/- S.E.) in control cells was 6.47 +/- 1.21 fmoles/cell and that in cells treated with tamoxifen was 3.60 +/- 0.35 fmoles/cell; this 44% reduction in cellular melphalan was statistically significant (P = 0.006). Thus, the antagonistic cytocidal effect of melphalan and tamoxifen against breast cancer cells appeared to be due to inhibition of melphalan uptake at the steady state by the antiestrogen. Further investigation revealed that tamoxifen inhibited unidirectional melphalan influx in human breast cancer cells both by the sodium-independent system L and by the sodium-dependent system ASC. Tamoxifen also appeared to stimulate melphalan efflux from human breast cancer cells. The first-order rate constant K for melphalan efflux from control cells was 0.085 +/- 0.008 and that from cells treated with tamoxifen was 0.129 +/- 0.005; the difference was highly significant (P less than 0.001). Therefore, the antagonistic effect of tamoxifen on the uptake and cytocidal activity of melphalan in breast cancer cells appeared to be due to inhibition of melphalan influx and stimulation of drug efflux. PMID- 3977954 TI - Induction of DNA single- and double-strand breaks by diethylstilbestrol in murine L5178Y lymphoblasts in vitro. AB - The mechanism of action of the synthetic estrogen diethylstilbestrol (DES) was investigated in murine L5178Y lymphoblasts. The dose-survival curve of cells treated with DES in serum-free medium for 1 hr was characterized by a prominent shoulder followed by a simple exponential decline; the Do, the dose of DES reducing cell survival to 1/e, was 1.52 nmoles/ml. DNA single-strand breaks, as measured by the alkaline elution method, were observed in DES-treated cells, and these followed a dose-response relationship after an apparent threshold of 10 microM DES was exceeded. Protein-associated strand breaks, which represent the increment in single-strand breaks that occurs by exposing drug-treated cells to proteinase K, were also noted. DNA double-strand breaks as measured by filter elution technology at pH 9.6 were observed and increased markedly to reach a level of approximately 9000 rad equivalents at a DES concentration of 20 microM. The measured ratio (mean +/- S.E.) of single- to double-strand breaks induced by DES in L5178Y limphoblasts was 0.09 +/- 0.035. A comparison of the ratio of single- to double-strand breaks induced by DES to that observed following radiation suggested that all of the single-strand breaks produced by DES could be attributed to double-strand breaks. The close correspondence of the dose-response curve for cytocidal activity of DES with that obtained for induction of DNA double-strand breaks suggested that such breaks may play an important role in the mechanism of cell kill by DES. PMID- 3977955 TI - 4-Fluoro-3-nitrophenyl azide, a selective photoaffinity label for type B monoamine oxidase. AB - The effects of 4-fluoro-3-nitrophenyl azide (FNPA) on types A and B monoamine oxidase in rat brain cortex were studied using serotonin and phenylethylamine as substrates respectively. FNPA competitively inhibited the oxidative deamination of both serotonin (Ki = 3 microM) and phenylethylamine (Ki = 0.78 microM) in the dark. Upon photoirradiation in the presence of FNPA, a photodependent inhibition of type B MAO activity resulted. This photodependent inhibition was apparently irreversible since there was no recovery of activity upon washing of the photolyzed FNPA-enzyme mixture. Additional evidence for the photoinduced covalent binding of FNPA to type B MAO is that non-competitive inhibition kinetics resulted after photolysis. The specificity of the photodependent incorporation of FNPA to type B MAO was shown by the protective effect of phenylethylamine and by decreased [3H]pargyline labeling after the enzyme was photolyzed with FNPA. Under the same experimental conditions, only minimal photodependent inhibition of type A MAO by FNPA was found. The observed difference in the efficiencies of the photodependent inactivation of the two types of MAO by FNPA suggests that there is a conformational or a structural difference in the active sites of the two types of MAO. The active site of type B MAO could be characterized by utilizing FNPA as a photoaffinity labeling probe. PMID- 3977956 TI - Effect of tolbutamide on myocardial energy metabolism of the ischemic heart. AB - The oral hypoglycemic agent tolbutamide has been found to protect the ischemic myocardium against irreversible mechanical failure. The possibility that this salutary effect of tolbutamide was related to its ability to alter energy metabolism was examined in ischemic rat hearts perfused with 5 mM glucose, 5mM acetate and 2.5 units/l insulin. In the presence of 0.6 mM tolbutamide, coronary flow and oxygen consumption were unaltered; however, glucose utilization was stimulated by 30%, glycogenolysis was enhanced by 23%, and the drop in ATP content was reduced by 17% after 30 min, of low-flow perfusion. This elevation in glycolytic flux occurred without a parallel rise in the production of inhibitory metabolites; lactate production was unaltered and tissue lactate/pyruvate ratio decreased. Pyruvate dehydrogenase flux measurements reveal that the mechanism by which tolbutamide increases glycolysis without increasing lactate production is by promoting the entry of pyruvate into the mitochondria. The basis for the observed stimulation of anaerobic metabolism and pyruvate oxidation and how this contributes to the increase in ATP content and benefits the ischemic heart is discussed. PMID- 3977957 TI - Auramine O as a fluorescent probe for the binding of basic drugs to human alpha 1 acid glycoprotein (alpha 1-AG). The development of a simple fluorometric method for the determination of alpha 1-AG in human serum. AB - A cationic fluorescent dye, auramine O (AO), exhibited an intense increase in fluorescence after binding to human alpha 1-acid glycoprotein (alpha 1-AG). The interaction between AO and the protein was studied by fluorescence spectroscopy and by equilibrium dialysis. AO binds to the protein via a single site with a dissociation constant of 24 microM. Various basic drugs such as chlorpromazine, imipramine, desipramine, quinidine, propranolol and lidocaine, which are known to bind to the protein, competitively inhibited the AO binding to the protein. The dissociation constants of these basic drugs obtained from such inhibitory experiments were comparable to those obtained with other methods (equilibrium dialysis, quenching of protein intrinsic fluorescence, and the difference spectrophotometric method) and from the literature. It is concluded that AO may be a useful fluorescent probe that binds to a single basic drug binding site on alpha 1-AG. In addition, a simple fluorometric method for the determination of alpha 1-AG in serum was developed using AO, and the validity of this method was confirmed by comparing it with the conventional radial immunodiffusion method. PMID- 3977959 TI - The biliary elimination of amaranth, indocyanine green and nitrazepam in germ free rats. AB - In anaesthetised bile duct-cannulated rats the overall rate of bile flow was 15 50% lower in both male and female germ-free (GF) rats. Except in the case of amaranth in female GF rats, this was reflected in a lower rate of biliary excretion of the three test xenobiotics, of which two (amaranth and indocyanine green) are excreted unchanged and one (nitrazepam) is excreted solely as metabolites. It was also noted that compared with conventional (CV) rats the relative liver weights (g/kg body weight) were about 20% lower in GF animals. After the intravenous injection of 14C-nitrazepam, thin-layer chromatographic separation of biliary nitrazepam-derived radioactivity revealed three loci (A, B and C in decreasing order of polarity). The relative proportions of A, B and C were similar in GF and CV rats, with C and B being the major and minor "metabolites" respectively. When 14C-nitrazepam was given intragastrically to non anaesthetised rats, by 9 days about 20% and 70% of the dose had been recovered in the urine and faeces respectively of both GF and CV rats. The rate of elimination of urinary radioactivity was similar in GF and CV rats. However, faecal elimination was much slower in GF animals, for example after 24 hr the respective amounts of radioactivity excreted in GF and CV rats corresponded to 13% and 52% of the dose. These findings indicate that the indigenous bacterial population of an animal may indirectly affect the disposition of a xenobiotic whether or not it is metabolised by the bacteria. PMID- 3977958 TI - Enhancement of reactive oxygen-dependent mitochondrial membrane lipid peroxidation by the anticancer drug adriamycin. AB - Mitochondrial degeneration is a consistently prominent morphological alteration associated with adriamycin toxicity which may be the consequence of adriamycin enhanced peroxidative damage to unsaturated mitochondrial membrane lipids. Using isolated rat liver mitochondria as an in vitro model system to study the effects of the anticancer drug adriamycin on lipid peroxidation, we found that NADH dependent mitochondrial peroxidation--measured by the 2-thiobarbituric acid method--was stimulated by adriamycin as much as 4-fold. Marker enzyme analysis indicated that the mitochondria were substantially free of contaminating microsomes (less than 5%). Lipid peroxidation in mitochondria incubated in KCl Tris-HCl buffer (pH 7.4) under an oxygen atmosphere was optimal at 1-2 mg of mitochondrial protein/ml and with NADH at 2.5 mM. Malonaldehyde production was linear with time to beyond 60 min, and the maximum enhancement of peroxidation was observed with adriamycin at 50-100 microM. Interestingly, in contrast to its stimulatory effect on NADH-supported mitochondrial peroxidation, adriamycin markedly diminished ascorbate-promoted lipid peroxidation in mitochondria. Superoxide dismutase, catalase, 1,3-dimethylurea, reduced glutathione, alpha tocopherol and EDTA added to incubation mixtures inhibited endogenous and adriamycin-augmented NADH-dependent peroxidation of mitochondrial lipids, indicating that multiple species of reactive oxygen (superoxide anion radical, hydrogen peroxide and hydroxyl radical) and possibly trace amounts of endogenous ferric iron participated in the peroxidation reactions. In submitochondrial particles freed of endogenous defenses against oxyradicals, lipid peroxidation was increased 7-fold by adriamycin. These observations suggest that some of the effects of adriamycin on mitochondrial morphology and biochemical function may be mediated by adriamycin-enhanced reactive oxygen-dependent mitochondrial lipid peroxidation. PMID- 3977960 TI - Formation of pentachlorophenol glucuronide in rat and human liver microsomes. PMID- 3977961 TI - Relationship between the rate of reduction of benzo(a)pyrene-3,6-quinone and the formation of benzo(a)pyrene-3,6-quinol glucuronides in rat liver microsomes. PMID- 3977962 TI - Position selective sex difference in imipramine metabolism in rat liver microsomes. PMID- 3977964 TI - Effects of ELF (1-120 Hz) and modulated (50 Hz) RF fields on the efflux of calcium ions from brain tissue in vitro. AB - We have previously shown that 16-Hz, sinusoidal electromagnetic fields can cause enhanced efflux of calcium ions from chick brain tissue, in vitro, in two intensity regions centered on 6 and 40 Vp-p/m. Alternatively, 1-Hz and 30-Hz fields at 40 Vp-p/m did not cause enhanced efflux. We now demonstrate that although there is no enhanced efflux associated with a 42-Hz field at 30, 40, 50, or 60 Vp-p/m, a 45-Hz field causes enhanced efflux in an intensity range around 40 Vp-p/m that is essentially identical to the response observed for 16-Hz fields. Fields at 50 Hz induce enhanced efflux in a narrower intensity region between 45 and 50 Vp-p/m, while radiofrequency carrier waves, amplitude modulated at 50 Hz, also display enhanced efflux over a narrow power density range. Electromagnetic fields at 60 Hz cause enhanced efflux only at 35 and 40 Vp-p/m, intensities slightly lower than those that are effective at 50 Hz. Finally, exposures over a series of frequencies at 42.5 Vp-p/m reveal two frequency regions that elicit enhanced efflux--one centered on 15 Hz, the other extending from 45 to 105 Hz. PMID- 3977963 TI - Salicylate-induced loose coupling: protonmotive force measurements. PMID- 3977965 TI - Effects of electric field exposure on some indices of CNS arousal in the mouse. AB - Mice given ELF electric field exposures of 50-400 Vm-1 at frequencies of 15, 30, and 50 Hz failed to display any significant changes in barbiturate sleeping time or exploratory activity. PMID- 3977966 TI - Current densities measured in human models exposed to 60-Hz electric fields. AB - This paper gives current densities measured in homogeneous grounded human models exposed to vertical, 60-Hz electric fields. The methods used for these measurements were validated by measuring the current densities induced in a grounded hemisphere and in a grounded prolate hemispheroid; agreement between measurement and theory was good. For an unperturbed field strength of 10 kV/m, current densities measured in the human chest were in the range 125-300 nA/cm2. A strong horizontal current-density enhancement was observed in the axillae, with peak values of about 400 nA/cm2. The vertical current density in the arms, when held downward, was in the opposite direction to that in the chest. Current densities in the abdomen, pelvis, and legs were a strong function of whether the body was grounded through one or both feet. With one foot grounded, the horizontal current density in the lower pelvic region, just above the crotch, was 770 nA/cm2. This value was the largest of those measured in the head, arms, or torso of the human model. Scaling factors derived from these data and similar data for animals will provide a quantitative basis for comparing animal and human exposure to 60-Hz electric fields. In addition, current-density data given in this paper can be directly extrapolated to higher frequencies, at least to 1 MHz. These extrapolated data may be useful to individuals and groups involved in the determination of safety standards for the lower radiofrequency region. PMID- 3977967 TI - Further studies of human whole-body radiofrequency absorption rates. AB - Further studies of human whole-body radiofrequency (RF) absorption rates were carried out using a TEM-cell exposure system. Experiments were done at one frequency near the grounded resonance frequency (approximately 40 MHz), and at several below-resonance frequencies. Absorption rates are small for the K and H orientations of the body, even when grounded. For the body trunk in an E orientation, the absorption rate of a sitting person is about half of the rate for the same person standing with arms at the sides; the latter in turn is about half the rate for the same subject standing with arms over the head. Two-body interactions cause no increase in absorption rates for grounded people. They do, however, increase the absorption rates for subjects in an E orientation in free space; the largest interaction occurs when one subject is lambda/2 behind the other (as seen by the incident wave). When these results are applied to practical occupational exposure situations, the whole-body specific absorption rate does not exceed the ANSI limit of 0.4 W/kg for exposures permitted by the ANSI standard (C95.1-1982) at frequencies from 7 to 40 MHz. PMID- 3977968 TI - Viability and phagocytosis of neutrophils exposed in vitro to 100-MHz radiofrequency radiation. AB - Rabbit polymorphonuclear leucocytes (PMN, neutrophils) obtained from peritoneal exudate were exposed in vitro for one-half or one hour to continuous wave or amplitude-modulated (20-Hz) 100-MHz RF radiation in a temperature-controlled coaxial exposure chamber at field strengths from 2.5 to 4.1 V/cm (SARs of 120 to 341 W/kg). RF exposure at 37 +/- 0.2 degrees C had no detectable effect on PMN viability or phagocytosis compared to sham-exposed cells simultaneously subjected to the same time-temperature regime. Temperature control studies indicated that at 37 degrees C no effect on PMN viability would be expected but phagocytosis would be reduced by approximately 6%/degrees C temperature increase. The absence of an effect of RF exposure suggests that there was minimal undetected intrasample heating and that phagocytosis was not affected by 100-MHz RF radiation under the conditions of this study. PMID- 3977969 TI - Effects of an extremely low frequency electromagnetic field on the cell division rate and plasma membrane of Paramecium tetraurelia. AB - The eukaryotic protozoan, Paramecium, was examined as a model for effects of pulsated electromagnetic fields (PEMF) on cells. A 72-Hz PEMF similar to fields employed clinically increased cell division rates in Paramecium by 8.5%. Two calcium transport mutants of these organisms showed differential responses to the same field. Verapamil, a calcium channel blocker, abolished any effect of PEMFs on cell division rates. A fluorescent probe that is thought to sense changes in membrane potential also manifested an altered response in the PEMF-exposed cells whereas a fluorescent lipid bilayer fluidity probe produced evidence of decreased membrane fluidity in the exposed cells. An effect of PEMFs on ion transport mediated by either a direct or indirect effect on the cell membrane is suggested by these studies. PMID- 3977970 TI - Specific absorption rate in rats exposed to 2,450-MHz microwaves under seven exposure conditions. AB - Both positive and negative biological effects of microwaves on drug actions in rats exposed to 1-mW/cm2, 2,450-MHz microwaves have been reported by several investigators. We conducted dosimetry studies for seven different exposure conditions to determine whether these different results could be due to the rats having been exposed differently. They included anterior and posterior exposures in a circular waveguide, near field, far field with E- or H-field parallel to the long axis of the body and dorsal exposure in a miniature anechoic chamber with E- or H-field parallel to the long axis of the body. The average specific absorption rates (SARs) in the head, tail, and body of the exposed rats were measured by means of a calorimetry system. The local SARs at eight locations in the brain were determined by temperature measurement with Vitek probes. Intensive coupling of energy to the tail when it was exposed parallel to the E-field was shown by thermography. For the same average incident power density, the average SARs in the heads of rats were about two times higher in the circular waveguide than for other exposures. The local SARs in the brain varied for different exposure conditions. Statistical comparisons of SARs under the different exposure conditions are presented. PMID- 3977971 TI - Effects of continuous-wave, pulsed, and sinusoidal-amplitude-modulated microwaves on brain energy metabolism. AB - A comparison of the effects of continuous-wave, sinusoidal-amplitude-modulated, and pulsed square-wave-modulated 591-MHz microwave exposures on brain energy metabolism was made in male Sprague-Dawley rats (175-225 g). Brain NADH fluorescence, adenosine triphosphate (ATP) concentration, and creatine phosphate (CP) concentration were determined as a function of modulation frequency. Brain temperatures of animals were maintained between -0.1 and -0.4 degrees C from the preexposure temperature when subjected to as much as 20 mW/cm2 (average power) CW, pulsed, or sinusoidal-amplitude modulated 591-MHz radiation for 5 min. Sinusoidal-amplitude-modulated exposures at 16-24 Hz showed a trend toward preferential modulation frequency response in inducing an increase in brain NADH fluorescence. The pulse-modulated and sinusoidal-amplitude-modulated (16 Hz) microwaves were not significantly different from CW exposures in inducing increased brain NADH fluorescence and decreased ATP and CP concentrations. When the pulse-modulation frequency was decreased from 500 to 250 pulses per second the average incident power density threshold for inducing an increase in brain NADH fluorescence increased by a factor of 4--ie, from about 0.45 to about 1.85 mW/cm2. Since brain temperature did not increase, the microwave-induced increase in brain NADH and decrease in ATP and CP concentrations was not due to hyperthermia. This suggests a direct interaction mechanism and is consistent with the hypothesis of microwave inhibition of mitochondrial electron transport chain function of ATP production. PMID- 3977972 TI - 60-Hz electric fields: detection by female rats. AB - Female rats were trained to detect a vertical, 60-Hz electric field using the same apparatus and procedure we used previously to study behavioral detection of the field by male rats. Each rat was trained individually to press a lever in the presence of the field and not to press in its absence. Correct detections occasionally produced a food pellet. The probability of detecting the field increased as field strength increased. The threshold of detection--ie, the field strength required for detections at a probability of 0.5 after correction for errors--varied among rats between 3 and 10 kV/m. Behavioral detection by female rats was indistinguishable from that by male rats. PMID- 3977973 TI - Prognostic factors in polymyositis/dermatomyositis. A computer-assisted analysis of ninety-two cases. AB - An effort was made to identify all patients with polymyositis/dermatomyositis (PM/DM) admitted to hospitals in Israel from 1956-1976. The diagnosis of PM/DM was retrospectively reviewed in 92 (46 definite, 26 probable, and 20 possible) cases. The most common complaints and physical findings in the course of the disease were muscle weakness (86 patients), rash (53 patients), arthritis or arthralgia (39 patients), and dysphagia (35 patients). Elevated serum aldolase levels were found in 64% of the patients for whom data were available; 92% had abnormal electromyogram results, and 60.9% had muscle histopathology consistent with PM/DM. Malignancy was diagnosed in 13 patients. Malignancy, ischemic heart disease, and pulmonary complications were the most common causes of death. The actuarial survival curve was heterogeneous, with an accelerated mortality during the first year after diagnosis and a slower mortality during the following 7 years. Independent unfavorable prognostic signs were: failure to induce remission, leukocytosis, fever, older age, a shorter disease history, and dysphagia. PMID- 3977974 TI - Evidence for intravascular coagulation in systemic onset, but not polyarticular, juvenile rheumatoid arthritis. AB - After observing a child with systemic onset juvenile rheumatoid arthritis (S-JRA) who developed purpura fulminans in association with disseminated intravascular coagulation, with subsequent gangrene and autoamputation, we undertook a prospective study of coagulation parameters in children with JRA. Ten consecutive children with S-JRA, 10 children with rheumatoid factor-negative, polyarticular juvenile rheumatoid arthritis (P-JRA), and 10 age- and sex-matched controls were studied. Routine coagulation screening tests were performed, as were tests for plasma fibrinopeptide A (a sensitive measure of intravascular thrombin generation), factor VIII-related antigen (an endothelial cell protein), and platelet factor 4 (a platelet-secreted protein). Our studies suggest that activation of intravascular coagulation is common in systemic onset JRA, but not in rheumatoid factor-negative, polyarticular disease. The coagulopathy may cause severe morbidity. In addition, marked elevations of plasma factor VIII-related antigen suggest perturbation of endothelial cells and vascular involvement in S JRA, but not in P-JRA. Normal ranges of platelet factor 4 indicate that intravascular platelet consumption does not occur in either type of JRA, despite the thrombocytosis common in both. PMID- 3977975 TI - Quantitation of the Sm nuclear antigen in tissues and activated lymphocytes. AB - Anti-Sm antibodies are specific for the diagnosis of systemic lupus erythematosus both in humans and in mice. Because the autoantibody response to this nuclear ribonucleoprotein particle is probably antigen driven, we have quantitated the Sm antigen in cells and tissues, using a highly sensitive and specific enzyme-linked immunosorbent assay. The Sm content of several in vitro cell lines was determined to be approximately 1 pg of Sm/cell. We found that murine spleen cells stimulated in vitro with either T cell or B cell mitogens contained up to 10 times more Sm than did unstimulated cells and that they also released increased amounts of Sm. In a survey of organs from several mouse strains, we found that lymphoid tissues had the largest amounts of Sm and that the Sm content of a particular tissue correlated with its DNA content. Increased amounts of Sm in and around activated lymphocytes, as found in systemic lupus erythematosus, may provide a source of antigen for the induction of the anti-Sm autoantibody. PMID- 3977977 TI - Kinetics of extraction of proteoglycans from human cartilage. AB - Fifty-one uniformly sliced human patellar cartilage specimens were extracted with physiologic buffer containing inhibitors. Galactosamine-rich proteoglycans were more easily extracted than glucosamine-rich proteoglycans. Extraction occurred in 2 phases. There was a large proteoglycan extraction during the first 30 minutes, followed by a steady loss proportional to the square root of time. The amount of proteoglycans extracted during phase 1 was approximately half that of phase 2. Extraction of proteoglycans varied with age, structural integrity, and cartilage thickness. Intact osteoarthritic cartilage had normal proteoglycan extraction. PMID- 3977976 TI - Assessing physician/patient perceptions in rheumatoid arthritis. A vital component in patient education. AB - Patient education surveys were completed by 101 patients with rheumatoid arthritis and by 28 rheumatologists to assess and compare patients' reports with physicians' perceptions of patients' needs regarding content, provider, and education program delivery methods. Both groups agreed on the importance of patients' education about arthritis, especially on the topics of medication, physician/patient communication, quackery, and maintaining ambulation. A higher proportion of physicians reported that patient education was needed in psychosocial areas, activities of daily living, sexual concerns, and community resources. Patients sought more education in disease process, diagnostic procedures, and nutrition. Patients rated pharmacists and nutritionists significantly more important as educational sources than did physicians. Both groups reported individual patient/practitioner meetings as the preferred delivery method. Physicians reported group education to be valuable for some psychosocial topics; patients disagreed significantly. Despite considerable consensus, disagreements were evident in the psychosocial area and in the role of allied health professionals. Clarification, understanding, and resolution of these differences should be sought before implementing patient education programs. PMID- 3977978 TI - Cardiac involvement in Behcet's disease. PMID- 3977979 TI - In vitro IgM and IgM rheumatoid factor production and response to remittive agents in rheumatoid arthritis. PMID- 3977980 TI - Comment on article by van der Linden et al. Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. PMID- 3977981 TI - The CREST acronym and some related problems. PMID- 3977982 TI - Survey of current audiometric practices. PMID- 3977983 TI - Protection of human subjects in speech and hearing research. PMID- 3977984 TI - Memory deficits subsequent to chronic consumption of alcohol in mice: an analysis based on spontaneous alternation behavior. AB - Male mice of the BALB/c strain were given a solution of 15% ethanol as their only source of fluid for periods varying from 5 weeks to 8 months. For behavioral testing, they were compared with control groups which had received either an isocaloric solution of sucrose or tap water. Memory was tested by using spontaneous alternation behavior in a T maze. Each test consisted of two forced trials (acquisition) followed by a free trial (test) given at different acquisition--test intervals (from 30 s to 24 h). Results from two independent experiments showed that after 25 weeks of ethanol administration there was an accelerated rate of decay of spontaneous alternation as a function of the acquisition--test interval. Such a phenomenon persisted after ethanol was omitted from the diet. A third experiment showed that when tested on two successive sessions separated by a 5 h interval, experimental subjects exhibited a decreased ability to perform normally on the second test. Our data are interpreted as showing that long-term ethanol administration results in accelerated forgetting and increased vulnerability to proactive interference and, as such, they are compared to the memory dysfunctions observed in amnesic patients. PMID- 3977985 TI - Movement and non-movement related pallidal unit activity during bar press feeding behavior in the monkey. AB - Activity was recorded from 358 neurons in the globus pallidus (GP) of monkeys (Macaca fuscata) during an operant feeding task consisting of 3 stages: (1) food or non-food presentation (1st stage); (2) bar pressing (2nd stage); and (3) food acquisition and ingestion (3rd stage). There were two kinds of neurons, one with high and the other with very low (almost silent), spontaneous firing rates. Two hundred and four neurons (57%) responded in one or more of the feeding stages. Of the 21 neurons which responded in the 1st stage, two responded selectively to food presentation, and 19 responded to both food and non-food visual presentation. One hundred and seventy-four neurons (49%) and 107 neurons (30%) responded in the 2nd and 3rd stages, respectively, and 106 (30%) of these were directly related to specific feeding motor acts such as arm extension, flexion, bar pressing, grasping, chewing etc. Both high and low firing neurons responded to motor acts with sharp or gradual onset. More than half of those that responded to arm extension showed laterality (contra or ipsi)- and function (extension or flexion)-dependent responses. The incidence of the motor related neurons was higher in the caudodorsal part of the GP. On the other hand, about one third, especially in the rostroventral part of the GP, showed dissociating responses in that they responded during bar pressing for food or during ingestion in an operant task, but not during bar pressing for non-food or during forcible ingestion. The magnitude of firing changes during arm extension and bar pressing depended on the nature of the food. Moreover, in trials using new food or false (model) food, firing changes during bar press appeared or disappeared within a few trials with no correlation to bar press movement. These data suggest heterogeneous functions within the GP; the caudodorsal part is strictly concerned with motor execution and preparation, while the rostroventral part is not related to motor function directly, but may rather be important in coupling internal, motivational information to the motor system. PMID- 3977986 TI - Persistence of working memory of rats in an aversively motivated radial maze task. AB - The effects of various within-trial delays on the performance of rats in an 8-arm radial water maze (RWM) were investigated. Rats (n = 13) were trained to escape from 25 degrees C opaque water onto a submerged bench situated at the far end of each channel of the maze. After 20 s the chosen bench was collapsed and the rat had to return to a central platform, 1 cm above water level. After 15 s the platform was lowered and the animal was forced to choose again. This was repeated until all 8 channels had been visited. After 30 daily trials the mean number of correct choices per trial (first 8 choices) was 7.8. In Experiment 1, delays from 40 min up to 21 h were inserted between choices 4 and 5. The number of revisited channels (errors) in the second half of a trial increased rapidly with the duration of the delay, and was not significantly different from chance at 640 min. In Experiment 2, delays of 2.5, 5, 10 or 20 min were inserted between individual choices. Again, performance deteriorated with the duration of the delay. When the incidence of errorless trials was analyzed, performance was not significantly different from random at 5 min inter-choice delays. Comparison with conventional radial maze studies indicates that spatial working memory in the RWM has a slower, but also exponential decay. PMID- 3977987 TI - Stimulus-dependent form discrimination deficits in cats with superior colliculus lesions. AB - Previous studies have shown that cats with damaged superior colliculi are slower than normal in learning new visual discriminations based upon shape but show no losses in retention of discriminations learned prior to the tectal lesion. To elucidate the possible mechanisms producing this deficit, the rate at which cats with superior colliculus lesions learned to discriminate between targets differing either in (1) global features, or (2) a single, uniquely localized, feature was measured. Cats were first tested with problems shown in earlier studies to produce acquisition deficits and those with superior colliculus lesions showed the expected deficits. The rate of acquisition of form discriminations based on global stimulus features in these cats was, however, comparable to normals and sham-operated controls. When tested with targets differing only in a single, localized feature, acquisition of the discrimination was severely impaired compared to controls. The observed deficits did not depend upon damage to pretectum or total ablation of the superior colliculus. The results support the view that the superior colliculus is a major contributor to visuomotor integration (e.g. foveation of salient stimulus features), and that such visuomotor behavior is an important determinant in form discrimination learning. PMID- 3977988 TI - Operant behavior and drinking suppression in vasopressin-deficient rats (Brattleboro strain). AB - A group of Brattleboro rats homozygous for diabetes insipidus (DI) and a group of normal Long-Evans (LE) rats were deprived of water and tested on two tasks thought to measure reinforcement strength: a progressive-ratio schedule in an operant chamber and a quinine-induced drinking-suppression task. Since water deprived DI rats are in more severe negative water balance than LE rats, it was hypothesized that they would sustain higher ratios than LE rats on the progressive-ratio schedule and would suppress drinking at higher quinine concentrations than LE rats. It was found that DI rats responded less than LE rats on the progressive-ratio schedule and that DI rats suppressed drinking as much as LE rats at each concentration of quinine used on the drinking-suppression test. It is suggested that the reinforcement strength of water for DI rats is not higher than that for LE rats. PMID- 3977989 TI - Brief preoperative exposure to saline protects rats against behavioral impairments in salt appetite following central gustatory damage. AB - Adult rats who receive large electrolytic lesions at the level of the thalamic taste relay display impairments in taste related behavior, specifically the appetite for salt that results from changes in sodium balance. However, if the rats are given preoperative experience of ingesting a salty taste they are protected against these impairments in salt appetite that result from the lesion. In the present study we found that a brief (30 s) preoperative exposure to saline is sufficient to protect adult rats against expected deficits in salt appetite that normally result from central gustatory damage at the level of the thalamic taste relay. It is becoming increasingly clear that preoperative events can lessen the severity of the effects of brain damage. The results are discussed in the context of the appetite for salt, and preoperative immunization from behavioral deficits that result from brain damage. PMID- 3977990 TI - [Structure of alveolar bone during tooth eruption in the dog: preliminary findings]. AB - The structure of the alveolar bone during the tooth eruption in the young dog mandibles was investigated by microradiographic and polarized light techniques. Around the first erupting molar root a trabecular network of primary alveolar bone, less mineralized than the surrounding cortical one, was found. Numerous calcified spicules parallel one to others radiate out the spongiosa near the periodontal ligament. The collagen fiber bundles of the alveolar, woven, bone are continuous with the periodontal ligament ones. This finding indicates that the alveolar bone increases by ossification of the periodontal ligament. Therefore the latter is the forming alveolar bone substratum. The trabeculae of the occlused premolar alveolar bone are ticker and more mineralized. This modification of the occlused tooth alveolar bone could be related to the occlusal stresses. PMID- 3977991 TI - The effect of some sulfhydryl reagents on the respiratory chain activity. AB - The observation that in cation transport experiments N-ethylmaleimide (NEM) behaves as uncoupler and as a respiratory inhibitor at the same time, the effect of sulfhydryl reagents on the redox state of respiratory chain, has been studied. Spectra of mitochondrial suspension in the span 300-630 nm have revealed that NEM promotes the oxidation of all the respiratory intermediates, cytochrome a included. Azide completely reverses the oxidation effect of NEM, suggesting that it cannot be ascribed to an irreversible damage of mitochondrial intactness. Mersalyl, which shares the highly sensitive SH reagent and specific inhibitor of Pi transport properties of NEM, gives completely different results. It is proposed that, besides the generally accepted inhibitory effect on primary dehydrogenases reacting with their SH groups, NEM may also behave as an oxidizing agent which can promote the release of reducing equivalents from the respiratory chain. PMID- 3977992 TI - [Changes in the erythrocyte in liver cirrhosis: role of cholesterol and plasma phospholipids]. AB - To investigate the role played by plasmatic lipids in the altered erythrocyte deformability observed in cirrhotic patients we studied 15 patients with liver cirrhosis (histologically diagnosed) and 10 healthy volunteers. Erythrocyte filtration time, plasmatic free and esterified cholesterol and phospholipids were measured in all subjects. The erythrocyte filtration time resulted to be significantly increased in cirrhotic patients (35'' +/- 3, 35 M +/- SEM) when compared to control subjects (26'' +/- 2, 53: M +/- SEM) (t = 2,078 p less than 0,05). This increase correlated in cirrhotic patients (but not in control subjects) with free/esterified cholesterol ratio (p less than 0,01) as well as free cholesterol/phospholipid ratio (p less than 0,001). Our results confirm that decreased erythrocyte deformability in cirrhotic patients which is accompanied by altered erythrocyte morphology is due, at least in part, to the altered lipids blood levels. PMID- 3977993 TI - [Modification of granulocyte chemotaxis during anesthesia for surgery]. AB - The PMNs of fourteen patients undergoing general anesthesia for surgical operations were examined to determine whether abnormal chemotaxis occurs during these procedures. Neutrophil chemotaxis was determined immediately before anesthesia and after the anesthetic somministration. Anesthetic agents included 0.2-1% enflurane, 0.3-1% halothane or N20-02 (60:40). Neutrophil chemotaxis was reduced an average of 10.9% by fluorinated anesthetics, no significant modification (+8.1 +/- 13.0%) was detected by N20-02. PMID- 3977994 TI - [Changes in HDL-cholesterol, subfractions HDL2 and HDL3 and apo-A, apo-A1 and apo B lipoproteins in patients with chronic renal failure subjected to maintenance hemodialysis]. AB - Hyperlipoproteinemia was found in 200 patients affected by chronic renal failure on maintenance hemodialysis, due to increase in Total Cholesterol, VLDL-TG, LDL, TG, LDL and VLDL. In 30 of these patients, the analysis was extended to the dosing of decreased Total Serum HDL-Cholesterol, HDL2, HDL3, Apoprotein A and Apoprotein A1 values, and of increased Apoprotein B values. These findings further contribute to proving accelerated atherogenesis in the patients examined. PMID- 3977995 TI - [Rapid method for evaluating intra-erythrocyte Na+ activity]. AB - The measurements of intracellular "Na+ activity" was performed in 10 ml of heparinized venous blood. First the blood was three times washed in isotonic magnesium chloride solution (114 mmol/l). Thereby the buffy coat was removed. Then the microhematrocrit was taken for packet cell volume determination. After the erythrocytes were lysed by ultrasound. Sodium "Na+ Activity" is measured in the hemolysate by Ion-Selective electrode. With this method all "pipetting" operations are eliminated and for the "Na+ activity" determination was used ion selective electrode with an indirect measurements, which is less influenced by the matrix. Reference intervals determined for a healthy population were 7.3 +/- 0.6 mmol/l. PMID- 3977996 TI - [Evaluation of intra-erythrocyte Na+ activity in persons at high risk for essential arterial hypertension and as an aid in differential diagnosis from secondary forms of hypertension]. AB - The intracellular "Na+ activity" was measured in erythrocytes of normotensive subjects (46), in essential hypertensive patients (18), in their children (20) and in patients with secondary hypertension (8). In normotensive subjects without a genetic trait of hypertension intracellular "Na+ activity" was 7.3 +/- 0.8 mmol/l, in secondary hypertensive patients was 7.5 +/- 0.6 mmol/l, in essential hypertensive patients was 10.9 +/- 1.1 mmol/l and in their children was 8.6 +/- 2.1 mmol/l. In this group (children) it was possible to differentiate between 2 population, the 1 degree with height intracellular "Na+ activity" (8); the 2 degrees with normal intracellular "Na+ activity". PMID- 3977997 TI - Further data indicating ovarian hormone independent cells in the human endocervical crypts. AB - This study was carried out in order to verify the existence of two types of muciparous cells in the human endocervical mucosa on the basis of their ovarian hormone dependence. Uterine cervices of fertile and late menopause women were compared to define histochemically the morphology of muciparous cells found in two opposite ovarian hormone patterns. A similar morphology was observed in the fertile and late menopause groups, although they differed in both a higher number of muciparous cells and more intracellular mucus present in the fertile women. A comparative evaluation of these data suggest that hormone independent cells are present in the cervical crypts of late menopause women and that a cyclic change of hormone dependent cells may occur in fertile women, analogous to the cyclic changes of endometrial mucosa. PMID- 3977998 TI - Alkaline phosphatase in Hirudo medicinalis L.: partial purification and study of certain molecular and catalytic properties. AB - The authors carried out extraction and purification of an alkaline phosphatase (AP) from Hirudo medicinalis and studied certain characteristics of the enzyme. After homogenizing specimens of H. medicinalis and centrifuging the homogenate at 70,000 g, the enzyme, likely membrane-bound, was obtained in a soluble form by treating the sediment with n-butanol. It was then purified by acetone fractionation and Sephadex G-200 chromatography. A fairly good purification degree was achieved; the enzyme appears to be in a single form and displays a molecular weight of about 268,000. The optimum pH (9.5) is lower than the ones generally observed as regards APs from both Invertebrata and Mammalia. The studied AP displays a strong substrate inhibition, similar to that concerning Metazoa at a higher evolutionary level (Mollusca, Echinodermata). On the contrary, the enzyme-substrate affinity, as shown by Km value (2.447 mM), is lower than as regards APs from more advanced organisms (Echinodermata, Mammalia). PMID- 3977999 TI - [Structure of the periodontal ligament during tooth eruption in the dog: descriptive aspects]. AB - Serially stained uncalcified sections of young dog mandibles were examined to study the structure of the periodontal ligament of the erupting first right molar. The periodontal ligament around tooth crown presents three zones. The first, near the dental follicle, is a tick layer of parallel collagen bundles with numerous flattened fibroblasts. The second, intermediate, contains a blood vessels network, particularly veins and capillaries. The third, outer, is occupied by a continuous layer of osteoclasts and osteoblasts. Also the periodontal ligament around the tooth presents three layers, the outer and the intermediate rich of cells more than the inner. Particularly, the outer layer shows numerous osteoblasts surrounding the developing trabeculae of the alveolar bone and the collagen fiber bundles of the periodontal ligament. These penetrate into the trabeculae and appear similar to the osteoid layer. These results indicate that the alveolar bone increases by ossification of the connective tissue of the periodontal ligament. PMID- 3978000 TI - [Use of horseradish peroxidase as a marker in studies of the formation of the blood-brain barrier (optic tectum of the normal and experimentally-treated chick embryo)]. AB - The development of the blood brain barrier (BBB) and the vessel permeability to horseradish peroxidase (HRP) have been analyzed in the optic tectum of chick embryos developed under normal and hypoxic conditions, normal chickens, and chickens born from fertilized eggs incubated under hypoxia but kept in the open air after hatching. The development of chick embryos under a situation of chronic hypoxia was obtained by covering, a half of the shell of fertilized eggs with a thick layer of melted paraffin to obtain a reduction of the exchanges normally occurring between embryonic blood vessels and open air. In the tecta developed in normal conditions the BBB to HRP begins to form on the 14th i.d. and it is complete on the 17th i.d. The O2 deprivation, producing remarkable alterations of the neural substratum, does not affect the development of the BBB to HRP, since in chicks of 17 i.d., grown up under hypoxic conditions, the tectal microvessels are not permeable to the tracer, being it mainly confined within the vessel lumina. Nevertheless in specimens kept under hypoxia until hatching, areas of perivascular spread of the marker have been observed corresponding to the vessel wall tracts presumably damaged by the experimental conditions along which the BBB to HRP is not complete. PMID- 3978001 TI - [Differentiation of cerebellar Purkinje neurons of the normal and chronically hypoxic chick embryo]. AB - A microscopical and ultrastructural study on the cerebellum development, with peculiar attention to the Purkinje cell differentiation, has been undertaken in chick embryos from the 8th incubation day (i.d.) until hatching, both in normal and hypoxic conditions; the development under hypoxia was obtained by covering, at the 2nd i.d., a half of fertilized egg shells with melted wax (Menkes et al., 1975). The observations, carried out on paraffin, semithin, and ultrathin sections of cerebellum anlagen, indicate that, under normal conditions, the cerebellar "folia" begin to appear on the 9th-10th i.d., and the secondary and tertiary ones are completely formed at the 14th i.d., when also the cortex layers begin to be recognizable owing to the successive migration processes of cells from two germinal layers and the mitotic proliferation of neuroblasts. The Purkinje cells are identifiable only at the 10th i.d. as large neuroblasts, irregularly stratified beneath the external granular layer, and characterized by a scanty amount of basophilic cytoplasm; they progressively acquire features of neurocytes, with abundant basophilic cytoplasm and numerous ramifications of their dendritic tree. The differentiation of Purkinje neurocytes, complete at the 17th i.d., is accompanied by degeneration events affecting some of them, which appear modified in shape, size and both structural and ultrastructural features (e.g. nuclear pycnosis, condensation and/or vacuolization of the cytoplasm). In the hypoxic embryos the main morphogenetic and histogenetic processes normally unfold during the embryonic life and the Purkinje cell differentiation occur like in the normal embryos until the 15th i.d.; afterwards a progressively greater number of them undergoes severe morphological modifications, comparable to those affecting only few neurons in the cerebellum of normally developed embryos.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978002 TI - [The autonomic and somatic nervous systems]. PMID- 3978003 TI - [Anatomy and development of the peripheral autonomic nervous system]. PMID- 3978004 TI - [Topographic mapping of regional cerebral blood flow by xenon-enhanced CT- introducing a simplified method as a routine examination]. AB - Measurement of regional cerebral blood flow (rCBF) has become a routine examinations in the field of clinical neurology and neurosurgery. Therefore, various methods for measuring rCBF have been developed. Among them, xenon enhanced CT method has many advantages compared with others. An obtainable topographic flow map, high anatomical spatial resolution, and readily available instrument, namely CT scanner, are regarded as the advantages. On the one hand, anesthetic effects of xenon gas on the patients, taking a great expense for a single examination, and a significant dose of radiation delivered to the patients are thought to be the disadvantages. Due to the disadvantages, xenon-enhanced CT is regarded as an unpractical examination. In the paper, we introduce a method with a brief xenon inhalation, named a simplified method, with which the disadvantages can be avoided. Conventional xenon-enhanced CT requires 20 to 25 minute inhalation of xenon gas in order to achieve a saturation of xenon in the cerebral tissue for a calculation of the partition coefficients (L). In the simplified method, instead of using the calculated L, L was given as 1.0 in all the cerebral regions and xenon gas was terminated at 4 minute inhalation. Four minute inhalation of xenon gas did not make any significant anesthetic effects on the patients nor the changes of physiological parameters, such as, PaCO2 and blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978005 TI - [Localization of lesions in aphasia: clinical-CT scan correlations (Part II)]. AB - On the basis of the characteristic symptoms or the result of a speech examination, 127 right-handed cases with various types of aphasia were subdivided into two groups within each aphasic syndrome. Using a microcomputer, the locus and extent of the lesions, as demonstrated by computed tomography for each group were superimposed onto standardized matrices. The relationship between the focus and the extent of the lesions and the various symptoms was investigated. Broca aphasics: More than 80% of the group with obvious anarthric components had lesions of the third frontal gyrus involving Broca's area and the lower part of the precental gyrus as well as opercular and insular regions. The size of the lesions of this group was significantly larger than that of the group without marked anarthric components, and the latter was proved to have little localizing value. Wernicke aphasics: The group with poor reading comprehension had cortical and/or subcortical lesions, involving posterior parts of both superior and middle temporal gyri as well as the supramarginal gyrus. On the other hand, lesions of the group with poor auditory comprehension were more anteriorly located and localized in the deep structures. Lesions of the group with poor Token test scores were large and scattered more anteriorly and/or posteriorly compared with those of the group with good Token test scores. Amnestic aphasics: The group with poor naming scores had somewhat larger lesions than the group with good naming scores, and the lesions were scattered about the left hemisphere. The finding has proved that both groups had little localizing value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978006 TI - [A rare case of subarachnoideal pneumocephalus after ear douche therapy]. AB - No detailed reports on pneumocephalus caused by any factors other than head trauma, and their courses accompanied with this disease have been so far available. We recently experienced a case of pneumocephalus complicated with severe clouding of consciousness, ocular deviation, and unilateral spatial neglect with the results being reported hereinafter. A 54-year-old man had often received ear douche therapy due to chronic sinusitis and tubal obstruction about 3 years before without any history of head trauma. On Jan. 6, 1984, sudden clouding of consciousness accompanying stiffness of the left arm occurred immediately after ear douche, and then he was transferred to our center. At admission, semicomatose, bilateral ocular deviation to the right, and left hemiparesis were observed. Plain skull X-ray films showed a retention of air in the frontal and temporal regions, while CT scan revealed air retention on the bilateral frontal region, bilateral temporal tip and suprasellar cistern. However, no abnormal findings were detected in the brain. Consciousness and hemiparesis recovered on the next day of hospitalization, however, the left hemispatial neglect still remained. This symptom was still observed on the 3rd day but disappeared by the 4th day of hospitalization. For clarifying its cause, cerebral angiography, CT scan and electroencephalography were then performed. CT scan revealed no anomalies in the brain, while cerebral angiography showed a cerebral circulation pattern in favor of the right internal carotid artery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978007 TI - Fentanyl by constant rate i.v. infusion for postoperative analgesia. AB - Fentanyl by continuous i.v. infusion (1.5 microgram kg-1 min-1 or 0.5 microgram kg-1 min-1) was compared with placebo infusion as an analgesic regimen for 24 h after hysterectomy. The drugs were infused using a new disposable device which required no external power source. All patients were allowed morphine i.m. if they experienced pain. Patients in the higher dose fentanyl group demanded less i.m. morphine and had better pain relief after operation, without important respiratory depression. PMID- 3978008 TI - Continuous extradural infusion of 0.0625% or 0.125% bupivacaine for pain relief in primigravid labour. AB - The efficacy of an extradural infusion of 0.0625% or 0.125% bupivacaine was studied in 98 primigravid mothers in active labour. No special measures were taken to posture the mother (except to avoid aorto-caval compression). The study regimen included a control group (no infusion) receiving intermittent top-ups (0.25%. bupivacaine 8-10 ml), two groups receiving bupivacaine 6.25 mg h-1 infusion in different concentrations (0.0625% and 0.125%), a fourth group receiving 0.125% bupivacaine 12.5 mg h-1 infusion, and a fifth group receiving 0.125% bupivacaine 18.75 mg h-1 infusion. The optimum infusion rate was 0.125% bupivacaine 10 ml h-1, at which 69% of primigravid mothers required none or only one "top-up" of 0.25% bupivacaine 8-10 ml during a mean duration of 7.1 h labour. In the group who had no extradural infusion, only 32% of mothers managed with one or no top-up. The median interval between top-ups was increased from 145 min in the no infusion group to 245 min in those mothers receiving 0.125% bupivacaine 10 ml h-1 by infusion. Increasing the rate of infusion to 15 ml h-1 did not improve the results. Spread of local anaesthetic to higher levels was limited (less than T5) so that testing sensory loss at the T5-6 level at 2-hourly intervals should detect accidental spinal blockade resulting from inadvertent intrathecal infusion. PMID- 3978009 TI - Buprenorphine-supplemented anaesthesia. Influence of dose on duration of analgesia after cholecystectomy. AB - Fifty-one patients undergoing cholecystectomy received a single dose of buprenorphine 4.5-12 micrograms kg-1 at induction. Median duration of analgesia after surgery was 6 h. Multiple regression analysis showed the duration of analgesia to be slightly dependent on the age of the patient. No relationship was found between the duration of analgesia and the weight-related dose of buprenorphine, the age, sex or body weight of the patient, the duration of anaesthesia, or the dose of droperidol or thiopentone administered. PMID- 3978010 TI - Fentanyl and bupivacaine mixtures for extradural blockade. AB - In a prospective double-blind study, single dose lumbar extradural blockade was instituted in 80 healthy male patients undergoing lower abdominal surgery. Patients were assigned randomly to one of four groups. Each group received treatment with 0.5% bupivacaine 20 ml containing adrenaline 1:200 000. To this solution was added fentanyl 0, 50, 100 or 200 micrograms. The time to regression of analgesic blockade was significantly prolonged (P less than 0.05) only with mixtures containing fentanyl 200 micrograms; no effect was demonstrated with lower doses of the opioid. However, the degree of motor blockade was less intense and incomplete S1-blockade (root-jumping) was more frequent with mixtures containing increasing doses of fentanyl. Patients treated with bupivacaine fentanyl mixtures shivered less than the control group and showed fewer instances of acute hypotension. The side-effects observed were minor. PMID- 3978011 TI - Lumbar sympathectomy: a single needle technique. AB - A single-needle lumbar sympathectomy technique is described which uses the tip of the 12th rib as a marker to determine the appropriate position for the insertion of the needle. Radiological screening is used to control final placement at the body of L3 and to visualize spread of radio-opaque phenol in the correct prevertebral plane. Following sympathectomy, fore-foot temperatures increased by a mean of 3 degrees C and lower leg blood flow doubled, these being accompanied by significant increases in ankle pressure index and venous oxygen tensions in the affected foot. These physiological improvements brought about resolution of ischaemic foot pain in 70% of patients at follow up 1 month later. As these results were not significantly different from those obtained in patients having two-needle sympathectomy, blockade with a single needle under x-ray control is considered to be an effective technique for the performance of neurolytic sympathectomy. PMID- 3978012 TI - Subarachnoid blockade and total hip replacement. Effect of ephedrine on intraoperative blood loss. AB - Thirty-eight patients undergoing total hip replacement under subarachnoid blockade were allocated randomly to one of two groups. Following institution of the blockade, patients in group A received ephedrine i.v. to maintain the systolic arterial pressure at, or above 100 mm Hg. Patients in group B were managed in an identical way, but did not receive ephedrine. Significant differences in arterial pressure (P less than 0.001), and heart rate (P less than 0.005), but no significant difference in blood loss was observed in the two groups. This was confirmed by similar blood transfusion requirements and postoperative haemoglobin concentrations. The relevance of the use of pressor agents in spinal anaesthesia is discussed. PMID- 3978013 TI - Airway patency in the unconscious patient. AB - Airway patency was explored in patients breathing spontaneously under deep halothane anaesthesia. Opening and closing of the airway was observed with a flexible bronchoscope looking proximally from the nasopharynx at the epiglottis and the tongue. With the occiput elevated at various angles the smallest angle of retroflexion of the neck necessary to open the airway was measured. The influence of artificial airways on this angle of retroflexion was measured. Cadaveric preparations of the upper airway were studied to assess the mechanisms involved in airway patency. The results indicate that the epiglottis and not the tongue is the main cause of obstruction of the upper airway. When methods are applied to displace the hyoid anteriorly, the airway will be cleared on most occasions. PMID- 3978014 TI - Clinical study of a lignocaine-prilocaine cream to relieve the pain of venepuncture. AB - The efficacy of a topical anaesthetic formulation, EMLA 5% cream (Eutectic Mixture of Local Anaesthetics) in obtunding the pain produced by venepuncture, was determined in a double-blind randomized, cross-over study in 31 adult volunteers. Pain was registered on a 10-cm visual analogue scale. In each subject the mean pain score after treatment with EMLA was compared with that following placebo. Twenty-eight subjects had lower pain scores with EMLA, and in the remaining three subjects EMLA and placebo were equi-effective. Transient skin reactions (blanching, erythema and oedema) were observed with both formulations. These reactions were not found to be aggravated by repeated applications. PMID- 3978015 TI - A methodological study of spinal (subarachnoid) anaesthesia in the rat and the mouse. AB - Rat and mouse were utilized as models to study the spinal (subarachnoid) anesthetic effects of five commonly used local anaesthetic agents. Duration and frequency of motor and sensory blockade, and onset time were determined after injection of 5.0% lignocaine, 0.75% bupivacaine and 1.0% amethocaine to the same groups of rats with chronically implanted catheters in the lumbar subarachnoid space. Dose-response curves for lignocaine, mepivacaine, bupivacaine, amethocaine and cinchocaine were obtained after single intrathecal injection to the mouse. The relative potency and other characteristics of the compounds investigated were in agreement with results obtained in other species, including man. The techniques described may provide useful adjuncts to methods in larger animals for the evaluation of potential new spinal anaesthetic agents, and the study of various factors that may influence spinal anaesthesia. PMID- 3978016 TI - Resin injection studies of the lumbar extradural space. AB - Two resin injection studies of the lumbar extradural space were performed to elucidate its size and shape. To counteract the lack of cerebrospinal fluid pressure in the cadaver, the subarachnoid space was filled with water. In group 1, the extradural injection of resin caused an immediate increase in subarachnoid pressure. The casts produced varied in thickness, but were situated predominantly in the dorsomedial and dorsolateral regions of the spinal canal. Thin anterior spread occurred in 40% of cases. In group 2, resin was injected to the subarachnoid space before the extradural injection of dyed resin. The resulting extradural casts were thinner than in group 1, but the distribution of resin was similar. The problems of interpreting resin casts are discussed in relation to the results obtained, with reasons for suggesting that the extradural space is only potential. PMID- 3978017 TI - Proceedings of the Anaesthetic Research Society. London, November 9-10, 1984. Abstracts. PMID- 3978018 TI - Suxamethonium spasm. PMID- 3978019 TI - Spinal morphine in enuresis. PMID- 3978020 TI - Indirect blood pressure measurement during intravenous isoprenaline infusions. PMID- 3978022 TI - Metoclopramide reduces carbohydrate absorption in man. AB - The effect of metoclopramide (20 mg p.o) on the times taken for a radiolabelled liquid starch meal to empty from the stomach and to reach the ileum (230 cm from the mouth), the ileal flow rates and the degree of carbohydrate absorption were studied in five normal male volunteers, intubated with a four lumen intestinal tube. Administration of metoclopramide significantly reduced the time taken for delivery of 50% and 80% of the meal to the ileal aspiration site, but had no significant effect on the half time for gastric emptying. Administration of metoclopramide did not affect the average flow rate or the total postprandial volume, which passed the ileal aspiration site. Administration of metoclopramide reduced carbohydrate absorption in every subject by between 8 and 30%. This study is consistent with the hypothesis that metoclopramide may reduce the degree of absorption in the human small intestine by decreasing the contact time between food and small intestinal epithelium, though it could also act by reducing the area of mucosa in contact with nutrients. PMID- 3978021 TI - Coumarin 7-hydroxylase activity in human liver microsomes. Properties of the enzyme and interspecies comparisons. AB - Coumarin 7-hydroxylation and other cytochrome P-450-associated enzyme activities were studied in human liver biopsy homogenates and compared with activities in livers of other species. Coumarin 7-hydroxylation is extraordinarily active in human liver biopsy samples in vitro. Activity is lower in mouse, rabbit or guinea pig liver and essentially absent in rat liver. Cytochrome P-450 content and other associated enzyme activities were higher in animals. Coumarin 7-hydroxylation is induced by phenobarbitone in mouse liver, but no significant increase was seen in human or rat liver after exposure to inducers. Correlations amongst coumarin 7 hydroxylase, aryl hydrocarbon hydroxylase, 7-ethoxycoumarin O-deethylase and cytochrome P-450 are statistically significant (r values from 0.56 to 0.73), but do not permit the conclusion, that the same P-450 form catalyzes all the reactions studied. The correlations between coumarin hydroxylation and antipyrine half-life or clearance are statistically significant, but not good enough for predictive purposes. Coumarin 7-hydroxylase in human liver is inhibited by alpha naphthoflavone, SKF 525A, metyrapone and aniline. PMID- 3978023 TI - The pharmacokinetics and bioavailability of a tracer dose of [3H]-mebendazole in man. AB - Five volunteers, whose ages ranged between 37 and 64 years, took part in a crossover study to determine the pharmacokinetics and bioavailability of mebendazole in man following intravenous and oral administration of a tracer dose of [3H]-mebendazole. Following intravenous administration, the average distribution half-life, elimination half-life and rate of clearance were 0.20 h, 1.12 h, and 1.063 min respectively. After oral administration of the solution, the average elimination half-life was 0.93 h, the apparent rate of clearance was 0.846 l/min, the average time to peak plasma concentration was 0.42 h, and the bioavailability of mebendazole was 22%. Comparison of metabolite area under the plasma concentration vs time data from each route of administration indicates that absorption of mebendazole from the gastrointestinal tract at this dose level is almost complete. The low bioavailability observed following oral administration at this dose level is postulated to be due to high first pass elimination. Approximately half of the administered dose of radioactivity following intravenous and oral administration was detected in the urine, and the major unconjugated metabolite of mebendazole was found to be 2-amino-5(6) [alpha hydroxybenzyl]benzimidazole (IV), not 2-amino-5(6)benzoylbenzimidazole (II), as previously reported. PMID- 3978025 TI - Serum concentrations and urinary excretion of pinacidil and its major metabolite, pinacidil pyridine-N-oxide following i.v. and oral administration in healthy volunteers. AB - Serum concentrations of pinacidil and its major metabolite pinacidil pyridine-N oxide were determined following administration of both an intravenous solution and a sustained release oral preparation to healthy volunteers. Mean bioavailability of pinacidil was 57.1 +/- 13.7%. Following intravenous administration, the mean AUC0-8 h metabolite/AUC 0-8 h pinacidil ratio was 0.559 +/- 0.272 and after oral administration, 0.825 +/- 0.656. Only one subject had serum metabolite concentrations in excess of pinacidil during the intravenous study whereas three subjects achieved metabolite concentrations in excess of pinacidil during the oral study. The mean serum elimination half-life of metabolite was significantly longer than parent drug following intravenous administration (P less than 0.01) but not after oral administration. No significant difference was found in the maximum measured metabolite concentration (Cmax.m) between the studies. The time to Cmax.m was significantly delayed (P less than 0.001) following oral dosage. Twenty four hour urinary excretion of metabolite was significantly increased (P less than 0.001) following oral administration whilst that of pinacidil was decreased (P less than 0.02). These results suggest that pinacidil pyridine-N-oxide may be a 'first-pass' metabolite of pinacidil. In most patients pinacidil pyridine-N-oxide is unlikely to contribute significantly to the hypotensive effect of pinacidil. PMID- 3978024 TI - The effect of dose form on the bioavailability of mebendazole in man. AB - Four different dose forms of mebendazole were administered to human volunteers, and urine was collected and assayed for mebendazole and unconjugated metabolites of mebendazole. Oral administration of mebendazole as an oily suspension slightly enhances the bioavailability of the drug, however mebendazole is not absorbed following rectal administration. The major urinary metabolite of mebendazole in humans is 2-amino-5(6)[alpha-hydroxybenzyl]benzimidazole (IV), not 2-amino-5(6) benzoylbenzimidazole (II), as previously reported. PMID- 3978026 TI - Lack of effect of amoxicillin on theophylline pharmacokinetics. AB - The effect of the antibiotic drug amoxicillin on steady state pharmacokinetics of theophylline was studied in healthy adults by comparing the pharmacokinetic parameters as found during a 9 day course of theophylline alone and as obtained during comedication with amoxicillin. Theophylline plasma concentrations were measured by means of h.p.l.c. analysis. On the ninth day of each of the two periods of drug administration a concentration-time curve was evaluated. It showed no influence of amoxicillin on absorption, elimination and volume of distribution of theophylline, as a result of which mean steady state plasma concentrations were not significantly different during both treatments. It is concluded that both drugs can be given concomitantly without any dosage adjustment of theophylline. PMID- 3978027 TI - Fifth Gordon Hamilton-Fairley memorial lecture. Methotrexate resistance and gene amplification: an experimental model for the generation of cellular heterogeneity. AB - Gene amplification is a mechanism whereby cultured animal cells and human tumours become resistant to cancer chemotherapeutic agents. This review of studies from the authors' laboratory describes properties of the acquisition of resistance to methotrexate in cultured mammalian cells by virtue of amplification of the dihydrofolate reductase gene. These properties result in a heterogeneous cell population with respect to many cell properties, including the number and stability of the amplified genes. Gene amplification results from overreplication of DNA in a single cell cycle as a result of inhibition of DNA synthesis. The cells surviving such overreplication constitute a heterogeneous population with multiple chromosomal changes, including partial or complete endoreduplication of chromosomes, as well as a variety of chromosomal rearrangements. A similar phenomenon may underlie the generation of aneuploidy in tumours, their malignant progression, and the generation of heterogeneity in the tumour cell population. PMID- 3978029 TI - Stress and breast cancer. AB - In order to assess whether exposure to stress was associated with an increased risk of breast cancer, 100 women presenting with carcinoma of the breast completed a standard life events inventory documenting life stresses experienced during the previous three years. The same questionnaire was completed by 100 women presenting with benign breast lumps and 100 apparently healthy controls. Both groups of patients with breast disease also completed the Eysenck personality inventory. There was no difference in the number of stressful life events experienced by the patients with benign and malignant breast lesions and the nature and severity of those stresses encountered were similar for both groups. The personality indices were also the same for both groups. The controls, however, recorded significantly higher levels of stress exposure than the patients with breast disease. On the basis of this series, there is no evidence to support the hypothesis that stress predisposes to breast cancer development. PMID- 3978028 TI - Observations on the pharmacokinetics of low dose aminoglutethimide in patients with advanced breast cancer. AB - Serum aminoglutethimide (AG) and N-acetylaminoglutethimide (NAG) concentrations were measured by high pressure liquid chromatography (HPLC) in 24 postmenopausal women with advanced breast cancer receiving increasing doses of oral AG. Patients received 62.5 mg b.d., 125 mg b.d., 250 mg b.d., and 500 mg b.d. of AG alone, and 500 mg b.d. of AG combined with hydrocortisone (HC) 20 mg b.d. Dose was increased at monthly intervals. Each dose increment was accompanied by a significant rise in serum AG and NAG levels (P less than 0.05). The addition of HC to the dose of 500 mg b.d. of AG did not alter serum AG or NAG concentrations significantly. Although serum AG and NAG levels appeared to increase linearly with dose, serum NAG increased significantly more slowly, leading to a fall in the NAG:AG ratio during therapy. The NAG:AG ratio appeared to stabilise only after about 6 months of treatment. PMID- 3978030 TI - Possible intermediates in the action of adriamycin--a pulse radiolysis study. AB - Over a wide range of pH, the semiquinone free radicals formed by reduction of adriamycin exist as a form which is strongly stabilised by internal hydrogen bonding and resonance. They protonate with pKa = 2.9. Below this pH they exhibit absorption maxima at 430 nm (Emax = 13,200 dm3 mol-1 cm-1) and approximately 720 nm (Emax = 4,200 dm3 mol-1 cm-1). Above pH 2.9 they have maxima at 480 nm (Emax = 14,600 dm3 mol-1 cm-1) and approximately 700 nm (Emax = 3,400 dm3 mol-1 cm-1). In acid and alkaline solution the radicals rapidly disappear by disproportionation, but within the approximate pH range 6 to 11 they appear to be relatively stable for at least 10-20 ms, existing in transient equilibrium with parent adriamycin and the full reduced form. Some rate constants for the formation and reactions of the semiquinone are given, including the reaction with oxygen to give O2.-. Fully reduced adriamycin has absorption maxima at 410 nm (Emax = 11,000 dm3 mol-1 cm-1) at pH 5 and 430 nm (Emax = 19,000 dm3 mol-1 cm-1) at pH 11. It undergoes decomposition within a few hundred ms. The intermediates from daunomycin would be expected to have properties similar to those from adriamycin. PMID- 3978032 TI - Sunburn, suntan and the risk of cutaneous malignant melanoma--The Western Canada Melanoma Study. AB - A comparison of interview data on 595 patients with newly incident cutaneous melanoma, excluding lentigo maligna melanoma and acral lentiginous melanoma, with data from comparison subjects drawn from the general population, showed that melanoma risk increased in association with the frequency and severity of past episodes of sunburn, and also that melanoma risk was higher in subjects who usually had a relatively mild degree of suntan compared to those with moderate or deep suntan in both winter and summer. The associations with sunburn and with suntan were independent. Melanoma risk is also increased in association with a tendency to burn easily and tan poorly and with pigmentation characteristics of light hair and skin colour, and history freckles; the associations with sunburn and suntan are no longer significant when these other factors are taken into account. This shows that pigmentation characteristics, and the usual skin reaction to sun, are more closely associated with melanoma risk than are sunburn and suntan histories. PMID- 3978031 TI - Assay of anti-cancer drugs in tissue culture: relationship of relapse free interval (RFI) and in vitro chemosensitivity in patients with malignant cerebral glioma. AB - One hundred and seventeen patients with cerebral glioma (Kernohan grades III and IV) were treated with adjuvant chemotherapy using procarbazine (PCB), CCNU and vincristine (VCR) following whole head irradiation. Cell cultures were prepared from 40 patients in this series and their sensitivity to each cytotoxic drug was assessed in a mictotitration assay with 35 S-methionine incorporation as the end point. Twenty-two of forty (55%) patients responded to PCB and/or CCNU in vitro, and sensitivity to these drugs was linked with increased RFI, whilst sensitivity to VCR was not. The RFI of patients who had responded to PCB or CCNU in vitro was significantly longer than the RFI of patients whose tumours failed to respond in vitro or patients who had not been tested. There was no difference in sex ratio, extent of operation, radiation dose and degree of steroid cover between responders, non-responders and untested groups. Grade III tumours tended to be more sensitive in vitro than grade IV tumours. The age of patients also influenced in vitro chemosensitivity. Patients with chemosensitive tumours in vitro tended to be younger than patients with insensitive tumours in vitro. Further statistical analysis, taking into account these prognostic factors, indicated an association between chemosensitivity in vitro and RFI. PMID- 3978033 TI - A computer simulation model for the practical planning of cervical cancer screening programmes. AB - There is ample evidence of the efficacy of cytological screening in the prevention of cervical cancer but disagreement on the form which screening programmes should take. Simulation models have been used as a convenient and rapid method of exploring the outcome of different screening policies and of demonstrating the importance and interrelationships of the variables concerned. However, most such models are either too abstract or too simplistic to be of practical value in planning screening programmes. A model is described which reproduces demographic events in a female population (that of England and Wales) over a 30 year period, and onto this superimposes the natural history of cervical carcinoma, using data derived from published studies. A microsimulation approach- each individual in the population being retained as a unit--allows factors such as disease onset and screening uptake to be dependent upon personal characteristics and past events. Screening can be offered as part of a routine programme, or incidentally--for example during pregnancy or hospital attendance. The model allows quantitative evaluation of the complex patterns of screening that are actually observed and the relative importance of the different components of such screening programmes. Assumptions about natural history can thus be studied. PMID- 3978034 TI - Joint meeting of the British Association for Cancer Research & the Royal Society of Medicine (Section of Oncology) (incorporating a symposium on "Clonal evolution of tumours"). November 22-23, 1984. Abstracts. PMID- 3978035 TI - Symposium on "Genetics and regulation of DNA repair", November 24, 1984, London. Abstracts. PMID- 3978036 TI - Accumulation of inflammatory cells in response to intracutaneous platelet activating factor (Paf-acether) in man. AB - Platelet activating factor (Paf-acether, AGEPC) is a family of ether-linked phospholipids known to be released from a range of inflammatory cell types. In vitro and in experimental animals, it seems to be a mediator of inflammation, and intradermal injection of Paf-acether in man elicits a biphasic inflammatory response, reminiscent of the dual response to allergen in sensitized individuals. In the present study, cutaneous histology was assessed in sequential skin biopsies from six normal volunteers after intradermal injection of 200 or 800 pmol Paf-acether. Paf-acether (200 pmol) induced intravascular accumulation of neutrophils, accompanied by a perivascular mixed cellular infiltrate which was composed predominantly of neutrophils at 4 and 12 hours, and lymphocytes and histiocytes at 24 hours. Control injections of lyso-Paf and normal saline induced no noteworthy histological changes. Paf-acether (800 pmol) resulted in vessel destruction, gross endothelial swelling and a perivascular infiltrate of mononuclear cells and neutrophils, accompanied by occasional evidence of leucocytoclasis. By virtue of its ability to induce inflammatory cell accumulation in human skin, Paf-acether should be considered as a potential mediator of inflammatory disorders such as psoriasis. PMID- 3978037 TI - An improved method for in vitro perfusion of human skin. AB - We have developed a procedure for establishing a long-living supravital skin preparation. Our model has made in vitro perfusion of human cutis, fatty tissue and lymph nodes possible. We describe the method of preparation, the technical construction and preliminary results of our experiments. PMID- 3978038 TI - Lichen aureus: a localized persistent form of pigmented purpuric dermatitis. AB - Localized persistent pigmented macules and plaques due to a chronic form of pigmented purpuric dermatitis are described in forty-two patients. The designation 'lichen aureus' for this eruption can be justified because of the striking yellowish or bronze-like colour assumed by many of the lesions. The lower legs were the commonest sites but other body regions can be affected also. Histologically lichen aureus differs from other pigmented purpuric dermatoses in the density of the lichenoid tissue reaction and the marked accumulation of pigment-containing macrophages. Recently developed endothelial cell markers have been studied in selected cases. PMID- 3978039 TI - Relapsing linear acantholytic dermatosis. AB - A 5-year-old girl with a unilateral linear systematized skin lesion showing the clinical, histological and ultrastructural features of Hailey-Hailey disease is described. We suggest that this relapsing linear acantholytic dermatosis represents a new distinct entity within the spectrum of unilateral linear skin diseases. PMID- 3978040 TI - Climacteric flushing in a patient with carcinoid tumour. AB - A 70-year-old man had frequent flushing attacks and a carcinoid tumour was verified histologically. The characteristics of his flushing reaction were typical of climacteric flushing and he had undergone orchiectomy for adenocarcinoma of the prostate 2 years ago. Laboratory studies indicated a normal production of serotonin and excretion of 5-hydroxyindoleacetic acid. A rapid and complete remission of the flushing attacks was obtained with oral diethylstilbesterol therapy. Thus, although the patient had a carcinoid tumour, he was having post-orchiectomy climateric flushing reactions. PMID- 3978041 TI - Uptake of solvents from the lungs. PMID- 3978043 TI - Mortality and cancer incidence in the perfumery and flavour industry of Geneva. AB - An analysis has been made of the mortality and cancer incidence of 1168 workers who entered the three factories of the perfumery industry of the Canton of Geneva from their establishment at the turn of the century to the end of 1964. The workers were followed up from their entry until 31 December 1980, at which date 344 were dead and 28 lost to follow up. Among the whole study population only mortality from tuberculosis was significantly raised; there was no significant increase in the incidence of or mortality from any cancer. Analysis by four exposure categories showed a significant excess of deaths from heart disease among the compounders. In addition, two deaths from aplastic anaemia were recorded in chemical process workers exposed to benzene. Further analysis by cohort of entry and by birth cohort indicated that, among the subgroup of men first employed in 1900-29 and born in 1880-99, the mortality from a wide range of causes was significantly increased below the age of 70. This increase is unlikely to be due to an occupational factor as indicated by the absence of an upward trend of mortality with longer exposure. PMID- 3978042 TI - Strain on the back in concrete reinforcement work. AB - To investigate the long term effect of heavy construction work on the back the occurrence of postures, lifting, carrying, and accidents in concrete reinforcement work and in maintenance house painting were measured. The 32 620 observations covering 272 work hours showed that reinforcement work necessitated stooped postures and heavy lifting more often than did painting. Reported minor back accidents were more than ten times as common in reinforcement work than in painting (1.3 compared with 0.11 accidents per man-year, p less than 0.001). Accidents of the musculoskeletal system, registered by the insurance companies, were also several times more common in reinforcement work (81 compared with 25 per 1000 man-years, p less than 0.001). The premature development of lumbar degeneration detected in the clinical study of the reinforcement workers was evidently due to the occupational strain on the back. The different types of hazardous back loads probably potentiate the effects of each other. PMID- 3978044 TI - Professional driving, smoking, and lung cancer: a case referent study. AB - In a case referent study of about 600 cases of male lung cancer in northern Sweden the risk in professional drivers was specifically studied. Data concerning occupations, time and type of employment, and smoking habits were collected by questionnaires directed to close relatives. On average, professional drivers were heavier smokers and this was the chief cause of a slightly increased crude risk ratio in the study as a whole. Smoking drivers in an upper age group (70 and over) had a high relative risk of lung cancer, whereas in a lower age group (under 70) no significant increase was found. The relative risk in non-smoking drivers in the upper age group was moderately raised with borderline statistical significance. The high relative risk estimated for smoking drivers in the upper age group suggests a synergistic effect between smoking and occupational exposure. PMID- 3978046 TI - Comparative study of vibration disease among operators of vibrating tools by factor analysis. AB - Principal component analysis was carried out to determine the interrelationships between subjective symptoms experienced by workers using various types of vibrating tools (brush saws (41), rock drills (39), chipping hammers (42) and chain saws (49)) and control groups (clerks (44), farmers (42)). The characteristics of the patterns of common factors extracted from these symptoms and the frequency distribution of the factor score of the main principal components were compared among the groups. From a wide variety of symptoms, a principal component related to peripheral nerves, muscles, and joints and a component related to peripheral circulation were extracted specifically and separately. The complaints of rock drillers reflected peripheral circulatory factor and those of chain saw users presented a complex factor of nerve muscle, and joints. PMID- 3978045 TI - Relation of haemostatic function, neurovascular impairment, and vibration exposure in workers with different stages of vibration induced white finger. AB - Haemostatic function and neurovascular symptoms were investigated in 67 workers exposed to vibration and 46 comparable referents. Of these 65.6% of vibration workers complained of neurological disturbances (stages 0T, 0N of Taylor's classification for vibration induced white finger (VWF) and 20.9% suffered from Raynaud's phenomenon (stages 1-2-3). The severity of the staging symptoms showed a close relation with an index of vibration dose computed on the basis of vibration measurement and individual exposure time. Indices of platelet aggregation, both in vitro and in vivo, antithrombin III, fibrinogen and fibrinopeptide A levels were not different in the exposed workers compared with the referents. No relation was found between haemostatic parameters and the severity of VWF. Exposed workers responded to a cooling procedure with a more pronounced vasoconstriction in the digital vessels than the referents, as indicated by delayed recovery time of finger skin temperature after the cold test. These findings suggest that both in the early stages (0T, 0N) and in more severe stages of VWF (stages 1-2) cold induced hyperreactivity in the digital vessels and Raynaud's syndrome are vascular disorders of functional origin occurring without any prethrombotic alterations. PMID- 3978047 TI - Follow up study of vibration induced white finger in chain saw operators. AB - The current status of subjects with vibration induced white finger (VWF) was observed in order to follow up the natural course of VWF after the use of chain saws had ceased. The prevalence rate of VWF after the use of chain saws had ceased in all time periods fell to 50.2% after more than 12 years' observation. There was a pronounced tendency for the percentage prevalence to rise as the vibration exposure periods after VWF occurred increased, and a similar pattern was observed concerning the exposure periods before VWF occurred. Numbness of hands and arms takes longer to recover than VWF. PMID- 3978048 TI - Sympathetic and local vasoconstrictor response to cold in vibration induced white finger. AB - To study the relative roles of sympathetic and local vasoconstrictor response to cold in vibration induced white finger (VWF) seven lumberjacks with bilateral VWF and seven age matched controls were investigated. During body cooling finger systolic blood pressure was measured with a cuff technique simultaneously on one affected finger on each hand at 30 degrees, 15 degrees, and 6 degrees C. Both affected fingers had an increased vasoconstrictor response at 15 degrees and 6 degrees C compared with the control group (p less than or equal to 0.05). During unilateral sympathetic nerve block the cold provocation test was repeated on both fingers. The unblocked finger affected by VWF showed no significant difference in the cold response between the two cold provocation tests (p greater than 0.10). The local cold response of blocked finger did not differ from that of the control group (p greater than 0.10). The sympathetic vasoconstrictor response to cold was estimated as the difference between the cold response before nerve block and the cold response during nerve block. The median sympathetic vasoconstrictor response at 6 degrees C was about twice as large as the local response during nerve block (p less than 0.05). The results indicate that the sympathetic vasoconstrictor response to cold plays the dominant part in VWF. PMID- 3978049 TI - Reduced killer cell activity of lymphocytes from patients with asbestosis. AB - Immunological abnormalities in 30 patients with asbestosis were investigated by examining the cytoxicity of natural killer (NK) cells and antibody dependent cellular cytotoxicity by killer (K) cells from peripheral blood lymphocytes; the effects of interferon on NK activity was also examined. Fifteen men and 15 women (mean age 58; range 40-72) with asbestosis but who were free of complications such as tuberculosis, carcinoma, or steroid treatment were the subjects for study. There were nine cases of type 1, 19 cases of type 2, and two cases of type 3 disease as described in the ILO classification of pneumoconiosis. They were all textile workers with a mean duration of 18 years (3-40 years) since first exposure to chrysotile. Controls matched for age and sex were selected from a population without occupational exposure to asbestos. The activity of the NK and K cells in patients with asbestosis was significantly lower than in the control group, but the populations of NK and K cells in the peripheral blood lymphocytes were not significantly different in the two groups. An in vitro experiment showed that the increase in the cytotoxicity of the NK cell after treatment with interferon-alpha was significantly lower in the subjects than in the controls. These results indicate that one of the defence mechanisms in relation to cancer is deficient in patients with asbestosis. PMID- 3978050 TI - Mortality of tanners. AB - The mortality of 833 male tannery workers known to have been employed in the industry in 1939 and who were followed up to the end of 1982 was studied. A total of 573 men had been employed in making leather tanned by vegetable extracts for soles and heels, and 260 men had used chrome tanning to make leather for the upper parts of shoes. No significant excesses of deaths were found for any of the common sites of cancer in either group of workers. One death from nasal cancer (0.21 expected) was reported among the men who worked with sole and heel leather. PMID- 3978051 TI - Rubella--continuing problems. PMID- 3978052 TI - Immunoreactive oestrogens and progesterone in amniotic fluid in twin pregnancies. AB - Amniotic fluid concentrations of immunoreactive oestrogens and progesterone were measured at the time of caesarean section in 32 twin pregnancies; 25 women had an elective section and seven were in labour at the time of operation. No significant differences between concentrations in the amniotic fluid of the first and second twin were found in respect of conjugated and unconjugated oestrone, oestradiol, oestriol, oestetrol and unconjugated progesterone either before or during labour. It is unlikely that changes in oestrogens or progesterone in the amniotic fluid are responsible for the selective changes seen in prostaglandins and fetal adrenal steroid during labour in the first twin. PMID- 3978053 TI - Risk factors associated with small-for-dates and large-for-dates infants. AB - Relative risks were calculated to assess the potency of different factors associated with the two extremes of the birthweight distribution. Maternal height affected the chances of having a small-for-dates (SFD) or large-for-dates (LFD) baby to an equal and opposite extent; but the risks associated with maternal weight were greater for LFD than SFD infants. Smoking increased the SFD risk by 3.5 times, whereas the LFD risk was only reduced by a half. Pre-eclampsia was associated with a very high SFD risk (14.6); in the LFD group it was insignificantly raised. The LFD relative risk steadily rose with increasing parity, but in the SFD group it fluctuated around unity. Among multiparae the risks of an SFD or LFD infant when previous siblings had been of relatively low or high birthweight for gestational age, respectively, were much increased. Estimates of attributable risk showed that if pathological factors such as smoking, hypertensive disorders and congenital abnormalities could be completely eliminated the number of SFD babies in this population would be reduced by about 60%; conversely the number of LFD babies would be increased by about 30%. PMID- 3978054 TI - Long-term effects of the menopause and sex hormones on skin thickness. AB - Skin collagen content and skin thickness in a group of postmenopausal women who had been treated with sex hormone implants were compared with those in an untreated group of similar women. Both skin collagen content and thickness were found to be significantly greater in the treated than in the untreated group. In the untreated women skin collagen content declined in relation to menopausal age but not to chronological age. No correlation was found with menopausal age, chronological age or duration of therapy in the treated group. These data suggest that skin collagen is influenced by the sex hormone status and declines after the menopause, contributing to the increase in urinary hydroxyproline excretion that has been reported to occur at this time. PMID- 3978055 TI - The effects of age and body composition on circulating serum oestrogens and androstenedione after the menopause. AB - Circulating levels of oestrone, oestradiol and androstenedione were measured in two large groups of postmenopausal women, in one group the women were between 46 and 56 years of age and in the second, older group they were 70 years of age. In addition the fat mass was calculated from the height, weight and age of the women. Serum concentrations of both oestrogens did not change with age, whereas the serum androstenedione concentration decreased significantly. A change in body composition included decreased height and increased fat mass in the older group. Serum concentrations of both oestrogens correlated significantly with the fat mass and serum androstenedione as well as with each other. From the correlation analysis it may be concluded that the conversion rate of androstenedione to oestrone, and of oestrone to oestradiol, increases with age, which presumably explains the unchanged concentrations of the circulating oestrogens in relation to postmenopausal age, although the precursor decreases during the same period. PMID- 3978056 TI - Training in tubal microsurgery. AB - The restoration of normal tubo-ovarian function was investigated in a training programme using oviduct anastomosis in the rabbit as an experimental model. Ovulation rate, pregnancy rate, nidation index, implantation failure index and degree of adhesions were used as parameters. More than 100 anastomoses had to be performed to reach a perfect degree of atraumatic, function-restoring surgery. It is concluded that the most difficult aspect in female infertility surgery is not the use of the operating microscope but the experience in applying the principles of atraumatic surgery. PMID- 3978058 TI - Radionuclide imaging of ovarian tumours with 123I-labelled monoclonal antibody (NDOG2) directed against placental alkaline phosphatase. AB - A radiolabelled monoclonal antibody (NDOG2) directed against placental alkaline phosphatase (PLAP) was used in the radio-immunodetection of ovarian carcinoma. Tumour deposits were successfully visualized in 11 of 15 patients and the abnormalities demonstrated were classified as focal or diffuse. Of the 11 patients, eight showed focal abnormalities alone and three had a diffuse abnormality, of which two also showed a focal abnormality. False-positive results may occur not only due to uptake of 123I by gut mucosa and an inadequately blocked thyroid gland but also from activity in an incompletely emptied bladder. A false-negative result occurred due to high background activity in the liver masking a known, discrete tumour deposit. PMID- 3978057 TI - Clinical implications for immunoscintigraphy in patients with ovarian malignancy: a preliminary study using monoclonal antibody 791T/36. AB - Twelve patients with suspected primary and recurrent carcinoma of the ovary have undergone immunoscintigraphy with an antitumour monoclonal antibody in order to assess the impact of the technique on patient management. Consistent tumour uptake of radiolabelled antibody was visualized in malignant tumours after subtraction of the blood background activity. Eight patients were imaged before surgery and in all of these the sites of uptake visualized on the images agreed with the surgical findings. In one patient with recurrent disease the imaging information was used as an aid for establishing the extent of external beam radiotherapy. A repeat study in this patient 6 months later revealed a reduction in the size of the tumour, which still concentrated labelled antibody and confirmed the viability of repeat investigations. Immunoscintigraphy was capable of providing diagnostic information which may offer an alternative to second-look surgery in these patients. PMID- 3978059 TI - Topical 5-fluorouracil in the treatment of vaginal intraepithelial neoplasia. AB - The effectiveness of 5-fluorouracil (Efudix) in the treatment of vaginal intraepithelial neoplasia was assessed in 14 patients diagnosed with the condition between January 1980 and December 1982. All patients received a standard dose of 2.5 g 5-fluorouracil cream once weekly for at least 10 consecutive weeks; mean duration of treatment was 12 weeks (range 10-20 weeks). The vaginal lesion was associated with a major dysplastic lesion of the cervix in all patients. The duration of follow-up ranged from 4 to 42 months (mean 15 months). Thirteen patients had complete resolution both colposcopically and cytologically. One patient still had colposcopic evidence of intraepithelial neoplasia (aceto-white epithelium) but a vaginal smear has been negative. This patient has since been lost to follow-up. We conclude that in the regimen described 5-fluorouracil is an effective treatment for vaginal intraepithelial neoplasia. PMID- 3978060 TI - Successful treatment of fetal bladder obstruction in utero. Case report. PMID- 3978061 TI - Recurrence of Cushing's disease in pregnancy. Case report. PMID- 3978062 TI - The sex ratio of infants born after hormonal induction of ovulation. PMID- 3978063 TI - Malignant melanoma of the eyelid skin: histopathology and behaviour. AB - Histological sections from 24 patients with malignant melanoma of the eyelid skin were studied and correlated with clinical follow-up for an average of 8.6 years. There was an average post-treatment follow-up of 7.4 years with a cure rate of 78% in the superficial spreading group. The average follow-up in the nodular melanoma group was 9.4 years with a cure rate of 75%. Nodular melanoma patients with the lesion in the lid margin have a worse prognosis than those with the lesion on the eyelid skin. PMID- 3978064 TI - Capnocytophaga keratitis. AB - We report two cases of bacterial keratitis caused by Capnocytophaga, a genus of capnophilic Gram negative bacilli. Both responded to topical and subconjunctival clindamycin. PMID- 3978065 TI - Granulomatous uveitis in neurological disease. AB - Five women with granulomatous uveitis were diagnosed as having probable multiple sclerosis. Three of the women developed curious iris nodules that resolved with topical prednisolone acetate treatment. The association of granulomatous type uveitis, with or without iris nodules, should alert the ophthalmologist to inquire about neurological symptoms attributable to multiple sclerosis. PMID- 3978066 TI - Morphological variation of Dalen-Fuchs nodules in sympathetic ophthalmia. AB - Fifty cases of sympathetic ophthalmia were examined histologically to determine the incidence and morphology of Dalen-Fuchs nodules. At least one well-defined Dalen-Fuchs nodule was identified in 18 (36%) of the eyes examined. Three types of lesions at the level of the retinal pigment epithelium were recognised. One type was found to consist of focal hyperplasia and aggregation of retinal pigment epithelial cells. A second type, classically referred to as Dalen-Fuchs nodules, consisted of epithelioid cells and lymphocytes covered by an intact dome of retinal pigment epithelium. The third type of lesion was characterised by degeneration of the overlying retinal pigment epithelium leading to disorganisation of the Dalen-Fuchs nodule and possible release of their contents into the subretinal space. Our study demonstrated that Dalen-Fuchs nodules in sympathetic ophthalmia vary in their morphological appearance as determined by light microscopy. PMID- 3978067 TI - Serum antibody level to S-antigen in children with chronic uveitis. AB - Bovine S-antigen was purified by gel filtration and ion exchange chromatography according to previously described techniques. An enzyme linked immunosorbent assay (ELISA) using antiserum to bovine S-antigen raised in guinea-pigs was employed to detect S-antigen in the chromatographic fractions. The purity of the S-antigen was determined by SDS-PAGE electrophoresis, where a single band was found. The purified S-antigen in microgram quantities together with Freund's complete adjuvant induced uveitis in rats two weeks after injection into the foot pad. Serum samples from children suffering from chronic uveitis and healthy children were tested for antibodies to S-antigen by the ELISA. A statistically significant difference in the level of specific antibodies between patients and controls was found. There was no clear-cut correlation between the severity of uveitis and antibody titre, but cases with retinal involvement and aggressive uveitis all showed definite elevations of antibodies to S-antigen. PMID- 3978068 TI - Penetration of timolol eye drops into human aqueous humour: the first hour. AB - Samples of aqueous humour were removed from 26 eyes at the start of cataract extraction. Two drops of timolol 0.5% had been instilled into the conjunctival sac 12-71 minutes before operation. Analysis by gas chromatography showed a mean timolol concentration of 55.46 ng/mg, with a range of 8 to 100 ng/mg. PMID- 3978069 TI - Possible cataractogenic effect of radionuclides deposited within the eye from the blood stream. AB - The clinical and histological examination of a cataract in a man of 47 is described together with a review of the deposition of radionuclides in the eye. It is suggested that the cataract was possibly due, at least in part, to irradiation of the sensitive cells in the germinative zone of the lens epithelium by alpha particles deposited in the pigmented tissues of the eye from the 239Pu circulating in the blood. PMID- 3978071 TI - Blue light hazard and aniridia. AB - The fundi of three patients with aniridia were photographed with a 470 nm illuminating light source. No apparent change in contrast was observable throughout the macular region. This would suggest an absence of the macular pigment. The likelihood of aniridics being more susceptible than normal persons to blue light damage is discussed. PMID- 3978070 TI - Ocular dominance, reading, and spelling ability in schoolchildren. AB - The association of reading disability with perceptuomotor problems has had a chequered history. This study examines the relationship between a new test of ocular dominance and reading and spelling ability in a group of 298 schoolchildren. Similar rates for unstable ocular dominance were found for poor readers as in comparable studies. The rates of unstable ocular dominance did not differ between the 'dyslexics' and the controls. These findings in a blind study question the role of this test as a diagnosis of 'dyslexia.' PMID- 3978072 TI - Structural basis for stabilization of Z-DNA by cobalt hexaammine and magnesium cations. AB - In the equilibrium between B-DNA and Z-DNA in poly(dC-dG), the [Co(NH3)6]3+ ion stabilizes the Z form 4 orders of magnitude more effectively than the Mg2+ ion. The structural basis of this difference is revealed in Z-DNA crystal structures of d(CpGpCpGpCpG) stabilized by either Na+/Mg2+ or Na+/Mg2+ plus [Co(NH3)6]3+. The crystals diffract X-rays to high resolution, and the structures were refined at 1.25 A. The [Co(NH3)6]3+ ion forms five hydrogen bonds onto the surface of Z DNA, bonding to a guanine O6 and N7 as well as to a phosphate group in the ZII conformation. The Mg2+ ion binds through its hydration shell with up to three hydrogen bonds to guanine N7 and O6. Higher charge, specific fitting of more hydrogen bonds, and a more stable complex all contribute to the great effectiveness of [Co(NH3)6]3+ in stabilizing Z-DNA. PMID- 3978073 TI - Kinetics of the daunomycin--DNA interaction. AB - The kinetics of the interaction of daunomycin with calf thymus DNA are described. Stopped-flow and temperature-jump relaxation methods, using absorption detection, were used to study the binding reaction. Three relaxation times were observed, all of which are concentration dependent, although the two slower relaxations approach constant values at high reactant concentrations. Relaxation times over a wide range of concentrations were gathered, and the data were fit by a minimal mechanism in which a rapid bimolecular association step is followed by two sequential isomerization steps. The six rate constants for this mechanism were extracted from our data by relaxation analysis. The values determined for the six rate constants may be combined to calculate an overall equilibrium constant that is in excellent agreement with that obtained by independent equilibrium measurements. Additional stopped-flow experiments, using first sodium dodecyl sulfate to dissociate bound drug and second pseudo-first-order conditions to study the fast bimolecular step, provide independent verification of three of the six rate constants. The temperature dependence of four of the six rate constants was measured, allowing estimates of the activation energy of some of the steps to be made. We speculate that the three steps in the proposed mechanism may correspond to a rapid "outside" binding of daunomycin to DNA, followed by intercalation of the drug, followed by either conformational adjustment of the drug or DNA binding site or redistribution of bound drug to preferred sites. PMID- 3978074 TI - Donor activation in the T4 RNA ligase reaction. AB - T4 RNA ligase catalyzes the adenylation of donor oligonucleotide substrates. These activated intermediates react with an acceptor oligonucleotide which results in phosphodiester bond formation and the concomitant release of AMP. Adenylation of the four common nucleoside 3',5'-bisphosphates as catalyzed by T4 RNA ligase in the absence of an acceptor oligonucleotide has been examined. The extents of product formation indicate that pCp is the best substrate in the reaction and pGp is the poorest. Kinetic parameters for the joining reaction between the preadenylated nucleoside 3',5'-bisphosphates, A(5')pp(5')Cp or A(5')pp(5')Gp, and a good acceptor substrate (ApApA) or a poor acceptor substrate (UpUpU) have been determined. The apparent Km values for both preadenylated donors in the joining reaction are similar, and the reaction velocity is much faster than observed in the overall joining reaction. The nonnucleotide adenylated substrate P1-(5'-adenosyl) P2-(o-nitrobenzyl) diphosphate also exhibits a similar apparent Km but reacts with a velocity 80-fold slower than the adenylated nucleoside 3',5'-bisphosphates. By use of preadenylated donors, oligonucleotide substrates can be elongated more efficiently than occurs with the nucleoside 3',5'-bisphosphates. PMID- 3978075 TI - Elementary steps in the reaction mechanism of chicken liver fatty acid synthase: beta-ketoacyl reductase and enoyl reductase. AB - The following reactions catalyzed by chicken liver fatty acid synthase have been studied with the stopped-flow method in 0.1 M potassium phosphate (pH 7.0) and 1 mM ethylenediaminetetraacetic acid at 25 degrees C by monitoring the change in NADPH fluorescence: the transfer of acetoacetyl from acetoacetyl coenzyme A to the enzyme, reduction of the enzyme-bound acetoacetyl by NADPH (beta-ketoacyl reductase), and reduction of enzyme-bound D-hydroxybutyryl/crotonyl by NADPH (enoyl reductase). The first two reactions were studied by mixing enzyme-NADPH with acetoacetyl-CoA under conditions where the kinetics can be analyzed as two consecutive pseudo-first-order processes: a mechanism consistent with the aceto acetyl-CoA dependence of the pseudo-first-order rate constant associated with formation of the aceto-acetyl-enzyme is a relatively rapid binding of substrate to the enzyme, with a dissociation constant of 650 microM, followed by formation of covalently bound acetoacetyl, with a rate constant of 10.2 s-1. The aceto acetyl-enzyme is reduced by enzyme-bound NADPH with a rate constant of 20 s-1, and the NADPH binding is characterized by a dissociation constant of 5.3 microM. Reduction of the D-hydroxybutyryl-/crotonyl-enzyme was studied by mixing NADPH with enzyme that was equilibrated with D-hydroxybutyryl-CoA or crotonyl-CoA; the rate constant for reduction of an equilibrium mixture of D-hydroxybutyryl- and crotonyl-enzyme is 36.6 s-1. Steady-state kinetic studies of the reduction of acetoacetyl-CoA and crotonyl-CoA by NADPH also have been carried out.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978076 TI - Use of secondary isotope effects and varying pH to investigate the mode of binding of inhibitory amino aldehydes by leucine aminopeptidase. AB - Ki values for leucine aldehyde, a competitive inhibitor of leucine aminopeptidase, vary with pH in a manner compatible with binding of uncharged inhibitor. The pH dependence of kcat/Km suggests likewise that the substrate leucine p-nitroanilide is productively bound as the uncharged species. Comparison of pKa values of the model compounds aminoacetone and aminoacetal indicates that the equilibrium constant for hydration of amino aldehydes is reduced by a factor of about 2 when a proton is lost from the alpha-ammonium group near pH 8. Effects of deuterium substitution at C-1 on equilibrium binding of leucine aldehyde were determined with immobilized enzyme and inhibitors doubly labeled with radioisotopes. The observed isotope effect (KD/KH) is approximately unity, suggesting that leucine aldehyde combines with the enzyme as an oxygen adduct, not as the intact aldehyde. PMID- 3978077 TI - Catalytic Ca2+-binding site of pancreatic phospholipase A2: laser-induced Eu3+ luminescence study. AB - 7F0----5D0 excitation spectroscopy of Eu3+ has been used to study the catalytic Ca2+-binding site of pancreatic phospholipases A2. Eu3+ binds competitively with Ca2+ to the enzyme with retention of about 5% of the activity found with Ca2+. The dissociation constants for the Eu3+-enzyme complexes of bovine phospholipase A2 and porcine isophospholipase A2 are 0.22 mM and 0.16 mM, respectively. Results obtained with the porcine phospholipase A2 at neutral pH indicate aggregation of this enzyme at protein concentrations above 0.18 mM. The Eu3+ bound at the catalytic site of pancreatic phospholipase A2 is coordinated to four or five water molecules, which, in conjunction with binding constant data, suggests the involvement of two or three protein ligands. Addition of a monomeric substrate analogue to the enzyme-Eu3+ complex results in the loss of an additional water molecule from the first coordination sphere of the bound Eu3+. This result suggests an interaction between the negative charge of the polar head group of the substrate analogue and the Eu3+. Binding of the enzyme-Eu3+ complex to micelles results in a nearly complete dehydration of the Eu3+ bound to the catalytic center. In the phospholipase A2-Eu3+-micelle complex, only one H2O molecule is coordinated to Eu3+. This dehydration at the active site of phospholipase A2 in the protein-lipid complex can be an important reason for the enhanced activity of this enzyme at lipid-water interfaces. PMID- 3978078 TI - Hydrogen exchange of lysozyme powders. Hydration dependence of internal motions. AB - The rate of exchange of the labile hydrogens of lysozyme was measured by out exchange of tritium from the protein in solution and from powder samples of varied hydration level, for pH 2, 3, 5, 7, and 10 at 25 degrees C. The dependence of exchange of powder samples on the level of hydration was the same for all pHs. Exchange increased strongly with increased hydration until reaching a rate of exchange that is constant above 0.15 g of H2O/g of protein (120 mol of H2O/mol of protein). This hydration level corresponds to coverage of less than half the protein surface with a monolayer of water. No additional hydrogen exchange was observed for protein powders with higher water content. Considered in conjunction with other lysozyme hydration data [Rupley, J. A., Gratton, E., & Careri, G. (1983) Trends Biochem. Sci. (Pers. Ed.) 8, 18-22], this observation indicates that internal protein dynamics are not strongly coupled to surface properties. The use of powder samples offers control of water activity through regulation of water vapor pressure. The dependence of the exchange rate on water activity was about fourth order. The order was pH independent and was constant from 114 to 8 mol of hydrogen remaining unexchanged/mol of lysozyme. These results indicate that the rate-determining step for protein hydrogen exchange is similar for all backbone amides and involves few water molecules. Powder samples were hydrated either by isopiestic equilibration, with a half-time for hydration of about 1 h, or by addition of solvent to rapidly reach final hydration. Samples hydrated slowly by isopiestic equilibration exhibited more exchange than was observed for samples of the same water content that had been hydrated rapidly by solvent addition. This difference can be explained by salt and pH effects on the nearly dry protein. Such effects would be expected to contribute more strongly during the isopiestic equilibration process. Solution hydrogen exchange measurements made for comparison with the powder measurements are in good agreement with published data. Rank order was proven the same for all pHs by solution pH jump experiments. The effect of ionic strength on hydrogen exchange was examined at pH 2 and pH 5 for protein solutions containing up to 1.0 M added salt. The influence of ionic strength was similar for both pHs and was complex in that the rate increased, but not monotonically, with increased ionic strength. PMID- 3978079 TI - Anion Bohr effect of human hemoglobin. AB - The pH dependence of oxygen affinity of hemoglobin (Bohr effect) is due to ligand linked pK shifts of ionizable groups. Attempt to identify these groups has produced controversial data and interpretations. In a further attempt to clarify the situation, we noticed that hemoglobin alkylated in its liganded form lost the Bohr effect while hemoglobin alkylated in its unliganded form showed the presence of a practically unmodified Bohr effect. In spite of this difference, analyses of the extent of alkylation of the two compounds failed to identify the presence of specific preferential alkylations. In particular, the alpha 1 valines and beta 146 histidines appeared to be alkylated to the same extent in the two proteins. Focusing our attention on the effect of the anions on the functional properties of hemoglobin, we measured the Bohr effect of untreated hemoglobin in buffers made with HEPES [N-(2-hydroxyethyl)piperazine-N'-2-ethanesulfonic acid], MES [2 (N-morpholino)ethanesulfonic acid], and MOPS [3-(N-morpholino)propanesulfonic acid], which being zwitterions do not need addition of chlorides or other anions for reaching the desired pH. The shape acquired by the Bohr effect curves, either as pH dependence of oxygen affinity or as pH dependence of protons exchanged with the solution, was irreconcilable with that of the Bohr effect curves in usual buffers. This indicated the relevance of solvent components in determining the functional properties of hemoglobin. A new thermodynamic model is proposed for the Bohr effect that includes the interaction of hemoglobin with solvent components. The classic proton Bohr effect is a special case of the new theory. PMID- 3978080 TI - Time-resolved fluorescence anisotropies of diphenylhexatriene and perylene in solvents and lipid bilayers obtained from multifrequency phase-modulation fluorometry. AB - Time-resolved decays of fluorescence anisotropy were obtained from frequency domain measurements of the phase angle difference between the parallel and perpendicular components of the polarized emission and the ratio of the modulated amplitudes. These data were measured at modulation frequencies ranging from 1 to 200 MHz. To demonstrate the general applicability of this method, we describe the resolution of both simple and complex decays of anisotropy. In particular, we resolved single, double, and triple exponential decays of anisotropy and the hindered rotational motions of fluorophores within lipid bilayers. The ease and rapidity with which these results were obtained indicate that frequency-domain measurements are both practical and reliable for the determination of complex decays of anisotropy. PMID- 3978081 TI - Light-driven protonation changes of internal aspartic acids of bacteriorhodopsin: an investigation by static and time-resolved infrared difference spectroscopy using [4-13C]aspartic acid labeled purple membrane. AB - The molecular events during the photocycle of bacteriorhodopsin have been studied by the method of time-resolved and static infrared difference spectroscopy. Characteristic spectral changes involving the C=O stretching vibration of protonated carboxylic groups were detected. To identify the corresponding groups with either glutamic or aspartic acid, BR was selectively labeled with [4 13C]aspartic acid. An incorporation of ca. 70% was obtained. The comparison of the difference spectra in the region of the CO2- stretching vibrations of labeled and unlabeled BR indicates that ionized aspartic acids are influenced during the photocycle, the earliest effect being observed already at the K610 intermediate. Taken together, the results provide evidence that four internal aspartic acids undergo protonation changes and that one glutamic acid, remaining protonated, is disturbed. The results are discussed in relation to the various aspects of the proton pumping mechanism, such as retinal isomerization, charge separation, pK changes, and proton pathway. PMID- 3978082 TI - Inhibition of enzymic incision of thymine dimers by covalently bound 2-[N [(deoxyguanosin-8-yl)acetyl]amino]fluorene in deoxyribonucleic acid. AB - The effects of DNA adducts of the carcinogen 2-[N-(acetoxyacetyl)amino]fluorene on enzymic incision of thymine dimers was investigated. Escherichia coli DNA labeled with [3H]thymidine was reacted with the carcinogen. Thymine dimers were then introduced into the modified DNA by irradiation with monochromatic 254-nm light in the presence of the photosensitizer silver nitrate. This DNA containing both types of damages, mainly 2-[N-[(deoxyguanosin-8-yl)acetyl]fluorene and thymine dimers, was then used as substrate for pyrimidine dimer-DNA glycosylase, purified from E. coli infected by bacteriophage T4. Activity was assayed by measuring release of free labeled thymine after photoreversal of the enzyme reacted DNA by 254-nm light. The Vmax of the enzyme was decreased when it was reacted with the extensively arylamidated substrate. This inhibition of incision of pyrimidine dimers was increased with the number of carcinogen-DNA adducts, although no enzymic activity against modified guanines was present. Therefore, carcinogen-modified purine moieties can interfere with initiation of excision repair of ultraviolet-induced pyrimidine dimers. This suggests an indirect pathway by which modified DNA bases can be mutagenic. PMID- 3978083 TI - Interaction of the 43K protein with components of Torpedo postsynaptic membranes. AB - Interactions of the major Mr 43 000 peripheral membrane protein (43K protein) with components of Torpedo postsynaptic membranes have been examined. Treatment of membranes with copper o-phenanthroline promotes the polymerization of 43K protein to dimers and higher oligomers. These high molecular weight forms of 43K protein can be converted to monomers by reduction with dithiothreitol and do not contain any of the other major proteins found in these membranes, including the subunits of the acetylcholine receptor, as shown by immunoblotting with monoclonal antibodies. To study directly its interactions with the membrane, the 43K protein was radioiodinated and purified by immunoaffinity chromatography. Purified 43K protein binds tightly to pure liposomes of various compositions in a manner that is not inhibited by KCl concentrations up to 0.75 M. The binding can be reversed by adjusting the pH of the reaction to 11, the same treatment that removes 43K protein from postsynaptic membranes. Unlabeled 43K protein solubilized from Torpedo membranes with cholate can be reconstituted with exogenously added lipids in the absence of the receptor. The results suggest that 43K protein molecules are amphipathic and that they may interact with each other and with the lipid bilayer. These interactions cannot explain the coextensive distribution of 43K proteins with acetylcholine receptors in situ. However, they could account for the association of the 43K protein with the postsynaptic membrane and may contribute to the maintenance of the structure of the cytoplasmic specialization of which this protein is a major component. PMID- 3978085 TI - Evidence from 13C NMR for polarization of the carbonyl of oxaloacetate in the active site of citrate synthase. AB - The carbon-13 NMR spectrum of oxaloacetate bound in the active site of citrate synthase has been obtained at 90.56 MHz. In the binary complex with enzyme, the positions of the resonances of oxaloacetate are shifted relative to those of the free ligand as follows: C-1 (carboxylate), -2.5 ppm; C-2 (carbonyl), +4.3 ppm; C 3 (methylene), -0.6 ppm; C-4 (carboxylate), +1.3 ppm. The change observed in the carbonyl chemical shift is successively increased in ternary complexes with the product [coenzyme A (CoA)], a substrate analogue (S-acetonyl-CoA), and an acetyl CoA enolate analogue (carboxymethyl-CoA), reaching a value of +6.8 ppm from the free carbonyl resonance. Binary complexes are in intermediate to fast exchange on the NMR time scale with free oxaloacetate; ternary complexes are in slow exchange. Line widths of the methylene resonance in the ternary complexes suggest complete immobilization of oxaloacetate in the active site. Analysis of line widths in the binary complex suggests the existence of a dynamic equilibrium between two or more forms of bound oxaloacetate, primarily involving C-4. The changes in chemical shifts of the carbonyl carbon indicate strong polarization of the carbonyl bond or protonation of the carbonyl oxygen. Some of this carbonyl polarization occurs even in the binary complex. Development of positive charge on the carbonyl carbon enhances reactivity toward condensation with the carbanion/enolate of acetyl-CoA in the mechanism which has been postulated for this enzyme. The very large change in the chemical shift of the reacting carbonyl in the presence of an analogue of the enolate of acetyl-CoA supports this interpretation. PMID- 3978084 TI - Interaction of gentamicin and spermine with bilayer membranes containing negatively charged phospholipids. AB - We measured the electrophoretic mobility of multilamellar phospholipid vesicles, the 31P NMR spectra of both sonicated and multilamellar vesicles, and the conductance of planar bilayer membranes to study the binding of spermine and gentamicin to membranes. Spermine and gentamicin do not bind significantly to the zwitterionic lipid phosphatidylcholine. We measured the concentrations of gentamicin and spermine that reverse the charge on vesicles formed from a mixture of phosphatidylcholine and either phosphatidylserine or phosphatidylinositol. From these measurements, we determined that the intrinsic association constants of the cations with these negative lipids are all about 10 M-1. This value is orders of magnitude lower than the apparent binding constants reported in the literature by other groups because the negative electrostatic surface potential of the membranes and the resultant accumulation of these cations in the aqueous diffuse double layer adjacent to the membranes have not been explicitly considered in previous studies. Our main conclusion is that the Gouy-Chapman Stern theory of the aqueous diffuse double layer can describe surprisingly well the interaction of gentamicin and spermine with bilayer membranes formed in a 0.1 M NaCl solution if the negative phospholipids constitute less than 50% of the membrane. Thus, the theory should be useful for describing the interactions of these cations with the bilayer component of biological membranes, which typically contain less than 50% negative lipids. For example, our results support the suggestion of Sastrasinh et al. [Sastrasinh, M., Krauss, T. C., Weinberg, J. M., & Humes, H. D. (1982) J. Pharmacol. Exp. Ther. 222, 350-358] that phosphatidylinositol is the major binding site for gentamicin in renal brush border membranes. PMID- 3978086 TI - Tetrahydrobiopterin analogues: solution conformations of 6 methyltetrahydropterin, 7-methyltetrahydropterin, and cis- and trans-6,7 dimethyltetrahydropterins as determined by proton nuclear magnetic resonance. AB - The conformation of tetrahydrobiopterin analogues in aqueous solution at 23 degrees C has been determined by analyzing the 200-MHz 1H NMR spectral parameters of the enzymatically active 6-methyltetrahydropterin, 7-methyltetrahydropterin, and cis- and trans-6,7-dimethyl-5,6,7,8-tetrahydropterins. Each of these cofactors, with the exception of the cis-6,7-dimethyl isomer, exhibited an unusually small trans 6H-7H spin-spin coupling (8.5-9.1 Hz). An empirical equation that accounts for the effects of substituent electronegativity and orientation on vicinal couplings [Haasnoot, C. A. G., deLeeuw, F. A. A. M., & Altona, C. (1980) Tetrahedron 36, 2783-2792] predicted this coupling to be 11.3 11.6 Hz. We attribute the discrepancy between the calculated and experimentally observed values of this coupling to hyperconjugation of the axially oriented C7-H bond with the pi orbital of the vinylogous amide protein of the pterin ring (N8 C8a = C4a-C4 = O) rather than conformational averaging. The trans 6H-7H interproton distance in the 6-methyl analogue is calculated to be 3.0 A from the measured decrease in the spin-lattice relaxation rate of the axially oriented C7 proton after specific deuteration at C6. This is consistent with the single conformer interpretation. Chemical shift comparisons of the methyl resonances of these analogues, NOE measurements from selectively deuterated analogues, and the differential sensitivities of axially vs. equatorially disposed ring protons to protonation at N5 all indicate that (i) the methyl substituents at both the C6 and C7 positions markedly prefer equatorial-like orientations and (ii) the tetrahydropterin ring is, with the exception of a pronounced pucker at C6, nearly planar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978087 TI - Nonstereospecific biosynthesis of 11-cis-retinal in the eye. AB - [3H]-all-trans-Retinol injected intraocularly into rats is processed to [3H]-11 cis-retinal, the visually active retinoid that binds to opsin. After 18 h, virtually all (93%) of the radioactive retinals recovered were in the form of 11 cis-retinal. At earlier times, however, both all-trans- and 13-cis-retinals, the latter being a nonphysiological isomer, were formed. Both of these isomers disappeared concomitant with the formation of 11-cis-retinal. The rise and fall of 13-cis-retinal suggest that this isomer can be converted into 11-cis-retinal either directly or indirectly in vivo and, hence, that the biosynthesis of the latter is nonstereospecific. This hypothesis was verified by showing that in double-labeling experiments [14C]-13-cis-retinol was converted into 11-cis retinal nearly as well (approximately 70%) as [3H]-all-trans-retinol. These studies show that the biosynthesis of 11-cis-retinal can be nonstereospecific and, hence, that the process may be chemically rather than enzymatically mediated in vivo. In contrast, double-labeling studies with [14C]-9-cis-retinol and [3H] all-trans-retinol showed that very little, if any, of the 9-cis isomer was processed to 11-cis-retinal in vivo although it did form isorhodopsin. This is consistent with what is known about the relative chemical stabilities of 9-cis retinoids from model studies. The isomerization of 9-cis-retinoids is much slower than that of their all-trans, 13-cis, or 11-cis congeners. These results are discussed in terms of a possible mechanism for the biosynthesis of 11-cis-retinal in vivo and suggest that the isomerization event need not necessarily be enzyme mediated. PMID- 3978088 TI - Structures of N-glycans of a ricin-resistant mutant of baby hamster kidney cells. Synthesis of high-mannose and hybrid N-glycans. AB - The asparagine-linked glycopeptides (N-glycans) of a ricin-resistant mutant of baby hamster kidney (BHK) cells, RicR21, have been isolated and fractionated from a Pronase digest of disrupted cells by concanavalin A (Con A)-Sepharose chromatography, ion-exchange chromatography, and lentil lectin chromatography. The structures of all the major N-glycans have been determined by 500-MHz H NMR spectroscopy. RicR21 synthesizes only hybrid and high-mannose N-glycans. All the hybrid structures contain only three mannose residues. The major hybrid glycopeptide has the following structure: (Formula: see text). There is also about 15% of the nonfucosylated species present. Only a small amount (less than or equal to 5%) of the asialo hybrid is produced. Branched hybrid N-glycans are also present in RicR21 cells, containing two complex antenna linked beta 1----2 and beta 1----4 to the Man alpha 1----3 arm; about 70% of this species is core fucosylated. Man6GlcNAc2 glycopeptide is the most abundant (about 70%) of the high-mannose N-glycans. These studies account for the very poor ricin binding property of this mutant, as the sialic acid residues of the major hybrid N-glycan are exclusively linked alpha 2----3 to galactose and ricin is unable to bind to alpha 2----3-substituted galactosyl residues [Baenziger, J. U., & Fiete, D. (1979) J. Biol. Chem. 254, 9795-9799]. PMID- 3978089 TI - Synthesis and polymorphism of 3-acyl-sn-glycerols. AB - 3-Acyl-sn-glycerols with even-numbered saturated fatty acyl chains from decanoate to lignocerate were synthesized. Successful hydrolysis of the long acyl chain intermediate 1,2-isopropylidene-3-acyl-sn-glycerols from stearate to lignocerate was accomplished by applying the compounds to silica gel and exposing them to hydrogen chloride gas at -75 degrees C. The purity of the compounds was checked by boric acid impregnated thin-layer chromatography, 13C NMR, and reverse-phase high-pressure liquid chromatography. Differential scanning calorimetry and X-ray diffraction techniques were used to study the polymorphism of the compounds. In the beta phase obtained from solvent of crystallization, the acyl chain packing was in a two-dimensional oblique lattice with specific chain-chain interactions with a tilt angle of 55.4 degrees from the bilayer plane. The thickness of the region containing two glycerol head groups was 12.7 A. The phase transition enthalpy of melting for the beta phase was 1.06 kcal/mol of CH2. On being cooled these compounds crystallized reversibly to an unstable alpha phase, which on being further cooled underwent a second crystallization to a beta or beta' phase. The thermodynamic parameters and long spacings of these compounds in both beta and alpha phases were linear, indicating isostructural packing in each phase. The enthalpy of the melting transition of the alpha phase was 0.69 kcal/mol of CH2. In this phase, the chains were packed in a hexagonal lattice with nonspecific chain-chain interactions. The thickness of the head-group region (12.2 A) and the tilt angle (55 degrees) of the acyl chains in the alpha phase were very similar to those in the beta phase. PMID- 3978090 TI - Synthesis of lysogangliosides. AB - The synthesis of gangliosides GM3, GM2, GM1, and GD1a solely lacking the fatty acid moiety, and thus called lysogangliosides in analogy to lysophospholipids, is described. Since a selective elimination of the fatty acid residue has not been achieved as yet, the gangliosides were first subjected to alkaline hydrolysis. By this procedure the fatty acyl as well as the acetyl groups of the sialic acid residue(s) were completely removed. The acetamido group of the N acetylgalactosamine moiety of the gangliosides GM2, GM1, and GD1a was very little (congruent to 10%) hydrolyzed. In a two-phase system composed of water and ether, the selective protection of the sphingoid amino group was accomplished with a hydrophobic protective group (9-fluorenylmethoxycarbonyl). Lysogangliosides were obtained after re-N-acetylation of the sialooligosaccharide amino group(s) followed by removal of the protecting group. The overall yield was about 30%. The structures of the lysogangliosides were confirmed by chemical analysis as well as negative ion FAB mass spectrometry and 1H NMR spectroscopy. By simple re-N acylation of lysogangliosides with any labeled fatty acid, labeled gangliosides are now obtainable that are identical with their parent gangliosides except for their labeled fatty acid residue. This has been demonstrated by the synthesis of GM1 with a [1-13C]palmitic acid moiety in its ceramide portion. If desired, double-labeled gangliosides may be obtained by use of labeled acetic anhydride in the synthesis of the lysogangliosides. PMID- 3978091 TI - Model for calcium binding to gamma-carboxyglutamic acid residues of proteins: crystal structure of calcium alpha-ethylmalonate. AB - The crystal structure of a Ca2+ salt of alpha-ethylmalonic acid was determined from three-dimensional X-ray diffraction data. The dicarboxylate anion represents the functional side chain of gamma-carboxyglutamic acid (Gla) residues, which are implicated as essential calcium-binding ligands in a variety of proteins. The alpha-ethylmalonate ion chelates the Ca2+ ion in a bidentate manner that involves an O atom from each of the two malonate carboxylate groups. This type of binding arises from the constrained arrangement of carboxylate ligands in the malonate group and may be of significance to the calcium-binding properties of Gla containing sites in proteins. The Ca2+-malonate chelation forms a six-membered ring, which is stabilized by interactions that are consistent with the preferred stereochemistries of both calcium-carboxylate and metal-malonate complexes. No other interactions are observed between Ca2+ ions and alpha-ethylmalonate ions that depend upon the malonate juxtaposition of two carboxylate groups. The potential for this type of binding distinguishes Gla residues from the monocarboxylate residues, aspartate and glutamate, and confers a novel calcium chelation ability upon Gla-containing sites in proteins. PMID- 3978092 TI - Identification of membrane-embedded domains of lipophilin from human myelin. AB - The organization of lipophilin in the intact human myelin membrane has been studied by labeling with the carbene photogenerated from 3-(trifluoromethyl)-3-(m [125I]iodophenyl)diazirine ([125I]TID). This hydrophobic probe labels mostly lipophilin (the main intrinsic protein of myelin) and the lipids within the bilayer. The domains of lipophilin which are embedded within the membrane have been identified by proteolytic fragmentation of the [125I]TID-labeled myelin, extraction with organic solvents, and separation by chromatography. Four labeled peptides were purified in this way. Polyacrylamide gel electrophoresis, amino acid compositions, automated sequencing, and carboxy-terminal analyses identified a 15K molecular weight peptide, T1 (residues 1-143), as representing the amino terminal fragment, a 10K peptide, T2 (residues 1-97), representing a smaller amino-terminal fragment, a 5K peptide, T4 (residues 53-97), which represented the COOH-terminal half of peptide T2, and a 7K peptide, T3 (residues 205-268), which represented a sequence near the COOH terminus of lipophilin. The specific radioactivities of the peptides were determined; peptides T1 and T2 had similar specific activities, which were twice the specific activities of peptides T3 and T4. The data provide direct chemical evidence that human lipophilin has membrane embedded domains between residues 1-97, 53-97, and 205-268, in agreement with some of the predictions of other investigators based on the sequence of bovine myelin lipophilin (proteolipid apoprotein) and a hydrophobicity diagram. PMID- 3978093 TI - Uncoupling of oxidative phosphorylation by divalent cationic cyanine dye. Participation of phosphate transporter. AB - The trinuclear cationic cyanine dye tri-S-C4(5) was found to be an uncoupler of oxidative phosphorylation. Its uncoupling required inorganic phosphate (Pi) or arsenate, which is transported into mitochondria via the Pi transport system, and was abolished by the Pi-transport inhibitor N-ethylmaleimide or mersalyl. The dye stimulated Pi uptake into mitochondria, and its uncoupling action was accompanied by swelling of the mitochondria. The adenine nucleotides ADP and ATP protected mitochondria from uncoupling by the dye. The dye taken up by mitochondria was released into the incubation medium on induction of uncoupling. In the absence of Pi, the dye did not cause uncoupling, but its uptake was much greater than in the presence of Pi. The cyanine dye is suggested to induce uncoupling by acting on the membrane, rather than after its electrophoretic transfer into the mitochondria. PMID- 3978094 TI - Photoaffinity labelling of submitochondrial membranes with the 3-azido analogue of 9-amino-3-chloro-7-methoxyacridine. AB - 9-Amino-3-azido-7-methoxyacridine has been synthesized and shown to be a suitable photoaffinity probe for the site(s) of interaction of 9-amino-3-chloro-7 methoxyacridine with submitochondrial membranes. Both the excitation and emission spectra of the azido analogue covalently bound to membranes in the energized state display distinctive differences from the spectra of labelled, non-energized membranes (i.e., in the absence of oxidizable substrate, or its presence when uncoupler (FCCP) is also present during photolysis). Enzymatic analyses indicate that the probe interacts with the ATPase and the respiratory chain enzymes; energization appears to afford some protection against inactivation. Electrophoresis of the labelled membranes and isolation of their lipid and protein components indicate that the spectral differences are attributable to differing interactions with the lipid components of energized, relative to non energized, membranes. Similar results have been obtained with the 3-azido analogue of quinacrine (Mueller, D.M., Hudson, R.A. and Lee, C.P. (1982) Biochemistry 21, 1445-1453), which differs significantly, however, in the extent of its interactions with the enzymes of the respiratory chain and the ATPase. These results indicate that the energy-linked fluorescence responses of 9 aminoacridines with submitochondrial membranes arise from direct interactions with membrane components and may involve redistribution of the probe molecules and/or alteration of their microenvironments upon energization. PMID- 3978095 TI - Manganese stimulates calcium flux through the mitochondrial uniporter. AB - Mn2+ alters the balance between the simultaneous uptake and release of Ca2+ across the mitochondrial inner membrane toward a lower external level. Addition of as little as 0.5 microM Mn2+ to energised mitochondria from rat liver, rat heart or guinea-pig brain changed the level at which they buffered Ca2+ in the medium. That extramitochondrial Mn2+ was responsible was suggested by a partial decay in the shift in Ca2+ steady state at a rate similar to the rate at which Mn2+ was accumulated by the mitochondria. The alteration of transmembrane Ca2+ distribution by Mn2+ required that both Mg2+ and Pi be present, and was almost maximal at Mg2+ and Pi levels in the physiological range. Substitution of spermine or Ni2+ for Mg2+, or acetate for Pi, abolished the effect. In contrast to Sr2+, Mn2+ did not inhibit either EGTA- or Ruthenium red-induced release of Ca2+ from the mitochondria. However, when flux through the uniporter was rate limiting, Mn2+ accelerated Ca2+ uptake. The stimulation showed hyperbolic kinetics, with an element of competition discernible in the Mn2+-Mg2+ interaction. Thus, extramitochondrial Mn2+ at levels occurring in vivo can alter the mitochondrial 'set-point' by stimulating Ca2+ influx through the uniporter. PMID- 3978096 TI - Interaction of human erythrocyte Band 3 with Ricinus communis agglutinin and other lectins. AB - Agglutination and competition studies suggest that human erythrocyte Band 3 can interact with both mannose/glucose- and galactose-specific lectins. Purified Band 3 reconstituted into lipid vesicles binds concanavalin A, but the nonspecific binding component, measured in the presence of alpha-methylmannoside, is very high. This glycoprotein also carries binding sites for the galactose-specific lectin Ricinus communis agglutinin. Binding was inhibited poorly by lactose, but much more effectively by desialylated fetuin glycopeptides, suggesting that the lectin recognizes a complex oligosaccharide sequence on Band 3. The glycoprotein bears two separate classes of binding sites for R. communis agglutinin. High affinity binding sites exist which show strong positive cooperativity and correspond in number to the outward-facing Band 3 molecules. A low-affinity binding mode is abolished by 40% ethyleneglycol, suggesting the involvement of hydrophobic lectin-glycoprotein interactions. Studies on binding of R. communis agglutinin to human erythrocytes indicate positively cooperative binding to 7 X 10(5) very-high-affinity sites per cell, and lectin binding is completely inhibitable by lactose. Based on its binding characteristics in vesicles, it seems likely that Band 3 forms the major receptor for this lectin in human erythrocytes. Properties such as positive cooperativity thus appear to be a common feature of the interaction of Band 3 with a variety of lectins of different specificity, both in erythrocytes and lipid bilayers. PMID- 3978097 TI - The environment of tryptophan in pig pancreatic phospholipase A2 bound to bilayers. AB - Binding of pig pancreatic phospholipase A2 to ternary codispersions of diacylphosphatidylcholine/lysophosphatidylcholine/fatty acid (100:22:22, mole ratio) is monitored by the increase in intrinsic fluorescence intensity of the single tryptophan residue. The fluorescence is quenched by the brominated fatty acid components in the ternary codispersions. The quenching efficiency is in the order: 11,12-dibromo- greater than 9,10-dibromo- greater than 6,7-dibromo- greater than 2-bromo fatty acid. The quenching efficiency of the 9,10-brominated derivatives of the three components in the ternary codispersions is in the order diacylphosphatidylcholine greater than fatty acid greater than lysophosphatidylcholine. Two isomers of diacylphosphatidylcholine with 9,10 dibromo substituents on chain 1 or 2 are equally efficient quenchers. While succinimide also quenches the fluorescence of the free and the membrane bound enzyme, the tryptophan residue in both systems is not accessible to 1 methylnicotinamide. These results are rationalized by a hypothesis that the acyl chains of the substrate interacts with the tryptophan residue of pig pancreatic phospholipase A2, which is readily accessible to water soluble neutral quenchers both in the free and the bound state. PMID- 3978098 TI - Mechanisms of uptake of ketone bodies by luminal-membrane vesicles. AB - The energetics and location of renal transport of acetoacetate, beta hydroxybutyrate, alpha-hydroxybutyrate and gamma-hydroxybutyrate by luminal membrane vesicles from either whole cortex or pars convoluta or pars recta of rabbit proximal tubule were studied. Addition of either acetoacetate or beta hydroxybutyrate or its analogues to dye-membrane-vesicle suspensions in the presence of Na+ gradient (extravesicular greater than intravesicular) resulted in absorbance changes indicative of depolarizing event(s). Valinomycin enhanced the Na+-dependent uptake of monocarboxylic acids, provided a K+ gradient (intravesicular greater than extravesicular) was present. By contrast, Na+ dependent uptake of these compounds was nearly abolished by ionophores that permit Na+ to pass through the luminal-membrane via another channel, either electrogenically (e.g. gramicidin D) or electroneutrally (e.g. nigericin). These results established that the Na+-dependent transport of ketone bodies and analogues by luminal-membrane vesicles is an electrogenic process. Eadie-Hofstee analysis of saturation kinetic data suggested the presence of multiple transport systems in vesicles from whole cortex for these compounds. Tubular localization of the transport systems was studied by the use of vesicles derived from pars convoluta and pars recta. In pars recta uptake of all these compounds was mediated by means of a single high affinity common transport system. Uptake of these compounds by vesicles from pars convoluta was carried out via a relatively low affinity but common transport system. The physiological importance of the transport systems is discussed. PMID- 3978099 TI - p-Chloromercuribenzenesulfonic acid stimulation of chloride-dependent sodium and potassium transport in human red blood cells. AB - The organic mercurial p-chloromercuribenzensulfonic acid (PCMBS) reversibly increases fluxes of sodium and potassium across the human red blood cell membrane. We examined the effect of different monovalent anions on cation fluxes stimulated by PCMBS. A substantial portion of the fluxes of both cations was found to have a specific anion requirement for chloride or bromide, and was not observed when chloride was replaced by nitrate, acetate or methylsulfate. The chloride-dependent component of the cation fluxes was only observed when the cells were exposed to PCMBS concentrations of 0.5 mM or greater. Furosemide (1 mM) did not inhibit the PCMBS-stimulated cation fluxes. The observed anion specificity is directly associated with the transport process rather than PCMBS binding to the membrane. A portion of the potassium transport stimulated by PCMBS appears to involve K+-K+ exchange; however, Na+ + K+ cotransport is not stimulated by this sulfhydryl reagent. PMID- 3978100 TI - Fluidity characteristics of bovine thyroid plasma membranes. AB - Highly purified plasma membranes of bovine thyroid were obtained by differential pelleting followed by discontinuous gradient centrifugation in a swing-out rotor. Subfractions of plasma membranes were prepared by affinity chromatography on Con A-Sepharose. The final membrane fractions were enriched 25-30-fold over homogenate in 5'-nucleotidase and alkaline phosphatase and displayed a protein to phospholipid ratio of 1.67 and a cholesterol to phospholipid molar ratio of 0.55. The phospholipid composition did not deviate appreciably from that of whole tissue except for the higher sphingomyelin level (22.5 vs. 14.0%). The predominant fatty acids were palmitic (16:0), oleic (18:1), stearic (18:0) and linoleic (18:2) acid. The physical state of the membrane was studied by (i) calculation of the lipid structural order parameter SDPH from steady-state fluorescence anisotropy determinations of the hydrophobic probe 1,6-diphenyl 1,3,5-hexatriene (DPH); (ii) estimation of the lateral diffusion coefficient of pyrene following excimer formation. These parameters were determined in native thyroid plasma membranes and in reconstituted vesicles, obtained by detergent dialysis from octylglucoside solubilized membrane components. The presence of membrane protein or neutral lipids induced more restraint on the movements of the fluorophores. The lipid order parameter, SDPH was mainly determined by the neutral lipids. Subfractions of plasma membrane enriched in luminal membranes have a slightly lower fluidity (higher SDPH and lower Ddiff values) than subfractions enriched in basolateral membranes. This difference appears to be due to both differences in lipid as well as protein composition. Under physiological conditions, no significant alterations in probe dynamics could be observed upon addition of thyrotropin or cholera toxin, even at micromolar concentrations. PMID- 3978101 TI - Characterization of cellular and extracellular plasma membrane vesicles from a non-metastasizing lymphoma (Eb) and its metastasizing variant (ESb). AB - Plasma membrane fragments from two variants of a murine lymphoma, Eb and ESb, with different metastatic capacity were investigated. Plasma membranes were isolated from tumor cells recovered from the peritoneal cavity. They differed in their lipid composition, indicating a more fluid state of the plasma membranes derived from the highly metastatic tumor line ESb. Extracellular membrane vesicles could be isolated from the ascites of the tumor-bearing mice. The shedding capacity of ESb cells was much higher than that of Eb cells. The extracellular membranes by chemical analysis and the measurement of marker enzymes proved to be derived from the plasma membranes. However, they differed from the plasma membranes from which they were derived in several aspects: the lipid to protein ratio was diminished; the activities of some plasma membrane associated enzymes were lower while others were identical in plasma membranes and extracellular membranes; the content of saturated fatty acids in phospholipids was enhanced in extracellular membranes. These effects were more pronounced in the highly metastasizing tumor line ESb. It is thus concluded that shedding of extracellular membranes is not a random process. The biochemical differences found in the plasma membranes and the extracellular membranes of the two tumor lines are discussed with respect to the different metastatic capacity of the tumors. PMID- 3978102 TI - Molecular species composition of membrane phosphatidylcholine influences the rate of cholesterol efflux from human erythrocytes and vesicles of erythrocyte lipid. AB - The efflux of [3H]cholesterol from prelabelled human erythrocytes having modified phosphatidylcholine compositions was measured during 24-h incubations in the presence of unlabelled acceptor liposomes composed of equimolar amounts of egg phosphatidylcholine and cholesterol. The cells were modified by replacement of part of the native phosphatidylcholine with either dipalmitoylphosphatidylcholine, palmitoyloleoylphosphatidylcholine or dilinoleoylphosphatidylcholine catalyzed by phosphatidylcholine-specific transfer protein from bovine liver. The results indicated that the efflux of [3H]cholesterol was faster from erythrocytes in which the dipalmitoylphosphatidylcholine content was increased from 7 to 25% of the total, than from cells enriched in palmitoyloleoylphosphatidylcholine or dioleoylphosphatidylcholine. Incorporation of dilinoleoylphosphatidylcholine to a level of 13% of the total phosphatidylcholine slowed the rate of efflux of [3H]sterol. The phosphatidylcholine replacements produced no significant differences in cholesterol/phospholipid ratio before or after 24 h of incubation with the acceptor egg phosphatidylcholine-cholesterol vesicles. Using vesicles prepared from erythrocyte lipid, modified to reflect the changes in the phosphatidylcholine composition induced in the whole cells, the same influence of composition on the rate of cholesterol exchange was evident. Enhancement of the dipalmitoylphosphatidylcholine content from 7 to 25% of the total phosphatidylcholine pool increased the rate of [3H]cholesterol efflux, while the addition of the same amount of dilinoleoylphosphatidylcholine slowed it compared to controls. The magnitude of the effect was comparable in intact cells and erythrocyte lipid vesicles enriched in dipalmitoylphosphatidylcholine, while the influence of dilinoleoylphosphatidylcholine was more marked in the intact cells. These results demonstrate that changes in the molecular species composition of the phosphatidylcholine pool can influence the rate of exchange of cholesterol but not necessarily the cellular content of sterol in the human erythrocyte. The influence of this phospholipid appears to be expressed independently of the presence of membrane protein or an underlying cytoskeleton. PMID- 3978103 TI - Modification of vesicle surfaces with amphiphilic sterols. Effect on permeability and in vivo tissue distribution. AB - In this paper, we describe the permeability of vesicles prepared with various synthetic cholesterol derivatives. Cholesterol derivatives with side-chains ending in hydroxyl groups reduced the permeability of unilamellar vesicles. However, addition of cholesterol derivatives with terminal amino groups makes the vesicles more permeable. Vesicles prepared with a short-chain amino-cholesterol derivative were found to be less permeable in phosphate-buffered saline, but not in bovine serum, while long-chain amino-cholesterol-containing vesicles were very permeable in both media. Studies in vivo indicate a rapid clearance rate for intravenously administered amino-cholesterol-containing vesicles with a concomitant increase in liver uptake. However, no difference was found in either the clearance or tissue distribution of control vesicles and the less permeable hydroxyl-cholesterol-containing vesicles. PMID- 3978104 TI - A fluorescence anisotropy study on the phase behavior of dimyristoylphosphatidylcholine/cholesterol mixtures. AB - The phase behavior of L-alpha-dimyristoylphosphatidylcholine/cholesterol mixtures was studied in multilamellar vesicles by fluorescence polarization of the sterol molecule dehydroergosterol and of the polyene molecule alpha-parinaric acid. In the absence of cholesterol, dehydroergosterol exhibited an increase in polarization as DMPC vesicles were heated through the phase transition. This rise in polarization anisotropy was observed over a 0.6-1.0 degrees C increase in temperature with the midpoint of the phase transition occurring at 23.6 degrees C. Addition of 5 mol% cholesterol completely obliterated this change in polarization anisotropy through the phase transition of DMPC. alpha-Parinaric acid underwent a characteristic decrease in polarization anisotropy through the phase transition of DMPC. The change in anisotropy through the phase transition was over 4-fold greater than the values observed with dehydroergosterol. Vesicles containing 5 mol% cholesterol in the presence of alpha-parinaric acid underwent a decrease in polarization anisotropy that was over 75% of the original decrease in amplitude observed in the absence of any membrane cholesterol. The difference in sensitivity of the two fluorescent probes to the phase transition of DMPC as a function of membrane cholesterol content may be explained by a preferential partitioning of dehydroergosterol (and cholesterol) into a sterol-rich phase at low sterol concentrations. This partitioning allows dehydroergosterol to detect sterol-rich regions in the membrane bilayer. PMID- 3978105 TI - Action of phospholipase A2 on bilayers. Effect of fatty acid and lysophospholipid additives on the kinetic parameters. AB - Action of pig pancreatic phospholipase A2 on the ternary codispersions of diacylphosphatidylcholine, 1-acyllysophosphatidylcholine and fatty acids is examined. The binding and kinetic constants are found to be the same under a variety of conditions. These parameters and the catalytic turnover number change with the phase-transition temperature of the ternary codispersions, and optimal binding, kinetic and catalytic constants are seen in the phase-transition range where an equilibrium exists between laterally separated phases. The effect of changing the structure of any of the three components is also via a change in the phase-transition temperature of their ternary codispersions. These observations suggest that the binding of pig pancreatic phospholipase A2 to the defect sites on the substrate interface determines the substrate concentration dependence of the initial rate of hydrolysis, and the catalytic turnover by the bound enzyme also depends upon the phase state of the bilayer. An additive-induced stabilization of the defects in the substrate bilayer is postulated to account for the enhanced binding of the enzyme to the bilayer. PMID- 3978106 TI - Action of phospholipase A2 on bilayers. Effect of inhibitors. AB - Action of several solutes on the kinetics of phospholipase-A2-catalyzed hydrolysis of the ternary codispersions containing dimyristoylphosphatidylcholine + 1-palmitoyllysophosphatidylcholine + palmitic acid is examined. The kinetics of hydrolysis is interpreted in terms of the ability of the enzyme to bind to the substrate interface. The inhibitory effect of these solutes is correlated with their ability to modify fluorescence intensity of the bound enzyme, to modify the phase-transition profile, and to inhibit aggregation/fusion of the ternary codispersions. Based on these observations, it is suggested that the solutes like n-alkanols, ketamine, alphadolone, alphaxalone, flufenamic acid, tobramycin, mepacrine, EMD 21657 and U-10029A modulate the phase equilibria in the codispersions and thus noncompetitively inhibit the phospholipase action. Inhibition by feverfew extract (Tanacetum parthemium) is also by a similar mechanism. Lipid-soluble drugs as indomethacin had little effect on the kinetics of hydrolysis. All these inhibitors decrease the total extent of hydrolysis of the available substrate. However, none of these inhibitors have any effect on the hydrolysis of monomeric substrate or on the inactivation of the phospholipase A2 by p-bromophenacylbromide. These observations suggest that all these inhibitors do not interact directly with the catalytic site of the free or the bound enzyme, and their effect is primarily on the enzyme-binding sites on the substrate vesicle, that is, by perturbation of lipid-protein interaction. PMID- 3978107 TI - Fe2+ uptake by intestinal brush-border membrane vesicles from normal and hypoxic mice. AB - Fe2+ uptake by mouse intestinal brush-border membrane vesicles consists of two components: a rapid, high affinity (Kd less than 1 microM), low capacity binding (less than 2 nmol/mg protein), presumably to the outside of the vesicles, and a second, large capacity component with an initial rate showing a hyperbolic dependence on medium Fe2+ (Km 35-90 microM). The latter, predominant process is relatively independent of medium ascorbate: Fe2+ ratio, is inhibited by Co2+ and Mn2+ but varies greatly from one membrane preparation to another. This component is strongly inhibited by large extravesicular NaCl and KCl concentrations and may represent transport into the vesicles. No significant change in uptake could be observed in vesicles prepared from hypoxic mice. PMID- 3978109 TI - Ultraviolet difference spectroscopic analysis of the saccharide-binding properties of Ricinus communis agglutinin. AB - The nature of the binding of saccharides to Ricinus communis agglutinin was studied by ultraviolet difference spectroscopy. Upon binding of galactose and galactose-containing saccharides, R. communis agglutinin displayed difference spectra with an extreme maximum at 291-293 nm and a smaller maximum at 284-285 nm. Such difference spectra suggest that the environment of a tryptophan residue located at or near the saccharide-binding site of R. communis agglutinin is being changed by an interaction between a tryptophan residue and the bound saccharides. The value of the difference spectra (delta epsilon) increased upon progressive addition of saccharide until the saccharide binding site was saturated with ligand. From the increase in delta epsilon at 291-293 nm, the association constants were obtained for the R. communis agglutinin-saccharide interaction over the temperature range 5-35 degrees C and various pH values. The results clearly demonstrate that the association constants are nearly equal in the range of pH 5-8, but decrease beyond the above pH range and with elevation of temperature. From the thermodynamic parameters for the binding of various saccharides to R. communis agglutinin, we suggest that there exists a subsite structure in the saccharide-binding site of the R. communis agglutinin molecule. PMID- 3978108 TI - Hydrolysis of phospholipid monolayers by human spermatozoa. Inhibition by male contraceptive gossypol. AB - Monomolecular films of phospholipid were used to study the interaction of intact human spermatozoa with model membranes. Exclusively with negatively charged phosphatidylglycerol monolayers rapid penetration of spermatozoa into the monolayer with subsequent hydrolysis of the lipid was triggered by the addition of 5 mM calcium into the medium. The results suggest the localization of a calcium-dependent phospholipase A2 at the outer acrosomal or plasma membrane of human spermatozoa with its active site exposed to the external environment. Preincubation of the cells with 100 microM gossypol completely abolished the ability of human spermatozoa to hydrolyze or penetrate monolayers of phosphatidylglycerol. The inhibition of the phospholipase activity by gossypol may contribute to the unknown contraceptive mechanisms of this non-steroidal male antifertility agent. PMID- 3978110 TI - Fluorescence energy transfer between points in G-actin: the nucleotide-binding site, the metal-binding site and Cys-373 residue. AB - Fluorescence energy transfers were studied in order to investigate the spatial relationships between the nucleotide-binding site, the metal-binding site and the Cys-373 residue in the G-actin molecule. When 1-N6-ethenoadenosine-5' triphosphate (epsilon-ATP) in the nucleotide-binding site and Co2+ or Ni2+ in the metal-binding site were used as fluorescence donor and acceptor, respectively, the fluorescence intensity of epsilon-ATP was perfectly quenched by Ni2+ or Co2+. This indicated that the nucleotide-binding site is very close to the metal binding site; the distance should be less than 10 A. When N-iodoacetyl-N'-(5 sulfo-1-naphthyl)ethylenediamine (IAEDANS) bound to Cys-373 residue and Co2+ in the metal-binding site were used as a fluorescence donor and an acceptor, respectively, the transfer efficiency was equal to 5 +/- 1%. The corresponding distance was calculated to be 23-32 A, assuming a random orientation factor K2 = 2/3. PMID- 3978111 TI - Malonyl-CoA: acetyl-CoA cycling. A new micromethod for determination of acyl-CoAs with malonate decarboxylase. AB - A new micromethod for determination of acetyl-CoA and malonyl-CoA using malonate decarboxylase is described. This enzyme catalyzes decarboxylation of malonate in a cyclic manner and produces acetate in proportion to the amount of a given acyl CoA, such as acetyl-CoA, malonyl-CoA or propionyl-CoA. The acetate generated is converted to acetylphosphate by acetate kinase (EC 2.7.2.1) added at the same time and is determined spectrophotometrically as acetohydroxamate. The sensitivity of this method is high enough to detect 10(-12) mol of acetyl-CoA or malonyl-CoA. The simplicity of the method allows more than 30 samples to be analyzed at the same time without any prior extraction step. Although this method does not distinguish between acetyl-CoA and malonyl-CoA, malonyl-CoA alone can be measured by elimination of acetyl-CoA with citrate synthetase (EC 4.1.3.7). PMID- 3978112 TI - Chemical structure of carcinoma ganglioside antigens defined by monoclonal antibody C-50 and some allied gangliosides of human pancreatic adenocarcinoma. AB - A hybridoma, C-50, obtained by fusion of mouse myeloma cells with spleen cells from a mouse immunized with cells from the colorectal carcinoma cell line COLO 205, produced antibodies that detected ganglioside antigen in human adenocarcinomas in many organs. The major ganglioside antigen fraction isolated from liver metastases of a pancreatic adenocarcinoma, behaving as a homogenous band on thin-layer chromatography, consisted of three different gangliosides. One of them, A (25%), had the same carbohydrate structure as the ganglioside antigen defined by monoclonal antibody 19-9, NeuAc alpha 2-3Gal beta 1-3(Fuc alpha 1 4)GlcNAc beta 1-3Gal beta 1-4Glc-Cer(Fuc-3'-isoLM1) Magnani, J.L., Nilsson, B., Brockhaus, M., Zopf, D., Steplewski, Z., Koprowski, H. and Ginsburg, V. (1982) J. Biol. Chem. 257, 14365-14369). The major ganglioside, B (60%), was the isomeric hexasaccharide ganglioside (NeuAc alpha 2-3Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3-Gal beta 1-4Glc-Cer(Fuc-3'-LM1) and the third ganglioside, C, was 6'-LM1, NeuAc alpha 2-6Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc-Cer (15%). Ganglioside B, isolated from human kidney, did not react with the C-50 MAb. Based on this result and on studies of COLO 205 cell induced tumours where the ganglioside antigen fraction only consisted of A, it is suggested that the C-50 MAb defines an antigen determinant present in A. PMID- 3978113 TI - Modification of fatty acid composition in adipocyte plasma membranes by an oral treatment with a new antidiabetic agent, AS-6, in genetically obese diabetic mice, db/db. AB - Male 12-week-old C57BL/KsJ db/db mice were treated for 1 week with a dietary admixture of an experimental antidiabetic agent, AS-6 (4-O carboxymethylascochlorin, 0.1%). The fatty acid composition of the adipose tissue and its plasma membranes in the treated mice was compared with that in untreated db/db mice and their lean littermates. The results indicate that, when compared with the lean, the db/db adipose tissue and its plasma membrane are extremely rich in nonessential fatty acids, and AS-6 treatment modifies the fatty acyl composition only in the membranes in which 16:1 and 18:1 increase and C18 decreases. PMID- 3978114 TI - A defect in mobilization of cholesteryl esters in rabbit macrophages. AB - Macrophages provide an important way for cholesteryl esters to accumulate in tissues in pathologic amounts. We studied cholesteryl ester metabolism in thioglycollate-induced peritoneal macrophages obtained from normocholesterolemic and hypercholesterolemic rabbits. The macrophage preparations from normocholesterolemic rabbit (MN cells) had 26 nmol esterified cholesterol/mg cellular protein, incorporated 1 nmol of labeled oleate into cholesteryloleate/2 h per mg cellular protein and had an acyl-coenzyme A:cholesterol acyltransferase activity of 22 pmol cholesterylpalmitate formed/min per mg protein in isolated membranes. The macrophage preparations from hypercholesterolemic rabbits (MHC cells) contained a 12-fold greater mass of cholesteryl ester, had an 8-times higher rate of formation of cholesteryloleate, and had 3-times more acyl-coenzyme A:cholesterol acyltransferase activity in the isolated membranes. When a cholesterol acceptor (10% fetal bovine serum or 10 mg of lipid-free fetal bovine serum protein) was added to the culture medium of rabbit MHC cells, the MHC cells retained more than 70% of their cholesteryl esters after 48 h of incubation. In contrast, when a cholesterol acceptor (10% fetal bovine serum) was added to the medium of thioglycollate-induced, cholesterol-enriched macrophages from mice, the mice macrophages retained only 19% of their cholesteryl esters after 48 h of incubation. The limited capacity of rabbit macrophages to release unesterified cholesterol from stored cytoplasmic cholesteryl esters to an exogenous acceptor may be related to the propensity of rabbits to develop atherosclerotic lesions. PMID- 3978115 TI - Gastric lipolysis of milk lipids in suckling rats. AB - Fatty acid composition of the major lipid classes in stomach contents of suckling rats at 1, 5, 10, 17 and 20 days of lactation was compared to that of milk lipids. In milk, 98% of fatty acids were in triacylglycerols at all lactation times. Medium-chain fatty acid concentrations increased from 8% in colostrum to 26% at day 5. Fatty acid composition of stomach acylglycerols at all lactation times was different from that of milk triacylglycerols, containing less medium chain fatty acids, 8:0 and 10:0. This preferential hydrolysis was also shown by higher concentrations of medium-chain fatty acids in the free fatty acid fraction. The lipolysis of medium-chain fatty acids from triacylglycerols resulted in the appearance of di- and monoacylglycerols with 50-100% higher amounts of 14:0 and 16:0. The similar fatty acid composition of products suggests that considerable lipolysis occurred in stomachs of suckling rats even at 1 day of age. Although there was a 10-fold increase in milk consumption, the extent of lipolysis was similar throughout the suckling period because of a parallel rise in lingual lipase levels. PMID- 3978116 TI - Effect of cortisol on the synthesis of lamellar body glycerophospholipids in fetal rabbit lung tissue in vitro. AB - The effect of cortisol on the rate of choline incorporation into tissue phosphatidylcholine was investigated in lung explants from fetal rabbits of 19-28 days gestational age. The explants were incubated in medium with or without fetal calf serum for up to 7 days. When lung tissues were incubated in serum-free medium, a stimulatory effect of cortisol on tissue phosphatidylcholine synthesis was found in explants from 21-, 24-, 26- and 28-day fetal rabbits; a stimulatory effect of cortisol was observed in 19-day fetal lung explants only if fetal calf serum was present in the culture medium. To assess directly the effect of cortisol on the synthesis of lamellar body phosphatidylcholine, choline incorporation into phosphatidylcholine associated with a purified lamellar body fraction isolated from lung explants of 21- and 28-day fetal rabbits was also investigated. Cortisol caused a marked stimulation of synthesis and accumulation of lamellar body phosphatidylcholine in lung explants from both 21- and 28-day fetal rabbits. The magnitude of the stimulatory effect of cortisol on the rate of synthesis of lamellar body phosphatidylcholine was always greater than the effect of cortisol on the rate of choline incorporation into lipids of tissue homogenates. The relative rates of synthesis of lamellar body phosphatidylinositol and phosphatidylglycerol were also significantly altered in lung explants from 21- and 28-day fetal rabbits by cortisol treatment. Lamellar bodies that were formed initially in the fetal lung explants were enriched in phosphatidylcholine and phosphatidylinositol and had a relatively low phosphatidylglycerol content. With cortisol treatment there was a decrease in the relative rate of synthesis of lamellar body phosphatidylinositol and an increase in the relative rate of synthesis of phosphatidylglycerol. The stimulatory effect of cortisol on the synthesis of lamellar body phosphatidylcholine was observed at an earlier time-point of incubation than was the effect of cortisol on the relative rates of synthesis of lamellar body phosphatidylinositol and phosphatidylglycerol. The temporal sequence of the cortisol-induced changes in the synthesis of lamellar body glycerophospholipids, therefore, reflects that which occurs with maturation in vivo. PMID- 3978117 TI - Tissue distribution of liposomes exhibiting long half-lives in the circulation after intravenous injection. AB - The previously established direct relationship between long half-life of uncharged small unilamellar liposomes in the circulation of injected animals and reduced permeability to entrapped solutes in the presence of blood plasma was investigated further. It was found that vesicle size and surface charge override state of membrane permeability in determining rates of vesicle clearance. Thus, half-lives of liposomes that were practically impermeable in plasma were much shorter for larger vesicles or vesicles with a negative charge on their surface. 111In-labelled bleomycin-containing small unilamellar liposomes with long half lives accumulated in the liver after injection to a much lesser extent (e.g., 26%) than similar liposomes (55% of the dose) exhibiting a shorter half-life. Much of the injected long-lived liposomes (about 35%) were recovered in the carcass of the animals. Scanning of the carcasses revealed quantitative accumulation of radioactivity in the bones, presumably the phagocytic cells of the bone marrow. Long-lived liposomes appear suitable for drug delivery to, or imaging of the bone marrow. PMID- 3978118 TI - Isolation and characterization of a link protein from bovine aorta proteoglycan aggregate. AB - Proteoglycan aggregates were isolated from bovine aorta by extraction with 0.5 M guanidine hydrochloride in the presence of proteinase inhibitors and purified by isopycnic CsCl centrifugation. The bottom two-fifths (A1) of the gradient contained 30% of proteoglycans in the aggregated form. The aggregate had 14.8% protein and 20.4% hexuronic acid with hyaluronic acid, dermatan sulfate and chondroitin sulfates in a proportion of 18:18:69. A link protein-containing fraction was isolated from the bottom two-fifths by dissociative CsCl isopycnic centrifugation. The link protein that floated to the top one-fifth of the gradient was purified by chromatography on Sephadex G-200 in the presence of 4 M guanidine hydrochloride. It moved as a single band in SDS-polyacrylamide gel electrophoresis with a molecular weight of 49 000. The amino acid composition of link protein resembled that of link protein from cartilage, but was strikingly different from that of the protein core of the proteoglycan monomer. The neutral sugar content of link protein was 3.5% of dry weight. Galactose, mannose and fucose constituted 21, 62 and 16%, respectively of the total neutral sugars. In aggregation studies the link protein was found to interact with both proteoglycan monomer and hyaluronic acid. Oligosaccharides derived from hyaluronic acid decreased the viscosity of link protein-free aggregates of proteoglycan and hyaluronic acid but not of link-stabilized aggregates, demonstrating that the link protein increases the stability of proteoglycan aggregates. PMID- 3978119 TI - A reappraisal of leukocyte dehydroascorbate reductase. AB - Dehydroascorbate reductase (glutathione:dehydroascorbate oxidoreductase, EC 1.8.5.1) activity was determined in human leukocyte homogenates using a direct spectrophotometric assay. Despite previous studies, using a less sensitive coupled assay, which reported that this enzyme was present in leukocytes, we found that neither neutrophil nor chronic lymphocytic leukemia lymphocyte extracts had detectable activity. Furthermore, when the product was quantitated by HPLC, protein-dependent generation could not be demonstrated. Mixing experiments with a partially purified enzyme preparation from spinach leaves provided no evidence for the presence of an inhibitor in neutrophil homogenates. These findings suggest that in human leukocytes, dehydroascorbate reduction does not occur enzymatically. PMID- 3978120 TI - Intracellular digestion of saturated and unsaturated phospholipid liposomes by mucosal cells. Possible mechanism of transport of liposomally entrapped macromolecules across the isolated vascularly perfused rabbit ileum. AB - The mechanism of intestinal absorption of liposomally entrapped [14C]inulin and 125I-labelled poly(vinylpyrrolidone) was studied using the isolated rabbit intestinal loop with intact perfused vasculature, a system more closely resembling an in vivo system than the everted sac technique. [14C]Inulin or 125I poly(vinylpyrrolidone) was entrapped in liposomes prepared from unsaturated egg phosphatidylcholine and soya phosphatidylcholine, and saturated distearoylphosphatidylcholine (18:0), dipalmitoylphosphatidylcholine (16:0) and dimyrostoylphosphatidylcholine (14:0). Free and liposomally entrapped macromolecules were introduced in the ileum and the transport of liposomes and entrapped macromolecules into the venous effluent was monitored by measuring the presence of the aqueous marker 125I-poly(vinylpyrrolidone) or [14C]inulin, and lipid marker [3H]cholesterol. The results show that intact liposomes are not transported across intestine into the venous effluent, but they are taken up by mucosal cells and digested intracellularly, releasing the entrapped markers 125I poly(vinylpyrrolidone) and [14C]inulin. These markers are then transported into the venous effluent as free molecules. The absorption of liposomally entrapped [14C]inulin into the venous effluent is biphasic, first slow for 30 min (i.e., a lag period of 30 min), followed by a rapid linear increase. The duration of the lag period and the rate of absorption of the entrapped [14C]inulin are dependent on the degree of saturation and the transition temperature of the phospholipids used to prepare liposomes. The possible explanation of the lag period based on the evidence presented here is that it is the time required for the liposomes to be taken up by mucosal cells and digested intracellularly. Intracellular digestion of liposomes prepared from saturated phospholipids is more rapid than from those prepared from unsaturated phospholipids, and the greater the fatty acid chain length of the saturated phospholipids the more rapid the intracellular degradation of liposomes. PMID- 3978121 TI - The selenoenzyme phospholipid hydroperoxide glutathione peroxidase. AB - The reduction of membrane-bound hydroperoxides is a major factor acting against lipid peroxidation in living systems. This paper presents the characterization of the previously described 'peroxidation-inhibiting protein' as a 'phospholipid hydroperoxide glutathione peroxidase'. The enzyme is a monomer of 23 kDa (SDS polyacrylamide gel electrophoresis). It contains one gatom Se/22 000 g protein. Se is in the selenol form, as indicated by the inactivation experiments in the presence of iodoacetate under reducing conditions. The glutathione peroxidase activity is essentially the same on different phospholipids enzymatically hydroperoxidized by the use of soybean lipoxidase (EC 1.13.11.12) in the presence of deoxycholate. The kinetic data are compatible with a tert-uni ping-pong mechanism, as in the case of the 'classical' glutathione peroxidase (EC 1.11.1.9). The second-order rate constants (K1) for the reaction of the enzyme with the hydroperoxide substrates indicate that, while H2O2 is reduced faster by the glutathione peroxidase, linoleic acid hydroperoxide is reduced faster by the present enzyme. Moreover, the phospholipid hydroperoxides are reduced only by the latter. The dramatic stimulation exerted by Triton X-100 on the reduction of the phospholipid hydroperoxides suggests that this enzyme has an 'interfacial' character. The similarity of amino acid composition, Se content and kinetic mechanism, relative to the difference in substrate specificity, indicates that the two enzymes 'classical' glutathione peroxidase and phospholipid hydroperoxide glutathione peroxidase are in some way related. The latter is apparently specialized for lipophylic, interfacial substrates. PMID- 3978122 TI - Activation of peritoneal macrophages by lysophosphatidylcholine. AB - Lysophosphatidylcholine (lyso-PC), a product of inflammation induced by infectious and other agents, is able to stimulate mouse peritoneal macrophages to ingest target cells coated with IgG but not IgM regardless of the presence of complement. In vitro treatment of mouse resident peritoneal macrophages (adherent cells) alone with lyso-PC stimulated spreading activity but did not enhance ingestion activity of macrophages. However, when mixed cultures of adherent and nonadherent (lymphocytes) cells were treated with lyso-PC, macrophage ingestion activity of IgG-coated target cells (i.e., via Fc-mediated ingestion) was markedly enhanced. Analysis of lyso-PC activation process of macrophages for ingestion activity suggests that nonadherent (lymphocytes) cells are required for the induction of the manifestation of ingestion capacity. This requirement was also met by addition of untreated nonadherent cells to treated adherent cells. Thus, the activation mechanism of macrophages by lyso-PC for ingestion requires contribution of lymphocytes to promote enhanced ingestion activity. Since lyso-PC is a metabolite of a representative membrane phospholipid, we propose that lyso PC and other lysophospholipids are mediators for activation of macrophages regardless of the type of inflammation-causative agent. PMID- 3978123 TI - The stimulatory effect of alloxan diabetes on citrulline formation in rabbit liver mitochondria. AB - The effect of alloxan diabetes on citrulline formation from NH4Cl and bicarbonate was studied in rabbit liver mitochondria incubated with glutamate or succinate as respiratory substrate, as well as with exogenous ATP in the presence of uncoupler and oligomycin. In contrast to ornithine transcarbamoylase, the activity of carbamoyl-phosphate synthetase (ammonia) was higher in mitochondria from diabetic animals than in those from normal ones. In diabetic rabbits the rates of citrulline synthesis were stimulated under all conditions studied. In contrast, levels of N-acetylglutamate, an activator of carbamoyl-phosphate synthetase (ammonia), were significantly increased only in the presence of glutamate, while the highest rates of citrulline formation occurred in uncoupled mitochondria incubated with exogenous ATP as energy source. Treatment of animals with alloxan resulted in an increase of both the intramitochondrial ATP level and the rate of adenine nucleotide translocation across the mitochondrial membrane. The results indicate that the stimulation of citrulline formation in liver mitochondria of diabetic rabbits is mainly due to an increase in carbamoyl-phosphate synthetase (ammonia) activity and an elevation of content of intramitochondrial ATP, a substrate of this enzyme. PMID- 3978124 TI - Effects of antilipolytic agents on rat liver peroxisomes and peroxisomal oxidative activities. AB - The mechanisms involved in the inhibitory effects of antilipolytic agents on rat liver peroxisomal fatty acid oxidative activity have been explored. Treatment of fasting rats with antilipolytic drugs (either 3,5-dimethylpyrazole (12 mg/kg body weight) or Acipimox (25 mg/kg body weight] resulted in a decrease in free fatty acid and glucose plasma levels within 5-10 and in a significant increase in the plasma glucagon to insulin ratio within 15. Changes in the fatty acid oxidative activity appeared with a 2.5-3 h delay and were then very rapid (a 30-40% decrease in the activity occurred in additional 2 h). Many peroxisomal enzyme activities (including non-beta-oxidative activities such as uricase and D-amino acid oxidase) exhibited similar changes with the same delay. Simultaneously with the enzyme changes, at the electron microscope level many autophagic vacuoles were detected in the liver cells, often containing peroxisomal structures. Glutamine, an inhibitor of proteolysis in vivo, prevented the decrease in enzyme activities. It was concluded that the decrease in peroxisomal enzyme activities may be the consequence of enhanced peroxisome degradation due to the stimulation of autophagic processes in liver cells. PMID- 3978125 TI - Ultrastructural changes of sarcolemma and mitochondria in the isolated rabbit heart during ischemia and reperfusion. AB - Isolated rabbit hearts were perfused by the Langendorff technique, made ischemic and subsequently reperfused. It was found that ischemia results in: (i) aggregation of the intramembranous particles in the sarcolemma and (ii) extrusion of pure lipidic multilamellar structures (liposomes) from swollen mitochondria. Subsequent reperfusion resulted in further aggregation of the sarcolemmal intramembranous particles and disruption of the sarcolemma, which was attended by the formation of liposome-like structures. Intramembrane particle aggregation is explained in terms of lateral phase separation of the membrane lipids and a reduction of repulsive forces between the membrane proteins, both induced by a decrease in pH and an increase in Ca2+ concentration intracellularly. The formation and extrusion of the multilamellar structures are discussed in terms of destabilization of the bilayer which results in a structural blebbing-off of pure lipid. PMID- 3978126 TI - Cell-cycle differences of HL-60 leukemia cells fractionated by centrifugal elutriation. AB - HL-60 leukemia cells were fractionated into G1 and S/G2 populations using a rapid centrifugal elutriation technique, and studied for differences between the cell cycle phases. The G1 fraction was found to contain smaller cells with a sedimentation velocity of 7 mm/h. The S/G2 fraction consisted of larger cells with a sedimentation velocity of 125 mm/h. The latter fraction was found to have a peak level of the enzyme (2'-5')An-binding protein, as compared to the G1 fraction, indicating a possible role for (2'-5')An-binding protein and its products in the growth regulation of these leukemic cells. In addition, cytofluorometric analysis of fractionated HL-60 cells indicates that elutriation is an effective fractionation method, rapidly yielding large numbers of cells for study, without the use of chemical treatments. PMID- 3978127 TI - Effects of (dihydro)cytochalasin B, colchicine, monensin and trifluoperazine on uptake and processing of liposomes by Kupffer cells in culture. AB - We investigated the effects of (dihydro)cytochalasin B, colchicine, monensin and trifluoperazine on uptake and processing of large unilamellar liposomes by rat Kupffer cells in maintenance culture. The phospholipid vesicles were labeled in the lipid moiety with phosphatidyl[14C]choline and contained [3H]inulin or [125I]iodoalbumin as nondegradable and degradable markers of the aqueous vesicle content, respectively. Cytochalasin B and dihydrocytochalasin B, inhibitors of microfilament function, reduced inert inulin label uptake by 75% maximally, but residual uptake was not followed by release of lipid degradation products from the cells. By contrast, colchicine, an inhibitor of microtubule assembly, reduced uptake of liposomal inulin by maximally 55% but could not inhibit release of lipid degradation products from the cells. It is concluded that the cytochalasins partly inhibit uptake but fully prevent the arrival of internalized liposomes in the lysosomal compartment, while the action of colchicine is to slow down the overall process of uptake and subsequent transportation to the lysosomes. Monensin reduced inulin uptake to an extent similar to that found with colchicine, but reversibly blocked degradation of liposomal lipid and encapsulated protein. The kinetics of degradation of liposomal constituents suggests that residual uptake in the presence of monensin represents accumulation in an intracellular compartment. Trifluoperazine did not affect binding, internalization or degradation of encapsulated protein at low concentration (6 microM), but completely inhibited release of liposomal lipid degradation products under these conditions. At intermediate concentration (14 microM), the drug also reduced the internalization, while a high concentration (22 microM) was required to inhibit protein degradation as well. We conclude that trifluoperazine has multiple sites of action in the uptake and processing of liposomal constituents by Kupffer cells. PMID- 3978128 TI - Functional disability of rat splenocytes provoked to lipid peroxidation by cumene hydroperoxide. AB - Rat splenocytes were provoked to lipid peroxidation in a dose-dependent manner by cumene hydroperoxide. After exposure to cumene hydroperoxide, formation of high molecular weight protein, presumably through cross-linking of lower molecular weight protein, was stimulated in splenocytes as well as in erythrocyte ghosts. The mitogenic response to concanavalin A of splenocytes was remarkably depressed by addition of cumene hydroperoxide to cultures. This depression was due rather to failures of splenocytes in responding to concanavalin A than deactivation of concanavalin A molecules. It is notworthy that the viability of splenocytes was unaffected by cumene hydroperoxide under the culture conditions where the mitogenic response was depressed. The addition of alpha-tocopherol or thiourea could block the depression of mitogenic response by cumene hydroperoxide, indicating that the depressed response to concanavalin A was related to radical formation. Overall evidence suggests that the function of immunocompetent cells can be depressed through lipid peroxidation-associated mechanisms without suffering from lethal damage. PMID- 3978129 TI - Reversal of antisecretory activity of omeprazole by sulfhydryl compounds in isolated rabbit gastric glands. AB - We have examined the interaction of omeprazole, a gastric antisecretory agent, with endogenous or exogenous sulfhydryl compounds in isolated rabbit gastric glands. The glands exposed to omeprazole (2 microM for 50 min) could recover acid secretory response to dibutyryl-cAMP upon addition of dithiothreitol, cysteine or glutathione. Washing the omeprazole-exposed glands free of the extracellular drug also led to a similar recovery of the acid secretory response. Depletion of cellular glutathione with 2-cyclohexen-1-one had no considerable effect on the secretory response of the glands to dibutyryl-cAMP, but prevented the reversal of the antisecretory effect of omeprazole upon washing or adding exogenous cysteine. Also, the antisecretory potency of omeprazole increased several fold in the glutathione-depleted glands. These observations indicate that cellular glutathione is essential to reactivate the omeprazole-modified enzyme(s), possibly (H+ + K+)-ATPase, in acid secretory process and led us to propose that omeprazole is an agent reacting with sulfhydryl groups. PMID- 3978130 TI - Plasma membrane fluidity measurements on whole living cells by fluorescence anisotropy of trimethylammoniumdiphenylhexatriene. AB - Trimethylammoniumdiphenylhexatriene (TMA-DPH) is a hydrophobic fluorescent probe with a high quantum yield, which was shown earlier to have specific localization properties in the plasma membranes of whole living cells. This probe was used in aqueous suspensions of L929 mouse fibroblasts, rat mast cells and ReH6 leukemic lymphocytes for determining plasma membrane fluidity from fluorescence stationary anisotropy measurements. TMA-DPH was only partially incorporated into the membranes, most of it remained as a stable form in the buffer solution; the distribution was governed by an equilibrium. The measurements were influenced by unavoidable parasitic scattered light and an appropriate correction is described. A set of precautions for the proper use of the probe is proposed. The results indicated that the fluidity was considerably lower in whole cells than in isolated membranes from the same system. PMID- 3978131 TI - [Comparative study of crystallins from the nucleus and cortex of the bovine ocular lens by the gel filtration and x-ray diffraction methods]. AB - Water--soluble proteins (alpha-, beta H-, beta L- and gamma-crystallins) from the bovine lens nucleus and cortex were fractionated and compared by gel filtration on Sephadex G-200. X-ray diffraction patterns from concentrated gels of these proteins were obtained. It allowed to compare qualitatively the structures of different crystallins and also to identify the maxima on X-ray diffraction patterns of the lens intact tissue. PMID- 3978132 TI - [A model of constant color perception for continuous spectral functions]. AB - A trichromatic model is proposed of constant pattern of colour perception (MCCP) for scenes with a single illumination source. In MCCP functions of the source emission, surface reflection, photoacceptor sensitivity are approximated by the normal distribution curves. MCCP characteristics "colour tone", "cleanness", and "lightness" organize its output colour metric by the human's pattern, and in a wide range of spectral composition of illumination they are invariant under these changes. Special colorimetric regime of MCCP work which estimates the colour of visual stimulus permits a comparison between the efficiencies of two proposed algorithms of visual information processing for MCCP. PMID- 3978133 TI - [Non-linear and parametric resonance in the organs of hearing and sight in man]. AB - Nonharmonic and parametric resonance in man's hearing and sight organs are considered. For the first time for combination tones omega 2-omega 1 and 2 omega 1-omega 2 arising in hearing organs under low intensities of an acoustic signal the parametric equations are suggested to explain the properties of these tones. On the basis of the experimental data of the nonharmonic sight the scheme of cis trans-isomerization of the chromophore group (retinal) of visual pigments under simultaneous absorption of two infrared photons is suggested. Possible appearance of nonharmonic resonances in other biological systems is analysed. PMID- 3978135 TI - [Directionality of sound perception in the external ear of the dog]. AB - Sound pressure level of tone was measured using a probe tube microphone at entrance to the dog's external meatus as a function of the azimuth of the sound source. It was demonstrated that directionality of the dog's external ear and corresponding values of interaural intensity differences (delta I) were gradually increased as the tone frequency raised from 0.5 to 40 kHz. Transfer in pinnae locations from lateral to frontal positions (one of the components of orientation reaction to an unexpected sound) resulted in some narrowing of directionality diagrams and in a displacement of their maxima towards the head midline. It was calculated that owing to this effects the extent of monotonic part of the function relating delta I and azimuth of a source were enlarged. The lateral pinnae position was suggested to be optimal for sound detection and the frontal one for localization of the moving sound source. PMID- 3978134 TI - [Migration of parachloromercuribenzoic acid along the binding sites of hunan oxyhemoglobin]. AB - Oxidation kinetics-characterized state of human oxyhemoglobin bound with p chloromercuribenzoic acid (PCMB) (above 2 mole per tetramer) is changed during incubation at 20 degrees C. This suggests transfer of PCMB molecules from primary occupied centres to the secondary ones having higher affinity to PCMB. The same effect is observed at increased temperature without incubation. By means of gel chromatography the hypothesis that the change of oxyhemoglobin state is accompanied by its increased equilibrium dissociation into dimers is acknowledge. PMID- 3978136 TI - [Simulation of spontaneous discharge and short-term adaptation in acoustic nerve fibers]. AB - A model for firing of the auditory nerve fibres was carried out on a general purpose digital computer. In the model a noise with small correlation time and with assigned standard deviation (when modeling a spontaneous discharge) or a sum of a noise and a determinated signal (when modeling an elicited discharge) is compared with incremental threshold. When the threshold is exceeded a spike occurs and the threshold is increased. The threshold qualitative properties and quantitative values were chosen in a way to provide the most reliable patterns of spontaneous discharge, according to the literature data obtained from the cat's auditory nerve. When stimulated by tone-bursts the model reveals intrinsic ability of mimicking the phenomena of discharge rate short-term adaptation. Thus according to our model the short-term adaptation is entirely due to the properties of the incremental threshold. PMID- 3978137 TI - [The role of the relaxation properties of muscles in the formation of movement]. AB - A linear rheology model with memory was constructed theoretically for an activated muscle moving joint of animal body. It was shown that during unidirectional moving the muscle acts like a controlled viscoelastic body with drifting of length. PMID- 3978138 TI - [Physical basis of the generation of neuromagnetic fields]. AB - Electrical processes at the neuronal level are considered, which cause the neuromagnetic fields. Those fields presently measured are due to the synchronous activity of about 10(5) neurons. Short magnetic signals can be caused by afferent and efferent strains of action potentials, the longer ones being due to the synaptic activity at the ends of apical dendrites in the fissural cortex. PMID- 3978139 TI - [Induction of determined oscillations of lactate dehydrogenase activity after rapid heating]. AB - It has been found that macroscopic fluctuations of lactatedehydrogenase activity are determined beats: in four series of measurements carried out at different time of the day activity was determined beginning from the 65th minute after defreezing of the enzymic preparation. Practically similar pictures of the variation course with the amplitude about 8% were observed. PMID- 3978140 TI - [Covalent cross-linking and degradation of proteins caused by ozone]. AB - Molecular products of ozonolysis of tyrosine in proteins have been investigated by means of spectroscopy. The processes of covalent crosslinking and destruction of proteins have been studied. Possible mechanism of crosslinking induced by ozone is discussed. PMID- 3978141 TI - [Chemiluminescent characteristics of ubiquinones]. AB - The paper deals with peculiarities of antioxidative activity of natural antioxidants (exemplified by ubiquinones) which permit their participation in the control of peroxidation intensity of membrane lipids. Ability of different ubiquinone forms to react with peroxide radicals is evaluated by chemiluminescent method. It has been shown that only reduced forms with free hydroxyl groups are highly effective. PMID- 3978142 TI - [Theoretical analysis of the relation between the cell state and pathways of carbon isotope fractionation in metabolic processes]. AB - On a dynamic model of fractionation of carbon isotopes in the living cell there are considered relationships between the distribution of carbon isotopes in the structures approximating basic biochemical fractions, their isotopic composition and parameters characterizing the dynamics of carbon metabolism, i.e. efficient carbon isotope separation factor in pyruvate enzymic decarboxylation, degree of its transformation at primary and secondary decarboxylation and ratios between the currents of carbon substrates. A wide range of variations of cell isotope parameters resulting from the change of its functional states was revealed. Possible applications of the relationships observed for studying biological systems are shown. PMID- 3978144 TI - New experimental data on cat's optokinetic responses. Is there need to revise previous models of the optokinetic reflex? AB - New data on cat's optokinetic reflex (OKR) provided by Godaux and Vanderkelen (1984) have been interpreted by using a nonlinear model of OKR previously proposed by the authors. A general agreement between experimental data and theoretical predictions was obtained. In particular, the steep decrease of OKR gain observed experimentally at high frequencies appeared as a straightforward consequence of the intrinsic nonlinearity of OKR. In contrast with a recent statement by Gillis et al. (1984), it was concluded that the new data seem to confirm, rather than disprove, previous models of cat's OKR. PMID- 3978143 TI - Adaptation of spatial modulation transfer functions via nonlinear lateral inhibition. AB - Adaptation, or change of shape of spatial modulation transfer functions (MTFs) on change of mean luminance level, occurs in visual interneurone and human psychophysical observations. Generally the bandwidth decreases and relative low frequency attenuation decreases as mean luminance decreases. Here it is shown how these changes in MTFs can be accounted for by nonlinear lateral inhibition based on spatial distributions of efficacy of voltage controlled synaptic conductance variation. PMID- 3978145 TI - Internal representations and operations in the visual comparison of transformed patterns: effects of pattern point-inversion, position symmetry, and separation. AB - A scheme for visual pattern recognition is described. It is supposed, amongst other things, that patterns are internally represented by the visual system in terms of local features, spatial-order relations between local features, and global spatial relations specifying approximate pattern position with respect to the point of fixation. It is further supposed that there are two distinct types of internal operation that may be applied to the components of internal representations in the process of pattern comparison: typically a discrete spatial-order-reversal operation and a continuous position-shift operation. Some general predictions of the scheme are tested against data obtained in an experiment using random-dot patterns that were subjected to rigid transformations and presented at various locations along the horizontal meridian. Patterns were presented sequentially, in pairs, to subjects in a "same-different" comparison task. Pattern pairs were to be responded to as "same" if they were identical or related by point-inversion (planar rotation through 180 degrees) or responded to as "different". Extending earlier findings, the present results showed that "same"-detection performance for identical and point-inverted patterns depended differentially on the distance between the patterns and the symmetry of the pattern positions about the point of fixation in a manner consistent with the predictions of the scheme. PMID- 3978147 TI - Leg movements of stick insects walking with five legs on a treadwheel and with one leg on a motor-driven belt. II. Leg coordination when step-frequencies differ from leg to leg. AB - Stick insects walking with five legs on a self-propelled treadwheel and with the left hindleg (L3) on a motor-driven belt may move the "belt" leg L3 and the "wheel" legs with different frequencies. When L3 made less steps than L2, that step of L2, which was performed during the swing phase of L3, is prolonged. The time interval between the end of swing phase of L3 and the onset of the following swing phase of L2 was remarkably constant. When L3 made more steps than L2, that step of L3, which was performed during the swing phase of L2, is prolonged. Again, the time interval between the end of swing phase of L3 preceding a L2 swing phase and the onset of the L2 swing phase was relatively constant. For both kinds of walking situations phase response curves were drawn. They show that two types of coordinating channels exist: An anteriorly directed type is more dependent on absolute time than on phase. A posteriorly directed type is phase dependent. Both inhibit the transition from stance to swing for some time. The results are compared with the existing coordination models. PMID- 3978146 TI - Leg movements of stick insects walking with five legs on a treadwheel and with one leg on a motor-driven belt. I. General results and 1:1-coordination. AB - Five legs of a fixed stick insect walked on a double treadwheel. The left hindleg (L3) walked on a motor-driven belt. When the belt was slower than the wheels L3 made less steps than the other legs and when the belt was faster than the wheels it made more steps than the other legs. In the case of slowlier stepping of the "belt-leg", the motor neurons of the retractor coxae muscle of this leg showed a high activity when the leg was pulled backwards by the belt. This activity was modulated in the step rhythm of the "wheel-legs". When all legs showed the same stepping frequency (1:1-coordination) the protraction duration of L3 was almost independent of step-period, as well as the lag between onset of protraction of L3 and that of L2. In some cases only L3 could be made to step on the belt even when all other legs did not walk. PMID- 3978148 TI - Entrainment of two coupled van der Pol oscillators by an external oscillation. As a base of "holonic control". AB - A system composed of two coupled internal oscillators and an external oscillation is studied as a model of biological control systems. The type of interaction between the internal oscillators is a mutual and dissipative one. Three macroscopic states of the internal oscillators are demonstrated in the absence of the external oscillation. Strict and loose entrainment regions of the internal oscillators by the external oscillation are shown in respect to the intensity of the mutual interaction, the intrinsic frequency difference of the internal oscillations, and the magnitude and frequency of the external oscillation. On the other hand, an idea of "holonic system" is introduced and the fundamental properties of the model as a holonic system are elucidated. PMID- 3978149 TI - [Transmission behavior of the neuromuscular synapse: interpretation of experimental data by a model]. AB - A model of neuromuscular transmission has been proposed which considers morphological structure and interrelated chemical and electrical mechanisms. The adequate kinetic scheme has been described by means of a system of nonlinear first order differential equations and the network of corresponding electrical processes has been treated as a linear first order differential equation with one variable coefficient. By the analytical investigation of derived differential equations detailed informations about the qualitative behaviour of the solutions were obtained. Present results of modelling characterize the neuromuscular synapse as a "perfect" transfer element, since all the possible dynamic solutions tend to exactly one singular point - the "resting state", independent of initial values and all other parameters. The special time-dependent solutions simulated by computer with biologically relevant parameters are in good agreement with experimentally determined transient response of the neuromuscular synapse. The paper concludes with an outlook of the possible pharmacologic application of the developed model. PMID- 3978150 TI - A theoretical model of phase transitions in human hand movements. AB - Earlier experimental studies by one of us (Kelso, 1981a, 1984) have shown that abrupt phase transitions occur in human hand movements under the influence of scalar changes in cycling frequency. Beyond a critical frequency the originally prepared out-of-phase, antisymmetric mode is replaced by a symmetrical, in-phase mode involving simultaneous activation of homologous muscle groups. Qualitatively, these phase transitions are analogous to gait shifts in animal locomotion as well as phenomena common to other physical and biological systems in which new "modes" or spatiotemporal patterns arise when the system is parametrically scaled beyond its equilibrium state (Haken, 1983). In this paper a theoretical model, using concepts central to the interdisciplinary field of synergetics and nonlinear oscillator theory, is developed, which reproduces (among other features) the dramatic change in coordinative pattern observed between the hands. PMID- 3978151 TI - [Effect of chemical modification of tyrosine residues of cholesterol hydroxylating cytochrome P-450 on the interaction with high-spin effectors]. AB - The role of tyrosine residues of cytochrome P-450scc in the interaction with adrenodoxin and cholesterol was investigated, using chemical modifications with tetranitromethane. Selective chemical modification of tyrosine residues resulted in hemoprotein inactivation. Nitration changed the kinetic parameters of the cholesterol side chain cleavage reaction. Both high spin effectors, i.e., substrate and adrenodoxin, prevent cytochrome P-450scc from the inactivation caused by tetranitromethane. Modification of cytochrome P-450scc decreased the affinity of the hemoprotein for cholesterol and adrenodoxin. Some direct evidence for tyrosine involvement in the interaction between cytochrome P-450scc and adrenodoxin was obtained through the use of zonal affinity chromatography on immobilized ferredoxin. PMID- 3978152 TI - [Mechanism of inhibition of non-enzymatic fibrinolysis by a spleen factor]. AB - Some data on the mechanism of inhibition of non-enzymatic fibrinolysis by a spleen factor are presented. It is demonstrated that the spleen protein factor which interacts with heparin at certain ratios forms a complex with the latter. As a result, the anticoagulating activity and properties of the spleen factor as a non-enzymatic fibrinolysis inhibitor are blocked. PMID- 3978153 TI - [Comparison of the antioxidative defense system of pigment epithelium of the eye in pigmented animals and in albinos]. AB - The efficiency of lipid peroxidation inhibition by retinal pigment epithelium of pigmented rabbits is higher than that of albino rabbits. The superoxide dismutase and glutathione peroxidase activities are nearly the same in both tissues; the alpha-tocopherol content is higher in retinal pigment epithelium of albino animals; the oxidation of the pigment epithelium lipid fraction si higher in pigmented animals. It is concluded that the high resistance of pigmented tissue to the effects of prooxidant systems is due to the presence of melanoprotein granules in the pigment epithelium. PMID- 3978154 TI - [Purification of dopamine-beta-monooxygenase and extremely acidic, copper containing proteins from the adrenal medulla. Extremely acidic, copper-containing proteins as electron donors for dopamine-beta-monooxygenase]. AB - A procedure for purification of two copper-containing proteins from bovine adrenal medulla has been developed. The method is based on the extraction of proteins with Triton X-100, DEAE-cellulose chromatography and fractionation with polyethylene glycol. The yield of dopamine-beta-monooxygenase and extremely acidic copper-containing protein per 1 kg of brain medullar tissue is 100 and 150 mg, correspondingly. The ability of the reduced extremely acidic copper containing protein to act as an electron donor in the reactions of side chain hydroxylation of tyramine and dopamine catalyzed by dopamine-beta-monooxygenase was demonstrated. The kinetics of the products formation and oxygen consumption in the course of these reactions and the specific activities of dopamine-beta monooxygenase were compared, using the reduced extremely acidic copper-containing protein, ascorbate and ferrocyanide as cosubstrates. PMID- 3978155 TI - Prenatal alcohol exposure: abnormalities in placental growth and fetal amino acid uptake in the rat. AB - On day 20 of gestation, after ethanol feeding (27% ethanol calories, 25% protein), placental weights, DNA, RNA and water content were greater than in controls pair-fed an isocaloric diet without ethanol or those ad lib fed a pellet diet of similar composition. Rat litter size and fetal body, liver and brain weights were similar in all groups. In vivo fetal amino acid accumulation was significantly lower after alcohol exposure despite similar placental uptake. These results indicate that both placental hyperplasia and abnormal fetal amino acid uptake occur at a low alcohol dose when fetal body weight is unaffected. PMID- 3978156 TI - Relationship between metabolic rate and body size in fetal life. AB - To define the O2 consumption rate (VO2) versus body mass relation during fetal growth, we compared fetal sheep VO2 at mid and late gestation. VO2 per kg wet weight was 37% higher at mid gestation. However, VO2 per kg dry weight was 2.5 times higher, and associated with a high viscera/body weight ratio. Fetal VO2 tends to grow proportionally to body mass because marked decreases in the relative growth of visceral organs and in the VO2/dry weight ratio are accompanied by a decrease in body water. PMID- 3978157 TI - Serum glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase activity in premature and full-term asphyxiated newborns. AB - The serum activity of SGOT and SGPT is one of the more specific parameters of liver cell injury both in adults and in the pediatric age-group. The determination of serum transaminase activity could offer a routine and rapid laboratory test for establishing the presence of hepatic cellular damage following intrauterine or perinatal asphyxia. In fact, it appears that there is a correlation between hypoxia and the increase in serum activity of transaminases in full-term and premature asphyxiated newborns. However, this increase is reversible up to the 30th day of life. The behavior of transaminase enzymatic activity in premature asphyxiated newborns compared to full-term asphyxiated newborns suggests a higher resistance of membranes to hypoxic-ischemic injuries and a lower enzymatic pool of cellular metabolism in premature newborns. Therefore, knowledge of the behavior of SGOT and SGPT activity may have important implications in the diagnosis and early treatment of perinatal asphyxia. PMID- 3978158 TI - Effect of neonatal cerebrospinal fluid on monocyte chemotaxis. AB - We have reported in our previous study that macrophages constitute 58% of the total number of white cells in noninfected neonatal cerebrospinal fluid (CSF). CSF macrophages are probably derived from blood monocytes. To explain their predominance, we compared the chemotactic response of monocytes from cord and adult blood to neonatal (NCSF) and non-neonatal spinal fluids (NNCSF). Zymosan activated serum (ZAS) was used as a positive control. Significance was accepted as p less than or equal to 0.05. We observed that both random migratory (RM) activity and chemotactic responses (CM) of cord monocytes to neonatal CSF and ZAS were greater than those of monocytes obtained from adult blood, resulting in a significant increase in the chemotactic differential (CD). Chemotactic responses of neonatal monocytes were significantly greater in the presence of neonatal CSF as compared to CSF from older children as indicated by CD. The CD of neonatal monocytes to neonatal CSF was greater than that of neonatal neutrophils. These findings are consistent with the presence of specific monocyte chemotaxins in noninfected neonatal CSF. PMID- 3978159 TI - Separate effects of fatty acid oxidation and glucagon on gluconeogenesis in isolated hepatocytes from newborn pigs. AB - In hepatocytes isolated from 48-hour-old suckling pigs, the inhibition of endogenous fatty acid oxidation leads to a 30% inhibition of glucose production from lactate. Addition of oleate plus carnitine to hepatocytes from 48-hour-old fasting pigs increases by 30% the rate of gluconeogenesis from lactate. In hepatocytes isolated from fasting newborn pigs, addition of glucagon (0.5 ng/ml) produces a 30% increase in the rate of glucose production from lactate and a 70% increase of glucose synthesis from dihydroxyacetone. The high rate of lactate plus pyruvate production in fasting piglets is markedly suppressed by glucagon and return to the value measured in suckling newborns. Combined addition of oleate and glucagon to hepatocytes from fasting piglets increases by 2-fold the rate of glucose production from lactate but does not restore totally the rate of glucose synthesis found in suckling piglets. It is concluded that fatty acid oxidation and hormonal environment contribute significantly to the development of an active gluconeogenesis in the newborn pig but do not represent the sole factors involved in the regulation of hepatic gluconeogenesis. PMID- 3978160 TI - Uptake of taurocholate by freshly isolated hepatocytes from fetal and newborn rabbits. AB - During early postnatal maturation a significant increase in the rate constant of translocation (Michaelis-Menten constant; Km) for taurocholate uptake occurs in isolated rabbit hepatocytes. This age-dependent change is related to a decrease in the efficiency of uptake for taurocholate and is probably associated with changes in the receptor or its microenvironment within the plasma membrane. Cholic acid conjugates (taurocholic and glycocholic acids) are the predominant bile acids found in the premature and neonatal human. It is therefore of interest that in the fetal and neonatal rabbit we have found a developmentally dependent alteration of taurocholic acid transport. PMID- 3978161 TI - Peptide-containing fractions in depression. AB - A mixture of peptides and glycoproteins has been found in benzoic acid precipitable material from urines of psychomotorically agitated and retarded endogenous depressive patients. This complex mixture of compounds is fractionated on a Sephadex G-25 gel, from which the different peaks are further separated on Biogel P2. The G-25 elution profiles ultraviolet absorbance, 280 nm) from depressive patients deviated from the normal pattern. The increase in hydrolyzable ninhydrin-colorable material of the P2 fractionation step encountered in psychotic depression was several-fold that of the normal population. Neurochemically active peptide-containing fractions were found. As explanation of these findings, it is probable that a genetically determined peptidase insufficiency is present, causing a peptide overflow when the secretion outstrips the breakdown. This model could easily combine more psychodynamic models with the genetic-biological models. The variability of the peptide patterns could possibly reflect the considerable clinical variability of the syndrome. Furthermore, the presence of a group of active compounds with different neuropharmacological activities might reflect the composite nature of the depressive syndrome. PMID- 3978162 TI - Comparison of whole blood serotonin and platelet MAO in children with schizophrenia and major depressive disorder. AB - Whole blood serotonin and platelet monoamine oxidase (MAO) activity in boys with schizophrenia, schizotypal personality disorder, or major depressive disorder was compared with that of boys serving as controls. Boys with schizophrenia and schizotypal personality disorder had significantly higher platelet MAO than boys with major depressive disorder or controls. Boys with major depressive disorder had lower whole blood serotonin than boys with schizophrenia or schizotypal personality disorder. PMID- 3978163 TI - Prolactin response to morphine in depression. AB - Twenty-two unmedicated inpatients with major depression and 18 healthy volunteers of either sex were given an intravenous injection of 5 mg morphine. Blood samples were drawn immediately before and at intervals for 3 hrs after the injection and assayed for prolactin. Morphine stimulated prolactin secretion. The prolactin response of females was significantly greater than the response of male subjects. There were no significant differences in the prolactin response to morphine between depressed and healthy subjects. The implications of these findings for the hypothesized role of the opioid system in the pathophysiology of depression are discussed. PMID- 3978164 TI - Pathway and hemispheric differences in the event-related potential (ERP) to monaural stimulation: a comparison of schizophrenic patients with normal controls. AB - Previous research has established the stability of the contralateral dominance effect of the auditory temporal N120 peak amplitude. The purpose of this experiment was to examine event-related potential (ERP) asymmetries in schizophrenia, with particular reference to this contralateral dominance phenomenon. Ten unmedicated schizophrenic patients and ten controls heard a series of monaural tones, with no task requirements, while EEG was recorded from Cz, Pz, T3, and T4 referred to linked earlobes. Patients were characterized by smaller N120 amplitudes than controls, an effect that was slightly more pronounced at temporal sites. Patients failed to show the normal N120 contralateral dominance effect. Hemisphere asymmetry ratios revealed that 50% of the patients showed ipsilateral dominance in the auditory pathways. Furthermore, the hemisphere asymmetries (whether ipsilaterally or contralaterally dominant) seen in patients were significantly greater than for controls. These data offer a new level of explanation for schizophrenic performance abnormalities in dichotic listening paradigms and an explanation for for the apparent dichotomy in patient performance between exaggerated right ear advantage (REA) and left ear advantage (LEA). PMID- 3978165 TI - Effects of smoking on fluphenazine clearance in psychiatric inpatients. PMID- 3978166 TI - Failure to normalize the dexamethasone suppression test: association with length of illness. PMID- 3978167 TI - Serum creatine kinase MB (heart) isoenzyme activity in schizophrenia. PMID- 3978168 TI - ECT-induced amnesia and postictal EEG suppression. PMID- 3978169 TI - Biological psychiatry in developing countries. PMID- 3978170 TI - Red blood cell choline. I: Choline in Alzheimer's disease. AB - Seventeen drug-free patients with Alzheimer's disease (AD) and 15 normal elderly controls, of which 13 age- and sex-matched pairs were included, participated in a study of red blood cell (RBC) and plasma choline. Mean values for RBC choline, plasma choline, and the ratio of RBC/plasma choline did not differ between the AD and control groups. Degree of dementia did not correlate with any blood choline measure. A correlation was found between age and RBC choline (r = 0.57; p less than or equal to 0.01) and the RBC/plasma choline ratio (r = 0.56; p less than or equal to 0.03) in normals, but not in AD patients. RBC choline correlated with plasma choline in AD patients only (r = 0.46, p less than or equal to 0.03). These results do not support the use of RBC and plasma choline concentrations as either a diagnostic tool to identify AD patients or an antemortem index of the cholinergic deficit in brains of patients with Alzheimer's disease. PMID- 3978171 TI - Red blood cell choline. II: Kinetics in Alzheimer's disease. AB - The kinetic parameters of choline uptake into red blood cells from patients with Alzheimer's disease and normal elderly controls were compared. The Kd and Vmax values for choline uptake into red cells were determined based on a kinetic analysis of choline uptake at six different concentrations of labeled extracellular choline. The theoretical choline uptake, representing the initial rate of choline influx into choline-depleted red cells given the plasma choline concentration and the kinetic parameters of choline uptake, was also calculated. Alzheimer's disease patients and normal controls did not differ in any kinetic parameter of choline uptake. Kd and Vmax values for red cell choline uptake were strongly correlated among normal controls, but not among patients with Alzheimer's disease. In addition, among the patients with Alzheimer's disease, the theoretical choline uptake was strongly correlated with the severity of dementia. The possible significance of these findings in relation to altered choline metabolism in Alzheimer's disease is discussed. PMID- 3978172 TI - Characteristics of phospholipid methylation in human erythrocyte ghosts: relationship(s) to the psychoses and affective disorders. AB - Recent studies have shown that patients with a schizophrenic-like illness have a significant deficit in erythrocyte ghost membrane (EGM) phosphatidylcholine (PC); patients with the most severe deficiency showed a marked decrease in Na+-Li+ counterflow activity (Hitzemann et al. 1984a and b). The present study was undertaken to see if the decrement in PC is associated with a decrease in phospholipid methylation activity. Phospholipid methylation in human EGMs is distinctly different from that in rat EGMs (Hirata and Axelrod 1980) in that the human activity is not Mg++-dependent, and apparent methyltransferase I activity is located in the external membrane surface. The patient population consisted of 20 DSM-III schizophrenics (SCZ), 13 DSM-III schizophreniform (SF) disorder patients, and 11 DSM-III manics (M). Twelve age- and sex-matched controls were used for the comparison group. Methylation activity was significantly decreased in all three patient groups, although the M group had significantly higher activity than the SF group. Twenty-four of the SCZ and SF patients entered a Li+ trial. The Li+ responder group (n = 8) showed significantly lower activity than the nonresponder group (n = 16). Overall, we conclude that the decrement in phospholipid methylation activity partially contributes to the decrement in PC levels. PMID- 3978173 TI - Cholinergic REM induction response: separation of anxiety and depression. AB - Five groups of subjects underwent EEG sleep recordings, arecoline rapid eye movement (REM) induction response testing, and Schedule for Affective Disorders and Schizophrenia (SADS) interview. Group I: 20 patients with primary major depressive disorder (MDD) (endogenous) without any coexisting anxiety disorder; Group II: 19 primary MDD (endogenous) patients with secondary panic, GAD, or phobic disorders; Group III: 18 patients with primary anxiety disorder without coexisting MDD; Group IV: 14 patients with primary anxiety plus secondary MDD; Group V: 26 normal controls. Modified Research Diagnostic Criteria (RDC) were used for diagnosis, based on the SADS interview. There was considerable overlap of SADS scaled scores between patient groups, which is consistent with a heterogeneous clinical presentation of depressive and anxiety states. REM latency was significantly shorter in patients with primary MDD (without anxiety) as compared with that in patients with primary anxiety (no MDD) and normals. Arecoline REM induction response time was significantly shorter in both primary affective groups (I and II) as compared with primary anxiety (no MDD) patients and normal controls. REM latency and arecoline REM induction time was not significantly different between the primary anxiety groups (III and IV) and normals. The study highlights the use of biological markers in differentiating between clinical syndromes confounded by mixed or overlapping phenomenology. PMID- 3978174 TI - Age and gender contributions to intersubject variability of the auditory brainstem potentials. AB - This study of auditory brainstem potentials in 123 normal hearing subjects examines the contributions of age and gender to intersubject variability of the response form and latency. The main features, wave I, wave III, and wave V, and the I-V interval were separately examined in premature infants, neonates, infants, children, and young adults. Perinatal changes in response latency were confirmed and significant additional shortening in the I-V interval was observed through childhood and adolescence. Significant gender differences in I-V interval were also observed in both children and adults. Whereas the age changes were consistent with the effects of myelination on conduction time, the nature and magnitude of the gender differences were in keeping with the differential growth changes in the central nervous system, reflected in the skull diameters of females and males. These two sources of intersubject variability, age and gender, should be considered when using the auditory brainstem potentials in clinical studies. PMID- 3978175 TI - EEG sleep in elderly depressed, demented, and healthy subjects. AB - In a prospective study of EEG sleep patterns in 25 elderly depressives, 25 elderly demented patients, and 25 healthy, elderly control subjects, the sleep of depressives was characterized by reduced REM sleep latency, increased REM percent and first REM period density, and altered temporal distribution of REM sleep, as well as by diminished sleep maintenance (correlated significantly with Hamilton ratings of depression: multiple R = -0.42, p less than 0.05). In contrast, the sleep of demented patients showed reduced REM sleep percent, but normal REM temporal distribution, increased loss of spindles and K-complexes (the latter correlating significantly with severity of cognitive impairment as measured by the Folstein score: multiple R = -0.59, p less than 0.01), and less severe sleep maintenance difficulty than for depressives. An examination of REM latency demonstrated a skewed distribution in depression (i.e., 42% of nights with sleep onset REM periods), but a normal distribution in the controls and demented subjects. A REM latency cut-off score of 30 min correctly classified 68% of all patients (kappa = 0.36; p less than 0.005), compared with 78% correctly identified in our retrospective study (Reynolds et al. 1983). PMID- 3978176 TI - Third ventricular enlargement on CT scans in schizophrenia: association with cerebellar atrophy. AB - The width, length, and ventricle-to-brain area ratio (VBR) of the third ventricle were measured in 55 consecutive young male schizophrenic patients and 27 matched control subjects. No differences in third ventricular dimensions were found between the two groups. However, schizophrenic patients with cerebellar atrophy had a significantly greater mean third ventricular length. Correlations of third ventricular VBR with lateral ventricular VBR, but not with sulcal widening, were found. The possible existence of a subset of schizophrenic patients defined by cerebellar atrophy and third ventricular enlargement is discussed. PMID- 3978177 TI - Red-cell lithium transport and affective disorders in a multigeneration pedigree: evidence for genetic transmission of affective disorders. PMID- 3978178 TI - Visualization and measurement of flow with magnetic resonance imaging. PMID- 3978179 TI - [Applied optical research in the near-infrared and red bands using human whole blood: examples of its application]. PMID- 3978180 TI - [ERD (event-related desynchronization) mapping--a new procedure for functional brain diagnosis]. PMID- 3978181 TI - [Reference measurement of the fluidity of blood and blood cell suspensions by their migration rates on filter paper strips]. PMID- 3978182 TI - [Surfing amplitude window discriminator]. PMID- 3978183 TI - Orientation constraints in diffusion-limited macromolecular association. The role of surface diffusion as a rate-enhancing mechanism. AB - Ligand association to a reactive site on a macromolecular surface could be very slow if the site is small. The effective capture radius of the reactive site can be significantly increased if the ligand can bind weakly to the nonspecific surface around the site and then slide in a two-dimensional diffusion along the surface. In this model, the diffusion along the surface has to be properly coupled with the free diffusion in solution and the effective bimolecular association rate constant to the reactive site can be calculated as a function of the nonspecific affinity. This is carried out both for a plane and spherical surface, modeling the association to a membrane receptor or to the catalytic site on an enzyme. The result of these calculations can be used to assign reasonable values to the parameters in the quasichemical approximation of K. Solc and W. H. Stockmayer (1973, Int. J. Chem. Kinet., 5:733-752). In this way a simple analytical expression can be derived for the diffusion-limited association rate constant of two asymmetrically reactive molecules, with or without surface diffusion contributing. PMID- 3978184 TI - Supported phospholipid bilayers. AB - Phospholipid bilayers have been formed on glass, quartz, and silicon surfaces by a sequential transfer of two monolayers at a pressure of approximately 40 dyn/cm from the air-water interface to the solid substrates. Lateral diffusion measurements of L-alpha-dipalmitoylphosphatidylcholine (DPPC) bilayers supported on oxidized silicon wafers reveal two sharp phase transitions at temperatures similar to those found in multilayer systems with several different techniques. The diffusion measurements obtained using fluorescence recovery after pattern photobleaching provide evidence for the existence of an intermediate (probably P beta' or ripple) phase in single bilayers. While in the intermediate and high temperature (liquid-crystalline L alpha) phase, the diffusion coefficients do not vary very much with temperature, a strong temperature dependence is observed in the low temperature (gel L beta') phase. This is attributed to defect-mediated diffusion. Lipids in silicon supported bilayers made from L-alpha dioleoylphosphatidylcholine (DOPC) or L-alpha-dimyristoylphosphatidylcholine (DMPC) diffuse rapidly above their respective chain-melting transition temperatures. Arrhenius plots show straight lines with activation energies of 40.9 and 43.7 kJ/mol, respectively. Supported DPPC bilayers on oxidized silicon form long tubular liposomes when heated through their oxidized silicon form long tubular liposomes when heated through their chain-melting-phase transition, as viewed with epifluorescence microscopy. It is suggested that this is a consequence of the expansion of the lipid on the fixed solid support. Conversely, DOPC bilayers form large void areas on this substrate upon cooling. Large circular membrane defects (holes) are observed under rapid coating conditions. The formation of these defects is modulated by including small amounts of lyso-L palmitoyl phosphatidylcholine in the DMPC-supported bilayers. A simple model describes the dependence of hole size and hole number on the concentration of lysolecithin. PMID- 3978185 TI - Time-resolved absorbance changes induced by fast acidification of bacteriorhodopsin in vesicle systems. AB - The direction of the accessibility to protons of the binding site in bacteriorhodopsin is of primary importance in elucidating the proton-pump mechanism. The problem is approached via the pH-dependent equilibrium bR560 in equilibrium bR605 in vesicles with preferentially oriented purple membranes. Fast acidification (stopped-flow) experiments with inside-out, monomeric, bR vesicles were carried out with and without a buffer enclosed in the vesicle interior. The results, showing a buffer-induced delay in the formation of bR605, indicate that the binding site is accessible to protons from the inside of the vesicles. We arrive at this conclusion also by working with inside-out trimeric vesicles in the presence and in the absence of H+ (and K+) ionophores. The results suggest that in Halobacterium halobium, the binding site and thus the retinal Schiff base are exposed to the outside of the cell. This conclusion is consistent with a pumping mechanism based on a light-induced pK change. PMID- 3978186 TI - Hydration of noncharged lipid bilayer membranes. Theory and experiments with phosphatidylethanolamines. AB - Calorimetric measurements have been made on the thermodynamics of the chain melting phase transition of saturated diacylphosphatidylethanolamines, with chains containing 12-20 carbons, as a function of water content. The transition temperature, Tt, and the transition enthalpy, and entropy all decrease with an increase in water content; however, the effect on Tt lessens with an increase in chainlength. These results are compared with a theoretical description of lipid hydration in terms of the interlamellar water polarization (i.e., modified water structure) in the interbilayer region. The measured free energy, enthalpy and entropy of the transition and the transition temperature have an approximate hyperbolic tangent dependence on water content, infinity tanh (dw/2 xi), where dw is the interlamellar water-layer thickness and xi approximately equal to 0.25 nm is the water-order correlation length, in agreement with the theory. Auxiliary x ray diffraction experiments yield results on the repulsive hydration forces between lipid lamellae consistent with the theory, and allow an estimate of the water orienting potential of the interface. The molecular origin of this potential is discussed in electrostatic terms, and the values of its associated molecular parameters are found to yield the right size of hydrational thermodynamic quantities. The theory thus provides an integrated, clear, and simple approach to the hydration properties of lipid membranes. PMID- 3978187 TI - Saxs study of structure and conformational changes of crotamine. AB - The radius of gyration of crotamine is determined by the small angle x-ray scattering technique. Several molecular solutions have been studied to correct for concentration effects. The apparent molecular radius of gyration is also determined as a function of pH. An important change between pH 9.5 and 12.5 is attributed to a dominant effect of molecular aggregation. PMID- 3978189 TI - Excited-state dynamics of bacteriorhodopsin. AB - Near infrared emission of bacteriorhodopsin at neutral pH and at room temperature was characterized by a large Stokes shift. This characteristic was lost in an acidic pH (approximately pH 2) where a remarkable enchancement (more than 10 times) in the fluorescence quantum yield accompanied the red shift in the main absorption band. It is suggested from fluorescence polarization measurements that the emission occurs from the first allowed excited state of the retinylidene chromophore, irrespective of pH. We suggest that the large Stokes shift observed at neutral pH is a result of a charge displacement (e.g., proton translocation) that occurs immediately after excitation, and is prevented by protonation (in the ground state) of an amino-acid residue in the protein. PMID- 3978188 TI - A laser-induced ultrasonic probe of the mechanical properties of aligned lipid multibilayers. AB - The recently developed laser-induced phonon spectroscopy (LIPS) technique is applied to the determination of dynamic mechanical properties of aligned dilauroylphosphatidylcholine (DLPC) multibilayer arrays containing 2 and 20% water by weight. Sample excitation by two crossed 100-ps laser pulses generates a longitudinal ultrasonic wave whose wavelength depends on the crossing angle. In these experiments, the acoustic wave propagates parallel to the bilayer planes. The ultrasonic velocity and attenuation are monitored through the diffraction of a variably delayed probe pulse by the acoustic grating. The velocity measures the lateral area compressibility of the bilayers, while the attenuation is related to the viscosity. Velocities obtained in the gel and liquid crystal phases are compared with those found previously using Brillouin scattering. The acoustic attenuation is shown to be an order of magnitude more sensitive to the gel-liquid crystal phase transition than the velocity. The lipid area compressibility and viscosity of DLPC-20% water multilayers with and without 100 mM CaCl2 are found to be identical within our experimental error. PMID- 3978190 TI - Picosecond events in the photochemical cycle of the light-driven chloride-pump halorhodopsin. AB - The early events in halorhodopsin after light excitation are studied with picosecond time resolution. Absorption and fluorescence measurements show that the electronically excited state of the incorporated retinal has a lifetime of 5 ps. Within that time a red-shifted photoproduct is formed that remains stable for at least 2 ns. PMID- 3978191 TI - Amino acid side-chain partition energies and distribution of residues in soluble proteins. AB - Energies required to transfer amino acid side chains from water to less polar environments were calculated from results of several studies and compared with several statistical analyses of residue distributions in soluble proteins. An analysis that divides proteins into layers parallel with their surfaces is more informative than those that simply classify residues as exposed or buried. Most residues appear to be distributed as a function of the distance from the protein water interface in a manner consistent with partition energies calculated from partitioning of amino acids between water and octanol phases and from solubilities of amino acids in water, ethanol, and methanol. Lys, Arg, Tyr, and Trp residues tend to concentrate near the water-protein interface where their apolar side-chain components are more buried than their polar side-chain components. Residue distributions calculated in this manner do not correlate well with side-chain solvation energies calculated from vapor pressures of side-chain analogs over a water phase. Results of statistical studies that classify residues as exposed to solvent or buried inside the protein interior appear to depend on the method used to classify residues. Data from some of these studies correlate better with solvation energies, but other data correlate better with partition energies. Most other statistical methods that have been used to evaluate effects of water on residue distributions yield results that correlate better with partition energies than with solvation energies. PMID- 3978193 TI - Donnan potentials from striated muscle liquid crystals. Sarcomere length dependence. AB - Donnan potentials from A-bands and I-bands were measured as a function of sarcomere length in skinned long-tonic muscle fibers of the crayfish. These measurements were made using standard electrophysiological technique. Simultaneously, the relative cross-sectional area of the fibers was determined. Lattice plane spacings and hence unit-cell volumes were determined by low-angle x ray diffraction. At a sarcomere length at which the myosin filaments and actin filaments nominally do not overlap, measurements of potential, relative cross sectional area, and unit-cell volume were used in conjunction with Donnan equilibrium theory to calculate the effective linear charge densities along the myosin filament (6.6 X 10(4) e-/mu) and actin filament (6.8 X 10(3) e-/mu). Using these linear charge densities, unit-cell volumes and Donnan equilibrium theory, an algorithm was developed to predict A-band and I-band potentials at any sarcomere length. Over the range of sarcomere lengths investigated, the predicted values coincide with the experimental data. The ability of the model to predict the data demonstrates the applicability of Donnan equilibrium theory to measurements of electrochemical potential from liquid-crystalline systems. PMID- 3978192 TI - Charge-shift probes of membrane potential. Characterization of aminostyrylpyridinium dyes on the squid giant axon. AB - The characteristics of transmittance and fluorescence changes of 4-(p aminostyryl)-1-pyridinium dyes in response to voltage-clamp pulses on the squid giant axon were examined. A zwitterionic styryl dye displays transmittance and excitation spectra on the voltage-clamped squid axon with shapes similar to those previously measured on a model membrane system and consistent with a postulated electrochromic mechanism. The speed of the transmittance response is faster than 1.2 microseconds. The size of the fluorescence change is a factor of 40 lower than on the model membrane; this diminution can be rationalized in terms of the background fluorescence from Schwann cells and the nonoptimal geometric arrangement of the axon membrane. When the emission spectrum is dissected from the excitation response, a nonelectrochromic component is found. This component might result from molecular motion during the excited state lifetime. A positively charged dye permeates the axon membrane and displays complex response waveforms dependent on the method of application and the axon holding potential. This contrasts markedly with model membrane results where the behavior of the cationic and zwitterionic dyes were indistinguishable. PMID- 3978194 TI - The role of polymer matrix structure and interparticle interactions in diffusion limited drug release. AB - A lattice random-walk model is used to simulate diffusion in a porous polymer. This model may be useful for the practical design of drug-release systems. Both interacting and noninteracting particles (random walkers) were allowed to diffuse through a pore with a single exit hole. It was found that the specific interactions among the diffusing particles have little influence on the overall release rate. Diffusion through more complicated structures was investigated by simulating the diffusion of particles through two pores connected by a constricted channel whose length and width were varied. The overall rate of release was found to be proportional to the width of the constricted channel. When the length of the channel was greater than or equal to the length of the pore, the rate of release was also inversely proportional to the channel length. From a practical standpoint, release rates can be decreased (and times for release increased) by one or two orders of magnitude by decreasing the width and expanding the length of the interconnecting channels in the polymer matrix. PMID- 3978195 TI - Structural studies of calcium-binding proteins using nuclear magnetic resonance. AB - Lanthanide-shifted 1H nuclear magnetic resonance (NMR) spectroscopy has been used to compare the structure in solution of the EF-hand calcium-binding domains of four parvalbumins (isoelectric pH[pI] 3.95, 4.25, and 4.37 from carp, and pI from buffalo fish). These four parvalbumins are shown by NMR to have very similar structures at the level of resolution typical of x-ray structures. At the higher resolution possible by the lanthanide NMR technique, specific differences are noted between the pI 3.95 isoprotein from carp and the other two carp isoproteins, and the buffalo fish parvalbumin is shown to be different from all three carp isoproteins. The differences are estimated to correspond to changes of the order of 0.2 A in the positions of some of the nuclei surrounding the EF calcium site. PMID- 3978196 TI - Magnetic birefringence studies of dilute purple membrane suspensions. AB - We have observed the magnetically induced orientation of purple membrane suspensions by measuring the birefringence as a function of concentration and temperature at fields up to 10.5 Tesla (T). At these fields, the orientation approaches saturation even in dilute solutions; therefore, the birefringence data, together with an estimate of the membrane size distribution obtained from electron microscopy, permits one to determine the diamagnetic susceptibility anisotropy. We find delta chi mole = 1.2 +/- 0.3 X 10(-3) erg G-2mol-1 of bacteriorhodopsin. If delta chi were due only to the oriented peptide bonds of the transmembrane alpha helices, this experimental value would indicate that delta K, the anisotropy per mole of peptide bonds, is considerably larger than previously suggested. On the other hand, the large value for delta chi mole of bacteriorhodopsin can also be explained by a net orientation of the aromatic amino acid side chains of bacteriorhodopsin with their planes perpendicular to the membrane surface. In addition, the present data analysis demonstrates the critical dependence of the calculated delta chi value on the values for the membrane size distribution. PMID- 3978197 TI - Binding of myosin subfragment 1 to glycerinated insect flight muscle in the rigor state. AB - The binding of rabbit muscle myosin subfragment 1 (S1) to glycerinated insect flight muscle fibers has been studied by low-angle x-ray diffraction, quantitative sodium dodecyl sulfate gel electrophoresis, quantitative interference microscopy, and electron microscopy. Changes induced in the rigor x ray diffraction pattern are consistent with the idea that vacant myosin-binding sites on thin filaments are filled by exogenous S1. Electron microscopy indicates that S1 permeates and labels fibers and fibrils completely. Electron micrographs also show that cross-bridges are not displaced by exogenous S1 under the conditions used, and this is supported by the unchanged mechanical stiffness of the S1-labeled fibers. The amount of bound S1, as measured by gel electrophoresis and interference microscopy, together with the magnitude of the intensity changes in the x-ray diffraction pattern, is consistent with a thick filament structure that contains four molecules of endogenous myosin per 14.5 nm of its length, but does not agree well with earlier estimates of six myosins per crown. Lack of information on possible inhibition of S1-binding by factors other than the presence of cross-bridges, e.g., troponin, render uncertain calculations of the number of attached cross-bridges in the rigor state. However, it appears that at least 75% of the endogenous myosin heads are attached. Occupancy of binding sites on thin filaments after incubation with S1 is high, probably greater than 85%, so that x-ray scattering from those parts of the structure that adhere to the symmetry of the thin filaments can be treated as diffraction from S1-decorated thin filaments. In addition, we show in thin flared X cross sections that exo-S1 heads bind to actin with the geometry described in decorated actin by Taylor, K.A., and L.A. Amos. PMID- 3978198 TI - Oxygen delivery from red cells. AB - This paper deals with the theoretical analysis of the unloading of oxygen from a red cell. A scale analysis of the governing transport equations shows that the solutions have a boundary layer structure near the red-cell membrane. The boundary layer is a region of chemical nonequilibrium, and it owes its existence to the fact that the kinetic time scales are shorter than the diffusion time scales in the red cell. The presence of the boundary layer allows an analytical solution to be obtained by the method of matched asymptotic expansions. A very useful result from the analysis is a simple, lumped-parameter description of the oxygen delivery from a red cell. The accuracy of the lumped-parameter description has been verified by comparing its predictions with results obtained by numerical integration of the full equations for a one-dimensional slab. As an application, we calculate minimum oxygen unloading times for red cells. PMID- 3978199 TI - Phospholipid surface bilayers at the air-water interface. II. Water permeability of dimyristoylphosphatidylcholine surface bilayers. AB - Dispersions of dimyristoylphosphatidylcholine (DMPC) in water have been reported to form a structure at 29 degrees C at the equilibrium air/water surface with a molecular density equal to that of a typical bilayer. In this study, the water permeability of this structure has been evaluated by measuring the rate of water evaporation from DMPC dispersions in water in the temperature range where the surface film density exceeds that of a monolayer. Evaporation rates for the lipid dispersions did not deviate from those for lipid-free systems throughout the entire temperature range examined (20-35 degrees C) except at 29 degrees C, where a barrier to evaporation was detected. This strengthens the view that the structure that forms at this temperature has the properties of a typical bilayer. PMID- 3978200 TI - Constitutive equations of skeletal muscle based on cross-bridge mechanism. AB - The statistical mechanics of cross-bridge action is considered in order to develop constitutive equations that express fiber tension as a function of degree of activation and time history of speed of contraction. The kinetic equation of A.F. Huxley (1) is generalized to apply to the partially activated state. The rate parameters of attachment and detachment, and cross-bridge compliance are assumed to be step functions of extension, x, with a finite number of discontinuities. This assumption enables integration of the kinetic equation and its moments with respect to x resulting in analytic equations from which x has been eliminated. When the constants in the rate parameters and the force function are chosen so that Hill's force-velocity relation and features of the transient kinetic and tension data can be fitted, the resulting cross-bridge mechanism is quite similar to the one proposed by Podolsky et al. (2). Because the derived constitutive equations simplify mathematical analysis, the influence of various cross-bridge parameters on the mechanical behavior of muscle fibers may be evaluated. For example (a) instantaneous elastic response (T0-T1) and the magnitude of rapid recovery (T2-T1) after a step length change can be adequately explained when the rate of attachment is assumed high for positive x. In that case T2 corresponds to the force generated by cross-bridges in the region of negative x. (b) Kinetic transients occur as a result of the jumps that exist in the distribution of attached cross-bridges during the isometric state. Because of the hyperbolic nature of the kinetic equation, these jumps propagate in the--x direction causing rapid changes in the speed of contraction. (c) When the number of actin sites available for attachment is assumed to depend on the degree of activation, computational results indicate that the speed of shortening is insensitive to the degree of activation at each relative load. (d) It is shown that during sinusoidal oscillation, the mean and second-order harmonics of the experimental force-time curve are strongly dependent on cross-bridge parameters. Therefore, significant information may be lost when the data is expanded into Fourier series and only the first term is considered. PMID- 3978201 TI - Arrhenius parameters of the bacteriorhodopsin photocycle in dried oriented samples. AB - In dried oriented samples of purple membranes isolated from Halobacterium halobium the Arrhenius parameters of the photocycle showed an abrupt change at a water content of approximately 80 H2O molecules per bacteriorhodopsin molecule. This makes probable the existence of a water-dependent conformational change of the protein. This result underlines the importance of water in the proton conduction mechanism inside the protein. The effect of the external electric potential on the rate constants of the photoelectric signals was also measured. The data demonstrate that the membrane potential affects the steps of the proton transport during the photocycle. PMID- 3978202 TI - The representation of equilibrium solute distributions for nonideal polydisperse systems in the analytical ultracentrifuge. Application to mucus glycoproteins. AB - It is relatively easy to represent by computer simulation the observed Rayleigh equilibrium fringe data for systems that are both associative and nonideal in the thermodynamic sense, and to extract the determinant parameters (see, for example, Roark, D., and D. A. Yphantis, 1969, Ann. NY Acad. Sci., 164:245-278; and Johnson M. L., J. J. Correia, D. A. Yphantis, and H. R. Halvorson, 1981, Biophys. J., 36:575-588). It is, however, considerably more difficult to represent systems that are both polydisperse (namely, those that consist of noninteracting species of different molecular weight) and nonideal, although the ideal case has been well described (see, for example, Tindall, S. H., and K. C. Aune, 1982, Anal. Biochem. 120:71-84). Here we show that the representation of nonideal polydisperse systems is now possible, after certain assumptions, by using a two part interdependent minimization routine that uses readily available numerical packages. The method is applied to a well-characterized mucus glycoprotein (Mr approximately 2 X 10(6)) from the bronchial secretion of a cystic fibrosis patient. An excellent fit to the observed fringe data is obtained for a polydisperse three-component system, with a value for the second virial coefficient, B, of 0.57 ml mol g-2. PMID- 3978203 TI - Resonance Raman spectra of the acidified and deionized forms of bacteriorhodopsin. AB - The 568-nm absorption band of light-adapted bacteriorhodopsin (BR) shifts to 605 nm at pH 2, forming BR605A, and it shifts back to 565 nm at pH 0, forming BR565A. We have obtained resonance Raman spectra of BR605A and BR565A using purple membrane samples that have been suspended in a rotating Raman cell with a polyacrylamide gel. Raman spectra were also obtained of purple membrane in deionized solutions (BR605D). The spectra of BR605A and BR605D are very similar, and they correspond closely with the Raman spectrum of dark-adapted BR, which contains an approximately equal mixture of 13-cis and all-trans retinal protonated Schiff-base chromophores. This shows that BR605A and BR605D are not homogeneous molecular species but contain a mixture of pigment molecules with both 13-cis and all-trans retinal isomers. The Raman spectrum of BR565A is nearly identical to that of light-adapted BR, demonstrating that BR565A contains an all trans protonated Schiff-base chromophore. These data provide constraints on the possible structural changes that can be invoked to explain the spectral shifts induced in the acid and deionized species. PMID- 3978204 TI - Continuum rheology of muscle contraction and its application to cardiac contractility. AB - A set of constitutive equations is proposed to describe the mechanics of contraction of skeletal and heart muscle. Fiber tension is assumed to depend on the degree of chemical activation, the stretch ratio, and the rate of stretching of the fibers. The time rate of change of activation is governed by a differential equation. The proposed constitutive equations are used to model the time courses of isotonic and isometric twitches during contraction and relaxation phases of the muscle response to stimulation. Various contractility indices of the left ventricle are considered next by using the proposed constitutive equations. The present analysis introduces a new interpretation of the index of contractility (dP/dt)/P used in cardiac literature. It is shown that this index may not be related at all to the maximum speed of shortening and that it may be dependent on both preload and afterload. The development of pressure during isovolumetric contraction of the left ventricle is shown to be governed by a differential equation describing the time rate of change of tension during isometric contraction of myocardium fibers. PMID- 3978205 TI - Normal-mode analysis of lateral diffusion on a bounded membrane surface. AB - The normal-mode analysis of fluorescence redistribution after photobleaching, introduced for the characterization of lateral diffusion on spherical membrane surfaces, has been generalized and extended to other surface geometries. Theoretical expressions are derived for the characteristic values and orthogonal characteristic functions of the diffusion equations for cylindrical surfaces, ellipsoids of revolution and dimpled discoidal surfaces. On the basis of these results, a simple analytical function is proposed as an empirical solution for the analysis of photobleaching data on a variety of discoidal surfaces. Special experimental and computational methods for determining the surface-diffusion coefficient are described, and demonstrated with data for lipid diffusion in erythrocyte membranes. PMID- 3978207 TI - Calorimetric studies of the state of water in deeply frozen human monocytes. AB - Intra- and extracellular phase transitions in human peripheral blood monocyte suspensions with and without the cryoprotectant 1 M dimethylsulfoxide were measured using differential scanning calorimetry. Using an fluorescence diacetate/ethidium bromide assay for membrane integrity and a phagocytosis assay for cell function, it was found that mortality was correlated with several phase transitions under a variety of cooling and warming regimens. As a result of these studies we concluded that: intracellular freezing is lethal, but avoidance of freezing during fast cooling is not sufficient to provide complete protection; a subtle freezing injury in the cryoprotected monocytes can be correlated with a measurable increase in devitrification on warming; and the cell contents form more stable glasses than the Hanks' balanced salt solution with fetal calf serum used as the extracellular medium. PMID- 3978206 TI - Raman spectroscopy of nerve fibers. A study of membrane lipids under steady state conditions. AB - The molecular structures of different nerve fibers kept in good physiological conditions were studied by laser Raman spectroscopy. For myelinated nerves like the rat sciatic nerve, the Raman spectrum is dominated by bands due to the lipid component of the myelin sheath. The temperature dependence of these bands does not reveal any thermotropic phase transition between 0 and 40 degrees C. There is, however, with temperature, a linear increase in the intermolecular disorder that is accompanied by an increase in the number of gauche bonds of the phospholipid acyl chains. For unmyelinated nerves such as the lobster leg nerve, the C-H stretching region of the Raman spectrum is covered by bands arising from the protein component of the axoplasm. However, for the garfish olfactory nerve that has a high density of excitable membranes, phospholipid bands are observed and can be used as intrinsic structural probes of the excitable membranes. The relative intensity of these bands is also temperature dependent. PMID- 3978208 TI - Bound trace element content of bovine retinal disk membranes as determined by particle-induced x-ray emission. AB - Particle-induced x-ray emission (PIXE) was used to determine the trace element content of bovine retinal disk membranes. PIXE is a multielemental analytical technique capable of the simultaneous detection and quantization of all elements from sodium and above in atomic number. The multielemental capability of PIXE allows the analysis time per element to be very low if a number of elements are detected in each sample. In addition, the multielemental capability of PIXE can be used to determine elemental content with respect to an internal reference. Here the content of detected trace element per rhodopsin was determined without recourse to an external rhodopsin assay. This was accomplished by using the sulfur content of rhodopsin as an internal reference. Detected trace element contents per rhodopsin were 1.58 +/- 0.049 Ca, 0.081 +/- 0.024 Fe, 0.393 +/- 0.200 Cu, and 0.150 +/- 0.031 Zn. Upper limits were placed on the amount of manganese, molybdenum, and nickel per rhodopsin as 0.019, 0.019, and 0.006, respectively. Two proteins known to be present in disk membranes, retinol dehydrogenase and a large protein, approximately 238,000 mol wt, are considered as potential metallo-proteins. No correlation was observed between the content of any detected element and bleaching levels. PMID- 3978209 TI - Time-resolved x-ray diffraction study of photostimulated purple membrane. AB - A nanosecond resolution laser-driven x-ray source has been used to perform a time resolved, x-ray diffraction study of the purple membrane of the Halobacterium halobium. Alterations in diffraction patterns have been observed 1 ms after photostimulation, and are interpreted to show disorder of bacteriorhodopsin packing in the plane of the membrane with little bacteriorhodopsin structural change. PMID- 3978210 TI - Digitized precision measurements of the movements of sea urchin sperm flagella. AB - High speed cinemicrographs were made of sea urchin sperm at temperatures varying from 22 to 6 degrees C. Apparatus, combining a television camera and a video digitizer, was constructed to scan individual flagellar images and to digitize the flagellar waveforms. With appropriate smoothing and averaging procedures, the rough data were condensed by a microcomputer into the coordinates of 20 points along a flagellum, spaced 2 microns apart. The curvature of the flagellum at these points was also computed. The coordinates of the flagellar positions were obtained to an accuracy of approximately +/- 0.1 micron, flagellar curvature to an accuracy of approximately +/- 50 cm-1. At all temperatures the amplitude of the flagella was found to vary with time in a purely sinusoidal fashion to within +/- 2%. The local curvature of the flagella had basically a purely sinusoidal time course to within +/- 50 cm-1, but a varying amount of asymmetry was present in the distal and the proximal ends of the flagella. This asymmetry in the curvature was related to the radius of the circular path of the sperm. The flagellar waveforms can probably be summarized in simple algebraic functions. PMID- 3978212 TI - Quantitative characterization of a biological membrane by means of its spatial autocovariance. AB - Profiles for the exoplasmic face (EF) of the freeze-fractured plasma membrane from the root storage tissue of red beets are reconstructed by microdensitometry of micrographs of surface-shadowed-platinum carbon replicas. Autocovariance functions (ACFs) are computed from those profiles. The initial portions of the ACFs have a Gaussian form whose parameters (root mean square surface roughness and autocovariance length) are estimated. The parameter estimates are used to show that the pits on the EF faces are in good complementarity with the intramembrane particles seen on the complementary protoplasmic fracture faces. PMID- 3978211 TI - The stabilization of proteins by osmolytes. AB - The preferential interactions of lysozyme with solvent components and the effects of solvent additives on its stability were examined for several neutral osmolytes: L-proline, L-serine, gamma-aminobutyric acid, sarcosine, taurine, alpha-alanine, beta-alanine, glycine, betaine, and trimethylamine N-oxide. It was shown that all these substances stabilize the protein structure against thermal denaturation and (except for trimethylamine N-oxide for which interaction measurements could not be made) are strongly excluded from the protein domain, rendering unlikely their direct binding to proteins. On the other hand, valine, not known as an osmolyte, had no stabilizing effect, although it induced a large protein-preferential hydration. A possible explanation is given for the use of these substances as osmotic-pressure-regulating agents in organisms living under high osmotic pressure. PMID- 3978213 TI - A high capacity data recording device based on a digital audio processor and a video cassette recorder. AB - A modified digital audio processor, a video cassette recorder, and some simple added circuitry are assembled into a recording device of high capacity. The unit converts two analog channels into digital form at 44-kHz sampling rate and stores the information in digital form in a common video cassette. Bandwidth of each channel is from direct current to approximately 20 kHz and the dynamic range is close to 90 dB. The total storage capacity in a 3-h video cassette is 2 Gbytes. The information can be retrieved in analog or digital form. PMID- 3978214 TI - Self-association of sodium cholate in isotonic saline solutions. AB - The self-association of dialyzed solutions of sodium cholate in isotonic saline solutions has been studied by vapor pressure osmometry and sedimentation equilibrium. These studies were carried out at 25, 31 and 37 degrees C. In all experiments the self-association could be described as a two-equilibrium constant, indefinite self-association in which odd species beyond monomer were absent. The plots of M1/Mna or M1/Mwa vs. c were quite smooth with no sharp breaks; this suggested that there were no critical phenomena. The temperature dependence of the self-association was quite small. Our results are in accord with other studies on sodium cholate which indicate that the self-association involves several species, and that it is not a monomer-n-mer self-association. PMID- 3978216 TI - Mechanism of the binding of 2-(4'-hydroxyphenylazo)benzoic acid to bovine serum albumin. AB - The mechanism of the binding of 2-(4'-hydroxyphenylazo)benzoic acid (HABA) to bovine serum albumin was studied by relaxation methods as well as the binding isotherm using gel chromatography. A single relaxation was observed over a wide range of HABA concentration except at the extremes of high concentration where another slow process was observed. The concentration dependence of the reciprocal relaxation time of the fast process decreased monotonically with increase in concentration of HABA at constant polymer concentration. The data were analyzed on the basis of Brown's domain structure model and were found to be consistent with a sequential binding mechanism. The azohydrazon tautomerism of HABA was identified with the intramolecular step of the complex. The activation parameters of the step, determined from the temperature dependence of the relaxation time of the fast process, showed that this step is rate limited by an enthalpy barrier in both forward and backward directions. Comparison of the activation parameters with those of other serum albumin-ligand systems suggests that there is an enthalpy-entropy compensation in the activation process of the intramolecular step with the compensation temperature at about 270 K; the enthalpy-entropy compensation is thought to be related to the hydrophobic nature of the ligand. PMID- 3978215 TI - The interaction between alkyl derivatives and elastin. AB - Elastin from bovine ligamentum nuchae is exposed to aqueous solutions of different alkyl sulfates and carboxylates (fatty acids). The substrates of alkyl chain lengths varying between C8 and C17 bind to the elastin, the more so the longer the alkyl chain. However, the presence of two (or more) double bonds in the chain obstructs the penetration into the elastin network. As a result of absorption the elastin swells. The rate of binding is determined from the swelling of an elastin strip, that is monitored using a cathetometer. The diffusion of the substrate in the elastin is slower the longer the alkyl chain. The binding is reversible so that the Gibbs energy involved can be derived from the absorption isotherm. The values for the Gibbs energy of binding may amount to some tens of kJ per mol of substrate, with an increment of -4 kJ mol-1 per CH2 group. From the influence of temperature it is concluded that the binding is entropically driven. This, as well as the observation that the glass transition temperature of elastin is not affected by the presence of the alkyl derivatives, suggests that the substrates are bound to the amino acid residues of the elastin, rather than to the polypeptide backbone. Stress-strain experiments reveal that the elasticity decreases markedly on swelling of the sample, irrespective of the type of substrate that is absorbed. The phenomena described in this paper may be similar to those that occur between fatty acids in blood and arterial elastin, which could be at the origin of the development of atherosclerosis. PMID- 3978217 TI - Nucleotide aggregation in aqueous solution. A multicomponent self-diffusion study. AB - The self-aggregation of the mononucleotides (AMP, CMP, GMP and UMP) and caffeine up to their solubility limit in 2H2O has been monitored through self-diffusion measurements, using the Fourier transform NMR pulsed-gradient spin-echo self diffusion technique. The data were iteratively fitted to a number of aggregation models. It was concluded that the best agreement between simulations and experiment for the mononucleotides was obtained for a 'semi-isodesmic', indefinite aggregation model (also known as a Type III SEK or cooperative indefinite self-association model), where the first (dimerization) aggregation constant is a magnitude lower than those for the higher aggregation steps. Typical values were 0.4 and 6 l mol-1, respectively. Under these conditions, the main fraction of solute is monomeric throughout the concentration range and the distribution of higher oligomers is very broad. Caffeine self-aggregation is clearly different and is consistent with several aggregation models. The mixed aggregation of caffeine (at a low total concentration) and the mononucleotides was successfully monitored in an extension of the basic study. It was found that caffeine binding to mononucleotide aggregates increases in the series UMP, CMP, GMP and AMP. PMID- 3978218 TI - Theory of counterion electrophoresis. Guidelines for determination of ligand binding parameters. AB - A theory is formulated to provide guidelines for the quantitative interpretation of steady-state counterion electrophoretic patterns (T.-H. Ueng and F. Bronne, Arch. Biochem. Biophys. 197 (1979) 205) in terms of intrinsic ligand-binding constant and number of binding sites on the protein molecule. Briefly, the prescribed procedure calls for extrapolation of the steady-state binding constant to infinite dilution of protein to obtain a quantity which is the product of a readily evaluated kinetic factor and the intrinsic binding constant. On the other hand, extrapolation of the steady-state number of binding sites to infinite dilution can probably be dispensed with if determined at a reasonably low protein concentration. PMID- 3978219 TI - On the coordination properties of Eu3+ bound to tRNA. AB - The luminescence properties of Eu3+ have been used to investigate the binding and coordination properties of the ion with tRNA, as an attempt to resolve the discussion of whether metal ions bind to tRNA in solution only by Debye-Huckel screening, or whether direct coordination to specific sites may occur. Binding studies with Escherichia coli tRNAmet/f (taking advantage of 4-thiouracil sensitized Eu3+ emission) distinguish three classes of binding affinities. Two of these are single sites with affinities approx. 10(4) and approx. 10(3) tighter than the nonspecific affinity of Eu3+ for native DNA. Mg2+ competes for binding at both these sites. Measurement of the lifetime and excitation spectrum of Eu3+ bound to the highest affinity site shows that the ion has two to five non phosphate ligands in its inner coordination sphere. The existence of this coordinated site demonstrates that electrostatic screening is not the only mechanism for metal ion interaction with tRNA. The coordination properties of the high-affinity Eu3+ site do not agree with the properties of any of the metal ion sites found in the two tRNAphe crystal forms. Possible reasons for this discrepancy are discussed; it may be that ions bind differently to isolated molecules in solution than to molecules packed in a crystal lattice. PMID- 3978220 TI - Temperature-dependent conformational transitions in poly(dG-dC) and poly(dG m5dC). PMID- 3978221 TI - Hydrogen-exchange evidence for distinct structural classes in globular proteins. PMID- 3978222 TI - Determinations of atomic partial charges for nucleic acid constituents from x-ray diffraction data. I. 2'-Deoxycytidine-5'-monophosphate. PMID- 3978223 TI - Diffusion of bovine serum albumin in a neutral polymer solution. PMID- 3978224 TI - Physical properties of rod-shaped molecules in solution. PMID- 3978225 TI - Thermodynamics of the daunomycin-DNA interaction: ionic strength dependence of the enthalpy and entropy. PMID- 3978226 TI - Single-cell origin of human mixed hemopoietic colonies expressing various combinations of cell lineages. AB - We have established single-cell culture for human mixed hemopoietic colonies using a micromanipulator. Mononuclear cells from human umbilical cord blood were cultured at a concentration of 1 X 10(4) cells per milliliter in methylcellulose medium containing medium conditioned by phytohemagglutinin-stimulated leukocytes and erythropoietin. It was possible to identify the single hemopoietic progenitors in situ in methylcellulose culture on the basis of unique morphology and migratory ability after 36 to 60 hours of incubation. Candidate single hemopoietic progenitors from methylcellulose medium were individually micromanipulated to secondary culture dishes and cultured for an additional ten to 14 days. The colonies derived from the single progenitors were individually picked and stained with May-Grunwald-Giemsa for analyses of the cellular composition. A total of 288 single cells were individually transferred to second dishes. Then 186 single cells produced secondary colonies consisting of cells in one to five different lineages. A total of 39 single cells produced mixed hemopoietic colonies consisting of cells in two, three, four, and five different lineages. There were eight types of colonies revealing two different lineages, ie, neutrophil (n)-erythrocyte (E), macrophage (m)-E, m-megakaryocyte (M), eosinophil (e)-basophil (b), eE, bE, bM, and EM lineages. Three types of colonies consisting of cells in three lineages were also seen, ie, nmM, nbE, and ebE. There were six types of colonies consisting of cells in four lineages, ie, nmbM, nmEM, nebE, mebM, and meEM. One type of colony consisted of cells in five different lineages (nmbEM). These results indicate the single-cell origin of human mixed hemopoietic colonies expressing various combinations of cell lineages. It also provides experimental data in support of stochastic mechanisms of stem cell differentiation. PMID- 3978227 TI - Altered response of stored red cells to Ca2+ stress. AB - Short-term Ca2+ loading of erythrocytes was used as a test for probing membrane protein susceptibilities toward intrinsic enzymes in cells from fresh and from stored blood. The proteolytic response, affecting mainly glycophorin and band 3, could be elicited only in fresh cells, whereas the transglutaminase-mediated cross-linking reaction was evident both in fresh and stored cells. Loss of the proteolytic response might be an important sign of erythrocyte damage from blood bank storage. PMID- 3978228 TI - Myelofibrosis with myeloid metaplasia: pathophysiologic implications of the correlation between bone marrow changes and progression of splenomegaly. AB - We undertook a study of 35 cases of myelofibrosis with myeloid metaplasia to assess the histopathologic findings in the bone marrow of patients with this disorder, to ascertain if changes in morphology occurred with time, and to attempt to correlate marrow findings with splenic size. We reviewed 71 bone marrow biopsies and studied 13 splenectomy specimens. Sequential bone marrow biopsies were obtained in 21 cases over intervals ranging from two to ten years (mean, 4 1/2 years). We noted a patchy nature and variable degree of stromal proliferation in most marrow biopsies, and were unable to demonstrate a correlation between the extent of medullary fibrosis and duration of disease, splenic weight, or degree of splenic myeloid metaplasia. We were unable to document a progression of medullary fibrosis as a cause for increasing splenomegaly. However, the alteration in the marrow stroma in this disorder is responsible for the presence of distended marrow sinusoids with intravascular hematopoiesis, a phenomenon we observed in all cases. We believe that this morphological feature, not emphasized by previous investigators, is of significance in understanding the pathophysiology of myeloid metaplasia. PMID- 3978230 TI - Altered factor VII activity in hemophilia. AB - Factor VII levels have been studied in hemophilia A and B plasmas and normal controls in a controlled, prospective study. Three assay methods were used: a standard clotting assay (FVIIc-A); a modified clotting assay (FVIIc-B) (Seligsohn et al, Blood 52:978-988, 1978); and a coupled amidolytic assay. By the FVIIc-B assay, the hemophilic plasmas were significantly lower than in the normal group (68.2 +/- 3.3% [SE] and 83.5 +/- 3.8%, respectively; P less than .01). The amidolytic assay, however, which measures total factor VII regardless of its activity state (factor VII or VIIa), was higher in the patient group than in the control group (126.9 +/- 9.6% and 99.4 +/- 5.7%, respectively; P less than .01). Control experiments showed that the differences in FVIIc-B activity were not caused by artifactual activation of factor VII ex vivo in the control group. The mean FVIIc-A assay of hemophilic plasmas (126.3 +/- 6.5%) agreed closely with the amidolytic assay, suggesting that the FVIIc-A method is also insensitive to the factor VII activity state. These data support the hypothesis that the FVIIc-B assay is more sensitive to the presence of factor VIIa. The increased sensitivity of the FVIIc-B assay to factor VII activation was confirmed by comparison of the two clotting assays on plasma subjected to activation in glass at 4 degrees C. The results of this study indicate that factor VII in hemophilic plasma is less activated than in normal plasma. Whether this contributes to the bleeding diathesis of hemophilia is unknown. However, it does provide evidence for the idea that factor VII in vivo is normally subject to some degree of activation by an enzyme (or enzymes) generated by a turnover of the intrinsic pathway. PMID- 3978229 TI - Immune complexes containing factor V in a patient with an acquired neutralizing antibody. AB - An 82-year-old woman presented with extensive hematomas and melena associated with markedly decreased plasma factor V coagulant activity (FV:C). Using a competitive enzyme-linked immunosorbent assay developed in our laboratory, we made serial measurements of factor V antigen (FV:Ag) in plasma and found it to be normal or elevated. The patient's plasma was demonstrated to contain an IgG antibody that could neutralize FV:C in normal plasma. The antibody was of restricted heterogeneity (IgG1, IgG2,kappa). Circulating immune complexes containing antibody to factor V and FV:Ag were demonstrated directly in the plasma by immunoelectrophoresis with polyclonal monospecific antibody and with a monoclonal antibody using an enzyme-linked immunosorbent assay. Presence of neutralizing antibody could be demonstrated in vitro even at times when FV:C was within normal limits by heat inactivation of FV:C. Treatment with plasma and platelet transfusions as well as plasmapheresis induced definite but transient elevation of FV:C. Steroid therapy lowered the neutralizing antibody concentration and produced a rapid and persistent elevation of FV:C during two separate hospitalizations. This report describes a patient in whom levels of FV:Ag have been serially measured, and the presence of circulating immune complexes consisting of factor V and a neutralizing antibody have been directly demonstrated. PMID- 3978231 TI - Regulation of heme synthesis in erythroid cells: hemin inhibits transferrin iron utilization but not protoporphyrin synthesis. AB - The inhibition of delta-aminolevulinic acid (ALA) synthase activity by heme is commonly thought to regulate the overall rate of heme synthesis in erythroid cells. However, since heme inhibits erythroid cell uptake of iron from transferrin, we have tested the hypothesis that in reticulocytes heme regulates its own synthesis by controlling the cellular acquisition of iron from transferrin rather than by controlling the synthesis of ALA. We found that hemin added to reticulocytes in vitro inhibits not only the total cell incorporation of 59Fe from transferrin but also the incorporation of [2-14C]-glycine and transferrin-bound 59Fe into heme. However, hemin did not inhibit [2-14C]-glycine incorporation into protoporphyrin. Furthermore, cycloheximide, which increases the level of non-hemoglobin heme in reticulocytes, also inhibited [2-14C]-glycine into heme but not into protoporphyrin. With high concentrations of ferric pyridoxal benzoylhydrazone (Fe-PBH), which, independent of transferrin and transferrin receptors, can be used as a source of iron for heme synthesis in reticulocytes, significantly more iron is incorporated into heme than from saturating concentrations of Fe-transferrin. This suggests that some step (or steps) in the pathway of iron from extracellular transferrin to protoporphyrin limits the overall rate of heme synthesis in reticulocytes. In addition, hemin in concentrations that inhibit the utilization of transferrin-bound iron for heme synthesis has no effect on the incorporation of iron from Fe-PBH into heme. Our results indicate that in reticulocytes heme inhibits and controls the utilization of iron from transferrin but has no effect on the enzymes of porphyrin biosynthesis and ferrochelatase. This mode of regulation of heme synthesis may be a specific characteristic of the hemoglobin biosynthetic pathway. PMID- 3978232 TI - Neutralization of erythroid burst-promoting activity in vitro with antimembrane antibodies. AB - To investigate the relatedness of soluble and pelletable vesicular erythroid burst-promoting activity (BPA) present in lymphocyte-conditioned medium (LCM), we immunized rabbits with partially purified lymphocyte plasma membranes and tested the antisera for biological and immunologic crossreactivity with LCM and its component fractions. When preincubated with IgG purified from post-immune but not from preimmune serum, BPA expression by unseparated LCM, LCM-derived pellets, and supernatants was abolished in a dose-related fashion. As little as 0.001 mg/mL post-immune IgG reduced burst formation by 50%. Antimembrane IgG crossreacted on immunoblots with multiple components of both supernatants and pellets of LCM. Crossreactivity was also seen in LCM-derived supernatants that were subjected to ultracentrifugation. Soluble BPA was adsorbed from LCM supernatants incubated with antimembrane IgG-coated Staphylococcus aureus. Conversely, incubation of purified antimembrane IgG with intact circulating lymphocytes removed BPA neutralizing effects from the antibody preparation. Antimembrane IgG incompletely suppressed erythroid colony-forming unit (CFU-E)-derived colony formation, an effect that could not be explained by alteration in erythropoietin sensitivity or action. There was no effect of the antibody preparation on erythroid differentiation of K562 cells or on CFU granulocyte/macrophage-derived colony growth, (CFU-G/M) by human or murine bone marrow. Taken together, our findings suggest that antibodies directed against lymphocyte plasma membranes react with both soluble and vesicular BPA, and that these physically separable erythroid growth factors may share antigenic determinants. PMID- 3978233 TI - Fluorescent cytoplasm and Heinz bodies of hemoglobin Koln erythrocytes: evidence for intracellular heme catabolism. AB - Hb Koln, one of the common mutant hemoglobins responsible for unstable hemoglobin disease, was found to be degraded to a fluorescent yellow pigment (FYP) in circulating erythrocytes. FYP is responsible for a strong green fluorescence observed in the cytoplasm and is particularly abundant in the Heinz bodies of Koln RBC. Front face fluorometry and fluorescence microscopy showed that Heinz bodies emit 10% to 20% of the fluorescence of RBCs. Hb-free FYP was obtained by means of a cellulose column separation of the cytoplasm or from a precipitate formed during the incubation of Koln RBC cytoplasm at 50 degrees C. The absorption and emission spectra of FYP are consistent with those of dipyrroles. PMID- 3978234 TI - Rapid changes in surface antigen expression by blood monocytes cultured in suspension or adherent to plastic. AB - Cell surface antigens used as markers of in vivo differentiation may not be stable on monocytes maintained under different conditions of in vitro culture. Monocytes were isolated from blood by centrifugation over Percoll or by adherence to plastic dishes, and the cells cultured in suspension or as adherent monolayers. Initially, monocytes obtained by both methods were similar in size, morphology, and surface antigen expression detected with the antimonocyte monoclonal antibodies OKM1, FMC17, PHM2, and PHM3. After culture, cells maintained in suspension were predominantly small, whereas those adherent to plastic rapidly increased in size; however, cytochemical staining for nonspecific esterase and acid phosphatase showed increased enzymic activity by monocytes in both systems, possibly reflecting increased cell maturation. The most striking difference was a substantial loss of FMC17 antigen by most monocytes within four hours in suspension culture, as compared with a qualitative and quantitative increase in expression by plastic adherent cells within two hours. These changes occurred even if the cells were first reacted with lipopolysaccharide. Monocytes taken from suspension culture and allowed to adhere to plastic rapidly synthesized the antigen, a process inhibited by cycloheximide, and conversely, cells removed from plastic progressively displayed decreased FMC17 antigen expression when transferred to suspension culture. No functional role in adherence or phagocytosis has been found for the FMC17 antigen. The results suggest that antigen expression may depend as much on the physical state of the cells as on apparent activation or maturation events. PMID- 3978235 TI - Erythropoietin concentration during the development and recovery from iron deficiency in the rat. AB - The concentration of plasma erythropoietin was determined by radioimmunoassay during the progression of and subsequent recovery from iron-deficiency anemia in the rat. During the development of anemia, the plasma erythropoietin level rose as the hemoglobin (Hgb) concentration declined, reaching maximal levels when the Hgb was lowest. During the recovery from iron-deficiency anemia after institution of the control diet, the plasma erythropoietin concentration rapidly declined to baseline or below baseline levels even before the Hgb had completely returned to control values. This early fall in the erythropoietin level was associated with a sustained decrease in blood oxygen affinity (increase in P50). The rise in P50 was associated with an increase in the number of circulating reticulocytes in addition to and independently of an increase in the concentration of 2,3 diphosphoglycerate (DPG) in red cells. Therefore, reticulocytosis may play a part in the recovery from anemia, not only by replenishing the red cell pool but also by temporarily facilitating oxygen delivery to the tissues. PMID- 3978237 TI - The vasorelaxant action of parathyroid hormone fragments on isolated rat tail artery. AB - Previous studies have demonstrated that parathyroid hormone (PTH) and its 1-34 amino terminal fragment possess a hypotensive action in vivo which appeared to be direct and dose-dependent. However, attempts to demonstrate the phenomenon in isolated vascular tissue have been minimally successful at best. The present study reports that bovine PTH-(1-34) can relax isolated rat tail artery helical strips precontracted by either arginine vasopressin, depolarizing concentrations of potassium chloride, or norepinephrine. The phenomenon occurs in a dose dependent manner and is not dependent upon the presence of the endothelial lining of the vessels. These studies support the hypothesis that bovine PTH-(1-34) produces a direct vasorelaxant action mainly in small arteries. PMID- 3978238 TI - Effect of prazosin on the efflux of 3H-norepinephrine and metabolites from the intima and adventitia of the rabbit ear artery. AB - The spontaneous and stimulation-induced (SI) effluxes of 3H-norepinephrine (3H NE) and its metabolites from the intimal and adventitial surfaces of perfused segments of rabbit ear arteries were determined; vessels were previously incubated with 3H-NE (0.6 microM). The total SI adventitial efflux of 3H was approximately 10-fold greater than the intimal efflux, contained a higher percentage of unchanged 3H-NE (48 vs. 12%) and a lower percentage of O-methylated metabolites (17 vs. 55%); there was little difference between the percentages of deaminated catechols (35 vs. 31%). Prazosin, at a concentration (0.24 microM) which prevented the arteries constricting during stimulation, had little effect on the composition of the SI effluxes; however, it caused 2- to 3-fold increases in the effluxes of 3H-NE and its metabolites into the lumen during the period of stimulation. This effect is attributed to the failure of the vessel wall to thicken during stimulation, thus facilitating diffusion of 3H-NE and its intraneuronally formed metabolites across the media. Prazosin decreased the percentage of unchanged 3H-NE and increased that of the deaminated catechols in the spontaneous efflux; these effects are attributed to a direct effect of prazosin on the intra-neuronal metabolism of 3H-NE. PMID- 3978236 TI - The monoclonal antibodies alpha S-HCL 1 (alpha Leu-14) and alpha S-HCL 3 (alpha Leu-M5) allow the diagnosis of hairy cell leukemia. AB - To define cell surface antigens associated with hairy cell leukemia (HCL), and to gain better insight into the origin of this disease, we developed monoclonal antibodies against spleen cells of a patient with this disease. Although none of these antibodies alone proved specific for the leukemic cells, two of them, designated alpha S-HCL 1 (alpha Leu-14) and alpha S-HCL 3 (alpha Leu-M5) were found to be valuable in the diagnosis of HCL when used in combination. alpha S HCL 1 recognizes an antigen associated with greater than 95% of B cells in the peripheral blood. Biochemical analysis identified this antigen as a single polypeptide chain with a molecular weight of 150,000 daltons (150 kilodaltons). alpha S-HCL 1 expression on hairy cells is markedly increased when compared with normal B lymphocytes isolated from peripheral blood, tonsils, and spleens. alpha S-HCL 3 reacts with an antigen present on hairy cells but also on monocytes, macrophages, in a lower density on neutrophils, and a small percentage (less than 2%) of lymphocytes. The antigen recognized by alpha S-HCL 3 is composed of a non covalently linked biomolecular complex of 90 and 150 kilodaltons. Since the HCL 3 antigen was not detectable on other lymphomas of either T or B cell type, the co expression of S-HCL 1 and S-HCL 3 on hairy cells is a unique marker for this disease. PMID- 3978239 TI - Vascular injury compared to ageing of normal rabbit aorta. Biochemical and histochemical studies on time-dependent alterations of vascular connective tissue. AB - Male albino rabbits of the Danish country strain, 5 months of age, were divided into two groups. One group of animals was killed 180 days after a single mechanical dilatation injury of the thoracic aorta. A second group of untreated controls was killed at ages of 150, 165, 180, 210, 330, and 450 days. Glycosaminoglycans, uptake of 35S-sulphate, collagen, uptake of 125I-albumin, and vascular histochemistry and morphology were analyzed in the thoracic aorta. In the injured aortae the dry weight and the total amounts of hexosamine, hyaluronic acid, chondroitin-4,6-sulphate, dermatan sulphate, heparan sulphate, and hydroxyproline were increased. The concentration of hyaluronic acid decreased, whereas the concentration of dermatan sulphate increased. The concentrations of chondroitin-4,6-sulphate and heparan sulphate were unchanged. The total uptake of 35S-sulphate into the sulphated proteoglycans as well as the uptake of 125I albumin were increased. The light microscopical examination showed thickening of the intima, medial changes with fibrosis, accumulations of proteoglycans, calcifications, formation of cartilage, and ossified tissue with haematopoiesis. In the uninjured thoracic aorta the only significant change during ageing was an increase in the total amount of hyaluronic acid and a decrease of the 35S sulphate incorporation into the chondroitin-4,6-sulphate in the aorta. No morphological or histochemical alterations were observed during ageing. Spontaneous lesions were observed in 2 out of 55 aortas. It may be concluded that injury and ageing are reflected quite differently in the thoracic aorta of the rabbits. The observations may be of relevance to the interpretation of the alterations in human arterial diseases involving processes of injury and repair as well as ageing. PMID- 3978240 TI - Impaired in vitro growth of PHA induced T lymphocyte colonies in hemodialyzed renal failure patients. AB - Using an in vitro method that allows the study of the colony forming capacity of phytohemagglutinin stimulated peripheral blood T lymphocytes, we have detected an impaired T cell colony formation in hemodialyzed renal failure patients. By contrast a near normal pattern of responses was observed in patients treated with a conservative therapy. The poor in vitro T cell responsiveness of hemodialyzed patients was not corrected by supplementing the cultures with an adherent cell contitioned medium prepared from normal donors. We conclude that an intrinsic defect of the T cell colony forming capacity exists in hemodialyzed patients. PMID- 3978241 TI - The effect of low-dose estroprogestinic preparations on prothrombin complex factors: no significant increase after an 8-month trial. AB - The behavior of the prothrombin complex factors in 16 healthy women during low dose estroprogestinic treatment (laevonorgestrel 0.15 mg and ethynilestradiol 0.30 mg) at basal conditions and during 8 months of therapy has been investigated. We found a statistically significant decrease of the PTT (Partial Thromboplastin Time). The prothrombin time, on the other hand, became slightly decreased, but not to a statistically significant extent. Among the prothrombin time derived tests for evaluating the prothrombin complex only the PP test (Prothrombin Proconvertin test) was significantly shortened. Of the coagulation factors (factors II, VII and X) only a modest, but not statistically significant, increase in Factor VII and Factor X was noted. We conclude that, during the 8 month observation period, prothrombin complex factors are not altered substantially. PMID- 3978243 TI - ICSH/ICTH recommendations for reporting prothrombin time in oral anticoagulant control. International Committee for Standardization in Haematology/International Committee on Thrombosis and Haemostasis. PMID- 3978242 TI - Growth of erythroid colonies in agar cultures of normal human bone marrow. AB - The use of methylcellulose (MC) gels or plasma clots, for the support of human erythropoiesis in vitro, is associated with several technical disadvantages. Substitution of soft agar offers the prospect of overcoming these difficulties. In comparative studies, normal human bone marrow cells were cultured with erythropoietin (Epo) in agar (0.1%-0.3%) and MC. Concentrations of 0.175% and 0.2% agar proved to be optimal with respect to the combination of cloning efficiency and colony density. Further morphological examination revealed that subcolony formation in erythroid 'bursts' was influenced by gel viscosity. In additional experiments, miniaturising the assay system, to 0.25 ml culture volumes, increased cloning efficiency and reduced Epo utilization. These results confirm and expand earlier observations, and support a preference for the general use of agar in human erythroid cell cultures. PMID- 3978244 TI - Patients with early breast cancer benefit from effective axillary treatment. AB - We have reviewed the available clinical data on the benefit of axillary treatment in patients with early breast cancer. The results of these studies suggest that perhaps 5-10% of patients are cured by effective axillary treatment. We conclude that effective axillary treatment should still be considered an essential aspect of primary treatment. PMID- 3978245 TI - Development of a new human breast cancer cell line Ia-270. AB - A new human breast cancer cell line (Ia-270) has been isolated from a malignant pleural effusion from a woman with metastatic infiltrating ductal carcinoma of the breast. This cell line contains cytoplasmic estrogen (ER) and progesterone (PR) receptors. Following estradiol (E2) administration, PR synthesis is augmented and a higher level of saturation density is reached. In an athymic mouse, the cell line produced a tumor morphologically similar to the primary tumor. The results of isoenzyme and karyotype analyses demonstrate Ia-270 to be of human origin and free of HeLa cell contamination. The cell line has been maintained in continuous culture since April 1982 and may provide a useful in vitro system for studying the biology of human breast cancer. PMID- 3978246 TI - Interobserver reproducibility of histopathological features in stage II breast cancer. An ECOG study. AB - Eleven surgical pathologists studied microscopic sections from 45 mastectomy specimens of node positive breast cancer patients who had been entered into ECOG clinical trials. Inter-observer reproducibility for histoprognostic features was examined as a prerequisite before a subsequent evaluation of their possible clinical applicability could be undertaken. Histological type, nuclear grade, tubular formation, and lymphoid reactions were studied in the cancerous tissues. Lymph nodal responses (follicular and pulp prominence, sinus histiocytosis) were also examined in a manner that stimulated slide review in routine surgical pathology practice. Numerous two-way comparisons of the pathologists' findings resulted in low levels of agreement (usually much less than 90%). The degree of inter-observer reliability is clinically unacceptable using customary slide review analysis. New ways of examining breast cancer tissues need to be explored in the search for prognostic features which can be applied to the clinical management of breast cancer patients. PMID- 3978247 TI - Breast cancer markers: comparison between sialyltransferase and human mammary epithelial antigens (HME-Ags) for the detection of human breast tumors grafted in nude mice. AB - Sialyltransferase (CMP-sialic acid:asialofetuin sialyltransferase) and human mammary epithelial antigens (HME-Ags, cell surface antigens specific to human mammary epithelial cells) were determined in plasma of nude mice grafted with breast and non-breast human tumors to assess their possible usefulness as breast cancer markers. The plasma transferase activity was significantly higher (p less than 0.01) in tumor groups relative to the control. However, no significant difference (p less than 0.05) could be found in the transferase level between breast and non-breast tumor groups, showing the enzyme's lack of specificity for breast cancer. Furthermore, the surgical procedure performed on the control normal healthy group (no tumor), resulted in an important increase of the enzyme level, while HME-Ags remained unchanged. HME-Ags were essentially negative in control as well as non-breast tumor groups. After surgical removal of breast tumors, HME-Ags level dropped drastically to the background level (from 122 to less than 30 ng/ml plasma). These data indicate that HME-Ags are more sensitive and specific than sialyltransferase as markers for human breast tumor, and suggest that HME-Ags may be clinically useful in the early detection of breast cancer as well as in the followup of patients with metastatic breast tumor. PMID- 3978248 TI - Androgen metabolism and apocrine differentiation in human breast cancer. AB - Metabolism of (7 alpha-3H)testosterone has been measured in 111 human breast cancers and compared retrospectively with the degree of apocrine differentiation in the tumors. Cancers in which apocrine characteristics were a marked feature metabolized significantly more testosterone precursor than those in which apocrine features did not predominate. Higher metabolism was accounted for by increased conversion to 5 alpha-reduced products such as 5 alpha dihydrotestosterone and 5 alpha-androstanediols. PMID- 3978249 TI - Nandrolone decanoate added to tamoxifen in the treatment of advanced breast cancer. AB - Since 1980 we have been carrying out a prospective randomized trial comparing tamoxifen with the combination of tamoxifen plus nandrolone decanoate in advanced breast cancer. The tamoxifen dose is 30 mg daily and the nandrolone decanoate dose 100 mg i.m. once a week for four weeks and thereafter every other week. 98 post-menopausal patients have been evaluated for the response. The number of patients is 49 in both groups. The overall response rates (CR + PR) to tamoxifen and tamoxifen plus nandrolone decanoate were not significantly different; in the tamoxifen group the response rate was 49% and in the combination group 45%. The mean time to progression in tamoxifen group is over 13 months and in tamoxifen plus nandrolone decanoate group over 12 months. Our results do not suggest a synergistic effect from combining tamoxifen and nandrolone decanoate treatments. The response rates to tamoxifen at different sites of metastases were as follows: bones 47%, soft tissues 56%, and viscera 48%. The respective figures with the combination therapy were 36%, 64%, and 40%. Both treatments were well tolerated and in no patient was withdrawal of the therapy necessary. Mild virilization and hoarseness were experienced by all patients treated with nandrolone decanoate. Side-effects associated with tamoxifen were rare, although five patients experienced nausea and two had hot flushes. PMID- 3978251 TI - The relative persistence in soil of five acetanilide herbicides. PMID- 3978250 TI - Height, weight, and risk of breast cancer relapse. AB - The records of 231 patients with primary breast cancer and 85 patients with metastatic breast cancer were reviewed to determine whether indices of body weight were associated with prognosis. Results support previous reports that indices of body weight are relatively weak, but real, prognostic factors. PMID- 3978252 TI - Identification of 2,4-dichloroanisole and 2,4-dichlorophenol as soil degradation products of ring-labelled [14C]2,4-D. PMID- 3978253 TI - Comparative study of two chromatographic columns used in the GLC determination of methylmercury. PMID- 3978254 TI - Blood pressure and hair cadmium, lead, copper, and zinc concentrations in Mississippi adolescents. PMID- 3978255 TI - Tellurium burden and neurochemical effects in moderate peroral exposure. PMID- 3978256 TI - Heavy metals in lamb liver: contribution from atmospheric fallout. PMID- 3978257 TI - Assimilation of zinc, cadmium, lead, copper, and iron by the spider Dysdera crocata, a predator of woodlice. PMID- 3978258 TI - Effect of calcium on cadmium uptake and toxicity in larvae and juveniles of striped bass (Morone saxatilis). PMID- 3978259 TI - Disturbance of motor performance and thermoregulation in mice given two commercial chlorinated paraffins. PMID- 3978260 TI - Alkyl phosphate residue values in the urine of Florida citrus fieldworkers compared to the National Health and Nutrition Examination Survey (HANES) sample. PMID- 3978261 TI - Determination of polyaromatic hydrocarbons in scallops (Pecten maximus) by UV fluorescence and HPLC combined with UV and fluorescence detectors. PMID- 3978263 TI - Effects of trichloroacetic acid, a new contaminant found from chlorinating water with organic material, on dragonfly nymphs. PMID- 3978262 TI - Volatile organic pollutants in biota and sediments of Lake Pontchartrain. PMID- 3978264 TI - Atypical growth in Periplaneta brain after malathion treatment. PMID- 3978265 TI - Air pollution effects on Attica's natural ecosystems. PMID- 3978266 TI - Subchronic effects of a mixture of "persistent" chemicals found in the Great Lakes. PMID- 3978267 TI - Bird use and heavy metal accumulation in waterbirds at dredge disposal impoundments, Corpus Christi, Texas. PMID- 3978268 TI - Identification of asbestos and glass fibers in municipal sewage sludges. PMID- 3978269 TI - Pesticide residues in Kansas pheasants. PMID- 3978270 TI - Effect of bacterial cultures on microbial toxicity assessment. PMID- 3978271 TI - Increased response of the rainbow trout gonad cell unscheduled DNA repair assay. PMID- 3978272 TI - Uptake of cadmium by eggs and alevins of Atlantic salmon (Salmo salar) as influenced by acidic conditions. PMID- 3978273 TI - Nitrite toxicity to the crayfish Procambarus clarkii. PMID- 3978274 TI - Mortality of early life stages of largemouth bass, Micropterus salmoides due to pentachlorophenol exposure. PMID- 3978275 TI - Gill damage as a determinant of residual oxygen concentration in the sealed jar test. PMID- 3978277 TI - Applicator exposure to maleic hydrazide (MH) in flue-cured tobacco. PMID- 3978276 TI - Identification and determination of some trace organic compounds in coastal seawater of northern Greece. PMID- 3978278 TI - Transient proteinuria and aminoaciduria in rodents following uranium intoxication. PMID- 3978279 TI - Influence of dietary vitamin E on susceptibility to ozone exposure. PMID- 3978281 TI - Inhibitory effects of calmodulin antagonists on urinary enzyme excretion in rats after nephrotoxic doses of mercuric chloride. PMID- 3978282 TI - Effect of lead on tissue deposition of mercury in mice. PMID- 3978280 TI - Embryotoxicity study on cyclopiazonic acid in mice. PMID- 3978283 TI - Nickel acetate-induced mortality in mice of different ages. PMID- 3978284 TI - Investigations of the interaction of aluminum with bovine plasma monoamine oxidase. PMID- 3978286 TI - Transit time analysis of spirograms. PMID- 3978285 TI - [Determination of nasal resistance in healthy subjects using 2 technics of rhinomanometry]. AB - Transnasal pressure-flow relationship was studied by active rhinomanometry. Nasal resistance was determined by a microprocessor assisted technique during quiet inspiration in 106 adults (49 females and 57 males) and in 52 children (21 girls and 31 boys) in various circumstances. The study was performed 1) to calculate the airflow nasal resistance (R) in different subjects, 2) to determine the laminar (K1) and turbulent (K2) coefficients of flow in the upper airways according to Rohrer's equation: R = K1 + K2 V, and 3) to compare the results of anterior and posterior rhinomanometry. The results of the experiments show that 1) nasal resistance was constant during the nasal cycle and from one week to another in the same subjects; 2) nasal resistance were higher in females than in males, and higher in children than in adults depending on nose development; and 3) the nasal resistance measured by posterior rhinomanometry (RP) was approximately twice as by anterior rhinomanometry (RA) and the correlation was highly significant. The regression line was RA = 0.82 RP - 0.06 in kPa . 1(-1) . s (r = 0.998). Anterior rhinomanometry was easier to perform than posterior rhinomanometry and more useful for performing challenges of the nasal mucosa. PMID- 3978287 TI - Monitoring of peak expiratory flow rates in subjects with mild airway hyperexcitability. AB - Twenty-seven subjects with mild symptoms of bronchial hyperexcitability (cough, dyspnea, wheezing) and low to moderate degree of airway response to histamine monitored their peak expiratory flow rates (PEFR) for a mean +/- SD of 14.4 +/- 4.0 days. This assessment was performed without the use of any medication in 15 subjects, and before and after inhalation of salbutamol in 12 others. 100% and 52% of individuals, respectively, showed baseline FEV1 and maximum mid-expiratory flow rates greater than 80% of predicted. The improvement in FEV1 after salbutamol was less than 20% in every subject and from 10 to 20% in 15%. The mean daily percentage changes in PEFR were greater than the ones observed in normal individuals in only 21% and 50% of the subjects on no medication and on salbutamol, respectively. Diurnal changes in PEFR were significantly negatively correlated with the response to histamine (r = -0.51; p less than 0.01) and baseline FEV1 (r = -0.49; p less than 0.02). We conclude that there are minor fluctuations of PEFR in subjects with mild symptoms and low degree of airway excitability. PMID- 3978288 TI - Effect of increasing bronchodilatation on the single breath nitrogen test. AB - To determine if and how changes of the slope of phase III of the N2 test reflect drug-induced bronchodilatation, we studied patients with moderate to severe reversible airflow limitation who inhaled increasing doses of salbutamol. The bronchodilating response on each dose level was monitored both by the N2 test and dynamic spirometry. The study shows that the slope of phase III is related to drug-induced bronchodilatation in a dose-dependent way. Furthermore, the decrease of the slope of phase III mirrors the concomitant increase of FEV1. These results are consistent with bronchomotor tone as a determinant of the slope of phase III. Alternatively, the decrease of the slope of phase III may be independent of bronchomotor tonus per se and be explained by a decrease in residual volume as reflected by the observed dose-dependent increase in vital capacity. PMID- 3978289 TI - Suitability of a new turbine spirometer for epidemiological surveys in children. AB - The performance of a new turbine spirometer, which has several advantages over equipment previously used to measure lung function, was compared with that of a conventional spirometer (Vitalograph) in a cross-over trial on 368 children six to 11 years old. On average, slightly higher values of forced expiratory volume at 0.75 s and forced vital capacity were recorded on the turbine spirometer. These differences occurred mainly in children aged less than eight years. Assuming the Vitalograph remained accurate, there appeared to be a slight tendency for readings on the turbine spirometer to drift downwards at a rate of 0.04 1 per 100 children measured but this was not statistically significant (p greater than 0.10). In conclusion, the machines differed mainly in the youngest age group. Until a recording of the complete expiration curve can be made using the turbine spirometer, it is not possible to assess whether this effect of age arose because of errors in the breath manoeuvre by younger children undetectable in the turbine spirometer or because the simpler design of the spirometer makes it easier than the Vitalograph for young children to use it correctly. PMID- 3978290 TI - [Measurement of the frequency response of several stethoscopes in common use. Consequences for cardiac and pulmonary auscultation]. AB - We measured the frequency response of eight stethoscope membranes and of thirteen types of stethoscopes. Measurements were made in an anechoic chamber calculating the ratio between the intensity of a sinusoidal sound coming from a loud speaker and the intensity of the transmitted sound through the membrane of the stethoscope. Small membranes have a bandwidth (without attenuation or amplification) between 10 and 600 Hz while large membranes have a bandwidth twice the size (10-1200 Hz). This good result does not appear in the case of stethoscopes showing increasing attenuation versus frequency, with a mean value from -2.5 to -10.5 dB and variations of 10 dB in the range 50-1200 Hz which is the useful bandwidth for cardiac and pulmonary auscultation. By contrast, fidelity of the measured stethoscopes was good. Discussion of the results suggests modification of stethoscope design to eliminate faults of sound transmission and to elaborate a microphone sensor allowing an electric transmission. PMID- 3978291 TI - Long term follow-up of radiological signs of pulmonary hypertension in correlation with haemodynamic changes. AB - Patients with pulmonary hypertension of unknown cause show a typical radiological pattern with prominence of the pulmonary segment, increase in diameter of the right descending branch of the pulmonary artery and marked tapering of the peripheral vascular bed. The aim of this study was to evaluate if changes in radiological indices correlate with hemodynamic changes during long term follow up, in 19 patients with pulmonary hypertension followed for a mean of 8.4 years. In 10 patients, an increase in pulmonary arterial pressure (Ppa) was measured, and in all further increase in the diameter of the right descending branch was seen. The prominence of the pulmonary segment increased in only six of the ten patients. In three patients, no change in Ppa and in the radiological signs was noted. But in four of six patients a decrease in Ppa was not followed by changes of the radiological signs. In conclusion, we could show that there is a good correlation between radiological signs of pulmonary hypertension and further increase of pulmonary arterial pressure in patients with pulmonary hypertension, whereas a decrease in pressure is not necessarily reflected by a decrease in the radiological signs. PMID- 3978292 TI - The effect of U.S. policies on the economics of libraries. AB - The decline in federal support of educational programs has made it difficult for libraries to apply new technologies to improve practices and services. While federal support has declined in constant dollars, there has been a modest increase in grants from private foundations. Current U.S. policies require federal agencies to recover full costs of rendering services (Circular A-25) and require the transfer of many federal service-oriented activities to the commercial sector (Circular A-76). Additionally, the Paperwork Reduction Act of 1980 is inhibiting the production and dissemination of federal publications. Government pursuit of these policies adds a heavy economic burden to libraries and threatens to reduce access to the scholarly and scientific record. PMID- 3978293 TI - Down on the farm. PMID- 3978294 TI - Evaluating the impact of library services on the quality and cost of medical care. AB - Recent federal regulations have minimized the role of the hospital library in contributing to the quality of medical care and in lowering hospital costs. We trace the events that have led to these assumptions and discuss the complex problem of evaluating the impact of library services. Current research on the value and effectiveness of information is outlined. PMID- 3978295 TI - Integrated information management and hospital libraries. AB - It is demonstrated that hospitals are information-dependent and that there is need for integration of information generated and gathered through their subsystems. This paper discusses recommendations of the Matheson Report for an integrated information management system which would link these subsystems. The library's statement of mission, means for self-assessment, and analysis of information needs and uses are explored. Future directions with examples of new roles for the library are outlined. PMID- 3978296 TI - Expanded roles for hospital libraries: a direction for successful change. AB - Hospitals are changing to cope with a new environment and their libraries are changing with them. We demonstrate that hospital librarians can influence the change process and that expanding the role of the library is one option. Four case reports are presented to illustrate generic problems and how each library has coped with them. The issues facing hospital libraries today are viewed within the broader perspective of the American health care system. PMID- 3978297 TI - Implications of an AHEC library program evaluation: considerations for small rural hospitals. PMID- 3978298 TI - Response of the Medical Library Association to the Report of the Register of Copyrights to Congress Library Reproduction of Copyrighted Works (17 U.S.C. 108) PMID- 3978299 TI - Personal/departmental journal subscriptions: comment. PMID- 3978300 TI - BACS: evolution of an integrated library system toward information management. AB - The evolution of the Washington University School of Medicine BACS integrated library system toward information management functions is outlined. The creation of a machine-readable database and its extension through telecommunications have consequences that reach beyond the functions of the library as we have perceived them. It is argued that libraries are flexible institutions that, with automation, are likely to enlarge rather than to diminish. PMID- 3978301 TI - Object-relations theory and psychohistory. PMID- 3978302 TI - DSM-III and the use of the term borderline. PMID- 3978303 TI - Autistic aloofness reconsidered. Case reports of two children in play therapy. PMID- 3978304 TI - Levels of countertransference toward Vietnam veterans with posttraumatic stress disorder. PMID- 3978305 TI - Multiple determinants of anxiety in a patient with borderline personality disorder. PMID- 3978306 TI - On countertransference boredom. PMID- 3978307 TI - Autoradiographic study of the distribution of [3H]- and [14C]-hydrallazine in the rat. AB - The distribution of [3H]-hydrallazine (HP) in the rat was investigated using autoradiography from the whole-body, to the electron microscopic level. Intravenous dosing gave rapid and persistent labelling of blood vessels, particularly arteries, whilst radiolabel from orally administered drug was detectable in the vasculature in modest amounts only at 6 h, the longest interval studied. Light microscopic autoradiographs of blood vessels showed silver grains associated with elastic laminae and the marginal region of smooth muscle cells. Analysis of electron microscopic autoradiographs of arteries from rats dosed intravenously (1 h and 6 h) and orally (6 h) revealed the greatest percentage of radiolabel in each case to be associated with the elastic laminae (34.9 to 40.3%). Significant proportions of total radiolabel (between 12.7 and 34.8%) were ascribed to the smooth muscle cells. It is concluded that radiolabel, possibly in the form of intact HP, is accessible to the vascular smooth muscle cells where the vasodilator action of HP is held to be exerted. PMID- 3978308 TI - The influence of digoxin antibodies on digoxin disposition and effect: studies in guinea-pigs and HeLa cells. AB - Pretreatment of guinea-pigs with digoxin-specific Fab (fragment antigen binding) fragments reduced the cardiotoxicity of intravenously infused digoxin (the lethal doses in Fab-treated and control animals were 1.0 and 0.6 mgkg-1, respectively). At death the serum digoxin concentration was elevated 2 fold in the Fab-treated animals, while the tissue concentrations were generally lower. The 30-40% lower cardiac digoxin concentration (seen in whole homogenate and throughout the subcellular fractions examined) was surprising; presumably this reflects a difference from the controls in the proportion of pharmacologically active/inactive digoxin in this organ. Adding digoxin-specific immunoglobulin G or the Fab fragments to HeLa cells before incubation with digoxin, reduced specific digoxin binding (Na pump-bound) slightly more than the non-specific binding. Adding specific antibody after digoxin, however, did not reduce digoxin binding or effect a recovery in Na pump activity. It seems that the protective effect of digoxin-specific antibodies seen in the guinea-pig can to some extent be simulated using HeLa cells. However, this is apparently not so regarding the widely-reported ability of these antibodies to reverse the action of digoxin. PMID- 3978309 TI - The response of non-pregnant rat myometrium to oxytocin in Ca-free solution. AB - The contractile response of the longitudinal muscle of non-pregnant rat myometrium to oxytocin (0.2-20 nM) consisted of a phasic and a tonic component. Ca-removal abolished the phasic component but a tonic contraction could be evoked without reduction of amplitude for 50 h. Exceptionally, the tonic contraction also disappeared gradually in Ca-free medium containing 2 mM EGTA. When oxytocin was repeatedly applied in the absence of Ca, the response became at first progressively larger before reaching a steady state. Transient addition of Ca to the medium reduced the size of the subsequent oxytocin contraction. In Ca-free medium, the tissue lost Ca slowly, but it still contained 40 mumol kg-1 after 6 h and roughly 1 mumol kg-1 wet weight after 24 h exposure. 45Ca efflux was marginally increased by oxytocin (20 nM). Caffeine (5-30 mM) produced no contraction, but slightly reduced the resting tension and strongly inhibited the oxytocin response both in the presence and in the absence of Ca. Caffeine also blocked the contraction induced by Ca added to Ca-free 40 mM K solution. However, pretreatment with caffeine (30 mM) had no effect on the following oxytocin response. A calmodulin antagonist, trifluoperazine (1-10 microM) suppressed strongly the Ca-induced contraction, but had only a weak effect on the oxytocin response in Ca-free medium. Chlorpromazine (10-100 microM) and fluphenazine (10 30 microM) had similar effects. A different type of antagonist, N-(6-aminohexyl) 5-chloro-1-naphthalene sulphonamide (W-7) (0.1 mM) almost completely blocked responses to both oxytocin and to Ca, but recovery of the Ca-induced contraction was much better than that of the oxytocin response in Ca-free solution. 6 Since no evidence was found for intracellular Ca release by oxytocin, and as there were several differences between the effects of calmodulin antagonists on the oxytocin response and on the Ca-induced response of similar size, the possibility remains that some Ca-independent process is involved in the contractile response to oxytocin observed in Ca-free solution. PMID- 3978310 TI - Effects of anticonvulsants in vivo on high affinity choline uptake in vitro in mouse hippocampal synaptosomes. AB - The effects of several anticonvulsant drugs on sodium-dependent high affinity choline uptake (HACU) in mouse hippocampal synaptosomes was investigated. HACU was measured in vitro after in vivo administration of the drug to mice. HACU was inhibited by drugs which have in common the ability to facilitate gamma aminobutyric acid (GABA) transmission, pentobarbitone, phenobarbitone, barbitone, diazepam, chloridiazepoxide, and valproic acid. Dose-response relationships were determined for these drugs and the drugs' potencies at inhibiting HACU correlated well with their anticonvulsant potencies. Clonazepam, ethosuximide, carbamazepine, and barbituric acid had no effect on HACU in the doses used while phenytoin and trimethadione stimulated HACU. These results suggest that certain anticonvulsants may elicit a part of their anticonvulsant activity by modulating cholinergic neurones. This effect may be mediated through a GABA mechanism. PMID- 3978311 TI - Muscarinic subsensitivity without receptor change in monkey ciliary muscle. AB - Intense muscarinic stimulation of the monkey ciliary muscle causes long-lasting muscarinic subsensitivity. This could be due to changes in number or affinity of muscarinic receptors which would cause a threshold elevation detectable in vivo. Since plasma levels of the agonists causing contraction in vivo were not available, the accommodation response to systemic muscarinic agents in subsensitized eyes was compared with that in the normal fellow eyes, usually seven days after a single subsensitizing dose of 100 micrograms carbachol to cornea. Subsensitivity was present whether the agonist tested was pilocarpine, carbachol or bethanechol but no evidence for threshold elevation was found. The conclusion is that changes in the muscarinic receptors are of minor importance for the kind of subsensitivity studied. PMID- 3978312 TI - Characterization of the receptor mediating contraction of human umbilical artery by 5-hydroxytryptamine. AB - The 5-hydroxytryptamine (5-HT) receptor in human umbilical artery was found to be similar to that in rabbit aorta. The pD2 was 7.45, pA2 for methysergide 8.63 and pA2 for phentolamine 6.21. Noradrenaline gave only very weak contractions at non physiological concentrations. Amidephrine and xylazine did not contract human umbilical artery. It is concluded that there is no significant population of functional alpha-adrenoceptors in this vessel. The implications of these findings are discussed in relation to the control of the umbilical circulation. PMID- 3978313 TI - 5-hydroxytryptamine releases adenosine 5'-triphosphate from nerve varicosities isolated from the myenteric plexus of guinea-pig ileum. AB - 5-Hydroxytryptamine (5-HT)-evoked release of ATP from nerve varicosities isolated from the myenteric plexus of guinea pig ileum was investigated. 5-HT released ATP from myenteric varicosities by a Ca2+-dependent mechanism. The EC50 for release of ATP was 7 X 10(-7) M 5-HT. 5-HT-evoked release of ATP was not blocked by tetrodotoxin (TTX), indicating that release was not initiated by the opening of Na+-channels in the isolated myenteric varicosities. Release of ATP by 5-HT was diminished to 56% of control values by in vivo pretreatment of the guinea-pig with 6-hydroxydopamine (6-OHDA, 250 mg kg-1, i.p.) for 24 h. 6-OHDA pretreatment caused extensive destruction of noradrenergic varicosities as indicated by an 87% loss of noradrenaline content. Quipazine (5 X 10(-6) M) and methysergide (10(-4) M) caused a small release of ATP and blocked subsequent 5-HT-induced release of ATP. Metergoline (2.5 X 10(-5) M), (+)-tubocurarine (7 X 10(-5) M) and cocaine (10(-4) M) decreased 5-HT-induced ATP release. 5-Methoxytryptamine (10(-4) M), picrotoxin (3.5 X 10(-6) M), spiroperidol (10(-6) M), morphine (1.3 X 10(-6) M) and phenoxybenzamine (3.7 X 10(-7) M) were ineffective. The results demonstrate a 5-HT-receptor-mediated release of ATP from noradrenergic and possibly non adrenergic varicosities in the myenteric plexus of guinea-pig ileum. The 5-HT induced release of ATP is consistent with a possible transmitter, cotransmitter or modulatory role for ATP in the myenteric plexus. PMID- 3978314 TI - Loss and recovery of sensitivity of guinea-pig isolated ileum to the spasmogenic action of the complement peptide C5adesArg. AB - Deactivation (tachyphylaxis) of the guinea-pig isolated ileum to the spasmogenic action of the complement peptide C5adesArg was analysed. It appeared to consist of 2 components: a fast one, characterized by rapid onset of deactivation and by recovery within 2-3 min (see Damerau et al., 1985b), and a slow component, characterized by progressively increasing loss of sensitivity (until complete deactivation after several minutes) and by recovery within about 80 min. Slow deactivation shows an exponential time course; it is dependent on concentration as well as contact time with C5adesArg and occurs under conditions (incubation in Ca2+-free medium or at 16 degrees C) in which the peptide has no spasmogenic effect. Recovery from slow deactivation follows an exponential time course at 34 degrees C but is blocked at 16 degrees C; on average it reaches about half of the initial sensitivity. The results indicate that the slow deactivation is mainly due to blockade of C5a receptors by the ligand and is independent of the spasmogenic effect of C5adesArg. PMID- 3978315 TI - Pharmacological characterization of the slow component of deactivation of guinea pig isolated ileum to the spasmogenic action of C5adesArg. AB - The slow component of deactivation of guinea-pig isolated ileum to C5adesArg was studied to analyse the mechanism of loss and subsequent recovery of sensitivity. Neither cycloheximide (10(-3) M) nor colchicine (5 X 10(-5) M), vinblastine, lumicolchicine, or cytochalasin B (each 2 X 10(-5) M) affected significantly the spasmogenic effect of C5adesArg or the course of deactivation produced by repeated applications; chloroquine (2 X 10(-4) M) inhibited the spasmogenic effect unspecifically without interfering with deactivation. Recovery from slow deactivation was totally blocked by chloroquine and considerably diminished by colchicine and vinblastine, but was not affected by the other agents. It is proposed that recovery involves lysosomal processing of C5a receptors (occupied by the peptide) but does not require biosynthesis of new receptors. PMID- 3978316 TI - A study of the relationship between the pharmacokinetics and the pharmacodynamics of the 4-hydroxycoumarin anticoagulants warfarin, difenacoum and brodifacoum in the rabbit. AB - The pharmacokinetics and pharmacodynamics of the 4-hydroxycoumarin anticoagulants, brodifacoum, difenacoum, and warfarin have been studied in the rabbit. Sensitive (50 ng ml-1) and specific high performance liquid chromatography assays have been developed for the determination of plasma concentrations of warfarin, brodifacoum and difenacoum. After administration of a single intravenous dose (20 mumol kg-1), plasma concentrations of warfarin underwent mono-exponential decay, with a terminal half-life of 5.6 +/- 0.7 h (mean +/- s.e. mean), whereas plasma concentrations of brodifacoum and difenacoum underwent bi-exponential decay with terminal half-lives of 60.8 +/- 1.9 h and 83.1 +/- 10.3 h respectively. The plasma half-life of brodifacoum in a single patient poisoned with the compound was 487 h. The pharmacological response to the anticoagulants was measured as changes in prothrombin complex activity, from which the rate of clotting factor synthesis was determined. Clotting factor synthesis recovered in a monophasic fashion after a single intravenous dose of warfarin, compared with a more complex biphasic, pattern of recovery of clotting factor synthesis after administration of either brodifacoum or difenacoum. The slope (m) of the intensity of effect-log (amount of drug in the body) curve was derived for each anticoagulant. There was no significant difference in the value of m after single intravenous doses of racemic, R-, and S-warfarin, difenacoum and brodifacoum, which is consistent with the hypothesis that all the 4 hydroxycoumarin anticoagulants produce their anticoagulant effect by acting at the same receptor site, vitamin K epoxide reductase. Determination of the minimum plasma concentration of each anticoagulant that corresponded with the complete inhibition of clotting factor synthesis indicated that racemic warfarin, R warfarin and brodifacoum have similar potencies in the rabbit and are less potent than S-warfarin and difenacoum. PMID- 3978317 TI - The binding of doxepin to histamine H1-receptors in guinea-pig and rat brain. AB - The affinity constant for doxepin obtained from inhibition of histamine-induced contraction of guinea-pig intestinal smooth muscle at 30 degrees C was 2.6 +/- 0.18 X 10(10)M-1. The slope of a Schild plot was not significantly different from unity. The affinity constant of doxepin did not vary markedly with temperature. At 37 degrees C it was 3.75 +/- 0.02 X 10(10)M-1 and at 25 degrees C 2.1 X 10(10)M-1. Doxepin was a competitive inhibitor of [3H]-mepyramine binding to guinea-pig cerebellar homogenates. The affinity constant derived for doxepin at 30 degrees C was 1.12 +/- 0.45 X 10(10)M-1. Hill coefficients for curves of doxepin or mepyramine inhibition of [3H]-mepyramine binding in guinea-pig cerebellum, cerebral cortex and hippocampus did not differ significantly from unity. The mean affinity of mepyramine for histamine H1-receptors in rat brain homogenates at 30 degrees C was 3.5 X 10(8)M-1. Hill coefficients for curves of doxepin or mepyramine inhibition of [3H]-mepyramine binding to homogenates of rat cerebral cortex or rat whole brain were near unity. These studies provide no evidence that doxepin binds preferentially to a sub-class of histamine H1 receptors in rat brain. PMID- 3978319 TI - Effects of amosulalol on the electrical responses of guinea-pig vascular smooth muscle to adrenoceptor activation. AB - The effects of amosulalol, a newly synthesized sulphonamide-substituted phenylethylamine derivative, on electrical responses of smooth muscle cells of the guinea-pig vascular tissues to noradrenaline, isoprenaline and perivascular nerve stimulation were investigated. Amosulalol (10(-10) -10(-5)M) did not alter the resting membrane potential of smooth muscle cells of the mesenteric artery, the mesenteric vein, the main pulmonary artery and the portal vein. In the mesenteric artery, main pulmonary artery and portal vein, but not in the mesenteric vein, membrane depolarizations produced by noradrenaline were antagonized by amosulalol. In the portal vein, membrane hyperpolarizations produced by isoprenaline were antagonized by amosulalol. In the mesenteric artery, amosulalol (over 10(-6)M) enhanced the amplitude of excitatory junction potentials (e.j.ps) produced by perivascular nerve stimulation. Amosulalol antagonized the noradrenaline-induced decrease in the e.j.p. amplitude; this effect was much weaker than that of phentolamine. Amosulalol also antagonized the isoprenaline-induced enhancement of the e.j.p. amplitude. In the mesenteric vein, the slow depolarizations produced by perivascular nerve stimulation were depressed by amosulalol (over 10(-6)M), but the effect was much weaker than that of prazosin, yohimbine or phentolamine. Actions of amosulalol on electrical properties of vascular tissues can be summarized as follows: amosulalol blocks alpha 1- and beta-adrenoceptors. It also blocks alpha 2-adrenoceptors, though weakly. PMID- 3978318 TI - The effects of meptazinol in comparison with pentazocine, morphine and naloxone in a rat model of anaphylactic shock. AB - The actions of meptazinol, pentazocine, morphine and naloxone on the cardiovascular changes accompanying anaphylactic shock were evaluated in ovalbumin-sensitized anaesthetized rats. Pretreatment with meptazinol and pentazocine prevented the fall in mean arterial pressure associated with antigen challenge, whereas morphine and naloxone attenuated but did not completely prevent, this change. None of the drugs significantly altered the antigen-induced decreases in heart rate. All the drugs partially reversed the fall in mean arterial pressure when given after antigen challenge although the activity of naloxone was less marked. Pretreatment with reserpine prevented the restoration of blood pressure by all drugs. Additional experiments with meptazinol showed that pretreatment with phentolamine prevented its pressor action. In pithed non sensitized rats the frequency-pressor response curve to splanchnic stimulation was shifted to the left by meptazinol and shifted to the right by pentazocine, but the changes were small Morphine and naloxone had no significant effects. It was concluded that opioid mixed agonist-antagonists reverse the cardiovascular changes associated with anaphylactic shock. These effects appear to be mediated by facilitation of sympathetic neurotransmission. PMID- 3978320 TI - Vasoactivity of trimetazidine on guinea-pig isolated ductus arteriosus. AB - The effect of trimetazidine (TMZ), an anti-anginal drug, on the mechanical response of the guinea-pig ductus arteriosus placed under conditions of mild hypoxia (PO2 approximately equal to 75 mmHg) was investigated. When the PO2 of the bathing solution was 75 mmHg, TMZ caused a dose-dependent increase in tension. The median effective dose (ED50) for the drug was 8 X 10(-5)M. TMZ induced increase in tension was not significantly affected by pretreatment of the preparation with adrenoceptor blocking agents, or indomethacin. The amplitude of the PO2-dependent tension was significantly augmented by exposure of the strip to TMZ 10(-4)M, whereas neither the resting tone (low PO2), nor the oxygen-induced contraction (high PO2) were altered. This ability of TMZ to increase the tension response during hypoxia was dependent on the external calcium concentration. Under low PO2 conditions, a contractile activity of 10(-4)M TMZ was unmasked in preparations perfused with 18 mM K+-PSS medium. This response to TMZ disappeared after the removal of calcium from the bath. At the maximally effective dose of 10(-3)M, and during low PO2, the TMZ-induced contractile response changed to a relaxation response when the external K+ concentration was raised more than five fold. The possibility that TMZ stimulates the mechanism by which oxygen normally controls the concentration of free intracellular calcium in the ductus arteriosus is proposed. PMID- 3978321 TI - 5-Carboxamide tryptamine, a compound with high affinity for 5-hydroxytryptamine1 binding sites, dilates arterioles and constricts arteriovenous anastomoses. AB - The effects of 5-carboxamide tryptamine, which activates non-5-hydroxytryptamine2 'atypical' receptors for 5-hydroxytryptamine (5-HT) in the dog saphenous vein, was studied on the complete distribution of cardiac output and common carotid blood flow in anaesthetized pigs. The drug was infused for 10 min at the rate of 0.025, 0.1 and 0.4 micrograms kg-1 min-1 either intravenously (cardiac output distribution) or intra-arterially (carotid distribution). 5-Carboxamide tryptamine decreased arterial blood pressure due to a reduction of cardiac output. This reduction was confined to its arteriovenous anastomotic component; the component used for the tissue perfusion (nutrient part) in fact increased. Similar changes were observed in the carotid blood flow distribution. Vasodilation was observed in several tissues, but the skin, ears and stomach responded most prominently. The effects of 5-carboxamide tryptamine on the carotid distribution were not significantly modified by cyproheptadine (1 mg kg 1). It is concluded that, like 5-HT, 5-carboxamide tryptamine constricts arteriovenous anastomoses and dilates arterioles by activating non-5-HT2 'atypical' receptors. These 'atypical' 5-HT receptors appear to be of the 5-HT1 type since both 5-carboxamide tryptamine and BEA 1654, a new piperazine derivative, produced similar vascular effects in the carotid bed of the pig and also showed a high and selective affinity for the 5-HT1 binding sites. PMID- 3978322 TI - An operational model of pharmacological agonism: the effect of E/[A] curve shape on agonist dissociation constant estimation. AB - An operational model of pharmacological agonism has been analysed to predict the behaviour of rectangular hyperbolic and non-hyperbolic agonist-concentration effect, E/[A], curves with variation in receptor concentration, [Ro]. Irreversible antagonism is predicted to cause E/[A] curve gradient changes in non hyperbolic cases but not in hyperbolic cases; in both cases estimation of agonist dissociation constants (KAS) is theoretically valid. 5-Hydroxytryptamine (5-HT) produced "steep' E/[A] curves in contracting the rabbit isolated aorta preparation. Irreversible antagonism by phenoxybenzamine (Pbz) produced a flattened E/[A] curve, consistent with theoretical predictions. Fitting 5-HT E/[A] curves in the presence and absence of Pbz to the model provided an estimate of KA for 5-HT which was not significantly different from the estimate obtained using Furchgott's null method. The operational model of agonism appears to account qualitatively and quantitatively for the effects of [Ro] changes on hyperbolic and non-hyperbolic E/[A] curves. Under conditions where irreversible antagonism may be used to estimate KAS, fitting the operational model directly to E/[A] data represents a valid, economical and analytically simple alternative to the conventional null method. PMID- 3978325 TI - Spontaneous seizures after ECT. PMID- 3978324 TI - Alternatives to psychiatric hospitalisation. PMID- 3978323 TI - Proceedings of the British Pharmacological Society. London, 17th-19th December, 1984. Abstracts. PMID- 3978326 TI - Suicide in hospital. PMID- 3978327 TI - Koro in non-Chinese subjects. PMID- 3978328 TI - Water intoxication in psychiatric patients. AB - Compulsive water drinking is associated with a broad spectrum of psychopathology, from mild neurosis to psychosis. Since the normal kidney is capable of excreting large volumes of fluid rapidly, water intoxication requires both a pathological basis and a psychiatric explanation of why so much water is being taken. Excessive water consumption can be dangerous, so that the fluid intake of patients with a history of polyuria together with a low urinary specific gravity should be closely observed. Four cases of water intoxication resulting from psychogenic polydipsia are described, three of them in chronic schizophrenics, where inappropriate ADH secretion might represent part of the psychosis. PMID- 3978329 TI - Predicting improvement in patients with non-endogenous depression. AB - Forty-three patients with non-endogenous depressive disorders were assessed shortly after psychiatric referral, and reassessed at six and at 20 weeks. The pattern of improvement appeared to be set shortly after the initial consultation, but could be most clearly predicted by the degree of improvement at the end of the third week. Key baseline factors predicting a more marked improvement at each follow-up were a more severe depression, the break-up of an intimate relationship, and the presence of weight loss. Positive life events occurring after the initial assessment predicted improvement at six and at 20 weeks, while the presence of a neutralising event (which negated an earlier threatening life event) predicted improvement at 20 weeks. PMID- 3978330 TI - Academic difficulty among male Egyptian university students. I. Association with psychiatric morbidity. AB - A survey was made of academic difficulties among undergraduate students at Ain Shams University, Cairo, during the academic year 1979-1980. Almost 6% of students dropped out before graduating and a further 8% required substantial extra time to complete their course of study: these figures were almost identical for both sexes. Psychiatric disorders were diagnosed in 42% of male students with academic problems (compared with 9% among the academically successful), with neuroses accounting for nearly half of the cases and schizophrenia for a quarter. Serious psychiatric illness was nearly four times as frequent among 3rd-year students as among 1st-year students. PMID- 3978331 TI - Academic difficulty among male Egyptian university students. II. Associations with demographic and psychological factors. AB - We compared 178 students with academic problems with 77 academically successful students. Academic difficulty showed highly significant associations with low socio-economic status, over-crowded housing, paternal behaviour problems and a poor relationship between the parents; also significant associations with family history of psychiatric disorder and living away from home. Academic achievement at school was no guide to university performance. Failed students had fewer friendships, especially with women, and more limited recreational activities. They also scored significantly lower on tests of verbal and non-verbal IQ, and worse on the Bender Gestalt and trail-making tests. EPQ results suggested that university students, particularly those with academic difficulties, are more neurotic and introverted than the general Egyptian population. PMID- 3978332 TI - Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969-78. AB - Annual age-standardised first admission rates from 1969-78 for Scottish mental hospitals were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Significant decreases were found in the diagnosis of schizophrenia (P less than 0.001) and, to a lesser extent, affective psychoses (P less than 0.01) and depressive neuroses (P less than 0.02). The incidence of paranoid states, reactive psychoses, and mania did not change significantly. Several factors possibly contributing to the decline in diagnoses of schizophrenia are discussed, but it is concluded that the figures probably reflect a genuine fall in incidence. The decline in the categories of affective disorder is likely to reflect trends towards increasing provision of community-based care. PMID- 3978333 TI - Epileptic psychosis: an evaluation of PSE profiles. AB - Data are presented on 24 patients with epilepsy and psychosis whose clinical presentation was rated using the Present State Examination (PSE). Seventeen had complex partial seizures and a diagnosis of temporal lobe epilepsy, seven had generalised epilepsy. An association between a CATEGO category of nuclear schizophrenia (NS) and a lesion of the left side was noted. No clear link between depressive symptoms and a right-sided focus was discovered. Affective disorders were noted in both groups of epileptic patients, although paranoid psychoses were commoner in the temporal lobe group. There was also a tendency for the latter to have more delusions of persecution, ideas of reference, and special features of depression. The group rated as NS appear less likely to show evidence of intellectual deterioration than the other psychotic patients; in addition, the interval between the onset of their epilepsy and the onset of their psychosis is shorter. Radiological assessment by CAT reveals few differences between groups, but the psychotic samples do show higher than expected values on a number of variables, in particular the bilateral septum-caudate distance and the size of the third and fourth ventricle. PMID- 3978334 TI - More and more is less and less the myth of massive psychiatric need. AB - The idea of massive unmet need for mental health services is a myth, generated and perpetuated by processes within the system which provides psychiatric care and within society. Diffusion of the traditional boundaries of mental health care, lack of norms and standards, medicalisation and 'healthism', specialoid practice and patient selection, diversion of resources from the long-term mentally ill and their absorption by better-functioning patients, substitution and development of new mental health service providers, and changes in the threshold for help-seeking all affect our assumptions of need. Needs are less massive, if the boundaries of psychiatry are defined so as to include only those disorders which the profession is best able to treat. PMID- 3978335 TI - A comparison of elective mutism and emotional disorders in children. AB - The case notes of 24 children diagnosed as elective mutes were compared with those of 24 matched controls with diagnosed emotional disorders. One-third of the elective mutes (but none of the controls) had experienced delayed development of speech or difficulties in articulation. All the elective mutes lived in two parent families, but marital discord was noted in half the families in both groups. Compared with the controls, the mute children were more often described as 'anxious', 'depressed' and 'manipulative', and their mothers were characterised as 'over-protective', and tending to 'spoil' their children. Three unusual cases, of mutism at home, are described in detail. It is proposed that elective mutism is associated with particular personal and family characteristics and represents a condition different from any recognised emotional disorder. PMID- 3978336 TI - Why teetotallers abstain. AB - Drinking practices and attitudes to alcohol among the members of a Southampton church were investigated by questionnaire (602 subjects) and by interviews (126 subjects). Teetotallers were older than drinkers, and included a higher proportion of women. They perceived their childhood upbringing and the teaching of the Bible as the main factors influencing them to abstain. Both teetotallism and alcoholism were more common among relatives of teetotallers than among relatives of social drinkers. PMID- 3978337 TI - Attempted infanticide. AB - The offence of attempted infanticide has hitherto been unknown in English Law. A case is here described in which a woman was convicted of infanticide, and attempted infanticide, having been charged with murder and attempted murder. The relevance of this is discussed, together with an aspect of infanticide previously unreported in the English literature, i.e. repetition of the offence. PMID- 3978338 TI - The brain-fag syndrome in Nigeria: cognitive deficits in an illness associated with study. AB - In a controlled study, intellectual capacity and memory functions were assessed using standard instruments in a sample of 16 patients with 'brain-fag syndrome'. The intelligence of the affected group was found to be generally above average and not significantly different from that of the control group. However, the patients had more difficulty in learning new words and in retaining such learning. The psychopathology of the syndrome is discussed. PMID- 3978340 TI - Language in dementia. PMID- 3978341 TI - Measurement of body image in anorexia nervosa. PMID- 3978339 TI - Atheroma, infarction and dementia: need for a new name? PMID- 3978342 TI - Examining children who are Wards of Court. PMID- 3978343 TI - Oral contraception and serious psychiatric illness: absence of an association. AB - The incidence of serious psychiatric illness, as measured by first referral to hospital for specialist advice and treatment, has been investigated among 16,746 women taking part in the Oxford Family Planning Association contraceptive study. Of these women, 9,504 were recruited while using oral contraceptives, 4,144 while using a diaphragm and 3,098 while using an intrauterine device. The results are reassuring with respect to oral contraceptive use. First referral rates per 1000 woman-years of observation in the oral contraceptive, diaphragm, and intrauterine device entry groups were 3.0, 2.6, and 2.8 respectively for non-psychotic psychiatric disorders and 0.46, 0.43 and 0.53 respectively for psychotic disorders. Attempted suicide occurred only 40% as often amongst diaphragm users as amongst users of oral contraceptives or intrauterine devices; this finding presumably reflects the characteristics of women who choose the diaphragm as their birth control method. PMID- 3978344 TI - The needs of young intellectually retarded adults. 18th Blake Marsh lecture February 1984. PMID- 3978345 TI - Chronicity and the General Health Questionnaire. AB - We propose a new scoring for Goldberg's (1972) General Health Questionnaire. We argue that the response 'no more than usual', to an item describing pathology, should be treated as an indicator of chronic illness rather than of good health, and we score these responses accordingly. We give evidence that this set of responses is associated with other measures of neurotic illness, and that the revised scoring provides a better prediction of caseness than the conventional scoring. The revised scoring is more strongly associated with trait neuroticism, and is more stable in repeated measurement. It is recommended in preference to the conventional scoring for most research and epidemiological purposes. PMID- 3978346 TI - The impact of lithium in South-west Scotland. II. A longitudinal study. AB - In a longitudinal study in South-west Scotland of patients suffering mainly from affective illness, the introduction of lithium as prophylactic therapy was associated with a significant reduction in the number and length of hospital in patient admissions, as well as in the number of courses and total number of electro-convulsive treatments. However, there was no significant reduction in the length of time patients received either antidepressants or major tranquillisers. A rating of individual patients suggested that a bare majority (52%) had improved considerably following the introduction of lithium. PMID- 3978347 TI - The impact of lithium in South-West Scotland. III. The discontinuation of lithium. AB - A review in South-West Scotland of all patients prescribed lithium for the first time during the years 1972-82 showed that on average, 12 per 100,000 of the general population start this drug each year. By the end of the period, lithium had been stopped in 58% of patients; the most common reason for discontinuation was the development of side-effects, of which tremor was the most frequent. In only 15% was lithium stopped as it was considered no longer necessary; 44% of patients discontinued lithium within one year of starting it. PMID- 3978348 TI - Transient sensory, cognitive and affective phenomena in affective illness. A comparison with complex partial epilepsy. AB - Behavioural changes have often been noted in patients with epilepsy. This study investigated the converse phenomenon--the occurrence of transient sensory, cognitive and affective changes resembling those described by epileptics, in affectively ill patients. Forty-four patients with affective illness, 37 with complex partial seizures, and 30 hypertensive controls were interviewed to determine the lifetime occurrence of these phenomena. Such symptoms occurred frequently in association with episodes of affective illness and epilepsy, but were rare in controls. Visual, auditory, olfactory and epigastric symptoms, illusions, jumbled thoughts and amnesia were common to both epilepsy and affective illness. Greater numbers of symptoms were associated with better response to lithium and tricyclic antidepressants. Transient sensory, cognitive, and affective phenomena may be more common in affective illness and other psychiatric conditions than is generally recognised, and may be clues to the underlying pathophysiology of these conditions. PMID- 3978349 TI - De Clerambault's syndrome--a nosological entity? AB - The consistency of de Clerambault's syndrome and its relationship to other diagnostic labels is examined in terms of operational criteria derived from the original description of the syndrome. Five new cases of erotic delusions are examined, and 53 cases reported in the recent literature are reviewed; none of these completely satisfies the diagnostic criteria, while the majority of patients actually suffered from another disorder, most commonly schizophrenia. The justification for the retention of the syndrome as a nosological entity is discussed, and it is argued that the term should be seen as principally of historical interest. PMID- 3978350 TI - The Pisa syndrome: a report of two cases. PMID- 3978351 TI - What price psychotherapy? A rejoinder. PMID- 3978352 TI - The use of lithium in severely demented patients with behavioural disturbance. PMID- 3978353 TI - Right- and left-hand skill: failure of the right shift model. AB - Annett's right shift model of the distribution of skill asymmetry, and of the genetics of handedness, is examined in relation to several sets of data. It is found to be a less adequate description than is the more intuitively obvious 'symmetric bimodal' model, which is described in this paper. PMID- 3978355 TI - High speed memory scanning in retarded and non-retarded adolescents. AB - Four groups of 13-14-year-olds, classified on the basis of Raven's Progressive Matrices scores as intellectually above average, average, below average and retarded, were subjects in a Sternberg (1966) type memory scanning task in which memory sets of two, three and four letters were used. Slope values of the memory search function did not differ between groups, whereas intercept values decreased with higher intelligence up to the average intelligence level. There was an overall inverse relation between intercept values and intelligence (r = -0.77) and similar relations obtained within the three non-retarded groups (rs greater than or equal to -0.57), but not within the retarded group (r = -0.06). Possible connections between these results and findings from inspection time studies are discussed. PMID- 3978354 TI - Development of face recognition: an encoding switch? AB - Two experiments were designed to examine Carey's (1978) theory that face recognition improves with age because young children (less than 10 years) encode predominantly piecemeal details from unfamiliar faces, whereas older children (greater than or equal to 10 years) and adults rely mainly on configurational information. In Expt 1, children (7-16 years) were tested for ability to recognize unfamiliar faces presented upright and inverted. Performance in the inverted condition was significantly poorer for all age groups. In a second experiment, subjects (4-8 years) were given a forced-choice, face recognition task. The tendency of young children to select incorrectly paraphernalia cues as a basis for identity judgements was found to be dependent on the similarity of the faces paired in each trial. These results suggested that Carey's original data were contaminated by floor effects. It was argued that there is insufficient evidence to endorse Carey's explanation of an encoding switch at age 10 years as a satisfactory account of the development of face recognition. PMID- 3978356 TI - The recognition of tachistoscopically presented words, varying in imagery, part of speech and word frequency, in the left and right visual fields. AB - Previous research has shown conflicting findings when subjects have performed some task involving words varying in imagery, part of speech (nouns versus verbs) and word frequency presented to the left and right visual fields. This problem was investigated in the present paper. In the first investigation, a group of subjects rated 308 words for imagery and part of speech. It showed that nouns tended to be of higher imagery than verbs. This implies that it is important to control for part of speech while investigating imagery, and vice versa. Experiments 2 and 3 investigated the effects of imagery and part of speech on recognition performance using different sets of words and subjects while keeping other aspects of the experiments identical. Conflicting results were found when the analysis regarded words as being a 'fixed effect' rather than a 'random effect' (cf. Clark, 1973). A quasi-F analysis revealed no significant effects due to either variable. When the data were combined from the two experiments, a quasi F analysis revealed that imagery had an equal effect in both visual fields. Thus we can draw the conclusion that the effect of imagery in both visual fields is reliable across both new subjects and new words. However, a sufficiently large sample is required in order to demonstrate this. No other effects were significant. Experiment 4 investigated the effect of frequency on report from the two visual fields. Quasi-F analysis revealed that the effect of frequency was larger in the right visual field than in the left visual field. We can conclude that this effect is reliable across both new subjects and new words--if a sufficiently large sample is used. The findings are discussed. in terms of whether one could ever draw conclusions on the basis of previous work, when the analysis had regarded words as a fixed effect. It was concluded that it was possible to draw tentative conclusions, but a firm conclusion could only be based on an experiment in which large numbers of words had been used and in which the results were significant on a quasi-F analysis. PMID- 3978357 TI - The experience of unemployment among black and white urban teenagers. AB - The psychological health and labour market commitment of 1150 unemployed 17-year olds in 11 urban areas of England were examined. Distress levels were significantly higher than among comparable employed samples, and symptoms had usually commenced after the onset of unemployment. Unemployed black respondents (of Afro-Caribbean descent) were found to exhibit significantly lower levels of distress and depression than whites. However, no differences were recorded between black and white respondents in respect of anxiety, financial strain and concern over being unemployed. Commitment to the labour market was significantly greater among white males than black males, perhaps because the latter have responded realistically to their disadvantaged labour market position. However, ethnic differences in commitment were generally absent in the case of females. Length of time out of work was unrelated to affective well-being and employment commitment in both ethnic groups, but job search attitudes were significantly less positive among respondents who had been unemployed for longer periods. PMID- 3978358 TI - Noise, biased probability and serial reaction. AB - Recent studies have shown that moderate intensity noise does influence performance although most studies showing effects of this level of noise have used verbal materials. An experiment showed that moderate intensity noise (85 dBC) also influences attentional selectivity in a serial reaction task which involved the processing of sensory information. Noise decreased response times to signals with high probabilities of occurrence but increased latencies for signals which occurred less frequently. Although attentional selectivity in noise depended on signal probability, it was not influenced by the spatial location of the signal. When a mode of responding is adopted in noise, subjects are often rather inflexible and continue to use this strategy even though it is inappropriate. This was demonstrated in the present study because the noise induced bias continued even when the signal probabilities were returned to normal. Previous studies using higher noise intensities have shown that noise often increases the number of errors or gaps. The moderate intensity noise used in the present study did not have this effect. PMID- 3978359 TI - Rice-bodies, synovial debris, and joint lavage. PMID- 3978360 TI - Use of sequential analysis to assess patient preference for local skin anaesthesia during knee aspiration. PMID- 3978361 TI - Methyl prednisolone infusion in rheumatoid arthritis. PMID- 3978363 TI - Peripheral joint involvement in polymyalgia rheumatica: a clinical study of 56 cases. AB - A follow-up study of 56 patients with the provisional diagnosis of polymyalgia rheumatica showed that 12 developed peripheral synovitis during the course of the illness. Five of the 12 were noted to have synovitis on presentation which was characteristically mild, pauci-articular and cleared quickly after commencing prednisolone therapy. The remaining seven had persistent synovitis of peripheral small joints despite an initial brisk response to oral prednisolone. Five of these patients were found to satisfy the ARA criteria for rheumatoid arthritis after a mean follow-up period of 3.5 years. It is suggested that the persistence of peripheral synovitis in patients treated as polymyalgia rheumatica should alert the clinician to the possible development of rheumatoid arthritis. PMID- 3978362 TI - A comparative study of the aetiological factors in shoulder pain. AB - Sixty patients presenting consecutively with shoulder pain to a rheumatology clinic have been studied. There was a significant association of shoulder capsulitis with diabetes mellitus and antecedent trauma when compared with supraspinatus tendonitis (SST). There were no immunological or other biochemical differences between the capsulitis and SST patients. The results suggest that patients with shoulder capsulitis should be investigated to exclude diabetes mellitus particularly when there is no history of antecedent trauma. PMID- 3978364 TI - Methods of X-ray assessment in rheumatoid arthritis: a re-evaluation. AB - We have re-examined the value of hand radiographs in the assessment of joint damage in rheumatoid arthritis in a series of related studies. Our objectives were: to assess the reproducibility of scoring hand radiographs and the relationships between different types of changes; to analyse the correlations between radiographic changes and hand function; and to assess the inter-relation between hand changes and overall joint damage. We confirmed the reproducibility of radiological assessments and showed that two observers can reproducibly score hand radiographs separately for joint space loss and erosions; both of these correlated with the Larsen score derived from standard radiographs. However, hand radiographic changes were not closely related to hand function; nor did they predict damage to large joints. Finally, examination of changes in 13 joint groups showed that there is a weak relationship between damage and disease duration, and the rate of damage is greatest in the initial years. We conclude that the status of hand radiography as a measure of overall outcome in rheumatoid arthritis remains an open question. PMID- 3978365 TI - Symptomatic osteoarthrosis of the knee: a follow-up study. AB - In a retrospective study at a single rheumatology centre of 72 patients with symptomatic arthrosis of the knee, more than 50% of the clinical phenomena improved within six months while patients were treated conservatively. This improvement appeared to be irrespective of age and duration of knee complaints except for a group of obese patients with symptoms for more than one year. PMID- 3978366 TI - The nature of arthritis pain. AB - A modified version of the McGill Pain Questionnaire in visual analogue format was used to evaluate the sensory, affective and evaluative intensities of pain experienced by 40 patients with rheumatoid arthritis and 20 patients with degenerative arthritis. The affective component of the pain was found to be more intense than the sensory component in all patients indicating the importance of emotional factors in the pain experience. The sensory aspects of the pain were more complex than the affective ones reflecting the varied sources and combinations of somatic pathology. There were no significant differences found in the overall pain experience between rheumatoid and degenerative arthritis. No differences were noted in the evaluative category of pain. Overall pain intensity increased with disease duration in both rheumatoid and degenerative arthritis. The relationship of affective and sensory components of the pain experience did not alter with duration of disease. PMID- 3978367 TI - Effects of joint lavage on knee synovitis in rheumatoid arthritis. AB - Ten patients with rheumatoid arthritis and persistent knee synovitis had synovial fluid aspirated through a 14 gauge wide-bore needle followed by joint lavage and intra-articular triamcinolone. This resulted in the removal of variable quantities of intra-articular debris including rice bodies. When compared to a control group of patients, the addition of joint lavage to the standard procedure of aspiration and injection of corticosteroid resulted in more sustained resolution of synovitis after 12 weeks as judged by knee tenderness and circumference, recurrence of effusion, and synovial fluid leucocyte count. This study suggests that knee joint lavage may be a useful adjunct to therapy in rheumatoid arthritis patients having persistent knee synovitis. PMID- 3978368 TI - The effect of a reversed ileal segment and artificial valve on intestinal transit and absorption following colectomy and low ileorectal anastomosis in the dog. AB - The main problem facing patients with ulcerative colitis after mucosal proctectomy and ileo-anal anastomosis (MP + IAA) is severe frequency of bowel action. Although the addition of a pelvic reservoir can improve matters, some patients still complain of this problem. In an attempt to slow transit, enhance absorption and improve function, we investigated the effects on these parameters of a reversed ileal segment, an artificial valve in an animal model. Studies were conducted before and after operation. The dogs randomly underwent either colectomy and low ileorectal anastomosis (IRA) alone (control, n = 12), IRA with a 10 cm reversed loop (IRA + RL, n = 10) or IRA with an artificial valve (IRA + valve, n = 10). Operative mortality rates were similar in the groups. Mean transit time (MTT) was significantly reduced after the control operation and after IRA + RL but not after IRA + valve. In addition MTT after IRA + valve (21 +/- s.d., 3.4 h) was significantly greater than in the other two groups (control = 12.1 +/- 4.3 h, IRA + RL, 12.8 +/- 5.5 h, P less than 0.04) and frequency of bowel actions seemed less. Measurements of absorption and nutritional state, however, did not differ significantly between the groups. Thus, although the artificial valve made no difference to absorption, it did prevent the reduction in MTT that occurred after the control operation whereas the reversed loop did not. This effect might thus benefit patients who undergo MP + IAA. PMID- 3978369 TI - Lesser curve disconnection using a stapling device: highly selective vagotomy made quicker and easier. AB - A stapling device has been used to disconnect the lesser curve of the stomach during highly selective vagotomy in a consecutive series of ten patients. This modification renders the operation technically easier and quicker to perform. Postoperative recovery was uneventful in all patients, and in the subsequent follow-up period of 7-15 months, no problems relating to the technique were encountered. PMID- 3978370 TI - Proximal gastric vagotomy in patients resistant to cimetidine. AB - Fifty-seven patients, with chronic duodenal ulceration resistant to cimetidine therapy, underwent proximal gastric vagotomy during the period August 1979 to May 1984. Thirty-five failed to respond to cimetidine in a dose of 1 g/day, whilst 22 relapsed on reduction of dosage to 400 mg daily or on cessation of therapy. Forty have been followed up for a period of 12-53 months (median duration = 28.5 months), and assessed using the modified Visick system. Thirty-four patients (85 per cent) were graded Visick I or II. Four patients (10 per cent) had non specific upper gastrointestinal symptoms (Visick III). In these patients endoscopy has shown no evidence of recurrent ulceration. Two patients (5 per cent) were graded Visick IV. One had recurrent ulceration on endoscopy. The other developed symptomatic gastro-oesophageal reflux, necessitating further surgery. These results support the view that cimetidine resistance is not a predictor of poor results following proximal gastric vagotomy. PMID- 3978371 TI - Carcinoma of the breast developing in a woman with an androgen-secreting tumour of the adrenal gland. PMID- 3978372 TI - Natural history of cystic disease: the importance of cyst type. AB - All breast cysts aspirated from a series of 100 patients followed for a minimum period of 2 years were classified on the basis of electrolyte composition as apocrine or flattened, this being the nature of the epithelium lining the two populations of breast cysts. Patients with a single cyst were more than 3 times as likely to have a flattened rather than an apocrine cyst. Multiple cysts, whether simultaneous or sequential in any individual patient, were usually all of the same type, and were more commonly apocrine than flattened. A comparison of the frequency of subsequent cysts in patients whose initial cysts were of either apocrine or flattened type showed further cysts were over 5 times more common in patients who presented with apocrine cysts. These observations suggest that the natural history of cystic disease is closely related to cyst type. PMID- 3978373 TI - Phaeochromocytoma and renal artery stenosis. PMID- 3978374 TI - Umbilical artery cutdown: an improved procedure for reinsertion. PMID- 3978376 TI - Allergic contact dermatitis to epoxy resin in ostomy bags. AB - Six ostomy patients presenting with peristomal rashes have been shown to be allergic to their ostomy bags and to epoxy resin. Subsequent investigation confirmed the presence in the bags of low molecular weight epoxy resin oligomers, which are known as potent contact sensitizers. PMID- 3978375 TI - Bilateral gastric venous decompression by a modified Warren shunt. AB - A new modification of the Warren shunt by which the coronary and short gastric venous systems can be simultaneously decompressed was carried out on two patients with oesophagogastric varices due to liver cirrhosis. One was an elective and the other an emergency operation. The left gastric vein entering the splenic vein was also drained through a Gore-Tex graft between the splenic and left renal veins. The proximal end of the splenic vein was ligated at its junction to the superior mesenteric vein. Porta-azygos disconnection was achieved by ligating the right gastric and gastro-epiploic veins. The shunt was patent and its effect on the varices was immediate with good decompression in both patients. The patients have had no recurrent variceal haemorrhage or postshunt encephalopathy. This modification may be indicated for selected patients with portal hypertension for both elective and emergency operations. PMID- 3978377 TI - Surgically correctable recurring pancreatitis. PMID- 3978378 TI - Diagnosis and management of spontaneous transmural rupture of the oesophagus (Boerhaave's syndrome). AB - The presentation, diagnosis and management of 14 cases of spontaneous transmural oesophageal rupture have been reviewed. Analysis suggested that the classical triad of vomiting, chest pain and subcutaneous emphysema was rare (1/14) and therefore misleading. Abdominal pain and tenderness obscured the clinical picture; the temporal relationship of pain to vomiting varied and subcutaneous emphysema was uncommon (4/14). Consequently, only two cases were correctly diagnosed on presentation and diagnosis in the others was markedly delayed (average 4 days). Contrast swallow examination, when eventually performed, was diagnostic. Twelve patients underwent repair: four under 24 h, who all survived and eight over 24 h, amongst whom there were one (12.5 per cent) operative and two (25 per cent) late deaths. Conservative management was successful in the remaining two cases. Oesophageal fistula, empyema and incorrect initial surgery were common and serious complications. Management options are reviewed and their relative merits considered. PMID- 3978379 TI - The management of spontaneous oesophageal perforation by thoracoscopy and irrigation. PMID- 3978380 TI - Mucosal bridges of the oesophagus in Candida oesophagitis. PMID- 3978381 TI - Malignant duodenocolic fistula: long-term survival following an extended right hemicolectomy with wide local excision of the duodenum. PMID- 3978382 TI - Reimplantation of the papilla of Vater. AB - Detachment of the papilla of Vater from the duodenum may happen (a) deliberately, during duodenal resection for tumour without concomitant resection of the pancreatic head, and (b) accidentally in the course of gastrectomy for duodenal ulcer, when attempts to exteriorize the ulcer are made. In this report two case histories are cited encompassing both of these circumstances, in which the ampulla was successfully reimplanted into a Roux loop. PMID- 3978383 TI - Cholecystectomy in the elderly: a prospective study. AB - The mortality and morbidity of 151 elderly patients (greater than 64 years of age) undergoing biliary surgery for benign disease were prospectively studied. The overall mortality was 3.3 per cent. This comprised a 0.77 per cent mortality in the elective group and a 19 per cent mortality in the emergency group. In spite of 77 per cent of the emergency group having a gangrenous gallbladder, a complication difficult to predict preoperatively, the majority of deaths were from cardiovascular disease. The overall incidence of common bile duct exploration was 36 per cent, which was similar in the elective and emergency groups. A comparison between the old (65-74 years) and the aged (over 74 years of age) revealed twice the number of emergency cases in the aged. Considering elective biliary surgery, there was no difference between the mortality, morbidity, or common bile duct exploration rate comparing the old with the aged. This suggests that elective biliary surgery is safe even in the aged. PMID- 3978384 TI - Pancreatic duct haemorrhage. PMID- 3978386 TI - Seat-belt aorta: isolated abdominal aortic injury following blunt trauma. PMID- 3978385 TI - Determination of necrosis in necrotizing pancreatitis. AB - The diagnosis of necrosis and its extent in acute necrotizing pancreatitis is one main problem in establishing criteria for possible pancreatectomy. With this in mind a clinicopathological analysis was carried out on 54 patients who had undergone pancreatic resection for acute necrotizing pancreatitis. The macroscopic appearance of the gland correlated poorly with its histology. Parenchymal necrosis varied from 0 to 100 per cent of the resected specimen though all the glands were considered totally or subtotally necrotic. In the clinicobiochemical status no criteria were found determining the extent of necrosis. Obesity, hypotension, hypocalcaemia and elevated serum creatinine in severely ill patients (as determined by Ranson criteria) strongly supported extensive peripancreatic and septal necrosis; however, 38 per cent of patients developed necrosis without those stigmata. While waiting for new methods to determine necrosis we prefer conservative treatment. In contrast to our previous tactics we think that resection should be limited to extreme cases in order to avoid resection of glands with limited necrosis and thus mainly reversible parenchymal damage. PMID- 3978387 TI - Non-traumatic metastatic clostridial myonecrosis in a seventeen-year-old. PMID- 3978389 TI - Problems with rectal foreign bodies. PMID- 3978388 TI - Persimmon bezoars as a cause of intestinal obstruction: pitfalls in their surgical management. PMID- 3978391 TI - Minitracheostomy. PMID- 3978390 TI - Computed tomography in gastric cancer. PMID- 3978392 TI - Postmastectomy breast reconstruction with an inflatable prosthesis. PMID- 3978393 TI - The oculomotor behaviour of human albinos. AB - Horizontal and vertical eye movements were recorded in 16 human albinos with a scleral search coil technique. Spontaneous nystagmus, responses to target steps, voluntary pursuit and optokinetic nystagmus (OKN) were assessed, including the effects of selective stimulation of the nasal or temporal halves of the retina. The results suggest a subdivision of albinos into three classes of oculomotor behaviour. Class I (n = 11) is characterized by vigorous spontaneous nystagmus (of the pendular unidirectional jerk or bidirectional jerk type), the absence of true horizontal OKN but the presence of the ability to control the direction of gaze in an imprecise way. In Class II (n = 2) there is a vigorous unidirectional jerk nystagmus which reverses in direction spontaneously or as a result of visual stimulation. Moving stimuli typically elicited inverted pursuit, the smooth eye movements having a direction opposite to that of the stimulus movement. Class III (n = 3) is characterized by very little or no spontaneous nystagmus and virtually normal oculomotor responses. Only pursuit of motion in the temporal direction, projected onto the temporal half retina, was defective. In all three classes, vertical eye movements were disturbed much less than horizontal. Anomalous visual projections (confirmed in all subjects by asymmetrical monocular visual evoked cortical potentials) are a likely basic cause underlying the oculomotor instability, but the large intersubject differences show that the eventual consequences of misrouting and secondary adaptations can vary widely among subjects. PMID- 3978394 TI - Cerebral somatosensory potentials evoked by muscle stretch, cutaneous taps and electrical stimulation of peripheral nerves in the lower limbs in man. AB - Somatosensory cerebral evoked potentials were recorded in man to natural forms of somatosensory stimulation of the lower extremity including stretching of the muscle tendons, tapping on muscle bellies and tapping on cutaneous surfaces. These potentials were compared with those evoked by electrical stimulation of peripheral nerves measuring the amplitudes and latencies of the evoked potential components and defining the effects of stimulus variables on these parameters. Spinal cord potentials could only be detected to electrical stimuli. Mechanical stimulation of tendons and muscle bellies evoked scalp potentials at latencies earlier than those evoked by electrical stimulation of the peripheral nerve and by cutaneous stimulation at the same level of the leg. Muscle receptors, most probably muscle spindles, are the source of the short latency components obtained by the stretching of tendons and tapping on muscle bellies. The proximal location of these receptors as well as very rapid spinal conduction account for the latency difference. The potentials were larger to electrical stimulation of nerve trunks than to mechanical stimulation of tendons or skin, suggesting the asynchronous activation of a smaller number of fibres by the latter. Individuals with the largest potentials to one form of stimulation usually had the largest potentials to the other modes of stimulation. The use of physiological stimuli such as muscle stretch to test the transmission in specific neural pathways might be useful in investigating the processing of relatively selective afferent volleys using noninvasive evoked potential recordings. PMID- 3978395 TI - Spatiotemporal responses of the visual system in demyelinating diseases. AB - Previous studies have shown that, in patients with lesions of the visual pathway, contrast sensitivity (CS) measured with stationary sine-wave gratings can demonstrate deficits, that is, anomalies in pattern detection. The purpose of this study was to investigate whether temporal processing can be affected in demyelinating lesions of the visual pathway. CS was measured for eight spatial frequencies (SF), using stationary and temporally modulated stimuli in a group of 10 patients with multiple sclerosis or optic neuritis. A control group was composed of 48 normal eyes. With stationary stimuli, CS losses were found in 17 eyes of patients; 11 of these eyes were 'unaffected'. The importance of the CS measurements in detecting early subclinical visual damage is emphasized. The effect of temporal modulation in patients with CS deficits was different from that observed in normals: CS deficits were modified by temporal variation in three distinct manners. In 7 eyes (type 1 effect), temporal modulation reduced the deficit at all SFs. In type 2 (5 eyes), the effect was reversed at low and high SFs: the deficit was reduced at low SFs (below 2-3 cycles/deg) and aggravated at high SFs. In type 3 (4 eyes), CS deficit was aggravated over most SFs. Thus these patients exhibited anomalies of the spatiotemporal responses which could not be predicted by the CS to stationary stimuli. Some theoretical models of spatiotemporal processing proposed in normal vision might account for our results. Possible explanations of these findings are proposed and discussed. PMID- 3978396 TI - Effects of ageing on local rates of cerebral protein synthesis in Sprague-Dawley rats. AB - The effects of ageing on local rates of protein synthesis in 39 brain structures in resting conscious rats have been examined. Young adult rats (aged 6 months) have been compared with a group of middle-aged/aged rats (aged 15-23 months). The results show that ageing is associated with significant decreases in rates of protein synthesis in the brain as a whole as well as in several specific brain regions. Brain regions involved in visual and auditory function were selectively affected, perhaps due to a chronic lack of sensory input. Several regions involved in motor function and two areas in the limbic system had significantly decreased rates of protein synthesis in the old rats. Notably, there was a significant age-related decrease in protein synthesis in the locus coeruleus which contains the cell bodies of origin of the major ascending noradrenergic innervation of the cortex. PMID- 3978397 TI - The effects of L-DOPA on regional cerebral blood flow and oxygen metabolism in patients with Parkinson's disease. AB - Studies performed on 18 patients with Parkinson's disease and 6 control subjects have shown that acute administration of L-DOPA in clinically effective doses gives rise to a diffuse increase in regional cerebral blood flow without accompanying stimulation of regional oxygen utilization. The data suggest that this rise in rCBF is caused by vasodilatation due to a direct action of the drug on the cerebral blood vessels. The effect of L-DOPA on rCBF did not correlate with the degree of clinical improvement seen in each patient after treatment. The therapeutic effect of L-DOPA in the brain was not reflected in any change of regional cerebral oxygen utilization as measured by our technique. We suggest that the pharmacological actions of L-DOPA in the brain take place on at least two different levels. PMID- 3978398 TI - Chronic optic nerve compression. An experimental study. AB - Chronic progressive compression of the optic nerve in the cat was produced by an inflatable silicon rubber balloon implanted in the orbit. Within the first week the predominant pathological change was demyelination. Both partially and completely demyelinated fibres were seen at all stages of the experiments but by the fifth week some axons had been remyelinated by oligodendrocytes despite the continued presence of the balloon. The myelin sheaths of the new internodes were abnormally thin and short, and many showed an atypical paranodal organization. There was evidence of breakdown of some of the new internodes. The pathophysiology of optic nerve compression in man is reviewed. PMID- 3978399 TI - A qualitative limitation on visual transfer via the anterior commissure. Evidence from a case of callosal agenesis. AB - Interhemispheric transfer of visual information was investigated in a patient with agenesis of the corpus callosum. CT scanning, pneumoencephalography, and neuropsychological evaluation failed to reveal any evidence of extracallosal cortical damage. The patient's performance was within normal limits both in the left and right visual fields on tasks requiring identification of briefly presented material. In contrast, his performance was abnormally poor when required simply to detect or localize a dot presented to the right of fixation. Performance with presentations in the left visual field was normal. These findings suggested that the absence of the corpus callosum may result in a selective impairment of visuospatial, but not identification, processes for material initially presented to the left hemisphere. To document this possibility further, the patient was tested on tasks designed to assess these processes simultaneously by requiring him both to identify and judge the exact location of each stimulus presented. Performance was normal in both lateral fields for identification accuracy, but significantly worse in the right visual field for location judgements. A similar pattern of results was found on a task requiring the identification of a stimulus and specification of its spatial orientation. These findings suggest a qualitative limitation on the type of information which may be transferred via the anterior commissure, possibly due to the inability of temporal lobe neurons to encode spatially organized information. Furthermore, the findings suggest that in the normal brain the right hemisphere may be crucially involved in visual attention and spatial functions, regardless of the field of presentation. PMID- 3978400 TI - Fundamental importance of arterial oxygen content in the regulation of cerebral blood flow in man. AB - The relationships between cerebral blood flow (CBF), arterial oxygen content, whole blood viscosity and the transport of oxygen to the brain have been studied in 54 subjects with variations in arterial oxygen content resulting from alterations in haemoglobin concentration ranging from 5.7 to 19.1 g/dl. A highly significant relationship was found between CBF and arterial oxygen content, CBF altering to maintain the rate of transport of oxygen to the brain within certain limits. No significant effect of changes in blood viscosity was evident. In a multiple regression analysis arterial oxygen content emerged as the major determinant of CBF and after this effect had been taken into account there was no significant influence of blood viscosity, arterial pCO2, age or mean arterial blood pressure. The results imply that the alterations in CBF found in subjects with anaemia and polycythaemia are primarily physiological and not caused by the accompanying alterations in blood viscosity. It is proposed that the response of the cerebral circulation to arterial oxygen content is mediated by a local mechanism sensitive to alterations in local tissue oxygen tension. PMID- 3978401 TI - Weight appreciation in the hand in normal subjects and in patients with leprous neuropathy. AB - The Weber fraction was used as an index of the sensitivity with which subjects appreciated weights ranging from 20 to 500 g suspended from the middle finger. Normal subjects were able to appreciate weight when it caused cutaneous compression alone. The sensitivity increased when subjects lifted weights by flexing the metacarpophalangeal joint. This increase was more marked for weights ranging from 20 to 100 g than for weights ranging from 200 to 500 g. When subjects lifted weights by flexing the elbow joint, the sensitivity with which they appreciated weight was comparable to that from cutaneous compression alone. Leprous subjects having glove anaesthesia were unable to appreciate any weight up to 500 g when it caused cutaneous compression alone. However, they were able to appreciate weights above 200 g when they lifted weights by flexing the metacarpophalangeal or elbow joints. PMID- 3978402 TI - Right hemisphere appreciation of prosodic and linguistic indications of implicit attitude. AB - Appreciation of attitudes conveyed through prosodic cues and lexical content was examined in subjects with temporal lobe seizure foci. One task involved auditory judgments of the consistency of verbal and intonational meaning of sentences. Errors on judgments of consistent verbal and prosodic stimuli were not only more frequent in the right temporal group than in left temporals or controls but were strongly related to neuropsychological indices associated with extent of right temporal involvement. Answering questions based on written narratives in which multiple attitude markers were either redundant or conflicting comprised the second task. Right temporal patients as a group had difficulty in answering inferential questions about paragraphs with inconsistent indicators of attitude. Even low-scoring right temporals were able, however, to answer inferential and factual questions when the verbal context markers consistently reinforced a particular attitude. PMID- 3978403 TI - Contrasting speech patterns in apraxia of speech and phonemic paraphasia. AB - This study was designed to determine if perceptual phonological analysis would reveal distinctions between patients with apraxia of speech and patients with phonemic paraphasic speech. Test findings from 10 Broca's aphasics with apraxia of speech were compared to findings from 10 paraphasic speakers (5 conduction and 5 Wernicke's aphasics). Several marked differences were revealed. Predominant locus of errors and relative difficulty of different classes of phonemic segments were significant discriminators. There was a nonsignificant trend for substituted phonemes to be further from target phonetically in the paraphasic patients. In addition, the two groups showed certain consistent differences in the types of errors they produced. Apraxic patients produced many errors of transitionalization, while sequencing errors were more typical of the patients with phonemic paraphasia. The findings are interpreted in relation to a neuropsychological model of speech. It is suggested that phonemic paraphasia represents a breakdown mainly in the retrieval of phonological word patterns, while apraxia of speech is characterized predominantly by a disturbance in encoding phonological patterns into appropriate speech movements. PMID- 3978404 TI - Extending formant transitions may not improve aphasics' perception of stop consonant place of articulation. AB - Synthetic speech stimuli were used to investigate whether aphasics' ability to perceive stop consonant place of articulation was enhanced by the extension of initial formant transitions in CV syllables. Phoneme identification and discrimination tests were administered to 12 aphasic patients, 5 fluent and 7 nonfluent. There were no significant differences in performance due to the extended transitions, and no systematic pattern of performance due to aphasia type. In both groups, discrimination was generally high and significantly better than identification, demonstrating that auditory capacity was retained, while phonetic perception was impaired; this result is consistent with repeated demonstrations that auditory and phonetic processes may be dissociated in normal listeners. Moreover, significant rank order correlations between performances on the Token Test and on both perceptual tasks suggest that impairment on these tests may reflect a general cognitive rather than a language-specific deficit. PMID- 3978405 TI - Ear asymmetries in dichotic listening tasks which increase in difficulty. AB - Accuracy and laterality of ear preference in repeating 2, 3 and 4 word pairs (WP) of dichotic stimuli in English and French were determined in 80 right-handed subjects (anglophone/francophone, male/female), who were tested in both their native language (L1) and nonnative language (L2). Relative performance accuracy decreased as a function of word pairs per trial (from 2 to 4) as well as language (from L1 to L2). Right-lateral preference in turn increased as a function of WP (from 2 to 4) as well as language (L1 to L2). Right-ear advantage (REA) in L2 decreased as a function of language proficiency (low to high). REA was observed in over 90% of subjects. A rationale for greater lateralization of L2 performance is offered. PMID- 3978406 TI - Picture-naming in aphasia. AB - The distribution of picture-naming errors for Broca's aphasics (n = 9), Wernicke's aphasics (n = 9), conduction aphasics (n = 9), frontal anomics (n = 7), and posterior anomics (n = 9) was examined to determine the diagnostic power of error types in picture-naming. Negated responses were associated with Broca's aphasia, whole-part errors ("hose" for nozzle) were associated with frontal anomia, and poor phonemic cuing was associated with Wernicke's aphasia. In addition, the relative distribution of the three most prominent naming errors phonemic errors, semantic errors, and multiword circumlocutions-tended to distinguish the two anomic subgroups from the other aphasia subgroups. Anomic aphasics produced the fewest phonemic errors and the most multiword circumlocutions; this pattern suggests minimal word-production difficulty in anomic aphasia relative to the other aphasia syndromes. Despite such group differences, the overall picture indicates that there is considerable similarity among aphasia syndromes in terms of picture-naming behavior. PMID- 3978407 TI - Language lateralization in English-French bilinguals. AB - Forty English-French bilinguals divided into equal numbers of nonfluent and fluent subjects took part in a dichotic listening test involving both intralingual and interlingual conditions. No difference in lateralization was found between primary and secondary language in either condition. In the intralingual condition, however, fluent bilinguals showed a significantly lower right ear advantage than did their nonfluent counterparts. In the interlingual condition, French-dominant subjects were found to be more ambilateral than English-dominant subjects, while both groups tended to respond preferentially to French words. These results suggest that growing bilingual proficiency does increase left ear/right hemisphere participation, but in intralingual situations only. Moreover, when both languages are contrasted, French appears to be more salient than English. PMID- 3978408 TI - Self-monitoring behavior in a case of severe auditory agnosia with aphasia. AB - This case report describes an unusual combination of speech and language deficits secondary to bilateral infarctions in a 62-year-old woman. The patient was administered an extensive series of speech, language, and audiologic tests and was found to exhibit a fluent aphasia in which reading and writing were extremely well preserved in comparison to auditory comprehension and oral expression, and a severe auditory agnosia. In spite of her auditory processing deficits, the patient exhibited unexpected self-monitoring ability and the capacity to form acoustic images on visual tasks. The manner in which she corrected and attempted to correct her phonemic errors, while ignoring semantic errors, suggests that different mechanisms may underlie the monitoring of these errors. PMID- 3978409 TI - Different methods of lexical access for words presented in the left and right visual hemifields. AB - Right-handed adults were asked to identify by name bilaterally presented words and pronounceable nonwords. For words in the normal horizontal format, word length (number of letters) affected left visual hemifield (LVF) but not right visual hemifield (RVF) performance in Experiments 1, 2, 3, 5, and 6. This finding was made for words of high and low frequency (Experiment 6) and imageability (Experiment 5). It also held across markedly different levels of overall performance (Experiments 1 and 2), and across different relative positionings of short and long words in the LVF and RVF (Experiment 3). Experiment 4 demonstrated that the variable affecting LVF performance is the number of letters in a word, not its phonological length. For pronounceable nonwords (Experiment 7) and words in unusual formats (Experiment 8), however, length affected both LVF and RVF performance. The characteristics identified for RVF performance in these experiments also hold for the normal reading system. In this (normal) system the absence of length effects for horizontally formatted words is generally taken to reflect the processes involved in lexical access. Length effects in the normal reading system are thought to arise when lexical access for unusually formatted words and for the pronunciation of nonwords requires the short-term storage of information at a graphemic level of analysis. The characteristics of LVF performance indicate that horizontally formatted words presented to the right cerebral hemisphere can only achieve lexical access by a method that requires the short-term storage of graphemic information. This qualitative difference in methods of lexical access applies regardless of whether the right hemisphere is seen as accessing words in the left hemisphere's lexicon or words in a lexicon of its own. PMID- 3978410 TI - Purdue pegboard performance of disabled and normal readers: unimanual versus bimanual differences. AB - Differences between dyslexics and controls in the unimanual and bimanual conditions of the peg placement section of the Purdue Pegboard Test were examined. Twenty-three disabled and twenty-three normal readers were studied. The groups were carefully screened on a neuropsychological battery. The disabled readers were comprised of a relatively homogeneous language-disordered subgroup exhibiting deficits in naming. Significant Group X Condition interactions were obtained for both raw and percentile scores and indicated that disabled readers performed worse than controls in the unimanual compared to bimanual conditions. The dyslexics performed particularly poorly compared with controls on the left hand condition. The implications of these data for hypotheses which argue for left hemisphere dysfunction, as well as those which posit interhemispheric transfer deficits in reading disabled children, are discussed. PMID- 3978411 TI - Myelinated non-axonal neuronal elements in the feline olfactory bulb lack sites with a nodal structural differentiation. AB - Myelinated dendrites in the external plexiform layer (EPL) of the feline olfactory bulb and myelinated axons in the lateral olfactory tract (LOT), were examined by transmission electron microscopy. The results show that the non axonal myelin sheaths are extremely thin and short and that the number of myelin lamellae does not increase with increasing dendritic diameter. In myelinated LOT axons the sheaths tend to be thicker and the myelin lamellar number increases with axon diameter. Domains with node-like structural characteristics are not encountered along myelinated dendrites, neither between successive myelin sheaths nor where single sheaths terminate. The partly myelinated neuronal perikarya, which occur in the EPL, also lack node-like domains. In contrast, typical nodes are easily found in myelinated LOT axons. In the periglomerular region dendrites and neuronal perikarya are surrounded by non-compacted glial sheets. It is concluded that myelination and node formation are relatively independent events and that morphogenetic glial-neuronal interactions may give different results in different parts of the same neuron. PMID- 3978412 TI - Effect of locus coeruleus stimulation on regional cerebral oxygen consumption in the cat. AB - Regional cerebral oxygen consumption was determined during stimulation of the intra-axial noradrenergic pathway to quantitate the metabolic effects of this manipulation on cerebral oxygen extraction, cerebral blood flow (CBF) and its regional distribution. Regional arterial and venous oxygen saturation were examined microspectrophotometrically. Regional CBF was examined using radioactively tagged microspheres (15 +/- 3 microns in diameter). Oxygen consumption was calculated as the regional product of CBF and oxygen extraction. Bipolar concentric electrodes were stereotaxically implanted bilaterally in the locus coeruleus of alpha-chloralose anesthetized, artificially respired adult mongrel cats. The control group was killed after hemodynamic and CBF measurements were taken. The experimental group was sacrificed after these same measurements were taken before and during 10 min of bilateral locus coeruleus stimulation. The cats' heads were simultaneously sawed in 3 places and quickly frozen in liquid nitrogen-cooled propane. Systolic blood pressure was significantly increased during treatment. The heterogeneity of venous oxygen saturation was significantly reduced by stimulation. Average CBF and oxygen consumption were significantly decreased to 57% and 59% of control, respectively. Oxygen consumption was significantly reduced in the hypothalamus from 1.5 +/- 0.3 to 0.9 +/- 0.3 ml O2/min/100 g and from 3.5 +/- 0.9 to 1.2 +/- 0.4 ml O2/min/100 g in the cerebellum by treatment. Changes in the neuronal and/or synthetic cerebral activity produced regional decreases in cerebral oxygen consumption and secondarily altered CBF. These changes are probably due to interaction of the intraparenchymal noradrenergic pathways with other systems or processes in the brain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978413 TI - The coincidental effects of dehydration and rehydration on plasma and cerebrospinal fluid angiotensin II levels in unrestrained steers. AB - Changes in plasma (pAII) and cerebrospinal fluid (csf AII) immunoreactive angiotensin II have been measured in 6 unrestrained steers during dehydration and rehydration. Prior to dehydration, plasma osmolarity (pOsm) was 301.3 +/- 0.62 mOsm/l (mean +/- S.E.M.) and on dehydration progressive elevation of pOsm developed so that after 4 days it was 338.5 +/- 3.00 mOsm/l (P less than 0.001). Packed cell volume was elevated during dehydration from 39.9 +/- 0.64% to 44.7 +/ 1.24% (P less than 0.001). Radioimmunoassay (RIA) of pAII indicated a similar pattern of progressive elevation during dehydration when after 4 days pAII had risen from 54.7 +/- 11.6 fM/ml to 177.6 +/- 18.4 fM/ml (P less than 0.001). RIA of csf AII, however, indicated no complementary pattern of change during dehydration, the only significant alteration from basal levels of 166.0 +/- 13.2 fM/ml occurred after 2 days when csf AII was reduced to 83.1 +/- 14.5 fM/ml (P less than 0.01). Antiserum specificity tests indicated that some of the csf AII could have been due to metabolites of AII, and high performance liquid chromatographic separation of angiotensin peptides in csf suggested that the major contributants were AII and AIII. These analogues which may have central neural effects were not consistently elevated during dehydration of cattle. It is concluded therefore, that the role of angiotensin in central neural mechanisms of fluid balance in dehydrated animals depends primarily on the systemic renin angiotensin system and not an endogenous brain renin-angiotensin system. PMID- 3978414 TI - Differential effects of naloxone on the release of neurohypophysial hormones in normotensive and spontaneously hypertensive rats. AB - The hypothalamo-neurohypophysial system is altered in the spontaneously hypertensive rat (SHR). We hypothesized that an aberrant regulation of vasopressin (VP) and oxytocin (OT) release by endogenous opioid peptides alters this neuroendocrine system in the SHR. Concentrations of the neurohypophysial hormones in plasma and the pituitary were measured in 17-week-old SHRs and two strains of normotensive controls. Wistar Kyoto (WKY) and Sprague-Dawley rats. Animals were decapitated 20 min after s.c. injection of saline (1 ml/kg) or naloxone hydrochloride (1 or 10 mg/kg). In addition, neurohypophysial hormones excreted during the day (08.00-17.30 h) and night (17.30-08.00 h) were determined in urine from 16-week-old animals kept in metabolic cages for 5 days. VP at extrahypothalamic sites was also measured as [VP] in acid extracts of the subfornical organ area, hippocampal commissure-fornix and choroid plexus. Hormones were quantified by radioimmunoassay. The pituitary content, plasma concentration, and urinary excretion of OT were reduced (P less than 0.05) in SHRs, whereas VP content was increased (P less than 0.05) in the pituitary and plasma, but unchanged in urine, of hypertensive animals. In extrahypothalamic tissues, [VP] in the hippocampal commissure-fornix was increased in the SHR. Naloxone elevated (P less than 0.05) the plasma concentration of OT in WKY animals and VP in SHRs. Neither [VP] nor [OT] in plasma was changed by naloxone in Sprague-Dawley rats. Pituitary stores of the neurohypophysial hormones were not altered by naloxone in either hypertensive or normotensive rats. In conclusion, endogenous opioid peptides tonically inhibit OT release in WKY rats, whereas VP release is decreased by opioid peptides in SHRs, 16-17 weeks of age. The neuromodulatory role of opioid peptides in the release of neurohypophysial hormones appears to be altered in the SHR such that VP release is suppressed and OT release is augmented. PMID- 3978415 TI - Metabolic alterations of endoneurial lipids in developing trembler nerve. AB - In vitro incorporation of [14C]acetate into desheathed sciatic nerve (endoneurium) was studied in developing normal and mutant trembler mice. The total uptake of [14C]acetate peaked 6 days after birth and decreased thereafter for both normal and trembler mice. Substantially less [14C]acetate (approximately 50% of normal) was incorporated in trembler mouse as early as 3 days after birth. In 3 and 6 day-old trembler mice, proportionately less [14C]acetate was incorporated into phospholipids and cerebrosides and more was incorporated into cholesterol. From 9 days, however, less [14C]acetate was incorporated into cholesterol of trembler compared to normal nerve. At later times (greater than or equal to 20 days), the proportion of [14C]acetate in both phospholipids and cerebrosides of trembler nerve was increased above that of controls. Throughout development, the relative incorporation of [14C]acetate into triacylglycerol and cholesteryl esters was about two times higher in trembler than in normal mice. In normal nerve, the 14C-label in free fatty acids increased (4-25%) progressively with age. In contrast, this incorporation in trembler nerves remained constantly low (less than 7%). Morphologically, the nerves of trembler mouse are markedly hypomyelinated. The abnormal myelin sheath undergoes cycles of breakdown and partial regeneration. Thus, the biochemical profile of extended active but perturbed lipid metabolism may provide a basis for the morphologic findings of continued active but ineffective myelination in trembler peripheral nerve. PMID- 3978416 TI - The noradrenergic innervation of vasopressin neurons in the paraventricular nucleus of the hypothalamus: an ultrastructural study using radioautography and immunocytochemistry. AB - Immunocytochemical and radioautographic procedures were combined at the ultrastructural level to study the noradrenergic synaptic input to vasopressin neurons in selected portions of the paraventricular nucleus of the hypothalamus (PVN) of the rat. Radioactive norepinephrine (NE) was infused into the lateral ventricle or applied topically to the region of the PVN. After appropriate survival times, brain tissues were processed for ultrastructural immunocytochemical demonstration of vasopressin using a monoclonal antibody. [3H]NE varicosities were detected by electron microscopic radioautography. In the periventricular zone of the PVN, radioactive varicosities were numerous accounting for 20-30% of all nerve terminals in this zones. These NE terminals primarily innervated dendritic processes of non-vasopressinergic neurons. Although an occasional axosomatic synapse was observed, input to vasopressin positive neurons was exclusively to their dendrites. In the lateral magnocellular sub-nucleus of the PVN (designed pvl2), noradrenergic terminals were fewer in number accounting for only 1-2% of the total. These terminals were found predominately but not exclusively making axodendritic synapses onto non vasopressin processes. In both regions, many of the radiolabeled terminals had well-defined membrane appositions with their post-synaptic partners which included a synaptic cleft and post-synaptic density of varying thickness. In both the periventricular zone and the lateral magnocellular regions, noradrenergic varicosities were seen in close proximity to numerous blood vessels. PMID- 3978418 TI - Hippocampal unit activity and delayed response in the monkey. AB - Single unit activity was recorded from the hippocampus while Japanese monkeys (Macaca fuscata, n = 4) were performing a delayed response (DR) task. A total of 272 units showed an obvious change in discharge rate in relation to the events of the DR task. These 272 related units were classified into 6 groups: cue-light related units (n = 24), cue- and choice-light related units (n = 41), choice light related units (n = 21), response-related units (n = 51), reward-error units (n = 17), and delay units (n = 118). Reward-error units contained reward-related and error-related units. Error-related units showed changes in firing after incorrect responses and/or after omission of reward on correct trials. It is noteworthy that 43.4% of the related units are delay units which showed increased or decreased firing preferentially during the delay period. Some units showed a differential firing pattern during cue or delay period depending on the spatial position of the cue. The results of the present study are interpreted as an experimental evidence for the involvement of the hippocampus in DR task. PMID- 3978417 TI - Catecholaminergic activity of the baroreceptor areas of the brain in response to bilateral dorsolateral transection of medulla oblongata in rats. AB - Central catecholaminergic activity was studied by measurement of norepinephrine (NE), epinephrine (EPI), their metabolites: total 3-methoxy-4-hydroxyphenylglycol (MHPG) and 3,4-dihydroxyphenylglycol in brain nuclei in response to bilateral dorsomedullary knife-cut (DMK-cut) in rats. In saline-pretreated conscious rats DMK-cut caused a marked hypertension, tachycardia and increases in plasma NE, EPI and vasopressin. Chlorisondamine (CHL) prevented the rise in plasma catecholamines and the tachycardia but failed to prevent the hypertension and the increment in plasma vasopressin. DMK-cut decreased NE and EPI in the nucleus tractus solitari (NTS) and A2 area; there were no catecholamine changes in A1 area or the periventricular nucleus but an increase in the paraventricular nucleus (PVN), the latter effect reversed by CHL. CHL alone or combined with DMK cut had no effect on catecholamine concentrations in NTS-A2 area but lowered MHPG content. It is suggested that DMK-cut decreases the activity of the catecholaminergic system originating in A1 and terminating in PVN, where it causes catecholamine accumulation and may be involved in vasopressin release and thereby contribute to hypertension. In NTS-A2 area, however, the DMK-cut appears to increase catecholaminergic activity since catecholamines are depleted. Central effects of DMK-cut differ from those of ganglionic blockade-induced inhibition of the baroflex presumably due to sectioning of other pathways in addition to the primary baroreceptor input. PMID- 3978419 TI - Nucleus basalis neurons exhibit axonal branching with decreased impulse conduction velocity in rat cerebrocortex. AB - Single neurons in the basal forebrain (nucleus basalis area) were antidromically activated from the frontal or parietal cortex in anesthetized rats. Wide ranges of antidromic latencies were observed overall, with frontal and parietal stimulation yielding values ranging from 1.0 to 26.0 ms and 1.6-24.0 ms, respectively. Individual neurons often exhibited multiple antidromic latencies, such that deeper sites of stimulation or greater stimulation amplitudes generally yielded discretely different, shorter latencies than more superficial sites or lower amplitudes of stimulation. Single neurons were also often driven from neighboring sites (1-2 mm apart) within the frontal cortex, but no cell was coactivated from both frontal and parietal cortices. Finally, patterns and rates of spontaneous activity varied markedly among these cortically projecting neurons, with some cells being non-spontaneous and others exhibiting tonic rates of 30-40 Hz. Impulse waveforms also differed among driven cells, from relatively low-amplitude, negative spikes to large-amplitude, entirely positive spikes in unfiltered signals. These results indicate that cortically projecting, putatively cholinergic neurons in the basal fore-brain form a physiologically heterogeneous population in terms of impulse conduction velocity, spontaneous discharge, and spike waveforms. Our finding of multiple antidromic latencies and driving from neighboring sites indicate that these fibers may be highly branched in local terminal fields, but that individual cells may project exclusively to a single cortical area. Faster conduction velocities for deep compared to superficial cortical stimulation sites imply that these fibers may become non-myelinated upon entering cortical terminal fields, or that they may become markedly thinner as they travel within the cortex. This system of cholinergic cortical afferents differs in many physiologic aspects from the other non-thalamic cortical input systems of catecholamine or indoleamine neurons. PMID- 3978420 TI - Protective effect of diazepam pretreatment on soman-induced brain lesion formation. AB - Histopathological analyses of brains of rats receiving a single 0.9 LD50 injection of soman, a potent anticholinesterase neurotoxin, revealed massive widespread lesions in the cerebral cortex and thalamus 4 weeks post-injection. Such lesions were not evidenced in rats receiving diazepam (2.2 mg/kg, i.m.) 10 min prior to soman treatment. Thus, anticonvulsant antidotes may aid in preventing extensive or permanent brain damage in rats surviving near-lethal soman dosages. PMID- 3978421 TI - Single intralaminar thalamic neurons project to cerebral cortex, striatum and nucleus reticularis thalami. A retrograde anatomical tracing study in the rat. AB - The hypothesis of triple axonal branching to the cortex, striatum and nucleus reticularis thalami (RT) of the forebrain projecting thalamic intralaminar neurons (TIN) was studied by retrograde axonal transport of horseradish peroxidase (HRP), iron-dextran complex and [3H]wheat germ agglutinin [3H]WGA. The best combination of tracers for this purpose was demonstrated to be: HRP-pellet implantation in the rostral cortex, iron-dextran injections into the striatum and [3H]WGA injections into the rostral RT. Prussian blue labeled neurons were observed in the ipsilateral TIN, substantia nigra, mediodorsal nucleus, medial part of the ventral anterior-ventral lateral complex, anterior medial and anterior ventral nuclei. HRP labeled neurons were observed in ipsilateral ventral nuclei, mediodorsal nucleus and the TIN. Radiolabeled neurons were located only in the TIN. HRP-Prussian blue labeled neurons (cortex-striatum branched neurons) were scattered in the TIN. Prussian blue radiolabeled neurons (striatum-RT branched neurons) could be observed in the TIN, as well as a few HRP radiolabeled neurons (cortex-RT branched neurons). Triply labeled neurons were scattered throughout the TIN until the rostral part of the centre median nucleus. These results demonstrate the existence of triple axonal branching on TIN efferent axons directed to the cerebral cortex, striatum and RT. The RT directed branch provides an anatomical basis to describe an intrathalamic regulatory loop well suited to control ascending messages arising from the TIN. PMID- 3978422 TI - Descending lumbosacral cord potentials (DLCP) evoked by stimulation of the median nerve. AB - In 22 normal human subjects, descending lumbosacral cord potentials (DLCP) were recorded intrathecally after stimulation of the median nerve at the elbow. The onset of DLCP is very short in latency (mean 12.1 ms) with a prominent sharp early positive peak (mean latency 13.7 ms) followed by a sharp negative peak (mean 17.6 ms). The amplitude of the first part of DLCP varied between 0.6 and 6.7 microV (mean 2.3 microV). The response was recorded most easily when the tip of intrathecal electrode was posterolaterally positioned. The threshold of the response was above or around the excitation threshold of the motor nerve fibers and it could not be produced by pure skin nerve stimulation. It resisted to subtetanic peripheral shocks. Mean peripheral conduction velocity responsible for the response was about 60.8 m/s. Some late and slower deflections appeared in many cases. It was concluded that the DLCP must have originated from the descending and very fast conducting propriospinal pathways located within the anterolateral funiculus which has an oligosynaptic anatomical organization. This response seemed to be the first direct evidence of interlimb reflex action between the arm and leg in man which is important in the coordination of movements and posture. PMID- 3978423 TI - Retinotectal synapses formed by ipsilaterally projecting fibers in the doubly innervated goldfish tectum. AB - When one tectum of an adult goldfish is removed, the severed retinal fibers regenerate ipsilaterally into the remaining tectal lobe. Initially fibers from the two eyes overlap in the tectum but EM-HRP data suggest that few mature retinal synapses are formed between the ipsilateral eye and tectum at this time. At longer time periods, when some fibers appear to segregate into eye-specific termination bands, our data suggest that a significant number of synapses from the ipsilateral eye are present. These findings have important implications for how eye-specific termination bands are formed in doubly innervated tecta. PMID- 3978424 TI - Regulation of intracellular pH in vertebrate central neurons. AB - The regulation of intracellular pH (pHi) was investigated in reticulospinal neurons of the lamprey using ion-selective microelectrodes. Steady-state pHi in 23 mM HCO-3-buffered Ringer was 7.44 +/- 0.03 with a membrane potential of 54 +/- 4 mV (mean +/- S.E.M., n = 6). In nominally HCO-3-free solutions, pHi recovery from acid loading was blocked by 10(-3)M amiloride. Recovery was stimulated by transition to HCO-3-containing solutions. Results suggest that pHi regulation in lamprey reticulospinal neurons is mediated by a Na+-H+ exchanger. The presence of a distinct, HCO-3-dependent pHi regulatory mechanism is postulated. PMID- 3978425 TI - Some insect sensory neurones contain 5-hydroxytryptamine. AB - Immunocytochemistry of the locust central nervous system shows that most segmental nerves, in particular those of the legs, contain afferent fibres that react with antibody to 5-hydroxytryptamine (5-HT). Adsorption controls indicate that the antigen is 5-HT or a closely related compound. This is supported by the finding of significant amounts of 5-HT in leg nerves using reverse phase high performance liquid chromatography (HPLC) and electrochemical detection. On the other hand 5-HT was not detectable in locust antennal and cercal nerves with either immunocytochemistry or with HPLC. These results strongly support that some populations of sensory neurones in the locust contain 5-HT. PMID- 3978427 TI - Bicuculline blocks circadian phase delays but not advances. AB - Phase delays of hamster locomotor rhythms, which normally can be produced by light pulses given in the early subjective night, were blocked by bicuculline, a selective antagonist of gamma-aminobutyric acid (GABA) activity. Phase advances induced by light pulses given in the late subjective night were unaffected by bicuculline. This suggests that GABA may be involved in the mediation of some, but not all, light input to the mammalian circadian system. Furthermore, it raises the possibility that light input may be mediated at different circadian time points by functionally separate pathways. PMID- 3978426 TI - The effects of diisopropylfluorophosphate on spatial frequency responsivity in the cat visual system. AB - Visual-evoked responses to counterphased gratings were recorded from area 17 of cat visual cortex before and after diisopropylfluorophosphate (DFP) administration. DFP produced effects similar to those obtained following physostigmine sulfate administration, in that responses to low spatial frequencies were preferentially reduced. The time course of the effects was quite different for the two types of drugs, and for high doses of DFP responses to all spatial frequencies were approximately uniformly depressed or abolished. PMID- 3978428 TI - Differential distribution of locus coeruleus projections to the hippocampal formation: anatomical and biochemical evidence. AB - Locus coeruleus (LC) fibers in the fornix mainly innervate the septal pole of the dentate gyrus, whereas the cingulum projects to the ventral hippocampal formation to provide LC input to the dentate gyrus. LC fibers in the ventral amygdaloid bundle have a wide-spread distribution, innervating the entire hippocampal gyrus, as well as the mid-septotemporal and temporal regions of the dentate gyrus. The LC fibers of the fornix and ventral amygdaloid bundle do not appear to overlap significantly in the septal pole of the dentate gyrus. PMID- 3978429 TI - Deficits in manipulative behaviors induced by local injections of muscimol in the first somatosensory cortex of the conscious monkey. AB - Injection of muscimol (GABA agonist) in the finger region of area 2 of the alert monkey led to the striking yet reversible loss of finger coordination, thus disabling the monkey from picking up a small piece of food from a small hole or a funnel. Symptoms varied depending on sites of injection within the finger region. Neither weakness of hand or finger movements nor deficit in hand reach was observed. PMID- 3978431 TI - GABAergic control of the cholinergic projections to the frontal cortex is not tonic. AB - The turnover rate of acetylcholine was measured in the frontal cortex of rats after either microinjection of bicuculline into the substantia inominata (the source of the cortical cholinergic innervation) or kainic acid lesioning of the nucleus accumbens (the source of GABAergic innervation of the substantia inominata). Neither treatment affected cortical acetylcholine metabolism, suggesting that the GABAergic inhibition of the substantia inominata-cortical cholinergic pathway is not tonic. PMID- 3978430 TI - Chronic haloperidol inactivates brain noradrenergic neurons. AB - Rats were administered haloperidol (0.5 mg/kg/day) for 21 days. Twenty percent of locus coeruleus (LC) neurons recorded were not spontaneously active, while no such neuron was observed in control animals. A further 22% of neurons (spontaneously active) had rates greater than 2 standard deviations from the mean of LC control cells. These results reveal that haloperidol has profound effects on LC neurons that develop with prolonged administration, indicating a possible role of brain noradrenergic systems in clinical effects (and possible side effects) of this neuroleptic. PMID- 3978432 TI - Brainstem immaturity in sudden infant death syndrome: a quantitative rapid Golgi study of dendritic spines in 95 infants. AB - Quantitative analysis of reticular dendritic spines was performed on rapid Golgi impregnated neurons in 7 brainstem areas from 61 sudden infant death syndrome (SIDS) and 34 control infants. Throughout the first postnatal year, mean spine density in SIDS was significantly greater than the mean density in controls (P less than 0.0001). There were significantly higher values of spine density in SIDS compared to controls (P less than 0.0001) in both term and preterm infants. Within the SIDS brainstem itself, the density of dendritic spines was significantly different (P less than 0.05) between two medullary regions and between reticular and non-reticular formation areas. Among these brainstem areas in controls, there was no significant difference. Our findings indicate an immature developmental pattern of increased dendritic spine density in the SIDS brainstem which may be responsible for abnormal central respiratory and arousal control. These significant quantitative differences in spine density are considered in the present study to represent an anatomical substrate of brainstem immaturity in the multifactorial pathogenesis of SIDS. PMID- 3978433 TI - Vasopressin cells in the bed nucleus of the stria terminalis of the rat: sex differences and the influence of androgens. AB - A sex difference in the number of vasopressin-immunoreactive cells was found in the bed nucleus of the stria terminalis of the rat. The number of cells found in males exceeded the female corresponding value. A sharp decrease in the number of vasopressin-immunoreactive cells was noted 21 weeks after the castration of adult male rats. This decline could be reversed completely by a 5-week testosterone substitution therapy. PMID- 3978434 TI - Peripheral and central distribution of major branches of the facial taste nerve in the carp. AB - The major pathways of the peripheral facial taste system in the carp, Cyprinus carpio, are the maxillary (Max), mandibular (Mand), palatine (Pal) and recurrent nerve rami. The peripheral distribution of the sensory fibers of these branches (B) was determined by means of electrophysiological techniques. Max.B., Mand.B. and Pal.B., each of which arises from the gasserian-geniculate ganglionic complexes, were found to innervate respectively, the upper lip and the adjacent skin, the internal and external surface of the lower lip region, and the upper lip and the anterior palate, ipsilaterally. The recurrent nerve sends fibers mainly via dorsal and ventral branches of the posterior lateral line nerve (NPLL), and a pectoral branch of the occipito-spinal nerve. The dorsal and ventral branches of NPLL innervate respectively, the dorsal fin and the adjacent body surface, and the remainder of the body surface. The pectoral branch supplies the pectoral fin. The central connections of the above branches were also examined by using the techniques of transganglionic tracing with horseradish peroxidase (HRP). HRP was applied to each of the branches, and its penetration of the brainstem was carefully followed. Labeled fibers were observed only in the ipsilateral region of the brainstem. When Max.B or Mand.B. was treated with HRP, labeled fibers were observed in the facial sensory root and in the descending trigeminal root. When Pal.B. was treated, however, they were traced only to the facial sensory root; thus indicating that the former two branches are trigeminofacial complexes and the latter is a pure facial nerve. Labeled fibers for NPLL were found in the facial sensory root as well as in bundles projecting to the lateral line areas. The facial fibers of Max.B. and Mand.B. innervate respectively in the dorsal-intermediate portion of the rostral half of the facial lobe, and in the ventral portion of the caudal half of the lobe. Those of Pal.B. however, cover a large area of the lobe anteroposteriorly except for the dorsal and ventral portions. The recurrent fibers of NPLL and the pectoral B. end in the dorsal-medial portion of the caudal half of the lobe. Thus the results of this study show that there is a topographical relation between the receptive field of the 6 peripheral nerve branches and their locus of representation in the facial lobe. Similarly, that the gustatory system through Pal.B. is represented on the facial lobe in a disproportionately large area compared to that of the other 5 branches. PMID- 3978435 TI - Inhibition of nicotinic receptor mediated ion fluxes in rat sympathetic ganglia by BGT II-S1 a potent phospholipase. AB - The mechanism of action of the bungarotoxin fraction II-S1 (BGT II-S1), which copurifies with alpha-bungarotoxin (alpha-BGT) and inhibits nicotinic transmission, has been further characterized. BGT II-S1 (1 microM) inhibited the carbachol (100 microM) or nicotine (50 microM) stimulated uptake of [3H]agmatine into rat sympathetic ganglia by 73% and 52%, respectively. These responses were inhibited 90% by D-tubocurarine (100 microM), but unaffected by alpha-BGT (1 microM) or atropine (10 microM), suggesting that BGT II-S1 affects nicotinic function at a postsynaptic site. Binding of physiologically active [125I]BGT II S1 could be demonstrated to intact sympathetic ganglia; however, the binding could not be displaced by nicotinic agents, suggesting that BGT II-S1 is not interacting at the receptor. Because some neurotoxins produce their effect at the synapse through a phospholytic action, the phospholipase activity of BGT II-S1 was determined. The results demonstrate that BGT II-S1 is a very potent calcium dependent phospholipase. In addition, conditions which abolished the toxin's phospholytic activity prevented its effects on nicotinic transmission and on nicotinic receptor mediated ion fluxes. These include irreversible inhibition of enzymic activity by treatment of BGT II-S1 with p-bromophenacylbromide, as well as reversible inhibition of the phospholipase by substitution of Ba2+ or Sr2+ ions for Ca2+ ions in the physiological medium. Thus, in rat sympathetic ganglia, BGT II-S1 blocks the nicotinic receptor mediated movement of ions across the membrane. This is probably not due to a direct interaction at the nicotinic acetylcholine recognition site; rather, it may be an ion channel associated effect which is mediated by alterations in the phospholipid environment of the receptor complex or of the membrane. Although BGT II-S1 also has presynaptic actions, in a cultured system of postsynaptic cells, it could prove a useful tool to study the role of phospholipids in neuronal nicotinic receptor regulation. PMID- 3978436 TI - Footshock-induced analgesia: its opioid nature depends on the strain of rat. AB - Previous studies have indicated that stressful footshock can induce both opioid, naloxone-sensitive, and non-opioid, naloxone-insensitive forms of analgesia, depending on stimulation parameters used with 30 min of intermittent footshock (3 mA, 1 s on, 5 s off) producing opioid analgesia and 3 min of continuous shock (3 mA) producing non-opioid analgesia. Using a local strain of Charles River (CR) derived rats we conducted a parametric investigation of footshock-induced analgesia applying both AC and DC scrambled shock ranging from 1 to 4 mA, continuous shock of 1, 3 and 5 min in duration and intermittent shock lasting 1, 3, 5, 10, 20, 30 and 80 min. All shock parameters produced potent analgesia. In no case did 10 mg/kg of naloxone block this analgesia. Varying the dose of the antagonist (0.1-10 mg/kg) and testing the animals at different points in the diurnal cycle did not result in the emergence of naloxone-sensitive anangesia. Based on the assumption that non-opioid systems may mask the activity of opioid analgesia systems, we attempted to either enhance opioid analgesia by: preventing enkephalin degradation by the use of D-phenylalanine; increasing the entry of blood-borne opioids into the brain by the use of DMSO; and the attenuation of non opioid analgesia by the use of reserpine. In no case did a naloxone-sensitive component of analgesia emerge. To test whether the animals possess an intact opioid analgesia system, both electrical stimulation of, and injection of opiates into the periaqueductal gray (PAG) were examined. Both procedures produced analgesia which was reversed by naloxone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978437 TI - Circadian rhythms in hippocampal responsiveness to perforant path stimulation and their relation to behavioral state. AB - Male rats were chronically implanted with electrodes to record the monosynaptic granule cell response in the dentate gyrus of hippocampus to perforant path stimulation while the animals were unrestrained. Samples of the dentate response were collected every 15 min for up to 14 days under various lighting conditions including constant light (LL) and constant darkness (DD). Circadian rhythms in the slope of evoked population EPSPs were found in all records. EPSP rhythms reached peak values during subjective night. Circadian rhythms in the height of the population spike were found in 8 out of the 12 animals studied. Spike rhythms reached peak values during the subjective day at times when EPSPs were at a daily minimum. Rhythms were confirmed statistically by periodogram. Rhythms followed changes in the LD cycle and persisted under LL or DD. The behavioral state associated with each sample was determined by EEG and video records of 4 animals. Day-night differences in EPSPs were found within the active awake, still alert, slow-wave and paradoxical sleep states. Day-night differences in the spike were detected during the still alert and paradoxical sleep states. PMID- 3978438 TI - Frontal eye field projection to the paramedian pontine reticular formation traced with wheat germ agglutinin in the monkey. AB - Injections of the retrograde tracer [125I]wheat germ agglutinin have been placed in different areas of the paramedian pontine reticular formation (PPRF), a well known premotor center for gaze control. Experiments in 5 monkeys revealed 3 major sources of input: (1) bilateral projections from the so-called frontal eye field (FEF), which is situated in the frontal cortex around the arcuate sulcus; (2) the intermediate and deep layers of mainly the contralateral superior colliculus; and (3) ipsilateral projections from brainstem structures such as the accessory oculomotor nuclei (nucleus interstitialis of Cajal, nucleus of Darkschewitsch, and nucleus of the posterior commissure), the mesencephalic reticular formation, the vestibular nuclei, the nucleus prepositus hypoglossi, and the cerebellar fastigial nucleus. The results are compared with previous anatomical investigations and confirm the electrophysiologically demonstrated FEF-PPRF abducens disynaptic pathway. PMID- 3978439 TI - Reduced calcium uptake by rat brain mitochondria and synaptosomes in response to aging. AB - Synaptosomes were isolated from cerebral cortex of 3-, 18- and 24-month-old male, Fisher 344 rats and 45Ca2+ uptake was measured at 1, 3, 5, 15 and 30 s time periods following 65 mM KCl depolarization. Identical experiments were performed in which 5 mM KCl was added to examine age-related changes in resting 45Ca2+ accumulation by synaptosomes. Both 'fast-' and 'slow-phase' voltage-dependent 45Ca2+ uptake were significantly reduced in synaptosomes from 18- and 24- vs 3 month-old rats. No age-related change in resting (5 mM KCl) 45Ca2+ accumulation was observed. ATP-dependent and respiration-linked 45Ca2+ uptake was examined in mitochondria isolated from whole brains of 3- and 28-month-old male, hooded Long Evans rats. Both ATP-dependent and glutamate-malate-ADP stimulated 45Ca2+ uptake by mitochondria were markedly reduced in response to aging. Respiratory control ratios were the same for 3- and 28-month-old mitochondria, suggesting that the decrement in 45Ca2+ uptake was not caused by an age-related decline in respiratory activity of mitochondria. The results of this study show that both voltage-dependent calcium entry into presynaptic nerve terminals and calcium uptake by mitochondria in brain decline with advanced aging. Age-related changes in cytosolic calcium levels could underlie, at least in part, cellular decrements in brain observed with aging. PMID- 3978440 TI - The rat claustrum: afferent and efferent connections with visual cortex. AB - We have examined the afferent and efferent projections between the claustrum and visual cortex in the Long-Evans rat using anterograde and retrograde axonal transport techniques. Injections of either wheat germ agglutinin/horseradish peroxidase (WGA/HRP) or Fast Blue were made into each of the main visual regions (17, 18a or 18b) as well as directly into the claustrum. The cortical injections were placed in either the upper, middle or deep layers so as to assist in determining the laminar organization of these connections. Of the 3 visual areas, only area 18b appears to have extensive and reciprocal connections with the claustrum. After a WGA/HRP injection of this area, dense labeled terminals and numerous labeled cells were found intermixed throughout the full extent of the claustrum. The density of this labeled activity was found to vary directly with the amount of the infragranular layers involved by the injections. Injections in the other visual areas did produce labeled cells in the claustrum, but their number was always small or even negligible. There was never any evidence of anterograde labeled terminals in the claustrum from any injection of areas 17 or 18a. Tracer injections directly in the claustrum confirmed and extended these findings by showing that the labeled terminals and/or labeled cells were localized predominantly in layer VI of area 18b of visual cortex. On the basis of these injections, two major conclusions are reached. First, the pattern of connections between the claustrum and visual cortex in the rat differs fundamentally with that found in other species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978441 TI - Differential rearing effects on rat visual cortex synapses. I. Synaptic and neuronal density and synapses per neuron. AB - The bulk of the evidence indicating that different experiences can lead to differences in synapse numbers involves inference from measures of postsynaptic surface (spines and dendrites) in Golgi impregnated tissue. The capriciousness of Golgi impregnation and the absence of direct evidence regarding changes in afferents mandate confirmation of synapse changes by electron microscopy. We calculated the ratio of synapses per neuron in layers I-IV of occipital cortex of rats reared in complex (EC), social (SC), or isolated (IC) environments. Synaptic density estimates were derived from electron micrographs of osmium-uranyl-lead stained tissue and neuronal density estimates were derived from toluidine blue stained semithin sections using stereological methods which correct for group differences in the sizes of synapses and neuronal nuclei. The ratio of these densities, synapses per neuron, was highest in complex environment rats, intermediate in socially reared rats and lowest in isolates, in accordance with predictions from prior Golgi studies. The bulk of the differences were attributable to neuronal density, which was highest in IC rats and lowest in ECs. Synaptic density did not differ statistically across groups. These results indicate, at least within this area and paradigm, that differences in dendritic measures in Golgi impregnated tissue reflect differences in the number of synapses per neuron. PMID- 3978442 TI - Connections of neurons in the region of the nucleus tractus solitarius with the hypothalamic paraventricular nucleus: their possible involvement in neural control of the cardiovascular system in rats. AB - Extracellular recordings were made from 607 spontaneously firing neurons within the nucleus tractus solitarius (NTS) and its vicinity in urethane-anesthetized male rats. Following electrical stimulation of the hypothalamic paraventricular nucleus (PVN) area, 21% of the neurons were orthodromically excited, 6% were inhibited and 2.5% were antidromically activated. The antidromic spike latencies were 22-64 ms. Among those orthodromically responding neurons, 81 neurons were tested by pressure pulse stimulation of the isolated carotid sinus. The pressure stimulation produced excitation in 7 and inhibition in 13 neurons. Of the 8 tested neurons which were antidromically activated, one neuron was excited and another neuron inhibited by the pressure pulse stimulation. These results provide electrophysiological evidence for reciprocal connections between neurons in the NTS region and the PVN, and give support to the hypothesis that the PVN is involved in the neural control of the cardiovascular system. PMID- 3978443 TI - Cholinergic projections from the midbrain and pons to the thalamus in the rat, identified by combined retrograde tracing and choline acetyltransferase immunohistochemistry. AB - The distribution of cholinergic neurons in the midbrain and pons which project directly to the thalamus was investigated in the rat using a procedure which allows the simultaneous detection of retrogradely transported horseradish peroxidase (HRP) and immunohistochemical demonstration of choline acetyltransferase (ChAT) in the same neurons. HRP injections were placed in the dorsal half of the anterior third of the thalamus on one side which included the anteroventral nucleus as well as portions of the rostral intralaminar and reticular nuclei. These thalamic nuclei showed the highest density of immunohistochemically detectable cholinergic fibers. Neurons containing both HRP and ChAT, which represented cholinergic neurons projecting directly to the thalamus, were found in the midbrain and pons in the lateral tegmental reticular formation, parabrachial region and lateral dorsal tegmental nucleus. Ipsilateral to the injection site over 91% of the HRP labeled neurons in all of these regions were cholinergic, while an average of 60% of the cholinergic neurons had transported HRP. Contralateral to the injection site 5-6% of the cholinergic neurons in these regions were also retrogradely labeled. These findings demonstrate direct cholinergic projections to the thalamus from neurons in several regions in the tegmentum and suggest that tegmental projections to the thalamus are predominantly cholinergic. PMID- 3978444 TI - Mechanisms mediating the sympathetic silent period: studies in the isolated spinal cord of the neonatal rat. AB - The properties of the sympathetic silent period were examined using the isolated spinal cord of the neonatal rat. In all spontaneously active sympathetic preganglionic neurons (PGN) examined, repetitive stimulation of the ventral root gave rise to a prolonged inhibition (up to 30 s) of spontaneous activity. The silent period could also be demonstrated in most 'silent' PGN using a condition test paradigm. The characteristics of the silent period in this preparation resembled those previously reported in the adult cat. Using several paradigms, we were able to show a dissociation between the duration of the silent period and the recent firing history of the PGN. This indicates that the silent period is not due solely to recovery processes intrinsic to the PGN. By stimulating adjacent ventral roots or rostral and caudal bundles of the same ventral root, we found that the system producing the silent period was confined to a restricted anatomical locus. Activation of the silent period was capable of inhibiting glutamate-evoked activity, implying that the inhibition impinges directly on the PGN. We found no evidence of a cholinergic mediation of the silent period. However, experiments with naloxone indicated that opiate mechanisms play an unsuspected role in modulating the silent period. We conclude that at least some component of the silent period is mediated by a synaptic mechanism extrinsic to the PGN. PMID- 3978446 TI - The effects of haloperidol on synaptic patterns in the rat striatum. AB - A morphometric analysis of the corpus striatum of rats chronically treated with haloperidol was performed at the light and electron microscopic levels. Although the density of striatal neurons was unchanged in the haloperidol-treated group, there was a small increase in neuronal size (13%). This change in cell size was paralleled by a trend towards larger dendrite calibres occurring in the drug treated animals. The distribution curve for axon terminal size indicated that 12% of the overall population was shifted from a range with a median size of 0.8 micron 2 to one with 1.6 micron 2 in the drug-treated group. This increase in size of some striatal terminals was accompanied by a concomitant increase in numbers of their associated synaptic vesicles, resulting in a similar density of vesicles for both control and drug-treated animals. PMID- 3978445 TI - The amygdalostriatal projections in the monkey. An anterograde tracing study. AB - Amygdalostriatal projections have been studied in the monkey with the autoradiographic method for demonstrating axonal transport of tritiated amino acids. Amygdaloid fibers were found to project in a roughly topographical manner to widespread areas of the striatum and ventral striatum, including the nucleus accumbens, the striatal-like portions of the olfactory tubercle, ventral portions of the putamen and ventral and caudal parts of the caudate nucleus. The parvicellular part of the basal nucleus and the amygdalohippocampal area appear to be the major sources of fibers to the nucleus accumbens, whereas projections to the tail of the caudate nucleus seem to arise mainly from the magnocellular part of the basal nucleus. In many of these areas, the amygdalostriatal fibers are concentrated in patches. PMID- 3978448 TI - Trifluoperazine and calcium antagonists accelerate cholinergic desensitization in Aplysia neurons. AB - The onset of desensitization of excitatory acetylcholine responses in isolated, voltage clamped Aplysia RB neurons to microperfused agonist was accelerated by trifluoperazine and the calcium antagonists SKF-525A and D-600. In the absence of these drugs the time course of desensitization is described as the sum of two exponentials plus a constant. All 3 compounds accelerated the fast exponential component of desensitization, but had opposite effects on the slow component: trifluoperazine and SKF-525A accelerated the slow component, whereas this phase was greatly slowed by D-600. These results provide further evidence that the two components of cholinergic desensitization may be independent and influenced by agents which may affect calcium binding to the acetylcholine receptor. PMID- 3978447 TI - Effects of capsaicin applied to a peripheral nerve on the responses of primate spinothalamic tract cells. AB - Capsaicin is a neurotoxin that appears to affect unmyelinated nociceptive sensory fibers selectively. We examined the effects of capsaicin applied topically to the sural nerve on peripheral nerve volleys and on the responses of neurons belonging to the spinothalamic tract (STT) in the monkey. The responses examined included those following electrical stimulation of the sural nerve and also those produced by more natural forms of noxious and innocuous stimuli applied to the skin. Capsaicin (1% solution) applied onto the sural nerve for 15 min resulted in a reduction of the sizes of A delta- and C-fiber afferent volleys. These changes paralleled the reduction of A- and C-fiber responses of the STT cells elicited by electrical stimulation of the sural nerve. During capsaicin application onto the sural nerve, the background activity of STT cells increased for 5-10 min. After capsaicin treatment, the responses of STT cells to innocuous mechanical stimuli applied to the cutaneous receptive field were increased, whereas the responses to noxious mechanical stimuli were decreased. However, topical capsaicin application almost eliminated the responses of STT cells to noxious heat stimuli. The results of the present study suggest that topical capsaicin application onto a peripheral nerve produces a transient nociceptive response followed by a decrease in sensitivity to noxious stimuli, particularly to noxious heat. These changes are due to conduction block of the nerve fibers at the site of capsaicin application. PMID- 3978449 TI - Neurons with whorl bodies have increased numbers of synapses. AB - The endoplasmic reticulum in some neurons of the rat hypothalamic arcuate nucleus forms concentric sheets of smooth cisternae which are known as whorl bodies. It has been reported that the number and size of these structures change under varying endocrine conditions. For example, the number of rat arcuate nucleus neurons containing whorl bodies increases after gonadectomy. In studying their relationship to other components of the cell, we found that neuron profiles which contain whorl bodies receive a significantly increased number of axosomatic presynaptic terminals (P less than 0.001). Whorl bodies may mark a subpopulation of endocrine sensitive cells which are characterized by a different pattern of connections and whose response to stimuli includes changes in endoplasmic reticulum organization. PMID- 3978450 TI - Surprisingly rich projection from locus coeruleus to the olfactory bulb in the rat. AB - The brainstem nucleus, locus coeruleus (LC), is the major, if not the sole, source of noradrenergic (NE) innervation of the telencephalon. It is generally held that LC neurons project diffusely to the entire neuroaxis and this had been the basis for theories that postulate 'general' functions (sleep, attention, learning, etc.) for LC. We report that at least 40% of all LC neurons project to the olfactory bulb; the projection is almost 10 times greater than to any other part of the cerebral cortex. This unsuspectedly rich LC-olfactory bulb connection is consistent with current theories which implicate LC neurons in heightened sensory vigilance and trophic regulation of connectional development and plasticity. PMID- 3978451 TI - Reinnervation of the canine tooth pulp after section of the inferior alveolar nerve in the cat. AB - The apices of lower canine teeth have been examined 9 weeks after unilateral section of the inferior alveolar nerve. The teeth were extensively reinnervated although there was considerable variation in the number of axons present. The myelinated axons were smaller than normal with thinner myelin sheaths. There were fewer axons per non-myelinated fibre (Remak bundle). The proportions of myelinated and non-myelinated fibres were normal. PMID- 3978452 TI - Synaptogenesis and changes in synaptic morphology related to acquisition of a new behavior. AB - Systemic testosterone treatment induces adult female canaries to develop male like song. This same treatment induces a doubling in size of the forebrain nucleus robustus archistriatalis (RA), known to be involved in song control, and a 51% increase in the number of synapses formed on RA neurons. In central RA, the number of synaptic vesicles per synapse increases as do several measures of synaptic size. Housing in spring-like conditions is also associated with larger synapses and more vesicles per synapse than housing in fall-like conditions. We suggest that formation of new synapses on existing neurons leading to or associated with modifications in synaptic morphology is important for acquisition of a new behavior. We also suggest that maximal behavioral and anatomical effects are associated with testosterone given under spring-like conditions. PMID- 3978453 TI - Do kainate-lesioned hippocampi become epileptogenic? AB - Kainic acid lesions of hippocampal subfields CA3-CA4 produced dramatic synchronous afterdischarge activity in subfield CA1 when studied 2-4 weeks post lesion in the in vitro slice preparation. This epileptiform discharge was correlated with a loss of intrinsic firing-induced afterhyperpolarizations and synaptic IPSPs. Two to 4 months post-lesion, intrinsic afterpotentials and synaptic inhibition appeared normal in most cells studied. PMID- 3978454 TI - Forelimb responses to cutaneous nerve stimulation during locomotion in intact cats. AB - The reflex responses of forelimb muscles to electrical stimulation of the cutaneous superficial radial nerve were recorded during treadmill locomotion in chronically implanted cats. In brachialis and cleidobrachialis (muscles which are active mainly during the swing phase) the responses were maximal during the swing phase and minimal or absent during the stance phase. In the long head of triceps which is active mainly during the stance phase, responses were also minimal during stance and maximal during swing. It is concluded that, for some muscles, the period of maximal reflex responsiveness can be out of phase with the period of the step cycle during which they are normally active. PMID- 3978455 TI - Cholinergic and non-cholinergic forebrain projections to the interpeduncular nucleus. AB - A combined fluorescent retrograde tracing and acetylcholinesterase (AChE) histochemical technique was used for the study of some forebrain projections to the interpeduncular nucleus (IPN). After injections of a fluorescent tracer into the IPN, the distribution of AChE-containing and of fluorescent retrogradely labeled neurons was simultaneously studied in the habenular nuclei, medial septum and diagonal band of Broca. In all these regions, the majority of retrogradely labeled neurons also contained AChE: neurons located in the habenular nuclei stained lightly or moderately for the enzyme, while neurons located in the diagonal band and medial septum displayed intense AChE staining and were classified as putatively cholinergic perikarya. In all regions, a minority of labeled neurons did not stain for AChE, and were identified as non-cholinergic neurons projecting to the IPN. The present study shows the existence of a biochemical heterogeneity in the habenulo-interpeduncular and telencephalo interpeduncular pathways, and indicates that the latter contains putatively cholinergic as well as non-cholinergic fibers. PMID- 3978456 TI - Spinal topography of the projection of the auricular nerve in the rabbit: a transganglionic WGA-HRP study. AB - The central projections of the nervous branches supplying the rabbit's concha auriculae have been determined by means of the transganglionic transport of WGA HRP. Labeling appeared in trigeminal, C2 and C3 ganglion cells, but terminals were observed only at spinal levels (C2 and C3). There, they formed a wedge shaped column of label centered mainly in lamina II; scattered terminals appeared in lamina III and I. These terminals constitute the afferent link of the pathway that accounts for the analgesia obtained after electrical stimulation of the concha auriculae. PMID- 3978457 TI - Caudate unit activity in freely moving cats: effects of phasic auditory and visual stimuli. AB - Quantitative analyses of the single unit responses to sensory stimuli were made in caudate nucleus neurons in the unanesthetized freely moving cat. Over half of the cells were responsive to repetitive presentation of simple sensory stimuli. Typically, neurons gave similar responses to both auditory (click) and visual (flash) stimuli. This study confirms previous reports of the polysensory response characteristics of caudate nucleus neurons, and extends these observations to the freely moving animal. PMID- 3978458 TI - The synaptic relationship between vasoactive intestinal polypeptide (VIP)-like immunoreactive neurons and their axon terminals in the rat small intestine: light and electron microscopic study. AB - The present study demonstrates synaptic contacts between vasoactive intestinal polypeptide (VIP)-like immunoreactive neurons and immunoreactive axon terminals in the submucous and myenteric plexuses of the rat small intestine. Our observations suggest that VIP afferents directly affect the VIP neurons in the small intestine via synapses. PMID- 3978459 TI - Quantitative light microscopic autoradiography of [3H]hemicholinium-3 binding sites in the rat central nervous system: a novel biochemical marker for mapping the distribution of cholinergic nerve terminals. AB - The distribution of specific [3H]hemicholinium-3 ( [3H]HC-3) binding sites sites throughout the rat forebrain was studied by means of quantitative light microscopic autoradiography. Tissue sections were labeled with 2.5 nM [3H]HC-3, apposed to tritium-sensitive film for 2 months and analyzed by computer-assisted densitometry. Regions of intense [3H]HC-3 labeling include the caudate-putamen, nucleus accumbens, olfactory tubercle, amygdala, habenula and the granule cell layer of the dentate gyrus. Little or no specific binding was detected in the corpus callosum, a white matter region. This distribution of specific [3H]HC-3 binding sites is compatible with a selective labeling of central cholinergic nerve terminals. PMID- 3978461 TI - Pontomedullary raphe neurons: monosynaptic excitation from midbrain sites that suppress the jaw opening reflex. AB - The intracellular responses of pontomedullary raphe neurons to midbrain stimulation were studied in chloralose anesthetized cats. Electrical stimulation of the periaqueductal gray region at sites that suppressed the nociceptive jaw opening reflex evoked monosynaptic excitatory postsynaptic potentials in the majority of raphe neurons recorded. Intracellular labeling of studied cells demonstrated that recordings were obtained primarily from large and medium sized neurons in nucleus raphe magnus and the rostral nucleus raphe obscurus. These results provide further evidence that analgesia induced by periaqueductal gray stimulation may result in part from the direct activation of caudal raphe neurons. PMID- 3978460 TI - The course of paraventricular hypothalamic efferents to autonomic structures in medulla and spinal cord. AB - By application of the anterograde transport technique of Phaseolus vulgaris leuco agglutinin the descending autonomic projection of the paraventricular hypothalamic nucleus was investigated. The Phaseolus lectin technique allowed the detection of the cells of origin in the paraventricular PVN, the precise position of two distinct descending axon pathways and the detailed morphology of terminal structures in midbrain, medulla oblongata and spinal cord. PMID- 3978462 TI - Properties of cutaneous mechanosensitive afferents during the early stages of regeneration in man. AB - The technique of percutaneous microneurography was used to record single unit activity from 75 regenerated primary afferents innervating the glabrous skin of the human hand. Thirteen patients were studied, who had suffered complete transection, with subsequent suture or graft, of the median or ulnar nerves. The recordings were obtained from 7 to 23 months postoperatively (early regeneration). Three types of mechanoreceptive afferents (RA, SAI, SAII) and many deep units of unknown origin were found. No regenerated PC units could be identified. The reinnervated receptors were predominantly located in the palm and proximal fingers, comparable to those found 3 years or more postoperatively (late regeneration). Response thresholds and in general, discharge and receptive field characteristics of the majority of afferents were largely comparable to late regeneration and normal. The properties of SAII units were like normal in all respects. However, several distinct abnormalities were encountered early during regeneration: multiple receptive fields innervated by a single afferent (2/9 RA and 2/9 SAI), unusually small or large receptive fields (RA and SAI), pronounced fatigue on repetitive stimulation (7/15 SAI, 4/6 deep). Responses of reinnervated skin to sustained and repeated indentations were found to be similar to those of normal skin, and therefore, could not account for the abnormal discharge behavior. It is suggested that the transitional properties of regenerating afferents reflect unstable axon-end organ connections and immature axonal properties. Both factors would contribute to the slow course of sensory recovery, making prognosis on tactile recovery unpredictable. PMID- 3978463 TI - The relationship between cortically induced mandibular movements and lateral pterygoid and digastric muscle EMG activity in the anesthetized guinea pig. AB - Vertical and horizontal jaw movements along with lateral pterygoid (PT) and anterior digastric (DIG) muscle electromyogram (EMG) activity were recorded in anesthetized guinea pigs during electrical stimulation of the masticatory area of cortex. Both repetitive stimulation at 25 Hz and short pulse-train stimulation (3 pulse, 500 Hz) delivered 2/s produced jaw opening with a horizontal component contralateral to the side of cortex stimulated in addition to short latency (7-12 ms) evoked EMG bursts in the ipsilateral PT muscle and in the DIG muscles bilaterally. Evidence was also obtained which indicated that both types of cortical stimulation resulted in time-locked inhibition of the contralateral PT muscle. Unlike each short train of stimulus pulses, however, each pulse in the repetitive train did not evoke jaw movement and EMG bursts of a consistent amplitude. Rather, repetitive stimulation produced rhythmical movements of the jaw associated with recurrent periods of activity and inactivity in the EMG records. These results demonstrate the presence of a corticotrigeminal pathway between masticatory cortex and PT motoneurons in addition to a similar pathway to DIG motoneurons, and suggest that both pathways are similarly modulated by a central pattern generator to produce rhythmical jaw movements. PMID- 3978465 TI - Pars plana vitrectomy for the complications of diabetic retinopathy: a report on 131 cases. AB - The results of primary vitrectomy for the complications of proliferative diabetic retinopathy were explored in 131 eyes of 105 patients. A minimum of 6 months' follow-up was obtained. The primary indications for surgery were persistent vitreous hemorrhage (in 66% of the eyes) and progressive tractional macular detachment (in 31%). Technical (surgical) success (clearing of the ocular media or relief of macular traction, or both) was achieved by the time of the last examination in 69% of the eyes; it was achieved in 70% of those with persistent vitreous hemorrhage and in 68% of those with tractional macular detachment. Visual improvement was observed in 55% of all the eyes. PMID- 3978464 TI - Colchicine-induced differential sprouting of the endplates on fast and slow muscle fibers in rat extensor digitorum longus, soleus and tibialis anterior muscles. AB - The patterns of sprouting of motor endplates were examined in fast extensor digitorum longus and slow soleus muscles and in tibialis anterior muscles containing fast and slow muscle fiber types. A histochemical technique combining nerve silver impregnation and endplate cholinesterase staining was developed for this task. Temporal examination of the innervation was conducted 3, 7 and 10 days after either a 45 or 90 min application of the ipsilateral sciatic nerve with 5 mM colchicine. This dosage of drug did not cause detectable axon or muscle fiber degeneration, unlike 60 mM which was highly neurotoxic. At 3 days following treatment with the lower concentration, there were no significant differences in the percentages of intranodal, preterminal and ultraterminal sprouts between the normal (non-treated), sham-treated, contralateral systemic-control and drug treated groups of muscles. By 7 and 10 days, the muscles on the drug-treated side exhibited significant increases in the 3 types of sprouts. Collateral sprouting was uncommon: most outgrowths remained on the muscle fibers innervated by the parent axons. Endplates in the tibialis anterior muscles of the control and drug treated groups were classified Complex, Intermediate or Simple according to the relative degrees of branching of the terminal arbors. The occurrence of endplate classes and muscle fiber types was correlated in the superficial and deep regions of this muscle. Complex endplates innervated fast glycolytic fibers, Intermediate endplates supplied fast oxidative glycolytic fibers, and Simple endplates served slow oxidative fibers. In response to colchicine, the endplates of the slow muscles sprouted more than those of fast muscles while the innervation of slow fiber types sprouted less than that of fast fiber types. Furthermore, intranodal sprouts were more prevalent in slow muscles and ultraterminal sprouts more numerous in fast muscles whereas intranodal sprouts predominated on fast fiber types and ultraterminal sprouts were characteristic of slow fiber types. These apparently contradictory results were reconciled when it was noted that soleus endplates were mostly Complex and Intermediate, and the extensor digitorum longus contained more Simple endplates. Thus, consistency of sprouting patterns among endplate types of the 3 muscles was recognized when the pre-existing branching patterns were considered. This indicated that the patterns of sprouting were determined by the motor neurons rather than the muscle fibers. The observed sprouting responses supported the hypothesis that colchicine treatment of motor axons caused muscle fibers to elaborate a diffusible sprout-inducing factor. PMID- 3978466 TI - Giant retinal tears, retinal detachment and retinitis pigmentosa. AB - A patient with retinitis pigmentosa and sensorineural deafness presented with bilateral giant retinal tears and a unilateral retinal detachment. The peripheral visual field loss could have been erroneously ascribed to the primary retinal dystrophy. A retinal detachment must be considered in patients with a sudden loss of visual acuity or field even if they have a primary retinal dystrophy. PMID- 3978467 TI - Voluntary entropion. AB - Voluntary entropion, which has been reported only once before, was photographically documented in a 12-year-old girl. The lower-eyelid retractors and protractors were clinically normal. The postulated mechanism of the entropion was selective innervational control of separate components of the orbicularis oculi complex, which allowed the preseptal portion to override the pretarsal portion. PMID- 3978468 TI - Eye injuries in Canadian amateur hockey. AB - The incidence of eye injury in Canadian amateur hockey has declined sharply, from 257 cases in the 1974-75 season to 124 in the 1983-84 season, since face protectors certified by the Canadian Standards Association (CSA) and attached to CSA-certified helmets became mandatory for minor hockey players in this country. None of the reported cases in 1983-84 were in players wearing such equipment. The average age of the injured players was 14 years in 1974-75 but 24 years in 1983 84; that is, younger players are now protected, but older players are not. Hockey sticks and pucks were the top two causes of eye injury in both seasons, but hyphema became the commonest type of injury in 1983-84, surpassing soft tissue damage. The frequency of legal blindness as the visual outcome fell from 19% in 1974-75 to 11% in 1983-84. A suitable face protector must now be developed for older players. PMID- 3978469 TI - Depression in adduction syndrome. AB - Three cases of depression in adduction syndrome are described. All occurred unilaterally, in the left eye, in boys and were characterized by depression and retraction of the involved eye with attempted adduction. This was accompanied by an inability to elevate the eye in adduction and a markedly abnormal head posture. Surgery, consisting of superior oblique tenotomy and recession of the lateral rectus muscle, did not allow the ocular rotation to improve but did allow the anomalous head posture to be corrected. The homogeneity of the clinical appearance and the lack of response to surgery suggests that this is a distinct clinical entity. PMID- 3978470 TI - [Inverse corneal incision in cataract surgery]. AB - In a prospective study of 100 cases of cataract surgery, astigmatism surgically induced by the reversed corneal incision technique was evaluated. There was a tendency towards with-the-rule and oblique astigmatism in the early post operative period, but the final distribution of cases was similar to the preoperative distribution. The sutures could be left in place in about one third of the cases. PMID- 3978471 TI - Pellet-gun eye injuries. AB - Twelve male patients with pellet-gun eye injuries are presented. Most were young teenagers. Six patients had a significant loss of vision due to retinal injury, and in one of these cases the eye was enucleated. The injuries ranged in severity from contusion with a small hyphema to rupture of the globe with uveal prolapse, retinal hemorrhage and detachment, optic nerve contusion, glaucoma and intracranial penetration. PMID- 3978472 TI - Cross correlation studies in primate motor cortex: event related correlation. AB - Simultaneous extracellular unit recordings were made from each cell of 237 pairs in two awake monkeys, during a voluntary reaching movement of the forelimb. The cells were located in contralateral precentral cortex and functionally coupled to single forelimb joints, as indicated by intracortical microstimulation and passive sensory stimulation. Cross correlation analysis showed that 72 of these pairs exhibited significant event-related correlation over periods of up to 780 ms, comparable to and coincident with the forelimb movement. Spatial analysis showed that such correlation extended across contiguous portions of all four forelimb joint zones of precentral cortex, over distances up to 3.5 mm. No preferred direction of correlation was observed. The data confirm the previously described nested organization of the forelimb area of precentral cortex. Findings are discussed in terms of mechanisms by which columns of neurons in motor cortex participate in the reaching movement. PMID- 3978473 TI - Pineal region tumors. AB - The management of pineal region tumors has changed considerably since the introduction of microsurgery and CT scanning. Analysis of our own series of 36 patients, comparing those treated in the pre-CT scan and microsurgery era with those treated afterwards, shows the important role these two techniques play. Current controversies in treatment and our own approach to management of pineal region tumors are discussed. PMID- 3978474 TI - Cough syncope mimicking epilepsy in asthmatic children. AB - Cough syncope is a more common complication of childhood asthma than formerly recognized. We report twelve children with typical cough syncope who were identified in a pediatric clinic over a period spanning seven years. The condition may be confused with epilepsy because of frequently associated brief clonic convulsive movements during the height of the cerebral anoxia. Cough syncope is readily distinguished from epilepsy by a thorough history. The management and prevention of cough syncope is directed at the aggressive control of bronchospasm in children with asthma. PMID- 3978475 TI - The changing picture of pseudotumor cerebri in children. AB - Among 38 children with pseudotumor cerebri only 3 cases were due to ear disease or its complications. The commonest cause was a refeeding syndrome either due to nutritional deprivation or as an early finding in the treatment of cystic fibrosis. It is uncommon to find the cause of pseudotumor in older children but in those under 6 years the cause was found in 85%. Because of the adverse effects of steroids we use this treatment in the more resistant cases. PMID- 3978476 TI - Adrenoleukodystrophy mimicking multiple sclerosis. AB - We report a 47 year old woman who was initially diagnosed as having multiple sclerosis. She has subsequently been found to be heterozygous for adrenoleukodystrophy (ALD). The female carrier state for ALD may be associated with intermittent symptoms and it is therefore important to consider ALD in patients diagnosed as multiple sclerosis. PMID- 3978477 TI - Post-surgical contrast enhancement mimicking residual brain tumour. PMID- 3978478 TI - Pruning scientific papers will provide an opportunity for new growth. PMID- 3978479 TI - Third leukocyte differential counts: utilization study in a general hospital. PMID- 3978480 TI - Adverse effects of NSAIDs. PMID- 3978481 TI - Looking at the only animal we're interested in. PMID- 3978482 TI - Canadian departments of pediatrics and family medicine: in need of family therapy? AB - Whether and how much the departments of pediatrics in Canadian medical schools collaborate with the family medicine departments in training for child care were the focus of a survey conducted in 1983-84. Responses to a questionnaire sent to department heads indicated that in general the most supportive relationships existed in the western provinces, with progressively more problems uncovered from west to east. The responses concerning the roles of pediatricians and family physicians paralleled this trend, with the western view being that pediatricians are consultants and not competitors for primary care. Many respondents supported the expansion of family medicine, particularly into ambulatory and behavioural areas. The data provide some cause for concern about the future health care of children, as the forecasted oversupply of physicians is likely to encourage competition rather than consultation between the two groups. Also, many Canadian pediatricians accept the US model of pediatrics, which includes primary care, although in Canada the ratio of family physicians to pediatricians is six times that in the United States, and Canadian specialists are concentrated in urban centres. This means that family physicians will continue to provide most of the child care in Canada and need adequate training. They also need to develop cooperative, supportive relationships with specialists in child health care to enhance appropriate referral patterns. PMID- 3978483 TI - Impact of vaccination on selected diseases in Canada. AB - Vaccination has dramatically reduced the morbidity and mortality rates of a number of diseases. The crucial element of vaccination programs is commitment to widespread coverage and to containment of outbreaks. Vaccines have led to virtual elimination of poliomyelitis and promise to eliminate measles. The incidence of congenital rubella syndrome will probably only be diminished if vaccination is extended to all 1-year-olds and susceptible prepubertal girls. The employment of diphtheria toxoid is one of the great success stories in public health. The incidence of pertussis has declined because of the diphtheria-pertussis-tetanus (DPT) vaccine given to infants, although elimination of the disease will probably have to await development of a more potent pertussis antigen. A remarkable reduction in the incidence of tetanus and tuberculosis has also been achieved. PMID- 3978484 TI - Evaluation of sponging to reduce body temperature in febrile children. AB - A study was conducted to evaluate the efficacy of sponging as a way of reducing body temperature in febrile children. Of 130 children 73 received antipyretic medication and sponging and 57 received antipyretic medication alone. No difference in temperature reduction was noted between the two groups. It is therefore suggested that sponging be abandoned as a mode of temperature reduction in febrile children whose increased temperature is due to an infectious process. PMID- 3978485 TI - Dysgonic fermenter 2 infection resulting in chronic glomerulonephritis. AB - Dysgonic fermenter 2 (DF-2) is a fastidious gram-negative pathogen that is capable of causing multiorgan disease in humans. In the case reported here infection resulted in subacute bacterial endocarditis, brain abscess and chronic type 1 membranoproliferative glomerulonephritis, a form of renal disease not previously reported in DF-2 infections. The literature is reviewed, and difficulties in diagnosis and treatment are discussed. PMID- 3978486 TI - Fatal diphtheria in an older woman. AB - A previously healthy 68-year-old woman presented with fever and sore throat. Her condition was initially diagnosed as necrotizing streptococcal tonsillitis and was treated with penicillin G, given intravenously. A swab of her throat taken for culture at the time of admission yielded Corynebacterium diphtheriae 48 hours later. At that time an electrocardiogram showed new T-wave inversion--evidence of diphtheritic myocarditis. She was immediately given 60 000 units of equine diphtheria antitoxin (following a test dose), but later that day she began choking, became apneic and died. The patient had not received any immunizing agents as a child, and no antitoxin was detected in a blood sample obtained prior to administration of the antitoxin. Her death re-emphasizes the seriousness of diphtheria, an infection to which many elderly people are susceptible. PMID- 3978487 TI - Infectious disease issues in resuscitation training. PMID- 3978488 TI - James Welsh: Amnesty International's medical office coordinator. PMID- 3978489 TI - Biometeorology: linking weather and health. PMID- 3978490 TI - An authors' code of ethics for medical editors? PMID- 3978492 TI - Information science and the general professional education of the physician. PMID- 3978491 TI - Adverse effects of NSAIDs. PMID- 3978493 TI - British Medical Association attacks cigarette smoking. PMID- 3978494 TI - Pigmentary retinopathy associated with low-dose thioridazine treatment. PMID- 3978495 TI - Homosexuality: an addiction? PMID- 3978496 TI - Northern fowl mite dermatitis. PMID- 3978497 TI - Paralysis in an immunocompromised adult following oral polio vaccination. PMID- 3978498 TI - Statement on human milk banking. Nutrition Committee, Canadian Paediatric Society. AB - If expressed human breast milk is used certain considerations and precautions are needed depending on the donor. Appropriate safety standards and procedures should be used by all milk banks. Screening of donors of breast milk must include history-taking for acute or chronic infections and drug use. Expressed breast milk should be stored at 3 degrees C to 4 degrees C if it is to be used within 48 hours and at -20 degrees C or lower if it is to be stored for more than 48 hours. Because of the dangers of microbiologic contamination pooled milk should be pasteurized before use. Although the standards are empiric, it has been suggested that breast milk that is free of pathogens and has a total bacterial colony count of less than 10(7)/L at the time of sampling is safe to use. Breast milk expressed by an infant's own mother can be used without banking procedures, but the safety precautions, apart from pasteurization, still apply. PMID- 3978499 TI - Children's multiple vitamins: overuse leads to overdose. AB - A suburban Ontario community hospital encountered 21 +/- 1 overdoses of children's multiple vitamins yearly between 1978 and 1981. Of these, 35% involved one particular cartoon character preparation. Parents were surveyed to determine whether this particular preparation resulted in a disproportionate number of accidental overdoses. However, the use of vitamins with a cartoon character format did not lead to a greater risk of overdose than did conventional preparations. Of the 1051 families who had given multiple vitamins to their children 34 (3%) had experienced an overdose. The number of vitamin preparations used by each family was the most powerful determinant of overdose (p less than 0.001). The risk of accidental overdose increased from 1.5% with one multiple vitamin preparation to 8% with four or more preparations. Among all the variables examined, exposure was the most important element in the risk of multiple-vitamin overdose. PMID- 3978500 TI - Quality of use of parenteral metronidazole therapy in a teaching hospital. AB - The recent release, relatively high cost and potential adverse effects of parenterally administered metronidazole prompted a quality-of-use audit at a 1000 bed teaching hospital. Ninety-two courses of treatment in 81 inpatients during a 6-week period were studied. Appropriateness of therapy was assessed on the basis of published indications. Parenterally administered metronidazole was prescribed primarily in anaerobic and anaerobic-aerobic infections. It was used as frequently for prophylaxis as for therapy. Surgical services accounted for 95% of the treatment courses. Inappropriate use was noted in 27 (29%) of the courses: agents other than parenterally administered metronidazole were indicated in 12 (13%), while the dose, dosing interval or duration of treatment was suboptimal in 15 (16%). Substantial savings would be achieved if oral or rectal metronidazole therapy were substituted for intravenous therapy for perioperative prophylaxis in elective colorectal surgery. Written justification for use and automatic stop orders are recommended to improve the cost effectiveness of both prophylactic and therapeutic use of selected antimicrobial agents. PMID- 3978501 TI - Prevention of alcohol withdrawal seizures with oral diazepam loading. AB - Twenty patients withdrawing from alcohol who had reliable histories of previous alcohol-withdrawal seizures and thus were at high risk for a subsequent seizure were treated in hospital with oral diazepam loading: 20 mg of the drug was given every hour to a minimum total of 60 mg. None of the patients had a seizure during the stay in hospital. We believe that phenytoin prophylaxis is not necessary in these circumstances. However, if the patient is already taking phenytoin, this drug should not be abruptly discontinued in the withdrawal period in favour of diazepam loading. PMID- 3978502 TI - Tuberous sclerosis: case report and investigation of family members. AB - Familial tuberous sclerosis probably occurs more often than is indicated by the literature: many family members show signs of being carriers of the gene for the disease when carefully examined. This article reports on a family with documented tuberous sclerosis in three generations and discusses the examination and investigation of at-risk family members, including the newborn, for signs of the disease. The potential teratogenic effects of anticonvulsants, used to control seizures in tuberous sclerosis, are also discussed. PMID- 3978503 TI - Two cases of dysphagia due to cervical spine osteophytes successfully treated surgically. AB - Two cases of dysphagia due to osteophytes at the level of the fifth and sixth cervical vertebrate are reported. The patients were two women aged 47 and 50 years. The diagnosis was confirmed by means of roentgenography, barium studies and, in one case, esophagoscopy. Both patients were successfully treated surgically. The importance of properly investigating cervical dysphagia is stressed. Doctors in many different fields of practice should be aware of this rare cause of dysphagia. PMID- 3978504 TI - Dactylitis in a child with sickle cell trait. AB - Dactylitis commonly occurs in patients with homozygous hemoglobin S disease (sickle cell anemia), sickle cell-hemoglobin C disease or sickle cell-beta thalassemia. A case is reported of dactylitis associated with sickle cell trait, a very rare occurrence. It may be that in this patient the disorder was secondary to severe diarrhea and dehydration. PMID- 3978505 TI - Hepatitis B infection in Canada. PMID- 3978507 TI - Is there a future for homeopathy? PMID- 3978506 TI - Hong Kong: highrise hospitals and powdered rhino horn. PMID- 3978509 TI - A quick look at medical abbreviations. PMID- 3978508 TI - New future for the Royal College. Interview by David Woods. PMID- 3978510 TI - Drug management of pain in cancer patients. PMID- 3978511 TI - Can essential fatty acid deficiency predispose to AIDS? PMID- 3978512 TI - Outbreak of pertussis in a small community. PMID- 3978513 TI - Who should promote health and provide preventive care? PMID- 3978514 TI - Limited-protein diet: a means of delaying the progression of chronic renal disease? AB - Recent studies suggest that restricting the dietary protein intake of patients with progressive renal disease slows their loss of renal function. Studies in animals have shown that an increase in the filtration rates of individual nephrons (hyperfiltration), an adaptive response to loss of renal mass, appears to induce progressive renal damage and that such damage may be prevented by dietary protein restriction. Preliminary evidence suggests that restriction of protein intake to less than 50 g/d in man has a similar beneficial effect in slowing the progression of chronic renal disease. Dietary therapy appears to be particularly effective for patients with early renal disease, allowing a doubling in the time until dialysis is required in many cases. Although large-scale clinical studies are planned, there is now sufficient evidence to warrant the use of moderate protein restriction (to less than 50 g/d) in most patients suffering from progressive renal disease. Such therapy should only be instituted with expert dietary and nephrologic consultation. PMID- 3978515 TI - The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. AB - Cycle and treadmill exercise tests are unsuitable for elderly, frail and severely limited patients with heart failure and may not reflect capacity to undertake day to-day activities. Walking tests have proved useful as measures of outcome for patients with chronic lung disease. To investigate the potential value of the 6 minute walk as an objective measure of exercise capacity in patients with chronic heart failure, the test was administered six times over 12 weeks to 18 patients with chronic heart failure and 25 with chronic lung disease. The subjects also underwent cycle ergometer testing, and their functional status was evaluated by means of conventional measures. The walking test proved highly acceptable to the patients, and stable, reproducible results were achieved after the first two walks. The results correlated with the conventional measures of functional status and exercise capacity. The authors conclude that the 6-minute walk is a useful measure of functional exercise capacity and a suitable measure of outcome for clinical trials in patients with chronic heart failure. PMID- 3978518 TI - Trends in rates of reported gonococcal infections in Canada, 1962-83. PMID- 3978516 TI - Canadian survey of thyroid cancer. AB - We report the results of a multicentre retrospective chart review of 2214 patients with thyroid cancer registered at 13 radiotherapy centres between 1958 and 1978. The data analysed included sex, age at the time of diagnosis, pathological diagnosis, extent of disease before treatment, types of treatment and their complications, and the rates of recurrence and survival up to 24 years after diagnosis. Although papillary cancers were most common, anaplastic and miscellaneous tumours were more frequent than expected, which reflects the type of patients referred by endocrinologists and surgeons to radiotherapy centres. There were marked differences in patterns of referral to the centres. Some patients with papillary and follicular thyroid cancers died of these cancers up to 20 years after diagnosis. The clinical manifestations, treatment and outcome of the rarer types of thyroid malignant tumours were of particular interest. The influence of age at the time of diagnosis on survival rates for patients with papillary or follicular thyroid cancer was highly significant, indicating much more aggressive behaviour of these cancers in older patients, particularly those beyond the age of 60 years. A more detailed analysis of tumour subtypes should provide new information on their natural history and lead to better management. PMID- 3978519 TI - Horizons bleak for offshore medical graduates. PMID- 3978520 TI - Hong Kong physicians prepare for the future. PMID- 3978517 TI - Ischemic skin lesions in ulcerative colitis. PMID- 3978521 TI - Health for all and public health. PMID- 3978522 TI - Rotavirus infection in children with diarrhoea admitted to a general hospital in Metro Toronto. PMID- 3978523 TI - Outbreak of rotavirus gastroenteritis in a James Bay Cree community. PMID- 3978524 TI - Smoking prevalence among Canadian adolescents. A comparison of survey estimates. PMID- 3978525 TI - Drinking patterns in Canada: variations in drinking frequencies and demographic characteristics of current drinkers. PMID- 3978526 TI - Suicide in Canada: birth-cohort analysis. PMID- 3978527 TI - Parent report of school-related injuries. PMID- 3978528 TI - An employee office smoking policy. PMID- 3978529 TI - Happy hours in metropolitan Toronto: their prevalence, timing and content. PMID- 3978530 TI - A summer-camp outbreak of beta hemolytic streptococcal tonsillitis. PMID- 3978531 TI - Child sexual abuse and juvenile prostitution: a commentary on the Badgley Report on sexual offences against children and youth. PMID- 3978532 TI - The four arenas of prevention. PMID- 3978533 TI - Emergency management of the patient with upper airway obstruction. PMID- 3978535 TI - Obstructive azoospermia: a study of 102 patients. AB - A comprehensive study is presented of a series of 102 infertile men with non surgical obstructive azoospermia. Details are given of the presentation, clinical features, apparent aetiology, sites of obstructive lesions and treatment. Identifiable aetiological factors were present in only 50% of cases. Amongst these, associated chronic lung disease (Young's Syndrome) accounted for 23%; genital infection, trauma and previous surgery were present in low incidence. The results of corrective surgery were poor and this fact, together with the clinical and pathological features of the patients in this series suggests that an ill defined change in the aetiology of obstructive azoospermia may have occurred over the past 2 decades. PMID- 3978534 TI - Human artificial insemination by donor and the Australian community. AB - Findings from a national sample of 989 persons and an 'Opinion Leader' survey of 279 executive and ordinary members of 40 organizations identified as having an interest in AID showed that Australians overall approved of the procedure for helping infertile married couples, only 17% of the national sample unequivocally disapproving. Key variables in determining opinions on AID included age, education, country of origin, family status, religion and exposure to infertility. However only 15% of national respondents accepted that AID should be made available to any unmarried women on request although opinions were more evenly spread on its provision to unmarried women in a long-term relationship with a man. Over one-third of 'Opinion Leaders' believed that children should never be told of their AID conception, 13% that they should be given identifying and one third non-identifying information on the donor. A majority believed that AID should be directly carried out or supervised by doctors in hospital clinics. There was strong opposition to business or voluntary organization involvement. Suggestions for changes in the law, while emphasizing protection of donors, recipients, children, persons who ran AID programs and control over futuristic research activities, often showed a misunderstanding of the legal process. The major reasons for exclusion of donors were genetic defects and medical problems although many behavioural characteristics were mentioned. Views on recipients' rights to choose the sex of the AID child were marginally against the proposition. PMID- 3978536 TI - Factors influencing the success of microsurgical tuboplasty for sterilization reversal. AB - A series of microsurgical sterilization reversal procedures has been analysed. It demonstrates that better pregnancy rates are achieved where mechanical sterilization techniques have resulted in only short lengths of tubal destruction. Isthmo-isthmic anastomoses have the most favourable outcome. PMID- 3978538 TI - Improved tissue perfusion during pressure regulated hyperthermic regional isolated perfusion. A clinical study. AB - In previous studies on isolated hindlimb perfusions in dogs, the authors proved that the extracorporeal circuit should be regulated at a delta pressure (systemic mean arterial pressure minus hindlimb mean arterial pressure) of not more than 15 mmHg, to achieve adequate tissue perfusion. To confirm this in patients the authors performed clinical perfusions, divided into three groups. In group I and II the extracorporeal circuit was regulated at a delta pressure of 15 mmHg and 50 mmHg, respectively. In group III perfusions were performed using the common technique of a predetermined fixed flow. Tissue oxygenation, determined by means of a transcutaneous pO2 electrode, was adequate in group I and was severely impaired in group II and III. Although in group I high perfusion flows were needed, leakage was less than 10%. To achieve adequate tissue perfusion during clinical regional perfusions, the extracorporeal circuit must be regulated at a delta pressure of 15 mmHg. PMID- 3978537 TI - A comparison of the actual and expected pain response following insertion of an intrauterine contraceptive device. AB - The expected, immediate, and three-minute pain response following IUCD insertion was evaluated in 84 nulliparous women undergoing a first IUCD insertion. Expected pain was significantly higher than immediate pain and both were significantly higher than three-minute pain. Immediate pain following IUCD insertion was positively related to expected pain but the relationship was not strong enough to be of clinical value. The pain was significantly related to the degree of cervical resistance and this relationship was made much more obvious by the use of the expected pain parameter which is a valuable additional clinical measurement in pain research. IUCD insertion pain consists of a short cervical (less than 3 minutes) and longer fundal component. Avoiding excessive uterine manipulation during device insertion results in lower immediate and later pain response scores for a given device when comparisons are made with other studies, where standard techniques were used. PMID- 3978539 TI - What can be expected when radiation therapy becomes the only curative alternative for endometrial cancer? AB - Fifty-four patients with endometrial carcinoma were treated by radiation alone between 1962 and 1977, because of severe associated medical problems that contraindicated surgery. The overall 5-year absolute and determinate survival rates were 46% and 54%, respectively. The majority of patients who presented with Stage I, grade I disease were treated with only intracavitary radiation; this yielded a 75% 5-year survival rate. However, the combination of external and intracavitary radiation achieved the best results in the overall group. The stage of the disease, grade, age at diagnosis, and treatment techniques correlated well with failure rates. However, only the tumor grade and treatment techniques influenced failure patterns. The length of the uterine cavity did not have any prognostic influence in these patients. PMID- 3978540 TI - Parathyroid carcinoma of the oxyphil cell type. A report of two cases, light and electron microscopic study. AB - Parathyroid adenomas are subdivided into chief cell and oxyphil cell variants. However, the parathyroid carcinomas described thus far have been only of the chief cell type. Two cases of oxyphil cell carcinoma of the parathyroid gland are reported, with light and electron microscopic study. The patients presented apparent clinical hyperparathyroidism with x-ray finding of generalized fibrous osteitis and palpable parathyroid tumors. Initially, a pathologic diagnosis of parathyroid adenoma was made in both of them. However, in due course, pulmonary metastases developed in one patient and a local recurrence occurred in the other, 5 and 8 years after the primary operation, respectively. Review of the microscopic slides showed that both primary tumors met the criteria of parathyroid carcinoma. A matter of interest in both cases is that the neoplasms were composed principally of oxyphil cells. Electron microscopic study confirmed the existence of typical oxyphil cells packed with numerous mitochondria. PMID- 3978541 TI - Lymphatic dissemination of hepatic metastases. Implications for the follow-up and treatment of patients with colorectal cancer. AB - Hepatic spread of colorectal cancer is a prominent cause of treatment failure, but selected patients with liver metastases may attain long-term palliation or cure with liver resection. A review of the records of 81 patients seen at the National Cancer Institute for treatment of colorectal hepatic metastases revealed 7 instances of metastases discovered at operation within the hepatic lymphatic drainage in the absence of other extrahepatic tumor. These patients were studied with reference to location and stage of the primary colon cancer and location of metastases at the time of planned liver resection. All seven patients had their extrahepatic lymphatic disease limited to nodes draining the liver, implicating lymphatic dissemination from hepatic metastases as the mechanism of tumor spread. This pattern of spread rendered these patients unresectable for cure. If lymphatic metastases occur from hepatic tumor this implies a need for frequent and thorough follow-up of patients following resection of a primary colon cancer, and indicates urgency in treatment of liver metastases. PMID- 3978542 TI - Medullomyoblastoma. A teratoma. AB - Three cases of medullomyoblastoma in children are reported. The second case is unique in that in addition to areas of medulloblastoma and rhabdomyosarcoma, there were areas of well-differentiated teratoma containing all mature elements. This observation lends support to the teratomatous nature of medullomyoblastoma. PMID- 3978543 TI - Serum copper, serum ceruloplasmin, and erythrocyte sedimentation rate measurements in children with Hodgkin's disease, non-Hodgkin's lymphoma, and nonmalignant lymphadenopathy. AB - Between 1975 and 1981, 29 children with Hodgkin's disease, 22 with non-Hodgkin's lymphoma, and 13 with lymphadenopathy from various nonmalignant causes were studied with respect to the usefulness of serum copper, ceruloplasmin, and erythrocyte sedimentation rate (ESR) as markers of disease activity. Although elevated copper and ceruloplasmin levels were indicators of disease activity in the childhood lymphomas, and in patients with Hodgkin's disease the levels tended to be higher in those with advanced clinical stage, they were no better markers of disease activity than the ESR. Moreover, elevated serum copper and ceruloplasmin were nonspecific, since one child with benign lymphadenopathy and one Hodgkin's disease patient with an infection had raised levels. Low levels of copper and ceruloplasmin were found in four jaundiced patients probably because of impaired hepatic synthesis of ceruloplasmin. The authors conclude that serum copper and ceruloplasmin levels are no better markers of disease activity in children with lymphomas than is the ESR. PMID- 3978544 TI - Immunohistologic localization of estrogen receptors in breast cancer with monoclonal antibodies. Correlation with biochemistry and clinical endocrine response. AB - Breast cancer specimens from 114 patients were assayed for the presence of estrogen receptors (ER) utilizing highly specific, monoclonal antiestrophilin antibodies and the peroxidase-antiperoxidase technique. Results were compared with conventional ER determinations by the dextran-coated charcoal method (DCC) and were in agreement as to positivity and negativity in 86%. Semiquantified immunocytologic assay results were in accord with the level of ER as measured by DCC in 66%. The tumors studied included 43 from patients with Stage IV disease where clinical response to hormonal manipulation was known. In the latter group, the immunohistologic method had a sensitivity similar to that of DCC but showed a superior positive predictive value and a significantly better specificity. These results indicate that this new method is a valuable laboratory tool, enabling prediction of hormone responsiveness in advanced mammary carcinoma and capable of performance at the community hospital level. PMID- 3978545 TI - Determination and characterization of hexokinase in thyroid cancer and benign neoplasms. AB - Hexokinase (ADP: D-hexose-6-phosphotransferase, EC 2.7.1.1) was studied in human thyroid carcinomas (n = 11), follicular adenomas (n = 32), and normal thyroid tissue (n = 21). The specific activity was significantly increased in carcinoma (0.163 +/- 0.083 U/mg protein) compared with normal tissue (0.030 +/- 0.010 U/mg protein) (P less than 0.001). Specific activities of follicular adenomas are rather heterogeneous, but when subdivided into three groups according to histopathologic criteria, a significant difference was found between follicular adenomas group I and II and follicular adenomas group III. A lesser cellular differentiation of adenomas is indicated by the lower degree or even absence of colloid production and follicle formation. A higher proliferation rate may be assumed on the grounds of the irregularities in outline, the often defective pseudocapsule, and signs of compression of the surrounding tissue. The highest specific activity in adenomas was found in the group with the highest proliferative activity, i.e., group III, whereas the lowest specific activities were found in adenomas with the lowest grade of proliferation, i.e., group I; the former was comparable with values found in carcinomas and the latter was comparable with values found in normal thyroid tissue. An interesting difference was found when the compartmentation of hexokinase was compared in carcinomas of different degree of differentiation. In papillary carcinomas a significantly lower proportion of hexokinase (HK) is present in the cytosol in comparison to follicular and undifferentiated carcinomas. In carcinomas more HK II and less HK I was found in comparison with normal thyroid tissue. In contrast hexokinase isozyme composition and compartmentation in adenomas were not different from normal thyroid tissue. PMID- 3978546 TI - Correlation of thyroglobulin measurements and radioiodine scans in the follow-up of patients with differentiated thyroid cancer. AB - Correlation of radioiodine (131I) scans and serum thyroglobulin (Tg) concentrations were performed in the follow-up of 85 differentiated thyroid cancer patients who had undergone total thyroidectomy. Tg results were also compared with the control group of 33 thyroidectomized patients with no evidence of thyroid carcinoma and normal values for Tg established. Excellent correlation between Tg and scans was noted in patients with scan evidence of metastasis distant from the neck. Poor correlation was present in patients with scan evidence of local neck metastasis only, thyroid bed activity, and those with mediastinal activity. In addition, in 8% of the patients, the Tg assay could not be performed because of interfering antibodies. The conclusion is that elevated Tg concentration is a good indicator of metastasis outside of the neck as detected by 131I scans. Caution should be used when Tg alone is used in evaluating local neck metastasis demonstrated on scans. The significance of mediastinal activity warrants further investigation. PMID- 3978547 TI - Ependymoblastoma. A reappraisal of a rare embryonal tumor. AB - This article reviews the clinicopathologic features of 12 ependymoblastomas, including those of 7 previously unreported cases. The histologic characteristics included a high density of small to medium-sized neuroepithelial cells with a uniform cytologic appearance, frequent mitotic figures, and numerous diagnostic ependymal rosettes and tubules. Differentiation was restricted to glial precursor cells and to cells with the differentiating features of ependymal cells. Cytogenetically, the tumor cells with the differentiating hallmarks of ependymal cells but which have retained their mitotic activity were considered to be ependymoblasts. Many of the rosettes in the tumors were of the ependymoblastic type, but ependymal rosettes were also present. The absence of pleomorphism, giant cells, multinucleation and pseudopalisades, and the scanty proliferation of vascular endothelial cells are additional features that delineate this tumor from an anaplastic (malignant) ependymoma. The median age of the patients was 2 years. After surgical treatment the median survival time was 12 months. Because of the frequency of leptomeningeal involvement, whole neuraxis radiation should be considered. PMID- 3978548 TI - Primary malignant melanoma of the oral cavity. A review of 177 cases. AB - Malignant melanoma of the oral cavity is rare, accounting for about 1% to 8% of all melanomas. There have been no prospective studies of melanoma in this location, and all previous papers have reported small numbers of cases or have retrospectively reviewed case reports from the literature. The authors report six new cases and review 171 cases published since the last major review in 1975. The classification of oral melanomas with radial growth phases is discussed. PMID- 3978549 TI - Survival of cancer patients by economic status in a free care setting. AB - Patients with lung, breast, and colorectal cancer were classified as to their economic status for comparison of survival. Patients at the City of Hope Medical Center are admitted and treated without regard to their economic status, providing an excellent place to test the effect of low economic status on survival. In none of these disease sites was an effect of low economic status observed, even when adjusting for age, sex, stage, smoking status, and alcohol usage. The only variable that consistently predicted survival was stage of disease; when accounting for stage, there was no independent effect of low economic status. In the presence of uniform care, low economic status as defined in this study is not a factor in patient survival. PMID- 3978550 TI - Influence of oral contraceptives on the prognosis of breast cancer in young women. AB - The possible effect of oral contraceptive (OC) use on the prognosis of established breast cancer was investigated in 154 young women aged 35 and younger. No significant differences were found between the study group of 59 OC users, and the control group of 95 nonusers in age, parity and gravidity, family history of breast cancer, benign breast disease, morphology, or surgical therapy. No appreciable differences were found between OC users and nonusers in extent of disease at presentation (P = 0.78), histologic features of tumor (P = 0.83), or axillary node involvement (P = 0.88). No significant or even suggestive differences were found between users and nonusers in disease-free interval (P = 0.41), metastatic period (P = 0.66), or survival (P = 0.54), respectively, either alone or when adjusted for extent of node involvement, duration of OC use, or other risk factors. In this study no evidence was found that the use of OC has any harmful or beneficial effect on evolution and survival of breast cancer. PMID- 3978551 TI - Ethnicity, survival, and delay in seeking treatment for symptoms of breast cancer. AB - This study examined differences in 10-year survival rates from breast cancer among white, black, and Hispanic women controlling for the effects of age, socioeconomic status (SES), stage of disease, and delay in seeking treatment for symptoms. Breast cancer patients (n = 1983) treated at M. D. Anderson Hospital and Tumor Institute in Houston, Texas between 1949 and 1968, were followed for 10 years. Ethnicity, SES, stage of disease, and delay were all found to affect survival when considered separately. Black patients were less likely to survive than either white or Hispanic patients whose survival experience appeared to be similar. Multivariate analysis that used a Cox regression technique showed that ethnic differences remained when age, SES, stage, and delay were included in the model. In contrast, the authors could not detect an effect of delay on survival when ethnicity and all other variables were included. These data suggest that ethnic differences in breast cancer survival are not mediated by differences in delay in seeking treatment for breast cancer symptoms. PMID- 3978552 TI - Recurrence rates for colorectal polyps. AB - Of 276 patients who underwent an initial colonoscopic polypectomy for adenomatous polyps over a 45-month period, 118 subsequently had one or more repeat screening colonoscopies. The mean follow-up time was 26 months with an overall polyp recurrence rate of 30%. Analysis of these data retrospectively suggests that the bulk of the recurrences occurred within the first year. Increasing age was found to be a significant risk factor for polyp recurrence. Asymptomatic recurrence of adenomatous polyps detectable by colonoscopy is a common occurrence in postpolypectomy patients. Prospective studies utilizing colonoscopy as a screening tool are needed to establish a rational screening policy for this high risk group. PMID- 3978553 TI - Histopathologic grading of squamous cell carcinoma of the uterine cervix. An evaluation of 70 stage Ib patients. AB - Multiple histopathologic parameters were evaluated to determine which were of prognostic value in predicting patient outcome. Seventy patients with clinical stage Ib squamous cell carcinoma constituted the study population. The patients were primarily treated by surgery, with actuarial survival rates of 76%, 68%, and 57% at 5-, 10-, and 15-year intervals. Eight of 57 patients (14%) with lymph node material available for review had pelvic lymph node metastases and a decreased survival rate (P less than 0.001). Thirty-six patients had 5 mm or less depth of tumor invasion in their hysterectomy specimen and a 5-year survival rate of 94%. Thirty patients had greater than 5 mm of invasion in resected uteri and a 5-year survival rate of 58% (P = 0.007). None of the patients with less than 5 mm of invasion died of their disease. Evaluation of nine histologic parameters in the initial biopsy specimens demonstrated that only vascular invasion (lymphatic and/or capillary) predicted a poor outcome (P = 0.046). Cell size, inflammatory response, degree of keratinization, or any of the other histologic parameters tested failed to demonstrate significant prognostic value in this study. PMID- 3978554 TI - Leimyosarcoma of the urinary bladder. 13 years after cyclophosphamide therapy for Hodgkin's disease. AB - A leiomyosarcoma of the urinary bladder occurred in a 17-year-old boy who was treated with a total dose of 67 g cyclophosphamide over a period of 5 years for Hodgkin's disease diagnosed at the age of 4. Cyclophosphamide was discontinued at the age of 9 because of gross hematuria, and intermittent hematuria recurred 8 years after (at the age of 17) the cessation of this drug. A large exophytic tumor found in the urinary bladder was diagnosed as leiomyosarcoma by light and electron microscopic studies. In addition, there were microscopic features of long-term cyclophosphamide toxicity throughout the bladder wall. PMID- 3978555 TI - A testicular tumor resembling the sex cord with annular tubules in a case of the androgen insensitivity syndrome. AB - Sex cord tumor with annular tubules (SCTAT) is a distinctive neoplasm with indifferent cells of sex cord derivation in a characteristic arrangement of ring like tubules. Much attention has been drawn to its association with the Peutz Jeghers syndrome (PJS) with reported occurrence of the tumor in the testis of a boy with PJS. The authors present two cases of the androgen insensitivity syndrome (AIS), one of the cases being distinctive in having a large multicystic tumor resembling the SCTAT in the immature gonad. Additionally, the focal areas of the tumor, the large Sertoli cells lining the tubules, resembled those of a large cell calcifying Sertoli cell tumor (LCCSCT) although no calcific areas were discernible. Although the occurrence of neoplasms like germinomas and tubular adenomas is well known in the AIS, SCTAT has hitherto not been reported in a gonad of the AIS. SCTAT has been placed under an "unclassified sex cord-stromal" category in the World Health Organization (WHO) Classification, yet, opinions are divided as to its origin from a granulosa or Sertoli cell, although an overlap in the histologic features of the two cell categories is to be anticipated in view of their homologous nature. In the case presented, the close resemblance of the tumor cells to the Sertoli cells of the uninvolved gonad would further support the concept of a Sertoli line of differentiation of the SCTAT. PMID- 3978557 TI - Cancer of the penis. Prognosis and treatment plans. AB - Sixty-one patients with clinical low-stage (Jackson Stage I) and 22 patients with clinical high-stage (Jackson Stage II or III or T3-4N0-1M0) carcinoma of the penis who were seen between 1952 and 1979 and followed for at least 3 years or until death were reviewed. The majority of patients with Stage I cancer were treated with partial penectomy, either with or without ilioinguinal lymphadenectomy. The remainder of patients with these early small lesions were treated with local excision or circumcision. Forty-one of the patients with this early penile cancer (Jackson Stage I or Tcis, T1N0M0 or T2N0M0) survived at least 3 years and were considered cured. The other 20 patients died of cancer (12 cases) or unrelated disease (8 cases). If the patients who died of other diseases are excluded, the corrected 5-year survival rate was 77%. Treatment failure was primarily due to metachronous inguinal metastases after initial treatment of the primary tumor and failure of response of metastatic disease to salvage treatment. Four factors probably were associated with a poor prognosis: large primary tumor, moderately to poorly differentiated cancer, younger age at onset, and inadequate initial treatment. In advanced (Jackson Stages II and III) disease, treatment by partial or total penectomy alone or in combination with radiation to inguinal nodes after penectomy produced 3-year or longer survival in only 2 of 9 patients, whereas treatment by early extended excision of both the primary lesion and the ilioinguinal lymph nodes produced 3-year or longer survival in 11 of 13 patients. The results suggest that local excision is appropriate only for carcinoma in situ. Partial penectomy and monthly follow-up for at least 1 year is appropriate for patients with small, well-differentiated primary tumors. Patients who have large or moderately to poorly differentiated primary tumors probably should undergo partial or total penectomy and immediate ilioinguinal lymphadenectomy. PMID- 3978556 TI - Testicular tumors in the Netherlands. AB - The data of 764 patients, registered with the Netherlands Committee for Testicular Tumors during the 1971-1978 period, were analyzed. To a large degree the results were in agreement with those in the literature. Chest x-rays and bipedal lymphangiograms were the most useful investigations for detection of metastases, with supplementation by lung planigraphy where indicated. Local invasion of extratesticular tissue by tumor had no relationship to prognosis. The survival figures were comparable to those of the better series in the literature. There was essentially no difference between the behavior and treatment of combined tumors and malignant teratomas, so these may be viewed as a single entity. Because recurrences occurred after 2 years in 21% of seminoma patients, and in 4% of nonseminoma patients, a minimum follow-up period of 5 years is desirable. PMID- 3978558 TI - Low-dose cytosine arabinoside treatment for acute nonlymphocytic leukemia in elderly patients. AB - Thirty patients older than 65 years of age with acute nonlymphocytic leukemia were treated with low-dose cytosine arabinoside (10 mg/m2 subcutaneously every 12 hours for 15 to 21 days). Fifteen achieved complete remission and five had partial remission. Treatment was more effective when initial bone marrow cellularity was low (P = 0.007). Four of six patients with secondary leukemia entered complete or partial remission. Therapy was well tolerated with reduced myelosuppression and few number of early deaths. Sixteen patients followed the whole treatment as outpatients. Six of 12 patients who achieved complete remission showed no evidence of post-therapeutic bone marrow aplasia. These data are consistent with the view that low-dose cytosine arabinoside acts on leukemic cells as a differentiating agent. PMID- 3978559 TI - Clinical effects of total-body hyperthermia combined with anticancer chemotherapy for far-advanced gastrointestinal cancer. AB - The authors treated 17 patients with far-advanced gastrointestinal cancer with extracorporeally induced total-body hyperthermia (TBHT) combined with anticancer chemotherapy. Although all patients' tumors were clinically resistant to prior chemotherapy with 1-(2-tetrahydrofurlyl)-5-fluorouracil or 5-fluorouracil and mitomycin C, three patients had an objective response to TBHT plus the same anticancer agents with or without cyclophosphamide. That is, a partial response was obtained in 2 of 12 patients with recurrent gastric cancer and in 1 of 5 patients with recurrent large bowel cancer. However, their survival time was not markedly prolonged. As a characteristic complication of TBHT, the authors noted reversible weakness of the muscles of the lower extremities. Two patients died due to hepatorenal syndrome; preoperatively these patients had manifested hepatic or renal dysfunction. Therefore, in patients with hepatic or renal dysfunction, the application of TBHT must be considered carefully. PMID- 3978560 TI - Restoration of defective EAG-rosetting capacity of cancer patient neutrophils by levamisole. AB - Levamisole, used in vitro at therapeutic concentrations, was found able to restore the defective Fc-receptor activity of cancer patient neutrophils. In addition, the drug prevented the inhibition of normal neutrophils Fc-receptor function by cancer patient sera. The neutrophil Fc-receptor function was also restored in six of seven cancer patients after in vivo administration of levamisole (2.5 mg/Kg/day for 3 days). Due to the central role played by the Fc receptor function in host defence mechanisms, including phagocytosis as well as antibody dependent cellular cytotoxicity, the capacity of levamisole to restore defective neutrophil Fc-receptor function in cancer patients could contribute to the "immunomodulating" effect of the drug. PMID- 3978563 TI - The prognostic significance of lymph-vascular space invasion in stage I endometrial cancer. AB - Surgical specimens from 111 patients with Stage I endometrial cancer were reviewed for the presence of lymph-vascular space invasion by tumor cells. Lymph vascular space invasion was noted in 16 cases, and occurred most frequently in poorly differentiated tumors with deep myometrial penetration. Tumor recurrence developed in 44% of patients whose tumors demonstrated lymph-vascular space invasion as opposed to only 2% of patients without this finding (p less than 0.001). Of seven patients with lymph-vascular space invasion who experienced tumor recurrence, five developed extra-pelvic metastases. Discriminant function analysis of these data revealed a statistically significant correlation between lymph-vascular space invasion and tumor recurrence, independent of histologic differentiation of myometrial penetration. These findings suggest that lymph vascular space invasion by tumor cells is an important prognostic variable in Stage I endometrial cancer which should be considered in treatment planning. PMID- 3978562 TI - A cell kinetic study on medulloblastomas. AB - The cell kinetics of medulloblastoma were studied to define characteristic proliferation for comparison with other neuroectodermal tumors. Four patients with cerebellar medulloblastoma received 3H-thymidine intravenously 1 to 2 days before surgery. Biopsy specimens from each tumor were processed for autoradiography. The respective average labeling indices were 14.4%, 14.1%, and 11.2% in the three mid-cerebellar medulloblastomas and 8.0% in the cerebellar hemispheric medulloblastoma. The mean survival time with various treatments including radiation therapy before or after the study in these four patients was 6 years (range, 3-9 years). In contrast, patients with malignant gliomas that had a labeling index greater than 5% died within 1 year. This difference in survival was attributed to the greater sensitivity of medulloblastoma to radiation therapy. PMID- 3978561 TI - Neoplastic pathology of oncogenic osteomalacia/rickets. AB - Reported are two cases of oncogenic osteomalacia, each caused by a small mesenchymal tumor, with detailed assessment of the tumors by light microscopy, electron microscopy, and immunohistochemistry. One tumor was a primitive mesenchymal tumor with prominent giant cell and vascular components, and the second resembled the giant cell variant of soft parts chondroma. Osteoclast-like, multinucleated giant cells and vascularity were prominent features in both tumors. Although the literature documents a histologically heterogeneous group of tumors as causing this syndrome, most have multinucleated giant cells and/or extensive vascularity. The high incidence of these two histologic features in this group of tumors suggests that either or both may be related to the pathogenesis and/or metabolic consequences of oncogenic osteomalacia/rickets. PMID- 3978565 TI - Metastatic chondroblastoma. Report of a fatal case with a review of the literature on atypical, aggressive, and malignant chondroblastoma. AB - A boy with metastatic and fatal chondroblastoma is presented. Unlike previously published examples of metastatic chondroblastoma, these metastases developed before any operative manipulation of the primary tumor. The histologic characteristics of the primary, metastatic, and locally recurrent tumors were those of a conventional chondroblastoma. A review of published cases of atypical, aggressive, and malignant chondroblastoma is presented with current follow-up information. Although some metastatic chondroblastomas may result from operative manipulation of the primary tumor and are clinically benign, other histologically benign chondroblastomas exist that are capable of pursuing a malignant course. The authors designate these as malignant chondroblastomas. No histologic criteria exist for the separation of these tumors. PMID- 3978564 TI - Analysis of proliferative compartments in human tumors. II. Seminoma. AB - Growth pattern and cell kinetics of 12 human seminomas were determined by means of vascular organ perfusion after orchiectomy. The arteria testicularis of the tumor-bearing testis was perfused up to 5 hours with dextran-diluted blood under normothermic and normotonic, simulated physiologic conditions. At defined periods, the specimen was exposed to tritiated and/or carbon 14-labeled thymidine. Autoradiograms prepared of whole tumor sections revealed a dependence of growth pattern on the stage of development. A homogeneous distribution of DNA synthesizing seminoma cells was found in small tumor foci. With increasing size, the zone of proliferation shifted to the periphery of the nodule giving rise to nodular subpopulations of high proliferative activity. In nodules of a diameter of more than about 2 cm the growth compartment consists of a highly proliferating invading cell layer at the edge of the tumor and intratumoral patches of proliferating cells near the vascular stroma. The largest part of the tumor remains at this stage in a quiescent state (G0). The mean labeling index of the seminoma cells was 11.6 +/- 1.4%, with the highest values found immediately adjacent to tumor vessels. High mitotic activity in an anaplastic seminoma was coupled with maximum labeling indices up to 41.9%. DNA synthesis time ts was 15.9 +/- 2.0 hours. The potential population doubling time for the proliferating fraction was in the range of 5 days. Lymphocytic infiltration reduced the proliferative activity in some parts, but was without effect in other areas of the seminoma. The seminoma is an example of a malignant human tumor with a rather regular growth pattern: The distribution of the proliferating compartment appears less dependent on cytologic or histologic structure, but more on tumor geometry and size. PMID- 3978566 TI - Nephrotic syndrome in two patients with cured Hodgkin's disease. AB - Two cases of lipoid nephrosis (minimal change glomerulonephritis) in patients cured of Hodgkin's disease are reported and the literature is reviewed. Cases reported to date have shown a close temporal relationship between this renal lesion and the presence of Hodgkin's disease. The patients reported are 11 and 9 years without evidence of active malignancy after successful treatment for Hodgkin's disease. Each had abnormal immunologic parameters, depressed T4 (helper) cells and increased T8 (suppressor) cells, which may predispose to the development of the nephrotic syndrome. However, the advent of this complication is not necessarily a harbinger of recurrent lymphoma. PMID- 3978567 TI - The Tanzanian human albino skin. Natural history. AB - Three hundred fifty albinos in the city of Dar-es-Salaam have been registered at the Tanzania Tumor Centre. Their skin changes were followed for at least 2 years. Chronic skin damage was evident in all albinos by the first year of life; by 20 years, the skin of every subject demonstrated subclinical malignant change, and some had clinical epitheliomas. Untreated, the latter tumors become intractable and disseminate, usually causing death in the third or fourth decade of life. Four clinical stages could be identified, each one associated with distinct pathologic changes: Stage 1, erythema; Stage 2, epidermal atrophy with dermal hypertrophy; Stage 3, solar keratosis; and Stage 4, clinical carcinoma (under 3 cm). It was found that clinical Stage 2 only occurs in those skin areas that show evidence of previous Stage 1 change. Similarly, Stage 3 occurs only in areas that have gone through Stages 1 and 2. Stage 4 cancers were only found in those areas that had gone through all of the three prior stages. During the 2-year period of this study, 104 skin cancers, both early and advanced, were recorded at the albino skin clinic. Thirty-three of the 104 cancers were advanced (over 4 cm in diameter). The median age of the latter group was 31.0 years. Whereas there was no sex bias in the distribution of clinical cancer, 28 of the 33 advanced cancers were in men. Histologically, the great majority of the advanced tumors were squamous cell carcinomas: 29 of 33. There was one melanoma and three basal cell tumors. The predominant site of advanced cancers in the study group was the head and neck region (30 patients); the other three occurred on the trunk, which is generally covered by clothes. PMID- 3978568 TI - Advanced ovarian carcinoma. Factors influencing survival. AB - One hundred ten patients with advanced ovarian carcinoma (Stages IIIA, IIIB, and IV) were evaluated for survival. They received as first treatment one of the following regimens: melphalan (L-PAM) (41 patients), cyclophosphamide plus methotrexate plus 5-fluorouracil (CMF) (16 patients), cyclophosphamide plus doxorubicin plus 5-fluorouracil (CAF) (17 patients), cyclophosphamide plus doxorubicin plus hexamethylmelamine plus cisplatin (CHAD) (13 patients, thiotepa plus methotrexate (TM) with fixed rotation with CAF (TM/CAF) (17 patients), and 6 patients received other chemotherapy as first treatment. There was no significant difference in survival time with the various treatment arms despite differences in response rates. Patients with Stage IIIA had significantly longer survival than those with Stages IIIB and IV (P less than 0.01). Patients with good performance status (PS 0) had significantly better survival than those with poor performance status (PS 3-4) (P less than 0.02). At this time the improved response rates on combination chemotherapy has not given improved survival rates, and disease stage and performance status remain of prime importance in survival prediction. PMID- 3978570 TI - Epidemiology of cancer of the vulva. A case-control study. AB - Few epidemiologic studies have been undertaken to investigate the etiology of cancer of the vulva. To identify risk factors associated with this cancer, a case control study was conducted in 149 patients with histologically proven vulvar carcinoma and the same number of control patients matched for age, race, marital status, and hospital from five U.S. metropolitan areas. As previously suspected, we found prior histories of leukoplakia of the vulva, inflammation of the vulva or vagina, and urogenital cancer to be significantly associated with vulvar cancer. In addition, we found moderately high odds ratios associated with occupational histories of private household maids and servants, and work in laundry, cleaning, and other garment services. A slightly increased odds ratio was associated with coffee consumption and a dose-response effect was demonstrated. The findings suggest that environmental exposures may play a role in vulvar carcinogenesis. PMID- 3978571 TI - Ependymoblastoma associated with prenatal exposure to diphenylhydantoin and methylphenobarbitone. AB - Ependymoblastoma developed in a 28-month-old girl whose epileptic mother took diphenylhydantoin and methylphenobarbitone throughout pregnancy. The child was also shown to be a genetic carrier for ornithine transcarbamylase deficiency, an x-linked inborn error of urea cycle metabolism. The possibility of transplacental carcinogenesis should be considered, as other juvenile embryonic tumors such as neuroblastoma, melanotic neuroectodermal tumor, and mesenchymoma have been reported in offspring after diphenylhydantoin use by the mother during pregnancy. PMID- 3978569 TI - Sexual functioning morbidity among cancer survivors. Current status and future research directions. AB - The current article reviews available data and considers methodologic issues for future research in which sexual functioning among adult cancer patients is an endpoint variable. Circumstances that may cause sexual disruption for any cancer patient are suggested, including mood disturbance, changed health status, somatization, and reprioritization of life concerns. Data on the incidence and magnitude of sexual functioning morbidity following the diagnosis and treatment of cancer at major organ sites, including breast, genital, colon, rectum, and bladder, are reviewed. Finally, strategies for continuing descriptive study of the sexual problems of cancer patients are suggested. Such data are necessary to eventually target preventive or therapeutic resources to patients in greatest need. PMID- 3978572 TI - Subsequent upper aerodigestive malignancies following treatment of esophageal cancer. AB - One hundred ninety-eight patients received radiation therapy for carcinoma of the esophagus. Eight patients subsequently developed at least one other epidermoid carcinoma within the upper aerodigestive tract. Analysis by life-table method suggests a steadily increasing risk for second malignancies as survival lengthens. Implications with regard to the treatment and management of patients with squamous cell carcinoma of the esophagus are discussed and the relevant literature is reviewed. PMID- 3978573 TI - Computerized tomography evaluation of chest wall involvement in lymphoma. AB - One hundred fifty-nine computed tomographic (CT) scans were performed on 123 patients (90 Hodgkin's disease and 33 non-Hodgkin's lymphoma). Seventeen patients were shown to have involvement of the chest wall. Computed tomographic scans were more sensitive in detecting chest wall lesions than conventional x-rays and clinical examination. This information was important in staging the extent of disease at presentation, guiding radiation therapy, and assessing response to treatment. The anterior chest wall was most commonly affected with or without associated anterior mediastinal disease, but other sites also were involved. PMID- 3978574 TI - Angioimmunoblastic lymphadenopathy with dysproteinemia. Circulating immune complexes and the review of 18 cases. AB - Eighteen patients with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) have been analyzed by reviewing all available biopsy, laboratory, and clinical data. Because of features suggesting the presence of circulating immune complexes (CIC), CIC serial sample determinations were performed throughout their disease in available patients. Age, sex, and clinical and laboratory characteristics were consistent with previously reported series. Six of 18 (33%) patients having a drug exposure associated with onset or exacerbation of symptoms demonstrated a significantly decreased survival (P less than 0.02). Achievement of complete remission was a significant indicator of longevity (P less than 0.001). Only one patient (6%) developed diffuse histiocytic lymphoma. Elevated CIC were detected in the four patients tested. In two patients fluctuating CIC levels could clearly be correlated to clinical remission or exacerbation. Despite the small number of patients tested, it was concluded tha CIC may provide useful information for therapy selection, prediction of relapse, and further insight into pathogenetic mechanisms in AILD. PMID- 3978575 TI - Terminal deoxynucleotidyl transferase activity in childhood leukemia. AB - The activity of terminal deoxynucleotidyl transferase (Tdt) was measured in mononuclear cells of 70 children with acute leukemia, in whom raised levels of Tdt were noted at diagnosis, relapse, or during remission. Serial measurements of Tdt activity were related to the percentage of blasts in the bone marrow and the clinical course of children both during therapy and after its completion. The Tdt values did not predict relapse in children with acute lymphoblastic leukemia nor did the quantitative determination correlate with the percentage of blasts in the bone marrow. PMID- 3978576 TI - Malignant mesothelioma secondary to chronic inflammation and old scars. Two new cases and review of the literature. AB - Old scars of the pleura, for example from chronic empyema or therapeutic pneumothorax, can cause a malignant mesothelioma appearing some decades later. The authors describe two cases of primary pleural tumors, which probably had such an etiology. A literature review revealed 20 further cases, the majority of which were squamous cell carcinomas. Whether these tumors developed from metaplastic mesothelium or inplanted cells from the skin is not clear. PMID- 3978577 TI - Surgical and pathologic complications associated with peritoneovenous shunts in management of malignant ascites. AB - Forty-three peritoneovenous shunts have been inserted to palliate malignant ascites in 33 patients. Ascites was controlled for a time in every patient, but 18 shunts eventually blocked. Further shunt revision successfully controlled ascites until death in five of these patients and for prolonged periods in another five. The authors observed a marked difference between the performances of the two available shunts, but emphasize that the two groups of patients were not selected at random and therefore may not be comparable. Twelve postmortem examinations have been performed in the 33 patients to ascertain causes of shunt malfunction and to identify possible evidence of abnormal or accelerated tumor spread. The postmortem findings highlight great variability in the capacity of iatrogenically introduced showers of tumor cells to seed. There was a spectrum of tumor growth in the lung from a complete absence of tumor cells through dormant tumor clumps to developing metastases. The authors found no evidence either clinically or at autopsy, that the procedure had adversely affected the prognosis, except in one patient who died from pulmonary edema immediately after the operation. PMID- 3978578 TI - Prognostic value of the topographic grid method in women with T2 N- breast cancer. Statistical results from a series of 203 patients. AB - In 1977, the authors described the grid method, a topographic technique for mapping the microscopic spread of breast cancer. The current report describes the relapse-free survival of a series of 203 patients with T2 N- mammary cancer (T2 N0 N1 ab N-) who were treated by mastectomy and regional lymph node dissection and have been followed since 1974. A good prognosis did not prevent relapse in 15% to 20% of patients within the first 5 years. To determine whether the grid method can identify patients at high risk within this group, disease-free survival and survival were compared in two subsets, a "limited" group (L) and a "diffuse" group (D). The difference between the two groups was statistically significant for both parameters (88%) versus 77% and 93% versus 85% after 5 years) (P less than 0.01 and P less than 0.02). Other prognostic measures were uniformative. Thus, the grid method has a good prognostic score when compared with the factors usually measured--menopausal status, estrogen receptors, histologic type--and could be used to select appropriate adjuvant therapy in breast cancer. PMID- 3978579 TI - Diagnostic approach to incidental adrenal nodules in the cancer patient. Results of a clinical, radiologic, and fine-needle aspiration study. AB - Twenty-three nonfunctioning adrenal nodules were discovered during computed tomographic (CT) evaluation of the abdomen in 16 patients with a variety of primary extra-adrenal malignant neoplasms. In seven cases the adrenal masses were bilateral. Following percutaneous fine-needle aspiration biopsy, pathologic diagnosis was consistent with benign adenoma in seven patients, and with adrenal metastasis in nine. There was no significant difference in age, sex, or incidence of bilateral distribution among these two groups. Three of the adenomas were calcified, and the size of the benign nodules in all patients was less than 3 cm. No calcification was seen in metastatic adrenal nodules, and their sizes ranged between 2 and 20 cm. The clinical and radiologic features of these two groups of patients are evaluated, and a rational approach for the management of adrenal masses is described. The CT images of adrenal adenoma and adrenal metastasis, along with their corresponding cytopathologic features, are illustrated. PMID- 3978580 TI - Adrenal adenomas and adrenal carcinomas in association with hereditary adenomatosis of the colon and rectum. AB - Hereditary adenomatosis of the colon and rectum (HACR) is associated with a wide variety of extracolonic manifestations. Two cases of neoplasia involving the adrenal gland are reported, one adenoma and one carcinoma. The literature relating these lesions to HACR and other syndromes of malignant and nonmalignant growth disturbance is reviewed. The increasing list of the extracolonic manifestations associated with HACR emphasizes the generalized nature of the growth disorder of this disease. An increased awareness of these lesions is important, as many patients with HACR now live longer by avoiding death from colorectal carcinomas due to the increasing usage of prophylactic colectomy. PMID- 3978581 TI - Soft tissue sarcomas of the hand and foot. AB - A retrospective study was made of 82 soft tissue sarcomas of the hand and foot. Prognosis was related to histopathologic grade of malignancy and success or failure of local tumor control. After treatment with curative intent, low-grade tumors gave a 5-year survival rate of 90%, compared to 63% for high-grade tumors. Simple excision or limited amputation of the digit, hand, or foot yielded a 5 year survival rate of 68% (15/22) and a local recurrence rate of 32%. Amputation below the elbow or knee or higher resulted in a similar survival of 68% (19/28) but no local recurrences. All patients who developed local recurrences died, except for two with low-grade tumors and one patient lost to follow-up. These observations indicate the need for systemic chemotherapy to prevent death from metastasis, and for effective local tumor control. Conventional radiation therapy may be difficult to apply at these sites. Innovative local treatment approaches to preserve limb function without jeopardizing tumor control merit study. PMID- 3978582 TI - Factors influencing survival in carcinoma of the ovary. Study from a well-defined Swedish population. AB - Prognostic factors were studied in 770 cases of carcinoma of the ovary treated at Radiumhemmet during 1974 to 1979. Centralization of the treatment in a well defined population with complete follow-up permits a nonselective study of the disease. The analysis was made separately for early and late stages. For the early cases, histology and grading were the most dominant prognostic factors. For the most advanced cases successful surgical treatment, either primary or secondary, showed significant relation to survival. Successful secondary surgery could be achieved in twice as many cases where radiotherapy was included in the treatment. Even for the advanced cases, the stage but not the histology was of prognostic significance. The major difficulties in evaluating treatment of ovarian cancer, especially in advanced cases, are associated with the multiplicity of sites of the disease and the prognostic factors that may contribute independently to the outcome. PMID- 3978583 TI - Occupation, tobacco use, coffee, and bladder cancer in the county of Mataro (Spain). AB - This report presents the results of an epidemiologic case-control study. The study includes 58 cases and 116 controls from both sexes, selected from the Admission Register of the Hospital and from the Death Registry Office of the local city authorities. Controls have been matched to cases by age, sex, place of residence and source of selection. The results demonstrated no increased risk associated with coffee consumption. Habitual smokers present a 2.3 times higher risk than nonsmokers. The estimated relative risk for occupation standardized by age and smoking habit, is 5.5. A multiplicative effect of the simultaneous action of smoking and occupational exposure has been observed to be an estimated relative risk of 11.7. The attributable risk of the population has been estimated to be 39% for smokers and 12% for occupational exposure. A strong association was found between bladder cancer and occupational exposure to carcinogenic substances, especially in the dye and print textile industries. PMID- 3978584 TI - American Cancer Society National Conference on Radiation Oncology 1984. San Francisco, California, June 14-16, 1984. PMID- 3978585 TI - Radiation therapy treatment of larynx cancers. AB - Cancers in the mouth and throat area comprise only 5% of all cancers seen in the US. Because of their critical location and the various consequences of treatment, they produce a devastating impact on the quality of life. Of the many anatomic sites in the upper air and food passages, the oral cavity and larynx are involved with cancer in two thirds of the patients. In the oral cavity, less than 50% of the cancers are diagnosed when the disease is still localized, leading to a generally poor overall result. In the larynx, two thirds of the primaries arise in the glottis where hoarseness stimulates early diagnosis, leading to an excellent prognosis. Treatment strategies must be directed toward the observed patterns of failure. For mouth and throat cancers, even when modestly advanced, distant failure is observed in fewer than one third of the patients. Control of the disease in the primary site and regional node stations generally employs aggressive use of surgery, radiation therapy, or a combination of the two. More recently, the use of chemotherapy programs combined with either surgery or radiation therapy has been of benefit to patients with advanced lesions. The choice of a specific management program depends upon (1) the cancer control to be expected, (2) the effectiveness of a possible salvage treatment program, and (3) the quality of life experienced by the successfully treated patient. Radiation therapy is increasingly becoming the treatment of choice for early carcinomas of the larynx. Recently published results from four major institutions embracing over 4000 patients suggest radiation therapy cure rates for T1 lesions of 90% and T2 lesions of 70%, with the successful salvage by surgery of more than 50% of the radiation therapy failures, bringing the ultimate cure rate to over 95% for T1 lesions and over 85% for T2 lesions. The excellent results coupled with the good quality of life mandates this approach. Surgical alternatives are more frequently suggested for T3 lesions or for supraglottic lesions. Primary radiotherapy for T3 glottic lesions currently cures more than 50% of such patients with surgical salvage, bringing the total cure rate to 75%. Also two thirds of the cured patients retain their functioning larynx, increasing consideration must be given to primary radiation therapy and surgical salvage for these more advanced glottic lesions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3978586 TI - Rationale for combining surgery and radiation therapy. AB - The combination of radiation and surgery is being employed increasingly in preference to radical surgery alone or high radiation dose alone in the treatment of malignant epithelial and mesenchymal neoplasms. The basis for this interest is that the scope of the surgery and/or the radiation dose level are less than if either were employed alone. A reduction in treatment related morbidity, improved cosmetic and functional status, and in some instances a lower local failure rate may be achieved by this approach. The rationale for combining radiation and surgery is that radiation at moderate dose levels is effective in the eradication of microscopic extensions of tumor beyond the clearly obvious mass while the surgery (usually more conservative) removes the principal mass. PMID- 3978587 TI - Reaction potentials of the constituent bases of DNA and the effects of base stacking. AB - Reaction potential maps (RPM's) around the constituent bases of DNA have been plotted using the CNDO/2 method. The maps were drawn to evaluate site selectivity in electrophilic attack on the bases of DNA as a function of two considerations: base sequence and the nature of the attacking reagent. It was found that base sequence does have a substantial effect on a site's reactivity and that a change in the nature of the attacking reagent can alter site selectivity of the electrophile. The former result was applied in a specific case to offer a plausible explanation for some results of a recent study of the mutagenic effects of arylating metabolites of nitrofluorenes in the Salmonella tester strains TA98 and TA97. These strains differ in the arrangement of guanine and cytosine residues at the mutational target ("hot spot"). The results also suggest that the "hot spot" for TA98, which consists of a run of alternating guanine and cytosine base pairs, does not exist in the Z-configuration. PMID- 3978588 TI - Kinetics of amino acid transport by human-mouse myeloma hybrids--difference between human immunoglobulin producers and nonproducers. AB - Somatic cell hybridization techniques have allowed the preparation of interspecies hybrids that express the features of both parental cell lines. We have studied hybrids made with human myeloma cells fused to a continuous mouse myeloma cell line. In the present study we analyzed the kinetics of leucine influx and efflux in Ig producer and nonproducer hybrids. We found no statistical difference in amino acid influx; however, the rates of efflux were markedly increased in nonproducer hybrids as compared to the producers. The producer cells were tested further in puromycin known to inhibit protein synthesis. Under these conditions amino acid influx was not altered, but efflux was markedly increased resembling the findings in nonproducers. We conclude that hybrids that synthesize human immunoglobulins show decreased efflux of labeled leucine and this effect can be abolished by inhibition of protein synthesis. This difference in the efflux rate appears to be a consequence of immunoglobulin synthesis, rather than a component of a control mechanism of Ig synthesis. PMID- 3978589 TI - Antitemplate effect of polynucleotides and their hybrid complexes. AB - In continuation of efforts to correlate the antitemplate activities of modified polynucleotides with their structure, and to understand the factors governing both their potency and stability, a group of single-stranded poly(ribo- and deoxyribo-) nucleotides, and the "hybrid" double-stranded complexes were prepared and investigated. The double-stranded hybrid poly(A,hs5U).poly(dT) section was found to be more stable to murine blood nucleases than was the single-stranded poly(A,hs5U). In a comparative study as inhibitors of the DNA polymerase alpha from rat hepatoma, the results showed that the modified polynucleotides were more potent than the unmodified ones, in general, the polydeoxyribonucleotides were better antitemplates than their ribo counterparts and the poly(A70,hs5U30).poly(dT) hybrid was more active than either of the single stranded components. Thus it is possible to increase the nuclease resistance of the modified polyribonucleotides by forming hybrid complexes with complementary polydeoxyribonucleotides, and at the same time, to augment their antitemplate activities. PMID- 3978590 TI - Nonrandom chromosome alterations in rhabdomyosarcoma. AB - Chromosome banding analysis was attempted on tumor cells from a total of six rhabdomyosarcomas. Results revealed a variety of chromosome alterations, including frequent structural rearrangement of chromosome #1 and the finding in one patient of multiple double minutes. The single chromosome most consistently involved in structural rearrangements was #3. Simple deletion or translocation of either the long or short arm of chromosome #3 was found in all rhabdomyosarcoma tumors examined in this report. Further, a review of the limited previous literature on rhabdomyosarcoma provided further support for the frequent alteration of chromosome #3 in this disease. Results from our study provide preliminary evidence that alterations of chromosome 3p14-21 may represent a site of nonrandom chromosome change in rhabdomyosarcoma. PMID- 3978591 TI - Tumorigenicity, major histocompatibility antigens, and karyotypes of interspecific hybrids between mouse neuroblastoma and rat glioma or liver cells. AB - Five interspecific hybrids of mouse neuroblastoma with rat glioma (NG108-15, 140 3, and 141-B) or with nontransformed rat liver cells (NBr-10A and NBr-20A) were examined for major histocompatibility (MHC) antigens and tumorigenicity in comparison with their karyotypes. Both mouse and rat MHC antigens were present in each hybrid population, as determined by a simple cytotoxicity test. All five hybrid cell lines produced tumors in athymic nude mice with varied take incidences. Four hybrid cells, NG108-15, 140-3, NBr-10A, and NBr-20A, were highly tumorigenic. Their karyotypes were characterized by a higher modal chromosome numbers than would be expected from the fusion of parent cells in which at least one parent contained an increased number of chromosomes. In contrast, 141-B cells, with massive loss of chromosomes from both malignant parents, were weakly tumorigenic. The results suggest that the retention of marker chromosomes as well as double minutes (DMs) or microchromosomes of neuroblastoma origin may be required for expression of malignancy in these hybrid cells. The survival time of tumor-bearing mice also varied within the five cell lines, but it was significantly short in NG108-15, which yielded lung metastases in the host animals. PMID- 3978592 TI - Leukemia with a novel 4q11q rearrangement. AB - Translocation (4;11)(q21;q23) is characteristic of a distinct acute leukemic syndrome. We report an 8-wk-old male patient with the clinical features ascribed to t(4;11), but with an unusual chromosome rearrangement consisting of an insertion of the 11q23 band into the q21 region of chromosome #4. PMID- 3978594 TI - Translocation t(1;5) in a case of carcinoma of the cervix. AB - We report a case of carcinoma of the cervix uteri, which presented both numerical and structural chromosome changes. The tumor showed the coexistence of lines with different modal chromosome numbers, but all of them with the t(1;5)(q25;132). We also observed the presence of double minutes, dicentric chromosomes, small acentric fragments, and/or tri- and quadriradial figures in 11% of the cells. PMID- 3978593 TI - Chromosomal analysis of bladder cancer: technical aspects. AB - Of 77 patients with bladder carcinoma, 99 tissue specimens--including tissues of patients with recurrent tumors taken after radiotherapy or cytostatics--were subjected to chromosomal analysis. In 42 specimens, recognizable metaphases could be obtained after conventional Giemsa staining and in a smaller number after C- and/or G-banding. All except one had abnormalities of the chromosomes. Short-term cultures for 24-48 hr in RPMI 1640 plus 15% fetal calf serum plus penicillin streptomycin gave better results than a direct technique (30 min in 0.075 M KCl + 0.1 microgram colcemid/ml at 37 degrees C, followed by fixation). In low stage/grade tumors the number of recognizable metaphases obtained after short term cultures is lower than in higher stage/grade tissue specimens. PMID- 3978595 TI - Acquired idiopathic sideroblastic anemia and terminal deletion of chromosome 11. PMID- 3978596 TI - Translocation t(3;5) in ANLL. PMID- 3978597 TI - Nonendemic Burkitt's lymphoma with complex chromosome abnormalities involving chromosomes 2 and 8. AB - A long surviving patient with nonendemic Burkitt's lymphoma and complex cytogenetic findings is presented. Chromosome abnormalities were seen as a minor clone in peripheral blood and were considered consistent with the t(2;8)(p12;q24) variant. The karyotype was 47,XY, -2, -8, + der2(8qter-8q24::2p12-2qter), + der8(8pter-8q23::2p12-2pter) + der8(8qter-8cen::1q21-1qter). This case illustrates the value of extensive chromosome analysis in hematologic disorders and, at the time of writing, is the first example in Britain of the t(2;8) variant in Burkitt's lymphoma. PMID- 3978598 TI - Chromosome rearrangements in a metastatic adenocarcinoma of the prostate. AB - Cytogenetic analysis of a metastatic tumor derived from an adenocarcinoma of the prostate revealed a hypodiploid karyotype with the presence of six marker chromosomes. The findings are discussed in relation to cytogenetic findings in other cancers, including those in prostatic cancer. PMID- 3978599 TI - Cytogenetic forms of retinoblastoma: their incidence in a survey of 66 patients. AB - Sixty-six retinoblastoma patients were investigated using high resolution banding techniques, sister chromatid exchange (SCE) studies, and esterase-D phenotype determination and dosage. Seven patients (in six families) were found to be carriers of a rearrangement of band 13q14 due to de novo deletions, apparently balanced de novo translocations, or parental insertions. The possible role of submicroscopic parental insertions is suggested to explain transmission of nonchromosomal forms through unaffected carriers. PMID- 3978600 TI - Multiple cancers in a Turner's syndrome with 45,X/46,XXp-/46,XX/47,XXX karyotype. AB - A female patient with a clinical picture of Turner's syndrome had five separate malignant tumors (three squamous cell carcinomas of the tongue, a colon cancer, and a glioblastoma multiforme). Her peripheral blood cells showed a 45,X/46,XXp /46,XX/47,XXX mosaicism. The findings are discussed in relation to other extragonadal tumors in Turner's syndrome reported to-date. PMID- 3978601 TI - Insertion of part of chromosome 5 into chromosome 1 in a case of sideroblastic anemia with an excess of blasts. PMID- 3978602 TI - Oncogene expression in rat hepatomas and during hepatocarcinogenesis. AB - In this study we examined oncogene expression in several Morris hepatomas. We found elevated transcripts for Ha-ras, Ki-ras, and the myc oncogenes, while the src oncogene was not increased. Northern analysis revealed transcript sizes of 1.4 kb for Ha-ras and 2.5 kb for myc. Analysis of primary tumors induced by the carcinogen 3'-methyl-4-dimethylaminoazobenzene (3'-MDAB) showed increasing oncogene transcript production with increasing length of diet. The results show enhanced ras and myc expression in rat hepatocellular carcinomas and during hepatocarcinogenesis. PMID- 3978603 TI - Seventh-Day Adventist vegetarians have a quiescent proliferative activity in colonic mucosa. AB - The proliferation of epithelial cells in colonic mucosa was studied in humans at varying degrees of risk for colon cancer. Seventh-Day Adventist vegetarians, known to have significantly lower mortality from colon cancer than the general U.S. population, had the most quiescent proliferative activity of mucosal epithelial cells. Increased replication and expansion of the proliferative compartment accompanied increased colon cancer risk. The analytical methods of this study may be useful in assessing the influence of dietary components involved in the initiation, promotion or inhibition of colon cancer, and in developing strategies for nutritional intervention. PMID- 3978604 TI - Stimulation of 3-benzo[a]pyrenyl glucuronide hydrolysis by calcium activation of microsomal beta-glucuronidase. AB - Rates of hydrolysis of 3-hydroxybenzo[a]pyrenyl glucuronide by microsomal beta glucuronidase from rat liver were 397 +/- 17 nmol/min per g protein and were half maximal with about 100 microM substrate. Treatment of rats with phenobarbital or 3-methylcholanthrene, which elevates activities of glucuronosyltransferase(s), lowered rates of hydrolysis of benzo[a]pyrene glucuronide by 25%. Hydrolysis of the glucuronide by microsomal beta-glucuronidase was stimulated by micromolar concentrations of calcium in the range existing in cytosol of hepatocytes (apparent Km approximately 0.2 microM). Thus, humoral factors that change intracellular concentrations of free calcium may alter the production and export of glucuronides of benzo[a]pyrene metabolites from the liver. PMID- 3978605 TI - Identification and occurrence of two new N-nitrosamino acids in tobacco products: 3-(N-nitroso-N-methylamino)propionic acid and 4-(N-nitroso-N-methylamino)butyric acid. AB - Two new N-nitrosamino acids, 3-(N-nitroso-N-methylamino)propionic acid (CAS: 10478-42-9) and 4-(N-nitroso-N-methylamino)butyric acid (CAS: 61445-55-4) were isolated and identified for the first time in various types of tobacco, including snuff, chewing and pipe tobacco, cigars and cigarettes. Their levels ranged from 0.15 to 7.4 and 0 to 2.2 mg/kg of dry weight tobacco, respectively. For comparison, amounts of other N-nitrosamino acids like N-nitrosoproline (NPRO) and tobacco-specific-nitrosamines (TSNA) were determined in the same samples. The levels of N-nitrosamino acids were highly correlated with the levels of TSNA. PMID- 3978607 TI - Pyruvate dehydrogenase levels in Morris hepatomas with different growth rate. AB - Pyruvate dehydrogenase (PDH) activity has been evaluated with respect to normal liver in 3 lines of Morris hepatomas (H), i.e. the highly differentiated H 9618A, the well differentiated H 44 and the poorly differentiated H 3924A. Assays of both total (PDHt) and active (PDHa) form show a progressive decrease of enzyme activity going from liver to the H 3924A. PDHa better correlates with the degree of hepatoma differentiation than does PDHt. Further enzyme analysis has been achieved in partially purified extracts from liver and H 3924A. The possible implications of such an enzymatic variation are discussed. PMID- 3978608 TI - Effect of phenobarbital on the activity of RNA polymerase II during diethylnitrosamine-induced hepatocarcinogenesis in the rat. AB - The effects of dietary phenobarbital (PB) on RNA polymerase II (nucleoside triphosphate: RNA nucleotidyltransferase, EC 2. 7. 7. 6) in the liver of male Sprague-Dawley rats previously administered diethylnitrosamine (DENA) were studied. When a diet containing 0.05% phenobarbital was administered, the activity of DNA-dependent RNA polymerase II in the liver nuclei of rats was temporarily increased 1 and 2 weeks after the onset of feeding and expressed to be relatively higher afterwards, compared with the activity in rats fed the control diets. PMID- 3978606 TI - Effects of vitamin C on tumor induction by diethylnitrosamine in the respiratory tract of hamsters exposed to cigarette smoke. AB - A large dietary supplement (1%) of vitamin C was given to male Syrian hamsters exposed to cigarette smoke and receiving 12 weekly subcutaneous injections of diethylnitrosamine (DEN) to determine whether or not high doses of vitamin C can prevent the development of tumors by DEN in the respiratory tract. Treatment with DEN developed various types of tumors in the respiratory tract of hamsters and cigarette smoke exposure potentiated the tumor development in the nasal cavity, larynx and trachea. In comparison with the smoke-exposed hamsters treated with DEN, the vitamin C-supplemented hamsters showed significantly lower incidence of nasal cavity tumors and exhibited significantly earlier appearance of tracheal tumors. In addition, the laryngeal tumors also tended to develop earlier in the vitamin C-supplemented hamsters. The results indicate that high doses of vitamin C may inhibit tumor induction by DEN and exposure to cigarette smoke in the nasal cavity, but the development of laryngeal and tracheal tumors appeared to be accelerated by vitamin C supplement. PMID- 3978609 TI - Pharmacological perturbation of murine melanoma growth by copper chelates. AB - Groups of BDF1 and DBA mice were treated with either the cupric chelate of nitrilotriacetic acid (NTA-Cu+2) or the cuprous chelate of neocuproine (NC-Cu+1) every other day for 7 days prior to either i.p. or s.c. inoculation with 10(6) viable B16 melanoma cells, and then every other day for 15 days post-tumor inoculation. This treatment schedule was non-toxic to host mice. NC-Cu+1 acted as a tumor growth promoting factor in mice by enhancing tumorigenicity, stimulating body weight gain, inhibiting encapsulation of i.p. tumors that permitted growth as unrestrained ascites, and increasing final tumor weight over a shortened host survival period regardless of the site of tumor inoculation. Treatment with NTA Cu+2 inhibited pigmentation in DBA mice bearing s.c. tumors, while treatment with NC-Cu+1 enhanced tumor pigmentation regardless of the site of tumor inoculation and murine strain. These results suggest that exogenous copper in the form of chelates alters the growth characteristics of a copper-requiring tumor system in both a copper-chelate- and murine-specific manner, and further suggests that the growth promoting activity of exogenous copper in the B16 melanoma system involves both enhanced copper nutrition and concomitant alteration of host reactions to tumors. PMID- 3978610 TI - Enhanced thermal response of a rat sarcoma by Corynebacterium parvum. AB - Corynebacterium parvum was investigated in the response of rat Mc7 sarcoma to local waterbath hyperthermia. Heat treatment of 1-1.5 cm3 foot tumors at 43 degrees C for 2 h resulted in complete regression of 71% of the tumors. The Mc7 cure was reduced to 31% when the tumors were heated at 43 degrees C for 1.5 h. C. parvum (700 micrograms, i.v.) when given 1-3 days before tumor heating at 43 degrees C for 1.5 h increased the host phagocytic activity, and the tumor regression from 31% to 65% (P less than 0.05). C. parvum by itself had no curative effect on the tumor, and it did not enhance the thermal response of normal rat foot to hyperthermia. These findings suggest that host response to tumor heating may be 'non-specific' in nature involving phagocytes of the reticulo-endothelial system. PMID- 3978611 TI - Heterogeneity in the sensitivities of the 13762NF rat mammary adenocarcinoma cell clones to cytolysis mediated by extra- and intratumoral macrophages. AB - The susceptibility of cloned cell lines of the 13762NF rat mammary adenocarcinoma to macrophage-mediated cytolysis was investigated using both intra- and extratumoral macrophages. The percentage of Fc receptor-positive cells in tumors growing s.c. in syngeneic F344 rats ranged from 8 to 20%, but we could not demonstrate a significant correlation between the number of Fc receptor-positive cells within tumors and their spontaneous metastatic potentials. In macrophage mediated cytolysis assays, cloned 13762NF cell lines of differing metastatic potential, established from tissue culture lines, fresh tumor explants, or short term cultures (one passage in vitro), were used as targets. Effector cells were thioglycolate-elicited peritoneal macrophages (activated in vitro with bacterial lipopolysaccharide) or intratumoral macrophages (activated in vitro with lipopolysaccharide). When the effector cells were peritoneal macrophages, established cloned 13762NF cell lines showed little correlation in their susceptibility to macrophage-mediated cytolysis and metastatic potential, while this was not observed when fresh tumor explants were used. Highly metastatic MTLn3 cells were the least sensitive, less metastatic MTF7 and MTLn2 cells were more susceptible, and the low metastatic parental MTPa cells were the most sensitive in 72-h cytolysis assays. When the effector cells were intratumoral macrophages, all 13762NF cell lines showed less sensitivity in cytolysis assays than similar assays using thioglycolate-elicited peritoneal macrophages. With the exception of line MTLn2, short-term cultures (one passage in vitro) did not differ substantially in susceptibility to intratumoral macrophages compared to fresh explants. In this system, the sensitivity of 13762NF cells to macrophage mediated cytolysis is a function of effector as well as target cell source. PMID- 3978613 TI - Initiation of urinary bladder carcinogenesis in rats by freeze ulceration with sodium saccharin promotion. AB - Sodium saccharin was previously shown to induce a significant incidence of transitional cell carcinoma of the bladder when administered to rats either immediately or beginning 2 weeks after ulceration of the bladder epithelium induced by freezing or cyclophosphamide injection. However, the marked regenerative hyperplasia following ulceration by either of these methods is not completely repaired until 3 to 4 weeks after ulceration. To determine whether initiation in this model was due to the ulceration and regenerative hyperplasia alone or if it was due to the administration of sodium saccharin acting on the hyperplastic epithelium, the effect of administering sodium saccharin at various times after ulceration was examined. Five-week-old F344 male rats were given sodium saccharin as 5% of the diet beginning either immediately (Group 1) or 2, 4, 6, or 18 weeks (Groups 2, 3, 4, or 5, respectively) after freezing of the bladder, and sacrificed 2 years after the start of the experiment. The incidences of rats with transitional cell carcinoma of the bladder were 11 of 36 rats (31%) in Group 1, 6 of 36 (17%) in Group 2, 12 of 40 (30%) in Group 3, 7 of 36 (19%) in Group 4, and 9 of 39 (23%) in Group 5. Sodium saccharin without prior ulceration induced a transitional cell papilloma in one rat, and freeze ulceration without subsequent sodium saccharin induced a transitional cell carcinoma in one rat. No bladder lesions were seen in the untreated control rats. Scanning electron microscopic examination of rats fed sodium saccharin after ulceration showed evidence of multifocal hyperplasia and significant surface changes either at Week 18 of the experiment (Groups 1 to 3) or 18 weeks after beginning sodium saccharin administration (Groups 4 and 5). These results indicate that freeze ulceration of the bladder induced irreversible changes in the epithelial cells related to bladder cancer initiation even though the regenerative hyperplasia is morphologically reversible, and that sodium saccharin promotes the tumorigenic expression of those freeze ulceration-induced cellular changes even after healing from the injury. PMID- 3978612 TI - Cell cycle-dependent heat sensitization of murine granulocyte-macrophage progenitor cells in regenerating marrow. AB - The response of murine granulocyte-macrophage progenitor cells to hyperthermia was examined using normal and regenerating marrow. Hyperthermic exposure was given in vitro at 41-44 degrees C for periods of up to 60 min, and the results were compared between the 2 groups. Although almost no difference in percentage of survival was observed between them at 41 degrees C, murine granulocyte macrophage progenitor cells of regenerating marrow showed markedly increased thermal sensitivity at and above 42 degrees C in comparison with that of normal marrow. Hydroxyurea suicide experiments revealed that the proportion of in vitro colony-forming units in the DNA-synthetic phase of the cell cycle [S phase] was greatly increased in regenerating marrow [66 +/- 4% (SD)] as compared with that in normal marrow [18 +/- 8%]. These data indicate that heat sensitization of hemopoietic cells occurs because of cell cycle effects, when they apparently mean the relative proportion of cells in S phase. PMID- 3978614 TI - Intestinal uptake of hexoses and fatty acids in tumor-bearing rats. AB - An in vitro technique was used to examine the rate of uptake of varying concentrations of glucose, galactose, and a homologous series of saturated fatty acids into the jejunum of control rats and Noble rats bearing prostatic tumor variants of primary human prostatic adenocarcinoma 52. Both groups of animals were healthy, eating and gaining weight normally. The uptake of acetic and butyric acid was reduced in tumor-bearing rats, but the uptake of four medium chain-length fatty acids was unchanged. The similar value of the incremental change in free energy in the control and tumor-bearing animals indicates similar passive permeability properties of the jejunum in the two groups. The uptake of varying concentrations of glucose and galactose was similar in the control and in the tumor-bearing animals. It is concluded that there are only subtle changes in nutrient uptake in tumor-bearing rats that are eating and gaining weight normally. It is suggested that any alteration in nutrient absorption which might occur in the cachectic tumor-bearing animal is probably due to alterations in food intake or body weight, rather than due to a direct effect of the tumor on the intestine. PMID- 3978615 TI - Genetically determined susceptibility of Fischer 344 rats to propylnitrosourea induced thymic lymphomas. AB - Administration of propylnitrosourea p.o. by our protocol induced a high incidence of hematolymphatic neoplasms in all six rat strains studied. Remarkable strain differences in susceptibility to thymic lymphomas were observed. The incidence of thymic lymphomas was high in Fischer 344 (98%) and Wistar/Furth (71%) but low in Sprague-Dawley (29%), ACI/Ms (23%), Donryu (24%), and Long-Evans (10%) strains. Segregation of thymic lymphoma incidence among crosses between highly susceptible Fischer and poorly susceptible Long-Evans rats indicated that the increased susceptibility to thymic lymphomas of Fischer rats was determined by a dominant gene TIs-1 (thymic lymphoma susceptible) and that this gene was linked to the coat color loci, p and c, in Linkage Group I in the order of TIs-1 - c - p. The presence of another independently assorting dominant gene, TIs-2, was also suggested to accelerate the thymic lymphoma-genesis. Expression of the group specific antigen of murine leukemia virus as well as infectious viruses was not detected in nine propylnitrosourea-induced thymic lymphomas of Fischer rats. PMID- 3978616 TI - Similar differential for total polyglutamylation and cytotoxicity among various folate analogues in human and murine tumor cells in vitro. AB - Four folate analogues, methotrexate, aminopterin, 10-deazaminopterin, and 10 ethyl-10-deazaaminopterin were assessed for their ability to be metabolized to poly-gamma-glutamyl derivatives in three tumor lines which vary in their sensitivity to these agents. Cytotoxicity of the four analogues against the murine L1210 leukemia and the human Manca B cell leukemia, as determined by a 3-h clonogenic assay, showed aminopterin and the two 10-deazaaminopterin compounds to be approximately equivalent for each cell type and were 3- to 10- (L1210) and 7- to 14-fold (Manca) more potent than methotrexate. In murine Sarcoma 180 cells, 10 ethyl-10-deazaaminopterin and aminopterin were similarly potent but were 5- to 10 fold more potent than 10-deazaaminopterin and 40- to 80-fold more potent than methotrexate. These results could be explained in part by the differences in transport properties and substrate activities for polyglutamylation for each analogue in these cell types. Initial rates of polyglutamate accumulation of the four analogues, which were determined under conditions of comparable rates of drug entry into the three tumor cell lines, were 7- to 18-fold less than drug entry rates. In L1210 and Sarcoma 180 cells, the relative rates of polyglutamylation were in the order aminopterin greater than 10-ethyl-10 deazaaminopterin greater than methotrexate greater than 10-deazaaminopterin. In contrast, the relative rates of polyglutamylation in Manca cells were in the order 10-ethyl-10-deazaaminopterin approximately equal to aminopterin greater than 10-deazaaminopterin greater than methotrexate, suggesting that folylpolyglutamyl synthetase may have varying substrate preferences in different cell types. The maximum relative extents of total polyglutamate accumulation in L1210 cells were 85 to 95% of the total drug at 24 h. In Manca cells, the maximum polyglutamate accumulation was also 85 to 95%, but this was obtained by 6 h. However, in Sarcoma 180 cells, only aminopterin polyglutamates reached a similar maximum percentage of accumulation, while lower relative polyglutamate levels were achieved with the other analogues. Accumulation of individual polyglutamates in each cell line was similar for all analogues except aminopterin. For methotrexate and the two 10-deazaaminopterins, accumulation occurred mainly as the tetraglutamate or as higher polyglutamates. Aminopterin was accumulated mainly as the diglutamate, particularly in Manca cells where 70% of total drug was in the diglutamate form within the first 3 h and remained the predominant form for 24 h.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3978617 TI - Metabolism of 3-tert-butyl-4-hydroxyanisole to 3-tert-butyl-4,5-dihydroxyanisole by rat liver microsomes. AB - 3-tert-Butylhydroxyanisole (3-BHA) is an antioxidant which can have a modulating effect on chemical carcinogenesis. Information concerning the metabolism of 3-BHA is incomplete. In the present study, the metabolites formed by incubating 3-BHA with liver microsomes from rats given beta-naphthoflavone by p.o. intubation were studied. Three metabolites were identified, two major metabolites and a minor metabolite. One of the major metabolites was the catechol of 3-BHA, i.e., 3-tert butyl-4,5-dihydroxyanisole, which has not previously been reported. A characteristic of this compound is its capacity to be oxidized readily. The second major metabolite was tert-butyl hydroquinone which has been reported previously to be a liver microsomal metabolite of 3-BHA. The third metabolite, which occurred in small quantities, was 2,2'-dihydroxy-3,3'-di-tert-butyl-5,5' dimethoxydiphenyl. 2,2'-Dihydroxy-3,3'-di-tert-butyl-5,5'-dimethoxydiphenyl has been identified previously as a major metabolite of 3-BHA in the rat intestine. An understanding of the metabolism of 3-BHA may assist in elucidating the mechanism(s) of its biological effects. PMID- 3978618 TI - Cytotoxic efficacy of reconstituted and stored antitumor agents. AB - The stability of the cell-killing efficacy of 10 antitumor drugs stored at different temperatures and concentrations was evaluated on an established human colon carcinoma cell line using the colony formation technique. Drugs were reconstituted in the appropriate solvent, further diluted in 0.9% NaCl solution to obtain the desired storage concentration, and stored at 4 degrees C, -20 degrees C, and -70 degrees C for periods of up to 3 weeks. Cytotoxic efficacy was tested weekly by exposing the cells to the final drug dilution for 1 h at 37 degrees C. Stability of cytotoxic potency depended on the particular drug, and the duration, concentration, and temperature of storage but, in general, most drugs remained efficacious only within limited periods of time (at most, 2 weeks). These results suggest that the conditions of drug storage following reconstitution are critical factors with respect to lethal efficacy. Therefore, analysis of in vitro cytotoxic efficacy can be meaningful only when storage conditions are specified in order to avoid false-negative results in the human tumor clonogenic assay. PMID- 3978619 TI - Quantitation of the rate of spontaneous generation and carcinogen-induced frequency of anchorage-independent variants of rat tracheal epithelial cells in culture. AB - The rate of spontaneous generation and the frequency of carcinogen-induced anchorage-independent variants of preneoplastic rat tracheal epithelial (RTE) cells in culture were quantitated. Anchorage-independent variants of different RTE cell lines arose spontaneously by a stochastic process at rates of 0.5 X 10( 4) to 5.4 X 10(-4) variants/cell/generation, as determined by fluctuation analyses. These variants were also induced by the mutagen N-methyl-N'-nitro-N nitrosoguanidine with a frequency of approximately 10(-3) variants/surviving cell. The rates of spontaneous change and the frequencies of induction are the first reported for epithelial cells and are similar to some, although not all, rates and frequencies of change to anchorage independence for fibroblast-like cells in culture. In addition, these rates and frequencies are similar to those for mutations at some known gene loci. The induced frequency of this late change in neoplastic progression is, however, considerably lower than the frequency of induction of the initial, preneoplastic changes in RTE cells in culture (approximately 3 X 10(-2)/surviving cell). These quantitative determinations are useful in defining the mechanisms of late changes occurring during the progression of RTE cells to the neoplastic state. PMID- 3978620 TI - Differential sensitivity of human breast cancer cell lines to the growth inhibitory effects of tamoxifen. AB - In eight estrogen receptor (ER)-positive breast cancer cell lines (including three sublines of MCF-7) and five ER-negative breast lines, the action of the nonsteroidal antiestrogen, tamoxifen, was studied, and the concentrations of ER and antiestrogen binding site were measured. The concentration of antiestrogen binding site was significantly [P less than 0.005] greater in ER-positive cells [236,600 +/- 29,900 (SE) sites/cell] than in ER-negative cell lines [66,600 +/- 16,800 sites/cell]. In ER-positive cell lines, a cell cycle phase-specific growth inhibitory effect, 20% inhibitory dose less than 0.1 to 1.0 microM, was seen which was shown for some representative cell lines to be estrogen reversible. Within this group of cell lines, the degree of tamoxifen-induced inhibition of growth correlated with control population doubling time, but not ER or antiestrogen binding site concentration. The changes in cell cycle kinetic parameters characteristic of all ER-positive lines were a decrease in percentage of S-phase cells and a corresponding increase in percentage of G0-G1 cells. In all cell lines, 5 to 12.5 microM tamoxifen caused cytotoxicity, and this was shown to be estrogen-irreversible in 3 representative cell lines; moreover, estradiol synergistically enhanced the cytotoxic effects of tamoxifen under some experimental conditions. The cell cycle effects of tamoxifen in three ER-negative cell lines (Hs0578T, MDA-MB-231, MDA-MB-330) were decreased proportions of G0-G1 cells with an increase in percentages of S and G2+M cells. These results implied that the mechanism of tamoxifen cytotoxicity may differ in ER-positive and ER negative breast cancer cells. However, although the ER-negative BT-20 line was much less sensitive to tamoxifen than were the ER-positive cells, growth inhibition and cytotoxicity in this line were associated with a slight decrease in percentage of S-phase cells. These results confirm that ER-positive breast cancer cells are more sensitive (4- to greater than 75-fold) than ER-negative breast cells to the growth-inhibitory effects of tamoxifen and demonstrate that, in all ER-positive cells, growth inhibition and cytotoxicity are accompanied by characteristic changes in cell cycle kinetic parameters. In contrast, different mechanisms may be involved in the effects of tamoxifen on different ER-negative cell lines. PMID- 3978621 TI - Experimental radiotherapy of murine lymphoma with 131I-labeled anti-Thy 1.1 monoclonal antibody. AB - Monoclonal antibodies against the Thy 1.1 differentiation antigen are ineffective in the treatment of transplanted AKR T-cell lymphoma once a palpable tumor nodule is present, due to the inability of the host to eliminate antibody-coated tumor cells. To overcome this limitation, we have evaluated the use of 131I-labeled anti-Thy 1.1 antibodies for the therapy of established AKR/J SL2 lymphoma (Thy 1.1+) nodules growing in congeneic AKR/Cu mice (Thy 1.2+). In these experiments, 131I-anti-Thy 1.1 antibody specifically localized to a s.c. tumor with a mean of 6.5% of the infused dose per g of tumor at 24 h after infusion. The proportion of infused anti-Thy 1.1 antibody localizing to tumor was constant following antibody doses of up to 400 micrograms/animal. Antibody iodinated with up to 2 atoms of iodine per antibody of molecule maintained binding activity and localization to tumor equivalent to antibody labeled with less iodine. The concentrations of 131I anti-Thy 1.1 in tumor would result in delivery of a mean of 1600 cGy to tumor following infusion of 500 muCi of 131I-labeled anti-Thy 1.1 antibody. In comparison, 500 muCi 131I-labeled irrelevant antibody would deliver a mean of 380 cGy to tumor. Treatment of animals with palpable tumor nodules with 500 muCi 131I anti-Thy 1.1 led to regression of the tumor nodule in 44% of animals, significantly prolonged survival, and cured two of five of the animals treated prior to the development of metastatic disease. In contrast, unlabeled anti-Thy 1.1 led to tumor response in 6% of animals, and up to 1000 muCi 131I-labeled irrelevant antibody had no effect on tumor growth. Therapy was limited by the emergence of variant tumor cells lacking the target antigen and by bone marrow toxicity following 131I-labeled antibody doses of greater than or equal to 1000 muCi/animal. These studies demonstrate that 131I-labeled monoclonal antibodies can have a significant antitumor effect in a situation where unmodified antibody is ineffective. PMID- 3978622 TI - Clearance studies of methotrexate in dogs after multiple-rate infusion. AB - Plasma, renal, and nonrenal clearances of methotrexate as well as their interrelationship were studied in five conditioned male beagle-mongrel dogs using the multiple-rate infusion method. Steady-state plasma methotrexate concentrations of 1, 20, and 100 micrograms/ml were targeted for by i.v. bolus doses followed by i.v. infusions. An isotonic solution of sodium bicarbonate or ammonium chloride was simultaneously infused to study the effect of acid-base imbalance on the clearances. NaCl solution (0.9%) infusion served as a control. Plasma and urine concentrations of methotrexate were quantitated by a sensitive high-performance liquid chromatographic method. Distortion of body acid-base balance did not significantly change the clearances of methotrexate. The results showed that the plasma clearance (4.02 to 4.68 ml/min/kg) of methotrexate was relatively constant over the concentration range studied. The renal and nonrenal clearances, on the other hand, were concentration dependent. As the plasma methotrexate concentration increased from 1 to 20 or 100 micrograms/ml, renal clearance decreased from 3.60 to 4.28 ml/min/kg to 2.62 to 2.73 ml/min/kg, and nonrenal clearance increased form 0.35 to 0.42 ml/min/kg to 1.38 to 1.74 ml/min/kg. Concentration-dependent renal clearance may be due to saturation of the process involving active tubular secretion of methotrexate. PMID- 3978623 TI - Restoration of sensitivity to oxazaphosphorines by inhibitors of aldehyde dehydrogenase activity in cultured oxazaphosphorine-resistant L1210 and cross linking agent-resistant P388 cell lines. AB - The sensitivity of cultured L1210 and P388 cells sensitive (L1210/0, P388/0) and resistant (L1210/OAP, P388/CLA) to oxazaphosphorines, to 4 hydroperoxycyclophosphamide, ASTA Z-7557, phosphoramide mustard, and acrolein was determined in the absence and presence of known (disulfiram, diethyldithiocarbamate, cyanamide) or suspected [ethylphenyl(2 formylethyl)phosphinate] inhibitors of aldehyde dehydrogenase activity. The L1210/OAP cell line is resistant specifically to the oxazaphosphorines; P388/CLA cells are partially cross-resistant to other cross-linking agents. All four inhibitors of aldehyde dehydrogenase activity potentiated the cytotoxic action of the oxazaphosphorines, 4-hydroperoxycyclophosphamide and ASTA Z-7557, against L1210/OAP and P388/CLA cells; in the presence of a sufficient amount of inhibitor, sensitivity was essentially fully restored in both cases. The inhibitors did not potentiate the cytotoxic action of the nonoxazaphosphorines, phosphoramide mustard and acrolein, against these cell lines. The cytotoxic action of the oxazaphosphorines and nonoxazaphosphorines against L1210/0 and P388/0 cells was not potentiated by any of the aldehyde dehydrogenase inhibitors. Inhibitors of xanthine oxidase or aldehyde oxidase activities did not potentiate the cytotoxic action of the oxazaphosphorines against L1210/OAP cells. These observations strongly suggest that (a) aldehyde dehydrogenase activity is an important determinant with regard to the sensitivity of a cell population to the oxazaphosphorines; (b) L1210/0 and P388/0 cells lack the relevant aldehyde dehydrogenase activity; (c) the phenotypic basis for the resistance to oxazaphosphorines by L1210/OAP cells is aldehyde dehydrogenase activity; and (d) the major reason that P388/CLA cells are resistant to oxazaphosphorines is aldehyde dehydrogenase activity. PMID- 3978624 TI - Comutagenic effects of 3-aminobenzamide in Chinese hamster ovary cells. AB - Inhibition of poly (ADP-ribose) synthesis by agents such as 3-aminobenzamide (3 AB) potentiates the cytotoxic, carcinogenic, and clastogenic effects of certain DNA-damaging agents. Experiments were carried out in Chinese hamster ovary cells to compare chromosome aberration production and cytotoxicity with the induction of somatic mutations at the hypoxanthine-guanine phosphoribosyltransferase (HGPRT) and sodium-potassium ATPase loci after treatment with 3-AB in combination with certain monofunctional alkylating agents. On its own, 1 to 10 mM concentrations of 3-AB were not mutagenic, reduced plating efficiencies only slightly, and produced a small elevation in the frequency of chromatid aberrations. In combination with ethyl methanesulfonate (EMS), 3-AB increased cytotoxicity and the frequency of alkylation-induced chromatid aberrations. 3-AB also increased the frequency of EMS and N-methyl-N'-nitro-N-nitrosoguanidine induced 6-thioguanine-resistant cells (a marker for the HGPRT- phenotype). It had no effect on the frequency of EMS-induced ouabain-resistant cells (a marker for ATPase mutations). All the effects were dose dependent. Larger absolute increases were found with 10 mM 3-AB as compared with 1 mM 3-AB and with 2 mM EMS as compared to 1 mM EMS. The 3-AB-mediated increases in 6-thioguanine-resistant cells, which are often deletion mutations, and the lack of any increase in the frequency of ouabain-resistant cells, which can only arise through point mutation induction, along with the increases in chromosome aberration frequency, suggests that 3-AB increases the frequency of deletion mutations by increasing the frequency and duration of DNA strand breaks. PMID- 3978625 TI - Type I and II cyclic adenosine 3':5'-monophosphate-dependent protein kinase in human gastric mucosa and carcinomas. AB - Cyclic adenosine 3':5'-monophosphate (cAMP)-dependent and cAMP-independent protein kinase activity and the isoenzyme pattern of cAMP-dependent protein kinase were compared in tissues from human nonneoplastic gastric mucosa, 11 human gastric carcinomas, and 2 xenotransplantable human gastric carcinomas (SC-6-JCK and St-15). No difference in total protein kinase activity could be observed between nonneoplastic gastric mucosa and gastric carcinomas. According to diethylaminoethyl cellulose column chromatography, the isoenzyme pattern of the nonneoplastic gastric mucosa was the same in both the gastric fundus and the antrum, and the activity ratio of type II to type I was 5.01. In gastric carcinomas, the elevation of type I was detected independently of the histological type. In xenotransplantable human gastric carcinomas in nude mice, type I isoenzyme was significantly elevated. The activity ratio of type II to type I was 1.70 in SC-6-JCK carcinomas and 1.81 in St-15 carcinomas, respectively. These results suggest that type I cAMP-dependent protein kinase activity in the stomach may be a biochemical marker for malignant transformation and transplantability of gastric tumors. PMID- 3978626 TI - Species- and length of exposure-dependent differences in the benzo(a)pyrene:DNA adducts formed in embryo cell cultures from mice, rats, and hamsters. AB - The activation of benzo(a)pyrene (BaP) to DNA-binding metabolites in early passage embryo cell cultures prepared from various species of rodents was investigated by exposing cells from mice (BALB/c and Sencar), rats (Wistar and Fischer 344), and Syrian hamsters to [3H]BaP for various lengths of time. The BaP:DNA adducts containing cis-vicinal hydroxyl groups such as those formed from 7 beta,8 alpha-dihydroxy-9 alpha,10 alpha-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene (anti-BaPDE) were separated from the other types of BaP:DNA adducts by immobilized boronate chromatography, and the individual adducts were analyzed by high-performance liquid chromatography. A number of BaP:DNA adducts were present in the DNA from the cultures from all three species after 5 h of BaP treatment. After a 24-h exposure to BaP, the mouse and hamster embryo cell DNA contained a large amount of the adduct formed by reaction of (+)-anti-BaPDE with the 2-amino group of deoxyguanosine (dGuo) and a small amount of a 7 beta,8 alpha-dihydroxy-9 beta,10 beta-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene:dGuo adduct. A large number of BaP:DNA adducts derived from 7 beta, 8 alpha-dihydroxy-9 beta,10 beta-epoxy 7,8,9,10-tetrahydrobenzo(a)pyrene and other unidentified BaP metabolites were present in rat embryo cell cultures at all times. Neither the Fischer 344 nor the Wistar rat embryo cell cultures had a significant amount of (+)-anti-BaPDE:dGuo adduct after 5 h of BaP treatment, and in the Wistar rat cells larger amounts of other adducts were present even after a 96-h exposure to BaP. In cell cultures from all three species the proportion of (+)-anti-BaPDE:dGuo adduct increased as the length of time of exposure to BaP increased. There are major differences in the metabolic activation of BaP to DNA binding metabolites in embryo cells from various species of rodents. However, the variations between cell cultures from different strains of rats or mice are not as great as the variations between cell cultures from different species. The time-dependent alterations in the BaP:DNA adducts indicate that analysis after various lengths of time of exposure to BaP is essential to characterize accurately the pathways of metabolic activation of BaP in cells from various species and tissues. PMID- 3978627 TI - Effects of clumps and clusters on survival measurements with clonogenic assays. AB - The growth of colonies in semisolid medium is receiving widespread attention as a possible test for predicting the clinical response of individual human tumors to specific drugs. One problem encountered in these studies is the difficulty of preparing single-cell suspensions from solid tumors. Often, microscopic examination of the cultures just after plating reveals many clusters or clumps of cells; these are often large enough and numerous enough that some plates are counted or fixed immediately so that this "background" can be subtracted from the "colony" count used to assess cell viability. However, this correction addresses only one of the problems created by the presence of clumps and clusters. It does not eliminate errors and artifacts introduced by multiplicity (multiple clonogenic cells contributing to a colony), abortive clones, and cell volume changes, or by inhomogeneities in the microenvironment, cell metabolism, and drug distribution within clumps. Because of such factors, survival curves determined using suspensions contaminated with clumps and clusters may provide inaccurate assessments of the true drug sensitivity of the individual tumor cells. PMID- 3978628 TI - Oxygen dependence of the photosensitizing effect of hematoporphyrin derivative in NHIK 3025 cells. AB - Cells of the established line NHIK 3025 were incubated with hematoporphyrin derivative and exposed to light at different concentrations of oxygen. The efficiency of photoinactivation of the sensitized cells decreased with decreasing oxygen concentration. No photoinactivation was observed when the atmosphere above the medium overlying the cells was pure N2 gas. With 1% O2 in the atmosphere, the quantum yield of photoinactivation was reduced by 50% compared to the yield in air-saturated medium. It is hardly possible to inactivate cells in anoxic regions of a tumor by means of porphyrin sensitized photochemotherapy. In spite of this, the therapy seems to be efficient in several cases. Thus, it seems that anoxic tumor cells are inactivated in secondary reactions, probably due to breakdown of the circulatory system in the tumor. PMID- 3978629 TI - Effect of estrogens and antiestrogens on growth-regulatory enzymes in human breast cancer cells in tissue culture. AB - The effect of estrogens and antiestrogens is examined on three enzymes the activities of which are known to correlate with cell growth. Estrogen treatment increases thymidylate synthetase binding sites up to 4-fold over controls. The extent of induction is dependent on incubation time and the basal rate of cell growth in untreated cells. Amount of active enzyme generally shows a positive correlation with rates of DNA synthesis and cell growth. Thymidine kinase activity and the number of dihydrofolate reductase binding sites are similarly induced by estrogen treatment. Conversely, the effect of antiestrogens on MCF-7 cells is exceedingly complex in that responses in enzyme activities and several generally accepted indices of cell growth (cell number, protein content, rate of DNA synthesis) are dissimilar. Dose response, magnitude of response, and direction of response (increase or decrease) are distinct for each enzyme and for each measure of cell growth with each antiestrogen tested. These results suggest that specific cellular activities are modulated independently by estrogens and antiestrogens and that changes in ligand-receptor complex cannot be the sole explanation for the specificity of estrogen and antiestrogen action. Some degree of specificity and heterogeneity may reside at the level of receptor interaction with the various genes subject to estrogenic modulation. PMID- 3978630 TI - Effect of bile salts on rates of formation, accumulation, and export of mutagenic metabolites from benzo(a)pyrene produced by the perfused rat liver. AB - The effect of sodium taurocholate on the biliary export of stable mutagenic phenolic glucuronide metabolites of benzo(a)pyrene from livers of corn oil- or 3 methylcholanthrene-treated rats was studied using a nonrecirculating perfusion system. Sterile bile samples were collected every 4 min and assayed for mutagens using the Ames Salmonella (Ta 98) test without addition of microsomes but containing beta-glucuronidase. Rates of export of mutagens produced from benzo(a)pyrene (20 microM) into the bile were stimulated 5-fold by the bile salt sodium taurocholate, concomitant with a 2- to 3-fold increase in bile flow. Steady-state rates of 60 and 90 revertants/g/h were observed in bile when 20 microM benzo(a)pyrene was infused into livers from corn oil or 3 methylcholanthrene-treated rats, respectively. These rates of efflux were increased to 250 and 550 revertants/g/h by the addition of taurocholate. Rates of production of mutagenic phenolic metabolites which account for the mutagenic activity were determined by adding rates of efflux into bile and effluent perfusate with rates of accumulation of metabolites in the cell. In livers from 3 methylcholanthrene-treated rats, rates (8 min) of benzo(a)pyrene phenol formation averaged 300 nmol/g/h during the initial 20 min of perfusion but increased to 450 nmol/g/h after 1 h. The addition of taurocholate increased maximal rates of phenol efflux in the bile from 6 to 148 nmol/g/h and decreased rates of phenol accumulation in intracellular stores from 342 to 220. Rates of efflux into the vena cava effluent averaged 120 nmol/g/h and were not affected by taurocholate. Infusion of dehydrotaurocholate increased the appearance of metabolites of benzo(a)pyrene in the effluent perfusate but did not change rates of efflux into bile. Taurocholate doubled rates of output of phenolic metabolites into the effluent perfusate when bile flow was arrested by perfusion with calcium-free buffer. Thus, mutagenic glucuronides from benzo(a)pyrene phenols accumulated in hepatocytes much faster than rates at which they were exported. Total rates of production of phenolic glucuronides by the liver were not affected by bile salts; however, taurocholate stimulated their export into bile, while dehydrotaurocholate increased their concentration in the effluent perfusate. Both salts probably act by displacing metabolites from intracellular binding sites. PMID- 3978631 TI - Oxidative properties of 12-O-tetradecanoylphorbol-13-acetate-stimulated human blood monomorphonuclear leukocytes and their toxicity against a human lung carcinoma cell line. AB - Human monomorphonuclear leukocytes (MMNs) stimulated with 12-O tetradecanoylphorbol-13-acetate (TPA) were found to be toxic towards human A549 lung carcinoma cells which have been desensitized against the direct growth inhibitory effect of TPA. This toxicity was dependent on the TPA concentration and the ratio of MMNs to A549 cells. Using a TPA concentration of 10(-7) M and an effector:target cell ratio of 30:1, experiments were performed to give clues as to the mechanisms by which TPA-stimulated MMNs cause toxicity. Levels of the endogenous thiol glutathione were reduced by 37% in MMNs exposed to TPA for 24 h, but the glutathione levels in the A549 target cells were not markedly affected by TPA-stimulated MMNs. The supernatant of incubations of MMNs with TPA contained a species which was capable of oxidizing the thiol agent 5-thio-2-nitrobenzoic acid. Within 2 h, 9 nmol of this oxidant were produced by 10(7) MMNs. The oxidant exhibited a half-life of 20 h, and its formation was abolished by adding catalase (150 units/ml), azide (1 mM), or cyanide (1 mM) to the incubations of MMNs with TPA. The addition of superoxide dismutase (100 units/ml) enhanced oxidant formation. These results indicate that its generation was dependent on the myeloperoxidase:H2O2:halide system. Large amounts of an oxidizing species with properties identical to those described here have been characterized recently in polymorphonuclear leukocytes [S. J. Weiss, M. B. Lampert, and S. T. Test. Science (Wash. DC), 222: 625-627, 1983]. The toxicity exerted by TPA-stimulated MMNs was partially inhibited by superoxide dismutase and by retinoic acid (30 microM) but not at all by catalase, azide, or cyanide. Therefore, the 5-thio-2-nitrobenzoic acid oxidant does not appear to be involved in the process which led to cytotoxicity by TPA-stimulated MMNs in A549 cells. PMID- 3978632 TI - Effects of estrogen and tamoxifen on the regulation of dihydrofolate reductase gene expression in a human breast cancer cell line. AB - We have studied the effects of estrogen and the antiestrogen tamoxifen on the regulation of dihydrofolate reductase (DHFR) gene expression in a methotrexate resistant (MTXR) human breast cancer cell line MCF-7, which contains a 50-fold increase in the level of DHFR enzyme and amplified DHFR gene sequences. Despite their selection for methotrexate resistance, the MTXR cells have retained many characteristics of the parental MCF-7 cell line. Concentrations of estrogen receptors as well as their binding affinity to estradiol are identical in both cell lines. MTXR MCF-7 cells remain sensitive to estrogen and respond to estradiol with an induction of progesterone receptors, as well as increases in the rate of DNA synthesis and cell growth. Incubation of MTXR MCF-7 cells with estradiol results in an additional 1.5- to 3.0-fold increase in their already elevated level of DHFR. The hormone-induced increases in DNA synthesis and DHFR levels are similar both with respect to the time course of inductions, as well as their dose response to estradiol. However, these two estrogen-induced effects are not coupled, since the induction of DHFR occurs even in the absence of concomitant DNA synthesis. Estradiol has no effect on DHFR enzyme stability; thus, the entire effect of estrogen on DHFR levels results from the increased synthesis of this housekeeping enzyme. In contrast, treatment of MTXR MCF-7 cells with the antiestrogen tamoxifen reduces the rate of DHFR enzyme synthesis, resulting in lower cellular levels of DHFR. These MTXR MCF-7 cells represent a useful model in which to study the mechanisms involved in the modulation of DHFR gene expression by estrogen and tamoxifen. Since the level of DHFR is a critical determinant of methotrexate cytotoxicity understanding, the regulation of DHFR gene expression may have clinical implications for the use of hormonal therapy in combination with chemotherapy for the treatment of breast cancer. PMID- 3978633 TI - Verapamil-induced augmentation of etoposide accumulation in L1210 cells in vitro. AB - The effects of the calcium antagonist verapamil on the intracellular disposition of 4'-demethylepipodophyllotoxin-9-(4,6-O-ethylidene-beta-D-glucopyra noside) (etoposide) (VP-16) as well as on subsequent DNA damage and cytotoxicity were studied in L1210 cells in vitro. At extracellular VP-16 concentrations of 1 to 5 microM, verapamil (10 microM) addition resulted in an increase of DNA single strand break frequency comparable to that found when VP-16 was present alone at a 3-fold higher concentration. In addition, the elevation of cellular VP-16 levels in the presence of verapamil was linearly correlated with the enhancement of DNA damage and increased cell kill. Verapamil-mediated increase in net VP-16 transport was rapid (1 to 2 min), and allowed for the same elevation of steady state VP-16 concentration, whether verapamil was added simultaneously with VP-16 or was added after a steady-state level of VP-16 was achieved. Verapamil-mediated elevation of VP-16 levels was not seen at reduced temperature (0 degrees C). Studies of bidirectional VP-16 transport revealed that verapamil (40 microM) did not alter influx of VP-16 (15 microM), but lowered the unidirectional rate constant for efflux by 93%, resulting in the observed increase of steady-state level of the epipodophyllotoxin. Removal of verapamil resulted in a rapid return of VP-16 to levels comparable to that seen with VP-16 alone. When VP-16 was allowed to flow out of the cell in the presence of verapamil, less than 5% of cellular epipodophyllotoxin was retained, suggesting that the calcium antagonist is not acting by enhancing intracellular binding of VP-16. These results indicate that verapamil potentiates VP-16 activity by elevation of intracellular exchangeable epipodophyllotoxin; an activity which seems to be due to inhibition of the efflux mechanism for VP-16. The low intracellular retention of this epipodophyllotoxin and the good correlation between intracellular VP-16 and subsequent DNA damage and cytotoxicity suggest that the epipodophyllotoxin class of anticancer agents may be more useful for probing calcium antagonist effects on drug transport in sensitive cells and in cells exhibiting pleiotropic drug resistance than the vinca alkaloids and anthracyclines which have large tight binding intracellular components. PMID- 3978634 TI - Murine tumor cell lysis by antibody-dependent macrophage-mediated cytotoxicity using syngeneic monoclonal antibodies. AB - Four monoclonal antibodies to MH134 murine syngeneic hepatoma cells, 3H1, 7C2, 11G2, and 12A2, were produced by hybridomas constructed by fusing P3-X63-Ag8-U1 murine myeloma cells with spleen cells of a C3H/HeN mouse immunized with the syngeneic tumor cells. Immunodiffusion analysis with rabbit anti-mouse immunoglobulin antisera showed that 3H1, 7C2, 11G2, and 12A2 are IgG2a, IgM, IgG1, and IgG2a, respectively. Enzyme-linked immunosorbent assay using cells of five syngeneic tumor lines, MH134, MM102, MM46, MM48, and X5563, and lymph node cells of C3H/HeN and C57BL/6 mice showed that 3H1 specifically bound to MH134 tumor cells, whereas 7C2, 11G2, and 12A2 reacted not only with MH134 but also with MM102 and MM46 tumor cells. None of these monoclonal antibodies bound either to cells of MM48 or X5563 tumor lines or to normal lymph node cells. These results strongly suggest that MH134 tumor cells display at least two kinds of tumor-associated antigens on their cell surfaces: one is expressed uniquely by MH134 tumor cells, which are recognized by 3H1; the other is commonly shared by MH134, MM102, and MM46 tumor cells, which are determined by the other three antibodies. 3H1, 11G2, and 12A2 but not 7C2 were found to be able to induce antibody-dependent cellular cytotoxicity (ADCC) against MH134 tumor cells. Target specificity of ADCC induced by these monoclonal antibodies was identical with that seen in enzyme-linked immunosorbent assay. 3H1, 7C2, and 12A2 but not 11G2 exhibited complement-dependent cytotoxicity, showing the same specificity in target cell lysis as that seen in enzyme-linked immunosorbent assay or ADCC. Pretreatment of MH134 tumor cells with 7C2 inhibited ADCC of both 11G2 and 12A2. Pretreatment of the tumor cells with 11G2 inhibited complement-dependent cytotoxicity of both 7C2 and 12A2. Neither ADCC nor complement-dependent cytotoxicity of 3H1 was inhibited by the pretreatment of the cells with 7C2 or 11G2. These results strongly suggest that tumor-associated antigens recognized by 3H1 are located apart from that recognized by 7C2, 11G2, and 12A2 and that the binding sites of the latter three antibodies are closely associated with, or identical with, each other in the tumor-associated antigen. The ability of 12A2 to induce ADCC against MH134 tumor cells was significantly stronger than that of 3H1 or 11G2.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3978635 TI - Altered mouse bone marrow glutathione and glutathione transferase levels in response to cytotoxins. AB - The mouse bone marrow has been used as a model for the investigation of the response of cells to cytotoxins and carcinogens. The effects of cyclophosphamide, 1-beta-D-arabinofuranosylcytosine, and X-irradiation on the levels of glutathione and glutathione transferases have been studied. A high dose of cyclophosphamide (500 mg/kg) caused a significant depletion of glutathione levels in marrow, liver, and blood. A lower dose, 75 mg/kg, caused a similar depletion but only in marrow and liver. In this case, 5 to 7 days following treatment, the glutathione content of surviving cells was 1.8- to 3-fold higher than in controls. Glutathione transferase activity was also increased at this time (2- to 3-fold). 1-beta-D-Arabinofuranosylcytosine and X-irradiation also caused a depletion of marrow glutathione and glutathione transferase levels followed increased cellular levels (approximately 2-fold) 3 to 4 days later. Animals given cyclophosphamide (75 mg/kg) survived an otherwise lethal dose of this compound administered 5 to 7 days later. The time course of this effect closely paralleled the higher glutathione and glutathione transferase levels, suggesting a correlation between these effects. PMID- 3978636 TI - Regional measurements of [14C]misonidazole distribution and blood flow in subcutaneous RT-9 experimental tumors. AB - Regional [14C]misonidazole-derived radioactivity (MISO*) was measured by quantitative autoradiography in s.c. RT-9 experimental tumors 0.5, 2, and 4 h after an i.v. bolus (25 mg) and constant infusion (10 mg/h) in rats. Misonidazole (MISO) concentration in plasma, tumor, and other tissues was also measured by high-pressure liquid chromatography. The distribution of MISO* in the tumors always resulted in a characteristic pattern with high peripheral and low central values. The high-activity regions in the tumor rim achieved tissue: plasma MISO* activity ratios of 0.97 and 2.2 by 0.5 and 4 h, respectively; for central tumor regions, this ratio was 0.20 and 0.32 for the same periods, respectively. The limited distribution of MISO* to central tumor regions could be correlated to low values of blood flow (measured with [131I]iodoantipyrine) and to diffusion from peripheral tumor regions. Low blood flow in the central regions of these tumors will significantly limit the distribution of MISO and other drugs to viable appearing cells in these areas and could account in part for the failures of chemotherapy in certain solid tumors. Pharmacokinetic modeling indicates that 1 to 9 h may be necessary for MISO concentrations in some tumor regions to reach 50% of that in plasma. PMID- 3978638 TI - Variation in histology and growth characteristics of transplantable Marek's disease lymphomas. AB - A comparative study was made of the histology and growth characteristics of three different Marek's disease virus-induced transplantable lymphomas. These lymphomas were developed previously in related inbred chicken lines G-B1 and G-B2. The UG1 lymphoma was developed by serial i.m. passage in G-B1 chickens, and the UG2 and UG4 lymphomas were developed similarly in G-B2 chickens. While all three lymphomas grow progressively and cause rapid death in syngeneic hosts, differences in pathogenicity exist. For equivalent passage levels, the mean time to death of syngeneic chickens inoculated with 10(5) lymphoma cells was 10.8, 12.8, and 16.3 days postinoculation for UG1, UG2, and UG4, respectively. Histological features examined at the light microscopic level included tumor necrosis, muscle invasion, mitotic activity, and presence of heterophils (comparable to mammalian neutrophils). The UG2 lymphoma was characterized by a high degree of necrosis during all stages of growth. This feature was least pronounced in UG4 lymphomas, which generally grow to a much larger size than UG1 or UG2 lymphomas. Vascular invasion was a feature of UG2 lymphoma cells in skeletal muscle and may account for the necrosis. The UG2 cells, which are somewhat larger than UG4 cells, occasionally contained cytoplasmic vacuoles. While the number of heterophils was highest in early stages of UG2 tumors, the role of these cells is unclear. The findings provide the basis for utilizing the transplantable lymphomas as a model to study mechanisms underlying variable pathogenicity of malignant tumors. PMID- 3978637 TI - Antineoplastic effects in rats of 5-fluorocytosine in combination with cytosine deaminase capsules. AB - 5-Fluorocytosine (5-FC) lacks antineoplastic activity in human subjects because of the absence of cytosine deaminase (CDase) in mammalian cells. Intratumoral conversion of 5-FC into 5-fluorouracil (5-FUra) by locally implanted capsules containing CDase followed by systemic administration of 5-FC can be expected to induce antineoplastic activity at a local site with minimal systemic toxicity. In vitro and in vivo experiments were performed to evaluate this hypothesis. Spectrophotometric analysis confirmed the deamination of 5-FC to 5-FUra by CDase extracted from cultivated Escherichia coli. In vitro studies showed that 5-FC combined with CDase induced significant growth-inhibitory effects on the cultured glioma cells. An active CDase capsule, made of cellulose tubing, was newly designed for local implantation. 5-FC concentrations in the s.c. tumors of the rats given these CDase capsules, followed by 5-FC administration, showed a sufficient amount of delivery of 5-FC to the tumor tissue. 5-FUra appearing in the tumor reached the level of 8.0 micrograms/g at 2 h and stayed at more than 1.0 microgram/g at between 1 and 6 h. Significant reduction of the tumor growth and cytotoxic changes were observed. The passive cutaneous anaphylaxis reaction demonstrated no allergic reaction to the host due to the capsule. These results suggest that this chemotherapeutic method is effective for human brain tumors. PMID- 3978639 TI - Effect of tunicamycin on release of macromolecules and tumor antigens by human melanoma cells. AB - Tunicamycin, an inhibitor of glycosylation, was used to examine whether glycosylation is required for shedding of tumor antigens and other macromolecules by human melanoma cells. Cellular proteins were labeled with [35S]methionine, glycoproteins with [14C]glucosamine, and external surface components with 125I by the lactoperoxidase method; 0.5 and 2.5 microgram tunicamycin/ml effectively inhibited glycosylation without significantly reducing protein synthesis. We found that release of labeled macromolecules in the presence or absence of tunicamycin was similar. Tunicamycin-treated cells released 10.2% of [35S]methionine, 29.8% of [14C]glucosamine, and 57.2% of 125I-labeled macromolecules in 24 h compared to 5.5, 14.9, and 50.8%, respectively, for untreated control cells; 62.5% of the radioactivity associated with cell-surface melanoma-associated antigens defined by specific antiserum were released in 24 h as opposed to 50.4% by untreated cells. These results indicate that release of many cellular proteins, including glycoproteins, external surface proteins, and some melanoma-associated antigens, does not require glycosylation. PMID- 3978640 TI - Activity of mitozolomide (NSC 353451), a new imidazotetrazine, against xenografts from human melanomas, sarcomas, and lung and colon carcinomas. AB - The chemosensitivity of human tumor xenografts to mitozolomide, 8-carbamoyl-3-(2 chloroethyl)imidazo[5-1-d]-1,2,3,5-tetrazin-4(3H) -one, was studied in 3 different assay systems. In concentrations of 1 to 500 micrograms/ml, mitozolomide completely inhibited the colony-forming ability in soft agar of cell suspensions from sarcomas, melanomas, lung and colon cancers, and a mammary carcinoma. When a panel of tumors of the different histological types was tested for its sensitivity to mitozolomide in vitro, in the 6-day subrenal capsule assay in conventional mice, and, in some cases, as s.c. growing tumors in nude mice, good agreement between the different assay systems was seen. In most cases, a very pronounced antitumor effect was observed. The efficacy of mitozolomide was as good or better than that of the drugs clinically used against the tumor types tested. Tumor size measurements and histological examinations indicated that nude mice carrying a melanoma, a small cell lung cancer, and an osteosarcoma were cured of their tumors. The approach here used for evaluating the effect of a new drug on human cancers may be useful for selecting the tumor types which primarily should be studied in clinical trials. The results indicate that clinical responses to mitozolomide may be anticipated in sarcoma, melanoma, small cell lung cancer, and possibly in colon cancer. PMID- 3978641 TI - Antitumor activity and minimal toxicity of concentrated thymidine infused in nude mice. AB - To avoid infusing large volumes of fluid while treating patients with the standard thymidine solution (30 g/liter), it may be possible to administer this drug in more concentrated form. At 25 degrees C, thymidine is saturating at a concentration of 52 g/liter of 0.6% NaCl solution, and the thymidine concentration at saturation increases with temperature. Nude mice were infused at 29 degrees C with thymidine (60 or 72 g/liter) in cycles consisting of 4 to 5 days infusion followed by 9 days rest. Therapeutically effective doses of concentrated thymidine did not cause significant mortality in mice, and weight loss attributable to treatment was small and reversible. Significant growth inhibition of CA 1 human melanoma heterotransplants was observed after 3 treatment cycles. After 4 or 5 cycles, tumor responses were obtained in 7 mice (6 complete responses) of 12 inoculated with this tumor. These results show that concentrated thymidine solutions are highly effective against human tumor heterotransplants in nude mice and suggest that clinical use of concentrated thymidine may allow practical administration of maximum tolerated doses of this drug. PMID- 3978642 TI - Nucleotide sequence preservation of human leukemic mitochondrial DNA. AB - Nucleotide sequence variation in mitochondrial DNA isolated from human leukemic cells has been analyzed by recombinant DNA techniques. Three hundred eighty-seven independent recombinant DNA clones, each containing one of three defined segments of mitochondrial DNA isolated from the neoplastic cells of four leukemic patients, were analyzed. Partial nucleotide sequence determination of the 387 clones yielded a total of 81.7 kilobases of nucleotide sequence information. The only evidence of within-individual nucleotide sequence divergence consisted of three clones containing deletions of one or two nucleotides in one mitochondrial DNA region. These clones were three of 113 independent clones isolated from a patient with acute lymphocytic leukemia. The low level of nucleotide sequence divergence in the mitochondrial DNA population of neoplastic cells from individual leukemic patients suggests that a mechanism or mechanisms exist that limit the development of nucleotide sequence divergence in mammalian mitochondrial DNA. The results further suggest that this mechanism does not appear to be abrogated by neoplastic transformation in leukemic patients. PMID- 3978643 TI - Development and progression of karyotypic variability in melanoma K1735 following X-irradiation. AB - Chromosomal aberrations are often assumed to be deleterious to cells. However, we have found that many metastases are populated by cells with chromosomal recombinants induced by radiation of the original tumor population. The tumor, K 1735-M2, was already capable of metastasis so that the recombinant chromosomes were not necessary for this property of the tumor. Stable recombinants, like other aberrant forms, could be disadvantageous or, alternatively, could confer selective advantage to some tumor cells. We investigated these possibilities by irradiating the parental tumor line and examining the formation and persistence of chromosomal markers in cell culture and in s.c. tumors. The karyotype of the K 1735-M2 parental tumor is composed entirely of telocentric chromosomes, and recombinant forms are relatively easy to recognize. Unstable forms of chromosome damage were lost rapidly. The frequency of stable recombinants after two weeks in culture was higher than that in tumors growing in primary inoculation sites. In contrast, secondary (spontaneous metastatic) foci showed a far greater frequency of chromosomal markers, suggesting a positive association between markers and acquisition of properties benefiting growth and metastasis. PMID- 3978644 TI - Hyaluronic acid content of effusions as a diagnostic aid for malignant mesothelioma. AB - A high-performance liquid chromatographic technique, using a size exclusion column (TSK-5000PW), has been developed for the quantification of hyaluronic acid (HA) in pleural and peritoneal effusions. Sample preparation requires only a 100 fold dilution of the exudate with phosphate buffer prior to analysis. Chromatographic conditions are: 0.05 M phosphate buffer (pH, 5.0) mobile phase at a flow rate of 1.0 ml/min, ultraviolet absorbance detection at 200 nm. The method resolves HA from all other glycosaminoglycans. The presence of HA is confirmed by the removal of the HA peak (retention time, approx. 5.3 min) by incubation of a second sample aliquot with hyaluronidase. Effusions of 13 of 14 patients with confirmed malignant mesothelioma contained HA in the 0.3 to 11.1 mg/ml range. In only one case was no HA detected. None of the effusions from 56 control patients with various other primary tumors contained detectable HA, i.e., there were no false positives. An unidentified peak, not susceptible to hyaluronidase appeared in 11% (6 of 56) of the controls. A single mesothelioma case was correctly identified in a group of 10 coded samples. It is suggested that an effusion with an HA concentration greater than 0.25 mg/ml, confirmed by hyaluronidase susceptibility, is an indication of the presence of malignant mesothelioma. The test is simple and rapid, and it is recommended that any effusion of uncertain etiology be screened for the presence of HA. PMID- 3978645 TI - Demographic study of clinically atypical (dysplastic) nevi in patients with melanoma and comparison subjects. AB - We examined 296 patients with a history of melanoma and 145 controls for the presence of atypical (dysplastic) nevi. We found that 34% of patients with melanoma and 7% of controls had clinically atypical (dysplastic) nevi. Patients and controls with atypical (dysplastic) nevi had more nevi than the subjects without. The number of nevi varies negatively and significantly with age (r = 0.37, P less than 0.001). Ten % of patients and controls had hypopigmented halos around one or more nevi. Both patients and comparison subjects with atypical (dysplastic) nevi tended to have this subtle variant of halo nevi more often than those without (r = 0.17, P less than 0.01). The number of nevi on the irides of melanoma patients was greater than that in the comparison group. The results of this study suggest that patients with a melanoma exhibit more commonly cutaneous and ocular pigmentary lesions than comparison subjects without a melanoma. PMID- 3978646 TI - Phase I and clinical pharmacological evaluation of 4'-deoxydoxorubicin in patients with advanced cancer. AB - We have conducted a Phase I and initial clinical pharmacological evaluation of 4' deoxydoxorubicin (4'-DXDX), administering the drug i.v. on an every 21-day schedule to 60 patients with advanced cancer. Patients were treated at six dosage levels ranging from 10 to 35 mg/sq m. Leukopenia was the dose-limiting toxic effect, and no cardiac, renal, or hepatic toxicity was observed; stomatitis was not seen; and there were no drug-related deaths. Significant alopecia was rare at doses less than 35 mg/sq m, mild nausea and vomiting occurred in one-third of patients at myelosuppressive doses; 12 patients had a transient local urticarial reaction. In the 30 patients with measurable disease, two partial remissions were seen, lasting 5 months in a patient with a nasopharyngeal adenocarcinoma, and 7 months in a patient with endometrial adenocarcinoma. The recommended dose of 4' DXDX for Phase II studies is 30 mg/sq m in good-risk patients and 25 mg/sq m in moderate-risk or heavily pretreated patients. Pharmacokinetic studies were carried out in ten patients, four of whom received 4'-DXDX at a dose of 10 mg/sq m and six at 30 mg/sq m. Disappearance of 4'-DXDX from plasma was triphasic with a rapid initial phase clearance showing a t1/2 alpha of 1 to 2 min and a prolonged terminal phase with a median t1/2 gamma in excess of 90 h in patients receiving 30 mg/sq m. PMID- 3978647 TI - Phase I study and pharmacokinetics of weekly high-dose 13-cis-retinoic acid. AB - In an attempt to increase the peak plasma levels of 13-cis-retinoic acid (13-cis RA) and its efficacy in vivo, a Phase I study and pharmacokinetics of weekly high dose, oral 13-cis-RA was conducted in 23 cancer patients who were refractory to conventional treatments. At 200 mg/sq m, the mean peak plasma level of 13-cis-RA was 1.5 +/- 0.1 (SE) micrograms/ml; at 400 mg/sq m, the mean peak plasma level increased to 3.8 +/- 0.7 micrograms/ml. Further increases of the 13-cis-RA dose up to 1800 mg/sq m did not lead to proportional increases in either the mean peak plasma levels or area under the curve, indicating a saturable absorption phenomenon. The terminal half-life was highly variable (range, 2.8 to 101.3 h) and was not related to the dose given. A secondary peak plasma concentration was seen in five patients, suggesting enterohepatic circulation. The toxicities such as headache, cheilitis, dry skin, and dry eyes were frequent on the weekly schedule but were not dose-limiting. One patient had an elevation of the triglycerides of 2 to 5 times the upper limit of normal; five patients had an elevation of 1.1 to 2 times normal. No objective responses were observed to treatment with 13-cis-RA. Of 20 patients receiving an adequate trial of the drug, 18 showed progression of their cancer, and two had stable disease. PMID- 3978649 TI - Pharmacokinetics of melphalan in clinical isolation perfusion of the extremities. AB - The pharmacokinetics of melphalan in clinical hyperthermic isolation perfusion was studied in 16 patients with malignant melanoma. Analysis by computer generated lines of best fit showed that the loss of melphalan from perfusate conforms best to a biexponential equation. The initial loss with a half-life (t1/2) of approximately 5 to 10 min is interpreted as rapid uptake of melphalan by the tissue of the perfused extremity. The terminal portion of the curve with a half-life of approximately 35 to 50 min is interpreted as due predominantly to the hydrolysis of melphalan, with a lesser component of loss due to absorption of melphalan to the filters and tubing of the perfusion apparatus. Determination of the area under the curve suggests that there is no appreciable uptake of melphalan by the tissue of the perfused extremity after 30 min. PMID- 3978648 TI - Disposition of mitoxantrone in cancer patients. AB - We have used a highly sensitive high-performance liquid chromatographic assay to evaluate the pharmacokinetics and tissue disposition of mitoxantrone, an investigational anthracene derivative which has shown significant activity during Phase II clinical trials in the treatment of metastatic breast cancer, unfavorable histology non-Hodgkin's lymphoma, and acute leukemia. Mitoxantrone (12 mg/sq m over 30 to 35 min in 250 ml of dextrose 5% in water) and 14C-labeled mitoxantrone (specific activity, 8.85 muCi/mg) were administered to eight patients who had advanced soft tissue cancers. The plasma disappearance of mitoxantrone concentrations measured by high-performance liquid chromatography was best described by a three-compartment model with a mean t alpha of 0.1 h, a t beta of 1.1 h, and a t gamma of 42.6 h. The mean apparent Vc was 12.2 liters/sq m, while the mean Vd was 1875 liters/sq m. The mean plasma clearance was 0.57 liters/min/sq m, and the mean renal clearance was 45 ml/min/sq m. Only 6.5% of the total mitoxantrone dose was excreted in the urine as unchanged drug over 5 days. The mean recovery of 14C-labeled material in feces over 5 days was 18.3% of the administered dose. Thirty-five days after mitoxantrone administration to a patient who died of progressive kidney cancer, approximately 15% of the 14C dose could be accounted for in seven major organs. We conclude that mitoxantrone appears to distribute into a deep tissue compartment from which it is slowly released. These data provide a pharmacological rationale for use of mitoxantrone on an intermittent dosing schedule. PMID- 3978650 TI - Role of opium in esophageal cancer: a hypothesis. PMID- 3978651 TI - Bromocriptine: problems with low-dose de novo therapy in Parkinson's disease. AB - Twenty Parkinson's disease patients, who had not yet received levodopa, were treated with low-dose bromocriptine. At a mean daily bromocriptine dose of 13.2 mg, 13 patients (65%) improved and had a 32% reduction in the combined score for tremor rigidity and bradykinesia. Adverse effects were frequent, and 25% of the patients were taken off the drug because of nausea or vomiting. After 30 months follow-up, only three patients continued on bromocriptine alone. Ten patients were eventually maintained on low-dose bromocriptine and levodopa-carbidopa, and a clear synergistic effect of bromocriptine in this drug combination was documented in eight patients. Low-dose bromocriptine does not replace levodopa as initial therapy for Parkinson's disease. The potential long-term benefit of the early use of combined low-dose levodopa-dopamine agonist therapy needs to be further studied. PMID- 3978652 TI - Measurement of plasma levels of clomipramine in the treatment of chronic pain. AB - The analgesic effect of clomipramine and the possible relationships between the antalgic action and the plasma levels of this tricyclic drug have been studied in 30 patients with chronic pain induced by nervous lesions determining a deafferentation. Twenty of 30 patients treated with clomipramine reported a significant improvement (up to 50%) observed as soon as the 4th day, with few side effects. The pharmacokinetic analysis shows the existence (r = 0.358; p less than 0.001) of a relationship between analgesia and plasma levels of clomipramine for each individual patient. This study also indicates a "therapeutic window" of plasma levels between 20 and 85 ng/ml. These results permit discussion of measurement of plasma levels of clomipramine in the treatment of chronic pain. PMID- 3978653 TI - Qualitative assessment of Parkinson's disease: study of reliability and data reduction with an abbreviated Columbia Scale. AB - Research in Parkinson's disease has given little attention to the reliability of subjective-qualitative assessment, or to the empirical aggregation of physical signs to supraordinate indexes of motor disturbance. We illustrate methods for examining observer reliability and discuss the importance of reliability to the interpretation of results. Observers rated patients (n = 70) for physical signs (selected Columbia Scale scores), disability stages, and abnormal involuntary movements. Observer agreement was achieved for Columbia scores and disability stages (range of Spearman rho = 0.67-0.95), but not for dyskinesias or dystonic postures. A factor analysis of Columbia scores revealed two indexes of motor disturbance: motor deficiency and tremor. PMID- 3978654 TI - Levodopa during pregnancy. PMID- 3978655 TI - Naloxone ameliorates narcolepsy. PMID- 3978656 TI - Treatment of renal cell carcinoma with alpha (human leukocyte) interferon and vinblastine in combination: a phase I-II trial. AB - Twenty-four patients with measurable metastatic renal cell carcinoma were treated in a phase I-II trial with alpha (human leukocyte) interferon (alpha IFN) and vinblastine (VBL) in combination. Patients received 3 X 10(6) IU/day of alpha IFN im 5 days/week and VBL iv weekly (at a starting dose of 0.15 mg/kg), with doses modified for toxicity. All patients were evaluable for toxicity; 23 patients were evaluable for response. An objective response rate of 13% was observed (three partial responses). An additional 22% of patients had minimal responses (five patients). The occurrence of nausea, vomiting, thrombocytopenia, hepatic dysfunction, and fever was comparable to that seen in previous studies of alpha IFN alone. Granulocytopenia, neurotoxicity, and malaise, however, occurred with increased frequency and severity. alpha IFN and VBL administered in combination in this dose schedule demonstrated activity similar to but toxicity greater than that seen in previous trials of alpha IFN alone. PMID- 3978657 TI - Effect of forphenicinol, a small molecular immunomodifier, in combination with cyclophosphamide on growth of and immunity to syngeneic murine tumors. AB - Forphenicinol (FPL) is a low molecular immunomodifier derived from forphenicine, a microbial product found by Umezawa and co-workers. We studied the antitumor effect of FPL, cyclophosphamide (CY), and the combination of the two on several syngeneic murine tumors. The tumors used were mammary carcinoma, L1210 leukemia, B16 melanoma, Lewis lung carcinoma, and glioblastoma. A single ip injection of CY on Day 1 followed by eight consecutive daily oral doses of FPL beginning 6 days after tumor inoculation showed strong cooperation in curing syngeneic mammary carcinoma inoculated intradermally in C3H/HeN mice, most mice being cured of the tumor by the combination therapy and subsequently having acquired strong specific immunity. Treatment with FPL alone (either pre- or post-treatment) also significantly inhibited the growth of the mammary tumor. FPL and CY also showed cooperation in inhibiting the growth of L1210 leukemia transplanted intradermally into CDF1 (BALB/c X DBA/2) mice and markedly prolonged the survival time but FPL treatment alone had no effect. The FPL-CY treatment also affected Lewis lung carcinoma and glioblastoma in syngeneic C57BL/6 mice and produced therapeutic synergism. FPL alone significantly inhibited the growth of B16 melanoma in C57BL/6 mice as well as the syngeneic mammary carcinoma in C3H/HeN mice. These findings suggest that oral administration of FPL in combination with chemotherapeutic agents can be used for treating cancer without causing toxicity, because of the synergistic efficacy of the combination. PMID- 3978658 TI - Inability of dimethyl sulfoxide to increase brain uptake of water-soluble compounds: implications to chemotherapy for brain tumors. AB - There is conflicting evidence as to whether dimethyl sulfoxide (DMSO) can reversibly open the blood-brain barrier and augment brain uptake of water-soluble compounds, including anticancer agents. To investigate this, 125I-human serum albumin, horseradish peroxidase, or the anticancer drug melphalan was administered iv to rats or mice, either alone or in combination with DMSO. Some animals received an additional ip priming dose of DMSO. The regional brain concentrations of each substance were measured after the animals were killed. DMSO administration did not significantly increase the brain uptake of any of the compounds as compared to control uptakes. These results do not support prior reports that DMSO increases the permeability of water-soluble agents across the blood-brain barrier. PMID- 3978659 TI - Severe central nervous system toxicity from high-dose cytarabine: expressive aphasia occurring after the second day of treatment. AB - A patient with acute erythroleukemia secondary to polycythemia vera was treated iv with high-dose cytarabine at a dose of 3 g/m2 every 12 hours. After the fourth dose, he developed an expressive (Broca's type) aphasia and somnolence, which progressed until after the treatment was stopped at the seventh dose. The somnolence cleared partially during the next 2 weeks but recurred after cytarabine was restarted at a dose of 100 mg/m2 daily for 7 days. The patient died 5 days later of refractory extreme thrombocytopenia and bleeding. The normal spinal fluid obtained during life and the postmortem findings were consistent with previously reported findings with central nervous system toxicity from high dose cytarabine. Three unusual aspects of this case are early onset of symptoms, expressive aphasia as the dominant manifestation, and exacerbation of symptoms with standard doses (100 mg/m2/day). PMID- 3978660 TI - Phase II trial of mitogauzone in malignant primary brain tumors. AB - Sixteen patients with primary malignant brain tumors, recurrent or progressive after surgery and radiation therapy, were treated with mitoguazone. Starting dose was 500 mg/m2 iv on a weekly schedule. In 15 evaluable patients no tumor regressions were observed. Four patients had stabilization of disease. PMID- 3978661 TI - Phase II evaluation of bisantrene in metastatic breast cancer. PMID- 3978662 TI - Acute renal failure and death following sequential intermediate-dose methotrexate and 5-FU: a possible adverse effect due to concomitant indomethacin administration. PMID- 3978663 TI - N-methylformamide-induced hypophosphatemia. PMID- 3978664 TI - The marked decline in coronary heart disease mortality rates in the United States, 1968-1981; summary of findings and possible explanations. AB - During the years 1940-1967, age-adjusted mortality rates from coronary heart disease (CHD) rose in the USA by 14.1% for all persons aged 35-74. This upward trend was recorded for white men, black men, and black women, but not for white women. From 1968 to 1981 (year of latest record), the trend in the preceding period was reversed, i.e., CHD death rates decreased steadily, at a rate averaging about 3% per year. This downward trend has involved all age-sex-color groups in the adult population and all regions of the country. It has encompassed both main categories of CHD, i.e., acute myocardial infarction (AMI) and chronic ischemic heart disease (CIHD), the former more prominently than the latter, especially among adults aged 35-64. The US decline in CHD mortality rates is greater-absolutely and relatively-than that of any other country. US death rates from stroke have also fallen markedly over these years, so that death rates from the major cardiovascular diseases (CVD) and all causes also fell substantially, with savings of hundreds of thousands of people from premature death since 1968. Responding to vigorous development in the USA over the last 25 years of public policy and strategy for the prevention and control of the coronary epidemic, tens of millions of Americans have made changes in eating habits resulting in lower population mean intake of total fat, saturated fat, cholesterol; increased intake of polyunsaturated fats; decreased mean levels of serum cholesterol and rates of hypercholesterolemia. Prevalence rates of cigarette smoking among adults have also decreased markedly. Tens of millions have taken up leisure time exercise. All these changes have occurred more among the more educated-affluent than among the less educated-affluent. Over the last decade the proportion of persons with hypertension whose hypertension was detected, treated, and controlled has risen from 10 to 15% to embrace a majority of hypertensives. It is a reasonable inference that these mass changes in life-styles and life-style-related major CHD risk factors have contributed importantly to the large sustained declines in CHD, CVD, and all causes death rates in the USA. Concordant with this inference are data sets indicating greater declines in CHD mortality among the more educated affluent strata than among the general population (matched for age-sex-color), in keeping with the greater changes in life-styles among the more educated-affluent, e.g., as exemplified by findings for physicians.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3978665 TI - Coronary heart disease mortality, morbidity, and risk factor trends in New Zealand. AB - Coronary heart disease (CHD) mortality rates declined by 22 and 13% for European men and women respectively between 1968 and 1981. Data from two methodologically identical population-based registers indicate that in the period 1974-1981 there was no change in either the event rates or case fatality rates of definite myocardial infarction. In the same period there was a significant 17% decline in the sudden death event rates. These declines have been associated with a decrease in the consumption of dairy products, a reduction in self-reported cigarette smoking habits, improved control of hypertension, and possibly by reductions in serum cholesterol levels and an increase in habitual physical activity in the community. There have also been improvements in the medical management of patients with CHD although this appears to be of secondary importance in contributing to the decline in CHD mortality. PMID- 3978666 TI - Liver damage as a potential source of error in the estimation of myocardial infarct size from plasma creatine kinase activity. AB - The occurrence of liver damage was investigated in patients with uncomplicated acute myocardial infarction (AMI). Cumulative plasma release of creatine kinase (CK) and alpha-hydroxybutyrate dehydrogenase (HBD) was compared with release of alanine aminotransferase (ALT). Up to 48 h after AMI, the appearance of ALT could be fully explained by myocardial ALT release. Thereafter additional release of ALT occurred, indicating liver damage. A possible effect of liver function on the rate of elimination of CK from plasma was studied in the dog. Complete temporary arrest of hepatic blood supply was obtained after previous implantation of a portacaval shunt, ligation of secondary inflows and blockade of retrograde perfusion. Neither these preliminary haemodynamic interventions nor the acute arrest of hepatic blood flow had any effect on the disappearance rate of CK from plasma. It is concluded that some liver damage commonly occurs in patients after AMI. However, this phenomenon does not interfere with the estimation of infarct size because the elimination of CK from plasma is unaltered during total hepatic ischaemia. PMID- 3978667 TI - Effects of elevated extracellular potassium concentrations on the class III antiarrhythmic action of sotalol. AB - The electrophysiological and mechanical effects of sotalol, a beta-adrenergic blocker with Class III antiarrhythmic properties, were compared with those of atenolol in rabbit right ventricular papillary muscles studied in vitro using intracellular microelectrodes. Sotalol produced a dose-dependent increase in action potential duration and effective refractory period without any effect on parameters of rapid inward current. Atenolol had no Class I or Class III effect. The actions of equipotent beta-blocking concentrations of sotalol (10(-4) mol X litre-1) and of atenolol (10(-5) mol X litre-1) in elevated extracellular potassium concentrations of 8 and 12 mmol X litre-1 were investigated. There were reductions in membrane potential, action potential amplitude and upstroke velocity in elevated potassium which were not influenced by sotalol and atenolol, apart from a small additional depression of action potential amplitude and membrane potential in 12 mmol X litre-1 potassium. Hyperkalaemia caused shortening in action potential duration but lengthening in effective refractory period (post-repolarisation refractoriness). The increase in effective refractory period over control produced by sotalol in normal potassium was preserved in elevated potassium. This effect was attributable to lengthening of action potential duration rather than alteration in the duration of post-repolarisation refractoriness. The Class III effects of sotalol are preserved even in partially depolarised fibres where rapid inward current is depressed. PMID- 3978668 TI - Freeze-thaw injury of rat heart across an intact diaphragm: a new model for the study of the response of myocardium to injury. AB - A new method for producing a circumscribed injury in rat myocardium is described. It utilises laparotomy and freeze-thawing across an intact diaphragm. Morbidity and mortality are negligible because the chest and pericardial cavities, the major coronary vessels, and the major branches of the conduction system remain intact. The size and location of the injury are reproducible and its sharp delineation facilitates accurate collection of samples from areas of interest. The myocytes are killed in the area of injury, whereas the capillary, nerve and connective tissue cells are killed centrally but preserved peripherally in a perimeter zone of injury in which capillaries remain patent. The reparative activities are initiated at the border between injured and uninjured myocardium; as they progress over the ensuing 6 weeks, the volume of damaged myocardium diminishes rapidly leaving only a rim of subepicardial scar tissue, and the thickness of ventricular muscle between the scar and endocardium returns almost completely to its pre-injury width. The mechanisms involved in the repair process are being investigated. PMID- 3978669 TI - Nuclear-cytoplasmic interactions affecting DNA synthesis during induced cardiac muscle growth in the rat. AB - Nuclear-cytoplasmic interactions affecting DNA synthesis during induced cardiac muscle growth were examined in 29 to 46 day old rats. DNA synthesis was examined in vitro using isolated nuclei from rat heart and adult X. laevis spleen. Cytoplasmic extract (CE) was obtained from a 105 000 g supernatant of rat heart and fetal liver homogenates. To measure DNA synthesis we utilised DNA within the isolated quiescent nucleus as the template and measured the effect of CE on the incorporation of 3H-TTP into an acid precipitable product. In a homologous system of rat heart nuclei from weanling rats and CE from cardiac muscle undergoing induced growth, no stimulation of 3H-TTP incorporation was observed. Cardiac muscle CE however, did possess stimulatory factor(s) since quiescent X. laevis nuclei could be stimulated with the rat heart CE. Furthermore, CE from hearts undergoing induced growth had greater activity than extract from control hearts. While cardiac muscle nuclei were not stimulated by heart CE, they showed substantial stimulation by CE from fetal rat liver, which contains a large population of proliferating cells. Stimulation by fetal rat liver was greater with nuclei obtained from hearts undergoing induced growth than from control hearts. Stimulatory factor(s) in CE was distinct from DNA polymerase-alpha activity, as shown by separation of the two activities on a 5 to 15% glycerol gradient. PMID- 3978670 TI - Temperature-dependency of nifedipine as a protective agent during cardioplegia in the rat. AB - An isolated working rat heart preparation was used to characterise the temperature-dependency of the anti-ischaemic properties of nifedipine. In this study hearts were subjected to pre-ischaemic infusion with the St Thomas' cardioplegic solution with or without added nifedipine (0.075 mumol X litre-1). Hearts were then rendered globally ischaemic for various periods, (35, 42, 48, 56, 55, 65, 80, 105 or 130 min) at various temperatures (37.0, 35.5, 34.0, 32.5, 31.0, 29.0, 27.0, 24.0 or 20.0 degrees C, respectively). The duration of ischaemia at each temperature was selected to produce a post-ischaemic (37 degrees C) recovery of aortic flow that was approximately 50% of its pre ischaemic (37 degrees C) control. In addition to functional indices (aortic flow, cardiac output, coronary flow, aortic pressure and heart rate) creatine kinase leakage during reperfusion was measured. At all temperatures at or above 31 degrees C the addition of nifedipine enhanced significantly (maximal value = 43%) the post-ischaemic recovery of aortic flow and other indices of pump function, while at the same time reducing significantly (by up to 56%) enzyme leakage. At ischaemic temperatures below 31 degrees C nifedipine failed to afford any significant additional protection when assessed functionally or enzymatically. It would therefore appear that hypothermia either blocks the action of nifedipine or, by acting on some common mechanism, renders the actions of the drug redundant. PMID- 3978671 TI - [Progress in space physiology in the first half of the 80s]. PMID- 3978672 TI - [Research on urinary concretions]. PMID- 3978673 TI - [Analgesic nephropathies in Czechoslovakia (1977-1981)]. PMID- 3978674 TI - [Effects of hypersaturation with ascorbic acid in patients with disorders of renal elimination of uric acid and hyperuricemia]. PMID- 3978675 TI - [Therapy of urinary tract infections with cefotaxime]. PMID- 3978676 TI - [Acquired dysfibrinogenemia in renal insufficiency and the effect of hemodialysis]. PMID- 3978677 TI - [Sarcoidosis of the stomach]. PMID- 3978678 TI - [Cathepsin B-like and possibilities of its use in the diagnosis of ascites of neoplastic origin]. PMID- 3978679 TI - [Hemocoagulation status in reinfusion of ascitic fluid in patients with liver cirrhosis]. PMID- 3978680 TI - [Improvement of the technic of needle biopsy of muscles]. PMID- 3978681 TI - [Health--a component of the manifestation of the living standard of a people]. PMID- 3978682 TI - [The present status and perspectives in the development of immunopharmacologic agents]. PMID- 3978683 TI - [Evaluation of the nutritional status and immunological reactivity in patients with heart diseases]. PMID- 3978684 TI - [Evaluation of nutritional status using anthropometric and biochemical indicators and tests of cellular immunity. Mutual relations between individual parameters]. PMID- 3978685 TI - [Enteroviral etiology of neuroinfectious diseases]. PMID- 3978686 TI - [The concentration of C-reactive protein in synovial fluid in rheumatologic diseases]. PMID- 3978687 TI - [In defense of the classical signs of epidural hematoma]. PMID- 3978688 TI - [Nontraumatic intracerebral hematomas]. PMID- 3978689 TI - [Microsurgical cure of the cause of facial hemispasm]. PMID- 3978690 TI - [A Czechoslovakian aseptic unit for strict reverse isolation]. PMID- 3978691 TI - [An inhalation glucocorticoid--budesonide]. PMID- 3978692 TI - Appearance and distribution of fetal brain macrophages in mice. Immunohistochemical study with a monoclonal antibody. AB - A study on the localization of fetal and neonatal brain macrophages of mice from embryonic day 10 (E10) to postnatal day 21 (P21) was carried out immunohistochemically using a monoclonal antibody against a macrophage differentiation antigen (Mac-1) and the labeled avidin-biotin technique. In the central nervous system, the macrophages recognized first were mainly located in the choroid plexuses of the fourth and lateral ventricles at E14. Their number increased at E17-P3 and gradually decreased thereafter. In the cerebral parenchyma, a few macrophages appeared at E14 in the matrix cell layer. They were also detected in the migrating zone at E15, E17 and in the cortical plate at E19. Mapping of positive cells at the stage of neuroblast formation (E15, E17, E19) disclosed the precise distribution of cerebral macrophages. The macrophages that appeared first in the choroid plexuses at E15 may be derived from the subarachnoid vessels, which extend into the stroma of the choroid plexuses when the matrix cell layer invaginates into the lateral ventricle to form the choroid plexuses. Almost all of the macrophages recognized in the cerebral parenchyma disappeared at P9 when the cytoarchitecture seemed to be completed. In the cerebellum, which develops later than the cerebrum, macrophages appeared after birth and were located mainly in the internal granular layer. The brain macrophages always appeared in the regions where cell proliferation and brain remodeling are most active at each stage. These findings suggest that fetal and neonatal brain macrophages may play an important role in scavenging degenerated cells and cell debris during histogenesis of the central nervous system. PMID- 3978693 TI - Immunocytochemical studies of vasotocin and mesotocin in the hypothalamo hypophysial system of the chicken. AB - The hypothalamo-hypophysial system of the adult chicken has been studied with a monoclonal antibody that cross-reacts with arginine vasotocin and mesotocin. We have used this antibody on thick (100 micrometers) sections in conjunction with a peroxidase-conjugated rabbit antimouse antibody that permits the visualization not only of entire perikarya, but also of long portions of their axons and dendrites. Our results confirm older concepts based on classical methods, but the more sensitive immunocytochemical method reveals that the system is more extensive than previously recognized. Immunostained neurons in the chicken are widely scattered in the hypothalamus. In the rostral preoptic region, there are three immunostained neuronal cell groups: a prominent closely packed group that extends along the ventromedial surface, a diffusely distributed lateral group, and an external group that surrounds the lateral aspect of the septomesencephalic tract. Caudally in the preoptic area and in the anterior hypothalamus, the same groups are present; but there are also conspicuous periventricular perikarya. Many of them have processes that project to the lumen of the third ventricle, as well as parallel axons that arch lateroventrally in the hypothalamus. In the midhypothalamic area, the periventricular perikarya and processes are particularly numerous at the level of the pallial commissure. The dorsal periventricular group located at the level of the dorsomedial anterior nucleus of the thalamus are the most caudal perikarya. They extend laterally in a wing-like formation. The immunostained axons from all of these perikarya form a compact hypothalamo-hypophysial tract as they run from the mid-hypothalamus to the median eminence and converge beneath the third ventricle. Axons branching from this tract innervate the zone externa of the anterior median eminence; another group of axons running in the fibrous layer of the zona interna proceeds to the neural lobe. PMID- 3978694 TI - Fine structure of the lysosomes in the two types of synoviocytes of normal rat synovial membrane. A cytochemical study. AB - The lysosomal system of the two types of synoviocytes (A and S) from the knee joint of normal rat synovial membrane was studied by electron-microscopic acid phosphatase cytochemistry. In random sections of the synovial intima lysosomes were more often encountered in the A-cell profiles than in the S-cell profiles. Characteristically, type-A synoviocytes showed many large and medium-sized lysosomes the cytochemical appearance of which varied considerably. No acid phosphatase activity was detectable in the cisternae of the Golgi apparatus or in the Golgi vesicles. In type-S synoviocytes the lysosomes were smaller, and more uniform in cytochemical appearance. Heavy deposits of acid phosphatase reaction product were constantly demonstrated in cisternae of the Golgi apparatus as well as in smooth-walled Golgi vesicles in type-S cells. The findings that type-A and type-S synoviocytes show distinctly different organization of the lysosomal system indicate that the roles of the lysosomes in these two types of cells may be different. PMID- 3978695 TI - Ultrastructure of corpora allata of known activity during the vitellogenic cycle in the cockroach Diploptera punctata. AB - Ultrastructure was correlated with rates of juvenile hormone synthesis in corpora allata from females of the viviparous cockroach Diploptera punctata at seven daily intervals during the first vitellogenic cycle. Synthetic activity of the glands was determined by in vitro radiochemical assay before the glands were fixed for electron microscopic analysis. The cycle in rates of juvenile hormone synthesis progressed from about 20 pmol h-1 per gland pair (oocytes 0.60 mm long) to a maximum mean rate of 140 pmol h-1 per pair (oocytes 1.40-1.47 mm long) and declined to about 20 pmol h-1 per pair at ovulation (oocytes about 1.65 mm long). Conspicuous ultrastructural changes occurred with changing synthetic rates. In glands with increasing rates of synthesis, mitochondria showed less electron dense matrix, greater diameter and more irregular shape. Smooth endoplasmic reticulum changed from easily seen to obscure tubules, networks, and vesicles. Rough endoplasmic reticulum appeared in longer, more curved segments. Newly formed autophagic vacuoles appeared in all glands of highest activity rates. In glands with decreasing rates of synthesis, the mitochondrial matrix became denser, width smaller, and shapes less irregular. Smooth endoplasmic reticulum again appeared tubular and distinct. Golgi complexes were more conspicuous. Rough endoplasmic reticulum in whorls and large numbers of autophagic vacuoles continued to be present. PMID- 3978696 TI - Electron-microscopic studies on the physiological cell loss in the gastric mucosa of the golden hamster. AB - Fine-structural aspects of physiological cell loss in the gastric mucosa of the golden hamster were observed. As the surface mucous cell ascends along the gastric pit, the cell becomes taller and funnel-like in shape. The interfoveolar cell located at the superficial portion of the gastric pit has many lysosomes and a few lipid droplets in the cytoplasm. The nucleus moves toward the upper region of the cytoplasm, while the Golgi apparatus moves downward toward the infranuclear region. After the rupture of the apical plasma membrane takes place, the lateral and basal plasma membranes of this cell reamin in spite of loss of the cell contents. Between the basal plasma membrane of the interfoveolar cell and the capillary endothelium is a thick connective tissue layer characterized by densely packed collagen fibrils. The remaining basal and lateral plasma membranes of the ruptured cell and the thick underlying collagenous layer might play a role in protecting the tissue from potential damage induced by the physiological cell loss. PMID- 3978697 TI - The ultrastructural and biosynthetic characteristics of steroidogenic cells in the gonad of Monopterus albus (Teleostei) during natural sex reversal. AB - The ultrastructural and biosynthetic characteristics of the steroid cells in the gonad of Monopterus albus have been studied. Ultrastructural features related to steroidogenesis have been identified in the interstitial Leydig cells, Sertoli cells, granulosa cells and thecal cells, and are especially abundant in the Leydig cells during the mid-intersexual phase. Steroidogenic ultrastructures in the Sertoli cells develop only during the maturation of the spermatogenic cysts, whereas in the granulosa and thecal cells, these features become obvious only during the maturation of the large oocytes. EM evidence also suggests a nutritive function for the Sertoli cells and the granulosa cells. Results of in vitro steroidogenic studies, using either testosterone or progesterone as a precursor, show a predominant conversion to androstenedione and 5 alpha-reduced compounds, and suggest a change in biosynthesis from 5 alpha-reduced products to androstenedione during sex reversal. 11-Ketotestosterone (11KT) has been identified, but not 11 beta-hydroxytestosterone. Production of 11KT is high in the late intersexual and the male phases, but a lack of a marked variation in 11KT production between the early and the mid-intersexual phase suggests that this steroid is not a trigger for natural sex reversal in Monopterus. PMID- 3978698 TI - Ultrastructural changes in the spleen of the natterjack, Bufo calamita, after antigenic stimulation. AB - In the present study comparative aspects of the ultrastructure of the spleen were analyzed in non-immunized and T-dependent antigen-challenged natterjacks, Bufo calamita. Special attention is focused on the role of the non-lymphoid components in the splenic immunoreactivity. Ten days after primary immunization with sheep erythrocytes, splenic lymphoid follicles increase considerably in number and size. By that time, lymphoblasts, medium and large lymphocytes abound in the periphery of the white pulp near the marginal zone. Meanwhile, in the red pulp numerous monocytes migrating across the sinusoidal walls apparently transform into giant, dendritic-like cells. Twenty days after immunization the splenic lymphoid follicles decrease in number, although certain reactivity persists and numerous plasma cells occur in the cell cords and sinusoids of the red pulp. These results are discussed comparatively with those reported in other lower vertebrates. PMID- 3978700 TI - Demonstration of the granular layer and the fate of the hyaline layer during the development of a sea urchin (Lytechinus variegatus). AB - Employing electron-microscopic methods that help retain polyanionic materials, we describe the extracellular coverings of a sea urchin (Lytechinus variegatus) throughout ontogeny. The surface of the embryo is covered by a two-layered cuticle (commonly called the hyaline layer), which in turn is covered by a granular layer. The granular layer is retained after addition of alcian blue to the fixative solutions, and has not been previously described for any sea urchin. After hatching, the granular layer disappears, but the hyaline layer continues to cover most of the larval surface until settlement and metamorphosis. A few days before metamorphosis, the hyaline layer lining the vestibular invagination of the competent pluteus larva is replaced by a three-layered cuticle resembling that of the adult sea urchin. The hyaline layer covering the rest of the larva is evidently lost at metamorphosis during the involution of the general epidermis. PMID- 3978699 TI - Visualization of the secretory canaliculi of human parietal cells with a peroxidase-labelled peanut lectin. Light- and electron-microscopic observations. AB - Peanut lectin reactivity was examined in normal fundic glands from human gastric samples, both at light- and electron-microscopic levels, using a peroxidase conjugate. Positive reaction was observed in the glycocalyx of parietal cell secretory canaliculi as well as in the mucous globules of mucous cells and in the luminal cell coat of chief cells. The presence of terminal galactose in the canalicular glycocalyx may be connected with the peculiar function of hydrochloric acid secretion. Peroxidase-labelled peanut lectin is proposed as a marker for visualizing the secretory canaliculus of parietal cells. PMID- 3978701 TI - X-ray microanalytical studies on cryofixed blood cells of the ascidian Phallusia mammillata. I. Elemental composition of morula cells. AB - Cryofixed blood morula cells of Phallusia mammillata (Cuvier), which are considered to be vanadium-accumulating cells, were examined by X-ray microanalysis using STEM (scanning transmission electron microscopy) and SEM (scanning electron microscopy). It is thought that cryopreparation preserves the native distribution of diffusible elements such as sodium, chlorine, and potassium, and prevents the displacement of vanadium, all of which may occur during conventional preparation. The results show that morula cell globules contain a large amount of sulphur and chlorine, and some sodium, magnesium, bromium and potassium, but very little or no vanadium. PMID- 3978702 TI - Reorientation of the Golgi apparatus and the microtubule-organizing center inside macrophages subjected to a chemotactic gradient. AB - Mouse peritoneal macrophages subjected to gradients of activated mouse serum were found by immunofluorescence observations to have their Golgi apparatus and their microtubule-organizing center largely oriented in the direction of the gradient. By analogy with similar results obtained with motile fibroblasts, it is proposed that these two organelles are rapidly and coordinately reoriented inside the macrophages in order to direct the insertion of new membrane mass, via vesicles derived from the Golgi apparatus, into the leading edge of the cell. Consistent with the importance of such membrane insertion to cell migration, we found that the ionophore monensin, an inhibitor of Golgi functions, inhibited cell motility in the chemostactic gradient. It was further shown that several inhibitors of chemotaxis (monensin, cytochalasin D, cycloheximide) did not inhibit the reorientation of the Golgi apparatus/microtubule-organizing center in cells exposed to a chemotactic gradient, and that the reorientation required extracellular Ca+2. PMID- 3978703 TI - Flow birefringence of microtubules and its relation to birefringence measurements in cells. AB - Understanding the molecular basis of mitotic movements in living cells will require correlative experiments on intact cells, cell models, purified tubulin, and perhaps other biopolymers. Birefringence is one assay that is useful in all of these experimental situations. Heretofore, studies of birefringence changes during mitosis have lacked a quantitative basis for interpretation in terms of microtubule number and packing density. One of the aims of this work was to establish that relationship. Purified calf brain tubulin was polymerized to equilibrium and oriented in the hydrodynamic field of a microcapillary flow birefringence apparatus. The relationship between birefringence and microtubule packing density was determined by a combination of optical, electron microscopic, and biochemical methods. The data correlate surprisingly well with those obtained by others from in vitro measurements on isolated mitotic spindles. Using the flow birefringence data, the sensitivity of polarizing microscopes for detecting microtubules was examined and found to depend on microtubule packing density, object thickness, and instrumental factors that limit both the detection and measurement of weakly birefringent objects. Because of the dependence of measurement sensitivity on object thickness, a method of measuring the thickness of microtubule bundles using the dispersion of birefringence was developed. This method is capable of measuring thickness to within two or three Airy diffraction units and does not require any assumptions regarding object symmetry. PMID- 3978705 TI - Successful result from delayed streptokinase administration: subtotal thrombotic occlusion in a subsequently normal coronary artery. AB - This report describes successful results from intracoronary streptokinase administered beginning 6 hr after onset of symptoms to a 32-year-old male with subtotal vessel occlusion by thrombus. Coronary angiography 26 days later demonstrated normal vessels. We conclude that 1) duration of symptoms beyond 3-4 hr should not preclude the use of thrombolytic therapy in evolving myocardial infarction, 2) this patient exemplifies the higher incidence of subsequently demonstrated normal coronary arteries in patients under age 35 with acute myocardial infarction; arterial spasm and platelet aggregation are the most likely causes of coronary occlusion in these patients. PMID- 3978706 TI - Absence of left anterior descending coronary artery associated with anomalous origin of left circumflex coronary artery from the right coronary artery: a case report and review. AB - In this report we present a case of a 30-year-old female patient with a single coronary artery, which consisted of a right coronary artery from which there was an anomalous origin of the left circumflex coronary artery. There was no left anterior descending coronary artery. The clinical and other noninvasive diagnostic features of this rare angiographic variant are described and compared to other known varieties of coronary anomalies. The absence of objective evidence of ischemia or left ventricular functional impairment and analysis of the angiographic data suggest that this is another benign variant of coronary anatomy. PMID- 3978704 TI - Bending patterns of Chlamydomonas flagella: II. Calcium effects on reactivated Chlamydomonas flagella. AB - Ca2+ has profound effects on the movement of cilia and eukaryotic flagella, including those of Chlamydomonas. Two clear changes seen in Chlamydomonas flagella with changes in Ca2+ are beat frequency and symmetry. Photographic and computer assisted analysis of flagellar bending patterns on a uniflagellate mutant of Chlamydomonas have been used to examine details of the effects of Ca2+ on the movement of ATP-reactivated, demembranated flagella. In addition to the forward mode bending pattern seen at low Ca2+ concentrations (10(-9)M), which has a frequency of about 50 Hz and the reverse mode bending pattern seen at high Ca2+ concentrations (10(-4)M) with a frequency around 70 Hz, we carefully examined bending patterns in the intermediate Ca2+ concentration range of 1-6.5 X 10(-6)M. In this intermediate range, the bending patterns have significantly reduced asymmetry and slightly increased frequency, compared to the motility observed at low Ca2+ concentrations. These observations indicate that changes in these two parameters of motion do not occur in parallel and suggest that the effects of Ca2+ may be a multicomponent process. Physiologically, these changes in the beat pattern at intermediate Ca2+ may signal either 1) the beginning stages of transition to the symmetrical, high-frequency beating seen at high Ca2+, or 2) a more normal forward mode motility for the trans flagellum as suggested by Kamiya and Witman [1984]. No large amplitude bending patterns associated with transitions between forward and reverse mode beating in intact cells were seen at the intermediate Ca2+ concentrations. PMID- 3978707 TI - Sarcoidosis, pulmonary hypertension, and acquired peripheral pulmonary artery stenosis. AB - An unusual case of a young woman with sarcoidosis and pulmonary hypertension who developed new bilateral continuous murmurs and was found to have peripheral pulmonary artery stenoses is reported. The patient has improved symptomatically, radiographically, and hemodynamically on steroid therapy. PMID- 3978708 TI - Congenital pericardial defect diagnosed by computed tomography. AB - Complete or partial absence of the pericardium is a relatively rare disorder. While physical examination, electrocardiogram, and chest x-ray may suggest the diagnosis, definitive noninvasive diagnosis has until recently not been possible. In the patient described in the present report, the basis for chest pain initially attributed to myocardial ischemia was established noninvasively by computed tomographic examination of the chest to be congenital absence of the left pericardium. Experience with this patient emphasizes the fact that one of the known bases for nonischemic chest pain--congenital pericardial defects--can be precisely defined by contrast-negative computed tomographic imaging. PMID- 3978709 TI - The effects of pregnant mare serum gonadotropin (PMSG) on rat ovarian granulosa cell proliferation in vitro. PMID- 3978710 TI - In vitro assembly of microtubules from tubulins of several higher plants. AB - Tubulins were isolated by a combination of affinity (ethyl N-phenylcarbamate Sepharose 4B) and ion exchange (DEAE-Sephacel) chromatography from several higher plants (mung bean, pea, whole pod bean, zucchini, cucumber seedlings and carrot suspension cultured cells). All these higher plant tubulins readily polymerized to microtubules in a polymerization medium containing GTP, Mg2+, EGTA, leupeptin and DMSO. Tubulins from mung bean, pea and whole pod bean showed identical behaviour on polyacrylamide gel electrophoresis but differed from carrot zucchini and cucumber tubulin. Consequently, tubulin of higher plants seems to have different molecular properties in different plant species. PMID- 3978711 TI - Mechanical stimulation of smooth muscle cells by arterial pulsations. An important stimulus for the formation of elastic laminae in arterial tissue. PMID- 3978712 TI - The phenotypic nature of malignancy--an hypothesis. AB - Malignant cells exhibit two constant behavioural features which together determine lethality: cell proliferation and invasion. Since proliferation alone produces only benign tumours, invasion is the key to malignancy. All tissue cells are inherently motile, so it is argued that invasion will occur in vivo whenever cell movement is not under control. From embryological studies it is understood that movement is normally controlled by interacting sets of cell surface recognition molecules. Accordingly it is hypothesized that the prime phenotypic defect in malignancy is loss (or masking) of the malignant cells' recognition molecules. It is believed that malignant transformation occurs in stem cells at critical differentiation "switching" steps involving changes in surface phenotype. A cell recognition defect could arise therefore if cell surface marker deletion is not followed by full expression of a complete set of new markers. Investigation of such a possibility could test the hypothesis. PMID- 3978713 TI - The outer and inner thymus cortex is a functional syncytium. PMID- 3978714 TI - Some biochemical properties of higher plant tubulins. AB - Tubulin was isolated by a combination of affinity (ethyl N-phenylcarbamate Sepharose) and ion exchange (DEAE-Sephacel) chromatography from mung bean and cultured carrot suspension cells. SDS-PAGE (Blose 1981) of mung bean tubulin has shown it to consist of two major subunits (MBT1 and MBT2) and a minor subunit (MBT3). Tubulin isolated from carrot cells was resolved into only two bands on SDS-PAGE (slow moving subunit was named CT1). However, the faster moving subunit on SDS-PAGE was resolved into two bands (CT2 and CT3) on SDS-4M urea-PAGE. On SDS 4M urea-PAGE, CT1 migrated faster than CT2, CT3. By contrast in SDS-4M urea-PAGE, mung bean tubulin remains unresolved. Mammalian tubulin could be resolved into alpha and beta-subunits in both electrophoretic systems. Monoclonal antibodies to mammalian alpha and beta-tubulin subunits (MCA-T alpha and MCA-T beta, respectively) and Western blot analysis clearly demonstrated a cross-reactivity of MCA-T alpha with MBT2, MBT3, CT2 and CT3, while MCA-T beta showed cross reactivity with MBT1 and CT1. Although MBT2, MBT3, CT2 and CT3 are immunologically related to the alpha-subunit of mammalian tubulin, their migration on SDS-PAGE was reversed with respect to MBT1 or CT1, which were immunologically related to the beta-subunit of mammalian tubulin. Peptide mapping patterns also supported above the results. PMID- 3978715 TI - Intracellular and secreted proteins of density-inhibited, serum-arrested and proliferating mouse embryo cells. AB - Short-term labelling of secondary cultures of mouse embryo fibroblasts with [14 C] aminoacids enabled the identification and quantitation of proteins specific for quiescent and proliferative stages. Intracellular and secreted proteins of cells maintained under different growth conditions were resolved in high resolution SDS-polyacrylamide gradient gels. Two proteins, identified as fibronectin and procollagens and a 34 000 D polypeptide were found to be secreted by all three types (density-arrested, serum arrested and proliferating) of cells. Both types of arrested cells exclusively secreted a 375 000 D protein while the proliferating cells specifically secreted a 48 000 D polypeptide. During progression of cells from quiescence to proliferation, two intracellular proteins showed major variations. A 205 000 D intracellular protein was found to be synthesized in higher amounts by proliferating cells than by arrested cells. Another protein, identified as actin, showed a marked increase in synthesis following the release of cells from serum arrest. The arrested cells showed reduced levels of actin synthesis and the turning-off process in the synthesis of actin was found to be relatively slow as the cells entered into quiescence. PMID- 3978717 TI - Alternative pathway of respiration in Physarum polycephalum plasmodia. AB - The external application of inhibitors of glycolysis in the presence of KCN shows a lethal effect on plasmodia of Physarum polycephalum. However, alpha ketoglutarate, but not succinate, maintains the contraction-relaxation cycle of plasmodial actomyosin in spite of the fact that glycolysis and cytochrome oxidase are inhibited. The oscillations supported by ketoglutarate disappear in the presence of SHAM, an inhibitor of alternative oxidase. These results imply the existence of KCN-resistant, alternative pathway of electron transport in the mitochondria of Physarum polycephalum. PMID- 3978716 TI - Different patterns of filipin-sterol labeling in prostate nuclear membranes from normal and castrated rats. AB - Filipin was used as cytochemical probe for sterol detection in freeze-fractured prostate nuclear membranes from rats under different hormonal conditions. Isolated prostate acini and nuclei were fixed in glutaraldehyde and post-treated with filipin, according to Robinson and Karnovsky (1980). In general, most plasma and intracellular cytoplasmic membranes displayed a marked response to filipin in either epithelial and stromal cells from normal and castrated animals. Nuclear membranes from epithelial secretory cells were systematically negative to filipin labeling in normal animals, although after castration a positive response was detected. Stromal nuclear membranes were labeled both in normal and castrated animals. Filipin-treated isolated nuclei displayed the same overall labeling pattern but there was a different distribution of induced deformations relative to intact cell nuclei. These observations indicate that: a) nuclear membranes from different cell types have different responses to filipin; b) a change in the molecular organization of nuclear membranes from prostate secretory cells follow castration; c) nuclei isolation affects the distribution of filipin induced deformations on the membranes. PMID- 3978718 TI - Non-random distribution of lymphoid cells within the follicle-associated epithelium is caused by lymphoid cells associated with M cells. PMID- 3978719 TI - Taurine and human spermatozoal capacitation. AB - The effect of taurine at various concentrations (0.01, 0.1 and 1 mM) on the in vitro motility and fertilizing capacity of human spermatozoa was studied. Spermatozoa collected from 10 normal men were washed in BWW medium and incubated with taurine for 5 hours, the period required for spermatozoal capacitation. The percent motilities were recorded at 0 and 5 hours during capacitation preincubation with taurine. After incubation, the spermatozoa were washed with BWW medium to remove taurine before insemination of the zona-free hamster ova for an assessment of the fertilizing capacity. Taurine caused a significant dose dependent increase in the penetration of the zona-free hamster ova in comparison to the control (p less than 0.05). Taurine did not have any significant effects on the spermatozoal motility during capacitation preincubation. The results suggest that there may be a physiological role for this beta-amino acid in human spermatozoal capacitation in vivo. PMID- 3978720 TI - Induction of self-tolerance and enhanced stress protein synthesis in L-132 cells by cadmium chloride and by hyperthermia. AB - The effect of heat shock or cadmium treatment on protein synthesis and cell survival in L-132 cells has been examined. After cadmium treatment, the synthesis of a polypeptide of Mr 68000 (P68) was greatly enhanced over that of untreated cells. Besides P68 the synthesis of another polypeptide of Mr 89000 (P89) was also enhanced in heat-shocked cells. Both heat shock and cadmium treatment induced self-tolerance. The kinetics of the synthesis of induced polypeptides correlated well with the development of self-tolerance. The patterns of peptide maps obtained after partial proteolytic digestion from P68 induced in cadmium treated and heat-shocked cells were virtually identical. However, neither heat shocked cells did not confer cadmium tolerance nor did cadmium-treated cells induce thermotolerance. PMID- 3978721 TI - Effects of spermine on transferrin and iron uptake by reticulocytes: I. Action on the endocytic uptake of transferrin. AB - Iron uptake by rabbit reticulocytes was inhibited by spermine in a concentration dependent manner. Examination of the single-cycle endocytosis of 125I-transferrin showed that a graded reduction in the rate of exocytosis of transferrin was related to increasing extracellular spermine concentrations. This reduction could affect the recycling of transferrin receptors and resulted in the loss of membrane binding sites in spermine-treated cells. As large vacuoles were observed in cells treated with spermine, the endotubular function of these cells was probably affected. Spermine also enhanced the binding affinity of transferrin to membrane receptors. The mechanism for this enhancement was not clear. PMID- 3978722 TI - Glycoconjugates of human sperm surface. A study with fluorescent lectin conjugates and lens culinaris agglutinin affinity chromatography. AB - Distribution of glycocompounds in human spermatozoa was studied by using fluorescent lectin-conjugates. Con A bound predominantly to acrosomal and posterior head regions whereas RCA I bound to the acrosomal region of intact spermatozoa, stained in suspension. Other lectins used (LCA, WGA, SBA, PNA) stained the the entire sperm surface. In airdried sperm smears binding of both Con A and RCA I were identical with the staining pattern obtained with living cells whereas LCA, WGA, SBA and PNA now bound heavily into acrosomal region. As a similar staining pattern was obtained with permeabilized sperm cells, this staining is apparently due to binding to intracellular structures. The efficiency of Lens culinaris agglutinin affinity chromatography in purification of human sperm glycoproteins was tested after their external radiolabelling with the neuraminidase/galactose oxidase/sodium borohydride method. 22% of applicated radioactivity could be eluted from the column with the specific inhibitory saccharide, and most of the radiolabelled surface glycoproteins of the whole sperm lysate, were also present in the LCA affinity column eluate. LCA affinity chromatography seems thus be an effective method to enrich membrane glycoproteins of human spermatozoa. PMID- 3978723 TI - Presence of cilia in the chick embryonic notochord. AB - Cilia have been observed in cells of the chick embryonic notochord in different developmental stages. The ciliated notochordal cells were present both at the center and at the periphery of the organ. A well outlined central cavity in the notochord was not observed. PMID- 3978724 TI - Microspectrophotometric study and kinetics of autogamy during encystment of Tetrahymena rostrata. AB - The process of autogamy that accompanies encystment in Tetrahymena rostrata was divided into five stages; A: first meiotic division, B: second meiotic division. C: post-meiotic division and fusion of the pronuclei, D: first and second synkaryon's mitosis and E: macronuclear-polyploidization. In this communication the kinetics of these phases is reported. The degeneration of the old macronucleus begins about the second meiotic division (stage-B), and the development of the new-macronucleus progressively rises during about 15h. PMID- 3978725 TI - [Psychopathology and the phenomenological method]. PMID- 3978726 TI - [Use of psychomotor therapy in psychiatric institutions]. PMID- 3978728 TI - [The role of immunologic factors in mental disorders. Minisymposium. 3d Congress of Czechoslovakian immunologists. Hradec Kralove, 30 August-2 September 1982]. PMID- 3978727 TI - [Expectation index in Raven's PM in the diagnosis of alcoholics]. PMID- 3978730 TI - [Experience in the treatment of ischemic cerebral accidents in children]. PMID- 3978729 TI - [Modern psychiatry in Yugoslavia]. PMID- 3978731 TI - [Dexterity training in hemiparetic forms of childhood cerebral paralysis based on stereognostic tests]. PMID- 3978733 TI - [Analysis of indications for lumbar puncture based on 5 years of clinical material (1979-1983)]. PMID- 3978732 TI - [Slow virus infections of the CNS--etiology and pathogenesis]. PMID- 3978735 TI - [Echocardiographic diagnosis of uncorrected transposition of the great vessels]. PMID- 3978734 TI - [Injuries of abdominal cavity organs in newborn infants]. PMID- 3978736 TI - [Osteomyelitis in neonates and young infants]. PMID- 3978737 TI - [Test of primitive locomotion in a group of patients treated at the Zeleznice Spa]. PMID- 3978738 TI - [Paucispastic biparetic form of childhood cerebral palsy]. PMID- 3978739 TI - [Early diagnosis of childhood cerebral palsy in children treated at Zeleznice, a Czechoslovakian state spa, during the past 6 years]. PMID- 3978740 TI - [Craniocerebral injuries in children and their rehabilitation]. PMID- 3978741 TI - [Contribution of computer tomography to increasing the accuracy of laryngeal cancer diagnosis]. PMID- 3978742 TI - [Roentgenographic assessment of the function of the left ventricle of the heart]. PMID- 3978743 TI - [Degenerative changes in osteophytes of the hip joint]. PMID- 3978744 TI - [Spondylosclerosis hemispherica, the radiological picture and clinical aspects]. PMID- 3978745 TI - [Post-traumatic sternoclavicular osteoarthropathy]. PMID- 3978746 TI - [Universal connectors for phlebography]. PMID- 3978747 TI - [A protective instrument table for radiodiagnosis]. PMID- 3978748 TI - [An angiologic protective unit for use in translumbar aortoarteriography]. PMID- 3978749 TI - [Changes in the size of the pancreas and kidneys in type I diabetics detected by computer tomography]. PMID- 3978750 TI - Interaction of dietary fat and route of carcinogen administration on 1,2 dimethylhydrazine-induced colon tumorigenesis in rats. AB - Since the results of an earlier study indicating no effect of dietary fat on dimethylhydrazine (DMH)-induced colon cancer in rats differed from those of other investigators, the present study was initiated to determine if the modulating effect of fat intake on colon tumorigenesis was dependent on the route of DMH administration. Male weanling Sprague-Dawley rats (160) were fed one of two nutritionally balanced diets containing 5% or 24% corn oil (CO). Following 3 weeks adaptation to their respective diets, 40 rats from each diet group were treated with five doses of DMH (30 mg/kg) by intragastric (i.g.) gavage or subcutaneous (s.c.) injection, over a 3 week period. Rats were sacrificed when they showed clinical signs of colon tumor and surviving animals were killed 51 weeks after the initial DMH treatment. The cumulative probability of death with colon carcinoma did not differ between the dietary or treatment groups. There was no effect of route of administration or dietary fat on total intestinal tumor incidence. The number of rats with colon carcinoma was: 5% CO.IG = 25; 24% CO.IG = 27; 5% CO.SC = 23; 24% CO.SC = 19. Polypoid tumor incidence was significantly higher in the 24% CO.SC group (12/40) compared to the 5% CO.SC group (3/40) (Chi squared = 5.25; p less than 0.03) while sessile tumor incidence was the inverse. Marginally significant differences in tumor morphology were noted between the IG groups. PMID- 3978751 TI - Further characterization of the in vitro assay for inhibitors of metabolic cooperation in the Chinese hamster V79 cell line. AB - 12-O-Tetradecanoylphorbol-13-acetate (TPA) has been previously shown to inhibit metabolic cooperation in Chinese hamster V79 cells. An in vitro assay, based on this phenomenon, has been developed to study tumor promoters. Several parameters concerning the metabolic cooperation assay using V79 Chinese hamster cells were further investigated in this report. Pretreatment of the cells with TPA in situ for different periods of time did not result in any detectable change in the inhibition of metabolic cooperation. If cells were replated after TPA treatment, a different result was obtained. There was an apparent decrease in the ability of TPA to inhibit metabolic cooperation when TPA was added back to the TPA pretreated cultures. However, when TPA was omitted from the TPA pretreated cultures after replating, the inhibition of metabolic cooperation remained high. It was also found that pretreatment of the cells with another chemical, aldrin, exhibited the same pattern as the in situ TPA pretreatment effect on inhibition of metabolic cooperation. In order to obtain a high level of inhibition of metabolic cooperation when using aldrin in this assay, it was determined that the chemical needed to be present for more than one day. Our studies also showed that a 24 h treatment with 6-thioguanine did not kill 6-thioguanine-sensitive cells quickly, nor did it prevent them from performing metabolic cooperation. The relationship of cell density and TPA concentration was also studied. It was observed that a higher cell density required higher TPA concentration to inhibit, maximally, metabolic cooperation. A 'down regulation' type effect was noted when culture was challenged with different concentrations of TPA. These results were interpreted to be consistent with the hypothesis that inhibited gap-junctional intercellular communication is one of the components of tumor promotion. PMID- 3978753 TI - Higher sensitivity for the detection of chemically-induced DNA damage: role of DNA unfolding in determining alkaline elution rate. AB - CHO-K1 cells exposed to log-spaced concentrations of methyl methanesulfonate (MMS) and liver cells from rats treated with log-spaced single i.p. doses of N nitrosodimethylamine (DMN) were examined for changes in the rate of DNA alkaline elution induced by incubation in high ionic strength non-denaturing (pH 10) lysing solution. While the elution rate of DNA from control cells was marginally modified, that of treated cells increased proportionally to the length (from 0.5 to 48 h) of incubation, without any significant reduction of DNA average mol. wt. These experiments were suggested and then explained by a recently described physico-chemical model which has shown that the changes in DNA elution profiles are strongly determined also by related changes in DNA chain flexibility and packing. These chemical-induced changes in DNA superpacking and the subsequent differential kinetics of DNA unfolding in the lysing solution are compatible with previous results by independent physical methods. This allows significantly higher sensitivity in the detection of chemically-induced DNA damage, now possible even for a quite low chemical concentration. At the same time, it may be inferred that any material capable of altering DNA superpacking--by damaging either DNA itself or any other chromosomal constituents, such as protein--may well give rise to an increased elution of DNA from the filter. PMID- 3978752 TI - Alterations in nonhistone chromatin proteins during hepatocarcinogenesis induced by diverse acting carcinogens. AB - Nonhistone chromosomal proteins (NHCP) from normal, regenerating rat liver, fetal liver, stages during acetylaminofluorene (AAF) and diethylnitrosamine (DEN) induced carcinogenesis, and resultant primary hepatocellular carcinomas (PHC) were analyzed by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). These studies sought to determine if changes in proteins putatively involved in catalyzing specific gene expression (NHCP) occur during liver cancer development that might be related to the malignant phenotype. NHCP extracted in high salt urea buffers, analyzed by 2D-PAGE and silver staining were resolved into some 530 560 polypeptides. Increases in number of NHCP amounting to 8.4, 8.6 and 8.8%, respectively, were detected in AAF induced nodules (AAF-NOD), AAF-PHCs and DEN PHCs when compared to normal chromatins. The majority of the 51 qualitative changes detected reflected cell cycling and/or reexpression of fetal-NHCP. Within the total changes, seven new NHCP were found only in AAF- and DEN-induced PHCs. Further, four NHCP with isoelectric points and relative molecular weights (pI/MW) of 5.62/19.3, 5.96/30.7, 6.25/46.6 and 8.16/53.5 occurring in both AAF- and DEN PHC also were found in AAF-NOD, a carcinogenesis stage considered to represent premalignant nodules. Reciprocally, three NHCP of pI/mol.wt.: 6.81/34.0, 5.82/43.7 and 8.18/67.0 present in normal liver, disappeared in all carcinogen involved tissues analyzed. These findings indicate that while AAF and DEN exposure results in a number of qualitative NHCP changes specific for the particular carcinogen, a total of only ten changes, seven inductions and three losses, occurred in common during hepatocarcinogenesis induced by these diverse agents. At least four of these NHCP may prove critical inductions during malignant conversion or alternatively might serve as tumor markers since they appear first in a well characterized premalignant stage and persist in resultant tumors. PMID- 3978754 TI - The effect of ellagic acid on the uptake, persistence, metabolism and DNA-binding of benzo[a]pyrene in cultured explants of strain A/J mouse lung. AB - Ellagic acid (EA), a plant phenol found in a variety of fruits and vegetables normally consumed by humans, inhibited the metabolism of benzo[a]pyrene (B[a]P) and covalent binding of B[a]P metabolites to DNA in cultured lung explants from strain A/J mice. Explants were incubated in medium containing EA at concentrations of 10 - 100 microM for 16 h followed by the addition of 1 microM [3H]B[a]P for 24 h. Culture medium was extracted and analyzed by high-performance liquid chromatography. DNA from the explants was extracted, purified and quantitated to determine B[a]P metabolite binding to DNA. EA at concentrations of 10, 25, 50, 100 microM inhibited the metabolism of B[a]P in lung explants by 24 47% and DNA-binding of B[a] metabolites by 36-71%. Analysis of total lipids and trichloroacetic acid insoluble fractions of homogenized lung explants showed two to three times more radioactivity in EA-treated cultures even though EA did not affect the uptake of B[a]P. Explants maintained for four days after the removal of EA and [3H]B[a]P from the culture medium exhibited significant persistence of B[a]P and B[a]P metabolites associated with the total lipid and TCA insoluble fractions and in B[a]P metabolites bound to DNA. H.p.l.c. analysis of the total lipids extracted from homogenized lung explants showed that during the first 3 days of incubation most of the radioactivity in the EA-treated cultures was unmetabolized B[a]P while that in the control cultures existed as metabolites of B[a]P. The inhibition of metabolism of B[a]P and the consistently lower B[a]P-DNA binding in EA-treated mouse lung explants support the role of EA as a naturally occurring inhibitor of B[a]P-induced carcinogenesis. PMID- 3978755 TI - Metabolic activation of the terminal N-methyl group of N-isopropyl-alpha-(2 methylhydrazino)-p-toluamide hydrochloride (procarbazine). AB - The NADPH-dependent microsomal metabolism of [14C]procarbazine, labeled on the terminal N-methyl group, resulted in the covalent binding of the drug to exogenously added DNA; this reaction was inhibited by metyrapone. Procarbazine metabolism was also shown to result in covalent binding of the methyl group of the drug to microsomal protein upon metabolism, but the extent of protein binding was at least an order of magnitude smaller than that seen with its primary oxidative metabolite. N-isopropyl-alpha-(2-methylazo)-p-toluamide. The characteristics of the reactions leading to the covalent binding of the N-methyl group of the azo derivative to microsomal protein and its metabolism to form the hydrocarbon, methane, possessed a number of similarities in the apparent kinetic parameters (Km and Vmax), induction, and inhibition patterns indicating a common pathway of metabolism to form a reactive intermediate and the involvement of cytochrome P-450. Reduced glutathione stimulated methane formation and inhibited covalent binding to protein. One azoxy derivative, N-isopropyl-alpha-(2-methyl ONN-azoxy)-p-toluamide, was chemically unstable and its decomposition was shown to lead to covalent binding to microsomal protein. A diazene intermediate and a methyl radical are proposed to be intermediates in the formation of methane during the oxidative metabolism of the azo derivative of procarbazine and a common intermediate in the activation of procarbazine may result in both covalent binding to cellular macromolecules and methane production. In addition, chemical decomposition of the azoxy metabolites may also contribute to a small portion of the covalent binding, but not to methane formation. PMID- 3978756 TI - Species differences in the cytotoxic and genotoxic effects of 2 acetylaminofluorene and its primary metabolites 2-aminofluorene and N-OH-2 acetylaminofluorene. AB - 2-Acetylaminofluorene (AAF), 2-aminofluorene (AF) and N-hydroxy-2 acetylaminofluorene (N-OH-AAF) could be activated to mutagens in S. typhimurium using either 9000 g supernatant (S9) or hepatocytes isolated from rats, mice, hamsters or guinea pigs. Their relative mutagenic potency was generally N-OH-AAF greater than AF greater than AAF. Monolayer cultures of hepatocytes exposed to AAF/AF/N-OH-AAF showed evidence of DNA damage measured as unscheduled DNA repair synthesis. The order of activity in rat and hamster was N-OH-AAF greater than AAF greater than AF, in guinea pig and mouse N-OH-AAF greater than AF greater than AAF. Only N-OH-AAF caused observable cytotoxicity, and the rat hepatocytes were the far more sensitive species. Neither the resistance of guinea pig liver nor the greater susceptibility of the rat liver to the carcinogenic effects of AAF and N-OH-AAF could be readily explained by the species differences in activating these compounds to mutagens in Salmonella or to DNA damaging agents in the hepatocytes. It is possible that cytotoxic effects of N-OH-AAF may be of some importance for the observed species differences in the liver carcinogenic effects of AAF and N-OH-AAF. PMID- 3978757 TI - Specific DNA repair mechanisms may protect some human tumor cells from DNA interstrand crosslinking by chloroethylnitrosoureas but not from crosslinking by other anti-tumor alkylating agents. AB - In two recent reports we have shown that pretreatment of MER+ cells [cells proficient at: reactivating N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-treated adenovirus; removing O-6 methylguanine from their DNA; and preventing DNA interstrand crosslinks produced by the chloroethylnitrosoureas (CNUs)] with MNNG apparently inhibits the repair process that these cells utilize to prevent CNU induced DNA interstrand crosslinking. The MNNG pretreatment, accompanied by a subsequent CNU treatment, resulted in a synergistic increase in cell kill of 2-3 logs. In the present study we have examined whether or not conditions which inhibit the ability of a cell to prevent CNU-induced DNA interstrand crosslinking can also prevent DNA interstrand crosslinking induced by four clinically used alkylating anti-tumor agents. The agents used in the present study include cis diamminedichloroplatinum(II) (cis-Pt), L-phenylalanine mustard (L-PAM), nitrogen mustard (HN-2) and 4-S-(propionic acid)-sulfidocyclophosphamide (C-2), a derivative of cyclophosphamide. Alkaline elution analysis was used to measure DNA interstrand crosslinking, and colony formation assays to estimate cell survival. Unlike the CNUs, all four agents produced DNA interstrand crosslinks in a Mer+ cell line in the absence of MNNG pretreatment. MNNG pretreatment did not alter the levels of DNA interstrand crosslinks formed. Similar results were seen with a Mer- cell line. In cytotoxicity studies, in contrast to the CNUs, MNNG pretreatment did not appreciably increase the cell kill produced by the four agents. Since all four agents studied are thought to react primarily at the N-7 position in guanine, these data suggest that: the DNA repair system which prevents CNU-induced crosslinking is specific for methyl, ethyl, and chloroethyl monoadducts; this DNA repair system is specific for adducts only at the O-6 position of guanine and does not recognize and remove adducts at other positions in DNA; or a combination of the two explanations. PMID- 3978758 TI - Differentiated genotoxic response of carcinogenic and non-carcinogenic benzacridines and metabolites in rat hepatoma cells. AB - Two closely related hepatoma cell lines were examined for their genotoxic response to benacridines and their metabolites by the appearance of alkaline labile DNA sites: H5, a dedifferentiated line expressing cytochrome P-448 dependent mono-oxygenase(s); and HF1-4, a differentiated line expressing cytochrome P-450-dependent monooxygenase(s). The parent heterocycles had no effect on both cell lines. In contrast to the 3,4-dihydrodiol of benz[c]acridine the 3,4-dihydrodiol of benz[a]acridine induced no DNA strand breaks in both cell lines. All diol epoxides, however, induced DNA-damage in both cell lines, the syn derivatives in the same order of magnitude as the dihydrodiol of benz[c]acridine. The antidiol epoxides (epoxide group on the opposite side to the benzylic hydroxyl group) were the most potent to induce DNA-single strand breaks. The diol epoxide of benz[c]acridine was three times more efficient in HF1-4 than in H5, whereas for the diol epoxide of benz[a]acridine, the reverse was true. The results indicate that benz[c]acridine-3,4-diol is oxidized to metabolites which can induce DNA-damage. This is consistent with the hypothesis that the benz[a]acridine and derivatives are not easily metabolized to active mutagens but more likely are converted to inactive metabolites, possibly via N-oxidation. This is illustrated with 3,4-diol-1-2 anti-diol epoxide of benz[a]acridine which is inactivated in cell line HF1-4 due to the reactivity of the epoxide ring in the bay region. Since all diol epoxides show similar activity in both hepatoma cell lines, they are of great interest because of their ability to detect DNA-damaging agents and to analyse their metabolic activation and mechanism of action. PMID- 3978759 TI - Induction of in vitro transformation by near-u.v. light and its interaction with beta-propiolactone. AB - The ability of u.v.-A light (320-400 nm) to induce cellular transformation in vitro and to modify chemical carcinogen-induced cellular transformation was investigated in BALB/c 3T3 cell cultures. When administered as a series of nontoxic exposures, u.v.-A alone was found to induce cellular transformation as a linear function of the numbers of u.v-A exposures. Possible interactions of u.v. A with environmentally encountered chemical carcinogens were studied by examining the effects of u.v.-A light exposures on cellular transformation in cells exposed to the direct acting carcinogen, beta-propiolactone (BPL), an alkylating agent, with a standard initiation/promotion protocol. Twenty-four hours after a single treatment with 2.5 micrograms/ml of beta-propiolactone, cells were exposed to 3.0 kJ/m2 of u.v.-A light. U.v.-A exposures were repeated weekly for up to 5 weeks, after which cells were fixed, stained and dishes were scored for type III transformed foci. Weekly exposures to u.v.-A alone for 5 weeks induced approximately 3 foci/dish. Treatment with BPL alone induced approximately 1 focus/dish (background was 0.17 foci/dish). A combination of the two treatments resulted in a marked increase in the yield of transformed foci/dish, with the u.v.-A enhancement increasing with increasing numbers of exposures (approximately 10 foci/dish after a single exposure to BPL and five u.v.-A exposures). These results suggest a synergistic interaction between BPL and subsequent u.v.-A exposures in the induction of in vitro neoplastic transformation. PMID- 3978760 TI - Induction by asbestos fibers of anaphase abnormalities: mechanism for aneuploidy induction and possibly carcinogenesis. AB - Syrian hamster embryo cells were treated with crocidolite asbestos at a dose (1 microgram/cm2) which was shown in previous studies to induce cell transformation and aneuploidy in these cells. Treatment of cells with asbestos induced a greater than 20-fold increase in the incidence of cells in anaphase with abnormalities, including lagging chromosomes, bridges, and sticky chromosomes. Asbestos fibers were observed in mitotic cells and appeared, in some cases, to be interacting directly with the chromosomes. From these studies, we propose that the physical interaction of the asbestos fibers with the chromosomes or structural proteins of the spindle apparatus causes missegregation of chromosomes during mitosis resulting in aneuploidy. These findings provide a mechanism, at the chromosomal level, by which asbestos and other mineral fibers might induce cell transformation and cancer. PMID- 3978761 TI - Editorial responsibility in the humane care and use of experimental animals. PMID- 3978762 TI - Distribution of intrarenal blood flow consequent to left atrial balloon inflation. AB - The effects of inflation of a balloon within, and consequent distension of, the left atrium (LABI, left atrial balloon inflation) on total renal blood flow (RBF) and intrarenal blood flow distribution were measured and compared to values obtained from another group of dogs that were hemorrhaged (HEM) to the same level of hypotension as that produced by LABI, a mean systemic arterial pressure of 88 mm Hg. Kidney wt/kg, RBF/kg body wt, and urine flow were markedly reduced during the hemorrhage period in the HEM group when compared to values obtained during the experimental period for the LABI group. Data from the freeze-dissection (133Xe) analysis revealed that the percentage distribution of blood flow as renal outer cortical (OC) blood flow was less (26%) in the HEM group than in the LABI group (50%), this latter value being very similar to that of control dogs that experienced no hypotension (49%). LABI better maintains OC blood flow and urine flow when compared to HEM at the same systemic blood pressure, suggesting a role for cardiopulmonary receptors in reflex sympathetic control of renal blood flow distribution during hypotension. PMID- 3978763 TI - Alterations of capillary flow during sepsis. AB - Normal red cells are flexible and can thus negotiate small capillaries with ease. Impaired red cell deformability (RCD) has been found in patients with uremia, peripheral vascular disease, and diabetes. This study was performed in order to determine if impaired RCD is present during sepsis. The RCD of citrated whole blood (WB) and citrated buffy coat-poor whole blood (BCP) from ten septic patients was compared to ten age-, sex-, and race-matched control patients. The samples were passed through polycarbonate 5 micron pore filters at -10 cm H2O pressure according to the technique of Reid. A red cell deformability index was calculated for each patient by multiplying the volume of blood flowing through the apparatus in a 1-minute period by the hematocrit. The results show very highly significant decreases of flow in both the WB and BCP blood in the septic group. Alterations in flow in the WB can be explained on the basis of changes in the buffy coat fraction and/or the red cell deformability. A decrease in flow in the BCP blood can be explained in terms of a diminished deformability of the red cells themselves. This increased rigidity of the red cells could, in part, explain the AV shunting and decreased microcirculatory flow seen in the septic state. PMID- 3978764 TI - Morphological differences in cutaneous and skeletal muscle vasculature during compensatory and decompensatory hemorrhagic hypotension. AB - PURPOSE: to determine if morphological differences exist between vasculature shown to decompensate, ie, skeletal muscle (SM) and vasculature that maintains the compensatory effort, ie, cutaneous (C). METHODS: dogs were anesthetized and subjected to a Wiggers hemorrhagic shock protocol. SM and C flows were monitored using electromagnetic flowmeters. Gracilis (SM) and saphenous (C) arterial segments were removed during: prehemorrhage control, compensation, and decompensation. Segments were fixed at in vivo intraluminal pressures. Both light and EM sections were made from each sample. RESULTS: During the compensatory phase, both SM and C showed signs of strong vasoconstriction. Even though the amount of endothelial folding was comparable, the C did and the SM did not sustain the vasoconstriction. Vascular diameters of the SM but not C increased during decompensation. Ultrastructural changes consisted of extreme folding of the internal elastic lamina (IEL) during compensation and subsequent flattening out of the IEL during decompensation in the SM but not the C tissues. Cell deformation, damage, and exfoliation were seen in both SM and C tissues. CONCLUSION: The data are consistent with the theory that SM vasculature, specifically endothelium, synthesizes an inhibitor of NE release, probably prostaglandins. PMID- 3978765 TI - The effect of prophylactic heparinization on DIC arising from transitory circulatory arrest in dogs. AB - To evaluate the beneficial effect of heparin administration on the prevention of disseminated intravascular coagulation (DIC) which appears following circulatory arrest, experimental studies were carried out with one group of dogs during circulatory arrest (control group) and compared to a group of dogs that received heparinization (heparinized group) soon after termination of circulatory arrest. Dogs of the control group were subjected to transitory circulatory arrest with occlusion balloons in the aorta and the femoral vein for a period of 8 minutes and allowed to recover without further treatment. Dogs of the heparinized group were given continuous infusions of 20 units/kg/hour of heparin as soon as circulatory arrest was started. The control group developed DIC 5 hours after circulatory arrest; however, the heparinized group demonstrated reduced platelet counts and low levels of antithrombin III (AT-III) 2 to 3 hours subsequently to circulatory arrest, but these changes were not serious, and normal levels of platelet count and AT-III were restored rapidly thereafter. Prophylactic heparin therapy is, accordingly, recommended as a useful measure of preventing the occurrence of DIC in circulatory arrest and the subsequent detrimental consequences. PMID- 3978766 TI - The effects of hemorrhage on mitogen-induced lymphocyte proliferation. AB - Bacterial infection often occurs after trauma and hemorrhage and is believed to be a reflection of a compromised host defense system. In the present study, the effect of temporary loss of blood on lymphocyte proliferative capacity was investigated. Hemorrhage was induced in unanesthetized rats with chronically catheterized carotid arteries. Two hours after withdrawal of 30% of total blood volume, phytohemagglutinin-induced lymphocyte proliferation was almost completely suppressed; proliferation remained depressed for at least 24 hrs. The degree of suppression in lymphocyte proliferation was found to be dependent on the duration of hemorrhage. Mitogen-induced proliferation of lymphocytes was significantly reduced as early as 30 min after hemorrhage and became more depressed at 2.0 hr after hemorrhage. This abnormality in host defense mechanisms may contribute to the increased incidence of sepsis present after trauma and hemorrhage. PMID- 3978768 TI - Role of the lung in metabolism of prostaglandin E during severe hemorrhagic shock in the dog. AB - The pulmonary handling of prostaglandin E (PGE) during a hemorrhagic shock procedure was evaluated in pentobarbitalized dogs. Net extraction [(V - A)/V] and turnover [(V - A) X total plasma flow] of endogenous PGE were measured. Following hemorrhage to 40 mm Hg arterial pressure, the endogenous arterial plasma PGE level rose from ca 400 to ca 700 pg/ml, and net extraction fell from 42.5% to 30%, indicating a shift from preponderant removal of endogenous PGE by the lung to net release. Reflecting this, turnover decreased from a control average of 480 ng/min to -60 ng/min. At two hours post-reinfusion, net extraction and turnover were still essentially zero. These findings support the hypothesis that changes in net metabolism of PGE by the lung in hemorrhagic shock result in increased systemic arterial blood levels of PGE, which may contribute to peripheral vasodilation during the decompensatory phase of hypotension, and to the irreversible phase of the post-infusion period. PMID- 3978769 TI - Exchange transfusions in rats with a perfluorated blood substitute: effect on thromboxane B2 levels during endotoxemia. AB - The effect of exchange transfusion with the perfluorated blood substitute (Fluosol-43) on endotoxin-induced synthesis of immunoreactive (i) thromboxane (Tx)B2, the stable metabolite of TxA2, was investigated in rats. Fluosol-43 was infused via the femoral vein with matched, incremental blood withdrawal from the carotid artery. Blood was replaced with Fluosol-43 to a final hematocrit of less than 3% in anesthetized rats maintained on 95% O2 and 5% CO2. Circulating platelet counts were reduced from 875 +/- 47 X 10(3)/mm3 in sham controls (N = 21) to 75 +/- 10 X 10(3)/mm3 in Fluosol-43 exchange transfused rats (N2 = 19, P less than 0.001). Circulating leukocytes were decreased from 105 +/- 6.3 X 10(2)/mm2 in sham controls (N = 21) to 17 +/- 1.4 X 10(2)/mm3 in the exchange transfused group (N = 19, P less than 0.001). Immunoreactive (i)TxB2 was measured in plasma or Fluosol-43 obtained from rats prior to and after injection of Salmonella enteritidis endotoxin (20 mg/kg). The iTxB2 levels at 30 minutes after endotoxin increased from 438 +/- 83 pg/ml (N = 4) to 2,895 +/- 663 pg/ml (N = 7) (P less than 0.01) in sham controls. iTxB2 also increased from 242 +/- 23 pg/ml (N = 7) to 2,213 +/- 589 pg/ml (N = 7) in the Fluosol-43 group (P less than 0.002) following endotoxin. The iTxB2 levels also remained significantly elevated (P less than 0.01) in both the sham and the Fluosol-43 groups 2 hours after endotoxin treatment. Endotoxin-stimulated iTxB2 levels at both 30 minutes and 2 hours in sham and Fluosol-43 exchange transfused rats did not vary significantly from each other. Indomethacin pretreatment (2 mg/kg) inhibited the increase in iTxB2 levels by greater than 85% in both groups (P less than 0.004). Blood and Fluosol-43 were taken from sham and exchange transfused rats and incubated ex vivo with the calcium ionophore, A23187 (10 microM). These studies demonstrated that ionophore-stimulated iTxB2 synthesis in the ex vivo Fluosol-43 samples was only 2.6% that of whole blood. Collectively these observations suggest that tissues other than blood components are potential sources of iTxB2 synthesis in endotoxin shock. PMID- 3978767 TI - Successful treatment of irreversible hemorrhagic shock in dogs with fructose-1,6 diphosphate and dichloroacetate. AB - Hemodynamic and metabolic effects of fructose-1,6-diphosphate (F.D.P.) and dichloroacetate sodium (D.C.A.) administration were studied in 17 mongrel dogs during experimentally induced hemorrhagic shock using a modified Wigger's technique. During the oligemic period, which was maintained for 3 hours, a control group of animals (A) received a 5% glucose solution at a rate of 3 mg/kg/min, while the treated group (B) received D.C.A. (175 mg/kg for 30 minutes) and F.D.P. (5 mg/kg/min) as aqueous solutions. After retransfusion of the shed blood, both groups of animals were left to recover. All eight dogs of the control group died within 3 hours following the experiment, while six out of the nine treated dogs survived during a week of follow-up (p = 0.007). Two hours after retransfusion, blood pressure and cardiac index in group B returned to control levels (115 +/- 4.8 mmHg and 0.097 +/- 0.008 liters/min/kg), while group A demonstrated a rapid and progressive deterioration (64 +/- 9.7 mmHg and 0.041 +/- 0.005 liters/min/kg). Severe core hypothermia (down to 33.3 degrees C) developed in group A dogs despite retransfusion, while a normal core temperature was maintained in the treated dogs. Calculated oxygen consumption during the oligemic period was significantly higher in group B animals despite similar calculated oxygen delivery in both groups of animals. Hyperlactemia was significantly lower in group B animals despite F.D.P. administration. This can be attributed to the addition of D.C.A. to the treatment. F.D.P. and D.C.A. administration prevented the occurrence of respiratory failure resulting, most probably, from respiratory muscle fatigue owing to depressed metabolic rate and increased lactate formation in these muscles during the shock period. It is suggested that administration of F.D.P. and D.C.A. during hemorrhagic shock in dogs has a favorable effect on the outcome of this life-threatening condition. PMID- 3978770 TI - Carotid baroreceptor reflex coronary vasodilation in the dog. AB - The hypothesis that neurally mediated coronary vasodilation occurs as part of the carotid baroreceptor reflex was investigated. The left main coronary artery was cannulated and perfused at constant pressure (100 mm Hg) in closed-chest, chloralose-anesthetized dogs. The heart was paced at a constant rate between 60 and 70 beats/min after atrioventricular heart block. Propranolol (1 mg/kg) was given to prevent beta-receptor-mediated alterations in contractility. Aortic blood pressure was stabilized with a blood reservoir. The aortic depressor nerves were cut bilaterally to prevent the buffering influence of aortic arch baroreceptors on the carotid baroreceptor reflex. The carotid sinuses were vascularly isolated and perfused with arterial blood at controlled pressures. Under these conditions, a step change in carotid sinus pressure from 70 to 210 mm Hg produced a 0.29 ml/min per g increase in coronary flow above control and a 10 mm Hg increase in coronary sinus blood oxygen tension. A step in carotid sinus pressure from 70 to 150 mm Hg resulted in a flow increase of 0.13 ml/min per g and a coronary sinus oxygen tension increase of 5.3 mm Hg relative to prestimulation values. Atropine (0.5 mg/kg, iv) blocked most of the reflex coronary vasodilation, indicating a parasympathetic component, and the addition of adrenergic alpha-receptor blockade with phenoxybenzamine (0.25 mg/kg, ic) abolished the remaining response, demonstrating sympathetic participation. The reflex nature of the coronary response was confirmed with carotid sinus denervation and vagotomy. It is concluded that carotid sinus hypertension results in a graded reflex neural coronary vasodilation independent of myocardial metabolic factors. The major component is due to activation of parasympathetic coronary vasodilator fibers, but there is also inhibition of sympathetic vasoconstrictor fibers. PMID- 3978771 TI - Role of adenosine in coronary blood flow regulation after reductions in perfusion pressure. AB - We employed intracoronary infusion of adenosine deaminase to test the hypothesis that endogenous adenosine contributes to regulation of coronary blood flow following acute reductions in coronary artery pressure. In 16 closed-chest anesthetized dogs, we perfused the left circumflex coronary artery from a pressurized arterial reservoir and measured coronary blood flow following changes in perfusion pressure before and 10 minutes after the start of intracoronary adenosine deaminase, 5 U/min per kg body weight. Parallel studies showed that this dose of enzyme resulted in cardiac lymph adenosine deaminase concentrations of 3.2 +/- 0.4 U/ml. Adenosine deaminase abolished the vasodilator response to intracoronary adenosine, 4 and 8 micrograms, but had no effect on the vasodilator response to intracoronary papaverine, 200 and 300 micrograms, demonstrating enzyme efficacy and specificity. Additional experiments demonstrated that adenosine deaminase reversibly attenuated myocardial reactive hyperemia following 5- and 10-second coronary occlusions by 30% (P less than 0.05), evidence that the infused enzyme effectively degraded endogenous adenosine. However, adenosine deaminase did not alter the time course for coronary autoregulation or the steady state autoregulatory flow response over the pressure range between 125 and 75 mm Hg. Further, adenosine deaminase did not alter steady state coronary flow when perfusion pressure was reduced below the range for effective autoregulation (60 40 mm Hg). Such results show that adenosine is not essential for either coronary autoregulation or for the maintenance of coronary vasodilation when autoregulatory vasodilator reserve is expended. PMID- 3978772 TI - Differential effects of antihypertensive drug therapy on vascular smooth muscle cell hypertrophy, hyperploidy, and hyperplasia in the spontaneously hypertensive rat. AB - The present report extends our previous studies of smooth muscle cell hypertrophy, hyperploidy, and hyperplasia in the 5-month-old spontaneously hypertensive and Wistar-Kyoto rats to include analyses of 3- and 7-month-old rats and explores the effects of antihypertensive drug treatment on the accelerated growth of vascular smooth muscle in aortas of spontaneously hypertensive vs. Wistar-Kyoto rats. Drug-treated rats were administered a combination of reserpine, hydralazine, and chlorathiazide in their drinking water, either between 3 and 5 months or between 5 and 7 months of age. Drug treatment decreased the blood pressure of spontaneously hypertensive rats to values at or below those of Wistar-Kyoto rats for both age-treatment groups. Smooth muscle growth was evaluated by morphometric analyses of aortic smooth muscle content, flow cytometric and microdensitometric measurements of the frequency of polyploid smooth muscle cells, biochemical estimates of aortic medial smooth muscle cell number, and microdensitometric measurements of individual smooth muscle cell protein content. The following results were obtained. Aortic medial smooth muscle content was not significantly increased in 3-month spontaneously hypertensive compared to Wistar-Kyoto rats, indicating that aortic smooth muscle hypertrophy occurred post-3 months, as well as after blood pressure was elevated. In 5-month old spontaneously hypertensive and Wistar-Kyoto rats, medial smooth muscle hypertrophy could be accounted for by cellular hypertrophy without hyperplasia; in contrast, medial hypertrophy in 7-month-old spontaneously hypertensive rats involved both cellular hypertrophy and hyperplasia. Antihypertensive treatment prevented the accelerated growth of vascular smooth muscle that occurred in spontaneously hypertensive rats via cellular hypertrophy and hyperploidy, but it did not prevent an increase in smooth muscle cell number in spontaneously hypertensive rats between 5 and 7 months of age. Furthermore, it had no effect on the parallel increases in aortic medial smooth muscle cell number that occurred in both spontaneously hypertensive and Wistar-Kyoto rats between 3 and 5 months of age. Whereas drug treatment prevented accelerated development of smooth muscle cell polyploidism in spontaneously hypertensive rats, in no case (spontaneously hypertensive or Wistar-Kyoto rats) did it reverse changes in ploidy that existed at the time of initiation of drug treatment, although it did cause cellular atrophy in smooth muscle cells of each ploidy class.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3978773 TI - Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. AB - In a previous analysis of ventricular arterial interaction (Sunagawa et al., 1983), we represented the left ventricle as an elastic chamber which periodically increases its volume elastance to a value equal to the slope of the linear end systolic pressure-volume relationship. Similarly, the arterial load property was represented by an effective elastance which is the slope of the arterial end systolic pressure-stroke volume relationship. Since the maximal transfer of potential energy from one elastic chamber to another occurs when they have equal elastance, we hypothesized that the left ventricle would do maximal external work if the ventricular elastance and the effective arterial elastance were equal. We tested this hypothesis in 10 isolated canine left ventricles, ejecting into a simulated arterial impedance, by extensively altering arterial resistance and finding the optimal resistance that maximized left ventricular stroke work under various combinations of end-diastolic volume, contractility, heart rate, and arterial compliance. Each of these parameters was set at one of three levels while others were at control. The optimal resistance varied only slightly with arterial compliance, whereas it varied widely with contractility and heart rate. We thus determined that the ratio of the optimal effective arterial elastance to the given ventricular elastance remained nearly unity. This result supports the hypothesis that the left ventricle does maximal external work to the arterial load when the ventricular and arterial elastances are equalized. PMID- 3978774 TI - Effects of acetylcholine on action potential characteristics of atrial and ventricular myocardium after bilateral cervical vagotomy in the cat. AB - Acetylcholine, the parasympathetic neurotransmitter, shortens the action potential duration of cat atrial muscle cells, but not ventricular muscle cells. In mammalian species, atrial tissue receives a richer cholinergic nerve supply than ventricular tissue. To determine whether chronic withdrawal of cholinergic tone might influence the subsequent response of these tissues to cholinergic stimulation, we examined the effect of acetylcholine on the action potentials of atrial and ventricular myocytes from cats with intact vagi and cats after chronic bilateral cervical vagotomy. Following bilateral cervical vagotomy, physostigmine (10(-6) M) failed to alter atrial tension development or action potential duration. Acetylcholine produced shortening of the action potential duration in atrial muscle from cats with intact vagi and in cats following bilateral cervical vagotomy. However, the degree of shortening produced by acetylcholine after bilateral cervical vagotomy was significantly greater (P less than 0.001). In ventricular muscle from cats with intact vagi, acetylcholine did not alter action potential duration. In ventricular muscle from cats after bilateral cervical vagotomy, acetylcholine shortened the action potential duration. Maximal effect was seen at a concentration of 10(-5) M where acetylcholine shortened action potential duration at 90% repolarization from a control value of 179 +/- 4 to 150 +/- 7 msec. Atropine (10(-6) M) reversed the effects of acetylcholine. Addition of propranolol (10(-6) M) to the superfusate or pretreatment of the animals with reserpine (2 mg/kg, ip) 24 hours before sacrifice failed to alter the response of ventricular muscle cells to acetylcholine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978775 TI - Comparison of the stability of a mite and a pollen extract stored in normal conditions of use. AB - Pollen extracts are stable in solutions containing 50% glycerol. The stability of Dermatophagoides pteronyssinus (Dp) extracts have not been determined. Two lyophilised extracts (Dp and cocksfoot pollen) were reconstituted in 50% glycerol and stored for up to 6 months at +4 degrees C. Every day the extracts were placed at room temperature for 1 hr to mimic the natural use of allergen extracts by allergists. Every 2 months the extracts initially prepared were compared to freshly reconstituted extracts by means of prick skin tests in fifteen allergic patients. It was observed that cocksfoot pollen extract is stable but there appears a slight but significant (P less than 0.05) decay in activity when the extract stored for up to 6 months was compared with a freshly prepared extract. On the other hand there is a significant (P less than 0.01) decay in activity of the Dp extract after 2 months of storage. Dermatophagoides pteronyssinus and cocksfoot pollen extracts behave differently when stored. These findings have particular importance in the diagnosis and treatment of allergic disorders. PMID- 3978776 TI - Aspirin intolerance and asthmal induction of a tolerance and long-term monitoring. AB - Acetylsalicylic-acid (ASA) intolerance is well recognized as a possible cause for exacerbating asthma. It has been postulated that if this could be overcome, long term aspirin administration could improve asthma symptoms and enable reduction of the use of other anti-asthmatic drugs. We succeeded in inducing an ASA tolerance in nine corticosteroid-dependent asthmatics, and this tolerance lasted at least 1 month and at most 1 year. Progressive deterioration in lung function was seen, however, in all patients taking ASA for more than 1 month, unless the corticosteroid intake was increased. These results suggest that ASA long-term treatment is of no help to severe corticosteroid-dependent, ASA-sensitive asthmatics. This conclusion differs from other reports on ASA intolerance in asthma. PMID- 3978777 TI - Challenge tests with tartrazine in patients with asthma associated with intolerance to analgesics (ASA-Triad). A comparative study with placebo. AB - In a study of the incidence of respiratory reaction to tartrazine, challenge tests were made with doses of 5, 25, 50, 100 and 200 mg of tartrazine and with a placebo, on forty-seven patients with asthma associated with intolerance to analgesics (ASA-Triad). The patient's clinical and spirographic condition was satisfactory when the test was made, and the administration of bronchodilators had been stopped 24 hr previously. In a total of 141 tests with tartrazine on forty-seven patients, only five tests were positive and occurred in only four patients. In three patients the test gave a negative result when repeated with an identical or larger dose of tartrazine. Only one patient had a respiratory reaction with 5 mg of tartrazine on two successive occasions, and this result is considered doubtful bearing in mind that the variation in FEV1 was at its limit. All the tests with placebo were negative except one. The clinical lability of the ASA-Triad patients could be the cause of some of the respiratory reactions attributed to tartrazine in some studies. The lability could, above all, be dependent on the suppression of the symptomatic treatment. The inconvenience associated with a colour-free diet and the small incidence of proven reactions to tartrazine, tend to invalidate the practice of recommending such diets unless evidence is available of a positive challenge test on at least two occasions. Even so, the risks induced are minimal. PMID- 3978778 TI - Skin test, RAST and clinical reactions to peanut allergens in children. AB - One-hundred-and-four children were skin-tested with four peanut-allergen preparations, a commercial extract, extracts of raw and roast peanuts prepared by NH4HCO3 extraction, and a wheatgerm lectin-reactive glycoprotein obtained by affinity chromatography. The presence of symptoms after ingestion of peanut or peanut products was also recorded. The roast allergen extract provided the greatest specificity with eight symptomatic children having a positive skin test and only one positive skin-test reaction in an asymptomatic child in the group of 104 children tested. Despite differences in the incidence of skin-test reactions there was a strong correlation between raw, roast and commercial RAST suggesting common allergens were being identified by circulating IgE. Clinical sensitivity was observed particularly in younger children with 75% of the children being under 4 years of age. A positive roast skin test or a RAST test adds confirmation to the clinical history of allergic reactions to peanuts. PMID- 3978779 TI - Basophil immunoglobulin receptors in asthmatics under immunoscanning electron microscopy. AB - Immunolatex particles were used as markers for IgE receptors on basophils using electron-microscope scanning. These particles appeared to bind specifically to basophils. Basophils from atopic asthma patients showed greater binding to latex particles than those from intractable asthma patients or healthy subjects. Cap and patch formations on IgE receptors were frequently found in basophils of atopic asthmatics, and cap formation was observed only on basophils that were pear-shaped. The redistribution of IgE receptors, such as that by cap formation, may be a significant triggering mechanism for basophil activation. The latex density on basophils pre-treated with anti-human IgG was much greater in intractable asthmatics than in atopic asthmatics or healthy subjects, and almost all basophils with increased immunolatex particles were pear-shaped, suggesting the presence of some IgG receptors on the surface, and such receptors may play an important role in intractable asthma. PMID- 3978780 TI - Hereditary dysfibrinogenemia. AB - Inherited qualitative abnormalities of fibrinogen have been documented in more than 100 families. These dysfibrinogenemias usually are clinically silent, but in some cases are associated with bleeding, thrombosis, or defective wound healing. Abnormalities of the fibrinogen molecule may impair any of the major steps involved in the conversion of fibrinogen into stabilized fibrin; i.e., cleavage of the fibrinopeptides by thrombin, polymerization, and cross-linking of fibrin. Biochemical studies of several abnormal fibrinogens have demonstrated that the functional defects are the result of single amino acid substitutions. The hereditary dysfibrinogenemias are the first coagulation disorder in which the pathophysiology has been elucidated on a molecular level. Studies of these "experiments of nature" have important implications in such diverse processes as wound healing and thrombosis. PMID- 3978781 TI - Improved ultrafiltration method for simultaneous measurement of free thyroxin and free triiodothyronine in serum. AB - We describe a new ultrafiltration method for measuring concentrations of free thyroxin (FT4) and free triiodothyronine (FT3). Serum containing [131I]T4 and [125I]T3 is diluted 10-fold in phosphate buffer (500 mmol/L, pH 7.4 at 37 degrees C), then passed through a YMT membrane in an Amicon MPS-1 centrifugal ultrafiltration device. Radioactive iodide and protein-bound thyronines are separated from FT4 and FT3 in the ultrafiltrate by use of a Sephadex G-25 microcolumn. In normal controls, the fraction of T4 that passes into the ultrafiltrate is 0.021 +/- 0.006% (mean +/- SD), FT4 is 19.6 +/- 6.5 ng/L, the fraction of T3 that passes into the ultrafiltrate is 0.18 +/- 0.5%, and the FT3 is 2.03 +/- 0.50 ng/L. Intra-assay precision (CV) is 5.4% for FT4 and 4.2% for FT3; the respective interassay CVs are 10.1% and 8.0%. In various groups of patients with thyroid disease and other conditions that influence serum T4 and T3 concentrations, FT4 by ultrafiltration correlated with FT4 measured by equilibrium dialysis (r = 0.84, p less than 0.001) and FT3 by ultrafiltration correlated with FT3 measured by the Diagnostic Products RIA kit (r = 0.87, p less than 0.001). The accuracy, reproducibility, speed, and simplicity of the ultrafiltration method compared favorably with the more cumbersome method of equilibrium dialysis. PMID- 3978782 TI - Specificity of autoantibodies to lactate dehydrogenase isoenzyme subunits. AB - We studied serum from 12 unrelated patients with variant electrophoretic patterns for lactate dehydrogenase (EC 1.1.1.27; LD) isoenzymes characteristic of LD immunoglobulin complexes. Immunoglobulin class was identified in four cases. In all 12 cases, mixing the patient's serum with control serum altered the mobility of normal LD isoenzymes to that of the variant. To determine antigenic specificity, we mixed ammonium sulfate-precipitated fractions of patient's samples with purified LD1 (H tetramer) or LD5 (M tetramer) prepared by anion exchange chromatography. In six cases the fractionated antibody displayed a pure M-subunit specificity. In four cases it acted against both M tetramers and H tetramers, and in two cases the antibody affected the migration only of LD isoenzymes containing both M and H subunits (i.e., hybrid isoenzymes). Depending on the relative excess of antibody or LD5 in such mixtures, various different anomalous electrophoretic patterns were produced. These results indicate that apparent differences between variant LD isoenzyme patterns in whole serum of different individuals can arise from autoantibodies with similar reactivities being present in various ratios of antigen to antibody. PMID- 3978783 TI - Appearance of a cathodic band in the electrophoretogram of blood creatine kinase isoenzyme-MM fraction during hypoxia in rats. AB - In electrophoretograms of creatine kinase (CK; EC 2.7.3.2) in patients' blood, a band, presumably of mitochondrial origin, is occasionally observed on the cathodic side of the CK-MM fraction. We studied the implications of this phenomenon in rats exposed to hypoxic conditions. In the hypoxic cardiac muscle, the proportions of CK-MB and CK-MM were not significantly different from controls, but that of the mitochondrial CK was lower. In the corresponding blood, the cathodic mitochondrial CK band appeared, but disappeared as the animals recovered from hypoxia. The CK-MB isoenzyme was increased in the blood of the control rats, as obtained by heart puncture, but no mitochondrial fraction was detected. We believe that changes in myocardial mitochondria during hypoxia are related to the appearance of the cathodic band. Cytoplasmic CK-MB, unlike mitochondrial CK, markedly increased in the rats' blood during the recovery stage rather than during the hypoxia. PMID- 3978784 TI - Steroid receptor analysis by size-exclusion liquid chromatography: considerations for the clinical laboratory. AB - Steroid receptor activity can be more quickly estimated by size-exclusion chromatography than by conventional analysis on sucrose gradients, and profiles of receptor activity are better resolved. Here we discuss several factors affecting this form of analysis in clinical laboratories. The composition of the elution buffer influences steroid receptor elution and recovery: high ionic strength, neutral pH, and the presence of dimethylformamide are important. Of the TSK-SW (Beckman) size-exclusion chromatographic columns we considered, the TSK G2000SW column appeared to be the most appropriate. "Reference" elution profiles are presented for several marker proteins and estrogen receptor forms generated under different sample-treatment conditions. In examining the sensitivity of receptor analyses by this method, we used fresh rodent preparations, a commercial receptor reference (Estrocept), and human tumor material obtained by needle biopsy. We also compared frozen and lyophilized receptor preparations with fresh ones. PMID- 3978785 TI - Total cholinesterase in plasma: biological variations and reference limits. AB - Factors affecting biological variation in total cholinesterase activity in plasma were studied in a population of 3372 apparently healthy subjects at least four years old. Determination of the dibucaine number, after inhibition of the activity by dibucaine, made it possible to specify the contributions of genetic and physiological characteristics to variations in the total activities by using a statistical method of segmentation. The main factors modifying plasma cholinesterase activity in males are genetic status (dibucaine number) and degree of overweight (subscapular skinfold). In females, hormonal status (puberty or menopause), genetic status (dibucaine number), and the use of oral contraceptives are the factors mainly responsible for the variations of plasma cholinesterase activity. These data allow us to propose reference limits for total plasma cholinesterase. PMID- 3978787 TI - Nickel concentrations in serum of patients with acute myocardial infarction or unstable angina pectoris. AB - Nickel was measured, by electrothermal atomic absorption spectrophotometry, in sera from (a) 30 healthy adults, (b) 54 patients with acute myocardial infarction, (c) 33 patients with unstable angina pectoris without infarction, and (d) five patients with coronary atherosclerosis who developed cardiac ischemia during treadmill exercise. Mean (and SD) concentrations in Group a were 0.3 (0.3) microgram/L (range less than 0.05-1.1 microgram/L). Within 72 h after hospital admission, hypernickelemia (Ni greater than or equal to 1.2 microgram/L) was found in 41 patients of group b (76%) and in 16 patients of group c (48%). Hypernickelemia was found before and after exercise in one patient of Group d (20%). Peak values averaged 3.0 micrograms/L (range 0.4-21 micrograms/L) in Group b, 1.5 microgram/L (range less than 0.05-3.3 micrograms/L) in Group c. In Group b, the mean time interval between the peak values for creatine kinase activity and for nickel was 18 h. Serum nickel concentrations were unrelated to age, sex, time of day, cigarette smoking, medications, clinical complications, or outcome. Mechanisms and sources of release of nickel into the serum of patients with acute myocardial infarction or unstable angina pectoris are conjectural, but hypernickelemia may be related to the pathogenesis of ischemic myocardial injury. PMID- 3978788 TI - Use of a diode array detector in investigation of neonatal organic aciduria. AB - We investigated the use of a diode array detector in conjunction with isocratic cation-exchange liquid chromatography for detection of organic acids in urine. The spectra and retention times of abnormal peaks found on chromatography of urine from patients with methylmalonic aciduria, maple syrup urine disease, and lactic aciduria were recorded and compared with those obtained for group of pure organic acids. Our results show that diode array detection helps considerably in tentatively identifying peaks appearing on an abnormal chromatogram while awaiting confirmation by mass spectrometry. PMID- 3978790 TI - Precision of sensitivity estimations in diagnostic test evaluations. Power functions for comparisons of sensitivities of two tests. AB - The precision of estimates of the sensitivity of diagnostic tests is evaluated. "Sensitivity" is defined as the fraction of diseased subjects with test values exceeding the 0.975-fractile of the distribution of control values. An estimate of the sensitivity is subject to sample variation because of variation of both control observations and patient observations. If gaussian distributions are assumed, the 0.95-confidence interval for a sensitivity estimate is up to +/- 0.15 for a sample of 100 controls and 100 patients. For the same sample size, minimum differences of 0.08 to 0.32 of sensitivities of two tests are established as significant with a power of 0.90. For some published diagnostic test evaluations the median sample sizes for controls and patients were 63 and 33, respectively. I show that, to obtain a reasonable precision of sensitivity estimates and a reasonable power when two tests are being compared, the number of samples should in general be considerably larger. PMID- 3978786 TI - Simultaneous determination of trace elements in lavage fluids from human bronchial alveoli by energy dispersive x-ray fluorescence. 1: Technique and determination of the normal reference interval. AB - We have applied energy dispersive x-ray fluorescence to the analysis of broncho alveolar lavage fluids, to determine the concentration of several elements simultaneously with manipulation of the sample minimized. A 20-microL sample of a homogenized lavage fluid, to which two internal standards (containing Y and V) have been added, is deposited on a polypropylene film, 4 microns in thickness, and analyzed by x-ray fluorescence. We report the analytical procedure, the detection limits, and the reproducibility. The normal concentration range for trace elements is reported for a selected population. The simplicity and rapidity of the method, and the possibility of automating measurements, make this procedure suitable for screening large numbers of lavage specimens and to establish the diagnosis of some pneumoconioses. PMID- 3978789 TI - Determination of urinary free cortisol by "on-line" liquid chromatography. AB - This is a fully automated method for the specific assessment of urinary free cortisol. A 1-mL urine sample is concentrated and prepurified on a reversed-phase precolumn with alkaline, acid, and organic washes. After selective elution, the cortisol-containing organic eluate is "polarized" by admixing water in such a way that cortisol is focused on the top of a second reversed-phase precolumn. From this precolumn, cortisol is desorbed by backflush, separated from the still remaining related compounds on an analytical column, and finally detected by ultraviolet absorbance. Losses of cortisol throughout the total procedure are negligible and thus external calibration is feasible for quantification. CVs were 4.1% for interassay variability, 2.6% for intra-assay variability. Cortisol concentrations down to 15 nmol/L are assayable, we estimated the median amount of free cortisol excreted daily by normal students, outpatients, hospitalized patients, and patients under intensive care. After stimulation with corticotropin1-24, the median concentration of free cortisol in urine increased from 99 nmol/L to 1238 nmol/L (n = 6). Results by radioimmunoassay for normal persons and hospitalized patients were about fourfold those by this technique. The same method can also be used for free cortisone in urine. PMID- 3978791 TI - Hypergastrinemia--a risk factor for myocardial infarction? AB - We determined gastrin and pepsinogen I in serum samples obtained in 1968-69 from 256 women (175 women 54 years old and 81 women 60 years old when sampled). The concentration of gastrin in serum was significantly (p less than 0.01) and positively correlated with the incidence of myocardial infarction during a 12 year follow-up, with age taken into account as a background variable in multivariate analysis. It was not correlated with overall mortality or with the 12-year incidences of angina pectoris, electrocardiographic changes indicating ischemic heart disease, or stroke. The correlation with myocardial infarction was independent of smoking, systolic blood pressure, indices of obesity, concentrations of blood glucose during fasting and of serum triglycerides and cholesterol, and of the presence of diabetes mellitus at screening or during follow-up. Serum gastrin was significantly (p less than 0.05) related to body mass index (positive age-specific relation) and to smoking (negative age-specific relation). These findings may provide a new aspect to analysis of risk factors for myocardial infarction. PMID- 3978792 TI - Determination of cyanide in whole blood, erythrocytes, and plasma. AB - We describe a method for determination of cyanide in whole blood, erythrocytes, and plasma after stabilization of cyanide by addition of silver ions. The cyanide is then transferred from the acidified sample, by aeration, into sodium hydroxide and quantified by the Konig reaction, with sodium hypochlorite as the chlorinating agent. A rapid loss of measurable cyanide found when cyanide was added to plasma in the absence of silver ions was attributed to a reaction with serum albumin. Cyanide added to whole blood was bound to a saturable component in erythrocytes, which we identified as methemoglobin. PMID- 3978793 TI - Head-space gas-chromatographic determination of 3-hydroxybutyrate in plasma after enzymic reactions, and the relationship among the three ketone bodies. AB - In this sensitive, reproducible method for determination of D-3-hydroxybutyrate (3-OHB) in plasma, it is converted to acetone by use of 3-hydroxybutyrate dehydrogenase (EC 1.1.1.30)/lactate dehydrogenase (EC 1.1.1.27) coupled with acetoacetate decarboxylase (EC 4.1.1.4). The resulting acetone is detected by head-space gas chromatography. The lowest concentration of 3-OHB detectable in plasma was 2 mumol/L. The calibration curve showed a linear relationship for 3 OHB concentration from 0 to 5 mmol/L (r = 0.999). Analytical recovery of 3-OHB (50 mumol/L) was 97.9 (SD 3.8)%. The method was developed for determination of the three ketone bodies in plasma. The ratio of acetone to acetoacetate was not significantly different (p greater than 0.2) between normals (n = 31) and diabetics (n = 86). In normal subjects, the ratio of 3-OHB to acetoacetate was 1.20 (SD 0.44). In diabetic patients, the ratio correlated with the logarithm of the total ketone body concentration (r = 0.828). PMID- 3978794 TI - Measurement of urinary chloride with the Kodak Ektachem 400. AB - Urinary chloride can be measured simply, precisely, and accurately with the Ektachem 400 clinical chemistry analyzer. Because the coated film technique used in this instrument requires the presence of a protein matrix, we added a protein based calibrator to the urine samples to overcome the low protein concentration in these specimens. Its advantages over a coulometric titration method (Astra analyzer) include the extension of the range of linearity to lower concentrations and the absence of interference from prednisone metabolites in urine. A disadvantage is the negative bias interference of allopurinol. PMID- 3978796 TI - Evaluation and comparison of a radiative energy attenuation method for determining cholesterol in serum. AB - Determination of cholesterol by a radiative energy attenuation (REA) technique was evaluated and compared with results obtained by the Boehringer Mannheim High Performance Cholesterol Assay and the Du Pont aca. Within-assay and between-assay CVs for the REA method, for two sets of controls, were both less than 5%. We observed no interference with lipemic samples. Analytical recovery averaged 102.8%. We used all three methods for parallel determinations of 217 patients' samples containing a wide range of cholesterol concentrations. Linear regression analysis of the REA results vs those of the comparison methods were as follows: REA = 1.03 Boehringer - 0.072 (r = 0.993) and REA = 1.02 aca - 0.048 (r = 0.995). We also discuss bilirubin interference with the REA method for cholesterol. PMID- 3978795 TI - Erythrocyte porphobilinogen synthase activity as an indicator of lead exposure in children. AB - The European standardized method for measuring porphobilinogen synthase (PBGS, EC 4.2.1.24) activity in peripheral erythrocytes is widely used in epidemiological studies of low-level Pb absorption. We have modified it to include activation with dithiothreitol (DTT). In children with concentrations of Pb in whole blood ranging from 0.29 to 1.93 mumol/L, we found the following statistically significant correlations (r): blood Pb vs nonactivated PBGS activity = -0.773 (p less than 0.005); blood Pb vs DTT-activated PBGS activity = -0.265 (p less than 0.005); blood Pb vs the ratio of DTT-activated/nonactivated PBGS activity = +0.818 (p less than 0.005). At a DTT-activated/nonactivated PBGS activity ratio of 1, which indicates no Pb-dependent inhibition of PBGS, a corresponding blood Pb concentration of 0.24 mumol/L (50 micrograms/L) would be predicted. In individuals with hematological disorders, the DTT-activated/nonactivated ratio better predicted blood concentration of Pb than did the nonactivated PBGS activity, and largely compensated for the high variability in PBGS activity. We also describe techniques to minimize contamination by Zn and Pb and to stabilize enzyme activity during collection, transport, storage, and analysis of samples. PMID- 3978797 TI - K, Ca, Mg, and Zn in platelets, as determined by atomic absorption spectrometry with use of a sealed decomposition bomb and discrete nebulization. AB - In this new method for precise and accurate determination of K, Ca, Mg, and Zn in platelets, small amounts of platelets, prepared by differential centrifugation and cell washing, are decomposed in a homemade mini-vessel, a sealed Teflon bomb. The metal ions in the decomposed sample are measured by atomic absorption spectrometry with discrete nebulization. Overall, CVs ranged from 0.8 to 4.8%. We investigated sex-related differences (none were found) and intra-individual variations. PMID- 3978798 TI - Liquid-chromatographic assay of cimetidine in plasma and gastric fluid. AB - In this micro-scale method for liquid-chromatographic measurement of cimetidine in 250-microL volumes of plasma or gastric fluid, a combination of organic- and aqueous-phase extractions, and protonation of the internal standard and cimetidine, enabled us to detect 2.0 ng of cimetidine on the column. We also used a radial compression module, which reduced the retention times for cimetidine and the internal standard to only 2.78 and 2.00 min. The speed and sensitivity of this method facilitates analysis of large numbers of samples. PMID- 3978799 TI - Radioenzymic determination of homocysteine in plasma and urine. AB - Using a modification of the radioenzymic assay described previously (J Biol Chem 259: 2360-2364, 1984) we measured homocysteine in freshly prepared plasma and urine from volunteers. The concentration of free homocysteine--i.e., the amount measurable in plasma after deproteinization by strong acid--was 2.27 (SEM 0.11) mumol/L for 18 men and 1.95 (SEM 0.13) mumol/L for 16 women (p greater than 0.05, not significant). About 70% of the total homocysteine in human plasma was associated with plasma proteins, and was precipitated with strong acid. The concentration of protein-bound homocysteine in plasma was 6.51 (SEM 0.32) mumol/L for men and 7.29 (SEM 0.65) mumol/L for women, a significantly (p less than 0.01) different spread. Homocysteine was rapidly released from plasma proteins in the presence of a reducing agent, dithioerythritol. By gel filtration of plasma on a "high-performance" liquid-chromatographic column, albumin was shown to be the sole carrier of homocysteine in plasma. Because the fraction bound to protein as determined by this procedure equaled that obtained by precipitation of plasma proteins with acid, we conclude that homocysteine is bound to albumin in vivo. The concentration of homocysteine in urine ranged from 3.5 to 9.5 mumol/L, about 6 mumol of homocysteine being excreted per 24 h. PMID- 3978800 TI - Improved column-chromatographic isolation of glycosylated hemoglobin S. AB - We investigated glycosylated hemoglobin S by means of chromatography on Bio-Rex 70. The selected elution conditions were similar to those described by Trivelli et al. (N Engl J Med 284: 353-357, 1971), except for modified ionic strength and accurate temperature control. This enabled us to isolate a minor hemoglobin fraction whose properties, as determined by chromatography, electrophoresis, and two-dimensional maps of its tryptic peptides, were typical of a hemoglobin S tetramer with blocked N-terminal residues of the beta subunits. The colorimetric test indicated this to be a glycosylated hemoglobin. This procedure is notably improved over previous chromatographic techniques for isolating glycosylated hemoglobin S. Moreover, it can be easily used in any laboratories where Trivelli's method is routinely in use. PMID- 3978801 TI - Identification of hyperthyroid patients by means of a sensitive assay for thyrotropin. AB - We evaluated a new assay (TSH3 MAIAclone) for thyrotropin (TSH) with improved sensitivity, testing a series of hospital inpatients with increased free thyroxin indices (thyroxin concentration X triiodothyronine uptake on resin). This assay involves use of three monoclonal antibodies and an antibody-magnetic particle conjugate that rapidly and completely separates bound and free tracer in a magnetic field. The assay turnaround time is 3 h. By the TSH3-MAIAclone assay, 65% of these patients with an increased free thyroxin index were identified on the basis of a TSH value less than or equal to 0.50 milli-int. unit/L. In contrast, another commercially available assay for TSH detected suppressed TSH concentrations in less than 5% of these patients. We conclude that the TSH3 MAIAclone assay markedly improves our ability to discriminate hyperthyroidism from euthyroidism. PMID- 3978802 TI - Electroimmunoassay precision improved by using an internal standard. PMID- 3978803 TI - Errors in estimating ethanol concentration in plasma by using the "osmolal gap". PMID- 3978805 TI - Oxalate oxidase from banana peel for determination of urinary oxalate. PMID- 3978804 TI - Screening for hypercholesterolemia by use of blood spotted on filter paper. PMID- 3978806 TI - Li+ and sickling of homozygous HbS cells. PMID- 3978807 TI - Reference interval for thyroxin as measured by fluorescence polarization immunoassay. PMID- 3978808 TI - Improved dye-binding procedure--once again, or once too much? PMID- 3978809 TI - Roche Sensi-Chrome evaluated as a qualitative screen for choriogonadotropin in serum. PMID- 3978810 TI - Removal of lipids before liquid chromatography of vitamin D in serum. PMID- 3978811 TI - Stability of norepinephrine in blood. PMID- 3978812 TI - More on Al contamination of samples for Al analysis. PMID- 3978813 TI - Analyzed controls for lipid analysis available. PMID- 3978814 TI - Plasma prolidase in the rat: no index of liver fibrosis. PMID- 3978816 TI - Lack of influence of TfC genetic phenotype on iron, iron-binding capacity, percentage saturation, and immunologically determined transferrin in blood donor sera. AB - Although over 22 different genetic variants of human transferrin have been described, three subtypes of the TfC allele, TfC1, TfC2, and TfC3, have a combined gene frequency of over 0.95 in most US populations. We measured iron, iron-binding capacity, and immunologically determined transferrin in blood donor sera of known TfC phenotypes, since we thought the results might be transferrin phenotype dependent, as is haptoglobin concentration on haptoglobin genetic phenotype. However, we found no major differences in the mean iron, mean iron binding capacity, mean percentage saturation, or mean immunological transferrin in blood donors of different TfC phenotypes. We also found reasonably good correlation (r = 0.86) between immunologically determined transferrin and chemically determined iron-binding capacity with no significant differences in the linear regression parameters for sera of various TfC phenotypes. PMID- 3978815 TI - Aryl acylamidase activity in human erythrocyte, plasma and blood in pesticide (organophosphates and carbamates) poisoning. AB - Erythrocyte acetylcholinesterase (EC 3.1.1.7) and plasma pseudocholinesterase (EC 3.1.1.8) were determined from the day of admission up to 10 days in patients who have consumed organophosphate or carbamate poisons. In a number of patients, plasma pseudocholinesterase was completely inhibited on the day of admission but increased with the passage of days. Erythrocyte acetylcholinesterase was not completely inhibited and it also tended to increase with time in most cases. Patients in whom the erythrocyte acetylcholinesterase was very low and did not show an increase within the first few days expired indicating the prognostic importance of erythrocyte acetylcholinesterase. The profile of aryl acylamidase (EC 3.5.1.13) activity in plasma or erythrocytes showed a pattern similar to the respective cholinesterases. Moreover, whole blood aryl acylamidase activity was found to be a good index of erythrocyte acetylcholinesterase suggesting the prognostic usefulness of blood aryl acylamidase in the poisoned patients. PMID- 3978817 TI - Elevated copper and lowered zinc in the placentae of pre-eclamptics. AB - Selected cations (Ca, Co, Cu, Mg, Zn, Si, and K) were determined in the placentae of 18 women. Between pre-eclamptic and normal subjects there were significant (p less than 0.05) differences in copper and zinc concentrations and borderline significant differences in cobalt concentration. In the placentae of the ten women with a normal pregnancy, the average concentrations of copper and zinc were 53 and 192 micrograms atoms/kg placenta, respectively. In the placentae of 8 women with pre-eclampsia, the concentrations were 124 and 134 micrograms atoms/kg placenta for copper and zinc, respectively. Elevation of copper and decrease in zinc may be an exaggeration of normal pregnancy physiology that occurs in pre eclampsia. PMID- 3978818 TI - Substitution of tetramethylbenzidine for benzidine in cyanide analyses. PMID- 3978819 TI - Study of different factors affecting arginine-vasopressin radioimmunoassay. PMID- 3978820 TI - Reference values of blood components related to fuel metabolism in children after an overnight fast. AB - The interrelation between blood components, involved in fuel metabolism, and age, sex and glucose was studied in 72 control children (26 girls and 46 boys, aged between 3 and 15 yr) after an overnight fast (14 h). Glucose, lactate, pyruvate, triglycerides and cholesterol are age-independent. Alanine is positively correlated, whereas beta-hydroxybutyrate, acetoacetate and NEFA's are negatively correlated with age. With respect to blood sugar, acetoacetate, NEFA's and cholesterol are glucose-independent. Lactate, pyruvate, alanine and triglycerides are positively correlated with glucose, and beta-hydroxybutyrate--and total ketone bodies--are negatively correlated with glucose. Except for triglycerides, no differences in the concentrations of the above mentioned blood substrates are seen between boys and girls. These data demonstrate that after an overnight fast lipolysis and ketogenesis already are active in young children, probably related to inadequate gluconeogenesis and improvement of carbohydrate regulation with age. PMID- 3978821 TI - Radioimmunoassay for the middle region of human parathyroid hormone: comparison of two radioiodinated synthetic peptides. AB - Two synthetic peptides were evaluated to develop radioligands for midregion specific radioimmunoassay (RIA) of human parathyroid hormone (hPTH). Both contained the 44-68 sequence of hPTH (no tyrosine residues); one contained a tyrosine residue added to the amino-terminus, (Tyr43)hPTH(43-68). The purified radioligands showed similar chemical properties (stability to storage, efficient phase separation with dextran-coated charcoal, low adsorption to glassware). Both radioligands were tested using three anti-PTH sera of proven clinical utility. While each of these midregion-directed antisera showed unique specificity, they all reacted with high affinity with both radioligands and none of them discriminated significantly between the two synthetic midregion peptides. 125I (Tyr43)hPTH(43-68) gave RIAs that were 15-50% more sensitive to hPTH(1-84) and the unlabelled synthetic midregion peptides than RIAs using 125I-hPTH(44-68) with all three antisera examined. 125I-(Tyr43)hPTH(43-68) was more susceptible than 125I-hPTH(44-68) to degradation from plasma or serum; this susceptibility was reduced by the peptidase inhibitor aprotinin (500 KIU/ml). Simultaneous RIAs of a series of patient plasmas using either of the two radioligands with antiserum NG5/5 produced indistinguishable discrimination between samples (r = 0.984). Analysis of data on the relation of serum calcium and hPTH midregion immunoreactivity showed a useful separation hyperparathyroidism, primary hypoparathyroidism and secondary hypoparathyroidism. PMID- 3978823 TI - Investigation of mitochondrial metabolism in small human skeletal muscle biopsy specimens. Improvement of preparation procedure. AB - A method is presented which allows the investigation of almost the complete mitochondrial content of small human skeletal muscle biopsy specimens. Thorough mechanical disruption with a chopper apparatus results in the release of about 50% of the mitochondrial content. Subsequent treatment of the 600 x g sediment with trypsin releases another 30% of the total mitochondrial population. The biochemical characteristics of the two mitochondrial fractions obtained in these two successive steps have been compared. No obvious differences could be established. The procedure is well suited for biochemical investigation of muscle biopsy specimens from patients suspected of suffering from a mitochondrial myopathy. PMID- 3978822 TI - Diagnostic value of erythrocyte-free polyamines and histaminemia in malignant hepatic tumors and in liver cirrhosis. AB - The present study tries to evaluate the diagnosit value in malignant hepatic tumors of polyamines, of which the relationship with cellular kinetics is known, and histamine, of which catabolism follows a similar pathway. One hundred and fifty six patients were studied: 53 with malignant liver tumors (27 primary, 26 metastatic) and 103 with non-tumoral liver diseases of which 65 were cirrhotic and 38 non-cirrhotic. Erythrocyte polyamines (spermidine and spermine) and histamine levels were assayed. The results indicate the following. 1. Polyamine levels were significantly increased (a) in cirrhotic patients, not only when compared with controls (p less than 10(-8)), but also when compared with the non cirrhotic patients (p less than 10(-7)); (b) in primary malignant hepatic tumors (p less than 10(-3)). 2. Histamine was significantly increased (a) in the non tumoral liver diseases (p less than 10(-4)), but with no difference between cirrhotic and non-cirrhotic patients; (b) in the secondary malignant tumor patients, histamine levels were lower than in primary tumor patients (p less than 0.04). 3. There was no correlation, in all groups studied, between polyamine and histamine levels. These results suggest the following practical implications. 1. For non-tumor liver diseases, appreciably increased polyamine levels may represent a further argument favoring a cirrhotic condition. 2. In diagnosing hepatic scintigraphic defects, increased polyamine levels would suggest a primary malignant hepatic tumor; low histamine levels are more in favor of a secondary malignant hepatic process. PMID- 3978825 TI - Familial hypocalciuric hypercalcaemia I: Renal handling of calcium, magnesium and phosphate. AB - Ten hypercalcaemic members from three generations of a family with familial hypocalciuric hypercalcaemia (FHH) were compared with age and sex matched healthy subjects. Two of the former had undergone unsuccessful subtotal parathyroidectomy. Our results showed that the hypercalcaemia was mainly attributable to an increased capacity for tubular reabsorption of calcium, but in part also to an increased release of calcium from bone. The relative hypermagnesaemia had a similar dual origin. The serum phosphate concentration was low and this could be accounted for in full by a decrease in renal tubular reabsorption of phosphate, as assessed by the renal threshold phosphate concentration (TmPO4/GFR). The results of PHT measurements with two radioimmunoassays were equivocal. Most patients had normal serum PTH values, but with one assay mean serum PTH was significantly higher in the hypercalcaemic group. We conclude that the abnormalities of the divalent cation and phosphate metabolism cannot be accounted for in full by increased circulating PTH activity, and are predominantly due to an intrinsic renal abnormality. PMID- 3978824 TI - Relationship between the changes in serum thyroid hormone levels and protein status during prolonged protein supplemented caloric deprivation. AB - The relationship between the changes in serum thyroid hormone levels and nitrogen economy during caloric deprivation were investigated in ten obese men during a 40 d, 400 kcal protein-supplemented weight-reducing diet. This regimen induced increases in the serum levels of total T4, free T4 and total rT3, and decreases of total T3, while serum TSH remained unchanged. There were progressive decreases in total body weight and urinary losses of total nitrogen and 3-methylhistidine, with the early negative nitrogen balance gradually returning towards basal values during the 40 days. Subjects with the largest weight loss had the most increase in the serum levels of total T4 and free T4 index and the greatest decrease in T3. The magnitude of the increase of the nitrogen balance from its nadir was correlated with the extent of the reduction of T3 and increase of T3 uptake ratio and free T4 levels. The decrease in the urinary excretion of 3-methylhistidine correlated with the increase in free T4 and rT3 levels. Nadir serum transferrin values were directly related to peak rT3 values, and the lowest albumin concentrations occurred in subjects with the highest total T4 and free T4 index values. Further, the maximum changes in the serum thyroid hormone levels preceded those of the nutritional parameters. These relationships suggest that: (1) increases in serum rT3 and free T4 and reductions in T3 concentrations during protein supplemented weight reduction may facilitate conservation of visceral protein and reduce muscle protein turnover; and (2) the variation in the magnitude of these changes may account for the heterogeneity of nitrogen economy. PMID- 3978826 TI - Multiple intracranial metastases from a prolactin secreting pituitary tumour. AB - A 28 year old man presented with partial hypopituitarism and signs of a pituitary tumour. A chromophobe adenoma was partially removed by right frontal craniotomy. Seven years later complete hypopituitarism and hyperprolactinaemia were documented, at which time there was no evidence of tumour recurrence of CT scan. The patient was treated with bromocriptine but the pituitary tumour redeveloped a year later. Nine years after the original operation the first metastasis was demonstrated together with very high prolactin levels. The intracranial metastasis, and the pituitary tumour were removed at a second craniotomy following which the prolactin concentration fell. Further metastases developed subsequently and the patient died 12 years after the initial diagnosis. At autopsy multiple metastases were found in the brain, tumour cells were present in the subarachnoid space and in cerebral veins. The pituitary tumour and secondaries were shown by immunocytochemistry to contain prolactin but not ACTH or growth hormone. This appears to be the third well documented case of a metastasizing, prolactin secreting pituitary tumour. PMID- 3978827 TI - Variation in osmoregulation of arginine vasopressin during the human menstrual cycle. AB - Osmoregulation of vasopressin secretion was studied in eight healthy women in the follicular and luteal phases of the menstrual cycle. Basal plasma osmolality in the luteal phase was significantly lower than in the follicular period (282.4 +/- 0.6, 285.6 +/- 1.1mmol/kg, respectively, P less than 0.05). Plasma AVP (pAVP) and plasma osmolality (pOsm) were measured during the infusion of 850 mmol/l saline in both phases of the cycle, and linear regression analyses of these data gave the following regression equations (i) follicular, pAVP = 0.43 (pOsm - 284), r = + 0.93, (ii) luteal, pAVP = 0.31 (pOsm - 279), r = + 0.95. Both the slope and abscissal intercept were significantly different (P less than 0.01). Osmotic threshold for thirst sensation in the luteal phase was lower than the follicular (293 +/- 2,297 +/- 1 mmol/kg, P less than 0.005). We conclude that, in the luteal phase, the threshold for AVP release and the gain or sensitivity of the osmostat are reduced together with lowering of the thirst threshold, which account for the lower basal luteal plasma osmolality. PMID- 3978828 TI - The absence of any effect of methimazole on in vitro cell-mediated cytotoxicity. AB - Two recent studies have reported that antithyroid drugs inhibit killer (K) and natural killer (NK) cell function in vitro, which could be relevant to the changes in these cell populations during treatment of Graves' disease. In contrast to these reports we have found no in vitro effect of pharmacologically relevant concentrations of methimazole (MMI) (100 mumol/l) on (i) NK cell function using K562 cells or MOLT-4 cells as targets, (ii) K cell function using antibody-dependent cytotoxicity assays with L929 cells or thyroid-antigen-coated chick red cells, or (iii) monocyte-dependent cytotoxin-mediated killing of L929 cells. Enhanced cytotoxicity was found with 1 mmol/l MMI in some of these assays but this was not consistent since it occurred only in certain individual cultures. Since we have shown previously that 100 mumol/l MMI inhibits oxygen radical generation, the present results add to the evidence that these radicals are not directly involved in cell-mediated cytotoxicity and do not support the concept that antithyroid drugs have a significant effect on antibody-dependent cell-mediated cytotoxicity in Graves' disease. PMID- 3978829 TI - Bioactive forms of serum lactogens: effects of treatment of prolactinoma patients with bromocriptine. AB - An in vitro bioassay for lactogenic hormones, based on the specific mitogenic effects of lactogens on cultured Nb2 node rat lymphoma cells, was used to measure the levels of lactogens in whole serum and in fractionated serum samples from three patients with prolactin (PRL) secreting pituitary adenomas. Under basal conditions, after pituitary stimulation, and following treatment with bromocriptine which greatly decreased the serum PRL levels, the bioassay (BA) results closely paralleled fluctuations in the sum of radioimmunoassay (RIA) estimates of serum PRL and growth hormone concentrations. The extreme sensitivity (10 pg/ml) of the BA facilitated measurement of PRL in fractions obtained after Sephadex G-100 chromatography of only 0.1 to 0.3 ml of sera from both untreated and bromocriptine-treated prolactinoma patients. In both types of samples, similar heterogenous patterns of bioactive PRL were observed, although most of the recovered activity appeared to be due to monomeric PRL. BA and RIA of fractions obtained after DEAE cellulose chromatography of sera from untreated prolactinoma patients revealed two PRL peaks, the first one containing 75% of the activity. Therapy with bromocriptine led to a reduction in the total serum PRL activity and, in particular, in the activity of the second peak. PMID- 3978830 TI - End-organ responses to thyroxine therapy in subclinical hypothyroidism. AB - We studied variables known to change with thyroid hormone status in 18 patients with subclinical hypothyroidism before and during treatment with thyroxine in a dose sufficient to restore the plasma TSH response to TRH to normal. There was an associated increase in both plasma total T4 and free T4 within the normal range but plasma total T3 and free T3 were unchanged. As a result of thyroxine treatment there was a small but significant increase (P less than 0.05) in left ventricular ejection fraction (LVEF) with maximal exercise but no significant changes in LVEF at rest and moderate exercise, continuously monitored mean sleeping heart rate, day/night ratios of urinary sodium excretion, peripheral nerve conduction velocities, fasting serum triglycerides, total cholesterol (TC), high density lipoproteins (HDL) or TC/HDL ratios. On this evidence we do not consider that thyroxine replacement therapy is indicated in patients with subclinical hypothyroidism. PMID- 3978831 TI - Comparison between bioactivity and immunoreactivity of serum prolactin in uraemia. AB - The lactogenic potency of sera from 24 male uraemic patients on regular haemodialysis and 14 control subjects was measured by Nb2 node rat lymphoma cell bioassay, and was compared to serum prolactin levels measured by radioimmunoassay. Sera with immunoreactive growth hormone levels exceeding 5 ng/ml were excluded from comparisons. The uraemic patients had a higher serum immunoreactive prolactin (48.2 +/- 10.5 ng/ml) than controls (13.3 +/- 1.3 ng/ml (P less than 0.01). Similarly the lactogenic potency of uraemic serum was higher than that of the control sera (25.5 +/- 3.9 vs 12.6 +/- 1.4 ng/ml, P less than 0.02). The ratio of immunoreactive serum prolactin to the lactogenic potency of the serum was significantly higher in the uraemic group (1.80 +/- 0.14 vs 1.10 +/ 0.10, P less than 0.01) suggesting decreased bioactivity of prolactin in uraemic serum. To examine whether low molecular weight inhibitory molecules were responsible for this discrepancy, the lactogenic potency of 8 uraemic sera was studied before and after 4 h of dialysis against 1 litre of haemodialysis medium. Two of the eleven sera studied showed a significant increment in lactogenic potency after dialysis (47% and 57%). We conclude that there is a disparity between the bioactive and the immunoreactive serum prolactin concentrations in patients with chronic renal failure and that a dialysable factor may be partly responsible for this discrepancy in some cases. PMID- 3978832 TI - Amiodarone and thyroid hormone action. AB - In clinically euthyroid subjects on long-term amiodarone therapy free thyroxine (T4) concentrations were increased and free triiodothyronine (T3) levels reduced. There was also a marked increase in reverse T3 in the treated group. These changes are consistent with inhibition of peripheral deiodination of T4 and reverse T3. Despite the rise in T4 serum thyrotrophin (TSH) levels were increased, suggesting an effect of amiodarone on the anterior pituitary. To investigate the interaction of amiodarone with the cellular actions of thyroid hormones we examined the influence of the drug in vitro on the binding of T3 to isolated nuclei prepared from rat anterior pituitary tissue. Amiodarone inhibited the nuclear binding of T3 in a dose dependent fashion. Addition of amiodarone in vitro also stimulated TSH release from cultured rat anterior pituitary cells, consistent with a T3 antagonistic effect. These studies provide evidence for a direct influence of amiodarone on the thyrotroph, mediated via nuclear T3 receptor binding. PMID- 3978833 TI - Relationships between the circadian rhythms of TSH, prolactin and cortisol in surgically treated microprolactinoma patients. AB - Pharmacological doses of glucocorticoids inhibit TSH release both in vivo and in vitro and since the circadian rhythms of TSH and cortisol show a reciprocal relationship, the hypothesis has been advanced that changes in cortisol levels may be a primary determinant of circadian TSH changes. We have tested this hypothesis by studying the relationship between circadian cortisol and TSH rhythms in subjects before and during blockade with metyrapone. Seven patients were studied during their routine post-operative assessment following selective transethmoidal adenomectomy for microprolactinomas. PRL levels were restored to normal (less than 420 mU/l) in all patients by surgery (pre-op: 930-2752 mU/l, post-op: 33-376 mU/l) and the patients also had normal pituitary function in other respects. Blood was sampled hourly for 24 h before and on the third day of treatment with metyrapone (250 mg, 2 hourly). In order to compare circadian rhythms, hormonal data were subjected to cosinor analysis which involved fitting of the data with a cosine function using the method of least squares. The 6% cross reactivity of the cortisol antibody with 11-deoxycortisol was taken into account during the calculation of results. All subjects showed a normal cortisol rhythm which was strikingly blunted during metyrapone treatment. Group mean (+/- SD) TSH mesors, amplitudes and acrophases for control and metyrapone treated subjects were 1.5 +/- 0.26, 1.29 +/- 0.48; 0.46 +/- 0.26, 0.23 +/- 0.13 and -49 degrees +/- 9.8 degrees; -62 degrees +/- 2.7 degrees respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978834 TI - High frequency of goitre in cigarette smokers. AB - Thyroid function, the clinical occurrence of goitre and ultrasonically determined thyroid gland volume were investigated in 219 healthy subjects randomly chosen from hospital employees. Thirty-five subjects (16%) had a clinically detectable goitre. The frequency of goitre among smokers was higher (32 of 107, 30%) than among non-smokers (3 of 112, 3%), (P less than 0.001). Median thyroid volume was significantly higher in smokers, 26 ml (range 11-55 ml), compared with non smokers, 15 ml (range 8-37 ml), (P less than 0.001). The median serum thyroglobulin levels were significantly higher and median serum thyrotropin levels lower in smokers compared with non-smokers. There were no differences between the groups regarding serum levels of T4, T3, rT3, free T4 index, free T3 index, thyroglobulin antibodies and 131I uptake (24 h) in the thyroid gland. It is suggested that these findings could partly be due to inhaled thiocyanate and/or increased adrenergic stimulation of the thyroid gland in smokers. PMID- 3978835 TI - Determination of the frequency of pulsatile luteinizing hormone secretion by time series analysis. AB - Statistical methods of time series analysis, in particular, spectral analysis, have been used to determine the pulse frequency of LH secretion. This method can detect significant harmonic variation within the data. Six normal women in the early follicular phase of the menstrual cycle were studied at 5 and 15 min sampling intervals and significant dominant pulse frequencies were revealed in five subjects (51-120 min). In addition, a low frequency variation (greater than 6 h) was revealed in four subjects and more rapid frequencies (20 and 13.3 min) were seen clearly in one subject. Comparison of repeat studies on four individuals at the same stage of different menstrual cycles and on two individuals in the same cycle failed to demonstrate differences in five of the six subjects. This method of analysis offers a new approach to the analysis of LH pulse frequency. Realistic comparisons of this frequency between and within individuals can now be made. A new observation of superimposed harmonic components of LH pulsatility has also been recorded. PMID- 3978836 TI - De novo t(4;5)(q3100;q2200) with del(5)(q1500q2200). Tentative delineation of a 5q monosomy syndrome and assignment of the critical segment. AB - An 8-month-old boy with multiple malformations and psychomotor retardation was found to have a de novo t(4;5)(q1300;q2200) with del(5)(q1500q2200). The phenotypical comparison with 10 similar monosomic cases from the literature led us to tentatively delineate a 5q monosomy syndrome and to postulate the band 5q15 as the correspondent critical segment. PMID- 3978837 TI - Biochemical studies in Niemann-Pick disease. III. In vitro and in vivo assays of sphingomyelin degradation in cultured skin fibroblasts and amniotic fluid cells for the diagnosis of the various forms of the disease. AB - Sphingomyelinase activities were assayed in vitro in cultured skin fibroblasts of 61 patients with Niemann-Pick disease (NPD). Residual activities found in type A and B were 1% and 4%, respectively, of the mean control values, i.e. significantly higher in type B. In 27 cases with NPD type C, the mean activity was 42% of that in controls, with residual activities ranging from 15% up to normal. Fifteen pregnancies at risk for NPD type A and B were monitored; 4 affected foetuses were found. The uptake of exogenously added radiolabelled sphingomyelin by cultured cells and metabolism of the choline moiety of this lipid were studied in 35 patients with NPD and 14 controls. No difference of uptake between normal and mutant cells was observed. Normally, 77 +/- 5% of the radioactivity taken up was converted to phosphatidylcholine after 18 h incubation, compared to 5 +/- 2% (n = 7) in NPD type A. A substantially greater hydrolysis (31 +/- 12%; n = 8) occurred in NPD type B, and the test allowed complete discrimination between these two types. In NPD type C, 16 patients showed an abnormally low rate of intracellular sphingomyelin degradation (48 +/- 5%) while 4 others were not distinguishable from controls. There was a correlation (r = 0.76) between the results of the in vitro and in vivo assays, but also between the severity of the clinical symptoms and the impairment in sphingomyelin degradation. For the diagnosis of NPD type C, the in vivo test gave more reproducible and more clearcut results than the in vitro assay. PMID- 3978838 TI - Sister chromatid exchange with and without in vitro mutagen induction in cultured skin fibroblasts from patients with adenomatosis of the colon and rectum. AB - Fibroblast cell strains were obtained from skin biopsies taken from patients with adenomatosis of the colon and rectum (ACR), and their relatives. A total of 50 different fibroblast strains were tested for their frequencies of sister chromatid exchange (SCE) in vitro. These strains included nine from patients with the Gardner syndrome, 21 from patients with non-Gardner ACR, and 20 cell strains from healthy relatives who were not at an increased risk for ACR. In 23 strains, the SCE frequencies after in vitro exposure to N-methyl-N'-nitro-N-nitroso guanidine (MNNG) were also determined. Both with and without MNNG induction, SCE values in the Gardner strains were found to be significantly higher than in the control strains (p less than 0.02 and p less than 0.03, respectively). Non Gardner ACR strains differed only slightly from controls, thus making the difference between the control group and the pooled Gardner + non-Gardner ACR group not significant. In all groups, there was a significant increase in SCE after MNNG exposure, and those strains which had low SCE values spontaneously, also tended to have relatively moderate SCE values after MNNG induction. There was no significant difference between the ratios of SCE values with and without MNNG exposure in the different groups. PMID- 3978839 TI - Survival in trisomy 18. Life tables for use in genetic counselling and clinical paediatrics. AB - Clinical management of neonates with Trisomy 18 depends on a knowledge of life expectancy. True estimates of potential life span are required for genetic counselling purposes when parents interpret the genetic threat, not only in terms of the mathematical odds involved, but also in terms of the quality and length of life of an affected infant, should such be born. This paper reports the findings from a study to generate life tables for Trisomy 18. This study is a total population study over 10 years based on a primary population of 2.2 million. Forty-eight cases of Trisomy 18 were identified, five at amniocentesis. Four of the 43 clinical cases (9%) were mosaics. The median life expectancy for live-born infants was five days (range one hour to 18 months). Mean age at death was 48 days. Life tables, by sex and by sub-types (associated congenital abnormalities) are presented. The annual incidence is 14 per 100,000 total births, with a prevalence estimate of 0.06 per 100,000 total population. PMID- 3978840 TI - Genetic counseling for autosomal dominant diseases with a negative family history. AB - The first appearance of an autosomal dominant disease in a family is often attributed to new mutation, and the parents may be given a very low risk of recurrence for future offspring. This counseling is not appropriate if penetrance of the disease is incomplete and the reproductive fitness of affected individuals is close to normal. The risk of recurrence (PR) for an autosomal dominant disease in the sibling of an affected child, neither of whose parents is affected, may be estimated as: (Formula: see text) where f is fitness of the carrier genotype regardless of phenotype, y is penetrance, and mutation-selection equilibrium is assumed to exist. Recurrence risks have been calculated with this formula for various values of f and y. In cases in which penetrance is moderate and fitness is moderate or high, the risk of recurrence in siblings of the proband is often greater than 10%. When fitness is very high (f greater than 0.9), the risk to siblings may be greater than 25%. These observations have important implications for genetic counseling and may also affect mutation rate calculations, demonstration of paternal age effects, and determination of inheritance patterns in genetically heterogeneous conditions. PMID- 3978841 TI - A new nail dysplasia syndrome with onychonychia and absence and/or hypoplasia of distal phalanges. AB - A family in which two generations have a rare and previously undescribed form of nail dysplasia with bone abnormalities is reported. This disorder is characterized by onychodystrophy, anonychia, brachydactyly of the fifth digit of the hands, and digitalization of the thumbs, with absence and/or hypoplasia of the distal phalanges of the hands and feet. The probable mode of transmission is autosomal dominant. PMID- 3978842 TI - Trisomy 10 mosaicism in a newborn boy; delineation of the syndrome. AB - The fifth case of trisomy 10 mosaicism is presented. Only in cultured fibroblasts this mosaicism was found, while peripheral lymphocytes revealed a normal karyotype. In comparison with the literature, trisomy 10 mosaicism syndrome is further delineated compromising of failure to thrive, high forehead, hypertelorism, mongoloid eye slant, blepharophimosis, dysplastic, large ears, retrognathia, long slender trunk, marked plantar and palmar furrows, cardiopathy and early death. PMID- 3978843 TI - Karsch-Neugebauer syndrome: split foot/split hand and congenital nystagmus. AB - A family with four members with split foot/split hand malformations and congenital nystagmus is described. The clinical characteristics in this family correspond to those seen in two other families previously reported. Taken together, these three families suggest that a single, pleiotropic dominant gene is causal. Karsch-Neugebauer syndrome is suggested as an appropriate eponymic designation for this disorder. PMID- 3978844 TI - Frequency of the fragile X syndrome in infantile autism. A Swedish multicenter study. AB - In a Swedish multicenter study, 102 cases of infantile autism (I.A.) were examined for fragile X (q27). The fragile X syndrome was observed in 13 of the 83 (16%) boys with I.A., but in none of the 19 girls with I.A. PMID- 3978845 TI - Dermatoglyphic findings in patients with fragile X-chromosome. AB - Finger- and palmar prints of hemi- and heterozygote fragile X-patients with mental retardation (10 males and 5 females) were compared to dermatoglyphic findings in 20 mentally retarded patients (10 males and 10 females) without fragile X and to 200 healthy unrelated persons (100 males and 100 females). Characteristic whorls and double-loops with high ridge-counts on finger-tips and a pronounced transversal course of palmar ridges were restricted to males with fragile X. Female carriers of fragile X showed, corresponding to male patients, some abnormalities of the digital- and palmar ridge-pattern. Contrary to males, in carriers as well as in mentally retarded females without fragile X, fingerprints with low ridge-counts were found. Common to all mentally retarded patients, but more pronounced in males with fragile X, abnormal palmar creases and hand-measurements were observed. These findings probably are related to prenatal retarded growth of the length of the palma and of the middle-finger. PMID- 3978846 TI - Oral and dental development in X chromosome aneuploidy. AB - Though frequently noted, orofacial anomalies in poly X syndromes have been seldom reviewed. In a study of patients with an X chromosome aneuploidy (XXXXX, XXXX, XXXXY, XXXY) the following facial and dental defects were found to be characteristic features of these syndromes: mainly bifid uvula and macroglossia, enamel defects, dental taurodontism and abnormal roots. These observations are discussed in the light of the possible role of X-linked genes. PMID- 3978847 TI - Studies on human low serum IgD phenotype and Gm markers. AB - The human "low serum IgD phenotype" was studied by simultaneous Gm typing and IgD immunoassay of several populations. An association between Gm (f+b+) haplotype and low human IgD was confirmed and extended to the "low serum IgD phenotype"--as defined from population distribution and genetic studies by Dunnette et al. 1978. Further, it was shown that Black American sera determined by Gm haplotype, had a similar percentage of "low serum IgD phenotype" samples (16%) although they lacked the "associated" Gm(f+b+) haplotype of White American samples. Sardinian sera showed a low incidence of the "low serum IgD phenotype" which was not correlated with Gm haplotype distribution. Familial aggregation of the "low serum IgD phenotype" was observed. No association was found between "low serum IgD phenotype" and serum IgE values. Age related abiotrophy of IgD could not be attributed to selective survival of "low serum IgD phenotype" persons. PMID- 3978848 TI - Semiautomated chromosome analysis. A clinical test. AB - An interactive system for semiautomated chromosome analysis, consisting of a high speed image processor with light-pen, TV monitor and key-board interfaced to a microscope with motorized scanning stage and video-camera and to a hard-copy printer, has been clinically tested for twenty consecutive working days. Metaphase search takes place over night. Identified metaphases are ranked automatically according to their suitability for analysis. Less than every second metaphase found cannot be either counted or analysed. 164 samples were analysed. Only one was not completed. Two numerical and two structural abnormalities were identified and clinical consequences taken. Average time per completed analysis (10 counts, four karyotypes) were 37.5 min (28-84). Average time varied between technicians. In another test including 120 metaphases and 40 karyotypes average time for counting the chromosomes of a metaphase was 37 sec. (28-48), and average time for producing one karyotype, including a hard-copy was 4 min 30 sec (3 min 43 sec-5 min 54 sec). Number of manual interactions was 8 (2-17) and 36 (25-61), respectively. Although improvements are possible, the system is able to at least double the output of four cytogenetic technicians. PMID- 3978849 TI - Effect of balanced X/autosome translocations on sexual and physical development. A personal experience in 4 patients. AB - Four different balanced X/autosome translocations: 46,X,t(X;9)(p11;q13); 46,X,t(X;12) (p11;q12); 46,X,t(X;15)(q12;p11) and 46,X,t(X;19)(q26;p12) are described in four female patients. The effect of X/autosome translocations on physical and sexual development of these women and their offspring is discussed. PMID- 3978851 TI - Familial nevus flammeus of the forehead and Unna's nevus. AB - A familial nevus flammeus of the forehead associated with Unna's nevus is described. The pedigree suggests an autosomal dominant mode of inheritance. PMID- 3978850 TI - A distinct variant of intermediate maple syrup urine disease. AB - Branched chain alpha-ketoacid dehydrogenase (BCKAD) deficiency, or maple syrup urine disease (MSUD), can be categorized as classical, intermediate, intermittent or thiamine responsive, based on generally concordant in vitro BCKAD activity and severity of phenotype. We present clinical and enzymatic data on a boy with intermediate maple syrup urine disease, and suggest that he represents a novel category of mutation. He presented at age 10 months in ketoacidotic coma, with a history of irritability, poor feeding and growth and developmental delay. Branched chain amino acid restriction effected normal growth and developmental parameters by age 42 months. In contrast to previous patients with intermediate MSUD, his fibroblasts and fibroblast extracts failed to decarboxylate [1-14C] alpha-ketoisovalerate (KIV). The defect is not in mitochondrial transport of substrate, but rather in the catalytic activity of the E1 component of the BCKAD. Disrupted cells of the proband exhibited negligible BCKAD activity over a wide range of keto acid substrate concentrations, irrespective of the presence of added thiamine pyrophosphate (TPP). These results differ from the sigmoidal kinetics observed using classical MSUD extracts, and the hyperbolic kinetics with control preparations under the same assay conditions. We propose that the structurally altered enzyme possesses reduced but not negligible activity in vivo, and exists as an unstable complex in vitro under assay conditions used, even in the presence of added TPP. PMID- 3978852 TI - Tetraploidy in two sisters with the polycystic ovary syndrome. PMID- 3978854 TI - Decreased scattering coefficient of blue sclerae. AB - The optical scattering properties of blue and normal sclerae were studied with a fiber optic scattering monitor. The scattering was clearly reduced in two osteogenesis imperfecta patients with blue sclerae, and low normal in one osteogenesis imperfecta patient without blue sclerae. PMID- 3978853 TI - Diploid-tetraploid mosaicism in a malformed boy. AB - In a mentally retarded and malformed boy who is two years old, a diploid tetraploid mosaicism was identified by G-banding. Clinical and cytogenetical findings are discussed. PMID- 3978855 TI - The dysequilibrium syndrome: a study of the etiology and pathogenesis. AB - The optimality of prenatal and perinatal conditions, serum levels of radioreceptor-assayable somatomedins and activity of catechol-0-methyltransferase in erythrocytes were examined in 13 dysequilibrium (DES) patients. No differences from normal controls were found. As a group, the DES patients were not more exposed to non-optimal prenatal and perinatal events than healthy controls. No association between DES and somatomedin levels or between DES and catechol-0 methyltransferase activity was demonstrated. PMID- 3978856 TI - Supraumbilical midabdominal raphe and facial cavernous hemangiomas. AB - A 7-week-old Japanese female infant with supraumbilical midabdominal raphe and cavernous hemangiomas of the face is described. The combination of malformations in the infant, together with that in two infants previously reported from Germany, constitutes a clinical entity. PMID- 3978857 TI - Ethical aspects of medical genetics. A proposal for guidelines in genetic counseling, prenatal diagnosis and screening. PMID- 3978858 TI - The human gene map 1 December 1984. PMID- 3978859 TI - Natural killer cell function in atopic dermatitis. PMID- 3978860 TI - Chemical components of jelly-like matrix in digital mucous cyst. PMID- 3978861 TI - Clonal evolution in cutaneous malignant histiocytosis. PMID- 3978863 TI - Necrobiosis lipoidica in two diabetic sisters. PMID- 3978862 TI - Leucoderma induced by monomethyl ether of hydroquinone. PMID- 3978864 TI - Epidermolysis bullosa acquisita associated with chronic lymphatic leukaemia. PMID- 3978865 TI - Porphyria cutanea tarda and porphyria variegata unmasked by viral hepatitis. PMID- 3978866 TI - Dermatomyositis and lichen planus--an association or manifestation? PMID- 3978867 TI - Has REM syndrome a viral background? PMID- 3978868 TI - Pruritus and atopy in Asians. PMID- 3978869 TI - Papular urticaria caused by Dermestes maculatus Degeer. PMID- 3978870 TI - HLA antigens in lichen sclerosus et atrophicus. PMID- 3978871 TI - Vulnerability of the skin to surfactants in different groups of eczema patients and controls as measured by water vapour loss. PMID- 3978872 TI - Complement activating properties of complexes containing rheumatoid factor in synovial fluids and sera from patients with rheumatoid arthritis. AB - The relationship between complexes containing rheumatoid factor and complexes activating complement was examined in synovial fluids and sera from patients with rheumatoid arthritis (RA). In each case this was performed by quantifying the amount of rheumatoid factor bound by solid phase Fab'2 anti-C3 and/or solid phase conglutinin. Both anti-C3 coated and conglutinin coated microtitre plates bound high levels of complexes containing rheumatoid factor from sera of RA patients with vasculitis. Unexpectedly, these complexes were detected in synovial fluids from only a minority of RA patients with synovitis. However, RA synovial fluids did contain other complexes as shown by the presence of complement consuming activity, C1q binding material and immunoglobulin attaching to conglutinin. It is considered that in RA synovial fluids the complexes containing RF and those activating complement are not necessarily the same whilst in vasculitic sera the complexes containing rheumatoid factor also activate complement. PMID- 3978873 TI - Differential suppressive influence of intranasal application of rye grass pollen extract on IgE antibody production in the mouse. AB - Serum antibody responses to a ubiquitous aero-allergen, rye grass pollen extract, have been monitored in BALB/c and BD1 mice following intranasal and parenteral administration. Parenteral treatments were shown to trigger antibody production while topical administration of low doses of allergen extract preferentially suppressed reaginic antibody production. However, higher doses of extract administered to the respiratory tract were found to induce the formation of IgE antibody. Thus in mice antigen administered intranasally can influence the immune response in a qualitatively different manner to parenteral exposure. PMID- 3978874 TI - Induction of non-IgE anaphylactic antibodies in dogs. AB - Dogs immunized with o-DNCP-BSA or eggs of Toxocara canis developed anaphylactic antibodies other than IgE. The antibodies were heat-resistant at 56 degrees C for 2 hours, not reduced by 2-mercaptoethanol and PCA and P-K reactivity was only observed at 3-4 h sensitized sites of recipient skin. High titres of antigen specific IgGd were determined by means of an ELISA technique. PMID- 3978875 TI - Allergen specific IgGd antibodies in dogs with atopic dermatitis as determined by the enzyme linked immunosorbent assay (ELISA). AB - Allergen specific IgGd antibodies were detected by the enzyme linked immunosorbent assay (ELISA) in 89% of the 62 atopic dogs studied. Antibodies were found most frequently against house dust (47%), human dander (50%), grass pollens (58%) and spring tree pollens (43%). These antibodies were also found in 11 of 20 dogs with atopic symptoms but without immediate skin test reactivity to inhalant allergens. Agreement between the presence of skin reactivity and allergen specific IgGd titres ranged from one of 14 for cat dander to 22 of 34 for house dust. Among dogs with atopic symptoms but without skin test reactivity and specific IgGd titres to the respective allergens, the agreement varied between 28 of 54 for human dander and 67 of 68 for cat dander. In view of the value of the dog as an experimental model of atopic disease in man, further studies of the pathophysiological significance of IgGd antibodies are warranted. In addition, reconsideration of the diagnostic criteria for canine atopic dermatitis, as done by Hanifin & Rajka (1980) in man, seems indicated. PMID- 3978876 TI - New lymphokines produced by SLE sera stimulated lymphocytes: the PNAF (polymorphonuclear activating factors). AB - Twenty-two SLE sera were assessed for their stimulating properties for lymphocytes. After fixation of specific serum factors, lymphocyte cultures were performed and supernatants of 24, 48, 72 and 96 h tested on two polymorphonuclear functions: chemotaxis and cyanide insensitive O2 consumption; 20 out of 22 SLE sera supernatants led to enhanced chemotaxis. The factors involved were not destroyed by heating for 30 min at 56 degrees C. Fifteen of the SLE sera supernatants increased the O2 consumption by PN. In most cases this second mediator was destroyed by heating. The buffer, the normal sera, the monoclonal antibodies stimulated lymphocytes supernatants and the total lymphocyte lysate did not display such enhancing activities. So it clearly appears that SLE sera contain factors acting on lymphocyte membrane and induce them to secrete new lymphokines called PNAF (polymorphonuclear activating factors) which may play a role in pathogenesis of tissue lesions in SLE. PMID- 3978877 TI - A simple method for electronic counting of rosette forming human blood lymphocytes. AB - We investigated the possibility of using a standard electronic laboratory cell counter, of a type which permits manual settings of discriminator and sensitivity levels, for the quantitation of E rosette forming human blood lymphocytes. The electronic counting was performed on rosette specimens prepared from 10 healthy donors, nine lymphoma patients and eight patients with chronic lymphocytic leukaemia (CLL) of B cell type. The simple procedure which was earlier developed for the electronic counting of thymocyte rosettes in guinea-pigs was used and now supplemented with a method for rapid, graphical determination of rosette frequency. The low level of E rosettes in CLL patients was easily distinguished from the higher level seen in the other groups and there was a good agreement between electronic and visual determinations. In samples with a high rosette frequency, the cell counter initially gave 10-30% lower values than when recorded visually. This discrepancy was corrected, however, by a minor adjustment of discriminator level and the introduction of a correction procedure for the presence of double rosettes. We conclude that the electronic counter can well be used for the counting of human rosette forming blood lymphocytes and, due to a high precision and large capacity, this approach would prove to be useful when screening of a large number of samples is required. PMID- 3978878 TI - Body composition and nutritional status in patients on continuous ambulatory peritoneal dialysis (CAPD). AB - Total body water (TBW), extracellular water (ECW), exchangeable potassium pool (EKP), and alkali-soluble nitrogen in skeletal muscle tissue (N) were determined in 9 CAPD patients on treatment from 5 to 14 months (mean 8.6 months). The parameters were reevaluated in 6 of these patients 5 to 13 months later (mean 8.6 months). The mean value of TBW was normal and directly correlated to body weight (BW), but TBW was abnormally distributed between extracellular and intracellular space. ECW volume was significantly lower than the predicted value (12.1 +/- 1.4 versus 16.8 +/- 1.9 l) and out of proportion to TBW (34.8 +/- 3.9% versus 47.8 +/ 1.5%). The calculated intracellular water, therefore, appeared clearly hyperexpanded. The mean value of EKP was slightly reduced, but in three patients there was a 25% reduction. N content was low in 5 out of 9 patients. When the parameters were re-evaluated BW and TBW were unchanged in two subjects. A third patient showed a simultaneous increase in both BW (12.7%) and TBW (19%). TBW variations (+19%, -23%, -24%) without changes in BW were seen in three patients. The mean value of EKP was unchanged, but there was a 25% reduction in one patient. N content improved in two and worsened in one of the three patients in whom it was determined. The data suggest that cell overhydration was the distinctive feature in our CAPD patients, and that the evolution of the nutritional status was variable, since the patients could remain stable, gain or loose body fat, and probably change their lean body mass. PMID- 3978879 TI - Membranous glomerulonephritis associated with hepatitis B antigen in children: a comparison with idiopathic membranous glomerulonephritis. AB - The laboratory and pathological findings are reported for 16 children with membranous glomerulonephritis (MGN) associated with hepatitis B virus (HBV) infection and compared with those of 12 children with idiopathic MGN. Serum hepatitis B surface antigen (HBsAg) was found in all children with HBV associated MGN and serum hepatitis B e antigen (HBeAg) in 11 of the 15 examined. Five patients with HBV associated MGN, but none with idiopathic MGN, showed reduced serum C3 values. Otherwise there was no difference in laboratory findings. HBeAg was detected in the glomeruli of all 7 patients with HBV-associated MGN examined but HBsAg was not detected. Of the 14 children with HBV-associated MGN examined by electron microscopy, all but one showed small mesangial deposits and 4 subendothelial deposits, whereas of 9 with idiopathic MGN only 2 showed mesangial deposits and none subendothelial deposits. Thus most of the children with HBV associated MGN are characterized by some laboratory and pathological features of membrano proliferative glomerulonephritis in addition to those of idiopathic MGN. These observations are consistent with HBV inducing a spectrum of glomerulopathy from typical MGN to typical membranoproliferative glomerulonephritis. PMID- 3978880 TI - Spontaneous remissions in frequently relapsing and steroid dependent idiopathic nephrotic syndrome. AB - We studied retrospectively the clinical course of 32 steroid sensitive nephrotic children with frequent relapses with or without steroid dependency associated with minimal glomerular lesions. Six hundred twenty-seven relapses were traced during a mean observation period of 7 years per patient. The median period between the beginning of significant proteinuria and the start of prednisone therapy was 5 days (range 0-194 days). At least one spontaneous remission occurred in 10 of the 15 frequent relapsers and in 11 of the 17 steroid dependent patients. Twenty-three percent of the relapses in frequent relapsers and 10% of the relapses in steroid dependent patients remitted spontaneously. The disappearance of proteinuria was documented in 79% of these relapses between day 4 and day 14 after onset. A delay of up to 10 days in starting prednisone therapy did not influence the further course of this or the subsequent relapse. Our results suggest that this delay is justified in the absence of progressive clinical signs and may, by the occurrence of spontaneous remissions, contribute to reduce the total amount of steroids needed. PMID- 3978881 TI - Treatment of arterial hypertension with nifedipine in patients with chronic renal insufficiency. AB - The acute and chronic antihypertensive effects of nifedipine were investigated in patients with chronic renal insufficiency (CRI). The acute effects were assessed after the administration either of a fast-release nifedipine capsule or a slow release nifedipine tablet in 10 and 15 patients respectively. Both the preparations induced prompt and marked reduction of systolic and of diastolic blood pressure, but the capsules showed a shorter antihypertensive effect (2 hours) than tablets (more than 6 hours). The chronic effects of nifedipine tablets given in addition to the previous therapy was assessed in 25 patients with CRI and resistant hypertension. Both systolic and diastolic blood pressure values promptly fell and maintained within the normal range over the whole period of the study (12 months). PMID- 3978882 TI - Hemolytic uremic syndrome in siblings. PMID- 3978883 TI - Vitamin C and iron overload in a chronic hemodialysis patient. PMID- 3978884 TI - Interaction of chronic cigarette and ethanol use on myocardium. AB - Chronic cigarette use is common in persons who habitually use other cardioactive agents that have been causally associated with heart disease. This study was undertaken to determine if cigarette use intensifies the abnormalities of myocardial function and composition observed in experimental alcoholism over an 18-month period. Young adult male beagles with tracheostomy were divided into four groups. There were 10 controls (group 1); 9 smoked seven cigarettes per day (group 2); 7 were fed ethanol as 20% of calories (group 3), and 6 received both ethanol and cigarettes (group 4). After a period of 18 months, left ventricular function was assessed under anesthesia. Heart rate, left ventricular end diastolic pressures, and volumes (indicator dilution) did not differ in the four groups. An index of contractility derived by normalizing peak dP/dt for pre- and afterload was reduced significantly below the level of 2.41 +/- 0.7 cm/s in controls to 1.41 +/- 0.35 in group 2, 1.19 +/- 0.38 in group 3, and 1.28 +/- 0.17 in the ethanol cigarette group (each p less than 0.002). Arterial pressures were moderately elevated above group 1 in all three experimental groups without evidence of left ventricular hypertrophy. In contrast to smoking, which elicited no abnormalities of myocardial cation composition, ethanol reduced myocardial potassium and sodium in group 3 without a gain of water content. In group 4, no further decline of tissue cations was observed. Thus, cigarette use when combined with ethanol over a relatively long period produced no greater myocardial abnormalities than ethanol alone and may not be essential to the genesis of cardiomyopathy in alcoholics. PMID- 3978885 TI - The relationship between the electrocardiographically estimated infarct size and 1- and 2-year survival in acute myocardial infarction. AB - In 587 patients with acute myocardial infarction (AMI) and no previous MI, electrocardiographically estimated infarct size was related to 1- and 2-year mortality. The overall mortality was higher in patients with transmural MI (Q- or R-wave changes in standard ECG) than in patients with subendocardial infarction (ST-T-wave changes in standard ECG) after 1 year (18.8% compared to 6.5% p less than 0.001) and after 2 years (22.2% compared to 13.8%, p = 0.049). When patients who were alive during primary hospitalization were analyzed separately, slightly higher mortality was found in patients with transmural MI than in subendocardial MI after 1 year (9.6% compared to 4.2%, p = 0.076) while no difference was found after 2 years (13.4% as compared to 11.7%, p greater than 0.2). In a subgroup of patients with anterior MI, precordial mapping with 24 chest leads was analyzed 4 days after arrival in hospital (n = 197). Patients were divided into quartiles according to the sum of R waves, the sum of Q waves, and the number of Q waves. There was a similar overall mortality in each quartile after 1 year and after 2 years regardless of ECG parameters studied. Neither did we find any correlation between the sum of R waves in leads II, III, and aVF on the fourth day in patients with inferior MI and overall 1- or 2-year mortality rate, although there was a trend towards higher mortality with more ECG changes. PMID- 3978886 TI - Myocardial infarction and the weather: a significant positive correlation between the onset of heart infarct and 28 KHz atmospherics--a pilot study. AB - The date of occurrence of a heart infarct was tabulated for 162 patients admitted to four Munich clinics with cardiology departments from January 1 to July 31, 1981. This occurrence calendar was correlated with the daily average density of 28 KHz and 10 KHz atmospheric (atm) impulses and several classic weather parameters. The occurrence of heart infarcts has a certain positive correlation with the increased appearance of "pure" 28 KHz impulses, the correlation with 10 KHz impulses is very slight. Among the classic weather parameters, the average daily humidity has the highest negative correlation coefficient. PMID- 3978887 TI - Combined administration of propranolol and quinidine in the conversion of paroxysmal atrial fibrillation. AB - Quinidine was combined with propranolol to restore sinus rhythm in cases of paroxysmal atrial fibrillation (PAF) in 42 patients. The treatment was started with propranolol and quinidine at a test oral dose of 10 mg and 0.2 g, respectively, thereafter a dose of 0.4 g of quinidine and 10 mg of propranolol every two hours was added. The procedure was stopped when sinus rhythm was achieved, or when the administered quinidine reached the total dose of 1.6 g. Sinus rhythm was restored in 37 patients. The side effects were gastrointestinal disorders in 16 patients, atypical ventricular tachycardia in one case, and embolism of the left femoral artery in another patient. PMID- 3978888 TI - Pentoxifylline treatment of moderate to severe chronic occlusive arterial disease. AB - A pilot study of the effects of pentoxifylline in 19 patients with moderate to severe chronic occlusive arterial disease (COAD) is described. The severity of disease was assessed by the degree of limitation in the walking distance on the flat surface (less than 100 m), the absence of peripheral pulses on palpation, the diminished Doppler tibial/brachial pressure (the ischemic index) at rest, and by contrast arteriography, when available. After a 2-week washout phase, all subjects received pentoxifylline (1200 mg/day) in an open-label manner for a total of 12 weeks. Twelve of the nineteen patients showed a definite increase in exercise tolerance by the end of the study, with a concomitant reduction in ischemic symptoms. All except 3 patients felt they had derived benefit from the medication. In contrast to the clear improvements in walking distance and symptoms, only small effects on noninvasive vascular laboratory measurements were noted. Platelet aggregation, induced by ADP, epinephrine, and collagen, gradually decreased over the study period. Pentoxifylline appears to be useful in the medical management of patients with moderate to severe chronic occlusive arterial disease; future controlled trials in such patients are now justified. PMID- 3978889 TI - Recurrent nontraumatic aortic tears resulting in valvular avulsion and aortic insufficiency. AB - A case of aortic insufficiency due to avulsion of two of three semilunar valves was remarkable because of the intimal and medial tears which caused it. The tears were in different stages of repair, suggesting repetitive injury. Antemortem steroid therapy and bouts of violent coughing may explain these unusual findings. PMID- 3978890 TI - The differential diagnosis of osteoporosis in post-menopausal women. PMID- 3978891 TI - Immune complexes and autoantibodies in patients with giant cell arteritis and their relationship with autologous rosette-forming cells. AB - Serologic studies and lymphocyte analysis were carried out in 29 patients with giant cell arteritis (GCA). IgA-containing circulating immune complexes (CIC) were detected in 16 GCA patients with or without polymyalgia rheumatica (55%). A significant difference was demonstrated in autologous rosette-forming cells between the patients as a whole, and matched controls (8.6 +/- 2.0 vs 11.6 +/- 2.4, p less than 0.001), and also between patients with and patients without CIC (7.9 +/- 1.6 vs 9.4 +/- 2.0, p less than 0.001). PMID- 3978892 TI - Intravertebral vacuum cleft: notes on five cases. AB - Analysis of five personal cases of the intravertebral vacuum cleft phenomenon and a close examination of the literature, suggest that it is rather more frequent than it first appears. Intravertebral vacuum cleft tends to occur more readily in the vertebrae of the dorsolumbar hinge and mainly in the elderly, slightly more common in women than men. The main factors, from the pathogenetic point of view, are osteoporosis, a history of trauma and frequent occurrence of rheumatic problems which are often complicated by vasculitis. The comparison between excessive uptake of calcium-mimetic technetium and uptake deficit of technetium phytate by the vertebra with a vacuum cleft, leads us to consider it as an expression of osteo and bone marrow necrosis. PMID- 3978893 TI - Type IV hyperlipoproteinemia in patients with algodystrophy. AB - The present work studies lipid metabolism in patients with algodystrophy (AD). A correct positive correlation (r = 0.75) between the triglyceride levels and low density lipoprotein (LDL)/very low density lipoprotein (VLDL) ratio and the VLDL increase observed by gel disk electrophoresis confirm that a type IV hyperlipoproteinemia is associated with AD. In contrast, the degree of high density lipoprotein (HDL) saturation in cholesterol (HDL-cholesterol/HDL phospholipids) and the classical atherogenous index (cholesterol/HDL-cholesterol) were not modified. The decrease of plasma post-heparin lipolytic activities (PHLA) was not significant but further studies should be performed to correlate PHLA with a reduced activity of the adipose tissue lipoprotein lipase. PMID- 3978895 TI - Inhibition of in vivo leucocyte migration by NSAIDs. AB - Leucocyte migration was studied in vivo using a skin window technique, and in vitro by migration under agarose. No difference was found between 28 patients with rheumatoid arthritis (RA), 10 patients with psoriatic arthritis (PA) and 30 healthy controls. Most patients were under treatment with anti-rheumatic drugs. Patients treated with non-steroidal anti-inflammatory drugs (NSAIDs) had significantly lower values (p less than 0.01) than untreated patients. In vivo but not in vitro migration decreased during short-term treatment with diclofenac and naproxen, an effect observed both in patients and in healthy individuals. After pre-incubation of normal polymorphonuclear leucocytes with diclofenac, in vitro migration was diminished only at concentrations of 50 micrograms/ml and above, which are at least 10 times higher than those attained clinically. The in vivo effect of NSAIDs on leucocyte migration may imply a long-term disease modifying influence in chronic arthritides. PMID- 3978894 TI - Measurements of red blood cell methotrexate concentrations and lymphocyte subsets during therapy of rheumatoid arthritis. AB - Nine patients with rheumatoid arthritis were treated with low dose oral weekly methotrexate for 6 months. Successful therapy was not associated with changes in concentrations of total circulating lymphocytes nor with alterations of T lymphocytes in the helper-inducer, OKT4, or cytotoxic-suppressor, OKT8, subpopulations. Concentrations of methotrexate in circulating erythrocytes stabilized by 1 month of therapy and this measurement did not correlate with clinical efficacy or methotrexate toxicity in the long-term patient assessments. PMID- 3978896 TI - Indoprofen in juvenile chronic arthritis. AB - Indoprofen at 10-12 mg/kg body weight was compared with aloxiprin at 80 mg/kg body weight in children suffering from juvenile chronic arthritis. Indoprofen was significantly superior to aloxiprin in reducing soft tissue swelling and joint limitation and was effective in relieving pain and morning slowness and improving grip strength. The drug was well tolerated and is a satisfactory agent for the treatment of chronic arthritis in children. PMID- 3978897 TI - Sjogren's syndrome and Crohn's disease. AB - Sjogren's syndrome has been associated with many of the disorders in which autoimmunity is considered likely to play a major role in pathogenesis. To date, no such association has been reported with Crohn's disease. A case where this association has been observed is reported here. In the absence of other known primary causes of Sjogren's syndrome, the features of this case are suggestive of a direct relationship between these disorders. PMID- 3978898 TI - Unusual erosive osteoarthropathy of a single midcarpal joint. PMID- 3978899 TI - The role of collagen fibrils in the pathogenesis of osteoarthrosis. PMID- 3978900 TI - Primitive neuroectodermal tumors including the medulloblastoma: glial differentiation signaled by immunoreactivity for GFAP is restricted to the pure desmoplastic medulloblastoma ("arachnoidal sarcoma of the cerebellum"). AB - Immunoreactivity of tumor cells for glial fibrillary acidic protein (GFAP) is usually regarded as sign of astrocytic histogenesis and/or differentiation. The present study aimed at a systematic evaluation of the significance of GFAP containing cells in primitive neuroectodermal tumors (PNETs) with special reference to the controversial entity of desmoplastic medulloblastoma (so-called "circumscribed arachnoidal sarcoma of the cerebellum"). Fifty-three PNETs, including 17 pure desmoplastic medulloblastomas were investigated, using GFAP antisera and the peroxidase-antiperoxidase (PAP) technique. Seventy percent of the pure desmoplastic medulloblastomas showed GFAP immunoreactive cells, in 47% indistinguishable from adjacent nonreacting tumor cells. Most immunoreacting cells were found in the reticulin free islands, showing in 6 cases a gradual transition of immunoreacting cells from tumor cells to larger cells shaped like astrocytes. The classical medulloblastomas showed only larger immunoreacting cells which were interpreted as reactive astrocytes. Therefore, the so-called circumscribed arachnoidal cerebellar sarcoma or pure desmoplastic medulloblastoma merits a separate place in the group of PNETs as a tumor with frequent signs of astroglial differentiation; this interpretation appears to be clinically correlated by a difference in age incidence and prognosis of that special tumor type in comparison with classical medulloblastoma. PMID- 3978901 TI - Extensive organization in a thrombosed giant intracranial aneurysm: case report. AB - A 58-year-old man presented with a 4-month history of personality changes and transient episodes of right lower extremity weakness, as well as transient episodes of aphasia. Computerized tomography revealed a large basal frontotemporal mass with extensive surrounding edema which was confirmed on angiography to be a partially thrombosed giant aneurysm. Pathologically, the lesion was extraordinary, demonstrating extensive organization, with the entire cavity of the aneurysm occupied by vascular channels of different sizes, some of which were thrombosed. These findings were substantiated by scanning electron microscopy which also illustrated areas of active platelet-fibrin interaction on the remaining luminal surface. PMID- 3978902 TI - Symposium: Arthrogryposis multiplex congenita. PMID- 3978903 TI - Arthrogryposis. Pediatric review and habilitative aspects. AB - A precise diagnosis among the types of arthrogryposis must be made. For amyoplasia, the recurrence risk is nonexistent, the natural history favorable. During the first weeks, frequent stretching supported by maintenance casting and splinting of severe or generalized contractures is indicated in a residential multidisciplinary center. The key to deformity is the rigidity of the periarticular structures. With limb growth, contractures progress or recur. The growth years must therefore be dominated by physical management, which consists of stretching, casting, and bracing interspersed by staged soft-tissue procedures. At completion of limb growth, final corrections should be attained by osteotomies. Adolescence should be a time to follow social and prevocational pursuits in preparation for a place in society. PMID- 3978904 TI - Arthrogryposis multiplex congenita. A long-term follow-up study. AB - Most patients with arthrogryposis function well in adult life; however, many remain partially dependent upon others (parents, relatives, government subsidy). This dependency was more closely related to personality, education, and overall coping skills than to degree of physical deformity. Properly sequenced corrective surgical procedures are required to maximize musculoskeletal function. In addition to appropriate surgical correction, good family support, a proper educational environment, and promotion of independence at an early age are required to achieve maximal adult function. PMID- 3978905 TI - Hyponatremia after spinal fusion caused by inappropriate secretion of antidiuretic hormone (SIADH). AB - The Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) was found to occur in at least 5% of patients recovering from a spinal fusion operation. A retrospective review was undertaken for all patients who had had a spinal fusion in 1981. The author applied strict criteria for the diagnosis of SIADH and found that at least eight of 161 patients suffered this complication. A factor analysis revealed that SIADH was most likely to develop in patients with large spinal deformities and greater than usual intraoperative blood loss. There was no correlation with age, sex, type of fusion, or cause of spinal deformity. The diagnosis, treatment, and pathogenesis of SIADH suggest that an extensive spinal fusion operation is a previously unrecognized predisposing condition. PMID- 3978906 TI - Vertebral osteotomy for correction of kyphosis in ankylosing spondylitis. AB - Eleven patients with ankylosing spondylitis had severe disabling kyphosis with forward bending of the upper part of the spine. The kyphosis was corrected by osteotomy by removal of a wedge composed of the spinous processes and the neural arch of the second lumbar vertebra and by excision of bone from the inside of the posterior part of the vertebral body of L2. By hyperextending the spine, a wedge fracture occurs in the vertebral body, producing lordosis and correction of the deformity without an anterior opening of the lumbar discs. PMID- 3978907 TI - The roentgenographic evaluation of anterior shoulder instability. AB - Retrospective evaluations of roentgenograms of 83 patients with unilateral shoulder instability were surveyed to evaluate the usefulness of various radiographic projections and to correlate the information with the osseous pathology associated with prior glenohumeral dislocation. The Hill-Sachs and the osseous Bankart defects were considered pathognomonic radiographic signs of glenohumeral joint instability. Based on history, physical examination, and examination under general anesthesia, patients were divided into three categories -(1) dislocation group, (2) subluxation group, and (3) combination group. Roentgen projections evaluated included the anteroposterior view with the humerus in internal and external rotation, axillary view, West Point view, Stryker notch, and Didiee view. The Hill-Sachs defect on the posterolateral aspect of the humeral head was best demonstrated on the combination of an internal rotation and a Stryker notch view. The osseous Bankart defect on the anteroinferior glenoid rim was best documented on the Didiee and West Point views. The external rotation and axillary view did not add significantly to the preoperative radiographic findings. In a patient with an unstable shoulder, a radiographic series that includes an internal rotation, a Stryker notch view, and either a West Point or a Didiee view would maximize the diagnostic yield per radiographic cost, time, and exposure. PMID- 3978908 TI - Intratendinous tear of the supraspinatus tendon exhibiting winging of the scapula. A case report. AB - An intratendinous tear of the supraspinatus tendon without communication with the joint or with the subacromial bursa occurred in a 31-year-old man. Repair of the cuff relieved the pain and led to functional recovery. Although the true cause of the unusual pattern of limitation of motion caused by this lesion remains unclear, it was associated with reflex muscle spasm around the shoulder, which was provoked by pain originating in the subacromial bursa secondary to the cuff tear. No comparable case seems to have been documented in the literature. PMID- 3978909 TI - Sternocostoclavicular hyperostosis. A case report and review of the literature. AB - Sternocostoclavicular hyperostosis (SCCH) or intersternocostoclavicular ossification is a recently recognized disorder of unknown origin. SCCH is characterized by painful, condensing hypertrophy of the sternum, both clavicles, and the upper ribs. Since its original description by Sonozaki in 1974, approximately 40 cases have been reported, mainly in the Japanese literature. This peculiar hyperostotic syndrome is often misdiagnosed. The differentiation from osteitis deformans can be difficult. Clinically, the disease produces a swelling in the upper chest area with persistent, pulling pain exacerbated by cold and dampness. The condition is a nonspecific inflammatory syndrome. Radiographs usually show symmetric hyperostosis of the sternal portions of the clavicles, synostosis of the sternoclavicular joints, a thickened sternum, and varying degrees of involvement of the upper ribs and intercostoclavicular space. Biopsy specimens reveal hyperostotic sclerosis of the cancellous bone. Although the cause of the syndrome is unknown, clinical, radiologic, and histologic findings indicate that it represents a distinct entity. The treatment of SCCH remains symptomatic. PMID- 3978910 TI - An anomalous flexor digitorum superficialis muscle-tendon unit associated with ulnar neuropathy. A case report. AB - A previously undescribed accessory flexor digitorum superficialis muscle-tendon unit was discovered on surgical exploration of the wrist in an 18-year-old girl with symptoms of distal ulnar neuropathy and a volar soft-tissue mass. Excision of the muscle-tendon unit resulted in complete resolution of symptoms. The preoperative diagnosis of an accessory muscle is difficult, being commonly mistaken for synovitis, ganglia, or tumor. PMID- 3978911 TI - Gouty infiltration of a flexor tendon simulating rupture. AB - A 28-year-old hyperuricemic man injured his left long finger and presented with a possible rupture of the flexor digitorum profundus. Operative exploration revealed gouty infiltration of the flexor tendon within its fibrous synovial sheath. Urate crystal deposition in tendons is rare. Superimposed trauma was a possible predisposing factor. PMID- 3978912 TI - Extensor tendon rupture due to Coccidioides immitis. Report of a case. AB - In a 60-year-old man, extensor tendon rupture was associated with coccidioidal tenosynovitis. Dissemination of Coccidioides immitis to the tenosynovium in the wrist is an unusual complication following pulmonary coccidioidomycosis. PMID- 3978913 TI - An unusual avulsion fracture of the proximal tibial epiphysis. Case report and proposed addition to the Watson-Jones classification. AB - Avulsion injuries of the tibial tuberosity are uncommon fractures that are seen most frequently in adolescents. Watson-Jones classified these injuries into three types, but this classification does not account for fractures of the tibial tuberosity that extend into the posterior cortex, nor has such a fracture configuration been described in the literature. The present case of a 16-year-old boy indicates that the Watson-Jones classification should be expanded to include this fracture configuration (Type IV). PMID- 3978914 TI - Isolated tuberculous tenosynovitis of the Achilles tendon. A case report. AB - The diagnosis of isolated tuberculosis of the Achilles tendon was made in a 50 year-old man by excision of the lesion and histologic examination. The patient was free of other systemic symptoms or other foci of infection. The wound healed without complication with the aid of antituberculous chemotherapy. The lesion recurred after nine years, at which time it was again excised and the diagnosis confirmed. Eight years later, the patient remains symptom-free with no signs of recurrence. PMID- 3978915 TI - The stabilizing effect of soft-tissue constraints in artificial Galeazzi fractures. AB - Shortening of the radius is observed in Galeazzi (Piedmont) fractures and results from muscle pull after distal radioulnar joint disruption. A cadaver study was designed to examine the normal laxity at the distal radioulnar joint and contributions of the fibrocartilaginous complex (triangular ligament) and the interosseous membrane in prevention of proximal displacement of the distal radius fragment. It was found that up to 5 mm of radial shortening occurred after osteotomy alone. Shortening of over 10 mm did not occur unless both the interosseous ligament and the triangular ligament were sectioned. Some Galeazzi type fractures may occur in the absence of distal radioulnar joint disruption, and others may result in disruption of the interosseous membrane of the forearm in addition to disruption of the triangular ligament at the wrist. Diaphyseal fractures of the distal radius may occur in several stages of severity. Attempts to produce a Galeazzi lesion by axial loading and pronation of the forearm above the dorsiflexed wrist caused a variety of injuries but did not result in an isolated fracture of the distal radius or disruption of the distal radioulnar joint. PMID- 3978917 TI - An improvised passive motion apparatus. PMID- 3978916 TI - Displaced transverse sacral fractures. A case report, review of the literature, and the CT scan as an aid in management. AB - Displaced transverse sacral fractures are rare injuries and may be associated with sacral nerve-root damage. Studies of a 21-year-old man with a transverse sacral fracture and bowel and bladder dysfunction demonstrated the value of the CT scan as an aid in diagnosis and management. PMID- 3978918 TI - A method of intraoperative limb length measurement in total hip arthroplasty. AB - Equalization of leg-length discrepancy during total hip arthroplasty is a major concern to both the patient and surgeon. A stable pelvic reference point must be established during surgery to determine leg-length changes. An accurate method of intraoperative leg-length measurement is presented to improve the surgeon's ability to determine the exact amount of limb lengthening or shortening occurring during total hip arthroplasty. PMID- 3978919 TI - Subtrochanteric fracture as a complication of proximal femoral pinning. AB - The circumstances of subtrochanteric fractures following the use of multiple pins for fixation of femoral neck fractures were reviewed in four women (age range, 67 94 years). Internal fixation by use of multiple pins in the proximal femur is a common orthopedic procedure. The pins, however, create a significant stress riser in the lateral subtrochanteric cortex. Subtrochanteric fracture has been reported after internal fixation of slipped capital femoral epiphysis with multiple conventional pins and, recently, after internal fixation of femoral neck fractures with large Garden screws. PMID- 3978920 TI - Common avoidable problems in nonunions. AB - Fracture-healing problems today occur predominantly in the weight-bearing tibia and femur. This review of 83 lower-limb nonunions out of a series of 100 fracture healing problems identified avoidable causes in 30%. These included rigid fixation, which produced fracture gap, fibulectomy, which destabilized the tibia, and soft-tissue procedures, which impeded fracture management. The significance of these factors was evident when treatment to avoid the above-noted adverse factors did produce union. The fact that complications occur with certain techniques does not interdict their proper use. However, critical analysis of a large number of cases suggests the following three principles for avoiding nonunion: (1) Rigid fixation eliminates the critical external callus response of the first six weeks after fracture. Consequently, less than rigid fixation obtained with functional fracture braces or intramedullary rods, which maximize external callus and avoid fracture distraction, is generally preferable for weight-bearing bones. (2) Fibulectomy may encourage impaction across a tibial fracture gap. However, the resection should be performed well away from the tibial fracture site, thereby avoiding tibial instability. (3) With the open fracture, priority of management should be given to achieving fracture union rather than to absolute soft-tissue coverage. No fracture in this series failed to heal because of exposed bone. PMID- 3978921 TI - Clinical and metallurgical analysis of retrieved internal fixation devices. AB - The clinical performance, corrosion characteristics, and metallurgical properties of 82 retrieved stainless-steel bone plates have been examined. The plates had been in situ for periods ranging from one to 169 months. Only 29% of these devices (24 of 82 plates) were removed on a routine asymptomatic basis, while 62% (51 of 82 plates) were removed for cause-related reasons such as implant-related pain, infection, nonunion or malunion, and so forth; seven plates were removed for unknown reasons. Although most patients who had plates removed for pain reported some improvement in symptoms, others felt no improvement after removal. On examination, over 89% of the recovered implants displayed some degree of either surface (pitting) or screw-plate interface (crevice and fretting) corrosion or both. Statistical analyses revealed that the metallurgical properties of grain size and nonmetallic inclusion content correlated significantly with the degree of both types of corrosion. PMID- 3978922 TI - Pachydermodactyly. AB - Pachydermodactyly is a rare distinct form of fibromatosis characterized by dense fibrosis and fibroblastic proliferation around one or more proximal interphalangeal joints. Pachydermodactyly affects the appositional and dorsal aspects of proximal digits II-V. The lateral aspects of the index fingers, the medial aspect of the fifth digits, and the thumbs are usually unaffected. A typical patient was a young adult man with a long history of idiopathic asymptomatic swelling in the fingers. Skin biopsy specimens obtained from three patients with pachydermodactyly showed marked thickening of the dermis with extension of collagenous fibers into the subcutaneous tissues. There was poor demarcation between the papillary and reticular dermis. The cytology of the fibroblasts appeared benign. Isolation of collagen from the involved sites revealed collagen Types I, III, and V in a pattern typical of fibromatoses; i.e. increased Types III and V. Compared with the collagen profile of normal reticular dermis, increased numbers of fine-diameter collagen fibers were notable in electron micrographs. PMID- 3978923 TI - Mauch S.N.S. hydraulic knee units in above-knee amputees. A long-term follow-up study. AB - From 1963 to 1980, 70 Mauch S.N.S. hydraulic knees were prescribed for 60 service connected, above-knee amputees. The average length of the follow-up period was 7.5 years and the average age of the patient at the time of follow-up evaluation was 47 years. Four of the 60 patients who were given the Mauch S.N.S. units rejected them, for a success rate of 93%. Three of the four patients who opted for devices other than this unit had been given inappropriate prescriptions. Thus, the overall success rate for appropriately prescribed hydraulic knee units was 98.2%. Chart records were available on all patients in the series and 47 patients were available for direct survey, most of whom had used other prosthetic devices prior to receiving the Mauch unit. Survey results and clinical evidence have shown that the hydraulic knee unit is superior to the single-axis hinged device when appropriately prescribed. The hydraulic knee units are recommended for use in the active above-knee amputee who has a strong, relatively long stump and desires a variable cadence gait and more stability in stance, along with the consequent ability to increase activity level. These units are not recommended for use in the weakened, debilitated patient or in patients not willing to care for and maintain the devices. PMID- 3978924 TI - A simple method of obtaining equal leg length in total hip arthroplasty. AB - Leg length in total hip arthroplasty can be measured and equalized with no increase in operating time through the use of a method that is applicable to any of the standard approaches to the hip joint. PMID- 3978926 TI - Total hip arthroplasty. An investigation of factors related to postoperative urinary retention. AB - The predisposing factors to urinary retention in patients undergoing hip arthroplasty were investigated by a review of the charts of 272 patients. Age, sex, surgeon, choice and duration of anesthesia, volume of fluid replacement, and use of postoperative intramuscular narcotics did not correlate significantly with urinary retention. However, urinary retention increased from 24% to 62% with the use of epidural morphine for postoperative pain management. PMID- 3978927 TI - The radiopaque ruler as an alignment aid for knee arthroplasty. PMID- 3978925 TI - Radiographic loosening after revision with gentamicin-containing cement for deep infection in total hip arthroplasties. AB - Seventy-two infected total hip arthroplasties were revised with cement containing gentamicin and were followed up with regular radiograms for periods of up to six years. The infection healed in 61 cases and persisted in 11. An analysis of the radiographic changes in regard to the signs of loosening showed that about half of the cases with a healed infection had a minimal demarcation between bone and cement. In about one-third of the patients, a radiolucent zone of up to 2 mm in thickness developed during the first one to two years and then seemed to remain stable. In the other cases, a progressive resorption, indicating true loosening, was observed. All the cases with remaining infection (except one patient who died of heart disease) exhibited progressively increasing resorption zones. Progress, however, was possibly slowed by the effects of the gentamicin cement and the systemic antibiotic treatment. PMID- 3978928 TI - Femoral component loosening in total knee arthroplasty. AB - From experience with over 1600 condylar-type total knee arthroplasties performed between 1974 and 1981, the authors identified 15 knees in which the femoral component had loosened and shifted into flexion on the end of the femur. This mode of failure was related to inadequate support of the prosthetic posterior condyle, which resulted from inaccurate surgical cuts, poor cementing technique, or deficient bone stock either primary or secondary to persistent rheumatoid synovitis. Newer prosthetic designs that allow for greater range of motion and maximal function will further test the critical posterior condylar bone interface, as a result of which a higher incidence of femoral component loosening with flexion shift may be seen. Femoral component design changes and surgical techniques that sustain the posterior femoral condyle metal-bone interface may thus be necessary. Femoral components with intramedullary stems may be appropriate for high-risk patients. PMID- 3978929 TI - False aneurysm of the medial superior genicular artery complicating a closed knee injury. AB - A 21-year-old man sustained a closed injury of the medial collateral ligament that was complicated by a traumatic false aneurysm of the medial superior genicular artery. The mechanism of injury may be related to the anatomy of the genicular arteries. PMID- 3978930 TI - The periosteum in growth plate failure. AB - To investigate the periosteal contribution to the integrity of the growth plate, the authors subjected the proximal tibias of 110 male and female Sprague-Dawley rats between the ages of 25 and 65 days to axial and perpendicular forces to produce epiphysiolysis by use of a slow-loading technique and a cross-head speed of 10 mm per minute. Paired tibias of each rat were loaded under identical conditions, the only difference being the presence or absence of an intact periosteum. Mean values of body weight, tibial length, and cross-sectional areas of the growth plate after epiphysiolysis showed a linear increase with the age of the rat. No significant differences at the 5% level were observed in the tibial length and cross-sectional areas of the paired tibias. However, a consistently higher force was needed to produce epiphysiolysis with the periosteum intact. This was significant at all ages in both axial and perpendicular loading but was marked for young rats aged 45 days and under that were subjected to axial loading, where the level of significance was less than 1%. Calculated stress values showed a similar significant trend. The periosteum contributes significantly to the stiffness of the system, as shown by typical load deformation curves, and if it is divided, the gradient of the curve is clearly reduced up to epiphysiolysis. All periosteal fibers are not recruited in resisting a perpendicular force. Histologic examination of the specimens showed two patterns of failure corresponding to axial and perpendicular loading and also showed the failure path. PMID- 3978931 TI - Neuropathologic aspects of arthrogryposis multiplex congenita. AB - Arthrogryposis multiplex congenita is not a specific disorder but rather a symptom complex of congenital joint contractures associated with both neurogenic and myopathic disorders. Pathologic studies, including autopsy evaluation and muscle biopsy alone, were performed on 74 children with features of arthrogryposis. In 69 children (93%), the deformities were found to be neurogenic in origin, while five (7%) had myopathic disorders. The children in these two groups could be subdivided into 17 specific disorders, depending on the site of the pathologic lesions: anterior horn cells, roots, peripheral nerves, motor end plates, or muscle. Disorders associated with dysgenesis of anterior horn cells were the most common pathologic type. The neurogenic groups were also characterized by a high incidence of other congenital anomalies, while the myopathic group had few associated defects. The main feature shared by these disorders appears to be the presence of severe weakness early in fetal development, which immobilizes joints, resulting in contractures. PMID- 3978932 TI - Effect of fixation devices on radiostrontium clearance in the intact canine femur. AB - Femoral metaphyseal/diaphyseal blood flow was studied by 85Sr clearance in unfractured segments of dog femurs following compression plating and various control procedures (drilling with and without application of screws). The animals were tested as early as seven days and as late as two months after surgery. The only statistically significant change in strontium clearance (SrC) was an increase produced by the application of stainless-steel bone screws, with or without plates. The presence or absence of compression had no consistent effect on changes in the rate of SrC. During the period of study, no changes in bone mineralization, haversian porosity, or cortical bone thickness accompanied the SrC alterations. PMID- 3978933 TI - Genetic aspects of arthrogryposis. AB - Multiple congenital contractures or arthrogryposis is a birth defect that occurs in approximately one in 3000 births. It can be seen in isolation or in association with other abnormalities. The etiologic and genetic basis of multiple congenital contractures is very heterogeneous. In order to understand the genetic basis and natural history of a specific case, a specific diagnosis must be made. Over 150 conditions are known in which multiple congenital contractures are a predominant sign. In this chapter, the emphasis is on a systematic differential diagnosis and consideration of empiric recurrent risk figures if a specific diagnosis cannot be reached. PMID- 3978934 TI - Passive motion therapy for infants with arthrogryposis. AB - A comprehensive program for treatment of arthrogryposis multiplex congenita has been developed based on experiences with 95 infants and young children with arthrogrypotic deformities. The regimen emphasizes early passive stretching and serial splinting to improve joint motion. Ninety percent of the patients had contractures of all extremities; 40% had multiple congenital anomalies. Daily intensive passive stretching of joints and serial splinting have substantially increased patient function in this population. Surgical procedures have been used only in cases in which persistent deformities require correction. PMID- 3978935 TI - Comprehensive management of arthrogryposis multiplex congenita. AB - Arthrogryposis multiplex congenita syndrome, characterized by multiple congenital joint contractures, is a manifestation of a neurogenic or myopathic disorder of unknown etiology. An accurate diagnosis is critical in management strategy. Muscle biopsy is usually the most important diagnostic procedure. Once the diagnosis is established, a team approach to comprehensive care is instituted, and the child is assisted in achieving maximum cognitive, physical, and social development. Physicians, nurse clinicians, therapists, social workers, and others constitute the team and work in coordination to develop an individual habilitation plan. The treatment plan is continually updated and modified as needed. Because the musculoskeletal deformities are generally the most prominent abnormality, the orthopedist usually has the major role in management. The orthopedist may serve as coordinator of the comprehensive care team and therefore must have a fundamental understanding of and global approach to management. PMID- 3978936 TI - Management of upper limb problems in arthrogryposis. AB - The management of upper limb problems in arthrogryposis multiplex congenita (AMC) is described on the basis of the author's own experience gained from the care of a large number of affected children. Emphasis is placed on evaluation of the disability by repeated testing and observation. In many cases, the deformities will be accepted and improvements in function will be gained by orthoses or attention to details of seating, dressing, and toileting. Surgery is indicated in some cases, especially at the elbow, to obtain mobility, flexor power, or both. Arthrodesing the wrist is also useful in some cases. When surgery is indicated, it is often desirable to rearrange all three levels--shoulder, elbow, and wrist. PMID- 3978937 TI - Hand assessment and management of arthrogryposis multiplex congenita. AB - Arthrogryposis of the upper extremity is easy to diagnose. The shoulders, when affected, are adducted and internally rotated; they are thin, and very little girdle muscle is noted. The elbows are usually straight, and extension contractures are present. The hand and wrist are clublike; the wrist is contracted in flexion, with slight ulnar deviation. The thumb is usually adducted and flexed in a palmar direction. The small joints of the fingers are stiff, and frequently the fingers are ulnar deviated. Early treatment consists of passive stretching of the contracted parts by either plaster casts or splints. If successful, this treatment is followed by functional splinting. If stretching is not successful, then surgical release of contracted major joints or parts can be helpful. Tendon transfers are used to give a dynamic force to aid correction of the deformity and provide useful motion. Surgical correction of small joints of the hand has not proved too successful and frequently will decrease mobility even further. The goal in treating upper extremity deformities in arthrogryposis is to provide one extremity that can be brought to the mouth for feeding and hygiene and one that can be used to push up from a sitting position or to be used with a crutch if necessary. Hand function can be improved by careful evaluation and planned procedures that are consistent with the above goals. PMID- 3978938 TI - A plan of management and treatment results in the arthrogrypotic hip. AB - In a retrospective review of 52 hips in 26 patients with arthrogryposis, 65% of all hips studied were affected by the disorder; 46.6% of the patients were independent ambulators, 33.3% required some type of bracing for ambulation, and 20% were confined to a wheelchair. Based on the results of the authors' treatment as determined by a functional hip score, the authors recommend a one-stage open reduction, varus shortening femoral derotational osteotomy for all unilateral hip dislocations and those bilateral hip dislocations that have a less severe generalized involvement. They also recommend an aggressive traction program with appropriate soft-tissue releases during the neonatal period for patients with subluxation and/or marked limitation of motion of the hip. PMID- 3978939 TI - The hip in arthrogryposis multiplex congenita. AB - The hip is involved in up to 80% of individuals with a diagnosis of arthrogryposis multiplex congenita. The hip deformity consists of contracture with or without dislocation. Isolated contracture can usually be treated conservatively by manipulation and splinting, only occasionally requiring operative intervention. Dislocation is as frequently bilateral as unilateral. Bilateral hip dislocations are best left unreduced; only accompanying contractures should be treated. The unilateral dislocation should be treated aggressively, because persistent dislocation will give rise to pelvic obliquity and scoliosis. Open reduction is always necessary. PMID- 3978941 TI - Foot and ankle deformities in arthrogryposis multiplex congenita. AB - When 51 patients with arthrogryposis multiplex congenita followed an average of 12 years were reviewed, talipes equinovarus was the most common foot and ankle deformity. The best results were obtained by talectomy. The majority of tendo Achillis lengthenings, posteromedial releases, and triple arthrodeses were unsuccessful and were associated with a high complication rate. Congenital convex pes valgus was the second most common deformity. Surgical treatment by open reduction generally resulted in unsuccessful outcomes. Ambulation was achieved in 46 patients. Residual foot deformity was the primary reason for persistent difficulties in walking. PMID- 3978940 TI - The knee in arthrogryposis. AB - Of 104 patients with arthrogryposis multiplex congenita treated between 1952 and 1982, 74 had significant knee contractures, instability, or recurvatum. The minimum follow-up period was two years. Nonoperative treatment modalities included physical therapy, bracing, and serial casting in 43 patients (78 knees). Thirty-one other patients (46 knees) had 62 operative procedures, including hamstring and posterior capsular release, epiphysiodesis, distal femoral or proximal tibial osteotomy, arthrodesis, and knee disarticulation. Surgery was reserved for the more resistant causes and was recommended only as part of an overall treatment plan including the correction of foot and hip deformities. The average follow-up period for the surgically treated patients was 11 years, with a range of two to 20 years. Recurrence of deformity was frequent, with no one procedure being clearly favored. Physiotherapy alone rarely resulted in clinically significant improvement unless accompanied by prolonged casting and bracing. The most useful surgical procedure in the growing child was posterior capsular release performed in conjunction with hamstring tenotomy. Contractures treated by osteotomies before the completion of growth had a high rate of recurrence. PMID- 3978943 TI - Reconstruction of a balanced thumb through tendon transfers. AB - The ability to use the thumb determines its functional relation to the fingers and the resulting dexterity of the hand. Median palsy results in a failure of abduction and pronation. Ulnar palsy results in loss of adduction and flexion at the metacarpophalangeal joint. Following median, ulnar, and even radial palsy, the thumb can develop adduction deformity. Thumb contracture must be released prior to tendon transfers. Abduction and pronation are best substituted by transfer of the extensor indicis proprius. Adduction is best substituted by transfer of the extensor carpi radialis brevis and arthrodesis of the metacarpophalangeal joint. Median cutaneous sensibility should be reconstructed after appropriate tendon transfers are functional. PMID- 3978942 TI - The role of the Verebelyi-Ogston procedure in the management of the arthrogrypotic foot. AB - The Verebelyi-Ogston procedure, initially described in the nineteenth century, was recently reported by Stephen Kopits for the treatment of the myelodysplastic foot. The author has used this procedure for the rigid myelodysplastic or arthrogrypotic foot. The operation, consisting of subchondral decancellization of the cuboid and talus, is effective in converting a rigid varus foot into a supple, braceable, plantigrade foot. Based on the author's experience with four arthrogrypotic feet with a minimum follow-up period of 57 months, the procedure is recommended as an alternative to talectomy. Prolonged postoperative orthotic support is necessary to prevent recurrence. PMID- 3978944 TI - Reconstruction of the thumb in tetraplegia following spinal cord injury. AB - Functional positioning of the thumb is paramount to the restoration of lateral pinch to the hands in patients with tetraplegia as the result of spinal cord injury. Useful lateral pinch can be provided to patients with at least wrist extension control preserved by use of a combination of flexor pollicis longus tenodesis or transfer and carpometacarpal and inter phalangeal joint stabilization. In patients who retain function in the brachioradialis, extensor carpi radialis longus and brevis, pronator teres, and flexor carpi radialis, strong grasp as well as effective lateral pinch can be restored to the hand by surgery. Thumb control for flexion and extension is provided by tendon transfer to the flexor pollicis longus and tenodesis or transfer to the extensor pollicis longus. Proper positioning for lateral pinch can be accomplished by either arthrodesis of the first metacarpal-trapezial joint or tendon transfer to restore adduction-opposition to the thumb. The surgical concepts presented in this paper have been applied to the functional reconstruction of the hands of more than 50 patients with spinal cord injury during the last 15 years. The patients have been pleased with the significant improvement in function, strength, and speed that has resulted from surgery and have been cooperative advocates as the alternate methods of thumb control have been evaluated. PMID- 3978945 TI - Silastic condylar arthroplasty. AB - Interpositional Silastic condylar arthroplasty of the first carpometacarpal joint was used in 40 patients with disabling arthritis. Limiting bone resection at the base of the thumb improves prosthetic stability. Pain was lessened and function improved in most cases. Technical modifications and their rationale are discussed. PMID- 3978946 TI - Arthroplasty of the thumb basal joints. AB - Implant arthroplasty reconstruction of the thumb basal joints can provide pain free, stable mobility and improved strength. The complications are few and essentially retrievable. The recommended operative procedures are challenging and must be carefully executed to obtain rewarding results. PMID- 3978947 TI - Total joint arthroplasty at the carpometacarpal joint of the thumb. AB - A series of 50 cases of total joint arthroplasty at the carpometacarpal joint of the thumb demonstrate surgical procedure and cement technique. Most patients showed a full range of motion within four weeks of suture removal and continue to demonstrate good long-term results. Less motion is anticipated in patients with contractures or systemic disease. Five patients showed clinical or radiographic evidence of loosening. Revision procedures document the retrieval potential of a failed implant. The author's ten-year experience with this system indicates that the concept is viable. Future modifications are discussed. PMID- 3978948 TI - Early motion with cast-brace after modified Coventry high tibial osteotomy. AB - The records of 31 patients who were treated by a modified Coventry high tibial osteotomy were reviewed, and the early results of postoperative management with a cylinder cast were compared with those with early motion in a cast-brace. Thirteen patients (15 knees) who had immobilization in a cylinder cast after surgery for an average of 44.3 days had lost a mean of 10 degrees of flexion at three months of follow-up study. Their average total hospitalization was 15.5 days. Eighteen patients (19 knees) treated by early motion in a cast-brace had not lost any preoperative flexion at three months of follow-up study. The two most recent of these patients received continuous passive motion in the immediate postoperative period. The average total hospitalization for this group was 10.7 days. One patient in the cast-brace group had a significant loss of correction at the osteotomy site during healing. Eleven of the patients treated by a cylinder cast (84.6%) and 17 of the patients managed with a cast-brace (94.4%) stated that they had been improved by the surgery at this early stage. There were no nonunions or loss of internal fixation in either of the two groups. Early motion in a cast-brace (with a continuous passive motion machine, if available) is safe and is comfortable for and well accepted by patients. PMID- 3978949 TI - Skeletal management of humeral shaft fractures associated with forearm fractures. AB - Nine cases of ipsilateral humeral shaft and forearm fractures in multiply injured patients were reviewed in an attempt to ascertain the preferred management of these complex injuries. Satisfactory anatomic and functional results were achieved only in those cases treated by rigid internal fixation of the humeral fractures. Nonoperative management is associated with a significant risk of malunion or nonunion of the humerus. PMID- 3978950 TI - Early diagnosis of acute rupture of the quadriceps tendon by arthrography. AB - Arthrographic study of the knee was performed in six patients for diagnosis of acute rupture of the quadriceps tendon. All of the patients gave a history of attempting to recover from a fall. Pain and tenderness over the suprapatellar area were common findings in all patients. Four patients had a positive arthrogram demonstrating extravasation of the radiopaque material outside the knee along the quadriceps tendon. Of these four patients, two had complete loss of quadriceps function, but the other two were able to partially extend the knee when the gravity was eliminated. Two patients had negative arthrograms; both had loss of active extension of the knee against gravity but were able to extend the knee when the gravity was eliminated. All four patients with a positive arthrogram had rupture of the quadriceps tendon, which was demonstrated at the time of surgery. In one patient with a negative arthrogram, exploration of the knee revealed an intact extensor mechanism. Arthrography of the knee is an aid to the diagnosis of rupture of the quadriceps tendon and when indicated can be performed in the emergency room. PMID- 3978951 TI - The cephaloscapular projection. A special diagnostic aid. AB - The cephaloscapular roentgenographic projection is a new projection for diagnosing subluxation about the glenohumeral joint. When properly projected, the acromion, glenoid, humeral head, and coracoid can be seen in independent relief. The relatively radiolucent clavicle overlies the area but does not obscure the landmarks. This view should prove useful in diagnosing a variety of acute and chronic shoulder problems. PMID- 3978952 TI - Anterior compartment syndrome in a patient with fracture of the tibial plateau treated by continuous passive motion and anticoagulants. Report of a case. AB - Open reduction and internal fixation with anterior compartment fasciotomy for fractures of both tibial plateaus in a 36-year-old woman was complicated by deep vein thrombosis three days after surgery. After establishing anticoagulation, continuous passive motion (CPM) was instituted. Twenty-four hours after the commencement of CPM, an anterior compartment syndrome developed. A second operation revealed a large hematoma within the anterior compartment musculature, the development of which appeared to be the result of the combination of continuous passive motion and anticoagulation therapy in a seriously injured limb. In this clinical condition, especially close observation for the development of signs of elevated intracompartmental pressure is mandatory. PMID- 3978953 TI - Quadriceps tendon ruptures in uremia. AB - Chronic renal failure and its sequelae, particularly secondary hyperparathyroidism, may be associated with spontaneous quadriceps tendon ruptures. This is a report of two cases of bilateral spontaneous simultaneous quadriceps tendon ruptures in uremia and a review of the literature. The level at which the tendon ruptures is inconstant. Light microscopy reveals nonspecific changes of degeneration and calcification. Under electron microscopy, the structure and maturity of collagen fibers are normal. The ruptures occur in patients younger than 40 years of age who reject medical treatment (i.e. oral phosphate binder) and have long-standing renal disease (mean = 12.3 years). The predisposing causes of rupture are unknown. An abnormality of collagen metabolism, ischemia, direct effects of parathormone, and dystrophic calcification are some of the possible contributory factors. PMID- 3978954 TI - A stochastic model of age-related bone loss and fractures. AB - A stochastic model of age-related bone loss capable of predicting age-specific incidence of fractures has been implemented by Monte Carlo simulation. Each simulation involves aging a large cohort of individuals from 20 to 100 years. Every individual is randomly allocated a particular amount of bone as a young adult, an age of onset of bone loss, and parameter values that determine the subsequent bone loss. Fracture risk is assumed to be zero when the amount of bone is above a global threshold level, increasing progressively as the amount of bone falls below the threshold. From the individual fracture risks, a fracture subpopulation is identified and age-specific incidence evaluated numerically. By adjusting the model parameters, predicted and observed incidences of femoral neck fracture can be closely matched in both sexes by use of a linear function to describe age-related bone loss. For fracture of the distal radius, a close match can be achieved in women by use of an exponential function to describe the bone loss phase. In men, the incidence is independent of age; trauma, rather than the amount of bone in the forearm, appears to be the main determinant of fracture risk. PMID- 3978955 TI - Structural scoliosis in osteoporotic women. AB - Fifty women (mean age 69 +/- 5 years) with biopsy-proven osteoporosis and back pain were radiographically studied for scoliosis, kyphosis, and compression fractures. Twenty-four (48%) osteoporotics had at least 10 degrees of structural scoliosis. Curves were indistinguishable from those of idiopathic scoliosis. Lumbar and thoracolumbar curves were most common. The kyphosis averaged 70 degrees +/- 17 degrees and spanned 9.8 +/- 1.75 vertebrae. Forty-seven patients had 140 compression fractures. Fractures occurred within, but were usually not the cause of, scoliotic curves. Scoliosis in elderly women is a clinical marker and may be a risk factor for osteoporosis and compression fractures. Adult scoliotic patients should be evaluated for osteoporosis with iliac bone biopsies and aggressively treated. PMID- 3978956 TI - Assessment of metabolic bone diseases by quantitative computed tomography. AB - Advances in the radiologic sciences have permitted the development of numerous noninvasive techniques for measuring the mineral content of bone, with varying degrees of precision, accuracy, and sensitivity. The techniques of standard radiography, radiogrammetry, photodensitometry, Compton scattering, neutron activation analysis, single and dual photon absorptiometry, and quantitative computed tomography (QCT) are described and reviewed in depth. Results from previous cross-sectional and longitudinal QCT investigations are given. They then describe a current investigation in which they studied 269 subjects, including 173 normal women, 34 patients with hyperparathyroidism, 24 patients with steroid induced osteoporosis, and 38 men with idiopathic osteoporosis. Spinal quantitative computed tomography, radiogrammetry, and single photon absorptiometry were performed, and a spinal fracture index was calculated on all patients. The authors found a disproportionate loss of spinal trabecular mineral compared to appendicular mineral in the men with idiopathic osteoporosis and the patients with steroid-induced osteoporosis. They observed roughly equivalent mineral loss in both the appendicular and axial regions in the hyperparathyroid patients. The appendicular cortical measurements correlated moderately well with each other but less well with spinal trabecular QCT. The spinal fracture index correlated well with QCT and less well with the appendicular measurements. Knowledge of appendicular cortical mineral status is important in its own right but is not a valid predictor of axial trabecular mineral status, which may be disproportionately decreased in certain diseases. Quantitative CT provides a reliable means of assessing the latter region of the skeleton, correlates well with the spinal fracture index (a semiquantitative measurement of end-organ failure), and offers the clinician a sensitive means of following the effects of therapy. PMID- 3978957 TI - Functional evaluation of total hip arthroplasty with five- to ten-year follow-up evaluation. AB - Forty-seven patients with unilateral hip disease had a preoperative and postoperative gait analysis of total hip arthroplasty with a follow-up period of five to ten years. The object was to correlate the levels of function with mechanical loosening. Unilateral total hip arthroplasty in uncomplicated patients restored function to 80% of normal over a two- to four-year period. Patients followed longer than five years appeared to have an accelerated decline in function unassociated with pain. No Class C patient, regardless of age or gait velocity, developed loosening or required revision of the hip prosthesis. Survivorship studies revealed an 85%-90% incidence of loosening by the seventh postoperative year in Class A patients 55 years or younger and those walking preoperatively at more than 50% of normal gait velocity. In these same two groups of patients, the probability of revision for mechanical failure by ten years is 58% for age and 66% for fast walkers. The majority of patients in this study had a technical rating not acceptable by present standards so that these results represent most likely the worst prognosis for longevity of total hip arthroplasty. In high-risk patients, protected ambulation with crutches for six months postoperation may improve their prognosis. PMID- 3978958 TI - A clinical and metallurgical analysis of retrieved Jewett and Richards hip plate devices. AB - The metallurgical properties of 61 retrieved 316L stainless steel (ASTM F138-76) hip plate devices used for the treatment of intertrochanteric fractures were examined. Surface and screw-plate interface corrosion characteristics were graded, and grain size, inclusion content, and hardness values were measured. These measurements were then correlated with the clinical performance of the devices. The devices studied included 21 Jewett nail-type and 40 Richards compression screw-type hip plates. The devices had been in situ an average of 26.7 months, with in situ periods ranging from 2.0 to 156.0 months. Cause-related reasons represented the majority of removals (89.8%), while only 10.2% of the hip plates were removed on a routine asymptomatic basis. The data suggest that surgeons consider this type of device as a permanent implant, with removal undertaken only for causative factors. Of all devices removed, 30.6% were retrieved from patients who presented with fracture nonunion. Upon microscopic examination, 97% of the retrieved implants exhibited some degree of either surface of interface corrosion. Statistical analysis revealed significant correlations between corrosion scores and the metallurgical properties of grain size and nonmetallic inclusion content. No statistically significant metallurgical or corrosion differences were discerned between the two types of devices studied. However, four implants of the Jewett design and four of the Richards design were found to be out of ASTM specification F-138-76. It should also be noted that four devices of the Jewett design (19%) fractured in situ, while none of the retrieved Richards designs had fractured. No correlation was observed between the plates' corrosion scores and in situ time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3978959 TI - Resection of large tumors of the anterior pelvic ring while preserving functional stability of the hip. AB - Periacetabular tumors of the anterior pelvic ring often present difficult problems in diagnosis and treatment. The use of computed tomography is valuable. In cases of unquestionable malignancy, hemipelvectomy is the generally accepted treatment. In pelvic tumors of low grade or questionable malignancy, a local wide resection is indicated. Total acetabulectomy results in an unstable hip with marked leg shortening. Transacetabular anterior pelvic ring resection is recommended to preserve the superior part of the acetabular fossa. This procedure is illustrated in two men, 26 and 30 years of age, presenting with low or questionable malignancies. PMID- 3978960 TI - Response of the rabbit metaphysis to implants of bovine bone morphogenetic protein (bBMP). AB - The response of protodifferentiated and differentiated bone cells to bovine bone morphogenetic protein (bBMP) was observed in implants in the adult rabbit distal femoral metaphysis. Bovine serum albumin and denatured bBMP were implanted in the contralateral femur of controls. The changes of the bone marrow reflected the reaction of protodifferentiated cells. The changes in preexisting trabecular bone tissue reflected the reaction of differentiated cells to bBMP. 45Ca radioisotope quantitative methods demonstrated that the bone morphogenetic response was superimposed upon the reaction to the injury of surgical implantation. By the end of the fourth week, roentgenograms and histologic sections showed larger deposits of intrametaphyseal cartilage and bone in bBMP than in control implanted femurs. By the end of the eighth week, bone formation was associated with remodeling of the entire distal femur and expansion of the external diameter of the metaphysis. These observations indicate the need for investigation of perisinusoid and perivascular cells of periosteum, endosteum, and marrow stroma that are undifferentiated with respect to cartilage and bone but are principal target tissues for BMP. PMID- 3978961 TI - Creatine kinase MB in skeletal muscle and serum of spine-fusion patients. AB - The low specificity of creatine kinase (CK) MB elevations for myocardial infarction was confirmed by a prospective analysis of paraspinal muscle and postoperative serum levels of CK-MB. Eleven of 30 patients had serum elevations of CK-MB without myocardial infarction. Elevated CK-MB was not specific for myocardial infarction after spine surgery. CK-MB was found in paraspinal muscle of 93% of patients. CK-MB may be a pathologic marker in patients with spinal disease. PMID- 3978962 TI - Long-term myoneural function after an induced compartment syndrome in the canine hindlimb. AB - For evaluation of long-term myoneural function in a compartment syndrome model of the canine hindlimb, five conditioned dogs had injections of autologous plasma into the hindlimb anterolateral muscle compartment, maintaining the pressure at 40 mmHg for eight hours. A newly described technique for measuring muscle function was used before pressurization and at weekly intervals following pressurization for a period of one month. Two days after pressurization, isometric twitch torque and tetanic torque showed a significant decrease (p less than .05) when compared with baseline values. Time to peak tension, one-half relaxation time, and endurance tests showed no significant change throughout the four-week testing. At four weeks following pressurization, no muscle dysfunction was noted, and muscle examined histologically was normal. Therefore, the initial muscle dysfunction present was reversed by skeletal muscle recovery or regeneration. Although no long-term muscle dysfunction occurred in this study of dogs, there may exist a lower tolerance to elevated intramuscular pressure in humans. Since dogs have only fatigue-resistant muscle fibers with higher oxidative capacity than human fibers, dog muscle may have a greater regenerative capacity than human muscle. Therefore, exact extrapolation of these dog studies to clinical compartment syndromes is difficult. Although muscle function was recovered in these animal experiments, human muscle may have less capacity to recover. It is advisable to decompress muscle compartments at a pressure of 30 mmHg as soon as clinical symptoms of a compartment syndrome appear. PMID- 3978963 TI - Aggressive osteoblastoma. A case report and review of the literature. AB - A recurrent osteoblastoma involving the acetabulum in a 27-year-old woman was found to be locally aggressive and histologically appeared to become more anaplastic with each recurrence. However, there was no evidence of distant metastases. Similar cases have been reported under such names as pseudomalignant or malignant osteoblastoma. In view of the prolonged clinical course without evidence of distal metastases, the term "aggressive osteoblastoma" seems to be more appropriate. The treatment of choice for such tumors should be further en bloc resection, avoiding the morbidity and possible mortality of the chemotherapy demanded by true malignant tumor of bone, as well as unnecessary ablative surgery. PMID- 3978964 TI - Desmoplastic fibroma of the first metatarsal. A case report. AB - Desmoplastic fibroma is a benign but frequently aggressive tumor of bone. A 27 year-old man was treated for this lesion in the first metatarsal. The lesion recurred, extending into the medial cuneiform necessitating ray resection. The similar clinical and histologic findings of this tumor and other tumors, both benign and malignant, makes familiarity with the character of desmoplastic fibroma essential for proper treatment. PMID- 3978965 TI - Total hip acetabular cup flange design and its effect on cement fixation. AB - The design of pods and flanges on the acetabular cup surface was investigated to determine the effects on cement fixation of the total hip arthroplasty (THA) acetabular cup. To a basic cup designed with pods, four different types of flange designs were added: a cup without a flange, a cup having a flange with 12 scallops, a cup having a flange with three scallops, and a cup having a continuous flange. The cups were each inserted, via an MTS machine, into an instrumented simulated acetabulum containing polymerizing polymethylmethacrylate (PMMA). The PMMA intrusion pressure was measured by four pressure transducers, and the cement intrusion depth was measured via three rheometers. Also, three continuous-flange cups were manually inserted into cadaver acetabula in order to study the shape of the cement mantle around the cup. A cup with a continuous flange generated significantly higher cement intrusion pressures and depths when compared with the other three cups. A cup with pods and a continuous flange produced concentric positioning of the cup with a uniform cement thickness around the cup and was well contained within the reamed acetabulum. PMID- 3978966 TI - Thermally induced bone necrosis in rabbits: relation to implant failure in humans. PMID- 3978967 TI - Reconstruction of the hypoplastic thumb. AB - Blauth has classified congenital hypoplasia of the thumb into five grades. Grade I requires no treatment. Grade II can be reconstructed by widening the first web space with various flaps, stabilizing the metacarpophalangeal joint, and performing an opponensplasty. In such cases, a pollex abductus configuration of the flexor pollicis longus should be sought, and if found, corrected. Grades III, IV, and V require pollicization, a procedure that has become more sophisticated by attention to skin flap design, intrinsic transfer, and positioning of the head of the second metacarpal. Partial aplasia should be treated by phalangization, distraction lengthening with free toe phalanx transfer, on-top plasty, or toe-to hand transfer. The last is made more complex by the anomalous anatomy frequently present in aplasia. Reconstruction of the infant thumb should be complete before the first birthday. PMID- 3978968 TI - Anatomic variations in the motor and sensory supply of the thumb. AB - Variations in the motor and sensory nerve supply to the thumb exist despite stereotyped descriptions in modern anatomy texts. A careful dissection of ten specimens under high magnification has been made with special reference to the nature and incidence of anatomic variations. Transligamentous passage of the recurrent motor branch of the median nerve was noted in six dissections; two of these included multiple motor branches to the thenar musculature. The Riche Cannieu anastamosis was observed in three specimens. Variations in the branch pattern of the median nerve fibers supplying sensation to the thenar eminance and palmar thumb were also noted. No dorsal (superficial radial nerve) to palmar communications were detected, although this pattern has been described clinically. The differences give rise to an element of diagnostic uncertainty in treating the nerve-injured patient; functional deficits and therapeutic consequences are discussed in relation to the authors' observations and a review of the literature. PMID- 3978969 TI - Artifactual focal accumulation of Tc-99m bone imaging tracer in the chest. Technical note (bone imaging artifact). AB - Four patients undergoing routine bone imaging with a Tc-99m bone imaging agent were observed to have multiple focal areas of increased uptake in the lungs. Delayed or repeat examination demonstrated resolution of the areas. The authors conclude that this was an isolated and bizarre case of aggregate formation. PMID- 3978971 TI - Inadvertent lymphoscintigraphy? AB - Several examples of what is believed to be lymph node uptake of the bone imaging agent Tc-99m imidodiphosphate (Tc-99m IDP) are presented. This agent may prove to be useful for lymphoscintigraphy. PMID- 3978970 TI - Liver scan in traumatic right hemidiaphragmatic hernia. AB - Liver imaging was performed in two patients with traumatic right hemidiaphragmatic hernia. It has elucidated the cause of obliteration of the right hemidiaphragmatic shadow on the chest x-ray. These cases are illustrative of the usefulness of liver imaging in the diagnosis of traumatic right hemidiaphragmatic hernia as well as hepatic injury. PMID- 3978972 TI - Free fatty acid scintigraphy in patients with successful thrombolysis after acute myocardial infarction. AB - Twenty-three patients with successful intracoronary thrombolytic therapy in the acute stage of infarction underwent scintigraphy with radioiodinated heptadecanoic acid two weeks after myocardial infarction and three to 12 months later. In patients with normal or slow elimination rates in the infarct area, ejection fractions were significantly higher than in patients with fast elimination (70 +/- 6% vs 47 +/- 13%, P less than 0.05). Consequently, left ventricular damage score was lower in patients with normal and slow elimination rates (1.7 +/- 1.6 vs 4.9 +/- 2.4, P less than 0.05). Repeated scintigraphy showed normalization of the elimination rates in patients with previously slow elimination, except in one patient in whom the elimination rate remained slow, patients with fast elimination rates remained unaltered. It is concluded that scintigraphy with radioiodinated heptadecanoic acid is an appropriate method to assess myocardial viability in patients with successful thrombolytic therapy. PMID- 3978973 TI - Scintigraphic imaging of an unusual liver displacement. AB - The authors present a patient with a mass in the right lung due to a partial herniation of the liver. PMID- 3978974 TI - False-positive liver scan due to ascites. AB - Extrahepatic structures (breast, costal margin, kidney, pleural effusion, right lower lobe lung mass) may occasionally result in a false-positive liver scan by causing attenuation of the gamma rays emenating from the liver, thereby simulating an apparent intrahepatic lesion. A false-positive diagnosis of intrahepatic pathology may often be avoided by simple maneuvers such as elevating the breast, obtaining another projection, etc. A case of false-positive liver scan due to loculated ascites is presented in which these maneuvers failed to resolve the problem. Ultrasound or CT examination may be helpful in this circumstance due to the cross-sectional nature of the information they provide. PMID- 3978975 TI - Tentative evidence of Y-linked statural gene(s). Growth in the testicular feminization syndrome. AB - The linear growth data of 48 XY individuals, presumed to be androgen-insensitive as a consequence of the testicular feminization syndrome, were found to be similar to normal male standards and tall for normal female standards. These data are interpreted as evidence for one or more Y-linked gene function(s) which augment stature independently of testosterone effects. PMID- 3978976 TI - Palpable spleens in newborn term infants. AB - Spleen tip size was determined in 470 full-term appropriate-for-gestational-age infants within the first 24 hours of life. The spleen was palpable in 17.9 percent of them. It was palpated less than 1 cm below the costal margin in 11.7 percent, between 1 and 2 cm in 3.6 percent, and 2 cm or more in 2.6 percent. No cause for spleen enlargement was found except in two infants with ABO hemolytic disease. PMID- 3978978 TI - An analysis of waiting times in a pediatric emergency department. AB - Waiting times in a pediatric emergency department were studied using direct observations of patients and health providers on 14 separate days. The mean waiting time (from entry to first physician contact) of the 216 children studied was 49 minutes. Time spent in the waiting room was increased by both the nonavailability of a nurse and the nonavailability of an examining room, and was decreased by the severity of the patient's illness. Time spent in the examination room waiting for the physician was related to the availability of the physician and the number of patients concurrently registered in the emergency department as well as the severity of their complaint. Recommendations for decreasing waiting time, based on the observations, are made. Although each setting is unique, the study provides a model for the analysis of waiting patterns in similar facilities. PMID- 3978977 TI - Maximal work capacity in prepubescent obese and nonobese females. AB - Measurements of cardiorespiratory function during an incremental treadmill test were compared in 15 obese (OB) prepubescent girls, 7 to 12 years old, and in 15 age-matched, nonobese (NOB) controls. Open circuit calorimetry was used for data collection during the progressive work test. Maximal oxygen consumption indexed for weight was significantly lower in the obese group of girls (23.0 +/- 3.9 ml/kg/min) than in the nonobese controls (36.7 +/- 0.9 ml/kg/min). In addition, exercise tolerance was longer in the nonobese group, albeit not statistically significant. In conclusion, diminished cardiopulmonary performance and attenuated exercise tolerance in prepubescent obese females in the current investigation seemed to be influenced by excess body weight. PMID- 3978979 TI - The pediatric population of two free-standing emergency clinics. AB - We studied the pediatric patient population of two free-standing emergency clinics (FECs) through an audit of medical records for 20 days randomly selected throughout 1983. We recorded the age, sex, number of visits, patient diagnoses, laboratory work, and charges. This information was compared with earlier national studies of physician practice. Of the 1062 visits audited, 27.6 percent were by patients 21 years of age or younger. This number is comparable to the percentage of office visits made to a national sample of general and family practitioners but well below the same figure for pediatricians. The pattern of FEC visits by this age group emerged as quite different from the pattern of visits to a national sample of office-based physicians by the same age group. The most frequent diagnoses for pediatric patients visiting FECs were upper respiratory infection (31.9%) and trauma related problems (28.5%). The number of laboratory diagnostic procedures ordered in FECs was lower than similar statistics for a national sample of pediatricians. Mean charges for visits in the FECs studied were $40.23. PMID- 3978980 TI - Fatal aortic rupture presenting as chest pain in an adolescent. The role of echocardiography in occult cystic medial necrosis. AB - An adolescent female with occult cystic medial necrosis died following spontaneous aortic rupture. A large saccular aortic aneurysm that had ruptured into the pericardial space was demonstrated by two-dimensional echocardiography and confirmed at surgery. Echocardiographic screening of the patient's family members revealed a 13-year-old brother with unsuspected aortic root dilatation. He is now being followed for possible progression of his disease. This case demonstrates the role of echocardiography in cystic medial necrosis. It can aid the acute management of patients with aortic dissection or aneurysm. It can also define patients with occult disease who require serial follow-up and genetic counseling. PMID- 3978981 TI - Congenital fiber type disproportion myopathy. Report of a case with late onset and myalgia. PMID- 3978982 TI - Cerebrocostomandibular syndrome. Case report and literature review. AB - Cerebrocostomandibular syndrome (CCM) is characterized by micrognathia, cleft palate, rib defects, and frequently, mental deficiency. Death from respiratory complications occurs in 40 percent of cases before they reach 1 year of age. We describe a case of CCM with the previously unreported findings of large for gestational age at birth, radiologic evidence of bilaterally displaced radial heads, and development of brachycephaly. PMID- 3978983 TI - Orbital cellulitis. A presentation of two cases with unusual features. PMID- 3978984 TI - Desquamative interstitial pneumonia responsive to chloroquine. PMID- 3978985 TI - Symposium on noninvasive neonatal diagnosis. PMID- 3978986 TI - Neonatal oxygen-cardiorespirograms. AB - To those used to intermittent blood sampling, intermittent viewing of ECG, or intermittent counting of heart and respiratory rates, the rapid changes in these variables, as revealed when monitored continuously, must come as a surprise. These rapid changes are found even in quiet, healthy infants. Because of this variability and the diagnostic significance of each single variable, the potential of these variables can be utilized only if they are continuously recorded. It is like studying movement from a videorecording instead of from a couple of photographs taken at different intervals. Knowing normal levels and the trend of changes in all the variables, it becomes easier and more accurate to predict significant clinical changes than before. Or, in M. E. Avery's words, "Those of us who have used continuous monitors would not like to return to the era of sporadic sampling of information." PMID- 3978987 TI - Intracranial pressure measurements in the newborn. AB - This article describes four techniques for the noninvasive measurement of intracranial pressure in the newborn, and discusses common pitfalls in their use, and various pathologic states (for example, intraventricular hemorrhage, perinatal asphyxia, posthemorrhagic hydrocephalus, and bacterial meningitis) in which measurements of ICP have been demonstrated to be or are likely to be of value. PMID- 3978988 TI - Nuclear magnetic resonance imaging in the diagnosis and follow-up of neonatal cerebral injury. AB - NMR scanning is feasible in the newborn period, and is capable of diagnosing most of the problems in this age group, but its general application presents a number of difficulties at present. It cannot be transported to the bedside. Adequate monitoring of ill patients is difficult, and scanning takes a relatively long time. The neonatal brain has an extremely high water content, and NMR scanning procedures require adaptation to apply to these conditions. NMR imaging, however, has already proved extremely useful in the follow-up of neonatal insults. Repeated scanning is possible after closure of the fontanelle without subjecting the infant to ionizing radiation. The scans are able to demonstrate not only the anatomic changes associated with the various lesions, but also how these might affect myelination. Development of better coils and more suitable scanning sequences for neonates and infants are needed to improve image quality and establish the normal range of T1 and T2 values and the normal range of myelination at various ages. Further studies will also establish whether the changes in myelination primarily reflect the pathologic processes occurring in the tissues, such as the amount of gliosis, or are a marker of functional involvement. PMID- 3978989 TI - Investigation of cerebral energy metabolism in newborn infants by phosphorus nuclear magnetic resonance spectroscopy. AB - 31P NMR spectroscopy can be safely and successfully used to study cerebral energy metabolism in sick newborn infants, provided a suitable life support and monitoring system is available. Studies of normal infants have shown characteristic spectral peaks assigned to adenosine triphosphate, phosphocreatine, phosphodiesters plus phospholipids, inorganic orthophosphate, and a large peak at the phosphomonoester resonance frequency that is attributable mainly to phosphoethanolamine, a precursor of membrane phospholipids. Both the PCr/Pi and PCr/ATP ratios were lower in normal newborn infants than reported in studies using invasive techniques in adult animals. Tissue hypoxia-ischemia was associated with a fall in PCr levels and a rise in Pi. The PCr/Pi ratio, which is an index of cerebral energy status, was normal during the first day of life in infants who had suffered severe birth asphyxia, but subsequently fell to levels well below the normal range. The presence of this latent period raises the possibility of effective early treatment following birth asphyxia, before irreversible impairment of cellular energy metabolism occurs. Low PCr/Pi ratios have also been demonstrated in infants with idiopathic cerebral infarction, periventricular leukomalacia and inborn errors of metabolism. Preliminary experience suggests that ratios below 0.8 are associated with irrecoverable failure of energy metabolism and cellular necrosis. 31P NMRS and other spectroscopic NMR techniques utilizing, for instance, 1H and 13C nuclei, have exciting potential for exploring the mechanisms and methods of prevention of various forms of cerebral damage in the newborn period. PMID- 3978990 TI - Electrophysiologic assessment of auditory and visual function in the newborn. AB - This chapter describes the utility of event-related potential recordings in the assessment of auditory and visual system integrity in the newborn infant. A battery of electrophysiologic tests is described that permits the evaluation of sequential levels of processing within these sensory system. PMID- 3978991 TI - Transillumination in neonatal diagnosis. AB - Transillumination is a safe, nonionizing, and noninvasive diagnostic technique that is particularly well-suited for use in the newborn. In addition, its portability, minimal expense, and facility make it a useful and necessary tool for the neonatal intensive care unit. This article reviews the principles of transillumination, describes equipment currently in use, and summarizes the clinical applications of transillumination. PMID- 3978993 TI - The evaporimeter and emotional sweating in the neonate. AB - Emotional sweating from the palm of the hand occurs from birth in the term infant and can be conveniently measured with a skin evaporimeter. Such measurements provide objective information about an infant's state of arousal that might be useful to neonatologists and psychologists who are interested in studying stress and its modification in the newborn. PMID- 3978992 TI - Neonatal transcutaneous bilirubinometry. AB - The authors present data supporting the conclusion that the transcutaneous bilirubin index may be a valuable tool to help distinguish term babies with a total serum bilirubin value less than 13 mg/dl from those with higher levels and that it serves as a valuable screening device to decrease the number of unnecessary total serum bilirubin tests. Also examined are clinical guidelines and limitations of the device. PMID- 3978994 TI - Measurements of transepidermal water loss in newborn infants. AB - Measurement of transepidermal water loss without disturbing the microclimate in the air layers above the skin has not been possible with previously available methods. The introduction of a new instrument, the Evaporimeter, for measuring the vapor pressure gradient above the skin surface meant that the evaporation of water from the skin could be determined. Each measurement is of short duration, and measurements can be made even in the most preterm infants under the conditions in which they are normally nursed. Studies of the evaporation rate and transepidermal water loss by this technique have increased our knowledge considerably during the last ten years. It is now well established that the loss of water from the skin surface is related to the ambient humidity, gestational age at birth, and postnatal age, and to weight, activity, and body temperature, and that it differs between appropriate- and small-for-gestational-age infants. Conclusions of special clinical importance drawn from these studies are that the most preterm infants may lose as much as 13 per cent of their body weight as TEWL during their first day after birth even at an ambient humidity of 50 per cent, and much more at a lower ambient humidity, and that their losses gradually diminish with age but are of significance even four weeks after birth. Small-for gestational-age infants have a lower TEWL early after birth than appropriate-for gestational-age infants. For heat exchange between the infant and its environment, TEWL plays an important role. In preterm infants, losses of heat through evaporation are very high early after birth. On the other hand, their heat losses through other routes are smaller because of the high ambient temperature in which they have be nursed in order to maintain a stable and normal body temperature. Simultaneous measurements of evaporation rate and skin blood flow have shown that the skin blood flow increases at a lower body temperature than the evaporation rate and that not all full-term infants sweat in a warm environment even when their body temperature becomes higher than 37.2 degrees C, which may indicate a delay in the postnatal adaptation of heat regulation. In addition, this regulation can easily be disturbed by a central cold-stimulation in infants who react with sweating in a warm environment. PMID- 3978995 TI - New drug applications: how long to gain approval? PMID- 3978996 TI - Acceleration of digoxin clearance by activated charcoal. AB - The effect of repeated oral doses of activated charcoal on intravenous digoxin kinetics was evaluated in a randomized, crossover study. Ten healthy subjects received infusions of 10 micrograms/kg digoxin alone and with 225 gm activated charcoal over 40 hours. Multiple serum digoxin concentration determinations were made after each dose by radioimmunoassay. Noncompartmental kinetic analysis was used. Digoxin clearance increased an average of 47% (range -2% to 119%) during charcoal treatment, from 12.2 +/- 2.0 to 18.0 +/- 2.9 L/hr. The volume of distribution at steady state decreased from 495 +/- 196 to 375 +/- 162 L, and the terminal t1/2 was shortened from 36.5 +/- 11.8 to 21.5 +/- 6.5 hr during charcoal treatment. Likewise, mean residence time decreased, from 41.1 +/- 20 to 19.9 +/- 7.8 hr. Kinetic predictions would suggest greater proportional increases in digoxin clearance in patients with renal impairment. We conclude that repeated doses of charcoal enhance the clearance of digoxin and should be considered for use in digoxin toxicity. PMID- 3978997 TI - Effect of metoclopramide on plasma catecholamine release in essential hypertension. AB - The catecholamine (CA)-releasing action of metoclopramide (MCP) observed in patients with pheochromocytoma was tested in 20 subjects with essential hypertension and compared with the same effect of glucagon in 10 of them. We found that even in the absence of pheochromocytoma, MCP is a CA-releasing substance, moderately increasing systolic blood pressure and pulse rate. The release of CA is reflected by an increase in concentrations of free norepinephrine and total (free plus sulfated) epinephrine 3 minutes and of total dopamine and norepinephrine 10 minutes after the MCP bolus dose, whereas glucagon had an effect on the release of free epinephrine. Regional catheterization before and after MCP dosing in one subject showed a considerable increase in adrenal epinephrine and norepinephrine concentrations 45 seconds after the MCP bolus dose. MCP has a free CA-releasing potency much like that of glucagon. Because the released free CA is readily sulfoconjugated, the effect on CA release can be more easily detected when conjugated CA is determined. MCP should thus be used with caution in pheochromocytoma as well as in other forms of hypertension. PMID- 3978998 TI - Effect of propranolol on hepatic blood flow in patients with cirrhosis. AB - The effect of propranolol on systemic and hepatic hemodynamics was studied in patients with cirrhosis. One hour after 40 mg propranolol by mouth as well as during continuous oral dosing at doses that reduced heart rate 25%, cardiac output and the hepatic venous pressure gradient fell significantly, whereas arterial pressure and hepatic blood flow did not change significantly. In six patients with cirrhosis and surgical end-to-side portacaval shunts, cardiac output and the hepatic venous pressure gradient also decreased 15 minutes after intravenous propranolol (5 mg), whereas hepatic blood flow did not change significantly. In the patients with surgical shunts, systemic vascular resistance rose significantly but hepatic arterial vascular resistance fell. Our data show that in patients with cirrhosis, propranolol induces an increase in the fraction of cardiac output reaching the liver. PMID- 3978999 TI - Age-dependent lidocaine disposition in patients with acute myocardial infarction. AB - To evaluate age-dependent changes in lidocaine disposition in patients with acute myocardial infarction, we measured plasma concentrations of lidocaine and its metabolites monoethylglycinexylidide and glycinexylidide after discontinuation of a maintenance lidocaine infusion. Plasma lidocaine clearance was calculated by dividing the lidocaine concentration at the end of the infusion into the maintenance infusion rate. Lidocaine clearance in 35 patients was related to body weight and was reduced by heart failure. Heart failure was more common in the elderly, occurring in 15 of 27 (56%) patients over 65 years old and seven of 29 (24%) patients under 65 years old. There was a reduction in lidocaine clearance with age due, in part, to lower body weight and a higher prevalence of heart failure in the elderly. Multilinear regression analysis showed that age and weight contributed to the prediction of lidocaine plasma clearance in patients with and without heart failure. Age was a particularly important predictor of lidocaine clearance in patients with heart failure. Adjustment of lidocaine maintenance doses based on age, weight, and heart failure may help control the frequency of lidocaine adverse reactions in the elderly. PMID- 3979000 TI - Dazoxiben in human sepsis and adult respiratory distress syndrome. AB - Levels of thromboxane B2 (TxB2), the stable metabolite of thromboxane A2, are elevated in human and experimental septic shock. The thromboxane synthetase inhibitor dazoxiben has improved survival and decreased pulmonary hypertension in experimental endotoxemia. A randomized prospective study of 10 patients with the clinical diagnosis of sepsis and early adult respiratory distress syndrome (hypoxemia, radiologic evidence of the syndrome, and intrapulmonary shunt greater than 20%) was performed to test the efficacy of dazoxiben in ameliorating the effects of human sepsis. Five subjects received dazoxiben and five received placebo. Dazoxiben, 100 mg, or placebo was injected intravenously every 4 hours for a maximum of 72 hours. Plasma immunoreactive TxB2 (iTxB2) levels were determined by radioimmunoassay. Before dazoxiben, the plasma iTxB2 level was 752 +/- 261 pg/ml (n = 5) and was reduced within 1 hour to 333 +/- 137 pg/ml. The plasma levels of iTxB2 remained significantly decreased with subsequent doses of dazoxiben and it was 201 +/- 67 pg/ml (n = 4) 60 hours after dosing. In contrast, placebo had no significant effect on plasma iTxB2 levels (n = 5) throughout the entire period of observation. Dazoxiben did not induce any significant changes in pulmonary or systemic vascular resistance, intrapulmonary shunting, clotting studies, or extravascular lung water. One of the five subjects in the placebo group died and two of the five subjects in the dazoxiben group died. We conclude that dazoxiben was safe and effectively lowered plasma iTxB2 levels in patients with sepsis and incipient adult respiratory distress symptom, but did not significantly alter the hemodynamic and pulmonary sequelae of established sepsis. PMID- 3979002 TI - Interaction between metronidazole and drugs eliminated by oxidative metabolism. AB - Single-dose kinetics of 0.1 mg/kg intravenous diazepam, 10 mg/kg oral antipyrine, and 300 mg oral phenytoin were followed in healthy subjects before and after 400 mg metronidazole twice a day for 5 days. When data before metronidazole dosing were compared with those after metronidazole dosing, there were no changes in total plasma clearance of diazepam (0.53 and 0.65 ml/min/kg), antipyrine (39.0 and 38.0 ml/min/kg), or phenytoin (0.56 and 0.55 ml/min/kg). Plasma t 1/2s and volumes of distribution of the three drugs tested were not affected by metronidazole, but urinary excretion of 4-hydroxyantipyrine decreased after metronidazole dosing. There was no change in the elimination of phenytoin as its hydroxylated metabolite after metronidazole. It is concluded that, at therapeutic concentrations, metronidazole does not significantly inhibit oxidative drug metabolism. PMID- 3979001 TI - Effects of influenza virus vaccine on hepatic drug metabolism. AB - Experimental and more limited clinical studies have suggested that influenza vaccination may depress the oxidative hepatic metabolism of various drugs and lead to drug toxicity. The alleged mechanism is the formation of interferon and the resulting decrease in cytochrome P-450 available for drug oxidation. Because of the clinical and basic science implications of these reports, we undertook to study the effects of influenza vaccine on the metabolism of three commonly used drugs: chlordiazepoxide, theophylline, and lorazepam. Our healthy male subjects were studied just before and 1 and 7 days after vaccination. As expected, lorazepam metabolism, which proceeds by glucuronidation and not oxidation, was not altered by vaccination. Surprisingly, however, the oxidation of chlordiazepoxide was also not depressed by the vaccine. Theophylline oxidation, which proceeds primarily by microsomal oxidation (demethylation), was significantly decreased 1 day, but not 7 days, after vaccination. Serum alpha interferon levels rose after vaccination for only about 8 hours, and levels of gamma-interferon rose to about 500 IU/ml at 24 hours, peaked at 72 hours, and returned to normal by 100 hours after dosing. It appeared that the higher the theophylline clearance before vaccination, the greater the degree of clearance depression after vaccination. Thus the inhibition of drug oxidation after influenza vaccination is selective and each drug should be studied individually. The degree of depression of theophylline clearance is small and transient and appears to be greater in subjects with higher prevaccination clearance. PMID- 3979003 TI - High levels of methylxanthines in chocolate do not alter theobromine disposition. AB - Theobromine disposition was measured twice in 12 normal men, once after 14 days of abstention from all methylxanthines and once after 1 week of theobromine (6 mg/kg/day) in the form of dark chocolate. Mean theobromine t 1/2, apparent volume of distribution, and clearance after abstinence from all methylxanthines were 10.0 hours, 0.76 L/kg, and 0.88 ml/min/kg. High daily doses of chocolate for 1 week did not change these values. After subjects abstained from methylxanthines, urinary radioactivity over 72 hours after a single, oral dose of [8 14C]theobromine consisted of 42% 7-methylxanthine, 20% 3-methylxanthine, 18% theobromine, 10% 7-methyluric acid, and 10% 6-amino-5[N-methylformylamino]-1 methyluracil. A week of daily theobromine consumption in the form of dark chocolate also did not alter this urinary profile of theobromine and its metabolites. Although these results might appear to differ from other reports of inhibition of theobromine elimination after five consecutive daily doses of theobromine in aqueous suspensions, both the rate and extent of absorption of theobromine in chocolate were less than that of theobromine in solution. Relative bioavailability of theobromine in chocolate was 80% that of theobromine in solution. This reinforces the fundamental principle that both the metabolic and the therapeutic consequences of a particular chemical can differ when that chemical is given in the pure compared with the dietary form. PMID- 3979004 TI - Cimetidine clearance in the obese. AB - Six subjects with normal weight (mean weight = 62 kg) and six obese subjects (mean weight = 140 kg) were given a single intravenous cimetidine infusion of 600 mg over 10 to 15 minutes. Both groups of subjects had normal serum creatinine levels and were matched with respect to age, desirable body weight, height, renal function, and sex. Compared with subjects of normal weight, obese subjects had higher cimetidine systemic (1147 and 637 ml/min) and renal (808 and 318 ml/min) clearances. Volume of distribution at steady state was of the same order for the two groups (82 and 84 L), but the t 1/2 was shorter in the obese group (1.2 and 1.9 hr). Obese subjects had lower cimetidine sulfoxide serum concentrations and greater cimetidine sulfoxide renal clearance (856 and 509 ml/min). Cimetidine systemic clearance and cimetidine sulfoxide renal clearance values were of the same order in the two groups when normalized by the value of weight raised to the 0.76 and 0.5 powers. Under the assumptions of an average weight of 70 kg and that average serum concentrations produced by cimetidine, 300 mg iv every 6 hours, are appropriate, people with normal renal function and body weight usually receive 48 mg/day/weight0.76. This same dosage in obese individuals with normal serum creatinine values should result in the same average steady-state serum concentrations. In our obese subjects, the mean cimetidine dose would have been approximately 500 mg iv every 6 hours. PMID- 3979005 TI - Etretinate kinetics during chronic dosing in severe psoriasis. AB - Fourteen patients with various forms of psoriasis participated in a clinical study to characterize the pharmacokinetics of etretinate before, during, and after 6 months of therapy. A single 100 mg dose was initially given, followed 2 days later by approximately 170 days of multiple dosing with 25 mg one, two, three, or four times a day depending on the subject's response and tolerance. Blood samples were drawn for 48 hours after the initial dose, for 12 hours after dosing at monthly intervals, and for up to 8 months after administration of the last dose. Blood concentrations of etretinate were determined by a specific reverse-phase gradient elution HPLC assay. Blood concentrations after the first dose declined with an apparent t1/2 of approximately 7 hours, whereas those after the last dose declined with an apparent t1/2 of approximately 120 days. The lengthening of the t1/2 during chronic dosing appears to result from the cumulation of blood concentrations in the measurable range rather than from time related alterations in drug kinetics. This is substantiated by the fact that etretinate blood concentration--time data for the entire course of therapy were fit by a nonlinear least-squares computer program designed to accommodate changes in the dosing regimen. A single polyexponential kinetic equation described the entire 6-month course of therapy as well as the 8-month washout without the need to invoke nonlinear kinetics. Although single-dose kinetic data for etretinate may not be good predictors of steady-state blood concentrations, etretinate appears to follow linear kinetics during these dosing regimens. PMID- 3979006 TI - Pupillary response to methadone challenge in heroin users. AB - The relationship between self-reported illicit heroin use and pupillary response to a low-dose methadone challenge was examined in 28 men beginning methadone therapy for opiate dependence. Pupil diameter was assessed before and 60, 90, and 120 minutes after a 20 mg methadone dose on day 1 of treatment. Self-reports of opiate drug effects were also taken at these times. There was a significant negative correlation (r = -0.53) between pupillary constriction 120 minutes after drug dosing and the average dollar value of subjects' reported heroin use per week. In other words, those who showed the least pupillary constriction generally reported the highest amount of illicit heroin use. Total years since first opiate use was also a significant predictor of pupillary response (r = -0.46). Self reported amount of heroin use and years since first opiate use together accounted for 60% of the total variance in pupillary response to the challenge (Mult r = 0.77). Pupillary response to a low-dose methadone challenge appears to be a clinically practical and objective method for determining opiate tolerance levels in applicants for methadone therapy. PMID- 3979008 TI - Symposium on anesthesia in plastic surgery. PMID- 3979007 TI - Reduction of serum theophylline levels by terbutaline in children with asthma. AB - We studied the effect of oral terbutaline on serum theophylline levels in 12 children with asthma. Sustained-release theophylline (10 mg/kg twice a day) was given with placebo or terbutaline (0.075 mg/kg three times a day) in a chronic, randomized, double-blind, crossover design. The trough serum theophylline concentration fell from 13.8 +/- 4.0 to 10.8 +/- 3.6 micrograms/ml and the peak expiratory flow rate increased from 285 +/- 30 to 310 +/- 29 L/min after terbutaline. Further investigation is needed to clarify the mechanism of action by which terbutaline decreases serum theophylline levels. PMID- 3979009 TI - Regional anesthesia in head and neck surgery. AB - Regional anesthesia in the head and neck area is a common and effective tool for the plastic surgeon. For short procedures, it offers the advantages of convenience and comfort to the patient. In many procedures, in addition, it offers advantages to the plastic surgeon over general anesthesia. A knowledge of anatomy of the course of the sensory nerves in the head and neck is essential to execute regional anesthesia. Some variability is always present. However, the most important factor in success is practice with a specific technique until it is mastered. No attempt was made in this article to provide an exhaustive reference to all acceptable forms of anesthesia. An attempt was made, however, to indicate one or two successful methods for each type of commonly used block so that when studied and practiced it can be expected to yield consistent results. Some repetition has been unavoidable because the intent has been to provide a relatively self-contained section for each block so that it may be as a reference without having to read the entire article. It is hoped that frequent practice will result in effective local and regional anesthesia in the head and neck area. PMID- 3979011 TI - Blood pressure recording in the ambulatory patient and evaluation of cardiovascular risk. PMID- 3979012 TI - Impaired baroreflex sensitivity in the aetiology of salt hypertension in the rabbit. AB - This study was designed to see whether normotensive rabbits with an impairment in baroreflex control of heart rate due to genetic factors are more susceptible to high salt or deoxycorticosterone acetate (DOCA)-salt hypertension. The baroreflex sensitivity of 27 conscious rabbits was assessed by both the 'steady-state' and 'ramp' methods in response to injections of phenylephrine (2.5-30 micrograms/kg). Animals with differing baroreflex sensitivities were then given 4 weeks treatment with 8% NaCl and 1.3% KCl in food (treatment A), or DOCA (25 mg pellet, subcutaneously) with 0.5% NaCl and 0.13% KCl in drinking water (treatment B). A third group were maintained on a regular diet of food and water (controls). A highly significant negative correlation (r = 0.91, P less than 0.01) was found between the increase in mean arterial pressure (MAP) produced either by treatment A or treatment B and the baroreflex sensitivity before treatment. There was no significant correlation between the increase in MAP and initial MAP; increase in body weight; serum K+ after treatment; baroreflex sensitivity before treatment, when assessed by the 'ramp' method. It is concluded that animals with low baroreflex sensitivity due to a reduced ability to suppress cardiac sympathetic activity in response to a pressor stimulus, are more likely to develop hypertension as a result of salt loading. It remains to be determined whether the susceptibility to salt of rabbits with lower baroreflex sensitivity is also associated with a difference in the renal excretion of Na+ ions. PMID- 3979010 TI - Hemostasis in plastic surgical patients. AB - Every surgeon should be acutely cognizant of the importance of the evaluation and treatment of bleeding abnormalities. Dependence upon a normal platelet and clotting system is a requirement for surgery. Significant emphasis should always be placed on a detailed history and physical examination. Routine laboratory evaluations should be regarded as a screening method and be augmented by suspicion raised during the history and physical examination. The importance of a basic understanding of hemostasis and the correction of abnormalities in hemostasis is essential to the practicing surgeon. PMID- 3979013 TI - Changes in plasma catecholamines in response to reflex modulation of sympathetic vasoconstrictor tone by cardiopulmonary receptors. AB - The effects of selective deactivation and stimulation of cardiopulmonary receptors on plasma noradrenaline (radioenzymatic method) were studied in nine normotensive subjects by reducing and increasing central venous pressure for 20 min via lower body suction and leg-raising manoeuvres that did not alter arterial blood pressure and heart rate. Deactivation of cardiopulmonary receptors was accompanied by a rise in plasma noradrenaline that achieved a peak within 5 min (91.8 +/- 22%, mean +/- SE) and was then sustained. Stimulation of cardiopulmonary receptors was accompanied by a fall in plasma noradrenaline ( 16.6 +/- 3.4%) that levelled off at the second minute and was then sustained. On average the increase and the reduction in plasma noradrenaline had a time course and a magnitude similar to the increase (80.5 +/- 10.5%) and the reduction (-28.4 +/- 5%) in forearm vascular resistance (derived from plethysmographic flow measurement) concomitantly caused by cardiopulmonary receptors. Furthermore, analysis of individual data showed that changes in plasma noradrenaline and forearm vascular resistance were linked by a positive relationship (r = 0.64). Thus the cardiopulmonary receptor reflex can produce rapid, marked and sustained changes in both plasma noradrenaline and forearm vasomotor tone. This is in sharp contrast with the previously observed inability of the carotid baroreflex to alter both these humoral and haemodynamic variables. Taken together these findings support the hypothesis that sympathetic tone to skeletal muscle is an important determinant of the concentration of plasma noradrenaline in blood. PMID- 3979014 TI - Cation transport functions in vitro in patients with untreated essential hypertension: a comparison of erythrocytes and leucocytes. AB - We have measured intracellular sodium concentrations and specific 3H-labelled glycoside binding characteristics in the erythrocytes and leucocytes of patients with untreated essential hypertension, and have compared the results with those in well-matched normotensive control subjects. Intracellular sodium concentrations were increased in the leucocytes, but not in the erythrocytes, of patients with untreated essential hypertension. There were no differences in the 3H-labelled glycoside binding characteristics of either the erythrocytes or the leucocytes of hypertensive and normotensive subjects. There was no difference in the ability of plasma samples from hypertensive and normotensive subjects to inhibit the binding of [3H]-ouabain to intact leucocytes from normotensive subjects. These findings are not consistent with the presence of increased concentrations of a substance which behaves like a cardiac glycoside in the circulation of patients with untreated essential hypertension. PMID- 3979016 TI - The retention of cobalamin by the liver in the cobalamin-deficient rat. AB - The effect of cobalamin deficiency on whole body cobalamin content and its turnover was examined in the rat. Quantitative and qualitative changes in hepatic cobalamin were also followed and the effect of deficiency on the turnover of this cobalamin was determined in the isolated perfused liver. As cobalamin deficiency developed after total gastrectomy, whole body cobalamin content declined at a constant rate, indicating no attempt to conserve total body cobalamin stores even when depleted (5% of normal). In contrast, the cobalamin concentration of liver declined more slowly, indicating conservation of hepatic cobalamin. Furthermore, the methylcobalamin (MeCbl) content of liver was maintained or even increased. Measurement of the rate of release of cobalamin by the isolated perfused liver at varying times after gastrectomy showed that as depletion of whole body and hepatic cobalamin stores proceeded, the rates of release of hepatic cobalamin into plasma and bile decreased. Regression analysis showed that the fractional rates of release of hepatic cobalamin into plasma (r = 0.9, P less than 0.001, n = 15) and bile (r = 0.65, P less than 0.01, n = 15) were significantly correlated with hepatic cobalamin content. It is concluded that conservation of hepatic cobalamin in deficiency is achieved, at least in part, by a specific decrease in the rate of release of hepatic cobalamin. PMID- 3979015 TI - Human Tamm-Horsfall glycoprotein: urinary and plasma levels in normal subjects and patients with renal disease determined by a fully validated radioimmunoassay. AB - A recently developed, simple and sensitive radioimmunoassay has been used to examine 24 h excretion and plasma levels of Tamm-Horsfall glycoprotein (THG) in normal subjects, stone formers and patients with stable chronic renal disease. In normal subjects THG excretion ranged from 22 to 66 mg/24 h, with no sex difference and no correlation with creatinine clearance or body surface area. There was no correlation between 24 h THG excretion and urine volume, pH or osmolality, excretion of Na+, K+ or Ca2+ or free-water clearance. There was a small significant correlation between plasma THG concentration and urinary THG excretion. A good correlation was obtained between the THG/creatinine ratio in 24 h and random samples. This made possible the use of random samples to establish a reference range for THG excretion of 0.15-0.50 micrograms/ml of creatinine clearance which did not depend on sex or age. The excretion rate of THG in stone formers was generally within the reference range. It was not significantly different in those who were hypercalciuric or in those taking thiazides. In patients with chronic renal disease there was a good correlation between 24 h THG excretion, plasma THG concentration and creatinine clearance. The range of excretion of THG per ml of creatinine clearance was greater than in normal subjects, independent of the type of renal disease and unrelated to proteinuria. In patients with glomerulonephritis the excretion of THG per ml of creatinine clearance was significantly higher in those with well-preserved tubules compared with those with tubular atrophy. PMID- 3979017 TI - The effect of long-term circulatory occlusion on pH and energy metabolism of the quadriceps muscle in man. AB - The effect of up to 2.5 h circulatory occlusion on muscle pH and energy metabolism of the quadriceps muscle was studied in 13 patients operated on for an inveterate knee injury. Muscle samples were taken by the percutaneous needle biopsy technique at different times during the arterial occlusion and after restoration of circulation. Energy was provided by a complete utilization of phosphocreatine and by a low rate of glycolysis during 2 h of occlusion. The ATP level remained unchanged throughout the occlusion period. Muscle pH decreased from 7.0-7.1 to about 6.8 after 2 h occlusion. Muscle pH was essentially normalized within 20 min after restoration of the blood flow. PMID- 3979018 TI - Staphylococcus epidermidis arthritis following catheter-induced bacteremia in a neutropenic patient. AB - Sepsis due to methicillin-resistant Staphylococcus epidermidis occurred in a neutropenic man during management with a Hickman-Broviac catheter. Despite catheter removal and 10 days of i.v. cefazolin therapy, he developed septic arthritis 6 weeks later in a nonprosthetic hip joint. S. epidermidis was isolated from the joint and found to have plasmid and phage susceptibility patterns identical to the previous blood isolate. This case is the first to document a metastatic infection from catheter-associated S. epidermidis bacteremia. It suggests that cephalosporins may not be optimal in such infections despite in vitro sensitivity. Vancomycin appears to be the drug of choice for S. epidermidis bacteremia in the neutropenic population. PMID- 3979019 TI - Disc diffusion method to screen for high-level resistance to clindamycin and erythromycin in the Bacteroides fragilis group. AB - High-level clindamycin resistance in Bacteroides species was investigated by measuring zone sizes surrounding 2 micrograms clindamycin and 60 micrograms erythromycin discs, using a nonstandardized disc diffusion method, and by determining minimal inhibitory concentrations (MIC). The absence of a zone of inhibition surrounding either disc was predictive for all isolates having high level resistance to both antibiotics (MIC greater than 256 micrograms/ml), characteristic of macrolide-lincosamide-streptogramin (MLS) cross-resistance. Although zone size could not be used as an absolute predictor of MIC, a clindamycin zone diameter of less than 17 mm was suggestive of strains with a moderate level of clindamycin resistance (MIC greater than or equal to 8 micrograms/ml), regardless of erythromycin zone size. Disc diffusion testing using a combination of clindamycin and erythromycin discs can be a useful screening method for detection of clindamycin-resistant Bacteroides species, occurring either alone or as part of the MLS resistance phenotype. PMID- 3979020 TI - An evaluation of a leukocyte esterase/nitrite test strip and a bioluminescence assay for detection of bacteriuria. AB - A leukocyte esterase/nitrite (Chemstrip LNTM) and a bioluminescence assay (LumacTM) were evaluated for detection of bacteriuria in 1,000 urine specimens. Both devices provided high predictive negative values (95.4-97.8%); however, false-negative values at levels of bacteriuria greater than or equal to 10(4) CFU/ml were 22.6% and 12.3%, respectively, for the leukocyte esterase/nitrate and the bioluminescence assay tests. The corresponding false-negative values at levels of bacteriuria of greater than or equal to 10(5) CFU/ml were 16.5% and 3.9%, respectively. PMID- 3979021 TI - Occurrence and antimicrobial susceptibility of gram-negative nonfermentative bacilli in cystic fibrosis patients. AB - Isolation of nonfermentative gram-negative bacilli (other than Pseudomonas aeruginosa) from respiratory tract cultures of cystic fibrosis (CF) patients has increased in recent years. Species recovered include Pseudomonas cepacia, P. maltophilia, P. fluorescens/putida, P. alcaligenes, P. pseudoalcaligenes, P. stutzeri, Acinetobacter spp., Achromobacter xylosoxidans, Flavobacterium spp., and CDC groups IVe and Ve. Although colonization with most of these organisms is sporadic, P. cepacia (and to a lesser extent, P. maltophilia) is usually isolated consistently, and can be associated with significant clinical deterioration. Occurrence of P. cepacia in CF respiratory tract cultures obtained close to the time of death rose nearly ten-fold from 1979 to 1982. Strains representing all nonfermentative gram-negative species encountered were assayed for susceptibility to 17 newer antimicrobial agents. Ceftazidime, n-formimidoyl thienamycin, and aztreonam were most active; cefsulodin, ceforanide, and ceftriaxone were not active against these isolates. PMID- 3979022 TI - Clinical and laboratory features of an outbreak of Vibrio cholerae O1 infections in the United States. AB - A point source outbreak of Vibrio cholerae O1 El Tor Inaba infections occurred aboard an oil rig south of Port Arthur, Texas, in September 1981. Sixteen crew members had V. cholerae O1 infections as determined by serology or stool specimens; 15 were symptomatic. The high percentage of symptomatic infections was attributed in part to the ingestion of a large number of V. cholerae O1 organisms by susceptible individuals. Symptoms included diarrheal stools (100%), weakness (60%), abdominal cramps (53%), nausea (40%), and vomiting (27%). Only one of the three patients who sought medical attention was diagnosed by his physician as having cholera. Physicians who treat patients who live near or travel to the Gulf Coast should consider cholera in patients with watery stools. If cholera is suspected, laboratories should use thiosulfate-citrate-bile salts-sucrose (TCBS) agar in addition to routine enteric media for processing stool specimens. PMID- 3979023 TI - Infective endocarditis. PMID- 3979024 TI - Diagnosis and management of malignant hypertension. PMID- 3979025 TI - Rehabilitation after myocardial infarction. AB - The rehabilitative approach to care is designed to reduce the physical and psychosocial invalidism associated with coronary disease. Important components of rehabilitation for patients with myocardial infarction involve the behaviors and capacities to meet life-style demands and goals. The acquisition of personal skills, techniques, attitudes, and knowledge derived from participation in physical activity and educational counseling regimens may significantly enhance the patient's realistic adaptation to illness and ability to cope with family, workplace, and community challenges and problems. PMID- 3979026 TI - Taste potentiation of auditory aversions in rats (Rattus norvegicus): a case for spatial contiguity. AB - An aversion for an auditory stimulus was established in laboratory rats when a tone was spatially and temporally contiguous with a novel taste in a food conditioned stimulus compound followed by toxicosis. The procedure involved varying the location of the tone relative to a novel tasting food. During toxicosis conditioning, one group ate sweet food with a speaker located in the food, two groups ate sweet food with the speaker displaced (near or far) from the food, and a fourth group was presented with a tone without food available. It was found that the potentiation of auditory aversions required both the presence of a novel taste and spatial contiguity between the taste and the tone. PMID- 3979027 TI - Factors influencing song development in the white-crowned sparrow (Zonotrichia leucophrys). AB - Nestling white-crowned sparrows (Zonotrichia leucophrys nuttalli) were hand reared in sound-isolation chambers under a variety of conditions. The songs of total isolates were compared with songs of birds tutored with song, and the number of inputs sufficient for a bird to produce a normal song was explored. The flexibility of the song learning system was investigated with a range of tape recorded tutor songs: alien dialects, alien subspecies, alien species, alternating alien dialects, and an aberrant song. Adult songs were obtained for 40 males and 7 testosterone-injected females. All of the tutor songs could be learned. Also, some birds learned elements of an alien species' song. Birds tutored with two songs copied one or the other, were bilingual, or sang a hybrid of the two. No bird presented with fewer than 120 songs learned the tutor song; 2 birds tutored with 252 songs copied the tutor song. It is concluded that the song learning system is quite flexible, hat the results obtained with tape-tutors are very different from those with social tutors, and that there may be an interaction between total number of song inputs and the number presented on a single day. Some implications of these data for physiological mechanisms and the possible functional significance of the acquisition system are discussed. PMID- 3979028 TI - Constitutional biases in early perceptual learning: III. Similarities and differences between artificially selected and imprinted color preferences in quail chicks (Coturnix coturnix japonica). AB - Color preferences and preference generalization were tested in naive and imprinted Japanese quail chicks drawn from the 20th generation of a genetic control line and two genetic lines that were bidirectionally selected for preferences between blue and red. Twelve hours of imprinting to blue or red on the first posthatch day resulted in large preference changes in the genetic controls, and these subjects exhibited no or only small additional changes from 3 more days of imprinting (for the total of 66 hr of exposure time). By contrast, 12 hr of imprinting of artificially selected subjects did not change or only marginally changed their genetically manipulated preferences, but 66 hr of imprinting changed them by magnitudes as large as or larger than those in genetic controls. Reciprocal imprinting partially mimicked the phenotypic effects of bidirectional selection. Differences between transfer and generalization of phenotypically similar but genetically and experimentally different preferences indicated dissimilar mediation of the implicit gene effects and learning effects. PMID- 3979029 TI - Genetic differences in avoidance learning by Rattus norvegicus: escape/avoidance responding, sensitivity to electric shock, discrimination learning, and open field behavior. AB - The behaviors of rats selectively bred for either good or poor shuttle box avoidance learning were studied. The results of Experiment 1 indicated that the phenotypic difference in avoidance learning is not associated with differences in speed of escape or avoidance responding. Differences between the lines in frequency of intertrial responses (ITRs), which appear during training but not during pretest, suggest that ITRs in animals of the low-avoidance (SLA) line are more suppressed by electric shock than in animals of the high-avoidance (SHA) line. This result suggests that SLA animals may be more emotionally responsive than SHA animals. Experiment 2 demonstrated that the animals of the two lines do not differ in absolute sensitivity to electric shock, and Experiment 3 showed that the poor performance of the SLA line is not due to an inability to learn. Experiment 3 also provided evidence which suggests that the poor avoidance learning by SLA animals is due to their emotional reactivity. Observations of open-field behavior in Experiment 4 are consistent with this hypothesis. The major consistent correlate of the phenotypic difference in avoidance learning is greater emotionality or emotional reactivity in SLA than in SHA animals. PMID- 3979030 TI - Life-span changes in the copulatory behavior of male rats (Rattus norvegicus). AB - The copulatory behavior of 5-, 10-, 15-, and 20-month-old sexually naive male rats (Long-Evans) was studied during 2-hr tests with receptive females. There was no apparent change in sexual arousal as measured by latency to initiate copulation across age, with subjects from all groups exhibiting comparable latencies to first mount and first mount with intromission. The numbers of ejaculations achieved were also similar across ages. Significant age differences were found for frequency of mounts, with 20-month-olds having the highest mean frequency. The persistent mounting by older males appeared to account for significant group differences in interintromission interval and ejaculation latency. It is suggested that motor deficits may impair the ability of older males to achieve intromission, increasing the number of mount bouts as well as the number of mounts per bout, thus extending the length of each copulatory series. PMID- 3979031 TI - Determinants of mating success in the golden hamster (Mesocricetus auratus): I. Male capacity. AB - Rested adult golden hamsters produced a mean of 13 ejaculations and then showed a modified copulatory pattern consisting of long intromissions (10-30 s of intravaginal thrusting) during which no sperm transfer occurs. When a second (fresh) female was introduced, 58% of the males produced at least one more ejaculation, and 17% of the males produced one further ejaculation when placed with a third female. In similar three-female tests conducted 24 hr later, all males ejaculated (M = 4 ejaculations); this level of ejaculatory output was maintained over a subsequent 10-day period of daily testing. Four ejaculations ensured a nearly 100% pregnancy rate and maximum litter size in the first females. Second and third females, however, received fewer ejaculations and subsequently showed reduced fertility and produced smaller litters. Most males showed high levels of long intromissions on all days and with all females. The physiological significance of these long intromissions may be to trigger the progestational response. Examination of the rate of recovery from sexual exhaustion indicated that 2 or 8 hr of rest resulted in fewer than 50% of the males being capable of one further ejaculation. However, most of these single ejaculations were accompanied by long intromissions and resulted in successful pregnancies. Four to eight days were required for full recovery of ejaculatory capacity. This study showed that the male golden hamster has a higher ejaculatory output and more rapid recovery from sexual exhaustion than other small rodents that have been studied. Thus, the limits of male capacity appear to vary widely among species. PMID- 3979032 TI - Constant rate of evolution in the antigenicity of glucose 6-phosphate dehydrogenase revealed by the enzyme inhibition method. AB - Rabbit and chicken antisera against pure and impure rat glucose 6-phosphate dehydrogenase (G6PD) samples were prepared, and their inhibition potencies (RIP) were measured against G6PDs from 26 vertebrate and invertebrate species. The results demonstrated that the -logRIP values of antisera against G6PDs from various test species neatly correlate with paleontologically estimated divergence times between rat and the test species. This suggests that the antigenicity of G6PD has evolved at a constant rate. The correlation coefficients were evidently greater with chicken antisera than with rabbit antisera, but did not markedly differ between chicken antisera elicited to pure and impure rat G6PD samples. Based on the data obtained with chicken antisera, it is estimated that lineages which separated 250-300 million years ago differ in their G6PDs by one unit of the -logRIP. PMID- 3979033 TI - Protein phenotype and gene expression in the rat perineal levator ani muscle. AB - The rat perineal levator ani (LA) and bulbocavernosus (BC) muscles are homogeneously type 2B fibers as determined by Ca, Mg-ATPase activity. The LA and extensor digitorum longus (EDL) muscles contain similar quantities of creatine kinase and several glycolytic enzymes despite significant differences in fiber composition. The LA muscles synthesizes and accumulates only the fast isoforms of protein C, myosin heavy chain and myosin light chains. PMID- 3979034 TI - Studies on equine transferrin--I. The isolation and partial characterization of the D and R variants. AB - Each of two genetic variants of equine transferrin, D and R, is isolated from the blood of the heterozygote by a gentle fractionation procedure at pH 7.2. It is shown by step gradient polyacrylamide gel electrophoresis at pH 7.9 that each of these phenotypes exhibits two major bands (designated F, fast, and S, slow) and several minor bands. Components corresponding to these bands are separated by ion exchange chromatography at pH 6.6 and 6.9 respectively for the D and R variants. The F and S components of each variant contain respectively four and two sialic acid residues. The nature of their heterogeneity is, at least in part, due to their varying sialic acid contents. It has not been possible to desialylate them completely by neuraminidase. On the basis of comparative studies of the tryptic and chymotryptic peptide maps of transferrins D and R it is concluded that there are at least two amino acid substitutions--D:R:Asp:Gly and Glu:Gly. These two substitutions are qualitatively in accordance with the difference in the electrophoretic mobility between the two variants at alkaline pH. PMID- 3979035 TI - New medium for solubilizing proteins of the eye lens core (nucleus). AB - The eye lens core (nucleus) is a practical source of proteins for use as genetic markers. A new, simple extraction solution for these proteins is described. The solution was tested on fish (mullet, rockfish, and barracuda) lens nuclei, which produced weak extracts with other extraction media. A new solution, in addition to producing the strongest extracts, demonstrated desirable qualities relating to electrophoresis and storage. This solution may serve as a general extraction solution for nuclear lens proteins. PMID- 3979036 TI - Swine uterus carnosinase activity in oestrous cycle and early pregnancy. AB - Carnosinase activity was determined in uterus extracts of sexually immature sows, on particular days of the oestrous cycle, and on the 20th and 30th day of pregnancy. In mature sows carnosinase activity in the uterus was on the average 4.5 times higher than in immature sows. Activity of the enzyme in the oestrous cycle increased from the zero day (first day of the heat) until 13th day, followed by a rapid decrease, reaching the lowest levels on the 17th day of the cycle (3 times lower on the average than on the zero day). On the last days of the cycle (20-21st) activity of carnosinase reached again levels similar to those of the zero day. Carnosinase activity in a uterus corner of pregnant sows (20th day of pregnancy) was over 4 times higher than in the "peak" day of the oestrous cycle (13th day), and over 12 times higher than in immature sows. Activity of the enzyme increased along with progressing pregnancy. It was found that activity of carnosinase in uterus corner of swines was related to the level of progesterone determined by other authors in the blood plasma. PMID- 3979037 TI - Characterization of sheep liver and lung microsomal ethylmorphine N-demethylase. AB - Ethylmorphine N-demethylase activity of the sheep liver and lung microsomes was reconstituted in the presence of solubilized microsomal cytochrome P-450, NADPH cytochrome c reductase and synthetic lipid, phosphatidylcholine dilauroyl. The Km of the lung microsomal ethylmorphine N-demethylase was calculated to be 4.84 mM ethylmorphine from its Lineweaver-Burk graph and lung enzyme was inhibited by its substrate, ethylmorphine, when its concn was 25 mM and above, reaching to 67% inhibition at 50 mM concn. The Lineweaver-Burk and Eadie-Hofstee plots of the liver enzyme were found to be curvilinear. From these graphs, two different Km values were calculated for the liver enzyme as 4.17 mM and 0.40 mM ethylmorphine. Ethylmorphine N-demethylase activities of both liver and lung microsomes were inhibited by NiCl2, CdCl2 and ZnSO4. Ethylalcohol inhibited N-demethylation of ethylmorphine in lung and liver microsomes. Acetone (5%) slightly enhanced the N demethylase activity of the liver enzyme, whereas 5% acetone completely inhibited the lung enzyme. Phenylmethylsulfonyl fluoride at 0.10 mM and 0.25 mM concn had no effect on liver enzyme activity, while at these concns, it inhibited the activity of the lung enzyme by about 35%. PMID- 3979038 TI - Establishing a medical research computer facility. AB - We report on the design and implementation of a computer facility (called the Data Bank) for medical research. The system was designed to be accessible to medical researchers and their staff. Its chief requirements were ability to handle large volumes of data efficiently and be reasonably user-friendly, since most medical research staff members are computer-naive. We describe how we set-up a user friendly system and report on the problems we had in making it accessible. The chief problems were caused by difficult communication between computer staff and medical research staff. We discuss the ways we have attempted to overcome the problems. PMID- 3979039 TI - An expert system for information on pharmacology and drug interactions. AB - Pharmacological information has been organized and encoded in rules and frames for systematic retrieval. This includes: delineation, definition, and hierarchical subdivision of mechanisms responsible for drug interactions; division of pharmacological agents into a hierarchy of subclasses to allow for defining interacting drugs by classes as well as by specific agents; correlation of drug classes and specific drugs with mechanisms by which they may be involved in drug interactions. This information, accessible through a natural language like and menu driven interface, allows clinicians to know what may happen when two drugs are used together, why, what can be done to alleviate detrimental interactions, and what related drugs may also be involved in similar interactions. PMID- 3979040 TI - The Finn chamber methylene blue ring. AB - Metallic aluminium and methylene blue applied to human skin interact and give a strong resistant coloration, obtained neither with methylene blue itself nor with other dyes. The reaction proves that aluminium is not an inert material and that the aluminium in Finn chambers can be expected to interact with other patch test substances. PMID- 3979041 TI - Cytostatic agents and contact allergy: the efferent limb. AB - The effects upon the contact allergic reaction in the guinea pig of the 3 cytostatic agents most commonly used for their immunosuppressant properties, cyclophosphamide, methotrexate and azothioprine, have been investigated in an experimental model which allows comparison of the qualitative and quantitative aspects of the dermal inflammatory infiltrate and the macroscopic response. The 3 agents were given in single, relatively high doses and had effects on the dermal inflammatory infiltrate which varied in nature, degree and time course. Changes often showed a cyclical development with time, with "rebound" often following initial changes. Although cyclophosphamide had the most marked effect, all agents affected the mononuclear, basophil and eosinophil dermal infiltrates at some point in the experiment. Cyclophosphamide was the only agent found to affect the total white cell count of peripheral blood, but the leukopenia did not affect recruitment of mononuclear cells to the dermis. In the period immediately after administration of cyclophosphamide and methotrexate, the macroscopic score increased. Whilst the mechanism of this effect is unclear, it may be a manifestation of a basophil, perhaps IgE mediated reaction. Further manipulation of dose and dose interval may result in administration schedules relevant to the treatment of cell-mediated hypersensitivity in clinical practice. PMID- 3979042 TI - Patch testing with silver sulfadiazine cream. AB - 23 patients who had used silver sulfadiazine cream were patch tested. No reactions to the active principle occurred but 2 vehicle components, cetyl alcohol and propylene glycol, were positive. No sulfonamide-sensitive subject reacted to silver sulfadiazine. There is no evidence that silver sulfadiazine has a contact sensitizing potential or that it is contra-indicated for patients with a history of sulfonamide hypersensitivity. PMID- 3979043 TI - Zinc pyrithione (Zinc Omadine) allergy. PMID- 3979044 TI - Cerumenex allergy. PMID- 3979045 TI - Flare-up of cobalt dermatitis from Antabuse treatment. PMID- 3979046 TI - Allergy to dyes used in lymphangiography. PMID- 3979047 TI - Contact allergic reaction to valerate esters of betamethasone and hydrocortisone. PMID- 3979048 TI - Role of the macrophage in immunologically induced glomerulonephritis. PMID- 3979049 TI - Methods of identification of macrophages in tissues. PMID- 3979050 TI - Role of monocytes in human glomerulonephritis. Histochemical study. PMID- 3979051 TI - Monocytes in human glomerulonephritides: immunohistochemical and ultrastructural correlations. PMID- 3979052 TI - Clinicopathologic correlations in lupus nephritis. PMID- 3979054 TI - Evoked potentials in uremia. PMID- 3979053 TI - Aluminium encephalopathy. PMID- 3979055 TI - Dysfunction of the autonomic nervous system in patients with end-stage renal failure. PMID- 3979057 TI - Blocking mechanisms of impulse propagation along CNS fibres studied by means of evoked cortical responses. PMID- 3979056 TI - Carpal tunnel syndrome in long-term dialyzed patients. PMID- 3979059 TI - Small animal medicine. Past, present and future. PMID- 3979058 TI - Large animal medicine. Many changes in forty years. PMID- 3979060 TI - Avian diseases. PMID- 3979061 TI - The veterinary profession: changes and challenges. PMID- 3979062 TI - Toxicology: an overview. PMID- 3979063 TI - Poultry nutrition. A twentieth century achievement. PMID- 3979064 TI - The future of parasitology. PMID- 3979065 TI - Salmonellosis: a continual threat to New York State's cattle and horses. PMID- 3979066 TI - Cannulation of big arteries in critically ill patients. AB - A retrospective evaluation of 350 axillary and femoral artery cannulations in ICU patients revealed a 6.3-day mean duration of catheterization. Minor incidents such as hematoma (3.7%), catheter malfunction (5.1%), and local inflammation (2.5%) were noticed. The catheter was removed in 25 patients in whom it was suspected of causing sepsis. Six septic patients had the same organism in catheter and arterial blood cultures (with a negative venous blood culture), probably denoting an infected, catheter-linked thrombus. In 241 cases the catheter was removed at the end of the monitoring period. In only 21 of these cases did an organism grow in the catheter culture, but in 18 of these cases, the same organism was found in previous blood, sputum, and/or urine cultures. Thus, in only six patients (of 266 survivors) could arterial cannulation be held responsible for generalized sepsis. However, because no bacteriologic study was performed on catheters removed after the patient's death, this number could have been higher. Percutaneous axillary and femoral artery cannulation is highly recommended for extended monitoring because of its low incidence of minor complications, and no evident danger of tissue ischemia. PMID- 3979067 TI - Hemodynamic effects of vasodilators on pulmonary hypertension in decompensated chronic obstructive pulmonary disease. AB - Vasodilators have been reported to improve the hemodynamic status of some patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease (COPD). We investigated the effects of sodium nitroprusside (50 micrograms/min) and hydralazine (25 mg) on pulmonary hemodynamics in 12 patients during acute exacerbation of COPD. Apart from its known systemic effects, nitroprusside decreased significantly mean pulmonary artery pressure (MPAP) from 36 +/- 10 to 31 +/- 12 mm Hg (p less than .04), decreased slightly pulmonary vascular resistance, and did not change cardiac index. Except for a slight but significant increase in MPAP from 35 +/- 5 to 38 +/- 5 mm Hg (p less than .002), hydralazine produced no significant hemodynamic changes. These results suggest that vasodilator therapy with sodium nitroprusside and hydralazine for pulmonary hypertension secondary to acute COPD is probably not helpful. PMID- 3979068 TI - Intracranial pressure and cerebral perfusion pressure in near-drowning. AB - Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were strictly controlled in 11 pediatric victims of near-drowning. Three outcome groups were defined: complete recovery, persistent vegetative state, and death. In the early postimmersion phase (first 72 h), CPP was consistently above 50 mm Hg in all patients. There were occasional, nonrepetitive, and easily controllable ICP spikes above 15 mm Hg in three patients from each group. Repeated ICP spikes above 15 mm Hg were observed in some patients with adverse outcome only after 72 h. Successful control of ICP and CPP did not ensure intact survival, and sustained late intracranial hypertension is more likely a sign of profound neurologic insult rather than its cause. PMID- 3979069 TI - Predictability and consequences of spontaneous extubation in a pediatric ICU. AB - To determine the incidence of, and the factors contributing to spontaneous extubation (SE), we followed prospectively all intubated children admitted to a pediatric ICU. Eleven potential risk factors were monitored and scored twice daily for 8 consecutive months. Using data from the first 204 patient admissions, we evaluated the risk factors by orthogonal discriminant analysis and found that four factors (patient age, amount of secretions, endotracheal tube slippage, and state of consciousness), when considered together, had good discriminating power for SE vs. intentional extubation. We tested this method on the next 45 patient admissions and identified all seven spontaneously extubated patients as high risk. Analysis of covariance revealed successful discrimination between low-risk and high-risk patients for up to three days after patient admission. Overall, the incidence of SE was 13% (33 of 249). The effect of extubation on gas exchange was the same for spontaneously and intentionally extubated patients. No morbidity or deaths were attributed to SE. Standard ventilator low-pressure alarms did not reliably signal the presence of SE, nor did upper extremity restraints keep patients from extubating themselves. PMID- 3979070 TI - Effect of intra-alveolar meconium on pulmonary surface tension properties. AB - To evaluate the effect of meconium on pulmonary surface tension properties, the mechanics of 30 excised, separated canine pulmonary lobes were studied. Meconia were blended in normal saline to produce solutions of 10% and 20%. Solutions were filtered to remove large particles and instilled endobronchially into the canine lobes. The static pressure-volume deflation curve of each lobe was determined before and 4 h after instillation of either normal saline or meconium solution. In the saline control group (eight lobes), the curve was essentially unchanged before and after instillation. In the 10% meconium group (14 lobes), the curve was significantly depressed after instillation, especially at a transpulmonary airway pressure of 10 cm H2O (p less than .05) and 5 cm H2O (p less than .005). In the 20% meconium group (eight lobes), the depression of the pressure-volume curve was essentially the same as that of the 10% solution group. It is concluded that meconium depresses the surface-active properties of the alveolar linings. PMID- 3979072 TI - Unprecedented sedative requirements during delirium tremens. AB - A 34-yr-old male in delirium tremens required a total of 2640 mg iv diazepam for adequate sedation. Doses of benzodiazepines clearly must be individualized, and doses higher than those currently recommended may be required. PMID- 3979071 TI - Surgical repair of acute postinfarction cardiac rupture. AB - Acute myocardial infarction is complicated by cardiac rupture in 4% to 24% of all infarction deaths, and approximately 10% of hospital infarction deaths. There are no reliable indices to determine which patients run an increased risk of cardiac rupture. This report describes the surgical treatment and outcome of a patient who sustained a rupture of the left ventricular free wall, nine days after extensive anterior myocardial infarction. PMID- 3979073 TI - Further uses of glucagon. PMID- 3979074 TI - Hypercapnia complicating massive pulmonary embolism. PMID- 3979075 TI - Seleno-DL-methionine and the protection of human platelets against freezing injury. AB - The effect of seleno-DL-methionine, which has antioxidative properties, on the recovery of human platelets after freezing with 0.5 mol/liter glycerol or 0.7 mol/liter (5% v/v) dimethyl sulfoxide was investigated. Incubation of platelets with 2 mumol/liter seleno-DL-methionine for 30 min at room temperature before equilibration with the protective additives improved the post-thaw uptake of 5 hydroxytryptamine and the percentage reversal in the hypotonic stress test. The effect was small, but in view of the ability of seleno-DL-methionine to inhibit lipid peroxidation in membranes, the results suggest that oxidative damage is implicated in freezing injury. The dimethyl sulfoxide protocol apparently afforded greater protection to the platelets than the glycerol protocol. But, if the platelets were incubated for 24 hr at 37 degrees C after thawing, there was a marked improvement in the response of cells in the hypotonic stress test, particularly in the samples frozen with glycerol, and there was no longer any difference between the two additives. There was, however, a concomitant loss of almost half the number of cells in the thawed suspensions during the prolonged incubation at 37 degrees C. PMID- 3979076 TI - Aggregate formation in cryopreserved leukocyte suspensions. AB - During cryopreservation of leukocytes, a great part of the granulocytes is injured. The latter is responsible for aggregate formation in the suspension and a loss in the number of preserved cells. The formation of aggregates in the suspension is potentiated in the presence of serum in the cryoprotective medium. On the other hand, the presence of sugar (sucrose, lactose, dextrose) in the washing solution diminishes the aggregate formation, the latter effect being directly proportional to the final concentration of the sugar in the suspension. The aggregates contain mainly cells and very rarely amorphous or fibrous zones. They appear only in the presence of serum. Their formation is not connected with presence of traces of fibrinogen in the serum. PMID- 3979077 TI - Functional changes in mitochondrial properties as a result of their membrane cryodestruction. I. Influence of freezing and thawing on succinate-ferricyanide reductase of intact liver mitochondria. AB - The interaction of the succinate dehydrogenase complex of rat liver mitochondria with an artificial electron acceptor (K3Fe(CN)6), impermeable to the mitochondrial membrane as an index of a cryoinjury is investigated. It is shown that the freeze-thawing stimulates succinate-ferricyanide reductase (SFCR) activity of intact mitochondria. The increase of the freezing and thawing rates leads to a decrease in the released SFCR activity. The released SFCR activity after low-temperature treatment is a consequence of a nonspecific change in membrane ferricyanide permeability. The released SFCR activity decreases as the freezing and thawing rates increase. PMID- 3979078 TI - Freeze-etching study on membrane ultrastructural changes caused by freezing: cooling rate-dependent intramembrane particle aggregation in erythrocyte stripped ghosts. AB - The changes of membrane ultrastructures by freezing stresses were examined on stripped ghosts which were made by removing almost all peripheral membrane proteins from human erythrocyte membranes. By freezing these stripped ghost membranes showed cooling rate-dependent intramembrane particle (IMP) aggregation. With the cooling rates at and faster than 30,000 degrees C/min, their IMPs were evenly distributed on the fracture faces. However, cooling rates at and slower than 8000 degrees C/min resulted in IMP aggregation. The degree of IMP aggregation increased in parallel with decreasing cooling rates. Without freezing, the IMP aggregation in stripped ghosts could be induced by exposing these ghosts to hypertonic salt solutions, but lowering the temperature did not affect IMP aggregation. The cooling rate-dependent IMP aggregation during freezing was suppressed by adding cryoprotective agents which were known to reduce the salt concentration of the medium during freezing. It is suggested that the IMP aggregation in stripped ghosts by freezing occurs by exposure to concentrated salt solutions during freezing. This result indicates the possibility that IMP aggregation may arise during slow freezing of some biomembranes as a result of an increase in salt concentration rather than as a result of reduction in temperature. PMID- 3979079 TI - Profound endoesophageal cryotherapy. AB - Studies are reported to define the tolerance of the feline esophagus to cryoinjury. Thirty-seven cats underwent endoesophageal cryotherapy to temperatures of -100, -120, -140 degrees C for 30 sec. Animals were sacrificed at 90 min, 4, 10, 14, and 20 days. The extent of cryoinjury was evaluated with cine esophagogram, esophageal manometrics, and pathologic evaluation. Esophagograms demonstrated mural edema, coinciding with diminished amplitude of peristalsis in the area of freeze. All animals frozen to -100 degrees C survived with complete healing. Of the animals frozen to -120 and -140 degrees C, 14 and 15%, respectively, developed esophageal perforation. The feline esophagus tolerates local freezing to levels of -100 degrees C with complete healing. This modality may be useful in treating superficial lesions of the esophagus. PMID- 3979080 TI - Frequency and coordination of ciliary beat after cryopreservation of respiratory epithelium. AB - The effect of cryopreservation on human nasal mucosal biopsies was evaluated by determining the frequency and coordination of the ciliary beat. Samples were cryopreserved in a medium containing 80% Gey's balanced salt solution, 10% dimethyl sulfoxide, and 10% fetal calf serum. After thawing, the samples were put in a solution of 90% Gey's balanced salt solution and 10% fetal calf serum. Video recordings of the samples before and after cryopreservation were compared using a semiquantitative method. All the frequencies and coordination patterns seen before cryopreservation could be found in the sample after cryopreservation. It is concluded that ciliated epithelial biopsies can be stored in liquid nitrogen with the maintenance of ciliary beat frequency. In the recorded ciliated cells the ciliary beat coordination was slightly reduced; a lack of coordination was present in 20% of cells after cryopreservation as compared to 10% before cryopreservation. PMID- 3979081 TI - Degradation of functional integrity during long-term storage of a freeze-dried biological membrane. AB - Trehalose, and to some extent a few other carbohydrates, is capable of stabilizing the structure and function of isolated biological membranes during lyophilization. In this paper the results of investigations into the long-term stability of the lyophilized membrane-carbohydrate mixtures were reported. The effects of varying water content, oxygen level, and light on the rates of oxidation, browning, and degradation of biological activity were reported. The efficiency with which three carbohydrates stabilized membrane structure was also reported, with glucose shown to be less efficient than maltose or trehalose. Increased water content accelerated loss of biological activity, possibly because, under the same conditions, nonenzymatic browning and photooxidation were accelerated also. Glucose-containing samples were especially unstable at elevated humidities. Efficiency of preservation could be maximized by storage under conditions of low oxygen, low humidity, and dark, and by the inclusion of high levels of trehalose. PMID- 3979082 TI - Effects of short-term hypothermic perfusion and cold storage on function of the isolated-perfused dog kidney. AB - The isolated-perfused dog kidney was used as a model to measure the effects of short-term hypothermic preservation on renal function and metabolism. Kidneys were cold-stored in Collins' solution, hypotonic citrate, or phosphate-buffered sucrose for 4 and 24 hr, or were continuously perfused for 4 and 24 hr with a synthetic perfusate. Following preservation kidneys were perfused with an albumin containing perfusate at 37 degrees C for 60 min for determination of renal function. The results indicate that many of the effects of short-term preservation on renal function in dog kidneys are similar to results reported for rat and rabbit kidneys. Cold storage for 4 hr resulted in a large decrease in GFR (57%), but only a small decrease in Na reabsorption (from 97 to 87%). Cold storage for 24 hr caused a further decline in renal function (GFR = 95% decrease, Na reabsorption = 49-64%). Results were similar for all cold storage solutions tested. Perfusion for 4 hr was less damaging to renal function than cold storage. The GFR decreased only 14% and urine formation and Na reabsorption were practically normal. After 24 hr of hypothermic perfusion, the GFR was reduced by 79%, urine flow was normal, and Na reabsorption was 78%. There were no obvious biochemical correlates (adenine nucleotides, tissue edema, or electrolyte concentration) with the loss of renal function during short-term preservation. The results suggest that the isolated-perfused dog kidney can be used to test the effects of preservation on renal function, and yields results similar to those obtained using small animal models.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979083 TI - The influence of temperature on the function of renal cortical slices frozen in various cryoprotectants. AB - Renal cortical slices were frozen to various subzero temperatures after treatment with 2.1 M of one of three cryoprotectants, dimethyl sulfoxide (Me2SO), ethylene glycol, or glycerol. The effects on tissue [K+]/[Na+] of cooling to these temperatures were tested (using identical procedure times, cooling rates, and warming rates) by holding the slices at each experimental temperature for appropriate periods of time prior to rewarming. The effects of the holding time were assessed by comparison with slices which were cooled and rewarmed with no intermediate holding time. Slices treated with ethylene glycol or glycerol were found to exhibit a continuous decrease in [K+]/[Na+] with lowered temperatures, in contrast to those treated with Me2SO. Slices treated with Me2SO actually experienced a continuous increase in [K+]/[Na+] with lowered temperature (-12 to 33 degrees C). Me2SO does exhibit toxic effects at subzero temperatures. Adverse effects of holding time on viability are seen for Me2SO-treated slices at higher subzero temperatures. These effects were alleviated as the temperature is reduced, suggesting that temperature has a greater effect on survival of renal cortical tissue than Me2SO concentration. However, the toxicity observed at higher subzero temperatures is expected to be of importance, particularly for slowly cooled tissues which are exposed to these temperatures for relatively long periods of time. PMID- 3979084 TI - Effects of hypothermic kidney preservation on the isolated perfused kidney: a comparison of reperfusion methods. AB - Two isolated-perfused kidney methods were used to study the effects of hypothermic preservation on renal function in dog kidneys. The isolated-machine perfused kidney (IMPK) used an in vitro perfusion technique--the perfusate was a Krebs-bicarbonate type delivered to the kidney at 37 degrees C by a mechanical pump at a constant pressure (100 mm Hg). The isolated-blood-perfused kidney (IBPK) utilized transplantation of the preserved kidney to the femoral vasculature. Renal function (urine analysis) was determined over a 1-hr reperfusion interval and included GFR (creatinine clearance), urine formation, and Na+ reabsorption. Kidneys preserved for only 24 hr by cold storage in either Collins'--C3 solution or in hypotonic citrate and kidneys hypothermically perfused for 24 hr demonstrated greater retention of renal function when reperfused by blood (IBPK) than with the in vitro perfusate (IMPK). The GFR was reduced by 38-58% when tested with the IBPK, but by 80-90% when tested with the IMPK. Na+ reabsorption was normal (97%) with blood reperfusion but was reduced to 36-50% in cold-stored kidneys and 82% in hypothermically perfused kidneys determined by machine reperfusion (IMPK). However, kidneys perfused for 72 hr demonstrated more similar renal functions when tested by either IMPK or IBPK. GFR was reduced to 20% (IBPK) and 11% (IMPK) and Na+ reabsorption averaged 76-85% (IBPK or IMPK). These results suggest that either reperfusion method is suitable for determining the effects of renal preservation on kidney function in kidneys preserved for 72 hr but, for short-term preserved kidneys (24 hr), the IBPK model may be preferred. PMID- 3979085 TI - Reaction of bone marrow after cryo- and thermolesions on internal organs. AB - Focal thermo- and cryolesions were placed on one kidney and the liver of Wistar rats. The wound healing was investigated histologically and by tritiated thymidine autoradiography. Furthermore, the 3H labeling indices of neutrophilic and eosinophilic promyelocytes and myelocytes as well as that of erythroblasts were determined in bone marrow samples from femur and vertebra. Normal nonoperated rats and rats which underwent sham operation (simple laparotomy) served as controls. The cryonecrosis healed completely after 4 weeks, whereas thermonecrotic areas were still observed 12 weeks after operation. The maximum mesenchymal and epithelial proliferation occurred between the 2nd and 3rd postoperative days. In the bone marrow, the highest labeling indices were estimated in animals with thermonecrosis, with values remaining increased during the 2 weeks after operation. Significant differences between the bone marrow response after cryolesions and sham operation were not observed. Thermolesions of internal organs, for example, after electrocoagulation, evoke a persisting local granulomatous inflammation accompanied by a distinct bone marrow reaction probably because of the pure resorption of carbonized tissue components. Iatrogenic cryolesions, in contrast, are characterized by a quick and uncomplicated wound healing without a significantly increased proliferation of bone marrow cells, thus corresponding to the wound healing after sham operation. PMID- 3979086 TI - Effect of varying freezing and thawing rates in experimental cryosurgery. AB - Six different freezing/thawing programs, which varied freezing rate, duration of freezing, and thawing rates, were used to investigate the effect of these factors on cell destruction in dog skin. The range of tissue temperatures produced was from -15 to -50 degrees C. The extent of destruction was evaluated by skin biopsies 3 days after cold injury. In single, short freezing/thawing cycles, the temperature reached in the tissue was the prime factor in cell death. Longer freezing time and slow thawing were also important lethal factors which increased destruction of cells. Cooling rate, whether slow or fast, made little difference in the outcome. The experiments suggested that present-day, commonly employed cryosurgical techniques, which feature fast cooling, slow thawing, and repetition of the freeze/thaw cycle, should be modified by the use of maintenance of the tissue in the frozen state for several minutes and slow thawing. Thawing should be complete before freezing is repeated. These modifications in technique will maximize tissue destruction, an important consideration in cancer cryosurgery. PMID- 3979087 TI - In situ freezing of the pancreas and portal vein in the pig. AB - The pathophysiological results of a study of simultaneously freezing the pancreas and portal vein in the pig are presented. There was little reduction in portal venous flow despite the vein being frozen, and there were no cases of occlusion, rupture, or dilatation of the vein. Major histological changes in the vein wall were noted however. The frozen pancreatic tissue was completely destroyed and replaced by granulation tissue. The possible use of this form of therapy to treat pancreatic cancer is discussed. PMID- 3979088 TI - Optimum warming rates to maintain glucose metabolism in porcine skin cryopreserved by slow cooling. AB - The optimum warming rate for cryopreserved skin (dimensions: 7.6 cm X 20 cm X 0.38 mm thick) folded double in a flat package format was tested using a recently developed quantitative assay of skin cell metabolism. The assay measured the metabolic conversion of glucose to carbon dioxide by intact partial-thickness skin. Skin cooled at a constant, controlled rate of -1 degree C min-1 to a temperature of -100 degrees C, and then rapidly transferred to -196 degrees C for overnight storage, could be optimally warmed at rates of 95-260 degrees C min-1 by immersion in 10-20 degrees C water. The amount of metabolic activity remaining in skin warmed at rates within this optimal range was 76-78% of normal. Slightly less than maximal metabolic activity, 71-75% of normal, resulted from warming rates of 292-458 degrees C min-1, obtained by immersion in 25-37 degrees C water. Skin metabolism remaining after warming rates of 30-53 degrees C min-1 (3-5 degrees C water) was 52-70% of normal, while that remaining after rates of 501 882 degrees C (40-65 degrees C water) was 0-47% of normal. These experiments establish practical upper and lower limits for post-cryopreservation warming rates employed to maintain skin cell metabolism, and the cellular viability which depends upon that metabolism. PMID- 3979089 TI - A non-invasive instrument for clinical assessment of the pre-corneal tear film stability. AB - A simple, non-invasive technique has been developed for assessment of the stability of the pre-corneal tear film. Changes are observed in the reflection of a grid pattern from the tear film surface. Breaks in the tear film appear as random discontinuities in the grid image. Using this non-invasive technique the stability of the pre-corneal tear film was assessed in nine normal subjects and twelve established dry-eye patients. The non-invasive tear film break-up time (NIBUT) of the dry-eye patients was on average only 25% to 32% of normal values. The non-invasive technique provides an alternative approach to diagnosing non wetting disorders as well as a means of evaluating the efficacy of artificial tear solutions. PMID- 3979090 TI - An in vitro model of leukocyte mediated injury to the corneal epithelium. AB - To enhance efforts directed at unraveling the role and mechanisms of leukocytes in mediating injury to corneal epithelium, an isolated bovine corneal cup was developed and evaluated. Bovine peripheral leukocytes and lysates were added to the corneal epithelial surface of isolated cornea for various periods after which the degree of morphologic changes and cell damage were assessed using light and electron microscopy. Results of these studies indicate that leukocyte/epithelial cell interactions are characterized by five successive stages: (1) leukocyte adhesion to superficial layer of the epithelium, (2) leukocyte penetration beneath the superficial epithelium, (3) epithelial cell injury, (4) leukocyte phagocytosis of killed epithelial cells and (5) ulceration and total destruction of the full thickness of the epithelial layer. The above sequence appears to be both time and dose dependent; that is epithelial cells exposed to leukocytes for short periods (5-60 minutes) or to low dose levels (10(5) - 10(7) cells/ml) shows leukocyte adhesion and penetration beneath the superficial layer of the epithelium, (stage 1 and 2), while longer exposures (2-3 hours) or higher numbers of leukocytes (10(7) - 10(8) cells/ml), leads to deeper penetration of epithelium by leukocytes and epithelial injury (Stages 3,4,and 5). We also observed that direct contact of intact leukocytes with epithelial cells is apparently necessary to induce this type of injury. These findings demonstrate the ability of leukocytes to destroy corneal epithelial cells and the value of this new ocular model for studies of the basic immunology of ocular inflammation. PMID- 3979091 TI - The effect of retrobulbar epinephrine injection on ocular and optic nerve blood flow. AB - The effect of retrobulbar epinephrine administration on ocular and optic nerve blood flow was studied in phakic and aphakic rabbit eyes using a radioactive microsphere (85Sr) technique. One hour before blood flow determination, 10 microliter of a 0.2% (base) epinephrine bitartrate solution was administered to the right eye of each experimental rabbit by the retrobulbar route. For control rabbits, 10 microliter of saline was injected retrobubarly. Blood flow measurements were determined for the iris, scrap[ed ciliary processes, choroid, retina, and optic nerve. Neither optic nerve nor ocular blood flow was altered by this dose which is approximately the dose used in retrobulbar injections in humans. PMID- 3979092 TI - Mitosis in the lens epithelium of the galactose-fed rat after prolactin treatment. AB - We have investigated the effect of the anterior pituitary hormone, prolactin, on mitosis in the lens epithelium of the galactose-fed rat. Our findings indicate that prolactin had a stimulatory effect on galactose-triggered mitosis within 24 hours after hormone administration. After three full days of galactose-feeding and daily prolactin injections, lens epithelia from prolactin treated rats had fewer mitoses than those from saline-injected controls. At the time when the number of mitoses had fallen to a subnormal level due to galactose-feeding (i.e., after 7 days), lenses of prolactin-treated animals exhibited less of a decrease in mitotic activity. Thus, it seems that prolactin modulates the mitotic response of lens epithelial cells when animals are on a galactose-rich diet. This modulation may be due, among other things, to a general acceleration of the cataractogenic process, mediated by the osmoregulatory action of prolactin. PMID- 3979093 TI - Effect of fluorescein instillation on the pre-corneal tear film stability. AB - Non-invasive tear film break-up time (NIBUT) was measured in nine normal subjects to investigate the effect of fluorescein instillation of tear film stability. It was found that fluorescein instillation reduced the tear film stability in the treated group, compared with the control group (P less than 0.05). It is, therefore likely that the tear film stability may be greater than had hitherto been suggested by the fluorescein method. PMID- 3979094 TI - Infective endocarditis: improved diagnosis and treatment. PMID- 3979095 TI - Pulmonary hemosiderosis. PMID- 3979096 TI - The misuse of the patch test to determine "hypersensitivity" to mercury amalgam dental fillings. PMID- 3979097 TI - Metastasis of pulmonary carcinoma to the nail unit. PMID- 3979098 TI - Considerations in the use of home ultraviolet radiation therapy for psoriasis. PMID- 3979099 TI - Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol. AB - Infiltrative dermatitis and marked alopecia of the scalp appeared shortly after a new beta-blocker, nadolol (Corgard), was prescribed for the treatment of a patient with hypertension. Cessation of the beta-blocker therapy, after four months of therapy, was followed by a dramatic involution of the eruption, and total regrowth of scalp hair occurred within three months. The associated eruption and rapid regrowth of hair upon discontinuation of nadolol distinguish this alopecia from the telogen effluvium previously associated with other beta blocker drugs, such as propranolol (Inderal) and metoprolol (Lopressor). PMID- 3979100 TI - Rendu-Osler-Weber-like telangiectasia associated with primary biliary cirrhosis. AB - An otherwise asymptomatic woman presented with the recent onset of telangiectasias of the lips and fingertips, and without a family history of similar lesions. Results of laboratory tests included elevated liver function, positive antimitochondrial antibodies, and microscopic findings compatible with the diagnosis of primary biliary cirrhosis (PBC). New lesions of skin and mucous membranes resembling manifestations of the Rendu-Osler-Weber syndrome should prompt the physician to rule out PBC and associated autoimmune diseases. PMID- 3979101 TI - Late reactions at Zyderm skin test sites. AB - We report on two patients in whom results of skin tests to injectable bovine collagen (Zyderm) became positive six weeks after administration. In one of these patients, the test was repeated, and showed identical result. It is recommended that Zyderm skin test sites be observed for at least six weeks before the test result is considered negative. PMID- 3979102 TI - Malignant melanoma of the plantar aspect of the foot. AB - Malignant melanoma is the most frequently diagnosed malignant lesion of the foot. We present an overview of the diagnosis, classifications, and treatment of malignant melanoma. We report a case involving surgical intervention as well as treatment of postoperative skin slough with human amniotic membrane. PMID- 3979103 TI - Neonatal herpes simplex: a newborn infected by a midwife. AB - Infection with herpes simplex in the newborn usually occurs in the maternal delivery canal during the course of labor, but some cases of infection are reported to occur from nonmaternal origins. A case of neonatal herpes simplex from an infected midwife who had recurrent herpes simplex on her lip is reported. Dermatologists should be aware of possible neonatal herpes simplex (NHS) infection to newborns not only from mothers but also from medical workers. PMID- 3979104 TI - The office visit and the self-help concept in the treatment of psoriasis. PMID- 3979105 TI - Catfish poisoning. PMID- 3979106 TI - Pityrosporum folliculitis. PMID- 3979107 TI - How may one learn clinical dermatology through dermatohistopathology? PMID- 3979108 TI - Purpura following timber rattlesnake (Crotalus horridus horridus) envenomation. PMID- 3979109 TI - Pigmentary changes due to long-term minocycline therapy. PMID- 3979110 TI - Follicular secondary syphilis. PMID- 3979111 TI - Sporotrichosis associated with an infected cat. PMID- 3979112 TI - Post-radiation subungual squamous cell carcinoma. PMID- 3979114 TI - In vitro growth and chromosome constitution of placental cells. I. Spontaneous and elective abortions. AB - Placental cultures from chromosomally normal spontaneous abortions, as well as placental and fetal cultures from chromosomally normal elective abortions, were established, and the growth and cytogenetic constitution of the cultures were compared. Fetal cultures grew well and remained chromosomally stable over the entire 100-day period of observation. In contrast, placental cultures were relatively short-lived, many becoming senescent and dying within the time of observation. This was particularly marked in cultures established from spontaneous abortions. Five of the 18 cultures established from spontaneous abortions, but only 1 of the 24 cultures from elective abortions, developed chromosomally abnormal clones. The emergence of such clones was unrelated to the senescence of the cultures. PMID- 3979113 TI - Econazole nitrate (Spectazole) cream, 1 percent: a topical agent for the treatment of tinea pedis. PMID- 3979115 TI - Identification of sex chromosomes in lake trout (Salvelinus namaycush). AB - In the male trout there is a difference in the quinacrine banding and C-banding patterns between the two homologs of the second largest chromosome pair. This chromosome is the only large submetacentric in the karyotype, making it easy to identify and suggesting that the sex chromosomes have become differentiated since the time of tetraploidization. In males one homolog has a medium-to-large quinacrine bright heterochromatic band on the end of the short arm, while the other lacks it completely. In females both homologs have medium-to-large quinacrine bright heterochromatic bands. Approximately half the progeny from every lake trout cross studied and half the eggs from every lake trout population examined were heteromorphic for a difference in this chromosome band. Results from sexed fish, reciprocal F1 hybrids between brook trout and lake trout, and gynogenetic haploids are all consistent with the interpretation that chromosome 2 is the sex chromosome. These results suggest that the addition of heterochromatin to the X can be the first step in the inhibition of crossing over between the X and Y chromosomes required for sex chromosome differentiation. PMID- 3979116 TI - Meiotic association between the XY chromosomes and unpaired autosomal elements as a cause of human male sterility. AB - Intimate association between autosomal translocation trivalents and XY bivalents at pachytene was observed in a majority of cells of two men ascertained through primary sterility and found to be heterozygous for a 14;21 Robertsonian translocation. The association, studied by light and electron microscopy of spread first spermatocytes, was between the unpaired short arms of the normal chromosomes of the translocation trivalent and the differential axes of the XY chromosomes. In a minority of cells, this contact was not established, or not maintained, as alternative combinations between the elements available for non homologous pairing were realized. Following a suggestion of Lifschytz and Lindsley (1972), sterility in these patients was attributed to spermatogenic arrest caused by physical contact of sex chromosomes with autosomal material and consequent interference with the normal metabolism of the sex chromosomes. Autosomal aberrations and polymorphisms, which lead to the presence of unpaired segments at meiosis, may thus play a critical role in a general mechanism of chromosomally-derived male sterility. It is proposed that such a mechanism may also be instrumental in the initiation of reproductive barriers in nature. PMID- 3979117 TI - Comparative chromosome analysis of nine squamous cell carcinoma lines from tumors of the head and neck. AB - The chromosomes of nine cell lines from human squamous cell carcinomas of the head and neck were examined. Five of the lines were derived from patients who had received chemotherapy and radiotherapy, one line was derived from a lymph-node metastasis from one of these patients, and three lines were from patients who had not been treated. The cell lines from the untreated patients had lower modal chromosome numbers than those of all but one of the lines from the treated patients. A structural abnormality involving chromosome 1 with breakpoints located in p13, p22, q21, or q32 was found in all cases. The NRAS and SK oncogenes are located in or near some of these segments. In four of the cell lines the nucleolus organizer regions (NORs) were 10-30 times larger than the NORs of the normal human chromosomes. Double minutes (DM) and homogeneously staining regions (HSR) were found in four of the lines. PMID- 3979118 TI - G-banding evidence for a conserved complement in the Marsupialia. AB - G-banding data are presented for a wide range of Australian marsupial species and one South American species, all of which have 2n = 14. The chromosome banding pattern in each of these species is very similar. Variations between species can be explained by structural changes internal to individual chromosomes. This evidence favors the hypothesis of a conserved complement common to both Australian and American marsupials and underlies the dominant role of chromosome fission in the evolution of this group. PMID- 3979119 TI - Cell surface differentiation antigen of human muscle encoded by a gene (MIC12) on chromosome 15. AB - Monoclonal antibody 30.2A8 was produced by a hybridoma made by fusing cells from rats that had been immunized with rat-human muscle cell hybrids. The 30.2A8 reacts with a differentiation antigen in human skeletal muscle that is synthesized by myoblasts but not myotubes. The gene controlling synthesis of the antigen recognized by 30.2A8 was found to be encoded by human chromosome 15. PMID- 3979120 TI - Assignment of the human antithrombin III structural gene to chromosome 1q23-25. AB - The human antithrombin III (ATIII) structural gene was mapped by in situ hybridization and quantitative analysis of ATIII gene dosage in DNA isolated from carriers of chromosome 1 deletions. These studies indicate that the ATIII structural gene maps to human chromosome q23-q25 and so is likely identical to AT3. PMID- 3979121 TI - In vitro growth and chromosome constitution of placental cells. II. Hydatidiform moles. AB - Histopathological features, in vitro growth, and cytogenetic characteristics of tissue samples from molar placentae were studied. Tissue from complete moles is often degenerate, making them more difficult to establish in culture. However, if viable stromal cells are present, complete moles can be cultured as easily as other placental tissue. Longitudinal cytogenetic studies of molar cultures showed the emergence of clonal chromosome abnormalities to be a common feature in both complete and partial moles. The distribution of chromosome abnormalities among these clones was nonrandom, with a high proportion having an additional chromosome 20; among the complete moles, 9 of the 14 clones studied were trisomic for chromosome 20. PMID- 3979122 TI - The G-banded chromosomes of Roosevelt's muntjac, Muntiacus rooseveltorum. AB - The chromosomes of a female Roosevelt's muntjac (Muntiacus rooseveltorum) captured in Laos have been studied with G-banding. The diploid number is six and the karyotype is indistinguishable from that of the Indian muntjac (Muntiacus muntjak vaginalis). PMID- 3979123 TI - A viable calf with trisomy 22. AB - Karyotyping of eight malformed calves resulted in the detection of trisomy 22 in one calf. This calf had a hernia umbilicalis, a urachus fistula, and slight brachygnathia inferior. This trisomy was not associated with lethality. PMID- 3979124 TI - X chromosome rearrangements and leukemia. PMID- 3979125 TI - Assessment of airway excitability in epidemiologic surveys. PMID- 3979126 TI - Tuberculosis and gastrectomy. PMID- 3979127 TI - Gallium-67 scintigraphy for preoperative evaluation of the mediastinum in lung cancer patients. PMID- 3979128 TI - Critical evaluation of the gallium-67 scan for surgical patients with lung cancer. AB - Seventy-five patients with lung cancer underwent a gallium scan and thoracotomy with total mediastinal nodal dissection. Evaluation of mediastinal lymph nodes by means of the gallium scan showed a sensitivity of 23 percent (3/13), a specificity of 82 percent (31/38), an accuracy of 67 percent (34/51), a positive predictive valve of 30 percent (3/10), and a negative predictive value of 76 percent (31/41) in those patients whose primary tumors demonstrated uptake of radioactive gallium. The low sensitivity was due to an inability to detect microscopic disease in mediastinal lymph nodes. The specificity was decreased by gallium-67 uptake in enlarged inflamed nodes that contained no metastases. These results do not support the use of the gallium scan in the selection of patients with lung cancer for thoracotomy. PMID- 3979129 TI - Apnea duration and hypoxemia during REM sleep in patients with obstructive sleep apnea. AB - Nocturnal sleep studies of 12 patients with obstructive sleep apnea and a matched control group of 12 subjects without the sleep apnea syndrome were analyzed to compare arterial oxyhemoglobin saturation (SaO2) during REM and non-REM sleep. Mean percentage of total sleep time spent in REM sleep was not significantly different in patients with obstructive sleep apnea and in subjects without significant apnea (14.2 +/- SEM 2.2 percent in patients vs 12.0 +/- 2.2 percent in nonapnea subjects). Apneas were longer during REM than non-REM sleep in all 12 patients (p less than 0.01). Oxyhemoglobin desaturations were more frequent during REM than non-REM sleep in both apnea patients and the control subjects. In addition, there was a greater mean fall in SaO2 per desaturation episode in both the apnea patients and non-apnea subjects. We conclude: 1) sleep apneas are longer during REM sleep than non-REM sleep in patients with obstructive sleep apnea; 2) hypoxemia is greater during REM sleep than non-REM sleep in subjects with and without the sleep apnea syndrome. PMID- 3979130 TI - Relationship between pulmonary function and sleep-induced respiratory abnormalities. AB - The relationships between pulmonary function and sleep-induced respiratory events were studied in 34 consecutive male patients with suspected sleep apnea syndrome. In view of the effects of obstructive airway disease on pulmonary volume and airway resistance (Raw), patients were divided into two groups, those with and those without obstructive airway disease. Percent predicted functional residual capacity (FRC) correlated significantly with the apnea-plus-hypopnea index (AHI) in patients with and without obstructive airway disease (r = -0.62 and p less than 0.01; and r = -0.57 and p less than 0.01, respectively) whereas percent predicted total lung capacity had a significant relationship with AHI only in patients with obstructive airway disease (r = -0.80; p less than 0.001). In patients without such disease, a significant correlation between inspiratory airway conductance (Gaw) and AHI (r = -0.47; p less than 0.05) was also present, while percent predicted FRC and Gaw did not correlate with normalized weight. These findings suggest that decreased pulmonary volume and increased Raw contribute to the severity of sleep-induced respiratory abnormalities in patients with sleep apnea syndrome regardless of the degree of obesity. PMID- 3979131 TI - Assessment of myocardial stress from early ambulatory activities following myocardial infarction. AB - Little is known of the magnitude of the stress imposed on the heart by ambulatory activities following infarction. Heart rate, blood pressure, and rhythm provide simple and important estimates of these potential stresses. We therefore measured these variables in 32 patients during sitting, standing, and walking in the first two days following myocardial infarction. Ambulatory activities caused only a small increase in heart rate, with a maximum increase of 9 beats/minute during walking. The blood pressure was either unchanged or decreased during activity. In six other patients, we also measured central hemodynamics during the same activities. The wedge pressure fell with sitting and standing and remained low after walking. All activities were well tolerated. The major problem was hypotension; this was associated with chest pain in one patient, dizziness in four and shortness of breath in two. Most of the patients with hypotension were taking nitrates. In conclusion, mild ambulatory activities produce little stress for the myocardium and can be permitted in the first few days following infarction as long as blood pressure is measured. PMID- 3979132 TI - Radiologic findings in farmer's lung. Prognosis and correlation to lung function. AB - We classified the radiologic findings of 93 patients with acute or subacute farmer's lung (FL) disease by type and severity of the change in chest x-ray film. Acute radiologic changes, further divided as nodular, ground-glass, or striated patchy opacities, were found in 78/93 patients at the first evaluation; 11 showed chronic changes (radiologic "fibrosis"), which persisted unchanged throughout the follow-up period; and four initially had a normal chest x-ray film. Patients were followed up 23 months on an average. The more severe the radiologic change at the first evaluation, the more impaired the diffusing capacity (Dsb). Severe radiologic changes disappeared more slowly than the less severe ones. The differences in the initial pulmonary function values between the two groups disappeared during the follow-up. The type of acute change did not predict the recovery of respiratory performance. Treatment with oral corticosteroids did not affect the outcome of lung function or appearance of chronic changes, although corticosteroids seemed to hasten the disappearance of diffuse opacities. At the final evaluation, the chest x-ray film was normal in 55/93 patients. Chronic changes were detected in 38 patients. Severe radiologic appearance and striated patchy opacities predisposed to development of chronic changes. PMID- 3979134 TI - Gas exchange alterations in patients with chronic obstructive lung disease. AB - In a series of 23 patients with COPD, Wagner et al showed three distinct patterns of VA/Q distributions and a correlation between Burrows' clinical classification and the observed distribution patterns. Using the inert gas method, we studied 51 patients suffering from severe but stable COPD (FEV1 = 0.84 +/- 0.38 L; PaO2 = 58.5 +/- 10.5 mm Hg; PaCo2 = 48 +/- 6 mmHg; Ppa = 22 +/- 8 mmHg) breathing room air in a steady state. The H pattern (high mode of VA in high VA/Q) was found in 24 cases. There was an L pattern (Q mode in low VA/Q units) in nine cases and an HL (high-low) pattern in 16 cases (two patients were assigned another group). The analysis of the distribution data confirmed that VA/Q heterogeneity was the main factor underlying gas exchange disturbances in COPD. The PaO2 of the H subjects was higher than that of both HL (p less than 0.02) and L subjects. The true shunt value in the L group was significantly lower than in the H and HL groups. However, the relationship between clinical or functional aspects and distribution was not direct. The fraction of patients of H, HL, or (H + HL) types was nearly identical in the three clinical groups. The H pattern was found to be predominant in cases of COPD. PMID- 3979133 TI - Open lung biopsy. Its effects on therapy in the pediatric patient. AB - The records of 35 pediatric patients who had open lung biopsies at Columbus Children's Hospital, Columbus, Ohio, were analyzed to determine the results and the effects on therapy. Twenty-two (63 percent) of these patients were immunocompromised, and they are compared to the non-compromised group. A diagnosis was obtained in all cases. An infectious agent was identified in 13 (37 percent) of the patients. Ten of these were immunocompromised. In 43 percent (15 patients) of the total group and 55 percent (12 patients) of the immunocompromised group, the results of the biopsy effected a change in therapy. Five patients died, all of whom were immunosuppressed. None died as a direct result of the open lung biopsy. The total morbidity rate was 23 percent (eight patients). We concluded that open lung biopsy can be accomplished safely in the pediatric patient and that the results affect the therapeutic decision-making process a significant portion of the time. PMID- 3979135 TI - Life-threatening bacterial pneumonia in male homosexuals with laboratory features of the acquired immunodeficiency syndrome. AB - Two male homosexuals with laboratory features of the acquired immunodeficiency syndrome developed fulminating pneumonia requiring mechanical ventilatory support despite antibiotic therapy. Pathology consistent with bacterial pneumonia without other opportunistic pathogens were found at open lung biopsy. Cultures from the open biopsy grew Hemophilus influenzae in one, and Streptococcus pneumoniae was seen on Gram stain and sputum culture prior to antimicrobial treatment in the other. Each recovered on continued single antibiotic therapy. Life-threatening bacterial pneumonia may be a feature of the acquired immunodeficiency syndrome, possibly due to B cell abnormalities. PMID- 3979136 TI - Fiberoptic bronchoscopy in the evaluation of lung abscesses. AB - To define the results of flexible fiberoptic bronchoscopy (FFB) in patients with lung abscess and to characterize those patients most likely to have an underlying carcinoma, we retrospectively studied the records of 52 consecutive patients undergoing FFB at our institution between 1975 and 1982. Nineteen patients (36.5 percent) had an associated bronchogenic carcinoma (group 1); 33 (63.5 percent) had no malignancy (group 2). The FFB aided in diagnosing 73.7 percent of group 1 patients, but added no information in group 2 patients. Group 1 and 2 patients differed significantly with respect to prevalence of systemic symptoms (15.8 percent vs 51.5 percent, p less than 0.01); predisposition to aspiration pneumonia (26.3 percent vs 60.6 percent, p less than 0.01); mean presenting white blood cell count (10.9 vs 14.2, p less than 0.05); mean oral temperature at presentation (37.5 vs 38.3 degrees C, p less than 0.05); and the prevalence of extensive infiltrates on the initial chest roentgenogram (17.0 percent vs 83.6 percent, p less than 0.05). Based on these data, we believe that by carefully considering the available clinical information, it is possible to identify those patients whose lung abscesses are likely to be related to bronchogenic carcinoma. Such individuals should be promptly evaluated. It is not necessary, however, to routinely order bronchoscopy for all patients with lung abscess. PMID- 3979137 TI - Nontuberculous mycobacteria in pleural fluid. Assessment of clinical significance. AB - We reviewed the case records of 22 patients from whose pleural fluid a nontuberculous Mycobacterium (NTM) was isolated. Three patients had pleural effusions definitely due to NTM infection, with evidence of NTM infection in other tissues; 16 had pleural effusions of known etiology unrelated to the isolated NTM and no other evidence of NTM infection; and three had pleural effusions of undetermined etiology and no other evidence of NTM infection. The case histories of the three patients with pleural effusions due to NTM are presented and the significance of the isolation of NTM from the remaining 19 patients is discussed. Criteria are proposed for evaluating the significance of NTM isolated from pleural fluid. PMID- 3979138 TI - Use of linear tomography to confirm the diagnosis of allergic bronchopulmonary aspergillosis. AB - Allergic bronchopulmonary aspergillosis (ABPA) has been recognized increasingly in the past few years. In minimal disease, plain chest films may be insensitive. Early detection of pulmonary involvement may help prevent irreversible damage to the lungs and bronchi. Bronchography, while both sensitive and specific, is not without hazard, particularly to the asthmatic patient. We evaluated the usefulness of linear tomography in confirming ABPA prior to initiation of corticosteroid therapy. We find that tomography is a simple, noninvasive instrument for detecting the presence of or proving the absence of the earliest manifestations of ABPA. PMID- 3979139 TI - Pulmonary disease caused by rapidly growing mycobacteria in patients with cancer. AB - Five patients with microbiologically documented pulmonary infection caused by rapidly growing mycobacteria (Mycobacterium fortuitum and M chelonei) in patients with malignant diseases are described. These cases occurred over a seven-year period (1976 to 1983) and were found in patients with solid tumors and hematologic malignancies. Colonization (40 patients) with these organisms was far more frequent than true infection (five patients). Factors predisposing to infection were (1) antineoplastic chemotherapy and (2) previous pulmonary involvement with malignant disease. Mortality in these patients was due primarily to the underlying tumor. Although pulmonary infection caused by rapidly growing mycobacteria in patients with cancer is relatively uncommon, it might become an important diagnostic consideration in the presence of pulmonary infiltrates, especially in patients treated with intensive chemotherapeutic regimens. PMID- 3979140 TI - Efficiency of air compressor-driven nebulizers. AB - Five different volumes of test solutions (1 to 3 ml) containing 15 mg of metaproterenol were placed in each of five different nebulizers. The time to complete nebulization and the amount of drug delivered varied considerably, depending upon the initial volume of solution placed in the nebulizer. Small volumes (1 ml) were almost totally retained in the nebulizer, whereas larger volumes (3 ml) took an unacceptably long time for nebulization. With vigorous agitation, a maximum of 53 to 72 percent of the dose left the nebulizer, but even less (34 to 59 percent) was delivered under simulated clinical conditions. When nebulization was synchronized with breathing, only 0.33 to 0.54 ml of solution (2 to 3.2 mg of metaproterenol) was delivered with 90 deep inhalations. If nebulization was continuous instead of intermittent during the time to take 90 breaths, the majority of the drug was nebulized to the atmosphere. PMID- 3979141 TI - Unusual QRS morphology associated with transvenous pacemakers. The pseudo RBBB pattern. AB - Eleven patients with implanted pervenous pacemakers were found to have unusual QRS morphology resembling right bundle branch block (RBBB) on the 12-lead electrocardiogram. In nine patients, the tip of the electrode catheter was established with certainty to be in the right ventricular apex. In eight of the nine, the standard leads showed a left bundle branch block pattern (LBBB), whereas only the precordial leads V1 and V2 resembled RBBB. In only one of the nine was the RBBB pattern also seen in the standard leads. In all nine, recording the precordial leads one intercostal space below the usual space eliminated the RBBB pattern in V1-V2 and resulted in inscription of a QS complex, whereas recording the leads one space higher than usual enhanced the height of the R wave. This is explained by the marked superior and slight anterior orientation of the main QRS complex in right ventricular pacing. It is suggested that the pattern of RBBB in V1-V2 + LBBB in lead 1 be named pseudo RBBB pattern since it does not represent left prior to right ventricular activation. PMID- 3979142 TI - Agenesis of the lung. Report of four patients with unusual anomalies. AB - Four patients had pulmonary agenesis. All were symptomatic in infancy. In three, symptoms improved during two to six years of follow-up. One, who died at one month, had a unique combination of agenesis of the right upper and middle lobes and a hypoplastic right lower lobe supplied by systemic arteries from below the diaphragm, total anomalous pulmonary venous drainage to the left superior vena cava, tricuspid regurgitation with severe right atrial dilatation, patent ductus arteriosus, and reduplication of the right thumb. Abnormalities of the thumb were encountered in three patients. Parental consanguinity in all four patients suggests an autosomal recessive mode of inheritance. Cardiac catheterization and angiography are essential procedures for diagnosis and elucidation of the anatomic abnormalities and identification of associated cardiac defects. PMID- 3979143 TI - Thoracic actinomycosis. PMID- 3979144 TI - The clinical dilemma of mild hypertension. PMID- 3979145 TI - Successful repair of extensive inferior myocardial infarction with septal and free wall rupture. AB - A woman had severe cardiogenic shock complicating rupture of both the interventricular septum and the inferior free wall of the left ventricle. She survived with emergency surgery. PMID- 3979146 TI - Pseudolesion of the chest. A conglomerate shadow on the lateral radiograph. AB - A pseudolesion encountered in the lateral chest roentgenogram of normal patients is described. This concatenation of shadows can produce an opacity which projects over the distal aortic arch and can simulate a mass or pneumonia. This pseudolesion can be found in 4 to 5 percent of normal lateral chest films and is formed by superimposition of normal upper lobe vascular structures. PMID- 3979147 TI - Immediate effects of a sandstorm on asthma and other respiratory problems. AB - A violent sandstorm failed to provoke any immediate increase in asthma or other respiratory problems, as measured by emergency room visits and patients hospitalized. PMID- 3979149 TI - Pulmonary lymphangiomyomatosis. Long-term survival in a patient with poor response to medroxyprogesterone. PMID- 3979148 TI - Unilateral neck pulsations in a patient with a permanent pacemaker. AB - An asymptomatic patient with a permanent pacemaker presented with unilateral accentuated neck pulsations. Evaluation revealed tricuspid insufficiency, a massively dilated right internal jugular vein, and obstruction of the left internal jugular vein. There was no evidence of aneurysm, vascular tumor, or fistula. The most likely explanation for this constellation of findings is tricuspid regurgitation occurring in the setting of unilateral internal jugular vein occlusion. Such a combination should be considered in the differential diagnosis of asymmetrical neck pulsations in a patient with a transvenous pacemaker. PMID- 3979150 TI - Exposure to hard metal. PMID- 3979151 TI - Multiple myeloma and sick sinus syndrome. PMID- 3979152 TI - Oxprenolol-induced life-threatening bronchospasm. PMID- 3979153 TI - Termination of spontaneous tachycardia in a patient with WPW syndrome. PMID- 3979154 TI - Innovative mental health services for child disaster victims. PMID- 3979155 TI - Infant development program. Special care for special families. PMID- 3979156 TI - Spanking: a grand old American tradition? PMID- 3979157 TI - Family ties. PMID- 3979158 TI - Defense mechanisms used by sexually abused children. PMID- 3979159 TI - Group counseling for children adopted at older ages. AB - Children adopted at older ages have special emotional needs and problems that can complicate their development. Counseling groups specifically designed for this population provide these children with opportunities to share with others who have had similar experiences. PMID- 3979160 TI - Assessing the cost of behaviorally oriented residential treatment: predictive program factors. AB - The authors identify program characteristics most predictive of cost in 13 residential treatment facilities for emotionally disturbed children and discuss how easily obtainable quantitative information can be used to decide resource allocation. PMID- 3979161 TI - Day versus residential treatment for juvenile offenders: the impact of program evaluation. AB - A case study of a public service department's program evaluation provides insights into the social policy-making process as well as findings on the effectiveness of two different forms of treatment for the same social problem. PMID- 3979163 TI - [A new cervical scoring for elective induction of labor]. PMID- 3979162 TI - Decision-making factors in cases of child neglect. AB - The author presents findings of an analogue study of factors that influence child protection workers' initial decision in potential cases of child neglect. Contrary to previous research findings, the subjects displayed considerable agreement in their decision making. PMID- 3979164 TI - [Study of labor induction methods in late pregnancy]. PMID- 3979165 TI - [Efficiency of labor induction with oxytocin in late pregnancy]. PMID- 3979167 TI - [Age and delivery]. PMID- 3979166 TI - [Clinical analysis of augmentation of labor in 423 cases]. PMID- 3979168 TI - [Fertility survey of different birth cohort women in Beijing city]. PMID- 3979169 TI - [Diagnosis and treatment of Turner's syndrome (analysis of 24 cases)]. PMID- 3979170 TI - [Dysgerminoma of the ovary (analysis of 17 cases)]. PMID- 3979171 TI - [Clinical observation on the treatment of 616 cases of cervical carcinoma with the 60Co afterloading device (brachytron)]. PMID- 3979172 TI - [Two years' clinical experience with puerperal insertion of intrauterine devices]. PMID- 3979173 TI - [Preliminary observation on the use of intrauterine devices after cesarean sections (a report of 735 cases)]. PMID- 3979174 TI - [Study on indications for labor induction]. PMID- 3979175 TI - Identification of a polytene chromosome band containing a male sex determiner of Chironomus thummi thummi. AB - Hybrid males of Chironomus thummi piger female x Ch. th. thummi male crosses were backcrossed with females of both parental stocks. Fourth-instar larvae of these backcrosses showed sex specific differences in the pairing behavior of region D3d g in chromosome arm F of salivary gland chromosome III. Analysis of the banding pattern of region D3d-g after RB and quinacrine staining demonstrated that in piger female x thummi male hybrid males a single selectively stained band occurs within this region in the heterozygous condition at map position D3e1. This band could only be found in the thummi chromosome partner, it is heterochromatic and contains AT-rich DNA. In female hybrid larvae, however, such a selectively stained band is present in neither the thummi nor the piger chromosome region D3d g. From these results it is concluded that the selectively stained band D3e1 represents the male sex determiner of our Ch. th. thummi stock and that the male is the heterogametic sex. PMID- 3979177 TI - Equilocality of heterochromatin distribution and heterochromatin heterogeneity in acridid grasshoppers. AB - Comparative fluorescence studies on the chromosome of ten species of acridid grasshoppers, with varying amounts and locations of C-band positive heterochromatin, indicate that the only regions to fluoresce differentially are those that C-band. Within a given species there is a marked tendency for groups of chromosomes to accumulate heterochromatin with similar fluorescence behaviour at similar sites. This applies to all three major categories of heterochromatin - centric, interstitial and telomeric. Different sites within the same complement, however, tend to have different fluorescence properties. In particular, centric C bands within a given species are regularly distinguishable in their behaviour from telomeric C-bands. Different species on the other hand, may show distinct forms of differential fluorescence at equilocal sites. These varying patterns of heterochromatin heterogeneity, both within and between species, indicate that whatever determines the differential response to fluorochromes has tended to operate both on an equilocal basis and in a concerted fashion. This is reinforced by the fact that structural rearrangements that lead to the relocation of centric C-bands, either within or between species, may also be accompanied by a change in fluorescence behaviour. PMID- 3979176 TI - Chromosome banding in Amphibia. IX. The polyploid karyotypes of Odontophrynus americanus and Ceratophrys ornata (Anura, Leptodactylidae). AB - The somatic and meiotic chromosomes of the South American leptodactylid toads Odontophrynus americanus, Ceratophyrys ornata, and C. cranwelli were analysed both with conventional staining and differential banding techniques. The karyotypes of O. americanus were tetraploid; those of C. ornata octaploid. Ceratophrys cranwelli is a diploid species whose karyotype displays great similarities with that of C. ornata. The high frequency of multivalent pairing configurations in the meioses of O. americanus and C. ornata indicate that these animals were of autopolyploid origin. The conventionally stained somatic chromosomes of O. americanus can be arranged into sets of four similar chromosomes (quartets); those of C. ornata, into sets of eight similar chromosomes (octets). The banding patterns revealed heterogeneity within some quartets of O. americanus, dividing each of them into two pairs of homologous chromosomes. In analogy, some octets of C. ornata can be subdivided into two quartets of chromosomes with homologous bands. These structural heterogeneities within the quartets and octets are interpreted as a "diploidization" of the polyploid karyotypes. Diploidization leads to genomes that are polyploid with respect to the amount of genetic material and diploid with respect to chromosomal characteristics and the level of gene expression. In tetraploid O. americanus, the number of nucleolus organizer regions (NORs) and their DNA content is proportional to the degree of ploidy. In contrast, up to eight NORs have been deleted in the octoploid C. ornata. These NOR losses are discussed as a possible reason for the reduction of genetic activity in polyploid genomes. PMID- 3979179 TI - The three-dimensional architecture of chromosome fibres in the crane fly. II. Amphitelic sex univalents in meiotic anaphase I. AB - Microtubules of amphitelically oriented sex univalent chromosome fibres were traced in longitudinal serial sections. The investigated chromosomes were from four different cells representing consecutive stages of anaphase segregation. A correlation was found between chromosome movement and a characteristic distribution of free microtubules (fMTs) oriented obliquely with respect to the kinetochore microtubules. During chromosome segregation the proportion of these skew fMTs (the proportion of skew fMTs is a measure of the degree of disorder in the fibre) is higher in the fibre pointing in the direction of movement than in the trailing fibre. The results are discussed in relation to spindle forces. Although the anaphase of amphitelic sex chromosomes is different in several respects (orientation of chromosome fibres, mutual connexion of chromosomes via kinetochore microtubules, spindle elongation occurring simultaneously), the observations on the distribution of fMTs in the chromosomes fibres is, in principle, compatible with those previously made on syntelic autosomes. PMID- 3979178 TI - The fine structure of euchromatin and centromeric heterochromatin in Tenebrio molitor chromosomes. AB - The fine structure of constitutive heterochromatin and euchromatin was compared in electron microscope whole-mount preparations of Tenebrio molitor (Insecta, Coleoptera) spermatocyte nuclei. Tenebrio molitor pachytene chromosomes display extended segments of centromeric heterochromatin and thus are especially suitable for this purpose. When nuclei were incubated in solutions containing different concentrations of NaCl or of MgCl2, two levels of chromatin fine structures were observed in the euchromatic segments: nucleosome fibers (0.1 mM-20 mM NaCl) and supranucleosomal fibers with 28 nm in diameter (40 mM-100 mM NaCl, 0.2 mM-1.0 mM MgCl2). The fine structure in the heterochromatic segments was the same as that in the euchromatic segments in all NaCl concentrations and in MgCl2 concentrations up to 0.4 mM. In higher MgCl2 concentrations the heterochromatin remained more compact than the euchromatin and consisted of 37-nm-thick fibers in 0.6 mM MgCl2 and of 65-nm-thick fibers in 1.0 mM MgCl2. After the 37-nm and the 65-nm fibers had been dispersed in Mg2+-free solutions they could be recondensed by incubation in 0.6 mM and 1.0 mM MgCl2, respectively. It is concluded that a Mg2+-sensitive component of the heterochromatin is responsible for the folding of the nucleosome chain to heterochromatin-specific supranucleosomal structures. PMID- 3979180 TI - [Assessment of platelet aggregation in 93 patients with coronary heart disease]. PMID- 3979181 TI - [Clinico-pathological study on the relationship between the onset of myocardial infarction and coronary artery lesions]. PMID- 3979182 TI - [Blood lactate in chronic obstructive pulmonary disease with chronic cor pulmonale]. PMID- 3979183 TI - [Disseminated mycosis. A report of 14 autopsied cases]. PMID- 3979184 TI - [Clinical characteristics of L-form bacteremic septicemia. Report of 5 cases]. PMID- 3979185 TI - [Clinical significance of plasma amino acid determination in patients with liver disease]. PMID- 3979186 TI - [Plasma lecithin-cholesterol acyltransferase activity (LCAT) in late schistosomiasis and chronic liver disease]. PMID- 3979187 TI - [Aortic valve prolapse. Analysis of 11 cases]. PMID- 3979188 TI - [Induction of sister chromatid exchanges in human peripheral blood lymphocytes treated with Chinese chrysotile asbestos]. PMID- 3979189 TI - [Toxicity study on a local produced natural food color oiltea shell brown pigment]. PMID- 3979190 TI - [A simple method for monitoring the disinfection of tableware]. PMID- 3979191 TI - [Selection of school sites with reference to traffic noise in cities]. PMID- 3979192 TI - [Rodent genotoxic assays of NE-109--a special regulator for rootless bean sprouts]. PMID- 3979194 TI - [Application of a performance test in the evaluation of lead exposure]. PMID- 3979193 TI - [The reduction and residue of dimethoate in vegetables]. PMID- 3979195 TI - [Monitoring of experimental contamination of radioactive nuclides in organism by autoradiography]. PMID- 3979196 TI - [effects of porta-systemic shunts on the liver]. PMID- 3979197 TI - [Prevention of post-laminectomy adhesion: preliminary report of experimental observations]. PMID- 3979198 TI - [Heating and bandaging treatment of chronic lymphedema: report of 1045 cases]. PMID- 3979199 TI - [Pathophysiological observations after jejunal interposition choledochoduodenostomy]. PMID- 3979200 TI - ["Dish-opening" of the omental pouch in the treatment of hemorrhagic necrotizing pancreatitis]. PMID- 3979201 TI - [Primary dilatation of the veins of the neck]. PMID- 3979202 TI - [The value of endoscopic retrograde cholangiography in the diagnosis of cases with recurrence of symptoms following biliary surgery]. PMID- 3979203 TI - [Treatment of aneurysm or arteriovenous fistula of the artery with an occluding spring coil passing through a catheter]. PMID- 3979204 TI - [Significance of residual tumors at the esophageal stump after resection for carcinoma]. PMID- 3979205 TI - [113m in bone scanning: a new method for the early diagnosis of acute osteomyelitis]. PMID- 3979206 TI - [Electric cauterization combined with valve replacement for bacterial endocarditis: report of a case]. PMID- 3979207 TI - [On operative approaches in resection of the first rib]. PMID- 3979208 TI - [Experiences in the surgical treatment of pulmonary bullae in 30 cases]. PMID- 3979209 TI - [Surgical experience in 78 cases of cerebral schistosomiasis]. PMID- 3979210 TI - [Clinical analysis of carcinoma of the penis in 200 cases]. PMID- 3979211 TI - [Perivesical lipomatosis: report of 2 cases]. PMID- 3979212 TI - [Experimental study of venous transplantation for the reestablishment of lymphatic pathways]. PMID- 3979213 TI - [Ultrastructural changes in the microcirculation in hemorrhagic shock]. PMID- 3979214 TI - DNase I sensitivity of nuclear DNA measured by flow cytometry. AB - The DNase I digestion kinetics of DNA in isolated nuclei (from HeLa or murine mammary carcinoma, 67 cells) were assayed flow cytometrically by measuring the changes in ethidium bromide (EtBr) fluorescence following various digestion time intervals. The DNase I digestion curve was characterized by an initial 25-30% increase in fluorescence upon addition of the enzyme, a rapid reduction in fluorescence to approximately 50-55% in 30 minutes, and a limit digest of 45-50% beyond 45 minutes. Throughout digestion, the DNA histogram retained its characteristic bimodal shape, showing that histogram rearrangement was not responsible for the changes in EtBr fluorescence. Irradiation with 5 X 10(6) rads (137Cs-gamma-rays) or exposure to 50 mM EDTA caused an increase in EtBr fluorescence similar to that caused by DNase I, suggesting that DNA nicking and/or chromatin loosening were responsible for this increase. Residual DNA assayed by the solubilization of 14C-TdR (thymidine)-labeled DNA indicated a similar kinetic pattern without the initial increase. However, at the limit digest, the fraction of DNA remaining trichloroacetic acid (TCA) insoluble (10%) was smaller than that measured by loss of EtBr fluorescence (50% of initial, 40% of maximum). Part of this difference was due to the presence of TCA soluble DNA trapped within the nuclear matrix (15-20%). This trapped DNA was released when the digested nuclei were exposed to 0.5-1.0 M NaCl just prior to EtBr staining. Exposure of HeLa cells to three agents that are believed to cause changes in chromatin structure resulted in alterations in the DNase I digestion kinetics measured flow cytometrically.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979215 TI - Linearity and noise sources in flow cytometry. AB - A model of pulse formation in flow cytometers is presented that demonstrates the proportionality between the area (or the peak height) of the fluorescence signal produced by the photomultiplier and the number of fluorochrome molecules present in the cell that cause the signal. The model clarifies the possible instrumental origins of inaccuracy in this linearity that results in a broadening of the histograms obtained. A comprehensive formula for the coefficient of variation of the unimodular histograms of an homogeneous population is presented that clearly discriminates among the different contributions of staining, possible inhomogeneity of the examined population, photon statistics, and instrumental instabilities. Finally, some experimental data are presented that show the agreement with the proposed formula. PMID- 3979216 TI - Inexpensive upgrading of a FACS I and isolation of rare somatic variants by double-fluorescence sorting. AB - We have modified a FACS I by addition of a tunable dye laser and an optical system for fluorescence detection that allows physically independent measurement of green and red immunofluorescence. These modifications are inexpensive and should be applicable to most single-laser systems. By using the modified machine and double-fluorescence activated selection with H-2Kk-specific monoclonal antibodies labelled with FITC or Texas Red, we have isolated from a murine T-cell lymphoma line variant subclones expressing structurally altered histocompatibility class I (H-2Kk) molecules. PMID- 3979217 TI - Evaluation of colony-forming ability experiments using normal and DNA repair deficient human fibroblast strains and an automatic colony counter. AB - An automated procedure for evaluation of colony-forming ability experiments has been developed using normal and xeroderma pigmentosum fibroblast strains. Technically this consists of an image analyzer equipped with a contrast intensifying video camera, monitor, and a desk-top computer. Complex structures composed of overlapping colonies could be reduced to the constituent single colonies by special correction programs. Eighteen experiments were evaluated, and the D0 values for colony-forming ability were determined. A systematic but correctable deviation between visual and automated counting was found. The source of this deviation is described and a solution for correction is provided. The automatic procedure reduced the evaluating time by a factor of five to ten. PMID- 3979218 TI - Flow cytometric determination of DNA content in malignant and benign bone tumours. AB - The nuclear DNA content of 38 malignant and 25 benign bone tumours was measured by flow cytometry. The specimens were taken either from biopsies or from surgical specimens. Seventeen of 26 primary malignant bone tumours were aneuploid, 15 had a single aneuploid DNA content, and 2 had a biclonal abnormality. Thirteen of 15 osteosarcomas were aneuploid, but only 2 of 6 chondrosarcomas showed an aneuploid DNA content. Six of 12 metastatic malignant bone tumours were also aneuploid. All 25 benign tumours had a diploid DNA content. Cell cycle analysis showed that the proportion of cells in S- and G2M-phases was higher in the malignant compared to benign tumours, indicating a higher proliferative activity. The increase was statistically significant (p less than 0.05) both in diploid and in aneuploid tumours. Among five tumours studied after chemotherapy, four displayed a marked hyperdiploid abnormality. Aneuploidy and high proliferative activity both were highly associated with malignant bone tumours, suggesting that DNA flow cytometry may be an adjunct in the assessment of malignancy of bone tumours. PMID- 3979219 TI - Flow cytometric enumeration of absolute lymphocyte number in peripheral blood using two parameters of light scatter. AB - A method was developed to measure the absolute lymphocyte count (ALC) of whole blood using the Spectrum III automated flow cytometer. Ninety-nine samples of human peripheral blood were analysed on the Spectrum and the Coulter Counter S Plus II, to allow for comparison of the two machines. Regression analysis was used to test the extent of agreement between the sets of measurements on the two machines. The results demonstrated that the slope of the regression line was not significantly different from one, indicating a high level of correlation between Spectrum and Coulter ALC's. However, the mean difference between Coulter and Spectrum ALC's was not equal to zero, with the Spectrum giving counts approximately 10% lower than those of the Coulter machine. This is attributed to the different ways by which the two machines define a lymphocyte, the Spectrum III by two parameters of light scatter and the Coulter S Plus II by the single parameter of cell volume. PMID- 3979220 TI - A comparison of different focus functions for use in autofocus algorithms. AB - A number of functions for the autofocusing of microscopes and other optical instruments are to be found in the literature. In this article we compare 11 of them to determine, in an objective manner, which functions are most suitable for implementation with real-time video acquisition systems. Three different images, each representing a typical class of image, are used in the comparison. Among the best focus functions found in our study are the squared magnitude gradient, the squared Laplacian, and the normalized image standard deviation. PMID- 3979222 TI - The sandwich approach: irradiation-surgery-irradiation in rectal cancer. Four years' experience. AB - A sandwich technique of adjuvant radiotherapy was used to treat 47 patients with rectal cancer. Preoperatively, 3000 rads were given for 12 days; 300 rads per day for five days, with a two-day interruption and another five days of 300 rads per day, followed by surgery ten days later. On the basis of the histopathologic findings, 26 patients with Dukes' B2 and C rectal cancer were given 3000 rads postoperatively in the same manner as the preoperative irradiation, starting four weeks after surgery. Patients with Dukes' A and B tumors received no postoperative irradiation. The preoperative radiotherapy was well tolerated by all patients with only minimal side effects. During surgery there was no technical difficulty in removing the tumor en bloc and, in some cases, the macroscopic impression was that the tumor had actually disappeared. In most cases, microscopic examination revealed fibrotic tissue replacing the tumor. In some cases, no cancer tissues were observed. The postoperative course was uneventful, the average length of hospitalization being 14.5 days. We believe that this technique of adjuvant radiotherapy with a moderate dose of irradiation is a logical and well-tolerated approach in the treatment of rectal cancer, and patients who were inoperable before irradiation became resectable after it. PMID- 3979221 TI - Reduced incidence of rat colon cancer metastases by perioperative immunostimulation with maleic anhydride-divinyl ether-2 (MVE-2). AB - Intra-abdominal operations result in profound immunodepression during a period when tumor cells are released into the systemic and portal circulations. This combination may augment tumor metastases. The authors have developed a model in which rat colon carcinoma cells transplanted into the portal vein consistently induce hepatic metastases by four weeks, and death within nine weeks. Additionally, the authors have shown that perioperative treatment with levamisole significantly reduces the incidence of metastases. This study tested whether maleic anhydride-divinyl ether-2 (MVE-2), a known immunostimulant, would produce similar effects. Rats pretreated with MVE-2 the day before and day of tumor implantation developed fewer metastases (34 percent of animals treated with MVE 2, compared with 5 percent of animals not treated with MVE-2 had less than or equal to two liver metastases). Eighteen percent of MVE-2-treated rats developed no hepatic metastases. Comparison of median liver weights between the MVE-2 treated group and the nontreated, tumor-bearing group was significant (P = 0.03) and the MVE-2-treated animals had significantly prolonged survival (P = 0.04). The authors conclude that the perioperative period is critical for the implantation and growth of metastases and that perioperative immunostimulation may be a factor in decreasing the incidence of metastases. This model may have relevance to the adjuvant treatment of human colonic cancer. PMID- 3979223 TI - Results of treatment of fistula-in-ano. AB - To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classification was found to be a useful guide in the operative management of patients with fistula-in-ano. PMID- 3979224 TI - Clinical and manometric evaluation of continence after the Bacon two-stage pull through procedure. AB - Twenty-eight patients who underwent the Bacon pull-through operation were evaluated for continence by clinical and radiologic means. Six patients were available for anal manometry. Eighty-three percent of those patients followed for function did not have the sensation to defecate spontaneously. They had normal functioning of the external sphincter, failure of reflex inhibition of the internal sphincter, and decreased rectal compliance secondary to fibrosis of the presacral space. These factors created a distal high-pressure zone which, when combined with sensory loss due to transection of the levators, rendered the patient continent but without the ability to defecate spontaneously unless an enema was administered. PMID- 3979225 TI - The effect of glucagon and glucagon 1-21 on anal sphincter function. AB - Resting anal sphincter pressure and rectoanal reflex were studied in six healthy volunteers after administration of placebo, glucagon, and glucagon 1-21. Glucagon resulted in a marked but short-lived early decrease in resting anal pressure, whereas the 1-21 fragment of the glucagon molecule had no effect. Further investigation of the possible hormonal/peptidergic regulation of anal sphincter function is necessary. PMID- 3979226 TI - Melanosis of the rectum in patients with chronic constipation. AB - In patients with constipation the prevalence of melanosis in rectal biopsies was evaluated in an attempt to correlate its occurrence with laxative consumption and intestinal stasis. Melanosis was present in 58 percent of the patients and in none of a control group. Melanosis was present in 73.4 percent of patients consuming anthracene laxatives and in 26.6 percent of those not consuming anthracene laxatives (P less than 0.01). No correlation was found between the occurrence (and grading) of melanosis and pattern of transit through the large bowel, bowel movements, and duration of symptoms. Results of this study seem to indicate that intestinal stasis is not a cause of melanosis of the colon and rectum and confirm that melanosis may well be due only to the consumption of anthracene laxatives; melanosis coli does not appear to be a sensitive marker of impairment of motor function in the "cathartic colon." PMID- 3979227 TI - Myoelectric and motor activity of the terminal ileum after pelvic pouch for ulcerative colitis. AB - The electrical and motor activity of the terminal ileum after proctocolectomy and ileoanal reservoir was evaluated in seven patients who had undergone surgery for ulcerative colitis. Recordings were carried out with an intraluminal probe under fasting conditions, during stepwise distention of the pouch, in the postprandial state and after administration of Prostigmine and bisacodyl. Ileal sensitivity was also studied. Phase III of the interdigestive myoelectric motor complex, when detectable (four patients), was characterized by regular spike bursts superimposed on slow waves at a frequency of 9 cycles per minute. Two different types of motor patterns were observed: short phasic waves lasting 2 to 6 seconds and long tonic waves lasting up to 2 minutes. In most cases, the amplitude and frequency of the pressure events were higher in the efferent limb than in the reservoir. Electrical activity of the surrounding rectal muscle and striated sphincters was also recorded. When distended to the maximum tolerable volume, the reservoir showed spike bursts propagated aborally at a frequency of 15 per minute, leading to large propulsive waves. An overall increase of spike activity was observed after a meal, which did not affect the slow waves. Neostigmine caused an irregular increase of electrical and motor activity, more evident in the efferent limb. Bisacodyl, used to test the functional integrity of the myenteric plexus, elicited strong propulsive contractions and urgency. Leakage did not occur frequently either at rest or under stimuli. Onset of sensation was elicited with volumes of 271 +/- 149 ml (Mean +/- SD) in the reservoir and 17 +/- 6 ml in the efferent loop of small bowel (P less than 0.001). IN CONCLUSION: 1) most of the electrical and motor properties of the terminal ileum are retained after surgery; 2) due to its large capacity, the reservoir acts as a storage organ; and 3) overall motility is reduced in the pouch when compared with the distal ileum and propulsion in the triple-loop system is opposed by the activity of the anal sphincters. PMID- 3979228 TI - Is anterior resection of the rectosigmoid safe after preoperative radiation? AB - Forty patients with carcinoma of the rectum or rectosigmoid underwent preoperative irradiation, followed by anterior resection with anastomosis. The radiation dose was 4500 rads administered in 25 fractions over a period of five weeks. One to three weeks after the radiation was completed, anterior resection of the rectosigmoid with anastomosis was done. Of the 40 patients, 23 had hand sewn anastomoses and 17 had EEA stapled anastomoses. Fourteen of the 40 had diverting loop colostomies, all colostomies were subsequently closed, and there were no clinical postoperative anastomotic leaks. Anterior resection and anastomosis are considered to be technically safe with the surgical and radiation techniques used. PMID- 3979229 TI - The sialomucin content of colonic resection margins. AB - In a prospective trial, the resection margins of 130 patients who underwent apparently curative resection for colorectal cancers were examined. Sialomucin was markedly increased in 17.0 percent of proximal resection margins and 17.3 percent in distal resection margins. Clinical follow-up has demonstrated four patients who have developed local recurrence of their disease. Three of these patients had increased sialomucin staining in the resection margins at the time of initial surgery. High iron diamine-alcian blue staining of resection margin may identify those patients at risk of developing local recurrence of colorectal cancer or metachronous tumor following apparently curative resection. PMID- 3979230 TI - Cocaine colitis. Is this a new syndrome? AB - An unusual case of colitis in a 37-year-old cocaine addict is described. The patient presented with right-sided abdominal pain and diarrhea exacerbated by his use of cocaine. Significant antibiotic ingestion was denied. At laparotomy, an edematous cecum and ascending colon were found, the cut surface of which revealed diffuse superficial ulcerations and yellowish fibrinous material. Microscopic examination demonstrated findings consistent with pseudomembranous colitis with an ischemic component. A mechanism involving catecholamine-induced mucosal ischemia is postulated to explain the findings seen in this patient. PMID- 3979231 TI - Intestinal obstruction due to Ascaris lumbricoides mimicking intussusception. AB - Two children were admitted for clinical and radiologic signs of small-bowel obstruction. Examination revealed an abdominal mass that was suspected of being a mass of intussusception. Bowel obstruction caused by Ascaris lumbricoides was found at surgery. The laboratory, radiologic, and surgical findings are presented with a short review of the literature with emphasis on diagnosis, incidence, complications, and treatment. PMID- 3979232 TI - The technique of intraoperative segmental artery arteriography to localize vascular ectasias. PMID- 3979233 TI - Rubber bands. The unanswered question. PMID- 3979234 TI - The cecum: a "watershed area"? PMID- 3979235 TI - Pelvic motility and response to intraluminal bisacodyl in slow-transit constipation. AB - The resting motility of the pelvic colon was studied in 28 patients with constipation and compared with control subjects and patients with diarrhea. Colonic activity in patients who had been shown to have slow colonic transit was not significantly different from controls. In contrast, activity in patients who complained of constipation but who were found to have normal colonic transit time was increased (P less than 0.02). The response of the pelvic colon to the introduction of a surface-acting laxative was studied in 18 patients with slow transit constipation. Eleven patients developed progressive peristaltic waves, while in 7 there was no response. It is possible that the relative inactivity of the colon in the latter group is due to a disorder of the myenteric plexus. If so, the bisacodyl stimulation test may distinguish patients with an abnormal myenteric plexus from those in whom it is normal. PMID- 3979236 TI - Colonic myoelectric activity in persons with spinal cord injury. AB - Colonic myoelectric activity was recorded from six para- or quadriplegic subjects with spinal cord injury and seven normal controls via bipolar electrodes in contact with the rectal mucosa. Recordings were carried out in the fasting (basal) state and after stimulation by a standard meal and by 1.0 mg neostigmine intramuscularly. The recordings were visually analyzed for spike activity, average slow wave frequency, and percentage occurrence of subsets of slow wave frequency (2-4 and 5-12 cycles/min). The spinal-cord-injured subjects had significantly more spike wave activity in the basal state than did the controls (12.6 spikes per 10 min vs 3.3). However, meal stimulation did not lead to an increase in spike activity in the spinal-cord-injured subjects (13.7 spikes per 10 min vs 12.6) while it did in the controls (6.4 vs 3.3 spikes per 10 min). Neostigmine significantly increased spike activity in both groups. There was no difference in average slow wave frequency nor any slow wave subsets between the two groups studied. Thus persons with spinal cord injuries have higher basal colonic myoelectric activity than normals but lack a demonstrable gastrocolic reflex. We conclude that the central nervous system exerts a tonic inhibitory influence on basal colonic motility and appears to participate in the gastrocolic reflex. PMID- 3979238 TI - Comparison of cimetidine and ranitidine on 24-hour intragastric acidity and serum gastrin profile in patients with esophagitis. AB - Twenty-four-hour intragastric pH and serum gastrin profiles were monitored in six male asymptomatic patients who previously were found to have esophagitis on endoscopy and biopsy. They received cimetidine 300 mg qid (C), ranitidine 150 mg bid (R), or placebo (P) for one week each, utilizing the Latin-square design. The mean BAO was 0.4 +/- 0.2 mmol/hr, and the pentagastrin-stimulated MAO was 21.2 +/ 3.2 mmol/hr. In the P-treated patients, the pH fluctuated between 1.8 and 3.5 and over 90% of the readings were less than pH 4. As compared to P, both C and R significantly suppressed H+ after breakfast, overnight, and over the 24-hr period. The mean pH after lunch was significantly higher in R than in P, but not in C. Over the 24-hr period, a higher percentage of the readings were above pH 4.0 in R as compared to C. During the night, 50% of the pH readings were above pH 4.0 in C and R, whereas in P 50% of the pH readings were less than pH 2.0. The integrated gastrin responses after each meal were similar in C and R and were greater than in P. The biphasic response of the ratio of H+ and gastrin (H+/G) following each meal was suppressed by both H2-receptor antagonists, with numerically lower values obtained in R than in C. This study suggests that ranitidine 150 mg bid is superior to cimetidine 300 mg qid in suppressing the 24 hr intragastric acidity. PMID- 3979237 TI - Gastroduodenal inflammation in patients with non-ulcer dyspepsia. A controlled endoscopic and morphometric study. AB - Proper control and quantitation are important in the accurate evaluation of gastroduodenal inflammation in dyspeptic patients without ulcers or erosions as proved by endoscopy. The endoscopic findings and the gastroduodenal mucosal inflammatory cell count in 31 patients with non-ulcer dyspepsia were compared with an age-matched group of 32 healthy controls. Endoscopy revealed similar mucosal changes and in similar frequency in both groups. Differential mucosal inflammatory cell count showed a statistically significant (P less than 0.001) increase in the neutrophil count in the gastric body, antrum, and duodenal cap of the dyspeptic group, as well as a slight but significant (P less than 0.05) increase in the round cell and eosinophil count of the duodenal mucosa alone. No correlation was found between the endoscopic changes and an increase in neutrophil count above a normal level determined by the healthy controls. However, an endoscopically normal mucosa was more likely to be associated with a normal neutrophil count. Active inflammation of the gastroduodenal mucosa likely accounts for the symptoms in patients with non-ulcer dyspepsia. PMID- 3979241 TI - Bread-barium swallow. PMID- 3979239 TI - Zinc absorption and leukocyte zinc in alcoholic and nonalcoholic cirrhosis. AB - To determine if malabsorption of zinc contributes to the zinc deficiency found in cirrhosis, the absorption of an oral dose of ZnCl2, labeled with 65Zn and a nonabsorbed marker 51CrCl3, was determined from the ratio of these isotopes in a stool specimen. Average 65Zn absorption in 25 alcoholic cirrhotics, 37 +/- 17% (SD), was low compared to 55 +/- 16% in 31 healthy volunteer controls (P less than 0.01). In contrast, mean 65Zn absorption, 47 +/- 11%, in 11 nonalcoholic cirrhotics was not significantly different from the average result in healthy controls. Low 65Zn absorption was accompanied by low leukocyte zinc in a subgroup of alcoholic cirrhotics with ascites and/or ascites and encephalopathy, but not in the subgroup in which these clinical features were absent. Thus, low zinc absorption contributes to zinc deficiency in decompensated alcoholic cirrhosis. The failure to find similar abnormalities in nonalcoholic cirrhosis suggests that the long-standing consumption of alcoholic beverages contributes to the malabsorption of zinc. PMID- 3979240 TI - Inhibition of canine gastric secretion by the prostanoid Ro 22-6923. AB - The synthetic prostanoid, Ro 22-6923, was studied for its effects on canine gastric secretion. Histamine-stimulated acid secretion was inhibited for up to 8 hr after an orally administered dose of 0.25 mg/kg Ro 22-6923. In the Amdrup (modified Pavlov) pouch model, Ro 22-6923 significantly inhibited food-stimulated acid secretion at an oral dose of 0.5 mg/kg. The effect lasted for 4 hr and was of greater intensity than that observed with 5 mg/kg cimetidine. The ED50 for Ro 22-6923 in this model was 0.25 mg/kg and 0.09 mg/kg for oral and intrapouch administration, respectively. Natural prostaglandin E2 was inactive up to 1 mg/kg orally, but had an ED50 of 0.08 mg/kg when administered directly into the pouch. The results indicate that Ro 22-6923 is a potent, long-acting antisecretory drug that may be useful in the therapy of peptic ulcer disease in man. PMID- 3979242 TI - Endoscopic findings after string-capsule test. PMID- 3979243 TI - Familial history in IBD. PMID- 3979244 TI - [Immunologic inhibitory factor in nasopharyngeal cancer (NPC)--effect of the NPC immunologic inhibitory factor on natural killer (NK) cell function]. PMID- 3979245 TI - [Fluorescence analysis of hematoporphyrin derivative in the serum of cancer patients]. PMID- 3979246 TI - [Influence of sodium selenite on the number of sister chromatid exchanges in V 79 cells induced by N-methyl-N-nitronitrosoguanidine (MNNG) and N-methyl-N nitrosourea (MNU)]. PMID- 3979247 TI - [Result of treatment of squamous carcinoma in the mobile tongue]. PMID- 3979248 TI - [Treatment of squamous carcinoma of the floor of the mouth--an analysis of 33 cases]. PMID- 3979249 TI - [Clinical analysis of 86 cases of carcinoma of the lip]. PMID- 3979250 TI - [Functional tracheo-esophageal shunt for vocal rehabilitation after laryngectomy]. PMID- 3979251 TI - [Long term results of total laryngectomy in laryngeal cancer--report on 525 cases]. PMID- 3979252 TI - [Results of the treatment of carcinoma of the larynx--report on 100 cases]. PMID- 3979253 TI - [60Co teletherapy plus afterloading intracavitary radiation in nasopharyngeal carcinoma--report on 22 patients]. PMID- 3979254 TI - [Long term result of radiotherapy of carcinoma of the nasal cavity--report on 62 cases]. PMID- 3979255 TI - [Presentation of treatment results according to 'Reporting Results of Cancer Treatment' recommended by the World Health Organization (WHO), 1981--long term survival of 1,035 cases of nasopharyngeal carcinoma]. PMID- 3979256 TI - [Pectoralis major myocutaneous flap (PMMCF) for reconstruction after resection of head and neck cancer]. PMID- 3979257 TI - [Treatment and prognosis of metastatic neoplasms of the neck with unknown primary lesion]. PMID- 3979258 TI - [Stereochemistry of the transpeptidation reaction in the ribosome. The ribosome generates an alpha-helix in the synthesis of the protein polypeptide chain]. PMID- 3979259 TI - Seizures following oral lidocaine for esophageal anesthesia. AB - Lidocaine is absorbed from mucous membranes of the oropharynx, gastrointestinal tract, and tracheobronchial tree. First-pass hepatic metabolism of the drug greatly reduces the amount reaching the general systemic circulation in the normal individual. In patients whose hepatic metabolism is reduced by disease or drugs, or in whom liver blood flow is reduced, this first-pass effect is decreased and lidocaine concentrations may be higher than those produced by the same dose in normal patients. We report an elderly man taking cimetidine with congestive heart failure in whom the accidental ingestion of lidocaine solution for esophageal anesthesia was followed by seizures and elevated serum lidocaine concentrations. PMID- 3979260 TI - Gout-like arthritis following cimetidine and ranitidine. AB - A case report is presented of a patient having a history of gouty arthritic attacks who suffered similar attacks subsequent to receiving cimetidine and ranitidine. The patient was rechallenged twice with each drug and reacted on each occasion. During the therapy with H2-receptor antagonists, he suffered no attacks that were not immediately preceded by one of these drugs. It is suggested that alternate forms of therapy such as antacids, sucralfate, or carbenoxalone may be preferable in patients suffering from ulcers and gouty arthritic problems. PMID- 3979261 TI - Comment: poisoning prevention. PMID- 3979263 TI - Comment: neuroleptic malignant syndrome. PMID- 3979262 TI - Comment: monitoring pediatric iv drugs. PMID- 3979264 TI - Haloperidol-associated hyperthermia. PMID- 3979266 TI - Impact on perception of side effects. PMID- 3979265 TI - Reducing cephalosporin purchases. PMID- 3979267 TI - The role of the extended half-life second-generation cephalosporins in surgical prophylaxis. PMID- 3979268 TI - Comment on mitoxantrone. PMID- 3979269 TI - Postgraduate pharmacy fellowships (1984-85). AB - During July and August 1984, the Pharmacy Services Department of the Brigham and Women's Hospital conducted its fourth annual national mail questionnaire survey of postgraduate pharmacy fellowships. It was found that 91 fellowships are offered at 36 fellowship sites. Information regarding type of specialty fellowship, fellowship characteristics, fellowship location and contact person, and qualifications of applicants is presented. PMID- 3979270 TI - Potassium-sparing diuretics--when are they really needed. PMID- 3979271 TI - [Serologic analysis of HBc antigen in patients with HBs-antigen carrier state]. AB - Treatment of serum with sodium thiocyanate in HBs antigen carrier patients leads to liberation of circulating HBc antigen which can be demonstrated radioimmunologically. Investigations were done in 54 HBs antigen carriers, 44 of whom had chronic inflammatory liver disease (22 patients each HBe antigen positive and negative), and in 10 patients who were asymptomatic (so-called healthy HBs antigen carriers). Out of the 22 HBe antigen positive patients 17 were HBc antigen positive serologically. In the HBe antigen negative group of HBs antigen carriers two out of 22 patients with HBc antigen in serum were detected. All 10 asymptomatic HBs antigen carriers were HBc antigen negative. In 11 out of the 40 immunohistologically assessed patients HBc antigen could be demonstrated in hepatocellular nuclei; these 11 patients also demonstrated HBc antigen in serum. The liberated HBc antigen was associated with Dane particles in the density gradient. Serologic demonstration of HBc antigen may thus be considered as direct evidence of presence of hepatitis B virus. PMID- 3979272 TI - [Unusual course of renal osteopathy with Paget's disease and aluminum deposits]. AB - In a woman with chronic renal failure due to interstitial nephritis after chronic analgesic abuse, secondary hyperparathyroidism was at first the predominant feature during a one-year period of dialysis. After parathyroidectomy severe aluminium-induced osteomalacia dominated the picture in the final phase. Surprisingly hyperparathyroidism recurred despite removal of all glandular tissue, and there also developed--previously undescribed--Paget's disease. PMID- 3979273 TI - [Differential diagnosis of the tetany syndrome]. PMID- 3979274 TI - [Therapy of the tetany syndrome]. PMID- 3979275 TI - [Oncogenes--controlling factors of growth and differentiation]. PMID- 3979276 TI - [Right of the patient to disclosure of his psychiatric chart]. PMID- 3979277 TI - [A coprolith as a cause of obstruction of the large intestine]. PMID- 3979278 TI - [Rectoscopy: rigid or flexible? A comparative study]. AB - The customary rigid rectoscope was compared prospectively, with a new, flexible one (prototypes of Olympus Opt. and Fuji) in each of 114 patients selected at random. Maximal depth of introduction was reached on average after 1 min with the rigid instruments, after 1 min 40 sec with the flexible one. Mean depth of introduction was 16 cm for the rigid and 33 cm for the flexible one. In 21 patients (18.4%) additional information was obtained with the flexible rectoscope. 80% of patients reported that the flexible instrument caused them no or only slight discomfort. Skill in using the flexible instrument can be quickly acquired. PMID- 3979280 TI - [Non-steroidal antirheumatic agents and nephrotoxicity]. PMID- 3979279 TI - [Dantrolene in the treatment of life-threatening psychiatric disease pictures. A contribution to the therapy of the malignant neuroleptic syndrome and acute febrile catatonia]. AB - The malignant neuroleptic syndrome and acute febrile catatonia are life threatening psychiatric disorders which frequently are treated in intensive care units outside psychiatric departments. Their manifestations are very similar to those of anaesthesia-specific malignant hyperthermia. The three syndromes have in common signs of increased muscle metabolism. Dantrolene, a specific drug in the treatment of malignant hyperthermia, has been used successfully several times recently in the treatment of the malignant neuroleptic syndrome. One such case is reported. In a 23-year-old man with signs of acute febrile catatonia parenteral dantrolene and electroconvulsive shocks succeeded in counteracting the symptoms of the abnormally raised muscle metabolism. PMID- 3979281 TI - [Classification of pancreatic cancer]. PMID- 3979283 TI - [Maprotiline in asthma therapy]. PMID- 3979282 TI - [Thiamazole- and lithium therapy-resistant iodine-induced hyperthyroidism]. PMID- 3979284 TI - [Dependence on narcotics, drugs and alcohol]. PMID- 3979285 TI - [Chemotherapy protocol for metastasizing colorectal carcinoma. Methotrexate, 5 fluorouracil and cytarabine]. AB - A new treatment protocol was developed for colorectal carcinomas consisting of sequential administration of methotrexate, 5-fluorouracil and cytarabine. The latter was included into the protocol in order to suppress the DNA salvage pathway of tumour cells. The sequential high-dosage combination was administered to 34 patients with metastatic colorectal carcinoma, 23 patients had been pretreated with cytostatics. Remission could be achieved in 14 out of the 34 patients. Two patients with carcinoma of the rectum have complete clinical remission lasting for 7 months. Eight of the 14 patients responding to treatment had had cytostatic pretreatment. The median time of survival of patients in remission is 15 months, median survival of non-responders 4,3 months. Combination treatment was well tolerated. Leuko- and thrombocytopenia according to grade 3 and 4 of the WHO classification were only rarely observed. PMID- 3979287 TI - [Masked depression]. PMID- 3979286 TI - [Colliquation necrosis of the skin caused by a cardiac pacemaker]. AB - In two patients with cardiac infarction of a medical intensive care unit blisters developing into deep necroses were observed on the upper extremities and adjoining regions of the trunk within the first days of treatment. Clinical findings and histology indicated extensive caustic artefacts. The cause for the initially mysterious event was found to be a defect in the extracorporeal cardiac pacemaker. Defective isolation had lead to a continuous current potential between pacemaker cover and electrode. The resulting electrolysis caused a dramatic increase of pH on the moist body surface underneath the pacemaker. As a result of the pH shift caustic damage with extensive dermal necroses was observed. PMID- 3979288 TI - [Interruption of pregnancy by private physicians. Opinion of the Baden Wurttemberg Superior Court of 1-30-1985]. PMID- 3979289 TI - [Allergy to hosiery dyes]. PMID- 3979290 TI - [Intra-abdominal abscesses--percutaneous or surgical drainage?]. PMID- 3979291 TI - [Prophylactic immunoglobulin administration after major gastric resections. A prospective randomized study]. AB - Immunoglobulins in a dosage of 0,25 g/kg body weight were administered in a prospective randomised study prophylactically to 90 out of 180 patients with gastric surgery of variable extent on the day of operation and on the first postoperative day. Wound infection rates of the treated group were 4.4%, of the control group 14.4%. In addition, the control group had a pneumonia rate of 21% and the treatment group of 11%. However, there were no differences between both groups as regards other assessments (mortality, further postoperative complications, time of hospitalisation, duration of ventilation, postoperative use of antibiotics). It can be concluded that although immunoglobulins lower the risk of infection prophylactic administration should for reasons of expense be limited to patients with preoperatively increased pulmonary risks. The appropriate therapeutic use is to be evaluated. PMID- 3979292 TI - [Heart surgery with extracorporeal circulation in long-term hemodialysis patients]. AB - Prolongation of life expectancy achieved by chronic dialysis permits occurrence of correctable cardiac disease to an increasing degree. In contrast to the previously poor prognosis in dialysis patients with coronary and valvular heart disease the present series demonstrates successful management of such interventions. Nine patients are presented (8 bypass operations, one aortic valve replacement) with a mean age of 51 years and a mean duration of dialysis treatment of 47 months. Patient risks are not markedly increased by this additional disease. Patients with chronic renal insufficiency and chronic continuous dialysis should not generally be excluded from surgery due to an assumed increased risk of operation. PMID- 3979293 TI - [Potentials of reconstructive breast surgery]. PMID- 3979294 TI - [Can antireflux surgery prevent malignant degeneration of Barrett esophagus?]. PMID- 3979295 TI - [Benefit and risk of preoperative bile drainage from the surgical viewpoint]. PMID- 3979296 TI - [CEA elevation 16 months after the detection of liver metastases in colonic carcinoma]. PMID- 3979297 TI - [Small intestine ileus after consuming figs]. PMID- 3979298 TI - [Glass fiber or chip? The new electronic endoscopes]. PMID- 3979299 TI - [Supraventricular tachycardia: the results of bundle of His ablation]. AB - Transvenous electrical ablation of AV conduction was performed in 15 patients with drug-resistant supraventricular tachycardia. Eight patients had paroxysmal AV nodal reentry tachycardia, one had permanent junctional reentry tachycardia, five had recurrent atrial flutter and one paroxysmal atrial tachycardia. The intracardiac ablation was done with 150-350 J, on average twice per patient. Permanent 3 degrees AV block was achieved in ten patients, in none of whom there was a recurrence of the tachycardia. In four patients with re-established AV conduction the clinical symptoms had nonetheless improved; despite repeated use of His-bundle ablation, permanent junctional reentry tachycardia could not be controlled satisfactorily and required surgical section of the accessory pathway. Apart from septic fever in one patient there were no serious complications. Implantation of a pacemaker, however, was required in all those patients in whom a permanent 3 degrees AV block had been produced. For this reason alone, His bundle ablation should only be used in drug-refractory supraventricular tachycardias. But in these this method presents an important advance in treatment. PMID- 3979301 TI - [Diagnosis and clinical significance of mitral valve prolapse]. PMID- 3979300 TI - [Hemodynamics during long-term combination therapy of arterial hypertension]. AB - In 20 patients with essential arterial hypertension, grade II or III, the haemodynamic effect of a fixed combination of antihypertensive drugs (bemetizide, triamteren, bupranolol and dihydralazine) was studied by percutaneously introduced flow-guided catheter in the pulmonary artery before, after three weeks and at the end of a six-month period of treatment; systemic arterial blood pressures were measured by the cuff method. Mean pressures, both at rest and on exercise were significantly and persistently lowered. Mean blood pressure at rest fell from 184/110 mmHg before treatment to 167/98 mmHg after three weeks, and to 158/93 mmHg after six months. The initial blood pressure on exercise was 226/129 mmHg, which fell after three weeks to 199/113 mmHg and after six months to 190/106 mmHg. At the same time, pulmonary artery pressure (as a measure of preload) fell by 23% at rest and 30% on exercise. Exercise tolerance of the patients rose by 28%. Pressure-heartrate product fell by 18%, as a pointer to an additional favourable effect on left ventricular oxygen consumption. PMID- 3979302 TI - [Dealing with medical records through commercial secretarial agencies]. PMID- 3979303 TI - [Importance of spirometry in the early diagnosis of airway diseases]. PMID- 3979304 TI - [Nontargeted biopsy during gastroscopy]. PMID- 3979305 TI - [Self measurement of blood pressure and the compliance of hypertensive patients]. PMID- 3979306 TI - [Myocardial biopsy]. PMID- 3979307 TI - [Are psychiatric hospitals necessary?]. PMID- 3979308 TI - [Prevention of pregnancy and abortion in adolescence]. PMID- 3979309 TI - [Central pontine myelinolysis--a complication of hyponatremia therapy?]. PMID- 3979310 TI - [Embolization of renal cancer with absolute alcohol]. PMID- 3979311 TI - [Obturator hernia]. PMID- 3979312 TI - [Treatment of depression]. PMID- 3979313 TI - [Electrolyte imbalance and central pontine myelinolysis]. PMID- 3979314 TI - [Cell-anchoring proteins, fibronectin and laminin]. PMID- 3979315 TI - [From hydroxyproline to recombinant DNA--Finnish collagen research today]. PMID- 3979316 TI - [Research in cellular energy metabolism and bioenergetics in Finland]. PMID- 3979317 TI - [Polyamines in animal cells--from molecular biology to clinical application]. PMID- 3979318 TI - [Viral envelopes as models in molecular biology]. PMID- 3979319 TI - [Cell membrane research]. PMID- 3979320 TI - [Steroid endocrinology]. PMID- 3979321 TI - [Control of differentiation]. PMID- 3979322 TI - [Alpha lipoproteins (HDL) as key particles in atherogenesis]. PMID- 3979323 TI - [Are intravenous contrast media improving?]. PMID- 3979325 TI - [Culture of hematopoietic progenitor cells in the diagnosis of myeloproliferative disorders]. PMID- 3979324 TI - [Allergy to bee and yellow jacket venoms]. PMID- 3979326 TI - [Indicators for the pathologic-anatomical study of placenta and fetal membranes]. PMID- 3979327 TI - An overview of ENT infections and antibiotics. PMID- 3979328 TI - Carcinoid tumors of the larynx. PMID- 3979329 TI - Angiography in the treatment of severe epistaxis. PMID- 3979330 TI - Primary tuberculosis of the larynx in children. PMID- 3979331 TI - Hamartoma of the tonsil. PMID- 3979332 TI - Hemangiopericytoma of the head and neck. PMID- 3979333 TI - Peripheral vertigo. PMID- 3979334 TI - Oral nystatin. PMID- 3979335 TI - [Interaction of different N-nitroso compounds with DNA in vitro]. AB - The interaction of 11 N-nitroso compounds of different structure and carcinogenic activity with DNA in vitro under the influence of UV light was studied by the method of melting. UV light is shown to induce the DNA damage by N-nitroso compounds irrespective of their carcinogenic activity. PMID- 3979336 TI - [Effect of N-nitrosodiethylamine on the liver cells of chick embryos in primary culture]. AB - The morphology and proliferative activity of liver cells from chick embryos were studied. In vitro, the cells were treated with N-nitrosodiethylamine (NDEA) in doses of 100 and 75 mg/ml of culture medium for a 10-day period. The primary culture from liver cells of 9-day chick embryos was prepared on the highly permeable celloidine membrane. In early periods of cultivation there were degenerative signs, mainly in the parenchymal cells, which shows a cytotoxic effect of NDEA. Proliferation of a small population of light epithelioid cells was observed towards the end of the experiment. There were also some atypical and pathological mitoses in the fibroblasts. The obtained results show that a neoplastic transformation of the chick embryonal liver cells occurs under in vitro conditions. PMID- 3979337 TI - [TPA enhancement of the mutagenic and transforming action of bovine adenovirus type 3 on cultured mouse cells]. AB - The cultured 10TI/2C3H mouse cells were infected with bovine adenovirus 3(BAV-3) and treated by TPA. This combined treatment induced ouabain-resistant mutants 19 to 26 times more often than action of only BAV-3. BAV-3- and TPA-treated cells were implanted to syngenic mice. The tumours appeared 10 times more often than in the mice after implantation of only adenovirus treated cells. PMID- 3979338 TI - [Effect of immunization with tularemia vaccine on 3,4-benz[a]pyrene-induced blastomogenesis and mutagenesis in rats]. AB - The living tularemia vaccine is studied for its effect on rat tumours and chromosome aberrations in bone marrow cells during 3,4-benz(a)pyrene injection (BP). It is established that a single epicutaneous vaccination of rats decreases the incidence of BP-induced tumours, prolongs the latent period and reduces the mean weight of tumours as well as lowers the number of myelocaryocytes with chromosome aberrations when BP is administered 15 days after immunization. 125 days after a single subcutaneous injection of BP in a dose of 4 mg the tumours appeared in 57% of animals and in 35% of preliminarily immunized animals. 24 h after intraperitoneal administration of 4 mg of BP the immunized rats revealed a 35% decrease in the amount of chromosome aberrations in myelocaryocytes as compared to the nonimmunized rats. PMID- 3979339 TI - [Effect of phytohemagglutinin, pokeweed mitogen and blood serum on the in vitro cloning of normal hematopoietic cells and in leukemias]. AB - Culture of normal and leukemic hemopoietic cells was performed in the "agar drop liquid medium" system. It is shown that cloning of the hemopoietic cells with mitogen does not result in amplication of proliferation of clonal cells, and does not enchance formation of optimal conditions for cell growth in vitro. Addition of blood serum of healthy people, and especially the serum of patients with different hematologic diseases to the liquid medium, leads to an increase in CFU GM or colonies. It is suggested that mitogens may exert an indirect action on the clonogenic cells in which a colony stimulating serum factor probably takes part. PMID- 3979340 TI - [Hemopoietic precursor cells during the development of carminomycin resistance]. AB - A comparative quantitative investigation of colony-forming ability of mouse bone marrow hemopoietic stem cells in the case of ordinary leukemia variant (P-388) and carminomycin-resistant variant (P-388/k) was carried out. Leukemia bearing mice received single injections of increasing doses of carminomycin on the 5th day after transplantation and 24 hours later the bone marrow was investigated for quantity of colony-forming units in the spleen (CFUs). Dynamics investigation of bone marrow cells in the case of P-388 and P-388/k (without treatment) reveals the common tendency to a decrease of these cells in the period before animal death. Sensitivity of colony forming cells (CFUs) to different doses of the antibiotic of mouse bone marrow in both cases (P-388 and P-388/k) was practically the same. Dynamics of CFUs in two populations of cells after a single injection of carminomycin in doses causing the killing of 50% of CFUs showed that the antibiotic inhibited CFUs equally (50%). However this inhibition in case of CFUs with P-388/k leukemia was almost five times longer than in the case of ordinary P 388 one. Based on the investigations conducted the second injection of the antibiotic to mice with P-388/k leukemia on the fifteenth day after the first one may be recommended. PMID- 3979342 TI - [Ribamidil as a modulator of the toxic effect of 5-fluorouracil]. AB - The in vitro experiments on CaOv cells demonstrated that ribamidyl (ribavirine) (Rb) enhances the intracellular pool of pyrimidine precursors of DNA. This was the basis for studies of its modifying effect on the antitumour activity of antimetabolites. In experiments with intact hybrid mice F1 (CBA+C57B1) the five times administration of ribavirine increase sharply the toxicity of 5-FU. The data should be taken into consideration when combining Rb with antimetabolites in clinical practice. PMID- 3979341 TI - [Effect of cyclophosphane, chlorbutin and degranol on protein biosynthesis in the lymphocytes of donors and chronic lympholeukemia patients in vitro]. AB - The alkylating agents in different concentrations are studied for their effect on protein biosynthesis and the relative content of leu-tRNA. The rate of elongation and termination of polypeptide translation in lymphocytes of donors and of patients with chronic lymphoid leukemia in vitro is studied. The therapeutic doses of cyclophosphamide are shown to inhibit the amino acid incorporation into acid insoluble pool of predominantly leukemic lymphocytes, while chlorbutin and degranol caused the greater suppression of the amino acid incorporation into healthy cells. Chlorbutin, cyclophosphamide and degranol in doses above therapeutic caused approximately 95, 48 and 34% inhibition of the protein synthesis, respectively. The mechanism of action on the translation is different. Only chlorbutin acted directly on the translation rate and also increased leu tRNA content. Degranol decreased the leu-tRNA content. Cyclophosphamide produces no effect on these processes in vitro. PMID- 3979343 TI - [Light optical and electron microscopic studies of the tumor cells in rats exposed to vinblastine against a background of increased activity of the anticoagulating system]. AB - It is shown that the damage of sarcoma 45 cells at different stages of cell life cycle occurs under the effect of vinblastine treatment against a background of higher activity of the blood anticoagulating system. A decrease in the mitotic activity, mitosis accumulation in prophase and especially in the metaphase as well as essential changes in the interphase cell ultrastructure are detected. PMID- 3979344 TI - [Increased body resistance to the toxic action of cyclophosphane through the use of short-term hypoxic hypoxia]. AB - Experiments were carried out on 535 SHK albino male mice weighing 24.0 +/- 4.0 g to study the modifying effect of gas hypoxic mixture containing 10.0 +/- 1.0% O2 and 90.0 +/- 1.0% N2 (GHM-10) on cyclophosphane toxicity after intraperitoneal injection of 800, 1000, 1200, 1400, 1600, 1800, and 2000 mg/kg. Before the injection, the animals were kept in a hypoxic medium for 30 min, which reduced mortality rate. It is found that human organism can endure GHM-10 quite well. PMID- 3979345 TI - [Effect of synthetic polymers on the formation of carcinogen-protein antigens in the early stages of carcinogenesis]. AB - Polymers of different chemical structure were studied for their effect on the production of carcinogen-protein antigens (CPA) at early stages of benzidine induced carcinogenesis in mice. Polyacrylic acid (out of the four polymers studied) was found to exert the most pronounced inhibitory effect on the CPA production mainly in the liver. PMID- 3979347 TI - [Selective action of argon laser radiation in breast cancer]. AB - The attempts were made to apply the argon laser radiation (the green region of light spectrum) for the treatment of breast carcinoma. The 46 post-operative skin metastases of breast carcinoma in 15 women were irradiated with no photosensitizers used. As a result of the treatment (4 to 50 sessions) the complete resolution of metastatic tumours was achieved in 13 patients. In contrast to the methods of laser coagulation treatment of tumours, used till now, the described approach provides for selective elimination of tumour cells without normal tissue alteration. The involvement of photothermic or photochemical mechanisms in this selective effect is discussed. PMID- 3979346 TI - [Thermal field created by an irradiator with a slot capacitance studied on tissue equivalent phantoms]. AB - Experiments were carried out on phantoms imitating muscular and fatty tissues which were exposed to a single action of microwave hyperthermia in microwave set "Volna-2" (460 MHz installation with a modified antenna. The temperature in the phantoms was measured by copper-constant thermocouples in periods of automatic switching off the microwave power. Temperature distribution in the phantoms was found to depend on the depth, exposure time and power. PMID- 3979349 TI - The boundary conditions for measurement of the conduction velocity of muscle fibres with surface EMG. PMID- 3979348 TI - Somatosensory evoked potentials (SEP) in relation to nociception and anesthesia. PMID- 3979350 TI - Single switch contraction curves in patterns with spastic hemiparesis in relation to EMG findings. PMID- 3979351 TI - Cross-correlation and cross-talk in surface electromyography. PMID- 3979352 TI - An empirical study of the power of the Terpstra-Jonckheere test using binary data. AB - A Monte-Carlo simulation is performed to evaluate the power of the Terpstra Jonckheere test for monotonic trend as applied to binary data. The effects of the magnitude and shape of the underlying response and of varying the number of treatment levels for in vitro experiments in cytogenetics are examined. It is shown that choice of the number and spacing of the treatment levels can be critical factors in determining the power of the test. These findings indicate that selection of the proper experimental design is a very important step in the process of conducting a viable study. PMID- 3979353 TI - Tests of homogeneity and trend with medians. AB - Algorithms for tests of homogeneity and trend with medians are presented. Under certain conditions the tests are more efficient than many standard nonparametric tests on one-way classification designs. Computationally the tests are very simple and could be performed by hand or with the help of a calculator. Application to certain types of data derived in cytogenetics is pointed out with an example. PMID- 3979354 TI - Introduction to the Genetic Toxicology Association workshop on statistical analysis of cytogenetics test systems. PMID- 3979355 TI - Parametric approaches to the analysis of in vivo cytogenetics studies. AB - A number of parametric models are evaluated for the analysis of data arising from in vivo cytogenetics studies. Parallels between the structure of data arising from these studies and teratology studies are discussed. Evaluation of historical control data demonstrates the importance of recognizing non-independence of responses among cells within an animal. Models investigated that take into account this non-independence of responses include the beta-binomial, negative binomial, and correlated binomial models. Results indicate that the beta-binomial model performs best in terms of its ability to fit available control data. Suggestions for the incorporation of historical control data, based upon the two stage structure of the candidate models, are made. PMID- 3979356 TI - A statistical examination of historical controls for mouse bone marrow cytogenetic assays. AB - Data from 1,111 controls from assays run over 11 years are examined to determine a most powerful statistical procedure for detecting a mutagenic effect. It is concluded that the data do not show a constant probability of chromosomal abnormalities and that the data do not fit a simple Poisson or binomial distribution. Empirical Bayes techniques are used to derive a test that declares an effect if three or more cells in a group of 50 tested contain abnormalities. PMID- 3979357 TI - Sister chromatid exchanges: a reexamination of the evidence for sex and race differences in humans. AB - Published evidence for human sex and race differences in sister chromatid exchange (SCE) levels is reexamined. There is substantial support for the conclusion that women average approximately 0.5 SCE/cell higher than men among normal healthy adults. An index of heterogeneity for SCE counts for cells from a single subject is introduced, and this statistic is applied to the data of Butler [1981], who compared Caucasians, Blacks, Native Americans, and Orientals with regard to SCE levels. There is evidence in Butler's data of differences in the heterogeneity index among these four racial groups, but this finding needs independent verification in a larger study. PMID- 3979358 TI - Some experimental design and analysis considerations for cytogenetics studies. AB - Cytogenetic analysis has been used for several years in attempts to detect the mutagenic effects of suspect agents. Yet there remain many questions related to statistical analysis. While several procedures have been and are being used, many unfortunately are not always appropriate for the types of data actually obtained. Two general analysis approaches are discussed together with ways to insure that the test assumptions are reasonably met. Because assay sensitivity is a major concern, the sample size issue is discussed with examples for specific situations. PMID- 3979359 TI - The distribution of dust in the rat lung following administration by inhalation and by single intratracheal instillation. AB - A comparison was made of the distribution of dust in the rat lung following its administration by inhalation and by a single intratracheal instillation. Due to the wide variety of instillation techniques, an "average" method was adopted based on the results from a survey of 15 laboratories in Europe and the USA. Novel techniques were developed to quantify the distribution of dust within the lung both microscopically and macroscopically. The distribution of dust obtained by instillation was shown to be much less homogeneous that that obtained by inhalation and penetration to the periphery was minimal. The effects of (a) changing the volume of suspension, (b) changing the concentration of the suspension, and (c) introducing air into the syringe were investigated. Although the use of air in the syringe was beneficial, none of the other modifications effected any improvement in the distribution. The difference in distribution following inhalation and instillation leads to the conclusion that the latter may be of use in establishing the nature and comparative response of the lung to different dusts, but not for establishing an absolute dose-response relationship. It is recommended that no more than 1 mg of fibrous or 5 mg of nonfibrous dust be given in a single instillation to adult rats. PMID- 3979360 TI - Morphologic and physiologic response of lungs to steroid and cigarette smoke: an animal model. AB - The combined effects of cigarette smoke inhalation and hydrocortisone acetate (HCA) treatment induce prominent abnormalities in lungs of C57BL/6 male mice. These abnormalities include (1) a marked reduction of pulmonary macrophage population which is normally elevated by smoke inhalation, (2) an accumulation of surfactant and flocculent material in alveoli, (3) a decrease in alveolar space surrounded by normal septal tissue, and (4) an increase in hypertrophied alveolar parenchyma. Concomitant with altered lung morphology, lung volume and gas diffusing capacity were significantly compromised in animals subjected to smoke exposure and steroid treatment. It was found that smoke inhalation or HCA administration alone had no ill effects on the animals. The data presented indicate that manifestation of pathologic conditions resembling pulmonary fibrosis and pulmonary alveolar proteinosis is a result of cigarette smoke-drug interaction. The information reported provides a basis for an animal model which might be applicable to assessment of factors related to smoke inhalation and development of pulmonary disorders. PMID- 3979361 TI - Erythrocytic and leukocytic responses to cadmium poisoning in a freshwater fish, Puntius conchonius Ham. AB - Chronically sublethal concentrations of cadmium caused conspicuous hematological anomalies in the cyprinid fish, Puntius conchonius. Exposure to 0.63 and 0.84 mg/liter cadmium chloride (1/20 and 1/15 of 96-hr LC50) induced morphological aberrations in mature erythrocytes including cytoplasmic vacuolation, hypochromia, deterioration of cellular membrane, basophilic stippling of cytoplasm, clumping of chromatin material and extrusion of nuclei, and schistocytosis. Anomalous basophils and monocytes were also encountered though less frequently. Decreased erythrocyte counts, hemoglobin and hematocrit values were also associated with chronic cadmium poisoning. The mean corpuscular hemoglobin and mean corpuscular volume increased (30 days) but mean corpuscular hemoglobin concentration showed no obvious change. A significant thrombocytopenia (90 days), elevated small lymphocyte and basophil populations, and a mild neutropenia were manifested in the cadmium-exposed fish. Large lymphocytes were not significantly affected. PMID- 3979362 TI - Description of microparticles in urea-formaldehyde foam insulation products. AB - Thousands of families living in homes insulated with urea-formaldehyde foam (UFF) have complained of various health problems. This product is now banned from the market both in Canada and the United States. Formaldehyde gas emitted by the product has been considered to be the source of these health problems but this cause-effect relationship has not been confirmed as yet. It has been suggested that other contaminants released by the foam could be involved. Work initiated to verify this possibility has permitted the observation of microparticles of less than 1 micron in diameter in foam samples obtained from various houses. The microparticles can easily be removed from the foam by passing air through it or, simply, by immersing it in water. These particles have been studied by different microscopy techniques and their morphological characteristics are described. They may represent a potential health risk. PMID- 3979363 TI - Multicompartment kinetic models for lead. I. Bone diffusion models for long-term retention. AB - The long-term retention of lead in bone poses a number of difficulties for the usual multicompartment models. The use of diffusion models based on exchange of lead between blood in canaliculi and the crystalline bone of the osteon allows a linear compartmental approximation suitable for statistical estimation of kinetic parameters in peripheral compartments. The model is applied to lead retention by beagle dogs. PMID- 3979364 TI - Multicompartment kinetic models for lead. II. Linear kinetics and variable absorption in humans without excessive lead exposures. AB - Multicompartment models with constant fractional transfer rates have been fitted to experimental data on lead metabolism in four subjects studied by M. B. Rabinowitz, G. W. Wetherill, and J. D. Kopple (Science 182, 725-727, 1973; Environ. Health Perspect. 7, 145-153, 1974; Arch. Environ. Health 31, 220-223, 1976; J. Clin. Invest. 58, 260-270, 1976; J. Lab. Clin. Med. 90, 238-248, 1977). Long-term retention is estimated for blood, soft tissue, cortical and trabecular bone pools, and for facial hair. The absorption of lead from diet is shown to change with time, but no evidence was found for other variable or nonlinear kinetic mechanisms of lead metabolism in humans without excessive lead exposure. PMID- 3979365 TI - Multicompartment kinetic model for lead. III. Lead in blood plasma and erythrocytes. AB - Multicompartment models have been fitted to experimental data on plasma lead and blood lead concentrations of subjects studied by P. E. deSilva (Brit. J. Ind. Med. 38, 209-217, 1981) and one subject studied by W.I. Manton and C.R. Malloy (Brit. J. Ind. Med. 40, 51-57, 1983). Nonlinear models for plasma lead vs blood lead in populations provide significantly better descriptions than does a linear model. Short-term kinetic data do not clearly resolve the precise nonlinear mechanism, however, Parameters of plasma and erythrocyte distribution in a single subject were significantly different on two occasions. PMID- 3979366 TI - "The Apocalyptics". PMID- 3979368 TI - Contribution of ethology to clinical interpretation of the horse's welfare. PMID- 3979367 TI - Physiological stimuli of thirst and drinking patterns in ponies. AB - The stimuli that elicit thirst were studied in four ponies. Nineteen hours of water deprivation produced an increase in plasma protein from 67 +/- 0.1 g/litre to 72 +/- 2 g/litre, a mean (+/- se) increase in plasma sodium from 139 +/- 3 to 145 +/- 2 mmol/litre and an increase in plasma osmolality from 297 +/- 1 to 306 +/- 2 mosmol/litre. Undeprived ponies drank 1.5 +/- 0.9 kg/30 mins; 19 h deprived ponies drank 10.2 +/- 2.5 kg/30 mins and corrected the deficits in plasma protein, plasma sodium and plasma osmolality as well as compensating for the water they would have drunk during the deprivation period. In order to determine if an increase in plasma osmolality would stimulate thirst, 250 ml of 15 per cent sodium chloride was infused intravenously. The ponies drank when osmolality increased 3 per cent and when plasma sodium rose from 136 +/- 3 mmol/litre to 143 +/- 3 mmol/litre. Ponies infused with 15 per cent sodium chloride drank 2.9 +/- 0.7 kg; those infused with 0.9 per cent sodium chloride drank 0.7 +/- 0.5 kg. In order to determine if a decrease in plasma volume would stimulate thirst, ponies were injected with 1 or 2 mg/kg bodyweight (bwt) frusemide. Plasma protein rose from 68 +/- 2 g/litre pre-injection to 75 +/- 2 g/litre 1 h after 1 mg/kg bwt frusemide and to 81 +/- 1 g/litre 1 h after 2 mg/kg bwt frusemide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979369 TI - Feed preferences of ponies. AB - Preference trials were conducted with mature ponies. In Trial 1, oats were compared with oats plus sucrose. Four of six pony geldings selected oats plus sucrose, but one pony demonstrated a dislike for sucrose and one selected from the bucket on the right side regardless of content. Oats, maize, barley, rye and wheat were compared in Trial 2 using six mature pony mares. Oats were the preferred grain, with maize and barley ranking second and third respectively. Wheat and rye were the least preferred. Even though the ponies demonstrated preference, the total intake at a given meal was not greatly depressed when only the less palatable grains were fed. In Trial 3, pony mares selected a diet containing 20 per cent dried distillers' grain and 80 per cent of a basal mixed diet of maize, oats, wheat bran, soybean meal, limestone and molasses over 100 per cent basal mixed diet, but selected the basal diet over diets containing 20 per cent blood meal, beet pulp or meat and bone meal and 80 per cent basal diet. They did not differentiate against diets containing 20 per cent alfalfa meal or 10 or 5 per cent meat and bone meal when the diets were compared to the basal mixed diet. PMID- 3979371 TI - Arthrodesis of the pastern joint in the horse. AB - Arthrodesis of the pastern joint was performed in six horses with a history of acute trauma and in 10 horses with a history of chronic lameness of one to six months duration. Five surgical techniques were employed: curettage of the joint, lag screw compression and immobilisation in a plaster cast; curettage, compression using a T plate and immobilisation; drilling, lag screw compression and immobilisation; lag screw compression and immobilisation; and curettage and immobilisation. Pre- and postoperative clinical course are described together with significant radiographical findings. The best results were achieved by luxating the joint to curette the articular cartilage, followed by fixation and compression with either lag screws or a T plate and immobilisation in a plaster cast. PMID- 3979370 TI - Selection of an aminoglycoside antibiotic for administration to horses. AB - The serum concentrations of the aminoglycosides neomycin, kanamycin and streptomycin were determined after intravenous (iv) and intramuscular (im) administration. These values were then related to the minimum inhibitory concentrations (MIC) of a number of equine pathogenic bacteria to determine the duration of therapeutic serum concentrations of the aminoglycosides in the horse. Pharmacokinetic analysis of the data using neomycin as the example revealed a mean (+/- sd) peak serum concentration of 23.2 +/- 10.2 micrograms/ml present at 30 mins, and at 8 h the serum concentration was 2.8 +/- 0.8 micrograms/ml. From the pharmacological analysis of concentration-time data it was shown that neomycin was very rapidly absorbed from the im injection site, with an absorption half-time of 0.16 +/- 0.05 and was well absorbed (systemic availability was 73.7 +/- 26.9 per cent). A peak tissue level, which represented 40 per cent of the amount of drug in the body, was obtained at 32 mins after injection of the drug. At 8 h, the fractions of the dose in the central and peripheral compartments of the model were 1.5 per cent and 2.5 per cent respectively, and 96 per cent was the cumulative amount eliminated up to that time. Based on the MIC values of the majority of isolates of Corynebacterium equi, and only a few isolates of Klebsiella pneumoniae, Escherichia coli, Salmonella typhimurium and Streptococcus equi, one would expect a serum concentration of more than 2 micrograms neomycin/ml up to 8 h following im dosage (10 mg/kg) to be therapeutically effective. PMID- 3979372 TI - Cardiopulmonary effects of dopamine hydrochloride in anaesthetised horses. AB - Dopamine hydrochloride was infused intravenously into six horses anaesthetised with halothane. Three dose rates; 0.5, 2.5 and 5.0 micrograms/kg/min, were evaluated in each horse. The cardiac output was significantly increased at 15 and 30 mins following administration of dopamine at 2.5 and 5.0 micrograms/kg/min. The heart rate, facial artery pressure and pulmonary artery pressure remained unchanged. Total peripheral resistance was significantly decreased at 30 mins with 2.5 micrograms/kg/min and at 15 and 30 mins with 5.0 micrograms/kg/min. No significant change was produced in packed cell volume, total protein, white blood cell count, platelets, glucose or lactate at any infusion rate. Supraventricular premature contractions occurred in one horse and episodes of tachycardia occurred in two horses during infusion of dopamine at 5.0 micrograms/kg/min. The results of the investigation demonstrated that dopamine administered at 2.5 and 5.0 micrograms/kg/min effectively increased the cardiac output of halothane anaesthetised horses and that dopamine at the high dosage may cause dysrhythmias. PMID- 3979373 TI - Tendon injuries in horses treated with carbon fibre implants. AB - Implants of carbon fibre, made by plaiting a tow of 10,000 filaments of Grafil type HT-S, were used to treat strains and ruptures of digital flexor tendons in 46 horses. The relevant clinical data, the techniques employed and an analysis of the results are described. Apart from two horses in which the implant was extruded and had to be removed, there were minimal untoward consequences of the surgery. Of the 34 horses with acute or chronic tendinitis, 14 returned to racing, seven were used as hunters and seven as hacks. Among the former group, seven suffered a further strain while racing but the others performed well for some time. Twelve horses with severed tendons recovered well and only in one did infection occur. Overall the results in the latter were better than had previously been achieved using other repair materials. PMID- 3979374 TI - Clinical anaesthesia in the horse: comparison of enflurane and halothane. AB - Anaesthesia was induced in 24 horses with xylazine and ketamine and maintained with halothane (12 cases) or enflurane (12 cases) in oxygen. Pulse rate, arterial blood pressure, arterial blood gas values, respiratory rate and tidal volume were measured at regular intervals during anaesthesia. Serial venous blood samples were taken for assay of glucose, urea, haemoglobin, packed cell volume, gamma glutamyl transpeptidase, aspartate aminotransferase, alanine aminotransferase and creatine kinase. Operating conditions and the horses' behaviour in the recovery period were also recorded. In the case of the group of horses receiving enflurane, difficulty was experienced maintaining anaesthesia deep enough for surgery. This group also displayed greater respiratory depression. There were no significant differences between arterial blood pressure values, or any of the haematological or biochemical parameters recorded in each group. Recovery from anaesthesia was significantly faster in horses receiving enflurane but less smooth. It was concluded that, although enflurane appeared to be safe in the horse, the respiratory depression and the unpleasant recovery did not make it a desirable alternative to halothane. PMID- 3979375 TI - Plasma concentrations of fenbendazole and oxfendazole in the horse. PMID- 3979377 TI - Some observations on bone cysts in the carpal bones of young Thoroughbreds. PMID- 3979376 TI - Rapid strip test method to assist management of foaling mares. PMID- 3979378 TI - Six cases of degenerative joint disease of the proximal interphalangeal joint of young Thoroughbreds. PMID- 3979379 TI - Hepatic-lipidosis in a post parturient mare. PMID- 3979380 TI - Oxygen-binding characteristics of Potamilla chlorocruorin. AB - Accurate oxygen equilibrium curves of chlorocruorin of a marine polychaete annelid, Potamilla leptochaeta, were determined under a variety of experimental conditions. Like chlorocruorins from other species Potamilla chlorocruorin exhibited a low oxygen affinity, a large Bohr effect, and high cooperativity compared to those of human hemoglobin. However, in contrast to chlorocruorins from other species, the shape of the oxygen equilibrium curve for Potamilla chlorocruorin varied dramatically upon changes of pH or temperature. As observed in hemocyanins and annelid hemoglobins, cations, especially divalent ones such as Mg2+ and Ca2+, caused marked increase in oxygen affinity and cooperativity of Potamilla chlorocruorin. This finding together with the determination of cations in Potamilla blood has made clear the physiological role of chlorocruorin as an oxygen carrier. A graphical analysis based on the Monod-Wyman-Changeux allosteric model indicated that the number of sites for oxygen binding involved in heme-heme interactions is six, defining the functional unit of chlorocruorin molecule. PMID- 3979381 TI - Identification of 2-guanidinoethanol in human urine. AB - Guanidino compounds in normal human urine were analyzed by high-performance liquid chromatography; an unknown peak was observed in the chromatogram that was identical to the peak of synthetic 2-guanidinoethanol. In another experiment, the substance was purified from human urine by successive use of strongly acidic ion exchanger, thin-layer chromatography and then weakly acidic ion-exchanger. After this it was reacted with acetylacetone to form dimethylpyrimidyl derivative. After further reaction of this derivative with trifluoroacetic anhydrate, it was analyzed by gas chromatography/mass spectrometry. The mass chromatogram and mass spectrum were identical to those of the trifluoroacetylated dimethylpyrimidyl derivative of synthetic 2-guanidinoethanol. This is the first report on the identification of 2-guanidinoethanol in human urine. The concentration of 2 guanidinoethanol in the urine of healthy humans was 5.7 +/- 1.8 (mean +/- SD) mumol/g creatinine. PMID- 3979382 TI - Mechanism of enzymatic and non-enzymatic tyrosine iodination. Inhibition by excess hydrogen peroxide and/or iodide. AB - Non-enzymatic (I2-mediated) and lactoperoxidase-catalyzed iodination of tyrosine are inhibited by excess iodide (I-) and/or hydrogen peroxide (H2O2). This phenomenon is a consequence of the concentration-dependent dual role of I- and H2O2 in the iodinating system. I- and H2O2, in addition to their function as primary substrates of peroxidase, may act as alternative 'iodine acceptors' and therefore compete with tyrosine for the active iodinating agent, irrespective of whether this compound is an enzyme-associated iodinium cation (E X I delta +) or an equivalent oxidized iodine species (IOH, IC1, I2). The competitive reaction pathways resulting from excess I- and/or H2O2 in the iodination system are I2/I-3 generation and/or pseudo-catalatic degradation of H2O2, respectively. Our results also demonstrate that I2 (and alternative medium-dependent oxidized iodine species such as IOH and IC1) generated in the iodination system may play an important role as iodinating agent(s). They serve as a substitute for the enzyme bound iodinium species (E X I delta +), if the prevailing I- concentration favours this pathway. The proposed mechanism of the various antagonistic and interactive reaction pathways is summarized in a scheme. PMID- 3979383 TI - Modulation of chloroplast membrane lipids by homogeneous catalytic hydrogenation. AB - A method is reported for the modification of lipids in situ in chloroplast membrane by which a homogeneous, water-soluble catalyst Pd(QS)2 (QS, sulphonated alizarine; C14H6O7NaS) is incorporated into the thylakoids of isolated chloroplast. The catalyst itself did not affect the photosynthetic activity but caused an extensive loss of unsaturated fatty acids in the presence of hydrogen gas. The polyunsaturated fatty acids were hydrogenated at a faster rate than the monoenoic acids. During hydrogenation the orientational ordering of membrane lipids, as measured with the C-12 positional isomer of spin-labelled stearic acid, displayed a slight increase in agreement with the alterations in membrane composition. Progressive saturation of double bonds of lipids primarily inhibits electron transport between the photosystems followed by the inhibition of electron flow around photosystem II. Photosystem I electron transport was not inhibited even by 50% fatty acid hydrogenation. We suggest that using Pd(QS)2 catalyst for thylakoid hydrogenation offers an excellent technique to study the role of various unsaturated fatty acids in the regulation of membrane fluidity and photosynthetic processes. PMID- 3979384 TI - Physicochemical and functional characterization of the polymerization process of the Geodia cydonium lectin. AB - The extracellularly localized, galactose-specific lectin from the sponge Geodia cydonium binds at one class of sites, 40 mol Ca2+/mol lectin with an association constant (Ka) of 0.3 X 10(6)M-1. Stoichiometric calculations reveal that in the extracellular milieu 22 mol Ca2+ (maximum) are complexed per mol lectin. Binding of Ca2+ to the lectin increases its apparent Mr from 44000 to 56000 (electrophoretic determination) or from 36500 to 53500 (high-pressure liquid gel chromatographical determination); the s20, w increases from 4.3 S to 4.5 S if Ca2+ is added to the lectin. In the presence of Ca2+ the lectin undergoes a conformational change perhaps by expanding the carbohydrate side chains which are terminated by galactose. Subsequently the lectin molecules polymerize to large three-dimensional clumps (diameter up to 8 micron). Turbidimetric studies reveal an inhibition of the lectin polymerization by lactose. The Ka of the lectin lectin polymerization rises from 0.9 X 10(6)M-1 to 14.0 X 10(6)M-1 after increasing the Ca2+ concentration (from 1 microM to 100 microM). Parallel with this increase in affinity, the Ka value of the lectin-aggregation factor binding drops from 41.2 X 10(6)M-1 (1 microM Ca2+) to 1.3 X 10(6)M-1 (100 microM Ca2+). In the absence of Ca2+, the Geodia lectin forms 1-10-micron two-dimensional sheets in the presence of homologous glycoconjugates. Cell binding experiments with polyacrylamide gels, containing covalently bound galactose, show that both homologous (Geodia cydonium) and heterologous cells (L5178y) bind with a higher affinity to the lectin-polymer matrix than to the lectin-monomer one. These data suggest that lectin-polymer structures, together with lectin-glycoconjugate associates, are components of the cell-substrate adhesion system(s) of sponges in vivo. PMID- 3979385 TI - The shapes of biantennary and tri/tetraantennary alpha 1 acid glycoprotein by small-angle neutron and X-ray scattering. AB - Two forms of alpha 1 acid glycoprotein (orosomucoid) have been studied using small-angle neutron and X-ray scattering techniques; in one form all the five glycan chains were biantennary, while in the other they were either triantennary or tetraantennary. The radius of gyration RG was found to be sensitive to salt for the biantennary form, but to be unchanged up to an ionic strength of 3 M for the triantennary and tetraantennary forms. Conformational heterogeneity is thus associated with carbohydrate heterogeneity. Hydrodynamic frictional coefficients confirm these findings. Simple models of alpha 1 acid glycoprotein were developed to account for the RG and values. These show that the compact conformation is slightly more elongated than a globular protein and that the expanded biantennary conformation has a most extended carbohydrate structure. Up to half of the surface of the compact shape can be covered by carbohydrate residues. PMID- 3979386 TI - Translational discrimination between the four RNAs of alfalfa mosaic virus. A quantitative evaluation. AB - In an attempt to relate the translational characteristics of alfalfa mosaic virus (A1MV) RNAs to their structure [Ravelonandro et al. (1983) Nucleic Acids Res. 11, 2815-2826; Gehrke et al. (1983) Biochemistry 22, 5157-5164] we measured the relative affinities (discrimination ratios) of these RNAs for the initiation complex, in the wheat germ extract and in the nuclease-treated reticulocyte lysate, using a competition method designed by Brendler et al. [(1981) J. Biol. Chem. 256, 11747-11754]. As a prerequisite of this study we ascertained that the molecular mass distribution of the translation products was independent of RNA concentration in both translation systems. In the wheat germ extract the discrimination ratios are very similar for two strains of A1MV (S and B) which differ mainly by the presence (strain S) or absence (strain B) of a stable 5' proximal hairpin. Hence this structure has no bearing on discrimination. Taking the affinity of RNA 3 as reference, the following orders of magnitude are found for the affinities of the different RNAs in the wheat germ: RNA 3, 1.0; RNA 1, 10; RNA 2, 60; RNA 4, 150. In the reticulocyte lysate the discrimination ratios are not significantly different from the wheat germ. Thus it seems that the mechanism of discrimination is essentially the same in the two translation systems, despite a difference in rate-limitation. PMID- 3979387 TI - Prokaryotic triterpenoids. The hopanoids of the purple non-sulphur bacterium Rhodomicrobium vannielii: an aminotriol and its aminoacyl derivatives, N tryptophanyl and N-ornithinyl aminotriol. AB - Triterpenoids belonging to the hopane family are widely distributed in prokaryotes. Three new hopanoids have now been isolated from the purple non sulphur bacterium Rhodomicrobium vannielii and identified essentially by spectroscopic methods. The basic compound is the 35-aminobacteriohopane-32,33,34 triol, from which the other two hopanoids are derived by introduction of a tryptophanyl or an ornithinyl moiety linked to the amino group at C-35 via an amide linkage. This is the first report of hopanoids possessing an amino group in their side-chain and linked to aminoacyl residues. PMID- 3979388 TI - Lack of nucleosomal structure in a DNase-I-solubilized transcriptionally active chromatin fraction of Physarum polycephalum. AB - Light treatment of nuclei of Physarum polycephalum microplasmodia with DNase I, at low MgCl2 concentration (less than or equal to 3% DNA acid solubility, 0.1 mM MgCl2) selectively solubilizes a defined fraction of chromatin, in the form of a macromolecular complex. This fraction (up to 15% of the total chromatin) contains a full complement of the core histones and a reduced amount of histone H1, and is enriched in the high-mobility-group type of proteins. It is preferentially associated with nascent RNA and RNA polymerase B actively engaged in transcription. Digestion of DNAase-I-solubilized chromatin by micrococcal nuclease releases a size-heterogeneous population of cleavage products, indicative of lack of a typical nucleosomal packaging. It is concluded that the procedure used allows the isolation of structurally and functionally distinct regions of Physarum chromatin. PMID- 3979389 TI - The ribonuclease-III-processing site near the 5' end of an RNA precursor of bacteriophage T4 and its effect on termination. AB - Infection of RNase III- (rnc) Escherichia coli cells with bacteriophage T4 delta 27, a deletion mutant missing seven out of the ten genes in the tRNA transcription unit, results in the accumulation of a tRNA precursor (10.5-S RNA) that contains the sequences of tRNAGln, tRNALeu and species 1 RNA [Pragai and Apirion (1981) J. Mol. Biol. 153, 619-630]. In vitro studies, using partially purified RNase III or cell extracts and 10.5-S RNA as substrate, have revealed a cleavage site at the 5' side of the molecule. A computerized secondary structure suggests that the RNase III cleavage site can be placed in a small bulge which could be part of a duplex structure and is adjacent to A-A-G and its complementary sequence U-U-U in the same relative relationships found for most RNase III cleavage sites were the adjacent sequences are (A-A-G/U-U-C). Under normal processing conditions (presence of RNase III) the 3' end of the processed intermediate precursors, 10.1-S and p2Sp1 RNAs, is C-U-U-(U1-2)-UOH, which is determined by a stem and loop structure that could serve as a rho-independent termination signal site. However, in the absence of RNase III, the accumulated 10.5-S precursor RNA does not terminate at the same site and its 3' end is shifted a few nucleotides downstream. Thus, RNase III, besides playing a role in processing of 10.5-S RNA, also affects the termination of that molecule, even though both sites, the RNase III cleavage site and the termination site, are about 390 nucleotides apart. PMID- 3979390 TI - Thrombin-induced fibrinopeptide release from a fibrinogen variant (fibrinogen Sydney I) with an Aalpha Arg-16----His substitution. AB - Fibrinogen, purified from a recently identified case of dysfibrinogenaemia, fibrinogen Sydney I, was shown by thrombin digestion, high-performance liquid chromatography (HPLC) and amino acid analysis to be a heterozygous case of an A alpha Arg-16----His substitution. Kinetic studies have been carried out on the thrombin-induced release of fibrinopeptide A (FPA), fibrinopeptide B (FPB) and the variant peptide [His16]FPA. When thrombin was added to fibrinogen Sydney I at a concentration of 0.2 U/ml release of FPA was rapid and there was a 79-fold reduced rate of release of [His16]FPA, but the rate of release of FPB was not appreciably reduced. In contrast, at lower thrombin concentrations the rate of FPB release was reduced in proportion to the rate of total FPA release, supporting the view that release of fibrinopeptides is a sequential process. The second-order kinetic constant kcat/Km for hydrolysis of the abnormal A alpha chain by thrombin was calculated from Lineweaver-Burk plots to be 16-30-fold less than that for the normal A alpha chain. Molecular modelling studies, using a refined model of the trypsin-pancreatic-trypsin-inhibitor complex have been used to suggest how the histidine at the P1 site can be accommodated within the enzyme hydrophobic active-site pocket. PMID- 3979391 TI - Transport and metabolism of adenosine in relation to the transcriptional activity of hnRNA genes in Chironomus salivary gland cells. AB - The transport and metabolism of adenosine in explanted salivary gland cells of Chironomus tentans have been investigated. The adenosine transport is rapid and reaches a maximum velocity within seconds after administration. Nevertheless, a transmembrane equilibrium in adenosine concentrations could never be attained because of the efficiency of the intracellular trapping reaction. Only about 10% or less of the extracellular adenosine concentration could be maintained intracellularly. The rapidity of adenosine phosphorylation did not allow us the assessment of transport kinetics with any degree of accuracy. At lower external [3H]adenosine doses, [3H]ATP was the predominating metabolite, yielding a [3H]ATP/[3H]AMP ratio of 2.5-3.5, while at higher concentrations the [3H]ATP/[3H]AMP ratio was lowered to below 0.9. The [3H]AMP fraction derived from [3H]adenosine-treated cells was not uniform, but rather it consisted of 3H labeled 5'AMP, 3'AMP and 2'AMP isomers. Whereas the accumulation of 3H-labeled 5'AMP and ATP attained steady-state levels after 30-60 min of incubation at higher exogenous adenosine concentrations, the content of 3H-labeled 3'AMP and 2'AMP continuously and linearly increased. The data indicate that the metabolism of adenosine to 2'AMP and 3'AMP represents a salvage pathway operating at unphysiological adenosine levels and that the well-known inhibitory effect of adenosine on polymerase-II-promoted RNA transcription is not exerted by its phosphorylated metabolites. PMID- 3979392 TI - Isolation of cardiac myosin light-chain isotypes by chromatofocusing. Comparison of human cardiac atrial light-chain 1 and foetal ventricular light-chain 1. AB - Cardiac myosin light chain isotypes have been resolved using chromatofocusing, a new preparative column chromatographic technique. The method relies on production of narrow-range, shallow and stable pH gradients using ion-exchange resins and buffers with even buffering capacity over the required pH range. Light chains were resolved in order of decreasing isoelectric point in the pH range 5.2-4.5. Gradients of delta pH = 0.004-0.006/ml elution volume were achieved which were capable of resolving light chains with isoelectric point differences of only 0.03. Analytical isoelectric focusing of light chains in polyacrylamide gels could be used to predict the results of preparative chromatofocusing for method development. Chromatofocusing was capable of resolving human and bovine cardiac light chain 1 and 2 subunits, atrial (ALC) and ventricular (VLC) light chain isotypes and homologous VLC-2 and VLC-2* light chains. The technique was used to purify and resolve the human foetal ventricular light chain 1 (FLC-1) from adult ventricular light chain 1 (VLC-1) present in foetal ventricles and the atrial light chain 1 (ALC-1) in adult atria. Comparative peptide mapping studies and amino acid analyses were carried out on FLC-1 and ALC-1. No differences were detected between FLC-1 and ALC-1 using three different proteases and amino acid compositions were similar with the exception of glycine content. The studies indicate that FLC-1 and ALC-1 are homologous, and possibly identical, light chains. Comparison of human FLC-1/ALC-1 with VLC-1 suggested marked structural and chemical differences in these light chain isotypes, in particular in the contents of methionine, proline, lysine and alanine residues. Differences in the contents of these residues were also apparent in the corresponding bovine atrial and ventricular light chains [Wikman-Coffelt, J. & Srivastava, S. (1979) FEBS Lett. 106, 207-212]. The latter three residues are known to be rich in the N termini of cardiac and skeletal light chain 1 isotypes, an area that has been implicated in actin binding, suggesting that atrial and ventricular light chains may differ functionally in this region. PMID- 3979393 TI - Control of ureogenesis. AB - Control of urea synthesis was studied in rat hepatocytes incubated with physiological mixtures of amino acids in which arginine was replaced by equimolar amounts of ornithine. The following observations were made. Intramitochondrial carbamoyl phosphate was always below 0.1 mM. Only when ornithine was absent and when, in addition, the concentration of amino acids was higher than four times their plasma concentration, intramitochondrial carbamoyl phosphate rose up to about 3 mM; under these conditions ammonia accumulated in the medium. The relationship between ornithine-cycle flux and the concentration of the cycle intermediates at varying amino acid concentration indicated that under near physiological conditions the ornithine-cycle enzymes are far from being saturated with their subsidiaries. Moderate concentrations of norvaline had no effect on the rate of urea synthesis unless the cells were severely depleted of ornithine. Activation of carbamoyl-phosphate synthetase (ammonia) by addition of N carbamoylglutamate only slightly stimulated urea production at all amino acid concentrations. However, in the presence of the activator the curve relating ornithine-cycle flux to the steady-state ammonia concentration was shifted to lower concentrations of ammonia. The intramitochondrial concentration of carbamoyl phosphate in rat liver in vivo was below 0.1 mM. This value is far below the concentration required for substantial inhibition of carbamoyl phosphate synthetase. It is concluded that in vivo the function of activity changes in carbamoyl-phosphate synthetase, via the well-documented alterations in the intramitochondrial concentration of N-acetylglutamate, is to buffer the intrahepatic ammonia concentration rather than to affect urea production per se. At constant concentration of ammonia the rate of urea production is entirely controlled by the activity of carbamoyl-phosphate synthetase. PMID- 3979394 TI - Detergent-soluble form of acetylcholinesterase in the electric organ of electric rays. Its isolation, characterization and monoclonal antibodies. AB - The detergent-soluble form of acetylcholinesterase was purified from the electric organ of the electric rays Narke japonica and Torpedo californica, and its properties were examined. The electric organ of N. japonica and T. californica contains three types of acetylcholinesterase: low-salt-soluble, asymmetric or tailed, and detergent-soluble forms. Results showed that in N. japonica, asymmetric forms were predominant, whereas in T. californica the detergent soluble form was predominant. Low-salt-soluble acetylcholinesterase constituted 10% of the total acetylcholinesterase in both species. Detergent-soluble acetylcholinesterase was purified by immunoaffinity chromatography with a monoclonal antibody (Nj-601) to acetylcholinesterase. Triton X-100 extracts of these electric organs were applied to a column of Nj-601-Sepharose, and the bound acetylcholinesterase was eluted quantitatively by lowering the pH to 2.8. This simple procedure gave good yields. The purified enzymes gave single peaks at 6 S on sucrose gradients in the presence of detergent and polydisperse aggregates in the absence of detergent. Reduction of disulfide bonds gave peaks at 4.4 S. On polyacrylamide gel electrophoresis in sodium dodecyl sulfate, the purified acetylcholinesterases gave bands with Mr of about 130 000 in the unreduced state and with Mr of 66 000 in addition to a very faint band of Mr 130 000 in the reduced state. The Mr-66 000 polypeptides were labeled with diisopropylfluorophosphate. Thus, the detergent-soluble acetylcholinesterases exist as dimers of the Mr-66 000 components. Two-dimensional electrophoresis of the purified enzymes indicated their homogeneity. The isoelectric points of both enzymes were 5.1 under the conditions employed. The two enzymes had very similar amino acid compositions, and contained more than 14% of neutral sugars and glucosamine. Monoclonal antibodies were raised to detergent-soluble acetylcholinesterase by the hybridoma technique; eight were obtained. All of them recognized the catalytic subunits of detergent-soluble and asymmetric acetylcholinesterase, and reacted only with detergent-soluble acetylcholinesterase in immunoblots. Four of the monoclonal antibodies inhibited the activities of both the detergent-soluble and asymmetric forms of acetylcholinesterase. PMID- 3979395 TI - Structural studies on the linkage unit of ribitol teichoic acid of Lactobacillus plantarum. AB - Structural studies were carried out on the linkage unit which joins ribitol teichoic acid to peptidoglycan in the cell walls of Lactobacillus plantarum AHU 1413. The heating of the cell walls at pH 2.5 led to release of only 5% of ribitol teichoic acid components as water-soluble material. In contrast, the same treatment of the cell walls after N-acetylation led to release of about 80% of the teichoic acid moiety, giving a teichoic-acid-linked sugar preparation which contained about equimolar amounts of mannosamine, glucosamine and glycerol as minor components. The teichoic-acid-linked sugar was hydrolyzed by mild alkaline treatment into a disaccharide, N-acetylmannosaminyl(beta 1----4)N acetylglucosamine and ribitol teichoic acid linked to glycerol. The Smith degradation of the N-acetylated cell walls gave a characteristic fragment, 1,2 ethylenediol-phospho-glycerol-phospho-N-acetylmannosaminyl(beta 1----4) N acetylglucosamine. Furthermore, when the intact cell walls were subjected to the NaNO2 treatment followed by NaBH4 reduction, the ribitol teichoic acid moiety was recovered for the most part in the water-soluble polymer fraction, from which a sugar, N-acetylmannosaminyl-2,5-anhydromannitol, was released by mild alkaline treatment. These results lead to the conclusion that the ribitol teichoic acid chain in the intact cell walls of this organism is linked to peptidoglycan through a unique linkage unit, glycerol-phospho-N-acetylmannosaminyl(beta 1----4) glucosamine. The anomalous stability of the linkage between the teichoic acid moiety and peptidoglycan against acid hydrolysis seems to be accounted for by the involvement of the N-substituted glucosamine residue in the phosphodiester bridge that joins the two polymers. PMID- 3979396 TI - The muntjak satellite IA sequence is composed of 31-base-pair internal repeats that are highly homologous to the 31-base-pair subrepeats of the bovine satellite 1.715. AB - The nucleotide sequence of a cloned Muntjak satellite IA repeat unit (Muntiacus muntjak vaginalis) was determined. The repeat is 807 base pairs (bp) long. By introducing minor deletions and insertions, the whole sequence of the satellite can be arranged in 27 subrepeats of 31 bp length. Although diverged relative to each other, all subrepeats show a homology of more than 53% with the common consensus sequence. In 29 out of the 31 bp the consensus sequence of the Muntjak satellite subrepeat is identical to the 31-bp subrepeat of the bovine satellite 1.715. This suggests that both satellites are derived from a common ancestral sequence. The results have interesting implications for the evolution of the two satellites. PMID- 3979397 TI - The widespread distribution of alpha-N-trimethylalanine as the N-terminal amino acid of light chains from vertebrate striated muscle myosins. AB - Identical tripeptides of the sequence X-Pro-Lys, where X is an unknown blocking group, were isolated from trypsin digests of bovine cardiac alkali light chain and the LC2 light chain of rabbit fast muscle. Chemical, electrophoretic and 1H NMR evidence characterized X as an unusual amino acid, alpha-N-trimethylalanine (Me3Ala), which was earlier reported as the N-terminal amino acid of the A1 alkali light chain of rabbit fast muscle [Henry et al. (1982) FEBS Lett. 144, 11 15]. The narrow line width and chemical shift position (delta = 3.23 ppm) of the- N+-(CH3) protons of Me3Ala made 1H-NMR spectroscopy a convenient method to search for this residue in other light chains. A survey of many different light chains showed that this signal was present in all vertebrate striated muscle light chains of the A1-type (LC1, 'essential' light chains) and LC2-type ('DTNB'-light chains, 'phosphorylatable' light chains) but was absent from all invertebrate muscle and vertebrate smooth muscle light chains tested. It was also absent from the vertebrate fast-muscle-specific A2-type (LC3) light chains. The spectral characteristics of these signals were consistent with their having arisen from the protons of an--N+-(CH3)3 grouping. Since no epsilon-trimethyllysine could be detected in acid hydrolysates of these proteins, it appears that Me3Ala is a general feature as the N-terminal amino acid in these light chains. 1H-NMR studies on bovine cardiac myosin subfragment 1 (S1) showed that the Me3Ala methyl proton signal was clearly visible and that the spectrum more closely resembled that of a rabbit S1 isoenzyme, S1(A1), than S1(A2), suggesting that the 40 residue N-terminal segment of the alkali light chain in cardiac S1 also possesses a high segmental mobility. Addition of actin caused the same gross changes to the cardiac S1 spectrum as noted earlier for rabbit S1(A1) [Prince et al. (1981) Eur. J. Biochem. 121, 213-219]. In particular, a marked reduction in the segmental mobility of the N-terminal region of the alkali light chain was noted, consistent with a direct interaction of this area with actin. PMID- 3979398 TI - A-form to A'-form conformational switch of double helices in rat liver 5S and 5.8S rRNA. Solution X-ray scattering evidence and circular dichroic measurements. AB - The wide-angle X-ray scattering of rat liver 5S rRNA and 5.8S rRNA molecules showed significant differences in the positions of the scattering maxima when dissolved in Mg2+-containing Tris/HCl buffer or in Mg2+-depleted buffer. A comparison of the experimental curves with theoretical curves calculated from atomic coordinates of double-helical models proved a switch from A form to A' form of the double-helical regions within the molecules by changing the buffer conditions. This result was supported by circular dichroic measurements. The A to A' transition may have important consequences for RNA-protein interactions. PMID- 3979399 TI - Identification and characterization of fragments of major glycoproteins from platelet membrane after chymotrypsin treatment. AB - Human platelets were surface-labeled by the periodate/NaB3H4 method or by lactoperoxidase-catalysed iodination with 125I. The labeled platelets were treated with chymotrypsin under conditions known to give platelets which aggregate with fibrinogen without stimulation with ADP. Platelets and supernatant were then analysed by various gel electrophoretic techniques including isoelectric focusing/sodium dodecyl sulfate-polyacrylamide gel electrophoresis under reducing or non-reducing conditions and two-dimensional non-reduced/reduced sodium dodecyl sulfate polyacrylamide gel electrophoresis followed by fluorography or indirect autoradiography. Chymotrypsin-treatment of surface labeled platelets degraded the major glycoproteins Ib, IIb and IIIa but also GP120(4.9-5.4), GPIc and GPV. The membrane-bound fragments of GPIb, IIb and IIIa could be identified and also the supernatant fragments of GPIb and GPV. GPIIIa was also cleaved within a loop structure formed by disulfide bond(s). The fact that remnants of both GPIIb and IIIa are left on chymotrypsin-treated platelets which aggregate spontaneously with fibrinogen may indicate that a complex formed by these remnants constitutes the fibrinogen-binding site on platelets. PMID- 3979400 TI - The cellular distribution of transported amino acids in monolayers of MDCK renal epithelial cells. PMID- 3979401 TI - Synchronous exocytosis in Paramecium cells. V. Ultrastructural adaptation phenomena during re-insertion of secretory organelles. AB - We used aminoethyldextran (AED) as a secretagogue for the simultaneous exocytosis of a great proportion of secretory organelles (trichocysts) from Paramecium tetraurelia cells and we applied freeze-fracturing and ultrathin sectioning for a quantitative analysis of the re-arrangement of ultrastructural details within the cell membrane during re-insertion of new trichocysts. Characteristic arrangements of membrane-intercalated particles (MIPs) occur over trichocyst docking sites: 300 nm large double rings of MIPs and a MIP rosette in the middle. Empty sites, displaying a compressed ring ("parenthesis") without a rosette, are expanded to full size rings when a trichocyst is docked. We obtained a first hint on the possible existence of a short lived (approximately 5 min) adaptation stage, represented by rings without a rosette. This could mean that docking of a trichocyst would induce the assembly of rosette MIPs over a newly docked trichocyst. The reformation of rosettes is paralleled by an increasing number of extrudable trichocysts which underscores the causal role of rosette MIPs in exocytosis performance. New trichocysts are inserted at the old predetermined sites after removal of ghosts and formation of a "plug" as a receptor-type structure. The number of non-docked, free trichocysts in the cytoplasm is only slightly changed, indicating a continuous synthesis and docking rate (approximately 2-3 organelles per min). Since in strain 7S ghosts are removed within approximately 10 min and docking goes on over 9 h, there occur many empty docking sites in the time period in between, with a maximum of approximately 1 h after AED triggering, thus providing a unique situation for further experiments. PMID- 3979402 TI - Binding and degradation of proteoglycans by cultured arterial smooth muscle cells. II. Binding sites of proteoglycans on the cell surface. AB - Exogenous proteoglycans stained for electron microscopy with colloidal gold and/or cuprolinic blue bind to the surface of cultured arterial smooth muscle cells at two different sites. (I) About 20% of the proteoglycans adsorbed to the cells from the culture medium interact as monomeric and multimeric proteoglycans with smooth or coated membrane areas. (II) The bulk of exogenous proteoglycans exhibits high affinity binding to cell membrane-associated 10 nm fibrils containing or being closely associated with fibronectin and to collagen. It is suggested that the self association of proteoglycans and their binding to the cell membrane and to cell surface-associated fibronectin and collagen are important for maintaining an appropriate micro-environment for the cultured cells. PMID- 3979403 TI - Ultrastructural localization and characterization of proteoglycans in human lung alveoli. AB - In order to localize and characterize proteoglycans in human lung alveoli, we have used the cationic dye Cuprolinic Blue according to the critical electrolyte concentration method. After staining, five types of Cuprolinic Blue-positive filaments become apparent: two types in the basement membranes of type I and type II epithelial cells respectively and lying in one or two layers; one type, more scattered, localized in the basement membrane of the endothelial cells and another kind associated with collagen fibrils and separated from each other according to the main banding period (+/- 60 nm) of these fibrils. Finally, there was a type of filament which was only locally present at a variety of places. The basement membrane filaments were sensitive to heparinase, heparitinase, pronase (without prefixation) and nitrous acid treatment, but not to Streptomyces hyaluronidase, neuraminidase, chondroitinase ABC, chondroitinase AC, pronase (after prefixation) and 2.0 M MgCl2 treatment. The basement membrane filaments, therefore, represent heparan sulphate-containing proteoglycans. On the other hand, the collagen fibril associated filaments were sensitive to treatment with heparinase, chondroitinase ABC and pronase (without prefixation), but insensitive to Streptomyces hyaluronidase, neuraminidase, nitrous acid, heparitinase, chondroitinase AC, pronase (after prefixation) and 2.0 M MgCl2 (after prefixation) treatment. These filaments thus represent iduronic acid-rich dermatan sulphate-containing proteoglycans. Several physiological functions for these proteoglycans are discussed. PMID- 3979404 TI - Native and acetylated low density lipoprotein metabolism in proliferating and quiescent bovine endothelial cells in culture. AB - Lipoprotein binding and metabolism in actively dividing (sparse) and quiescent (confluent) bovine aortic endothelial cells (EC) were compared quantitatively using 125I-labelled lipoproteins. The amounts of receptor-bound low density lipoproteins (LDL) decreased five- to ten-fold as the cultures progressed from sparse to confluent morphology. High affinity receptor-bound LDL levels were extremely low in confluent EC and accounted for the inability of confluent EC to internalize and degrade significant amounts of LDL. Conversely, the amounts of acetylated LDL (acLDL) bound and degraded via distinct sites increased at least five-fold during EC growth to confluence. LDL binding and metabolism in individual cells was assessed by fluorescence microscopy using 1,1'-dioctadecyl 3,3,3',3'-tetramethylindocarbocyanine-labelled lipoproteins or fluorescein conjugated antibodies. LDL and acLDL bound to the surfaces of sparse EC, at either 4 degrees or 37 degrees C, in a random distribution of fine punctate foci, contrary to a previous report. EC therefore appear to resemble fibroblasts in their distribution of surface LDL receptors. No binding or uptake of LDL was seen in confluent EC. Patterns of acLDL binding and uptake in confluent EC resembled those of LDL in sparse EC. Intracellular LDL and acLDL occurred as perinuclear accumulations of large fluorescent foci in sparse EC. Regeneration experiments were carried out in artificially wounded confluent cultures and renewed LDL receptor activity was shown in actively-dividing cells which had migrated into the "wounded" areas. We conclude that quiescent endothelial cells metabolize little LDL via the LDL-receptor pathway due to a drastically reduced number of receptors in confluent cells. This contrasts with the ability of confluent cells to metabolize relatively large amounts of acLDL via a receptor-mediated mechanism. PMID- 3979405 TI - Adhesive membrane protein of rat brain enhances neurite outgrowth of neuroblastoma cells. AB - A protein that stimulates neurite outgrowth of neuroblastoma cells has been solubilized with octyl glucoside from cell membranes of young rat brain. Neuroblastoma cells from clones N 18 and NIE 115 adhere and rapidly extend neurite-like processes when cells suspended in a serum-free medium are added to polystyrene wells coated with the protein. The activity of the solubilized substance is comparable to that of fibronectin and laminin. The following characteristics of the active substance are described: 1. The activity can be solubilized from membrane pellets with octyl glucoside but not with low or high salt. 2. The activity is destroyed by heating and by protease treatment. 3. The activity binds, at least partially, to gelatin. 4. Polyclonal antibodies to fibronectin or laminin do not inhibit the neurite-promoting effect of the solubilized substance. 5. Analysis of the octyl glucoside-solubilized active fractions with sodium dodecyl sulphate/polyacrylamide-gel electrophoresis does not detect any fibronectin or laminin, but the activity correlates to the occurrence of a 52 kilodalton protein on the gels. We discuss the possible biological role of the 52 kilodalton protein in the differentiation of central neurons and its relationship to other adhesive proteins, especially fibronectin, laminin and spreading factors. PMID- 3979406 TI - Determination of total and divided clearance without blood sampling and not using a whole-body counter or gamma camera. AB - A method is suggested for the determination of total and divided clearance on the basis of one renal function-excretion. The method, which can also be used for hydronephrotic cases, does not involve blood sampling or the use of a whole-body counter or gamma camera. The method was applied to 73 patients, 14 of whom presented with hydronephrosis. Of the 73 patients, 12 were comparatively examined, and the divided clearance was simultaneously determined in three different ways: graphically, by the areas enclosed between the blood-clearance heart curve and the beginning of the secretion phase of the nephrograms; by catheterizing and measuring the excreted urine from each kidney in a well-crystal detector; by the suggested method without taking blood samples. There was good agreement between the results obtained by the last two methods. PMID- 3979407 TI - Lung and renal uptake of technetium Tc 99m sulphur colloid related to disseminated intravascular coagulation. AB - In addition to a recently published case study, we present another three cases in which we observed both lung and renal uptake of technetium Tc 99m sulphur colloid which was related to a period of disseminated intravascular coagulation. Being familiar with this relationship may influence the diagnosis and course of the illness in certain patients. PMID- 3979408 TI - Measurements of the rubidium isotopic activities and the elution parameters of 81mKr generators using a standardized 114mIn source. AB - A method is described for measuring a number of parameters associated with an inorganic ion-exchange krypton generator. These are the activities of rubidium isotopes in inorganic ion-exchange krypton generators, the 81mKr extraction rate, the 81mKr activity delivered to patients during ventilation studies, the elution efficiency, and the radionuclide purity of the eluted gas. The method is based on the calibration of detectors, Ge(Li) and NaI(Tl), with a standardized 114mIn source at matching photon energies. The average activities present in our generators at the end of bombardment (EOB) were 14.6 +/- 3.8 mCi (81Rb), 6.2 +/- 1.6 mCi (82mRb) and 53 +/- 9.4 microCi (83Rb). The 81mKr extraction rate 2 h post EOB was 10.2 +/- 2.3 mCi/min at an air flowrate of 1 l/min. The 81mKr activity delivered to patients during a ventilation study was 91 +/- 16 mCi. The elution efficiency of the generators averaged 50% +/- 7% at an air flowrate of 1 l/min. The eluted gas contained Rb radioisotopic impurities in trace quantities of approximately 0.06 microCi/l. PMID- 3979409 TI - Tumor localization of alpha-aminoisobutyric acid (AIB) in human melanoma heterotransplants. AB - The nude mouse bearing a human tumor heterotransplant is a useful model for studying the tumor localization of radiolabeled compounds. The biological tissue distribution of carbon 14-labeled alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid, was determined in nude mice bearing human malignant melanoma heterotransplants in order to investigate the feasibility of using carbon 11 (t 1/2, 20.4 min)-labeled AIB for the visualization of human melanoma in vivo with positron emission tomography (PET). Our laboratory has previously demonstrated the use of 11C-labeled AIB as a tumor-imaging agent in a number of animal tumor models. The mean relative concentration of 14C-labeled AIB in tumor tissue at 45 min was 1.95 in this melanoma model. Tumor/blood and tumor/muscle ratios at 45 min postinjection were 5.42 and 12.2, respectively. These values suggest that 11C-labeled AIB may be useful for the in vivo study of malignant melanoma in humans. Alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid, is thought to be actively accumulated into viable cells primarily by the A-type, or "alanine-prefering", amino acid transport system. AIB has been labeled with the short-lived, positron-emitting radionuclide, carbon 11 (t 1/2, 20.4 min), using a modified Bucherer-Strecker synthesis for amino acids. 11C labeled AIB has been used to visualize tumors in dogs bearing spontaneous cancers, such as adenocarcinoma, lymphosarcoma, and osteogenic sarcoma, by utilizing positron-emission tomography (PET) and high-energy gamma (HEG) scintigraphy at the Sloan-Kettering Institute.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979411 TI - Bromine-82 contamination in fission product 99mTc-generator eluate. AB - Following receipt of fission product 99mTc-generators, results of radionuclide purity analysis, performed within 30 min after the first elution, demonstrated detectable levels of a contaminate radionuclide not previously reported. Gamma spectroscopy and half-life determinations confirmed the presence of 82Br. Bromine 82 activity, in eluates from the first elution of 30 generators, received weekly during a 7-month period, ranged from 0.22 microCi (8.235 kBq) to 0.67 microCi (24.68 kBq) per eluate. The ratio of 99Mo to 99mTc ranged from 0.13 nCi to 0.39 nCi per mCi 99mTc. The presence of 82Br in 99mTc-generator eluate resulted in falsely elevated 99Mo assay determinations using whole vial 99Mo assay procedures. For every 0.1 microCi 82Br present in 99mTc eluate the 99Mo assay results were elevated by 1 microCi. Gamma spectroscopy of eluates from additional elutions of these generators failed to detect the presence of 82Br demonstrating the displacement of monovalent bromine anions from the alumina column during the first elution. PMID- 3979410 TI - Evaluation of [1-11C]-alpha-aminoisobutyric acid for tumor detection and amino acid transport measurement: spontaneous canine tumor studies. AB - Alpha-aminoisobutyric acid (AIB), or alpha-methyl alanine, is a nonmetabolized amino acid transported into cells, particularly malignant cells, predominantly by the 'A' amino acid transport system. Since it is not metabolized, [1-11C]-AIB can be used to quantify A-type amino acid transport into cells using a relatively simple compartmental model and quantitative imaging procedures (e.g. positron tomography). The tissue distribution of [1-11C]-AIB was determined in six dogs bearing spontaneous tumors, including lymphosarcoma, osteogenic sarcoma, mammary carcinoma, and adenocarcinoma. Quantitative imaging with tissue radioassay confirmation at necropsy showed poor to excellent tumor localization. However, in all cases the concentrations achieved appear adequate for amino acid transport measurement at known tumor locations. The observed low normal brain (due to blood brain barrier exclusion) and high (relative to brain) tumor concentrations of [1 11C]-AIB suggest that this agent may prove effective for the early detection of human brain tumors. PMID- 3979412 TI - In vivo localization of radioiodinated peanut lectin in a murine TA3/Ha mammary carcinoma model. AB - Peanut lectin (PNA) binds avidly to oligosaccharides containing the terminal sequence beta-D-Gal(1----3)alpha-D-GAlNAc. This disaccharide is the immunodeterminant group of the Thomsen-Friedenreich (T) antigen which is present in an exposed form on a number of human and animal adenocarcinomas and can be identified in tumor tissue sections by histochemical PNA staining techniques. We have studied the in vivo uptake of radioiodinated PNA in a murine TA3/Ha mammary adenocarcinoma model to evaluate the potential applications of radiolabeled PNA for the immunodetection of T antigen expressing carcinoma. We have found that PNA has a high in vitro binding affinity for the TA3/Ha tumor cells as well as for epiglycanin, a glycoprotein fraction shed by the TA3/Ha cells. Tissue biodistribution studies after IV 125I-PNA injection into TA3/Ha tumor-bearing mice indicated tumor:blood ratios of 7:1 and 55:1 at 24 and 48 h with corresponding tumor:muscle ratios of 33:1 and 77:1. The high tumor uptake and rapid blood clearance allowed clear scintigraphic delineation of tumor by 24 and 48 h without the necessity for background subtraction techniques. Rapid in vivo deiodination of 125I-PNA also contributed to localization of radioactivity in the stomach, salivary glands, thyroid, and kidney. PMID- 3979413 TI - Amplitude distribution in the right ventricle. AB - Amplitude distribution in the right ventricle obtained from ECG-gated ventriculography has been reviewed and six amplitude distribution patterns were identified. Homogeneous distribution was rarely observed even in patients without any cardiac or pulmonary diseases. Furthermore, there was no difference in frequency distribution of the amplitude distribution patterns between the control group, patients with coronary diseases, and those with recent inferior myocardial infarction. It was concluded that amplitude distribution could not be used to detect hypokinetic areas in the right ventricle. PMID- 3979414 TI - Provocation test for children with bronchial asthma monitored by 81mKr ventilation and perfusion lung scans. AB - A provocation test of bronchial asthma was performed on two children. The test involved the continuous inhalation of krypton-81m gas and intermittent intravenous injections of krypton-81m glucose solution. The patient's response was carefully monitored in order to clarify the relationship between the time of the appearance and the intensity of ventilation and perfusion defects. The bronchial sensitivity of each patient was determined according to the dose of allergen or bronchoconstrictor delivered before the first ventilation defects were observable. The test was sensitive enough for the children not to develop asthmatic symptoms during and after the test. The results showed that perfusion defects appeared after ventilation defects and were less intense. The perfusion defects disappeared rapidly and before the ventilation defects had become undetectable. PMID- 3979415 TI - Facial myokymia--a false localizing sign in obstructive communicating hydrocephalus. A case report. AB - Facial myokymia was evident in a 57-year-old man exhibiting both clinical and radiological signs of obstructive communicating hydrocephalus. Insertion of a ventriculoatrial shunt resulted in resolution of clinical symptomatology including the facial myokymia. Since there was no evidence of a structural brain stem pathology, it is believed that in this case, facial myokymia represented a false localizing sign secondary to obstructive communication hydrocephalus. PMID- 3979416 TI - Amyotrophic lateral sclerosis presenting with respiratory insufficiency as the primary complaint. Clinicopathological study of a case. AB - A 59-year-old man presented with dyspnoea, hypersomnia followed by acute respiratory failure necessitating mechanical ventilation. There were no signs of cardiopulmonary disease and on the first few days, extubation was impossible. Further neurological evaluation supported the diagnosis of amyotrophic lateral sclerosis. The neuropathological examination corroborated this diagnosis, and showed a preponderance of lesions in the phrenic nuclei and axonal alterations associated with a fast evolution. PMID- 3979417 TI - Hypercalcemic encephalopathy in the course of hyperthyroidism. AB - A hypercalcemic condition can be observed in association with hyperthyroidism. The case of a patient suffering from hypercalcemia and hyperthyroidism is reported. A confusional state and EEG alterations, among which diffuse monomorphic delta rhythms were remarkable, are shown. As soon as normalization of calcemia was achieved, a rapid clinical and EEG improvement took place. A hypothetical interpretation is proposed, according to which a prolonged, though inconstant, and mild hypercalcemia in the course of hyperthyroidism could determine an encephalopathy, concealing in some way thyrotoxic symptoms. PMID- 3979418 TI - Asymptomatic large arachnoid cyst of the middle cranial fossa. A clinical and neuropsychological study. AB - The authors studied a 26-year-old healthy subject in whom a large arachnoid cyst of the right middle cranial fossa was revealed by chance. As there were no subjective or objective neurological findings, we checked the existence of any neuropsychological impairment. In spite of this, the patient obtained a good general performance level and sometimes the hemisphere containing the cyst performed better, in accordance with the patient's handedness. PMID- 3979419 TI - Changes of protein synthesis in liver tissue following ligation of hepatic artery or portal vein in rats. AB - The effects of short-term (1 h) complete liver ischemia, hepatic artery ligation (HAL) and portal vein ligation (PVL) on protein synthesis and ATP in liver tissue were studied in rats. Protein synthesis was measured by determining rate of amino acid incorporation into protein in incubated liver slices and was reduced to 34% of the control value after 1 h of complete liver ischemia. ATP was reduced from 3.2 to 0.28 mumol X g-1 wet weight. Following HAL for 1 h, protein synthesis was reduced to 63% of control value and ATP to 2.4 mumol X g-1 wet weight. No significant changes of protein synthesis or ATP were noticed 1 h after PVL. The results indicate that deprivation of hepatic arterial blood plays a greater role than exclusion of portal blood for impairment of protein synthesis in short lasting liver ischemia. The effect of complete ischemia was more pronounced than the sum effect of HAL and PVL, suggesting that accumulation of metabolites and tissue acidosis might contribute to the consequences of abolished blood supply in liver ischemia. In another series of experiments the effects of HAL and PVL on protein synthesis and ATP in liver tissue were studied after 1, 3 and 7 days. Protein synthesis was reduced 1 day after HAL but normalized after 3 days, probably reflecting development of collaterals. Following PVL, protein synthesis was reduced after 1 day and remained depressed up to 7 days at which time it was 55% of the control value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979420 TI - Evaluation of an in vitro method for the study of hepatic protein synthesis in liver ischemia. AB - The effects of liver ischemia on hepatic protein synthesis were studied by measuring the incorporation of radioactivity into protein in rat liver slices incubated in a medium containing 14C-leucine and a mixture of 19 L-amino acids at a concentration four times that in plasma. Following liver ischemia for 1 h the amount of radioactivity incorporated into protein was reduced by about 60%. Specific radioactivity of free 14C-leucine in incubation medium and incubated liver slices was not different when slices from control or ischemic liver were incubated. Thus, apparent reduction of leucine incorporation into protein in ischemic liver slices probably reflected decreased protein synthesis and not reduction of precursor specific radioactivity. Changes of in vitro protein synthesis in the postischemic liver (1 h following reperfusion) were compared to changes in vivo. Protein synthesis in vivo was determined from specific radioactivity of protein-bound and free 14C-leucine in liver tissue following intravenous administration of a large dose of 14C-leucine. Protein synthesis in vivo was reduced to 30% of the control value in the postischemic liver. The corresponding value in vitro was 40%. Alterations of protein synthesis in vitro during and after a period of liver ischemia were similar to changes of ATP in liver tissue. Thus, changes of protein synthesis noticed in vitro reflected alterations of protein synthesis in vivo and changes of energy level in liver tissue. The results indicate that the present in vitro system is suitable for studying the effects of ischemia on hepatic protein synthesis. PMID- 3979421 TI - Mott cells are plasma cells defective in immunoglobulin secretion. AB - Plasma cells containing intracellular inclusions of immunoglobulin (Russell bodies) are known as Mott cells, and are found in large numbers in lymphoid organs in autoimmune mice. Hybridoma technique was used to produce cell lines of this phenotype by fusing spleen cells from a NZB mouse with a nonproducing hybridoma cell line (Sp2/0-Ag14), allowing us to carry out studies of this cell type at the biochemical level. Ultrastructurally the inclusions were distended cisternae of rough endoplasmic reticulum, suggesting a block in the secretory pathway of the cells. Biosynthetic labeling studies confirmed that these cell lines have either a complete or partial block of secretion of immunoglobulin, possibly due to an abnormal light chain. PMID- 3979422 TI - A 3 beta-cholestanyl-containing mono-benzylpenicilloyl oligoamide and peptide suppress anti-benzylpenicilloyl antibody formation in mice. AB - A long-chain linear mono-benzylpenicilloyl (BPO) oligoamide and a succinoylated mono-BPO decalysine were tested in BALB/c mice for suppression of IgE and IgG1 antibody formation. Both compounds were available with either a free C-terminal end or were C-terminally linked to a hydrophobic 3 beta-cholestanyl residue. Only the sterol-containing derivatives suppressed hapten-specific IgE and IgG1 responses. Substantial suppression was obtained when the compounds were administered before primary or secondary, but not later immunizations. In an adoptive cell transfer experiment, spleen cells from tolerized animals actively suppressed anti-BPO IgE antibody formation of immune spleen cells. This effect was reversed by pretreatment of the tolerized spleen cells with anti-Lyt-2.2 antibody plus complement. The requirement for macrophages in the induction of T suppressor cells was demonstrated by injecting antigen-pulsed macrophages into naive recipients; upon immunization, only mice treated with tolerogen-pulsed macrophages showed suppressed anti-BPO IgE responses. It is suggested that lipid modification of antigens alters their processing and presentation by macrophages in a manner that leads to the induction of T suppressor cells. Injection of the cholestanyl derivatives into passively sensitized guinea pigs elicited anaphylactic reactions. By immune precipitation analysis and molecular weight estimation, these derivatives were shown to form micelles in aqueous solution. Therefore, the anaphylactic response appeared to be due to their behavior as multivalent antigens. PMID- 3979423 TI - Effects of anesthetic and anticonvulsant drugs on calcium-dependent efflux of potassium from human erythrocytes. AB - Anesthetic (halothane, enflurane, isoflurane, chloroform, diethyl ether, pentobarbital, phenyclidine) and anticonvulsant (ethosuximide, phenytoin, phenobarbital, sodium valproate, carbamazepine, delta 9-tetrahydrocannabinol) drugs were investigated for their effects on the calcium-dependent efflux of 86Rb (used as a marker for potassium) from resealed human red blood cells. Most anesthetic agents produced biphasic effects, having stimulatory actions at low (anesthetic) concentrations and inhibitory actions at higher (toxic) concentrations. The drug concentrations required to increase calcium-dependent 86Rb efflux were closely correlated with plasma concentrations required for anesthesia in vivo. Two anticonvulsant agents (phenytoin and phenobarbital) inhibited the efflux process in a concentration-dependent manner, while all other tested anticonvulsants were without significant effects. Neither the anesthetic nor the anticonvulsant substances significantly altered the calcium-independent release of 86Rb. The possibility that general anesthetic and anticonvulsant drugs act on calcium-dependent potassium conductance in the central nervous system, and the therapeutic importance of such actions, is discussed. PMID- 3979424 TI - Influence of peripheral and central administration of apomorphine and morphine on intragastric pressure in the dog. AB - Apomorphine was about 30 times more potent in inducing gastric relaxation when applied intracerebroventricularly (i.c.v.) than when injected intravenously (i.v.) in the conscious dog. In the anesthetized dog, the dose of apomorphine producing gastric relaxation via the vertebral artery was at least 10 times lower than that needed to produce gastric relaxation via the i.v. route. For morphine, similar doses had to be given i.c.v. and i.v. to obtain the same degree of gastric relaxation in the conscious dog; in the anesthetized dog, morphine was 3 times more potent via the vertebral artery than i.v. The results suggest that apomorphine-induced gastric relaxation in the dog is mediated via a central site located in the region supplied by the vertebral artery, but that the gastric relaxatory effect of morphine is mediated by both a peripheral and a central site of action. PMID- 3979425 TI - Lorazepam and pentobarbital discrimination: interactions with CGS 8216 and caffeine. AB - Baboons and rats were trained under a two-lever, food-reinforced drug discrimination procedure. The training drug was either lorazepam (1.0 mg/kg) or pentobarbital (5.6 mg/kg in baboons, 10.0 mg/kg in rats). Under test conditions, a range of training drug doses occasioned 100% drug lever responding. CGS 8216 (3.2-10.0 mg/kg) combined with lorazepam produced a complete shift to the no-drug lever in both species; this shift was surmountable with higher doses of lorazepam. CGS 8216 (32.0 mg/kg) combined with pentobarbital produced a statistically significant decrease in drug-lever responding in rats, and in baboons CGS 8216 initially, but not subsequently, produced a complete shift to the no-drug lever. Caffeine (0.32-10.0 mg/kg) combined with lorazepam inconsistently decreased drug-lever responding across multiple determinations in baboons and significantly decreased drug lever responding in rats. Caffeine combined with pentobarbital also yielded an inconsistent decrease in drug lever responding in baboons but there was no effect in rats. Thus the most reliable and complete antagonism across species was obtained with the CGS 8216/lorazepam combinations. PMID- 3979426 TI - The use of [3H](-)-DO 710 as selective dopaminergic ligand for binding and autoradiographic studies. AB - DO 710, a benzamide derivative previously shown to display a dopamine antagonistic potency superior to that of sulpiride, was 3H-labeled. Its use as radioligand was assessed in membrane binding and autoradiographic studies. The compound displayed relatively high affinity (Kd 2 nM) and pronounced selectivity for dopamine receptors (distinct from D-1 receptors) as well as low non-specific binding particularly evidenced in autoradiographic experiments. Hence [3H](-)-DO 710 displays distinct technical advantages over commonly used dopaminergic radioligands. PMID- 3979427 TI - Sympathoadrenal dysfunction in rats with chronic neurogenic hypertension. AB - Compared to sham-operated controls 5 weeks after surgery neurogenic hypertensive rats with sino-aortic baroreceptor deafferentation had higher blood pressure, higher plasma noradrenaline and adrenaline levels, lower heart noradrenaline concentrations, higher adrenomedullary adrenaline levels and increased cardiac intraventricular pressure (dp/dtmax). PMID- 3979428 TI - [3H]GBR-12935: a specific high affinity ligand for labeling the dopamine transport complex. PMID- 3979429 TI - Agonist and antagonist effects of 3-PPP enantiomers on functional dopamine autoreceptors and postsynaptic dopamine receptors in vitro. AB - In contrast to racemic 3-PPP (3-(3-hydroxyphenyl)-N-n-propylpiperidine), (+)-3 PPP appeared to inhibit the electrically evoked release of both [3H]dopamine (DA) and [14C]acetylcholine (ACh) from superfused rat neostriatal slices, although it was considerably less potent in this respect that the DA receptor agonists apomorphine, TL-99 (6,7-dihydroxy-N,N-dimethyl-2-aminotetralin) and LY 141865. At concentrations higher than 1 microM both of the 3-PPP enantiomers increased the spontaneous efflux of 3H but not that of 14C. (+)3-PPP also inhibited the cholera toxin-stimulated release of immunoreactive alpha-MSH from dispersed intermediate lobe cells of the rat pituitary gland. The inhibitory effects of (+)3-PPP on both transmitter and alpha-MSH release were antagonized by the selective D-2 receptor antagonist (-)-sulpiride. Neither [3H]DA nor [14C]ACh release were inhibited by ( )3-PPP but, in contrast, the release-inhibiting effect of the selective D-2 receptor agonist LY 141865 as well as that of (+)3-PPP were antagonized by (-)3 PPP, although less effectively than by (-)sulpiride. The inhibitory effect of LY 141865 on alpha-MSH release from intermediate lobe cells was also antagonized by (-)3-PPP. The data indicate that (+)3-PPP is a weak agonist and (-)3-PPP a weak antagonist at D-2 receptors and that neither of the 3-PPP enantiomers interacts selectively with DA autoreceptors mediating presynaptic modulation of striatal DA release. PMID- 3979430 TI - Dopamine receptor-mediated hypothermia induced in rats by (+)-, but not by (-)-3 PPP. AB - The novel dopaminergic agents (+)- and (-)-3-PPP were evaluated for their effects upon thermoregulation in rats maintained at room temperature (approximately 22 degrees C). Although approximately 30 times less potent than apomorphine, (+)-3 PPP induced a clearcut, dose-dependent and haloperidol/pimozide-reversible hypothermia. In contrast, the (-)-enantiomer per se lacked a significant effect upon rat body temperature. However, (-)-3-PPP clearly attenuated apomorphine induced hypothermia. Simultaneous biochemical investigations confirmed the presence of central dopamine (DA) agonist and antagonist properties for (+)- and (-)-3-PPP, respectively, at the doses employed. The results are compared to the agonist and antagonist effects of the 3-PPP enantiomers in various other central DA receptors systems. Particular reference is made to the recent hypothesis by Carlsson (J. Neural Transm. 57 (1983) 309, relating agonist intrinsic activity to the DA receptor responsiveness state, in turn determined by the endogenous tone. Based on the findings with (+)- and (-)-3-PPP it is suggested that DA receptors mediating hypothermia in the rat may be more akin to 'normosensitive' postsynaptic than to highly 'agonist-responsive' autoreceptors. PMID- 3979431 TI - Repeated daily treatments with estradiol benzoate increase the [3H]imipramine binding in male rat frontal cortex. PMID- 3979432 TI - Photoaffinity labelling of serotonin-S2 receptors with 7-azidoketanserin. PMID- 3979433 TI - Development of tolerance to repeated administration of 5-methoxy-N,N dimethyltryptamine in rats. AB - Chronic administration of 5-methoxy-N,N-dimethyltryptamine (5-MeODMT, 2 mg/kg i.p., every 30 min for 4 h) produced a dramatic tolerance to the behavioral effects of the drug in rats. The ED50 for the syndrome-inducing effects of the drug was increased from 1.3 to 2.4 mg/kg, and the mean duration of the syndrome was decreased from 14.9 to 1.2 min after this treatment. This tolerance effect totally disappeared within 4 h following termination of drug treatment. This effect was not due to changes in the uptake of 5MeODMT into the brain, but rather appears to be due to a decrease in the binding of the drug to serotonin receptors in the central nervous system. These studies are in contrast to previous results which reported no development of tolerance to 5-MeODMT. PMID- 3979434 TI - Age-related changes in guinea pig respiratory tissues: considerations for assessment of bronchodilators. AB - Tracheal tissues from immature guinea pigs were significantly more sensitive to histamine and carbachol than their counterparts from mature animals. Bronchial but not tracheal tissues from immature animals were more sensitive to isoproterenol and salbutamol than tissues from mature animals. Functional antagonism between carbachol-induced tension and salbutamol-induced relaxation was greatest in bronchial tissues from immature animals. Functional antagonism was not evident when a concentration of histamine required to induce maximal but not supramaximal tension was used to induce tone. Inhibition of catechol-o-methyl transferase (COMT) with U 0521 (10 microM) or inhibition of extraneuronal uptake with hydrocortisone (200 microM), in tissues from animals in either age group, affected neither the potency of, nor the extent of relaxation induced by, isoproternol or salbutamol in histamine-contracted tissues. We conclude that extraneuronal uptake and metabolism by COMT do not modify tissue sensitivity to the relaxants studied. Therefore age-related changes in the relaxant properties of isoproterenol and salbutamol are not due to differences in their uptake or metabolism but probably reflect changes at the receptor level. PMID- 3979435 TI - The analgesic activity of calcitonin and the central serotonergic system. AB - The effect of peripherally administered cyproheptadine or reserpine and the administration of 5,7-dihydroxytryptamine (5,7-DHT) in the nucleus raphe dorsalis on the analgesic activity of salmon calcitonin (sCT) injected into the lateral ventricle were investigated in male rats. Cyproheptadine or reserpine, given respectively 30 min or 24 h before the peptide, completely abolished the analgesic activity at all the times studied. However, when reserpine was given before the peptide it increased the effect of sCT at 30 (P less than 0.01), 60 (P less than 0.001), 120 (P less than 0.01) and 180 (P less than 0.01) min. 5,7-DHT injected in the nucleus raphe dorsalis 15 days before the peptide led to complete abolition of the analgesic activity. If neurotoxin was injected 4 days before sCT, the effect of the peptide was significant (P less than 0.05) only at 60 min. The results obtained confirm that the analgesic activity of sCT may involve central serotonergic pathway(s), and that the midbrain raphe nuclei 5-HT content is an important focus for this activity. PMID- 3979437 TI - The effect of graded doses of norepinephrine on the O2 supply/consumption balance in ischemic and nonischemic rabbit myocardium. AB - The purpose of this study was to determine the effect of graded doses of norepinephrine on the regional O2 supply/consumption ratio in ischemic rabbit hearts. Open chested, anesthetized rabbits were used and regional flows, O2 extraction, consumption and O2 supply/consumption ratios were determined before and 1 h after occlusion of the left anterior descending coronary artery in controls and animals given 0.1, 1.0 and 10 micrograms/kg per min norepinephrine (NE). After occlusion in controls, mean myocardial blood flow decreased 40% in the occluded region. Blood flow was also depressed in the occluded region for all NE doses compared to their own preocclusion values, but was higher in these regions compared to control animals. O2 extraction was higher in the occluded region compared to the nonoccluded region for all groups; however these values were lower in the NE groups compared to controls. NE increased O2 consumption in the occluded and nonoccluded regions compared to control group values. The O2 supply/consumption ratio was depressed in the occluded region in all groups compared to the nonoccluded region, though no differences were seen between NE and control groups. Thus, increases in the blood flow to the occluded region were proportional to the increases in O2 consumption with infusion of NE, indicating that a reserve exists and can be utilized with NE. PMID- 3979436 TI - Interactions between serotonin and cisapride on myenteric neurons. AB - Intracellular recording methods were used to investigate the interactions between serotonin (5-HT) and cisapride on myenteric neurons of guinea-pig small intestine. Serotonin had three actions on the neurons. One was a slowly rising depolarization associated with increased input resistance and discharge of spikes that lasted six or more times longer than the duration of the 5-HT application. The second action was a transient depolarization associated with decreased input resistance and brief discharge of spikes. This response desensitized quickly and could be evoked only at intervals of 2 to 3 min. The third action of 5-HT was presynaptic inhibition of acetylcholine release at nicotinic synapses. Cisapride reduced or abolished both the prolonged and transient responses to 5-HT. The threshold concentration for reduction of the responses was 0.1 microM and the responses were abolished at 1.0 to 10 microM. Cisapride suppressed stimulus evoked slow excitatory postsynaptic potentials (EPSPs) in the same cells for which cisapride blocked the prolonged responses to 5-HT. There were no effects of cisapride on resting electrical behavior or spike generation. Cisapride reduced the amplitude of fast cholinergic EPSPs, suggesting that it behaved as an agonist at the presynaptic serotonergic receptors. PMID- 3979438 TI - TL 333, a benzhydro[g]quinoline, stimulates both D-1 and D-2 dopamine receptors: implications for the selectivity of LY 141865 towards the D-2 receptor. AB - TL 333, (trans-N-ethyl-6,7-dihydroxyoctahydrobenzo[g]-quinoline), stimulates both D-1 and D-2 dopamine receptors. In contrast, LY 171555 (the active enantiomer of the selective D-2 agonist LY 141865) and LY 149632 stimulate only D-2 receptors. The structural differences between TL 333, LY 171555 and LY 149632 are discussed with regards to understanding the basis for the selective D-2 agonist activity of LY 171555 or LY 149632. PMID- 3979439 TI - Differential effects of metoclopramide and zetidoline on gastrointestinal motility. AB - There is a recently formulated hypothesis that metoclopramide (MCP) may stimulate gastrointestinal (GI) motility via an antagonistic action on presynaptic, release modulating muscarinic receptors. We have tested this hypothesis by comparing MCP and zetidoline (ZTD), another putative presynaptic muscarinic antagonist, in various GI motility assays. The muscarinic and dopamine receptor binding affinity was also measured. Both MCP and ZTD acted as stimulants of electrically induced twitches of the isolated guinea-pig ileum and as antagonists of the inhibitory effects of intermittent exposure to cholinomimetics on the same preparation. In vivo, MCP significantly accelerated GI transit in mice and gastric emptying in rats. In contrast, ZTD had no effect on these in vivo parameters. Thus MCP and ZTD seem to act on the isolated guinea-pig ileum as presynaptic muscarinic antagonists. However, this mechanism apparently does not contribute to stimulation of GI motility in vivo. PMID- 3979440 TI - Antagonism of Ca2+-induced contractions of K+-depolarized smooth muscle by local anaesthetics. AB - Drugs known to interact with Na+ channels were compared as antagonists of Ca2+ induced contractions of K+-depolarized taenia preparations from guinea-pig caecum. Tetracaine (apparent pA2 5.3 +/- 0.2), quinidine (5.2 +/- 0.1) quinine (5.1 +/- 0.1), d-propranolol (4.7 +/- 0.1), 1-propranolol (4.7 +/- 0.1), lignocaine (4.0 +/- 0.1) and procaine (3.6 +/- 0.1) displaced cumulative concentration-response curves to Ca2+ to the right without depression the maximal response. The slopes of Arunlakshana and Schild plots were close to unity for quinidine, quinine, lignocaine and procaine. These drugs relaxed the established Ca2+-induced contractions rapidly and thus the effects of these drugs resembled the effects of low concentrations of verapamil. However, the effects of the local anaesthetics were increased in the presence of sodium salicylate (5-10 mM) which increases the negative surface charge. In contrast the effects of verapamil were decreased by salicylate. Veratridine (10-100 microM), which activates Na+ channels, had only depressant effects on Ca2+-induced contractions. Thus, drugs acting on Na+ channels can also interact with Ca2+ channels but there are qualitative as well as quantitative differences between the effects of these drugs and those of drugs such as verapamil. These findings indicate different mechanisms of action for the inhibition of Ca2+-induced contractions by local anaesthetics and verapamil. PMID- 3979441 TI - Dopamine receptors: structure-activity relationship of d-tubocurarine analogues. AB - d-Tubocurarine (dTC) and d-tubocurine acted as antagonists of the dopamine induced inhibition of adrenergic neurotransmission in the isolated, perfused rabbit ear artery. N-Methyl-dTC and O,O,N-trimethyl-dTC (metocurine) did not exhibit dopaminergic antagonist activity. dTC contains one tertiary (3 degrees) nitrogen and one quaternary (4 degrees) nitrogen and d-tubocurine contains two 3 degrees nitrogens; whereas, both N-methyl-dTC and O,O,N-trimethyl-dTC have two 4 degrees nitrogens. The results suggest that a dTC analogue (e.g., metocurine) which lacks a 3 degrees nitrogen should be considered for use in patients treated with dopamine. PMID- 3979442 TI - A transmissible developmental block in Tetrahymena thermophila. AB - When the amicronucleate mutant BI3840 of Tetrahymena thermophila is mated with normal micronucleate cells, it receives a pronucleus from its partner but there is no further nuclear development and the conjugants separate, retaining their original macronuclei. Both of these sexually mature exconjugants and any cells with which they are mated show an unconditional block in macronuclear development. Although prezygotic nuclear divisions, nuclear transfer and post zygotic nuclear divisions appeared normal upon cytological analysis of Giemsa stained conjugants, macronuclear development was invariably aborted. Since the original macronucleus was resorbed, the cells were rendered amacronucleate and they died. When no macronuclear development was initiated, as in crosses with the aneuploid strain A* (III), the exconjugants were viable and retained their original macronuclei. This pattern was invariant with three different strains serving as the original micronuclear source, and in the case of one non-BI3840 exconjugant, persisted for over 200 cell generations. Exconjugants from a cross of one of the micronuclear donors with strain A* (III) did not show arrested development when crossed. It thus appears likely that there is conjugal transfer of non-nuclear information originating in BI3840 which is self-replicating and which causes an arrest in macronuclear development. PMID- 3979443 TI - In situ nick translation of human and mouse chromosomes detected with a biotinylated nucleotide. AB - In situ nick translation of human and mouse chromosome preparations has provided further evidence that DNase I sensitivity correlates with transcriptionally active chromatin. Chromosomes from differentiating cells and particular chromosome regions, known to differ in transcriptional activity, generally reveal predicted differences in relative DNase I sensitivity. The application of a biotinylated nucleotide in these studies provides a new level of cytological resolution and offers the potential for further refinement. PMID- 3979444 TI - Myoblast senescence in muscular dystrophy. AB - The limited proliferative capacity of normal diploid cells predicts that the utilization of cell divisions in vivo should reduce the lifespan of cells in culture. Because of the continuing demands for muscle regeneration in muscular dystrophy, myoblasts isolated from affected muscles should thus show a decrease in the number of cell divisions they are capable of expressing in culture. This hypothesis was tested by examining the proliferative capacity of myoblasts from different muscles for normal line 412 and dystrophic line 413 chickens of various ages. Prior to approx. 2 months of age, dystrophic myoblasts exhibited a relatively normal proliferative lifespan. By 5 months of age, myoblasts from the severely affected pectoralis major showed a 40% reduction in their proliferative potential, while myoblasts from the less affected posterior latissimus dorsi muscle showed a 25% decrease in their cultured lifespan. The time course of the appearance of a decreased proliferative capacity only after the disease has been clinically manifested strongly supports it representing a secondary response rather than it being an intrinsic property of dystrophic myoblasts. A hypothesis for manipulating the pattern of stem cell division in order to increase the mass of muscle produced from a constant number of cell divisions is presented. If myoblast senescence and the consequent failure of muscle regeneration is a contributing factor in the progressive deterioration of muscle function in the disease, then this hypothesis might provide an important therapeutic strategy for ameliorating the course of muscular dystrophy. PMID- 3979445 TI - Liposomes induce chromosome aberrations in human cultured cells. AB - The genotoxic effect of multilamellar lipid vesicles (MLV) was analysed on cultured heteroploid and diploid human cells. Dose-dependent reduction of cell survival and mitotic rate as well as induction of chromosome aberrations were observed. Chromatid and chromosome breaks and chromatid exchanges were found in 24-h culture after liposome treatment, whereas chromosome rearrangements were prevalent at 48 h. Neutral (PC/Chol) and positive (PC/SA) MLV showed a greater damage than negative (PS/PC; PS) MLV. Fibroblasts were the most sensitive cell type. In the case of PC/Chol MLV vesicles, control experiments with PC and Chol of controlled purity ruled out the possibility that the observed chromosome aberrations were caused by toxic oxidation products present in commercial preparations. PMID- 3979446 TI - Chondrogenesis in agarose gel culture. A model for chondrogenic induction, proliferation and differentiation. AB - An in vitro model has been developed to study chondrogenic induction, proliferation and differentiation. Embryonic rat mesenchymal cells isolated from muscle and embedded in agarose were treated with a partially purified extract from bovine demineralized bone powder. Treated cells proliferated and synthesized matrix similar to differentiated chondrogenic cells in a dose-dependent manner. By employing an enzyme-linked immunosorbent assay (ELISA), cartilage-specific proteoglycan and type II collagen synthesis were quantitated. Of the cells tested, only embryonic mesenchymal cells from muscle responded to bone extract. Proteoglycan synthesis was sensitive to type of medium and cell density. PMID- 3979447 TI - Influence of histone H5 on mononucleosome structure during differentiation in the avian erythroid series. AB - Changes in nucleosome repeat length during avian erythroid development have been previously correlated with changes in H5 content. In order to determine the effects of H5 on the length of DNA in mononucleosomal particles as a function of differentiation, a two-dimensional electrophoretic system was used to analyse DNA and histones of particles generated by micrococcal nuclease digestion of nuclei from several stages of erythroid development. Although the relative proportions of H5- to H1-containing mononucleosomes increased during development, only in mature erythrocytes did H5 protect a greater length of linker DNA from micrococcal nuclease digestion than did H1. These results suggest that changes in average nucleosome repeat length during erythroid development can be attributed only partially to an increase in the proportion of H5-containing nucleosomes which contribute to this average. PMID- 3979448 TI - Induction of functional Fc receptors in P388 leukemia cells. Requirement for multiple differentiation signals. AB - The development of functional Fc receptors (FcR) during induced differentiation with the tumor promoter, phorbol myristate acetate (PMA), was studied in the murine tumor cell line, P388. PMA induced the appearance of FcR on the membranes of P388 cells as indicated by the binding of IgG-coated sheep red blood cells (IgG-SRBC). Concentrations of PMA as low as 1 ng/ml were sufficient to induce the expression of FcR as well as to inhibit cellular division and to induce adherence in the P388 tumor cell line; however, optimal FcR induction occurred at PMA concentrations of 10-100 ng/ml. Immunofluorescent analysis with heat-aggregated myeloma proteins indicated that PMA induced FcR which were capable of binding IgG2a and IgG2b immunoglobulins, but not IgG1. Adherence to a substratum was determined to be a second required signal for expression of FcR, since PMA induction of P388 tumor cells in teflon dishes failed to fully develop FcR and adherence of P388 cells to poly-L-lysine-coated culture dishes in the absence of PMA was insufficient for FcR expression. FcR which appeared after PMA induction were non-functional in the sense that membrane-bound IgG-SRBC were not ingested to any significant extent by the tumor cells. However, if FcR induction occurred in the presence conA-induced rat spleen cell culture supernatants, phagocytosis of membrane-bound erythrocytes occurred. These findings suggest that for the expression of FcR which are capable of particle internalization, at least three identifiable membrane-transmitted signals are required during differentiation. PMID- 3979449 TI - Detection of sugar-binding proteins in membrane-depleted nuclei. AB - Nuclear sugar-binding proteins were detected in membrane-depleted nuclei isolated from hamster BHK cells and mouse L 1210 leukemia cells by means of fluorescein labelled neoglycoproteins. In fluorescence microscopy, the fluorescence was seen throughout the nucleus but was generally brighter over the nucleoli than over the rest of the nucleus. Flow cytofluorometry analysis demonstrated the presence of nuclear sugar-binding proteins for synthetic glycoproteins associated with different sugar residues. Among the nine neoglycoproteins used, four neoglycoproteins (namely alpha-rhamnosylated, alpha-glucosylated, N-acetyl-beta glucosaminylated and alpha-mannosylated-6P-serum albumin) strongly labelled nuclei. Various controls strongly argue for the specificity of the nuclear labelling. The possibility that some of the sugar-binding proteins might correspond to endogenous nuclear lectins is considered. PMID- 3979450 TI - Conversion of dense lysosomes into light lysosomes during hepatocytic autophagy. AB - Incubation of isolated rat hepatocytes under conditions which support maximal autophagy (amino acid-free medium) caused a marked alteration in the density distribution of lysosomes in continuous metrizamide gradients (mean peak density reduced from 1.14 to 1.09 g/ml). The autophagic sequestration inhibitor 3 methyladenine (3MA) partially prevented the density shift, presumably by stopping the formation of light autophagosomes which otherwise fuse with dense lysosomes and thereby alter the lysosomal density. PMID- 3979451 TI - Scanning electron microscopic examination of the secondary constriction of vero cells. AB - Vero cells (African green monkey kidney in origin) were prepared by the conventional air-drying method and then processed for SEM by a modification of the conductive method based on thiocarbohydrazide-osmium binding. Under SEM, not only metaphase chromosomes but also resting nuclei showed distinct fibres 30 nm in diameter. A few such fibres were found to run across the secondary constriction of the NOR-carrying chromosome. PMID- 3979452 TI - In vitro studies of microwave-induced cataract: reciprocity between exposure duration and dose rate for pulsed microwaves. AB - Rat ocular lenses exposed to pulsed microwave irradiation were maintained at constant temperature by circulating phosphate buffered saline in a thermostatically-controlled chamber. Irradiations with pulsed radiation (10 musec, 24 kW pulses) of 918 MHz were done at several different specific absorption rates (SAR) for durations up to 1 hr in order to explore a possible reciprocal relationship. The extent of damage was measured by the maximum depth of granular degeneration in the equatorial region of lenses fixed immediately after irradiation. The parameters of the pulses were increased to 20 musec and 48 kW to explore the variation in the biological effects and threshold with respect to average power, as well as pulse parameters (pulse width, peak power and energy per pulse). A total of 47 lenses were used in 3 X 4 factorial experimental design to explore effects observed at different average powers and durations (6, 20 and 60 min). The results were statistically analyzed by ANOVA and multiple regression analysis with logarithmic transformation. The results are summarized as follows. This data showed clear trends towards increasing depth of granular degeneration with increasing duration of exposure and dose rate. There was considerable evidence to confirm such reciprocity suggesting that total dose is an important parameter. A model postulating reciprocity was shown to explain observed variation in depth of damage as well as one allowing for separate effects of duration and dose rate. Lens fibre cell effects were detected by scanning electron microscopy after 6 min irradiation at the SAR values of 40 and 20 mW g 1. Light microscopic evidence of lens fiber cell damage can be detected at an SAR of 10 mW g-1 after a 1 hr exposure. PMID- 3979453 TI - Age dependence of selenite uptake in rat eye lenses. AB - 75Se-selenite was administered to young and adult rats in subcutaneous injection or added into the medium in which eye lenses were incubated. The 75Se uptake in lenses of the young was significantly higher in comparison with adults both in vivo and in vitro. The in vivo 75Se uptake, referred to unit of lens weight, was almost 500 times higher in young animals while in vitro it was only five times higher, which apparently reflects the age-dependent differences in the structure and function of membranes and/or system barriers. PMID- 3979454 TI - Adsorption of tear proteins on soft contact lenses. AB - To better understand protein deposit formation on contact lenses, a study of adsorption of lacrymal proteins was undertaken. Purified tear proteins were radiolabelled with 125I. The time course of adsorption of single protein solutions at various pHs or in mixture systems at pH 7.5 was determined. The maximum amount of lysozyme and albumin adsorbed in the presence of diluted tears was obtained. The influence of an early adsorbed layer on further adsorption was investigated. PMID- 3979457 TI - Persistent hyaloid vasculature and vitreal haemorrhage in albino rats: a morphological and histological study. PMID- 3979456 TI - Failure to detect conjugated dienes in cataractous lenses from normal and glucose 6-phosphate dehydrogenase-deficient patients. PMID- 3979455 TI - Validity and reproducibility of the Cooperative Cataract Research Group (CCRG) cataract classification system. AB - The validity and reproducibility with which six classifiers [one experienced (L.T.C.), and five novices (W.G., F.G., W.W., J.W. and O.W.)] used the CCRG cataract classification system was assessed. The validity of index classifications was assessed by computing sensitivities and pairwise interclass correlations between experienced and novice classifiers using the former's classification as the standard. The number of unordered combinations of terms in the CCRG's classification was reduced by combining cortical terms according to the CCRG's accepted system of staged simplification. The number of combinations of terms at each stage is as follows: Stage I (greater than 1000); II (127); III (63); IV (15); V (7); VI and VII (3) and VIII (2). Excellent agreement was obtained between the experienced and novice classifiers for Stages VII and VIII of the classification, good agreement for Stages V and VI and poor agreement for Stages IV, III and II (sensitivities of 97, 96, 72, 59, 40, 24 and 20% respectively). Good agreement was also achieved for the classifications of single lenticular regions, except for subcapsular regions. The intra- and interobserver reproducibility was assessed by computing the Kappa statistic to (1) compare classifications between novice observers and (2) compare repeat classifications made by the same observer by viewing the same cataract once on each of three different days. The novice classifiers had excellent intraobserver reproducibility for Stages VII and VIII (Kappas of 0.87 and 0.97 respectively), good reproducibility for Stages IV, V and VI (Kappas of 0.53, 0.62 and 0.62, respectively) and marginal reproducibility for stages II and III (Kappas of 0.39 and 0.40, respectively). The intraobserver reproducibility of the experienced classifier was superior to the others for virtually all characteristics with excellent reproducibility for Stages IV, V, VI, VII and VIII with Kappas of 0.79, 0.90, 1.0, 1.0 and 1.0, respectively and good reproducibility for Stages II and III (Kappas of 0.55 and 0.64, respectively). These results indicate that the simplified CCRG cataract classification system (Stages IV-VIII) passes the minimum standards for reproducibility. The performance of the experienced classifier far exceeds the minimum standards and indicates the feasibility of improving classifier performance with training and practice. PMID- 3979458 TI - Fluorescent, physiological and pharmacokinetic properties of fluorescein glucuronide. AB - When fluorescein is administered systemically, it is metabolized to form a fluorescent compound, fluorescein monoglucuronide. The molar fluorescent intensity of this compound is less than that of fluorescein but its fluorescent intensity compared to fluorescein varies considerably depending on the wavelength employed for excitation. Several hours after oral or intravenous administration the conjugate can become the dominant fluorophore in the plasma. When fluorescein is administered systemically and fluorescent intensity is measured in the eye, it is necessary to determine which compound is being measured since the time courses of the plasma concentrations and the permeability of the ocular barrier of each compound may not be the same. A technique suitable for measuring the relative concentration of each fluorophore in ocular tissues in vivo is suggested. PMID- 3979459 TI - Differential synthesis of rat lens proteins during development. AB - Developmental regulation of crystallin protein synthesis was observed in rat lenses between embryonic day 19 and postnatal day 21. Studies on lenses incubated in [35S]-methionine and on lens messenger RNAs translated in a reticulocyte lysate showed that several new polypeptides were synthesized in the lens beginning approximately 1 week after birth. One new polypeptide which had a molecular weight of 27 000 comigrated with the beta crystallins on SDS-PAGE and became a predominant component in older lenses. By crossed rocket immunoelectrophoresis and isoelectric focusing, synthesis of several native beta crystallins and one gamma crystallin was detected only in the postnatal lens. Many crystallin proteins were synthesized in the embryonic and the postnatal lens and did not change during the time period studied. These data suggest a differential regulation of the crystallin proteins during development. It appears that the lens undergoes a transition from embryonic to adult crystallin expression during the first weeks after birth. Factors such as maturation of the retina may be necessary for this transition. PMID- 3979460 TI - Comparative morphological studies on blood vessels in eyes of normotensive and spontaneously hypertensive rats. AB - The spontaneously hypertensive rats (SHR) show a lower intraocular pressure- despite high arterial blood pressure--than the normotensive Wistar Kyoto rats (NR). In SHR the quantitative evaluation of resin casts and flat-mount preparations of the blood vessels of the ciliary body and choroid showed a significant dilation of the vessels when compared to NR. In the capillaries of the ciliary processes, as well as in the choriocapillaries, a vascular rarefaction was seen. In all regions of the ciliary body the number of fenestrations found in the endothelium of the capillaries was reduced by about half in SHR. In addition, hyalinization of the connective tissue--particularly around the vessels at the base of ciliary processes--was seen in SHR. The morphological changes of the vasculature and connective tissue described here may be considered the cause of the reduced aqueous formation and low intraocular pressure found in SHR. PMID- 3979461 TI - Characterization of polypeptides from human nuclear cataracts by Western blot analysis. AB - Water-soluble and water-insoluble polypeptides from nuclei of clear vs. opaque and brunescent human lenses were resolved by sodium dodecyl sulfate polyacrylamide gel electrophoresis and electrophoretically transferred to nitrocellulose paper. Treatment of the nitrocellulose blots with monospecific antisera to human alpha and beta crystallin and to antisera against the Major Intrinsic Polypeptide (MIP26) of lens membrane demonstrated no difference in binding between microdissected sections of clear vs. opaque (and brunescent) nuclei. In contrast, treatment of nitrocellulose blots with monospecific antisera to human gamma crystallin demonstrated little or no binding to polypeptides from opaque (and brunescent) nuclei as compared with age-matched clear nuclei. These results demonstrate the selective involvement of gamma crystallins in opacification (and brunescence) in the human lens nucleus, and strongly suggest the presence of covalent changes of the gamma crystallin molecule during development of the human nuclear cataract. PMID- 3979462 TI - Modelling cortical cataractogenesis VII: Effects of vitamin E treatment on galactose-induced cataracts. AB - The possibility that vitamin E or other antioxidants might prevent cataracts was tested by incubating rat lenses in vitro in galactose-enriched medium or by treating rats fed a diet containing 50% galactose (w/w). The vitamin E was added to the medium at 2.4 microM, and to the diet at a level of 5 g kg-1 diet. In vitro, lenses incubated with 55.6 mM galactose underwent globular degeneration, which was partially prevented by addition of vitamin E (2.4 microM). Even in such vitamin E-protected lenses, which appeared clear, many small globules could be seen in the region of interdigitation at the 'corners' where hexagonal cells intersected. In vivo, in dietary experiments, a dense nuclear opacity of the lens was observed after approximately 5 weeks; unlike diabetic cataracts, this was not prevented by the addition of vitamin E to the diet. The extensive globular degeneration observed was typical of that found in long-term (21-week diabetic) cataracts. Although no significant difference in cataract incidence was observed, the extent of damage in vitamin E-treated rat lenses appeared to be less. The difference in effectiveness of vitamin E in galactose-induced cataracts, as compared to diabetic cataracts, is tentatively ascribed to (1) the more severe osmotic stress expected from the products of the aldose reductase pathway for galactose and (2) the greater depletion of reduced pyridine nucleotides (NADPH + NADH) expected of galactose as compared to glucose. PMID- 3979464 TI - Lens epithelium and radiation cataract. V. Observations on acid phosphatase and meridional row nuclear fragmentation. AB - The influence of X-radiation on acid phosphatase activity in differentiating meridional row cells of rat lens epithelia was examined by ultrastructural cytochemistry. X-ray doses of 10-12 Gy (1000-1200 rads) produced clearly observable nuclear and cytoplasmic damage at 13-19 hr postirradiation. In those cells, acid phosphatase reaction product was associated with much of the electron dense material of fragmented nuclei and various parts of the cytoplasm. In addition, many irradiated cells without observable damage were positive for reaction product. The presence of acid phosphatase activity in these otherwise normal-appearing cells is suggestive of more subtle radiation damage than that observed in the more severely damaged cells. PMID- 3979463 TI - Sorbitol/fructose metabolism in the lens. AB - The function of the sorbitol pathway, both as a secondary energy source and as an osmotic counterbalancing force, was examined. Rat lenses were incubated in media containing fructose as the primary exogenous energy source, and 31P nuclear magnetic resonance (NMR) spectra were accumulated. Fructose was found to be a sub optimal but usable substrate for glycolysis. The utilization of fructose was further confirmed by a 14C fructose tracer study, using high-pressure liquid chromatography. Thus the intralenticular pool of sorbitol + fructose could serve as a secondary energy source during severe hypoglycemia in the diabetic lens. However, fructose is not a physiologically significant alternative to glucose. 13C NMR spectroscopy was employed to determine the kinetics of sorbitol/fructose accumulation in lenses incubated in 35.5 mM 13C1-glucose, and the sorbitol/fructose consumption after the preincubated lenses were transferred to media containing no glucose. Based on these kinetic studies, we concluded that the sorbitol pathway cannot generate sorbitol/fructose fast enough to offset increased osmotic pressure from high glucose levels in the aqueous humor of the diabetic eye. The contribution of osmotic equivalents from sorbitol + fructose, however, cannot be ignored. PMID- 3979465 TI - Characterization and crystallization of delta-crystallin from the eye lens of adult turkey: comparison with delta-crystallin from adult quail and young chick. AB - delta-Crystallin, purified from either adult turkey or quail lenses, and characterized by amino acid composition and circular dichroism spectroscopy, is shown to be similar to delta-crystallin purified from 3-day-old chick lenses. Crystallization of turkey delta-crystallin is reported along with the characterization of the crystal unit cell by X-ray diffraction techniques. Variation in unit cell parameters is observed and is correlated with hydration. PMID- 3979466 TI - The in vitro photolysis of whole rat lenses using focused 290 nm laser radiation. AB - Whole rat lenses have been irradiated with a UV laser at 290 or 298 nm focused to a 0.08 mm diameter spot. The irradiated spot was analyzed using fluorescence spectroscopy and it was observed that the intensity of fluorescence (290 nm excitation, 335 nm emission) fell as the irradiation proceeded. These observations were interpreted in terms of a model which postulates photolysis of tryptophan, primarily present as residues in lens proteins, and formation of photoproducts which absorb the UV laser radiation to an ever-increasing extent as the irradiation proceeds. The effect is to produce a linear dependence of log If on log t, where If is the observed tryptophan fluorescence intensity after time, t, of exposure to the laser radiation. Evidence is also presented which indicates that an observed fast component of the tryptophan fluorescence decay results from local heating of the lens tissues due to energy dissipation by the laser. The most important conclusion from the present series of experiments is that tryptophan residues can be photolyzed by UV light in the whole lens, in vitro, in a fashion entirely analogous to that reported previously only for lens protein solutions. Hence the present work demonstrates that the photochemical behavior of lens protein solutions is indeed relevant to whole lens photolysis and that no special protective mechanism appears to be operative in the intact organ. PMID- 3979467 TI - Aspirin prevents carbamylation of soluble lens proteins and prevents cyanate induced phase separation opacities in vitro: a possible mechanism by which aspirin could prevent cataract. AB - The carbamylation of lens proteins by cyanate causes conformational changes, and cyanate causes cataract. There is some evidence that aspirin is beneficial to cataract patients, so its effect on the carbamylation of lens proteins and on opacification produced by cyanate in vitro was studied. Aspirin decreased the phase separation temperature in lenses exposed to cyanate, and was found to reduce the rate of carbamylation of most, if not all, soluble lens proteins. Studies with radiolabelled aspirin lead to the conclusion that the drug achieves this protection by chemically modifying the proteins. The nature of this modification and the relevance of these results to human cataract is discussed. PMID- 3979468 TI - Lacrimal protein secretion: comparison of young and old rats. AB - The in vitro protein secretory response of lacrimal glands from healthy 4- and 24 month-old F344 rats was measured. Tissue fragments were incubated in a 0.2 ml perifusion chamber and stimulated to secrete protein by a 4-min bolus of 0.01 mM carbachol. Fractions of the perifusate were collected and assayed for protein concentration and peroxidase activity. The response to carbachol was a well defined peak of secreted protein that included peroxidase. The response was inhibited by 1.0 microM atropine. No differences were found between the responses of male and female glands. The peak of protein secretion by the young glands contained 263.9 +/- 71.8 micrograms g tissue-1 compared to 175.4 +/- 56.5 micrograms g tissue-1 for the old glands (P less than 0.005). While the mean activity of the secreted peroxidase was similar in the two age groups, the aged glands were significantly more variable in their response. The F344 rat may provide a useful model for studying the normal age-dependent changes that occur in lacrimal gland. PMID- 3979469 TI - Comparison of erythropoietic response to erythropoietin-secreting stimuli in mice following polycythemia induced by transfusion or hypoxia. AB - The erythropoietic response, measured as RBC-59Fe uptake, in response to either 24-h exposure to hypoxia or administration of dexamethasone, isoproterenol, testosterone, or erythropoietin, was determined in both posthypoxic (PH) and hypertransfused (HT) polycythemic mice. Highly significant differences between PH and HT mice exposed to hypoxia or injected with dexamethasone, isoproterenol, or testosterone were observed, isotope incorporation being always higher in PH than in HT mice. On the other hand, the response to erythropoietin did not show a significant difference between PH and HT mice. These results suggest that PH mice have been preconditioned by exposure to hypoxia in a way that makes them more sensitive to at least some kinds of erythropoietic stimuli. Since these stimuli have been shown by others to increase erythropoietin production, the results support our hypothesis that hypoxia induces sensitization of the erythropoietin producing organ(s). PMID- 3979471 TI - Clonal origin of human basophil/mast cells from circulating multipotent hemopoietic progenitors. AB - The origin of the human basophil/mast cell lineage from a pluripotent hematopoietic stem cell has been surmised but never demonstrated. By examining individual hemopoietic colonies in methylcellulose under inverted microscopy and using histochemical stains in conjunction with single-colony histamine assays, we have previously identified basophil/mast cell progenitors in human peripheral blood. We now report that a large proportion of normal human peripheral blood mixed granuloerythropoietic (GEMM) colonies contain histamine, in contrast to a significantly lower frequency of histamine positivity among normal neutrophil macrophage, eosinophil, erythroid, macrophage, or megakaryocyte colonies. Morphological observations confirmed the presence of basophil/mast cells in the majority of GEMM colonies. In our work, the clonal derivation of basophils/mast cells from circulating multipotent (CFU-GEMM) hemopoietic stem cells was formally demonstrated, using combined histamine and G6PD isoenzyme analysis of single colonies grown in methylcellulose from a normal G6PD heterozygote. PMID- 3979470 TI - DNA synthesis by erythroid precursors in a completely defined medium: a rapid, sensitive, and convenient bioassay for erythropoietin. AB - We detail a novel, sensitive, and reproducible in vitro bioassay for erythropoietin that can be performed conveniently in any laboratory and is well suited for analysis of large numbers of samples. The assay measures DNA synthesis by a cohort of highly erythropoietin-responsive red cell precursors appearing in bone marrow of anemic rabbits after treatment with a single dose of actinomycin D. The assay is conducted in a completely defined culture medium that totally dispenses not only with serum but also with serum-replacing factors. Under well defined conditions, incorporation of [3H]thymidine by the cells depends specifically on erythropoietin. A stimulation index of up to 40-fold is obtained at 50 mU/ml of the hormone. The assay is linear in the range 0-50 mU/ml and not saturated before 1 U/ml of erythropoietin. Sample volumes of 1-30 microliter suffice for assay. Assay cells can be frozen in aliquots that retain their viability and ability to respond to erythropoietin over extended periods. Using microtiter-plate techniques, cells from one rabbit suffice for over 5000 triplicate erythropoietin determinations. Concentrations of 0.1-0.2 mU/well of erythropoietin can be detected. Erythropoietin values determined in sera from a variety of patients correlate extremely well with values obtained by the colony formation method. The ability to follow erythropoietin-dependent DNA synthesis and multiple cell divisions by a cohort of erythroid precursors in completely defined culture conditions may find application in controlled studies of red cell development. PMID- 3979472 TI - Long-term oral cadmium produces bone marrow hypoplasia in mice. AB - Marrow hypoplasia is described in CBA/H mice that drank water containing 300 mg/liter cadmium chloride for 12 months. This was characterized by a significant reduction of the totipotent stem cells (CFU-s), granulocyte-monocyte progenitor cells (GM-CFUc), and erythroid progenitor cells (CFU-e). The bone marrow cellularity and the proliferative capacity of GM-CFUc in vitro were decreased. The animals reflected these marrow alterations by demonstrating an anemia with reticulocytopenia and neutropenia. They did not show increased mortality or increased susceptibility to infections; however, their body weight was significantly reduced. In addition, iron deficiency was demonstrated in the cadmium-treated mice. The animals had a hypochromia of the peripheral red cells and diminished marrow iron stores. Thus, the anemia of cadmium toxicity is probably the combined result of bone marrow hypoplasia and iron deficiency. PMID- 3979473 TI - Lung function in progressive systemic sclerosis is dominated by poorly compliant lungs and stiff airways. AB - Pulmonary function was investigated in 24 patients with progressive systemic sclerosis. The lung volumes were measured by a body plethysmograph. Bronchial and parenchymal properties were studied by relating pulmonary resistance and lung volume to pulmonary elastic recoil pressure. Pulmonary mechanics and arterial blood gases were studied during graded exercise on a bicycle ergometer. The most fundamental abnormality was a less compliant lung parenchyma together with lowered TLC, VC and ventilatory capacity. A mild intrinsic bronchial obstruction was found, irrespective of smoking habits. In 7 patients, resistance did not, however, increase towards residual volume as it does in normal subjects. This phenomenon is interpreted as stiff airways withstanding compression. Blood gas values at rest, and during work, were remarkably normal. There was no correlation between fibrosis judged from static lung compliance and from chest roentgenograms. PMID- 3979474 TI - Increased bronchial responsiveness caused by ingestion of ice. AB - We studied 7 asthmatics who had a history of symptoms exacerbated by ice-cold drinks. Bronchial responsiveness to inhaled histamine was measured before and after ingestion of 40 ml of ice or water at room temperature. Although there was no change in baseline peak flow, a significant increase in bronchial responsiveness to histamine developed by 90 min after the ingestion of ice. No satisfactory explanation could be found. PMID- 3979475 TI - No effect of cefaclor on theophylline pharmacokinetics. AB - The effect of the antibiotic drug cefaclor on steady state pharmacokinetics of theophylline was studied in healthy adults by comparing the pharmacokinetic parameters as found during a 9 days course of theophylline alone and as obtained during comedication with cefaclor. Theophylline plasma concentrations were measured by means of HPLC analysis. On the ninth day of each of the 2 periods of drug administration, a concentration-time curve was evaluated. It showed no influence of cefaclor on volume of distribution and clearance of theophylline and only a slight, but significant (p less than 0.05) influence on the values for Cmax and tmax after cefaclor co-treatment. It is concluded that both drugs can be given concomitantly without any dosage adjustment of theophylline. PMID- 3979476 TI - Treatment of malignant pleural effusions with intrapleural Corynebacterium parvum or tetracycline. AB - Thirty two patients with malignant pleural effusion were randomly allocated to treatment with intrapleural Corynebacterium parvum or tetracycline hydrochloride in an attempt to prevent symptomatic recurrence of pleural fluid. Success in preventing recurrence of fluid at one month, using up to 2 doses of each drug, was 14 of 16 cases for Corynebacterium parvum, 5 of 9 for tetracycline given via an intercostal needle, and 6 of 7 for tetracycline given through an intercostal tube. These difference were not statistically significant. Corynebacterium parvum was significantly more likely to produce pyrexia equal or greater than 38 degrees C (P less than 0.001) and pain requiring analgesia (P less than 0.05) than tetracycline hydrochloride. Corynebacterium parvum is a useful agent for the management of malignant pleural effusion, but is associated with more side effects than tetracycline. PMID- 3979477 TI - Pulmonary cavitation, fibrosis and Legionnaires' disease. PMID- 3979478 TI - Acute pancreatitis in Legionnaires' disease. AB - Legionnaires' disease may cause severe multisystem damage. We report the case of a patient in whom Legionnaires' disease induced an acute pancreatitis. PMID- 3979479 TI - Pleural effusion and recurrent broncho-pneumonia with lymphedema, yellow nails and protein-losing enteropathy. AB - A case is reported in whom the triad generalized lymphedema, nail dystrophy, and pleural effusion was associated to protein-losing enteropathy. This combination, not previously described, was also characterized by exacerbations of pleural effusion with recurrent episodes of broncho-pneumonia. Albumin turnover study showed depletion of the total body pool, decreased catabolic rate, and elevated albumin removal through the gastrointestinal tract. During bronchopneumonia, increased capillary permeability due to pleural involvement may worsen the basic deficit of pleural lymphatic drainage. PMID- 3979480 TI - Achalasia and tracheal obstruction in a child. AB - A 13-year-old patient was referred for evaluation of pulmonary symptoms and was subsequently diagnosed to have achalasia. An esophagram revealed a dilated esophagus which obstructed the trachea at the thoracic outlet during a forced expiratory maneuver. Pulmonary function tests, obtained before and after esophagomyotomy, are presented. PMID- 3979481 TI - Asymptomatic pulmonary nodule in sarcoidosis. AB - A case of an asymptomatic solitary pulmonary nodule which proved to be due to sarcoidosis, is described. Only an excisional biopsy can establish the diagnosis. Sarcoidosis, although rare, must be added to the differential diagnosis of asymptomatic solitary pulmonary nodule. PMID- 3979482 TI - Effect of naloxone on arterial gases in chronically obstructed patients with acute respiratory failure. AB - In a randomized double-blind design 10 patients with decompensated COPD received intravenous naloxone (2 mg) and placebo. Arterial gases were monitored at 15, 30 and 60 min. No significant changes were observed in pCO2 after naloxone as compared to placebo. PMID- 3979483 TI - Ultrastructural observations on basal apparatus of respiratory cilia in immotile cilia syndrome. AB - The fine structure of the basal apparatus of cilia from respiratory epithelium has been studied in 5 subjects with immotile cilia syndrome without any specific defects in ciliary morphology. The ultrastructural analysis revealed the presence of abnormalities, heretofore undescribed, in basal bodies and accessory structures. In particular defective basal bodies of the so-called "half centriole" type, abnormal basal bodies showing an unusual dense granule in their central part, as well as abnormal accessory structures (i.e., giant striated roots, and double basal foot arising from single basal bodies) were found to be variously distributed in the patients examined. The significance of these morphological changes is discussed. PMID- 3979484 TI - Abnormal length of cilia as a possible cause of defective mucociliary clearance. AB - A 12-year-old girl with obstructive lung disease was examined with respect to the ultrastructure of her nasal mucociliate epithelium. She had the characteristics of the immotile-cilia syndrome: chronic rhinitis, sinusitis, and bronchitis, a severely decreased mucociliary clearance of the lungs, and nasal polyps. The nasal cilia showed a normal cross-sectional appearance but were found to have twice the normal length: 12 micron rather than 6 micron. We conclude that the patient represents a new subgroup of the immotile-cilia syndrome and that her cilia are unable to perform their normal tasks. PMID- 3979485 TI - Relieving dyspnea with an inexpensive and simple method in patients with severe chronic airflow limitation. AB - The effect of inspiratory resistive breathing training using a simple apparatus was tested in 27 optimally medicated consecutive outpatients with severe chronic airflow limitation, randomly assigned to a test and a control group. Patients trained in their homes for up to 10 min thrice daily and increments in resistance were made, if possible, every fortnight. The control group used the same apparatus, but without inspiratory resistance. Three months from the start of training, the following statistically significant differences between the 2 groups were observed: a marked decrease in dyspnea in the trained group, a 60% versus 22% rise in endurance time on a cycle ergometer at 2/3 of maximal work load, a fall in functional residual capacity, and a fall in respiratory frequency both at rest and during exercise. PMID- 3979486 TI - Effects of short-term exposure to ambient nitrogen dioxide concentrations on human bronchial reactivity and lung function. AB - Eight normal and 8 asthmatic subjects were exposed to NO2 in a modified body box for plethysmography during 20 min at 0,230,460 and 910 micrograms/m3 on 4 separate days. Bronchial reactivity (histamine inhalation test) was measured after exposure to air alone and to 910 micrograms/m3NO2. Airway resistance (Raw), thoracic gas volume (TGV) and specific airway resistance (SRaw) were measured before, during and after exposure. The bronchial reactivity of the asthmatic subjects increased significantly (p = 0.04) by 20 min exposure to 910 micrograms/m3 NO2. In the non-asthmatic group the airway resistance increased significantly (p = 0.03) after 20 min exposure to 460 micrograms/m3 NO2 and decreased significantly (p = 0.01) after 20 min exposure to 910 micrograms/m3 NO2. In the asthmatic group the trend in airway resistance was the same but not statistically significant. In the latter group TGV was significantly decreased (p = 0.02) during exposure to 910 micrograms/m3 NO2. Short term NO2-exposure in concentrations even below 1000 micrograms/m3 seems to have effects on human bronchial reactivity and lung function. PMID- 3979488 TI - Incidence of pulmonary gold toxicity. PMID- 3979487 TI - X-ray microanalysis of chloride in nails from cystic fibrosis and control patients. AB - Nail clippings from 60 individuals were examined. There were 34 "old" (greater than 16 years) controls, 16 "young" controls and 10 CF patients. In regard to elements found, Si and Al were considered as exogenous contamination. Other elements examined were variable in both control and CF. Examination of the Cl levels among the 3 groups showed a highly significant difference between the mean Cl integral values of the young controls (619 integral) and the CF patients (2956 integral). The results of the older control population ranged from 0-905 integral with a mean of 269 integral. We found no age or sex difference in the amount of Cl or any other element from either the CF or control population. Results show that the x-ray energy dispersive system (EDS) is very useful in studying the Cl in nails. We found that examination of nails frozen in liquid nitrogen followed by fracturing without prior washing was the preferred method. Although the results of this study clearly show statistically the value of EDS analysis of Cl in the diagnosis of CF, we must await further study of a larger group of patients to determine its usefulness in evaluating individual patients, particularly newborns. PMID- 3979489 TI - Association between falls in atmospheric pressure and spontaneous pneumothorax. PMID- 3979490 TI - The inhibitory role of the visually responsive region of the thalamic reticular nucleus in the rat. AB - Two-shock inhibition, a feature of 98 of 100 P cells recorded in the dorsal lateral geniculate nucleus of the normal rat, was not observed in 91 of 140 geniculate cells after an electrolytic lesion had been made in the adjacent visually responsive thalamic reticular nucleus. Nine geniculate cells recorded both before and after a reticular lesion had their initial inhibition abolished or substantially reduced after the lesion. The reticular lesion eliminated the bursts of spikes which normally terminate periods of inhibition following electrical or photic stimulation but caused no other changes in receptive field organization of geniculate cells. We conclude that the visually responsive region of the thalamic reticular nucleus in the rat is responsible for the profound two shock inhibition and for the post-inhibitory bursts which are normal properties of relay cells of the dorsal lateral geniculate nucleus. PMID- 3979492 TI - Projections to the posterior visual hyperstriatal region in the chick: an HRP study. AB - The thalamic nuclei in birds are known to receive afferents from the retina and project to the hyperstriatum. However, the efferent connections of one of these, the anterior lateral nucleus (LA) have been a subject of controversy for some time. Using horseradish peroxidase tracing techniques we have shown that, in the chick, the efferents of the thalamus (including the LA) project to the visual hyperstriatum. In the case of the LA this is to the right hyperstriatum only and to posterior regions not previously regarded as having a visual function. PMID- 3979491 TI - Ontogeny of human locomotor control. I. Infant stepping, supported locomotion and transition to independent locomotion. AB - Locomotor patterns of human infants were studied during stepping in the newborn period (first two months of life), during supported locomotion (6-12 months of age) and during independent locomotion in children who just were able to walk by themselves without external support (10-18 months of age). Leg movements, pattern of muscular activity and reaction forces were studied by a computerized system. The locomotor pattern during the newborn period lacked the specific functions that are unique for human plantigrade locomotion. There was no heel strike in front of the body; the foot was placed instead on its forepart straight under the body. Hip and knee joints were hyperflexed during the whole step cycle and flexed synchronously during swing. The specific knee-ankle coordination of human adults was missing. The ankle extensors were activated prior to touch down together with other extensor muscles. There was no propulsive force. A similar immature non plantigrade pattern recurred after an inactive period. During the subsequent period of supported locomotion there was a gradual transformation of the infantile pattern towards the plantigrade pattern continuing after establishment of independent locomotion. It is suggested that innate pattern generators in the spinal cord produce the infant stepping and also generate the basic locomotor rhythm in adults, but that neural circuits specific for humans develop late in ontogeny and transform the original, non-plantigrade motor activity to a plantigrade locomotor pattern. PMID- 3979494 TI - Direction selectivity of simple cells in cat striate cortex to moving light bars. I. Relation to stationary flashing bar and moving edge responses. AB - Quantitative estimates of the direction selectivities of 118 simple cells in response to moving light bars were expressed as a percentage calculated from the ratio of the response peaks: (preferred minus nonpreferred)/preferred. Virtually all simple cells were direction selective to some degree (mean direction selectivity 73.6%). Static-field plots to a stationary flashing bar were prepared from 74 of the 118 cells. Particular attention was given to the 42 cells with only two subregions in their static-field plot, one subregion responding at light on and the other at light off. It was concluded that interactive effects between subregions, whether synergistic or antagonistic, have little if any influence on the direction selective mechanism when the stimulus is a narrow light bar. Eighty two of the 118 cells were also tested with moving light and dark edges and of these 53 had response profiles with only two response peaks, one to the light edge and the other to the dark edge. Forty one of the 53 cells were each not only direction selective for both a light edge and a dark edge but also had a preferred direction for both edges that was the same as that for a light bar. Only two cells had preferred directions for both light and dark edges that were opposite to the direction preferred by the light bar. With one possible exception, every cell with two response static-field plot showed a one-to-one correspondence between the ordinal sequence of the response peaks and the ordinal sequence of the subregions. Depending upon the polarity of the moving edge and the ordinal sequence of the subregions, the mean level of the direction selectivity to a moving edge was significantly below that to a narrow moving light bar. This reduction in the degree of the direction selectivity appears to be due to an interaction between the subregions leading to a reduction in the amplitude of the response in the preferred direction rather than a suppression of the direction selective mechanism that operates in the nonpreferred direction. Moving edges cause a weak interactive effect between the subregions that seems always to reduce the degree of the direction selectivity, never increasing it. PMID- 3979493 TI - An intracellular HRP-study of cat tensor tympani motoneurons. AB - The morphology of single tensor tympani motoneurons was investigated following antidromic identification and intracellular injection of horseradish peroxidase. Eight motoneurons were selected for complete reconstruction and quantitative analysis. The mean size of tensor tympani somata (26.3 +/- 1.8 micron) make this parvocellular cluster of motoneurons below the trigeminal motor nucleus a population of the smallest cranial motoneurons yet described. Axons emerged from either the soma or a primary dendrite. They coursed dorsolaterally frequently through the trigeminal motor nucleus before looping ventrolaterally into the Vth nerve. No collaterals were observed within the brainstem. The 5 primary dendrites of each cell branched heavily and, on average, exhibited 40 terminal branches with an average tree expansion of 1262.5 micron. The dendritic arborization extended far beyond the nuclear boundaries described by the distribution of cell bodies. These data suggest that the overall membrane area for synaptic innervation is large and thus it provides morphological evidence for the hypothesis that tensor tympani motoneurons receive divergent multisensory synaptic input. The latter assumption was supported by morphological and electrophysiological evidence including close the proximity of motoneuronal dendrites to auditory (superior olivary complex) and somatosensory (trigeminal) relay centers. Since no dendrite ever entered the trigeminal motor nucleus proper the tensor motoneuron pool is distinct from the trigeminal not only in terms of soma size, location and function, but also the disposition and expansion of the postsynaptic receptive field. Based on these criteria the tensor tympani motoneuron pool should no longer be regarded as an accessory trigeminal nucleus but be recognized in its own right as the tensor tympani motor nucleus of V. PMID- 3979495 TI - Direction selectivity of simple cells in cat striate cortex to moving light bars. II. Relation to moving dark bar responses. AB - The response properties of 84 simple striate cells in anaesthetized (N2O/O2 supplemented with sodium pentobarbital) and paralyzed cats were examined quantitatively using narrow optimally-oriented light and dark bars moving at optimal velocities. Different cells gave two to five spatially-offset response peaks, the light bar and the dark bar response peaks alternating with one another. With only 5 exceptions, the cells had the same preferred direction for movement of the dark bar as for the light bar. Static-field plots were prepared from 32 of the 84 cells using stationary flashing bars. The receptive fields of different cells had from two to four subregions responding either at light on (ON subregion) or at light off (OFF subregion) although one cell had only a single subregion. In the preferred direction of stimulus movement cells gave either the same number of response peaks to moving bars as there were subregions or one additional response peak. The additional response peak, termed a boundary response, always occurred at the end of the sequence of response peaks and was always completely direction selective. The direction selectivities of the individual response peaks in the responses from 49 of the 84 cells were analyzed. To ensure that each response peak and the corresponding peak in the opposite direction both came from the same subregion, the 49 cells were selected on the basis of having a response in the nonpreferred direction sufficient for analysis and of having a stimulus velocity less than 2.5 degrees/s so as to avoid significant spatial shifts of the peaks due to response latencies. For all but two of the 49 cells, the response peaks in any given profile always showed a progressively greater degree of direction selectivity as the stimulus advanced from one subregion to the next, the first subregion giving the least directionally-selective response peak and the last subregion the most directionally-selective peak. This observation was independent of the direction of stimulus motion and of the particular sequence in which the ON and the OFF subregions were traversed by the stimulus. The response patterns observed experimentally have been correlated with theoretical response patterns based on the responses of lateral geniculate neurons. PMID- 3979496 TI - Visual recognition in monkeys: effects of transection of fornix. AB - An earlier finding from this laboratory of only a mild recognition impairment after hippocampal removal in mature monkeys (Mishkin 1978) contrasts with the severe deficit originally reported by Gaffan (1974) following transection of the fornix in immature monkeys. Investigation of some of the methodological differences between the two studies (lesion site, age of monkeys, and behavioral paradigm) failed to resolve the discrepancy in results, only a small impairment resulting under all conditions examined. While some still unexplored differences must underlie the divergent findings, it appears that only a comparatively mild impairment in recognition memory results from damage to the hippocampal system under a wide variety of conditions. PMID- 3979497 TI - Visual recognition in monkeys: effects of separate vs. combined transection of fornix and amygdalofugal pathways. AB - Performance on an object recognition test was assessed in monkeys with transections of either the fornix, the amygdalofugal pathways, or both. Whereas separate transection of the two pathways produced only small and unreliable effects, their combined transection produced a severe deficit. Comparison with the results of a previous study (Mishkin 1978) indicates that combined disconnection of the amygdala and hippocampus from the diencephalon yields a memory impairment similar to that following combined damage to the two limbic structures themselves. The findings suggest that recognition memory in monkeys depends on two parallel limbo-diencephalic pathways. PMID- 3979498 TI - Prediction in the oculomotor system: smooth pursuit during transient disappearance of a visual target. AB - Eye movements were recorded in human subjects who tracked a target spot which moved horizontally at constant speeds. At random times during its trajectory, the target disappeared for variable periods of time and the subjects attempted to continue tracking the invisible target. The smooth pursuit component of their eye movements was isolated and averaged. About 190 ms after the target disappeared, the smooth pursuit velocity began to decelerate rapidly. The time course of this deceleration was similar to that in response to a visible target whose velocity decreased suddenly. After a deceleration lasting about 280 ms, the velocity stabilized at a new, reduced level which we call the residual velocity. The residual velocity remained more or less constant or declined only slowly even when the target remained invisible for 4 s. When the same target velocity was used in all trials of an experiment, the subjects' residual velocity amounted to 60% of their normal pursuit velocity. When the velocity was varied randomly from trial to trial, the residual velocity was smaller; for target velocities of 5, 10, and 20 deg/s it reached 55, 47, and 39% respectively. The subjects needed to see targets of unforeseeable velocity for no more than 300 ms in order to develop a residual velocity that was characteristic of the given target velocity. When a target of unknown velocity disappeared at the very moment the subject expected it to start, a smooth movement developed nonetheless and reached within 300 ms a peak velocity of 5 deg/s which was independent of the actual target velocity and reflected a "default" value for the pursuit system. Thereafter the eyes decelerated briefly and then continued with a constant or slightly decreasing velocity of 2-4 deg/s until the target reappeared. Even when the subjects saw no moving target during an experiment, they could produce a smooth movement in the dark and could grade its velocity as a function of that of an imagined target. We suggest that the residual velocity reflects a first order prediction of target movement which is attenuated by a variable gain element. When subjects are pursuing a visible target, the gain of this element is close to unity. When the target disappears but continued tracking is attempted, the gain is reduced to a value between 0.4 and 0.6. PMID- 3979499 TI - Somatotopic termination of spinal afferents to the feline lateral cervical nucleus. AB - The labelling pattern of the feline lateral cervical nucleus (LCN) was investigated after pressure injections of lectin-conjugated horseradish peroxidase into cervical, thoracic or lumbar segments of the spinal cord. Sixteen cats received a 5-8 nl injection staining large parts of mainly the ipsilateral grey matter of a single segment. Light microscopic examination of frozen sections reacted with tetramethylbenzidine showed a somatotopic organization in the LCN. Rostral segments of the spinal cord projected mainly to rostroventral and medial parts of the ipsilateral LCN, while more caudally located segments projected to more dorsocaudal and lateral parts of the nucleus. Minor contralateral labelling with a similar somatotopic arrangement was seen in animals given cervical and lumbar injections. No significant labelling was found in the LCN of three control animals, the segmental injections of which were engaged mainly into the ipsilateral dorsal columns and the dorsolateral funiculus. Ultrastructural analysis in two animals which received multiple cervical or lumbar injections showed that about 70% of the peroxidase-positive structures in the LCN were boutons and the rest small myelinated axons. The precise termination pattern of ascending afferents to the LCN is compatible with the somatotopic organization of the other relay centres in the spino-cervico-thalamic pathway. PMID- 3979500 TI - Distribution in areas 18 and 19 of neurons projecting to the pontine nuclei: a quantitative study in the cat with retrograde transport of HRP-WGA. AB - Following large injections of horseradish peroxidase - wheat germ agglutinin in the pontine nuclei, corticopontine neurons in areas 18 and 19 were quantitatively mapped and flat maps showing the distribution of retrogradely labeled cells were constructed. The areal borders were defined either cyto- and myeloarchitectonically or from standard retinotopic maps presented in frontal sections (Tusa et al. 1981). Maps of the retinotopic organization in areas 18 and 19 (Tusa et al. 1979) were transferred to the present flat maps. Thus, the number and distribution of pontine projecting cells could be correlated with the retinotopic organization. The cell density (number of labeled cells per mm2 cortex) is in both areas highest in the cortex representing the lower and upper visual periphery and decreases towards the representation of the retinal central area. However, since in both areas 18 and 19 the visual field representation is twisted and portions of the visual field are magnified, the actual number of cells is higher in the cortex representing the central area and the lower medial visual field than in other parts. The cortex representing the lower hemifield contains approximately 2/3 (mean, N = 4) of the corticopontine cells in both areas. The average density of corticopontine cells increases from area 17 through 18 to 19, but the total number of cells within each of the areas is about the same (area 17: 18000 cells, area 18: 13400 cells, area 19: 17200 cells; mean, N = 4; data on area 17 from Bjaalie and Brodal, 1983). In conclusion, areas 17, 18 and 19 contribute about equally in quantitative terms to the pontine nuclei. Furthermore, assuming that the corticopontine neurons transmit spatially relevant information, there is a moderate overrepresentation of central vision and the lower medial visual field in the pontine projection from areas 18 and 19. This visual field representation is remarkably similar to that found in the corticopontine projection from area 17 (Bjaalie and Brodal 1983). PMID- 3979501 TI - Horizontal saccades induced by stimulation of the central mesencephalic reticular formation. AB - The central mesencephalic reticular formation (cMRF) was electrically stimulated in the alert monkey. Saccadic eye movements were induced to the contralateral side in the horizontal plane at latencies of 18-35 ms. Smooth or slow eye deviations were not produced by cMRF stimulation. If the stimulus was given during slow phases of nystagmus, rapid eye movements were elicited, and the velocity of the slow phases was not affected. The function of cMRF neurons and/or of pathways that lie within it appear primarily related to generation of rapid eye movements in the horizontal plane. The amplitude of induced saccadic eye movements depended solely on the region of cMRF that was activated. When the stimulation frequency was lower, the latency was longer, but the size and characteristics of the induced movement were the same. The product of latency and stimulus frequency was approximately constant, suggesting that saccades had been triggered after a fixed number of pulses had been given. Stimulation of cMRF at frequencies that were too low to elicit rapid eye movements had a tonic effect on saccade generation. When the animal was having optokinetic nystagmus (OKN), stimulation modulated beat frequency according to the direction of the nystagmus: contralateral quick phases were facilitated and ipsilateral quick phases were suppressed. The frequencies of stimulation necessary to suppress ipsilateral quick phases increased as slow phase eye velocity increased. This demonstrates that both cMRF activity and slow phase velocity affect quick phase triggering. When the cMRF on both sides were simultaneously stimulated, the eyes were fixed in place, and no further rapid movements occurred until the stimulus had ended. Thus, activity in pathways and/or cells in cMRF is not only able to trigger saccades, but can also change the excitability of saccade generating mechanisms and promote fixation by suppressing eye movements. Two types of rapid eye movements were elicited from cMRF. From dorsal portions of cMRF saccades were induced whose size was relatively constant and not dependent on the initial position of the eyes in the orbit. The size of saccades increased from small to large as the stimulating electrode was advanced through cMRF from dorsal to ventral. This suggests that the tecto-bulbo-spinal efferents coursing through cMRF and/or cMRF neurons related to this input, are organized in a topographic fashion, with cells and fibers related to eye movements of increasing size being layered one beneath another.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3979502 TI - Effects of entopeduncular lesions upon treadmill locomotion in cats. AB - Bilateral lesions were induced in the entopeduncular nuclei of eight treadmill trained cats. The pre- and postoperative locomotor performances of these cats were then compared, with no notable differences being apparent. This finding is discussed in relation to phylogenetic differences in the neural control of locomotor behavior. PMID- 3979503 TI - Relationship between orientation tuning and spatial frequency in neurones of cat area 17. AB - The orientation bandwidth was measured at different spatial frequencies for simple and complex cells. With increasing spatial frequency, the orientation tuning of simple cells became progressively narrower. This tendency was much less marked in complex cells. The results are interpreted in support of geniculate cells with orthogonal orientation biases providing the excitatory and inhibitory inputs to a simple cell. PMID- 3979504 TI - Essentiality of a specific cellular terrain for growth of axons into a spinal cord lesion. AB - To date, there are no reports of growth of significant numbers of axons into or across a lesion of the mammalian spinal cord. However, recent studies showing that CNS axons will grow into PNS environments indicate that comparable growth into spinal cord lesions could be achieved if ischemic necrosis could be prevented and the lesion site repopulated by astrocytes and ependymal cells rather than by the macrophages, lymphocytes, and fibroblasts that generally accumulate at sites of CNS injury. To examine this possibility, we made a laminectomy at T5 in rats and crushed the spinal cord for 2 s with a smooth forceps (leaving the dura mater intact to prevent ingrowth of connective tissue). At 1 week, the lesion was filled with mononuclear cells, degenerating nerve fibers, and capillaries that were oriented parallel to the long axis of the spinal cord. By 2 weeks, longitudinally oriented cords of ependymal cells and astrocytes had migrated into the lesion from the adjacent spinal cord, and similarly oriented nerve fibers had begun to grow into the lesion along these capillaries and cellular cordons. The mononuclear cells had now assumed phagocytic activity and were engorged with myelin and other cellular debris. After 3 weeks, the astrocytes had elaborated thick cell processes. The nerve fibers in the lesion were still oriented longitudinally but had increased in number and were often arranged in small fascicles. These observations provide the first histological evidence of growth of nerve fibers into a lesion of the rat spinal cord. We conclude that the intrinsic regenerative capacity of the spinal cord can be expressed if ischemic necrosis and collagenous scarring are prevented and the spinal cord parenchyma is first reconstructed by its nonneuronal constituents. PMID- 3979505 TI - Spinal cord contusion in the rat: production of graded, reproducible, injury groups. AB - A weight drop technique was used to produce a contusive injury of the spinal cord in the rat. A restricted laminectomy was carried out at T8 and the spinal column stabilized by clamps attached to the spinous processes of adjacent vertebrae. A 2.4-mm-diameter impounder was lowered onto the dura and a 10-g weight dropped 0.0, 2.5, 5.0, 7.5, 10.0, or 17.5 cm onto the impounder. The functional deficit was assessed for 4 weeks after injury and the spinal cord tissue processed for histopathologic analysis. The results indicated that groups of rats (N = 10) subjected to the weight dropped from increasing heights exhibited a graded final functional deficit as measured by scores on a modified Tarlov scale or the mean angle attained in the inclined plane test of Rivlin and Tator. Histopathologic results also indicated the production of graded lesions. Three groups of experimental animals were statistically distinguished corresponding to those with mild, moderate, or severe final functional deficit. The average functional deficit in these injury groups, produced by dropping the weight 2.5, 5.0, or 17.5 cm, respectively, was reproducible in replicate experiments. This model of spinal cord contusion in the rat may be useful in screening putative therapeutic drug regimens for subsequent clinical trials on different groups of patients with spinal cord injury. PMID- 3979506 TI - Spinal cord contusion in the rat: behavioral analysis of functional neurologic impairment. AB - A graded spinal cord injury in rats was produced by dropping a 10-g weight from 2.5, 5.0, 10,0, or 17.5 cm onto the exposed dura at the T8 vertebral level. Groups of rats (N = 10) for each of these weight drop (WD) levels as well as unoperated and WD controls (0 cm) were subjected to behavioral analysis that included evaluation of simple and complex reflexes as well as spontaneous and evoked motor patterns. On the basis of this analysis, we developed a protocol for evaluating functional deficits that follow spinal cord injury in the rat. The resulting combined behavioral score, a measure of functional deficit, closely correlated with the magnitude of the mechanical injury. The protocol used for neurologic assessment was administered routinely by personnel who were easily and rapidly trained. It should therefore prove useful in detecting the effects of treatment on recovery of function in a rat model of spinal cord injury. PMID- 3979507 TI - Spinal cord contusion in the rat: morphometric analyses of alterations in the spinal cord. AB - Morphometric analyses were carried out on rat spinal cords which were injured by a weight drop technique. A 10-g weight was dropped 0.0, 2.5, 5.0, 7.5, 10.0, or 17.5 cm onto the dura which was exposed at the T8 vertebral level. Four weeks after injury, lesion volume, lesion length, and the dimensions of the tissue at the epicenter (lesion area, area of gray matter, and area of white matter) were measured and correlated with the height from which the weight was dropped and the results from tests of motor and sensory functional deficit. The results, based on linear regression analyses, indicated significant correlations between certain morphologic parameters (lesion volume, lesion length, and the area of gray and white matter at the epicenter) and both the height from which the weight was dropped and behavioral scores. Because the area of white matter at the epicenter is a very simple measurement which correlates well (r = 0.91) with behavioral outcome, this morphologic feature is a useful quantitative measure of the histopathologic consequences of spinal cord injury. PMID- 3979508 TI - Microtubule density and size of axons in early diabetes: implications for nerve cell homeostasis. AB - The density of microtubules and the axonal caliber were studied in myelinated axons from sural nerves of young male alloxan-diabetic and age-matched rats, at 0, 15, 30, and 60 days after diabetes induction. The longitudinal growth of axons was normal in diabetic rats, but in contrast, the radial growth of axons was impaired. The axonal area was 20% less than normal in diabetic rats at the 60th day. Microtubule density was assessed in 3-micron-diameter axons. No differences in microtubule density (range: 25.0 to 28.0 microtubules/micron2) were found between or within diabetic and control groups. However, the subnormal axonal size in diabetic rats entailed a reduced content of microtubules in a nerve trunk because the relation between axonal size and microtubule density remained normal. The results showed that microtubule density was independent of axonal length, and of age, weight, or diabetic conditions of the rats, and was related only to the axonal size. These findings have implications in nerve cell homeostasis. PMID- 3979509 TI - On the brain of a scientist: Albert Einstein. AB - Neuron:glial ratios were determined in specific regions of Albert Einstein's cerebral cortex to compare with samples from 11 human male cortices. Cell counts were made on either 6- or 20-micron sections from areas 9 and 39 from each hemisphere. All sections were stained with the Kluver-Barrera stain to differentiate neurons from glia, both astrocytes and oligodendrocytes. Cell counts were made under oil immersion from the crown of the gyrus to the white matter by following a red line drawn on the coverslip. The average number of neurons and glial cells was determined per microscopic field. The results of the analysis suggest that in left area 39, the neuronal: glial ratio for the Einstein brain is significantly smaller than the mean for the control population (t = 2.62, df 9, p less than 0.05, two-tailed). Einstein's brain did not differ significantly in the neuronal:glial ratio from the controls in any of the other three areas studied. PMID- 3979510 TI - Muscle fiber transformation in capsaicin-treated rats. AB - Rats were injected with capsaicin or solvent on the 2nd day of life. Nine weeks later both animal groups were further subdivided: one was untreated and the other group underwent surgery consisting in either (a) removal of one sternohyoid superior muscle or (b) a sham operation. The sternohyoid superior muscles were removed at 3-day intervals and investigated for their myofibrillar ATPase reaction. Capsaicin application alone produced a primary (baseline) muscle fiber transformation from fast to slow which was reflected in a considerable increase in the type IA fiber population (almost lacking in normal controls). However, at all stages investigated the degree of transformation (i.e., the amount of IA fibers) displayed a great individual variability. In addition to this basic transformation, both surgical procedures elicited a concordant behavior of the muscles and an undulating time course of the number of type IA fibers. This secondary reversible muscle fiber transformation was superimposed on the primary one. There is evidence that the operative treatments caused a synchronization of the on-going transformation processes in the labile primary transformed fiber population rather than fiber changes per se. PMID- 3979511 TI - Influence of molecular layer on pyramidal tract neurons. AB - Activity in layer I increases the excitability of pyramidal tract (PT) neurons, the effect being stronger on slow than on fast PT neurons. Extracellular recordings were made from lateral postcruciate cortex of domestic cats, using antidromic activation from medullary pyramid to identify and classify PT neurons. Their responses to contralateral forepaw (CFP) and direct cortical (Ctx) stimulation, 3 to 4 mm caudal to the recording site, were determined before and after placement of vertical cuts between the Ctx stimulating and recording sites. These cuts had a minor effect on the responses of PT neurons to CFP stimulation, but a strong effect on the responses to Ctx stimulation. Cuts through layers I and II markedly delayed the responses of slow PT neurons, but had no effect on fast PT neurons. After deeper cuts (II/III through V/VI), half the fast and half the slow PT neurons failed to respond to Ctx stimulation. Of those that did, fast PT responses were markedly delayed, but slow PT responses were only mildly affected. The Ctx-CFP interactions showed the familiar facilitation-depression sequence. The period of depression was unaffected by any of the vertical cuts, but disappeared after undercutting the stimulus site below layer VI. The period of facilitation depended primarily on layer I for its production, although deeper layers also contributed to the facilitation of fast PT neurons. PMID- 3979512 TI - Difference between measured and calculated critical delay of bulbospinal respiratory neurons caused by determinations of refractoriness. AB - We hypothesized that differences between the critical delay for antidromic activation of bulbospinal respiratory neurons and the sum of their antidromic latency and refractory period are due to the use of techniques which measure refractoriness at the site of recording rather than of stimulation. This hypothesis was confirmed by measuring the critical delay for bulbospinal neurons, their antidromic latencies, and their refractoriness both at the sites of stimulation and recording. PMID- 3979513 TI - Sleep-waking modulation of respiratory sinus arrhythmia in aged and young adult cats. AB - Heart rate variation at the respiratory frequency was examined in young adult and aged cats during waking and quiet sleep. Respiratory sinus arrhythmia was found to be significantly enhanced during quiet sleep compared with waking in both groups of cats. Aged cats exhibited respiratory sinus arrhythmia comparable to that of young adult cats during both waking and quiet sleep. PMID- 3979514 TI - Triethanolamine, tris, hepes, and cytosine arabinoside show neuritogenic activity in cultured chick embryo ganglia. AB - Neuritogenesis, which occurs to a slight extent in chick embryo ganglia maintained under standard conditions and which is maximally stimulated by nerve growth factor, also was enhanced by presence in the medium of buffers (triethanolamine, Tris, and Hepes) and cytosine arabinoside and by the passage of direct electric current. The major effect of the buffers probably was to remove protons from cell membranes, that of the current to produce accelerated movement of ions through membranes of the ganglionic cells, and that of cytosine arabinoside to decrease the numbers of nonneural cells by inhibiting DNA synthesis. The buffers were neuritogenically ineffective on nerve growth factor sensitive PC12 pheochromocytoma cells in culture. Media from ganglia in which triethanolamine or passage of electric current had elicited outgrowth of neurites produced no observable effect on PC12 cells under our experimental conditions. Current data fit the hypothesis that, whereas nerve growth factor exerts direct neuritogenic effects on neurons, the other treatments affect neural-nonneural interactions, possibly by way of gap junctions or changes in direct physical contact, so as to disinhibit inherent neural neuritogenic potential and/or to stimulate it. PMID- 3979515 TI - Enhancement of axonal growth into a spinal lesion by topical application of triethanolamine and cytosine arabinoside. AB - We have demonstrated that a brief compression lesion of the rat spinal cord produces axotomy with minimal necrosis or scarring and that axons grow into such a lesion along longitudinally oriented capillaries and similarly oriented cordons of ependymal cells and astrocytes. Inasmuch as extensive, oriented growth of axons into a spinal lesion is never seen after transection, concussion, or other models of spinal cord injury, this new surgical procedure appeared to be applicable to the in vivo testing of pharmacological agents designed to promote neuritic outgrowth. The spinal cord of anesthetized rats was crushed extradurally for 1 s with a smooth jeweler's forceps. After 2 days when edema had subsided, the animals were reoperated. The dura mater was opened, and a polyethylene tube was implanted so that one end was fastened over the injury site and the other end was exteriorized at the back of the neck. The lesion site was superfused with 0.1 ml of control or test solutions four times daily for 2 weeks and then the animals were anesthetized and killed by vascular perfusion with fixative. After decalcification, the vertebral column and spinal cord were embedded in paraffin and stained by several histologic procedures including the protargol silver impregnation method for nerve fibers. Treatment with triethanolamine and cytosine arabinoside, substances which promote neuritogenesis in cultured spinal ganglia of chick embryos, markedly stimulated the growth of axons into the lesion of the rat spinal cord. We conclude (i) that it is possible to pharmacologically enhance the intrinsic growth capacity of CNS neurons and (ii) that brief compression provides a type of injury that is well suited to the evaluation of treatments aimed at promoting axonal regeneration. PMID- 3979516 TI - Influence of trophic substances in the regulation of resting membrane potential and ionic concentration in skeletal muscle. AB - We studied the ionic and water content and the resting membrane potential of rat extensor digitorum longus EDL muscles at different times after unilateral nerve crush. Intracellular potassium concentration decreased progressively during the 1st week after nerve crush whereas intracellular sodium concentration increased significantly. At about day 10, when functional reinnervation (presence of end plate potentials and miniature end-plate potentials) was detected, the above changes tended to return to control values. In addition, there was a significant difference between muscles with long and short nerve stumps. These results suggest a neurogenic dependency of muscle hydroelectrolytic composition. The decrease in resting membrane potential was greatest after 6.5 days of denervation when changes in the internal ionic concentration were maximum; however, these ionic changes contributed little to the decrease. The recovery of the resting membrane potential commenced at least 48 h before the first signs of functional reinnervation (10th day). This finding suggested an important contribution of some neurotrophic material in early stages of the reinnervation when nerve-muscle contacts were already established. Later, the contribution of mechanical activity to the restoration of the RMP became apparent (20th day); fibrillation potentials had disappeared by that time. PMID- 3979517 TI - Calcium metabolism in aluminum encephalopathy. AB - Electrophysiologic deficits occurred in the in vitro hippocampal slice preparation removed from rabbits at various stages of an aluminum-induced encephalopathy. These deficits were associated with a progressive increase in total tissue calcium content. The deficits were reversed, in part, by increasing extracellular calcium concentration. Whereas calmodulin and calcium-binding protein, as measured by radioimmune assay, did not change in amount, the activity of calmodulin, as a calcium-calmodulin activator of the enzyme 3',5'-cyclic nucleotide phosphodiesterase, declined progressively as the aluminum encephalopathy developed. Cholinergic neurochemical transmission, measured by choline acetyltransferase activity and muscarinic binding, did not change in the encephalopathy. We postulate that aluminum alters brain calcium homeostasis, perhaps through an effect on calmodulin. PMID- 3979518 TI - Moderate prenatal ethanol exposure interacts with strain in affecting brain development in BALB/c and C57BL/6 mice. AB - The development of two forebrain fiber tracts, the corpus callosum and anterior commissure was examined in BALB/cCF and C57BL/6J mice in relation to moderate maternal consumption of ethanol during gestation. Pregnant animals were fed ethanol 10% v/v in the drinking water from days 5 to 19 of gestation, when fetal brain development was assessed. Control animals received an isocaloric sucrose solution and were pair-fed to the experimental animals. An additional ad libitum control group was included. The alcohol treatment did not increase the incidence of the CC being absent in a midsagittal section. In BALB/c animals which had been exposed to ethanol the area of both the corpus callosum and anterior commissure was smaller than in the two control groups, and this effect was independent of the lower brain weight resulting from the treatment. The area of the corpus callosum, adjusted for brain weight, was smaller in both the alcohol-treated and sucrose control C57 animals than in the ad libitum control group; this suggests a nutritional effect. There was no evidence of an effect of ethanol on anterior commissure area or brain weight in C57 animals. PMID- 3979520 TI - Pulmonary toxicity of cyclophosphamide: a 1-year study. AB - The development of cyclophosphamide-induced pulmonary lesions over a 1-year period was studied in mice. Male BALB/c mice received a single intraperitoneal injection of 100 mg/kg of cyclophosphamide. Within 3 weeks there were scattered foci of intraalveolar foamy macrophages. With time, these foci increased in size and, 1 year later, occupied large areas in all lung lobes. There was also diffuse interstitial fibrosis. Chemical determination done 3, 12, 24, and 52 weeks after cyclophosphamide showed that lungs of animals treated with cyclophosphamide had significantly more hydroxyproline per lung than controls. One year after cyclophosphamide pressure-volume curves measured in vivo were shifted down and to the right and total lung volumes were decreased. A single injection of cyclophosphamide produced an irreversible and progressive pulmonary lesion. PMID- 3979519 TI - The saline effect: minimizing the severity of brain damage by reduction of secondary degeneration. AB - Rats with bilateral lesions in the caudate nucleus received intracerebral injections of isotonic saline directly into remaining caudate tissue. Compared with noninjected controls, saline-treated animals performed a spatial footshock task better when tested after a 9-day recovery period but not if tested shortly after surgery. Histological evaluation revealed that the saline treatment significantly reduced anterograde degeneration in substantia nigra pars reticulata. In addition, behavioral measures correlated with lesion size and degree of anterograde degeneration in saline-treated animals but not in operated controls. It seems that saline injections can prevent neuronal death in tissue surrounding the zone of trauma, possibly through an alteration of ionic properties in the extracellular space. PMID- 3979521 TI - Experimental pulmonary fibrosis induced by trisodium citrate and acid-citrate dextrose. AB - A single intrapulmonary injection of 3.8% trisodium citrate and acid-citrate dextrose (ACD) into rabbits results in extensive degeneration and necrosis of alveolar pneumocytes, including the type II pneumocyte, and of bronchiolar or bronchial epithelial cells. Subsequently, the alveoli and alveolar ducts collapse, and the septa and ductal walls adhere to each other, accompanied by the proliferation of interstitial fibroblasts. These fibroblasts produce fibrous connective tissue which is followed by pulmonary fibrosis in 1 week. Epithelial regeneration, especially that resulting from the proliferation of immature type II pneumocytes, occurs around the periphery of the fibrous lesions. The synthesis and release of large amounts of surfactant materials by the proliferated type II pneumocytes may induce the surfactant materials to reopen the air spaces of the collapsed and adhesive alveoli. By 4 weeks those fibrous areas in the pathological lungs become smaller and/or appear normal. These results suggest that this is a useful experimental animal model for pulmonary fibrosis, and that epithelial cells, especially type II pneumocytes, are associated with both the induction of and the recovery from the disorder; in the early stage, interference by reepithelization resulting from type II pneumocyte proliferation may elicit the proliferation of fibroblasts, and in later stages, reepithelization and surfactant synthesis by newly proliferated type II pneumocytes may permit the reopening of collapsed and adhesive air spaces. PMID- 3979522 TI - Cytopathogenic cerebrospinal fluid from neurological and psychiatric patients. AB - Cerebrospinal fluids (CSFs) were examined for the presence of a cytopathogenic component by an in vitro assay. No abnormal proteins were detected in CSF which produced cytopathic effects. The cytopathic effect was associated with high molecular-weight material which was resistant to enzyme treatment. The effect persisted after extensive ultraviolet irradiation. The presence of the cytopathic effect was associated with increased CSF enolase levels. PMID- 3979523 TI - Intracellular accumulation of mercury in the anterior pituitary of rats exposed to mercuric chloride. AB - A histochemical technique has been used to reveal mercury deposits by light and electron microscopy in the anterior pituitary of adult rats. After administration of mercuric chloride either in the drinking water or by intraperitoneal injection, deposits were found within lysosomes and secretory granules in somatotrophs, thyrotrophs, follicular cells, and marginal cells. The amount of mercury deposited was proportional to the dose of mercuric chloride given. Significantly more mercury was found in rats given intraperitoneal injections compared to those intoxicated with mercuric chloride in the drinking water. Mercury was retained in the cells for at least 4 months after the last injection although the amount of deposits decreased in this period. PMID- 3979524 TI - Contraceptive use, pregnancy and fertility patterns among single American women in their 20s. AB - Eighty-two percent of never-married American women aged 20-29 have had sexual intercourse; black women are somewhat more likely than white women to have had intercourse. In all, 53 percent of never-married women in this age-group had intercourse at least once in the four weeks preceding the 1983 National Survey of Unmarried Women. Black women are more likely than white women to have done so (62 percent compared with 51 percent). Nearly all of the women who ever had intercourse have used a contraceptive method at some time; 78 percent practiced contraception at the time of their most recent intercourse. A high proportion did not start using birth control until some time after first intercourse, however: On average, the delay between first coitus and first contraceptive use was eight months, and one-fifth of the respondents said that they began using a method only after their first pregnancy. Most of the women who did use a method at the time of first intercourse relied on the condom or withdrawal; in contrast, about two thirds of white women and three-quarters of black women now rely on the pill, IUD or sterilization. Eighty-six percent of the women who had intercourse in the four weeks before the interview were current users--88 percent of the white women and 77 percent of the black women. Catholic women are no less likely than others to have ever had intercourse, to be currently sexually active or to be using contraceptives. However, Catholic women who receive communion at least once a week are less likely to be sexually active and substantially less likely to use medical contraceptive methods. Women who consider themselves very religious are less likely to be sexually active, but the sexually active among them are about as likely as others to use contraceptives. Better-educated women are much more likely than less-educated women to practice contraception, and women who work outside of the home are more likely than those who do not to use contraceptives. Thirty-three percent of unmarried 20-29-year-olds have had at least one pregnancy (about 40 percent of those who have ever had intercourse). Thirty-two percent of sexually active white women have been pregnant, compared with 70 percent of comparable black women. Furthermore, whereas 14 percent of white 20-29-year-olds have had an out-of-wedlock birth, 62 percent of black women have done so.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3979527 TI - Study of a family of differential equations arising in biology. PMID- 3979525 TI - Family planning clinic services in the United States, 1983. AB - Almost five million women were enrolled in family planning clinics in the United States in 1983, eight percent more than in 1981. The number of family planning provider agencies declined slightly, from 2,504 to 2,462, but the number of clinic sites that could be identified increased slightly, from 5,124 to 5,174. Family planning clinics operate in three-quarters of U.S. counties; in 1975, the last time county coverage was checked, four-fifths of the counties had clinics. About one in 20 women who are exposed to the risk of unintended pregnancy and live in unserved counties are teenagers or low-income women. Nonmetropolitan counties are more likely to be without clinics than are metropolitan counties. Overall, there are 417,000 low-income women and 249,000 teenagers at risk of unintended pregnancy living in counties where there are no family planning clinics. In 1983, health departments constituted six in 10 of all family planning agencies and served two-fifths of all family planning clinic patients; Planned Parenthood affiliates accounted for fewer than one in 10 agencies and served more than one-quarter of all patients. Hospitals and all other agencies served about one-third of the total 1983 caseload. These patterns were similar to those reported for 1981. Family planning clinics continue to serve primarily low-income women: Four-fifths of the nearly five million clinic patients in 1983 had family incomes below 150 percent of the federally defined poverty level. About 1.6 million women aged 19 and younger were served, representing one-third of all clinic patients in 1983.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979526 TI - The holy war. PMID- 3979528 TI - Spectrophotometric, fluorometric and colorimetric determination of terbutaline sulphate and orciprenaline sulphate. PMID- 3979529 TI - [Heterogeneous phase titration of imidazoles in pharmaceutical preparations]. PMID- 3979530 TI - [Determination of sympathomimetic amines with bromthymol blue by 2-phase titration]. PMID- 3979531 TI - [Mechanisms of the inotropic action of nonachlazine]. AB - It has been demonstrated clinically and experimentally that administration of nonachlazine enhances myocardial contractility because of the stimulation of beta adrenostructures and that the initial status of the latter ones determines in many respects the drug action intensity. PMID- 3979532 TI - [Effect of indomethacin and voltaren on glutathione oxidation and reduction in the liver of white rats]. AB - It has been established that oral administration of indomethacin (2.5 mg/kg) to albino rats for one week leads to a decline in the level of reduced and an increase in the level of oxidized glutathione with a simultaneous activation of liver glutathione reductase and glutathione peroxidase. Administration of the drug for two weeks makes the indicators under study return in the main to normal. The raising of the drug dose up to 5 mg/kg makes the total content of glutathione fall at the expense of its reduced form. The activity of the enzymes significantly rises in all the observation periods (days 1-5 after administration). The use of voltaren in doses of 2.5 and 5 mg/kg does not produce any action on the glutathione forms or glutathione reductase and glutathione peroxidase activity in the liver. PMID- 3979533 TI - [Gas chromatographic analysis of different classes of psychotropic preparations]. AB - The authors describe a method for simultaneous extraction of the psychotropic compounds of various classes from a sample of biological material. Discuss the use of different stationary liquid phases, solid supports, and carrier gases in respect to gas chromatographic analysis of the psychotropic drugs. Demonstrate the possibility of analyzing these drugs on a Soviet Tsvet-100 chromatograph with the use of available materials. PMID- 3979534 TI - [Research on the pharmacokinetics of ftorotan and pemtrane in human blood using gas-liquid chromatography]. AB - Gas liquid chromatography was used to study and compare the changes in pentrane and halothane concentrations in the blood of patients with general surgical diseases under the conditions of monopentrane and combined (pentrane plus nitrous oxide) anesthesia (19 children aged 1-14 years), monohalothane anesthesia with different types of premedication (18 children aged 6-12 years) and with different types of the general anesthesia maintenance (24 patients aged 20-52 years). The use of combined anesthesia and premedication with suppositories containing phentanyl, methacin and etaperazine under the conditions of monohalothane anesthesia makes it possible, upon the attainment of stage III1 anesthesia, to reduce the concentration of the fluorine-containing anesthetics in the venous blood of the children by 1.7-1.8 times on an average. The maintenance of the general anesthesia by subanesthetic concentrations of a mixture of halothane, pentrane, nitrous oxide and phentanyl provides for adequate general anesthesia with substantially reduced concentrations of the fluorine-containing anesthetics in the arterial and venous blood of patients at the main stage of surgical intervention: halothane concentration is reduced 1.6 and 1.7-fold, that of pentrane 2.6- and 3.6-fold, respectively. PMID- 3979535 TI - [Clinical pharmacokinetics of mebikar. Computation of individual dosage regimens]. AB - The authors review the principles of calculating the optimal dosage regimens of mebicar used in the treatment of borderline psychopathological abnormalities in alcoholics. Mebicar administered to patients according to the calculated dosage regimens ensures the positive clinical effect. This is supported by the clinicopsychopathological and electrophysiological data. PMID- 3979536 TI - [Clinical evaluation of the anti-arrhythmic properties and cardiohemodynamic effects of the basic anti-arrhythmia agents]. AB - The authors studied the antiarrhythmic and antifibrillatory effects of the known antiarrhythmic agents and the new Soviet coronaroactive drug phenicaberan exhibiting an antiarrhythmic action. All the drugs were examined for side effects and the action on the central and intracardiac hemodynamics in patients with acute myocardial infarction. Recommendations have been given as to the choice of effective drugs for the prophylaxis of arrhythmias depending on the pattern of heart rhythm abnormality and the hemodynamics. PMID- 3979537 TI - [Effect of the chromatographic purification method on the isolation of prostaglandins E and F from a natural lipid mixture and their stability]. AB - Separation of PGE2 and PGF2 alpha and their ethyl ethers on silica gel from a natural lipid mixture permits the attainment of the 97-100% purity of the substances. However, the losses for PGE2 amount to 20-25, those for PGF2 alpha to 35-40%. Thus chromatography on silica gel can be used only for analytical purposes. As regards the preparative purposes the best method of PG isolation from a natural lipid mixture is gel filtration with a preliminary separation of phospholipids from the mixture over the oleophilic sulfacationite KO-I. After separation on sephadex the preparations can be stored for up to 4-6 months at 5-8 degrees C. PMID- 3979538 TI - [Chromatographic determination of orthomenthane hydrocarbons in biological media]. AB - The authors have offered a technique of gas chromatography of orthomenthane hydrocarbons (orthocymene, ortho-1,4-menthadiene and ortho-1-menthene), growth stimulants of agricultural plants, in biological media. The technique has been tried in experiments on 64 albino rats. The method sensitivity has been found to be 1-2 micrograms/g. It has been established that CCl4 extracts 36-89% of orthomenthane hydrocarbons exhibiting marked tropism to the fatty tissue from organ and tissue homogenates. This permits using the fatty tissue as the test tissue for identification of the residual amounts of the stimulants in foods of animal origin. PMID- 3979539 TI - [Toxicological characteristics of the Soviet antidepressant pyrazidol]. AB - It has been demonstrated in different species of experimental animals (mice, rats, cats, dogs) that the Soviet drug pyrazidol is a little toxic drug. Prolonged repeated administration of pyrazidol does not exert any damaging action on the vitally important organs and systems of the body. Pyrazidol is less toxic than imipramine. PMID- 3979540 TI - [Tolerance for nonsteroidal anti-inflammatory agents by experimental animals during pregnancy]. AB - The authors studied the tolerance of three nonsteroidal anti-inflammatory drugs, voltaren, indomethacin and ibuprofen by rats at different times of pregnancy and compared voltaren tolerance by pregnant and nonpregnant females. It was shown that as compared to nonpregnant animals, pregnant animals tolerated voltaren more poorly. The tolerance of both voltaren and indomethacin was particularly poor in the last trimester of pregnancy. The enhancement of the drug toxicity during pregnancy because of the changes in body function is discussed. PMID- 3979541 TI - [Dependence of the embryotoxic action of dioxidine and cyclophosphamide on the immunoreactivity of the maternal-fetal system in mice]. AB - It has been shown that the embryotoxic action of cyclophosphamide and dioxydin (an antibacterial drug) was more pronounced upon syngeneic than upon reciprocal crossing of CBA and C57BL/6 mice. Preliminary (21 days before crossing intrauterine sensitization of C57BL/6 mice with syngeneic or allogeneic lymphocytes obtained from males' spleen led to the attenuation of the embryotoxic action of cyclophosphamide and dioxydin. During sensitization with allogeneic lymphocytes, the embryotoxic action was attenuated more appreciably. Extirpation of the paraaortal lymph nodes in female C57BL/6 mice performed 14-15 days before crossing potentiated the embryotoxic action of cyclophosphamide in the case of allogeneic crossing of females. Upon syngeneic crossing of females with the extirpated paraaortal lymph nodes the intensity of the embryotoxic action of cyclophosphamide remained unchanged. It is concluded that the immune status of the mother-embryo system can, under the definite conditions, determine the intensity of the embryotoxic action of xenobiotics on the mammals. PMID- 3979542 TI - [Carcinogenic activity of dioxidine]. AB - A study was made of the blastomogenic activity of dioxydin, a new antibacterial broad-action drug. Administration of dioxydin in doses of 20-100 mg/kg (exceeding 2-10-fold the therapeutic dose for humans) to mice and rats intragastrically for 18 months and intraperitoneally (2 years of observation) as well as combined administration of the drug to rats transplacentally and postnatally (1.5 years of observation) did not induce any neoplasms. PMID- 3979543 TI - [Circadian fluctuations in dioxidine toxicity]. AB - It has been established in rat experiments that toxicity of the antibacterial drug dioxydin (1,4-di-N-oxide 2,3-dioxymethylquinoxaline) depends on the time of administration. The drug exhibits the minimal and maximal toxicity upon administration at 8 o'clock p.m. and at 12 o'clock, respectively. PMID- 3979544 TI - [Information value of research on the enzyme status of the peripheral blood leukocytes in a toxicological experiment]. AB - Cytochemical methods were used to explore the changes in the activity of redox (succinate dehydrogenase, mitochondrial alpha-glycerophosphate dehydrogenase) and hydrolytic (acid, alkaline phosphatase, myeloperoxidase) enzymes of peripheral blood leukocytes of random-bred albino rats during simulation of toxic hepato-, nephropathy and hemic hypoxia of different gravity. The studies of the changes of leukocyte distribution according to the activity of the above enzymes were demonstrated to be informative for the diagnosis of prepathological conditions. The possibility was also shown of differentiating the gravity of the pathological conditions with the aid of an analysis of the enzymes under study by the method of linear discriminant functions. PMID- 3979545 TI - [Reparative regeneration of the liver as a model for the preclinical study of the hepatotropism of anti-alcohol agents]. AB - It has been established that administration of teturam (200 mg/kg) per os once a day for 14 days retards reparative regeneration of the liver in rats following partial hepatectomy and exerts an additional damaging action on the population of regenerating hepatocytes. Administration of potassium orotate (100 mg/kg) per os once a day for 14 days speeds up, on the contrary, organ regeneration. The combined use of the drugs potentiates paradoxically the negative hepatotropic effect of teturam. It is concluded that experimental reparative regeneration of the rat liver can be applied to the assessment of hepatotropism of the antialcoholic drugs. PMID- 3979546 TI - Synthesis and properties of 3-aminomethyl derivatives of 3H-2-imino-7-methyl-4 oxopyrido-[3,2-e]-1,3-thiazine-5- and -6-carboxylic acids. AB - It was stated that esters of 3H-2-imino-7-methyl-4-oxopyrido [3,2-e]-1,3-thiazine 5- and -6-carboxylic acids (I, II) undergo the Mannich reaction giving the corresponding 3-aminomethyl derivatives (III-XIV). Derivatives of ester II [(XII) and (XIV)] showed distinct analgesic and antiserotonic activities. PMID- 3979547 TI - Investigations on the synthesis and properties of new derivatives of pyrido[3,2 e]-1,3-thiazino[3,2-a]-s-triazine. AB - It has been found that the condensation of esters of 3H-2-imino-7-methyl-4 oxopyrido[3,2-e]-1,3-thiazine-5- and -6-carboxylic acids (I, II) with formaldehyde and primary amines affords the corresponding derivatives of a new heterocyclic system pyrido[3,2-e]-1,3-thiazino [3,2-a]-s-triazine (IX-XXIV). PMID- 3979548 TI - Relationship between Na+-dependent cytoplasmic pH homeostasis and Na+-dependent flagellar rotation and amino acid transport in alkalophilic Bacillus. AB - The cytoplasmic pH homeostasis of alkalophilic Bacillus strains required the presence of Na+ in the medium, and Li+ was found to be equivalently substitutable for Na+. Flagellar rotation and amino acid transport of these bacteria also required Na+ but Li+ was not substitutable for Na+. Na+ concentration of about 1 mM was enough for the cytoplasmic pH homeostasis, while more than 10 mM Na+ was required for the full activities of flagellar rotation and amino acid transport. The addition of 150 mM ethanolamine to the cells at pH 9.6 disrupted the pH homeostasis and increased the cytoplasmic pH close to the external pH. Under this condition, however, flagellar rotation and amino acid transport were not so much affected. Thus, it is clear that flagellar rotation and amino acid transport themselves require the presence of Na+ in the medium, independent of the Na+ dependent cytoplasmic pH homeostasis. PMID- 3979549 TI - Action of influenza virus neuraminidase on gangliosides. Haemagglutinin inhibits viral neuraminidase. AB - The action of partly purified neuraminidase (NA) of influenza A virus, a mixture of detergent solubilized NA and haemagglutinin (HA) and of intact virions on gangliosides GT1b, GD1a, GD1b, GM1 was studied. The viral NA transformed GT1b mainly into GD1b with formation of only minor amounts of GM1. HA was found to inhibit the hydrolysis activity of viral NA. At the same time viral NA transformed GD1a quantitatively into GM1 which was not hydrolyzed by the enzyme. These results suggest that the function of NA is to transfer the 'primary' receptor (such as GT1b) into the proper carbohydrate sequence (GD1b-like) which is proposed to serve as the minimal structure required for influenza virus reception. PMID- 3979550 TI - An improved electrofusion technique for production of mouse hybridoma cells. AB - An experimental procedure is described for the reproducible production of hybridoma cells using the electrofusion technique. High yields can be obtained when fusion is performed in isotonic inositol solutions containing Ca2+ and Mg2+ in a ratio of 1:5 in the millimolar range. The hybridoma cells are transferred 10 min after the field pulse application into a balanced salt solution for 30 min at 37 degrees C. PMID- 3979551 TI - Differential photoaffinity labelling of serotonin-S2 receptors and histamine-H1 receptors using 7-azidoketanserin. AB - 7-Azidoketanserin, a potent photoaffinity probe for serotonin-S2 receptors was shown to irreversibly photoinactivate histamine-H1 receptors as well. The photolabelling of H1-receptors could be prevented by several selective histamine H1 antagonists. In guinea pig cerebellum, a brain area that is highly enriched in H1-receptors, photolabelling could be directed exclusively to these receptors by adding a high concentration of pipamperone, which selectively blocks serotonin-S2 receptors. In rat pre-frontal cortex, a region that is enriched in serotonin-S2 receptors, pyrilamine was used to block H1-receptors, thereby directing the photolabelling exclusively to S2-receptors. PMID- 3979552 TI - Aryldiazonium salts as photoaffinity labels of the nicotinic acetylcholine receptor PCP binding site. AB - Several aryldiazonium salts are described as irreversible blockers of the phencyclidine binding site of the nicotinic cholinergic receptor. A partial hydrophobic character increases the affinity of these salts for the phencyclidine binding site. Photoaffinity labelling with a tritiated diazonium salt in the presence of either carbamylcholine or alpha-bungarotoxin leads to incorporation of radioactivity into the 4 subunits of the receptor. Among these diazonium salts, an imidazole derivative is unique in that the photoinduced irreversible blocking in only effective when the receptor is in a desensitised state. PMID- 3979553 TI - A fluorescence decay time study of tryptophan in isolated hemoglobin subunits. AB - The time-resolved fluorescence behavior of tryptophan residues in isolated human hemoglobin subunits was determined using a sync-pumped dye laser system and time correlated single photon counting detection. Two decay components having values near 80 ps and 2 ns were found in the fluorescence decay of the alpha-subunit. The data for the beta-chains were best fitted with 3 decay components of 90 ps, 2.5 ns and 6.4 ns. We propose that the decay times correspond to conformations of the proteins in which the disposition of the tryptophan to the heme residue differs. PMID- 3979554 TI - A novel structural transition in poly(dG-Me5dC):Z in equilibrium B in equilibrium Z. AB - Poly(dG-Me5dC) is known to exhibit a B----Z transition in the presence of very high concentrations of NaCl. For the first time, we report the presence of a Z structure in sodium concentrations as low as 0.5 mM. A novel Z in equilibrium B in equilibrium Z transition is observed as the salt concentration is gradually increased. The role of water structure in B to Z transitions is discussed. PMID- 3979555 TI - Structural evidence for three different types of glutathione transferase in human tissues. AB - Cytosolic glutathione transferase was purified from human placenta and human liver. Three different forms of the enzyme were obtained, the acidic (pi), the near-neutral (mu), and the basic (alpha-epsilon) forms; two had free alpha-amino groups (pi, mu) and one had a blocked alpha-amino group (alpha-epsilon). N terminal sequence analyses and total compositions gave clearly different results for each form, although transferases pi and mu showed 35% sequence homology in the N-terminal regions, with a 1-residue shift in starting position. Consequently, the proteins are concluded to be products of three discrete but related genes. PMID- 3979556 TI - Limited proteolysis of porcine pancreatic lipase. Lability of the Phe 335-Ala 336 bond towards chymotrypsin. AB - Mild chymotrypsin digestion of native lipase (449 amino acids) preferentially cleaved the Phe 335-Ala 336 bond. On SDS-gel electrophoresis, 3 major bands were observed: band 1 (52 kDa) representing native lipase, bands 2 and 3 (40 and 12 kDa) representing the two lipase fragments A and B. Fragment A does not retain lipase activity but maintains its ability to adsorb to interfaces. Fragment B was identified with the lipase C-terminal region (336-449). It does not exhibit any activity towards tributyrylglycerol emulsions and any ability to adsorb to interfaces. PMID- 3979557 TI - High sensitivity of carnitine acyltransferase I to malonyl-CoA inhibition in liver of obese Zucker rats. AB - Carnitine acyltransferase of liver mitochondria prepared from obese Zucker rats has a higher sensitivity to inhibition by malonyl-CoA compared with carnitine acyltransferase of mitochondria prepared from lean Zucker rats. PMID- 3979558 TI - 500 MHz 1H-NMR study of the interaction of daunomycin with B and Z helices of d(CGm5CGCG). AB - The interaction of daunomycin with B and Z helices of a self-complementary DNA fragment d(CGm5CGCG) in solution was studied by 1H-NMR spectroscopy at 500 MHz. The results show that the B-Z transition kinetics is not affected by addition of daunomycin. Daunomycin binds exclusively to the B form of d(CGm5CGCG). Z exchanges with B while the latter also exchanges with the B duplex-daunomycin complexes. PMID- 3979559 TI - A----Z transition in the synthetic hexanucleotide (dCdGfl)3. AB - 500 MHz proton NMR and NOE measurements on (dCdGfl)3 show that at very low ionic strength the hexanucleotide adopts an A-DNA conformation, whereas at high salt concentrations a Z-form is found. At intermediate salt concentrations the two species are in slow exchange on the proton NMR time scale. This transition was also observed by characteristic changes in the CD spectra. PMID- 3979560 TI - Light changes the membrane potential and ion balances of retinal rod disks. AB - Light stimulation of rod cells in vertebrate eyes may cause Ca2+ release from the intracellular disks. Radiolabelled tracers show that light causes a small hyperpolarization of intact disk stacks and redistribution of the ions Ca2+ and Cl-. PMID- 3979561 TI - Sequence-specific chemical modification of a 365-nucleotide-long DNA fragment with an alkylating oligonucleotide derivative. AB - An aromatic 2-chloroethylamino group was attached to the 5'-terminal phosphate of the oligodeoxyribonucleotide pCCCTCTTTCTT. The oligonucleotide derivative prepared was used for modification of the 365-nucleotide-long DNA fragment. It was found that modification of the fragment proceeds in a sequence-specific way at 3 guanosine residues within the sequence complementary to the oligonucleotide reagent. PMID- 3979562 TI - Histone H1(0) is distributed unlike H1 in chromatin aggregation. AB - Non-uniform distribution of H1 histone in bovine thymus chromatin was demonstrated previously. Two classes of chromatin differ in aggregation properties and histone content. The class aggregatable by physiological saline is enriched in H1, especially H1ab, the variant known to be most powerful in condensing DNA. Now, the distribution of H1 subtypes is reported for brain chromatin, where H1ab and H1c were distributed as in thymus. In contrast, H1(0) preferred neither the aggregatable chromatin nor the aggregation-resistant class. It is suggested that H1(0) is uniformly distributed with regard to euchromatin and heterochromatin, whereas H1 is concentrated in heterochromatin. PMID- 3979563 TI - Identification of lipoglycan antigens from the Acholeplasma laidlawii cell membrane in crossed immunoelectrophoresis. AB - Membranes from the wall-less prokaryote Acholeplasma laidlawii contain a component termed lipoglycan or lipopolysaccharide (LPS). The lipoglycan has extraction properties, which are similar to those of LPS of gram-negative bacteria, but it is chemically distinct from bacterial LPS. The membrane-bound lipoglycan of A. laidlawii did not seem to be particularly immunogenic and antibodies against it could not always be detected by rocket immunoelectrophoresis (RIE) or crossed immunoelectrophoresis (CIE) in hyperimmune sera raised against membranes. The immunoprecipitate corresponding to the lipoglycan, obtained by CIE of Tween 20-solubilized A. laidlawii membranes, has been identified and shown to be both a cathodically and anodically migrating component at pH 8.6. The shape of the immunoprecipitate in both RIE and CIE showed that the lipoglycan antigen is composed of at least two components, which are immunologically related. PMID- 3979564 TI - Specific immunolysis of serotonergic nerve terminals using an antiserum against tryptophan hydroxylase. AB - An antiserum to tryptophan hydroxylase purified from whole rat brain when incubated with rat striatal synaptosomes in the presence of complement caused release of 18% of LDH, 20% loss of potassium and 60% loss of tryptophan hydroxylase. Uptake of 5-HT was reduced by 60%. Anti-tryptophan hydroxylase alone, or complement alone were without action. The antiserum plus complement had no effect on DA uptake and did not release TH or GAD. These results suggest selective lysis of serotonergic nerve terminals had occurred. The antiserum plus complement reduced choline uptake by 45%. However, this did not seem due to lysis of cholinergic terminals, as ChAT was not released. PMID- 3979565 TI - Collagen cross-links: location of pyridinoline in type I collagen. AB - Collagen from bone, dentine and tendon (type I), all of which contain the pyridinoline cross-link at varying levels, were each digested with CNBr. The resulting peptide mixtures were resolved by gel filtration on A1.5m agarose and assayed for pyridinoline. The polymeric cross-linked peptide complex, poly alpha 1CB6 [(1980) Biochem. J. 189, 111] isolated from each of these tissues did not contain pyridinoline. Only one peptide fraction contained the pyridinoline cross link; that identified as alpha 2CB3,5. However, this peptide showed only a small increase in Mr in its cross-linked form (approx. 2000-5000) demonstrating that pyridinoline is not involved in the formation of polymeric structures like poly alpha 1CB6. These data, considered in the light of the recent finding that pyridinoline is present in type I collagens from different sources in widely varying amounts, cast doubt on its role in collagen maturation. PMID- 3979567 TI - Activation and stabilization of asparaginase by anti-asparaginase IgG and its Fab. AB - Modified asparaginase, in which 4 tryptophan residues were modified with 2 hydroxy-5-nitrobenzyl bromide, had little enzymic activity and retained immunoreactivity [(1976) FEBS Lett. 65, 11-15]. Addition of IgG or its Fab towards asparaginase to the modified asparaginase gave rise to marked enhancement of the enzymic activity. Native asparaginase (4 subunits) lost the enzymic activity due to dissociation into subunits by dilution of the enzyme solution. However, in the presence of Fab, asparaginase did not lose enzymic activity on dilution, probably due to no dissociation into subunits occurring. PMID- 3979566 TI - Microsomal membranes contain phosphatidylcholine that equilibrates across the bilayer, and phosphatidylcholine that does not. AB - Results of experiments using phosphatidylcholine transfer protein and phospholipase C as probes indicate that there are at least two pools of phosphatidylcholine in rat liver microsomes. One of these is preferentially labelled with [14C]choline and does not equilibrate across the bilayer. The second pool is labelled with [3H]glycerol and does equilibrate across the bilayer. Our observations also confirm that phosphatidylcholine exchange protein does not modify the distribution of phospholipids or cause randomization of the inner and outer leaflet pools of phosphatidylcholine when these are differentially labelled by [14C]choline. PMID- 3979568 TI - Primary structure of two sialylated triantennary glycans from human serotransferrin. AB - Glycopeptides obtained from human serotransferrin by pronase digestion were separated into two fractions by affinity chromatography on Con A-Sepharose. The retarded fraction (85% of total glycopeptides) contained sialylated biantennary glycans of the N-acetyllactosaminic type, the primary structure of which has been previously determined. The non-retained fraction (15% of total glycopeptides) consisted of two isomeric triantennary glycans of the N-acetyllactosaminic type. The primary structure have been elucidated by methylation analysis and 500 MHz 1H NMR spectroscopy. Both contain an additional NeuAc(alpha 2----3)Gal(beta 1--- 4)GlcNAc antenna. The latter is linked to C-4 of the (alpha 1----3) bound Man residue in 45% of the glycans in the non-retained fraction but to C-6 of the (alpha 1----6) bound Man residue, in the remaining 55% of the glycans in this fraction. PMID- 3979569 TI - Effect of depolarizing concentrations of potassium on calcium uptake and metabolism in rat liver. AB - Exposure of perfused livers of fed rats to 60 mM K+ induces rapid responses in the Ca2+-sensitive metabolic events, glycogenolysis, cytoplasmic and mitochondrial NADH/NAD ratios and octanoate oxidation. All increase within 45 s of K+ addition. Metabolic responses were not observed following K+ addition to livers perfused in the absence of added Ca2+. Movements of Ca2+ into the liver were suggested from experiments in which 45Ca2+ uptake was measured. The Ca2+ antagonists verapamil, diltiazem and Ni2+ essentially abolished changes to tissue metabolism and Ca2+ fluxes induced by K+ addition. K+-induced changes were consistent with Ca2+ channel activation. PMID- 3979570 TI - Comptroller General calls NIH multiyear funding scheme "unlawful". PMID- 3979571 TI - The psychological component of infertility. PMID- 3979573 TI - Revised American Fertility Society classification of endometriosis: 1985. PMID- 3979574 TI - Treatment of endometriosis with danazol: report of a 6-year prospective study. AB - Presented are the results of a 6-year prospective study designed to evaluate the effectiveness of danazol for the treatment of endometriosis. Ninety-six patients completed 6 months of therapy at a dosage of 800 mg daily, and 107 patients completed therapy with 400 mg daily. No difference was reported in the incidence of side effects, regardless of dosage. Gross resolution of disease (as determined by second-look laparotomy or laparoscopy) was evaluated in 110 patients and found to be similar, regardless of dosage. Ovarian endometriosis greater than 1 cm was observed to respond significantly less well to danazol than peritoneal or ovarian disease less than 1 cm. Pregnancy rates for 157 patients with no other discernible causes of infertility were slightly higher for the 800-mg danazol regimen than for the 400-mg regimen. In patients with mild disease, the use of danazol alone resulted in pregnancy rates lower than those achieved with conservative surgery alone. Its use preoperatively for all stages of disease resulted in slightly higher pregnancy rates than when conservative surgery alone was employed. Danazol was less effective when used postoperatively. No differences were observed between three classification schemes in their ability to predict subsequent prognosis for conception. PMID- 3979572 TI - Evolution of the revised American Fertility Society classification of endometriosis. PMID- 3979575 TI - Growth rate of follicular estrogen secretion in relation to the outcome of in vitro fertilization and embryo replacement. AB - Estradiol growth rate (EGR) during active follicular development was calculated for 89 stimulated in vitro fertilization cycles by exponential curve fit (r = 0.83). Cycles could be divided into four groups with very low, low, moderate, and high EGR values. Cases without oocyte fertilization and/or embryo replacement did not occur in the moderate EGR range, which also corresponded to a significantly better ratio of replaceable embryos versus oocytes recovered. This group was also endowed with a pregnancy rate amounting to 28.5% per laparoscopy and per replacement, i.e., about three times higher than in the three other groups. Very low or high EGR entailed significantly higher percentages of missed oocyte recovery and/or fertilization failure. The frequency of occurrence of a spontaneous luteinizing hormone peak was negatively correlated with EGR. The data indicate that a better outcome of in vitro fertilization may be expected when the estrogen rise starts early in the cycle and adopts a moderate growth rate (0.3 to 0.4). PMID- 3979576 TI - Tubal infertility in relation to prior induced abortion. AB - One hundred twenty-seven women who had been given diagnoses of tubal infertility between 1979 and 1981 in King County, Washington, yet previously had been pregnant, were interviewed to determine their prior history of legally induced abortion. Their responses were compared with those of 395 women who conceived a child at the same time the infertile women began their unsuccessful attempt to become pregnant. In making the comparison, we adjusted for the effects of variables that in this population were related both to having an induced abortion and to the occurrence of infertility, i.e., age, number of prior pregnancies, number of sexual partners, cigarette smoking habits, Dalkon Shield (A. H. Robins Company, Richmond, VA) use, and whether the woman worked outside the home. The risk of tubal infertility in women who had had an induced abortion was not increased above that of other women (relative risk, 1.15; 95% confidence interval, 0.70 to 1.89). For women with two or more abortions, the relative risk was 1.29 (95% confidence interval, 0.39 to 4.20). When only the most recent pregnancy was considered, the relative risk was 1.19 (95% confidence interval, 0.72 to 1.97). Our results suggest that legal abortion, as performed during the past decade in the United States, does not carry an excess risk for future tubal infertility. PMID- 3979577 TI - Hot flashes in postmenopausal women ameliorated by danazol. AB - Six postmenopausal women with hot flashes were studed for two 8-week periods during which they received low-dose danazol (100 mg/24 hours) for one time interval and placebo for the other in a randomized double-blind manner. The patients recorded the number and severity of their hot flashes daily. On the last day of each period the patients were admitted to the research center overnight for an 8-hour monitoring of forehead skin temperatures and for continuous withdrawal of blood to determine 20-minute integrated levels of luteinizing hormone. Three of the six patients responded to danazol with a mean reduction of 88% in the number of hot flashes and a 53% decrease in the severity of hot flashes. Responders differed from nonresponders in that on treatment the frequency of nocturnal pulses of luteinizing hormone was reduced more (36.1% versus 14.4%), the increase in amplitude of the pulses was greater (+30.7% versus -11.8%), and the fall in the mean level of luteinizing hormone was more marked (19.0% versus 10.5%). The findings suggest that danazol may be a reasonable alternative to estrogen in the treatment of postmenopausal women with severe vasomotor symptoms. PMID- 3979578 TI - Lipoprotein and phospholipid distribution in human follicular fluids. AB - Human preovulatory follicular fluids, obtained in the course of stimulated cycles, were analyzed for their lipid and protein compositions. By combining different methods, a single class of lipoprotein, high-density lipoprotein, was detected in all cases. The phospholipid distribution revealed an accumulation of lysophosphatidylcholine. These data are discussed in view of the possible roles of the follicular fluid during fertilization and in relation to the high levels of estradiol and progesterone measured in those fluids. PMID- 3979579 TI - Radioimmunoassay of progesterone in saliva: a simplified technique using 125I radioligand. AB - The value of serial salivary progesterone (P) determinations for evaluation of corpus luteum function compared with sporadic serum samplings is recognized. Salivary P concentrations have previously been determined by a relatively difficult assay which utilizes a tritiated radioligand. The present study was designed to compare this conventional method with a simpler assay utilizing an iodinated radioligand. The values obtained with two different radioimmunoassay (RIA) systems were compared for samples collected throughout the luteal phase of seven normal menstrual cycles and three conception cycles. In the seven nonconception luteal phases as well as in the three conception luteal phases, daily salivary P determinations by the two techniques correlated significantly with each other (r = 0.56; P less than 0.001). For the seven nonconception luteal phases, the salivary P determinations obtained by 125I RIA (Saliva 125I) correlated significantly with the matched serum values (r = 0.54; P less than 0.001). However, the correlation was poor between the salivary P determinations obtained by the 3H RIA (Saliva 3H) and the matched serum values. The simplicity and accuracy of the 125I RIA and the convenience of saliva sampling provide a practical approach to monitor human luteal function. PMID- 3979580 TI - The leukocytic reaction of the human uterine cervix to spermatozoa. AB - Cervical smears were taken before, and at intervals after, artificial insemination and scored for the ratio of leukocytes to squamous cells. Most women showed a significant rise in this ratio after insemination with whole fresh or frozen/thawed semen, but this was not seen when fresh or frozen sperm-free seminal plasma was used. Some women had received spermatozoa naturally less than 24 hours before our tests, and most showed some leukocytosis before insemination; even these women showed further response to artificial insemination with spermatozoa. It is concluded that women, like rabbits, normally respond by leukocytosis to cervical deposition of spermatozoa. The primary function of the leukocytes may be sperm selection by phagocytosis or the "mopping up" of introduced bacteria. Some of the patients became pregnant at the monitored cycle; so it is very clear that this is a physiologic response of the cervix, not a pathologic leukocytic reaction. PMID- 3979581 TI - In vitro fertilization: a treatment for male infertility. AB - Three-quarters of 41 women whose husbands were the cause of infertility in the couple had one or more embryos replaced after in vitro fertilization. One-third became pregnant despite their long history of infertility; the incidence of pregnancy was 45% after one or more replacements of embryos. In a group of 61 couples where both partners were infertile, 26% became pregnant. These data indicate that the lower chance of fertilization with poor semen is balanced by a higher chance of pregnancy in women with a normally functioning reproductive system. Oligospermia, asthenospermia, teratospermia, and autoimmunity are among the many forms of male infertility which can now be successfully treated by in vitro fertilization. Overall, 57% of the oocytes were fertilized, and almost 50% of men with very low numbers of active spermatozoa (less than or equal to 0.5 X 10(6)/ml motile spermatozoa) were successful in establishing pregnancy. Two semen parameters impaired fertilization most: seminal inflammatory cells and low progressive activity. The collection of split ejaculates and the careful preparation of spermatozoa, by sedimentation and layering methods, proved to be beneficial, improving sperm motility and raising the chance of fertilization. PMID- 3979582 TI - The zona-free hamster egg penetration assay as a prognostic indicator in a human in vitro fertilization program. AB - The present study was designed to test the validity of the hamster egg penetration assay as a prognostic indicator of male fertility in 54 patients undergoing in vitro fertilization. Human oocyte fertilization, cleavage, and pregnancy were compared with the results of this bioassay. Good correlation was found between hamster egg penetration and oocyte fertilization. Conversely, a definite lower limit of hamster egg penetration to define absolute male infertility could not be established because human oocyte fertilization, cleavage, and even pregnancy occurred in spite of low hamster egg penetration. PMID- 3979583 TI - Increased frequency of autoantibodies in men with sperm antibodies. AB - Autoantibodies to thyroid microsomes were more frequent in 102 infertile men with complement-dependent sperm-immobilizing activity (sperm immobilization test [SIT] ) in serum (11.8%) than in a control group of 277 men of comparable ages and semen quality without sperm antibodies (4.3%, P less than 0.05). Frequencies of organ-specific antibodies (antigastric parietal cell, antithyroglobulin, and antithyroid microsome) in 57 men with genital tract obstructions and positive SIT were similar to those for control subjects, and there were no significant differences in the frequencies of non-organ-specific autoantibodies (antinuclear antibody, rheumatoid factor, antimitochondrial, and anti-smooth muscle) in the three groups. Because in men without genital tract obstruction antithyroid microsomal autoantibodies were more common with sperm antibodies than without, the possibility of a genetic factor in the causation of sperm autoimmunity should be considered. PMID- 3979584 TI - Are there adverse effects of periconceptional spermicide use? AB - Recent studies have suggested that spermicide exposure around conception may cause congenital malformations, reduced birth weight, or spontaneous abortion. This large, prospective study examined the risk for multiple malformation, patterns of malformations, low birth weight, preterm delivery, and spontaneous abortion in infants whose mothers used spermicides only before or after their last menstrual period, compared with a control group using other contraceptive methods. The multiple malformation rates in women using spermicides only before or after their last menstrual period were 3.8 and 4.8 per thousand, respectively. For the control groups, the corresponding rates were 5.4 and 6.4 (not significant). No pattern of malformations was found in spermicide-exposed infants. The risk of preterm delivery, the risk for producing a low-birth-weight (less than 2500 gm) infant, and the risk of spontaneous abortion were no higher in women exposed to spermicides than in women using other methods of contraception. This study finds no evidence that spermicide exposure around the time of conception is dangerous to the fetus. PMID- 3979585 TI - Serotonin but not dopamine is involved in the naloxone-induced luteinizing hormone release in man. AB - Endogenous opioid peptides exert a tonic inhibition on gonadotropin secretion at the hypothalamic level, but the mechanisms by which they act are still unknown. Previous experimental studies suggest that the endogenous opioid peptides change dopaminergic and serotoninergic tones at the hypothalamic level. We have investigated whether the stimulatory effect of naloxone on luteinizing hormone (LH) secretion is due to its influence on these neurotransmitters. Two experimental models were studied, and two sets of effects on LH secretion induced by intravenous naloxone infusion (20 mg over 2 hours) in 14 normal men 20 to 25 years of age were evaluated: the effect of oral sulpiride (150 mg), a potent dopaminergic antagonist, and the effect of oral fenfluramine (60 mg), a drug that stimulates the serotoninergic receptors by releasing serotonin and inhibiting its reuptake. The study demonstrated that naloxone infusion significantly stimulated the LH secretion throughout the period of observation (P less than 0.01 versus saline). The pretreatment with sulpiride did not change the LH response to naloxone. After fenfluramine pretreatment, naloxone failed to induce any rise in LH secretion. Follicle-stimulating hormone did not show any important variation in either test. The data suggest that in man the stimulatory ability of the opiate receptor antagonist naloxone to elicit a rise in LH plasma levels may involve the serotoninergic, but not the dopaminergic, hypothalamic system. This hypothesis, however, does not exclude the involvement of other hypothalamic neurotransmitters. PMID- 3979587 TI - Titrating the dose of bromocriptine when treating hyperprolactinemic infertile women. AB - We have shown that a smaller dose of bromocriptine is effective in lowering the PRL level to the normal range in some hyperprolactinemic women. Based on these findings, we recommend that when treating hyperprolactinemic women who desire conception, the dose of bromocriptine should be titrated according to the response of circulating PRL levels. This will minimize the dose, reduce cost, probably reduce side effects, and possibly avoid undesirable functional effects such as corpus luteum dysfunction. PMID- 3979586 TI - Direct ovarian effect of clomiphene citrate in the rabbit. AB - The effects of clomiphene citrate (CC) on ovulation and ovum maturation were studied using the isolated perfused rabbit ovary. CC (10(-5) M) added to the perfusate with human chorionic gonadotropin (50 IU) did not affect ovulatory efficiency, ovulation time, oocyte maturation, or degeneration of ovulated ova and follicular oocytes. During perfusion without human chorionic gonadotropin, the percentage of follicular oocytes with germinal vesicle breakdown was significantly increased in response to CC (10(-5) M or 10(-7) M); a greater percentage of follicular oocytes was degenerated. Estradiol (100 ng/ml) added to the perfusate reversed the effect of CC on degeneration of follicular oocytes. Of follicular oocytes from ovaries perfused with CC, 79.3% were degenerated; in contrast, 25% were degenerated in ovaries treated with CC plus estradiol. These data suggest that CC has a direct ovarian effect and that ovum degeneration associated with CC may be related to an antiestrogenic action. PMID- 3979589 TI - Characteristics of human ejaculates collected via masturbation and a new Silastic seminal fluid collection device. PMID- 3979588 TI - Monoamine oxidase reactivity in the human fallopian tube. PMID- 3979590 TI - [Effect of electrostimulation of the hypothalamus on the lactate and malate dehydrogenase activity and isoenzyme composition of the rat myocardium]. PMID- 3979591 TI - [Dependence of the changes in the resistance and blood capacitance of the intestinal vessels on their initial state and force of the humoral stimulus]. PMID- 3979592 TI - [Effect of increased blood potassium levels on various indices of the blood system in rats]. PMID- 3979593 TI - [Compensation and adaptation mechanisms in the blood system in hemic hypoxia]. PMID- 3979594 TI - [Pulmonary blood flow in healthy children 11- to 13-years-old based on data of zonal impedance rheoplethysmography]. PMID- 3979595 TI - [Inspiratory and expiratory flow rates under different breathing regimens in people of different ages]. PMID- 3979597 TI - [Effect of the salivary glands on gastric secretion]. PMID- 3979596 TI - [Effect of immune sera of different specificities on the heart]. PMID- 3979598 TI - [Effect of serotonin, adrenaline and histamine on the mucosal metabolism of the small intestine in white rats]. PMID- 3979599 TI - [Biochemical and immunological shifts in the body of animals with a chronic stomach ulcer in the period immediately following gastric resection]. PMID- 3979600 TI - [Effect of electrical stimulation and destruction of different hypothalamic structures on the blood coagulation system]. PMID- 3979602 TI - [Changes in blood morphological indices in mice of different ages exposed to an alternating electrical field]. PMID- 3979601 TI - [Thymus participation in modulating antibody genesis induced by exposure to a magnetic field]. PMID- 3979603 TI - [Changes in the indices of external respiration, gas exchange and the oxygen transporting function of the blood in chronic methemoglobinemia]. PMID- 3979604 TI - [Seasonal characteristics of normal liver excretory function and in xenobiotic induced lesions]. PMID- 3979605 TI - [Assessment of heart function by the end-systolic pressure/volume ratio of the left ventricle]. PMID- 3979606 TI - [Proceedings of the Conference of Young Scientists. Kiev, 18 May 1983. Abstracts]. PMID- 3979608 TI - The message in the bottle: a value predicament in cancer research. PMID- 3979607 TI - Medical grand rounds: a fatal case of pneumonia. PMID- 3979609 TI - The effect of piped water on early childhood mortality in urban Brazil, 1970 to 1976. PMID- 3979610 TI - Marriage and divorce in twentieth century American cohorts. AB - Marital status life tables have provided a basis for describing the marriage, divorce, and mortality experience of U.S. cohorts born 1888-1950. In brief, marriage occurred earlier and became more universal from the earliest cohorts to those of the late 1930s. More recent cohorts show declines in the proportion ever marrying and increases in the mean age at marriage. Period data for 1980 and cumulative cohort data by age suggest the likelihood of a continuing retreat from first marriage. Divorce has been rising steadily, with the latest cohorts indicating that 46 percent of male marriages and 42 percent of female marriages will end in divorce. Period data for males in 1980 raise the possibility that levels of divorce may have reached a peak, but cumulative cohort data by age show no such pattern. The present results are consistent with the view that a fundamental change in the traditional concept of marriage is underway. Traditional marriage involved the husband providing the wife with economic support and protection in return for her companionship and maternal services. Strong social pressures urged men and women to marry, and made the coveted services married persons provided each other difficult to obtain elsewhere. Recent economic changes have undermined the social and economic forces that maintained the institution of marriage. The U.S. economy has grown to include a large service sector in its labor force, and that growth has produced a dramatic increase in female labor force opportunities (Oppenheimer, 1970). The resultant large scale participation of women in economic activity blurs the traditional division of labor by sex, and goes to the very heart of the traditional marriage "bargain." At the same time, economic changes have weakened family ties by encouraging lower fertility, stressing achieved as opposed to ascribed characteristics, and fostering geographical mobility (Goode, 1970). The "marital union" of the past may be giving way to the "marital partnership" of the future, which will accommodate informal as well as formal marriages, less dependence between spouses, greater egalitarianism, lower fertility, and higher levels of divorce. PMID- 3979611 TI - Can spouses be trusted? A look at husband/wife proxy reports. PMID- 3979612 TI - Individual and couple intentions for more children: a research note. PMID- 3979613 TI - Estimation of period-specific gross migration flows from limited data: bi proportional adjustment approach. PMID- 3979614 TI - Black and white birth weights. PMID- 3979615 TI - The increasing proportion of men with low earnings in the United States. AB - This study has provided an examination of recent changes in the lower tail of the male earnings distribution. Data from the CPS for 1967 through 1978 were used to analyze the increasing proportion of male workers with annual and weekly earnings below a fixed low earnings threshold. Our central purpose was to assess the extent to which the growth in the probability of low earnings could be explained by the more salient changes in the structure of the male labor force over this period. To this end, logit analysis was used to examine the roles of education, experience, cyclical conditions, and cohort size in explaining variations in the probability of subthreshold earnings, conditional on experience and education. The estimates generally yielded the expected effects. However, the most important findings from our analysis concern the trends estimated net of education, experience, unemployment, and cohort size. These variables appear to explain satisfactorily the recent growth in the proportion of men with low earnings among those with at least sixteen years of education. For all other educational categories, our independent variables were unable to account for a major portion of the growth in the probability of low earnings. Our results supplement previous findings of positive trends for mean annual and weekly earnings net of a similar set of independent variables. Hence, we have provided substantial evidence of stagnation in the lower tail of the male earnings distribution--a stagnation not shared by the average worker nor fully explicable by education, experience, aggregate unemployment, or the entrance of the baby boom cohort into the labor market. Investigation of alternative explanations for this phenomenon, such as changes in female labor supply or the structure of labor demand, is clearly warranted. PMID- 3979616 TI - The impact of international migration upon the timing of marriage and childbearing. PMID- 3979618 TI - Trend and variation in the seasonality of U.S. fertility, 1947-1976. PMID- 3979617 TI - Childbearing and family in remarriage. PMID- 3979619 TI - [Principles of topical glucocorticoid therapy in dermatology]. PMID- 3979620 TI - [Recurrence following cryosurgical basalioma therapy]. PMID- 3979621 TI - [Alopecia in vulgar psoriasis of the scalp. A clinical and histologic report]. PMID- 3979622 TI - [Effect of psoriasis serum on rosette formation in nonpsoriasis donor lymphocytes]. PMID- 3979623 TI - [Meningococcal infection with hemorrhagic-necrotizing exanthema]. PMID- 3979624 TI - [Bloch-Sulzberger pigment incontinence]. PMID- 3979625 TI - [Haptoglobin typing in sarcoidosis]. PMID- 3979626 TI - [Electron microscopic diagnosis in dermatology]. PMID- 3979627 TI - [Effect of dithranol on epidermal proliferation by urea modification]. PMID- 3979628 TI - [Reduction of the UV dose in combined dithranol-UV therapy of psoriasis]. PMID- 3979629 TI - [Diagnosis and therapy of malignant melanoma in the dermatology clinics of East Germany]. PMID- 3979630 TI - Lipoatrophia semicircularis. Report of a case. AB - A case of lipoatrophia semicircularis is described in a 5-year-old child. Histological examination revealed the complete loss of adipose tissue. No associated abnormalities were found. PMID- 3979631 TI - Diabetes mellitus and skin diseases in childhood. AB - The skin diseases observed in 41 children affected by type-1 diabetes and in 1,273 children unaffected by diabetes were compared to evaluate the dermatoses that are associated to type-1 diabetes. A high prevalence of vitiligo, psoriasis and herpes simplex infections was found in diabetics. These data are confirmed by statistical comparison. PMID- 3979632 TI - Ocular abnormalities occurring with alopecia areata. AB - This study was carried out on 83 patients with alopecia areata. Ophthalmological examinations showed lens changes in 65 patients and alterations in the retinal epithelium in 28 patients. The relationships between pigment cells and hair cycle are discussed. PMID- 3979633 TI - Photosensitivity associated with carprofen (Imadyl). AB - Photodermatitis from Carprofen in 3 patients was reported. The absorbance spectrum of Carprofen revealed maximum absorbance at UVB range. The clinical presentation in the 3 patients suggested that a phototoxic mechanism may be responsible. PMID- 3979634 TI - Unusual manifestations of Reiter's disease in a child. AB - Reiter's disease in a child, manifesting as circumscribed, thick, hyperkeratotic, rupioid lesions over the skin and later in the course of the disease developing pyopericardium and cardiac failure, is reported. Recovery of Chlamydia from the urethral discharge, too, was significant. PMID- 3979635 TI - Lepromatous leprosy complicated with systemic lupus erythematosus. AB - This paper presents a case of lepromatous leprosy complicated with systemic lupus erythematosus and diagnosed as having typical systemic lupus erythematosus from clinical features and results of laboratory tests. We discuss the appearance of autoantibodies in systemic lupus erythematosus as well as in leprosy. PMID- 3979636 TI - Cutaneous leiomyoma of the male nipple. AB - A case of cutaneous leiomyoma of the male nipple is reported. This is the second case reported by dermatologists to the best of our knowledge. PMID- 3979637 TI - [Connective tissue compartments in scleroderma. Study of the structure and the biomechanical properties]. AB - A combined histological and biomechanical study was performed in patients with localised or systemic scleroderma. The inflammatory reaction was variable in intensity and location, predominating around the superficial vascular plexus, the deep dermo-hypodermal plexus, the paraseptal plexus or in the fasciae. Secondary sclerosis resulted from the lateral fusion of bundles of collagen fibers. Three degrees of intensity of sclerosis were disclosed by our noninvasive technique of tonometry by vertical traction of the skin in vivo. That measurement allowed a follow-up of the evolution of the disease and a control of the therapeutic efficacy. PMID- 3979639 TI - Multiple familial pilomatricomas: a cutaneous marker for myotonic dystrophy. AB - 4 members of the same family with association of multiple pilomatricomas and myotonic dystrophy are described. A muscular electron microscopic study and the electromyographic findings are reported. PMID- 3979638 TI - Immune response to Staphylococcus aureus in atopic dermatitis. AB - The skin of patients with atopic dermatitis (AD) is severely colonized with Staphylococcus aureus. Therefore, a study was conducted to assess some basic features of the S. aureus-specific immune response in patients with AD and healthy nonatopic individuals. Some particular features were found: a selective hyporesponsiveness to purified S. aureus cell walls (PCW) in delayed skin reactivity; half of our AD patients showed serum IgE to PCW and soluble S. aureus protoplast antigens; elevated PCW-IgE did not correlate with positive immediate skin reactions to whole S. aureus and their cell walls; regional lymphadenopathy but not impetiginization was associated with increased PCW-IgE and high total IgE. It is suggested that these changes in the immune response to S. aureus are related to the chronic S. aureus colonization of the skin. PMID- 3979640 TI - Chancroid or chancroidal ulcers. AB - 1532 cases with genital ulcers were investigated, of whom 610 presented with features suggestive of chancroid; classic, multiple lesions of chancroid were observed in 312, while its other variants, i.e. dwarf, giant and phagedaenic chancroid were also seen. In addition, 162 cases had a conspicuous morphology characterised by a single ulcer which was well-defined, soft, tender, non indurated and had weakening edges. These were termed chancroidal ulcers. The latter had a longer incubation period of 8-11 days. Absence of lymphadenopathy was prominent in these cases. The male/female ratio was 27/1. Persons of low socio-economic status in the sexually vulnerable age-group were predominantly affected. The prepuce, coronal sulcus and glans penis were the common sites of affliction in males, while the labia minora was frequently involved in females. Due to the limited value of gram-stained smears for the detection of H. ducreyi and lack of good culture media, chancroid and chancroidal ulcers should be differentiated clinically. PMID- 3979641 TI - Romberg's syndrome: a case report. AB - A first case of Romberg's syndrome from Libya is reported. Romberg's syndrome is a rare disease causing progressive facial hemiatrophy. It was first described by Parry in 1825 and then by Romberg in 1846. Since then there have been sporadic case reports and reviews in the literature [1-5]. For the first time, we report a case from Libya. PMID- 3979642 TI - Betamethasone dipropionate cream for the treatment of psoriasis. A double-blind comparison with clobetasol propionate cream. PMID- 3979643 TI - Multifactorial or polygenic inheritance in ophthalmology. PMID- 3979644 TI - So-called 'acute retinal necrosis syndrome'--an acute ocular panvasculitis syndrome. AB - An acute ocular disorder, characterized by panuveitis, retinal vasculitis, retinal necrosis (with frequent secondary retinal detachment) and frequent optic atrophy, has been reported since 1971 under different eponyms in 74 patients (103 eyes). I report 4 more cases. This paper presents, based on a critical review of 107 eyes in 78 patients, a detailed clinical description, pathogenesis and terminology of this distinct ocular disease entity. The available clinical and histopathological evidence very strongly indicates that the basic pathology is acute vasculitis of the iris, choroid, retina and optic nerve head, producing vascular occlusion in the choroid, retina and optic nerve head; the clinical findings thus represent acute ischemic lesions of those tissues, in addition to panuveitis. From the available evidence, it seems more appropriate to call this condition 'acute ocular panvasculitis syndrome' rather than 'acute retinal necrosis syndrome' since retinal necrosis is only one of a number of lesions seen in this disease. The etiology of the panvasculitis still remains a mystery. PMID- 3979645 TI - Phthisis bulbi--an intraocular fluoride proliferative reaction. AB - This study reports the findings in 74 mainly posttraumatic phthisical human eyes enucleated after varying time intervals. It was usually a result of severe anterior segment injury with marked intraocular hemorrhage and tissue damage. In summary, the tissue reactions in these eyes are those known from wound healing elsewhere in the body with additional traction changes and ocular hypotension. In phthisis bulbi the complex reactions associated with inflammatory, healing, and scarring processes reach a maximum within the first 3 months, but can go on for years. Cell proliferation and transformation are early and important features of this process which lead to retinal and ciliochoroidal detachment, hypotension and marked shrinkage of the globe. The results also indicate that reactions initiated by intraocular hemorrhages have an important part in the development of phthisis bulbi. The process of phthisis bulbi is a process of wound healing in the sense of an intraocular fluoride proliferative reaction. Main areas of proliferation are the pars plana of the ciliary body, the optic disc and the base of the iris. Finally degenerative changes will develop additionally. It appears that repair of the injured tissues with early primary (within 6 h) and secondary (within the first 2 weeks) intraocular surgery and other preventive surgical measures should be performed by an experienced surgeon. Further work on postoperative medical treatment to control the secondary reactions is needed. To compare the therapeutic efforts a 5-stage classification is proposed. PMID- 3979646 TI - [Pedagogy and diabetes]. PMID- 3979648 TI - [Teaching of diabetics: evaluation of the questions put to patients by health care personnel and the usefulness of a pedagogic analysis]. AB - In order to be fully therapeutic diabetes education should allow the patient to understand the mechanisms of the illness as well as the steps to be taken to achieve optimal treatment. In the course of their classes health care personnel ask diabetic patients questions with the intention of encouraging their participation. An education specialist has analysed the use of these questions: their number, their type and their functions' were noted. A) By type of question we refer to the various answers possible. Two groups can be distinguished: 1) limited number of answers possible as the result of a closed question, 2) multiple answers possible as the result of an open question. B) By function of question we refer to the cognitive effect a question may have on the patient. Again two categories can be described. In the first case numbers, terminology or facts learnt by heart; this being the result of questions of simple knowledge. In the second case, the establishment of relationships between facts as well as the solving of problem situations are encouraged by questions of understanding. The study shows that health care personnel tend to put forward closed rather than open questions. Regarding the function of the question most of them aim at simple repetition. Few activate the thinking process. As a result of the pedagogical training our team received concerning the use of questions in patient education an increase in the number of open questions and of questions of understanding was noted. These questions encourage the thinking process and the solving of problems encountered by the patient in the treatment of his/her diabetes. PMID- 3979649 TI - Head shape and size and body weight in the newborn infant. AB - Biparietal diameter, occipitofrontal diameter, cephalic index and occipitofrontal circumference were measured in 108 newborns delivered at term by cesarean section. Statistical analyses were carried out to assess the relationship between each of the parameters and birth weight. Particular attention was paid to the cephalix index/birth weight, the former being assumed as an expression of head shape. No correlation between birth weight and cephalic index was observed. Birth weight best correlates with occipitofrontal circumference. PMID- 3979647 TI - [A broad educational approach to insulin-dependent diabetics]. AB - Self monitoring of diabetes requires technical knowledge and suitable diabetes oriented behaviour; the latter arises from the patient's psycho-affective functioning, maturity and self sufficiency. A group of 9 insulin dependent ambulatory, adult, diabetics met 15 times over 5 months. The somatic and psycho affective aspects of the disease were approached by an original methodology. Group animation was focussed on the participants themselves. Dynamic mobilisation of the persons was sought by listening to their explicit and implicit requests, by acting out (case studies and role-playing), by restatement and questioning. Diabetes oriented and psycho-affective behaviours were assessed on the basis of questionnaires and statements. At the end of the study, the psycho-affective attitude of the participants towards their illness was modified. The aggressiveness, mockery and rejection of diabetes and diabetics, initially noted, were progressively replaced by self-awareness and acceptance. As a result, better adjustment of technical behaviour responses was noted. Without precluding any psychodynamic explanation (reunification of the person), this study suggests that the participant's reactions towards their own image can be improved with consequential educational benefit. PMID- 3979650 TI - Which is the best placental function test? A comparison of placental lactogen and unconjugated oestriol in the prediction of intrauterine growth retardation. AB - Serum placental lactogen (hPL) and unconjugated oestriol (E3) levels were measured in 392 women at weekly intervals from 36-40 wk gestation. The levels of both hPL and E3 were reduced in subjects delivering a growth-retarded child. The clinical significance of this observation was similar for the two compounds, with a marginal advantage to hPL. There was a higher incidence of falling levels of hPL and E3 in cases of growth retardation but the finding had very little predictive value in an individual patient. PMID- 3979651 TI - Roll-over test--errors in interpretation, due to inaccurate blood pressure measurements. AB - In order to make the earliest possible prediction of the type of woman likely to develop pregnancy-induced hypertension (PIH), one hundred and ninety-six primigravidas underwent a roll-over test (ROT) during wk 28-32 of their pregnancy. Blood pressure (BP) readings were taken with a standard 12 cm cuff as well as with cuffs adapted to various arm circumferences. We found that the prediction rate of ROT readings with a standard 12 cm cuff was relatively low (38.5%) as compared with Gant's study (94%) (Amer. J. Obstet. Gynec., 120 (1974) 1). When a suitably sized cuff was used, the prediction rate dropped (to 14.7%). Data analysis at term for the whole population of this study shows that, by measuring with a standard 12 cm cuff, 10.2% of the women were found to have PIH, whereas measuring with a suitable cuff showed PIH in only 2.55% of the cases (1:4 ratio). We suggest that the low prediction rates in this and other studies demonstrate that the ROT test is not sufficiently reliable as a tool for predicting which women are liable to develop PIH, but there is definitely enough in it to predict which group will not develop PIH (in this study 89-93%). It has been recommended that ROT be considered only as a test of possible reliability. It should be done according to proper criteria for BP measuring, and a repeat ROT should be considered after several days before starting any kind of treatment. PMID- 3979652 TI - A rapid RIA for LH in serum and first morning void urine--application in an AID programme. AB - A rapid luteinizing hormone (LH) radioimmunoassay, with a 40-min incubation time, has been described and was used to measure the serum and urinary LH profiles in 92 menstrual cycles. A comparison of LH concentrations in first morning voiding (FMV) urine samples demonstrated that the pre-ovulatory LH peak in urine could be detected within 24 h of that in serum and that its offset was somewhat prolonged. FMV urine samples may be used as a convenient alternative to serum for the monitoring of artificial insemination by donor (AID) cycles. PMID- 3979653 TI - Evaluation of 24 patients with IUD-related problems: hysteroscopic findings. AB - The clinical and diagnostic findings in 24 patients with IUD-related abnormal uterine bleeding or missing IUDs have been evaluated with special reference to hysteroscopy. For the IUD-related abnormal uterine bleeding no gross uterine or tissue pathology has been revealed except for chronic inflammatory reaction of the endometrium. In half of the cases the IUD showed embedment, displacement within the uterine cavity or migration into the uterine wall, which may be a possible cause of the IUD-related abnormal uterine bleeding. For the detection and removal of IUDs with missing strings, partially embedded and perforated IUDs or retained broken parts of it, the hysteroscopic procedure appeared to be invaluable and in our opinion should be the method of choice. PMID- 3979654 TI - Changes in histological differentiation of human tumors transplanted to athymic nude mice: a morphometric study. AB - Differing conclusions have been reached regarding the phenotypic stability of human tumors transplanted to athymic nude mice. Since previous conflicting studies of tumor histology have been largely subjective, quantitative methodology was applied to an analysis of 13 human adenocarcinoma tumor lines that were originally derived directly from surgical specimens. Glandular differentiation was quantitated, both in the original human tumor (OHT) and in a minimum of 6 serial passages of the nude mouse-grown tumors (MGT), by means of point counting. A significant change in differentiation was noted in 12 lines, with 9 showing a decrease. Variance from the OHT was most commonly noted in the initial MGT, but additional changes were also noted in 8 lines during subsequent passages. Most of the lines also showed increased necrosis in the MGTs. Since histological differentiation and necrosis are related to tumor aggressiveness, it would appear that the predominant tendency was to evolve toward a more malignant phenotype. These changes may mimic those seen in human tumor metastases. PMID- 3979655 TI - Repair mechanisms involved in muscle regeneration following partial excision of the rat gastrocnemius muscle. AB - The sequential cytological events of the regeneration process, after partial excision of the gastrocnemius muscle in the rat, were followed by light and electron microscopy. During the first 2 days after injury leukocytes and macrophages infiltrate into the traumatized area. Myogenic regeneration is then characterized by mainly two repair mechanisms. Mononucleated cells, that populate the excised area, most probably fuse together to give rise to newly formed multinucleated myotubes that further develop to striated myofibers. Another mechanism involves the repair of injured muscle fibers by the possible fusion of mononucleated cells with their necrotic cut ends. Consequently, by addition of nuclei and new muscular material, sarcoplasmic outgrowths from the injured fibers are formed. It is concluded that mainly two repair mechanisms are involved in the regeneration process following partial excision of a muscle: addition of new muscle fibers in a process similar to that of embryonic myogenesis and also meristic growth from the injured fibers. PMID- 3979656 TI - Chlamydia isopodii sp. n., an obligate intracellular parasite of Porcellio scaber. AB - In an ultrastructural study of the hepatopancreas of Porcellio scaber, an obligate intracellular parasite, Chlamydia, was noted in the epithelial cells. Although the infection was found to extend the entire length of the hepatopancreas, it was most extensive in the glandular region. Indirect immunofluorescence testing revealed no cross-reactivity with either lymphogranuloma venereum or psittacosis antisera. PMID- 3979657 TI - The role of ketotifen in children with recurrent bronchitis. AB - The efficacy and safety of ketotifen in the treatment of recurrent bronchitis were studied in twenty Thai children with an average age of 5.3 years. Symptoms studied were cough, hypersecretion and wheezing and 4-point rating scores were assigned to each of the symptoms with regard to their frequency, severity and duration. Score per dose of the symptomatic agents used was also given. The symptoms and the use of symptomatic agents were recorded during a full year prior to ketotifen treatment and during a further full year study period. PEFR measurement was performed in the children above the age of 6 years at 2-weekly intervals under the supervision of the authors at the clinic. Assessment of efficacy was done by comparing monthly symptom scores and medication scores during the study period with the mean value of the previous year. Thirteen children received ketotifen for the whole year while seven children who were almost symptom-free after 4 months ketotifen treatment, were then only observed for a further 8 months. At the end of the study period, ketotifen treatment was rated very good and good in 85% of children, satisfactory in 10% and poor in 5%. Drowsiness was the only side-effect reported in a few cases but then only initially. There were no abnormalities in any laboratory parameters studied. PMID- 3979658 TI - Treatment of HBeAg-positive chronic hepatitis with a streptococcal preparation (OK-432). AB - Forty-two patients with hepatitis Be antigen (HBeAg)-positive chronic hepatitis were treated by intramuscular injections with OK-432, an immunopotentiator possessing interferon-inducing activity. They were monitored with serial measurements of virological parameters to evaluate therapeutic effectiveness, and compared with a group of seventy-five untreated patients (natural course group). In the group receiving OK-432 therapy, twenty-seven patients (64.3% of the forty two patients) became negative for HBeAg in an average observation period of 20.1 months. Of these, fourteen patients (33.3% of the forty-two patients) underwent seroconversion from HBeAg to anti-HBe antibody (anti-HBe). In the natural course group, twenty-three patients (30.7% of the seventy-five patients) lost HBeAg reactivity in a mean follow-up period of 32.3 months, and thirteen patients (17.3% of the seventy-five patients) became seroconverted. Thus, the drug group showed significantly higher percentages of patients with disappearance of HBeAg and seroconversion, notwithstanding the shorter duration of the follow-up. Young males and females, females generally, or patients with high serum GPT levels were more likely to respond to the therapy. The serum GPT level tended to stabilize more in patients receiving OK-432. PMID- 3979659 TI - Ibuprofen: plasma concentrations in man. AB - The plasma levels of ibuprofen were measured in five healthy subjects who took 600 mg tablets of ibuprofen twice daily, three times daily and four times daily in a crossover study. Peak plasma levels were obtained 1 hour after the first dose in all but one subject (slow absorber), the mean peak value being 51.3 micrograms X ml-1 (range 39.4-63.7 micrograms X ml-1). After the repeated dose regimens of two, three or four times daily of ibuprofen, the peak levels achieved were in a similar range to those seen after the first dose: Twice daily 39.4-66.4 micrograms X ml-1; Three times daily 43.6-63.3 micrograms X ml-1; Four times daily 44.1-58.4 micrograms X ml-1. There was no evidence of accumulation of the drug and no side-effects occurred during the trial. PMID- 3979660 TI - Intravenous flunitrazepam (Rohypnol) in conservative and restorative dentistry. AB - The study was undertaken to assess the suitability of intravenous flunitrazepam (Rohypnol) in patients requiring sedative cover for prolonged dental surgery. Fifty patients received up to 2 mg flunitrazepam to induce a satisfactory level of sedation. Further maintenance doses and local anaesthesia were given if required. The results showed the level of sedation and working conditions, as assessed by anaesthetist and surgeon, to be satisfactory in all but one patient. The majority of patients remained slightly drowsy the following morning but all stated they would undergo a similar procedure again. PMID- 3979661 TI - Hormonal regulation of casein synthesis at the end of pregnancy. AB - Ovariectomy or ovariohysterectomy on day 18 of pregnancy augmented mammary beta casein content 28 h later. Progesterone injected immediately and 12 h after ovariectomy showed a clear inhibitory effect on casein synthesis. Estrogen induced a significant increase in mammary beta-casein content when injected 12 h after surgery. Treatment with CB-154 to prevent prolactin release did not affect the increase of casein induced by ovariectomy. When CB-154 was injected to ovariohysterectomized pregnant rats, significant reduction of casein synthesis was obtained. According to these findings, rat placental lactogen in the absence of prolactin and progesterone induces beta-casein synthesis. Therefore prolactin, ovarian and placental hormones interplay at the end of pregnancy for full expression of the mammary gland genome. PMID- 3979662 TI - Social preferences in stump-tailed macaques (Macaca arctoides): effects of companionship, kinship, and rearing. AB - Social preferences in the directionality of social behavioral patterns in a heterogeneous group of 26 stump-tailed macaques (Macaca arctoides) were examined to see if kin recognition occurred. Four behavioral measures were analyzed: proximity, contact, grooming, and play. Three independent variables were examined: early companionship, condition of early rearing, and kinship. The latter was divided into partrilineal, matrilineal, and shared kinship. Partial correlational analysis showed that social preferences correlated most strongly with companionship, followed by kinship and rearing conditions. Within kinship, patrilineal and matrilineal effects differed markedly, suggesting that natural selection has operated differentially in a species in which normal child-rearing is done by matrilineal kin. PMID- 3979663 TI - Effects of maturation and priming on audiogenic seizure thresholds in mice. AB - The rise and fall of audiogenic seizure vulnerability were followed in three lines of mice selected for brain/body weight ratio and in the heterogeneous stock from which they were derived. Over a period of 12 to 24 days, susceptibility increased and then declined. Subjects retested after a 2-day interval were more susceptible, but this priming effect declined steadily. Differences in seizure threshold varied unsystematically among the lines. No sex differences in susceptibility were found. Mice who seized were heavier on the average than nonseizers of the same age and line. It is proposed that mice with a slower development rate are less susceptible to the stimulus used to evoke seizures. If so, rapid development may tend to lower the threshold of audiogenic seizures in mice. PMID- 3979664 TI - The organization and stability of sleep states in in fullterm, preterm, and small for-gestational-age infants: a comparative study. AB - Sleep state organization in the neonatal period was compared for groups of fullterm, preterm, and small-for-gestational-age infants. Preterm and small-for gestational-age groups were found to have greater rates of state change than the fullterm group, and maternal perception of the infants was found to be negatively correlated to rates of state change in the preterm infants. Small-for-gestational age infants had more active sleep without rapid eye movements than fullterm or preterm infants. The findings are discussed with regard to implications for CNS organization and possible early identification of infants at risk of developmental problems. PMID- 3979665 TI - Spatial memory of children and adults assessed in the radial maze. AB - To assess the development of accurate spatial memory and its relationship to organized search strategies, children (18-71 months old) and college students searched for rewards hidden at the ends of the arms of an eight-arm radial maze. Subjects made their first four choices in random order selected by the experimenter (forced choice) or in whatever order they wished (free choice). In some conditions, a retention interval was imposed between arm choices 4 and 5, followed by a resumption of the task. With free choice, accuracy of spatial memory increased linearly with age, and the proportion of tests on which the child entered four adjacent arms in sequence during the first four choices, a measure of organized searching, also increased linearly with age. Disrupting this sequential search strategy (forced choice) reduced accuracy for both children and college students, although the reduction with college students was small. Delays had minimal effects for children who met criterion at 0-delay and for college students. Although response patterns seem unimportant in accurate spatial memory in rats, systematic search strategies mature together with, and probably contribute to, the improvement of spatial memory with age in humans. PMID- 3979666 TI - Ontogenesis of learning: V. Variation in associative and nonassociative control of an operant forelimb response in infant rats. AB - To study ontogenetic variation in the mechanisms that control operant responding, infant rats 4-16 days old were trained to lift a forelimb in order to receive an infusion of a sucrose-milk solution (reinforcer). Although the learning processes that contribute to this behavior were to some extent functional in pups 5-6 days old (Experiment V), there were major age-related constraints on the performance of this response. We were unable to observe selective responding with the reinforced forelimb until pups were 9 days old (Experiment I). This was in part because pups tested when 7, but not 9 days old, were highly activated (as measured by responding with both forelimbs) by both the reinforcer (Experiment II) and cues associated with the reinforcer during training (Experiment IV). Implications of these findings are discussed. PMID- 3979667 TI - Nocturnal myoclonus--a sleep disturbance in children with leukemia. PMID- 3979668 TI - Primitive reflex profile. PMID- 3979669 TI - Prevention of spastic paralytic dislocation of the hip. AB - In a retrospective review of 99 children with spastic cerebral palsy, the efficacy of soft-tissue procedures alone in reducing early subluxation of the hip and preventing further subluxation and dislocation was determined. The indication for surgery was early subluxation of one or both hips. Surgery was either adductor tenotomy with or without anterior branch obturator neurectomy, or adductor tenotomy in combination with iliopsoas recession. Results were poor for 64 per cent after adductor tenotomy and anterior branch obturator neurectomy. For patients who also had iliopsoas recession the success rate was 72 per cent. Radiographic analysis showed that uncovering of the femoral head had halted or improved in 80 per cent of patients following iliopsoas recession. PMID- 3979670 TI - Preliminary support for the oral administration of valine, isoleucine and leucine for phenylketonuria. AB - Recent behavioral data have demonstrated the importance of maintaining low phenylalanine concentrations beyond early childhood in patients with phenylketonuria, which can be a difficult task, particularly during adolescence. Administration of certain large neutral amino-acids (valine, isoleucine, leucine- VIL) appears to reduce phenylalanine concentrations in the cerebrospinal fluid of humans and in the brain of rats. The present study compared neuropsychological test-performance of six patients with phenylketonuria during periods of VIL administration and periods when this supplement was not given. Although individual responses to VIL were variable, there was an over-all improvement of about 1 1/2 SD in neuropsychological test performance during VIL treatment. Abstract reasoning and tactile motor problem-solving increased more than pure motor performance. PMID- 3979671 TI - Infantile status epilepticus as a complication of 'near-miss' sudden infant death. AB - Among 13 infants with apparently cryptogenic status epilepticus occurring between two and four months of age, two shared several features of 'poliodystrophy' encephalopathy. For the other 11, an anoxic-ischaemic event was suggested by the history, the seizure and EEG characteristics, and clinical and CT-scan evolution. The possible relationship with 'near-miss' sudden infant death is discussed. PMID- 3979672 TI - The psychological characteristics of infantile hypercalcaemia: a preliminary investigation. AB - A sample of 23 children aged seven to 12 years with diagnoses of infantile hypercalcaemia was assessed on a battery of psychological tests and rating scales in an attempt to describe the psychological characteristics of this disorder. All children were found to have a mild or moderate degree of mental handicap. As a group, their expressive language skills were superior to their verbal comprehension. They displayed a high degree of behaviour and emotional disorders, most notably in terms of high levels of activity. Most children were reported as being highly sensitive to noise. This study clarifies some of the psychological correlates of infantile hypercalcaemia and some implications for management are suggested. PMID- 3979673 TI - Migraine and benign epilepsy with Rolandic spikes in childhood: a case-control study. PMID- 3979674 TI - Convulsions and lumbar puncture. PMID- 3979675 TI - Psychological sequelae of head injury in children. PMID- 3979676 TI - Prevention of stress-induced upper gastrointestinal bleeding by cimetidine in patients on assisted ventilation. AB - A double-blind controlled trial was conducted in which the efficacy of cimetidine in a dosage of 20 mg/kg/24 h in preventing upper gastrointestinal hemorrhage was tested in 34 critically ill patients on assisted ventilation. In 28 patients, 14 on cimetidine and 14 on placebo, gastric pH measurements and blood loss measured by 51Cr-labelled erythrocytes could be analyzed. Although cimetidine produced a markedly lower number of days with a gastric pH below 3.5 (17.4% vs. 72.2%) 5 patients on cimetidine bled as against 1 on placebo. These results do not suggest that cimetidine was effective in preventing stress-induced upper gastrointestinal bleeding. PMID- 3979677 TI - Decreased sulfation of serum and tissue gastrin in hypergastrinemia of antral origin. AB - The sulfation of gastrin in serum, antrum and duodenum was studied in 22 normo- and 20 hypergastrinemic patients. The ratio between gastrin-17 and gastrin-34 was measured in antrum and duodenum. The degree of sulfation was reduced in the antrum of hypergastrinemic patients (35.3 +/- 1.3%, mean +/- SEM) compared with 48.0 +/- 2.1% in normo-gastrinemic patients (p less than 0.001). The degree of sulfation in serum and duodenum was similar to that of the antral gastrins in all patients. The percentage of gastrin-34 in antrum was increased (7.3 +/- 0.7%) in hypergastrinemic compared with 4.9 +/- 0.3% in normogastrinemic patients (p less than 0.01). In the duodenum the percentage of gastrin-34 was similar in normo- and hypergastrinemia. When classified according to clinical diagnosis, sulfation of antral gastrin was normal in duodenal ulcer (47.6 +/- 4.5%) but decreased in gastric ulcer (36.7 +/- 1.6%, p less than 0.01) and pernicious anemia (31.3 +/- 1.9%, p less than 0.001) compared with 48.2 +/- 2.2% in control patients. In pernicious anemia a larger proportion of antral gastrins occurred as gastrin-34 (8.2 +/- 0.9%) compared with 4.8 +/- 0.4% in control patients (p less than 0.01). Our study suggests that both sulfation and proteolytic processing of the gastrin precursor is diminished in hypergastrinemia of antral origin. PMID- 3979678 TI - Adaptation of hexose uptake by the rat jejunum induced by the perfusion of sugars into the distal ileum. AB - The effects of perfusing solutions of different composition into the distal ileum of the rat, on glucose or galactose absorption from the jejunum has been determined in vivo. The rate of glucose absorption via the active, phlorhizin sensitive pathway was increased significantly when either glucose or maltose were present in the lower ileum. In contrast, the presence of galactose, lactose and fructose produced only minimal effects on active glucose absorption. The phlorhizin-insensitive component of glucose absorption was unaffected by the presence of sugar in the distal region. Perfusion of glucose into the ileum enhanced the active uptake of the poorly metabolized hexose, galactose, from the jejunum. The administration of cycloheximide abolished the increase in active glucose absorption induced by distal maltose perfusion. The response to distal glucose (a) required the sugar to be perfused for a minimum of 3 h before increases in absorption became significant, and (b) was not dependent on distal glucose absorption by the phlorhizin-sensitive pathway. The possible mechanisms involved in this adaptive response are discussed. The enhancement of jejunal absorption may be important in man in conditions where glucose is present at abnormally high levels in the distal ileum. PMID- 3979679 TI - Effect of truncal vagotomy on GIP release induced by intraduodenal glucose or fat in dogs. AB - In order to elucidate the role of the vagus nerve in the release of gastric inhibitory polypeptide (GIP), mongrel dogs were given a 4-min intraduodenal infusion of 10 g glucose or 5 g soybean oil before and again 1 month after truncal vagotomy (TV). The basal GIP concentrations were significantly elevated after TV. The plasma GIP levels following glucose infusion in the vagotomized dogs were significantly higher than those in the untreated dogs, whereas the GIP levels following fat infusion were not affected by TV. These results suggest that TV influences glucose-induced GIP release but not fat-induced GIP release, indicating that different mechanisms of the vagus nerve may be involved in glucose- and fat-induced GIP secretions. PMID- 3979680 TI - Factors relevant to the prognosis of chronic duodenal ulcer. AB - The aim of the study was to define the effects of sex, age, smoking, alcohol, analgesic ingestion, and treatment method whereby healing was initially induced on the prognosis of patients with a chronic duodenal ulcer (DU). 122 patients were assessed 1 year after the endoscopic demonstration of a DU. Two outcome variables for this 1-year period were studied - freedom from symptoms, and proven recurrence of the DU. Additionally, the outcome groups were compared to a community control population as regards the exposure variables. The results of the study indicate that each increase in smoking by 10 cigarettes daily increased the risk of DU recurrence within 1 year by 40%. Comparisons between patients and community controls revealed that smoking was significantly associated with DU and this association was present whether the ulcer was in exacerbation or in remission. PMID- 3979681 TI - Relationship of renal size to nephropathy in type 1 (insulin-dependent) diabetes. AB - Thirty-five patients with Type 1 (insulin-dependent) diabetes mellitus and 90 normal subjects had renal size (renal area index) determined by X-ray and also had examination of renal biopsies by light and electron microscopy. Renal area index of 206 +/- 32 cm2/1.73 m2 (mean +/- SD) in the Type 1 diabetic patients exceeded that in the normal subjects (180 +/- 25 cm2/1.73 m2, p less than 0.001). In the diabetic patients, the renal area index correlated with creatinine clearance (r = +0.43, p less than 0.05), but did not correlate with urinary albumin excretion, or the electron microscopic measurements of percentage total mesangium and glomerular basement membrane width. In diabetic patients with clinical nephropathy or severe glomerulopathy on biopsy, the kidneys may remain large. Thus, renal size does not indicate the severity of diabetic renal lesions on biopsy. PMID- 3979682 TI - Diabetes in part-aborigines of Western Australia. AB - One thousand, two hundred and eighteen diabetic subjects living in and around country towns of Western Australia were screened for complications of diabetes. This population included 134 subjects of Aboriginal descent, who were compared with the Caucasoids taking part. In the Aboriginal group there was a greater proportion of Type 2 (non-insulin-dependent) diabetic patients, a relative female preponderance (69% compared with 51%) and a tendency to present at an earlier age of onset than their Caucasoid counterparts. Diabetic complications were at least as common in the Aboriginal group as in the Caucasoid patients. Indeed, retinopathy within 10 years of onset of diabetes was more common in the Aborigines. Peripheral neuropathy was more prevalent in Aborigines treated by diet alone or oral hypoglycaemic agents than in Caucasoids. A much greater prevalence of proteinuria was an additional feature of the Aboriginal subgroup (29% versus 4%). PMID- 3979683 TI - Non-enzymatic glycosylation of skin collagen in patients with type 1 (insulin dependent) diabetes mellitus and limited joint mobility. AB - Forearm skin biopsies were obtained from diabetic subjects with and without limited joint mobility, and from non-diabetic control subjects. Collagen purified from these samples was assayed for non-enzymatic glycosylation. The level in all diabetic patients was significantly greater than that in control subjects (p less than 0.001), but those diabetic patients with limited joint mobility had a level of collagen glycosylation similar to that in those with normal joints (15.3 +/- 1.3 and 16.5 +/- 1.3 nmol fructose/10 mg protein, respectively; mean +/- SEM). Glycosylation of collagen in the diabetic patients correlated with glycosylated haemoglobin measured at the time of skin biopsy (r = 0.60). These results do not support the hypothesis that non-enzymatic glycosylation of collagen, as reflected by the ketoamine link, plays an important role in the development of limited joint mobility in diabetes. PMID- 3979684 TI - Prevalence of coronary heart disease, left ventricular failure and hypertension in middle-aged, newly diagnosed type 2 (non-insulin-dependent) diabetic subjects. AB - The prevalence of coronary heart disease, left ventricular failure and hypertension was examined in a representative group of 133 newly diagnosed Type 2 (non-insulin-dependent) diabetic subjects (70 men, 63 women), aged 45 to 64 years, and in a group of 144 randomly selected non-diabetic control subjects (62 men, 82 women) of the same age group. The prevalence of previous myocardial infarction (major Q-QS abnormalities in resting ECG and/or myocardial infarction verified at hospital) was increased 1.7-fold in male (NS) and 4.4-fold in female (p = 0.007) diabetic patients compared with that found in non-diabetic subjects. Chest pain symptoms and ischaemic ECG abnormalities were about twice as common among diabetic than among non-diabetic subjects. The frequency of coronary heart disease defined by chest pain symptoms and ECG abnormalities was 3.5 times higher in male (p = 0.001) and 3.1 times higher in female (p = 0.001) diabetic patients than in the respective non-diabetic subjects. The frequency of current digitalis therapy was increased 3.3-fold in male (p = 0.006) and 3.9-fold in female (p = 0.001) diabetic patients suggesting an increased frequency of left ventricular failure among diabetic subjects. The prevalence of hypertension, based on the elevated blood pressure levels and/or current use of antihypertensive drugs, was increased 1.6-1.7-fold among the diabetic patients. PMID- 3979685 TI - Insulin receptors in the gastrointestinal tract of the rat fetus: quantitative autoradiographic studies. AB - Purified carrier-free 125I-insulin was injected into the vitelline vein of rat fetuses in utero after 17, 19 or 21 days of a 22-day gestation. Three minutes later, the weight and radioactivity of various organs and the remaining carcass were measured. A radioactivity concentration index was calculated by dividing the specific activity of each organ by that of the whole feto-placental unit. In each of the three age groups studied, the gastrointestinal tract radioactivity concentration indices were 1.7, 2 and 1.9 respectively, indicating that the gastrointestinal tract concentrated the labelled hormone. Three, 9 and 15 min after 125I-insulin injection, the gastrointestinal tract was removed, homogenized and chromatographed on a G-50 fine Sephadex column. At 3 min, 91.4% of gastrointestinal tract radioactivity co-eluted with a standard of 125I-insulin. At the later time intervals studied, the percentage of 125I-insulin decreased while that of low molecular weight degradation products increased. Quantitative autoradiographic study of the fetal gastrointestinal tract indicated that epithelial cells bound 125I-insulin and that this binding was inhibited by co injection of large amounts of unlabelled insulin. 125I-insulin binding was highest in the proximal small bowel and lowest in the colon. Insulin binding did not appear to depend upon degree of cell maturation or cell type. These results indicate that the epithelium of the gastrointestinal tract is characterized by the presence of numerous insulin receptors and is a potentially important insulin target. PMID- 3979686 TI - Identification of subjects with a high risk of developing type 1 (insulin dependent) diabetes. Summary of a workshop held on 25 May 1984 at the Children's Hospital, Basel, Switzerland. PMID- 3979687 TI - Hyperproinsulinaemia in cirrhosis. PMID- 3979688 TI - Diet and insulin-dependent diabetes in the BB rat. PMID- 3979689 TI - Blood pressure and metabolic control as risk factors for nephropathy in type 1 (insulin-dependent) diabetes. AB - The respective roles of arterial blood pressure and metabolic control in different stages of diabetic nephropathy were analyzed retrospectively in 52 sequentially-followed Type 1 (insulin-dependent) diabetic patients. A negative correlation was found between median post-prandial blood glucose and median duration of diabetes until onset of persistent proteinuria (p less than 0.01). Systolic blood pressure was higher in patients who subsequently developed persistent proteinuria than those who did not (140 versus 121 mmHg; p less than 0.05), but duration of the interval until onset of persistent proteinuria was not related to blood pressure. After onset of persistent proteinuria, hypertensive diabetic patients developed elevated serum creatinine concentrations more frequently than normotensive diabetic patients (67% versus 14%, p less than 0.05). In these patients, the delay until elevation of serum creatinine concentration was negatively correlated with blood glucose (p less than 0.01). Once serum creatinine was raised, decay of renal function occurred faster in patients with persistent than intermittent hypertension (p less than 0.05). No effect of metabolic control was demonstrable at this stage of nephropathy. It is concluded that metabolic control determines the early course of diabetic nephropathy, whereas blood pressure is more important in advanced stages of nephropathy. PMID- 3979690 TI - Effects of streptozotocin-induced diabetes and noradrenaline infusion on cardiac output and its regional distribution in pithed rats. AB - 46Sc-and 99mTc-labelled microspheres were used to measure the effects of noradrenaline infusion on cardiac output and its regional distribution in 10 control and 10 streptozotocin-diabetic pithed rats. Plasma noradrenaline concentrations during the infusion were similar in both groups. Pressor responses were significantly smaller in the diabetic animals (controls: + 79, diabetic: + 44 mmHg; p less than 0.001). Cardiac output remained similar in both groups before and during the noradrenaline infusion. Total peripheral resistance was similar in both groups before noradrenaline but the noradrenaline-mediated increase was significantly smaller in the diabetic animals (controls: + 150%, diabetic: + 76%; p less than 0.05). Noradrenaline-mediated resistance increases were significantly reduced in several tissues of the diabetic rats including the small intestine (controls: + 132%, diabetic: -4%; p less than 0.005), the large intestine (controls: + 150%, diabetic: + 39%; p less than 0.05) and the kidneys (controls: + 180%, diabetic: + 27%; p less than 0.05), but were very similar in other areas, e.g. in the hindlimbs and tails. PMID- 3979691 TI - Continuous subcutaneous insulin infusion does not induce a significant acute phase response of serum amyloid A protein. AB - In a study of 23 matched pairs of Type 1 (insulin-dependent) diabetic patients receiving continuous subcutaneous insulin infusion or conventional insulin injection therapy respectively, there were no significant differences in serum levels of the acute phase proteins, serum amyloid A and C-reactive protein. These results do not support the suggestion that continuous subcutaneous insulin infusion stimulates serum amyloid A production or that it carries a risk of inducing reactive systemic amyloidosis. PMID- 3979692 TI - Glycosylated haemoglobin in normal pregnancy: a longitudinal study with two independent methods. AB - Twenty-one women completed a longitudinal study of glycosylated haemoglobin in normal pregnancy. Glycosylated haemoglobin levels were measured using two independent techniques (ion-exchange column and colorimetric). Concurrent serial oral glucose tolerance tests (75-g glucose load) and erythrocyte indices were obtained. Changes in mean glycosylated haemoglobin were similar with both techniques with a nadir at 17 weeks, a peak at delivery (p less than 0.002 versus 17 weeks) and a fall post-partum. Glycosylated haemoglobin levels in abnormal pregnancies, e.g. diabetic, should be interpreted in the knowledge of these physiological changes. PMID- 3979694 TI - [2 types of adaptation of human cardiorespiratory indices to physical loading]. PMID- 3979693 TI - Sera from diabetic pregnant women contain reduced titres of inhibiting factors on killer cell activity. AB - The presence of Fc-receptor-blocking factors in the sera of normal and insulin dependent diabetic pregnant women was investigated by means of an antibody dependent cell-mediated cytotoxicity assay. Sera from normal pregnant women induced a significant depression of antibody dependent cell-mediated cytotoxicity when compared with sera from normal and diabetic non-pregnant women (p less than 0.0001; p less than 0.002, respectively). The effect of sera from diabetic pregnant women, however, was not different from that observed with sera from normal and diabetic non-pregnant women. Thus, we confirm the presence of Fc receptor-blocking factors in the sera of normal pregnant women. The higher cytotoxicity levels measured in the presence of sera from pregnant women with insulin-dependent diabetes suggests that the titres of such factors are reduced in this condition. PMID- 3979695 TI - [Disorder of the Frank-Starling principle in diseases of the circulatory system]. PMID- 3979696 TI - [Work capacity and hemodynamics of men living at median and high latitudes]. PMID- 3979697 TI - [Relation between the biomechanical properties of muscles and their capacity to utilize the energy of elastic deformation]. PMID- 3979698 TI - [Individual and typological characteristics of autonomic reactions in the autogenic training of polar researchers during wintering in the Antarctic]. PMID- 3979699 TI - [Effect of different vitamin doses on the nonspecific mechanisms of human adaptation]. PMID- 3979700 TI - [Endocrine mechanisms regulating gastric secretion at rest and during muscle activity]. PMID- 3979701 TI - [Craniocerebral temperature studied by decimetric radiothermometry]. PMID- 3979702 TI - [Intellectual and mnestic processes following a single dose of ethanol]. PMID- 3979703 TI - [Dynamics of the changes in the statistical indices of the cardiac rhythm of persons with various degrees of susceptibility to motion sickness]. PMID- 3979704 TI - [Relation of the light sensitivity of the retinal rods to cyclic nucleotide metabolism]. PMID- 3979706 TI - [Optimization of a method for recording the action potentials of human motor units using a needle electrode]. PMID- 3979705 TI - [Characteristics of the sensorimotor reactions and rheoencephalograms of persons with a desynchronized type of EEG]. PMID- 3979707 TI - [Correlation of the magnitude of voluntary muscle strength and the characteristics of the adaptation of skeletal muscle to force loads in women and men]. PMID- 3979708 TI - [Functional organization of the bioelectrical activity of the brain in the pubertal period of development]. PMID- 3979709 TI - [Dependence of the interpretation of tactile stimuli on the orientation of the receptive field]. PMID- 3979710 TI - [Effect of a threshold physical load on the function of the microcirculatory system and central hemodynamics in 10- to 11-year-old children]. PMID- 3979711 TI - [Interhemispheric asymmetry in the recognition of standardized and noise modulated textural stimuli]. PMID- 3979712 TI - [Analysis of lexical and grammatical material during transient inactivation of the left and right hemispheres of the brain]. PMID- 3979713 TI - [Spectral and temporal characteristics of long-latency auditory evoked potentials]. PMID- 3979714 TI - [Evaluation of the physical properties of human lungs based on research on airway resistance]. PMID- 3979715 TI - [Measurement of alveolar pressure during forced respiration using a whole-body plethysmography]. PMID- 3979716 TI - [Relation between the perception of the position of body parts and movement]. PMID- 3979717 TI - [Effect of emotional strain on the hemostatic system of healthy persons]. PMID- 3979718 TI - [Compliance of the human brachial artery under low transmural pressures: its application to the theory of Korotkoff's method]. PMID- 3979719 TI - [Human body impedance and the physiological indices under physical loads]. PMID- 3979720 TI - [Evaluation of the chrono- and inotropic functions of the heart at different degrees of physical training of the body]. PMID- 3979721 TI - [Anorectal motility in idiopathic constipation. Study of 200 consecutive patients]. AB - The aim of our work was to study anorectal motility and tension of the rectal wall in 200 constipated adult patients. Anorectal manometry was normal in 88 patients (group A), showed abnormal amplitude of the anorectal inhibitory reflex in 33 patients (group B) and hypertonia and ultraslow waves in 70 patients (group C). These anomalies were: a) reproducible in the 20 patients studied twice; b) observed in patients with enterocolitis, thus not specific of constipation; c) associated with an increased frequency of fecal evacuation difficulties. Despite normal values of tension of the rectal wall: a) the threshold of conscious perception of distension was increased in 14 p. 100 of patients; b) a paradoxical relationship between the anorectal inhibitory reflex and rectal tension was observed in group B patients. Our results support the concept of outlet obstruction due to anorectal dysfunction and suggest the possibility of neurologic and or ischemic mechanisms in group B patients. PMID- 3979722 TI - [Incidence of esophageal cancer synchronous with upper aerodigestive tract cancers (100 cases): value of vital staining with lugol and toluidine blue]. AB - A number of studies have demonstrated a high incidence of synchronous or metachronous esophageal carcinoma in association with carcinoma of head and neck. Carcinoma of the esophagus must be systematically looked for before the treatment of head-neck carcinomas and during follow-up. The aim of this study was to determine the incidence of synchronous esophageal carcinoma in patients with head and neck carcinoma and to evaluate the advantages of lugol and toluidine blue vital staining in fiberoptic endoscopy. One hundred patients (97 males and 3 females, mean age 54.9 years) were studied. A fiberoptic esophagoscopy was performed in all patients. Vital staining was realized with 5 p. 100 lugol in 40 cases and with 1 p. 100 toluidine blue e in 20 cases. Squamous cell carcinoma of the esophagus was observed in 12 patients, typical grossly in 5 cases and occult in 7 cases. In these latter cases, lugol (2 cases) or toluidine blue (5 cases) stain facilitated the forceps biopsies. Histological examination was positive in all cases. The incidence of esophageal carcinoma synchronous to carcinoma of the mouth was high (35.3 p. 100). Lugol vital staining seems to be sensitive, non specific and easy to realize. Toluidine blue staining calls for a more difficult and prolonged technique. Although it can reveal occult carcinoma, false positive or negative results may be observed. PMID- 3979724 TI - [Effect of pentagastrin and cimetidine on gastric protein loss in exudative gastropathies]. AB - The effectiveness of cimetidine in decreasing protein loss in protein-losing gastropathies has recently been questioned. The present investigation was designed to test the effects of pentagastrin and cimetidine on gastric protein loss in 6 patients with this type gastropathy: 4 with Menetrier's disease and 2 with Stempien's disease. Fecal and gastric loss of 51Cr-labelled proteins were measured and expressed as ml of plasma per unit of time +/- SEM. Gastric protein loss was measured during intravenous infusion of normal saline, pentagastrin alone (6 microgram/kg/h), combined pentagastrin and cimetidine (1.5 mg/kg/h), and cimetidine alone. Each solution was perfused during 105 min to obtain a steady state effect upon gastric protein loss during one hour. Fecal clearance was increased in all patients: 193 +/- 16 ml/day (N less than 40 ml/day). Gastric 51Cr albumin loss was increased by pentagastrin stimulation (15.9 +/- 1.2 ml/h); cimetidine resulted in a reduction of the pentagastrin induced loss (7.0 +/- 3.8 ml/h) while cimetidine alone had no effect (3.8 +/- 0.6 ml/h) on basal loss. Our results suggest that cimetidine therapy may be of benefit in decreasing protein loss in patients with this type of gastropathy. PMID- 3979723 TI - [Release of pancreatic polypeptide in response to the intragastric administration of a meal is not different in duodenal ulcer patients and normal subjects]. AB - The high basal and meal-induced acid secretions in duodenal ulcer patients has led to the concept that vagal hyperactivity is a common factor in the pathogenesis of peptic ulcer. For these reasons, since pancreatic polypeptide secretion is known to be under vagal control, we studied the pancreatic polypeptide release after intragastric administration of two protein meals (10 and 20 g protein in 400 ml) in 18 duodenal ulcer patients and in 17 normal subjects. After a 10 g protein meal was administered, gastric pH was either maintained at pH 4.5 or allowed to decrease. The 20 g protein meal induced a higher pancreatic polypeptide release than did the 10 g protein meal (p less than 0.05): the integrated pancreatic polypeptide responses were 1.07 +/- 0.5 and 3.21 +/- 0.58 nmol/l/60 min respectively in the duodenal ulcer group and 0.46 +/- 0.21 and 2.67 +/- 0.69 nmol/l/60 min respectively in the control group. On the other hand, the responses to the two protein meals in duodenal ulcer patients were not different from those obtained in normal subjects, despite the higher meal-induced acid secretions in the duodenal ulcer group. pancreatic polypeptide increase was not larger when gastric pH was fixed than when it was allowed to decrease, 0.56 +/- 0.21 and 1.7 +/- 0.63 nmol/l/60 min respectively in normal subjects and 1.07 +/- 0.5 and 1.07 +/- 0.49 nmol/l/60 min respectively in duodenal ulcer patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979725 TI - [Constipation: from the symptom to the person]. PMID- 3979726 TI - [Value of ultrasound-guided cytopuncture in the diagnosis of tumors in cirrhosis. Study of 29 cases]. AB - Ultrasonically guided fine needle aspiration biopsy is known to be of great value in the diagnosis of malignant liver disease, with an overall accuracy rate of 73 94 p. 100. However, investigators have essentially reported cases of liver metastases. In this report, we examined the diagnostic value of this method in the specific case of tumors associated with cirrhosis. Twenty-seven patients with cirrhosis (20 alcoholic, 4 post-hepatitis, 3 hemochromatosis) with ultrasonically suspected hepatic malignancy were studied. They all presented severe blood clotting disturbances and/or ascites. At the end of the study, all patients had proven malignancy (by post mortem biopsy in 14 cases and/or serum AFP greater than 500 microgram/l in 17 cases). There were 25 primary and 2 metastatic tumors. Twenty-nine fine needle aspiration biopsies were performed under ultrasonic guidance. material suitable for cytologic evaluation was obtained in 25 patients. In 14 cases, a diagnosis of malignant involvement of the liver was firmly established by cytological examination; it was suggested in 4 other cases. Tumor typing was possible in 12 primary and 2 metastatic tumors, in agreement with the proven diagnosis. The present study shows that fine needle aspiration biopsy under ultrasound guidance is a safe and accurate diagnostic procedure in malignant liver disease associated with cirrhosis. PMID- 3979727 TI - [Results of endoscopic sphincterotomy in common bile duct lithiasis]. AB - Endoscopic sphincterotomy (ES) was attempted in 409 patients with common bile duct stone(s) (CBDS). The mean age of patients was 72.0 +/- 0.8 years (m +/- SEM); 47 p. 100 presented risk factors; 57 p.100 had previously been cholecystectomized while 43 p. 100 had not. On an average, patients in the former group were older (80 +/- 0.7 years) than in the latter 65.4 +/- 1.0 years, p less than 0.001). The procedure was successful in 98 p. 100 of the patients, after a standard ES in 78.5 p. 100 or after different technical artifices in 21.5 p. 100. The vacuity of the CBD was obtained in 96.5 p. 100 of the cases. During the first month after the ES, 13 p. 100 of the patients had complications and 4 p. 100 died; 37 complications (9 p. 100) were related to the ES and were responsible for death in 4 patients: 18 episodes of bleeding at the site of ES, 7 acute pancreatitis, 6 cholangitis, 4 retroperitoneal perforations and 2 other complications. The occurrence of these complications was closely related to the technique of ES being more frequent after technical artifices than after a standard ES (p less than 0.001). On the other hand, these complications occurred independently of the age of patients or of previous cholecystectomy. Seventeen complications (4 p. 100) did not depend directly on ES and were responsible for death in 14 patients (3 p. 100): pneumopathy, pulmonary embolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979728 TI - [Cancer of the esophagus: early endoscopic diagnosis]. PMID- 3979729 TI - Psychological distress in non-ulcerous dyspepsia. PMID- 3979730 TI - [A case of hypoprothrombinemia induced by cefoperazone (Cefobis)]. PMID- 3979731 TI - [Endoscopy in tumors of the Oddi region. Diagnostic and therapeutic possibilities]. AB - Between 1976 and 1983, 92 patients (mean age: 70 years) with ampullary or periampullary tumors, were evaluated by endoscopic procedures. The ampulla appeared malignant in 66 p. 100 of cases, enlarged but not obviously malignant in 15 p. 100 and normal in 18 p. 100. In one case, a tight duodenal stenosis prevented the endoscopist from seeing the ampulla. ERCP was performed in 70 patients and the common bile duct was opacified in 63 cases; it was dilated in 60 patients. Two types of tumors could be distinguished: 67 p. 100 grew within the duodenum and were seen by duodenoscopy and 33 p. 100 grew outside the duodenum and ERCP opacified a dilated common bile duct above a stenotic region; in these cases, diagnosis was established by biopsies performed through the ampulla, after endoscopic sphincterotomy (EST). Biopsy specimens were obtained in 67 p. 100 of cases and yielded a diagnosis of adenocarcinoma in 59 p. 100, questionable carcinoma in 15 p. 100, benign tumor in 16 p. 100 and normal mucosa in 10 p. 100. In 8 patients with the preoperative diagnosis of non-malignant tumor, operative biopsies finally revealed carcinoma in 7. EST or infundibulotomy was performed in 42 patients with 2 deaths from hemorrhage and cholangitis. Twenty-three patients received only EST as final treatment with complete disappearance of jaundice and/or cholangitis in 70 p. 100. Our results confirm the efficacy of duodenoscopy, ERCP and EST in the diagnosis and sometimes in the treatment of ampullary and periampullary tumors. PMID- 3979733 TI - [Esophageal motility, systemic scleroderma and Raynaud's phenomenon]. PMID- 3979732 TI - [Sclerosing cholangitis following surgical treatment of hydatid cysts of the liver. Probable role of the formol injection of bile ducts]. AB - Three cases of secondary sclerosing cholangitis which developed during the early postoperative phase of surgical treatment of hydatid liver cysts are reported. The cysts had ruptured into the biliary tree and the treatment consisted of infection of formol into the cysts. Evolution was pejorative since one patient died within 3 months and the remaining two underwent liver transplantation following biliary sclerosis. An experimental protocol using dogs has shown that the injection of 5, 10 and 20 p. 100 formalin into normal bile ducts rapidly causes sclerosing cholangitis which often leads to death. In man, it is very likely that the contact of 2 p. 100 formalin with mucosal tissue damaged by episodes of cholangitis could result in sclerosing cholangitis. These observations should be sufficient to discourage the use of formalin to sterilize hydatid cysts of the liver. PMID- 3979734 TI - [Esophageal motility in Raynaud's disease, systemic scleroderma and presclerodermal Raynaud's syndrome]. AB - Fifty-five consecutive subjects with Raynaud's phenomenon were submitted to esophageal manometry. According to the results of clinical examination and periungual capillaroscopy, they were divided into three groups: sixteen patients presented presclerodermal Raynaud's phenomenon, and nineteen, systemic sclerosis; twenty others had Raynaud's disease. Twenty volunteers formed the control group. Esophageal motor disorders were observed in the group with presclerodermal Raynaud's phenomenon, affecting the esophageal lower sphincter and the peristalsis of the body of the esophagus. In the group with systemic sclerosis, these motor disorders were associated with alterations in the amplitude and the duration of contractions. Esophageal motility was normal in subjects with Raynaud's disease. We can conclude that: 1) esophageal motor disorders can be seen in presclerodermal Raynaud's phenomenon. The kind of abnormalities observed at this stage of the disease are in favor of an early alteration of the neurogenic component of esophageal motility; 2) there is no relationship between esophageal motor disorders and Raynaud's phenomenon in scleroderma. PMID- 3979735 TI - [Intestinal adaptation and enzymatic changes following reciprocal jejunoileal transposition in rats. Effects of a high-fructose diet]. AB - The longitudinal localization of nine enzymes of the carbohydrate metabolism was studied in rats fed standard or high fructose diets, two months after a reciprocal jejuno-ileal transposition. In the ileal segment transposed to jejunal location, an adaptive increase of mucosal mass was observed, but the functional characteristics of enterocytes remained the same in the case of triokinase, aldolase, triose phosphate isomerase, glucose-6-phosphate isomerase and glucose-6 phosphatase activities. In the case of ketohexokinase and hexokinase activities, the functional properties of cells tended to resemble that of jejunum, as revealed by a significant increase in the specific enzyme activity. In the jejunum transposed to the place of the ileum, the fundamental properties of enterocytes and the functional capacity of the gut were maintained except in the case of fructose-1.6-bis phosphatase and of glucose-6-phosphatase. The high fructose diet did not facilitate the re-establishment of the gradient in its normal, aboral, direction. Indeed except for glucose-6-phosphatase, the enzymes of the jejunum transposed to the place of the ileum kept a high sensitivity and the enzymes of transposed ileum a low sensitivity to dietary fructose. Our conclusion is that the response to the diet depends more on the original position of the intestinal segment than on the local nutritional conditions and therefore that the basal activity of the majority of the intracellular enzymes implicated in carbohydrate metabolism and also their regulatory systems, are an intrinsic characteristic of the intestinal cells. PMID- 3979736 TI - [Encephalopathy following portal shunting in nodular regenerative hyperplasia of the liver]. AB - Two patients with nodular hyperplasia of the liver developed a chronic disabling encephalopathy after an interposition mesocaval shunt. Both had a low total hepatic blood flow-rate postoperatively. Encephalopathy disappeared following surgical occlusion of the shunt. These observations emphasize the risk of postshunt encephalopathy in patients with non-cirrhotic intrahepatic portal hypertension. PMID- 3979737 TI - [Erythema multiforme premonitory for acute hepatitis B]. PMID- 3979740 TI - [Cimetidine and ulcer stenosis]. PMID- 3979738 TI - Albendazole: does it increase the risk of rupture for hydatid cyst of the liver? PMID- 3979739 TI - [Cassoulet and activated charcoal...]. PMID- 3979741 TI - [Glandulo-cystic fundus polyps associated with rectocolonic adenomatous polyposis]. PMID- 3979742 TI - Fibromuscular dysplasia of arteries in Hirschsprung's disease. AB - Abnormal arteries were demonstrated in the intestines of 8 of 25 children with Hirschsprung's disease. The histologic findings were similar to those seen in fibromuscular dysplasia with proliferation of smooth muscle cells in the thickened adventitia. We propose a new pathological entity, "adventitial fibromuscular dysplasia." The abnormal arteries were located only in the transitional zone, which includes the proximal aganglionic, the oligoganglionic, and the distal normoganglionic segments. These findings are compatible with the suggestion that the craniocaudal migration of ganglion cells might be interrupted by intestinal ischemia in the presence of abnormal arteries in the embryo. PMID- 3979743 TI - Effect of cholinergic agonists on muscle from rodent proximal and distal small intestine. AB - Proximal and distal rat small intestine was cut into strips measuring 6.0 X 10.0 mm. Strips cut along the oral-caudal axis were called longitudinal strips, whereas those cut 90 degrees to that axis were called circular strips. Stress in circular and longitudinal muscle strips was measured continuously as they were superfused with acetylcholine, carbamylcholine, methacholine, bethanechol, or physostigmine. Resting stress during stretch, acetylcholine-stimulated active stress, and total stress were determined. Proximal circular muscle was five times as sensitive to acetylcholine as distal circular muscle (p less than 0.05); proximal longitudinal muscle was 2.8 times as sensitive to bethanechol as distal muscle (p less than 0.05). Resting, active, and total stress were similar in proximal and distal muscle, but circular muscle showed nearly twice the resting stress of longitudinal muscle at either proximal or distal sites (p less than 0.05). Physostigmine (10(-6) M) increased acetylcholine-stimulated active stress in proximal and distal circular muscle by 29% and 70%, respectively (p less than 0.05), but not in longitudinal muscle (p greater than 0.05). This difference between proximal and distal circular muscle (41%) was also significant (p less than 0.05). Thus, the proximal and distal muscle of the rat small intestine differs in its sensitivity to various cholinergic agonists, but not in its length stress properties. PMID- 3979744 TI - Simulation of colonic carcinoma by ischemia. AB - Nine cases of colonic ischemia are presented in which an initial diagnosis of carcinoma was made from roentgenographic, endoscopic, or intraoperative appearance of the lesion. The clinical features were insufficient to differentiate colonic ischemia from carcinoma. In 7 patients a barium enema was interpreted as, or consistent with, carcinoma. In 3 of these patients colonoscopy also suggested malignancy. In 2 patients, endoscopy suggested a neoplasm but no barium enema was performed. Endoscopic biopsies when performed were negative for malignancy. Three patients were considered to have cancer from the gross appearance of the lesion at laparotomy. Routine use of both barium enema and colonoscopy in patients with suspected colonic neoplasms will usually identify the ischemic nature of lesions incorrectly diagnosed by one technique or the other. In the uncommon patient in whom both studies suggest a neoplasm, but biopsy specimens are negative for tumor, repeat studies 7-10 days later may identify the evolving nature of ischemic lesions and obviate the need for surgery. When no changes are seen, prompt laparotomy is indicated. PMID- 3979745 TI - Gastric bicarbonate secretion in patients with duodenal ulcer. AB - The gastric mucosa secretes both acid and bicarbonate. In patients with duodenal ulcers, gastric acid hypersecretion is well-established. However, gastric bicarbonate secretion rates in these patients have not been reported. Accordingly, we calculated gastric acid and bicarbonate secretion rates in 13 patients with duodenal ulcer and 13 healthy subjects (controls) using a recently validated method that uses measurements of gastric juice volume, acidity (hydrogen-ion concentration), and osmolality. Non-parietal and parietal gastric volume secretion were also calculated. Although ulcer patients secreted significantly more acid than controls under basal conditions and during a submaximal intravenous pentagastrin infusion, they secreted similar amounts of bicarbonate. Ulcer patients secreted significantly more parietal and nonparietal fluid than controls. Increased nonparietal secretions in duodenal ulcer patients diluted excessive, acidic parietal secretions, preventing significant differences in gastric acidity in ulcer patients and control subjects (50.1 +/- 8.7 vs. 44.0 +/- 9.7 mmol/L basally; 111.0 +/- 3.1 vs. 102.4 +/- 7.5 mmol/L during pentagastrin infusion, respectively). These studies indicate that gastric bicarbonate secretion is close to normal in patients with duodenal ulcer, whereas acid secretion from parietal cells and nonparietal volume secretion are greater than normal. PMID- 3979746 TI - Endoscopic prediction of major rebleeding--a prospective study of stigmata of hemorrhage in bleeding ulcer. AB - Two hundred fifty patients with stigmata of active or recent hemorrhage from peptic ulcer were studied. Stigmata, subgrouped according to bleeding status and the presence or absence of a visible vessel, were related to the subsequent clinical course of hemorrhage. Sixty patients (24%) rebled massively and required emergency hemostasis. At the initial endoscopy a visible vessel was a relatively rare finding (21%). Less than one-third of the visible vessels rebled massively. None of the stigmata or subgroups of stigmata emerged as reliable predictors of major rebleeding. Bleeding status and ulcer site, however, were observed to influence the relative importance of a visible vessel. When a visible vessel was identified in patients with oozing, overlying clot, or gastric or duodenal ulcer, the probability of major rebleeding increased, but not significantly. However, when a visible vessel was identified in patients without other stigmata or in patients with prepyloric ulcer or older stigmata, there was a decreased probability of major rebleeding. Older stigmata was a superior predictor of self limited hemorrhage. PMID- 3979747 TI - Manometric evaluation of functional upper gut symptoms. AB - Pressure activity in the stomach and upper intestine was studied in 104 patients referred to the Mayo Clinic for evaluation of functional symptoms (nausea, vomiting, upper abdominal pain, or other dyspeptic symptoms in the absence of structural gut abnormalities). Manometric abnormalities were found in 75 patients. Forty-three of these had gastric abnormalities and 32 patients had both gastric and intestinal abnormalities. In the stomach, decreased antral phasic pressure activity after a solid meal was the most common abnormality. In the upper intestine, unpropagated bursts of phasic and tonic contractile activity were a relatively frequent abnormality but a number of other altered manometric patterns also were observed. Digestive tract symptoms were not good predictors of the presence or site of the gastrointestinal manometric abnormalities. Patients with associated neurologic, urologic, or metabolic (diabetes) disease were more likely to exhibit manometric abnormalities than were those without evidence of disease outside the gut. Almost two-thirds of the patients with symptoms and normal manometry presented features suggestive of psychiatric disease. We conclude that in patients with severe functional-type symptoms gastrointestinal manometry is a useful technique to evidence the underlying gut motor disturbance that is present in a relatively high proportion of these patients. PMID- 3979748 TI - Heterozygosity for HLA-linked hemochromatosis as a likely cause of the hepatic siderosis associated with sporadic porphyria cutanea tarda. AB - Subnormal activity of hepatic uroporphyrinogen decarboxylase is responsible for the derangement of porphyrin biosynthesis in both sporadic and familial porphyria cutanea tarda, but the enzymatic defect is not clinically expressed in the absence of hepatic siderosis. The pedigree study described here offers support for the hypothesis that a single allele for HLA-linked hereditary hemochromatosis is responsible for the hepatic siderosis in sporadic porphyria cutanea tarda. A two-locus causation model for sporadic porphyria cutanea tarda might explain both the observed incidence of overt cases and the rarity of multiple affected individuals within a pedigree. PMID- 3979749 TI - Protoporphyrin metabolic balance in human protoporphyria. AB - Short-term maintenance of different stable steady state balances for protoporphyrin production, accumulation in erythrocytes and plasma, and fecal excretion was demonstrated in 5 patients with uncomplicated protoporphyria in whom red blood cell, plasma, and fecal protoporphyrin levels were determined on 5 7 sequential days. The patients were hospitalized in a research unit for dietary control and standardization of specimen collection. Each patient was found to quantitatively partition protoporphyrin among these compartments in a pattern that was reproducible from day to day, and characteristic for that patient. These observations partially substantiate a previously proposed hypothesis that protoporphyrin partitioning patterns may provide a criterion for prospective classification of these patients into groups that may ultimately be shown to have different risk for development of symptomatic liver disease. PMID- 3979750 TI - Manometric disorders in patients with suspected sphincter of Oddi dysfunction. AB - Sphincter of Oddi (SO) manometry was conducted in 48 subjects who had previously undergone cholecystectomy. Ten of these subjects had no detectable biliary or pancreatic disease and served as controls. The other 38 patients were presumed to have SO dysfunction and had presented with episodes of severe biliary-type pain with either dilatation of the bile duct on a retrograde cholangiogram, transient changes in liver function tests, or both of these abnormalities. A triple-lumen low-compliance manometric system was used to record the SO basal pressure, SO phasic contraction amplitude, SO wave frequency, direction of wave propagation, and SO response to intravenously administered cholecystokinin-octapeptide 20 ng/kg. Satisfactory manometric recordings were obtained from 32 of 38 patients and of these, 25 patients showed one or more abnormalities when compared with data from the 10 controls. The abnormalities included excess of retrograde contractions (12), high frequency of SO phasic contractions (11), elevation of the SO basal pressure (8), and paradoxical cholecystokinin-octapeptide response (10). The study has demonstrated a spectrum of manometric abnormalities in the SO of patients with suspected SO dysfunction. PMID- 3979751 TI - Diltiazem and granulomatous hepatitis. AB - A case of granulomatous hepatitis proven by biopsy and related to diltiazem use is described. Clinicians should be alert to the possible presence of this complication in patients who develop fever, laboratory abnormalities, or clinical evidence of hepatic injury while taking diltiazem. PMID- 3979752 TI - Gastric adenocarcinoma complicating Gardner's syndrome in a North American woman. AB - Gastric carcinoma has not been recognized as a complication of Gardner's syndrome in the Western world. We report a 37-yr-old white woman with Gardner's syndrome who had gastric adenocarcinoma in association with diffuse gastric polyps. At the time of laparotomy, the disease was metastatic to regional lymph nodes. In addition, the patient had mesenteric and retroperitoneal fibromatosis, thyroid adenomas, a chest wall hemangioma, and fibrocystic disease of the breast. This is the first reported case of gastric adenocarcinoma complicating Gardner's syndrome in North America. PMID- 3979753 TI - A vascular cause for Hirschsprung's disease? PMID- 3979754 TI - Porphyria cutanea tarda and HLA-linked hemochromatosis. PMID- 3979755 TI - Diabetes mellitus and chronic liver disease. PMID- 3979756 TI - Gastric antral vascular ectasia: the watermelon stomach. PMID- 3979757 TI - Methane production and colon cancer. PMID- 3979758 TI - Abstracts of papers submitted to the American Gastroenterological Association. 86th annual meeting, May 11-17, 1985, New York. PMID- 3979759 TI - Abstracts of papers submitted to the American Association for the Study of Liver Disease. Annual meeting, May 11-17, 1985, New York. PMID- 3979760 TI - An improved technique for accessory papilla cannulation in pancreas divisum. AB - Cannulation of the accessory papilla with dorsal pancreas ductography was accomplished in 13 of 15 consecutive cases of pancreas divisum. When routine cannulation of the main pancreatic papilla fails to produce a pancreatogram or yields only a ventral pancreas, the use of intravenous secretin and a 23-gauge needle catheter is recommended to facilitate accessory duct cannulation. PMID- 3979761 TI - Explosion-safe, enema-free, nutritious colonoscopy preparation using a prepackaged formula diet. AB - Breath hydrogen and methane concentrations were normal before morning colonoscopy in 72 ambulatory patients randomly assigned to Ensure or clear liquid diet preparation for 48 hours. Mechanical bowel preparation was equal with each diet using an evening-laxative and morning-enema regimen and with Ensure using two consecutive evenings of laxatives without enemas. Ensure is an explosion-safe, mechanically acceptable, nutritionally adequate method of colonoscopy preparation. With a suitable laxative, Ensure eliminates the need for enemas in colonoscopy preparation. PMID- 3979762 TI - Granular cell myoblastoma of the esophagus: endoscopic diagnosis and therapy. PMID- 3979763 TI - Triple lumen pylorus--a complication of peptic ulcer. PMID- 3979764 TI - Coexistence of annular pancreas and pancreas divisum--ERCP diagnosis. PMID- 3979765 TI - Intramural duodenal hematoma. PMID- 3979766 TI - Pyloroduodenal obstruction due to a biliary stone (Bouveret's syndrome) managed by endoscopic extraction. PMID- 3979767 TI - The National Institutes of Health grant mechanisms for gastrointestinal endoscopic research. PMID- 3979768 TI - Sucralfate and esophageal ulcers. PMID- 3979769 TI - A chopstick is removed after 60 years in the duodenum. PMID- 3979771 TI - Cimetidine therapy and duodenal candidiasis. PMID- 3979770 TI - Propranolol for duodenal mucosal edema. PMID- 3979772 TI - Prognostic importance of visible vessels in hemorrhage of peptic ulcers. PMID- 3979773 TI - The introverted appendix problem. PMID- 3979774 TI - An electrifying endoscopy (suite) experience. PMID- 3979775 TI - The stalk from a resected adenoma can simulate a polyp. PMID- 3979776 TI - Esophagogastric polyp. PMID- 3979777 TI - Giant hydronephrosis mimicking ascites. PMID- 3979778 TI - Xenon lamps increase infrared radiation from the fiberoptic bundle. PMID- 3979779 TI - [A rare case of congenital hypodysfibrinogenemia]. PMID- 3979780 TI - [Hypercoagulation syndrome in paroxysmal nocturnal hemoglobinuria]. PMID- 3979781 TI - [Interaction of the complement system with the main components of hemostasis]. PMID- 3979782 TI - [Possible role of the inhibitor of fibrin self-assembly in regulating blood coagulation]. PMID- 3979783 TI - [Effect of plasmacytapheresis on thrombocyte ultrastructure]. PMID- 3979785 TI - [Use of blood cell separation methods]. PMID- 3979784 TI - [Antishock effects of blood components and tranquilizers]. PMID- 3979786 TI - [Methods of continuous-flow centrifugation]. PMID- 3979787 TI - [Rheological and suspension characteristics of preserved donor blood stabilized with sodium saccharate]. PMID- 3979788 TI - [Erythrodieresis in extreme conditions and its role in blood regeneration]. PMID- 3979789 TI - [Effect of vasoactive drugs on the effectiveness of transfusion therapy in the late period of hemorrhagic shock]. PMID- 3979790 TI - [Increasing the effectiveness of blood substitute solutions in the treatment of hemorrhage and shock]. PMID- 3979791 TI - [Hemodynamic and biochemical indicators of the blood in filtration plasmapheresis]. PMID- 3979792 TI - [Effect of perfluoroorganic emulsions on hematological indicators in laboratory animals]. PMID- 3979793 TI - [Proteolysis of globin chains on acetylcellulose film in the molecular diagnosis of abnormal hemoglobins]. PMID- 3979794 TI - [Post-transfusion hepatitis in patients after heart surgery]. PMID- 3979795 TI - Stimulation of the mouse hepatic microsomal aniline p-hydroxylases by acetone and polyamines. AB - The effects of acetone +/- spermine on the high (AH-I) and low (AH-II) affinity forms of aniline hydroxylases in the mouse hepatic microsomes were investigated under in vitro conditions. The addition of either acetone or spermine alone stimulated both AH-I and AH-II activities at low concentration while some decline in stimulation was noted at higher concentrations. In the presence of both the modifiers the observed monoxygenation rates were greater than those produced by any one enhancer alone for AH-I and more than additive for AH-II. The results suggest that the enhancement of aniline p-hydroxylation by the acetone and spermine in the mouse hepatic microsomes involves at least two separate and possibly interdependent mechanisms. PMID- 3979796 TI - Effects of phenobarbital and p,p'-DDT on carboxylesterase activity and hydrolysis of propanidid in rat liver. AB - Time-dependent responses of microsomal and cytosolic carboxylesterases (EC 3.1.1.1) to administration of phenobarbital or p,p'-DDT were studied in rat liver using p-nitrophenylacetate and propanidid as substrates. In vitro and in vivo studies indicate that the hepatic carboxylesterases are induced by phenobarbital and p,p'-DDT. The induced metabolism of propanidid does not appear to be due to the microsomal polysubstrate monooxygenase system of the liver. PMID- 3979797 TI - Colonic absorption of 1,2-dimethyl hydrazine (DMH) in the rat. AB - 1,2-Dimethyl hydrazine (DMH) is absorbed in the colon by passive diffusion in the 0.1-5.0 mM concentration range. Absorption of DMH is enhanced by both conjugated and unconjugated bile acids. The presence of hydroxy-fatty acids in the colon markedly increased DMH absorption while fatty acids of different chain length did not influence absorption. PMID- 3979798 TI - The effect of alpha-solanine on the active calcium transport in rat intestine. AB - Solanine, an alkaloid isolated from potatoes was found to inhibit active calcium transport in rat duodenum both when added to the everted intestine sacs in vitro and when given to the rats in drinking water for 12 days. The inhibition by solanine of the active calcium transport in the rat intestine was found to be noncompetitive, the inhibitory constant being 25 microM. PMID- 3979799 TI - Effect of bromocriptine on serum PTH, calcium and phosphate levels in azotemic rats. AB - The dopamine agonist, bromocriptine, was studied with respect to its effects on PTH secretion and calcium homeostasis in Sprague-Dawley rats made azotemic by either total or subtotal nephrectomy. The oral or intraperitoneal administration of 0.25 mg of bromocriptine resulted in a significant increase in the serum calcium concentration when compared to animals given placebo. Bromocriptine produced no significant change in the BUN or the serum concentrations of creatinine, inorganic phosphate or PTH. The mechanism of the hypercalcemic effect of bromocriptine in azotemic rats is unknown. The hypercalcemia may, however, be due to stimulation of PTH secretion, since PTH levels in the serum were inappropriately high for the corresponding levels of calcium. PMID- 3979800 TI - Comparative effects of homoplastic pituitary pars distalis homogenate (PDH), pregnant mare serum gonadotrophin (PMSG), human chorionic gonadotrophin (HCG), growth hormone (GH), PMSG + GH, and HCG + GH on oocyte recruitment and development in the long-term hypophysectomized frog, Rana cyanophlyctis (Schn). AB - Follicular development and oocyte recruitment were studied in the ovaries of long term (2 months) hypophysectomized frogs Rana cyanophlyctis during the postbreeding season (October/November). The effects of homoplastic pituitary pars distalis homogenate (PDH) (1 pituitary per frog), 40 IU pregnant mare serum gonadotrophin (PMSG), 40 IU human chorionic gonadotrophin (HCG), 10 micrograms growth hormone (GH), 40 IU PMSG + 10 micrograms GH, and 40 IU HCG + 10 micrograms GH in 0.2 ml saline on oocyte growth and recruitment were also studied in these frogs. Injections (ip) were given on alternate days for 30 days, with autopsy on the 31st day. The frogs were fed with minced thigh muscles of other frogs and injected twice a week with 0.02 IU adrenocorticotrophic hormone (ACTH) in 0.2 ml saline to maintain their health. One month after hypophysectomy there was a significant reduction in the weight of the ovaries and oviducts, mean diameter of the largest oocytes, and the total number of oocytes in the ovaries. Oogonial mitosis was not impaired. In 2-month hypophysectomized saline-treated frogs, oocyte growth occurred and as a result there was an increase in the mean size. Also, the total number of oocytes in the ovaries increased compared to 1-month hypophysectomized controls. HCG induced maximum recruitment of oocytes from first growth phase (FGP) to second growth phase (SGP) but the number of oocytes in the ovary remained unchanged. In contrast, PMSG induced the recruitment of FGP oocytes and to a lesser extent SGP oocytes. Thus, PMSG, unlike HCG, caused a significant increase in the total number of oocytes in the ovary. Bovine GH alone had no effect on the recruitment of FGP or SGP oocytes but it enhanced the gonadotrophic action of PMSG and HCG when given in combination. The PDH caused a greater stimulation of the ovary by inducing the recruitment of both FGP and SGP oocytes in the long-term hypophysectomized frogs. The percentage of oocytes undergoing atresia was considerably reduced following PDH, PMSG, HCG, and even GH treatment. The decrease in the weight of the oviduct caused by hypophysectomy was not overcome by any of the hormone treatments. The present findings suggest that in R. cyanophlyctis oogonial proliferation may be independent of hypophysial hormones and show that recruitment of FGP and SGP oocytes can be induced in long term hypophysectomized frogs using PDH, PMSG, and HCG.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3979801 TI - Adipokinetic hormone-immunoreactive peptide in the endocrine and central nervous system of several insect species: a comparative immunocytochemical approach. AB - The distribution of intrinsic glandular cells containing adipokinetic hormone (AKH)-like material in the corpora cardiaca (CC) and the occurrence of immunoreactive neurons in the nervous system in 19 species belonging to nine insect orders was studied by means of an immunocytochemical method (peroxidase antiperoxidase), with antisera raised against an AKH analogue [( Tyr1]-AKH). The CC gland cells in Locusta migratoria migratorioides and Schistocerca americana gregaria were strongly immunoreactive. Those in other orders showed less or no immunoreactivity indicating that AKH has a very restricted distribution. Neurons containing immunoreactive material were found in the brain and ventral ganglia in all species investigated. As the specificity of the antiserum has not been determined, it is not known whether this peptide is identical to AKH. Considering the distribution of their axons, these neurons may be involved with one or more of the following functions: (1) nervous communication within the central nervous system; (2) communication with the stomatogastric nervous system; (3) possible release of peptide from the CC; (4) release of neuropeptide in or from the corpus allatum. A combination of these features has been found in only a few of the species investigated. The immunocytochemical study demonstrated significant differences among species belonging to Apterygota, Hemi-, and Holometabola in the number of neurons, the length and degree of branching of their axon, and the amount of immunoreactive peptide stored therein. PMID- 3979802 TI - An oviposition-stimulating factor in the male accessory reproductive gland of the locust, Locusta migratoria. AB - The data derived from mating experiments demonstrate that mating has an accelerating effect on oviposition in the female Locusta migratoria. The effect of mating could be mimicked by injection of extracts of the male accessory reproductive gland. The oviposition-stimulating factor was localized in the opalescent gland of the male accessory gland and was transferred to the female via the spermatophore during copulation. Gel filtration of an extract of the opalescent gland revealed a 13,000 Da protein, which, when injected into virgin female locusts, could stimulate the oviposition rate to that seen in mated females. Extracts of the corpus cardiacum also stimulated oviposition when injected into virgin female locusts. This increase was not observably different from that seen after mating. The relevance of these findings will be discussed. PMID- 3979803 TI - Effects of natural androgens and corticosteroids on gonad differentiation in the rainbow trout, Salmo gairdneri. AB - Rainbow trout fry were treated with equimolar quantities of cortisol, cortisone, androstenedione, and 11 beta-hydroxyandrostenedione, added to the aquarium water during a 4-week period. All four steroids inhibited ovarian growth. Androstenedione did not influence gonadal sex differentiation; the other steroids pushed the sex ratio in the male direction. However, a near to normal sex ratio was observed 300 days after the 11 beta-hydroxyandrostenedione treatment. When added to the food in two different doses during 8 weeks, 11 beta hydroxyandrostenedione had a pronounced masculinizing effect, and androstenedione did not modify the gonads at all. It is suggested that the two exogenous corticosteroids were probably converted into 11-oxygenated androstenedione derivatives, and that these 11-oxygenated androstenedione derivatives are particularly important in sustaining the differentiation and early development of the testes in rainbow trout. Testosterone does not seem to be indispensable for these processes, because two different doses of testosterone-blocking cyproterone acetate, added to the food for 8 weeks, failed to affect early gonad development. PMID- 3979804 TI - Identification and synthesis of [1-asparagine, 5-valine, 9-glycine] angiotensin I produced from plasma of American eel Anguilla rostrata. AB - The major peptide produced by incubation of American eel (Anguilla rostrata) plasma with the eel kidney extract was identified as [1-asparagine, 5-valine, 9 glycine] angiotensin I (I). Two minor peptides were also identified as [1 aspartic acid, 5-valine, 9-glycine] angiotensin I (II) and [5-valine, 9-glycine] angiotensin I-(3-10)-octapeptide (III). These structures were further confirmed by comparison of these peptides on high-pressure liquid chromatography (HPLC) and high-performance thin-layer chromatography (HPTLC) with the synthetic peptides and the tryptic and chymotryptic digests of the synthetic and natural angiotensins. In the rat pressor bioassays, the synthetic decapeptides I and II possessed 45.4 and 52.2%, respectively, of the pressor activity of [1-aspartic acid, 5-isoleucine] angiotensin II. The pressor activity of I and II was blocked with the converting enzyme inhibitor captopril. Study of the conversion of asparaginyl decapeptide into aspartyl decapeptide in eel plasma indicated that the presence of thimerosal (sodium ethylmercurithiosalicylate) in the incubation mixture inhibited the conversion of I into II. These results suggest that (a) I is the natural form of angiotensin inherent in the American eel while II may be formed during incubation with plasma; (b) eel plasma contains an enzyme which is capable of converting asparaginyl angiotensins into aspartyl angiotensins; and (c) pressor activity of I and II is due to their conversion into the corresponding octapeptides. In a previous work when thimerosal was not included in the incubation mixture, the major peptide produced by incubation of Japanese eel (Anguilla japonica) plasma with its kidney extract was identified as II. (Y. Hasegawa, T. Nakajima, and H. Sokabe, 1983, Biomed. Res. 4, 417-420). PMID- 3979805 TI - Hepatic estrogen receptors and plasma estrogen-binding activity in the Atlantic salmon. AB - Livers of male and female immature Atlantic Salmon (Salmo salar) contain specific high-affinity [3H]estradiol binding sites in cytosol (Kd 2-4 nM, concentration about 0.6 pmol/g liver). Low levels of high-affinity binding are detectable in salt extracts of nuclei of untreated fish, but injections of estradiol result in transient depletion of the cytosol binder and in accumulation of high levels of binding sites in nuclear salt extracts (Kd 5-6 nM; concentration about 6 pmol/g liver). Both the cytosol and nuclear binding sites are temperature sensitive and are optimally assayed by incubation at 2 degrees. Both are specific for estradiol and diethylstilbestrol (DES) and no significant competition by dihydrotestosterone (DHT), progesterone, or hydrocortisone is seen. The triphenylethylene nonsteroidal antiestrogen, 4-hydroxytamoxifen, exhibits an affinity comparable to that of estradiol. The nuclear binding activity sediments with a coefficient of 3.6 S in salt-containing sucrose density gradients, and is stable on storage at -20 degrees for several months. The cytosol binder on the other hand is not stable on sucrose density gradients or on prolonged storage. Salmon plasma contains two [3H]estradiol binding components, one with a relatively high affinity for [3H]estradiol (kd 13 nM) and the other having a much lower affinity but present in high concentrations. The high-affinity plasma binder exhibits distinctive specificity with no affinity for DES or 4 hydroxytamoxifen but some affinity for DHT and progesterone. These properties serve to distinguish the plasma activity from the intrahepatic estrogen binders. The salmon liver estrogen receptor system has many features in common with typical estradiol receptors from other vertebrates. Immature salmon liver appears to be the richest source of hepatic estrogen receptor so far found for any vitellogenic species. PMID- 3979806 TI - Properties of an in vitro bioassay for hypertrehalosemic hormone of Blaberus discoidalis cockroaches. AB - The ability of the fat body to respond to the hypertrehalosemic action of corpora cardiaca-allata (CC + CA) extracts was measured in vitro with tissue from adult, male Blaberus discoidalis cockroaches. Only trehalose increased in the hemolymph when gland extracts were injected in vivo; likewise, only trehalose levels responded when fat bodies were exposed to gland extracts in vitro. Although fat bodies from 0-day-old animals gave the least response to gland extracts, all animals 5 or more days old showed elevated responses. A linear dose-response occurred between 0.02 and 0.08 CC + CA pair. Fat bodies did not show an in vitro, hypertrehalosemic response to insulin, glucagon, proctolin, dopamine, epinephrine, norepinephrine, serotonin, octopamine, or tyramine. A strong hypertrehalosemic response was found to both synthetic adipokinetic hormone and red-pigment concentrating hormone; however, reversed-phase, thin-layer chromatography of CC + CA extracts and adipokinetic hormone indicated that the hypertrehalosemic effect and the adipokinetic hormone were separate. This in vitro system comprises a relatively rapid, simple, and accurate bioassay for the hypertrehalosemic neurohormone of insects. PMID- 3979807 TI - Effects of hypophysectomy and substitution with growth hormone, prolactin, and thyroxine on growth and deposition in juvenile frogs, Xenopus laevis. AB - Growth was studied in young metamorphosed frogs, Xenopus laevis, following hypophysectomy and substitution with mammalian growth hormone (bGH or pGH), mammalian prolactin (oPRL), and thyroxine. Hypophysectomy reduced growth (weight and length increase). GH and PRL proved equally efficient in restoring growth and in mobilizing energy stores (fat bodies and liver glycogen). No synergistic effects between GH and PRL could be observed. GH exerted its growth-promoting effects by increasing gross food conversion efficiency (weight increase/food intake), but did not stimulate appetite. Moderate GH doses given to a group of frogs in growth stagnation exerted moderate metabolic effects, and may have stimulated appetite in some animals, but did not increase body size significantly. Thyroxine was unable to promote growth, but increased mobilization of energy stores. Hypophysectomy and hormone substitution affected feeding behavior. The nature of the actions of pituitary somatotropic hormones and of thyroxine on growth and deposition is discussed. PMID- 3979808 TI - Annual variations of thyroid reactivity following thyrotropin stimulation and circulating levels of thyroid hormones in the frog Rana ridibunda. AB - Annual variations in plasma concentration and thyroid gland content of thyroid hormones were studied in male Rana ridibunda during 2 consecutive years together with in vitro capacity of the thyroid gland to release thyroxine (T4) following stimulation with bovine thyrotropin (b-TSH). A low thyroidal content of triiodothyronine (T3) (2-4 ng) and T4 (300-400 ng) is found during winter and increases rapidly after hibernation to maximal values of +/- 50 ng T3 and 2000 2500 ng T4 in May-July. Plasma levels of T3 vary between 10 and 15 pg/ml for all months studied except for a low of 5.4 and 5.7 pg/ml in December and March, respectively. Plasma concentrations of T4 are low in winter (100-200 pg/ml) but increase in January, reaching maximal levels in February-March (700-1000 pg/ml). In the first year levels decrease again until August (last observation month) to about 250 pg/ml, whereas in the second year this decrease is more sudden, reaching winter values of 100-200 pg/ml as early as May-June. Thereafter a second increase in plasma concentrations of T4 is observed again with maximal values of 800 pg/ml obtained in October. This biphasic circannual pattern, from two different observations, is also found in the in vitro T4 release capacity of the thyroid glands following stimulation with 100 mU of b-TSH. The maximal release capacity of the thyroid glands following stimulation with 100 mU of b-TSH. The maximal release capacity of the thyroids is present in March and July-August. Minimal release capacities are present in winter but also in April-June.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979810 TI - Some new observations on the binding of thyroxine and triiodothyronine to plasma proteins and lipoproteins in the domestic fowl. AB - In addition to the previously recognised thyroid hormone-binding proteins, three plasma components possibly involved in T3 and T4 transport have been identified in chicken plasma using gel filtration at pH 7.4. In mature female, though not male and immature female birds, a significant amount of T3 (11%) is bound to very low- and low-density lipoproteins. These could mediate transport of the hormone into the egg. Similarly vitellogenin appears to bind small quantities of both T3 and T4. Selective precipitation of the lipoproteins and vitellogenin from laying hen plasma produces a binding profile identical to that observed in male and juvenile female birds. Treatment of adult male birds with oestrogen induces a binding profile for T3 similar to that observed in adult females. Also a low molecular-mass protein (9 X 10(3) D) which preferentially binds thyroxine in substantial amounts (20-30%) was found in plasma from adult male and female and immature female birds. The technique employed allows detection of plasma thyroid hormone-binding proteins which have not previously been resolved by simple electrophoretic procedures. PMID- 3979809 TI - The course of steroid release by intact ovarian follicles of Atlantic salmon (Salmo salar) incubated in vitro with and without gonadotrophin. AB - Intact ovarian follicles were dissected from a single ovary and groups of follicles incubated in balanced saline at 6 degrees with and without a pacific salmon gonadotrophin (GTH) preparation. Aliquots of the incubation media were withdrawn at intervals, the steroids were extracted with solvent, and 17 alpha, 20 beta-dihydroxy-4-pregnen-3-one (17 alpha 20 beta P), 17 alpha hydroxyprogesterone, progesterone, androstenedione, testosterone, and oestradiol were separated chromatographically and measured by radioimmunoassay. The main findings were (1) germinal vesicle breakdown commenced on Day 8 under the influence of GTH, (2) after an induction period of about 2 days there was a dramatic and continuing release of 17 alpha 20 beta P in the presence of GTH, (3) GTH promoted a moderate release of 17 alpha-hydroxyprogesterone, (4) GTH stimulated testosterone release up to Day 6 but thereafter levels fell, reflecting either absorption or catabolism of the released steroid, (5) GTH induced a precipitous release of androstenedione during the first few hours of incubation, and (6) progesterone and oestradiol release were little affected by GTH. Steroid concentrations were also measured in ova stripped from naturally ovulating wild fish and the relative amounts were shown to bear some similarity to those released into the incubation medium in the presence of GTH. The routes of biosynthesis and functions of these steroids are considered in light of the results. PMID- 3979811 TI - Neurohypophyseal hormones as evolutionary tracers: identification of oxytocin, lysine vasopressin, and arginine vasopressin in two South American opossums (Didelphis marsupialis and Philander opossum). AB - The neurohypophyseal hormones of two South American opossums (Didelphis marsupialis and Philander opossum) were isolated by molecular sieving and preparative high-pressure liquid chromatography (HPLC). One oxytocin-like and two vasopressin-like peptides were found in each species. These peptides have been identified by their amino acid composition and by their retention time in HPLC. Oxytocin, lysine vasopressin, and arginine vasopressin have been characterized in both species. Lysine vasopressin is roughly as abundant as arginine vasopressin. Comparison is made with Australian marsupials Macropodidae and Phalangeridae, and possible evolutionary mechanisms are discussed. PMID- 3979812 TI - Mutagenesis in Caenorhabditis elegans. II. A spectrum of mutational events induced with 1500 r of gamma-radiation. AB - We previously established a gamma-ray dose-response curve for recessive lethal events (lethals) captured over the eT1 balancer. In this paper we analyze the nature of lethal events produced, with a frequency of 0.04 per eT1 region, at a dose of 1500 r. To do so, we developed a protocol that, in the absence of cytogenetics, allows balanced lethals to be analyzed for associated chromosomal rearrangements. A set of 35 lethal strains was chosen for the analysis. Although the dosage was relatively low, a large number of multiple-break events were observed. The fraction of lethals associated with rearrangements was found to be 0.76. Currently most X- and gamma-ray dosages used for mutagenesis in C. elegans are 6000-8000 r. From our data we conservatively estimated that 43% of rearrangements induced with 8000 r would be accompanied by additional chromosome breaks in the genome. With 1500 r the value was 5%. The 35 lethals studied were derived from 875 screened F1's. Among these lethals there were (1) at least two unc-36 duplications, (2) at least four translocations, (3) at least six deficiencies of chromosome V (these delete about 90% of the unc-60 to unc-42 region) and (4) several unanalyzed rearrangements. Thus, it is possible to recover desired rearrangements at reasonable rates with a dose of only 1500 r. We suggest that the levels of ionizing radiation employed in most published C. elegans studies are excessive and efforts should be made to use reduced levels in the future. PMID- 3979813 TI - Genetic mapping of Caenorhabditis elegans collagen genes using DNA polymorphisms as phenotypic markers. AB - In Caenorhabditis elegans collagens comprise a dispersed family of 40-150 genes, the majority of which probably code for collagen proteins found in the animal's cuticle. The conserved (Gly-X-Y)n triple helix coding sequence of collagen genes has facilitated the isolation of a large number of C. elegans collagen genes by recombinant DNA methods. We have begun a study of the chromosomal organization of these genes by screening laboratory strains of C. elegans for DNA polymorphisms in the regions surrounding collagen genes. Polymorphisms near seven genes have been identified and have been used as phenotypic markers in genetic crosses to assign the genes to linkage groups II, III, IV, and X. Four genes are shown by multifactor crosses to map to a 2-3 map unit interval between unc-24 and unc-22 on chromosome IV. PMID- 3979815 TI - Selection with partial selfing. I. Mass selection. AB - The expected responses to mass selection carried out before or after reproduction in a population whose members all have a fixed probability of self pollination (s) are formulated using covariances of relatives and their component quadratic functions for a model with arbitrary additive and dominance effects. The response measured in the first generation offspring after selection (immediate gain) can differ from that retained when the population has regained equilibrium (permanent gain). The population mean behaves in a predictable manner during the return to equilibrium, and its value at any time can be predicted from earlier generations. The permanent gain from selection after reproduction is always (1 + s)/2 times as large as that from selection before reproduction, but the relationship of the immediate gains depends on the genetic model assumed. Numerical analysis applied to a model with two alleles per locus and varying allele frequencies, dominance ratios and numbers of loci showed that the proportion of the immediate gain retained at equilibrium was reduced with the large inbreeding depression associated with increasing dominance levels and numbers of loci and was generally lower for selection after reproduction than before. In the absence of information as to the magnitude of genetic variances and inbreeding depression in species reproducing by partial selfing, the importance of this phenomenon is unknown. PMID- 3979814 TI - Variation in the major urinary protein multigene family in wild-derived mice. AB - The levels of expression and genomic organization of genes coding for the major urinary proteins (MUPs) were examined in several stocks of wild-derived mice. Levels of MUP mRNA in the liver varied considerably with M. musculus Brno and M. castaneus males having several-fold more MUP RNA than inbred C57BL/6 males, whereas M. hortulanus, M. caroli and M. cervicolor displayed levels much lower than C57BL/6. Analysis of RNA with MUP cDNAs specific to two different subfamilies of MUP genes revealed that M. caroli and M. cervicolor primarily expressed a MUP mRNA that was less abundant in C57BL/6, suggesting differential expression of subfamilies of genes within the MUP multigene complex. Although inbred males usually have five-fold more MUP mRNA than inbred females, male to female ratios for wild-derived stocks ranged from one to several hundred. Southern blots of genomic DNA hybridized to MUP subfamily probes revealed differences in restriction fragment sizes as well as possible variation in the number of MUP genes in some species. Analysis of urinary proteins from hybrids between C57BL/6 and M. spretus suggested that low MUP expression in M. spretus females was due to cis-acting genetic elements. PMID- 3979816 TI - Gene conversion at the gray locus of Sordaria fimicola: fit of the experimental data to a hybrid DNA model of recombination. AB - A hybrid DNA (hDNA) model of recombination has been algebraically formulated, which allows the prediction of frequencies of postmeiotic segregation and conversion of a given allele and their probability of being associated with a crossing over. The model considered is essentially the "Aviemore model." In contrast to some other interpretations of recombination, it states that gene conversion can only result from the repair of heteroduplex hDNA, with postmeiotic segregation resulting from unrepaired heteroduplexes. The model also postulates that crossing over always occurs distally to the initiation site of the hDNA. Eleven types of conversion and postmeiotic segregation with or without associated crossover were considered. Their theoretical frequencies are given by 11 linear equations with ten variables, four describing heteroduplex repair, four giving the probability of hDNA formation and its topological properties and two giving the probability that crossing over occurs at the left or right of the converting allele. Using the experimental data of Kitani and coworkers on conversion at the six best studied gray alleles of Sordaria fimicola, we found that the model considered fit the data at a P level above or very close (allele h4) to the 5% level of sampling error provided that the hDNA is partly asymmetric. The best fitting solutions are such that the hDNA has an equal probability of being formed on either chromatid or, alternatively, that both DNA strands have the same probability of acting as the invading strand during hDNA formation. The two mismatches corresponding to a given allele are repaired with different efficiencies. Optimal solutions are found if one allows for repair to be more efficient on the asymmetric hDNA than on the symmetric one. In the case of allele g1, our data imply that the direction of repair is nonrandom with respect to the strand on which it occurs. PMID- 3979817 TI - The sampling distribution of linkage disequilibrium under an infinite allele model without selection. AB - The sampling distributions of several statistics that measure the association of alleles on gametes (linkage disequilibrium) are estimated under a two-locus neutral infinite allele model using an efficient Monte Carlo method. An often used approximation for the mean squared linkage disequilibrium is shown to be inaccurate unless the proper statistical conditioning is used. The joint distribution of linkage disequilibrium and the allele frequencies in the sample is studied. This estimated joint distribution is sufficient for obtaining an approximate maximum likelihood estimate of C = 4Nc, where N is the population size and c is the recombination rate. It has been suggested that observations of high linkage disequilibrium might be a good basis for rejecting a neutral model in favor of a model in which natural selection maintains genetic variation. It is found that a single sample of chromosomes, examined at two loci cannot provide sufficient information for such a test if C less than 10, because with C this small, very high levels of linkage disequilibrium are not unexpected under the neutral model. In samples of size 50, it is found that, even when C is as large as 50, the distribution of linkage disequilibrium conditional on the allele frequencies is substantially different from the distribution when there is no linkage between the loci. When conditioned on the number of alleles at each locus in the sample, all of the sample statistics examined are nearly independent of theta = 4N mu, where mu is the neutral mutation rate. PMID- 3979819 TI - Cancer and AIDS. 19th annual San Francisco Cancer Symposium. San Francisco, Calif., March 2-4, 1984. PMID- 3979818 TI - Osteoporosis: protective measures of nutrition and exercise. AB - Postural correction and strengthening exercises should be prescribed--and we must be as particular about these prescriptions as we are about those for drugs. An ideal exercise program for an older osteoporotic patient can be easy to understand, simple to carry out, and safe. Add a calcium supplement if the dietary intake is inadequate. However, calcium alone can only prevent further bone reduction. It must be combined with exercise--ideally before menopause--to prevent bone loss and build up a "reserve" of bone mass. PMID- 3979820 TI - Kaposi's sarcoma: gastrointestinal manifestations. PMID- 3979821 TI - Kaposi's sarcoma in AIDS: the role of radiation therapy. PMID- 3979822 TI - Incidence of the acquired immunodeficiency syndrome in San Francisco. PMID- 3979823 TI - AIDS: prevention strategies. PMID- 3979824 TI - UCLA psychological study of AIDS. PMID- 3979825 TI - AIDS infection control precautions. PMID- 3979827 TI - AIDS and the general population. PMID- 3979826 TI - AIDS: the impact on the health care worker. PMID- 3979828 TI - Transfusion-associated AIDS. PMID- 3979830 TI - Neurological syndromes complicating AIDS. PMID- 3979829 TI - AIDS and Hodgkin's disease. PMID- 3979831 TI - Sessile macrophages forming clear endotheliumlike membrane on the inside of successful keratoprosthesis. AB - Clinical observation and cytological study of a successful "through and through" type of Cordona keratoprosthesis, which was removed along with a corneal button about 20 years after its implantation in an aphakic eye, revealed an acellular epitheliumlike film on its outer surface, firm anchoring of its supporting skirt by stable fibrous connections to the stroma, and a continuous separating membrane composed of a homogeneous proteinaceous film with fibroblastlike cells of macrophage origin on its inner surface. The significance of the successful adaptation of the plastic materials of the prosthesis to the tissues of the cornea and the fluid of the inner eye for the future of tissue engineering is discussed. PMID- 3979832 TI - Ultrastructural localization of retinal S-antigen in the rat. AB - Using a peroxidase-antiperoxidase immunohistochemical technique, the light and electron microscopical localization of retinal S-antigen was demonstrated in the rat retina, using antisera to bovine and guinea pig S-antigen. Comparable localization of S-antigen was observed with both antisera, although in our hands, the antiserum to bovine S-antigen gave more intense immunostaining. By light microscopy, the most intense immunoreactivity to retinal S-antigen was seen in the outer segment of the photoreceptor layer. Some immunostaining was also demonstrated surrounding the cell bodies of the outer nuclear layer. The inner segment of photoreceptors was virtually devoid of immunoreactivity. Ultrastructurally, immunoreactivity to S-antigen was demonstrated mainly on the inner surfaces of the visual discs of the rods. The plasma membranes of the outer segment of the rods were stained as well. Immunoreactivity surrounding the cell bodies of the outer nuclear layer was ultrastructurally localized on plasma membranes. The inner segment of the photoreceptor layer, other parts of the retina, or any eye structures other than retina showed no immunoreactivity. The relationship of retinal S-antigen to other cell components in the retina and the possible mechanisms of the autoimmune uveal diseases are discussed. PMID- 3979833 TI - Optic neuritis during lactation. AB - The condition called "lactation optic neuritis" has been previously considered a clinical entity of its own. Four women, who developed optic neuritis within 1-12 months while breast-feeding their infants, were investigated ophthalmologically and neurologically in order, to find specific clinical features for this condition. The course of the disorder was similar to classic optic neuritis without lactation. The clinical history and laboratory findings in three of the four patients suggested a demyelinating disorder. It is possible that the decreased immunosuppressive activity just after pregnancy induces the manifestation of an underlying demyelinating disease. The existence of "lactation optic neuritis," however, is questioned as a separate entity of its own. Lactation together with decreased immunosuppression may merely act as a provocateur in the onset of optic neuritis, which in many cases is the first clinical manifestation of incipient multiple sclerosis. PMID- 3979835 TI - Constricting retroretinal membranes associated with traumatic retinal detachments. AB - The author describes the clinical, autoptical, light microscopical and ultrastructural features of a particular type of retroretinal membrane in four eyes with total rhegmatogenous retinal detachment after severe anterior segment trauma. The membranes originate from defects of the most posterior pars plana at the site of disinsertions or detachments of the ciliary epithelium. From here they spread over parts of the whole posterior face of the detached retina encircling and constricting its folds. These formations are primarily composed of fibrin and secondarily become populated by macrophages, fibroblasts, pigment epithelial cells, as well as fibrous astrocytes, and finally are organized. The significance of such membranes for the therapy and prognosis of posttraumatic detachments is discussed. PMID- 3979834 TI - Is it possible to maintain a normal glutathione level in lenses in vitro? AB - In most types of experimentally induced cataracts, glutathione (GSH) content decreases considerably before the onset of opacity. GSH may provide a protective function for protein SH groups by scavenging oxidative products that may impair lens metabolism. To avoid impairment of lens metabolism by decreased levels of GSH it may be possible in vitro: (1) to stimulate GSH synthesis by enrichment of the incubation medium with the amino acids necessary for GSH synthesis or (2) to enrich the incubation medium with the tripeptide itself so that it can be taken up by the lens. Both approaches were investigated with bovine lenses. Lenses were incubated in pairs in a salt solution without carbohydrates, so as to deplete lens of GSH. Following starvation, one lens of each pair was incubated for recovery in TCM 199 enriched with MgSO4 and the three amino acids of GSH; the other lens was put into a freshly prepared salt solution. After 6 h, lenses from the recovery solution contained more GSH than the other lenses. Addition of fructose-1,6-diphosphate to the medium enhanced this effect. When, after starvation, lenses were incubated in the presence of different amounts of GSH, GSH lens content rose, with the highest in those lenses incubated in a medium with a final molarity of 4 X 10(-3) M GSH. Therefore, incubation of lenses depleted of GSH in medium with either the amino acids of GSH or GSH itself appear to facilitate recovery of GSH content. PMID- 3979836 TI - Heat and protease treatment of aqueous humor: effect on cell DNA synthesis and growth. AB - Rabbit skin and Tenon's capsule fibroblasts were cultured in media containing 20% rabbit aqueous humor as a stimulatory agent. Cell stimulation was quantitated by 3H-thymidine uptake. The aqueous humor was either: (1) untreated; (2) heated at 37 degrees C for 60 min; (3) boiled for 2 min; or (4) heated at 37 degrees C for 60 min with 0.025% trypsin, followed by boiling. The effects of the various treatments of aqueous humor on cell stimulation were compared among themselves and to 10% fetal bovine serum. It was found that: (1) heating of aqueous humor at 37 degrees C for up to 60 min had no apparent effect on its ability to stimulate DNA synthesis in culture; (2) boiling and trypsin plus boiling reduced the ability of 20% aqueous humor to promote thymidine uptake to varying degrees; (3) 20% untreated aqueous humor was more effective than 10% fetal bovine serum in stimulating DNA synthesis in Tenon's capsule fibroblasts; skin fibroblasts responded similarly to both media. PMID- 3979837 TI - An ultrasonographic study of choroidal indentation height after scleral buckling with lyophylized human tissues. AB - The height of the choroidal indentation produced by 26 lamellar scleral pockets filled with lyophylized human fascia lata and by 9 exoplants made up of lyophylized human dura mater was measured with A-scan and B-scan ultrasonography. The mean height of the choroidal indentation produced by lamellar scleral pockets was 4.3 mm 5-20 days postoperatively, 3.2 mm 3 months postoperatively, and 2.5 mm 6-9 months postoperatively. The mean height of the choroidal indentation produced by exoplants made up of dura mater was 4.6 mm 5-20 days postoperatively, 3.5 mm 3 months postoperatively, and 2.9 mm 6 months postoperatively. PMID- 3979838 TI - Ocular fluorophotometry. International symposium. Creteil, France, April 16-18, 1982. PMID- 3979839 TI - Calculation of the permeability of the blood-retinal barrier to fluorescein. AB - A method is presented, for calculation of the permeability of the blood-retinal barrier to fluorescein which is based upon simultaneous determination of the free fluorescein concentration in plasma and the fluorescein concentration profile in the vitreous body. By aid of a simplified mathematical model of the eye the blood retinal barrier permeability is calculated automatically on a computer from corresponding values of the fluorescein concentration in plasma and in the vitreous body. The present method eliminates some of the factors of uncertainty, which have been present in earlier applied fluorophotometric methods, thus contributing to increasing the exactness of the fluorophotometric method for the estimation of the permeability of the blood-retinal barrier to fluorescein. Apart from the permeability of the barrier, the diffusion coefficient for fluorescein in the vitreous body is also estimated by the present method. PMID- 3979841 TI - Measurement with fluorophotometry: I. Plasma binding. II. Anterior segment, and III. Aqueous humor flow. PMID- 3979840 TI - Action of prostaglandins on the dynamics of the aqueous humor. AB - Prostaglandins exercise different actions on the structures of the eye; among these is ocular hypertension. The mechanism by which ocular hypertension is provoked seems to be the breaking of the hematoaqueous barrier at the level of the iris and the ciliary processes. By fluorophotometry we studied the dynamics of the aqueous humor after topical administration of prostaglandin E-2 in rats. We observed an important reduction in flow that was interpreted as secondary to the increase in output resistance. PMID- 3979842 TI - Technical variables in vitreous fluorophotometry. AB - The technical variables that affect vitreous fluorophotometry are presented. Serum fluorescein pharmacokinetics are discussed with respect to early and late fluorescein appearance in the vitreous. The problem of axial resolution was analyzed systematically and parameters to minimize or eliminate choroidal fluorescence were defined. The timing of fluorophotometry and the effects of eye movement on fluorescein spread appear to be important factors. A vitreous diffusion model is presented that may minimize artifact introduced by these factors. PMID- 3979843 TI - Factors affecting vitreous fluorescence. AB - A variety of mechanical (intensity of the light source, the width and the angle of the exciting source) and physiological factors (retinal pigmentation, vitreous fluorescence) and many systemic factors affect the results of vitreous fluorophotometry. These factors are discussed with respect to identifying those that are inconsequential and those that are significant. Methods to compensate for the important factors are described. PMID- 3979844 TI - The spectrophtal: an instrument for ocular spectrophotometry and fluorophotometry. AB - We describe the technical characteristic of a new instrument, which is controlled by a microcomputer and is aimed at ocular spectrophotometric and fluorophotometric studies. We also discuss some practical applications. PMID- 3979845 TI - Design considerations for a fluorophotometer for ocular research. AB - Fluorometric studies have been made with modified slit-lamp microscopes. These instruments offered considerable versatility in modifying experimental parameters, but were seldom optimized in terms of detector and illuminator apertures, filter band-pass characteristics, detection system, light-source stabilization, or optical resolution. Improper control of these parameters can result in artifacts which override useful information. A new fluorophotometer for ocular research has been designed that utilizes an optical system, which eliminates the need for a contact lens. An effort was made to optimize both the axial resolution and the minimum detectable signal. The characteristics of standard barrier filters and excitation filters were examined and compared with photomultiplier sensitivity curves. It was necessary to use double filters in order to reduce artifacts due to excitation light that was not rejected by the barrier filter. In order to optimize the signal-to-noise ratio, a photon counting detection system was used. A dark current equivalent to 3 X 10(-10) g/ml allows a useful detection range of 1 X 10(-10) g/ml. PMID- 3979846 TI - Vitreous fluorophotometry in diabetics: study of artifactual contributions. AB - A vitreous fluorophotometry study was performed on normal and diabetic subjects, with particular emphasis on instrumentation characterization (calibration and detection characteristics, axial resolution and intraocular optics). The role of lens fluorescence and post-lenticular spread function was explored, as well as the role of retinal fluorescence and pre-retinal spread function. Their influence on vitreous readings is discussed and the study of artifactual contributions presented. PMID- 3979847 TI - Pharmacokinetic interpretation of kinetic vitreous fluorophotometry. AB - A refined mathematical model for interpretation of the data on fluorescein kinetics across the blood-vitreous barrier is presented. This model is better adapted to the geometry of the human eye and thus yields superior results. PMID- 3979848 TI - The performance of a new commercial ocular fluorophotometer in the clinical environment. AB - Studies using the Fluorotron Master fluorophotometer in vitro and in vivo are presented. The in vitro tests include lower limit of detection and error of measurement, and the in vivo tests include spread function, axial resolution, and reproducibility. Results show that many technical problems have been resolved by this system. Furthermore, this system can be satisfactory handled by technical personnel after short periods of training. PMID- 3979849 TI - Optimized protocol for Fluorotron Master. AB - The technical aspects of fluorophotometry equipment are presented. The sources of artifact are described and a protocol to optimize the use of the "Coherent Fluorotron Master" system is presented. The results of fluorophotometry studies on ten patients indicate that more accurate data evaluation can be achieved using this approach. PMID- 3979851 TI - Vitreous fluorophotometry recordings in posterior segment disease. AB - The results of vitreous fluorophotometry in a variety of retinal and systemic diseases are described, particularly in photoreceptor and retinal pigment epithelium dystrophies, in Best dystrophy, in choriocapillaris atrophy, in choroidemia and in inflammatory conditions, and in cystoid aphakic and non aphakic macular edema. The patterns involved in breakdown of the blood-retinal barrier are defined for various diseases, and an attempt is made to characterize each disease type by a fluorophotometric "profile." PMID- 3979850 TI - Vitreous fluorophotometry studies in retinitis pigmentosa. AB - Six patients with various genetic types of retinitis pigmentosa and ten carriers of the X-linked recessive type were studied by vitreous fluorophotometry. Kinetic vitreous fluorophotometry showed an alteration of the blood-retinal barrier (BRB) in patients with retinitis pigmentosa, even in those who had minimal fundoscopic abnormalities and only minor changes on the electroretinogram. Furthermore, an alteration of the BRB could be detected in the carriers of the X-linked recessive form of retinitis pigmentosa. In general, higher concentration of fluorescein in the vitreous correlated topographically with the extent of photoreceptor and retinal pigment epithelial disease, as well as with the presence of leakage from retinal capillaries. PMID- 3979853 TI - Diffusion of fluorescein in the corneal stroma. AB - Movement of fluorescein in the eye was simulated on the basis of a multiple compartment model, in which the cornea was divided into a series of cylindrical sleeves to allow 3-dimensional diffusion of fluorescein with rapid exchange at the limbus. If the dye was administered into the central 5 mm of the cornea, the loss at the limbus was found to be negligible in the early period but it became considerable later. The effect of fluorescein exchange at the limbus on the calculations of the dye transfer coefficients was estimated. Systematic errors in the fluorophotometric measurement of aqueous humor flow are discussed. PMID- 3979852 TI - Vitreous fluorophotometry studies in aphakia. AB - Vitreous fluorophotometry was performed on 63 patients undergoing cataract extraction. Pre- and postoperative studies demonstrated that this procedure always induces alterations in the blood-aqueous barrier. A correlation was found between the degree of this alteration and the frequency of cystoid macular edema. PMID- 3979855 TI - [Hygienic evaluation of purified industrial waste waters from an anilin dye plant]. PMID- 3979854 TI - Outward transport of fluorescein from the vitreous in normal human subjects. AB - Vitreous fluorophotometry was performed on eight normal subjects to compare the outward and inward permeabilities of fluorescein into the vitreous. The results indicate that diffusion alone does not account for the outward flow of fluorescein in the vitreous. The possible underlying factors and significance of these findings are discussed. PMID- 3979856 TI - [Sanitary-microbiological characteristics of South Atlantic seawater]. PMID- 3979857 TI - [Evaluation of emissions from civil aviation aircraft in the airport area]. PMID- 3979858 TI - [Predicting sanitary-chemical properties of polymers]. PMID- 3979859 TI - [Hygienic evaluation of new technological processes and equipment in chemical fiber production]. PMID- 3979861 TI - [Various socio-hygienic aspects of career choice by adolescents]. PMID- 3979860 TI - [Hygienic characteristics of lighting in compartments without windows]. PMID- 3979862 TI - [Psychological correction of career choice by adolescents during vocational consultation]. PMID- 3979863 TI - [Selection of surveillance areas in large industrial cities to determine the effect of atmospheric pollution on the health of the population]. PMID- 3979864 TI - [Food toxicology as a part of nutrition hygiene and a training course]. PMID- 3979865 TI - [Effectiveness of physical culture and sports as health-improving activities in a pioneer camp]. PMID- 3979866 TI - [Rapid photometric technic of determining ammonia in the air]. PMID- 3979867 TI - [Exacerbation of bronchial asthma as an indicator of air pollution]. PMID- 3979868 TI - [Detection of sulfolanes in sanitary-chemical analysis of textiles]. PMID- 3979869 TI - [Cartographic method of monitoring air pollution in the region]. PMID- 3979870 TI - [Gas-chromatographic analysis of aromatic amines in the air]. PMID- 3979871 TI - [Study of the bacterial population of distilled water]. PMID- 3979872 TI - [Method of hygienic evaluation of the microclimate in motor vehicles]. PMID- 3979874 TI - [Analysis of para-tert-butylphenol, phenol and diphenylpropane]. PMID- 3979873 TI - [Method of toxicological evaluation of polymers]. PMID- 3979875 TI - [Hygienic basis for evaluating total air pollution in populated areas]. PMID- 3979876 TI - [Evaluation of cumulative properties of harmful substances suggested by V.I. Tikhonov and V.K. Shitikov]. PMID- 3979877 TI - [Providing sanitary-epidemiological measures for improving the health of the rural population of the Donetsk district]. PMID- 3979878 TI - [Changes in morphological and functional states of X chromosomes after 1-phenyl-4 amino-5-chloropyridazone-6 poisoning]. PMID- 3979879 TI - [Protective role of forests in localizing emissions from industrial plants]. PMID- 3979880 TI - [Interrelations between health indicators in healthy and sick schoolchildren]. PMID- 3979881 TI - [Hygienic evaluation of daily schedules of older schoolchildren]. PMID- 3979882 TI - [Various hygienic aspects of home studies of schoolchildren]. PMID- 3979883 TI - [Extrapolation of electrostatic field values from animal studies to man]. PMID- 3979885 TI - [Effect of organotin compounds on lactate dehydrogenase isoenzyme content of the liver and blood serum of rats]. PMID- 3979884 TI - [Biological effects and hygienic evaluation of butylacrylate and methylmethacrylate as air pollutants in populated areas]. PMID- 3979886 TI - [Toxicity of copper phthalocyanine]. PMID- 3979887 TI - [Hygienic evaluation of working conditions in zinc hydrometallurgy]. PMID- 3979888 TI - Using the milieu: treatment-environment consistency. PMID- 3979889 TI - Future housing assistance policy for the elderly. PMID- 3979890 TI - What children see: the aged on television in Japan and the United States. PMID- 3979891 TI - Effects of television viewing on knowledge and attitudes about older adults: a critical reexamination. PMID- 3979892 TI - Alternative interpretations of aging among gay males. PMID- 3979893 TI - Patients' anticipation of stress in nursing home care. PMID- 3979894 TI - [Plastic surgery of acquired heart defects]. PMID- 3979895 TI - [Angiocardiographic diagnosis of main forms of total transposition of the great vessels]. PMID- 3979896 TI - [Problem of surgery of the lungs and pleura in children discussed in the journal "Grudnaia Khirurgiia"]. PMID- 3979897 TI - [Differentiated therapeutic tactics in acute suppurative destructive pneumonia in children]. PMID- 3979898 TI - [Surgical treatment of pulmonary emphysema]. PMID- 3979899 TI - [Pedunculated benign lung neoplasms]. PMID- 3979900 TI - [Hermetic sealing of bronchial fistulas under experimental and clinical conditions]. PMID- 3979901 TI - [Empyema after surgical treatment of bronchopulmonary cancer]. PMID- 3979902 TI - [Microtracheostomy in the treatment of chronic nonspecific lung diseases]. PMID- 3979904 TI - [Quantitative evaluation of embolism of the pulmonary vessels]. PMID- 3979903 TI - [Tumors and cysts of the mediastinum]. PMID- 3979905 TI - Ascitic fluid pH in alcoholic cirrhosis: a reevaluation of its use in the diagnosis of spontaneous bacterial peritonitis. AB - An ascitic fluid pH less than or equal to 7.31 has been advanced as being the best index in the early diagnosis of spontaneous bacterial peritonitis in cirrhotic patients. In order to test the validity of this criteria, 55 patients with alcoholic cirrhosis and ascites were studied. In each patient, arterial blood and ascitic fluid samples were analysed for pH, PCO2, total CO2 and PO2, and the pH gradient between blood and ascites was calculated. White blood cell and polymorphonuclear cell counts were determined in ascitic fluid, and cultures of ascites were done under aerobic and anaerobic conditions. Twelve patients had a culture proven spontaneous bacterial peritonitis. Their mean ascitic fluid pH (+/- SD) was 7.38 +/- 0.09 (range 7.21-7.49) and differed significantly (p less than 0.05) from that found in patients without spontaneous bacterial peritonitis: 7.44 +/- 0.06 (range 7.34-7.6.3). A marked overlap was observed, however, between the two groups, and only three out of the 12 patients with spontaneous bacterial peritonitis had an ascitic fluid pH less than or equal to 7.31. The pH gradient was 0.10 +/- 0.08 (range -0.01 to +0.28) in the spontaneous bacterial peritonitis group, as compared with 0.02 +/- 0.04 (range -0.09 to +0.12) in the sterile group (p less than 0.01), but a marked overlap was also noted between the two groups. In the spontaneous bacterial peritonitis group, the polymorphonuclear count was 3588 +/- 3849/microliter (range 60-11 776) versus 41 +/- 138/microliter (range 0 813) in the sterile group (p less than 0.0001). All but one patient in the spontaneous bacterial peritonitis group and only two patients in the sterile group had over 250 polymorphonuclear/ microliter. Thus, in our experience, neither the ascitic fluid pH nor the pH gradient values accurately discriminated the individual patients with and without spontaneous bacterial peritonitis. A polymorphonuclear count less than 250/ microliter remained the best criteria for the diagnosis of spontaneous bacterial peritonitis in cirrhotic patients, before having the results of ascitic fluid cultures. PMID- 3979906 TI - Oesophageal motor events at the occurrence of acid reflux and during endogenous acid exposure in healthy subjects and in patients with oesophagitis. AB - In order to assess the oesophageal motor events associated with the occurrence of gastro-oesophageal acid reflux and those during endogenous acid exposure, we studied six healthy subjects and nine patients with symptoms and lesions of reflux oesophagitis. In the case of each subject simultaneous pressure and pH measurements of the distal oesophagus were taken both in fasting conditions and after a standardised balanced meal. Reflux episodes occurred in the absence of a lower oesophageal sphincter relaxation (34.3%, 17.7%) or in the presence of a relaxation associated (34.2%, 30.8%) or unassociated (31.5%, 51.5%) with a peristaltic sequence, in the controls and patients respectively. No significant differences were found between the two groups. During endogenous acid perfusion the distal oesophagus showed mainly a peristaltic motor activity, but the mean hourly number of peristaltic sequences was significantly lower in the patients than in the controls (33.5 +/- 27.2 vs 81.5 +/- 3.2, p less than 0.01). Our results show that the mechanisms of reflux are similar in controls and in patients, while the peristaltic frequency is reduced in the latter. This motor failure may be responsible for the increased reflux duration observed in patients with oesophagitis. PMID- 3979907 TI - Relationship between gastric emptying of solids and gall bladder emptying in normal subjects. AB - Very little is known about the normal temporal and quantitative relationships between gastric emptying and gall bladder emptying. Using a non-invasive double isotope technique these relationships were investigated in 22 normal healthy adults. 99Tcm EHIDA was used as the biliary tracer and 113Inm labelled bran as the gastric content tracer. Gastric emptying was monoexponential with a t1/2 of 45 +/- 3 minutes (mean +/- SEM). In 15 subjects the gall bladder emptied in relation to eating according to a double exponential function. In these subjects 15.0 +/- 1.6% of gall bladder contents emptied before gastric emptying began. They could be further divided into two clear cut types (p less than 0.001), according to the ejection fraction at 10 minutes and the t1/2 of the first exponential. Emptying of the gall bladder was faster and more of its contents were ejected in subjects with a type I response (n = 9) than in subjects with a type II response (n = 6). In the remaining seven subjects the gall bladder began to empty spontaneously, unrelated to eating. These observations suggest that gall bladder emptying: (a) may have a cephalic phase, (b) can be expressed as a double exponential function, (c) may occur unrelated to eating, (d) which occurs only in relation to eating would appear to be either fast (type I) or slow (type II). PMID- 3979908 TI - Non-steroidal anti-inflammatory drugs and peptic ulcer perforation. AB - A retrospective study is reported in which the ingestion of non-steroidal anti inflammatory drugs (NSAID) in 269 patients with perforated peptic ulceration and 269 age/sex matched controls admitted between 1973-1982 was compared. A highly significant statistical difference was found (p less than 0.001) in those aged over 65. There was no statistical difference, however, in those aged under 65. Furthermore we have shown a highly statistically significant correlation (p less than 0.0001) between the annual number of patients aged over 65 with perforated peptic ulcers taking NSAID and the annual number of prescriptions issued for these drugs in the region. No such correlation was found for patients aged under 65 years. We suggest that the elderly especially women are unduly susceptible to NSAID associated peptic ulcer perforation, and discuss factors that may account for this. PMID- 3979909 TI - Uptake and subcellular localisation of bismuth in the gastrointestinal mucosa of rats after short term administration of colloidal bismuth subcitrate. AB - Despite the topical action of colloidal bismuth subcitrate in promoting the healing of peptic ulcers, slight absorption of bismuth from the gastrointestinal tract has been reported in colloidal bismuth subcitrate-treated animals and man. The uptake and subcellular distribution of bismuth by the gastrointestinal tract of rats after 24 hours of colloidal bismuth subcitrate administration was studied. Mucosal uptake of bismuth (mean +/- SEM nmol/g protein) by gastric fundus (8.85 +/- 1.0) and antrum (7.23 +/- 1.50) was similar, but was significantly less than duodenum (19.2 +/- 3.7, p less than 0.05), jejunum (26.9 +/- 2.4, p less than 0.001) or ileum (22.4 +/- 2.2, p less than 0.001). Bismuth concentrations in antral and duodenal mucosae fell progressively over 72 hours to approximately 10% of initial concentrations (p less than 0.02). Subcellular fractionation studies of colloidal bismuth subcitrate treated duodenal enterocytes showed a brush border membrane and cytosolic localisation. These data suggest that some gastrointestinal mucosal uptake of bismuth occurs in colloidal bismuth subcitrate treated rats. PMID- 3979910 TI - In vivo assessment of granulocyte migration to diseased bowel in Crohn's disease. AB - It has been suggested, on the basis of impaired granulocyte migration to skin windows, that there is a fundamental granulocyte defect in Crohn's disease. In vitro tests of granulocyte function have, however, failed to confirm this. We have studied granulocyte migration to inflamed bowel in Crohn's disease using a new approach which utilises dynamic gamma camera imaging after injection of 111In labelled autologous granulocytes. In 20 of 22 studies there was rapid migration to diseased bowel, compatible with no migration delay. Only two patients showed delays in migration of 12 and 15 minutes respectively, but neither had any clinical characteristics to distinguish them from the other 20 patients. This study shows that the majority of patients with Crohn's disease in relapse have rapid granulocyte migration to diseased bowel and provides evidence against a significant migration defect in this condition. PMID- 3979911 TI - Clinical evaluation of the histochemical diagnosis of Hirschsprung's disease. AB - The histochemical staining of suction rectal biopsies for acetylcholinesterase (AChE) activity is a safe and accurate diagnostic tool in the management of patients with symptoms and signs of Hirschsprung's disease. In this study 101 patients who have undergone AChE analysis of suction rectal biopsies are presented in order to correlate histochemical findings with subsequent clinical course after a minimum of 18 months follow up. There were no false positive results, but the limitations and problems associated with the technique which we have encountered are discussed. Equivocal, atypical, or negative results when contradicting clinical features are indications for repeat biopsy or full thickness biopsy, and awareness of the situations in which false negative results may occur is essential. PMID- 3979912 TI - Topical administration of 5-aminosalicylic acid enemas in patients with ulcerative colitis. Studies on rectal absorption and excretion. AB - 5-aminosalicylic acid (5-ASA) is a new treatment for patients suffering from ulcerative colitis but only limited information is available about its rectal absorption. We therefore studied seven patients with ulcerative colitis in remission, and five with active disease to determine acetylated and free 5-ASA plasma concentrations and urinary acetyl 5-ASA after the administration of three different types of enemas: (2 g 5-ASA/100 ml, 4 g/100 ml, and 200 ml). In patients in remission urinary acetyl 5-ASA excretion was dose and volume dependent (p less than 0.01; p less than 0.05) but this correlation was absent in active disease. Because aminosalicylates are usually eliminated through the kidney, these low values (10% in active disease and 19% in those in remission) suggest that the beneficial action may be local. Urinary recovery was significantly lower in patients with active disease (p less than 0.01; p less than 0.02). No accumulation of 5-ASA was found in plasma after repeated daily administration. PMID- 3979913 TI - Comparative radiological and morphological study of human pancreas. Pancreatitis like changes in postmortem ductograms and their morphological pattern. Possible implication for ERCP. AB - A postmortem study by ductography and histology was performed on 69 human pancreata with no clinical or histological signs of chronic pancreatitis. The ductograms, supplemented by five postmortem ductograms of chronic pancreatitis, were independently evaluated by six clinicians, skilled in ERCP; the degree of alteration was estimated by simple rating, forced choice rating, and by determination of the grade of chronic pancreatitis, Histologically, the amount of intraductal epithelial proliferation, periductal, intralobular and perilobular fibrosis, intraductal protein plugs, and fat necrosis was determined by semiquantitative methods. The six ductographical evaluations significantly differed in the level of their data, but corresponded in the range of distribution. All evaluations were correct regarding judgement of ductograms from patients with chronic pancreatitis. Ductograms of patients without chronic pancreatitis, however, were also frequently classified as chronic pancreatitis; overall 81% (minimal 37%, moderate 33%, severe 11%). This high level of false positive diagnosis indicates the frequency of pancreatitis like lesions in the main duct and its side branches in patients without chronic pancreatitis. Ductal lesions were significantly correlated with perilobular fibrosis. This finding favours the assumption, that in the non-inflamed pancreas, perilobular fibrosis plays a key-role in the development of ductal alterations, as in chronic pancreatitis. Perilobular fibrosis may result from intralobular inflammation caused by age-dependent intraductal epithelial hyperplasia. PMID- 3979914 TI - Lactitol in the treatment of chronic hepatic encephalopathy: an open comparison with lactulose. AB - Lactulose is currently the drug of choice for the treatment of hepatic encephalopathy. It is, however, only available as a syrup which is contaminated with other sugars. Consequently patients may express aversion to its excessively sweet taste and many experience nausea because of its hyperosmolarity. Lactitol is a disaccharide analogue of lactulose which can be produced as a pure crystalline powder with a low relative sweetness. Theoretically it should have the same therapeutic effects as lactulose but fewer side effects. Five patients with chronic hepatic encephalopathy on maintenance lactulose were monitored clinically, psychometrically, and by measurement of venous blood ammonia, electroencephalogram mean cycle frequency, and cerebral blood flow during three months treatment with lactulose and a similar period on lactitol. Lactitol was at least as efficacious as lactulose but was more acceptable because its cathartic effect was more predictable, its formulation was more convenient and its less sweet taste preferred. Lactitol is the ideal successor to lactulose for treatment of this condition. PMID- 3979916 TI - Types of pancreatitis. PMID- 3979917 TI - [Sex disorders in gynecologic practice: what can be done?]. PMID- 3979918 TI - [Optimal therapy of uterine cancer in a geriatric patient sample (operation versus irradiation)]. PMID- 3979915 TI - Citrate in oral rehydration therapy. PMID- 3979919 TI - [Early detection of gynecologic neoplasms: value of lactate dehydrogenase in vaginal secretions as a tumor marker]. PMID- 3979920 TI - ["Lower" gonorrhea in the female]. PMID- 3979921 TI - [Clinical aspects and therapy of "upper gonorrhea"]. PMID- 3979922 TI - [Genital Chlamydia infection in the female]. PMID- 3979923 TI - Effect of precursors on biosynthesis of monensins A and B. AB - Precursors of monensins (acetate, propionate, butyrate, isobutyrate) affect the total production and the relative proportion of monensins A and B. Addition of propionate into the fermentation medium causes a prevalence of monensin B whereas butyrate and isobutyrate stimulate the production of monensin A and suppress the production of monensin B. PMID- 3979924 TI - Antimicrobial activity of methyl esters and nitriles of 2-cyano-3-(5'-R-2' furyl)propenic acid. AB - Derivatives of 2-cyano-3-(2'-furyl)propenic acid with a markedly polarized double bond inhibit the growth of Chlorella pyrenoidosa, Saccharomyces cerevisiae, Candida albicans and Aspergillus niger at concentrations above 40 mumol/L. Their antibacterial activity (Escherichia coli B, Bacillus subtilis) is low. The biological effect increases with an increasing electron acceptor effect and decreasing hydrophobicity of the substituent on the furan ring. Substitution of methoxycarbony] group with cyano group in position 1 slightly increases the biological activity. PMID- 3979925 TI - Lysosomal enzyme activities in polymorphonuclear leukocytes, macrophages, serum, and spleen of conventional, germ-free, and antigen-free Minnesota miniature swine. AB - The activities of lysozyme, myeloperoxidase, and elastase were lower in PMNs and AMs from GF and AF Minnesota miniature piglets than in the leukocytes from their CONV counterparts. In the spleen and serum of gnotobiotic piglets only the levels of lysozyme were slightly reduced. Substantially depressed activities of these LEs were found also in PMNs from precolostral piglets in comparison with PMNs from their CONV mother. The bisassociation of GF piglets with Enterococcus liquefaciens and Escherichia coli caused an increase of LE activities in their AMs, spleens, and sera. Fewer LEs were released after phygocytic stimulation with zymosan from PMNs of GF, AF, and precolostral piglets than from PMNs of CONV animals of the same age. These data suggest that the antigenic-microbial stimulation is important for the development of normal lysosomal enzyme activities in PMNs and AMs from gnotobiotic animals. PMID- 3979927 TI - Intraindividual parameters of the singer's formant. PMID- 3979926 TI - On putative 'transpositions' in spelling. PMID- 3979929 TI - [Experiences with phoniatric rehabilitation in patients with a Staffieri neoglottis phonatoria]. PMID- 3979928 TI - [Male disposition for communication disorders]. PMID- 3979930 TI - Morphine levels in urine subsequent to poppy seed consumption. AB - Urine morphine levels after the consumption of poppy seeds were measured in two separate trials. Maximum levels of approximately 18 micrograms/ml were found using RIA, EMIT-ST and GC methodologies. Positive immunoassay results were seen up to 60 h post-ingestion. Several different lots of seeds from various sources were assayed for morphine and found to range from 4-200 mg/kg. Differentiation of poppy seed eaters from opiate users was not possible via the identification of minor alkaloid constituents of poppy seeds. It is, however, possible to analyse opiate urines with respect to 6-O-acetylmorphine. Below the level of approximately 5 micrograms/ml total opiates, GC/MS is the method of choice for this analysis. PMID- 3979931 TI - A method for investigating specialised accidents with special reference to diving. AB - This paper describes a format for the investigation of complicated accidents which result in diving deaths. It emphasises the necessity for communication between technical, medical and legal personnel to arrive at a reasoned appreciation of factors leading to an accident. Properly applied this can result in a meaningful accumulation of data, which can be periodically analysed and be used in formulating Regulations for prevention of further accidents. PMID- 3979932 TI - Drug levels found in cases of fatal self-poisoning. AB - A list of drug levels found in cases of fatal self-poisoning is presented here. These are all cases where only one drug was found and the cause of death in each case was attributed to an overdose of that particular drug. For each case a full drug screen was carried out. In general thin-layer chromatography (TLC) was used as the initial screening technique and any positive findings were then confirmed by gas liquid chromatography (GLC) and high performance liquid chromatography (HPLC). When the drug had been positively identified, the blood level was measured. PMID- 3979933 TI - Spontaneous rupture of the oesophagus. AB - A case of death due to spontaneous rupture of the oesophagus is reported. Few similar cases have been previously reported. In some the oesophageal wall had been weakened by previous ulceration or scarring. In this case there was no history or postmortem evidence of such damage. Under certain circumstances postmortem rupture of the oesophagus could occur and should be distinguished from antemortem rupture. PMID- 3979934 TI - [Andrologic aspects of in vitro fertilization]. PMID- 3979935 TI - [Treatment of renal osteopathy]. PMID- 3979936 TI - [Treatment of eczematous skin diseases with betamethasone 17-benzoate. Statistical evaluation of changes in selected symptoms using contingency tables]. PMID- 3979937 TI - [The Centre Nationale de la Recherche laboratory for occupational physiology investigates for a better quality of life. The French research institute with international recognition]. PMID- 3979938 TI - [Anthropogenic lead and cadmium burden in the human. Studies on skeletal and organ material]. PMID- 3979939 TI - [Mitoxantrone--a new cytostatic agent]. PMID- 3979940 TI - [Separation of somatic from psychosomatic medicine can be overcome. Suggestions for special-combining cooperation in medicine]. PMID- 3979941 TI - [Progressive supranuclear ophthalmoplegia--a clinical entity?]. AB - The syndrome of progressive supranuclear ophthalmoplegia (Richardson-Steele Olszewski-Syndrom) and its relation to other syndromes are discussed on the basis of a number of case histories and a survey of the pertinent literature. The validity of vertical ophthalmoplegia as a pathognomonic symptom is questioned. The main symptoms are as follows: the heightened tone of the neck muscles, as a rule combined with other indications of parkinsonism and an inclination to fall down. To varying degress there are also bulbar signs and subcortical dementia. Neuropathologically the syndrome can be classed with the "multiple system degeneration" group, on which little enough is known. It remains an open question whether the syndrom of Richardson-Steele-Olszewski is a syndrome of its own or whether it is just a variety of parkinsonism. PMID- 3979942 TI - [Opsoclonus and myoclonus syndrome. Clinical and electronystagmography findings with course studies]. AB - This review is based on the clinical experience with 7 patients and a total of 171 additional cases described in literature. Clinical features are presented of this "benign" cerebellar encephalopathy, which occurs preferably in association with viral infections, neuroblastomas or rarely carcinomas. Numerous descriptions of single cases stress a heterogeneous variety of other diseases which possibly may cause this syndrome. Special emphasis is put on the electronystagmographic documentation of eye movements with follow up of the spontaneous recovery over several years. The eye movement characteristics of opsoclonus allow for a clear differentiation from other forms of acquired ocular oscillations, such as ocular flutter, ocular dysmetria, square wave jerks, macro-saccadicoscillations, lightning eye movements, pendular nystagmus, obliquus superior myokymia and voluntary nystagmus. Differential diagnosis of the underlying diseases is particularly dependent on the age of onset. Histopathological findings as well as the hitherto suggested immunologic pathogenesis, therapeutic regimen and the prognosis are discussed critically on the basis of the literature. PMID- 3979943 TI - [Does the evaluation of affect crimes deal with a psychopathologic problem?]. AB - The reformulation of the sections 20, 21 StGB (concerning the defense of insanity in the German law) brought a renewed interest in the controversy about the disease concept and the assessment of responsibility in forensic psychiatry. Although the opinions of Kurt Schneider are still very influential, there are competing conceptions based on positions of normal psychology, social psychology or motivational psychology. The controversial issues are discussed and an integrating approach is proposed, though the psychopathological analysis is still regarded as the most important aspect. The question, whether one of the categories of the sections 20, 21 StGB is qualified and whether the intensity of the psychological disturbance indicates a reduced responsibility, must be answered regarding the empirical knowledge of mentally ill, abnormal and sane individuals. Instead of the former concept of disease, which was based on a known or postulated somatic pathology, a psychopathological system of reference for each category of the sections 20, 21 StGB has to be developed for the assessment of the disfunction during the offense. As an example, two catalogues of positive and negative criteria are proposed for the detection of a "profound disturbance of consciousness" in crimes of passion. PMID- 3979944 TI - The role of biopsy in the diagnosis of myocarditis. AB - Reference to the background of myocarditis since the early nineteenth century has been made to emphasize the problem of diagnosis of this condition which has been largely overcome by the introduction of the bioptome and morphological evaluation of the fresh endomyocardial biopsies obtained by these means. A definition and classification into active, healing and healed phases has been provided and constitutes a rational approach to therapy with corticosteroids and immunosuppressive agents. The observation that myocarditis is evident in biopsy tissue from patients suspected with dilated cardiomyopathy and additional virological and immunological investigations have shed light on a possible pathogenetic mechanism which in some patients with this condition is an infectious immunological process. In addition, when myocarditis in the active or early healing phases is found, it has been shown that therapy is beneficial to the patient. Myocarditis is also the initial morphological expression of endomyocardial disease associated with eosinophilia. The eosinophils are in addition morphologically abnormal in the form of degranulation. Examination of blood films and endomyocardial biopsies has defined the earliest form of this disease process and early treatment can also now be instituted. This up-to-date overview of our present state of knowledge has repeatedly demonstrated that biopsy examination in the diagnosis of myocarditis plays a vital role. PMID- 3979945 TI - [Histologically detectable myocarditis in patients with impaired left ventricular function]. AB - In patients with impaired left ventricular function in whom dilated cardiomyopathy is initially suspected after performance of comprehensive diagnostic studies, histologic evidence of myocarditis or status-post myocarditis is being documented with increasing frequency since the systematic use of endomyocardial biopsy has been incorporated into the work-up. This investigation was undertaken to analyze the histologic, clinical, hemodynamic and immunologic findings in these patients to delineate possible relationships between histologically-documented myocarditis and dilated cardiomyopathy. Incidence of histologically-documented myocarditis. In our patient population, 41 of 150 patients with impaired left ventricular function, the etiology of which had been unknown, histologic evidence of myocarditis was documented. In seven of eight in whom active myocarditis was diagnosed at initial biopsy, after a mean follow-up period of two years the histologic findings were consistent with dilated cardiomyopathy. In similar groups of patients comparable incidences of myocarditis have been reported by Parrillo et al. in 19 of 100 (19%) and Fenoglio et al. in 34 of 135 patients (25%). A higher incidence has been reported by Zee Cheng et al. in 22 of 35 patients (63%). Accordingly, pooled data indicate that the overall incidence of histologically-documented myocarditis was 30% in 528 patients initially suspected to have dilated cardiomyopathy. The variances in the incidence reported by the respective authors may be attributable to differences in the histologic definition of myocarditis, number of biopsies obtained, size of the patient population and the epidemiologically-related incidence of viral disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979946 TI - Immunosuppressive therapy in the management of biopsy proven acute myocarditis. AB - The effectiveness of immunosuppressive treatment in impeding rejection reactions after cardiac transplantation provided the impetus for the introduction of this form of therapy for myocarditis, a disease in which nearly-identical histologic findings are observed. The histologic findings of myocarditis may be present in a variety of disease entities. The clinical features of myocarditis range from an asymptomatic course to severe congestive heart failure and sudden cardiac death. Clinically, the disease may be suspected but establishment of the diagnosis with certainty is enabled only on the basis of histologic confirmation by means of endomyocardial biopsy, a safe and easily-performed procedure. The histologic criteria of myocarditis have been defined by international agreement. From serial biopsies, the initial findings can be differentiated as those of acute and borderline as well as healed myocarditis and those of follow-up biopsies as persistent, healing or healed forms. The basis for the use of immunosuppressive treatment in myocarditis was derived from laboratory studies demonstrating that, after a short initial phase, immunological pathomechanisms assume an essential role. Two clinical studies have indicated that immunosuppressive treatment may be of benefit in patients with myocarditis. The regimen employed is generally a combination of prednisolone and azathioprine for a period of six months. The initial dosage is 1.25 mg/kg prednisolone daily with reduction to 0.3 mg/kg and 2 mg/kg azathioprine daily modified, as necessary, according to the leukocyte count.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979947 TI - Bioassay of growth-stimulating activity of serum: comparison of lymphocyte and cartilage assays in normal and growth hormone-deficient children. AB - The somatomedin and/or growth-stimulating activity of serum from hypopituitary children and short children with normal growth hormone (GH) response to stimulation tests were studied using different bioassays: thymidine incorporation into human activated lymphocytes; sulfate incorporation into chick embryo cartilage; and simultaneous thymidine uptake into the same cartilages. The results showed that lymphocyte assay is highly sensitive to small amounts of serum and is GH-dependent in children with low GH secretion. On the contrary, the cartilage assays need higher serum concentration and their GH-dependence appears only in subjects with normal or low-normal GH secretion. The lack of correlation between the results of the three bioassays suggests that they measure both somatomedins and different serum factors involved in the regulation of growth. PMID- 3979948 TI - Virilization during pregnancy due to bilateral hyperthecosis. A case report. AB - A case of recurrent maternal virilization associated with bilateral hyperthecosis of the ovary during two pregnancies is described. In the first pregnancy, serum testosterone increased to the level of 12.5 nmol/l and in the second pregnancy to 35 nmol/l and after delivery to 66 nmol/l.5 months after the second birth the testosterone level was 2.7 nmol/l and virilization had spontaneously regressed. Puerperal stimulation tests with human menopausal or with human chorionic gonadotropin did not increase ovarian androgen production. Female babies were not virilized. PMID- 3979949 TI - Effects of alloxan-induced diabetes on dopaminergic receptors in rat striatum and anterior pituitary. AB - The binding of [3H]-spiroperidol after 4 weeks of hyperglycemia was determined in the rat striatum and anterior pituitary. Alloxan-induced diabetes increased the number of dopaminergic binding sites in the striatum but not in the anterior pituitary. The interaction of metoclopramide with striatal dopaminergic receptors was slightly modified, while that of dopamine, bromocriptine and haloperidol was unaffected. These results suggest that chronic hyperglycemia exerts selective effects on nigrostriatal dopaminergic system in the rat. PMID- 3979950 TI - Epidemiology and clinical impact of hepatitis D virus (delta) infection. AB - We tested sera collected between 1976 and 1984 from 362 persons in a variety of epidemiologic categories with acute and chronic hepatitis B and from 76 hemophiliacs and drug addicts with hepatitis B antibodies for hepatitis D markers. Hepatitis D markers were common in hemophiliacs, drug addicts, Afghanistanis, prisoners and hemodialysis patients; rare in persons from other hepatitis-B endemic areas, persons with sporadic hepatitis B and homosexual men; and absent in health-care workers and institutionalized mentally retarded persons. No change was observed in the frequency of this infection during the 9 years of this study. We found hepatitis D markers in 5% of patients with acute hepatitis B, 1 of 3 with fulminant hepatitis and in 4 (1 in a homosexual male) of 12 episodes of acute hepatitis in hepatitis B carriers. Hepatitis D markers were more frequent in chronic liver disease (18%) than in asymptomatic hepatitis B carriage (2%), but there was no association between severity of chronic hepatitis and hepatitis D. These findings indicate that, to date, health-care workers and institutionalized mentally retarded persons have been spared from infection with this agent but suggest that homosexual males may not continue to be spared. Even in an area nonendemic for hepatitis D, this agent contributed to 20 to 30% of chronic hepatitis B and acute hepatitis superimposed on chronic hepatitis B infection. PMID- 3979951 TI - The effects of colchicine and vinblastine on the biliary excretion of carcinoembryonic antigen. AB - The biliary output of carcinoembryonic antigen (CEA) in bile fistula rats following treatment with the microtubule poisons vinblastine and colchicine increased 3-fold over a 4-hr period. Cytochalasin B and the inactive colchicine derivative lumicolchicine had no effect. These treatments did not effect the rate of CEA clearance from the circulation. Biliary output of low molecular weight fragments from CEA degradation was decreased in the presence of colchicine and vinblastine. Mechanical obstruction of the bile duct for 3 days followed by relief of obstruction resulted in a 3-fold increased output of CEA into the bile. These results are consistent with a paracellular mechanism for CEA transport from blood to bile. Biliary duct obstruction and vinblastine and colchicine probably affect the permeability of junctional complexes between hepatocytes allowing CEA to penetrate more easily. PMID- 3979952 TI - Long-term maintenance of taurocholate uptake by adult rat hepatocytes co-cultured with a liver epithelial cell line. AB - Taurocholate (TC) uptake by adult rat hepatocytes co-cultured with other rat liver epithelial cells (RLEC) was studied comparatively to hepatocytes in primary culture. Cells were cultured on Petri dishes for desired times prior to measuring their ability to transport TC. TC uptake was linear for 150 sec in both culture conditions. In hepatocytes cultured alone, the initial rate of TC uptake at an extracellular concentration of 100 microM was 0.19 +/- 0.02 nmole per min per 10(6) cells after 48 hr of culture and decreased by 75% after 4 to 6 days. In hepatocytes co-cultured with RLEC, the rate of uptake at 48 hr (0.31 +/- 0.01 nmole per min per 10(6) cells) was significantly higher than in hepatocytes cultured alone (p less than 0.01); in addition, TC uptake remained stable at an average rate of 0.17 +/- 0.01 nmole per min per 10(6) cells for up to 56 days. No detectable uptake was found in RLEC cultured alone. TC uptake exhibited both saturable (Vmax = 0.30 +/- 0.03 nmole per min per 10(6) cells and Km = 42.6 +/- 4.4 microM) and nonsaturable components. These kinetic parameters were similar to those previously reported in isolated hepatocytes and in short-term cultured hepatocytes. TC uptake exhibited sodium dependence and was significantly reduced when extracellular sodium was replaced by lithium and sucrose, or in the presence of 1 mM ouabain. After 18 days of co-culture, TC uptake had qualitatively the same characteristics as at 48 hr, with a saturable and a nonsaturable component.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979953 TI - Endocytosis and binding of asialoorosomucoid by hepatocytes from rats with jejunoileal bypass. AB - Rats with jejunoileal bypass were used to study the biological activity of the hepatic binding protein. Hepatocytes were prepared 11 weeks after surgical procedure, and presence of asialoorosomucoid in serum has been determined. Compared to control rat hepatocytes, endocytosis of [3H]asialoorosomucoid by bypassed rat hepatocytes was decreased by about 60%. This was due to a decreased number of total and surface receptors. In most sera, an accumulation of asialoorosomucoid was found. A reduction of protein synthesis or turnover could be considered. PMID- 3979955 TI - Acetaminophen-induced hepatotoxic congestion in mice. AB - Acetaminophen-induced (750 mg per kg p.o.) hepatotoxicity in mice is characterized by hepatomegaly and massive centrilobular congestion which precede the appearance of necrosis. The vascular changes are correlated with the morphologic features using liver hemoglobin content to quantitate erythrocyte sequestration, and hematocrit measurements and 125I-albumin injections to determine plasma and blood volume. The initial increase in liver size was a result of plasma accumulation due to endocytic vacuolation of hepatocytes and Disse space enlargement in centrilobular regions. Further increases in liver size after 3 hr were a consequence of erythrocyte and additional plasma sequestration within the damaged liver. These events occurred without any increase in intrahepatic or portal venous pressure. Hepatic hemoglobin and plasma levels increased 10- and 5-fold, respectively, by 4.5 to 6 hr after administration of acetaminophen. There are two major consequences of acetaminophen-induced hepatotoxic congestion. First, blood and plasma volumes fell significantly, and we suggest that hypovolemic shock contributes to early mortality after acetaminophen. Second, impaired circulation within the congested liver, as manifested by reduced 125I-albumin entry into the liver when 125I-albumin was injected after congestion had developed, probably aggravates the initial injury. Early lesions were always evenly distributed around central veins. However, the pattern of damage at 24 hr could be variable. Occasional large confluent areas of necrosis were always congested, which is consistent with the concept that secondary ischemic damage can develop. Congestion and hypovolemia are reversible and can be largely prevented by administration of the protective compound N acetylcysteine (1,200 mg per kg p.o.) 3 hr after acetaminophen. PMID- 3979954 TI - Severe and progressive steatosis and focal necrosis in rat liver induced by continuous intragastric infusion of ethanol and low fat diet. AB - Blood alcohol levels (BAL) were maintained at high levels (overall mean +/- S.D. achieved in 14 alcoholic rats was 216.0 +/- 120.1 mg%) in male Wistar rats for 15 to 85 days by continuous intragastric infusion of ethanol and nutritionally defined low fat liquid diet. The ethanol intake was progressively increased from 32% of total calories up to 41.4% in order to maintain high BAL. Pair-fed animals received isocaloric glucose solution and the liquid diet. Despite the low level of dietary fat (4.9% of total calories), histopathological evaluation of the liver revealed severe and progressive fatty infiltration in the alcoholic rats. In addition, following 30 days of intoxication, one third of the animals showed focal necrosis with mononuclear cell infiltration in centrilobular areas of the livers. This was correlated with the markedly elevated levels of SGOT and SGPT in these animals. Pair-fed controls showed no abnormality in the morphology of liver or blood chemistry. Chemical quantitation of liver triglycerides confirmed the histological observation, with triglyceride levels of 61.51 +/- 16.45 and 89.61 +/- 5.94 mg per gm at 30 and 85 days, respectively. Most importantly, the degree of steatosis was tightly and significantly correlated with the mean BAL achieved (r = 0.80, p less than 0.001). These data represent the first confirmation of the hypothesis that continuously high BAL correlate with the severity of alcohol induced liver pathology. PMID- 3979956 TI - Respective roles of hypoxia and halothane metabolism in halothane-induced liver injury in rats. AB - To evaluate the respective roles of halothane metabolism and hypoxia in rats with halothane hepatotoxicity, experiments were designed with special reference to blood gas. After pretreatment with phenobarbital (80 mg per kg., i.p.) for four consecutive days, rats were exposed to 1.0% halothane under a mildly hypoxic condition (FiO2 = 14%) for 2 hr. Since halothane anesthesia caused significant decrease in PaO2 levels, rats exposed to a highly hypoxic atmosphere (FiO2 = 10%) in which PaO2 levels were comparable to those in the halothane group, served as the control. In the halothane group, marked centrilobular necrosis and elevation of SGPT activity were observed; neither significant histological lesions nor elevation of transaminase activity occurred in the highly hypoxic group. Although phenobarbital treatment did not decrease PaO2 levels during halothane anesthesia, the serum fluoride level, which appears to reflect quantitatively the reductive pathway of halothane metabolism, increased. These results strongly indicate that halothane metabolism rather than hypoxia, per se, plays a major role in development of halothane-induced liver injury in rats. PMID- 3979957 TI - Temporal relationship between hyperaldosteronism, sodium retention and ascites formation in rats with experimental cirrhosis. AB - To investigate the role of aldosterone in sodium retention and ascites in cirrhosis, the urinary sodium excretion, sodium balance and urinary excretion of aldosterone-18-glucuronide (UAldV) were serially measured in 11 rats undergoing cirrhosis induction with carbon tetrachloride (CT) and phenobarbital (CT rats) and in 10 control rats which received phenobarbital. All CT rats developed ascites, seven within the ninth week after starting the program and four within the 10th week. One week before the onset of ascites, CT rats and control rats were different with respect to sodium excretion (1.41 +/- 0.15 vs. 1.82 +/- 0.1 mEq per day), sodium balance (0.57 +/- 0.12 vs. 0.20 +/- 0.09 mEq per day) and UAldV (67.8 +/- 9.5 vs. 25.7 +/- 1.7 ng per day). These differences were more pronounced within the week in which ascites was detected in CT rats. Before these 2 weeks, both groups did not differ with respect to these parameters. In the 132 urine samples obtained in CT rats, there was a correlation between sodium excretion and UAldV (r = -0.53; p less than 0.001). Twenty-one additional CT rats were divided into two groups. Eleven animals were given spironolactone (20 mg per day s.c. in olive oil) from the 6th week, and 10 only received olive oil. Thirteen weeks after starting the program, all rats not treated with spironolactone had sodium retention and ascites (in five rats, ascites appeared within the ninth week and in five within the tenth week); this occurred in only one animal treated with spironolactone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3979958 TI - Ascitic fluid chemical analysis before, during and after spontaneous bacterial peritonitis. AB - A retrospective analysis of 22 patients whose ascitic fluid had been analyzed prior to the onset of spontaneous bacterial peritonitis, during infection and/or after treatment of peritonitis revealed that neither the ascitic fluid total protein nor the absolute ascitic fluid glucose changed during the infection or after treatment of the infection although the ascitic fluid/serum glucose ratio did decrease (p less than 0.001) with infection. The ascitic fluid lactate dehydrogenase increased significantly (p less than 0.05) during infection compared to the baseline value. Contrary to the typical findings in infected body fluids, the total protein content and absolute glucose content of "spontaneously" infected ascitic fluid do not measurably change. PMID- 3979959 TI - Aldehyde dehydrogenase in alcoholic subjects. AB - Hepatic aldehyde dehydrogenase activity is depressed in alcoholic liver disease and may account for the observation that alcoholics develop high blood acetaldehyde concentrations following ethanol. To determine whether this is a specific defect in alcoholics, aldehyde dehydrogenase was studied in liver tissue obtained from three groups of subjects. Group I comprised 30 patients with alcoholic liver disease, Group II consisted of eight subjects with liver disease unrelated to alcohol abuse and Group III was a control group of 10 individuals with no significant liver disease. Mean hepatic aldehyde dehydrogenase activity was significantly lower in Group I than in Groups II or III [4.9 +/- 0.6 (mean +/ S.E.), compared to 10.2 +/- 1.8 and 12.4 +/- 1.1 nmoles of acetaldehyde oxidized per min X mg of protein, respectively]. Aldehyde dehydrogenase activity in Group II was relatively well maintained. Aldehyde dehydrogenase activity was found in cytosolic and mitochondrial fractions of liver homogenates. In alcoholic subjects, cytosolic aldehyde dehydrogenase activity was not more depressed than was mitochondrial aldehyde dehydrogenase. Isoelectric focusing demonstrated a single mitochondrial isoenzyme and a single cytosolic isoenzyme in most cases in Group III. In contrast, multiple cytosolic isoenzymes were consistently found in liver tissue from Group I subjects. These findings suggest that depressed aldehyde dehydrogenase activity in alcoholic subjects is not a consequence of liver disease. PMID- 3979960 TI - The liver in the acquired immunodeficiency syndrome: a clinical and histologic study. AB - We reviewed the clinical data and hepatic histologic findings of 25 patients with the acquired immunodeficiency syndrome who underwent 29 liver biopsies. Our experience indicates that the only hepatic feature characteristic of acquired immunodeficiency syndrome is serologic evidence of exposure to the hepatitis B virus. The most common histologic finding was macrovesicular steatosis. Granulomas appeared in seven patients and were due to mycobacterial disease (3 patients), histoplasmosis (1 patient), adverse reaction to sulfonamide (2 patients) and unknown causes (1 patient). The clinical indication for liver biopsy was not significantly different in the patients without or with granulomas or with granulomas secondary to mycobacteria or fungi. Mycobacteria were cultured from all histologically positive specimens and one histologically negative specimen. Liver biopsy should be performed in any patient with acquired immunodeficiency syndrome who has unexplained fever, hepatomegaly or abnormal results of serum biochemical liver tests, and all specimens should be stained and cultured for mycobacteria and fungi. PMID- 3979961 TI - Viral hepatitis in Colombia: a study of the "hepatitis of the Sierra Nevada de Santa Marta". AB - The prevalences of hepatitis B virus (HBV), hepatitis delta virus and hepatitis A virus infections were studied in two regions of Colombia. In Bogota, 10 of 53 patients with acute hepatitis were HBsAg positive and three of these were hepatitis D antigen positive. Hepatitis A virus was the major cause of acute hepatitis in this group. In 366 healthy controls from Bogota, 1.6% were HBsAg positive and 7.1% had at least one marker of HBV infection. In northern Colombia, individuals from three villages with outbreaks of the fulminant "hepatitis of the Sierra Nevada de Santa Marta" were tested. The prevalences of HBsAg (1.8 to 23%) and HBV infection (35 to 93%) were generally high and varied from village to village; 60% of the HBsAg carriers in one village were positive for antibody to hepatitis D antigen, and two individuals in the outbreak area had circulating hepatitis D antigen. The findings suggest that HBV and the associated hepatitis delta virus are etiologic factors in the "hepatitis of the Sierra Nevada de Santa Marta." PMID- 3979962 TI - The effect of cimetidine on hepatic drug elimination in cirrhosis. AB - Both cimetidine therapy and cirrhosis individually interfere with normal elimination of various drugs. Cimetidine is often prescribed in patients with cirrhosis but there is incomplete data on its effect on drug elimination in cirrhotics. The purpose of this study was to address this issue. Eight stable cirrhotics were studied prior to and following 7 days of cimetidine administration, (300 mg orally q.i.d.). Chlordiazepoxide (Librium), which is eliminated by the liver after demethylation, and indocyanine green, which is removed by the liver without biotransformation, were used as probes. Consistent with the concept that cimetidine interferes with drug metabolism by inhibiting microsomal oxidation, chlordiazepoxide clearance in the cirrhotics was inhibited by cimetidine (p less than 0.05), but indocyanine green clearance was unaffected. As shown by us previously (Roberts, R. K. et al., Gastroenterology 1978; 75:479 485), untreated cirrhotics had substantially lower chlordiazepoxide clearance than did controls. The inhibitory effect of cimetidine on chlordiazepoxide clearance was less in cirrhotics than in controls (p less than 0.05). In all subjects, there was excellent correlation between initial clearance and magnitude of depression in clearance after cimetidine, i.e., the larger the initial clearance, the larger the change (r = 0.97, p less than 0.0001). Forty-eight hours after stopping cimetidine, chlordiazepoxide clearance returned to baseline in cirrhotics and controls. Our data demonstrate that cimetidine and cirrhosis may act additively to impair drug metabolism. This effect of cimetidine on chlordiazepoxide clearance is smaller in cirrhotics than in controls, but, because of impaired initial drug elimination in cirrhosis, it may result in adverse clinical effects. PMID- 3979963 TI - Effects of phenobarbital on bilirubin metabolism and its response to phototherapy in the jaundiced Gunn rat. AB - Jaundiced Gunn rats, treated with phenobarbital (60 mg per kg i.p. for 7 to 10 days) showed 25 and 36% decreases in mean plasma bilirubin levels in two experiments (p less than 0.01). Kinetic studies with tracer 14C-bilirubin revealed that there was no change in bilirubin turnover or total pool size due to phenobarbital, but a 49% increase in the hepatic pool and a 27% decrease in the cutaneous pool of bilirubin. The increase in the hepatic pool accounted for over 90% of the bilirubin lost from the plasma. Such pretreatment with phenobarbital did not alter the decline in plasma bilirubin or total bilirubin pool due to subsequent phototherapy. Phenobarbital followed by phototherapy produced a significantly greater reduction in plasma bilirubin levels than either treatment alone. These studies demonstrate that phenobarbital does decrease plasma bilirubin in Gunn rats primarily by shifting the pigment to the liver, and suggests that combined treatment with phenobarbital and phototherapy might be of value in patients with congenital hyperbilirubinemia due to glucuronyl transferase deficiency. PMID- 3979965 TI - Hypercarnitinemia in cirrhosis. PMID- 3979964 TI - Preliminary observation of hepatitis B-associated membranous glomerulonephritis treated with leukocyte interferon. PMID- 3979966 TI - Blood-brain barrier permeability to gamma-aminobutyric acid in hepatic encephalopathy. PMID- 3979967 TI - Malignant histiocytosis. Report of twenty-five cases with pulmonary, renal and/or gastro-intestinal involvement. AB - Recent papers have shown that malignant histiocytosis (MH) can be well controlled if the disease is diagnosed early and treated intensely. Previous reports proposed the usefulness of lymph nodes and liver biopsy or bone marrow aspiration in making a diagnosis of MH, but even when a combination of these three procedures was used, between 24 and 61% of patients with MH could not be correctly diagnosed. In the present study, clinical and autopsy findings in 25 patients with MH were reviewed to identify possible alternative diagnostic sites to lymph nodes, liver or bone marrow. Clinical symptoms were observed in the respiratory (40%) and gastro-intestinal (48%) tracts. Proteinuria was also frequently identified (60%). Autopsy findings showed that involvement of lung, stomach and small intestine, and kidney by atypical histiocytes were present in 100% of patients with respiratory symptoms, 85% of those with abdominal symptoms and 80% of those with proteinuria, respectively. From the analysis of this pattern of histiocytic infiltration, lung, renal, gastric or jejunal biopsies are demonstrated as sites for the diagnosis of MH. PMID- 3979968 TI - Steroid hormone influences on the mating behavior of vervet monkeys (Cercopithecus aethiops). AB - Eight ovariectomized female vervet monkeys (Cercopithecus aethiops) were tested in heterosexual and isosexual pairs, under estradiol and testosterone treatments. Pairs were tested under two different experimental situations in which the male was either restrained or left free. There were only small behavioral changes across the treatments, involving mainly male responses. Erection time, frequency of intromission, ejaculation, and olfactory investigation increased during estradiol treatment whereas during administration of testosterone erection time, the number of approaches, contacts, and olfactory investigations decreased. Female behaviors were relatively independent of hormone treatment showing only the disappearance of negative responses with estradiol and an increase of yawns with testosterone. Female behaviors were performed at a higher level with male partners than with other females, and the frequencies of spontaneous presents varied with the sex of partner. It is suggested that in vervet monkeys both estradiol and testosterone affect female attractivity, estradiol further influences receptivity, whereas proceptivity appears to be less directly involved in sexual interactions and more related to social context. PMID- 3979969 TI - Effects of testosterone on ontogeny of urinary behavior in male and female dogs. AB - Development of urinary behavior from birth to adulthood was observed in six groups of beagles including normal males (NM), normal females (NF), males castrated soon after birth (CM), males castrated soon after birth and treated with testosterone (T) for the next 90 days (CMT), females exposed to T in utero (FTU), and females exposed to T in utero and during infancy, i.e., the first 30 40 days postpartum (FTUI). Prenatal treatment with T had masculinizing effects on juvenile urinary behavior in FTU and FTUI. On the other hand normal development of fully adult masculine urinary patterns in males and females necessitated both prenatal and postnatal androgenic stimulation. It was not necessary that T be present at the time the overt behavior developed. For example, adult male behavior appeared in FTUI at the same time as in NM, i.e., 6-10 months, although the supply of exogenous androgen in FTUI had been exhausted within 30-40 days after birth. CMT showed precocious development of all components of the adult male pattern. Development of adult responses was markedly retarded in most CM, and their performance did not equal that of NM at 23 months. They were then injected with TP which promptly evoked completely normal male urinary behavior. It is tentatively concluded that T acting before birth and during the juvenile period "prepares" critical CNS mechanisms so that when general maturation reaches the appropriate point adult male behavior develops. Although the preparatory role of T is essential, the behavior is not dependent on T after it has developed. PMID- 3979970 TI - Duration of hormonal deprivation: influences on physiological and behavioral responsiveness to estradiol. AB - A total of 54 ovariectomized female guinea pigs were divided into three groups and tested six times at 2-week intervals for their responsiveness to exogenous ovarian hormones (3 days of 4 micrograms/kg estradiol benzoate plus 1 day of 0.4 mg/kg progesterone) or control injections (0.2 ml oil vehicle). Two weeks after ovariectomy, treatment with estradiol significantly reduced food intake and body weight, and also produced vaginal membrane rupture in 98.1% of the females. When tested for sexual behavior at 4, 6, and 8 hr after the progesterone injection, 29 of the subjects (53.7%) displayed lordosis in response to manual stimulation. Twelve weeks after ovariectomy, the effects of estradiol on food intake, body weight, and vaginal membrane condition had not diminished. However, the overall proportion of females from which lordosis could be elicited declined to 27.8%. Biweekly injections of estradiol benzoate plus progesterone to one of the groups of females did not prevent this decline in the sexual response. Based on these results, it was concluded that the observed reduction in behavioral lordosis does not represent a general decline in the responsiveness of ovariectomized guinea pigs to estrogenic stimulation, but may involve changes in their responsiveness to progesterone or in other mechanisms more specifically associated with sexual behavior. PMID- 3979971 TI - Does neonatal gonadectomy affect the sexual differentiation of quail? AB - This experiment was designed to determine the contribution, if any, of posthatching gonadal hormones to sexual differentiation of behavior in Japanese quail (Coturnix coturnix japonica). Males and females were gonadectomized or sham operated (controls) prior to age 7 days posthatching. At age 4-9 weeks controls were gonadectomized. All birds were then given 2 weeks of testosterone propionate injections and tested for sexual behavior with female partners. Neonatally gonadectomized females exhibited more male-typical copulatory behavior than control females, but this effect was not statistically significant. Neonatal gonadectomy had no effect on males, and neonatally gonadectomized males exhibited significantly more male-typical copulatory behavior than neonatally gonadectomized females. Although the process of sexual differentiation may extend to a minor degree into the posthatching period in females, nonetheless it is largely complete at hatching in this species. PMID- 3979973 TI - The prison of mental disability. PMID- 3979972 TI - Naltrexone facilitation of sexual receptivity in the rat. AB - Naltrexone hydrochloride (3mg/kg) facilitated sexual receptivity in ovariectomized female rats given estradiol benzoate 44 hr previously. The latency of naltrexone facilitation is 3 hr, which is similar to that by progesterone. Other doses of naltrexone (1 and 5 mg/kg) were ineffective. Unlike the effect of progesterone, the facilitation of behavior by naltrexone is not blocked by the protein synthesis inhibitor anisomycin. Naltrexone facilitation was blocked by pargyline, a monoamine oxidase inhibitor. PMID- 3979974 TI - Examining the application of the guilty but mentally ill verdict in Michigan. AB - The insanity defense has come under increased criticism after the highly publicized acquittal of John Hinckley, Jr. A variety of proposals have been suggested to rectify the perceived injustices of an insanity acquittal. In 1975 Michigan passed a guilty but mentally ill statute that allowed for individuals to be found mentally ill at the time of the offense but still criminally responsible for their actions. The authors review the history of the Michigan statute, scrutinize an empirical study of the statute's effectiveness, and debate a number of controversial issues. They suggest that guilty but mentally ill may be a misleading verdict established because of purely political motives. PMID- 3979975 TI - The obviously ill patient in need of treatment: a fourth standard for civil commitment. AB - The three relatively standard criteria currently contained in most state civil commitment laws (danger to self, danger to others, and gravely disabled) have forced many obviously ill patients to deteriorate to the point of dangerousness before receiving treatment, to become criminalized, or to wander the streets untreated. After discussing the origins of present civil commitment laws and the plight of obviously ill patients, the author details the cooperative effort of several groups in Wisconsin to codify a fourth standard for civil commitment that would ensure that obviously ill patients receive treatment with proper procedural and due process safeguards. Other statutory alternatives to remedy the plight of obviously ill patients are also discussed. PMID- 3979976 TI - Commitment to outpatient treatment: a national survey. AB - State mental health directors and state attorneys general were surveyed on the use of outpatient commitment in their states. The survey found considerable disagreement between the two groups on responses to several of the items, including whether outpatient commitment was even permitted in their states. The responses also indicated that two-thirds of the jurisdictions that permit outpatient commitment use it as an alternative to inpatient commitment in fewer than 5 percent of commitments. The author concludes that unless states obtain more input from both inpatient and outpatient clinicians in devising procedures for outpatient commitment, it will continue to be underutilized and ineffective. PMID- 3979977 TI - Treatment planning for the patient who is incompetent to stand trial. AB - National attention has focused on criminal defendants who plead not guilty by reason of insanity, but the insanity defense is rarely successful. A far larger number of criminal defendants, estimated at 9,000 annually, are admitted for forensic and civil hospitals because they are found incompetent to stand trial. Once hospitalized, many of these defendants face the likelihood of indefinite commitment. This paper discusses issues related to he concept of incompetency to stand trial and presents an approach to treatment planning and programming designed to restore patients to competency. PMID- 3979978 TI - The chronic mentally ill and the criminal justice system: when to call the police. AB - Certain mentally ill patients who repetitively commit minor crimes as part of their lifestyle rather than because of psychotic thinking are best managed by a cooperative effort between the criminal justice and the mental health systems. This effort, which is based on the belief that such patients should be dealt with as any other responsible citizen who commits a crime, involves educating and supporting the patients, the patients' families, and criminal justice professionals throughout the entire judicial process. The involvement of the criminal justice system is not a substitute for treatment by the mental health system, nor should arrest or incarceration be used simply because mental health treatment is unavailable. PMID- 3979979 TI - Atypical depression: a review of diagnosis and treatment. AB - The diagnosis of atypical depression has been used in a variety of ways in the psychiatric literature. The authors review the different uses of the term and then examine the syndrome's capacity to reliably predict course of illness, family prevalence, biological test date, and response to treatment. They conclude that as a diagnosis, atypical depression is misleading and does not describe a discrete or homogeneous group of patients. However, the literature on atypical depression has been extremely important in identifying patients for whom pharmacological intervention may be of great benefit and for whom it has been underutilized in the past. PMID- 3979980 TI - A retrospective study of alcohol use by VA psychiatric inpatients. AB - Psychiatric inpatients are prone to the use of alcohol, often in attempts to self medicate. A retrospective review of patient records in a Veterans Administration neuropsychiatric facility identified 28 patients for whom use of alcohol was documented while they were in the hospital; the number of episodes totaled 47. The patients tended to be young and unmarried and to have a diagnosis of schizophrenia. The study found a trend toward underreporting of alcohol use by hospitalized patients because staff believe it to be an accepted part of adult life in American society. Possibly because staff do not identify alcohol use as a serious problem for psychiatric inpatients, it is not considered in treatment planning. The authors conclude with recommendations for management of inpatients who use alcohol. PMID- 3979981 TI - The reliability of psychiatric diagnosis in the emergency room. AB - The authors compared the diagnoses made for 50 patients in an emergency room with those made during a subsequent inpatient hospitalization. They found an acceptable level of reliability for broad diagnostic categories, such as psychosis, depression, and alcoholism. The authors believe such diagnostic reliability is sufficient for emergency assessment and triage. However, the diagnosis of more specific subtypes of mental illness, such as schizophrenia and bipolar disorder, were not made reliably in the emergency room. The authors point out the risk of diagnostic labeling, and suggest that the tendency to overlook nonalcoholic substance abuse deserves special attention. PMID- 3979982 TI - The impaired physician movement: an interim report. AB - The impaired physician movement gained prominence in 1972 with the American Medical Association (AMA) council on mental health report entitled The Sick Physician. The movement grew as a necessary reaction to the conflicts inherent in the healing profession's attempt to heal its own members. The author traces the growth of the impaired physician movement, highlighting the contributions that the AMA, the American Psychiatric Association, and students of physician suicide have made to the laws and programs now in existence. Problems faced by the movement, areas requiring further efforts, such as restoration of the physician to practice, and the outlook for the future are also discussed. PMID- 3979983 TI - Unusual erectile activity as a side effect of trazodone. PMID- 3979984 TI - The impact of life events on chronic mental patients. PMID- 3979985 TI - Motivation among forensic patients facing trial. PMID- 3979986 TI - Celebrating a vital resource. PMID- 3979987 TI - Hospitals more interested in incentives. PMID- 3979988 TI - Network drawing employers to Seattle PPO. PMID- 3979989 TI - Mental health centers now able to compare staffing, service costs. PMID- 3979990 TI - Executive succession: who decides? PMID- 3979991 TI - Downsizing without layoffs. PMID- 3979992 TI - How do consumers receive local health care information? PMID- 3979993 TI - A legacy of challenge and competition. Interview by Emily Friedman. PMID- 3979995 TI - Hospital economic forecast. PMID- 3979994 TI - Will health care delivery and insurance merge?. Interview by Emily Friedman. PMID- 3979997 TI - Small hospitals face a big challenge. PMID- 3979996 TI - Executive demand highest in marketing, information systems. AB - The overall comparison of senior executive demand shows that corporate CEOs see a greater need for senior managers during the next year, but both groups concur on the need for more senior executives in the long term. Although the CEOs agree on the increase in demand in marketing/sales and information systems/data processing during each time frame, hospital CEOs will require fewer senior executives in general management and their corporate peer call for fewer planning/corporate development professionals, reflecting the respective changes occurring in both sectors surveyed. PMID- 3979999 TI - The evolution of hospice. PMID- 3979998 TI - Atlanta coalition tackles UR. PMID- 3980000 TI - Assessing readiness for guest relations programs. PMID- 3980001 TI - Board involvement key to incentive comp plans. PMID- 3980002 TI - Maternity services shift in response to consumer demand. PMID- 3980003 TI - Women's unique psychiatric needs addressed. PMID- 3980004 TI - Hospital-based MOBs: important growth component. PMID- 3980005 TI - The coming era of hard choices. Interview by Emily Friedman. PMID- 3980006 TI - When is a test diagnostic? PMID- 3980007 TI - Hermansky-Pudlak syndrome: a clinicopathologic study. AB - The Hermansky-Pudlak syndrome is a rare disease characterized by multisystemic involvement. Seven families with the disorder were identified in the Puerto Rican population of one municipal hospital, suggesting that the incidence in the Puerto Rican community is sufficient to warrant both dissemination of information about the disease and further investigation. The present study was an attempt to achieve both of these goals. PMID- 3980008 TI - Extrapulmonary silicosis: a clinical, morphologic, and ultrastructural study. AB - A variety of silicotic lesions derived from thoracic silicosis via lymphohematogenous spread to the liver, spleen, bone marrow, and extrathoracic lymph nodes are described. The morphologic features of these lesions depend on the extent of macrophage aggregation, the occurrence of fibrogenesis, and the development of necrosis and degradative changes in macrophages and adjacent extracellular matrix, presumably caused by lysosomal enzymes released from macrophages. Ultrastructurally, the degenerative alterations of matrix material include longitudinal splitting and breakage of collagen fibrils into segments one and three quarters the length of the original fibrils and deposition of flocculent electron-dense material either focally or diffusely around collagen fibrils. The corresponding changes viewed light microscopically are those of fibrinoid necrosis. The sclerohyaline nodule, the characteristic lesion of silicosis, includes all of these features as it evolves through nodular histiocytic and subsequent fibrohistiocytic phases. Its ultimate morphology appears to be determined by the reassembly of the degraded matrix into non native, fibrous long-spacing collagen via a spiny collagen intermediary. The sclerohyaline nodule occurs infrequently in the spleen and liver, although less typical lesions caused by silica alone or admixed with other dusts seem to occur more commonly in these organs. These lesions appeared as loose or nodular histiocytic or fibrohistiocytic aggregates. Nonspecific fibrous nodules or more extensive fibrosis, as seen in portal triads, may represent advanced stages of such lesions. Acute or healed focal segmental glomerulonephritis occurred in 40 per cent of the cases, suggesting that it may be an important remote effect of silicosis. Continuous destruction of lymphocytes adjacent to silicotic nodules may be an antigenic source of the high concentration of autoimmune reactants described in silicosis. PMID- 3980009 TI - Squamous cell carcinoma of the liver. AB - A case of squamous cell carcinoma arising in a hepatic cyst is presented. The neoplasm probably originated in a developmental cyst. Four other cases that were reported previously are reviewed, together with accounts of adenocarcinomas arising in hepatic cysts. PMID- 3980010 TI - Isolated xanthomatosis of the small bowel. AB - A case of xanthomatosis of the small bowel is described. Beginning with the proximal jejunum, an 85-cm segment of small bowel was distorted by regularly spaced nodular accumulations of lipid-laden macrophages that expanded the submucosa and muscularis and extended to the serosal surface. The conditions often associated with xanthomatosis were not found in this patient. PMID- 3980011 TI - Lymphoma arising in an adenolymphoma. AB - A malignant lymphoma that originated in association with an adenolymphoma (Warthin's tumor) of the parotid salivary gland is reported. The occurrence of lymphomas in salivary glands is discussed briefly. PMID- 3980012 TI - Aortitis and large vessel arteritis in a newborn. AB - Disseminated arteritis with extensive involvement of the aorta, as well as involvement of the arch vessels, coronary arteries, and pulmonary arteries, but not of the arteries within the liver, spleen, kidneys, or other organs, is unusual in a newborn. The presence of both acute and chronic inflammation with fibrosis, as well as calcification and focal ossification in the aorta, would suggest that the process had been present for some time before birth. This lesion should be described rather than designated by an eponym or included with such entities as Takayasu's disease. An additional finding of interest was widespread calcification in Bowman's capsules of numerous glomeruli. PMID- 3980013 TI - The gene coding for a sphingolipid activator protein, SAP-1, is on human chromosome 10. AB - SAP-1 is a sphingolipid activator protein found in human tissues required for the enzymatic hydrolysis of GM1 ganglioside and sulfatide. It appears to be missing in patients who have a genetic lipidosis resembling juvenile metachromatic leukodystrophy. Using rabbit antibodies against human SAP-1 it could be visualized in extracts from cultured human skin fibroblasts after sodium dodecylsulfate-polyacrylamide gel electrophoresis, followed by electroblotting to nitrocellulose membrane and immunochemical staining (Western blotting). A series of 23 human-Chinese hamster ovary cell hybrids containing different human chromosomes were examined. The parent Chinese hamster ovary cells did not have a reacting protein in the region of human SAP-1. Only in the eight hybrid clones containing human chromosome 10 was a reacting protein identified. Other chromosomes were excluded by this method. Therefore the gene for SAP-1 and the genetic mutation resulting in a fatal lipidosis are located on human chromosome 10. PMID- 3980014 TI - A cytogenetic study of a population of retarded females with special reference to the fragile (X) syndrome. AB - A cytogenetic survey of a population of 278 mentally retarded females on community placement is described. Thirty-five females had an aneuploid chromosome constitution and a single female was found to have the fra(X) syndrome. The frequency of the fra(X) syndrome among female retardates is discussed together with the apparent absence of de novo mutants among this class of fra(X) probands. PMID- 3980016 TI - A distinct dysmorphic syndrome with spinocerebellar ataxia and probable autosomal recessive inheritance. AB - Two brothers and their sister aged 8, 13, and 7 years were found to have unusual facies (gross, rough and abundant hair, wide forehead, mild palpebral ptosis, small nose, anteverted nostrils, thick lips, and down-slanting corners of the mouth), dysarthria, delayed psychomotor development, scoliosis, feet deformities, and limb and gait ataxia. The characteristic clinical picture in the three sibs, once compared with other ataxic syndromes, allowed one to conclude that this could correspond to a distinct entity probably inherited as an autosomal recessive disorder. PMID- 3980015 TI - Genetic heterogeneity at the glucose-6-phosphate dehydrogenase locus in southern Italy: a study on the population of Naples. AB - Glucose-6-phosphate dehydrogenase (G6PD) electrophoretic phenotype was determined in red cells from 979 male subjects born in Naples (Southern Italy). In 0.7% of the cases no activity could be detected in haemolysates, while in 1.3% of the cases G6PD activity was approximately 20% of normal and electrophoretic mobility was altered. Moreover in two subjects a G6PD with altered mobility and normal activity was shown. G6PD was characterized in 10 subjects with variant phenotype. We conclude that the G6PD(-) phenotype in the population of Naples consists of at least six different G6PD variants associated with mild deficiency and at least one, G6PD Mediterranean, associated with severe deficiency. PMID- 3980018 TI - DNA probe localization at 18p113 band by in situ hybridization and identification of a small supernumerary chromosome. AB - Recombinant plasmid clone B74 (also named D18 S3) containing a human single-copy DNA segment of 6 kilobases (kb) was localized by in situ hybridization on band p113 of chromosome 18. This probe was then used in cytogenetic diagnosis to identify precisely a small supernumerary chromosome as an isochromosome i(18p). PMID- 3980017 TI - High resolution cytogenetic evaluation of couples with recurring fetal wastage. AB - Both high resolution and routine chromosome analyses were used to study couples with a history of two or more spontaneous abortions in early pregnancy. In the 20 couples studied, two of the women were found to have an inversion. One paracentric inversion, (13)(q13.1q22.3), was apparent on routine analysis. The small pericentric inversion (11)(p11.12q12.3), was only detected by high resolution techniques. Given the low yield and increased cost and effort involved, we do not believe that high resolution studies are justified for screening couples with repeated abortions. PMID- 3980019 TI - Detection of cystic fibrosis heterozygotes using a modified loading with bromide. AB - A three day loading with sodium bromide was performed in 19 healthy controls, 16 definite cystic fibrosis heterozygotes, and 14 homozygote patients with cystic fibrosis. After three days sodium, potassium, chloride, and bromide were determined in serum and sweat. Using a multivariate discriminant analysis two nonelementary functions with the features sodium index, bromide index, potassium index, and chloride in sweat allowed us to identify the three groups. The reclassification of the probands, however, was correct in only 69.3%. A second analysis with the groups of controls and heterozygotes only resulted in a unidimensional nonelementary function with the features potassium index, bromide/sodium in sweat, and sodium index. The reclassification of the probands was correct in 91.4%. The discriminant values were 8.28 +/- 0.96 in the controls and 11.67 +/- 1.03 in the heterozygotes with an overlap of twice the standard deviations between 9.61 and 10.20. PMID- 3980020 TI - Inversion of chromosome 2 (p11p13): frequency and implications for genetic counselling. AB - Two cases of a pericentric inversion of chromosome 2 were found amongst 3619 blood specimens referred for karyotypic analysis. An additional three cases were identified within 1820 pregnancies presenting for genetic amniocentesis because of late maternal age. The implications for management in these cases are discussed. PMID- 3980021 TI - Transferrin variants in Tuscany (Italy). Evidence for two "new" Tf alleles. AB - Polyacrylamide gel isoelectric focusing (PAGIF) with carrier ampholytes was used for the determination of Tf phenotypes in a sample of 965 unrelated healthy blood donors from Tuscany (Italy). Thirteen rare variants in a heterozygote state were found (four Tf D, seven Tf B, and two rare Tf C subtypes). Among them two apparently new variants, tentatively called Tf C15 and Tf B4, were identified. The rare Tf B0 mutant was also observed. PMID- 3980023 TI - Neurosyphilis: the most common things are most common. AB - Reports published in the past twenty years include many purporting to show, without much reason, that classic presentations of neurosyphilis are the exception rather than the rule. We join the few who take another view, and discuss here the reasons underlying the conflict of opinions. PMID- 3980022 TI - Hepatitis B virus markers in prostitutes in Singapore. AB - The prevalence of hepatitis B virus markers in 121 men and 239 women prostitutes was studied. Of 33 (9.7%) with hepatitis B surface antigen (HBsAg), nine (27.3%) also had hepatitis Be antigen, which was more prevalent in men than women. Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in about 71% of men and women prostitutes. Hepatitis B virus markers were more prevalent in men than in women prostitutes. Compared with other people, prostitutes had a significantly greater prevalence of hepatitis B virus markers. This study strongly suggested the importance of sexual transmission of infection with hepatitis B virus in a country where infection is endemic. PMID- 3980024 TI - On-line monitoring of the median frequency of the surface EMG power spectrum. PMID- 3980025 TI - Evaluation of the effectiveness of EMG parameters in the study of neurogenic diseases--a statistical approach using clinical and simulated data. PMID- 3980027 TI - The position of innervation zones in the biceps brachii investigated by surface electromyography. PMID- 3980026 TI - Measurement of torsion from multitemporal images of the eye using digital signal processing techniques. PMID- 3980028 TI - Automated analysis of rodent three-channel electrocardiograms and vectorcardiograms. PMID- 3980029 TI - Automated spectral characterization of wheezing in asthmatic children. PMID- 3980030 TI - A microcomputer system for spatiotemporal visual receptive field analysis. PMID- 3980031 TI - Multiterm Debye dispersion relations for permittivity of muscle. PMID- 3980032 TI - The use of unipolar epicardial QRS potentials to estimate myocardial infarction. PMID- 3980033 TI - Determination of body segment parameters and their effect in the calculation of the position of center of pressure during postural sway. PMID- 3980034 TI - Correlation between arterial blood pressure levels and (dZ/dt)min in impedance plethysmography. PMID- 3980035 TI - Use of time integrals of the ECG to solve the inverse problem. PMID- 3980036 TI - Muscle fatigue monitor (MFM): second generation. PMID- 3980037 TI - Analysis of a digital EMG signal processor in dynamic conditions. PMID- 3980038 TI - Optimization of neural stimuli based upon a variable threshold potential. PMID- 3980039 TI - Effect of high-frequency current on nerve and muscle tissue. PMID- 3980040 TI - A device for zero-eye-movement reading. PMID- 3980041 TI - New heart rate meter based on frequency grading. PMID- 3980043 TI - Thirty-sixth annual meeting of the Tissue Culture Association. June 2-6, 1985, New Orleans, LA. Abstracts. PMID- 3980042 TI - Statistical mechanics of neocortical interactions: EEG dispersion relations. PMID- 3980044 TI - [Analysis of individual antibody reactivity of patients allergic to grass pollen using isoelectric focusing and immunoblotting]. AB - Isoelectrofocussing and immunoblotting provide means to determine individually the specific antibody response of grasspollen allergics, especially of the IgE class. Furthermore, these methods permit the assessment of the allergenic potency of single components of antigen extracts. PMID- 3980045 TI - Opsonization of Legionella pneumophila in human serum: key roles for specific antibodies and the classical complement pathway. AB - Legionella pneumophila has previously been shown to require serum factors for efficient uptake by phagocytic cells. In this investigation, the roles of specific antibody and complement in phagocytosis of L. pneumophila by human polymorphonuclear leucocytes (PMN) and tissue macrophages were determined. Opsonization was assessed by quantitating the uptake of [3H]-labelled Legionellae. Compared to other Gram-negative and to Gram-positive bacterial species, L. pneumophila was highly resistant to the opsonic activity of normal pooled human serum (PHS). Of 12 donor sera tested, only four promoted significant L. pneumophila uptake when used at full strength. Experiments with immune antibody, and with human sera deficient in immunoglobulins, or the complement components C2, C3, or C5, revealed that L. pneumophila opsonization was dependent on antibody-mediated activation of the classical complement pathway; activation of the alternative pathway could not be detected. At high concentrations, immune antibody alone could adequately opsonize L. pneumophila. Human alveolar and peritoneal macrophages required very similar amounts and types of opsonins for L. pneumophila phagocytosis as did human PMN. Heating L. pneumophila to temperatures greater than or equal to 80 degrees abolished its resistance to opsonization by diluted PHS; however, activation of complement via the alternative pathway or via other antibody-independent routes remained undetectable. These studies show that, in addition to immune antibody, the classical pathway of complement plays an important role in the opsonization of L. pneumophila. The limited ability of these bacteria to interact with human complement provides a likely explanation for their resistance to opsonization and may be partly based on heat-sensitive structures on the surface of L. pneumophila. PMID- 3980046 TI - The carriage and delivery of substances to lymphatic tissues by recirculating lymphocytes. I. The concentration of ricin in lymphocyte traffic areas. AB - Thoracic duct lymphocytes (TDL) were loaded in vitro with ricin before intravenous injection into syngeneic rats. TDL that had been incubated at 10 micrograms of ricin/5 X 10(7) cells/ml migrated from the blood into the spleen and lymph nodes (LN) according to the physiological pattern, and TDL incubated at 10 times that concentration were only slightly impaired in their ability to enter LN. The transfer of cells to recipients with thoracic duct fistulae indicated that very few ricin-treated lymphocytes left the LN to recirculate back to lymph. Most of the ricin-loaded lymphocytes died within the lymphatic tissues, probably between 7 and 15 hr after injection. The ricin toxicity was transferred locally, causing selective damage to the cell population within the traffic areas of the lymphatic tissues without disrupting the tissue architecture. This pattern of intensive cell destruction was not seen after a lethal dose of free ricin, which caused more diffuse and less severe damage to the spleen and LN, proving that lymphocytes are effective carriers of ricin. The surviving host lymphocytes were distributed abnormally, presumably because of the obvious damage to small blood vessels in LN and elsewhere. Lymphocytes accumulated especially in the red pulp of the spleen. Although the method described has drawbacks, it might be developed in order to concentrate ricin in the vicinity of neoplastic cells in diffuse lymphomas and leukaemias. PMID- 3980047 TI - Quantitation of maternal-fetal IgG transport in the chicken. AB - Quantitative and temporal features of maternal-fetal transport of IgG in the chicken have been determined by means of a sensitive and specific radioimmunoassay. The first step in this two-step process is the transport of maternal IgG from the hen plasma across the oolemma into the maturing oocyte in the ovarian follicle. Oocytes sequester IgG throughout most of their maturation from 10 mg pre-vitellogenic oocytes to fully mature 20 g oocytes ready to be shed into the oviduct. IgG uptake is exactly proportional to mass accumulation at every point. Thus, the concentration of IgG in the yolk is invariant throughout maturation of the oocyte (approximately 8 mg/ml) and the rate of uptake in this single specialized cell can be as great as 45 mg/day during its last 3 days of growth before ovulation. The second step, uptake of yolk IgG across the yolk sac and into the fetal circulation, is detectable at the earliest time points tested (Day 7), but accumulation into the embryonic plasma occurs at a relatively low rate (less than 100 micrograms/day) until a dramatic increase in uptake (greater than 600 micrograms/day) occurs in the last 3 days before hatching. The hatchling has 1-2 mg/ml of maternal IgG in its plasma. Increase in IgG uptake lags significantly (approximately 4 days) behind increase in mass by the developing embryo, suggesting that IgG uptake occurs predominantly in the last few days before hatching. This ensures that the hatching is endowed with those maternal IgGs which will be its planopy when it enters the hostile world. PMID- 3980049 TI - Inhibition of human neutrophil locomotion by the polyamine oxidase-polyamine system. AB - The polyamines, spermine and spermidine, in the presence of either bovine serum [containing polyamine oxidase (PAO) activity] or partially purified PAO, inhibited human neutrophil locomotion. This effect could not be produced by either bovine serum, PAO, or the polyamines alone. The results suggested that at least two of the products generated during the oxidation of polyamines by PAO, namely H2O2 and ammonia, are not responsible for the effects on neutrophils. Acrolein, a breakdown product of other products (aminoaldehydes), was found to inhibit the neutrophil functions. Since polyamines, and possibly PAOs, accumulate at inflammatory sites, products of the PAO-polyamine reaction could function as regulators of the inflammatory response. PMID- 3980048 TI - Specific antibody in the equine genital tract following systemic and local immunization. AB - An enzyme-linked immunosorbent assay (ELISA) was adapted for the horse to investigate the production of antibody in response to subcutaneous, intrauterine or intravaginal immunization with dinitro-phenylated human serum albumin. An IgM response was not detected, but antibodies of the IgGab, IgGc, IgGT and IgA isotypes were measured in serum, uterine and vaginal secretions. Local immunization produced antibody titres in serum and secretions, with evidence of significant local production. PMID- 3980050 TI - The ingestion and degradation of soluble immune complexes by guinea-pig macrophages and neutrophils. AB - The kinetics of ingestion and degradation of guinea-pig IgG2-containing soluble immune complexes by guinea-pig macrophages and neutrophils have been compared and aspects of the biochemical control of these events in neutrophils have been investigated using a selection of inhibitors. Differences were observed between the macrophages and neutrophils in the stability of complex attachment to their surface membranes, in the rates and modes of complex ingestion and in the relative and absolute rates of digestion of the antibody and antigen components within the complexes. On the other hand, the response of the neutrophils to different inhibitors was broadly similar to that previously observed with the macrophages. The differences observed are discussed and the importance of the Fc receptor expression in determining these differences is assessed. PMID- 3980051 TI - Sheep major histocompatibility complex OLA: gene frequencies in two French breeds with scrapie. Evidence for a linkage between OLA and resistance or susceptibility to the disease. AB - Gene frequencies of 13 sheep lymphocyte factors (11 factors controlled by the sheep OLA complex including three closely linked loci, and two factors by two minor loci) were compared in 189 sheep of two breeds: a. infected with scrapie, b. healthy in a contaminated environment, and c., normal. In a and c, OLA gene frequencies were similar. In healthy sheep in a contaminated environment (b), some OLA gene frequencies were higher in one breed and lower in the other. In each breed, three antigens had their frequencies significantly modified; two of them were the same in the two breeds, but they showed an inverse variation. Thus, the relative risk of clinical scrapie decreased in one breed and increased in the other for the same OLA gene. These data indicate first, that OLA antigens are not directly involved in causing scrapie, and second, that the OLA complex is linked to at least one scrapie resistance/susceptibility locus. In practice, it should be possible to select more resistent sheep, using some OLA antigens but an investigation of the OLA genes and the resistance to scrapie in a given breed is necessary before the selection. PMID- 3980052 TI - Mouse monoclonal antibodies to class I and class II antigens of the chicken MHC. Evidence for at least two class I products of the B complex. PMID- 3980053 TI - Age-related changes of baroreflex function, plasma norepinephrine, and blood pressure. AB - Interrelationships between age, baroreflex sensitivity, plasma norepinephrine levels, and systolic blood pressure were assessed in a group of 54 normal subjects ranging in age from 14 to 77 years. Baroreflex sensitivity was measured by the change in R-R intervals per unit change in systolic blood pressure during phase 4 of the Valsalva maneuver. All correlations among these four variables were statistically significant (p less than 0.05 or 0.01). To investigate possible causal relationships between age-related changes of baroreflex sensitivity, plasma norepinephrine levels, and blood pressure, partial correlative analysis was then performed. After the effect of age was eliminated, plasma norepinephrine levels were found to be related positively to blood pressure (r = 0.29, p less than 0.05) and negatively to baroreflex sensitivity (r = -0.34, p less than 0.05). The increase in plasma norepinephrine levels could be causally related to the elevation of blood pressure, as plasma norepinephrine levels could provide an index of sympathetic activity. Furthermore, baroreflex sensitivity was found to be negatively related to age (r = -0.44, p less than 0.01) independent of plasma norepinephrine levels, whereas plasma norepinephrine levels were no longer related to age (r = 0.10) after adjusting for the effect of baroreflex sensitivity. This finding suggests that an increase in plasma norepinephrine levels with age could be mediated by the age-related change of baroreflex sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980054 TI - Blood pressure experience and risk of cardiovascular disease in the elderly. AB - For the 1254 persons in the Framingham Heart Study who survived to age 65 without prior cardiovascular disease or prior use of antihypertensive medications, significant univariate correlates of the development of cardiovascular disease after age 65 included (1) the systolic blood pressure at age 65, (2) the average systolic blood pressure before age 65, and (3) the slope of blood pressure change up to age 65. After controlling for the systolic blood pressure at age 65, average pre-age 65 blood pressure remained significant (p less than 0.05) and the slope of the pre-age 65 blood pressure was marginally significant (p = 0.06). Even after controlling for the mean of up to three blood pressure measurements at age 65, an average systolic blood pressure of 160 mm Hg or greater before age 65 was an independently significant predictor of the post-age 65 development of cardiovascular disease (rate ratio = 1.79; 95% confidence interval = 1.04, 3.07). These data suggest that even after performing multiple measurements at a single examination, knowledge of past systolic blood pressure history, especially if it averages 160 mm Hg or greater, adds a small but statistically significant increment in predicting future cardiovascular disease in the elderly. PMID- 3980056 TI - Acute vasodilator action of pindolol in humans. AB - The local hemodynamic effect of pindolol, a nonselective beta-blocker with intrinsic sympathomimetic activity, was investigated in 17 healthy volunteers. Changes in forearm blood flow (FBF) in response to infusion of drugs into the brachial artery were measured by plethysmography. Pindolol increased FBF dose dependently to a maximal value of 62 +/- 8% (mean +/- SEM, p less than 0.001) without inducing changes in heart rate or blood pressure. For a single dose of pindolol the maximal effect on FBF was seen after approximately 4 minutes of infusion, and this effect persisted for at least 12 minutes after the infusion. The pindolol-induced increase in FBF was reduced by concomitant infusion of propranolol (p less than 0.001). Intra-arterial infusion of practolol did not influence FBF. No significant influence of pindolol was found on the vasoconstriction induced by the alpha 1-adrenergic receptor agonist methoxamine, the alpha 2-adrenergic receptor agonist BHT-933, or angiotensin II. Measurement of plasma pindolol concentrations in the venous effluent of the forearm suggested that vasodilatation occurred at drug levels within the therapeutic range. These results indicate that the beta-blocker pindolol has vasodilatory properties owing to stimulation of vascular beta 2-adrenergic receptors and that this effect may be of therapeutic relevance. PMID- 3980055 TI - Central cardiovascular effects of physostigmine in humans. AB - Central cholinergic control of pulse rate and blood pressure has seldom been studied in humans. In the current study we contrasted the cardiovascular effects of the centrally acting cholinesterase inhibitor physostigmine, which increases central and peripheral acetylcholine levels, with those of saline placebo and with those of the non-centrally acting cholinesterase inhibitor neostigmine, which only increases peripheral acetylcholine levels. We found that physostigmine, in contrast to neostigmine and saline, caused significant and often profound increases in pulse rate and blood pressure levels in humans. Thus, we conclude that acetylcholine may have a role in central cardiovascular regulation in humans. We also found that administration of physostigmine may cause net increases in pulse of up to 74 beats/minute, systolic blood pressure increases of up to 50 mm Hg, and diastolic increases of up to 45 mm Hg. Such increases could be dangerous in elderly patients with concomitant cerebrovascular or coronary circulation disorders. PMID- 3980057 TI - Pseudopheochromocytoma. PMID- 3980058 TI - Epinephrine enhances neurogenic vasoconstriction in the rat perfused kidney. AB - Epinephrine has been implicated in the genesis of some forms of hypertension. We have investigated the effects of epinephrine on vasoconstrictor responses evoked by adrenergic stimuli in the isolated perfused rat kidney. Low concentrations of epinephrine (2.5 - 5 X 10(-9) M) increased the amplitude of vasoconstrictor responses evoked by electrical stimulation of the renal adrenergic nerves. These concentrations of epinephrine had no effect on the basal perfusion pressure of the kidney or on the amplitude of vasoconstrictor responses evoked by exogenous norepinephrine. The potentiating effect of epinephrine persisted after infusion of the amine had ceased. Kidneys that had been perfused with 3H-epinephrine accumulated radioactivity, which could then be released by renal nerve stimulation. Cocaine (3 X 10(-5) M) reduced the renal accumulation of 3H epinephrine and abolished both the persistent potentiating effect of the amine and the release of radioactivity evoked by subsequent nerve stimulation. The potentiating effect of epinephrine infusion was abolished by the beta 2-selective adrenergic receptor antagonist ICI 118,551 (3 X 10(-8) M), but not by the beta 1 selective adrenergic receptor antagonist atenolol (10(-6) M). These results indicate that concentrations of epinephrine that can be achieved during acute stress can enhance the amplitude of neurogenic vasoconstrictor responses. This effect appears to be mediated via a prejunctional beta 2-adrenergic receptor. The persistent nature of this effect may be due to the neuronal accumulation and subsequent release of epinephrine. PMID- 3980059 TI - Factors that influence stroke in Dahl salt-sensitive rats. AB - Japanese rat chow and cerebral sympathetic denervation increase the incidence of stroke in stroke-prone spontaneously hypertensive rats. The purpose of this study was to determine if Japanese rat chow and sympathetic denervation would result in a high incidence of stroke in Dahl salt-sensitive (DS) rats, which have not been reported to be stroke prone. At 3 to 4 weeks of age, DS rats of both sexes began consumption of a high salt Japanese or American chow and underwent unilateral superior cervical sympathetic ganglionectomy. The rats fed American chow were found to have a high incidence of stroke (46%). Rats fed Japanese chow had shorter survival and a higher incidence of stroke (78%) than rats fed American chow (p less than 0.05). Blood pressure increased faster in DS rats fed Japanese chow (p less than 0.05). Metabolic studies indicated that increased sodium consumption accounted for only part of the acceleration of hypertension by Japanese rat chow. In DS rats grouped for equal levels of blood pressure, those fed Japanese chow had modestly reduced survival (p less than 0.05) compared with those fed American chow and had a greater incidence of stroke (85% vs 38%; p less than 0.05). Location of stroke was not influenced by removal of sympathetic nerves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980060 TI - Cerebrospinal fluid angiotensin II immunoreactivity is not derived from the plasma. AB - To elucidate whether the presence of angiotensin II immunoreactivity (ANG II-ir) in the cerebrospinal fluid (CSF) of the dog is in part due to passage of the peptide across the CSF-blood-brain barrier, [Ile5] angiotensin II (ANG II) was infused intravenously for 7 days in conscious, trained dogs at a rate of 10 micrograms/kg/day. Mean arterial pressure (MAP) and heart rate were monitored each day, and samples of arterial blood and CSF (with a catheter secured into the cisterna magna) were drawn at regular intervals for determination of catecholamine levels, ANG II-ir, and electrolyte levels. Within 2 days after ANG II infusion, MAP stabilized at 35 +/- 1 mm Hg (mean +/- SE, p less than 0.001) above control values. The hypertension was associated with bradycardia, suppressed plasma renin activity, and a fall in both plasma and CSF Na+ concentrations. These changes coincided with a considerable and sustained decrease in the levels of plasma and CSF norepinephrine. On the other hand, levels of epinephrine and K+ in the two compartments remained unchanged. Although concentration of ANG II-ir in plasma was augmented markedly (368% above control values, p less than 0.001), ANG II-ir in the CSF remained within the low values measured in the control period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980061 TI - Oral load of tyrosine or L-dopa and plasma levels of free and sulfoconjugated catecholamines in healthy men. AB - The levels of free and sulfoconjugated catecholamines were measured in the plasma of fasting, recumbent normal subjects before and after an oral load of the catecholamine precursors tyrosine or L-dopa. Basal values of sulfoconjugated catecholamines, measured in plasma samples diluted 1:100 were 7998 +/- 540 pg/ml for dopamine sulfate, 2938 +/- 281 pg/ml for norepinephrine sulfate, and 2958 +/- 288 pg/ml for epinephrine sulfate (n = 37 tests in 15 men); these basal values are higher than those reported previously. Neither free nor sulfoconjugated catecholamine concentrations were changed by a tyrosine load (100 mg/kg) that induced a doubling of the plasma tyrosine level or by a meal low in phenylalanine and tyrosine (but otherwise supplying constituents of normal nourishment) that induced a greater than 50% reduction in the plasma tyrosine concentration. After an oral load of L-dopa (125 mg) the following were observed. (1) An extremely large increase (greater than 100-fold) in dopamine sulfate levels was noted, an increase that was less marked in the same subjects given L-dopa (125 mg) plus the peripheral dopa-decarboxylase inhibitor carbidopa (12.5 mg); as expected, free dopamine concentration also was increased. (2) Neither free nor sulfoconjugated norepinephrine concentrations were altered. (3) Epinephrine sulfate but not free epinephrine concentration was increased (more than ten-fold) after L-dopa ingestion alone; this result was unexpected and has to be confirmed before considering its physiological meaning, if any. PMID- 3980063 TI - Left ventricular wall stress and systolic function in untreated primary hypertension. AB - A noninvasive investigation was undertaken in four blood pressure (BP) groups of untreated 49-year-old men derived by screening a random population sample: normotensive men (n = 20) and subjects with borderline (n = 30), mild (n = 45), or moderate BP elevation (n = 24). We here report the findings regarding left ventricular (LV) wall stress, LV wall thickness, and LV systolic function. Although there was an increase in LV wall thickness with hypertension, the raised BP was not compensated for by a sufficient degree of LV wall thickening to keep wall stress within normal limits in the hypertensive groups. Among a subset of individuals with pronounced increase in wall thickness peak systolic wall stress approached the normal range, but end-systolic wall stress was still high. In spite of high wall stress LV systolic function was normal or supranormal in the hypertensive men. The LV ejection phase indices showed a close inverse correlation with end-systolic wall stress (r = -0.67 to -0.84) in all four BP groups, but no correlation or only a weak correlation with peak systolic wall stress (r = 0.18 to -0.40). As judged from the relationship between end-systolic wall stress and ejection phase indices of LV function in the normotensive controls, all hypertensive groups had higher than expected values for LV ejection phase indices, which indicates an increased myocardial contractility secondary to adrenergic stimulation or to a more efficient contractile machinery in the myocardial cells. PMID- 3980064 TI - Ambulatory blood pressure monitoring. PMID- 3980062 TI - The sympathetic nervous system and hypertension in primary aldosteronism. AB - To assess the role of the sympathetic nervous system in mineralocorticoid hypertension in humans, results from 24 patients with aldosterone-producing adenoma were compared with those in 27 appropriately matched essential hypertensive subjects and 26 normotensive subjects. Resting plasma catecholamine levels averaged 292 +/- 140 (SD) pg/ml in patients with aldosterone-producing adenoma, 305 +/- 101 in patients with essential hypertension, and 260 +/- 120 in normotensive subjects; none of the differences among the three groups was significant. With head-up tilt (60 degrees for 10 min) plasma catecholamine levels increased similarly in the aldosterone-producing adenoma and essential hypertensive groups (up to 681 +/- 111 and 611 +/- 57 pg/ml respectively, NS). beta-Blockade (propranolol, 10 mg i.v.) in eight aldosterone-producing adenoma patients decreased heart rate (from 78 +/- 5 to 68 +/- 3 beats/min, p less than 0.005) and cardiac output (from 5.5 +/- 0.4 to 4.6 +/- 0.3 liter/min, p less than 0.001), but left mean blood pressure unchanged (127 +/- 4 to 127 +/- 2 mm Hg). Combined alpha- and beta-blockade with phentolamine and propranolol in five patients with aldosterone-producing adenoma produced no detectable changes in blood pressure. Thus, results from biochemical, functional, and pharmacological studies in humans showed no evidence of enhanced peripheral sympathetic activity in the hypertension of primary aldosteronism. PMID- 3980065 TI - The effects of epinephrine on norepinephrine release in essential hypertension. AB - The effects of endogenous epinephrine (E), released by glucagon injection, and exogenously infused E on plasma norepinephrine (NE) and cardiovascular responses before and after beta-blockade were studied in patients with essential hypertension and in age-matched normotensive controls. The resting plasma NE and E levels were significantly higher in the borderline hypertensive subjects (NE: 251 +/- 21 pg/ml [SEM], p less than 0.005; E: 57 +/- 5, p less than 0.05, n = 18) than in controls (NE: 129 +/- 12; E: 39 +/- 5, n = 18). An intravenous injection of glucagon (1.0 mg) induced a transient rise of both plasma catecholamine levels and blood pressure in every subject studied. Plasma E levels rose transiently and returned to the basal levels by 20 minutes after the injection, whereas plasma NE levels showed a more prolonged rise over 20 minutes. beta-Blockade with propranolol did not affect the plasma E response to glucagon, but inhibited the prolonged rise of plasma NE levels. An intravenous infusion of exogenous E (1.25 1.50 micrograms/min) for 30 minutes caused an apparent rise of both plasma NE levels and blood pressure, which lasted more than 60 minutes after stopping the E infusion. Propranolol did not affect the time course of plasma E but again inhibited the prolonged rise of both plasma NE levels and blood pressure. No significant differences could be observed in the cardiovascular or plasma NE responses to glucagon or to E infusion between normal and hypertensive subjects. These findings lend support to the view that plasma E can act physiologically as a sustained stimulator of presynaptic beta-adrenergic receptors, which leads to an enhanced NE release from peripheral sympathetic nerve terminals and a rise of blood pressure in humans. PMID- 3980067 TI - In vitro arterial responses to vasopressin in subjects with a family history of hypertension. AB - Intrinsic vascular responsiveness was examined in isolated, helically cut strips of cystic artery from 32 normotensive women. Contractions were elicited by vasopressin, norepinephrine, 5-hydroxytryptamine and transmural electrical stimulation. Of the 32 subjects, 17 had a family history of hypertension in a first-degree relative (parent, sibling, or adult offspring) and 15 had no family history of hypertension. The ages and mean arterial blood pressures of the two groups were not different: 39 +/- 12 versus 35 +/- 11 years (mean +/- SD; p = 0.263) and 87 +/- 4 versus 85 +/- 5 mm Hg (p = 0.214) respectively. The vasopressin dose-response curve was significantly shifted to the left for arteries of those subjects with a family history of hypertension compared with that for arteries of subjects with no family history (e.g., response--percent of norepinephrine maximum--to 100 mU/ml = 31 +/- 23 versus 12 +/- 16; p = 0.014). All other responses were not significantly different, although in general the arteries of those subjects with a family history tended to have greater responses to all stimuli except norepinephrine. Arteries from the two groups did not differ with respect to physical dimensions (e.g., cross-sectional area), passive mechanical properties, or maximal responses to norepinephrine. The data indicate that altered intrinsic vascular responsiveness is linked to a family history of hypertension in normotensive subjects and thus could play a role in the familial aggregation of elevated blood pressure. PMID- 3980066 TI - Orthostatic hypertension. Pathogenetic studies. AB - Among 1800 referred hypertensive patients, 181 had recumbent diastolic blood pressures (DBP) below 90 mm Hg and standing DBP above 90 mm Hg. Orthostatic increments in DBP were greater in these orthostatic hypertensive patients than in 181 persistently hypertensive patients and 134 normotensive subjects. In 12 patients with orthostatic hypertension, the orthostatic fall in cardiac output (27.3 +/- 2.9%, measured by a respiratory method) was double that in 8 normotensive subjects (13.3 +/- 3.7%, p less than 0.01). An inflated pressure suit over the pelvis and lower limbs prevented the excessive fall in cardiac output and significantly reduced (p less than 0.02) the excessive rise in standing DBP in orthostatic hypertensive patients. Gravitational pooling of blood in the legs and reduction of blood in the head was measured by external gamma counting of autologous erythrocytes labeled with sodium pertechnetate Tc 99m through ports in fixed positions over the leg and the temple. Orthostatic intravascular pooling was significantly greater (p less than 0.01) in orthostatic hypertensive subjects than in normotensive subjects, and the magnitudes of orthostatic pooling and orthostatic increases in DBP were closely correlated (r = +0.85). Plasma norepinephrine concentrations were similar in recumbency and after sustained handgrip exercise, but significantly greater (p less than 0.01) after 5 to 60 mins of standing in orthostatic hypertensive subjects than in normotensive subjects. Our results indicate that orthostatic hypertension is common and that its mechanism in representative patients involves excessive orthostatic blood pooling, which results in decreased venous return, decreased cardiac output, increased sympathetic stimulation (presumably through low-pressure cardiopulmonary receptors), and excessive arteriolar, but not venular, constriction. PMID- 3980068 TI - Selective antagonism of humoral versus neural vasoconstrictor responses by nisoldipine. AB - The effects of nisoldipine administration on vascular reactivity to humoral and neural vasoconstrictor stimuli were examined in the intact rat. For these experiments, rats were instrumented with miniaturized pulsed Doppler flow probes to allow continuous measurement of renal, mesenteric, and hindquarters blood flow. In conscious and anesthetized rats, intravenous doses of angiotensin II (75 and 150 ng/kg), norepinephrine (0.6 and 1.2 microgram/kg), and epinephrine (0.6 and 1.2 microgram/kg) caused dose-dependent increases in arterial pressure and renal and mesenteric vascular resistance. Nisoldipine (0.7 microgram/min) administration significantly attenuated (p less than 0.05) the pressor and regional vasoconstrictor actions of all three circulating pressor agents; however, nisoldipine infusion had little effect on neurally mediated regional vasoconstrictor responses elicited by electrical stimulation of the posterior hypothalamus or greater splanchnic nerve. These data indicate that nisoldipine depressed vascular responsiveness to humoral vasoconstrictor agents, while neural vasoconstrictor responses were unaffected. Thus nisoldipine appears to exert preferential antagonistic effects on humoral rather than on neural vasoconstrictor stimuli. PMID- 3980069 TI - Vascular reactivity in the spontaneously hypertensive rat. Effect of high pressure stress and extracellular calcium. AB - The role of extracellular calcium and high blood pressure stress in altered vascular adrenergic responsiveness in rings of femoral artery from spontaneously hypertensive rats (SHR) was investigated. A model in which partial ligation of the external iliac artery prevents the increase in blood pressure to the ipsilateral femoral artery was used to assess the effect of the increase in pressure stress on these alterations. Age-matched (5-week-old) male Wistar-Kyoto rats (WKY) and SHR were used in the study. Partial ligation was performed before a substantial increase in blood pressure occurred (6 weeks of age), and studies on vascular reactivity were carried out at 10 to 12 weeks of age when the SHR were considered hypertensive (indirect systolic blood pressure greater than 150 mm Hg). Maximal contractility of rings of unprotected femoral artery from the SHR in response to KCl in either a normal (2.5 mM) or low (0.25 mM) calcium Krebs solution was significantly greater (p less than 0.05) than was that of protected vessels from the SHR or protected and unprotected vessels from the WKY; however, no difference in the sensitivity to KCl was observed. Isoproterenol-induced relaxation was significantly attenuated in rings of vascular smooth muscle from unprotected femoral arteries of the SHR (p less than 0.05), while the responses of protected vessels from the SHR were similar to controls. Equilibration of vascular smooth muscle in a low calcium Krebs solution resulted in an increase in beta-adrenergic mediated relaxation in all groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980070 TI - Loss of accommodation in sympathetic neurons from spontaneously hypertensive rats. AB - Synaptic transmission and membrane properties of sympathetic neurons in superior cervical ganglia of spontaneously hypertensive rats (SHR), normotensive Wistar Kyoto rats (WKY), and Sprague-Dawley rats (SD) were investigated in vitro by extracellular and intracellular recording. The sympathetic neurons of SHR showed an atypical loss of spike accommodation. The spike discharge was insensitive to the sodium channel blocker tetrodotoxin, but it was reversibly blocked by a variety of calcium antagonists. The loss of accommodation in the neurons of SHR was not due to a loss of M-current, a potassium current involved in controlling spike frequency adaptation in sympathetic neurons. Superfusion of ganglia of SHR with muscarine (10 microM), which suppresses M-current and leads to a loss of accommodation, potentiated the repetitive discharge. In the presence of muscarine the current-voltage curves in neurons of SHR and SD were shifted to similar extents. Resting membrane potentials of neurons of SHR and WKY were consistently depolarized as compared with neurons of SD. Synaptic efficacy through the ganglia of SHR, assessed by extracellular recordings of presynaptic and postsynaptic compound action potentials at 0.25 Hz stimulation, was elevated when compared with the ganglia of WKY, but was similar to that of the ganglia of SD. These results indicate that strain differences should be considered when attempting to attribute changes in sympathetic neuron membrane properties to hypertension. The sympathetic neurons of SHR appear to have lost their accommodative properties and might possess an exaggerated calcium conductance. This calcium conductance may explain the augmented calcium-dependent release of norepinephrine during sympathetic nerve stimulation in the SHR. PMID- 3980071 TI - Ouabain binding and Na+ content in resistance vessels and skeletal muscles of spontaneously hypertensive rats and K+-depleted rats. AB - The possible role of Na+ in the development of hypertension in rats was explored in measurements of intracellular Na+, 22Na efflux, and 3H-ouabain binding sites in resistance vessels and skeletal muscles. In resistance vessels obtained from 13-week-old spontaneously hypertensive rats (SHR) or age-matched Wistar-Kyoto rats (WKY), (Na)i, total or ouabain-resistant 22Na efflux, and the concentration of 3H-ouabain binding sites showed no significant differences. Soleus muscles obtained from 6-week-old and 13-week-old SHR contained 5 to 11% more 3H-ouabain binding sites than those of WKY. The small difference in ouabain binding probably was related more to variations in growth rate and strain than to the hypertension. In SHR and WKY the Na+ and K+ contents of gastrocnemius muscles were almost identical at 6 and 13 weeks of age. By contrast, in Wistar rats in which the (Na)i of skeletal muscle was increased sixfold by K+ depletion, the systolic blood pressure was decreased by 10%. The K+ depletion was associated with a 35 to 55% decrease in the concentration of 3H-ouabain binding sites in both resistance vessels and skeletal muscles. The results provide no support for any simple cause-effect relationships between either elevated (Na)i or altered concentration of 3H-ouabain binding sites and hypertension in SHR. PMID- 3980072 TI - Effects of antiglucocorticoids on glucocorticoid hypertension in the rat. AB - The early phase of hypertension induced in rats by a glucocorticoid agonist RU 26988 was studied. Systolic blood pressure increased by 35 mm Hg. Water and sodium urinary excretion increased transiently, and plasma volume decreased. Total and ouabain-sensitive sodium efflux, as well as rubidium efflux, were enhanced by glucocorticoid administration. Low salt intake did not prevent hypertension. Pretreatment with RU 38486, a steroid with antiglucocorticoid properties, largely prevented the rise in blood pressure (+10 mm Hg) and suppressed transient natriuresis and the decrease in plasma volume. Changes in total and ouabain-sensitive sodium efflux were completely prevented, whereas changes in rubidium efflux were only partly reversed. Similarly, administration of progesterone, a steroid with antiglucocorticoid effects, prevented glucocorticoid hypertension (+11 mm Hg) and vascular ionic changes. In contrast administration of RU 28318, an antimineralocorticoid agent, was without effect on glucocorticoid hypertension (+38 mm Hg). Progesterone or RU 38486 administered after glucocorticoid also decreased blood pressure. Present data indicate that glucocorticoid hypertension may be prevented or reversed in its early phase by steroid drugs with antiglucocorticoid properties. These drugs also appeared to prevent the sodium and rubidium flux abnormalities induced by glucocorticoid. We suggest that activation of the vascular glucocorticoid receptors may be involved in the pathophysiology of glucocorticoid hypertension. PMID- 3980073 TI - Permeability-increasing ability of PAF-acether in rat skin. AB - Platelet-activating factor (PAF-acether), a phospholipid compound with effects on several cells, e.g., platelets and polymorphonuclear leukocytes (PMNs), was examined for its effect on microvascular permeability in rat skin. It was found to increase microvascular permeability, measured as exudation of [125I]human serum albumin, in amounts exceeding 1 pmol, and was more than 1000 times as potent as histamine. The effect was independent of cell infiltration, as no accumulation of PMNs, measured as the amount of myeloperoxidase in the skin, occurred and as the response was unaltered in animals rendered neutropenic due to treatment with an antiserum against PMNs. PMID- 3980075 TI - Influence of fluid-phase chemoattractants on polymorphonuclear leukocyte chemotaxic responsiveness to a surface-bound attractant. AB - Polymorphonuclear leukocytes (PMNLs) were allowed to migrate on slides with fixed yeast particles dotted about on the surface. Locomotion was quantified by counting the number of yeast particles in association with a PMNL. Addition of a complement source to yeast particles able to activate the complement system resulted in a chemotactic response even when fluid-phase attractants were removed prior to the measurement of PMNL chemotaxis, indicating that surface-bound attractants guided the PMNLs to the yeast particles. The presence of high concentrations of fluid-phase chemoattractants resulted in a reduced PMNL chemotactic response to the surface-bound gradient. From comparisons between the yeast-slide system and the locomotion-under-agarose assay, it could be concluded that PMNL chemotaxis in response to a surface-bound gradient is less influenced by factor-specific deactivation than the response to a fluid-phase attractant. The PMNL chemotactic response is reduced to both surface-bound and fluid-phase gradients as a result of a non-factor-specific deactivation. PMID- 3980074 TI - Methyltransferase and phospholipase A2 activity in membranes of neutrophils and lymphocytes from patients with bacterial and viral infections. AB - Phospholipid methylation and phospholipase A2 activation in the cell membrane are necessary for the induction of cell function in neutrophils and lymphocytes. We assessed the activity of membrane-associated methyltransferase and phospholipase A2 in neutrophils and lymphocytes from patients with acute and severe bacterial and viral infections. In bacterial patients, methyltransferase and phospholipase A2 activities of neutrophils were significantly enhanced, and [3H]methyl incorporation of lymphocytes was slightly increased. In viral infections, only phospholipase A2 activity of the lymphocytes was increased. These enhanced enzyme activities paralleled disease activity of the two disorders. The methylated products detected by two-dimensional thin-layer chromatogram were confined to methylated phospholipids, indicating that our assay system measures specifically the activity of methyltransferase which mediates the translocation of membrane phosphatidylethanolamine (PE) to phosphatidylcholine (PC) and lyso-PC(LPC). The two enzymatic activities of both neutrophils and lymphocytes in bacterial infections and phospholipase A2 of lymphocytes may, in part, have some correlation to the defense mechanism in these two disorders. PMID- 3980076 TI - Cytokineplasts from human blood polymorphonuclear leukocytes. Lack of oxidase activity and extended functional longevity. AB - Cytokineplasts (CKPs) are membrane-bounded, anucleate, granule-poor cytoplasmic fragments, induced from PMNs by brief heat (45 degrees C, 9 min), which retain motile function including chemotaxis and phagocytosis. CKPs can respond to repeated chemotactic stimuli even after having been held overnight at room temperature, and hence "outlive" control PMNs. We now report that adherent CKPs lack significant oxidase activity, as measured by reduction of nitroblue tetrazolium (NBT) dye, (1) 5 min after heat, when they are often still attached to their parent PMNs (which generally do not reduce NBT either); (2) later on, when they are free; and (3) when cells have been pretreated on endotoxin-coated substrata or with phorbol myristate acetate (PMA); both pretreatments cause the large majority of adherent control PMNs to reduce NBT. Moreover, cells harvested from glass just after heat lack the normal increase in oxygen consumption seen on stimulation with PMA or with heat-killed staphylococci. PMA-stimulated respiratory burst activity was not restored to heated cells by exogenous NADPH. Thus, heat applied to normal PMNs can dissociate motile function from oxidase activity; in this respect CKPs resemble PMNs in chronic granulomatous disease. The apparent increased functional stability of CKPs may indicate that normal PMNs are not immune to their own oxidative killing mechanism. PMID- 3980077 TI - Protective vaccination against virulent Babesia bovis with a low-molecular-weight antigen. AB - A Babesia bovis low-molecular-weight antigen was purified from crude material by using affinity adsorption techniques first with a mouse monoclonal antibody and then by adsorption with normal bovine sera. The antigen was then further purified by gradient gel electrophoresis. Analysis by Western transfer revealed only one antigen band, with an apparent molecular mass of 29 kilodaltons. A band (12 by 0.3 by 0.6 cm) corresponding to this antigen was excised from the acrylamide gel and injected twice 4 weeks apart, together with 2.5 ml of Freund complete adjuvant, into nine nonsplenectomized adult cattle. The vaccinated cattle and five susceptible control animals were challenged with a virulent homologous strain 4 weeks after the second vaccination. None of the vaccinated animals was clinically affected, whereas three of five controls were severely affected. Control animals had significantly greater declines in packed cell volume and greater rises in temperature and parasitaemias than vaccinated animals. PMID- 3980078 TI - Susceptibility to staphylococcal alpha-toxin of Friend virus-infected murine erythroblasts during differentiation. AB - Splenic erythroblasts obtained from BALB/c mice infected with the anemia strain of Friend virus were compared with "matured" cells and adult erythrocytes for their sensitivity to staphylococcal alpha-toxin. Matured cells were obtained by treating erythroblasts in culture with erythropoietin for 48 h. Sensitivity to staphylococcal alpha-toxin, measured both by release of 86Rb and by cell lysis, failed to demonstrate significant differences among the cell types. Since maturation of erythroblasts to matured cells or erythrocytes is associated with synthesis of band 3, hemoglobin, and spectrin and the loss of transferrin receptors, we conclude that none of these compounds serves as the specific receptor for staphylococcal alpha-toxin in BALB/c mice. PMID- 3980079 TI - Disulfide-bonded outer membrane proteins in the genus Legionella. AB - Legionella pneumophila and related species were examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis for outer membrane proteins. Of the 10 species examined, 9 contained a 24-kilodalton (kDa) major outer membrane protein (MOMP) that was resolvable only when outer membrane material was heated in the presence of 2-mercaptoethanol. Labeling studies with [35S]cysteine indicated that the protein contained cysteine, and disulfide cross-linking of the unreduced complex was demonstrated by labeling with iodoacetamide. The unreduced outer membrane preparation contained peptidoglycan, and after treatment with lysozyme to remove peptidoglycan, a protein complex of 95 kDa was observed by sodium dodecyl sulfate polyacrylamide gel electrophoresis in the absence of 2 mercaptoethanol. Reduction of the 95-kDa complex yielded 24-kDa monomers, suggesting that the 95-kDa complex was composed of four subunits. The 24-kDa MOMP from L. pneumophila was purified, and antibody produced to this protein cross reacted with all species of Legionella as determined from an immunoblot of a sodium dodecyl sulfate gel. Only serogroup 1 strains of L. bozemanii lacked the 24-kDa MOMP and showed no cross-reactivity. These results suggest that the 24-kDa MOMP common to most species of Legionella contains a genus-specific epitope. PMID- 3980080 TI - Chlamydial pneumonitis induced in newborn guinea pigs. AB - One- to three-day-old guinea pigs were inoculated intranasally with the chlamydial agent of guinea pig inclusion conjunctivitis. Physical signs of infection included a marked increase in respiration rate on days 5 to 10 of infection and radiographic evidence of pneumonia on day 6. When animals were killed at various times after infection and lung tissue was examined by histopathology, evidence of pneumonia was found beginning on day 4 and lasting as long as day 12, with maximal pathological changes on days 6 to 8. The pneumonia was generally unilateral and consisted of an acute inflammatory component in the bronchioles with granulocytes in both the lumen and the wall of the bronchioles and an interstitial and intra-alveolar mononuclear infiltrate in the parenchyma of the lung. Chlamydial antigen was detected in the bronchial epithelial cells by immunoperoxidase staining, and the guinea pig inclusion conjunctivitis organism was isolated from lung tissue on days 6 to 9. No other significant bacteria were isolated from lung tissue or seen on gram stains of lung sections. Both immunoglobulin M and immunoglobulin G serum antibodies to the guinea pig inclusion conjunctivitis agent were detected as early as day 8 and reached peak levels on day 12. The infection was apparently self-limiting. This model presents the opportunity to investigate pathophysiological and immunological aspects of chlamydial respiratory infections in a neonatal animal. PMID- 3980081 TI - Epidemiology of virulence-associated plasmids and outer membrane protein patterns within seven common Salmonella serotypes. AB - Antibiotic-sensitive Salmonella isolates belonging to seven common serotypes and originating from 29 different countries from all continents were investigated for their plasmid DNA content (337 isolates) and their outer membrane protein profiles (216 isolates). Of the S. typhimurium, S. enteritidis, S. dublin, and S. choleraesuis isolates, 90% or more carried a serotype-specific plasmid. The molecular sizes of the plasmids were 60 megadaltons (Md) for S. typhimurium, 37 Md for S. enteritidis, 56 Md for S. dublin, and 30 Md for S. choleraesuis. The outer membrane protein profiles were homogeneous within each of the seven serotypes, except that a minority of S. enteritidis and S. dublin strains were lacking one major outer membrane protein. Virulence studies were performed with 39 representative strains by measuring the 50% lethal doses (LD50S) after oral infection of mice. The LD50 values obtained for plasmid-positive strains of S. typhimurium, S. enteritidis, and S. dublin were up to 10(6)-fold lower than the values obtained for the plasmid-free strains of the same serotype. Only the plasmid-positive strains could invade the livers of orally infected mice, and only they were resistant to the bactericidal activity of 90% guinea pig serum. Strains of S. infantis were generally plasmid free, whereas S. panama and S. heidelberg isolates carried heterogeneous plasmid populations. The virulence properties of the latter three serotypes could not be correlated with the predominant plasmids found in these strains. PMID- 3980083 TI - A comparison of bacterial aggregation induced by saliva, lysozyme, and zinc. AB - Aggregation of bacteria by zinc and lysozyme was studied and compared with aggregation induced by a high-molecular-weight salivary agglutinin. Each ligand was found to exhibit a unique profile of properties when examined by both a microradiochemical centrifugation assay and a turbidimetric assay. Significant differences in rate of aggregation and bacterial species specificity were noted. Zinc- and lysozyme-mediated aggregations were shown to be calcium independent and to proceed rapidly at 0 degree C, in contrast to the salivary agglutinin. Zinc produced large, asymmetric aggregates, saliva produced intermediate-sized aggregates, and lysozyme produced the smallest aggregates. These size differences are consistent with many of the observed reaction properties. PMID- 3980082 TI - Dissipation of the proton motive force in oral streptococci by fluoride. AB - Strains of oral streptococci maintain an intracellular pH (pHi) that is more alkaline than the external pH (pHo). The delta pH (pHi-pHo) was about 0.6 in neutral media and about 0.9 in media of pH 5.5. Addition of 10 micrograms of F- per ml at pH 7.0 reduced the delta pH in Streptococcus salivarius to 0.17. The reduction of delta pH in S. sanguis H7PR3 was less pronounced, whereas the delta pH in S. mutans IB 1600 was unaffected. The F- -resistant mutant of S. salivarius, strain Flr103, maintained a delta pH of 0.51 with 100 micrograms of F per ml. Addition of F- to cells in media below pH 6.0 led to a reduction of delta pH in all strains. The anion had no effect on the transmembrane electrical gradient of either mutant or parental cells of S. salivarius at pH 7.0. The principal effect of F- addition at neutral pH, therefore, was on the delta pH component of the proton motive force. At pH 5.5, 100 micrograms of F- per ml reduced the transmembrane electrical gradient from 71 to 40 mV in the parent and from 80 to 42 mV in the mutant. We propose that the greater sensitivity of cells to F- at lower medium pH stems from the rapid dissipation of delta pH by the anion. Thus, pH equilibration in media of low pH would lead to a greater reduction of metabolic activity than when it occurs in media at neutral pH. The data also suggest that the growth of streptococci, with or without added F-, is limited when the intracellular pH falls below about 5.7. PMID- 3980084 TI - Immunopharmacological activities of a synthetic counterpart of a biosynthetic lipid A precursor molecule and of its analogs. AB - Synthetic lipid A analogs (compounds 404 through 406) were examined for their immunopharmacological activities. These compounds had two amide-bound and two ester-bound (R)-3-hydroxytetradecanoyl groups at the C-2 and C-2' and the C-3 and C-3' positions, respectively, of beta (1-3)glucosamine disaccharide. In all of the in vitro assays, these synthetic compounds exhibited high activities comparable to those of a reference lipid A prepared from Escherichia coli O8:K27 Re-mutant strain F515. The compounds activated the clotting enzyme cascade of the horseshoe crab, activated the human complement via the classical pathway, caused polyclonal B-cell activation, stimulated the phagocytosis of sheep erythrocytes by murine peritoneal macrophages, and enhanced the migration of human polymorphonuclear leukocytes. They also increased the thymidine uptake of splenocytes of BALB/c nu/nu and C3H/HeN mice but not those of C3H/HeJ (a nonresponder to lipopolysaccharide). A dephosphorylated derivative, compound 403, was barely active in all of the above assays except for the enhancement of polymorphonuclear leukocyte migration. However, compounds 404 through 406 were feeble in pyrogenicity and could not prepare the local Shwartzman reaction, although they were very lethal to galactosamine-loaded mice. Therefore, synthetic lipid A analogs described here were fully immunopharmacologically active in in vitro assays, but all of them were far less active than natural E. coli F515 lipid A regarding the biological activities characteristic of endotoxic lipopolysaccharides and lipid A's. The high lethal toxicity of compound 406 (1,4' bisphosphate) to the galactosamine-loaded mice may not reflect its real toxicity to normal mice. In all activities examined, compound 406 was quite comparable to a biosynthetic lipid A precursor, a natural counterpart of compound 406. The immunopharmacological activities of these newly synthesized lipid A analogs, especially compound 406, were much stronger than those of compounds that had been synthesized earlier by using the originally proposed model of the lipid A structure. The findings described in this report justify the acylation pattern of a disaccharide backbone of lipid A, revised on the basis of recent analytical studies. The low in vivo endotoxic activities of the present lipid A analogs are most probably due to the fact that the kinds of acyl groups were different from those of the complete lipid A from E. coli, although there were no differences in the acylation positions on the disaccharide backbone. PMID- 3980085 TI - Simultaneous loss of bacteriophage receptor and coaggregation mediator activities in Actinomyces viscosus MG-1. AB - Actinomyces bacteriophages were used as tools to study coaggregation between actinomyces and streptococci. Four bacteriophage isolates, phages AV-1, AV-2, AV 3, and 1281, bound to coaggregation group A Actinomyces viscosus and to group E A. naeslundii. No binding to groups B, C, D, or F was observed. Only A. viscosus MG-1 was capable of supporting a productive infection by these phages. Spontaneously occurring bacteriophage-resistant mutants of A. viscosus MG-1 were isolated and were shown to fall into two classes. Class I mutants were resistant to all four phages, whereas class II mutants were resistant only to phage AV-3. In each case, strains resistant to a particular phage were unable to bind that phage, suggesting that a loss or alteration of the cell surface phage receptor had occurred. Both classes of mutants were unable to coaggregate with streptococci representing coaggregation group 1 and had also lost the ability to mediate one type of coaggregation with group 4 streptococci. Class II mutants also were unable to coaggregate with group 2 streptococci. Lactose-inhibitable interactions with other streptococci (groups 3 and 4) were unchanged in the mutants. The simultaneous loss of sensitivity to phage AV-3 and the ability to coaggregate with coaggregation group 1 streptococci suggests the possibility of a relationship between these two cell surface structures. PMID- 3980086 TI - Expression of the temperature-inducible outer membrane proteins of yersiniae. AB - The expression of the temperature-inducible plasmid-coded outer membrane proteins (YOPs) of Yersinia pseudotuberculosis was studied. These proteins were not recovered in the outer membrane fraction when the strain was grown in minimal medium at 37 degrees C, but they were expressed under these conditions. A strict correlation was found between Ca2+ dependency in the virulent strain, YPIII(pIB1), and ability to express YOPs. Ca2+-independent plasmid mutants or RNA polymerase mutants harboring the virulence plasmid were unable to express YOPs, in contrast to the wild-type strain. These strains were also found to be avirulent. Sera recovered from patients or animals undergoing infection with either Y. pseudotuberculosis, Y. pestis, or Y. enterocolitica possessed antibodies directed against YOPs, indicating that they were expressed in all three pathogenic Yersinia species during infection. The YOPs of the three different species showed high immunological relatedness. PMID- 3980088 TI - Large plasmids associated with virulence in Shigella species have a common function necessary for epithelial cell penetration. AB - Large plasmids (120 to 140 megadaltons) associated with virulence of Shigella sonnei, S. flexneri 2a and S. dysenteriae 1 were transferred from each strain into Escherichia coli K-12 and avirulent S. flexneri 1b strains by ampicillin transposon (Tn1)-mediated conduction. Strains with the virulence plasmid could penetrate tissue culture cells irrespective of the original host of the plasmid. PMID- 3980087 TI - Immunomodulation of the antibody response to lipopolysaccharide in C3H/HeJ mice by complexing with heterologous ribosomes. AB - We show that formaldehyde fixation of Salmonella typhimurium lipopolysaccharide (LPS) to ribosomes purified from Brucella abortus induced a primary immunoglobulin M (IgM) response to LPS in C3H/HeJ mice and upon revaccination resulted in elevated titers of IgM and induction of IgG antibody to the O antigens of LPS, as measured by an enzyme-linked immunosorbent assay. A similar LPS-Aspergillus fumigatus ribosomal complex yielded IgM and IgG antibody to LPS only after secondary stimulation. These results demonstrate that the hyporesponsiveness of C3H/HeJ mice with respect to antibody formation to LPS can be overcome by complexing this molecule to ribosomal particles and provide a theoretical mechanism for the action of some "ribosomal" vaccines. The results are compatible with the hypothesis that LPS in complex with the ribosomes is converted to a T-dependent form of the antigen to which the C3H/HeJ mice can respond. PMID- 3980089 TI - Naturally acquired immunity to tetanus toxin in an isolated community. AB - Literature on natural immunity to tetanus is scarce. We examined antitetanus antibody levels with the enzyme-linked immunosorbent assay in 200 people living in an isolated community and clarified the influence of age and sex on immunity. In 197 subjects, antitoxin antibodies were measured. No sex differences were noted, and 30% had protective levels (above 0.01 IU/ml). The percentage of those considered protected was age dependent. PMID- 3980090 TI - Detection of circulating antigens in sera of rabbits infected with Toxoplasma gondii. AB - Experiments were performed to investigate the usefulness of an enzyme-linked immunosorbent assay utilizing avidin-biotin interaction as a diagnostic tool for detection of Toxoplasma antigen in blood. The lower limit of sensitivity of the assay by this method was ca. 4 ng/ml, and standard assays provided a linear plot of antigen concentration over a range up to 250 ng/ml. In rabbits inoculated subcutaneously with trophozoites of the RH strain, Toxoplasma antigen became demonstrable in the circulation 3 days after injection, before emergence of antibody in serum and development of parasitemia. Analysis of the antigen in serum from infected rabbits by high-permeation liquid gel chromatography suggested the occurrence of antigens of four different molecular weights, greater than or equal to 400,000, 220,000, 130,000, and 45,000. Of these antigens, those of molecular weights 220,000 and 130,000 showed a conspicuous elevation with time after infection. PMID- 3980091 TI - Immunologically reactive proteins of Streptococcus equi. AB - Immunologically reactive proteins in acid extracts and culture supernatants of Streptococcus equi were recognized through a combination of chromatographic and immunologic procedures. Both high- and low-molecular-weight components of each of these protein preparations were protective for mice and were, therefore, presumed to contain a variety of hydrolytic products or fragments of the M protein of S. equi. Convalescent horse sera that exhibited strong bactericidal activity for S. equi always reacted with polypeptides in the molecular weight range of 24,000 to 29,000, whereas preinfection sera did not. Rabbit antisera to affinity-purified S. equi protein also reacted with these polypeptides, as well as with a polypeptide of about 36,000 to 37,000 molecular weight. M protein in acid extract and culture supernatant did not cross-react in immunodiffusion, but rabbit antiserum to affinity-purified M protein from an acid extract of S. equi reacted strongly with culture supernatant proteins of approximate molecular weights of 67,000, 58,000, and 43,000. We suggest, therefore, that the M protein in culture supernatant is masked by other sequences that are removed by hot acid during preparation of acid extracts. Polypeptides common to acid extracts of S. equi and Streptococcus zooepidemicus were also identified. These polypeptides had molecular weights of about 55,000 and 31,000. PMID- 3980092 TI - In vivo evidence that bacteria in urinary tract infection grow under iron restricted conditions. AB - The outer membrane protein composition of bacteria isolated directly and without subculturing from the urine of two patients with urinary tract infections was investigated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The results indicated that the bacteria grew under iron-restricted conditions, as revealed by the expression of several high-molecular-weight outer membrane proteins which could also be observed when the same isolates were grown under iron-depleted conditions in laboratory media. The antigenicity of outer membrane components of the bacteria isolated was studied by immunoblotting with serum samples from the patients. The results indicated that the sera from the patients contained antibodies against major outer membrane components of the bacteria present in the urine, including the iron-regulated membrane proteins. PMID- 3980093 TI - Competitive displacement of mutans streptococci and inhibition of tooth decay by Streptococcus salivarius TOVE-R. AB - The ability of Streptococcus salivarius TOVE-R to displace virulent representatives of the most prevalent human mutans streptococci from the teeth of rats, and thereby to inhibit caries, was studied. Streptococcus mutans 10449S- or Streptococcus sobrinus 6715-13WT-infected specific-pathogen-free rats consuming a high-sucrose diet were inoculated by TOVE-R. The infectants were differentially recovered from swabs of the teeth over the time course of infection and from sonically treated material of extracted teeth and excised tongues. Despite initial colonization of the teeth by the mutans streptococci, TOVE-R colonized the teeth, unlike other essentially nonvirulent plaque formers already described. It did not colonize the tongues of the rats. TOVE-R emerged and persisted as a prominent member of the plaque ecology. There was an associated decline in the mutans streptococci on the teeth, and this decline was associated with significant inhibition of the caries component attributable to 10449S infection (56%) and to 6715-13WT infection (52%). TOVE-R did not reliably inhibit the component of fissure caries attributable to the nonmutans indigenous flora of the rats. TOVE-R itself induced no detectable decay. The data suggest the potential therapeutic utility of TOVE-R to inhibit caries by displacement of mutans streptococci from the teeth. These results supplement the already reported ability of TOVE-R to preempt initial colonization of teeth by the mutans streptococci. PMID- 3980094 TI - Modulation of pulmonary clearance of bacteria by antioxidants. AB - To further delineate the mechanisms underlying murine pulmonary defenses against bacterial infection, we studied the effects of antioxidant enzymes and hydroxyl radical scavengers on pulmonary clearance processes. Intratracheal injection of catalase and superoxide dismutase resulted in prolonged intraalveolar residence of the enzymes, but caused no decrease in rates of clearance of either Staphylococcus aureus 502A or Pseudomonas aeruginosa PAO1. In contrast, dimethylsulfoxide and dimethylthiourea caused significant depression of clearance of P. aeruginosa without altering clearance of S. aureus. These results provide further differentiation between clearance processes affecting gram-negative and gram-positive bacteria and suggest that murine clearance of gram-negative organisms may be in part mediated by reactions which generate hydroxyl anion. In vivo administration of agents which inhibit hydrogen peroxide-, superoxide-, or hydroxyl anion-mediated reactions do not alter normal clearance of S. aureus. PMID- 3980095 TI - Purification and characterization of an extracellular cytolysin produced by Vibrio vulnificus. AB - An extracellular cytolytic toxin produced by the halophilic bacterium Vibrio vulnificus was isolated free of detectable contamination with medium constituents and other bacterial products by sequential ammonium sulfate precipitation, gel filtration with Sephadex G-75, hydrophobic interaction chromatography with phenyl Sepharose CL-4B, and isoelectric focusing in an ethylene glycol density gradient. The cytolysin is a heat-labile, hydrophobic protein that is inhibited by large amounts of cholesterol, is partially inactivated by proteases and trypan blue, has a molecular weight (estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and by amino acid analysis) of ca. 56,000, and has an isoelectric point of ca. 7.1. The first 10 amino-terminal amino acid residues of the cytolysin are Gln-Glu-Tyr-Val-Pro-Ile-Val-Glu-Lys-Pro. Lysis of mouse erythrocytes by the purified cytolysin is a multi-hit, at least two-step process consisting of a temperature-independent, toxin-binding step, followed by a temperature-dependent, membrane-perturbation step(s). In addition to possessing cytolytic activity against erythrocytes from 17 animal species and against Chinese hamster ovary cells in tissue culture, the purified cytolysin preparation was lethal for mice (ca. 3 micrograms/kg, intravenous 50% lethal dose) and had vascular permeability factor activity in guinea pig skin. PMID- 3980096 TI - Promotion of Streptococcus mutans glucose transport by human whole saliva and parotid fluid. AB - Human saliva and parotid fluid have two effects on glucose uptake by Streptococcus mutans: a reduction in the overall rate of uptake, and the promotion of a biphasic mode of uptake. The former effect had been previously shown to result from lactoperoxidase-mediated inhibition of transport or metabolism or both. The objective of the present study was to uncover the basis of the second effect. Biphasic glucose uptake consisted of a rapid phase of low capacity and short duration (approximately 10 to 15 s) followed by a slower phase of high capacity and long duration (several minutes). The slow phase is typical of cells not exposed to the secretions (control cells). S. mutans BHT cells pretreated with as little as 10 microM glucose for 10 min at 37 degrees C, followed by its removal, subsequently exhibit biphasic glucose uptake typical of saliva- or parotid fluid-treated cells. Since pretreatment of the organism with glucose, whole saliva supernatant, or parotid fluid supported subsequent transport of the nonmetabolized glucose analog, 2-deoxyglucose, we concluded that pretreatments established a relatively stable pool of glycolytic intermediates (i.e., a phosphoenolpyruvate potential). Thin-layer chromatographic analysis of extracts from [14C]glucose-pretreated cells confirmed the presence of a stable pool of triose phosphates. Dialysis experiments indicated that high-molecular weight substrates in the secretions were readily utilized by the organism to establish a phosphoenolpyruvate potential, especially when the lactoperoxidase system was rendered inactive. A survey of several carbohydrate constituents of salivary glycoproteins revealed that mannose, galactose, and N-acetylglucosamine, in addition to glucose, established phosphoenolpyruvate potentials in the organisms. Inactive substances included, among others, N-acetylgalactosamine and N-acetylneuraminic acid. In a survey of selected amino acids, arginine alone promoted 2-deoxyglucose accumulation by the organism, albeit feebly. Finally, it is argued that the phenomenon of biphasic glucose uptake provides evidence that the rate limiting step in glucose uptake by S. mutans is glucose metabolism and not glucose transport. PMID- 3980097 TI - Systemic Chlamydia trachomatis infection in mice: a comparison of lymphogranuloma venereum and trachoma biovars. AB - We developed a murine model of systemic infection with Chlamydia trachomatis biovar lymphogranuloma venereum (LGV). The pathological features of this infection resemble those of human LGV infection since both are characterized by granuloma formation. Mice developed resistance to reinfection with LGV, and this resistance was based on cellular immune mechanisms since it was transferable with immune spleen cells but not with immune serum. Resistance required viable organisms for induction. We compared LGV biovar infection with trachoma biovar infection. Trachoma biovar produced similar but less marked microbiological and pathological features. Cross-immunity was less apparent between serovars from trachoma and LGV biovars than it was between serovars within the same biovar. This model of systemic C. trachomatis infection will be useful in exploring virulence features of LGV. PMID- 3980098 TI - Effect of fibronectin on adherence of Staphylococcus aureus to fibrin thrombi in vitro. AB - Staphylococcus aureus binds to purified fibronectin in solution and may bind to fibronectin present in wound tissue. When incorporated into a solid fibrin thrombus, however, plasma fibronectin may fail to bind S. aureus, because the S. aureus-binding sites on fibronectin may be occupied by fibrin. Both S. aureus and fibrin bind to the same 27-kilodalton amino-terminal fragment of fibronectin. To determine whether fibronectin incorporated into fibrin still promotes the adherence of S. aureus, we clotted citrated normal plasma and fibronectin depleted plasma onto petri dishes. We then measured bacterial adherence to these in vitro fibrin thrombi. We found that the adherence of five of seven S. aureus strains decreased significantly (by 26 to 58%) when fibronectin had been depleted from the fibrin thrombi. Adding fibronectin back reversed this decrease in adherence. The reversal was dose dependent; the increase was in proportion to the amount of fibronectin added back to the plasma. Bacteria known not to bind to fibronectin (Escherichia coli and Staphylococcus epidermidis) adhered 100-fold less than S. aureus, and their adherence was unaffected by the absence of fibronectin in the fibrin thrombus. We conclude that fibronectin incorporated into solid fibrin thrombi does mediate the adherence of most S. aureus strains to fibrin thrombi. Fibronectin may be an important molecule that mediates the adherence of S. aureus to fibrin in wounds. PMID- 3980101 TI - The use of perfluorochemicals during open heart surgery. AB - Several experimental studies of global myocardial ischemia involving different animal models have demonstrated enhanced oxygen delivery and oxygen consumption when oxygenated perfluorochemical cardioplegic solutions were used. Use of these solutions results in improved recovery of ventricular function after prolonged periods of global ischemia when compared with either standard crystalloid cardioplegic solutions or oxygenated blood cardioplegic solutions. Furthermore, intracellular pH and myocardial ATP levels are well maintained during protracted periods of global myocardial ischemia with oxygenated perfluorochemical cardioplegic solutions. Based on these convincing experimental results, clinical investigation of an oxygenated perfluorochemical cardioplegic solution is warranted. Although current methods of myocardial protection during open heart surgery usually are adequate, patients undergoing complicated open heart surgical procedures or those with significant left ventricular dysfunction prior to surgery--that is, those patients most in need of highly effective myocardial protection--would likely benefit substantially if oxygen were delivered via the cardioplegic solution. Furthermore, perfluorochemical solutions may be especially useful for cardiopulmonary bypass pump priming in patients unable to accept whole blood transfusion during open heart surgery. PMID- 3980100 TI - Introduction to fluorocarbons. PMID- 3980099 TI - Identification and characterization of Vibrio cholerae surface proteins by radioiodination. AB - Whole cells and isolated outer membrane from Vibrio cholerae (Classical, Inaba) were radiolabeled with Iodogen or Iodo-beads as catalyst. Radiolabeling of whole cells was shown to be surface specific by sodium dodecyl sulfate-urea polyacrylamide gel electrophoresis of whole cells and cell fractions. Surface labeled whole cells regularly showed 16 distinguishable protein species, of which nine were found in radiolabeled outer membrane preparations obtained by a lithium chloride-lithium acetate procedure. Eight of these proteins were found in outer membranes prepared by sucrose density gradient centrifugation and Triton X-100 extraction of radiolabeled whole cells. The mobility of several proteins was shown to be affected by temperature, and the major protein species exposed on the cell surface was shown to consist of at least two different peptides. PMID- 3980102 TI - Chemistry of fluorocarbons in biomedical use. PMID- 3980103 TI - Fluorocarbons in the resuscitation of hemorrhage. PMID- 3980105 TI - Potential application of perfluorochemicals in cancer therapy. AB - PFC emulsions, because of their excellent oxygen-transporting properties and possibly other properties as well, have broad and promising potential in cancer therapy. Although this potential is readily apparent to both laboratory and clinical investigators who are concerned with tumor hypoxia, it should be equally apparent that the formulations that are currently available are wholly inappropriate for such an application. The sublethal toxicities of these emulsions may appear to indicate a poor prognosis for this approach, but they may be a blessing in disguise. All known approaches to tumor hypoxia are limited by our inability to administer enough of the agents to be effective. In many cases, the limiting factor was not uncovered until the approach had been introduced into clinical trials. Had we relied on such parameters as lethality in the case of PFC emulsions, the same mistake might have been made here. Instead, the death of a single rat has caused us to focus our attention on what would surely have produced major problems in the initial clinical trials. Recognition of the sublethal toxic effects of PFC emulsions at this early stage should allow us to optimize our formulations at the preclinical stage, thereby increasing the likelihood that PFC emulsions will someday live up to their full potential. PMID- 3980104 TI - Present status of clinical studies of Fluosol-DA (20%) in Japan. AB - Fluosol-DA (20%) is a fine-particle stable emulsion with low toxicity and rapid elimination from the body. Based on comprehensive animal experiments and phase one human studies, Fluosol-DA (20%) has been given clinically to 401 patients in Japan. In 270 of these patients, it was given to treat severe hemorrhage, and in 131, it was given to improve impaired cerebral circulation or for other nonhemorrhagic indications. In these studies, Fluosol-DA (20%) was effective as a blood gas carrier as well as a plasma expander. After infusion of 20 ml of Fluosol-DA (20%) per kilogram of body weight, while maintaining the FIO2 at or near 0.5 or 0.6, PFCs transport an amount of oxygen equivalent to approximately 6.3 +/- 1.4% of the oxygen transported by the hemoglobin phase and approximately 100% of the oxygen transported by plasma. The arteriovenous oxygen difference in the PFC phase was approximately 25 to 30% of that in the hemoglobin phase. Of the oxygen consumed by the tissues, approximately 17% was provided by the PFC phase after treatment with Fluosol-DA (20%). Hemodynamic parameters of patients with hemorrhage were either maintained or recovered to normal levels after Fluosol-DA (20%) infusion. No acute or chronic untoward reactions were observed either early or late after infusion of Fluosol-DA (20%), except for a transient decrease in neutrophils and platelets after the initial administration of a test dose of 1 ml, and these parameters recovered spontaneously in 30 minutes. No abnormal findings that could be attributed to Fluosol-DA (20%) were found in the heart, lungs, liver, spleen, kidneys, bone marrow, endocrine system, or other organs. Organ retention of PFC particles was evaluated in 6 autopsy cases in Japan. Although PFCs were detected in many organs several months after a single Fluosol DA (20%) injection of 20 ml per kilogram of body weight, PFCs were not found in body tissues of those who were autopsied more than 7 months after its infusion. RES function was slightly depressed for a few days in patients receiving 20 ml of Fluosol-DA (20%) per kilogram of body weight. It was also depressed for several days in rats given 40 ml per kilogram of body weight. Compared with that of control patients, recovery to preoperative levels was slightly delayed in patients receiving Fluosol-DA (20%). Despite this, administration of up to 20 ml of Fluosol-DA (20%) per kilogram of body weight should be safe with respect to the RES function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3980106 TI - Surfactants and perfluorochemical emulsions for use in blood replacement preparations. PMID- 3980107 TI - Immunological biocompatibility in blood substitutes. PMID- 3980108 TI - Transport of oxygen by perfluorochemical emulsions. PMID- 3980109 TI - Quantitation of immunoglobulin isotypes in chronic lymphocytic leukaemic cells compared with normal adult and neonatal lymphocytes. AB - Radioimmunoassays were used to measure the total cellular content of mu, gamma, alpha, delta, kappa and lambda immunoglobulin chains in peripheral blood lymphocytes from normal adults, neonates and 11 patients with chronic lymphocytic leukaemia (CLL). Normal adult lymphocytes contained all classes of immunoglobulin, but predominantly IgG, associated with both types of light chain (kappa:lambda ratio 2:1). In contrast, mu was the major heavy chain in cells from 10 of the CLL patients, and the small amount of IgG found in CLL cells was not produced by the leukaemic clone. Approximately equimolar amounts of one type of light chain were also present, indicating monoclonality. The class distribution of the immunoglobulin in the neonatal cells was intermediate between that of CLL and normal adult cells. CLL B cells had substantially less surface IgM than normal but more cytoplasmic IgM. These data demonstrate the immaturity of neonatal B cells and suggest that CLL cells are also immature--at a stage not normally found in the adult circulation. PMID- 3980110 TI - Chronic cutaneous granulomatous dermopathy: morphologic and serologic evaluation, differential diagnosis and pharmacologic control. AB - We report on a syndrome of disfiguring lower extremity cutaneous lesions of 6 years duration. Previous medical evaluations included 5 skin biopsies and several therapeutic regimens which did not alter the course of illness. The histologic interpretations of skin biopsies included panniculitis, papulonecrosis, and granuloma. One biopsy was interpreted as a localized cutaneous vasculitis with a wedge-shaped infarct. Infectious, collagen vascular, and factitious etiologies could not be demonstrated to explain the patient's lesions. The Chicago Dermatological Society included in their differential diagnosis bacterial allergy, including the tuberculoid reaction. Mycobacterium tuberculosis as the etiology was dismissed by negative cultures, histologic staining and failure of response to antituberculous therapy. Our report includes a series of immunologic tests that might be consistent with but do not definitively establish a bacterial hypersensitivity reaction to explain this patient's skin lesions. Despite a lack of proven etiology dramatic improvement occurred with corticosteroid therapy. PMID- 3980112 TI - Leukocyte procoagulant activity as an in vitro index of nickel contact hypersensitivity. AB - Following 20-hour incubation with nickel sulphate, peripheral blood mononuclear cells from patients with nickel contact dermatitis showed increased procoagulant activity compared with healthy controls. The Ni-induced response was dose-related and specific as judged by the use of cobalt as a control. This convenient new assay may prove valuable not only in contact dermatitis, but also in other types of skin disorder where at present there are no satisfactory in vivo or in vitro methods of assessment. PMID- 3980111 TI - Immune responses to polyethylene glycol modified L-asparaginase in mice. AB - Suppression of anti-L-asparaginase (anti-A-ase) IgG and IgE antibody responses was achieved in Balb/c mice with polyethylene glycol (PEG, MW, 5,000) conjugated Escherichia coli A-ase. Following the administration of the mixture of A-ase and PEG-A-ase, antibody production to A-ase was reduced. PEG-A-ase administration prior to A-ase suppressed the primary and secondary responses to A-ase antibody. The suppression could be transferred to normal mice with spleen cells from A-ase tolerant mice. The cell transfer experiment showed that the suppression was caused by suppressor T cells. Since PEG-A-ase administration failed to suppress antibody response to ovalbumin, the suppression seemed to be A-ase specific. PEG A-ase administration also suppressed the delayed type hypersensitivity reaction. IgG and IgE antibodies to PEG or PEG-A-ase were not detected in mice immunized with PEG or PEG-A-ase in the presence of Freund's complete adjuvant or A1(OH)3, respectively. PMID- 3980114 TI - Immunopathology and immunopharmacology of the lung. Advanced course at the Alessandro Volta Center, Como, Italy, May 31-June 2, 1984. PMID- 3980113 TI - Binding of ssDNA-antibody complexes to thioglycollate-induced mouse peritoneal macrophages in the presence of serum. AB - The binding of DNA-antibody complexes to thioglycollate-induced mouse peritoneal macrophages is inhibited by fresh but not by decomplemented normal mouse serum. Binding to macrophage complement receptors was not observed. PMID- 3980115 TI - Pulmonary immunodeficiency. PMID- 3980116 TI - Cellular biology and pathology of type II pneumocytes. PMID- 3980118 TI - Additivity of fast neutron and gamma ray induced thermoluminescence and reusability of CaF2:TLD-300 ribbons. AB - TL response of CaF2:Tm to fast neutrons and gamma rays is found to be additive. No significant change in the response is observed for a number of irradiation, anneal and readout cycles. Problems associated with mixed field dosimetry are discussed. PMID- 3980117 TI - "Interstitial pathology': an overview of the chronic interstitial lung disorders. PMID- 3980119 TI - Radiological impact of fallout 99Tc in Seville, 1965-1967. AB - From 99Tc concentrations in Seville air, measured previously for a 26 month period in 1965-67, we deduce the amount of intake by inhalation and the following committed dose equivalent to the population using in different ways a compartmental model to describe clearance from the respiratory system. Extremely low values of less than 10(-2) Bq intake per year and a corresponding committed dose equivalent below the nSv are deduced. PMID- 3980121 TI - The effect of external regeneration on the performance of CaSO4:Dy discs. AB - The authors have investigated the effect of annealing on the reproducibility of CaSO4: Dy dosimeters. The dosimeters cannot be used without external thermal treatment in high precision therapy level dosimetry while a 600 degrees C-1 h external regeneration resulted in a better reproducibility than a 400 degrees C-1 h treatment (which may be used if the absorbed dose in water does not exceed a few Gy). The background of the dosimeters increased considerably even in a 10 X 1 mGy exposure as a result of irradiation history if no external regeneration was used. PMID- 3980122 TI - Relative density measurements in a simple lung phantom by Compton backscatter. AB - Compton backscatter of 60 keV gamma radiation from a simple lung phantom has been used to measure changes in "lung" density. It was shown how introduction of a small volume of air can increase as well as decrease the count. Radiation scattered from the "chest wall" was prevented from entering the detector by careful choice of geometry. The remaining count increased linearly with "lung" density. The relative increase of count rate with density was entirely independent of "chest wall" thickness. With our apparatus a change of 0.01 kg/L in "lung" density produced a change in count rate of 2.2%. PMID- 3980120 TI - Use of 11C as a tracer for studying the synthesis of [11C]urea from [11C]cyanide. AB - The use of reversed-phase liquid chromatography and radiochemical detection with carbon-11 (t1/2 = 20.4 min) as a tracer allowed the study of the preparation of [11C]urea from [11C]cyanide at no-carrier-added concentrations. [11C]cyanate was readily prepared by permanganate oxidation of [11C]cyanide at 75 degrees C. The conversion of NH4O11CN (approximately 0.03 mM) to [11C]urea in the presence of excess ammonium ions (0.28 M) was found to best fit pseudo first order reaction kinetics with a rate constant of 0.065 +/- 0.008 min-1 at 75 degrees C. Heating at higher temperatures (180-200 degrees C) revealed that the conversion of NH4O11CN to [11C]urea occurred in high yield in less than 3 min. The hydrolysis of [11C]cyanate to [11C]carbonate, a possible side reaction, was found to proceed at a rate of 0.010 +/- 0.001 min-1 at 113 degrees C. PMID- 3980124 TI - A practical, high-resolution, microcomputer-based method for the analysis of relaxation data exhibiting multicomponent exponential decays. AB - We have developed and tested a practical, rapid, high-resolution, microcomputer based method for the analysis of multicomponent exponential decays. The analysis utilizes the Fourier deconvolution technique and includes methods to reduce noise both in the input data and in the results. The developed method is particularly well suited for analysing decays consisting of a wide range of decay times. The method resolves two exponential decays differing by a factor of two when the input data are mathematically generated and without noise, and resolves two decays differing by a factor of three when 2% Gaussian noise is present in the same data. The method lends itself to routine analysis of any relaxation process consisting of exponential decays, including biomedical applications such as enzyme kinetics, circulatory transport functions, pharmacokinetics, plasma exchange therapy, and analysis of compartmental models for any process. PMID- 3980123 TI - Dipole source derivation. Application to the half-field pattern evoked potential. AB - Dipole modelling is a technique for estimating the location of sources of electrical activity in the brain responsible for the generation of surface recorded potentials on the human scalp. A detailed description of this technique is given with a modification that allows for possible activity at the reference electrode during the surface potential measurement. The application of this technique to localisation of the source of the principal components of the left half-field pattern visual evoked potential is described. PMID- 3980125 TI - The third heart sound. AB - A unitary concept is proposed to explain the genesis of the third heart sound and associated "rapid filling wave" of the apexcardiogram in physiological and pathological states including constrictive pericarditis. This theory not only clarifies the hitherto unexplained phenomenon such as presence of S3 in significant mitral stenosis, but also places in proper perspective the hemodynamic significance of S3 in physiological and various pathological states. PMID- 3980127 TI - Acute renal failure following cardiopulmonary bypass in children: results of treatment. AB - Following open heart surgery using cardiopulmonary bypass, 18 (4%) of 441 operated children required treatment with peritoneal dialysis for acute renal failure or refractory oliguria. Nine recovered renal function (50%) and 5 (28%) survived. Only 2 died from renal causes. Despite both adequate symptomatic treatment of renal failure and few complications of dialysis itself, the prognosis remains poor, even with early treatment, but an aggressive approach is justified because some survivors can be expected. PMID- 3980128 TI - An unusual type of anomalous pulmonary venous drainage associated with a complex left heart hypoplasia and a variety of divided left atrium ("cor triatriatum"). AB - A previously unreported complex congenital cardiac malformation was noted in which a vestigial left atrium consisted of two completely separate portions, one of which was connected to the pulmonary veins but had no outlet orifice. The pulmonary venous drainage was through an anomalous intrapulmonary vein within the displaced right lung into the inferior caval vein above a deformed diaphragm. The left atrioventricular connexion was absent. Some points of terminology are considered. PMID- 3980130 TI - Anterograde sinuatrial conduction evaluated by sinus node electrogram in atropine blocked retrograde atrial conduction. AB - Two cases are described where atropine induced the disappearance of reset zone as response to premature atrial stimulation for blocked retrograde atrial conduction. Because of this, sinuatrial conduction time could not be estimated. The sinus node electrogram allowed the direct measurement of sinuatrial conduction and showed a facilitated anterograde conduction through the perinodal fibers after administration of the drug. PMID- 3980129 TI - A method for evaluating different modes of action of an antiarrhythmic drug in man. The effects of propafenone on sinus nodal functions. AB - In vitro experiments have shown that the antiarrhythmic effects of propafenone are due to a direct depressant action and to a beta-blocking activity. In this study a method was used to evaluate the direct effect and the autonomically mediated actions of an antiarrhythmic agent in a clinical setting. An electrophysiological study was performed twice, at an interval of 24 hr, in 17 patients (age: 52 +/- 17 years) with normal resting and intrinsic heart rate. In the first study the overall effect of intravenous propafenone (1.5-2 mg/kg) was evaluated by comparing the sinus node parameters obtained during the basal state and after drug administration. In the second study the direct depressant effect of the drug was evaluated by comparing the electrophysiological variables obtained following autonomic blockade (propranolol 0.2 mg/kg and atropine 0.04 mg/kg) and after propafenone. In the first study there was no significant change in the sinus cycle length and corrected sinus node recovery time and only a small (9.1%) increase in sinuatrial conduction time, whereas in the second study these variables increased significantly. The degree of increase in sinus cycle length and corrected sinus node recovery time was significantly higher in the second study than in the first one. These data suggest that: (1) propafenone has direct depressant effect on sinus automaticity but this effect is counteracted by autonomically mediated actions (most likely of vagolytic type); (2) the beta blocking effect of the drug demonstrated in isolated atria is not seen in a clinical setting. PMID- 3980126 TI - Pulmonary arterial development in infants with large perimembranous ventricular septal defects associated with overriding of the aortic valve. AB - Intracardiac anatomy and pulmonary vascular structure were studied in 13 cases having large perimembranous ventricular septal defects associated with overriding of the aortic valve, 12 of whom died aged 2 days-9 months. In all cases the ventricular septal defect and aorta were of the same size, but the diameter of the pulmonary orifice was usually greater. Quantitative morphometric techniques were used to study the lungs. Structural adaptation to extra-uterine life was shown to have occurred normally in the 4 patients who died as neonates. In the cases aged 2 months-4 years, there was an increase in arterial medial thickness and extension of muscle, while the intra-acinar arteries were larger than normal in size and normal in number. Intimal proliferation was seen in 1 case at 4.5 months, but such proliferation caused significant obstruction only in one child aged 4 years. These findings emphasize the rapidity with which structural adaptation to extra-uterine life can occur in the patient with a large unrestrictive ventricular septal defect. A rapid increase in muscularity can be seen by 2 months of age. Should banding of the pulmonary artery be required in patients with more complicated intracardiac abnormalities in whom it is desirable to achieve a normal pulmonary vascular bed, our findings encourage its early performance, particularly in those destined for a Fontan repair. PMID- 3980131 TI - Isolated atresia of the left pulmonary veins. AB - Four cases of congenital isolated atresia of the left pulmonary veins were observed over a 12-year period. The diagnosis was established through radionuclide pulmonary perfusion studies together with cardiac catheterization and pulmonary arteriography. Both procedures showed an elevated pulmonary pressure wedge and decreased blood flow with late poor filling of the pulmonary capillary bed on the affected side. Arteriography revealed non-visualization of the left pulmonary veins. The possibility of congenital atresia of the pulmonary veins should be borne in mind when confronted by unexplained hemoptysis, recurrent lower respiratory infections with protracted infiltrates, or pulmonary arterial hypertension. Surgical treatment, though difficult, is feasible. PMID- 3980133 TI - Cardiovascular dysfunction in septic shock: new insights into a deadly disease. PMID- 3980132 TI - An unusual case of rapidly progressive primary pulmonary hypertension in childhood. AB - A 7-year-old child died with primary pulmonary hypertension only 6 months after the onset of symptoms. Autopsy demonstrated severe pulmonary arterial medial hypertrophy and intimal proliferation. This case emphasizes the rapidity with which pulmonary vascular obstruction may occur, death resulting from potentially reversible structural abnormalities. It also demonstrates the variability in pulmonary vascular pathology in primary pulmonary hypertension and the necessity of biopsying the lung in order to predict those in whom vasodilator therapy might be helpful. PMID- 3980134 TI - Lidocaine and prevention of ventricular fibrillation complicating acute myocardial infarction. AB - Prehospital prevention of primary ventricular fibrillation using 400 mg lidocaine i.m. may be effective in subjects aged under 70, but routine administration is not yet recommended since mortality was unaffected. Although in-hospital prevention of ventricular fibrillation can be achieved by routine i.v. administration of lidocaine in rather high dosages, this regimen is still controversial in well-equipped CCUs in view of conflicting results on mortality. PMID- 3980136 TI - Partition and determination of cadmium, copper, lead and zinc in marine suspended particulate matter. AB - A method for the determination of Cd, Cu, Pb, and Zn in the total and acetic acid (25%) soluble fraction of suspended particulate matter collected on Nuclepore membranes is described. The acetic acid leaching was carried out in a modified Millipore vacuum filtration apparatus. The total sample and the acetic insoluble fraction were decomposed in teflon bombs with HF/aqua regia. Flame or graphite furnace AAS was used for metal determinations. Sequential acetic acid extractions (3) show that on the average 76.4-92.0% of the metals are removed with the first extraction. Cadmium is potentially most easily available to biota with 90.4% of the total metal concentration located in the acetic acid soluble fraction. PMID- 3980137 TI - Evaluation of the sweep co-distillation cleanup technique for the determination of environmental contaminants in human adipose tissue. AB - Beef and pork fat, corn, peanut, rapeseed and paraffin oils, as well as vegetable shortening were used to investigate their suitability as fortification media for environmental chemicals in the evaluation of the sweep co-distillation technique. The animal fats produced considerable gas chromatographic background interference, while the oils were partly carried over during the sweep co distillation process, except for rapeseed and peanut oil. Residue free rapeseed oil was fortified with 26 environmental chemicals in several groups at 20 and 200 ng/g of oil. Recoveries for most compounds were greater than 80% with a coefficient of variation of less than or equal to 10. At the 20 ppb fortification level, recoveries for Aroclor 1260, Mirex and pentachlorobenzene were only 70 80%. A similar low recovery was observed for p,p'-DDT, Mirex, hexachloro-1,3 butadiene, while at the 200 ppb level, 1,2,4-trichlorobenzene was only 33% recovered. The sweep co-distillation technique was further evaluated by using rendered human fat and the same fat diluted with residue free peanut oil. Residue levels in diluted and non-diluted fat were in good agreement, except for hexachlorobenzene. These residue levels were further compared with those obtained by two other cleanup procedures: Florisil-silicic acid column chromatography and low temperature precipitation. In general the sweep co-distillation technique compared favourably with these other cleanup procedures. There was evidence, however, that p,p'-DDT broke down into p,p'-TDE and varying operating procedures did not completely remedy this situation. PMID- 3980135 TI - Determination of 23 polycyclic aromatic hydrocarbons in atmospheric particulate matter of the Paris area and photolysis by sunlight. AB - Twenty-three polycyclic aromatic hydrocarbons (PAH) were determined in atmospheric particulate matter in 4 places of the Paris area at several times of the year. Fractionation was performed by reversed-phase high-pressure liquid chromatography. Determination was done by recording emission or excitation fluorescence spectra via a stopped-flow technique. Triphenylene was also extemporaneously determined by its phosphorescence spectrum at low temperature. Among the PAH determined dibenz(e,ghi)perylene has not been detected before in atmospheric particulate matter. The 10 more abundant PAH ranged from 0.1 to 40 ng/m3 of filtered air. Concentrations in August are from 14 to 250 times less than in January depending on the PAH. The reasons for this difference of behaviour among the PAH were investigated with regard to their photochemical and non-photochemical reactivity. PMID- 3980138 TI - Resistance of exotic and domestic lambs to experimental infection with Haemonchus contortus. PMID- 3980139 TI - Nippostrongylus brasiliensis: in vitro feeding activity. PMID- 3980140 TI - Comparative scanning electron microscope (SEM) study of miracidia of four human schistosome species. PMID- 3980141 TI - Transmission electron microscopic observations on lipid release in Schistosoma mansoni maintained in vitro. PMID- 3980143 TI - Proterometra macrostoma (Trematoda:Azygiidae): functional morphology of the tegument of the redia. PMID- 3980142 TI - The influence of level of infection of rats with Nippostrongylus brasiliensis on the haematology and phospholipase activity and mast cell numbers in the small intestine and colon. PMID- 3980144 TI - Prenatal and lactational transmission of Toxocara canis and Ancylostoma caninum: experimental infection of the bitch before pregnancy. PMID- 3980145 TI - Structural and histochemical changes in the salivary glands of Rhipicephalus appendiculatus during feeding. PMID- 3980146 TI - Nippostrongylus brasiliensis: feeding activity in the mouse. PMID- 3980147 TI - Influence of deamidation(s) in the 67-74 region of ribonuclease on its refolding. AB - The influence of chemical mutation featuring the selective conversion of asparagine or glutamine to aspartic or glutamic acid, respectively, on the kinetics of refolding of reduced RNase has been studied. The monodeamidated derivatives of RNase A, viz. RNase Aa1a, Aa1b, and Aa1c having their deamidations in the region 67-74, were found to regain nearly their original enzymatic activity. However, a marked difference in the kinetics of refolding is seen, the order of regain of enzymic activity being RNase A greater than Aa1c congruent to Aa1a greater than Aa1b. The similarities in the distinct elution positions on Amberlite XE-64, gel electrophoretic mobilities, and u.v. spectra of reoxidized and native derivatives indicated that the native structures are formed. The slower rate of reappearance of enzymic activity in the case of the monodeamidated derivatives appears to result from altered interactions in the early stages of refolding. The roles of some amino acid residues of the 67-74 region in the pathway of refolding of RNase A are discussed. PMID- 3980148 TI - Oxygen-17 n.m.r. of peptides. AB - Peptide-17O chemical shifts of linear dipeptides with and without protecting groups in H2O, CH3OH, CH2Cl2, CHCl3, CCl4, CH3CN and DMSO were between 256-350 ppm downfield from external water. Increasing solvent H-bond donating ability correlated with shifts to higher field. The 17O resonance of several cyclic dipeptides appeared at higher field relative to comparable linear dipeptides (303 317 p.p.m. vs. 327-337 p.p.m.). Separate signals were simultaneously observed by 13C and 17O n.m.r. for cis and trans N-tert.-butyl-formamide in binary mixtures with H2O, (CH3)2CO, and CCl4. The differences in the 17O nuclear screening of the amide isomers and most probably for cis and trans peptides were independent of contributions from H-bonding at the amide or peptide linkage, apparently reflecting differences between geometric isomers in electron distribution and through space effects. Peptide-17O of Gly-Ala, Gly-Leu and Gly-Glu in aqueous solution experienced upfield shifts of 6-12 p.p.m. and 12-16 p.p.m. upon deprotonation of the C-terminal COOH and of the N-terminal NH3+ groups respectively. These observations were rationalized in terms of the attendant changes in substituent effects, especially on the pi electron donating ability of the N atom at the peptide linkage and increased partial negative charge on the peptide oxygen. Temperature studies of peptide-17O of Gly-Ala between pH 1.5-9.0 revealed a chemical shift coefficient of 0.08 p.p.m./degree K and similar behavior of T1 and T2 relaxation times. Ea for molecular rotation was 5 kcal/mol between 301-331 degrees K. Rotational correlation times, tau c, were within the range expected from the Stokes-Einstein relation. PMID- 3980149 TI - Conformational analysis of cyclized dipeptide models for specific types of beta bends by two-dimensional nuclear Overhauser spectroscopy. AB - The solution conformations in DMSO-d6 of the two cyclized dipeptides, cyclo(L alanyl-L-alanyl-epsilon-aminocaproyl) and cyclo(L-alanyl-D-alanyl-epsilon aminocaproyl), have been analyzed by means of the two-dimensional nuclear Overhauser effect (2D-NOE). The preferred conformations for the two compounds have been deduced by comparing proton-proton distances, derived from the 2D-NOE data and relaxation-time measurements, with the corresponding distances in several possible computed low-energy conformations. The predominant conformations are a type III bend and a type II bend, respectively, for the two compounds. These conclusions agree with those deduced earlier on the basis of infrared and Raman spectra and circular dichroism measurements. PMID- 3980150 TI - Evidence for the existence of [Gln9]-beta-lipotropin in human pituitary glands. AB - The isolation of two peptides similar in amino acid composition to that of human beta-lipotropin is presented. Peptide patterns after enzymatic digestions of these two peptides by Staphylococcus aureus protease and by trypsin were nearly identical. Paper electrophoresis and amino acid analyses of acidic peptides generated from the enzymatic digestions of these two peptides indicate that there is an amide difference between the two peptides. It is proposed that this amide difference is in amino acid residue number nine, and that one is the human beta lipotropin and the other its [Gln9] analog. PMID- 3980151 TI - New evidence on the callosal system. AB - In the present paper experimental data on the principles of functional organization of the animal callosal system and the roles of symmetry and asymmetry in interhemispheric interaction are considered. A conclusion has been made that the cerebral hemispheres function not according to homotopicity principle but according to the principle of heterotopicity. A utilization of both homotopical callosal projections and intracortical pathways takes place. In interhemispheric relations the major role is played by the principle of the common pathway. Of great importance in asymmetry organization is the physiological dominant, which is formed and reinforced by excitation spreading through the corpus callosum and along intracortical pathways. Transcallosal excitation, interacting with thalamocortical and extracallosal ones, contributes to the creation and modulation of functional interhemispheric asymmetry. PMID- 3980152 TI - Hemisphere lateralization of the extrapolation reflex. AB - The interhemispheric asymmetry of extrapolation task solution in infant and adult Norway rats (Rattus norvegicus) was investigated. L. V. Krushinsky's technique with a screen was used in combination with hemisphere inactivation by means of spreading depression. It was shown during a short-term adaptation to the experimental conditions, in extrapolation of movement direction at its multiple presentation, that the left hemisphere dominated in infant rats and the right one in adult rats. An additional adaptation caused the change of the asymmetry sign in the adult animals, which is discussed in terms of prevalence of the visuospatial or the rational component of the extrapolation task. PMID- 3980153 TI - Superiority of the left hemisphere in the recognition of emotional faces. AB - Thirty-two right-handed university students (16 males and 16 females) participated in a choice reaction time study assessing the perception of hemispheric differences in positive (happiness, surprise) and negative (anger, disgust) facial affect. Subjects were exposed to slides of facial expressions in either the left or right visual field, and latency of affect identification was measured by having each subject move a lever forward or backward in a specified direction to indicate the emotion perceived. An analysis of variance with repeated measures over hand used, visual field, and affect across sex of subject revealed significant main effects for visual field, affect and sex of subject. In contrast to prior studies, the emotional faces were perceived faster in the right visual field than in the left visual field. This finding is explained in terms of the more demanding analytical task chosen in contrast to previous research which typically employed a holistic matching or recognition task. The faster perception of positive affect may be attributed to the increased salience of the facial cues present in those faces displaying happiness or surprise. Finally, the faster response of males supports existing data suggesting greater cerebral lateralization in the male brain. PMID- 3980154 TI - Critical flicker fusion and double flash discrimination in different parts of the visual field. AB - The temporal sensitivity of the visual system was investigated in fifteen healthy subjects by determining the critical flicker fusion frequency (CFF) and the performance in a double flash discrimination (DFD) task. Measurements were obtained using a small test light of 2.5 degrees diameter in the fovea and at eight different perifoveal retinal locations along the horizontal and vertical meridians. Statistically significant differences were found for both the CFF and the DFD task showing a higher temporal sensitivity of the nasal and upper than the temporal and lower retinal areas. The functional significance of the findings is discussed and related to electrophysiological and behavioral data which describe a functional superiority of the upper over the lower hemiretinal system. PMID- 3980155 TI - The involvement of the two hemispheres in the reaction time to central and peripheral visual stimuli. AB - Central and peripheral visual stimuli were presented randomly to subjects in three situations: (a) two eyes open; (b) only left eye open and (c) right eye open. The main finding is slower reaction time to right peripheral visual stimuli observed in one eye. No correlation was found between reaction time and scores on the Type A behavior test. The role of the right hemisphere in mediating this effect is discussed. PMID- 3980156 TI - IQ revisited in the time domain: a critique or irresponsible brainwaves. AB - In 1969 two authors proposed that human visual evoked potentials could be predictors of psychometrically scored "intelligence." This interpretation of their data was subsequently invalidated. In 1982 two other authors made a similar claim for auditory evoked potentials; their published methodology and general theoretical background in sensory neurophysiology suggest even less likelihood of predictive validation. PMID- 3980157 TI - Hemispheric advantages and shifts of laterality differences in visual and tactual modalities. AB - Laterality and practice effects were examined on two visual and two tactual kinesthetic tasks in 32 right-handed males. There was an overall RVF superiority in accuracy of discrimination of tachistoscopically presented pairs of lines and pairs of squares of dots, and a left-hand advantage in RT in judging tactually presented lines. For the visual and tactual length tasks, these advantages were present only on the first block of trials in each half of the experiment; there were no differences in the second block in each half. These shifts in laterality are discussed in terms of development of a left-hemisphere descriptive set for length. PMID- 3980158 TI - Auditory short-term memory in the Japanese monkey. AB - Auditory short-term memory in Japanese monkeys (Macaca fuscata) was studied using a GO/NO GO auditory delayed matching to sample task. Three temporal parameters: delay interval, intertrial interval and sample stimulus duration were manipulated. Delayed matching performance deteriorated as the delay interval was lengthened, and reached a near chance level at 16 sec. Longer intertrial intervals and sample duration ameliorated performance. When the number of the sample stimulus was increased to 3 tones to examine a serial position effect, a primary effect was not observed, although a recency effect was obtained. The fragility of auditory delayed matching performance was discussed. PMID- 3980159 TI - Selection of B16 melanoma cells with increased metastatic potential and low intercellular cohesion using Nuclepore filters. AB - A method was developed to isolate tumor cell variants which penetrate filter pores 10 X smaller than their cell diameter. Variants with very high penetration ability in a standard filter assay showed increased metastatic capacity compared to non-selected cells when assayed in vivo with intramuscular injection and removal of the primary tumor, or in a subcutaneous injection assay with the primary tumor left intact. The parent cell line, as well as randomly chosen clones displayed less metastatic capacity, which correlated with correspondingly reduced filter penetration rates. A characterization of the cells so far analyzed in vitro showed that selection through Nuclepore filters led to increased invasive spread, reduced intercellular cohesion and a somewhat higher motility. The B16 melanoma cells tested so far which showed this in vitro behavior had increased metastatic capacity, suggesting that such traits may be involved in metastatic behavior of the B16 melanoma. The procedure described for the isolation of variant tumor strains should provide cells which will help to analyze penetration phenomena in metastasis. PMID- 3980160 TI - Cellular behavior of metastatic B16 melanoma in experimental blood-borne implantation and cerebral invasion. An electron microscopic study. AB - Using B16 melanoma variant subline B16-B14b, which was selected in vivo for enhanced brain surface colonization abilities in C57BL/6 mice, we have examined ultrastructurally the cellular behavior of B16 melanoma cells during the process of cerebral invasion. Within 14 days after the injection of viable tumor cells (10(5) cells/0.2 ml) into the common carotid artery, gross nodular tumors were identifiable in the cerebral cortex. Tumor cells in the boundary area of the cerebral cortex and leptomeninges breached the limiting glial membrane with numerous small cytoplasmic protrusions and invaded into the brain parenchyma by direct extension or along blood vessels. Direct invasion into the brain parenchyma was characterized by two ultrastructural features of the tumor cells: the production of many elongated cytoplasmic protrusions at zones of invasion which separated, fragmented, and eventually engulfed nervous tissue; and the formation of tumor cell attachments to the dendrites of nerve cells via tight junction-like structures. Another mechanism of brain parenchyma infiltration by the melanoma cells was invasion and migration along blood vessel walls of the cerebral capillaries. In this case B16 melanoma cells were found attached directly to the basolateral side of the blood vessel basal lamina. The tumor cells appeared to achieve their basal lamina location by pushing aside the perivascular astrocytes. PMID- 3980161 TI - B16 melanoma metastases in mouse liver and lung. I. Localization. AB - Experimental metastases are often located preferentially near the surfaces of liver and lungs. There are indications that some surface preference also exists in human metastasis. Since this phenomenon has thus far received little attention, we quantitatively analyzed the distribution of metastases in mouse liver and lungs, produced by intraportal or intravenous injection of B16 melanoma cells. We also compared the distribution of these metastases to that of initially arrested tumor cells. The main findings were: The metastases had a highly significant surface preference. Most liver metastases were roughly spherical, but those in lungs were usually exceedingly flattened, a shape apparently imposed by the structure of the invaded tissue. Initial tumor cell arrest occurred randomly in the two target organs, and is therefore not responsible for the irregular distribution of the metastases found later. PMID- 3980162 TI - Mechanically induced trauma suffered by cancer cells in passing through pores in polycarbonate membranes. AB - As mechanically induced trauma to cancer cells passing through the micro circulation may well modify their metastatic behavior, we have categorized the damage done to cultured L1210 and Ehrlich ascites tumor cells passing through 5 12 micron pores in polycarbonate membranes, as a simple, albeit limited in vitro mechanical model. It was shown that in passing through membrane pores, impaired cell reproductive integrity and 3H-thymidine incorporation were the first detected signs of trauma, followed by impaired protein synthesis (14C-labelled amino acid incorporation) and finally, impaired plasma membrane integrity (loss of trypan blue exclusion). This, together with consideration of whole cell and nuclear diameters, suggests that damage may be the consequence of traumatic spatial dissociation between components of the cell periphery, the cytoskeleton and nucleus. Following a single filtration and return to culture, there was a progressive decline in cell numbers up to 96 h. After this, the survivors remained in a 'dormant' steady state for a further 5-6 days, and only then began to divide. The induction of a 'dormant' state in cancer cells by mechanical trauma, analogous to that inflicted in the passage through the microvasculature, is as interesting as it is unexpected. PMID- 3980163 TI - Survival of L1210 and Ehrlich ascites cancer cells after mechanical trauma is a random event. AB - Mechanical trauma in the microcirculation is thought to contribute to the inefficiency of the metastatic process in terms of cancer cells. In order to study some aspects of the kinetics of cancer cell destruction in passing through narrow pores, we have developed a model system in which cancer cells are passed through polycarbonate filter membranes in vitro. Filtration through 5-micron pores causes immediate internal damage, reflected in the arrest of active cellular metabolism and reproduction, followed by loss of plasma membrane integrity and, ultimately, the death of the majority of the cells. In this communication, we address the question of whether survival from mechanically initiated filtration damage is a random event, or whether it is a manifestation of a subpopulation of cells, with hereditary resistance to mechanical trauma. Studies on the patterns of cell survival after repeated filtration, and comparisons of the filtration resistance of clonal derivatives developed from filtration survivors with original 'wild' populations, indicate that survival from mechanical trauma is a random event and that resistance to trauma is a nonhereditary property. PMID- 3980164 TI - Platelet-aggregating activities of metastasizing tumor cells. III. Platelet aggregation as resulting from thrombin generation by tumor cells. AB - Thrombin generated in the process of platelet aggregation induced by three metastasizing murine tumors was measured using a chromogenic substrate specific for thrombin. Addition of B16 cells or 3LL cells to the platelet-rich plasma induced the generation of a significant amount of thrombin during the lag period preceding aggregation, while that of MH134 cells did not. Thrombin generation was observed in both the presence and the absence of platelets, indicating that platelets are not necessarily required for thrombin generation by these tumor cells. This suggests that the adherence of platelets to tumor cells is not an essential step for the initiation of thrombin-mediated aggregation induced by B16 and 3LL cells. Furthermore, the results of a one-stage clotting assay using plasma deficient in coagulation factors indicated that B16 and 3LL cells generated thrombin through direct activation of factor X. PMID- 3980165 TI - Some aspects of the ocular circulation. Friedenwald lecture. PMID- 3980166 TI - Cellular migration and morphology in corneal endothelial wound repair. AB - After a mechanical denudation of rabbit corneal endothelial cells, the healing process was followed with wide-field specular microscopy. Individual cell migration and morphologic changes were analyzed by computer-assisted morphometry. The cells surrounding the wound migrated to cover the defect without producing intercellular gaps. The greatest cellular migration and morphologic alterations occurred close to the wound edge. As the cells migrated toward the wound, they elongated and increased their surface area in the direction of the migration. As the healing proceeded, the cells lost their original hexagonal pattern, which returned after coverage was complete. The wound was covered completely by large, irregularly shaped cells showing mitotic figures between 24 and 48 hr. During this period, cellular migration decreased and normal cellular morphology began to recover. When mitosis decreased, the normal cellular pattern rearranged towards a more hexagonal shape. During the healing process, the degree and direction of cellular migration varied from cell to cell. Additionally, changes in cell-to cell contact (positional changes of neighboring cells) occurred in one-third of migrating cells. Such cellular migration can account for monolayered cells sliding without producing gaps between individual cells. PMID- 3980167 TI - Effect of LTD4 on conjunctival vasopermeability and blood-aqueous barrier integrity. AB - The effect of leukotriene D4 (LTD4) on the microvascular permeability of selected ocular tissues of the guinea pig was evaluated quantitatively by utilizing 125I albumin and 51Cr-erythrocytes. Topically applied LTD4 (1 ng-10 micrograms) produced a dose-related increase in conjunctival microvascular permeability. However, topical administration of such doses of LTD4 did not promote albumin leakage into the aqueous humor or iris-ciliary body. Intravitreal injection of graded doses of LTD4 also failed to increase the albumin content of the aqueous humor and iris-ciliary body. Thus, although LTD4 increased conjunctival microvascular permeability, it does not appear to disrupt the blood-aqueous barrier of the guinea pig eye. PMID- 3980168 TI - Partial characterization of three distinct populations of human gamma crystallins. AB - Certain low molecular weight crystallins may be involved preferentially in the process of human cataractogenesis. Three distinct populations of monomeric crystallins with molecular weights ranging from 19,000 to 24,000 have been demonstrated previously by electrophoresis in the presence of sodium dodecyl sulfate (SDS). The authors now report the chromatographic separation of these three components from young human lenses. Each of the three species has unique profiles on isoelectric focusing and native polyacrylamide gels as well as on SDS gels. All three species show similar patterns of age-related modification in their charge characteristics. These three populations of polypeptides all appear to be gamma-crystallins. The relative amounts of the three vary with age, which accounts for the greater ease of their separation in extracts from young lenses as compared with adult lenses. PMID- 3980169 TI - Lens transmission of blue-green light in diabetic patients as measured by autofluorophotometry. AB - Lens transmission for blue-green light (lambda = 490 nm and 530 nm) was assessed by means of fluorophotometry in 67 diabetic patients without cataracts and compared with that of 52 healthy controls. Lens transmission was determined from peak autofluorescence values in the anterior and posterior parts of the lens, assuming an about equal fluorescence peak quantum efficiency in both parts. The variation in lens transmission between individuals of about the same age was found to be larger in the diabetic patients than in the healthy controls. Decrease in lens transmission as a function of age occurred about 15 years earlier in patients with diabetes of more than 10 years' duration than in the healthy controls. The calculated average extra decrease of lens transmission in the diabetic group amounted to 0.5% for each year of diabetes. PMID- 3980170 TI - Distribution of phosphatic metabolites in the crystalline lens. AB - The phosphatic metabolite content of specific anatomic regions within the crystalline lens was determined by phosphorus-31 nuclear magnetic resonance analyses performed on tissue perchloric acid (PCA) extracts. Anatomically distinct zones each were dissected from five sets of 10 porcine lenses, isolated, and frozen in liquid N2. Separate pooled-tissue PCA extracts were prepared for each set of lens tissue corresponding to the following anatomic regions: capsule with attached epithelium, cortex, and nucleus. Randomly selected tissues were evaluated by light microscopy to determine the accuracy of the described dissection technique. Thirty-four phosphorus-containing metabolites were detected and quantitated by P-31 NMR from each of the three zones studied. Included among the phosphatic metabolites of these lens tissues were 18 chemically unidentified compounds. Significant regional differences in the metabolite distribution pattern were detected. The levels of ATP in the capsule + epithelium and in the cortex were 2.2-fold and 3.2-fold higher, respectively, than in the nucleus. In contrast, the Pi content was 2.3-fold greater in the capsule + epithelium and nucleus than in the cortex. End products of phospholipid metabolism (eg, glycerol 3-phosphocholine) also varied according to the anatomic region, with the highest content found in the nucleus. The prominent unidentified lens metabolite at 6 delta was highest in the nucleus, 35% lower in the cortex, and quite low in the capsule + epithelium. When individual P-31 NMR spectral profiles from each zone were summed according to normalized weighting factors, which reflected the relative phosphorus concentration of each region, a spectral profile of the lens was generated that was essentially indistinguishable from that of the whole (undissected) lens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980171 TI - Uveitis in melanomatous swine: lack of evidence for humoral immune melanocyte destruction. AB - A strain of miniature Sinclair swine that have cutaneous malignant melanomas destroy their tumors via an immunologic process. Destruction of apparently normal melanocytes of the uveal tract occurs concurrently with tumor cell lysis. The authors investigated possible involvement of humoral antibodies in uveal melanocyte lysis. Uveal antigens solubilized by a variety of reagents were tested by immunodiffusion against autologous and homologous sera; no precipitation lines were found. Western blots of electrophoresed uveal proteins when tested against serum from an animal with a great tumor load showed no antigen-antibody reactions. No specific humoral antibodies were detected. Sera tested for immune complexes also were negative. Invasion of the uveal tract by mononuclear cells was quantified in 1-micron-thick sections of tissue taken at various stages of ocular depigmentation. Disappearance of melanocytes was preceded by an increase in mononuclear cells and followed by an increase in melanin-containing macrophages. The ultrastructural features of the invading cells are presented. The authors conclude that cell-mediated uveal melanocyte destruction is the most likely basis for the uveitis and other damaging sequelae. PMID- 3980173 TI - The value of searching films without specific preconceptions. AB - The detection of simulated pulmonary nodules was measured in three different situations that required: (1) reports of all significant chest findings (Free Search), (2) only reports of possible nodules (Nodule Search), or (3) evaluation of particular film locations as nodules (Specified Location). ROC curves from these conditions compared how accurately readers could distinguish between the nodule and normal "test locations," and between the films that did and did not contain nodules. In replication of previous results for heterogeneous chest findings, detection accuracy was superior when readers had to search the films. Each reader's distinctions between the nodule and normal test locations became considerably less accurate when these locations were prespecified for explicit evaluation. When asked to search only for pulmonary nodules, most readers substantially increased their false reports of nodules at each level of confidence, with little improvement in their (already high) true-detection rates. Searching for nodules increased both the true-detection and false-detection rates for two readers, who simply appeared to relax a strong bias against reporting nodules in the initial Free-Search situation. PMID- 3980172 TI - 5-Fluorouracil toxicity to the ocular surface epithelium. AB - The antimetabolite, 5-fluorouracil (5-FU), has been used to control proliferation of retinal pigment epithelial cells and fibrocytes, and is currently the subject of a multicenter clinical trial of its value in the control of scarring after glaucoma operations. To evaluate possible ocular surface toxicity, the effect of 5-FU on the mitotic rate and differentiation of the ocular surface epithelium in rabbits was measured. 5-FU was instilled into eyes with 10-mm diameter central epithelial wounds and into nonwounded eyes at a dose of 9 mg per day for 4 days. Saline treated control wounded eyes healed within 4 days (n = 5) while 40% (4 of 10) of the 5-FU treated wounded eyes had defects at 4 days. The normal mitotic rate of the corneal epithelium was 1.0 +/- 0.3 (n = 4) tritiated thymidine labeled cells per 100 basal corneal epithelial cells after 2.5 hr incubation. Saline treated control wounded eyes had an increased mitotic rate, 7.1 +/- 1.3 (n = 5) labeled cells per 100 basal corneal epithelial cells after 2.5 hr incubation. Topical 5-FU decreased both of those rates to about 1% of normal. The normal conjunctival epithelial mitotic rate was 1.8 +/- 0.4 (n = 4) labeled cells per 60 basal cells after per 2.5 hr incubation. This rate was the same in wounded eyes, but was decreased in eyes treated with 5-FU. Thus, 5-FU (9 mg/day topically) has serious toxic effects to ocular surface epithelium which must be carefully considered if this drug is to be used clinically. PMID- 3980174 TI - On searching films and begging the question. PMID- 3980176 TI - Morphology of oleic acid-induced lung injury. Observations from computed tomography, specimen radiography, and histology. AB - Previously, we reported that oleic acid infusion in dogs produced a patchy and predominantly peripheral increase in lung density. The present study examines in more detail the morphology of the early stages of development of the oleic acid lesion using computed tomography (CT), specimen radiography, and conventional histology. Dogs were sacrificed 10, 30, 60, and 240 minutes after infusion of oleic acid (.05 ml/kg). After freezing in dry-ice, the thorax was scanned and cut into 1-cm thick sections. Frozen sections were then contact radiographed and sampled for histology. Within 10 minutes of infusion, subtle increases in peripheral lung density were visible on the contact radiographs. Patchy areas of peripheral density, resembling secondary lobules, were especially prominent 60 and 240 minutes after infusion. These lesions were often clearly associated with the distal bronchovascular structures. Histologic signs of edema were present in all animals sacrificed 30 or more minutes after receiving oleic acid. These correlative studies provide additional insight into the early subgross development of oleic acid-induced injury by showing the relationship between the developing edema and the bronchovascular structure of the lung. PMID- 3980175 TI - Intracoronary thallium-201 assessment of thrombolysis in acute myocardial infarction. Validation of the method of imaging before and after therapy. AB - In order to study acute changes in perfusion with intracoronary thrombolytic therapy, we have used ten times the pretherapy intracoronary thallium-201 dose for the posttherapy study. Because of the larger posttherapy dose, the posttherapy images had ten times as many counts as the pretherapy images. Since the change in image quality between the pretherapy and posttherapy studies might affect interpretation, we studied the effect of image statistics on interpretation of perfusion scintigraphy. The pretherapy and posttherapy images were scored on a four-point scale in five segments on each of three views. In 31 patients, Poisson-distributed pseudorandom noise was added to the posttherapy study in order to match the statistical accuracy of the pretherapy study. A blinded interpretation of the pretherapy and posttherapy noise-added images was performed in the same way as the initial unblinded interpretation. The mean difference between the unblinded pretherapy and posttherapy scores (the improvement in thallium distribution with therapy) was 2.5+/-0.8 (standard error) compared with the difference between the blinded pretherapy and posttherapy noise added scores which was 2.6+/-1.0. The correlation between readings of similar pairs of data was higher than the correlation between pretherapy and posttherapy studies. Thus, the difference in statistic quality of the pretherapy and posttherapy studies did not affect the interpretation of these studies. Therefore, our evaluation of pretherapy and posttherapy studies using a ten-fold increase in thallium-201 dosage is valid. PMID- 3980177 TI - Variability of myocardial CT measurements in vivo. AB - Variability of myocardial CT measurements, as indicated by standard deviations of mean CT numbers from four myocardial regions, was compared in 12-second scans, 3 second scans, and gated end-diastolic and end-systolic images, all from the same 12 seconds of scan data, both without and with radiographic contrast enhancement in experimental animals. There were statistically significant differences (P less than 0.05) in standard deviations of myocardial CT measurements when comparing 3 second and 12-second scans without contrast (10.4 vs. 7.7 CT#s), and 12-second scans without and with contrast (7.7 vs. 11.2 CT#s). Standard deviations of mean myocardial CT measurements were significantly greater (P less than 0.01) in gated images (end-diastolic) when compared with 12-second scans, both without contrast (22.2 vs. 7.7 CT#s) and with contrast (20.2 vs. 11.2 CT#s). In this study variability of myocardial CT measurements increased as scan time decreased, with radiographic contrast enhancement and with gating cardiac images. PMID- 3980178 TI - Assessment of human right ventricular cast volume by CT and angiocardiography. AB - Angiocardiographic methods available for cardiac chamber volume measurements have been shown to be less accurate although more practical than CT for the evaluation of the LV. To explore the capability of CT for RV volume measurements, silastic casts of seven normal RV were measured by a displacement method, conventional angiocardiographic biplane methods, and CT. The displacement method used degassing beneath vacuum to remove air trapped in the casts, and the actual volumes, which varied between 62 and 188 cc, were measured by Archimedes' principle. Cast volumes measured by biplane angiogram methods displayed a varying degree of spread around the regression line, caused by the chamber's irregular shape and its variation in orientation relative to the x-ray beams. CT measurements were in all aspects significantly more accurate. PMID- 3980179 TI - Venous prosthetic valves. The first step toward an investigation in the canine model. AB - Bioprosthetic valves were surgically placed in the inferior vena cava of four canines as a first step in the investigation of prosthetic valves for the treatment of nonobstructive chronic venous stasis. Valve patency and thrombus formation involving either the valve or the IVC was evaluated by serial follow-up inferior vena cavagrams in each canine. No thrombus occurred in any of the canines as observed at six months in two canines and eight months in two canines. The ultimate goal of this and other ongoing investigations is to develop a valvular prosthesis which may be placed into the venous system for the management of nonobstructive chronic venous stasis. PMID- 3980180 TI - Tamm-Horsfall glycoprotein excretion and aggregation during intravenous urography. Relevance to acute renal failure. AB - The effect of intravenous urography (IVU) on the excretion rate and precipitation of Tamm-Horsfall glycoprotein (THG) has been evaluated in 19 patients. Urine samples were collected immediately before the administration of contrast medium (U1) and then during the period of the excretion urogram (U2). The urinary THG: creatinine clearance ratio decreased in 15 patients by a mean of 28.2% (range 2.9 70.8) and increased in four by a mean of 22.8% (range 13.5-36.4). In 18 of 19 patients the amount of THG precipitated following the IVU decreased from an average of 75.6% of the total in U1 (range 2.2-100) to 19.5% (range 2.0-59) in U2. In the one exception the fraction precipitated was only 2.2% in U1 and 2.5% in U2. It is concluded that during routine IVU there is no marked increase in the excretion rate of THG. More importantly, the percentage of THG precipitated actually decreases. PMID- 3980181 TI - Pathogenesis of postmyelographic arachnoiditis. AB - The causal relationship between a myelogram with an aqueous contrast medium and postmyelographic arachnoiditis has not been clarified. Primates after myelography with metrizamide or meglumine iocarmate were studied with fluorescent microscopy, energy dispersion analysis and with scanning and transmission electron and light microscopy. All controls and, up to the eighth day after myelography, all treated animals had normal-appearing arachnoid membranes by microscopy. After eight days the treated animals had progressively more severe arachnoid fibrosis. Energy dispersive analysis revealed iodine in the arachnoid only up to 24 hours after myelography. Fluorescent microscopy revealed no evidence of immune complexes in the arachnoid. The chronic effects of water-soluble media on the arachnoid are not apparently mediated by contrast medium persisting in the arachnoid or by immune complexes. PMID- 3980183 TI - Ultrasound biofeedback for speech training. Instrumentation and preliminary results. AB - Real-time ultrasound scanning was employed as biofeedback therapy to correct a persistent articulatory speech defect in a subject. The subject continuously imaged her tongue with a transducer placed submentally. During a speech exercise, the subject could compare her tongue's positioning and movement with an ultrasound image showing the correct tongue placement prerecorded onto video tape by a speech therapist. Preliminary results suggest that this technique could be a valuable addition to speech therapy. PMID- 3980182 TI - Early changes in thallium distribution. Effect on quantitative analysis. AB - Thirty-two patients with coronary artery disease and an abnormality on an initial anterior view thallium scan had repeat images obtained after delays of 30 and 240 minutes. Scans were analyzed by quantitative criteria. Comparison of the initial stress study with the 30-minute redistribution scan showed no significant change in 11 patients, defects becoming smaller in 13 patients, and defects becoming larger in eight patients. When comparing the stress or the early redistribution images with the late redistribution scans, the diagnosis (eg, scar vs. ischemia) would have been affected in 14 cases. Analysis of the sources of variability showed that all the apparent worsening but only part of the defect resolution could be explained by variability inherent to repositioning the patient. Thus, the size of an initial defect is very sensitive to the time between the end of exercise and the onset of data collection and the nature of changes in scan appearance is complex. PMID- 3980184 TI - Nodule detection with and without a chest image. AB - The detectability of nodules displayed on uniform backgrounds was compared with their detectability on chest images by using receiver operating characteristic (ROC) curves. The images were displayed using a digital television system. Two conditions, chest image and uniform background, were compared at three different levels of added random noise. The viewing conditions were made as similar as possible by setting the luminance of the uniform background equal to the luminance of the lung in the chest image. Nodule detectability was significantly lower for the chest image than for the uniform background at each level of added random noise. The anatomic structure of the chest image interferes with the structural integrity of the nodule image resulting in lower detection performance. PMID- 3980185 TI - Characterization of phages derived from strains of Rhodococcus australis and R. equii. AB - Rhodococcus australis strain CSIR-A201 and R. equii strain CSIR-A655 spontaneously liberated phages A and B, respectively. The phages have different host ranges, but both infect R. rubropertinctus ATCC 14352. phage infection of strains resulted in stable lysogeny. The phages have similar morphologies and belong to the family Styloviridae. The DNA restriction enzyme patterns of the phages differ and do not correspond to those of actinophage phi EC. These temperate phages did not transduce prototrophic or antibiotic resistance markers to appropriate hosts. PMID- 3980186 TI - Characteristics and taxonomy of Parvoviridae. PMID- 3980187 TI - Evidence for the ubiquitous presence of a protein kinase in human adenoviruses capable of preferentially phosphorylating capsid protein IIIa. AB - Several years ago a protein kinase activity was demonstrated in subgroup C adenoviruses. In this report we have demonstrated the presence of a similar protein kinase activity in adenoviruses of subgroups A, B, and D; like the subgroup C adenovirus kinase, it preferentially phosphorylates capsid protein IIIa. Further, we have shown that the protein kinase activity is independent of the host cell line used to grow the virus and is not inhibited by N-tosyl-L lysine chloromethyl ketone or by N-tosyl-L-phenylalanine chloromethyl ketone (known inhibitors of other protein kinases). These results suggest that the adenovirus-associated protein kinase is an inherent component of all mature adenovirus particles, and as such may play a role in the virus life cycle. PMID- 3980188 TI - Iron deficiency anemia among Jewish and Arab infants at 6 and 12 months of age in Hadera, Israel. AB - Infants attending six Family Health Centers of the Israel Ministry of Health in various Jewish and Arab localities in the Hadera subdistrict were examined for hemoglobin levels at 6 and 12 months of age. The prevalence of anemia (hemoglobin less than 11 g/dl) among Jewish infants rose from a total of 44.7 to 60% from 6 to 12 months. For the Arab infants, the prevalence of anemia increased from a total of 43.7% at 6 months to 71.0% at 12. The prevalence of severe anemia (less than 10 g/dl) for the Jewish infants rose from 4.5 to 13.1% and for the Arab infants from 7.7 to 19.6%. Of the Jewish infants with a hemoglobin level less than 10 g/dl at 6 months, 50% were still less than 10 g/dl at 12 months. Of the Arab infants less than 10 g/dl at 6 months, 36.4% were still at that level at 12 months. The lack of routine iron supplementation as a preventive procedure and the routine use of cow's milk for infant feeding are the probable causes of this high prevalence of iron deficiency anemia. PMID- 3980189 TI - Blood level of C3 complement component as an aid in the management of acute phase glomerulonephritis. AB - Ninety-five patients with acute glomerulonephritis, based upon clearly defined pathological criteria, were studied and scored. The scoring was correlated to their levels of blood complement components. Patients with low C3 serum levels had a severe course during the acute phase of their disease, as compared with those with normal C3 serum levels. No such correlation was established with regard to C4 serum levels. It is suggested that C3 serum level may serve as an indicator of the expected severity of the inflammatory process and thus as an aid in the management of patients with acute glomerulonephritis in the initial phase of the disease. PMID- 3980190 TI - Association of infant mortality with lack of regular prenatal care in the Haifa subdistrict, 1980. AB - Results from a retrospective, matched case-control study on infant mortality in the Haifa subdistrict in 1980 are presented. Its most significant result was the demonstration of a positive association of lack of prenatal care with subsequent infant mortality among Jews. Of the Jewish mothers whose infants died, 19.2% did not attend a clinic regularly for prenatal care, compared with only 6.8% in the control group (P = 0.06). Among Arab mothers, the percentages were 30.0 and 25.0, respectively, and were not statistically significant. The most probable explanation is that regular prenatal care actually decreases neonatal mortality, but this study cannot confirm it directly. Other results were: none of the Arab mothers whose infants died had been under follow-up in a high-risk clinic during pregnancy, compared with 28.6% of the Jewish mothers whose infants died; and no association was demonstrated between infant mortality and mother's age or birth order. PMID- 3980192 TI - Reversible acute interstitial nephritis associated with indomethacin. AB - Nonsteroidal, anti-inflammatory drugs have been implicated in causing acute renal failure of several distinct patterns. We report a case of reversible acute renal failure associated with indomethacin therapy. Renal function recovered upon cessation of indomethacin treatment. Renal biopsy disclosed the presence of tubulointerstitial nephritis which was thought to have been responsible for the acute renal failure in this patient. Following presentation of this unusual side effect within the wide spectrum of renal and electrolyte disorders related to nonsteroidal, anti-inflammatory agents, we recommend that kidney function indices should be frequently tested in patients receiving indomethacin. PMID- 3980191 TI - Subclinical rubella in pregnancy--occurrence and outcome. AB - Between the years 1972 and 1979, 40,589 pregnant women were tested for rubella antibodies following suspected illness or exposure, using hemagglutination inhibition (HI), complement fixation and staphylococcal absorption for determination of specific immunoglobulin M (IgM). Recent primary infection was confirmed by antibody rise in paired sera and/or the presence of specific IgM. Reinfection was differentiated from primary asymptomatic rubella by absence of specific IgM. Determination of neutralizing antibodies was also useful in confirming reinfections. Clinical rubella was confirmed in 1,448 patients (3.6%). In 154 cases asymptomatic rubella infection was detected; 98 had primary infection and 56 experienced reinfection. In a selected group of 2,200 women exposed to confirmed rubella, 6.8% had clinical rubella, 3.8% asymptomatic infection, and in 7.1% the results were doubtful. Reinfection was detected in 12.4% of 265 women with initially low HI titers. The prospective follow-up on pregnancy outcome was available in 87 women with asymptomatic infection. Seven cases of congenital rubella were detected in the group of primary infections, while all 25 children born following reinfection were healthy. PMID- 3980193 TI - Accessory urethral channel. AB - A case of accessory urethral channel with wide divergence of the pubes, suggesting a relationship to the exstrophy-epispadias complex, is described. The various embryogenic factors and possible modes of treatment are discussed. PMID- 3980194 TI - Botulism intoxication after surgery in the gut. AB - Botulism intoxication is described in a 45-year-old woman who was hospitalized with symptoms suggesting an intestinal obstruction. At intervention a 20-cm length of necrotic small intestine was excised and prophylactic antibiotics were given. Five days after surgery--during which time the patient was fed only parenterally--dryness of the mouth, difficulty in swallowing, general weakness, and difficulty with speech and in keeping her eyes open were noted. The patient was alert and well oriented. The clinical symptoms and the electrophysiological studies suggested the diagnosis of botulism. A serum sample caused death in mice upon inoculation and two samples of feces were positive for the presence of Clostridium botulinum organisms. Supportive treatment with botulinum antitoxin was given and the patient was discharged in good condition. PMID- 3980195 TI - Topical treatment with imidazole for cutaneous leishmaniasis. PMID- 3980196 TI - Serum thyroxine and triiodothyronine elevation following intravenous amiodarone administration. PMID- 3980197 TI - Serum cortisol levels: the first 10 days in full-term and preterm infants. PMID- 3980198 TI - Streptococcus viridans vertebral osteomyelitis with bacteremia. PMID- 3980199 TI - Prevalence of chlorpropamide alcohol flush in Jewish Israeli diabetics. The role of serum chlorpropamide concentrations. AB - Among 53 patients with noninsulin-dependent diabetes (NIDD), chlorpropamide alcohol flushing (CPAF) was more prevalent than among 18 patients with insulin dependent diabetes (64 vs. 28%, respectively). Among the former, chronic users of chlorpropamide (CP) had a higher prevalence of CPAF than those challenged once with the drug (86 vs. 56%, respectively). Serum CP concentrations were much higher in CP-treated patients, but levels were not different in CPAF-positive compared with CPAF-negative subjects, regardless of the length of their exposure to the drug. Our data confirm the association between CPAF and NIDD in a Jewish Israeli diabetic population and the effect of serum CP levels on the prevalence of this phenomenon. PMID- 3980200 TI - Why tolerate the statistical victim? PMID- 3980201 TI - A duty to warn, an uncertain danger. PMID- 3980202 TI - Thinking about the body. PMID- 3980203 TI - The mistreatment of dead bodies. PMID- 3980204 TI - Religious justifications for donating body parts. PMID- 3980206 TI - Coping with uncertainty. PMID- 3980207 TI - Access to data on toxic chemicals. PMID- 3980205 TI - Imperiled newborns raise moral doubts. PMID- 3980208 TI - Do the perils of patenting outweigh the plusses? PMID- 3980209 TI - Mental child abuse. PMID- 3980210 TI - Treatment of Clonorchis sinensis in Hawaii's Laotian population--experience with praziquantel. PMID- 3980211 TI - Human Brucella canis infection in Hawaii. PMID- 3980212 TI - A 37-year medical follow-up of Manhattan Project Pu workers. AB - Twenty-six male subjects, who worked with Pu during World War II under extraordinarily crude conditions, have been given medical examinations periodically over the past 37 y to identify potential health effects. Inhalation was the primary mode of the Pu exposures. Current estimates of the systemic Pu depositions in these individuals range from 2 to 95 nCi with a mean of 26 nCi. Seven individuals have depositions of 40 nCi or more, often considered the lifetime maximum permissible body burden for workers. Two individuals have died compared to 6.6 expected deaths based on U.S. adjusted rates for white males. The causes of death were myocardial infarction and accidental trauma. Examinations completed in 1981-82 revealed no cases of cancer in the group except for a history of skin cancers in three individuals. The diseases and physical changes noted in these individuals are characteristic of a male population in their upper 50s or 60s. This study yields no evidence suggesting that adverse health effects have resulted from the 37 y of exposure to internally deposited Pu. PMID- 3980213 TI - Verification of the generalized Kusnetz method for measuring potential alpha energy from Rn daughters. AB - The equations describing serial radioactive build-up and decay contain symmetries which provide flexibility for measuring potential alpha energy. Mathematical analysis indicates that sample and count times may be interchanged or combined to enhance measurement protocols. Experiments have verified that these mathematical properties can be used for routine measurements of working level from Rn daughters. PMID- 3980216 TI - Determination of U and Th in urine by neutron activation. AB - Urinalysis for natural U and Th was done by neutron activation. Percent recovery (+/- 1 sigma) was 80 +/- 20 for U and 80 +/- 10 for Th. The method is sufficiently sensitive to detect, in a 100-ml sample, less than 1 and 6 micrograms/l. of 232Th and 238U, respectively. PMID- 3980215 TI - Radon emanation from coals: effects of moisture and particle size. AB - The emanation of 222Rn from several coal samples (including lignites) was measured as a function of particle size and water content. From 10 to 0.85 mm, particle diameter had no measurable effect on 222Rn emanation. However, the fraction of 222Rn emanated did have a linear dependence on water content, the upper limit observed being equal to the weight fraction of water in the coal. Coals and lignites having typical concentrations of 238U emanate no more 222Rn than do comparable masses of typical soils. Our results appear to have implications for the spatial relationship between the 226Ra atoms and the pores in the coals on the scale of the 222Rn recoil range (0.05 micron). PMID- 3980214 TI - Radon entry into houses having a crawl space. AB - The transport of 222Rn from soil, through a vented crawl space, and into the living space of single-family residences was studied. Two houses were monitored in detail for periods of 5 and 7 weeks. With crawl space vents open, the average indoor 222Rn concentrations were 1.2 and 0.6 pCi 1.-1 (44 and 22 Bq m-3); with the vents sealed the averages rose to 2.2 and 1.0 pCi 1.-1 (81 and 37 Bq m-3). The data suggest that, of the Rn released into the crawl space from the soil beneath the house, a significant fraction, perhaps 50% or more, enters the living space. The effect of 3 meteorological parameters--wind speed, indoor-outdoor temperature difference, and rate of barometric pressure change--on Rn concentration and entry rate were examined. In 1 of the houses a higher temperature difference corresponded to a higher indoor concentration, suggesting that the increased infiltration rate is more than compensated by an increase in the Rn entry rate. On the other hand, a high wind speed tended to reduce the indoor concentration, presumably by increasing both cross-ventilation of the crawl space and the infiltration rate of the living space. Results suggest that Rn transport into the crawl space of at least 1 of the houses occurred by pressure-driven flow, rather than solely by molecular diffusion. The diffusion coefficient of 222Rn through polyethylene sheeting, such as was present on the ground beneath this house, was measured in the laboratory and found to range from 0.65 X 10(-7) cm2 s-1 at 11 degrees C to 1.6 X 10(-7) cm2 s-1 at 25 degrees C, implying that the maximum diffusive flux through the sheet was many times smaller than that necessary to account for the rate of Rn entry into the house. A third house was studied using a tracer gas injected into the crawl space at a controlled rate. The fraction of air leaving the crawl space that entered the living space ranged from 0.3 to 0.65, in good agreement with results for Rn transmission in the other 2 houses, assuming that the 222Rn flux into the crawl space was comparable to that which would have resulted from molecular diffusion from soil having a 222Rn diffusion length of 1.0 m. By sealing leaks in the floor of this house, the average infiltration rate was reduced by 25%, but the indoor concentration of the tracer gas remained constant. PMID- 3980218 TI - The limitations of atmospheric dispersion data and their contribution to uncertainties in dose assessment. AB - The calculation of atmospheric dispersion patterns is often an important component of radiation dose estimates. These dispersion calculations are a possible source of error and such errors or uncertainties need to be quantified. An important source of uncertainty is the meteorological data used in the calculations. Such data may be less than ideal because of constraints imposed by both availability and by the variances associated with population from which the data are obtained. We have studied a simple and much used model of atmospheric dispersion--the Gaussian plume. We discuss the uncertainties on the meteorological data which are input to the model and how these uncertainties could be used to estimate uncertainties for the modeling results. In doing this we have addressed both the uncertainty associated with a recorded climatology and the added uncertainty arising from the year-to-year variability at any given location. PMID- 3980217 TI - Using radiation damage to obtain a large quantity of matched-sensitivity thermoluminescent dosimeters. AB - We used radiation damage to reduce the sensitivity of thermoluminescent dosimeters (TLD) to match that of the working stock in our Dosimetry Laboratory. The mean sensitivity of the TLDs we altered fell within 1% of the stock mean and the distribution we obtained was much narrower than the +/- 10% limits on the working stock. By rejecting 1.5% of the test material, limits of +/- 5% could be established, thereby improving the precision of dosimetry measurements. The shapes of glow curves after irradiation remained unchanged. Our phototransferred thermoluminescence dose-reestimation procedure was still viable; however, the necessity for removing the TLDs' prior dose history became apparent, and we describe a procedure to handle this problem. PMID- 3980219 TI - Deposition of excess amount of natural U from the atmosphere. AB - The concentration of 238U in rain and snow collected at Fayetteville (36 degrees N, 94 degrees W), AR, showed a marked increase during the summer months of 1980; and also during spring 1981, while Mount St. Helens remained active. This observed increase of 238U was due to the fallout of natural U from the eruption of Mount St. Helens. Based on the results from the analysis of rain and snow samples for the period March 1980-October 1982, the amount of 238U brought down by the rain is estimated to be 6.55 X 10(3) Ci. PMID- 3980220 TI - Radiocesium levels in Irish Sea fish and the resulting dose to the population of the Irish Republic. AB - Discharges of radioactive materials from the nuclear fuel reprocessing plant at Sellafield in the United Kingdom give rise to 137Cs and 134Cs in fish caught in the Irish Sea. Measurements made on fish catches landed in the Irish Republic show average activities of 68 and 3 Bq/kg (wet) of 137Cs and 134Cs, respectively. The estimated population dose to the Irish public is approximately 2 man-Sv y-1 and the possible dose to a member of the critical group is 1.4% of the limit recommended by the International Commission on Radiological Protection. PMID- 3980221 TI - Measurements of effluent radioactivity during the incineration of carcasses containing radioactive microspheres. PMID- 3980222 TI - Comparison of radiological risks from coal burning and nuclear power. PMID- 3980223 TI - Investigation of charcoal filters used in monitoring airborne radioactive I. PMID- 3980224 TI - Comments on informing the public about the risks of ionizing radiation. PMID- 3980225 TI - Distribution of KI. PMID- 3980226 TI - Residence half-times of 129I in undisturbed surface soils based on measured soil concentration profiles. AB - Measured 129I concentration profiles in southeastern United States soil are examined by means of a six-compartment model to estimate accumulation and downward migration in undisturbed surface soil. Effective mean residence half times in the top 30-cm-depth interval averaged 30 +/- 6 y, based on estimated annual 129I deposition rates in the vicinity of a chemical separations facility for nuclear material over a 25-y period. The model demonstrates the need for subdividing the soil into small depth intervals of 5 cm or less near the surface. The results of this study differ significantly with other surface soil residence time studies where a large single depth interval was assumed. The conclusions do, however, compare favorably with distribution coefficient studies in the surface hydrosphere. Application of the results are graphically demonstrated. PMID- 3980228 TI - Emanation coefficients for Rn in sized coal fly ash. AB - Emanation coefficients for 222Rn in sized samples of dry coal fly ash were evaluated as a function of source and particle size using a modification of the "sealed-can, gamma-only" technique. The emanation coefficient is defined as the fraction of Rn atoms that escape the solid particles of a source. Diffusible Rn was separated from nondiffusible Rn by adsorption on charcoal, and each was measured independently by gamma-ray spectrometry of the Rn daughter, 214Bi. Samples of ash from eastern bituminous coal, western bituminous coal and mid western bituminous coal with aerodynamic equivalent diameters of less than 15 micron were examined, and the measured emanation coefficients ranged from 0.098 down to 0.007. These values were dependent on both the size and source of the fly ash. The emanation coefficients and the specific activities generally decreased monotonically with increasing aerodynamic equivalent diameter. For unfractionated standard fly ash, SRM 1633a, from the U.S. National Bureau of Standards, the emanation coefficient for 222Rn was found to be 0.018. The results suggest that only a small fraction of the Rn in lung-deposited fly ash will be removed by exhalation. PMID- 3980227 TI - A field experiment on Rn flux from reclaimed uranium mill tailings. AB - Design and construction techniques are described for a 1.6 ha experimental reclamation plot consisting of a 1-m-thick slab of uranium mill tailings covered with various depths of overburden. A passive, activated charcoal device was developed and used for measurements of Rn flux at the soil surface. Observations on Rn flux vs overburden depth indicated that tailings covered with 1.5 m of revegetated or 0.3 m of bare overburden had Rn exhalation rates comparable to background. Vegetated subplots exhibited a significantly higher (often an order of magnitude) flux than the bare subplots. A positive correlation was observed between precipitation quantities and Rn flux. PMID- 3980229 TI - Radiation exposure risks to nuclear well loggers. AB - This report is based on statistical data from the Canadian National Dose Registry (As82) and information obtained from visits to 1 supplier and 9 oil-well service companies in the Province of Alberta. The companies are representative of most in this industry and provide services at the well head from logging, perforating and fracturing to cementing and tracer work. The information obtained indicates that typical exposures can account for an average dose of 1 to 2 mSv/y. The observations of well-logging procedures revealed a number of potentially hazardous situations which could lead to unnecessary exposure and based upon these, several recommendations are included. PMID- 3980230 TI - Estimation of absorbed dose in cell nuclei due to DNA-bound 3H. AB - The average absorbed dose due to DNA-bound 3H in a cell nucleus was estimated by a Monte Carlo simulation for a model nucleus which was assumed to be spheroidal. The shape of the cell nucleus was found to be of minor importance in determining the average absorbed dose. The volume of the cell nucleus was the major dose determining factor for cell nuclei which have the same DNA content and the same specific activity of DNA. This result was applied to estimating the accumulated dose in the cell nuclei of organs of young mice born from mother mice which ingested 3H-thymidine with drinking water during pregnancy. The values of dose modifying factors for the accumulated dose due to DNA-bound 3H compared to the dose due to an assumed homogenous distribution of 3H in organ were found to be between about 2 and 6 for the various organs. PMID- 3980231 TI - Campbell's theorems and calculations on the effects of randomly distributed intakes of radioactive materials. PMID- 3980232 TI - Reduction of Cm translocation from lung by constant infusion of DTPA after inhalation of Cm2O3 by rats. PMID- 3980233 TI - The plant concentration ratio concept as applied to natural U. PMID- 3980234 TI - The effect of uncertainty of model parameters on estimates of committed dose equivalent. PMID- 3980235 TI - A new unit for effective dose equivalent. PMID- 3980236 TI - Comment on 'Forecasting radiation exposure from fallout'. PMID- 3980237 TI - Social networks and social support: implications for health education. Introduction. PMID- 3980238 TI - Social ties and health status: an examination of moderating factors. AB - The goals of the study are to assess the relationship between social ties and health status and to determine if factors that may inhibit or enhance the mobilization of resources available in social ties specify this relationship. Two factors which may influence the effective use of social network resources perceived control and trusting others, are examined as possible moderating factors. The study population includes 2,603 adults, who were randomly selected from among the enrollees of a large health maintenance organization. The subjects were part of a large household interview survey. Medical record data covering seven years of outpatient services were linked with the survey data on the respondents. The findings indicate that having more social ties, being more trustful of others and perceiving more control are all related to having better health. Perceived control does specify the relationship between social ties and health status. The findings suggest that a larger social network is more important for those less able to utilize the resources available in their networks effectively, while among those more able to mobilize support from their networks, size is less important. The implications for health education research and practice are discussed. PMID- 3980239 TI - Evaluation of family health education to build social support for long-term control of high blood pressure. AB - Sustaining patient motivation for long-term adherence to drug therapies remains a substantial problem for physicians, other health care providers, the patients themselves, and their families. Other therapeutic requests such as dietary changes and weight control may be even more difficult to maintain than taking pills. As part of a controlled experimental design implemented in an outpatient teaching hospital, an educational program was implemented to improve family member support for medical compliance among hypertensive patients. Family members were interviewed, counseled, and provided with a booklet for the purpose of educating and involving them in the home management of high blood pressure. The booklet identified ways the family member could assist the patient with medication compliance, appointment keeping, as well as diet and weight control. These items were identified and recorded as behavioral objectives in the booklet. Patients were followed for three years to assess long-term outcomes. Results showed a strong statistically significant difference between the experimental and control groups, with the experimental group demonstrating higher levels of appointment-keeping behavior, weight control, and BP under control (all p values less than .001). Analysis of the main effects of the educational program demonstrated that the family member support intervention accounted for the greatest decrease in diastolic blood pressure variability, R2 = .20, p less than .001. PMID- 3980240 TI - Social networks and social support: an overview of research, practice, and policy implications. AB - Following a brief overview of the stressful life events-illness model and its implications for intervention, this article highlights the role of social support as a resource for resisting stress-induced illness and disability. It identifies three different connotative meanings that have been assigned to the social support construct, and describes their empirical operationalizations in several recent studies. Specifically, the social integration/participation formulation, the social network approach, and the social intimacy measurement strategy are described and contrasted. Within the latter approach, one study that illuminated types of informal helping behaviors is discussed in greater detail. A review of possible mechanisms whereby social support accomplishes its health-protective impact is also offered, and two types of planned interventions involving the mobilization or optimization of social support are spotlighted. The article concludes with ideas about ways that professionals can safeguard the natural helping skills of citizens and achieve an appropriate balance between formal and informal systems of service delivery in the health and human services fields. PMID- 3980241 TI - Impact of breast self-examination planned educational messages on social network communications: an exploratory study. AB - This two-part study examined the effect of college women's participation in a breast self-examination (BSE) educational program on discussion of BSE with specific members of their social network. In addition, the characteristics of college women who did report discussion with others were investigated as was the relationship between this discussion and the participants' mothers' breast cancer screening behaviors. Results suggest that a BSE education intervention which includes explicit messages to encourage discussion with social network members is effective in increasing communication with mothers, sisters and friends. College women who discussed BSE with their mothers were more likely to have mothers who have a high quality BSE practice and who state an intention to request a clinical breast examination at their next physician visit. The limitations of this study are discussed with recommendations for future research. PMID- 3980242 TI - Social networks and social support: implications for natural helper and community level interventions. AB - The convincing evidence of the relationship between social support, social networks, and health status has influenced the development of program strategies which are relevant to health education. This article focuses on the linkage between social support and social networks and health education programs which involve interventions at the network and community level. Two broad strategies are addressed: programs enhancing entire networks through natural helpers; and programs strengthening overlapping networks/communities through key opinion and informal leaders who are engaged in the process of community wide problem solving. Following a brief overview of definitions, this article highlights several network characteristics which are often found to be related to physical and mental health status. Suggestions are made for how these network characteristics can be applied to the two program strategies. Principles of practice for the health educator, and some of the limitations of a social network approach are delineated. The article concludes with a recommendation for engaging in action research--a perspective highly consistent with both the strategies discussed and the concepts of social networks and social support. This approach not only recognizes, but also acts to strengthen indigenous skills and resources. PMID- 3980243 TI - Institutionalizing social support through the church and into the community. AB - The positive influence of social support on such health related outcomes as patient adherence to medical regimens and stress reduction at the worksite has captured the attention of public health researchers and practitioners alike. Yet, the broader social outcome of building community competency to undertake and sustain health related solutions without constant intervention from professionals still remains elusive. The difficulty may lie with the need to uncover on each occasion the various roles and functions of social support structures that may or may not exist in a given community. The intent would then be to graft an intervention onto these existing roles and functions in order to mirror the naturally occurring social support structures. A conceptual framework that has been used to institutionalize health related activities through the role and function of the black Church, as a social unit of identity and solution for rural black communities in North Carolina, is put forth for consideration. PMID- 3980244 TI - Supportive ties: a political economy perspective. AB - The growing body of evidence linking social support and health has important implications for health promotion, disease prevention and treatment. But serious unsolved problems remain in the areas of research, practice and policy. Key among these are the ethical issues which arise when the reality of the importance of social support is translated simplistically into a policy emphasis stressing individual and interpersonal responsibility for health and justifying major cutbacks in health and social programs. This article examines the interdependencies between supportive ties on the individual and community levels and the larger social and political environments within which social networks operate. The effectiveness of families and other micro level support systems is seen as heavily dependent upon the adequacy of programs and policies on the local state and national levels which provide help with income maintenance, housing, transportation and other basic necessities. The cutting back of these more basic programs and services will be seen to disrupt the delicate web of natural relationships. Professionals concerned with the application of social support and health findings need to look beyond the individual and interpersonal levels toward policy and institutional level interventions. They thus may make an important contribution in advocating on behalf of those policies and programs which are critical to the effective functioning of natural helping networks, and which are at the same time faced with cutbacks. By helping alert colleagues, policy makers and the public both to the promise of the social support and health findings, and to the interdependence of support on local, state and national levels, health educators and others in the health professions may help to facilitate the effective application of these findings in policy and practice. PMID- 3980245 TI - Histamine-immunoreactive cells in the superior cervical ganglion and in the coeliac-superior mesenteric ganglion complex of the rat. AB - Histamine-immunoreactive small cells were detected in the superior cervical ganglion and in the coeliac-superior mesenteric ganglion complex of the rat with a specific antiserum produced in rabbits. Most histamine-immunoreactive cells were arranged in clusters, often around small blood vessels. Solitary immunoreactive small cells were also observed and they were easily distinguished from mast cells. The principal nerve cells showed no immunoreactivity to histamine and no histamine-containing nerve fibers were detected in the ganglia by the present method. Due to close morphological similarities, it is concluded that the small immunoreactive cells observed in the present study represent small intensely fluorescent (SIF) cells first detected by formaldehyde-induced catecholamine fluorescence. PMID- 3980246 TI - [Nasal cycle using rhinomanometric measurements]. AB - Observations on cyclical variations in the nasal resistance were made using active anterior rhinomanometry. About 80% of 40 healthy individuals showed a nasal cycle with a mean period of 2.5 h. Measurements were made during a 8 h at intervals of 30 min. Quantitative values for the variations of the flow volume V1.5 at 1.5 hPa are given and discussed. PMID- 3980247 TI - [Formation of roentgen dense structures in aspergillus mycoses of the paranasal sinuses]. AB - On screening x-rays or tomography almost half of the patients with a mycotic sinusitis presented metal-dense structures in the the paranasal sinuses. It can be demonstrated that this is due to extraordinary amounts of calcium phosphate and calcium sulphate which are deposited intracellularly, mainly inside necrotic fungal cells. In the absence of a foreign body history these radiographic shadows are almost definite proof of a mycotic sinusitis caused by aspergillus species. PMID- 3980248 TI - [Rhinolithiasis--with special reference to minerology]. AB - A rhinolith present for 77 years and weighing 18 g. is reported. Special emphasis is given to the problems of establishing the diagnosis of nasal calculi and foreign bodies. Furthermore, the study discusses the mineralogy of the rhinolith on the basis of the results yielded by the electron-ray micro-probe, x-ray diffractometry and infrared-spectroscopy with respect to the mineral Whitlockite. PMID- 3980249 TI - [Abnormalities of the salivary glands from the clinical viewpoint]. AB - Malformations of the salivary glands may be an occult cause of sialadenitis, fistulae, tumours, or xerostomia. Diseases of the salivary glands occurring at atypical sites may result from several forms of dystopia of the glands, or from the presence of accessory or aberrant salivary glands, causing considerable problems in differential diagnosis and therapy. PMID- 3980250 TI - [Hyperbaric oxygen therapy of anaerobic brain abscesses following tonsillectomy]. AB - This study describes the clinical course of a 31 year old woman who developed multiple anaerobic brain abscesses six days after tonsillectomy, followed by hemoparesis and dysarthria. In spite of craniotomy, repeated punctures and drainage of pus and high dose local and systemic antibiotics, there was an obvious deterioration in the patient's condition. Hyperbaric oxygen therapy was tried as a last resort. The patient improved quickly, and six months after the tonsillectomy seems to be neurologically symptomfree. PMID- 3980251 TI - [Sleep apnea syndrome in children: indications for tonsillectomy]. AB - Laryngo-tracheo-bronchoscopy on a 2 year old boy with the sleep apnea syndrome showed no anatomic abnormalities and no signs of upper airway obstruction. After tonsillectomy the infant revealed an improvement in sleep pattern, and 1 1/2 years later, the syndrome has been relieved completely. In our opinion, the sleep apnea syndrome is an indication for tonsillectomy. PMID- 3980252 TI - [Flexible ENT endoscopy--video technic]. AB - This study discusses the solutions to the problem of documenting moving processes in the field of otolaryngology. A flexible bronchoscope and video equipment connected to it are presented as a specific solution of the problem, with ample of observations. A technical comparison is used as the basis for a discussion of the pros and cons of the video and film techniques. A successful arrangement of examination facilities illustrates the future of flexible-endoscope techniques in the field of otolaryngology. PMID- 3980254 TI - Iatrogenic esophageal perforation: report of a case. PMID- 3980253 TI - Sex influences transmission of the supratype associated with the C2 deficiency allele: a possible mechanism for the maintenance of heterozygosity and disease susceptibility. AB - We have examined the transmission of the supratype associated with C2 deficiency (C2Q0) using our own and many published pedigrees in order to determine whether nonrandom transmission may contribute to the stability of disease-associated supratypes. Unexpectedly, we found that C2Q0 may be preferentially transmitted to the opposite sex and therefore propose that such "zig-zag" transmission may result in the preservation of recessive disease susceptibility genes and in the maintenance of heterozygosity. Further pedigrees are required to verify our findings. PMID- 3980255 TI - Guidelines to ensure viability of the reverse soleus muscle flap. PMID- 3980256 TI - Local fibrinolysis for the treatment of massive pulmonary embolism: efficacy of streptokinase infusion through pulmonary arterial catheter. PMID- 3980257 TI - Current trauma management of patients with multiple injuries. PMID- 3980258 TI - The Keystone Regional Spinal Cord Injury System: a comprehensive approach to the care and treatment of spinal cord injury. PMID- 3980259 TI - Pneumatic antishock garment. PMID- 3980260 TI - Renal trauma: a review. PMID- 3980261 TI - Vascular emergencies in the emergency department. PMID- 3980262 TI - Medicolegal considerations in emergency medicine. PMID- 3980264 TI - The role of radiation therapy in the management of intracranial meningiomas. AB - Thirty-two patients with the diagnosis of intracranial meningioma were treated with radiation therapy over the past 24 years at the Thomas Jefferson University Hospital. Indications for irradiation included incomplete resection, malignant histology, and progressive or recurrent disease after curative surgery. Patients with malignant histology did poorly, with only 2 of 7 alive. This contrasts with 17 of 25 patients with benign histology who are either alive and well or who have enjoyed a long-term disease-free survival. No difference in ultimate outcome could be found between patients with benign histology irradiated in the immediate postoperative period as opposed to those irradiated at time of progression or recurrence. PMID- 3980265 TI - Improving the therapeutic ratio of craniospinal irradiation in medulloblastoma. AB - Radiation therapy delivered to the entire cerebrospinal axis is indicated for a number of pediatric brain tumors, especially medulloblastoma. Improved radiotherapy techniques have changed the near fatal prognosis for children with medulloblastoma to a 50%, 5-year survival. Nevertheless, the treatment results in substantial acute toxicity, and many survivors have serious sequelae. Further improvement in survival with optimal surgery and radiotherapy is not expected unless chemotherapy is added. Refinements in radiotherapy technique, however, can improve the therapeutic ratio of the treatment by lowering its side effects. In the last year children who required craniospinal irradiation at M. D. Anderson Hospital were treated with 6 MV photons to the brain and primary tumor and with 15-17 MeV electrons to the spinal canal. The elective dose to the whole brain was 30 Gy in 17 fractions and 30 Gy in 20 fractions to the spine. The primary tumor received an additional 20-25 Gy. An electron-beam dose distribution was drawn on a computerized tomography (CT) reconstructed sagittal plane. The electron energy was selected so that the 90% isodose line was at least 3 mm anterior to the cord after correction for bone heterogeneity. The treatment was well tolerated in the first five patients. It is projected that the current technique will cause fewer late effects and improve the tolerance to chemotherapy. PMID- 3980263 TI - Pulmonary embolism: incidence, diagnosis, prevention, and treatment. PMID- 3980266 TI - Carcinoma of the tonsil: the effect of dose-time-volume factors on local control. AB - Between 1970 and 1979, 372 patients with squamous cell carcinoma of the tonsil were treated with primary irradiation therapy, with salvage surgery for failures. The median age was 60 years and the male to female ratio was 2:1. The staging system used was the 1974 UICC TNM system. There were 47 T1 lesions (13%), 161 T2 lesions (43%), and 164 T3 lesions (44%). Regional nodes were not palpable in 173 (46%); 122 had N1 nodes (33%), 6 had N2 nodes (2%) and 71 had N3 nodes (19%). All patients received external beam radiation which was supplemented in 68 patients with a radioactive implant for disease into adjacent tongue. The overall survival for all patients was 38% at 5 years and 54% when corrected for intercurrent disease. Local control was 87% for T1 lesions, 68% for T2 lesions and 50% for T3 lesions. Regional control was 96% for N0, 67% for N1 and 37% for N2-3. A detailed dose-time-volume analysis revealed that increasing volume improved local control in T1 and T2 lesions (77% had local control if the volume was greater than 80 cm2 versus 53% if the volume was less than 80 cm2, p = 0.014), except for T3 lesions. Increasing the dose in the range of 5000 to 6500 rad had no significant effect on primary control in any stage of disease. The addition of a radioactive implant did not increase local control if disease extended into the tongue (57% local control if implant, 52% if no implant). This study demonstrates the significance of adequate treatment volume in local control for carcinoma of the tonsil. No significant dose response was found and subsequent surgery was not compromised when a moderate dose of radiation was used. PMID- 3980267 TI - Parotid area lymph node metastases from carcinoma of the skin. AB - From January 1966 through April 1980, 38 patients with squamous cell carcinoma and one patient with basal cell carcinoma of the skin with lymphatic metastases to the parotid area were treated with curative intent at the University of Florida. Fourteen were initially treated with surgery, nine inoperable patients were treated primarily with radiation therapy, and 16 were treated with planned combined therapy, i.e., superficial or total parotidectomies with preoperative or postoperative radiation therapy. The ultimate parotid area control rate for the group treated with radiation alone was 50%; there were no failures at doses above 6500 rad. The parotid area control rate was 88% in the combined-treatment group with no failures when the surgical margins of resection were free; however, when gross residual disease was left behind, only 4 of 6 lesions were controlled. In the surgery-alone group, the ultimate parotid area and neck control rate was only 15%. The major sequela from combined therapy was sacrifice of the seventh nerve at surgery. Treatment methods are discussed. PMID- 3980268 TI - Relation between local cure and dose-time-volume factors in interstitial implants. AB - The dose and volume data of 119 patients treated with radium or iridium-192 implants for cancer of the tongue, bladder or perineum are presented. The computer dosimetry system used in the Antoni van Leeuwenhoek Hospital permitted analysis of data regarding treated volume, dose variation inside the treated volume, patterns of geographical defects and their impact on the result of treatment. Dose was expressed in a number of ways, including prescribed (reference) and average dose and the CRE (Cumulative Radiation Effect) level attained. The CRE value included a time correction and a volume correction. The average dose proved to be the best predictor of local result in case of tongue and perineal implants. Great care is needed in case of tongue carcinoma to avoid a geographical miss by an inadequate treatment volume or geometric defects. The hypothesis that a dose reduction factor is necessary, in case of a high dose rate, could not be validated. PMID- 3980269 TI - Radiotherapy for prostate carcinoma: the JCRT experience (1968-1978). II. Factors related to tumor control and complications. AB - We have analyzed treatment failure and complications as a function of radiotherapy technique and other factors in 229 patients irradiated for prostate carcinoma from 1968-1978. Thirty-four patients (15%) developed clinical evidence of local-regional recurrence. In about one-quarter of these recurrences, there was a component of ureteral obstruction, possibly due to marginal miss in the seminal vesicles. Although different parameters of treatment technique were not significantly correlated with local failure, there was a trend toward higher failure rates for Stage B and C patients when the length and/or width of the conedown field was less than 8 cm (p = 0.27 and 0.25, respectively). As in other recent studies, patients with Stage C disease who had undergone trans-urethral resection of the prostate had a lower disease-free survival rate than patients who had only needle biopsy (39 vs. 65% at 5 years, p = 0.055). The use of larger initial fields treating the pelvic lymph nodes did not result in better local tumor control or better overall control. However, the use of larger fields did result in a higher rate of significant complications (8.7 vs. 1.6% for fields greater than or equal to 150 cm2 or less than 150 cm2, respectively, p = 0.013). In view of the higher complication rate and the absence of convincing evidence of benefit for whole pelvic treatment, irradiation of all pelvic lymph nodes can be questioned. PMID- 3980270 TI - Extrapelvic colon--areas of failure in a reoperation series: implications for adjuvant therapy. AB - A total of 230 patients had planned single or multiple reoperative procedures following "curative" resection of colorectal cancer at the University of Minnesota. The site of the primary lesion was extrapelvic in 91, and later evidence of cancer was found in 58 patients (64%) at re-operation and/or other follow-up. Eight of the 58 (14%) were converted to disease-free status. Incidence and patterns of failure were correlated with initial operative-pathologic extent of disease (87 of the 91 at risk had initial tumor extension beyond the bowel wall, involved nodes or both) and comparisons were made with the previously analyzed rectal reoperation patients. While a component of local-regional failure was more common with rectal lesions (48/74 at risk, 65%), it was not uncommon with extrapelvic primaries (44/91-48%). The incidence of hematogenous metastasis (DM) was equal, but the pattern of initial DM differed (extrapelvic colon- primarily liver; rectum--liver and lung). Peritoneal seeding was a more common component of failure with the extrapelvic primaries (19/91--21% vs 3/74-4%). Since surgery alone is inadequate treatment for many patients with colon as well as rectal cancer, the rationale of adjuvant radiation and systemic therapy, alone or in combination, is discussed. PMID- 3980271 TI - Tolerance of the human spinal cord to high energy p(66)Be(49) neutrons. AB - The risk of post irradiation myelopathy was evaluated in 76 patients followed for 1-5 years after neutron irradiation of the cervical and thoracic regions. No overt myelopathy was observed. Forty-six patients received doses (central cord dose) in excess of 10 Gy, 9 received doses in excess of 12 Gy, and 5 received doses between 13 and 17 Gy, all without any evidence of spinal cord injury. On careful questioning, a subjective transient neuropathy (a tingling sensation in one extremity) was reported by 6 patients, but this was apparently unrelated to dose. A review of available literature revealed a total of 14 patients with myelopathy, 13 of whom received doses in excess of 13 Gy delivered with relatively low energy neutrons generated by the deuteron + beryllium reaction. It is concluded from these studies that the tolerance limit for the human spinal cord irradiated with high energy [p(66)Be(49)] neutrons is close to 15 Gy, above which the risk of cord injury becomes significant. Central cord doses of 13 Gy or less appear to be well tolerated with little, if any, risk of myelopathy. These conclusions are valid for a treatment time of 4 weeks or more with two or more fractions per week (9 or more fractions). The RBE for the human spinal cord irradiated under the above conditions compared with conventionally fractionated photon therapy does not exceed 4.0. PMID- 3980272 TI - Combination chemo-radiotherapy for residual, recurrent or inoperable carcinoma of the rectum: E.C.O.G. study (EST 3276). AB - Thirty evaluated patients were randomized to either continuous radiation + 5-FU (16 patients), or split-course radiation + 5-FU (14 patients) for the treatment of residual, recurrent, or inoperable carcinoma of the rectum or recto-sigmoid. Twenty-one of these patients received maintenance MeCCNU + 5-FU chemotherapy following radiation. Entry was terminated when late treatment reactions were seen in the precursor pilot study. Twenty-four of the patients have died; the estimated median survival is 17 months in each of the treatment arms. Performance status was the only significant prognostic factor for survival. The rate of severe, acute reactions during the radiation treatment period was higher for the continuous-course than for the split-course regimen (69 vs. 21%, p = .01). The rates of severe late treatment reactions, 23% (7 of 30), and severe chemotherapy toxicity, 48%, were similar for the two treatment programs. Late treatment reactions, primarily bowel complications, were seen from 3 to 23 months after radiation in 3 patients treated with continuous course, and 4 patients treated with split course. Ten of 21 patients (48%) who received maintenance chemotherapy had severe or worse toxicity. Toxicity was seen for 6 of 12 continuous-course, and 4 of 9 split-course patients. Twenty-seven patients have had disease progression, and the median length of disease control is 11 months. PMID- 3980273 TI - Reduced thoracic vertebrae metastases following post mastectomy parasternal irradiation. AB - A retrospective study of 118 women with breast cancer metastatic to bone is presented. All had originally received post mastectomy adjuvant radiation therapy for Stage II (T2 N0, T2 N1, T1 N1) infiltrating duct carcinoma of breast. Sixty two women (group A) received a parasternal portal and 56 women (group B) did not. There was significantly less metastatic involvement of the mid-dorsal vertebrae D5-6-7-8, 13% in group A compared to 60% in group B. The mean time to diagnosis of metastatic disease was 33 months (group A) and 36 months (group B). The dose of radiation to the vertebrae through which the parasternal beam exited was estimated at between 1000-1600 rad over three to four weeks. This observation may have significant implications for the management of high risk operable breast cancer. PMID- 3980275 TI - Radiation-induced heart disease in rats. AB - After local irradiation of the rat heart with X ray doses of over 10 Gy (single dose), animals developed symptoms of radiation-induced heart disease, which at higher doses would lead to fatal cardiac failure. The LD 50 at 1 year was between 15 Gy and 20 Gy. The pericardium and epicardium responded to irradiation with exudative pericarditis after 4 months. Focal myocardial damage was secondary to progressive capillary damage. PMID- 3980274 TI - Phase I and pharmacologic study of 72-hour infused 5-fluorouracil and hyperfractionated cyclical radiation. AB - We have studied 21 patients infused for 72 hours with 5-Fluorouracil (5-FU) at progressive doses combined with hyperfractionated radiation. The schedule was chosen as being one capable of inducing 5-FU radiosensitization (RS). All patients were started at a daily 5-FU dose of 40 mg/kg/24 hours; doses were then escalated with each subsequent treatment cycle to limiting toxicity or until taken off study. Patients received between one and six infusion cycles. Every treatment cycle included coincident hyperfractionated radiation to various body areas including the abdomen, chest, and head and neck region. Radiation fractionation was invariant; 1,000 rad were delivered in four equal fractions. Two fractions of 250 rad each were given on days 1 and 2 of each three day 5-FU cycle, i.e. at approximately 0, 8, 24, and 32 hours into the drug infusion. Patients were followed for toxicity; serum 5-FU concentrations were determined using a high pressure liquid chromatographic assay. 5-FU clearances were calculated from the mean serum drug levels and the infused drug dose. The toxicity spectrum was not found to be significantly different from infused drug alone in this dose range save when the head and neck region received coincident irradiation. In that region the two anticipated toxicities combined in what appears to be a synergistic fashion to enhance mucositis. Most toxicities including gastrointestinal and bone marrow appeared dependent on the mean serum 5 FU level as did mucositis itself. 5-FU clearance was found to be non-linear in this dose region but did not appear influenced by radiation to any part of the body. This study shows that 72-hour infused 5-FU can be combined with external beam radiation and will produce reasonably predictable toxicity patterns which depend on the region of the body being irradiated. 5-FU toxicity correlates with mean serum drug level which is itself dependent on 5-FU clearance. Minor variations in 5-FU clearance therefore probably contribute to the natural range found in the dose-response relationship for infused 5-FU toxicities. Future studies should integrate this understanding of 5-FU pharmacokinetics into treatment regimens. The combination of infused 5-FU and coincident radiation appears useful in treating several tumor types, particularly squamous and squamous-like cancers. However, further scheduling and radiation fractionation studies are desirable to optimize 5-FU RS in man and to quantify late effects. PMID- 3980277 TI - Thermal distributions in a water bath heated mouse tumor. AB - In the past several years numerous investigators have employed various mouse tumor systems and a variety of heating methods to examine the effects of hyperthermia in vivo. These studies have led, in some cases, to different results in tumor response in what appear to be similar experiments. Our results indicate that these discrepancies may in part be attributable to variations in intratumor temperature and depend strongly upon the method and conditions of heating employed. In all cases, we have employed the C3H mammary carcinoma tumor system with the tumor implanted in the right hind limb of the mouse. All tumors were 7-9 mm in diameter at the time of the experiments. Water bath heating was employed with the animals under one of four possible conditions: the presence or absence of anesthesia, and the use or lack of core cooling. Thermometry was performed with an array of multiple microthermocouples, each less than 150 micron in diameter, implanted in the tumor in a grid-like pattern. Significant variations (1.0 degrees C for no anesthesia, p less than .01; 1.3 degrees C for Thorazine/Ketamine, p less than .001) in intratumor temperature were found across the tumor in the unperturbed state. These variations were essentially eliminated under all hyperthermic conditions. Control of core (rectal) temperature (with or without anesthesia) reduced the intratumor temperatures even though the water bath temperature was held constant resulting in variations between water bath and tumor temperatures of from 0.1-0.8 degrees C. PMID- 3980276 TI - Radiation response of human normal and leukemic hemopoietic cells assayed by in vitro colony formation. AB - The effect of ionizing radiation on the survival of bone marrow cells from patients with acute nonlymphocytic leukemia or from hematologically normal controls was studied using colony formation as an endpoint. A modified agar culture method which incorporated daily feeding with new medium was used to allow the growth of leukemic cell colonies. Analysis of radiation-dose survival curves revealed that normal bone marrow cell populations exhibited a relatively steep slope, with values of D0 ranging from 0.5-1.3 Gy (mean = 0.82 +/- 0.22 Gy). There was essentially no shoulder to the survival curves, with Dq values ranging from less than 0 to 0.3 Gy. The leukemic cells tested displayed survival curves that did not differ qualitatively from those obtained with normal cells, i.e., steep slopes and neglible shoulders. However, the average value of the D0 (0.62 +/- 0.15 Gy) was statistically different (p less than 0.025) than that obtained for the normal cells. The results of these studies may have implications both for the use of radiation therapy for the treatment of malignant hemopoietic diseases, and for total body irradiation prior to bone marrow transplantation. PMID- 3980278 TI - Computation of radiation dose distributions for shielded cervical applicators. AB - While cervical applicators with shielded ovoids are used widely in brachytherapy, we know of no system for calculating dose distributions for them. For shielded sources, because of a lack of symmetry and because of a rapid variation of dose as a function of position relative to the source, extensive measured data in three dimensions are required. In the method we have developed, the dose at a given point from a source in a shielded ovoid is calculated by multiplying the dose from an unshielded source by the "effective attenuation factor" of the shields. The latter quantity is obtained by linear-interpolation in a three dimensional table generated from measurements described in an earlier paper. The unshielded-source dose is calculated as the product of source strength, time of implant, distance-dependent geometry factor and a tabulated quantity called the "relative dose rate factor". Relative dose rate factor is obtained by dividing measured dose rate by the product of geometry factor and source strength. Division by the geometry factor reduces the amount of data required with respect to accuracy in linear-interpolation. Input localization data must include not only the position of the end points defining the source but also a third reference point to define the orientation of the shields. PMID- 3980279 TI - Current status of 10B-neutron capture therapy: enhancement of tumor dose via beam filtration and dose rate, and the effects of these parameters on minimum boron content: a theoretical evaluation. AB - At least 8 classes of compounds are being evaluated in various laboratories around the world as possible vehicles for the transport of boron to tumor for neutron capture therapy (NCT). A parameter of major importance is the minimum concentration of boron needed in tumor in order to produce improved results in cancer therapy. Calculations are made here of the minimum boron content in tumor necessary for NCT. These estimations are obtained for various neutron beams, on the basis of therapeutic gain produced by the effective dose (absorbed dose X relative biological effect). The effects of repair are considered, in anticipation of having boronated bio-molecules with selective and long-term binding to tumor cells, thus allowing protracted irradiations. Pure epithermal neutron beams (free of significant fast neutron and gamma contamination) are found to offer major advantages, particularly when the effects of repair are included. The various boron compounds being investigated for NCT are evaluated on the basis of necessary minimum boron content in tumor. PMID- 3980280 TI - Pelvic lymphadenectomy combined with transperineal interstitial implantation of iridium-192 and external beam radiotherapy for locally advanced prostatic carcinoma: technical description. AB - Regardless of the treatment modality, control of locally advanced extracapsular prostatic cancer remains a therapeutic challenge. At the Mayo Clinic, we have recently developed a combined approach for surgically staged patients employing interstitial irradiation with 192 Iridium via a transperineal template. The Martinez Universal Perineal Interstitial Template (MUPIT-II) and moderate doses of external beam irradiation. The procedure consists of: 1) preoperative single dose external beam irradiation to decrease potential for tumor seeding or showering of malignant cells during MUPIT-II placement; 2) adequate surgical staging through a bilateral retroperitoneal lymphadenectomy; 3) transperineal interstitial implantation of the tumor and retropubic palpation of the needles to verify proper position; 4) intraoperative X rays are taken and used for documentation of needle position as well as for calculation and optimization of the implant dose distribution with the aid of a computerized system; 5) moderate doses of external beam irradiation postoperatively to the prostate with adequate margins. Our favorable preliminary results obtained in 18 patients treated with the above approach warrant the continuation of this trial. Details of this technique are presented. PMID- 3980281 TI - Primary cancers of extrahepatic biliary passages. AB - We analyzed the records of 22 patients with cancers of extrahepatic biliary passages (EHBP) to understand their natural histories and patterns of failure and to evaluate the effectiveness of various treatments. None of the preoperative investigations consistently defined the entire extent of tumor. Percutaneous transhepatic cholangiography (PTHC) was the most helpful (100%) in accurately defining the site of ductal obstruction. Computed tomography was helpful in diagnosing liver metastases in 53% and primary tumor mass in 23% of patients. The most common sites of tumor failure or persistence were: liver (67%), tumor bed (56%), peritoneum (22%), porta hepatis and lymph nodes (17%). The median survival for the entire group was 6.8 months. Surgery plays an important role in managing these tumors and in defining tumor extent for subsequent adjuvant irradiation. Patients receiving radiation doses greater than or equal to 70 TDF had a longer median survival (11 months) than patients receiving less than 70 TDF (4.4 months). All three patients, who were alive and free of disease greater than 1 year, received radiation doses greater than or equal to 70 TDF. From our data, it is difficult to comment on the effectiveness of chemotherapy. We have made suggestions regarding radiation volume and doses to various structures. The need for entering these patients into multi-institutional clinical trials is stressed. PMID- 3980282 TI - Hyperthermia enhances X ray cell killing in normal and homozygous and heterozygous ataxia telangiectasia human cells. AB - Two homozygous and heterozygous ataxia telangiectasia (AT) cell strains were compared to normal human cells for heat and radiation responses. The thermal sensitivities to one hour heating at 42.0 degrees C were comparable in the five cell strains. Thermal enhancement of radiosensitivity occurred in both homo- and hetero-zygous AT cell strains and was comparable to the thermal enhancement observed in the normal cell strain. Normal cells recovered during incubation at 37.0 degrees C between the two treatments of heat and X rays while homozygous AT cells showed no recovery. The heterozygous cell strains showed only a slight sequence dependence for heat and radiation sensitivity. PMID- 3980283 TI - Tenure and the allied health professions: issues and alternatives. AB - This article traces the development of tenure from its origins to modern times. External and internal pressures and constraints which have led to a debate on the nature and need for the existence of tenure are described. The traditional and alternative tenure models are set forth. The impact of the tenure process upon the allied health professions is discussed, and the authors recommend that the allied health professions should strive for professional parity by adopting the traditional criteria for tenure. PMID- 3980284 TI - Learning preferences, values, and student satisfaction. AB - This study sought to determine the relative importance of values and learning preferences for educational satisfaction and to examine differences in value and learning preferences among undergraduate and graduate occupational therapy students and undergraduate physical therapy students. Although all three groups conformed to a profile of preferring teacher-structured, concrete, interpersonal learning, the graduate occupational therapy students appeared to give greater emphasis to universal social values and to have a stronger preference for abstract learning than both groups of undergraduates. The undergraduates expressed significantly greater satisfaction with their education than the graduate occupational therapy students; for each of the three groups educational satisfaction correlated with a different set of values or learning preferences. PMID- 3980286 TI - The editorial review process: what happens to your manuscript. PMID- 3980285 TI - The redundancy of student comments and numerical ratings in evaluations of teaching. AB - Student evaluation of teaching effectiveness is widely used in undergraduate institutions as one element of determining overall faculty effectiveness. The evaluation format typically consists of (1) a number of questions the student answers by indicating a numerical rating and (2) an open-ended section for written comments. Some faculty members believe that the numerical ratings are not taken seriously by the students, and that the written comments impose greater accountability on the part of students. On the other hand, numerical ratings are necessary to minimize the fear that unfavorable written comments will be taken out of context in promotion decisions. Tabulation of numerical ratings is essential if a computerized data base for faculty evaluation is to be established. This study was designed to examine the relationship between student's numerically based ratings and written comments by evaluating allied health instructors using a standard, schoolwide evaluation form. Written comments were categorized according to a five-point scale and compared to mean values obtained from numerical ratings. Twenty-two faculty and 1,311 student evaluations were included. Significant positive correlations were found between the numerical student ratings and the written comments. The highest correlations were between student comments and two items related to overall teaching effectiveness. Students who evaluated instructors at either extreme on the spectrum of effectiveness were most likely to include written comments. Based on the consistency of numerical ratings and written comments we recommend that only the numerical ratings be used as part of the promotion and tenure decision-making process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980287 TI - Making accountability less painful: program evaluation in allied health education. AB - Information from a program review can stimulate program change and document program effectiveness in times when retrenchment is of concern to administrators and faculties in higher education. The School of Allied Health Professions at the University of Connecticut conducted a comprehensive program evaluation of its undergraduate programs in physical therapy, medical technology, and clinical dietetics. In this paper the evaluation process is described as well as a model that appears to meet the unique needs of postsecondary programs in allied health fields. PMID- 3980289 TI - Role conflicts in nursing and allied health: a comparison of professional and organizational commitment. AB - Role compatibility and conflict between organizational and professional commitment for nurses, high school teachers, college faculty, and social workers have been the focus of several studies over the past two decades. The typical view has been that the professional employee must choose between the profession and the employing organization, since the values of each conflict. Primarily, studies have shown a basic incompatibility between professionals and organizations: the professional is seen as responding to authority based on expertise, while the organization is characterized by authority based on hierarchical position. Since a study of this type has not been conducted in allied health specifically, the purpose of this study was to examine whether bureaucratic and professional role concepts conflict with the allied health professional. Recent graduates and graduates with two years of employment experience representing nursing and four allied health disciplines at one institution were surveyed. Results of the study indicated that the respondents were able to maintain a high degree of professional commitment without perceiving undue conflict from the demands of the organization. Based on the findings, allied health educators are encouraged to examine the curriculum to ensure graduates are prepared for the realities of employment as well as committed to their respective professions. PMID- 3980288 TI - Into the looking glass: self-assessment for allied health faculty development. AB - Frequently allied health faculty are unprepared to assume the role of professional academician. Instituting a professional development program can assist faculty in enhancing their effectiveness in that role. As the first step, a faculty group in the School of Health Related Professions, State University of New York at Buffalo, designed a questionnaire to obtain information on faculty members' judgments about their own skills in various activities--teaching, research, writing, service, and administration--and the importance of these activities. The goal of this survey was to identify those activities for which there was the greatest need for faculty development. Research and writing were identified as areas having the greatest overall potential for professional development. The survey also provided groundwork for implementing an on-going professional development program that could be systematically evaluated. PMID- 3980290 TI - Influential factors in recruitment and retention of minority students in a community college. AB - To alleviate the problem of underrepresentation of minorities in allied health professions, colleges are encouraged to target and strengthen their recruitment and retention programs. The two-year college is often cited as the major entry point into higher education for minority students. To determine effective ways in which retention and recruitment programs could be enhanced in two-year colleges, the most influential and least influential factors were determined through a survey of successful minority graduates of allied health programs in a large two year college. Certain results contradict what generally has been associated with successful recruitment and retention of minorities. Findings suggest that colleges begin closely examining what is occurring within their respective institutions to determine which factors could be having a positive, as well as negative, impact upon recruitment and retention of minorities. This study also suggests that student perception could be a valuable source of information. PMID- 3980291 TI - Environment, ideology, and role performance: a contextual needs assessment for an allied health profession. AB - Two major issues for semiprofessions are the lack of a clearly defined and unique theory base and the degree to which practitioners can maintain their identity while conforming to the expectations of their work settings. Thus, an important aspect to an educational needs assessment for allied health professions is an examination of the interaction between a theory-based ideology of practice and environmental demands. This paper describes a survey that was conducted as a needs assessment for occupational therapy. By examining the presence of ideologies in a field characterized by identity confusion and by ascertaining the relative susceptibility of these ideologies to environmental influences, the survey was seen as a beginning step toward development of a proactive, change oriented needs assessment for an allied health profession. PMID- 3980292 TI - Cognitive styles and learning styles as predictors of academic success in a graduate allied health education program. AB - The inclusion of noncognitive variables in the admissions decision process has been suggested as a reliable means of more fully assessing the potential abilities of individuals within the applicant pool. An increase in predictive efficiency is particularly important now that allied health educational programs are faced with a continuing decline in the number of applicants. This study was designed to determine whether cognitive-style and learning-style variables are predictive of success in a graduate allied health education program. Three cognitive-style measures were used to assess integrative complexity, dogmatism, and field-independence-dependence. Learning-style preferences were measured by Canfield's Learning Styles Inventory. Academic success was measured by scores on the Master's Comprehensive Examination (MCE). The results indicated that there was no significant relationship between academic success and the cognitive-style variables. However, a stepwise multiple regression indicated that 20.44% of the variance on the multiple-choice section of the MCE and 41.36% of the variance on the essay portion of the MCE were explained by learning-style variables. PMID- 3980293 TI - Sexual identity and anticipated occupation of male and female allied health and medical students. AB - The general purpose of this study was to help delineate the relationship among sex-stereotypic attributes, gender, and occupational choice in the health professions. Specifically, the study attempted to determine if there were differences in perceptions of sex-stereotypic attributes among four groups of individuals: male medical students, female medical students, male allied health students, and female allied health students. It was found that there were significant differences among the four previously described groups on their sex role perceptions as measured by the Bem Inventory. This variance can be attributed to the main effect of gender. Occupation was found not to be a significant variable in explaining variance among the four groups on their masculinity, femininity, and androgyny scores. Likewise, androgyny scores did not distinguish individuals in traditional careers from those in non-traditional careers. PMID- 3980294 TI - Putrescine and cadaverine formation in vacuum packed beef. AB - Bacterial numbers, putrescine and cadaverine concentrations and pH were measured at regular intervals during the chill storage of vacuum packed beef. Odours on opening the packs were also assessed. Cadaverine concentration increased more rapidly than that of putrescine and measurable increases were evident before maximum bacterial numbers were attained and before any permanent off-odours were detected. Diamine concentrations correlated better with total viable count (TVC) than with counts of Gram negative organisms. PMID- 3980295 TI - The development of a formulation for radiation-sterilizable urea broth. AB - Urea broth, a medium used for the identification of the genus Proteus, was sterilized by gamma radiation, using radiation doses of 1-1.5 Mrad. The radiation sterilized medium, modified by adding sodium ascorbate and increasing its phenol red and yeast extract content, performed as well as the commercial formulation prepared aseptically, when tested with different Proteus and non-Proteus species. Gamma-irradiation appears to be an attractive and economical method for sterilizing nutrient media in sealed tubes, avoiding the risk of contamination during processing. PMID- 3980296 TI - Identification of coagulase-negative staphylococci from farm animals. AB - The species identify of 661 strains of coagulase-negative staphylococci isolated from the skin and nares of cattle, pigs, poultry, goats and sheep was determined. They belonged either to the novobiocin-sensitive species Staphylococcus hyicus, Staph. simulans, Staph. epidermidis, Staph. haemolyticus and Staph. warneri or to the novobiocin-resistant species Staph. sciuri, Staph. lentus, Staph. xylosus, Staph. cohnii, Staph. saprophyticus and Staph. gallinarum; twenty-one strains remained unidentified. The staphylococcal flora of the farm animals studied differed markedly from that associated with man; several species which do not occur in man were isolated and novobiocin-resistant strains, which occur infrequently in man, were present in large numbers in animals. Two simplified schemes for the identification of staphylococci from farm animals and man are presented. PMID- 3980297 TI - A note on the effect of different storage procedures on the ability of Preston medium to recover campylobacters. AB - The effect of different storage procedures on the ability of Preston medium to recover campylobacters was investigated. Freshly poured media was shown to recover more campylobacters than media stored under aerobic or anaerobic conditions at room temperature or at 4 degrees C. The growth of Campylobacter laridis was greatly reduced by storage of media and although most strains of C. jejuni and C. coli were not markedly affected, the growth of one strain of C. jejuni was considerably reduced. It is recommended that freshly prepared media be used whenever possible, but if storage is necessary, then plates should be held at 4 degrees C, preferably under anaerobic conditions. These precautions may not be necessary for workers interested solely in C. jejuni or C. coli, but are essential for the optimum isolation of C. laridis. PMID- 3980298 TI - Menaquinone composition of mycolic acid-containing actinomycetes and some sporoactinomycetes. AB - The menaquinones of 141 actinomycetes representing the genera Caseobacter, Mycobacterium, Nocardia, Rhodococcus and some related taxa lacking mycolic acids were examined by mass spectrometry. The mycolic acid-containing strains were assigned to four groups on the basis of the predominant isoprenologue detected: Rhodococcus coprophilus, R. equi, R. erythropolis, R. globerulus, R. rhodnii, R. rhodochrous and R. ruber contained dihydrogenated menaquinones with eight isoprene units; Nocardia asteroides, N. brasiliensis, N. carnea, N. otitidis caviarum and N. transvalensis contained tetrahydrogenated menaquinones with eight isoprene units; Caseobacter polymorphus, R. bronchialis, R. rubropertinctus and R. terrae and representatives of twenty-one approved species of Mycobacterium contained dihydrogenated menaquinones with nine isoprene units; a single strain of 'Mycobacterium album', contained unsaturated menaquinones with nine isoprene units. Actinomycetes containing meso-diaminopimelic acid, arabinose and galactose in the wall peptidoglycan but lacking mycolic acids were recovered in two groups: tetrahydrogenated menaquinones with eight isoprene units were the main components from 'Nocardia' autotrophica and Pseudonocardia thermophila whereas Saccharopolyspora hirsuta and Pseudonocardia spp. contained tetrahydrogenated menaquinones with nine isoprene units. Promicromonospora citrea and 'skin coryneforms' with LL-diaminopimelic acid and glycine in the wall peptidoglycan also contained tetrahydrogenated menaquinones with nine isoprene units as the major isoprenologue. In contrast, representatives of the genera Kitasatoa, Microellobosporia, Streptomyces and Streptoverticillium were characterized by the presence of complex mixtures of tetra-, hexa- and octa-hydrogenated menaquinones with nine isoprene units. The menaquinone data correlate well with other developments in actinomycete systematics and confirm earlier suggestions that menaquinone analyses are of value in both the classification and identification of actinomycetes. Indeed, the data suggest that minimal descriptions of wall chemotype IV taxa should ideally include information on menaquinone composition. PMID- 3980299 TI - A note on Yersinia enterocolitica in a swine farm watershed. AB - Swine faeces from three pig farms in the La Crosse River watershed near La Crosse, Wisconsin, were sampled for Yersinia enterocolitica; 19 presumptive isolates were recovered and biochemically confirmed as Y. enterocolitica. Simultaneously, during a 2.2 cm rainfall, the confluences of runoff water flowing from the swine holding pens and of nearby streams were also sampled; a single isolate was obtained from one holding pen runoff-stream confluence. Biochemical analysis showed that the water isolate was a biotype identical with that of a swine isolate from the adjacent farm. These results demonstrate one possible mechanism for the introduction of Y. enterocolitica into water supplies; faecal material from swine, a suspected natural reservoir of the bacterium, is transported via runoff water to streams. PMID- 3980300 TI - Colonization of components of a model hot water system by Legionella pneumophila. AB - A model hot water distribution network was seeded with a virulent strain of Legionella pneumophila serotype 1. Ten weeks after inoculation, components of the system, which include aluminium discs, copper, stainless steel, silicone tubing, rubber and glass beads, were examined for colonization by L. pneumophila. The samples were stained with fluorescein-labelled antibodies to the strain and were examined with scanning electron microscopy. Colonization, which was accompanied by copious quantities of a slime-like debris, was heaviest on the rubber and least on the copper. Adherence to silicone tubing and stainless steel was observed. PMID- 3980301 TI - Regulation of syringomycin synthesis in Pseudomonas syringae pv. syringae and defined conditions for its production. AB - Production of the phytotoxin, syringomycin (SR), by Pseudomonas syringae pv. syringae strain B301D was regulated by both iron and inorganic phosphate similar to that of many bacterial secondary metabolites. Iron concentrations of 2 mumol/l or more in deferrated potato-dextrose broth (PDB) resulted in the production of 1024 SR units/ml, a yield comparable to that produced in non-deferrated PDB. Moreover, production of one SR unit required approximately 0.4 ng of available FeCl3. No SR was produced by strain B301D in deferrated PDB despite growth nearly identical with that of B301D in deferrated PDB supplemented with 10 mumol/l FeCl3. Furthermore, a phosphate concentration of 1 mmol/l or more was suppressive to SR production. Of the amino acids tested, L-histidine at a concentration of ca 20 mmol/l was the most effective nitrogen source for SR synthesis under defined conditions. Based on these observations, a synthetic medium, SR minimal, was formulated for SR or syringotoxin production by representative strains of Ps. syringae pv. syringae. The regulation of phytotoxin production is discussed in relation to pathogen survival and virulence. PMID- 3980302 TI - Biological indicators for low temperature steam formaldehyde sterilization: effect of defined media on sporulation, germination index and moist heat resistance at 110 degrees C of Bacillus strains. AB - Choice of a biological indicator depends upon selecting a strain with the optimum balance of desirable properties. Screening 20 strains of Bacillus spp. for sporulation on three defined media has shown the wide variation that occurs in requirements for sporulation and properties of the resultant spores. Comparison of germination index and moist heat resistance of resultant spores suggest that a combination of high germination index, high heat resistance and linear inactivation may not be possible. PMID- 3980303 TI - A note on a membrane filtration method for the concentration and enumeration of bacteriophages from water. AB - A membrane filtration method is described for the recovery and enumeration of bacteriophage from water. The method is conveniently used in the field and requires no complex or expensive equipment. PMID- 3980304 TI - A note on gentamicin susceptibility testing: the validity of the MS-2 system and Rosco Neosensitabs agar diffusion. AB - The MS-2 automated system was compared with Rosco Neosensitabs agar diffusion for the gentamicin susceptibility of a group of 267 organisms isolated from clinical material. With Rosco Neosensitabs agar diffusion agreement with reference minimal inhibitory concentrations was 98.5%, while with the MS-2 system it was 100% if calcium and magnesium-supplemented MS-2 broth was used. PMID- 3980305 TI - Chemotherapy for 'exotic' RNA viruses. PMID- 3980306 TI - Chemoprophylaxis of bacterial meningitis. PMID- 3980307 TI - Hypoprothrombinemia caused by cephalosporins. PMID- 3980308 TI - Serum protein binding and extravascular distribution of antimicrobials. PMID- 3980309 TI - The in-vitro activity of Ro 17-2301, a new monobactam, compared with other antimicrobial agents. AB - The susceptibility of 554 recent clinical isolates and known resistant bacterial strains to the new monocyclic beta-lactam Ro 17-2301 were studied and compared to that to other beta-lactams (including aztreonam and temocillin) and gentamicin. Ro 17-2301 had a high degree of activity against the Enterobacteriaceae (MIC90 less than or equal to 0.25 mg/l) being similar or slightly more active than aztreonam and ceftazidime. Strains of Acinetobacter spp. (MIC90 16 mg/l). Haemophilus influenzae strains (including beta-lactamase producers) were more susceptible (MIC90 0.5 mg/l) than those of Neisseria gonorrhoeae (MIC90 4 mg/l); against these latter two groups of isolates aztreonam was more active (MIC90 0.12 mg/l). Both aztreonam and Ro 17-2301 had little activity against Gram-positive cocci with the exception of Streptococcus pneumoniae for which the MIC90 of RO 17 2301 was 16 mg/l. Ro 17-2301 had modest activity against Bacteroides fragilis. The MBC of Ro 17-2301 was very similar to the MIC and the addition of human serum had little effect on the amount of the compound. The mean serum protein binding was 26.3%. A study of the penicillin binding protein affinity of Ro 17-2301 in a strain of Escherichia coli showed PBP 3 to be the primary target. The morphological response to exposure to Ro 17-2301 was filamentation followed by lysis after prolonged exposure. PMID- 3980310 TI - Ultrastructural analysis of the effect of trimethoprim and sulphamethoxazole on the development of Chlamydia trachomatis in cell culture. AB - Folic acid antagonists have been demonstrated to cause gross changes in the morphology of chlamydial inclusions in cell culture. The ultrastructural changes were examined by electron microscopy in cultures of Chlamydia trachomatis treated with trimethoprim and sulphamethoxazole. Examination of these cultures demonstrated a failure of the reticulate bodies to develop into normal elementary bodies. These changes were seen in cultures treated with either compound, although sulphamethoxazole was more active by weight, and suggest that both drugs ultimately interfere with nucleic acid synthesis. PMID- 3980311 TI - Primaxin in the treatment of acute bacterial pneumonia in adults. AB - Imipenem (N-Formimidoyl thienamycin) (MK-0787) is a new beta-lactam carbapenem antibiotic. When it is combined with the renal dipeptidase inhibitor cilastatin (MK-0791) the combination is known as primaxin. In this study 28 adult patients (24 males and 4 females) with acute bacterial pneumonia were treated with primaxin. Twenty-one patients were evaluable and 20 (95%) were clinically cured of their pneumonia. Bacteriological cures were demonstrated in 84% of the cases. One patient with a susceptible Pseudomonas aeruginosa failed. Major complications or toxic reactions included antibiotic associated diarrhoea in one patient; hypotension in one patient; increased grand mal seizures in one patient and elevated liver function studies in one patient. Results of this study suggest that primaxin will be useful in the treatment of a variety of serious Gram positive and Gram-negative pneumonias. The true incidence of possible toxic reactions with this drug is not known at this time and awaits further experience. PMID- 3980312 TI - Activity of C2a gentamicin. PMID- 3980313 TI - Sensitivity of organisms from general practice urine specimens. PMID- 3980314 TI - In-vitro activity of some quinoline derivatives against Mycobacterium fortuitum. PMID- 3980315 TI - The laboratory and antibiotic prescribing. PMID- 3980317 TI - Outpatient antibiotic therapy. PMID- 3980316 TI - Clavulanic acid/antibiotic ratios. PMID- 3980318 TI - Infection and intravenous catheters. PMID- 3980319 TI - Methodology and evaluation of in-vitro models of antimicrobial chemotherapy. Proceedings of a joint meeting, 27-29 March 1984, organized by the Paul-Ehrlich Gesellschaft fur Chemotherapie and British Society for Antimicrobial Chemotherapy. PMID- 3980320 TI - An in-vitro model simulating the hydrokinetic aspects of the treatment of bacterial cystitis. AB - Various applications of an in-vitro model that simulates the hydrokinetic features of the treatment of bacterial cystitis are described. Results obtained correlate well with clinical observations, suggesting that the model has relevance in the elucidation of clinical problems. PMID- 3980321 TI - Relevance of urinary bladder models to clinical problems and to antibiotic evaluation. AB - Applications and shortcomings of models of the bladder which employ urine as a medium have been described. A 'continuous culture' model was no better than conventional susceptibility tests in predicting response of patients with acute uncomplicated urinary infections to amoxicillin, but gave a good correlation with a mouse infection protection test for synergy studies with mecillinam and ampicillin. Some Enterobacteriaceae destroyed high concentrations of amoxicillin in urine under conditions resembling the milieu of the infected human bladder. Destruction was enhanced at increased residual urinary volumes and did not occur in the presence of clavulanic acid. The beneficial effects of clavulanic acid at urinary, as opposed to tissue, concentrations may be due to its antibacterial, as well as its antienzymic, activity. PMID- 3980322 TI - Possible approaches to the simulation of antibiotic kinetics and the determination of antibacterial activity in vitro. AB - Various methods of determining antibacterial effects in vitro by simulation of antibiotic kinetics were investigated. MICs were determined in fluids with and without proteins. Only concentrations of free drug were antibacterially active, and these concentrations should therefore be simulated in culture media without protein. Varying drug concentrations can easily be simulated in our in-vitro system, but the question remains which of the concentrations found in the different body fluids is the most representative. Cephalosporins were more active when phagocytosis was simulated, as shown by the continuous elimination of approximately 90% of the bacteria. If phagocytosis was not simulated, the effects of long-lasting concentrations were not decreased as much as those of concentrations corresponding to short half-lives and repeated doses. PMID- 3980323 TI - In-vitro model for simultaneous simulation of the serum kinetics of two drugs with different half-lives. AB - Simultaneous administration of two drugs is frequently practised in clinical chemotherapy because of the synergistic potential of drug combinations. During in vitro testing of the effect of such drug combinations, differences in the pharmacokinetic properties of the two drugs should be considered. This paper presents the mathematical background and the technical components of an in-vitro model that allows the simultaneous simulation of first order elimination kinetics of two drugs with different half-lives. The model allows simulations of multiple dose regimens of either bolus injections or continuous infusions of each drug. PMID- 3980324 TI - Two compartment kinetic model with multiple artificial capillary units. AB - A two compartment in-vitro model was designed to simulate human pharmacokinetics and to expose bacterial cultures to changing drug concentrations, thereby avoiding limitations of conventional antibiotic testing at constant drug levels. Serially placed bacterial compartments, representing extravascular infection sites, interface with a central compartment through artificial capillaries. Drug concentrations within the culture chambers closely mimic interstitial concentrations in vivo. Simultaneous first order elimination kinetics of two drugs with different half-lives were simulated to study antibacterial effects of drug combinations. This in-vitro model is an efficient tool for optimal dosage regimen design and the study of synergistic/antagonistic effects of antibiotic combinations. PMID- 3980325 TI - Kill kinetics and regrowth pattern of bacteria exposed to antibiotic concentrations simulating those observed in vivo. AB - Antibiotic concentrations observed in vivo were simulated in an in vitro two compartment model with a dialyser interconnection. Kill kinetics and regrowth pattern of bacteria were investigated under these fluctuating antibiotic concentrations. There were large differences in the rate of reduction of viable organisms by various antibiotics not reflected in small differences in initial MIC values. Data suggested that the area under the concentration curve might be of importance in determining the antimicrobial activity of substances rather than the initial concentration. The inclusion of pharmacokinetic parameters in antimicrobial susceptibility testing might add a new dimension to the appreciation of the activity of antimicrobial substances. PMID- 3980326 TI - Effect of antibiotics eliminated by first order kinetics. AB - We wanted to simulate the conditions within the body where bacteria are exposed to antibiotics at concentrations which diminish exponentially and thus do not remain constant as in the usual test systems for determination of the minimum inhibitory or bactericidal concentrations (MIC, MBC). For this purpose we employed a model with a glass chamber containing a constant volume of culture which was supplied continuously with medium at a constant rate. We studied the pattern of bacterial response using a series of bactericidal and bacteriostatic agents added to the system at various multiples of the MIC of several bacterial strains, and using different rates of elimination of the antibacterial agent. Strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pyogenes were exposed to amoxicillin, ampicillin, benzylpenicillin, carbenicillin, cefazolin, chloramphenicol, flucloxacillin, gentamicin, or oxytetracyclin. The bacteria were killed or maintained at their initial density depending on the antibiotic and its concentration. The main findings were: for most drugs drop in bacterial number persisted while the concentration of the chamber remained above MIC, a period of time elapsed before recovery and bacterial multiplication resumed at the same rate as in control cultures, the period of antibacterial postantibiotic effect lasted longer with Gram-positive than with Gram-negative species, the point in time when the bacteria resumed multiplication corresponded to the IC50. We observed only minor differences in the pattern of bacteria during exposure to potentially bactericidal agents compared to antibiotics with mainly bacteriostatic effects. PMID- 3980327 TI - Low concentrations of antibiotics. AB - Low concentrations of antibiotics have been shown to alter the morphology and ultrastructure of bacteria. Exposure to beta-lactam antibiotics produces large Gram-positive cocci or long filaments of Gram-negative bacilli. The ultrastructure of staphylococci in infected animals and patients treated with beta-lactam antibiotics is comparable to the structure of staphylococci grown on a solid support medium such as hard agar or a filter membrane but is different from the structure of staphylococci grown in liquid media. Antibiotic-modified bacteria are phagocytosed very efficiently; considering their bacterial mass, Escherichia coli filaments are killed much more efficiently by PMNs than is an equal mass of normal sized bacilli. Antibiotics at sub-MIC alter the synthesis and excretion of bacterial metabolites which results in a change in their virulence. Antibiotics at a very low dosage, 10 mg of ampicillin per day which resulted in sub-MICs in the urine, were shown to cure urinary infections in patients. These therapeutic results were attributed to the inhibition of bacterial adherence by sub-MICs of ampicillin. PMID- 3980328 TI - Bactericidal effects of amoxycillin/clavulanic acid and ticarcillin/clavulanic acid in in-vitro kinetic models. AB - The bactericidal effects of amoxycillin and ticarcillin in the presence of clavulanic acid against beta-lactamase-producing bacteria were investigated in in vitro kinetic models. Amoxycillin/clavulanic acid was rapidly bactericidal as a simulated intravenous 1.2 g bolus dose, against a strain of Klebsiella pneumoniae highly resistant to amoxycillin. Similarly, ticarcillin/clavulanic acid at concentrations similar to those achieved with a 30 min iv infusion of ticarcillin/clavulanic acid (5.0 g/200 mg) produced bactericidal effects against a ticarcillin-resistant strain of Pseudomonas aeruginosa. Addition of gentamicin to the system resulted in a further enhancement of activity. PMID- 3980329 TI - Influence of ampicillin elimination half-life on in-vitro bactericidal effect. AB - Escherichia coli ATCC 12407 was exposed in an in-vitro kinetic model to multiple dose ampicillin regimens differing in simulated drug elimination half-life but with equal dosage intervals and similar dose levels. Bacterial sensitivity was monitored during drug exposure. Greater bactericidal effect was observed with long half-life regimens. The development of rapid low-level resistance was not influenced by the half-life. Results suggest that in-vivo drug activity may be improved by increasing the drug elimination half-life. PMID- 3980330 TI - Correlation of antibacterial activities of antibiotics in vitro and in animal models of infection. AB - Laboratory tests of antibiotic activity in vitro, ranging from simple MIC determinations to sophisticated, computerized models for studying the effects of simulated plasma concentration-time curves of antibiotics in broth, differ inherently from tests in vivo in both the general and specific variables. There are therefore likely to be discrepancies between the results obtained. Apart from the obvious lack of host-defence mechanisms in the in-vitro tests systems, the reasons for these discrepancies have still not been fully elucidated. For the time being, it seems unrealistic to expect that in-vitro tests could be developed that would make it possible to predict the efficacy of any antibiotic against any specific infection in vivo. PMID- 3980331 TI - Comparative analysis of the antimicrobial action of polymorphonuclear leucocytes in vitro, ex vivo and in vivo. AB - A comparative study on the phagocytic capacity of human and rat polymorphonuclear leucocytes was performed. The activity of rat leucocytes was assessed by using the rat polyvinyl sponge model and the granuloma pouch model. Isolated human leucocytes were either suspended in buffer or homologous serum. Assessments of the susceptibility of Pseudomonas aeruginosa or Klebsiella pneumoniae to the antimicrobial action of leucocytes revealed that the activity of normal human leucocytes and rat leucocytes was very similar, whereas human leucocytes obtained from chronically infected patients were significantly more active. Pretreatment of the bacteria with subinhibitory mezlocillin and azlocillin concentrations with or without immunoglobulin G rendered the bacteria more susceptible to the antimicrobial action of both types of leucocytes. Again results obtained by the different methods were very similar. PMID- 3980332 TI - Successful prophylaxis of experimental streptococcal endocarditis with single doses of sublethal concentrations of penicillin. AB - Penicillin prophylaxis against experimental endocarditis due to a strain of Streptococcus intermedius isolated from a patient with endocarditis was studied in rats. The minimum bactericidal concentration of penicillin for this strain was more than 64 mg/l and was higher than the peak penicillin serum level obtained in rats 30 min after the iv injection of 60 mg/kg, and in man after an oral dose of 2 g of phenoxymethyl penicillin. Moreover timed kill curves performed in the presence of 64 mg/l of penicillin showed no decrease in the number of colony forming units during the first 6 h of incubation and only a 95% decrease after 24 h. In addition, no bactericidal activity could be detected in the serum 30 min after penicillin injection, that is at the time of bacterial challenge. Using the minimum bacterial inoculum needed to produce endocarditis in 90% of control animals (ID90), penicillin successfully prevented endocarditis due to this strain. We conclude that penicillin may prevent streptococcal endocarditis by other mechanisms than bacterial killing. PMID- 3980333 TI - The influence of dosing schedules and cerebrospinal fluid bactericidal activity on the therapy of bacterial meningitis. AB - Bacterial meningitis represents an infection in an area of impaired host defence. Optimal therapy of meningitis requires attaining bactericidal activity within cerebrospinal fluid (CSF). Studies in experimental animal models of meningitis suggest that maximal rates of bacterial killing in vivo and optimal cure rates are achieved when CSF antibiotic concentrations exceed the MBC of the test strain by greater than or equal to ten-fold. The results of clinical trials support this conclusion. In addition, a variable post-antibiotic effect occurs in-vivo after short periods of exposure to antimicrobial activity, thus maintaining therapeutic efficacy with intermittent dosage regimens. These basic principles of therapy are outlined in this review and serve as a basis for rational treatment regimens. For most antibiotics, the optimal dose, dosage interval, and duration of therapy for bacterial meningitis remain to be established. PMID- 3980334 TI - Combination antibiotic therapy: comparison of constant infusion and intermittent bolus dosing in an experimental animal model. AB - To determine the effect of the mode of administration on antibiotic efficacy, 300 neutropenic rats were infected intraperitoneally with an LD-70 inoculum of Pseudomonas aeruginosa and treated with synergistic combinations of amikacin and ticarcillin by intermittent or constant infusion technique. The treatment regimens were designed to provide the same peak serum concentrations that would be observed in humans receiving these drugs. Drug administration over the 24-h period was controlled to ensure that intermittent and constant infusion techniques achieved the same area under the serum concentration/time curves. Based on cumulative mortality at 96 h and viable bacterial cell counts at the site of inoculation constant infusion of both antibiotics produced the best therapeutic results. PMID- 3980335 TI - Postantibiotic effects. PMID- 3980336 TI - Dual individualization: antibiotic dosage calculation from the integration of in vitro pharmacodynamics and in-vivo pharmacokinetics. PMID- 3980337 TI - General principles of antibiotic tissue penetration. AB - It is well established that, at equilibrium, the concentrations of free drug on either side of a porous capillary are equal. However, the dynamic factors which operate on the way to achieving this equilibrium, while drug levels fluctuate in serum and extravascular sites, have been less well studied. This paper reviews some of the physical principles relating to diffusion through capillary pores and permeation through capillary membranes. Emphasis has been placed on the importance of the surface area-to-volume ratio in determining the time required to reach various stages of equilibrium. The effects of infection have been considered. At equilibrium, the AUC of free drug in serum and non-specialized extravascular compartments must be equal. Therefore, although the mode of administration (e.g. continuous infusion versus intermittent bolus) will affect the profile of the concentration-time curve in extravascular loci, it will not affect the overall AUC of drug in these sites. We have derived an equation to estimate the levels of drug within an abscess when bacteria are destroying the drug. Brief consideration has been given to transport in specialized sites with non-porous capillaries and with active transport systems. Throughout the analysis, we have focused on the application of these principles to in-vitro models and the potential use of in-vitro models to substantiate these principles. PMID- 3980339 TI - The relevance of pharmacokinetics to in-vitro models: protein binding--does it matter? PMID- 3980338 TI - Influence of substrate limitation and growth phase on sensitivity to antimicrobial agents. PMID- 3980340 TI - Pharmacokinetic considerations for the setting of in-vitro models. AB - Nearly all in-vitro kinetic models hitherto employed only consider serum concentration curves of the antibiotic. Data thus obtained at best reflect the situation in septicaemia. However, they are not applicable for infections where infecting bacteria are not localized within the blood. This paper presents a method for calculating the time course of the non-protein bound drug in tissue water. The concept makes use of serum concentration curves, the extent of serum protein binding and the peak time of total drug concentration in the tissue. This is practicable since all data necessary for calculation are available experimentally. Using cefmenoxime, cefotaxime, latamoxef (moxalactam) and ceftriaxone as examples, the vast differences between the total concentration of the antibiotic in serum and the concentration of the non-protein bound antibiotic in the tissue water are demonstrated. Therefore, only the results of in-vitro experiments, which are based on time courses of the non-protein bound drug in the tissue water, are considered relevant for assessing therapeutic efficacy of an antibiotic. PMID- 3980341 TI - Historical review of in-vitro models. PMID- 3980343 TI - Pleural stress pressure as a force to control liquid accumulation and maintain lung expansion. AB - Total gas pressure in the pleural space is more subatmospheric than that in the alveolar cavity. This pressure difference minus elastic recoil pressure of the lung was termed stress pressure. We investigated the relationship between stress pressure and a force that would hold the lung against the chest wall to prevent accumulation of liquid. The condition was a pleural space with an enlarged pleural surface pressure. Dogs anesthetized with pentobarbital sodium were placed in a box maintained subatmospherically at approximately -30 cmH2O and breathed atmospheric air for 4 h. Liquid volume in the pleural space of the dogs was measured under conditions of thoracotomy. In the normal group, the volume of the pleural liquid was within the normal range of approximately 2.0 ml and the visceral and the parietal pleura made contact. In the pneumothorax group, established by injecting 50 ml of air into the pleural space, the liquid increased significantly in all cases by a mean value of approximately 12 ml. Thus pleural stress pressure seems to be an important force holding the lung against the chest wall and aiding in the control of accumulation of liquid in a more subatmospheric pleural space. PMID- 3980342 TI - Capillary transport of macromolecules: pores and other endothelial pathways. AB - Can a pore or pore-equivalent model account for transport of macromolecules across microvascular endothelium, or are alternate nonpore pathways necessary? Pores may be defined as aqueous channels of any shape or configuration, including those through a fiber matrix. Such pathways exhibit selective restriction to passage of macromolecules depending on their size, shape, and electrical charge. At least two pore pathways (small and large), differing in both sieve-element spacing and in hydraulic conductivity by an order of magnitude, are required to account for observed size selectivity for plasma proteins of similar shapes and charges. For the two organs examined critically in this review (cat ileum and dog paw), transport of macromolecules through small and large pore pathways is predominately convective. Total transport through small and large pores (alternatively, narrow and wide slits or fine and coarse fiber matrices) is insufficient to account for observed transport rates at low-to-moderate levels of volume flow. Either the estimated pore sizes and hydraulic conductivities derived from measurements of high volume-flow sieving are incorrect or other nonconvective transport pathways contribute substantially to macromolecular transport at low (normal) volume flow. PMID- 3980344 TI - Evaluation of phase correction and low gas density to improve thoracic gas volume measurement. AB - We investigated two methods of decreasing the error on plethysmographic determinations of thoracic gas volume (TGV) related to cheeks movements during panting maneuvers: lowering gas density in the airways with an 80% He-20% O2 mixture and computing TGV from the in-phase component of the plethysmographic signal (TGVr). The methods were tested by measuring how TGV estimates varied when panting frequency was raised from 0.8 to 2.5 Hz during the same occlusion. The measurements were performed in 6 normal subjects and 12 patients with chronic bronchitis with and without cheeks support and when the airway was connected to an external device simulating an increased cheeks compliance. A small negative frequency dependence of TGV (delta TGV/delta f = -1.2 +/- 0.8%/Hz with cheeks support), most probably unrelated to upper airway walls, was found in normal subjects. Delta TGV/delta f was positive and algebraically larger in patients than in normals, reaching 2.2 +/- 3.4%/Hz without cheeks support and 11.8 +/- 8.0%/Hz with the additional cheeks. The latter value was only 20% smaller when computed on the basis of TGVr, demonstrating the limited usefulness of the phase based correction. In contrast, breathing He-O2 decreased delta TGV/delta f to approximately 50% of its air value (P less than 0.01) and appears as an effective way to diminish the error in obstructive patients. PMID- 3980345 TI - Pharyngeal resistance in normal humans: influence of gender, age, and obesity. AB - Investigation into the etiology of obstructive sleep apnea is beginning to focus increasing attention on upper airway anatomy and physiology (patency and resistance). Before conclusions concerning upper airway resistance in these patients can be made, the normal range of supraglottic and, more specifically, pharyngeal resistance needs to be better defined. We measured supraglottic and pharyngeal resistances during nasal breathing in a normal population of 35 men and women. Our technique measured epiglottic pressure with a balloon-tipped catheter, choanal pressure using anterior rhinometry, and flow with a sealed face mask and pneumotachograph. Resistance was measured at a flow rate of 300 ml/s during inspiration. Men had a mean pharyngeal resistance (choanae to epiglottis) of 4.6 +/- 0.8 (SE) cmH2O X l-1 X s, whereas women demonstrated a significantly (P less than 0.01) lower value, 2.3 +/- 0.3 cmH2O X l-1 X s. Supraglottic resistance was also higher in men (P = 0.01). Age (r = 0.73, P less than 0.01) correlated closely with pharyngeal resistance in men, but no such correlations could be found in women. These results may have implications in the epidemiology of obstructive sleep apnea. PMID- 3980346 TI - Cardiogenic motion of right lung parenchyma in anesthetized intact dogs. AB - Cardiogenic motion of the right lung parenchyma (CGLM) was measured in six morphine-pentobarbital-anesthetized dogs (11-16 kg) under conditions of varying paced and spontaneous sinus heart rates. Motion of 1-mm-diameter percutaneously implanted radiopaque lung parenchymal markers were measured using a computer based biplane video-roentgenographic assembly. Correlation of the amplitudes and phases of marker motions to the R wave of the electrocardiogram (ECG) were determined utilizing a modified fast Fourier transform algorithm. Of initial importance was the observation that CGLM was significantly greater than the variability of repeated measurements. The total amplitudes of motion of the markers (where AT = square root A2X + A2Y + A2Z and AX, AY, AZ are the amplitudes of marker motion along the orthogonal X, Y, and Z body axes) in the right apical, cardiac, and diaphragmatic lobes were 0.025 +/- 0.005 (SE), 0.046 +/- 0.005, and 0.023 +/- 0.025 cm, respectively, (P less than 0.01, cardiac lobe vs. others). The total amplitude of motion observed in the cardiac lobe was equivalent to earlier observations of total amplitude (0.045 +/- 0.004 cm) of marker motion in response to high frequency airway oscillation at a pump stroke volume of 22-26 ml. An analysis of the higher harmonics of marker oscillation suggested that the second harmonic of CGLM is also larger than the variability of our measurements. PMID- 3980347 TI - Potentially conflicting metabolic demands of diving and exercise in seals. AB - Metabolic replacement rates (Ra) for glucose and free fatty acids (FFA) were determined during rest, exercise, and diving conditions in the gray seal using bolus injections of radiotracers. In the exercise experiments the seal swam at a metabolic rate elevated twofold over resting Ra for glucose and FFA while resting were similar to values found in terrestrial mammals and other marine mammal species. During exercise periods glucose turnover increased slightly while FFA turnover changes were variable. However, the energetic demands of exercise could not be met by the increase in the replacement rates of glucose or FFA even if both were completely oxidized. Under diving conditions the tracer pool displayed radically different specific activity curves indicative of the changes in perfusion and metabolic rate associated with a strong dive response. Since the radiotracer curves during exercise and diving differed qualitatively and quantitatively, it is possible that similar studies on freely diving animals can be used to assess the role of the diving response during underwater swimming in nature. PMID- 3980348 TI - Muscle and femoral vein temperatures during short-term maximal exercise in heart failure. AB - Core temperature decreases throughout short-term maximal exercise in heart failure patients. To investigate possible causes for this unusual response to exercise, we studied core (pulmonary arterial blood), femoral vein, muscle, and skin temperatures in eight patients with severe heart failure who performed maximal upright incremental bicycle exercise to 50 W. A normal group (n = 4) was exercised for comparison. In the heart-failure patients, core temperature was 36.95 +/- 0.37 degrees C at rest, significantly (P less than 0.05) decreased at 25 W of exercise to 36.59 +/- 0.40 degrees C, and at 50 W remained decreased to 36.57 +/- 0.40 degrees C. In comparison, we found that the resting core temperature in the normal subjects was 37.28 +/- 0.34 degrees C, was the same at 25 W (37.29 +/- 0.41 degrees C), and increased significantly (P less than 0.05) to 37.50 +/- 0.32 degrees C at 50 W of exercise. Femoral vein temperature in heart-failure patients (n = 6) was below core temperature throughout exercise to 25 and 50 W (36.22 +/- 0.62 and 36.34 +/- 0.65 degrees C, respectively). Muscle temperature (n = 7) was significantly (P less than 0.05) lower in the heart failure patients (34.8 +/- 1.1 degrees C) at rest compared with the normal subjects (36.2 +/- 1.0 degrees C). During exercise, muscle temperature increased above core temperature in only four of the heart-failure patients and was significantly (P less than 0.05) lower (36.5 +/- 1.3 degrees C) compared with the normal subjects (38.0 +/- 0.2 degrees C).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980349 TI - Central control of cardiovascular adjustments to exercise. AB - Voluntary heart rate (HR) control during moderate exercise on a bicycle ergometer was studied in 10 healthy physically conditioned men (5 experimental and 5 control). The results showed that subjects could learn to attenuate the tachycardia of exercise while exercising at a steady work level of 60-70% of maximum HR. Experimental subjects who saw beat-to-beat displays of HR and were instructed to slow HR showed 22% less increase in HR than did control subjects who exercised without HR displays or instruction to slow HR (42.6 vs. 54.6 beats/min). When the control subjects were given feedback in additional sessions, they also decreased HR significantly by 9% (54.6 vs. 49.9 beats/min). Analyses of concomitant respiratory and metabolic data showed that HR attenuation was accompanied by decreased O2 consumption (P less than 0.06) and pulmonary ventilation (P less than 0.01). Rate pressure product also fell, indicating a decrease in myocardial O2 consumption. Comparisons among pre- and postsubmaximal and cardiovascular pulmonary and humoral responses during maximal test sessions suggested that the improvement in cardiopulmonary function during feedback training occurred with no sacrifice to working muscle requirements because blood lactate concentrations were similar. The attenuation of the HR response obtained in the present study indicates that feedback training in physically conditioned subjects can influence cardiovascular responses even under conditions of heavy local demands imposed by working muscles. PMID- 3980350 TI - Osmotic reflection coefficient for total plasma protein in lung microvessels. AB - The osmotic reflection coefficient (sigma) for total plasma proteins was estimated in 11 isolated blood-perfused canine lungs. Sigma's were determined by first measuring the capillary filtration coefficient (Kf,C in ml X min-1 X 100g-1 X cmH2O-1) using increased hydrostatic pressures and time 0 extrapolation of the slope of the weight gain curve. Kf,C averaged 0.19 +/- 0.05 (mean +/- SD) for 14 separate determinations in the 11 lungs. Following a Kf,C determination, the isogravimetric capillary pressure (Pc,i) was determined and averaged 9.9 +/- 0.5 cmH2O for all controls reported in this study. Then the blood colloids in the perfusate were either diluted or concentrated. The lung either gained or lost weight, respectively, and an initial slope of the weight gain curve (delta W/delta t)0 was estimated. The change in plasma protein colloid osmotic pressure (delta IIP) was measured using a membrane osmometer. The measured delta IIP was related to the effective colloid osmotic pressure (delta IIM) by delta IIM = (delta W/delta t)0/Kf,C = sigma delta IIP. Using this relationship, sigma averaged 0.65 +/- 0.06, and the least-squares linear regression equation relating Pc,i and the measured IIP was Pc,i = -3.1 + 0.67 IIP. The mean estimate of sigma (0.65) for total plasma proteins is similar to that reported for dog lung using lymphatic protein flux analyses, although lower than estimates made in skeletal muscle using the present methods (approximately 0.95). PMID- 3980351 TI - Dilating forces on the upper airway of anesthetized dogs. AB - We reasoned that in an isolated sealed upper airway a pressure change would be caused by a change in airway volume. In eight spontaneously breathing anesthetized dogs, we isolated the upper airway by transecting the cervical trachea and sealing it from the lung and from the atmosphere. Pressure changes in this isolated upper airway were studied in relation to respiratory phase as evidenced by alae nasi electromyographic (EMG) activation and tidal volume measured at the distal trachea. A fall in pressure, indicating airway dilation, occurred with each spontaneous respiratory effort. Like the moving average of the alae nasi EMG, the pressure drop reached a peak value early in inspiration, was inhibited by further lung inflation, and was absent during passive mechanical ventilation. End-expiratory tracheal occlusion or vagotomy prolonged and augmented EMG activity and also the inspiratory fall in upper airway pressure. Increased levels of CO2 increased the magnitude of change in pressure during inspiration. An inhibiting effect of lung inflation was present to an equal extent at low and high levels of chemical drive. We show that dilation of the airway is concurrent with upper airway muscle activation during early inspiration, that this dilation increases with increasing chemical drive, and that vagal reflexes during lung inflation inhibit this dilation during the latter half of inspiration. PMID- 3980352 TI - Thermoelastic properties of uniaxially deformed lung strips. AB - We examined the temperature dependence of small degassed hamster lung strip mechanics to develop insights into the molecular basis of lung elasticity. Quasi static length-tension curves of adapted lung strips were generated at 10, 23, 37, 50, and 80 degrees C; quasi-static tension-temperature plots (QSTT) at strains of 0.5, 0.75, and 1.0 were then formulated. Static tension-temperature (STT) plots at strain 1 were independently generated from other strips. Stress relaxation was evaluated as a function of temperature at different strains; hysteresis ratio was calculated as a parameter of mechanical efficiency. Between 23 and 37 degrees C, the slopes of the QSTT plots at the different strains were close to zero. The slope of the STT plot was slightly positive, indicating that the tension developed by a stretched strip was primarily due to entropic changes with length, suggesting that strips behave like rubber polymers near physiological temperature. Between 10 and 23 degrees C, the slope of the QSTT curve was zero at the two lowest strains but was negative at strain 1; and slope of the STT curve was zero at strain 1. These data indicated that collagen fiber and possibly glycosaminoglycan function was abnormally affected at 10 degrees C. Between 50 and 80 degrees C at strain 1, the slopes of both the QSTT and STT plots at all strains were positive. These data suggested that elastic fiber function was altered between 50 and 80 degrees C such that both internal energetic and entropic contributions to the tension were changed. Stress relaxation and hysteresis data were consistent with these findings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980353 TI - Effect of exercise duration on feed intake and body composition of Swiss albino mice. AB - The purpose of this study was to examine the effects of daily exercise of varying duration on the body composition, weight, and feed intake of mature Swiss albino mice. Fifty-four male mice were equally divided into a control group and five exercise groups (n = 9) performing 20, 40, 60, 120, and 240 min of daily exercise on a treadmill (7.2 m/min). Feed intake and body weight were measured weekly for 10 wk. At the completion of the study the mice were killed and the animal carcasses were chemically analyzed for fat, dry matter, and protein content. The results of this study demonstrate no differences in the body weight among groups (P less than 0.97) with all groups gaining 4.5-5.8 g during the 10-wk period. However, fat content decreased significantly from 15.7% in the control to 12.0% in the 120- and 240-min exercise groups (P less than 0.05). In contrast, protein content showed an insignificant rising trend from 13.0 to 14.6% with increasing duration of exercise. Feed intake showed a nonsignificant drop during the 20-min exercise treatment and remained unchanged among groups. These data show a slight but variable appetite-suppressing effect of light exercise in mice accompanied by favorable body composition changes even in the absence of differences in body weight. These findings suggest the mouse to be an acceptable experimental model for body composition and exercise studies. PMID- 3980354 TI - Influence of G-suit abdominal bladder inflation on gas exchange during +GZ stress. AB - Available data relating duration of +GZ stress to blood gas exchange status is limited. Furthermore, studies focusing on pulmonary gas exchange during +GZ stress when abdominal restriction is imposed have yielded conflicting results. To examine the time course of blood gas changes occurring during exposure to +GZ stress in dogs and the influence of G-suit abdominal bladder inflation on this time course, seven spontaneously breathing pentobarbital-anesthetized adult mongrel dogs were exposed to 60 s of up to +5 GZ stress with and without G-suit abdominal bladder inflation. Arterial and mixed venous blood were sampled for blood gas analysis during the first and last 20 s of the exposure and at 3 min postexposure. Little change in blood gas status was seen at +3 GZ regardless of G suit status. However, with G-suit inflation, arterial PO2 fell by a mean of 14.7 Torr during the first 20 s at +4 Gz (P less than 0.01, t test) and 20.6 Torr at +5 GZ (P less than 0.01). It continued to fall an additional 10 Torr during the next 40 s at both +4 and +5 GZ. Arterial PO2 was still 5-10 Torr below control values (P less than 0.05) 3 min postexposure. A second series of experiments paralleling the first focused on blood gas status during repeated exposure to acceleration. Blood gas status was assessed in five dogs during the late 20 s of two 60-s exposures separated by 3 min at 0 GZ. No significant differences between the initial and repeated exposures were detected. The data indicate that G-suit abdominal bladder inflation promotes increased venous admixture. PMID- 3980355 TI - In vitro responses of cat skeletal muscle to halothane and caffeine. AB - Strips of soleus (100% type I) and gracilis (90% type II) muscle were obtained from anesthetized cats and mounted in organ baths filled with aerated Krebs Ringer solution (37 degrees C). The contractile patterns in response to electrical stimulation (0.1 Hz, 25 V, 5 ms), caffeine, halothane, and caffeine in the presence of halothane were examined in the two fiber types. The ability of 25 microM dantrolene to alter the contractile patterns was also evaluated. In vitro contractile properties in response to electrical stimulation were similar to properties observed in situ, except that twitch tension in soleus muscle was significantly less in vitro than in situ. In the presence of halothane, type I soleus muscle developed a rapid contracture. The contracture was blocked by pretreatment with dantrolene and was reversed by addition of dantrolene at the peak of the response. Halothane-induced contractures were not observed at any time in type II gracilis. Type I soleus was also significantly more sensitive both to caffeine alone and to caffeine in the presence of halothane than was type II gracilis. In both fiber types, halothane increased the sensitivity of the muscles to caffeine. Dantrolene attenuated caffeine-induced contractures in both fiber types, but the attenuating effect was less in the presence of halothane. The findings of a halothane-induced contracture in the cat soleus and differential sensitivities of the two muscle fiber types to caffeine indicate that further studies in these two muscles may be useful for delineating the mechanisms inducing contracture in muscle from individuals susceptible to malignant hyperthermia. PMID- 3980356 TI - Expiratory pattern of newborn mammals. AB - The passive mechanical time constant (tau pass) of the respiratory system is relatively similar among newborn mammalian species, approximately 0.15-0.2 s. However, breathing rate (f) is higher in smaller species than larger species in order to accommodate the relatively larger metabolic demands. Since tidal volume per kilogram is an interspecies constant, in the fastest breathing species the short expiratory time should determine a substantial dynamic elevation of the functional residual capacity (FRC). We examined the possibility of a difference in expiratory time constant between dynamic and passive conditions by analyzing the expiratory flow pattern of nine newborn unanesthetized species during resting breathing. In most newborns the late portion of the expiratory flow-volume curve was linear, suggesting muscle relaxation. The slope of the curve, which represents the dynamic expiratory time constant of the respiratory system (tau exp), varied considerably among animals (from 0.1 to 0.7 s), being directly related to the inspiratory time and inversely proportional to f. In relatively slow-breathing newborns, such as infants and piglets, tau exp is longer than tau pass most likely due to an increase in the expiratory laryngeal resistance and FRC is substantially elevated. On the contrary, in the fastest breathing newborns (such as rats and mice) tau exp is similar or even less than tau pass, because at these high rates dynamic lung compliance is lower than its passive value and the dynamic elevation of FRC is small. In dynamic conditions, therefore, the product of tau exp and f is maintained within narrow limits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980357 TI - Comparison of canine cardiovascular response to inhaled and intraperitoneally infused CO. AB - We compared the hemodynamic and blood gas data from anesthetized dogs given 0.15% carbon monoxide (CO) to breathe (INH group) and from dogs injected with 100% CO intraperitoneally while breathing room air (ITP group). The animals were observed for a period of 150 min after reaching a level of 50% carboxyhemoglobin (HbCO). The time required to reach this level was similar for both groups, i.e., 102 +/- 54 and 90 +/- 21 min for the ITP and INH groups, respectively. The average HbCO% for the duration of the experiment was 58.3 +/- 2.4 and 62.9 +/- 1.5% for the ITP and INH groups, respectively. All the animals survived in each group. There was no significant difference in their hemodynamic response to CO, except for a higher mean systemic blood pressure in the INH group. This difference was also present during the base-line measurements, suggesting that it was not related to the effects of CO. Following the 150-min comparison period, we attempted to precipitate a terminal cardiovascular crisis by increasing the amount of CO given. The animals in the ITP group lived indefinitely as the result of a "plateau" effect in the level of HbCO%. The measured HbCO% level did not rise above 70% regardless of the amount of CO injected into the peritoneal space. Those in the inhalation group died with an average HbCO% of 80.0 +/- 3.5%. It is concluded that the toxic effect of CO is the result of impaired O2 delivery to the peripheral tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980358 TI - Thermal mapping of the airways in humans. AB - To characterize the intrathoracic thermal events that occur during breathing in humans, we developed a flexible probe (OD 1.4 mm) containing multiple thermistors evenly spaced over 30.2 cm, that could be inserted into the tracheobronchial tree with a fiberoptic bronchoscope. With this device we simultaneously recorded the airstream temperature at six points from the trachea to beyond the subsegmental bronchi in six normal subjects while they breathed ambient and frigid air at multiple levels of ventilation (VE). During quiet breathing of room air the average temperature ranged from 32.0 +/- 0.05 degrees C in the upper trachea to 35.5 +/- 0.3 degrees C in the subsegmental bronchi. As ventilation was increased, the temperature along the airways progressively decreased, and at a VE of 100+ 1/min the temperature at the above two sites fell to 29.2 +/- 0.5 and 33.9 +/- 0.8 degrees C, respectively. Interval points were intermediate between these extremes. With cold air, the changes were considerably more profound. During quiet breathing, local temperatures approximated those recorded in the maximum VE room-air trial, and at maximum VE, the temperatures in the proximal and distal airways were 20.5 +/- 0.6 and 31.6 +/- 1.2 degrees C, respectively. During expiration, the temperature along the airways progressively decreased as the air flowed from the periphery of the lung to the mouth: the more the cooling during inspiration, the lower the temperature during expiration. These data demonstrate that in the course of conditioning inspired air the intrathoracic and intrapulmonic airways undergo profound thermal changes that extend well into the periphery of the lung. PMID- 3980359 TI - Transient depletion of lung glutathione by diethylmaleate enhances oxygen toxicity. AB - Diethylmaleate (DEM) decreases glutathione (GSH) levels in various organs by enzymatic conjugation with reduced GSH catalyzed by GSH transferase. We have examined levels of GSH, glutathione reductase (GR), and glucose-6-phosphate dehydrogenase (G6PD) in lungs of 200-250-g rats after intraperitoneal injection of 0.5 or 1 g DEM/kg body wt. The GSH levels are severely depressed at 2 and 4 h but have essentially recovered by 12 and 24 h after either dose of DEM. The GR and G6PD activities in the 1 g/kg group are depressed at 4 h to a lesser extent than the GSH levels and also return to normal by 12 and 24 h. These enzymes are not affected in the 0.5 g/kg group. To determine whether these transient decreases in GSH and related enzymes affected O2 tolerance, we exposed rats injected with DEM to greater than 98% O2 and found that halftime (t1/2) for survival was decreased in rats receiving both 0.5 and 1 g DEM/kg body wt when compared with untreated or saline-injected controls (t1/2 control, 74 h; 0.5 g DEM, 59 h; 1 g DEM, 53 h). No deaths occurred in air controls at 1 mg/kg DEM for up to 5 days. DEM, in itself, caused no morphological alteration of the lung. Thus a decrease in lung GSH and related enzymes, occurring by 4 h and reversed by 12 h, has a significant effect on the subsequent progression of lung pathology and indicates that early biochemical events occurring in lungs exposed to hyperoxia may be very important in determining the degree of longer-term damage to rat lungs. PMID- 3980360 TI - Reflex control of expiratory duration in newborn infants. AB - We investigated the effect on expiratory duration (TE) of application of graded resistive and elastic loads and total airway occlusions to single expirations in 9 full-term healthy infants studied on the 2nd or 3rd day of life. The infants breathed through a face mask and pneumotachograph, and flow, volume, airway pressure, and diaphragm electromyogram (EMG) were recorded. Loads were applied to the expiratory outlet of a two-way respiratory valve using a manifold system. Application of all loads resulted in expired volumes (VE) decreased from control (P less than 0.05), and changes were progressive with increasing loads. As VE became smaller, end-expiratory volume (EEV) became greater. TE, measured either from the pattern of airflow or airway pressure, or from diaphragm EMG activity, progressively increased with increasing loads and was greatest with total occlusions (P less than 0.05, compared with control). Resistive loading resulted in a greater accumulated VE history than elastic loading to the same EEV. For equivalent changes in EEV, TE was more prolonged with resistive than with elastic loading. Expiratory loading did not change the inspiratory duration determined from the diaphragm EMG activity of the breath immediately following each loaded expiration. These findings in infants are consistent with an integrative neural mechanism that modulates TE in response to the accumulated VE history, including both EEV and rate of lung deflation. PMID- 3980361 TI - A model for determining alveolar and small airway dimensions from aerosol recovery data. AB - A mathematical model is presented that allows the determination of alveolar and small airway dimensions from a series of aerosol recovery measurements performed at different inspiration volumes. The model assumes 1) a symmetric dichotomous lung, 2) representation of airway and alveoli as ensembles of straight tubes, and 3) Gaussian dispersion of the aerosol bolus. Calculations with this model using dimensions given by Weibel show general agreement with experimental data on six human subjects obtained by Palmes et al. (J. Appl. Physiol. 34: 356-360, 1973). Close agreement is found by varying two parameters describing alveolar size and airway size to obtain the best fit. The resulting estimates of size are almost independent of the choice of the dispersion coefficient; however, the estimate of alveolar size is quite dependent on the form of settling assumed during breath holding. The values of alveolar diameter in the six subjects, determined under the assumption of stirred settling, ranged from 0.13 to 0.33 mm, whereas under the assumption of still settling the range was 0.24-0.65 mm. Small airway (generations 18-24) dimensions ranged from 0.41 to 0.66 mm under the still settling assumption and 0.39 to 0.63 mm under the stirred-settling assumption. With the assumption of an intermediate (partially stirred) form of settling, the alveolar diameter in the six subjects is 0.28 +/- 0.02 mm, in close agreement with morphometric measurements by other investigators. A partially stirred form of settling is also consistent with model predictions of recovery vs. breath holding time and with cardiogenic gas mixing in the lung. PMID- 3980362 TI - Airway reactivity in ponies with recurrent airway obstruction (heaves). AB - We measured lung function and airway reactivity to histamine administered by aerosol in two groups of ponies. Principal ponies had a history of heaves, a disease characterized by recurrent airway obstruction when ponies are housed in a barn and fed hay; control ponies had no history of airway obstruction. Ponies were paired (principal and control) and measurements were made when principal ponies were at pasture and in clinical remission (period A), following barn housing when principal ponies had acute airway obstruction (period B), and after a further 1 and 2 wk at pasture (periods C and D). At periods A, C, and D dynamic compliance (Cdyn), pulmonary resistance (RL), arterial O2 tension (PaO2), and CO2 tension (PaCO2) of principals and controls did not differ. Barn housing (period B) decreased Cdyn and PaO2 and increased RL in principals but not controls. The ED65Cdyn (the dose of histamine to reduce Cdyn to 65% of base line) did not differ in principals and controls at periods A, C, and D. At period B, ED65Cdyn decreased by 2.5-log doses of histamine in principals while ED65Cdyn was not affected in controls. There was no correlation between changes in airway reactivity and changes in RL and Cdyn. We conclude that ponies in clinical remission from heaves are not hyperreactive to histamine aerosol. This model of lung disease is similar to some forms of industrial asthma in which hyperreactivity occurs only during acute airway obstruction. The lack of correlation between ED65Cdyn and the degree of airway obstruction suggests that the hyperreactivity of principal ponies to histamine aerosol cannot be explained solely by alterations in baseline airway caliber. PMID- 3980363 TI - Effects of exercise training on plasma lipids and lipoproteins in rats. AB - We studied the effects of exercise training on plasma lipid and lipoprotein concentrations of rats on a high-fat and high-cholesterol diet. Twelve weeks of training occurred at moderate [Mod-Exer, 70% peak O2 consumption (VO2)] and high (High-Exer, 82% peak VO2) intensities. The duration of daily training sessions was adjusted to maintain equivalent energy expenditure between groups. Following training, body weight and lean body mass were 10% lower in the High-Exer group than the Mod-Exer or control groups. Compared with control values, carcass fat content was 33% lower for both trained groups. The oxidative capacity of skeletal muscle was approximately 30% greater in the trained groups compared with the control group. Total cholesterol, high density lipoprotein cholesterol, and total triglyceride concentrations in plasma were not different between the trained groups, but were 33-47% lower compared with the control group. The exercise induced changes in plasma lipid and lipoprotein concentrations may be a result of a change in preferred substrate utilization in skeletal muscle toward a greater oxidation of lipid. PMID- 3980364 TI - Fiber number, area, and composition of mouse soleus muscle following enlargement. AB - Muscle fiber number, cross-sectional area, and composition were studied in response to enlargement produced by synergistic ablation in the mouse soleus muscle. The effect of the location of a histological section on the number of fibers that appear in the section was also studied using the mouse soleus muscle. Enlargement was produced in the soleus muscle of 15 male and 15 female mice by ablation of the ipsilateral gastrocnemius muscle. Fiber counts, using the nitric acid digestion method, revealed no difference between control and enlarged muscles in male and female mice. Mean fiber area, determined by planimetry, was 49.1 and 34.5% greater following enlargement in male and female mice, respectively. Increase in muscle weight could be totally accounted for by the increase in fiber area following enlargement. A transformation of type II to type I fibers occurred following enlargement for both sexes. Counts of fibers from histological sections revealed that there was a progressive decrease in the fiber number as the section was moved from the belly to the distal end of the muscle. The results of these studies indicate that muscle enlargement in the mouse soleus muscle is due to hypertrophy of the existing muscle fibers. PMID- 3980365 TI - Histamine dose-response curves in guinea pigs. AB - Histamine dose-response curves were performed on anesthetized tracheostomized guinea pigs that were paralyzed and mechanically ventilated at a constant tidal volume and breathing frequency. The dose was calculated by generating an aerosol of known concentration and measuring the volume delivered to the lung. Increasing the dose was accomplished by increasing the number of breaths of aerosol delivered. The response to each dose was determined by measuring the change in airway resistance (RL) and dynamic compliance (Cdyn) using the method of Von Neergaard and Wirz (Z. Klin. Med. 105: 51-82, 1927). With increasing doses of histamine, RL increased and reached a plateau at approximately five times the base-line value and Cdyn fell to approximately 20% of its initial value. The variability in the base-line and maximum response as well as the calculated sensitivity and reactivity was less than that previously reported. Propranolol pretreatment increased resting RL and shifted the dose-response curve for RL to the left of the controls, increasing reactivity but not sensitivity. Atropine shifted the dose-response curve to the right of the control, decreasing sensitivity but without changing reactivity. The data for Cdyn showed that atropine pretreatment caused a higher resting value and propranolol pretreatment a lower value at the highest histamine dose but no differences in either sensitivity or reactivity. PMID- 3980366 TI - Factors influencing regional patency and configuration of the human infant upper airway. AB - To study factors influencing patency and configuration of the upper airway, we studied 11 infant cadavers using endoscopy and photography. In most cases, studies were performed shortly after death. The naso-, oro-, and hypopharynx and the larynx were studied. The upper airway was sealed at the nose and mouth so that transmural airway pressure could be raised or lowered. As pressure was lowered airway closure was seen in each of the four regions studied. With respect to closing pressure, the oropharynx was the most compliant region and the larynx the least compliant. In the naso-, oro-, and hypopharynx, lowering the transmural pressure was associated with inward movement of the anterior, posterior, and lateral airway walls. In the larynx, closure occurred by vocal cord opposition in the midline. Tension applied to the genioglossus and geniohyoid tongue muscles had an effect opposite to that of airway suction, causing a more or less symmetrical dilation of the naso- and oropharynx. When the airway was closed, additional tension was needed to produce airway reopening, suggesting that adhesion forces act to maintain airway closure. Neck flexion caused pharyngeal closure, and neck extension caused pharyngeal dilation. Secretions adherent to the walls of the airway visibly narrowed its lumen. The relevance of these findings for the obstructive sleep apnea and laryngomalacia syndromes is discussed. PMID- 3980367 TI - Radiographic visualization of airway wall movement during oscillatory flow in dogs. AB - It has been suggested that radial movement of the central airway walls during oscillatory flow might contribute to the increased frequency dependence of compliance seen in chronic obstructive pulmonary disease (COPD) (J. Appl. Physiol. 26: 670-677, 1969). Radial airway wall motion has also been invoked to explain the frequency-dependent decreases in the efficiency of gas exchange during low-volume high-frequency ventilation (HFV) in histamine bronchoconstricted dogs and in patients with respiratory insufficiency. To test the possibility that airway wall motion increases with bronchoconstriction, we measured central airway diameters using cinebronchoradiography in anesthetized tracheostomized dogs during oscillatory HFV [50 and 100 ml tidal volume (VT) at frequencies (f) of 2, 6, and 12 Hz], under control conditions, during electrical stimulation of the vagi, and after exposure to histamine aerosol. Cineradiobronchograms from two dogs were evaluated quantitatively for tracheal diameter and for lengths and diameters of a number of major airways. Under control conditions, the diameter of the airways fluctuated 7-9% of the mean with VT of 50 ml and 9-18% with VT of 100 ml in the range of frequencies studied. Bronchoconstriction produced by aerosolized histamine increased radial airway wall movement to 10-47% with VT of 50 ml, and during vagal stimulation diameters changed 7-20% at VT of 50 ml. After histamine, the central airways displayed large diameter changes during HFV, whereas more peripheral airways were markedly constricted and did not change in diameter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980368 TI - Effect of respiratory alkalosis on skeletal muscle metabolism in the dog. AB - These experiments were conducted to determine whether changes in skeletal muscle metabolism contribute to the previously reported increase in whole-body O2 uptake (VO2) during respiratory alkalosis. The hind-limb and gastrocnemius-plantaris preparations in anesthetized and paralyzed dogs were used. VO2 of the hindlimb and gastrocnemius muscle was calculated from measurements of venous blood flow and arterial and venous O2 concentrations (Van Slyke analysis). Whole-body VO2 was measured by the open-circuit method. Minute ventilation (hence blood gases and pH) was controlled by a mechanical respirator. Whole-body, hind-limb, and gastrocnemius muscle VO2 increased 14, 19, and 20%, respectively, during alkalosis (P less than 0.05). In all experiments, arterial lactate concentration increased significantly (P less than 0.05) during alkalosis. A positive venoarterial lactate difference across muscle during alkalosis indicated that skeletal muscle is a source of the elevated blood lactate. We concluded that VO2 of resting skeletal muscle is increased during states of respiratory alkalosis and that this increase can account for much of the increase in whole-body VO2. PMID- 3980369 TI - A rodent treadmill for inhalation toxicological studies and respirometry. AB - A 10-runway treadmill was enclosed for inhalation toxicological studies of rodents under exercise exposure to environmental pollutants. The exposure system was lined with sheet stainless steel to minimize scrubbing of charged particles and reactive gases. Average metabolic gas exchange of exercising animals was derived from measurements of inlet or outlet airflow and data from an O2 analyzer in conjunction with either a CO2 or N2 analyzer. An airflow rate of 400 l X min-1 ensured a response time of 1 min to reach 95% of a step change in metabolic rate and held scrubbing losses of an O3 test atmosphere to less than 2% of treadmill inlet concentration. Gas exchange averaged for 10 rats during incremental exercise up to their highest collective performance was similar to published data for rats tested individually. PMID- 3980370 TI - Potentiation of lung vascular response to endotoxin by superoxide dismutase. AB - We studied the effects of superoxide dismutase (SOD), an enzyme that converts superoxide into peroxide, on the cardiopulmonary response to endotoxin in sheep. Sheep (n = 18) were prepared for chronic measurement of cardiopulmonary variables, including lung lymph flow, by surgically implanting catheters under halothane anesthesia. Nine of the animals were studied before and after the administration of endotoxin (0.75 microgram/kg) with and without SOD. An additional nine animals received SOD without the lipopolysaccharide. Endotoxin produced an increase in lung lymph flow that was initially associated with a marked pulmonary arterial (PA) hypertension and reduced lymph-to-plasma protein ratio (L/P). The lymph flow remained elevated later in the response, but there was only a mild increase in PA pressure, and the L/P was normal. There was also a fall in blood neutrophils and in cardiac index. SOD increased this secondary elevation in lung lymph flow, and the corresponding L/P was greater than the preendotoxin value. The fall in neutrophil count, cardiac output, and the elevation in PA pressure seen with endotoxin were not affected by SOD. When administered in the absence of endotoxin, SOD produced no perceptible change in the cardiopulmonary and lymph values. We conclude that peroxide, hydroxyl ion, and/or other free radicals formed by the action of SOD must be responsible for a portion of the endotoxin response rather than superoxide itself. PMID- 3980371 TI - Postpneumonectomy airway growth in the ferret. AB - To investigate the participation of the conducting airways in compensatory growth following partial lung resection, bronchial casts of six ferrets having undergone right-sided pneumonectomy at 8 wk of age were compared with those of five sham operated control animals. At maturity, the left lungs of the postpneumonectomy animals were 65% larger than those of the controls. Central airway cross sectional areas at 10 specific locations in each cast were 12% larger in the postpneumonectomy animals compared with controls. To characterize the size of more peripheral airways, the size and number of the terminal bronchioles subtended by each airway in each left lower lobe cast were identified so that the fraction of the lobe served by that airway could be estimated. The characteristic cross-sectional areas of airway serving 0.7, 2.2, and 9.5% of the left lower lobe in postpneumonectomy animals were 18, 13, and 13% larger than those of controls, but this difference was statistically significant only at the two more peripheral levels. Although airway areas were larger in postpneumonectomy animals, the ratio of airway cross-sectional area to the 0.67 power of lung volume was 20-26% smaller in operated than in control animals at each of the four levels. Following pneumonectomy in the weanling ferret, central and peripheral conducting airways increase in cross-sectional area to similar degrees, but this airway growth is less than the compensatory increase in lung volume. PMID- 3980372 TI - A technique for quantitating airway size from bronchial casts. AB - To develop a technique for quantitating the size of airways at various positions in the bronchial tree, we analyzed casts of formalin-fixed excised lungs of five mature male ferrets. The left lower lobe of each cast was dissected, the diameter and position of each terminal bronchiole were entered into a computer programmed to reconstruct the airway system, and the cross-sectional areas of 120 conducting airways were measured. The fraction of the lobe served by each measured airway was estimated by dividing the sum of the squared diameters of the terminal bronchioles subtended by that airway by the summed squared diameters of all terminal bronchioles in the lobe. In each cast the relationship between an airway's cross-sectional area (Y) and the fraction of the lobe it was estimated to subtend (X) was described (0.91 less than R2 less than 0.95) by the expression ln(Y) = A + B ln(X) + C [ln(X)]2. Linear regression of ln(Y) on ln(X) for 30-50 airways estimated to serve fractions of the lobe around each of three arbitrarily selected levels (airways serving 0.7, 2.2, and 9.5% of the lobe) was adequate to characterize the area of airways at each level in each of the five animals with 95% confidence intervals narrower than 8% of the estimated area. Variability of airway size at each level among the five casts was modest, suggesting that this technique identified analagous airways in the various animals. Interindividual variability did not increase when the data were reanalyzed with terminal units defined on the basis of airway diameters rather than on the morphological identification of terminal bronchioles. PMID- 3980373 TI - Low-frequency response characteristics of three Grass model 7 polygraphs. AB - A low-frequency response analysis of three Grass model 7 polygraphs was undertaken. Observed error was generally found to fall within the manufacturer's stated range of +5 to -10% of DC signal height over the frequency range of human respiration (0.1-3 Hz), but this was not the case for frequencies greater than 6 Hz under certain circumstances. The magnitude of error was seen to vary directly with frequency and indirectly with pen-deflection amplitude and paper speed. The pen-oscillograph apparatus was the predominant source of low-frequency error, and this is probably due to pen inertia and pen friction on the writing surface. Two schemes to reduce such error are presented. PMID- 3980374 TI - A high-precision automatic closed-circuit respirometer for small animals. AB - An automatic apparatus for the continuous measurement of O2 consumption of small laboratory animals is described. By use of a high-sensitivity pressure transducer with associated circuitry together with a peristaltic O2 delivery system, the closed respirometer chamber is maintained at atmospheric pressure +/- 0.5 mmH2O. O2 delivery is measured to within 0.25 ml by recording rotations of the peristaltic pump, following calibration by the withdrawal of a preset volume of air from the chamber. Static trials (with the chamber empty) indicate a high degree of reproducibility of data with the chamber pressure remaining at atmospheric pressure +/- 0.5 mmH2O as a result of the proportional, as opposed to fixed-volume, delivery of O2. Trials with mice and rats have likewise produced data with a high degree of reproducibility. PMID- 3980375 TI - Error due to dead-space admixture in single-breath method for estimation of pulmonary blood flow. AB - The single-breath method of Kim et al. (J. Appl. Physiol. 21: 1338-1344, 1966) for the estimation of pulmonary blood flow is based on a single-alveolus lung model for which an analytical relationship has been established between the kinetic behavior of the alveolar O2 and CO2 tensions and the pulmonary blood flow. The analysis is based on the assumption that the dead-space contribution to the expirate is negligible after expiration of a predefined volume. We have examined the influence of this assumption on the estimation of pulmonary blood flow by computer simulation in a lung model that incorporates deadspace contribution to the expirate. Data on the fractional contribution of the dead space to the expired gas were obtained from Tsunoda et al.'s study (J. Appl. Physiol. 32: 644-649, 1972) on the emptying pattern of normal adult lungs. The results show that failure to take account of the dead-space contribution can cause an underestimation in the pulmonary blood flow of greater than 30%. The error can be reduced by ignoring the first part of the expiration but only at the cost of an increase in the sensitivity of the single-breath method to measurement noise. This property of the system is demonstrated experimentally. The error due to dead-space admixture depends on the total volume of dead-space gas, the measurement noise, the pulmonary blood flow, and the emptying characteristics of the dead-space compartment during expiration. In normal subjects it is possible to optimize the experimental design so that the systematic error is less than 5% and the coefficient of variation is less than 10%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980376 TI - Effects of pleural pressure and abdominal pressure on diaphragmatic blood flow. AB - The aim of this experiment was to determine if blood flow to the diaphragm is affected by generating the transdiaphragmatic pressure mainly with positive abdominal pressure or mainly with negative pleural pressure, during both sustained and intermittent diaphragmatic contractions. Diaphragmatic blood flow was measured in anesthetized mongrel dogs by the radionuclide-labeled microsphere method. Sustained and intermittent tetanic diaphragmatic contractions were produced with 1) free abdomen and closed chest (high negative pleural pressure) and 2) bound abdomen and open chest (high positive abdominal pressure). During sustained contractions, diaphragmatic blood flow at maximum levels of activation was significantly higher with negative pleural pressure (P less than 0.05). In contrast with this, intermittent diaphragmatic contractions did not yield a significant difference between diaphragmatic blood flow with negative pleural pressure and with positive abdominal pressure at maximal levels of transdiaphragmatic pressure. During both sustained and intermittent contractions, blood pressure, as measured from the carotid artery, did not vary significantly between negative pleural pressure and positive abdominal pressure. We conclude that during sustained tetanic diaphragmatic contractions, diaphragmatic blood flow is obstructed by high positive abdominal pressures, but during intermittent diaphragmatic contractions, high positive abdominal pressures do not affect total blood flow, since any inhibition of blood flow during the contractile period can be compensated for during the relaxation period between contractions. PMID- 3980377 TI - Muscle blood flow patterns during exercise in partially curarized rats. AB - We studied the distribution of blood flow within and among muscles of partially curarized (40-100 micrograms/kg body wt) rats during preexercise and at 1 min of low-speed treadmill exercise (15 m/min). Glycogen loss in the deep red muscles and parts of muscles was significantly reduced in the curarized animals during exercise, indicating the fibers in these muscles were recruited to a lesser extent and/or had lower metabolisms than fibers in the same muscles of control rats. However, elevations in blood flow in the red muscles of the curarized rats were as great or greater than those in the control rats. Thus reduced recruitment and/or metabolism of the deep red muscle fibers of the curarized animals was not accompanied by reduced blood flow. These findings suggest a dissociation between red fiber metabolism and blood flow in the curarized rats during the 1st min of slow treadmill exercise and indicate that release of vasodilator substances or local physical factors associated with muscle fiber activity are not solely responsible for the initial hyperemia during exercise. PMID- 3980378 TI - Diaphragmatic fatigue in normoxia and hyperoxia. AB - Diaphragmatic fatigue was induced in six normal young men inspiring against a variable alinear resistance. Breathing pattern was rigidly controlled (tidal volume 0.75 liter, 12 breaths . min-1). Fatigue was defined as an inability to continue to generate a target transdiaphragmatic pressure (Pdi = 0.65 - 0.84 Pdimax). Diaphragmatic electromyogram (EMG, esophageal electrode) and perceived effort (PE, open-ended scale) were recorded. Subjects were tested on an identical resistance inspiring air or 100% O2 in random order on different days. They were unaware of the gas mixture inspired. Mean endurance time (tlim) +/- SE for air was 4.1 +/- 1.4 min and for O2 was 8.6 +/- 2.7 min (P less than 0.005). The increased tlim in O2 was associated with a delay in onset of EMG changes heralding diaphragmatic fatigue and a decrease in PE at any time during the study compared with the level of PE in air. Arterial O2 saturation (ear oximeter) remained at the resting level of 99.0 +/- 0.2% in O2 and decreased from the resting level of 97.2 +/- 0.2% by 2.8 +/- 0.7% (P less than 0.01) in air. The end tidal CO2 fraction increased to a similar degree in air and O2 studies. We conclude that when breathing pattern, minute ventilation, and Pdi are held constant during inspiratory resistive loading, breathing O2 delays the onset of diaphragm fatigue and decreases PE. PMID- 3980379 TI - Effect of hematocrit on vascular pressure profile in dog lungs. AB - We studied the effect of blood hematocrit (Hct) on the longitudinal distribution of pulmonary vascular pressure profile in an in situ isolated left lower lobe preparation of dog lung using the arterial and venous occlusion technique. The total arteriovenous pressure drop (delta PT) across the lobe was partitioned into pressure drops across an arterial (delta Pa), a venous (delta Pv), and a middle segment (delta Pm). Three levels of Hct were studied: low (18 +/- 5%), normal (41 +/- 4%), and high (66 +/- 5%). Arterial and venous occlusions were performed under constant-flow or constant-pressure perfusion. When flow was maintained constant, the increase in delta PT between low and normal Hct was due to increases in delta Pa, delta Pm, and delta Pv; however, between normal and high Hct, the increase in delta PT was primarily due to an increase in delta Pm. When delta PT was kept constant by adjusting flow, changes in delta Pa and delta Pv were in the same direction as changes in blood flow rate but in opposite direction to changes in Hct. In contrast, changes in delta Pm were in the same direction as changes in Hct. The results showed that the vascular resistance of the middle segment ranged from 7% of total pulmonary vascular resistance at low Hct to 53% at high Hct, suggesting that the vessels within this segment offer the greatest impairment to the transit of blood cells. PMID- 3980380 TI - Effects of transfusion-induced polycythemia on O2 transport during exercise in the dog. AB - An increased hematocrit could enhance peripheral O2 transport during exercise by improving arterial O2 content. Conversely, it could reduce maximal delivery of O2 by limiting cardiac output during exercise or by limiting the distribution of blood flow to peripheral capillaries with high O2 extractions. We studied O2 transport at rest and during graded treadmill exercise in splenectomized tracheostomized dogs at normal hematocrit (38 +/- 3%), and 48 h after transfusion of type-matched donor cells. This procedure increased hematocrit (60 +/- 3%) but also increased blood volume (P less than 0.05). Following transfusion, resting cardiac output (QT) and heart rate were not different. During exercise, QT was significantly lower at each level of O2 consumption (VO2) at high hematocrit (P less than 0.01). A reduction in QT was also seen during polycythemic exercise with hypoxemia produced by breathing 12 or 10% O2 in N2. Despite the reduction in QT, mixed venous PO2 was not lower at high hematocrit, and the increase in base deficit with VO2 was not different from control measurements. O2 delivery (QT X arterial content) was similar at each level of VO2 at both levels of hematocrit, during both normoxic and hypoxic studies. Both systemic and pulmonary arterial pressures were increased at rest after transfusion (P less than 0.05). However, pulmonary and systemic pressures were not higher than control during exercise at high hematocrit. We conclude that a hematocrit of 60% with increased blood volume is not associated with a cardiac limitation of O2 delivery, nor does it interfere with peripheral O2 extraction during exercise in the dog. PMID- 3980381 TI - Free dopamine in dog plasma: lack of relationship with sympathoadrenal activity. AB - To investigate the relationship between dopamine (DA) released into the bloodstream and sympathoadrenal activity, levels of free DA, norepinephrine (NE), and epinephrine (E) in plasma were recorded in four dogs subjected to three tests: treadmill exercise at two work levels [55 and 75% maximal O2 uptake; 15 min], normobaric hypoxia (12% O2; 1 h), combined exercise and hypoxia. Normoxic exercise induced slight nonsignificant decreases in the arterial partial pressure of O2 (PaO2), increases in NE [median values and ranges during submaximal work vs. rest: 1086 (457-1,637) vs. 360 (221-646) pg/ml; P less than 0.01] and E [277 (151-461) vs. 166 (95-257) pg/ml; P less than 0.05], but it failed to alter the DA level. Hypoxia elicited large decreases in PaO2 [hypoxia vs. normoxia: 42.8 (40.3-50.0) vs. 97.6 (83.2-117.6) Torr; P less than 0.01], increases in DA [230 (105-352) vs. 150 (85-229) pg/ml; P less than 0.01] and NE [383 (219-1,165) vs. 358 (210-784) pg/ml; P less than 0.05], but it failed to alter the E level. Combined exercise and hypoxia further increased NE levels but did not alter the DA response to hypoxia alone. The data indicate that free DA in plasma may vary independently of the sympathoadrenal activity. PMID- 3980382 TI - Heat exchanges in wet suits. AB - Flow of water under foam neoprene wet suits could halve insulation that the suits provided, even at rest in cold water. On the trunk conductance of this flow was approximately 6.6 at rest and 11.4 W . m-2 . C-1 exercising; on the limbs, it was only 3.4 at rest and 5.8 W . m-2 . degrees C-1 exercising; but during vasoconstriction in the cold, skin temperatures on distal parts of limbs were lower than were those of the trunk, allowing adequate metabolic responses. In warm water, minor postural changes and movement made flow under suits much higher, approximately 60 on trunk and 30 W . m-2 . degrees C-1 on limbs, both at rest and at work. These changes in flow allowed for a wide range of water temperatures at which people could stabilize body temperature in any given suit, neither overheating when exercising nor cooling below 35 degrees C when still. Even thin people with 4- or 7- mm suits covering the whole body could stabilize their body temperatures in water near 10 degrees C in spite of cold vasodilatation. Equations to predict limits of water temperature for stability with various suits and fat thicknesses are given. PMID- 3980383 TI - Arterial blood pressure response to heavy resistance exercise. AB - The purpose of this study was to record the blood pressure response to heavy weight-lifting exercise in five experienced body builders. Blood pressure was directly recorded by means of a capacitance transducer connected to a catheter in the brachial artery. Intrathoracic pressure with the Valsalva maneuver was recorded as mouth pressure by having the subject maintain an open glottis while expiring against a column of Hg during the lifts. Exercises included single-arm curls, overhead presses, and both double- and single-leg presses performed to failure at 80, 90, 95, and 100% of maximum. Systolic and diastolic blood pressures rose rapidly to extremely high values during the concentric contraction phase for each lift and declined with the eccentric contraction. The greatest peak pressures occurred during the double-leg press where the mean value for the group was 320/250 mmHg, with pressures in one subject exceeding 480/350 mmHg. Peak pressures with the single-arm curl exercise reached a mean group value of 255/190 mmHg when repetitions were continued to failure. Mouth pressures of 30-50 Torr during a single maximum lift, or as subjects approached failure with a submaximal weight, indicate that a portion of the observed increase in blood pressure was caused by a Valsalva maneuver. It was concluded that when healthy young subjects perform weight-lifting exercises the mechanical compression of blood vessels combines with a potent pressor response and a Valsalva response to produce extreme elevations in blood pressure. Pressures are extreme even when exercise is performed with a relatively small muscle mass. PMID- 3980384 TI - Effect of endurance exercise training on ventilatory function in older individuals. AB - To evaluate the effect of endurance training on ventilatory function in older individuals, 1) 14 master athletes (MA) [age 63 +/- 2 yr (mean +/- SD); maximum O2 uptake (VO2max) 52.1 +/- 7.9 ml . kg-1 . min-1] were compared with 14 healthy male sedentary controls (CON) (age 63 +/- 3 yr; VO2max of 27.6 +/- 3.4 ml . kg-1 . min-1), and 2) 11 sedentary healthy men and women, age 63 +/- 2 yr, were reevaluated after 12 mo of endurance training that increased their VO2max 25%. MA had a significantly lower ventilatory response to submaximal exercise at the same O2 uptake (VE/VO2) and greater maximal voluntary ventilation (MVV), maximal exercise ventilation (VEmax), and ratio of VEmax to MVV than CON. Except for MVV, all of these parameters improved significantly in the previously sedentary subjects in response to training. Hypercapnic ventilatory response (HCVR) at rest and the ventilatory equivalent for CO2 (VE/VCO2) during submaximal exercise were similar for MA and CON and unaffected by training. We conclude that the increase in VE/VO2 during submaximal exercise observed with aging can be reversed by endurance training, and that after training, previously sedentary older individuals breathe at the same percentage of MVV during maximal exercise as highly trained athletes of similar age. PMID- 3980385 TI - Effects of chronic hypoxia on structure and reactivity of rat lung microvessels. AB - The reactivity of lung microvessels is determined by a method based on planimetry of elastic laminae (EL) in vessel cross sections. Because wall structure is assessed, arteries that undergo remodeling during chronic hypertension can be identified. To study the structure and reactivity of such vessels, slices obtained from lungs of six rats exposed to hypobaric hypoxia for 14 days and from normoxic controls were incubated in culture with 10(-4) M l-epinephrine (EPI), then fixed and processed for microscopy. For muscular arteries (less than 200 microns diam), the circumferential length of internal EL (IEL) is positively correlated with length of external EL (EEL). In larger arteries, EEL is shorter than IEL and may restrict distension, but in smaller arteries the converse is true. After chronic hypoxia, the regression line shifts, indicating structural remodeling. For newly muscularized arteries found only after hypoxia the new IEL is always shorter than EEL, and a complex network of elastin connects the two. Muscular arteries constrict with EPI to the same degree after hypoxia as after normoxia. Nonmuscular vessels (arteries and veins) also constrict similarly after either exposure regimen. For newly muscularized arteries of the same size and location as the nonmuscular vessels, the response is significantly less. PMID- 3980386 TI - Hypoxia and angiotensin II infusion redistribute lung blood flow in lambs. AB - To assess the effects of alveolar hypoxia and angiotensin II infusion on distribution of blood flow to the lung we performed perfusion lung scans on anesthetized mechanically ventilated lambs. Scans were obtained by injecting 1-2 mCi of technetium-labeled albumin macroaggregates as the lambs were ventilated with air, with 10-14% O2 in N2, or with air while receiving angiotensin II intravenously. We found that both alveolar hypoxia and infusion of angiotensin II increased pulmonary vascular resistance and redistributed blood flow from the mid and lower lung regions towards the upper posterior region of the lung. We assessed the effects of angiotensin II infusion on filtration pressure in six lambs by measuring the rate of lung lymph flow and the protein concentration of samples of lung lymph. We found that angiotensin II infusion increased pulmonary arterial pressure 50%, lung lymph flow 90%, and decreased the concentration of protein in lymph relative to plasma. These results are identical to those seen when filtration pressure increases during alveolar hypoxia. We conclude that alveolar hypoxia and angiotensin II infusion both increase fluid filtration in the lung by increasing filtration pressure. The increase in filtration pressure may be the result of a redistribution of blood flow in the lung with relative overperfusion of vessels in some areas and transmission of the elevated pulmonary arterial pressure to fluid-exchanging sites in those vessels. PMID- 3980387 TI - Spectral analysis of the EMG and diaphragmatic muscle fatigue during periodic breathing in infants. AB - Periodic breathing occurs commonly in full-term and preterm infants. The mechanisms which switch breathing on and off within a cycle of periodic breathing are not certain. Since immature infants may experience diaphragmatic muscle fatigue, one potential switching mechanism is fatigue. Power spectra of the electromyogram, uncontaminated by the electrocardiograph artifact, were studied for evidence of diaphragmatic muscle fatigue during spontaneous periodic breathing in infants. A fall in the high-frequency (103-600 Hz) power and an increase in the low-frequency (23-47 Hz) power during periodic as compared with normal breathing would indicate fatigue. This effect was not observed in any of the infants studied. Hence, there is no evidence that periodic breathing is the result of diaphragmatic muscle fatigue. This finding suggests that the effect of drugs such as theophylline in eliminating periodic breathing may be unrelated to the fact that they also reduce fatigue. PMID- 3980389 TI - Decreased brain levels of ascorbic acid in rats exposed to high pressures. AB - Ascorbic acid was repeatedly monitored in vivo in the striatum of rats subjected to an increasing pressure (100 bar/h compression rate; 0.5 bar partial pressure of O2 He-O2 mixture, up to 120 bar (121 ATA), to which they were exposed for 1 h. Measurements were performed using differential pulse voltammetry and carbon fiber microelectrodes. High-pressure-exposed animals exhibited a dramatic decrease of striatal ascorbic acid. This decrease was detectable at pressures as low as 50 bar and significant over 70 bar (75% of the control level), and the lower level (25% of the control level) was reached shortly after the end of the compression period. This finding is discussed in relation to the physiological role of ascorbic acid in the brain, e.g., its participation in the defense mechanisms against reactive O2 intermediates and lipid peroxidations and its probable involvement in neurotransmission. Emphasis is placed on a possible increased sensitivity of nerve cell membrane phospholipids to peroxidation under stressful hyperbaric situations. PMID- 3980388 TI - Respiratory epithelium inhibits bronchial smooth muscle tone. AB - The aim of the present study was to determine whether or not the respiratory epithelium can modulate the responsiveness of bronchial smooth muscle. Paired rings of canine bronchi (4-6 mm OD), in some of which the epithelium had been removed mechanically (by rubbing the luminal surface), were mounted in physiological saline solution, gassed with 95% O2-5% CO2, and maintained at 37 degrees C. The presence or absence of the epithelium was confirmed by histological examination. Removal of the epithelium increased the contractile responses evoked by acetylcholine, histamine, and 5-hydroxytryptamine. Transmural nerve stimulation evoked similar peak responses in the presence and absence of epithelium. In unrubbed preparations, the peak response was followed by a gradual decrease when the stimulation was continued. This decrease, which persisted in the presence of propranolol, was not observed in epithelium-denuded preparations. In bronchial rings contracted with acetylcholine, isoproterenol produced concentration-dependent relaxations which were significantly greater in rings with epithelium compared with denuded rings. These results suggest that respiratory epithelial cells may generate an inhibitory signal to decrease the responsiveness of bronchial smooth muscle to contractile agonists and augment the effectiveness of inhibitory stimuli. PMID- 3980390 TI - Effects of prolonged elevated microvascular pressure on lung fluid balance in sheep. AB - Experiments were conducted in seven chronically instrumented unanesthetized sheep to estimate the osmotic reflection coefficient (sigma d) for total proteins and the solvent-drag reflection coefficients (sigma f) for six endogenous protein fractions. We measured the lymph-to-plasma ratio of total proteins (CL/CP) and six protein fractions during base-line conditions and after left atrial pressure elevations of 24-26 h per elevation. We also monitored pulmonary arterial pressure, left atrial pressure, systemic arterial pressure, and lung lymph flow at the various levels of pulmonary microvascular pressure. Our results indicate the CL/CP may require up to 24 h to reach a true steady state. It was found that sigma d is at least 0.89 for total proteins and sigma f is at least 0.84, 0.87, 0.86, 0.92, 0.95, and 0.96 for protein fractions with effective molecular radii of 36, 39.5, 44, 66, 105, and 123 A, respectively. In addition, the sigma f values for various protein fractions obtained from this investigation are compared with the predicted values of various mathematical models of the lung microcirculation. PMID- 3980391 TI - Assessment of fluid balance in isolated sheep lungs. AB - In this study we demonstrate the validity and utility of an isolated lung preparation developed for the study of pulmonary fluid balance. Lungs of 2- to 3 mo-old sheep were perfused in situ with autologous blood treated with indomethacin (20 micrograms/ml). Lung lymph flow (QL), uncontaminated by systemic lymph, was measured from either the efferent duct of the caudomediastinal lymph node or the thoracic duct in the superior mediastinum. Lung weight change (delta W) was measured as the opposite of the change in weight of the extracorporeal blood reservoir. A unique feature of this experimental model is the ability to assess lung fluid balance from simultaneous measurements of delta W and QL. In addition, hemodynamic and blood gas variables can be tightly controlled. Our results show that changes in QL and the lymph-to-plasma oncotic pressure ratio caused by an increase in microvascular pressure were comparable with those seen previously in intact sheep. When microvascular pressure was returned to control levels, QL fell despite a sustained increase in the amount of extravascular lung water, suggesting compartmentalization of the filtrate and/or effects of intravascular volume on lymph-driving pressure or resistance. Lymph flow was directly proportional to respiratory frequency over the range of 0-30 min-1 when the change in frequency was maintained for periods as long as 30 min. This preparation should prove useful in the study of lung fluid balance, particularly when it is desired to use interventions which are precluded or difficult in intact animals. PMID- 3980392 TI - Pulmonary C-fibers reflexly increase secretion by tracheal submucosal glands in dogs. AB - Stimulation of bronchial C-fibers evokes a reflex increase in secretion by tracheal submucosal glands, but the influence of pulmonary C-fibers on tracheal gland secretion is uncertain. In anesthetized dogs with open chests, we sprayed powdered tantalum on the exposed mucosa of a segment of the upper trachea to measure the rate of secretion by submucosal glands. Secretions from the gland ducts caused elevations (hillocks) in the tantalum layer. We counted hillocks at 10-s intervals for 60 s before and 60 s after we injected capsaicin (10-20 micrograms/kg) into the right atrium to stimulate pulmonary C-fiber endings. Right atrial injection of capsaicin increased the rate of hillock formation fourfold, but left atrial injection had no significant effect. The response was abolished by cutting the vagus nerves or cooling them to 0 degree C. We conclude that the reflex increase in tracheal submucosal gland secretion evoked by right atrial injection of capsaicin was initiated as capsaicin passed through the pulmonary vascular bed, and hence that pulmonary C-fibers, like bronchial C fibers, reflexly increase airway secretion. PMID- 3980393 TI - Oxygen-induced lung microvascular injury in neutropenic rabbits and lambs. AB - We did two studies to see if severe neutropenia might reduce the severity or delay development of O2-induced lung microvascular injury. First, we treated 11 rabbits with nitrogen mustard until their circulating neurophil count decreased to less than 50/microliters of blood, after which the rabbits breathed pure O2 until death; nine other rabbits received no nitrogen mustard and had normal numbers of circulating neutrophils during O2 breathing. All rabbits died of respiratory failure with pulmonary edema, and although chemotherapy decreased the number of neutrophils in the lungs by greater than 90%, it did not influence survival time or extravascular lung water content. To see if severe neutropenia might slow the development of O2-induced lung microvascular injury, we assessed the effects of sustained hyperoxia on lung fluid balance in unanesthetized lambs treated with hydroxyurea, so that their absolute neutrophil count was less than 50/microliters of blood. We measured pulmonary arterial and left atrial pressures, cardiac output, lung lymph flow, and concentrations of protein in lymph and plasma during a 2- to 4-h control period and then daily for 2 to 4 h as the lambs continuously breathed pure O2. After 3 days of hyperoxia, lymph flow doubled and the concentration of protein in lymph increased from 3.3 +/- 0.5 to 4.2 +/- 0.3 g/dl. Tracer studies with 125I-albumin before and 3 days after the start of O2 breathing confirmed the development of increased lung vascular permeability to protein. All lambs died of respiratory failure with pulmonary edema after 3-5 days in O2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980394 TI - Evaluation of vapor permeation through garments during exercise. AB - Five males [age 28 +/- 8 yr; maximum O2 uptake (VO2max) 50 +/- 6 ml O2 . kg-1 . min-1; body wt 70 +/- 3 kg; DuBois surface area 1.85 +/- 0.02 m2] exercised on a cycle ergometer, placed on a Potter scale, at 31% VO2max for up to 2 h at an ambient temperature (Ta) of 25 degrees C and a dew-point temperature of 15 degrees C. Air movement was varied from still air to 0.4 and 2 m/s. Each subject, in separate runs, wore a track suit (TS ensemble) of 60% polyester-40% cotton (effective clo = 0.5); a Gortex parka (GOR ensemble), covering a sweat shirt and bottom of TS (effective clo = 1.4); or the TS ensemble covered by polyethylene overgarment (POG ensemble). Esophageal, skin temperature (Tsk) at eight sites, and heart rate were continuously recorded. Dew-point sensors recorded temperatures under the garments at ambient and chest (windward site) and midscapular sites. Local skin wettedness (loc w) and ratio of evaporative heat loss (Esk) to maximum evaporative capacity were determined. An observed average effective permeation (Pe, W . m-2 . Torr-1) was calculated as Esk/loc w (Ps,sk - Pw), where w is the average of chest and back loc w and (Ps,sk - Pw) is the gradient of skin saturation vapor pressure at Tsk and Ta. Additionally, the local effective evaporative coefficient was determined for chest and back sites by Esk/(Ps,dpl - Pw). The GOR ensemble produced an almost as high a Pe as the TS ensemble (82-86% of Pe with TS in still air and 0.4- and 2-m/s conditions). Direct dew-point recording offers an easy practical dimension to the study of efficacy of latent heat loss and skin wettedness properties through garments. PMID- 3980395 TI - Electrical and mechanical failures during sustained and intermittent contractions in humans. AB - This paper compares the effects of sustained and intermittent contractions on electrical and mechanical failure during muscle fatigue in the human adductor pollicis electrically stimulated at 30 Hz via its motor nerve. Sixty-second sustained contractions are compared with a series of 60 1-s contractions, separated by 2.0-, 1.0-, and 0.5-s intervals for identical duration of tension development. Sixty-second sustained contractions decrease tetanic force to 60% (P less than 0.05) of initial values. No significant difference (P greater than 0.05) of force reduction was observed during intermittent 1-s contractions separated by 1-s intervals (-40%), but final force reduction was found to be significantly smaller (P less than 0.05) for 2-s intervals (-18%) and larger (P less than 0.05) for 0.5-s intervals (-65%). When identical force reduction is present in both fatigue tests, it appears that concomitant electrical failure is considerably different during sustained and intermittent contractions (P less than 0.05). This electromechanical dissociation suggests that slowing of conduction along nerve and muscle membranes, as well as possible increase of synaptic delay, does not explain the observed mechanical failure. It is therefore suggested that intracellular processes play the major role in contractile failure during sustained and intermittent contractions. PMID- 3980396 TI - Interaction between cold and altitude exposure on pulmonary circulation of cattle. AB - Hereford calves were exposed in a temperature-controlled hypobaric chamber to environmental temperatures of -2 to 1 degree C (cold) at altitudes of 1,524 m (resident altitude) and 3,048 m 1) to characterize the effects of cold exposure on the pulmonary circulation; 2) to examine the role of cold-induced hypoventilation on the pulmonary circulation; and 3) to examine the interaction between cold and hypoxia on the pulmonary circulation. Cold exposure produced a significant increase in pulmonary arterial pressure (Ppa), pulmonary arterial wedge pressure (Ppaw), and pulmonary vascular resistance (PVR) at both 1,524 and 3,048 m without affecting cardiac output. Concomitantly, cold exposure caused reductions in minute ventilation, respiratory rate, end-tidal O2 tension (PETO2), and arterial O2 tension (PaO2). Tidal volume, end-tidal CO2 tension, and arterial CO2 tension increased. Neither arterial pH nor O2 consumption changed during cold exposure. These results indicated that both pulmonary arterial and venous vasoconstriction were responsible for the pulmonary hypertension associated with cold exposure. Acute exposure to 3,048 m during cold exposure produced increases in Ppa and PVR that were similar to those elicited by cold exposure at 1,524. It was concluded that altitude exposure neither attenuated nor potentiated the effect of cold exposure on the pulmonary circulation; rather, altitude and cold exposure interacted additively. O2 administered during cold exposure to restore PETO2 and PaO2 to control values partially restored Ppa and PVR to control values. This suggested that a portion of the pulmonary hypertension associated with cold exposure was due to hypoxic pulmonary vasoconstriction elicited by the cold-induced alveolar hypoventilation. PMID- 3980397 TI - Metabolic and vasomotor insulative responses occurring on immersion in cold water. AB - Twenty male volunteers (17-28 yr of age) exhibiting a range of body weights (60 kg less than or equal to Wt less than or equal to 95 kg) and body fat (7% less than or equal to BF less than or equal to 23%) underwent total immersion while at rest in water between 36 and 20 degrees C. The metabolic heat production measured as a function of time and water temperature was converted to explicit linear functions of core (Tre) and mean skin (Tsk) temperature for each individual immersion. The metabolic functions defined planes of thermogenic activity that showed a fourfold steeper slope with respect to changes in Tsk for small lean subjects than for large fatter subjects. Small lean males also exhibited steeper slopes with respect to changes in Tre than heavier phenotypes. The time course of Tsk and Tre was simulated for each individual immersion with the aid of a time dependent system of differential heat balance equations coupling different body compartments to the water bath. This formulation permitted the evaluation of internal and external conductances as a function of water temperature. Maximal internal insulation, indicating full vasoconstriction, was achieved at higher bath temperatures in small lean subjects than large fatter subjects. A decline in insulation is seen above a critical metabolic level (approximately 150 W) in small to average size subjects. PMID- 3980398 TI - Determination of phosphorus in processed cheese: collaborative study. AB - A second interlaboratory collaborative study of the determination of phosphorus in processed cheese products by the molybdenum blue method verifies that this method is prone to producing a laboratory-induced systematic error. It would be useless to continue to make minor modifications in the details of the method, which will improve only the within-laboratory precision, until an accuracy control of the final measurement step is incorporated into the method. PMID- 3980399 TI - Gas chromatographic determination of oxalic acid in foods. AB - A new quantitative gas chromatographic (GC) method has been developed for the determination of oxalic acid in foods. Solid sample is extracted with water (soluble oxalic acid) or 2N hydrochloric acid (total oxalic acid) at room temperature. An aliquot of sample extract is evaporated to dryness, and the oxalic acid in the residue is methylated with 7% hydrochloric acid-methanol. The reaction mixture is extracted with chloroform, and dimethyl oxalate is quantitated by GC. Recovery of oxalic acid added to liquid samples averaged 100.6%; recoveries from extracts of solid samples were 96.2-99.5 and 97.2-100.1% for water and hydrochloric acid extractions, respectively. Results are shown for determination of oxalic acid in spinach and beverages. The technique is simple, rapid, and accurate, and small samples may be used. The limit of determination is 20 micrograms. PMID- 3980400 TI - Performance characteristics of methods of analysis used for regulatory purposes. I. Drug dosage forms. C. Automated methods. AB - For analysis of drug dosage forms, precision measures of AOAC approved automated methods, usually containing a spectrophotometric or fluorometric measurement step, were recalculated on a consistent statistical basis, using a computer program "FDACHEMIST." Ten collaborative studies of 14 compounds in 38 materials, consisting of various dosage forms, usually in 10 replications by an average of 7 laboratories, with a total of 2461 determinations, were reviewed. The average relative standard deviations within-laboratory (RSDo) and among-laboratories (RSDx) were 1.1 and 1.9%, respectively, and the ratio of RSDo/RSDx was 0.57, with an average outlier rate of 0.57% of the reported values. The line of best fit for RSDx plotted against - log concentration increases slightly with decreasing concentration, extending from an RSDx of about 1.6% at 100% concentration to an RSDx of 2.2% at 0.1% concentration, a change in RSDx of about 0.2% for a 10-fold decrease in concentration, independent of analyte and matrix. PMID- 3980401 TI - The FDA Surveillance Index for Pesticides: establishing food monitoring priorities based on potential health risk. AB - Through an approach called the Surveillance Index (SI), the U.S. Food and Drug Administration (FDA) is systematically evaluating the potential health risk of pesticides that may be present as residues in foods. The SI is being used as a primary tool in the establishment of monitoring priorities. Each pesticide is classified and assigned to one of 5 levels of potential risk. The SI documents that are prepared for individual pesticides summarize the information used to assess potential dietary exposure and health risk, provide the rationale for the assigned classification, and identify needs and actions necessary to accomplish appropriate monitoring of the food supply. Reasons are described for the development of the SI, the content of the SI Documents, and the use of the SI in planning and redirecting FDA pesticide monitoring activities. PMID- 3980402 TI - Long-term preservation of egg and tissue homogenates for determination of organochlorine compounds: freezing versus freeze-drying. AB - Storage of wet egg homogenates at temperatures from -18 degrees to -28 degrees C was more suitable for long-term preservation than freeze-drying. Changes in residue levels of heptachlor epoxide, oxychlordane, dieldrin, hexachlorobenzene,p,p'-DDE, mirex, and PCBs were not significant over a 3-year period in fresh herring gull egg homogenates stored at -18 degrees to -28 degrees C. Compounds with gas chromatographic retention times shorter than hexachlorobenzene vaporized during freeze-drying at a rate proportional to their volatility. Evaporative losses of components with vapor pressures less than hexachlorobenzene did not occur in naturally contaminated herring gull eggs after storage at room temperature for up to 1 year. Higher losses of all compounds, up to 25% for p,p'-DDE, occurred in freeze-dried whole-body herring gull homogenates. Easily dehydrochlorinated compounds were rapidly degraded in freeze dried chicken egg homogenate at room temperature: The half-life of p,p'-DDT and p,p'-DDD was about 20 days, and that of alpha- and gamma-hexachlorocyclohexane was much less than 16 days. About one-third of oxychlordane in herring gull eggs was lost in 1 year under these conditions, but none was lost after freeze-drying when the homogenate was stored at -18 degrees to -28 degrees C. PMID- 3980403 TI - Indirect enzyme-linked immunosorbent assay for saxitoxin in shellfish. AB - An indirect enzyme-linked immunosorbent assay (ELISA) was developed for the detection of saxitoxin (STX). Antibodies against STX were demonstrated in rabbits 5 weeks after immunizing with STX-bovine serum albumin (STX-HCHO-BSA). In the ELISA, STX-HCHO-BSA or polylysine-STX was coated onto the microtiter plate, followed by incubation with standard toxin and anti-STX antibody. The amount of antibody bound to the solid phase was determined by incubation with goat anti rabbit IgG peroxidase conjugate and a reaction with chromogenic substrate. Competitive indirect ELISA revealed that the anti-serum did not cross-react with either carbamoyl-neo-STX-sulfate or tetrodotoxin. The antibodies for STX cross reacted with decarbamoyl-STX and neo-STX about 56% and 16% as much as they did with STX, respectively. The lower detection limits for STX, decarbamoyl-STX, and neo-STX in this system were about 25, 45, and 156 pg per assay, respectively. When STX added to clams or mussels was assayed, the detection limit for STX was about 50-100 ppb, and recoveries were in the range of 86.8-107%. PMID- 3980404 TI - Extraction of organic acids by ion-pair formation with tri-n-octylamine. Part 7. Comparison of methods for extraction of synthetic dyes from yogurt. AB - Synthetic dyes were extracted from yogurt by different methods, but all methods had in common a liberation of dyes from the food followed by ion-pair formation with tri-n-octylamine. Extraction with pH 5.5 phosphate buffer gave high recoveries for 5 of the 7 dyes investigated and was relatively fast. Precipitation of proteins followed by polyamide adsorption and desorption gave high yields for all the dyes but was tedious and long. PMID- 3980405 TI - Improved method for extraction of light filth from 90% rye brain crisp bread. AB - A new technique has been developed for the analysis of light filth in a high bran rye product. Compared with the official AOAC method, 44.063, the plates were much easier and less time-consuming to read microscopically (about 8 min compared with about 34 min for the AOAC method). Average recoveries for insect fragments and mouse hairs were 93.4 and 90.8%, respectively, with coefficients of variation (32 samples) of 7.7 and 7.9%, respectively. Average recoveries by the AOAC method were 87.5% for insect fragments and 62.5% for mouse hairs, with coefficients of variation (6 samples) of 7.9 and 14.1%, respectively. A ruggedness test for 7 variables in the extraction indicated that 2 variables caused significant changes in the results. PMID- 3980406 TI - Screening tests for sulfa drugs and/or dinitrobenzamide coccidiostats and their monoamino metabolites in chicken livers. AB - Two procedures were developed for the simultaneous determination of 0.1 ppm sulfaquinoxaline and sulfadimethoxine, 1.0 ppm Zoalene and nitromide, and/or 0.1 ppm of their reduced coccidiostat metabolites from the same sample of chicken liver. Both methods include blender extraction of 5 g liver with chloroform-ethyl acetate (1 + 1), adsorption of the drugs and metabolites on neutral alumina, and subsequent elution with 0.2M carbonate buffer (pH 11.0). In Method A, all parent drugs and coccidiostat metabolites were partitioned into dichloromethane, following the addition of a small amount of tetrabutylammonium hydroxide (TBAH). The presence of the dinitrobenzamides was confirmed by the formation of a color with TBAH, which occurs when the solvent is concentrated (Zoalene = green; nitromide = red). Sulfa drugs and coccidiostat metabolites were detected by the Bratton-Marshall reaction after thin layer chromatographic (TLC) separation. Method B separates the individual classes by selective extraction techniques. The coccidiostats and their metabolites were extracted from the buffer eluate by ethyl acetate-dichloromethane (3 + 1) before ion pairing: sulfa drugs were extracted with dichloromethane after ion pairing with TBAH. The detection techniques were similar to those described for Method A. PMID- 3980407 TI - Quantitative gas chromatographic-mass spectrometric assay of five sulfonamide residues in animal tissue. AB - A gas chromatographic-mass spectrometric procedure using isotopically labeled internal standards and the technique of selective-ion monitoring was used to assay sulfamethazine, sulfadimethoxine, sulfabromethazine, sulfathiazole, and sulfaquinoxaline in liver and muscle tissue of swine, poultry, and cattle. The data presented clearly demonstrate the applicability of this procedure for confirmation of sulfonamide residues in animal tissue. PMID- 3980408 TI - Sensitive determination of ethopabate residues in chicken tissues by liquid chromatography with fluorometric detection. AB - A liquid chromatographic (LC) method is described for determination of ethopabate residues in chicken tissues. The drug is extracted from tissues with acetonitrile, and the extract is concentrated to 2-3 mL. This aqueous solution is rinsed with ethyl acetate and cleaned up by Florisil column chromatography. LC analysis is carried out on a Zorbax ODS column, and ethopabate is quantitated by using a fluorometric detector set at 306 nm (excitation) and 350 nm (emission). Recoveries of ethopabate added to chicken tissues at levels of 0.01 and 0.05 ppm were 87.8 and 92.7%, respectively. The detection limit was 100 pg for ethopabate standard, and 0.5 ppb in chicken tissues. PMID- 3980409 TI - Determination of neomycin in animal tissues, using ion-pair liquid chromatography with fluorometric detection. AB - A liquid chromatographic (LC) method is described for the determination of neomycin in animal tissues. Tissues are homogenized in 0.2M potassium phosphate buffer (pH 8.0); the homogenate is centrifuged, and the supernate is heated to precipitate the protein. The heat-deproteinated extract is acidified to pH 3.5-4 and directly analyzed by LC. The LC method consists of an ion-pairing mobile phase, a reverse phase ODS column, post-column derivatization with o phthalaldehyde reagent, and fluorometric detection. The LC method uses paromomycin as an internal standard, and separates neomycin from streptomycin or dihydrostreptomycin because they have different retention times. The LC column separates neomycin in 25 min; the detection limit is about 3.5 ng neomycin. The overall recovery of neomycin from kidney tissues spiked at 1-30 ppm was 96% with a 9.0% coefficient of variation. The method was also applied to muscle tissue. PMID- 3980410 TI - Determination of nitrate in dried foods by gas chromatography-thermal energy analyzer. AB - The method described for determining NO3- in dried foods is based on extraction of NO3- from the sample with subsequent nitration of benzene. The nitrobenzene is extracted with ethyl acetate, analyzed by using a gas chromatograph-thermal energy analyzer (GC-TEA), and quantitated against a nitrobenzene standard. Sensitivity is 100-200 micrograms/kg. Coefficients of variation for analyses of dried foods were 3-13%. Recovery of NO3- from nonfat dry milk spiked at 10 mg/kg averaged 100%. PMID- 3980411 TI - Atomic absorption spectrophotometric determination of liver copper: collaborative study. AB - Eleven collaborating laboratories conducted replicate analyses on 4 blind duplicate pairs of bovine liver samples that either had naturally acquired copper levels or were spiked with one of 3 copper levels. A National Bureau of Standards Bovine Liver sample (SRM 1577, 193 +/- 10 mg copper/kg) and a 1000 mg copper/L standard were also submitted to the collaborators. The method requires the tissue to be digested with concentrated HNO3 at 60 degrees C, diluted to volume with water, and analyzed by atomic absorption spectrophotometry. The intralaboratory coefficients of variation (CVo) ranged from 5.6 to 19%; the interlaboratory CVx values ranged from 7.1 to 21%. The lower limit of detection was estimated to be 1 mg copper/kg tissue. The method has been adopted official first action. PMID- 3980412 TI - Comparison of Carr-Price analysis and liquid chromatographic analysis for vitamin A in fortified milk. AB - The determination of the vitamin A concentration in fortified milk was compared using Carr-Price analysis and liquid chromatography (LC). Carr-Price analysis required saponification of the sample with alcoholic potassium hydroxide, extraction with ether, and colorimetry with antimony trichloride in chloroform. LC analysis required hexane extraction of a 71% alcohol-sample solution and centrifugation at 2000 rpm. A 100 microL aliquot of the extract was analyzed on a LiChrosorb Si-60, 5 micron column, using an ethyl ether-hexane (2 + 98) mobile phase and detection at 313 nm. Each method was statistically evaluated for precision and sample-to-sample reproducibility. The LC extraction procedure was examined for efficiency. Each LC value was divided by the Carr-Price value obtained for the same sample; an average value of 0.975 with a coefficient of variation of 6.90% was obtained. It was concluded that the procedures were statistically equivalent. PMID- 3980413 TI - Gas chromatographic determination of picloram in fish. AB - A simple method for determining picloram in fish is described. The sample is homogenized with ethyl acetate, acidified with 1N HCl, and extracted twice more with ethyl acetate. Ethyl acetate fractions are pooled, derivatized with diazomethane, cleaned up by column chromatography, and analyzed by electron capture gas chromatography. Rainbow trout exposed to 14C-picloram were used to evaluate the efficiency of 2 methods of extraction and to provide data on the rate of uptake and the bioconcentration factor. The detection limit for this method is 5 ng/g, using a 4 g sample. PMID- 3980414 TI - Determination of phosphine: comparison of rates of desorption by purge-and-trap method and by sulfuric acid treatment. AB - Two methods were compared for quantitative determination of phosphine present on fumigated food and materials. The rate of desorption of PH3 by using a purge-and trap method was shown to be much slower when compared with sulfuric acid treatment and was also simpler. Application of the modified sulfuric acid treatment for real samples is described. PMID- 3980415 TI - The Luke et al. method for determining multipesticide residues in fruits and vegetables: collaborative study. AB - Ten laboratories analyzed unfortified and fortified samples of lettuce, tomatoes, and strawberries for organochlorine and organophosphorus pesticides by applicable portions of the comprehensive multipesticide method of Luke et al. The 3 crops were fortified with 6 pesticides, alpha-BHC, dieldrin, chlorpyrifos, acephate, omethoate, and monocrotophos, each at 3 levels per crop. Included in the 54 fortifications were 16 pairs of blind duplicates: same pesticide, crop, and level. Recoveries were calculated by area comparisons with known reference materials, using the responses obtained from 2 separate element-specific gas chromatographic (GC) systems. The organochlorine pesticides were chromatographed on a methyl silicone column and detected with a Hall 700A electrolytic conductivity detector, and the organophosphorus pesticides were determined with a flame photometric detector after being chromatographed on a specified DEGS column material. Chlorpyrifos was quantitated on both GC systems. Mean recoveries ranged from 82.6% for acephate fortified at 0.5000 ppm in strawberries to 118.1% for 0.0636 ppm fortification of chlorpyrifos in lettuce. Interlaboratory coefficients of variation ranged from 4.0% for 0.6360 ppm fortification of chlorpyrifos in tomatoes to 17.8% for the 0.0636 ppm chlorpyrifos level in lettuce. The procedure features essentially no cleanup before GC and proved comparable to existing multiresidue methods for pesticides of the class types studied, as evidenced by the intra- and interlaboratory measurements of precision and recoveries obtained. The method with the 2 GC systems has been adopted official first action. PMID- 3980416 TI - Residue methodology for AMDRO fire ant insecticide (AC 217,300) in pasture grass and crops. AB - Residue methodology is described for the determination of AC 217,300 residues in pasture grass and crop samples. After extraction and subsequent cleanup on an XAD 2 column, residues of AC 217,300 are determined by liquid chromatography (LC), using a reverse phase paired-ion chromatographic system and detection at 300 nm. The method has a validated limit of sensitivity of 0.05 ppm with corresponding control values for the commodities analyzed of less than 0.01 ppm. Apparent residues over 0.05 ppm can be confirmed by either gas chromatography with an electron capture detector (GC-EC) or gas chromatography-negative ion chemical ionization mass spectrometry (GC-NICI). The direct GC-NICI method circumvents the need for sample cleanup on the XAD-2 column, and offers a greatly simplified procedure that is useful for screening samples. Recoveries of AC 217,300 from the commodities analyzed have been satisfactory with all methods of analysis. PMID- 3980417 TI - Improved polarographic method for determination of glyphosate herbicide in crops, soil, and water. AB - A prior method for determination of glyphosate in water samples has been modified to accommodate samples of crops and soils. Differential pulse polarography as the determinative step enables analysis in an aqueous medium, which is important during extraction of this compound. Residues are cleaned up and concentrated by ion exchange on a strong basic resin in OH- form. The method is rapid, is applicable to a relatively broad selection of sample types, and gives recoveries consistently better than 60% with good precision. The main shortcoming of the method is that the limit of detection of 0.5-1.0 ppm may sometimes be inadequate. The metabolite, aminomethyl phosphonic acid, is not detected. PMID- 3980418 TI - Extraction of organic acids by ion-pair formation with tri-n-octylamine. Part 6. Determination of sorbic acid, benzoic acid, and saccharin in yogurt. AB - The sorbate content of commercial yogurt samples is determined by reverse phase liquid chromatography following ion-pair extraction with tri-n-octylamine. Mean recoveries (70-88%), precision (1.1-3.3% RSD), and detection limit of the method are presented for sorbic acid, benzoic acid, and saccharin. PMID- 3980419 TI - Simple colorimetric method for determination of thiamine hydrochloride in pharmaceuticals. AB - A simple colorimetric method is described for the determination of thiamine hydrochloride (vitamin B1) in dosage forms. The method is based on measurement of a yellow complex formed when thiamine HCl is treated with p-methylaminophenol sulfate (Metol) under alkaline conditions. Compounds such as vitamins A, B2, B6, B12, C, D, and E, and niacinamide, citric acid, liquid glucose, calcium pantothenate, biotin, liver extract, and folic acid do not interfere in the reaction. Extracting the complex into chloroform before quantitation enhances the stability of the reaction product and removes interference of water-soluble colored constituents in syrup samples. Statistical validation shows that the method is precise and accurate. Results agree well with those obtained by other methods in the literature. PMID- 3980420 TI - Liquid chromatographic determination of primidone in tablets: collaborative study. AB - Six laboratories collaboratively studied a liquid chromatographic (LC) method for the quantitative determination of primidone in tablets. Two lots each of commercially prepared 50 and 250 mg tablets and 2 authentic mixtures, at 50 and 250 mg levels, were sent to each collaborator. Samples were dissolved in the mobile phase, filtered, and injected into the chromatograph. Average recoveries for the 8 samples ranged from 97.5 to 101.2%, and coefficients of variation ranged from 0.53 to 3.01%. The LC method has been adopted interim official first action. PMID- 3980421 TI - Normal phase liquid chromatographic determination of sulfamethoxazole in tablets: collaborative study. AB - A stability-indicating liquid chromatographic method is presented for determining sulfamethoxazole in tablets. The method uses a 10 micron silica column, an isooctane-methylene chloride-2-propanol-acetonitrile-glacial acetic acid (70 + 25 + 5 + 5 + 0.5) mobile phase, and photometric detection at 254 nm. Seven laboratories collaboratively studied this method on powdered composite samples prepared from commercial 500 and 1000 mg tablets and on an authentic tablet mixture containing 83.32% added sulfamethoxazole. Mean assay results for the 500 and 1000 mg tablets were 102.2 and 97.9% of declared, respectively (n = 4). The mean recovery value for the synthetic sample was 99.4% (n = 4). The pooled reproducibility standard deviation (SD) (coefficient of variation (CV)) and pooled repeatability SD (CV) were +/- 1.01 (1.01%) and +/- 0.96 (0.96%), respectively. These results were in good agreement with those obtained by the Associate Referee for the titration method of USP XX. The proposed method can also be used for monitoring the presence of sulfanilamide in sulfamethoxazole by increasing the proportions of both acetonitrile and 2-propanol in the mobile phase. The method has been adopted official first action. PMID- 3980422 TI - Colorimetric determination of sympathomimetic amines methyldopa and noradrenaline. AB - The chromogenic reagent p-dimethylaminocinnamaldehyde (PDAC) is introduced for the determination of the sympathomimetic amines methyldopa and noradrenaline. The method is based on measurement of the orange color developed when the alkaline solution of methyldopa and noradrenaline is allowed to react with PDAC at pH 5.0. The color developed obeys Beer's law in the concentration range 0.1-1.5 mL of 2 X 10(-3)M solution of noradrenaline and methyldopa. The results are compared with those obtained with another chromogenic reagent, p-dimethylaminobenzaldehyde (PDAB). Determinations on dosage forms of the drugs, using PDAC and PDAB reagents, agreed well with results of determinations by official pharmacopoeial methods. PMID- 3980423 TI - Validation of liquid chromatographic method for assay of chlorthalidone in tablet formulations. AB - A stability-indicating, reverse phase liquid chromatographic (LC) method was developed for assay of chlorthalidone in tablet formulations. The chromatographic system separates the parent compound from its potential hydrolysis product (4' chloro-3'-sulfamoyl-2-benzophenone carboxylic acid), which can be quantitated at low levels, and another degradation product (2-chloro-5-(1-methoxy-3-oxo-1 isoindolinyl)benzenesulfonamide), which was found during the experimental work. The procedure can also be used for content uniformity determinations. The general utility of the method was demonstrated by the assay of several product brands. The validated procedure was shown to be accurate, precise, reproducible, and specific. PMID- 3980424 TI - Colorimetric determination of stanozolol in pharmaceutical formulations. AB - In acidic medium, stanozolol reacts with phenoldisulfonic acid to form a stable yellow chromophore, which is quantitated by spectrophotometry at 385 nm. The reaction gives a linear response at concentrations from 5 to 50 micrograms/mL. The method is suitable for routine analytical control of stanozolol and its formulations. PMID- 3980425 TI - Autism and lactic acidosis. AB - Four patients are described who have two coexistent syndromes: the behavioral syndrome of autism and the biochemical syndrome of lactic acidosis. One of the four patients also had hyperuricemia and hyperuricosuria. These patients raise the possibility that one subgroup of the autism syndrome may be associated with inborn errors of carbohydrate metabolism. PMID- 3980426 TI - Cavum velum interpositum in a boy with infantile autism. PMID- 3980427 TI - Conceptual problem-solving in highly verbal, nonretarded autistic men. AB - Nine highly verbal, nonretarded men, ages 18 to 39, with clearly documented childhood diagnoses of infantile autism were studied with the Wisconsin Card Sorting Test, a measure of conceptual problem solving sensitive to frontal system dysfunction, and with a measure of social-adaptive functioning. Their performances were compared with 10 controls matched for age, sex, education, and IQ, as well as with published norms for various groups of brain-damaged patients. Significant deficits in the formulation of rules and significant perseverative tendencies were documented in the autistic sample. No significant correlation between these deficits and social-adaptive deficits was seen. These findings were discussed with respect to the heterogeneity of the autistic disorder and Damasio's hypothesis concerning frontal-subcortical dysfunction in autism. PMID- 3980428 TI - Motor imitation abilities and neurological signs in autistic children. AB - Autistic children were compared with chronological and mental age-matched normal children on two tests of motor imitation and on the Herzig Battery for Non-Focal Neurological Signs. The results indicated that autistic children have significant handicaps in the neurodevelopmental area, with very poor performance on motor imitation tasks and a universal and significant excess of soft signs of neurological dysfunction. Such "dyspraxias" may underlie the failure of these children to learn to use gesture. PMID- 3980429 TI - The experience of infantile autism: a first-person account by Tony W. AB - A first-person account of the experience of autism is presented by a 22-year-old man who was first evaluated at the Yale Child Study Center at 26 months of age. His history and current status are reviewed. Factors related to outcome and diagnostic issues are discussed. Such accounts may be helpful in guiding research. PMID- 3980430 TI - Event-related brain potential correlates of the processing of novel visual and auditory information in autism. AB - Event-related brain potentials (ERPs) elicited by visual and auditory stimuli were recorded from nonretarded individuals with autism (ages 13-25 years) and age matched normal controls. In "no-task" conditions, subjects simply looked at or listened to these stimuli; only one difference was found between subject groups. Several ERP differences between groups were found in "task" conditions; subjects pressed a button at the occurrence of target stimuli intermixed with unexpected, novel stimuli and also with expected, nonnovel stimuli. Visual ERP abnormalities in the autistic group differed from auditory abnormalities. Results suggest that (1) nonretarded autistic individuals may have a limited capacity to process novel information--they are neither hypersensitive to novel information nor misperceive it as nonnovel and insignificant; (2) classification of simple visual information may be less impaired than auditory; and (3) with one exception, visual and auditory ERP abnormalities do not seem to reflect maturational delay. PMID- 3980431 TI - Cognitive subtypes in developmentally disabled children: a pilot study. AB - Differential diagnoses within the pervasive developmental disorders have insufficient reliability, validity, and descriptive homogeneity within groups to be used as distinct categories for research purposes. This study reports the results of cognitive subtyping of 54 developmentally disabled children. Fifty-one were successfully categorized in a small number of groups, characterized by different strengths and weaknesses on verbal, performance, memory, and quantitative tests. About half of the children had the relatively good visuospatial performance expected on the basis of previous literature on autistic children; these children were not behaviorally more autistic than the others. Measures of internal validity are reported, as well as validation by cognitive and behavioral variables. These results tentatively suggest that such psychiatric manifestations as autistic aloofness and maintenance of sameness may be relatively independent of cognitive skill patterns. PMID- 3980432 TI - Visual overselectivity: a comparison of two instructional remediation procedures with autistic children. AB - The present study compared two classroom-relevant procedures for remediating visual overselectivity in autistic children. One approach was based on perceptual motor theory in which possible relationships between functional object-use and overselectivity were studied. The second strategy, equivalence training, used a four-step stimulus shift procedure. A comparison group of autistic children was exposed to simple repeated practice trials with the test tasks. Results showed that equivalence training was more effective than functional object-use in improving posttest scores, with repeated practice falling in between. The results are discussed in terms of theoretical and practical issues relating to stimulus overselectivity, including the incorporation of microcomputer technology. PMID- 3980433 TI - Sequence of a cellulase gene of the thermophilic bacterium Clostridium thermocellum. AB - The nucleotide sequence of the celA gene, encoding the extracellular endoglucanase A of Clostridium thermocellum, was determined and compared with the NH2-terminal amino acid sequence of the purified enzyme. The mature protein appeared to be extended by a signal sequence of 32 amino acids. A segment of 23 amino acids was duplicated at the COOH-terminal end of the protein. The putative GUG initiation codon was preceded by an AGGAGG sequence, typical of procaryotic ribosomal binding sites. The segment of DNA presumably specifying transcriptional initiation contained a high percentage of adenine and thymine residues, including an adenine-thymine tract extending over 54 base pairs. PMID- 3980434 TI - Enzymes of glucose metabolism in Frankia sp. AB - Enzymes of glucose metabolism were assayed in crude cell extracts of Frankia strains HFPArI3 and HFPCcI2 as well as in isolated vesicle clusters from Alnus rubra root nodules. Activities of the Embden-Meyerhof-Parnas pathway enzymes glucokinase, phosphofructokinase, and pyruvate kinase were found in Frankia strain HFPArI3 and glucokinase and pyruvate kinase were found in Frankia strain HFPCcI2 and in the vesicle clusters. An NADP+-linked glucose 6-phosphate dehydrogenase and an NAD-linked 6-phosphogluconate dehydrogenase were found in all of the extracts, although the role of these enzymes is unclear. No NADP+ linked 6-phosphogluconate dehydrogenase was found. Both dehydrogenases were inhibited by adenosine 5-triphosphate, and the apparent Km's for glucose 6 phosphate and 6-phosphogluconate were 6.86 X 10(-4) and 7.0 X 10(-5) M, respectively. In addition to the enzymes mentioned above, an NADP+-linked malic enzyme was detected in the pure cultures but not in the vesicle clusters. In contrast, however, the vesicle clusters had activity of an NAD-linked malic enzyme. The possibility that this enzyme resulted from contamination from plant mitochondria trapped in the vesicle clusters could not be discounted. None of the extracts showed activities of the Entner-Doudoroff enzymes or the gluconate metabolism enzymes gluconate dehydrogenase or gluconokinase. Propionate- versus trehalose-grown cultures of strain HFPArI3 showed similar activities of most enzymes except malic enzyme, which was higher in the cultures grown on the organic acid. Nitrogen-fixing cultures of strain HFPArI3 showed higher specific activities of glucose 6-phosphate and 6-phosphogluconate dehydrogenases and phosphofructokinase than ammonia-grown cultures. PMID- 3980435 TI - Conjugative mapping of pyruvate, 2-ketoglutarate, and branched-chain keto acid dehydrogenase genes in Pseudomonas putida mutants. AB - Branched-chain keto acid dehydrogenase, an enzyme in the common pathway of branched-chain amino acid catabolism of Pseudomonas putida, is a multienzyme complex which catalyzes the oxidative decarboxylation of branched-chain keto acids. The objective of the present study was to isolate strains with mutations of this and other keto acid dehydrogenases and to map the location of the mutations on the chromosome of P. putida. Several strains with mutations of branched-chain keto acid dehydrogenase, two pyruvate and two 2-ketoglutarate dehydrogenase, were isolated, and the defective subunits were identified by biochemical analysis. By using a recombinant XYL-K plasmid to mediate conjugation, these mutations were mapped in relation to a series of auxotrophic and other catabolic mutations. The last time of entry recorded was at approximately 35 min, and the data were consistent with a single point of entry. Branched-chain keto acid dehydrogenase mutations affecting E1, E1 plus E2, and E3 subunits mapped at approximately 35 min. One other strain affected in the common pathway was deficient in branched-chain amino acid transaminase, and the mutation was mapped at 16 min. The mutations in the two pyruvate dehydrogenase mutants, one deficient in E1 and the other deficient in E1 plus E2, mapped at 22 minutes. The 2-ketoglutarate dehydrogenase mutation affecting the E1 subunit mapped at 12 minutes. A 2-ketoglutarate dehydrogenase mutant deficient in E3 was isolated, but the mutation proved too leaky to map. PMID- 3980436 TI - Effects of temperature and sodium chloride concentration on the phospholipid and fatty acid compositions of a halotolerant Planococcus sp. AB - The phospholipid headgroup composition and fatty acid composition of a gram positive halotolerant Planococcus sp. (strain A4a) were examined as a function of growth temperature (5 to 35 degrees C) and NaCl content (0 to 1.5 M) of the growth medium. When the growth temperature was decreased, the relative amount of mono-unsaturated branched-chain fatty acids increased. When Planococcus sp. strain A4a was grown in media containing high NaCl concentrations, the relative amount of the major fatty acid, Ca15:0, increased. The relative amount of anionic phospholipid also increased when the NaCl concentration of the growth medium was increased. The increase in anionic phospholipid content resulted from a decrease in the relative mole percent content of phosphatidylethanolamine and an increase in the relative mole percent content of cardiolipin. PMID- 3980437 TI - Transformation of Azotobacter vinelandii with plasmid DNA. AB - Azotobacter vinelandii cells can be transformed at high frequencies with the broad-host-range plasmids pRK2501, RSF1010, and pGSS15, using a modification of the procedure developed by Page and von Tigerstrom (J. Bacteriol. 139:1058-1061, 1979) for chromosomal DNA-mediated transformation. The frequency of transformation per microgram of plasmid DNA per viable cell with pRK2501 and pGSS15 was about 5 X 10(-2) and 2 X 10(-2), respectively. With RSF1010, transformation frequencies ranged from 3 X 10(-4) to 4 X 10(-2). With each plasmid, the frequency of transformation was independent of the phase of the growth cycle. When concentrations of pRK2501 ranging from 0.1 to 51 micrograms of DNA were tested, the frequency of transformation was directly proportional to the amount of DNA. This linear response indicated that, although the uptake of plasmid DNA with this procedure may be inefficient, there is a high probability that once inside a cell the plasmid will be stably maintained. Cells that have been transformed with pRK2501 did not grow well on transforming medium which lacks iron and contains fixed nitrogen. However, on growth medium which contains iron and lacks fixed nitrogen, transformants produced distinctive colonies larger than those of nontransformed cells. Resistance to kanamycin due to transformation by pRK2501 was stably maintained for at least 10 successive generations in the absence of selective pressure. The present protocol should facilitate the molecular cloning of genes in Azotobacter spp. PMID- 3980438 TI - Glycerol metabolism and osmoregulation in the salt-tolerant yeast Debaryomyces hansenii. AB - A glycerol-nonutilizing mutant of the salt-tolerant yeast Debaryomyces hansenii was isolated. When subjected to salt stress the mutant produced glycerol, and the internal level of glycerol increased linearly in proportion to increases of external salinity as in the wild-type strain. However, at increased salinity the mutant showed a more pronounced decrease of growth rate and growth yield and lost more glycerol to the surrounding medium than did the wild type. Uptake experiments showed glycerol to be accumulated against a strong concentration gradient, and both strains displayed similar kinetic parameters for the uptake of glycerol. An examination of enzyme activities of the glycerol metabolism revealed that the apparent Km of the sn-glycerol 3-phosphate dehydrogenase (EC 1.1.99.5) was increased 330-fold for sn-glycerol 3-phosphate in the mutant. Based on the findings, a scheme for the pathways of glycerol metabolism is suggested. PMID- 3980439 TI - Cloning of genes involved in myo-inositol transport in a Pseudomonas sp. AB - A soil isolate of a Pseudomonas sp. can utilize myo-inositol (MI) as the sole carbon source. In this strain, MI is transported through the membrane by a high affinity transport system in which a periplasmic binding protein is involved. Mutants impaired in the transport system were obtained by mutagenesis with N methyl-N'-nitro-N-nitrosoguanidine and subsequently identified by their slow growth rate at low MI concentrations. Strains with a low linear initial rate of MI uptake were analyzed. Using a broad-host-range cosmid cloning system, we have constructed a gene bank of the wild-type Pseudomonas sp. in an Escherichia coli recA-host. A rapid mating technique enabled us to screen the gene library for clones which are able to restore the active transport of MI in the mutant. An 11.5-kilobase segment containing genes involved in the MI transport has been isolated, and its restriction enzyme cleavage map has been determined. PMID- 3980440 TI - Structure of complex flagellar filaments in Rhizobium meliloti. AB - The complex flagella of Rhizobium meliloti 2011 and MVII-1 were analyzed with regard to serology, fine structure, subunits, and amino acid composition. The serological identities of flagellar filaments of the two strains were demonstrated by double immunodiffusion with antiflagellin antiserum. The filaments had a diameter of 16 nm. Their morphology was dominated by the prominent undulations of an external three-start helix running at a 10-nm axial distance and at an angle of 32 degrees. Faint nearly axial striations indicated the presence of a tubular core of a different helical order. The complex filaments consisted of 40,000-dalton flagellin monomers. Typically, the amino acid composition was 3 to 4% higher in nonpolar residues and 5 to 7% lower in aspartic and glutamic acids (and their amides) than that of plain flagellar proteins. There were no immunochemical relationships among Pseudomonas rhodos, Rhizobium lupini, and R. meliloti complex flagella, suggesting that the latter represent a new class. PMID- 3980441 TI - Heat shock proteins in bacilli. AB - Five strains of bacilli, including a nonsporulating strain, when heat shocked, accelerated the synthesis of a specific subset of proteins. The major heat shock protein in all bacilli had a molecular weight of 66,000. The response persisted for at least 40 min and could be eliminated upon a shift down to 37 degrees C. PMID- 3980442 TI - Dispersed repetitive DNA sequence of Mucor racemosus. AB - A dispersed repetitive DNA sequence has been identified within the genome of the fungus Mucor racemosus. Recombinant phage clones, as well as a plasmid harboring the sequence, have been isolated. Examination of cloned fragments comprising part of the repetitive sequence has led to a partial characterization of the element. The sequence has been detected in other Mucor species, and although the apparent number and chromosomal position of the repetitive sequence vary from strain to strain, it is clear that at least portions of the element have been conserved. PMID- 3980444 TI - Genetic transfer in Halobacterium volcanii. AB - Auxotrophic mutants of Halobacterium volcanii generated by chemical mutagenesis were used to demonstrate a native genetic transfer system in this extremely halophilic member of the class Archaeobacteria. PMID- 3980443 TI - Acylated proteins in Acholeplasma laidlawii. AB - The covalent modification of membrane proteins by long-chain fatty acids was determined in two strains of Acholeplasma laidlawii by one-dimensional gel electrophoresis of radiolabeled membranes. Of the more than 50 membrane polypeptides detected, approximately 30 were labeled with [3H]palmitate, whereas covalent binding of [3H]oleate to membrane proteins could not be demonstrated. We suggest that in these wall-less bacteria, membrane protein acylation with saturated fatty acids may serve to ensure the structural integrity of the membrane. PMID- 3980445 TI - High-frequency transformation of Brevibacterium lactofermentum protoplasts by plasmid DNA. AB - An efficient polyethylene glycol-assisted method for transformation of Brevibacterium lactofermentum protoplasts that uses plasmid vectors has been developed. Two small plasmids, pUL330 (5.2 kilobases) and pUL340 (5.8 kilobases), both containing the kanamycin resistance gene from transposon Tn5 and the replication origin of the natural plasmid pBL1 of B. lactofermentum, were selected as vectors. Supercoiled forms of the plasmids yielded a 100-fold higher transformation frequency than did linear forms. The optimal transformation frequency was achieved with 10 ng of DNA in 1 ml of transformation buffer. Higher concentrations of plasmid DNA resulted in a decrease in transformation frequency per microgram of DNA. Optimal transformation was obtained with 25 to 35% polyethylene glycol 6000. Under optimal conditions, 10(6) transformants per microgram of DNA were obtained. PMID- 3980446 TI - Calmodulin levels in the yeast and mycelial phases of Ceratocystis ulmi. AB - The calmodulin content of the yeast and mycelial phases of Ceratocystis ulmi was determined by radioimmunoassay. Calmodulin levels increased at the G1-S boundary of the cell cycle, coinciding with the first visible appearance of buds or germ tubes. However, in both phases the cellular calmodulin levels were equivalent. No differential synthesis was observed. PMID- 3980447 TI - Component A2 of the methylcoenzyme M methylreductase system from Methanobacterium thermoautotrophicum. AB - Component A2 of the methylcoenzyme M methylreductase system of Methanobacterium thermoautotrophicum has been purified 370-fold by liquid chromatography. Homogeneity was obtained by anaerobic preparative polyacrylamide gel electrophoresis. Component A2 is a colorless, air-stable protein consisting of a single polypeptide as indicated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The relative molecular mass of the native protein was determined by high-performance, size exclusion chromatography to be Mr 52,000; on sodium dodecyl sulfate-polyacrylamide gel electrophoresis a value of Mr 59,000 was obtained. When cell extract was subjected to N6-ATP-agarose affinity chromatography the methylcoenzyme M methylreductase system was resolved into two fractions; one of them was component A2. This work provides a new operational definition for component A2, i.e., its characteristic chromatographic behavior on N6-ATP-agarose. However, its functional definition is its ability to reconstitute the methylreductase activity with components A1, A3, and C. Several attempts to assign a role to component A2 are reported. PMID- 3980448 TI - Inhibition of methanogenesis and carbon metabolism in Methanosarcina sp. by cyanide. AB - NaCN was tested for its inhibitory effects on growth of and metabolism by Methanosarcina barkeri 227. NaCN (10 microM) inhibited catabolism of acetate methyl groups to CH4 and CO2 but did not inhibit methanogenesis from methanol, CO2, methylamine, or trimethylamine. NaCN also inhibited the assimilation of methanol or CO2 (as the sole carbon source) into cell carbon and stimulated the assimilation of acetate. These results suggest that inhibition by NaCN was a result of its action as an inhibitor of in vivo CO dehydrogenase. The results also implicate CO dehydrogenase in the oxidation of acetate but not methanol methyl groups to CO2. PMID- 3980450 TI - Electroconvulsive therapy: a survey of use in the private psychiatric hospital. AB - All 184 member hospitals of the National Association of Private Psychiatric Hospitals (NAPPH) were sent a specially designed 19-item questionnaire regarding their use of electroconvulsive therapy (ECT). Of the 153 respondents, 89 (58%) reported using ECT. Most followed the guidelines delineated in the 1978 American Psychiatric Association Task Force Report. PMID- 3980449 TI - High state of order of isolated bacterial lipopolysaccharide and its possible contribution to the permeation barrier property of the outer membrane. AB - The conformational properties of the isolated S form of Salmonella sp. lipopolysaccharide (LPS), of Re mutant LPS, and of free lipid A were investigated by using X-ray diffraction and conformational energy calculations. The data obtained showed that LPS in a dried, in a hydrated, and probably also in an aqueous dispersion state is capable of forming bilayered lamellar arrangements similar to phospholipids. From the bilayer packing periodicities, a geometrical model of the extensions of the LPS regions lipid A, 2-keto-3-deoxyoctulosonic acid, and O-specific chain along the membrane normal could be calculated. Furthermore, the lipid A component was found to assume a remarkably high ordered conformation: its fatty acid chains were tightly packed in a dense hexagonal lattice with a center-to-center distance of 0.49 nm. The hydrophilic backbone of lipid A showed a strong tendency to form domains in the membrane, resulting in a more or less parallel arrangement of lipid A units. According to model calculations, the hydrophilic backbone of lipid A appears to be oriented approximately 45 degrees to the membrane surface, which would lead to a shed roof like appearance of the surface structure in the indentations of which the 2-keto 3-deoxyoctulosonic acid moiety would fit. In contrast, the O-specific chains assume a low ordered, heavily coiled conformation. Comparison of these structural properties with those known for natural phospholipids in biological membranes indicates that the high state of order of the lipid A portion of LPS might be an important factor in the structural role and permeation barrier functions of LPS in the outer membrane of gram-negative bacteria. PMID- 3980451 TI - Relationship between patient variables and lithium dosage requirements. AB - The relationships between several patient variables and lithium dosage requirements were determined in 71 inpatients receiving a slow-release lithium product. Age, weight, ideal body weight, sex, body surface area, creatinine clearance, presence of depression, concurrent use of tricyclic antidepressants, and acuteness of symptoms were significantly related to dosage requirements. The contribution of each factor to dosage requirements was further defined using multiple regression analysis and used to assess a published patient variable based lithium dosing technique. Addition to that model of information concerning presence of depression, acuteness of symptoms, and creatinine clearance minimally improved predictability. The published model is recommended as an alternative to empiric methods. PMID- 3980452 TI - Anterograde amnesia with oral lorazepam. AB - Twelve healthy volunteers were enrolled in a double-blind placebo-controlled study to evaluate the amnestic effects of orally administered lorazepam. The subjects were tested for immediate and delayed recall, using a word recall memory task. The subjects taking lorazepam did not differ from subjects receiving placebo on immediate recall. However, the delayed recall scores of lorazepam subjects were significantly lower compared to the placebo group (p less than .01). PMID- 3980453 TI - Lithium-responsive schizophrenia: case reports. AB - Two patients with lithium-responsive schizophrenia are described. Lithium withdrawal, done to evaluate the efficacy of lithium, triggered schizophrenic relapse, an infrequently reported phenomenon. Leonhard's comprehensive classification may help identify lithium-responsive forms of schizophrenia. PMID- 3980454 TI - Panic attacks and temporal lobe seizures associated with a right temporal lobe arteriovenous malformation: case report. AB - A 33-year-old woman developed temporal lobe seizures and was found to have a right frontotemporal arteriovenous malformation. She subsequently developed panic attacks that could be induced by lactate infusion and were successfully treated with imipramine. The possibility that the panic attacks were caused by a structural lesion of the right temporal lobe is discussed. PMID- 3980455 TI - Tear lithium concentration. PMID- 3980456 TI - Geographic category confusion: a sign of thinking disorder? PMID- 3980457 TI - Tardive dyskinesia in thiothixene treatment. PMID- 3980458 TI - Cholesterol side chain cleavage in rat adrenal supported by outer mitochondrial membrane NADH-semidehydroascorbate reductase. AB - Rat adrenal mitochondria have an active rotenone-insensitive outer mitochondrial membrane NADH-semidehydroascorbate (NADH-SDA) reductase which supports cholesterol side chain cleavage at a rate equal to that supported by malate. Side chain cleavage activity supported by both of these electron donor systems is equally inhibited by cycloheximide. Catalase or butylated hydroxyanisole are required for the NADH-SDA reductase-supported cholesterol side chain cleavage. This requirement can be removed by briefly subjecting the mitochondrial preparations to -20 degrees C. Ascorbic acid alone or with malate is either inhibitory or has no effect on side chain cleavage activity. These observations demonstrate that outer mitochondrial membrane NADH-SDA reductase in rat adrenal functions to provide cytoplasmic reducing equivalents to intramitochondrial cytochrome P-450scc and provides a new explanation for the function of ascorbic acid in corticosteroidogenesis. PMID- 3980459 TI - Purification and properties of creatinine iminohydrolase from Flavobacterium filamentosum. AB - Creatinine iminohydrolase (EC 3.5.4.21), which catalyzes hydrolysis of creatinine to N-methylhydantoin and ammonia, was purified from Flavobacterium filamentosum. The average molecular weight of the purified enzyme was 272,480, and the subunit molecular weight was 44,300. Extensive specificity studies indicated that the enzyme utilized cytosine (Km, 0.62 mM; Vm, 20.1 units/mg) as well as creatinine (Km, 5.00 mM; Vm, 40.4 units/mg) as a substrate. Each was a competitive inhibitor toward hydrolysis of the other compound. Dialysis of creatinine iminohydrolase in the presence of 0.01 M Tris phosphate buffer, pH 7.5, containing 1,10 phenanthroline decreased activity by 98%. Reactivation was accomplished by incubating the apoenzyme in the presence of certain divalent metal chlorides, listed in decreasing order of effectiveness: iron(II), zinc, cobalt(II), cadmium, and nickel. The extent of reactivation depended on the substrate and on which metal ion was added to the apoenzyme. Creatinine to cytosine activity ratios varied from 1:3.75 (iron(II) chloride), to 1:0.9 (zinc chloride), to 1:0.06 (nickel chloride). For different preparations of the holoenzyme that ratio ranged from 1:0.45 to 1:1.10. Variable but significant quantities of zinc and iron were present in all preparations of the purified enzyme. PMID- 3980460 TI - S-Adenosylmethionine synthetase from human lymphocytes. Purification and characterization. AB - S-Adenosylmethionine synthetase has been purified to apparent homogeneity from human chronic lymphocytic leukemia cells. Equilibrium sedimentation studies and denaturing polyacrylamide gel electrophoresis indicate that the native enzyme has a molecular weight of 185,000 and a subunit composition of either alpha alpha' beta 2, alpha 2 beta 2, or alpha' 2 beta 2, where alpha, alpha', and beta are polypeptide chains of molecular weight 53,000, 51,000, and 38,000. The alpha and alpha' subunits appear to be the same polypeptide and presumably differ by some kind of post-translational modification. Stoichiometric studies show that the expected products S-adenosylmethionine, pyrophosphate, and orthophosphate are generated in equimolar amounts. The enzyme exhibits linear kinetics with respect to substrate dependency and product inhibition, except for orthophosphate which shows parabolic noncompetitive inhibition with respect to ATP. Initial velocity studies of substrate dependence and product inhibition indicate a steady state mechanism that is ordered Bi Ter with ATP adding before L-methionine and S adenosylmethionine as the first product released. Pyrophosphate and orthophosphate, however, appear to be released by a random mechanism. Free Mg2+ is an essential activator with a half-maximal effect at 1.0 mM. The Km and Kia for ATP are 31 microM and 84 microM, and the Km for L-methionine is 3.3 microM. The enzyme also has tripolyphosphatase activity which is stimulated by S adenosylmethionine. PMID- 3980461 TI - Inhibition of fibronectin binding to platelets by proteolytic fragments and synthetic peptides which support fibroblast adhesion. AB - To define regions within fibronectin (Fn) recognized by platelet binding sites, inhibition of Fn binding by an Fn fragment and synthetic peptides has been analyzed. A highly purified 120-kDa chymotryptic fragment, which has cell attachment activity but did not bind to insolubilized heparin or gelatin, inhibited Fn binding to platelets with an ID50 approximately 3 microM. Previous work indicates that fibroblasts attach to an 11.5-kDa subfragment of this 120-kDa fragment, and that one of four 30-residue synthetic peptides containing sequences from this region supports cell attachment. Only the peptide containing the COOH terminus of the 11.5-kDa fragment inhibited Fn binding to platelets, with an ID50 approximately 10 microM and is the peptide which supports fibroblast attachment. Of the smaller peptides studied from this sequence, all peptides containing the Arg-Gly-Asp-Ser sequence, including the tetrapeptide itself, were active in inhibiting Fn binding to platelets (ID50 values approximately 10-20 microM). The same peptides support fibroblast attachment. Those which lacked this sequence including Gly-Asp-Ser-Pro and Thr-Gly-Arg-Gly (immediately adjacent tetrapeptides) lacked both activities. Further evidence for specificity of inhibition was provided by structurally modified peptides in which substitution of a Glu for Asp abolished inhibitory activity and substitution of Lys for Arg or Ala for Gly reduced activity 6- and 8-fold, respectively. In addition, Arg-Gly Asp-Ser-containing peptides inhibited the rate and extent of thrombin-induced platelet aggregation. These data suggest that the Arg-Gly-Asp-Ser tetrapeptide contains a recognition specificity involved in the binding of Fn to platelets and that platelets share features of this recognition specificity with fibroblasts. PMID- 3980462 TI - A specific decrease in collagen synthesis in acutely fasted, vitamin C supplemented, guinea pigs. AB - Weight loss often results from various experimental conditions including scurvy in guinea pigs, where we showed that decreased collagen synthesis was directly related to weight loss, rather than to defective proline hydroxylation (Chojkier, M., Spanheimer, R., and Peterkofsky, B. (1983) J. Clin. Invest. 72, 826-835). In the study described here, this effect was reproduced by acutely fasting normal guinea pigs receiving vitamin C, as determined by measuring collagen and non collagen protein production after labeling tissues in vitro with [3H]proline. Collagen production (dpm/microgram of DNA) decreased soon after initiating fasting and by 96 h it had reached levels 8-12% of control values. Effects on non collagen protein were much less severe, so that the percentage of collagen synthesis relative to total protein synthesis was 20-25% of control values after a 96-h fast. These effects were not due to changes in the specific radioactivity of free proline. Refeeding reversed the effects on non-collagen protein production within 24 h, but collagen production did not return to normal until 96 h. The effect of fasting on collagen production was independent of age, sex, ascorbate status, species of animal, and type of connective tissue and also was seen with in vivo labeling. Pulse-chase experiments and analysis of labeled and pre-existing proteins by gel electrophoresis showed no evidence of increased collagen degradation as a result of fasting. Procollagen mRNA was decreased in tissues of fasted animals as determined by cell-free translation and dot-blot hybridization with cDNA probes. In contrast, there was no decrease in translatable mRNAs for non-collagen proteins. These results suggest that loss of nutritional factors other than vitamin C lead to a rapid, specific decrease in collagen synthesis mainly through modulation of mRNA levels. PMID- 3980463 TI - Involvement of surface potential in regulation of polar membrane lipids in Acholeplasma laidlawii. AB - Upon induced variation of membrane lipid acyl chain unsaturation in Acholeplasma laidlawii, the cells strongly change in a characteristic manner the proportions of individual (charged and noncharged) polar lipids synthesized. Monolayer analysis of polar lipid extracts revealed different mean lateral molecular areas but similar surface charge densities. Microelectrophoresis of these lipids indicated an almost constant lipid membrane zeta-potential of about -35 mV. Simulation by the Gouy-Chapman-Stern (GCS) relations verified that the zeta (surface)-potentials remain constant. Exposing cells to increasing concentration of Na+ yielded a substantial increase in amounts of charged lipids synthesized. In model systems consisting of mixtures of A. laidlawii phosphatidylglycerol (anionic) and glucolipid (diglucosyldiglyceride, noncharged) microelectrophoresis showed; (i) increasing PG amounts resulted in an increased-, and (ii) increasing Na+ concentration resulted in a decreased zeta-potential, respectively, (iii) at physiological ionic strength and lipid surface charge densities the zeta potential was approximately -35 mV, and (iv) simulation according to the GCS theory yielded an acceptable fit with experimental data. This behavior of the phosphatidylglycerol/diglucosyldiglyceride mixtures is very similar to that of phosphatidylserine/phosphatidylcholine mixtures. It is concluded that the changes in lipid surface charge densities (and surface potential) in A. laidlawii membranes brought by variation in lateral areas of lipid acyl chains and the concentration-dependent quenching of lipid charge by Na+, is compensated for by the cellular regulation of charged lipid amounts thereby maintaining a constant lipid surface potential. PMID- 3980464 TI - The use of the biotinyl estradiol-avidin system for the purification of "nontransformed" estrogen receptor by biohormonal affinity chromatography. AB - Several biotinyl estradiol derivatives have been prepared by coupling estradiol 7 alpha-carboxylic acid to biotin via different linear linkers. All these compounds exhibit a high affinity for the estrogen receptor as determined by competitive binding assays against [3H]estradiol. These compounds also displaced the dye 4 hydroxyazobenzene-2'-carboxylic acid from the biotin-binding sites of avidin free or immobilized on agarose. It was demonstrated that only the derivatives bearing a long spacer chain (greater than 42 A greater than) between estradiol and biotin were able to bind receptor and avidin simultaneously, suggesting some steric hindrance. The biotin-avidin system has been investigated for the purification of the cytosoluble "nontransformed" estrogen receptor stabilized by sodium molybdate. The method relies on: 1) high biohormonal affinity of receptor for biotinyl estradiol derivative; 2) the specific selection by avidin-agarose column of biotinyl estradiol-receptor complexes; and 3) the biohormonal elution step by an excess of radioactive estradiol. Starting from unfractionated cytosol containing molybdate-stabilized nontransformed 8S estrogen receptor with estradiol 7 alpha-(CH2)10-CO-NH-(CH2)2-O-(CH2)2-O-(CH2)2-NH-CO-(CH2)3-NH-biotin, preliminary experiments using avidin-agarose chromatography and then a specific elution step by exchange with free [3H]estradiol, allowed a 500-1,500-fold purification. Further purification of estrogen receptor was obtained by ion exchange chromatography through a DEAE-Sephacel column and led to a congruent to 20% pure protein, assuming one binding site/65,000-Da unit. The hydrodynamic parameters of the purified receptor were essentially identical to those of molybdate-stabilized nontransformed receptor present in crude cytosol. The advantages of this double biotinyl steroid derivative-avidin chromatographic technique over more conventional affinity procedures are discussed and make it applicable to the purification of minute amounts of steroid receptors in a wide variety of tissues. PMID- 3980465 TI - Biochemical characterization of mucous glycoproteins synthesized and secreted by hamster tracheal epithelial cells in primary culture. AB - Hamster tracheal epithelial cells growing on type I collagen gel synthesize and secrete high molecular weight glycoconjugates which elute in the void volume upon Sepharose CL-4B column chromatography. The presence of any proteoglycans in this void volume material was ruled out based on both enzymatic analysis and behavior on DEAE-ion exchange chromatography. Based on the incorporation of radioactive precursors, followed by strong acid hydrolysis or neuraminidase digestion, the material was shown to contain sialic acid, fucose, galactose, N acetylglucosamine, N-acetylgalactosamine, and sulfate. Complete susceptibility to papain digestion and reductive beta-elimination suggests that the material consists of O-linked glycoproteins. The identification of N acetylgalactosaminitol in the beta-eliminated oligosaccharides confirms this notion. The molecular weight of the oligosaccharides following beta-elimination ranges from 4,000 to 15,000. We conclude that the high molecular weight glyconjugates produced by hamster tracheal epithelial cells in primary culture are mucous glycoproteins based on size, sensitivity to alkaline borohydride treatment, and monosaccharide composition. Further characterization of these mucous glycoproteins showed both size and charge microheterogeneity among molecules. Detailed structural analysis of oligosaccharides of these mucous glycoproteins is currently under way. PMID- 3980466 TI - Oligosaccharide microheterogeneity of the murine major histocompatibility antigens. Reproducible site-specific patterns of sialylation and branching in asparagine-linked oligosaccharides. AB - The influence of peptide structure of endogenous cell-surface glycoproteins on the branching and sialylation of their asparagine-linked oligosaccharides was evaluated in a murine B cell lymphoma, AKTB-1b. This cell line simultaneously synthesizes two classes of major histocompatibility antigens that, within each class, share a high degree of amino acid sequence homology and possess potential N-linked glycosylation sites at invariant positions. [3H]Mannose-labeled oligosaccharides were released from each of 11 purified glycosylation sites by the almond peptide:N-glycosidase and analyzed by a variety of chromatographic procedures and glycosidase treatments. The data indicate: 1) a unique distribution of oligosaccharide structures is present at each glycosylation site; 2) each site-specific oligosaccharide pattern is highly reproducible, independent of the number of in vivo tumor passages. The heavy chain of the class I antigens, H-2Kk and H-2Dk contain two and three sites, respectively, in which biantennary structures predominate. However, each site varies with respect to the extent of sialylation and the proportions of more highly branched structures present. The class II antigens, I-Ak and I-Ek, each contain an alpha-chain site toward the N terminus and a single beta-chain site where the overall extent of sialylation is similar, yet the distributions of antennary structures are dramatically different for each. The alpha-chains of each class II antigen also contain a more C terminal underglycosylated site where sialylation and branching are reduced to differing degrees depending upon the site. The influence of peptide structure on oligosaccharide microheterogeneity is manifest at two levels. First, the overall distributions of oligosaccharides at corresponding sites on structurally related glycoproteins are similar. Second, the specific "fingerprint" of sialylation and branching patterns at a particular site are reproducibly unique. These data suggest that subtle changes in peptide structure are reflected in the extent of sialylation and branching of oligosaccharides found at corresponding glycosylation sites of structurally related glycoproteins. PMID- 3980467 TI - Presence of a nonmetabolizable solute that is translocated with Na+ enhances Na+ dependent pH homeostasis in an alkalophilic Bacillus. AB - The presence of a nonmetabolizable solute whose uptake is coupled to the inward translocation of Na+ has been found to enhance Na+-dependent pH homeostasis and survival of an obligately alkalophilic bacterium. Upon shift of cells of Bacillus firmus RAB from growth medium to buffers at pH 10.5, viability and maintenance of a relatively acidified cytoplasm depended upon the presence of Na+ and was augmented by the inclusion of alpha-aminoisobutyric acid in the buffer. Similarly, when cells were first equilibrated at pH 8.5 and then shifted to buffer at pH 10.5, an extraordinary capacity to maintain a relatively low pHin was exhibited, but only in the presence of Na+. In this protocol, the inclusion of alpha-aminoisobutyric acid actually resulted in an early overshoot of proton influx and also rendered a suboptimal concentration of Na+ efficacious in pH homeostasis. When a protonophoric uncoupler was added to the equilibration and shift buffers, Na+-dependent acidification of the interior was inhibited at early time points. The results support the conclusion drawn from earlier work that a Na+/H+ antiporter plays a critical role in pH homeostasis in the obligately alkalophilic bacilli. Moreover, the current findings indicate that the Na+/solute symporters are a physiologically functional pathway for completing the sodium cycle that controls pHin. PMID- 3980468 TI - Generation of nitric oxide by enzymatic oxidation of N-hydroxy-N-nitrosamines. AB - The nitric oxide (N = O) free radical exhibits potent cytocidal, mutagenic and vasodilatory properties. We have examined the hypothesis that the hydroxynitrosamino functionality (see sequence in text), which occurs naturally in antineoplastic and antihypertensive agents, will directly generate N = O following peroxidatic 1-electron oxidation. Cupferron (see sequence in text) is indeed an excellent (k greater than 10(7) m-1 s-1) substrate for horseradish peroxidase. The products are N = O and nitrosobenzene (phi - N = O) which are generated and consumed as follows. First, cupferron is oxidized by the classical peroxidatic mechanism to form an unstable nitroxide free radical (see sequence in text) which then forms N = O and phi - N = O spontaneously (see sequence in text). The N = O then reacts with phi - N = O to reform cupferron (see sequence in text) or with the enzyme to generate the characteristic peroxidase--N = O chromophore. Simultaneously, in a competitive reaction with O2, the N = O is converted to NO-2 (4N = O + O2 + 2H2O------------4NO-2 + 4H+). The reactivity of hydroxynitrosamino compounds with horseradish peroxidase is in the order cupferron greater than hydroxynitrosaminomethane greater than alanosine. These model reactions, involving direct oxidation of the hydroxynitrosamino moiety, comprise a novel pathway for the biological production of N = O. PMID- 3980469 TI - Movement of cholesterol between vesicles prepared with different phospholipids or sizes. AB - The rates of exchange of [4-14C]cholesterol between lipid vesicles prepared with different phospholipids and with different sizes have been measured. The first order rate constants were higher using vesicles prepared from phosphatidylcholines with highly branched or polyunsaturated fatty acyl chains than with saturated diacyl or di-O-alkyl chains. The rate measurements indicate that the affinity of cholesterol for phospholipid does not vary significantly on change of the type of linkage (ether or ester) in phosphatidylcholine (PC) or of the positions of the fatty acyl chains in 1,2-diacyl-PC bearing one saturated and one unsaturated chain; furthermore, egg phosphatidylglycerol and egg phosphatidylethanolamine appear to have comparable affinities for cholesterol. However, the molecular packing in the bilayer and nearest-neighbor interactions involving cholesterol appear tightened more by N-palmitoylsphingomyelin than by dipalmitoyl-PC; on incorporation of 44 mol % of these phospholipids (which have the same fatty acyl chain composition) into either small or large unilamellar vesicles prepared with egg phosphatidylglycerol, the exchange rates were strikingly slower when the donor species contained sphingomyelin compared with PC. The rate of cholesterol exchange was 100% faster with small unilamellar vesicles than with large unilamellar vesicles as donors, suggesting that the looser packing in the highly curved small vesicles facilitates cholesterol desorption. The cholesterol exchange rate did not vary with the size of the acceptor vesicles, which indicates that desorption is the rate-limiting step in the exchange process in the presence of excess acceptors. PMID- 3980470 TI - Structure of the carbohydrate units of human amniotic fluid fibronectin. AB - Human amniotic fluid fibronectin was found to contain three types of carbohydrates: complex-type N-glycosidic glycans, lactosaminoglycans, and O glycosidic glycans. The structures of the complex-type glycans were established by carbohydrate and methylation analysis, Smith degradation, sequential exoglycosidase treatments, lectin chromatography, and DEAE-Sephadex chromatography. Lactosaminoglycans were analyzed by fast atom bombardment mass spectrometry, and the O-glycosidically-linked oligosaccharides by gas-liquid chromatography-mass spectrometry and high-pressure liquid chromatography. The results show that amniotic fluid fibronectin contains 2 mol of biantennary and 2 3 mol of triantennary, complex-type N-glycosidic glycans. Unlike the N-glycosidic glycans of human adult plasma fibronectin, which contain only traces of fucose and are completely sialylated, the glycans from amniotic fluid fibronectin are fucosylated and only partially sialylated. The complex-type N-glycosidic glycans present in amniotic fluid fibronectin also include a fractional amount (0.1 mol) of glycans with a polylactosaminyl structure. In addition, 4 mol of O-glycosidic oligosaccharides, which have not previously been described in fibronectins, were found in amniotic fluid fibronectin. The major oligosaccharides in this fraction have the structures Gal beta 1----3GalNAcol, NeuNAc alpha 2----3Gal beta 1--- 3GalNAcol and NeuNAc alpha 2----3Gal beta 1----3(NeuNAc alpha 2----6)GalNAcol. O glycosidically linked oligosaccharides were also detected in human adult plasma fibronectin but in smaller amounts than in amniotic fluid fibronectin. These results show that amniotic fluid fibronectin differs from plasma fibronectin with regard to the number of glycans attached to the polypeptide and that the glycans present in these two fibronectins differ in structure. PMID- 3980471 TI - Pyruvylated glycolipids from Mycobacterium smegmatis. Nature and location of the lipid components. AB - The dipyruvylated glycolipid from Mycobacterium smegmatis (Saadat, S., and Ballou, C.E. (1983) J. Biol. Chem. 258, 1813-1818) has been shown to have the following structure in which FA1 is tetra- or hexadecanoic acid and FA2 is 2,4 dimethyl-2-eicosenoic acid. (formula; see text) The fast atom bombardment mass spectrum showed two major ions [M - H]- at m/z 1511 and 1539 (Mr 1512 and 1540) in a ratio of 1.4:1, suggesting that the glycolipid was a mixture of homologs that differed in fatty acid composition by 2 methylene groups. Analysis revealed C14, C16, and C22 fatty acids in ratios of 0.6:0.4:1.0, indicating that 60% of the molecules contained a C14 and C22 fatty acid whereas 40% contained a C16 and C22 fatty acid. The fragmentation pattern showed that a single glucose unit along with the smaller fatty acid could be lost to yield a tetrasaccharide with attached C22 fatty acid, and a second fragmentation yielded a trisaccharide containing 2 pyruvic acids but without attached fatty acid. The C14 and C16 fatty acids were identified as myristic and palmitic acid, whereas the C22 fatty acid was 2,4-dimethyl-2-eicosenoic acid. Precise localization of the fatty acids came from periodate oxidation and methylation analysis. PMID- 3980472 TI - Kinetics of carbon monoxide binding to monomeric hemoproteins. Role of the proximal histidine. AB - The effect of pH on (i) the second-order rate constant for CO binding and (ii) the spectral properties of the deoxygenated derivative of several monomeric hemoproteins has been investigated in the pH range between 2.3 and 9.0. As in the case of 3-[1-imidazolyl]-propylamide monomethyl ester mesoheme, the rate constant for CO binding to sperm whale, horse, Dermochelys coriacea, Coryphaena hippurus, and Aplysia limacina myoglobins (the latter only in the presence of acetate/acetic acid mixture) increases, as the pH is lowered, to a value at least 1 order of magnitude higher than at pH 7.0. Such an effect is not observed in A. limacina myoglobin (in the absence of the acetate/acetic acid mixture) and Chironomus thummi thummi erythrocruorin. Moreover, the absorption spectrum, in the visible region, of the deoxy derivative of all these monomeric hemoproteins (with the exception of A. limacina myoglobin in the absence of the acetate/acetic acid mixture) undergoes a transition as the pH is lowered, an effect observed previously with 3-[1-imidazolyl]-propylamide monomethyl ester protoheme. On the basis of analogous spectroscopic and kinetic properties of chelated heme model compounds we attribute this behavior to the protonation of the N epsilon of the proximal imidazole involved in the bond with the iron atom. On the basis of this model the movement of the iron atom to the heme plane appears as a crucial step for CO binding, the activation free energy of the process amounting to approximately 2 kcal/mol. PMID- 3980473 TI - Secretion of C-reactive protein becomes more efficient during the course of the acute phase response. AB - We studied the kinetics of synthesis and secretion of the acute phase plasma protein, C-reactive protein, in primary hepatocyte cultures prepared from rabbits manifesting differing degrees of the acute phase response to inflammatory stimulus. In cultures prepared from progressively more responsive animals, rate of C-reactive protein secretion increased to a much greater degree than did intracellular C-reactive protein content, resulting in a progressive decrease in the ratio of intracellular content to rate of secretion. This ratio, which represents the time required to secrete the amount of C-reactive protein contained within the intracellular pool, decreased from 18 h in cultures from unstimulated rabbits to 2.5 h in cells from highly responsive animals. In contrast, these ratios for albumin were short and fell within a narrow range (0.8 2.1 h). In pulse-chase labeling experiments, the time required for secretion of 50% of pulse-labeled C-reactive protein varied markedly, ranging from well over 6 h in cells from a minimally responsive animal to about 75 min in cells from a highly responsive rabbit. In contrast, the half-time for secretion of albumin was consistently about 45 min in the same cultures. Taken together, these findings indicate that the process by which C-reactive protein is secreted becomes more efficient during the course of the acute phase response. Recent studies have indicated that secretory proteins pass from the rough endoplasmic reticulum to Golgi at different and characteristic rates, possibly by a receptor-mediated process in which rate of transfer is determined by receptor affinity. We postulate that C-reactive protein secretion is regulated, during the course of the acute phase response, either by alterations in availability of specific receptors or by competition between different secretory proteins for a common receptor. PMID- 3980474 TI - Muscarinic acetylcholine receptor structure in acinar cells of mammalian exocrine glands. AB - Characterization of muscarinic acetylcholine receptors in acinar cells from rat pancreas and lacrimal and parotid glands was achieved by binding of the reversible muscarinic antagonist [3H]quinuclidinyl benzilate (QNB) and the specific alkylating reagent [3H]propylbenzilylcholine mustard (PrBCM) to intact acini or dispersed acinar cells. Binding studies with [3H]QNB showed that acinar cells from pancreas contain 26,400, from parotid 21,400, and from lacrimal gland 25,700 binding sites/cell. To assess molecular size of the receptor in each gland, acini were prepared by digestion with purified collagenase and singly dispersed acinar cells were prepared by a combination of digestion with crude collagenase, hyaluronidase, and alpha-chymotrypsin and divalent cation chelation using EDTA. Muscarinic receptors on acini or dispersed cells were covalently labeled with 5 nM [3H]PrBCM, solubilized directly in hot sodium dodecyl sulfate buffer, and resolved by polyacrylamide gel electrophoresis. When solubilized acini were electrophoresed, a major labeled peak was observed on gels along with a smaller peak of lower apparent molecular weight. For pancreatic acini, the apparent molecular weights of these peaks were 117,600 and 85,700; for parotid acini, 104,800 and 74,500; and for lacrimal acini, 87,200 and 63,100. Addition of muscarinic antagonists to the labeling medium abolished both peaks. When dispersed acinar cells were labeled, the larger peak was eliminated, and all radioactivity was concentrated in a single peak: 87,600 for pancreas, 78,000 for parotid gland, and 62,800 for lacrimal gland. Digestion of prelabeled acini with the mixture of enzymes used to produce dispersed acinar cells similarly shifted all radioactivity into this second peak. Limited digestion of acini or dispersed cells with 1 mg/ml of papain resulted in the disappearance of these higher molecular weight peaks and the appearance of a broad peak at Mr = 40,000. Cells of nonepithelial origin, IM-9 lymphocytes and NG108 neuroblastoma X glioma hybrids, also were labeled with [3H]PrBCM and electrophoresed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980475 TI - The interrelation between DNA synthesis rates and DNA polymerases bound to the nuclear matrix in synchronized HeLa cells. AB - Quantitative rates of DNA synthesis can be determined by DNA:propidium fluorescence measurements of synchronized cells progressing through S-phase. We have previously reported that HeLa cells have discontinuous rates with values of about 2.9, 1.6, and 4.4 pg of DNA/h for early, middle, and late S-phase, respectively. In attempts to understand why two peaks of DNA synthesis rates are observed, we have examined the nuclear DNA polymerases alpha and beta over the S phase. Nuclear matrices isolated from HeLa cells contained 2% of the alpha polymerase and 12% of the beta polymerase that was present in cell lysates, and about 2% of the original DNA. The amounts of endogenous DNA synthesis in isolated nuclear matrices were comparable to the amounts observed when exogenous DNA was added. DNase treatment abolished the endogenous DNA synthesis but not the exogenous DNA synthesis, suggesting that polymerase alpha binding does not depend on matrix-bound DNA. As synchronized cells progressed through the S-phase, there appeared two peaks of enzymatic activity of alpha polymerase bound to the nuclear matrix which correlated with in vitro DNA synthesis in these nuclear matrices and with the two peaks of quantitative DNA synthesis rates. Two peaks of alpha polymerase activity were also observed with isolated nuclei, but not with cell lysates or cytosol. Our results suggest that, over the S-phase, the differential binding of polymerase alpha to the nuclear matrix determines the differential rates of DNA synthesis. PMID- 3980476 TI - The refinement and the structure of the dimer of alpha-chymotrypsin at 1.67-A resolution. AB - The two molecules of the asymmetric unit of the pH 3.5 conformer of alpha chymotrypsin have been refined at 1.67-A resolution using restrained least squares methods with Hendrickson's program (PROLSQ). The final R factor is 0.179 (including 247 water molecules). The folding of the main chain of the independent molecules is the same within experimental error but the same does not generally apply to the side chain stereochemistry. From this we conclude that the folding of a protein structure is basically independent of most of the detailed stereochemistry of its side chains. The side chains of the interface region between the independent molecules display pronounced asymmetry. This asymmetry suggests that dynamic and asymmetrical structural changes take place at the time of oligomerization leading to more energetically favorable interactions for the dimer. Comparison of the structures of the independent molecules of alpha chymotrypsin with the structure of monomeric gamma-chymotrypsin revealed that although the folding of the three molecules is essentially the same, numerous and significant differences pervade the side chain stereochemistry attributable to general flexibility. The specificity site of alpha-chymotrypsin is occupied by ordered water molecules in a similar way to gamma-chymotrypsin and other proteins. Some of these water molecules are displaced when substrate binds to the enzyme, while the others appear to help identify and position the aromatic side chain in catalysis. PMID- 3980477 TI - A novel approach to the analysis of mass spectrally assayed stable isotope labeling experiments. AB - A novel approach to the analysis of mass spectrally assayed stable isotope labeling experiments for studies of biosynthetic pathways is reported. This method determines in a mixture of product molecules, the relative number of product molecules synthesized from the stable labeled precursor pathway and those that were either present prior to the labeling period or were produced by an alternate pathway during the course of an experiment. In addition, the isotopic enrichment of the labeled atoms in the product molecules produced from the stable labeled precursor is determined. These isotopic enrichments represent the isotopic enrichment in the immediate precursors which form the product molecules and would reflect any cellular compartmentation of precursor pools. The feasibility of the method using 15NH4Cl and L-[5-15N]glutamine as precursors to study the de novo pyrimidine biosynthetic pathway in isolated rat hepatocytes is demonstrated. The results of these studies show that after incubation of rat hepatocytes with either precursor it is possible to determine the fraction of the uracil nucleotide pool that is formed by the de novo pathway during the period of exposure. The pattern of 15N labeling in the N1 and N3 positions in the uracil moiety is different for the two precursors; however, in most cases the 15N enrichment of each position remained relatively constant for each precursor with either time (15-120 min) or precursor concentration (1 to 10 mM). This method will allow the actual quantitation and isotopic enrichment of product formed by a specific biosynthetic pathway during the course of an experiment and, as such is an improvement over existing labeling techniques. PMID- 3980478 TI - Acetylcholinesterase from fetal bovine serum. Purification and characterization of soluble G4 enzyme. AB - Acetylcholinesterase (EC 3.1.1.7) from fetal bovine serum (FBS) was purified to electrophoretic homogeneity. The procedure involved procainamide affinity chromatography with native FBS, followed by chromatography on Sepharose 6B and DEAE-Sephadex. The acetylcholinesterase was purified approximately 44,000-fold, and 13 mg was obtained corresponding to an overall yield of about 45%. The purified acetylcholinesterase was stable at 4 degrees C for at least 8 weeks but was labile to freezing; however, in 50% glycerol the enzyme was stable at -20 degrees C for at least 12 weeks. FBS acetylcholinesterase exhibited typical substrate inhibition, had a Km of 120 microM, and a turnover number of 5300 s-1 with the substrate acetylthiocholine. The enzyme was highly sensitive to the specific acetylcholinesterase inhibitor 1,5-bis(4 allyldimethylammoniumphenyl)pentan-3-one. FBS acetylcholinesterase was characterized as a G4 form of acetylcholinesterase and was distinguished from bovine erythrocyte acetylcholinesterase on the basis of lectin gel binding, [3H] Triton X-100 binding, amino acid composition, number of catalytic subunits/molecule, and hydrodynamic properties. FBS acetylcholinesterase had a Stokes radius of 76 A as judged by gel filtration, and from this a molecular weight of 340,000 daltons was calculated. The enzyme had a subunit weight of approximately 83,000 daltons by sodium dodecyl sulfate-polyacrylamide gel electrophoresis; paraoxon titration indicated a relative active site mass of 75,000 daltons. The amino acid composition of FBS acetylcholinesterase was similar to the human erythrocyte acetylcholinesterase (Rosenberry, T. L., and Scoggin, D. M. (1984) J. Biol. Chem. 259, 5643-5652). A monoclonal antibody directed against human erythrocyte acetylcholinesterase, AE-2, (Fambrough, D. M., Engel, A. G., and Rosenberry, T. L. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 1078 1082) cross-reacted with FBS acetylcholinesterase. PMID- 3980479 TI - Dimeric hemoglobins from the arcid blood clam, Noetia ponderosa. Structure and functional properties. AB - The hemoglobin found in the nucleated erythrocytes of the arcid blood clam Noetia ponderosa is heterogeneous and consists of two electrophoretic components, Hb Major and Hb-Minor, present in about 80% and 20% proportions, respectively. Both components are hemoglobin dimers over a wide concentration range based on light scattering measurements. No higher aggregation states are observed. The oxygen binding by Hb-Major and Hb-Minor is characterized by p50 values of 16.8 and 8.7 mm of Hg and Hill coefficients of 1.4 and 1.2, respectively, at pH 7.0 and 25 degrees C. Neither component exhibits an alkaline Bohr effect. An unusual nonlinear Hill plot is observed for Hb-Major. Hb-Major is composed of two different polypeptide chains and thus is a heterodimer based on sodium dodecyl sulfate/urea-polyacrylamide gel electrophoresis and reverse phase high performance liquid chromatography. By the same methods, Hb-Minor is a homodimer and may share a common chain with Hb-Major. Amino acid compositions of the two hemoglobins indicate 2 histidines/polypeptide chain which are presumably involved in the coordination of the heme iron. Visible absorption spectra indicate the heme environment is normal in the oxy state but perhaps more constrained in the deoxy state. Oxygen binding as a function of temperature and concentration and binding by the intact erythrocytes indicates the absence of intracellular regulators of oxygen binding. PMID- 3980480 TI - Sites of phosphorylation on the high molecular weight basic nuclear proteins of the winter flounder. AB - The high molecular weight basic nuclear proteins from winter flounder sperm are a group of at least 16 proteins which are on average 1000 amino acids long. Despite their large size and complexity, this group of proteins gave rise to only 20 major peptides when digested with trypsin, suggesting that they are closely related to each other and contain sequences which are repeated internally many times over. When the phosphorylated forms of the high molecular weight basic nuclear proteins were isolated from mid-spermatid nuclei and digested with trypsin, six of the major peptides were shown to be phosphorylated. Five of these phosphopeptides were purified, and sequenced by automated Edman degradation. Each of the five contained all or part of the consensus sequence X-Ser(P)-X-Ser(P) Pro, where X represents lysine or arginine. These phosphorylation sites which may be repeated an average of 20 times in each of the high molecular weight proteins, are different from the phosphorylation sites seen in other basic nuclear proteins. The dephosphorylated high molecular weight basic nuclear proteins from flounder sperm are phosphorylated in vitro at these sites by mid-spermatid nuclei. PMID- 3980481 TI - The sites at which brain microtubule-associated protein 2 is phosphorylated in vivo differ from those accessible to cAMP-dependent kinase in vitro. AB - The most conspicuous brain microtubule-associated protein, MAP-2, has been shown to contain 8-10 mol of covalently bound phosphate/mol, as isolated. The MAP-2 associated cAMP-dependent protein kinase can add 10-12 more phosphates, using cycled microtubule preparations, but it does not catalyze exchange between ATP and the pre-existing protein phosphate. We now show that the phosphates that turn over in vivo, after intracerebral injection of 32Pi, are primarily in the projection domain of MAP-2, whereas the sites phosphorylated in vitro are more concentrated in the binding domain. Phosphoserine and phosphothreonine were recovered in a 6:1 ratio from partial acid hydrolysates of MAP-2 phosphorylated either in vivo or in vitro. A protein phosphatase, purified from brain, released residues from in vitro sites in both domains. The enzyme did not release appreciable phosphate that had turned over in vivo, and similar specificity was shown by three other purified protein phosphatases: calcineurin (also from brain) and smooth muscle phosphatases I and II. Thus, even in the projection domain, different sites may be involved. PMID- 3980482 TI - An immunologic probe for a defined region of the myelin proteolipid. AB - Antiserum has been prepared against an isolated polypeptide fragment, designated BPS4, which comprises residues 181-211 of the bovine myelin proteolipid. The antiserum recognizes the intact bovine proteolipid protein but not several other polypeptide fragments within the molecule, nor the myelin basic protein, thus demonstrating specificity of the antiserum. In a competitive enzyme-linked immunosorbent assay, both the major proteolipid and the DM 20 bands observed on sodium dodecyl sulfate-polyacrylamide gels reacted equally well with the antiserum, indicating that the BPS4 segment is present in both molecular species. The rat myelin proteolipid protein cross-reacted with antiserum against the intact bovine protein but showed minimal cross-reactivity with the antiserum against the bovine BPS4 fragment. This was demonstrated in parallel experiments using three types of preparations, namely, sodium dodecyl sulfate-solubilized myelin, delipidated myelin, and isolated proteolipid apoprotein. The difference between the bovine and rat proteins, which presumably reflects amino acid sequence differences, is thus detectable by the antiserum against the polypeptide fragment but not by the antiserum against the intact protein. Isolated bovine myelin membranes did not bind the antiserum in the absence of detergent or without delipidation. On the other hand, in vesicles reconstituted with the intact bovine apoprotein, the BPS4 segment was oriented on the exterior face of the liposome where it was capable of binding antibody and was susceptible to Pronase digestion. PMID- 3980483 TI - Sulfation and constitutive secretion of dopamine beta-hydroxylase from rat pheochromocytoma (PC12) cells. AB - The biosynthesis and secretion of dopamine beta-hydroxylase were investigated by radiolabeling rat pheochromocytoma (PC12) cells in culture. Intracellular dopamine beta-hydroxylase from a crude chromaffin vesicle fraction and secreted dopamine beta-hydroxylase from culture medium were immunoprecipitated using antiserum made against purified bovine soluble dopamine beta-hydroxylase. Analysis of the immunoprecipitated enzyme on sodium dodecyl sulfate polyacrylamide gel electrophoresis showed that: 1) the membrane-bound form of the hydroxylase from crude secretory vesicle membrane extracts contained two nonidentical subunits in approximately stoichiometric amounts (Mr = 77,000 and 73,000); 2) the soluble hydroxylase from the lysate of these secretory vesicles was composed predominantly of a single subunit (Mr = 73,000); and 3) the hydroxylase secreted into the medium under resting conditions was also composed of a single subunit (approximate Mr = 73,000). All subunits of the multiple forms of hydroxylase were glycoproteins. Under resting conditions, the rate of secretion of hydroxylase was approximately 6% of total cellular enzyme/15 min. The secreted form of the hydroxylase incorporated [35S]sulfate, whereas no significant [35S]sulfate was incorporated into the cellular forms of enzyme. We propose that in addition to the dopamine beta-hydroxylase which is found in catecholamine storage vesicles and released during stimulus-coupled exocytosis, PC12 cells also have a constitutive secretory pathway for dopamine beta hydroxylase and that the enzyme released by this second pathway is sulfated. PMID- 3980484 TI - Induction of proline-rich glycoprotein synthesis in mouse salivary glands by isoproterenol and by tannins. AB - Glycoproteins which contain about 45 mol% proline were dramatically induced in mouse parotid and submandibular glands by isoproterenol treatment, but these unusual proteins were not detected in control animals. These acid-soluble substances were obtained by extracting tissues with 10% trichloroacetic acid, as reported previously for isolating proline-rich proteins from rat submandibular glands (Mehansho, H., and Carlson, D.M. (1983) J. Biol. Chem. 258, 6616-6620). Three major proline-rich glycoproteins were induced in parotid glands with apparent molecular weights of 66,000 (GP-66p), 45,000 (GP-45p), and 27,000 (GP 27p), whereas only one such protein was expressed by the submandibular glands (66,000 (GP-66sm]. Both GP-66p and GP-66sm contained about 19% carbohydrate with the following molar ratios, respectively; GalNAc, 1.0, 1.0; Gal, 1.6, 2.3; GlcNAc, 0.8, 1.1; sialic acid, 0.9, 1.9. The peptide chains of GP-66p and GP-66sm appear to be identical by amino acid compositions, glycopeptide analysis, and preliminary amino acid sequencing data. Northern blot analysis of RNAs from parotid glands of normal and isoproterenol-treated rats, probed with a 32P labeled proline-rich protein cDNA, confirmed that control animals were devoid of mRNAs encoding these proteins and that isoproterenol treatment dramatically induced expression of these genes. Feeding sorghum high in tannins caused changes in the parotid glands similar to those observed upon isoproterenol treatment, as noted earlier with rats (Mehansho, H., Hagerman, A., Clements, S., Butler, L., Rogler, J., and Carlson, D.M. (1983) Proc. Natl. Acad. Sci. U.S.A. 80, 3948 3952). These glycoproteins have high affinities for tannins as demonstrated by competitive binding curves. PMID- 3980485 TI - Measurement of surface deformation of soft tissue. AB - A method is described for measuring the surface shape and deformations of soft tissue in three dimensions. The method uses close range stereophotogrammetry to record the three-dimensional locations of miniature optical targets applied to the tissue surface. This has been applied to study of human lumbar intervertebral disc. Measurements of the strain along surface annular fibers have been made under varying loads. In this case the maximum expected errors are about 0.15 mm, which corresponds to a strain of less than 1%. Preliminary findings have differed from predictions made in published mathematical models for the disc in that they show very little strain of the annulus in compression loading, but confirm axial torsional loading as liable to produce mechanical disruption of the disc annulus. PMID- 3980486 TI - Biped gait stabilization via foot placement. AB - It is shown that stable biped gaits can be achieved by discrete foot placement based on feedback of information available at the time of foot placement. The model, developed by Townsend (1981, J. Biomechanics 14, p. 727) to evaluate the coordinations of torso motions, subsumes most of the salient body members and motions. The modeling yielded a generalized inverted pendulum with a movable support point which physically defines lateral foot placement. The principal result is that stable gaits can be defined by foot placements which are a linear function of the system center of mass position and velocity at the time of foot placement (only). Gaits may be 'smooth' or may have impulsive corrections to adjust the character of the motions and foot placement. Several general algorithms and specific simulations are presented, and calculations for non impulsive gaits and impulsive corrections are presented. The model predictions are compared with published data. The predictions are sufficiently close to the data such that the general algorithms appear to be validated. Of particular interest are the non-sinusoidal character of the motions and the relatively simple algorithms. Indeed, the simplicity of the algorithms suggests the practical possibility of legged mobile robots. Accordingly, further investigation seems warranted for determining the parametric variation and control of gait. Some attention is also given to continuous-feedback control such as would exist during double-leg support and in specialized tasks such as rope walking or skating. Subsequent investigation will consider superposition of single and double leg support, although clearly the discrete gaits pose the more restrictive stability problem. PMID- 3980487 TI - The frequency content of gait. AB - We address amplification of noise in double differentiation of position histories for dynamic analysis of gait. Measurements of the frequency domain characteristics of signal and noise are required to quantitatively assess errors in raw, filtered, and dynamic gait data. The results of a simple technique to determine the frequency content of gait using a population of 12 subjects and a total of 30 gait records is presented. PMID- 3980488 TI - Modulation of limb dynamics in the swing phase of locomotion. AB - A method was presented for quantifying cat (Felis catus) hind limb dynamics during swing phase of locomotion using a two-link rigid body model of leg and paw, which highlighted the dynamic interactions between segments. Comprehensive determination was made of cat segment parameters necessary for dynamic analysis, and regression equations were formulated to predict the inertial parameters of any comparable cat. Modulations in muscle and non-muscle components of knee and ankle joint moments were examined at two treadmill speeds using three gaits: (a) pace-like walk and trot-like walk, at 1.0 ms-1, and (b) gallop, at 2.1 ms-1. Results showed that muscle and segment interactive moments significantly effected limb trajectories during swing. Some moment components were greater in galloping than in walking, but net joint maxima were not significantly different between speeds. Moment magnitudes typically were greater for pace-like walking than for trot-like walking at the same speed. Generally, across gaits, the net and muscle moments were in phase with the direction of distal joint motion, and these same moments were out of phase with proximal joint motion. Intersegmental dynamics were not modulated exclusively by speed of locomotion, but interactive moments were also influenced significantly by gait mode. PMID- 3980489 TI - Anisotropic yield behavior of bone under combined axial force and torque. AB - In this study the yield behavior of cortical bone was determined under combined loading conditions involving tension, compression and torsion. The axis of each test sample coincided with the long bone axis. To minimize viscoelastic behavior, tests were conducted using an effective strain rate in the range of 0.01-0.06 s 1. Experimental yield loci for bovine and human cortical bone were determined using a strain offset technique to determine the 'common yield point' for combined loading. Several failure criteria which have been used for composite materials were examined for applicability to the experimental results. Data were obtained for bovine and human tibial and femoral bone. The Tsai-Wu criterion was in best agreement to the test data, although Hill's criterion could describe the individual compression-torsion or tension-torsion regimes with good accuracy. PMID- 3980490 TI - Toward quantification of athetotic movements by frequency spectrum analysis. AB - The frequency spectrum of the elbow movements of one normal subject and six handicapped subjects were obtained in order to investigate the possibility of using this technique in quantifying athetosis. The frequency spectrum technique appears to be useful but data from more subjects must be obtained and specific details regarding scaling need to be investigated. PMID- 3980491 TI - Incompressibility in bone. PMID- 3980492 TI - Predictions of knee and ankle moments of force in walking from EMG and kinematic data. AB - A deterministic model was developed and validated to calculate instantaneous ankle and knee moments during walking using processed EMG from representative muscles, instantaneous joint angle as a correlate of muscle length and angular velocity as a correlate of muscle velocity, and having available total instantaneous joint moments for derivation of certain model parameters. A linear regression of the moment on specifically processed EMG, recorded while each subject performed cycled isometric calibration contractions, yielded the constants for a basic moment-EMG relationship. Using the resultant moment for optimization, the predicted moment was proportionally augmented for longer muscle lengths and reduced for shorter lengths. Similarly, the predicted moment was reduced for shortening velocities and increased if the muscle was lengthening. The plots of moments predicted using the full model and those calculated from link segment mechanics followed each other quite closely. The range of root mean square errors were: 3.2-9.5 Nm for the ankle and 4.7-13.0 Nm for the knee. PMID- 3980493 TI - The need for a standardized system for evaluating results of total hip surgery. PMID- 3980494 TI - Long-term results of revision total hip replacement. A follow-up report. AB - The results of 110 revision total hip replacements performed for aseptic failure, with an average follow-up of 3.4 years, were reported in 1982. We were able to continue to follow ninety-nine of these patients for an average of 8.1 years (range, five to 12.5 years). With this longer follow-up, we found that twenty nine (29 per cent) of these revised arthroplasties have since failed. Most of the failures after 1982 occurred in the hips that were known to have a progressive radiolucency at the time of the first evaluation. We concluded that there is an increased failure rate with longer follow-up of revision total hip replacement, and that progressive radiolucency at an interface indicates a poor prognosis for the arthroplasty. PMID- 3980495 TI - Revision total hip arthroplasty. AB - Two hundred and ten hips in 206 patients who had an initial total hip arthroplasty performed at the Mayo Clinic between 1969 and 1978 required revision of the arthroplasty at the Mayo Clinic for reasons other than infection. One hundred and sixty-two of the patients (166 hips) were followed both clinically and roentgenographically for two years or more. One hundred and forty-five (90 per cent) reported that they had improvement after the surgical revision. Complications that occurred with revision included deep sepsis, superficial would infection, dislocation, intraoperative femoral fracture, and postoperative femoral fracture. Roentgenographic analysis showed probable loosening in thirty three acetabular components (20.1 per cent) and seventy-two femoral components (44 per cent). Symptomatic loosening (moderate to severe pain and probable roentgenographic loosening) was seen in thirty-five patients. Eight patients required a second revision for this reason, and seven others required a second revision for other reasons. Modified Harris hip scores, calculated for 108 hips, showed a good or excellent result in sixty-seven hips (62 per cent), a fair result in twelve (11 per cent), and a poor result in twenty-nine (27 per cent). Using a new Mayo Clinic hip score that incorporates roentgenographic data (which will be described) in the evaluation of 165 revised hips, there was a good or excellent result in eighty-five (52 per cent), a fair result in thirty-two (19 per cent), and a poor result in forty-eight hips (29 per cent). Although 90 per cent of the patients thought that their condition had improved, the high incidence of roentgenographic signs of probable loosening of a component is of serious concern. PMID- 3980496 TI - Aneurysmal bone cyst of the spine. AB - The cases of twenty-two patients with an aneurysmal bone cyst of the spine above the sacrum were analyzed with regard to sex, age, site, symptoms, and radiographic findings. Four patients had extension of the lesion to the adjacent vertebra or rib, and twelve patients had neurological deficits. The primary treatment was either radiotherapy or surgery alone, or surgery and radiotherapy combined. No recurrences were found in patients who were treated with surgery alone or with surgery and radiotherapy, while three of the six patients who were treated with radiotherapy had a local recurrence, two of which were fatal. The patients with neurological deficits recovered after healing of the cyst. PMID- 3980497 TI - Intra-articular transfer of the iliotibial tract. Two to seven-year follow-up results. AB - A proximally based transfer of a composite structure of the iliotibial tract, its osseous insertion, the lateral retinaculum, and part of the vastus lateralis was used in 111 anterior cruciate-deficient knees that were followed for two to seven years. No other ligament procedures were performed simultaneously. The clinical results included a negative Lachman test in 81 per cent (ninety) of the knees, an anterior drawer test of 1+ or less in 84 per cent (ninety-three knees), and a negative pivot-shift sign in 94 per cent (104 knees). Subjectively, 74 per cent (eighty-two) of the knees were rated as excellent; 21 per cent (twenty-three), as good; and 5 per cent (six), as poor. A significant modification in surgical technique, consisting of a limited posterior dissection of the iliotibial band, yielded even better static stability than the original operation did. These results, sustained for as long as seven years, are consistent with the physiological aspects of this transfer. The surgical technique is reproducible and the immediate fixation of bone allows early motion of the knee and reasonable rehabilitation. PMID- 3980498 TI - Congenital proximal radio-ulnar synostosis. Natural history and functional assessment. AB - We evaluated the cases of twenty-three patients with thirty-six congenital proximal radio-ulnar synostoses who had been followed between 1938 and 1984. None of the patients had had any attempt at surgical correction or any ipsilateral congenital anomalies. Emphasis was placed on analyzing the natural history of the lesion in these patients who had not been operated on, and on determining the effect of a fixed position of the forearm on function. Ten patients had unilateral and thirteen, bilateral synostosis. Their mean age when last examined was twenty-two years (range, three to fifty years). Eight patients were female and fifteen, male. The forearms were fixed in an average of 30 degrees of pronation. The position of the forearm was not found to be related to subjective functional limitations, employment status, or the results of the hand-function test of Jebsen et al. Most patients had few or no functional limitations, and were employed in jobs that demanded extensive use of the forearm. Contrary to the findings of other studies, we observed four distinct radiographic patterns based on the presence of an osseous synostosis and the position of the radial head. However, we noted no relationship between any of these patterns and function. We concluded that operative treatment of congenital radio-ulnar synostosis is rarely indicated, that less emphasis should be placed on the single factor of the position of the forearm, and that objective functional tests should be included in the assessment of these patients. PMID- 3980499 TI - Long-term results of tibiotalar arthrodesis. AB - One hundred and one tibiotalar arthrodeses were performed using a single surgical technique that has not been previously reported. The average follow-up was ten years (range, two to twenty-five years). The rate of pseudarthrosis was 5 per cent, four to five times less than in other recent large reports. Pseudarthrosis occurred only in patients with a sensory deficit. Secure fusion was radiographically documented in 95 per cent and the functional clinical result was good to excellent in 90 per cent. The ideal fusion position was found to be neutral or slight equinus angulation, and varus-valgus angulation equal to that of the contralateral side. More than 7 degrees of varus angulation of the heel was associated with symptomatic lateral metatarsalgia in all feet in which it occurred. Radiographic measurement documented an average 85 per cent (11-degree) increase in postoperative tarsal motion. Neither symptoms nor function correlated with the degree of tarsal hypermobility. PMID- 3980500 TI - Use of internal compression in arthrodesis of the ankle. AB - An ankle arthrodesis was done on twenty-five patients, using a specially designed T-plate. The T-plate provides a compressive force across the ankle of approximately 18.5 newtons per square meter and is most often applied through a medial approach to the ankle joint. This new approach provides excellent exposure and supplementary bone graft, and facilitates alignment of the ankle and foot in a neutral position. A successful arthrodesis was obtained in each patient. In the thirteen patients for whom a functional rating could be obtained, the average preoperative score of 47 points improved to an average postoperative score of 82 points. PMID- 3980501 TI - Rupture of the posterior tibial tendon causing flat foot. Surgical treatment. AB - Rupture of the posterior tibial tendon results in a progressive, painful flat foot deformity. Other physical findings are an inability to invert the heel on tip-toe standing and loss of inversion power. In this study we report on seventeen patients with this condition who were surgically treated with a transfer of the flexor digitorum longus tendon into the navicular or an advancement of the posterior tibial tendon. Follow-up results were excellent in twelve, good in one, fair in three, and poor in one patient. Arthrodesis of the talonavicular and calcaneocuboid joints was subsequently done for the patient with the poor result. PMID- 3980502 TI - Neurogenic acceleration of degenerative joint lesions. AB - A severe form of degenerative joint lesion (neuropathic arthropathy) is known to complicate a variety of diseases that are associated with sensory abnormalities. We studied the relationship between sensory deficits and the development of degenerative joint lesions in dogs in two complementary experiments. In Experiment 1, dogs that were subjected to unilateral dorsal-root ganglionectomy (fourth lumbar to first sacral vertebra) failed to show biochemical, gross, or histological evidence of degenerative joint lesions in ipsilateral femoral condylar cartilage after sixteen months. In Experiment 2, five of six dogs that were subjected to transection of the anterior cruciate ligament two weeks after deafferentation of the ipsilateral limb showed striking gross or histological lesions, or both, of the femoral condylar cartilage three weeks after ligament transection (five weeks after ganglionectomy). We concluded that the neuromuscular mechanisms that protect normal joints from damage are inadequate to protect unstable joints from becoming rapidly and severely damaged. PMID- 3980503 TI - Successive bilateral total knee replacement. AB - We studied the results of 304 posterior stabilized condylar knee arthroplasties, performed over a two and a half-year period, to compare unilateral, bilateral one stage, and bilateral staged arthroplasty. The minimum length of clinical follow up was two years. Using The Hospital for Special Surgery rating system, we found the clinical results to be identical for all three groups. The medical complications were similar in each group except that there was a higher incidence of thromboembolism and pulmonary embolism, as seen venographically, in the patients with staged procedures. We concluded that one-stage bilateral knee arthroplasty is preferable in a patient who requires replacement for severely arthritic knees. PMID- 3980504 TI - The coexistence and characteristics of osteoarthritis and osteoporosis. AB - We defined the clinical features and radiographic coexistence of osteoarthritis and osteoporosis in fifty women with primary coxarthrosis and fifty age-matched women (average age, 69 +/- 5 years) with idiopathic osteoporosis. The patients with osteoarthritis had undergone total hip replacement. The diagnosis of primary osteoarthritis was established by clinical, radiographic, and histological criteria, and the diagnosis of osteoporosis was confirmed by histomorphometric analysis of specimens taken at iliac-bone biopsy. In the arthritic patients, spinal osteoporosis was identified by radiographic evidence of compression fractures, kyphosis, and scoliosis. Femoral osteoporosis was demonstrated by the index of Singh et al. and the femoral canal-shaft ratio. In the osteoporotic patients coxarthrosis was measured radiographically by the scale of Kellgren and Lawrence. On the average, the osteoporotic patients were twelve kilograms lighter than the osteoarthritic patients. Fifty-eight per cent of the osteoporotic and 18 per cent of the osteoarthritic patients had a scoliotic curve of at least 10 degrees. The prevalence of osteoarthritis of the hip in the osteoporotic women was 4 per cent, and the prevalence of compression fractures in the arthritic women was 6 per cent, which was approximately one-quarter of the expected incidence. These results show that: (1) osteoporosis does not protect against the development of coxarthrosis, (2) coxarthrosis is a negative risk factor for osteoporotic compression fractures, and (3) scoliosis and an ectomorphic habitus are clinical markers that identify a risk for osteoporosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980505 TI - Cervical myelopathy and posterior atlanto-axial subluxation in patients with rheumatoid arthritis. AB - Posterior atlanto-axial subluxation, which is uncommon and usually is considered a benign condition, was associated with cervical myelopathy in four patients with rheumatoid arthritis. The cause of the myelopathy appeared to be posterior kinking of the spinal cord without demonstrable compression. Contrast-enhanced sagittal imaging or computerized tomographic sagittal reconstruction provided the best means of demonstrating the abnormal configuration of the spinal cord. Halo traction and occipitocervical fusion yielded satisfactory results in all four patients after follow-up of one to two years. We developed a method to provide rigid fixation of an occipitocervical fusion in which a corticocancellous iliac bone graft was backed with metal mesh, wired in place, and reinforced with methacrylate. PMID- 3980506 TI - External skeletal fixation of canine tibial osteotomies. Compression compared with no compression. AB - In this study we compared the effects of compression on the maturity and pattern of osseous healing in canine tibial osteotomies that were fixed with an external fixation system at a single time-period, ninety days after osteotomy. The in vitro model demonstrated that compression increased rigidity of fixation. Relative to the rigidity of the intact tibia, this increase was small. Estimation of osteotomy-site bone blood flow at ninety days by 85Sr clearance and torsional testing to failure of the healed osteotomies were used to compare the maturity of bone union in each group. The pattern of healing of the osteotomy was evaluated by quantitative histological determination of new-bone formation and porosity. All of the osteotomies healed by the ninetieth day. We found no significant difference at that time in osteotomy-site bone blood flow or strength of healing of the osteotomy, although the compression-treated osteotomies healed with higher torsional stiffness. No differences were demonstrated between the two groups in the pattern of healing of the osteotomy. In both groups there was a significantly greater amount of periosteal new-bone formation in the relatively less rigidly fixed antero-posterior plane when compared with the mediolateral plane. Primary bone-healing of both the contact type and the gap type was seen in both groups. There were no significant complications and the pin-loosening rate was similar in both groups. PMID- 3980507 TI - The results of replantation after amputation of a single finger. AB - We reviewed fifty-nine consecutive cases of patients who had replantation of a single finger (excluding the thumb) after traumatic amputation, with an average follow-up of fifty-three months. Fifty-one (86 per cent) of the replanted fingers survived. Survival was found to be affected by the age of the patient, the number of vessels that were anastomosed, and the replantation experience of the surgeons. The survival rate was not affected by the gender of the patient, the mechanism of injury, or which finger was amputated. As compared with survival only, the functional results were most dependent on the level of amputation. The proximal interphalangeal joint in amputated fingers that were replanted distal to the insertion of the flexor superficialis tendon had an average range of motion of 82 degrees after replantation, while those amputated proximal to the insertion had an average range of motion of only 35 degrees after replantation. The average operating time was six hours and ten minutes, and the average time until the patient returned to work was 2.3 months. Based on this experience, it is our opinion that replantation of a single finger that was amputated distal to the insertion of the flexor superficialis tendon is justified, but that replantation of a single finger that was amputated proximal to this insertion is seldom indicated. PMID- 3980508 TI - Growth-disturbance lines in congenital dislocation of the hip. AB - In congenital dislocation of the hip, growth-disturbance lines as shown radiographically regularly occur in the proximal end of the femur after operative procedures are performed under general anesthesia. They can be seen in children who are between the ages of six months and four years and tend to disappear over several years. I think that the final shape of the femoral neck can be predicted by closely observing the development and displacement of the growth-disturbance lines that are induced at the time of surgical treatment. PMID- 3980509 TI - Fatal pulmonary embolism following tourniquet inflation. A case report. PMID- 3980510 TI - Isolated avulsion of the subscapularis insertion in a child. A case report. PMID- 3980511 TI - Focal scleroderma affecting the hand. Case report. PMID- 3980512 TI - Infection in a Charcot joint. A case report. PMID- 3980513 TI - Crepitation simulating gas gangrene. A case report. PMID- 3980514 TI - Bizarre parosteal osteochondromatous proliferation in the hand. A case report. PMID- 3980515 TI - The use of the Hickman catheter in orthopaedic infections. Brief note. PMID- 3980516 TI - Osteomesopyknosis. Case report. PMID- 3980517 TI - Myoelectric prostheses. PMID- 3980518 TI - Prophylactic cefamandole in orthopaedic surgery. PMID- 3980519 TI - To brace or not to brace? PMID- 3980520 TI - Chemical lumbar sympathectomy. PMID- 3980521 TI - Idiopathic scoliosis. Prevalence and ethnic distribution in Singapore schoolchildren. AB - Routine examination for spinal deformity as part of a school health screening programme was introduced in Singapore in 1981. The three different ethnic groups included in the study provided figures for the prevalence of idiopathic scoliosis in an Asian population. A three-tier system of examination was used and a total of 110744 children in three age groups were studied. In those aged 6 to 7 years the prevalence was 0.12%. The prevalence in those aged 11 to 12 years was 1.7% for girls and 0.4% for boys, a ratio of 3.2 to 1. In girls aged 16 to 17 years the prevalence was 3.1%. In the latter two age groups there was a significantly higher prevalence in Chinese girls as compared with Malay and Indian girls. The optimal age for school screening seemed to be 11 to 12 years, but repeated examinations may be worthwhile. PMID- 3980522 TI - Stature and idiopathic scoliosis. A prospective study. AB - A study of 130 scoliotic children with curves measuring 10 degrees or more has been performed in order to elucidate the importance of stature, growth and development. Girls with adolescent idiopathic curves measuring 15 degrees or more were taller than girls with smaller idiopathic curves and taller than those whose scoliosis was secondary to leg-length inequality (pelvic tilt scoliosis). No differences were observed as regards growth velocity or development. The increased standing height may be genetic but the uncoiling effect of the normal kyphosis to give a flat lateral profile is a more likely cause. The familial trend in idiopathic scoliosis may therefore be explained by the genetically determined shape of the spine in the median (sagittal) plane. PMID- 3980523 TI - Combined idiopathic kyphosis and scoliosis. An analysis of the lateral spinal curvatures associated with Scheuermann's disease. AB - A radiological study of 50 patients with thoracic Scheuermann's disease revealed two types of lateral spinal curvature. A total of 43 lateral curves was present in 35 of the patients. Thirteen were apical at the same level as the Scheuermann's kyphosis and were due to vertebral-body wedging in the coronal plane; these curves had a mean Cobb angle of 15 degrees, occurred with equal prevalence in boys and girls and were directed equally to right and left. Thirty curves occurred in regions of compensatory lordosis (mean 5.6 degrees) situated above or, more commonly, below the Scheuermann's kyphosis. These scolioses had a mean Cobb angle of 16 degrees, were more often convex to the right than to the left and were significantly more prevalent in girls than in boys. The presence of these kyphoses and scolioses in the same spine, separated by only a few vertebrae, emphasises the importance of the sagittal plane in idiopathic spinal deformities and strongly suggests that idiopathic scoliosis and Scheuermann's disease share a common pathological process. PMID- 3980524 TI - Growth arrest for progressive scoliosis. Combined anterior and posterior fusion of the convexity. AB - A review is presented of 13 young patients with congenital scoliosis who were treated by epiphysiodesis of part of the vertebral bodies combined with posterior fusion, both on the convex side; the plan was to arrest growth on the convexity which, combined with growth of the concave side, would result in progressive correction of the curve. The first patient was operated on at the age of four years and has now reached skeletal maturity with complete correction of her curve. Several others, still growing, are showing progressive correction. Only three curves, in which kyphosis was more severe than scoliosis, have deteriorated since operation. Although full assessment must await skeletal maturity of all the patients, this approach appears to have sufficient potential to justify an early report. PMID- 3980525 TI - The lumbar theco-peritoneal shunt syndrome and its surgical management. AB - Seven patients treated in infancy by a lumbar theco-peritoneal shunt for idiopathic communicating hydrocephalus presented later in childhood after developing a characteristic orthopaedic syndrome. This included a severe, rigid and progressive lumbar hyperlordosis, severe bilateral restriction of straight leg raising and abnormalities of stance and gait. Four of the patients, who had severe hyperlordotic curves of over 90 degrees, required operations to correct their extreme deformity. The recommended method of correction is a three-stage procedure: first, anterior wedge resection osteotomies at several levels in the lumbar spine, then a period of "90-90" femoral traction, and finally a posterior fusion and stabilisation using Harrington instrumentation. The results were good, with few complications. PMID- 3980526 TI - A technique for lumbar spinal osteotomy in ankylosing spondylitis. AB - Fourteen patients with ankylosing spondylitis had an extension osteotomy for severe flexion deformity of the spine. The Smith-Petersen technique was modified by using a compression device which allows a slow, finely controlled closure of the osteotomy, and provides rigid internal fixation. There were no serious neurological complications. All the patients were able to see straight ahead after operation, and all had solid fusion at nine months, having maintained good correction. PMID- 3980527 TI - Moire topography in scoliosis. Its accuracy in detecting the site and size of the curve. AB - Moire topography was added to school scoliosis screening in Singapore in 1982. The results from 1342 topographs, assessed in isolation, were used to study the accuracy of the method in predicting the radiographic location and magnitude of scoliotic curves. Accuracy in identifying the site of the curve was 68% in the thoracic spine, 54% in the thoracolumbar spine, and 15% in the lumbar region. There were 12.7% false-positive results and 4.3% false negatives. Of patients with a deviation of one moire fringe, 76.5% had a curve of 15 degrees or less; of those with a deviation of four moire fringes, 69% had a curve greater than 26 degrees. The prediction of the Cobb angle was less accurate when there was a deviation of two or three fringes. It is suggested that moire topography as a screening device should be reserved for use in the second tier of screening, since the forward-bending test is an effective and cheap method for the first tier of a mass school-screening programme. PMID- 3980528 TI - Primary total hip replacement for displaced subcapital fractures of the femur. AB - The management of displaced subcapital fracture of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age. A total of 163 cases, operated on over four years, have been reviewed. There were relatively more dislocations after operation for fracture than after total replacement for arthritis, and these were associated with a posterior approach to the hip. Only seven revision operations have been required. Of 57 patients who were interviewed an average of 42 months after replacement, 62% had excellent or good results as assessed by the Harris hip score. All the others had major systemic disease which affected their assessment. This inadequacy of current systems of hip assessment is discussed. It is concluded that total hip replacement is the best management for a selected group of patients with this injury, and that further prospective studies are indicated. PMID- 3980529 TI - Osteolytic changes in the upper femoral shaft following porous-coated hip replacement. AB - Ten uncemented total hip replacements were performed in 1975 using an implant in which the cobalt-chrome femoral stem was coated to give a porous surface. In all but one case a high-density polyethylene head was used. The radiological changes in the upper femoral shafts were assessed between three and nine years later. Seven showed extensive stress-relieving changes, loss of calcar, stress fractures at the root of the lesser trochanter with subsequent detachment, and osteoporosis followed by avulsion of the greater trochanter. In these seven patients the lower part of the stem appeared to be soundly embedded, although in only one was there evidence of bony incorporation. It is suggested that if the fixation of a fully coated implant of this sort remains sound, gross atrophy of the upper femoral shaft develops after five years. This atrophy, associated with an implant which can be removed only at the expense of further bone destruction, presents substantial problems if revision is needed. PMID- 3980530 TI - Acetabular cup failure after total hip replacement. AB - Fracture of the polyethylene acetabular cup is a rare late complication of total hip replacement. Five cases are reported. In each one this followed a fall, and involved a Muller arthroplasty which had previously been symptomless. It is postulated that ridges or other irregularities of bone, produced by keying holes, could lead to areas of thin cement and potential weakness of support for the cup. PMID- 3980531 TI - Surface morphology of Asian cadaveric hips. AB - The joint surfaces of 60 hips obtained from the cadavers of elderly Asians were studied to determine the incidence, the grade and the distribution of both non progressive (age-related) and progressive degenerative changes. It was observed that in the Asian population of 40 to 90 years of age, non-progressive changes were common, being seen in 66% of the acetabular specimens and 50% of the femoral heads. Only one specimen of the 60 showed unexplained progressive degenerative change. We conclude that primary osteoarthritis of the hip is rare in Asians. PMID- 3980533 TI - In defence of gait analysis. Observation and measurement in gait assessment. AB - The gait pattern of five amputees was recorded by visual observation and also by a quantitative measurement system. The results were compared with the gait pattern predicted from biomechanical analysis. Visual observation was found to be an unreliable clinical skill. The observers recorded only 22.2% of the predicted gait deviations and were unable to comment on 15.6% of all the required observations. The gait parameters which were difficult to assess visually, namely step length and step time, are considered by most workers to be of particular value as diagnostic clinical indicators in gait assessment. The measurement system used was accurate in recording gait deviations and picked up 3.4 times as many deviations as visual observation. This report demonstrates the inadequacy of visual observation as a diagnostic method and emphasises the need for measurements. PMID- 3980532 TI - Infection in experimental hip arthroplasties. AB - The relationship between the route of inoculation, the dose of inoculum and the development of infection after prosthetic replacement has been determined in an animal model. The rabbit hip served as the model and a Staphylococcus aureus isolated from an infected human hip arthroplasty was introduced using different protocols. The 50% infective dose (ID50) was determined for comparative purposes. Contamination of the wound site with only a few bacteria was likely to result in infection. It was considerably more difficult to induce infection when the operation was performed without inserting the prosthesis, which suggests that the implant inhibits the body's mechanism for dealing with the insult. It was difficult to produce infection by inoculating the organisms into the bloodstream: if this inoculation was delayed till three weeks after operation the animals were often grossly septicaemic by the time the arthroplasty was infected. The results emphasise the importance of minimising intra-operative contamination and the efficacy of antibiotic cover. PMID- 3980534 TI - Stemmed revision arthroplasty for aseptic loosening of total knee replacement. AB - Fifty-three failed knee replacements were revised using minimally constrained implants with smooth uncemented intramedullary stems and metal-backed tibial components. Polymethylmethacrylate was used only to replace lost bone near the surface of the implant. Excluding four knees which had serious postoperative complications, 91% had successful relief of pain, 84% had over 90 degrees of movement and 80% could walk for more than 30 minutes. Review of the radiographs showed that there were no progressive lucencies at the interface between bone and cement, and no subsidence of components or changes in alignment. At the uncemented stem-to-bone interface, thin white lines developed near the metal, and their significance is discussed. This revision technique is an effective treatment for aseptic failure of primary total knee arthroplasty. PMID- 3980535 TI - Fragmentation of the proximal pole of the patella. Another manifestation of juvenile traction osteochondritis? AB - Six boys with fragmentation of the proximal pole of the patella are reported; the condition was bilateral in one. Four of the six presented with symptoms of Osgood Schlatter's disease or Larsen-Johansson disease of the same or of the contralateral knee, but they had no symptoms or signs relating to the proximal pole of the patella; one also had features suggesting minimal chondromalacia patellae. Two boys had no objective abnormality in either knee. It is suggested that the fragmentation may be a further form of traction osteochondritis of the attachments of the quadriceps mechanism. Attention is drawn to its characteristic radiographic appearance, its association with other forms of juvenile traction osteochondritis (which are commonly symptomatic), and to its occurrence in boys aged 10 or 11 years. PMID- 3980536 TI - Avulsion of the distal pole of the patella in cerebral palsy. A cause of deteriorating gait. AB - Avulsion of the distal pole of the patella in spastic children with a flexed knee gait may upset the equilibrium of the knee and cause deterioration in walking. We emphasise the clinical features, discuss the mechanism and outline the principles of treatment. PMID- 3980537 TI - Advancement of the tibial tuberosity. A biomechanical study. AB - The effects of advancement of the tibial tuberosity by inserting bony wedges was studied on cadaveric specimens of the knee. The geometry, the contact areas and the forces acting on the patellofemoral joint were investigated, and the forces acting on the tibiofemoral compartment were calculated. A 1 cm advancement was found to be optimal in reducing the high patellofemoral joint forces occurring at 90 degrees and 110 degrees of flexion, whilst causing least reduction of the contact areas; the stresses on the joint were reduced significantly. Advancement by 2 cm and by 3 cm drastically reduced the congruity and the size of the contact area. It was also shown that 2 cm and 3 cm advancement caused an increase in forces at the patellofemoral joint and also in the tibiofemoral joint in a direction tangential to the articular surfaces. PMID- 3980538 TI - Bilateral hip and knee replacement for rheumatoid arthritis. AB - A series of 19 patients with severe rheumatoid arthritis had replacement of both hips and both knees. They are reviewed after a mean follow-up of 27 months. The preferred programme is to replace hips before knees. Pain was relieved in all the patients and function was improved in all but two. Severe rheumatoid disease and prolonged immobilisation before the operations were not contra-indications to a successful outcome, but the presence or the development of cervical myelopathy combined with gross upper limb deformity militated against a good result. PMID- 3980539 TI - Hand function in children with myelomeningocele. AB - Hand function in 33 patients with myelomeningocele, aged from 4 to 17 years, was investigated by clinical examination and formal tests of co-ordination and dexterity. The average score for hand function was 59% of normal and only two children had clinically normal upper limbs. Twenty-eight patients (85%) had cerebellar ataxia, either alone or combined with other abnormal signs, most commonly upper motor neuron lesions. Hand function was significantly better in children of 11 years and older, in children under 11 with milder degrees of hydrocephalus, and in the younger children who were right-handed. Function was not shown to be better in those with lesions lower in the spine, nor in those with stable spines as has been previously reported. When co-ordination of the upper limb, manual dexterity and simultaneous movements of both arms were examined separately, these three were affected equally. Some abnormalities of hand function could be overcome by encouraging affected children to sit up and to practise skillful use of their hands as early in life as possible. PMID- 3980540 TI - Myoelectric training methods for the preschool child with congenital below-elbow amputation. A comparison of two training programmes. AB - The Ontario Crippled Children's Centre has completed a two-year research project designed to develop effective strategies for training the preschool child to use a myoelectric prosthesis. Two programmes were developed: one home-based with the parent as primary trainer, and the other Centre-based with a therapist as trainer. Seventeen children were successfully trained and fitted with myoelectric prostheses. Both training programmes appear to be equally effective, proving that informed parents can assume responsibility for the training of their children. Economic implications are self-evident. The functional assessment of the children's skill with the myoelectric prosthesis is very encouraging so far. However, long-term studies are indicated for adequate assessment of the cost effectiveness of early myoelectric fitting. As a result of this study, effective training methods can now be used in routine clinical service; a manual is available to provide guidelines. PMID- 3980541 TI - Electrically powered prostheses for the adult with an upper limb amputation. AB - The value of fitting adult upper limb amputees with electrically powered prostheses is assessed. In a series of 164 amputees, complete or useful acceptance of an electrically powered prosthesis was recorded in 80% of below elbow amputees, 69% of above-elbow amputees and 72% of high level amputees. Patients expressed satisfaction with the combination of comfort, cosmesis and function. Results indicate that, accepting the high cost, an electrically powered prosthesis can provide important function to the upper limb amputee. PMID- 3980542 TI - Crush injury of the carpus. AB - Severe crush injuries affecting the bones of the carpus are rare. We review the nine cases that have previously been described and report four additional cases which we have treated and followed up. All 13 present remarkable similarities, with disruption of the carpal arch through the capitate-hamate articulation distally and the piso-triquetral joint proximally. Three slightly different variations of this pattern of fracture-dislocation are identified. The flexor retinaculum must be involved to allow the displacement which is seen, and there is usually an extensive laceration of the thenar eminence. Treatment by closed reduction is usually successful. Long-term follow-up shows that, in the absence of nerve or vascular damage, the results are surprisingly good. PMID- 3980543 TI - Periosteal chondroma of the humerus leading to shortening. A case report. AB - We report a case of periosteal chondroma of the proximal humerus with multiple cartilaginous masses extending around two-thirds of the metaphysial circumference. The humerus was short, presumably because the tumour interfered with growth at the epiphysial plate. PMID- 3980544 TI - The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. AB - Excellent results can be achieved by plating fractures of the shaft of the humerus in patients with multiple injuries. This helps in nursing care and in the management of other injuries. In 38 patients admitted to a regional trauma centre, 39 humeral shaft fractures were plated. There were 27 men and 11 women, with an average age of 31.5 years. Fourteen of the humeral fractures were compound and 20 had significant comminution; 23 were fixed by a plate on the day of admission and all 39 by the twentieth day. Follow-up of 34 fractures showed that all had united, 33 primarily. All patients but one had a fully functional shoulder and no patient with a fractured humerus alone had lost any elbow movement. Complications were rare--one case each of non-union, fixation failure and infection. No permanent nerve injuries were produced at operation. The plating of fractures of the humerus in these circumstances has been shown to produce excellent results and has a place in the management of the patient with multiple injuries. PMID- 3980545 TI - A new injury of the distal radio-ulnar joint. AB - A case of locked hypersupination of the distal radio-ulnar joint is described in which the ulnar displacement was purely rotational rather than volar. The mechanism of injury is discussed in the light of cadaveric dissections which reproduced the injury. PMID- 3980546 TI - Spontaneous healing of aneurysmal bone cysts. A report of two cases. AB - Two cases of aneurysmal bone cyst in the pelvis which healed spontaneously are described. Spontaneous regression of aneurysmal bone cysts has not previously been well documented. Our experience with these two cases suggests that radical intervention is not always necessary. PMID- 3980547 TI - The use of Dexon as a replacement for the calcaneal tendon in sheep. AB - We have studied the use of filamentous polyglycolic acid (Dexon) for the induction of neotendon in the calcaneal tendon of sheep. Uniformly good results were obtained, with the formation of a thick neotendon. However, in a control group the power of spontaneous regeneration of the tendon was studied; it was found that, provided overlengthening of the gap was prevented, an equally good tendon resulted. It is concluded that this particular model is not an appropriate one for testing neotendon induction, despite its use for this purpose in the past. The favourable results of using filamentous polyglycolic acid as a tendon replacement suggest that it should be further investigated (in a more suitable model) since it may well have useful clinical applications. PMID- 3980548 TI - [Plain films in supero-inferior ventricles]. AB - Chest radiographs of 11 patients with supero-inferior ventricles proven by echocardiography and angiocardiography are presented. The main feature is the modified configuration of the left heart contour. Even if not specific, this sign is encountered frequently (72%) and may suggest the diagnosis. PMID- 3980549 TI - Extraperitoneal gas: compartmental localization and identification of source. AB - We evaluated the plain films of the abdomen and chest in 24 patients with documented extraperitoneal gas collections. Compartmental localization of the extraperitoneal ectopic gas in these patients was as follows: the anterior pararenal space in 10 patients, the perirenal space in five and the posterior pararenal space in 15. In six of these 24 patients, the extraperitoneal gas was present in two compartments. The extraperitoneal gas collection resulted from perforation of the retroperitoneally located alimentary tract in 11, necrotizing pancreatitis in five, gas-producing infection in four and from extension of extra alveolar air in three patients. Air insufflation of the scrotum was the cause of the extraperitoneal gas in another patient. PMID- 3980550 TI - Etiology and method of radiologic assessment of male urinary incontinence. AB - Urinary incontinence presenting after iatrogenic or other trauma to the urethral sphincters is a distressing symptom for the patient and often a troublesome problem for a surgeon. Dynamic retrograde urethrography and voiding cystourethrography can greatly assist the urologist in determining the extent of the damage to the sphincters and thence selecting the appropriate treatment. We outline a method of urethrography for the assessment of male urinary incontinence, not previously described in the radiologic literature, to be used as a radiologic adjunct to clinical and urodynamic assessment. PMID- 3980551 TI - CT findings in normal and dislocating shoulders. AB - Computed tomographic (CT) scans of the shoulders of 10 normal individuals and six patients with a history of recent or recurrent shoulder dislocation were reviewed. In normal individuals, the surface of the glenoid was smooth and was always within 10 degrees of being perpendicular to the body of the scapula. As scans progressed from cephalad to caudad, the glenoid surface twisted and faced more anteriorly. The center of the humeral head always projected within the central one-third of the glenoid fossa. In the patients with dislocations, CT scans depicted a variety of lesions, including: bony abnormalities of the glenoid surface (fragmentation, fracture, irregularity) in three patients; abnormal glenoid-scapular angles in two; loose bodies in two; subtle subluxation, coracoid fracture, cystic humeral defect, and soft-tissue calcification in one patient each. Scans without intra-articular contrast could not demonstrate capsular or labral abnormalities. CT images are helpful in the pre- and postoperative assessment of some patients with shoulder dislocation. PMID- 3980552 TI - Retained lead shot in the appendix. AB - Sixty-two patients with retained lead shot in their appendices, discovered during routine radiographic studies, were followed for periods ranging from two months to 13 years. The number of lead shot in the appendices varied from one to over 200. Twenty patients who had barium studies showed no evidence of luminal obstruction of their appendices. Eight patients who had appendectomies showed no evidence of appendicitis on tissue examination. None of the other patients developed any clinical evidence of appendicitis or lead poisoning. It is concluded that no causal relationship exists between retention of lead shot, their number, the duration of their presence in the appendix, and appendicitis. PMID- 3980553 TI - The Montgomery tracheal cannula: radiological assessment. AB - The Montgomery silicone tracheal cannula is a relatively new tracheal airway device used in specific clinical situations including obstructive sleep-apnea in place of a conventional tracheostomy tube. The position of the cannula was evaluated in four patients by conventional or xeroradiographic lateral views of the neck. Improper positioning resulting in respiratory difficulty was detected in one patient. Lateral tomography was found to be helpful in visualizing the cannula in an obese patient. PMID- 3980554 TI - Statement from the 1984 Stockholm meeting of the International Commission on Radiological Protection. PMID- 3980555 TI - Bilateral adrenal hemorrhage associated with prior steroid use: CT diagnosis. AB - We report an adult man who developed clinical signs suggestive of septic shock postoperatively. An abdominal computed tomographic (CT) scan was obtained to look for a possible source of infection prior to repeat surgery. The CT scan revealed bilateral homogeneously enlarged hyperdense adrenal glands interpreted as representing adrenal hemorrhage. A diagnosis of acute adrenal insufficiency was suggested by the radiologist and appropriate therapy instituted. The adrenal hemorrhage was felt to be secondary to surgical stress in a patient with marginal adrenal function because of prior glucocorticoid use. The clinical features, etiologies and CT findings of adrenal hemorrhage and insufficiency in an adult are described. PMID- 3980556 TI - Broncho-gastric tube fistula as a complication of esophageal replacement. AB - Respiratory symptoms are a known complication of esophageal replacement by a gastric tube, and are usually due to aspiration secondary to a stricture. We report here a patient who developed a long standing broncho-gastric tube fistula as the underlying cause of severe respiratory symptoms and an unusual complication of this kind of surgery. This fistula was unsuspected for many years as it could not be demonstrated by the usual barium examinations. PMID- 3980557 TI - Benign collagenous nodule of the pleura associated with pleural plaques. AB - We describe the radiographic, gross morphologic and microscopic appearance of a pleural collagenous nodule presenting as a "solitary nodule." We believe that this lesion is within the spectrum of "pleural plaques," an associated condition present in our patient who had a history of potential asbestos exposure. Awareness of this probably rare variant of a common abnormality may obviate the need for a diagnostic thoracotomy in certain circumstances. PMID- 3980558 TI - Cervical facet joint arthrography. AB - We describe a technique for cervical facet joint arthrography; a posterior approach is used. The patient is positioned prone, the neck flexed maximally, and the head turned 60-90 degrees opposite to the side of injection. The x-ray tube is angled cephalad in order to obtain a true tangent to the facet joint. The needle is inserted using fluoroscopic control in a direction parallel to the x ray beam. Before the therapeutic infiltration, the intraarticular position of the needle is confirmed by injecting 0.3 ml of contrast medium. PMID- 3980559 TI - An enzymatic differential assay for urinary diamines, spermidine, and spermine. AB - Subsequent to the hydrolysis of urinary conjugated amines by heating with hydrochloric acid, free amines were isolated by cation-exchange chromatography. SPD and SPM in an aliquot of amine extract were first oxidized by PAO from Penicillium chrysogenum, producing PUT and hydrogen peroxide. DIAs, which consist of the initially present DIAs plus PUT produced by PAO, were subsequently oxidized by PUO from Micrococcus rubens, producing hydrogen peroxide. In an another aliquot of the amine extract DIAs and SPD were oxidized by PUO, producing hydrogen peroxide. Quinone dye, derived from hydrogen peroxide generated in each end-point reaction, was measured spectrophotometrically at 555 nm, and the amounts of the respective amines in urine were calculated. Significantly elevated levels of DIA, SPD, SPM, and an elevated DIA to SPD ratio were found in urine from 46 cancer patients, as compared to 34 normal control subjects. An increase in DIA and the ratio of DIA to SPD was found at clinical tumor stage I of the alimentary tract. The levels of DIA remained fairly constant and the ratio of DIA to SPD was consistently decreased with advancing clinical tumor stages. In patients who had undergone curative resection, there were greater decreasing rates (80% of cases for DIA and 80% for SPD) than in patients who had undergone noncurative resection (45.5% for DIA and 36.4% for SPD). PMID- 3980560 TI - Assay for the determination of human carcinoma cells in circulating blood. AB - Methods have been developed in an in vitro system (1) of assessing the number of disseminated tumor cells in peripheral blood and (2) of enriching tumor cells from peripheral blood samples for further characterization. Cells from three human carcinoma lines (E 14, ChaGo, and LEDWiDr) were mixed with leukocytes from normal individuals in various ratios. The proportions of tumor cells were determined by a quantitative assay using 3H-thymidine, 3H-leucine, and 3H galactose incorporation. Determination of tumor cell proportions with this method was most accurate in the range of 5 X 10(4) to 5 X 10(3) tumor cells mixed with a constant number (5 X 10(5] of lymphocytes. It was possible to separate 75Se labeled tumor cells from 51Cr-labeled blood leukocytes by centrifugation in isopyknic Percoll density gradients. These cells were mixed at different ratios and subjected to Percoll gradient centrifugation. By this approach as few as 5 X 10(3) tumor cells could by identified in the presence of 5 X 10(7) leukocytes, representing a ratio of 1: 10,000. Percoll centrifugation did not damage the tumor cells. In blood cells from two lung cancer patients with lung metastases the incorporation of 3H-thymidine and 3H-galactose was significantly enhanced compared with that in blood cells from patients with primary lung tumors and in cells from normal individuals. This difference became even more apparent when metabolically-labeled blood cells were subsequently separated by Percoll gradient centrifugation. PMID- 3980561 TI - Survival of human bone marrow cells after in vitro treatment with 12 anticancer drugs and implications for tumor drug sensitivity assays. AB - We investigated the responsiveness of human normal granulocyte-macrophage colony forming units in culture (GM-CFUC) continuously exposed in vitro to 1 of 12 anticancer drugs. All drugs except bleomycin showed a simple negative exponential dose-survival curve. The in vitro toxicity of drugs in GM-CFUC did not always correlate with the relative myelosuppressive potency observed in vivo. In addition, tumor specimens from 38 patients mainly with ovarian cancer were cultured in a human tumor colony-forming assay and continuously exposed to drugs at low, intermediate, and high concentrations capable of killing 40%, 78%, and 99% of GM-CFUC, respectively. The most active drugs were cis-platinum, velban, 5 fluorouracil, and 5-fluoro-ara-AMP. Dose-survival curves of bone marrow progenitor cells may serve as an in vitro reference system for selecting appropriate drug concentrations of myelosuppressive drugs in drug-sensitivity assays of human tumors. PMID- 3980562 TI - Fecal skatole and indole and breath methane and hydrogen in patients with large bowel polyps or cancer. AB - The object of this study was to explore the use of fecal skatole and indole and breath methane and hydrogen as metabolic markers of the anaerobic colonic flora in patients with unresected large bowel cancer or polyps. Patients with descending or sigmoid colon cancer were more likely to be breath methane excretors than control subjects, patients with proximal colon cancer, and patients with rectal cancer. Control subjects excreting breath methane excreted less fecal skatole than breath methane excretors in the following groups: patients with adenomatous polyps, all patients with colorectal cancer, patients with proximal colon cancer, patients with descending and sigmoid colon cancer, and patients with rectal cancer. These data suggest that fecal skatole excretion equal to or greater than 100 micrograms/g feces might be useful to discriminate colorectal cancer patients from control subjects. Twenty-nine percent (8 of 28) of the cancer patients had both "high" skatole levels and breath methane excretion compared with only 2% (1 of 41) of the control subjects (P less than 0.01). PMID- 3980563 TI - The analysis of mononuclear cell infiltrations in colorectal adenocarcinoma. AB - Mononuclear cell (MNC) populations in tissue specimens from 11 colorectal adenocarcinomas and 1 mucinous adenocarcinoma were analyzed, applying different monoclonal antibodies (MoAB). Tumor epithelium could be characterized by MoAB VEP9, predominantly binding to mucus secreted by the tumor cells. In approximately 30%-50%, the tumor epithelium also reacted in a patchy pattern with the MoABs OKT10 and OKIa, which define in the peripheral blood activated and HLA DR expressing cells. T-lymphocytes, as defined by the MoAB 9.6, and T-lymphocyte subpopulations, as characterized by the MoABs OKT4 and OKT8, were found in the intratumoral stroma and in peritumoral inflammatory areas. Quantifying the relative amounts of mononuclear cell subpopulations in the different stroma compartments, a predominance of OKT10- and OKIa-defined and MoAB-S39-reactive cells was observed. NK cells, as labelled by the MoAB Leu-7, were only demonstrated singularly in different areas of the stroma. Nonlymphoid structures such as vessel walls were shown to express antigens recognized by the MoABs OKIa, OKT10, and Leu-7. In some instances, nerve structures were labelled by the MoABs OKIa, OKT10, S39, and Leu-7. Using semiquantitative analysis, no correlation could be obtained between the intratumoral and peritumoral infiltration with T lymphocytes, T-lymphocyte subpopulations and monocytic cells, and histopathological tumor grading and staging. PMID- 3980564 TI - The prognostic value of age for patients with common epithelial ovarian cancer. AB - For 230 patients with common epithelial ovarian cancer, the prognostic impact of age was examined. Statistical analysis was done using proportional hazard models, 3- and 5-year survival rates and median survival of stratified groups, and the Kaplan-Meier mean. Taking the age-adjusted mortality into account, the prognosis of the older patients was significantly worse. This effect depended primarily on early mortality (survival time less than 2 months). A comparative analysis was made of the prognostic factors age, grade, and stage, taking into account the correlation between factors. This analysis showed that, for our series, age was of lesser prognostic significance than grading, and both of these were of much less prognostic importance than staging. PMID- 3980566 TI - Chylous metrorrhagia. AB - Insufficiency of the cisterna chyli may result in chyloperitoneum, chyluria, chyloedema of the lower limbs and rarest of all--chylous metrorrhagia. One case of the latter complication is fully described and one other briefly mentioned. Both were treated by excision of all the dilated lymphatics around the vena cava and iliac veins with good results. Both cases showed lacunae in the flat bones which may be related to the lymphatic dysplasia. PMID- 3980565 TI - DNA cytophotometry on atypical glands in stomach carcinogenesis of dogs induced by N-methyl-N'-nitro-N-nitrosoguanidine. AB - Microspectrophotometric measurement of the DNA content of cell nuclei was performed on the lesions (including atypical glands) in gastric carcinogenesis of 15 male beagle dogs, which had been induced by N-methyl-N'-nitro-N nitrosoguanidine (MNNG). The distribution patterns of DNA content were classified into three types: normal, subnormal, and abnormal. The histograms of the distribution in normal and regenerative glands were a normal type and subnormal type, respectively, while adenocarcinoma showed an abnormal distribution type. In atypical glands, the distribution patterns in autopsy cases were subnormal and abnormal types. When sequential endoscopic observation of the angulus of the stomach in dog No. 3 was carried out, atypical glands were found in an ulcer in the early stage of MNNG administration and a precancerous lesion in the late stage after termination of MNNG. The atypical glands in the early stage were of the subnormal type, while the atypical glands in the late stage were of the abnormal type. According to the results, these two types-subnormal and abnormal - of distribution of DNA content on the atypical glands may be related to regeneration and subsequent development of cancer, respectively. PMID- 3980567 TI - Albumin kinetics and oedema following reconstructive arterial surgery of the lower limb. AB - Of 26 patients who had either femoro-popliteal or aorto-iliac bypass surgery pitting oedema occurred in the reconstructed limb during the post-operative period in 13. Eleven of 13 patients (84.6%) who had a femoro-popliteal bypass developed oedema compared to 2 of 13 (15.4%) who had aorto-iliac operations (P less than 0.001 chi squared). There was a significant reduction in the serum concentration of total protein and the albumin fraction after operation in both groups of patients (P less than 0.01). The concentration of protein and albumin remained lower than the pre-operative values until the end of the study period but the mean values did not at any stage fall below the lower limit of the normal range. Albumin labelled with I125 was used to investigate changes in the albumin content of the reconstructed limbs. Following femoro-popliteal bypass there was a three fold increase in I125 albumin compared to the non-operated limbs and this persisted to the end of the study period (P less than 0.001). After aorto-iliac surgery there was only a small transient accumulation of I125 albumin in the legs compared to the pre-operative value (P less than 0.02). In both groups of patients large accumulations of albumin were associated with the presence of pitting oedema. It was concluded that altered albumin kinetics play an important part in the development of post-reconstruction oedema. The possible mechanisms involved are discussed together with the practical implications of the results. PMID- 3980568 TI - The helix filter: a new vena caval filter for the prevention of pulmonary embolism. AB - The helix caval filter is a continuous band spiral composed of a highly elastic metal alloy. A vertical double-helix coil fixes the filter in the infrarenal vena cava by elastic expansion while a watch spring type horizontal coil works as the filtering element. The diameter of the filter can be reduced by torsion from 32 to 7 mm. Transvenous implantation was performed under fluoroscopy using a newly developed instrument featuring intraoperative angiographic control, high flexibility, a guidance system, and a well-controlled release mechanism. The filter and the implantation technique were tested in a circulation system and in 10 dogs and 4 calves (follow-up 3-91 days). In addition, two filters were released intentionally into the right atrium of a dog and a calf. Flow resistance of the filter is negligible up to more than 10 1/min. Thrombi larger than 3.5 mm were filtered out reliably. Lethal complications, filter migrations or perforations did not occur in animal experiments. Filter coils which are in contact with the vessel wall become firmly incorporated within 3 to 4 weeks. The patency rate of the vena cava was 80% (8/10) for dogs and 100% (4/4) for calves. Implantations in the right atrium did not cause any symptoms. The filter's design allows fixation without hooks or spikes and consequently makes transvenous extraction possible up to 7-10 days after implantation. Comparable clinical results could extend the indications for caval filter implantation, and the decision which is still difficult today could be made easier. PMID- 3980569 TI - Screening for the potential pulmonary embolism victim. AB - The venous hemodynamics of 134 legs were evaluated using a bilateral impedance plethysmograph. Calf venous outflow following the release of proximal occluding cuffs and calf volume changes with ventilation were compared with the results of venography. We found that a two-second outflow of at least 65% indicated a patent deep venous system while an outflow of 50% or less indicated an obstruction of the proximal deep venous system. With outflow between 50% and 65%, a ventilatory wave height greater than 3 mm ruled out proximal deep venous obstruction while a height of 3 mm or less was not diagnostic. These two criteria yielded an accuracy of 92% with no false-negative results and a false-positive rate of only 10%. Thus, this technique can accurately rule out proximal deep venous obstruction and give the clinician considerable confidence in initiating anticoagulant therapy on those suspected cases with positive studies. PMID- 3980570 TI - Temporary arteriovenous fistula for venous reconstruction using synthetic graft: a clinical and experimental investigation. AB - This report discusses venous reconstructive surgery combined with a temporary distal arteriovenous fistula creation for ilio-femoral vein obstruction. One patient who had long standing, high degree edema of the left lower extremity due to postphlebitic syndrome and four patients who had acute occlusion of the iliac vein were treated by means of extra-anatomical femoro-femoral vein bypass grafting combined with temporary distal femoro-saphenous arteriovenous (a-v) fistula creation. An expanded polytetrafluoroethylene (EPTFE) graft was selected for this procedure instead of a cross-over saphenous vein. The surgically created a-v fistula was effective in keeping the implanted grafts patent for a long time in three out of the five patients. In animal experiments, the bilateral iliac veins of mongrel dogs were replaced with several kinds of synthetic graft. Femoro femoral a-v fistulae were made only on the left side. In 26 animals, 84.6% of the synthetic grafts on the a-v fistula side were patent, whereas only 11.5% of the grafts on the control side were patent. This investigation clearly demonstrates that the increased blood flow velocity through the created distal a-v fistula preserved the patency of synthetic vein grafts. PMID- 3980571 TI - Failure of arteriovenous fistulas at distal tibial bypass anastomotic sites. AB - Arteriovenous fistula formation has been advocated to increase the outflow for tibial and peroneal distal bypass grafts. Between January, 1981 and September, 1981, twenty-seven patients underwent thirty femoral to distal tibial or peroneal artery bypass procedures with creation of an arteriovenous fistula at the site of the distal anastomosis. Limb salvage was the primary indication for surgery in 97% of this severely ischemic group, with a mean ankle pressure index of 0.32. Despite high flow rates averaging 260 cc/minute and an initial patency rate of 97%, there were only two fistulas patent in intact limbs at the conclusion of the initial eight month follow-up period with one additional occlusion at 16 months. Limb salvage to the present (July 1983) was achieved in only six cases. In the patients with limb salvage, three bypass grafts remain patent despite fistula occlusion, two patients have occlusion of both graft and fistula but no rest pain, and a single patient has maintained both graft and fistula patency for 23 months. Creation of an arteriovenous fistula at the distal anastomotic site of tibial bypass procedures augments graft flow in the immediate post-op period; but, has very low long term patency rates and is not beneficial to graft patency or effectiveness. PMID- 3980572 TI - Radiographic anatomy of the extracranial carotid artery. AB - Only 55% of common carotid arteries bifurcate in the neck at the classically described level of C3 vertebra or C3/4 interspace. Others bifurcate as high as C2/3 interspace or as low as C5/6. Eighty-five percent of bifurcations occur at the same height as that on the contralateral side. Even if asymmetry occurs, it is not greater in magnitude than the height of one cervical vertebra. Atheroma does not appear to be associated with any particular bifurcation position. Abnormally curved or kinked morphology of the extracranial internal carotid occurs in 6% of angiograms. This feature also has no specific association with atheroma. PMID- 3980573 TI - Hemopneumothorax: complication of tunneler use in axillofemoral bypass. AB - Two cases of accidental entrance of the thorax with a vascular tunneler are reported. Passage of this instrument when performing axillofemoral bypass is probably safer when done in a cephalad-to-caudad direction. A counterincision at the costal margin may be helpful in avoiding the complication, especially when the tunneler is passed from the groin. PMID- 3980574 TI - Treatment of peripheral congenital arterio-venous fistulas. AB - The authors describe their experience in the treatment of peripheral congenital A V fistulas in 64 cases. Different surgical procedures (skeletation, "en bloc resection") have been performed in 19 patients, embolization in 15 patients. The need for a more radical and definitive procedure has induced the authors, in a recent series of 6 patients, to associate embolization and surgical therapy in the same operative session. The results are encouraging. The technique is reported. PMID- 3980575 TI - Tetralogy of Fallot: to patch or not to patch? AB - Angiograms of 11 patients with Tetralogy of Fallot were reviewed before and after total repair, and analyzed with respect to growth of the pulmonary valve annulus. At the operation none of the patients was more than 5-years-old, none received a transannular patch and all were asymptomatic at the last visit. The radiologic diameter of the pulmonary valve annulus was compared to the descending thoracic aorta at the level of the diaphragm. Preoperative ratio averaged 1.09 +/- 0.22 and increased postoperatively to 1.35 +/- 0.20 (p less than 0.02). A "catch-up" growth of small annuli could be demonstrated. PMID- 3980576 TI - Three distinct distributions of F-actin occur during the divisions of polar surface caps to produce pole cells in Drosophila embryos. AB - The F-actin distribution was studied during pole cell formation in Drosophila embryos using the phalloidin derivative rhodaminyl-lysine-phallotoxin. Nuclei were also stained with 4'-6 diamidine-2-phenylindole dihydrochloride to correlate the pattern seen with the nuclear cycle. The precursors of the pole cells, the polar surface caps, were found to have an F-actin-rich cortex distinct from that of the rest of the embryo surface and an interior cytoplasm that was less intensely stained but brighter than the cytoplasm deeper in the embryo. They were found to divide once without forming true cells and then a second time when cells formed as a result of a meridional and a basal cleavage. Three distinct distributions of the cortical F-actin have been identified during these cleavages. It is concluded that the first division, which cleaves the polar caps but does not separate them from the embryo, involves very different processes from those that lead to the formation of the pole cells. A contractile-ring type of F-actin organization may not be present during the first cleavage but is suggested to occur during the second. PMID- 3980577 TI - Site-specific inhibition of myosin-mediated motility in vitro by monoclonal antibodies. AB - Monoclonal antibodies directed against seven different sites on Dictyostelium myosin (Peltz, G., J. A. Spudich, and P. Parham, 1985, J. Cell Biol., 100: 1016 1023) were tested for their ability to inhibit movement of myosin in vitro, using the Nitella-based myosin-mediated bead movement assay (Sheetz, M. P., R. Chasan, and J. A. Spudich, 1984, J. Cell Biol., 99: 1867-1871). To complement this functional assay, we located the binding sites of these antibodies by electron microscopy, using the rotary shadowing technique. One antibody bound to the 18,000-dalton light chain and inhibited movement completely. All of the remaining antibodies bound to various positions along the rod portion of the myosin molecule, which is approximately 1,800 A long. Antibodies that bound to the rod about 470, 680, and 1400 A from the head-tail junction did not alter myosin movement. One antibody appeared to bind very close to the head-tail junction and to inhibit movement 50%. Surprisingly, three antibodies that bound about 1,200 A from the head-tail junction inhibited movement completely. This inhibition did not depend on using intact IgG, since Fab' fragments had the same effect. PMID- 3980578 TI - Identification of link proteins in canine synovial cell cultures and canine articular cartilage. AB - Link proteins are glycoproteins in cartilage that are involved in the stabilization of aggregates of proteoglycans and hyaluronic acid. We have identified link proteins in synovial cell cultures form normal canine synovium using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, immunofluorescence, and immunolocation with specific antibodies by electrophoretic transfer. We have also found evidence for the synthesis of link proteins in these cultures by fluorography of radiolabeled synovial cell extracts. We have identified a 70,000 mol-wt protein in canine synovial cell culture extracts that has antigenic cross-reactivity with the 48,000-mol-wt link protein. Three link proteins were identified in normal canine articular cartilage. These results indicate that link proteins are more widely distributed in connective tissues than previously recognized and may have biological functions other than aggregate stabilization. PMID- 3980579 TI - Evidence for a tubulin-containing lipid-protein structural complex in ciliary membranes. AB - The proteins and lipids of the scallop gill ciliary membrane may be reassociated through several cycles of detergent solubilization, detergent removal, and freeze thaw, without significant change in overall protein composition. Membrane proteins and lipids reassociate to form vesicles of uniform, discrete density classes under a variety of reassociation conditions involving detergent removal and concentration. Freed of the solubilizing detergent during equilibrium centrifugation, a protein-lipid complex equilibrates to a position on a sucrose density gradient characteristic of the original membrane density. When axonemal tubulin is solubilized by dialysis, mixed with 2:1 lecithin/cholesterol dissolved in Nonidet P-40, freed of detergent, and reconstituted by freeze-thaw, vesicles of a density essentially equal to pure lipid result. If the lipid fraction is derived through chloroform-methanol extraction of natural ciliary membranes, a moderate increase in density occurs upon reconstitution, but the protein is adsorbed and most is removed by a simple low ionic strength wash, in contrast to vesicles reconstituted from membrane proteins where even high salt extraction causes no loss of protein. The proteins of the ciliary membrane dissolve with constant composition, regardless of the type, concentration, or efficiency of detergent. Analytical ultracentrifugation demonstrates that monodisperse mixed micelles form at high detergent concentrations, but that membranes are dispersed to large sedimentable aggregates by Nonidet P-40 even at several times the critical micelle concentration, which suggests reasons for the efficacy of certain detergent for the production of ATP-reactivatable cell models. In extracts freed of detergent, structured polydisperse particles, but not membrane vesicles, are seen in negative staining; vesicles form upon concentration of the extract. Membrane tubulin is not in a form that will freely undergo electrophoresis, even in the presence of detergent above the critical micelle concentration. All chromatographic attempts to separate membrane tubulin from other membrane proteins have failed; lipid and protein are excluded together by gel filtration in the presence of high concentrations of detergent. These observations support the idea that a relatively stable lipid-protein complex exists in the ciliary membrane and that in this complex membrane tubulin is tightly associated with lipids and with a number of other proteins. PMID- 3980580 TI - Structural organization of interphase 3T3 fibroblasts studied by total internal reflection fluorescence microscopy. AB - We studied the laminar organization of 3T3 fibroblast cells growing on glass slides by use of total internal reflection illumination to excite fluorescence emission (TIRF) from labeled molecules and stained cellular compartments that are very close to the cell-substrate contact region. Mitochondria, distant from the contact regions and stained with the water-soluble cationic dye, dil-C3-(3), fluoresced only as the glass/cytoplasm critical angle was approached. A similar result was obtained when the nuclei were stained with Hoechst dye 33342. From this measured angle a cytoplasmic refractive index in the range 1.358-1.374 was computed. The plasma membrane of 3T3 cells was stained with dil-C18-(3), and the cytoplasmic compartment was stained with fluoresceinyl-dextran (FTC-dextran) or with carboxyfluorescein. We have demonstrated a high degree of correspondence between the low-reflectance zones in the reflection interference image of a live cell and the TIRF images of both the plasma membrane and cytoplasmic compartment. TIRF photometry of selected contact regions of cells provided data from which the absolute separation of cell and substrate was computed. From a population of 3T3 cells microinjected with fluorescein-labeled actin, motile and adherent interphase cells were selected for study. For adherent cells, which displayed fluorescent stress fibers, the TIRF image was composed of intense patches and less intense regions that corresponded, respectively, to the focal contact and close-contact zones of the reflection-interference image. The intense patches corresponded to the endpoints of the stress fibers. Cells of motile morphology, which formed some focal contacts and extensive close-contact zones, gave AF-actin TIRF images of relatively even intensity. Thin lamellar regions of the cytoplasm were found to contain concentrations of actin not significantly different from other close-contact regions of the cell. The major analytical problem of TIRF microscopy is separation of the effects of proximity to substrate, refractive index, and fluorescent probe concentration on the local brightness of the TIRF image. From our results, it appears possible to use TIRF microscopy to measure the proximity of different components of substrate contact regions of cells. PMID- 3980581 TI - Cytochalasin treatment disrupts the endogenous currents associated with cell polarization in fucoid zygotes: studies of the role of F-actin in embryogenesis. AB - We determined the distribution of F-actin in fucoid (Pelvetia, Fucus) embryos with nitrobenzoxadiazole-phallacidin, and studied the effect of cytochalasin upon the endogenous currents associated with cell polarization by using the vibrating probe. F-actin is not localized at the presumptive rhizoid immediately after experimental induction of the polar axis with a light gradient; however, a preferential distribution of F-actin develops at the presumptive rhizoid by the time the position of the polar axis is fixed. F-actin continues to be localized at the tip of the rhizoid after germination, except during cytokinesis, when the furrow is the only brightly staining region of the embryo. Incubation with cytochalasin can result in either an enhanced or a diminished pool of F-actin in the embryonic cortex (see Results). Cytochalasin D (100 micrograms/ml) significantly reduces the inward current at the rhizoid pole (n = 11) after a 2.5 h incubation. This drop is concentration dependent and occurs within approximately 30 min at 100 micrograms/ml and approximately 60 min at 10 micrograms/ml. Cytochalasin treatment eliminates the pulsatile component of the current. Preliminary results suggest that 100 micrograms/ml cytochalasin D prevents development of inward current at the presumptive rhizoid but does not completely delocalize this locus if added after photopolarization. We conclude that microfilaments are required for the establishment and maintenance of the pattern of endogenous currents observed during early embryogenesis. This suggests a new model for axis formation and fixation. PMID- 3980582 TI - Biogenesis of the polymeric IgA receptor in rat hepatocytes. II. Localization of its intracellular forms by cell fractionation studies. AB - In the companion paper (Sztul, E. S., K. E. Howell, and G. E. Palade, J. Cell Biol., 100:1248-1254), we have shown that pulse labeling of hepatic proteins with [35S]cysteine can be obtained in vivo in intact rats. Soluble label clears the plasma in approximately 5 min, and incorporated label reaches peak values in the liver approximately 20 min after injection. In the present study, we show that the 105,000-mol-wt protein (105K), kinetically the earliest intracellular form of secretory component (SC), is the predominant form found, between 5 and 20 min postinjection, in homogeneous rough microsomal fractions. The second kinetically defined form, i.e., 116K, is the predominant species present in relatively homogeneous, light Golgi fractions in which it appears at approximately 15 min, and peaks at approximately 25 min, postinjection. The third kinetically defined form, 120K, is found 30 min after injection as the major SC species (albeit still accompanied by its immediate precursor, 116K), in a sinusoidal plasmalemmal fraction isolated by immunoadsorption to anti-SC-coated Sepharose beads. These findings lead to the following conclusions: (a) SC is synthesized on polysomes attached to the rough endoplasmic reticulum (ER) membrane; (b) it is partially translocated across the ER membrane and core glycosylated co-translationally to give a 105K peptide; (c) 105K moves from the ER to the Golgi complex where it is terminally glycosylated to give the 116K form; (d) the latter moves to the sinusoidal plasmalemma where it appears together with the final mature form, 120K. Kinetic evidence indicates that the vesicular carriers involved in the transport of SC from the Golgi complex to the sinusoidal plasmalemma, and from the latter to the biliary front of the hepatocytes, are present in a Golgi heavy fraction and a crude carrier vesicle fraction from which they remain to be isolated, purified, and characterized. PMID- 3980583 TI - Cellular uptake and intracellular localization of benzo(a)pyrene by digital fluorescence imaging microscopy. AB - Uptake of benzo(a)pyrene by living cultured cells has been visualized in real time using digital fluorescence-imaging microscopy. Benzo(a)pyrene was noncovalently associated with lipoproteins, as a physiologic mode of presentation of the carcinogen to cells. When incubated with either human fibroblasts or murine P388D1 macrophages, benzo(a)pyrene uptake occurred in the absence of endocytosis, with a halftime of approximately 2 min, irrespective of the identity of the delivery vehicles, which were high density lipoproteins, low density lipoproteins, very low density lipoproteins, and 1-palmitoyl-2 oleoylphosphatidylcholine single-walled vesicles. Thus, cellular uptake of benzo(a)pyrene from these hydrophobic donors occurs by spontaneous transfer through the aqueous phase. Moreover, the rate constant for uptake, the extent of uptake, and the intracellular localization of benzo(a)pyrene were identical for both living and fixed cells. Similar rate constants for benzo(a)pyrene efflux from cells to extracellular lipoproteins suggests the involvement of the plasma membrane in the rate-limiting step. The intracellular location of benzo(a)pyrene at equilibrium was coincident with a fluorescent cholesterol analog, N-(7 nitrobenz-2-oxa-1,3-diazole)-23,24-dinor-5-cholen-22-amine-3 beta-ol. Benzo(a)pyrene did not accumulate in acidic compartments, based on acridine orange fluorescence, or in mitochondria, based on rhodamine-123 fluorescence. When the intracellular lipid volume of isolated mouse peritoneal macrophages was increased by prior incubation of these cells with either acetylated low density lipoproteins or with very low density lipoproteins from a hypertriglyceridemic individual, cellular accumulation of benzo(a)pyrene increased proportionately with increased [1-14C]oleate incorporation into cellular triglycerides and cholesteryl esters. Thus, benzo(a)pyrene uptake by cells is a simple partitioning phenomenon, controlled by the relative lipid volumes of extracellular donor lipoproteins and of cells, and does not involve lipoprotein endocytosis as an obligatory step. PMID- 3980585 TI - Endogenous metabolism by sperm in response to altered cellular ATP requirements. AB - A quantitative description of the relative importance of endogenous metabolism to overall ATP production has not been established for mammalian cells. We report herein results of experiments using sperm (selected because of their simple metabolic potential and absence of biosynthetic pathways) and calorimetry (chosen because it serves as a general monitor of metabolism) to assess the importance of endogenous metabolism to total ATP synthesis under several incubation conditions. In experiments in which sperm were incubated at different temperatures (20 degrees C, 25 degrees C, 30 degrees C or 35 degrees C) and with different substrates (glucose, fructose, lactate, or beta-hydroxybutyrate), endogenous metabolism occurred at a constant rate regardless of the rate of ATP turnover in the cells or the nature of the exogenous substrate available to them. Sperm incubated at 35 degrees C with glycolyzable substrates synthesized more ATP (9 mumol ATP . h-1/10(8) cells) than did sperm incubated with the nonglycolyzable substrate, lactate (6.2 mumol ATP . h-1/10(8) cells). To investigate this substrate-related difference in the rate of ATP synthesis, the motility of sperm incubated at 35 degrees C with glucose or with lactate was determined. The velocities of the sperm incubated with either substrate were identical, indicating that the rates of ATP consumption for support of motility were identical. Most of the additional ATP synthesized by cells with glycolyzable substrates was consumed in the process of substrate cycling of the metabolic intermediates of glucose. PMID- 3980584 TI - An elevated free cytosolic Ca2+ wave follows fertilization in eggs of the frog, Xenopus laevis. AB - The eggs of most or all animals are thought to be activated after fertilization by a transient increase in free cytosolic Ca2+ concentration ([Ca2+]i). We have applied Ca2+-selective microelectrodes to detect such an increase in fertilized eggs of the frog, Xenopus laevis. As observed with an electrode in the animal hemisphere, [Ca2+]i increased from 0.4 to 1.2 microM over the course of 2 min after fertilization, and returned to its original value during the next 10 min. No further changes in [Ca2+]i were detected through the first cleavage division. In eggs impaled with two Ca2+ electrodes, the Ca2+ pulse was observed to travel as a wave from the animal to the vegetal hemisphere, propagating at a rate of approximately 10 microns/s across the animal hemisphere. The apparent delay between the start of the fertilization potential and initiation of the Ca2+ wave at the sperm entry site as approximately 1 min. Through these observations describe only the behavior of subcortical [Ca2+]i, we suggest that our data represent the subcortical extension of the cortical Ca2+ wave thought to trigger cortical granule exocytosis, and we present evidence that both the timing and magnitude of the Ca2+ pulse we observed are consistent with this identity. This first quantification of subcortical [Ca2+]i during fertilization indicates that the Ca2+ transient is available to regulate processes (e.g., protein synthesis) in the subcortical cytosol. PMID- 3980586 TI - Butyrate stimulates fibronectin synthesis in cultured rabbit cornea. AB - To understand corneal wound healing, in which fibronectin plays an important role, we investigated the regulatory mechanism of fibronectin synthesis in cultured rabbit corneal blocks in situ. The amount of fibronectin was determined by enzyme-linked immunosorbent assay. We found that butyrate stimulated fibronectin synthesis in a dose-response fashion, and that butyrate had a greater stimulatory effect than did any of its derivatives examined. This suggests that butyrate stimulates fibronectin synthesis specifically; 8Br-cAMP also stimulated fibronectin synthesis. Additivity of stimulation by butyrate and by 8Br-cAMP was observed at the saturated concentration of each; the present result indicated an independent mechanism of action for these two compounds. PMID- 3980587 TI - Membrane phospholipid asymmetry as a factor in erythrocyte-endothelial cell interactions. AB - The tendency of human erythrocytes to adhere to vascular endothelial cells was assessed as a function of the transbilayer distribution of the phospholipids of the erythrocyte membrane, using erythrocyte ghosts in which transbilayer lipid arrangement was manipulated by varying the conditions under which the ghosts were prepared. By two different assays, ghosts with symmetric lipid bilayers adhered strongly to monolayers of cultured endothelial cells, whereas ghosts with normal asymmetric membranes, like normal erythrocytes, did not. These results provide direct evidence that changes in phospholipid asymmetry can alter the tendency of erythrocytes to adhere to endothelial cells, and therefore imply that transbilayer phospholipid arrangement may influence the behavior of erythrocytes in the circulatory system and may contribute to the formation of microvascular occlusions. PMID- 3980588 TI - The effects of osmotic stress on human platelets. AB - The effect of osmotic stress on human platelets was investigated at 0, 25, and 37 degrees C. The osmolality of the suspending plasma was decreased by adding water or increased by adding sodium chloride or sucrose. After 5 min, isotonicity was restored by dilution with an excess of isotonic phosphate-buffered saline. After centrifugation, the platelets were resuspended in autologous plasma and then incubated for 1 hr at 37 degrees C before assaying the active transport of 5 hydroxytryptamine (5-HT) and the hypotonic stress response. Anisosmotic conditions had a greater effect on the extent of volume reversal in the hypotonic stress test than on 5-HT uptake. At 25 degrees C, only moderate degrees of hypotonicity (0.25 osmol/kg) or hypertonicity (0.59 osmol/kg) were sufficient to depress the hypotonic stress response. In general, platelets tolerated departures from isotonic conditions better at 0 degree C than at the higher temperatures. Furthermore, at 0 and 25 degrees C approximately equiosmolal concentrations of sucrose and sodium chloride depressed the hypotonic stress response to similar extents, but at 37 degrees C high osmolalities (greater than 2 osmol/kg) were tolerated better when the additive was sucrose than when it was sodium chloride. Platelets shrank when subjected to hyperosmotic conditions, but their discoid shape and the peripheral band of microtubules were maintained. PMID- 3980589 TI - Degradation of extracellular matrix by the trophoblastic cells of first-trimester human placentas. AB - First-trimester human placental villi were cultured on 3H-leucine-labeled extracellular matrices isolated from the PF HR9 and PYS-2 cell lines. Both cell lines produced an extracellular matrix that contained basement membrane-specific macromolecules, including type IV collagen, laminin and proteoglycan. Both matrices promoted outgrowth of cells from the villi which, according to morphological criteria, were identified as cytotrophoblastic cells. As the cells migrated from the attachment site, they caused a marked focal dissolution of the matrix which was accompanied by a concomitant release of 3H-labeled material into the media. Approximately half of this material chromatographed near the inclusion volume of Sephadex G-50, indicating that the labeled matrix components had been degraded. This phenomenon was dependent on the age of the placenta. Second trimester placental villi also adhered to the matrix, but no areas of dissolution were formed and no significant amounts of radioactivity were released into the medium. These results suggest that culture of first-trimester human placental villi on extracellular matrices may be useful for the study of some of the early embryonic events leading to human implantation, during which the trophoblastic cells erode the uterine epithelium. PMID- 3980591 TI - [Extra-anatomic ilio- or femoro-femoral bypass]. AB - Twenty-six extra-anatomical by pass operations were performed for iliofemoral arterial lesions (23 crossed, 3 homolateral) due to severe atheroma (22 cases), infection (the 3 homolateral shunt) or iliac aneurysm (1 case). Limb saving was obtained in 73% of patients in whom vitality of limbs was involved. Permeability for crossed by pass procedure was as high as 92% at 1 year follow up. Operative techniques are discussed with emphasis on the need for good iliac artery flow and a sufficient distal vascular bed on the donor side. Indications for operation in this series were mainly poor general condition and/or associated affections (coronary disease in 1 out of 2 cases), but they should be enlarged because of the relative simplicity of the procedure. PMID- 3980590 TI - [Surgical treatment of severe radiation injuries of the small intestine and colon rectum. Apropos of 85 patients surgically-treated at the Gustave-Roussy Institute]. AB - Radiation lesions of the small intestine, colon and rectum were treated surgically in 85 patients between 1970 and 1983. These were serious complications in all cases involving the short-term vital prognosis in patients lacking signs of recurrence of cancer for which they had received radiotherapy. Immediate operative mortality was 26%. Anastomotic digestive fistulae complicated 31% of resection-anastomosis and 29% of internal bypass operations. During the next 2 years the progression of the chronic radiation lesions themselves required repeat operations due to further complications in 19% of patients, with an operative mortality of 33%. Rather than comparing efficacy of resection-anastomosis with that of internal bypass procedures they should be considered as complementary, since they have different indications. Based on the analysis of results and acquired experience, a surgical strategy is proposed for treating complicated radiation lesions of the intestines. PMID- 3980592 TI - [Nonwoven textiles in the operating room]. AB - Non-woven textiles are still not widely used in France, despite the great variety of their presentations. These products are clearly superior to traditional textiles in terms of a bacteriological barrier, which results in a lower rate of post-operative sepsis. It costs the same or less than classical textiles and it reduces the tasks of personnel and administration. Its presently limited used is essentially due to the reticence of surgeons, based on a poor understanding of the products and a psychological barrier which is difficult to overcome. PMID- 3980593 TI - [Spontaneous rupture of the liver in pregnancy. Diagnostic and therapeutic problems]. PMID- 3980595 TI - Attentional priority of the agent in the acquisition of word reference. PMID- 3980594 TI - [The left lateroportal lamina of the pancreas or left retropancreatic lamina]. AB - Findings on 100 cadaver dissections after lymphatic injections of fetuses and infants demonstrated the presence of the left posterior attachment of the pancreas corresponding to the left mesopancreatico-duodeno-umbilical contingent described by Couinaud. In adults, this hand, known initially as the left lateroportal process in no way constitutes a surgical obstacle to excision, but its pathologic role and embryologic significance cannot be disputed. As a result of the article by H. Richelme, the author is in entire agreement with the term left retropancreatic process. PMID- 3980596 TI - The development of locative comprehension in Spanish. PMID- 3980597 TI - Implicit contrast in adjectives vs. nouns: implications for word-learning in preschoolers. PMID- 3980598 TI - Facilitation of early syntax through discourse structure. PMID- 3980599 TI - A naturalistic study of the production of causal connectives by children. PMID- 3980600 TI - The emergence of pragmatic comprehension: a study of children's understanding of sentence-structure cues to given/new information. PMID- 3980601 TI - Towards a theory of definition. PMID- 3980602 TI - Examining relationships between input and language development: some statistical issues. PMID- 3980604 TI - The role of phonetic factors in parent reference. PMID- 3980603 TI - The semantic focus of maternal speech: a comment on Ninio & Bruner (1978). PMID- 3980605 TI - Affix processing strategies and linguistic systems. PMID- 3980606 TI - How the young French child avoids the pre-voicing problem for word-initial voiced stops. PMID- 3980607 TI - The comprehension of semantic relations by two-year-olds: an exploratory study. PMID- 3980608 TI - Acquiring case-marked pronouns in Hebrew: the interaction of linguistic factors. PMID- 3980609 TI - Preschool children's sentence comprehension: strategies with respect to animacy. PMID- 3980610 TI - Spanish prepositions introducing adverbial constructions. PMID- 3980611 TI - Behaviour problems and language abilities at three years and behavioural deviance at eight years. AB - A representative sample of 535 children were followed up from their third to their eighth birthday using measures of language ability and behaviour. At age 8 yr it was found that there were significantly more boys with behavioural deviance than girls, and that children from manual social class backgrounds also showed more behavioural deviance. The only difference between the immigrant and non immigrant children was a less frequent occurrence of neurotic deviance in the immigrant group. It was found that behaviour problems at age 3 yr were strongly related to behavioural deviance at school at age 8 yr, particularly for boys. This medium-term stability in behaviour problems had not been found in previous studies looking at younger children. A low score on a measure of language structure at age 3 yr was found to be related to a high rate of neurotic deviance at age 8 yr even when behaviour at age 3 yr was controlled. The implications of these findings for the early identification and intervention with children at risk for later behaviour deviance are discussed. PMID- 3980612 TI - Maternal caretaking and play with full-term and premature infants. AB - The contribution of past psychological experiences of the mother and medical complications of the infant to differences in caretaking of pre- and full-term infants are examined. Twenty full- and 20 pre-term matched mother-infant dyads were studied during a feed and play 1, 2 and 3 months after the expected date of birth. Full-term infants were more active than pre-terms at 4 weeks only. Mother of pre-terms showed differences in their interactions at all times. Interactions were related to maternal experiences in full-term infants only. Degree of neonatal illness was correlated with behavioral disorganization of premature infants, leading to differences in caretaking style. PMID- 3980613 TI - The influence of family type on children's behaviour and development at five years. AB - Development and behaviour at five years were assessed in children from a national cohort; comparisons were drawn between those living in one-parent families, in step-parent families and with both natural parents. On average, children from one parent families scored worst and children from two-parent families best on tests of behaviour, vocabulary and visuomotor co-ordination. The differences remained significant after allowing for associated influences. The behaviour of children from one-parent families and step-parent families was perceived on average as more 'anti-social' than that of children from two-parent families. Children in one-parent families were seen on average as marginally more 'neurotic' than children in two-parent families. PMID- 3980614 TI - Obsessive-compulsive adolescents and their parents: a psychometric study. AB - The present study examined obsessive personality traits and achievement expectations of parents with an obsessive-compulsive adolescent. The Leyton Obsessional Inventory (LOI) and rating scales of occupational and educational aspirations and expectations were administered to both parents and the adolescent of 12 families with an obsessional adolescent and 10 families having an anxious, nonobsessional son or daughter. The parents' LOI scores were similar in the two groups, though higher than normal adults on the trait and resistance scales. The obsessional adolescents perceived their parents to hold significantly higher career demands for them than the anxious adolescents. PMID- 3980615 TI - Depression in mothers in a multi-ethnic urban industrial municipality in Melbourne. Aetiological factors and effects on infants and preschool children. AB - In a cohort of 99 families with a newborn infant in a multi-ethnic poor socio economic municipality 35 mothers were depressed during the first year. While the clinical manifestations of depression in Australian-born and immigrant mothers were similar, there were differences in some aetiological factors. Immigrant mothers who had recently arrived in Australia, were unable to speak English and did not have a supporting social network had a significantly higher rate of depression. Depressed Australian-born mothers often had unhappy, unstable and insecure childhoods, having been reared in families with marital disruption, violence, alcoholism and desertion. Some also had previous depressive episodes. A strong supporting social network, especially by the father, and also by the extended family and friends, was significant in preventing depression. Behavioural problems in infants and preschool children were more common in families with depressed mothers. PMID- 3980616 TI - Auditory attentional abilities in hyperactive children. AB - Using dichotic monitoring procedures, various aspects of auditory attention were examined in hyperactive children and matched normal controls. Hyperactive children did not show deficits in the ability to sustain attention, although signal detection analysis showed some lowered capacity in both focused and selective attention to targets. Subsamples of learning-disabled and neurologically impaired hyperactive children showed minimal impairment of auditory attentional capacities. It was argued that more evidence concerning task and situational effects is needed before it can be claimed that hyperactive children show attention deficits. PMID- 3980617 TI - Anxiety in the child dental clinic. AB - A study was made of differences between children who had a history of refusing dental treatment in the community and control children, as rated by their parents. History of treatment refusal was found to be associated with a general fear of 'medical' people, intolerance for any pain or discomfort and greater difficulty in approaching novelty or adapting to change. These children were also rated by their parents as being generally more negative in their mood and having greater difficulty in playing with unfamiliar children. The implications of these findings are discussed. PMID- 3980618 TI - Mobile phase effects in reversed-phase chromatography. VII. Dependence of retention on mobile phase composition and column temperature. AB - The relationship between logarithmic retention factor, kappa, in reversed-phase chromatography and operating conditions including mobile phase composition and column temperature is still controversial. Earlier, the following analytical relationship was proposed for use with alkyl benzenes: kappa = A1 phi (1 - Tc/T) + A2/T + A3 where phi is volume fraction organic co-solvent of the hydro-organic mobile phase, T is absolute temperature and A1-A3 are parameters appropriate to the eluite and stationary phase. Insofar as its use had not been tested with polar eluites that are retained by only one mechanism, its description of the retention of 54 polar and apolar eluites was examined and compared to equations with other, usually more complex, relationships between retention and operating conditions. The following four-parameter equation described best most data: kappa = A1 phi (1 - Tc/T) + A2/T + A3 + A4 phi. But neither this nor any other four parameter equation under examination here emerged solely as the best expression for the dependence of retention on the eluent composition and temperature. The average relative errors were 7.8% and 6% with use of the three- and the four parameter equations which were found to be best for a given eluite, respectively. In view of the small decrease in error but significant increase in complexity and in data points with the use of the four-parameter equation, the three-parameter equation is recommended for general use. PMID- 3980619 TI - Confirmation of nivalenol and deoxynivalenol by on-line liquid chromatography mass spectrometry and gas chromatography-mass spectrometry. Comparison of methods. PMID- 3980620 TI - Rapid and sensitive method for the determination of proline by reversed-phase high-performance liquid chromatography with automated pre-column fluorescence derivatization. PMID- 3980621 TI - Determination of synthetic organic colours in lipsticks by thin-layer and high performance liquid chromatography. PMID- 3980622 TI - Stationary phase contributions to retention in high-performance anion-exchange protein chromatography: ligand density and mixed mode effects. AB - Several anion-exchange stationary phases (based on polyethyleneimine-coated silica) were synthesized so as to vary in ligand density and hydrophobicity. These materials were first examined for hemoglobin-binding capacity and then evaluated chromatographically. Protein binding, retention and resolution increased concomitantly with ligand density. Ferritin (molecular weight 440,000) could not be eluted from the more highly-charged surfaces, but was desorbed from a low ligand density support. The above parameters also varied with the hydrophobic character of the stationary phase. Retention and resolution increased as more hydrophobic moieties were added. Data from a non-ionic hemoglobin-binding assay correlated reasonably well with anticipated matrix hydrophobicities. Possible explanations and applications of the observed phenomena are discussed. PMID- 3980623 TI - Studies on residual antibacterials in foods. III. High-performance liquid chromatographic determination of penicillin G in animal tissues using an on-line pre-column concentration and purification system. AB - A simple and reproducible method for the determination of residual penicillin G in edible animal tissues by high-performance liquid chromatography (HPLC) is described. The method consists in an off-line clean-up step using a basic aluminium oxide column and a Sep-Pak C18 cartridge and an on-line pre-column concentration and purification system. The procedure shows good sensitivity and precision. The recoveries from cattle liver, kidney and muscle fortified with 1 microgram/g of sodium penicillin G were 75.0-92.6% and the relative standard deviations were 2.35-4.06%. The detection limit corresponded to 0.05 micrograms/g of sodium penicillin G in animal tissues. PMID- 3980624 TI - Determination of methamphetamine and its metabolites in rat tissues by gas chromatography with a nitrogen-phosphorus detector. AB - A method for the determination of methamphetamine and its metabolites in tissues of the rat receiving methamphetamine was developed using gas chromatography with nitrogen-phosphorus detection. The extraction procedure, volatility of various derivatives, the acylation procedure, mass spectra of various derivatives and the recovery of methamphetamine and its metabolites in rat tissues are reported. The detection limits of pentafluorobenzoyl derivatives of methamphetamine and amphetamine, and heptafluorobutyryl derivatives of p-hydroxymethamphetamine and p hydroxyamphetamine, were ca. 0.1 and 0.15 ng, respectively. This method could be used to determine concentrations as low as 10-15 ng/g of methamphetamine and its metabolites; recoveries from the rat brain, liver and serum were 94-106, 103-115 and 94-96%, respectively. PMID- 3980625 TI - Separation of hemoglobin variants by ion-exchange chromatography on Monobead resins. AB - Our studies on the separation of hemoglobin variants using Monobead ion exchangers show that these ion exchangers will resolve variants that heretofore could not be resolved. Procedures with these ion exchangers, therefore, extend our ability to detect hemoglobinopathies. Since it is also important to study the physicochemical properties of variants, their isolation is of critical importance to the researcher. The methods described in this report enable variants to be isolated in quantitative amounts so that such studies can be performed. Most isolations can be accomplished within 1 h, under mild conditions with aqueous buffers. Elution gradients can be changed conveniently to optimize resolution of most variants. These methods should serve as a valuable adjunct in studying the structure-function relationship of hemoglobin and other proteins. PMID- 3980626 TI - Affinity chromatography of B6-vitamin-dependent enzymes: purification of pig heart branched-chain amino acid transaminase. AB - Pig-heart branched-chain amino acid transaminase (EC 2.6.1.42) was purified to near homogeneity with a yield of 27%. A prepurification was performed by heat treatment, gel chromatography and DEAE-Sepharose methods. For the final step, several affinity gels were tested and the one containing cycloserine coupled to CNBr-activated Sepharose 4B was selected. This effected an additional five-fold purification with a yield of 60%. The present affinity results are compared with corresponding studies with other aminotransferases in an attempt to find possible universal techniques for their purification. PMID- 3980627 TI - High-performance thin-layer chromatography assay for epoxide hydrolase activity and the determination of phenoxypropane-1,2-diols. AB - A simple, rapid and sensitive high-performance thin-layer chromatographic assay for the determination of epoxide hydrolase activity in rat liver homogenates is described. It is extended to the determination of a series of phenoxypropane-1,2 diols. The hydrolase assay has the advantages of using a readily available substrate, 2,3-epoxypropyl 4-methoxyphenyl ether, of multiple sample application, and of the simultaneous determination of reaction product (diol) as well as unchanged substrate (epoxide). The use of an internal standard, 4-nitroanisole, results in high sensitivity and good reproducibility of the proposed method. The limit of diol detection is 20 pmol. PMID- 3980628 TI - Inter-laboratory study on the separation of cinchona alkaloids by high performance liquid chromatography. PMID- 3980629 TI - Separation of acebutolol and diacetolol diastereomers by reversed-phase high performance liquid chromatography. PMID- 3980630 TI - Determination of penicillamine in encapsulated formulations by high-performance liquid chromatography. PMID- 3980631 TI - Use of microbore high-performance liquid chromatography for the determination of caffeine, theobromine and theophylline in cocoa. PMID- 3980632 TI - Simultaneous analysis of thiamin and riboflavin in foods by high-performance liquid chromatography. PMID- 3980633 TI - Sepharose derivatives containing citric acid as affinity ligand. Purification of fumarase. AB - Six Sepharose derivatives, in which citrate was immobilized via methylene carbons, were prepared by coupling of the alpha- and beta-isomers of citrylpolymethylenediamine to Sepharose. The purification of fumarase from pig heart was dependent on the length of the spacer arm, but not on the isomeric configuration of the immobilized citrate. Gels having six methylene carbons had the largest adsorption capacity for the enzyme and therefore were the most suitable for use in affinity columns for its purification. Affinity chromatography with these gels was followed by hydrophobic interaction chromatography on an octamethylenediamine-Sepharose column. PMID- 3980634 TI - Subunits of bovine lutropin. Hormonal and immunological activity after separation with reversed-phase high-performance liquid chromatography. AB - By means of reversed-phase high-performance liquid chromatography, we have fractionated bovine lutropin (LH) standard preparations. The highly purified NIAMDD-bLH-4 was fractionated into two components, while the less pure NIH-LH-B9 revealed three distinct peaks. The eluted material was further characterized by in vitro bioassay and by homologous radioimmunoassay for bovine LH, ovine LH alpha and ovine LH-beta subunits. The material with the shortest retention time possessed almost no LH-activity and showed a displacement curve nearly identical with that of the ovine LH-alpha subunit. The material corresponding to the second peak exhibited 6% of the original LH-activity, and its immunoreactivity was equal to that of the ovine LH-beta subunit. Furthermore, the fractions supposed to contain the alpha and the beta subunits were rechromatographed and their aminoacid contents analyzed. The results show close similarities between the rechromatographed fractions and the pure subunits. PMID- 3980635 TI - Rapid analysis of starch, amylose and amylopectin by high-performance size exclusion chromatography. AB - Starch components, amylose and amylopectin, were analyzed by high-performance size-exclusion chromatography. These two-components were separated using a two column system (E-Linear and E-1000) and dimethyl sulphoxide as the mobile phase. The void volume (V0 = 2.22 ml) was measured using tobacco mosaic virus. Column calibration was accomplished with dextrans of known average molecular weight (Mw range = 10,100-2,000,000). The elution volume of amylopectin (Ve = 2.5 ml) indicated that this starch component was fractionated on the column system despite its very large molecular size. Standard curves were prepared from various mixtures of purified corn and wheat amylose and amylopectin. From the linear relationships obtained, the percentages of both components in corn and wheat starches were determined. The method developed proved useful to monitor the purity of amylose and amylopectin preparations, and to estimate rapidly the amylose:amylopectin ratio of starch samples. PMID- 3980636 TI - High-performance liquid chromatographic determination of cimetidine and related compounds (raw material and tablets). PMID- 3980638 TI - Development of a system to simplify identification of peptides and their catabolites in a high-performance liquid chromatographic effluent. PMID- 3980637 TI - Separation of cadaverine from putrescine, histamine and polyamines in rat kidney by phosphocellulose chromatography. PMID- 3980639 TI - Clinical analysis of steroids. XXXI. Assay of oestradiol 17-sulphate 4 hydroxylase activity by high-performance liquid chromatography with electrochemical detection. PMID- 3980640 TI - Identification of 1,3-diphenyl-2-aminopropane metabolites by gas chromatography, gas chromatography with Fourier transform infrared spectroscopy and gas chromatography-mass spectrometry. PMID- 3980641 TI - Simple determination of trichloroacetic acid in urine using head space gas chromatography: a suitable method for monitoring exposure to trichloroethylene. PMID- 3980642 TI - Simplified gas chromatographic assay of underivatized nitrazepam in plasma. PMID- 3980643 TI - Gas-liquid chromatographic determination of phentermine in human plasma following oral administration to healthy subjects. PMID- 3980644 TI - One-step extraction procedure for gas chromatographic determination of viloxazine as its acetyl derivative in human plasma. PMID- 3980645 TI - Urinary dimethylbenzoic acid excretion as an indicator of occupational exposure to white spirit. PMID- 3980646 TI - Rapid Extrelut column method for determination of levamisole in milk using high performance liquid chromatography. PMID- 3980647 TI - Liquid chromatographic assay of isoxicam in human plasma and urine. PMID- 3980648 TI - Simultaneous quantitation of verapamil, norverapamil, and N-dealkylated metabolites in human plasma following oral administration. PMID- 3980649 TI - High-performance liquid chromatographic analysis of amodiaquine in human plasma. PMID- 3980650 TI - High-performance liquid chromatographic assay for mexiletine enantiomers in human plasma. PMID- 3980651 TI - Antitumour imidazotetrazines. VII. Quantitative analysis of mitozolomide in biological fluids by high-performance liquid chromatography. PMID- 3980652 TI - Analysis of aminoglycoside antibiotics as benzoyl derivatives by high-performance liquid chromatography and its application to the quantitation of neomycin in the perilymph. PMID- 3980653 TI - New high-performance liquid chromatographic assay for plasma doxorubicin. PMID- 3980654 TI - High-performance liquid chromatographic method for the simultaneous determination of myocardial creatine phosphate and adenosine nucleotides. PMID- 3980655 TI - Rapid gas chromatographic--mass spectrometric quantitation of gamma-aminobutyric acid in biological specimens. AB - A mass fragmentographic method for gamma-aminobutyric acid (GABA) quantitation using the heptafluorobutyryl-cyclohexyl-GABA derivative is described. Both capillary and packed column gas chromatography were used. This procedure employs 2,2[2H2]GABA as an internal standard and allows the rapid, sensitive, and specific measurement of GABA with a minimum of sample clean-up. Application of the method is demonstrated in mouse embryonic brain, body, and palate and human platelets, plasma, cerebrospinal fluid, and urine. PMID- 3980656 TI - Analysis of D-penicillamine by gas chromatography utilizing nitrogen--phosphorus detection. AB - A method is presented for the analysis of the "orphan" drug D-penicillamine (D Pa), which is used for the treatment of the inherited rare copper metabolism dysfunction known as Wilson's disease, by assaying a derivative of the compound by gas chromatography employing a rubidium sensitized nitrogen--phosphorus detector. Analytical procedures are described for the analyses of residues of D Pa X HCl salt in animal feed and for the analyses of the salt or free base from aqueous solutions by utilizing a single-step double derivatization with diazomethane--acetone. Stability data for D-Pa X HCl in animal feed and for the free base in water are presented. An ancillary fluorescence derivatization procedure for the analysis of D-Pa in water is also reported. PMID- 3980657 TI - Reversed-phase high-performance liquid chromatographic determination of tricyclic nucleoside and tricyclic nucleoside 5'-phosphate in biological specimens. AB - An isocratic, sensitive, high-performance liquid chromatographic assay was developed for the determination of the tricyclic nucleoside 1,4,5,6,8 pentaazaacenaphthylene -3-amino-1,5-dihydro-5-methyl-1-beta-D-ribofuranosyl 5' monophosphate (TCN-P; NSC 280594) and its dephosphorylated metabolite TCN (NSC 154020). Separation was obtained using a C18 Sep-Pak precolumn, a reversed-phase column, and a mobile phase of phosphate buffer--methanol (87.5:12.5, v/v) containing 0.0025 M tetrabutylammonium hydroxide. The absorbance of both TCN and TCN-P was monitored at 280 nm with a sensitivity limit of 10 ng/ml. The recovery was 54 +/- 6% and 51 +/- 8% (mean +/- S.D.) from plasma for TCN and TCN-P, respectively. Rapid enzymatic dephosphorylation of TCN-P in plasma and tissue samples was prevented by adding a large excess of adenosine 5'-monophosphate. The assay was used to determine plasma and tissue concentrations of TCN-P and TCN after administration of TCN-P to cancer patients in a Phase I clinical study. PMID- 3980659 TI - Ion-paired high-performance liquid chromatographic determination of mitoxantrone in physiological fluids. AB - Mitoxantrone is one of the newer anthracenedione derivatives which has already been studied in phase I and II trials, where it has shown significant antitumor activity against a variety of human tumours. To determine the prolonged terminal half-life of mitoxantrone, we developed a sensitive high-performance liquid chromatographic method, providing a detection limit of 1 ng/ml of extracted serum. This system uses a C18 reversed-phase column. The mobile phase consists of a mixture of acetonitrile (30%, v/v) and an ammonium formate buffer (70%, v/v) with a pH of 2.7. Hexane sulphonic acid is added as an ion-pair former. Detection at a wavelength of 658 nm provides a highly selective system, showing no interfering peaks. Ametantrone, another anthracenedione derivative, is used as an internal standard. The extraction procedure for serum also uses hexane sulphonic acid in an ion-paired system. Because of the highly selective detection wavelength, urine samples can be injected without a sample clean-up procedure. This very sensitive method, combined with high selectivity and a fast and inexpensive serum clean-up procedure, has allowed us to document the prolonged terminal plasma half-life of mitoxantrone (levels of 2-5 ng/ml of plasma can still be detected six days after an intravenous infusion of 15 mg/m2 over 30 min). In urine an as yet unidentified metabolite was discovered. PMID- 3980658 TI - Simultaneous determination of cytosine arabinoside, its nucleotides and metabolites by ion-pair high-performance liquid chromatography. AB - Currently available high-performance liquid chromatographic assays for cytosine arabinoside (ara-C) and its metabolites suffer from two major shortcomings: inability to resolve both ara-C and its nucleotides in a single chromatographic step and/or inadequate sensitivity to allow quantitation of intracellular cytosine arabinofuranoside-5'-triphosphate (ara-CTP) without the use of radiolabelled drug. In this paper, we describe a new ion-pairing high-performance liquid chromatographic assay for ara-C in biological samples that can separate ara-C from its nucleotides, metabolites, and naturally occurring ribonucleotides in a single chromatographic step with a lower limit of quantitation of 5 pmol for ara-C and 10 pmol for ara-CTP. Examples of the utility of this assay are shown in studies of intracellular pharmacokinetics of ara-C in cultured human breast cancer cells and in analysis of plasma nucleoside levels in patients receiving high-dose thymidine chemotherapy. We conclude that this assay provides a rapid and versatile system that can be applied to the study of both cellular and plasma nucleoside pharmacokinetics. PMID- 3980660 TI - Absolute configuration of 3-hydroxyadipic acid in human urine. AB - A method involving derivatization and combined gas chromatography--mass spectrometry has been developed to separate the enantiomers of 3-hydroxyadipic acid. By combining this method with asymmetric synthesis of the same acid, it has been shown that 3-hydroxyadipic acid excreted in urine consists of at least 95% of the L-enantiomer. This finding supports the hypothesis that dicarboxylic acids are degraded by ordinary beta-oxidation, and indicates that adipic acid may be converted into succinic acid. PMID- 3980661 TI - High-performance liquid chromatographic analysis of bile acids in hamster bile. PMID- 3980662 TI - Simultaneous determination of ketone bodies in biological samples by gas chromatographic headspace analysis. AB - A method is described on gas chromatographic headspace analysis for the determination of the physiological ketone bodies: acetone, acetoacetate and beta hydroxybutyrate. The procedure proposed involves quantitative conversion of both acetoacetate by decarboxylation in a strong acidic medium, and beta hydroxybutyrate by oxidation to acetoacetate and decarboxylation to acetone, which is then quantified chromatographically. The successful application of the method is illustrated by the values of ketone bodies in plasma, kidney, lung, and liver of fed and 48-hr-fasted rats. PMID- 3980663 TI - Evaluation of HPLC column performance for clinical studies. AB - Several C18 HPLC columns, varying in column length as well as packing material diameter, were used to separate mixtures of biochemical compounds in standards and in various physiological fluids. The column performances were compared both qualitatively and quantitatively. Factors investigated included efficiency, resolution, selectivity, column effect on peak height, temperature effects, cost per analysis, and analysis times. Column lifetime was also examined. The results were used to evaluate the suitability of the various columns for use in the chromatographic analysis of physiological samples. PMID- 3980664 TI - Plaque identification of strand-forming canine distemper virus by staphylococcal protein A-mediated reverse passive haemadsorption. AB - The R252 neurotropic isolate of canine distemper virus (CDV) produces cytopathic effects (CPE) dominated by strand formation rather than by the formation of multinucleate giant cells. The lack of well-defined CPE and consequent rapid spread of infection throughout the cell monolayer has hindered plaque purification of this virus by conventional methods. However, the use of an immunological detection system which utilizes binding of hyperimmune dog serum to virus-infected cells, followed by the identification of those sites by staphylococcal Protein A-coupled sheep red blood cells (reverse passive haemadsorption) allowed infected foci in cell monolayers to be detected as early as 4 days after infection, coincident with the appearance of the first immunofluorescently identified viral foci. Foci of haemadsorption were specific to sites of CDV infection as demonstrated by blocking experiments. Material recovered from the plaques was successful in infecting Vero cells. Thus, immunologically mediated adsorption of Protein A coupled red blood cells can be used to identify and isolate foci of viral infection which exhibit minimal or no viral CPE without destroying viral replicative ability. PMID- 3980665 TI - Growth of brown bullhead (BB) and other fish cell lines on microcarriers and the production of channel catfish virus (CCV). AB - The growth of brown bullhead (BB) fish cells and other poikilothermic cell lines on four commercially available brands of microcarrier beads was evaluated. Three of the microcarriers carry a positive surface charge, while the fourth carries a negative surface charge. The four microcarriers vary in their capacity to support the growth of the BB cells and other poikilothermic cell lines tested. The polyacrylamide beads by Bio-Rad and the polystyrene beads by Nunc were found to best support the growth of the anchorage-dependent BB cells. Although the DEAE dextran beads by Flow Laboratories were also found to be satisfactory, similar Cytodex 1 beads by Pharmacia, were found to support the growth of BB cells poorly. Both the polyacrylamide and polystyrene beads were found to be satisfactory for reuse after resterilization. In contrast, the DEAE-dextran beads were unsatisfactory since they sustained obvious mechanical damage. The BB growth rate and final cell density in microcarrier culture were dependent on the concentration of beads in culture and of the size of the initial cell inoculum. In terms of cell yield per milliliter of culture medium the microcarrier culture was superior to conventional stationary cultures. Microcarrier spinner cultures of BB cells consistently produced higher yields of channel catfish virus than conventional monolayers of the same cells. Two important advantages of the microcarrier system are its suitability for large scale as well as small scale production of both cells and virus. PMID- 3980666 TI - Dot-blot procedure with [32P]DNA probes for the sensitive detection of avocado sunblotch and other viroids in plants. AB - Avocado sunblotch viroid (ASBV) has been detected down to a level of about 20 pg per gram fresh weight of leaves by the use of a dot-blot hybridization procedure and partially purified nucleic acid extracts. Three [32P]DNA probes were compared, two prepared from full-length ASBV clones in the single-strand M13mp93 vector and the other by primer extension on purified ASBV. All three probes gave the same sensitivity of detection of ASBV. The methods developed have also been used successfully for the routine detection of potato spindle tuber viroid, citrus exocortis viroid, and coconut cadang cadang viroid. PMID- 3980667 TI - Parathyroid hormone secretion from dispersed human hyperparathyroid cells: increased secretion in cells from hyperplastic glands versus adenomas. AB - The in vitro secretion of PTH by dispersed human parathyroid cells was examined under conditions of low and high extracellular Ca+2 using tissue from patients with primary hyperparathyroidism and hyperparathyroidism resulting from chronic renal failure (CRF). The PTH secretion rate (nanograms of PTH per 10(5) cells/h) was lower in adenomatous tissues than in either primary hyperplastic cells or CRF cells under conditions of low (0.5 mM) or high (2.0-3.0 mM) extracellular Ca+2. Among the adenomas, a wide spectrum of degree of suppressibility of PTH secretion by high Ca+2 was found, ranging from 0% (completely nonsuppressible) to 98%. Suppression of the hyperplastic tissues in general was similar. The most suppressible adenomas demonstrated 2-fold greater PTH secretion rates in low Ca+2 conditions than the least suppressible adenomas, but in high Ca+2 conditions, the two groups had similar secretory rates. We conclude that the rate of PTH secretion by cells from adenomas was substantially lower than that of cells from tissues exhibiting either primary hyperplasia or hyperplasia resulting from CRF under these in vitro conditions. Thus, in adenomas, an increase in absolute cell number as well as alterations in the degree of calcium responsiveness may prove to be important etiological factors in the expression of hyperparathyroidism. PMID- 3980668 TI - H-Y antigen in a 46,XX female with dysgenetic ovaries. AB - Hypogonadism secondary to ovarian dysgenesis or resistant ovary syndrome was diagnosed in a 19-yr-old obese woman with primary amenorrhea, a 46,XX karyotype, and an H-Y+ cellular phenotype. Small ovoid gonads (1.5 X 0.6 cm) were found found bilaterally; these were encased in a dense venous network. The stroma was ovarian, and primordial follicles and some primary follicles were present, but there were no follicles at or beyond the antrum stage. There was no evidence of testicular tissue and no evidence of malignancy. Analysis of serological data indicated the possibility of residual H-Y antigen in the blood cells of the mother. PMID- 3980669 TI - Differences in metabolic properties among cortisol, prednisolone, and dexamethasone in liver and renal diseases: accelerated metabolism of dexamethasone in renal failure. AB - Since previous reports concerning the altered metabolism of various glucocorticoids in liver or renal diseases were inconsistent, this study was undertaken to reexamine the metabolism of cortisol, prednisolone, and dexamethasone in patients with these diseases. One milligram each of these glucocorticoids was given iv simultaneously to patients with chronic liver disease, patients with chronic renal failure, and normal subjects after 1 mg betamethasone was administered on the previous night to suppress endogenous cortisol secretion. Plasma steroid levels in periodically collected blood samples were assayed by respective RIA after separation by paper chromatography. Prolongation of the t1/2 of cortisol was found in both patients with liver disease and those with renal failure, and prolonged t1/2 and reduced MCR of prednisolone were found in renal failure but not in liver disease. In contrast, while prolonged t1/2 and reduced MCR of dexamethasone were found in liver disease, shortened t1/2 and increased MCR were found in renal failure. These results suggest that different glucocorticoids are metabolized differently in patients with liver disease and those with renal failure, and that these differences may be important when these agents are used for therapeutic purposes or for study of hypothalamic-pituitary-adrenocortical function in patients with liver and renal diseases. PMID- 3980670 TI - The natural history of idiopathic hyperprolactinemia. AB - Idiopathic hyperprolactinemia (IH) can be defined as the presence of elevated serum PRL levels in a patient in the absence of demonstrable pituitary or central nervous system disease and of any other recognized cause of increased PRL secretion. This study examined the long term clinical outcome of 41 patients (mean age, 26 yr) with IH followed for up to 11 yr (mean, 5.5 yr). Initial and final PRL levels were determined by RIA in the same laboratory. A correction factor was used to obviate periodic changes in the potency of the NIH standards used in the PRL assay, so that all results are expressed in terms of the original VLS no. 1 standard. The initial serum PRL levels ranged from 27.2-243 ng/ml, with a mean of 57 ng/ml. Only three patients had initial serum PRL levels greater than 100 ng/ml. All had a normal skull x-ray and/or brain computed tomographic scan during their initial visit. All 41 patients had galactorrhea and/or amenorrhea. Serum PRL levels remained the same, decreased, or returned to normal in 34 of 41 patients. The mean PRL level at the time of reevaluation was 35 ng/ml. Thirty four percent of the patients had a normal serum PRL level. Only 17% of the patients had serum PRL levels that were significantly higher (greater than 50% of their original value). Six of 9 patients with an initial serum PRL level less than 40 ng/ml had normal levels. One patient developed a pituitary tumor (initial PRL, 150 ng/ml). All patients reevaluated with brain computed tomographic scans had normal pituitary size. No patient reported a worsening of signs or symptoms, and in many, improvement (n = 16) or complete resolution (n = 8) of the amenorrhea and/or galactorrhea occurred. Twenty-seven spontaneous or bromocriptine-induced normal pregnancies and deliveries occurred without development of a pituitary tumor. Therefore, our data clearly challenge the use of ablative pituitary therapy for IH and raises questions of the benefit of chronic medical therapy for this condition. PMID- 3980671 TI - Plasma clearance of intravenously administered pituitary human growth hormone: gel filtration studies of heterogeneous components. AB - Both pituitary and plasma human GH (hGH) comprise heterogeneous components, exhibiting similar patterns when gel filtered on Sephadex G-100. To determine at what rate the components are cleared from the circulation, blood was obtained at specific intervals following a bolus injection of pituitary hGH in hypopituitary patients. Each sample was gel filtered to determine its component profile of RIA values, which, when plotted vs. the time interval it represented, yielded a means of monitoring its disappearance from the plasma. Total hGH was cleared with a t 1/2 of 21.5 min, the little component was cleared at 19.0 min, the big component was cleared at 26.5 min, and the pre-big component was cleared at 45 min. These data indicate that the larger the hGH component, the longer it takes to be cleared from the plasma. PMID- 3980672 TI - Influence of continuous infusion of citrate on responses of immunoreactive parathyroid hormone, calcium and magnesium components, and other electrolytes in normal adults during plateletapheresis. AB - To study the relationships between changes in concentrations of different forms of calcium and the responses of immunoreactive PTH in humans during citrate induced hypocalcemia, we studied 12 healthy donors undergoing continuous flow plateletapheresis. Concentrations of intact, amino-terminal, and midregion PTH; ionized, ultrafiltrable, and total calcium; total and ultrafiltrable magnesium; protein; albumin; pH; phosphate; and citrate were measured in sera collected during the first 95 min of apheresis. Although ionized calcium decreased steadily in every donor, both intact and amino-terminal PTH rose quickly in most donors to a peak level 5-15 min after starting the infusion of citrate and then declined during the remainder of apheresis. Midregion PTH also rose quickly by 5-remainder of apheresis. Midregion PTH also rose quickly by 5-15 min, but levelled off at 30 90 min. Total calcium inversely correlated with both intact PTH (r = -0.76) and amino-terminal PTH (r = -0.81) better than did ionized calcium (r = -0.47 and 0.46, respectively). The rapid rise and then gradual fall of PTH may be due to glandular depletion of stored PTH, increased peripheral metabolism of PTH, or PTH initiation of other hormonal actions that compensate for hypocalcemia. Protein bound calcium measured, and this change probably reflected dissociation of calcium from its albumin-binding sites to minimize the changes in ionized calcium concentrations. PMID- 3980673 TI - Therapeutic effect of calcium channel blockade in primary aldosteronism. AB - To determine the potential therapeutic effect of calcium entry blockade in primary aldosteronism, 10 patients (5 adenoma and 5 hyperplasia) documented by endocrine testing and/or surgery were given nifedipine (20 mg, sublingually) in the afternoon. In all patients, nifedipine acutely lowered systolic and diastolic blood pressure to normal for up to 6 h. Plasma cortisol and potassium did not change in the acute study. The basal plasma renin concentration was suppressed and was not altered by nifedipine. However, nifedipine reduced aldosterone within 120 min [22 +/- 5 (+/- SE) to 10 +/- 2 ng/dl; P less than 0.02], including the 5 patients with adenomas (22 +/- 3 to 10 +/- 3; P less than 0.02). In a 4-week study, nifedipine controlled blood pressure (134 +/- 5 mm Hg systolic and 85 +/- 3 mm Hg diastolic) and normalized serum K+ (3.0 +/- 0.1 to 3.7 +/- 0.1 meq/liter; P less than 0.01) while reducing plasma aldosterone levels (46 +/- 8 to 20 +/- 3; P less than 0.02). These results suggest that Ca+2 channel blockers may provide a new medical therapy, both controlling blood pressure and reducing aldosterone levels, for patients with primary aldosteronism. PMID- 3980674 TI - Androsterone long chain fatty acid esters in human breast cyst fluid. AB - We reported previously that incubation of [3H] androsterone in homogenates of human breast tumor resulted in production of long chain fatty acid esters of androsterone (A-LCFE). To identify the individual A-LCFE, breast tumor homogenates were incubated with androsterone, then submitted to solvent extraction, Celite chromatography, high pressure liquid chromatography and OH- negative chemical ionization mass spectrometry. The (M-1)-ions of the oleate, linoleate, palmitoleate, palmitate, arachidonate, and stearate esters of androsterone were produced. The first 3 cited unsaturated esters accounted for over 90% of the total. Since fibrocystic disease of the breast is a reported risk factor for the development of breast cancer, breast cyst fluids were analyzed for A-LCFE as part of an overall program to relate endocrine profiles in cyst fluid to the incidence of cancer. Breast cyst fluids were analyzed for total A-LCFE by a method involving solvent extraction, saponification, purification of the liberated androsterone, and then quantification of the steroid by RIA. The 10 fluids analyzed contained 0.52-3.79 ng/ml fatty acid esters, measured as androsterone. In 4 of these samples, the individual A-LCFE were analyzed by mass spectrometry. As in the incubation study, the unsaturated fatty acid esters predominated. In 3 samples, palmitoleate and in 1 sample, oleate predominated. The palmitate varied from undetectable to 25% of the total. The divergent total concentrations and profiles of A-LCFE indicate potential parameters for correlations with the subsequent course of fibrocystic disease of the breast. PMID- 3980675 TI - Primary cortisol resistance accompanied by a reduction in glucocorticoid receptors in two members of the same family. AB - This report describes studies of a man suspected of having primary cortisol resistance. This conclusion is based on his high plasma cortisol levels and high 24-h urinary 17-hydroxycorticosteroid and cortisol excretion, plus the fact that he had no manifestations of Cushing's syndrome. Among family members tested, his mother also had hypercortisolemia. Both mother and son had high levels of unbound plasma cortisol, but their plasma ACTH concentrations were within the normal range. Both were partially resistant to dexamethasone adrenal suppression, and both had mild hypertension without hypokalemia. To study this apparent end-organ resistance to cortisol, we examined the glucocorticoid receptors in peripheral mononuclear cells. Using whole cell assays, glucocorticoid receptors in both patients were found to have reduced total binding capacity. We conclude that these two patients, members of the same family, have primary cortisol resistance accompanied by a reduced number of glucocorticoid receptors. PMID- 3980676 TI - Prevention of Streptococcus mutans colonization by salivary IgA antibodies. AB - The levels of salivary and serum IgA, IgG, and IgM antibodies to the seven serotypes (a-g) of Streptococcus mutans were established in 12 laboratory volunteers using a sensitive enzyme-linked immunosorbent assay. Salivary IgA antibody levels to the serotype c organism were significantly lower (P less than 0.005) than antibody levels to the other six serotypes of S. mutans. Similar results were found with a purified S. mutans serotype c carbohydrate. Serum IgG and IgM antibody titers to the serotype c whole cells were significantly higher (P less than 0.05) than to four other S. mutans serotypes (a, e-g). The abilities of S. mutans serotypes c and d to colonize molar tooth surfaces were examined in eight volunteers. S. mutans serotype d was cleared from the tooth surfaces within 24 hr of challenge, whereas S. mutans serotype c was detected in six of the eight volunteers after 2 weeks and in three of eight after 3 weeks. These results provide additional evidence for the role of salivary IgA antibodies in regulating S. mutans infection and suggest that the low levels of salivary IgA antibodies to S. mutans serotype c may contribute to the predominance of this serotype in the U.S. population. PMID- 3980678 TI - Pedal asymmetries and handedness. AB - The relationship between pedal asymmetries and handedness has been the subject of several investigations. Support for pedal asymmetries occurring in the normal population have been reported which are claimed to be a function of handedness and sex. If true, these asymmetries would confound the assessment of trophic changes due to localized brain injury. However, at least four attempts to replicate these results have failed. The present study was undertaken to reassess this hypothesis using more rigorous measurement of handedness and foot length with a more representative sample allowing for larger hand by sex groups than has been previously used. No differences in the direction of foot size were found regardless of hand or sex classification. PMID- 3980677 TI - Memory for recent U.S. presidents in patients with cerebral disease. AB - Four tasks were developed to assess memory for recent U.S. presidents: free recall of presidents' names, naming their photographs, and temporal ordering of their printed names and photographs. The tasks were standardized on a sample of 250 hospital control subjects and administered to 55 patients with cerebral disease. Recall of the presidents' names, a task frequently advocated for mental status examination, was relatively difficult for hospital control patients and was least sensitive to brain disease. None of the brain-damaged patients manifested an isolated retrieval defect. Generalized memory impairment for recent presidents was not found with focal lesions. In the context of a diffuse or bilateral disease, generalized memory impairment for recent presidents was a frequent concomitant of substantial intellectual loss. This brief, multi-task assessment of memory for recent presidents may prove a more useful adjunct to neurobehavioral evaluation than testing simple recall of presidents' names. PMID- 3980679 TI - Does memory impairment exist in narcolepsy-cataplexy? AB - Approximately one-half of patients with the narcolepsy-cataplexy syndrome suffer from subjective memory problems, mainly involving recent events. Ten untreated narcoleptic patients (7 male, 3 female, aged 28-65 years) with such problems and 10 matched controls were given a battery of tests to study the complaint. Tests included the digit span, Knox cube, recurring figures (verbal and nonverbal), visual reproduction, paired associates learning and logical memory test, plus naming and fluency tests to control for language capabilities. No significant intergroup differences were found. It is concluded that narcoleptics do not have a true organic memory deficit, but rather experience a subjective problem due to drowsiness which they are able to suppress during short testing sessions in a laboratory environment. PMID- 3980680 TI - Speeded performance following head injury in children. AB - Fifty-one children who has sustained head injuries were divided into mildly, moderately and severely injured groups according to neurological criteria. The groups were matched for age, sex, and injury-test interval. Approximately 1 year after their injuries, patients were tested on speeded and nonspeeded measures of motor, visual-motor, and visual-spatial functioning as well as on the WISC-R. The performance of the mildly and moderately injured groups was similar, with both groups performing significantly faster than the severely injured group on measures of speeded performance. There were few significant differences between groups on measures requiring little speed. In contrast to the results for the other two groups, the severely head-injured group performed significantly worse on the highly speeded tests than on the low speed tests. The findings are discussed in relation to the literature on the cognitive sequelae of head injuries. PMID- 3980681 TI - Verbal and cognitive sequelae following unilateral lesions acquired in early childhood. AB - Eight left-hemisphere lesioned children and eight right-hemisphere lesioned children between 18 months and 8 years of age were compared to control subjects on a battery of intelligence and language measures. Both left- and right-lesioned subjects had lower IQ scores than their controls, yet most functioned within the normal range or higher. Lexical comprehension and production were depressed in both subject groups and appeared to be depressed to a greater degree in right lesioned subjects than in those with left lesions. In contrast, syntactic production in left-lesioned subjects was markedly deficient in comparison to controls as well as right-lesioned subjects. Although both subjects and controls included children with articulation errors, the number of misarticulating children and misarticulated sounds was greatest in the left-lesioned group. Finally, fluency disorders were observed in both right- and left-lesioned subjects but were not observed in controls. The study provides further evidence that the right and left hemispheres are not equipotential for language and that left-hemisphere lesions acquired early in childhood impair syntactic development to a greater degree than do right-hemisphere lesions. PMID- 3980682 TI - Remediation of memory disorders: experimental evaluation of the spaced-retrieval technique. AB - Research concerning remediation of memory disorders has frequently been concerned with mnemonic techniques that demand a great deal of elaborative and effortful processing. The present study examines a relatively simple technique, known as spaced retrieval, in which patients are taught to retrieve information at increasingly long temporal intervals after initial presentation. Results indicated that the spaced-retrieval technique aided patients' learning of new information. There was also evidence of learning to learn: Two of the four patients who were studied learned to use the technique in the absence of explicit cues from the experimenter. Issues pertaining to the possible usefulness of spaced retrieval in everyday life are discussed. PMID- 3980683 TI - Construction of matched verbal and design continuous paired associate tests. AB - We developed verbal and figural continuous paired associate tests (CPAT) that are matched on internal consistency and on the distributional properties of mean item difficulty, variance, and skewness. The Verbal CPAT is composed of high frequency nouns, verbs, and adjectives. Selection of the designs was guided by literature on the effects of right-hemisphere damage on memory for designs. One hundred subjects were given 80 items from the verbal CPAT and 80 items from the designs CPAT. Twenty subjects at these five ranges of Wechsler Memory Quotient were evaluated: less than or equal to 79, 80-89, 90-99, 100-109, greater than or equal to 109. The final 40-item version of the Verbal CPAT had a mean of 26.72, a SD of 7.03, and an alpha of .859. The Designs CPAT had a mean of 26.42, a SD of 7.75, and an alpha of .886. Neither test was significantly skewed. These matched tests should be useful in making inferences about differences between verbal and figural memory that are not confounded with the problem of differential test sensitivity. PMID- 3980684 TI - Collaborative evaluation of the UniScept qualitative antimicrobial susceptibility test. AB - The UniScept system (Analytab Products, Plainview, N.Y.) is a commercially prepared microdilution antimicrobial susceptibility test for the determination of qualitative susceptibility results for gram-negative and gram-positive bacteria. The system showed excellent correlation with the reference agar diffusion approach for organisms from clinical specimens and with stock and reference cultures. Intra- and interlaboratory reproducibility was high. PMID- 3980685 TI - Detection of Mycoplasma hominis septicemia by radiometric blood culture. AB - The ease with which Mycoplasma hominis can be recovered and the frequency of its occurrence in septicemia may not be fully appreciated. We detected the growth of M. hominis radiometrically with an automated blood culture instrument. The organism grew in both aerobic and anaerobic culture media, but the cultures were not visibly positive. It was necessary to stain the cultures with acridine orange to visualize M. hominis and to subculture them on Columbia base sheep blood agar to confirm the positive growth index indicated by the instrument. Sodium polyanetholesulfonate inhibited the growth of M. hominis and is not recommended for use as the anticoagulant when blood is cultured for Mycoplasma spp. PMID- 3980686 TI - Isolation and characterization of two hemolytic phenotypes of Vibrio damsela associated with a fatal wound infection. AB - Two hemolytic phenotypes of Vibrio damsela, isolated from the tissue of a patient with a fatal wound infection, were characterized. The patient had underlying disease, and the wound was associated with an injury inflicted during the handling of a catfish. The phenotypes were morphologically and biochemically similar except for their lecithinase, lipase, and hemolytic activities. When grown on rabbit blood agar, one phenotype (LZ) produced a large zone of hemolysis (10 mm) around the colony, whereas the other type (SZ) produced only a small zone (1 to 2 mm). On sheep blood agar, the differences in hemolytic activity were more subtle. By a modified CAMP test in which V. damsela was streaked perpendicularly to Staphylococcus aureus, it was determined that a factor elaborated by the LZ phenotype (but not the SZ phenotype) protected sheep erythrocytes from the hemolysis normally caused by S. aureus toxins. Cell-free filtrates of broth cultures of each phenotype had the same effects on erythrocytes as did the organisms themselves. PMID- 3980687 TI - Pseudomonas mesophilica infections in humans. AB - Reported here is the case of a patient with metastatic adenocarcinoma of the lung who had bacteremia involving Pseudomonas mesophilica. Of the common laboratory media tested at 35 degrees C, buffered charcoal yeast extract agar and nutrient agar provided the best growth; however, other media supported growth at lower temperatures. Since blood cultures are routinely subcultured onto chocolate agar and then incubated at 35 degrees C, awareness of the characteristics of P. mesophilica and of the isolation techniques as outlined may enhance the recovery of this and related bacterial species. PMID- 3980688 TI - Serogrouping of Clostridium difficile strains by slide agglutination. AB - Six different agglutinating antisera were obtained by immunizing rabbits with Formol-treated strains of Clostridium difficile. After appropriate absorption, these antisera were used to define six serogroups designated by the letters A, B, C, D, F, and G. Altogether, 315 strains of C. difficile from various origins were tested for slide agglutination by these antisera; 312 (99%) of them were agglutinated by one of these antisera. A and C were the most common serogroups. An excellent correlation, ranging from 85 to 100%, was found between the serogroup and the toxigenicity of the strains. The correlation between serogroup and sorbitol fermentation was higher, ranging from 89 to 100%. The results of this typing were compared with the clinical origin of the strains. Only strains of serogroups A, C, and D were isolated in 153 cases of antibiotic-associated diarrhea. This series included strains from three outbreaks; all the strains in two of the outbreaks belonged to serogroup C, and in the third, all the strains belonged to serogroup A. Strains of serogroups B, F, and G were only found in the stools of asymptomatic neonates or young children. In the latter samples, strains of serogroups A and D were found in the same ratio as in adults with antibiotic associated diarrhea, but strains of serogroup C were seldom isolated. In patients treated with antineoplastic drugs and suffering from diarrhea, the distribution of the strains was the same as in cases of antibiotic-associated diarrhea. PMID- 3980689 TI - Effects of storage temperature and pH on the stability of eleven beta-lactam antibiotics in MIC trays. AB - Microdilution MIC test trays containing 11 beta-lactam antibiotics in Mueller Hinton broth at pH 7.31 or 6.80 were prepared and stored at 4, -10, -25, and -70 degrees C. The drugs tested were ampicillin, ticarcillin, mezlocillin, piperacillin, azlocillin, cefazolin, cefotaxime, moxalactam, cefoperazone, ceftriaxone, and imipenem. MICs for Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853 were determined at weekly intervals for up to 1 year. The data from the MIC determinations showed the stability of antimicrobial activity over time to be -70 degrees C greater than 25 degrees C approximately 4 degrees C much greater than -10 degrees C. The relative stability at 4 degrees C as compared with that at -10 degrees C cannot be explained by desiccation, as determined by changes in broth sodium concentrations. The relative instability at -10 degrees C may have been caused in part by a temperature fluctuation, resulting in intermittent freezing and thawing of the antibiotics. Some of the drugs appeared to be more stable when diluted in broth at pH 6.80, but endpoints were more difficult to read. Cefazolin and cefoperazone were stable at all four storage temperatures. Cefotaxime, moxalactam, and ceftriaxone also were relatively stable. The other drugs showed moderately rapid to rapid deterioration at each temperature except -70 degrees C. Storage at -25 degrees C is suitable for up to 3 months for many, but not all, beta-lactams; -10 degrees C appears to be unsuitable. Storage at -70 degrees C is recommended. PMID- 3980691 TI - Feasibility study of disk diffusion susceptibility tests with Mueller-Hinton broth solidified with Gelrite, an agar substitute. AB - Feasibility studies were done to determine whether a new agar substitute, Gelrite gellan gum, could be used to prepare a solid Mueller-Hinton medium for disk diffusion susceptibility tests. Mueller-Hinton broth was combined with 0.43% of the gellan gum and 0.75% KCI. The resulting medium had performance characteristics similar to those of Mueller-Hinton agars; however, zones on the gellan gum media tended to be a little larger. Significant differences among Mueller-Hinton broths and among Mueller-Hinton agars from different manufacturers were documented: zones on different lots of the gellan gum were more consistent. The Mueller-Hinton broth-gellan gum medium appears to represent a satisfactory alternative to agar media. However, because somewhat larger zones were seen on the gellan gum plates, further study will be needed to develop quality control limits and interpretive zone size standards for tests on this new medium. PMID- 3980690 TI - Molecular epidemiology of adenoviruses: global distribution of adenovirus 7 genome types. AB - Adenovirus 7 (Ad7) is the adenovirus species that most frequently has been associated with severe illness. Seven distinct genome types of adenovirus 7, Ad7p, Ad7a, Ad7b, Ad7c, Ad7d, Ad7e, and Ad7f, can be identified by using restriction endonucleases BamHI and SmaI. We analyzed the distribution of the different Ad7 genome types among 314 isolates from patients and healthy shedders. The Ad7b and Ad7c genome types accounted for 90% of the isolates from patients and appeared to be mutually exclusive. A shift from Ad7c to Ad7b genome types occurred in 1969 in Europe and in 1975 in Australia. During the last decade, Ad7b genome types predominated in Australia, Europe, and North America. Ad7c was detected in South Africa, Ad7d was detected in China, Ad7e was detected in Brazil, and Ad7f was detected in Australia. The Ad7p and Ad7a genome types dominated among isolates obtained from healthy shedders and appeared scattered through the years and the geographical areas. The prevalence of Ad7 infections is high in Japan as judged by the herd immunity. However, the low percentage (2%) of Ad7 isolates among all adenovirus isolates chiefly from patients, coupled with 30 to 50% antibody prevalence, argues for a high proportion of inapparent infections and, hence, Ad7 strain(s) of low pathogenicity. PMID- 3980692 TI - Radioenzymatic assays for aminoglycosides with kanamycin 6'-acetyltransferase. AB - To facilitate the rapid and accurate quantitation of parenterally administered aminoglycosides, we defined the optimum conditions (pH, duration of incubation, and cofactor concentrations) to permit radioenzymatic assays with kanamycin acetyltransferase. The accuracy in quantitating tobramycin, netilmicin, kanamycin, and amikacin at concentrations in the therapeutic range was greater than 90%, with a mean recovery of 102.8%. The mean of the interassay coefficient of variation was 7.8%. Typical standard curves at six different concentrations resulted in a correlation coefficient (r value) of greater than 0.99 for each aminoglycoside. The radioenzymatic assay correlates well with the bioassay (tobramycin and netilmicin) and radioimmunoassay (amikacin and kanamycin); the correlation coefficient is greater than 0.90 for all. We conclude that the radioenzymatic assay utilizing kanamycin 6'-acetyltransferase is feasible for all commercially available parenterally administered aminoglycosides. PMID- 3980693 TI - DNA probe specific for Legionella pneumophila. AB - A procedure for preparing a DNA probe to be used in the specific detection of Legionella pneumophila by dot or colony hybridization has been devised. When total DNA from L. pneumophila was used as a radioactive probe, cross hybridization occurred with DNA from many other species belonging to various families (including Legionellaceae, Enterobacteriaceae, Pseudomonadaceae, and Vibrionaceae). Cross-hybridizing restriction fragments in L. pneumophila ATCC 33152 DNA were identified on Southern blots. When unlabeled DNA from strain ATCC 33152 was cleaved by endonuclease BamHI, the DNA fragments cross-hybridizing with the labeled DNA from all of the other species and genera tested (or with Escherichia coli 16 + 23 S RNA) had a size of 21.4 and 16.2 kilobase pairs (major bands) and 28.0, 12.8, and 10.1 kilobase pairs (minor bands). BamHI restriction fragments of L. pneumophila DNA deprived of the cross-hybridizing fragments were pooled and used as a probe for the detection of L. pneumophila. This probe proved to be specific for L. pneumophila in colony and dot hybridization. It can potentially be used for the detection of L. pneumophila in clinical and water samples. The procedure described can be readily applied to the preparation of probes specific for phylogenetically isolated bacterial species other than L. pneumophila. PMID- 3980695 TI - Evaluation of the Micro-ID system for the identification of Yersinia pestis. AB - One hundred isolates of Yersinia pestis identified by conventional means were tested by the Micro-ID system to assess its reliability for distinguishing Y. pestis from other members of the family Enterobacteriaceae. The Micro-ID system gave Y. pestis as a choice for the identification of 89 of these cultures, although not always as the first choice. Most nitrate-negative strains of Y. pestis keyed out with Yersinia pseudotuberculosis as first choice and Y. pestis as second or fourth choice. PMID- 3980694 TI - Cervical osteomyelitis caused by Pseudomonas cepacia in an intravenous-drug abuser. AB - We report a case of vertebral osteomyelitis caused by Pseudomonas cepacia in a patient with a history of intravenous-drug abuse. P. cepacia infections are usually nosocomial, although community-acquired infections occur more commonly in intravenous-drug abusers than in the general population. Vertebral osteomyelitis caused by P. cepacia has not previously been reported. PMID- 3980696 TI - Antibody response to individual rubella virus proteins in congenital and other rubella virus infections. AB - Serum samples from patients with various forms of rubella virus infection were tested for antibodies to each of three viral structural proteins by radioimmunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. In most sera antibody to E1 protein was the predominant species. Sera from patients with congenital rubella syndrome, however, contained significantly more E2 antibody relative to E1 antibody than did sera from other rubella patients. PMID- 3980697 TI - Effect of adjuvant vaccines on dengue virus type 2 immune ascitic fluid production. AB - In a comparison of dengue type 2 immune mouse ascitic fluid immunization schedules, a schedule in which adjuvant vaccines were not used produced neutralizing antibody titers that were specific and a mouse mortality rate that was lower, resulting in a greater yield of ascitic fluids. In the schedules in which emulsified adjuvant vaccines were used, the quality of the emulsion had little effect on antibody titer produced. PMID- 3980698 TI - Inability to adequately control antimicrobial agents on AutoMicrobic System Gram Positive and Gram-Negative Susceptibility Cards. AB - The Vitek Gram-Positive Susceptibility Card (GPS) and Gram-Negative General Susceptibility Plus Card (GSC Plus) were tested on the AutoMicrobic System (AMS) 50 times each with the recommended control organisms. Only 1 drug (chloramphenicol) of 11 on the GPS and 1 (gentamicin) of 10 on the GSC Plus could be adequately controlled, leaving unsubstantiated the results obtained with patient isolates on the remaining 19 antimicrobial agents. PMID- 3980699 TI - Legionella oakridgensis: laboratory diagnosis of a human infection. AB - We report the laboratory diagnosis of a case of pneumonia caused by Legionella oakridgensis. L. oakridgensis, originally isolated from industrial cooling towers, has not previously been associated with human disease. PMID- 3980700 TI - Isolation of Bacteroides fragilis from the feces of diarrheic calves and lambs. AB - A selective medium was developed for the isolation of Bacteroides fragilis directly from ovine and bovine fecal samples. The medium (tryptose blood agar plus polymyxin B, triclosan (Irgasan), novobiocin, and nalidixic acid) permitted growth of B. fragilis and several other species of Bacteroides but inhibited growth of most other intestinal bacteria. PMID- 3980701 TI - Evaluation of the aldononitrile peracetate method for measuring arabinitol in serum. PMID- 3980702 TI - Skeletal presentation of congenital syphilis: case report and review of the literature. AB - Congenital syphilis is a rare disease. Primary skeletal presentation is also unusual, and recognition and prompt treatment are necessary to avoid devastating consequences. Differential diagnoses include trauma, Caffey's disease, scurvy, and hypervitaminosis D. Penicillin treatment will reverse most changes. PMID- 3980704 TI - Slipped capital femoral epiphysis: case 3. PMID- 3980703 TI - Intraoperative radiographs: a modified technique. AB - Multiple intraoperative radiographs are often required during pediatric orthopedic surgery. Cumbersome cassette draping protocols take time and provide for potential breaks in sterile technique. A double-cassette method is described that facilitates the taking of multiple intraoperative radiographs. PMID- 3980705 TI - Ganglia in children. AB - Sixty-one children with ganglia treated surgically at the Singapore General Hospital were reviewed. At the wrist the predominance of dorsal ganglia over volar ganglia, which is the pattern in adults, was found only in older children. In children less than 10 years old, volar ganglia predominated. A high recurrence rate (36%) following surgery was observed, putting in question the value of surgery. An expectant regimen is therefore advocated at first. A modified technique for excision of volar wrist ganglia without attendant risk to the radial vessels is discussed. PMID- 3980706 TI - Shear fractures through the capital femoral physis of the skeletally immature rabbit. AB - Shear fractures were created through the capital femoral physes of rabbits 2, 4, 6, 10, and 14 weeks of age. Biomechanically, the load to complete failure (i.e., fracture) increased with maturation. The load to failure increased with increasing area of the capital femoral physis. The shear stress increased with age and then began to plateau at 10 weeks of age. Histologically, the zone of failure involved the columnar zone in the specimens from rabbits 2-6 weeks old, progressed to the junction of the columnar and hypertrophic zones in the specimens from 10-week-old rabbits, and occurred within the zone of hypertrophy in the specimens from 14-week-old rabbits. Fractures progressed from a type I physeal fracture in the specimens from rabbits 4-6 weeks old to a type II physeal/metaphyseal fracture in the specimens from older animals, with the metaphyseal fragment increasing in size with increasing chondroosseous maturation of the specimen. PMID- 3980707 TI - Histologic patterns of capital femoral growth plate fracture in the rabbit: the effect of shear direction. AB - Growth plate fractures were produced in vitro in the rabbit capital femoral physis by applying shear loading parallel to the physeal complex in four different directions. Load-displacement curves were recorded and histologic sections were prepared from each specimen. Different histologic patterns were observed with different directions of shear loading. The histologic level within the growth plate through which the fracture propagated varied with each specimen and with the different directions of shear loading. The "classical" pattern of failure through the hypertropic cellular zone of the physis was not uniformly seen. The mechanical patterns of failure also varied with the direction of shear loading. The shear strength of the physeal complex was significantly greater with anterior to posterior loading than with posterior to anterior loading. The possible factors contributing to this mechanical anisotropy are discussed, and the literature on related studies is reviewed. PMID- 3980709 TI - Role of exercises in the Milwaukee brace treatment of scoliosis. AB - Specific exercises designed to strengthen trunk muscles are an integral part of most Milwaukee brace treatment protocols. To assess the effectiveness of these exercises, we established a prospective study evaluating a closely monitored exercise program coordinated with the use of a Milwaukee brace. Between 1973 and 1979, 24 girls treated with a Milwaukee brace for documented progression of primary right thoracic idiopathic scoliosis were selected for the study. All patients were instructed to perform a standard set of exercises based on the program of Blount and Moe (The Milwaukee Brace [Williams and Wilkins, 1973]). Twelve patients who were regular exercisers constituted the exercise group; 12 patients noncompliant in performing regular exercises composed the control group. Both groups remained faithful brace wearers. No significant difference was found between the two groups regarding age at onset, initial curve degree, skeletal maturity, total time in brace, or general activity level. There was no statistically significant difference in curve improvement between the two groups (p = 0.95). This preliminary study suggests that the Milwaukee brace alone is as effective in halting curve progression as a Milwaukee brace plus standard prescribed exercises. PMID- 3980708 TI - Deep, late infections associated with internal fixation in children. AB - Deep, late infection associated with internal fixation is well known in adults, but has not been previously reported in children. We report here six cases of deep, late infection in children associated with internal fixation of the proximal femur. All patients had cerebral palsy and had undergone a proximal femoral osteotomy for hip subluxation or dislocation. The patients presented with infection between 7 and 24 months after a period of total recovery. The clinical presentation was variable, although many patients had increasing hip pain. Radiographs showed radiolucency around the lag screw. The bacteriologic finding was usually Staphylococcus aureus, and patients responded to wound debridement, hardware removal, and intravenous antibiotics. In light of these cases of deep, late infection, we strongly urge routine removal of metallic implants as soon as bony healing will allow. PMID- 3980710 TI - Upper extremity tendon transfers in cerebral palsy: electromyographic and functional analysis. AB - This study was undertaken to evaluate tendon transfers in a group of children with spastic hemiplegia. Muscle grading, video recordings of function, and electromyographs were performed on 12 patients preoperatively. Postoperative electromyograms were obtained on 16 transferred tendons in eight patients as the children performed assigned tasks. Clinical evaluation demonstrated improvement in all patients at follow-up, which averaged 20 months. Four of the 16 muscles showed changes in their electrical activity postoperatively. Three muscles that fired continuously became phasic, and one muscle changed phase to match its recipient. Pre- and postoperative electromyography with video analysis provided a more complete understanding of the characteristics of tendon function with tendon transfers in cerebral palsy. PMID- 3980711 TI - Lateral longitudinal stress fracture of the patella: report of three cases. AB - Stress fracture of the patella is a rare occurrence. Two types, longitudinal and transverse, are known. We report three lateral longitudinal fractures of the patella caused by running, Japanese fencing, and long distance walking. Patients returned to physical activities after 2-3 months of conservative treatment. PMID- 3980712 TI - Pelvic fractures in children. AB - A retrospective study was performed on 141 patients with multiple injuries that included pelvis fractures. The mode of injury, type of fracture of the pelvis, associated injuries, morbidity and mortality, and outcome following healing of the fracture were studied. From this study a classification has been derived which appears to show a correlation among the type of pelvic fracture, the associated injuries, and the expected outcome from that fracture. Of the 141 patients, there were 11 deaths and 130 patients available for clinical review. The greatest morbidity, mortality, and complications from the fractures were in the type IV group, comprising patients with segmental instability of the pelvis. We suggest that computed tomographic scanning be used when segmental instability is suspected and when the posterior elements of the pelvis are difficult to examine by conventional radiographs. When there has been disruption of the acetabulum, then the treatment of choice is open reduction, stable fixation, and early motion. When there is segmental instability of the pelvis that cannot be controlled by conventional methods of pelvic slings or spica casts or when associated injuries preclude the use of these methods, then the treatment of choice should be external fixation. PMID- 3980713 TI - A technique for determining femoral head containment during gait. AB - Kinematic gait analysis was carried out on 42 hips, including normal joints and joints affected with Legg-Calve-Perthes disease. Data were analyzed by a computer algorithm that calculated three-dimensional femoral head contact with the acetabulum (containment). Patients were studied in and out of various abduction orthoses. The three-dimensional containment of the hip is reproducibly altered by various devices; specifically, the Atlanta brace increases posterior coverage and slightly increases lateral coverage, and Petrie casts improve lateral and anterior coverage at the expense of posterior containment. This analysis allows modeling of osteotomies and enhances clinical assessment of actual changes in containment with bracing. PMID- 3980714 TI - Dynamic splint for treatment of congenital dysplasia of the hip. AB - A prospective review of 108 cases of dysplasia of the hip treated with a new dynamic splint is presented. The success rate in restoring the acetabular angle was 100%, with no incidence of ischemic necrosis. PMID- 3980715 TI - Acute psoas abscess in a newborn infant. AB - A 1-month-old neonate was seen for an acute toxic illness, suggestive of septicemia. No obvious focus of infection was present. During attempted femoral venipuncture, purulent material, thought to originate from the right hip joint, was encountered. Because of this aspirate, as well as suggestive local signs, septic arthritis of the right hip was diagnosed. Arthrotomy failed to confirm the diagnosis, and on further surgical exploration a purulent psoas abscess was discovered. The patient made an uneventful recovery, and at follow-up 48 months later was asymptomatic with a normal clinical examination. This case illustrates the difficulty of differentiating acute psoas abscess from septic arthritis of the hip in the neonate. PMID- 3980716 TI - Chance fracture in a child: a case report with nonoperative treatment. AB - The Chance fracture is an unusual lesion of the lumbar spine. Although 33 cases have been reported, only eight have occurred in adolescents and none in young children. We report here a case in a 6-year-old child. PMID- 3980717 TI - Scoliosis due to epilepsia partialis continua. AB - A case is reported of scoliosis in a boy with epilepsia partialis continua, an unusual disorder with virtually constant episodes of seizures of only part of the body. The scoliosis appeared to be due to the seizure disorder. The epilepsy seriously inhibited conventional scoliosis management. The patient's scoliosis problem was finally solved by salvage surgery and intensive seizure medication supervision. Scoliosis management in complex seizure disorders presents special and unusual problems. PMID- 3980718 TI - Ewing's sarcoma arising in a unicameral bone cyst. AB - An 8-year-old boy sustained a fracture of the distal fibula. The fracture resulted from Ewing's sarcoma infiltrating a unicameral bone cyst. Ewing's sarcoma has not previously been described in association with a unicameral bone cyst. PMID- 3980719 TI - The control of product-related injuries in New Zealand. PMID- 3980720 TI - Health and the war against Nicaragua, 1981-84. PMID- 3980722 TI - Faith, evidence, and the epidemiologist. PMID- 3980721 TI - The changing relationships of epidemiology and society: the Robert Cruikshank lecture. PMID- 3980723 TI - Screening for cancer of the cervix: implications for public health policy. PMID- 3980725 TI - Environmental threats, communities, and hysteria. PMID- 3980724 TI - Air bags and seat belts--untangling standard 208. PMID- 3980726 TI - The public health profession. PMID- 3980727 TI - Scl-86, a marker antigen for diffuse scleroderma. AB - More than 300 sera from patients with a connective tissue disease were analyzed with the immunoblotting technique. The presence of autoantibodies against an 86,000-mol wt marker antigen for diffuse scleroderma (Scl-86) was found in 14 out of 33 patients with scleroderma. The presence of anti-Scl-86 antibodies seemed to correlate with the diagnosis of diffuse scleroderma since they were found in 13 out of 22 diffuse scleroderma patients and in only one out of 11 patients with limited scleroderma. All scleroderma sera (33 patients' sera and 13 reference sera) were also tested for the presence of anti-Scl-70 antibodies. It was found that all anti-Scl-70 positive sera (n = 25) contained anti-Scl-86 antibody as well, suggesting a relationship between these two antigens. However, the Scl-86 antigen was shown to be an extremely insoluble nonchromosomal protein, resistant to boiling in sodium dodecyl sulfate. This contrasts with the Scl-70 antigen, which has been described as a thermolabile, soluble antigen present in the chromatin fraction. Together, our results are consistent with the idea that Scl 70 is a degradation product of Scl-86. The Scl-86 antigen is present in freshly prepared rabbit thymus, spleen, and liver nuclei as well as in nuclei from various cultured cell lines, but is not detectable in extractable nuclear antigen from rabbit thymus. In a limited retrospective study, the anti-Scl-86 antibodies were found in two sera from patients with Raynaud's phenomenon before the development of diffuse scleroderma. Therefore, it is possible that screening of patients' serum for this antibody might predict the development of diffuse scleroderma. PMID- 3980728 TI - Mechanics of intercostal space and actions of external and internal intercostal muscles. AB - It is conventionally considered that because of their fiber orientations, the external intercostal muscles elevate the ribs, whereas the internal interosseous intercostals lower the ribs. The mechanical action of the intercostal muscles, however, has never been studied directly, and the electromyographic observations supporting this conventional thinking must be interpreted with caution. In the present studies, the external and internal interosseous intercostal muscles have been separately stimulated in different interspaces at, above, and below end expiratory rib cage volume in anesthetized dogs. The axial (cephalo-caudal) displacements of the ribs were measured using linear displacement transducers. The results indicate that when contracting in a single interspace and other muscles are relaxed, both the external and internal intercostals have a net rib elevating action at end-expiratory rib cage volume. This action increases as rib cage volume decreases, but it progressively decreases as rib cage volume increases such that at high rib cage volumes, both the external and internal intercostals lower the ribs. Stimulating the intercostal muscles in three adjacent intercostal spaces simultaneously produced similar directional rib motion results. We conclude that (a) in contrast with the conventional thinking, the external and internal interosseous intercostals acting alone have by and large a similar effect on the ribs into which they insert; (b) this effect is very much dependent on rib cage (lung) volume; and (c) intercostal muscle action is primarily determined by the resistance of the upper ribs to caudad displacement relative to the resistance of the lower ribs to cephalad displacement. The lateral intercostals, however, might be more involved in postural movements than in respiration. Their primary involvement in rotations of the trunk might account for the presence of two differently oriented muscle layers between the ribs. PMID- 3980729 TI - Absence of branched chain acyl-transferase as a cause of maple syrup urine disease. AB - Decreased function of human mitochondrial branched chain alpha-ketoacid dehydrogenase complex results in branched chain ketoacidemia or maple syrup urine disease. Activity of this multienzyme complex varies from 0 to approximately 15% of wild type branched chain alpha-ketoacid dehydrogenase complex activity within the population of homozygous affected individuals. We used the technique of Western Blotting with antibodies against purified bovine liver branched chain alpha-ketoacid dehydrogenase complex to screen mitochondrial proteins from cultured human fibroblasts for immunocrossreactive proteins. This method probes the physical structure of the proteins forming this multienzyme complex. One patient with branched chain ketoacidemia lacked an immunoreactive transacylase protein. This protein catalyzes the transfer of the branched chain acyl group from the decarboxylase to reduced coenzyme A. Kinetic analysis of the enzyme activity in cell lysates from this patient confirmed that the complex would not utilize coenzyme A. Thus, we have defined a structural basis for an impaired multienzyme complex of mitochondria in man. PMID- 3980730 TI - Additive effect of intravascular complement activation and brief episodes of hypoxia in producing increased permeability in the rabbit lung. AB - Systemic complement activation with intravascularly administered cobra venom factor (CVF) or infusion of either zymosan-activated rabbit plasma or a fifth component of complement fragment with anaphylatoxin activity in the rabbit have not caused significant increases in bronchoalveolar lavage albumin in rabbits (Webster, R. O., G. L. Larsen, B. C. Mitchell, A. J. Goins, and P. M. Henson. 1982. Am. Rev. Respir. Dis. 125:335-340). To assess if another stimulus (hypoxia) acting in concert with complement activation can produce significant lung injury, rabbits were challenged with CVF alone, 10 min of 12% oxygen alone, or CVF followed by a 10-min exposure to 12% oxygen. Either stimulus alone caused no significant changes in arterial oxygen, pulmonary resistance, or dynamic compliance during the 240 min of observation after either stimulus, and neither stimulus alone caused increased albumin accumulation in bronchoalveolar lavage over a 30-min period at the end of the experiment. However, the combination of insults significantly altered arterial oxygen, pulmonary resistance, and dynamic compliance while also increasing albumin and neutrophils recovered by lavage. The increase in lavage albumin did not appear to be due to hemodynamic events in that the pulmonary artery pressure increased acutely after CVF infusion and again during the hypoxic exposure, but was normal when albumin accumulation in the lung was measured. Neutrophil depletion with nitrogen mustard abolished all of these changes induced by CVF plus hypoxia. In addition, meclofenamate pretreatment and infusion during the 4-h study abolished the increases in lavage albumin and neutrophils as well as the increase in pulmonary artery pressure after CVF. Meclofenamate pretreatment did not, however, block accumulation of albumin in the lung (interstitium). We conclude that complement activation, as an isolated event, will not cause a significant increase in lavage albumin in this model. However, combining complement activation with an episode of hypoxia will lead to an increase in lavage albumin that is dependent on the presence of neutrophils for its expression. Meclofenamate treatment will prevent increases in lavage albumin and neutrophils while not preventing albumin accumulation in the lung (interstitium), suggesting a product of the cyclooxygenase pathway of arachidonic acid metabolism is needed to produce movement of albumin and/or neutrophils across the alveolar epithelium in this model. PMID- 3980731 TI - Cytochrome b deficiency in an autosomal form of chronic granulomatous disease. A third form of chronic granulomatous disease recognized by monocyte hybridization. AB - Three patients (two sisters and a brother) in one family are described with chronic granulomatous disease. The granulocytes of these patients did not respond with a metabolic burst to various stimuli and failed to kill catalase-positive microorganisms. The magnitude of the cytochrome b signal in the optical spectrum of the patients' granulocytes was less than 4% of the normal value, whereas the amount of noncovalently bound flavin in these cells was normal. The mode of inheritance of the genetic defect in this family is autosomal because the granulocytes of both parents (first cousins) and a nonaffected sister of the patients expressed 70-80% of the normal cytochrome b signal, showed low-normal or subnormal oxidative reactions during stimulation, and did not display mosaicism in the stimulated nitroblue-tetrazolium slide test. Somatic cell hybridization was performed between the monocytes from the affected boy in this family with monocytes from either a cytochrome b-negative male patient with X-linked chronic granulomatous disease or a cytochrome b-positive male patient with the classic autosomal form of this disease. In both combinations, monocyte hybrids were observed with nitroblue tetrazolium reductase activity after stimulation with phorbol myristate acetate. This complementation of the oxidase activity required protein synthesis. Our results prove that the defect in this family is genetically distinct from that in the other two forms of chronic granulomatous disease. Moreover, our results also indicate that the expression of cytochrome b in human phagocytes is coded by at least two loci, one on the X chromosome and one on an autosome. PMID- 3980732 TI - Inhibition of collagen deposition in the extracellular matrix prevents the establishment of a stroma supportive of hematopoiesis in long-term murine bone marrow cultures. AB - Long-term production of murine hematopoietic cells in vitro is dependent on establishment of a complex microenvironment consisting of a variety of stromal cells and an extensive extracellular matrix which includes collagen, fibronectin, laminin, proteoglycans, and other undefined components adherent to the culture dishes. Cis-4-hydroxyproline (CHP), a relatively specific inhibitor of collagen secretion, was used to examine the role of extracellular collagen deposition in supporting hematopoiesis in long-term C57B1/6J mouse bone marrow cell cultures. Throughout the 10-wk culture period, all culture dishes contained either 0, 10, 25, or 50 micrograms/ml of CHP. All medium and nonadherent cells were removed at weekly intervals and replaced with fresh medium containing the previous concentrations of CHP. Nonadherent cells were assayed weekly for total cells and pluripotent, erythroid, megakaryocytic, and granulocytic-macrophage progenitor cells. Dishes were killed at selected intervals to assess protein and collagen synthesis in the adherent layer. Adherent cell numbers, as judged by microscopic examination and DNA assays, correlated inversely with CHP concentrations used and paralleled degree of collagen synthesis inhibition. The decreased hemopoietic progenitor cell production correlated closely with percent inhibition of collagen synthesis and stromal cellularity. The CHP concentrations tested were not directly toxic to hemopoietic progenitor cells. These studies demonstrate that collagen deposition in the extracellular matrix of murine bone marrow cell cultures is essential to the establishment of a functional stromal microenvironment that is supportive of long-term hematopoiesis. PMID- 3980735 TI - Motivational deficit in depressed cancer patients. AB - A motivational theory of depression states that depression consists of low expectations and low values for rewards. This theory accurately describes one class of depression, the affective disorders. The present study tested its accuracy for another class of depression, adjustment disorder with depressed mood. This class of depression is precipitated by environmental stresses, such as chronic illness. The focus was therefore on people (N = 48) who were experiencing terminal cancer and nonterminal cancer. Results supported each prediction generated by the motivational theory. The cancer patients exhibited low expectations and low values; hence, they were unmotivated and depressed. Implications are that some of the symptoms exhibited by cancer patients may be manifestations of negative beliefs rather than physical impairments. PMID- 3980734 TI - Effects of endogenously produced leukotrienes, thromboxane, and prostaglandins on coronary vascular resistance in rabbit myocardial infarction. AB - In an effort to evaluate the synthesis and function of eicosanoids in myocardial infarction, we have developed a technique of in vivo myocardial infarction in rabbits followed by ex vivo cardiac perfusion. Isolated Langendorff perfused infarcted hearts (removed 1 or 4 d after infarction) responded to the inflammatory cell agonist N-formylmethionyl-leucyl-phenylalanine (fMLP) with (a) the release of leukotrienes B4, C4, and D4; (b) the release of large amounts of thromboxane (235 +/- 66 ng/5 min), prostacyclin (714 +/- 285 ng/5 min), and prostaglandin E2 (PGE2) (330 +/- 108 ng/5 min); and (c) a coronary vasoconstriction (21.1 +/- 2.5% increase in coronary perfusion pressure) that was specifically inhibited by the peptidoleukotriene receptor antagonist FPL-55712. While noninfarcted hearts challenged with fMLP also released leukotrienes B4, C4, and D4, they released only small amounts of the cyclooxygenase products (thromboxane, 30 +/- 9 ng/5 min; prostacyclin, 120 +/- 54 ng/5 min; PGE2, 27 +/- 10 ng/5 min) and showed minimal vasoconstriction (5.6 +/- 2.1% increase in perfusion pressure). Similarly, hearts challenged with fMLP 30 d following infarction released only small amounts of the cyclooxygenase products (thromboxane, 42 +/- 8 ng/5 min; prostacyclin, 386 +/- 31 ng/5 min; PGE2, 79 +/- 25 ng/5 min). When bradykinin was administered, no leukotrienes were produced, but acutely infarcted hearts released 10 times more thromboxane, prostacyclin, and PGE2 than normal hearts and significantly larger amounts of these products than 30-d infarcted hearts. Histologic analysis showed no inflammatory cells in normal hearts, a prominent polymorphonuclear leukocyte infiltration in 1-d infarcted tissue, fibroblast proliferation with mononuclear cell invasion in 4-d infarcted tissue, and a fibrotic scar with scanty mononuclear cell infiltrate in 30-d infarcted tissue. Inflammatory cell invasion was temporarily associated with augmented cyclooxygenase metabolism, suggesting that infiltrating leukocytes may be responsible for production of thromboxane, prostacyclin, and PGE2 in acutely infarcted hearts. The finding that endogenously produced peptidoleukotrienes are potent coronary vasoconstrictors in infarcted rabbit hearts suggests that these products may contribute to tissue injury in myocardial infarction. PMID- 3980733 TI - Effects of chronic ethanol intake on mobilization and excretion of cholesterol in baboons. AB - To investigate the effects of chronic ethanol administration on the mobilization and excretion of cholesterol, turnover and balance studies were carried out in baboons pair-fed cholesterol-free diets containing 50% of energy either as ethanol or as additional carbohydrate for several years. Ethanol feeding increased free cholesterol in all plasma lipoprotein fractions, and esterified cholesterol in very low density lipoprotein, intermediate density lipoprotein, and high density lipoprotein (HDL). The major increase occurred in HDL, mainly as esterified cholesterol. The latter was associated with decreased transfer of esterified cholesterol from HDL to low density lipoprotein. By contrast, the smaller increase in HDL-free cholesterol was associated with increased turnover in the plasma, increased splanchnic uptake, and increased fecal excretion of plasma cholesterol, mainly as neutral steroids. Cholesterol extraction predominated over release in the splanchnic vascular bed, suggesting that the excess of cholesterol excreted in the feces originated in extrasplanchnic tissues. Thus, these findings indicate that alcohol consumption favors mobilization of tissue free cholesterol for hepatic removal and excretion. By contrast the increase in HDL-cholesterol (mainly esterified) appears to be a poor indicator of cholesterol mobilization. PMID- 3980737 TI - The MMPI and the post-traumatic stress syndrome in Vietnam era veterans. AB - MMPI profiles of Post-traumatic Stress outpatient and newly admitted Random Psychiatric inpatient veterans are practically identical, which indicates the severity of delayed response to stress in Vietnam veterans, especially those from urban, disadvantaged environments. PMID- 3980736 TI - Paranoid and nonparanoid schizophrenia: drive dominated thinking and thought pathology at two phases of disorder. AB - A sample of acutely hospitalized paranoid and nonparanoid schizophrenics and another sample of paranoid and nonparanoid schizophrenics studied at follow-up were compared on measures of cognitive functioning, disordered thinking, and drive dominated thinking using the WAIS, the Rorschach test, the object sorting test, and an overall index of outcome functioning (N = 67). Results suggested that cognitive regression is related more to acute psychological disturbance than to the presence or absence of paranoia, that the presence of socialized drive dominated thinking during the acute phase is related to better posthospital adjustment at follow-up, and that paranoid schizophrenics show better cognitive functioning after the acute phase. Results did not support the theory that suggests an etiological relation between homosexual conflict and paranoia. PMID- 3980738 TI - The measurement of schizophrenic conceptualization using a Spanish translation of the Whitaker Index of Schizophrenic Thinking. AB - The Spanish translation of Form A of the Whitaker Index of Schizophrenic Thinking (WIST) was administered to 50 schizophrenic (25 acute; 25 chronic) and 50 (25 = depressives; 25 = normals) nonschizophrenic residents of the Commonwealth of Puerto Rico. Results suggest that this translation effectively discriminated between schizophrenics and non-schizophrenics on the WIST total score, time, and index. A cut-off of 25 on the WIST index correctly classified 98% of the schizophrenic volunteers. PMID- 3980739 TI - Social skills deficits and self-evaluation among depressed and nondepressed psychiatric inpatients. AB - Depressed psychiatric inpatients, nondepressed psychiatric inpatients, and nonpsychiatric controls role-played responses to 28 standardized interpersonal situations. Judges blindly rated these responses on overall social skill and component measures, and subjects rated their own social skills. Judges rated depressed and nondepressed psychiatric patients as having significant problems in social skills compared to normals. No differences were found between the two patient groups in judges' ratings of social skill. Depressed patients rated their own recent interpersonal behavior and optimal social skills significantly lower than did subjects in the other groups. Results suggest that social skills deficits are not specific to depression and that depressives and other psychiatric groups may differ primarily in their self-appraisals of social competence. PMID- 3980740 TI - The relationship between electromyogram level and the Children's Personality Questionnaire as measures of tension in upper elementary gifted students. AB - This study investigated the relationship between biofeedback and tension as measured by an EMG and a self-report inventory, the Children's Personality Questionnaire (CPQ), in a sample of 37 intellectually gifted fourth- through seventh-graders. Results showed that indirect factors that measure tension on the CPQ were correlated significantly with biofeedback measures. Those subjects who became the most relaxed during the biofeedback training appeared the least tense on the CPQ. Contrary to these findings, the Relaxed-Tense factor of the CPQ was correlated significantly and negatively with biofeedback measures, which indicates that subjects may not have been aware of their own tense state and thus would benefit from biofeedback training. PMID- 3980742 TI - Characteristics of female clients that influence preference for the socially intimate and nonintimate female psychotherapists. AB - This study documented the relationship among various client characteristics and client preference for therapists who exhibit intimate and nonintimate therapy styles. Seventy-five female college students were administered in random order measures to assess their levels of social intimacy, sex role type, locus of control, therapy expectancy, and authoritarianism. The participants then watched in random order of presentation the audiovisual recordings of first therapy sessions that reflected intimate and nonintimate therapy styles. After each tape was presented, the participants completed a measure to assess their perceptions of the therapeutic relationship and a preference form. Results show that the socially intimate women have a preference for the intimate therapist. Results also show that women expect the therapist to exhibit intimate behaviors and that those who prefer this type of therapist perceive her as possessing significantly higher levels of intimacy, regard, empathy, and unconditional acceptance. PMID- 3980741 TI - Clients with MMPI high D-PD: therapy implications. AB - The personal characteristics of 80 clients with elevated 2-4 (D-PD) scales on their MMPIs were compared with those of 109 clients without these elevations. Clients with the 2-4 elevated were significantly more depressed, had lower self esteem, and were more likely to come from disturbed families. They also had poor relationships with the opposite sex, became more dependent on the therapist, and often made little improvement in therapy. In comparison to previous descriptions of hospitalized patients with similar profiles, the counseling center clients continue to function in the community and show less pathological behavior. Implications for therapy are discussed. PMID- 3980743 TI - Cluster analytic methods applied to the Minnesota Multiphasic Personality Inventory in a psychiatric population. AB - Cluster analysis and the MMPI were used together to determine whether the heterogeneous diagnostic groups could be identified in an inpatient psychiatric population. The effectiveness of four clustering techniques in separating diagnostic groups was compared using percent of coverage, between-sample replication, between-method replication, cluster differences on age, and cluster differences on diagnosis. The results showed cluster analysis to be a poor diagnostic discriminator when compared to diagnostic groups, which were considered the "true" clusters of the sample. The final conclusion of the study was that cluster analysis should not be used to form groups that would be diagnostically labeled because each analytic technique produced misleading results. PMID- 3980744 TI - Mexican Americans' performance on the MMPI as a function of level of acculturation. AB - Previous researchers have concluded that differences in MMPI performance between Anglo and Mexican American surnamed subjects were due to cultural differences. The present research directly investigated this assumption by comparing MMPI scale score differences of 365 Anglo and Mexican American college students, with Acculturation, Age, and Socioeconomic status statistically controlled. Anglos scored significantly differently from Mexican American subjects on 10 of the 13 MMPI scales. With Acculturation and Age statistically controlled, however, Anglo vs. Mexican American subjects differed on only the L and MF scales. These results support previous conclusions that most MMPI differences between Anglo and Mexican American subjects are due to culture, or Acculturation. Our results are consistent with major findings within the MMPI literature and also support the hypothesis that personality differences identified by the L and MF scales reflect genuine characteristics of the Mexican-American culture. PMID- 3980745 TI - Depression Adjective Check Lists: Spanish, Hebrew, Chinese and English versions. AB - Data are presented on the translation, reliability, concurrent validity, and norms of the Spanish, Hebrew, and Chinese versions of three equivalent forms of the Depression Adjective Check Lists, and comparisons with the English version are made. Reliability estimates (split-half, alternate form, and internal consistency) for the four versions are quite similar in magnitude (.79 to .94). Concurrent validity was determined in each case by means of correlations with translated versions of a self-rating scale of depression, the Bradburn Scale, the Cantril Self-Anchoring Striving Scale, and the Katz Psychophysiologic psychosomatic Symptom Scale. The English and Hebrew norms are based upon national probability sampling. PMID- 3980746 TI - Performance of bilingual subjects on Spanish and English versions of the Depression Adjective Check Lists. AB - To study the performance of bilingual subjects on the Spanish and English versions of the Depression Adjective Check Lists (DACL), 27 males and 34 females completed the three forms of the DACL (E, F, and G), each of which was printed half in Spanish and half in English. Order of language was counterbalanced. No significant effects either for language or sex of subject were found. These findings, together with high correlations (.84 to .89) between the Spanish and English halves of each list, support the use of the Spanish version of the DACL in research with Spanish-speaking subjects from the southwestern United States. PMID- 3980747 TI - A statistical reevaluation of the STAI anxiety questionnaire. AB - This study examined the capability and efficiency of two commonly used scales, the trait and trait and state inventories (Spielberger et al., 1970), to measure anxiety construct (N = 100). The probabilistic Rasch Model (Wright & Masters, 1982) was applied to athletes' responses to trait and state anxiety items before competition (stress). The analysis indicated that several items of both scales produce misfit responses, share identical locations on the continuum, and do not produce equal units of measurement. The findings question the generalizability of the research on anxiety. Recommendations for improving the anxiety tests are made. PMID- 3980748 TI - Relationships between measures of brain functions and general intelligence. AB - Relationships between measures of general intelligence (Wechsler-Bellevue Verbal IQ, Performance IQ, and Full-scale IQ) and a measure designed to reflect adequacy of brain functions (Halstead Impairment Index) were studied using a control group and groups with left, right and generalized cerebral lesions. The results confirmed earlier findings of (1) differential levels of Verbal and Performance intelligence depending on damage of the left or right cerebral hemisphere; and (2) the greater general sensitivity of the Impairment Index than IQ values to brain damage. Comparative data suggested particularly that IQ values may underestimate brain-dependent adaptive abilities among non-brain-damaged subjects. A significant relationship between IQ values and the Impairment Index was present. This finding permitted evaluation of use of a differing cut-off Impairment Index, as an indicator of cerebral damage, depending on the subject's IQ level. The results suggested that increased accuracy in classifying subjects as brain-damaged might be achieved using a cutting Impairment Index of .4 or greater when the IQ value is 100 or more and .5 or greater when the IQ value is below 100. PMID- 3980749 TI - Normative data on the WAIS-R for Selz and Reitan's index of scatter. AB - The scatter index of Selz and Reitan (1979) was examined for the Wechsler Adult Intelligence Scale-Revised using the national normative sample. Results indicate that means and variances are substantially greater for adults than has been found for children. Correlations of scatter with several subject characteristics were found, which further limits potential utility of the index. Large percentages of the sample exceeded the Selz and Reitan criteria for abnormality, and, thus, invalidated these guidelines for adult populations tested with the WAIS-R. PMID- 3980750 TI - Differentiation of organics from functional psychiatric patients across various IQ ranges using the Bender-Gestalt and Hutt Scoring System. AB - This study investigated the effectiveness of the Hutt Scoring System (Hutt, 1977) in differentiating organic from functional psychiatric patients, the relationship of IQ to Bender-Gestalt errors as measured by this scoring system, and examined the discriminative power of this scoring system for various IQ ranges. One hundred eighty patients were utilized, 90 of whom had been classified as organics and matched with the remaining 90 subjects on the basis of age, education, and IQ range. In addition, the organic subjects' secondary diagnosis was matched with the primary diagnosis of the nonorganic patients. Results between WAIS IQ and Hutt error scores for organic subjects yielded an r = -.34 (p less than .01); between WAIS IQ and Hutt error scores for the nonorganic subjects, r = -.61 (p less than .001). No significant results were obtained for organics and nonorganics simultaneously within the same IQ cells. PMID- 3980751 TI - Attentional deficit disorder and short-term visual memory. AB - Twenty-four children with Attentional Deficit Disorder (ADD) were compared to a control group of 17 children with emotional problems. All the subjects were tested on the Wechsler Intelligence Scale for Children-Revised (WISC-R), along with an adaptation of the Coding subtest to measure short-term visual memory. The results showed superiority of the control group on the short-term visual memory task. The correlations of short-term visual memory with each of the subtests of the WISC-R were different for each group. For the emotional group short-term visual memory correlated significantly with the WISC-R verbal scores, while in the ADD group visual memory more often significantly correlated with performance subtests. In the discussion an attempt was made to explore the reasons for these differences and their implications for academic tasks. PMID- 3980752 TI - Comparative validity of two WAIS-R short forms with clients of low IQ. AB - This study investigated the validity of two- and four-subtest combinations as estimates of WAIS-R Full Scale IQ among clients of low IQ (N = 100). Differences between the short-form means were small and nonsignificant. The correlation between Full Scale IQ and two-subset estimates was .86 and was .92 for the four subtest estimate. These account for 74% and 85% of the variance, respectively. The two-subtest form correctly classified 69% of the subjects by intelligence category, and the four-subtest form correctly classified 85%. It was concluded the four-subtest form is superior as a screening device when complete administration of the WAIS-R is not feasible. PMID- 3980753 TI - Effect size estimates in chemical aversion treatments of alcoholism. AB - This study found that aggregate studies on alcohol aversion therapy tended to support a moderate level of treatment impact that may have noteworthy practical import. Emetics appear to generate fairly consistent findings; a paralysis inducing chemical may produce variable results. PMID- 3980754 TI - Validation of the Luria-Nebraska Intellectual Processes Scale as a measure of intelligence in male alcoholics. AB - This study investigated the Luria-Nebraska Intellectual Processes Scale (IPS) as a predictor of Wechsler Adult Intelligence Scale (WAIS) IQs among alcoholic inpatients. Strong correlations were found between the IPS and WAIS Verbal IQ and Full Scale IQ; however, the correlation with Performance IQ was only -.41. IQ estimates based on Prifitera and Ryan's (1981) regression equations derived on psychiatric inpatients differed significantly from obtained IQs in the current alcoholic sample. The importance of adequately assessing Performance IQ among patients with alcohol-related problems is discussed. PMID- 3980755 TI - Hedlund paranoia. AB - A brief review of Tarasoff vs. Regents of University of California (1976) 17 Cal.3d 425 is presented, followed by several important issues that have emerged from that decision. Tarasoff's most recent progeny, Hedlund vs. Superior Court (1983) 34 Cal.3d 695, then is reviewed in light of Tarasoff and current tort law in California. It is asserted that the Hedlund decision has been egregiously misread and that many psychologists consequently are painfully misinformed. PMID- 3980756 TI - Communicative effectiveness in Broca's aphasia. AB - The purpose of this study was to investigate communicative effectiveness in aphasia. Five patients with Broca's aphasia and five neurologically normal subjects participated in referential communication and spontaneous conversation tasks. Performance on the referential tasks was used to derive measures of communication success, learning, and efficiency. A representative sample of utterances from the referential tasks and 100 utterances from the spontaneous conversation task also were analyzed to determine the frequency of operationally defined errors in speech, lexical access, grammar, content, discourse, and use. Results suggest that patients with Broca's aphasia retain communicative effectiveness in the presence of significant speech and language deficits and experimentally imposed constraints on the use of visual and gestural communication modalities. PMID- 3980757 TI - Ear asymmetry for monaurally presented word lists in children and adults. AB - In order to study ear asymmetry during monaural stimulation, 80 listeners were asked to recall the word which followed a probe word in 40, 10-word lists. Subjects were divided into four age groups: 7-9, 13-16, 25-30, and 60+ years. Probe words occurred in early (position 2) or late (position 7) in each 10 word list. Superior recall accuracy was shown when words were presented to the right ear of 48 subjects. 12 subjects demonstrated superior left ear performance, and 20 subjects performed equally well in each ear. Subjects showing superior right ear performance also demonstrated superior overall performance. Older children and younger adults performed significantly better than younger children or older adults. The factor of subject sex was not significant. Ear asymmetry during monaural stimulation appeared to be related to competition between incoming and rehearsed stimuli during central memory processing. PMID- 3980758 TI - A word-ordering test to differentiate between aphasia and schizophrenia. AB - The capacity of a word-ordering task to differentiate aphasic and schizophrenic patients was assessed. Cards containing words from 10 types of sentences were given to the patients. Each sentence was presented individually with the words in jumbled order and patients were asked to reorder them to produce a gramatically correct sentence. Process and reactive schizophrenics were differentiated from aphasic patients using the dual criteria of more than three incorrect sentences or an average of more than 90 sec per sentence as indicative of aphasia. These criteria were initially tested on a group of aphasics matched with the schizophrenics on age and education and cross-validated using a second more representative sample (unmatched) of aphasics. Both comparisons showed no errors of classification. Further analyses indicated no need for separate norms or classification criteria related to the sex, age, or educational level of the patients. PMID- 3980760 TI - Speed of color naming and intelligence: association in girls, dissociation in boys. AB - We administered a rapid naming test to a sample of prereaders. Slow performance on this task among older children is known to be associated with reading disability. Results showed a sex difference in the degree of correlation between naming performance and a test of general intelligence. The finding was replicated on an independent sample. This finding bears theoretically on the degree to which a learning disability can appear as an isolated deficit in the two sexes. PMID- 3980759 TI - Speed of color naming and degree of familial sinistrality: correlation in girls, no correlation in boys. AB - Twenty-nine male and 35 female right-handed children, aged 5 to 7, were assessed for the effect of familial sinistrality on a rapid color-naming task. Controlling for age and family size, a significant effect for degree of familial sinistrality was found in the girls but not in the boys. Among the girls, those with two or more left-handed or ambidextral relatives were the fastest on the color-naming task, those with no such relatives were the slowest, and those with only one left handed or ambidextral relative scored between the other two groups in color naming speed. It is suggested that a gene associated with left-handedness, when present in a right-hander, interacts with sex to produce the superior color naming performance that we observed in girls but not in boys. PMID- 3980761 TI - Symbolic play and early communication development in hearing-impaired children. AB - This study investigated the relationship between symbolic play and language performance for young hearing-impaired children. Subjects included 20 hearing impaired youngsters ranging in age from 38 months to 69 months. The children were placed in two ordinal communication groups. Placement in one of the communication levels was dependent upon information concerning the number of spontaneous expressive communication units the child produced. The experimental task consisted of three predetermined play themes in which the child previously displayed functional play. A nonconventional item was then included, and the play behaviors were observed for the occurrence of symbolic play under a spontaneous or modeled condition. The results indicate a significant difference in symbolic play between the two ordinal communication levels. Additionally, there was a strong positive relationship observed between the variables of symbolic play and early communication development. PMID- 3980762 TI - The pretectal complex of the monkey: a reinvestigation of the morphology and retinal terminations. AB - The cytoarchitecture of the pretectal complex of the squirrel monkey was examined in Nissl- and myelin-stained sections in the coronal, horizontal, and sagittal plane. Five different pretectal subdivisions can be identified on the basis of their nuclear morphology. The general location and cytoarchitecture of these pretectal nuclei are similar to those described for non-primate mammals. Thus, the nomenclature used to designate the pretectal nuclei in other species can now be applied to the squirrel monkey. According to this standard terminology, the pretectal complex of the squirrel monkey consists of the nucleus of the optic tract; the pretectal olivary nucleus; and the medial, anterior, and posterior pretectal nuclei. The pattern of retinal innervation to the pretectum was also determined by placing intraocular injections of 3H-proline into one eye and processing the tissue according to standard autoradiographic techniques. The pattern of transported label is more dense over the contralateral nuclei than over the ipsilateral nuclei. In particular, dense transported label is observed bilaterally over the pretectal olivary nucleus and the nucleus of the optic tract with sparse label over the posterior and medial pretectal nuclei. PMID- 3980764 TI - The formation of the axonal pattern in the embryonic avian retina. AB - Both the polarity of the axonal growth and the formation of the optic fiber pattern early in retinal morphogenesis were studied in silver stained whole mounts of embryonic chick, quail, and pigeon retinae. The surface area of the retina and of the optic fiber layer increases in size exponentially, the optic fiber layer expanding faster than the retina. The optic fiber layer covers the retinal surface at E5 in quail and at E6 in chick and pigeon. In all species studied, the retinal fiber layer does not expand homogeneously with the optic nerve head as the center. Instead, the retinal fiber layer enlarges with polarities in the dorsal to ventral and nasal to temporal direction. The very first axon bearing ganglion cells appear at stage 16 in the dorsal and central portion of the retina and grow ventrally to merge at the optic disk. From stage 23 on, the optic fiber layer expands faster in the temporal than in the nasal side. Measurements on the initial polarization of young axonal processes show that the axonal growth is directed toward the optic fissure and the optic nerve head. This growth polarization is found at the onset of growth cone formation and in axons far from the nearest ganglion cells or ganglion cell axons. Therefore axon-axon interaction cannot be involved in the initial axon orientation early in retinal morphogenesis. PMID- 3980763 TI - Callosal and prefrontal associational projecting cell populations in area 7A of the macaque monkey: a study using retrogradely transported fluorescent dyes. AB - The spatial interrelationship of neurons in area 7a in the inferior parietal lobule that project through the corpus callosum to the corresponding field in the contralateral hemisphere or to the ipsilateral prefrontal cortex has been analyzed in macaque monkeys by using double-labeling procedures with retrogradely transported fluorescent dyes. The populations of callosal and associational projecting neurons have similar laminar distributions and are topographically intermingled. Less than 1% of the neurons were double-labeled, thus suggesting that the two populations are largely separate. Two-dimensional reconstructions of the distribution of labeled cells made on flattened reconstructions of the inferior parietal lobule revealed that the areal distribution of the two cortico cortical output arrays is complex. Although each pattern of labeling showed some discontinuities in density, there was no obvious periodicity within or between the spatial distributions of the two projecting populations. It was consistently observed that the cortex of the lateral wall of the intraparietal sulcus, adjacent to area 7a, projects more heavily to the prefrontal cortex than does area 7a itself. PMID- 3980765 TI - Corticomotoneuronal synapses in the monkey: light microscopic localization upon motoneurons of intrinsic muscles of the hand. AB - Some corticospinal neurons give rise to axons which terminate directly upon motoneurons, thereby establishing corticomotoneuronal connections. The location of corticomotoneuronal synapses upon motoneurons innervating intrinsic muscles of the hand in the monkey was demonstrated by the use of intra-axonal and intracellular horseradish peroxidase (HRP). After a number of corticospinal axons originating from the "hand" area of the precentral gyrus had been injected with HRP in the lateral funiculus at C7-C8, a number of nearby identified intrinsic hand muscle motoneurons were also injected. Connections between corticomotoneuronal fibres and motoneurons were reconstructed from longitudinal parasagittal sections treated by the cobalt-enhanced diaminobenzidine method. Corticospinal axons in the lateral funiculus gave rise to main collaterals which provided an extensive arborization in lamina IX, where it was predominantly longitudinal, and in the adjacent intermediate zone. En passant and single or clustered groups of terminal boutons arose from preterminal branches of these arbors. Seven light-microscopically identified corticomotoneuronal synapses were found. They were located upon the dendrites of recipient motoneurons at 40 micron to 750 micron from the soma and ranged in size from 0.6 X 3.0 micron to 2.4 X 3.6 micron. The results suggest that each main collateral of a corticomotoneuronal axon establishes very few synaptic contacts, and possibly only one, with the dendrites of recipient motoneurons. This small number of contracts per motoneuron is consistent with the small amplitudes of minimal and unitary corticomotoneuronal EPSPs recorded from forelimb and hand motoneurons. PMID- 3980766 TI - Ascending somatosensory projections to the medial accessory portion of the inferior olive: a retrograde study in cats. AB - The cells in the dorsal column nuclei, lumbosacral spinal cord, lateral cervical nucleus, and nucleus z that project to the medial accessory portion of the inferior olive of cats were identified with retrograde tracing techniques. Injections of wheat germ agglutinin complexed to horseradish peroxidase were made in the caudal portion of the medial accessory olive, either (1) involving no portion of the dorsal accessory olive or (2) involving in addition the caudal tip of the dorsal accessory olive. The tissue was processed with tetramethyl benzidine. The locations of all relay neurons were compared with those of dorsal accessory olive projection neurons, as described in a previous study (Molinari, '84a). Localized populations of neurons gave rise to most of the projection to the medial accessory olive. These neurons were found in the peripheral portions of the dorsal column nuclei caudal to the obex and in the ventromedial ventral horn of the entire lumbosacral enlargement. Few projection neurons were found in the lateral cervical nucleus and none in the nucleus z. Neurons in the peripheral dorsal column nuclei and ventromedial ventral horn were labeled by injections in either the medial or dorsal accessory olives. Following medial accessory olive injections, however, they constituted the only labeled somatosensory neurons, while following dorsal accessory olive injections they represented only a small fraction of the labeled neurons. Based on their locations, it is proposed that these neurons might be the source for both the medial and dorsal accessory olives of information signalling movement of the proximal limb. Such a proposal is consistent with functional descriptions of the medial and dorsal accessory olives and the cerebellar anterior lobe. PMID- 3980767 TI - Central distribution of efferent and afferent components of the pudendal nerve in macaque monkeys. AB - Central distribution of efferent and afferent components of the pudendal nerve was studied by the horseradish peroxidase (HRP) method in 13 macaque monkeys, i.e., in nine Japanese monkeys (Macaca fuscata), two rhesus monkeys (Macaca mulatta), and two crab-eating monkeys (Macaca fascicularis). The enzyme was applied to the central cut end of the pudendal nerve; then the monkeys were allowed to survive for 36 to 72 hr. Retrogradely labeled neuronal cell bodies of pudendal motoneurons constituted a slender longitudinal cell column in the ventral horn. The cell column extended from high or middle S1 to high or middle S2 in eight monkeys, from middle or low L7 to high S2 in four monkeys, and from high L7 to middle S1 in a monkey. The cell column appeared to correspond to Onuf's X nucleus in man. No sex difference was recognized in the position of the cell column. The average number of HRP-labeled pudendal motoneurons was larger in male than in female adult Japanese monkeys, whereas no sex difference was found in the average soma diameter of the pudendal motoneurons. Transganglionically labeled axons entered into the spinal cord through the S1 and S2 dorsal roots in 12 monkeys and through the L7 and S1 dorsal roots in one monkey. Labeled axons were distributed ipsilaterally in laminae I-VI and X of the spinal cord at the same and adjacent levels of entry of HRP-labeled dorsal root fibers (from L7 to S3 in 12 monkeys and from L6 to S3 in one monkey).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980768 TI - Parasol and midget ganglion cells of the human retina. AB - Golgi-impregnated ganglion cells were studied in two flat-mounted human retinas. A number of different morphologic forms were observed, and those showing a thickly branching dendritic field with terminals that stratified within a narrow zone of the inner plexiform layer were selected for further investigation. When the dendritic field diameter of these cells was plotted against distance from the fovea, the scatter diagram showed two distinct clusters. At any given eccentricity, there was no overlap between the cell group with large dendritic fields and the group with small dendritic fields. Those with the larger dendritic fields also tended to have larger somas and thicker axons than the group with the smaller dendritic fields. The dendritic fields of both groups tended to be elongated, and the orientation and degree of this elongation were quantified by determining the best-fitting ellipse for each dendritic field. The degree of elongation was independent of eccentricity. The orientation of the dendritic field (major axis of the ellipse) of a cell did not appear to be independent of its position on the retina. To test whether the major axes tended to be directed toward any particular point on the retina, the positions of the cells on the retinal flat mount were transformed to relative positions on the retinal hemisphere, and the orientations of the dendritic fields were expressed in a spherical coordinate system for this hemisphere. A search was made for the position on the hemisphere which minimized the mean square deviation of the orientations from this point. The group with the large dendritic fields showed a significant tendency to be radially oriented toward a specific location on the retinal hemisphere, and that location lay within a few degrees of the fovea. Leventhal and Schall ('83) have reported a similar finding for ganglion cells of the cat retina. For the group with small dendritic fields, the retinal location that minimized the mean square deviation was also near the fovea; however, the set of orientations showed no greater tendency for mutual alignment than did a randomized set. The cell group with the large dendritic fields appears to correspond to Dogiel's (1891) type II cells, to Polyak's ('41) parasol cells, to the A cells of the monkey retina described by Leventhal et al. ('81), observed following HRP injection to the magnocellular layer of the LGN, and to the P alpha cells of the monkey retina, observed by Perry and Cowey ('81), following HRP uptake by cut axons of the optic nerve.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3980769 TI - Computer reconstruction of all the neurons in the optic ganglion of Daphnia magna. AB - The cellular architecture of the Daphnia compound eye visual system was studied by using computer-aided techniques. All the neurons in one half of the bilaterally symmetric optic ganglion (OG) were reconstructed in three dimensions from serial electron micrographs. The techniques employed were those developed by Levinthal and collaborators (Macagno, Levinthal, and Sobel, Ann. Rev. Biophys. Bioeng. 8:323-351, 1979). The approximately 200 neurons reconstructed were classified according to where they branch in the OG (the lamina and/or the medulla) and whether they send processes to the supraesophageal ganglion and/or across the midplane. Within each class, neurons were further characterized according to cell body location and size and location of their branching fields. Centrifugal processes from neurons with cell bodies not in the OG were also identified. These results provide the bases for a detailed examination of the synaptic connectivity of the identified neurons and for hypotheses concerning their functional roles in visually evoked behaviors. PMID- 3980770 TI - Heterogeneous properties of segmentally homologous interneurons in the ventral nerve cord of locusts. AB - The G, B1, and B2 neurons are three prominent interneurons located in adjacent segmental ganglia in the central nervous system of locusts. Previous studies on the adult nervous system have shown that each of these cells has its own distinctive morphology and responsiveness to auditory input. Previous studies on the embryonic nervous system have described the lineage and development of one of these cells, the G neuron, in the mesothoracic (T2) segment. In this paper it is shown that the G, B1, and B2 neurons are segmental homologues in that they arise from equivalent lineages during embryogenesis in the T2, T3, and A1 segments, respectively. Each cell arises (along with its identified sibling neuron) from the division of the second ganglion mother cell of neuroblast 7-4. The segment specific morphology of the G homologues was determined in the T3 and A1 segments between 60-70% of embryonic development, and their identity was established as the adult B1 and B2 neurons by comparing the distinctive cell-specific features of their morphology between embryo and adult. Although all three neurons display striking morphological differences, they all share certain structural features in common, including the location of their primary axons and neurites in specific tracts in the neuropil. By recording intracellularly from the main neurites of the G, B1, and B2 neurons, clear differences were found in the synaptic inputs each of the neurons receives and the synaptic outputs each makes. For example, G and B2, but not B1, receive direct monosynaptic input from the descending contralateral movement detector (DCMD) interneurons and from auditory afferents; B1, but not B2, connects directly to G; and B2, but not B1 or G, connects directly to flight motoneurons. The main conclusion from these observations is that lineally equivalent neurons in different segments can develop similar primary structures but quite different secondary morphologies and synaptic connections. How these segment-specific differences arise during embryogenesis remains unknown. PMID- 3980771 TI - Interhemispheric pathways of the hippocampal formation, presubiculum, and entorhinal and posterior parahippocampal cortices in the rhesus monkey: the structure and organization of the hippocampal commissures. AB - The interhemispheric pathways originating in the hippocampal formation, presubiculum, and entorhinal and posterior parahippocampal cortices and coursing through the fornix system were investigated by autoradiographic tracing in 29 rhesus monkeys (Macaca mulatta). The results revealed that crossing fibers are segregated into three contiguous systems. A ventral hippocampal commissure lies at the transition between the body and anterior columns of the fornix in the vicinity of the subfornical organ and the interventricular foramina of Monro; it is formed by axons arising in the most anterior (uncal and genual) subdivisions of the hippocampal formation. A dorsal hippocampal commissure lies inferior to the posterior end of the body of the corpus callosum; it is formed by axons arising in the presubiculum and entorhinal cortex of the anterior parahippocampal gyrus and the proisocortical and neocortical subdivisions of the posterior parahippocampal gyrus but not in the hippocampal formation. A hippocampal decussation lies between the ventral hippocampal commissure and dorsal hippocampal commissure; it is formed by axons arising in the body of the hippocampal formation. In contrast to the fibers of the ventral hippocampal commissure and dorsal hippocampal commissure, which terminate in contralateral cortical areas, these decussating fibers terminate in the contralateral septum. Thus, the ventral hippocampal commissure and dorsal hippocampal commissure of the rhesus monkey appear to be homologous to similarly designated structures in other mammals. To the extent that these observations also apply to the interhemispheric fibers of the human hippocampal formation and parahippocampal areas, their possible preservation must be considered when interpreting the effect of callosal transection on seizures and the results of "split-brain" studies, since callosal transection may fail to sever the hippocampal commissures in their entirety. PMID- 3980772 TI - Tectoreticular pathways in the turtle, Pseudemys scripta. I. Morphology of tectoreticular axons. AB - Tectoreticular projections in turtles were examined by reconstructing from serial sections axons that were anterogradely filled with horseradish peroxidase after tectal injections. Three tectoreticular pathways each contain extensively collateralized axons. The crossed dorsal pathway (TBd) contains large and small caliber axons. After leaving the tectum, TBd axons emit collaterals into the ipsilateral profundus mesencephali rostralis and then give off a main rostral branch that bears secondary collaterals in the ipsilateral interstitial nucleus of the medial longitudinal fasciculus and the suprapeduncular nucleus. The main trunks cross the midline and descend in the predorsal bundle, generating collaterals at regular intervals. These terminate mostly in the medial half of the reticular core from the midbrain to the caudal medulla. Axons in the uncrossed intermediate pathway also emit collaterals into a midbrain reticular nucleus (profundus mesencephali caudalis) and often have a thick rostral branch. The main caudal trunks, however, remain ipsilateral and travel in a diffuse, laterally placed tract, where each emits a long series of collaterals into the lateral half of the reticular core. The uncrossed ventral pathway (TBv) contains medium and small caliber axons. TBv axons often have collaterals within the tectum and apparently lack main rostral branches. Their caudal trunks run in the tegmental neuropile below the TBi where they collateralize less exuberantly than do TBd and TBi axons. The morphology of axons in all three pathways suggests that projections from disjunct tectal loci converge at many rostrocaudal levels within the reticular formation. This point was examined explicitly in experiments in which two disjunct injections were placed in one tectal lobe. Intermediate pathway axons traced from the two loci initially formed two distinct bundles but then intermingled in the reticular formation. PMID- 3980773 TI - Tectoreticular pathways in the turtle, Pseudemys scripta. II. Morphology of tectoreticular cells. AB - The morphology of tectoreticular neurons in turtles was examined with serial section reconstructions of neurons retrogradely filled with HRP. Six classes of tectal neurons project into the three tectobulbar pathways characterized in the preceding paper (Sereno, '85). (1) Large multipolar neurons with somata in the central gray layers, and with moderately branched dendrites sometimes spanning over a millimeter, project into the dorsal tectobulbar pathway, TBd. Their dendrites are covered with fine spicules and tend to arborize in the lower third of the superficial gray layers. (2) Medium-sized neurons with multiple radial dendrites and somata in the central white and upper periventricular layers probably project into the ipsilateral intermediate tectobulbar pathway, TBi. Their dendrites also bear fine spicules and usually reach the tectal surface. (3) Small radial cells in the periventricular layers, and (4) small bitufted radial cells in the superficial gray project into the small caliber component of the ipsilateral ventral tectobulbar pathway, TBv(sm). (5) Medium-sized central gray neurons with stratified dendrites, and (6) medium-sized central gray neurons with horizontal dendrites probably project into the medium caliber component of the ventral tectobulbar pathway, TBv(med). In contrast to TBd and TBi neurons, these last four classes emit a spray of long, filamentous dendritic appendages in the central gray and have dendritic arbors near the top of the superficial gray. The morphology of the neurons described in this and the preceding paper is briefly discussed in light of current ideas about tectally mediated sensorimotor transformations. PMID- 3980774 TI - Rat medulla oblongata. I. Cytoarchitectonic considerations. AB - The goal of this study was to define the detailed cytoarchitecture of the medulla oblongata of the rat in order to accurately localize immunocytochemically distinct populations of neurons in this region. The cytoarchitectonic features of this region of the rat brain stem were examined in 40 micron thick serial sections of celloidin embedded brains blocked in the Horsley-Clarke stereotaxic plane. These sections were stained with cresyl violet and examined at a number of different magnifications with a variety of different intensities of staining to demonstrate particular features of the cells in this region. High magnification photomicrographs of this material revealed characteristic features of the various populations of cells. The results illustrate that the cytoarchitecture of the medulla oblongata of the rat changes remarkably within very short distances in the rostrocaudal direction. These changes indicate the need to study the anatomy and immunocytochemistry of this region in detailed serial sections. The ventral reticular formation of the rat medulla is cytoarchitectonically complex. Nuclear groups such as the lateral reticular nucleus (LRt) contain a number of cytoarchitectonically distinct subnuclei, as does the dorsally located nucleus of the tractus solitarious (nTS) (Kalia and Sullivan, '82). These nuclei occupy a considerable length of the medulla and terminate abruptly at the pontomedullary boundary. A number of other cytoarchitectonic features of the medulla were examined and the detailed characteristics were defined. PMID- 3980775 TI - T reticular interneurons: a class of serially repeating cells in the zebrafish hindbrain. AB - We describe a class of reticular neurons, named T interneurons after the branching pattern of their axons, in young larvae of the zebrafish Brachydanio rerio. The cells were identified by filling them with HRP from application sites within the CNS. A serially repeating set of about ten such neurons is present in a longitudinal column on each side of the caudal hindbrain. The T axons project across the midline, and branches course both rostrally and caudally within the medial longitudinal fascicle (mlf). The cells receive synaptic input from the Mauthner neurons, from unidentified axons in the mlf, and perhaps from trigeminal sensory fibers. They project to cranial and pectoral motor nuclei. T interneurons appear to be homologous to giant fiber neurons in the hatchetfish and to some of the cranial relay neurons in the goldfish. We discuss a possible functional role and comparative implications of their distribution in the hindbrain. PMID- 3980776 TI - Anatomy of the posterior lateral line system in young larvae of the zebrafish. AB - We studied the anatomy of neuromasts, afferent sensory neurons, and efferent neurons of the midbody branch of the posterior lateral line in larvae of the zebrafish (Brachydanio rerio), 5 days after fertilization. This simple sensory system consists of ten or 11 neuromasts, 15-20 sensory neurons, and about nine efferent neurons. The neuromasts are typical free neuromasts and both afferent and efferent synapses are present on hair cells within them. The sensory neurons project into a single longitudinal column of neuropil in the hindbrain. The sensory terminals appear by light microscopy to contact the dorsolateral dendrite of the ipsilateral Mauthner cell. Three types of efferent neurons are present; two types in the hindbrain and one type in the diencephalon. We provide several lines of evidence that demonstrate that these central neurons are efferent to the lateral line. We conclude from this morphology that the larval system includes all of the components of the adult system and is probably functional at this early stage. We also found that larvae have all of the efferent neurons found in adult zebrafish, while the number of neuromasts and sensory neurons will increase during subsequent development. PMID- 3980777 TI - Postnatal development of axosomatic synapses in the rat visual cortex: morphogenesis and quantitative evaluation. AB - Postnatal development of axosomatic synapses was studied in the rat visual cortex in order to obtain experimental data that may explain how the unequal distribution of asymmetric and symmetric synapses evolves on the soma of cortical neurons. Three types of synaptic junctions were identified: asymmetric or type 1 synapses, with postsynaptic densities greater than or equal to 20 nm, symmetric type 2 synapses, and symmetric synapses with an intermediate structure. The third synapse type had a structure similar to that of type 1 synapses, although the postsynaptic densities were thinner than 20 nm. Type 1 synapses developed in three phases. In phase 1, the first postnatal week, there were many free postsynaptic thickenings and immature synapses whereby a higher degree of postsynaptic differentiation was visible in comparison to the presynaptic elements. During the following 10 days, phase 2, type 1 synapses containing thin postsynaptic densities and intermediate synapses temporarily increased in number. Intermediate synapses are interpreted as precursors of type 1 synapses that have relatively immature postsynaptic elements. Toward the end of synaptogenesis, phase 3, the free postsynaptic thickenings reappeared while type 1 synapses containing well developed postsynaptic elements prevailed. Throughout the whole postnatal period, the numerical density of axosomatic type 1 synapses remained very low and the ratio of asymmetric to symmetric synapses at the neuronal somata was inversely proportional to that at the dendrites. Also, there was a significant decrease in the numerical density of type 1 synapses between postnatal days (P) 17 and 30. Data normalized according to cortical growth suggest that this is probably due to a decrease in the number of axosomatic type 1 synapses. This corresponds to the observation that in layers III and V a few type 1 synapses were found on pyramid-like cells up to P10 which then disappeared in later stages. Axosomatic type 2 synapses appear to be formed by two different presynaptic processes. The first presynaptic type contains flocculent material with glycogen granules and resembles axonal growth cones. These junctions contain multiple adhesion patches, intermediate junctions, one or more active zones, narrow synaptic clefts, and small pleomorphic vesicles. All of these are structural features of adult type 2 synapses. The growth-cone-like presynaptic elements disappeared after about 3 weeks. The second presynaptic type is smaller in size and also forms contacts with a structure similar to adult type 2 synapses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3980778 TI - A morphological study of glial cells in the hypoglossal nucleus of the cat during nerve regeneration. AB - The cat hypoglossal nerve and nucleus have been used as a model for the study of the occurrence and time course of modifications in the size and composition of the perineuronal glial cell population as they relate to cytological changes in the nerve cell body and the initiation and progress of axon regeneration. Animals were killed at 2, 5, 10, 20, 35, 65, and 115 days after crush injury to the hypoglossal nerve. At 5 days after surgery, growth cones and regenerating unmyelinated axons were present at the lesion site, but no conspicuous changes were apparent in the nerve cell bodies. At 10 days after surgery, the granular endoplasmic reticulum was disaggregated and depleted. The elongation phase appeared to be completed at 20 days, as judged by the bilateral retrograde labeling of the hypoglossal nuclei with horseradish peroxidase. By 35 days, the cytoarchitecture of the nerve cell bodies and maturation of axons, as determined by a comparison of the relative frequency distribution of cross sectional areas proximal and distal to the lesion, were completely restored. Comparative quantitative light microscopic examination of the hypoglossal nuclei of intact and experimental animals failed to reveal any statistically significant differences in the total number of glial cells, number of glial cells/unit area of neuropil, or relative proportions of glial cell types at any of the postoperative time intervals. Moreover, electron microscopic quantitation of the microglial cell population did not reveal any significant alterations in the number, density, location, or morphology of these cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980779 TI - Development of the human retina: patterns of cell distribution and redistribution in the ganglion cell layer. AB - Neurogenesis in the ventricular layer and the development of cell topography in the ganglion cell layer have been studied in whole-mounts of human fetal retinae. At the end of the embryonic period mitotic figures were seen over the entire outer surface of the retina. By about 14 weeks gestation mitosis had ceased in central retina and differentiation of photoreceptor nuclei was evident within a well-defined area which constituted about 2% of total retina area. This area was approximately centered on the site of the putative fovea, identified by the exclusive development of cone nuclei at that location. The area of retina in which mitosis had ceased increased as gestation progressed. By mid-gestation mitosis in the ventricular layer occupied about 77% of the outer surface of the retina and by about 30 weeks gestation mitosis in the ventricular layer had ceased. Cell density distributions in the ganglion cell layer were nonuniform at all stages studied (14-40 weeks). Densities were highest at about 17 weeks gestation, and by mid-gestation the adult pattern of cell topography was present with maps showing elevated cell densities in posterior retina and along the horizontal meridian. Cell densities generally declined throughout the remainder of the gestation period, except in the posterior retina, where densities in the perifoveal ganglion cell layer remained high during the second half of gestation. There is a rapid decline in cell density in the foveal ganglion cell layer toward the end of gestation, and it is suggested that the persistence of high densities in the perifoveal region may be related to migration of cells away from the developing fovea. The total population of cells in the ganglion cell layer was highest (2.2-2.5 million cells) between about weeks 18 and 30 of gestation. After this the cell population declined rapidly to 1.5-1.7 million cells. It is suggested that naturally occurring neuronal death is largely responsible for this decline. PMID- 3980780 TI - Cochlear nerve of the alligator lizard. AB - The innervation of the auditory organ of the alligator lizard is described. Patterns of distribution of the nerve fibers were studied at the light microscopic level with the horseradish peroxidase technique, and the types of synaptic contacts with hair cells were studied at the transmission electron microscopic level with standard techniques. The innervation of the two regions of the basilar papilla differs in the following ways. In the apical region, some fibers send branches along the length of the basilar papilla, and both afferent (non-vesiculated) and efferent (vesiculated) nerve endings are present. In the basal region, all fibers terminate in the immediate area where they enter the papilla without sending branches along the length of the papilla; efferent endings are lacking, and nerve fibers are of a smaller average diameter. The punctate nature of the innervation of hair cells in the basal region is consistent with the hypothesis that the systematic organization according to frequency sensitivity observed in electrophysiological recordings from basal nerve fibers may be related to the length of the stereocilia on the hair cells with which the nerve synapses. PMID- 3980781 TI - Growth and death of cells of the mesencephalic fifth nucleus in Xenopus laevis larvae. AB - Positions, numbers, and cell and nuclear sizes of mesencephalic fifth nucleus (M V) cells were determined in Xenopus laevis larvae in stages 47 through the end of metamorphosis at stage 66. M-V cells may be found at every tectal level, from the rostralmost section almost to the caudal pole, and in the anterior medullary velum. A large majority of the cells lie between 15 and 65% caudad of the rostral tip of the tectum. At anterior and middle tectal levels the cells lie lateral to but mainly above the optic ventricle. At posterior levels, to which the ventricle does not extend, a few cells may be seen at middle and lower tectal levels, as if in transition to the anterior medullary velum. At stage 47 fewer than ten cells are seen in each animal. The numbers rise to 20-40 by stage 50, and are uniformly above 100 after stage 51. Initially many M-V cells were small, i.e., 6-7 microns in diameter, but grew to a mean diameter of about 19 microns at stage 59, with a maximum value of 29 microns. A single individual at stage 57 had 581 cells. The peak of mean cell numbers, 387, occurred at stage 59, which was also the stage with the highest mean values for nuclear and cell sizes. Pyknotic M-V cells at low frequency were seen at stages 55 and 57, and at all stages thereafter. Cell death frequency peaked at stage 62, but continued through stage 66. By stage 66 mean cell numbers had been reduced to about 240, indicating survival of about 60% of cells present at stage 59. PMID- 3980782 TI - Multiaxonal horizontal cells in the retina of the tree shrew, Tupaia glis. AB - The retinas of most vertebrates contain two or more morphologically distinct types of horizontal cell, and usually one of these types lacks an axon. Among mammals, in which two types are observed, primates are exceptional in that both types of horizontal cell have axons. It then seemed of interest to study the horizontal cells of tree shrews (Tupaia glis), insectivores thought to be closely related to primates. Golgi impregnations of whole, flat-preparations revealed two types of horizontal cell. Uniaxonal cells have a compact dendritic organization with clusters of terminals, and a single thin axon with short collaterals and a few terminals, located along its length. Multiaxonal cells have a relatively large dendritic tree, and arising from the tips of about four to eight dendrites of an individual cell are thin axonlike processes which terminate as profusely branched telodendritic arborizations. This identification of the multiaxonal horizontal cells in Tupaia retina is the first time any vertebrate horizontal cell has been found to possess more than a single axon. A comparison of horizontal cells in tree shrew, monkey, cat, and squirrel retinas shows a remarkable morphological diversity within this class of mammalian retinal neuron. PMID- 3980783 TI - An EM-autoradiographic and EM-HRP study of the commissural projection of the superior colliculus in the cat. AB - Terminals of the commissural projection in the cat were characterized ultrastructurally by autoradiographic and horseradish peroxidase methods. The results of the two studies are complementary. Terminals of commissural cells are present in the intermediate and deep layers of the cat superior colliculus. Two distinct populations of terminals are present: one containing mostly round vesicles and forming asymmetric specializations, and a second containing mostly pleomorphic vesicles and forming symmetric specializations. Both populations contact small dendrites or dendritic appendages. The two populations, mostly round and mostly pleomorphic, are present in the ratio of 2:1. Terminals measure approximately 1.1 micron in mean diameter and contact profiles ranging in size from 0.2 to 4.6 micron. There is no significant difference between the two populations in either pre- or postsynaptic profile size. The colocalization of terminals of commissural neurons with other afferent and efferent projections of the intermediate layers of the superior colliculus is discussed. PMID- 3980784 TI - Numbers of myelinated and unmyelinated axons in the dorsal, lateral, and ventral funiculi of the white matter of the S2 segment of cat spinal cord. AB - The present work determines the numbers of myelinated and unmyelinated axons in the dorsal, lateral, and ventral funiculi of the S2 segment of the cat spinal cord. The major finding is that unmyelinated axons are almost as numerous as myelinated axons in these pathways. The myelinated axons tend to be distributed uniformly, although there is a slight concentration of these fibers in the dorsal part of the lateral funiculus. By contrast, the unmyelinated fibers, although found in significant numbers in all parts of these funiculi, concentrate in the dorsal part of the lateral funiculus and in the dorsal funiculus. Of particular note are the unmyelinated fibers in the dorsal funiculus, because it is highly likely that some of these are sensory. The findings in this study will serve as a basis for experimental studies to determine the numbers, locations, and types of unmyelinated fibers in the white matter of the mammalian cord. PMID- 3980785 TI - The dendritic architecture of the visual pretectal nuclei of the rat: a study with the Golgi-Cox method. AB - The dendritic architecture of the neurons of the visual pretectal nuclei in the rat was studied with the Golgi-Cox method. The olivary pretectal nucleus (PO) is characterized by distinctive neurons with a gnarled, tufted, richly branched dendritic arbor forming a dense neuropil within the nucleus. The distinct dendritic morphology of the olivary pretectal neurons enables this nucleus to be identified at all levels of the pretectum in Golgi-impregnated preparations. Rostromedially, the PO is surrounded by peripheral neurons whose dendrites wrap around the surface of the PO. The nucleus of the optic tract (NTO) contains three types of cells: (1) superficial horizontal cells whose dendrites extend out transversely; (2) large multipolar neurons whose dendrites spread out predominantly in a transverse plane, and (3) small to medium multipolar neurons with varying dendritic architecture. The posterior pretectal nucleus (PP) is composed predominantly of (1) multipolar cells with horizontally and vertically oriented dendrites extending out transverse to the optic axons; (2) piriform cells with dendrites extending dorsally toward the brachium; and (3) small multipolar neurons. The presence of superficial horizontal and large multipolar neurons in the NTO distinguishes the NTO from the PP in Golgi preparations. The horizontally oriented dendrites of many of the multipolar neurons in the PP give this nucleus an appearance distinct from that of the NTO. The differences in dendritic morphology between the visual pretectal nuclei in the rat permit identification of these nuclei at all levels within the pretectum. The boundaries of these nuclei, as determined in the Golgi-Cox preparations, correlate quite well with the boundaries defined by studying retinal projections (Scalia and Arango, '79). PMID- 3980786 TI - Immunocytochemical localization of choline acetyltransferase in rat cerebral cortex: a study of cholinergic neurons and synapses. AB - Choline acetyltransferase (ChAT), the acetylcholine-synthesizing enzyme and a definitive marker for cholinergic neurons, was localized immunocytochemically in the motor and somatic sensory regions of rat cerebral cortex with monoclonal antibodies. ChAT-positive (ChAT+) varicose fibers and terminal-like structures were distributed in a loose network throughout the cortex. Some immunoreactive cortical fibers were continuous with those in the white matter underlying the cortex, and many of these fibers presumably originated from subcortical cholinergic neurons. ChAT+ fibers appeared to be rather evenly distributed throughout all layers of the motor cortex, but a subtle laminar pattern was evident in the somatic sensory cortex, where lower concentrations of fibers in layer IV contrasted with higher concentrations in layer V. Electron microscopy demonstrated that immunoreaction product was concentrated in synaptic vesicle filled profiles and that many of these structures formed synaptic contacts. ChAT+ synapses were present in all cortical layers, and the majority were of the symmetric type, although a few asymmetric ones were also observed. The most common postsynaptic elements were small to medium-sized dendritic shafts of unidentified origin. In addition, ChAT+ terminals formed synaptic contacts with apical and, probably, basilar dendrites of pyramidal neurons, as well as with the somata of ChAT-negative nonpyramidal neurons. ChAT+ cell bodies were present throughout cortical layers II-VI, but were most concentrated in layers II-III. The somata were small in size, and the majority of ChAT+ neurons were bipolar in form, displaying vertically oriented dendrites that often extended across several cortical layers. Electron microscopy confirmed the presence of immunoreaction product within the cytoplasm of small neurons and revealed that they received both symmetric and asymmetric synapses on their somata and proximal dendrites. These observations support an identification of ChAT+ cells as nonpyramidal intrinsic neurons and thus indicate that there is an intrinsic source of cholinergic innervation of the rat cerebral cortex, as well as the previously described extrinsic sources. PMID- 3980787 TI - Mapping increased glycogen phosphorylase activity in dorsal root ganglia and in the spinal cord following peripheral stimuli. AB - A histochemical technique has been used to map the distribution and the relative proportion of the active and inactive form of the enzyme glycogen phosphorylase in the primary afferent cell bodies of lumbar dorsal root ganglia and within the lumbar spinal cord of the rat. The glycogen phosphorylase was found to be present in large and small diameter primary afferent cell bodies and in the grey matter of the spinal cord, except in lamina 2. Most of the glycogen phosphorylase in control rats was in the inactive form. Peripheral innocuous mechanical and thermal stimuli failed to alter the activity of glycogen phosphorylase in the lumbar spinal cord, but noxious mechanical, chemical, and thermal stimuli when applied to the hindlimb of decerebrate rats increased the enzyme activity in the ipsilateral dorsal horn within 10 minutes. The number of primary afferent cell bodies with active glycogen phosphorylase also increased. These changes are likely to be due to the conversion of the inactive "b" form of the enzyme to the active "a" form under the influence of a calcium or cyclic AMP activated phosphorylase b kinase. Pentobarbitone anaesthesia diminished but did not completely suppress the noxious stimulus-evoked glycogen phosphorylase activity changes. Graded electrical stimulation of the sciatic nerve was performed to simulate the effects of the peripheral noxious stimuli in a controlled fashion. Stimulation at a strength that activated only large myelinated afferents produced no greater effect on the distribution of the active form of the enzyme in the dorsal horn than that produced by exposure of the nerve, but stimulation of the thin myelinated A-delta afferents and unmyelinated C-fibres produced a widespread increase in glycogen phosphorylase activity in the spinal cord and in the L4 dorsal root ganglion. The increased activity could be detected after stimulation for as short a period of time as 5 minutes. The mechanisms underlying the stimulus-evoked increase in glycogen phosphorylase activity in the spinal cord and dorsal root ganglia are not yet known, nor have we positively established which elements in the spinal cord, neurones, or glia are responsible for the changes in the glycogen phosphorylase activity. Nevertheless, it is clear that the neural activity generated by certain types of high threshold input is associated with the activation of glycogen phosphorylase, and this may be a useful tool for studying the spatial distribution of some activity-related changes in the nervous system.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3980788 TI - No one should die of malignant melanoma. PMID- 3980789 TI - Dermatitis from cashew nuts. PMID- 3980790 TI - Eradication of scabies with a single treatment schedule. PMID- 3980791 TI - The sign of Leser-Trelat. PMID- 3980792 TI - Lichen planus and the liver. PMID- 3980793 TI - Lichen aureus. PMID- 3980794 TI - "Pediculid": an unusual id reaction to pediculosis capitis. PMID- 3980795 TI - Absence of vacuolization of upper epidermal cells in nonbullous congenital ichthyosiform erythroderma. PMID- 3980796 TI - Appearance of lupus erythematosus in a patient with lichen sclerosus et atrophicus of the elbows. PMID- 3980797 TI - Lynch syndrome II and Lynch syndrome I. PMID- 3980798 TI - Assessing child abuse in childhood condyloma acuminatum. AB - Adults with condyloma acuminatum are considered to have a sexually transmitted disease. Childhood condyloma acuminatum may often, but not always, be a manifestation of sexual abuse. We provide a checklist of criteria for suspecting child abuse. We recommend that if clinicians find a "yes" response on this checklist when caring for a child with condyloma acuminatum, consultation with local child protective services (CPS) be deemed mandatory. PMID- 3980799 TI - Psoriasis treatment with suberythemogenic ultraviolet B radiation and a coal tar extract. AB - Forty-nine patients with plaque-type psoriasis were enrolled in a randomized prospective trial that compared the efficacy of outpatient treatment with suberythemogenic doses of ultraviolet B (UVB) radiation administered with a tar oil to treatment with maximally erythemogenic UVB radiation with emollients. Seventeen percent of patients treated with tar oil and 26% of patients treated with maximally erythemogenic UVB failed to adhere to the protocol. Although the tar oil protocol seemed slightly less effective in those with more severe psoriasis, a roughly comparable fraction of patients who adhered to either protocol cleared at least 90% of psoriasis on surfaces exposed to UVB (76% vs 100%). The total dose of UVB to clearing was 44% less for patients treated with tar oil and suberythemogenic UVB. For most patients with moderate psoriasis, suberythemogenic UVB and tar oil is an effective, low-cost, and acceptable outpatient therapy. PMID- 3980800 TI - Predictive value of HLA antigen for methotrexate-induced liver damage in patients with psoriasis. AB - For an investigation of a possible association between HLA antigens and postmethotrexate liver damage, the A, B, C, and Dr loci of the HLA antigens were determined in thirty-two patients with severe psoriasis who had been treated with methotrexate. There was no association between HLA antigens and increasing severity of liver disease in these patients. HLA-A3 was increased in frequency in the group of patients with the more severe liver damage but was not significant when corrected for the number of antigens tested. There appears to be no predictive value in HLA typing of psoriasis patients prior to starting methotrexate therapy. PMID- 3980801 TI - Methoxsalen and ultraviolet A radiation in treatment of chronic cutaneous graft versus-host reaction. AB - Chronic cutaneous graft-versus-host reaction following bone marrow transplantation has been difficult to manage in some patients because of poor response to immunosuppressive agents or because of toxicity to these drugs. We recently used methoxsalen and ultraviolet A therapy and found it to be successful in controlling chronic cutaneous lichenoid graft-versus-host reaction in a bone marrow transplant patient. Although there was an initial flare of an eruption resembling acute cutaneous graft-versus-host reaction, both this acute eruption and the lichenoid lesions subsided and cleared with continued treatment. The skin lesions recurred when treatment was discontinued but responded promptly when it was initiated for the second time. Other than mild phototoxicity, there were no other significant side effects. PMID- 3980802 TI - Tinea versicolor: a light and electron microscopic study of hyperpigmented skin. AB - Hyperpigmentation in lesions of tinea versicolor has previously been reported to be a result of the effects of the fungus Pityrosporon orbiculare on melanosome formation and distribution. Examination of biopsy specimens from lesions of hyperpigmented tinea versicolor involving vitiliginous skin reveals an absence of melanosomes and melanocytes. Reddish-tan and fawn-colored hyperpigmentation in tinea versicolor of this type is not due to melanin pigment. The possible nature of the pigmentation that delineates hyperpigmented tinea versicolor from normal skin is discussed. PMID- 3980803 TI - Trimethylpsoralen bath plus ultraviolet A combined with oral retinoid (etretinate) in the treatment of severe psoriasis. AB - Twenty five patients with severe and extensive psoriasis were treated with trimethylpsoralen (trioxsalen) bath plus ultraviolet A (bath PUVA) combined with oral retinoid, etretinate (Ro 10-9359). Etretinate was started (1 mg/kg/day) 2 weeks prior to starting the bath PUVA treatment daily. Psoriasis cleared with fifteen treatments in 96% of patients with a mean total UVA dose of 3.9 joules/cm2. The control group of nine patients received only bath PUVA without retinoid, and eight of them cleared with nineteen treatments and with a mean UVA dose of 7.2 joules/cm2. In addition, three psoriatic patients previously resistant to bath PUVA treatment were given etretinate (1 mg/kg/day), and they cleared in 4 to 8 weeks after starting etretinate with a UVA dose of 37-144 joules/cm2. In the maintenance therapy after the combination therapy of twenty four patients, the results of treatment were good or excellent in fourteen of fifteen patients (93%) getting only bath PUVA one to two times a week and in four of nine patients (44%) getting etretinate (25-50 mg daily) in a mean follow-up time of 10 weeks. These results show the benefits of the combination of trimethylpsoralen bath PUVA with an oral retinoid, etretinate, in the treatment of severe and extensive psoriasis. PMID- 3980804 TI - Pityrosporum folliculitis: a common disease of the young and middle-aged. AB - Fifty-one patients, thirty-nine women and twelve men, with Pityrosporum folliculitis are described. This investigation clearly demonstrates that Pityrosporum folliculitis is a real entity. The diagnosis is based primarily on the clinical picture, direct microscopy, histopathology, and the effect of antimycotic treatment. The typical patient is a woman of 30 years with itching follicular papules and pustules localized to the upper trunk or upper arms. Direct microscopy reveals round yeast cells and sometimes even hyphae. In biopsy specimens, abundant round budding yeast cells and occasionally hyphae are seen in a dilated follicle. Yeast growth is obtained only on lipid-enriched media. Twenty five patients were treated with selenium sulfide shampoo, twelve with 50% propylene glycol in water, and ten with topical econazole cream with good results. Cure or marked improvement was seen after 3 to 4 weeks, but symptoms and lesions recurred if treatment was not continued intermittently. Predisposing factors such as occlusion and greasy skin are probably important, and future studies should focus on fungal hypersensitivity, quantitative variations in the number of Pityrosporum orbiculare, lipid composition of the skin, and extended epidemiologic data. PMID- 3980805 TI - Group therapy of psoriasis. Duo formula group treatment (DFGT) as an example. AB - Between 1978 and 1982 an experiment on group treatment for and by psoriasis sufferers was conducted, based on a pyramid of previous investigations since 1968. Each group was facilitated by a duo consisting of a fellow sufferer and a physician, both having trained together. The subjects practiced the procedure described, directed toward self-care and mutual aid facilitated and supported by the duo, in a series of ten 2-hour weekly sessions. A pretest/posttest control group design was used. Comparing the results of the quantitative analysis of the experimental groups with those of the control groups, the experimental groups showed significant change. The results of the qualitative analysis showed that decrease of anxiety correlated with mastering of the skills involved. The key element affecting outcome was the balance in cooperation within the duo, the expertise of the patient lying in his personal experience of the condition, and the expertise of the physician in his knowledge and skills. One of the method's main characteristics was the intrinsic complementarity of the duo partners. PMID- 3980807 TI - Significant response of oral aphthosis to thalidomide treatment. AB - The results are reported of the treatment of forty patients who had aphthous manifestations with the administration of thalidomide in daily doses ranging between 100 and 300 mg, over a period of 1 to 3 months. The study comprised nineteen patients with severe aphthosis, 17 with mild aphthosis, three with bipolar manifestations, and one with Sutton and Sutton's periadenitis mucosa necrotica recurrens. The results obtained were judged as remissions (35%) and marked improvements (40%). It is felt that thalidomide constitutes the most effective therapeutic approach so far available for oral aphthae, not only because it rapidly controls their manifestation but also because it controls recurrences. PMID- 3980806 TI - Psoriasis and susceptibility to nonmelanoma skin cancer. AB - Using data from a national skin cancer survey, we assessed the risk of basal cell and squamous cell carcinoma among patients with psoriasis compared with the general population. For both male and female psoriatic patients, the risk of basal cell carcinoma was significantly elevated (relative risk = 2.2 and 1.7; p less than 0.05, both comparisons). The risk of squamous cell carcinoma was not significantly or substantially different for persons with a history of psoriasis compared with other persons (relative risk = 1.3; p greater than 0.05). The relative risk of basal cell skin cancer among patients with psoriasis was significantly higher even after stratification for factors associated with both psoriasis and cutaneous malignancy, which include fair complexion, exposure to coal tar or pitch, and exposure to radiation. Contrary to long-standing beliefs, our findings support the hypothesis that even after allowing for possible greater exposures to cutaneous carcinogens, the risk of nonmelanoma skin cancer in patients with psoriasis is at least as great as in the general population. Thus persons with psoriasis who are treated with potential carcinogens such as ultraviolet radiation, tar, and oral methoxsalen photochemotherapy merit careful, long-term monitoring. PMID- 3980808 TI - Management of stasis leg ulcers with Unna's boots versus elastic support stockings. AB - Twenty-one patients with stasis leg ulcers were randomly assigned to two groups. The first group was treated with Unna's boots, while the second was treated with elastic support stockings with graded compression from 24 mm/Hg pressure at the ankle to 16 mm/Hg pressure at the calf. The ulcers on seven of ten legs (70%) treated with Unna's boots and on 10 of 14 legs (71%) treated with elastic support stocking healed. Although the two groups were small, there was no statistically significant difference between their success rate in healing stasis leg ulcers (p = 0.9394). Both treatment groups showed significant changes in lower limb volume, calf circumference, and ankle circumference, although there was no statistically significant difference between the two groups. If healing times are calculated, however, the average healing time in the Unna boot-treated group was 7.3 weeks, while patients treated with support stockings took an average of 18.4 weeks. If one patient whose ulcerations almost encircled her calves and took 78 weeks to heal is excluded, patients treated with support stockings had an average healing time of 11.8 weeks. PMID- 3980809 TI - Three or two times daily milking of older cows and first lactation cows for entire lactations. AB - Thirty-eight older (second and greater lactation) and 15 Holstein cows in first lactation were in a full lactation (44 wk) study to evaluate the effect of either twice or three times daily milking on yield of milk and milk components, milk composition, feed intake, and body weight change. All cows were managed alike and were fed diets of high, medium, and low energy concentration as lactation progressed from calving to 44 wk. First lactation cows were switched from diets of high energy to lower energy at the same milk production as lactation advanced. Dietary changes for older cows milked twice and three times (A) were at similar production, whereas three times (B) cows were switched to lower energy at higher milk production. Older cows milked three times daily (A and B) produced 17 and 13% more milk over the entire lactation than cows milked twice daily. Dry matter and energy intakes were not affected by three times milking, but gain of body weight was reduced. Cows milked three times daily during their first lactation produced 6% more milk than their twice counterparts, although this increase was not significant. Dry matter and energy intakes were not affected by three times daily milking, but three times milking of first lactation cows reduced weight gain over the lactation. Reproductive performance of cows milked three times daily was not significantly different from cows milked twice daily. Herds milking three times will require high management of nutrition and reproduction. PMID- 3980810 TI - Assessing efficiency of passive immune transfer in dairy herds. AB - Blood serum immunoglobulin concentrations of calves during their 2nd wk of life had a .97 correlation with 1st wk concentrations. Correlations between 1st wk concentrations and those in the 3rd, 4th, 5th, and 6th wk of life were .91, .90, .81, and .69. Ten herds were divided into those with mortality rates above and below the median. The major difference in distributions of immunoglobulin concentration between the two groups was percent of calves with concentrations less than 2.5 mg/ml during the 1st wk of life. Calves were sampled monthly for a full year in 19 herds, and all but one herd had one or more calves with immunoglobulin concentrations under 5.0 mg/ml. Overall, calves having immunoglobulin concentrations under 5.0 mg/ml were exposed to excess mortality risk; however, most of the excess risk was concentrated in three herds with high mortality rates (16 to 20%). Evaluating the efficiency of passive immune transfer through the use of management data was unreliable in comparison with assaying serum samples for immunoglobulin concentration. PMID- 3980811 TI - Intraruminal selenium pellet for control of nutritional muscular dystrophy in cattle. AB - Administration of an intraruminal selenium pellet to a herd of pregnant crossbred cows was evaluated for controlling nutritional muscular dystrophy in an area of northern Ontario with numerous losses of calves. Cows were winter-fed grass silage. Each spring cows and calves went to pasture. A single dose of intraruminal selenium pellet was given to 80 cows during last 3 mo of pregnancy the 1st yr only while the remaining 80 were controls. During 3 consecutive years, efficacy of intraruminal selenium pellet was evaluated by selenium status of recipient cows and their offspring as well by the incidence of nutritional muscular dystrophy. Selenium in plasma, as well as glutathione peroxidase in whole blood, in the cows administered intraruminal selenium pellet, were higher than in the deficient controls. Ten months after intraruminal selenium pellet treatment, selenium in tissues was higher in treated than in untreated cows but within normal ranges. Before cows were turned out to pasture the 1st yr, milk selenium of intraruminal selenium pellet cows were higher than controls. This technique of selenium dosing was effective in raising the selenium status of the progeny. There was no evidence of nutritional muscular dystrophy in calves from selenium-dosed cows, while 15 calves born of the untreated cows showed clinical symptoms of nutritional muscular dystrophy. PMID- 3980812 TI - Effects of climatic and management factors on conception rate of dairy cattle in subtropical environment. AB - Breeding records, representing 12,038 inseminations at Bassett's Dairy Farm (Monticello, FL), were analyzed to document effects of environmental and management factors on fertility of dairy cattle from January 1, 1975 to December 31, 1977. Conception rates of lactating cows decreased sharply when maximum air temperature on day after insemination exceeded 30 degrees C. In contrast, conception rates for heifers did not decline until 35 degrees C. Virgin heifers had higher conception rates for all services (50%) than lactating cows (34%) and suffered only slight depression of fertility during summer months. Heifers required 1.5 services per conception compared with 2.3 for lactating cows. Relationship between conception rate and rainfall on day after insemination was negative and curvilinear. Jerseys had higher conception rates (45%) than Holstein (39%) and Brown Swiss (41%). Services per conception were 1.7, 2.0, and 1.9. Substantial decreases of fertility were associated with advancing service number. Estrous status (standing; positive heat detection patch; mounting activity), inseminator, and year of service were related to variation of conception rate. Seasonal effects on fertility of lactating cows were marked. Thus, environmental management of the postpartum cow during hot summer months is warranted to maximize fertility. PMID- 3980813 TI - Mammary growth response of Holstein heifers to photoperiod. AB - Two groups of 10 prepubertal Holstein heifers (86 kg initial body weight) and two groups of 10 postpubertal heifers (292 kg initial body weight) each were maintained under 8 h light: 16 h dark or 16 light: 8 dark photoperiods for an average of 139 days. Then animals were slaughtered, and the total right half of the mammary gland was removed. Mammary parenchymal tissue was separated from surrounding adipose and connective tissue (extraparenchymal tissue). There was no effect of photoperiod on total weight of the mammary gland (parenchymal plus extraparenchymal portions). In contrast, mammary parenchymal weight increased 40 and 30% in prepubertal and post-pubertal heifers exposed to 16 light: 8 dark as compared with heifers exposed to 8 light: 16 dark. Similarly, mammary parenchymal tissue of heifers given 16 light: 8 dark contained 68 and 35% more total deoxyribonucleic acid (an index of cell numbers) than heifers exposed to 8 light: 16 dark. However, photoperiod did not influence concentrations of deoxyribonucleic acid or fat in parenchymal tissue. Extraparenchymal tissue weight was 12 to 35% less in heifers given 16 light: 8 dark than in heifers exposed to 8 light: 16 dark. We conclude that 16 light: 8 dark stimulates the mammary parenchymal tissue to grow into the fat pad (extraparenchymal tissue) of prepubertal and postpubertal Holstein heifers. PMID- 3980815 TI - Neuropsychological findings in relapsing-remitting and chronic-progressive multiple sclerosis. PMID- 3980814 TI - Correlated response of udder dimensions to selection for milk yield in Holsteins. AB - Response to selection for milk yield in Holsteins was examined by a controlled selection experiment initiated in 1964. Foundation cows were paired by sire and divided randomly into two breeding groups, selection and control. Selection group was mated to four sires each year highest for Predicted Difference milk. Twenty bulls selected in 1964 as near breed average for milk sired all control cows. Milk yield was recorded for each lactation, and height of udder from ground, distances between teats, and perimeter and area bound by the four teats were measured at 30 to 75 days postpartum on 153 selection and 202 control cows over 14 yr. Most estimates of repeatability and heritability of udder dimensions before and after milking were .45 or larger. Correlations with milk yield were negative for udder height and positive for other udder measurements. Selection cows exceeded controls for lactational milk yield. Daughters of high milk bulls had greater distances between teats, greater perimeters, and larger areas of udder floor. Selection cows did not differ from controls in udder height for first parity but were below controls in udder height and had udders that collapsed more for all parities. PMID- 3980816 TI - Behavior change, weight loss, and physiological improvements in type II diabetic patients. PMID- 3980817 TI - Expectancies versus background in the prediction of college drinking patterns. PMID- 3980818 TI - Cognitive skill and traditional trance hypnotic inductions: a within-subjects comparison. PMID- 3980819 TI - MMPI omitted items: a method for quickly determining individual scale impact. PMID- 3980820 TI - Behavioral treatment of Raynaud's disease: long-term follow-up. PMID- 3980821 TI - Cognitive-somatic anxiety response patterning in chronic pain patients and nonpatients. PMID- 3980822 TI - Validation of inattention/overactivity and aggression ratings with classroom observations. PMID- 3980823 TI - Social status of aggressive and aggressive/withdrawn boys: a replication across age and method. PMID- 3980824 TI - Behavioral effects of tricyclic drugs in depressed inpatients. PMID- 3980825 TI - Sexual functioning among breast cancer, gynecologic cancer, and healthy women. PMID- 3980826 TI - Neurobehavioral approach to classification of psychiatric patients using a competency model. PMID- 3980827 TI - Moving targets: patients' changing complaints during psychotherapy. PMID- 3980828 TI - Heterosexual social skills in a population of rapists and child molesters. PMID- 3980829 TI - Assessment of depression in alcoholics: comment on Hesselbrock et al. PMID- 3980830 TI - Assessment of depression in alcoholics: further considerations--reply to Hagan and Schauer. PMID- 3980831 TI - Comparison of procedures for the assessment of psychopathy. PMID- 3980832 TI - Replicated MMPI subtypes for alcoholic men and women: relationship to self reported drinking behaviors. PMID- 3980833 TI - Boys with peer adjustment problems: social cognitive processes. PMID- 3980834 TI - Body image, physical attractiveness, and depression. PMID- 3980835 TI - Social support in Vietnam veterans with posttraumatic stress disorder: a comparative analysis. PMID- 3980836 TI - The syringe skin hook. PMID- 3980837 TI - Cheilitis glandularis--a disorder of ductal ectasia. AB - Cheilitis glandularis is characterized by lip eversion and protrusion with obvious, mucoid-secreting ductal orifices along the mucosal-vermilion boundary. One may see confirmatory microscopic findings of ductal ectasia and metaplasia. Vermilionectomy can be efficacious. PMID- 3980838 TI - Eyelid surgery (Part II). PMID- 3980839 TI - Axillary hyperhidrosis: A simple surgical procedure. AB - A simple method for surgical treatment of excessive sweating of the axilla is presented. The procedure, which is performed under local anesthesia on an outpatient basis, is described in detail. After mapping the sweat gland bearing area with crepe paper, the hyperhidrotic area was excised using a bat-shaped excision. The skin was closed without undermining. This method has been used in 14 consecutive patients (28 axillae) resistant to topical administration of aluminum chloride hexahydrate in ethanol. The postoperative results were excellent in 12 patients and were good in 2. There were three minor wound infections and one case of postoperative bleeding. This procedure is suitable for all patients who need surgical treatment for axillary hyperhidrosis and requires no training in plastic surgery. PMID- 3980840 TI - Treatment of a large, ulcerating, granular-cell tumor by microscopically controlled excision. AB - Malignant granular-cell tumors with benign histologic appearance are normally identified only following nodal and metastatic spread. Local recurrence following conventional excision of both the benign and malignant variant is not uncommon. A patient with a large, rapidly growing, spontaneously ulcerating granular-cell tumor was treated by microscopically controlled (Mohs) surgery. The rationale for this treatment, as well as criteria for the differentiation of the benign from the malignant variant, is discussed. PMID- 3980841 TI - The surgical treatment of hypertrophic Darier's disease. AB - Simple surgical debridement under local anesthesia of a recalcitrant case of severe hypertrophic Darier's disease provided symptomatic and cosmetic improvement for 2 years. PMID- 3980842 TI - Basal-cell carcinoma of the nipple. PMID- 3980843 TI - [Effect of low-energy laser irradiation on normal skin and tumor tissues]. PMID- 3980844 TI - [Specific and nonspecific bone marrow reactions to exposure to prolonged gamma irradiation]. PMID- 3980845 TI - [Oxyhemoglobin oxidation in mice exposed to sodium nitrite and phenylhydrazine (in vitro and in vivo)]. PMID- 3980846 TI - [Approach to accelerating tissue cicatrization by using phagotherapy]. PMID- 3980847 TI - [Optimization and prognosis of the effectiveness of using nitrosomethylurea for treating malignant tumor patients based on pharmacokinetic parameters]. PMID- 3980848 TI - [Functionally caused changes in protein metabolism in different sections of the brain and liver of rats]. PMID- 3980849 TI - Sex differences in perceptions of desirable body shape. PMID- 3980850 TI - Excluding problem drinkers in high-risk studies of alcoholism: effect of screening criteria on high-risk versus low-risk comparisons. PMID- 3980851 TI - Selective attention to negative feedback in type A and type B individuals. PMID- 3980852 TI - Problem-solving characteristics of process and reactive schizophrenics and affective-disordered patients. PMID- 3980853 TI - Stability and change in aggression and withdrawal in middle childhood and early adolescence. PMID- 3980854 TI - Relationship of gender and marital status with symptomatology in psychotic patients. PMID- 3980855 TI - Longitudinal study of cognitions, life events, and depression in psychiatric inpatients. PMID- 3980856 TI - Parental death and depression. PMID- 3980857 TI - Childhood competence and behavior problems. PMID- 3980858 TI - Dysphoric mood and overeating: a test of restraint theory's disinhibition hypothesis. PMID- 3980859 TI - Wagering preferences of problem gamblers. PMID- 3980860 TI - Double hypnotic induction: an initial empirical test. PMID- 3980861 TI - Psychophysiology of relaxation-associated panic attacks. PMID- 3980862 TI - Aircraft noise annoyance at three joint air carrier and general aviation airports. AB - The results of social surveys conducted near three airports that support both general aviation and scheduled air carrier operations are presented and discussed. Inferences supported by these data include: The nature of noise exposure and community reaction at smaller airports may differ from that at larger airports; survey techniques are capable of identifying changes in annoyance associated with numerically small changes in noise exposure; changes in the prevalence of annoyance are causally produced by changes in noise exposure; and changes in annoyance associated with changes in exposure vary with time. PMID- 3980863 TI - The relationship of the spiral turns of the cochlea and the length of the basilar membrane to the range of audible frequencies in ground dwelling mammals. AB - The number of turns in the cochlear spiral and length of the basilar membrane in several mammalian species were compared with the octave range and the high-and low-frequency limits of hearing. Basilar membrane length and the number of spiral turns were not related. Among ground dwelling mammals, the number of turns in the cochlear spiral was more strongly related to octave range than was basilar membrane length. Basilar membrane length was inversely related to the high-and low-frequency limits of hearing. The best estimates of high-and low-frequency limits and octave range were derived from formulas which included both the number of turns in the cochlear spiral and the basilar membrane length as factors. The number of turns in the cochlear spiral was most highly correlated with the difference between the low-frequency limit of hearing and the lowest frequency mechanically analyzed by the traveling-wave envelope, peak-shift property of the basilar membrane [von Bekesy, Experiments in Hearing (McGraw-Hill, New York, 1960)]. The coefficient of correlation for the number of spiral turns and the octave difference between the lowest audible frequency and the lowest frequency distributed as a unique point of maximum displacement along the basilar membrane was r = 0.997 (P less than .001) at 60 dB SPL. Mechanisms by which the spiral form of the cochlea may affect the motion of hair cells and the selective response of the tectorial membrane to differences among traveling-wave envelope slopes and peak locations were reviewed. It was proposed that in ground dwelling mammals, the spiral form of the cochlea extends the octave range of hearing and that through mechanisms such as these increases the sensitivity of the cochlea to frequencies below the low-frequency peak-shift limit of the basilar membrane. PMID- 3980865 TI - Pulse-number distribution for the neural spike train in the cat's auditory nerve. AB - Pulse-number distributions (PNDs) were recorded from primary afferent fibers in the auditory nerve of the cat, using standard extracellular microelectrode recording techniques. Pure-tone and broadband-noise stimuli were used. The number of neural spikes (pulses) n was measured in a set of contiguous intervals, each of duration T seconds. The quantity n varies from one interval to another. These data were then used to determine the PND, which is the probability p(n,T) of occurrence of n spikes in the time T, versus the number n. The estimated mean and variance of p(n,T) were obtained. Two different values of T were used. An unexpected observation was that the count mean-to-variance ratio R is relatively constant and independent of the stimulus intensity. Use of the PND as a statistical measure of the underlying neural point process has a number of virtues. For example, the PND readily exhibits the existence of spike clusters (e.g., pairs) for some units. The PND is essentially unaffected by time jitter and time quantization and provides a statistically significant measure for units firing at low rates. A study of the scaled and unscaled pulse-interval distributions (PIDs), under conditions of spontaneous firing, demonstrates that the occurrences of neural events are generally not describable by a renewal process. Our investigation shows that none of the point processes customarily used to model the auditory neural spike train is consistent with all of the data. It appears that the encoding of acoustic information into nerve spikes in the peripheral auditory system takes the form of a cluster point process similar to the Neyman-Scott type. For pure-tone excitation, the PND will be well represented as a multinomial distribution in this case. PMID- 3980864 TI - Thresholds for primary auditory fibers using statistically defined criteria. AB - The discharge behavior of auditory-nerve fibers near "threshold" was investigated in anesthetized cats using low-intensity sinusoidal stimuli presented at the respective characteristic frequencies. Particular attention was paid to fibers with "low" and "medium" rates. Estimates of threshold derived from statistically significant increases in discharge rate indicate that the average threshold values for low-spontaneous fibers are only slightly higher (ca. 5 dB) than the averages for the corresponding high-spontaneous fibers, with the medium spontaneous fibers having intermediate averages. The difference between these average values is considerably less than the more than 20-dB difference obtained using threshold criteria based on an absolute increment in discharge rate [e.g., M. C. Liberman, J. Acoust. Soc. Am. 63, 442-455 (1978)]. The main reason for the difference between the results of the two techniques is the fact that the slopes of the rate-intensity functions for the high-spontaneous fibers are considerably steeper near "threshold" than those for fibers of the other two classes. The results are taken as supportive of a recent model of primary-fiber discharge [C. D. Geisler, Brain Res. 212, 198-201 (1981)]. PMID- 3980866 TI - Steps in loudness summation. AB - The dependence of binaural loudness summation on interaural phase of tones ranging between 250 and 1400 Hz was investigated in a series of experiments using a loudness-matching procedure. Observers matched loudness of monaural-binaural and binaural-binaural pairs of alternating tones by adjusting the amplitude of one of the two. Adjustable and reference components of each tone pair were equal in frequency and were varied independently in interaural phase angle through the range +/- 177 degrees. For each tone frequency, steps in loudness summation of approximately 3 dB were obtained in the vicinity of a constant value of phase angle, theta t, which depends on the Hornbostel-Wertheimer constant (tau H) according to the relations theta t = 2 pi f tau H for tones of low frequency (f less than or equal to 1/2 tau H), and theta t = 2 pi(1 - f tau H) for tones of higher frequency (1/2 tau H less than or equal to f less than or equal to 1/tau H). Spatial relationships among alternating tones observed in the above conditions covaried with relative loudness in a complex manner, but exhibited qualitative changes in the vicinity of theta t. PMID- 3980867 TI - Auditory profile analysis: frequency, phase, and Weber's law. AB - This paper reports three separate experiments on different aspects of performance in auditory profile analysis. The first experiment deals with the effects of the frequency and position of an increment in a single component of a multitonal complex. The general results indicate that detection of the signal is easier for components in the mid-frequency range (around 1000 Hz) independent of signal position within the complex. The second experiment investigates the effects of relative phase of the individual components of the complex. Regardless of the number of components, our results indicate that phase has very little effect, even when different phases are selected for each presentation. The third experiment compares the detection of an increment in intensity of a single component, the traditional Weber fraction experiment, and conditions where additional components are present, a profile experiment. The detection of the increment is measured as a function of the level of the standard. The single-tone condition shows the usual near miss to Weber's law whereas the multitone condition does not. In addition, threshold for the increment is better for the multitone condition than for the single tone condition for levels of the standard up to 70 dB SPL. This last result is investigated for ten observers, five of whom were experienced in profile tasks and five of whom were not. Using a low level standard, the five experienced observers replicate the results described above. The inexperienced observers show the opposite result. On average, they are better able to detect the increment in the single-component condition. PMID- 3980868 TI - Development of absolute thresholds in chickens. AB - Absolute auditory thresholds were estimated in chickens at 0 and 4 days after hatching. Momentary suppressions of the chicks' regular peeping, following the onset of a tone, were used as indications of stimulus detection. In the first experiment a staircase procedure was used to estimate thresholds. The absolute thresholds of both ages were the same at low frequencies (250-500 Hz), but at higher frequencies (1-2 kHz) 4-day-old chicks had lower thresholds than the 0-day old chicks. The estimates of thresholds at 1 kHz were corroborated in the second experiment with a method of constant stimuli. A more efficient modified method of limits was used to replicate the age by frequency interaction in the third experiment. These changing thresholds are likely to reflect a developmental process somewhere in the auditory system and not some nonsensory artifact for two reasons: similar thresholds at low frequencies show that developmental differences are not due to differences in the sensitivity of the testing procedure at the two ages and thresholds obtained from the 4-day-old birds are similar to estimates from mature birds. In conclusion, responsiveness to low frequencies develops before responsiveness to higher frequencies, showing that the development of absolute thresholds is correlated with other measures of functional maturation in the auditory system. PMID- 3980869 TI - Gap detection in chinchillas with temporary high-frequency hearing loss. AB - Estimates of auditory temporal acuity were obtained from normal chinchillas by measuring their gap-detection thresholds using wideband noise over a range of intensities. Afterwards, the animals were exposed to high-intensity noise whose low-frequency cutoff was progressively lowered towards the low frequencies in five 1-oct steps. The five exposures resulted in a temporary high-frequency hearing loss that progressively spread towards the low frequencies. In addition, there was a systematic and orderly increase in the gap-detection thresholds. These results indicate that gap resolution is strongly dependent on the audibility of the high-frequency energy in the test signal. PMID- 3980870 TI - The use of multidimensional perceptual models in the selection of sonar echo features. AB - The development of an accurate and efficient sonar-target classification system depends upon the identification of a set of signal features which may be used to discriminate important classes of signals. Feature selection can be facilitated through the identification of perceptual features used by human listeners in discriminating relevant sonar echoes. This study was conducted to establish a more reliable means of identifying perceptual features in terms of physical signal parameters as an initial step toward the development of an automatic sonar target classification system. The results of an experiment involving eight subjects and six sonar echoes are presented. A model of the perceptual structure of these echoes was derived from subject similarity judgments using a multidimensional scaling (MDS) technique. It was found that three perceptual features accounted for the similarity judgments made by the human listeners. Echoes modified along candidate physical dimensions were employed to aid in the identification of perceptual dimensions in terms of physical signal parameters. The three perceptual features could be associated with signal parameters involving the amplitude envelope of the echoes. PMID- 3980871 TI - Pattern analysis of Bekesy audiograms. AB - A data-dependent method for the objective classification of Bekesy audiograms is introduced. The technique uses orthogonal transformation from the pattern space to a reduced dimensionality feature space that allows a classification process to be implemented digitally. It is argued that this technique, with accretion of audiograms, could form the basis of a data-based system for determining and classifying the coherent structures of the various Bekesy patterns with as few as possible a priori hypotheses made about the Bekesy "types." PMID- 3980872 TI - The pursuit of invariance in speech signals. AB - The search for the acoustic properties useful to the listener in extracting the linguistic message from a speech signal is often construed as the task of matching invariant physical properties to invariant phonological percepts; the discovery of the former will explain the latter. These phonological percepts are essentially the phonemes of pregenerative phonology, and they are more or less faithfully reflected in standard alphabetic writing. Thus English deep and doom are supposed to be perceptually identical in their initial /d/s; the orthographic similarity is in agreement with the linguist's "representation" of these forms. The partial identity in spelling is only weak evidence for perceptual invariance, however. First, while some phonemes may comprise a single "sound," others are said by linguists to include phonetically distinct ones. Thus English /p/includes both aspirated and unaspirated voiceless labial stops. The view that it is not the phoneme, but rather the phonetic feature, to which an acoustic invariant might be attributed, raises two questions: (a) Since segments sharing a feature are rarely judged to constitute a single sound, the search for a feature-specific invariant, whose function is to explain perceptual constancy, is deprived of its essential motivation, and (2) there is no more reason to expect the acoustic cues to a feature to be context-independent than is the case with the phoneme. What seems more likely is to find that some phonemes, and some features, are more invariantly marked in the speech signal than others. PMID- 3980873 TI - On some issues in the pursuit of acoustic invariance in speech: a reply to Lisker. AB - This paper presents an alternative view of acoustic invariance in speech to that discussed by Lisker [J. Acoust. Soc. Am. 77, 1199-1202 (1985)]. Three points are considered--the minimal unit for acoustic invariance, the level of linguistic representation over which this unit operates, and the role that acoustic invariance plays in speech and language. Our position emphasizes the role of phonetic features in a theory of acoustic invariance, and we propose a series of working hypotheses to guide research in this area. PMID- 3980874 TI - Biomolecular absorption of ultrasound: II. Molecular structure. AB - Measurements of absorption coefficients in several globular and linear proteins yield no correlations of absorption with alpha-helix content or with the number of polypeptide chains in the protein. Removal of all but the primary structure with denaturing agents that convert proteins to random chains causes only small changes in the absorption of globular proteins. Complete denaturing of linear muscle proteins results in large reductions in absorption. Therefore, it is concluded that absorption in globular proteins is insensitive to structural characteristics while in linear proteins it is dependent upon the amount of alpha helix content. An alternative explanation of the results is that alpha-helix contributes to absorption in both globular and linear proteins but tertiary structure in globular proteins reduces absorption because of inhibited solvent interactions. PMID- 3980875 TI - Syllable identification by children and adults for two task conditions. AB - Both 6-year-old children and adults showed as good performance on a syllable identification task for a test condition having more trials per test run and a lower overall level of positive reinforcement as they did for a condition with fewer trials per test run and a higher, overall level of positive reinforcement. Differences between identification thresholds of children and adults are interpreted as reflecting age-related differences in speech processing rather than differences in responding to the test situation. PMID- 3980877 TI - Central auditory processing of peripheral vowel spectra. AB - This paper presents a review of recent experiments in vowel perception done at the Pavlov Institute of Physiology in Leningrad. The data concern three topics: experimental procedures appropriate for the study of phonetic quality perception, processing of the auditory spectral shape of a vowel, and processing of the auditory dynamic spectrum of a vowel. PMID- 3980876 TI - Perceptual cues to the voiced-voiceless distinction of final fricatives for listeners with impaired or with normal hearing. AB - Cues to the voicing distinction for final /f,s,v,z/ were assessed for 24 impaired and 11 normal-hearing listeners. In base-line tests the listeners identified the consonants in recorded /d circumflex C/ syllables. To assess the importance of various cues, tests were conducted of the syllables altered by deletion and/or temporal adjustment of segments containing acoustic patterns related to the voicing distinction for the fricatives. The results showed that decreasing the duration of /circumflex/ preceding /v/ or /z/, and lengthening the /circumflex/ preceding /f/ or /s/, considerably reduced the correctness of voicing perception for the hearing-impaired group, while showing no effect for the normal-hearing group. For the normals, voicing perception deteriorated for /f/ and /s/ when the frications were deleted from the syllables, and for /v/ and /z/ when the vowel offsets were removed from the syllables with duration-adjusted vowels and deleted frications. We conclude that some hearing-impaired listeners rely to a greater extent on vowel duration as a voicing cue than do normal-hearing listeners. PMID- 3980879 TI - The 109th meeting of the Acoustical Society of America. Austin, Texas, 8-12 April 1985. Abstracts. PMID- 3980878 TI - On the oscillation mode of gas-filled micropores. AB - Small pores in hydrophobic membranes trap gas when the membrane is immersed in aqueous media, and the resulting "gas bodies" may be used for studying biophysical effects of ultrasonic cavitation. In a previous study [D. L. Miller and W. L. Nyborg, J. Acoust. Soc. Am. 73, 1537-1544 (1983)], two modes of oscillation, a "pistonlike" and a "membranelike" mode, were described theoretically, and either model appears capable of qualitatively explaining observations of the linear behavior of the gas-filled micropores. In this study, low-amplitude nonlinear theory is employed with observations of second harmonic emissions to show that the membranelike model is the more appropriate model for the 3.4- and 4.0-microns-diam micropores tested at 0.81 and 1.62 MHz. In addition, this model is expanded to include the case for which the gas is asymmetrically situated in a pore, to discuss the motion of the three-phase line at the periphery of an air-water interface in a pore, and to suggest an explanation of the phenomenon of gas loss from the pores when the incident field intensity is raised. Knowledge of the behavior of the gas-filled micropores in an ultrasonic field should allow a more complete understanding of biological effects on cells exposed to this form of cavitation activity. PMID- 3980880 TI - Elephantiasis nostras 1984. AB - Elephantiasis nostras is a rare condition that usually presents as a persistent swelling of the lower extremity secondary to recurrent lymphangitis. We present a patient, originally referred for "angioneurotic edema of the lip," who presented with a history of several months of persistent swelling of the upper lip. There was probable evidence for recent infection of the lip that is consistent with the diagnosis of elephantiasis nostras. This disease should be included in the differential diagnosis of chronic persistent angioedema of the lip. PMID- 3980881 TI - Nightly asthma caused by allergens in silk-filled bed quilts: clinical and immunologic studies. AB - Bed quilts filled with silk waste were found to cause nightly attacks of asthma. The first symptoms appeared on an average after 7 mo of exposure at a mean patient age of 30 yr. About 50% of the patients could be classified as atopic. Extract of the filling material revealed positive scratch and RAST tests in most patients. The bed quilts were advertised as being filled with pure wild silk (from silk moths of the genus Antheraea feeding on oak leaves), but it was found that in most cases the filling also included waste of cultivated silk (Bombyx mori). The origin of the allergen was sought. Since textile products of silk are considered to be practically nonallergenic, some type of contaminant appeared the most likely candidate. No allergen was found in cocoons, chrysalis (pupa), or moths of Antheraea. However, some cocoons of Bombyx mori, usually in small amounts, and excretions of the silkworm did contain allergen. High concentrations of allergen were found in an extract of living insects of the genus Anthrenus that was present in one batch of Bombyx mori cocoons. Thus, the silk waste appeared to be contaminated with material from the silkworms and also with infesting insects, which together create a very potent allergen repertoire that after a short incubation time, in a considerable frequency, elicits a rise in asthmatic symptoms and high serum IgE antibody levels. PMID- 3980882 TI - Acquired hyper-IgM syndrome with necrotizing granuloma. AB - This article is highlighted by the finding of striking cervical lymphadenopathy in a patient with acquired hyper-IgM syndrome and the pathologic description of the involved nodes. Routine hematoxylin-eosin stains demonstrated the presence of idiopathic necrotizing granulomas in the nodal tissue, a finding not previously reported in this syndrome. Immunoperoxidase techniques were used to further characterize these granulomas and delineate the cellular composition of the nodal architecture. We found that the necrotizing granulomas consisted of a peripheral rim of Ia positive palisaded, epithelioid histiocytes and central areas of debris and scattered inflammatory cells that were T11 positive. In the uninvolved areas of the node, we observed a lack of IgG-bearing lymphocytes in germinal centers as well as an absence of IgG-containing and decreased IgA-containing plasma cells in interfollicular areas. In conjunction with these in situ observations, there was a lack of IgA and IgG immunoglobulin-secreting cell responses in pokeweed mitogen stimulated cultures of the patient's peripheral blood mononuclear cells. Unique features of this article include: (1) the association of necrotizing granulomas with the hyper-IgM syndrome and (2) the use of monoclonal antibodies to characterize the distributions of nodal lymphocytes in a patient with this disorder. PMID- 3980883 TI - Exercise-induced anaphylaxis: a serious form of physical allergy associated with mast cell degranulation. AB - Exercise-induced anaphylaxis (EIA) is a unique and an increasingly recognized syndrome consisting of premonitory symptoms and signs of generalized body warmth, pruritus, and erythema, which progresses on continued exertion to confluent urticaria, laryngeal edema with stridor or hoarseness, and gastrointestinal colic and frequently culminates in vascular collapse. Previous studies of five individuals with this condition have demonstrated significant elevations of serum histamine concurrent with the early clinical manifestations after experimental exercise. To assess relevant morphologic alterations in the skin of these patients, cutaneous mast cells were examined by light and transmission electron microscopy before and during the initial erythema elicited by exertion. The marked alterations observed in mast cells immediately after exercise consisted of (1) loss of electron density and internal substructure of granules, (2) fusion of granule membranes with those of adjacent granules and with mast cell membranes creating conduits to the extracellular space, and (3) an apparent decrease in the number of intact granules per cell. Biopsy specimens obtained before exercise from patients with EIA and from two normal individuals who served as control subjects were identical, and the control subjects had normal mast cell morphology after exercise. Serum histamine levels were significantly elevated in patients with EIA after exercise at the time of biopsy, whereas control subjects had normal levels. These observations provide evidence that EIA is a distinct form of physical allergy associated with mast cell degranulation similar in morphology to that of human pulmonary mast cell IgE-Fc-dependent activation secretion. Characterization of this disorder is important because its prevalence may be underestimated, and its clinical consequences, which may include some morbidity, are not fully known. PMID- 3980884 TI - Local nasal immunotherapy: efficacy of low-dose aqueous ragweed extract. AB - In previous studies preseasonal local nasal immunotherapy (LNIT) with moderate doses of aqueous ragweed extract (mean total dose 59 micrograms of AgE and 139 micrograms of AgE) was an effective treatment for ragweed hay fever; however, local adverse reactions during therapy were common. This study evaluated the clinical and immunologic responses to LNIT by use of lower doses of aqueous ragweed extract in order to minimize these adverse reactions. Patients were administered preseasonal LNIT for 7 wk and received a mean total dose of 4.7 micrograms of AgE. During the ragweed season, symptom/medication scores (SMS) of the treated patients were equivalent to SMS of untreated patients. Serum ragweed specific IgE and nasal secretory ragweed-specific IgA rose slightly in the treated patients but not to the extent observed in previous studies. After the ragweed season treated and untreated patients had a substantial increase in serum ragweed IgE antibody titers. No correlation could be found between antibody responses and SMS. This study indicates that LNIT with lower doses of aqueous ragweed extract is clinically ineffective. PMID- 3980885 TI - Late allergic bronchial reactions and the effect of allergen provocation on the complement system. AB - Forty-nine bronchial provocations were performed with different allergens in allergic asthmatic patients. Immediate bronchial reactions occurred in 33 instances, and late reactions occurred in nine instances. The material was divided into three groups according to patients with no reactions, patients with early reactions alone, and patients with late reactions. Titers of whole complement and factors C2 and C3 were determined hemolytically, and the serum protein contents of factors C3, C4, and C1q were measured immunochemically. Decreases in complement and complement components were observed on a number of occasions after bronchial challenge. When the groups were compared with respect to mean change in complement titers, the three groups were indistinguishable. No change was noted in the ratio between the complement contents in venous and arterial blood as a result of provocation, nor did the specific hemolytic activity of factor C3 change. No C3 split products could be traced. It is likely that there will be a higher proportion of patients with C2 consumption among those with late bronchial reactions. No special feature could be assigned to these individuals, however. It is concluded that no major complement activation is regularly found in allergic asthmatic patients as a result of exposure to allergens. However, groups of patients in whom such activation takes place might exist. PMID- 3980886 TI - Bisulfite sensitivity manifesting as allergy to local dental anesthesia. AB - A case of sulfite sensitivity first manifested as possible allergy to local anesthetics is described. Implications for the broad problem of local anesthetic reactivity are discussed and a possible approach by sulfite challenge of suspect patients is outlined. PMID- 3980887 TI - Use of the term "false positive" in referring to results of food skin tests. PMID- 3980888 TI - Dietary control of hypertension and obesity and body weight standards. PMID- 3980889 TI - Maternal variables related to potentially high-sodium infant-feeding practices. AB - Infant sodium intakes between 5 and 15 mEq per day for ages 0 to 6 months and between 11 and 33 mEq per day for ages 6 to 12 months are considered appropriate, safe, and adequate. Intakes exceeding these ranges should be avoided as a precautionary measure for infants who may be hereditarily predisposed to hypertension. The concern about high-sodium intakes is based on epidemiological findings of an association between such intakes by adults and hypertension. Feeding practices potentially associated with high-sodium intake were assessed in 87 white and 68 black mothers of a cross section of 1- to 12-month-old infants and were analyzed for associations with epidemiological correlates of hypertension. Lower frequency of breast feeding was reported by black mothers and by less educated mothers. Forward, stepwise regression analyses indicated that less education was also predictive of shorter breast-feeding duration, earlier introduction of solid foods, addition of salt to infant food, and use of salty foods as snacks. Addition of salt to infant food was also predicted by high maternal salt use and by positive family hypertension history; black mothers more often fed salty snacks. Considerable public attention has been drawn to the fact that commercial infant foods no longer contain added salt. This study implies a need for additional public attention to appropriate sodium levels in home prepared and snack foods fed to infants. PMID- 3980890 TI - Validity and utility of anthropometric measurements: a survey of cancer outpatients. AB - The use of anthropometric data to assess nutritional status in patient populations is controversial; this study explores relationships among such measures in cancer outpatients in order to evaluate their validity and usefulness. Eighty-eight subjects agreed to participate fully. They were interviewed, and arm measurements were taken. Correlations between percentage of ideal weight, weight change, arm muscle area, and arm fat area tended to be moderately positive in both men (N = 31) and women (N = 57). Percentage of ideal weight had the highest average correlation with other variables. In women who were not above usual weight and in men, factor analysis yielded two-factor solutions, with one factor dominated by arm muscle area and the other factor dominated by arm fat area. This indicates that muscle and fat area estimates supplement weight data and provide distinct information. Even though anthropometric measures lack the precision attained by biochemical analysis of blood and urine samples, they are useful for a variety of clinical and research purposes, and they are inexpensive, noninvasive, and easily obtained. Nutrition leaders should further study the reliability and validity of anthropometric approaches, develop guidelines for their most appropriate use, and communicate the results of their efforts in interdisciplinary forums. PMID- 3980891 TI - Dietary practices of persons with diabetes during insulin pump therapy. AB - Eating behaviors and diet composition were investigated in 15 individuals with insulin-dependent diabetes treated by continuous subcutaneous insulin infusion (CSII). Glycemic control was significantly improved and was near normal during pump treatment. Patients were interviewed with the use of a structured questionnaire composed of multiple question formats to document dietary practices and to identify changes from conventional therapy. Mealtimes were varied considerably on both conventional and pump therapy (as much as 110 +/- 19 and 126 +/- 20 minutes, respectively), but mealtime delays were reported to be manageable while the patients were using the pump. The practices of eating larger meals or additional snacks compensated for by extra insulin significantly increased during CSII therapy. Partly as a consequence of such practices, patients experienced a significant weight gain of 7.2 +/- 2 lb during pump treatment (p less than .005). Clearly, prospective studies are needed to determine the acceptable degree of dietary flexibility and the optimal management of diet during insulin pump therapy. PMID- 3980892 TI - Gastric reduction surgery: a dietitian's experience and perspective. AB - Gastric reduction operations are being performed for the treatment of the morbidly obese. Loop gastric bypass, Roux-en-Y gastric bypass, horizontal gastroplasty, and vertical banded gastroplasty are the four major types of gastric reduction operations that have been performed since 1966 at the University of Iowa Hospitals and Clinics. Vertical banded gastroplasty, the procedure currently being performed, creates a small upper pouch volume (10 to 30 ml) and a small stoma diameter (10 to 12 mm). This necessitates making drastic changes in patients' eating patterns, such as taking 30 minutes to eat a small meal and not drinking liquids with the meals. The changes help eliminate such complications as disruption of the staple line, stretching of the pouch, and obstruction of the stoma. A 30-ml medicine cup and a clock are important behavior modification tools to encourage patients to eat small amounts of food and sip beverages slowly. The dietitian can play a paramount role as educator for gastric reduction operation patients and should therefore become closely involved in their perioperative and long-term care. PMID- 3980893 TI - Protein-sparing diet for severely obese adolescents: design and use of an equivalency system for menu planning. AB - When severe, obesity in adolescence demands effective treatment, thus justifying use of a protein-sparing, low-energy diet for periods of 3 to 4 months. When properly planned and supervised, this diet is safe and effective, even if only to maintain a functional body weight. The regimen used at the Hospital for Sick Children, Toronto, provides 2.0 to 2.5 gm protein per kilogram ideal body weight, plus adequate fluid and nutrient supplements. The amounts of meat, poultry, and fish that supply this allocation of protein are determined using a protein equivalency system developed for the diet. The system allows both dietitians and patients to plan meals that minimize energy intake while maintaining protein adequacy and dietary variety. With prolonged use of the diet, limited carbohydrate may be added in the form of selected vegetables measured using a similar carbohydrate equivalency system. Recent use of the diet for 21 patients, 8 to 20 1/2 years old and averaging 211% ideal body weight, resulted in acceptable weight control. PMID- 3980894 TI - Dietetics at work in the workplace: academia and industry cooperate in a blood pressure program. AB - Here is one approach to the challenge of preparing dietetic students for a rapidly changing health care system. Hypertension screening and control are the focus of a cooperative project conducted at the Saginaw-Detroit plants of General Motors Corporation by students of the Medical Dietetics Program at Wayne State University, Detroit. The project reflects implementation, over a 3-year period, of the General Motors Blood Pressure Program. A model is presented for involving students in a health-oriented program at a work site. Effectiveness of student follow-up and counseling is demonstrated in a research component involving noncompliant hypertensive employees. Outcomes of cooperative efforts include: (a) development of guidelines for management of a hypertension monitoring program involving students, (b) support for an industrial medical staff in mounting a new program, (c) extension of faculty capabilities through plant medical staff, (d) baseline data for calculating cost-benefit of a monitoring program, and (e) achievement of superior blood pressure control in comparison with other industrial programs. PMID- 3980895 TI - Salt substitutes and medicinal potassium sources: risks and benefits. AB - The purpose of this investigation was to gather and summarize currently available product information on salt substitutes, low-sodium products, and medicinal potassium supplements. A review of the literature identified both risks (e.g., hyperkalemia) and benefits (e.g., changing sodium:potassium ratios, and low-cost substitutes for medicinal potassium replacement) resulting from the use of salt substitutes. Risks and benefits are related to individual patient conditions and treatment plans. Nutritionists and physicians must be aware of the medicinal and dietary potassium sources and be able to educate patients in the proper use of the products. Lists of medicinal and dietary sources of potassium are provided to aid health professionals in determining appropriate potassium equivalents. Case reports from the literature of patients developing hyperkalemia secondary to the use of salt substitutes are summarized. Regular monitoring of serum potassium levels is necessary to achieve and maintain normal values. PMID- 3980896 TI - Quality care management in clinical dietetics. PMID- 3980897 TI - Dietary counseling results in effective dietary sodium restriction. PMID- 3980898 TI - Improving nutrition components in medical and dental school curriculums. AB - This article has presented an alternative approach to the traditional, freestanding, concentrated course in nutrition. The integration of nutrition into other courses, with continuous reinforcement throughout the 4-year curriculum, may result in better learning and retention by the student. However, the lack of an accurate curriculum representation presents a problem in selecting topics that integrate with other courses. The unobtrusive approach to nutrition curriculum improvement involves three key points: development of the Nutrition Curriculum Guide, which provides detailed information on what is currently being taught, comparison of what is actually being taught with a set of ideal objectives in order to identify redundancies or omissions, and orchestrating the efforts of faculty in courses throughout the 4-year curriculum to help students integrate nutrition-related topics from the various disciplines. When one makes practical application of the unobtrusive approach, the most difficult problem is defining which interdisciplinary topics are currently being taught. An education specialist and the Tracer Method are important resources for one who is seeking to ameliorate the problem. PMID- 3980899 TI - Diet prescription guidelines--increased consultations through heightened accessibility. PMID- 3980900 TI - Weight reduction methods of college women. AB - Weight reduction attitudes and practices were obtained from a sample of 400 female students. Forty-eight percent reported using a weight loss program since admission to college. The programs most often selected included hypocaloric diets and exercise. Although the majority of subjects rated hypocaloric diets and exercise as good methods for weight reduction and indicated that they would recommend them to others, these methods supported the slowest rate of weight loss. Evidently, the side effects and costs of the other programs offset the rapid weight loss. Other methods, in descending order of use, included the Cambridge diet, drugs, weight loss clinics, and low-carbohydrate diets. Improved appearance was most often given as the reason for losing weight. PMID- 3980901 TI - Examination of the pseudophakic patient. AB - The use of intraocular lens implants in cataract surgery is rapidly increasing. Doctors of optometry will be performing examinations on pseudophakic patients. Observations and techniques particular to pseudophakic patient care are presented. The following discussion will assist the clinician in examination and proper management of these patients. PMID- 3980902 TI - Potential systemic and ocular side effects associated with topical administration of timolol maleate. AB - A review of current literary sources disclosed a host of adverse reactions which may potentially be associated with the topical administration of timolol maleate. Systemic complications included a variety of cardiovascular, respiratory, central nervous system, gastrointestinal, and dermatologic reactions. Numerous ocular side effects were also reported including superficial punctate keratitis, ocular pain or discomfort, corneal anesthesia, and vague visual disturbances. PMID- 3980903 TI - Two cases of the diagnosis of optic neuritis leading to the diagnosis of multiple sclerosis. AB - More than one of three persons with multiple sclerosis will eventually get optic neuritis during the course of their disease. In each case below, a patient presented to an optometrist with optic neuritis, the discovery of which aided in the subsequent diagnosis of multiple sclerosis. These patients exhibited most of the typical signs of optic neuritis; reduced visual acuity, Marcus Gunn pupil, central scotomata, reduced color vision, abnormal funduscopic appearance, and pain on eye movement. PMID- 3980904 TI - Case report: reticular degenerative retinoschisis. PMID- 3980905 TI - Pharmacology in optometry. PMID- 3980907 TI - Horner's syndrome: an unusual precursor of occlusive disease of the carotid arterial system. PMID- 3980906 TI - Talc retinopathy. PMID- 3980908 TI - The 'A' and 'V' pattern syndromes. AB - Variations in strabismic and heterophoric angles with differing positions of gaze are frequently encountered and should be of interest to all clinicians involved in strabismus evaluation and management. This paper discussed the "A-V" Pattern Syndromes, their etiology, diagnosis and management. PMID- 3980909 TI - Overcoming professional isolationism. PMID- 3980910 TI - Survey results: optometric terminology. PMID- 3980911 TI - Contemporary viewpoints on pigmentary glaucoma. AB - The pigment dispersion syndrome occasionally results in a specific form of open angle glaucoma (pigmentary glaucoma). Recent evidence suggests a mechanical etiology of pigment liberation. Consideration of these etiological factors influences the optometric management of patients with pigment dispersion syndrome and pigmentary glaucoma. A review of anatomical and histological factors as well as a representative case report are presented. PMID- 3980912 TI - A bitoric gas permeable hard contact lens with spherical power effect. AB - A 36 lens fitting set of gas permeable hard (Polycon II) bitoric contact lenses with spherical power effect in vivo was used to fit 50 patients. Thirty six patients (66 eyes) were correctly fitted with spherical power effect (SPE) lenses while 14 patients (27 eyes) required cylinder power effect (CPE) lenses. The mean flat base curve was 0.45 D.K. flatter than the mean flat corneal K reading, and the mean base curve toricity was 0.50 D.K. less than mean corneal toricity. Overall patient response was good to excellent for 82% of the patient sample. PMID- 3980913 TI - Refitting long-term asymptomatic PMMA lens wearers into gas permeable lenses. AB - Controversy exists as to whether patients who are asymptomatic, long term PMMA contact lens wearers demonstrating an acceptable clinical ocular response should be routinely refit into hard gas permeable lenses. Corneal thickness, corneal curvature, and refractive changes were measured on eight such patients when their lenses were changed to a gas permeable lens material (Boston II) while all other lens parameters were held constant. Corneal thickness decreased dramatically, corneal curvature flattened slightly, and refractive findings showed no significant changes. A simple reorder of the current lens design in the gas permeable material has been recommended as a reasonable "refitting" method for this type of patient. PMID- 3980914 TI - The contact lens environment: tear proteins in perspective. AB - Tear protein deposition on contact lenses can lead to interruption or even cessation of lens wear. Yet, there are positive roles that tear proteins play in the maintenance of ocular integrity, with and without contact lenses present. One of these roles, that of tear buffering, is explored here. PMID- 3980915 TI - Corneal refraction: relative effects of each corneal component. AB - The refractive power of the cornea may change after wearing contact lenses and as a result of disease or surgery. Each corneal component that contributes to the refractive power was analyzed and their relative significance was determined by comparing the refractive effects of a 10% change. In order of magnitude, the effect of a 10% change in each component was as follows: anterior corneal curvature (4.87 D), index of refraction (1.87 D), depth of anterior chamber (1.20 D), posterior corneal curvature (0.62 D) and corneal thickness (0.01 D). Refractive changes are the result of increases and decreases of each component and the total effect is the sum of the individual changes in each component. PMID- 3980916 TI - Central corneal thickness of patients with dry eyes. AB - Central corneal thickness was measured in 16 patients with clinical signs and symptoms of dry eyes. When compared to a control group of equal size with normal tear film physiology, no significant difference in central corneal thickness was found. PMID- 3980917 TI - The exposure of various polymers to a 24-hour soak in Lensept: the effect on base curve. PMID- 3980918 TI - Reactions of cardiac postganglionic sympathetic neurons to movements of normal and inflamed knee joints. AB - The effects of passive movements of normal and inflamed knee joints on unitary activity in filaments of the inferior cardiac nerve (ICN) were studied in cats anesthetized with chloralose and urethane. The effects were compared with those obtained by electrical stimulation of afferent A- and C-fibers in the medial articular nerve, in muscle and in cutaneous hind limb nerves. The vagus nerves were cut and the right carotid artery was tied off. The left carotid sinus was intact. All ICN units used in this study displayed spontaneous activity which was usually related to the cardiac and respiratory rhythms. The ICN units were regularly excited by electrically evoked single or short repetitive A-volleys in articular, cutaneous and muscle nerves. The excitation was followed by a silent period. Inclusion of C-fibers in the afferent volleys gave a second, long-latency burst of impulses which was seen only with short repetitive stimulation. Passive movements in the normal working range of the joint did not influence the activity of ICN units. However, noxious joint movements, particularly of inflamed joints, led to pronounced excitation of ICN units accompanied by rises in blood pressure. Most of these effects could still be seen after all nerves to the hind limbs, except the medial articular nerve, were cut. It is proposed (a) that ICN units form a homogeneous population of sympathetic postganglionic units whose reaction pattern to somatovisceral input is distinctly different from that of other sympathetic subsystems, and (b) that articular receptors make a substantial contribution to the ICN input particularly when many fine afferent units are sensitized to mechanical stimulation by an acute joint inflammation. PMID- 3980919 TI - Sympathetic-adrenal medullary and cardiovascular responses to acute cold stress in adult and aged rats. AB - In this study, adult (5 months) and aged (22 months) Fischer 344 (F-344) male rats were surgically prepared with chronic tail artery cannulae. Two days after surgery, rats were stressed by immersion in 12 degrees C water for 10 min. Blood samples (0.5 ml) were collected before and at timed intervals after cold immersion (0, 15 and 60 min) and were later assayed for content of norepinephrine and epinephrine. Consistent with earlier studies from this laboratory, there were no differences between ages in basal plasma levels of either catecholamine or in mean arterial pressure or core temperature. However, basal heart rates of aged rats were approximately 10% greater than values for adult rats. During cold immersion, aged rats had greater decrements in heart rate compared to adults but there were no age-related differences in mean arterial pressure or core temperature. Immediately following cold immersion, increments above basal values for plasma norepinephrine and epinephrine (4.2-4.6 and 11.8-14.1-fold, respectively) were similar for 5- and 22-month-old rats. However, in aged rats plasma norepinephrine was greater at 60 min post-immersion and plasma epinephrine was greater at 15 and 60 min post-immersion compared to values for adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980920 TI - Behaviorally conditioned changes in atrio-ventricular transmission in awake dog. AB - The purpose of this study was to examine the effects of behaviorally conditioned changes in autonomic activity on atrio-ventricular (AV) transmission in dog. To produce consistent activation of the cardiac nerves in the awake animal (n = 7), a classical appetitive conditioning paradigm was used. A conditioning trial consisted of a 30 s control period followed by one of two differing situations: (1) a 60-s conditional stimulus (CS+) tone wherein food (i.e. 'UCS' or unconditioned stimulus) was given during the last 30 s; or (2) at 30-s discriminative stimulus (CS-) tone which was never followed by food reward. Eight of each type trial were given daily until a stereotypic cardiovascular response was developed for the CS+ but not the CS-. The hemodynamic conditional response (i.e. 'CR', the response to the CS+) consisted of a moderate tachycardia (+14.5%, P less than or equal to 0.05), a small pressor response (+6.7%, P less than or equal to 0.01), and a moderate increase in the first time derivative of left ventricular pressure (+14.9%, P less than or equal to 0.01) reflecting an increase in inotropic state. The unconditional response (i.e., 'UCR', the response to the food reward) consisted of a substantial increase in HR (25.7%, P less than or equal to 0.01) above CR values while left ventricular pressure (LVP) and d(LVP)/dt increased 5.0% and 10.0% (P less than or equal to 0.01 for both) above their CR values. The effect of the conditioned changes in neural activity on the AV node was observed by pacing the atrium from 110 to 180 bpm during the first 15 s of each trial period (i.e. control, CS+, UCS). The discrepancy between the atrial pace rate and the transmitted ventricular rate is expressed as a 'mean difference score' and serves as an index of the fidelity of the AV transmission process: the smaller the difference, the closer a 1:1 ratio of atrial vs ventricular beats is approached. The relatively large mean difference score for the control periods (46.0 +/- 9 bpm) indicates that the paced atrial impulse did not faithfully precede ventricular contraction during these periods. The mean difference significantly decreased (34.6%, P less than or equal to 0.05) during the CS+, and approached an almost 1:1 ratio (75.6% decrease from CS+ values, P less than or equal to 0.01) during food delivery. beta-Adrenergic blockade (propranolol, 1 mg/kg, i.v.) eliminated the changes in mean difference during the CS+ but not during food delivery. There were no statistically significant physiological changes during CS-.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3980921 TI - Reticular formation of the lower brainstem. A common system for cardio respiratory and somatomotor functions. Considerations aided by computer simulations. AB - Parallel investigations were done using the reticular formation of the lower brainstem of dogs and computer simulated neuronal networks with properties of reticular neurones. By the aid of the simulations, understanding of the functional organisation of the common brainstem system, reticular formation and the experiments performed were optimized. The fact that discharge sequences of model neurones are very similar to those of reticular neurones was proved by interval histograms and covariance histograms. Discharges of neighbouring reticular neurones tend to be strongly coupled. In the model the discharges of the neurones could be coupled by common afferent inflows. Physiologically, neighbouring reticular neurones receive common afferents from peripheral somato sensory systems. Neighbouring neurones with strongly coupled discharging are organized in subpopulations. The configurations of the subpopulations are determined by number and type of afferents actively influencing neurones and by the level of intrinsic activity of the network. Signal processing and transfer by neuronal subpopulations depend on the level of activity and on the degree of coupled discharging, i.e. the local organisation of the neurones. PMID- 3980922 TI - Respiratory modulation of sympathetic activity. AB - Sympathetic activity recorded from cardiac and renal nerves was correlated with phrenic and internal intercostal nerve activity under normocapnea and hypercapnea. Cats were anesthetized with halothane for surgery switching to chloralose for recording. Both vagal and carotid sinus nerves were cut, animals were paralyzed and artificially ventilated. We found that sympathetic activity followed the rhythmic pattern of phrenic nerve discharge fairly closely except in two important respects: first, sympathetic activity was significantly depressed during early inspiration and second, it reached a minimum during post inspiration while phrenic activity was decaying but still active. These effects were accentuated when PACO2 was raised. In one cat early inspiratory depression was the only manifestation of respiratory modulation of sympathetic activity superimposed on an otherwise tonic pattern. In 4 cats sympathetic activity increased in an augmenting fashion in parallel with the augmenting discharge of expiratory alpha motoneurones. We suggest that respiratory-related, excitatory and inhibitory inputs modulate sympathetic activity at the brainstem level. Inspiratory and possibly expiratory interneurones may be the source of activation, and inhibitory inputs may derive from early inspiratory and postinspiratory interneurones. The inhibitory effects may be the only manifestation of respiratory modulation during strong tonic drive of the sympathetic activity. PMID- 3980923 TI - Studies on the mechanisms involved in iron transfer across the isolated guinea pig placenta by means of bolus experiments. AB - Placental binding and uptake of diferric transferrin as well as transplacental iron transfer has been studied in isolated, perfused guinea pig placenta. The process of binding and uptake of transferrin was saturable only on the maternal side. On the fetal side no specific binding occurred. This indicates an asymmetric distribution of transferrin receptors. No receptors are present for albumin, neither on maternal, nor fetal side. Most of the 125I-59Fe transferrin, administered with a single bolus, enters the trophoblast. A small part remains attached to the plasma membranes, as shown by cell fractionation and in transferrin exchange experiments. The majority transferrin, which was internalized, is unlikely to be bound to plasma membranes and may be bound to receptors dissociated from plasma membranes. Based on kinetics of 59Fe appearance and washout at the fetal side of the perfused placenta as a model for trans placental iron transfer has been postulated. A central feature is the role played by a small compartment (0.14 mumol) to which iron is supplied by a very rapid process at the trophoblast receptor, without internalisation of transferrin. A second un-identified pathway is supposed to regulate the magnitude of the iron transfer pool. PMID- 3980924 TI - Effects of medium-chain triglyceride feeding or glucose infusion on glucose kinetics in the newborn rat. AB - Hypoglycaemia which develops in starved newborn rats (0.15 +/- 0.01 mg/ml) is reversed by feeding medium-chain triglycerides (0.66 +/- 0.05 mg/ml). Despite similar glycaemia (0.71 +/- 0.07 mg/ml) starved newborns infused with glucose (10.7 mg/min/kg) show a 30% higher glucose turnover rate than medium-chain triglyceride fed animals (14.1 +/- 0.6 versus 10.6 +/- 0.3 mg/min/kg, p less than 0.01). For a comparable [6-3H]glucose turnover rate (10.5 +/- 0.3 mg/min/kg), glucose-infused (5.25 mg/min/kg) newborns have a 30% lower glycaemia (0.50 +/- 0.03 mg/ml, p less than 0.01) than medium-chain triglyceride-fed newborns. Thus, medium chain triglyceride feeding leads to a 30% decreased capacity of the tissues to utilize glucose. For a similar glucose turnover rate, medium-chain triglyceride-fed newborns have a higher blood lactate concentration than glucose infused newborns (0.26 +/- 0.03 versus 0.15 +/- 0.02 mg/ml). However, in medium chain triglyceride-fed newborns, the increase of blood lactate is not only due to the Cori cycle, as glucose recycling is less increased than glucose production. Thus medium-chain triglyceride increases the release of gluconeogenic precursors which are not derived from blood glucose. In presence of a glucose infusion (15.25 mg/min/kg) producing hyperglycaemia (1.35 +/- 0.05 mg/ml), endogenous glucose production is suppressed by only 37%. If 3-mercaptopicolinate, an inhibitor or gluconeogenesis, is given concomitantly, hyperglycaemia is prevented (0.72 +/- 0.08 mg/ml) and endogenous glucose production is suppressed. Glucose infusion in the hypoglycaemic newborn rat might thus lead to a precarious glucose homeostasis. PMID- 3980925 TI - Relationship between accelerations and decelerations in heart rate and skeletal muscle activity in fetal sheep. AB - Accelerations in fetal heart rate have been shown to be closely related to fetal body movements and are indicative of well-being in the human fetus. We have examined the association of accelerations and decelerations in heart rate with skeletal muscle activity in 8 fetal sheep between 125 and 145 days' gestation. Accelerations/decelerations were defined as transient increases/decreases in fetal heart rate of greater than or equal to 10 beats/min. lasting for 5 s or longer. For accelerations (n = 1180), the mean duration was 18.8 +/- 1.5 s (SEM) and the mean amplitude was 25.3 +/- 1.2 beats/min; for decelerations (n = 237), the mean duration was 17.4 +/- 1.6 s and the mean amplitude was 18.7 +/- 1.0 beats/min. Electromyograms were recorded from the nuchal muscles and antagonistic muscle groups of the fetal forelimb and hindlimb. Electromyogram activity occurred during 88.4 +/- 2.8% of accelerations and 60.6 +/- 7.7% of decelerations. There was a 36.6% reduction in the number of accelerations following fetal paralysis with gallamine, but no change in their amplitude or duration. It is concluded that accelerations in heart rate are highly associated with skeletal muscle activity in fetal sheep. The majority of these occur as a result of central neuronal output rather than as a consequence of fetal movement. PMID- 3980926 TI - Oxytocin and vasopressin in the rat do not readily pass from the mother to the amniotic fluid in late pregnancy. AB - In order to see whether the mother contributes to the vasopressin or oxytocin levels of amniotic fluid, these peptides were measured under conditions (1) in which the fetus lacks vasopressin (Brattleboro strain) and (2) where high maternal oxytocin and vasopressin plasma levels were induced by means of a controlled-delivery Accurel-collodion device. No vasopressin could be demonstrated in amniotic fluid of vasopressin-deficient fetuses present in a heterozygous (i.e., vasopressin-synthetizing mother). High peptide levels on the maternal side of Wistar rats generally failed to affect the amniotic fluid levels. The increase that was occasionally seen in amniotic vasopressin was probably due to fetal release concomitant with growth retardation. Amniotic vasopressin is derived from the fetus. Since amniotic fluid oxytocin is neither derived from the mother nor from the fetal brain, other fetal sources should be considered. PMID- 3980927 TI - Distal radioulnar joint arthroplasty: the hemiresection-interposition technique. AB - The hemiresection-interposition technique for distal radioulnar joint arthroplasty was developed from anatomic studies that indicated the importance of preserving the functional elements of the ulnocarpal ligament complex. The technique has been previously described. My experience with 38 patients who were followed for an average of 2 1/2 years shows that the procedure is most valuable for patients with rheumatoid arthritis (85% had stable, painless pronation averaging 84 degrees and supination of 77 degrees, while 15% had mild pain and pronation of 70 degrees and supination of 75 degrees). It is also valuable for patients with degenerative or trauma-induced arthritis (100% had painless rotation-pronation averaging 80 degrees and supination of 80 degrees). A modified procedure is useful for patients with ulnocarpal impingement syndrome where the Milch shortening osteotomy may not succeed because of radioulnar incongruity. PMID- 3980929 TI - Symptomatic carpal coalition. AB - The carpus is initially a cartilaginous structure that subsequently demarcates into separate carpal bones. Failure of differentiation of parts results in carpal coalition, the most common of which occurs between the lunate and triquetrum. Lunate-triquetral coalitions can be subdivided into four types according to the degree of union. Four types are identified. A case report of type I is presented that responded to a lunate-triquetral fusion. PMID- 3980928 TI - An approach to Kienbock's disease: triscaphe arthrodesis. AB - Sixteen patients with Kienbock's disease were treated with triscaphe arthrodesis (fusion of the scaphoid, trapezium, and trapezoid) with or without silicone rubber lunate arthroplasty. This approach removes compressive stress from the diseased lunate and treats the accompanying rotary subluxation of the scaphoid. Five patients were treated with triscaphe arthrodesis together with silicone rubber lunate arthroplasty. Three patients, who were symptomatic, after receiving silicone rubber lunate arthroplasty elsewhere, were treated with triscaphe arthrodesis. Eight patients were treated with triscaphe arthrodesis alone, without silicone rubber lunate arthroplasty. Two of these eight patients later required silicone rubber lunate arthroplasty. Radial styloidectomy and small lunate fragment excision were performed later on one patient. After an average follow-up of 20.5 months, relief of pain was satisfactory in all 16 patients. There was neither nonunion nor surgical infection. We believe that triscaphe arthrodesis with a silicone rubber lunate provides a means for load transference and heavy stress use capability of the hand. Triscaphe arthrodesis alone may suffice to bear the wrist load and can be used in an effort to preserve the diseased lunate. A silicone rubber lunate can easily be added at a later date if necessary. PMID- 3980930 TI - Hand and wrist joint problems in patients with Ehlers-Danlos syndrome. AB - Ehlers-Danlos syndrome is a heritable disorder of connective tissue that is clinically characterized by joint hypermobility and skin hyperextensibility and fragility. Four of our patients who fit the criteria for Ehlers-Danlos syndrome are presented. Abnormalities in the hand and wrist joint that are directly related to joint hypermobility are discussed. PMID- 3980931 TI - Divergent dislocation of the carpometacarpal joints: a case report. AB - A motorcyclist presented for treatment with divergent dislocation of the bases of the four medial metacarpals, avulsion of the hook of the hamate, dislocation of the trapezium from the scaphoid, and palmar fracture-dislocation of the wrist. This constellation of injuries has never been described. The carpometacarpal joints were reduced at surgery and pinned. The patient is doing well 8 years later despite nonunion of the hook of the hamate. PMID- 3980932 TI - Electromyographic analysis of the thumb: a study of isometric forces in pinch and grasp. AB - An electromyographic study of thumb muscles was performed on eight subjects by means of integrated polyelectromyography and simultaneous recordings of isometric flexion-extension, abduction-adduction, and prehensile pinch and grasp of the thumb. The integrated electromyographic signal proved to be an excellent index of thumb muscle activity, with a linear relationship found at low to middle levels of muscle strength. To facilitate understanding of thumb function, thumb muscles can be classified as primary or secondary on the basis of electrical potential activity. In isometric flexion, the flexor pollicis longus (FPL) was primary, whereas in extension, the extensor pollicis longus (EPL) and abductor pollicis longus were primary. In adduction, the adductor pollicis and EPL were primary and the FPL was secondary. In abduction, the abductor pollicis brevis and opponens pollicis were primary. The adductor pollicis, and FPL were nearly equal during pinch and grasp, with significant electrical activity increasing with greater force requirements. The first dorsal interosseous and EPL contributed secondarily in both pinch and grasp. When surgeons consider tendon transfers for nonfunctioning thumb muscles, the primary muscles should be replaced first to best restore pinch and grasp strength. PMID- 3980933 TI - Replantation of the amputated distal part of the fingers. AB - Microsurgical replantation has been attempted in the distal phalanx of the finger regardless of whether zones I and II were involved. There were 70 patients with 87 amputated fingers. The patients' ages ranged from 14 months to 71 years. Fifty one fingers were completely amputated. Five of the 87 replants failed. Seven fingers showed partial necrosis, but all others had no necrosis. Of the 74 fingers that had partial or no necrosis more than 6 months after surgery, 60 fingers (81.1%) are in excellent condition and have good daily use, and 14.8% have at least partial use. The patients were satisfied with the cosmetic appearance in all of the replanted fingers that survived. PMID- 3980934 TI - Hand reconstruction for multiple amputations by double microsurgical toe transplantation. AB - Double microvascular toe transplant procedures were used to restore function in 16 mutilated hands. In eight hands, both opposing surfaces were reconstructed with the great toe or second toe used for the thumb and the contralateral second toe for the ulnar side of the hand. In eight hands in which the thumb was still present, two fingers were reconstructed with a second toe from each foot. All 33 transplanted toes survived. In all patients, hand function was substantially improved, with an average of 9.15 pounds of pinch strength between the transplanted opposing digits or the transplanted digit and a normal thumb. Adequate sensibility was restored. The two transplant procedures were done sequentially in six patients, while the two transplantations were performed simultaneously in 10 patients. Simultaneous reconstruction proved time- and cost effective. PMID- 3980935 TI - Serial quantitative skin surface fluorescence: a new method for postoperative monitoring of vascular perfusion in revascularized digits. AB - Postoperative monitoring of vascular perfusion was performed in 72 revascularized/replanted digits in 40 patients. Sodium fluorescein (1.0 to 1.5 mg/kg) was administered intravenously every 2 hours for 36 to 48 hours beginning immediately after surgery. Quantitative fluorescence readings of each injured digit were obtained 10 minutes after fluorescein injection and were compared with readings from an uninjured (control) digit. A ratio between the fluorescence of the injured digit and that of the control digit was used for analysis. Viable digits had a fluorescein perfusion ratio of 86.4 +/- 16. Digits that did not survive had fluorescein perfusion ratios of 5.2 +/- 10 (p less than 0.001). The results of this study indicate that quantitative surface fluorescence assessment of revascularized/replanted digits is a minimally invasive, and reliable tool for monitoring vascular perfusion. PMID- 3980936 TI - Functional assessment of ray transfer for central digital loss. AB - Nineteen patients who had ray transposition for central digital loss were evaluated retrospectively with regard to postoperative function and appearance. Pinch and grip recoveries were better in patients with small-to-ring finger transfers than in those with index-to-long finger transfers. Total average pinch recovery measured 83.3% of the nonoperated side. Total grip recovery was 80.2% of the nonoperated side. Average ranges of motion for all transferred digits were 77.6 degrees (metacarpophalangeal joint), 87.6 degrees (proximal interphalangeal joint), and 80.8 degrees (distal interphalangeal joint). Overall results judged by a five-component assessment scale were excellent. PMID- 3980937 TI - Pyridoxine as an adjunct in the treatment of carpal tunnel syndrome. AB - Nineteen consecutive patients with carpal tunnel syndrome were treated with pyridoxine. Two thirds of the patients who specifically presented symptoms of median neuropathy eventually required surgical release. Although pyridoxine may have a place alongside other nonsurgical modalities in the treatment of carpal tunnel syndrome, surgical release continues to be indicated in many patients with carpal tunnel syndrome. PMID- 3980938 TI - Tuberculosis presenting as carpal tunnel syndrome. AB - A 44-year-old man presented with typical symptoms, signs, and laboratory findings of carpal tunnel syndrome. Mycobacterium tuberculosis was cultured from the flexor tenosynovium excised at surgery. Tuberculosis should be considered in the differential diagnosis of carpal tunnel syndrome with unexplained chronic synovitis. The diagnosis may be missed unless a tissue specimen is analyzed specifically with acid-fast stain and culture. Therapy should include excision of involved synovium, early postoperative mobilization, and appropriate chemotherapy. PMID- 3980939 TI - Congenital carpal tunnel syndrome. AB - A case of congenital carpal tunnel syndrome associated with melorheostosis is described. The symptoms were lack of use of the hand since birth, hypotrophy of the fingers innervated by the median nerve, and severe atrophy of the thenar muscles. The total degeneration of the nerve in the carpal tunnel was successfully treated with a sural nerve graft. PMID- 3980940 TI - Ligament stability of the metacarpophalangeal joint: a biomechanical study. AB - Capsuloligamentous contributions to metacarpophalangeal joint stability were obtained from load-displacement tests on the joints of 15 human cadavers. The contribution of each ligament to joint stability was obtained by measuring the reduction of load that induced a given joint displacement after sequential ligamentous sectioning. Four modes of joint displacement were examined: distal distraction, dorsopalmar dislocation, abduction-adduction rotations, and supination-pronation rotations. This study demonstrated that both radial and ulnar collateral ligaments play primary roles in stabilizing the metacarpophalangeal joint in all four modes of joint displacement. The accessory collateral ligaments contribute primarily to abduction-adduction rotational stability, but contribute little to stabilizing dorsopalmar dislocation or axial (supination-pronation) rotations. The palmar plate prevents dorsal dislocation only at full extension. The dorsal capsule has a moderate contribution to stability in distraction and supination-pronation rotations. PMID- 3980941 TI - Irreducible palmar dislocation of the proximal interphalangeal joint associated with an epiphyseal fracture of the middle phalanx. AB - A palmar dislocation of the proximal interphalangeal joint that became irreducible because of a Salter-Harris type I fracture of the epiphysis of the middle phalanx is described. The anatomic mechanisms of irreducible palmar dislocations are discussed. PMID- 3980942 TI - Histologic structure of the ulnar nerve in the hand. AB - Serial histologic sections of 20 ulnar nerves revealed broad individual variations in the number and diameter of the fascicles at all levels. The number of fascicles increased from the proximal portion to the distal portion, and interfascicular and perifascicular connective tissue occupied about 50% of the entire nerve section. These configurations explain the difficulties and setbacks encountered in the repair of injuries to the ulnar nerve. The counting of myelinated nerve fibers also revealed a great number of variations. PMID- 3980943 TI - Intraosseous nerve transposition for treatment of painful neuromas. AB - Symptomatic painful neuromas of the sensory nerves are a frequent cause of major impairment of the hand. Numerous techniques and measures have been used for managing this challenging problem. Boldrey first advocated a technique in 1943 in which the nerve end was transposed and implanted into bone and reported the successful use of this method in one patient. In 1981, Hemmy used a similar technique in five patients with no recurrence of pain. To date, no other studies that used this method have been reported. We performed intraosseous transposition of 23 painful neuromas in the hand of 11 patients and were successful in 10 cases. PMID- 3980944 TI - Metacarpal resection with a contoured iliac bone graft and silicone rubber implant for metacarpal giant cell tumor: a case report. AB - A definitive surgical procedure for a giant cell tumor that combines metacarpal resection with an iliac bone graft and arthroplasty with a silicone rubber implant is proposed for the elderly patient. The results were encouraging in one patient who had a cosmetically and functionally acceptable hand and no evidence of recurrence. PMID- 3980945 TI - Metastatic nontraumatic Clostridium septicum osteomyelitis. AB - Nontraumatic clostridial infections are rare, but need to be diagnosed and treated early or high morbidity and mortality rates result. We believe that this is the first reported case of metastatic nontraumatic Clostridium septicum osteomyelitis. Early treatment with surgical debridement and parenteral antibiotics without hyperbaric oxygen was used. An associated occult rectal malignancy was discovered and treated. PMID- 3980946 TI - Tumorous lesions of the hand. AB - A retrospective study was conducted of 543 tumorous lesions of the hand seen in a busy office practice for a 5-year period from April 1976 to April 1981. The lesions were grouped as benign lesions, of either the soft tissue or skeletal type, or as malignant lesions. The overall chance that a hand tumor was malignant was 2% (11 of 543). There was significant association of palmar radial ganglion and carpal tunnel syndrome (15%). Ganglions recur more often after aspiration than after surgery. Certain lesions, particularly a mucous cyst, have a high postoperative complication rate. A few of these unique lesions are described. PMID- 3980947 TI - Angiolymphoid hyperplasia with eosinophilia: a case report. AB - A case of angiolymphoid hyperplasia with eosinophilia of the hand is described. This tumor has also been described as subcutaneous angiolymphoid hyperplasia with eosinophilia and as an atypical pyogenic granuloma. It usually occurs in the head or neck. This highly recurrent tumor has not been previously described in the hand. It was completely excised and had not recurred 4 years after surgery. PMID- 3980948 TI - Infiltrating angiolipoma of the hand and wrist. AB - Three cases of angiolipomas involving the wrist and hand are reported that emphasize the pathologic differences between infiltrating and noninfiltrating types. Although not previously reported in the hand, infiltrating angiolipomas are biologically aggressive and usually invade local tissues. Proper treatment requires wide excision, but the proximity to important neurovascular structures limits adequate surgical margin in the hand. Compromising surgical resection to preserve function should be undertaken only with the understanding that recurrence is more likely. PMID- 3980949 TI - Gouty tenosynovitis in the hand. AB - Gouty tenosynovitis can present as an infection, tendon rupture, nerve compression, or digital stiffness. In ten patients, extensive urate deposition was encountered in the extensor tendons at both the wrist and digital levels in addition to involvement of the flexor tendons in the carpal canal and digital theca. Direct nerve or muscle involvement was not observed in the hand. Medical therapy, which is now the cornerstone of treatment for most aspects of gout, may not be the best treatment for tophaceous deposits in the hand. Operative treatment may be required to debulk tophaceous deposits, improve tendon gliding, decompress nerves, allow increased range of motion of joints, and ameliorate pain. PMID- 3980950 TI - Anomalous flexor superficialis indicis: two case reports and literature review. AB - Derived from postmortem dissections, early descriptions of a muscle belly in the palm that served the index finger in the manner of the flexor digitorum superficialis were published by MacAlister (1868), Graper (1917), and Mainland (1927). In the English literature, we have found reports on only 15 clinical cases that involved the palm. Based on available information regarding sex, 12 patients were female and one was male. The anomaly involved the right hand in all cases and was bilateral in four of the female patients. We report two additional cases, of which one is considered the first bilateral case in a man with symptoms on the left side. PMID- 3980951 TI - Pathologic anatomy of the forearm: intersection syndrome. AB - Intersection syndrome of the forearm is a common painful condition that is infrequently diagnosed. It presents with pain and swelling in the area where the muscle bellies of the abductor pollicis longus and extensor pollicis brevis cross the common wrist extensors. The etiology is not well understood, but operative treatment of 13 patients has shown that the basic pathologic abnormality is stenosing tenosynovitis of the sheath of the common radial wrist extensors. PMID- 3980952 TI - Chronic exertional compartment syndrome of the forearm: a case report. AB - A 40-year-old man sustained a circumferential crush injury to his right forearm. Four months after injury, he experienced the onset of numbness and tingling in the distribution of the median nerve after exercise. Elevated compartment pressures of the palmar forearm and slowing of median nerve conduction after exercise suggested chronic exertional compartment syndrome. A flexor fasciotomy led to complete relief of symptoms, which allowed the patient unrestricted activity. PMID- 3980953 TI - The skin incision in pollicization. PMID- 3980954 TI - Intraoperative tagging system to simplify tendon identification. PMID- 3980955 TI - Wrist arthroscope. PMID- 3980956 TI - A simple method of simultaneously administering intravenous fluids in the forearm with bilateral upper extremity tourniquets. PMID- 3980958 TI - Comparative strengths of internal fixation techniques. PMID- 3980957 TI - Reconstruction of central metacarpal ray defects of the hand with a free vascularized double metatarsal and metatarsophalangeal joint transfer. PMID- 3980959 TI - Comparative strengths of internal fixation techniques. PMID- 3980960 TI - Nephrolithiasis and intestinal disease. AB - Kidney stones in patients with inflammatory bowel disease are usually composed of calcium oxalate. Two factors are important in the increased absorption of dietary oxalate which is responsible for those stones: 1) increased absorption of oxalate in the presence of steatorrhea, and 2) increased permeability of the colon to oxalate. Fortunately, some of the physiologic abnormalities can be corrected. A therapeutic approach is detailed. PMID- 3980961 TI - Left-handedness and inflammatory bowel disease. AB - Handedness has been reported to be associated with several disorders, including "immune disease." We examined the specific association between left-handedness and inflammatory bowel disease in 213 persons. We personally questioned 43 patients with Crohn's disease, 40 with ulcerative colitis, 70 control patients with various gastrointestinal disorders, and 60 hospital employees with no known immune or gastrointestinal disorder. The clinical diagnosis of each patient was rigorously established. Handedness was determined by The Oldfield Inventory. Study groups were well matched for age, sex, socioeconomic, and cultural backgrounds. The incidence of left-handedness among these groups was 9.3% for those with Crohn's disease, 15.0% among those with ulcerative colitis, 11.4% and 13.3% among the control groups, respectively. There was no excess of left handedness, within any subgroup, when those with inflammatory bowel disease were analyzed according to sex; or disease location, duration, or overall severity. Our data do not confirm the previously suggested association of left-handedness and inflammatory bowel disease. PMID- 3980962 TI - The fate of the rectal segment after diversion of the fecal stream in Crohn's disease: its implications for surgical management. AB - Diverting the fecal stream has been considered to benefit the course of Crohn's disease. Clinical signs and symptoms have not, however, been distinguished previously from the objective inflammatory changes in the distal segment. We reviewed the course of 16 consecutive patients with Crohn's disease in whom sigmoidoscopy showed normal mucosa at the time of diversion and who underwent an ileostomy or colostomy, the rectal segment being left in place. As early as 3 months after diversion, all 16 patients showed progressive friability, ulceration, and exudation in the retained rectum. Stricture occurred in four and lead to abdominoperineal resection in three. Four of eight patients with only moderate inflammation on sigmoidoscopy underwent reanastomosis which was followed by a return to a normal-appearing rectal mucosa. The rectal segment inflammed after diversion rarely shows the histological characteristics of Crohn's disease when resected. This leads us to suspect that the disorder of nonspecific "diversion colitis" might account for this phenomenon entirely, or at least it may accelerate the Crohn's disease process. Continuity of the intestinal tract should be maintained in the course of Crohn's disease surgery if feasible. If a diversion is clinically warranted, reanastomosis should be considered as early as possible despite progressive inflammation of the rectal mucosa. PMID- 3980963 TI - Exploration of the biliary system in recurrent acute pancreatitis of undetermined etiology despite normal cholecystography. AB - The incidence of pancreatitis associated with biliary tract disease is high in certain parts of the world, including Israel. Sometimes, pancreatitis is the first or only manifestation of gallstone disease. However, this may be accompanied by a normal oral or intravenous cholangiogram. Between 1968 and 1980, 173 patients with acute pancreatitis were treated at the Hadassah University Medical Center in Jerusalem. One hundred and two patients (59%) suffered from proven biliary tract disease. In 36 of these 102 patients, repeat preoperative oral and intravenous cholecystograms failed to demonstrate disease in the biliary system. All were referred to surgery on the basis of a high index of suspicion only. At surgery, acute or chronic cholecystitis were found in all cases; gallstones were found in 32 and some degree of pancreatitis in 32. Operative cholangiography demonstrated a common entrance of the ductus choledochus and the pancreatic duct with reflux of contrast material into the pancreatic duct in at least 52.8% of the cases. In 14 patients (38.9%), palpation and cholangiography did not reveal stones and only bile aspiration and filtration through gauze demonstrated many tiny stones. All patients underwent cholecystectomy, and 11 additionally had a common duct exploration. The follow-up period ranged from 2 to 12 years (mean 7 years) with no signs or symptoms of recurrent pancreatitis or biliary tract disease. It has become our practice to attempt proving gallbladder disease radiographically in all cases of recurrent pancreatitis with no other known etiologic background. Failing this, surgical exploration of the biliary system is undertaken.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3980964 TI - Recruitment of subjects for fecal occult blood screening: a comparison of two methods in Jerusalem. AB - Two approaches to the recruitment of subjects for screening for fecal occult blood were tested in two middle-class neighborhoods in Jerusalem. After invitations were mailed to 2,909 persons aged 40 and older, 855 (29%) requested the special "Colo-Screen" packet of slides; and 496, one-sixth of those contacted originally, ultimately returned stool specimens for examination. In a parallel campaign by family doctors, invitations were distributed personally to 324 patients visiting a Sick Fund Clinic; 225 (69%) requested Colo-Screen slides and 137 (42% of the persons invited) sent in stool specimens. Males and females responded equally. Of the 633 specimens received, 29 (4.6%) were positive for occult blood; two cancers and seven adenomatous polyps were found and resected. Screening programs for colorectal cancer should encourage greater personal participation of family doctors in the recruitment process. PMID- 3980966 TI - Gastric obstruction from the Angelchik prosthesis. AB - A 47-year-old woman with gastroesophageal reflux underwent insertion of an angelchik antireflux prosthesis. Five days postoperatively, the prosthesis had slipped and obstructed the stomach, requiring reoperation. PMID- 3980965 TI - Enhanced toxicity of acetaminophen in alcoholics: report of three cases. AB - Severe intoxication from excessive acetaminophen without suicidal intent occurred in three patients, all alcohol abusers, one with evidence of underlying cirrhosis. Apparently, acetaminophen toxicity may be enhanced by alcohol. PMID- 3980967 TI - Chronic lymphocytic leukemia presenting as an anal mass. AB - A middle-aged man sought medical attention because of a large perianal mass. The lesion was caused by a massive subepithelial infiltrate of small neoplastic lymphocytes representing a localized tissue manifestation of chronic lymphocytic leukemia. This report emphasizes the possibility of leukemia/lymphomas occurring at the anus, to stress that leukemia should be considered in the differential diagnosis of patients presenting with perianal disease in the presence of lymphadenopathy and constitutional symptoms. PMID- 3980968 TI - Operating on patients with pancreatitis without known etiology. PMID- 3980969 TI - Must we pay for medical education? AB - This month, I present a situation in which gastroenterologists have been incorporated into a money-raising plan to support a university hospital's medical education program. This issue of whether such a plan could be enacted is addressed. Provided the bylaws contain no prohibitions and the plan itself is not unreasonable or unfair, it appears that successful enactment is likely. The issue of equal protection is presented as it applies to the enactment of this plan to gastroenterologists. Finally, a few of the down side effects of the plan are presented. It would be safe to say that as the economics of health care delivery continue to evolve, situations like the one presented herein will arise. PMID- 3980970 TI - Autosomal recessive inheritance of congenital goiter in Afrikander cattle. AB - Congenital goiter was reported in a number of herds of Afrikander cattle in the 1950's. Some affected animals were assembled and maintained as a closed herd. Although considerable biochemical research into the nature of the disease has been conducted, no definitive report has described the mode of inheritance of the defect. This paper presents the results of breeding studies that indicate the defect is inherited as an autosomal recessive. Southern blot analysis of the thyroglobulin gene confirms this finding. In addition, serum levels of TSH (thyroid stimulating hormone, thyrotropin), T3 (3,4,3'-tri-iodothyronine), T4 (thyroxine), rT3 (3,3',5'-tri-iodothyronine), and DIT (diiodotyrosine) of goitrous animals are compared with normal animals. PMID- 3980972 TI - Genetic control of red cell osmotic fragility. AB - Among normal mouse strains, natural genetic variation offers the potential to investigate the structure and function of cell membranes. One such polymorphism between C57BL/6J and DBA/2J is a difference in erythrocyte sensitivity to osmotic lysis. The genetic basis for erythrocyte osmotic fragility differences between mouse strains C57BL/6 and DBA/2 was examined through analyses of their serial backcross progeny, recombinant inbred (ri) strains (BXD), and congenic C57BL/6 strains with allelic differences at Hbb or Fv-2. The data indicate that the fragility difference between C57BL/6 and DBA/2 is the result of allelic differences at a minimum of two segregating loci. One of these might be linked to, but is not identical with the gene encoding the beta chain of hemoglobin (Hbb). Allelic differences at Fv-2, a gene known to control the proportion of erythroid precursors in the S phase, and at Hba, the structural locus of hemoglobin alpha chain also appear to exert no major influence on red cell osmotic fragility. Furthermore, the fact that red cells from one of the RI strans (BXD-31) are strikingly more resistant than those from the resistant parental strain DBA/2 leads to the conclusion that the degree of resistance/susceptibility for either strain is determined by the combined contributions of gene effects not all of which act in the same direction. We also found that red cells from strans C57BL/6 and DBA/2 differ in their uptake of 51Cr. This result suggests the possibility that red cell osmotic fragility differences may be due in part to differences in ion metabolism or membrane transport. PMID- 3980971 TI - Aberrant segregation of R-locus genes in male progeny from incompatible crosses in Mormoniella. AB - Crosses of females from Mormoniella stocks containing pe-333 type cross incompatibility with males from stocks lacking the incompatibility produced progeny that included 29 males with unexpected eye colors. Eight of these males gave rise to stocks that included some individuals with "speckled" eyes, containing sectors or spots of different colors. In these stocks there were unexpectedly low frequencies of transmission of the new phenotypes to progeny. Phenotypes, and results of crosses, are consistent with the hypothesis that the original males and the stocks that they sired contained extra bits of chromatin contributed by the sperm of the males used in the incompatible crosses. In these stocks, these pieces are transmitted with greater frequency by sperm than by eggs, and are occasionally lost in mitosis (producing "speckled" eyes). Data also indicate that the extra chromatin contains only the O and S factors, or the O factor alone, of the eye color locus R. Examination of spermatogonia shows an extra piece of chromatin in cells of males with phenotypes that suggest the presence of such a piece. The piece has not been found in spermatogonia of controls. PMID- 3980973 TI - New allozyme variability in Italian honey bees. AB - Adult workers of the honey bee, Apis mellifera ligustica, from Italy were assayed for enzyme polymorphism using a variety of electrophoretic conditions. Three polymorphic enzyme systems are described, two of which, malic enzyme and an esterase, were previously unknown in indigenous A. m. ligustica. In addition, a new allozyme for the Mdh locus is reported. PMID- 3980974 TI - Chromosomal heteromorphisms in Delhi infants. III. Qualitative analysis of C-band inversion heteromorphisms of chromosomes 1, 9, and 16. AB - Qualitative analysis of C-band heteromorphisms was carried out in 200 infants (100 males and 100 females) in Delhi, India. Partial inversions minor and half inversions were observed as modal levels for chromosomes 1 and 9 in both sexes. No chromosome 16 with a C-band inversion was observed in the present investigation. A significantly higher incidence of percent inversions for chromosomes 1 and 9 was observed in males than in females. The frequency of heterozygous inversion level combinations for chromosome pairs 1 and 9 were remarkably higher than homozygous combinations both in males and females. Our results are compared with the other reported studies, and the possible role of these heteromorphisms in ethnic/racial variation and in developmental disturbances are discussed. PMID- 3980975 TI - Effects of 2.45 GHz microwaves on meiotic chromosomes of male CBA/CAY mice. AB - Male CBA/CAY mice were exposed daily (6 days a week) for 30 minutes in an environmentally controlled waveguide to continuous 2.45 GHz microwave radiation for 2 weeks at average whole body absorbed dose rates of 0.05, 0.5, 10, and 20 mW/g. Shan exposed animals served as controls. Chain translocations were observed at diakinesis at metaphase I in microwave exposed animals. The yield of translocations increased with exposure, and varied nonlinearly with dose rate. An increase in incidence of univalents was seen after exposure at 10 and 20 mW/g. The findings are interpreted to indicate interference with normal spermatogenesis during the exposure period. PMID- 3980976 TI - Inheritance of Equus asinus serum albumin variants in hybrid offspring. AB - Data from mule offspring of mares bred to an AI-CD jack document that the control of AI-C and AI-D zone variants in Equus asinus is due to the action of autosomal, codominant alleles, AIC and AID. PMID- 3980977 TI - Pediatric head injury. PMID- 3980978 TI - Toxocara canis in humans. PMID- 3980979 TI - Difference picture algorithms for the analysis of extracellular components of histological images. AB - A computer-assisted method for objectively identifying and displaying the distribution of molecules that can only be positively identified by a combination of staining characteristics and susceptibility to specific enzymatic digestion or chemical degradation is presented. The visual image of an enzymatically digested tissue section is subtracted from that of an adjacent buffer-incubated control section and the distribution of the extracellular molecules removed from the tissue section displayed. Photomicrographs are taken using white light and narrow bandwidth filters of wavelengths at or near the maximum absorbance for the dye products used to visualize the extracellular matrix and cells. Each negative is standardized using reference gray levels. The cell and matrix images of both digested and undigested sections are then registered. The locations of cells in both control and digested sections are identified and set to an undefined gray level value in the matrix images. The cell-removed images of the control and digested sections are then registered and the difference in gray levels between the two images calculated and displayed. The validity of results obtained is primarily dependent on the soundness of the histological visualization and digestion techniques used, but is independent of investigator interpretation. PMID- 3980980 TI - Extracellular matrix microfibrils are composed of core proteins coated with fibronectin. AB - Extracellular proteins of cultured calf aortic smooth muscle cells consist predominantly of microfibrils 10-20 nm in diameter typical of "elastin associated" microfibrils described in many tissues. Chemical and immunochemical evidence is presented that microfibrils consist of at least two proteins: core protein and fibronectin. Insoluble proteins of the microfibrils were obtained in the form of a pellet and antibodies raised in rabbits against these components. The antisera reacted with the insoluble microfibrillar proteins and with soluble fibronectin in enzyme-linked immunosorbent assay, and immunostained the extracellular microfibrils in cultured cells. An immunoglobulin (Ig) fraction was prepared and absorbed with fibronectin. The absorbed IgG retained its reactivity with the microfibrillar proteins but was no longer reactive with soluble fibronectin. Immunofluorescence studies were carried out using the absorbed IgG and IgG to soluble fibronectin. Both antibodies showed immunoreactive microfibrils in the extracellular matrix of cells in log phase. However, with increasing time in culture, as the cells reached confluence, the immunofluorescence of microfibrils reacting with the absorbed IgG became less intense, whereas that of microfibrils reacting with IgG to fibronectin increased; in confluent cells, essentially no staining was detected with the absorbed IgG, and a dense network of intensely stained microfibrils was seen with IgG to fibronectin. Treatment of these cultures with urea led to partial dissociation of the fibronectin and increased visualization of the microfibrils with the absorbed IgG; double-label immunofluorescence showed that both proteins occurred on the same microfibrils. The localization of immunoreactive sites to the extracellular microfibrils was confirmed by immunoelectron microscopy. Nearly quantitative cleavage with CNBr failed to dissociate the antigenically active fragments of fibronectin from the CNBr fragments of the core proteins of the microfibrils. It was concluded that microfibrils contain core proteins and fibronectin that are codistributed in insoluble, possibly covalently cross-linked, aggregates. The core proteins are first deposited by the cell and, as a function of time in culture, fibronectin gradually coats their surface. PMID- 3980981 TI - Vertical distribution of elements in cells and matrix of epiphyseal growth plate cartilage determined by quantitative electron probe analysis. AB - Quantitative electron probe analysis was performed on chick epiphyseal growth cartilage prepared by two anhydrous methods, ultrathin cryosections and freeze dried epoxy-embedded tissue. Levels of Na, Mg, P, S, Cl, K, and Ca were determined in cytoplasm, mitochondria, extracellular matrix, matrix vesicles, and mineral nodules in four zones of the cartilage--proliferative, prehypertrophic, early hypertrophic, and early calcification. The exceptionally high levels of Na and K (up to 550 and 200 mmol/kg wet wt, respectively) found in the matrix are believed to be largely bound to fixed anions. Within cells, Na was higher than K (140 versus 20-34 mmol/kg wet wt), a condition that may reflect hypoxia. Ca and P were low in cells and unmineralized matrix. Ca and P were high in mitochondrial granules of the early hypertrophic zone and diminished in amount in the calcifying zone; the converse occurred in matrix vesicles. Mg was low to undetectable except in heavily mineralized structures (i.e., mitochondrial granules, matrix vesicles, and mineral nodules). S levels were high in matrix (approximately 400 mmol/kg wet wt) and increased slightly with maturation. The amount of S present greatly exceeds Ca levels and implies that sulfate, the predominant form of sulfur in proteoglycans, may serve as an ion-exchange mechanism for the passage of Ca through the matrix to sites where Ca and phosphate are precipitated. PMID- 3980983 TI - Acid phosphatase localization in the digestive glands of Dionaea muscipula Ellis flytraps. AB - The intracellular localization of acid phosphatases in stimulated digestive glands of Dionaea flytraps has been studied to provide evidence for the route taken by this enzyme during secretion. Previous studies have either included or excluded a role for the dictyosomes in this pathway. Both p-nitrophenyl phosphate and beta-glycerophosphate were used as substrates, and both gave similar localization patterns. Unstimulated glands contained little phosphatase activity in the endomembrane system, whereas 24 and 48 hr after stimulation, heavy deposits of lead were located in the endoplasmic reticulum cisternae, including the nuclear envelope, the dictyosome cisternae, and secretory vesicles. Since dictyosome activation, as judged by the presence of secretory vesicles in the cytoplasm, also coincides with gland stimulation, we conclude that secretion of the hydrolase enzymes occurs via this route and not, as suggested elsewhere, via direct endoplasmic reticulum to plasma membrane connections. PMID- 3980982 TI - Identification of glycoproteins associated with elastin-associated microfibrils. AB - The microfibrils associated with elastic tissue have been shown to be predominantly proteinaceous. On the basis of their affinity for cationic stains, including ruthenium red, they have been assumed to be glycoprotein, but more evidence to support this claim has not been adduced. Despite repeated investigation of glycoprotein materials obtained by extraction of elastic tissues with reagents that appear to remove microfibrils, the chemical composition of elastin-associated microfibrils remains obscure. An electron microscopic study of the microfibrils in two elastin-rich tissues (bovine nuchal ligament and aorta) during their development was pursued using more specific histochemical methods. The periodic acid-alkaline bismuth stain (analogous to the periodic acid-Schiff stain for glycoproteins in light microscopy) has been adapted for this study. Specific aldehyde groups (confirmed by blocking with m-aminophenol or sodium borohydride) were identified after periodate oxidation as fine granules of bismuth stain. These were shown to localize specifically along the elastin associated microfibrils in a finely punctate form. Staining of the amorphous elastic component did not occur except for a fine rim adjacent to the microfibrils. Lectin binding with concanavalin A (with ferritin markers) confirmed that there are glucose- or mannose-containing proteins associated with the microfibrillar component of elastic tissue. This was true of these microfibrils in all layers of the aortic wall and throughout the ligament. It was also true of mature adult tissues in which there was a lesser proportion of microfibrils. It is concluded that elastin-associated microfibrils really are associated with glycoprotein(s). PMID- 3980984 TI - Rhodamine 123 alters the mitochondrial ultrastructure of cultured L1210 cells. AB - Exposure of exponentially growing L1210 cells in vitro to 5-10 micrograms/ml of rhodamine 123 (R123) for 16-48 hr inhibits cell proliferation and induces cell arrest in the G1A phase of the cell cycle. The cells remain viable during the arrest and resume growth after removal of R123; extended exposure to R123 is cytotoxic. Exposure to R123 results in morphological alterations in mitochondria of all cells observed; specifically, mitochondria of R123-treated cells are characterized by a distention of the intracristal spaces and a significant increase in the number of matrix granules. Gross morphological changes of mitochondria include formation of extended organelles and the appearance of doughnut-shaped structures. PMID- 3980985 TI - Filipin-cholesterol complexes (FCC) in the goblet cell granule membrane of the distal colon are arranged in a rhombic pattern. AB - After fixation in the presence of filipin, the membrane of the goblet cell granules of the distal colonic mucosa (guinea pig) displays, in freeze-fracture replicas, a rhombic pattern composed of intersecting "lines" of unknown nature. The filipin-cholesterol complexes of the granule membrane are ordered according to the same geometry. This arrangement--but not the "lines"--has been found for the filipin-cholesterol complexes of other membranes of the same goblet cells as well as of other colonic cells. These observations indicate that in some biological membranes cholesterol has an ordered distribution, comparable to that suggested by investigations on artificial membranes. PMID- 3980986 TI - A target structure for a series of human cloned natural killer cell lines is recognized by both anti-TNKtar and 4F2 monoclonal antibodies. AB - It was shown recently that a surface antigen termed TNKtar was likely to serve as a target molecule for three distinct human NK clones expressing the same clonotypic determinant (termed NKTa) present on a 90 KD recognition structure. In the present studies, we investigated whether TNKtar and a previously described antigen termed 4F2 were related. Parallel immunoprecipitations from membrane lysates of the same cells showed that both anti-TNKtar and 4F2 Mab precipitate a heterodimeric structure which resolves as two bands of identical m.w. (40 and 80 KD) in SDS-PAGE analysis under reducing conditions. Sequential immunoprecipitations demonstrated that the two antibodies are directed at the same molecule. However, one antibody did not block subsequent binding of the other, and vice versa, suggesting that anti-TNKtar and 4F2 Mab are directed at two distinct epitopes of the molecule. Functionally, it was found that 4F2 Mab was able, as well as anti-TNKtar, to selectively block cytotoxic function of JT9 cloned cells. Furthermore, as reported previously for anti-TNKtar, 4F2 had no effect when additional NKTa-NK clones were used as effector cells in cytotoxicity assays. Finally, cold target inhibition assays were performed by using cold target cells precoated with either anti-TNKtar or 4F2 Mab. These experiments showed that preincubation of target cells with either antibody blocked their ability to compete with their radiolabeled counterpart. Such results further strengthen the hypothesis that the activation antigen recognized by both anti TNKtar and 4F2 Mab serves as a specific target structure for NKTa+ NK active clones. We discuss the importance of previous data concerning the 4F2 molecule in light of this functional role, which had not been identified previously. PMID- 3980987 TI - Immunogenetic studies of spontaneous abortion in mice. Preimmunization of females with allogeneic cells. AB - CBA females (H-2k) mated with DBA2 males (H-2d) exhibit a high rate of fetal resorption (30%) when compared with the CBA female BALB/c male, CBA female/CBA male, DBA2 female/CBA male, DBA2 female/DBA2 male combinations (6 to 8%). Preimmunization of CBA females with spleen cells from DBA2, BALB/c, or CBA males were performed in order to test their effects on CBA maternal tolerance of (CBA X DBA2)F1 fetuses. Only preimmunization with BALB/c male cells was effective in decreasing resorption; cells from BALB/c females had no effect. In order to further test 1) the role of non-MHC-encoded antigens present in the BALB/c male background, 2) the necessity of an additional H-2 difference, and 3) whether or not the phenomenon is H-2d restricted, preimmunizations were performed by using cells from congenic BALB/k (H-2k), BALB/b (H-2b), or BALB/c (H-2d). Only the latter treatment was efficient, which suggests that the paternal H-2d haplotype must be presented in synergy with some non-MHC-encoded antigens in the BALB/c male background. Immunogenetic studies with cells from nine recombinant inbred strains that reassorted DBA2 and BALB/c genomes showed that three of them behave like BALB/c and six like DBA2. This would suggest that the genetic determinism of this phenomenon is simple. PMID- 3980988 TI - Hormonal influence on the secretory immune system of the eye: androgen modulation of IgA levels in tears of rats. AB - The objective of the present studies was to determine whether hormones influence the level of IgA in tears of rats. Our results demonstrated that IgA concentrations in tears of male rats were significantly higher than those of females. This difference appeared to be due to an effect of androgens. Castration of male rats led to a significant decline in the content of tear IgA. Administration of testosterone offset this response and stimulated a time dependent accumulation of IgA in tears of orchiectomized rats. This hormone action was only elicited by androgens, and not by other classes of steroid hormones. The testosterone-induced increase in tear IgA levels may have involved enhanced local production of IgA, and was found to occur in parallel with an elevation in tear secretory component concentrations. These findings indicate that androgens may regulate the ocular secretory immune system of the rat. PMID- 3980989 TI - Mechanisms of diminished natural killer cell activity in pregnant women and neonates. AB - Because alterations in natural killer (NK) activity in the perinatal period may be important in the maintenance of a healthy pregnancy, we examined the mechanisms by which these alterations are mediated in neonates and in pregnant and postpartum women. NK activity, as measured in a 4-hr 51Cr-release assay and compared with adult controls, is significantly diminished in all three trimesters of pregnancy and in immediately postpartum women. In postpartum women, NK activity appears to be higher than in pregnant women, although this does not reach statistical significance. Pregnant and postpartum women have normal numbers of large granular lymphocytes and normal target cell binding in an agarose single cell assay but decreased lysis of the bound target cells. NK activity of mononuclear cells from postpartum women, in addition, demonstrate a shift in distribution to higher levels of resistance to gamma-irradiation. Further, sera from postpartum women cause a similar shift to increased radioresistance in mononuclear cells from adult controls. Because radioresistance is a property of interleukin 2-stimulated NK, the shift to radioresistance may represent lymphokine-mediated stimulation occurring during parturition. In contrast, cord blood cells have a more profound decrease in NK activity as determined by 51Cr release assay and decreases in both binding and lysis of bound target cells in the single cell assay. The resistance of NK activity in cord cells to gamma irradiation is also increased, as seen in postpartum women. Cord blood serum, however, did not alter radioresistance or inhibit NK activity. The results suggest that the observed diminished NK activity in pregnant women and neonates arise by different mechanisms: an absence of mature NK cells in the neonate and an alteration of the NK cell in pregnancy leading to decreased killing. PMID- 3980990 TI - Therapeutic potential of rat monoclonal antibodies: isotype specificity of antibody-dependent cell-mediated cytotoxicity with human lymphocytes. AB - The ability of rat monoclonal antibodies to promote antibody-dependent cell mediated cytotoxicity with human effector cells was tested by using a variety of antibodies against different human and mouse leukocyte antigens. It was found that only IgG2b antibodies were effective. This isotype has already been shown to be efficient in fixing human complement, which suggests that among rat monoclonal antibodies, the IgG2b subclass might be a good choice for attempts at serotherapy. Further studies with other antibody-mediated effector mechanisms as well as suitable clinical trials are merited. PMID- 3980991 TI - Structural diversity of the fibroblast-activating factors generated by human blood monocytes and U937 cells. AB - The incubation of purified human blood monocytes with phytohemagglutinin (PHA) and of cultured U937 human monocyte-like cells with phorbol myristate acetate (PMA) evoked the generation of fibroblast-activating activity, as assessed by stimulation of the uptake of [3H]thymidine by human dermal fibroblasts. Filtration of the supernates from monocytes and U937 cells on Sephadex G-75 resolved fibroblast-activating factors of m.w. 25,000 to 40,000, designated FAF-M and FAF-U937, respectively, from smaller factors of an apparent m.w. of approximately 10,000. FAF-M and FAF-U937 were acidic by isoelectric focusing with respective pI values of 4.0 to 5.2 and 5.4 to 5.6. The smaller factors from both sources filtered on Sephadex G-25 in phosphate-buffered saline with an apparent m.w. of 10,000. However, filtration of the same factors on Sephadex G-25 in 0.1 M acetic acid revealed one predominant fibroblast-activating activity for each cell source of an apparent m.w. of 500 to 1000. The 500 to 1000 dalton factors were inactivated by treatment with trypsin and subtilisin, suggesting that the activity was attributable to fibroblast-activating peptides, termed FAP-M and FAP U937. FAP-M and FAP-U937 each appeared to be composed of a predominant hydrophilic activity by reverse-phase high-performance liquid chromatography. Human blood monocytes and U937 monocytes both produce structurally diverse fibroblast-activating proteins and peptides, which may contribute to the immunologic regulation of wound healing and fibrosis. PMID- 3980992 TI - Xenopus MHC class II molecules. II. Polymorphism as determined by two-dimensional gel electrophoresis. AB - The class II antigens from four inbred strains of Xenopus laevis (r, f, g, and j haplotypes) and six gynogenetic LG clones (two Xenopus laevis, two Xenopus gilli haplotypes) with functionally well-defined MHC types have been immunoprecipitated with the rabbit anti-human class II beta-chain serum anti-p29boost and analyzed by two-dimensional gel electrophoresis. The glycosylated material from 15-hr biosynthetically labeled cells runs as a broad fuzzy band around 33kD that, upon removal of N-linked glycans by Endo F, resolves into upper beta-chain bands and lower alpha-chain bands. Both the glycosylated and deglycosylated class II antigens give rise to multiple IEF spots in evenly spaced arrays (alpha-chain: two to eight spots in one to three arrays, beta-chain: two to 12 spots in one to five arrays). Both chains are polymorphic and both map to the functionally defined MHC. The large number of spots argues for multiple class II antigens; by radioactive N-terminal sequencing, two homologous alpha-chains and five beta chains are present in the f haplotype. By comparison with MHC-linked alloantisera, anti-p29boost recognizes all major polymorphic class II molecules in Xenopus laevis. A selection of outbred animals were typed by using an IEF procedure requiring only a million PHA-stimulated blood cells. PMID- 3980993 TI - Identification of cell surface antigens present on murine hematopoietic stem cells. AB - Nine antigens found on murine bone marrow cells were examined to define their pattern of expression in murine hematopoietic differentiation. Lymphocyte function antigen (LFA-1), heat stable antigen (recognized by M1/69), common leukocyte antigen (CLA, T200, Ly-5) and Lgp100a (recognized by 30-C7) were present on early hematopoietic progenitors, BFU-E, CFU-E, CFU-GM, and CFU-M. All antigens found on progenitors were found on some immature precursor cells, myeloblasts, erythroblasts, or monoblasts, but their pattern of expression on identifiable hematopoietic cells varied. Three of these antigens, LFA-1, heat stable antigen recognized by M1/69, and CLA, were expressed on leukocytes of all stages of maturity but were lost from the erythroid lineage during differentiation. MAC-1, Forssman antigen, heat stable antigen (recognized by M1/75), anti-P-95 (recognized by M5/113), and Ia (recognized by M5/114) were found only on differentiated hematopoietic precursors or mature cells. The expression of these antigens was more lineage-specific. MAC-1 and heat stable antigen (recognized by M1/75) were restricted to either mature myeloid or erythroid cells, respectively. The marked differences in distribution of these antigens suggest that they may be useful in negative or positive selection experiments to enrich progenitors, and that some of them may have a functional role in differentiation. PMID- 3980994 TI - Clearance of IgE from serum of normal and hybridoma-bearing mice. AB - The half-life of IgE in the mouse was investigated by using radiolabeled and unlabeled monoclonal antibodies of the IgE class. Quantitative serologic assays were used for the unlabeled antibodies. IgE was cleared rapidly upon i.v. inoculation; after 48 hr, less than 0.2% of the initial concentration remained in the serum. The IgE was cleared initially with a half-life of 1 to 2 hr, attaining a relatively constant value of 5 to 8 hr. The corresponding values for IgG1, determined as a control, were 11 to 12 hr and 9 to 11 days, respectively. The initial stage probably reflects equilibration with extravascular spaces. This is supported by experiments with mice in which IgE-secreting tumors were implanted and then resected; IgE was cleared from such mice with an average initial half life of about 5 hr. The rates of clearance of inoculated IgE were approximately the same in mice bearing an IgE-secreting tumor and in normal mice. This suggests that the initial rapid clearance of IgE from normal mice is not due to adherence of IgE to saturable sites; such sites might be expected to be occupied in mice expressing high serum concentrations of IgE. This conclusion was supported by experiments in which 1-mg quantities of IgE were inoculated i.v. into normal mice daily for 6 days. Additional IgE injected on day 7 was cleared normally. The results obtained with tumor-bearing mice indicate that the reported failure to elicit an IgE response to an antigen in mice bearing IgE-secreting hybridomas cannot be attributed to rapid clearance of newly synthesized IgE in such mice, as compared with normal mice. PMID- 3980995 TI - Antibody-induced suppression and postsuppression stimulation of complement in vitro. II. Intracellular and extracellular changes in C4 during long-term C4 suppression in guinea pig splenic fragments. AB - Suppression of the synthesis of the fourth component of complement in vitro was originally accomplished by exposing cultured guinea pig peritoneal cells to anti C4 alloantisera. When guinea pig splenic fragments were used instead of peritoneal cells, equivalent antibody treatment produced C4 suppression of significantly longer duration, lasting weeks instead of days after removal of antibody. As with peritoneal cell monolayers, antibody treatment induced specific suppression of C4 followed by nonspecific stimulation of C4 and other proteins such as C2. Although IgG2 is more readily sequestered by splenic tissue, both IgG1 and IgG2 antibodies were effective in inducing and maintaining suppression. Experiments with radiolabeled antibody demonstrated that a small amount (less than 5%) of the original dose of antibody was retained by the splenic fragments. Because there was no continuous slow release of that antibody, long-term suppression of C4 cannot be explained as a fluid-phase neutralization reaction. Because antibody treatment might induce production of aberrant C4 molecules with no functional activity, C4 antigens was also studied. Tissue culture supernatants were assayed by using an ELISA for C4. In none of these experiments was extracellular C4 antigen detectable immediately after antibody treatment. Extracellular and intracellular C4 were immunoprecipitated from biosynthetically labeled tissue cultures and analyzed by SDS-PAGE. Antibody treatment suppressed intracellular C4 as well as extracellular C4. Although extracellular C4 levels of antibody-treated cultures eventually returned to levels comparable to untreated cultures, intracellular C4 levels of treated fragments remained lower than controls for the full period of observation (22 days). Therefore, a short (4-day) exposure to anti-C4 antibody induced long-term effects that profoundly altered regulation of C4 synthesis and secretion by cultured splenic macrophages. PMID- 3980996 TI - Amidation of C3 at the thiolester site: stimulation of chemiluminescence and phagocytosis by a new inflammatory mediator. AB - We studied the ability of particle-bound and fluid-phase C3b monomers and monomeric amidated C3 (prepared by treatment of purified human C3 with ammonium chloride or methylamine) to stimulate chemiluminescence of human polymorphonuclear leukocytes (PMN) and monocytes and to promote phagocytosis in the absence of antibody. Particle-bound C3b evoked chemiluminescence from both PMN and monocytes, and fluid-phase C3b (0.5 mg/ml) elicited significant chemiluminescence from PMN but not from monocytes. Amidated forms of C3, both particle bound and fluid phase, were potent stimulators of chemiluminescence from phagocytic cells and caused a significantly greater response than did C3b. The phagocytosis of 1-micron microspheres by PMN and monocytes was enhanced by coating them with purified C3b in an antibody-free system. Microspheres coated with amidated C3 were avidly phagocytized, and to a greater degree than were C3b coated microspheres. In a direct binding assay with tritiated monomeric C3b and amidated C3, the affinity of the PMN complement receptor type 1 for C3b (Ka = 4.9 X 10(7) L/M) was similar to that for amidated C3 (Ka = 5.7 X 10(7) L/M). However, there was a fourfold increase in the number of apparent binding sites for amidated C3. This increase did not reflect binding of amidated C3 to the complement receptor type 3, because blocking of CR3 with the monoclonal antibody OKM 10 failed to decrease binding of amidated C3. In sites of increased ammoniagenesis, such as the kidney in chronic renal failure, amidated C3 may play a role as an inflammatory mediator by stimulating oxidative metabolism in phagocytic cells. PMID- 3980997 TI - Macrophage activation for microbicidal activity against Leishmania major: inhibition of lymphokine activation by phosphatidylcholine-phosphatidylserine liposomes. AB - Resident peritoneal macrophages from untreated mice develop microbicidal activity against amastigotes of the protozoan parasite Leishmania tropica (current nomenclature = Leishmania major) after in vitro exposure to LK from antigen stimulated leukocyte culture fluids. This LK-induced macrophage microbicidal activity was completely abrogated by addition of 7:3 phosphatidylcholine: phosphatidylserine liposomes. Liposome inhibition was not due to direct toxic effects against the parasite or macrophage effector cell; factors in LK that induce macrophage microbicidal activity were not adsorbed or destroyed by liposome treatment. Other phagocytic particles, such as latex beads, had no effect on microbicidal activity. Moreover, liposome inhibition of activated macrophage effector function was relatively selective: LK-induced macrophage tumoricidal activity was not affected by liposome treatment. Liposome inhibition was dependent upon liposome dose (5 nmoles/culture) and time of addition of leishmania-infected, LK-treated macrophage cultures. Addition of liposomes through the initial 8 hr of culture completely inhibited LK-induced macrophage microbicidal activity; liposomes added after 16 hr had no effect. Similarly, microbicidal activity by macrophages activated in vivo by BCG or Corynebacterium parvum was not affected by liposome treatment. Liposome treatment also did not affect the increased resistance to infection induced in macrophages by LK. These data suggest that liposomes interfere with one or more early events in the induction of activated macrophages (macrophage-LK interaction) and not with the cytotoxic mechanism itself (parasite-macrophage interaction). These studies add to the growing body of data that implicate cell lipid in regulatory events controlling macrophage effector function. PMID- 3980998 TI - Induction of protective immunity against Schistosoma mansoni by a non living vaccine. I. Partial characterization of antigens recognized by antibodies from mice immunized with soluble schistosome extracts. AB - A single intradermal injection of frozen and thawed schistosomula in conjunction with the bacterial adjuvant Mycobacterium bovis strain Bacille Calmette Guerin, Phipps substrain (BCG) induced significant levels of resistance to challenge Schistosoma mansoni infection in C57BL/6 mice. Immunization with the aqueous fraction remaining after 100,000 X G centrifugation of the larval lysate was also protective under these conditions, suggesting that some immunogenic determinants may not be membrane associated. Frozen-thawed cercariae and soluble components of adult worms also protected against challenge infection in these experiments. These observations indicate that soluble immunogens are present in both early and late developmental stages of the parasite, and therefore may be good candidate antigens for an immunochemically defined vaccine against schistosomiasis. Induction of humoral reactivity against soluble or membrane antigens was examined in mice protected against cercarial challenge by prior exposure to frozen-thawed larvae, soluble larval, or soluble adult antigens plus BCG. Animals that were immunized with frozen-thawed larvae produced low but significant levels of antibodies against larval surface antigens when examined by indirect immunofluorescence or by immunoprecipitation of surface-labeled schistosomula. Mice immunized with soluble antigens, however, showed negligible antibody reactivity against surface membrane antigens. Because mice immunized with soluble antigens were resistant to challenge infection, these results strongly suggest that anti-surface membrane reactivity is not required in the mechanism of protective immunity in this model. Sera from mice immunized with either total freeze-thaw larval lysate or soluble schistosome extracts all showed strong reactivity against soluble antigens, as detected by ELISA. Western blot analysis showed these antisera to react with a restricted number of high m.w. antigens that were present both in schistosomula and in adult worms. These antigens are therefore likely to play a major role in the development of resistance in this model as immunogens and/or as targets of protective immune response. PMID- 3981000 TI - Improved fusion methods. IV. Technical aspects. PMID- 3980999 TI - Role of endogenous complement in monoclonal IgM antibody-dependent leukemia suppression in vivo: participation of C3b. AB - The mechanism by which McAb of the IgM isotype causes prolonged survival of leukemic rats was investigated. The participation of endogenous C in the suppression of IgM-sensitized leukemia cells was demonstrated by the observations that a) suppression was abrogated in CVF-treated rats, and b) the CVF effect was partially reversed if C3b was provided on the surface of IgM-sensitized leukemia cells. PMID- 3981001 TI - A radioimmunoassay for detection of circulating antibodies reacting with the hepatic asialoglycoprotein receptor protein. AB - To determine whether circulating antibodies against the liver-specific membrane lipoprotein complex (LSP), which occur in a number of liver disorders, are directed at the hepatic asialoglycoprotein receptor protein (hepatic lectin)- recently shown to be a constituent of LSP--a radioimmunoassay for anti-hepatic lectin antibodies was developed based on the use of protein A in situ on staphylococcal cells to precipitate 125I-labelled rabbit hepatic lectin/anti lectin immune complexes. The assay was used to test sera from 30 patients (15 anti-LSP-positive and 15 anti-LSP-negative) with autoimmune chronic active hepatitis (CAH), hepatitis B virus-positive CAH or primary biliary cirrhosis. Anti-lectin antibodies (at titres of 1:200 to 1:1600) were found in all 15 anti LSP-positive sera and were not detected in the 15 anti-LSP-negative patients. Hepatic lectin is a highly purifiable, liver-specific, hepatocellular surface component and the anti-lectin assay (which proved sensitive, reliable and easy to perform) will permit further exploration of the role of autoimmune mechanisms in the pathogenesis of various liver diseases. PMID- 3981002 TI - Carboxyethyl gamma-aminobutyric acid, a polyamine derivative molecule with a growth effect on hybridomas. AB - An increased proliferation of hybridomas is induced by a polyamine derivative molecule, CEGABA (carboxyethyl gamma-aminobutyric acid). The effects of CEGABA and CR-ECGS (endothelial cell growth supplement) on hybridoma growth are similar. However, both factors are less efficient than HECS (human endothelial culture supernatant) in inducing hybridoma growth through all the steps of hybridoma production, including: recovery after fusion, cloning, and proliferation. PMID- 3981003 TI - Monoclonal capture antibody ELISA for respiratory syncytial virus: detection of individual viral antigens and determination of monoclonal antibody specificities. AB - An enzyme-linked immunosorbent assay (ELISA) for respiratory syncytial virus (RSV) that employs solid-phase monoclonal antibodies was developed. RSV antigens bound by these monoclonal capture antibodies were detected by addition of a polyclonal bovine antiserum, followed anti-bovine enzyme conjugate and enzyme substrate. The sensitivity and specific of the assay were determined by titrations of the solid-phase antibodies and by antigen titrations with both unpurified RSV-infected cell culture material and purified RSV nucleocapsids. The addition of a competitive binding step prior to the addition of antigen to the solid-phase antibody provides further evidence of the assay's specificity. Furthermore, the competitive binding assay enables the antigen specificity of monoclonal antibodies to be determined or compared without the use of purified antigens. Monoclonal capture ELISA is a convenient, rapid, and sensitive assay that can be used to measure specific RSV antigens in unpurified preparations as well as to determine anti-RSV antibody specificity and should prove useful in examining other complex antigen-antibody systems. PMID- 3981004 TI - Improved production of oestradiol antibodies of high affinity and specificity by hormonal manipulation of the immunised animals and affinity chromatography of the antisera. AB - The titre, affinity and specificity of oestradiol antisera were increased by hormonal manipulation of immunised rats. Castration was as effective as daily injection of the aromatase inhibitor, 1,4,6-androstene-3,17-dione. Chromatography on the affinity matrix oestrone-3-CME/Sepharose-4B was less successful. PMID- 3981005 TI - Microcalorimetry as a tool for the detection of complement-dependent cytotoxicity. AB - Microcalorimetry using a 4-channel static ampoule microcalorimeter of thermopile type has been evaluated as a tool for the detection of complement-dependent cytotoxicity against the surface antigens of living cells. Cytotoxic reactions mediated by a rabbit antiserum against human white blood cells and by 2 different monoclonal antibodies recognizing a melanoma-associated antigen on a human melanoma cell line were studied. The cytotoxic reactions were registered as a decrease of the heat production rate when the cells were exposed to antibodies in the presence of active complement as compared to the heat production rate of the cells exposed to the same antibodies in the presence of inactive complement. This investigation shows that microcalorimetry can be used as a highly sensitive method for the detection of complement-dependent immune reactions, detecting antibody dilutions higher than 10(-5). It also indicates that microcalorimetry may become a particularly important technique in the analysis of the kinetics of cytotoxic immune reactions in vitro. PMID- 3981006 TI - Effects of cryopreservation on human lymphocyte functions: comparison of programmed freezing method by a direct control system with a mechanical freezing method. AB - The effects of cryopreservation with a new-type programmed freezer (TNP-82) were examined on natural killer (NK) activity and cell recovery of lymphocytes. This instrument is controlled by a sensor which directly detects the temperature in the samples, enabling easy setting of the temperature curve. Comparing results obtained by the new method to those from a less sophisticated mechanical method, cell recovery after cryopreservation was improved (95.3%) in the new compared to the older (about 80%) method. Furthermore, NK activity, percentage of Leu7+ cells and other lymphocyte functions were unaltered. PMID- 3981007 TI - Measurements of the true affinity constant in solution of antigen-antibody complexes by enzyme-linked immunosorbent assay. AB - A simple, general procedure is described for the determination of the dissociation constant (KD) of antigen-antibody equilibria in solution. First the monoclonal antibody is incubated in solution with the antigen until the equilibrium is reached; then the proportion of antibody which remains unsaturated at equilibrium is measured by a classical indirect ELISA. The experimental values of KD found by this ELISA procedure for 2 monoclonal antibodies are shown to be very close to those obtained by conventional methods (immunoprecipitation of the radiolabeled antigen, or fluorescence transfer). Moreover, it is shown that, provided the measurements are made under conditions where the total antigen concentration is in large excess over the total antibody concentration, the dissociation constant of antibody-antigen complexes can be determined even with crude preparations of monoclonal antibody. The sensitivity of the ELISA used permits the detection of very small concentrations of antibody and the determination of KD values as small as 10(-9) M. This method also offers the great advantage of dealing with unmodified molecules since no labeling of either the antigen or the antibody is required. PMID- 3981008 TI - How does flow cytometry express Gaussian distributed biological information? AB - The analogue-to-digital conversion step in flow cytometric analysis introduces a positive skew into the distribution of any measured parameter. In this communication we describe a semi-analytical method to determine if a distribution skewed by the analogue-to-digital conversion step is compatible with a Gaussian origin. The procedure involves determining the errors associated with calculating the coefficient of variation from the skewed distribution and applying systematic corrections. The method was tested with a number of experimental data sets and is illustrated with 3 distributions. One of these was not compatible with a Gaussian origin, but the other 2 were, in spite of considerable positive skewness in the data. PMID- 3981009 TI - A new method of eliciting delayed hypersensitivity in the mouse abdominal cavity. AB - A new method of determining delayed hypersensitivity quantitatively was investigated in mice. Mice were sensitized with 150 micrograms of ferritin and, 3 weeks later, antigen challenge was performed by implanting a sponge containing antigen in the abdominal cavity. Cells accumulated in the sponge markedly increased in number for 24-72 h after the challenge; mononuclear cells predominated by 48 h. When sensitized lymphocytes were transferred passively to a normal recipient, marked cell accumulation in the sponge was found 48 h after the challenge. Immunological specificity was confirmed in animals sensitized to antigen and receiving passive transfer of sensitized cells. Strain differences in this reaction were observed. Cortisone (20 mg/kg for 6 days before challenge) significantly decreased cell accumulation. Delayed hypersensitivity was also elicited in the ear of sensitized animals. Extracts of sponges removed from antigen-challenged mice had macrophage chemotactic activity. PMID- 3981010 TI - Primary RIA screening of hybridoma supernatants without use of a negative control. PMID- 3981011 TI - A simple computer programme for standard curve tracing and calculations in RIA following sigmoid patterns. AB - A computer programme is described for the analysis of radioimmunoassays assuming a general sigmoid shape. The mathematical treatment uses the results obtained from a sigmoid equation to perform a limited operational search in order to optimize the fitness of the curve. The programme can be installed in most desk top microcomputers and has been tested for the calculation of Ig concentrations in biological fluids. PMID- 3981012 TI - Rat monoclonal antibodies. III. A simple method for facilitation of hybridoma cell growth in vivo. AB - Hybridoma cells that did not grow when injected subcutaneously or intraperitoneally in histocompatible or Rnu/Rnu rats were injected intravenously into histocompatible recipients. Eight of the 9 cell lines injected in this way grew in several organs of the recipient 3-7 weeks later. Hybridoma cells proliferated mainly in the liver. When the liver homogenate of these animals was injected intraperitoneally into histocompatible recipients, hybridoma cells grew readily giving rise to ascites containing the expected monoclonal antibody for 6 of the 9 cell lines. PMID- 3981013 TI - Enzyme-linked immunosorbent assay for subclass distribution of human IgG and IgA antigen-specific antibodies. AB - In this study we describe an ELISA using monoclonal antibodies to IgG 1, 2, 3, 4, IgA1 and IgA2 for determining the subclass distribution of human-specific antibodies. No cross-reactivity of the subclass-specific reagents under the conditions used was observed. The sensitivity was 0.5 ng/ml for IgG1, 3, 4; 1.5 ng/ml for IgG2 and 50 ng/ml for IgA1 and IgA2. The reproducibility as described by the coefficient of variation calculated on repeated runs was 8-26% if the data were obtained by relating the absorbance values to a positive serum run in the assay, 17-58% when relating the OD figures to those of a standard myeloma plate. The method may be considered semiquantitative with high sensitivity and specificity, easy to handle and with small day-to-day variation. The assay has been applied to a number of antigens of protein and polysaccharide nature. PMID- 3981014 TI - A chemiluminescent assay for mycoplasmas in cell cultures. AB - A chemiluminescent assay for the detection of mycoplasma contamination of cell cultures is described. Cells (and supernatant) derived from mycoplasma contaminated cultures stimulate a burst of luminol-dependent chemiluminescence in cell suspensions containing phagocytic effector cell types. The assay conditions for spleen cells, human and bovine polymorphonuclear leucocytes as the responder or indicator cells have been optimized. The chemiluminescent assay can be utilized for both monolayer and suspension cell cultures and is more sensitive than colony formation on agar plates and electron microscopy. Results are obtained within 3-5 h including the time required for the preparation of the indicator cells. CL can be measured in the tritium window of standard liquid scintillation spectrometers after switching off the coincidence circuit. PMID- 3981015 TI - Evaluation of flow cytometry and fluorescence microscopy for the estimation of bovine mononuclear phagocytes. AB - Bovine blood mononuclear cells were isolated by density gradient centrifugation on Ficoll-Paque. Phagocytic mononuclear cells were characterized functionally by ingestion of fluorescent latex beads. After incubation with beads the cells were treated with Triton X-100 and propidium iodide (PI) to stain DNA. Cells were analyzed with a FACS-III instrument connected to a Nuclear Data-6660 multiparameter computer system. The computer was used to evaluate the 2 parameter histograms in order to enumerate the percentage of cells with different numbers of associated beads. With this system we also obtained information about cell concentration and number of beads per cell. Results from flow cytometry and manual counting by fluorescence microscopy were compared and good correlation (r = 0.91) was obtained. During the first hours of incubation latex beads adhered to cell surfaces as demonstrated by FCM histograms and fluorescence microscopy. Blood mononuclear phagocytes have to be incubated for several hours before significant phagocytotic activity can be detected. PMID- 3981016 TI - Appraisal of C3DP as a tumour marker. PMID- 3981017 TI - A model for an improved method to study the action of anti-tumor treatment on malignant lymphoid cells. PMID- 3981018 TI - Isolation of macrophages from human placenta. AB - Human placentae have been extracted with combinations of enzymes to optimize the release of mononuclear phagocytes. A mixture of trypsin-DNAase used in sequential extraction was found to provide the best yield of adherent cells which were stable in culture. The majority of adherent cells exhibited phagocytic function and expression of receptor for IgG-Fc (FcR). Subsequent studies established that these functions were co-expressed by the same cells. The FcR+ cells were also shown by immunofluorescence with monoclonal antibodies to display monocyte macrophage distinctive antigens and class I and class II MHC antigens. The placenta has thus been shown to provide a rich source of class II-positive macrophages suitable for immunological studies. PMID- 3981019 TI - Use of the direct linear plot to estimate, in an immunoglobulin solution, the proportion which is specific monoclonal antibody against an unknown cell surface antigen. AB - A Cornish-Bowden direct linear plot was used to assess the level of specific monoclonal antibody in a protein A preparation from mouse ascitic fluid. With this method, experimental observations are plotted directly as lines in parameter space and estimates of kinetic parameters are read directly from the plot without need for further calculation. This method is particularly well suited for the analysis of systems, such as the one outlined here, where conventional kinetic analysis is not possible because the preparation contains both specific and non specific antibody. Results obtained with the direct linear plot showed that estimates of the level of specific immunoglobulin present in a given protein A preparation are consistent, not only within individual experiments, but also throughout a series of experiments using more than one labelled antibody preparation. PMID- 3981020 TI - Septicaemia in a teaching hospital in Kuwait--I: Incidence and aetiology. AB - During a period of 18 months of study, blood cultures were performed on 3845 patients in hospital with clinical signs of infection. Among these, 214 (5.6%) episodes of septicaemia were diagnosed which correspond to 10.9/1000 hospital admissions. About 80% of the episodes were due to Gram-negative organisms, most common of which were Escherichia coli (19.6%), Salmonella spp (16.5%) and Klebsiella spp (15.1%). Gram-positive organisms implicated in 20% of episodes were mainly Staphylococcus aureus (9.3%) and enterococci (4.9%). Of all the septicaemias 62.0% were community-acquired with Salmonella spp. being the organism most commonly implicated. Hospital-acquired infections were mainly due to Serratia spp, Pseudomonas spp and Flavobacterium spp. The antibiotic resistance pattern of the organisms showed that hospital-acquired organisms had relatively high resistance to most antibiotics as compared with community acquired organisms. PMID- 3981021 TI - Septicaemia in a teaching hospital in Kuwait--II: Factors influencing the outcome in III episodes. AB - The case fatality rate (CFR) among III episodes of septicaemia in Kuwait was 22.5%. It increased with age but was not influenced by sex. Gram-negative, polymicrobial and hospital-acquired septicaemia carried a high mortality rate. Due to the influence of the more common, but less fatal salmonella infections, however, mortality from septicaemia caused by Gram-negative bacteria was lower than that reported from more developed countries. Patients with underlying conditions, such as malignancy, chronic liver disease, diabetes mellitus, renal transplant and conditions requiring surgery, as well as those with unknown sources of infection or infection originating from the respiratory tract or from surgical wounds had high mortality rates. The chances of survival increased with the use of appropriate antibiotic therapy and the absence of underlying disease. None of the patients with underlying conditions survived after receiving inappropriate therapy as compared with 50% who were previously healthy. The changing aetiology and the emergence of immuno compromised patients are possible causes for the failure to reduce significantly the mortality from septicaemia in Kuwait. PMID- 3981022 TI - Pathogenicity of aeromonas. AB - The ability of 15 Aeromonas sobria and 9 Aeromonas hydrophila isolates to cause subcutaneous lesions was tested. An inoculum of 10(11) colony forming units/l was injected subcutaneously into mice. Surviving animals developed a subcutaneous abscess and/or localised skin sloughing and loss of hair (alopecia). An abscess was induced by all nine A. hydrophila isolates and by three of the 15 A. sobria isolates. The induction of local epidermal sloughing and loss of hair followed challenge with either A. hydrophila or A. sobria and correlated with the organisms' lethality for mice and their cytotoxicity in the Y-I adrenal cell assay. Local epidermal sloughing was not induced by the media used for growing the organisms or by sonicated cells of the isolates. The ability to cause epidermal sloughing was lost by incubating viable cells at 45 degrees C for 35 minutes. These yet unreported in vivo features of Aeromonas sp. may be useful in studies of the pathogenicity of the species as well as for rapid assay of toxicity of strains. PMID- 3981023 TI - Pneumococcal infections among immunised and splenectomised patients in Israel. AB - Pneumococcal sepsis is a life-threatening complication in splenectomised patients even since the introduction of a polyvalent pneumococcal vaccine. Eight episodes of pneumococcal sepsis in seven properly vaccinated splenectomised patients are described. All but two of the causative serotypes were included in the vaccine. The fact that most of the patients were immunosuppressed may explain the failure of the vaccine in these particular patients. A survey of 59 episodes of pneumococcal bacteraemia during 1982 at the Soroka Medical Center, however, shows that 32% of the strains of pneumococci isolated were among seven types not included in the vaccine. The addition of continuous antibiotic prophylaxis in vaccinated and splenectomised patients is suggested. PMID- 3981024 TI - An analysis of 12 months admissions to a regional infection unit with an open door admission policy. AB - All admissions to the Aberdeen Infection Unit over a period of 12 months have been analysed. Forty per cent of the patients proved to have non-infectious conditions although most were referred as having an infectious disease. Those patients with infectious diseases were younger and had a shorter stay in hospital. Also there was seasonal variation in the time of their admission as well as a low mortality rate when compared with older patients with non infectious disease admitted over the same period. Cross infection did not arise in spite of patients sharing accommodation. PMID- 3981025 TI - Meningococcal endocarditis with profound acquired hypocomplementaemia. AB - A patient is described who presented with chronic endocarditis, due to Neisseria meningitidis, affecting a previously normal mitral valve. The illness was associated with glomerulonephritis that caused renal impairment and the nephrotic syndrome. Despite antibiotic treatment and replacement of the mitral valve, serum complement values remained very low, only returning to normal when immune complexes and a type III cryoglobulin disappeared from the circulation three months after resection of the valve vegetation. Such acquired hypocomplementaemia may have contributed to the chronicity of the disease process in this patient. PMID- 3981026 TI - Generalised tuberculosis in a patient with acquired immunodeficiency syndrome. AB - We describe a heroin addict who presented with cellular immunodeficiency, generalised tuberculosis, and pneumonia caused by Pneumocystis carinii, and discuss the risk of these associations. PMID- 3981027 TI - Disseminated infection associated with corticosteroid therapy after transduodenal sphincteroplasty. AB - Treatment with oral prednisolone appears to have precipitated an episode of ascending cholangitis in an asymptomatic 55-year-old patient. He had undergone a Polya partial gastrectomy, a cholecystectomy and a sphincteroplasty 19, 6 and 2 years earlier, respectively. The cholangitis was complicated by septicaemia with six different enteric organisms including aerobes and anaerobes. He developed liver and lung abscesses, and an indolent Pseudomonas aeruginosa septic arthritis of both hip joints. The patient eventually made a complete recovery, but required surgical replacement of both hips. PMID- 3981028 TI - Disseminated herpes simplex infection complicating Darier's disease: successful treatment with oral acyclovir. PMID- 3981029 TI - Pathophysiologic alterations in Biomphalaria glabrata infected with Angiostrongylus costaricensis. PMID- 3981030 TI - Surface antigens of Biomphalaria glabrata (Gastropoda) hemocytes: functional heterogeneity in cell subpopulations recognized by a monoclonal antibody. PMID- 3981032 TI - Viability of Culex pipiens pipiens eggs affected by nutrition and aposymbiosis. PMID- 3981031 TI - Insecticidal activity of Bacillus laterosporus. PMID- 3981033 TI - The immunopathogenesis of dermatitis herpetiformis. PMID- 3981034 TI - Mast cell depletion in murine chronic graft-versus-host disease. AB - A murine model of chronic graft-versus-host disease (GVHD) was induced across minor histocompatibility barriers. This was done by injecting B10.D2 (H-2d) spleen cells into irradiated BALB/c (H-2d) mice. Chronic GVHD in this model includes features common to human idiopathic scleroderma, such as dermal fibrosis, loss of dermal fat and appendages, and a mononuclear cell filtrate. Serial skin biopsies showed a progressive loss of stainable mast cells in GVHD but not in irradiated controls. Mast cell depletion was noted as well in the tongue and kidney capsule of GVHD mice. Mast cell depletion was noted as early as 11 days after GVHD induction and persisted for at least 56 days. A hypothesis is put forth linking the T-cell activation of GVHD, mast cell degranulation, and increased fibrosis. The pertinence of this hypothesis to idiopathic scleroderma is pointed out. PMID- 3981035 TI - Intravenously injected, TNP-derivatized, Langerhans cell-enriched epidermal cells induce contact hypersensitivity in Syrian hamsters. AB - The ability of haptenated subpopulations of epidermal cells (EC) to induce contact hypersensitivity (CH) in Syrian hamsters was investigated. Crude haptenated EC and haptenated EC enriched for Langerhans cells (LC) inoculated i.v. into hamsters induced CH that was equivalent in intensity to that induced by epicutaneous application of hapten. By contrast, haptenated EC, relatively depleted of LC, failed to induce CH hypersensitivity responses. Upon subsequent reimmunization of all animals with epicutaneously applied hapten, hamsters that had first received haptenated EC depleted of LC failed to respond in CH assays, indicating that these animals had been rendered unresponsive. These data suggest that haptenated LC are capable of inducing CH regardless of the route of inoculation, whereas haptenated EC, when depleted of LC, deliver a down regulating signal via the i.v. route. PMID- 3981036 TI - A murine monoclonal antibody (VM-1) against human basal cells inhibits the growth of human keratinocytes in culture. AB - Using epidermal cells from psoriatic plaques as the immunogen, an IgG1 murine monoclonal antibody, VM-1, has been produced which stains basal keratinocytes on frozen sections of skin obtained from normal individuals and from psoriatic plaques. In some areas of both normal and psoriatic epidermis, the cell layer immediately above the basal cells is also stained. Cells in the external root sheath of the hair follicles also bind VM-1. The antibody binding site is trypsin resistant, and is not blocked by bullous pemphigoid serum. If dispersed epidermal cells are preincubated with VM-1 for 1 h or more before plating, the majority of the cells do not attach and spread out on a collagen-coated Petri dish surface or on a fibroblast feeder layer. When added to attached, preconfluent cultures of keratinocytes, VM-1 inhibits growth and alters cell morphology. The growth inhibition is specific for keratinocytes, and viability studies show that it is not due to an immediate toxic effect of the antibody. The VM-1-induced inhibition of keratinocyte growth is not reversed by soy bean or lima bean trypsin inhibitors added at the time of cell plating or at the time of addition of antibody. PMID- 3981037 TI - Photohemolytic potency of tetracyclines. AB - Hemolysis induced by long-wave ultraviolet radiation (UVA) and 8 different commercial tetracycline derivatives was studied in a model using human red blood cells. Demethylchlortetracycline and doxycycline were shown to have pronounced hemolytic properties causing 88% and 85% hemolysis, respectively, at a concentration of 50 micrograms/ml and 72 J/cm2 of UVA. Tetracycline, oxytetracycline, and chlortetracycline caused maximally 18% hemolysis at 200 micrograms/ml and lymecycline only 7% at 100 micrograms/ml. Methacycline showed intermediate hemolytic effect of 36% at 200 micrograms/ml. Minocycline had no hemolytic effect whatsoever. These experimental data correlate very well with clinical reports and comparative phototoxicity trials in humans. Photohemolysis may thus be of value for predicting tetracycline phototoxicity. PMID- 3981038 TI - The relationship of skin color, UVB-induced erythema, and melanogenesis. AB - The relationship between skin color, delayed erythema, and delayed tanning (DT) elicited by a single exposure of UVB was investigated. Both constitutive and facultative pigmentation were determined by skin reflectance using a melanometer. Skin reflectance using visible light was well correlated to the minimal immediate pigment darkening dose elicited by UVA irradiation, which may relate to epidermal melanin content, a determinant of skin color. Minimal erythemal dose (MED) was well correlated to skin color, but there was less correlation between minimal melanogenic dose and skin color or the MED, since melanogenesis is controlled by genetic factors. DT also correlated to the dose of UVB in terms of MED. A coefficient of the regression line of DT may suggest the tanning capacity of skin. The possibility of detecting mild photosensitivity in individuals from a regression line of the MED on skin color is suggested. PMID- 3981039 TI - Coal tar phototoxicity: characteristics of the smarting reaction. AB - We examined the properties and ultraviolet exposure parameters of tar smarts in an effort to elucidate the mechanisms involved. We showed that irradiation with 1 minimal smarting dose (MSD) of UVA immediately following tar removal lowered the MSD for 6 h, demonstrated by subsequent challenge with UVA. Following 3 MSDs this "memory" effect was demonstrable for 24 h. The smarting reaction was area dependent--smaller areas of exposure require higher doses of UVA to induce smarting. Smarting followed reciprocity over a 6-fold range of irradiances (2 12.5 mW/cm2) but higher irradiances required higher doses of UVA, perhaps due to a delay in the recognition and reporting of smarting. The smarting reaction and delayed erythema due to UVA and tar were equally blocked by sunscreen. PMID- 3981040 TI - The contributions of UVA and UVB to connective tissue damage in hairless mice. AB - UVA, in high-dose single exposures, can, like UVB, be deleterious to skin. Dermal damage resulting from chronic exposure to UVA has not been studied. To investigate the long-term effects, we irradiated albino hairless mice for 30-34 weeks with UVA radiation, alone, from two sources with differing spectral qualities, and in combination with UVB as solar-simulating radiation. The results were compared to UVB alone. Like UVB, the UVA waveband, especially that with a spectral distribution similar to solar UVA, caused elastic fiber damage, increased glycosaminoglycan levels, and produced hypertrophy of deep dermal tissues. There were, however, striking differences between UVB- and UVA irradiated skin. A combination of UVA and UVB summated the effects of both wavebands. Substantial protection against these effects was afforded by a broad spectrum sunscreen. PMID- 3981041 TI - Evidence that the centrally and peripherally located cells in the murine epidermal proliferative unit are two distinct cell populations. AB - The purpose of this investigation was to characterize the [3H]thymidine label retaining and the "maturing" classes of basal cells from the dorsal epidermis of adult SENCAR mice and to compare their early cellular kinetic responses to topical application of the tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA). Autoradiography of epidermal whole mounts and cross sections demonstrated that injection of [3H]thymidine every 6 h for 1 week labeled 95% of the basal nuclei, including those in the central region of the epidermal proliferative units. One month later, the labeling index was reduced to 2%; 90% of the label retaining cells were within a nuclear diameter of the central suprabasal column of the proliferative units. When mice were treated with 2 micrograms of TPA 1 month after labeling, mitotic label-retaining cells were found within 22 h after treatment. Seventy-five percent of the label-retaining cells remained on the basal layer through the 28-h experimental period. In contrast, the basal labeling index following a 1-h pulse of [3H]thymidine was 5%. Eighty-five percent of the labeled cells were found in the periphery of the proliferative units. By 4 days after pulse labeling, most of the originally labeled cells had divided, although vertical cross sections indicated that 92% remained on the basal layer. When mice were treated with TPA on day 4, labeled cells were rarely found in mitosis. Instead, about 60% of the labeled cells were displaced to the suprabasal layers. These observations suggest that 2 classes of epidermal basal cells have different early responses to TPA treatment: the label-retaining cells proliferate, and most of the "maturing" cells continue to differentiate. PMID- 3981043 TI - Fibronectin production by cultured keratinocytes. PMID- 3981042 TI - A possible function of structural lipids in the water-holding properties of the stratum corneum. AB - In order to clarify the possible role of lipids in the water-holding property of stratum corneum, the forearm skin of 6 healthy male volunteers was treated with acetone/ether (1/1) for 1, 5, 10, and 20 min. A prolonged treatment period of 5 20 min produced a chapped and scaly appearance of the stratum corneum without any inflammatory reactions. Under these conditions, there was a marked decrease in the water-holding capacity of the stratum corneum accompanied by a considerable and selective loss of intercellular lipids such as cholesterol, cholesterol esters, and phospholipids. These impairments persisted until day 4 after treatment. Electron microscopic observation of the altered stratum corneum revealed that naturally occurring intercellular materials were absent, leaving the area with the appearance of a vacant space. These findings suggest an additional and essential role of the specific structural lipids for the water holding properties of the stratum corneum. PMID- 3981044 TI - [Study on the histopathological abnormalities of the umbilical cord]. AB - There have been very few reports of studies on histological abnormalities of the umbilical cord. In the present study, we have investigated various abnormalities of the cord with special emphasis on the cord vasculature and the vestigial remnants based on developmental abberations. The incidence of single umbilical artery was 1/509 (0.2%), by which no special relation was signified between the single artery and the occurrence of congenital malformations of the neonate. Supernumerary umbilical vessels were found in 5/509 (1.0%) of the cases examined. Three out of five revealed the umbilical cord with two arteries and two veins, while two of them showed the umbilical cord with the normal 3 vessels associated with an accessory fourth vessel. It is of a great interest to note that fetal distress with or without fetal acidosis was demonstrated in all cases with the accessory fourth vessel, whereas the presence of supernumrary umbilical vessels was least related to the occurrence of congenital malformations of the neonates. The incidence of vestigial remnants was 30/509 (5.9%). The vestigial remnants were classified into two groups according to their epithelial pattern, i.e. flat epithelium and cuboidal or columnar epithelium. The vestigial remnants with flat epithelium type, considered to originate in the allantoic duct, were found in 2/3 (66.7%) of all cases with vestigial remnants. The vestigial remnants with cuboidal or columnar epithelium, considered to originate in the omphalomesenteric duct, were found in 1/3 (33.3%) of all cases with vestigial remnants, one of which case was associated with congenital malformation of omphalocele of the neonate. PMID- 3981045 TI - [Assessment of fetal lung maturity by determination of phosphatidylglycerol in human amniotic fluid]. AB - The enzymatic method for the specific quantification of phosphatidylglycerol (PG) and phosphatidylcholine (PC) was described in detail in this paper. Under the present assay conditions, as little as 2 nmoles of PG or PC was accurately measured. The possibility of contamination of cardiolipin and bilirubin in amniotic fluid was eliminated by chromatography on a silicic acid column. Using 275 amniotic fluid samples from uneventful pregnancies, fetal lung maturity was assessed by using a variety of parameters including PG and PC determination. Based on the results of the present investigation, critical concentrations of PG and PC were determined to be 0.36 and 3.0 mumoles/dl, respectively. 239 infants who had more than the critical PG concentration were all associated with normal respiratory function except 3 cases (false-positive rate, 1.3%). 30 out of 36 infants with a PG value lower than this level developed respiratory distress syndrome after birth (false-negative rate, 16.7%). These results indicated that the PG determination was the most accurate predictor of fetal lung well-being prior to birth among the clinical tests so far reported. PMID- 3981046 TI - [Endocrinological and histochemical studies of placental sulfatase deficiency]. AB - A pregnancy with placental sulfatase deficiency was suspected when a 31-year-old patient at 36 weeks of gestation was found to have extremely low urinary estriol excretion but an otherwise normal prenatal course. The maternal plasma level of estrogens was extremely low, whereas dehydroepiandrosterone sulfate (DHA-S) was normal. Following intravenous infusion of 100mg DHA-S, no rise in urinary or serum estrogens was noted. At 40 weeks of gestation, a male infant was delivered vaginally. In vitro incubation study confirmed the diagnosis of placental sulfatase deficiency. Arylsulfatase C activity was not demonstrated in sulfatase deficient placenta, whereas arylsulfatase C activity was detected in the cytoplasma of syncytiotrophoblast cells of all normal placentas, by light and electron microscopy. PMID- 3981047 TI - [Studies of screening, detection and mortality rates in mass screening for uterine cervical cancer in Shimane prefecture]. AB - To assess the value of mass-screening for uterine cervical cancer, we compared data obtained from a "model area" with findings obtained from the whole of Shimane Prefecture. The factors given attention were: Screening ratio, detection ratio and mortality directly related to cancer of the uterine cervix. These data were obtained from 1976-1980. The results are as follows: Screening ratio and mortality rates were 35.7% and 7.8% respectively, in the model area and 8.4% and 11.5% respectively, in Shimane Prefecture. Four years after setting up the "model area", the mortality rate for uterine cervical cancer reached zero. The ratio of cancer detection in the "model area" was 0.204%, that is about twice that in Shimane Prefecture. The ratios of detection of severe dysplasia, carcinoma in situ and infiltrative carcinoma were higher in the "model area" than in Shimane Prefecture. Detection of severe dysplasia and carcinoma in situ was significantly high in the "model area". Therefore, to reduce the mortality rate for cervical cancer, the CAI should be over 350. PMID- 3981048 TI - [The cell population kinetics of established human uterine cervical carcinoma in nude mice, with comparative examination by types of tissues]. AB - In order to clarify the cell kinetics as the biological features of human squamous cell cancer in uterine cervix, analysis was conducted on the cells of this cancer in nude mice to which various strains had been transplanted. The results of autoradiography revealed LI = 23 approximately 35.9%, Tc = 15 approximately 23 hours, and GF = 42.4 approximately 67.3%. The values for the small-cell non-keratinizing type were generally higher than in the other types. The results of FCM revealed G1 = 49.4 approximately 66.0%, S = 24.8 approximately 38.3%, and G2 approximately M = 5.8 approximately 17.7%. The results of comparison of tissue types were identical with those of paragraph 1. The results of calculation of the numbers of non-proliferative cell compartments on the basis of the results of autoradiography and FCM revealed Q1 = 26.7 approximately 44.9%, and Q2 = 0.84 approximately 10.5%. From these findings, the Q1/G1 ratio was found to be 50 approximately 70%. The comparison by types of tissues revealed the order small cell non-keratinizing less than large cell non-keratinizing less than keratinizing. From the above findings, it was regarded as very likely that the types of tissues and the cell kinetics in the cases with squamous cell cancer in the uterine cervix are closely related to each other. PMID- 3981050 TI - [Management of intracranial hemorrhage of the fetus and newborn]. PMID- 3981049 TI - [Production of monoclonal antibody (MCA-97) to endometrial adenocarcinoma]. PMID- 3981051 TI - [CT diagnosis of intracranial hemorrhage]. PMID- 3981052 TI - [Breast carcinoma associated with pregnancy]. PMID- 3981053 TI - Human cyclic hematopoiesis is associated with aberrant purine metabolism. AB - It appeared possible that abnormal purine or pyrimidine metabolism could cause cyclic hematopoiesis by analogy with the defective lymphopoiesis associated with inherited deficiencies of adenosine deaminase and purine nucleoside phosphorylase. Therefore, we examined erythrocyte purine and pyrimidine nucleotide levels, as well as plasma purine and pyrimidine nucleosides and bases in three patients and in normal controls. These studies showed that during neutropenia there was a significant elevation in the levels of guanosine triphosphate (P = 0.005) and adenosine triphosphate (P less than 0.001) in the patients' red cells not attributable to reticulocyte variation. Serial analysis of a patient's plasma showed a fivefold elevation of hypoxanthine (10.6 mumol/L) during neutropenia, with a return to normal values (1.4 mumol/L) as neutrophil numbers increased. Plasma inosine was also significantly elevated in comparison with normal control values (2.0 mumol/L vs. 0.8 mumol/L), whereas plasma and urinary uric acid were within the normal range. Serial analysis of red cells and plasma from two patients with chronic neutropenia showed no elevations of purine or pyrimidine metabolites. These results provide evidence of a link between abnormal concentrations of purine metabolites and cyclic hematopoiesis, and permit the speculation that aberrant purine metabolism is primarily related to the defective hematopoietic cell proliferation that is characteristic of this disease. PMID- 3981054 TI - Action of platelet-activating factor on type 1 diabetic human platelets. AB - Platelets from patients with type 1 diabetes have exhibited more sensitivity to aggregation when compared with platelets from controls without diabetes after challenge with platelet-activating factor (PAF). The production of thromboxane B2 (TxB2) and 12-hydroxyeicosatetraenoic acid (12-HETE) and the release of 5 hydroxytryptamine (5HT) were increased when the platelets were challenged by PAF (5.0 X 10(-6) mol/L and 1.0 X 10(-6) mol/L). The production of TxB2 and 12-HETE and the release of 5HT were related to the irreversible biphasic aggregation profiles observed in the patients with diabetes. Inhibition of thromboxane A2 (TxA2) production by acetylsalicylic acid abolished the secondary wave of aggregation of platelets from patients with diabetes, changing an irreversible aggregation to a reversible one. Inhibition of both TxA2 and 12-HETE production by eicosatetraynoic acid did not contribute further to the inhibition caused by acetylsalicylic acid alone, indicating that 12-HETE was not involved in the secondary wave of aggregation. These data show that the increased aggregation observed in the platelets from the group with diabetes in response to PAF results in part from their higher production of TxA2 and release of 5HT. PMID- 3981055 TI - Specificity of commercially available antibodies used for gastrin measurement. AB - We examined the specificity of commercially available antibodies used in measurement of serum gastrin. Antibodies were obtained from five commercial laboratories, and antibody immunoreactivity with gastrin and cross-reactivity with cholecystokinin (CCK) were determined. All antibodies were equally immunoreactive with gastrin, and cross-reactivity of three antibodies with CCK was minimal (less than 5%). In contrast, substantial cross-reactivity with CCK was found with two antibodies. To determine the clinical significance of cross reactivity with CCK, secretin injection tests were performed in 24 individuals: seven in normal health, four with Zollinger-Ellison syndrome, three with antral gastrin cell hyperfunction, six with ordinary duodenal ulcer disease, and four with atrophic gastritis. Serum gastrin levels were measured with all five gastrin antibodies. The response to secretin was negative in all normal subjects and in those with duodenal ulcer and antral gastrin cell hyperfunction. The response to secretin was positive in all four patients with gastrinoma with use of the five antisera. All four patients with atrophic gastritis had normal responses to secretin when antibodies with minimal CCK cross-reactivity were used; however, two of four had false positive secretin test results when serum gastrin levels were measured with the two antibodies with a high degree of cross-reactivity with CCK. These studies indicate that significant cross-reactivity of gastrin antibodies with CCK can result in false positive secretin injection test results and can lead potentially to the erroneous diagnosis of Zollinger-Ellison syndrome. PMID- 3981056 TI - Synergistic deleterious effects of nitrous oxide exposure and vitamin B12 deficiency. AB - Rats raised on a vitamin B12-deficient or -sufficient diet were either exposed or not exposed to nitrous oxide for 3 hours before sacrifice. Bone marrow cells were assayed for thymidylate synthetase activity by the deoxyuridine suppression test. A synergistic interaction between vitamin B12 deficiency and nitrous oxide exposure was observed. PMID- 3981057 TI - Erythropoietin and inhibitors of in vitro erythropoiesis in the development of anemia in children with renal disease. AB - The relative roles of erythropoietin and potential inhibitors of erythropoiesis in the development of anemia in children with renal disease have been studied. Thirty-five children with renal disease of varied origins and severity were compared with 30 children with anemia of similar severity and with normal renal function. Serum erythropoietin was measured by radioimmunoassay; erythroid (CFU E) and granulocytic (CFU-GM) progenitor cell growth were assessed in fetal mouse liver cell and normal human bone marrow cell cultures, respectively. The degree of serum inhibition of in vitro CFU-E growth in children with renal disease correlated with both creatinine clearance (r = 0.59, P less than 0.001) and hematocrit level (r = 0.55, P less than 0.005). Serum from children with renal disease inhibited in vitro CFU-E growth in a dose-related manner. Normal serum did not inhibit CFU-E growth in culture. The mean serum erythropoietin concentration was significantly (P less than 0.025) higher in children with anemia of renal disease (32.4 +/- 2.4 mU/ml) in comparison with serum values in normal children (19.6 +/- 1.5 mU/ml), but serum erythropoietin levels did not correlate with hematocrit level, creatinine clearance, or serum inhibition of in vitro erythropoiesis. In contrast, children with anemia and normal renal function showed a significant (P less than 0.001) linear increase in serum erythropoietin concentration (range 28.7 to 327 mU/ml), increased reticulocyte count, and stimulation of CFU-E formation with decreasing hematocrit levels. Coincubation of human urinary erythropoietin in the presence of serum from patients with uremia revealed markedly less immunoreactivity in the radioimmunoassay and less biologic activity in the fetal mouse liver CFU-E assay for erythropoietin than when erythropoietin was incubated with normal human serum, suggesting some alteration of erythropoietin in the presence of uremic serum, which reduced both the immunologic and biologic activity of erythropoietin. Normal and uremic sera inhibited CFU-GM growth to the same degree in comparison with controls. In conclusion, relative erythropoietin deficiency, direct alteration in the biologic activity of erythropoietin by uremic toxins, and serum inhibition of erythroid progenitor cells in the bone marrow are probably important factors in the pathogenesis of anemia in children with renal disease. PMID- 3981059 TI - Renal secretion of phenolsulfonphthalein: analysis of its vectorial transport in normal and mutant analbuminemic rats. AB - Transtubular transport of many organic anions, such as p-aminohippuric acid and phenolsulfonphthalein (PSP), from plasma into urine is an important renal function. Most of these nephrophilic ligands strongly bind to albumin in the circulation. To investigate a possible function of plasma albumin in vectorial transport of these organic anions, plasma clearance and urinary excretion of PSP, on one hand, and its interaction with serum proteins, on the other, were studied in normal and mutant Nagase analbuminemic rats (NAR). Intravenously administered PSP rapidly disappeared from the circulation, followed by its urinary excretion in both NAR and normal rats. However, its plasma clearance was significantly larger in NAR (53.9 ml/min/kg body weight) than in normal animals (4.7 ml/min/kg body weight). Gel exclusion Sephadex G-100 chromatography and ultrafiltration analysis revealed that the PSP binding capacity of serum proteins was considerably lower in NAR than in normal rats; 32.0% and 12.5% of the ligand bound to NAR serum protein and 94.4% and 84.2% to normal rat serum protein (predominantly albumin) at 0.1 and 0.5 mmol/L ligand concentrations, respectively. Despite the greater PSP clearance in NAR, its urinary excretion was lower in NAR than in the normal animals; 20.9% +/- 2.5% and 46.0% +/- 12.6% of the administered dose appeared in NAR and normal rat urine, respectively, within 3 hours of administration. Injection of PSP with equimolar albumin resulted in a decrease in plasma clearance and an increase in urinary excretion of PSP in NAR; more than 31.4% +/- 3.3% of the injected dose appeared in the urine within 3 hours of administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981058 TI - Actions of parathyroid hormone are not impaired during chronic metabolic acidosis. AB - The effect of parathyroid hormone (PTH) on renal excretion of calcium, phosphate, and bicarbonate was studied in acutely thyroparathyroidectomized dogs with metabolic acidosis. Ammonium chloride 10 gm/day for 3 days was given to 15 dogs to induce chronic metabolic acidosis. Clearance results obtained from these experiments showed that infusion of Beckman 1-34 PTH into normal and acidotic dogs resulted in a marked increase in phosphate and bicarbonate excretion, accompanied by a small reduction in calcium excretion and a slight but significant increase in plasma ultrafilterable calcium. Complementing our clearance data, micropuncture results obtained from the proximal and distal tubules of these animals indicated an enhancement of calcium reabsorption in the distal tubule after administration of PTH. Phosphate reabsorption by the proximal and distal tubules was reduced after infusion of PTH in both normal and acidotic dogs. The fraction of bicarbonate reabsorbed in the proximal tubule was reduced after PTH infusion, but the fraction of bicarbonate reabsorbed in the distal tubule remained unchanged. These data suggest that the phosphaturic, the hypocalciuric, and the bicarbonaturic effects of PTH were not impaired during chronic metabolic acidosis. PMID- 3981061 TI - Few CT scan abnormalities found even in neurologically impaired learning disabled children. PMID- 3981060 TI - Mass spectrometry identification of biliary bile acids in bile from patients with gallstones before and during treatment with chenodeoxycholic acid. An ancillary study of the National Cooperative Gallstone Study. AB - The chemical structure of individual bile acids in 255 duodenal bile samples obtained from patients with radiolucent gallstones before and during treatment with chenodeoxycholic acid (375 or 750 mg/day) was determined by coupled gas chromatography/mass spectrometry. The two primary bile acids, cholic acid and chenodeoxycholic acid, and their metabolic products, deoxycholic acid, lithocholic acid, and ursodeoxycholic acid, were present in all bile samples and constituted greater than 97% of all bile acids. In pretreatment samples, the 12 oxo derivative of deoxycholic acid (3 alpha-hydroxy-12-oxo-cholanoic acid) was the next most abundant bile acid, being present in 62% of the samples; the average concentration was 1%, but three individuals had 6% to 8% of this bile acid. The 7-oxo derivative of chenodeoxycholic acid was also present in the majority of samples, but at a lower proportion (0.3%); five individuals had 2% to 3%. The 7-oxo derivative of cholic acid was present in a minority of samples (37%) in trace concentrations; isodeoxycholic acid and the 3-oxo derivatives of chenodeoxycholic acid and deoxycholic acid were also present in trace amounts. Four patients had 1% to 11% ursocholic acid in bile. During treatment with chenodeoxycholic acid, bile became enriched in it in direct relation to dosage; the concentration of its bacterial metabolites increased, and the proportion of cholic acid and its bacterial metabolites showed a reciprocal decrease. No unusual bile acids appeared, indicating that treatment with these doses of chenodeoxycholic acid does not result in the occurrence of additional uncommon bile acids in bile. It is suggested that the paucity of uncommon bile acids in bile, which contrasts strikingly with the great variety of uncommon bile acids known to be present in urine and feces, is the result of two factors: (1) the conversion of uncommon bile acids to common bile acids by reduction, hydroxylation, or epimerization during hepatic passage; and (2) efficient hepatic transport of common but not uncommon bile acids into bile. PMID- 3981062 TI - The Revised Developmental Test of Visual-Motor Integration: its relation to the VMI, WISC-R, and Bender Gestalt for a group of elementary aged learning disabled students. PMID- 3981063 TI - Teachers' behavior toward LD and non-LD children: a strategy for change. PMID- 3981064 TI - Using psychological assessment in structural family therapy. PMID- 3981065 TI - Accepting the diagnosis: an educational intervention for parents of children with learning disabilities. PMID- 3981066 TI - The effects of an intermediary placement on learning disabled and low-achieving adolescents. PMID- 3981067 TI - Running can modify classroom behavior. PMID- 3981068 TI - Deficient linguistic rule application in a learning disabled speller: a case study. PMID- 3981069 TI - Data base. PMID- 3981070 TI - Clinical syndromes among the learning disabled. PMID- 3981072 TI - [Dynamic study of venous return from the lower extremities by means of krypton-81 m perfusion]. PMID- 3981071 TI - [Comparative study of 3 implanted micrografts placed in the abdominal aorta of the rat]. AB - A comparative study was conducted on three micrografts of 2 mm diameter: a frozen umbilical artery, a bovine heterograft and an inert P.T.F.E. material graft. These were implanted in the infrarenal aorta of 158 Wistar rats. Each graft was examined on eight occasions: after 4, 24 and 48 hours, one and two weeks, and 1, 2 and 6 months. Excluding 46 animals that died within 24 hours, the overall permeability rate for all grafts was 87.7% (88.9% for umbilical arteries, 82.8% for bovine heterografts and 85.4% for P.T.F.E.). All grafts were examined by optical and electron microscopy. The inert material showed excellent parietal stability. In contrast, alteration and resorption of the primary matrix were moderate in extent for bovine heterografts, and major for frozen umbilical arteries which appear to be a very unstable grafts. PMID- 3981073 TI - [Transcutaneous measurement of PO2 in healthy subjects and in arteriopathy patients during the exercise test]. AB - The authors studied the variation in tcPO2 during a stress test conducted on a treadmill in normal subjects and in patients with stage I and II vascular disease according to Fontaine's classification. The tcPO2 was measured in the foot. In normal subjects, during exercise, there was an inital fluctuation in the tcPO2 which subsequently remained stable. In patients with arterial disease, the tcPO2 was variable. During the recovery phase, the tcPO2 gradually decreased to its previous level in normal subjects, but in patients with arterial disease, it abruptly fell to below its original value and then gradually returned to this value. This fall and the recovery time are related to the degree of arterial insufficiency in the limb examined. The end of the pain on effort coincides with the beginning of the increase in tcPO2. These findings, during the recovery phase, are related, according to the authors, to the oxygen debt of the muscle masses situated proximally to the point of recording. PMID- 3981074 TI - [Role of erythrocyte deformability in erythrocyte transit time and bioavailability of O2]. AB - The bioavailability of oxygen and its transfer towards all of the cells of the body essentially depends on the flow rate of red blood cells in the capillaries, which often have a smaller diameter than the red cell itself. The authors discuss the results obtained for the mean transit time of erythrocytes, based on microfiltration through artificial polycarbonate capillaries with a diameter of 5 microns, a length of 13 microns and a density of 4.10(5) pores/cm2. PMID- 3981075 TI - [Pure hypertensive nephropathy associated with malignant arterial hypertension in disseminated lupus erythematosus. Case with a favorable outcome]. AB - The authors report the association of a clinically florid form of lupus with malignant hypertension and renal failure. The renal histology revealed lesions of nephroangiosclerosis, with virtually no signs of lupus proliferative glomerulonephritis. With a follow-up period of 42 months, the renal function has returned to normal, although steroid treatment has been interrupted for 33 months. However, intensive antihypertensive treatment is still required. This unusual case is discussed in the light of previous reports in the literature of the association of disseminated lupus erythematosus and malignant hypertension, which is nevertheless a rare entity. PMID- 3981076 TI - [In situ venous bypass using the great saphenous vein: analysis of the 5 year outcome of 129 procedures]. AB - One hundred and twenty nine in situ vein bypasses have been reviewed with a five year follow-up. Cumulative patency rates at five year are 71% (+/- 21%) for above knee femoro-popliteal bypasses, 69% (+/- 11.5%) for below-knee anastomosis and 94% (+/- 35%) when distal anastomosis is performed on tibial or peroneal vessel. Global cumulative graft patency rate is 71% (+/- 9.4%). It is 72% (+/- 11%) in limb salvage. PMID- 3981077 TI - [Long-term results of reversed venous femoro-popliteal bypass. Apropos of 151 cases]. AB - Of 151 inversed autogenous vein grafting done in 137 patients for femoro popliteal disease, 97 (65%) have been done for severe ischemia (rest pain or gangrene); others (35%) have been done for severe walking pain or popliteal and/or femoro-popliteal aneurysms. The follow-up is of 13 years. Hospital mortality was 5 (3,3%). Early failure is of 6%. Patency rate at 5 years is 60% and at 10 years 46%. The lower the anastomosis is done on the popliteal artery the better is the long-term patency rate. The worst results are in diabetic and younger patients. Technic of in situ vein grafting would have not allowed 26% of patients venous revascularization because of the poor condition of the saphenous vein, that the inversed technic permitted (on using internal + external saphenous, resection-suture, etc). PMID- 3981078 TI - [Anatomy and surveillance of key sites and collateral pathways in arteriopathies of the lower extermities]. AB - Key sites to be followed up are defined as a function of initial explorations of lesions in operated or unoperated arterial disease of the lower limb. Details of these key sites were obtained from pathologic examination of collateral vessel networks. Precise studies were conducted of the collateral circulation after infrarenal aortic obliterations, and femoral and tibial artery occlusions. Prediction of the ischemic risk and therefore of prognosis, and choice of therapy, can be obtained only by a detailed study of the reentry value through the bias of this collateral circulation. PMID- 3981079 TI - [TcPO2 and viability of an amputation stump. Preliminary study]. PMID- 3981080 TI - Lay medical ethics. PMID- 3981081 TI - Non-patient decision-making in medicine: the eclipse of altruism. AB - Despite its virtues, lay decision-making in medicine shares with professional decision-making a disturbing common feature, reflected both in formal policies prohibiting high-risk research and in informal policies favoring treatment decisions made when a crisis or change of status occurs, often late in a downhill course. By discouraging patient decision-making but requiring dedication to the patient's interests by those who make decisions on the patient's behalf, such practices tend to preclude altruistic choice on the part of the patient. This eclipse is to be regretted not just because widescale altruism has the capacity to provide important social goods and correct injustices in distribution, but for intrinsic reasons as well. It is argued that preserving the possibility of altruism obliges patients--and future patients--to make decisions about dying and other medical matters in advance, thus avoiding that displacement of decision making onto lay and professional second parties which results in altruism's eclipse. PMID- 3981082 TI - Parental discretion and children's rights: background and implications for medical decision-making. AB - This paper argues that liberal tenets that justify intervention to promote the welfare of an incompetent do not suffice as a basis for analyzing parent-child relationships, and that this inadequacy is the basis for many of the problems that arise when thinking about the state's role in resolving family conflicts, particularly when monitoring parental discretion in medical decision-making on behalf of a child. The state may be limited by the best interest criterion when dealing with children, but parents are not. The state's relation with the child is formal while the parental relation is intimate, having its own goals and purposes. While the liberal canons insist on the incompetent one's best interest, parents are permitted to compromise the child's interest for ends related to these familial goals and purposes. Parents decisions should be supervened, in general, only if it can be shown that no responsible mode of thinking warrants such treatment of a child. PMID- 3981083 TI - Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care. AB - This essay explores some of the conceptual and moral issues raised by illegal actions in health care. The author first identifies several types of illegal action, concentrating on civil disobedience, conscientious objection or refusal, and evasive noncompliance. Then he sketches a framework for the moral justification of these types of illegal action. Finally, he applies the conceptual and normative frameworks to several major cases of illegal action in health care, such as "mercy killing" and some decisions not to treat incompetent patients. PMID- 3981085 TI - Matching and maximizing with variable-time schedules. AB - Pigeons were offered choices between a variable-time schedule that arranged reinforcers throughout the session and a variable-time schedule that arranged reinforcers only when the pigeon was spending time on it. The subjects could maximize the overall rate of reinforcement in this situation by biasing their time allocation towards the latter schedule. This arrangement provides an alternative to concurrent variable-interval variable-ratio schedules for testing whether animals maximize overall rates or match relative rates, and has the advantage of being free of the asymmetrical response requirements present with those schedules. The results were contrary to those predicted by maximizing: The bias it predicts did not appear. PMID- 3981084 TI - Concurrent phencyclidine and saccharin access: presentation of an alternative reinforcer reduces drug intake. AB - Six monkeys self-administered orally delivered phencyclidine ("angel dust") and saccharin under concurrent fixed-ratio 16 schedules during daily three-hour sessions. Liquid deliveries were contingent upon lip-contact responses on solenoid-operated drinking spouts. Three saccharin concentrations (0.003%, 0.03% and 0.3%, wt/vol) were tested in a nonsystematic order. For each saccharin concentration, the following series of phencyclidine concentrations (mg/ml) was presented: 0.25, 0.5, 1, 0.25 (retest), 0.125, 0.0625, 0.0312, 0.25 (retest) and 0 (water with stimuli signaling phencyclidine). As the saccharin concentration increased, the number of drug deliveries decreased, and the peaks of the concentration-response functions were shifted to the right. The lowest saccharin concentration (0.003%, wt/vol) maintained responding in excess of phencyclidine levels in only one monkey. The two higher saccharin concentrations maintained behavior far in excess of phencyclidine, but saccharin deliveries decreased in some monkeys as phencyclidine concentration and intake (mg/kg) increased. The time course and patterns of phencyclidine-reinforced responding were also altered when saccharin was concurrently available. The results are discussed in terms of strategies to reduce drug-reinforced behavior, preference between different reinforcers, and measures of reinforcing efficacy. PMID- 3981087 TI - Sterile isolation of polymorphonuclear leukocytes from large blood volumes. AB - A method for preparation of pure polymorphonuclear leukocyte populations from large blood volumes is described. Methyl cellulose sedimentation and hypotonic haemolysis resulted in an efficient removal of erythrocytes. Subsequent separation with sodium metrizoate/Ficoll (density 1.077) gave rise to a preparation containing 95% polymorphonuclear leukocytes with a recovery of 56% and complete exclusion of red cell ghosts. The granulocyte function expressed by chemotaxis to the standard attractant casein and by trypan blue exclusion was not influenced by the separation procedure, which may be applied prior to granulocyte labeling for studies of cell kinetics and inflammatory disease. PMID- 3981088 TI - Biological influence factors and interference factors in clinical chemistry: general considerations. PMID- 3981086 TI - Hypohaptoglobinemia associated with familial epilepsy. AB - In select kindreds afflicted with familial idiopathic epilepsy, most individuals suffering seizures also have low levels of the plasma hemoglobin-binding protein, haptoglobin. This hypohaptoglobinemia may be causally associated with a tendency to develop epilepsy. Our experimental results indicate that artificially-induced hypohaptoglobinemia in mice causes retarded clearance of free hemoglobin from the central nervous system, and that such free hemoglobin may engender the peroxidation of brain lipids. We hypothesize that hypohaptoglobinemia, either inherited, or acquired via traumatic processes, may prevent efficient clearance of interstitial hemoglobin from the central nervous system, thereby predisposing these people to encephalic inflammation and the appearance of seizure disorders. PMID- 3981089 TI - Laboratory and clinical experience with a monoclonal antibody-based radioimmunoassay for serum total thyroxine. AB - The performance characteristics and diagnostic value of a monoclonal antibody based radioimmunoassay for serum total thyroxine (Mallinckrodt) are described. Between-batch precision (coefficient of variation) was 10.4% at 87 nmol/l and 3.3% at 185 nmol/l. Scatchard analysis revealed a linear plot with a Ka of 5.4 X 10(8) l/mol. Sensitivity was 4.5 nmol/l of thyroxine. An association study showed that the assay reached equilibrium well within the specified incubation time. Cross-reaction of triiodothyronine and reverse triiodothyronine in the assay was 0.6% and 25.0% respectively. Analytical recovery was 91-110%. Linearity was well demonstrated but dilutions of a high concentration of thyroxine in serum did not parallel the standard curve. The correlation coefficient for comparison with a polyclonal antibody assay was 0.95 for 83 patients. The diagnostic accuracy of the monoclonal antibody assay was adequate for most patients with thyroid disease, pregnant women, oral contraceptive users and subjects on thyroxine replacement therapy. Measurement of total thyroxine by a monoclonal antibody based method shows no definite advantage over the conventional polyclonal antibody assay. PMID- 3981090 TI - Comparison of RIA kits with polyclonal antiserum and IRMA kits with monoclonal antibodies for the determination of plasma prolactin and somatotropin in patients with pituitary adenoma. AB - Size heterogeneity of prolactin and somatotropin has been demonstrated in human plasma. In patients with pituitary adenomas the ratio of some hormone fragments has been reported to be changed. Monoclonal antibodies that are used now in some commercial IRMA kits can theoretically differ from polyclonal antisera in the recognition of hormone variants or fragments. In this study, we found a perfect correlation between plasma levels of prolactin or somatotropin of patients with pituitary hypersecretion as measured by commercial RIA kits with polyclonal antiserum and IRMA kits with monoclonal antibodies. A negative bias of 30% for the somatotropin IRMA was found. We observed no discrepancies for plasma samples of patients with pituitary adenomas. Thus, the investigated IRMA kits with monoclonal antibodies seem to detect "tumour" prolactin and somatotropin equally as well as conventional RIA kits. PMID- 3981091 TI - Short-term and long-term intra-individual variations and critical differences of clinical chemical laboratory parameters. AB - Twenty eight clinical chemical blood parameters were studied with respect to intra-individual variations. Both short term variations, within one day and during one week, and long term variations, during a six months period, were investigated in groups of 62, 16 and 274 individuals. Moreover, critical differences were calculated from the total variations, i.e. physiological (personal) and analytical variations. The influences of external factors (sex, smoking, and oral contraceptives) were being studied. It was concluded that the use of laboratory data in clinical diagnosis is considerably improved when intra individual variations and critical differences are used. PMID- 3981092 TI - Computers and health maintenance. PMID- 3981093 TI - The family and terminal care decisions. PMID- 3981094 TI - Postpartum pulmonary embolism. PMID- 3981095 TI - Stress as a precipitating factor in subjects with recurrent herpes labialis. AB - The model of recurrent herpes labialis was selected to evaluate the role played by stress in increasing susceptibility to illness. Initially, 35 paid volunteers with recurrent herpes were enrolled in the project. Compared with 35 age- and sex matched controls, this group demonstrated a familial predisposition for recurrent herpes labialis. Eighteen subjects without confounding variables known to precipitate recurrent herpes infections completed a pretested "stress" questionnaire during a dormant and again during an active stage of infection. In the week prior to the appearance of a recurrence, this group experienced increased daily hassles, increased stressful life events, and higher state anxiety. These findings are discussed in the broader context of stress-associated disease with some speculations concerning a possible biologic mechanism, which involves modulations of T-lymphocyte function. PMID- 3981096 TI - Changes in cardiovascular fitness following physical fitness classes. AB - A program aimed at improving cardiovascular fitness was evaluated. This program involved 298 volunteer middle-aged participants who initially had a bicycle ergometry test to calculate fitness. Other measurements included body fat (estimated by skin fold measurements) and a rating of coronary-prone personality. The participants were given their results and then offered a six-week fitness class consisting of both didactic and exercise segments. After six months, bicycle ergometry was repeated. During this period, mean calculated maximum oxygen uptake (a measure of fitness with a "normal" range of 20 mL/kg/min to 60 mL/kg/min) improved from 38.0 to 39.6 mL/kg/min (t test, P = .0001). Classifying this according to a cardiovascular fitness rating based on age and sex, with 5 being excellent fitness to 1 being very poor fitness, the mean fitness rating went from 3.08 to 3.31 (t test, P = .0001). There was no change in weight or percentage of body fat. Both those who attended the fitness classes and those who did not attend improved equally. Those who did not attend classes had higher ratings on a coronary-prone personality scale compared with those attending classes. In some groups, it appears that significant improvement in cardiovascular fitness may be initiated with a five-minute, office-based bicycle test. PMID- 3981097 TI - Childbirth preparation and outcomes of labor and delivery in primiparous women. AB - Preparation for childbirth (Lamaze classes) is becoming an increasingly popular addition to patient education. This retrospective study investigates its effect on 64 primiparas in comparison with a control group who had not taken classes. The two groups were matched for age, antenatal risk scores, ethnic derivation, and socioeconomic status. No difference was found in the use of analgesia and anesthesia, the length of labor, type of delivery, incidence of fetal distress, infant birth weights, Apgar scores, or maternal and neonatal complications. However, there was a statistically significant increase in the use of oxytocin for augmentation of labor (P less than 0.01) in the prepared group. PMID- 3981098 TI - Improved yield of endocervical cells on Papanicolaou smears in a residency setting. AB - Techniques employed in the collection of cervical cytology show a wide range of detection rates of endocervical cells. The presence of endocervical cells is currently considered to be an important factor in assessing the adequacy of a Papanicolaou smear. In a clinical trial in a university-based family practice center, the yield of endocervical cells was compared during several interventions. These interventions included wetting the cotton swab, changing the number of slides collected, and introducing an extended tip spatula. Clinic physicians were divided into experimental and control groups. Significant improvement in the yield of endocervical cells was found in the group using the extended tip spatula. There was no consistent effect of level of residency training on endocervical cell yield during any intervention. PMID- 3981099 TI - Full clinical departments of family practice: their relationship to hospital privileges in university hospitals. AB - All 52 family practice residency programs that hospitalize patients at a university hospital were surveyed to determine how many have full clinical departments of family practice and what effect having a full clinical department has on hospital privileges. A full clinical department is defined as one in which all hospital privileges for family physicians are reviewed and recommended by the family practice department without need for review by other specialties, even when the requested privileges overlap with another specialty. Responses were received from 100 percent of the surveyed hospitals. At 16 hospitals (30.8 percent) there is a full clinical department of family practice. When these hospitals were compared with the 36 (69.2 percent) at which there is no full clinical department, it was found that in every area of patient care, hospital privileges for family physicians are more extensive at hospitals with full clinical departments. The American Academy of Family Physicians is currently promoting the formation of full clinical departments of family practice as a method for improving hospital privileges for its members. The results of this study suggest that promoting the formation of full clinical departments will be an effective intervention. PMID- 3981101 TI - Self-assessment in family practice. PMID- 3981100 TI - The shared burden: when physicians and families decide to forego life-sustaining treatment. AB - Family physicians are being called upon to make decisions regarding whether to forego life-sustaining treatment. These decisions are made based on consultation with the family of the patient but are complicated by problematic family interactions. The family physician can manage difficult family reactions and assist the family in making a decision by understanding that there are common reactions to loss and bereavement on the part of family members such as anger, denial, and feelings of helplessness; assessing whether problems arise from chronic family conflicts (marital, parent-child, or previous unresolved mourning) or are situation related (unexpressed feelings, how to tell others, need to feel they have done everything, overwhelming other stresses); and incorporating several specific techniques into their practices such as family conferences, accepting anger, involving anxious members in treatment planning, referral to self-help family groups, reframing the decision in terms of the patient's wishes, and negotiating mutually acceptable solutions when patient or family members disagree. PMID- 3981102 TI - Diverticular disease in younger adults. PMID- 3981103 TI - Functional asplenia. PMID- 3981106 TI - Sudden death in hemodialysis patients. AB - Hemodialysis patients may die suddenly and unexpectedly from a number of causes. These may be divided into those deaths due directly to and occurring during hemodialysis, those deaths occurring while the patient is not undergoing dialysis, and those deaths that may occur at any time. The first group includes brain herniation, air embolism, acute hemorrhage as a result of machine malfunction or fistula rupture, electrocution, cardiac arrhythmia caused by hypokalemia, complications of subclavian intravenous catheter insertion, third degree heart block as a result of triglyceride emulsion, and disseminated intravascular coagulation (DIC) or hyperkalemia caused by overheated dialysate. The second group includes deaths due to pericardial tamponade because of effusion and suicidal causes of death (exsanguination, electrolyte imbalance as a result of excessive intake of salt, fluid, or potassium) as well as more conventional methods of suicide. The last category includes people dying of arteriosclerotic cardiovascular disease, hypertensive cardiovascular disease, and internal hemorrhage. Investigation of these deaths, including pertinent historical, laboratory, and autopsy data and investigation of dialysis equipment, is discussed. PMID- 3981104 TI - Identification via dental remains: Pan American Flight 759. AB - Pan American Flight 759 crashed on takeoff from New Orleans International Airport on 9 July 1982. One-hundred-and-fifty-four persons lost their lives making this the second worst air crash in the United States. A dental identification team was assembled and began working the next morning. Ninety-three victims were positively identified by dental means and twenty-three other victims had strong supporting dental evidence as to their identities. The organization, method used, planning, and problem resolution concerning the dental team for this crash are presented. PMID- 3981105 TI - Medical diagnosis versus legal determination of death. AB - This summary of the medical and legal descriptions of death notes that the physician makes a medical diagnosis of death, the physician then makes the legal pronouncement of death, and that statute or the courts make the legal determination of death. Medical diagnosis of death follows either the common law standard of total cessation of cardiac and respiratory function or the medically accepted standards of brain death, the latter being based on irreversible loss of brain function. Cessation of cardiorespiratory function inevitably causes brain death; similarly, brain death inevitably causes cessation of cardiac function. The common law definition of death has been redefined: death is brain death which inevitably causes cessation of the cardiorespiratory functions. Legal determination of death, since the advent of cadaver organ transplantation, has been made by case law, which is briefly summarized, or by statute in most jurisdictions. The history of the Uniform Determination of Death Act is briefly summarized; this observer joins those recommending adoption of this Act. A table gives the rules or statutes that determine death in 36 U.S. jurisdictions. PMID- 3981107 TI - Brain function and writing with the unaccustomed left hand. AB - Twenty right-handed subjects were asked to handprint a passage containing all the letters of the alphabet once with each hand. The purpose was to describe the changes a document examiner can expect to find in handprinting done with the unaccustomed left hand and to offer a hypothesis as to why these changes occur. It was found that many of the writers displayed persistent differences between their right- and left-hand writings. It is suggested that these differences were due to both a lack of manual dexterity when writing with the unaccustomed left hand and to the fact that different neurophysiological processes are involved. PMID- 3981108 TI - Determination of sex with a discriminant analysis of new pelvic bone measurements: Part II. AB - The pelves of 100 white skeletons were measured on both sides for the following: (1) length from the superiormost aspect of the pubic symphysis to the nearest rim of the acetabulum (PS-A), (2) length from the highest point of the pubic tubercle to the nearest rim of the acetabulum (PT-A), (3) acetabular diameter (AD), (4) the vertical distance from the anterior aspect of the ischial tuberosity to the farthest rim of the acetabulum (IT-A), and (5) greatest femur head diameter. From these, three indices were derived: AD/PS-A (acetabulum/pubis index), AD/PT-A (acetabular diameter/pubic tubercle-acetabular rim index), and IT-A/PS-A (ischium acetabulum height/pubic symphysis-acetabular rim index). The left AD/PS-A ratio and left IT-A height proved statistically to be of greatest discriminating value. Using these two variables, a discriminant function was derived which correctly separated 98% of our sample. The acetabulum/pubis ratio alone correctly assigned 95%. With either the discriminant function analysis of two variables or the acetabulum/pubis index as a single predictor, 97% of our sample of known sex was correctly identified if all specimens that fell within a doubtful or overlapping range of values were sorted by femur head diameter. PMID- 3981109 TI - Blood alcohol concentration determined from urine samples as a practical equivalent or alternative to blood and breath alcohol tests. AB - The value of urine tests for determining an equivalent blood alcohol concentration in driving under the influence (DUI) enforcement cases is reviewed from a historical, theoretical, and practical perspective. The limits of precision and accuracy that can be ascribed to urine alcohol results are demonstrated through an evaluation of actual case results wherein both a first void and a subsequent urine sample were analyzed and converted to an equivalent blood alcohol concentration (BAC) using a urine to blood conversion factor of 1.3:1. PMID- 3981110 TI - Homicide by intravenous injection of naphtha. AB - A case of homicide by the intravenous injection of Energine, a petroleum distillate spot remover, is presented. This case is the only known homicide committed with naphtha. This elderly man had severe natural disease in addition to chest trauma sustained in the assault leading to death; however, the rapid injection of approximately 25 mL of Energine was the overwhelming cause of death. PMID- 3981112 TI - Fatal malignant hyperthermia as a result of ingestion of tranylcypromine (Parnate) combined with white wine and cheese. AB - Fatal malignant hyperthermia occurred in a patient who was taking tranylcypromine (Parnate) and ingested wine and cheese. The case findings are presented along with a review of the literature concerning adverse interactions between monoamine oxidase (MAO) inhibitors and certain foods and beverages. Hyperthermia and its possible causative mechanisms and treatments are discussed. The facts suggest that the complicated dietary restrictions attending the use of MAO inhibitors and the possibility of severe and even catastrophic reactions resulting from violations of these restrictions make the use of these drugs fraught with danger and therefore not a first choice for the treatment of depression. PMID- 3981111 TI - Methanol intoxication: distribution in postmortem tissues and fluids including vitreous humor. AB - A 44-year-old man was found unconscious beneath an elevated rapid transit right of-way. On admission to the emergency room, the patient was comatose in metabolic acidosis with high anion and osmolal gaps. The serum methanol was 583 mg/dL. The serum ethanol and ethylene glycol were negative. The patient was treated with ethanol, bicarbonate, and hemodialysis. He expired 40 h after admission. The postmortem methanol concentrations in body fluids were as follows: bile 175 mg/dL, vitreous humor 173 mg/dL, and blood 142 mg/dL. Urine was not available for analysis. Postmortem methanol concentrations in body tissues are given in decreasing order: brain 159 mg/100 g, kidney 130 mg/100 g, lung 127 mg/100 g, spleen 125 mg/100 g, skeletal muscle 112 mg/100 g, pancreas 109 mg/100 g, liver 107 mg/100 g, and heart 93 mg/100 g. The total amount of methanol in the gastric contents was 73 mg. Methanol determinations were performed on a Hewlett-Packard 5840A gas chromatograph with flame ionization detection using a glass column packed with 0.2% Carbowax 1500 on Carbopack C. The internal standard used was n propyl alcohol. PMID- 3981113 TI - Metropolitan forensic anthropology team (MFAT) case studies in identification: 3. Identification of John J. Sullivan, the missing journalist. AB - Skeletal remains removed from an unmarked grave in El Salvador were intensively studied by a team of forensic science experts. Even though the skull, teeth, and several major bones were missing, a positive identification was made of the missing journalist. This was contrary to reports submitted to the State Department by Salvadorian officials. All of the methods used in this investigation, which includes a new method for simultaneously assessing sex and race by discriminant function analysis that was tested by application, are fully described. The international background of this case and information regarding the cause of death is discussed. PMID- 3981114 TI - Stab wounds and personal identity determined from skeletal remains: a case from Kansas. AB - Evidence for cause of death in skeletonized remains is uncommonly found and cases that involve stabbings are particularly rare. In the following report, evidence is presented for a fatal stabbing, determined from analysis of a recent homicide. Because multiple stab wounds were present and several different bones were involved, estimates of the dimensions of the murder weapon were also possible. We also review some distinct vertebral anomalies used for personal identification. PMID- 3981116 TI - Death at high altitude in the hypobaric chamber. AB - A small number of accidental and suicidal deaths have occurred in the hypobaric, or high altitude, chamber. A case of an unusual suicide in a hypobaric chamber is presented. The changes that resulted from decompression and hypoxia are discussed. PMID- 3981115 TI - Identification of a murder weapon by a peculiar blunt force injury pattern and histochemical analysis. AB - Attempts to determine the instrument in the brutal killing of a middle-aged male resulted in the positive identification of an auto jack column as the actual instrument used. This was accomplished by the use of three modalities: (1) the edge of the jack column conformed exactly to a multi-curved laceration in the forehead (site of lethal injury), (2) blood found within this edge of the jack column afforded the same blood type as that of the victim, and (3) tissue sections made of the blood and debris from this edge of the jack column revealed tissue fragments containing human keratin (antihuman keratin technique) and positive staining with collagen stains. PMID- 3981117 TI - Pyrolysis products of heroin. AB - Heating of heroin hydrochloride or of heroin at 250 degrees C led to extensive degradation. Major components of the pyrolysate were identified as heroin, 6 acetylmorphine, N,6-diacetylnormorphine, and N-acetylnorheroin by comparison of mass spectra and 13C- and 1H-nuclear magnetic resonance (NMR) spectra with those of authentic compounds. There was evidence for degradation of the piperidino moiety and the structure 3,4-diacetoxyphenanthrene was proposed for a minor product. PMID- 3981118 TI - The forensic science use of reflective ultraviolet photography. AB - Reflective ultraviolet photography has many forensic science applications particularly in child abuse, rape, homicide, and bite mark cases. The potential of this relatively simple and inexpensive procedure has not been fully explored. The procedure for its use in bite mark cases is presented. PMID- 3981119 TI - Physicians' confusion demonstrated by competency requests. AB - A study was performed at a Veteran's Administration (VA) Hospital of the requests for competency evaluations made by medical and surgical services to a psychiatric consultant service. Since less than half the requests were found to be appropriate and specific, this study emphasizes the need for forensic psychiatrists to educate our nonpsychiatric colleagues about the problems engendered by confusion regarding competency. To do so, psychiatrists as well as other physicians and mental health professionals must be trained in discriminating between different types of competencies and the criteria appropriate for each. Because of continuing legal developments, it is becoming increasingly essential to be precise not only about the specific purpose for a competency request but also about the criteria necessary for evaluating different types of competencies. Forensic psychiatrists could play an important role in the education process to clarify the confusion. This study highlights the need for clarity and education concerning competency issues. PMID- 3981120 TI - Medicolegal problems of elopement from psychiatric units. AB - Elopements from psychiatric units are a frequent but usually low-grade risk. However, they are sometimes followed by harmful consequences, for which the psychiatrist and the hospital may be held liable. We describe management methods developed to reduce such liability. These include a structured observation system and procedures to return elopers to the hospital or to refer them for community based treatment. Data on 105 elopers and 360 controls were gathered and analyzed. Acceptance of some risk of elopement is inevitable on wards that follow the principle of treatment in the "least restrictive alternative." PMID- 3981121 TI - Discussion of "determination of carboxyhemoglobin in the presence of other blood hemoglobin pigments by visible spectrophotometry". PMID- 3981122 TI - Studies of toxic gas production during actual structural fires in the Dallas area. AB - Gases produced during structural fires were studied as to their potential toxicities. Carbon monoxide was the only gas measured in concentrations considered to be lethal within a short period of time. No correlations were found between gases produced and materials burning. However, significant correlations were discovered between gases produced and the physical aspects of the fire (intensity, burning rate, and the like). The organic compounds identified within the gases gave insight as to another potential health hazard not yet considered. These organic compounds are the products of free radical reactions and as free radicals their potential as toxics is enormous. PMID- 3981124 TI - Digoxin-like immunoreactive substance in postmortem blood of infants and children. AB - A digoxin-like immunoreactive substance (DLIS) has been reported in the serum of infants not receiving digoxin. This study was undertaken to determine if DLIS is present in the postmortem blood and tissues of infants or children and whether the endogenous substance could interfere with forensic toxicological analysis in suspected overdose. Ninety blood specimens taken from the heart at autopsy of children or infants were screened for DLIS using commercial radioimmunoassay kits. The average age at death in these cases was 8.6 months, the median age was 2 months. DLIS equivalent to 0.25 to 2.0 ng/mL digoxin was found in one third of the cases. The incidence of positive findings was 5/6 stillborns, 10/45 Sudden Infant Death Syndrome (SIDS), 10/15 deaths as a result of infection, 4/7 homicides, 1/8 deaths caused by congenital defects, and 0/9 accidental deaths. The body distribution of DLIS was investigated and highest levels were found in the liver. Findings of DLIS in blood were correlated with renal failure, (elevated vitreous urea nitrogen), electrolyte imbalance, and liver trauma. Apparent concentrations were in the equivalent therapeutic range of digoxin and would not be confused with accidental or intentional overdose with digoxin. PMID- 3981123 TI - Discussion of "procedures and responsibilities in forensic toxicology--to what extent are they the results of laboratory facilities?". PMID- 3981125 TI - Postmortem redistribution of digoxin in rats. AB - Adult male Wistar rats were treated with either 0.1 or 3 mg/kg body weight X day of digoxin for five days, then killed and stored at 4 degrees C for 12 h in an attempt to mimic the normal preautopsy procedures in our hospital. In rats treated with 0.1 mg/kg body weight X day, the antemortem serum digoxin concentrations (SDC) were 1.1 +/- 0.4 ng/mL while the 12-h postmortem concentration was markedly increased (16.3 +/- 5.9 ng/mL) (P less than 0.01). In rats treated with 3 mg/kg body weight X day, SDC was not changed significantly (11.2 +/- 4.8 ng/mL antemortem and 13.3 +/- 6 ng/mL postmortem). Postmortem redistribution of digoxin was assessed by injection of 125I-labelled digoxin with or without pretreatment with the unlabelled drug. The results indicate that after death passive redistribution of digoxin may take place. When the SDC are within the therapeutic or low toxic range, digoxin may reenter the blood. High antemortem serum concentrations of digoxin may prevent such passive redistribution. Therefore, antemortem digoxin intoxication cannot be reliably inferred on the basis of high postmortem levels of the drug. Digoxin intoxication can be ruled out when postmortem SDC remain within the therapeutic range. The above changes cast doubt on some of the forensic and cardiologic literature, which has in the past been based on incorrect assumptions concerning postmortem behavior of digoxin. PMID- 3981126 TI - The effect of nucleotides on the rate of spontaneous quantum bumps in Limulus ventral photoreceptors. AB - The effect of intracellular nucleotides on the rate of spontaneous quantum bumps in Limulus ventral photoreceptors has been examined. Internal dialysis of photoreceptors with solutions lacking nucleotide leads to an elevation of the quantum bump rate that can be reversed by introduction of nucleotide. Similarly, elevation occurs after treating intact cells with the metabolic inhibitor 2 deoxyglucose. This effect can be reversed by intracellular injection of ATP. The rate of spontaneous quantum bumps in unpoisoned cells can be reduced to below normal levels by injection of ATP. These results support the hypothesis that high energy nucleotides suppress the rate of spontaneous quantum bumps. PMID- 3981128 TI - Rapid ionic modifications during the aequorin-detected calcium transient in a skinned canine cardiac Purkinje cell. AB - A microprocessor-controlled system of microinjections and microaspirations has been developed to change, within approximately 1 ms, the [free Ca2+] at the outer surface of the sarcoplasmic reticulum (SR) wrapped around individual myofibrils (0.3-0.4 micron radius) of a skinned canine cardiac Purkinje cell (2.5-4.5 micron overall radius) at different phases of a Ca2+ transient. Simultaneously monitoring tension and aequorin bioluminescence provided two methods for estimating the peak myoplasmic [free Ca2+] reached during the spontaneous cyclic Ca2+ release from the SR obtained in the continuous presence of a bulk solution [free Ca2+] sufficiently high to overload the SR. These methods gave results in excellent agreement for the spontaneous Ca2+ release under a variety of conditions of pH and [free Mg2+], and of enhancement of Ca2+ release by calmodulin. Disagreement was observed, however, when the Ca2+ transient was modified during its ascending phase. The experiments also permitted quantification of the aequorin binding within the myofibrils and determination of its operational apparent affinity constant for Ca2+ at various [free Mg2+] levels. An increase of [free Ca2+] at the outer surface of the SR during the ascending phase of the Ca2+ transient induced further release of Ca2+. In contrast, an increase of [free Ca2+] during the descending phase of the Ca2+ transient did not cause further Ca2+ release. Varying [free H+], [free Mg2+], or the [Na+]/[K+] ratio had no significant effect on the Ca2+ transient during which the modification was applied, but it altered the subsequent Ca2+ transient. Therefore, Ca2+ appears to be the major, if not the only, ion controlling Ca2+ release from the SR rapidly enough to alter a Ca2+ transient during its course. PMID- 3981130 TI - A correlation between mode of growth and regional ultrastructure of the plasma membrane of Schizosaccharomyces pombe as revealed by freeze-fracturing before and after filipin treatment. AB - The ultrastructure of the plasma membrane of Schizosaccharomyces pombe was studied by freeze-fracture using invaginations of the plasma membrane as natural markers and filipin-induced deformations as artificial markers. In accord with the mode of growth of this organism, ultrastructural aspects of the plasma membrane were related to the following ring zones: the growing pole, adjacent regions, proximal regions, the new cell pole, and the middle in dividing cells. The growing pole and adjacent regions had no or only a few invaginations. Filipin induced numerous deformations in these regions. By contrast, the proximal regions of the plasma membrane had several invaginations and resisted filipin-induced deformation. Concomitantly with commitment to cytokinesis, both the invaginations and the resistance to filipin-induced deformation disappeared in the middle. The results presented here strongly suggest the existence of two states of the plasma membrane of S. pombe, a fact which correlates well with the mode of growth of this organism. PMID- 3981129 TI - Alterations in trehalase solubility during development in the cellular slime mould Dictyostelium discoideum. AB - Previous studies have indicated that during development in the slime mould Dictyostelium discoideum, compartmentation of the isoenzymes of trehalase (alpha, alpha'-trehalose 1-D-glucohydrolase, (EC 3.2.1.28) occurs between the extracellular and intracellular environments. The compartmentation of trehalase between soluble and particulate cell fractions was examined in this work. The trehalase present in crude homogenates prepared during the first 12 h of development was completely soluble. Starting at about the pseudoplasmodial stage (i.e. the 14th hour of development), trehalase activity became associated with insoluble cellular material and this increased to a maximal value in homogenates from mature sorocarps, where 50% of the activity was insoluble. Spore cells accounted for only 2 to 3% of the trehalase associated with mature sorocarps, with the remaining 97% being localized in stalk cell material. Although trehalase recovered from spores was completely soluble, more than half of that from the stalk was recovered in the buffer-insoluble pellet fraction. PMID- 3981127 TI - The role of metarhodopsin in the generation of spontaneous quantum bumps in ultraviolet receptors of Limulus median eye. Evidence for reverse reactions into an active state. AB - The origin of spontaneous quantum bumps has been examined in the ultraviolet photoreceptors of Limulus median eye. These cells have a rhodopsin with a lambda max at 360 nm and a stable photoproduct, metarhodopsin, with a lambda max at 470 nm. The steady state rate of spontaneous quantum bumps was found to be higher when the metarhodopsin concentration was high than when the rhodopsin concentration was high. This result implicates metarhodopsin in the generation of spontaneous quantum bumps. Furthermore, this result is consistent with the idea that the reaction which inactivates metarhodopsin (terminates the ability of metarhodopsin to initiate the reactions leading to a quantum bump) is reversible and that such reversions can be a significant source of spontaneous quantum bumps. Given that the rate of spontaneous quantum bumps is approximately 1/s under conditions where the number of inactive metarhodopsin molecules is approximately 10(9), it follows that the molecular switch that inactivates metarhodopsin reverses with a probability of less than 10(-9). A model is presented of how a molecular switch with this reliability might be constructed. PMID- 3981131 TI - ELISA for the detection of specific IgM and IgG in human leptospirosis. AB - ELISA was used to detect specific IgM and IgG in sera from humans with current or past leptospirosis. A serological pattern of a high IgM titre (greater than or equal to 1280), or moderately increased IgM (160-640) in conjunction with a low IgG titre (less than or equal to 20), with serovar copenhageni antigen was characteristic for approximately two-thirds of the sera from serovar icterohaemorrhagiae patients obtained in the first two months of the disease. The antigen was the supernatant of a heated and centrifuged culture of leptospires. Antigens were prepared from serovars copenhageni, grippotyphosa, hardjo and patoc. Sera from patients with icterohaemorrhagiae, grippotyphosa and hardjo infections showed cross-reactivity when different antigens were used. In past infections the IgG titres were clearly higher with the homologous antigen. ELISA for IgM and IgG allows the rapid diagnosis of acute leptospirosis. PMID- 3981132 TI - Purification, characterization and immunological properties of the serotype specific capsular polysaccharide of Pasteurella haemolytica (serotype T4) organisms. AB - The serotype-specific capsular polysaccharide from two strains of Pasteurella haemolytica serotype T4 organisms was purified and characterized by chemical analysis and NMR spectroscopy. The polymer, a teichoic acid, has the backbone structure ----(2-glycerol-l)----(phosphate)----(6-alpha-D-galactose-1)---- and is partially O-acetylated on the C2 and C3 galactose residues. Chemical removal of O acetyl groups from the polysaccharide destroyed both its ability to precipitate with antiserum raised against killed whole serotype T4 organisms and its ability to adhere to sheep erythrocytes in passive haemagglutination experiments. Attempts to elicit antisera using the purified polymer were unsuccessful but a partially purified material was immunogenic. PMID- 3981133 TI - A comparison of the patterns of extracellular proteins produced by the high alpha toxin-secreting organism Staphylococcus aureus (Wood 46) during aerobic and anaerobic growth. AB - Staphylococcus aureus (Wood 46) was grown aerobically and anaerobically in supplemented 3% (w/v) Tryptone Soya Broth medium for 24 h at 37 degrees C. Although the bacterial density achieved was 9 times higher in the aerobic culture, the exoprotein produced per unit of bacterial dry weight was only 1.4 times higher than in the anaerobic culture. However, the SDS-PAGE patterns of extracellular proteins were quite different: the aerobic products occurred almost exclusively in the mol. wt range 15-30000 compared with 30-60000 for those produced anaerobically. The only major component common to both preparations was alpha-toxin which accounted for 2.4 times more of the total exoprotein under aerobic than under anaerobic conditions. PMID- 3981134 TI - Constitutive expression of a murine interferon alpha gene in hamster cells and characterization of its protein product. AB - The coding part of a murine interferon alpha (MuIFN-alpha) gene was cloned into an expression plasmid containing the simian virus 40 early promoter and the rabbit beta-globin polyadenylation signal. This construct was transfected into Chinese hamster ovary cells, together with a plasmid containing the Ecogpt gene as a selection marker. Resulting colonies were assayed for constitutive interferon production and analysed for integration of MuIFN-alpha genes. There was no obvious correlation between the number of genes integrated and the amount of interferon produced. The highest producer, designated CHO-pSV10EF-3, contained four copies of the mouse gene and constitutively secreted up to 100 000 International Units of interferon per ml per day. The MuIFN-alpha subspecies produced by this clone was characterized by analysis of its antiviral activity on heterologous cells, heparin-Sepharose affinity chromatography and chromatofocusing. The results obtained indicate that it is identical or closely related to a minor component present in conventional MuIFN-alpha preparations. PMID- 3981137 TI - Mechanisms of neutralization of influenza virus by IgM. AB - IgM which neutralized influenza virus infectivity by over 99% prevented the attachment of only half the virus population to BHK cells at 37 degrees C. However, the half of the population that attached to cells was not internalized. Loss of infectivity brought about by IgM is thus totally different from that caused by neutralizing IgG which does not inhibit attachment or penetration. PMID- 3981135 TI - Stimulation of fibroblast interferon production by a 22K protein from human leukocytes. AB - We have studied the appearance of human interferon-beta (HuIFN-beta) as well as its mRNA in cells treated with a protein, 22K factor, isolated from the culture supernatant of mitogen-stimulated human peripheral blood leukocytes. By itself 22K was found to be unable to induce production of significant amounts of HuIFN beta protein. However, when aided by treatment with cycloheximide or cycloheximide and actinomycin D (superinduction), 22K caused increases in production ranging from 3- to 20-fold, depending on the cells (diploid or MG-63 osteosarcoma) and the induction schedule. Cells treated with 22K alone produced small amounts of HuIFN-beta mRNA, which was only detectable with a highly sensitive method. In combination with cycloheximide, 22K induced levels of mRNA detectable with less sensitive methods as well. These experiments provide further support for the concept that the antiviral activity of 22K is mediated by its ability to stimulate transcription of the HuIFN-beta gene in cells. PMID- 3981136 TI - Genetic and antigenic variations among geographical isolates of Sindbis virus. AB - The genetic and antigenic variation in 12 Sindbis (SIN) virus isolates from four zoogeographic regions (Paleoarctic, Ethiopian, Oriental and Australian) has been examined at a molecular level. RNase T1 oligonucleotide fingerprinting of genomic RNA from SIN isolates revealed that the primary structure of the RNA from viruses from each zoogeographic region was unique. The E1 and E2 glycoproteins and the capsid protein of two isolates from each zoogeographic region were compared by tryptic peptide mapping with the Egyptian prototype strain AR-339. Tryptic peptide maps of viruses from Sicily and the Ethiopian region were similar to those of the prototype; maps of isolates from the Oriental and Australia regions were different from each other and from those of the prototype strain. Viruses from each of the four zoogeographic regions were analysed antigenically by neutralization with polyclonal serum to AR-339 and by enzyme-linked immunosorbent assay with an anti-E2 monoclonal AR-339 antibody. Clear antigenic divergence of SIN isolates into two groups, representing the Paleoartic-Ethiopian and Oriental Australian regions were demonstrated. These results support a hypothesis which proposes that ancestral SIN virus diverged into two distinct groups. The genetic changes have resulted in further phenotypic divergence within the geographic varieties. PMID- 3981138 TI - [In search of morphogenes]. AB - May we talk about morphogenes as it is actually done about oncogenes? The author reviews some recent experimental discoveries which launch embryology on a new way: rethinking mitosis, studying cell movement and adhesion, neuronal migration, the role of gap-junctions, cell-death programmation. Embryology and genetics are today converging on identic aims, particularly in the fields of the homeotic genes and of transgenic animals. PMID- 3981139 TI - [Osteodysplasia or the Melnick-Needles syndrome; (apropos of a new case)]. AB - Osteodysplasty (Melnick and Needles syndrome) without facial dysmorphy in a 26 1/2 years old woman, mother of a normal 5 months female infant. First male newborn was stillborn at 37 weeks of amenorrhea with Potter syndrome and severe malformations (microcephaly, cleft lip and palate, posterior scalp lesions, bilateral palmar transverse crease) just like 13 trisomy. Spine and limb X-ray anomalies pointed out a week before foetus expulsion are not proved subsequently because examinations deficiency. PMID- 3981140 TI - [Amniotic disease in the mother and severe heart abnormalities in 2 infants]. AB - Detailed clinical presentation including radiographs and palmar dermatoglyphics of one young, healthy woman affected by hand and feet anomalies that at the outset looked alike brachydactyly type B but that are very likely brought about amniotic disease. The problem of genetic counseling came up after the death of two sons born with transposition of great vessels and septal defect but free from malformations of their mother. PMID- 3981141 TI - [Detection of microcythemia in a school population in Milan: survey of microcythemic subjects 8 years after the diagnosis was made]. AB - In the Milan School population the screening for microcythemy is performed from 1963. It was conducted an investigation among the subjects who were recognized microcythemics eight years ago and who now are eighteen years old. Almost all of them are conscious about their situation and about half of them has a scrupulous notion about a cross-breeding with a high risk. Are also offered the results of the research on the personal behaviour in front of the direct prevention of the mediterranean anemia by prenatal diagnosis. PMID- 3981142 TI - [Intercalary de novo deletion of chromosome 1: del(1) (q24 to q32)]. AB - We present one unrelated girl with a de novo interstitial deletion of a segment in the long arm of chromosome 1 (q24----q32). Comparison of the phenotypic characteristics of this proband with those of six previously described patients with similar deletion, does not suggest the existence of a 1q interstitial deletion syndrome. Clinical manifestations of these patients are variable and non specific: intrauterine growth retardation, low set ears, height and weight failure and mental retardation, clinodactyly of the fifth fingers. Other well detailed cases will be necessary to prove the existence of a 1 q interstitial deletion syndrome (q24----q32). PMID- 3981143 TI - Familial inv(2) (p2300q11.2). AB - A hitherto undescribed inv(2) (p2300q11.2) was found in 2 generations of a family ascertained through a holoprosencephalic liveborn boy with normal karyotype. This inversion, quite probably not related to the child malformations, does not seem neither impair reproductive fitness nor to yield viable recombination aneusomies. PMID- 3981144 TI - Trisomy 10p, due to an unusual translocation. AB - A mentally retarded boy with short stature, craniofacial dysmorphia, clubfeet, hypertonia and several other congenital anomalies is described. Chromosome analysis revealed a trisomy 10p, due to a peculiar t(10 ; 14) (p11 ; p12) translocation. PMID- 3981145 TI - Trisomy 20p: case report and genetic review. AB - Partial trisomy for the distal part of the short arm of chromosome 20 reported in a girl aged 11/2 years with typical craniofacial dysmorphies and psychomotor retardation. The trisomy resulted from a paternal translocation t(14;20) (q32.3;p11.1). The review of 25 cases of partial trisomy 20p showed that most cases (22 : 25) were due to parental translocations. Predominant involvement of small chromosomes in translocations with chromosome 20 was also detected. PMID- 3981146 TI - Neutralizing antibody and interferon-alpha in cerebrospinal fluids and sera of acute aseptic meningitis. AB - Cerebrospinal fluids (CSFs) and sera from 20 patients with echovirus 30 (E 30) meningitis, 4 patients with enterovirus 71 (EV 71) meningitis, and 5 patients with acute aseptic meningitis (AM) of unknown etiology were investigated at the acute and the convalescent phases of the disease to elucidate the roles of neutralizing antibody (NT) and interferon-alpha (IFN-alpha) in the central nervous system (CNS) in cases of AM in humans. Viruses were isolated from the CSFs at the acute phase of AM, but not at the convalescent phase. There was a fourfold or greater rise in NT titer between paired sera to E 30 or EV 71 but only a slight rise between paired CSFs. IFN-alpha was detected in the CSFs ranging from less than 10 to 25.5 IU/ml but not in the sera, and the IFN-alpha level in the CSF was significantly higher in the acute phase than in the convalescent phase. These results suggest that in cases of acute enteroviral infections in the CNS, NT plays only a small role in the recovery from AM, and IFN-alpha plays a direct or indirect role in curbing the local spread of the virus and eliminating the virus from the CNS at the acute phase of AM. PMID- 3981147 TI - Perinatal transmission of hepatitis B virus: role of maternal HBeAg and anti-HBc IgM. AB - The development of hepatitis B surface antigen (HBsAg) carrier states in newborns of HBsAg-positive mothers was correlated to the presence of anti-HBc IgM and HBeAg in the mothers. There was a positive correlation between infection of the newborn and the presence of HBeAg, as shown previously, but no correlation with anti-HBc IgM. PMID- 3981149 TI - Detection of HBV-DNA by in situ hybridization using a biotin-labeled probe. AB - A biotin-labeled DNA probe specific for hepatitis B virus (HBV) nucleotide sequences was hybridized in situ to liver tissue of 20 patients; 16 were chronic carriers of hepatitis B surface antigen (HBsAg) and 4 had no markers of HBV infection. HBV-DNA was also analyzed in the serum and the liver of these patients by spot and Southern blot hybridization, respectively. Liver specimens from six carriers were positive for HBV-DNA both by in situ and Southern blot hybridization; ten carriers were negative by in situ hybridization, and two of these were positive by Southern blot technique. The staining was granular, mainly cytoplasmic, limited to liver specimens containing replicative forms of HBV-DNA, and associated with detection of HBcAg in hepatocytes by immunofluorescence. The sensitivity of this technique was not sufficient to detect few copies of integrated HBV-DNA. The hybridization procedure was specific, as results were constantly negative in liver specimens of patients without markers of HBV infection, and no reaction was observed using DNA probes lacking HBV-DNA sequences. Detection of HBV-DNA by in situ hybridization, using a biotinylated probe, is a rapid, reproducible, and specific histochemical method. Currently available biotinylated probes are advantageous when absolute sensitivity is not the limiting factor, and they also facilitate studies of the cellular and subcellular distribution of HBV nucleic acids. PMID- 3981151 TI - Report from the Office of Governmental Affairs. The 1984 legislative experience: allied health professionals and other legislative issues. PMID- 3981148 TI - Comparative sequence analysis of duck and human hepatitis B virus genomes. AB - We have cloned and sequenced an infectious, functionally active genome of a duck hepatitis B virus (DHBV). It is 3,021 base pairs (bp) in length and shows little DNA sequence homology to the genome of human hepatitis B virus (HBV). However, the amino acid sequences of predicted viral gene products are similar between DHBV and HBV, and the genome organization present in DHBV reflects that of HBV. As in the mammalian virus the long minus strand of the DHBV genome encodes three long overlapping reading frames designated as P, S, and C. The fourth open reading frame, termed X, is absent in DHBV. A comparison with a sequence of a second DHBV isolate [Mandart et al, Journal of Virology 49:782-792, 1984] revealed a nucleotide sequence variation of 5.6% and confirmed the presented overall gene organization of DHBV. PMID- 3981150 TI - Incidence of hepatitis A virus (HAV) infection in rural Liberia. AB - To provide background for future hepatitis A vaccine trials, sera were collected from 0- to 4-year-old Liberian infants and their mothers on two occasions an average of 14.75 months apart and tested for antibody to hepatitis A virus (anti HAV). The prevalence of anti-HAV rose from 2.5% in infants 0-6 months of age to 70% in children 3-4 years of age and did not differ between male and female infants. The annual incidence of new infections was slightly lower in the first year of life (35%) than in the subsequent 3 years, when it averaged 45%. The presence of HBV infection did not affect the incidence of HAV seroconversion. No clinical hepatitis was recognized in the subjects who seroconverted. Dual hepatitis A and B virus infection were observed; these were all clinically inapparent. The extraordinary incidence of HAV infection documented in the present study offers an opportunity for vaccine efficacy trials requiring minimal numbers of subjects. PMID- 3981152 TI - Multimodal therapy for esophageal carcinoma. PMID- 3981153 TI - A young female with a persistent unilateral pulmonary infiltrate. PMID- 3981154 TI - Medicine in Japan 1981-1983. PMID- 3981155 TI - Epidemiology of depressive symptoms in black communities. A comparative analysis. AB - Data from a community survey of depressive symptoms in a black community in Alabama are analyzed using a binary regression procedure to assess the effects of sociodemographic risk factors. These results are compared to two other studies of depressive symptoms in black communities using the same methods to assess the interaction of risk factors with community/region. Community/region is found to modify the relationship of sex, marital status, and income to rates of depressive symptoms within black populations. It is argued that this interaction is evidence of differential sociocultural processes operating in these communities. Suggestions for more detailed research on depressive symptoms in the black community are offered. PMID- 3981156 TI - A two-year longitudinal study of poststroke mood disorders. In-hospital prognostic factors associated with six-month outcome. AB - In a prospective study of mood disorders in stroke patients, variables obtained during the acute hospitalization were examined for their relationship to outcome at either 3- or 6-month follow-up. Distance of the lesion on computerized axial tomography scan from the frontal pole in patients with left anterior infarcts was significantly associated with severity of depression at 3 and 6 months poststroke. In addition, intellectual and functional physical impairment in hospital were significantly correlated with severity of depression and social functioning scores at 3 and 6 months poststroke. Thus, patients who develop depression during the first 6 months poststroke may be responding to the severity of their impairment whereas the patients who develop depressions during the acute poststroke period may have a neuroanatomical and neurophysiological basis for their depression. Although other explanations might be proposed, the dynamic nature of the relationship between depression and associated variables during the first 6 months poststroke indicates that etiology of poststroke depression may be different depending upon the time of onset of the depression after brain injury. PMID- 3981157 TI - The relationship between depression and marital maladjustment. A descriptive study. AB - Measures of depression and marital adjustment were completed by patients hospitalized on an inpatient psychiatric unit and their spouses. Therapists also provided ratings of the patients' depression and couples' marital adjustment. Results indicated a significant negative correlation between patient self-reports of depression and marital adjustment, which was supported by the correlation between therapist ratings. These results demonstrate generalization of the previously established depression-marital maladjustment relationship from outpatients to inpatients. Analyses of sex differences indicated that, although there were no differences between depressed men and women in the severity of the depression, depressed men rated their marriages as significantly better adjusted than depressed women. Clinical implications of these findings with respect to depression and marital maladjustment are discussed. PMID- 3981158 TI - Irrational ideas. Older vs. younger inpatients. AB - The relationship to age of irrational beliefs among psychiatric inpatients has not been explored using the rational-emotive model. This study addressed the following two questions: 1) Do older and younger psychiatric inpatients differ in irrational beliefs? 2) Do older depressives differ from older nondepressives in irrational beliefs? Upon admission to a large medical center, 58 younger (less than 45 years old) and 54 older (greater than 55 years old) subjects were assessed on a battery of psychological tests, including the Idea Inventory and the Beck Depression Inventory. Results showed that older and younger inpatients did not differ on irrational beliefs. Results also showed that older and younger groups of depressives did not differ on the irrationality scores. When a correlational analysis was used, depression was related to irrationality within the older group but not within the younger group. PMID- 3981159 TI - Treatment of social phobia by exposure, cognitive restructuring, and homework assignments. AB - Seven patients who experienced clinically significant anxiety in situations involving public speaking or heterosexual performance and who had received a DMS III diagnosis of social phobia participated in a 14-week program of cognitive behavioral treatment. Treatment was conducted in a group format and consisted of: imaginal exposure, in which patients visualized their own participation in phobic events; performance-based exposure, in which patients enacted simulated phobic situations during sessions; cognitive restructuring, in which patients' cognitions experienced during exposure situations were assessed and analyzed; and systematic homework assignments involving the confrontation of environmental events previously simulated in the group. Self-report, behavioral, and physiological measures of anxiety were collected weekly during baseline and treatment periods, and additional measures were collected before and after treatment. After treatment, most patients demonstrated significant gains, and improvements were maintained at 3-month and 6-month follow-ups. PMID- 3981160 TI - Family hysteria in a Kenyan setting. AB - A case study of hysterical fits affecting five children in the same family in rural Kenya is presented. The only girl in the study was the last to succumb, probably reflecting her modeling upon her mother. The psychopathology of the family is discussed. Conjoint family therapy led to rapid and dramatic recovery. PMID- 3981161 TI - Effect of the normal nerve impulse flow on the synthesis and utilization of GABA in the rat substantia nigra. AB - The concentrations of GABA, glutamate, serine, glutamine, threonine, glycine and taurine in the substantia nigra and in the corpus striatum of the rat were determined electrochemically following condensation with o-phthalaldehyde-beta mercaptoethanol and reverse-phase, high performance liquid chromatography. After a frontal hemisection at the level of the caudal hypothalamus, the GABA concentration in the substantia nigra on the operated side decreased to about 20 per cent of the normal value in 4 days, in all probability caused by degeneration of the nerve terminals of the striato-nigral GABA neurons. The concentrations of taurine in the substantia nigra and of GABA in the corpus striatum were initially lowered and later elevated following this lesion. The concentration of glutamate in the substantia nigra was lower on the sectioned side and higher on the intact side at 14 days as compared to 4 hours after a hemisection. Following an acute hemisection, the GABA transaminase inhibitor gamma-acetylenic GABA increased the concentration of GABA by 36% and 79% in the substantia nigra on the sectioned and intact side, respectively. The glutamate decarboxylase inhibitors 4 deoxypyridoxine and isoniazid lowered the concentration of GABA in the substantia nigra by about 50% on both the sectioned and intact side. The results indicate that the synthesis, but not the utilization of GABA in the substantia nigra is dependent on the normal nerve impulse flow. The concentration of glutamine was changed in directions contrary to that of GABA following a chronic hemisection or treatment with gamma-acetylenic GABA, in agreement with the suggestion that glutamine is a precursor of the GABA transmitter pool. PMID- 3981162 TI - Peripheral benzodiazepine binding sites on striated muscles of the rat: properties and effect of denervation. AB - In order to test the hypothesis that peripheral benzodiazepine binding sites mediate some direct effects of benzodiazepines on striated muscles, the properties of specific 3H-Ro 5-4864 binding to rat biceps and rat diaphragm homogenates were investigated. In both tissues a single population of sites was found with a KD value of 3 nmol/l. The density of these sites in both muscles was higher than the density in rat brain, but was considerably lower than in rat kidney. Competition experiments indicate a substrate specificity of specific 3H Ro 5-4864 binding similar to the properties already demonstrated for the specific binding of this ligand to peripheral benzodiazepine binding sites in many other tissues. The properties of these sites in the rat diaphragm are not changed after motoric denervation by phrenicectomy. It is concluded that peripheral benzodiazepine binding sites are not involved in direct effects of benzodiazepines on striated muscles. PMID- 3981164 TI - On the interaction of Cu2+ with the heavy dipeptide Gly-Trp. AB - Distinct species are observed upon complexing of glycil-triptophan with Cu2+. The spectroscopic characterization of these complexes formed in different pH was made using visible light absorption (350-1100 nm) and electron paramagnetic resonance at room and liquid-nitrogen temperatures, with the samples in aqueous solution at the ratio of 10L:1M. Three species were identified in the following pH ranges: 4.0-6.0, 6.5-11.0, and above 12.00. The spectroscopic data and pK values of the Gly-Trp deprotonatable groups (in the presence of the metal) suggest that the complexes are CuL2(pH approximately 5.0), CuL(H2O). The complex above pH = 12.00 showed the bulky effect of the tryptophan side chain on the stereochemistry of the complex. The square planar symmetry is destroyed and a distorted tetahedral symmetry is achieved: the hyperfine parameter Az is reduced towards the value that occurs in blue proteins and the lowering of axial symmetry can be viewed by an increase in [gx-gy]. The tridentate complex CuL(H2O) was crystallized and single crystal measurements gave the molecular gyromagnetic tensor, but spin-spin interaction between neighbor ions masked the copper hyperfine interaction. PMID- 3981163 TI - Synthesis and spectroscopic studies of potential anticancer [platinum(II)(2,2' bipyridine)(amino acid)]n+ (n = 1 or 2) complexes. AB - Six new platinum complexes of the formula [Pt(2,2'-bipyridine)(amino acid)]n+, where n = 1 to 2 and amino acid is an anion of L-histidine, L-lysine, L asparagine, L-phenylalanine, L-tryptophan, or L-tyrosine, have been prepared by interaction of [Pt(2,2'-bipyridine)Cl2] and an appropriate amino acid (sodium salt) in water or water-methanol mixture. They have been characterized by chemical analyses and spectral methods such as ultraviolet-visible, infrared, and 1H NMR spectroscopy. The 1H NMR studies of these complexes ascertain the modes of binding of amino acids to platinum. The histidine binds to platinum through the nitrogen of a -NH2 group and another nitrogen of heterocyclic ring. All other amino acids bind to platinum through nitrogen of a -NH2 group and oxygen of a COO- group. The mode of binding of some amino acids to platinum in these complexes has been further confirmed by infrared spectroscopy, and the formulations of these complexes have been supported by conductivity measurements. These six amino acid complexes and also other complexes of glycine, alanine, leucine, serine, cysteine, methionine, and glutamine have shown growth inhibition against P-388 lymphocytic leukemic cells. PMID- 3981165 TI - Mechanistic flexibility in the reduction of copper(II) complexes of aliphatic polyamines by mercapto amino acids. AB - The reactions of copper(II)-aliphatic polyamine complexes with cysteine, cysteine methyl ester, penicillamine, and glutathione have been investigated, with the goal of understanding the relationship between RS- -Cu(II) adduct structure and preferred redox decay pathway. Considerable mechanistic flexibility exists within this class of mercapto amino acid oxidations, as changes in the rate law could be induced by modest variations in reductant concentration (at fixed [Cu(II)]0), pH, and the structure of the redox partners. With excess cysteine present at 25 degrees C, pH 5.0, I = 0.2 M (NaOAc), decay of 1:1 cys-S- -Cu(II) transient adducts was found to be first order in both cys-SH and transient. Second-order rate constants characteristic of Cu(dien)2+(6.1 X 10(3) M-1 sec-1), Cu(Me5dien)2+ (2.7 X 10(3) M-1 sec-1), Cu(en)22+ (2.1 X 10(3) M-1 sec-1), and Cu(dien)22+ (4.7 X 10(3) M-1 sec-1) are remarkably similar, considering substantial differences in the composition and geometry of the oxidant first coordination sphere. A mechanism involving attack of cysteine on the coordinated sulfur atom of the transient, giving a disulfide anion radical intermediate, is proposed to account for these results. Moderate reactivity decreases in the cysteine-Cu(dien)2+, Cu(Me5dien)2+ reactions with increasing [H+] (pH 4-6) reflect partial protonation of the polyamine ligands. A very different rate law, second order in the RS- Cu(II) transient and approximately zeroth order in mercaptan, applies in the pH 5.0 oxidations of cysteine methyl ester, penicillamine, and glutathione by Cu(dien)2+ and Cu(Me5dien)2+. This behavior suggests the intermediacy of di-mu mercapto-bridged binuclear Cu(II) species, in which a concerted two-electron change yields the disulfide and Cu(I) products. Similar hydroxo-bridged intermediates are proposed to account for the transition from first- to second order transient dependence in cysteine oxidations by Cu(dien)2+ and Cu(Me5dien)2+ as the pH is increased from 5 to 7. Yet another rate law, second order in transient and first order in cysteine, applies in the pH 5.0 oxidation of cysteine by Cu(Me6tren)2+ (k(25 degrees C) 7.5 X 10(7) M-2 sec-1, I = 0.2M). Steric rigidity of this trigonal bipyramidal oxidant evidently protects the coordinated sulfur atom from attack in a RSSR- -forming pathway. Formation of a coordinated disulfide in the rate-determining step is proposed, coupled with attack of a noncoordinated cysteine molecule on a vacated coordination position to stabilize the (Me6tren)Cu(I) product. PMID- 3981166 TI - The relationship between serum concentrations and central nervous system actions of metoprolol. AB - The relationship between serum levels of metoprolol, hydroxymetoprolol and changes in psychomotor function as measured by standard reaction time and flash fusion frequency was studied. Blinded subjects were given placebo or 150 mg dose of metoprolol and crossed over on the next study day. Flash fusion frequency, reaction time, and serial blood levels of metoprolol and hydroxymetoprolol were collected. Oral dosing of metoprolol produced no significant changes in reaction time. However, significant decreases in flash fusion frequency were observed from 2 to 6 hours after the dose. Changes in flash fusion frequency were related to levels of metoprolol. Flash fusion frequency changes lagged behind the time course of metoprolol concentrations. The nadir of variance in the metoprolol plus hydroxymetoprolol concentration-effect relationship occurred when potency of hydroxymetoprolol was assumed to be 0.3 of metoprolol. These data suggest that the central nervous system actions of metoprolol are related to metoprolol serum levels and occur at low metoprolol concentrations. However, CNS effects of metoprolol do not intensify at high concentrations. Further CNS activity of hydroxymetoprolol may explain the lag seen in the relationship between concentration and CNS effect. PMID- 3981167 TI - An assessment of 24-hour ambulatory EEG/ECG monitoring in a neurology clinic. AB - The relative merits of 24-hour ambulatory EEG/ECG monitoring and routine EEG recording have been compared in a group of 62 patients attending a neurological clinic because of episodes of loss of consciousness. Overall, ambulatory EEG abnormalities were detected in 21 cases (34%) compared with 16 cases (26%) for routine EEG. Ambulatory EEG mainly improved the detection of generalised paroxysmal activity, but in some cases lateralised abnormalities were detected which were not present on the routine record. Patients who reported clinical attacks once a week or more frequently showed an improved yield of diagnostic abnormalities on ambulatory EEG, but the technique did not prove superior to routine EEG if attacks were less frequent. The indications for, and limitations of, ambulatory EEG monitoring are discussed. PMID- 3981168 TI - Fatal intracranial arterial dissection: clinical pathological correlation. AB - The clinical pathological features of fatal arterial dissection confined to the intracranial vessels are described. Three patients with anterior circulation dissections presented with focal ischaemic neurological deficits and pathological examination of involved vessels revealed a dissection plane between internal elastic lamina and media accompanied by intravascular thrombosis. Three of four patients with posterior circulation dissections had clinical pathological features of subarachnoid haemorrhage and at necropsy had transmural dissections. In contrast to previous reports, primary vasculopathies either degenerative or inflammatory were not identified in affected vessels. The pathogenesis of intracranial arterial dissection is discussed and the clinical features are correlated with the pathological abnormalities. PMID- 3981169 TI - Incidence of delayed cerebral ischaemia following subarachnoid haemorrhage of unknown cause. AB - A retrospective study was made of 50 consecutive patients with spontaneous subarachnoid haemorrhage for which no cause was found, looking for evidence of delayed cerebral ischaemia particularly during the first 2 weeks after the bleed. Twenty-three patients had blood visible on the CT scan but only 4-6% developed delayed ischaemia, all of whom made a good recovery. The low incidence of this complication in this group of patients suggests that subarachnoid blood is not a sufficient cause for delayed ischaemia. PMID- 3981170 TI - Neuropsychological evaluation of mild head injury. AB - Neuropsychological deficits following mild head injury have been reported recently in the literature. The purpose of this study was to investigate this issue with a strict methodological approach. The neuropsychological performance of 50 mildly head injured patients was compared with that of 50 normal controls chosen with the case-control approach. No conclusive evidence was found that mild head injury causes cognitive impairment one month after the trauma. PMID- 3981171 TI - Two basic properties of space representation in the brain: evidence from unilateral neglect. AB - It is argued, on the grounds of earlier findings, that the neural substrate of egocentric space representation has analogue (non-symbolic) topo-topical properties. It is then argued from fresh evidence that space representation appears to be anchored to the sagittal midplane of the trunk and to the line of sight. A tentative reduction of the suggested properties of space representation to the neuro-physiological level is briefly outlined. PMID- 3981172 TI - Cerebellar degeneration in dominantly inherited spastic paraplegia. AB - The clinical features of five affected members in three generations of a family with dominantly inherited Strumpell's spastic paraplegia are described, together with the pathological findings in two cases. The late presentation and slow progression of the disease encompass features of the types I and II of other authors illustrating the heterogeneous expression of the disorder. Cerebellar involvement was evident clinically and pathologically. PMID- 3981173 TI - Vitamin B nutrition in the Nigerian tropical ataxic neuropathy. AB - Assessment of nutritional status of vitamin B components by plasma or blood levels indicated riboflavin deficiency and possibly thiamine deficiency in Nigerian patients who suffered from tropical ataxic neuropathy and neurologically normal Nigerians who subsisted on predominant cassava diet. Serum levels of folate, niacin, pyridoxine and panthothenic acid were normal. Vitamin deficiencies probably are minor factors, if any, in the pathogenesis of tropical ataxic neuropathy in Nigerians. PMID- 3981174 TI - Outcome from "rescue clipping" of ruptured intracranial aneurysms during induction anaesthesia and endotracheal intubation. AB - Eight patients with ruptured aneurysms during induction anaesthesia and endotracheal intubation underwent an emergency "rescue clipping" of their lesion. Three patients died. Of the five survivors three made a good final recovery, one patient was moderately disabled and one remained in coma. Conservative management of this crisis is doomed to failure but the comparatively good outcome of the operative cases supports emergency "rescue clipping". PMID- 3981175 TI - Pseudotumour cerebri and the Turner syndrome. AB - One of 170 patients with karyotype-proven Turner syndrome from our institution has had pseudotumour cerebri. This patient and one previous report suggest that patients with Turner syndrome may be predisposed to increased intracranial pressure. Fourteen patients with pseudotumour cerebri were ascertained from hospital records; karyotypes of four were obtained and were normal. Karyotyping may be appropriate in women with pseudotumour cerebri who also have infertility, short stature, multiple pregnancy losses, or other features suggestive of Turner syndrome. PMID- 3981176 TI - Hypotrophy of type I fibres with central nuclei: recovery 4 years after diagnosis. AB - A case of myopathy is reported in a child, first biopsied at 11/2 years of age and whose muscle showed hypotrophy of type I fibres with central nuclei. The case was followed up with another biopsy from the contralateral muscle at 6 years of age. The second sample showed only predominance of type I fibres. PMID- 3981177 TI - Neurological involvement in type 1 (adult) Gaucher's disease. AB - A case of type 1 (adult) Gaucher's disease with a late onset tapeto-retinal degeneration and an initially dopamine responsive extrapyramidal syndrome is described. The literature reporting neurological involvement in type 1 Gaucher's disease is reviewed, and it is concluded that the absence of symptoms and signs of nervous system involvement cannot be used as the sole basis for the classification of this type of Gaucher's disease. PMID- 3981178 TI - The effect of skin temperature on vibratory sensitivity in polyneuropathy. AB - In normal subjects, a rise in skin temperature causes a decrease in vibratory perception thresholds. In this study, vibratory thresholds on the foot were measured before and after local warming of the skin in patients with diabetic or uraemic neuropathy. On warming, the thresholds increased in nine of 11 diabetic patients while they decreased in 10 of 13 uraemic patients. In two-thirds of the patients, the response was outside the range of normal short term variation. PMID- 3981179 TI - Polyneuropathy due to polyangiitis overlap syndrome. AB - A patient presented with a mild polyneuropathy, developed a large intra-abdominal haemorrhage and died of cardiac arrest within a few days. Microscopic examination revealed a polyangiitis overlap syndrome (Fauci) with lesions in many organs, including the peripheral nerves and the heart. A myocarditis was considered to be the cause of death. PMID- 3981181 TI - Epilepsy: an early symptom of systemic lupus erythematosus. PMID- 3981180 TI - The effects of conditioning stimuli on the F-response. AB - The effect of conditioning stimuli on the F-response was investigated in normal subjects using stimulus pairs with interstimulus intervals of 1 to 400 ms. The "recovery curve" for the F-response was found to be similar to that for the H reflex but differences were found between male and female subjects. The significance of these findings is discussed. PMID- 3981182 TI - Unusual features in a case of bilateral paramedian thalamic infarction. PMID- 3981183 TI - Transient hemiparesis--a cautionary tale: coexistence of phaeochromocytoma and intracranial aneurysm. PMID- 3981184 TI - Recurrent intracranial haemorrhage in Behcet disease. PMID- 3981185 TI - The relation of essential tremor to Parkinson's disease. PMID- 3981186 TI - Papilloedema with extramedullary erythropoiesis and Cushing's syndrome. PMID- 3981187 TI - Syringomyelia, an hypothesis and proposed method of treatment. PMID- 3981188 TI - Viloxazine and anticonvulsants. PMID- 3981189 TI - Brain atrophy in chronic alcoholic patients: a quantitative pathological study. AB - There are essentially no objective neuropathological data on brain atrophy in chronic alcoholic patients despite numerous neuroradiological studies which show a high incidence of shrinkage or atrophy. Therefore measurements were made of the intracranial volume (ICV) and brain volume (BV) in a necropsy study of 25 chronic alcoholic patients and 44 controls. The pericerebral space (PICS) was calculated according to the formula (formula; see text) The PICS will increase in patients with brain atrophy since the ICV remains constant throughout life. The mean PICS value was 8.3% in controls, 11.3% in the alcoholic group, 14.7% in alcoholics with superimposed Wernicke's encephalopathy (thiamine deficiency) and 16.2% in those alcoholics with associated liver disease. Thus there was a statistically significant loss of brain tissue in chronic alcoholic patients which appeared to be more severe in those with associated nutritional vitamin deficiencies or alcoholic liver disease. PMID- 3981191 TI - The effect of lithium on choline transport in human erythrocytes. AB - Erythrocytes from lithium treated patients were separated according to the time they had been circulating in the plasma. Choline transport and choline content were measured in the erythrocyte fractions separated according to age, in order to investigate the relationship between decreased choline transport and increased choline content seen in lithium treated patients. The most recently formed erythrocytes of normal subjects had the greatest choline content and the most active choline carrier. The erythrocytes of lithium treated patients had reduced choline carrier activity and increased choline content in all age bands. However the greatest accumulation of choline and least inhibited choline carrier activity was seen in the most recently formed cells. The alteration in phospholipid concentrations measured could not of themselves account for elevated erythrocyte choline levels seen in lithium treated patients. It is concluded that the increase in choline content levels in lithiated erythrocytes does not have a simple inverse relationship with the deficiency in choline transport. The inhibition of the choline carrier is caused by modification due to circulation in lithiated plasma rather than a lack of its synthesis in reticulocytes. PMID- 3981190 TI - Vasopressin secretion in progressive autonomic failure: evidence for defective afferent cardiovascular pathways. AB - Patients with progressive autonomic failure with multiple system atrophy show a severely blunted response of plasma arginine vasopressin to the stimulus of head up tilt. Whether this could be due to lesions either at one or more sites within ascending neural pathways from cardiovascular stretch receptors in the thorax or, alternatively, to lesions affecting vasopressin secreting cells within the hypothalamus was investigated. The arginine vasopressin response to an intravenous infusion of hypertonic saline was determined in six patients with progressive autonomic failure. The mean plasma concentration of arginine vasopressin rose from 1.0 to 3.7 pmol/l, a change comparable to that observed in normal controls. This demonstrates normal functioning of the efferent connections from the osmoreceptors within the hypothalamus and suggests that the loss of vasopressin response to head-up tilt is due to lesions in ascending pathways from cardiovascular receptors. There was a significant rise in mean blood pressure during the infusions on patients with progressive autonomic failure, a change which was not observed with the controls. This may have been at least partly caused by the rise in circulating arginine vasopressin concentrations, since these patients have been reported to be extremely sensitive to the pressor effects of arginine vasopressin. PMID- 3981193 TI - Phrenic nerve conduction time in Guillain-Barre syndrome. AB - Phrenic nerve conduction was studied in 28 patients with Guillain-Barre syndrome. Conduction time was prolonged in 18 (64.3%) patients and serial studies showed progressive improvement with restoration of normal values in the majority by 12 weeks. The conduction abnormalities had a positive correlation with the extent of the disease, morbidity and mortality. Phrenic nerve conduction time was found to be a more sensitive parameter than vital capacity or median nerve motor conduction velocity in assessing the severity of the disease and predicting impending ventilatory failure. PMID- 3981192 TI - The pathological basis of conduction block in human neuropathies. AB - Conduction block was detected in patients with neuropathy by measuring a decrease in the size of the compound muscle action potential of more than 20% on proximal versus distal stimulation of the peroneal, median or ulnar nerve in the absence of excess temporal dispersion of the potential. The teased fibre analyses of nerve biopsies from four patients with "definite" and six patients with "probable" conduction block and from seven patients with neuropathy but without conduction block were compared. All patients with conduction block had significant demyelination (X% demyelinated and remyelinated fibres = 50%) while those without conduction block did not (X = 5.0%). Demyelination is the pathological basis of conduction block in human neuropathies. PMID- 3981194 TI - Orthodromic sensory action potentials from palmar stimulation in the diagnosis of carpal tunnel syndrome. AB - It is known that the major slowing of nerve conduction in the carpal tunnel syndrome occurs in the palm to wrist segment. A technique exploiting this fact and easily applicable in the routine laboratory would be useful in diagnosing early examples of the condition. To this end, orthodromic sensory potentials from stimulation of digits II and V, and of the palmar branches of the median and ulnar nerves were recorded at the wrist in 53 healthy hands, 72 hands with a tentative diagnosis of carpal tunnel syndrome and in 20 hands of patients with unrelated neurological conditions. Using conventional criteria, 53% of the 72 hands from those suspected of carpal tunnel syndrome were thought to have median nerve compression. When conduction velocity in median palm wrist fibres was taken into account, 67% of hands were then considered abnormal. It is concluded that orthodromic sensory action potentials from palmar stimulation provide a rapid, sensitive and acceptable method of diagnosing the carpal tunnel syndrome. PMID- 3981195 TI - Ultrastructure of cerebral arteries following experimental subarachnoid haemorrhage. AB - Scanning and transmission electron microscopy have been used to examine the ultrastructure of cerebral arteries taken from dogs up to nine days following the injection of autologous blood into the suprachiasmatic cistern and using meticulous perfusion-fixation technique. No ultrastructural changes in the cerebral arteries were noted either at sites of radiologically demonstrated arterial constriction or elsewhere. The only abnormality noted was the presence of some leucocytes and macrophages in the subarachnoid space surrounding the arteries. These results are discussed in relation to changes in cerebrovascular reactivity that occur at this stage following subarachnoid haemorrhage. PMID- 3981196 TI - Small cerebellar strokes may mimic labyrinthine lesions. AB - Thirty nine cases of cerebellar infarct and haemorrhage were seen over a period of 3 years. Of these, 69% had no impairment of consciousness. Six cases had nystagmus and gait ataxia as their only abnormal signs. Small cerebellar strokes may present with only vertigo, unsteady gait, and unidirectional nystagmus, thus mimicking labyrinthine lesions. Care in managing vertigo attacks in patients with risk factors for cerebrovascular disease appears to be warranted. PMID- 3981197 TI - Distal amyotrophy of predominantly the upper limbs with pyramidal features in a large kinship. AB - An autosomal dominant disease characterised by amyotrophy of predominantly distal upper limb muscles and mild pyramidal features is described. There are sensory changes in older patients, whilst in others the disease presents itself as a disorder of motor neurons. Owing to variations in the clinical picture, it may be difficult to distinguish this disease in individual patients from distal spinal muscular atrophy, or from pure pyramidal syndromes. There is an overlap in clinical signs between this disease and peroneal muscular atrophy with pyramidal features. Whether or not the latter two conditions are genetically distinct, is a matter of doubt. PMID- 3981198 TI - Positive bromide partition test in the absence of tuberculous meningitis. AB - Five cases of lymphocytic meningitis are described where a Bromide Partition Test was performed and proved positive at levels usually considered consistent with tuberculous meningitis. Three of these cases were ultimately shown to have herpes simplex viral encephalitis, one had Listeria monocytogenes in the CSF and the fifth patient recovered without treatment and was thought to have had a viral encephalitis. The Bromide Partition Test may not be as good a discriminant as has previously been suggested in differentiating between tuberculous and viral meningitis, especially when performed in a population at low risk of getting tuberculous meningitis. PMID- 3981199 TI - The cytopathogenic agent in CSF: evidence for a relationship with enolase levels. PMID- 3981200 TI - Computed tomography and acute carbon monoxide poisoning. PMID- 3981201 TI - Isoniazid and action tremor in multiple sclerosis. PMID- 3981202 TI - Drug-induced alpha coma. PMID- 3981204 TI - Juvenile muscular atrophy of distal upper extremities. PMID- 3981205 TI - The effects of magnetic resonance imaging on different types of microsurgical clips. PMID- 3981206 TI - Rapid enlargement of non-functioning pituitary tumour following withdrawal of bromocriptine. PMID- 3981203 TI - Development of tolerance to anticonvulsant effect of clobazam. PMID- 3981207 TI - Spinal angiomatosis presenting as a sensory neuropathy. PMID- 3981208 TI - Cephalic tetanus presenting with Bell's palsy. PMID- 3981210 TI - Blink reflex in patients with hemispheric cerebrovascular accident (CVA). Blink reflex in CVA. AB - A blink reflex consists of an early unilateral component, R1, and a late bilateral component, R2. During an acute phase of hemispheric cerebrovascular accident, R1 and R2 were abnormal in 30 and 50 of 66 patients, respectively. Paired stimuli usually corrected R1 but not R2, which was profoundly suppressed. The discrepancy between polysynaptic R2 and oligosynaptic R1 indicates a greater disfacilitation at the level of interneurons than at the motoneuron, which serves as the final common path. Abnormality of R2 occurred bilaterally with stimulation on the affected side of face and contralaterally after stimulation on the normal side in 31 patients. This finding suggests a diffuse loss of internuncial excitability, contralateral to the hemispheric lesion. Changes of R2 implicated the brainstem pathways forming the afferent and efferent arc of the reflex in 7 and 8 patients, respectively. The remaining 4 comatose patients had no R2 irrespective of stimulus sites. Clinical localization of the hemispheric lesion showed no consistent correlation with the type of blink reflex abnormalities. The CT scans revealed widely scattered changes in 29 patients with abnormal blink reflex but with a tendency to overlap in the inferior Rolandic area. This contrasted with conspicuous sparing of the inferior post-central region in 10 patients with normal blink reflex. These findings suggest the presence of crossed facilitation to this reflex from wide areas of the cortex but most prominently from the sensory representation of the face. PMID- 3981209 TI - ConA and WGA receptors in rat skeletal muscles. Changes in density, distribution and composition following denervation. AB - The differential binding of fluorescein-labeled ConA, WGA and UEA to cryostatic sections of control and of 8 days denervated muscles is described. Receptor sites for ConA and WGA appear to be very abundant in skeletal muscles and their abundance seems to increase following denervation. In contrast, concentration of receptor sites for UEA is below the sensitivity of the method. Differences in the distribution of the binding sites for ConA and WGA, apparent in untreated sections, were further analysed following predigestions by collagenase, hyaluronidase or neuraminidase. The most important difference among lectins appeared to be the preferential binding of ConA to the surface of muscle fibres and of WGA to connective tissue. By comparing results in control and denervated muscles a clear change of the effects of neuraminidase on WGA binding was evident following denervation. The binding of fluorescein-labeled ConA and WGA to untreated and to predigested cryostatic sections of skeletal muscle is a sensitive and simple histochemical method which can disclose precocious changes in composition of glycoconjugates following denervation and, what might be useful, in other experimental or pathological conditions. PMID- 3981212 TI - An attempt to differentiate female relatives of Duchenne type dystrophy from healthy subjects using an automatic EMG analysis. AB - A new automatic EMG analysis and on-line assignment of MUAP into 8 dynamic cluster algorithm classes (P1......P8) were applied to female relatives of patients with Duchenne type dystrophy. Promising results are given. MUAP amplitude and duration differed significantly in the female relatives compared to the control subjects. MUAP distribution patterns found in the carrier population were significantly different from those found in controls; the carrier population exhibited higher percentages of MUAP (than healthy subjects) in the classes where were assigned the great majority of the potentials obtained from patients with Duchenne type dystrophy. All the known carriers and 55.5% of the possible carriers were detected using these methods. Nevertheless, the absolute accuracy of the results cannot yet be considered achieved because no recognizable distribution pattern was observed in carrier's daughters. No correlation was found between CK levels and EMG distribution. PMID- 3981211 TI - Plasma and cerebrospinal fluid concentrations of magnesium in epileptic children. AB - In order to discriminate between conflicting reports in the literature, plasma and cerebrospinal fluid magnesium levels from epileptic children were compared with those of control children. To exclude the possibility of methodological artifacts, two methods for Mg determination were used: atomic absorption spectrophotometry and a colorimetric procedure. By both methods a significantly decreased concentration of Mg in plasma was found in epileptics. A positive correlation of the hypomagnesemia with the severity of epilepsy was found: the more severe the epilepsy, the lower was the plasma Mg. A significant increase of Mg concentration in CSF of epileptics was found. The most likely origin of Mg in CSF in epilepsy is the CNS tissue from which Mg is released. It is suggested that these alterations of Mg concentrations in plasma and CSF originate from a functional impairment of the cell membranes which might occur in epilepsy. PMID- 3981214 TI - Innervation of rabbit intrapulmonary neuroepithelial bodies. Quantitative and qualitative ultrastructural study after vagotomy. AB - The purpose of this study was to locate the cell bodies of origin of the intracorpuscular nerve endings of the intrapulmonary neuroepithelial bodies (NEB). Left infra- or supranodosal vagotomy was performed on 35 young rabbits. In control animals, the NEB innervation index (i.e. the ratio of the number of intracorpuscular nerve endings to the number of NEB corpuscular epithelial cells) was 0.3 in both left and right lungs. Left infranodosal vagotomy decreased the NEB innervation index in the left lung to 0.1 by 24 h postoperatively. Degenerating nerve endings displaying neurofilamentous hyperplasia, were found among the few surviving nerve endings. Left supranodosal vagotomy did not influence the innervation of the NEB of the left lung, even at 5 days postoperatively. In the right lungs, neither procedure had significant effects. These findings indicate that the NEB are predominantly innervated by sensory nerve fibers, derived from cell bodies in the nodose ganglion of the vagus nerve. This neuroanatomical argument corroborates our hypothesis that NEB represent intrapulmonary neuroreceptors. PMID- 3981213 TI - Incongruence of regional cerebral blood flow increase and blood-brain barrier opening in rabbits at the onset of seizures induced by bicuculline, methoxypyridoxine, and kainic acid. AB - Cerebral blood flow (CBF) was estimated using [3H]nicotine as tracer in 18 discrete rabbit brain regions at the onset of generalized seizures induced by bicuculline (BC), methoxypyridoxine (MP), and kainic acid (KA) and compared with the previously described regional pattern of blood-brain barrier (BBB) opening. Regional CBF increased 3- to 5-fold in BC-seizures, 2- to 3-fold (except in inferior colliculus) in MP-seizures, and twofold (no change in inferior colliculus) and periaqueductal gray) in KA-seizures. In general, CBF elevation was greater in areas with a high original CBF, and below average in regions with a low control value. However, under each condition a few areas did not follow this rule, viz. the occipital cortex and the basal part of the cerebellar vermis with low flow values in BC-seizures, the inferior colliculus with no change and the pallidum with a relatively high flow during MP-seizures, and limbic system areas with an exceptionally high flow during KA-seizures. The usual rise in arterial blood pressure (BP) at the onset of the seizure, necessary for the development of a BBB lesion, was absent in a few animals with BC- and MP seizures, yet, their CBF was elevated in most regions although to a lesser extent. No relationship appeared to exist between the rise in CBF and the regional pattern of BBB opening. It is concluded that a loss of cerebral autoregulation is a prerequisite for BBB leakage, but the location of the opening is determined by neuronally derived factors which differ from convulsant to convulsant and from brain region to brain region. PMID- 3981215 TI - Tuberoinfundibular dopaminergic system and anterior pituitary dopamine receptor in Shy-Drager syndrome. AB - Tuberoinfundibular dopaminergic system (TIDA) together with anterior pituitary dopamine receptor was evaluated in 9 patients with Shy-Drager syndrome (SDS) through the responses of serum growth hormone (GH) and prolactin (PRL) to dopaminergic stimulation or dopamine receptor inhibition. A variety of abnormal responses of serum GH and/or PRL following the administration of these drugs suggests the TIDA involvement as well as the nigrostriatal system and moreover the different degeneration processes in each dopaminergic system in SDS. PMID- 3981216 TI - Experimental amyotrophic lateral sclerosis in the guinea-pig. AB - In guinea-pigs a diet which was deficient in ascorbic acid provoked neurogenic atrophy of the muscles, degeneration of the anterior horn motor cells and demyelination of the pyramidal tract. Muscles showed a decrease of cytochrome and cytochrome c oxidase. Subcutaneous haemorrhages were also found, particularly around the knee joints. The haemorrhages and the histopathology of the muscles and spinal cord were prevented by a high dosage of ascorbic acid. In animals with an ascorbic acid deficiency, histopathology of muscles and spinal cord were also prevented by L-cysteine, L-methionine and L-hydroxyproline. Subcutaneous haemorrhages were not prevented by these supplements. PMID- 3981217 TI - Schwann cell and oligodendrocyte remyelination in lysolecithin-induced lesions in irradiated rat spinal cord. AB - Localised irradiation of adult rat spinal cord was achieved by implanting for 2 weeks a 192Ir pin alongside vertebral segments in the thoraco-lumbar region of the spinal column. Following removal of the implant, lysolecithin (LPC) was injected directly into the dorsal columns in order to induce demyelination in the most intensely irradiated segments of spinal cord. Eight weeks after LPC injection, remyelination was much less extensive in dorsal columns which absorbed more than 40Gy than in LPC lesions in less intensely irradiated spinal cords or in unirradiated animals. No oligodendrocytes, few astrocyte processes and little myelin debris lay among the demyelinated axons. However, capillary vessels were surrounded by astroglial end-feet so that the glial-limiting membrane remained intact in the demyelinated regions. There were some oligodendrocyte remyelinated fibres around the edges of the demyelinated zones but none among the naked axons. Schwann cells, which probably migrated into the lesions from the proximal segments of the dorsal roots, provided some fibres with myelin sheaths. These remyelinated fibres abutted demyelinated axons without an intervening glial limiting membrane or astrocyte process. Oligodendrocytes may fail to migrate into the demyelinated regions because of the scarcity of astrocyte processes. A possible explanation for the limited Schwann cell remyelination may be that the presence of astroglial end-feet around capillaries deprived Schwann cells of ready access to the demyelinated regions. PMID- 3981218 TI - Heavy metal concentrations in blood cells in patients with amyotrophic lateral sclerosis. AB - Manganese (Mn) and selenium (Se) concentrations in blood cells were measured by neutron activation analysis. Blood was obtained from patients with amyotrophic lateral sclerosis (ALS), patients with other neurological diseases and control subjects. Dried blood cells were activated by neutron irradiation. Mn was determined after chemical separation and Se was determined nondestructively. Mn concentrations in blood cells from ALS patients were significantly lower (P less than 0.01) than those from the other groups. The Mn concentrations were also significantly lower (P less than 0.01) in late than in earlier stages of ALS. Se concentrations in blood cells from ALS patients were significantly higher (P less than 0.01) than those from the other two groups. A generalized abnormal distribution of these metals may play a role in the pathogenesis of this disorder. Bromine, zinc, rubidium, and iron concentrations of erythrocytes were the same in all groups. PMID- 3981219 TI - Effects of acute nerve compression on conduction of impulse trains of increasing frequency. AB - The acute effect of localized nerve compression has been detected electrophysiologically in isolated rat tail nerve by utilizing a special stimulus pattern, a STIF (Stimulus Train of Increasing Frequency), which shows the highest frequency that the most sensitive axons in a compound potential can transmit through the compressed region. The same method also detected recovery after release of compression. Overlap of waveforms at high frequencies of stimulation required special techniques to permit unequivocal measurements. The best endpoint at which to detect the acute nerve compression in these experiments was found to be that frequency at which only a few fibers were blocked. The method was also effective when part of the nerve was completely blocked by the compression, and was more sensitive than measure of change in latency of a single response. PMID- 3981220 TI - Peripheral autonomic surface potential. A quantitative technique for recording sympathetic conduction in man. AB - Using EMG equipment with time locked recording and standard averaging facilities we were able to record a previously poorly defined skin potential. The potential, termed by us the peripheral autonomic surface potential (PASP), was recorded from the palmar surface of the hand and the plantar surface of the foot in 30 normal subjects. The PASP usually consisted of a biphasic potential with an initial negative and a later positive peak. It was elicited by randomly timed electrical stimuli over the median nerve at the wrist. The mean palmar PASP latency was 1.52 +/- 0.13 s and the mean plantar PASP latency was 2.07 +/- 0.16 s. The mean palmar and plantar PASP amplitudes were 479 +/- 105 microV and 101 +/- 40 microV, respectively. A mean sympathetic conduction velocity was calculated to be 1.28 +/ 0.18 m/s. In 5 normal subjects a similar technique was used to record a PASP from the volar surface of the left middle finger. Iontophoresis of atropine into the skin under the recording site abolished the PASP in all subjects. Palmar and plantar PASPs were recorded in 10 diabetic patients. The amplitudes (palmar 179 +/- 158 microV, plantar 17 +/- 16 microV) were significantly reduced compared to normals (P less than 0.001). Five patients with unilateral lumbar or cervical sympathectomy were studied. The PASP was absent or markedly reduced on the side of the sympathectomy in all patients. PMID- 3981222 TI - Monoclonal antibody immunocytology: potential applications for staging and monitoring malignant disease activity. PMID- 3981221 TI - The integrity of the blood-brain barrier in Alzheimer's type and multi-infarct dementia evaluated by the study of albumin and IgG in serum and cerebrospinal fluid. AB - Albumin and IgG have been determined in the serum and cerebrospinal fluid (CSF) of 64 patients affected by Alzheimer's disease and senile dementia of Alzheimer type (SDAT/AD), 17 multi-infarct dementia (MID) patients and 52 controls. The concentrations of albumin and IgG in the serum and CSF have been taken into account to evaluate the integrity of the blood-brain barrier (BBB) and the occurrence of intrathecal immunological activation in demented patients. Clear cut signs of BBB damage have been shown only in the group of patients affected by MID, whilst none of the two groups of patients displayed signs of immunological activation, expressed by an increase in IgG index, nor abnormally low CSF/serum ratios for IgG, previously suggested as expressive of a "consumption" of IgG by the brain parenchyma. PMID- 3981223 TI - Primary lymphomas of the central nervous system: patterns of failure and factors that influence survival. AB - Primary lymphomas of the CNS are rare tumors accounting for less than 2% of all extranodal non-Hodgkin's lymphomas. The treatment for this disease has been disappointing. Radiation therapy and surgery have produced consistently poor control of this disease, with a median survival of 15 months. We have reviewed ten cases of primary lymphoma of the CNS treated at the Joint Center for Radiation Therapy or Dana-Farber Cancer Institute (Boston) from 1968 to 1981. All patients had biopsy-proven CNS lymphomas without systemic disease at presentation. In our series, control of CNS lymphoma was seen only in patients receiving craniospinal radiation or CNS-penetrating chemotherapy. PMID- 3981224 TI - Non-Hodgkin's lymphoma of the stomach: a prospective pilot study of surgery plus chemotherapy in early and advanced disease. AB - A prospective pilot study of 23 patients with non-Hodgkin's lymphoma involving the stomach was undertaken to assess the efficacy of surgical resection followed by chemotherapy with adjuvant cyclical cyclophosphamide, vincristine, and prednisolone (CVP) in early stage disease, and cyclical cyclophosphamide, vincristine, prednisolone, and doxorubicin (CHOP) in advanced disease. One of 18 evaluable patients died postoperatively; 17 of 18 completed therapy and are alive and disease-free at a median follow-up of 41 months after surgery (range, 5 to 111 months), including four patients with stage IV disease who remain in complete remission 19 to 47 months after surgery. There was one postoperative death, giving an actuarial survival rate of 94% in the study group. Three of five inoperable patients were treated with CHOP, with two achieving complete remission. Two untreated patients died. Overall actuarial disease-free survival was 82.6%. Surgical resection plus chemotherapy is capable of producing long-term remission and cure in both localized and advanced non-Hodgkin's lymphoma of the stomach. Intensive supportive care plus chemotherapy may salvage a proportion of patients with inoperable tumors. PMID- 3981225 TI - Echocardiographic abnormalities following cardiac radiation. AB - Five years or more after receiving cardiac radiation, 41 patients with Hodgkin's disease and seminoma in remission were subjected to echocardiography. The abnormalities detected included pericardial thickening in 70%, thickening of the aortic and/or mitral valves in 28%, right ventricular dilatation or hypokinesis in 39%, and left ventricular dysfunction in 39%. In the 23 patients treated by an upper mantle technique with shielding, the incidence of right ventricular abnormalities and valvular thickening was significantly lower than in patients treated with modified techniques. Although no symptoms were attributable to the observed abnormalities, longer follow-up time may reveal important functional implications. PMID- 3981226 TI - Neoplastic fever responds to the treatment of an adequate dose of naproxen. AB - Twenty-one patients with neoplastic fever due to malignancy were treated with naproxen. A prompt and complete lysis of fever was obtained in 20 patients within 12 hours when an adequate dose of naproxen was given, and a sustained normal temperature was maintained in all responding patients while receiving naproxen except for one in whom a low grade fever recurred. Lysis of fever usually was followed by excessive sweating and subjective symptomatic improvement. However, when naproxen was discontinued in ten patients, febrile state to the pretreatment level recurred in seven patients within three days. This observation suggests naproxen has a definite and effective antipyretic activity against neoplastic fever although it may recur as the drug is discontinued. Naproxen may be a useful adjunctive agent in patients with neoplastic fever for a short-term symptomatic relief. PMID- 3981227 TI - Effects of medial geniculate lesions on sound localization by the rat. AB - Rats with bilateral lesions of the medial geniculate body were tested on a two choice sound-localization task that required a directional response to a distant sound source. Stimuli included both broadband and filtered noise bursts presented singly or in repetitive trains. Separate tests were conducted with loudspeakers 180 and 60 degrees apart, centered around 0 degree azimuth. With complete bilateral destruction of the medial geniculate, rats could localize both trains and single bursts of noise and were capable of high levels of performance even at small angles of speaker separation. Some evidence of impaired performance was noted with high-frequency noise bursts, but generally the deficits were not severe. Animals with lesions that extended caudally into the brachium of the inferior colliculus and lateral tegmentum were severely impaired in their ability to localize sounds even at large angles of speaker separation. Three of the four animals in this group were incapable of localizing single bursts even with loudspeakers separated by 180 degrees, and the fourth was unable to perform above chance at 60 degrees. The effects of medial geniculate lesions were very similar to those reported previously for rats with lesions of the auditory cortex, but contrasted with reports of severe impairments in sound localization following damage to the auditory cortex in other mammalian species. PMID- 3981228 TI - Primate globus pallidus and subthalamic nucleus: functional organization. AB - Neuronal relations to active movements of individual body parts and neuronal responses to somatosensory stimulation were studied in the external (GPe) and internal (GPi) segments of the globus pallidus (GP) and the subthalamic nucleus (STN) of awake monkeys. In GPe (n = 249), GPi (n = 151), and STN (n = 153), 47, 29, and 28% of the cells, respectively, discharged in relation to active arm movements, 10, 11, and 15% to leg movements, and 22, 22, and 18% to orofacial movements. Of the neurons whose activity was related to arm movements, 26, 16, and 21% in GPe, GPi, and STN, respectively, discharged in relation to movements of distal parts of the limb. Of cells whose discharge was related to active limb movements, 37, 22, and 20% in GPe, GPi, and STN, respectively, also responded to passive joint rotation, which was usually specific in terms of joint and direction of movement. Only a small percentage of cells responded to muscle or joint palpation, tendon taps, or cutaneous stimulation. Short-latency, direction specific neuronal responses to load perturbations confirmed the existence of proprioceptive driving. In both GPe and GPi, leg movement-related neurons were centrally located in the rostrocaudal and dorsoventral dimensions. In contrast, arm movement-related cells were found throughout the entire rostrocaudal extent of both segments, although in greater numbers caudally. In the central portions they were situated largely inferior and lateral to leg movement-related neurons. Neurons related to orofacial movements were largely confined to the caudal halves of both segments, where they were located largely ventral to arm movement-related cells. The STN cells whose activity was related to leg movements were observed largely in the central portions of the nucleus in the rostrocaudal and mediolateral dimensions. Cells whose activity was related to arm movements were found throughout the rostrocaudal extent of the nucleus, but were most numerous at the rostral and caudal poles. Neurons related to movements of the facial musculature and to licking and chewing movements were distributed over the entire rostrocaudal extent of the nucleus, where they generally occupied the ventrolateral regions. In all three nuclei, neurons with similar functional properties were sometimes clustered together. Within the arm and leg areas, however, there was no clear evidence for a simple organization of clusters related to different parts of the limb. These studies provide further evidence for a role of the basal ganglia in the control of limb movements.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981229 TI - Cat lateral suprasylvian cortex: Y-cell inputs and corticotectal projection. AB - Retinal Y-cells activate most cells in the deep layers of the cat's superior colliculus via an indirect pathway involving the occipital cortex. The lateral suprasylvian area seems to be an important source of visual input to the deep collicular strata but it is unclear whether Y-cell influences reach this extrastriate area and, hence, whether this area participates in the indirect Y cell pathway. In this study, retinal influences on the posteromedial lateral suprasylvian area (PMLS) were studied in anesthetized cats. Responses to electrical stimulation of the optic disk (OD) and optic chiasm (OX) were recorded in single units in PMLS and in neurons of the dorsal lateral geniculate nucleus (LGNd) that were antidromically driven from PMLS. Virtually all PMLS cells (99%; 99/100) exhibited small differences (less than or equal to 0.8 ms) between OD- and OX-activation latency, indicating that they were driven by a pathway originating in rapidly conducting Y-cell axons. A small number of PMLS cells (17%; 20/118) had very short activation latencies (less than or equal to 3.2 ms from OX), comparable to those of cells in areas 17 and 18 receiving monosynaptic inputs from geniculate Y-cells. Further, LGNd cells with latency behaviors typical of Y-cells could be antidromically driven from PMLS, confirming that geniculate Y-cells project directly to PMLS. Most PMLS cells (83%; 98/118), though exhibiting small OD-OX latency differences, had absolute latencies too long to be attributed to direct inputs from geniculate Y-cells (3.3-8.5 ms from OX). Thus Y-cells in the LGNd influence most PMLS cells by way of a multisynaptic pathway. PMLS cells antidromically activated from the superior colliculus were driven only by this multisynaptic Y-cell input. Total conduction time from the retina through PMLS to the colliculus corresponds closely to the latency of the indirect Y-cell activation observed in the deep collicular layers. These results support the view that the lateral suprasylvian cortex constitutes an important source of visual input to the cat's deep collicular layers and, more generally, that the extrastriate visual cortex may figure prominently in the cortical control of gaze. PMID- 3981230 TI - Role of visual experience in activating critical period in cat visual cortex. AB - Cats were reared in total darkness from birth until 4-5 mo of age (DR cats, n = 7) or with very brief visual experience (1 or 2 days) during an otherwise similar period of dark rearing [DR(1) cats, n = 3; DR(2) cats, n = 7]. Single-cell recordings were made in area 17 of visual cortex at the end of this rearing period and/or after a subsequent prolonged period of monocular deprivation. Control observations were made in normal cats (n = 3), cats reared with monocular deprivation from birth (n = 4), and cats monocularly deprived after being reared normally until 4 mo of age (n = 2). After rearing cats in total darkness, the majority of visual cortical cells were binocularly driven and the overall distribution of ocular dominance was not different from that of normal cats. Orientation-selective cells were very rare in dark-reared cats. Monocular deprivation imposed after dark rearing resulted in selective development of connections from the open eye. Most cells were responsive only to the open eye and the majority of these were orientation selective. These results were similar to, though less severe than, those found in cats reared with monocular deprivation from birth. Monocular deprivation imposed after 4 mo of normal rearing did not produce selective development of connections from the open eye in terms of either ocular dominance or orientation selectivity. In DR(1) cats visual cortical physiology was degraded in comparison to dark-reared cats after the rearing period. Most cells were binocularly driven but there was a higher frequency of unresponsive cells and a reduced frequency of orientation-selective cells. Subsequent monocular deprivation resulted in a further decrease in the number of binocularly driven cells and an increase in unresponsive cells. However, it did not produce a bias in favor of the open eye in terms of either ocular dominance or orientation selectivity. In DR(2) cats there was a high incidence of unresponsive cells and a marked loss of binocularly driven cells after the rearing period. Subsequent monocular deprivation failed to produce any significant changes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981231 TI - Primate frontal eye fields. I. Single neurons discharging before saccades. AB - We studied the activity of single neurons in the frontal eye fields of awake macaque monkeys trained to perform several oculomotor tasks. Fifty-four percent of neurons discharged before visually guided saccades. Three different types of presaccadic activity were observed: visual, movement, and anticipatory. Visual activity occurred in response to visual stimuli whether or not the monkey made saccades. Movement activity preceded purposive saccades, even those made without visual targets. Anticipatory activity preceded even the cue to make a saccade if the monkey could reliably predict what saccade he had to make. These three different activities were found in different presaccadic cells in different proportions. Forty percent of presaccadic cells had visual activity (visual cells) but no movement activity. For about half of the visual cells the response was enhanced if the monkey made saccades to the receptive-field stimulus, but there was no discharge before similar saccades made without visual targets. Twenty percent of presaccadic neurons discharged as briskly before purposive saccades made without a visual target as they did before visually guided saccades, and had weak or absent visual responses. These cells were defined as movement cells. Movement cells discharged much less or not at all before saccades made spontaneously without a task requirement or an overt visual target. The remaining presaccadic neurons (40%) had both visual and movement activity (visuomovement cells). They discharged most briskly before visually guided eye movements, but also discharged before purposive eye movements made in darkness and responded to visual stimuli in the absence of saccades. There was a continuum of visuomovement cells, from cells in which visual activity predominated to cells in which movement activity predominated. This continuum suggests that although visual cells are quite distinct from movement cells, the division of cell types into three classes may be only a heuristic means of describing the processing flow from visual input to eye-movement output. Twenty percent of visuomovement and movement cells, but fewer than 2% of visual cells, had anticipatory activity. Only one cell had anticipatory activity as its sole response. When the saccade was delayed relative to the target onset, visual cells responded to the target appearance, movement cells discharged before the saccade, and visuomovement cells discharged in different ways during the delay, usually with some discharge following the target and an increase in rate immediately before the saccade. Presaccadic neurons of all types were actively suppressed following a saccade into their response fields.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981233 TI - Simple and B-cells in cat striate cortex. Complementarity of responses to moving light and dark bars. AB - This report is based on the quantitatively recorded responses of 72 striate cells in the simple (S and SH) and B-cell (B and BH) families to narrow (0.14 degrees) moving light and dark bars. Cells were regarded as hypercomplex (SH and BH) if the end-zone inhibition reduced the response to 50% of its peak value. The contrast of the bars was relatively low and matched to be equal but opposite for the two kinds of bar. Average response histograms to the two kinds of bar were recorded separately and only subsequently combined. The response histogram from a given S- or SH-cell shows separate response peaks to the light and dark bars. The number of peaks varies from two to five in different cells. Cells with two response peaks were encountered most commonly (54%), and rather less common were cells with three (31%), four (7.5%), and five (7.5%) peaks. By defining the sequence of the response peaks according to the direction preferred by a moving light bar, the number of distinct spatial patterns of responses to the moving bars increases from four to eight since the first response in the sequence can be either to a light bar or to a dark bar. Examples of all eight responses have been recorded. For cells in the simple family with two response peaks, as well as for B-cells, the width of the light-bar peak was the same as, or closely similar to, that of the dark-bar peak. For S- and SH-cells with more than two response peaks this was also true for the two principal peaks, namely the largest and the next largest immediately adjacent peak. In the simple family, the mean widths of the two principal response peaks remained closely similar despite the progressive decrease in their respective widths as the number of peaks in the pattern increased from two to five. The mean width of the two principal response peaks from S- and SH-cells (0.6 degrees) was significantly less than the mean width for B-cells (1.4 degrees). For simple-family cells the spatial overlap between the two principal peaks (mean 14%) was always less than 50% of the overall width of the two peaks, whereas for B-cells the overlap (mean 79%) was always greater than 50%. For cells in both the simple and B-cell families the length of the receptive field as given by a moving light bar is the same as that given by a moving dark bar.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981232 TI - White noise analysis of cable properties of neuroblastoma cells and lamprey central neurons. AB - The integrative properties of two kinds of excitable cells, a cultured neuroblastoma cell and the lamprey giant interneuron, are described using a white noise impedance method. The impedance functions were fitted with a neuron model consisting of an isopotential soma plus a single equivalent dendritic process, which contained up to 16 equal elements. The frequency-domain characteristics of both the passive and active conductances were used to estimate the dendritic-to soma areas, the electrotonic length of an equivalent dendrite, the membrane time constant, and the relaxation time constants associated with the voltage-dependent conductances. The effect of differing degrees of synaptic input was simulated by localizing the synaptically activated conductances to the soma, a point at the end of the dendrite, or the entire dendritic membrane. PMID- 3981234 TI - An electrophysiological and anatomical study of projections to the mouse cortical barrelfield and its surroundings. AB - This study establishes a cortical map of the somatosensory periphery of the mouse head, with emphasis on the whisker pad. Data in the literature on the projection of the common hair follicles are confusing, notably the question whether or not this projection is separated from or overlaps with that of the facial vibrissae, the barrelfield. Microelectrode recordings in the barrelfield and its immediate surroundings upon natural stimulation of the periphery were followed by microlesions and histological reconstruction. Results show that the barrelfield consists of two parts: an anterior part where vibrissal follicles and the skin bearing them are represented, and a posterior part receiving only vibrissa inputs. The skin between these latter vibrissae is represented outside the barrelfield. We conclude that the partially dissociated cortical representation of skin and vibrissae may allow large vibrissae to be used in tasks requiring greater acuity than the shorter ones provide. This hypothesis is supported by the observation that, owing to special muscles, large vibrissae are more mobile than short ones. We also propose that the segregation of inputs from vibrissae and common fur is related to the number of nerve fibers serving one follicle, and we indicate an experimental model to test this possibility. PMID- 3981235 TI - Responses of neurons in the cat's superior colliculus to acoustic stimuli. I. Monaural and binaural response properties. AB - Using extracellular electrodes we studied acoustic responses in the superior colliculus (SC) of the barbiturate-anesthetized cat. Pure tonal stimuli were delivered through sealed and calibrated earphones and were presented either monaurally or binaurally with interaural intensity differences (IIDs) and interaural time differences (ITDs). Acoustically sensitive cells were found in the intermediate and deep layers of the SC throughout its rostrocaudal and mediolateral extent. Most cells (80%) discharged only at stimulus onset; the rest had more complex firing patterns. For 88% of our sample the mean first-spike latency measured at 20 dB above threshold ranged between 6 and 16 ms. The sharpness and threshold intensity of the frequency tuning curves varied widely. In the SC, the average characteristic frequency and threshold intensity were higher than in other auditory brain stem nuclei. Neurons whose characteristic frequency was low were never sharply tuned. The probability of response decreased when the repetition rate at which the stimuli were delivered increased. The mean stimulus interval at which spike count reached 50% of maximum was 360 ms. Most (83%) of the cells discharged only to monaural stimulation of the contralateral ear, 7% responded to tones applied to either ear and only 1% to only ipsilateral input. The remaining cells responded only to stimulation of both ears. With binaural stimuli, most neurons (80%) could be shown to receive input from both ears. Seventy percent of the binaural cells showed predominant binaural inhibition (BI), 25% binaural facilitation (BF), and 5% a more complex mixture. Because the majority of SC neurons had high characteristic frequencies, we examined their responses to IIDs. The spike count vs. IID functions of BI cells were monotonic and sigmoidal, those of BF cells were nonmonotonic and bell shaped. The slopes and horizontal positions of the curves varied among neurons. IIDs favoring the contralateral ear were the most effective. For a given cell, increasing the mean binaural level extended the range of IIDs that evoked maximal discharge. A small number of cells was sensitive to physiologically significant interaural time differences of low-frequency tones or the envelopes of amplitude modulated, high-frequency tones. PMID- 3981236 TI - Responses of neurons in the cat's superior colliculus to acoustic stimuli. II. A model of interaural intensity sensitivity. AB - Most neurons in the deep and intermediate layers of the superior colliculus (SC) that respond to acoustic stimuli are sensitive to interaural intensity disparities (IIDs). We examine a model for the generation of sensitivity to IIDs that depends upon temporal coincidence of the inputs from each ear at a given binaural neuron. Because the neural response latency decreases with increasing stimulus intensity, IIDs affect the relative timing of arrival of the inputs. If this model were true, the neurons sensitive to IIDs should also respond to interaural time differences (ITDs) of isointensive stimuli, provided that the magnitude of the delays reflect the neural latency-intensity relationship. For both major classes of binaural cells in the SC, namely those that exhibit binaural inhibition (BI) and binaural facilitation (BF), our results support the model in that the detection of IIDs is largely due to their sensitivity to the temporal overlap of inputs from each ear. The shapes of the IID and ITD functions for each class are similar. The summation of inputs includes inhibitory as well as facilitatory interactions. Estimates of the durations of the subliminal excitatory events in BF cells using the model indicate that they are relatively short (1-4 ms), whereas the durations of the inhibitory processes in BI cells are much longer. The model specifies a common neuronal mechanism for comparison of interaural disparities of time and intensity and does not separate the processing of IIDs and ITDs, as the classic duplex theory suggests. The model provides a physiological explanation for certain features of the psychophysical phenomenon of time-intensity trading. It is also consistent with recent experiments that have shown that the auditory system is sensitive to behaviorally significant ITDs of high-frequency complex signals. The model applies only to the processing of transient stimuli and does not address neural sensitivity to IIDs of continuous high-frequency tones. PMID- 3981237 TI - Axonal branching patterns and funicular trajectories of raphespinal sympathoinhibitory neurons. AB - We studied axonal branching patterns and funicular trajectories of cat medullary raphespinal neurons with spontaneous activity related to inferior cardiac postganglionic sympathetic nerve discharge (as demonstrated with spike-triggered averaging). These neurons were excited by raising carotid sinus pressure. We have classified these neurons as sympathoinhibitory in function and refer to them here as RS neurons. Microstimulation of the second thoracic spinal segment (T2) antidromically activated RS neurons (as determined with time-controlled collision of spontaneous and evoked action potentials). The longest-latency antidromic responses were elicited with the lowest-threshold current from sites in the intermediolateral nucleus (IML). This observation suggests that RS neurons innervated IML. Most RS neurons activated from T2 were also antidromically activated by stimulation of a more caudal thoracic spinal segment (T6 or T12). Time-controlled collision of action potentials evoked by stimulation at two thoracic levels allowed us to distinguish activation of an axonal branch in T2 from that of the main axon coursing through T2 to the more caudal thoracic level. Of those RS axons that branched in T2, 78% descended at least as far caudal as T6, whereas 65% reached T12. The axonal projections of other RS neurons that innervated T2 were restricted to no more than two consecutive thoracic spinal segments (as determined by stimulation in T3). Antidromic mapping of T2 further revealed that the axons of RS neurons coursed through the dorsolateral, ventral, or ventrolateral funiculus to innervate the ipsilateral and/or contralateral IML. The conduction velocities of dorsolateral and ventral RS axons indicated that they were finely myelinated. The data demonstrate the existence of RS neurons with restricted and widespread axonal branching patterns, thereby supporting the view that the medullary raphe complex is capable of regional as well as global inhibitory control over spinal sympathetic outflow. PMID- 3981238 TI - Raphe magnus inhibition of feline T1-T4 spinoreticular tract cell responses to visceral and somatic inputs. AB - Background activity of spinoreticular tract neurons in the T1-T4 segments was on average inhibited 80% by electrical stimulation of nucleus raphe magnus. Nucleus raphe magnus stimulation inhibited responses of spinoreticular tract neurons to somatic input produced by touching the skin and hair (innocuous stimulus) or pinching the skin and muscle (noxious stimulus). Inhibition of responses to noxious and innocuous somatic inputs was not significantly different. Inhibition produced during nucleus raphe magnus stimulation was less effective when the activity of spinoreticular tract cells increased. This relationship was consistent for both background activity and responses to somatic noxious or innocuous input. Nucleus raphe magnus stimulation inhibited responses of spinoreticular tract neurons to visceral input produced by electrical stimulation of cardiopulmonary sympathetic afferent fibers. Responses to C-fiber sympathetic afferent fibers were more effectively inhibited than were responses to A-delta sympathetic afferent fibers. In conclusion, stimulation of the nucleus raphe magnus inhibits T1-T4 spinoreticular tract neuronal responses to visceral and somatic inputs. Since spinoreticular neurons project to the medullary reticular formation, activation of the nucleus raphe magnus could modulate affective motivational behavior and cardiovascular adjustments that often occur during angina pectoris. PMID- 3981239 TI - Tonotopic organization in lateral part of posterior group of thalamic nuclei in the cat. AB - Responses of single units and clusters of units to tone-burst stimulation were recorded at 100-micron intervals along vertical electrode penetrations through the lateral part of the posterior group of thalamic nuclei (Po) in five barbiturate-anesthetized cats. Best frequencies and minimum response latencies to tone-burst stimulation were studied at each location along a penetration. Most of Po is located rostral to the medial geniculate body (MGB) and is contiguous with the ventral nucleus and medial division. Po is characterized physiologically by narrowly tuned, short-latency (less than 40 ms) responses. Considerable scatter of best frequencies occurs along electrode penetrations, although a clear tonotopic organization is apparent in the distribution of best frequencies obtained from several electrode penetrations located in the same frontal plane of an individual brain. A "single" frequency is represented as an irregularly shaped lamina. A three-dimensional "block" model of the tonotopic organization of Po is described in which the highest best frequencies are located caudally, and the lowest best frequencies are located rostrally within the nucleus. The high frequency representation of Po is contiguous with the high-frequency representation of the ventral nucleus of the MGB. The low- and middle-frequency representations of the ventral nucleus and Po are discontinuous. The ventral nucleus and Po have similar physiological properties and together constitute the tonotopic division of the auditory thalamus in the cat. Neurons in the medial division adjacent to the medial border of Po are larger than neurons in Po, lack tonotopic organization, and respond at short latencies. PMID- 3981240 TI - The acquisition and expression of a peptidergic phenotype in the grasshopper embryo. AB - We have examined the developmental acquisition and regional expression of the neurotransmitter proctolin in neurons of the grasshopper embryo, using both assay and immunocytochemistry. There are four stages in the acquisition and accumulation of proctolin in the embryo. The first stage (50 to 60% embryogenesis) consists of a slow accumulation of proctolin prior to the onset of central nervous system (CNS) staining. During the second stage proctolin levels increase at a 5-fold faster rate. During this stage, which ends at 70% of development, a stable pattern of staining is established in the ganglia. The third stage (70 to 95% embryogenesis) consists of a rapid accumulation of peripheral proctolin levels that occurs principally in motor endings, without a significant increase in the CNS. This stage also correlates with the onset of peripheral staining. During the fourth stage, over the final 5% of embryogenesis, there is a 20% loss of proctolin in the periphery. We have attempted to relate these changes to developmental events occurring in identified clusters of neurons, by examining the development of neuromuscular connections made by embryonic terminal ganglion motoneurons to the intrinsic muscles of the hindgut. Of the 30 hindgut motoneurons, only six anterior medial (AM) efferents are proctolin immunoreactive in the embryo. Their axons establish a dense proctolin staining arborization over the intrinsic muscles. The peptide accumulates in the endings as staining appears in the terminal ganglion. Hindgut proctolin levels increase substantially and then decline in a manner similar to that found for total peripheral proctolin. By the end of embryogenesis the endings will release proctolin, in a calcium-dependent manner, when depolarized. The six proctolin staining AM neurons constitute a simple model system for studying the determination and expression of neurotransmitters in identified embryonic cells. PMID- 3981241 TI - Evidence of functional mossy fiber sprouting in hippocampal formation of kainic acid-treated rats. AB - In the rat hippocampal formation, degeneration of CA4-derived afferent fibers provokes the growth of mossy fiber collaterals into the fascia dentata. These aberrant fibers subsequently form granule cell-granule cell synapses. The hippocampal slice preparation was employed to determine whether these recurrent connections are electrophysiologically functional. Hippocampal slices were prepared 12 to 21 days after the bilateral destruction of CA4 neurons with either intracerebroventricular or intravenous kainic acid (KA). In slices from control rats, antidromic stimulation of the mossy fibers elicited a single population spike in the granular layer of the fascia dentata. In contrast, when slices from some KA-treated rats were similarly tested, antidromic stimulation elicited multiple population spikes. This effect was not reproduced by blocking inhibitory transmission with bicuculline methiodide. Slices from other KA-treated rats fired a single population spike, but an antidromic conditioning volley increased the amplitude of a subsequent antidromic population spike by 5 to 15%. In slices from control rats, on the other hand, an antidromic conditioning volley always either decreased or failed to alter the amplitude of an antidromic test response. Superfusion with Ca2+-free medium containing 3.8 mM Mg2+ reversibly abolished all effects of KA administration. Abnormal responses to antidromic stimulation correlated with the loss of CA4 neurons and the growth of supragranular mossy fiber collaterals in the same animals. These results suggest that supragranular mossy fiber collateral sprouts form a functional recurrent excitatory circuit. These aberrant connections may further compromise hippocampal function already disrupted by neuronal degeneration, such as by facilitating seizure activity. PMID- 3981242 TI - Studies of the earliest generated cells of the cat's visual cortex: cogeneration of subplate and marginal zones. AB - The earliest generated cells of the cat's telencephalon that may play a role in the formation of the primary visual cortex are the subject of this study. Using [3H]thymidine autoradiography, we have found that these cells are generated between embryonic day 24 (E24) and E30 (gestation is 65 days) and that they are present in very low numbers in the white matter of the adult brain. These cells are rarely labeled by injections made after E30, when the cells destined for the cortical layers are generated. Examination of the labeling pattern in the fetal brain 10 days or more after administration of [3H]thymidine between E24 and E30 revealed a bistratified distribution of these early generated cells. Labeled cells were found in large numbers in two embryonic zones flanking the developing cortical plate: above in the marginal zone and below in the subplate. (Some if not all of the marginal zone cells constitute the population of Cajal-Retzius cells of the cat's telencephalon.). These experiments indicate that cells of the subplate and marginal zones are cogenerated in time during the days just preceding the genesis of the cortical plate. We also examined the distribution of the early generated cells shortly after their genesis--on E30, a time when cells of the cortical plate are just being generated at the ventricular zone. In this case, the labeling pattern at the occipital pole was not bistratified. Rather, labeled cells were situated within a single zone extending from the pial surface inward to the border of the ventricular zone. This finding indicates that the cells of the subplate and marginal zones are generated as a contiguous population that is subsequently split apart by the insertion of cells forming the cortical plate. A comparison between the number of early generated cells found in fetal and newborn brains with that found in adult brains suggests that these cells are generated initially in substantial numbers but then largely disappear during early postnatal life, since injections of [3H]thymidine between E24 and E30 yielded large numbers of labeled cells in the white matter and layer 1 at birth, but very few at 2 months postnatal. This significant loss contrasted with the results from injections made just a few days later (E33) that resulted in large numbers of labeled cells in cortical layer 6 not only at birth but also in adulthood.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981243 TI - Characterization of muscarinic cholinergic receptors in the brains of copper deficient rats. AB - In order to assess a possible role for copper as a regulator of muscarinic receptors in vitro, the receptor was characterized in rats made copper deficient by a dietary regimen. In forebrain regions there was a decrease in both the affinity of the receptors for [3H]-1-quinuclidinyl benzilate and the density of receptors in the copper-deficient animals compared with control animals. Copper treatment in vitro of homogenates from deficient animals did not reverse the in vivo effects on antagonist binding but, rather, decreased receptor occupancy and ligand affinity in a manner similar to copper treatment of control homogenates. Minimally deficient rats displayed very similar changes in receptor properties compared with the more severely deficient animals. Minimal copper deficiency produced robust effects on the binding of agonists, increasing ID50 and derived dissociation constants. The addition of copper to the assay medium caused an apparent reversal of the in vivo effect of copper deficiency on agonist binding, decreasing ID50 and derived dissociation constants to values near those observed with homogenates from normal animals in the presence of copper. Since copper deficiency has dramatic effects on both receptor number and the binding of agonists to muscarinic receptors in the central nervous system, it is suggested that copper, because of its ability to form complexes with some proteins, may have an endogenous role in the regulation of the receptor. PMID- 3981244 TI - Antibody against nerve growth factor-inducible large external (NILE) glycoprotein labels nerve fiber tracts in the developing rat nervous system. AB - The NILE (nerve growth factor-inducible large external) glycoprotein is a 230,000 dalton molecule found on the surface of PC12 cells. Immunologically cross reactive glycoproteins in the molecular weight range of 215,000 to 230,000 have been found on many types of neurons in culture. Using immunohistochemical methods, we have shown that NILE-related glycoproteins are present in neuronal fiber tracts of the developing rat brain. Antibody against the NILE glycoprotein specifically labels processes that appear identical to those recognized by antibodies against the neurofilament triplet of proteins. These processes are clearly distinct from the radial glial fibers recognized by antibody against the intermediate filament protein vimentin. NILE glycoprotein is not distributed uniformly over the entire neuronal surface but is concentrated on neurites and is much less abundant on cell bodies. NILE-positive fiber tracts are first seen in the spinal cord and rhombencephalon on embryonic day 11 and over the next 2 days appear in the mesencephalon and diencephalon. Staining in the telencephalon is not seen until embryonic day 15. The appearance of NILE immunoreactivity in these various regions closely parallels the appearance of neurofilament polypeptides, suggesting that NILE-related glycoproteins are present during the early phases of fiber tract formation. This idea is supported by the finding that the NILE glycoprotein can be found postnatally in parts of the nervous-system such as the cerebellar cortex and olfactory bulb which undergo major histogenesis during the postnatal period. In the cerebellum the appearance of NILE immunoreactivity in the two major fiber zones, the molecular layer and the white matter, parallels the development of the fiber structure of these layers. These findings support tissue culture studies which suggest a role for the NILE glycoprotein in mediating nerve fiber fasciculation. PMID- 3981245 TI - Opioid pathways in an avian retina. I. The content, biosynthesis, and release of Met5-enkephalin. AB - By means of an enzyme-linked immunosorbent assay, the concentration of enkephalin immunoreactive substances was estimated to be about 25 nM in the chicken retina. The biosynthesis of 3H-Met5-enkephalin in this retina was studied by a pulse chase incubation technique. Isolated retinas were incubated with 0.2 ml of oxygenated Ringer's solution containing 40 microCi of [3H]methionine and trasylol, a peptidase inhibitor, for 30 min at room temperature. The tissue was then rinsed three times in large volumes of Ringer's solution and incubated in the same solution containing unlabeled methionine (100 micrograms/ml) and trasylol for at least another hour. The products synthesized were extracted in acetic acid and assayed by high performance liquid chromatography (HPLC) and immunoassay. A peak of radioactivity that comigrated with Met5-enkephalin on HPLC and cross-reacted with antibodies against enkephalins was detected. The level of 3H-Met5-enkephalin radioactivity increased approximately 10-fold as the chase incubation period increased from 0 to 120 min, suggesting that, as in other tissues, Met5-enkephalin may be synthesized as part of a larger precursor. The newly synthesized Met5-enkephalin could be released by depolarization of the retina with high extracellular K+ concentration. Furthermore, this K+-stimulated release was greatly suppressed by 5 mM Co2+ in the medium, suggesting that this release is Ca2+-dependent and may be synaptically mediated. PMID- 3981246 TI - Opioid pathways in an avian retina. II. Synaptic organization of enkephalin immunoreactive amacrine cells. AB - Peroxidase-antiperoxidase immunocytochemistry was utilized to investigate the synaptic organization of enkephalin-like immunoreactive amacrine (Enk-amacrine) cells in the chicken retina. An initial light microscopic analysis revealed that immunostained cell bodies were situated in either the second or third tier of cells from the border of the inner nuclear and inner plexiform layers. The processes of such cells extended into the inner plexiform layer where they ramified as a fine plexus in sublaminae 1 and 3 to 5. At the ultrastructural level, enkephalin-positive somas exhibited a rather dense and evenly distributed peroxidase reaction product throughout their cytoplasm. Furthermore, the nucleus of Enk-amacrine cells was characterized by a round, unindented nuclear membrane. Immunoreactive processes of such cells were found to receive synaptic input from unstained amacrine and bipolar cells. Immunolabeled varicosities formed conventional synaptic contacts onto other vesicle-filled, nonimmunoreactive profiles tentatively suggested to originate from amacrine cells. Bipolar cell terminals did not receive synaptic input from stained varicosities of enkephalin immunoreactive amacrine cells. Moreover, each of the above synaptic relationships were identified in each of sublaminae 1, and 3 to 5 of the inner plexiform layer. In addition, labeled varicosities of Enk-amacrine cells synapsed upon unstained processes which lacked synaptic vesicles and possibly arise from ganglion cells. Enkephalin-positive processes were also observed to synapse upon the vitreal pole of unstained somas situated in the innermost cell row of the inner nuclear layer. Lastly, large immunoreactive varicosities of Enk-amacrine cells were often characterized by the presence of large dense-core vesicles in addition to typical, small agranular synaptic vesicles. PMID- 3981247 TI - Metabolic alterations in rat somatosensory cortex following unilateral vibrissal removal. AB - Local cerebral metabolic rates for glucose were studied by [14C]-2-deoxyglucose autoradiography in adult rats following acute and chronic unilateral deafferentation, with particular attention to the barrel field regions of the primary somatosensory cortex. Deafferentation was produced by permanently removing all of the large whiskers (vibrissae) on one side of the face. Data from experimental animals were then compared to data from sham-operated controls at 1, 5, 10, 15, 30, and 60 days after deafferentation. The rate of glucose utilization was maximally depressed at day 1 in the deafferented barrel field. After that, there was a progressive recovery of glucose utilization toward control levels at each subsequent time point. In contrast, glucose utilization in the barrel field associated with the intact set of whiskers increased by day 5 and remained elevated throughout the duration of the experiment. Similar patterns of altered cerebral metabolism were observed following unilateral infraorbital nerve transection. These results demonstrate that interference with normal somatosensory input causes a transient decrease in glucose metabolism of the contralateral cortical barrel-field and, in addition, causes long-term increments in glucose metabolism in the ipsilateral cortical barrel field--a structure not normally influenced by acute manipulation. PMID- 3981248 TI - Cooperative firing activity in simultaneously recorded populations of neurons: detection and measurement. AB - Recent advances in techniques for chronic recording from multiple extracellular microelectrodes allow simultaneous observation of firings of substantial populations of neurons. We describe a new conceptual representation of cooperative behavior within the observed neuronal population. This representation leads to a new technique for detecting and studying functional neuronal assemblies that are characterized by temporally related firing patterns. The representation may be applied to both dynamic and long-term aspects of cooperativity. The basic idea is to map activity of neurons into motions of particles in a multidimensional Euclidean space. Each neuron is represented by a point particle located in this space. In the simplest version of the mapping, each nerve impulse results in an increment in a "charge" associated with that particle; between firings the charges decay. The force exerted by any such particle on any other is, by analogy with some physical forces, proportional to the product of their charges and may depend on the Euclidean distance separating them. The force on a particle directly affects its velocity rather than its acceleration, as with actual particles in a viscous medium. These forces result in aggregation of those particles that correspond to neurons tending to fire together; separate clusters represent independent cooperative groups. Modification of the charges and forces permits inclusion of inhibitory interactions. Identification, measurement, and display of the resulting clusters can be performed with any of a number of algorithms. We illustrate the application of this approach to populations of computer-simulated neurons having both direct and indirect excitatory coupling. PMID- 3981249 TI - The mapping of visual space onto foveal striate cortex in the macaque monkey. AB - Visuotopic maps of foveal striate cortex have been obtained by means of single cell recordings from four hemispheres in two awake, behaving macaque monkeys. The numbers of successful separate striate penetration sites in the four hemispheres were 42, 58, 81, and 61, for a total of 242. The resolution of the maps is 10 min of visual angle, nearly an order of magnitude finer than previous maps. No striate receptive field center was found more than 5 min into the ipsilateral visual field. The four maps were sufficiently compatible with one another that they could be combined into one. There are only minor magnification differences between the right and left hemispheres and between the upper and lower quadrants. There is a vertical/horizontal magnification anisotropy of about 1.5:1 in central foveal cortex (0 to 20 min). The composite map can be approximated by the complex logarithmic equation, w = 7.7 * ln (x + iy + 0.33), where w is expressed in millimeters and x and y are expressed in degrees. PMID- 3981250 TI - Accessory abducens nucleus and conditioned eye retraction/nictitating membrane extension in rabbit. AB - The role of accessory abducens nucleus neurons in the conditioned eye retraction/nictitating membrane extension response was defined in the rabbit. Horseradish peroxidase injections into the retractor bulbi muscle showed that accessory abducens nucleus is the principal location of its motor-neurons. Single and multiple unit recording in accessory abducens indicated that these motor neurons show a marked responsiveness to corneal and periorbital stimulation and fire in close correlation with conditioned, unconditioned, or spontaneous eye retraction/nictitating membrane extension. Complete lesions of accessory abducens showed, at most, a partial reduction of the conditioned and unconditioned eye retraction response. Section of the extraocular muscles, other than retractor bulbi, also caused a partial reduction of the eye retraction response. Accessory abducens lesions, combined with extraocular muscle section, were necessary to dramatically reduce the eye retraction response permanently. These experiments demonstrated that accessory abducens is a primary controller of eye retraction through its axons to retractor bulbi. The other extraocular muscles act in concert with retractor bulbi to elicit conditioned and unconditioned eye retractions. PMID- 3981251 TI - Recovery of acetylcholinesterase at intact neuromuscular junctions after in vivo inactivation with di-isopropylfluorophosphate. AB - Recovery of acetylcholinesterase (AChE) at endplates of mouse sternomastoid muscle was studied after inactivation with di-isopropylfluorophosphate in vivo. A short incubation with alpha-bungarotoxin was used to prevent muscle necrosis which usually occurs after esterase inactivation. Under these conditions there was no delay in AChE recovery, unlike what we had previously seen in necrotic muscle. However, even in non-necrotic muscle, the overall recovery of AChE at the postjunctional membrane was very slow, with a half-life of about 20 days. The fact that, at adult neuromuscular junctions, both esterases and receptors turn over about 10 times slower than they do in embryonic muscle suggests a similar regulation of these two molecules by the nerve. PMID- 3981253 TI - Differences in the developmental patterns of three microtubule-associated proteins in the rat cerebellum. AB - The developmental distribution patterns of microtubule-associated proteins (MAPs) 1, 2, and 3 were studied using three monoclonal antibodies. Immunochemical staining at the light and electron microscopic levels demonstrated the specific localization of each MAP in different cellular and subcellular compartments. MAP2, which is specifically associated with dendritic microtubules in the adult brain, is strictly associated with growing dendrites from the onset of their formation. MAP3, a recently described MAP of Mr = 180,000, which in the adult brain is associated with neurofilament-rich axons and glial processes, is associated with axons from the beginning of outgrowth. Although MAP3 is not detectable in granule cells and their parallel fiber axons in the mature cerebellum, it does appear transitorily in these axons during development. During neuronal differentiation, MAP1 is found first in axons and only later in dendrites where the highest concentrations are eventually to be found. These results indicate that the combined appearance of MAP1 and MAP2 (dendrites) or MAP1 and MAP3 (axons) correlates with the appearance of morphologically distinct microtubules and provide further evidence that specific MAPs are molecular determinants of dendritic and axonal formation. PMID- 3981252 TI - The neural circuit for touch sensitivity in Caenorhabditis elegans. AB - The neural pathways for touch-induced movement in Caenorhabditis elegans contain six touch receptors, five pairs of interneurons, and 69 motor neurons. The synaptic relationships among these cells have been deduced from reconstructions from serial section electron micrographs, and the roles of the cells were assessed by examining the behavior of animals after selective killing of precursors of the cells by laser microsurgery. This analysis revealed that there are two pathways for touch-mediated movement for anterior touch (through the AVD and AVB interneurons) and a single pathway for posterior touch (via the PVC interneurons). The anterior touch circuitry changes in two ways as the animal matures. First, there is the formation of a neural network of touch cells as the three anterior touch cells become coupled by gap junctions. Second, there is the addition of the AVB pathway to the pre-existing AVD pathway. The touch cells also synapse onto many cells that are probably not involved in the generation of movement. Such synapses suggest that stimulation of these receptors may modify a number of behaviors. PMID- 3981254 TI - The distribution of a peptide neurotransmitter in the postembryonic grasshopper central nervous system. AB - Proctolin is a peptide neurotransmitter, discovered in the visceral muscles of the cockroach. The peptide has recently been identified in the nervous systems of many invertebrates. Using reverse phase high pressure liquid chromatography together with a sensitive bioassay, we analyzed the distribution of proctolin in the central nervous system of the grasshopper Schistocerca nitens. We also used immunocytochemistry to identify about 70 diverse proctolin-staining neurons in the postembryonic ventral nerve cord. Proctolin immunoreactivity is rare, being found in only about 0.6% of the ganglionic neurons. Among the cells we stained for proctolin were thoracic skeletal motoneurons, a cluster of efferents to the intrinsic muscles of the hindgut, and both inter- and intraganglionic thoracic interneurons, as well as several interspecies homologues to proctolin-staining neurons in the cockroach. The map of proctolin expression within the central nervous system is not extensively altered during postembryonic life. It is the product of embryonic development, which is the subject of the following paper (Keshishian, H., and M. O'Shea (1985) J. Neurosci. 5: 1005-1015). PMID- 3981255 TI - Rapid clearance of iodine-131 MIBG from the heart and liver of patients with adrenergic dysfunction and pheochromocytoma. AB - Iodine-131 MIBG, a radiolabeled adrenergic neuron-blocking agent, decreased rapidly from the heart and liver of patients with adrenergic dysfunction (n = 3) and pheochromocytoma (n = 2) when compared with eight controls. The 4-hr activity expressed as percentages (mean +/- s.d.) of the 20-min counts were as follows: 80 +/- 3.0% in the controls compared with 60 +/- 7.6% in the patients over the heart (p less than 0.01) and 79 +/- 3.2% in the controls compared with 51 +/- 17% in the patients over the liver (p less than 0.02). However, there was no significant difference in the rate of [131I]MIBG decrease in these organs between controls and patients in the intervals subsequent to 4 hr (p greater than 0.05). These findings suggest that adrenergic neuronal uptake of [131I]MIBG in these organs is smaller in the patients than in the controls. Measurements of time-activity relationships of radioiodinated MIBG may be useful for assessment of adrenergic function of these organs and thus of generalized disorders of adrenergic innervation. PMID- 3981256 TI - Disparate hepatic imaging with technetium-99m sulfur colloid and disofenin in Wilson's disease. AB - A 10-yr-old boy presented with fulminant hepatic failure. Technetium-99m sulfur colloid images showed absent reticuloendothelial function in the liver. A [99mTc] disofenin hepatobiliary scan visualized liver parenchyma and biliary excretion. Disparate appearance of the liver may be seen in other hepatic diseases, but should be remembered as a possible pattern in Wilson's disease. PMID- 3981257 TI - Technetium-99m DADS complexes as renal function and imaging agents: II. Biological comparison with iodine-131 hippuran. AB - To find a 99mTc agent with a high renal extraction efficiency similar to [131]hippuran, 21 analogs of DADS were labeled and evaluated. Preliminary screening by serial gamma camera imaging in rabbits showed that most analogs had a higher liver uptake and/or slower renal clearance, than hippuran. Three agents (P-DADS, AP-DADS, and CAP-DADS), exhibiting a relatively rapid blood clearance and lower liver uptake in the rabbit, were studied in greater detail in comparison with hippuran and CO2-DADS-A, the best analog to date. In the rat, the plasma clearance of the four DADS analogs was slower than that of hippuran. In rats with tubular damage induced by cisplatin, the difference in renal retention at 1 hr compared to controls was much greater with hippuran than with the DADS compounds. In the dog, there was marked hepatic retention of the four DADS compounds. In volunteers, serial posterior images obtained with these [99mTc]DADS complexes showed significant hepatic as well as renal activity. The 1-hr plasma clearance and urinary excretion were much lower than with simultaneously injected hippuran. Although these 99mTc agents are satisfactory for imaging the kidneys, they closely mimic the biodistribution of hippuran only in the rabbit, and not in the rat, dog, or man. PMID- 3981258 TI - Parallax error in pinhole thyroid scintigraphy: a critical consideration in the evaluation of substernal goiters. AB - Parallax error is found to be another pitfall in pinhole thyroid scintigraphy, i.e., a substernal goiter may appear between the thyroid cartilage marker and the suprasternal notch marker. Unless one is aware of this pitfall, a substernal extension of the thyroid may not be realized or be seriously underestimated in its size and extent. We illustrated the parallax error using a thyroid phantom. An illustrative case is shown. PMID- 3981259 TI - Practicality of National Electrical Manufacturers Association performance specification measurements for user-based acceptance testing and routine quality assurance. PMID- 3981260 TI - Dietary protein effects on lipoproteins and on sex and thyroid hormones in blood of rhesus monkeys. AB - We studied plasma lipoprotein and hormone concentrations in rhesus monkeys that had consumed either a low protein (3.8% of kilocalories) or a control protein (13.9%) purified diet since birth (6-10 yr before the beginning of this experiment) in order to test the hypothesis that chronic protein deficiency could influence plasma lipoproteins through an effect on the hepatic metabolism of gonadal or thyroid hormones. Protein-deficient monkeys had greater plasma concentrations of very low density lipoproteins (VLDL) plus high density lipoproteins (HDL) than controls. They also had lower serum albumin and greater alkaline phosphatase levels than the controls. Plasma thyroxine (T4) and free T4 concentrations were lower and the triiodothyronine (T3) levels tended to be greater in the protein-deficient group than in controls. This effect was apparent at two widely different levels of dietary iodide. Plasma T3 concentrations were elevated in other adult rhesus monkeys that were fed the low protein diet for only 6 wk. Monkeys injected with estradiol benzoate (100 micrograms/kg body weight) for 4 d had a marked reduction of VLDL concentrations. VLDL triglycerides were depressed more and plasma estrone levels were greater in deficient monkeys than in controls at 24 h after the last injection. In the control monkeys the T3 level rose and T4/T3 fell in response to estrogen injections, whereas the deficient monkeys did not respond. PMID- 3981262 TI - Cholesterol transport in mesenteric lymph of the preruminant calf: contribution of cholesterol transposition from blood to lymph. AB - Eight preruminant male calves were prepared surgically with lymphatico-venous shunts and re-entrant gallbladder to proximal duodenum shunts. Liquid diets were formulated to contain 12.5% dried skim milk (SM) or 10.5% SM to which was added 2% soybean oil (SBO), milk fat (MF) or beef tallow (T). Two calves were assigned to each dietary treatment. Transposition of cholesterol from blood capillaries to intestinal lymph was determined by injection of 100 microCi [4-14C]-cholesterol into the blood of calves at feeding time. To avoid recirculation of [4-14C] cholesterol via the enterohepatic circulation, bile was diverted and replaced with bile from a donor calf fed an identical diet. For the SM, SBO, MF and T diets, respectively, cholesterol transposed from capillaries was 44, 61, 36 and 48% of the cholesterol transported in the mesenteric lymph. When cholesterol synthesis in response to test diets was calculated, we found that intestinal cholesterol synthesis is less when calves are fed SM or SBO than when fed T or MF. PMID- 3981261 TI - Quantitation of fat and cholesterol transport in the mesenteric lymph and bile of the preruminant calf. AB - Nine preruminant male calves were prepared surgically with lymphatico-venous shunts and/or re-entrant gallbladder to proximal duodenum shunts to evaluate the effects of degree of saturation of dietary fat on cholesterol transport in intestinal lymph and bile. Liquid diets were formulated to contain 12.5% dried skim milk (SM) or 10.5% SM to which 2% soybean oil (SBO), milk fat (MF), beef tallow (T) or one of these fats plus supplemental cholesterol was added. After 3 d dietary treatments, total lymph collections were made to determine flow rate, total lipid and cholesterol transport. Total bile collections were made to determine flow rate and cholesterol and bile acid transport. For SM, SBO, MF and T diets, respectively, average lipid transport in mesenteric lymph was 8.94, 32.58, 64.86 and 38.12 mg/(h X kg body weight), and cholesterol transport averaged 1.09, 1.92, 2.41 and 2.70 mg/(h X kg body weight). Lipid and cholesterol transport in lymph was less (P less than 0.05) in SM-fed calves than in fat-fed calves. Source of fat or supplemental cholesterol had no statistically significant effect on amount of cholesterol or bile acid transported in bile; however, calves fed SM transported greater quantities of cholesterol in bile than did calves fed fat or fat plus cholesterol. PMID- 3981263 TI - In vivo intestinal absorption of selenate and selenite by rats. AB - Intestinal absorption of selenate and selenite was investigated in rats by using an in vivo perfusion technique. Different segments of the intestine were perfused with an isotonic solution containing different concentrations of SeO42- or SeO32 . The site of greatest SeO42- absorption was found to be the ileum followed in descending order by the proximal jejunum and large intestine (cecum and colon). Furthermore, SeO42- was absorbed significantly faster from the ileum than SeO32-. The concentration dependence of SeO42- absorption indicates that SeO42- is absorbed by a saturable transport mechanism of the ileal mucosa. Absorption of SeO42- at a concentration of 0.01 mM was not affected by the presence of 1 mM SeO42- in the perfusate. When the SeO42- concentration of the perfusate was increased to 1 mM, the absorptive functions of the ileal epithelium appeared to be generally impaired. It is concluded that selenate is absorbed from the ileum by a carrier-mediated mechanism. PMID- 3981264 TI - Manganese deficiency: effects on susceptibility to ethanol toxicity in rats. AB - Previous studies have shown that manganese (Mn) deficiency in rats results in reduced activity of manganese superoxide dismutase (MnSOD) and increased levels of mitochondrial lipid peroxidation. These findings suggested to us that the Mn deficient rat may be especially susceptible to the toxic effects of ethanol, as the metabolism of this compound results in production of superoxide anion. Offspring from Mn-sufficient and Mn-deficient adult rats were given either 20% (wt/vol) ethanol or distilled-deionized water as their drinking fluid for 14 d. Response to ethanol feeding was different between Mn-sufficient and deficient rats as evidenced by severe reductions in caloric intake and body weight observed in the Mn-deficient rats. Furthermore, after 14 d of ethanol feeding, these rats were extremely lethargic and in poor physical condition. Although Mn-sufficient rats responded similarly to the deficient rats during the first 6 d of ethanol feeding, they increased their caloric intake and body weight during the remainder of the experimental period. MnSOD activity in the ethanol-fed Mn-sufficient and Mn-deficient rats was similar, thus the alcohol-induced toxicity observed in the deficient rats was not due to reduced MnSOD activity. Iron-induced lipid peroxidation may be one of the mechanisms leading to the toxicity observed, as ethanol feeding resulted in liver Fe levels that were 30% higher than those in Mn deficient rats that were not fed ethanol. PMID- 3981265 TI - Effects of vitamin E deficiency on the distribution of cholesterol in plasma lipoproteins and the activity of cholesterol 7 alpha-hydroxylase in rabbit liver. AB - Vitamin E-deficient rabbits with signs of muscular dystrophy showed accumulation of cholesterol in muscle as well as elevation of plasma cholesterol. The increase in plasma cholesterol was detected in low density lipoprotein (LDL) and very low density lipoprotein (VLDL) but not in high density lipoprotein (HDL) fractions of plasma lipoproteins. In liver, the activity of cholesterol 7 alpha-hydroxylase, the key enzyme involved in degradation of cholesterol, was approximately one fifth that of control rabbits. Cytochrome P-450 level of liver microsomes was also reduced significantly. These results suggested that accumulation of cholesterol observed in dystrophic muscle of vitamin E-deficient rabbits may be due to an increase in LDL and VLDL cholesterol, the plasma lipoproteins carrying cholesterol to peripheral tissue, and to a decrease in cholesterol 7 alpha hydroxylase activity, whose activity may have been affected by the reduced level of cytochrome P-450. PMID- 3981266 TI - Effect of copper deficiency on the apolipoprotein E-rich high density lipoproteins in rats. AB - Twenty-four male weanling Sprague-Dawley rats were randomly divided into two treatments, namely a copper-adequate (8 mg Cu/kg diet) or a copper-deficient (0.85 mg Cu/kg diet) group. Feed and distilled-demineralized water were provided ad libitum. After 7 wk, plasma high density lipoproteins (HDL) were isolated by ultracentrifugation and agarose column chromatography. A heparin-Sepharose affinity column chromatographic method was used to subfractionate HDL into apolipoprotein E (apoE) -rich and apoE-poor subfractions. Significantly higher protein and cholesterol contents of HDL and the second retained (RII) subfraction (apoE-rich) were observed in copper-deficient than in control rats. The apoE contents of HDL and the apoE-rich (RII) subfraction were about threefold higher in copper-deficient rats. The increase in apoE in the HDL fraction was due primarily to the increased apoE concentration of the RII subfraction. In addition to a higher apoE concentration, apolipoprotein A-I concentration was also higher in the RII subfraction of the copper-deficient rats as compared to controls. However, the percentage of these apolipoproteins remained unaltered by copper deficiency. The present data suggest that the hypercholesterolemia observed in copper deficiency was associated with marked increases in cholesterol and apolipoprotein contents of the apoE-rich HDL. PMID- 3981267 TI - Whole-body protein turnover in chicks at early stages of growth. AB - Changes in whole-body protein turnover rate in young chicks were measured during very early stages of chicken growth. Day-old single comb White Leghorn male chicks were fed an adequate purified diet. Whole-body protein turnover was determined weekly for 4 wk. Fractional rates of protein synthesis (percent/day) in the whole body decreased from 1 to 4 wk of age while those of degradation remained unchanged. When expressed in terms of body weight per se, no significant change in absolute protein turnover rate (grams/day) was found during the experimental period; however, when expressed in terms of metabolizable body weight (kilograms 0.75), turnover rates increased slightly. Thus, during the first 4 wk of life no decrease in the whole-body protein turnover rate was found in chickens on the basis of units or metabolic body size. Twenty to 28% of the total heat production was accounted for by the energy expenditure due to whole body protein synthesis. PMID- 3981269 TI - Zinc deficiency, reduced food intake and essential fatty acids. PMID- 3981270 TI - Procedure to measure blood flow for the hind limb of steers. PMID- 3981268 TI - Urinary lumichrome-level catabolites of riboflavin are due to microbial and photochemical events and not rat tissue enzymatic cleavage of the ribityl chain. AB - The occurrence of 7- and 8-carboxylumichromes as a significant fraction of riboflavin-derived material in rat urine has led to a reexamination of tissues for possible enzymatic activity that could contribute to cleavage at position 10 of the D-ribityl chain of the vitamin. For this, homogenates were incubated in the dark under various conditions with pure [2-14C]riboflavin with and without cofactors prior to extractions with phenol for flavins or chloroform for lumichromes, and high pressure liquid chromatography was used to separate and to quantitate all radioactive compounds. Only unmodified riboflavin and small amounts of flavin mononucleotide (FMN) were found even though the level of detection of known derivatives including 10-(2'-hydroxyethyl)flavin and lumichrome was shown to be extremely sensitive. Hence, rat tissue per se does not appear responsible for significant cleavage of the D-ribityl chain of riboflavin. Rather such cleavage to the lumichrome level must result from the known actions of intestinal microflora and potentially from photolysis. PMID- 3981271 TI - Metabolic role of urea cycle intermediates: nutritional and clinical aspects. Introduction. PMID- 3981272 TI - Metabolic aberrations associated with arginine deficiency. AB - The significance of dietary arginine deficiency is often unrecognized since growth and nitrogen balance are generally positive. However, inadequate intakes of dietary arginine are typically associated with dramatic alterations in intermediary metabolism in mammals. Most of the symptoms that develop following arginine deprivation can largely be accounted for by a decreased efficiency of ammonia detoxification. However, species differences in the metabolic aberrations associated with arginine deficiency are clearly evident. Therefore, selected animals fed an arginine-deficient diet may serve as a useful model for the study of chronic hyperammonemia. In rats, mice, hamsters, guinea pigs and rabbits, the excretion of citric and orotic acid is a sensitive indicator of arginine availability. Increased orotic acid production is reduced or prevented by inclusion of the urea cycle intermediates arginine, citrulline or ornithine. However, growth in the rat is stimulated only when arginine or citrulline are included in the diet. Increased orotic biosynthesis is observed with increasing ammonia concentrations in rat, mouse and human liver and is reduced by in vitro arginine supplementation. The fatty infiltration of the rat fed an arginine deficient diet is associated with changes in the ratio of purine to pyrimidine bases and is corrected by the dietary addition of adenine. The arginine-deficient rat should serve as a model for examining the dynamic interrelationship of the urea cycle with pyrimidine and purine biosynthesis. PMID- 3981275 TI - Major causes of sickness absence in a steel industry in Nigeria. PMID- 3981274 TI - Preplacement examination of temporary hospital workers. AB - One hundred ninety-nine temporary hospital employees were given preplacement medical examinations during the New York City hospital strike in 1984. Major findings pertain to susceptibility to communicable disease and to drug abuse. Sixty-three percent of individuals examined were found to be inadequately immunized against diphtheria and tetanus, 41% to be susceptible to rubella, and 12.6% to be tuberculin skin test positive. Three percent had positive urine toxicologies for either cocaine, heroin, or phencyclidine and were subsequently denied employment. Thirteen percent had potentially significant physical findings. One individual was denied employment pending treatment; two individuals with seizure disorders were placed in noncritical areas. Forty-one percent of individuals examined smoked and were eligible for smoking cessation programs. PMID- 3981273 TI - Nutritional and metabolic responses to arginine deficiency in carnivores. AB - The metabolic basis for the high dietary arginine requirement of the cat appears to be primarily the low activity of the enzyme pyrroline-5-carboxylate synthase (P5C synthase) in the intestinal mucosa. P5C synthase is required for de novo production of glutamyl-gamma-semialdehyde, the immediate precursor for the synthesis of ornithine from glutamate. The next enzyme in ornithine synthesis, ornithine amino-transferase, in the cat intestinal mucosa shows low activity, which provides an additional barrier to ornithine and citrulline formation. It is suggested that the low activities of these enzymes corroborate other evidence that indicates that the cat evolved as a strict carnivore. The dog has a requirement for arginine intermediate between the cat and the rat, which is consistent with the dog having an omnivorous diet during its evolution. It is suggested that during periods of fasting, depletion of urea cycle intermediates in the cat results in some conservation of nitrogen while maintaining urea cycle enzymes at a relatively high level. However, after ingestion of animal protein (and arginine) the urea cycle of cats is capable of rapidly responding to the ammonia load, which rises from the deamination of amino acids. By this method of regulation the cat can respond rapidly to short-term fluctuations in protein intake. PMID- 3981276 TI - Mental health and work stress in office workers in Hong Kong. AB - Mental health and work stress among 653 office workers in Hong Kong were studied using Goldberg's 12-item general health questionnaire (GHQ), with slight modification, and McLean's self-assessment scheme in a self-administered questionnaire. It was found that more respondents reported symptoms in the six negative than in the six positive GHQ items. The proportions reporting problems in McLean's areas of coping, context, and stressors were 20.9%, 47.7%, and 14.8%, respectively. Females reported more problems in both context and coping than did males, but no difference was found between them for stressors. Multiple regression analysis revealed a strong association (r = .63) between mental ill health and McLean's three factors, with coping the most important factor for females, context the most important for males, and stressors the least important for both sexes in predicting mental ill health. PMID- 3981277 TI - A computer-administered neurobehavioral evaluation system for occupational and environmental epidemiology. Rationale, methodology, and pilot study results. AB - To facilitate the conduct of epidemiologic studies of populations at risk for or suffering from central nervous system (CNS) dysfunction due to environmental agents, a computer-administered neurobehavioral evaluation system has been developed. The system includes a set of testing programs designed to run on a microcomputer and questionnaires to facilitate interpretation of results. Standard tasks evaluating memory, psychomotor function, verbal ability, visuospatial ability, and mood were selected and adapted for computer presentation following the recommendation of an expert committee of the World Health Organization and the National Institute for Occupational Safety and Health. In two pilot surveys, test performance was found to be influenced by age, education level, and socioeconomic status in ways consistent with prior research findings. Performance on tests of short-term memory and reaction time was negatively correlated with intensity of organic solvent exposure among industrial painters. In view of the ease of administration and data handling, high subject acceptability, and sensitivity to the effects of known neurotoxic agents, computer-based assessment of CNS function holds promise for future epidemiologic research. PMID- 3981278 TI - Effects of an SCBA on breathing pattern, gas exchange, and heart rate during exercise. AB - The effects of a pressure demand-type self-contained breathing apparatus (SCBA) (total weight, 15.5 kg) on breathing pattern, gas exchange, and heart rate were studied in 13 firemen. The subjects performed sequential progressive exercise tests on a treadmill both without and with an SCBA. The use of an SCBA consistently limited tidal volume. During submaximal exercise oxygen consumption and heart rate increased remarkably more with the SCBA than without it. Four subjects reached their maximal heart rate with the SCBA. Their mean ventilation rate was 68% and oxygen consumption was 83% of the maximal values attained without the SCBA. The shoulder harness of the heavy SCBA prevented free motion of the thorax, affecting the regulation of breathing, and thus seriously disturbed ventilation and gas exchange, particularly at heavier exercise levels. PMID- 3981279 TI - Cardiovascular risk factors in employees of a petrochemical company. PMID- 3981280 TI - Analysis of visual modulation sensitivity. II. Peripheral retina and the role of photoreceptor dimensions. AB - Temporal-frequency characteristics were measured as a function of retinal location, with test-field size scaled to provide equivalent sensitivity at each eccentricity. The results showed that the temporal-frequency limits increased uniformly by about a factor of 2 between the fovea and 45 degrees eccentricity, corresponding to a decrease in the response-time constant from 70 to 35 msec. These data were compared with the change in inner- and outer-segment diameters of the cones across the same retinal range. The data conform to the hypothesis that visual time constant varies inversely with cone outer-segment diameter. A second hypothesis that visual sensitivity increases in proportion to come outer-segment length in the central fovea was also supported. PMID- 3981281 TI - Discrimination of crossed and uncrossed disparities. AB - Tanner's theory of recognition [J. Acoust. Soc. Am. 28, 882 (1956)] was applied to the discrimination of retinal disparity stimuli for both diplopic and fused images. The results for diplopic stereopsis suggest a two-channel model with separate encoding of crossed and uncrossed disparities, similar to the model proposed by Richards [Exp. Brain Res. 10, 308 (1970)]. For fused images the results were consistent with a multichannel model with overlapping disparity sensitivities. PMID- 3981282 TI - Discrimination of luminance increments and decrements. AB - Discrimination of pulsed increments from decrements improves relative to detection when the adaptation level is decreased or stimulus duration is increased. Using Tanner's theory of recognition [J. Acoust. Soc. Am. 28, 882 (1956)], we show that the subject's internal decision variables corresponding to the increment and decrement stimuli also show increased statistical independence as adaptation is decreased or stimulus duration increases. We infer from this result that at high adaptation levels detection is based predominantly on information in one channel, whereas at low adaptation levels there is information from two channels. Similarly, for long durations, we infer two independent channels, which contribute little information about the sign of the stimulus at short durations. PMID- 3981283 TI - Detection of light and flicker at low luminance levels in the human peripheral visual system. II. A mechanistic model. AB - A model describing the processing of quantal effects at low luminance levels is evaluated with respect to generally known experimental results for the temporal domain. The model consists of two sequential stages: a square-root scaler and a simple integrate-to-threshold detector. It is shown that with this model the experimental behavior of the absolute light threshold in relation to the flash duration and to the interval for periodic stimuli can be correctly described. When the detection mechanism is changed to a mechanism that detects a fixed minimum number of changes per time unit, the model can describe experimental data obtained at low luminance levels on the increment and decrement thresholds, the modulation transfer function, and the flicker experiments with varying light-dark ratio. From the data fitting it is concluded that in the near-peripheral visual field, adaptation processes have typical time constants of the order of 100 msec, whereas in the far periphery these processes have typical time constants ranging from 50 to 5000 msec, depending on stimulus size. The sampling time of the visual system for the above mentioned stimuli lies between 350 and 1500 msec. PMID- 3981284 TI - Comment on "Line-separation discrimination curve in the human fovea: smooth or segmented"? AB - In a recent publication, Westheimer concluded that the foveal line-separation discrimination function was smooth [J. Opt. Soc. Am. A 1, 683-684 (1984)]. However, when the Westheimer data are replotted in the Weber-fraction (delta s/s) form, segments in the discrimination function similar to those previously described by Hirsch and Hylton [J. Opt. Soc. AM. 72, 1367-1374 (1984)] can be observed. PMID- 3981285 TI - Continence-preserving operations in the management of ulcerative colitis. PMID- 3981286 TI - Turner syndrome: clinical investigations and review. PMID- 3981287 TI - Results of a nutrition information study among family practitioners in Oklahoma County. PMID- 3981288 TI - Nutrition for the practitioner VI. Current concepts in nutrition: vitamin K. PMID- 3981289 TI - Topographical variations in the morphology and biochemistry of adult canine tibial plateau articular cartilage. AB - Topographically, there are both morphological and biochemical differences in the articular cartilage of the tibial plateau of normal adult dogs when the cartilage covered by the meniscus is compared with that more centrally placed and not covered by meniscus. Histologically, differences are present in the surface morphology, in intra- and extracellular lipid content, and in the morphology of the mineralization front. Electron microscopy shows, in the covered cartilage, variability in collagen fiber size, with evenly spaced fibers apparently randomly distributed and an orderly relationship between the proteoglycans and collagen, whereas in the uncovered area, the collagen is aggregated into bundles and appears to be dissociated in large part from the proteoglycans. The most striking feature in the biochemistry of the two regions is an increased water content in the uncovered cartilage, as compared with the covered. In addition, there is an increased amount of proteoglycans that can be extracted in the uncovered cartilage. The heterogeneity of the cartilage on the tibial plateau should be taken into account when considering both the histologic and biochemical variations found in osteoarthritic cartilage; and when reflecting on the pathogenesis of osteoarthritis. PMID- 3981290 TI - Determination of callus quantity in 4-week-old fractures of the rat tibia. AB - In clinical practice the quantity of fracture callus is usually estimated on the basis of radiographs. In experimental studies on fracture healing, more exact chemical measurements (total protein, DNA, and mineral contents) have been used to quantitate the amount of callus. It is not known, however, how these two parameters correlate with each other. In this study we used different (radiographic, histomorphometric, and chemical) methods to evaluate the quantity of fracture callus in 4-week-old tibial fractures of rats stabilized by intramedullary nailing. The wet and dry weights and the nitrogen, collagen, calcium, phosphorus, and DNA contents of the calluses showed no correlation with the radiographic size of the calluses. There was a strong correlation (p less than 0.001), however, between radiographic and histomorphometric callus sizes. The mass of callus and the chemically defined parameters of callus production thus indicate different properties of the healing bone. PMID- 3981291 TI - Reliability after repeated use of a torque screwdriver employed for halo pin fixation. AB - It has been recommended that halo torque screwdrivers be used only once. To determine if this advice is justified on biomechanical grounds, five commercially available torque screwdrivers were cycled 1,600 times each in an Instron testing machine over a 7-day period. The screwdrivers displayed an initial error from the dial reading at both 6 and 10 in-lb of only +/- 0.3 in-lb. After cyclic loading and retesting, the percent deviation from original calibration was 8% at both 6 and 10 in-lb. These data demonstrate the accuracy and dependability of the torque screwdrivers and imply that repeated use of these devices should be safe. PMID- 3981292 TI - The organization of collagen in cryofractured rabbit articular cartilage: a scanning electron microscopic study. AB - Adult rabbit articular cartilage was prepared for scanning electron microscopy using, in order, glutaraldehyde fixation, enzymatic removal of proteoglycan, dehydration in ethanol, cryofracture in liquid nitrogen, and critical-point drying. Enzymes were effective in fixed material. Fixation, cryofracture, alignment of fracture surfaces with "split lines," and retention of subchondral bone were found to be necessary steps for the preservation of collagen detail. The fibrous framework was found to be similar to that proposed by Benninghoff and favored by more recent phase-contrast microscopic studies. Vertical fibers extending from subchondral bone and a network of tangentially oriented superficial fibrils converge in the transitional zone. No random layer is seen. Pericellular capsules interdigitate with the vertical fibers. When cartilage is prepared in a manner that minimizes tissue damage, scanning electron microscopy provides useful, unique information. PMID- 3981293 TI - Induction of heat-shock protein synthesis in chondrocytes at physiological temperatures. AB - Induction of heat-shock protein (HSP) synthesis is demonstrated in cultured calf chondrocytes at temperatures shown to occur in normal human cartilage during experiments subjecting intact cadaverous hip joints to the parameters of level walking. A 70,000 MW heat-shock protein (HSP-70) is synthesized by chondrocytes at temperatures above 39 degrees C, while induction of synthesis of a 110,000 MW HSP only occurs at temperatures of 45 degrees C or greater. These differences in critical temperatures for induction, and data showing differences in kinetics of induction and repression of synthesis, suggest that there are differences in the mechanism of induction of the two HSPs. The duration of HSP synthesis and inhibition of synthesis of normal cellular proteins is directly proportional to the duration and magnitude of the temperature rise. Possible relationships between these new findings and the initiation and progression of degenerative joint disease are discussed. PMID- 3981294 TI - Cell culture of rabbit meniscal fibrochondrocytes: proliferative and synthetic response to growth factors and ascorbate. AB - This study was undertaken to determine whether the cells of the fibrocartilaginous meniscal substance are capable of proliferation and matrix synthesis. Cells were isolated from the fibrocartilaginous menisci of young New Zealand white rabbits, and grown in two alternative culture regimens differing only in the basal nutrient medium used to initiate primary monolayer growth. Under each culture regimen, the cells attached and proliferated both initially and after passage into secondary (2 degrees) culture. Differences were noted in cell morphology and time to reach confluence in primary (1 degrees) culture. Upon passage into 2 degrees culture, the fibrochondrocytes assumed two distinct morphologies depending upon the type of medium used for 1 degree culture. These morphological changes were accompanied by differences in the population doubling time and incorporation of 35SO4 into sulfated proteoglycans. The proliferation of both fibrochondrocyte subtypes was stimulated by the addition of either pituitary fibroblast growth factor (FGF) or human platelet lysate in a dose-dependent manner. Both FGF (10 ng/ml) and ascorbate (40 micrograms/ml) decreased 35-sulfate incorporation, whereas only ascorbate was found to alter the amount of sulfated glycosaminoglycan in the pericellular coat. We conclude that the fibrochondrocytes of the meniscal substance are capable of replication and synthesis of matrix macromolecules if given the proper stimuli. Additionally, there may be two subpopulations of fibrochondrocytes that can be distinguished by their in vitro behavior. PMID- 3981295 TI - Finger joint contact areas and pressures. AB - Although the joints of the index finger are similar geometrically and kinematically, the occurrence of degenerative joint disease is more frequent and severe in the distal interphalangeal joint. Much circumstantial evidence exists to suggest a mechanical cause for the observed differences in frequency. This article presents the results of in vitro experiments designed to determine contact areas and average pressures in the joints of the human index finger for positions simulating tip pinch and power grasp. The results show that the highest average contact pressures do, in fact, occur in the distal interphalangeal joint. Average joint contact pressure correlates well with clinically observed patterns of frequency of degeneration and degenerative joint disease score. This correlation between clinical experience and experimental results indicates that mechanical stress is among the factors responsible for the initiation and/or propagation of degenerative joint disease in the joints of the finger. PMID- 3981296 TI - Kinematic behavior of the human wrist joint: a roentgen-stereophotogrammetric analysis. AB - Using a roentgen-stereophotogrammetric measurement system, the three-dimensional kinematic characteristics of each carpal bone in two human wrist joints were obtained as the hands were moved in vitro through dorsopalmar flexion and through radioulnar deviation, both in the supinated and pronated positions of the hand. The results were described in terms of Euler rotation angles and showed that in flexion, the distal carpal bones may be considered as one fixed group while the proximal carpals may not. For the deviation motion, quite different rotational excursions for the carpal bones were observed, therefore, none of the two rows may be assumed acting as rigid groups. In both of the hand motions performed, all carpal bones moved synchronously and uniformly. These results demonstrate that accurate measurements of three-dimensional carpal-bone motions are feasible by using an adequately refined roentgen-stereophotogrammetric system. The detailed and precise kinematic information obtained can serve as a database for future developments of functional wrist-joint models, and will provide more insight into carpal-bone behavior, useful in clinical diagnosis and surgical reconstruction procedures. PMID- 3981297 TI - Antibodies to synovial-derived cells in patients undergoing artificial prosthesis implants. AB - In this preliminary study, the authors have found cytotoxic complement-dependent synovial antibodies in the serum of patients undergoing prosthesis implantation; these were particularly evident in those patients undergoing revision surgery. In order to demonstrate the synovial antibodies, it was necessary that the authors modify the method they had previously used in their studies of cytotoxic lung and kidney antibodies. While conventional trypsinization dispersion produced synovial target cells that would not react in the test system, mechanical dispersion successfully produced target cells sensitive to complement-dependent cytotoxic antibodies. In this study, synovial antibodies reacted similarly to cells derived from the synovium of different individuals, but they did not react to cells derived from tissues other than synovium. This tissue specificity was confirmed by absorption studies that indicated the synovial antibodies to be organ specific. Whether these cytotoxic synovial antibodies can be predictive of the impending loss of an artificial prosthesis, or somehow be directly involved in the failure mechanism of that prosthesis, will require additional studies. PMID- 3981298 TI - A cumulative damage model for bone fracture. AB - A mathematical model is presented to describe the combined time-dependent and cycle-dependent fracture characteristics of devitalized cortical bone. Failure is interpreted based on a linear-life fraction rule, which accounts for cumulative creep and fatigue damage under arbitrary loading histories. The model is successful in describing the influence of loading rate on monotonic tensile strength, the time to failure in constant stress creep-fracture tests, and bone fracture in zero-tension and tension-compression cyclic loading. The possible implications of the model to in vivo bone fracture, deformity, and remodelling in response to various loading histories are considered. PMID- 3981299 TI - Chemotherapy-induced alterations in the biomechanics of rat bone. AB - The effects of methotrexate and doxorubicin (Adriamycin) on intact and fractured bone were studied in a rat model. Methotrexate, 0.1 mg/kg i.p., was administered five times a week, or doxorubicin, 1 mg/kg i.v., was given once a week. Animals were killed and evaluated at 4, 8, 12, and 16 weeks after surgical production of a unilateral femoral osteotomy and initiation of the chemotherapeutic program. Both intact and fractured bones were tested to failure in rapid torsion, and the torque, angular deformation, stiffness, and energy were measured. There was a significant alteration in the strength of the healing osteotomies in doxorubicin- and methotrexate-treated animals compared with the control group. The torsional strength of intact bone was not significantly altered by either drug protocol over the period of this observation. PMID- 3981300 TI - Effects of short-term cyclosporin-A on biomechanical properties of intact and fractured bone in the rat. AB - Cyclosporin-A is a new immunosuppressant drug being used widely for solid organ transplantation. The systemic effects of Cyclosporin-A on the skeletal system have not previously been defined. This study examined the effects of Cyclosporin A on biomechanical properties of intact bone and fracture repair in a rat model. Closed midshaft femoral fractures were produced over a preplaced intramedullary pin. Cyclosporin-A, dissolved in olive oil and administered by gavage, was begun the day following surgery and continued for 14 consecutive days at a dose known to prolong solid organ allograft survival in rats (7 mg/kg/day), and a second group of control animals received comparable volumes of plain olive oil under identical circumstances. Groups of both experimental and control animals were killed at 4, 8, 12, or 16 weeks following fracture, after which both intact and fractured femurs were tested to failure in torsion. As judged by torque, angular deformation, stiffness, and energy absorption, Cyclosporin-A did not significantly alter the biomechanical properties of fracture repair or intact bone turnover. Based on current biomechanical data, we can find no reason to discourage the short-term clinical use of Cyclosporin-A in patients with or without fractures. Histomorphometric studies are required to accurately assess the biologic effects of this drug on bone biology and to complete the analysis of skeletal toxicity. PMID- 3981301 TI - Cocaine recovery support groups and the language of recovery. AB - The authors have attempted to make clear that recovery is a lifelong process. In its early phases, clients are working primarily to achieve relief from guilt and pain created by their addiction. As recovery progresses, however, there is a movement from a relief mentality to a true experience of delight (Enright 1980). The goals of treatment have been achieved when this shift is evident: when one is living comfortably, responsibly and joyfully without cocaine or other drugs. The authors' experience indicates that treating cocaine addicts in cocaine-specific groups is useful in that the homogeneity facilitates group identification and the educational component of treatment. However, the content of the groups and nature of the recovery process are not drug specific or unique. The emergence of C.A., which is based on the same 12 steps as A.A., also illustrates this. What is being treated is addictive disease, not alcoholism or cocaine addiction. Regardless of the chemical, the essentials of treatment are the same: The language of recovery is universal. PMID- 3981302 TI - Tradition, cultural patterns and drug availability as predictors of youthful drug abuse: a comparison of Malaysia with post-revolutionary Iran. PMID- 3981303 TI - Family interaction and acculturation in Mexican-American inhalant users. PMID- 3981304 TI - M. Ageyev's Novel with Cocaine: Russian fiction or snow job? PMID- 3981305 TI - Ketamine use in a burn center: hallucinogen or debridement facilitator? PMID- 3981306 TI - Psychoactive properties of amantadine. PMID- 3981307 TI - Home pneumograms in normal infants. AB - To obtain age-specific normative data, we performed home cardiorespiratory recordings (pneumograms) in 56 normal infants at 1 month of age. A repeat pneumogram was performed at 3 months in 39 infants. Total sleep time was determined and all sleep intervals were summed and analyzed for five respiratory pattern variables: frequency of all apneic episodes greater than or equal to 6 seconds in duration (A6/D%), periodic breathing, longest apneic episode, and number of episodes greater than 11 and greater than 15 seconds. The normal infants at 1 and at 3 months were compared with 66 patients with apnea of infancy. Median A6/D% was 0.1 in the normal infants at 1 and 3 months, compared with 0.64 in those with apnea of infancy (P less than 0.001). Median periodic breathing was 0.4 and 0.2 episodes per 100 minutes in the normal infants at 1 and 3 months, respectively, compared with 1.25 in infants with apnea of infancy (P less than 0.001). Median longest apneic episode was 8.0 seconds in the normal infants at 1 and 3 months, compared with 11 seconds in those with apnea of infancy (P less than 0.001). No normal infant had an apneic episode greater than 15 seconds in duration, whereas the group with apnea of infancy had 0.4 +/- 1.0 episodes of apnea of greater than 15 seconds (P less than 0.01). Despite these significant group differences, use of these respiratory patterns either alone or in combination permitted only about 80% correct classification of normal infants and those with apnea of infancy. PMID- 3981308 TI - Exercise conditioning in children with asthma. AB - A controlled study of 20 children with asthma who participated in a 4-month running program (30 min/day, 3 days/wk), using inhalation of a beta-2 stimulant prior to each running session to prevent exercise-induced asthma, showed significant increases in work tolerance (120.5 +/- 45.0 W before, 131.5 +/- 43.5 W after, P = 0.002) and cardiopulmonary fitness (peak oxygen consumption 37.6 +/- 8.6 ml/kg/min before, 43.1 +/- 10.5 ml/kg/min after, P less than 0.001). Asthma severity judged by daily asthma diary scores and twice daily peak flows did not change. Thirteen control patients with asthma did not exercise and demonstrated no change in work tolerance, fitness, or severity of asthma. Thus, children with asthma can safely engage in a running program and can increase work tolerance and fitness without worsening their asthma. PMID- 3981309 TI - Acute hemorrhagic, hepatic, and neurologic manifestations in juvenile rheumatoid arthritis: possible relationship to drugs or infection. AB - Seven children with juvenile rheumatoid arthritis had a syndrome characterized by hemorrhage and neurologic, hepatic, hematologic, and metabolic manifestations. The disease did not seem to conform clearly to the characteristics of Reye syndrome or any other well-known entity. This severe complication may be induced by macrophage activation secondary to a drug or intercurrent infection. Our data suggest that a sudden fall in erythrocyte sedimentation rate or in platelet and fibrinogen levels may mark the start of this complication and may be an indication for rapid steroid therapy. PMID- 3981310 TI - Impaired granulocyte chemotaxis and increased circulating immune complexes in Kawasaki disease. AB - Our study was carried out to clarify the changes in granulocyte functions and circulating immune complexes in 32 children with Kawasaki disease. Patients were divided into two groups, those with or without coronary aneurysm. In the group with coronary aneurysm, impairment of both granulocyte chemotaxis and phagocytosis was found, together with higher circulating immune complexes and normal intracellular killing activity. In the group without coronary aneurysm, impaired phagocytosis was observed, with normal granulocyte chemotaxis, circulating immune complexes, and intracellular killing activity. No correlation was observed between granulocyte chemotaxis and circulating immune complexes. Impairment of granulocyte chemotaxis and circulating immune complexes may yield pertinent information as to the degree of severity of vasculitis in Kawasaki disease. PMID- 3981311 TI - Hepatitis B surface antigenemia in North American children with membranous glomerulonephropathy. Southwest Pediatric Nephrology Study Group. AB - We describe 11 North American children with hepatitis B-associated membranous glomerulonephropathy (MGN). The children are predominantly black boys (seven of 11) and younger (mean age 5.3 years) than children with idiopathic MGN (10.6 years) or lupus-associated MGN (13.4 years). Most of the patients (10 of 11) had nephrotic syndrome, and although clinical evidence of liver disease was present in only one child, eight of 10 patients had elevated aspartate amino transferase levels. Liver biopsies performed in three children revealed chronic persistent hepatitis in two and chronic active hepatitis in one. Hepatitis B surface antigen was found in the serum of one of the parents of five patients and in the brother of one patient. Low serum C3 values were observed in all 11 children at some stage of their illness. Renal biopsy specimens revealed stage II or III glomerular capillary wall changes, and immunofluorescence studies revealed three or more glomerular immunoreactants in 10 of 11 biopsies. One patient developed end-stage renal disease 9 years after presentation of nephrotic syndrome; the duration of follow-up of the other 10 patients is limited at this time. We conclude from these data that hepatitis B-associated MGN is more frequent in North American children than previous reports have suggested, is most commonly seen in young black boys, and is characterized by low serum C3 levels. It appears, therefore, to be a distinct clinicopathologic entity. PMID- 3981313 TI - Low-dose fibrinolytic therapy in infants. AB - We describe three pediatric patients in whom locally infused streptokinase at a dose of 50 U/kg/hr was used successfully to treat thrombosis in a major artery, a major vein, and a systemic-to-pulmonary arterial graft. Complications, including hemorrhage and distal embolization, were minimized by careful monitoring of the coagulation status of the blood and by avoiding rapid infusions. Selective thrombolytic therapy appears to be as effective in infants as in adults. Because the dose required is reduced, the incidence of complications is lower than with systemic infusions. PMID- 3981312 TI - Effect of growth hormone replacement on development of hypothyroidism and hyperlipidemia. AB - To determine the frequency with which hypothyroidism develops during human growth hormone therapy and to corroborate its onset with blood lipid changes, we measured growth rate, serum T4 and T3, and plasma cholesterol, triglyceride, and lipoprotein concentrations at 4-month intervals for a year in two subgroups of hGH-deficient children. The first group was initially euthyroxinemic (n = 16), and the second was TSH deficient and therefore already receiving thyroxine (n = 15). Basal plasma concentrations of total and low-density lipoprotein cholesterol and, to a lesser extent, plasma triglycerides were increased in both groups compared with an age-matched reference group. Basal plasma cholesterol levels were not statistically different in the euthyroxinemic and thyroxine-treated subgroups, and hGH treatment for a year did not lower lipid values in either subgroup. With hGH replacement, 25% of the euthyroxinemic patients experienced a slowdown in growth rate (3.2 +/- 0.7 cm/yr) associated with decreasing T4 (4.8 +/ 1.1 micrograms/dl) and increasing cholesterol concentrations (218 +/- 23 mg/dl); with thyroxine treatment, the growth rate improved (6.9 +/- 2.2 cm/yr), T4 increased (10.0 +/- 4.0 micrograms/dl), and cholesterol decreased (173 +/- 44 mg/dl, P less than 0.05). Although our results do not justify routine thyroid replacement, they do indicate that hypothyroxinemia and hypercholesterolemia may precede the growth slowdown during hGH treatment, and the need to monitor thyroid function at this time. PMID- 3981314 TI - Hemorrhagic shock and encephalopathy: further description of a new syndrome. AB - Abrupt onset of coma, seizures, severe shock, and hyperpyrexia occurred in two previously healthy children. Their illnesses closely resembled a clinical syndrome of uncertain cause, the hemorrhagic shock and encephalopathy syndrome. Our patients had striking similarities to as well as certain differences from reported patients. Based on the similarities, we believe our two cases represent additional occurrences of the syndrome. Based on the differences, we conclude that the syndrome should be labeled "shock and encephalopathy syndrome" and that the prognosis may be improved by early aggressive treatment of shock. PMID- 3981315 TI - Near-drowning: cold water on a hot topic? PMID- 3981316 TI - Cerebral resuscitation therapy in pediatric near-drowning. PMID- 3981317 TI - Tenosynovitis of the superior oblique muscle (Brown syndrome) associated with juvenile rheumatoid arthritis. PMID- 3981318 TI - Quick screening and diagnosis of organic acidemia by NMR urinalysis. PMID- 3981319 TI - Apnea associated with regurgitation in infants. AB - To determine whether regurgitation might be a factor in the pathogenesis of apnea in certain infants, we compared the frequency of short and prolonged apnea immediately following regurgitation to that during control periods. Ten infants (nine preterm and one term) with histories of frequent regurgitation and also apneic spells were studied for 2 to 3 hours by monitoring nasal airflow, abdominal respiratory movements, electrocardiogram, pharyngeal pH, and pharyngeal pressure. In six of these infants additional observations were made without the intrapharyngeal recording devices. Fourty-four episodes of regurgitation were observed. Both prolonged apnea (P less than 0.05) and short apnea (P less than 0.01) occurred much more frequently during regurgitation than during the control period; however, the majority of prolonged apneic spells observed were unassociated with regurgitation. The increased frequency of apnea during regurgitation was not related to the presence of intrapharyngeal recording devices. Although nasal regurgitation was frequently associated with short apnea, no prolonged apnea was observed during the seven episodes of nasal regurgitation observed. The 14-fold increase in prolonged apnea frequency immediately following regurgitation supports the hypothesis for a causal relationship between apnea and regurgitation. PMID- 3981320 TI - Nonsurgical management of obstructive aortic thrombosis complicated by renovascular hypertension in the neonate. AB - The use of umbilical artery catheters has become commonplace in the intensive care nursery and has facilitated management in the very ill newborn infant. Thrombotic complications associated with the use of such catheters may be as high as 30%. The successful, nonsurgical management of either complete or partial aortic thrombosis, associated with renovascular hypertension, is reported in three infants. Aggressive supportive medical management resulted in a satisfactory outcome in all three infants. PMID- 3981321 TI - Vitamin E status in preterm infants fed human milk or infant formula. AB - Vitamin E status was assessed in 36 infants with birth weights less than 1500 gm who were assigned randomly to receive one of three sources of nutrition: milk obtained from mothers of preterm infants (preterm milk), mature human milk, or infant formula. Infants in each dietary group were further assigned randomly to receive iron supplementation (2 mg/kg/day) beginning at 2 weeks or to receive no iron supplementation. All infants received a standard multivitamin, providing 4.1 mg alpha-tocopherol daily. Serum vitamin E concentrations at 6 weeks were significantly related both to type of milk (P less than 0.0001) and to iron supplementation (P less than 0.05). Infants fed preterm milk had significantly higher serum vitamin E levels than did infants fed mature human milk, and both groups had significantly higher levels than did those fed formula. Ratios of serum vitamin E/total lipid were also significantly greater for infants fed human milks than for those fed formula. The addition of iron to all three diets resulted in significantly lower serum vitamin E levels at 6 weeks (P less than 0.05); however, only in the group fed formula was there evidence of vitamin E deficiency. Preterm milk with routine multivitamin supplementation uniformly resulted in vitamin E sufficiency in VLBW infants whether or not iron was administered. PMID- 3981322 TI - Treatment of acute renal failure in an infant using continuous arteriovenous hemofiltration. PMID- 3981323 TI - Clinical pharmacology of netilmicin in preterm and term newborn infants. AB - Sixty-four neonates, with gestational age ranging from 27 1/2 to 40 weeks, postnatal age from 1 to 15 days, and birth weight from 800 to 3400 gm, were given netilmicin 2.5 mg/kg intramuscularly two or three times per day according to postnatal age, for 5 to 14 days. Serum concentrations were measured before and 1 hour after a dose at least twice during treatment. The serum washout profile of the drug was observed in 22 neonates after discontinuation of therapy. Renal function was studied in 37 infants by measuring serum creatinine concentrations and in 27 by urinary excretion of N-acetyl-glucosaminidase during and up to 15 days after therapy. Behavioral and impedance audiometry, and in infants failing those, auditory brainstem evoked response tests, were performed between 6 and 12 months of age. In 23.5% of the neonates, trough serum levels were greater than 3 micrograms/ml. The serum washout followed a multiexponential decay, accounting for distributional, rapid (initial), and slow (tissue) elimination phases. Linear regression analysis performed between each kinetic parameter and gestational age or birth weight showed that initial elimination half-life, steady-state volume of distribution, and total body clearance were significantly correlated with both variables. Netilmicin did not cause detectable renal or auditory damage. PMID- 3981324 TI - Response to frequent low doses of nebulized salbutamol in acute asthma. PMID- 3981325 TI - Effects of sucrose ingestion on the behavior of hyperactive boys. AB - A challenge design was used in two separate studies to investigate the effects of sucrose ingestion on the behavior and learning of hyperactive boys. In both studies, 16 boys were admitted to a clinical research center for 3 successive days, on each of which they were given a sucrose-free diet. On day 1, baseline levels on the learning tasks were established; on days 2 and 3 a challenge drink of either sucrose 1.75 gm/kg or a placebo (aspartame in equivalent sweetness) was presented, in a counterbalanced order. In the first study the challenge drink was administered 1 hour after lunch; in the second study it was given in the morning after an overnight fast. On days 2 and 3 of both studies, 37 behavioral (playroom observation and examiner ratings) and cognitive (learning and memory tasks) measures were collected, starting 1/2 hour after ingestion of the drink. The results of both studies revealed no differences between the boys' performance on the two challenge days. These findings undermine the hypothesis that sucrose plays a major role in accounting for the inappropriate behavior of hyperactive boys. PMID- 3981326 TI - School achievement and absence in children with chronic health conditions. AB - Families of 270 children with chronic health conditions observed in 11 subspecialty clinics at a tertiary care center were surveyed to assess the relation of demographic and health variables to school achievement and absenteeism. National achievement test scores and school days absent were compared with North Carolina state results. The mean days absent for children with chronic health conditions was 16 days, compared with the state average of less than 7 days, during the 1981-1982 academic year. The mean national achievement score for the chronically ill children was at the 51st percentile, compared with the 63rd percentile for the state's sixth graders. Log of school days absent was correlated with the number of clinic visits, physician rating of activity limitations, sex, and specific health conditions (R2 = 0.17, P = 0.001). National achievement scores were mainly related to socioeconomic factors and specific health conditions (R2 = 0.44, P = 0.001), but were unrelated to school absence. Children with spina bifida, sickle cell disease, or epilepsy, and children with the added burden of low socioeconomic status, were at particular risk for poor school achievement. PMID- 3981327 TI - Respiratory patterns during sleep and temperament ratings in normal infants. PMID- 3981328 TI - Neonatal pancytopenia after maternal azathioprine therapy. PMID- 3981329 TI - Thrombocytopenia of neonatal cold injury. PMID- 3981330 TI - Familial persistent pulmonary hypertension. PMID- 3981331 TI - Thrombocythemia and myelofibrosis. PMID- 3981332 TI - CRP and ZSR as indicators of bacteremia in pediatric patients. PMID- 3981333 TI - Rhinebothrium biorchidum n. sp., a tetraphyllidean cestode from a yellow-spotted stingray, Urolophus jamaicensis, in Jamaica. AB - Rhinebothrium biorchidum n. sp. (Tetraphyllidea: Phyllobothriidae) is described from the spiral valve of the yellow-spotted stingray, Urolophus jamaicensis, from Jamaica. It was most similar to R. spinicephalum Campbell 1970 but differed by having fewer proglottids (15 to 26 vs. 36 to 49), smaller peduncle (110 to 146 vs. 330 to 470) and pedicels (100 to 180 vs. 170 to 370), fewer transverse septa (6 to 8 vs. 16 to 17), fewer total loculi per bothridium (22 to 30 vs. 32 to 34) and larger ovarian lobes (148 to 310 vs. 88 to 176). A key to bitestate species of Rhinebothrium is included. PMID- 3981334 TI - Life cycle and postembryonic development of Oochoristica anolis (Cyclophyllidea: Linstowiidae). AB - Gravid proglottids of Oochoristica anolis from naturally infected anole lizards, Anolis carolinensis, were placed in covered Petri dishes with laboratory-reared beetles, Tribolium confusum and Tenebrio molitor. After maintenance at 25 C, metacestodes developed in 29 of 61 T. confusum (48%), but in none of 5 T. molitor. Beetles contained from 1 to 22 metacestodes (means = 3.3), which were fully developed by day 40 postexposure. A primary lacuna was never observed, but the possibility of its presence could not be ruled out without histological study. No cercomer was formed and metacestodes retained larval hooks throughout development. Scolices were invaginated at removal from the hemocoel, but usually evaginated quickly in Ringer's. On day 60 postexposure, metacestodes were fed by stomach tube to 5 anoles, 2 lacertid lizards (Podarcis muralis) and 2 mice. Worms developed only in anoles, 3 of which were infected upon examination. Oncospheral hooks were present in worms after 7 days development in the lizard; a median excretory pore was present at the posterior tip of all stages examined, including the terminal mature proglottid of a worm after 105 days in a lizard. Scolex growth rate was linear throughout metacestode and adult development, but growth rate in body length was diphasic, punctuated by change of hosts, associated with strobilization. Attempts to establish parenteral infections in anoles were unsuccessful. Present data constitute the most complete life history study thus far for any species of Oochoristica. PMID- 3981335 TI - Effects of environmental temperature, sex, and infection with Hymenolepis microstoma on the liver and bile duct weights of mice. AB - Liver weight of mice was significantly influenced, in order of decreasing prominence, by environmental temperature, infection with Hymenolepis microstoma and sex. Livers of infected and uninfected mice (both sexes) maintained at 5 C for 20 days were proportionally larger (alpha less than or equal to 0.05) than those from corresponding groups of mice kept at 35 C and, except for uninfected males, at 21 C. regardless of temperature, H. microstoma (single-worm infections) produced significant (alpha less than or equal to 0.05) hepatomegaly in all groups of female mice, but, in males, this occurred only in mice maintained at 5 C. At 21 C male mice had proportionally larger livers (alpha less than or equal to 0.05) than corresponding groups of females, but this sexual difference disappeared when mice were maintained at 5 or 35 C. Temperature and sex had a slight but significant effect on bile duct weight. Infection, on the other hand, produced a marked increase in the weight of this organ in both sexes at 5, 21 and 35 C. PMID- 3981336 TI - Pennella filosa and Pennella instructa (Copepoda: Pennellidae) on swordfish (Xiphias gladius L.) from the northwest Atlantic Ocean. PMID- 3981337 TI - Behavior of Schistosoma mansoni miracidia in gradients and in uniform concentrations of glucose. PMID- 3981338 TI - Developmental regulation of protein synthesis in Hymenolepis diminuta: two dimensional electrophoretic and fluorographic analysis of protein synthesis in onchospheres. PMID- 3981339 TI - Cytogenetics of ticks (Acari: Ixodoidea): chromosomes and timing of spermatogenesis in Amblyomma inornatum. PMID- 3981340 TI - Feeding of Nippostrongylus brasiliensis in oxygen and serum. PMID- 3981341 TI - Haemaphysalis kutchensis, an Indian-Pakistani bird and mammal tick, parasitizing a migrant whitethroat in the sultanate of Oman. PMID- 3981342 TI - Prevalence of presumed Dirofilaria tenuis microfilariae in raccoons near Vero Beach, Florida. PMID- 3981343 TI - Primary isolation and growth patterns of Leishmania donovani in mammalian non phagocytic cell lines. PMID- 3981344 TI - Development of Dipetalonema gracile in the squirrel monkey (Saimiri sciureus), with notes on its biology. AB - Infective larvae of Dipetalonema gracile, which had developed in Culicoides hollensis, were inoculated into 4 laboratory-born squirrel monkeys, Saimiri sciureus. Weekly blood sampling revealed the mean prepatent period to be 297 days. All 4 monkeys developed patent infections in which peak microfilaremias were reached 13 to 18 wk after patency. Two laparotomies, performed at 27 and 64 wk, were conducted to evaluate pathological involvement and, at that later time, to recover adult parasites. Slight capsular fibrosis was observed on the spleen of 2 of the animals but fibrous adhesions were absent. Microfilaremias in the 4 monkeys ranged from 15 to 250 mf/20 mm3 of blood and the number of adult parasites recovered varied from 7 to 13. However, the level of microfilaremia did not correlate directly to the number of adult parasites recovered. PMID- 3981345 TI - The life cycle of Cloacitrema michiganensis McIntosh, 1938 (Trematoda: Philophthalmidae). AB - Experimental infections of Cloacitrema michiganensis were established in chicks by inoculation per cloaca with excysted metacercariae. Ovigerous adults were present 20 days later with eggs containing ocellate miracidia after 21 days. The eggs hatch in utero; the miracidium contains a fully developed redia. Rediae of 2 size groups were present in the digestive gland of the brackish-water snail, Cerithidea californica. Megalurous cercariae are released and encyst on submerged objects. The stages of C. michiganensis resembled those of Parorchis acanthus, a philophthalmid also infecting C. californica, except for differences in the epidermal plate count of their miracidia and in their cercarial stage which was larger in P. acanthus and had a spinuous tegument with a collar of spines. PMID- 3981346 TI - Capping of immune complexes by sporozoites of Eimeria tenella. AB - Sporozoites of Eimeria tenella were incubated for 10, 20, or 30 min with parasite specific monoclonal IgG antibody 3D3II from mice and then rinsed in a Tris buffered glucose saline solution (TBGS). Some sporozoites were then incubated for 10, 20, or 30 min with ferritin- or colloidal gold-conjugated goat anti-mouse IgG antibody and then fixed in 2.5% glutaraldehyde and prepared for transmission (TEM) or scanning (SEM) electron microscopy. Other sporozoites that had been previously exposed to monoclonal antibody were prefixed with 0.25% glutaraldehyde, incubated with ferritin- or colloidal gold-conjugated anti-mouse IgG antibody and then fixed and prepared for TEM or SEM. Control preparations consisted of sporozoites exposed only to TBGS, monoclonal antibody 3D3II or to ferritin- or colloidal gold-conjugated anti-mouse IgG antibody. Capping of immune complexes occurred only on the surface of those sporozoites exposed to monoclonal antibody 3D3II followed by ferritin- or gold-conjugated antibody. Immune complexes moved laterally and posteriorly on the outer surface of the parasite plasma membrane to form a cap at the posterior end of the sporozoite. Capping did not occur in TBGS controls nor in sporozoites treated with monoclonal antibody 3D3II and prefixed in 0.25% glutaraldehyde before exposure to ferritin- or gold conjugated antibody. Thus, capping of surface antigens did not occur in the presence of monoclonal 3D3II antibody only, whereas specimens exposed to both monoclonal and ferritin- or colloidal gold-conjugated antibodies were able to cap immune complexes. PMID- 3981347 TI - Morphology of Baerietta hickmani n. sp. (Cestoda, Nematotaeniidae) from Australian scincid lizards. AB - Baerietta hickmani was described from Lampropholis challengeri, L. delicata, L. guichenoti, L. mustelina and Nannoscincus maccoyi (Reptilia: Scincidae) from Australia. Diagnostic features included hyperapolysis, mature segments longer than wide, gonads tandem and seminal receptacle present. The genus Baerietta was emended to include diagnostic features of B. hickmani and to extend the host range to included both amphibians and reptiles. Other morphological features of the new species included tandem paruterine capsules, allometric growth of segments and the investiture of paruterine capsules by numerous elongate calcareous corpuscles. PMID- 3981348 TI - Reversal of immunosuppression induced with plasma of malarious rats by supplemented complement. AB - Suppression of antibody producing splenic lymphocytes by plasma from rats infected with Plasmodium chabaudi malaria was confirmed. Suppressive activity was found in plasma drawn on the sixth, seventh and eighth day of infection. It was temporally associated with anemia, elevated levels of soluble immune complex, reduced titers of lytic complement and elevated titers of immunoconglutinin (IK) in the plasma. Heat inactivation of the plasma to destroy complement and removal of IK by absorption did not reduce the suppressive activity. Incubating the plasma-treated lymphocytes with normal rat complement largely, but not completely, reversed the suppressive action. Soluble immune complexes prepared from bovine serum albumin (BSA) and antiBSA (BSA-antiBSA) alexinated complex (BSA antiBSA-C') and immunoconglutinated complex (BSA-antiBSA-C'-IK) each suppressed the capacity of splenic lymphocytes from rats immunized with sheep blood cells to produce hemolytic Jerne plaques. Incubating the complex-treated cells with fresh complement largely reversed the suppressive activity. It is suggested that the suppressed responses of lymphocytes from malarious animals to antigens or mitogens, reported by others, may have been in part induced by complexes in blood of the animals, and that antibody producing cells might also have been suppressed. Since suppressive activity was not influenced by complement inactivation, but was reversed when plasma-treated cells were incubated with fresh complement, it is suggested that the hypocomplementemic state of suppressive plasma may have contributed to immunosuppression. PMID- 3981349 TI - Anti-Dirofilaria immitis antibody levels before and after anthelmintic treatment of experimentally infected dogs. AB - Antibody to Dirofilaria immitis was measured in 6 dogs before and after treatment with thiacetarsamide. Antibody to microfilarial surface antigens was ascertained with an indirect fluorescent antibody assay (IFA). Various patterns of the production, or presence, of antibody to microfilarial surface antigens were observed. There was no apparent relationship between IFA results and adulticide success. Antibody to adult worm antigen was measured with an enzyme-linked immunosorbent assay (ELISA). ELISA titers increased following infection and decreased transiently at the end of the prepatent period. A marked increase in ELISA titers was noted in all dogs subsequent to an initial thiacetarsamide treatment. In general, ELISA titers returned to low levels in dogs which were successfully treated; however, in dogs with persistent infections or infections which apparently necessitated 2 adulticide treatments ELISA titers remained at pre-treatment levels during the period of observation. Since ELISA titers appeared to decrease to pre-infection levels in successfully treated dogs, the assay should have utility in subsequent antibody determinations and may permit retrospective prediction of chemotherapeutic success. PMID- 3981350 TI - Some observations on a possible role of lung and fecal IgA antibodies in immunity of rats to Nippostrongylus brasiliensis. AB - Factors influencing lung IgA antibody responses to Nippostrongylus brasiliensis infections and the role of lung and fecal IgA antibodies in immunity to this nematode were studied in rats. Hooded Lister rats were vaccinated subcutaneously with infective larvae radio-attenuated at 80-180 kr or with a single dose of infective larvae somatic proteins administered intravenously or intragastrically, and then challenged 14 days later with normal larvae. It was found that optimal lung IgA antibody responses depended more on the duration of the antigenic stimulation than on the quantity of antigenic material present, although a threshold amount was required. However, comparisons of lung anti-larval IgA antibody levels in rats resistant or susceptible to challenge indicated that these antibodies were not directly involved in specific host protective immunity. Levels of haemagglutinating fecal antibodies reacting with adult nematode metabolites were correlated with the numbers of adult worms recovered from the intestines following vaccination and also with the degree of resistance to reinfection. However, preincubation of adult (day 5) nematodes in media containing the IgA fraction of fecal globulins from primary infected rats did not reduce the ability of these worms to establish and survive in naive rats. PMID- 3981351 TI - Ultrastructural morphology of the neuropile of the cerebral ganglion of Moniliformis moniliformis (Acanthocephala). AB - The cerebral ganglion of Moniliformis moniliformis consists of an outer single layer of cell bodies and an inner core of neuropile occupied by cellular processes. Morphological characteristics of 5 types of cellular processes have been described. Most of the processes in the neuropile were of large size, although sites containing numerous small processes (neurites) were also observed. Small processes in the neuropile were the sites of synaptic interaction. The majority of presynaptic membranes were well defined by the presence of electron dense material at the inner leaflet, while postsynaptic membranes appeared to lack marked postsynaptic density. Round or flattened lucent vesicles were concentrated around the presynaptic membranes. Electron-dense and dense-cored vesicles were usually separated from the clear vesicles and situated at some distance from synaptic sites. PMID- 3981352 TI - Parasitism by Placobdella multilineata (Hirudinoidea: Glossiphoniidae) and its first record from Asia. AB - Placobdella multilineata (Hirudinoidea: Glossiphoniidae) a temporary, bloodsucking ectoparasite, was previously recorded only from the southern United States, with turtles and the American alligator (Alligator mississipiensis) as hosts. This is the first record of P. multilineata from Asia (Beijing, People's Republic of China) and also a new host record for the estuarine crocodile (Crocodylus porosus). The introduction of P. multilineata to Asia occurred as a result of the transfer of American alligators. All 34 specimens of P. multilineata collected in Beijing were non-clitellate but blood in their guts indicated that feeding had occurred on the host. PMID- 3981353 TI - Bacterial endosymbionts of Acanthamoeba sp. AB - Gimenez staining of presumably axenic Acanthamoeba sp., strain HN-3, showed rod shaped cytoplasmic inclusions. Electron microscopy of thin sections of the amebae showed these to be bacilli which measured 1.3 to 3.3 microns by 0.22 to 0.33 micron. Their cell envelopes were those typical of gram-negative bacteria, surrounded by an electron-translucent area that stains with ruthenium red, suggesting the presence of a capsule. The bacilli grew and reproduced in the cytoplasm of both trophozoites and cysts of Acanthamoeba sp. There was no evidence of a surrounding phagosomal or phagolysosomal membrane. They were retained by the ameba both during encystment and excystment. All attempts to isolate the endosymbionts in embryonated eggs and/or standard bacteriological media failed; and they persisted within the amebae for 1 to 6 mo despite temperature shocking or constant treatment of cultures with penicillin, streptomycin, chloramphenicol, tetracycline, erythromycin, polymyxin B, ampicillin, isoniazid, rifampicin, or gentamycin at concentrations of 10(-5) to 10(-3) M. PMID- 3981354 TI - Understanding gastric emptying: implications for feeding the healthy and compromised infant. PMID- 3981355 TI - Cell culture of embryonic chick duodenal cells: preparation of epithelial fibroblast bilayers and homotypic cultures of fibroblasts and epithelial cells. AB - A method for the primary cell culture of trypsin-dissociated embryonic chick duodenum is described. Both heterotypic (epithelial cells and fibroblasts together) and homotypic (highly enriched cultures of epithelial cells or fibroblasts alone) cell cultures were established. Dispersed duodenal epithelial cells and fibroblasts grown in 10% fetal bovine serum (FBS) spontaneously aggregated and proliferated as a bilayer of cells with the epithelial cells growing on top of the fibroblasts. Changing the serum supplement to 6% chicken serum (CS) and 4% FBS when the fibroblast monolayer reached confluence resulted in epithelial cell proliferation. Homotypic cultures of epithelial cells and fibroblasts were prepared and analyzed by scanning electron microscopy and transmission electron microscopy. Fibroblasts, isolated by differential adhesion and grown in 10% FBS, did not demonstrate measurable alkaline phosphatase activity. Homotypic epithelial cell cultures, isolated by floating them off the fibroblasts with collagenase, and maintained on collagen in 6% CS/4% FBS, demonstrated higher alkaline phosphatase-specific activity (16.1 +/- 2.3 U/mg protein) compared with epithelial-fibroblast bilayer cell cultures (12.1 +/- 1.3 U/mg protein). PMID- 3981357 TI - Generalized juvenile polyposis in an infant: report of a case and successful management by endoscopy. AB - A case of juvenile gastrointestinal polyposis in an infant is described and the literature is reviewed. Major clinical problems are related to the extent of the juvenile polyposis. The disease has a poor prognosis. The endoscopic techniques used when polyposis is limited allow histologic evaluation of the polyps and conservative treatment. PMID- 3981356 TI - Expression of ornithine transcarbamylase deficiency in the small intestine and colon of sparse-fur mutant mice. AB - Sparse-fur mutant mice have an X-linked deficiency of liver ornithine transcarbamylase (OTC), similar to congenital hyperammonemia type II seen in children. The purpose of the present study was to see whether the expression of enzyme deficiency in the small intestine and colon was similar to that in the liver. Our results show that the level of residual OTC activity in duodenal, jejunal, and ileal mucosa is not significantly different from that of the liver, both in mutant heterozygous female and hemizygous male mice. A highly significant (p less than 0.001) positive correlation was seen between the enzyme activity from all segments of the normal and mutant intestine and that of the liver. pH dependence of mucosal OTC was similar to liver enzyme, when compared within normal or hemizygous mutant mice. Apparent Km (ornithine) of the enzyme from normal or mutant small intestine did not show any significant differences when compared with OTC from normal or mutant livers, respectively. Apparent Km (carbamyl phosphate) from both organs of normal mice was also similar. However, Km (carbamyl phosphate) of mutant intestine and liver gave variable results on statistical comparisons. The specific activity in the proximal and distal colon of mutant mice was significantly lower (p less than 0.001) than normal mice, and showed a similar expression of enzyme deficiency as seen in the small intestine. The similarity of OTC deficiency in the intestine and liver of sparse-fur mice would provide a basis for investigating the use of mucosal biopsies in the confirmation and characterization of human disease. PMID- 3981358 TI - Intrahepatic cholangitis associated with mucocutaneous lymph node syndrome. AB - Although gallbladder hydrops occurs frequently in patients with mucocutaneous lymph node syndrome (MCLS), the etiology of the gallbladder lesion is unclear. Recently we performed a liver biopsy on a child with severe MCLS and demonstrated selective invasion of biliary ductular epithelial cells by polymorphonuclear leukocytes with sparing of the hepatocytes. The possible role of the selective destruction of biliary cells in the pathogenesis of biliary disease in MCLS is discussed. PMID- 3981359 TI - Transient neutral fat steatorrhea, elevated sweat chloride concentration, and hypoparathyroidism in a child with celiac disease. AB - A patient with celiac disease and the unusual features of transiently elevated sweat chlorides, reversible exocrine pancreatic insufficiency, symptomatic hypocalcemia/hypomagnesemia, and transient secondary hypoparathyroidism is presented along with a brief discussion of the physiologic mechanisms thought to underlie their development. PMID- 3981360 TI - Superior mesenteric artery syndrome: an unusual cause of Watson biopsy capsule retention. AB - The prolonged intestinal retention of a Watson biopsy capsule in a 12-year-old girl with chronic diarrhea is reported. Radiological investigation showed a duodenal obstruction due to superior mesenteric artery syndrome. A preliminary barium study of the upper gastrointestinal tract, before performing blind intestinal biopsies, may decrease the incidence of similar complications. PMID- 3981361 TI - Sjogren's syndrome with abnormal manifestations of the gallbladder and central nervous system. PMID- 3981362 TI - Family risks of hepatitis B transmission. PMID- 3981363 TI - Enteric disease and malnutrition: a plea for a more comprehensive view of a complex interaction. PMID- 3981364 TI - Therapeutic effects of human leukocyte interferon on chronic active hepatitis B in children. AB - Seven children with chronic active hepatitis (CAH) and one child with persistently abnormal results of liver function test due to hepatitis B virus (HBV) infection were treated with human leukocyte interferon (Hu-alpha-IFN). Five of them were positive for eAg and two of the three who were measured for DNA polymerase (DNAP) activity in sera showed moderate elevations of its levels. Hu alpha-IFN was injected intramuscularly daily or once weekly at doses of 0.05-1 X 10(6) IU. The total dose per patient varied from 10.5-54 X 10(6) IU. After administration of Hu-alpha-IFN, rapid loss of eAg was observed in two of the five eAg patients, and DNAP activity reverted to normal ranges in the two patients with moderate elevations of its levels. One of the patients who lost eAg has retained normal serum glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase levels for more than 2 years after therapy with Hu-alpha-IFN. Serial hepatic biopsies were performed in only one patient. In the second biopsy, 3 months after therapy with Hu-alpha-IFN, infiltration of inflammatory cells in the portal region was improved compared with earlier findings. Immediate and/or prolonged adverse side effects were not observed during or after administration of Hu-alpha-IFN. For the present, we propose these six conditions for use of Hu alpha-IFN in children with HBV infection. Children should: (a) be more than 1 year old; (b) have abnormal liver function for more than 6 months; (c) have a liver biopsy demonstrating CAH; (d) have moderate elevation of DNAP activity; (e) be eAg positive; and (f) be unresponsive to other treatments. PMID- 3981365 TI - Bile acid profiles in siblings with progressive intrahepatic cholestasis: absence of biliary chenodeoxycholate. PMID- 3981366 TI - Bilirubin production after supplemental oral vitamin E therapy in preterm infants. AB - The purpose of this investigation was to determine the influence of early vitamin E supplementation on the rate of heme catabolism (bilirubin production) in healthy preterm infants. Bilirubin production was estimated from the concentration of carbon monoxide in "end-tidal" gas. Serum vitamin E, hemoglobin, and bilirubin levels were determined by standard techniques. Thirty infants received supplementation with vitamin E or placebo in a double-blind, randomized fashion. Infants were studied on day 1 of life prior to therapy, and on days 3 and 7 postnatally. Results showed that in both placebo-supplemented and vitamin E supplemented groups, vitamin E levels were significantly higher on days 3 and 7 compared with day 1. Bilirubin production was not significantly different on day 3 compared with day 1 in either group, but was significantly lower in both groups by day 7 compared with day 1. There were no significant differences in hemoglobin and serum bilirubin levels between the two groups at any point in time. In conclusion, although vitamin E supplementation significantly raises vitamin E levels, placebo-supplemented premature infants also achieve vitamin E sufficiency and a decrease in bilirubin production by day 7 of age. PMID- 3981367 TI - The diagnosis of ornithine transcarbamylase deficiency. PMID- 3981368 TI - Linoleic acid absorption from lipid supplements in patients with cystic fibrosis with pancreatic insufficiency and in control subjects. AB - To determine the relative role of malabsorption as the cause of decreased linoleic acid in blood and tissue lipids of patients with cystic fibrosis (CF) and pancreatic insufficiency, the increase in plasma linoleic acid was determined after ingestion of various lipid supplements. CF patients with documented pancreatic insufficiency and normal control subjects were given each of four different lipid supplements on separate days (a minimum of 3 days apart). The supplements were commercial safflower oil, Microlipid, Captex 810D, and Captex 810B. Fasting subjects consumed 36 g of lipid in a milk shake containing 15 g of protein and 45 g of carbohydrate. Plasma samples obtained at 0, 2, 4, 6, and 8 h after the meal showed that CF patients absorbed linoleic acid from all of the lipid preparations tested when administered with their regular dose of pancreatic enzyme supplement. The mean maximal increase in percent plasma linoleic acid in CF patients was not different from controls after ingestion of safflower oil, Microlipid, and Captex 810B. With Captex 810D the CF patients had a significantly higher increase in percent plasma linoleic acid than controls, 6.75% vs. 2.27%, respectively, at 2 h (p less than 0.01), and 11.10% vs. 4.65% at 8 h (p less than 0.01). The CF patients also appeared to absorb the Captex products faster than controls, suggesting that presence of medium chain length fatty acids in these structured lipids facilitated their utilization by CF patients. The results indicate that malabsorption alone cannot account for the inadequate or marginal essential fatty acid status of CF patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981369 TI - The effect of early feeding on the onset of symptoms in celiac disease. AB - The appearance of celiac disease in infancy has often been related to the time when gluten is introduced into the diet, and more recently, to the kind of milk received in the early months. This retrospective study attempts to clarify the relation between breast-feeding and gluten introduction to the onset of symptoms of the disease. One hundred forty-six children with celiac disease, aged from 4 months to 11 years, were studied. The timing and types of feeds were recorded as well as the presenting symptoms of the disease. Data were analyzed by nonparametric statistical methods, as well as by parametric analysis after appropriate transformation. Children breast-fed for 3 months or more showed a marked delay in the onset of the disease and a longer latency time from gluten introduction to onset of disease, when compared with bottle-fed children. This relationship was present for both statistical analyses and was unrelated to the age at gluten introduction into the diet. Onset of disease was positively correlated to the duration of breast-feeding and not related to the age at gluten introduction. PMID- 3981370 TI - Giardiasis with protein-losing enteropathy. AB - Generalized edema and ascites were the main presenting features of giardiasis in a 3-year-old boy. Hypoalbuminemia, jejunal villous atrophy, Giardia lamblia in the duodenal aspirate, and abnormal gastrointestinal protein loss were present before therapy with metronidazole. Eradication of parasites resulted in complete clinical, histological, and biochemical remission. Giardiasis must now be included in the etiology of protein-losing enteropathy. PMID- 3981371 TI - Spontaneous endotoxinemia in premature infants: correlations with oral feeding and bowel dysfunction. AB - Infants admitted to a tertiary care nursery were tested serially to determine the frequency and epidemiology of spontaneous endotoxinemia, a phenomenon suggested by previous studies. Plasma and stools were tested for endotoxin-like activity (ELA) using a Limulus amoebocyte lysate method and results were correlated with clinical data. We detected ELA in plasma of 28 of 47 infants (60%) tested throughout their hospital stay: only two of 58 separate episodes could be attributed to infection. Endotoxinemia was not consistently associated with classical signs of fever, shock, and jaundice. Prior to oral feeding, little or no ELA was detected in stools and endotoxinemia was ascertained in only six of 45 infants (13%). With feeding, fecal ELA concentrations rose sharply, and endotoxinemia was detected in 56% of remaining infants (p less than 0.001). Bowel disease predisposed to endotoxinemia: 16 of 20 infants (80%) with necrotizing entercolitis or difficult establishment on feeding were affected, compared to five of 17 infants (29%) without such problems (p less than 0.01). Fecal ELA concentrations were not abnormally elevated in those with bowel disease. We conclude that endotoxinemia occurs commonly in immature infants as their fecal flora develops with feeding but the amount of circulating endotoxin required for injury and the patterns this takes require further investigation. PMID- 3981372 TI - Magnesium metabolism studies in children with chronic inflammatory disease of the bowel. AB - Magnesium metabolism was studied in seven patients with severe chronic inflammatory disease of the bowel (CIDB), and in 20 children without intestinal pathology. Four of the CIDB patients had ulcerative colitis and three had granulomatous disease of the bowel. All had diarrhea as well as other gastrointestinal complaints for 1 to 6 years prior to the study. All were being treated with sulfasalazine and were also receiving corticosteroids intermittently. All but one had had intestinal surgery. Basal plasma and urine were obtained in all patients and, if surgery was performed, a piece of muscle was excised. The CIDB patients received an intravenous magnesium infusion of 2 mEq/kg/day for 4 days, 2 days postsurgery. Electrocardiograms were recorded throughout the study. The mean basal plasma magnesium levels were reduced in CIDB patients as compared with controls. Mild hypomagnesemia was observed in six of seven CIDB patients. The mean basal urine excretion of magnesium was also reduced in CIDB patients, but the muscle concentrations of this element were similar to controls. Basal hypomagnesuria was present in only two of the three patients with granulomatous disease and in one patient with ulcerative colitis. The three patients with granulomatous disease excreted minimal amounts of magnesium in the urine during intravenous administration of this ion. A positive magnesium balance persisted throughout the 4-day period of infusion. In contrast, only two of the four patients with ulcerative colitis had magnesium retention during the first day of intravenous administration, and all four had negative magnesium balances thereafter. The data suggest that hypomagnesemia in CIDB patients may occur with or without magnesium deficiency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981373 TI - Lactose absorption and malabsorption in healthy Italian children: do the quantity of malabsorbed sugar and the small bowel transit time play roles in symptom production? AB - Using breath hydrogen analysis after an oral lactose load (2 g/kg; maximum 50 g), we investigated the prevalence of lactose malabsorption in 61 healthy Italian children aged 6-13 years. We also examined the relationship between symptoms and small bowel transit time and the degree of sugar malabsorption. Three of 61 subjects produced no H2 after both lactose and lactulose load and thus were eliminated at the outset. Lactose malabsorption was defined as excretion of greater than 20 ppm H2. Lactose intolerance was classified as mild (colicky pain, flatulence, abdominal distension, borborygmi) or severe (diarrhea). The frequency of lactose malabsorption in the children aged 6-8 years (group I) was 25%; in the children aged 8-11 years (group II), it was 35%, and in the children aged 11-13 years (group III) 56%. The differences in frequency between the first and the third groups were significant (p = 0.05). Three of 20 (15%) in group I, two of 20 (10%) in group II, and three of 18 (17%) in group III were classified not only as lactose malabsorbing, but also as lactose intolerant, with symptoms during and after the test. We found no difference in the small bowel transit times or in the quantities of malabsorbed lactose in symptomatic and asymptomatic malabsorbing subjects. Other factors that may play a role in symptom production are discussed. PMID- 3981374 TI - Trace elements (copper, zinc, manganese, and selenium) in plasma and erythrocytes in relation to dietary intake during infancy. AB - All determinations of copper, zinc, manganese, and selenium were performed with a flameless atomic absorption spectrophotometer. Seventy-three full-term infants aged 1 to 52 weeks were divided into three age groups. Each age group contained two subgroups, breast-fed and formula-fed. No statistically significant differences between formula-fed and breast-fed subgroups were found in regard to the levels of copper and zinc in plasma and erythrocytes. At 1 to 5 weeks of age, the manganese concentration of erythrocytes was higher in formula-fed than in breast-fed infants (p less than 0.001). This might be due to the high dietary intake of this element in the formula-fed subgroup. On the other hand, plasma selenium concentrations were significantly higher in breast-fed than in formula fed infants of all ages (p less than 0.01 at 1 to 5 weeks and p less than 0.05 at 6 to 52 weeks). This suggests that selenium compounds are biologically more available for infant nutrition in breast milk than in formula. PMID- 3981375 TI - Congenital seesaw nystagmus. AB - A 14-year-old boy with congenital seesaw and horizontal pendular nystagmus associated with decreased visual acuity, high myopia, esotropia, and normal peripheral visual fields is reported. Neurologic and computed tomographic evaluation, as well as auditory evoked potentials, were normal. The findings in, and recommended evaluation of, seesaw nystagmus in young patients are reviewed. PMID- 3981377 TI - Normal saccadic velocities. AB - Although it is desirable that each laboratory establish its own normal values, this study examines the comparability of results obtained in two different laboratories with the Tracoustics RV-275 recorder. Twenty neurologically normal subjects, ages 8 to 32 years, with no history of strabismus or ocular muscle surgery, were studied. Horizontal saccades of 20 degrees across the midline, with fixation by the recorded and by the non-recorded eye, were observed. Peak velocity determinations distributed normally and ranged from 281 to 541 (mean and SD = 393 +/- 50) degr/sec. Mean velocities recorded during non-fixation were similar to those recorded during fixation. Based on these results, a twenty degree peak horizontal saccadic velocity of less than 300 degr/sec using this equipment is highly likely to be abnormally slow, irrespective of antagonist or symmetric movement comparisons; the latter cannot be relied on in cases of bilateral or multiple rotation abnormalities. The recording sequence may influence antagonist and symmetric pair comparisons. PMID- 3981376 TI - A performance test to accompany ophthalmic examination in the young school age child: the "draw a bicycle" test. AB - A performance test is proposed as an addition to the routine eye examination of the child performing poorly in school. Performance on the "draw a bicycle test" has a strong correlation with academic performance among children in grades one through three. Poor performance on the "draw a bicycle test" by children who have otherwise normal eye findings implicates a non ocular cause for the poor academic performance. Since the results of this simple test are immediately visible and readily understood by an attending parent, the ophthalmologist's role in counseling the parents against further ocular investigation and therapy is apparent. PMID- 3981378 TI - Are anisometropia and amblyopia common in Duane's syndrome? AB - Seventy cases of Duane's syndrome are summarized with particular attention to the prevalence of anisometropia and amblyopia. We found a 17% prevalence of anisometropia and a 3% prevalence of amblyopia among these patients. Amblyopia and anisometropia are not more common in Duane's syndrome than in the general population. PMID- 3981379 TI - Bilateral acquired inflammatory Brown's syndrome. AB - An 11-year-old boy presented with fever, skin rash, joint pains and vertical diplopia, and was found to have a right Brown's syndrome and systemic onset Juvenile Rheumatoid Arthritis (JRA). Later in the course of his illness, he developed a left Brown's syndrome. Acquired Brown's syndrome may occur as a complication of JRA during exacerbations of the systemic inflammatory disease. PMID- 3981380 TI - Diffuse infiltrating retinoblastoma associated with persistent primary vitreous. AB - A two-and-a-half-year-old male child presented with unilateral leukocoria. Clinical examination disclosed what was believed to be a mild form of persistent hyperplastic vitreous associated with total retinal detachment and exophytic retinoblastoma. The enulceated eye contained diffuse infiltrating retinoblastoma with tumor cells involving a stalk of persistent primary vitreous without hyperplasia. PMID- 3981381 TI - Treatment of congenital nasolacrimal system obstruction. PMID- 3981382 TI - Treatment of congenital nasolacrimal system obstruction. PMID- 3981383 TI - Prolonged parasympathetic paralysis and psychosis caused by atropine eye drops. PMID- 3981384 TI - Microphthalmos with cyst: clinical presentations and computed tomographic findings. AB - Four patients with microphthalmos with cyst were examined and evaluated by computed tomography (CT). Each patient had a different clinical presentation, which varied according to the appearance of the anterior segment and the size and location of the orbital cyst. All had very poor vision in the involved eye. CT was of great value in the diagnosis and definition of this condition. The differentiation of microphthalmos with cyst from coloboma and from other orbital masses by means of CT is discussed. PMID- 3981385 TI - Impulsivity and perception: individual differences in the processing of the local and global dimensions of stimuli. AB - There appears to be an association between a "global" mode of perceptual processing and a cluster of personality traits, one of which is impulsivity. The goal of the present study was to clarify this relationship. Subjects differing in impulsivity (as measured by a self-report inventory) performed speeded cardsorting tasks. They sorted stimuli consisting of large letters made up of smaller letters. Highly impulsive subjects had no more difficulty than other subjects in ignoring the large, "global," letters when they tried to attend to the smaller, "local," letters of which they were composed, nor were they more vulnerable than other subjects to Stroop-like response interference produced by the global letters. High impulsives did have particular difficulty when the task required that they integrate the information provided by the local and global letters. This finding can be explained in terms of individual differences in the value placed on speed relative to accuracy in information processing. PMID- 3981386 TI - Alcohol and social behavior I: The psychology of drunken excess. AB - Drinking alcohol clearly has important effect on social behaviors, such as increasing aggression, self-disclosure, sexual adventuresomeness, and so on. Research has shown that these effects can stem from beliefs we hold about alcohol effects. Less is known about how alcohol itself affects these behaviors. A cognitive explanation, that alcohol impairs the information processing needed to inhibit response impulses--the abilities to foresee negative consequences of the response, to recall inhibiting standards, and so on--has begun to emerge. We hypothesize that alcohol impairment will make a social response more extreme or excessive when the response is pressured by both inhibiting and instigating cues- in our terms, when it is under inhibitory response conflict. In that case, alcohol's damage to inhibitory processing allows instigating pressures more sway over the response, increasing its extremeness. In the present meta-analysis, each published test of alcohol's effect on a social, or socially significant behavior was rated (validated against independent judges) as to whether it was under high or low inhibitory conflict. Over low-conflict tests, intoxicated subjects behaved only a tenth of a standard deviation more extremely than their sober controls, whereas over high-conflict tests they were a full standard deviation more extreme. The effect of conflict increased with alcohol dosage, was shown not to be mediated by drinking expectancies, and generalized with few exceptions across the 34 studies and 12 social behaviors included in this analysis. PMID- 3981387 TI - Subjective past, present, and future fit: effects on anxiety depression, and other indicators of well-being. AB - Hypotheses were tested regarding the effects of subjective current, retrospected, and anticipated person-environment fit on affective and somatic strain and well being. Two-hundred seven university students preparing for annual academic examinations at an Indian university completed self-administered questionnaires measuring parameters of the hypotheses. A distinction was made between cognitive (e.g., meeting demands for intelligence, good memory) and motivational (e.g., being able to muster the effort) fit. Cognitive poor fit had a greater effect on predicting high levels of strain across all time frames but did best in the past and current frames. Motivational poor fit had its greatest effect on strain when poor fit dealt with anticipated or current fit. These findings are discussed in terms of hypotheses, which suggest that the more subjectively uncontrollable a dimension of fit, the more salient it is in the past time frame, whereas the more subjectively controllable the dimension, the more salient it is in the future time frame. PMID- 3981388 TI - Learned helplessness and learned resourcefulness: effects of noncontingent success and failure on individuals differing in self-control skills. AB - We designed two experiments to investigate the role of self-control processes in learned-helplessness studies by assessing the differential reactions to uncontrollability of subjects who presumably had either a rich (high resourceful, or HR) or poor (low resourceful, or LR) repertoire of self-control skills. HR and LR subjects received noncontingent success feedback, failure feedback, or no feedback on a task that ostensibly assessed "therapeutic abilities." Subjects were subsequently tested on insolvable puzzles (Experiment 1) or on solvable anagrams (Experiment 2). According to Kanfer and Hagerman's (1981) self regulation model, self-regulatory activities are evoked primarily in situations in which subjects are faced with repeated failure. Hence we predicted that individual differences in self-control would influence performance on the insolvable puzzles and not anagram performance after exposure to noncontingent failure. This prediction was confirmed: Only the performance of LR subjects on the insolvable puzzles was debilitated by the helplessness induction, whereas HR and LR subjects showed equal helplessness-induced deficits on the anagrams. The latter finding was interpreted in terms of the learned-helplessness model without the mediating effects of self-regulatory processes. As predicted from the self control model, HR subjects more frequently checked statements indicating positive self-evaluations and task-oriented thoughts and less frequently checked negative self-evaluations than did LR subjects during exposure to uncontrollability in both experiments. We concluded that the self-control model accounts best for subjects' self-reactions during exposure to uncontrollability or failure, whereas the learned-helplessness model accounts for the generalization of helplessness from uncontrollable situations to controllable ones. PMID- 3981389 TI - Some psychological effects associated with positive and negative thinking about stressful event outcomes: was Pollyanna right? AB - This study investigated psychological effects associated with tendencies to focus one's thinking on positive versus negative outcomes of concluded stressful events, called respectively, positive and negative thinking. Four questions were addressed: (a) whether positive and negative thinking benefit or reduce psychological well-being, (b) whether these effects are transitory or enduring, (c) whether they are limited to thoughts about an event's impact on oneself or generalize to thoughts about an event's external consequences, and (d) whether tendencies to think positively or negatively about prior stressors influence psychological vulnerability to the impact of future ones. College students completed an event-outcome appraisal questionnaire designed to make salient positive and negative thoughts about the outcomes of recent stressful events. Subjects' well-being was then assessed both immediately after the salience manipulation and again 8 weeks later. Positive thinking increased the well-being that subjects reported immediately after their thoughts were assessed, but was unrelated to the well-being they reported after an 8-week delay. This suggests that although thinking positively about past event outcomes may temporarily lead to perceptions of increased well-being while the thoughts are salient, it has no enduring influence. In contrast, negative thinking was associated with lower reported well-being not only when the thoughts were salient but after a delay as well. Psychological effects associated with both types of thinking were due mostly to self-relevant thoughts rather than to externally relevant ones. Negative thinking about prior stressor outcomes appeared to increase vulnerability to the impact of later ones on several aspects of well-being. Overall, results for negative thinking are consistent with evidence reported after an 8-week delay. This suggests that although thinking positively effects that persist over time. However, positive thinking does not seem to have beneficial effects that continue once these thoughts are no longer salient. PMID- 3981390 TI - Factors in the self-deception questionnaire: associations with depression. AB - Disagreement presently exists over whether depressed or nondepressed persons exercise more cognitive distortion on material about the self. A negative correlation between the Self-Deception Questionnaire (SDQ, Sackeim & Gur, 1978, 1979) and the Beck Depression Inventory (BDI, Beck, 1967) has been cited as evidence that it is the nondepressed individuals who exercise more distortion (Sackeim, 1983). This negative correlation was replicated, and the SDQ was factor analyzed to determine which factors might account for the correlation with depression. The three largest factors, identified by content themes of relationships with parents, emotionality, and denial of tabooed activities, correlated reliably with the BDI. Discussion focused on whether these correlations reflect differences in self-deception that are associated with depression or differences in veridical responding between depressed and nondepressed subjects on those items in the SDQ. Suggestions for future research and possible therapeutic implications are also discussed. PMID- 3981391 TI - Alcohol and social behavior II: the helpful drunkard. AB - Can alcohol make people more helpful, and if so, how? We hypothesized that alcohol would increase helping when, if the person were sober, the helping response would be under high inhibitory conflict--that is, when it would be affected by strong instigating and inhibiting pressures. Alcohol's damage to inhibitory processing should then allow instigating pressures to have more influence on the response, increasing helping. We expected that under low inhibitory conflict, when either or both of these response pressures would be weak under sobriety, alcohol would have little effect on helping. In two experiments we examined this reasoning. In Study 1, a mild dose of alcohol increased helping among high-conflict subjects pressured to help with a task they did not like, but did not increase helping among low-conflict subjects who either liked the task or were weakly pressured to help. In Study 2, a somewhat stronger dose of alcohol increased helping among all high-conflict subjects pressured to help with an undesirable task, yet again had no effect among low-conflict subjects weakly pressured to help. These studies provided an experimental demonstration of the role of inhibitory response conflict in mediating alcohol's social effects, and show that this process generalizes to prosocial behavior. Additional evidence from both experiments helped to rule out alternative explanations concerning drinking expectancies, alcohol's ability to enhance mood, and its ability to make the task more bearable. PMID- 3981392 TI - Conditioned placebo responses. AB - Following earlier animal research, we attempt to condition placebo effects in human subjects. Four groups of 8 voluntary subjects were told that the experimenters would test a powerful new analgesic cream over three sessions by assessing its ability to reduce experimentally induced pain. The analgesic cream was, in fact, a placebo. In the first session all subjects were tested with and without the cream to assess their placebo response. In the second session, to condition two groups (with differing stimulation levels) to experience pain relief in response to the placebo, we repeatedly paired a reduction in nocioceptive stimulation with placebo administration. (Subjects were unaware that stimulation levels were manipulated). To condition the other two groups (with different stimulation levels) to experience an exacerbation of the pain, we paired an increase in nocioceptive stimulation with placebo administration. In the third session, all subjects were again tested for placebo response. Results suggested that placebo responses are conditionable in the laboratory in both a positive and negative direction. The clinical implications of a learning theory of placebo behavior are discussed. PMID- 3981393 TI - What you say and how you say it: the contribution of speech content and voice quality to judgments of others. AB - In three studies, judgments based on separated channels (speech content, voice quality, face alone and body alone) were correlated with judgments based on combined channels (speech, face + speech, and face + body + speech). The judges observed spontaneous behavior in two different types of interview situations and rated various aspects of the behavior. Correlations between separated and combined channels varied significantly depending on the kind of behavior judged, the attribute rated, and whether other channels of information were available. PMID- 3981395 TI - Sensation seeking, augmenting-reducing, and the perceived and preferred effects of drugs. AB - The following measures were administered to 78 undergraduates: the General and Disinhibition subscales of Zuckerman's (1971) Sensation-Seeking Scale; the Reducer-Augmenter Scale (RAS; Vando, 1970, 1974); self-reported use of alcohol, tobacco, and cannabis; the degree of attribution of stimulant, depressant, and neutral effects to these drugs; and desirability ratings of stimulant and depressant effects ascribed to various drugs. Major findings were as follows: (a) On the RAS, reducing correlated positively with both sensation-seeking measures. (b) Seven of the nine personality-versus-drug-use correlations were positive and significant. (c) Generally, the effects attributed to drugs did not differ by sex, personality, or use. (d) However, frequent drinkers attributed stimulant effects to alcohol more strongly than depressant effects, whereas infrequent drinkers did the opposite. (e) The mean desirability ratings of stimulant and depressant drug effects correlated positively. (f) High disinhibitors rated drug effects of both kinds more favorably than did lows. (g) A similar, more favorable evaluation by high than by low general sensation seekers was significant for male subjects only. (h) Score on the Reducer-Augmenter Scale was not significantly predictive of subjects' desirability ratings. PMID- 3981394 TI - The prediction of semantic consistency in self-descriptions: characteristics of persons and of terms that affect the consistency of responses to synonym and antonym pairs. AB - Subjects described themselves, using an alphabetically ordered list of 191 trait adjectives, which included sets of synonyms and antonyms, half of each type more difficult than the other half. Subjects were randomly assigned to one of two experimental conditions. In one condition, each adjective was listed with its dictionary definition; in the other condition, only the adjectives were listed. All subjects were administered a battery of demographic, cognitive, and personality measures. We analyzed both the relative consistency elicited by different pairs of terms and the individual differences in semantic consistency displayed by different sorts of subjects. Although the provision of definitions served to increase consistency (especially for the difficult antonyms), it did not decrease the range of consistency values across either synonym or antonym pairs. And, although interpair differences in semantic consistency were as difficult to predict in this study as in previous ones, individual differences were highly predictable. The implications of our many findings are discussed in the context of various hypotheses about semantic inconsistency in self-reports. PMID- 3981397 TI - Perception of social distributions. AB - Accurate representation of the distribution of social attitudes and behaviors can guide effective social behavior and is often essential for correct inferences. We examined the accuracy of people's beliefs about the distributions of a large number of attitudinal and behavioral dimensions. In two studies we measured actual attitudes and behaviors in a student population, and we assessed beliefs by asking subjects to estimate the distribution of 100 students on these dimensions. We examined the accuracy of subjects' perceptions of the means, standard deviations, and distribution shapes. Subjects showed a number of systematic biases, including overestimation of dispersion and overestimation of the means of behavioral distributions and a false consensus bias, but their overall accuracy was impressive. PMID- 3981396 TI - Effects of stereotypes on decision making and information-processing strategies. AB - In two experiments we investigated the effects of stereotyping on (a) reactions to a behavioral transgression and (b) the recall of information bearing on it. Subjects read a case file describing a transgression committed by a target (in Experiment 1, a job-related infraction; in Experiment 2, a criminal act). In some cases, the target's transgression was stereotypic of the target's ethnic group (conveyed through his name), and in other cases it was not. After reading the case file, subjects judged the likelihood that the transgression would recur and recommended punishment for the offense. These judgment data supported the hypothesis that stereotypes function as judgmental heuristics. Specifically, subjects used a stereotype of the target to infer the reasons for his transgression, and then based their punishment decisions on the implications of these inferences, considering other relevant information only when a stereotype based explanation of the behavior was not available. However, recall data suggested that once a stereotype-based impression of the crime and its determinants was formed, subjects reviewed other available information in an attempt to confirm the implications of this impression. This led to differential recall of presented information, depending on whether its implications were consistent with, inconsistent with, or irrelevant to those of the stereotype. PMID- 3981398 TI - Cognitive mediators of reactions to rape. AB - Subjects were exposed to slides that primed different concepts associated with aggression, close personal interactions between men and women, and women as sex objects. Then, as part of an ostensibly unrelated study, they read the testimonies of several rape victims and made judgments concerning both the victim and the alleged rapist. Exposure to negative consequences of aggression apparently threatened subjects' beliefs in a just world, leading subjects to interpret rape incidents in ways that reaffirm this belief (i.e., it strengthened subjects' beliefs that the defendant should be punished, but it also caused them to attribute more responsibility for the incident to the victim). Portrayals of close personal relationships between men and women increased male subjects' beliefs that rape victims were responsible for the incident, but had the opposite effect on female subjects' beliefs. Portrayals of women as sex objects decreased male subjects' beliefs in the victim's credibility and increased their beliefs that she was responsible for the incident; however, it had the opposite effects on female subjects' judgments. Despite their effects on judgments of the rape victim, priming manipulations did not affect beliefs that the defendant should be convicted. Implications of these results for the effects of the public media on attitudes and beliefs about rape are discussed. PMID- 3981399 TI - The effects of jury size and polling method on the process and product of jury deliberation. AB - The U.S. Supreme Court has repeatedly assumed the functional equivalence of different sized juries (at least in the range of 6- to 12-person groups). Several formal models of jury decision making predict that larger juries should hang more often, particularly for very close cases. Failures to confirm this prediction in several previous studies were attributed to inadequate sample sizes or to insufficiently close cases. An experimental simulation study that minimized these problems was undertaken to test the models' prediction. Social decision scheme and social transition scheme analyses permitted comparisons of the decision making processes of the different-sized mock juries. The effect of the method used to poll group members' verdict preferences was also examined. As group size increased, the observed probability of a hung jury increased significantly. No process differences between 6- and 12-person groups were detected, but 3-person groups did exhibit several process differences from the larger groups. When cases were very close, the likelihood of a hung jury for typically sized juries was found to be lower when the group was polled by secret ballot than when a show-of hands polling method was used. PMID- 3981400 TI - Components of reward in social dilemmas. AB - A social dilemma (Dawes, 1980) may be defined as a situation in which a collection of individuals is faced with a conflict between maximizing selfish interests and maximizing collective interests. The dilemma is based on the fact that if all choose to maximize selfish interests, all are worse off than if all choose to maximize collective interests. In a decomposed social dilemma (Pruitt, 1967), the outcomes are divided into two components: one component is based on one's own choice and the second component is based on the choices made by the others. Using 3-person decomposed games, two types of incentives were contrasted: a positive incentive (bonus) for cooperative choices and a negative incentive (penalty) for noncooperative choices. Two experiments were conducted using male college students. The results of both experiments showed that the positive incentive evoked a higher level of cooperation than the negative incentive. The results are discussed in terms of nonadditive utility components, Pruitt's motivational interpretation, and Kelley and Thibaut's (1978) theory of interdependence. PMID- 3981401 TI - Personality resemblances in adoptive families when the children are late adolescent or adult. AB - Members of 220 families who had adopted one or more children from a Texas home for unwed mothers at least 14 years ago completed the California Psychological Inventory and the Thurstone Temperament Schedule. Consistent with other recent adoption studies in Minnesota and Texas, there was very little resemblance between parents and adopted children or between adoptive siblings (average correlations about .05). The presence of a biological relationship raised correlations a little, but only a little, to about .15, suggesting that much of the explanation for personality variation must lie in within-family environmental variation or nonadditive genetic effects. In an earlier study, young adopted children appeared to be better adjusted, on the average, than biological children in the same families. This was no longer true for the late-adolescents and young adults of the present study. PMID- 3981402 TI - Revision of the sentence completion test for ego development. AB - New forms of the Washington University Sentence Completion Test are presented, revised to be closely comparable for men and women. The two pages of each form are usable as alternate 18-item forms. All stems on the new forms have a manual derived for women, for men, or for both. Order of items on the new forms is designed to maximize cooperation and to insure independent answers on the several stems. Data taken from several diverse samples using the previous forms show the median item validity (correlation of item rating with total protocol rating) slightly higher for women (about .50) than for men (about .46). However, the difference is wholly accounted for by difference in the variance of the samples. First-person stems and impersonal ones are about equally valid for women, but impersonal ones appear to be more valid for men. More impersonal stems are included on the new forms. PMID- 3981403 TI - On specificity in the impact of social participation on physical and psychological health. AB - Although it has been suggested that social participation is likely to be beneficial for health and well-being, there is little research demonstrating specifically which aspects of socializing may be responsible. This study distinguishes specific components of social interaction and health and examines differential relationships among them. Three distinct categories of social participation variables were posited: quality, quantity, and social traits. If was hypothesized that health problems would be more frequent among persons with poor quality interaction. The only exception to this prediction was that illnesses that are socially communicated were expected to be more prevalent among persons with a greater quantity of social participation, regardless of quality. Results confirmed these predictions for females. For males, the pattern of results was more complex, in that masculinity and femininity influenced the manner in which symptoms were expressed. These results supported the notion that social relations have a specific impact on health, and that if research is to provide useful information for intervention, we must learn more about which specific aspects of social participation are beneficial as well as how this occurs. PMID- 3981404 TI - Masculinity, femininity, type A behavior, and psychosocial adjustment in medical students. AB - The freshman class of a midwestern medical school completed measures of masculinity and femininity, Type A behavior, and a variety of dependent variables concerning psychological well-being, adjustment, and interpersonal satisfaction. Appropriate statistical treatment of the data revealed strong and consistent masculinity effects on neuroticism, depression, self-esteem, confidence, hedonic capacity, locus of control, and relationship satisfaction. Femininity main effects varied in number as a function of the statistical method employed and involved a more diverse group of variables than is typically reported. Additive androgyny formulations of mental health were supported; balance androgyny formulations were not. No evidence for a Type A X Masculinity effect on adjustment was found. Discussion focuses on the correct interpretation of masculinity and femininity scales, comparability of analysis of variance (ANOVA) and multiple regression statistical analyses, and the viability of the concept of androgyny. PMID- 3981405 TI - Assay of nitrofurantoin oral suspensions contaminated with 3-(5 nitrofurfurylideneamino)hydantoic acid. AB - A reversed-phase high-performance liquid chromatographic (HPLC) analysis of oral suspensions for nitrofurantoin (1) and 3-(5-nitrofurfurylideneamino)hydantoic acid (2), an impurity derived from 1, is presented. The concentration of the impurity ranged from 20 to 300 micrograms/mL in several lots of commercial oral suspensions. Conversion of 1 to 2 with citrate buffer, an excipient in the oral suspension, was achieved; selective hydantoin ring cleavage was accomplished in preference to the generally observed cleavage at the azomethine linkage. The hydantoic acid 2 was synthesized and identified by NMR, IR, TLC, and elemental analysis. PMID- 3981406 TI - Liquid chromatographic determination of propoxyphene and norpropoxyphene in plasma and breast milk. AB - A sensitive and specific high-performance liquid chromatographic (HPLC) procedure was developed for determination of propoxyphene and norpropoxyphene in plasma and breast milk. The compounds were isolated from the biological specimen by extraction, the organic phase was evaporated to dryness, and the residue was redissolved in mobile phase [acetonitrile: 0.002 M H2SO4 (1:1)]. The resultant solution was then injected into an HPLC system utilizing a C18 reversed-phase analytical column and a variable-wavelength detector set at 205 nm. Under these conditions the method has a sensitivity of 20 ng/mL using 1 mL of plasma or milk. The within-run coefficient of variation for both compounds varied between 6.2 and 8.9% within the concentration range tested. Applicability of the method was demonstrated in a nursing mother who received multiple oral doses of propoxyphene. PMID- 3981407 TI - Determination of hydrazine in pharmaceuticals IV: Hydrazine and benzylhydrazine in isocarboxazid. AB - A GC procedure for the simultaneous determination of hydrazine and benzylhydrazine in isocarboxazid raw material and tablet formulations has been developed. The method is based on the reaction of benzoyltrifluoroacetone with hydrazine and benzylhydrazine to form the corresponding pyrazole derivatives. The minimum detectable amounts of hydrazine and benzylhydrazine in isocarboxazid are 0.002 and 0.02%, respectively. PMID- 3981408 TI - Theoretical limits of changes in plasma protein binding on renal drug clearance. PMID- 3981409 TI - Studies of powder flow using a recording powder flowmeter and measurement of the dynamic angle of repose. AB - This paper describes the utility of the dynamic measurement of the angle of repose for pharmaceutical systems, using a variable rotating cylinder to quantify powder flow. The dynamic angle of repose of sodium chloride powder sieve fractions was evaluated using a variable rotating cylinder. The relationship between the static and the dynamic angle of repose is discussed. The dynamic angle of repose of six lots of a multivitamin preparation were compared for inter and intralot variation. In both cases, no significant differences (p greater than 0.05) were observed. In the multivitamin formulation, lubricants at lower concentration levels did not show a significant effect (p greater than 0.05) on the dynamic angle of repose when compared with flow rates. The effect of different hopper sizes and geometry has been evaluated using the recording powder flowmeter. The results indicate that although different hoppers affect the quantitative nature of the results, the same general trends are apparent. Thus, it appears possible to use a recording powder flowmeter with small quantities of material to predict the effect of formulation and processing variables on the flow of production scale quantities. This paper does not describe a comprehensive evaluation of the pharmaceutical utility of measuring the dynamic angle of repose. However, the results discussed are not encouraging and suggest that the recording powder flowmeter is more sensitive to the effects of formulation and production variables on powder flow. PMID- 3981410 TI - Preformulation studies in a drug development program for tablet formulations. AB - Recently developed techniques were applied in a preformulation program to select a compound and a suitable salt for use in a one-month toxicological test. The program showed that valuable information can be obtained prior to the choice of a compound as a candidate for a solid-dosage form. Information about the physical and mechanical properties of the chosen compound can be obtained with a limited amount of substance, i.e., surface color and hygroscopicity (1-2 g), dissolution rate and solubility (1-2 g), powder properties (1-2 g), and compaction properties (5-7 g). PMID- 3981411 TI - Steady-state bioavailability of dexbrompheniramine and pseudoephedrine from a repeat-action combination tablet. AB - The steady-state bioavailabilities of dexbrompheniramine and pseudoephedrine were evaluated following multiple-dose administrations of a repeat-action combination tablet containing 6 mg of dexbrompheniramine maleate with 120 mg of pseudoephedrine sulfate every 12 h for 7 d compared with reference standards. The reference standards used in this study were concomitant administration of conventional 2-mg dexbrompheniramine maleate tablets every 4 h and 120-mg pseudoephedrine sulfate repeat-action tablets every 12 h, each for 7 d. Twelve healthy adult male volunteers completed this randomized two-way crossover study. Blood samples for subsequent assay were obtained at frequent time intervals throughout each 7-d dosing phase. Sensitive and specific gas-liquid chromatographic methods were used for the determination of dexbrompheniramine and pseudoephedrine in plasma. Based on the plasma levels, the times to reach steady state were determined. In addition, the major bioavailability parameters (Cmin, Cmax, tmax, and AUC) for days 6 and 7 of dosing were determined and statistically evaluated. The results of this study demonstrate that, at steady state, the repeat-action combination tablet and concomitant administration of the reference standards are bioequivalent. PMID- 3981413 TI - Relationship between powder surface characteristics and viscoelastic properties of powder-filled semisolids. AB - The viscoelastic properties of dispersions of powdered zinc oxide in anhydrous lanolin and colloidal sulfur in anhydrous lanolin were characterized by dynamic mechanical testing. The elastic shear modulus, G', viscous shear modulus, G", and loss tangent (damping), tan delta, were determined as a function of shear frequency, v, temperature, T, and volume fraction of powder, phi 2. A priori, it might be expected that zinc oxide and colloidal sulfur would elicit different viscoelastic properties due to their contrasting surface characteristics; zinc oxide has a hydrophilic surface and colloidal sulfur has a hydrophobic surface. Even though constitutive mathematical models, derived to predict the mechanical behavior of solid-filled polymeric materials, were not designed to account for differences in surface characteristics of the filler, the findings of these experiments show that these models are useful in explaining the differences in viscoelastic behavior of powder-filled semisolids due to surface characteristics of the filler. One model of particular value was the Kerner equation. With it, mechanisms were postulated for zinc oxide-zinc oxide interactions, sulfur-sulfur interactions, zinc oxide-anhydrous lanolin interactions, and sulfur-anhydrous lanolin interactions, within dispersions as a function of nu, T, and phi 2. In addition, damping was used to further identify the influence of temperature. Data obtained from three temperatures, where anhydrous lanolin exists in three different structural states, shows that the influence of the powder on damping is not only determined by the surface characteristics of the powder but also the structural state of anhydrous lanolin. PMID- 3981412 TI - Sterility test systems for product recovery. AB - When presterilized, closed canister, membrane filter units for sterility testing are validated for process, large volumes of therapeutic products for injection can be tested for sterility, recovered, and added to a subsequent bulk prior to sterile filtration. Intermittent positive pressure, applied to the canisters through the vent filters, makes possible the relatively rapid filtration, with minimal foaming, of viscous solutions such as 25% (w/v) normal serum albumin (human). Canister systems appear to be at least as effective as the standard membrane filter method, and the canisters are particularly suited to the sterility testing of bulks. PMID- 3981414 TI - N-dealkylation of oxprenolol: formation of 3-aryloxypropane-1,2-diol, 3 aryloxylactic acid, and 2-aryloxyacetic acid metabolites in the rat. AB - Oxprenolol (1), like related beta-adrenergic antagonists, undergoes oxidative N dealkylation to form the corresponding 3-aryloxypropane-1,2-diol (2), 3 aryloxylactic acid (3), and 2-aryloxyacetic acid (4) metabolites. Compounds 3 and 4 were synthesized by conversion of 2-allyloxyphenol (5) to the aryloxyacetaldehyde 6 and subsequent elaboration to the desired acids. Both acids (3 and 4) and glycol 2 were confirmed as metabolites formed from 1 in vivo in the rat and in vitro in the rat liver 9000 X g supernatant fraction. Incubation of a pseudoracemate of 1, made up of equal molar amounts of (2S)-1-d0 and (2R)-1-d2, showed that 2 and 3 arise principally from (2S)-1 by S/R ratios of approximately 5:1 and 2:1, respectively. On the other hand, acetic acid derivative 4 arises about equally from both enantiomers of 1. PMID- 3981415 TI - Syntheses and hypotensive properties of substituted 2-aminotetralins. AB - The synthesis and activity in the spontaneously hypertensive rat of several 4 (1,2,3,4-tetrahydronaphthyl-2-amino)-1-(4-fluorophenyl)-1-but anones is reported. Maximal antihypertensive activity was associated with 5,6-dimethoxy substitution in the aminotetralin moiety. PMID- 3981417 TI - Conformational analysis of some alpha-phenylpropionic acids with anti inflammatory activity. AB - CNDO/2 quantum mechanical conformational calculations, as well as 13C and 1H NMR measurements, have been carried out for the propionic acid residues of 2-(p isobutylphenyl)propionic acid (ibuprofen) and 2-methyl-2-(p isobutylphenyl)propionic acid. A relationship between the conformational angle of the propionic acid residue and the anti-inflammatory activity appears to exist. The more open the Ph--C alpha--COOH dihedral angle, the larger the anti inflammatory activity. PMID- 3981416 TI - Efforts toward combined analgesic/antidepressants: synthesis and evaluation of (3 aryl-2,3-dihydrobenzofuran-3-yl)alkanamines. AB - Several (3-aryl-2,3-dihydrobenzofuran-3-yl)alkanamines, designed as potential antidepressant agents with analgesic properties, were synthesized and pharmacologically evaluated. While two compounds (1a, 1f) displayed potent antitetrabenazine activity, concomitant antinociceptive activity in the phenylquinone writhing assay was not observed. PMID- 3981418 TI - Pharmacokinetics of morphine and its surrogates V: Naltrexone and naltrexone conjugate pharmacokinetics in the dog as a function of dose. AB - Sensitive reversed-phase HPLC assays with electrochemical detection, developed to quantify naltrexone, 6 beta-naltrexol, and their conjugates in biological fluids, provided assay sensitivities of 2-14 ng/mL in plasma, urine, and bile. Plasma, urine, and bile were monitored in dogs after bolus administrations of 0.5 and 5.0 mg/kg iv naltrexone hydrochloride. Plasma-time data showed two sequential half lives of 5 +/- 1 (SEM) and 47 +/- 5 min. Pharmacokinetics were dose-independent; total and renal clearances were 1043 +/- 98 mL/min and 72 +/- 11 mL/min, respectively, with a similar renal clearance (85 +/- 12) for the conjugate. The percentages of the dose excreted in the urine as naltrexone and its conjugate were 7 +/- 1% and 58 +/- 3%, respectively, with the remainder being excreted in the bile as conjugates. As much as 36% was collected as conjugate in the total bile of the bile-cannulated dog. There was no biliary secretion of unchanged naltrexone. The conjugate was apparently enterohepatically recirculated. 6 beta Naltrexol is not a metabolite of naltrexone in dogs. Within the limits of analytical detection (2 ng/mL) neither 6 beta-naltrexol nor its conjugates appeared in any monitored biological fluids when such fluids were assayed quickly after sampling. PMID- 3981420 TI - Chloride ion nuclear magnetic resonance spectroscopy probe studies of copper and nickel binding to serum albumins. AB - The binding of Cu2+ and Ni2+ to bovine, dog, and human serum albumin has been studied by the 35Cl NMR probe technique. The number of primary copper sites were estimated to be 1.3 for human serum albumin, 3.1 for bovine serum albumin, and 6.6 for dog serum albumin. A similar number of primary nickel sites was determined for each of these albumins. On the basis of the chloride probe experiments, it appears that both copper and nickel have the same binding sites on albumin. PMID- 3981419 TI - Factors affecting the measurement of lidocaine protein binding by equilibrium dialysis in human serum. AB - A systematic study was undertaken to assess in vitro factors that influence the value of the lidocaine free fraction obtained by equilibrium dialysis in human serum. These factors include pH readjustment to 7.40 after serum storage; choice of buffers for dialysis; the effect of phosphate buffer ionic strength; temperature of storage for serum samples; the use of untreated versus silanized glassware for storage; and age of serum. It was concluded that the pH of serum that contains lidocaine must be brought back to the original whole blood pH found in the patient before equilibrium dialysis because the protein binding of lidocaine is critically dependent on pH. It was also found that Krebs-Ringer bicarbonate buffer, when used with room air atmosphere in the dialysis cell, is not adequate to control pH even when serum pH is readjusted to the physiological pH of the patient. Isotonic phosphate buffer and 0.10 M phosphate buffer are effective for pH control and give identical values of lidocaine free fraction when the original serum sample is first pH-adjusted. If the pH of the serum is correct and the pH of the buffer remains constant, then freezing, the choice of container, or the age of serum are not important variables affecting the measurement of the lidocaine free fraction. PMID- 3981421 TI - Methods for in vitro percutaneous absorption studies IV: The flow-through diffusion cell. AB - A flow-through diffusion cell system for percutaneous absorption studies has been developed. The results of initial studies with a limited number of compounds are reported. The cells were constructed from Teflon and contained a glass window in the bottom for viewing the receptor contents. A flow rate of at least 5 mL/h is required through the receptor (volume, 0.4 mL) for accurate results. The skin permeation of water, cortisone, and benzoic acid was determined in the flow through cell and a standard static-diffusion cell. The absorption profiles and quantitative values obtained were similar for the two types of cells. The permeation of cortisone and benzoic acid applied in a petrolatum vehicle was determined in vivo in rats and with rat skin in the flow-through and static diffusion cells. Good agreement was obtained between the results of the in vivo and in vitro procedures. The percutaneous absorption of a hydrophobic compound [3 phenyl-2-propenyl 2-aminobenzoate (cinnamyl anthranilate)] was enhanced with normal saline receptor solution in the flow-through cell when compared with results in the static cell. Maximum in vitro absorption was obtained with either cell using a 6% solution in water of the nonionic surfactant polyethylene glycol 20 oleyl ether (PEG-20 oleyl ether). PMID- 3981422 TI - Epimerization kinetics of moxalactam, its derivatives, and carbenicillin in aqueous solution. AB - The mechanism of the epimerization of moxalactam was studied by measuring the rate of epimerization after deuteration of the C-7 side-chain chiral carbon, introduction of different substituents on the side chain, and variation of the ring system. Deuteration slowed the epimerization rate considerably. The rate was also influenced by the choice of the ring system and the substituent on the C-7 side-chain chiral carbon. When the penicillin ring system with the 2-carboxy-2 phenyl-acetamide was studied, the epimerization rate decreased indicating that the same ring system needed to be used throughout the epimerization studies. Thus, experiments were conducted with different substituents replacing the phenolic group at the C-7 side-chain chiral carbon of moxalactam. The epimerization rate decreased in the substituent order thienyl, phenyl, 4 hydroxyphenyl, the ionized form of 4-hydroxyphenyl, and ethyl. These results showed that dehydrogenation of the chiral carbon seems to be the rate-determining step and that the stronger the electron-donating effect of the substituent, the slower the epimerization rate becomes. PMID- 3981423 TI - Determination of dissociation constants of 5-[1-hydroxy-2-[(1 methylethyl)amino]ethyl]-1-3-benzenediol. AB - The microdissociation constants of 5-[1-hydroxy-2-[ (methylethyl)amino]ethyl]-1-3 benzenediol have been determined by means of spectrophotometric and spectrofluorometric techniques. Experimental data were analyzed using the linear regression method. Values of 8.90, 10.0, 10.25, 9.15, and 12.5 have been found for the microdissociation constants. PMID- 3981424 TI - Capillary gas chromatographic-mass spectrometric analysis of 15-deoxy-16-hydroxy 16-vinylprostaglandin E2. AB - A new topically active antihypertensive agent, the methyl ester of 15-deoxy-16 hydroxy-16-vinylprostaglandin E2 (1), rapidly hydrolyzes in blood to the carboxylic acid 2, which also has antihypertensive activity. A capillary gas chromatographic-mass spectrometric method is described for measuring 2 in human plasma or serum at expected experimental blood levels of 75-1500 pg/mL. The assay is based on selected-ion monitoring of the carboxylate anion formed from negative ion chemical ionization of the trimethylsilylpentafluorobenzyl ester of 2, using a trideuterated analogue of 2 as internal standard. The method has been used to analyze samples from subjects following topical application of 1-2 mg of 1. Sample preparation included isolation from 1 mL of plasma or serum and purification of the ester derivative with C18 cartridges, followed by a two-step trimethylsilylation. PMID- 3981425 TI - Anticariogenic activity of licorice and glycyrrhizine I: Inhibition of in vitro plaque formation by Streptococcus mutans. AB - The effect of licorice and its active sweet component glycyrrhizin was tested on the growth and adherence to glass of the cariogenic Streptococcus mutans. Neither licorice nor glycyrrhizin promoted growth or induced plaque formation. In the presence of sucrose, glycyrrhizin did not affect bacterial growth, but the adherence (plaque formation) was markedly inhibited. At 0.5-1% glycyrrhizin, inhibition was almost complete. These results support our previous suggestions that glycyrrhizin might serve as an efficient vehicle for topical oral medications. PMID- 3981426 TI - Overlapping ionization constants for cefotaxime. AB - The attribution of three ionization constants (2.1, 3.4, and 10.9) for cefotaxime has been made, based on potentiometric titration and UV absorption data simultaneously. Two overlapping constants were found (2.1 and 3.4) and attributed to the carboxyl group in the 4 position and to the aminothiazole nucleus, respectively. PMID- 3981427 TI - Solution kinetics of a water-soluble hydrocortisone prodrug: hydrocortisone-21 lysinate. AB - Hydrocortisone-21-lysinate was synthesized as an amino acid prodrug of hydrocortisone to serve as a substrate for brush border aminopeptidases. This strategy was developed to demonstrate that an improvement in oral absorption could be obtained through reconversion in vivo. The aqueous stability of hydrocortisone-21-lysinate was studied over the pH range 3-8 at 25 degrees C. Reversible acyl migration of the lysine group between the 21- and 17-position hydroxyl groups was observed as well as hydrolysis. The observed half-life for direct hydrolysis of hydrocortisone-21-lysinate is 40 d at pH 3 and 30 min at pH 7. The relative instability at pH 7 is probably due to electrostatic stabilization of the negatively charged tetrahedral intermediate by the protonated amino groups. PMID- 3981428 TI - Novel method of calculating absolute bioavailability in nonlinear pharmacokinetics. AB - Current methods of evaluating the bioavailability of drugs with nonlinear disposition kinetics are based on specific pharmacokinetic models in contrast to the more rational model independent (structureless) area under the curve (AUC) and deconvolution methods used in linear pharmacokinetics. A novel method of evaluating bioavailability is presented which applies to any nonlinear type of drug elimination, but is limited to drugs with a distribution phase which is short relative to the elimination phase. The method applies to drugs with autonomic disposition characterized by a rate of decline in the systemic drug level in the absence of drug input which depends only on the drug level, i.e., dC/dt = -q(C), where q can be any function dependent only on C and constant kinetic parameters. It is shown that the disposition function q(C) can be evaluated in an empirical fashion from elimination-phase data and that this function can be used to calculate the absolute bioavailability of autonomic, nonlinear drugs. Some preliminary results are presented to demonstrate the procedures involved in applying the method. PMID- 3981429 TI - Primary dose-dependent pharmacokinetic study of veralipride. AB - A dose-dependent pharmacokinetic study of veralipride (a new post-menopausal "hot flushes" regulator) was developed in humans after oral solution administration (100, 150, 200, and 250 mg). In most cases, two maxima of plasma drug concentrations occurred, probably due to a double intestinal site of absorption. From model independent pharmacokinetic parameters, it can be concluded that a linearity in the tested range doses exists. PMID- 3981431 TI - Surgical treatment of a hypertrophic nonunion of the talar neck. PMID- 3981430 TI - Cyclazocine and norepinephrine uptake, metabolism, and turnover in the rat brain. AB - The effects of cyclazocine, a narcotic agonist/antagonist, on the uptake, metabolism, and turnover of norepinephrine in rat brains were studied. Cyclazocine significantly depressed the accumulation of intracisternally administered [3H]norepinephrine and the formation of 3,4-[3H]dihydroxymandelic acid but did not alter the formation of [3H]-normetanephrine. Comparatively, imipramine reduced the uptake of [3H]norepinephrine, decreased the formation of 3,4-[3H]dihydroxymandelic acid, and increased the formation of [3H]normetanephrine. Moreover, cyclazocine increased the formation of endogenous 3-methoxy-4-hydroxyphenylethylene glycol and produced a fall in endogenous norepinephrine. It is suggested that cyclazocine reduces the accumulation of [3H]norepinephrine, decreases endogenous norepinephrine levels, and increases the formation of 3-methoxy-4-hydroxyphenylethylene glycol by interacting with brain adrenergic nerves, presumably by inhibiting neuronal uptake and facilitating norepinephrine turnover. PMID- 3981432 TI - Cardiac arrhythmias during the perioperative period. PMID- 3981433 TI - Unexplained hepatitis after podiatric surgery with halothane anesthesia. PMID- 3981435 TI - Postoperative management following digital surgery. PMID- 3981434 TI - Lipoma and fibroma occurring in the same foot. A case report. PMID- 3981436 TI - Macrodactyly. A case report. PMID- 3981437 TI - A bizarre lipoma of the hallux. PMID- 3981438 TI - Freiberg's infarction in a football player. PMID- 3981439 TI - Podiatric services in a public health department hypertension clinic. PMID- 3981440 TI - Transmetatarsal amputation with collateral use of radioisotope studies. PMID- 3981441 TI - A review of osteomyelitis with case presentation. PMID- 3981442 TI - Clinical measurement of the axis of the subtalar joint. PMID- 3981443 TI - Pharmacologic properties of antibacterial agents and their clinical usage. PMID- 3981444 TI - A review of the literature on the US foot health care system. Part II. PMID- 3981445 TI - Pretibial myxedema. A review of the literature and case report. PMID- 3981446 TI - Migratory polyarthralgia following intestinal bypass. A case report. PMID- 3981447 TI - Compression neuropathy secondary to neurilemoma. PMID- 3981449 TI - Varicose ulcers. A physiologic treatment approach. PMID- 3981448 TI - Recurring Kaposi's sarcoma of the foot. A case report. PMID- 3981450 TI - Altered methadone pharmacokinetics in methadone-maintained pregnant women. AB - We studied the influence of human pregnancy on the maternal disposition and effects of methadone. Nine healthy pregnant women who had been on p.o. methadone maintenance for at least 2 months were studied between 20 and 34 weeks of gestation (phase I), 35 and 40 weeks (phase II), 1 to 4 weeks post partum (phase III) and 8 to 9 weeks post partum (phase IV). Two subjects who breast-fed their infants had plasma and breast milk samples collected simultaneously. With or without normalization for dose and body weight, trough plasma concentrations of methadone were significantly lower and total or unbound methadone clearances greater during pregnancy than after delivery. Plasma protein binding of methadone was lower during pregnancy but the difference was only statistically significant between phases I and IV. The greater ratios of urinary excretion of the major metabolites to total and unbound methadone areas under the curve during pregnancy suggests that methadone metabolism was enhanced. The ratios of concentrations of methadone in milk to plasma were constant in two subjects, 0.32 +/- 0.06 and 0.61 +/- 0.07, respectively. Some of the women reported symptoms of methadone withdrawal during pregnancy, even when the daily methadone dose did not change. Because of the lower plasma methadone concentrations, increased methadone doses may be required during pregnancy to achieve methadone maintenance. PMID- 3981451 TI - Regulation of muscarinic cholinergic receptor density in neuroblastoma cells by brief exposure to agonist: possible involvement in desensitization of receptor function. AB - Cell membrane surface muscarinic receptors on mouse neuroblastoma cells (clone N1E-115) are subject to a rapid receptor-mediated regulation upon contact with receptor agonists. Pretreatment of cells for 30 min at 37 degrees C resulted in a significant reduction in the specific binding of the hydrophilic ligand N-[3H] methylscopolamine. The magnitude of the reduction was dependent on agonist concentration and temperature. This phenomenon also demonstrated saturability. Further characterization of this reduced binding revealed that it is a "true" disappearance of the cell membrane surface receptors and that receptor activation is needed to trigger this receptor regulation. Once the agonist was removed, almost complete recovery of the cell membrane surface receptors was seen within 30 min at 37 degrees C. A number of similarities have been demonstrated to exist between agonist-induced desensitization of receptor-mediated increase in cyclic GMP formation and agonist-induced receptor regulation, which suggests that both phenomena might be related. PMID- 3981452 TI - LY171883, 1-less than 2-hydroxy-3-propyl-4-less than 4-(1H-tetrazol-5-yl) butoxy greater than phenyl greater than ethanone, an orally active leukotriene D4 antagonist. AB - LY171883, 1-less than2-hydroxy-3-propyl-4-less than 4-(h-tetrazol-5-yl)butoxy greater than phenyl greater than ethanone, proved to be a potent antagonist of leukotriene (LT) D4 in guinea-pig ileum, trachea and lung parenchyma. The compound had little or no effect on contractions of isolated tissues to LTB4, prostaglandin F2 alpha, serotonin, histamine, bradykinin or carbamycholine. Responses of trachea to U46619, a thromboxane A2 mimetic, were antagonized by LY171883, but the doses required were approximately 10-fold higher than those necessary to produce the same degree of antagonism against LTD4. U46619 produced weak ileal contractions that were not blocked by LY171883. LY171883 antagonized both LTD4- and antigen-induced increases in total pulmonary resistance in anesthetized guinea pigs. LTD4 given intradermally to guinea pigs caused vascular leakage which was suppressed by prior administration of LY171883. LTC4-induced contractions of isolated ilea were only minimally antagonized by LY171883 whereas this agent reduced LTC4-evoked increases in total pulmonary resistance. Trachea contracted by LTD4 were relaxed by LY171883. Likewise, trachea contracted by either histamine or carbamylcholine were relaxed by LY171883 suggesting that this compound has airway smooth muscle relaxing properties. In vivo experiments supported these observations. In concert with these findings, biochemical studies showed LY171883 to be a potent inhibitor of phosphodiesterase obtained from human polymorphonuclear leukocytes and various guinea-pig tissues. This pharmacologic analysis indicates that LY171883, or a congener, may be of therapeutic value in asthma and in disease states characterized by an overproduction of LTD4. PMID- 3981453 TI - Endothelial cells and the electrical and mechanical responses of the rabbit coronary artery to 5-hydroxytryptamine. AB - The influence of endothelial cells on the response of smooth muscle in the rabbit coronary artery to 5-hydroxytryptamine (5-HT) was investigated with intracellular microelectrode and mechanical methods. Recent work has suggested that 5-HT stimulates the release of a smooth muscle relaxing factor from endothelial cells, which will reduce the direct constrictor action of 5-HT on the artery wall. In arteries with intact endothelial cells, 5-HT (10(-8) to 10(-4) M) produced dose dependent depolarization of muscle cells in the inner part of the media. Hyperpolarization to 5-HT was not observed, even with 1 microM ketanserin (a 5 HT2 receptor antagonist) present to reduce its direct action on the smooth muscle. After removal of the endothelium 5-HT produced similar sized depolarization, but the graded depolarization was now often accompanied by rhythmical oscillations in membrane potential. Isolated, perfused arteries with an intact endothelium were insensitive to the constrictor action of 5-HT and at wall tensions similar to that in vivo did not show dilatation, even with ketanserin present. Small dilator responses to 5-HT could be recorded in the presence of increased tone to K-rich saline (30 mM). After removal of the endothelium, the mechanical responsiveness greatly increased and 5-HT produced large constrictor responses. The findings suggest that an endothelial-released factor protects the coronary artery from 5-HT which reaches it from the intimal surface and that this protective role could in part be due to inhibition of rhythmical electrical activity in the smooth muscle. PMID- 3981454 TI - Metabolism, distribution, seminal excretion and pharmacokinetics of caffeine in the rabbit. AB - The pharmacokinetics, tissue distribution and metabolism of caffeine were studied in male New Zealand White rabbits after an i.v. dose of 4 mg/kg. The mean (n = 4) distribution half-life was 0.2 hr and the mean elimination half-life was 3.8 hr. The mean clearance was 0.20 liters/kg/hr and the mean volume of distribution was 0.82 liters/kg. Concurrent samples of blood and semen from three rabbits, trained to ejaculate into an artificial vagina, were analyzed. The mean semen/blood concentration ratio of caffeine was 1.0. The concentrations of caffeine in the tissues of three rabbits were examined at 1 hr after an i.v. dose of 4 mg/kg. Most tissues exhibited a tissue/blood concentration ratio of approximately 1.0. Exceptions to this included fat, adrenals, liver and bile in which the ratios were 0.2, 0.6, 1.5 and 2.7, respectively. Urinary metabolites were investigated after an i.v. dose of 4 mg/kg of [14C]caffeine. The metabolites of caffeine were separated by high-pressure liquid chromatography and quantified by liquid scintillation counting. The major urinary metabolites of caffeine in the rabbit were 1-methylxanthine (22%), 1-methyluric acid (19%), 7-methylxanthine (16%) and 1,7-dimethylxanthine (14%). PMID- 3981455 TI - Response and sensitivity of isolated human pulmonary muscle preparations to pharmacological agents. AB - The responsiveness (grams per millimeter squared) and sensitivity (pD2 value) of various agonists were examined in isolated stored human bronchial and pulmonary arterial and venous preparations. In isolated bronchial muscles, large preparations (internal diameter about 6 mm) were less responsive (grams per millimeter squared) to contractile agents than smaller preparations (internal diameter approximately 2 mm). Noncumulative concentration-effect curves were produced in bronchial preparations using histamine, acetylcholine, carbachol and barium chloride. Histamine contracted both bronchial and vascular preparations whereas 5-hydroxytryptamine contracted only vascular tissues. The latter effect was always blocked by either methysergide or ketanserin. 5-hydroxytryptamine relaxed bronchial tissues that were contracted with either histamine, acetylcholine or prostaglandin E2. This relaxation was not antagonized by methysergide, ketanserin, propranolol or indomethacin. Dimaprit and 4-methyl histamine were without effect in isolated contracted bronchial preparations. Vasoactive intestinal peptide, Substance P and platelet-activating factor when added to preparations at resting tone failed to induce a contraction. These agents did not relax histamine-contracted isolated human pulmonary muscle preparations. Anti-immunoglobulin E antibody sometimes contracted isolated human bronchial muscle but not pulmonary vascular preparations. However, these data were difficult to assess because of the variations observed. Anti-immunoglobulin G antibody was inactive. Noradrenaline did not elicit a physiological response in isolated bronchial muscle preparations at concentrations which always induced a contraction in the pulmonary vascular preparations. In the presence of propranolol, noradrenaline neither contracted nor relaxed isolated human bronchial preparations. We also determined the sensitivity of isolated bronchial muscle preparations to isoproterenol, salbutamol and theophylline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981456 TI - Age-related alteration in the activities of drug-metabolizing enzymes and contents of sex-specific forms of cytochrome P-450 in liver microsomes from male and female rats. AB - Age-related changes in the amounts of sex-specific forms of cytochrome P-450 as well as the activities of drug-metabolizing enzymes in liver microsomes of Fischer-344 rats of different ages ranging from 3 to 30 months were studied. Activities of 7-propoxycoumarin O-depropylase and benzo(a)pyrene hydroxylase in male rats, which were higher than those in female rats in younger adults (3-12 months), decreased with increasing age, resulting in the loss of sex differences after 25 months. The male-specific form of cytochrome P-450, namely P-450-male, present in younger adults, was not detectable in older ages. In old male rats, the female-specific form of cytochrome P-450, namely P-450-female, appeared instead of P-450 male. In liver microsomes of young and old female rats, rather constant levels of P-450-female were observed, whereas P-450-male was not detectable. Serum concentrations of testosterone and estradiol were also quantitated. The ratio of testosterone to estradiol concentrations decreased with age in male rats whereas the ratio was not changed in female rats. Based on these results, we propose that the age-related decrease in the activities of drug metabolizing enzymes in male rats is attributable to the change in the population of cytochrome P-450, especially P-450-male and P-450-female, probably owing to the alteration of the levels of gonadal hormones. PMID- 3981457 TI - Effects of calcium entry blockers on coronary constriction and myocardial ischemia due to leukotriene D4. AB - Recent studies show that leukotrienes (LTs) produce profound coronary artery constriction. Although calcium entry blockers are commonly used to remedy coronary vasospasm, their capacity to interfere with LT-mediated coronary constriction is unknown. Therefore, we compared effects of intracoronary LTD4 before and during treatment with calcium entry blockers in the in situ, blood perfused hearts of domestic pigs. Intravenous administration of verapamil (0.1 1.6 mg/kg), nifedipine (10 or 100 micrograms/kg) or diltiazem (0.6-2.0 mg/kg) sufficient to increase base-line coronary blood flow (CBF) and decrease mean arterial pressure did not change decrement in CBF after LTD4. Infusion of verapamil (0.01-0.04 mg/min) into the left anterior descending coronary artery raised pre-LTD4 CBF almost 2-fold without alteration in mean arterial pressure, heart rate or left ventricular end-diastolic pressure. Intracoronary boluses of LTD4 (0.3, 1.0 and 3.0 micrograms) during verapamil infusion into the same vessel caused dose-dependent decreases in CBF identical to those observed when LTD4 was injected during control infusion. ECGs showed myocardial ischemia during severe flow reduction after high dose intracoronary LTD4 (3.0 or 10.0 micrograms). When the same LTD4 doses were injected during intracoronary verapamil, electrocardiographic changes did not occur despite similar decreases in CBF. The capacity of verapamil to prevent LTD4-induced ischemia may be caused by higher residual CBF after LTD4 even though the magnitude of LTD4-induced CBF decrement was unaltered. LTD4-induced coronary constriction seems to be mediated by a mechanism unrelated to calcium entry channels blocked by verapamil, nifedipine or diltiazem. PMID- 3981458 TI - Potentiation of the hepatotoxic effect of acetaminophen by prior administration of salicylate. AB - The effect of sodium salicylate (SS) pretreatment on acetaminophen (APAP) metabolism and hepatotoxicity in mice was studied. Mice were given a single oral dose of SS (100 mg/kg) 1 hr before graded doses of APAP (150-500 mg/kg). Liver histology, serum hepatic enzymes (serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase and isocitric dehydrogenase) and APAP metabolites in urine were examined 24 hr after APAP treatment. Free plasma APAP and liver glutathione were determined over 24 hr after treatment with 400 mg/kg of APAP alone or after SS pretreatment. At 500 mg of APAP per kg, mortality rate was 38% in SS + APAP group; no mortality was seen among animals treated with APAP alone. Centrilobular hepatic hemorrhagic necrosis and/or vacuolation were observed in both treatments. Mitosis of hepatocytes was increased in all APAP-treated mice. Incidence of hepatic necrosis and mean lesion grades at 300- and 500-mg/kg doses increased in mice pretreated with SS. Mice that received SS + APAP had significantly higher levels of serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase and isocitric dehydrogenase at all doses compared to mice treated with APAP alone. APAP glucuronide and sulfate conjugates decreased and APAP mercapturate conjugate increased in urine of mice receiving SS + APAP treatment. Free plasma APAP was significantly higher 2 hr after APAP treatment in SS + APAP-treated mice as compared to mice that received APAP alone. Hepatic glutathione levels were similarly decreased over 24 hr in both groups. These data demonstrate that SS pretreatment alters APAP biotransformation profile and potentiates the hepatotoxic effect of APAP in mice. PMID- 3981459 TI - Evidence for a central site of action for the antitussive effects of caramiphen. AB - The antitussive properties of caramiphen edisylate were studied in the decerebrate cat in which cough was elicited by direct electrical stimulation of the cough center. In this preparation dextromethorphan hydrobromide was compared to caramiphen as an antitussive agent. Dextromethorphan was somewhat more potent when given i.v. as well as when given directly into the left vertebral artery (i.a.). Both agents were far more effective when given i.a. than when given i.v. The effective dose ratios of i.v./i.a. were about 12 and 14 for caramiphen and 11 and 7 for dextromethorphan (actual and cumulative doses). These ratios indicate that both agents have a central rather than a peripheral site of antitussive action. Both drugs had antitussive effects in i.a. doses which did not alter arterial blood pressure or respiration greatly. However, after i.v. administration transient changes in both arterial blood pressure and respiration were observed with both agents. It was concluded that the antitussive action of both caramiphen and dextromethorphan is due to a selective effect on the cough center in the brainstem of the cat. On a milligram per kilogram basis, caramiphen required a 3 to 4 times larger dose than dextromethorphan for equieffective antitussive effects. PMID- 3981460 TI - Chlorphentermine-induced biochemical alterations in mitochondrial membranes. AB - The effects of chlorphentermine (CP) on bioenergetics and monoamine oxidase activity in rat liver mitochondria were examined. Oxidation rates of isocitrate, glutamate and succinate were investigated in the presence of CP (0.5-5.0 mM). In the presence of low concentrations (0.5-2.0 mM) CP decreased respiratory control ratio and ADP/O ratio, and stimulated state 4 respiration. State 3 respiration and uncoupled state were unaffected. The same pattern of changes was found after in vivo CP treatment for 1 or 2 weeks (30 mg/kg i.p., 5 days/week). CP also increased respiration in state 3 that had been inhibited previously by oligomycin. These data indicate that CP functions as an uncoupler of oxidative phosphorylation. In the presence of higher concentrations of CP (3.0-5.0 mM), respiration in states 4, 3 and in uncoupled state, as well as respiratory control ratio and ADP/O, were decreased. Oxidation of norepinephrine, serotonin, tyramine and dopamine by monoamine oxidase, an enzyme marker of the outer mitochondrial membrane, was inhibited in the presence of 0.05 to 0.5 mM CP. Tryptamine and benzylamine oxidation was unaffected. A kinetic study of serotonin oxidation in the absence and presence of CP (0.05-0.25 mM) indicated that both the Vmax and Km were affected. This drug is an inhibitor of liver mitochondrial monoamine oxidase with mixed-type inhibition. These combined data show that CP affects biochemical processes in both inner and outer mitochondrial membranes. PMID- 3981461 TI - Effects of 6-methoxy-2-benzoxazolinone on the pineal melatonin generating system. AB - 6-Methoxy-2-benzoxazolinone (6-MBOA) at concentrations greater than 20 microM stimulates serotonin N-acetyltransferase (NAT) activity of rat pineal glands in 48-hr organ culture as well as of glands freshly cultured, indicating that 6-MBOA acts postsynaptically. The effects of 6-MBOA on NAT activity can be blocked by propranolol but not by prazosin, suggesting that 6-MBOA acts on the beta receptor. At the doses used 6-MBOA stimulation does not block or enhance NAT stimulation by norepinephrine, but is additive with vasoactive intestinal polypeptide which stimulates NAT activity at a site different than the beta receptor. This study demonstrates that 6-MBOA stimulates rather than inhibits melatonin biosynthesis and does not prevent stimulation of melatonin synthesis by norepinephrine. The progonadal association with eating plants containing 6-MBOA in the Montane vole may be due to over stimulation of melatonin receptor sites. Other possible explanations include an extrapineal action such as a blockade of melatonin receptors in the central nervous system, a blockade of receptors on the gonads or to a direct action of this agent on the gonads. PMID- 3981462 TI - Differential effects of xylamine on extracellular concentrations of norepinephrine and dopamine in rat central nervous system: an in vivo electrochemical study. AB - The effects of xylamine (N-2-chloroethyl-N-ethyl-2-methylbenzylamine) on tissue content and extracellular concentration of catecholamines in the rat brain were examined after systemic administration using in vivo voltammetry and high performance liquid chromatography-electrochemical detection. Xylamine at a dose of 12.5 mg/kg i.p. reduced the extracellular concentration of norepinephrine (NE) in the cortex, while having no effect on the extracellular concentration of dopamine in the striatum. The content of NE in the cortex was reduced by approximately 41% at a dose of 12.5 mg/kg and 62% at 25 mg/kg within a 4-hr period, whereas dopamine contents remained unaltered. Both the reduction in extracellular concentration and the depleting action of xylamine on NE content were blocked by pretreatment with desmethylimipramine. The data suggest that xylamine has a selective action on the NE system that is mediated through the neuronal uptake carrier; however, the depleting action of xylamine and its effect on extracellular NE concentration may be unrelated actions. PMID- 3981463 TI - Renal tubular excretory transport of oxalate in the chicken. AB - By use of the Sperber in vivo chicken preparation, infusion of radiolabeled oxalic acid ([14C]oxalate) into the renal portal circulation indicated net excretory transfer of unchanged oxalate. At infusion rates of 0.1 to 100 nmol/min, approximately 26% of the oxalate reaching the kidney was excreted directly into the urine. The excretory transport of oxalate was not altered by infusion of probenecid or terephthalic acid, at rates that blocked completely the excretory transport of simultaneously infused p-aminohippuric acid. Because probenecid and terephthalic acid are also known to inhibit uric acid excretory transport in the chicken kidney, these findings suggest that the transport system for oxalate in the chicken kidney is separate from those handling p-aminohippuric acid and uric acid. The excretory transport of oxalate was decreased by the infusion of alpha-ketoglutaric acid, suggesting that oxalate competes at least in part with other endogenous dicarboxylic acids for uptake at the peritubular membrane. PMID- 3981464 TI - Mechanisms of the synergistic combination of metolazone and bumetanide. AB - We assessed the effects of metolazone and of bumetanide alone and in combination in normal volunteers when both sodium replete and when sodium deprived. In both conditions a supra-additive natriuretic (P less than .025) and chloruretic (P less than .05) effect of the combination was observed, the magnitude of which was somewhat greater in the sodium-deprived state. Neither phosphate excretion nor an index of delivery to the diluting segment was supra-additive, indicating that the synergistic effect most likely did not emanate from the proximal tubule. In contrast, in the sodium-deprived subjects, free water clearance relative to the delivery term was diminished 72 +/- 2% with the combination compared to 64 +/- 2% for the two diuretics individually (P = .003). These data indicate that the supra additive response is due to a synergistic effect of the combination at the diluting segment. PMID- 3981465 TI - Relationship between serotonin and tryptamine receptors in the rat stomach fundus. AB - Tryptamine and serotonin (5-HT) are relatively potent contractile agonists in the rat fundus, a tissue in which contraction to 5-HT is not mediated by interaction with 5-HT1 or 5-HT2 receptors. The identification of [3H]tryptamine binding sites in the brain and fundus that show high affinity for certain beta-carbolines raised the possibility that 5-HT and tryptamine may be interacting with a similar receptor that is best described as a tryptaminergic receptor in the fundus. The affinity of five 5-HT receptor antagonists, ketanserin, metergoline, 1-(1 naphthyl)piperazine, LY154930 and LY175041 was similar when 5-HT or tryptamine was the agonist, indicating that 5-HT and tryptamine are interacting with the same receptor in the fundus. Furthermore, maximum contractile response to both 5 HT and tryptamine was reduced to the same extent by the calcium channel blocker, diltiazem, and by the calmodulin inhibitor, trifluoperazine. Inasmuch as diltiazem and trifluoperazine did not similarly inhibit contraction to agents interacting with other receptors (i.e., carbamylcholine), these data are consistent with the contention that 5-HT and tryptamine are interacting with the same receptor in the fundus. Consistent with this conclusion is the observation that affinity of the beta-carbolines, harmaline and harmine was also similar when tryptamine or 5-HT was used as the agonist. However, affinity of the beta carbolines for the tryptamine/5-HT receptor in the fundus was dramatically lower than reported for [3H]tryptamine binding sites in brain membranes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981466 TI - Effect of halothane-oxygen anesthesia on the pharmacokinetics of diazepam and its metabolites in rats. AB - Inhalation anesthetics have been shown to substantially diminish the clearance of several drugs eliminated by hepatic routes. The purpose of the present study was to determine the influence of halothane-oxygen anesthesia on the hepatic metabolism of diazepam and its proximate metabolites in anesthetized rats whose physiologic status was monitored and maintained. The portal vein, femoral artery and bile duct of male Sprague-Dawley rats 370 to 395 g, were cannulated under pentobarbital anesthesia. After a 2-hr recovery period, [14C]diazepam was administered in to the portal vein as a 0.25-mg/kg bolus followed immediately by a 0.25-mg/kg/hr infusion by the same route. After the attainment of steady state, the halothane group (seven rats) received 1% halothane in oxygen whereas the control group (six rats) continued to breathe room air. The diazepam infusion was maintained for an additional 3 hr. Concentrations of diazepam, N desmethyldiazepam, 4-hydroxyphenyldiazepam and 3-hydroxydiazepam were determined in plasma; these metabolites as well as oxazepam and N-desmethyl-4 hydroxyphenyldiazepam were also determined in bile. Radioactivity in bile was approximately 98% conjugated; radioactivity in plasma was approximately 30% conjugated. Halothane anesthesia caused an increase in the concentrations of diazepam and its metabolites in plasma, but the steady-state ratios of the concentration of the individual metabolites in plasma to diazepam concentration were not changed. The intrinsic clearance of diazepam was decreased by 42%, P less than .01, and the ratio of formation to elimination clearance of the metabolites measured in plasma was not changed. Halothane anesthesia also decreased the excretion rate of 14C into bile.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981468 TI - Transient responses of coronary flow in the blood-perfused isolated rat heart submitted to changes in oxygen content. AB - This study examines the transient response of coronary blood flow to acute changes in O2 content at normal and high arterial PO2 (Pa, O2) in the blood perfused, working isolated rat heart. The perfusion system used in this study presents the following advantages: it eliminates the gas/blood interface, includes a peripheral circulation for control of pre-load and after-load, and allows for rapid change of perfusates and continuous recording of aortic and coronary blood flow. With this system the isolated rat heart is capable of stable haemodynamic performance for periods in excess of 4 h. A sudden decrease in O2 content from 0.147 to 0.067 11(-11) at constant Pa,O2 (133 mmHg; n = 15) was associated with a marked increase in coronary blood flow (QCOR). This increase showed two phases: a rapid phase which reached 200% of the control value in 20 s, followed by a slow phase (235% in 90 s). When the same decrease in O2 content (0.135 to 0.057 11(-1] was associated with an increase in Pa, O2 (n = 22; 143 to 412 mmHg), the response of QCOR was limited both in amplitude (175% rather than 235%) and in rate of onset (response time of 15.6 instead of 9.2 s). These results are consistent with the majority of currently popular hypotheses regarding control of QCOR including the adenosine hypothesis and that of vessel wall PO2 being a direct mediator. The time course of changes in coronary vascular resistance, with a Pa, O2-dependent rapid phase, suggests the simultaneous function of the two mechanisms. PMID- 3981467 TI - The selective innervation of guinea-pig superior cervical ganglion cells by sprouts from intact preganglionic axons. AB - If the guinea-pig superior cervical ganglion is partially denervated in a way which spares some preganglionic axons arising from each of the spinal cord segments which normally innervate this ganglion (C8-T7), sprouting of the intact preganglionic axons occurs without a loss of selective end-organ responses to stimulation of individual ventral roots (Maehlen & Nja, 1981). In the present work we examine the selective innervation of individual ganglion cells by ventral roots after sprouting and compare it to that in normal ganglia. After sprouting the pattern of ganglion cell innervation by the intact preganglionic axons shows some of the features typical of normal ganglia. Thus each ganglion cell is strongly innervated by one or two neighbouring spinal cord segments, with the adjacent segments contributing a synaptic influence which diminishes with distance from the dominant one. Acutely after the partial denervation there is a tendency for the rostral segments to innervate ganglion cells more strongly than do caudal segments, compared to the situation in normal ganglia. The same is true following sprouting. The pattern of ganglion cell innervation observed after sprouting can be explained if the affinities of ganglion cells for innervation from particular spinal levels are assumed to be unchanged and the shift in the relative availability of different preganglionic axons, caused by the partial denervation, is taken into account. This view was substantiated by statistical analysis based on a model of selective synapse formation in the guinea-pig superior cervical ganglion. We conclude that the ability of individual ganglion cells to distinguish preganglionic axons arising from different spinal levels is maintained during sprouting. Moreover, the way in which selective recognition and the availability of different preganglionic axons combine to produce particular patterns of innervation appears to be similar in normal development and after partial denervation in maturity. PMID- 3981469 TI - The effects of oestrogens on spontaneous activity and responses to phenylephrine of the mammalian urethra. AB - The electrical and mechanical activity of strips of urethral smooth muscle from female ovariectomized rabbits were studied. Results were compared with strips from guinea-pigs, dogs and Tammar wallabies and with anaesthetized rabbits. From pressure recordings in intact animals and contractile responses of strips it was concluded that in the urethra of the rabbit both cholinergic and alpha-adrenergic receptors were excitatory. Urethral strips from rabbits and wallabies had continuous spontaneous mechanical activity that was reduced by pre-treatment with oestrogen. In dogs spontaneous activity was transient and in guinea-pigs was usually absent. The alpha-adrenergic agonist, phenylephrine, produced a dose related contraction of urethral strips from all species. Pre-treatment with oestrogen produced no significant change in the rabbit and guinea-pig but increased sensitivity in the dog and wallaby. Electrical activity was recorded with micro-electrodes from smooth muscle cells of rabbit and guinea-pig urethra. In both species pre-treatment with oestrogen produced slight depolarization. In rabbits regular spike activity was recorded from all animals but there was a tendency for double spikes and reduced amplitude following oestrogen treatment. In guinea-pigs bursts of spikes occurred in control animals; after hormone treatment there was often incomplete recovery of spikes within the burst. The results indicate that oestrogens can influence the smooth muscle of the urethra by modifying both spontaneous activity and the responses to stimulation of alpha adrenoceptors. PMID- 3981470 TI - Structural and topographical influences on functional connectivity in spinal monosynaptic reflex arcs in the cat. AB - A greatly expanded version of spike-triggered averaging (Mendell & Henneman, 1971), performed off-line on tape-recorded signals, was utilized to determine the presence or absence of functional connexions between stretch-afferent fibres and homonymous motoneurones. As many as 264 possible connexions between eleven Ia or spindle group II fibres and twenty-four motoneurones were studied in each single, acute experiment. Morphological and topographical factors influencing functional connectivity were analysed with the aid of wiring diagrams and connectivity matrices. In all experiments the greater the conduction velocity (i.e. diameter) of a Ia or group II fibre, the higher was the probability of its having functional connexions with homonymous motoneurones. The greater the longitudinal distance between the spinal entry points of Ia fibres and the location of a motoneurone, the less was the same probability. The influence of axonal conduction velocity of motoneurones on functional connectivity was apparent in some experiments, but not in others. In pooled data large motoneurones received functional connexions from a higher percentage of group II fibres than did small cells. The projection percentage reached 100 only when both Ia fibres and motoneurones were large, suggesting that motoneurone size influences the probability of functional connexions from group Ia as well as group II fibres. On a cell-to-cell level, connectivity apparently does not follow strict, deterministic rules. The results raise the question of how probabilistic connexions between afferent fibres and motoneurones give rise to deterministic outputs from the whole pool. PMID- 3981471 TI - Cholinergic mechanisms in human coronary artery preparations: implications of species differences. AB - Acetylcholine dilates most arteries, including dog coronaries, if the endothelium is intact. The present study has shown only contraction of human coronary arteries to acetylcholine. Both strip and ring preparations of human coronary epicardial vessels, the latter done particularly to protect the intimal surface from unintentional denudation, contracted to acetylcholine at low to high concentrations (6.84 X 10(-9)-2.05 X 10(-5) M). These responses were blocked by atropine (3.45 X 10(-6) M). Acetylcholine contracted the arteries about as much as ergonovine and considerably more than noradrenaline. Field stimulation of coronary artery strips caused a vasoconstriction which was partially antagonized by atropine (3.45 X 10(-6) M). The release of [3H]noradrenaline from superfused coronary artery preparations during field stimulation was inhibited by methacholine (6.24 X 10(-6) M), a stable muscarinic analogue of acetylcholine. Dog coronary arteries relaxed to acetylcholine but not if the endothelium was intentionally denuded, in which case there was either no response at all or a weak relaxation. Coronary arteries of sheep, pig and cattle always contracted to acetylcholine, and those of monkey contracted in two out of three responsive preparations. Histological examination of the intimal surface of human coronary vascular segments confirmed the presence of an intact endothelial cell layer. Rabbit aorta gave dilator responses to acetylcholine even after being left in the animal for as long after death as the human arteries had been; they did not give dilator responses after the endothelium was rubbed off. It is concluded that cholinergic vasoconstriction of coronary arteries occurs in humans, though not in the dog, and is probably important in some cases of coronary artery spasm. PMID- 3981472 TI - Magnocellular red nucleus activity during different types of limb movement in the macaque monkey. AB - Three hundred and thirty-four neurones located in the magnocellular division of red nucleus (r.n.m.) were studied in three alert macaque monkeys. These cells had low discharge rates at rest and produced high frequency bursts during movement. Single cells were selectively active for movement of one body part, and a motor somatotopy was evident. From dorsal to ventral we encountered cells related to movements of the face, contralateral upper limb, contralateral lower limb and, in one case, the tail. Free-form tests indicated that 76% of upper-limb cells were preferentially related to hand and finger movements, and 84% of lower limb cells were preferentially related to foot and toe movements. Quantitative tests of movement relations were based on depths of modulation in discharge rate recorded while the monkeys operated several devices that served as manipulanda in a tracking task; each device elicited a different movement. We conducted 220 tests on eighty-one cells using eleven devices. The modulation in discharge rate exceeded a 50 pulses/s criterion level in seventy-nine cases; eleven were well related to proximal movements, twenty-two to movements of the digits and forty six to a co-ordinated hand movement elicited by a device called the twister. Both unidirectional and bidirectional patterns of bursting were frequent. A few cells showed reciprocal patterns consisting of a large increase in rate for one direction of movement and a small decrease for the other. The bursts in discharge preceded movement onset (97% of 132 cases) by an average of 135 ms. Electromyographic activity in forearm muscles preceded movement by about 55 ms. In some cases we recorded from a single cell while the monkey operated two, three or four devices. Depth of modulation on the twister device was twice that on a proximal device in nine cases whereas one case showed a proximal device preference; five cases showed overlap. Comparison between twister and digits yielded ten cases of twister preference, four of digit preference and twenty cases of overlap. A directional preference was found for ten out of eleven cells responsive during active movement restricted to the metacarpo-phalangeal joints, and in all cases the preferred direction was extension. Responses to natural somatosensory stimulation were weak or absent for the majority of cells. When present, sensory fields were confined to the same limb but were frequently out of register with motor fields.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981474 TI - Excitation-contraction coupling and charge movement in denervated rat extensor digitorum longus and soleus muscles. AB - K contractures and asymmetrical charge movement were recorded in extensor digitorum longus (e.d.l.) and soleus muscles that had been denervated for 2-68 days. The relationship between maximum tension during a K contracture and membrane potential shifted to more negative potentials in denervated e.d.l. muscles (by -25 mV on average) and to a lesser extent in soleus (by -8 mV on average), and became steeper, more so in e.d.l. than soleus. Apart from an early negative shift of -11 mV in the voltage dependence of tension in e.d.l. muscles during the first week, the other changes in K contractures following denervation occurred progressively during the first 3 weeks and then stabilized. There was a clear difference in charge movement in denervated e.d.l. fibres but little change in denervated soleus fibres, so that the characteristics of charge movement in e.d.l. and soleus became very similar. The maximum amount of charge movement fell from an average normal value of 23 nC/microF to 6 nC/microF in e.d.l. within the first 2 weeks. The voltage sensitivity shifted to more negative potentials (by about -12 mV on average) within the first week. There was no significant change in the slope of the relationship between charge and membrane potential. The effects of denervation on charge movement could only partly explain the changes in K contractures. The only obvious parallels were the early negative shift in the voltage dependence of charge movement and tension in denervated e.d.l. fibres. The other changes in K contractures in denervated fibres could be due to a change in the relationship between charge movement and Ca concentration in the myoplasm or an increase in the Ca affinity of the myofilaments. Although charge movement fell to about a quarter of normal in denervated e.d.l. fibres, membrane capacity increased approximately 3-fold. A similar increase in capacity in soleus fibres was not associated with a change in charge movement. Fewer indentations were seen in denervated than in normal e.d.l. fibres. The decrease paralleled the fall in charge movement. PMID- 3981473 TI - Relation between red nucleus discharge and movement parameters in trained macaque monkeys. AB - Correlation and regression analyses were performed on thirty-three of the magnocellular red nucleus cells described in the previous paper. We sought to test for reliable relations between the parameters of individual tracking movements and corresponding bursts of neural discharge. High correlations were found between the following burst and movement parameters: (i) burst latency versus movement latency; (ii) burst duration versus movement duration; (iii) burst frequency versus movement velocity and (iv) number of spikes in the burst versus movement amplitude. Cells were ranked according to the average of the duration, velocity and amplitude correlation coefficients. The top twenty cells had average correlation coefficients ranging from 0.69 to 0.88 for their preferred movement. These cases were judged most likely to reveal the control functions of the red nucleus, and the following points refer to this sample. Burst onset led movement onset by 118 +/- 23 ms, and burst offset led movement offset by 50 +/- 38 ms. Burst duration increased as the duration of the movement increased (r = 0.87 +/- 0.11). The duration of the burst was approximately equal to movement duration (slope of 0.99 +/- 0.16) plus a constant (72 +/- 34 ms) throughout a broad range. Average discharge rate during the burst increased with average movement velocity (r = 0.69 +/- 0.15). The slope of the relation was 0.36 +/- 0.21 (pulses/s)/(deg/s) of joint rotation. The regression lines had consistent upward offsets (56 +/- 15 pulses/s) that exceeded the spontaneous discharge rate (17 +/- 10 pulses/s). The number of spikes in the burst increased with movement amplitude independent of velocity (r = 0.72 +/- 0.11). The slope of the relation was 0.62 spikes/deg and the offset was 13 +/- 4 spikes. The preferred movement was co-ordinated hand in fifteen cases, digit in three, elbow in one and shoulder in one. When these cells were tested with an alternate movement, the failure rate (cases in which a burst did not accompany a movement) increased from 1.4 to 20%, and the correlation coefficients generally were low and lacked significance. Cells in the top twenty had directionally specific responses, low variance in lead time, large depths of modulation (41-118 pulses/s) and low failure rates. Cells that failed to show strong parametric correlations often had one or more of the former attributes. It appears that high parametric correlations with individual movements are particularly restrictive criteria of relatedness.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3981475 TI - Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome. AB - A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively. PMID- 3981476 TI - Assessing depression and anxiety in chronic dialysis patients. AB - One hundred and twenty-eight patients on chronic dialysis were studied by the Zung Self-Rating Depression Scale and Self-Rating Anxiety Scale, the Differential Emotion Scale (DES), the Test of Emotional Styles (TES), and the Social Dysfunction Rating Scale (SDRS). As measured by the Zung scales, approximately half of the sample manifested depression and anxiety symptoms at clinically relevant levels. The data suggested an inverse correlation between depression and anxiety levels and patients' total length of time on dialysis, which may explain some of the variation in depression and anxiety results obtained with different samples. Depression and anxiety scores were correlated with related DES and SDRS factors, but patients' scores on the DES, TES, and SDRS generally indicated positive mood and functioning. Scales containing disease-related somatic items may yield exaggerated depression and anxiety scores for dialysis patients. It may be useful to assess patients' psychological functioning with several different instruments. PMID- 3981477 TI - Loneliness, birth order and social loss among a group of elderly women. AB - This paper is concerned with birth order as a childhood experience which may effect how and when older adults experience loneliness. In this study 207 elderly women (mean age 77) were studied in terms of birth order, social loss, depressive disorder and loneliness. As hypothesized, firstborns will experience less loneliness than laterborns under socially stable circumstances. But, after a social loss, firstborns are likely to experience more loneliness than laterborns. The effect of social loss and loneliness was also examined in terms of two health outcome variables--depressive disorder and physical complaints. No direct or indirect (via loneliness) effect of social loss on the health variables was found. Loneliness was found to have an effect on depressive disorder but not on physical complaints. Finally, for firstborns an interaction between social loss and loneliness was observed on physical complaint outcomes. PMID- 3981478 TI - Obesity and post-operative pain. AB - Patients underwent elective abdominal surgery for morbid obesity (mean = 154 kgs, n = 55) or cholecystectomy (mean = 71 kgs, n = 54). Post-operative narcotics were transformed into morphine equivalent units (ME). Morbidly obese patients received significantly fewer total doses than cholecystectomy patients and less total mg ME/kg over a five-day period. Sedative use for both groups was comparable. In the morbidly obese patients, preoperative psychiatric and drug usage data predicted 67% of the variance in number of doses and 69% of the variance in total mg ME/kg. PMID- 3981479 TI - The effects of cognitive task demand on subjective stress and blood glucose levels in diabetics and non-diabetics. AB - Blood glucose levels (BGLs) and subjective estimate of stress levels (SESLs) were measured repeatedly in 45 min baseline sessions on three successive days in insulin-dependent diabetic and non-diabetic groups. In the diabetic groups the initial level of BG was twice that of the non-diabetic group and BGLs declined steadily within each session but not across sessions whereas BGLs in the non diabetic group remained steady both within and across sessions. On two subsequent days half of each group performed a high demand and half a low demand task, BGLs and SESLs being assessed before, during and after the stress period. Stress did not appear to induce significant changes in BGL in any of the groups even though SESL measures indicated that the task appeared stressful to the groups. The implications of these findings for the relationship between stress and increases or decreases in BGL are discussed. PMID- 3981480 TI - The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. AB - This report describes the construction of a questionnaire to measure three dimensions of human eating behavior. The first step was a collation of items from two existing questionnaires that measure the related concepts of 'restrained eating' and 'latent obesity', to which were added items newly written to elucidate these concepts. This version was administered to several populations selected to include persons who exhibited the spectrum from extreme dietary restraint to extreme lack of restraint. The resulting responses were factor analyzed and the resulting factor structure was used to revise the questionnaire. This process was then repeated: administration of the revised questionnaire to groups representing extremes of dietary restraint, factor analysis of the results and questionnaire revision. Three stable factors emerged: (1) 'cognitive restraint of eating', (2) 'disinhibition' and (3) 'hunger'. The new 51-item questionnaire measuring these factors is presented. PMID- 3981481 TI - Environmental stress factors associated with toddler's diarrhoea. AB - Seventeen children with toddler's diarrhoea showed significantly higher incidence of environmental and biographical indicators of personal or familial stress than a matched group with other physical disorders. An association is suggested between environmental influences and the aetiology and maintenance of toddler's diarrhoea. PMID- 3981482 TI - Biofeedback, self-control and tension headache. AB - This research tested the belief that muscle contractions are a primary source of tension headache. EMG level was found to be associated with both headache specific and more global symptoms following biofeedback training. However, the level of pretreatment relationship between EMG level and headache symptoms was weak, and the amount of reduction in EMG activity over the course of biofeedback did not explain improvement. In addition, although the voluntary control over muscle spasming evidence by lowered EMG readings appeared to enhance patients' post-treatment level of self-control, this cognitive process variable also could not account for outcome variance. The results offer limited support for the muscle-origins conception of tension headache and suggest the need for further research to clarify the contribution of physiological, cognitive and social factors to pain reduction. PMID- 3981483 TI - Hormonal modulation of human natural killer cell activity in vitro. AB - This study investigates the effect of steroid and polypeptide hormones on human NK cell activity in vitro. Solutions of hormones were incubated with normal peripheral blood cells in a 4 h cytotoxic assay against the NK-sensitive erythromyeloid cell line K562. The steroid hormones oestradiol, progesterone and testosterone did not exhibit a significant effect on K562 lysis at concentrations within the normal physiological range. HCG and LH, however, had a marked effect on NK activity, the latter at concentrations within the range observed in normal menstruating females. PMID- 3981484 TI - Human NK cell activity is not inhibited by pregnancy and cord serum factors and female steroid hormones in vitro. AB - The effects of female sex steroid hormones and of pregnancy and cord sera on human NK cell activity against the NK sensitive K562 cells were studied. The cytotoxicity of adult peripheral blood lymphocytes was measured after incubation of peripheral blood effector cells in vitro with estrone, 17 beta-estradiol, estriol, or progesterone at concentrations ranging from 1 to 1000 nM. The cytotoxic activity of effector cells was not altered by pre-treatment of cells with steroid hormones, and the presence of the steroids in the NK assays caused minor changes only at the highest concentrations. Similarly, the effects of sera obtained from pregnant women during the third trimester and from cord blood were studied. Compared to normal pooled AB serum, pregnancy and cord sera had no effect on NK cell activity. On the contrary, the presence of fetal calf serum in the culture medium consistently resulted in a higher NK activity than that obtained with AB serum, cord serum, pregnancy serum, or the medium alone. The augmenting effect of human leukocyte interferon on NK cell activity was not inhibited by these sera. It is concluded that female sex steroid hormones and pregnancy and cord sera are not inhibitory in vitro to normal human NK cells. PMID- 3981485 TI - The suppressive effect of progesterone on lymphocyte cytotoxicity: unique progesterone sensitivity of pregnancy lymphocytes. AB - The effect of progesterone on the cytotoxic activity of lymphocytes obtained from healthy pregnant women, women with threatened pre-term delivery, healthy non pregnant women and healthy male donors has been compared. The cytotoxic activity of lymphocytes from healthy pregnant women was significantly reduced by progesterone at concentrations present in the serum during pregnancy. In contrast, a 100-fold higher concentration of progesterone was required to diminish the cytotoxic activity of lymphocytes from women with threatened pre term delivery and from healthy male donors. Individuals with lymphocytes of high and low progesterone sensitivity could be found amongst non-pregnant women. The results of investigations at the single cell level suggested that although progesterone did not inhibit the ability of the lymphocytes to bind to the target cells, it markedly reduced the target cell lysing capacity of the bound effector cells. PMID- 3981486 TI - Evaluation of a rosette inhibition test for pregnancy diagnosis in pigs. AB - A rosette inhibition test was developed using pig lymphocytes and sheep red blood cells. Antilymphocyte serum (ALS) in the presence of complement inhibited rosette formation by greater than 95% at 1/250 declining to no inhibition at 1/8000. Sera obtained from a total of 14 pregnant sows before and 1, 2, 3 and 4 wk after mating were tested for their ability to augment the rosette depression caused by ALS. In one experiment in which the responses of 4 pregnant sows were compared to 4 non-pregnant sows by discriminant analysis, sera were classified correctly in 83% of the samples taken from either pregnant or non-pregnant sows. When the more usual method of calculating the rosette inhibition titre was used, the responses of sera from pregnant pigs were classified with 31% accuracy and those from non pregnant pigs with 80% accuracy. In a second experiment, sera from 10 pregnant sows were classified with 25% accuracy using the rosette inhibition titre. Thus 4 of these pigs were classified as non-pregnant by this method. Data from the second experiment were not suitable for discriminant analysis. It was concluded that there was some factor present in the sera of pregnant pigs, particularly by 3 or 4 wk post-mating, which could be detected by the rosette inhibition test. However, the test is not sensitive enough to allow specific diagnosis of early pregnancy in pigs. PMID- 3981487 TI - Formulation of a potential antipregnancy vaccine based on the beta-subunit of human chorionic gonadotropin (beta-hCG). I. Alternative macromolecular carriers. AB - The antibody response obtained after vaccinating rabbits with the beta-subunit of human chorionic gonadotropin (beta-hCG) linked to several protein and polysaccharide carriers was measured. In all but one preparation, carbodiimide was used to couple the beta-hCG to the carrier. Tetanus toxoid (TT) and cholera vaccine proved the most effective carriers among those examined. TT from different manufacturers proved to be greatly different in free amino group content and differed in ability to participate in the coupling reaction. Reasonably good replication of the coupling reaction was obtained with different production lots from the same manufacturer. Inferior antigenic response was obtained with the products of coupling beta-hCG to H. pertussis, influenza vaccine, polylysine, pneumococcus polysaccharide, or E. coli polysaccharide. The findings indicate TT and cholera vaccine to be especially effective in enhancing the antigenicity of a weakly antigenic peptide but point to significant differences in the TT from different manufacturers. PMID- 3981488 TI - Formulation of a potential antipregnancy vaccine based on the beta-subunit of human chorionic gonadotropin (beta-hCG). II. Use of compounds of the muramyl dipeptide (MDP) family as adjuvants. AB - Earlier tests of an antipregnancy vaccine consisting of the beta-subunit of human chorionic gonadotropin (beta-hCG) linked by reaction with a carbodiimide reagent to tetanus toxoid (TT) and adsorbed on Al(OH)3 resulted in antibody responses that were judged inadequate in some women. Experiments were therefore conducted to evaluate the effectiveness of additional adjuvants in increasing the antibody response. Muramyl dipeptide (MDP) and several of its analogs were formulated with the vaccine and tested in rabbits. Some of the analogs, and notably N-acetyl normuramyl-L-alanyl-D-isoglutamine, elicited substantial increments in the ability of the antisera to bind [125I]hCG and in its ability to neutralize hCG in the rat uterine weight assay. The effectiveness of these peptides was greatest when formulated in a water-in-oil emulsion. Increments of 10 fold were attained using a vegetable oil as the oil component. The MDP analogs were much less effective as adjuvants when formulated in oil-in-water emulsions or in aqueous suspensions of the antigen. It is concluded that selected MDP analogs incorporated in a water-in-vegetable oil emulsion can markedly increase the circulating antibody response to the beta-hCG-TT vaccine. PMID- 3981489 TI - Formulation of a potential antipregnancy vaccine based on the beta-subunit of human chorionic gonadotropin (beta-hCG). III. Evaluation of various vehicles and adjuvants. AB - Rabbits were used to test the efficacy of several materials as supplementary adjuvants when administered as part of a vaccine formulation consisting of the beta-subunit of human chorionic gonadotropin linked to tetanus toxoid (beta-hCG TT) and adsorbed on Al(OH)3. In the amounts used, Corynebacterium parvum, levamisole, thymic factor, and N,N-dioctadecyl-N',N'-bis(2 hydroxyethyl)propanediamine exhibited little adjuvant activity although the latter material elicited marginal increments when incorporated in liposomes. A Salmonella lipopolysaccharide preparation (SPLPS) and a streptococcal preparation (OK-432) each gave approximately 7-fold increments in titer. The SPLPS preparation was pyrogenic at the doses used. OK-432 was nonpyrogenic and did not cause other evident undesirable effects. It may therefore prove to be a useful adjuvant. It gave a nearly flat dose response curve over the range of 0.5 to 4.0 mg per rabbit. Incorporation of beta-hCG-TT on Al(OH)3 in a water-in-oil emulsion caused a moderate increase in titers. Incorporation into liposomes or an oil-in water emulsion was not effective. PMID- 3981490 TI - Standard curves for birth weight. AB - The standard curves based on data from Denver are used to determine whether birth weights are appropriate. Several reports note differences between their birth weights and those from the Denver report and ascribe them to climatic and socioeconomic conditions. This study analyzed the data for a middle-class city near sea level. The birth weights for two years (1970 and 1982) were analyzed. The 10th, 50th and 90th percentiles were provided for 36-44 weeks of gestation for the 1982 data. The birth weights increased significantly over time. A statistical analysis of proportions gave significance to the birth weight differences in terms of sex and parity. Part of the increase in cesarean sections might have been the result of the increase in birth weights. Standard curves for birth weights should be based on regional data and updated periodically. PMID- 3981491 TI - Transverse vaginal septum. A report of four cases. AB - Transverse vaginal septum is an uncommon congenital anomaly. At our institution four patients were seen with this condition, each one presenting in a different manner. PMID- 3981492 TI - Assessment of severe pulmonary disease in pregnancy with Swan-Ganz monitoring. A report of two cases. AB - Two parturients with severe pulmonary disease had cardiopulmonary hemodynamics assessed by invasive techniques, and vaginal delivery was conducted under continuous epidural anesthesia. Both patients demonstrated hypoxemia (F1O2 = 0.21%) by arterial blood gas analysis. Supplemental oxygen was administered throughout the last trimester of pregnancy. The patient with chronic pulmonary fibrosis had dyspnea at rest prior to pregnancy and delivered a viable, 1,400-gm infant prematurely. She died suddenly three weeks postpartum. The second patient, 41 years old, had a twin gestation. A pneumonectomy had been performed previously for tuberculosis. The patient demonstrated numerous bouts of acute pulmonary embarrassment and pneumonia, developed gestational diabetes and dyspnea late in gestation and spontaneously delivered two viable, 1,600-gm infants prematurely. All did well. Swan-Ganz catheters were used to assess cardiopulmonary hemodynamics in both patients. Epidural anesthesia was used successfully in both. PMID- 3981493 TI - Identification of nuchal cords during nonstress testing. AB - A reactive nonstress test (NST) has been demonstrated to be an excellent predictor of fetal well-being. Unfortunately, some fetuses continue to be lost, perhaps secondary to umbilical cord accidents. While examining this problem, we noted a unique "double variable," or "W pattern," on the NSTs of fetuses found at delivery to have a nuchal cord. In a prospective study to examine the accuracy of predicting the presence of a nuchal cord, 200 consecutive patients undergoing antepartum fetal heart rate testing were monitored for the occurrence of a W pattern on their NSTs. One hundred percent of the women with a W pattern delivered infants with at least one nuchal cord. In addition, the W pattern was associated with a higher incidence of five-minute Apgar scores of less than 7. The ability to identify infants with nuchal cords prior to delivery may be beneficial in identifying infants at increased risk of unexpected fetal distress or death. PMID- 3981494 TI - Measurements of maximum respiratory pressures in polymyositis and dermatomyositis. AB - Measurements of maximum respiratory pressures and routine pulmonary function tests were performed in 8 patients with polymyositis (PM) and 2 patients with dermatomyositis (DM). Serial measurements of routine pulmonary function tests in 8 patients remained unchanged. Maximum respiratory pressures were decreased initially in 7 patients with proximal muscle weakness and clinically active muscle disease and improved with corticosteroid therapy in the 5 patients who were followed serially. In 3 patients with clinically stable disease the maximum respiratory muscle power was normal. Serial measurements of maximum respiratory pressures have been of value in monitoring patients with PM and DM. PMID- 3981495 TI - Anterior spinal flexion in healthy Mexican children. AB - We investigated anterior spinal flexion (ASF) in a group of 250 healthy Mexican children (125 boys and 125 girls) aged from 6 to 15 years using the Schober's and Macrae and Wright's techniques and 4 new variants. Two of these variants were the more reliable methods of measuring the ASF in children. Marks either 5 cm (Method 3) or 10 cm (Method 4) above and 2.5 cm below the lumbosacral junction were made in the midline of the back with the children standing upright. After bending their trunks, the distraction between the inferior and superior marks was measured. ASF did not increase nor decrease with age. Highest values were found in boys. Values of at least 4 and 6 cm for boys and 3 and 5 cm for girls using Methods 3 and 4 are required to consider ASF in children aged from 6 to 15 as normal. PMID- 3981496 TI - Rare adverse reactions to nonsteroidal antiinflammatory drugs. AB - Excluding the most frequent kinds of problems seen with the nonsteroidal antiinflammatory drugs (NSAID)--gastritis, peptic ulceration and renal effects- published reports indicate that these drugs may cause a wide variety of rare adverse reactions. The most serious of these are hypersensitivity reactions: blood dyscrasias (aplastic anemia, thrombocytopenia, agranulocytosis, hemolytic anemia), erythema multiforme and hepatitis. Aseptic meningitis and anaphylactoid reactions may strike patients with underlying immunologic abnormalities; urticaria, bronchospasm and proctocolitis may affect aspirin-sensitive patients. Other unusual reactions include several kinds of bullous dermatitis, febrile reactions, pneumonitis, esophageal ulceration, parotitis, pancreatitis and neurological or psychological effects. PMID- 3981497 TI - Chondrocalcinosis and rapid destruction of the hip. AB - The frequency and significance of articular chondrocalcinosis was studied in 86 cases of osteoarthritis (OA) with rapid destruction of the hip that underwent total arthroplasty. The occurrence of articular chondrocalcinosis was 3 times more frequent than in a matched control population without rheumatic complaints (32.5% vs 10.5%). In a matched group of control patients operated on for common OA of the hip, the frequency of articular chondrocalcinosis (18.6%) was higher than in the control patients but significantly lower than in the patients with rapid destruction of the hip. Fifty-five patients in each of the 3 groups were aged 70 years or more, and the frequency of articular chondrocalcinosis in those patients with rapid destruction of the hip rose to 45.4% compared to 13.7% for the control group (p less than 0.01) and 27.2% for the group with common OA of the hip (p less than 0.05). PMID- 3981498 TI - Plasma and synovial fluid concentrations of salicylic acid and its metabolites in patients with joint effusions. AB - Equilibration of salicylic, salicyluric and gentisic acids between plasma and synovial fluid (SF) was measured in 36 patients receiving chronic salicylate therapy and from whom SF was required for diagnostic purposes. Gentisic and salicyluric acids equilibrated completely, while SF salicylic acid concentration was less than that in plasma. The presence of significant gentisic acid concentrations in SF could contribute to the therapeutic response to chronic salicylate therapy, since its antiinflammatory effect is even greater than that of acetylsalicylic acid. PMID- 3981499 TI - Plasma and synovial fluid gentisate in patients receiving salicylate therapy. AB - Our study was undertaken to assay gentisate, an oxidation metabolite of salicylate, in plasma and synovial fluid (SF) samples from patients taking antiinflammatory doses of aspirin. A close correlation between plasma and SF concentrations was found for (1) salicylate, (2) salicylurate, and (3) gentisate, in 20 patients studied. Our data suggest ready equilibration of these compounds between the plasma and synovial spaces. In vitro experiments confirmed that in the presence of an oxy radical flux, salicylate is oxidized to gentisate. However, no evidence was obtained to implicate peripheral conversion of salicylate to gentisate in inflamed joints where oxy radicals may be produced. PMID- 3981500 TI - Joint contractures and acroosteolysis in Ehlers-Danlos syndrome type IV. AB - Among a series of 10 patients with Ehlers-Danlos syndrome Type IV, several had peripheral joint contractures and 3 had acroosteolysis. The consequent deformities simulated the appearance of chronic inflammatory joint disease and hence, patients with this rare syndrome may come to the attention of rheumatologists. Recognition of Ehlers-Danlos syndrome Type IV is important because of the risk of early death from arterial rupture. The syndrome is also of theoretical importance as an "experiment of nature" illustrating functional consequences of deficiency of Type III collagen. PMID- 3981501 TI - Arthritis in children with multiple epiphyseal dysplasia. AB - Multiple epiphyseal dysplasia is an autosomal dominantly inherited disorder characterized by dwarfism, stubby digits, and abnormalities in maturing epiphyses. This syndrome has been associated with the onset of osteoarthritis during early adolescence; frank arthritis before puberty has not been reported. We describe 4 children with multiple epiphyseal dysplasia who developed chronic arthritis during the first decade of life. PMID- 3981502 TI - Thiemann's disease. AB - Two cases of Thiemann's disease in children are reported for the first time from North America. A history of swollen, tender proximal interphalangeal joints with radiographic evidence of irregularities of the epiphyses leading to premature fusion and subsequent shortening of the middle phalanges resulted in this diagnosis. Recognition of these features should lead to its more frequent diagnosis. PMID- 3981503 TI - Peritendinous nodules in overlap syndrome. AB - Peritendinous nodules were observed in 4 patients with overlap syndrome. In all cases they were multiple, minute and located around the flexor tendons of the forearms and the extensor tendons of the hands. Similar nodules were also found on the extensor aspect of elbows, dorsum of the feet, hamstring muscles and Achilles tendons. Common histologic features were inflammatory granuloma with scattered areas of fibrinoid necrosis, mononuclear cell infiltration and occasional vasculitic lesions. Multiple peritendinous nodules should be considered another clinical feature of overlap syndrome. PMID- 3981504 TI - Idiopathic eosinophilic myositis with preexisting fibromyalgia. AB - Idiopathic eosinophilic myositis is a rare entity. Only 6 other cases have been reported in the literature. We report a patient with degenerative joint disease and fibromyalgia who subsequently developed eosinophilic myositis over a tender trigger area. PMID- 3981505 TI - Lichen myxedematosus (scleromyxedema) serum stimulates hyaluronic acid and prostaglandin E production by human fibroblasts. AB - Serum from a 45-year-old patient with scleromyxedema (withdrawn prior to therapy) was added to synovial and foreskin human fibroblast cultures and its effect compared to that of normal human serum. The patient's serum stimulated production of both hyaluronic acid and prostaglandin E by fibroblast cultures. This stimulation was inhibited by hydrocortisone and indomethacin and was not accompanied by stimulation of cell proliferation. PMID- 3981506 TI - Different fibronectin concentrations in plasma samples drawn from the affected and unaffected arms of a pagetic patient. AB - Plasma fibronectin concentrations in blood drawn from both arms of a pagetic patient affected only at the humerus, ulna and radius of the right arm were studied. Significantly higher levels were observed in the affected arm compared to the nonpagetic arm. Results suggest that in vivo synthesis of soluble fibronectin is associated with increased bone turnover and demonstrate the value of bilateral blood sample collection when localized bone disease is present. PMID- 3981507 TI - Clinical features of ankylosing spondylitis in women and men and its relationship with age of onset. PMID- 3981508 TI - Erosive osteoarthritis in males. PMID- 3981509 TI - Arthritis occurring with hidradenitis suppurativa. PMID- 3981510 TI - Bacterial pyomyositis in a patient with preleukemia. PMID- 3981511 TI - Massive pulmonary hemorrhage: fatal complication of systemic lupus erythematosus. PMID- 3981512 TI - Ibuprofen and benign cecal ulcer. PMID- 3981513 TI - A question of logic. PMID- 3981514 TI - Optic neuritis in systemic lupus erythematosus. PMID- 3981516 TI - In vivo studies on the mononuclear phagocyte system Fc receptor function in rheumatoid arthritis. Correlations with clinical and immunological variables. AB - The mononuclear phagocyte system Fc receptor function was assessed in 13 control subjects and 17 patients with rheumatoid arthritis (RA) by intravenous injection of IgG coated (IgG-RBC) or of heat-damaged (HD-RBC) 99mTc-labeled autologous erythrocytes. Although the clearance half-times of control and RA erythrocytes were not significantly different, the spleen to liver uptake ratios per surface area (S/Ls), determined by quantitative scintigraphic analysis, were significantly lower in RA patients than in controls. The S/Ls were significantly correlated with the Steinbrocker stages (r = 0.92; p less than 0.01), the disease duration (r = 0.73; p less than 0.01) and the total immunoglobulin levels (r = 0.73; p less than 0.01). The Clq binding activity of the sera was inversely correlated with the spleen (r = 0.90; p less than 0.01) and liver uptakes (r = 0.73; p less than 0.02). Our results therefore show an alteration of the Fc receptor function of splenic and hepatic mononuclear phagocytes in RA patients. PMID- 3981515 TI - Benoxaprofen reduces osteophyte formation and fibrillation after articular cartilage injury. AB - We examined the in vivo effect of benoxaprofen on the degeneration of articular cartilage after injection of sodium iodoacetate into the guinea pig knee. As shown previously, 3 weeks after the injection, samples from the ipsilateral knee of animals that did not receive benoxaprofen invariably exhibited marked loss of chondrocytes, absence of staining with safranin-O, fibrillation, and prominent osteophytes. In contrast, in samples from animals which received daily benoxaprofen (25 mg/kg) orally after the intraarticular injection of iodoacetate, pericellular safranin-O staining persisted, cell loss was less marked, osteophyte formation was markedly diminished and fibrillation occurred in only one of 5 samples. Knee cartilage from 2 animals that received benoxaprofen but were not injected with iodoacetate exhibited focal fibrillation, which may have been unrelated to the drug. Thus, benoxaprofen exhibited a marked protective effect in this chemically induced model of cartilage injury. PMID- 3981517 TI - Ankylosing spondylitis: the case for the underestimated female. PMID- 3981518 TI - Influence of antecedent lymphoid surgery on the odds of acquiring rheumatoid arthritis. AB - The occurrence of rheumatoid arthritis (RA) and the extent of antecedent lymphoid surgeries was examined using case control study methods. Two hundred sixty-four patients with definite or classic RA were considered and 283 patients with rheumatic diseases presumably of nonimmunologic origin were used as controls. The odds for developing RA were found to be significantly higher for patients with multiple lymphoid surgeries (tonsillectomy and adenoidectomy or tonsillectomy and adenoidectomy plus appendectomy) and exhibited a gradient, increasing with more extensive surgery. Significant rank correlations were found in patients with RA between the age at tonsillectomy and the rheumatoid factor (RF) titer. An earlier tonsillectomy correlated with lower titers of RF. A significant decrease of serum RF titer was also seen in patients with RA subjected to tonsillectomy, adenoidectomy and appendectomy. We conclude that antecedent removal of lymphoid tissue from the tonsils, adenoids and appendix constitutes a risk factor predisposing to RA. Moreover, this risk seems related to the quantity of lymphoid tissue removed. PMID- 3981519 TI - HLA genetics and inherited predisposition to JRA. PMID- 3981520 TI - Platelet bound IgG levels in patients with systemic lupus erythematosus. AB - Platelet bound IgG (PBIgG) measured by antiglobulin consumption assay was compared with indices of clinical and laboratory disease activity in 37 nonthrombocytopenic patients with systemic lupus erythematosus. There was no correlation with clinical disease activity. When patients with a PBIgG level over 50 ng/10(7) platelets were compared to those with normal PBIgG levels (less than 20 ng/10(7) platelets), however, they had a significantly higher DNA binding level (p less than 0.05). In 17 patients there was no correlation between PBIgG levels and circulating immune complexes as measured by the Raji cell assay. Ten patients with PBIgG levels over 50 ng/10(7) platelets were followed for a mean of 23 months (5-26 months). None developed thrombocytopenia. PMID- 3981521 TI - The effect of serum from patients with systemic lupus erythematosus on the immune response of normal lymphocytes. AB - In contrast to influences that act to reduce the function of suppressor T cells, we describe a factor found in the sera of 13/28 patients with systemic lupus erythematosus (SLE) that augments the response of normal donor peripheral blood lymphocytes to stimulation by pokeweed mitogen (PWM) in vitro. This factor was present in 1/2 of our patients with active SLE, but not in normal blood donors; it required the presence of pooled AB serum in the culture medium; was specific for stimulation by PWM and not by phytohemagglutinin, concanavalin A or purified protein derivative; it appeared to act predominantly on B lymphocytes and was neither immunoglobulin nor interferon. This augmentation was seen to a lesser degree with rheumatoid sera, but not with psoriatic arthritis sera or sera of SLE patients on dialysis. PMID- 3981522 TI - Effect of antimalarial treatment on circulating immune complexes in rheumatoid arthritis. AB - The relationship between the effect of chloroquine treatment on circulating immune complexes in patients with rheumatoid arthritis (RA) was determined by the 125I Clq binding assay. Three groups were studied: (a) 20 patients treated daily for 6 months with chloroquine sulphate 250 mg plus prednisone 7.5 mg and nonsteroidal antiinflammatory drugs (NSAID); (b) 20 patients not taking antimalarials but treated with prednisone and NSAID; (c) 41 controls. Results suggest that chloroquine sulphate therapy induced a marked decrease of immune complexes in patients with RA, an effect not observed with treatment by prednisone and NSAID only. PMID- 3981523 TI - Use of biofeedback training in treatment of Raynaud's disease and phenomenon. AB - To assess biofeedback training in Raynaud's, we retrospectively reviewed 23 patients' records. Eleven had Raynaud's disease and 12 had Raynaud's phenomenon; 9 had recurrent digital ulcers. Patients demonstrated lower baseline digital temperatures than controls (p less than or equal to 0.001), patients with Raynaud's and scleroderma manifesting the lowest. After biofeedback training all patients elevated baseline temperatures. Patients with scleroderma and systemic lupus erythematosus had the greatest elevations. Improvement, both subjective (57%) and ulcers (44%), persisted one year after treatment. Four of 7 patients were capable of elevating digital temperatures within 5 min, 18 months after their last training session. These findings support biofeedback training as beneficial therapy in Raynaud's. PMID- 3981525 TI - Acute respiratory infections in the population. PMID- 3981524 TI - Management of unilateral chronic pyelonephritis. PMID- 3981526 TI - Long-term follow up of trans-sphenoidal hypophysectomy for Cushing's disease. AB - Fourteen patients with Cushing's disease treated by trans-sphenoidal hypophysectomy between 1962 and 1975 were reviewed in 1983. Complete ablation had been attempted. There were no surgical deaths and one episode of bacterial meningitis. Two patients required a second operation for a cerebrospinal fluid leak. There have been three late deaths from unrelated causes. All patients had a biochemical remission of their Cushing's disease postoperatively and no relapse has been recorded. Most patients need some hormone replacement but residual pituitary function and sella radiography have remained stable. This treatment seems satisfactory and the evidence implies a pituitary aetiology of the syndrome. PMID- 3981527 TI - Richard Smith ankle arthroplasty. AB - The indications for ankle joint replacement and the advantages of a 'ball-and socket' type of prosthesis are examined. The results of 24 Richard Smith ankle replacements of which 18 were followed for an average of 7 years are analysed and the case for abandoning this prosthesis is discussed. PMID- 3981528 TI - Large gallstones may pass spontaneously. AB - We report two cases in which gallstones greater than 1 cm in diameter passed spontaneously from the common bile duct into the duodenum. The possibility of spontaneous passage should be borne in mind in the management of patients with common duct stones. PMID- 3981529 TI - Videotex in medicine: discussion paper. PMID- 3981530 TI - Pachydermoperiostosis with multiple basal cell carcinomata. PMID- 3981531 TI - Foreign body sensation in the throat. PMID- 3981532 TI - Compactin (ML-236B) and related compounds as potential cholesterol-lowering agents that inhibit HMG-CoA reductase. PMID- 3981533 TI - Myocardial imaging agents: synthesis, characterization, and evaluation of (Z)- and (Z,E)-18-[82Br]bromo-5-tellura-17-octadecenoic acids. AB - The effects of replacement of radioiodide with radiobromide on the biological properties of a model vinyl halide substituted tellurium fatty acid have been evaluated. The use of a facile radiobromination method involving the reaction of [82Br]Br2 with vinylmercuric bromide substrates has been investigated. Unexpectedly, both the cis- and trans-vinyl bromide products are formed as confirmed by chromatographic and spectral studies. With use of this technique, (E,Z)-1-[82Br]bromo-13-iodo-1-tridecene was prepared and used as the substrate to prepare (E,Z)-18-[82Br]bromo-5-tellura-17-octadecenoic acid (13-E,Z), which was evaluated in rats. Both [82Br]-13-E,Z and [82Br]-13-Z, prepared by an established procedure using N-chorosuccinimide-Br- reaction with the trans-boronovinyl substrates, showed tissue distribution properties similar to those of (E)-18 [125I]iodo-5-tellura-17-octadecenoic acid. These results demonstrate that replacement of I with Br and also the stereochemistry about the olefinic bond do not drastically affect heart uptake and retention. PMID- 3981534 TI - Synthesis and biological activity of a novel adenosine analogue, 3-beta-D ribofuranosylthieno[2,3-d]pyrimidin-4-one. AB - The title nucleoside 5 was prepared by a condensation of the silylated heterocycle thieno[2,3-d]pyrimidin-4-one (1) with 1-O-acetyl-2,3,5-tri-O-benzoyl beta-D-ribofuranose (2a) in the presence of a Lewis acid or with 2,3,5-tri-O acetyl-D-ribofuranosyl bromide (2b) in the presence of mercuric oxide and mercuric bromide. The site of ribosylation and anomeric configuration of this nucleoside were established by 1H NMR. The synthesis of 3-beta-D ribofuranosylpyrrolo[2,3-d]pyrimidin-4-one (8), 1-phenyl-5-beta-D ribofuranosylpyrazolo[3,4-d]pyrimidin-4-one (9), 5-methyl-3-beta-D ribofuranosylthieno[2,3-d]pyrimidin-4-one (10), and 2-methyl-6-beta-D ribofuranosyltriazolo[5,4-d]pyrimidin-7-one (11) is also described. The title compound inhibited the growth of murine L-1210 leukemic cells in vitro with an ID50 of 3 X 10(-5)M. The growth inhibition could not be prevented by uridine, cytidine, thymidine, deoxycytidine, cytosine, hypoxanthine, or uridine and hypoxanthine together. On the other hand, inhibition of adenosine kinase by 10( 7) M 5-iodotubercidin prevented the cytotoxic effect. Also a subline of L-1210 cells resistant to several cytotoxic adenosine analogues was also resistant to this nucleoside. Thus it appears that this compound 5 may act as an adenosine analogue. PMID- 3981535 TI - Synthesis and platelet aggregation inhibitory activity of 4,5-bis(substituted) 1,2,3-thiadiazoles. AB - Routine screening of compounds for inhibition of collagen-induced platelet aggregation in vitro revealed 4,5-bis-(4-methoxyphenyl)-1,2,3-thiadiazole (2) was active and it represents the first example of a 1,2,3-thiadiazole with possible antithrombotic activity. In order to develop a structure-activity relationship for this heterocycle, a number of new 4(5)-mono- and -disubstituted 1,2,3 thiadiazoles were synthesized. These were tested in our screen and a number of additional active compounds were found. The most active compounds (2, 5a, 5b, and 6c) were those in which the heterocycle was substituted with benzene rings possessing para electron-donating groups. PMID- 3981536 TI - 7-substituted-4-hydroxyquinoline-3-carboxylic acids as inhibitors of dehydrogenase enzymes and of the respiration of Ehrlich ascites tumor cells: multivariate analysis and quantitative structure-activity relationship for polar substituents. AB - The inhibitory activities of a set of nine 7-substituted-4-hydroxyquinoline-3 carboxylic acids against three dehydrogenase enzymes and one whole cell system (Ehrlich ascites tumor cells) have been subjected to principal component analysis. The results clearly indicate that activity against the whole cell test system cannot directly be attributed to inhibition of the enzymes evaluated. The enzyme systems are reflected by the first component that can be identified with polar and steric parameters while hydrophobic effects are absent. The second component is entirely due to the inhibition of ascites cell respiration that depends primarily on hydrophobicity. PMID- 3981537 TI - Analgesics of the 6,14-ethenomorphinan type. 6-deoxy-7 alpha-orvinols and 6-deoxy 8 alpha-orvinols. AB - 6-Deoxythebaine (3) has been prepared as a precursor to C-6 alkyl substituted orvinols 15 and 17. The C-6 methyl group was introduced by addition of methyllithium to codeinone. Transformation of 6-methylcodeine to its 6-methyl ether and 1,4-elimination of methanol with potassium tert-butoxide in Me2SO then gave 6-deoxythebaine (3) in 49% overall yield. Diels-Alder addition of methyl vinyl ketone to this diene yielded four ketones: three regio- and stereoisomeric 6,14-endo-ethenomorphinans and one exo adduct. The major ketone isomer provided the set of C-19 diastereomeric orvinols 15 in which the pendant carbon has the 7 alpha configuration. Regioisomeric ketone 8, in which the acetyl group is at C-8, was formed in 3% yield and was similarly converted to the corresponding orvinols 17. Orvinol (R)-15 (R at C-19) is an analgesic of very high potency, 2200 times that of morphine; regioisomeric orvinols 17, in which the pendant tertiary alcohols are on C-8, are much less potent. The higher activity of the C-6 methyl and methoxyl analogues (R)-15 and (R)-22 relative to hydrogen-substituted (R)-19 indicates that C-6 alkyl substitution enhances analgesic potency. PMID- 3981538 TI - Potential inhibitors of S-adenosylmethionine-dependent methyltransferases. 8. Molecular dissections of carbocyclic 3-deazaadenosine as inhibitors of S adenosylhomocysteine hydrolase. AB - A series of 9-(hydroxyalkyl)-3-deazaadenines, which are analogues of the carbocyclic derivative of 3-deazaadenosine (3-deaza-C-Ado), were synthesized. The analogues were tested as inhibitors of bovine liver S-adenosyl-L-homocysteine (AdoHcy) hydrolase (EC 3.3.1.1) and as inhibitors of vaccinia virus (WR) replication in clone 929 mouse L cells and the results were compared to those observed for the parent compound, 3-deaza-C-Ado. 4-Amino-1-(2,3-dihydroxy-1 propyl)imidazo[4,5-c]pyridine (14), the analogue which included the 1'-, 2'-, and 3'-carbons of 3-deaza-C-Ado, was the most active inhibitor toward purified AdoHcy hydrolase. The inhibitory effect of 14 (Ki = 768 nM) on AdoHcy hydrolase was significantly less than that observed for 3-deaza-C-Ado (Ki = 4 nM). Analogue 14 also exhibited inhibitory activity against vaccinia virus replication, but the activity was less than that observed with 3-deaza-C-Ado. 4-Amino-1-(4-hydroxy-1 butyl)imidazo[4,5-c]pyridine (15) showed little or no inhibitory activity toward AdoHcy hydrolase, but it did exhibit antiviral effects comparable to 14. These results suggest that 3-deaza-C-Ado and analogue 14 may be producing their antiviral effects by altering a critical viral methylation (e.g., methylation of the 5'-cap of viral mRNA), whereas analogue 15 may be acting through an alternative mechanism. PMID- 3981539 TI - Potential inhibitors of S-adenosylmethionine-dependent methyltransferases. 9. 2',3'-Dialdehyde derivatives of carbocyclic purine nucleosides as inhibitors of S adenosylhomocysteine hydrolase. AB - A series of purine (e.g., adenine, N6-methyladenine, 8-azaadenine, 3 deazaadenine) carbocyclic nucleosides, nucleoside 2',3'-dialdehydes, and nucleoside 2',3'-diols were synthesized as potential inhibitors of bovine liver S adenosyl-L-homocysteine (AdoHcy) hydrolase (EC 3.3.1.1) and as potential inhibitors of vaccinia virus replication. The 2',3'-dialdehydes were prepared by periodate oxidation of the corresponding carbocyclic nucleosides. Reduction of the intermediate dialdehydes with sodium borohydride afforded the corresponding 2',3'-diols. Of the nucleosides tested, the most potent inhibitors of AdoHcy hydrolase were the adenine analogue (Ki = 110 +/- 38 nM) and the 3-deazaadenine analogue (Ki = 4 +/- 0.9 nM), which were reversible, competitive inhibitors. In contrast, the 2',3'-dialdehydes produced irreversible inhibition of AdoHcy hydrolase, resulting in incorporation of two to four molecules of the dialdehyde per molecule (tetramer) of the enzyme. On the basis of an Ackermann-Potter analysis, the following "apparent" Ki values were determined for the 2',3' dialdehydes: adenine analogue, 61 nM; 8-azaadenine analogue, 57.5 nM; and 3 deazaadenine analogue, 32 nM. The nucleoside 2',3'-diols were substantially less effective as inhibitors of AdoHcy hydrolase, requiring millimolar concentrations to achieve significant inhibition. When tested for their ability to inhibit vaccinia virus replication, several carbocyclic nucleosides (e.g., adenine and 3 deazaadenine analogues) and several nucleoside 2',3'-dialdehydes (e.g., adenine, N6-methyladenine, 8-azaadenine, and 3-deazaadenine analogues) exhibited good antiviral effects. A good correlation existed between a compound's inhibitory effects on AdoHcy hydrolase and its antiviral effects, suggesting that the inhibition of viral replication is caused by inhibition of a critical methylation reaction, e.g., methylation of the 5'-cap of viral mRNA. PMID- 3981540 TI - Potential inhibitors of S-adenosylmethionine-dependent methyltransferases. 10. Base- and amino acid modified analogues of S-aristeromycinyl-L-homocysteine. AB - A series of base- and amino acid modified analogues of S-aristeromycinyl-L homocysteine, a carbocyclic nucleoside, were synthesized and evaluated as inhibitors of S-adenosyl-L-methionine-dependent methyltransferases, including catechol O-methyltransferase, phenylethanolamine N-methyltransferase, and histamine N-methyltransferase. The base-modified analogues (8-azaadenine, 3 deazaadenine, and N6-methyladenine) were prepared by reaction of the corresponding carbocyclic 5'-chloro-5'-deoxynucleosides with the anion of homocysteine generated in situ either from L-homocystine or S-benzyl-L homocysteine in Na/liquid NH3 or with DL-homocysteine thiolactone in alkaline solution. S-Aristeromycinyl-D-homocysteine was prepared with use of D-homocystine in the Na/liquid NH3 reaction. The sulfoxide and sulfone analogues were prepared by oxidation of S-aristeromycinyl-L-homocysteine. The various base- and amino acid modified analogues of S-aristeromycinyl-L-homocysteine were inactive as inhibitors of catechol O-methyltransferase. In contrast, the 3-deaza analogue was a good inhibitor (Ki = 20.5 +/- 1 microM) of phenylethanolamine N methyltransferase whereas S-aristeromycinyl-D-homocysteine was an excellent inhibitor (Ki = 10.4 +/- 2.4 microM) of histamine N-methyltransferase. On the basis of these results, it would appear that the structural requirements for the binding S-aristeromycinyl-L-homocysteine are similar to those for binding S adenosyl-L-homocysteine. Therefore, these carbocyclic analogues have the potential of being better inhibitors in vivo, because they should be more stable to metabolism than the ribosyl analogues. PMID- 3981541 TI - A new class of cardiotonic agents: structure-activity correlations for natural and synthetic analogues of the alkaloid A new class of A new class of cardiotonic agents: structure-activity correlations for natural and synthetic analogues of the alkaloid pumiliotoxin B (8-hydroxy-8-methyl-6-alkylidene-1 azabicyclo[4.3.0]nonanes). AB - Pumiliotoxin B (PTX-B, 6-(6',7'-dihydroxy-2',5'-dimethyl-(E)-4'-octenylidene)-8 hydroxy-8 -methyl-1- azabicyclo-[4.3.0] nonane) increases the force of contractures of spontaneously beating guinea pig atrial strips by 3- to 5-fold with half-maximal effects at about 3 microM and increases rates of atrial contractions by 2- to 3-fold with half-maximal effects at about 6 microM. The presence of an axial 7-hydroxy substituent (PTX 339A) decreases the efficacy but not the potency of PTX-B as a positive inotropic agent while having only slight effects on activity as a positive chronotropic agent. The presence of an equatorial 7-hydroxy substituent (PTX 339B) greatly decreases efficacy and potency of PTX-B as a positive chronotropic and inotropic agent. Pumiliotoxin A which lacks the side-chain 7'-hydroxy group of PTX-B causes only a 2-fold increase in force of contracture at 54 microM while having minimal effects on rate. The presence of an axial 7-hydroxy substituent (PTX 323B' and 323B", epimeric at the 6'-hydroxy) markedly enhances positive inotropic and chronotropic effects of PTX-A. Another congener, PTX 251D with a 6-(2'-methylhexylidene) side chain, and a synthetic analogue with a 6-(6'-heptenylidene) side chain are cardiac depressants. Both lack hydroxyl groups in the side chain. The presence of an omega-1 hydroxy group in the side chain of PTX 251D yields an alkaloid (267C) with weak positive inotropic effects and minimal chronotropic effects. The presence of an axial 7-hydroxy group in the indolizidine ring of PTX 251D results in a compound (PTX 267A) with very weak positive inotropic effects while retaining the negative chronotropic effects of PTX 251D. A synthetic analogue with a 6-(7'-hydroxyheptylidene) side chain is a cardiac depressant even though it contains a side-chain hydroxyl corresponding in position to the 7'-hydroxyl of the side chain of PTX-B. The positive chronotropic and inotropic effects of pumiliotoxin B are reversed only by relatively high concentrations of the calcium channel blockers nifedipine and verapamil, suggesting that pumiliotoxin B may owe its cardiotonic activities to effects on internal mobilization of calcium. PMID- 3981542 TI - Structure-activity relationship of estrogens: receptor affinity and estrogen antagonist activity of certain (E)- and (Z)-1,2,3-triaryl-2-propen-1-ones. AB - (E)- and (Z)-1,2,3-triphenyl-2-propen-1-ones and some of their phenolic and alkoxy analogues, substituted at the para position in one or more of the aromatic rings, were synthesized and assigned geometry on the basis of their spectroscopic data. The structure-activity relationship of the triarylpropenones was studied from the point of view of their estrogen receptor affinity and estrogen agonist and antagonist activities. (E)- as well as (Z)-propenones were found to compete with estradiol for binding with the mouse uterine cytosol receptors, with phenolic analogues usually more potent than the unsubstituted as well as alkoxypropenones. The (E)-propenones, which have now emerged as a new group of estrogen receptor ligands, were found to differ from Z isomers quite markedly in their binding specificities. The uterotrophic and antiuterotrophic assays in immature mice revealed that while some of the compounds were marginally estrogenic, nearly all the isomeric propenones were antiestrogenic to a varying degree. PMID- 3981544 TI - Conformational factors in cardiac glycoside activity. AB - Gomphoside, a 5 alpha-H cardiac glycoside isolated from Asclepias fructicosa, has an unique double glycosidic linkage to the aglycon through oxygen atoms at 2 alpha and 3 beta of the steroid. The 3'-axial hydroxyl of its conformationally rigid sugar residue appears to be the functional group responsible for its potent inotropic activity. With use of gomphoside as the model compound, the conformation of the flexible glycosidic linkage of the 5 beta-H cardenolides, digitoxigenin alpha-L-rhamnoside and digitoxigenin beta-D-digitoxoside, and the 5 alpha-H cardenolides, uzarigenin alpha-L-rhamnoside and uzarigenin beta-D-6 deoxyalloside, were investigated with the aid of computer graphics and conformational potential energy calculations. The relative inotropic potencies of these cardenolides can be accounted for by considering their active binding conformations with their potential energy distributions. The conformational distribution of the glycosidic moiety was postulated to be the major determinant of the biological activity of these cardenolides. PMID- 3981543 TI - Stereoselective metabolism of conformational analogues of warfarin by beta naphthoflavone-inducible cytochrome P-450. AB - Previous studies have shown that the structurally related oral anticoagulants warfarin and phenprocoumon are regioselectively hydroxylated in the 6- and 8 positions by hepatic microsomes obtained from 3-methylcholanthrene (3-MC) or beta naphthoflavone (BNF) pretreated rats. Stereoselectivity for hydroxylation is also observed and favors (R)-warfarin but (S)-phenprocoumon. The possibility that the stereoselectivity of warfarin hydroxylation is a function of the solution conformation of the drug was tested with conformationally restricted analogues. In these experiments the analogues were incubated with microsomes obtained from BNF-pretreated rats and any stereoselectivity associated with 6- and 8 hydroxylation was determined. The R enantiomer of cyclocoumarol, the cyclic ketal analogue of warfarin, was found to be selectively hydroxylated, in contrast to the S enantiomer of warfarin 4-methyl ether, the ring-opened analogue. The latter compound is known to have a preferred solution conformation similar to that of phenprocoumon. The results suggest that at the active site of BNF-induced cytochrome P-450 (R)-warfarin is metabolized in its cyclic hemiketal tautomer, a form which spatially mimics the preferred solution conformation of (S) phenprocoumon. PMID- 3981545 TI - Synthesis and dopaminergic activity of (R)- and (S)-4-hydroxy-2-(di-n propylamino)indan. AB - A synthetic precursor to a potent dopaminergic agonist, (RS)-4-hydroxy-2-(di-n propylamino)indan, has been resolved by classical recrystallization procedures, and the absolute configurations of the enantiomers have been established by X-ray crystallographic analysis. The enantiomers were converted by literature procedures into (R)- and (S)-1. (R)-1 was approximately 100 times as potent as (S)-1 in an assay for dopamine agonist effect in the isolated cat atrium. PMID- 3981546 TI - Dicesium N-succinimidyl 3-(undecahydro-closo-dodecaboranyldithio)propionate, a novel heterobifunctional boronating agent. AB - The synthesis of a novel heterobifunctional agent, dicesium N-succinimidyl 3 (undecahydro-closo-dodecaboranyldithio)propionate, is described. This structure contains an active ester component known to react rapidly under very mild conditions with amino groups of proteins, resulting in covalent linkage. With use of this boronating agent, approximately 480 boron atoms have been incorporated per molecule of a polyclonal antibody directed against human thymocytes and 1300 boron atoms per molecule were incorporated into a monoclonal antibody, 17-1A, directed against human colorectal carcinoma cells. Binding of the boronated antibodies to the corresponding target cells was demonstrated by means of membrane immunofluorescence. There was some loss in reactivity, as determined by fluorescent end point titers, but specificity remained unchanged. The data suggest that boronated antibodies potentially could be used to selectively deliver boron-10 to tumor cells in order to achieve their destruction by neutron capture. PMID- 3981547 TI - Synthesis and evaluation of N,N'-bis(arylsulfonyl)hydrazines as antineoplastic agents. AB - Several N,N'-bis(arylsulfonyl)hydrazines, with the potential to function as biological methylating agents, were synthesized and evaluated for antineoplastic activity against the L1210 leukemia and other transplanted rodent tumors. In general, the N-methyl-N,N'-bis(arylsulfonyl)hydrazines that possess the capacity to generate an alkylating species under physiological conditions showed significant antineoplastic activity, while N,N'-bis(phenylsulfonyl)-hydrazine and N-methyl-N,N'-dibenzoylhydrazine were inactive. PMID- 3981548 TI - Field studies on the introduction of the mosquito predator Toxorhynchites amboinensis (Diptera: Culicidae) into Fiji. PMID- 3981549 TI - Skin lesions of papular urticaria induced experimentally by Cheyletus malaccensis and Chelacaropsis sp. (Acari: Cheyletidae). PMID- 3981550 TI - Differences in paralyzing ability and sites of attachment to cattle of Rocky Mountain wood ticks (Acari: Ixodidae) from three regions of western Canada. PMID- 3981552 TI - Host-feeding patterns of Culex mosquitoes (Diptera: Culicidae) on farms in Gharbiya Governorate, Egypt. PMID- 3981551 TI - Reduced productivity in tretamine-treated adult populations of Aedes aegypti (Diptera: Culicidae). PMID- 3981553 TI - The role of adult Ixodes dammini (Acari: Ixodidae) in the transmission of Lyme disease in New Jersey, USA. PMID- 3981554 TI - Characterization of refractoriness in Aedes aegypti (Diptera: Culicidae) to infection by Dirofilaria immitis. PMID- 3981556 TI - A survey of Culicoides midges (Diptera: Ceratopogonidae) associated with cattle operations in Florida, USA. PMID- 3981557 TI - Seasonal variations in population size, fecundity, and parity rates of Culicoides insignis (Diptera: Ceratopogonidae) in Florida, USA. PMID- 3981555 TI - Laboratory assessment of a species-specific radioimmunoassay for the detection of malaria sporozoites in mosquitoes (Diptera: Culicidae). PMID- 3981558 TI - Growth and survival of Culicoides melleus larvae (Diptera: Ceratopogonidae) on four prey organisms. PMID- 3981559 TI - Bionomics of anthropophilic Simuliidae (Diptera) from the Adirondack Mountains of New York State, USA. 1. Adult dispersal and longevity. PMID- 3981560 TI - A high-fecundity aedine: factors affecting egg production of the western treehole mosquito, Aedes sierrensis (Diptera: Culicidae). PMID- 3981561 TI - Hyalomma schulzei (the large camel tick): distribution in Saudi Arabia. PMID- 3981562 TI - Medical ethics--a Christian view. AB - All ethics has a religious dimension. This paper considers how specific Christian insights concerning death, suffering, human nature and human creatureliness can help to expose more fully the moral issues at stake in some of the dilemmas faced by doctors. It ends by acknowledging the crushing burden of decision-making which rests on many in the medical profession, and indicates the importance of religious resources in dealing with this. PMID- 3981563 TI - Medical ethics and medical practice: a social science view. AB - This paper argues that two characteristics of social life impinge importantly upon medical attempts to maintain high ethical standards. The first is the tension between the role of ethics in protecting the patient and maintaining the solidarity of the profession. The second derives from the observation that the foundations of contemporary medical ethics were laid at a time of one-to-one doctor-patient relations while nowadays most doctors work in or are associated with large-scale organisations. Records cease to be the property of individual doctors, become available not only to other doctors but also to educational and social work personnel. Making records openly available to patients is suggested as the only antidote to this irreversible loss of individual practitioner control. The importance for doctors of understanding the nature of professional and bureaucratic organisations in order to deal with the hazards involved is stressed as is the responsibility of the General Medical Council to regulate medical competence as well as personal behaviour. PMID- 3981564 TI - Are we teaching students that patients don't matter? AB - Medical students may fear that their training leeches away the caring attitudes which attracted them to medicine. Some research suggests they are right. The medical school has a duty to support and encourage their values, but the reverse may happen. Students are taught about legal consent but not ethical consent. They may see or participate in concealment of medical mistakes and learn to practise deceit. The use of unconscious females for gynaecology teaching may encourage the wrong attitudes to patients. Trainee GPs may learn that the doctors' rights are more important than those of the patient. Measuring patients' views should be included in research protocols. PMID- 3981565 TI - Teaching medical ethics in other countries. AB - In the past 20 years, around the world, there has been an explosion in the teaching of medical ethics. As the dust begins to settle, it would appear that such teaching is likely to have its most effective impact not during the undergraduate period but at the immediate postgraduate level and in continuing education. Whilst important contributions can be made by teachers of religion, philosophy and law, probably the essential wisdom, capable of standing a doctor in good stead throughout the developments of a lifetime's career, must largely come from those who have studied both medicine and ethics. It would be appropriate if the study of medical ethics were to lead to better international understanding among doctors. PMID- 3981566 TI - Current arrangements for teaching medical ethics to undergraduate medical students. AB - Those teachers in contact with medical students from pre-clinical days onwards will impart their ethical views by example and by precept, but such learning by 'osmosis' is insufficient. There is a knowledge base to be imparted which will enrich the understanding of ethical judgements on clinical problems seen during the undergraduate years. However, the learning process continues after qualification and in particular the doctor's capacity to make ethical clinical judgements will evolve with maturity and experience. It is essential therefore that students see their teachers willing and able to debate ethical issues at the postgraduate level. PMID- 3981567 TI - Methods of teaching medical ethics at the University of Nottingham. AB - Medical ethics has been described as a thread woven into the fabric of the Nottingham curriculum. There exist a wide variety of relevant learning experiences, occurring at intervals throughout each of the five years of the course. The introduction of the students to clinical method from the start creates the need for early consideration of ethical aspects of professional behaviour and this in turn stimulates spontaneous discussion and inquiry amongst the students. The school has chosen to rely on having a sufficient number of medical teachers from various disciplines willing to discuss in all the necessary detail their own clinical decisions. PMID- 3981568 TI - Two concepts of medical ethics. PMID- 3981569 TI - Self help in medical ethics. AB - The paper traces the development of programmes of lectures and symposia in most British medical schools, which have developed into a postgraduate programme of research and publication. It is asserted that a morally neutral approach is a necessary prerequisite for wide multidisciplinary involvement, as is a high level of student participation in identifying topics for discussion. Alternative possibilities for formal teaching are discussed and pitfalls highlighted. PMID- 3981571 TI - The teaching of medical ethics from a junior doctor's viewpoint. AB - This is a short paper covering my own views on the methods and reasons behind the teaching of medical ethics. All the whys and wherefores are discussed and some conclusions reached. This paper is given from a junior doctor's viewpoint but could equally apply to many others. PMID- 3981570 TI - The teaching of medical ethics. AB - Students at Newcastle are exposed to patients during their first week at medical school and attached to a family within the first month. The object is to sensitise them to patients as people rather than vehicles of disease. Medical ethics is introduced as part of the multidisciplinary Human Development, Behaviour and Ageing Course by a lecturer who shows a film which poses an ethical problem. At subsequent tutorials led by the Department of Family and Community Medicine's general practitioner lecturers the subject is discussed as ethical issues arise in the course of their work. PMID- 3981572 TI - What's in a name? PMID- 3981573 TI - Objections to hospital philosophers. AB - Like morally sensitive hospital staff, philosophers resist routine simplification of morally complex cases. Like hospital clergy, they favour reflective and principled decision-making. Like hospital lawyers, they refine and extend the language we use to formulate and defend our complex decisions. But hospital philosophers are not redundant: they have a wider range of principles and categories and a sharper eye for self-serving presuppositions and implicit contradictions within our practices. As semi-outsiders, they are often best able to take an 'external point of view,' unburdened by routine, details, and departmental loyalties. Their clarifications can temporarily disrupt routine, but can eventually improve staff morale, hence team practice and patient welfare. PMID- 3981574 TI - Two sets of ten commandments for obstetricians. PMID- 3981575 TI - The General Medical Council and medical ethics. PMID- 3981576 TI - Medical confidence. AB - If medical confidentiality is not observed patients may well be reluctant to disclose information to their doctors or even to seek medical advice. Therefore, argues the author, it is of the utmost importance that doctors strive to protect medical confidentiality, particularly now when it is under threat not only in this country but also overseas. The profession must cease to regard ethical issues to do with confidentiality, and indeed to do with all areas of medical practice, as abstract phenomena requiring no justification. If it does not then it will come under increasing and justified criticism from the community it serves. PMID- 3981577 TI - Reduced penetrance in tuberous sclerosis. AB - Two first cousins are reported with clinical evidence of tuberous sclerosis. The intervening brother and sister show no evidence of the disease on clinical and Wood's lamp examination, nor on CT scan. PMID- 3981578 TI - Profound limb deficiency, thoracic dystrophy, unusual facies, and normal intelligence: a new syndrome. AB - A newly recognised profound limb deficiency malformation syndrome in two Arab sibs of different sexes with consanguineous parents is described. Additional features, which include thoracic dystrophy, unusual facies, and normal intelligence, are consistent in both of them. Autosomal recessive inheritance is suggested. PMID- 3981579 TI - Trigonocephaly and the Opitz C syndrome. AB - We present 12 cases of trigonocephaly of which six were associated with other malformations. On the basis of this experience we examine the diagnostic criteria for the presumed autosomal recessive trigonocephaly C syndrome. PMID- 3981582 TI - A complex balanced rearrangement involving four chromosomes in an azoospermic man. AB - A complex chromosomal rearrangement involving chromosomes 1, 5, 10, and 12 is described. The patient was an infertile, phenotypically normal male. Cytogenetic analyses of his parents showed that the complex translocation arose de novo. Testicular histology showed spermatogenic arrest. PMID- 3981580 TI - Short rib-polydactyly syndrome: a single or heterogeneous entity? A re-evaluation prompted by four new cases. AB - Four cases of lethal short rib-polydactyly syndrome (SRPS) from three non consanguineous families are described. Radiological features were similar in all four cases and were most consistent with type III SRPS (Verma-Naumoff syndrome), but many differences in external and systemic abnormalities were noted. The considerable overlap of supposedly distinctive features displayed by the three main forms of SRPS is suggestive of a single locus mutation with variable expressivity, particularly for types I and III, possibly related to different mutant alleles and secondary intrauterine modification of the phenotype. All four cases showed anomalous sexual development. In spite of testicular differentiation in all four and a 46, XY karyotype in the two on whom chromosome studies were done, two infants were phenotypic females and two had ambiguous genitalia. A definitive diagnosis of SRPS was made at 26 weeks' gestation in a pregnancy at risk. PMID- 3981581 TI - A family with three independent autosomal translocations associated with 7q32--- 7qter syndrome. AB - Two persons within the same family were discovered to be trisomic for the segment 7qter. However, several features differed from those described in other patients with this syndrome, for example, normal birth weight and neck size, cleft palate, and beaked nose. In addition to the phenotypic variation, there were three independently segregating autosomal translocations in the pedigree: t(1;7)(q43;q32), t(1;6) (p22.3;q14.1), and t(3;10)(q26.1;p11.21). This is a finding that, to our knowledge, has not been previously reported. PMID- 3981583 TI - A child with a recombinant of chromosome 8 inherited from her carrier mother. AB - A female child with mental retardation and dysmorphic features was found to have a duplication deficiency of chromosome 8: rec(8)dup q,inv(8)(p23q24), a recombinant product derived from a familial pericentric inversion, inv(8)(p23q24)mat. Clinical features of this previously undescribed inversion product are compared with other reported cases of partial trisomy for the distal long arm of chromosome 8, since this segment is thought to be primarily responsible for the phenotypic features of the trisomy 8 syndrome. PMID- 3981584 TI - 'Pure' partial trisomy 2q in a male owing to malsegregation of a maternal translocation t(X;2)(p22.3;q32.1). AB - This report describes a male infant with partial trisomy 2q: 46,Y,der(X),t(X;2) (p22.3;q32.1)mat. The phenotype was compatible with partial trisomy 2q syndrome. Replication studies showed a random X inactivation in the mother. Soluble isocitrate dehydrogenase (IDH-1) dosage was within the expected range for a trisomic patient and favours the assignment of this locus to the region 2q32--- qter. PMID- 3981585 TI - Partial trisomy 12q24.31----qter. AB - Clinical details of a male child with the karyotype 46,XY,-4,+der(4),t(4;12) (p16;q24.31)mat are reported and compared with those of other known cases of partial trisomy of the distal region of 12q. This condition is apparently associated with mental and psychomotor retardation, widely spaced eyes, flat nasal bridge, low set ears, down-turned mouth, micrognathia, loose skin at the nape, widely spaced nipples, simian creases, clinodactyly, abnormalities of the genitourinary system, alterations in the sacrococcygeal region, and deformities of the lower limbs. In the majority of the reported cases, the break-point was in the 12q24 region and resulted from adjacent 1 segregation of a maternal balanced translocation. PMID- 3981586 TI - Familial opposable triphalangeal thumbs associated with duplication of the big toes. AB - A rare association of triphalangeal thumbs and duplication of the big toes is described. The family pedigree confirms autosomal dominant inheritance with marked penetrance. A systematic approach to the diagnosis of this anomaly is presented. The distinction between the two types of triphalangeal thumb, true (opposable) and finger-like (non-opposable), is emphasised. PMID- 3981587 TI - The impact of legal medicine education on medical students' attitudes toward law. AB - Physicians' negative attitudes toward law and the legal system derive in part from the physician's lack of understanding of basic legal principles relating to medical practice. Required legal medicine education at the medical school level offers a vehicle for changing these attitudes while at the same time clarifying physicians' rights and responsibilities under the law. The authors in this study assess the impact of required curriculum programming in legal medicine at Southern Illinois University School of Medicine on medical students' attitudes toward law and the legal system. A total of 80 students completed a survey instrument prior to and immediately following required instruction in legal medicine. This instrument enabled the authors to gather information regarding students' attitudes toward law and the legal system as well as students' perceptions of ther medical/legal knowledge. The results suggest that legal medicine education has a favorable impact on the attitudes of medical students toward law and the legal system. PMID- 3981588 TI - An analysis of the magnitude of clinical-reasoning deficiencies in one class. AB - Clinical-reasoning ability is indispensable to a good doctor, but students are generally expected to "pick it up" in the course of their clinical clerkships. Concern by the University of Washington School of Medicine that some students did not master the concepts of clinical reasoning led to the formation of an ad hoc committee whose retrospective study on the class of 1981 is reported here by the authors. Nineteen students (11 percent of the graduating class) who were repeatedly noted by faculty members to have problems with clinical reasoning throughout their clinical clerkships were identified as a result of this study. PMID- 3981589 TI - Premature conclusions in diagnostic reasoning. AB - The purpose of the study reported here was to explore the characteristics of premature diagnostic conclusions in a group of physicians, medical students, and residents. When the subjects were asked to construct complete, precise problem lists from three case abstracts, premature closure occurred frequently, it could be recognized with good interrater reliability, and it seemed to appear with equal frequency regardless of the level of training. PMID- 3981590 TI - The home as a site for teaching gerontology and chronic illness. AB - The care for the chronically ill elderly is a major national health problem. Considerable concern and attention have been focused on the shortcomings of medical education in this area of care. Research findings have demonstrated the relevance of a home care experience for teaching the interactions of the social, psychological, environmental, and biological factors which characterize chronic illness. The value of such an experience has taken on added significance in light of the federal government's prospective payment system for reimbursing health care costs under the Medicare program, a system that encourages early discharge of patients from the hospital. To manage these patients successfully, physicians need to understand and appreciate the influence of social, psychological, and environmental factors in the course of a disease. The home setting is an appropriate place for teaching about these factors, just as the hospital ward is appropriate for the understanding required of acute illness. PMID- 3981591 TI - Measures of knowledge and attitude toward preventive cardiology. AB - In this paper, the authors describe the development and validation of an inventory of preventive cardiology at the University of Virginia. The inventory contains two instruments designed to measure medical students' preinstructional and postinstructional knowledge of and attitude toward preventive cardiology. The knowledge test subscales provide unique and significant information about knowledge in preventive cardiology and can discriminate among groups differing in level of instruction and expertise in preventive cardiology. The attitude survey provides information about two attitude factors: cardiovascular disease prevention and cardiovascular disease research priorities. In the study reported here, attitudes appeared not to differ among groups of students with different preventive cardiology instructional levels and expertise. Both instruments were demonstrated to be useful measures of medical students' knowledge and attitudes concerning preventive cardiology educational programs. PMID- 3981592 TI - Evaluating continuity and comprehensiveness of care in an elective family practice clerkship. AB - The University of Wisconsin Medical School has operated an intensive, elective, three-month family practice clerkship since 1980. Beginning in 1981, a computerized, sampling instrument has been used to generate measures of the continuity and comprehensiveness of care being learned by the students and the clinical content of the students' experience. This tool has proved useful for motivating students and faculty members to concentrate on the factors of continuity and comprehensiveness in the clerkship experience. The data collected regarding the students' activities are presented here. PMID- 3981593 TI - Findings on geriatric medicine and gerontology from the NBME examinations. PMID- 3981594 TI - Factors affecting the selection of psychiatry and the distribution of psychiatrists. PMID- 3981595 TI - Impact of a residency program information videotape on resident selection interviewing as a time-saving strategy. PMID- 3981596 TI - Attitudes of medical students toward psychiatric, oncologic, and general medical patients. PMID- 3981597 TI - Reliability of a survey of residency graduates in evaluating a behavioral science curriculum. PMID- 3981598 TI - Behavioral science workshops. PMID- 3981600 TI - Biomedical research: a great newspaper's feet of clay. PMID- 3981601 TI - Female physicians. PMID- 3981599 TI - Utilization of an anthropomorphic model in pelvic examination instruction. PMID- 3981603 TI - Assessment of Hitachi HME-20 pulse and blood-pressure monitor. AB - The performance of the Hitachi HME-20 pulse and blood-pressure (BP) monitor in comparison with direct intra-arterial BP recording and electrocardiographic monitoring is described. Highly significant (p less than 0.001) correlations were found between intra-arterial systolic and diastolic pressures and pressures recorded by the Hitachi monitor. Similarly, the electrocardiographically computed heart-rate, and that given by the Hitachi monitor were significantly correlated (p less than 0.001). Systolic blood-pressure was underestimated by a mean of -12 mmHg and tended to become more erroneous when intra-arterial pressure was greater than 150 mmHg. These results are comparable to more expensive pulse and blood pressure monitors. We conclude that the instrument can reproduce a satisfactory estimate of heart-rate and blood-pressure and may be of particular use when a change of blood-pressure is of prime importance, rather than an absolute measurement. PMID- 3981602 TI - Humanistic medicine. PMID- 3981604 TI - Pulse wave recording--development of a method for investigating foetal circulation in utero. AB - The need to investigate the elastic properties of arterial vessels 'in situ' for the early recognition of degenerative disorders in arteries has long been apparent. Volume pulses in defined segments of arteries can be evaluated for this purpose, and the present paper contains a survey of earlier attempts to quantify volume pulses by means of ultrasound. A presentation is given of a recently developed digital system, comprising a phase-locked echo tracker, capable of monitoring non-invasively the diameter and its pulsatile changes of a selected artery along two chosen image lines of a linear array ultrasound scanner. The physical limitations of tracking fast-moving ultrasound echoes by means of phase locked range gating are reported and the advantage is emphasized of using a gate length of one full period. This system has been calibrated, tested and applied in measurements of pulse wave pattern and propagation velocity in the descending aorta of human foetuses in the last trimester of gestation. The present high resolution echo-tracking method has yielded reproducible results in the foetus and appears suitable also for screening studies on adult vessels. PMID- 3981605 TI - Evaluation of humidifiers for medical use. PMID- 3981607 TI - Evaluation of defibrillators. PMID- 3981606 TI - Evaluation of defibrillators. PMID- 3981608 TI - Telemetry system for heart-rate and blood temperature using a microcomputer. AB - A radio-telemetry system using a microcomputer has been constructed to measure both the heart-rate (HR) and right atrial blood-temperature in dogs. The telemeter incorporates a thermistor temperature probe, which allows blood temperature measurements in the range of 35 degrees-42 degrees C with an available resolution of +/- 0.02 degree C. The output of the receiver is connected to active filters, a frequency counter and an HR meter, and finally to a microcomputer, through an appropriate interface circuit, for data linearization and storage. PMID- 3981609 TI - A morphological study of bacterial colonisation of intravenous cannulae. AB - In an investigation of bacterial colonisation of intravascular cannulae, 16 peripheral venous cannulae of the Venflon variety and 24 chronic haemodialysis cannulae were studied after removal from patients. Studies of colonisation included semi-quantitative microbiological culture and scanning electronmicrographic (SEM) observations. The microbiological findings indicated colonisation of the intravascular portion of the catheter in 4 of 16 Venflon cannulae and 18 of 26 haemodialysis cannulae, largely with skin commensal organisms. The results of the SEM studies were in broad agreement with the microbiological observations. Surface defects on the cannulae were shown to be associated with microbial colonisation which occurred either as isolated colonies or in association with a cellular fibrinous matrix. These observations are illustrated and discussed. PMID- 3981610 TI - Comparative growth of Bacteroides species in various anaerobic culture media. AB - The growth of five species of Bacteroides in four anaerobic culture media was continuously monitored turbidimetrically. Interspecies differences were observed in the growth of Bacteroides spp. in the various media, but growth in Brain Heart Infusion broth supplemented with yeast extract, haemin and menadione, was consistently better than in Wilkins-Chalgren, Thioglycollate or Schaedler broths. Microscopy of cultures grown overnight in Brain Heart Infusion broth showed that the bacteria exhibited normal morphology but most species grown in the other media displayed filamentation or chain formation. Four of the five species grown in Schaedler broth also exhibited spheroplast formation. This morphological change occurred in the stationary phase of growth, was reduced by inclusion of NaCl in the medium and was abolished in Schaedler broth prepared at double the recommended strength. PMID- 3981611 TI - A simple adult-mouse test for tissue invasiveness in Yersinia enterocolitica strains of low experimental virulence. AB - The virulence of Yersinia enterocolitica depends on the presence of a 70-kilobase plasmid, called the Vwa plasmid. This situation is particularly favourable for studies of the mechanism of pathogenicity, but these are hindered by the lack of a suitable animal test to monitor the virulence of the human-pathogenic strains isolated outside the USA which belong to serogroups O:3, O:9 and O:5,27. We observed that, after oral administration to the mouse, the Vwa-positive strains of these serogroups produce a discrete systemic infection while the Vwa-negative strains do not. We present here a simple mouse-virulence test based on this observation. PMID- 3981613 TI - Effect of microwave energy on the metabolism of Enterobacteriaceae. AB - The effect of microwave irradiation on the metabolism of 94 strains of Enterobacteriaceae was studied. Sixteen substrates were used and the results obtained with microwave irradiation were compared with those given by conventional biochemical tests. There was good correlation between the methods but not sufficient to enable accurate identification of unknown species. However, microwave irradiation considerably increased the enzymatic activity of bacterial suspensions and the results obtained could form the basis for a rapid method of microbial identification. PMID- 3981612 TI - Unusual cellular fatty acids and distinctive ultrastructure in a new spiral bacterium (Campylobacter pyloridis) from the human gastric mucosa. AB - Spiral bacteria, named Campylobacter pyloridis, were obtained from endoscopic biopsies of the gastric antrum of 14 patients with active chronic gastritis. Methyl esters of their cellular fatty acids were prepared by acid-catalysed transmethylation of whole cells. Their major fatty acids were tetradecanoic acid (14:0) and cis-9,10-methyleneoctadecanoic acid (19:0 delta), with a very small amount of hexadecanoic acid (16:0). This is markedly different from the fatty acids of other Campylobacter sp. whose major fatty acids are hexadecanoic, octadecenoic (18:1) and hexadecenoic acids (16:1). This is also different from other enterobacteria. Thin-section electronmicroscopy of gastric mucosal biopsies, and negative staining of cultured C. pyloridis, revealed features that differ from those of other campylobacters so far studied. C. pyloridis has a smooth not a rugose surface and multiple unipolar flagella of the sheathed type, each with a terminal bulb. Flagellar sheaths were in continuity with the unit membrane of the outer cell wall. The proposed species C. pyloridis does not belong among the spirochaetes and its DNA composition is incompatible with membership of the genera Spirillum or Vibrio but is compatible with Campylobacter. Thus C. pyloridis is either an atypical member of the genus Campylobacter, the limits of which may have to be redefined to accommodate the new species, or a representative of a new genus. PMID- 3981614 TI - Methods for the detection of haemagglutinins in Aeromonas. AB - When grown in specified conditions and tested by a rocked-tile method, 40 of 41 isolates of two species of Aeromonas formed simultaneously at least two haemagglutinins among which were: (i) a mannose-sensitive haemagglutinins with strongest activity for guinea-pig or fowl red cells, formed by all of 31 isolates of A. hydrophila and 9 of 10 isolates of A. punctata ss. caviae; (ii) a haemagglutinin, sensitive to L-fucose or D-mannose, that reacted with human red cells and which was formed by all 41 isolates; and (iii) a mannose-resistant 'tanned red cell' haemagglutinin formed by 29 isolates of A. hydrophila and one isolate of A. punctata ss. caviae. Results emphasise that for the fullest possible identification of haemagglutinins produced by Aeromonas spp., strains should be cultured in a variety of conditions and tested with a wide range of red cell species. PMID- 3981615 TI - Crossreactivity of antiphospholipid antibodies. AB - Using a solid phase radioimmunoassay to detect anticardiolipin antibodies, the crossreactivity of these antibodies with phospholipids and DNA was tested in 10 patients with autoimmune disorders and 1 patient with secondary syphilis. The crossreactivity of anti-ds DNA and anti-ss DNA antibodies with cardiolipin was tested in 10 additional patients with SLE. In the 10 sera tested with high anticardiolipin antibody levels, there was marked inhibition of anticardiolipin antibody activity by negatively charged phospholipids. The zwitterionic phospholipids inhibited anticardiolipin antibody activity in some sera, and in instances where this occurred, inhibition was less than that obtained for the negatively charged phospholipids. There was minimal inhibition of anticardiolipin antibody by ss DNA in only 2 of 10 sera tested and no inhibition by ds DNA in any sera tested. Conversely, cardiolipin inhibited anti-ss DNA antibody activity in 2 of 10 sera, and anti-ds DNA antibody activity in 2 of 10 sera tested. There was no correlation between anticardiolipin antibody levels and either anti-ds DNA or anti-ss DNA antibody levels. These results suggest that antiphospholipid and anti DNA antibodies are largely separate groups of antibodies. On the basis of these studies, we suggest that there may be various groups of antiphospholipid antibodies in patients with SLE and other autoimmune disorders. PMID- 3981616 TI - Formation of total and stable E-rosettes by lymphocytes from patients with pulmonary tuberculosis stimulated by Con A or PPD. AB - The percentage of total and stable E-rosette forming lymphocytes (tE-RFC and sE RFC, respectively) were determined in the peripheral blood of patients with either active non-chronic, active chronic or inactive pulmonary tuberculosis as well as in healthy controls, both skin test positive and negative. Patients had low percentages of tE-RFC but increased values of sE-RFC when compared with controls. Lymphocytes cultured for 48 hr with or without 10 micrograms/ml of Con A exhibited decreased capacity to form total E-rosettes. Mitogen stimulation resulted in a very significant increase in the percentage of sE-RFC from control individuals. Although lymphocytes from tuberculous patients were able to respond to Con A stimulation, this response was significantly diminished compared to the controls. Incubation of the cells in the presence of various concentrations of PPD did not affect the formation of total E-rosettes by normal cells nor by lymphocytes obtained from tuberculous patients. Nevertheless, PPD induced a significant increase in the percentage of sE-RFC from normal tuberculin positive controls whereas lymphocytes from the same group incubated without antigen or cells from tuberculin negative controls cultured in the presence of 50 micrograms/ml of PPD did not form sE-RFC, indicating that the response might be antigen specific. Even though lymphocytes from patients with active tuberculosis formed higher numbers of stable E-rosettes than controls, they did not respond to antigen with significant increases of sE-RFC. In all the experiments it was not possible to demonstrate differences between the 3 groups of patients with various stages of the infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981617 TI - Biochemical purification of tumoricidal factors obtained from human plasma. AB - Continuous DEAE-Sephadex ion-exchange gradients were utilized to purify 2 human plasma factors (A and B) which possessed cytotoxic activity in vitro against human tumor cells but not against normal cells. Antibodies were elicited in rabbits against human factors A and B. After insolubilization of the rabbit anti human tumoricidal factor antibodies, the 2 factors, could then be purified utilizing immunoadsorbent techniques. Human plasma was adsorbed to the insolubilized antibodies so that factors A and B could be isolated in quantities large enough to conduct biologic studies. When the 2 factors purified by DEAE ion exchange chromatography were examined by SDS-polyacrylamide gel electrophoresis, both factors A and B consisted of 1 protein band with an approximate molecular weight of 67,000. Both factors A and B were destroyed by heating at 100 degrees C. However, when heated at 56 degrees C for 30 min, factor A was destroyed whereas factor B retained its cytotoxic effects. Furthermore, the mechanism of tumor killing by the human factors appears to be by means of a soluble mediator. The addition of arginine to the incubation mixture had no effect on cytotoxicity. However, incubation with catalase or superoxide dismutase suppresses cytotoxicity. Thus it appears that O2- or H2O2 functions as an anti-tumor substance in our system. When the kinetics of tumor killing were studied, it was found that human factors were non-cytotoxic after 4 hr incubation, possessed slight cytotoxicity at 8 hr but reached maximal cytotoxicity levels after 24 hr incubation. PMID- 3981618 TI - Histological changes in the penis of the Chacma baboon--a model to study aging penile vascular impotence. AB - Light and scanning electron microscopy was performed on the penes of Chacma baboons to establish their suitability as animal model for studying vascular impotence. Analogous aging penile vascular changes were found in man, and a fibrous trabeculopathy with intertrabecular senechiae was demonstrated. Considering the corresponding changes, the Chacma baboon could thus be regarded suitable for studying the pathophysiology of aging penile vascular changes. PMID- 3981619 TI - Autonomic control of heart rate in the neonatal rhesus monkey. AB - Autonomic control of resting heart rate was assessed using atropine and propranolol in 20 neonatal (2 to 3 weeks old) male Rhesus monkeys. After release from restraint for placement of a venous catheter, the average heart rate significantly decreased from 220 +/- 7 beats/min to 181 +/- 6 beats/min within 15 minutes and remained stable for the 2 hours. Autonomic control of resting heart rate is mediated through both divisions of the autonomic nervous system with the sympathetic system having a dominant influence. This is in contrast to the adult Rhesus, where the parasympathetic nervous system controls resting heart rate. PMID- 3981620 TI - Cosmetic repair of chronic head restraint defects. AB - Surgically implanted head restraint devices have been used in nonhuman primate research for more than a decade. Superficial scalp defects are created by the implantation procedures and remain after the devices are removed, a factor that occasionally hinders continued use of the animals by investigators on esthetic grounds. A technique is described whereby the scalp defects are surgically repaired, resulting in a good cosmetic appearance and effectively increasing the potential for reuse of these animals. PMID- 3981622 TI - Testicular blood flow in monkeys as measured by xenon clearance and radioactive microspheres. AB - Testicular blood flow was measured in monkeys using a 133xenon clearance technique and a 141cerium microsphere entrapment technique. The clearance procedure provided values that tended to be lower than those obtained using the microspheres, was technically less difficult, and has the advantage of being a clinical tool. The microsphere entrapment technique provides the simultaneous evaluations in numerous tissue sites but requires the removal of the tissues to be evaluated. The xenon clearance technique appears to be better suited for evaluations in nonhuman primates. PMID- 3981621 TI - Fetal alcohol syndrome: an examination of craniofacial dysmorphology in Macaca nemestrina. AB - The purpose of this investigation was to evaluate the craniofacial features in nonhuman primate models exposed in utero to moderate and high weekly binge doses of ethanol. While the high-dosed animal did have unusual craniofacial dysmorphology, she did not exhibit the typical facial pattern seen in human fetal alcohol syndrome. The high-dosed specimen displayed a scaphocephalic head shape secondary to synostosis of the sagittal suture. The brain of this monkey was grossly abnormal and microcephalic. PMID- 3981623 TI - Hematology and serum chemistry values of juvenile and adult ruffed lemurs (Varecia variegata). AB - Hematologic and serum chemistry values are presented for adult and juvenile red ruffed lemurs (Varecia variegata rubra) and black and white ruffed lemurs (Varecia variegata variegata) maintained in a zoological collection. Hematologic and serum chemical values are compared between age groups and subspecies and with other primate species. Elevated hematocrit, total protein, and serum albumin values were noted. Significant differences in cholesterol, total protein, and serum albumin values between the two age groups are discussed. PMID- 3981624 TI - Stress and health among Polynesian migrants to New Zealand. AB - A survey study of 228 Samoans, 212 Cook Islanders, and 224 native-born New Zealanders of European background randomly selected from the same working-class neighborhoods of Auckland was interviewed in their own language by same-sex interviewers on their adaptation to life in New Zealand's major industrial city. Strong positive associations were found between the number of symptoms of poor health reported and both the frequency of external situational stressors and the strength of Type A psychological attributes, which together account for 25% of the variance in health status. These statistical relationships were replicated within all ethnic and both sex groups. Social support systems, however, did not provide the stress-buffering effects anticipated, raising the issue of the possible psychic costs of maintaining these kinship ties, particularly among Samoan migrants. PMID- 3981625 TI - Effects of diazepam (Valium) and trait anxiety on human physical aggression and emotional state. AB - The effects of diazepam (10 mg orally) and trait anxiety on the aggressive behavior of normal male undergraduates were studied in a competitive reaction time task paradigm which entails shock setting with an increasingly provocative "opponent." Diazepam produced an aggression-enhancing effect which was specifically shown only by the low-trait anxious group under low provocation and generally shown by all groups under conditions of higher provocation. Reductions in state anxiety following diazepam ingestion were seen most clearly in the high- and, somewhat, the moderate-trait anxious groups. In contrast, the low-trait anxious group evidenced an increase in depression but little change in anxiety. The results are consistent with reports of the ability of antianxiety drugs to disinhibit suppressed behaviors. Moreover, trait anxiety appears to mediate the effects of diazepam on both mood states and aggressive behavior. PMID- 3981626 TI - Tolerance of aversive stimuli in relation to life change. AB - This study investigated the relation between an individual's tendency to tolerate and/or report discomfort and the amount of life change experienced by that individual. The role of attention in this relation was also examined and manipulated through instruction. Eighty college freshman were selected and divided into three groups (high, medium, low) as a function of scores obtained on the College Schedule of Recent Experience (CSRE). Participants were asked to experience two known discomforting stimuli, the cold pressor and loud broad-band noise. Dependent measures included participant's tolerance time, report of discomfort, and amount of attention paid to each of the stimuli. Results indicated that "high"-life change groups tolerated the two discomforting stimuli significantly less than either the "low"- or the "medium"-life change groups. Neither discomfort ratings nor attention was significantly different across groups. Findings are discussed in relation to epidemiological studies of the life change and illness relation. PMID- 3981627 TI - Are social-psychological smoking prevention programs effective? The Waterloo study. AB - Recent evaluations of smoking prevention programs have suggested considerable promise for curricula emphasizing resistance of social influences. The present study extends these evaluations by addressing key methodological limitations in previous work. Twenty-two matched schools were randomized to experimental and control conditions. Grade 6 students received a 6-week core curriculum, plus additional sessions through Grades 7 and 8. Questionnaires, and saliva samples to validate self-reported smoking behavior, were collected at five times over the 2 year study period. Cross-sectional and longitudinal analyses examined program impact for five levels of initial smoking experience, ranging from "never smoker" through regular, weekly smoker. Significant program effects were documented, most clearly for those having some experience with smoking before the program began and for those with smoking peer and family models. This study provides the methodologically most rigorous test to date of social influence programs for smoking prevention and documents for the first time significant effects for those at high risk for smoking. PMID- 3981629 TI - Quality medical care at a reasonable cost. PMID- 3981628 TI - Brief consultation and stress management treatments for drug-dependent insomnia: effects on sleep quality, self-efficacy, and daytime stress. AB - Brief consultation and stress management treatments to help insomniacs withdraw from sleep medication were evaluated with 12 drug-dependent women. The effects of treatment were assessed by all-night home polysomnographic recordings and questionnaires. All 12 subjects succeeded in withdrawing from sleep medication and showed a number of improvements independent of the treatment received: (a) decreased latency to sleep onset, (b) increased minutes of Stage 3 sleep and total slow-wave sleep, (c) increased self-efficacy, and (d) reductions in some types of daytime stress. Subjects in the stress management treatment compared to those in the brief consultation program showed (a) significantly greater improvement on latency to sleep onset, total wake time, total dark time, and sleep efficiency, (b) less of an increase in minutes awake after sleep onset, and (c) greater reductions in anger and depression. Results of 6- and 12-month follow up and partial replication of the brief consultation program are reported. PMID- 3981630 TI - Ultrasonic absorption in tobacco mosaic virus and its protein aggregates. AB - The structural fluctuations specific to self-assembled biological systems have been investigated further with ultrasonic techniques by using two strains of tobacco mosaic virus (TMV), as well as the helical aggregate of the common strain protein and subassemblies of it. We confirmed our earlier conclusion that protein assemblies exhibit specific structural fluctuations detected in ultrasonic experiments. As in spherical viruses, the fluctuations exhibited by the protein aggregates having a quaternary structure similar to that of the virion were modified in the virus by interaction with the RNA strand. It is unlikely that the origin for the observed effect is due either to: (1) the difference in local mobility of the segment 89 to 113 of the polypeptide chain in TMV and in the helical aggregate on the one hand, and in smaller aggregates, on the other hand; or (2) a local fluctuation associated with proton transfer reactions or ion-pair interactions. The most remarkable feature in the TMV system is the fact that the two-ring disk showed no excess of ultrasonic absorption with respect to the A protein oligomer, while a large increase of ultrasonic absorption was observed in the rod-like aggregate that had undergone the disk-helix transition. PMID- 3981631 TI - Unstained microtubules studied by cryo-electron microscopy. Substructure, supertwist and disassembly. AB - Unstained microtubules embedded in amorphous ice have been studied by cryo electron microscopy and image reconstruction. The structural integrity is well preserved, judging by the similarity of optical diffraction patterns with X-ray fiber diagrams. Protofilaments are not straight but show a variable right-handed twist around the tubule axis with a pitch of several micron. While rapid freezing of warm solutions (about 37 degrees C) leaves microtubules intact, gradual cooling, followed by rapid freezing, allows one to visualize the time-course of microtubule breakdown. Disassembly proceeds both from the ends and from inside, and short protofilament fragments are among the early breakdown products. PMID- 3981632 TI - Improving sequence-matching algorithms by working from both ends. AB - Recent algorithms (e.g. Ukkonen, Fickett) align nucleic acid sequences (starting from the left) by bounding the allowed distance between subsequences by d, aligning, then incrementing d until all of both sequences are aligned. Aligning from both ends is more efficient. If the single-ended algorithm has computational cost CNk (C, k = constants; N = sequence length), the double-ended algorithm often has cost C(N/2)k. PMID- 3981633 TI - Crystallization of an NAD+-dependent glutamate dehydrogenase from Clostridium symbiosum. AB - Crystals of a bacterial NAD+-dependent glutamate dehydrogenase (GDHase) have been grown over a wide range of pH values by using the hanging drop method of vapour diffusion with ammonium sulphate as the precipitant. Sodium dodecyl sulphate/polyacrylamide gel electrophoresis of this enzyme together with high pressure liquid chromatography/gel filtration, shows that this GDHase is hexameric like the GDHases of vertebrates. X-ray photographs of the crystals show that they diffract to at least 2.0 A, and an analysis of the diffraction pattern demonstrates that the hexamer is arranged in at least pseudo 32 symmetry. PMID- 3981634 TI - Screening of isolated DNA for sequences released from anchorage sites in nuclear matrix. AB - Isolated chromosomal DNA is associated with polypeptides that are not released from DNA by several methods designed to purify DNA, e.g. treatment with sodium dodecyl sulphate. DNA fragments associated with these very tight DNA/protein complexes show high affinity to nitrocellulose filters in the presence of salt concentrations of 500 mM or greater. Consequently, a fraction of AluI-fragmented native DNA comprising the complexes and 0.2 to 0.3 micron of vicinal DNA can be isolated by one filtration step. This fraction of DNA shows characteristics of residual DNA sequences retained in nuclei after extraction with nucleases and high salt (nuclear matrix). The DNA fragments retained on filters are highly enriched in replicative DNA; and their degree of hybridization with poly(A)+ RNA points to enrichment in actively transcribed sequences. The results support previous work indicating that the very tight DNA/polypeptide complexes co isolating with DNA under conditions that release other peptide materials from DNA may be anchorage sites of DNA in the nuclear matrix. Moreover, the method described here allows isolation of replicating and actively transcribed DNA sequences directly from isolated total genomic DNA by skipping artefact-prone isolations of the nuclear matrix. PMID- 3981635 TI - Nucleotide sequence and genetic organization of the genome of the N-specific filamentous bacteriophage IKe. Comparison with the genome of the F-specific filamentous phages M13, fd and f1. AB - The nucleotide sequence and genetic organization of the genome of the N-specific filamentous single-stranded DNA phage IKe has been established and compared with that of the F-specific filamentous phages M13, fd and f1 (Ff). The IKe DNA sequence comprises 6883 nucleotides, which is 476 (475) nucleotides more than the nucleotide sequence of the Ff genome. The data indicate that IKe and Ff have evolved from a common ancestor (overall homology approx. 55%) and that their genomes contain ten homologous genes, the order of which is identical. Similar to Ff, the major coat protein and the gene III-encoded pilot protein of IKe are synthesized via precursor molecules. The extent of homology between the genes of IKe and Ff differs significantly from one gene to another. Genes that code for viral capsid proteins are less homologous than genes whose products are involved in the processes of DNA replication and phage morphogenesis. During evolution, large nucleotide sequence rearrangements have occurred in the gene (gene III) whose product is needed for the attachment of the virion to the conjugative pili of the host cell, suggesting that these rearrangements have led to phages with different host specificities. Extensive nucleotide sequence homology was noted between the structural elements involved in DNA replication and phage morphogenesis, indicating that the mechanisms involved in DNA replication and morphogenesis are highly conserved. PMID- 3981636 TI - Regulation of growth hormone messenger RNA synthesis by dexamethasone and triiodothyronine. Transcriptional rate and mRNA stability changes in pituitary tumor cells. AB - We have characterized the process by which the growth hormone (GH) gene is stimulated in rat pituitary tumor cells (GC or GH3) by the steroid hormone dexamethasone (Dex) and the thyroid hormone, L-triiodothyronine (T3). A primary transcriptional response is detected within 60 minutes of addition of T3 or Dex + T3 to GH-producing cells (GC or GH3). A fivefold transcriptional stimulation of GH nuclear RNA occurs in cells cultured with serum substitute medium and induced with Dex + T3, while T3 alone induces a modest two- to threefold stimulation. The absence of fetal calf serum from the cell culture medium does not decrease the level of transcriptional activity of the GH gene during hormone stimulation. Twenty-four hours after addition of Dex + T3 the cytoplasmic GH mRNA shows a 50 fold increase, as measured by S1 nuclease analysis. This large accumulation of cytoplasmic GH mRNA in contrast to the relatively small changes in GH gene activity is inconsistent with solely a transcriptional mechanism of hormone induction. We suggest that a change in specific GH mRNA stability also takes place in response to Dex + T3. In contrast to other reports, transcriptional stimulation of the GH gene by Dex is insignificant except in the presence of T3. PMID- 3981637 TI - Neutron diffraction studies of collagen in fully mineralized bone. AB - Neutron diffraction measurements have been made of the equatorial and meridional spacings of collagen in fully mineralized mature bovine bone and demineralized bone collagen, in both wet and dry conditions. The collagen equatorial spacing in wet mineralized bovine bone is 1.24 nm, substantially lower than the 1.53 nm value observed in wet demineralized bovine bone collagen. Corresponding spacings for dry bone and demineralized bone collagen are 1.16 nm and 1.12 nm, respectively. The collagen meridional long spacing in mineralized bovine bone is 63.6 nm wet and 63.4 nm dry. These data indicate that collagen in fully mineralized bovine bone is considerably more closely packed than had been assumed previously, with a packing density similar to that of the relatively crystalline collagens such as wet rat tail tendon. The data also suggest that less space is available for mineral within the collagen fibrils in bovine bone than had previously been assumed, and that the major portion of the mineral in this bone must be located outside the fibrils. PMID- 3981638 TI - Interaction of recA protein with single-stranded DNA. Quantitative aspects of binding affinity modulation by nucleotide cofactors. AB - We have investigated quantitative molecular aspects of the interaction of recA protein with single-stranded DNA, by using a fluorescent modified-DNA referred to as etheno-M13 DNA. In addition, the effects of the nucleotide cofactors ATP and ADP, and the analogues ATP-gamma-S, AMP-P-C-P, and AMP-P-N-P on this interaction have been studied. It is shown that ATP, AMP-P-N-P and, in particular, ATP-gamma S significantly increase the affinity of recA protein for single-stranded DNA, whereas ADP and, to a lesser degree, AMP-P-C-P decrease the affinity. Binding to etheno-M13 single-stranded DNA is co-operative, with the value of the co operativity parameter, omega, being approximately 50 under all conditions measured. The effect that ADP has on recA protein-DNA affinity is to lower the intrinsic binding constant, but it has no effect on the co-operativity of binding. In addition, the stability of the recA protein-DNA complex is very salt dependent (d log K/d log [NaC1] approximately -10) and it is the intrinsic binding affinity rather than the co-operativity of binding that is affected; thus, under all conditions observed, recA protein binds single-stranded DNA co operatively with a value of omega = 50 +/- 10. The binding affinity is also influenced by the type of anion present, being approximately 10,000-fold higher when acetate ion is present instead of chloride ion. These data have been interpreted to suggest that recA protein forms up to five ionic interactions when it binds to single-stranded DNA and that five to six anions are displaced upon binding. The modulation of recA protein-DNA complex stability by nucleotide cofactors suggests that these cofactors play a role in the cycling of recA protein on and off single-stranded DNA, with ATP being required for DNA binding under physiological conditions and ADP serving as a "release" factor. These results are discussed in terms of a model for the role of ATP hydrolysis in a recA protein-single stranded DNA binding cycle. PMID- 3981639 TI - Tadpole Xenopus laevis hemoglobin. Correlation between structure and functional properties. AB - Perutz & Brunori (1982) proposed that the COOH-terminal His and Ser F9 of the beta-chains of fish and amphibian hemoglobins are responsible for their Root effect and part of their alkaline Bohr effect. Analysis of the kinetics of carbon monoxide binding by hemoglobin from the tadpole of Xenopus laevis supports that model and suggests an explanation for the absence of an alkaline Bohr effect in many aquatic Anura and Urodela. PMID- 3981641 TI - Aquatic prey capture in ambystomatid salamanders: patterns of variation in muscle activity. AB - Functional morphologists commonly study feeding behavior in vertebrates by recording electrical activity from head muscles during unrestrained prey capture. Rarely are experiments designed to permit a partitioning variation in muscle electrical activity patterns. Analysis of muscle activity during aquatic prey capture in two morphologically distinct species of salamanders, Ambystoma dumerilii and A. mexicanum, is conducted to assess variation at four levels: between species, among individuals within species, among experiments conducted on different days, and among feedings. The results show that 1) mean correlations among the 11 electromyographic variables measured for each feeding are low and vary considerably among individuals, 2) many of the variables show significant differences among experimental days, 3) only one variable, the difference in timing between the depressor mandibulae and sternohyoideus muscles, showed significant variation between species, and 4) seven of the 11 variables showed significant variation among individuals within species. Overall, the variation between feedings (trials) was high, and there was some variation between days on which the experiments were conducted. Neither electrode position within the muscle nor satiation contributed to the high trial variance. The results suggest that functional analyses of feeding behavior should include an assessment of variation due to individuals, days, and trials, because the amount of variation at these levels may render differences between species nonsignificant. PMID- 3981640 TI - Bacteriophage P2 late promoters. II. Comparison of the four late promoter sequences. AB - The late genes of bacteriophage P2 are clustered into four transcription units. We have reported the transcription initiation sites for two of the late messenger RNAs, encoding genes QP and ONMLKRS. We have now located the 5' ends of the two remaining late mRNAs. The first gene in the VJHG transcription unit has been located by DNA sequence determination of the single nucleotide change in a V amber mutant. Location of the first gene in the FETUD transcription unit has been inferred from the DNA sequence. The 5' ends of the mRNAs for these two transcription units were located by protection of end-labeled restriction fragments in RNA-DNA hybrids from digestion with nuclease S1. Similar protection of hybrids using RNA that had been 5' end-labeled with [alpha-32P]GTP and guanylyl transferase confirmed that these 5' termini resulted from initiation of transcription. The DNA sequences preceding the P2 late transcription starts are different from the Escherichia coli promoter consensus sequences at -10 and -35, consistent with the apparent requirement for phage-encoded proteins in the regulation of P2 late gene expression. The four P2 late promoters do share sequence homologies in the -10 and -35 regions, however, and several additional homologies further upstream. P2 late gene expression also appears to involve negative regulation by a product of the ONMLKRS gene cluster. When cells are infected with P2 polar O amber mutants, a marked increase in the levels of proteins encoded by the other three gene clusters is observed. This increase is reflected in the amounts of late mRNAs, suggesting that RNA synthesis is normally repressed or that late mRNAs are more labile in the presence of a gene product from the ONMLKRS transcription unit. Satellite phage P4 induced P2 late gene expression without the usual requirement for P2 DNA replication. The 5' ends of the P2 late mRNAs are the same during P4 transactivation as during normal P2 late gene expression. Thus, the regulation of P2 late gene expression by P4 does not involve altered promoter selection. PMID- 3981642 TI - Use of the term "trophoblast" for tissues in therian mammals. AB - Use of the term "trophoblast" in descriptions of therian (marsupial and eutherian) mammals has caused confusion because of misinterpretations of blastular homologies and because of imprecise application in functional versus ontogenetic-phylogenetic senses. Marsupials follow the plan of early development characteristic of noneutherian amniotes. Eutherians, in contrast, are unique in the early determination of presumptive embryonic versus extraembryonic cells through formation of inner cell mass versus trophoblastic (or trophectodermal) tissues, respectively. No cellular unit of the eutherian blastula is recognizable unequivocally as the homologue of a specific part of the protodermal marsupial blastula; progressive deletion of innovative but phylogenetically older ontogenetic steps probably figured importantly in the evolution of eutherian early embryogenesis. Because of marked differences in mode of formation and in cellular fates, homology of the blastocoel between marsupials and eutherians is questioned. It is suggested that use of the term "trophoblast" be restricted to eutherians in discussions of ontogenesis or phylogenesis, and be deemphasized in the functional sense (i.e., fetal-maternal exchanges) for marsupials, in favor of the more appropriate tissue terms of "choriovitelline" and "chorioallantoic" membranes. Integral to the origin of the eutherian style of embryogenesis was the evolution during Cretaceous time of neomorphic, extraembryonic tissues (i.e., trophoblast) having physiological properties that allowed the unique combination of intimate apposition of fetal and maternal tissues and circulatory systems, along with sustained, active morphogenesis. Marsupials have not achieved such a combination. PMID- 3981643 TI - Temporal analysis of the role of growth hormone in the initiation and maintenance of limb regeneration in the hypophysectomized newt Notophthalmus viridescens. AB - This study was designed to investigate and determine for how long, after either hypophysectomy or the third (last) growth hormone injection (to previously hypophysectomized newts), the circulating and now declining titers of endogenous or exogenous hormone remained at a sufficient concentration to permit a morphologically normal forelimb regeneration response in the adult newt Notophthalmus viridescens. To examine the declining levels of endogenous hormone (hormone withdrawal series [HW]), left forelimbs were amputated at specific times following hypophysectomy. Right forelimbs were amputated 5 days prior to hypophysectomy. The declining levels of exogenous hormone (hormone replacement series [HR] were examined in newts whose left forelimbs were amputated at specific times following the last of three consecutive alternate-day growth hormone injections that were initiated 5 days post hypophysectomy. Right forelimbs were amputated immediately following the first hormone injection. All experimental animals were sacrificed when their right forelimbs regenerated to an advanced digitiform regenerate. In both series right forelimbs regenerated normally. In the HW series normal regeneration resulted only when forelimbs were amputated within 48 hours post hypophysectomy, whereas in the HR series normal regeneration occurred in only those newts whose forelimbs were amputated within 12 hours of the last hormone injection. The regeneration response of left forelimbs in both series gradually declined with the time interval between either hypophysectomy or hormone injection and forelimb amputation. As the hormone titer declined, fewer limbs initiated a normal response; they became progressively more hypomorphic and eventually failed to undergo typical regeneration. PMID- 3981644 TI - Management and medicine, never the twain shall meet. AB - Historically, there has been very little management in medicine. The author suggests that the nature of medicine has changed recently, and changed in such a way that medicine needs management. The people who practice medicine need to use increasingly sophisticated management techniques. The clients of the system, particularly black clients, cannot be served well unless medicine is well managed. PMID- 3981645 TI - Spare-part surgery: the ethics of organ transplantation. AB - It has been written, "Material problems are easy to solve. It is the moral and ethical implications that reveal the defects in human nature."(1) Organ transplantation allows physicians to manipulate the course of, or to even surmount, the inevitable deterioration of human organ systems. To date, necessary reexaminations of ethical and moral beliefs have not kept pace with the tremendous surge in surgical prowess. Opposing viewpoints on the ethics of transplantation have been so emotive that the differing protagonists have been unable to reach a consensus for a national donor policy. This multifaceted dispute involves questions about costs and priorities, the problem of choice, the quality of life, the definition of death, and the welfare of the individual and society. PMID- 3981646 TI - Rat erythrocyte insulin receptors: radioreceptor assay and characterization. AB - Highly specific insulin receptors have been identified on the rat erythrocyte. A radioreceptor assay for the evaluation of these receptors has been developed, and the characteristics of these receptors have been investigated. Insulin receptor binding on the rat erythrocytes was found to be dependent on pH, temperature, time, and ionic strength. When incubated for 31/2 hours at 15 degrees C, 5.0 * 10(9) erythrocytes/mL from each of 10 rats were found to bind specifically 7.54 percent (+/-0.15 SEM) of 40 pg of (125)I-insulin. Specific binding was found to be a function of cell concentration. The pH optima for insulin binding were found to be 7.4 and 7.0 in the absence of cations. The presence of cations not only shifted pH optimum to 7.4 from 7.0, but also increased specific insulin binding.These observations suggest the stabilization of negatively charged groups on ligand and receptor, as well as providing a suitable ionic environment for the hormone-receptor interaction. Based on the resistance of rat erythrocytes to the pH of the external buffer, a simple method for determining the internal pH of rat red- blood cells is described. Scatchard analyses of insulin-binding data yielded curvilinear plots, and the number of receptor sites per cell was found to be 762 (+/-12.1 SD), as opposed to the large variation (410 +/- 260 SD) in normal humans. The rat erythrocytes may serve as a useful, precise, sensitive, and efficient model system for future erythrocytic-receptor studies that would be difficult to obtain from human subjects. PMID- 3981648 TI - Infectious drug resistance. AB - The emergence of antibiotic-resistant bacteria is a serious threat to public health. Infectious drug resistance, the transmission of resistant determinants from antibiotic-resistant bacteria to antibiotic-sensitive bacterial populations, creates clinical problems that must be addressed. Adequate knowledge of the mechanisms responsible for bacteria resistance is important for ensuring the benefits of antimicrobial therapy. PMID- 3981647 TI - Alcohol consumption and hypertension: a review with suggested implications. AB - Alcohol abuse and hypertension are two important health concerns for the general US population. A review of the literature indicates, however, that black Americans are at greater risk of experiencing primary and secondary health and behavioral problems associated with these two concerns. Empirical evidence exists suggesting a relationship between alcohol consumption and hypertension and its related sequelae. Although the correlation is not of a dose-effect nature, the results of numerous longitudinal and other studies have suggested a positive relationship. Various implications exist in the treatment, control, and prevention of hypertension for highrisk groups. For example, existing health-care protocols may be modified for regular screening and monitoring of "excessive" alcohol consumption patterns, especially of hypertensive and borderline hypertensive patients. Whenever possible, health-care counseling and education should be a necessary adjunct to treatment and prevention efforts to better control hypertension in the black community. PMID- 3981649 TI - Unravelling the pathophysiology of male pattern baldness. AB - The cause of male pattern baldness remains unknown. The author discusses its possible pathophysiology and its therapy. A case revealing significant points is described. PMID- 3981650 TI - Nuclear magnetic resonance (NMR): a promising future. PMID- 3981652 TI - Increased cancer risk in blacks--is it true? PMID- 3981651 TI - Medulloblastoma: are we overtreating? AB - Modern advances in the concept and the techniques of megavoltage radiation therapy have revolutionized the treatment of medulloblastoma. Five-year survivals of 50 to 70 percent are achieved by craniospinalaxis irradiation with a boost to the posterior fossa. However, the price paid by the long-term survivors is significant. Sequelae include growth retardation, thyroid deficiency and anomalies, marrow suppression, gonadal irradiation, IQ and psychological deterioration, immunological alterations, second malignancies, and pituitary hormonal deficiencies.The literature is reviewed in terms of these sequelae and analyzed to determine optimal therapeutic doses. Although the authors agree with the doses used to treat the posterior fossa, the current doses recommended to eradicate the microscopic disease in the rest of the neuroaxis appear excessive; a lesser dose can be as effective and may decrease the rate and severity of complications.The authors believe that there is enough evidence to initiate a randomized, multi-institutional clinical trial using 20 to 25 Gy to the neuraxis (other than the posterior fossa) in one of the arms, especially when there is no evidence of tumor outside the posterior fossa.Electron beam radiation of the spinal component can decrease the dose to some of the normal structures and prevent some of the long-term sequelae. PMID- 3981653 TI - Endoscopic sphincterotomy in clinical practice. AB - Endoscopic sphincterotomy was performed in 22 patients with biliary obstruction. Nineteen patients had obstructing choledocholithiasis and three patients had distal common-bileduct obstruction due to malignant disease. All patients had excellent biliary decompression. Three patients had complications that responded to medical management. Endoscopic sphincterotomy is a safe and effective procedure for the nonsurgical management of obstructive-biliary-tract disease. PMID- 3981654 TI - A description of life style attributes among cancer patients and their spouses. AB - The same type of cancer occurring in both husband and wife has been reported in the literature.(1-6) The authors describe their experience in a community hospital on the central western coast of Florida. PMID- 3981656 TI - Sarcoidosis in Lagos. AB - The clinical manifestations of sarcoidosis seen at the Lagos University Teaching Hospital are presented. The clinical features and management were in the main similar to those described in the temperate countries, but the patients tended to be older at presentation and were seen at a more advanced stage of the disease.Erythema nodosum and ocular lesions were relatively rare. The rarity of sarcoidosis in Lagos may be more apparent than real. Increased physician awareness of the disease is leading to the detection of more cases. PMID- 3981655 TI - Nephrogenic adenoma: a light and electron microscopic and immunohistochemical study. AB - Nephrogenic adenoma is a relatively infrequent lesion that involves the bladder, the ureters, and the urethra. Even though several cases have been described since the early 1950s, the etiopathogenesis of the lesion is still uncertain. Electron microscopic and immunohistochemical studies seem to favor a congenital origin. PMID- 3981657 TI - Vanishing lung tumor. AB - The case of a patient with a lung mass that disappeared after therapy with furosemide and digoxin is presented. PMID- 3981658 TI - Angiographic density averaging in a case of renal artery intimal fibroplasia and recanalized thrombus. AB - The angiographic appearance of renal artery, intimal fibroplasia with recanalized luminal thrombus is presented. Criteria for diagnosis are discussed. PMID- 3981659 TI - Formation of DNA-damaging nitroso compounds by interaction of drugs with nitrite. A preliminary screening for detecting potentially hazardous drugs. AB - Fifty-seven theoretically nitrosatable widely used drugs that are commonly administered orally have been screened to determine the formation of nitroso compounds by drug-nitrite interaction and to evaluate the genotoxicity of their nitrosation products against Chinese hamster ovary (CHO) cells, measured as DNA damaging potency by the alkaline elution technique. The drug (0.1 mmol) was reacted with NaNO2 (0.4 mmol) at pH 3-3.5 for 1 h. Nitroso compounds were present in varying yield in the nitrosation mixture of 47 drugs. Twenty-two drugs formed direct-acting nitroso compounds capable of producing DNA fragmentation, i.e., a statistically significant (p less than 0.01) increase in the elution rate of CHO cell DNA. On a molar basis, their DNA-damaging potency varied over a 570-fold range, with 12 exhibiting greater potency than that of N-nitroso-N-methylurea. PMID- 3981660 TI - Determination of acute toxic effects in mice following exposure to methyl bromide. AB - An inhalation system was designed and constructed for acute nose exposure of mice to methyl bromide. Animals were exposed for 1 h to concentrations ranging from 0.87 to 5.93 mg/l. Mice exposed to concentrations up to 1.72 mg/l did not exhibit any indication of developing a toxic response. Animals exposed to concentrations to 2.20 and 2.70 mg/l exhibited significantly decreased lung and liver weights when compared to controls. Animals exposed to concentrations above 3.50 mg/l exhibited kidney lesions. At concentrations of 3.82 mg/l and above, animals exhibited abnormal clinical signs, weight loss, and mortality. In addition, at 4.70 mg/l, a liver lesion was observed. At concentrations above 5.77 mg/l, pathological changes were observed in the color and a decreased motor coordination was evident. Methyl bromide exposures of up to 3.82 mg/l did not affect the ability of mice to recall a single-task passive-avoidance test. The 1 h LC50 of methyl bromide in mice via inhalation was determined to be 4.68 mg/l (approximately 1200 ppm). The dose-response curve was quite steep and the LC10 to LC90 range of mortality was contained within a doubling of concentration. PMID- 3981661 TI - A histomorphometric assessment of BHT-induced pulmonary toxicity. AB - The morphological heterogeneity of the lung and the poor extent of knowledge concerning alveolar repair following toxic insult have made morphology, and especially morphometry, a most suitable approach for the study of the injured lung. In this study we aimed to further develop a rapid and quantitative morphological approach to evaluate the sequence of lesion-repair in the aggressed alveolus. Swiss-Webster mice were treated with butylated hydroxytoluene (BHT, 400 mg/kg ip) and the lung was sampled at 1, 3, 5, 7, and 14 d after treatment. A morphometric evaluation, carried out on histological sections, was used to quantify the inflammatory and epithelial regenerative components of the alveolar primary reaction. Classical morphometric parameters such as the Aa and Na ratios, and the mean cellular surface were determined by planimetry. Following BHT administration, the alveolar stem cells (type II pneumocytes) proliferate and differentiate according to a biphasic pattern, with proliferative peaks at d 3 and 7. Furthermore, the challenged pulmonary alveolus retains increased numerical and surface density of macrophages and type II pneumocytes as late as d 14 after initial aggression. PMID- 3981662 TI - Humoral immunodepression following acute NO2 exposure in normal and adrenalectomized mice. AB - The effects following 20 ppm NO2 exposure on humoral immunity were investigated in C57Bl/6 mice after 48, 72, and 96 h exposure. Both spleen plaque-forming cell (PFC) responses and serum hemagglutinins (HA) using sheep red blood cells (SRBC) as antigen were studied. Splenic and thymic weight and cellularity decreased on acute exposure to NO2. PFC were markedly depressed after 48 h exposure and continued to decrease as exposure time was lengthened. HA titers were also depressed. The same significant suppression of PFC and HA titers was observed in adrenalectomized mice after 96 h NO2 exposure. The depression of humoral immunity in NO2-exposed mice was independent of stress-induced endogenous steroids. PMID- 3981664 TI - Prolonged vaginal cornification and other changes in mice treated neonatally with coumestrol, a plant estrogen. AB - This study used the neonatal mouse model to determine if early exposure of female mice to coumestrol, a plant estrogen, would result in reproductive-tract alterations similar to those seen after neonatal exposure to diethylstilbestrol (DES). Newborn female C57BL/Crgl mice were given daily subcutaneous injections of 0.08 micrograms DES or 100 micrograms coumestrol in 0.005 ml dimethyl sulfoxide (DMSO), or DMSO alone, or were untreated, for the first 5 d of life. The doses chosen were equivalent in biological activity based on published uterine bioassay data (using young adult mice). Observations were made twice daily for 1.5 mo to determine the times of eye and complete vaginal opening. Half of the animals were ovariectomized at 40 d of age. Vaginal lavages were examined for 30 consecutive d beginning both at 2 and at 5 mo of age. DES and coumestrol significantly advanced the time of complete vaginal opening and induced a comparable degree of ovary independent persistent vaginal cornification. In addition, coumestrol resulted in the occurrence of hemorrhagic ovarian follicles. PMID- 3981663 TI - Developmental toxicity of nine selected compounds following prenatal exposure in the mouse: naphthalene, p-nitrophenol, sodium selenite, dimethyl phthalate, ethylenethiourea, and four glycol ether derivatives. AB - Ethylene glycol dimethyl ether (EGdiME), diethylene glycol dimethyl ether (diEGdiME), triethylene glycol dimethyl ether (triEGdiME), diethylene glycol diethyl ether (diEGdiEE), ethylenethiourea (ETU), sodium selenite (SS), dimethyl phthalate (DMP), naphthalene (NAP), or p-nitrophenol (PNP) were administered by gavage for eight consecutive days to female CD-1 mice. Weight loss was insensitive as an index of sublethal adult toxicity and was inadequate for determining a maximum tolerated dose. LD50 values indicate that SS, NAP, and PNP were more toxic (8.4, 353.6, and 625.7 mg/kg, respectively) than the polyglycol ethers, ETU, and DMP (LD50 values ranged from 2525.8 to 6281.9 mg/kg). Each of the compounds was administered on d 7 through 14 to pregnant animals at a single dose estimated to be at or just below the threshold of adult lethality. In such a reproductive study, each of the compounds could be categorized on the basis of the pattern of maternal lethality and fetotoxicity which it produced. The number of dams with complete resorptions was significantly increased after administration of ETU, and no mice in the EGdiME-, diEGdiME-, or triEGdiME treated groups delivered any viable offspring. Maternal lethality was significant in the EGdiME, triEGdiME, PNP, and NAP groups. There was a slight reduction in the average number of live pups per litter in the diEGdiEE- and PNP-treated groups and a significant reduction in the NAP group. The number dead per litter was increased with diEGdiEE. SS and DMP had no effect on maternal or fetal survival at the doses administered. Individual pup weight at d 1 postpartum was only significantly reduced by diEGdiEE, and no gross congenital abnormalities were detected in neonates from any treatment group. These results provide guidelines for the subsequent toxicity testing of these chemicals. PMID- 3981665 TI - The effect of tetrachlorohydroquinone on hexachlorobenzene-induced porphyria in Japanese quail. AB - Female Japanese quail received either hexachlorobenzene (HCB, 100 mg/kg . d) or tetrachlorohydroquinone (TCHQ, 175 mg/kg . d) for 10 d as a primary treatment. Following this, a secondary treatment of HCB (100 mg/kg . d) or TCHQ (175 mg/kg . d), alone or in combination, was administered for 1, 5, 10 or 15 d. The primary HCB treatment caused elevated delta-aminolevulinic acid synthetase (ALA-S) activities and small increases in porphyrin concentrations. Subsequent treatment of these birds with lactose resulted in no further increases in porphyrins or ALA S. TCHQ treatment caused increases in porphyrins similar to those seen with continued HCB treatment. Apparently, despite the fact that TCHQ alone had no affect on ALA-S or porphyrin levels, this compound is able, in the presence of elevated ALA levels to cause porphyria. A combination of HCB and TCHQ administered to HCB-pretreated animals caused a more severe porphyria than did follow-up treatment with either HCB or TCHQ alone. PMID- 3981667 TI - Trauma registries revisited. PMID- 3981666 TI - A comparison of the effects of hexachlorobenzene, beta-naphthoflavone, and phenobarbital on cytochrome P-450 and mixed-function oxidases in Japanese quail. AB - Hexachlorobenzene (HCB), beta-naphthoflavone (BNF), or phenobarbital (PB) was administered to Japanese quail to determine their effects on hepatic porphyrin levels and drug-metabolizing enzymes. While HCB increased porphyrin levels, PB slightly reduced them, and BNF had no effect. HCB was an excellent inducer in quail, increasing the specific content of cytochrome P-450 to levels similar to those produced by BNF. Additional similarities between HCB- and BNF-treated quail included a comparable hypsochromic absorption shift in the CO-reduced difference spectra of cytochrome P-450 and similar effects on the activities of cytosolic glutathione S-transferase (GSH-t), biphenyl hydroxylase (BPH), and ethoxyresorufin O-deethylase (EROD). However, a differential response to HCB and BNF treatment was seen in the activities of hepatic NADPH-cytochrome P-450 reductase, epoxide hydrolase, GSH-t (microsomal), aryl hydrocarbon hydroxylase (AHH), and ethoxycoumarin O-deethylase (ECOD). The activities of NADPH-cytochrome P-450 reductase, AHH, and ECOD following treatment with HCB were similar to those found after dosing with PB. HCB caused a pattern of induction that was distinct from either BNF or PB and appeared to be a "mixed-type" inducer. The rapidity of the HCB-induced porphyrogenic response of Japanese quail, as compared to mammals, may provide unique advantages for making correlations between the in vivo metabolism of haloaromatic hydrocarbons and their effects on porphyrin metabolism. PMID- 3981668 TI - Prospective evaluation of the CRAMS scale for triaging major trauma. AB - In order to effectively implement a community-wide trauma system, a mechanism of field triage is required. This process of triage should be simple to use and should accurately identify patients who are in need of level I trauma facility care. It should also allow the less critically injured to be cared for at the local hospital of their choice or at the nearest community hospital. The CRAMS (Circulation, Respiration, Abdomen, Motor, Speech) scale was prospectively studied as a potential triage tool by using it to score patients in the field and then comparing their scores to their emergency room dispositions and final outcomes. The CRAMS scale was easy to apply and accurately identified both the critically injured who should be triaged to a Level I center and the less critically injured who can be adequately cared for by Level II and III centers. PMID- 3981669 TI - Unstable fractures of the thoracolumbar spine: a 10-year experience at Sacre Coeur Hospital. AB - In a 10-year period, 108 unstable fractures involving the thoracolumbar junction (T11 to L2) were treated. This study evaluates the influence of the different treatments on the rate of complication, reduction of the fracture, and neurological recovery. METHODS: mechanism of injury, initial treatment and delay, neurologic deficit, operative findings, and duration of hospitalization were recorded. X-rays were reviewed for classification of fracture, measurement of deformity, and for instability scoring according to White and Panjabi's criteria. Seventy-seven patients were examined and nine more interviewed by telephone. RESULTS: a flexion-rotation injury occurred in 65% and a burst-fracture in 29%. A laminectomy was performed in 30 patients and Harrington instrumentation and fusion in 71 patients. Sixteen patients were treated conservatively. Fifty-five patients presented either a complete or partial neurological deficit. Seventy five complications were noted and were more frequent in the laminectomy group. The instrumented group showed a clear tendency for earlier ambulation and discharge and pain level was found to be less. An increased residual deformity was found in patients treated by laminectomy, short fusion, and by nonsurgical modality. The neurologic recovery in the laminectomy and the nonlaminectomy group was not significantly different. Spinal realignment was better in the group where an instrumentation of five levels or more was performed and where posterior elements were not removed by laminectomy. PMID- 3981670 TI - Open tibial fractures with associated vascular injuries: prognosis for limb salvage. AB - Open tibial fractures complicated by limb-threatening vascular injuries present an infrequent but difficult management problem. Twenty-three cases were reviewed with an ultimate amputation rate of 61% (22% primary, 39% delayed). Crush injuries, segmental tibial fractures, and revascularization delays of greater than 6 hours were associated with a bad outcome. Guidelines for primary amputation (crushing injuries, delay in revascularization, segmental tibial fractures) are proposed and implications of limb salvage are reviewed. PMID- 3981671 TI - Measure of tissue resistivity in experimental electrical burns. AB - Studies were conducted in 14 mongrel dogs to compare resistivities in normal muscle with those from muscle subjected to electrical burns. One-ampere, 60-Hz currents were passed between the hind limbs of the dogs producing injury in three measurement regions of the gracilis muscle. Histology, heart rate, body temperature, arterial and pulmonary artery pressure, cardiac output, hematocrit, leukocyte counts, fibrinogen levels, and platelet levels were determined. Muscle resistivity associated with severe tissue necrosis was 70% lower than control values. Resistivity in tissue showing edema and minimal necrosis decreased 20 to 40% from control values. Muscle showing only edema had a 10 to 30% decrease in resistivity. PMID- 3981672 TI - Burns in motor vehicle accidents. AB - Burns received as a result of motor vehicle accidents (MVA's) create special problems in their care, as they are frequently severe and are often associated with other injuries. One hundred seventy-eight consecutive patients with burns sustained in an MVA were studied. The mean TBSA burn was 33.9%. The mortality was 24.7%, but the mean burn size in this fatal group was almost doubled at 63.9%. The injury most commonly associated with death was inhalation injury (in 36.3%). Thirty-six per cent of the patients sustained other injuries in addition to their burn, the most frequent of which was to the musculoskeletal system (67 injuries). Multiple trauma had little effect on mortality unless severe, but fractures especially complicated burn wound care unless surgically stabilized. Current methods of management are presented along with our approach to multiply injured burn patients. PMID- 3981673 TI - The mass balance method for estimating transcapillary protein transport in an extremity. AB - A 'clinical' procedure for applying the mass balance method to estimate transcapillary protein transport was compared with the 'experimental' procedure of direct tissue monitoring of the rate of 125I-albumin accumulation in the dog hindlimb under conditions of venous pressure (Pv) elevation, norepinephrine infusion, and hemorrhagic hypotension. Over a wide range of venous protein flux (0.2 to 4.6 mg/min X 100 gm), the two estimates correlated well. The correlation coefficients were 0.987, 0.962, and 0.993 for Pv elevation in the control state, during norepinephrine infusion, and following hemorrhage, respectively. Since the 'clinical' format requires only estimates of tissue blood flow, the change in tissue volume, and the change in protein concentration easily obtained with strain gauge plethysmography and venous blood sampling, it represents a relatively innocuous procedure for estimating protein transport which should be suitable for clinical application. PMID- 3981674 TI - Effectiveness of prophylactic antibiotics in the outpatient treatment of burns. AB - We compared wound infection rates in 133 outpatient burns treated with prophylactic antibiotics in our emergency room and 161 similar, untreated burns. Infection rates in the treated and untreated groups were 3.8% (5/133) and 3.1% (5/161), respectively. Since this was an observational cohort study, it was necessary to demonstrate the comparability of treated and untreated groups with respect to risk factors for infection, including patient age, size, location, and etiology of the burn injury, time since injury, and presence of co-morbidity. The groups were found to be comparable for all risk factors except size of burn: larger burns were over-represented in the treated group (p less than 0.05). Even after controlling for size, antibiotic use did not lower the infection rate. These results argue strongly against routine use of systemic antibiotics in the treatment of outpatient burns. PMID- 3981675 TI - Use of peritoneal lavage to evaluate abdominal penetration. AB - A retrospective study was undertaken to evaluate peritoneal lavage in detecting abdominal penetration. Two hundred thirty-five patients with thoracoabdominal, flank, or tangential abdominal gunshot wounds were lavaged. Of these patients, 44 (18.7%) had positive lavages, defined as red blood cell counts greater than 10,000 cells/mm3, white blood cell counts greater than 500 cells/mm3, or the presence of bile, feces, or vegetable matter. There were 13.6% false positives and 1.0% false negatives, with an overall accuracy of 96.6%. The results were unaffected by mechanism or site of injury. If the criteria were changed to include red blood cell counts greater than 100,000 cells/mm3, there would have been no false positives, but an unacceptably high 11.1% false negative rate. Therefore we conclude that peritoneal lavage can be a reliable indicator of abdominal penetration provided sufficiently sensitive criteria are used. These criteria should include red blood cell counts greater than 10,000 cells/mm3 instead of 100,000 cells/mm3. PMID- 3981676 TI - The three wheeler--a menace to the preadolescent child. AB - Children riding three-wheeled motorcycles have recently become victims of serious or fatal accidents. Twelve children (aged 3 to 12 years, mean, 8.7 years) all white, sustained serious or fatal injuries as a result of striking objects or overturning while riding these vehicles. The injured children were preadolescent, white, rural, male, and from relatively affluent families. Most injuries were to the head and upper torso causing severe cosmetic and functional deficits. Our experience suggests the need for better regulations for these vehicles when being ridden by children. PMID- 3981677 TI - 110 bullet wounds to the neck. AB - Selective management of 110 patients with bullet wounds to the neck resulted in 31 explored and 79 observed. There was an overall mortality rate of 2.7%, well within that reported in the literature, which ranges from 2 to 6%. At our institution, it is believed that a substantial number of patients can be selectively managed, depending on the signs and symptoms, the site and direction of the trajectory, and whether the interval of time between injury and entrance to the hospital is longer than 6 hours. Patients who are stable and lack physical signs of obvious major neck injury are evaluated by diagnostic radiologic and endoscopic techniques. If no significant injury is found, they are admitted for observation. The efficacy of this mode of management is strengthened by savings in the costs of hospitalization, risks of undergoing an additional operation, overall negative exploration rate in the mandatory exploration studies, and our own results of selective management. We do not recommend this form of management for all institutions. It has been found that in this well-staffed teaching hospital with an extensive trauma service, experienced personnel doing careful and repeated physical examinations, in addition to 24-hour availability of radiologic and endoscopic modalities, the policy of selective management of bullet wounds to the neck can be adhered to. Further studies need to be done into the various mechanisms of penetrating neck trauma, separating each mechanism into morbidity, mortality, and treatment. PMID- 3981679 TI - Hemorrhagic acalculous cholecystitis causing acute pancreatitis after trauma. AB - Hemobilia is an uncommonly recognized entity and postoperative acute acalculous cholecystitis is an uncommon clinical entity. Hemorrhagic acalculous cholecystitis causing pancreatitis has apparently not been reported before. We report the case of a multiple trauma victim who, several weeks after his initial injuries, developed acute pancreatitis secondary to hemobilia caused by postoperative hemorrhagic acalculous cholecystitis. PMID- 3981678 TI - Hydrocarbon contact injuries. AB - Cutaneous injury caused by exposure to gasoline and other hydrocarbons is a clinical entity with potentially life-threatening effects. We report four cases of such injury. One patient developed full-thickness skin loss following gasoline immersion, and another developed severe systemic complications following contact with a carburetor cleaning solvent. Initial therapy should consist of removal of solvent-containing clothing and extensive lavage or soaking with water, followed by wound care that is generally similar to that used in the treatment of partial thickness burns. In most cases this includes debridement, topical antimicrobial agents, and dressing changes. Severe pulmonary, cardiovascular, neurologic, renal, and hepatic complications may accompany hydrocarbon absorption, particularly in cases involving gasolines containing lead additives. Therefore immediate surgical debridement should be considered if there is suspicion of continued absorption of toxic compounds from the wound. PMID- 3981680 TI - Aortoazygos fistula from gunshot wound to the suprarenal abdominal aorta. AB - Missile injury to the suprarenal abdominal aorta is particularly morbid. Most patients with this injury succumb before arrival in the emergency room. The reported case is unique in that the aortic injury spontaneously decompressed into the azygos vein system, allowing early hemodynamic stability. Diagnostic and therapeutic problems included the lack of evidence of azygos dilatation on the early X-ray and difficulty in achieving control of the false aneurysm and fistula. We recommend exploration of all periaortic hematomas. PMID- 3981681 TI - Necrotizing fasciitis in contused areas. AB - Four patients are presented who sustained blunt trauma and later developed necrotizing fasciitis in the areas of contusion, associated with the distant locus of sepsis. Three of the cases developed acute renal failure and later died. Early recognition of this condition allows prompt debridement beyond the margins of involved necrotic fascia, followed by wound inspection 8-hourly, and treatment with antibiotics, most recently third-generation cephalosporins, piperacillin, amikacin, and vancomycin. PMID- 3981682 TI - Traumatic fistula between the descending thoracic aorta and the left main pulmonary artery. AB - A patient sustained a low-velocity gunshot wound to the left chest which resulted in a clinically silent traumatic fistula between the descending thoracic aorta and the left main pulmonary artery. The bullet remained in the aorta and embolized to the left popliteal artery, from which it was removed 2 days after thoracotomy. Lateral repair of the aorta and pulmonary artery was performed as well as reinforcement of the posterior aortic wall which was weakened by the bullet as it ricocheted within the aorta. This appears to be the first reported case of a traumatic aorta to pulmonary artery fistula involving the descending thoracic aorta. PMID- 3981683 TI - Simultaneous anterior and posterior dislocation of the hip joints. AB - A case of successful treatment of simultaneous anterior and posterior bilateral traumatic dislocation of the hips associated with injuries of iliac and pubic segments of the pelvic ring is reported. The mechanism of this rare injury is thought to have been a simultaneous force from front and rear of the patient while he was seated in an airplane which crashed, with his right hip adducted and his left hip abducted. PMID- 3981684 TI - Aortic gunshot injury and paraplegia: preoperative definition with arteriography and computerized axial tomography. AB - Computerized axial tomography provided the diagnosis for an evolving paraplegia in a patient with a gunshot wound of the descending thoracic aorta. Successful surgical management of the aortic injury and considerations regarding the paraplegia are presented. We do not advocate arteriography and computed tomography routinely in major vascular injuries; however, in clinically stable patients with a high suspicion of associated injuries, use of both can be useful. PMID- 3981685 TI - Post-traumatic fracture-dislocation of manubriosternal joint with a wedge fracture of the body of the fourth thoracic vertebra. PMID- 3981686 TI - Changes of protein metabolism in liver and skeletal muscle following trauma complicated by sepsis. PMID- 3981687 TI - Changing trends with abdominal injury in seat-belt wearers. PMID- 3981689 TI - Dietary practices and aversions during pregnancy and lactation among Sudanese women. PMID- 3981688 TI - Attitudes toward breast-feeding among Mexican-American women. PMID- 3981690 TI - Breast milk and the absorptive process. PMID- 3981691 TI - Anaemia in children: a survey in (Obadan) a rural community in the rain forest zone of Nigeria. PMID- 3981692 TI - Infant nutrition and growth in relation to maternal nutrition in rural Kenya. PMID- 3981693 TI - Paediatric ophthalmic problems in Nigeria. PMID- 3981694 TI - Evaluation of a home based antenatal card. PMID- 3981695 TI - Analysis of low birth weight rates and associated factors in a rural and an urban hospital in Thailand. PMID- 3981696 TI - The advantages of human milk in the feeding of the premature infant. PMID- 3981697 TI - Serum IgG, IgA and IgM levels in rural Namibian infants. PMID- 3981698 TI - A review of thyroid disorders in Singapore children. PMID- 3981699 TI - Haemopoietic response of Nigerian village children to iron, folate supplementation and malaria prophylaxis. PMID- 3981700 TI - Why the mortality discriminating power of anthropometric indicators differs among populations. PMID- 3981701 TI - An epidemiological study of the 1978 outbreak of diphtheria in Khartoum Province. PMID- 3981702 TI - Combined renal and vena caval trauma: a review of personal and recorded experience. PMID- 3981703 TI - Flow cytometric deoxyribonucleic acid analysis of primary and metastatic human renal cell carcinoma. AB - The deoxyribonucleic acid profiles of 54 renal cell carcinoma specimens (43 primary and 11 metastatic tumors) from 50 patients are reported. Deoxyribonucleic acid ploidy and the proportion of cells in the S phase (S index) were determined by flow cytometry. Of the patients 44 had advanced disease (stages III and IV). The frequency of deoxyribonucleic acid aneuploidy (presence of a distinct aneuploid stemline) was 74.1 per cent for all tumors and 77.3 per cent for stages III and IV tumors. The percentage of aneuploid tumors did not vary significantly among the various histological types, between stages III and IV tumors, or between primary and metastatic tumors. S indexes for aneuploid tumors were significantly higher than for diploid tumors. When deoxyribonucleic acid ploidy of the tumor alone was considered with respect to survival, there appeared to be a slight survival advantage for patients with diploid tumors compared to those with aneuploid tumors. However, a larger patient population (especially patients with early stage disease) and a longer followup will be required to determine the prognostic role of flow cytometry deoxyribonucleic acid analysis of renal cell carcinoma. Flow cytometry analysis of 4 primary renal tumors and their subsequent metastases revealed concordance in ploidy in 3 specimens. In 1 patient the primary tumor showed a diploid pattern whereas the subsequent metastasis showed 2 aneuploid stemlines. Possible explanations for this observation are listed. Further flow cytometry studies of deoxyribonucleic acid profiles in renal cell carcinoma are warranted and should improve our understanding of the biological and clinical behavior of this tumor. PMID- 3981704 TI - Percutaneous ultrasonic lithotripsy in the community hospital. AB - A total of 38 patients underwent attempted percutaneous extraction of upper tract calculi with the Wolf nephroscope. A 1-day interval between radiological insertion of the guide wire and extraction of the stone with the patient under general anesthesia was used. Of the stones 87 per cent were removed successfully. Average operating and hospitalization times were 62 minutes and 9.9 days, respectively. Reduced morbidity and a shorter interval to return to work make this the procedure of choice in selected cases. PMID- 3981705 TI - A comparison of end versus loop stomas for ileal conduit urinary diversion. AB - We compared the loop and end stoma techniques for ileal conduit urinary diversion in 54 and 27 adults, respectively, with serious bladder disease during a 3-year interval. Followup by trained enterostomal therapists averaged nearly 2 years for all patients. Stenosis occurred in 12 end stomas (44 per cent) but not in any loop stomas. We believe that this result reflects the inherently better blood supply of the loop stoma, which we recommend over the end ileostomy for patients undergoing ileal diversion. PMID- 3981706 TI - Reconstruction of the lower urinary tract: observations on bowel dynamics and the artificial urinary sphincter. AB - In 14 patients the lower urinary tract was reconstructed using bowel and the artificial urinary sphincter. Of these patients 11 underwent augmentation cystoplasty. The ileocecal segment was used in 4, cecum in 4 and ileum in 3. Total reconstruction of the lower urinary tract was done using the sigmoid colon in 2 patients and an ileocecocolonic segment in 1. Significant bowel contractions were seen in all segments of the large bowel, including the ileocecal segment, which resulted in urinary incontinence in 3 patients with the artificial urinary sphincter and reflux in 3. The ileal cup-patch technique consistently produced low bladder pressures with excellent compliance and an adequate volume. Because of the unpredictable bowel contractions observed in the ileocecal, sigmoid and cecal segments we recommend that augmentation cystoplasty be performed using the cup-patch technique. This procedure will ensure the virtual absence of bowel contractions, and is associated with excellent compliance and capacity. PMID- 3981707 TI - The management of superficial bladder tumors and carcinoma in situ with intravesical bacillus Calmette-Guerin. AB - A phase II study was performed to assess the role of bacillus Calmette-Guerin as a prophylaxis against recurrent stages O and A bladder tumors, and in the treatment of existing superficial bladder tumors and carcinoma in situ. Tice strain bacillus Calmette-Guerin (1 vial, 2 to 8 times 10(8) organisms in 60 cc saline) was instilled intravesically without cutaneous inoculation. Instillations were given weekly for 6 weeks and then monthly or until recurrence in 22 patients with a history of recurrent tumors, while 22 with existing stages O and A transitional cell carcinoma, and 19 with carcinoma in situ were treated weekly for 8 weeks and then monthly for 12 months or until failure. Complications included cystitis in 88 per cent of the patients (severe in 20 per cent), fever in 15 per cent, a flu-like syndrome in 13 per cent, edema and pruritus in 1.5 per cent, and ureteral stenosis in 1.5 per cent. Twelve patients (19 per cent) did not complete the study owing to toxicity. Of the patients in the prophylaxis group 67 per cent have had no tumor recurrence 10 to 26 months (mean 15 months) after therapy. Of the patients with existing tumors 36 per cent had complete regression following bacillus Calmette-Guerin therapy and 23 per cent had a partial response. Among the patients with carcinoma in situ 13 (68 per cent) had reversal to normal urothelium and 3 (16 per cent) had marked improvement. None of the patients had recurrence at 11 to 20 months. Intravesical Tice strain bacillus Calmette-Guerin is effective as a prophylaxis against recurrent superficial bladder tumors and in the treatment of carcinoma in situ. PMID- 3981708 TI - Vinblastine and methotrexate for advanced bladder cancer. AB - Fifty-seven patients with advanced measurable urothelial tract cancer, 52 of whom had an adequate trial, were treated weekly with 3 to 4 mg. per m.2 vinblastine and 30 to 40 mg. per m.2 methotrexate. Of 3 patients with unidimensional parameters 2 showed improvement lasting 16 and 27 months, which was documented by serial cystoscopic examinations. An additional 2 patients had measurable disease that could have been encompassed in a preoperative radiotherapy field. Both patients are free of disease at more than 12 and 14 months, respectively. Of the 47 patients with bidimensionally measurable parameters 19 (40 per cent) achieved a complete or partial remission lasting a median of 8 months, with a range of 1 to 24 months. Of 25 patients with intra-abdominal or pelvic disease 7 achieved a complete or partial remission and 5 also had a minor remission. Of note, 18 of 38 patients who had received no prior chemotherapy achieved a remission versus 1 of 9 who had been treated previously (p equals 0.06). Responders frequently obtained another remission with subsequent chemotherapy (4 of 9 versus 0 of 16, p equals 0.03). Responders lived 14 months versus 8 months for nonresponders (p equals 0.02). Four responders had brain metastases compared to none of 28 nonresponders. The combination of vinblastine and methotrexate is a well tolerated, effective outpatient regimen for patients with urothelial tract cancers. PMID- 3981709 TI - Long-term results with transpubic urethroplasty. AB - From 1973 to 1982, 44 patients underwent transpubic urethroplasty for traumatic prostatomembranous strictures and were followed for 1 to 10 years. The most frequent late sequelae were permanent erectile dysfunction (22 patients) and progressive erectile dysfunction (4 patients). Of the 44 patients 6 (14 per cent) had significant primary urinary incontinence that necessitated placement of a genitourinary sphincter and 2 (4.5 per cent) had incontinence after secondary transurethral procedures because of involvement of the remaining voluntary sphincter mechanism. Prosthetic devices may be useful in correcting erectile dysfunction and urinary incontinence in this difficult patient population. Of 13 patients with post-urethroplasty strictures 10 required dilation. PMID- 3981710 TI - Epidermoid cyst of the testis: a surgical approach for testicular preservation. AB - We report on 6 patients with epidermoid cysts of the testis. Simple excision and testicular salvage are advocated when frozen section reveals the presence of an unequivocally benign lesion. PMID- 3981711 TI - Secondary tumors of the prostate. AB - The significance and clinical implications of secondary neoplasms of the prostate are discussed. These neoplasms are rare except for those that involve the gland by direct extension from adjacent structures. We report on 185 such cases found on a review of almost 6,000 male autopsies during the last 25 years. PMID- 3981712 TI - Effectiveness of castration versus intravenous estrogen therapy in producing rapid endocrine control of metastatic cancer of the prostate. AB - Nine men with histologically confirmed stage D cancer of the prostate were evaluated with serial serum testosterone levels after being treated with bilateral orchiectomy or intravenous estrogen. Bilateral orchiectomy produced castrate serum testosterone levels (less than or equal to 50 ng. per 100 ml.) within 2 to 6 hours (mean 3 hours) after surgery. Intravenous estrogen therapy did not consistently produce castrate serum testosterone levels immediately but did significantly decrease testosterone within 12 hours after infusion. Both forms of therapy are safe, produce a clinically effective response and offer advantages for patients with advanced prostatic cancer. PMID- 3981713 TI - Ultrastructural microbial ecology of infection-induced urinary stones. AB - With advanced techniques of scanning and transmission electron microscopy we studied the ultrastructural ecology of bacteria associated with struvite calculi on catheter surfaces, and in the bladder, ureter and renal pelvis. These detailed morphological data indicate that the interstices, core and external surface of such struvite aggregates contain large numbers of bacterial cells that grow as microcolonies and thick biofilms within extensive fibrous organic matrices. These bacterial cells and their secreted products (glycocalyx or biofilm matrix) appear to provide initial foci for crystal development and aggregation of crystals to form macroscopic struvite stones. The protective glycocalyx-enclosed microcolonial mode of bacterial growth also may explain the relative resistance to antibiotics observed in bacteria associated with infection stones. PMID- 3981714 TI - Pubectomy in urological surgery. AB - Pubectomy has been useful, particularly for the treatment of traumatic disruption of the deep urethra after a preliminary cystostomy. This procedure provides unparalleled exposure for mobilization of the apex of the prostate and distal urethral segment, and the accomplishment of an end-to-end anastomosis. Results have been good. Pubectomy has been helpful in selected cases of chronic osteitis pubis. Experience with the technique was helpful during radical pubectomy in 2 patients with chondrosarcoma of the pubis. PMID- 3981715 TI - Correlation between the findings of a clinical neurological examination and the urodynamic dysfunction in children with myelodysplasia. AB - Clinical neurological findings in 47 children with lumbosacral myelodysplasia did not correlate well with the existing dysfunction of the lower urinary tract as diagnosed by urodynamic studies. The level of intact skin sensation, and the presence or absence of bulbocavernosus and anal reflexes could not significantly predict the function of the detrusor muscle, proximal urethra and striated urethral sphincter. Therefore, one should not rely on a clinical neurological examination to outline the urological management in such patients. PMID- 3981716 TI - Intra-adrenal hepatic heterotopia. AB - The second case of intra-adrenal hepatic heterotopia is described in a normally structured male fetus stillborn at 26 weeks of gestation. The liver nodule, incidentally found in a random histological section of the right adrenal, was not encapsulated and blended with the adjacent fetal cortex. It consisted of cords of immature hepatocytes with abundant sinusoids and widespread hemopoiesis. Abnormalities included absence of a hexagonal pattern, incomplete portal tracts with dilated veins only, lack of bile ducts and canaliculi, and apparent failure of bile formation and glycogen deposition. PMID- 3981717 TI - Angiomyelolipoma associated with bilateral adrenocortical hyperplasia and hypertension. AB - We report a case of adrenal myelolipoma associated with adrenocortical hyperplasia and hypertension. Although several endocrine derangements have been described in association with myelolipomas, we have found no reports of its association with adrenocortical hyperplasia. PMID- 3981719 TI - Echinococcal disease of the kidney presenting as a renal filling defect. AB - We report a unique case of renal echinococcal disease. The patient presented with only a left renal pelvic filling defect without hepatic, pulmonary or other renal involvement. Management consisted of successful exploration and removal of the hydatid mass without sacrifice of renal tissue. The pathogenesis, diagnosis and treatment of echinococcal disease are reviewed. PMID- 3981718 TI - Xanthine-containing calculi during allopurinol therapy. AB - We report a case of urate overproduction owing to the Lesch-Nyhan syndrome (deficiency of hypoxanthine-guanine phosphoribosyltransferase). Urate crystalluria was controlled by allopurinol therapy but renal calculi developed, which contained a variety of purines, particularly the relatively insoluble xanthine, as well as oxypurinol and hypoxanthine. The potential hazard from the increased amounts of xanthine that are produced during allopurinol therapy for urate overproduction is stressed, as well as the importance of maintaining a high urine flow rate even during such therapy. PMID- 3981720 TI - Renal artery embolization to control urinary cutaneous fistula after partial resection of a horseshoe kidney. AB - We describe a patient with a chronic urinary cutaneous fistula following partial nephrectomy of a previously separated horseshoe kidney, who was treated successfully by stainless steel coil embolization of the renal artery. Thus, a major reoperation was avoided. PMID- 3981721 TI - Percutaneous ureterolithotomy. AB - We describe a case of direct percutaneous ureterolithotomy in which the combination of antegrade control, a ureteral stent and precise fluoroscopic imaging resulted in a successful outcome. This technique may be helpful when other more traditional methods for percutaneous ureteral stone removal fail. PMID- 3981722 TI - Human dirofilariasis of the bladder. AB - We report the first case of dirofilariasis of the human bladder. This organism is endemic in the southern and southeastern United States, and is responsible for the common dog heartworm disease. Since man is an unnatural host for this parasite this disease in humans still is uncommon, although it has been reported with increasing frequency in the last 3 decades. Transurethral resection was adequate for complete control in this patient and followup has revealed no evidence of recurrence. PMID- 3981723 TI - Bilateral synchronous germ cell tumors. AB - We present cases 38 and 39 of primary bilateral synchronous germ cell tumors of the testes and review the literature. Seminoma (42 of 68 cases) is the most common cell type reported, and bilateral seminoma is the most common cell type combination (19 of 34 cases). The incidence of cryptorchidism is not increased in patients with bilateral synchronous germ cell tumors. A tendency towards occurrence in older patients is noted. The stage of disease at presentation appears to be no worse than that for unilateral disease. PMID- 3981724 TI - Torsion of spermatocele: a newly described entity with 2 case reports. AB - We describe, to our knowledge, the first 2 cases of torsion of a spermatocele. This condition should be considered in the differential diagnosis of an acute scrotum in the adult. PMID- 3981725 TI - Re: Acute urinary retention in female patients: diagnosis and treatment. PMID- 3981726 TI - Re: Multiple fractures of the silver wire strands as a complication of the silicone-silver wire prosthesis. PMID- 3981727 TI - Re: Evaluation of the first 70 patients in the Center for Male Sexual Dysfunction of Beth Israel Medical Center. PMID- 3981728 TI - Re: Role of the gubernaculum and intra-abdominal pressure in the process of testicular descent. PMID- 3981729 TI - Re: Pitfalls in using human chorionic gonadotropin stimulation test to diagnose anorchia. PMID- 3981731 TI - Re: Scrotal hypothermia and the infertile male. PMID- 3981730 TI - Re: Morbidity of radical perineal prostatectomy following transurethral resection of the prostate. PMID- 3981732 TI - Re: In vitro characterization of Mat LyLu: a Dunning rat prostate adenocarcinoma tumor subline. PMID- 3981733 TI - The gubernaculum during testicular descent in the pig fetus. AB - The role of the gubernaculum during testicular descent was investigated in a study of 119 male pig fetuses obtained at gestational ages ranging from 53 to 116 days. Histologically the gubernaculum was shown to consist of primitive mesenchymal cells with an abundant intercellular material containing glycosaminoglycans (mucopolysaccharides). Rapid descent of the testis through the inguinal canal occurred between 77 and 88 days' gestation, while sustained but slower descent occurred up to 109 days. There was a dramatic increase in the total wet mass of the gubernaculum at the commencement of rapid testicular descent from 77 to 81 days, and a further increase in wet mass during sustained descent from 91 to 95 days. In the period just prior to rapid testicular descent (day 74-81) the percentage increase in the water content of the gubernaculum was larger than the percentage increase in the dry mass. After descent of the testis (day 95-109) there was a decrease in the water content, but also an increase in the dry mass of the gubernaculum. No comparable increase in the water content of umbilical cord or striated muscle tissue occurred during the period of testicular descent. Thus, the marked swelling of the gubernaculum, which dilates the inguinal canal and scrotum and may possibly exert traction on the testis by the force of its expansion, is due largely to an accumulation of water by the gubernaculum. This process may be mediated by the intercellular glycosaminoglycans, since these poly-anionic macromolecules are known to have a large hydrodynamic volume and can act as a "water trap." PMID- 3981734 TI - The effect of capsaicin pretreatment on the cystometrograms of urethane anesthetized rats. AB - Administration of capsaicin to newborn rats produced a slight but significant increase in bladder weight and markedly altered the cystometrograms of urethane anesthetized rats. In particular capsaicin pretreatment significantly increase micturition threshold. In many of these preparations the bladders exhibited a hypertonic response to saline filling; the flat phase of the cystometrogram was not observed. Capsaicin pretreatment of adult animals increased micturition threshold up to 1 month from capsaicin administration. In these preparations a flat volume-pressure relationship preceded micturition contractions. Administration of capsaicin to both newborn and adult animals did not alter the amplitude of micturition contractions. Intravesical installation of capsaicin had an acute excitatory effect on the responsiveness of the urinary bladder to reflex activation. These findings indicate that capsaicin pretreatment produces a functional impairment of the sensory branch of micturition reflexes and suggest that a capsaicin-sensitive mechanism(s) is involved in the regulation of micturition threshold. PMID- 3981735 TI - Hydrodynamics of the normal multicalyceal pyeloureter in pigs: the pelvic pressure response to increasing flow rates, its normal ranges and intraindividual variations. AB - In 39 normal pig pyeloureters, pelvic pressure was measured at the following perfusion rates: 0, 2, 4, 6, 8, 10 and 20 ml./min. The mean pelvic pressure increased from 7.09 to 21.53 cm. H2O. This increase showed 4 different phases. The first was a low pressure phase between 0 to 2 ml./min. where transport took place by peristalsis. The second was a high pressure phase between 2 and 4 ml./min. where the peristalsis opposed the passive interperistaltic filling of ureter. In the third phase, between 4 and 6 ml./min., a decreasing pressure increment was seen, probably caused by leakage through the contraction ring. In the fourth phase, between 6 and 20 ml./min., the pressure was proportional to the flow rate and ureter functioned hydrodynamically as a tube. The measurements were performed bilaterally in 19 animals. Fourteen animals showed a difference either in baseline pressure or in mean perfusion pressure between the 2 sides; in effect, no coherence in pressure exists between the pyeloureters in the individual pig. Ninety-five per cent confidence limits of the pelvic pressure were calculated at the different flow rates. The limits of the baseline pressure were 1.43 and 12.75 cm. H2O, respectively. During perfusion the upper limit of normal pressures increased markedly in the flow range 0 to 4 ml./min. being 25.46 cm. H2O at 4 ml./min. A further increase in flow rate caused only a modest increase in the upper limit. It is concluded that a comprehensive study of the pressure flow relationship provides new information concerning fluid transport in the upper urinary tract. PMID- 3981736 TI - Autoradiographic localization of estrogen and androgen target cells in human and rat prostate carcinoma. AB - The distribution of estrogen target cells within the Dunning R3327-H rat prostate tumor following intravenous injection of tritiated estradiol into rat hosts was compared to the distribution obtained following incubation of a 2 mm. sample of the tumor with tritiated estradiol in organ culture. No difference was observed, indicating that the in vitro method was an effective approach for autoradiographic analysis of tumor biopsy samples. Subsequently, tumor samples were excised from solid tumors of R3327-H and R3327-MAT LyLu tumors growing in Copenhagen rats. These tumor models were chosen as representatives of hormone sensitive (R3327-H) and hormone insensitive (R3327-MAT LyLu) tumors. Normal rat dorsal prostate and human tumor biopsy samples were also studied. Autoradiographic studies were performed in vitro utilizing tritiated estradiol and tritiated dihydrotestosterone to compare the distribution of estrogen and androgen target cells. The present research demonstrated that 1) similar patterns of nuclear uptake of steroids are obtained with in vivo and in vitro autoradiographic techniques, 2) estradiol receptors occur primarily in extra acinar epitheloid cells in both rat and human prostate carcinomas, 3) these epithelioid cells are not characteristic of the normal rat dorsal prostate, 4) androgen receptors occur in both acinar and stromal epithelioid cells in rat and primarily in acinar epithelial cells in human tumors and 5) in vitro autoradiographic methods can provide insight into differences in sensitivity to steroids which may be of diagnostic importance in the treatment of cancer. PMID- 3981737 TI - Hematozoa of raptors from southern New Jersey and adjacent areas. AB - Blood smears from 259 birds of 12 species, representing four families of raptors, from New Jersey, Pennsylvania, Delaware, and Virginia were examined for blood parasites. Infected birds constituted 59.1% of the total. Birds were infected with one or more of the following genera of protozoa: Leucocytozoon (43.2%); Haemoproteus (21.6%); Plasmodium (1.2%); and Trypanosoma (1.2%). Blood culture of 142 raptors of 11 species for Trypanosoma revealed a prevalence of 41.5%. Plasmodium circumflexum is reported for the first time in Accipiter striatus, and Trypanosoma sp. in Buteo jamaicensis. PMID- 3981738 TI - Asexual multiplication of tetrathyridia of Mesocestoides corti in Crotalus viridis viridis. AB - Prairie rattlesnakes, Crotalus viridis viridis Rafinesque, 1818, were infected with tetrathyridia of Mesocestoides corti Hoeppli, 1925, by means of oral intubation. Snakes were maintained at constant temperatures of either 25, 30, or 35 C for 4-24 wk. Postmortem examinations revealed the first experimental evidence of asexual multiplication of tetrathyridia in a laboratory-infected ectothermic host. Time and temperature were statistically significant with P values of less than 0.05. PMID- 3981739 TI - Fungal infections of ventriculi in captive birds. AB - Ventricular candidiasis was the apparent cause of death in 14 of 21 captive birds, and incriminated in six others. No clinical signs were recognized in 14 of the 21 birds prior to death, and in four of the 21, no other gross or microscopic lesions were documented. Microscopic lesions included colonization of the koilin layer of the ventriculi by fungi with occasional penetration into the glandular epithelium. No conclusive pattern of infection by family of birds was detected. PMID- 3981740 TI - Hematology and serum chemistry of bobcats in northcentral Minnesota. AB - Hematology and serum chemistry values were determined for 27 (18 male, 9 female) wild-caught bobcats (Felis rufus Schreber) greater than or equal to 1.0 yr old from northcentral Minnesota. Most blood parameters were similar to normal values for both captive bobcats and domestic cats. Deviations from these normals were likely the result of capture stress, nutritional status, and/or reproductive condition. PMID- 3981741 TI - Enzyme activities in plasma, kidney, liver, and muscle of five avian species. AB - Activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH) were determined in plasma, kidney, liver, and muscle from five species of captive birds. Few differences occurred in plasma activities between sexes but considerable differences occurred between species. All five enzymes were detected in each of the tissues sampled. Relative enzyme activities in liver, kidney, and muscle were similar for each species. CPK activity was much higher in muscle than in liver or kidney and, of the five enzymes studied, may be the best indicator of muscle damage. Most of the other enzymes were more evenly distributed among the three tissues, and no organ-specific enzyme could be identified for liver or kidney. Because of interspecific variations in plasma enzyme activities, it is important to establish baseline values for each species to ensure accurate interpretation of results. PMID- 3981742 TI - Cortisol and aldosterone comparisons of cottontail rabbits collected by shooting, trapping, and falconry. AB - Cortisol and aldosterone levels were measured in plasma of eastern cottontail rabbits (Sylvilagus floridanus) collected by three different methods, i.e., shooting, live-trapping and falconry. Cortisol levels ranged from near 0 to 27.5 micrograms/100 ml and aldosterone from near 0 to 220 ng/100 ml. Shot animals had significantly lower cortisol concentrations than those taken by either of the other methods. Trapped cottontails also had significantly lower aldosterone levels. PMID- 3981743 TI - Immobilization of polar bears (Ursus maritimus Phipps) with a mixture of tiletamine hydrochloride and zolazepam hydrochloride. AB - A 1:1 mixture of tiletamine hydrochloride and zolazepam hydrochloride was tested on 39 polar bears in and near Churchill, Manitoba, Canada during October 1983. The mean dose for satisfactory immobilization with a single injection was 5.1 mg/kg. Bears showed signs of ataxia from 1-3 min following injection and were usually sitting within 4 min. The mean induction time, taken as the adoption of sternal recumbency, was 5.1 min. Maximum relaxation was usually seen by about 20 min post-injection. The duration of immobilization appeared to be related to the dose of drug received. In bears that received a dose near the mean, recumbency lasted about 2 hr. Cubs of the year recovered more quickly than adults. Preliminary results indicated that the bears did not suffer respiratory depression and were able to thermoregulate while immobilized. Bears could be handled safely while under the effects of the drug and workers could readily evaluate the state of their sedation by their reactions. The drug did not appear to provide good analgesia at the doses tested. PMID- 3981744 TI - Carfentanil and xylazine for immobilization of moose (Alces alces) on Isle Royale. AB - Twenty-one moose were captured on Isle Royale between 28 May and 2 June 1984 at licks on the western end of the island. The animals were darted, at ranges of 10 to 35 m, with 3-cc dart syringes containing 3 or 4 mg of carfentanil and 100 or 175 mg of xylazine. Three animals were drugged with carfentanil alone. Immobilization time ranged from 2.5 to 6 min. There was no excitement phase evident in 18 of the animals and they rarely moved more than 30 m after darting. Reversal was begun at 30 to 90 min after darting using naloxone and diprenorphine given intramuscularly (i.m.) and intravenously (i.v.). Recovery time varied from 10 min to 3 hr with the longer times occurring at the higher doses of immobilizing drugs. Two animals died within 30 hr, one as the result of aspiration of rumen contents and the other was unable to get on its feet and was euthanized. Analysis of blood samples from the 18 moose immobilized with the drug combination yielded hemoglobin values of 13.1 +/- 0.3 g/dl, hematocrit: 37.6 +/- 0.7%, red blood cells: 5.46 +/- 0.1 million/microliter, leucocytes: 6.1 +/- 0.4 thousand/microliter, and serum urea nitrogen: 29.3 +/- 1.6 mg/dl. Our experience indicated that quiet, undisturbed moose can be immobilized with 3 mg carfentanil and 100 mg or less of xylazine. PMID- 3981745 TI - Isolation of avian paramyxoviruses (Yucaipa-like) from wild birds in Kenya, 1980 1982. PMID- 3981746 TI - Two cases of tuberculosis in raptors in Colorado. PMID- 3981747 TI - Evaluation of serologic tests for Mycoplasma gallisepticum in wild turkeys. PMID- 3981748 TI - Infection of Exophiala salmonis in Atlantic salmon (Salmo salar L.). PMID- 3981749 TI - Prevalence of Oslerus osleri (Cobbold, 1879) in coyotes (Canis latrans Say) from Connecticut. PMID- 3981750 TI - Tricholipeurus balanicus balanicus (Werneck, 1938) (Mallophaga, Trichodectidae) on blackbuck antelope (Antilope cervicapra L.) in Texas. PMID- 3981751 TI - Ectoparasites of vertebrates cohabiting black-tailed prairie dog towns in eastern New Mexico. PMID- 3981752 TI - Hematozoa from montane forest birds in Papua New Guinea. AB - Blood smears were examined from 141 montane forest birds of 45 species in southeastern Papua New Guinea. Haemoproteus spp. occurred in 46 (32.6%), Leucocytozoon fringillinarum Woodcock, 1910 in five, Trypanosoma sp. in one and Haemogregarina sp. in one. Intensity of infection by Haemoproteus was highest in those avian species and families with the highest prevalence; increasing altitude had no demonstrable effect on the prevalence of Haemoproteus spp. PMID- 3981753 TI - A seminoma and a leiomyosarcoma in an albino African lungfish (Protopterus dolloi). PMID- 3981754 TI - Lipoma in channel catfish (Ictalurus punctatus Rafinesque). PMID- 3981756 TI - Computer technology suggests new mode of anesthesia delivery. PMID- 3981755 TI - Secondary poisoning of Franklin's gulls in Texas by monocrotophos. PMID- 3981757 TI - Some sobering facts about laughing gas. PMID- 3981758 TI - Investigators eye ways to preserve vision. PMID- 3981759 TI - Leads from the MMWR. Measles--Puerto Rico. PMID- 3981760 TI - Leads from the MMWR. Contact spread of vaccinia from a National Guard vaccinee- Wisconsin. PMID- 3981761 TI - Psychosocial care team for patients with AIDS in a municipal hospital. PMID- 3981762 TI - Fulminant delta hepatitis in chronic asymptomatic HBsAg carriers. PMID- 3981763 TI - Squamous cell carcinoma of the epiglottis in a homosexual man at risk for AIDS. PMID- 3981764 TI - Cardiac arrest due to anesthesia. A study of incidence and causes. AB - Cardiac arrests due solely to anesthesia were studied in a large university hospital over a 15-year period. There were 27 cardiac arrests among 163,240 anesthetics given, for a 15-year incidence of 1.7 per 10,000 anesthetics. Fourteen of these patients (0.9 per 10,000) subsequently died. Detailed examination of the data from these 27 patients revealed that the pediatric age group had a threefold higher risk than adults, and that the risk for emergency patients was six times that for elective patients. Failure to provide adequate ventilation caused almost half of the anesthetic cardiac arrests, and one third resulted from absolute overdose of an inhalation agent. Hemodynamic instability in very ill patients was an association in 22%. Specific errors in anesthetic management could be identified in 75%. Progressive bradycardia preceding the arrest was observed in all but one case. PMID- 3981765 TI - Impact of computed tomography on subdural hematoma. A population study. AB - The Mayo Clinic (Rochester, Minn) medical record linkage and indexing system was used to examine the impact of computed tomography (CT) on the diagnostic investigation, management, and outcome of all cases of subdural hematoma (SDH) that occurred in Olmsted County, Minnesota, from 1965 through 1980. Comparisons were made between an eight-year period prior to the introduction of CT (1965 through 1972) and a similar period after CT became available in this community (1973 through 1980). The advent of CT did not change the treatment, course of the disease, or prognosis of SDH. However, the introduction of CT had a marked effect on the pattern of neurological investigations carried out. This resulted in a 15% reduction in the cost of diagnosing SDH in this community, while the overall cost of health care in the United States rose by 87% during the same period. PMID- 3981766 TI - A case-control study of caffeine and methylxanthines in benign breast disease. AB - A dietary case-control study of 854 histologically diagnosed cases of benign breast disease (BBD), 755 matched surgical controls, and 723 matched neighborhood controls was conducted in Israel between 1977 and 1980. No association between coffee consumption and BBD was found. Analyses by histological type, degree of ductal atypia, age, sex, and ethnic origin, controlling for several confounding factors, confirmed the lack of association. The estimated mean intake of methylxanthines was also similar for cases and controls (302, 312, and 313 mg for cases, surgical controls, and neighborhood controls, respectively). No evidence of a dose-response was noted. Our results suggest that there is no association between coffee or methylxanthine consumption and BBD, although we had a 70% chance of finding a risk ratio of 1.5 with an error of 5%. PMID- 3981767 TI - The epidemiology of disease expenses. The costs of caring for children with cancer. AB - We determined medical costs and family out-of-pocket expenses over time for 569 children with malignant neoplasms. All medical charges (inpatient and outpatient), family out-of-pocket expenses, and wages lost were collected and annualized. The mean cost of cancer care and treatment per patient-year was $29,708, with variation by diagnosis, prognosis, and year since diagnosis. The mean annual hospital inpatient cost was $15,455; mean ambulatory care cost, $3,806; and family out-of-pocket disease-related expenses, $9,787. Family out-of pocket expenses added about 50% to the total cost of disease-related care and consumed 38% of gross annual family income; wages lost accounted for nearly half. About 95% of all medical costs was paid by private, public, or charitable payers. Out-of-pocket medical expenses for which the family was responsible were about $1,000 each year. However, all nonmedical, disease-related expenses were borne by the family. PMID- 3981768 TI - A crisis in medical education. Thoughts on listening to a conference on medical education for the 21st century. PMID- 3981769 TI - Prehospital cardiopulmonary resuscitation. Is it effective? PMID- 3981770 TI - Reversible adrenal insufficiency induced by ketoconazole. PMID- 3981771 TI - Helicopter, other "air ambulances": time to assess effectiveness? PMID- 3981772 TI - In emergencies, second opinions are not mandatory. PMID- 3981773 TI - Phenylpropanolamine and blood pressure. PMID- 3981774 TI - The placebo effect. PMID- 3981775 TI - Precursors to malignant melanoma. PMID- 3981776 TI - SIDS: is it increasing? PMID- 3981777 TI - Hold the sushi. PMID- 3981778 TI - Identification of xanthochromia. PMID- 3981779 TI - The avoidance of cervical intraepithelial neoplasia. PMID- 3981781 TI - Motor vehicle childhood injuries caused by noncrash falls and ejections. AB - In a sample of children aged 0 through 14 years who were treated for injuries incurred in a motor vehicle accident, a large proportion of those involved in noncrash events fell or were ejected from the vehicle. This study was designed to describe the patterns of passenger travel, precipitating causes, and severity of injury in noncrash falls or ejections. The data were obtained from a larger ongoing hospital-based monitoring system. The Abbreviated Injury Scale was used to grade injuries. Over 50% of those ejected sustained serious injuries compared with 5% of those who remained in the vehicle. Two high-risk patterns emerged: (1) the young child traveling in a passenger seat falling out of the vehicle, and (2) the older child riding on the exterior of the vehicle and falling off during a vehicle maneuver. Door locks, restraint use, and prohibition of travel in nonpassenger locations would prevent these serious noncrash injuries. PMID- 3981780 TI - The effects of electroconvulsive therapy on serial electrocardiograms and serum cardiac enzyme values. A prospective study of depressed hospitalized inpatients. AB - Electroconvulsive therapy (ECT) is an effective, safe, and controversial treatment of severe depression. In order to further evaluate its safety, the effect of ECT on serial electrocardiograms and serum cardiac enzyme values was studied prospectively in 29 patients. Neither persistent electrocardiographic changes nor elevations in creatine phosphokinase or serum glutamic oxalaminase transaminase levels were observed following 85 treatments. Twenty-four percent of our patients had stable, preexisting cardiovascular disease, which included conduction system disease, recent myocardial infarction, and depressed ventricular function. Electroconvulsive therapy was well tolerated by all of these patients. The proposed mechanisms for transient or persistent electrocardiographic changes and cardiovascular complications of ECT are reviewed. PMID- 3981782 TI - Ocular findings in patients with histoplasmosis. AB - Presumed ocular histoplasmosis syndrome is a multifocal choroiditis; it is not an uncommon cause of visual loss in patients who have positive cutaneous responses to histoplasmin tests. However, Histoplasma capsulatum infection is, most often, a pulmonary disease, or a systemically disseminated disorder, without visual symptoms. For this reason, a correspondence between the nonocular and ocular aspects of this disorder has been difficult to ascertain. In a series of eight patients with histoplasmosis, we found asymptomatic ocular lesions in six. We believe that the presence of asymptomatic lesions may have prevented earlier investigators from recognizing this correlation. PMID- 3981783 TI - Staphylococcus aureus isolates from patients with nonmenstrual toxic shock syndrome. Evidence for additional toxins. AB - Although toxic shock syndrome toxin-1 (TSST-1) has been proposed as the toxin responsible for toxic shock syndrome, its role in this disease has not been proved. To study this question, we examined Staphylococcus aureus strains isolated from normally sterile sites in patients with nonmenstrual toxic shock syndrome for the presence of TSST-1 production. Only 20 (62.5%) of 32 produced TSST-1, compared with 41 (93%) of 44 vaginal isolates from patients with menstrual toxic shock syndrome. Of strains of S aureus from patients with nonmenstrual toxic shock syndrome, TSST-1-negative isolates were more likely to be associated with a fatal outcome and to not be phage group 1 than TSST-1 positive isolates. Seven of the TSST-1-negative strains were evaluated in a rabbit subcutaneous chamber model of toxic shock syndrome. Fifteen (60%) of 25 rabbits developed a toxic shock syndrome-like illness and nine died. Clinical signs and histopathologic findings in the rabbits were similar to those seen in rabbits inoculated with TSST-1-positive S aureus isolates. These results suggest that other, as yet unrecognized, toxins play a role in toxic shock syndrome, and that TSST-1 production may not be essential to the pathogenesis of toxic shock syndrome. PMID- 3981784 TI - SI units for clinical laboratory data. Council on Scientific Affairs. PMID- 3981785 TI - AMA's "Medicine Today" TV program. PMID- 3981786 TI - Dementia: its definition, differential diagnosis, and subtypes. PMID- 3981787 TI - Effects of lung volume on body surface electrocardiogram. Isointegral analysis of body surface maps in patients with chronic pulmonary emphysema. AB - To evaluate the effects of lung volume changes on the body surface electrocardiogram, we performed body surface potential mapping (87 lead points) in 20 normal subjects (group N) and in 21 patients with chronic pulmonary emphysema (group CPE). P-wave, QRS, ST-segment, ST-T and QRST iso-integral maps were constructed. Group-mean maps and the mean value of the maximum (max) and the minimum (min) on each map were compared between group N and group CPE. In group CPE, the body surface distribution of the P, QRS, ST, ST-T and QRST time integrals were all positioned downwards compared with those of group N. In addition, we also detected an increase in the max of P and decreases in the min of P; max and min of QRS; and in max of ST-T and QRST integrals. It was suggested that these changes were caused by the downward shift and clockwise rotation of the heart, and also by the decreased electrical conductivity of the lungs. PMID- 3981788 TI - Vectorcardiograms in dilated cardiomyopathy and triple vessel coronary artery disease: a comparative study by ventricular gradient. AB - An analysis using vectorcardiography and left ventriculography was made on forty patients, 17 of whom had dilated cardiomyopathy (DCM), 14 with triple vessel coronary artery disease (CAD) and 9 control subjects. QRS deflection area vector (Aqrs) was directed the most posteriorly in the DCM group and the second most posteriorly in the CAD group. Ventricular gradients (G) were smaller in the DCM and CAD groups than in the control group and directed more posteriorly in the DCM group than in the CAD and control groups. G/Aqrs was the smallest in the DCM group and the second smallest in the CAD group. Aqrs-At Angle was the widest in the DCM group and the second widest in the CAD group. Left ventricular ejection fraction (EF) showed high correlations with the azimuth of Aqrs (r = 0.659), with the magnitude of G (r = 0.720), with G/Aqrs (r = 0.785) and with Aqrs-At Angle (r = -0.855). From this evidence, we conclude that the magnitude of G, G/Aqrs and Aqrs-At Angle have a definable relationship with the impairment of left ventricular function and the Aqrs-At Angle is an especially useful parameter to detect the grade of myocardial damage in both the DCM and CAD groups. PMID- 3981789 TI - Centrally inhibitory effect of adrenaline on cardiovascular and sympathetic nerve system in urethane anesthetized rat. AB - The present study was undertaken to determine the central effect of adrenaline. Adrenaline was administered to the cisterna magna in urethane anesthetized rats. Following the intracisternal injections, the blood pressure dropped and reached a plateau after 15 min, the hypotensive effect continuing for at least 30 min. The heart rate also slowed concomitantly with the depressor effect. The vehicle treated rats did not show any cardiovascular responses. The cardiovascular responses in the experimental rats were accompanied by an inhibition of the sympathetic nerve activity. Pressor responses to electrical stimulation of the posterior hypothalamus were partly inhibited, while pressor responses to intravenous injections of noradrenaline remained unchanged. In DOCA hypertensive rats, the depressor responses to intracisternal injections of adrenaline were augmented. These findings suggest that adrenaline in the brain could contribute to the inhibitory mechanism of the cardiovascular system accompanied by inhibition of the sympathetic nerve system, and that this mechanism may be attenuated in DOCA hypertensive rats. PMID- 3981790 TI - Antiarrhythmic and myocardial metabolic effects of verapamil during coronary artery reperfusion. AB - The accumulation of metabolic intermediates subsequent to impaired beta-oxidation of free fatty acids has been suggested to be a cause of cellular damage and ventricular arrhythmias in the ischemic heart. The effects of verapamil on ventricular arrhythmias and free fatty acids metabolism during coronary artery reperfusion in experimental dogs were evaluated over a period of 40 minutes and followed by reperfusion for 15 minutes. One tenth mg/kg/min of verapamil was administered for 5 minutes before occlusion and followed by an infusion of 0.01 mg/kg/min to the end of the experiment. Myocardial samples were obtained from both the non-ischemic and ischemic areas after coronary artery reperfusion and then ATP, free carnitine, long chain acyl carnitine and long chain acyl CoA were measured. In the control group, 3 dogs (27%) had ventricular fibrillation and 2 dogs (18%) had ventricular tachycardia during coronary occlusion. In addition, 2 dogs (25%) developed ventricular fibrillation after reperfusion. On the other hand, all 6 dogs treated with verapamil had neither ventricular fibrillation nor tachycardia during both coronary artery occlusion and reperfusion. ATP and free carnitine levels in the ischemic area were significantly higher in the verapamil group than in the control group (ATP: p less than 0.01, free carnitine: p less than 0.05), while long chain acyl carnitine levels in the ischemic area were significantly lower in the verapamil group than in the control group (p less than 0.01). However, there was no significant change in long chain acyl CoA levels between the control and verapamil groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981791 TI - Aortic atresia with Ebstein's and Uhl's anomaly in corrected transposition of the great arteries: clinicopathologic findings. AB - The common form of aortic atresia is associated with atrioventricular and ventriculoarterial concordant connections, but it has been very rarely found in "discordant connection" in the literature. In a 6-day-old male infant, clinical and postmortem pathologic features of this rare lesion, associated with Ebstein's and Uhl's anomaly in "congenitally corrected transposition" in situs solitus, are described. A possible pathogenesis is suggested for the concomitant presence of aortic atresia and poor-functioning, morphologic right ventricle. PMID- 3981792 TI - Unique types of criss-cross heart. AB - Three cases of criss-cross heart which we have observed during last five years are described. All of these cases were diagnosed by angiocardiography and two dimensional echocardiography, and one of them was verified by autopsy. Two of them are unique among cases reported thus far. Case 1 shows ordinary criss crossing with supero-inferior ventricle, and case 2, extreme crossing atrioventricular (A-V) valves, in which the right-sided right atrium connects to the left posteriorly positioned right ventricle through the tricuspid valve, and the left-sided left atrium to the right anterior left ventricle via a posteriorly positioned mitral valve. In case 3, the criss-cross appearance is secondary to displacement of the heart by compression caused by a diaphragmatic hernia. Findings in these cases suggest that criss-cross heart is caused not only by primary rotation of the ventricles during cardiac morphogenesis but also by secondary rotation of a formed heart induced by extracardiac compression. The degree of rotation in these cases revealed a wide spectrum from minimal to extreme. In addition, subxiphoid two-dimensional contrast echocardiography is recommended as the only accurate method of non-invasive diagnosis of this condition. PMID- 3981793 TI - Usefulness of invasive and non-invasive electrophysiologic studies in the selection of antiarrhythmic drugs for the patients with paroxysmal supraventricular tachyarrhythmia. AB - A comparison of the effects of several antiarrhythmic agents was made in a study of 70 patients - 15 with manifest Wolff-Parkinson-White (WPW) syndrome, 17 with concealed WPW syndrome, 18 with AV nodal re-entrant tachycardia, 14 with paroxysmal atrial fibrillation and 6 with paroxysmal atrial flutter - employing intracardiac stimulation and esophageal pacing. For the termination of paroxysmal supraventricular tachycardia, intravenous administration of verapamil or aprindine was more effective than that of disopyramide or procainamide. In AV nodal re-entrant tachycardia, verapamil was the most effective for termination. In the manifest WPW syndrome, disopyramide or aprindine was indicated especially for patients with the accessory pathways of the short antegrade refractory period, because these drugs lengthened the refractory period of the accessory pathways. For the purpose of converting atrial fibrillation or flutter to the sinus rhythm, type IA drugs such as disopyramide were indicated. However, verapamil was effective for slowing down the ventricular rate in atrial fibrillation or flutter except in cases of manifest WPW syndrome. A 6-month follow-up study showed that oral administration of verapamil was also useful for putting a stop to the attacks in 24 out of 32 patients with paroxysmal supraventricular tachycardia, while oral disopyramide prevented the recurrence of atrial fibrillation in only 4 of 10 patients. PMID- 3981794 TI - Ventricular tachycardia associated with acute myocardial infarction--features, therapeutic effect and prognosis. AB - This study was performed to delineate the precise features and the treatment of ventricular tachycardia (VT) with acute myocardial infarction (AMI). Results indicate: 1) the incidence of VT in 310 AMI patients was 16.1% (50 patients); 2) the higher incidence of ventricular fibrillation and mortalities were observed in VT group compared with non-VT group; 3) the incidence of VT was higher in inferior infarction group (21.0%) than anterior group (13.1%); 4) more frequent VT were seen in patients with more severe heart failure; 5) two peaks of VT occurrence, on the first day and in the 4th week after the onset of AMI, were recognized especially in anterior infarction group; 6) supraventricular arrhythmias were more frequent than ventricular premature beats during one minute preceding VT; 7) the successful termination of VT was achieved in 63.9% of episodes by thump-version, 61.5% by lidocaine, 66.7% by disopyramide and 100% by mexiletine; 8) prophylactic effect on VT by class Ia antiarrhythmic agents seemed stronger than others; 9) IABP was effective to prevent VT in some cases; 10) poor prognosis was determined by frequent and later onset of VT, and combination of severe heart failure. PMID- 3981795 TI - Problems of artificial pacemaker therapy. AB - Four hundred and sixty-seven cases with implantation of an artificial pacemaker were studied. The postoperative survival rate was 63% for 15 years. Seventy-two percent of type III patients of the sick sinus syndrome were free from postoperative thromboembolism and the lowest of the three types of the sick sinus syndrome. Comparing postoperative physical activity, cardiothoracic ratio and exercise tolerance time, physiological pacing was superior to ventricular pacing in hemodynamic effects and clinical symptoms. In a hundred cases of physiological pacing, complications and problems of physiological pacing were discussed. Atrial sensing failure and over-sensing were observed in seven and two cases respectively. A low amplitude of atrial potential and use of unipolar atrial leads were considered to be the main causes of these complications. Bipolar lead should be used as the atrial lead to avoid such complications, because the atrial potential by bipolar leads is not less than that by unipolar leads. Atrial sensing may be more sensitive without electromagnetic interference. The fixed A-V delay time whenever the atrium is sensed or paced, often results in a ventricular fusion beat and hemodynamic change on every beat, according to the interval of atrial and ventricular contractions. The A-V delay time should be changed in accordance with atrial sensing or pacing. PMID- 3981796 TI - Problems and anti-tachyarrhythmic effects of chronic atrial pacing. AB - Sixty-six patients in whom atrial pacemaker (AAI) were implanted were followed for one year to 5 years for the occurrence of pacing failure, sensing problems, and later AV block. Pacing failure occurred in only one patient and sensing problems occurred in 15 patients but 10 of them improved after a change of sensing. Temporal change of AV conductivity was not recognized in the majority of patients. Eighteen patients developed transient decrease in AV conductivity. Two patients developed persistent decrease in AV conductivity and ended in clinical AV block for which the pacemaker was implanted. Out of 66 patients, 22 had a history of paroxysmal atrial flutter or fibrillation (AFF) prior to AAI implantation. They were divided into two groups. Group I consisted of 20 patients in whom paroxysmal AFF disappeared after AAI implantation. Group II consisted of 22 patients in whom paroxysmal AFF persisted after AAI implantation. Electrophysiological studies prior to the AAI implantation showed that sinus rate at control was significantly slower (36.3 +/- 10.1 beats per min in Group I, 57.1 +/- 10.8 beats per min in Group II), atrial fragmented activity zone was significantly narrower (62.7 +/- 32.9 msec in Group I, 88.1 +/- 19.7 msec in Group II), and the occurrence of PAC was less at an atrial pacing rate of 70 beats per min (8% in Group I, 67% in Group II) in Group I compared to Group II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981797 TI - [A case of stromal tumor of the testis with peculiar crystalloid structures]. AB - A case of poorly differentiated stromal tumor occurring in the left testis of a 37-year-old man is reported. Microscopically, the tumor was composed of polygonal cells arranged in a sheet-like pattern. The ill-defined cytoplasm contained disease-resistant PAS positive granules. Ultrastructurally, peculiar crystalloid structures were found in the cytoplasm of the tumor cells appearing in tubular, beaded or lamellar form and connected with the nuclear membrane as well as with the rough endoplasmic reticulum. These are somewhat similar to annulate lamellae. Interdigitation of the plasma membranes and zonula adherens was observed. Basal laminae were recognized in parts. These findings suggest that this tumor is a case of poorly differentiated gonadal stromal tumor showing a tendency to differentiate into Sertoli's cells. PMID- 3981798 TI - [A case of metastatic carcinoma of the spermatic cord due to cholangioma]. AB - Tumor in the spermatic cord is infrequent. Further, among such cases, it is extremely rare to encounter a carcinoma other than a nonepithelial malignant tumor; almost all are metastatic tumors. We recently experienced an interesting case of spermatic cord tumor in a 78-year-old male. He entered our hospital with the chief complaint of a right inguinal tumor. He underwent 2 operations to excise the tumor. The extirpated tumor mass from the right spermatic cord was composed of adenocarcinoma with abundant fibrous stroma, which is considered to be metastasis from the other viscerae. We were unable to find the primary focus in spite of extensive clinical and pathological examinations. In an autopsy about four months after the 2nd operation, the tumor was confirmed to be primary intrahepatic bile duct carcinoma, which is called cholangioma. There have been only 20 cases of metastatic spermatic cord tumor reported in Japan. However, we considered that this is the 1st case caused by cholangioma in Japan and even in other countries. PMID- 3981799 TI - [Present status and characteristics of the terminal care of dying patients in head and neck cancer]. AB - Sixty-two head and neck cancer patients who died in 1981 and 1982 were analyzed. At the terminal stage, most of the patients could see or feel their tumors by themselves. Seventy-one percent of them were laryngectomized or tracheotomized, so they could not speak, and its was frequently difficult to know what they wanted to say or ask. These 2 facts made the clinical care of these patients difficult. More than half of the families of these patients did not want them to live longer only to be tortured by their disease. PMID- 3981800 TI - [Clinicopathological study of early gastric carcinoma of the cardiac portion]. AB - Even nowadays, early gastric carcinoma of the cardiac portion still presents numerous diagnostic and pathological problems. Fifteen cases of early cancer of the cardiac portion were resected in the past 16 years. In order to clarify their characteristics, we carried out a comparison between the cardiac portion and the upper 3rd portion. The results were as follows: 1) There were cases of IIc type on the gross appearance of the cardiac portion. 2) As for the histological type, here were 14 cases of the differentiated type. on the other hand, there were 40% of the undifferentiated type of the upper 3rd portion. 3) Ten cases of early carcinoma of the cardiac portion had the lesion in the cardiac zone, while most of the early cancer of the upper 3rd portion had a strong connection with the fundic cone. PMID- 3981801 TI - [Metachronous hematogenous metastasis of gastric cancer--histopathologic characteristics of gastric cancer developing of the liver, lung or bone metastasis]. AB - Fifty-seven gastric cancer patients developing metachronous hematogenous metastasis were histopathologically analyzed. In 37 patients who developed metachronous liver metastasis as the main pattern of recurrence, papillary adenocarcinoma was the most frequent histologic type, followed by poorly differentiated adenocarcinoma of the medullary type. In 20 patients with metachronous lung or bone metastasis, poorly differentiated adenocarcinoma of the scirrhous type was the common histologic pattern. From the present data, we assume that liver metastasis of gastric cancer occurs when cancer cell clusters are transported to the liver, where they attach and proliferate, whereas single cells passed through the portal system tend to establish secondary deposits in the lung or bone. PMID- 3981802 TI - [Screening for colorectal cancer based on our experience with early colorectal cancer and adenoma]. AB - In order to establish method of screening for colorectal cancer, we studied clinicopathological features in 116 cases of adenoma, precancerous lesion, and in 80 cases of early colorectal cancer. The incidence of early cancer began to rise at the age of more than 40, reaching a peak in the sixth decade. The risk for men was higher than for women. In relation to the location of these lesions, 71% of the adenoma and 91% of the early cancer were in the left colon and rectum. As symptoms on admission, overt bleeding from the rectum appeared in 35% of the adenoma and in 56% of the early cancer patients, respectively. Therefore, we emphasize that it is extremely important to examine overt and occult bleeding as the first screening for colorectal cancer. PMID- 3981803 TI - [Tissue polypeptide antigen in gynecological cancer]. AB - Serum tissue polypeptide antigen (TPA), CEA and IAP were measured simultaneously in cervical cancer, corpus cancer and ovarian cancer. TPA levels were increased (more than 110 U/1) in 39% (32/82) of the cervical cancer and in 46% (6/12) of the corpus cancer patients, respectively. In ovarian cancer, TPA levels were elevated (146 U/1 or higher) in 64% (13/22). The positive rate of CEA was somewhat lower than that of TPA and LAP levels were as high as TPA. Moreover, TPA levels were correlated in clinical course. In immunohistochemical examination, TPA was present in cancer cells and absent in normal tissue. PMID- 3981804 TI - [Correlation between the growth of transplantable tumors under protein deprivation and intratumoral amino acid concentration]. AB - Nutritional restriction in the diet has a deleterious influence on tissue and transplantable tumor growths. Correlation between the growth of 81 B or MM 48 mammary tumors and intratumoral amino acid concentration was studied in syngeneic C3H/He mice fed a diet with a low (D) or normal (N) protein content. D-mice revealed a relatively longer lag phase than N-mice, but showed almost the same growth curve. Some kinds of amino acid, alanine, valin, glycine, and so on were recognized in D-mice tumors at higher levels more than in N-mice. In protein malnutrition, urea, the final amino acid degradation product, was not detected in the transplanted tumor or muscle of D-mice. The high tissue levels of alanine, glycine and glutamine are undoubtedly related to their participation in many metabolic reactions, so that they are readily and extensively synthesized. We speculate that D-mice would maintain an adequate intratumoral amino acid level through interorgan relationships in order for the transplanted tumor to grow. PMID- 3981805 TI - [Three cases of colonic-type adenocarcinoma in the head and neck region with positive CEA]. AB - Adenocarcinoma arising in the head and neck region is found very rarely. Recently, we have experienced 3 cases of papillary adenocarcinoma (2 of paranasal sinus and 1 of epipharyngeal origin) with a histological similarity to colon cancer. Histochemical study of CEA by the PAP method was positive in all 3 cases, and this resembled colon cancer with respect to the tumor marker. Adenocarcinoma of the colonic type in the head and neck region should be further investigated for tumor characterization including the significance of positive CEA, as this tumor might be regarded as usual adenocarcinoma so far. PMID- 3981806 TI - [Early invasive squamous cell carcinoma of the tongue--report of a case]. AB - A 65-year-old woman with early invasive squamous cell carcinoma of the tongue is reported. Atypical but not definitely malignant epithelium was detected by cytology, although the gross appearance of the glossal lesion looked like early invasive squamous cell carcinoma. On the surgical material, the basal and para basal cell layers were occupied by cancer, but the upper portion of the epidermis from the prickle cell layer through the surface of the mucosa was histologically benign. In such cases, to obtain the correct diagnosis on cytology, repeated examinations as well as using a sharp instrument like a curatte are necessary. PMID- 3981807 TI - [A case of resected renal cell carcinoma with massive pancreatic metastases]. AB - A case of resected renal cell carcinoma with massive pancreatic metastases is reported. A 72-year-old man was diagnosed as suffering from obstructive jaundice. Massive pancreatic tumor and left renal tumor were shown by several kinds of radiological examination. Total pancreatectomy and left nephrectomy were performed. Postoperatively this case was histologically diagnosed as renal cell carcinoma with massive pancreatic metastases. Very few cases of resected renal cell carcinoma with pancreatic metastasis have been reported in the world. In such cases, there is no useful treatment except for resection of both the primary and metastatic lesions. PMID- 3981808 TI - Transcatheter arterial chemo-embolization (TAC-E) for patients with locally advanced breast cancer. AB - Preoperative transcatheter arterial chemo-embolization (TAC-E) was used for 19 patients with locally advanced breast cancer, to eradicate the extensive loco regional areas prior to surgery and hopefully to reduce the postoperative recurrence rate. The results were as follows: (1) Each primary tumor showed marked regression within 2 weeks after TAC-E. (2) Surgicopathology confirmed the excellent efficacy of TAC-E against both primary tumors and metastatic lymph node tumors. (3) Side effects due to this treatment were few, compared with other forms of cancer chemotherapy. (4) The prognosis of each patient was good. We conclude that preoperative TAC-E has a great potential for the treatment of locally advanced breast cancer. PMID- 3981810 TI - Hepatectomy for metastatic liver tumor. AB - Hepatectomy for liver metastasis from the colo-rectum and other organs was performed in 77 cases at the National Cancer Center Hospital. The operative procedures included every variety of hepatectomy from extended resection as trisegmentectomy to small resection as partial resection. The operative mortality rate was 3.9% (3/77). The overall cumulative 5-year survival rate was 26.7 +/- 13.9% (survival rate +/- Greenwood's 5% standard error). The long-term survival of the patients with unilobular metastasis (H1) was better than that of bilobular (H2) and disseminated (H3 metastasis). When H1 was divided into solitary unilobular metastasis (H1 solitary) and multiple unilobular metastasis (H1 multiple), the prognosis for the former was better than for the latter after hepatectomy. The long-term survival of patients with H1 multiple was the same as that of patients with H2 and H3; that means that one of the factors affecting prognosis after hepatectomy is whether the tumor is solitary or multiple. PMID- 3981809 TI - Diagnosis of small pancreatic carcinoma. AB - A retrospective analysis was performed to evaluate the clinical symptoms and abnormal test findings in small pancreatic carcinoma. Five hundred and thirty-six cases of pancreatic carcinoma with the histology of duct cell carcinoma were collected from 14 medical centers in Japan. In 440 of the cases, tumor size was measured at the time of laparotomy or from the resected specimen. Three hundred and seventy-seven patients (86%) had a carcinoma larger than 3.0 cm; only 30% of these were resectable. Sixty-three patients (14%) had a carcinoma of 3.0 cm or less, with resectability of 97%. Detecting a tumor of "3 cm or less" with a high probability of resectability is the objective of early diagnosis with the resulting possibility of a cure. In most cases these small carcinomas were found easily when obstructive jaundice was present (73%). However, the estimated occurrence of obstructive jaundice associated with carcinomas of 3 cm or less was only 10% among the total cases of pancreatic carcinoma studied. Therefore, it is necessary for early diagnosis to detect carcinomas of 3 cm or less presenting without jaundice. The symptoms of small carcinoma without jaundice are weight loss, anorexia, upper abdominal pain, back pain and a palpable abdominal mass. Among the various available examinations, endoscopic retrograde cholangiopancreatography, computerized tomography and ultrasonography were valuable in diagnosing these small carcinomas. PMID- 3981811 TI - Villous adenoma in the large bowel following ureterosigmoidostomy: a case report and review of the pertinent literature. AB - This report presents a case of colonic adenoma which developed after ureterosigmoidostomy. A 71-year-old man was initially treated by total cystectomy and ureterosigmoidostomy for transitional cell carcinoma of the bladder in 1970. In 1983, a routine checkup revealed urinary occult blood. A barium enema x-ray showed a polypoid lesion in the sigmoid colon. Colonoscopy confirmed the presence of the polyp adjacent to the ureteral stoma. The biopsy findings were interpreted as villous adenoma with severe atypia. This tumor was removed endoscopically. This is the seventh case report of neoplasia occurring in the sigmoid colon after ureterosigmoidostomy in Japan. Review of the pertinent literature indicates that patients who have undergone this type of urinary diversion have an increased risk of development of large bowel neoplasia. Adequate and regular surveillance of these patients has been suggested in order to help in early detection. PMID- 3981812 TI - Ascites with peritoneal myeloid metaplasia in a patient with advanced non Hodgkin's lymphoma. AB - Peritoneal myeloid metaplasia associated with ascites containing numerous hemopoietic cells in a patient with non-Hodgkin's lymphoma is described. It is suggested that massive infiltration of lymphoma cells into the bone marrow caused marrow failure and compensatory mechanisms supervened leading to myeloid metaplastic implants in the peritoneum associated with ascites as well as in the liver, spleen and lymph nodes. There was also a significant leuko-erythroblastic reaction in the peripheral blood. PMID- 3981813 TI - Malignant lymphoma in the Miyazaki district: analysis of 237 biopsy cases. AB - Pretreatment biopsy specimens of 237 consecutive patients with malignant lymphoma, who presented to us from 1979 to 1982, were reviewed and reclassified. According to the new classification proposed by the Lymphoma Study Group of Japan (LSG), there were 226 patients with non-Hodgkin's lymphoma (NHL) which was further classified as diffuse lymphoma (216 cases), follicular lymphoma (4 cases), mycosis fungoides (4 cases), and others (2 cases). The 216 cases of diffuse NHL were subdivided into small cell (2 cases), medium-sized cell (71 cases), mixed (7 cases), large cell (92 cases), pleomorphic (40 cases), lymphoblastic (3 cases), and Burkitt's type (1 case) lymphoma. Cell surface marker studies using conventional methods were performed on 65 NHL patients, of whom 45 showed T-cell marker and 11 B-cell marker, and 8 had neither marker. The average survival periods were 13.1 mo for 107 patients with NHL, 27.9 mo for those with mycosis fungoides and 70.0 mo for 10 patients with Hodgkin's disease. Patients with adult T-cell leukemia survived for an average of only 5.5 mo. Histologically diffuse pleomorphic type had the worst prognosis. T-cell lymphoma appeared to have a poorer prognosis than B-cell lymphoma. PMID- 3981814 TI - Recurrence of intrathoracic esophageal cancer. AB - We have investigated the site of recurrence after resection of esophageal cancer in a total of 147 cases, which were examined and classified according to the site as follows: lymph nodes, organs, local sites, remnant of the esophagus, and peritoneum. The highest incidence of recurrence was 40% in both lymph nodes and organs. Recurrence was found frequently in the cervical and upper mediastinal lymph nodes. Careful examination should be made in the abdominal paraaortic lymph nodes. As for recurrence in organs, high rates were observed in lung, liver and bone; 70% of the recurrences in these organs were combined with simultaneous metastasis in other organs. In our examination of autopsied cases with local recurrence, the cancer was revealed as a tumor mass covering extensively each side of the posterior mediastinum. At the same time pleural dissemination was frequently observed. In the cases involving recurrence in the remnant esophagus, the disease-free interval was about 18 months--longer than the interval before recurrence in any other site. Peritoneal recurrence appeared in the patients with middle thoracic esophageal cancer. The prognosis following recurrence was extremely bad, with only a few exceptions: the survival period after recurrence was 8 months if it was in the lymph nodes, and an average of 4 months for other types of recurrence. The survival period was only 2 months after peritoneal recurrence. PMID- 3981815 TI - Phase II study of 7-N-(p-hydroxyphenyl)-mitomycin C (KW2083) in patients with advanced non-small cell carcinoma of the lung and metastatic pulmonary tumors. AB - Twenty-six patients with non-small cell carcinoma of the lung and 25 with metastatic pulmonary tumors were treated by intravenous injection of 7-N-(p hydroxyphenyl)-mitomycin C (KW2083), a derivative of mitomycin C, either at a single 70-mg/m2 dose or at a dose of 20-30 mg/m2 once a week for 3 weeks. Two patients with adenocarcinoma among 21 evaluable patients with non-small cell carcinoma of the lung, and one with embryonal cell carcinoma among 21 patients with metastatic pulmonary tumors achieved partial response lasting 5 to 7 weeks. In these three patients, KW2083 was administered by a single 70-mg/m2 dose, and no patients who received a dose of 20-30 mg/m2 weekly achieved objective response. Myelosuppression, primarily thrombocytopenia, was pronounced with either treatment regimen and it was the major dose-limiting toxicity. PMID- 3981816 TI - Time-dependent cytotoxic action of human recombinant alpha-interferon (Ro22-8181) in vitro and the sensitivity of various cultured leukemia and lymphoma cell lines to it. AB - The growth inhibitory activity of human recombinant leucocyte A interferon (Ro22 8181: alpha-interferon) against 23 human cultured cell lines derived from leukemias and lymphomas was measured quantitatively by regrowth assay. Daudi cells were the most sensitive to it. Two T-cell lines (RPMI-8402, HUT78), three B cell lines (Raji, Ly16, A3/Kawakami), one non-T, non-B acute lymphoblastic leukemia (ALL) cell line (KOPN-1) and three myelomonocytoid cell lines (U937, THP 1, ML-1) were moderately or slightly sensitive. Although the levels of sensitivity of these cell lines were different, cells could be killed by the recombinant alpha-interferon. Morphological changes in the sensitive cells treated with it were decreases in mitosis, pyknosis and fragmentation of the cells. Thirteen other cultured cell lines were not sensitive. The results indicated that the growth inhibitory activity of recombinant alpha-interferon is not always cell lineage-specific. There were only three cell lines whose sensitivity, expressed by the concentration required for 90% growth inhibition, was less than the several hundred units per milliliter that has usually been obtained as blood levels in clinical trials. These three included one of 10 T cell lines and two of seven B-cell lines; none of six non-T, non-B ALL and myelomonocytoid cell lines were that sensitive. Among virus-associated cell lines, only Epstein-Barr virus-associated B-cell lines were sensitive to the interferon; adult T-cell leukemia virus-associated T-cell lines were not sensitive. It was demonstrated that recombinant alpha-interferon has a time dependent, but not a concentration-dependent cytocidal action, indicating that optimal therapeutic schedules of recombinant alpha-interferon for cancer may be daily long-term treatment, not single or short-term large-dose therapy. PMID- 3981817 TI - Prevention of tumor metastasis after surgical removal of primary tumor by using in vitro activated macrophages. AB - In vitro activation of peritoneal macrophages by Propionibacterium acnes and its immunotherapeutic potential for inhibiting metastasis was investigated. C3H/HeN mouse adherent peritoneal exudate cells as a source of macrophages were treated in vitro with P. acnes. These P. acnes-activated macrophages were tested for tumoricidal activity in vitro and antimetastatic activity in vivo. In vitro cytotoxicity tests revealed that they had potent cytotoxicity. Surgical resection of X5563 tumors in syngeneic C3H/HeN mice 10 days after the tumor implantation failed to rescue the hosts from tumor metastasis despite successful removal of the primary tumor. When the activated macrophages were transferred intravenously into C3H/HeN mice following the surgical operation, an appreciable number of mice survived without exhibiting any sign of metastasis. Thus, these results demonstrate that macrophages can be activated in vitro by utilizing appropriate stimulating reagents, and that these activated macrophages have a potent antimetastatic effect. PMID- 3981818 TI - [Surgical management of ventricular tachycardia originating from the left ventricular apex. Report of 2 cases]. PMID- 3981819 TI - [New thermal parameters for quantitative analysis of the deep body temperature in cases of open heart surgery]. PMID- 3981820 TI - [A case of Noonan's syndrome with atrial septal defect and pulmonary valvular dysplasia]. PMID- 3981821 TI - [A case of Noonan's syndrome accompanied with thrombocytopenia necessitating platelet transfusion in intracardiac reoperation]. PMID- 3981822 TI - [Operation and postoperative observation of a case of Noonan syndrome with VSD, PS and low intelligence]. PMID- 3981823 TI - [Mitral valve replacement in infants and children]. PMID- 3981824 TI - [Clinical experience of the Kolobow membrane oxygenator with a hardshell reservoir in open heart surgery]. PMID- 3981825 TI - [New caval venous cannula designed for easy measuring of the central venous pressure during bypass]. PMID- 3981827 TI - [Successful surgical correction of endocardial cushion defect in the aged]. PMID- 3981826 TI - [Pre- and postoperative cardiac function using M-mode echocardiography in patients over 30 years of age with secundum atrial septal defect]. PMID- 3981828 TI - [Surgical treatment of left atrial myxoma: case report]. PMID- 3981829 TI - Pathogenicity of Erysipelothrix rhusiopathiae strains of serovars 1a, 3, 5, 6, 8, 11, 21, and type N isolated from slaughter pigs affected with chronic erysipelas. PMID- 3981830 TI - A method for avoiding false-positive reactions in an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of bovine paratuberculosis. PMID- 3981831 TI - Immunosuppressive proteins in the serum from the dog with squamous cell carcinoma. PMID- 3981832 TI - Urinary amyloids in bovine amyloidosis. PMID- 3981833 TI - Two cases of adiaspiromycosis in the Japanese pika (Ochotona hyperborea yesoensis Kishida). PMID- 3981834 TI - Training effect on the muscle fibre types in race horses. PMID- 3981835 TI - Histological and histochemical observations on the muscular lesions in a newborn calf with hydranencephaly. PMID- 3981836 TI - Changes in the skeletal muscles volume in horses with growth. PMID- 3981837 TI - Pseudorabies virus infection in piglets accompanying with the lesion of bilateral encephalomalacia. PMID- 3981838 TI - Induction of estrus in bitches with exogenous gonadotropins, and pregnancy rate and blood progesterone profiles. PMID- 3981839 TI - Second-degree atrioventricular block observed in a Thoroughbred foal on 2.5 months of age. PMID- 3981840 TI - Osteometrical studies on the phylogenetic relationships of Japanese native fowls. PMID- 3981841 TI - Cardiopathology of sinoatrial block in horses. PMID- 3981842 TI - Changes of body temperature related to oviposition and ovulation induced by LH in the domestic hen. PMID- 3981843 TI - The atrioventricular conducting system of the avian heart. PMID- 3981844 TI - Effect of cyclophosphamide on Tyzzer's disease of mice. PMID- 3981845 TI - Multiplication of canine parvovirus in CRFK cells. PMID- 3981846 TI - Apocrine cell carcinoma. PMID- 3981847 TI - Outpatient inguinal herniorrhaphies. PMID- 3981848 TI - Anorexia nervosa/bulimia in a male. PMID- 3981849 TI - Sleep apnea diagnosis in a sleep laboratory. PMID- 3981850 TI - The high risk cardiovascular patient. PMID- 3981851 TI - Carotid occlusion and pseudo-occlusion. PMID- 3981852 TI - Amitriptyline overdose. PMID- 3981853 TI - Pertussis outbreak in SE Kansas--1983-84. PMID- 3981854 TI - On the universality of medicine. PMID- 3981855 TI - Evaluation/treatment of acute knee injuries. PMID- 3981856 TI - Management of carotid aneurysms. PMID- 3981857 TI - [Hypotensive effect and tolerability of a short course of treatment with prazosin (pratsiol) and hydralazine (apressin) in a cooperative study of new drugs for the prevention of arterial hypertension]. AB - The hypotensive effect and tolerance of a 2-3 week course treatment with pratsiol (n = 59) and apressin (n = 60) were studied in patients with stage II essential hypertension and symptomatic arterial hypertension requiring no special therapy (diastolic arterial pressure in the horisontal position being 95 mm Hg and over). Seven patients were treated with apressin and pratsiol for 14 days under blind cross-over conditions. When used along for 2-3 weeks, apressin and pratsiol induced a hypotensive effect in 53% and 75% of the patients (p less than 0.05), respectively. When used in conjunction with hydrochlorothiazide, the hypotensive effect of apressin was 85%, that of pratsiol 93%. The daily effective dose of apressin equalled 155 +/- 9.9 mg, of pratsiol 9.3 +/- 0.6 mg. Side-effects of apressin were observed 3 times as often as with pratsiol (79% and 27%, respectively; p less than 0.01). The rate of discontinuation of apressin for side effects reached 35% of the patients, whereas in pratsiol treatment it was only 1.6%. PMID- 3981858 TI - [Experience with the use of trental in the treatment of essential hypertension]. PMID- 3981859 TI - [Treatment of arterial hypertension with calcium antagonists]. AB - The antihypertensive effect of finoptin (verapamil) and corinfar (nifedipin) and their impact on the hemodynamics and the repolarization complex of the ECG were studied in 52 patients with essential hypertension and 48 patients with secondary arterial hypertension. The calcium antagonists were found to effectively decrease the blood pressure by reducing the peripheral resistance. Verapamil may be recommended for the monotherapy of mild and moderate forms of arterial hypertension, whereas corinfar should be used in cases of marked hypertension and at the third stage of therapy. Patients with electrocardiographic signs of myocardial ischemia show the normalization of the ST segment and a decreased depression of T wave under the impact of corinfar. PMID- 3981860 TI - [Effect of anaprilin on the peripheral circulation of patients with arterial hypertension]. AB - The influence of a course therapy with anaprilin alone on the peripheral circulation in patients with essential hypertension of the early stages was investigated. Anaprilin was shown to have a significant effect on the peripheral blood circulation in the skeletal muscles expressed as veno- and artery dilatation, with the predominance of the former. PMID- 3981861 TI - [Sodium permeability of erythrocyte membranes of essential hypertension patients with and without a hereditary predisposition to the disease]. AB - Recording the maximum rate of Na/Li-antitransportation, the permeability of erythrocyte membranes was studied in patients with stage II and III essential hypertension whose parents had arterial hypertension (44 patients) or had the normal arterial pressure (20). In hypertensive patients with hereditary liability to the disease, the erythrocyte membrane permeability was higher (533 +/- 23 mumol per 1 1 of cells per hour) than in hypertensive patients without such predisposition (443 +/- 43 mumol per 1 1 of cells per hour; p less than 0.05). Arterial hypertension in patients with essential hypertension with hereditary predisposition to the disease developed five years earlier (p less than 0.05) as against hypertensive patients without aggravated heredity. The erythrocyte membrane permeability in men versus women showed no difference in both stage II and III essential hypertension. PMID- 3981862 TI - [Malignant arterial hypertension]. PMID- 3981863 TI - [Venous distensibility in essential hypertension]. AB - Using venous occlusive plethysmography, venous distensibility was examined in 85 hypertensive patients and in 21 normal men. Venous distensibility in the hypertensive versus normal subjects was significantly lower, being inversely depended on the blood pressure level. Venous distensibility depended directly on the blood flow in the forearm and inversely on the resistance of the resistive vessels at rest. This may indicate that the reduction of venous distensibility was caused by both functional and structural changes characteristic of both resistive and capacitance vessels. It appears that functional and structural alterations in the system of low pressure, along with an elevated resistance of the arterioles, were actively involved in changes of the peripheral resistance and the development of a hypertensive state. PMID- 3981865 TI - [Isolation and characteristics of calmodulin from the brains of rats with spontaneous genetic hypertension]. AB - Using column chromatography with phenylcepharase, calmodulin was isolated from the brain of rats with spontaneous hypertension (SHR) and control normotensive rats (NKWR). As judged from the findings of electrophoresis in polyacrylamide gel, UV-spectroscopy and spectrofluometry, the obtained samples of calmodulin contained no significant admixture of other proteins. The Ca-binding capacity of calmodulin of the brain of SHR and NKWR estimated by the method of fluorescent probes were identical. There were also no differences in their capacity to interact with troponine I and to activate the Ca-pump of the erythrocytic membrane and phosphodiesterase of the cardiac muscle. A study on the dependence of activity of phosphodiesterase on the protein content of the brain homogenate from SHR and NKWR revealed no differences in the calmodulin levels in this tissue. On the basis of these data a conclusion was made that impairments of the intracellular distribution of calcium in primary hypertension described earlier are not related to disorders in the metabolism of the universal Ca-binding protein-regulator. PMID- 3981864 TI - [Study of sodium metabolism in the bodies of patients with essential hypertension by the profile scanning technic using 22Na]. AB - Profile scanning with sodium-22 nuclide was performed in 37 patients with essential hypertension to determine the time-course of the isotope distribution in different parts of the body and the rate of its elimination. The rate of sodium-22 infiltration into the tissues of the pelvis and lower extremities was higher in women than in men, and that of elimination lower than in men with a stable course of arterial hypertension. This index showed no correlation with changes of the central hemodynamics and glomerular filtration. The labile and stable courses of arterial hypertension were characterized by different rates of sodium-22 uptake by the renal tissue. PMID- 3981867 TI - [Recognition of early changes in the heart in arterial hypertension by 1- and 2 dimensional echocardiographic technics]. PMID- 3981866 TI - [Baroreceptor reflexes after exposure to the hypotensive action of prazosin blocking postsynaptic alpha 1-adrenergic receptors]. AB - The effect of prazosin, a selective blocker of post-synaptic alpha 1-adrenergic receptors, on baroceptor regulation was studied in experiments on narcotized rabbits. Following the intravenous administration of prazosin (5, 10 and 50 micrograms/kg) the blood pressure decreased, depending on the drug dosage. Transmission of the vasomotor activity to the vascular musculature was disrupted only partially. The pressor and depressor responses to changes in the output value of the baroreflex remained intact. The reaction of cardiac rhythm slowing in response to an increased pressure in the aorta disappeared. The sensitivity of the baroceptors was considerably elevated. In addition to the effector structures, prazosin influenced many other components of the system of the blood circulation reflex regulation. PMID- 3981868 TI - [Results of prolonged use of minoxidil in patients with stable and malignant arterial hypertension]. PMID- 3981869 TI - About Kidney International. PMID- 3981871 TI - Morphometry of superficial glomeruli in acute hypertension in the rat. AB - Pressor doses of angiotensin II (AII) were infused intravenously in Munich-Wistar rats to study the effects of acute hypertension on the structural components of the superficial renal corpuscles and urinary protein excretion. All administration raises arterial blood pressure by 38% and increases 13-fold the normal rate of urinary excretion of proteins that contain albumin and IgG. Morphometric analysis of the quantitative characteristics of the glomerular capillaries reveals a 24% increase in the mean cross-sectional area of the capillary profiles and a 33% expansion of the capillary luminal volume. The amount of extracellular material present in the mesangium is also increased by 76%. The surface area of basement membrane available for ultrafiltration remains constant. However, the length density and the total length of the filtration slit diaphragms are reduced by 35 and 24%, respectively. Thus, the major findings of this investigation are as follows: The presence of IgG in the urine suggests a size defect in the glomerular filter with AII-induced hypertension; the dilatation of capillary loops may result in mechanical stretching of the basement membrane, altering the size-selective properties of the glomerular filter in acute hypertension; and the reduced pore area of the filtration slit diaphragms implies a lower hydraulic conductivity of the glomerular filter that may be responsible for the decreased glomerular capillary ultrafiltration coefficient present in this model of hypertension. PMID- 3981870 TI - Influence of systemically applied angiotensin II on the microcirculation of glomerular capillaries in the rat. AB - The effect of intravenous infusion of angiotensin II on microvascular parameters of the renal microcirculation of rats was studied. With the aid of fluorescence microscopy and a high sensitivity video system we observed the passage of fluorescence-labeled erythrocytes through single glomerular capillaries on the surface of the rat kidney. From videotaped recordings, we measured the velocity and the flux of erythrocytes using a modified dual-slit technique with support of a microprocessor system. Angiotensin II was administered intravenously at a rate of either 0.2 or 0.4 microgram/min/kg of body wt. Angiotensin II decreased renal blood flow in a dose-dependent fashion (a 32% decrease with 0.2 microgram/min/kg and a 42% decrease with 0.4 microgram/min/kg). The higher rate of angiotensin II infusion had a variable effect on red cell velocity in glomerular capillaries with an overall effect to decrease velocity by 18%. Red cell flux in capillaries was similarly decreased by 25% with angiotensin II infusion. Three successive infusions of angiotensin II did not significantly diminish the effect of the peptide on red cell velocity or flux. Volume flow through the glomerular capillaries (calculated from erythrocyte velocity and vessel diameter) decreased during angiotensin II infusion (0.4 microgram/min/kg) from 3.2 to 2.4 nl/min despite no change in capillary diameter or hematocrit (ratio of erythrocyte flux to volume flow). These data indicate that alterations of the ultrafiltration coefficient (Kf) are not induced by uniform capillary vasoconstriction mechanisms, as others have suggested. PMID- 3981872 TI - Basolateral endocytosis of protein in isolated perfused proximal tubules. AB - Luminal uptake and degradation of protein in proximal tubules is well documented. However, abluminal uptake has only been demonstrated in a few species and probably only amounts to a few percent of luminal absorption. To investigate this absorptive pathway, isolated perfused proximal tubules from rabbit kidney were exposed to either cationized ferritin or horseradish peroxidase in the bath for 30 min. The tubules were then fixed and processed for electron microscopy. Peroxidase and small amounts of ferritin were found in the intercellular spaces, in endocytic vesicles located in the abluminal part of the cells and in multivesicular bodies. No tracer was found in the lumina or in the apical part of the cells. The tubules were ultrastructurally intact thus excluding the possibility that the proteins were absorbed via the luminal endocytic pathway or as a result of damaged cell membranes. In conclusion, this study presents evidence that ferritin and peroxidase can be absorbed via the basolateral membranes in rabbit proximal tubules. PMID- 3981873 TI - A method for estimating nitrogen intake of patients with chronic renal failure. AB - A method for monitoring dietary compliance would be useful in treating patients with chronic renal failure (CRF). Nineteen nitrogen balances were measured while patients were eating unrestricted diets containing 6.4 to 15.1 g of nitrogen per day and 14 while patients consumed a 20 to 25 g mixed-quality protein ketoacid supplemented diet containing 5.2 to 6.6 g of nitrogen per day. Urea nitrogen appearance (U) calculated as the sum of urinary urea nitrogen plus the variation in the body urea pool (using changes in serum urea nitrogen and either the 14C urea space or 60% body weight) was correlated with nitrogen intake (r = 0.84). Both methods gave indistinguishable values for U. Total non-urea nitrogen excretion (NUN) and its components did not correlate with dietary nitrogen. NUN averaged 31.3 +/- 2.1 mg N/kg/day and was not different between the two groups or in patients in neutral compared to those in mildly negative or positive nitrogen balance. Nitrogen balance calculated using estimated U and 31 mg N/kg/day was indistinguishable statistically from measured nitrogen balance. Thus, U varies directly with dietary protein intake and can be estimated using urinary urea nitrogen, SUN, and body weight. Total nitrogen excretion can be estimated accurately as U + 31 mg N/kg/day. From the estimated total nitrogen excretion, dietary compliance of CRF patients in approximately neutral nitrogen balance could be assessed. Furthermore, if nitrogen intake were known, nitrogen balance could be estimated. PMID- 3981874 TI - An improved technique for ultrasound guided percutaneous renal biopsy. PMID- 3981875 TI - The clinical spectrum of hereditary nephritis. PMID- 3981876 TI - Abstracts: Italian Society of Nephrology. Abano Terme, Italy, May 30-June 2, 1984. PMID- 3981877 TI - [Pediatric social studies on morbidity in child day care centers]. PMID- 3981878 TI - [Performance capacity of children with growth retardation]. PMID- 3981879 TI - [Frequency of therapy resistant epilepsy]. PMID- 3981880 TI - [Determination of the time for active surgical procedures in juvenile pyopneumothorax]. PMID- 3981881 TI - [Noninvasive diagnostic procedure in neonatology]. PMID- 3981882 TI - [Status and measures for the further improvement of surgical care for the population of the Ukrainian SSR]. PMID- 3981883 TI - [Radical treatment of patients with acute inflammation of epithelial coccygeal cysts]. PMID- 3981884 TI - [Characteristics of early immunological shifts in peritonitis patients]. PMID- 3981885 TI - [ATP and 2,3-DPG concentrations in the erythrocytes of peritonitis patients]. PMID- 3981887 TI - [Discrete model of surgical interventions]. PMID- 3981886 TI - [Endovascular surgery in the clinic and in an experiment]. PMID- 3981888 TI - [Mathematical modeling of hemosorption]. PMID- 3981889 TI - [Treatment experience with complicated forms of paronychia]. PMID- 3981890 TI - [Diagnosis and treatment of paronychia]. PMID- 3981891 TI - [Combined treatment of destructive forms of lactation mastitis]. PMID- 3981893 TI - [Local use of immobilized antibiotics in suppurative and inflammatory complications following the surgical treatment of malignant neoplasms of the abdominal organs]. PMID- 3981892 TI - [Papain-furacillin dialysis and ultrasonic therapy combined with active surgical treatment of acute destructive lactation mastitis]. PMID- 3981894 TI - [Sodium mefenamine in suppuration surgery]. PMID- 3981895 TI - [Amorphous highly purified trypsin and chymotrypsin in treating suppurative processes]. PMID- 3981896 TI - [Treatment of peritonitis of appendiceal origin]. PMID- 3981897 TI - [Continuous and fractional intra-aortic infusion of drugs in the combined therapy of diffuse peritonitis]. PMID- 3981899 TI - [Hemosorption in treating the endogenous intoxication syndrome in patients with diffuse peritonitis]. PMID- 3981898 TI - [Variants of endolymphatic antibiotic therapy in the combined treatment of peritonitis]. PMID- 3981900 TI - [Biomechanics of the healing of an infected wound in an experiment]. PMID- 3981901 TI - [Complex evaluation of the effectiveness of preventing suppuration of an infected wound in an experiment]. PMID- 3981902 TI - [Morphobiochemical parallels of the dynamics of the intestinal failure syndrome in experimental peritonitis]. PMID- 3981904 TI - [Characteristics of the immune response to corpuscular antigen in hemorrhagic shock]. PMID- 3981903 TI - [Comparative evaluation of the effectiveness of carbon sorbents in experimental liver failure]. PMID- 3981905 TI - [Physician's error and an accident in medical practice]. PMID- 3981906 TI - [Laparotomy as a surgical operation and possible errors and complications]. PMID- 3981907 TI - [Anaerobic paraproctitis]. PMID- 3981908 TI - [Pyomyositis]. PMID- 3981909 TI - [Sepsis caused by Moraxella nonliquefaciens]. PMID- 3981910 TI - [Use of acupuncture reflexotherapy in the combined treatment of peritonitis]. PMID- 3981911 TI - [Trichomonal peritonitis]. PMID- 3981912 TI - [Blood plasma proteins studied by disc electrophoresis during the treatment of peritonitis]. PMID- 3981913 TI - [Method of correcting metabolic processes in the postoperative period]. PMID- 3981914 TI - [Device for extracting foreign bodies from hollow tubular organs]. PMID- 3981915 TI - [Prognosis of the course of a suppurative process and of suppurative wound healing]. PMID- 3981917 TI - [Therapeutic tactics in anorectal complications of Crohn's disease]. PMID- 3981916 TI - [Role of duodenal patency disorders in the surgery of pyloroduodenal ulcers]. PMID- 3981918 TI - [Classification, diagnosis and treatment of gastrogenic tetany]. PMID- 3981919 TI - [Prevention and treatment of ligature fistulae]. PMID- 3981920 TI - [Postoperative ventral hernias]. PMID- 3981921 TI - [Use of a hepatocyte suspension in a hemosorption system in acute hepatic failure (experimental study)]. PMID- 3981922 TI - [Gastric resection in 4 complications of duodenal ulcer in the presence of peritonitis]. PMID- 3981923 TI - [Invagination of the stomach into the esophagus in cardiospasm]. PMID- 3981924 TI - [Acute appendicitis in strangulated inguino-scrotal hernia]. PMID- 3981925 TI - [Treatment of complicated forms of peptic ulcer diseases in late middle-aged and elderly patients]. PMID- 3981926 TI - [Fat excretion after truncal and selective proximal vagotomy with pyloroplasty in ulcerative pyloroduodenal stenosis]. PMID- 3981927 TI - [Preoperative preparation and postoperative management in decompensated ulcerative pyloroduodenal stenosis in late middle-aged and elderly patients]. PMID- 3981928 TI - [Atropine test. Possibilities for a differential approach to the interpretation of long-term results of vagotomy in peptic ulcer of the duodenum]. PMID- 3981929 TI - [Selective proximal vagotomy in the surgical treatment of ulcerative stenosis]. PMID- 3981930 TI - [Immunologic reactivity in the determination of indications and timing of surgical treatment of peptic ulcer of the duodenum]. PMID- 3981931 TI - [Distensible pyloroduodenoplasty in the surgical treatment of bleeding and stenosing duodenal ulcers]. PMID- 3981933 TI - [Hernia of the esophageal hiatus of the diaphragm and chronic cholecystitis]. PMID- 3981932 TI - [Gastroduodenal hemorrhage of ulcerative etiology and its sequelae]. PMID- 3981934 TI - [External postoperative duodenal fistulae]. PMID- 3981935 TI - [Gangrenous appendicitis]. PMID- 3981936 TI - [Restoration of continuity of the large intestine after the Hartmann operation]. PMID- 3981937 TI - [Injuries of the colon and rectum]. PMID- 3981938 TI - [Repeated surgery in uncorrected Ledd's syndrome in an adult]. PMID- 3981939 TI - [Changes in the internal sphincter in anal fissures]. PMID- 3981941 TI - [Diagnosis and treatment of Meckel's diverticulum]. PMID- 3981940 TI - [Prevention and treatment of hemorrhoids in pregnant women and puerperants]. PMID- 3981942 TI - [Phlegmon of the small intestine]. PMID- 3981943 TI - [Surgical and biological aspects of allotransplantation of the small intestine (2)]. PMID- 3981944 TI - [Immunologic changes and their correction in different forms of acute cholecystitis in late middle-age and the aged]. PMID- 3981945 TI - [Basis for intensive treatment of peritonitis by regulated hemodilution with moderately controlled hypervolemia]. PMID- 3981946 TI - [Effect of surgery on a patient's phagocyte system]. PMID- 3981947 TI - [Complications of selective proximal vagotomy]. PMID- 3981948 TI - [Various complications of vagotomy]. PMID- 3981949 TI - [Surgical treatment of post-gastric resection peptic ulcers]. PMID- 3981950 TI - [Use of low molecular-weight heparin in hemodialysis patients]. AB - Low-molecular-weight (LMW) heparin has been compared to standard unfractionated (UF) heparin in a total of 49 patients on hemodialysis and hemofiltration in order to determine the necessary therapeutic dose and its effect on the coagulation system. A LMW heparin dose corresponding to 50% of the normal UF heparin dose was found to produce similar plasma heparin levels (anti-FXa-U/ml) in particular on minimal heparinization. At higher doses, UF heparin produced a more marked increase in plasma-heparin than did LMW heparin. Highly significant differences were found between UF and LMW heparin in their effects on PTT and thrombin time. Partial thromboplastin time (PTT) increased under UF heparin by an average of 120 s whereas LMW heparin only produced an increase of 5-7 s. Thrombin time was increased by 250-280 s under UF heparin and by 5-8 s under LMW heparin. With this LMW heparin dose of 50% of the UF heparin dose, no thrombosis of the extracorporal system occurred and no macroscopic detectable thrombotic material was found in the dialyzers or filters. No significant differences were observed between the effects of UF and LMW heparin on Factor VIII activity and fibrin monomers, so that a difference in coagulation activation between the two heparins can be excluded. Furthermore, there were no changes in thromboplastin time according to Quick, fibrinogen, antithrombin III, plasminogen, and a2 antiplasmin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3981951 TI - Non-Hodgkin's lymphomas presenting with gastrointestinal involvement. AB - Between 1978 and 1983 a total of 33 patients with non-Hodgkin's lymphoma (NHL) involving the gastrointestinal tract were seen in our institution. Pathological classification was performed according to Kiel. Low grade NHL was diagnosed in 17, high grade NHL in 16 patients. The most frequent histological entity was lymphoplasmocytoid immunocytoma (11 patients). The most common sites of origin were the stomach (23 patients) and the ileocecal region (6 patients). The majority of patients presented with stage I and II disease (20 of 33 patients). As a rule primary therapy consisted of surgery with curative intent. Most of the patients received additional chemotherapy or radiotherapy. Patients with limited disease and complete tumour resection showed long-term survival from 12+ to 57+ months (mean 32.9+ months). Patients with advanced disease (stage III and IV) and only palliative surgery or with lymphoblastic lymphoma had a probability of survival of less than 12 months. PMID- 3981952 TI - The efficacy of quantitative and qualitative chloride titrators in the estimation of human salt intake. AB - We evaluated the utility of chloride titrator sticks for facilitating the assessment of dietary salt intake, in a systematic series of clinical trials. These inexpensive devices were applied daily to 24-h or nocturnal urine specimens, thereby avoiding the inter- and intra-subject variability in salt excretion which confounds the use of occasional 24-h urine collections. Chloride and sodium concentrations in urine were highly correlated (r greater than 0.92) in either nocturnal, diurnal, or 24-h collections. The quantitative chloride titrator estimates and measured chloride concentrations were highly correlated as well (r greater than 0.99). The qualitative chloride titrator was graded on a simple scale, and was successfully employed by outpatients attempting to limit their salt intake. Commonly used antihypertensive medications did not interfere with the determinations. Additional chloride intake, such as supplemental potassium chloride, interfered with estimates of salt ingestion, but if the daily amount of potassium chloride supplement was constant, adjustments in interpretation could be made. Renal insufficiency introduced a systematic over estimation of salt intake by the qualitative chloride tirator, but only at high salt intakes. Relative estimates of salt intake in subjects with renal failure were still possible. We conclude that chloride titrators can facilitate the management of patients who require a prescribed salt intake. PMID- 3981953 TI - Effects of nicotine and its major metabolites on blood pressure in anaesthetized rats. AB - Blood pressure and heart rate in anaesthetized rats has been determined after i.v. injection of increasing doses of nicotine (NI) and its major metabolites, i.e. continine (CO), nornicotine (NOR), metanicotine (MN) and dihydrometanicotine (DMN). NI and MN elicited similar dose response curves, increasing blood pressure according to the dose injected. However, the dose response curve of MN was shifted to the right. Furthermore DMN caused similar pressor effects than MN and the pressor effects of NOR was even weaker. Only after injection of CO was a dose dependent depressor effect observed and this was reversed after very high doses. CO also reduced heart rate in a dose-dependent manner, whereas NI and its other metabolites did not significantly change heart rate. PMID- 3981954 TI - Acute arterial occlusions due to accidental intra-arterial injections of diazepam. PMID- 3981955 TI - The influence of acetylsalicylic acid on the transepithelial potential difference of gastric mucosa in children. AB - The gastric transepithelial potential difference seems to be a sensitive parameter of the integrity of gastric mucosa. The administration of acetylsalicylic acid in adults causes a rapid and significant decrease in gastric potential difference, whereas in children this characteristic reaction fails to occur. PMID- 3981956 TI - Low-dose dexamethasone suppression of urinary free cortisol in the differential diagnosis between Cushing's syndrome and obesity. AB - Urinary free cortisol (UFC) was measured in the basal state and on 2nd day of the low-dose dexamethasone (2 mg daily for 2 days) suppression test (LDDT) in 182 subjects. At first examination the results were in good agreement with the definite diagnosis in 21 of 27 patients with Cushing's syndrome (CS) and in 145 out of 155 obese subjects. In two obese subjects the basal UFC was increased and the response to the test insufficient. At re-examination their laboratory findings became normal. In 14 subjects the basal UFC was increased but the response to the test was normal. With nine of them, repeated examinations were performed over a period of 1-7 years. Six subjects progressed into obvious CS, while in two hypercortisolism spontaneously regressed and in one it remained unchanged. The combination of elevated basal UFC with a normal suppressibility during the LDDT is considered a borderline adrenocortical impairment. PMID- 3981957 TI - Local hirudin application--an aid in preventing occlusion of an arteriovenous fistula in dialysis patients? AB - In this pilot study we tested the effect of an ointment containing hirudin in a high concentration [20,000 ATU (anti-thrombin units)/100 g ointment] in ten patients on maintenance haemodialysis (six men, four women: mean age: 51 years; mean duration of dialysis treatment: 20.4 months). The duration of hirudin application was 4.5 months, the observation period in the total group was 43 months. During the total dialysis period of 204 months - before hirudin application - in these ten patients a shunt thrombectomy was necessary 18 times because of shunt occlusion. A shunt-thrombosis occurred in none of the ten patients during the period of application of the hirudin-containing ointment. PMID- 3981958 TI - Advances in the laboratory culture of octopuses for biomedical research. AB - Five species of Octopus were cultured in pilot, large-scale 2,600 liter circulating seawater systems. Improvements in system design, water management and culture methodology were described. These five species all produced large eggs and correspondingly large hatchlings that had no planktonic or larval stage and thus were easier to culture. Octopuses grew well only when fed live marine crustaceans, fishes and other molluscs. Growth occurred as a 4-7% increase in body weight per day during the early exponential growth phase and 2-4% during the latter 1/2 to 3/4 of the life cycle, which ranged from 6-15 months depending upon species. All species reproduced in captivity. Survival was 70-80% when octopuses were reared in individual containers, but in group culture survival dropped to as low as 40% by the adult stage. Causes of mortality were species-specific and included hatchling abnormalities, escapes, aggression, cannibalism, disease, senescence and laboratory accidents. Octopus bimaculoides showed superior qualities for laboratory culture. The future potential of providing American scientists with laboratory-cultured octopuses was discussed along with their uses in biomedical research. PMID- 3981959 TI - Dietary prevention of cataracts in the pink-eyed RCS rat. AB - The American Institute of Nutrition purified ingredient diet (AIN-76) prevented occurrence of mature cataracts associated with hereditary retinal degeneration in pink-eyed, tan-hooded Royal College of Surgeons (RCS) rats. Rats fed a natural ingredient open formula NIH diet or a closed formula commercial diet had a cataract incidence of 27-29% by 3 to 12 months of age. In contrast, only 1 of 50 rats fed the AIN diet developed a mature cataract in one year. When the NIH diet and the commercial diet were pelleted with 25% of ground sunflower kernels, rats fed these diets had a delay in onset and a reduced incidence of mature cataracts to 18% and 5%, respectively. No mature cataracts occurred in rats fed the AIN diet supplemented with 25% sunflower kernels. All diets were fed to the parental generation as well as the progeny (experimental group). The rats were reared at a low level of illumination (1-3 footcandles inside the cage) to minimize effects of light. Prevention of mature cataracts by the AIN purified diet suggests that diets permitting cataracts to occur may have a constituent at a concentration innocuous for normal rats but beyond the homeostatic control of the RCS rat. Posterior subcapsular cataracts of RCS rats are a model for cataracts associated with human hereditary retinal degenerations, such as retinitis pigmentosa and gyrate atrophy. Manipulation of dietary ingredients allowed by the use of the AIN diet may permit identification of nutrients, nutrient interactions of toxic factors involved in cataractogenesis and its prevention. PMID- 3981960 TI - Normal serum biochemical, hematological, and EKG parameters in anesthetized adult male Macaca fascicularis and Macaca arctoides. AB - Selected serum enzymes, cholesterol, triglycerides, glucose, uric acid, protein, albumin, bilirubin, BUN, hematology, and electrocardiograms (EKG) were obtained from adult male cynomolgus (Macaca fascicularis) and adult male stumptailed (Macaca arctoides) macaques. Serum alkaline phosphatase, uric acid, albumin, bilirubin, mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV) and monocytes were significantly lower in the cynomogus monkeys. This relationship was reversed for serum levels of triglycerides, phosphorus, red blood cell counts and lymphocytes. EKG analysis revealed significantly increased PR interval and QRS wave duration in the cynomolgus species. However, there were no differences in heart rate. Right axis deviation was common in both species. PMID- 3981961 TI - Serum chemistry reference values in two strains of Syrian hamsters. AB - Blood samples were collected from 30 male and female hamsters (Mesocricetus auratus) from two sources. Serum was collected and analyzed for 17 biochemical values. The results were analyzed statistically and comparisons were made between males and females and between strains. PMID- 3981962 TI - Potency of isoflurane and nitrous oxide in conventional swine. AB - The minimum alveolar concentration (MAC) of isoflurane in oxygen (O2) was determined to be 1.55 +/- 0.08 (SEM) volumes % in twelve pigs (Sus scrofa). Values for isoflurane MAC in the presence of 50% (I-50%N2O) and 66% (I-66%N2O) nitrous oxide were determined in nine and six of these same animals, respectively, and equalled 1.03 +/- 0.05 vol % for I-50%N2O and 0.95 +/- 0.07 vol % for I-66%N2O. Animals respired spontaneously and arterial blood pressure (AP), heart rate (HR), rectal body temperature, and arterial blood gases (PO2, PCO2, and pH) were recorded throughout the study period. These parameters were within normal limits near MAC for all three gas combinations. The MAC for isoflurane in swine was similar to that for other animals and, man and the use of this agent was associated with rapid and uneventful anesthetic induction and recovery. The addition of 50% and 66% nitrous oxide (N2O) reduced the isoflurane MAC by 30% and 42%, respectively. PMID- 3981963 TI - Clear cell carcinoma of the lung in a pigtailed macaque. AB - A primary tumor of the lung was observed in an adult pigtailed macaque (Macaca nemestrina). The neoplasm was diagnosed as a clear cell carcinoma, a rare variant of large cell carcinoma. An immunohistochemical test revealed the epithelial nature of this carcinoma. PMID- 3981964 TI - Use of a chemical tracer to evaluate water movement through two automatic watering rack manifolds during flushing. AB - A sodium fluorescein solution was introduced into an upfeed serpentine and a horizontal automatic watering rack manifold. Water samples were collected from nine drinking valves on each manifold prior to and after flushing at 12 pounds per square inch water pressure for 15 seconds, one minute, and five minutes. The water samples were assayed for fluorescein and it was found that the chemical was effectively removed by flushing from the upfeed serpentine manifold, while significant levels of fluorescein remained in the horizontal manifold even after five minutes flushing. PMID- 3981965 TI - Multipotent developmental capacity of cells in the adult animal. PMID- 3981966 TI - Identification and characterization of amyloid protein AA in spontaneous canine amyloidosis. AB - Amyloid fibrils were isolated from kidney tissue of a dog that presented with renal failure due to spontaneous amyloidosis. This fibril material was reduced, alkylated and chromatographed on a column of Sepharose CL6B. A major retarded fraction, when subjected to amino acid sequencing, demonstrated a blocked amino terminus. The isolated protein was then degraded with cyanogen bromide, and the resultant three peptides were isolated by high-pressure liquid chromatography. The amino acid sequence of one peptide corresponded to the sequence of human amyloid protein AA from position 17 to 23. A second peptide gave an amino acid sequence homologous to the published human protein AA sequence starting with position 24. Although a high degree of homology between canine and human AA is seen, the blocked amino terminus is similar to the AA protein of mink. These data show that spontaneous canine amyloid is analogous to human reactive (secondary) amyloid and, therefore, may aid in defining mechanisms of human amyloid pathogenesis. PMID- 3981968 TI - Positive desmosome staining in the uranaffin reaction. PMID- 3981967 TI - Enzymatic dissection of the glomerulus. AB - White rat kidneys were fixed in perfusion, postfixed with 10% glutaraldehyde, and cut into 1-mm slices. The slices were treated with a sequential digestion over 4 days with trypsin, pepsin, and pronase E. This treatment dissolved the glomerular basement membrane and the mesangial matrix. Teasing the slides in buffer released many glomeruli and tubules which were prepared for scanning electron microscopy while attached to gelatine glass cover slips. Four human renal biopsies were similarly treated. The enzymatic removal of the basement membrane permitted viewing of the basilar or capillary slide of loosened podocytes and their processes. The cell body of the podocytes often exhibited a considerable area of contact with the basement membrane. The primary and secondary podocyte processes and foot processes maintained a continuous contact with the basement membrane. Human podocytes, although larger, were similar to the rat. Podocytes from minimal change disease showed severe retraction and flattening of primary and secondary processes and foot processes. Extensive visualization of the basilar surface of the exposed endothelial tubes was possible with this technique. The fenestrated and nonfenestrated portions were revealed including the axial area where the endothelial cells contact the mesangial cells and matrix, which formed an impression on the surface of the endothelium. The mesangial cells and their connecting processes (the mesangial network) were revealed extending from the peripheral lobule to the glomerular hilus where they merged with lacis cells. The mesangial cells exhibited a variety of processes which anchored into the mesangial matrix. At the hilus, these cells assumed a flat, villous, lacy appearance, and these cells encircled the large hilar capillaries. Glomeruli with afferent and efferent arterioles and associated Goormaghtigh (lacis) cells were identified. The transition between mesangial, Goormaghtigh, and smooth muscle cells was observed. These observations provide a unique view of the organization of the rat and human glomerulus and suggest the potential for the use of the present technique in the study of diseased glomeruli. PMID- 3981969 TI - Extraction and quantification of paraquat in liver and hemolyzed blood. AB - A procedure for the extraction and quantification of paraquat from enzyme digested liver and hemolyzed blood is reported. Paraquat is extracted as an ion pair with sodium dodecyl sulphate and quantified by reverse phase ion-pair high performance liquid chromatography (HPLC) with ultraviolet (UV) detection. PMID- 3981970 TI - Methodology for the determination of dinitroaniline herbicides in tissue and excreta. AB - A method is presented for the analysis of trace amounts of dinitroaniline herbicides in tissue and excreta. The method employs extraction of the tissue or excreta with organic solvent, clean up by liquid/liquid partitioning or silica gel chromatography, and ultimate analysis by gas chromatography using electron capture detection. Recoveries of greater than 80% were noted over the range of concentration 0.1 to 1.0 microgram/g. PMID- 3981971 TI - A sensitive liquid chromatographic procedure for the analysis of camphor in equine urine and plasma. AB - A sensitive method was required to analyze low levels of camphor in equine urine and plasma. Camphorated oil (20% w/w camphor) was administered topically (6 g) and intratracheally (1 g) to standardbred mares. The drug was extracted from urine and plasma by diethyl ether and analyzed as its 2,4-dinitrophenylhydrazone derivative by reverse phase HPLC with UV detection. The UV detector was set at 368.5 nm and the samples were eluted from the C18 column by 82% acetonitrile in water. The detection limit achieved was about 10 ng/mL urine and about 20 ng/mL plasma. After topical administration, only trace amounts of camphor were found in urine, whereas in plasma detectable quantities appeared from 20 min to 12 hrs post-administration. After intratracheal administration, camphor appeared immediately in both urine and plasma and occurred in higher concentrations. The concentrations of camphor ranged from 11.4 to 21.6 ng/mL urine during 2 hrs post administration and from 46.7 to 1650 ng/mL plasma during 1 hr. All traces of camphor disappeared from urine after 4 hrs and from plasma after 12 hrs. A GC/MS analysis of hydrolyzed urine extracts indicated two metabolites of camphor: trans isoketopinic acid and an as yet uncharacterized hydroxycamphor. PMID- 3981972 TI - An automated analysis for superoxide dismutase enzyme activity. AB - The pyrogallol autoxidation assay for superoxide dismutase was adapted for analysis by centrifugal analyzer. The precision of the enzymatic assay was estimated using bovine blood superoxide dismutase. Specific activity determined for human erythrocyte superoxide dismutase by the procedure agreed with previously reported determinations. Recovery of bovine blood superoxide dismutase from hemolysates provided a measure of proportional analytic error. Difficulties inherent in attempting to spectrophotometrically assay an enzyme catalyzing a reaction requiring a free radical substrate cannot be eliminated by an automated method. However, the centrifugal analyzer method makes routine enzymatic analysis for superoxide dismutase in numerous samples technically feasible. Moreover, automated analysis can conveniently include a standard such as bovine blood superoxide dismutase when enzyme levels in tissue extracts are assayed. These advantages make the method for assay of superoxide dismutase enzyme activity a useful procedure. PMID- 3981973 TI - Propylene glycol as a cause of lactic acidosis. AB - Propylene glycol (PG) concentrations were measured in 35 sera and eight cerebrospinal fluids (CSF) from five patients receiving intravenous medications containing PG as a vehicle. Serum concentrations ranged from 6 to 711 mg/L, and CSF concentrations from 11 to 566 mg/L. The CSF concentrations were as high as 85% of the serum concentrations. In several instances, PG was also measured in urine and pleural fluid. Lactate concentrations ranged up to 24.1 mEq/L (217 mg/dL) and showed statistically significant correlation (r = 0.921) with the PG concentrations in serum (p less than 0.01). The PG:creatinine clearance ratios in two patients were 35.5% and 48.8%. Serum half-lives in two patients were 4.7 and 5.6 hrs. Propylene glycol administration may be an important cause of lactic acidosis in the hospitalized patient. PMID- 3981974 TI - A fatal case of trifluoperazine poisoning. AB - A fatal case of trifluoperazine poisoning is reported. Case history, pathological findings, and the concentrations of trifluoperazine and its metabolites in blood, liver, and kidney are presented. PMID- 3981975 TI - Bazooka: cocaine-base and manganese carbonate. PMID- 3981977 TI - Occupational medicine in Germany. PMID- 3981978 TI - The use of a microcomputer for descriptive epidemiologic research. PMID- 3981976 TI - The danger of wearing impermeable clothing while spraying. PMID- 3981979 TI - Mass media techniques to reduce smoking prevalence in staff groups. PMID- 3981980 TI - Longitudinal health risks among graduates and non-graduates of diving school. PMID- 3981981 TI - Investigation of a working population exposed to thallium. PMID- 3981982 TI - Dynamic capacitance of epicardial coronary arteries in vivo. AB - The dynamic capacitance of epicardial coronary arteries (i.d. greater than or equal to 0.4 mm) in vivo was assessed from the volume stiffness and volume of these arteries. The volume stiffness was derived from the pressure wave front velocity as determined in dogs by measuring the delay time between the pressure pulses recorded proximal and distal to a segment of the anterior descending branch of the left coronary artery. The pressure pulse was generated elsewhere in the arterial system during diastole. The volume of the epicardial coronary arteries was calculated from the lengths and diameters as measured in araldite casts, making corrections for in-vitro/in-vivo differences in dimensions. The dynamic capacitance of the right coronary artery, and the anterior descending and circumflex branches of the left coronary artery at an arterial pressure of 13.3 kPa and a frequency between 7 and 30 Hz was found to be 0.0024 +/- 0.0013, 0.0062 +/- 0.0028 and 0.0079 +/- 0.0035 mL/kPa (mean +/- SD), respectively. The total capacitance of the epicardial coronary arteries was calculated to be (0.007 mL/kPa)/100 g, which is small as compared to the total capacitance of the coronary vasculature, including the intramyocardial compartment, which is in the order of (0.5 mL/kPa)/100 g [1]. PMID- 3981983 TI - Arteriovenous difference of the blood density in the coronary circulation. AB - The mechanical oscillator technique permits determining blood density continuously with high accuracy. Using this technique arteriovenous density gradients were recorded in the coronary vascular bed of anesthetized dogs. It was found that the coronary sinus blood has a higher density than arterial blood due to the loss of filtered fluid in the microcirculation. The amount of fluid loss corresponds to the lymph flow in the myocardium. Increase of venous pressure leads to an increase of the density gradient. Intermittent coronary sinus occlusion (ICSO) surprisingly leads to a reduction of the density gradient. Injection of osmotically hypertensive fluids influences the arteriovenous gradient by shifting extravascular fluid into the blood. The method permits the determination of filtration coefficients and to estimate the tissue volume available for fluid exchange. PMID- 3981984 TI - The determinants of the pressure-flow relation in the coronary vasculature. PMID- 3981985 TI - Intramyocardial pressure and coronary extravascular resistance. AB - Intramyocardial pressure is an indicator of coronary extravascular resistance. During systole, pressure in the subendocardium exceeds left ventricular intracavitary pressure; whereas pressure in the subepicardium is lower than left ventricular intracavitary pressure. Conversely, during diastole, subepicardial pressure exceeds both subendocardial pressure and left ventricular pressure. These observations suggest that coronary flow during systole is possible only in the subepicardial layers. During diastolic, however, a greater driving pressure is available for perfusion of the subendocardial layers relative to the subepicardial layers. On this basis, measurements of intramyocardial pressure contribute to an understanding of the mechanisms of regulation of the phasic and transmural distribution of coronary blow flow. PMID- 3981986 TI - Interaction between intramyocardial pressure (IMP) and myocardial circulation. AB - In our concept of the interaction between intramyocardial pressure (IMP) and myocardial perfusion, IMP is defined as the hydrostatic pressure in the soft tissue surrounding the myocardial fibers. In a mathematical model of the mechanics of the left ventricle the latter definition results in values for IMP equal to left ventricular pressure in the inner layers of the wall, and a continuous decrease across the wall to zero in the outer layers. Modulation of coronary artery flow during the cardiac cycle is predominantly due to compression of the coronary vasculature by the IMP during the systolic phase of the cardiac cycle, resulting in back-squeezing components of this flow. In a mathematical model of the dynamics of the coronary circulation, containing a large capacitance at the level of the coronary microvasculature, the modulations of coronary artery flow were found to be similar to those found in animal experiments in open-chest dogs. PMID- 3981987 TI - An application of optimization methods to evaluate conditioning intervals. AB - A decision rule is obtained to determine when exercise is beneficial. The term beneficial used in this context refers to the extension of lifetime based on studies of cardiovascular conditioning. Models are used to characterize changes in heart rate with intense exercise. In addition, it is necessary to consider a model involving a heartbeat bank to help determine the conditioning interval. Optimization procedures are used to develop the decision rule, to examine the assumptions in the problem, and to point out when a unique solution exists. This procedure is applied to empirical data for one individual (inter-subject study) and a unique conditioning interval is obtained. PMID- 3981988 TI - Active contractions of ureteral segments. AB - The first step in the analysis of the biomechanics of any organ is to obtain its constitutive equation. In pursuit of a constitutive equation describing the peristalsis of the ureter, we measured the relationship between the length of the muscle, the velocity of contraction, and the active tension development of isolated ureter segments. The results of length-tension measurements (giving the maximum tension developed in isometric contraction of a ureter segment of specific length) were similar to those obtained by previous investigators and reflected the behavior of length-tension relationship for other smooth muscles. Two aspects of the force-velocity relationship of the ureter were examined: the effect of releasing the ureter at different times after stimulation, and that at different levels of afterload. Measurements were analyzed using the hyperbolic Hill's equation in the form T/T0 = (1-v/v0) (l + cv/v0)-1 where v is the velocity of contraction, v0 is the velocity of contraction when T = 0, T is the tension in the muscle after release, T0 is the tension in the muscle immediately prior to release, and c is the dimensionless constant. The results of force-velocity measurements showed that the so-called "maximum" velocity v0, is the largest if the tension is released at a time of contraction, early in the rise portion of the contraction cycle. Further, if tension is released from an isometric contraction at a fixed time in the rise portion of the contraction cycle, the largest value of v0 is obtained when the muscle length is in the range of 0.85 0.90 Lmax. Interestingly, the in vivo length of the ureter lies also in this range, 0.85-0.90 Lmax. PMID- 3981989 TI - Pressure change and gas mixing induced by oscillations in a closed system. AB - In an attempt to delineate some mechanical behaviors found in branching airways, pressure transmission, gas motion, and mixing were studied during high-frequency oscillation (HFO) in an idealized system consisting of a large straight tube and a rigid sphere linked together by a small straight tube. Depending on the frequency f, and on the unsteadiness dimensionless parameter alpha, pressure amplitude in the large tube is either strongly attenuated or amplified in the sphere. This finding may provide a theoretical basis for the pressure resonance phenomenon observed in the lung by previous investigators. Gas compression in the closed volume causes convective mixing throughout the system. The measured dispersion was found to be proportional to f(VT/A)2, in agreement with a recent report. However, bulk convective mixing was sufficient to explain the dispersion for oscillatory volumes (VT) as small as 80 percent of the small tube volume, as has been previously suggested. PMID- 3981990 TI - Steady-state analysis of self-heated thermistors using finite elements. AB - The purpose of this work is to validate, using numerical, finite element methods, the thermal assumptions made in the analytical analysis of a coupled thermistor probe-tissue model upon which a thermal conductivity measurement scheme has been based. Analytic, closed form temperature profiles generated by the self-heated thermistors can be found if three simplifying assumptions are made: the thermistor is spherical; heat is generated in all regions of the bead; and heat is generated uniformly in the bead. This analytic solution is used to derive a linear relationship between tissue thermal conductivity and the ratio of thermistor temperature rise over electrical power required to maintain that temperature rise. This derived, linear relationship is used to determine thermal conductivity from the observed experimental data. However, in reality, the thermistor bead is a prolate spheroid surrounded by a passive shell, and the heating pattern in the bead is highly nonuniform. In the physical system, the exact relationship between the tissue thermal conductivity and parameters measured by the thermistor is not known. The finite element method was used to calculate the steady-state temperature profiles generated by thermistor beads with realistic geometry and heating patterns. The results of the finite element analysis show that the empirical, linear relationship remains valid when all three simplified assumptions are significantly relaxed. PMID- 3981991 TI - A strain energy function for lung parenchyma. AB - The strain energy for the air-filled lung is calculated from a model of the parenchymal microstructure. The energy is the sum of the surface energy and the elastic energies of two tissue components. The first of these is the peripheral tissue system that provides the recoil pressure of the saline-filled lung, and the second is the system of line elements that form the free edges of the alveolar walls bordering the alveolar ducts. The computed strain energy is consistent with the observed linear elastic behavior of parenchyma and the data on large deformations around blood vessels. PMID- 3981992 TI - Cohesion in the narratives of normal and language-disordered children. AB - An adaptation of Halliday and Hasan's (1976) description of cohesion in English was applied to the spoken narratives of normal and language-disordered children. Three major questions were addressed: (a) the influence of the nonlinguistic environment on the use of cohesion, (b) the nature of language disorder as displayed in the use of cohesion, and (c) the relationship between comprehension and use of cohesion. Twenty normal and 20 language-disordered children, aged 7:6 10:6, were included in the study. Each child produced two narratives, one for an adult listener who saw a movie with the child and one who had not. Results indicate that both groups of subjects altered their use of cohesion as a function of the listener's needs in the same way. However, the normal and language disordered subjects differed in their manner of cohesive organization, their cohesive adequacy, and their comprehension of the story. PMID- 3981993 TI - Effects of stimulus material on the dichotic listening performance of patients with sensorineural hearing loss. AB - Dichotic listening scores were obtained from 27 patients with sensorineural hearing loss in response to four dichotic speech tests: digits, vowel words, consonant words, and CV nonsense syllables. Monotic performance-intensity functions for each ear were defined with the CV syllables, and the four dichotic tests were administered at an intensity that produced asymptotic monotic performance for both ears with the CV syllables. Four blocks of 30 pairs of items per block were presented for each dichotic test, which produced 240 responses per test for each patient. Reliable differences among left-ear scores, right-ear scores, performance level, and the ear advantage were observed among the four tests. The digit test appeared to be most promising for assessing central auditory function when the patient had a sensorineural hearing loss because performance for the digits was only slightly affected by the peripheral loss. PMID- 3981994 TI - Visual matching test-taking strategies used by deaf readers. AB - Earlier investigations of deaf students' test-taking strategies have described visual matching strategies consisting generally of locating a word in the question, locating the same word in the text, and selecting a response in visual proximity to that word. Studies to date have utilized multiple-choice measures. The present investigation sought to confirm and extend earlier findings by (a) determining whether visual matching test-taking strategies are used by deaf students in testing situations requiring them to generate responses; (b) describing these strategies, if found; (c) determining whether visual matching is related to overall test performance of deaf readers; and (d) determining whether there are differences between the strategies used by deaf and hearing readers with comparable SAT-HI reading comprehension test performance. The results of this investigation indicate extensive use of visual matching test-taking strategies by deaf subjects but not by hearing subjects. The extent of strategy use was not related to deaf subjects' overall performance on the lookback test. Nine variations of strategy were identified and described. Implications are drawn for teachers, researchers, and other practitioners working with deaf children. PMID- 3981995 TI - Perceived contrastive stress production in hearing-impaired and normal-hearing children. AB - Contrastive stress production patterns of 20 moderate-to-severely hearing impaired children, aged 4:5-18:2 (years:months), were compared with those of 20 normal-hearing children, aged 3:7-6:7. The groups were matched on the basis of a linguistic measure, mean length of utterance. Analyses of judges' responses to the speakers' audiotapes recorded during a conversation-based task yielded evidence of similar production patterns for the groups although considerable individual performance variation was noted. This finding supports the view that language-matched normal and hearing-impaired children may not be very different in their production of this prosodic cue. Results of this study further support the idea that prosodic features of the speech signal enhance intelligibility, a factor which merits consideration in the intelligibility assessment and training of hearing-impaired children. PMID- 3981996 TI - Primary modality for speech perception in children with normal and impaired hearing. AB - The relationships between each of seven predictor variables and the relative degree to which 84 normal and hearing-impaired children used audition or vision in their perception of word stimuli were investigated. The children's relative use of audition or vision was assessed by the auditory-visual presentation of monosyllabic word stimuli in which the visual word stimuli were in conflict with those presented acoustically. Six of the seven predictor variables were significantly correlated with the performance scores obtained within the auditory visual conflict condition. Only pure-tone average hearing level and auditory word identification performance, however, made unique contributions toward predicting the degree to which audition or vision was used in the perception of the word stimuli. We concluded that the relative use of audition or vision was almost completely related to their auditory capabilities as represented by the children's unaided threshold sensitivity and aided speech reception performance. PMID- 3981997 TI - Prespeech vocalizations of a deaf infant: a comparison with normal metaphonological development. AB - A comparative study of the speech-like vocalizations of a deaf infant and a group of 11 hearing infants was conducted in order to examine the role of auditory experience in the development of the phonological and metaphonological capacity. Results indicated that from 8 to 13 months of age, the deaf subject differed strikingly from hearing infants of comparable age. She produced no repetitive canonical babbling, whereas all the hearing infants produced many canonical syllables. The topography of the deaf infant's vocalizations resembled that of 4 6-month-old (i.e., Expansion stage) hearing infants. Detailed comparisons of the proportion of production of various metaphonologically defined categories by the deaf infant and Expansion stage hearing infants demonstrated many similarities in vocalization, although possible differences were noted. It is concluded that hearing impairment notably affects vocalization development by the end of the first year of life, if not earlier. Spectrographic displays illustrate the categories of infant sounds produced by the deaf and hearing infants. PMID- 3981998 TI - Relationships between the perception of nasalization and speech movements in speakers with cleft palate. AB - The purpose of this study was to examine the relationships between several temporal measures of speech movements and perceived nasalization in speakers with cleft palate. Four adult subjects with repaired cleft palate were filmed using high-speed (100 frames/s) cinefluorography as they produced target syllables embedded in a carrier phrase. Perceived nasalization of each extracted acoustic target syllable was rated by 18 trained judges. Movements of the tongue tip, tongue dorsum, jaw, velar knee, velar tip, and posterior pharyngeal wall were plotted over time. Time of movement onsets and movement offsets was identified from the plots. Voice onset and offset times were identified from the synchronized acoustic recordings. The findings indicate that normally expected velopharyngeal movements occurred near the time of jaw-lowering onset during nasalized CVC and CVN productions in two subjects who were judged to exhibit high levels of nasalization. The other two subjects showed no velopharyngeal movements during the CVC production. It is speculated that velopharyngeal movements normally expected in CVC utterances may be avoided by some speakers with cleft palate in order to minimize perceptible nasalization. PMID- 3981999 TI - Creative language abilities of deaf children. AB - The language flexibility and creativity of deaf children was investigated by having four deaf and four hearing 12-15-year-olds generate stories to experimenter-supplied themes. These were videotaped and examined for instances of nonliteral communication. Contrary to previous claims that deaf children are extremely rigid and literal in their language use, subjects here showed considerable use of creative language devices when evaluated in sign rather than vocal language. Deaf students produced traditional types of figurative contructions at a rate equal to their hearing age-mates and surpassed them in four other categories of nonliteral expression. These findings are discussed in terms of the cognitive skills required for and reflected by figurative language use and common assumptions concerning deaf children's related abilities. PMID- 3982000 TI - Prephonatory laryngeal and chest wall dynamics. AB - The timing of prephonatory movements of the larynx, rib cage, and abdomen was examined in order to gain insight into the contribution of the vocal folds to the posturing of the chest wall. A simple stimulus-response paradigm was used in eliciting brief utterances--/a/ and /ha/--from six adult males. Chest wall movements were observed using mercury strain gages while simultaneous electroglottographic and airflow records provided information about vocal fold behavior. Independence of prephonatory laryngeal and chest wall behavior was demonstrated. Laryngeal adjustment preceded the start of vocal fold oscillation by a constant amount of time, whereas the time of onset of the chest wall adjustment varied as a function of the utterance type. The qualitative characteristics of prephonatory chest wall posturing were unaffected by altering glottal configuration requirements. Rib cage enlargement occurred during postural adjustment while the vocal folds were abducted (in preparation for /h/). This implies that rib cage enlargement during prephonatory chest wall posturing was not a passive response to abdominal compression. PMID- 3982001 TI - Variability of lip and jaw movements in children and adults: implications for the development of speech motor control. AB - The development of speech motor skill was studied by measuring the variability of lower lip and jaw movements. Groups of five adults, and children at ages 4, 7, and 10 years produced [mae] and [bae] 20 times each. The duration of lip-opening movements, jaw-opening movements, lip-open postures, jaw-open postures, and the timing between the onset of lower lip opening and jaw opening decreased in variability between the child and adult groups. No significant differences were observed in the variability of these measures across the child groups. The variability of lower lip displacement decreased significantly between the 4-year old and 7-year-old groups, but not between any other age groups. Jaw displacement variability did not change significantly between any groups. No significant differences in variability were found between [bae] and [mae]. It is hypothesized that different developmental motor processes affect the variability of speech movements at early, intermediate, and older ages. PMID- 3982002 TI - Phoneme feature perception in noise by normal-hearing and hearing-impaired subjects. AB - The purpose of this investigation was to determine whether normal-hearing and hearing-impaired listeners perceive phoneme features differently in noise and to determine whether phoneme perception changes as a function of signal-to-noise ratio (S/N). Consonant-vowel recognition by normal-hearing and hearing-impaired listeners was assessed in quiet and in three noise conditions. Analysis of total percent correct recognition scores revealed significant effects of hearing status, S/N, and vowel context. Patterns of phoneme errors were analyzed by INDSCAL. Derived consonant features that accounted for phoneme errors by both subject groups were similar to ones reported by other investigators. However, weightings associated with the individual features varied with changes in noise condition. Although hearing-impaired listeners exhibited poorer overall nonsense syllable recognition scores in noise than normal-hearing listeners, no specific set of features emerged from the multidimensional scaling procedures that could uniquely account for this performance deficit. PMID- 3982003 TI - Speaking clearly for the hard of hearing I: Intelligibility differences between clear and conversational speech. AB - This paper is concerned with variations in the intelligibility of speech produced for hearing-impaired listeners under two conditions. Estimates were made of the magnitude of the intelligibility differences between attempts to speak clearly and attempts to speak conversationally. Five listeners with sensorineural hearing losses were tested on groups of nonsense sentences spoken clearly and conversationally by three male talkers as a function of level and frequency-gain characteristic. The average intelligibility difference between clear and conversational speech averaged across talker was found to be 17 percentage points. To a first approximation, this difference was independent of the listener, level, and frequency-gain characteristic. Analysis of segmental-level errors was only possible for two listeners and indicated that improvements in intelligibility occurred across all phoneme classes. PMID- 3982004 TI - Stochastic analysis of myoelectric temporal signatures for multifunctional single site activation of prostheses and orthoses. AB - This paper is concerned with a stochastic time-series analysis of the temporal signatures of myoelectric (ME) signals including the determination of model order and sampling rate. The paper considers the use of time-series parameters for the activation of artificial limbs for high-level amputees, of stimulation electrodes or of powered braces for paralysed persons, in several degrees of freedom, from a single or two surface-electrode pairs at locations where considerable ME cross talk exists. The multifunctional capability from a single site is based on the differences between the time-series (TS) parameters for different muscle activation patterns at the same ME site, these differences being thus used for limb function discrimination via easily trainable muscle activation patterns at the vicinity of the electrode site. Specifically, the analysis is in terms of identifying the AR parameters of a time-domain autoregressive (AR) signature model both for the complete ME spectrum and for parts thereof, and in terms of the autocorrelation of the signal and of the models residual. Determination of sampling rate and of model orders is discussed in detail. It is shown that, using online real-time analysis, differences in the AR time-series parameters can be observed for different trainable patterns of muscle activation, at the same electrode location, even at the same ME power levels, as long as considerable cross-talk exists at the electrode site. These parameter differences can be accentuated if one considers the AR parameters for lower-frequency spectral windows. A case is made in this paper for employing TS analysis to squeeze out information in a distinct but low-level ripple of the low frequency spectrum of the signal. This information tends to be ignored in frequency domain, but is all that the AR parameters care for in TS analysis, since they are not concerned, with a flat-average low-frequency spectrum, i.e., its white-noise-like part, which is the residual term of the AR Model and not an AR parameter. Discrimination between different functions from a single electrode-site, at even the same power level, is thus shown to require considerable cross-talk at the given site, and to require the consideration of only the low-frequency part of the spectrum. PMID- 3982005 TI - Electrical stimulation of smooth muscle strips from the urinary bladder of the pig. AB - Strips of smooth muscle from pig urinary bladders were electrically stimulated to contract. Stimulation parameters and conditions were optimized so as to obtain a maximum number of isometric contractions with maximal force. It was found that the contractions could be described mathematically by a simple model. In the model there is a constant probability for cells to pass from the non-contractile to the contractile state during stimulation; this leads to a linearly decreasing phase plot (a plot of the rate of rise of a variable as a function of the variable) for the force. 'Activation' of the cells is described by a physical step function. Isometric contractions were thus characterized by a set of three parameters: U, the time derivative of the force, extrapolated to zero force, Fiso the value of the isometric force which is approached asymptotically after infinitely long periods of stimulation and t1, the activation time. The sensitivity of these three parameters to variation of the stimulus parameters was investigated. It was found that the parameter U was consistently correlated with the stimulus parameters, suggesting that this parameter can be used to describe the effectiveness of electrical stimulation of such strips. PMID- 3982006 TI - A gamma-ray computed tomography scanner for the quantitative measurement of bone density. AB - A special purpose gamma-ray computed tomography scanner has been developed for the precise measurement of bone density in the distal forearm. Details of the scanner hardware and computer analysis technique are given. Suitable phantoms have been used to test the operation of the scanner, which has been used to measure trabecular and cortical bone density with a precision better than 1%. PMID- 3982008 TI - Vibration analysis in the assessment of conservatively managed tibial fractures. AB - A simple and quantitative method for the assessment of fracture healing has been developed. this method depends on a technique of vibration analysis evolved from a study of 30 intact human tibiae and has been applied to the study of 22 tibial fractures. Real time vibration analysis will allow quantitative comparisons of different methods of non-operative fracture management, and, in addition to providing a uniquely powerful research tool, may have value in aiding clinical management decisions. PMID- 3982007 TI - A technique for the long term measurement of intra-compartmental pressure in the lower leg. AB - The early diagnosis of an acute compartmental pressure syndrome is often difficult, but can be facilitated by long term, up to several days, measurement of intra-compartmental pressures. A measuring system has been developed, together with its associated surgical and operational procedures, which may be applied in a variety of situations, including an immobile patient or a patient mobilized following surgery. If the technique is adopted as soon as the patient enters hospital, or immediately postoperatively, an acute compartmental syndrome may be recognized early and measures taken to alleviate its consequences. PMID- 3982009 TI - Universal bone cutting device for precision knee replacement arthroplasty and osteotomy. AB - Since malplacement contributes most to loosening of total knee replacements (TKR), a jig was devised, aligned to and mounted on the tibia, with a 3 degrees of freedom sliding saw. A central distractor, attached to the jig, positions and aligns the knee at 0 degrees or 90 degrees. The femur is then rigidly linked to the jig for bone cutting. Resurfacing designs (Cloutier and Townley) have been regularly implanted, aligned +/- 1 degree. This precision should minimize loosening and improve function. PMID- 3982010 TI - A microcomputer system for the measurement of finger forces. AB - In the analysis of hand functions, the production and control of forces exerted during voluntary contraction of the finger muscles plays an important role; unfortunately such an analysis is rarely seen in routine clinical examinations of neurological patients. A microcomputer controlled system for the measurement and analysis of finger forces is described. The system consists of a modified Z80 based microcomputer, a commercially available high precision force transducer, a specially designed force signal amplifier and a suite of menu-driven user interactive programs. A variety of tasks is implemented by means of the computer programs. In addition to the measurement of maximum hand grip force, the system is able to record forces continuously as a function of time. Task characteristics and the type of feedback presented to the subject are under user control; they can be varied to meet clinical or experimental requirements. Examples of programs and clinical applications are presented and discussed. PMID- 3982011 TI - Some additional suggestions for an intervertebral disc prosthesis. AB - The paper, which refers to previous original papers on the subject, gives suggestions indicating four intervertebral disc prostheses, one utilizing bone cement for fixation to the bony substance of the motion segment. In the paper a modification of this inter-vertebral disc prosthesis offers a possibility for fixation of the prosthesis by osteointegration. PMID- 3982012 TI - Energy of gait in below-knee casts with different soles. AB - This study aims to provide some guidelines for the use of soles on below-knee walking casts. Whole-body energy changes during the single limb support phase of the gait cycle have been quantified in twenty volunteer subjects fitted with below-knee casts and each wearing one of five soles in turn. Simple gait analysis was carried out with a Kistler force plate and an Apple II microcomputer, the data were sampled at 50 Hz. Three commercial soles and two 'home made' ones were used; it was generally found that the commercial products produced a more energy efficient gait. Some recommendations are included regarding the design of soles to be used in this clinically demanding situation. PMID- 3982013 TI - Free-field acoustic stimulation: a reliable, inexpensive system for positioning loudspeaker. AB - We describe a single mechanical system for locating a sound source anywhere on the surface of an imaginary sphere centred on an animal subject. The system has been used in neurophysiological studies of localization in guinea-pig and example neural data are shown. PMID- 3982014 TI - IMA II brace for deambulatory treatment of Legg-Perthes disease. AB - Orthotic devices usually prescribed for ambulatory treatment of Legg-Perthes disease do not meet the severe kinematic requirements necessary for a comfortable gait. This paper describes the IMA II brace which offers several advantages in comparison with conventional braces. It is shown that improved kinematic characteristics are obtained by the use of six joints placed symmetrically at two levels of the brace. PMID- 3982015 TI - Development of an air displacement method for whole body volume measurement of infants. AB - An infant enclosed in a rigid-walled chamber displaces a volume of air equal to its own volume. The volume of air displaced can be estimated by the change in pressure produced by a standard reduction in the chamber's volume according to Boyle's law. An instrument embodying this principle has been developed in which the differential pressure between two identical chambers is measured during equal sinusoidally imposed volume changes in the two. Problems arising from variable departure of conditions of pressure cycling, from isothermal towards adiabatic, have been dealt with by empirically derived corrections. Data are presented on the use of the method for low birth-weight infants. PMID- 3982016 TI - Noninvasive measurement of femoral artery pressure for evaluating aortoiliac occlusive disease. AB - Femoral systolic pressures measured by a compression technique (FSCP), were compared with proximal thigh systolic pressures (PTSP), for evaluation of aortoiliac occlusive disease. In phase I FSCP were measured by compressing the artery with a pressure cuff rolled into a cylinder and using disappearance of the profunda femoris Doppler signal (FSCP-D), or flattening of thigh plethysmographic waveforms (FSCP-P), as sensors. In normal extremities the compression techniques yielded false high values. The mean ratio of FSCP-D to brachial systolic pressure, FSCP-D/BSP, was 1.25 +/- 0.06 and the mean FSCP-P/BSP was 1.37 +/- 0.15, a value approximately equal to the mean PTSP/BSP, 1.38 +/- 0.20. In patients with aortoiliac occlusive disease linear regression analysis revealed a good correlation between FSCP-D/BSP and direct intraoperative measurements of femoral/aortic systolic pressure, FSP/ASP, (R = 0.79 and R2 = 0.63), a fair correlation between FSCP-P/BSP and FSP/ASP (R = 0.49, R2 = 0.24) but a poor correlation between PTSP/BSP and FSP/ASP (R = 0.35, R2 = 0.12). In phase II studies a soft bladder was used for arterial compression. In normal extremities the mean FSCP-D/BSP was 1.07 +/- 0.06, close to the predicted normal value of 1.00. In a second group of patients with occlusive disease a better correlation was observed between values of FSCP-D/BSP and FSP/ASP (R = 0.91, R2 = 0.82), than any of the correlations of noninvasive measurements with direct intraoperative values of FSP/ASP obtained in the first phase of the study. PMID- 3982017 TI - The different effects of leucine, isoleucine, and valine on systolic properties of the normal and septic isolated rat heart. AB - Protein turnover in cardiac and skeletal muscle is affected by the provision of amino acids, particularly the branched chain amino acids (BCAA). The effect of each of the BCAA, valine, leucine, and isoleucine, on the systolic function of isolated normal or septic rat heart perfused as a Langendorff preparation was examined. Thirty normal control and 28 septic rats (cecal ligation and puncture) were perfused with either Krebs + 8.5 mM glucose or Krebs + 5.0 mM glucose and 3.5 mM valine, leucine, or isoleucine. Septic hearts perfused with Krebs + 8.5 mM glucose exhibited developed force (DF) and force velocity (dF/dt) levels which were reduced to an average of 45 and 50%, respectively, compared to normal controls, and improved by 35% during 60 min perfusion over measurements made at time zero. In normal hearts DF and dF/dt decreased significantly during perfusion with leucine (27%) and isoleucine (20%). In sepsis, perfusion with leucine and isoleucine resulted in a mild improvement in systolic function. However, valine was far less effective than leucine and isoleucine in maintaining systolic function in sepsis, due apparently to valine being a less efficient energy substrate for the cardiac muscle in a state of severe energy deficit. Thus, valine, leucine, and isoleucine seem to exert different effects on the systolic function of normal and septic isolated rat hearts. PMID- 3982018 TI - The control of peritendinous adhesions using topical beta-aminopropionitrile base. AB - The Lindsay chicken foot tendon model was utilized to test the effect of topically applied beta-aminopropionitrile base upon the tensile strength of peritendinous adhesions following tenolysis of a scarified flexor tendon. The agent reduced by one-third the force required to effect tendon gliding and flexion of the joints in the involved digit. The results show that topical beta aminopropionitrile is effective in the control of peritendinous adhesions and, therefore, achieves sufficient depth of penetration topically to affect the peritendinous location. No adverse effects of the topically applied agent were demonstrated. The principle of topical therapeutics that may have significant benefits to patients with tendon injuries is demonstrated. PMID- 3982019 TI - Skin wound healing determined by water loss. AB - An in vivo method of monitoring healing was tested incorporating an Evaporimeter measuring water evaporation; reepithelialization was detected through reestablishment of the water barrier. In the first study two wounds were created with a 2-mm biopsy punch on each of the backs of 15 rabbits and covered with occlusive and semiocclusive dressings. Water loss increased from a preoperative value of 6 g m-2 hr-1 to 55 g m-2 hr-1 after surgery. Water loss from the occluded site returned to baseline values in 9 days as opposed to 17 days for the semioccluded sites (P less than 0.05). The second study followed the healing of full-thickness 4 X 4-cm wounds in five rabbits treated with fine-mesh gauze and five treated with a human amnion dressing. Wound area and water loss were observed during the repair process. Visually measuring the wound area, the injuries appeared 100% healed on Day 30. The Evaporimeter continued to detect significantly increased water loss up until Day 45 when the original baseline values were reached. No differences were observed between the gauze and amnion groups. The Evaporimeter presents a simple yet accurate, noninvasive tool measuring the wound healing endpoint based on regeneration of the epidermal water barrier. PMID- 3982020 TI - The failure of truncal vagotomy to affect motilin release in dogs. AB - To elucidate the relationship between vagus nerve and motilin release, we have studied the influence of truncal vagotomy with pyloroplasty (TV) on motilin release in the fasting state and for 120 min following an intraduodenal administration of 10 g glucose in a 50-ml water solution or 5 g soybean oil. TV did not influence the intermittent fluctuation or concentration of plasma motilin in the fasting state. Intraduodenal glucose administration inhibited motilin release, but this was not affected by TV. Intraduodenal fat administration accelerated motilin release, but this effect also was not affected by TV. These results suggest that motilin secretion in the fasting state and after nutrient ingestion is not influenced by TV. PMID- 3982021 TI - Measurement of myocardial oxygen consumption. PMID- 3982022 TI - Blunt anorectal injuries in children. PMID- 3982024 TI - Exercises in the elderly--benefits, precautions and recommendations. PMID- 3982023 TI - If only I had seen him ... PMID- 3982025 TI - Southern Regional Task Force on Infant Mortality. PMID- 3982027 TI - The synthesis of 16 alpha-[131I]iodo-oestradiol and evaluation of its use as a radiotracer for oestrogen receptor positive breast tumours. AB - 16 alpha-Iodo-oestradiol binds with high affinity to the oestrogen receptor and has been shown to accumulate in oestrogen sensitive tissues in many test systems. We have prepared the compound labelled with 131I at four specific activities. Using these preparations we have attempted to image human primary and metastatic breast cancer deposits at various times from 15 min to 24 h post injection by external gamma scintigraphy. Clinical studies were conducted on 10 post menopausal patients. The receptor status was determined in seven cases, four were positive and three negative. The imaging results were very poor, in only two cases were images obtained, these were very faint and only of the primary, never of the metastatic deposits. The oestrogen receptor status was only available in one of these cases, it was positive. Dynamic studies in vivo revealed that the compound is cleared rapidly from the circulation during the first 5 min and thereafter undergoes extensive enterohepatic recycling. Studies of the radiochemical identity of the circulating species revealed that the injected compound was extensively metabolised. Neither an increase in specific activity of injected radiotracer nor imaging at shorter times after injection improved the results. PMID- 3982028 TI - Monoclonal antibodies to testosterone: the effect of immunogen structure on specificity. AB - A 15 beta-thioalkyl derivative of testosterone conjugated to bovine serum albumin (BSA) was synthesised and used to produce monoclonal antibodies. These antibodies were evaluated using 15 beta-(2-carboxyphenylthio)-testosterone [125I]histamine as radioligand. Out of 1368 hybrids, 5 secreted anti-testosterone antibodies. These were compared with monoclonal antibodies derived from immunisation with testosterone-3-carboxymethyloxime-BSA. The first group of monoclonal antibodies all showed very low cross-reactivity with 5 alpha-dihydrotestosterone (less than 2.8%) indicating that this site of linkage is a good choice for discriminating between differences at the 4-5 position in the A-ring on the testosterone molecule. However they generally showed much higher cross-reactivity with progesterone and androstenedione than monoclonal antibodies raised to the 3 linked immunogen. Nevertheless within each fusion there were monoclonal antibodies with markedly different specificities. None of these antibodies could be considered suitable for use in a testosterone immunoassay, but it does suggest that an antibody with an improved specificity profile could be found using the monoclonal antibody approach. PMID- 3982026 TI - Low levels of glucocorticoid binding sites in circulating lymphocytes of premature infants suffering from hyaline membrane disease. AB - The number and affinity of glucocorticoid binding sites in lymphocytes of newborns and prematures were determined by a whole cell [3H]dexamethasone binding assay. The average binding capacities were as follows: 1758 +/- 245 binding sites/cell in cord blood, 2758 +/- 307 binding sites/cell in mature newborns (Kd: 6,23 X 10(-9) M), and 2031 +/- 330 binding sites/cell in prematures. No specific binding was measurable in several cases. All the prematures, who did not display a measurable glucocorticoid binding capacity, suffered from a serious hyaline membrane disease (HMD), they died on 3.5-4 days of life. HMD diagnosis was established in 12 cases in toto. The number of glucocorticoid binding sites was significantly smaller in this group (639 +/- 216 per cell) than in the case of the rest of prematures (2959 +/- 404 per cell, P less than 0.001). Our results suggest that lack of glucocorticoid receptors may be one of the causes of the HMD. PMID- 3982030 TI - The distribution of (5E)-(10S)-10,19-dihydroercalciol and its metabolites in serum of rats. AB - The distribution of radioactivity in serum of male rats (275 g) after oral administration of tritium labelled (5E)-(10S)-10,19-dihydroercalciol (dihydrotachysterol2) has been studied as a function of time and dose level. Nine distinct radioactive substances, chromatographing in the range between calciol and calcitriol, could be demonstrated. No attempt was made to establish chemical structures. After a single dose of 1.84 nmol, (5E)-(10S)-10,19-dihydroercalciol is very rapidly metabolized to more polar forms. The time course of appearance, ranging between 30 min and 1 day after administration, and the polarity of these substances indicated that they might be formed in sequence. The highest serum concentrations of the major substances occurred between 2 h and 10 h after administration, but compared with the dosage they were very low. In response to daily administration the concentrations of the major substances achieved steady state levels within 1-4 days. The metabolism of (5E)-(10S)-10,19-dihydroercalciol was apparently not affected by its nutritional status at the dose level studied. After single administration of progressively increasing doses, ranging from 1.84 nmol to 1.84 mumol, the relative increments of the concentrations of the major substances rose in proportion to the relative increases of the dosage. The mechanisms responsible for the appearance of these substances in serum were found to be closely related. At dose levels up to 18.4 nmol feedback control was apparently absent. PMID- 3982029 TI - Characterization of an antiestrogen-binding protein in high salt extracts of human breast cancer tissue. AB - An antiestrogen binding protein which binds [3H]tamoxifen (1-[4-(2 dimethylaminoethoxy)-phenyl]1,2-diphenylbut-1(Z)-ene) with high affinity (Kd = 1.1 X 10(-9) M) is present in high salt (0.6 M KCl) extracts of washed breast cancer tissue pellets. Its concentration in high salt extract is higher than its concentration in cytosol. The characteristics of the antiestrogen binding protein from cytosol and salt extract of breast cancer tissue are indistinguishable. It specifically binds triphenylethylene and other nonsteroidal antiestrogens and displays little or no binding affinity for estrogens, progesterone, dihydrotestosterone and cortisol. The antiestrogen binding protein is of unusually large size as judged by gel filtration on agarose 0.5 m and sedimentation analysis on 5-20% sucrose density gradients. Differential centrifugation studies indicate that it is not principally microsomal in origin. This protein is more thermostable than the estrogen receptor from which it can also be distinguished by ion exchange chromatography. The antiestrogen binding protein was eluted from DEAE-Sephacel by 0.05 M KCl indicating that it is less negatively charged than the estrogen receptor which was eluted by 0.1 M KCl. Lipoprotein fractionation of breast cancer cytosol using potassium bromide density gradients did not reveal specific antiestrogen binding activity associated with any recognized class of lipoprotein. Specific [3H]tamoxifen binding sites were pelleted in potassium bromide gradients consistent with the apparent large size of this protein. The physical characteristics of the antiestrogen binding protein in normal human tissue (myometrium) and neoplastic tissue (breast cancer) are remarkably similar, possibly reflecting a highly conserved structure. PMID- 3982031 TI - The effects of RU486 on the luteal phase of the rhesus monkey. AB - RU486 is a steroid which possesses great affinity for the progesterone (P) receptor, but which has no P activity. It has been shown to be, as a result, a potent P antagonist. In the present study, we investigated the effect of this compound on the luteal phase of the rhesus monkey. The day of ovulation was diagnosed with a +/- 12 h accuracy, using serial laparoscopies and serum estradiol (E2) determinations, in regularly cycling rhesus monkeys. RU486 was administered by gavage (10 mg daily) in different regimens during the luteal phase: Group 1, days 1-5; Group 2, days 5-9; Group 3, days 9-13; and Groups 4, days 9-13, plus hCG (30, 60, 90, 180 and 360 IU i.m. on days 6-10). RU486 induced vaginal bleeding within 24-72 h after the initial administration in Groups 1-3. Animals of Group 4 presented luteal lengths ranging from 9-12 days. Progesterone concentrations at the onset of vaginal bleeding were 2.1 +/- 0.3, 4.9 +/- 0.6, 2.6 +/- 0.4 and 11.2 +/- 1.5 ng/ml (x +/- SEM) for animals of Groups 1-4, respectively. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), E2 and P levels were not altered during treatment. The availability of a compound such as RU486, that consistently induces vaginal bleeding due to its action at the target level (endometrium) without affecting the hormonal events of the menstrual cycle, opens a new approach to post-coital and interceptive contraception. PMID- 3982032 TI - Steroid biosynthesis by a sesterterpene pathway in the rat adrenal gland in vitro. AB - Rat adrenal gland preparations were incubated with radioactive cholesterol and 23,24-dinor-5-cholen-3 beta-ol. Steroids were isolated, purified by thin-layer and high performance liquid chromatography and crystallised to constant specific activity. It was found that the rat adrenal gland can utilise 23,24-dinor-5 cholen-3 beta-ol to produce corticosterone. Also, in contrast to the conversion of cholesterol to corticosterone which occurs in the mitochondrial fraction, the conversion of 23,24-dinor-5-cholen-3 beta-ol to corticosterone occurs in the microsomal fraction. It was concluded that the sesterterpene pathway for steroid biosynthesis can function in the rat adrenal gland and that the intermediates are converted to steroid hormones in the microsomal fraction. PMID- 3982033 TI - Effects of short-term treatment with a combined oestrogen-progestin oral contraceptive on biliary lipids and cholesterol saturation index in young women. AB - The effect of daily ingestion for 7 days of ethinyloestradiol (30 micrograms) plus DL-norgestrel [0.5 mg] (Eugynon-30) on the lipid composition of duodenal bile in 8 healthy young women was investigated from the fifth day after onset of menstrual bleeding. This treatment did not significantly affect the concentrations of cholesterol, phospholipid and total bile acids expressed as mmol/l, nor the mean molar percentage of phospholipid. However, the treatment caused a significant increase in the mean molar percentage of cholesterol which was accompanied by a significant decrease in the mean molar percentage of total bile acids. The cholesterol saturation index of the bile of 7 subjects was elevated after treatment while both serum cholesterol and testosterone were significantly reduced. The results show that administration to healthy young women, not previously exposed to oral contraceptives, with a low oestrogen progestin preparation for only 7 days produces a more lithogenic bile, accompanied by a decrease in serum cholesterol and plasma testosterone concentrations. PMID- 3982034 TI - 19-Hydroxylation of 18-hydroxy-11-deoxycorticosterone by adrenal mitochondria prepared from various animal species. AB - We have recently reported that bovine adrenocortical cytochrome P-45011 beta catalyzes 19-hydroxylation of 18-hydroxy-11-deoxycorticosterone (18(OH)DOC) in addition to 11 beta-hydroxylation of the steroid. In this report, we examine the presence of these two activities in 18(OH)DOC and 11 beta- and 18-hydroxylation activities on deoxycorticosterone (DOC) among the adrenal mitochondria prepared from man, ox, pig, rabbit, guinea-pig and rat. The results indicate that these animals could be classified into three groups with respect of these hydroxylation activities. Mitochondria of the first group comprising ox and pig showed rather high 19- and 11 beta-hydroxylation activities on 18(OH)DOC compared to the hydroxylation activities on DOC. Mitochondria prepared from the second group which comprised rabbit, guinea-pig and man showed low 19-hydroxylation activity on 18(OH)DOC, whereas the 11 beta-hydroxylation of 18(OH)DOC well occurred in these species. The last group comprising rat had very low activity both of 11 beta- and 19-hydroxylations when 18(OH)DOC was used as the substrate, whereas both 11 beta- and 18-hydroxylations of DOC were high in rat adrenal mitochondria. No significant difference of these activities could be found between zona glomerulosa cells and zonae fasciculata-reticularis cells of bovine adrenal cortex, and between adrenal mitochondria from spontaneously hypertensive rat and those from WKY normotensive rat. PMID- 3982035 TI - Biopsy of bone tumours. AB - Bone biopsy is not only the most important step in the diagnosis of bone tumours, but since the introduction of chemotherapy, it has also become essential in the evaluation of treatment of highly malignant bone tumours. A total of 206 bone biopsies were performed on 136 patients seen between January 1, 1978 and August 1, 1982 (99 open and 107 drill biopsies). Complications during or after biopsy were relatively rare, and none were of a serious nature. Pathological fractures at sites of biopsies developed exclusively in patients given chemotherapy. In gaining adequate histologic material, the overall result of open bone biopsies (98%) was superior to that of drill biopsies (70%). The choice between both techniques was dependent on individual patient factors. Of the total of 206 bone biopsies, 10% proved not to be representative. It is concluded that, especially in patients given chemotherapy for a malignant tumour of a long bone, the possibility of a spontaneous fracture after a bone biopsy should be borne in mind. PMID- 3982036 TI - Prognostic value of preoperative serum CEA level compared to clinical staging: III. An approach to scoring of prognostic factors in colorectal cancer. AB - In a clinical study of observed postoperative survival of colorectal cancer patients, we investigated the application of a risk score based on tumor-related prognostic parameters. Six hundred seventy-four patients have been registered for primary surgery of colorectal cancer since 1974 who did not receive further postoperative treatments. The prognostic parameters included operability, tumor extension, and preoperative serum carcinoembryonic antigen (CEA) level. The scoring system was based on the average death-rate ratios of subgroups of patients and their age and sex-matched reference groups derived from the general life table of the population of the Federal Republic of Germany. The individual score sums of the patients exhibited score sum ranges which characterized groups of patients with entirely different observed survival. The prediction of individual survival after primary operation was only partly possible. In the plot of individual survivals vs individual score sums, a marginal risk zone was obtained which evidently represents the zone of maximum expected survival of patients who do not receive further postoperative treatment. PMID- 3982037 TI - Diagnosis and operation for locally recurrent rectal cancer. AB - Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. Six patients with deeply invading recurrent lesions had pelvic exenteration combined with sacral resection. This procedure seems a reasonable treatment for palliation and the chance of cure in selected patients. In order to select good candidates for this extensive procedure, carcinoembryonic antigen (CEA) assays and the diagnosis of locally recurrent tumor with pelvic computed tomography (CT) were evaluated. CEA assay is valuable for diagnosing most recurrent rectal cancers, but it is inadequate for early detection. A high CEA level often indicates extrapelvic tumor spread. CT examination is very valuable for the early detection and localization of recurrence in relation to pelvic structures. PMID- 3982038 TI - The effects of hyperthermia on vascular permeability in experimental liver metastasis. AB - The effects of hyperthermia on vascular permeability in Walker carcinosarcomas and host liver tissue were studied in Sprague-Dawley rats. A quantitative Evans blue technique was used to measure permeability. With tumors heated to 40 degrees C, a nontherapeutic level, no changes in tumor vascular permeability as compared to control levels were noted. However, with tumors heated to 43 degrees C, within the therapeutic range of hyperthermia, significant rises in tumor vascular permeability occurred. Permeability was increased at both time periods studied, 30 minutes and 6 hours after hyperthermia and injection of Evans blue. These changes are similar to those seen after physical damage from freeze-thaw. It is likely that alterations in tumor microcirculation play a role in the therapeutic effect of intense hyperthermia. PMID- 3982039 TI - Hemangioendothelioma of the lymph node: a case report. AB - Primary benign vascular tumors of lymph nodes are very rare. Various forms of lymph nodal vascular transformations defined as hemangiomatoid lesions, pannodal vasodilatation, or nodal angiomatosis have been described. We present a patient who was thought to have an epithelial salivary gland tumor, but instead was found to have an hemangioendothelioma of an adjacent enlarged lymph node in the region of the left submandibular gland. PMID- 3982040 TI - Leiomyoma of the spermatic cord. PMID- 3982041 TI - Quantification of ethanol-induced gastric mucosal injury by transmission densitometry. AB - A method to objectively quantify the extent of ethanol-induced gastric lesions has been developed. The method utilizes a transmission densitometer to measure the optical density of the photographic negative of the stomach mucosa. Tissues from ethanol- and untreated animals are compared with tissues from animals pretreated with prostanoids before ethanol; this method permits a reproducible and objective evaluation of mucosal protection. We demonstrate that the optical density is proportional to subjective score and damage, and that the densitometry method differentiates between the protective effect of different doses of 16,16 dimethyl prostaglandin E2 and natural prostaglandin E2. PMID- 3982042 TI - Two hemodynamic problems commonly associated with the microsphere technique for measuring regional blood flow in rats. AB - The purpose of this study was to reevaluate two major steps associated with the radioactive microsphere technique in rats; the hemodynamic effects of the solutions used to inject the microspheres, and the hemodynamic effects of repeated blood withdrawals. With regard to the first, Flaim et al. (1978) have shown that 1.0 ml of 10% dextran injected into the rat may result in a severe pressure drop. The present study showed that even 0.1 ml of 10% dextran caused significant hypotension 46% of the time. Six other mediums were also tested as possible suspending media. It was concluded that a dextrose solution (sp gr 1.3) was the best microsphere injection medium based on the length of time the microspheres stayed mixed in the solution and the minimal hemodynamic alterations caused during injection. With regard to the second concern, cardiac output decreased approximately 7% with each reference sample withdrawal. When volume was replaced with a Ficoll-70 solution, cardiac output decreased less than 3%. These data show that repeated blood withdrawals are possible as long as the volume of blood is replaced. Thus, several isotopes can be injected in the same rat to allow measurement of regional blood flow under different experimental conditions. PMID- 3982043 TI - Effective activation energy of enzymatic and nonenzymatic reactions. Evolution imposed requirements to enzyme structure. AB - The difference of the activation energies in a protein globule and water has been treated in terms of the theory of an elementary act of charge transfer reaction with regards to the energy spent on the transfer of charged reactants from water into the protein. The protein was treated as a structureless dielectric with a given optical and static dielectric constants surrounded by the aqueous phase. Reactions of different types (charge exchange between reactants, charge separation, neutralization, etc.) have been analyzed both under prevalence of purely electrostatic effects and under considerable nonelectrostatic contributions to the activation energies. It is shown that for all one-electron and most multi-electron reactions involving two reaction centres the energy spent for charged reactant transfer from water into protein is greater than the concomitant activation energy gain. The same effect takes place in a number of cases for multi-centre processes as well. To overcome the entropy hindrances, the reactants and catalysts must combine into multiparticle complexes, i.e. form microscopic regions of low dielectric constant. This results in increased effective activation energy as compared to reactions in water. It has been hypothesized that in order to make up for this loss the evolution has selected the proteins which are characterized by considerable intraglobular permanent electric fields. The presence in proteins of high concentrations of strongly polar peptide groups renders them advantageous in this respect over other polymers that are less polar. PMID- 3982044 TI - New formulation of water and macromolecular flux which corrects for non-ideality: theory and derivation, predictions, and experimental results. AB - Classic irreversible formulation of coupled water and macromolecular transport across capillaries by Kedem & Katchalsky (1958), even with subsequent refinements (Spiegler & Kedem, 1966), assumes explicitly that colloid osmotic pressure (pi) is linearly related to macromolecular concentration. It is known, however, that pi is related to concentration by an accelerating function empirically expressed as a cubic equation (Landis & Pappenheimer, 1963). Using only basic rules of irreversible thermodynamics (Onsager, 1931), we rederived the coupled flux equations in exact form. To render them approximately solvable, we assumed mathematical continuity across the membrane and incorporated the Landis Pappenheimer relationship. Results yielded equations giving different membrane descriptors from the classic formulation (CF). Instead of a sieving coefficient (1 - sigma), the new formulation (NF) gives a parameter A which is solute flux per unit volume flux when oncotic gradient is zero. Instead of a permeability surface area product (PS), the NF gives a parameter phi which is solute flux per unit "solute pressure" at zero water flow. Relationships between sigma, PS, A, and phi are shown whereby differences between CF and NF can be investigated. Predictions were made comparing values expected from experiment for a variety of membrane descriptors and variables using either CF or NF. Predictions show that for any sets of lymph flux and lymph/protein concentration ratio, a number of inequalities are expected: For reflection coefficient, sigma NF greater than sigma CF; for PS, PSNF greater than PSCF; for mean relative membrane protein concentration, C/C p(NF) less than C/C p(CF); and for fraction of protein transport carried by permeative processes, Fr DNF greater than Fr DCF. In venous pressure perturbation experiments in the hindquarters of 21 dogs, the predictions were upheld. Moreover, CF values were not closely predictive of NF values. As others have noted, CF values of sigma and PS are correlated with capillary pressure or filtration; and this relationship is not obliterated by NF treatment, possibly indicating a true pressure or flow dependency of membrane descriptors. PMID- 3982046 TI - Why does brain make lactate? PMID- 3982045 TI - Nearly one dimensional dynamics in an epidemic. AB - The incidence of measles in New York City and Baltimore was studied using recently developed techniques in nonlinear dynamics. The data, monthly case reports for the years 1928-1963, suggest almost two dimensional, chaotic flows whose essential attributes are captured by one dimensional, unimodal maps. The effects of noise, inevitable in ecological and epidemiological systems are discussed. PMID- 3982047 TI - A three-dimensional representation for base composition of protein-coding DNA sequences. AB - Multi-dimensional scaling is applied to our codon space data on the protein coding sequences of DNA from a wide variety of organisms in an attempt to find the smallest number of parameters which will accurately represent these sequences. I find that a three-dimensional representation is satisfactory. One of the three resulting co-ordinates separates eukaryotes and their associated viruses from prokaryotes and their associated phages, while an orthogonal co ordinate separates those organisms capable of synthesizing proteins (eukaryotes and prokaryotes) from those not so capable (viruses and phages). Mitochondria show no relation in our plots to any of these groups. PMID- 3982049 TI - The origin of helping: the role of variability in reproductive potential. AB - We investigate the relationship between variation in reproductive potential among members of a family and genetic relatedness to determine which combinations favor natural selection for helping behavior. Conditions favoring helping are derived for the helper, the recipient, and the parents of these individuals. Our analysis reveals that a factor of general significance in the evolution of social organisms is variability in reproductive potential among offspring of a parent. To a limited extent this factor has already been appreciated because of its implicit role in "facultative altruism" and "parental manipulation", or suppression of offspring or sibs; however, the unifying role of variance per se and the ways by which it may act have not been widely appreciated. We show that suppression as a source of intra-brood variance is less powerful in the evolution of sociality than other, natural, sources of variance. The facts of natural history appear to be more consistent with a model utilizing natural variance than with a variance-enhancement model for most vertebrates. We present models for discrete and for overlapping generations. Fecundity of young potential helpers relative to adults is an important source of variance for the origin of helping. PMID- 3982048 TI - mRNA sequence predictions from homologous protein sequences. AB - A model has been developed that permits the prediction of mRNA nucleic acid sequence from the sequences of the translated proteins. The model relies on the information obtained from the comparison of protein sequences in related species to reduce the number of possible codons for those amino acids where mutations are observed. The predictions so obtained have been tested by applying the model to proteins whose mRNA sequences are known. The model's predictions have been found to be 100% accurate if three or more different amino acids are known at a given position and if the protein sequences are restricted to relatively closely related species (within the same class). The use of this model may permit a reduction of the mRNA sequence degeneracy and therefore be helpful in the synthesis of cDNA probes or for the prediction of restriction endonuclease sites. Computer programs have been developed to ease the use of the model. PMID- 3982051 TI - The geometric progression of nuclear volumes. AB - Vesicles formed by the fragmentation of biomembranes form discrete size classes. Their surface areas can be represented by two geometric series with a common ratio of 2. The surface areas of membrane vesicles found in intact cells, including nuclear envelopes are terms of the same two series. These observations can be interpreted as indicating that nuclear volumes have physically determined, discrete values, which do not vary in a continuous way. Therefore an increase of nuclear volume, for any reason, will result in a jump to the next larger term in the series. PMID- 3982050 TI - Stability of multienzyme systems with feedback regulation: a graph theoretical approach. AB - Stability of multienzyme systems with feedback regulation has been analyzed on the basis of the Lienard-Chipart criteria. The rules governing the topological graph construction for multienzyme systems have been developed. A theorem about correspondence of the graph constructed and coefficients of the characteristic polynomial of linearized kinetic equations is proved. The graph-theoretical stability analysis proposed is illustrated by a number of examples of multienzyme systems with feedback regulation. PMID- 3982052 TI - Accession of sweet stimuli to receptors. I. Absolute dominance of one molecular species in binary mixtures. AB - Intensity/time studies of sweetness response in pure solutions of each of nine different sweet stimuli have been carried out. Both variables exhibit simple power functions of the form Intensity (S) = kscns and Persistence (P) = kpcnp. In binary mixtures of these nine stimuli a depression (or negative synergism) of both sweetness intensity and persistence is observed which is predictable from the low exponents of the power functions. Combination of both power functions allows the "effective concentration" of each stimulus in a binary mixture to be calculated from its observed intensity/time characteristics. All "effective concentrations" calculable in this way show absolute dominance of one stimulus in mixtures of two irrespective of the relative proportions of the two stimuli. It is suggested that the "effective concentrations" may reflect real concentrations of a single molecular species in the microenvironment of the receptor. Thus the accession of sweet molecules to ordered, localized concentrations at the receptor is ultimately dependent on chemical structure. PMID- 3982053 TI - Are patterns of growth adaptive? AB - Models which define fitness in terms of per capita rate of increase of phenotypes are used to analyse patterns of individual growth. It is shown that sigmoid growth curves are an optimal strategy (i.e. maximize fitness) if (Assumption 1a) mortality decreases with body size; (2a) mortality is a convex function of specific growth rate, viewed from above; (3) there is a constraint on growth rate, which is attained in the first phase of growth. If the constraint is not attained then size should increase at a progressively reducing rate. These predictions are biologically plausible. Catch-up growth, for retarded individuals, is generally not an optimal strategy though in special cases (e.g. seasonal breeding) it might be. Growth may be advantageous after first breeding if birth rate is a convex function of G (the fraction of production devoted to growth) viewed from above (Assumption 5a), or if mortality rate is a convex function of G, viewed from above (Assumption 6c). If assumptions 5a and 6c are both false, growth should cease at the age of first reproduction. These predictions could be used to evaluate the incidence of indeterminate versus determinate growth in the animal kingdom though the data currently available do not allow quantitative tests. In animals with invariant adult size a method is given which allows one to calculate whether an increase in body size is favoured given that fecundity and developmental time are thereby increased. PMID- 3982054 TI - Derivation of the frequency distributions of cycle durations from continuous labeling curves. AB - In cell populations that are continuously exposed to radioactive thymidine over a long period, all proliferating cells become labeled as they pass through their DNA-replicating phase. The continuous labeling curve (CLC) shows the percentage of labeled cells versus time. Expected CLCs are calculated for cell populations with arbitrary frequency distributions of cycle durations. By optimizing the parameter values of a general probability function in the formula for CLC, frequency distributions of cycle durations are estimated from experimental CLCs. The analysis of several fetal rat tissues shows that the cycle durations vary over quite a wide range within the same tissue. PMID- 3982055 TI - The activation of the nicotinic acetylcholine receptor by the transmitter. AB - Experimental evidence has been published from isolated guinea pig muscle in vitro, and from direct ligand binding to receptors from T. californica, indicating that two agonist ions react with the nicotinic receptor by exchanging for one magnesium ion. It is the basis of the ion exchange receptor pair model, in which two acetylcholine ions exchange for one magnesium ion in contact with and between a pair of negatively charged receptor groups about 4 A apart. In the resting state the electrostatic attraction between the negatively charged receptor groups and the Mg2+ ion exerts a binding force. This binding force is opposed by the quantum mechanical repulsions of the electron clouds of the charged groups and ions in contact, together with the mutual repulsion of the pair of receptor oxyanions. When the Mg2+ ion is replaced by two acetylcholine ions the quaternary heads of the latter are positioned so that they form two mutually repelling ACh+ receptor group dipoles. As the Mg2+ ion leaves, its rehydration energy contributes to the sum of the electron cloud repulsions and the ACh+ receptor group dipole repulsions, causing the receptor groups to be forced apart activating the receptor macromolecule. The subsequent decrease in ACh+ concentration results in the reestablishment of the resting state. The coulombic electrostatic energy, the Born repulsion energy, the London attraction energy and the oxyanion ACh+ dipole repulsion energies have been calculated and shown to be consistent with the model. The displacement of the Mg2+ by two ACh+ ions makes several hundred kcals of energy available for receptor group separation and receptor activation. PMID- 3982056 TI - Valvotomy for pulmonary atresia with intact ventricular septum. A disciplined approach to achieve a functioning right ventricle. AB - During the past 20 years, a consistent policy in applying early valvotomy has resulted in a unique opportunity to appraise the long-term results of this approach in pulmonary atresia with intact ventricular septum. Since 1964, 27 of 35 patients with pulmonary atresia with intact ventricular septum had type 1 or 2 right ventricle, 25 of these had early valvotomy, seven with and 18 without concomitant shunt. The remaining two patients with type 2 right ventricle and the eight patients with type 3 right ventricle received a shunt alone. Overall operative mortality was 34%; for those patients weighing more than 3 kg and those operated upon since 1977, it was 18% and 16%, respectively. There were 17 survivors of early valvotomy: 11 had valvotomy alone and six had valvotomy with shunt; 12 had type 1 right ventricle and five had type 2 right ventricle. Survival rates (+/- standard error) for these 17 patients were 85% +/- 10% and 68% +/- 17% at 5 and 10 years, respectively. The probability of reoperation was 100% by 6 years of age; outflow patch reconstruction was employed in all patients in whom reoperation has been performed. Aggressive follow-up and early recatheterization were essential features of management. Delayed reconstruction after shunt alone was unsuccessful in three patients. Primary valvotomy without shunt is the operation of choice for patients with pulmonary atresia with intact ventricular septum and type 1 right ventricle. Concomitant shunt may be required for some patients with type 1 and most with type 2 right ventricle, selected preoperatively by angiography or after valvotomy by clinical necessity. Delayed right ventricular reconstruction after shunt alone is not an acceptable approach when an outflow tract is present. PMID- 3982057 TI - Mitral regurgitation due to ruptured chordae tendineae. Early and late results of valve repair. AB - From 1958 through 1980, 131 patients had repair of ruptured chordae tendineae of the mitral valve; 62% were men. Ages ranged from 5 to 70 years (median 57). Chordae to the anterior mitral leaflet were ruptured in 44 patients (34%), to the posterior mitral leaflet in 85 (65%), and to both leaflets in two patients (1%). The mitral valve was repaired by leaflet plication without resection in 116 patients, plication after wedge resection of the unsupported leaflet in six, Ivalon sponge buttress of the posterior leaflet in three, resuspension of chordae in two, and annuloplasty alone in the remaining four. Mitral valve annuloplasty was performed in addition to leaflet repair in 115 patients (88%). Operative (less than 30 days) mortality was 6.1%. Survival rate of patients dismissed from the hospital was 92% at 5 years and 73% at 10 years. There were no differences in late survival or risk of reoperation for recurrent or residual mitral insufficiency between patients with ruptured chordae to the anterior leaflet and those with ruptured chordae to the posterior leaflet. Survival was significantly better for the group with repair than it was for a group that underwent mitral valve replacement for ruptured chordae during this same time interval (5 year survival rate, 92% versus 72%, p less than 0.003). The incidence of thromboembolism after repair was 1.8 episodes/100 patient-years compared with 8.0 episodes/100 patient-years after replacement. Our data indicate that valvuloplasty is the procedure of choice for most patients with mitral regurgitation owing to ruptured chordae tendineae, including selected patients with ruptured chordae to the anterior leaflet. PMID- 3982058 TI - The porcine bioprosthetic valve. Twelve years later. AB - The porcine bioprosthetic heart valve has been commercially available since 1970 and has been the prosthetic heart valve of choice in our institution since 1971. Since that time 817 patients with 951 porcine valves have been discharged from the hospital and were available for long-term follow-up. Patient survival rates, with operative mortality excluded, were 80% +/- 1.7% (standard error) at 5 years and 68% +/- 2.7% at 10 years. Survival rates for patients with aortic valve prostheses were 78% +/- 2.8% at 5 years and 57% +/- 5.4% at 10 years; for patients with mitral valve prostheses, survival rates were 80% +/- 2.2% at 5 years and 69% +/- 3.2% at 10 years. Freedom from thromboembolism for aortic valves was 93% +/- 1.4% at 5 years and 88% +/- 2.6% at 10 years; for mitral valves the freedom from degeneration or primary tissue failure for aortic valves was 97% +/- 1.3% at 5 years and 71% +/- 7.6% at 10 years; for mitral valves these figures were 96% +/- 1.2% at 5 years and 71% +/- 4.1% at 10 years. Valves in patients 35 years of age and below had a significantly greater rate of degeneration (p less than 0.001). After 12 years' experience the porcine bioprosthetic valve has performed well with regard to patient survival and low rate of thromboembolism. For patients older than 35 years the freedom from primary tissue failure is 80% at 10 years. PMID- 3982059 TI - Intraoperative contrast two-dimensional echocardiography. Evaluation of the presence and severity of aortic and mitral regurgitation during cardiac operations. AB - We have used contrast two-dimensional echocardiography in the intraoperative evaluation of aortic and mitral regurgitation in 35 patients undergoing cardiac operations. All of them underwent previous cardiac catheterization in order to document the presence and severity of regurgitation. With the pericardium open, a catheter was introduced into the left ventricle (to document mitral regurgitation) or into the ascending aorta (to document aortic regurgitation). The two-dimensional echocardiographic probe was placed on the anterior surface of the right ventricle to obtain a basal image, equivalent to a conventional parasternal longitudinal view. Dextrose in water (5 ml) was rapidly hand-injected through the catheter, while echocardiograms were recorded on videotape. The observation of contrast medium (microbubbles) flowing in the retrograde direction through the incompetent valve was carefully evaluated with the same scoring system used in the hemodynamic laboratory. In 34 cases there was agreement between angiographic and echocardiographic evaluation of the presence and severity of mitral and aortic regurgitation. Only one case was evaluated as mild aortic regurgitation by angiography and moderate aortic regurgitation by echocardiography. There were no false positives or false negatives in the study. In view of the high degree of correlation between contrast two-dimensional echocardiography and hemodynamic data, we suggest that our method is an important tool for the cardiac surgeon. In addition, the present approach overcame the disadvantages of the conventional intraoperative methods, most of which are performed in a nonbeating or fibrillating heart. PMID- 3982060 TI - Intrathoracic extramedullary hematopoiesis simulating anterior mediastinal tumor. AB - Intrathoracic extramedullary hematopoiesis is a rare tumor occurring predominantly in the posterior mediastinum, most commonly in patients with congenital hemolytic anemias. The first reported case of this entity's occurring in the anterior mediastinum is described in a 68-year-old man with an incompletely characterized anemia. Definitive diagnosis was established only after median sternotomy and removal of the tumor. PMID- 3982061 TI - Effect of prethymectomy plasma exchange on postoperative respiratory function in myasthenia gravis. AB - The effect of prethymectomy plasma exchange on postoperative mechanical ventilation requirement and length of stay in the intensive care unit were studied retrospectively in 37 patients with myasthenia gravis. We found a significantly decreased time on mechanical ventilation (mean 1.02 +/- 0.40 versus 3.43 +/- 0.60 days) and a shorter stay in the intensive care unit (mean 3.09 +/- 0.99 versus 5.15 +/- 0.66 days) for 11 patients with respiratory weakness who were treated with preoperative plasma exchange compared with 26 patients who did not receive plasma exchange. Patients with respiratory weakness who received prethymectomy plasma exchange required less time on mechanical ventilation (mean 1.02 +/- 0.40 versus 2.73 +/- 0.88 days) and a shorter stay in the intensive care unit (mean 3.09 +/- 0.99 versus 4.46 +/- 1.08 days) than those patients without respiratory weakness who did not receive plasma exchange. Eleven patients met the criteria for plasma exchange but did not receive it. They required significantly more time on mechanical ventilation (mean 4.43 +/- 0.94 versus 1.02 +/- 0.40 days) and in the intensive care unit (mean 6.09 +/- 0.86 versus 3.09 +/- 0.99 days) than patients who received plasma exchange. Our results indicate that patients with severe forms of myasthenia gravis treated with prethymectomy plasma exchange require less mechanical ventilation and less time in the intensive care unit postoperatively. PMID- 3982063 TI - Repair of congenital pulmonary venous stenosis with living autologous atrial tissue. AB - Repair of localized bilateral congenital pulmonary venous stenosis with living autologous atrial tissue was accomplished in two patients, 3 and 4 months of age. The tip of the left atrial appendage was opened and used as an onlay patch to widen the stenotic area of the left pulmonary veins, leaving a double pathway for venous return. A flap of interatrial septum was evaginated through an incision in the right side of the left atrium and used as an onlay patch to widen the stenotic area of the right pulmonary veins. Effective relief of obstruction was demonstrated by nearly normal postrepair pulmonary artery pressure in each and early postoperative angiography in one. Although we believe this method of repair will increase the probability of a lasting result, further experience and subsequent late reevaluation are needed to demonstrate its long-term effectiveness. PMID- 3982062 TI - Tricuspid atresia. Morphology of the outlet chamber with special emphasis on surgical implications. AB - An anatomic study of 28 heart specimens with tricuspid atresia showed 15 hearts with ventriculoarterial concordance and a right-sided anterior outlet chamber. Of these 15 hearts, 12 showed evidence of restricted pulmonary blood flow. In eight of these 12 specimens, an anterior deviation of the outlet septum, relative to the primary septum, was present. This deviation caused a narrowing inside the outlet chamber and functioned as infundibular pulmonary stenosis. The outlet chambers of the 15 hearts with ventriculoarterial concordance were compared with those of 13 hearts with tricuspid atresia and ventriculoarterial discordance and also a right-sided anterior outlet chamber. In the latter group of 13 hearts, five showed evidence of restricted pulmonary blood flow, at least partially caused by posterior deviation of the outlet septum relative to the primary septum. A clear difference in outlet chamber morphology was found without exception between specimens with and without ventriculoarterial concordance. Clinical data in three long-term survivors of the Fontan procedure demonstrate that the special morphology of the outlet chamber can pose surgical problems. Especially in patients with ventriculoarterial concordance, when the outlet chamber is incorporated into the pulmonary circuit, the surgeon must give special attention to the specific morphology to prevent undesirable sequelae. PMID- 3982064 TI - Left ventricular wall stress and thickness in complete transposition of the great arteries. Implications for surgical intervention. AB - The effects of volume and pressure loading of the left ventricle on posterior wall thickness and left ventricular wall stress in transposition of the great arteries were studied by combining echocardiographic and cardiac catheterization data. Pure volume loading with low left ventricular pressure resulted in little or no thickening of the left ventricular posterior wall (0.52 mm/log month). Pressure loading to levels above half of the right ventricular pressure was associated with thickening (2.80 to 3.89 mm/log month); however, further increase in pressure or volume load did not significantly alter the rate of thickening. Estimates of ventricular wall stress using a simple radius/wall thickness ratio may be misleading. However, if allowance is made for variable ventricular geometry and pressure, estimated wall stress is constant in transposition and is approximately equal to that reported previously in patients with normally related great arteries. The walls of low-pressure left ventricles in patients with transposition are demonstrably thinner than those of high-pressure left ventricles by age 1 to 3 months (2.67 versus 3.52 mm). Surgical procedures to use the left ventricle for systemic work, such as the arterial switch operation, should be performed in the first month of extrauterine life. Preparatory operations, if necessary prior to arterial switch, should load the left ventricle to greater than half systemic pressure. PMID- 3982065 TI - Early and late results after resection and end-to-end anastomosis of coarctation of the thoracic aorta in early infancy. AB - Over a 9 year period, 55 infants underwent resection and end-to-end anastomosis for symptomatic coarctation of the thoracic aorta during their first 120 days of life (mean age 47 days; mean weight 3.7 kg). Forty-two had preductal coarctation and 13, postductal. Additional cardiac lesions were found in 48 patients. Ventricular septal defect, either isolated or associated with other malformations, was the most frequent finding (37 patients). Simultaneous banding of the pulmonary artery was performed in 14 infants because of nonrestrictive ventricular septal defects. The hospital mortality was 3.6% (two patients). There were no late deaths. All survivors have been reinvestigated, and 27 have been recatheterized. In the group as a whole, after an average follow-up of 4.5 years, the mean pressure gradient (arm/leg) was 7 mm Hg (range 0 to 45 mm Hg). In the recatheterized infants, the average systolic pressure gradient at the anastomotic site was 16 mm Hg (range 2 to 62 mm Hg), whereas the mean pressure gradient in this group was 7 mm Hg (range 0 to 33); only three of them had systolic pressure gradients of more than 20 mm Hg. One reoperation is scheduled. Our data suggest, that resection and end-to-end anastomosis for symptomatic coarctation in the first 3 months of life can be performed with very low operative mortality and excellent long-term results. PMID- 3982067 TI - Mitral valve replacement in idiopathic hypereosinophilic syndrome. AB - Idiopathic hypereosinophilic syndrome is a rare systemic disease that can cause one form of endocardial fibrosis. Endocardial fibrous tissue with overlying thrombus formation in idiopathic hypereosinophilic syndrome leads to a restrictive cardiomyopathy that may produce mitral and/or tricuspid regurgitation. This report describes a patient with idiopathic hypereosinophilic syndrome who underwent mitral valve replacement and successful steroid therapy for an usually localized form of endocardial fibrosis. PMID- 3982066 TI - Use of sufficient hemodilution to prevent coagulopathies following surgical correction of cyanotic heart disease. AB - During surgical correction of cyanotic heart disease with associated polycythemia, sufficient reduction of hemoglobin and hematocrit values has proved effective in preventing postoperative coagulopathies. Three groups of surgical patients were studied: Group I--a control group consisting of 75 adults undergoing uncomplicated correction of acquired heart disease and requiring no blood or blood component transfusion; Group II--15 patients with tetralogy of Fallot whose intraoperative hemoglobin values remained above 10 gm/dl with conventional hemodilution techniques; and Group III--21 cyanotic surgical patients whose intraoperative hemoglobin values were lowered to less than 10 gm/dl with sufficient hemodilution. Group III was further broken down into a subgroup of six patients (Group IIIa) who underwent sequential laboratory determinations, as in Group I. In Group IIIa, postoperative coagulation function tests were only slightly more abnormal than in the nonpolycythemic control group (Group I). Patients in Group III (who had ample hemodilution) experienced 45% less bleeding and required 54% fewer blood components than those in Group II (who underwent conventional hemodilution). PMID- 3982068 TI - Secondary left atrioventricular valve replacement in atrioventricular septal (AV canal) defect: a method to avoid left ventricular outflow tract obstruction. AB - Patients with atrioventricular septal defects are morphologically predisposed to subaortic obstruction. Some individuals require secondary left atrioventricular valve replacement for severe incompetence persisting after repair, and they are especially susceptible to left ventricular outflow tract obstruction. A surgical technique is described for replacement of the atrioventricular valve which seems to avoid the complication of left ventricular outflow tract obstruction by the prosthesis. PMID- 3982069 TI - Hemothorax associated with endometriosis. AB - Fifteen cases have been reported of pleural effusion associated with endometriosis. Common characteristics that may aid in the diagnosis are discussed and an additional case is presented. PMID- 3982070 TI - Subclavian flap repair of coarctation. PMID- 3982071 TI - Catecholamine effects during and after cardiopulmonary bypass. PMID- 3982072 TI - A chronically implantable arterial catheter for use in unrestrained small animals. AB - An easily constructed arterial catheter was designed for use in experiments requiring serial blood sampling from conscious, free-moving animals (Fischer 344 rat). It can be implanted chronically, at least several days before use, into the femoral artery, without interference of movement or damage by the animal. The catheter assembly is worn subdermally until the distal portion is exteriorized for blood sampling. The proximal tip of the catheter is occluded with a removable plug before implantation, thereby eliminating the necessity of daily flushing prior to use. The catheter has been used extensively in studies of the blood brain barrier involving the bolus injection of [14C]sucrose into the jugular vein of conscious, unrestrained rats. Tracer concentration in plasma and whole blood was subsequently determined from arterial blood samples collected serially over a 20-min period following injection of the tracer. PMID- 3982073 TI - A sensitive and specific radioenzymatic assay for the simultaneous determination of choline and phosphatidylcholine. AB - A radioenzymatic procedure for the simultaneous measurement of picomol quantities of phosphatidylcholine and choline is described. Phospholipase-D from Streptomyces chromofuscus hydrolyzes phosphatidylcholine to choline and phosphatidic acid. Choline kinase in the presence of [32P]ATP phosphorylates the choline to form [32P]phosphorylcholine. The phosphorylcholine, isolated by ion exchange chromatography, is measured by scintillation spectroscopy. Using a chloroform: methanol separation, phosphatidylcholine and choline can be measured from the same sample. Different sources of phospholipase-D were compared for their ability to hydrolyze phosphatidylcholine to choline and phosphatidic acid. Phospholipase-D from Streptomyces chromofuscus was found to result in almost complete hydrolysis. As a measure of specificity, lysophosphatidylcholine and sphingomyelin were assayed using this method and were found to result in, at most, only 2% of the amount of phosphorylcholine produced compared to phosphatidylcholine. This procedure allows for the simultaneous measurement of choline and phosphatidylcholine in brain and serum samples with a very high degree of sensitivity and specificity. PMID- 3982074 TI - A new transorbital surgical approach to the rabbit's optic nerve. AB - This work describes a surgical approach which establishes the rabbit's visual system as an experimental model for studying CNS regeneration. Using this model, the optic nerve, its cell bodies, and the axons, are easily accessible through an orbital approach, without the need for craniotomy and brain retraction. This surgical approach allows transplantation and 'wrap around' implantations of nerve segments from xenogeneic and syngeneic systems and diffusible substances derived from them, respectively. Furthermore, it enables studies aimed at determining deficiencies in mammalian CNS and investigating methods of augmentating mammalian CNS regeneration. PMID- 3982075 TI - Results, complications, and follow-up of 415 bypass operations for occlusive disease of the carotid system. AB - Selected patients with acute or continuing ischemic symptoms from occlusions or inaccessible stenotic lesions of the internal carotid artery or middle cerebral artery have been considered candidates for a carotid artery-middle cerebral artery bypass procedure at our institution since July 1974. We report herein an 8 year experience through June 1982 with 415 operations in 403 patients in whom a branch of the superficial temporal artery was anastomosed to a branch of the middle cerebral artery. Patients selected for operation usually had had more than one form of ischemic symptom. The primary indication for operation was transient ischemic attacks, and the most common vascular pathologic condition was internal carotid artery occlusion. Preoperatively, 183 patients were taking antiplatelet agents and 157 were taking anticoagulants. Neurologic function 6 months postoperatively was equal to or better than the function preoperatively in 95% of survivors. The bypass pedicle was patent in 99% of patients studied. The mortality and morbidity associated with the surgical procedure varied on the basis of the patient's preoperative neurologic condition but were 1% and 4%, respectively, for the entire group at 30 days postoperatively. Of the 54 deaths during the entire follow-up period, 27 were cardiogenic and 6 were from ischemic stroke. On the basis of patient-months of follow-up, stroke was 8 times more likely to occur within 6 months after operation than thereafter. PMID- 3982077 TI - Surgical pathology of combined aortic stenosis and insufficiency: a study of 213 cases. AB - The gross surgical pathologic features of the aortic valve were reviewed in 213 patients who had had clinically combined aortic stenosis and insufficiency and aortic valve replacement at our institution during the years 1965, 1970, 1975, and 1980. The three most common causes were postinflammatory disease (69%) and calcification of congenitally bicuspid (19%) and unicommissural (6%) aortic valves. Other causes included infective endocarditis (2%) and congenitally quadricuspid or malformed tricuspid aortic valves (1% each); the cause was indeterminate in 1%. In the postinflammatory and bicuspid states, calcification tended to be more extensive in men than in women. The relative incidence of postinflammatory disease in our study did not change appreciably from 1965 to 1980, despite the steadily decreasing incidence of acute rheumatic fever reported in western countries. PMID- 3982076 TI - Long-term mortality and stroke morbidity after superficial temporal artery-middle cerebral artery bypass operation. AB - Among 239 patients with transient ischemic attacks, mild stroke, or transient monocular visual symptoms who had superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass, no deaths occurred during the operation or within 30 days thereafter. After the first month, mortality on an actuarial basis was 3% per year. Survival at 5 years was 84% in comparison with an expected survival of 89% for persons of comparable age and sex in a general population. Among the 25 deaths that occurred during follow-up, 2 were due to stroke and 16 to cardiac causes. Of 28 strokes that occurred, 5 occurred during operation or that same day, and 3 others occurred within 30 days postoperatively. Thereafter, strokes occurred at the rate of 2.5% per year on an actuarial basis; a third of the strokes occurred contralateral to the surgical site. No difference was found in survival or in survival free of stroke among patients who had proven carotid artery occlusion (N = 157), carotid siphon stenosis (N = 53), or MCA stenosis or occlusion (N = 29). In regard to the probability of stroke, this group of patients compares favorably with population studies of patients with transient ischemic attacks of undetermined cause. When this surgical group was compared with 130 nonsurgical patients who had had ischemic symptoms related to proven internal carotid artery occlusion between 1965 and 1975, however, we could not conclude that the risk of occurrence of stroke was less in patients who had STA MCA bypass than in the nonsurgical patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982078 TI - The artificial urinary sphincter: experience with the AS 800 pump-control assembly for single-stage primary deactivation and activation--a preliminary report. AB - The introduction of a new pump-control assembly mechanism for the artificial urinary sphincter has eliminated the need for two-stage surgical procedures in patients with urinary incontinence and has provided the option of deactivation or activation both at the time of implantation and at a later time, in accordance with the clinical judgment of the surgeon. Individualization of treatment on the basis of the patient's clinical condition is a considerable advance in the management of urinary incontinence because it allows broader applications in the use of the artificial sphincter. PMID- 3982079 TI - Survival in adult respiratory distress syndrome caused by blastomycosis infection. AB - A 32-year-old man with diabetes had rapid development of acute respiratory failure and severe hypoxemia. Radiologic and hemodynamic evaluation confirmed the clinical diagnosis of adult respiratory distress syndrome, and open-lung biopsy disclosed blastomycosis as the etiologic agent. The survival of this patient, after amphotericin therapy, to our knowledge is the first reported recovery from substantiated adult respiratory distress syndrome secondary to blastomycosis. PMID- 3982080 TI - Amplification of extrachromosomal small circular DNAs in a murine model of accelerated senescence. A brief note. AB - Extrachromosomal circular DNA complexes from peripheral blood lymphocytes from inbred mice of accelerated senescence, were detected by mica-press-adsorption method. In senescence-resistant series (SAM-R), polydisperse circular DNAs were observed at 7 weeks of age and a restricted size class of small circular forms of 0.4-0.8 microns in contour length was amplified several-fold at 26 months of age. In senescence-prone series (SAM-P), a similar amplification of small circular DNAs was observed at young age of 10 weeks and more progressive at 17 months of age. PMID- 3982081 TI - Alteration of enzymes in ageing human fibroblasts in culture. III. Modification of superoxide dismutase as an environmental and reversible process. AB - The alteration of superoxide dismutase (SOD) defined as the change occurring in its thermostability and observed in ageing cells, concerned the cytoplasmic but not the mitochondrial enzymes. Altered SOD disappeared if it was incubated in a supernatant from the young cells whereas supernatants from the old cells induced the alteration. The alteration induced on purified SOD was found to be associated with the appearance of thermolabile tetramers. Cytoplasmic SOD tetramers were also observed in the supernatants of the old cells. The addition of NADPH into the incubation medium could reverse this alteration; also when cultivated in the presence of vincamine the alteration, normally present in the old cells, disappears. The alteration of SOD is therefore associated with the formation of tetramers; it is a reversible process influenced by the cytoplasmic composition of the old cells. PMID- 3982082 TI - Studies on catalase, glutathione peroxidase and superoxidismutase activities in aging cells of Paramecium tetraurelia. AB - The nature of the aging process has been the subject of considerable speculation. Now, some data indicate that free radical reactions going on continuously in the cells contribute to aging. Considering these data, we have investigated the activity of enzymes (catalase, glutathione peroxidase, superoxidismutase) present physiologically in the cell to limit to tolerable levels, the rate of free radicals or H2O2. These enzymes activities were assayed in Paramecium tetraurelia as clonal age increased. Catalase activity increases slightly during aging of paramecia, i.e. during maturity and senescence phases (20-150 fissions). No significant changes in glutathione peroxidase and superoxidismutase is found. Catalase activity was also assayed as a function of culture conditions. As the cells begin starving and the percentage of autogamous cells increases, catalase activity decreases. After autogamy, a large increase of catalase activity occurs during the sexual immaturity phase, i.e. during the first 20 fissions. By another way, H2O2 added in the culture medium (from 0 to 15 X 10(-5)M) causes an important increase of catalase activity (from 100 U.I. to 250 U.I.). The possible role of O-.2, OH. and H2O2 in aging is discussed. PMID- 3982083 TI - Age-related changes in the redox status of rat muscle cells and their role in enzyme-aging. AB - The redox status of three biological components capable of undergoing oxidation reduction reactions, glutathione, NAD and NADP, were determined in muscle tissues of young and old rats. A considerable increase in the relative concentration of the oxidized form, at the expense of the reduced one was found in the old tissue reflecting a significantly less reducing environment than in young cells. The effects of varying the ratio of reduced/oxidized glutathione in vitro on the activity of the enzyme glyceraldehyde-3-phosphate dehydrogenase extracted from young and old animals were compared. It was found that concentrations of GSSG as found in old muscle tissue do not affect enzyme samples extracted from young muscle. The accumulation of oxidized glutathione observed in old cells does not, therefore, directly cause the age-related activity loss of this enzyme. PMID- 3982084 TI - Glutathione peroxidase and reductase activities in the aging mouse. AB - Previous results from this laboratory demonstrated that glutathione concentrations decrease in aging mouse tissues. In this investigation glutathione (GSH) peroxidase and glutathione (GSSG) reductase activities were measured in tissues of standardized aging mice. Methods were validated for the quantitative determination of both enzymes in liver, kidney and heart tissues. GSH peroxidase activities were 27-53% lower in liver, kidney and heart of very old (36 months) mice compared to mature (10 months) mice (P less than 0.01). The same aging decreases were found with either hydrogen peroxide or cumene hydroperoxide as substrate. In a similar way GSSG reductase activities in liver and kidney were 25 28% lower in the old versus mature mice (P less than 0.01), but heart levels were unchanged. Further the lower GSSG reductase levels were unaffected by FAD supplementation in vitro. The changes in specific activity for both enzymes were not due to changes in organ weights and total protein contents, which were constant from 10 to 36 months of age. These decreases in GSH peroxidase and GSSG reductase do not account for the lower GSH levels in aging. Of special importance, however, is that these decreases indicate that detoxification via glutathione peroxidase and glutathione reductase could be impaired in senescence. PMID- 3982085 TI - Increasing skeletal involution in the elderly? AB - Studies of bone mineral content (MC) of the limbs in normal populations have shown there is an increase of MC during adolescence, a maximum MC for both sexes between 30 and 40 years of age and a subsequent decrease which is at least twice as great in females than in males. There are different findings in the literature on the course of these MC changes with aging. The present cross-sectional study of 180 subjects over age 70 showed a slight increase in the annual decrease of radius MC in females and a distinct acceleration of the MC decrease in males after about 80 years. This occurred for both a pure cortical measuring site of the radius (1/3-site) and for a mixed cancellous/compact site of the distal radius (1/10-site). These findings differ from those in other populations. PMID- 3982086 TI - Appearance of extrachromosomal circular DNAs during in vivo and in vitro ageing of mammalian cells. AB - Appearance of extrachromosomal circular DNAs with in vivo and in vitro cellular ageing was examined by using a new technique of mica-press-adsorption for electron microscopy. The size distribution and the copy number of circular DNA complexes varied, depending on the cellular age. Extrachromosomal circular DNA complexes of variable length of more than 0.5 microns or 1.5 kilobase (kb) appeared during in vivo ageing of rat lymphocytes and in vitro ageing of cultured human lung fibroblasts. A restricted size class of circular forms of less than 0.5 microns in contour length was amplified in human skin fibroblasts from aged normal or Werner's syndrome subjects. These circular DNA molecules are suggested to be products of DNA rearrangements or gene amplification occurring in the chromosome. PMID- 3982087 TI - Age dependent phagocytosis of red cell membranes by the reticulohistiocytary system of the isolated perfused rat liver. AB - Isolated rat livers were perfused with a medium free of immune globulins, protein and hemoglobin to investigate age-dependent differences in the phagocytosis of erythrocyte membranes. Membranes of young erythrocytes were phagocyted significantly more than those of old ones. The control parameters of the liver function also were significantly higher during the increased phagocytosis of the young cells than for the old cells and the control group. In the aged animals the characteristic of the elimination curve is changing. The old livers eliminated less ghosts than the young ones. These results are significant. PMID- 3982088 TI - Quantitative weightbearing and gait evaluation of paraplegics using functional electrical stimulation. PMID- 3982089 TI - Assessment and optimisation of dip-coating procedure for the preparation of electroenzymic glucose transducers. PMID- 3982090 TI - Electrode studies for the long-term ambulatory ECG. PMID- 3982091 TI - Fundamental criteria underlying the efficacy and safety of defibrillating current waveforms. PMID- 3982092 TI - Tissue stimulation: theoretical considerations and practical applications. PMID- 3982093 TI - Spectrum of a series of point events, generated by the integral pulse frequency modulation model. PMID- 3982094 TI - Computerised method for pattern recognition of intestinal motility: functional significance of the spread of contractions. PMID- 3982095 TI - Impulse propagation in rubber-tube analogues of arterial stenoses and aneurysms. PMID- 3982096 TI - Contribution of different sized vessels in the extremities to the arterial pulse waveform as recorded by electrical impedance and volume plethysmography. PMID- 3982098 TI - Reappraisal of methods in clinical length measurements: the potential of current technology. PMID- 3982097 TI - Apparatus for measuring relative cell diameter. PMID- 3982099 TI - Multichannel automatic foetal movement monitoring and classification system. PMID- 3982100 TI - Calculation and display of the rate/pressure product during anaesthesia using binary rate multipliers. PMID- 3982101 TI - Assessment of algorithms used to compute the fast Fourier transform of left ventricular pressure on a microcomputer. PMID- 3982102 TI - The Craggs connector: a termination for Cooper cable. PMID- 3982103 TI - The use of negative indexes of health to evaluate quality of care in a primary care group practice. AB - A quality assessment method using negative indexes of health as a measure of the quality of medical care was applied in a hospital-based primary-care group practice. During a 5-year period, records of 1,147 patients were analyzed. The study led to several observations regarding the use of this method in this setting: 1) The negative indexes of health method encourages physicians to include both primary and secondary preventive measures in their practice of medicine and to see their role as a broad one, from providing good care to individual patients to influencing public policy. 2) Most medical records do not now contain all the data required for use of this method. 3) In cases where this method identifies only a few instances of possibly preventable disease or untimely death, it is impossible to know whether the care is good and the method of evaluation is sensitive, or whether the care is poor and the method is insensitive to deficiencies in care. PMID- 3982105 TI - Elderly nonusers of health care services. Their characteristics and their health outcomes. AB - Sociodemographic, health, and health care utilization data on a large representative sample of elderly and multiple logistic regression were used to compare persons making no visits to physicians for 2 years with those making few (one to three) visits but in contact with health practitioners. Results suggest that elderly nonusers are more likely than low users to be single, to have some degree of mental impairment, and to have low educational attainment. Using Cox's proportional hazards model to compare outcomes over the next 7 years, no differences were found in the subsequent hospitalization rate of the two groups, but nonusers were at greater risk of a hospitalization episode of 16+ days and appeared to die sooner than low users. However, they were at no greater risk of poor health outcomes than elderly making four or more physician visits in 2 years. The policy implications of the findings are discussed. PMID- 3982104 TI - Determinants of physician utilization among Mexican-Americans. A three generations study. AB - Determinants of physician utilization were examined using a three-generational sample of Mexican-Americans in San Antonio. A typical version of Andersen's causal behavioral model was moderately successful in predicting physician utilization in the middle and older generations and less successful in the younger generation. Consistent with the literature, need factors (health indicators) tended to affect utilization most directly. The authors also examined whether acculturation into the larger society positively influenced utilization regardless of need, as the literature suggested. While three separate measures of acculturation had no independent effects on physician utilization, acculturation did affect utilization indirectly via the need variables in the middle generation, although these effects were not consistently in the direction of greater utilization. Generational differences in determinants of physician utilization are discussed particularly in relation to the model's greater relevance for the middle and older generations. PMID- 3982106 TI - Factors that predict psychiatric consultation in the emergency department. AB - The purpose of the study was to determine the basis for nonpsychiatrists' decisions to obtain psychiatric consultations in an emergency department (ED) for patients with transient to moderate psychiatric symptoms. The authors reviewed ED records during July-August 1982 and January-March 1983. Complete data were gathered for 133 of 134 patients with primary or secondary psychiatric discharge diagnoses and scores on the Global Assessment Scale (GAS) such that most clinicians would not think immediate consultation was required. Information included five sociodemographic variables, psychiatric history, GAS scores, type of interaction with staff, and specificity of medical complaints. Interrater reliability of GAS coding was 81%. A total of 50% of the patients received psychiatric consultations in the ED. Both psychiatric history and GAS scores were associated with consultations (P less than 0.001 for both). Using stepwise logistic regression, psychiatric history was more important in predicting consultation (SRR = 3.0, P = 0.001) than was GAS score, which did not enter the model as a significant predictor. Social characteristics also distinguished between patients who received a psychiatric consultation in the ED and patients who did not. It was concluded that nonpsychiatrists base important management decisions on a history of psychiatric treatment for patients with transient to moderate symptoms. Whether this is appropriate needs to be studied. PMID- 3982107 TI - Chronic disease and health system performance. Care of osteoarthritis across three health services. AB - Care of patients with osteoarthritis is compared for three different types of health service: fee-for-service, prepayment (Kaiser Health Plan), and an experimental service (Midpeninsula Health Service--MHS). While charging fees-for service, MHS modifies medical practice in defined ways and seeks to involve patients through supervised self-care. Volunteer panels of patients provide the data at 6-month intervals through self-administered questionnaires. This report covers the first 18 months. Health status has not changed. Annualized utilization data, adjusted for age, income, education, pain, disability, disease duration, and prescription drug use, indicate that MHS members have fewer physician visits, fewer diagnostic tests, and lower antiinflammatory drug use than the other two services. MHS members express satisfaction equal to or greater than other participants. The results suggest that, in addition to modified financial incentives, there is another strategy that is relevant to achieving effective, efficient, and satisfying health care. PMID- 3982108 TI - [Changes in high-density lipoproteins during the acute phase of acute myocardial infarction]. PMID- 3982109 TI - [Pathology of the newborn infant of the diabetic mother: its relation to the degree of metabolic control during pregnancy]. PMID- 3982111 TI - [Will I survive the operation, doctor?]. PMID- 3982110 TI - [Veno-occlusive disease of liver]. PMID- 3982112 TI - [Veno-occlusive disease associated with disseminated lupus erythematosus. Description of a case]. PMID- 3982113 TI - [Type J diabetes: apropos of a case]. PMID- 3982114 TI - [Drug fever caused by spiramycin]. PMID- 3982115 TI - [Haemophilus parainfluenzae endocarditis]. PMID- 3982116 TI - [Mediterranean boutonneuse fever. Observations on 23 cases]. PMID- 3982117 TI - [Anemia and primary amyloidosis]. PMID- 3982118 TI - [Vertebro-jugular arteriovenous fistula: an unrecognized complication of jugular catheterization]. PMID- 3982119 TI - [Acute non-lymphoblastic leukosis as a second neoplasm in Hodgkin's disease]. PMID- 3982120 TI - [Immediate effects of nifedipine and oxygen in acute episodes of chronic cor pulmonale]. PMID- 3982121 TI - [Arteriosclerotic risk factors in transient ischemic attacks, reversible ischemic attacks and infarctions with minimum residual effects]. PMID- 3982122 TI - [Uniform standards for original articles sent to biomedical journals. The International Committee of Editors of Medical Journals]. PMID- 3982123 TI - [Style and ethics. The new edition of the standards of the International Committee of Editors of Medical Journals]. PMID- 3982124 TI - [Transient acquired hypogammaglobulinemia following infectious mononucleosis]. PMID- 3982125 TI - [Diffuse cellulitis and Clostridium septicum septicemia in a non-cancer patient]. PMID- 3982126 TI - [Pneumococcal peritonitis in the nephrotic syndrome]. PMID- 3982127 TI - [Side effects and undesirable effects]. PMID- 3982128 TI - [Sacral epidural abscess of probable typhoid etiology]. PMID- 3982129 TI - [Treatment of Sweet's syndrome using potassium iodate]. PMID- 3982130 TI - [Acromegaly: clinical medicine and treatment in 15 cases]. PMID- 3982131 TI - [Prevalence and clinical aspects of cardiovascular vegetative neuropathy in a diabetic population]. PMID- 3982132 TI - [Treatment of acromegaly]. PMID- 3982133 TI - [Pulmonary ventilation: to will or to be able]. PMID- 3982134 TI - [Ondine's syndrome: presentation of a case associated with paralysis of the right hemidiaphragm]. PMID- 3982135 TI - [Delayed obliterative vasculopathy without interstitial fibrosis in toxic oil syndrome]. PMID- 3982136 TI - [Bases for the use of the Doppler effect in cardiology]. PMID- 3982137 TI - [Hyperlipoproteinemia type IIa with known cholesterol values]. PMID- 3982138 TI - [Intestinal angiodysplasia associated with an aortic stenosis]. PMID- 3982139 TI - [Legionnaires' disease in Alava]. PMID- 3982140 TI - [Superior vena cava syndrome: an infrequent complication of acute aortic dissection]. PMID- 3982141 TI - [Cause, facilitation or accident: Haemophilus and Streptococcus viridans polymicrobial endocarditis]. PMID- 3982142 TI - [Evaluation of fine-needle aspiration puncture in the diagnosis of thyroid nodules]. PMID- 3982143 TI - [Effect of age, physical exercise and previous coronariopathy on total cholesterol and its lipoprotein fractions in several groups of the Galician population]. PMID- 3982144 TI - [Analysis of geographic differences in mortality in Spain]. PMID- 3982146 TI - [The concept of 'author']. PMID- 3982145 TI - [Acromegaly and thyroid function]. PMID- 3982148 TI - [131I: the definitive treatment of choice in diffuse toxic goiter]. PMID- 3982147 TI - [McCune-Albright syndrome associated with hyperthyroidism]. PMID- 3982149 TI - [Association between hyperparathyroidism secondary to chronic renal insufficiency and papillary carcinoma of the thyroid]. PMID- 3982150 TI - [Puerperal endometritis, sepsis and meningitis caused by Streptococcus pneumoniae]. PMID- 3982151 TI - [Eosinophilic parapneumonic effusion]. PMID- 3982152 TI - [Amyloidosis: clinical and biological aspects of 60 cases]. PMID- 3982154 TI - [The vicious habit of using barbarisms]. PMID- 3982153 TI - [Use of the potassium permanganate technique in the differential diagnosis of amyloidoses]. PMID- 3982155 TI - [Autoimmune hemolytic anemia associated with Hodgkin's disease: apropos of 2 cases]. PMID- 3982156 TI - [Urinoma caused by the spontaneous outpouring of an excluded aorto-iliac aneurysm into a ureter]. PMID- 3982157 TI - [Idiopathic pulmonary hemosiderosis in an adult]. PMID- 3982159 TI - [Ethyl chloride sniffing--a rare form of abuse with severe mental and neurologic symptoms]. PMID- 3982158 TI - [Cardiac insufficiency as the initial clinical finding in Paget's disease]. PMID- 3982160 TI - [Remote symptoms of organic tuberculosis make the diagnosis difficult]. PMID- 3982161 TI - [Autoimmune hemolytic anemia as an unusual complication of sarcoidosis]. PMID- 3982162 TI - [Fecal incontinence--a review. Simple measures can give good therapeutic results]. PMID- 3982164 TI - [Breast feeding--the leading contraceptive in the world]. PMID- 3982163 TI - [A new prognostic instrument. Histopathological multi-factor analysis of invasive squamous cell carcinoma of the cervix uteri]. PMID- 3982165 TI - [Adopted children and hepatitis B infection]. PMID- 3982166 TI - [Disturbed energy metabolism and intracellular acidosis are important for the pathogenesis of cystic fibrosis]. PMID- 3982167 TI - [Malnutrition in the hospital: the physician should increase his interest for patients' nutritive condition and food habits]. PMID- 3982168 TI - [To eat right--a basis for children's' development and health]. PMID- 3982169 TI - [Theophylline in mixture form in the treatment of children with obstructive respiratory disorders]. PMID- 3982170 TI - [Data display screen operators during pregnancy--no conclusive evidence for damage to fetus]. PMID- 3982172 TI - [Breast cancer screening in Gavleborgs County--method, organization, economy]. PMID- 3982171 TI - [Akathisia as an adverse effect in the treatment with antiemetics]. PMID- 3982173 TI - [The computerized radiologic department--an imminent possibility?]. PMID- 3982174 TI - [Mucous membrane changes in the anterior ethmoid bone in chronic sinusitis and mycoses of the paranasal sinuses. An endoscopy, light and electron microscopy study. 1. Endoscopy and light microscopy findings]. PMID- 3982175 TI - [Mucous membrane changes in the anterior ethmoid bone in chronic sinusitis and mycoses of the paranasal sinuses. An endoscopy, light and electron microscopy study. 2. Electron microscopy findings]. AB - In the second part of this paper the findings of electron microscopical studies on ultrastructural changes of the cilia of the ethmoidal mucous membrane in patients with mycotic chronic sinusitis are presented. Many pathological variations of the normal 9 + 2 pattern can be demonstrated, along with compound cilia and central axis deviation beyond 25 degrees. This together with the endoscopical and lightmicroscopical findings results in conditions which are different from those in acute sinusitis. It may as well explain, why hardly a conservative therapy--aiming mostly for vasoconstriction and decrease of mucosal edema--is successful in chronic sinusitis. Endoscopical surgery of the diseased anterior ethmoid in most of the cases brings along cure of the dependent frontal and maxillary sinuses as well. PMID- 3982176 TI - [Decompression of the optic nerve]. AB - A case of a traumatic opticus lesion with frontobasal and temporal fracture was operated within the first two hours following the trauma. The vision was completely restituted. Interesting was the change of the pupil during the operation so that the amaurotic wide pupil was getting narrow similar to the uninjured one. In accordance with the further improvement, this observation was qualified as a sign of restitution. This case was selected from a series of 17 opticus decompressions. PMID- 3982177 TI - [Etiology and pathogenesis of sudden deafness]. AB - 163 patients suffering from sudden hearing loss were examined with regard to their cardiovascular risk factors (hypertension, hyperlipaemia, cigarette smoking, hyperglycaemia, hyperuricaemia and obesity). Patients with sudden hearing loss had significantly more vascular risk factors than a healthy control group. Significantly more risk factors were also seen in patients where the hearing loss could not be influenced by therapy. We consider this an indication for the importance of vascular risk factors in the genesis of sudden hearing loss, especially in cases with infaust prognosis. PMID- 3982178 TI - [Origin of acquired middle ear cholesteatoma]. AB - The acquired cholesteatoma of the middle ear develops from shifted ectodermal epithelium. The transposition takes place in a typical way by ingrowth from canal wall or tympanic membrane lining similar to wound healing. A precondition is a perforative chronic otitis media. In our terminology, an atypical shift of epithelium is a retraction pocket over poorly aerated parts of the tympanum. The matrix, activated by supporting connective tissue, follows the same tissue kinetic principles as the epidermis. In case of cholesteatoma we have a discrepancy of vertical (keratinisation) and horizontal (migration) regeneration, creating a keratin-cystlike structure. The cells of Langerhans, which control epidermal growth and type of keratinisation, seem to play an important role. Their density is low in stressregions of the epidermis and in the active matrix of the cholesteatoma. PMID- 3982179 TI - [Statistical study of gaze displacement calibration]. AB - The value of quantitative nystagmus analyses depends strongly on the accuracy of the calibration of gaze displacements. Therefore, 120 nystagmograms with one or two controls of the first calibrations (total: 300 calibrations) were evaluated to get a view over the characteristic properties, mainly the variations, of the calibration factors. Systematic and stochastic deviations were taken into account as potential sources of errors. These are mainly ascribed to variations of the corneo-retinal potential and inaccurate visual angles, e.g. as a result of head movements. Statistic evaluation shows no time-dependent variations of the mean and of the standard deviation of the calibration factors. For successive calibrations, relative differences (e2-e1)/e1 were additionally computed. These too, proved to be time-independent, yielding a mean and standard deviation of 2,37 +/- 16,4 %. It can be shown that in 76% of the nystagmograms positive differences are followed by negative ones, and vice versa. In 19% only positive differences and merely in 5% only negative differences were found. It is concluded, therefore, that stochastic variations predominate over the systematic ones. This means that changes in potential are by far of less consequence than patient-induced errors. PMID- 3982180 TI - [Local therapy of rhinopathies with topically active glucocorticosteroid aerosols. Review]. AB - The topical application of recently developed steroid aerosols is of great advantage in the treatment of rhinopathies. The modern steroid aerosols are inactivated after the first passage in the liver, following resorption by the respiratory or gastrointestinal mucosa. The desired therapeutic effect is therefore, restricted to the mucous membrane, and the well-known undesirable general side effects of the steroid hormone are avoided. The main indications for nasal application of steroid aerosols are allergic and non-allergic vasomotor rhinopathies and polyposis nasi. The basic requirement for a good therapeutic effect is tue proper application; therefore, satisfactory nasal ventilation and precise instruction and handling of the applicator are mandatory. The basic biochemical mechanisms of the glucocorticosteroid effects in relation to rhinopathies are given in a survey. PMID- 3982181 TI - Issues in early identification of hearing loss. AB - In a general hospital, an early detection research program based on a high risk register and brain stem electric response audiometry (BERA) using click and frequency-specific stimuli identified 631 at-risk neonates from the well baby nursery and the neonatal intensive care nursery (ICN). BERA tests were done before discharge and four months later; comparison of outcomes revealed substantial discrepancies. From the follow-up test, 51 cases of mild to severe hearing loss were identified. Experience from the research program has raised some issues relevant for establishment of service programs. Evaluation of all babies (general nursery and ICN) is justified on the basis of yield but is resource consuming; strategies for minimizing work load are discussed. Risk factor criterion levels affect case loading and yield. Frequency-specific BERA identifies cases which would not be detected by click stimuli and which raise management questions. Deferral of testing to four months is feasible and desirable. PMID- 3982182 TI - Industrial audiometry and the otologist. AB - The Hearing Conservation Amendment published by the Occupational Safety and Health Administration (OSHA) in 1983 requires hearing conservation programs to be provided for over 5 million workers whose daily noise exposures exceed 85 dBA time-weighted average. The permissible exposure level is 90 dBA, above which the use of hearing protectors is mandatory. Current policies rely heavily on periodic audiometry to detect early threshold shifts due to inadequate use of hearing protection or to individual variation in susceptibility to noise induced hearing loss (NIHL). Studies including over 1,000 noise exposed workers have shown that audiometry in the industrial setting is less reliable than clinical audiometry. Pure tone averaging markedly reduces test-retest variability and should be incorporated into rules for decision-making based on industrial audiometry. However, at least half of observed shifts are spurious. In addition, aging is an important confounding variable; in our data, about half of the population mean threshold shift seen was attributable to aging. Thus, only a minority of threshold shifts seen in industrial audiometry are due to NIHL. The large number of "false positive" shifts will inevitably eventually have the effect of a de facto lowering of the permissible exposure level to 85 dBA. Otologic referral and major administrative action should be reserved for large or repeated threshold shifts. OSHA does not specify rules for otologic referral, but the criteria recommended by the American Academy of Otolaryngology-Head and Neck Surgery are reasonable and should be supported. The necessity for otologic evaluation in the differential diagnosis of NIHL from other entities (particularly baseline audiometric abnormalities) is not universally appreciated; otolaryngologists need to educate their medical and nonmedical colleagues about this. PMID- 3982183 TI - Idiopathic (Bell's) facial palsy: natural history defies steroid or surgical treatment. AB - Idiopathic (Bell's) facial palsy is a self-limiting, non-life threatening, and spontaneously remitting disorder. The natural history of Bell's palsy is favorable: 84% of 1011 patients with Bell's palsy studied by one investigator recovered satisfactorily without treatment, and no valid clinical trials conducted to date have provided definitive evidence that treatment with steroids or surgery improves upon this figure. The authors studied 273 patients with Bell's palsy to evaluate the prognostic significance of evoked electromyography in predicting the possible benefit of transmastoid facial nerve surgical decompression. The results indicated that even when evoked electromyography was used to select those patients who might benefit most from transmastoid surgery, outcome in patients treated surgically was no better than can be expected to occur without treatment. Based upon these observations, transmastoid facial nerve surgery is not recommended to treat Bell's palsy because no benefits have been identified which outweigh the risks of surgery. PMID- 3982185 TI - Carotid body paraganglioma with metastases. AB - The diagnosis of a carotid body paraganglioma with metastases led us to a critical review of the literature of 106 cases with metastasis reported between 1893 and 1980. The percentage of tumors with metastasis is in the order of 11.5% to 13%. There is no proven histological criterion from which to assert or infer their malignancy. PMID- 3982184 TI - Causes of failure of mastoidectomy for chronic otitis media. AB - The operative findings of 66 patients who underwent revision mastoid surgery for recurrent chronic otitis media were analyzed for the causes of failure of the primary procedures. Recurrent cholesteatoma was found in 41% of the canal wall down and 70% of the canal wall up procedures requiring revision. Additional causes of failure included granulation tissue in unexenterated cells, particularly in the tegmental cells (41% of all cases and 64% of cases without cholesteatoma) and cells of the sinodural angle (38% of all cases and 58% of cases without cholesteatoma). The need for thorough exenteration of cells, particularly the tegmental cells and cells of the sinodural angle, mastoid tip, and facial recess, and the importance of lowering the facial ridge in canal wall down procedures were stressed. Following these principles, the success rate in creating a dry ear in 48 patients who had undergone from one to three previous mastoid procedures was 85% (mean follow-up three years). PMID- 3982186 TI - Studies of early laryngeal reinnervation. AB - In 1973, Hengerer and Tucker reported a method for laryngeal reinnervation. The purpose of this study is to objectively verify the reinnervation mechanism in 20 dogs with nerve-muscle pedicle grafts. Three months after the experimental operation direct stimulation of the nerve to the neuromuscular pedicle produced an evoked action potential of the posterior cricoarytenoid muscle. This was recorded. Histologic examination of the posterior cricoarytenoid muscle and the nerve-muscle pedicle were performed. The electromyogram revealed in ten of fifteen dogs an excitable action potential. This can be considered as objective evidence for reinnervation from the neuromuscular pedicle. PMID- 3982187 TI - The use of topical cocaine to prevent laryngospasm after general anesthesia on endoscopy procedures. PMID- 3982188 TI - Improved technique for the diagnosis of atypical nasopharyngeal cancer. AB - This article presents an improved technique for the diagnosis of atypical nasopharyngeal carcinoma tumor at deep sites beneath mucosa. It includes: 1. using spherical gauze to rub the nasopharyngeal cavity for exfoliative cytology; 2. using 1% H2O2 stain in the nasopharyngeal cavity to direct biopsy for suspected early carcinoma; 3. using multiple-hole needle puncture in the nasopharynx. These methods are simple, safe, quick, and have a high positive rate. PMID- 3982189 TI - Re: Intraoral ligation of the maxillary artery for posterior epistaxis. PMID- 3982190 TI - The laser organization. PMID- 3982191 TI - The biomedical effects of laser application. AB - This paper briefly reviews the authors' experimental and clinical use of lasers over a 20-year period, during which laser effects on 15 biological systems were studied. Low-energy laser radiation was found to have a stimulating effect on cells, and high-energy radiation had an inhibiting effect. The application of lasers to stimulate wound healing in cases of nonhealing ulcers is recommended. PMID- 3982193 TI - [Current views on the crisis in health services]. PMID- 3982192 TI - Extensive granuloma pyogenicum as a complication of endolaryngeal argon laser surgery. AB - A case report of an exuberant anterior transglottic granuloma pyogenicum as a complication of endoscopic argon laser surgery for an anterior web, after previous treatments of juvenile laryngeal papillomatosis, is described. PMID- 3982194 TI - [Chest pain--an ongoing problem in differential diagnostics in cardiology practice]. PMID- 3982195 TI - [Inflammatory bowel diseases--personal experience]. PMID- 3982196 TI - [Ventricular fibrillation as a complication in acute myocardial infarct. A retrospective study from 1977 to 1982]. PMID- 3982197 TI - [Arrhythmogenic dysplasia of the right ventricle (a report on 4 patients)]. PMID- 3982198 TI - [Recognition of boutonneuse fever (Marseilles fever) in Croatia]. PMID- 3982199 TI - [Comparative study of refraction using the Canon Autoref R-1 refractometer--the effect of age factors]. PMID- 3982200 TI - [Serologic diagnosis of syphilis]. PMID- 3982201 TI - [The effect of carotid sinus stimulation on changes in blood pressure and the heart rate and rhythm during neck dissection]. PMID- 3982202 TI - [The significance of anti-hepatitis A immunoglobulin M (anti-HAV IgM) in the clinical diagnosis of viral hepatitis]. PMID- 3982203 TI - [Congenital diaphragmatic hernia--prospects for survival of the child]. PMID- 3982204 TI - [Principles of modern surgical therapy of traumatic injuries of the spleen]. PMID- 3982205 TI - [Pseudoinfarct of the myocardium]. PMID- 3982206 TI - [Anticonvulsant properties of clobazam in a group of resistant epileptic patients]. PMID- 3982208 TI - [Treatment of acute diarrhea in children in clinical practice]. PMID- 3982207 TI - [Critical review of blood transfusion and transfusion of erythrocyte concentrate]. PMID- 3982209 TI - [Treatment of hyperlipidemias]. PMID- 3982210 TI - [Modern theoretical concepts in pediatric and adolescent psychiatry]. PMID- 3982211 TI - The effect of N-acetylcysteine on toxicity of cyclophosphamide and doxorubicin on murine hemopoietic progenitors. AB - The effect of N-acetylcysteine on hemopoietic stem cells was studied. The drug was given to mice untreated and injected with a single dose of cyclophosphamide or doxorubicin. The results show that the antioxidant drug N-acetylcysteine does not induce any significant decrease in the cytotoxic effect of cyclophosphamide or doxorubicin. PMID- 3982212 TI - Pituitary-dependent masculinization of hepatic hexobarbital hydroxylase in Crl:CD 1(ICR)BR mice. AB - The sexual dimorphism in hepatic drug metabolism found in Crl:CD-1 mice is due to the normally repressive effects of testicular androgens on the activities of hepatic monooxygenases. The ability of testosterone to elevate the Michaelis constant (Km) and reduce the maximum velocity (Vmax) of hepatic hexobarbital hydroxylase is dependent upon the pituitary, so that in the hypophysectomized mouse androgens have no repressive effects on the activities of hepatic monooxygenases. PMID- 3982213 TI - In vivo acetylation of homocholine and beta-methylcholine in rat brain. AB - A nitrogen phosphorus-gas chromatographic procedure was modified to determine the extent of in vivo acetylation of the choline analogs homocholine and beta methylcholine. Infusion of homocholine (18 mumoles) for 2 hours into the lateral ventricle of the rat produced 2.3 nmoles/gram of acetylhomocholine which represented 0.035% of the detected homocholine. Infusion of the same quantity of beta-methylcholine produced 1.0 nmole/gram of acetyl-beta-methylcholine representing 0.025% of the detected beta-methylcholine. Although pretreatment with hemicholinium-3 reduced the amount of acetylated product formed from either analog, the reduction was significant only for acetyl-beta-methylcholine (p less than 0.01). PMID- 3982214 TI - 5-HT-1a and 5-HT-1b selectivity of two phenylpiperazine derivatives: evidence for 5-HT-1b heterogeneity. AB - The ability of m-trifluoromethylphenylpiperazine (TFMPP) and an N-substituted derivative, LY 165163 (p-NH2-PE-TFMPP), to discriminate 5-HT-1 binding sites labelled by [3H]5-HT is compared in rat corpus striatum and rat cortex. TFMPP displays at least a 30 fold selectivity for the 5-HT-1b subtype. Furthermore, TFMPP reveals heterogeneity within the 5-HT-1b binding sites. TFMPP displays a Kd of 6 nM for approximately two-thirds of the 5-HT-1b binding sites and a Kd of 273 nM for the remaining one third of the 5-HT-1b sites. p-NH2-PE-TFMPP, on the other hand, discriminates the 5-HT-1 sites in a manner similar to spiperone, displaying a 110 fold selectivity for the 5-HT-1a sites. p-NH2-PE-TFMPP displays a Kd of about 3 nM for the 5-HT-1a sites. p-NH2-PE-TFMPP does not discriminate subtypes within the 5-HT-1b binding sites. The significance of the selectivity of these two compounds as well as structurally related compounds is discussed. PMID- 3982215 TI - Intracerebral site of convulsant action of bicuculline. AB - Bicuculline was injected intracerebrally in several forebrain sites of the rat. In a discrete area in the vicinity of prepiriform cortex, a single, unilateral injection of bicuculline (49 pmol) produced generalized clonic seizures documented behaviorally and electroencephalographically. This is the first identification of an anatomical site from which generalized seizures can be elicited by low doses of a chemoconvulsant. PMID- 3982216 TI - The effect of taurine depletion with guanidinoethanesulfonate on bile acid metabolism in the rat. AB - Administration of guanidinoethanesulfonate (GES) to male rats for 5 weeks resulted in a 90% decrease in the hepatic taurine concentration. This depletion of hepatic taurine was associated with a 570% increase in the concentration of glycine-conjugated bile acids, a 30% decrease in the concentration of taurine conjugated bile acids, and an increase in the ratio of glycine- to taurine conjugated bile acids from 0.046 to 0.45. The total concentration of bile salts in the bile and the turnover of cholic acid were not affected by administration of GES. The data indicate that the taurine-depleted rat conserves taurine to some extent by using glycine instead of taurine for bile salt synthesis but not by decreasing the daily fractional turnover of bile acids. PMID- 3982217 TI - Dynamic organ culture of precision liver slices for in vitro toxicology. AB - The lack of a reproducible method for the production of thin tissue slices has hindered the use of liver slices as an in vitro tool for hepatotoxicity studies. Fresh human, rat, and rabbit liver was processed using a mechanical slicer. With this instrument, precision (5% of thickness) liver slices in the submillimeter range could be produced at a rapid rate. Slices were prepared from fresh livers in chilled, oxygenated buffer to minimize trauma. Following incubation for up to 20 h in a dynamic organ culture system, histology of incubated slices suggested that 250 m precision-cut slices were optimum in regard to morphology relative to liver slices incubated under conventional organ culture conditions. Addition of bromobenzene to the culture showed time-dependent hepatotoxicity based on two classic parameters of cell degeneration. Histological evidence is presented which suggests the usefulness of this system for hepatotoxicity studies and the production of focal necrosis in vitro. PMID- 3982219 TI - Binding of physostigmine to rat and human plasma and crystalline serum albumins. AB - The binding of 3H-physostigmine (3H-Ph) to human and rat plasma proteins and crystalline serum albumin was studied by ultrafiltration technique. This study showed that the percentage of 3H-Ph bound to rat plasma slightly decreased from 49% to 41% whereas human plasma showed an increase in binding from 29% to 43% over a 50-fold increase in drug concentration. Human plasma samples which were collected in a bag coated with citrate phosphate dextrose adenine-1 solution bound 50% less 3H-Ph than samples collected with EDTA indicating a drug-drug interaction between 3H-Ph and anticoagulants. No significant change in binding was observed if the samples were frozen prior to use. Scatchard plots for binding of 3H-Ph resulted in a positive slope for human plasma and a negative slope for rat plasma; whereas curvilinear Scatchard plots with negative slopes were obtained for binding to human and rat crystalline serum albumin. PMID- 3982218 TI - Dietary choline affects response to acetylcholine by isolated urinary bladder. AB - Age-related increases occur in the response of isolated urinary bladders to the parasympathetic neurotransmitter acetylcholine (ACh). Experiments were carried out to determine whether long-term elevation or diminution in the amount of ingested choline can also affect the response of the urinary bladder to ACh. Female C57BL/6J mice were maintained on a choline-deficient chow and on drinking water supplemented with either 0, 1.5, or 4.0 mg/ml choline chloride from 8 to 20 months of age. Isolated bladders from choline deficient animals showed a 46% increase in the maximum response to ACh as compared to those from normal choline animals, while bladders from animals on choline enriched diets showed a 15% decrease in maximum contractile response. Radioligand binding experiments suggested that the functional changes result from alterations in the density of muscarinic receptors in the bladder. The results are consistent with the hypothesis that muscarinic receptors are down-regulated to compensate for increased parasympathetic activity associated with choline-enriched diets and up regulated to compensate for decreased parasympathetic activity associated with choline-deficient diets. PMID- 3982220 TI - Calcium-dependence of serotonin-mediated aldosterone secretion and differential effects of calcium antagonists. AB - The requirement for calcium in the serotonin-mediated aldosterone secretion was investigated using rat adrenal capsular cells. In the calcium-free medium both basal as well as serotonin-stimulated aldosterone secretion (at concentrations of 10(-7) M and 10(-8) M of serotonin) were significantly impaired. The effects of calcium-channel blockers were then examined. Verapamil (10(-5) M and 10(-6) M markedly inhibited basal and serotonin-evoked aldosterone secretion. In equimolar concentrations nifedipine had much less effect and diltiazem produced no apparent attenuation of either basal or serotonin-stimulated aldosterone secretion. These results indicate the calcium-dependence of serotonin-induced aldosterone secretion. The variable effects of the calcium-channel blockers suggest different or multiple mechanisms of action of these agents. PMID- 3982221 TI - Regional differences in carboxylesterase activity between human subcutaneous and omental adipose tissue. AB - Human adipose tissue was shown to contain carboxylesterase activity when measured by methylbutyrate as substrate. The enzyme has the same characteristics as carboxylesterase purified from rat epididymal adipose tissue. Like lipoprotein lipase, carboxylesterase activity was higher in large than in small fat cells. Both cell size and carboxylesterase activity were greater in human subcutaneous than in omental adipose tissue. However, the linear regression lines between the enzyme activity and cell volume in the two tissues were almost superimposable, suggesting that cell size is a determinant of enzyme activity. Although the physiological significance of adipose tissue carboxylesterase must await further clarification, it is possible that the enzyme is related to the hydrolysis of long-chain monoacylglycerols. PMID- 3982222 TI - In the search for new anticancer drugs XII. Synthesis and biological evaluation of spin labeled nitrosoureas. AB - The spin labeled nitrosourea 1-(2-chloroethyl)-3-(1-oxyl-2,2,6,6- tetramethyl piperidinyl)-1-nitrosourea (SLCNU, 4) and its analogues 5-7 were synthesized either by a regio-selective method or by a conventional route via the nitrosation of the spin labeled intermediates (11a-e). Nitrosation of the ureas 11a-e with dinitrogen tetraoxide resulted in better yields than those obtained with sodium nitrite. The nitrosoureas 4-8 were tested for their anticancer activity against the lymphocytic leukemia P388 in mice. Thus, either at the equal molar dose or at the dose of equal toxicity level, the SLCNU (4) was found to be more active than the clinically used CCNU (1). Unlike CCNU (1) whose LD50 is 56 mg/kg, the SLCNU (4) possesses a low toxicity (LD50 123 mg/kg). Therefore, SLCNU (4) is a promising new entry into the nitrosourea class of anticancer drugs. PMID- 3982223 TI - Dihydroergotoxine decreases blood pressure in spontaneously hypertensive rats by interacting with peripheral dopamine receptors. AB - Dihydroergotoxine (10 micrograms/kg s.c.) decreased mean carotid blood pressure in urethane-anaesthetized spontaneously hypertensive rats but failed to modify the same parameter in normotensive rats. The effect was statistically significant 20 min after the injection and relatively long lasting (up to 90 min). Pharmacological characterization of the phenomenon indicated that it is mediated by stimulation of dopamine receptors, since pretreatment with haloperidol, cis flupentixol but not with trans-flupentixol, completely prevent the reduction in blood pressure induced by dihydroergotoxine. Moreover, a challenge dose of dihydroergotoxine did not reduce mean blood pressure values in spontaneously hypertensive rats pretreated with domperidone or (-)sulpiride, but not with (+)sulpiride. These results suggest that the ergot derivative modifies the cardiovascular system by interaction with peripheral dopamine receptors of the DA2 type. PMID- 3982225 TI - D-2 dopamine receptors in the frontal cortex of rat and human. AB - D-2 dopamine receptors and serotonin receptors in the frontal cortex of rat and human were labelled with 3H-spiroperidol. The D-2 receptors were then distinguished in 4 ways. Dissociation of spiroperidol was biphasic, indicating two populations of sites. Cinanserin in competition with 3H-spiroperidol exhibited high (75%) and low (25%) affinity sites. Dopamine and LY 141865 in competition with 1.25 nM 3H-spiroperidol exhibited high (20-25%) and low (80-75%) affinity sites in the absence of cinanserin, while in the presence of 300 nM cinanserin only the high affinity sites remained. Lesioning of the dopaminergic meso-cortical pathway increased the number of cinanserin-resistant sites by 26%. Thus 3H-spiroperidol binding in the presence of cinanserin can be used to selectively label D-2 receptors in the frontal cortex. PMID- 3982224 TI - Serotonin uptake inhibitors differentially modulate high affinity imipramine dissociation in human platelet membranes. AB - The influence of selective serotonin uptake inhibitors on the dissociation rate of 3H-imipramine from its high affinity binding site in human platelet membranes was studied. Of the uptake inhibitors tested, one group of compounds attenuated dissociation, another group accelerated it, while a third group had little effect on the dissociation process. Drugs unrelated to the serotonin uptake system were ineffective. Removal of sodium ions markedly increased imipramine dissociation. Dose response curves of the active compounds indicated that micromolar concentrations were required to exert an effect on imipramine dissociation. These results can be adequately explained by an allosteric model which includes effector binding sites and distinct conformational states of the high affinity imipramine binding site. PMID- 3982226 TI - Increased cytosolic calcium in cystic fibrosis neutrophils effect on stimulus secretion coupling. AB - A disorder of calcium homeostasis has been related to the pathogenesis of Cystic Fibrosis (CF). The Authors have studied the relationship between the cytosolic free calcium concentration ([Ca2+]i), the amount of Ca2+ released from endogenous stores and the secretory response in CF neutrophils. Significantly elevated resting [Ca2+]i and depressed Ca2+ release induced by the chemotactic peptide N formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP) is present in CF neutrophils. In the absence of exogenous Ca2+ the secretory response of CF neutrophils after a weak stimulus such as Cytochalasin B (CB) is greater than in normal neutrophils, while a depressed secretion of azurophilic granules is evident in CF neutrophils stimulated by CB + FMLP. The data confirm the hypothesis of an altered Ca2+ homeostasis in CF cells. Cystic Fibrosis (CF), an autosomal recessive exocrinopathy, is characterized by secretory abnormalities and ion transport dysfunctions (for review see 1,2). Since intracellular Ca2+ seems to play a role in stimulus-secretion coupling and ion movements, several aspects of Ca2+ homeostasis have been investigated in CF. The total Ca2+ content has been reported to be increased in fibroblast cultures and in lymphocytes (3,4,5) and mitochondrial Ca2+ uptake was found elevated in fibroblast cultures (6). An elevated free cytosolic calcium concentration ([Ca2+]i) has been recently reported in buccal epithelial cells (7), while normal concentration has been found in lymphocytes and Epstein Barr virus transformed lymphoblasts (5,8). The present paper shows the results of a study in human neutrophils, a cell whose several functions such as secretion, movement and respiratory burst are in some way regulated by Ca2+. The data report that in neutrophils of CF patients the resting [Ca2+]i is higher and the secretory response is partly modified. PMID- 3982227 TI - Superoxide dismutase and glutathione peroxidase activities in neutrophils from selenium deficient and copper deficient cattle. AB - Oxygen consumption and the activities of the selenoenzyme glutathione peroxidase, and of the hexose monophosphate shunt were lower than normal in neutrophils from Se deficient cattle. However, these activities and the activity of Cu/zinc superoxide dismutase were unaffected in neutrophils from Cu deficient cattle. These results are discussed with reference to impaired neutrophil microbicidal activity previously demonstrated to result from Se or Cu deficiency in cattle. PMID- 3982228 TI - Effect of prazosin and yohimbine on systolic blood pressure and on renal norepinephrine content in DOCA-salt rats. AB - We studied the effect of alpha-1 and alpha-2 blockers (prazosin and yohimbine) on systolic blood pressure (SBP) and on renal norepinephrine (NE) content in Sprague Dawley normotensive and DOCA-salt rats. The administration of desoxycorticosterone acetate (DOCA) to these rats for 6 weeks increased their SBP from 137 to 183 mmHg (p less than .001). This increase was prevented by simultaneous administration of prazosin (p less than .001), yohimbine (p less than .01), or prazosin + yohimbine (p less than .001). DOCA rats on saline and on yohimbine had lower renal NE content (p less than .05 and p less than .001, respectively) than normotensive rats. Renal NE content of DOCA rats on yohimbine decreased with respect to those treated with prazosin (p less than .001) or prazosin + yohimbine (p less than .05). Besides, renal NE content of DOCA rats on prazosin increased when compared to control DOCA rats (p less than .05). However, these drugs showed no effect on SBP and on renal NE content in normotensive rats. These findings further confirm that the alpha adrenoceptor blockade can prevent the hypertension of DOCA-salt rats in such a way that their blood pressure stabilizes at similar levels to those observed in normotensive treated animals. PMID- 3982229 TI - Prolactin releasing and luteinizing hormone inhibiting activity of dermorphin shorter homologues in the rat. AB - Dermorphin, a heptapeptide isolated from the skin of the frogs Phillomedusa sauvagei and Phillomedusa rhodei, is endowed with potent peripheral and central opioid-like activity. Intracerebroventricular (icv) injection of dermorphin (31.2, 62.5 and 125 pmol/100g) induced in ovariectomized (OVX) rats dose related rises and decreases in prolactin (PRL) and luteinizing hormone (LH) levels, respectively. The aim of this work was to evaluate the same endocrine responses after administration of shorter peptide amide homologues, related to the N terminal sequence of dermorphin. These compounds retain a substantial analgesic activity although the latter decreases with the decrease in the number of amino acid residues. Icv administration of the hexapeptide homologue (dermorphin 1-6 amide) to OVX rats did not induce any PRL rise or LH inhibition, even at the high dose of 250 pmol/100g. The pentapeptide (dermorphin 1-5 amide), instead, increased PRL and decreased LH secretion, although the effect was significant only at the dose of 250 pmol/100g. Administration of the tetrapeptide (dermorphin 1-4 amide) induced a significant PRL rise and LH inhibition at both the doses of 125 and 250 pmol/100g. The tetrapeptide was the smallest fragment of the dermorphin moiety which caused endocrine responses while the tripeptide (dermorphin 1-3 amide) was completely ineffective in this context. These data indicate that a complete dissociation exists between the behavioral and endocrine effects of the dermorphin homologues examined. In fact, shorter dermorphins whose analgesic potency was directly related to the number of amino acids, exhibited an opposite pattern in evoking endocrine effects. PMID- 3982230 TI - Spontaneous reactivation of phosphinylated human erythrocyte acetylcholinesterase and human serum butyrylcholinesterase. AB - This report documents studies on the spontaneous reactivation of human erythrocyte acetylcholinesterase and human serum butyrylcholinesterase following inhibition by organophosphinate esters. The spontaneous reactivation reactions were carried out at 26.0 degrees C in 0.10 M phosphate buffer of pH 7.6. Based upon results at 24 h, human serum butyrylcholinesterase inhibited with 4 nitrophenyl methyl (4-methoxyphenyl) phosphinate was the most responsive (92.5% recovery) of the nine esters studied. Using the same criteria, the most active compound in the human erythrocyte acetylcholinesterase studies was 4-nitrophenyl methyl(phenyl)phosphinate (74.2% recovery). With seven of the nine compounds examined the response was greater from the serum enzyme than from the erythrocyte enzyme. PMID- 3982231 TI - Surgical ablation of oviductal extrinsic innervation changes GABA levels in the rat fallopian tube. AB - The origin of gamma-aminobutyric acid (GABA) in the rat oviduct was investigated by measuring GABA levels in the oviduct after selective ablation of the extrinsic oviductal innervation. Rats killed 20 days after ablation of nerves connected with the left oviduct showed no differences in GABA levels in the left vs the right oviduct. Rats killed 50 days after ablation of the left ovarian vascular nerve bundle showed a decreased GABA content in the left vs the right (intact) oviduct which was more pronounced in rats killed 90 days after ablation. In contrast, GABA levels were unchanged 50 days after ligation of either the suspensory ligament of the ovary or the uterine artery. Our results indicate the involvement of a GABAergic component in the extrinsic innervation of the rat oviduct. PMID- 3982232 TI - Uptake and/or binding of tricyclic antidepressants in human red cells. AB - The factors affecting the red blood cells (RBC) uptake and/or binding of tricyclic antidepressants imipramine (IMI) and desmethylimipramine (DMI) were investigated under in vitro conditions. The time course of drug distribution indicated that equilibrium between RBC and medium is reached rapidly. The uptake and/or binding of IMI and DMI to RBC was not saturable and RBC/medium ratio was unaffected by pH, nature of monovalent cations or by the presence of therapeutic concentrations (5-50 ng/ml) of antipsychotic drugs. In the protein-free medium, RBC/medium ratio of DMI was X +/- SE = 2.58 +/- 0.08 (n = 5) and that of IMI was 7.38 +/- 0.12 (n = 6). However, RBC/plasma ratio of DMI was 0.78 +/- 0.04 (n = 7) and IMI ratio was 0.64 +/- 0.03 (n = 9). The RBC/medium ratio was linearly related to free fraction of IMI in a buffer containing 60 mg/ml of human serum albumin with various concentrations of alpha 1-acid glycoprotein (r = 0.971, n = 7). These results suggest that in the absence of proteins the lipid solubility of antidepressants is the main determinant factor in RBC uptake and/or binding, whereas, in the presence of proteins, free fraction of the drug plays the major role. Hence, the RBC/plasma ratio of antidepressants may correlate with treatment outcome in clinical studies better than total drug concentration in plasma. PMID- 3982233 TI - Lipid analyses of isolated surface membranes of Leishmania donovani promastigotes. AB - Constituent lipids of surface membranes (SM) isolated from Leishmania donovani promastigotes were analyzed and compared with those obtained from whole cells and an isolated kinetoplast-mitochondrion fraction (KM). On a dry weight basis, the total extractable lipids constituted approximately 47%, 12% and 24% of the SM, cells and KM, respectively. The total lipids of SM, cells and KM all were composed of approximately 70% phospholipids (PL), 20-25% neutral lipids and 5-10% glycolipids. Sterols and diglycerides composed 60% and 30%, respectively, of the various neutral lipid fractions. Several mannose- and galactose-containing glycolipids were fractionated but not identified. The glycolipid fractions from cells and SM had demonstrable antigenic activities with rabbit anti-SM sera. Striking quantitative differences were apparent between the PL profiles of the 3 cellular components examined. The PL of SM, whole cells and KM, respectively, were composed of: 15%, 51% and 24% phosphatidylcholine; 37%, 13% and 11% phosphatidylethanolamine (PE); 18%, 10% and 14% phosphatidylinositol; 10%, 1% and 4% phosphatidylserine and traces of cardiolipin, phosphatidylglycerol and phosphatidic acid. An unknown PL containing sphingosine, choline and vicinal hydroxyl groups but no free amino moieties made up approximately 19% of the PL of SM and whole cells, but it constituted approximately 27% of the PL of KM. The PL side chain constituents of whole cells and SM were composed mainly of longchain fatty acids (C18-20). Further, over 50% of the PE of SM was in the alkyl and alK 1-enyl ether forms. These SM properties might contribute to the organism's resistance to digestion in the hydrolytic environs of both its insect vector and mammalian hosts. PMID- 3982234 TI - Sterol and fatty acid composition of the clam, Codakia orbicularis, with chemoautotrophic symbionts. AB - Codakia orbicularis may obtain nutrients from chemoautolithotrophic bacteria. The chemical composition of the C. orbicularis was investigated because of this unusual source of nutrition, and because it is a human food source in the Caribbean. The lipid fraction of these molluscs is discussed in detail. Polyunsaturated fatty acids account for only 11-15% of the total fatty acids, and non-methylene interrupted dienes are present as high as 9.5%. Cholesterol represents about 45% of the total sterols present. PMID- 3982235 TI - Fatty acid composition of phospholipids and neutral lipids during embryonic and early larval development in Atlantic herring (Clupea harengus, L.). AB - The fatty acid compositions of total polar and total neutral lipids of Atlantic herring eggs and larvae were determined immediately before fertilization, after fertilization and at various times during subsequent embryonic and early larval development. Within 3 hr after fertilization the percentage of total PUFA in neutral lipid decreased from 33% to 20%, with a reciprocal increase in monoenes. Thereafter the percentage of PUFA in the neutral lipids increased progressively, attaining the original level in ripe eggs by the time of yolk sac absorption. During the larval stages the percentage of PUFA continued to increase in the neutral lipid, reaching almost 44% of the total by day 32 after fertilization, although it was reduced to 32% by day 36. The percentage of monoenes in the neutral lipid displayed a progressive decrease during the whole period of development from 3 hr after fertilization. Throughout all the developmental periods the fatty acid composition of total polar lipids remained essentially constant. The polar lipids of the yolk sac displayed virtually the same fatty acid composition as the larval bodies, but the neutral lipids of the yolk sac were low in PUFA compared to the larval bodies. The results are discussed with reference to changes in lipid class composition during development. The conservation of high levels of PUFA in lipids during embryogenesis and early larval development reflects the importance of these fatty acids during development. PMID- 3982237 TI - Lipid class composition during embryonic and early larval development in Atlantic herring (Clupea harengus, L.). AB - The lipid class compositions of Atlantic herring eggs and larvae were determined immediately before fertilization, after fertilization and at various times during subsequent embryonic and early larval development. Total lipid constituted 15% of the dry wt of ripe eggs, 70% of the total lipid being polar lipid with phosphatidylcholine (PC) accounting for almost 90% of the polar lipid. In general, the total lipid content decreased gradually during embryogenesis and in particular during larval development. Within 3 hr after fertilization the relative percentage of neutral lipid decreased slightly. This was followed by a general decrease in polar lipid which, by the stage of yolk sac absorption, was reduced to 52% of the total lipid. The decreased percentage of polar lipid was due entirely to a decrease in PC, which was reduced to 66% of the polar lipids at the stage of yolk sac absorption. The accompanying increase in the percentage of neutral lipids was mainly due to increased percentages of triacylglycerols (TAG) up to yolk sac absorption and cholesterol esters in the larval stages. During the first 4 days after hatching, phospholipids and to a lesser extent cholesterol were preferentially depleted in the yolk sacs, which also had higher levels of free fatty acids. The results are discussed in relation to possible roles of different lipids during embryonic and early larval development. PMID- 3982236 TI - Inhibition of acyl CoA: cholesterol acyltransferase and sterologenesis in rat liver by diazepam, in vitro. AB - Diazepam, a commonly prescribed tranquilizer, was found to inhibit cholesterol biosynthesis in rat liver minces; inhibition appeared to occur at multiple post mevalonate sites. Diazepam also inhibited cholesterol esterification by acylCoA:cholesterol acyltransferase in isolated liver microsomes and minces. Liver minces incubated with [14C]oleate demonstrated increased uptake of the fatty acid and a greater incorporation of the substrate into triglycerides, diglycerides and phospholipids when diazepam was present. The results suggest possible mechanisms for the hypocholesterolemic effect of diazepam in experimental animals and for the elevation of triglycerides and very low-density lipoproteins in man and the rat. PMID- 3982239 TI - Kinetics of urea synthesis and alanine uptake by perfused rat livers. AB - Eight livers of 200 g rats were isolated and perfused in a single pass system with a semi-synthetic medium to which alanine was added to concentrations from 0.5 to 15 mmol/l. In each liver, 4-5 sets of urea synthesis rate and alanine uptake rate at different alanine concentrations were measured. The urea synthesis rate in relation to the alanine concentration was compatible with substrate inhibition kinetics. The kinetic constants were (mean +/- SD): Vmax = 10.34 +/- 3.41 mumol urea-N/(min X 100 g b.w.), Km = 1.56 +/- 0.67 mmol/l, and Ki = 5.35 +/ 2.44 mmol/l. The alanine uptake rate followed Michaelis-Menten kinetics with the constants (mean +/- SD) Vmax = 7.51 +/- 1.68 mumol/(min X 100 g b.w.) and Km = 2.14 +/- 1.04 mmol/l. The constants were assessed by non-linear iterative regression analysis. Urea synthesis exceeded alanine uptake at alanine concentrations below 2 mmol/l, and was smaller at higher concentrations. In two experiments, alanine metabolites were measured. The glucose production rate in relation to the alanine concentration suggested substrate inhibition. At high alanine concentrations, ammonia, lactate and pyruvate were released by the livers. The results indicate that whole liver urea synthesis and gluconeogenesis is inhibited by high blood alanine concentrations, in contrast to alanine uptake. PMID- 3982238 TI - Comparative studies of triacylglycerol structure of very low density lipoproteins and chylomicrons of normolipemic subjects and patients with type II hyperlipoproteinemia. AB - The triacylglycerols of very low density lipoproteins (VLDL) and of chylomicrons were analyzed in the fasting and postabsorptive states from normolipemic subjects and patients with Frederickson's Type II hyperlipoproteinemia, who subsisted on free choice diets, standard diets excluding lard, or were given a breakfast enriched in lard. The VLDL and chylomicrons were obtained by conventional ultracentrifugation, and the triacylglycerols were isolated by thin-layer chromatography (TLC). Representative sn-1,2-, sn-2-3- and sn-1,3-diacylglycerols were generated by partial Grignard degradation of the triacylglycerols and a stereospecific hydrolysis by phospholipase C of the mixed sn-1,2(2,3)-diacyl phosphatidylcholines prepared as intermediates. Representative sn-2-acylglycerols were obtained by hydrolysis with pancreatic lipase. Positional distribution of the fatty acids was established by subtracting in turn the fatty acid composition of the sn-2-position from the fatty acid composition of the sn-1,2- and sn-2,3 diacylglycerols. The molecular association of the fatty acids in the diacylglycerol moieties was determined by gas-liquid chromatography with mass spectrometry (GC/MS) of the tertiary-butyldimethylsilyl (t-BDMS) ethers. The molecular association of the fatty acids in the triacylglycerols was determined by 1-random 2-random 3-random calculation following experimental validation of the distribution. The results confirm a marked asymmetry in the positional distribution of the fatty acids in all triacylglycerol samples, with the palmitic acid predominantly in the sn-1-position, the unsaturated acids about equally divided between the sn-2- and sn-3-positions, and the stearic acid divided about equally between the sn-1- and sn-3-positions. The overall structure of the VLDL and chylomicron triacylglycerols from patients and control subjects was characterized by a non-correlative distribution of fatty acids under all dietary conditions. PMID- 3982240 TI - Hyperplastic foci in the atrophic liver of rats after portacaval anastomosis. AB - Hyperplastic focal areas were investigated in livers of male rats 1 and 9 months after portacaval anastomosis (PCA) by light and electron microscopy. These alterations, predominantly found in periportal areas, were characterized by light microscopy as clusters of enlarged hepatocytes along narrowed sinusoids, contrasting in the remaining liver acinus with smaller hepatocytes along widened sinusoids. No differences were observed between 1 and 9 months PCA except for glycogen content, which was homogeneously distributed in the liver at 1 month but completely lacking in foci at 9 months. The most striking ultrastructural alterations were the sinusoids delimited in these hyperplastic areas by a thickened barrier consisting of thick endothelial cells encircled by numerous subendothelial processes of the perisinusoidal fat-storing cells. Deep and widened recesses of the sinusoidal lumen separated the two-cell-thick plates of the hyperplastic cells. Hepatocytes in foci, thought to represent regenerative areas, tend to increase their exchange surface. Their progressive loss in glycogen and their two-cell-thick plates architecture should be in favour of a potential malignancy. However, the spontaneous evolution of these foci which do not necessarily give rise to nodules, as well as the lack of other features of transformation, do not support this possibility. PMID- 3982241 TI - Discrimination between organic and hepatic encephalopathy by means of continuous reaction times. AB - Measurement of continuous reaction times (CRT) was applied to 105 hospitalized controls, 65 patients with brain damage and 47 patients with hepatic encephalopathy. One hundred and fifty reaction times were measured in every patient. The best discrimination between controls and patients with organic brain damage was obtained with the 10 percentile of the reaction time distribution (86% correct classification). The 90 percentile discriminated best between controls and patients with hepatic encephalopathy (86% correct classification). Furthermore, the ratio between the 50 percentile and the difference between the 10 and 90 percentile made it possible to discriminate between the two groups of patients (91% correct classification), which indicates that the CRT test is suitable as a screening device for discrimination between organic brain damage and hepatic encephalopathy. PMID- 3982242 TI - Prognostic value of hepatitis B core antigen (HBcAg) expression in the liver of children with chronic hepatitis type B. AB - During a prospective follow-up study of 65 children with chronic hepatitis B, the HBcAg expression pattern in the liver was investigated, by immunofluorescence, in relation to biochemical and histological features and to the evolution of the disease. HBcAg was detected in 50 (77%) cases, with a diffuse pattern of distribution (more than 60% positive nuclei) in 20 cases, and with a focal pattern (less than 40% positive nuclei) in 30 cases. The diffuse pattern significantly prevailed in younger children, while the focal pattern was more frequent in children beyond 10 years of age. Transaminase levels were higher and histological features of activity were more frequent in patients with the focal pattern than in those with a diffuse pattern. Twenty-five hepatitis B e antigen (HBeAg) positive children, all initially HBcAg positive, were followed prospectively for 24 months. Seroconversion to anti-HBe, with subsequent normalization of transaminases, occurred in 72% of cases with a focal pattern, but only in 21% of those with a diffuse HBcAg pattern. In four patients transition from the diffuse to the focal pattern was observed during follow-up. These results suggest that, in children with chronic hepatitis B, the diffuse HBcAg pattern in the liver might reflect an earlier phase of infection. In HBeAg positive cases the focal HBcAg pattern may represent a prognostic marker of short term favourable evolution of the disease. PMID- 3982243 TI - Association of hepatitis Be antigen (HBeAg) with the core of the hepatitis B virus (HBcAg). AB - Three substances (pronase E, sodium dodecylsulfate (SDS) and guanidine hydrochloride) with different chemical actions partially convert HBcAg to HBeAg. This process retains the integrity of the HBcAg particle, which was not different between HBcAg subpopulations, and does not generate HBcAg or HBeAg sub-units. DNA polymerase activity was destroyed by SDS and guanidine hydrochloride, but not by pronase E. Serum HBeAg could not be converted into HBcAg, suggesting that this might be an irreversible process. The data are consistent with the assumption that HBcAg and HBeAg are coded for by the same gene (C gene of the HBV-DNA). PMID- 3982244 TI - Factors contributing to the current educational provision for medical laboratory scientific officers. PMID- 3982245 TI - The effects of exercise on platelet numbers and size. PMID- 3982246 TI - False low antithrombin III results in renal disease. PMID- 3982247 TI - A case for a high-throughput laboratory. PMID- 3982248 TI - 'Of making many books...'. PMID- 3982249 TI - Solid-phase ABO blood grouping using saliva. PMID- 3982250 TI - Water-soluble vitamin deficiency in the elderly. PMID- 3982251 TI - Indium 111 (111In) as a label for endothelial cells and fibroblasts used as target cells in cytotoxicity tests. PMID- 3982252 TI - [Prevention of radiation damage to the bladder and rectum using local application of dimethyl sulfoxide]. AB - A method for the prevention of radiation injuries of the urinary bladder and rectum for cervical cancer patients was worked out. It was based on the local application of the radioprotective agent dimethylsulfoxide (DMSO) before a session of interstitial irradiation with the AGAT-B apparatus. Concomitant radiation therapy with DMSO was provided to 22 cervical cancer patients. The control group included 59 patients who received similar treatment without DMSO. The expression of early reactions and late injuries of the rectum and urinary bladder were significantly lower in the DMSO group. A radioprotective DMSO effect with relation to tumor was not found. PMID- 3982253 TI - [Concept of effective equivalent dose for medical irradiation]. AB - The applicability of the concept of an effective equivalent dose to medical irradiation was substantiated. Some specific problems for calculating this value were discussed. The problem of a correct choice of a group of "the rest of organs" was considered. Basing on the mean estimation of the mean tissue doses received by patients in different x-ray studies a maximum of 6 organs was proposed for this group: the liver, kidneys, adrenals, stomach, pancreas, and spleen. It was shown that the same organs could be used in the calculation of effective equivalent doses from other (nonmedical) ionizing radiation sources. PMID- 3982254 TI - [Dynamic scintigraphy of the kidneys during chronic pyelonephritis in patients with arterial hypertension]. AB - It has been shown that latent renal diseases are detected by sectoral scintigraphy earlier than by other methods, and the former acquires particular importance when the only sign of disease is arterial hypertension. Early diagnosis of latent pyelonephritis makes this method especially valuable both for the selection of patients for further thorough examination and for the start of adequate therapy. Scintigraphy serves as a reliable criterion for the evaluation of the therapeutic efficacy in patients with chronic pyelonephritis (CP). Changes of scintigraphy parameters coincide quite exactly with the changed level of arterial pressure, concentration and nitrogen clearing function of the kidneys during treatment. This method (sectoral scintigraphy) is very important when used over time in CP patients with chronic renal insufficiency making it possible to detect with a sufficient degree of significance the improvement as well as impairment of renal function which is a crucial point for the choice of further therapeutic tactics. PMID- 3982256 TI - [Radiation safety during work on the ANET-V therapeutic apparatus with 252Cf sources]. AB - The Soviet ANET-W intracavitary neutron therapy apparatus is charged with 252Cf sources, the total mass of the radionuclide being 2100 micrograms. The radiation exposure of the staff has been studied and the results presented. Possible emergency situations have been analysed, methods of their prevention and liquidation worked out. Induced radioactivity in the patient's body has been estimated. Radiation dose levels for the medical staff are 10-15 times lower for the ANET-W apparatus than those for 252Cf sources administered by the manual series system but 10 times higher than those for the AGAT-W gamma-apparatus. The design, blocking system and emergency reset of the sources provide for safe work on the ANET-W apparatus. During liquidation of an emergency situation irradiation of the staff does not exceed 0.3 of the annual maximum tolerance dose. The level of induced activity in the patient's body is insignificant as in 10.5 min it does not exceed background values. PMID- 3982255 TI - [Multicollector lymphography and phlebography in lower limb edema following radiation and combination therapy]. AB - A multimodality x-ray study of the lymphatic and venous vessels was performed in 50 patients with secondary edema of the lower limbs. A complete block of the limb superficial lymphatic collectors was observed in 44% of the patients, a partial block in 26%. In 80% of the cases the level of partial or complete occlusion of the lymphatic vessels was noted in the ilioinguinal region and in 20% on the femur and leg. Distrubed permeability of the deep vessels of the femur and ilioinguinal region in the form of a complete or partial block was noted in 46% of the cases. In disturbed peripheral lymphodynamics different compensatory adaptation mechanisms like the functioning of the collateral tracts, lymphovenous anastomoses, the overflow of a radiographic contrast agent from the superficial vessels into the deep ones were observed in 60% of the patients. Indications for multicollector lymphography were defined. In secondary edema of the lower limbs, combined injuries of the lymphatic and venous systems were marked in 62%, an isolated disorder of the outflow of the peripheral lymph through the collector vessels was marked in 38%. PMID- 3982258 TI - [Spectral distribution of the radiation generated by therapeutic roentgen equipment]. PMID- 3982257 TI - [Radioimmunological study of the gonadotropic function of the pituitary in women during reestablishment of the menstrual cycle]. PMID- 3982259 TI - [Possibilities and future of mathematical modeling in radiotherapy]. PMID- 3982260 TI - [Effect of the duration of exposure of animals to light and dark regimes on the level of tumor radiosensitivity]. PMID- 3982261 TI - [Gamma-irradiation induced weakening of the stability of the DNA bond with nuclear matrix proteins]. PMID- 3982262 TI - [Effect of metronidazole on the radiosensitivity of Guerin's carcinoma during its growth]. PMID- 3982263 TI - [Late results and consequences of radiotherapy of fibrous dysplasia of the skull]. AB - The paper is concerned with the results of follow-up of 21 patients who were given radiation therapy (gamma-beam and x-ray therapy) for fibrous osteodysplasia of the cranial bones over the period of 1946-1973. The summary focal doses varied from 30 to 100 Gy. Radiation injuries came to the foreground (changes in the skin, radiation cataract, necrosis of the maxillary bones and the development of malignant tumors in two cases). Thus the use of radiation therapy in these cases turned out to be not only ineffective but also unsafe. PMID- 3982264 TI - Alterations in breast morphology consequent to a 21-day bust developer program. AB - Normal menstruating females, 19 to 32 years of age, were randomly assigned to either a control (C; N = 17) or an experimental (E; N = 17) group to determine alterations in breast size, shape, and volume consequent to a 21-day bust development program (BDP) using a commercial exercise device as specified by the manufacturer. E and C groups were evaluated on 2 consecutive d prior to initiating the BDP to establish reliability of the test procedures and again at the end of the BDP, 27 to 29 d following the initial measures. Anthropometric measures included the following girths: shoulder, chest, bust with and without brassiere, abdomen, deltoid, and flexed biceps. Breast photography included two 35-mm photographs each from the side and front views, in both full inspiration and full expiration, with the subject position carefully standardized. A total of 10 measurements, corrected for perspective error, were obtained from these photographs. Breast volume was measured using a water displacement technique, with three trials for each breast. Repeated measures analysis of variance procedures indicated no significant differences consequent to the BDP for any of the variables assessed, with the exception of a small decrease in shoulder girth in both E and C and a small decrease in left breast volume in E. It was concluded that the use of a commercial exercise device with a specific BDP does not result in changes in breast size, shape, or volume. PMID- 3982265 TI - Effects of aerobic training on fat distribution in male subjects. AB - To investigate the effects of aerobic training on adipose tissue morphology and fat distribution, several indicators of body fatness (percent body fat, seven subcutaneous skinfolds, fat cell weight) were assessed in 13 sedentary male subjects (SS) submitted to a 20-wk aerobic training program and in 20 male long distance runners (LDR). The LDR subjects had a mean +/- SD VO2max of 65.9 +/- 6.5 ml . min-1 . kg-1 and averaged 120 km . wk-1. Training increased the VO2max values of the SS group significantly (pre: 41.9 +/- 7.0 vs post: 53.4 +/- 6.4 ml . kg-1 . min-1; P less than 0.001) and decreased significantly percent body fat (P less than 0.01), sum of skinfolds (P less than 0.01), and fat cell weight (P less than 0.05). Trunk skinfolds were more altered by training than extremity skinfolds, with reductions of 22 and 12.5%, respectively. Significant correlations were found between fat cell weight and percent body fat in SS before and after training (r = 0.75; P less than 0.01), while no significant relationship was noted in the LDR group. Moreover, using the sum of skinfolds divided by percent fat or by fat mass to reflect the proportion of subcutaneous fat to total fat, the LDR subjects exhibited less subcutaneous fat than the SS group (P less than 0.01) and training did not alter these ratios in the SS group. These results suggest that 20 wk of aerobic training can alter body fatness in men but that the induced fat loss does not seem to deplete preferentially subcutaneous fat. PMID- 3982266 TI - Validity of "generalized" equations for body composition analysis in male athletes. AB - Equations by Durnin and Womersley [(D-W), Br. J. Nutr. 32:77, 1974], Jackson and Pollock [(J-P), Br. J. Nutr. 40:497, 1978], and Lohman [(L), Human Biol., 53:181, 1981] for estimating body density (BD) purportedly overcome the problem of specificity by accounting for age and/or the curvilinear relationship between skinfolds (SF) and BD. Their equations were validated on 265 male athletes against percent fat measured by underwater weighing [(UWW); mean +/- SD = 9.2 +/- 4.4%]. Equations by Sloan [(S), J. Appl. Physiol. 23:311, 1967], Katch and McArdle [(K-M), Human. Biol. 45:445, 1973], and Forsyth and Sinning [(F-S), Med. Sci. Sports 5:174, 1973] were included as "linear regression models" to compare to the curvilinear models of J-P, D-W, and L. Differences between UWW and estimated mean values ranged from -1.1 to +5.9%; correlations ranged from 0.58 to 0.85; SEE ranged from +/- 2.41 to +/- 3.61% and total error (E) ranged from 2.38 to 6.97%. The seven D-W equations overestimated mean percent fat by from 3.9 to 5.9%. The K-M, S, and L equations overestimated by 1.3, 0.5, and 1.7%, respectively. The F-S equations overestimated by 2.4 to 3.8%. Of the 21 equations evaluated, only 3 by J-P gave estimates not significantly different from UWW percent fat. Regression analyses of the relationship between UWW (y) and estimated (x) percent fat values from those equations were: y = 1.037x - 0.08 +/- 2.38, E = 2.38, r = 0.84; 0.869x + 1.36 +/- 2.45, E = 2.51, r = 0.83; 1.107x - 1.14 +/- 2.51, E = 2.53, r = 0.82.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982267 TI - Metabolic and cinematographic analysis of walking and running in men and women. AB - The purposes of this study were to compare the total metabolic costs and gait patterns of walking and running at self-selected, comfortable speeds in males and females. Total oxygen consumption was used to determine the metabolic cost, and cinematographic analysis was used to study the gait patterns of walking and running a distance of 1 km in 12 male and 12 female subjects. No significant sex difference was observed for the speed, vertical lift per stride, and total vertical lift per km of distance walked. Females ran at a significantly slower speed than males (P less than .01), but no significant sex difference was observed for the vertical lift per stride or total vertical lift per km of distance run. In both sexes, the gross and net energy costs of running were significantly greater (P less than .001) than those of walking when values were expressed as kcal . kg-1 . km-1 or cal . kg-1 . stride-1. No significant sex difference was observed in the gross or net metabolic cost of walking, whereas during running, the gross and net metabolic costs in kcal . kg-1 . km-1 were significantly higher (P less than .05) in females than in males. It was hypothesized that this sex difference was due to the cumulative effect of several factors which were biomechanical and metabolic in nature. PMID- 3982268 TI - Responses of pre- and post-menopausal females to aerobic conditioning. AB - This study sought to determine whether the ability to improve cardiorespiratory endurance and body composition is affected by the menopausal status of females. Twenty premenopausal females and 18 postmenopausal females, ages 35-49 and 47-66 yr, respectively, were randomly assigned to exercise and control groups depending on menopausal status. Both exercise groups (PRE-EX, N = 16; POST-EN, N = 14) participated in a progressive walking program (4 days/week for 9 weeks) at an intensity of 80% the age-adjusted heart rate maximum (80% HRM). Following training, both exercise groups significantly improved submaximal exercise capacity (SEC) as measured by oxygen consumption (l/min; ml/kg . min) and treadmill walking time at 80% HRM. The PRE-EX group significantly improved percent body fat and lean body weight, while there was no significant change in total body weight. The POST-EX group significantly improved total body weight and percent body fat with no significant change in lean body weight. Although some of these changes in body composition were statistically significant, overall the alterations were minimal. ANCOVA revealed exercise, not menopause, to be the effective treatment for improving percent body fat and SEC80%HRM. There were no significant differences between the PRE-EX and POST-EX groups in their ability to improve SEC80%HRM or to reduce percent body fat. The POST-EX group had a significantly greater reduction in total body weight, while the PRE-EX group had significantly greater increases in lean body weight. These findings suggest that the ability to favorably alter body composition and cardiorespiratory endurance through the aerobic conditioning of females is independent of menopausal status. PMID- 3982269 TI - Mechanical energy changes during treadmill running. AB - The purpose of this study was to investigate mechanical energy changes during treadmill running, using two biomechanical models of the human body: the multi segment model and the center of mass model. Two university distance runners ran at 3.33 and 2.67 m/s on the treadmill, while the right side was filmed by a 16-mm high-speed movie camera (100 fps). The instantaneous mechanical energies of the multi-segment model composed of 11 rigid segments (ME total) and those of the C.M. model (ME C.M.) were calculated for two strides for each trial. The following results were obtained: the trunk segment was the major contributor to the body energy variations, compared to the four limbs; internal kinetic energy, which was the difference between the energy amounts of the two models, was found to have a phase relationship directly opposite to those of the C.M. model. These findings were contrary to the previous studies on walking and were seen to be important characteristics of running energetics. PMID- 3982270 TI - Effects of shoes and foot orthotics on VO2 and selected frontal plane knee kinematics. AB - The objective of this study was to investigate the effects of shoes and foot orthotics on running economy and selected frontal plane knee kinematics during the support phase of running. Twenty-one male runners who had been fitted with orthotics served as subjects. Subjects participated in three submaximal runs on a treadmill under the following conditions: barefoot, shoes, and shoes plus orthotics. A run consisted of 1 min at 161 m . min-1, 2 min at 180 m . min-1, and 4 min at 201 m . min-1. VO2 was calculated for the last 3 min of each test. Frontal plane motion was filmed during the sixth min of each submaximal run, and linear and angular displacement of the knee were then calculated from film data. Results from the mechanical aspect of this study indicate that there were no significant differences among the means for linear displacement of the knee. Angular displacement of the knee during barefoot running was significantly (P less than 0.05) less than shoe and shoe-plus-orthotic conditions. There was no difference, however, between shoes and shoes plus orthotics. The economy results revealed that the aerobic cost of running increased as the amount of mass added to the foot increased. In absolute terms (1 . min-1), running in shoes plus orthotics was significantly (P less than 0.05) more costly than running barefoot. It appears that if orthotics do, in fact, improve running economy by improving running mechanics, the amount of improvement is negated by the additional cost of running associated with the mass of the orthotics. PMID- 3982271 TI - Maximal ventilation after exhausting exercise. AB - It remains unclear whether the hyperpnea of exercise severely stresses the ventilatory musculature. We hypothesized that the ability to ventilate maximally is decreased during and immediately following exhausting exercise. Subjects performed isocapnic maximal voluntary ventilations (60-s MVV) before, during the final minute, and after exhausting treadmill exercise lasting either 3-10 min or 60 min. Severe exercise lasting 3-10 min failed to change the 60-s MVV. In contrast, during the final minute and 5 and 10 min after 60 min of exhausting exercise, eight non-runners showed significantly lower (P less than 0.01) 60-s MVV values in comparison to control values. Eight runners had a lower (P less than 0.05) 60-s MVV 10 min post-exercise as compared with control and exercise values. Our data suggest that the capacity to ventilate maximally declines only in long-term exhausting exercise and that this decrement in most pronounced in non-runners. PMID- 3982272 TI - Evaluation of acute cardiorespiratory responses to hydraulic resistance exercise. AB - Accurate evaluation of the acute responses to resistance exercise training depends on the stability of the criterion measures. This is particularly true for maximal effort exercise where continuous "all-out" effort for each repetition is encouraged. The present study evaluated reliability of repetition number (repN), respiratory gas parameters (VO2, VCO2, VE), and heart rate (HR) for shoulder (SE), chest (CE), and leg (LE) exercise performed maximally on a single-unit, 3 station hydraulic resistance exercise machine (Hydra-Fitness, Belton, TX). On 2 separate days, 20 college men completed three 20-s bouts of SE, CE, and LE with a 20-s rest between bouts and 5 min between exercise modes. There were no significant differences between bouts or test days for repN, gas measures, or HR. Subjects performed 17, 19, and 21 reps during SE, LE, and CE. VO2 was 1.7 l . min 1 (24.3 ml . kg-1 . min-1) for SE, 1.87 l . min-1 (25.5 ml . kg-1 . min-1) for CE, and 2.1 l . min-1 (28.6 ml . kg-1 . min-1) for LE. These values, averaged, represented 52.8% of the max VO2 determined on a continuous cycle ergometer test. The corresponding HR's during hydraulic exercise averaged 84.6% of HR max. Test retest reliability coefficients ranged from r = .67 to .87 for repN, r = .41 to .83 for gas measures, and r = .72 to .89 for HR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982274 TI - Synthesis, experimentation, and the biomechanics of economical movement. AB - An issue that should concern sports biomechanists is the need for more synthesis of ideas and experimental testing of those ideas. Descriptive analysis is overemphasized at present, and more stress on synthesis of existing data and experimental testing of new ideas should generate new theories that will give us insights into the mechanical behavior of structures and the kinetics and kinematics of sports movements. One area where this approach may be especially helpful is in studying the question of what makes movements energetically economical. Twenty-six behavioral and mechanical factors have been shown to have an association with the economy of movement. A synthesis should be undertaken which probes the meaning of these various data. Trends in these findings point to intra- and intersegmental energy transfer, center of mass excursion, and elastic energy storage as potential areas for expanding our understanding of the biomechanics of economical movement. These possibilities might be explored by enhancing link-segmental mathematical models to predict what makes movements economical and then testing these predictions by using biofeedback techniques to train subjects to perform the correct movements while being monitored. Optimization models might offer an additional strategy for developing a theory of mechanically and energetically economical movement. PMID- 3982273 TI - Failure of caffeine to affect substrate utilization during prolonged running. AB - Nine sub-3-h male marathoners performed three 45-min monitored treadmill runs at approximately 75% of VO2max during a 2-wk period. The men were assigned in a random, double-blind fashion following the control run to receive either 350 ml of decaffeinated coffee or 350 ml of decaffeinated coffee with 400 mg of caffeine added 1 h before the second run with crossover to the other beverage for the third run. Venous blood was analyzed for free fatty acids, triglycerides, glucose, and lactic acid before beverage consumption and before and after each run. Oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (R), ventilation (VE), and perceived exertion were measured at 15, 30, and 45 min of each run. Of the blood parameters, free fatty acid and lactic acid concentration increased following caffeine ingestion. There was no difference in VO2, VCO2, or R between the three runs. Perceived exertion showed a significant decrease (P less than 0.05) at each time point in caffeine added and decaffeinated compared to control. Triglycerides, glucose, and lactic acid increased similarly in all three runs. In these well-trained marathoners, although plasma free fatty acids were elevated significantly prior to exercise after caffeine ingestion, there was no indirect evidence of altered substrate utilization during subsequent treadmill running. PMID- 3982275 TI - Current concepts in the diagnosis and treatment of hand and wrist injuries in sports. AB - The hand is the most commonly injured part in sport. Fortunately, most injuries are minor and do not interfere with the sport participation, but even these leave residual functional deficits that may increase with time. More severe injuries of the hand are appreciated instantly by the player and health care personnel and generally receive better care. The goal is to maintain the best functioning hands now for the sport and in the future for the life's work of the hand. A program is herein described outlining the care of minor and major sports injuries to the hand that tries to return the injured player quickly to the sport participation while not jeopardizing the future. Because injuries to this most important tool are so frequent, it is recommended that a lecture be given to each sport group prior to the season to describe and raise the awareness of the players regarding hand and finger injury. PMID- 3982277 TI - Pharmacological evidence for opioid and adrenergic mechanisms controlling growth hormone, prolactin, pancreatic polypeptide, and catecholamine levels in humans. AB - A group of 14 healthy subjects received 50 mg/kg body weight of 2 deoxy-D-glucose (2DG) IV in a 20-minute infusion to induce glucoprivation and stimulate the release of growth hormone (GH), prolactin (PRL), pancreatic polypeptide (hPP), and catecholamines. Six subjects having spontaneously high GH baseline levels (greater than 8 ng/mL) failed to mount a GH response to 2DG-induced glucoprivation while eight subjects having low GH baseline levels (less than 8 ng/mL) all had increases (greater than 10 ng/mL) of GH levels after 2DG (P less than 0.05). Baseline level of GH was a reliable predictor of subsequent GH response to 2DG. Administration of the alpha 2-adrenoreceptor agonist clonidine (0.5 mg po) reliably increased GH levels (P less than 0.05). Elevated GH levels following clonidine administration abolished GH responses to subsequently infused 2DG (P less than 0.05). While these data do not exclude the possibility of a short loop feedback control of GH secretion, they strongly suggest that the direction of the GH response to a provocative stimulus is determined by the antecedent GH level and that an alpha-adrenoreceptor mechanism is involved in such a biphasic modulation of GH levels. Clonidine administration significantly reduced total catecholamine, pancreatic polypeptide, and prolactin response to 2DG while opiate receptor blockade with naloxone (10 mg IV bolus followed by 2 mg/hr) did not affect catecholamine and pancreatic polypeptide response but did slightly attenuate the GH and PRL response to glucoprivation. We conclude that alpha adrenoreceptor mechanisms are of major importance while opiate receptor mechanisms are of relatively minor importance in modulating the effects of glucoprivation on sympathetic outflow and hPP, GH, and PRL levels. PMID- 3982276 TI - Normalization of low-density lipoprotein levels and disappearance of xanthomas during pregnancy in a woman with heterozygous familial hypercholesterolemia. AB - Serum lipids and lipoproteins were studied prior to conception, during pregnancy, and after delivery in a woman heterozygous for familial hypercholesterolemia. Prior to conception, serum and low-density lipoprotein (LDL) cholesterol levels were 613 and 528 mg/dL, respectively. At 37-week gestation, serum and LDL cholesterols decreased to the normal levels, 226 and 90 mg/dL, respectively. At two-week postpartum serum and LDL cholesterols returned to the preconception levels, 547 and 427 mg/dL, respectively. At delivery her cutaneous xanthomas almost disappeared. The patient was challenged by ethinyl estradiol of 120 micrograms/d for two months, as a result serum cholesterol decreased from 565 to 385 mg/dL, and LDL cholesterol fell from 460 to 208 mg/dL. During her second pregnancy, serum and LDL cholesterol decreased again significantly. Thus, this case, which showed dramatic reductions of serum and LDL cholesterol levels, may be considered a new variant of heterozygous familial hypercholesterolemia, and the reductions were probably brought about by the action of estrogens, which are known to increase LDL degradation through LDL receptors. PMID- 3982278 TI - Methods of digital information processing in clinical neurophysiology. PMID- 3982279 TI - Automated indexing based on SNOMED. PMID- 3982281 TI - Analyzing medicine by means of reprint requests. PMID- 3982282 TI - How to organize the medical data of chronically ill patients in the computer. PMID- 3982280 TI - On the analysis of three-dimensional contingency tables--application to the influence of allergy and age on cancer. PMID- 3982283 TI - How many pulmonary alveoli are supplied by a single arteriole and drained by a single venule? AB - A detailed measurement of histological specimens of the lungs of the cat shows that each terminal precapillary vessel (arteriole) supplies, on the average, 24.5 pulmonary alveoli; each terminal postcapillary vessel (venule) drains, on the average, 17.8 alveoli. These numbers link pulmonary alveolar blood flow in capillary sheets with the flow in pulmonary arteries and veins which are cylindrical tubes. They are key numbers needed for hemodynamic analysis. In the literature, these numbers are variously speculated to be 1 or smaller; thus our results correct, even though only for the cat, an important concept. PMID- 3982284 TI - Flow and distribution of India ink in microvessels of the frog. AB - Velocities of an India ink front and of RBCs moving ahead of it were studied by intravital microscopy in capillaries of frog mesentery and skeletal muscle. Measurements were made during microperfusion of single vessels or groups of connected vessels in mesentery, and following intravenous ink injection in both tissues. The presence of ink did not appear to interfere with microvascular flow or vasomotion during the period of observation. On the average, the ink spearhead moved only slightly faster than the RBCs. There was substantial variation in relative velocities of RBCs in the same vessel and in the relative velocities of ink front and RBCs. The time course of ink filling showed substantial heterogeneity of flow in mesentery, more nearly uniform flow in skeletal muscle. Comparison of the measured velocity ratios of ink to RBCs with published observations on relative velocities of RBC to blood suggest that the advancing, apparently parabolic front of ink moves at less than twice the mean blood velocity. This is due in small part to diffusive dispersion of the ink particles in the laminar flow gradient, but more largely to stochastic dispersion of the front by interaction with RBCs and by displacement at branches. PMID- 3982285 TI - Diffusion of labeled water and lipophilic solutes in the lung. AB - A perfused, in situ rabbit lung preparation was used to study the diffusion of tritiated water and labeled lipophilic solutes from the airways into the pulmonary vasculature. Following instillation into the airways, initial concentrations of labeled ethanol and butanol in the left atrial outflow usually exceeded those of 3H2O when the lungs were perfused at 37 degrees. In contrast, initial concentrations of [14C]acetone equaled 3H2O concentrations, and those of [14C]antipyrine were below 3H2O concentrations. Increasing the rate of perfusion increased concentrations of the labeled butanol and acetone but decreased that of antipyrine relative to 3H2O. This suggests that the tissues separating the gaseous and vascular compartments of the lung are more permeable to 3H2O than to antipyrine but less permeable to 3H2O than to the alcohols and acetone. Cooling slowed permeation of ethanol and antipyrine relative to 3H2O but seemed to slow diffusion of butanol less than that of 3H2O. These differences cannot be related to movement in the aqueous phase and suggest that cooling slows solute diffusion through lipid membranes. This phenomenon appears to be related to the activation energy of each molecule between the aqueous and lipid phases rather than a phase change in the membrane. 3H2O seems to diffuse through aqueous regions of the air perfusate barrier. PMID- 3982286 TI - Hypertrophy of arteriolar smooth muscle cells in the rat small intestine during maturation. AB - The purpose of this study was to define structural characteristics for vascular smooth muscle (VSM) cells from the submucosal arteriolar system of the rat small intestine during maturation. Arterioles from 6- to 8-week-old and 10- to 12-week old male WKY animals were selected from tissue prepared for scanning electron microscopy and mounted on end so that the entire circumference of each vessel could be observed by serial photography using scanning electron microscopy. From each vessel segment, the following measurements were made: outer vessel diameter, number of VSM cells occupying a length of vessel, the number of resolutions each VSM cell makes around the vessel, length of individual VSM cells, and width of lateral processes along their length. At a given age, the length and width of the VSM cell was statistically similar for all types of arterioles. However, the VSM cell increased substantially in length and width from the 6-8- to 10-12-week time periods. The outer diameter for a particular arteriolar type also increased with age. These data suggest that the intestinal vasculature as a common population of smooth muscle cells at a given age in terms of their length, size, and process morphology for the various types of arterioles. Furthermore, maturation of the microvessels is associated with a uniform hypertrophy of the VSM cells from the majority of arterioles such that cells of young adult rats and those of juvenile animals represent distinctly different populations. PMID- 3982288 TI - Doctor Berglund warns members of union pitfalls. PMID- 3982287 TI - Effects of 100% oxygen breathing on the capillary filtration coefficient in rabbit lungs. AB - Prolonged exposure to 100% O2 at 1 atm is known to result in a progressive increase of the alveolar epithelial permeability to lipid-insoluble molecules. To investigate whether the damage to the capillary endothelium precedes or follows this event, conscious, unanesthetized rabbits were exposed to 100% O2 from 24 to 66 hr, and (a) the filtration coefficient (Kf) of the pulmonary capillary endothelium in isolated, perfused lungs and (b) the arterial and carbon dioxide gas tensions and right and left heart vascular pressures were measured in intact animals. The mean value of the filtration coefficient (+/- SEM) in air-breathing animals was 0.036 +/- 0.002 ml/(min x Torr x g dry lung). After 48 and 66 hr in 100% O2, it increased by 58 and 114% from its baseline value, respectively. At the later period the lung wet/dry weight of the isolated, but not the intact lungs, increased also from 5.42 +/- .2 to 7.3 +/- .3 (means +/- 1 SEM) due to the combination of a higher capillary conductance and the lack of lymph flow in this preparation. All other variables remained normal throughout the exposure. Thus, in contrast to previous morphological findings, these results indicate that the oxygen damage to the capillary endothelium is progressive and occurs concurrently with the increase of the alveolar permeability to solute but before the appearance of pulmonary edema and the compromise of gas exchange. PMID- 3982289 TI - Medical news reporting: both sides of the story. PMID- 3982290 TI - Weigh the business risks of alternative delivery systems. PMID- 3982291 TI - New law removes one barrier for teens seeking prenatal care. PMID- 3982292 TI - Keeping patients at home a goal of British medicine. PMID- 3982293 TI - AIDS and the treatment of hemophilia. PMID- 3982294 TI - Prevention of prematurity and resultant infant mortality. PMID- 3982296 TI - Caring for our elder patients. PMID- 3982295 TI - The special challenges of caring for the elderly. PMID- 3982297 TI - 'Good geriatric care' requires a broad definition. PMID- 3982298 TI - Rx: consider these findings when prescribing for older patients. PMID- 3982299 TI - Vulnerable adults are at risk for abuse and neglect. PMID- 3982301 TI - Incontinence in the aged patient. PMID- 3982300 TI - Case management approach individualizes care for aged. PMID- 3982302 TI - Tips on talking to older patients. PMID- 3982303 TI - Prudent Purchaser Act summarized. PMID- 3982304 TI - Seat belt sponsor Cruce on the new law and his job. PMID- 3982305 TI - What's new with IRAs? PMID- 3982306 TI - [Lactobacillus in the saliva of persons with carious and non-carious teeth]. AB - The distribution of lactobacilli has been investigated quantitatively in the saliva of persons with carious and non-carious teeth. For this, a total of 500 students from the T.E.D. Ankara College, primary and middle school, aged 10-15, have been selected for investigation 315 students had non-carious teeth, whereas 185 suffered from carious teeth. Rogosa SL agar has been used for the cultivation of lactobacilli. The range of lactobacilli in the non-carious teeth group was 0-5 X 10(6). However, in the carious teeth group it was 0-6 X 10(6). The arithmetic mean of lactobacilli in the carious teeth was 1.9 X 10(5), but this was calculated to be 2.8 X 10(5) in the carious teeth group. PMID- 3982307 TI - [Rafanoxide therapy in a child with fascioliasis]. AB - A seven-year-old girl with fascioliasis was treated with rafanoxide which is used for therapy of fascioliasis in sheep and cattle. This is the first report in the literature concerning the usage of rafanoxide in children according to our knowledge. Rafanoxide was given in a single dose of 7.5 mg per kg body weight orally. PMID- 3982308 TI - [Dermatophytes isolated in the Sivas area of Turkey]. AB - In the Mycology Laboratory of the Department of Microbiology, Faculty of Medicine, Cumhuriyet University, the following dermatophytes were isolated from clinical specimens sent in for mycological examination: 26% T. rubrum, 21% T. menta, 10% T. shonleinii, 9% M. 12% E. floccosum, canis, 5% T. violaceum, 5% M. gypseum, 12% Candida sp. PMID- 3982309 TI - Objectives for medical education: expectations of society. AB - Since health care and the practice of medicine have become major topics for social and political comment a variety of expectations have emerged which, in a sense, define an idealized image of the medical profession and its work. Different sectors of the community tend to place different emphasis on specific aspects of doctors' roles. This paper reviews those specific expectations which have been expressed by patients, sociologists, allied health professionals, governments and health administrators, and derives from them objectives for medical education. PMID- 3982310 TI - Doctors' knowledge of the costs of medical care. AB - In achieving a more effective use of resources in the National Health Service (NHS), the medical profession has a role to play by improving cost efficiency in clinical practice. This role implies that doctors should have some knowledge of medical costs. In order to determine the extent of this knowledge, sixty-seven hospital clinicians, seventy-four general practitioners and a control group of novice clinical students completed a multiple choice questionnaire concerned with the costs of medical care. The doctors' knowledge of costs was poor and only marginally better than that of the students. The average number of correct responses obtained to twenty questions was 6.2 by the hospital clinicians, 5.5 by the general practitioners and 4.7 by the students. Performance on questions on overall NHS costs was better (P less than 0.01) than that achieved on questions on diagnostic costs, therapeutic costs and hospital costs. Knowledge of the costs of some commonly prescribed drugs, such as digoxin and ampicillin, was minimal. Ignorance of the financial consequences of clinical decisions may hamper attempts to improve the cost efficiency of medical practice. PMID- 3982311 TI - Does medical training affect personality? AB - We have compared results obtained for psychometric tests (Cattell's 16 PF and Eysenck's personality inventory) on a cohort of medical students who sat the tests in their second medical school year and repeated them in their sixth and final year. Most of the changes were in the direction expected of students maturing through the 19-24 year age period, but there were some significant differences from those obtained by other workers using the same tests on general student populations. Thus, in our study male students became 'brighter', more 'emotionally stable', less 'timid', more 'tough-minded', and more 'self controlled', all of these to a significantly greater extent than expected with the general student population. Similar changes were observed from females, although except for an increase in emotional stability, these were not significantly different from the values expected in the general population. PMID- 3982312 TI - Behavioural objectives for medical auxiliary training in Tanzania: 9 years' experience with an education model. AB - The behavioural objectives model of curriculum design was introduced to the Medical Auxiliary Training Sector in Tanzania during the 1970s while problems of expansion, novelty and economic stress were abundant. Experience in a relatively privileged school, Rural Medical Training Centre, Sengerema, shows that the model did not result in more practical teaching time, due mainly to various constraints. The students did, however, appreciate the 'sharing of objectives' at the onset of a teaching block as a great help for their (theoretical) learning. Due to unfamiliarity of teachers with new subject matter related to primary health care, the model has failed thus far to result in a relevant practical course in public health promotion. A more problem-oriented approach to curriculum development is recommended. PMID- 3982313 TI - Choice of career of doctors who graduated from Queen's University, Belfast in 1977. AB - Questionnaires were distributed in 1983 to 139 doctors who graduated from Queen's University Medical School in 1977, in the final stage of a longitudinal study of their choice of career. Replies were obtained from 96.4%. The average number of postgraduate qualifications among the men was 1.5 and among the women 1.7. An average of 41.6% were working in the field they had favoured in 1977, the greatest degree of consistency being among the general practitioners. The peak years for decisions about choice of specialty were reported by the respondents to be 1978 and 1979. Out of a given list of twenty-three factors likely to be taken into consideration in choice of specialty, the degree of importance accorded to eleven differed significantly between male and female respondents. Significant differences of priority emerged on eight factors among respondents in general practice and community medicine and patient- and technique-oriented hospital specialties. Of the 141 doctors who graduated in 1977, 30% had left the province and 65% wished to remain in Northern Ireland in the long term, an increase of 20% on 1977. PMID- 3982314 TI - Impact of supervision by medical teachers and in-patient test control programmes on the out-patient test utilization of residents. AB - The expense of clinical laboratory services and the broad variation in use of these services by doctors has led to several successful programmes to reduce the expense, particularly for in-patients. The applicability of the programmes to the care of out-patients of residents and the contribution of the interaction of the attending physician with the resident have not been formally studied. To address these issues, out-patient test utilization by first-year residents was studied both during and after an in-patient test control programme. Test utilization means how much the tests are used. It is another question whether the investigation makes any difference to patient care. The residents in the intervention group significantly reduced test utilization compared to the control group and the reductions were sustained for the duration of the study for the use of chemistry panels. Studies of the interaction of attending physicians with residents suggested that the residents' style of test utilization was the predominant one but that this style was magnified when working with an attending physician of similar or more extreme style. PMID- 3982315 TI - The value of the California Psychological Inventory in predicting medical students' career choice. AB - Much of the research in medical education has focused on the prediction of medical students' future career choices. This longitudinal study evaluates the effectiveness of the California Psychological Inventory (CPI) in predicting career choices of students attending the University of Maryland School of Medicine. While results did reveal some significant and consistent differences between career choice groups, these differences were not of the magnitude to allow discrimination among all specialty groups. There is no evidence to support the hypothesis that career choice can be predicted from CPI data. It was concluded that future research into career choice prediction should focus on variables other than personality characteristics as measured by the CPI or similar tests. PMID- 3982316 TI - The use of freeze frame (slow scan) video for health professional education. AB - Continuing education in the professions is receiving increased emphasis and the economic and effective delivery of programmes must be a priority for the future. Freeze frame video, one of the newer telecommunication technologies, is a promising method for delivering continuing medical education (CME) over distance for those who have difficulty in regularly attending educational update programmes, especially for those in rural and isolated areas. The system uses two telephone lines to transmit both voice and a still picture simultaneously to one or several sites. The video portion can be a view of the patient, text, 35-mm slides, microscopic slides, or any other still object. Five years' experience with a slow-scan system as used for education is outlined. Three types of programme formats were all presented with this technology; consultations; discussion/case presentations; and lectures. The best use of the system was for small groups, with discussion of their unique problems. The fully interactive nature of the slow-scan system assisted in the presentations and allowed all sites in multisite conferences to be fully involved. Because most teachers are not familiar with the technology in their everyday life it requires more orientation and experience to accomplish a skilled programme than with other telecommunication systems such as the telephone or television. PMID- 3982317 TI - The academic task. PMID- 3982318 TI - Medical problem-solving: some questionable assumptions. AB - This paper questions the idea that expert doctors use the hypothetico-deductive method when developing diagnoses of routine clinical cases. Up to now, this has not been justified by empirical evidence but by two indirect arguments. The first is that it is the standard procedure of scientific method. The second is that it is supported by research in cognitive psychology comparing the problem-solving behaviour of experts and novices. It is argued in this paper that both areas have been misinterpreted. In particular, the evidence from research in cognitive psychology on expert-novice comparisons indicates that the use of the hypothetico deductive method is a characteristic of novices rather than experts. Experts use what are called strong methods, which are dependent on a highly elaborated and structured knowledge base. It is concluded that a considerable amount of research on the nature of such strong methods in expert clinical reasoning is needed before any confident claims can be made regarding the use of the hypothetico deductive or any other method. PMID- 3982319 TI - Exercise and sudden cardiac death. PMID- 3982320 TI - Special admissions to a medical school. PMID- 3982321 TI - Health care problems in Afghanistan. PMID- 3982322 TI - A tattoo removal programme in Victoria. PMID- 3982323 TI - Percutaneous ultrasonic disintegration and removal of renal calculi. AB - The results of percutaneous renal stone removal in the first 50 patients to undergo this procedure are presented. The procedure was successful in 40 patients; in 16 of these, ultrasonic disintegration was necessary. The technique failed in 10 patients. The difficulties encountered and the resulting modifications of technique are described. PMID- 3982324 TI - Content of infusion packs. PMID- 3982325 TI - Doctors in politics. PMID- 3982326 TI - Birth after transfer of cryopreserved embryos. AB - A normal baby girl was delivered after the successful transfer of two thawed embryos which had been frozen for eight weeks. Embryo cryopreservation may improve the chances of conception by women who are undergoing in-vitro fertilization (IVF), reduce the risks of multiple pregnancies in association with IVF, and offer the chance of conception to women with serious gynaecological disease which threatens ovarian function. PMID- 3982327 TI - Sequelae of gangrene of the ileum in childhood. AB - An 81-year-old woman, who, at the age of 5 1/2 years, had undergone a series of operations for gangrene of the ileum, presented in 1983 with acquired megacolon and chronic malabsorption caused by the persistence of a jejunosigmoid fistula for 76 years. Follow-up in this case thus spans 76 years. PMID- 3982328 TI - Epidemiology in Australia. PMID- 3982329 TI - Voluntary euthanasia. PMID- 3982330 TI - RSI, or "kangaroo paw". PMID- 3982331 TI - Radiology in asbestos workers. PMID- 3982332 TI - Postcoital intervention. PMID- 3982333 TI - Early detection of pregnancy. PMID- 3982334 TI - Sequelae of therapeutic abortion. PMID- 3982335 TI - The "10-day rule". PMID- 3982336 TI - Eyedrop-induced asthma. PMID- 3982337 TI - Home management of asthma. PMID- 3982338 TI - Anabolic steroids and colonic cancer. PMID- 3982339 TI - Smoking and lung cancer. PMID- 3982341 TI - Neuropeptides and appetite regulation. PMID- 3982340 TI - International symposia on nutrition and obesity: the state of the science. PMID- 3982342 TI - Obesity studies in Australia. PMID- 3982343 TI - Metabolic causes of obesity. PMID- 3982344 TI - Bacteria, gastritis, acid hyposecretion and peptic ulcer. PMID- 3982345 TI - Attempt to fulfil Koch's postulates for pyloric Campylobacter. AB - A volunteer with histologically normal gastric mucosa received pyloric campylobacter by mouth. A mild illness developed, which lasted 14 days. Histologically proven gastritis was present on the tenth day after the ingestion of bacteria, but this had largely resolved by the fourteenth day. The syndrome of acute pyloric campylobacter gastritis is described. It is proposed that this disorder may progress to a chronic infection which predisposes to peptic ulceration. PMID- 3982346 TI - Pyloric Campylobacter infection and gastroduodenal disease. AB - In 1982, a new spiral Gram-negative bacterium which was similar to those of the genus Campylobacter was isolated from the gastric mucosa of 11 patients with gastritis. From then on, the organism was isolated in a further 114 of 267 patients who underwent antral biopsy in Fremantle Hospital between January 1983 and September 1984. During 1984, the bacterium was cultured from 88% of patients in whom it was detected histologically, and was not cultured from any patient with histologically normal gastric mucosa. The new bacterium, pyloric campylobacter, grew in three days on brain-heart infusion blood-agar at 37 degrees C in an atmosphere with added CO2. All isolates tested were sensitive to penicillin, erythromycin, tetracycline, cephalosporins, gentamicin and bismuth citrate; 80% of isolates were sensitive to metronidazole or tinidazole. It is suggested that pyloric campylobacter infection is a major factor in the causation of dyspeptic disease and peptic ulceration. Antibacterial regimens directed against the bacterium may provide a permanent cure for these chronic disorders. PMID- 3982347 TI - Prevention of pulmonary complications in severe Guillain-Barre syndrome by early assisted ventilation. AB - Sixty-seven patients with acute polyneuritis (Guillain-Barre syndrome) who required assisted ventilation (AV) were studied to determine the effect of early initiation of AV on the development of pulmonary complications in the subsequent week. Of 67 patients, 57 had ultimately a very low vital capacity (VC) of the lungs (less than 15 mL/kg) and, therefore, had disease of comparable severity. These were divided retrospectively into those in whom AV was started before their VC fell below 15 mL/kg ("early" group) and those who received AV only after their VC was 15 mL/kg or lower ("late" group). The development of lung abnormalities demonstrated on chest x-rays was compared in the two groups. Patients in the "early" group were less likely to develop pulmonary complications than those in the "late" group (P less than 0.0005). The beneficial effect of early AV was even greater if it was begun when the VC was higher than 25 mL/kg. The early initiation of AV in patients with Guillain-Barre syndrome and progressive respiratory paralysis reduces the risk of pulmonary complications. PMID- 3982349 TI - Choreoathetosis and clonazepam. PMID- 3982348 TI - Hormonal factors and melanoma in women. AB - The effect of exogenous hormones and reproductive factors on the risk of melanoma in women was investigated in a case-control study. Data from 91 women, aged from 15 to 81 years, and 91 matched controls were analysed in relation to use of oral contraceptives (OC), parity, age at the birth of the first child, and calculated length of ovulatory life. When potential confounding factors (including pigmentary characteristics and the lifetime exposure to sunlight were taken into account, there was no increase in risk of melanoma in relation to OC use, parity, or age at the birth of the first child. An unexplained association between melanoma and ovulatory life of greater length than 20 years was observed. The general findings of this study suggest that neither hormonal nor reproductive factors increase the risk of melanoma in women. PMID- 3982350 TI - Treatment of gonococcal ophthalmia. PMID- 3982351 TI - Injuries in sport. A prospective casualty study. AB - During the 12 months of 1980, 1652 sporting injuries were recorded in three casualty departments in Brisbane. More than 35 different sports were represented, although the four major football codes accounted for 63% of cases. Sixty-nine per cent of injuries occurred during competition, and 11% during training, while 20% were sustained during recreational sporting activities. The mechanisms, nature, and site of injuries are presented and comparisons are made between the four football codes. Foul play was responsible for 7% of injuries in contact sports. Closed soft-tissue injuries comprised 55% of cases, yet only in 8% of these were the patients referred for physiotherapy. The hospital presentation of football injuries was different from that seen in the field. PMID- 3982352 TI - Prolonged intensive therapy after snake bite. A probable case of envenomation by the rough-scaled snake. AB - A case of snake-bite envenomation, probably by the rough-scaled snake (Tropidechis carinatus), in a 9-year-old boy is reported which we believe to represent the most severe and prolonged case yet of non-fatal snake-bite envenomation in a human. The initial clinical features included loss of consciousness within minutes of the bite, followed by a period of partial recovery. The child subsequently developed total body paralysis, acute renal failure, and gross rhabdomyolysis. Artificial ventilation was maintained for 10 weeks; muscle paralysis and paresis persisted for 18 weeks before neuromuscular function returned to normal. Recovery occurred in centripetal fashion, the respiratory muscles and the palatal muscles being the last to recover. Acute renal failure persisted for 18 days and was treated by peritoneal dialysis. Some beneficial effects were seen even when antivenom was given 90 hours after the bite, but gross rhabdomyolysis caused by this species is not prevented by the administration of antivenom after 60 hours. It is concluded that if life can be sustained for 10 weeks by artificial ventilation, normal intellectual and neuromuscular recovery is possible in such cases. PMID- 3982353 TI - An eye for cricket. Ocular injuries in indoor cricketers. AB - Indoor cricket has become a popular form of recreation in Australia. Four cases of significant ocular trauma in indoor cricketers are reported. Three of the patients had diminished visual acuity in at least one eye before their injury. One patient may suffer long-term consequences as a result of his injuries. These injuries could probably have been prevented by the use of appropriate eye protection. Indoor cricketers might well be advised to undergo ocular assessment before taking up this sport. PMID- 3982354 TI - Ingestion of hydrochloric acid. AB - A case of intentional ingestion of concentrated acid, in which both disseminated intravascular coagulation and acute respiratory insufficiency complicated initial resuscitation, is reported. The assessment and the acute management of this unusual problem are reviewed, with emphasis on early endoscopy and laparotomy. PMID- 3982355 TI - Abortion in early pregnancy. PMID- 3982356 TI - Adolescent pregnancy. PMID- 3982357 TI - Complication of gastric bypass. PMID- 3982358 TI - Horse-riding accidents. PMID- 3982360 TI - [Homeopathy and pharmacology. Pharmacologic discussion of homeopathic drugs]. PMID- 3982361 TI - [Disease and personality]. PMID- 3982359 TI - Poisoning fatalities in Virginia. PMID- 3982362 TI - [Ophthalmology: new therapeutic methods]. PMID- 3982363 TI - Drugs for rheumatoid arthritis. PMID- 3982364 TI - Immunizations and chemoprophylaxis for travelers. PMID- 3982365 TI - Indirect serum haemagglutinating antibody response to black pigmented Bacteroides during experimental pure infections in rats. AB - The humoral immune response during experimental infection with black pigmented bacteroides was studied by the indirect haemagglutination test. Both Bacteroides melanimogenicus (ATCC 25845) and B. intermedius (ATCC 25611), grown in semi-solid agar culture, produced pure subcutaneous, intra-abdominal and lung infections. In each of these infection models, B. intermedius was found to be more pathogenic than B. melaninogenicus on the basis of gross pathology of the lesion, bacteriological and histopathological findings, and the capacity to produce persistent infection. Cytoplasmic extracts of these strains were used as an antigen for the indirect haemagglutination test. In all the infections, B. intermedius provoked a better and higher antibody response than did B. melaninogenicus, suggesting a potent immunogenic property of the former strain. Peak antibody titres in both groups during all the above infections were seen between the 10th and 15th days post infection (p.i.), which was precisely 3-5 days after peak lesion was achieved. A significant IHA antibody titre persisted up to days 30-37 p.i. These findings suggest that the antibodies to the black pigmented Bacteroides are not protective, but may play a role in the pathogenesis of the diseases. PMID- 3982366 TI - Statistics in medical journals: a survey of current policies and proposals for editors. PMID- 3982367 TI - Medical students' concepts of childhood cancer and its management. AB - Medical student's attitudes toward cancer and patients with cancer were studied prior to and following a required pediatric clerkship which included contact with children on an oncology service. Emphasis in the study was placed on the students' reactions to the child with cancer, and these were compared with the same students' attitudes in the context of the adult with cancer or general oncology. Early diagnosis is regarded as of more significance, and an aggressive therapeutic response following diagnosis of more urgency when the patient is a child. These attitudes, recognizing the importance of early diagnosis and expressing strong approval of aggressive therapy for the pediatric patient, increased during the clerkship. The students strongly supported a program aimed at return of the child to his normal activities with the least delay; recognized the special significance of long-range surveillance for secondary effects in the pediatric patient; and recommended the "center" as opposed to the community hospital as the site for care of the child with cancer. In other areas of cancer management, including (a) the importance of psychosocial support, (b) the problems of emotional involvement of the physician with the patient, and (c) care of the dying patient, attitudes toward patients in the two age groups was not significantly different. PMID- 3982368 TI - Cystic neuroblastoma in an infant. PMID- 3982369 TI - Urinary bladder tumors following cyclophosphamide therapy: a report of two cases with a review of the literature. AB - Sterile hemorrhagic cystitis following cyclophosphamide (Cph) therapy is a relatively frequent and well-documented phenomenon. On the other hand, cancer of the urinary bladder associated with Cph therapy is rarely observed. We present two cases and summarize 32 patients reported in the literature. Thirty patients had malignant disease elsewhere, 27 of them nonsolid tumors. The other four patients received treatment with Cph for nonmalignant disease (systemic lupus erythematosus--3; rheumatoid arthritis--1). The bladder tumor developed several months to years after treatment. In 20 patients hemorrhagic cystitis antedated the tumors. We conclude that hemorrhagic cystitis in patients on Cph therapy should indicate at least temporary withdrawal of the drug. The decision to resume treatment should be taken with extreme caution considering the risk of the development of bladder cancer. PMID- 3982370 TI - Secondary myelofibrosis with metastatic breast cancer simulating agnogenic myeloid metaplasia: report of a case and review of the literature. AB - A patient with carcinoma of the breast, who developed a clinical syndrome resembling agnogenic myeloid metaplasia, is described. She was found to have secondary myelofibrosis with metastatic carcinoma of the marrow, extensive extramedullary hematopoiesis resulting in massive splenomegaly, and leukoerythroblastosis. These findings are rare and myeloid metaplasia with striking extramedullary hematopoiesis causing massive splenomegaly and mimicking agnogenic myeloid metaplasia is seldom seen in patients with metastatic carcinoma. Previous case reports of secondary extramedullary hematopoiesis simulating agnogenic myeloid metaplasia (AMM) in patients with solid tumors are also reviewed. PMID- 3982371 TI - [Improvement of the examination for medical practitioners]. PMID- 3982372 TI - [Studies on antigen highly associated with human bronchogenic squamous cell carcinoma--enzyme-linked immuno-absorbent assay]. AB - Insoluble extracts of human bronchogenic squamous cell carcinoma were solubilized by desoxycholate. After fractionation, the soluble extracts were used to prepare antisera in guinea pigs. These antisera, after being highly absorbed with homogenates of several normal organ, serum and carcinoembryonic antigen, were reactive only with squamous cell carcinoma. There was no reactivity to fetal lung, normal adult organs or other cancers. PMID- 3982373 TI - [Endoscopic and histopathological studies of experimental esophageal cancer in beagles]. AB - In order to obtain a reliable experimental model simulating human esophageal cancer, endoscopic and histopathological studies were undertaken in the esophageal cancer produced in the beagle dog. Thirty-seven dogs had been given a solution of N-Ethyl-N'-nitro-N-nitrosoguanidine (ENNG) at a concentration of 150 micrograms/ml for 3-9 months. Follow-up studies included serial endoscopy and biopsy, and almost all animals were eventually sacrificed for histological examination. The results were as follows: Squamous cell carcinoma was observed in 5 out of 22 female dogs, while none in male dogs at all. For the induction of squamous cell carcinoma in the esophagus, administration in the condition of 150 micrograms/ml (75mg/day) for 6-9 months was most suitable. Almost all of esophageal lesions were protruding and well-differentiated squamous cell carcinoma with invasion of the submucosa. The stages of hyperplasia, dysplasia and squamous cell carcinoma in the esophagus were chronologically followed. Carcinoma had been observed in the stomach about 4 months prior to the appearance of esophageal carcinoma. This experimental model was proved to be useful for studies on histogenesis of human esophageal cancer both light and electron microscopically. PMID- 3982374 TI - [Systemic hemodynamics and oxygen metabolism after hepatectomy--effect of hyperdynamic systemic circulatory support on postoperative prognosis]. AB - This study was undertaken to evaluate inotropic effect of dobutamine (DOB) on systemic and hepatic hemodynamics after hepatectomy. Systemic hemodynamics after 70% hepatectomy using mongrel dogs was depressed and oxygen metabolism was disturbed. Whereas in the dogs administrated DOB after hepatectomy, systemic circulation was improved and oxygen metabolism was maintained in a favorable state. In these hepatectomized dogs, hepatic blood flow was increased after administration of DOB. Systemic hemodynamics after hepatectomy in 37 cases of cirrhotic hepatoma was studied. In 15 cases, 3 micrograms/kg/min of DOB was infused i.v.d. after operation, and remaining 22 cases were assessed without DOB as control group. In controls, systemic circulation was depressed and increase of peripheral oxygen demand was compensated by increase of oxygen extraction ratio. Whereas in DOB group, oxygen delivery increased according to hyperdynamic systemic circulation and was followed by increase of oxygen consumption. These favorable hemodynamic results in DOB group reflected on the postoperative prognosis of these patients; 5 of 22 in control group, whereas only 1 of 15 in DOB group died of hepatic failure postoperatively. It is concluded administration of DOB in cirrhotic hepatectomized patients maintained systemic circulation in a hyperdynamic state and this resulted in improvement of postoperative prognosis. PMID- 3982375 TI - [Experimental study on influence of obstructive jaundice and vagotomy upon stress ulcer in rats]. AB - The effect of water immersing and restraint stress upon the gastric acid secretion and gastric mucosal defensive factors was investigated in rats with special reference to the influence of obstructive jaundice and vagotomy. The results obtained were as follows. Water immersing and restraint stress ulcer may be caused by increased gastric acid secretion and deteriorated gastric defensive factors. Enhanced ulceration in jaundiced rats may be caused by severely damaged gastric defensive factors, rather than by the increased gastric acid secretion. Vagotomy itself, cannot inhibit stress ulceration completely, especially under the condition of damaged gastric defensive factors. PMID- 3982376 TI - [Prognosis of the pancreatic carcinoma in terms of the regional lymph node reaction]. AB - In order to elucidate immunological defense mechanism in tumor bearing host against pancreatic carcinoma, tissue reactions of the regional lymph nodes were investigated in terms of extension and prognosis of pancreatic carcinoma. As the site for investigation of lymph node reaction paracortical area, germinal center and sinus histiocytosis system were selected. In each case paracortical hyperplasia, germinal center hyperplasia and sinus histiocytosis were graded and the relation between such grade and prognosis of resected pancreatic carcinoma was studied with following results. The grades of each tissue reaction in cases without lymphatic node metastasis were higher than that observed in cases with metastasis. There was significant difference in sinus histiocytosis (p less than 0.01). Higher graded tissue reactions were observed in cases with primary lesion with histologic type classified as papillary adenocarcinoma or as well differentiated tubular adenocarcinoma as compared to those in cases of poorly differentiated histologic type. In cases with pancreatic carcinoma the prognosis was better in cases with higher grade of tissue reactions of the regional lymph nodes. In cases with pancreatic carcinoma both cellular immunity and humoral immunity are involved in host defense mechanism. It was considered that sinus histiocytosis is significant as an indicator for good prognosis and a factor to inhibit progression in pancreatic carcinoma. PMID- 3982377 TI - [Experimental study on intestinal absorption of elemental diet]. AB - An isolated intestinal segment separated from the flow of digestive fluid was made according to the method of Thiry Vella in the jejunum, ileum and large intestine of mongrel adult dogs in order to examine absorption of elemental diet at each intestinal segment. The same experiment was undertaken in a segment in the irradiated jejunum prepared as a model of disturbed intestine. Amino acids were adequately absorbed at the segments in the jejunum and ileum, and the absorbing pattern of each free amino acid at the two segments was almost the same. Nutritional components of the elemental diet were also absorbed adequately at the segment in the large intestine. Each intestinal segment showed specificity in absorbing electrolytes. There was no difference in absorption of nutritional components between the segments in the irradiated jejunum and the normal intestine, but absorption of electrolytes was affected by irradiation. PMID- 3982378 TI - [Surgical treatment of fusiform thoracoabdominal aortic aneurysm with Marfan's syndrome. A report on reconstruction of 4 major abdominal visceral branches]. AB - A fusiform thoracoabdominal aortic aneurysm involving celiac, superior mesenteric and renal arteries was successfully replaced in a 53-year-old female with Marfan's syndrome who also had annuloaortic ectasia, dissecting aneurysm of descending aorta and bilateral subclavian arterial aneurysms. Exposure of the aneurysm was obtained with a thoracoabdominal incision by reflecting the abdominal viscera to the right. First the limbs of a 24 X 12mm dacron bifurcated prosthesis were attached to common iliac arteries in an end-to-side fashion. Then renal arteries were anastomosed end-to-end to the branches previously attached to the body of the prosthesis. With the temporary bypass from left subclavian to left limb of the dacron graft, reconstruction of the celiac and superior mesenteric arteries was performed by direct suture of orifices to the opening made in the graft. Proximal anastomosis between descending aorta and the graft was made in an end-to-end fashion. The dissecting lesion of the proximal descending aorta was wrapped by dacron mesh. The immediate postoperative course was uneventful except transient hepatitis and pneumonia. The patient was discharged 49 days after operation. One month later, however, she died suddenly. Autopsy could not reveal the exact cause of death. Retrograde revascularization combined with Crawford's method was useful in shortening the occlusion time. PMID- 3982379 TI - [Mitral valve replacement with preservation of the posterior leaflet, chordae tendineae and papillary muscles (modified MVP)]. AB - The modified MVR leaving the posterior leaflet and its subvalvular tissues intact was performed in 40 patients including 17 of MR, 17 of MSR and 6 of MS from 1981 to 1984 in this institution. Mitral valves were replaced mostly with mechanical valves and using interrupted everting mattess sutures. Moreover, the aortic valve was simultaneously replaced in 13 patients and the tricuspid valve was also treated with annuloplasty, commissurotomy or replacement in 11 patients. There were no hospital deaths and 3 late deaths caused by MOF or unknown cause. Left ventricular rupture as a fatal complication did not occur. High cardiac index and LVSWI with low left atrial pressure were maintained in the immediate postoperative period. Q-d times at the base, mid portion and apex of the left ventricle were measured by 2-D echocardiograms in the follow-up period and were compared with those of patients with conventional MVR. Those at apex and mid portion were significantly shorter in patients with modified MVR than in patients with conventional MVR. These findings suggest that the left ventricular contraction might be maintained better in the former than in the latter. In conclusion, preservation of the posterior leaflet, chordae tendineae and papillary muscles should be preferable in MVR for prevention of both LOS and left ventricular rupture. PMID- 3982380 TI - [Correlation between anti-tumor effect and delayed hypersensitivity induced by topically applied OK-432 with histological findings]. AB - Delayed hypersensitivity (DH) against OK-432 was induced in BALB/c mice by injecting 2 KE of OK-432 with Freund's incomplete adjuvant into foot pads. One week after presensitization with OK-432, 2 X 10(5) cells of Meth A tumor were implanted subcutaneously in all mice, followed by intratumoral injection of 1 KE of OK-432 five times every other day starting at 7th day in experimental group. Tumor growth was significantly inhibited in the OK-432 presensitized group comparing to non-sensitized group. In experimental groups marked inhibition was observed in mice which were injected with OK-432 intratumorally 2 to 3 weeks after presensitization. This effect correlated well with delayed hypersensitivity against OK-432. Histological changes after intratumoral injection of OK-432 were examined in order to analyse the mechanism of this effect. The main finding of OK 432 injected specimen by H.E. staining were degeneration of tumor cells and infiltration of inflammatory cells. These changes were stronger in OK-432 presensitized mice. By beta-D-galactosidase staining accumulation of macrophages was found both inside the tumor and the surrounding tissue, and these macrophages increased in OK-432 presensitized mice. Immunoperoxidase staining with antiasialo GM1 anti-serum was also performed. Greater number of activate macrophages were observed to accumulate in the specimen of OK-432 presensitized mice than that of control mice. Some T cells were observed only around tumor tissues and not in the tumor of both presensitized and unsensitized mice. These results suggest that the activated macrophages play a major role in the augmentation of antitumor effect by presensitization with OK-432. PMID- 3982381 TI - [Effect of sex hormone on the experimental induction of esophageal cancer]. AB - The occurrence and the prognosis of human esophageal cancer shows a sex difference. It is assumed that sex hormone is one of the many causes of that sex difference. The effects of sex hormone on the experimental induction of esophageal cancer were investigated by the administration of chemical carcinogen. Multiple squamous cell neoplasms of the esophagus were induced by oral administration of 0.25% N-methylbenzylamine (MBeA) and 0.16% NaNO2 for 100 days or by subcutaneous (s.c.) injection of N-methylbenzyl nitrosamine (MBeN) at a dose level of 2.5mg/kg weekly for 16 weeks. The incidence of esophageal cancer in oral administration group was 42.9% in nontreated male rats, 30.0% in castrated male rats, 18.2% in estradiol s.c. injected male rats, 0% in castrated and estradiol s.c. injected male rats, 8.0% in nontreated female rats, 33.3% in castrated female rats, 33.3% in testosterone s.c. injected female rats and 36.4% in castrated and testosterone s.c. injected female rats. The incidence of esophageal cancer in s.c. injection group was 47.1% in nontreated male rats, 14.3% in early castrated and estradiol s.c. injected male rats, 23.1% in lately castrated and estradiol s.c. injected male rats, 7.7% in nontreated female rats, 33.3% in early castrated and testosterone s.c. injected female rats and 12.5% in lately castrated and testosterone s.c. injected female rats. These results showed a suppressing effect of estrogen and a promoting effect of androgen on the experimental induction of esophageal cancer. PMID- 3982382 TI - [Application of a potential difference to evaluate the absorptive faculty in the small intestine. The change of the transmural resistance and the transport system during post-natal development]. AB - Presently there is no effective method for evaluating the intestinal absorption of sugar, amino acid and small peptide. Since the transmural potential difference (delta PD) is generated immediately when sugar, amino acid or small peptide are absorbed in the small intestine, we tried to utilize this potential difference for the evaluation of absorptive faculty. The delta PD is the product of influx and electrical transmural resistance. To evaluate the intestinal absorptive faculty by the delta PD it is necessary that the electrical resistance of the small intestine does not change throughout the life time and that sugars, amino acids and peptides are transported actively. In guinea pig, the electrical resistance of the small intestine was examined in postnatal development in vitro. Transport systems of sugars amino acid and peptide were also investigated. Through the entire life the electrical resistance of the small intestine remained at almost the same value and sugars and amino acid were completely transported actively from the birth. But small peptide was transported actively after the period of weanling. Evaluation of intestinal aborptive faculty of sugars, amino acids and small peptides is considered to be possible by the transmural potential difference. PMID- 3982383 TI - [Arteriosclerosis of the aortic arch branches. An analysis of 43 cases]. AB - During 2 years and 8 months (1980.9.-1983.4), 100 patients of arteriosclerosis were admitted to our hospital. Of these patients, 43 who had clinical symptoms of TIA, RIND, or bruits on the neck or supraclavicular fossa, were reviewed. Ages ranged from 46 to 81 years (mean: 66.3). Male to female ratio was 1.9:1. Of the 43 patients, 33 were submitted to arteriography of the branches of the aortic arch. Thirty-two but one had arteriosclerotic lesions on the 62 arteries: 32 carotid, 18 vertebral, and 12 subclavian arteries, respectively. Morphologically there were 42 stenoses, 13 occlusions, 7 aneurysmal dilatations, and three other lesions. Seven patients were involved only one artery and 25 were involved more than two arteries. Eight patients were involved other regions such as lower extremities, too. Of the 43 patients, 12 were operated upon and there were no operative deaths and complications. Three of 31 who were treated conservatively, died of malignancies and heart failure. Although operative indications for TIA or RIND have been defined, those for asymptomatic lesions have not been established. Once stroke occurred, however, it would become difficult to recover from it. It is hoped that operative indications for asymptomatic lesions are established as soon as possible. PMID- 3982384 TI - [A successful transcatheter embolization with occluding spring emboli for vertebral arteriovenous fistulas following insertion of Swan-Ganz catheter]. AB - Vertebral arteriovenous fistulas caused by insertion of percutaneous monitoring catheter through internal jugular vein are rare complications. This is a case report of a successful treatment by transcatheter embolization using spring occluder for the fistulas. Particular attention should be paid to the following: Normal basilar and contralateral vertebral arteriograms are prerequisites to this procedure in order to avoid its potential neurological hazards. For the complete elimination of the fistulas with retrograde filling, embolic material should be placed in the artery not only proximal but also distal to the fistulas opening. PMID- 3982385 TI - [Surgical treatment for thoracoabdominal and suprarenal abdominal aortic aneurysm]. AB - We experienced 4 cases of thoracoabdominal and suprarenal abdominal aortic aneurysm in the last 6 months. There were 3 males and 1 female ranging in age from 43 to 66 years, 2 with an etiology of aortitis syndrome, 1 with non-specific inflammation and 1 with atherosclerosis. In all cases the modified Hardy procedure was employed. A 18 to 22mm X 9 to 11mm bifurcation, double velour woven dacron graft was sutured from the side of the lower descending thoracic aorta to the side of both common iliac arteries. Grafts of the same kind as above 6 to 7mm in size were attached from the main graft to major visceral arteries by end-to end or end-to-side anastomosis. A permanent aortic-excluding clamp was attached to the normal aorta just proximal to the aneurysm. Another clamp, or double ligature with silk, was placed on the lower abdominal aorta or both common iliac arteries distal to the aneurysm. No renal and spinal preservation of any kind was employed, but renal failure and paraplegia were not recognized in any of the cases. One patient died 2 days and another 21 days after the operation due to uncontrollable bleeding and multiple organ failure. The other two are doing well. PMID- 3982386 TI - [Liposarcomatous tumor emboli to the left iliac artery growing intraluminally into the femoral artery. A report of an operative and autopsy case]. AB - A 74-year-old female patient with a past history of the locally recurrent tumor of the liposarcoma in the right thigh over 20 years ago received an emergency vascular operation to relieve severe ischemic symptoms in the left leg. The left femoral artery was pulseless and was filled with several long, translucent and cord-like tumors which resembled the hands of a cuttlefish. The tumors were easily removed except its root adhering to the left common iliac artery. A crossover femoro-femoral artery bypass was carried out. On the 24th postoperative day she died suddenly. The autopsy findings were as follows: A hen egg-sized tumor occupied almost whole space of the left atrium, and connected with the metastatic right lung tumor via the pulmonary vein. The sudden death was probably due to the abrupt obstruction of the mitral valve by the tumor in the left atrium. The residual tumor was noted in the left common iliac artery, but its adventitia was not involved. The pathohistological diagnosis of each tumor was same, well differentiated liposarcoma. The tumors which occluded the left iliofemoral artery must have originated from the tumor in the left atrium in form of the tumor embolism, lodged in the left common iliac artery, grown intraluminally into external iliac and femoral artery, and finally caused ischemia of the left leg. PMID- 3982387 TI - [A case of abdominal aortic aneurysm ruptured into the left common iliac vein with symptoms resembling deep vein thrombosis]. AB - A 59 years old male with abdominal aortic aneurysm ruptured into the left common iliac vein was transferred to us with symptoms resembling deep vein thrombosis of the left lower extremity, such as leg pain, swelling and dilatation of the superficial veins. At operation, a Fogarty's occlusion catheter was inserted through the right greater saphenous vein into the inferior vena cava and inflated concomitantly during aortic clamp to prevent pulmonary embolism which may be caused by the dislodged thrombi from the aneurysm, and as well as to control back flow-bleeding from the central. The fistula (3.0 X 1.0cm) was closed from inside of the aneurysm using the inferior wall of the aneurysm. The blood from the fistula was collected by the Cell Saver and re-transfused to the patient. The abdominal aorta was replaced with a Dacron Y-shaped prosthesis. The postoperative course was uneventful. CTR on chest X-ray subsided from 51% to 42%, cardiac output normalized from 11l/min to 6l/min, and symptoms resembling the deep vein thrombosis disappeared. PMID- 3982388 TI - Agonist-induced regulation of the neuronal nicotinic acetylcholine receptor of PC12 cells. AB - Pheochromocytoma cells, clone PC12, possess neuronal nicotinic acetylcholine (ACh) receptors which can be activated by an agonist to produce a transient transmembrane cation flux similar to that seen with neuromuscular nicotinic ACh receptors. We have observed that these neuronal nicotinic ACh receptors are subject to long term regulation by the cholinergic agonist carbamoylcholine (carbachol). Receptor function was measured by agonist-induced uptake of 86Rb+ into the cells. Chronic exposure to concentrations of carbachol that caused receptor activation induced an adaptation (down-regulation) of the receptors, seen as a decrease in the responsiveness of the cells to a subsequent exposure to carbachol. The extent of the decreased responsiveness was proportional to the concentration of carbachol between 50 microM and 10 mM and was distinct from acute receptor desensitization. The concentrations of carbachol that caused down regulation were greater than those that caused maximum receptor activation, but were similar to those that greatly enhanced desensitization. This suggested that promotion of the desensitized state of the receptor could be the true stimulus for down-regulation. Adaptation was observed initially after several hours of exposure and maximally within about 7 days. Recovery from the down-regulated state required several days of growth in the absence of carbachol. Treatment with the antagonist mecamylamine did not cause a similar change in the responsiveness of the cells. However, concurrent exposure to carbachol and mecamylamine prevented down-regulation. Therefore, it appeared that receptor activation was necessary for regulation to occur. Comparison of the cellular responses of chronically treated and control cells to acute stimulation with carbachol supported the hypothesis that the mechanism for this down-regulation in PC12 cells was a decrease in the number of functional ACh receptors. PMID- 3982389 TI - Butyrylcholinesterase: inhibition by arsenite, fluoride, and other ligands, cooperativity in binding. AB - Arsenite is a quasi-irreversible inhibitor of human serum butyrylcholinesterase with a dissociation constant of 0.129 mM at pH 7.4, 25 degrees, 0.067 M phosphate, mu = 0.17 M. The inhibition process is second order with a rate constant of 340 M-1 min-1. The first order rate of dissociation, 0.044 min-1, is unaffected by fluoride but is decreased by substrate. The binding of arsenite and fluoride, as determined by the effect of fluoride on the apparent arsenite-enzyme dissociation constant, is highly anticooperative and may be mutually exclusive. The fluoride-enzyme dissociation constant determined from these experiments is 0.90 mM. The binding of a number of other substances, such as dibucaine, is markedly anticooperative with arsenite binding. The binding of some of these substances is positively cooperative with fluoride binding. The effect can be large; procainamide binds 17 times more strongly in the presence of fluoride. Similarly, the mutual binding of benzoylcholine as substrate and fluoride is cooperative, 30-fold, butyrylthiocholine and fluoride, 21-fold, propionylthiocholine and fluoride, 8.3-fold, and acetylthiocholine and fluoride, only 1.8-fold. PMID- 3982390 TI - Protection against toxic redox cycles between benzo(a)pyrene-3,6-quinone and its quinol by 3-methylcholanthrene-inducible formation of the quinol mono- and diglucuronide. AB - Cytotoxic effects of quinones are thought to be mediated by redox cycles between quinones and quinols whereby reactive oxygen species are generated. The role of glucuronidation in preventing these toxic redox cycles was investigated by using benzo(a)pyrene-3,6-quinone and isolated rat hepatocytes or Reuber hepatoma cells (H4IIE). Inhibition of quinol glucuronidation by salicylamide enhanced quinone dependent oxygen uptake and cytotoxicity. Conjugation of benzo(a)pyrene-3,6 quinol was shown to proceed via the 6-monoglucuronide to the diglucuronide. Diglucuronide formation was low in hepatocytes from untreated controls and phenobarbital-treated rats. However, it was highly stimulated (26-fold) in hepatocytes from 3-methylcholanthrene-treated rats and was also high in Reuber hepatoma cells. Kinetic analysis with liver microsomes indicated that 3 methylcholanthrene-stimulated glucuronidation was due to an increased Vmax of UDP glucuronosyltransferase which was enhanced 10- and 40-fold or mono- and diglucuronide formation, respectively. These findings suggest that the investigation of quinol glucuronidation (in particular the formation of benzo(a)pyrene-3,6-quinol diglucuronide) is a most useful probe for the 3 methylcholanthrene-inducible isoenzyme(s) of UDP-glucuronosyltransferase. Moreover, this isoenzyme may be particularly suited to protect against toxic redox cycles between benzo(a)pyrene quinones and quinols. PMID- 3982391 TI - Suicidal destruction of cytochrome P-450 and reduction of ferrochelatase activity by 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-trimethylpyridine and its analogues in chick embryo liver cells. AB - The ferrochelatase-reducing activity and cytochrome P-450- and heme-destructive effects of a variety of analogues of 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6 trimethylpyridine (DDC) were studied in chick embryo liver cells. A group of DDC analogues was found in which an inability to reduce ferrochelatase activity corresponded with an inability to cause cytochrome P-450 and heme destruction. In a second group of DDC analogues, the ability to reduce ferrochelatase activity corresponded with the ability to cause cytochrome P-450 and heme destruction. These observations support the idea that the protoporphyrin IX moiety of N alkylprotoporphyrin IX originates from the heme moiety of cytochrome P-450. A third group of DDC analogues caused cytochrome P-450 and heme destruction despite an inability to reduce ferrochelatase activity. With this third group of DDC analogues, the heme moiety of cytochrome P-450 is likely degraded to products other than N-alkylporphyrins. The inability of several lipophilic DDC analogues [4-benzyl, 4-isopropyl, 4-cyclohexyl, 4-(3-cyclohexenyl)] to reduce hepatic ferrochelatase activity may explain their low porphyrinogenicity. The pattern of porphyrin accumulation produced in response to two DDC analogues that did not inhibit ferrochelatase was investigated using high performance liquid chromatography. Coproporphyrin was the major porphyrin to accumulate in response to the 4-isopropyl analogue and uro- and heptacarboxylic acid porphyrins in response to the 4-benzyl analogue. These patterns of porphyrin accumulation are consistent with the inability of these analogues to inhibit ferrochelatase. PMID- 3982392 TI - Sexual differentiation of cytochrome P-450 in rat liver. Evidence for a constitutive isozyme as the male-specific 16 alpha-hydroxylase. AB - Cytochrome P-450 isozyme RLM5 [Cheng, K-C., and J.B. Schenkman, J. Biol. Chem. 257:2378-2385 (1982)], possessing a high steroid 16 alpha-hydroxylating activity, was isolated from male rat livers, and the hypothesis that this protein is the sexually differentiated 16 alpha-hydroxylase was tested. Isozyme RLM5 was not detected when the same purification procedure was applied to female rat liver microsomes. However, a female isozyme named DEa and possessing a similar Mr was obtained from similar column fractions. The DEa isozyme had insignificant steroid hydroxylating activity and a substrate specificity different from isozyme RLM5. The two proteins could also be distinguished in their primary structures and immunochemical properties. Rabbit antibodies were raised to isozyme RLM5 and were made specific by immunoabsorption with a crude female cytochrome P-450 fraction coupled to Affi-Gel 10. The antibodies were used in a Western blot immunoassay to demonstrate that isozyme RLM5 can be detected in liver microsomes of male rats at levels at least 20 times higher than those in the female, and that its sexual differentiation is neonatally imprinted by androgen. The antibodies were able to specifically inhibit 70% of the testosterone 16 alpha-hydroxylase activity in male rat liver microsomes but had no effect on the activity in females. It was concluded that isozyme RLM5 is the major sexually differentiated microsomal 16 alpha-hydroxylase. PMID- 3982393 TI - Interaction of the hepatic glucocorticoid-receptor complex with Affigel blue. AB - Unlike the unactivated glucocorticoid-receptor complex, the thermally activated glucocorticoid-receptor complex was able to bind to Affigel blue (a matrix previously shown to bind proteins containing a dinucleotide fold region) under low ionic conditions (0.05 M K C1). Glucocorticoid-receptor complex binding capacity to Affigel blue was enhanced by increasing salt concentration. Optimal binding was obtained at 0.15 M K C1 and remained at a plateau level up to 0.4 M K C1. In contrast to Affigel blue binding, glucocorticoid-receptor complex binding to nuclei was optimum at low ionic strength buffer, declined at 0.15 M K C1 and became negligible at 0.4 M K C1. Interestingly, at physiological ionic strength (0.15 M K C1) both nuclei and Affigel blue bound to the glucocorticoid-receptor complex with almost identical capacity. Glucocorticoid-receptor complexes incubated 45 min at 25 degrees C (activation conditions) in the presence of 10 mM molybdate were unable to bind to Affigel blue (or isolated nuclei) as expected. The results obtained suggest that Affigel blue mimics isolated nuclei in the binding of activated glucocorticoid-receptor complexes under physiological (0.15 M K C1) conditions. In addition, Affigel blue may provide a rapid and easy method to study glucocorticoid-receptor complex activation and interaction with nuclear acceptor sites. PMID- 3982394 TI - Intracellular localization and some properties of the system in guinea pig liver responsible for the aromatization of cyclohexanecarboxylic acid to hippuric acid. AB - The conversion of cyclohexanecarboxylic acid to hippuric acid in subcellular fractions from guinea pig liver was studied using a gas chromatographic-mass spectrometric method employing selected ion monitoring. Comparison of the activities of the cyclohexanecarboxylic acid to hippuric acid converting system (CHC-system) and marker enzymes in the various subcellular fractions showed that the CHC-system is localized exclusively in the mitochondria. No contribution to the total activity of the system was made by microsomal enzymes. The activity of the CHC-system in whole liver homogenate and in isolated mitochondria was similar when the latter were supplemented with ATP, alpha-ketoglutaric acid, glycine, ethylenediaminetetraacetate, PO4(3-) and Mg2+. The formation of hippuric acid in these mitochondrial preparations was linear with respect to time over a period of at least 60 min. Studies designed to optimize the incubation conditions showed that the activity of the CHC-system was reduced by PO4(3-) concentrations greater than approximately 70 mM. Conversely, both ATP and alpha-ketoglutaric acid stimulated the system. It is possible that two different types of acyl-CoA synthetases, one which is ATP-specific and one which is GTP-specific, may operate in the activation of cyclohexanecarboxylic acid. PMID- 3982395 TI - An experimental approach to evaluation of the relative hydrophobic character of biological liquids and tissues. AB - Total proteins extractable from a number of rat tissues were partitioned in the aqueous Ficoll-400-Dextran-70 biphasic system. The partition coefficient of the total proteins extractable from a given tissue, K, was shown to be a tissue specific constant. The free energy of transfer of a CH2 group from water to the aqueous solution of a given protein extract, delta(delta gCH2), was calculated from the corresponding K-value using the correlation relationship between K and delta(delta gCH2) reported earlier. It is suggested to use the parameter delta(delta gCH2)-value as a measure of the relative hydrophobic character of biological fluids and tissues. The difference between the delta(delta gCH2) values for blood plasma medium and for a given tissue medium is used to quantify the difference in the relative hydrophobic character of the biological tissues and fluids under study. The possibilities to use the above characteristics in drug research are considered. PMID- 3982396 TI - Non-histone chromatin protein fractions associated with 'active' chromatin in embryonic chicken liver. AB - Non-histone chromatin proteins synthesized during chicken embryonic liver development were labeled with [3H]tryptophan and [3H]methionine and characterized by electrophoresis. During embryonic development protein/DNA ratio in chromatin was low (1.30-1.62) but synthesis of non-histone protein was high. Especially one characteristic fraction K (MW 18 000), tightly bound with DNA was preferentially associated with DNAase II sensitive, active transcribed sequences. In 7-day old and adult chicken synthesis of all non-histone proteins was low, fraction K was absent or synthesized only in small amounts in association with non-active sequences, however protein/DNA ratio in chromatin was high (2.30-2.33). PMID- 3982397 TI - Methylcobalamin corrects the deleterious in vitro effect of nitrous oxide on thymidylate synthetase. AB - In this study, cobalamin deficiency was produced in vitro by the use of nitrous oxide, known to inactivate the vitamin. In 14 sets of experiments, normal human lymphocytes stimulated with phytohemagglutinin on day 0 were exposed to nitrous oxide and oxygen on day 2. MeCbl was delivered later to half of the cells. Untreated cells served as a control. On day 3, the cells were harvested, the lymphocytes were lysed, and the obtained extracts were assayed for thymidylate synthetase. In 16 other experiments the same procedure was performed, and the incorporation of radioactive thymidine or deoxyuridine by the intact cells was measured. In additional experiments, a deoxyuridine suppression test of treated and untreated stimulated lymphocytes was also performed. The results indicate that nitrous oxide significantly reduces the activity of thymidylate synthetase and that this reduction is significantly corrected by MeCbl, suggesting a causative relation between the vitamin and the enzyme. However, there was no statistically significant effect of nitrous oxide demonstrated on the nucleoside incorporation nor on the deoxyuridine suppression test. PMID- 3982398 TI - Repetitive DNA sequences within and around the rat prolactin gene. AB - Repetitive DNA sequences in and around the rat prolactin gene were identified and mapped by hybridizing labeled total rat DNA to cloned prolactin DNA and by hybridizing labeled prolactin DNA fragments to total restricted rat DNA. Repeated sequences were found 12-8 and 2.5-0.5 kb upstream of the first exon, within the fourth intron and throughout almost the entire 15.5 kb of cloned DNA downstream from the last exon. By cross-hybridization of the major repeated sequences, it was found that these repeats could be grouped into three families, one of which is novel. Human alu and mouse alu-like probes did not hybridize to the rat prolactin DNA. Several of the repeats from the rat prolactin gene hybridized to the intron and downstream flanking regions of the rat growth hormone gene. PMID- 3982399 TI - Isolation and characterization of safflower (Carthamus tinctorius L.) chloroplast DNA. AB - Safflower (Carthamus tinctorius L.) chloroplasts were isolated and purified with the aid of commercially available nylon mesh, differential centrifugation, and DNase I treatment. These chloroplasts were free of nuclei as determined by light microscopy of aceto orcein stained preparations, and similar to those observed by electron microscopy in spinach and many other higher plants, being bounded by a double membrane layer and characterized by the presence of a lamellar system surrounded by embedding matrix, and stacked membranes or grana lamallae. DNA was isolated and purified from such chloroplasts, and characterized with respect to cesium chloride density gradient isopycnic centrifugation, denaturation, renaturation kinetics and restriction enzyme analysis. These studies show that safflower chloroplast DNA is similar to many other higher plant DNAs having a density of 1.700 g/cm3 (G + C = 40.8%), a Tm of 86 degrees C (G + C = 40.7%) and a molecular complexity and genome size of about 10(8) daltons. PMID- 3982400 TI - Rapid, high temperature exchange assay for the hepatic glucocorticoid receptor. AB - Liver cytosol from adrenalectomized rats was prebound for 2 hr at 4 degrees C with unlabeled 10(-5) M corticosterone. After treatment of cytosol with dextran coated charcoal to remove free steroid, samples were incubated at 15-25 degrees C in the presence of 10 mM molybdate plus 5 mM dithiothreitol (followed by a 60 min incubation at 4 degrees C). Essentially, complete exchange of [3H] dexamethasone for receptor-bound unlabeled steroid was observed after 120 min at 15 degrees C, and near complete (80-95%) exchange occurred within 60 min at 25 degrees C using these conditions. However in control, 5 mM dithiothreitol (alone) and 10 mM molybdate (alone) treated samples, less than 50% exchange was found. Using a similar protocol, only partial exchange was found in brain and kidney cytosols, suggesting at least partial specificity for the hepatic system. We have used this rapid, high temperature exchange assay to study the regulation of hepatic cytoplasmic glucocorticoid receptors under some experimental conditions. PMID- 3982401 TI - Purification and subunit structure of RNA polymerases I and II from Dictyostelium discoideum vegetative cells. AB - A purification procedure to obtain RNA polymerases I (or A) and II (or B) from Dictyostelium discoideum amoeba has been developed. The enzymes were solubilized from purified nuclei and separated by DEAE-Sephadex chromatography. RNA polymerases I and II were further purified by a second chromatography on DEAE Sephadex followed by chromatographies on phosphocellulose and heparin-sepharose. The specific activities of purified RNA polymerases I and II are 92 units/mg protein and 70 units/mg protein, respectively. The subunit structure of both RNA polymerases were analyzed by polyacrylamide gel electrophoresis under denaturing conditions after glycerol gradient centrifugation of the enzymes. The putative subunits of RNA polymerase I have molecular weights of 180 000, 125 000, 43 000, 40,000, 34 000, 31 000, 25 000, 19 000, 17 000 and 14 000. The putative subunits of RNA polymerase II have molecular weights of 200 000 (170 000), 130 000, 33 000, 25 000, 19 000, 17 000, 15 000, 13 000. There are three polypeptides with common molecular weight in Dictyostelium RNA polymerases I and II. The subunit of 25 000 daltons of both enzymes has common immunological determinants with RNA polymerase II from crustacean Artemia. PMID- 3982402 TI - Non-immune interaction of erythrophilic IgG fractions with human red blood cells. AB - Immunoglobulin G was separated on cellulose phosphate column to afford four distinct protein fractions (CP-I, II, III and IV). 125I-labeled fractions CP-III and CP-IV were found to be capable of binding specifically to normal human erythrocytes. The effect of the four fractions on osmotic resistance of red blood cells (RBC) was studied. RBC were obtained from eight patients with hereditary spherocytosis (HS), from a single parent of two non-related patients, and from five normal donors. RBC fragility of normal and one parent were unaffected by any of the immunoglobulin fractions. In contrast, a small but significant decrease in osmotic resistance was observed when RBC from HS patients and the second parent were incubated with protein fractions CP-III and CP-IV. PMID- 3982403 TI - Nerve growth factor. A structural relationship between its proteolytic and leukocyte-chemotactic active sites. AB - High molecular weight mouse nerve growth factor (HMW-NGF), in addition to its effects on certain neural elements, is also chemotactic for human polymorphonuclear leukocytes. One of the subunits of HMW-NGF is a protease of the serine family and its active site contains a serine residue and a closely neighboring histidine residue that are both essential for proteolysis. Elimination of enzyme activity by irreversibly blocking the single serine has no effect on leukotaxis, but blocking the histidine abolishes leukotaxis. These results suggest the possibility that part of the proteolytic active site of this enzyme may have evolved to perform more than one, completely different, biologic function-proteolysis as well as nonproteolytically mediated chemotaxis. PMID- 3982404 TI - Studies of the purine analog associated modulation of human erythrocyte acid phosphatase activity. AB - The activity of the human erythrocyte acid phosphatase is modulated by a series of structural analogs of purine. The unsubstituted purine base does not affect the enzyme activity. Addition of a substituent at the number six position usually generates an analog which activates the enzyme while similar substitutions at the two position usually generate an inhibitor. Pyrimidines are generally ineffective as modulators while several modifications of the imidazole ring of the purine analogs do not abolish the modulator activity of the purine analog. The level of response to all active analogs is isozyme specific. Differences in apparent relative affinities among the modulators are noted. The modulators with a positive effect on enzyme activity, are effective in the presence of methanol which is more effective than H2O as a phosphate acceptor. These analogs act by enhancing the rate of transfer of phosphate to H2O, while decreasing the rate of transfer to methanol. The results suggest that the purine analogs may act by altering the rate of hydrolysis of the phosphoenzyme intermediate by H2O or may change the rate-limiting step in the catalytic mechanism. PMID- 3982405 TI - Polyamine-sensitive protein kinase from chick intestinal mucosa. AB - A cyclic nucleotide-independent protein kinase which phosphorylates preferentially acidic proteins such as casein or phosvitin was isolated from cytosol of chick duodenal mucosa. The enzyme was purified more than 633 fold to apparent homogeneity by ammonium sulfate fractionation, column chromatography on DEAE-cellulose, phosphocellulose, hydroxylapatite and by sucrose density gradient centrifugation. The native enzyme has a molecular weight of 131 000 as measured by gel filtration. The enzyme is a complex protein containing three polypeptides of molecular weight of 39 000, 36 000 and 27 000. It behaves as a complex throughout its purification and gel filtration but its components are readily separated by electrophoresis in denaturing buffer. The 27 000 molecular weight band was selectively autophosphorylated when the enzyme was incubated in the presence of [gamma-32P]ATP. When casein was used as substrate, physiological concentrations of naturally occurring polyamines such as spermine and spermidine markedly stimulated enzyme activity. However with phosvitin as substrate polyamines were strong inhibitors of the enzyme activity. This contrasting effect on intestinal kinase activity was also apparent using cytoplasmic proteins as endogenous phosphate acceptors. A characterization of this differential effect is presented and some possible physiological implications are discussed. PMID- 3982406 TI - [Electron spectroscopy and the electron structure of molecules]. AB - The experimental-theoretical approach to the study of physico-chemical, in particular, spectroscopic and photochemical properties of groups of related molecules is considered. The problem of physically correct spectral decompositions of complex electronic spectra into bands corresponding to separate electronic transitions and of the information obtained therefrom is discussed. Concrete examples of revealing photo- and enzymatic reaction mechanisms by combined spectroscopic and theoretical studies of molecular electronic structure and spectra are given. Special attention is paid to the connection of electronic structure of molecules with their physico-chemical, in particular, spectroscopic properties. PMID- 3982407 TI - [Primary organization of nucleosome core particles in active and repressed nuclei]. AB - A refined high-resolution map for the linear arrangement of histones along DNA in the nucleosomal core particles has been determined by DNA-protein crosslinking. Histones are aligned on one strand of the 145 bp core DNA in the following order: (5') H2B25,35--H455,65--H375,85,, 95/H488--H2B105, 115--H2A118--H3135, 145/H2A145 (3') (the subscripts indicate the approximate distance in nucleotides of the main histone binding sites from the 5'-end of the core DNA). This suggests a symmetrical and rather autonomous arrangement of the histone tetramer (H3, H4)2 and two dimers (H2A, H2B) on the double-stranded core DNA: H2A/H3--(H2A, H2B)- (H3, H4)2--(H2B, H2A)--H3/H2A. The arrangement of histones on DNA was found to be very similar for the cores isolated from the repressed nuclei of sea urchin sperm and chicken erythrocytes and from the active in transcription and replication Drosophila embryo and yeast nuclei. This indicates that the core nucleosome structure is highly conserved through evolution and that the overall inactivation of chromatin does not affect the primary organization of the cores. A new binding site H2B58 was found for a sea urchin spermal variant of H2B which contains an additional basic segment within the N-terminal part of the molecule. The core isolation procedure was shown to introduce changes into the core structure which are reflected in the appearance of a new binding site H2A75. PMID- 3982408 TI - [Cytosol aspartate aminotransferase from the chicken heart: three-dimensional structure at 2.8 angstroms resolution and the characteristic conformation of various enzyme forms]. AB - The spatial structure of cytosolic chicken aspartate aminotransferase (AAT) has been determined by X-ray crystallographic analysis at 2.8 A resolution. AAT consists of two chemically identical subunits. Each subunit can be subdivided into the large pyridoxal phosphate (PLP) binding domain and the small domain. The two active sites of AAT are situated in deep clefts at the subunit interface. The binding of PLP and 2-oxoglutarate is described. Conformations of the following enzyme forms have been compared by difference Fourier syntheses: the nonliganded PLP-form in phosphate and acetate buffers; the non-liganded pyridoxamine phosphate (PMP) form; complexes of the PLP-form with glutarate and 2 oxoglutarate. Lattice-induced dynamic asymmetry of the dimeric AAT molecules was revealed. In one subunit the small domain is mobile and shifted either toward the active site ("closed" conformation) or in the opposite direction ("open" conformation). The closed conformation is induced by the binding of dicarboxylate anions. In the second subunit the small domain is immobile and shifted toward the active site in all enzyme forms or complexes studied. In this subunit, there occurs a rotation of the PLP ring by approximately 20 degrees toward the substrate site. The rotation is observed when crystals are soaked in 0.6 saturated (NH4)2SO4 solution buffered with 0.3 M potassium phosphate, pH 7.5; it was explained by formation of an external aldimine between PLP and NH3. This aldimine is not formed in the presence of dicarboxylates or acetate. It was inferred that dicarboxylate or acetate anions stabilize the internal PLP-lysine aldimine and prevent its reaction with ammonia. Conversion of AAT from the PLP- to PMP-form is accompanied by rotation of the coenzyme ring by approximately 20 degrees; the rotation occurs in both subunits. PMID- 3982409 TI - [Chromatin activation and various problems of genetic activity regulation in eukaryotic cells]. AB - In this paper the results of the investigation of activated chromatin are considered in terms of modern ideas of molecular mechanisms of genetic activity regulation. Particular attention is given to the results obtained in the Laboratory for Functional Morphology of Chromosomes at the Institute of Molecular Biology in 1973-1984. PMID- 3982410 TI - [Purification of homogeneous gamma-cystathionase and study of its structure by circular dichroism]. AB - Rat liver gamma-cystathionase has been purified to homogeneity (verified by SDS electrophoresis and ultracentrifugation). The secondary and tertiary structures of the enzyme were studied by circular dichroism spectra. Our studies revealed that the holoenzyme molecule comprises approximately 22% of alpha-helices, 14% of beta-structure, 14% of beta-bends, and 50% of unordered structure. Conformational alterations of the enzyme molecule resulting from enzyme PLP elimination, reduction with sodium borohydride and irreversible inhibition by propargylglycine were examined. The enzyme's secondary structure was shown to be stable whereas the tertiary structure is labile. Saturation with PLP maintains the enzyme's optimal (catalytically active) tridimensional structure. Sodium dodecylsulfate alters its secondary (the amount of alpha-helix being raised to 34%) and tertiary structures. PMID- 3982412 TI - Linkage of the MBG locus to another functionally hemizygous gene locus (IDH2) on chromosome Z3 in Chinese hamster ovary cells. AB - To gain insight into the nature of hemizygosity in Chinese hamster ovary (CHO) cells and the mechanisms by which it has arisen, we are attempting to map and determine linkage relationships for as many hemizygous loci as possible. In this study, we have shown by segregation analysis of intraspecific somatic cell hybrids that the hemizygous gene locus associated with resistance to methylglyoxalbisguanyl hydrazone (MBG) in CHO cells is linked to the hemizygous IDH2 locus on chromosome Z3. Nine of the ten autosomal hemizygous gene loci that have been mapped to date in CHO cells are clustered on three chromosomes, with five such markers on chromosome 2, two on chromosome 8, and now two on the Z3 chromosome. With the mapping of MBG to the Z3 chromosome, selectable drug resistance markers are now available on eight different CHO chromosomes. PMID- 3982411 TI - Novel insertion mutation in Caenorhabditis elegans. AB - The mutation e1662 is an allele of the Caenorhabditis elegans unc-54 gene induced with the difunctional alkylating agent 1,2,7,8-diepoxyoctane. unc-54 encodes the major myosin heavy chain isozyme of body wall muscle cells. Filter-transfer hybridization and DNA sequence analysis show that e1662 is an insertion of 288 base pairs of DNA within unc-54. The inserted DNA is identical to a 288-base pair region of unc-54 located ca. 600 base pairs from the insertion site. Thus, e1662 is a displaced duplication. A 14-base pair sequence located at one end of the duplicated segment is found adjacent to the site of insertion. These homologous sequences are juxtaposed head-to-tail by the insertion event. e1662 thus contains a tandem direct repeat extending across one of its junctions. PMID- 3982413 TI - Dictyostelium discoideum mRNAs developmentally regulated during spore germination have short half-lives. AB - mRNA decay was studied during spore germination in Dictyoselium discoideum by the use of three previously isolated cDNA clones, pLK109, pLK229, and pRK270, which are specific for mRNAs developmentally regulated during spore germination. The half-life of a constitutive mRNA, pLK125, which is present throughout germination, growth, and development, as also determined. Nogalamycin, a DNA intercalating compound, was used to inhibit RNA synthesis. Total RNA was isolated at intervals after addition of the drug, and the decay of mRNAs specific for the cDNA clones was determined by both Northern blot and RNA dot hybridization. If nogalamycin was added immediately after activation of dormant spores, neither pLK229 nor pLK109 mRNA decayed, but pLK125 mRNA did decay. Although pLK109 mRNA did not decay under these conditions, the RNA was smaller 1 h after activation than in dormant spores, indicating that it was processed normally. At 1 h after activation, pLK229-, pLK125-specific mRNAs decayed exponentially, with half-lives of 24, 39, and 165 min, respectively. Under the same conditions, decay of pLK109 specific mRNA was biphasic. Thirty-eight percent of the mRNA decayed with a half life of 5.5 min, and the remainder decayed with a half-life of 115 min. It seems likely that nogalamycin inhibits the synthesis of an unstable component of the mRNA degradative pathway which is needed continuously for the decay of pLK109 mRNA. By extrapolating the curve representing the rapidly decaying component, a half-life of 18 min was calculated for pLK109-specific mRNA. The mRNAs developmentally regulated during spore germination have half-lives shorter than that of the constitutive messenger and shorter than the average half-life of 3 to 4 h previously determined for total Dicyostelium polyadenylated mRNA. PMID- 3982414 TI - Selective transfer of individual human chromosomes to recipient cells. AB - Two hypoxanthine phosphoribosyltransferase-deficient human cell lines, D98/AH-2 and HT1080-6TG, were stably transfected with pSV2 gpt, a plasmid containing the selectable marker Escherichia coli xanthine-guanine phosphoribosyl transferase (Eco gpt). Hypoxanthine-aminopterin-thymidine-resistant transformants arose with a frequency of ca. 10(-6) and contained mostly single, but occasionally multiple, copies of the plasmid sequences. These transformants actively express the Eco gpt marker. Single chromosomes from two different HT1080 gpt transformants and one D98 gpt transformant, containing the integrated plasmid sequences, were transferred via microcell-mediated chromosome transfer to hypoxanthine phosphoribosyl transferase-deficient mouse A9 cells. The transferred human chromosomes were identified as 2, 4, and 22, by using a combination of G-11 staining, G-banding, isoenzyme analysis, and in situ hybridization. This system is being used to create a library of interspecies microcell hybrid clones, each clone containing a unique single human chromosome in a mouse background. The complete library will represent the entire human karyotype. PMID- 3982415 TI - Structural requirements of adenovirus VAI RNA for its translation enhancement function. AB - Recently, by genetic and biochemical approaches, it has been shown that adenovirus VAI RNA is required for efficient translation of viral mRNAs at late times after infection. To understand the nucleotide sequences and the domains of the VAI RNA that are responsible for the role of VAI RNA in enhancement of translation, a mutational analysis of the VAI gene was undertaken. Deletion, substitution, and insertion mutations covering most of the nucleotide sequences of VAI RNA were introduced into the VAI gene at the plasmid level. These mutant genes were then reintroduced into the virus, and growth properties of the mutant viruses were studied. The majority of the mutants retained normal or nearly normal levels of biological function. Mutations in the region between +43 and +53 and between +107 and the 3' end of the gene resulted in a considerable loss of activity. These mutants, however, grew significantly better than did an adenovirus type 5 mutant lacking both functional VAI and VAII genes, indicating that they retain a portion of their activity. Because no one mutation was able to completely abolish the function, we suggest that the VAI RNA may have multiple functional sites for its translation modulation function. These multiple sites may be short oligonucleotide sequences that may interact with cellular or viral components or both during translation. PMID- 3982416 TI - Differential expression of three alpha-tubulin genes in Chinese hamster ovary cells. AB - Chinese hamster ovary cells contain a complex family of ca. 16 unique alpha tubulin sequences and a similar multiplicity of beta sequences. To examine which members of this multigene family are expressed, we constructed cDNA libraries from two Chinese hamster ovary cell lines according to the method of H. Okayama and P. Berg (Mol. Cell. Biol. 3:280-289, 1983). Each library consisted of 5.5 X 10(5) transformants and contained a high percentage of full-length tubulin clones. Three different alpha-tubulin genes were identified by sequence analysis of the 3' noncoding regions of these tubulin clones. The relative abundance of the transcripts corresponding to the three genes was estimated by gene-specific dot blotting of 96 cDNA alpha-tubulin clones and was found to be 71, 24, and 5%. There is little homology in the 3' noncoding sequences of these genes; however, a strong interspecies homology exists in this region for two of the Chinese hamster ovary genes with the two alpha-tubulin genes previously described in other systems. The third Chinese hamster ovary gene, with an expression frequency of 24%, is unique in that its 3' noncoding region is unlike that of the other mammalian alpha-tubulin genes. In addition, limited sequence data from the coding region of this gene indicates it codes for a unique alpha-tubulin protein. PMID- 3982417 TI - Blockage of tropoelastin secretion by monensin represses tropoelastin synthesis at a pretranslational level in rat smooth muscle cells. AB - The blockage of protein secretion in the R22 cultured rat aortic smooth muscle cell strain with monensin repressed tropoelastin gene expression at the mRNA level by ca. 50-fold as measured by biosynthetic pulse-labeling, in vitro translation, and hybridization with a tropoelastin genomic DNA probe. These results suggest that tropoelastin gene expression is autoregulated, and they represent the first reported effect of monensin on gene expression. PMID- 3982418 TI - NIH/3T3 cells transfected with human tumor DNA containing activated ras oncogenes express the metastatic phenotype in nude mice. AB - NIH/3T3 cells transfected with DNA from malignant human tumors produced experimental and spontaneous metastases in nude mice. In contrast, parent or spontaneously transformed NIH/3T3 cells failed to metastasize. The transfected clones contained either activated c-Harvey-ras or N-ras oncogenes. A representative clone (T71-17SA2) which was used to assess selected cellular and host factors relevant to the metastatic process produced lung metastases in 100% of the NIH nude mice recipients, secreted augmented levels of type IV collagenase, and invaded human amnion basement membrane in vitro. Expression of the metastatic phenotype was not related to decreased sensitivity to natural killer cells or macrophage-mediated cytotoxicity. Analysis of the cellular DNA from the T71-17SA2 transfectant and its corresponding metastases, both of which contained activated N-ras oncogenes, revealed a twofold increase in the N-ras specific DNA sequences in the metastatic cells. Thus, transfection with human tumor DNA containing activated ras oncogenes can induce the complete metastatic phenotype in NIH/3T3 cells by a mechanism apparently unrelated to immune cell killing. PMID- 3982419 TI - New acceptor cell for transfected genomic DNA: oncogene transfer into a mouse mammary epithelial cell line. AB - A line of mouse mammary epithelial cells (NMuMG) has been characterized for its ability to be stably transfected with exogenous DNA. A transfection frequency of at least 1 cell per 1,000 was obtained with the pSV2neo plasmid. Several thousand G418-resistant NMuMG cell clones can easily be generated in cotransfection of genomic DNA and pSV2neo. The NMuMG cells were isolated from normal mammary glands and do not form malignant lesions when injected into nude mice. We have cotransfected NMuMG cells with pSV2neo and genomic DNA from the human EJ bladder carcinoma line, a cell line which contains an activated c-rasH oncogene. When a pool of 4,700 G418-resistant colonies was injected into nude mice, tumors were obtained. These tumors contain a transfected human rasH gene. Genomic DNA transfection into a line of mouse epithelial cells, in combination with the selection of stable transfectants and tumor induction in nude mice, can be used to screen human tumor DNA for the presence of activated oncogenes. PMID- 3982422 TI - [Spatial distribution of light intensity with a phototherapy halogen lamp]. AB - The spatial energy distribution under a phototherapy unit fitted with a special halide lamp (ex. Hereaus, "Photo-Therapie 800") is particularly uneven, with a pronounced decrease in energy towards the edges. With a correct positioning of the child in the centre of the luminous cone however, the energy of the effective light is still distinctly higher than that received from a phototherapy unit fitted with 6 blue fluorescent tubes (Philips 20W/52 BAM blue). With the addition of lateral aluminium reflectors, not only is the effective energy intensity increased, but also the spatial energy distribution becomes more even, so that a very exact positioning of the child is no longer required. PMID- 3982421 TI - Elimination of micronuclear specific DNA sequences early in anlagen development. AB - After conjugation in Tetrahymena thermophila, the old macronuclei degenerate, and new macronuclei (anlagen) develop. During anlagen development a number of DNA sequences found in the micronuclear genome (micronuclear limited sequences) are eliminated from the anlagen. A cloned copy of a repetitive micronuclear limited sequence has been used to determine the developmental stage at which micronuclear limited sequences are eliminated. DNAs from anlagen of various developmental stages were examined by Southern analysis. It was found that micronuclear limited sequences are present in 4C anlagen and essentially absent in 8C and 16C anlagen. The precipitous loss of these sequences in the 8C anlagen rules out under replication as the mechanism for the loss and suggests that these sequences are specifically degraded early during anlagen development. PMID- 3982420 TI - Efficient correction of mismatched bases in plasmid heteroduplexes injected into cultured mammalian cell nuclei. AB - Heteroduplexes were prepared from two plasmids, pRH4-14/TK and pRH5-8/TK, containing different amber mutations in the neomycin resistance gene (Neor). The Neor gene was engineered to be expressed in both bacterial and mammalian cells. A functional Neor gene conferred kanamycin resistance to bacteria and resistance to the drug G418 to mammalian cells. In addition, the plasmids contained restriction site polymorphisms which did not confer a selectable phenotype but were used to follow the pattern of correction of mismatched bases in the heteroduplexes. In a direct comparison of the efficiency of transforming mouse LMtk- cells to G418r, the injection of heteroduplexes of pRH4-14/TK-pRH5-8/TK was 10-fold more efficient than the coinjection of pRH4-14/TK and pRH5-8/TK linear plasmid DNA. In fact, injection of 5 to 10 molecules of heteroduplex DNA per cell was as efficient in transforming LMtk- cells to G418r as the injection of 5 to 10 molecules of linear plasmid DNA per cell containing a wild-type Neor gene. To determine the pattern of mismatch repair of the injected heteroduplexes, plasmids were "rescued" from the G418r cell lines. From this analysis we conclude that the generation of wild-type Neor genes from heteroduplex DNA proceeds directly by correction of the mismatched bases, rather than by alternative mechanisms such as recombination between the injected heteroduplexes. Our finding that a cell can efficiently correct mismatched bases when confronted with preformed heteroduplexes suggests that this experimental protocol could be used to study a wide range of DNA repair mechanisms in cultured mammalian cells. PMID- 3982424 TI - [Portal hypertension in childhood. A therapy concept]. PMID- 3982423 TI - [Rare cause of a left ventricular aneurysm in a 10-year-old boy]. AB - A 3-year-old boy had an accident with a blunt chest trauma, 9 years later a left ventricular aneurysm was diagnosed by echocardiography and angiography. The 12 year-old-boy was operated successfully. The pathogenesis of cardiac lesions in association with blunt chest traumas is described, and frequent control examinations in the affected patients are recommended. PMID- 3982425 TI - [Ulcerative colitis and Crohn disease from the psychosomatic viewpoint]. AB - Ulcerative colitis and Crohn's disease in childhood and adolescence are discussed from the psychosomatic point of view. To our up-to-date knowledge the psychic determinant is not a necessary but a promoting factor within the multifactorial aethiology. Premorbid conflict situations are described, which overstrain the physical and psychic endurance of the young patients and thus endanger an adequate adjustment to the illness. Since there have not been any control studies, there is no proof of advantageous effects of psychotherapy on the course of disease in children and adolescents. Up to now there are only a few positive case reports available. Nevertheless, there is no doubt that proper psychological care aids convalescence. PMID- 3982426 TI - [Development of premature children below a birth weight of 1,500 g]. AB - 5,928 newborn infants were admitted between the years 1974 and 81 to the University of Innsbruck, Department of Pediatrics. 418 (7%) of them were premature infants with a birthweight of less than 1,500 g. 21 (18%) of the premature infants with a birthweight below 1,000 g survived (21 of 117). Among those 21 surviving infants only 7 (33%) had an appropriate birthweight, 14 (67%) were too small for their gestational age. Survival in the weight range between 1,000-1,500 g was 71% (213 of 301). The percentage of dystrophic infants was 23% (49 of 213). The place of birth has a significant influence on the survival of these very small immature infants. 24% (n = 84) of patients delivered in the nearby Clinic of Obstetrics survived in contrast to only 3% (n = 33) of those born in peripheral hospitals. This is reemphasized by the evaluation of psychomotor development of surviving infants; of 14 patients with normal psychomotor milestones 13 were delivered at our obstetric department. 157 patients were regularly followed up during their first year of life. 43% can be considered normal by all parameters. 57% show some abnormalities in their development during the first years of life. During their second year of life only 13% showed psychomotor problems and this number decreased to 5% in the third year. All these children show varying degrees of hemi- or diplegia and/or seizure activities. A routine check up at 12 month of life seems important as all patients with permanent retardation can be correctly diagnosed at this age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982427 TI - [Enzyme inductive effect of zixoryn (3-trifluoromethyl-alpha-ethyl-benzhydrol) in neonatal jaundice]. AB - Zixoryn, (3-trifluoromethyl-alfa-aethyl-benzhydrole) is a new product of the Hungarian Chemical Works of Gedeon Richter Ltd. It induces the mixed function oxydase enzyme system of the endoplasmic reticulum of the liver and has no other pharmacological effects. We have studied the effect of Zixoryn on early hyperbilirubin-aemia. 42 neonates were studied, 21 of them were randomly assigned to be treated and the others served as control group Zixoryn treatment consisted of drops containing 10 mg Zixoryn per ml in a single 20 mg/kg body weight dose through a gastric tube. Results are summarized in Fig. 2. It shows the mean se bi levels during the first six days of life. It is remarkable that the decline of se bi level was much faster in the treated than in the control group. On the third day the difference between the two groups was significant. We may conclude that after Zixoryn administration the se bi level of otherwise healthy newborns decreased significantly faster than that of untreated neonates. No side-effects what so ever were observed. The administration is easy, a single oral dose has a satisfactory effect. PMID- 3982428 TI - Ethyl methanesulfonate-induced mutations of major genes for quantitative phenotypes: mutant alleles for altered activity of brain or liver enzymes in C57BL/6J mice and their inheritance across several generations. AB - We recently identified and confirmed 8 induced mutations in the N2 and N3 progeny of ethyl methanesulfonate (EMS) treated C57BL/6J mice. Each of these mutations altered specific enzyme activities. These separate mutant sublines have been maintained through several generations as heterozygous mutant carriers. The percent decrease of the specific enzyme activity from normal in each subline was calculated for each generation. Additionally, the percentage of breeders within each mutant subline producing abnormal progeny and the fraction of such breeders' total progeny possessing abnormal activity were determined. The aberrant activity values observed in progeny of a confirmed mutant carrier were all lower than normal. 4 of the mutant sublines had decreases in enzyme activities which were constant across the generations analyzed. 3 of the mutant sublines had decreases in activities which were consistent over early generations but changed significantly in later generations. Another subline with decreased enzyme activity was lost. For 7 of the sublines, the number of progeny having altered activity and the number of breeders producing mutant progeny approximated that expected for single gene inheritance. In the remaining subline, a change in the decrease in enzyme activity probably accounts for the deviation from expected inheritance. Although the phenotypes for these quantitative traits are considered to be quasi-continuous, the data indicate that the mutations are probably of major genes. PMID- 3982429 TI - Induction of SCEs by some pyrrolizidine alkaloids in V79 Chinese hamster cells co cultured with chick embryo hepatocytes. AB - Genotoxicity of heliotrine, monocrotaline, seneciphylline and senkirkine was studied with the sister-chromatid exchange assay in V79 Chinese hamster cells. Exposure to these pyrrolizidine alkaloids, in the presence of co-cultured primary chick embryo hepatocytes, resulted in a high induction of SCEs. It was also shown for heliotrine that co-cultivation with chick embryo hepatocytes resulted in a much higher response than addition of activated rat-liver homogenate to the test medium. PMID- 3982430 TI - BrdUrd-dependent sister-chromatid exchanges are increased at high oxygen tension. PMID- 3982431 TI - An error in the calculation of the percentage of conceptions with an unbalanced chromosome rearrangement that survive birth. PMID- 3982432 TI - Repair of 8-methoxypsoralen induced DNA interstrand cross-links in Tetrahymena thermophila. The effect of inhibitors of macromolecular synthesis. AB - The effect of several growth-inhibiting compounds on the repair of 8 methoxypsoralen-UVA-light-induced DNA interstrand cross-links has been studied in the protozoan Tetrahymena thermophila. The repair process was analyzed by the alkaline elution technique and could be divided into 3 phases: a protein-DNA complexing phase, a DNA-incision phase and finally a DNA-ligation phase. The incision was found to be completely inhibited by novobiocin (50 micrograms/ml), nalidixic acid (150 micrograms/ml), n-butyrate (15 mM) and cycloheximide (1 microgram/ml), while no effect was observed for cytosine-1-beta-D arabinofuranoside (10 mM), puromycin (1 mM), hydroxyurea (5 mM) or 3 aminobenzamide (2.5 mM). None of the compounds showed any effect on the protein DNA complexing step, and the ligation was partly inhibited only by nalidixic acid (150 micrograms/ml). The involvement of topoisomerases in the repair of psoralen induced DNA interstrand cross-links is suggested. PMID- 3982433 TI - DNA repair in mouse embryo fibroblasts. II. Responses of nontransformed, preneoplastic and tumorigenic cells to ultraviolet irradiation. AB - Ultraviolet light-induced excision repair, as measured by single-strand DNA-break accumulation in the presence of hydroxyurea and 1-beta-D arabinofuranosylcytosine, undergoes an apparent decline concomitant with spontaneous transformation of mouse cells in vitro. This decline is seen in preneoplastic transformed cells as well as tumorigenic cells, suggesting that it is an early event in transformation. The difference between nontransformed and transformed mouse cells in apparent incision rates is greatest at short times after irradiation when nontransformed cells show a transient phase of rapid incision. No gross differences in the effects of UV on replicative DNA synthesis, bulk RNA synthesis, cell proliferation or clonal survival in nontransformed and transformed cells were seen, in spite of the reduced incision capacity of the latter. Taken together the results suggest that transformed cells are capable of growth in the presence of significantly increased amounts of DNA damage. A decreased ability of nontumorigenic cells to remove DNA lesions, coupled with unrestricted growth, may be responsible for genetic alterations which increase the probability of a cell becoming tumorigenic. PMID- 3982434 TI - High sensitivity of murine teratocarcinoma cells to UV radiation and the effect of post-irradiation treatment with caffeine. AB - The radiosensitivity of murine teratocarcinoma cells was investigated. Our findings are as follows: (1) the undifferentiated teratocarcinoma cells are 3 times more sensitive to UV than their differentiated counterpart and BALB/3T3 cells; (2) X-ray sensitivity of the undifferentiated cells is comparable to that of BALB/3T3 cells; (3) post-irradiation treatment with caffeine strongly sensitizes a fraction of the undifferentiated cells to UV and X-rays resulting in biphasic survival curves of the cells; (4) high UV sensitivity and hyper sensitization by caffeine is lost upon differentiation of the cells. Possible mechanisms for the unusually high sensitivity of undifferentiated teratocarcinoma cells to radiation and post-irradiation treatment with caffeine will be discussed. PMID- 3982435 TI - DNA repair synthesis induced by N-hydroxyurea, acetohydroxamic acid, and N hydroxyurethane in primary rat hepatocyte cultures: comparative evaluation using the autoradiographic and the bromodeoxyuridine density-shift method. AB - N-Hydroxyurea and two structurally related compounds, acetohydroxamic acid and N hydroxyurethane, were investigated for their potential to induce DNA repair synthesis in primary rat hepatocyte cultures. Repair was determined as repair replication by means of the bromodeoxyuridine density-shift method and, in the same cell preparations, as unscheduled DNA synthesis (UDS) by autoradiography. For all 3 compounds, a clear concentration-dependent induction of DNA repair replication could be demonstrated. Interpretation of the UDS data, however, depended on the mode whereby the results were evaluated. Expression of the results as net grains per nucleus after subtraction of cytoplasmic from nuclear grain counts yielded statistically significant increases over the control values for all compounds. In contrast, no significant changes of the nuclear labeling were obtained when nuclear and cytoplasmic grain counts were plotted separately. These findings demonstrate that the two modes to present UDS data may lead to different conclusions, a consequence of the uncertainty regarding the origin and importance of the cytoplasmic background. The observation that both hydroxyurea and the structurally related compounds acetohydroxamic acid and N-hydroxyurethane induce DNA repair in primary hepatocyte cultures suggests that metabolism dependent genotoxicity may be a common property of aliphatic hydroxamic acids. PMID- 3982436 TI - Benzyl chloride and 4-chloromethylbiphenyl induced DNA damage and its repair in excision-deficient (XP group A) or -proficient human cells. AB - Benzyl chloride (BC) and 4-chloromethylbiphenyl (4CMB) induce a class of alkaline stable DNA damage in human cells which, like UV-induced pyrimidine dimers, undergoes repair at a slow rate by an excision-repair pathway which can be inhibited by cytosine arabinoside (araC). In the present study, in an attempt to clarify whether BC and 4CMB are UV-like agents, the excision-deficient xeroderma pigmentosum complementation group A fibroblasts and excision-proficient human alveolar tumour cells (A549) were exposed to various doses of these compounds prior to monitoring the inhibition of cell growth, DNA damage and DNA repair. The data indicate that such XP fibroblasts repair BC- and 4CMB-induced DNA damage at a normal rate, which suggests that the alkaline-stable DNA adducts induced by these chloromethyl compounds and the UV-induced pyrimidine dimers are processed by distinct excision-repair mechanisms in human cells. PMID- 3982437 TI - A ninth complementation group in xeroderma pigmentosum, XP I. AB - A new complementation group of excision-deficient xeroderma pigmentosum (XP) is described in 2 patients living in the F.R.G. Dermatological, ophthalmological and neurological symptoms of XP are presented together with DNA repair characteristics such as unscheduled DNA synthesis, colony-forming ability and alkaline elution studied in cultured fibroblasts. The results are compared to normal controls. PMID- 3982438 TI - Mutagenic activation of biliary metabolites of 1-nitropyrene by intestinal microflora. AB - To investigate the modifying role of intestinal microflora in the metabolism of chemical carcinogens in vivo, we subjected bile from Fischer rats treated per os with chemical carcinogens and related compounds to a mutagenicity assay in the presence and absence of a cell-free extract from human feces. A mixture of the bile sample and potassium phosphate buffer was incubated in the presence or absence of human cell-free fecal extract and then further incubated with a bacterial suspension of Salmonella typhimurium tester strains TA98 or TA100. Bile from rats treated with 1-nitropyrene (1-NP) produced about 2700 and 400 revertants per plate in strain TA98 in the presence and absence of the fecal extract, respectively. There was a drug dose- and bile volume-related response. Treatment of 1-NP-bile with beta-glucuronidase, but not aryl sulfatase, enhanced its mutagenicity. Cell-free extracts of some strains of intestinal bacteria (Bacteroides fragilis ATCC 12044, B. vulgatus ATCC 8482, B. thetaiotaomicron ATCC 12290, Bacteroides sp. strain 524, Eubacterium eligens VPI C15-48, Peptostreptococcus sp. strain 204 and Escherichia coli A-5-18) also enhanced the mutagenicity of 1-NP-bile. These bacterial cell-free extracts hydrolyzed the synthetic beta-D-glucuronides of phenolphthalein and/or p-nitrophenol. These data indicate that the glucuronide(s) of 1-NP-metabolite(s) secreted into bile can be hydrolyzed in the intestine by bacterial beta-glucuronidases to potent mutagenic aglycone(s). PMID- 3982439 TI - Mutational changes of quantitative morphological traits in the convict cichlid (Cichlasoma nigrofasciatum Guenther) after irradiation of parental spermatogonia and oogonia with different doses of X-rays. AB - 10 continuous and 6 discrete variables of body dimensions as well as 16 proportions calculated from them were determined in postirradiation F1 convict cichlid fish (Cichlasoma nigrofasciatum) which were derived from spermatogonia and oogonia both exposed to either 0 (controls), 250, 500, 750, 1000, or 2000 R of X-rays. While no interactions with sex or radiation dose were found, clear dosage effects and some sex effects occurred. The highest response for almost all quantitative traits examined as well as for variants of coloration or of vertebral aberrations appeared after 250 R to both parental germ cells. The lowest effectiveness was observed for almost all characters under investigation after 0 and 500 R. Accordingly, the largest difference between the 6 different treatment groups was found between 250 and 500 R, followed by 250 and 0, 250 and 1000, and 250 and 750 R to parental gonia. The present finding on the alterations of quantitative morphological traits completely corresponds to the changes of intraspecific aggressiveness as found for the same individual fish in a previous study thus confirming the complete congruence of the mutational response of quantitative morphological characters with that of behavioral traits to ionizing radiation. PMID- 3982440 TI - Discrimination between the effects of X-ray irradiation of the mouse oocyte and uterus on the induction of dominant lethals and congenital anomalies. AB - In order to test whether irradiation of the postimplantation maternal environment had any effect on the apparent induction of dominant lethals or congenital anomalies by radiation, preimplantation embryos were surgically transferred between females which had been irradiated before conception or left untreated. A high proportion of preimplantation embryos, collected from females that had been irradiated 15-21 days prior to conception with 3.6 Gy X-rays, were either arrested or developmentally retarded compared with those collected from untreated females. The transfer experiments indicate that irradiation of the uterus has no significant effect on the frequency of subsequent postimplantation mortality or on mean fetal weight. However, it remains unclear whether irradiation of the uterus contributes to the induction of congenital anomalies. PMID- 3982441 TI - Discrimination between the effects of X-ray irradiation of the mouse oocyte and uterus on the induction of dominant lethals and congenital anomalies. II. Localised irradiation experiments. AB - In order to evaluate whether irradiation of the postimplantation maternal environment contributed to the induction of postimplantation mortality or congenital anomalies, mouse ovaries were surgically exteriorised and selectively irradiated or shielded in a specially constructed apparatus. The results show that exposure of the mouse abdomen and uterus to 3.70 Gy X-rays, 15-21 days prior to conception, has no significant effect on the incidence of either postimplantation mortality or congenital anomalies. Exposure of the ovaries to 3.27 Gy X-rays during the same period, however, increased the frequency of both postimplantation mortality and congenital anomalies. PMID- 3982442 TI - Cytological characterization of repair-deficient CHO cell line 43-3B. I. Induction of chromosomal aberrations and sister-chromatid exchanges by UV and its modulation with 3-aminobenzamide. AB - The induction of chromosomal aberrations and sister-chromatid exchanges (SCEs) by short-wave ultraviolet (UV) and X-irradiation was studied in Chinese hamster ovary (CHO) wild-type (WT) cells and one of its UV-hypersensitive mutants, 43-3B. The results indicate that CHO 43-3B show high levels of spontaneously occurring chromosomal aberrations and SCEs; these levels are, respectively, approximately 4 and 1.7 times those found in WT CHO. Treatment with UV produced a considerable delay in the cell-cycle progression of the mutant cells compared to the WT cells. Doses of UV that had no effect on WT cells, significantly induced chromosomal alterations in the mutant in a dose-dependent manner. An approximately 5-fold increase in the induced frequencies of SCEs was obtained in 43-3B cells after UV treatment. No synergistic effect was observed with UV irradiation and the inhibitor of poly(ADP-ribose) synthetase, 3-aminobenzamide (3AB), in either cell type. The frequency of SCEs in the mutant cell lines was lower than would be expected if the effects of UV and the inhibitor were additive. X-Ray alone in G1 and in combination with 3AB in G2 did not induce increased frequencies of chromosomal aberrations in mutant cells in comparison to the WT cells. PMID- 3982443 TI - Comparative mutagenic efficiencies of the DNA adducts from the cooked-food related mutagens Trp-P-2 and IQ in CHO cells. AB - The relationship between DNA-adduct formation and mutagenicity of two heterocyclic aromatic amines associated with cooked foods was determined in a CHO cell strain lacking nucleotide excision repair. Cells were exposed to tritiated IQ (2-amino-3-methylimidazo[4,5-f]quinoline) or Trp-P-2 (3-amino-1-methyl-5H pyrido[4,3-b]indole) supplemented with hamster S9 microsomal fraction for metabolic activation. DNA from nuclei was isolated by DNAase-mediated elution from polycarbonate filters after RNAase and proteinase treatment. The presumed metabolites of both compounds bound to DNA in a dose-dependent fashion. Although the dose required to produce 50% cell killing was 15 times higher for IQ than Trp P-2, the amount of radioactive material bound to DNA at that dose was about 10 fold lower with IQ. When mutations at the hprt and aprt loci were compared with the estimated levels of adducts, the calculated mutagenic efficiency of the adducts was about 4 mutations per 1000 adducts for both compounds, assuming a target sequence of 1000 base pairs for either locus. We conclude that IQ is acting as a weak mutagen in this system because its extracellular metabolites either do not reach or do not react efficiently with the DNA of the CHO cells. PMID- 3982444 TI - Chromosome damage induced by decay of 3H and 125I incorporated into DNA of Chinese hamster cells. AB - The present study was undertaken to compare the frequency of chromatid-type aberrations in Chinese hamster cells with previous results on accumulation of unrepaired DNA-strand breaks after incorporation of 3H-TdR or 125IUdR into DNA. A linear-quadratic function was fitted by the weighted-least-square method to the data on yield of chromatid aberrations at different dpm values. Based on a significant linear response at low doses, RBE for 125I in relation to 3H was calculated for (i) chromatid breaks (17 +/- 6), (ii) the sum of isochromatid breaks and chromatid exchanges (21 +/- 9), and (iii) the total number of chromatid aberrations (18 +/- 5). Analogously, the RBE for accumulation of DNA strand breaks was determined (13 +/- 6). Our results are consistent with the assumption that chromosomal aberrations mainly originate from unrepaired DNA strand breaks. PMID- 3982445 TI - Semi-conservative synthesis of DNA in UV-sensitive mutant cells of Chinese hamster after UV-irradiation. AB - A study was made of the rate of semi-conservative DNA synthesis in asynchronous UV-resistant (clone V79) and UV-sensitive clones (VII and XII) of Chinese hamster cells after UV-irradiation. In all 3 clones studied, UV-irradiation (5-30 J/m2) induced a decrease in the rate of DNA synthesis during the subsequent 1-2 h. In the resistant clone (V79) recovery of DNA synthesis rate started after the first 2 h post-irradiation (5 J/m2) and by the 3rd hour reached its maximum value, which constituted 70% of that observed in control, non-irradiated cells. The UV sensitive mutant clones VII and XII showed no recovery in the rate of DNA synthesis during 6-7 h post-irradiation. The results obtained show that the survival of cells is correlated with the ability of DNA synthesis to recover after UV-irradiation in 3 clones studied. The observed recovery of UV-inhibited DNA synthesis in mutant clones may be due to certain defects in DNA repair. PMID- 3982446 TI - Effect of caffeine and adenosine on G2 repair: mitotic delay and chromosome damage. AB - Proliferating plant cells treated during the late S period with 5-aminouracil (AU), give the typical response that DNA-damaging agents induce, characterized by: an important mitotic delay, and a potentiation of the chromosome damage by caffeine post-treatment. The study of labelled prophases, after a tritiated thymidine pulse, allowed evaluation of the mitotic delay induced by AU as well as its reversion by caffeine, while chromosome damage was estimated by the percentage of anaphases and telophases showing chromosomal aberrations. Post treatment with adenosine alone has shown no effect on mitotic delay or chromosomal damage. However, when cells after AU were incubated in caffeine plus adenosine, the chromosome damage potentiation was abolished without affecting the caffeine action on mitotic delay. As a consequence, we postulate that caffeine could have two effects on G2 cells with damaged DNA: the first, to cancel their mitotic delay and the second to inhibit some DNA-repair pathway(s). Only this last effect could be reversed by adenosine. PMID- 3982447 TI - Cells from patients with ataxia telangiectasia are abnormally sensitive to the cytotoxic effect of a tumor promoter, phorbol-12-myristate-13-acetate. AB - Fibroblast strains from 6 patients with ataxia telangiectasia (A-T) were found to be markedly hypersensitive to the cytotoxic action of the tumor promoter phorbol 12-myristate-13-acetate (PMA), their D37 values being 5 times lower than those of two normal controls. Two A-T heterozygous strains were slightly hypersensitive to PMA, while a third one showed normal sensitivity. It is concluded that the DNA lesion which is critical in A-T cells is an important component of the damage caused by PMA-induced free radicals and may play a role both in the tumor promoting activity of PMA and the cancer proneness of A-T patients. PMID- 3982448 TI - Mycotic otitis externa in animals. PMID- 3982449 TI - Studies on haemagglutinins of Microsporum gypseum. PMID- 3982450 TI - Antigenic diversity of the circumsporozoite proteins in the Plasmodium cynomolgi complex. AB - Antigenic diversity was observed in the circumsporozoite (CS) proteins of five of the six Plasmodium cynomolgi isolates (NIH, Mulligan, London, Gombak, Ceylon, RO) that we examined. Monoclonal antibodies were produced against salivary gland sporozoites of three of the isolates. Interaction of these monoclonal antibodies with the sporozoites was isolate specific, the exception being the anti-NIH monoclonals which also reacted with Mulligan strain sporozoites. Inhibition of binding between the different monoclonal antibodies indicated that for each of the NIH, London, and Gombak strains, the homologous monoclonals were recognizing the same or a topographically close immunodominant epitope on the respective CS protein. Also the binding of a polyvalent anti-NIH rhesus serum to the homologous antigen could only be inhibited by anti-NIH monoclonal antibody. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis of sporozoite extracts demonstrated clear differences in the apparent molecular weights of the CS proteins of four of the six isolates. This is the first study which provides evidence of antigenic diversity in the CS proteins of different isolates of a primate plasmodial species. PMID- 3982451 TI - Partial chemical characterization of the carbohydrate moieties in Leishmania adleri glycoconjugates. AB - Promastigotes of Leishmania adleri were submitted to an extraction procedure providing different carbohydrate-containing extracts. The purified aqueous extract showed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis a complex peptide pattern but carbohydrate was present only in bands of Mr approximately equal to 45 000-50 000 and 13 500. Methylated derivatives of the hexose components in this extract, analysed by mass spectrometry, suggest the presence of short sugar chains of alpha-D-mannopyranose and a branched alpha-D mannan. The phenol extract, released in the aqueous layer a chloroform/methanol/water soluble complex contained 25% protein, 17% phosphate, 11% glucosamine, uronic acid and 61% neutral carbohydrate, and a chloroform/methanol/water insoluble fraction consisting of a glycoprotein Mr approximately equal to 22 000 and a proteic doublet Mr approximately equal to 58 000-66 000. A polysaccharide, showing galactose as predominant sugar, was released through alkaline extraction corresponding to a branched, mainly 1----3 linked galactan associated with alpha-D-mannopyranosyl units. PMID- 3982452 TI - The interaction of human serum with the surface membrane of schistosomula of Schistosoma mansoni. AB - After contact with human serum, a series of proteins become exposed on the surface membranes of schistosomula of Schistosoma mansoni as revealed by radioiodination of the intact parasites. Among the proteins, a doublet (Mr 45 000) is particularly prominent. These doublet proteins, which are believed to be parasite-derived, become apparent after a very short time of incubation with human serum (10 min or less) and are expressed on the surface membranes after contact with a high molecular weight component of human serum (Mr greater than 80 000). Pretreatment of the parasites with 1.25 mM colchicine or fixation with 2% glutaraldehyde does not prevent the serum-induced expression of the doublet proteins. Extraction of the parasites with chloroform:methanol 2:1 (v/v), however, blocks the human serum effect. Affinity chromatography using immobilized low density lipoproteins (LDL) from human serum shows a tight binding between the 125I-labelled 45 kDa doublet to the LDL. The possible role of the 45 kDa doublet as a receptor for LDL is discussed. PMID- 3982453 TI - Trends in the incidence of myocardial infarction and in associated mortality and morbidity in a large employed population, 1957-1983. AB - We analyzed long-term trends in the incidence of a first acute myocardial infarction and in case-fatality rates among employees of the Du Pont Company from 1957 through 1983. A steady decline in incidence was observed among male employees. The annual age-adjusted rate in the 1957-1959 period was 3.19 per 1000, as compared with 2.29 per 1000 in the 1981-1983 period--a decline of 28.2 per cent. The rate of decline was higher among salaried (white-collar) employees than among production workers receiving hourly wages. No trend was seen among female employees, but the number of cases may have been to small to detect a decline. Beginning in 1969, the 24-hour case-fatality rate showed a moderate decline, but after 1975, there was a sharp drop in the 30-day case-fatality rate among persons who survived 24 hours after the attack. These declines did not begin until several years after the decline in incidence had begun. This study and others suggest that improved medical care probably made some contribution to the decline in mortality associated with coronary heart disease, but the major source of the decline has been a reduction in the incidence of the disease. PMID- 3982454 TI - The relation of faculty academic activity to financing sources in a department of medicine. AB - Academic medical departments confront important changes in funding sources and consequent pressure to change faculty activities. Valid information has often been lacking concerning the existing relations of faculty activity to funding sources. We examined those relations in the Stanford Department of Medicine through a combination of randomized observations of faculty and faculty self reports over a period of one year. For an average 62-hour workweek, there was approximate consonance between types of activities and sources of salary support. Sensitivity analyses indicated that even sizable errors in self-reports would not have changed the outcomes substantially. Over 60 per cent of the activity involved "joint products," representing two or more categories of activity. There was wide variation in activities and fund sources between divisions. Per full time faculty equivalent, research generated far more income than the most lucrative specialty practice; thus, at least in this type of department, attempts to compensate for lost research revenue by intensifying clinical practice will probably fail and undermine present research activities. The method of analysis used here may be useful in improving prospective planning by departments and by larger medical-policy bodies, particularly in the public sector. PMID- 3982455 TI - Selective antibody deficiency and recurrent pneumococcal bacteremia in a patient with Sjogren's syndrome, hyperimmunoglobulinemia G, and deficiencies of IgG2 and IgG4. PMID- 3982456 TI - Coronary heart disease: doing the "right things". PMID- 3982457 TI - Primary biliary cirrhosis. PMID- 3982458 TI - Management of precocious puberty. PMID- 3982459 TI - Breast cancer in mothers given diethylstilbestrol in pregnancy. PMID- 3982460 TI - Possible prevention of adriamycin-induced alopecia by tocopherol. PMID- 3982461 TI - Interaction of ketoconazole with rifampin and isoniazid. PMID- 3982462 TI - Thermogenesis in brown adipose tissue. PMID- 3982463 TI - Altered calcium uptake in cultured skin fibroblasts from patients with Alzheimer's disease. PMID- 3982464 TI - A geriatric evaluation unit in a VA hospital. PMID- 3982465 TI - More on bird attacks. PMID- 3982466 TI - More on doctors' unions: are private practitioners "de facto employees"? PMID- 3982467 TI - A president argues against reducing the sizes of medical school classes. PMID- 3982468 TI - The western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. A 12-month follow-up report. AB - After cardiac catheterization and coronary arteriography, 134 patients who had had an acute myocardial infarction were randomly assigned to treatment with intracoronary streptokinase (4000 U per minute, begun approximately 4 1/2 hours after the onset of symptoms, for a total of 286,000 +/- 77,800 U over 72 +/- 24 minutes); 116 control patients received standard care after they returned to the coronary care unit, immediately after angiography. Preliminary results of this trial have been published in the Journal (1983; 309:1477-81). During the first 30 days, 5 deaths occurred in the streptokinase group and 13 occurred in the control group (3.7 vs 11.2 per cent, P = 0.02); during the first year, the corresponding figures were 11 and 17 deaths (8.2 vs. 14.7 per cent, P = 0.10). However, when a minor imbalance in the ejection fraction and infarct location between the two groups was adjusted by logistic regression, the difference in one-year mortality became significant (P = 0.03). In the streptokinase group, 2 of the 80 patients in whom perfusion was reestablished (2.5 per cent) had died by one year, whereas 3 of the 13 with partial reperfusion (23.1 per cent) and 6 of the 41 with no reperfusion (14.6 per cent) had died (P = 0.008). Mortality among patients with partial reperfusion was not significantly different from that among those without reperfusion (P greater than 0.90). No base-line clinical, angiographic, or hemodynamic variable was predictive of successful reperfusion, according to univariate and multivariate analyses. We conclude that intracoronary streptokinase reduces one-year mortality among patients with acute myocardial infarction, but this improvement occurs only among those in whom thrombolysis results in coronary artery reperfusion. PMID- 3982469 TI - Calcitonin secretion in postmenopausal osteoporosis. AB - Calcitonin deficiency has been implicated in the pathogenesis of accelerated bone loss, especially in postmenopausal osteoporosis. To investigate this issue, we studied 25 patients with untreated postmenopausal osteoporosis, 14 age-matched and sex-matched healthy controls (spinal bone mineral density greater than or equal to age-specific and sex-specific mean), and 5 women who had undergone total thyroidectomy. Each subject received an intravenous infusion of 2 mg of elemental calcium per kilogram of body weight over 5 minutes, to test the C-cell secretory reserve. We measured calcitonin by radioimmunoassay in whole plasma and in silica cartridge extracts of plasma, the latter method providing greatly improved sensitivity and specificity for monomeric calcitonin. Basal immunoreactive calcitonin concentrations, whether measured in whole plasma or in extracts, were significantly higher in the subjects with osteoporosis (P less than 0.01) than in the healthy controls. The calcitonin secretory reserve, as assessed by calcium stimulation, was normal in the osteoporotic group but virtually absent in the thyroidectomy group. We conclude that postmenopausal osteoporosis is not associated with and does not result from calcitonin deficiency. On the contrary, excessive skeletal calcium release may stimulate calcitonin secretion in patients with the disorder. PMID- 3982470 TI - Hypertension and intravenous antidopaminergic drugs. PMID- 3982471 TI - Verapamil for multifocal atrial tachycardia. PMID- 3982472 TI - Serum triglycerides--an independent risk factor for myocardial infarction but not for angina pectoris. PMID- 3982473 TI - Abnormal metabolism or reduced transport of CSF gamma-trace microprotein in hereditary cerebral hemorrhage with amyloidosis. PMID- 3982474 TI - Asymptomatic bone marrow infiltration by blast cells. PMID- 3982475 TI - Rapid achievement of antidepressant effect with intravenous chlorimipramine. PMID- 3982476 TI - Public perceptions of medicine. PMID- 3982477 TI - Tarnishing the medical profession's image. PMID- 3982478 TI - The vulnerability of court-appointed impartial experts in child-custody cases. PMID- 3982479 TI - Blood donation by persons at high risk of AIDS. PMID- 3982480 TI - On vascular non-disease of the foot in diabetes. PMID- 3982481 TI - Untreated low-grade non-Hodgkin's lymphoma. PMID- 3982482 TI - Smoldering multiple myeloma associated with anemia. PMID- 3982483 TI - Cyclosporine in refractory severe aplastic anemia. PMID- 3982484 TI - Perturbation of sodium-lithium countertransport in red cells. PMID- 3982485 TI - Periodic skin blood flow. PMID- 3982486 TI - Removing cockroaches from the auditory canal: controlled trial. PMID- 3982488 TI - Measles vaccine not just for children anymore. PMID- 3982487 TI - Smoking in the physician's work place. PMID- 3982490 TI - Fungal flora of Egyptian baladi bread with special reference to the mutagenic effects of their toxic metabolites. AB - The fungal flora of wheat flour and baladi bread in upper Egypt were investigated. Most of the isolated fungal species belong to the genus Aspergillus. The presence of non heat resistant fungi of the both flat surfaces of baladi bread, came from contamination after baking and from improper handling at homes. Among the heat resistant fungi, A. fumigatus and A. niger, were recorded to inhabit the spongy crumb although the high temperature of baking process which reached approximately 100 degrees C in the center of the bread. The mutagenic effects of the fungal metabolites of the extract of mouldy Egypt were investigated. Most of the isolated fungal species all stages of mitotic division. The most interesting effect of these fungal metabolites were the induction of tripolar and quadripolar spindle. Multinucleate and polyploid cells were also observed under relatively high concentrations. It was noticed that at either higher concentrations or lower concentrations with long exposure, damaged cells were observed. The hazards involved through the consumption of individuals to such mouldy bread, is accumulation of possible deleterious effects from both long and short term exposure to these toxic metabolites. PMID- 3982489 TI - Paracoccidioidomycosis: a comparative study of the evolutionary serologic, clinical and radiologic results for patients treated with ketoconazole or amphotericin B plus sulfonamides. AB - A comparative study of two groups of patients with paracoccidioidomycosis was carried out with the objective of comparing the evolutionary serologic, clinical and radiologic results after 6, 12, 15 and 18 months of treatment with ketoconazole (22 patients) or amphotericin B plus sulfonamides (32 patients). The serologic data analyzed as a whole showed a tendency to sharper drops in antibody titers in the patients treated with ketoconazole. Clinically patients treated with ketoconazole fared better but the differences were not statistically significant. No statistical difference was detected between groups in terms of the results of radiologic evolution. PMID- 3982491 TI - Studies on the prevalence of tinea capitis infection in Ile-Ife, Nigeria. AB - Investigations were carried out into the prevalence of tinea capitis infection among school children in Ile-Ife, Nigeria. The prevalence rate of clinical infection was found to be 14.02%. The infection was found to be more frequent among pupils between ages 5 and 10 years, and more prevalent among the poor than the rich (p less than 0.005). Families having between 1 and 4 children had lower prevalence than families having minimum of five children (p less than 0.10). Approximately one-third of the clinically infected children were not receiving any treatment while about two-thirds of the remaining two-thirds were using local native remedies, some of which had resulted in deaths of some children. The most common causative agent isolated from the lesions was Microsporum audouinii. PMID- 3982492 TI - Scanning electron microscope studies on the parasitic cycle of Coccidioides immitis. AB - The process involved in the in vivo conversion of the arthroconidia of Coccidioides immitis into endosporulating spherules was studied with the aid of a scanning electron microscope. By the fifth and sixth day after inoculation of laboratory mice, complete conversion had occurred in their kidneys, lungs, and spleens. The progressive stages of cleavage that occurred in the enlarged arthroconidia were initiated by invagination at several points of the cytoplasmic membrane that covers the inner surface of the developing spherule's cytoplasm was divided into progressive smaller segments. These segments were aggregated in packets and enclosed in a membranous sac. At maturity the membrane dissolved, and the endospores were freed within the spherules. Finally, the spherule wall ruptured, and the endospores were released. PMID- 3982493 TI - Experimental candidiasis in iron overload. AB - In an attempt to study the influence of iron overload on deep mycotic infection, experimental candidiasis was induced in mice. One group received intravenous injections of colloidal iron (60 mg/kg weight) for three consecutive days before intravenous inoculation of Candida albicans spores (1 X 10(7). The other received the same number of Candida spores without iron overload. The animals in both groups were observed for 28 days. The Candida lesions, regardless of iron administration, were located mainly in the kidney. There was a marked difference in mortality between the two groups, i.e., 40% in the group without iron administration and 80% in the group with it. The higher mortality rate in the latter group may be explained by following reasons: increased serum iron and iron saturation (iron is essential to the growth of Candida), decreased phagocytic activity against intravenously inoculated Candida because of the saturation of the phagocytic cells by the preceding colloidal iron administration and enhanced proliferation of Candida, which tends to involve the kidney, exposed to abundant iron in the kidney due to increased excretion. The current experiment showed that excessive iron clearly promoted the proliferation of intravenously inoculated Candida in vivo. PMID- 3982494 TI - Hearts in the wrong place. PMID- 3982495 TI - Genetic engineering patents. Contest in prospect over interferon rights. PMID- 3982496 TI - Bendectin/debendox. Drug not guilty, says court. PMID- 3982497 TI - Genetic diseases. Problems of prenatal testing. PMID- 3982498 TI - Radiation data wanted. PMID- 3982499 TI - Nuclear structure. Taken with a grain of salt. PMID- 3982500 TI - Mechanisms for homologous recombination. PMID- 3982502 TI - Molecular biology. Coordination of sequence data. PMID- 3982501 TI - Infant mortality. US improvement halted. PMID- 3982503 TI - Multiple innervation of tonic endplates revealed by activity-dependent uptake of fluorescent probes. AB - During development of the vertebrate nervous system, there is a widespread reduction in the number of axons innervating target cells. This phenomenon, often called synapse elimination, has been particularly well studied at the neuromuscular junction of developing twitch muscle fibres: following a period of polyneuronal innervation, axonal branches are retracted, usually leaving each twitch fibre endplate innervated by only one axon. Here we describe a new technique for the study of synapse elimination--activity-mediated uptake of fluorescent probes. These probes selectively and supravitally label all the terminals of individual axons. The technique is used here in adult and embryonic snakes to study the innervation pattern of a thin muscle containing two fibre types: twitch fibres, which are fast-contracting and have propagated action potentials, and tonic fibres, which are slow-contracting and lack action potentials. We find that twitch muscle fibres, as expected, eliminate all polyneuronal innervation during development; in contrast, tonic fibre endplates remain polyneuronally innervated into adulthood. The persistence of multiple innervation at tonic endplates may be related to the lack of action potential activity in tonic muscle fibres. PMID- 3982504 TI - Levels of c-myc oncogene mRNA are invariant throughout the cell cycle. AB - The steady-state messenger RNA levels of several genes increase when cells are stimulated to proliferate. The transcripts from one such gene, the proto-oncogene c-myc, increase approximately 20-fold shortly after cells are stimulated to proliferate and then decline before the onset of DNA synthesis. It has been inferred from these data that expression of c-myc may be specific to the G1 portion of the cell cycle. Alternatively, this transient increase in c-myc mRNA following the stimulation of quiescent cells could be the result of an activational event that renders the cells competent to enter the cell cycle. To distinguish between these possibilities, we performed experiments to determine whether the amount of c-myc mRNA fluctuates during the cell cycle in cells that are under constant stimulation to proliferate. Although c-myc mRNA does undergo a transient increase within 2 h of serum stimulation of quiescent serum-deprived cells, our results show that the level of c-myc mRNA is constant throughout the cell cycle and does not diminish in density-arrested cells maintained in the presence of serum growth factors. In contrast to c-myc, the mRNA levels of two other genes whose expression has been associated with cellular proliferation do show consistent variations within the cell cycle. Both thymidine kinase (TK) and histone 2b (H2b) mRNA levels increase during S phase in continuously growing cells and decrease when cell replication ceases in density-arrested cultures. Therefore, the transient increase in c-myc transcription following the activation of quiescent cells is not due to the type of cell cycle-dependent regulation characteristic of the TK and H2b genes. PMID- 3982505 TI - Specific expression of a foreign beta-globin gene in erythroid cells of transgenic mice. AB - The globin gene family represents an attractive system for the study of gene regulation during mammalian development, as its expression is subject to both tissue-specific and temporal regulation. While many aspects of globin gene structure and expression have been described extensively, relatively little is known about the cis-acting DNA sequences involved in the developmental regulation of globin gene expression. To begin to experimentally define these regulatory sequences, we have taken the approach of introducing cloned globin genes into the mouse germ line and examining their expression in the resulting transgenic animals. Here we describe a series of transgenic mice carrying a hybrid mouse/human adult beta-globin gene, several of which express the gene exclusively or predominantly in erythroid tissues. These studies demonstrate that regulatory sequences closely linked to the beta-globin gene are sufficient to specify a correct pattern of tissue-specific expression in a developing mouse, when the gene is integrated at a subset of foreign chromosomal positions. PMID- 3982506 TI - Partial deficiency of erythrocyte spectrin in hereditary spherocytosis. AB - Hereditary spherocytosis (HS) is a common, clinically heterogeneous haemolytic anaemia in which the primary erythrocyte defect is believed to be some abnormality in the spectrin-actin membrane skeleton, leading to loss of surface membrane. Recessively inherited spectrin deficiency with extreme erythrocyte fragility and spherocytosis has been identified in certain mutant mice and two severely anaemic humans. Although suspected, deficiency of spectrin has not been demonstrated in less severe forms of human HS. We not report the quantitation of erythrocytes spectrin by radioimmunoassay. We found that normal erythrocytes contained 240,000 copies of spectrin heterodimer, whereas erythrocytes from 14 patients with a variety of types of HS were all partially deficient in spectrin (range 74,000-200,000 copies), the magnitude of the deficiency correlating with the severity of the disease. Spectrin deficiency of varying degrees is common in HS and probably represents the principal structural defect leading to loss of surface membrane. PMID- 3982507 TI - Congress acts on clear air. PMID- 3982508 TI - Voluntary authority set up. PMID- 3982509 TI - Baseless flagellation. PMID- 3982510 TI - Towards schistosomiasis vaccines. PMID- 3982514 TI - [Obstetrical consequences of unresolved mourning over the death of an infant in the perinatal period]. PMID- 3982512 TI - Release of cholecystokinin-immunoreactivity into the vascular bed of the guinea pig small intestine during peristalsis. AB - The release of cholecystokinin-immunoreactivity (CCK-IR) into the venous effluate of the isolated and vascularly perfused guinea-pig small intestine was measured. Raising the intraluminal pressure by 5 mbar for 8 min initiated peristalsis and was associated with an increased release of CCK-IR. The ganglion stimulant dimethylphenyl-piperazinium failed to alter the release of CCK-IR. The results are discussed in the light of a possible involvement of CCK-containing neurones in intestinal peristalsis. PMID- 3982511 TI - Modulation by ouabain and diphenylhydantoin of veratridine-induced 22Na influx and its relation to 45Ca influx and the secretion of catecholamines in cultured bovine adrenal medullary cells. AB - The effects of ouabain and diphenylhydantoin on the secretion of catecholamines induced by veratridine were investigated in cultured bovine adrenal medullary cells with special reference to ion fluxes. Veratridine itself induced an influx of 22Na and 45Ca as well as secretion of catecholamines, which were antagonized by tetrodotoxin, a selective inhibitor of voltage dependent Na channels. The secretion of catecholamines caused by veratridine was not observed either in Na free or Ca free medium. Veratridine-induced influx of 45Ca did not occur in Na free medium, while veratridine-induced influx of 22Na occurred even in Ca free medium. Veratridine-induced influx of 22Na, 45Ca and secretion of catecholamines were all potentiated by ouabain, a potent inhibitor of Na,K-ATPase. Omission of K from the medium, a condition which suppresses the Na,K-ATPase activity, also augmented these cell responses caused by veratridine. On the contrary, diphenylhydantoin, which is known to decrease the intracellular concentration of Na, reduced the veratridine-induced influx of 22Na, 45Ca and secretion of catecholamines. The potentiating effects of ouabain on the veratridine-induced cell responses were all abolished by diphenylhydantoin. These findings imply that veratridine, ouabain and K removal as well as diphenylhydantoin modulate the intracellular accumulation of 22Na which is involved in the influx of 45Ca and the secretion of catecholamines. PMID- 3982515 TI - [Behavior and heart infarct]. PMID- 3982513 TI - Involvement of central catecholamines in mediation of pressor responses of the rat to carotid occlusion. AB - Carotid occlusion evoked a pressor response in rats after transection of the spinal cord. Intraventricular pretreatment with 6-hydroxydopamine inhibited the pressor response. The pressor response to occlusion was also diminished by the intraventricular but not by the intravenous injection of guanethidine. Intravenous atropine or mecamylamine, or intraventricular captopril did not affect the pressor response. Thus, it appears that central catecholaminergic mechanisms are involved in the mediation of the pressor response to carotid occlusion. PMID- 3982516 TI - [Lens implantation; current status]. PMID- 3982517 TI - [The inaccuracy of the quotient of 2 percentages obtained in the differentiation of leukocytes]. PMID- 3982518 TI - [Vertical partial laryngectomy]. PMID- 3982519 TI - [Potential development of hypothermia and hypoglycemia in infants born at home after prolonged skin contact following delivery]. PMID- 3982520 TI - [Decrease in breast cancer mortality due to mass screening with mammography; results of the Nijmegen mass screening project 1975-1981]. PMID- 3982521 TI - [Influence of relative body weight on the prognosis of breast cancer in women]. PMID- 3982522 TI - [Breast carcinoma in women over 70]. PMID- 3982523 TI - [Surgical catheterization of the internal jugular vein; a safe alternative for the infraclavicular catheterization of the subclavian vein]. PMID- 3982524 TI - [Protein and phosphate in our diet and progressive skeletal decalcification in postmenopausal women]. PMID- 3982525 TI - [Is endoscopy of the proximal digestive system at the request of the general practitioner useful?]. PMID- 3982526 TI - [A patient with plasma cell leukemia]. PMID- 3982527 TI - [Fistula closure with fibrin glue; correction by the authors]. PMID- 3982528 TI - [Not enough sunlight]. PMID- 3982529 TI - [Rhinotherm, not a current therapy]. PMID- 3982530 TI - [The question behind the question]. PMID- 3982531 TI - [The epidemiological analysis of infectious diseases]. PMID- 3982532 TI - [20 years of cephalosporins]. PMID- 3982533 TI - [The treatment of myomas]. PMID- 3982534 TI - [Physician, dissertation and word processor]. PMID- 3982535 TI - [Chronic meningococcal septicemia, a forgotten disease]. PMID- 3982536 TI - [Incidence of bacterial meningitis in the Netherlands; comparison of 3 registration systems, 1977-1982]. PMID- 3982537 TI - [The value of herniography in inexplicable inguinal pain]. PMID- 3982538 TI - [Primary extratesticular seminoma]. PMID- 3982539 TI - [The KNMG (Royal Dutch Society for the Promotion of Medicine) viewpoint concerning regulated provision of hard drugs in Amsterdam]. PMID- 3982540 TI - [Corticosteroids in the treatment of severe typhoid]. PMID- 3982541 TI - [Ethical aspects of in-vitro fertilization; a critical reaction to the interim recommendation of the Public Health Council concerning in vitro fertilization]. PMID- 3982542 TI - [A dynamic splint for the treatment of hip dysplasia]. PMID- 3982543 TI - [Osteomyelitis caused by initially unrecognized Salmonella typhi]. PMID- 3982544 TI - [Candida albicans spondylodiskitis in intravenous heroin abuse]. PMID- 3982545 TI - [Atypical disease aspects in spondylodiskitis]. PMID- 3982546 TI - [A family with typhoid]. PMID- 3982547 TI - [Euthanasia before the Supreme Court]. PMID- 3982548 TI - Regular caffeine consumption: effects on resting cardiovascular function and cardiovascular changes induced by mental challenge. PMID- 3982550 TI - Abdominal surgery in the elderly patient. PMID- 3982549 TI - Problems in diagnosis and treatment of infantile hypertrophic pyloric stenosis. PMID- 3982551 TI - Myospherulosis. PMID- 3982552 TI - The importance of accurate pediatric diagnosis of cerebral dysfunction or should the cesarean section rate be increased? PMID- 3982553 TI - Correlation of electrocardiographic changes with plasma quinidine concentration. PMID- 3982554 TI - Sudden infant death syndrome--a six-year family follow-up in Nebraska. PMID- 3982556 TI - Studies of metronidazole radiosensitizing effect in radiation treatment of patients with oral cavity cancer. AB - Clinical observations of 26 patients with tongue, oral cavity and oropharyngeal cancer receiving telegammatherapy by dynamic dose fractionation scheme in combination with metronidazole (MZ) and of 38 patients from control group treated by identical schedule without MZ suggest that MZ favors increasing of the radiation damage in tumors of those sites without changing the character or intensifying early radiation reactions. After oral administration of MZ in single doses of 5-6 g/m2 it reaches its maximum in the blood serum within 2-4 h. When the total dose of 30-60 g of MZ was used, a marked toxic effect manifested by gastrointestinal symptoms was observed in 33.3% of patients. MZ has a negative effect on liver functions, however, changes in biochemical tests illustrating it, are reversible and within the norm. Simultaneous studies of biopsy material from 22 patients (11 from each group) in terms of proliferation activity showed that oral cavity tumors contain a significant portion of proliferating cells which notably decrease in the course of radiation therapy. To a greater extent that decrease is marked after irradiation with MZ. PMID- 3982555 TI - Iron overload as a result of transfusion therapy in a patient with adenosine deaminase deficiency. PMID- 3982557 TI - Epidemiological features of biliary tract cancer incidence in Slovakia. AB - This descriptive study is based on detailed data of biliary tract cancer incidence in Slovakia in the period 1968-1977. Age-adjusted incidence rates of biliary tract cancer in the given decade decreased in females while in males they showed a slight increase. The study of geographic distribution revealed diminishing incidence rates from west to the east in both sexes with extremely elevated rates in towns and suburban districts in males. Different shapes of age specific incidence curves together with the identified histological types suggested different epidemiological characteristics of individual subsites within this site. Relatively high incidence rates of biliary tract cancer in Slovakia as well as in whole Czechoslovakia, in comparison with other countries or areas of Europe, could be related to the excessive prevalence of gallstones and high number of surgical interventions upon biliary tract in this country while the decreasing incidence rates in women coincided with elevated number of cholecystectomies. The significance of detailed descriptive data from cancer registries for further analytic and etiologic study of biliary tract cancer according to subsites for a better delimitation of high risk groups and primary prevention strategies is stressed. PMID- 3982558 TI - Malignant tumors and embolizing paraneoplastic endocarditis. AB - A group of 4495 autopsied patients was evaluated. In 1011 (22.5%) of them various malignancies were found. In 20 of these cancer patients (2%) also a nonbacterial verrucous endocarditis was observed. The most serious complication of this paraneoplastic syndrome was central arterial embolization resulting in cerebral and myocardial infarctions. In our group this was observed in 12 patients (60%), in 9 cases of them infarction was the immediate cause of death. Fatal complications due to central embolization were seen also in 3 patients who had a malignant disease without symptoms of generalization. The most frequent tumors observed among the autopsied patients were adenocarcinomas of the digestive tract (40%). In the group of revealed tumors adenocarcinomas clearly prevailed (70%) in 10 cases (50%) also mucin production could be detected. PMID- 3982559 TI - Alkaline phosphatase from human uterine myoma. II. Kinetic and immunological properties. AB - Thermostability of the purified alkaline phosphatase derived from human uterine muscle and myoma was established before and after desialization. Both enzymes were inhibited by sucrose, glucose and maltose in proportion to the carbohydrate concentration. L-Homoarginine inhibits the myoma enzyme in 90%, L-leucine, L histidine and L-tryptophan in about 60%, and L-phenylalanine in less than 15%. The type of inhibition and Ki values were determined. Muscle and myoma enzymes cross-reacted with antisera against human liver and placental isoenzymes. Molecular and kinetic properties of the enzyme were compared with known human isoenzymes of alkaline phosphatase. PMID- 3982560 TI - DNCB and PPD skin tests and prognosis in 152 patients with breast cancer. A prospective 2-year follow-up. AB - The relationship of pretreatment immunologic status in terms of skin tests to prognosis within stages was studied in 152 breast cancer patients. DNCB and PPD testing was used. As for DNCB, no relationship was found at early stages of the disease. In locoregionally advanced disease, patients with stronger test grades had longer disease-free intervals. In case of distant dissemination significant difference in reactivity with respect to survival was found: short survivors were more frequently nonresponders or mild responders. Anergy was, however, more frequent in patients with general ill health and therefore this test does not provide an important additional prognostic information as compared to that given by conventional clinical findings. As for PPD, no relationship between reactivity to this antigen and prognosis at any stage of the disease was found. PMID- 3982561 TI - Changes in serum cathepsin B-like activity in patients with colorectal cancer. AB - Cathepsin B-like activity (CB-like) was estimated in sera of 30 male patients with colorectal cancer (n = 20), benign polyps of the rectum (n = 10) and in sera of control subjects (n = 50). Both total and residual activities of the enzyme in colorectal cancer patients showed a significant elevation in comparison with control subjects and patients with benign polyps. In the course of antitumor therapy a decline in catheptic activity was observed when a reduction in the volume of tumor tissue was present. On the other hand, an increment in CB-like activity was observed when antitumor therapy had no effects or tumor relapse was present. PMID- 3982562 TI - Postnatal carcinogenic study of dimethylnitrosamine in rats. AB - Wist: Han/Pce SPF strain rats were administered dimethylnitrosamine (DMNA) in 0.04% concentration since the first day after birth. Total dose of 0.2 mg per infant rat was administered on 1st to 5th day of life, 0.4 mg/infant rat on 1st to 10th day and 0.5 mg on 1st to 20th day of life. Maximum survival time was one year. Both higher DMNA doses were already toxic the effect manifesting itself by increased mortality of the infant rats (liver hemorrhages, bleeding into the intestinal lumen) and reduced weight increment. Hepatic and renal tumors were detected in the rats beginning with their 19th week of life. In the liver they were hepatocellular carcinomas, to a lesser extent also cholangiomas and cavernomas. Further, increased incidence of preneoplastic nodular hyperplasia and benign hepatomas was demonstrated. In the kidney it was always the case of mixed mesenchymal tumor. Comparison of the results of postnatal study with a long-term carcinogenic DMNA study is discussed and possible reasons of different localization and characteristics of tumors dependent on DMNA administered were demonstrated. PMID- 3982563 TI - bis-Mannich bases of styryl ketones as antileukemic agents. AB - A novel series of bis-Mannich bases have been synthesized and evaluated against P388 lymphocytic leukemia in mice. Two compounds showed a perceptible beneficial response in this screen and all the compounds displayed marked murine toxicity. A representative compound inhibited respiration in mitochondria isolated from rat and mouse liver cells by 90% approximately at a dose of 2.5 mumol and it caused a small elevation in mouse liver glutathione equivalent concentrations at 5 mg/kg. PMID- 3982564 TI - Identification of a tumor-related protein antigen in immune complexes derived from pleural effusions of patients with bronchial carcinoma. AB - Pleural effusions from 15 patients with advanced primary bronchial carcinoma, from 2 patients with metastatic lung cancer and from 6 patients with nonmalignant disease were studied. Immune complexes were found in examined fluids in amounts corresponding to 2.5-210 mg/100 ml of aggregated IgG by means of ELISA solid phase anti C3 and 125ICIq binding radioimmunoassay. Following determination of protein content and salting out by ammonium sulfate of examined fluids, the sediments were subjected to subsequent chromatographic procedure including molecular sieving (Sephadex G-200, Sepharose 4B) and affinity chromatography on Protein A-Sepharose CL-4B. The yield--apparently pure immune complexes--was then split by means of chaotropic agent 2.5 M KSCN. It permitted to obtain 2 fractions: one contained IgG while the other was a non-Ig protein of m. w. = 150 000. The latter isolated from malignant effusions possessed antigenic activity in the leukocyte migration inhibition (LMI) assay. It resulted in inhibition of migration of allogenic peripheral blood leukocytes from lung cancer patients in 87% of cases. It had no activity against leukocytes from nonmalignant disease patients. LMI activity of the final second fraction derived from malignant effusion was significantly different from that of other fractions obtained both from malignant and nonmalignant fluids. PMID- 3982565 TI - An experimental model for predicting the synergism of hyperthermia with cytostatics. AB - A simple prediction test for a combination of hyperthermia and chemotherapy checked on three experimental tumors and cells of the normal murine thymus is described. The testing procedure is based on checking the incorporation of labeled 125I 5-iodo-2-deoxyuridine into the DNA of tested cells affected solely by the enhanced temperature or by the cytostatic itself, or by a combination of both agents. The statistical analysis of repeated results demonstrated the reproducibility of the test. Testing of the potentiation effect of different non cytostatic substances with enhanced temperatures also gave results corresponding to findings of other authors, performed in vivo or by the use of other techniques. Thus, this simple method is recommended for a screening, before considering the individual use of the combination of hyperthermia and chemotherapy in patients. PMID- 3982566 TI - [Dopamine agonists in the therapy of parkinson syndrome]. PMID- 3982567 TI - [Acute total polyneuritis]. PMID- 3982568 TI - [Apolipoproteins A and B in cerebrovascular diseases]. AB - The present study has proved unequivocally the value of determining apolipoproteins A and B and the APO-L A/B quotient for establishing the risk for cerebrovascular disease. The determination of apolipoproteins should be preferred to the determination of HDL, LDL and VLDL, which has been practised so far. While only 30% of a group of 88 patients suffering from cerebrovascular disease had serum cholesterol levels of more than 250 mg/dl and approx. 57% showed HDL values below 40 mg/dl, a reduced APO-L A/B relation (less than 1.75) was demonstrated in 74%. A reduced APO-L A/B quotient was also observed in more than 70% of 62 CVD patients whose cholesterol level was within the range of normal. Determination of apolipoproteins may, therefore, be regarded as further progress in risk factor diagnostic of arteriosclerotic disease. PMID- 3982570 TI - In-vivo detection of tumours and metastases with (monoclonal) antibodies. PMID- 3982569 TI - [Hyperlipidemia and angiographic findings in ischemic insult]. PMID- 3982572 TI - Monoclonal gammapathies. An attempt at a new classification. PMID- 3982571 TI - Treatment of chronic lymphocytic leukaemia with monoclonal anti-idiotypic antibody. PMID- 3982573 TI - Systemic autoimmune disease and Raynaud's phenomenon. PMID- 3982574 TI - Sodium retention in nephrotic syndrome is due to an intrarenal defect: evidence from steroid-induced remission. AB - There is increasing evidence that the sodium retention of nephrotic syndrome is directly due to an intrarenal mechanism and not to a low blood volume stimulating the renin-angiotensin-aldosterone system. However the mechanism of the natriuresis that occurs during remission is not known. Patients with nephrotic syndrome were therefore studied during steroid-induced remission. At the onset of natriuresis, blood volume and plasma albumin were low and did not change. Plasma renin activity and plasma aldosterone were initially high and both fell during the natriuresis. At the end of the natriuresis when patients had lost their oedema, plasma renin activity and plasma aldosterone rose to high levels, plasma albumin and blood volume remained low, and yet the patients were no longer retaining sodium and were in sodium balance. These observations suggest that the natriuresis of remission is due to the correction of an intrarenal mechanism causing the sodium retention. This study raises two major unanswered questions. Firstly, when the presumed intrarenal mechanism is corrected, what tells the kidney to excrete large amounts of sodium when the blood volume remains low? Secondly, why do the patients come back into sodium balance when the blood volume is low, and plasma renin activity and plasma aldosterone are elevated? PMID- 3982575 TI - Asymptomatic pericardial effusion in uremic patients: effect of long-term dialysis. AB - The present study was undertaken to determine the prevalence of asymptomatic pericardial effusion in a population with end-stage renal failure just prior to the initiation of chronic dialysis, and to determine the effect of long-term dialysis on these effusions. We prospectively studied 50 uremic patients with M mode echocardiograms prior to initiation of chronic dialysis and followed 33 of these patients after 10 months of intense dialytic therapy. Predialysis effusion was present in 18/50 (36%) patients. Only 3/50 patients had clinical evidence of pericarditis (none of these individuals had an effusion). The incidence of clinical congestion and radiological evidence of volume overload was significantly higher in the patients with an asymptomatic pericardial effusion. Of these, the effusion disappeared on improved in 6 (43%), remained unchanged in 6 (43%), and worsened in 2 (14%). No patients developed new pericardise effusions during chronic dialysis. Changes in effusion size were related to changes in body weight between dialysis treatments (r = 0.39; p less than 0.05). Our data show that asymptomatic pericardial effusions are frequent in uremic patients prior to initiation of dialysis, the etiology of asymptomatic pericardial effusions in these patients appears to be related to volume overload, only 43% of the patients improved their effusions with chronic dialysis. PMID- 3982576 TI - Comparison of 1 alpha-OH-vitamin D3 and high doses of calcium carbonate for the control of hyperparathyroidism and hyperaluminemia in patients on maintenance dialysis. AB - 27 patients on hemodialysis (dialysate aluminium less than 0.7 mumol/l for 2 years, and 2 mumol/l before) whose plasma Ca and PO4 were adequately controlled for already 6 months by high doses of CaCO3 alone (mean +/- SD: 9 +/- 5 g/day), were randomly divided into 2 groups, a control group (c group) which was kept on the same treatment, and a group in which CaCO3 was reduced to 3 g/day but in which plasma Ca was kept normal due to 1 alpha-OH-vitamin D3 administration (1 microgram/day at the beginning, 0.3 microgram/day after 6 months; 1 alpha group) whereas plasma phosphate was kept below 6.0 mg/dl because of Al(OH)3 (2.7-5 g/day). Initially, the 2 groups were comparable as regards the plasma concentrations of total and ionized Ca, phosphate, alkaline phosphatases, medium and C-terminal parathyroid hormone (PTH) and aluminium, but the control group had lower plasma 25-OH-vitamin D (25-OHD.) After 6 months, the same difference in plasma 25-OHD was found with comparable plasma concentrations of total and ionized calcium as well as of medium and C-terminal PTH (beta error 1%). However, plasma concentration of phosphate and the plasma Ca phosphate product, as well as the plasma aluminium were higher in the 1 alpha group whereas their PCO3H- was lower. Although the alkaline phosphatase values were not significantly different between the 2 groups, they increased only in the control group because of 1 patient who developed a vitamin-D-deficient osteomalacia (plasma 25-OHD 3 ng/ml), which was subsequently cured by physiological doses of 25-OHD3. The incidence of transient hypercalcemia (15 vs. 21 episodes) and worsening of soft tissue calcifications (3 in each group) was the same in the 2 groups. PMID- 3982577 TI - Skeletal muscle water and electrolytes in chronic renal failure. Effects of long term regular dialysis treatment. AB - Skeletal muscle water, Cl, Na and K were studied in 24 patients with predialysis chronic renal failure (CRF) and in 16 patients under regular dialysis treatment (RDT) for 8-16 years; 35 healthy controls were also examined. Total Cl, Na and water (Clm, Nam, TW) were high in both CRF and RDT groups (p less than 0.001); high TW in CRF was due to both extra (ECW) and intracellular (ICW) fractions, which were calculated from Cl space; in RDT only ECW was increased and ICW was normal. Muscle K was diminished in CRF, in reference to both muscle fat free dry solids and ICW, and it was slightly but significantly higher than normal in RDT. The findings demonstrate that high cell volume and low intracellular K observed in CRF are fully corrected by long-term hemodialysis, probably because these abnormalities are mainly related to cell function disturbances due to uremic state. On the contrary, the persistence of high total Cl, Na and muscle ECW seems to be an expression of expanded extracellular fluid volume. PMID- 3982578 TI - Critical role of oxalate restriction in association with calcium restriction to decrease the probability of being a stone former: insufficient effect in idiopathic hypercalciuria. AB - The probability of being a stone former (PSF) was calculated in 3 groups of idiopathic calcium stone formers [with normocalciuria (NC), dietary hypercalciuria (DH) and idiopathic hypercalciuria (IH)] in 4 conditions: while on a free diet; on a calcium- and oxalate-restricted diet during 4 days; after an oxalate load, while on a 1.5-gram calcium diet, and after an oxalate load while on a calcium-restricted diet. Combined calcium and oxalate restriction significantly decreased PSF only in NC and DH whereas the decrease was not significant in IH because of a concomitant significant increase in oxalate excretion. Increase of PSF with the oxalate load was significantly greater during a calcium-restricted diet than during the 1.5-gram calcium diet in all groups of patients (4, 6 and 12 times greater in NC, DH and IH, respectively). These data show the critical role of oxalate restriction when calcium is restricted in order to decrease the PSF. This combined restriction is however not sufficient in idiopathic hypercalciuric patients to decrease their PSF. PMID- 3982580 TI - Renal lesions in sickle cell nephropathy in children. AB - Sickle cell nephropathy characterized by proteinuria and predominantly glomerular lesions has not been studied as extensively as renal tubular alterations in sickle cell disease. We reviewed our experience with this entity over a 14-year period. Of 13 children with either proteinuria or the nephrotic syndrome, 8 showed focal and segmental glomerulosclerosis, and 5 had mesangial proliferation. Children with focal and segmental glomerulosclerosis were older at onset of nephropathy and presented with the nephrotic syndrome more frequently than those with mesangial proliferation (p less than 0.05). All patients with mesangial proliferation and half of the focal and segmental glomerulosclerosis patients had supranormal renal clearances at onset of nephropathy suggesting hyperfiltration. Hyperfiltration seen in animals with reduced renal mass, and in human diabetic nephropathy before reduction in nephron units leads to mesangial proliferation and sclerosis. Our study suggests that sickle cell disease produces similar lesions in patients with sickle cell nephropathy. PMID- 3982579 TI - Sex differences in acquired cystic disease of the kidney on long-term dialysis. AB - Acquired cystic disease of the kidney in chronic glomerulonephritic patients who had been on hemodialysis more than 3 years (4.5 +/- 1.2 years at the base line examination), were followed for 3.6 +/- 0.5 years (at the follow-up examination) by computed tomography (CT scan). The renal volume in the 25 male patients was significantly greater at the follow-up examination than at the base line examination. On the other hand, the renal volume in the 12 female patients was similar on both examinations. The enlargement of kidney volume more than twofold during the follow-up was seen in 9 of 25 male and none of 12 female patients. The grade of cystic transformation was increased in male patients during the follow up period. These results indicate that sex-related endogenous substances might play a role in the pathogenesis of acquired cystic disease. PMID- 3982581 TI - Effects of diltiazem and manganese renal hemodynamics: studies in the isolated perfused rat kidney. AB - The effects of the organic calcium antagonist diltiazem (DIL) upon the alterations in renal hemodynamics produced by norepinephrine (NE) were assessed in the isolated perfused rat kidney. In the presence of propranolol, the administration of NE (3 X 10(-7)M) caused sustained reductions in renal perfusate flow (RPF) and glomerular filtration rate (GFR). The administration of 10(-5) M DIL to NE-treated kidneys did not reverse the NE-induced decrease in RPF. In contrast, DIL produced a striking reversal of the NE-induced decrease in GFR. In the absence of NE-treatment, DIL did not alter GFR or RPF. We conclude that NE induced constriction of major postglomerular resistance vessels of the rat kidney is not inhibited by DIL. In contrast, the DIL-induced increase in GFR of the NE treated kidneys indicates that the NE-constriction of preglomerular resistance vessels is inhibited by this organic Ca entry blocker. Under identical conditions, manganese, an inorganic calcium entry blocker, reversed the NE induced reductions in both RPF and GFR, indicating that although both responses depend upon Ca entry, only the latter is sensitive to DIL. These data are, therefore, consistent with the postulate that different regions of the renal vasculature are heterogeneous with regard to the mechanisms mediating NE-induced vasoconstriction. PMID- 3982583 TI - Treatment of ultrafiltration loss in continuous ambulatory peritoneal dialysis. PMID- 3982582 TI - Evidence for macrophage activation in dialysis patients exposed to silicone filing. AB - Spleen cell suspensions of 2 dialysis patients with hepatosplenomegaly and pancytopenia were studied in vitro. Spleen cells of a cadaver kidney donor were studied as control. In spleen macrophages of the patients, silicone particles could be demonstrated with TEM and electron microprobe analysis. Under basal conditions and after stimulation with zymosan and concanavalin A, release of PGE2, TXB2 and 6-keto-PGF1 alpha from patient cells was higher than control cells. This anecdotal observation parallels previous animal studies and suggests that loading of human macrophages with foreign material particles activates arachidonic acid metabolism. PMID- 3982584 TI - Bicarbonate dialysis using a single concentrate. PMID- 3982585 TI - Amyloidosis in Behcet's disease. PMID- 3982586 TI - Human brain tubulin purification: decrease in soluble tubulin with age. AB - The soluble tubulin of human cerebral cortex, as assessed by [3H]colchicine binding of the 100,000 g supernatant fraction, decreases drastically with age, 75 percent from age 0 to age 90. There is also a considerably lower concentration of high molecular weight proteins in the soluble fraction of postmortem human cerebral cortex than in that of nonhuman species. Human brain tubulin can be polymerized into microtubules with DEAE-dextran. The DEAE-dextran induced microtubules are stable to cold temperature (4 degrees) and calcium. However, in the presence of 1 M glutamate, the microtubules become cold labile and depolymerize at 4 degrees. Thus we have developed a novel method for purifying polymerization competent tubulin from fresh or frozen human cerebral cortex. Human brain tubulin purified by our novel method is very similar to tubulin from the brains of other mammals in molecular weight, amino acid composition, polymerization-depolymerization parameters, and structural dimensions of the microtubules formed. PMID- 3982587 TI - Release of preloaded taurine and hypotaurine from astrocytes in primary culture: stimulation by calcium-free media. AB - The spontaneous and stimulated release of taurine and hypotaurine from astrocytes in primary cultures were investigated. Spontaneous efflux was slow, less than one half of preloaded labeled taurine and hypotaurine still remaining in the cells after a 60-min efflux period. The release processes of both amino acids were in principle similar. No homo- or heteroexchange with extracellularly added taurine, hypotaurine or GABA could be detected, and depolarizing potassium concentrations failed to stimulate taurine or hypotaurine release. On the other hand, omission of calcium ions from medium increased efflux of taurine and hypotaurine about three- and twofold, respectively, in both high-K+ and normal-K+ media. PMID- 3982588 TI - Mature and immature synaptosomal membranes have a different lipid composition. AB - Subfractionation of the optic tectum in chick embryos results in the isolation of two fractions enriched in synaptosomes (fraction A and fraction B). In chicks after hatching, this fractionation results in the isolation of a single synaptosomal fraction (fraction B) and of a fraction enriched in myelin membranes devoid of synaptosomes (fraction A). The lipid composition of synaptosomal fractions (A and B) and corresponding synaptosomal plasma membranes has been analyzed and compared to the lipid composition of similar fractions isolated from 2-3 day-old chicks. The phospholipid composition of fraction A in embryos was mainly represented by phosphatidylcholine (PC) and phosphatidylethanolamine (PE). The PE content was significantly lower than that of PC, which accounted for by approximately 50%. Sphingomyelin (SP) and phosphatidylinositol (PI) accounted for by only 6% of the total membrane phospholipids. Fraction A isolated from the young chicks showed many significant changes. PC accounted for by approximately 40% and PE made up 35%. The amount of phosphatidylserine (PS) and SP increased. These data parallel our previous morphological observations, which showed that fraction A contains immature synaptosomes in embryos but myelin membranes and no synaptosomes in the young chicks. Fraction B has been shown to contain synaptosomes at all stages considered. It possessed in embryos a lipid composition similar to fraction A, except that PC content was higher in young embryos. The analyses on membrane fractions confirmed these results. On the contrary, this fraction showed many significant changes after hatching. The content of PC was significantly reduced, PE/PC ratio was significantly increased as well as ethanolamine plasmalogen (PLE) content. The percentage of PS, PI and SP were increased. The composition of fatty acids of the total fraction of phospholipids was also examined. The results parallel the observations on phospholipid classes. PMID- 3982590 TI - [Follow-up of primary pontine hemorrhage of the young adult by CT scan]. AB - A case of primary pontine hemorrhage of the young was reported. He was 22 years of age, who did not have the history of hypertension. He suddenly noticed disturbance of skilled act of his right hand and speech disturbance. He was admitted to our clinic two days after the onset. Neurological examination revealed right facial palsy, disturbance of delicate movement of his right hand and slight dysarthria. Lumbar puncture, after six days from the onset, yielded watery clear cerebrospinal fluid containing 6/3 cells/mm3, 27 mg/dl of protein and 65.1 mg/dl of sugar. An opening pressure was 75 mmH2O. The vertebral angiography revealed no evidence of mass lesion and vascular anomalies. CT scan demonstrated a pontine hematoma, the size of this hematoma sequentially enlarged in follow-up CT scan. His clinical symptoms were gradually aggravated, i.e. cerebellar sign, urinary disturbance and involuntary movement. Conservative therapy was performed and his symptoms gradually improved. The size of hematoma was reduced in follow-up CT scan. The genesis, diagnosis and treatment of primary pontine hemorrhage of the young were discussed. PMID- 3982589 TI - Incorporation of [3H]thymidine into DNA and of [35S]sulfate into sulfatides of oligodendroglial cells during development: effect of malnutrition. AB - Incorporation of [3H]thymidine into DNA and of [35S]sulfate into sulfatides of oligodendroglial cells isolated from brain slices incubated with the radioactive precursor was studied in normal and malnourished rats at different ages. The pattern and the values of incorporation of [3H]thymidine into DNA were similar in both groups of animals. The maximum value of incorporation was observed at 7 days of age decreasing rapidly thereafter and leveling off between 18-21 days. In both groups of animals labeling of sulfatides attained a maximum at 18 days of age, showing similar values of incorporation up to that age. However, at 21 days of age; the values corresponding to malnourished rats were found to be 40% lower in comparison to controls. The results suggest that (a) proliferation of oligodendroglial cells stops at similar ages in normal and malnourished rats, (b) expression of sulfatide synthesis by oligodendroglial cells is similar in both groups of animals up to 18 days, and (c) the starved rats seem to be unable to maintain a normal synthesis of these galactolipids throughout the entire period of active myelinogenesis. PMID- 3982591 TI - [A case of persistent primitive proatlantal intersegmental artery (proatlantal artery I) with aneurysm--a case report]. AB - A 70-year-old woman was admitted to our hospital with attack of SAH. On admission, she was semi-comatose with no other neurological deficit. Left carotid angiography revealed an aneurysm of the anterior communicating artery and a large abnormal vessel connecting the left external carotid artery and the left vertebral artery. This large anastomotic vessel was thought to be primitive proatlantal intersegmental artery (proatlantal artery I). Right carotid angiography revealed a coiling of the right internal carotid artery and hypoplasia of the right A1 portion. Left retrograde brachial angiography revealed aplasia of the left vertebral artery. After admission her consciousness gradually improved but 17 days after admission she died of rerupture of the aneurysm. Autopsied brain showed that the left vertebral artery, namely proatlantal artery, was almost as large as the basilar artery and its macroscopical appearance was similar to other arteries. It was also obvious that the right vertebral artery was hypoplastic. As the rate of combination of the persistent artery with the intracranial aneurysm is relatively high, the authors think that some congenital factor may affect the occurrence of intracranial aneurysms. PMID- 3982592 TI - [Traumatic delayed intracerebral hematoma--clinical aspects]. AB - In order to seek the occasion and the management of traumatic delayed intracerebral hematoma, we selected 17 cases (4.2%) of traumatic delayed intracerebral hematoma (secondary lesion) from 401 cases of head injury, and compared them with other 11 acute traumatic intracranial multiple lesion (immediate lesion). The age ranged from 15 to 78 (except for a newborn hit on the cranium by his mother) and the average was 49 in secondary lesion and 58 in immediate lesion. Sex distribution, 15 males and 2 females in secondary lesion, and 10 males and 1 female in immediate lesion. Though both lesions were supposed to be resulted from almost same severe loads, secondary lesion took worse prognosis than the other: misery outcome (poor and fatal) of secondary lesion was 59% and that of immediate lesion 27%. Of 8 hypertensive cases who were all fatal, 7 were of secondary lesion. Secondary lesion could be expected in only 59% (10/17) by the initial X-CT performed 5.4 +/- 6.2 hr. after trauma. The predicted secondary lesion were classified into three types: salt and pepper like high density lesion (Lanksh's II type), low density lesion (Lanksh's I type) and isodensity mass lesion. The shortest interval between injury and the X-CT detection of secondary lesions was 10 hours and the longest interval was 69 hours (40 hours mean) in conservatively treated patients. In operated patients, the shortest and longest intervals were 8 and 84 hours, respectively (33 hours mean, except for one case who was not examined for 10 days after operation).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982593 TI - [Some practical problems and several methodological trials in continuous intracranial pressure monitoring]. AB - The continuous intracranial pressure monitoring has been widely applied in intensive or critical care, but there are various kinds of methods for its monitoring at present. One hundred and forty-one cases mostly with severe head injury were subject to the intracranial pressure recordings in the critical care ward in Department of Emergency Medicine, University of Tokyo Hospital, from October, 1980 through May, 1983, and in Neurosurgical Unit, Showa General Hospital, in April and May, 1984. The authors made several methodological trials for the monitorings in them and compared with one another from the aspect of clinical practice. The subarachnoid catheter was inserted into the subarachnoid or sometimes into the subdural spaces by way of the burr hole in 112 cases and proved not to demonstrate in some cases the intracranial pressure waves clearly due to so called damping phenomenon but to indicate the reliable values, or trustworthy mean pressures in all the cases except for impending brain dead patients with swollen hemispheres and least cerebrospinal fluid remained in intracranial subarachnoid spaces. The ventricular fluid pressure was monitored in nine cases and was most dependable as well as the subarachnoid pressure. The ventricular cannulation and its maintenance were, however, difficult when the ventricles were compressed or deviated, which were often experienced in acute severe head injury and also in impending brain death just because of the same above mentioned reasons. These demerits were attempted to be conqured with epidural pressure monitorings such as the fiberoptic sensor (Ladd) in 17 cases, the intracranial catheter tip pressure transducer (Gaeltec) in nine cases and the sensor of bioimplantable polymer (Plastimed) in three cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982594 TI - [Effect of naloxone on focal cerebral ischemia in cats]. AB - The effect of naloxone, opiate antagonist, was investigated on systemic arterial blood pressure(BP), cerebral blood flow (CBF), and cerebral oxygen consumption in the cat brain following occlusion of the middle cerebral artery(MCA). A total of 21 adult cats was studied under the anesthesia of alpha-chloralose (50 mg/kg). The left MCA was exposed and coagulated using transorbital approach under a operation microscope. Naloxone of 5 mg/kg was administrated intravenously within 30 minutes after MCA occlusion in early therapy group and 2.5 hours after the occlusion in delayed therapy group. Isotonic saline was administrated in the control group. The basal value of CBF in the intact animals was 54.0 +/- 5.9 (+/- SEM) ml/100g/min. Significant increases in mean BP of 13%, CBF of 12%, and CMRO2 of 16% were noted in the intact animals after naloxone administration. The CBF in MCA territory reduced to 24% after MCA occlusion and 85% in contralateral hemisphere. MCA occlusion had no significant effect on either mean BP or the difference in oxygen concentration between arterial and superior sagittal sinus blood. Naloxone increased these reduced CBF and mean BP significantly, but increase in oxygen consumption was not significant. There was no difference between early therapy group and delayed therapy group in pathological study. The effect of naloxone was temporary. Therapy of repeated or continuous naloxone administration appears to be effective during temporary focal cerebral ischemia. PMID- 3982595 TI - [Disturbance of the coagulatory system in patients with head injury in acute phase]. AB - The coagulation and fibrinolytic function of 100 cases (male 75, female 25) of trauma limited to the head was evaluated in acute phase. The coagulation and fibrinolytic function was evaluated by 6 parameters, consisting of platelet counts, PT, APTT, fibrinogen, serum FDP, and protamine sulfate test. Head injury was categorized into 5 groups according to CT findings: subdural hematoma (SDH: 13 cases), cerebral contusion (CC: 46 cases), epidural hematoma (EDH: 21 cases), skull fracture only (Fr: 14 cases), and cerebral concussion (Co: 6 cases). The results were as follows, in 19 dead cases, severe coagulopathy was observed. In intracerebral injury group (SDH + CC), serum FDP level was markedly elevated. The incidence of disseminated intravascular coagulation (DIC) following head injury was 24% (in dead cases 73.7% in survival cases 12.3%) of all cases, and mortality of cases with DIC was exceedingly high (58.3%). In 14 dead cases with DIC, the patients did not recover from DIC, and their mean survival time was only 89.2 hours. In 10 survival cases with DIC, the patients recovered from DIC. APTT was the most important to estimate the mortality of head injury. Thus, the evaluation of coagulation and fibrinolytic function in head injury in acute phase is not only important to know the occurrence of DIC, but also useful to predict the severity and prognosis of head injury. PMID- 3982597 TI - [Epidermoid of the third ventricle--report of a case]. AB - A rare case of epidermoid of the third ventricle was experienced. The patient was a fifteen years old boy, who had been hospitalized four years earlier due to acute hydrocephalus. The ventriculography at that time revealed a large cystic tumor containing heterogeneous mass filling the entire third ventricle, which seemed to be a dermoid or epidermoid. Ventricular drainage and ventriculo peritoneal shunt were performed and he was discharged one month later without any complaint. On February 10th 1983, he was re-admitted with severe headache, nausea and showing markedly increased intracranial pressure and right hemianopsia. Computerized tomography scans demonstrated a large round low density mass in the entire third ventricle extending into the prepontine cistern. Radical operation was performed by the anterior transcallosal approach. After dissecting the interhemispheric fissure, a longitudinal incision about 15 mm long was made in the anterior part of the corpus callosum and the tumor was removed. Mild diabetes insipidus and subdural effusion appeared postoperatively. The patient was discharged on April 7th with right hemianopsia and returned to school. The anterior transcallosal approach seemed to be a good operative procedure in such large third ventricle tumor cases since it allowed excellent exposure of the third ventricle and minimized postoperative neurological deficits. PMID- 3982596 TI - [Rebleeding attack of the cerebral aneurysm--clinical significance of the early aneurysmal rebleeding]. AB - When one mentioned about aneurysmal rebleeding, timing and incidence of the rebleeding attack (RA) have been mainly discussed in relation to long term prognosis. But it was rarely considered about necessity of emergency treatment based on timing and incidence of RA. In this study, clinical significance of RA especially in the early stage is discussed in relation to severity of the patient's condition, timing of surgery, clinical results and so on. Three hundred sixty-eight cases of anterior communicating, internal carotid and middle cerebral aneurysms who were admitted on our hospital within 7 days after last attack were studied. Among them, 127 cases had 192 times of RA (1 RA: 83 cases, 2 RAs: 28 cases, 3 RAs: 12 cases, 4 RAs: 3 cases and 5 RAs: 1 case). Incidence of rebleeding attack increased in the severe cases. Most frequent timing of second attack was within 6 hours after the first attack (40 cases, 31.5%). Fifty two cases (41%) had their second attack within 24 hours from the first attack. Successive attacks were also most frequent within 6 hours following the preceding one, even in the cases with long term interval period before it. Severity of the patient was increased after RA especially in the cases with early repetitive attack. We experienced 56 cases who had more than two RAs within each 6 hours. 28 out of 56 cases were severe attack whose consciousness was disturbed more than semicoma and 27 cases died. Mortality and morbidity were higher in the cases with RA than single attack.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982598 TI - [Neurinoma with intrasellar extension: a case report]. AB - A 64-year-old female visited Kawatetsu Chiba Hospital complaining of left retro orbital pain. A month before, she had experienced ptosis and diplopia, that had been releaved two days later by corticosteroid. On admission, she had no neurological deficits except for minimal anisocoria, with the left pupil larger than the right. There was no cutaneous manifestation of von Recklinghausen's disease. Skull X-ray films showed depression of the floor of the sella turcica on the left side. CT scans demonstrated a parasellar enhancing mass with intrasellar extension. Left carotid angiogram showed intracavernous portion of the internal carotid artery displaced laterally, inferiorly, and anteriorly. With a tentative diagnosis of laterally extending pituitary adenoma, a transsphenoidal operation was carried out, which disclosed a solid tumor locating beside the medially displaced pituitary gland. The histological diagnosis was typical neurinoma. Parasellar neurinoma is not so common. It is usually difficult to determine the origin of the parasellar neurinoma. Trigeminal neurinoma arising from the Gasserian ganglion is generally recognized to be the most frequent. However, the absence of the trigeminal nerve involvement, unusual CT findings, and angiographical changes in the present case were all different from those of the typical trigeminal neurinoma. We believe that the tumor of this case originated from the oculomotor nerve. Fifteen cases of neurinoma of the oculomotor, trochlear, and abducens nerve have been reported to date. Their clinical features were reviewed. PMID- 3982599 TI - [Thrombosis of cortical vein: a case report]. AB - A 39-year-old woman presented with disturbed consciousness, left hemiparesis and headache. CT scan revealed subcortical hemorrhage in the right parietal region, which had lower density than usual intracerebral hemorrhage and was associated with irregular perifocal edema. Cerebral angiograms revealed narrowed cortical vein with irregular wall in the right parietal region, where delayed local blood flow into the deep cerebral veins through collateral vessels was noted. The diagnosis was subcortical hemorrhage due to thrombosis of cortical vein. Her symptoms and brain edema were progressive. To reduce intracranial pressure, evacuation of the hematoma was performed. The hematoma which existed 1cm under the right parietal cortex was about 20g in weight. She remarkably improved soon after operation. Frequency of sinovenous thrombosis has been reported to be about 10% of all cerebral ischemic diseases, however, localized venous thrombosis is rare among them. This is because it is not always symptomatic and it is difficult to make accurate diagnosis. Six cases of localized venous thrombosis were reviewed, in which accurate diagnosis were established by cerebral angiograms, CT scan and/or autopsy. Clinical and radiological features of this case were presented. PMID- 3982600 TI - Monovalent cation dependency for the inhibition of outward transport of [3H]norepinephrine. AB - Rat hearts were labelled with [3H]norepinephrine in vivo. Slices of ventricles were prepared, preincubated in Krebs-HCO3 medium (KRB), and then incubated in a Na+-deficient, choline+-Krebs HCO3 (Ch+-Ca2+). The choline+-Krebs HCO3 medium induced a delayed neurosecretion which could be inhibited by either one of the blockers of the uptake of NE, cocaine or desipramine, when included in both the Krebs and the Ch+-Ca2+. When either desipramine or cocaine was present in the Na+ rich preincubation medium only, the duration of action of desipramine was more prolonged than that of cocaine. When desipramine was first added to the Ch+-Ca2+ medium at various times after incubation, the inhibitory response became smaller as the duration of preliminary Na+-deprivation was increased. After incubation for 80 min neither desipramine nor cocaine inhibited secretion. Sodium (added to Ch+-Ca2+ medium or in a Krebs replacement medium) then slowed the rate of release stimulated by Ch+-Ca2+ and facilitated an inhibitory action for both inhibitors. The inhibition did not require the continued presence of Na+. Depolarizing concentrations of K+ in the Ch+-Ca2+ medium with Na+ and either one of the inhibitors, prevented the inhibition of neurosecretion. However, K+ which was added to the preincubation medium with either inhibitor did not prevent the prolonged inhibition of neurosecretion. By contrast with the secretory response to Ch+-Ca2+, the secretory response to K+ in Na+-enriched Ch+-Ca2+ medium was weakly inhibited by the inhibitors of transport. PMID- 3982601 TI - Cocaine and phencyclidine. Heterogenous dopaminergic interactions with tetrabenazine. AB - The present study investigated the actions of cocaine, phencyclidine and amfonelic acid upon the formation and release of dopamine in synaptosomes in the brain of the rat in the presence of tetrabenazine and reserpine. The results suggest that these three stimulants may act upon selective intraneuronal vesicles, heterogeneously associated with the formation of dopamine from phenylalanine and tyrosine. PMID- 3982602 TI - The role of serotonergic neurons in dorsal raphe, median raphe and anterior hypothalamic pressor mechanisms. AB - The role of serotonergic neurons in the dorsal raphe and median raphe in the pressor response to electrical stimulation of these areas, and the contribution of these neurons to the pressor response to serotonin (5-HT) in the anterior hypothalamus-preoptic area (AH/PO) have been studied by the use of local injections of 5,7-dihydroxytryptamine (5,7-DHT), a neurotoxin selective for 5 hydroxytryptamine (5-HT). When blood pressure was recorded in urethane anesthetized rats, selective lesions of 5-HT-containing neurons in the dorsal raphe nucleus reduced by 60% the pressor response to electrical stimulation (50 Hz, 100-150 microA, 0.3 msec pulse duration) of this nucleus. On the other hand, selective lesion of 5-HT-containing neurons in the median raphe nucleus had no effect on the pressor response to electrical stimulation of this area. Injection of 5,7-dihydroxytryptamine into the anterior hypothalamus/preoptic area resulted in an increased pressor response to the injection of 5-HT (5 nmol) into the lesioned area 10 days later. Furthermore, the destruction of 5-HT-containing neurons in the dorsal raphe nucleus resulted in an enhanced pressor response to the injection of 5-HT (5 nmol) into the anterior hypothalamus/preoptic area, while the destruction of 5-HT-containing neurons in the median raphe nucleus had no effect on the pressor response to the injection of 5-HT (5 nmol) into the anterior hypothalamus/preoptic area. Therefore, it appears that 5-HT neurons in the dorsal raphe nucleus are important in the pressor response to electrical stimulation and are involved in a pressor mechanism in the anterior hypothalamus/preoptic area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982603 TI - Effects of nicotine on schedule-controlled behaviour. Role of fixed-interval length and modification by mecamylamine and chlorpromazine. AB - The effects of nicotine, alone and in combination with mecamylamine and chlorpromazine, were studied in one group of rats exposed to a fixed-interval 30 sec schedule of food reinforcement, and a second group exposed to a fixed interval 120 sec schedule. For both groups nicotine increased overall response rates in a dose-related fashion up to a maximum at 0.3 mg/kg. Examination of the within-interval response patterns showed that nicotine tended to increase the low level response rates in the early and middle parts of the interval and decrease, or increase to a proportionally smaller extent, the higher level response rates at the end of the interval. The response rate and pattern of the animal, rather than the schedule to which it was exposed, was found to be the main determinant of the effects of nicotine. Mecamylamine (1.0 mg/kg) blocked most of the changes in rate produced by nicotine, although in the group exposed to the fixed-interval 30 sec schedule, the increases in response rate tended to predominate after combined administration of mecamylamine and nicotine. Chlorpromazine (1.0 mg/kg) failed to block the effects of nicotine in either group. Instead, the effects of combined administration of nicotine and chlorpromazine were similar to the added effects of the two compounds given alone. It appears that the behavioural effects of nicotine are not mediated through catecholaminergic systems. PMID- 3982604 TI - Differing effects of short-chain alcohols on body temperature and coordinated muscular activity in mice. AB - Administration of single doses of ethanol, 1-propanol, 1-butanol or 1-pentanol to mice caused hypothermia and impairment of rotarod performance. Repetitive doses, at 24-72 hr intervals led to development of tolerance to the hypothermic effects of ethanol but not of the other alcohols. No tolerance was seen in the impairment of rotarod performance with repeated doses of any of the alcohols. Ethanol did show an intersession tolerance on rotarod performance; at 20 and 80 min after injection, blood levels were similar, while performance was impaired at 20 but not at 80 min. PMID- 3982605 TI - Real time ultrasound diagnosis of hemorrhagic pathological conditions in the posterior fossa of preterm infants. AB - Real time echoencephalography (RTE) was used to diagnose and serially follow intracranial pathological conditions in the posterior fossa of infants with a gestational age of less than 34 weeks. The posterior fossa was studied in four planes (coronal, modified coronal, sagittal, and parasagittal) with a sector scanner equipped with a high frequency transducer that was placed on the fontanelles and the sutures. Hemorrhagic complications were easily differentiated from normal anatomy. RTE diagnosis was confirmed with computed tomographic scans (5 patients) and postmortem examination of the brain (18 infants). RTE is a precise and noninvasive technique to visualize hemorrhagic and other forms of abnormalities in the infratentorial compartment. PMID- 3982606 TI - Microsurgical excision of paraventricular arteriovenous malformations. AB - Periventricular arteriovenous malformations (AVMs) have often been deemed inoperable because of their location in critical structures. Furthermore, the excision of large lesions may be complicated by the potential for serious brain swelling and hemorrhage due to "autoregulation breakthrough." Nonetheless, the unfavorable natural history of the untreated disease in a symptomatic young patient has induced us to approach these lesions using staged microsurgical excision combined with elective barbiturate coma for maximal cerebral protection. Between 1979 and 1983, six patients (four female, aged 12 to 60 years, and 2 male, aged 14 and 29) who harbored large AVMs in the basal ganglia, thalamic, and hypothalamic areas presented with subarachnoid hemorrhage (2 cases), progressive neural deficits (3 cases), and intractable headache (1 case). Nineteen staged operations were performed for the complete excision of these lesions. Among the first three patients, there was one death due to "autoregulation breakthrough" hemorrhage into the lateral ventricle during the excision of a lesion approached through the sylvian fissure using standard anesthesia techniques. This led to the adoption of the transventricular surgical approach and elective barbiturate coma to facilitate exposure of the lesion and to protect the adjacent vital structures from potential ischemia. Three patients were treated in this fashion uneventfully. Of the five successfully treated patients, two have returned to their preoperative status and one has completely recovered from global hemispheric ischemia and hemiplegia. The hemiparesis in one patient worsened as a result of postoperative hypertensive intraventricular hemorrhage, and one patient developed mild dysphasia and hemiparesis. This experience suggests that this approach offers a valid therapeutic regimen for the treatment of this disease. During the same period, three patients--one man (age 23) and two women (aged 29 and 22)--harboring four intraventricular AVMs presented with intraventricular hemorrhage. After the acute effects of chemical ventriculitis and hydrocephalus were overcome with cerebrospinal fluid diversion, all four lesions were excised microsurgically using the transtemporal approach. One patient demonstrated significant and progressive improvement of her preoperative memory deficit. The remaining two patients have both returned to their preoperative employment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3982607 TI - Developments in the treatment and prognosis of multiple cerebral abscesses. AB - Multiple cerebral abscesses have been recognized with increasing frequency because of the use of computed tomography and have been the subject of various therapeutic proposals. Their prognosis has been considerably improved thanks to high dose antibiotic therapy. However, diagnostic and therapeutic problems persist. PMID- 3982608 TI - General metabolism in patients with acute paraplegia and quadriplegia. AB - This study measured the nutritional status of eight spine-injured patients during their first 10 to 14 days in the hospital. Initial and follow-up nutritional assessment showed that their nutritional status deteriorated at least partly due to an inadequate supply of protein and calories. Infective complications and prolonged respiratory support were common and may have been caused in part by impaired nutrition. This suggests that a prospective study of aggressive nutritional support for patients with spinal cord transection should be initiated to determine whether this acquired malnutrition and its associated complications can be prevented. PMID- 3982609 TI - Spontaneous cerebrospinal fluid rhinorrhea: evolving concepts in diagnosis and surgical management based on the Mayo Clinic experience from 1970 through 1981. AB - Spontaneous cerebrospinal fluid (CSF) rhinorrhea, occurring in the absence of recent trauma, is a distinct clinical entity that can be difficult to diagnose and treat. The case records of 28 patients with this entity were reviewed retrospectively. Pertinent historical data and the results of radiographic evaluation are discussed. The patients were classified into one of three major etiological categories: congenital anomaly, delayed posttraumatic, and tumor groups. The fistulas causing the rhinorrhea were approached extracranially or intracranially, depending on the suspected cause and location. A cure was obtained in 22 of the 27 patients surgically treated (81%). Seventeen patients were cured by a single operation, 5 were cured after multiple operations, and 5 continued to leak despite surgical treatment. Three of the 5 patients who were surgical failures had intracranial tumors, and 2 of them died from complications of persistent fistulas. With the use of a multidisciplinary team approach, an extracranial operation (transethmoidal or transsphenoidal) to repair a spontaneous CSF leak offers a high success rate and is associated with minimal morbidity in appropriately selected patients. PMID- 3982610 TI - Comparison of laser and radiofrequency dorsal root entry zone lesions in cats. AB - Dorsal root entry zone lesions are effective in the control of intractable pain in several types of spinal cord injuries. Traditionally, these lesions have been made with the radiofrequency technique. This is effective, but has the drawback of being laborious, and there is a significant incidence of permanent weakness. We have evaluated the carbon dioxide laser, hoping that it would be both faster and more controlled, thereby offering the chance to lower the complication rate. In comparing a parallel series of radiofrequency and laser dorsal root entry zone lesions along the cat's spinal cord, we observed that the radiofrequency lesion was larger. In addition, it had 3 times more variability in its size than the laser lesion. We attribute this in part to the nature of the laser in making a very precise and reproducible lesion. Second, the extremely brief pulse of the laser, a fraction of a second, means that movement of the spinal cord from respiration and heartbeat and movement of the surgical instrument from the surgeon's hand become far less important in inducing lesion variability. We also studied for 2 months a series of chronic cats; there were no complications due to the laser. This work suggests that the laser is a useful instrument for dorsal root entry zone lesions, but requires more precise aiming and focusing. PMID- 3982611 TI - Pituitary transplantation: Part 1. Successful reconstitution of pituitary dependent hormone levels. AB - Neonatal or adult pituitary glands were transplanted to the median eminence of adult rats of the same or a histoincompatible inbred strain. The hormonal status of 39 transplanted rats and of control animals was evaluated by serial determination of serum prolactin and thyroxine. Grafts of neonatal tissue to adults of the same strain resulted in normal postoperative hormone levels. This indicates not only that pituitary grafts had survived, but also that the transplants were under hypothalamic control. Grafts of adult tissue were less successful. The prolactin value was lower, but still within the normal range, whereas the thyroxine value was lower than normal, suggesting that viable pituitary tissue had survived but was not under hypothalamic control. Transplantation across a histocompatibility barrier was uniformly unsuccessful. Postoperative prolactin levels were low and thyroxine levels were not significantly different from those in hypophysectomized controls. PMID- 3982612 TI - Resistance to outflow of cerebrospinal fluid determined by bolus injection technique and constant rate steady state infusion in humans. AB - Two methods for the determination of resistance to the outflow of cerebrospinal fluid, the bolus injection technique and the constant rate steady state infusion technique, were compared. Thirty-two patients with a variety of intracranial diseases (usually communicating hydrocephalus) were studied. There was a high degree of correlation between the resistance values obtained with the two methods, but values based on the bolus injection technique were systematically and statistically significantly lower than those obtained with the constant rate infusion test. From a practical point of view, both methods were found to be applicable in a clinical setting. PMID- 3982613 TI - Arteriovenous malformations of the cerebellar vermis. AB - Fifteen cerebellar vermian arteriovenous malformations were surgically treated over a 7-year period. Intracranial hemorrhage was the presenting symptom in 73% of the cases and recurrent bleeding episodes occurred in 60%. Computed tomographic scans demonstrated the site of the malformation in 80% and documented the presence of intracerebral bleeding in all posthemorrhage patients. Angiography revealed two consistent patterns of arterial supply depending on the involvement by the malformation of the superior inferior cerebellar vermis. All lesions were surgically removed via a midline suboccipital posterior fossa microsurgical approach. Intraventricular extension of arteriovenous malformation was common, often in association with the choroid plexus of the 4th ventricle. Immediate postoperative angiography was used to document arteriovenous malformation removal. Three instances of unsuspected residual malformation were documented and required reexploration. The total operative mortality was 7%, and the neurological morbidity was 21%. PMID- 3982614 TI - Surgical treatment of spinal cord compression in patients with lung cancer. AB - We analyzed the clinical features, radiological findings, and results of surgical treatment in a series of 25 patients with lung cancer and invasion of the spine. In 12 of the 25 (40%) patients, involvement of the spine was present at the time of initial presentation of malignancy. Computed tomography revealed the presence of a large paravertebral soft tissue mass with destruction of adjacent ribs in the majority. The surgical approach consisted of an anterolateral exposure through a formal thoracotomy in 22 patients and a thoracoabdominal flank approach in the 3 patients with lumbar lesions. All gross tumor was resected from the involved paravertebral tissues, vertebral body, and epidural space. Immediate stabilization of the spine was then achieved with methyl methacrylate. Local brachytherapy (iridium-192 implants) was used in 19 patients. After treatment, 87% were ambulatory, and 67% maintained ambulation for more than 6 months. Our data suggest that compression of the spinal cord in many patients with lung cancer results from direct extension of tumor through the chest wall. Because the majority of such patients often have localized disease involving the spine, aggressive surgical treatment is indicated. PMID- 3982615 TI - Papilledema after acute head injury. AB - Low grade papilledema after acute, severe head injury was identified in 15 (3.5%) of 426 patients. Papilledema was recognized immediately after head injury in 1 patient, during the 1st week in 10 patients, and in the 2nd week or after in 4 patients. Initial computed tomographic scans showed evidence of brain injury in 11 of these patients. The intracranial pressure (ICP) was monitored continuously for 3 or more days in 9 patients; it was mildly elevated (20 to 40 mm Hg) in 7 patients and moderately elevated (40 to 60 mm Hg) in 2 patients. Intracranial hypertension was controllable in each patient. A sudden, severe, but transient increase in ICP best explained the immediate development of papilledema and survival of 1 patient. Sustained but mild to moderately elevated ICP accounted for papilledema appearing in the 1st week. Papilledema in the 2nd week or after occurred from impaired cerebrospinal fluid absorption and consequent communicating hydrocephalus or delayed focal or diffuse cerebral swelling. A lesser degree of head injury in patients with posttraumatic papilledema was suggested by a higher Glasgow coma score, milder and controllable elevations in ICP, and the absence of any fatality in this group. The favorable outcome was significant compared to the mortality of the more severely injured patients (chi square-4.327; P less than 0.04). Papilledema did not occur in 6 patients with sustained, severely elevated ICP (greater than 60 mm Hg) for 3 or more days. Each of these patients died. The severity of the trauma apparently accounts for the failure of papilledema to develop, possibly by arresting axoplasmic production and transport in retinal nerve fibers. PMID- 3982616 TI - Microsurgical removal of suprasellar meningiomas. AB - The authors report 17 cases of large suprasellar meningiomas operated on during the 2-year period from February 1982 through March 1984. The tumors ranged from 4 to 9 cm in diameter. These patients presented with severe visual loss (4 were blind) and optic atrophy or papilledema. These tumors were noteworthy in their encroachment against and around the carotid arteries and optic nerves laterally, as well as against the hypothalamus with extension into the interpeduncular cistern and frontal fossa. Advanced microsurgical technique assisted in total removal of all tumor tissue with preservation of vital structures. There were three deaths: two from pulmonary embolism and one from gastrointestinal hemorrhage. The surgical technique for the total removal of these very large tumors is described. PMID- 3982617 TI - Surgical resection of a pineal tumor containing elements of germinoma and astrocytoma. AB - A 15-year-old boy presented with hydrocephalus due to a pineal tumor presumed to be a germinoma. After a shunting procedure, gross total tumor resection was carried out via an occipital transtentorial approach. Histopathological examination of the tissue demonstrated that, in addition to the expected germinoma, the tumor also contained areas of astrocytoma and areas that, taken in isolation as in a needle biopsy, could have been diagnosed as pineocytoma. The diagnosis and therapy of a pineal tumor of mixed histological types such as this lesion would be seriously compromised by "conventional" empiric radiation and even a stereotactic needle biopsy may not have provided an adequate tissue sample. PMID- 3982618 TI - Scalp meningioma: case report. AB - The authors report a case of scalp meningioma. The mass was removed totally, and all of the following neuroradiological studies proved the absence of an intracranial meningioma. PMID- 3982619 TI - Posttraumatic acute arterial subdural hematoma manifested during anesthesia. AB - Traumatic acute arterial subdural hematomas are rare and are associated with a high mortality rate. The authors report a case in which the initial computed tomographic (CT) scan examination failed to reveal a hematoma. Within the subsequent 4 hours, while recovering from anesthesia given so that hemostasis of bleeding soft tissue injuries could be obtained, the patient suddenly developed bilaterally dilated pupils, both nonreactive to light. A repeat CT scan then revealed large subdural and intracerebral hematomas. The case is discussed and the pertinent literature is reviewed. PMID- 3982620 TI - Hemangiomatous anomaly of bone in Crouzon's syndrome: case report. AB - A striking and diffuse hemangiomatous architecture was identified by microscopic examination of bone specimens obtained at cranial synostectomy and from the craniofacial area of a young boy with Kleeblattschadel deformity and Crouzon's syndrome. A retrospective review of the histopathological appearance of bone specimens from other patients with Crouzon's syndrome treated on our service and a review of the literature on craniosynostosis suggest that the hemangiomatous pattern seen in this patient is rare if not unique. The unusual pathological findings provide evidence that the underlying pathophysiology of this disorder may be heterogeneous. PMID- 3982621 TI - Persistent primitive trigeminal artery, cavum septi pellucidi, and associated cerebral aneurysm in a patient with polycystic kidney disease: case report. AB - A 51-year-old man with polycystic kidney disease had a persistent primitive trigeminal artery, cavum septi pellucidi, and an unruptured cerebral aneurysm. He had a history of long-standing hypertension, but not of subarachnoid hemorrhage. Computed tomograms revealed cavum septi pellucidi. Because of the polycystic kidney disease, we performed four-vessel cerebral angiography, which revealed a persistent primitive trigeminal artery and a cerebral aneurysm at the bifurcation of the left internal carotid artery. The neck of the aneurysm was clipped successfully without producing any neurological deficit. The clinical significance of the combination of these multiple anomalies and cerebral aneurysms is discussed. PMID- 3982622 TI - Leiomyosarcoma metastatic to the brain: case report and literature review. AB - An intracerebral hematoma (ICH) developed in a patient during diagnostic evaluation for hemoptysis and guaiac-positive stools. Tissue obtained from colonic polyps, a pregastric mass, and cerebrum had features of poorly differentiated leiomyosarcoma. Only three other cases of pathologically confirmed cerebral metastasis of leiomyosarcoma are reported in the literature. The presence of cerebral metastasis at the time of the initial diagnosis of leiomyosarcoma and the associated ICH are features unique to this case. PMID- 3982623 TI - Surgical approach to the high subcranial internal carotid artery. AB - Two cases are presented to describe surgical approaches to the high cervical internal carotid artery permitting surgical treatment of conditions such as aneurysms of the high carotid artery, fibromuscular dysplasia, and arteriosclerosis by endarterectomy or resection of a segment with the interposition of a graft. PMID- 3982624 TI - Thoracic spinal angiomyolipoma: case report and literature review. AB - A rare case of thoracic spinal angiomyolipoma presenting with evidence of vertebral body infiltration and concurrent epidural spinal cord compression is described. Clinicopathological correlates, aspects of radiological diagnosis, considerations for surgical management, and histopathological features denoting possible unique attributes of biological behavior for this entity are discussed in conjunction with a review of the previous literature on angiolipomas in general. PMID- 3982625 TI - Falcine chondrosarcoma: case report and literature review. AB - We present a case of falcine chondrosarcoma in a 58-year-old man. Only a few other examples of chondrosarcomas in this location and a total of approximately 50 intracranial cases have been reported. Because its rarity prevents any group of neurosurgeons from collecting a large experience in managing this tumor, we reviewed descriptions of previous cases to determine the natural history of intracranial chondrosarcomas. The distinguishing features of this rare tumor are compared with previous examples of intracranial tumors derived from cartilage and more common tumors in the parasagittal region, such as meningioma. PMID- 3982626 TI - Surgical approaches to intraventricular meningiomas of the trigone. AB - A case of a large intraventricular meningioma of the trigone is described. The tumor was removed by the transcallosal route. The neuropsychological sequelae of this approach are discussed. The value of other surgical approaches for meningiomas of the trigone is reviewed. The transcallosal approach originally described by Kempe and Blaylock is highly recommended. PMID- 3982627 TI - Neurosurgical training in the countries of the Middle East: a summary round table discussion held at the annual meeting of the Middle East Neurosurgical Society, April 1983, Athens, Greece. AB - At the combined Annual Meeting of the Hellenic Neurosurgical Society and the Middle East Neurosurgical Society in Athens on April 10-13, 1983, a round table discussion of neurosurgical training in the Middle East took place. The types of training programs available in the panel members' respective countries were discussed, and the quality, requirements, and standards of training were delineated. Neurosurgical manpower in the Middle East was reviewed. The panelists explored the need for unification of programs and standardization and review of training and called for a well-recognized certification in neurosurgery among the countries of the Middle East. PMID- 3982628 TI - Nonoperative treatment of epidural hematomas. PMID- 3982629 TI - Dural AVM. PMID- 3982630 TI - EC-IC Bypass. PMID- 3982631 TI - Heterogeneity in dementia of the Alzheimer type: evidence of subgroups. AB - We reviewed records of 121 consecutive patients with dementia of the Alzheimer type. Patients with myoclonus or extrapyramidal signs had greater intellectual decline and functional impairment in daily activities. Among patients studied over 4 years, there were four groups: benign--little to no progression; myoclonic -severe intellectual decline and frequent mutism after younger onset; extrapyramidal--severe intellectual and functional decline and frequent psychotic symptoms; typical--a gradual progression of intellectual and functional decline, but without other distinguishing features. Except for the group with myoclonus, no subgroup was segregated by age at onset or other demographic variables. This study suggests that dementia of the Alzheimer type is heterogeneous, and that certain clinical manifestations may be useful in predicting outcome. PMID- 3982633 TI - Comparison of metrizamide computed tomography and magnetic resonance imaging in the evaluation of lesions at the cervicomedullary junction. AB - We compared intrathecal metrizamide-enhanced CT (metrizamide-CT) and magnetic resonance imaging (MRI) in the evaluation of 17 patients with clinical suspicion of lesions at the cervicomedullary junction. MRI was superior in imaging the position of the cerebellar tonsils and the size and extent of mass lesions. MRI and metrizamide-CT were equal in detecting syringomyelia. CT with and without IV contrast enhancement was necessary to detect calcium or defects in the blood brain barrier within neoplasms. PMID- 3982632 TI - Superficial temporal-middle cerebral artery anastomosis: effects on vascular, neurologic, and neuropsychological functions. AB - In 44 patients, we studied the effects of superficial temporal-middle cerebral artery anastomosis on cerebral blood flow (CBF), neurologic examination, and cognitive functions. At 3 months, there was significant improvement in all variables. At 9 months, CBF was no longer significantly greater, but neurologic examination and cognitive functions had further improved. Patients with TIA had significant postoperative decreases in TIA frequency and did not progress to stroke, but had no significant changes in any variable. In stroke patients, we could not separate the effects of surgery from the natural evolution of changes in CBF and examination after stroke. None of the preoperative measurements predicted postoperative clinical improvement. PMID- 3982634 TI - Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. AB - We studied 28 patients with subarachnoid hemorrhage and normal angiograms. On early CT (within 5 days) in 13 cases, blood was seen mainly or only in the cisterns around the midbrain. This pattern of hemorrhage was found in only 1 of 92 patients with a ruptured aneurysm. None of the unexplained perimesencephalic hemorrhages was associated with intracerebral hematoma or intraventricular hemorrhage. The clinical features also differed from those of aneurysmal hemorrhage; loss of consciousness was rare, and after 3 months, all 13 patients had returned to normal life. The cause of this benign disorder remains elusive, but a venous or capillary source seems likely. PMID- 3982635 TI - Noninvasive measurement of central sensory and motor conduction. AB - Potentials evoked by median and peroneal nerve stimulation were digitally filtered between 300 and 2,500 Hz to measure early latency components and assess sensory cord conduction velocity. Short (R1) and long (R2) latency reflex responses were recorded from contracting thenar and tibialis anterior muscles. R1 is considered a spinal reflex akin to the H-reflex. Clinical evidence suggests that R2 involves a reflex arc with turnaround at the motor cortex. Sensory-motor cord velocity was derived from the latencies of R1 and R2. The method can be used to compare peripheral and central sensory conduction or conduction in central sensory and motor pathways. PMID- 3982636 TI - Selective paralysis of downward gaze caused by bilateral lesions of the mesencephalic periaqueductal gray matter. AB - A patient who had selective paralysis of downward gaze caused by bilateral lesions of the dorsolateral mesencephalic periaqueductal gray (PAG) matter is reported. Her necropsy findings differed from all previous reports of the syndrome, in that regions of the mesencephalon that have been considered as critical for executing downward gaze (dorsomedial to red nuclei, rostral interstitial nuclei of the medial longitudinal fasciculus [ri MLF]) were normal. These lesions may have produced the syndrome by involving the caudal portions of the nuclei of the posterior commissure (subcommissural), from which one of the commissural systems used by the ri MLF originates. It is also possible that the syndrome was produced by selective destruction of PAG neurons that generate downward impulses or by interruption of posterior commissure fibers containing downward impulses that travel through the dorsolateral PAG before terminating in the more ventral mesencephalon. PMID- 3982637 TI - The heterogeneity of Parkinson's disease: clinical and prognostic implications. AB - In 334 patients with idiopathic Parkinson's disease, deterioration in mental status paralleled severity of bradykinesia, postural instability, and gait difficulty. Tremor was relatively independent of the other cardinal signs and was associated with relative preservation of mental status, earlier age at onset, family history of parkinsonism, and more favorable prognosis. There seem to be at least two Parkinson's subgroups: one with postural instability and gait difficulty and another with tremor as the dominant feature. PMID- 3982638 TI - Reversal of sleep disturbance in Parkinson's disease by antiparkinsonian therapy: a preliminary study. AB - In a previous study, the sleep pattern in Parkinson's disease patients was found to be altered. The disturbance consisted of a "light fragmented sleep pattern" with increased muscle activity. Using a combined polysomnographic and electromyographic recording technique, we found that a reversal of the light fragmented sleep pattern and normalization of muscle activity during sleep occurred after clinical improvement with dopaminergic treatment. The effect of dopaminergic treatment on sleep disturbance was analyzed. There is an intimate relationship between sleep pattern and the normalization of sleep muscle activity produced by dopaminergic agents. PMID- 3982639 TI - Dystonia and calcification of the basal ganglia. AB - We studied a family with dominantly inherited dystonia and intracranial calcification. Thirty-seven members were examined; 13 were affected by dystonia that was segmental in most patients, affecting especially the voice, face, neck, and limbs. Intracranial calcification involved the putamen, pallidum, cerebral white matter and cortex, and cerebellar nuclei. Several patients had both dystonia and calcification, but others had either dystonia or calcification alone. PMID- 3982640 TI - Declining incidence of multiple sclerosis in the Orkney Islands. AB - The incidence of MS in the Orkney Islands has been updated from 1941 to September 21, 1983. Since 1965, MS incidence rates have fallen significantly when compared with those for 1941 to 1964. Alterations in age-specific prevalence, mean duration of illness, and mean age of the MS population are consistent with the decline in incidence of MS in recent years. Although the reason for the decreasing incidence is uncertain, it is consistent with the hypothesis that MS may be caused by canine distemper virus. PMID- 3982641 TI - Long survival of primary cerebral lymphoma with progressive radiation necrosis. AB - A 56-year-old man lived 8 years after excision and irradiation of a primary cerebral lymphoma. Delayed radiation necrosis caused progressive neurologic deterioration and probably his steroid-responsive episodes of obtundation. Vasogenic edema induced by radiation may account for the latter. An incidental extraneural lymphoma was found postmortem without evidence of CNS lymphoma. PMID- 3982642 TI - Is the neurologic examination becoming obsolete? PMID- 3982643 TI - Differential effect of cimetidine on serum concentrations of carbamazepine and phenytoin. AB - Cimetidine is an inhibitor of drug metabolism. We studied the effects of cimetidine (1,200 mg/d) on steady-state serum concentrations of carbamazepine and phenytoin in 11 epileptic volunteers. The mean serum carbamazepine concentration was unchanged after 7 days of cimetidine treatment. Five subjects were taking phenytoin concurrently; their mean serum phenytoin concentration was significantly increased after 7 and 10 days of cimetidine treatment and returned to baseline 2 weeks after cimetidine was discontinued. Cimetidine apparently inhibits the clearance of phenytoin but not of carbamazepine in adults on chronic therapy. PMID- 3982644 TI - CSF dopamine-beta-hydroxylase activity in Parkinson's disease. AB - Although the most prominent neurochemical change in parkinsonism is nigrostriatal dopamine deficiency, norepinephrine content is also diminished in the CNS. In this study, dopamine-beta-hydroxylase (DBH) activity, a marker of central noradrenergic activity, was measured in the CSF of previously unmedicated parkinsonian patients and normal controls. The parkinsonian patients showed a reduction in CSF DBH levels to 41% of control values (p less than 0.01). Possible explanations for the decrease included a decreased noradrenergic nerve pool or a diminished rate of synthesis of catecholamines. PMID- 3982645 TI - Dementia after surgery for cerebellar stroke: an unrecognized complication of acute hydrocephalus? AB - Three patients became demented after surgery for cerebellar hemorrhage or infarction with acute hydrocephalus. All were inattentive, perseverative, and disoriented. They had difficulty with memory, and trouble solving arithmetic problems or copying geometric figures. None showed aphasia, apraxia, or agnosia, although one had word-finding difficulty. One improved substantially in 6 months; one improved slightly in 1 year, and one did not change. None had persistent hydrocephalus. Acute hydrocephalus may have damaged the periventricular white matter to cause the dementia. PMID- 3982646 TI - Motor function in the normal aging population: treatment with levodopa. AB - In normal elderly humans there is progressive motor dysfunction and loss of nigrostriatal neurons and brain dopamine similar to, although of a milder degree than, that seen in Parkinson's disease. Ten healthy elderly volunteers were given carbidopa/levodopa or placebo in a double-blind crossover study. We measured movement velocity, reaction time, tremor, visual evoked response (VER), and electroretinography (ERG). Significant changes were seen only in ERG. Motor functions and VER were unchanged. Although there appeared to be pharmacologic activity (ie, changes in ERG), levodopa, in adequate antiparkinson dosage, had no impact on the mild extrapyramidal impairment of normal elderly subjects. PMID- 3982647 TI - Hypersomnia, bithalamic lesions, and altered sleep architecture in Kearns-Sayre syndrome. AB - An 11-year-old boy with Kearns-Sayre syndrome developed hypersomnia associated with bithalamic lesions and had complete absence of sleep spindles on a nocturnal polysomnogram. PMID- 3982648 TI - Acetylcholine receptor antibody production by bone marrow cells in a patient with myasthenia gravis. AB - We briefly report antiacetylcholine receptor antibody production by cultured bone marrow cells (4.9 +/- 0.9 fmol/10(6) cells/wk, mean +/- SD) in a 65-year-old man with myasthenia gravis without thymoma. Lymphocytes from peripheral blood, thymus, and lymph nodes produced less antibody (1.8 +/- 0.1, 0.9 +/- 0.3, and 1.0 +/- 0.4, respectively). The thymus was involuted, and the effect of thymectomy was doubtful 6 months postoperatively. PMID- 3982649 TI - Guillain-Barre syndrome in Larimer County, Colorado: a high-incidence area. AB - During the period 1981-1983, 19 cases of Guillain-Barre syndrome (GBS) occurred in residents of Larimer County, Colorado, for an incidence of 4.0 cases per 100,000 population per year, compared with 1.2 cases per 100,000 per year in 1975 1980 (p less than 0.05). The higher incidence of GBS in 1981-1983 may represent an unusual chance occurrence, since no patient characteristics or predisposing events could be found to explain the increase. Nevertheless, the findings demonstrate that over a period of as long as 3 years, the crude average annual incidence of GBS in a large, well-defined population may exceed by twofold the upper limit of the previously reported range (0.6 to 1.9 cases per 100,000 per year). PMID- 3982651 TI - Generalized chorea due to bilateral small, deep cerebral infarcts. AB - We present a case of generalized chorea, with complete recovery, due to MRI documented bilateral lacunar infarcts of the caudate nucleus, putamen, and deep frontal white matter. MRI is probably more sensitive than CT in disclosing small deep cerebral infarcts. PMID- 3982650 TI - Cyproheptadine reduces or prevents ischemic central nervous system damage. AB - Several drugs that inhibit the effects of serotonin may reduce or prevent experimental CNS ischemic damage, but these drugs are not approved for human use in the United States. Administration of cyproheptadine (which is available for clinical use) 15 minutes before or 5 minutes after the onset increased the duration of experimental rabbit spinal cord ischemia required to produce irreversible paraplegia. Drugs thought to be serotonin agonists did not aggravate the damage, but bufotenin reversed protective effect of cyproheptadine. The results suggest that serotonin antagonists reduce ischemic CNS damage; cyproheptadine may be a potential treatment for ischemic stroke. PMID- 3982652 TI - Neurologic complications of a coral snake bite. AB - A 27-year-old man was bitten by a coral snake in Mexico. Within 24 hours he had ptosis, dysphonia, difficulty chewing, and limb weakness. His symptoms peaked at 72 hours with loss of ambulation. Neurologic examination was consistent with severe myasthenia. Repetitive stimulation of the median nerve showed a postsynaptic defect that was not corrected by edrophonium. He was monitored in an intensive care unit, but received no antivenom globulin or acetylcholinesterase inhibitors. The syndrome abated in 3 weeks. PMID- 3982653 TI - Dementia of different etiologies: vasoactive intestinal polypeptide in CSF. AB - Patients with normal-pressure hydrocephalus, multi-infarct dementia, and recent cerebral infarction had significantly lower vasoactive intestinal polypeptide (VIP) levels than age-matched controls (11 +/- 3 pmol/l, 17 +/- 4 pmol/l, 21 +/- 4 pmol/l, and 33 +/- 4 pmol/l, respectively). Three months after a shunt operation, the VIP levels had increased significantly in patients with hydrocephalus (54 +/- 13 pmol/l). VIP concentration in patients with senile dementia did not differ from that of controls. PMID- 3982654 TI - The effect of recombinant alpha 2-interferon on defective natural killer cell activity in multiple sclerosis. AB - Natural killer (NK) cell activity was evaluated in exacerbating/remitting MS patients. Peripheral blood mononuclear cells (MNC) from MS patients had impaired NK-cell cytotoxicity against the K562 myeloid target cell. NK activity was depressed, irrespective of the interval (2 to 13 months) after the last exacerbation. Recombinant alpha 2-interferon (100 U/ml) enhanced NK activity of both MS and control MNC. Cytotoxicity mediated by interferon-treated MS MNC was increased to the level of untreated control MNC. These studies show that MNC from exacerbating/remitting MS patients possess a defect in NK-cell activity that can be corrected in vitro by treatment with interferon. PMID- 3982655 TI - Incidence and prevalence of tuberous sclerosis in Rochester, Minnesota, 1950 through 1982. AB - The incidence of tuberous sclerosis in Rochester, MN, was 0.56 per 100,000 person years in 1950 through 1982, and point prevalence on December 31, 1980, was 10.6 per 100,000 persons. The true incidence and prevalence may be even higher, because cases with hypomelanotic macules and no other clinical manifestations are often unrecognized. Pertinent clinical observations in the eight cases identified included familial occurrence in two; hypomelanotic macules in all eight; seizures with onset before age 2 in four, of whom two were mentally retarded; and no neurologic abnormalities in those free of seizures. PMID- 3982656 TI - Hypomelanosis of Ito: association with a chromosomal abnormality. AB - We report the clinical and neuroradiologic findings and the association of a chromosome abnormality, t(2,8), with a case of hypomelanosis of Ito (incontinentia pigmenti achromians). Chromosome anomalies have not been previously recognized in this genetically determined, neurocutaneous disorder. PMID- 3982657 TI - Pattern evoked potentials (PEPs) in Parkinson's disease. AB - Controversy exists in the literature concerning whether Parkinson's disease (PD) results in prolongation of pattern evoked potential (PEP) responses. PEPs were obtained in 20 patients with PD. The latencies of the first major positive potential (P2) in response to independent left and right eye stimulation were evaluated. There was no statistically significant difference (group or individual) when patients with PD were compared with age-corrected controls. There was no difference in results in comparing patients with mild, moderate, and severe PD. These results contradict previous reports of markedly abnormal PEPs. PMID- 3982658 TI - Plasmapheresis in progressive MS. PMID- 3982659 TI - Bromocriptine dose and severity of Parkinson's disease. PMID- 3982660 TI - Transient foot dystonia in an adult woman. PMID- 3982661 TI - Ictal head-turning: lateralization and localization. PMID- 3982662 TI - Are cytoplasmic calcium concentrations increased in Duchenne myofibers? PMID- 3982663 TI - Migraine responsive to danazol. PMID- 3982664 TI - Efficacy of carbamazepine for febrile seizures. PMID- 3982665 TI - Sensory symptoms: Parkinson's disease. PMID- 3982666 TI - Posterior communicating artery giant aneurysm as a cause of seizures. PMID- 3982667 TI - Neuroleptic malignant syndrome and the endogenous opiate system. PMID- 3982668 TI - American Academy of Neurology. 37th annual meeting. Dallas, Texas, April 28-May 4, 1985. Abstracts. PMID- 3982669 TI - Operative risk in old age--an anesthesiological survey of octogenarians. AB - The anesthesiological records of 138 patients (158 operations), aged 80 years and older, were analysed retrospectively. Ninety-nine patients had received general anesthesia for 115 procedures. Complications and hemodynamic disturbances in this group were studied. Serious hemodynamic changes occurred 31 times in 24 patients. They were readily corrected and did not seem to have had any influence upon the mortality. The anesthesiological risk in our patients was negligible. The mortality in this survey is comparable to that of other series. PMID- 3982670 TI - Mo(o)re or less prostheses--retrospective study of 166 dislocated femoral neck fractures treated by the Moore endoprostheses. AB - Moore's endoprosthesis is still often used to treat (dislocated) medial femoral neck fractures. It appears from this retrospective investigation of 166 patients that while the results obtained with elderly patients are not unsatisfactory, only 16% of the patients under 70 years of age were complaint free after more than four years time. Therefore, it is recommended that 'head-neck' prostheses be only used in older people with limited life expectancies. A significant difference with other cemented or double articulated prostheses was not demonstrated. PMID- 3982672 TI - Mucocele of the appendix. AB - The history of two patients with a mucocele of the appendix is reported. It is stressed that in case of a tumour of the appendix the possibility of a malignant mucocele should always be considered. To prevent a peritoneal pseudomyxoma tumour spill should be avoided and great care should be taken in performing appendectomy. A survey of the literature is given. PMID- 3982671 TI - Chylothorax after gastric resection. AB - Traumatic chylothorax has been described as an uncommon complication of various thoracic and cervical surgical procedures. No previous reports have been made of chylothorax following gastric resection for malignancy. Two cases of chylothorax following damage to the thoracic duct during gastric resection for malignancy are presented and the literature is reviewed. The condition was successfully managed by conservative means. Pleural aspiration, combined with total parenteral nutrition in one case and positive end-expiratory pressure ventilation in the other, resulted in complete resolution of the chylous effusions. PMID- 3982674 TI - The free latissimus dorsi flap in reconstructive microsurgery. AB - The results are described of coverage of skin defects of the leg, foot and hand by use of a free vascularized musculocutaneous latissimus dorsi flap in 32 patients with previously incurable defects. Also presented are the case reports of three representative patients. The results show a success rate of 90%, with thrombosis of either the arterial or venous anastomoses as the only complications. Adequate postoperative screening (t.c. pO2, temperature, etc.) leads to early discovery of this thrombosis, after which revision can save the flap. PMID- 3982673 TI - Hemangioma of the mediastinum. AB - Benign hemangiomas of the mediastinum are rare. Histologically they can be differentiated into a capillary or a cavernous form. In general these are well encapsulated and slow-growing tumors, but infiltrative growth is not unusual. Metastases never occur. Often these tumors are accidentally found on routine chest roentgenograms. Phleboliths are characteristic. Symptoms are mostly caused by compression or invasion of mediastinal structures. The benign hemangioma should be treated surgically and must be removed as completely as possible. The prognosis is favorable. PMID- 3982675 TI - [Current views on the pathogenesis of venous thrombosis]. PMID- 3982676 TI - [Prethrombotic state: is diagnosis possible?]. PMID- 3982677 TI - [Clinical picture of deep venous thrombosis]. PMID- 3982679 TI - [Therapy of acute peripheral arterial obstructions]. PMID- 3982678 TI - [The revascularization syndrome]. PMID- 3982680 TI - [Surgical therapy of deep venous thrombosis]. PMID- 3982682 TI - [Heparin or heparins?]. PMID- 3982683 TI - [Low-dose heparin in thoracic surgery]. PMID- 3982681 TI - [Medical treatment of deep venous thrombosis]. PMID- 3982684 TI - [Medical therapy of acute peripheral ischemia]. PMID- 3982685 TI - [Deep venous thrombosis of the lower limbs. Importance of medical or early surgical treatment in relation to anatomo-clinical sequelae]. PMID- 3982686 TI - [Surgical therapy and prevention of massive pulmonary embolism]. PMID- 3982687 TI - [Deep venous thrombosis of the upper limbs of subclavian-axillary localization]. PMID- 3982688 TI - [Our experience with embolism and acute arterial thrombosis of the extremities]. PMID- 3982689 TI - [Role of surgery in the preventive treatment of pulmonary embolism]. PMID- 3982690 TI - [Massive pulmonary embolism: considerations on the surgical approach]. PMID- 3982691 TI - [The thrombodensitogram: a photometric and dynamic study of the clot (the slow clotting test)]. PMID- 3982692 TI - [Control of subcutaneous calcium-heparin therapy by the thrombodensitogram]. PMID- 3982693 TI - [Parathormone as a uremic toxin. Physiopathological bases and general therapeutic guidelines]. PMID- 3982694 TI - [Parathyroidectomy in secondary hyperparathyroidism]. PMID- 3982695 TI - [Surgical treatment of secondary hyperparathyroidism]. PMID- 3982697 TI - [Parathyroidectomy in secondary hyperparathyroidism in chronic uremic patients under dialysis treatment. Development of the surgical strategy]. PMID- 3982696 TI - [Therapeutic indications obtained from short- and medium-term biohumoral changes after parathyroidectomy]. PMID- 3982698 TI - [Variations in serum levels of phosphorus (iP), calcium (Ca), calcitonin (iCT) and parathormone (iPTH) in patients under periodic hemodialysis. Effects of exogenous calcitonin therapy]. PMID- 3982699 TI - [Evaluation of terminal parathormone NH2 and COOH and plasma calcitonin in the blood of uremic patients under hemodialysis therapy]. PMID- 3982701 TI - [Evolution of surgical methods in the treatment of renal osteodystrophy. Personal cases and remote results]. PMID- 3982700 TI - [Association of hyperplasia and cancer of the parathyroid glands in patients under dialysis. Pathogenetic hypotheses]. PMID- 3982702 TI - [Osteodensitometry: new interpretive technics of an old test]. PMID- 3982703 TI - [Correlations between osteodensitometry and parameters of uremic osteodystrophy]. PMID- 3982704 TI - An attempt to find vibrissa-related barrels in the primary somatosensory cortex of the cat. AB - An attempt was made to find vibrissa-related barrels in the primary somatosensory cortex in fetal kittens between 53-57 days of gestation. Barrels had not been found in adults of this species. Based on results in some rodent species with obscure barrels, the fetal kittens represented the best opportunity to observe barrels if they exist. The coronal gyrus was thoroughly examined in Nissl preparations and no barrels were found. PMID- 3982705 TI - Autoradiographic localization of [3H]nicotine binding sites in the rat brain. AB - In vitro autoradiography was used to visualize [3H]nicotine binding sites in the rat brain. Labeling was densest in the interpeduncular nucleus and medial habenula but was also detected in thalamic nuclei, areas related to sensory function, the cerebral cortex, and molecular layer of the dentate gyrus. Specific binding was sparse in the hypothalamus and caudate-putamen, and not detected in Ammon's horn of the hippocampus or in the periaqueductal grey matter. These findings may relate to the distribution of nicotine's cerebral loci of action. PMID- 3982706 TI - Ultrastructural evidence for phagocytosis by oligodendroglia. AB - Although the phagocytic ability of brain macrophages and astrocytes is well established, the question of whether oligodendrocytes may become phagocytic remains controversial. Observations reported here indicate that oligodendroglia may become activated and ingest degenerating or foreign material in vivo following experimental injury to the central nervous system. PMID- 3982707 TI - Autoradiographic localization of [3H]buspirone binding sites in rat brain. AB - Binding sites for [3H]buspirone were identified on sections from rat brain by light microscopic autoradiography. Incubated sections were processed by the Ultrofilm as well as the coverslip method. Highest densities of [3H]buspirone binding were localized in the caudate/putamen, nucleus accumbens septi, olfactory tubercle and in the glomerula of the olfactory bulb. This distribution pattern is different from any serotonin receptor but fits well with that of dopamine receptors. Therefore, this study supports the hypothesis that buspirone acts, at least partially, on dopamine receptors. PMID- 3982708 TI - Ureteral axon damage following subcutaneous administration of capsaicin in adult rats. AB - Systemic administration of capsaicin to adult rats results in the death of almost 90% of the axons in the ureter. Because of the massive axon loss we presume that sensory and possibly some sympathetic axons are killed. By contrast sensory axons in the dorsal root do not seem to be affected. We speculate that the axons in the ureter die because they are not protected by sleeves of perineurium. This hypothesis will be tested in subsequent work. PMID- 3982710 TI - The zona incerta: another source of centrifugal fibers to the main olfactory bulb. AB - Neurons in the ipsilateral anteropolar division of the zona incerta were retrogradely labeled following injections of horseradish peroxidase in the main olfactory bulb. In addition, labeled cell bodies were found in the dorsal hypothalamus. Fewer and less densely labeled neuron cell bodies were seen in the contralateral zona incerta and dorsal hypothalamus. Most of the cells had a characteristic fusiform shaped soma, but a small number of the hypothalamic cells had spherical or conical shaped cell bodies. PMID- 3982709 TI - Projections of the reticular complex of the thalamus onto physiologically characterized regions of the medial geniculate body. AB - Afferents from the reticular complex of the thalamus (RE) to the subdivisions of the medial geniculate body (MGB) in the cat were studied by retrograde axonal transport of horseradish peroxidase injected in sites where single unit responses to tones had been characterized. All MGB subdivisions studied received afferents from the same region of RE corresponding to its ventral posterior third, characterized by large neurons. No obvious differences were seen in the localization of labelled neurons within RE according to which MGB subdivision was injected, except that pars lateralis afferents seemed to originate from somewhat more limited portions of RE. PMID- 3982711 TI - The effect of clonidine on adrenal sympathetic nerve responses to mechanical, noxious and innocuous stimulation of the skin in rats. AB - The effect of clonidine on the reflex responses of the adrenal sympathetic nerve to mechanical stimulation of the lower chest skin was studied in anesthetized CNS intact and spinalized rats. Clonidine (3-120 micrograms/kg i.v.) administration resulted in a dose-related decrease in spontaneous adrenal efferent nerve activity in both CNS intact and spinalized rats. In CNS intact rats, noxious pinching caused a reflex increase in adrenal nerve activity while innocuous brushing caused a reflex decrease. In both cases, clonidine reduced the reflex response in a dose-dependent manner. In spinalized rats, both noxious and innocuous stimulation caused reflex increases in adrenal nerve activity, and clonidine produced a similar dose-dependent decrease in these responses as seen in CNS intact animals. The similar dose-response relationships for adrenal nerve tone or reflex response in CNS intact and spinalized animals suggest, although not conclusively, that at least some of clonidine's effect in CNS intact animals may be mediated at the spinal level. PMID- 3982712 TI - Tetrodotoxin elevates arterial pressure but not plasma vasopressin when injected into the caudal ventrolateral medulla of the rabbit. AB - When tetrodotoxin (TTS) is microinjected into the caudal ventrolateral medulla it elevates arterial pressure. This is consistent with previous microinjection experiments which show that the injected region contains neurons whose activity inhibits peripheral sympathetic vasomotor tone. However, TTX does not alter plasma vasopressin and this suggests that increases in plasma vasopressin which follow electrolytic lesions may result from excitatory effects of the lesions. PMID- 3982713 TI - Growth of the initial dendrite of early differentiated interneurons in the zona intermedia of the embryonic chick cervical cord: a morphometric study with the Golgi method. AB - From stages 24 to 45 of the chick embryo, the longest dendrite of each interneuron in the zona intermedia was measured in the upper cervical cord prepared by the Golgi method, the measuring being done exclusively on the large neurons at each stage to follow the dendritic growth of neurons homogeneous in their time of origin. The longest dendrite grew at a rate of 92-184 micron per day at stage 24, and thereafter its growth rate gradually slowed down to 4 micron per day at stage 36. Already at stage 27, the interneurons located deep in the mantle layer reached with their longest dendrite the marginal layer which was the site of synaptic contact in early developmental stages. Thus, the initial rapid growth of the dendrite could be regarded as highly effective for the early formation of synaptic contact. PMID- 3982714 TI - The mesencephalic locomotor region in cat: effects of local applications of diazepam and gamma-aminobutyric acid. AB - In decorticate unanaesthetized cats, displaying sequences of stereotyped locomotor movements in response to electrical stimulation of their footpad, local injections were made into the mesencephalic locomotor region (MLR). Diazepam (at 10 micrograms) and GABA (at 500 micrograms) induced complete suppression for 5-10 min, followed by partial amplitude recovery. It is suggested that: (i) MLR contains both diazepam and GABA receptors, and (ii) diazepam (and GABA) blockade is only short lasting because of a substitution (vicariancy) process through other structures also involved in locomotion. PMID- 3982715 TI - Amygdalospinal projections in the macaque monkey. AB - Injection of horseradish peroxidase into the cervical cord in the macaque monkey led to the retrograde labeling of neurons in the caudal part of the central nucleus of the amygdala ipsilateral to the spinal half where the injection was made. Although the number of labeled neurons in the amygdala was small, they were constantly found in 7 macaque monkeys (3 Japanese monkeys, 3 crab-eating monkeys and 1 rhesus monkey) which were injected with the enzyme into the upper and middle cervical cord segments. PMID- 3982716 TI - Fastigial inputs to the insular cortex in the cat: field potential analysis. AB - Electrical stimulation of the fastigial nucleus provoked surface-negative field potentials bilaterally in the cerebral cortical regions around the anterior ectosylvian sulcus (AES) in the cat anesthetized with pentobarbital. Laminar field potential analysis revealed that the active locus for the negative potentials is located within the cortical layer I of the lower bank of the AES, i.e. the insular cortex. PMID- 3982717 TI - The predictive value of diagnostic procedures. AB - Nurses are in an ideal position to answer clients' questions regarding the necessity of diagnostic tests and clarification of test results. A perfect test would always be positive in the presence of disease and negative in the absence of disease. However, false-negative or false-positive results are a reality and must be considered as the clinician strives for accuracy in diagnostic procedures. Understanding predictive value enables the nurse to discuss the rationale, usefulness and limitations of tests currently used to assess disease, disease activity and to guide therapy. PMID- 3982718 TI - Working with the chronically ill. PMID- 3982719 TI - Patient compliance and interpersonal style: implications for practice and research. PMID- 3982721 TI - Amniotic fluid volume as a risk factor in preterm premature rupture of the membranes. AB - During a prospective study evaluating the expectant management of preterm (26 to 34 weeks) premature rupture of membranes (PROM), the authors compared maternal and neonatal outcome of 17 patients with a marked reduction in amniotic fluid volume with 22 subjects having identifiable pockets of amniotic fluid after membrane rupture. The results demonstrated no significant differences in maternal age, gravidity, cervical dilatation, incidence of labor on admission, use of tocolytics, steroid usage, interval from membrane rupture to delivery, or cesarean section rate. The gestational age at which PROM occurred (31.4 +/- 1.9 versus 29.8 +/- 2.2 weeks) was significantly (P less than .05) more advanced in the adequate fluid patients when compared with the reduced fluid group. Clinical amnionitis was a far more common occurrence in the reduced fluid patients when compared with the adequate fluid group (47 versus 14%, respectively, P less than .05) as was postpartum endometritis (59 versus 18%, P less than .05). The incidence of overt neonatal sepsis was similar between the adequate fluid (14%) and reduced fluid (18%) patients. These results suggest that when a marked reduction in amniotic fluid after PROM is identified, patients are at a three times greater risk for antepartum amnionitis and postpartum endometritis. PMID- 3982722 TI - Supine position in labor and associated fetal heart rate changes. AB - Presented is an investigation of the relationship of fetal heart rate (FHR) deceleration and position of the patient in labor. In a group of 902 laboring patients, 126 (14%) demonstrated late decelerations. Of the 126, 24 (19%) patients demonstrated late decelerations in the supine position only. These occurred during uterine contractions and were associated with reduced femoral arterial blood pressure and amplitude of the capillary pulse of the big toe. A drop in capillary blood pH of the fetal scalp could also be demonstrated. These effects reproducibly appeared and disappeared when supine and lateral positions were alternated. These data would suggest that maternal aortic compression by the pregnant uterus plays a role in the etiology of fetal stress as expressed by changes in fetal heart rate and acid base balance. This effect can be evaluated and monitored simply by recording the pulse pressure of the big toe and femoral arterial pressure. These atraumatic procedures can be applied to any patient. PMID- 3982720 TI - First-trimester drug use and congenital disorders. AB - The authors determined the prevalence of certain major congenital disorders among live-born infants of 6509 mothers in a prepaid health plan for the 30-month period of January 1, 1980 through June 30, 1982 who used a wide variety of drugs during the first trimester of pregnancy. The results were similar to those obtained in this population in a prior 30-month study. No strong associations between any of the commonly used drugs and the congenital disorders studied were present. PMID- 3982723 TI - Moderate caloric restriction in obese women with gestational diabetes. AB - The effect of moderate caloric restriction on weight gain during pregnancy and fetal outcome in 22 obese women with gestational diabetes mellitus was assessed. A new tool was used to assess dietary compliance in an outpatient setting. The authors observed that obese gestational diabetics gained less weight during pregnancy than ten normal pregnant women or 31 lean women with gestational diabetes. Paradoxically, the placentas of obese gestational diabetics were larger (P not significant), and infants of these mothers were significantly heavier than those of normal women or lean women with gestational diabetes (P less than .03). The authors suggest that the currently recommended daily caloric allowances for normal women may be excessive for obese gestational diabetics who are not prone to ketosis but have a complex metabolic problem characterized by hyperinsulinemia and insulin resistance. PMID- 3982724 TI - Hyperprolactinemia and contraception: a prospective study. AB - The authors measured serum concentrations by single and multiple sampling techniques in 347 women before, during, and after treatment with either hormonal or barrier methods of contraception. The prolactin responses to an intramuscular injection of estrogen also were evaluated in control and selected study patients. The incidence of hyperprolactinemia in oral contraceptive users was higher than control subjects (12 versus 5%). Hyperprolactinemia was best assessed by multiple blood sampling, it is often transient and resolves spontaneously in about 50% of women. The estrogen provocation study suggests that some women who develop hyperprolactinemia while taking oral contraceptives are more sensitive to the effects of exogenous estrogen and may be at greater risk of developing pill related menstrual aberrations and hyperprolactinemia. PMID- 3982726 TI - Value of culdocentesis in the diagnosis of ectopic pregnancy. AB - The diagnostic value of culdocentesis was examined in all patients admitted with hemoperitoneum during a three-year period. There was a total of 158 women with positive culdocentesis, of whom 132 (83.5%) had tubal ectopic pregnancies and 26 had other diagnoses. Of the 132 patients with ectopic gestations, the majority (62%) had unruptured tubes. A nondiagnostic culdocentesis should not be used either to raise or to lower the clinician's suspicion of ectopic pregnancy as 16% of patients with an ectopic pregnancy had a nondiagnostic culdocentesis, of which one-quarter were ruptured and three-quarters had hemoperitoneum diagnosed at the time of surgery. A positive culdocentesis along with a positive serum human chorionic assay was associated with an ectopic pregnancy in 99.2% of cases. This procedure should not be limited to the evaluation of patients with classic peritoneal signs, as 45% of the authors' patients with a positive culdocentesis did not have such findings. PMID- 3982727 TI - Pseudocorpus luteum insufficiency: a study of cytosol progesterone receptors in human endometrium. AB - This prospective, controlled study of 38 women was designed to compare the number of endometrial cytosol progesterone receptor (PRc) binding sites in infertile women with documented luteal phase defect with those of similar women without luteal phase defect. A 25% reduction in PRc binding sites was observed in women with luteal phase defect (P less than .05). Considerable overlap was noted between luteal phase defect and control groups; thus, no definite range of binding site numbers was predictive of luteal phase defect. The results of this study, therefore, suggest that an end-organ receptor defect may exist in some women with luteal phase abnormalities. PMID- 3982725 TI - Current dilatation and curettage practice: a need for revision. AB - A ten-year retrospective review of 1383 diagnostic dilatation and curettages (D&C) was done at a university hospital. It was found that the detection or diagnosis of uterine cancer did not significantly increase until after the age of 50. No significant pathologic findings were detected in 60% or more of the women until the age of 70. Premalignant or other than benign tissue was observed to increase from 4% in the age 29 or less group to a peak of 16% in the age 45 to 49 group. The authors conclude that the current practice of routine D&C for abnormal uterine bleeding provides a low yield of cancer diagnoses, and that the indications for this procedure should be sharply reduced or replaced by simpler methods. PMID- 3982729 TI - Colposcopic accuracy in the diagnosis of microinvasive and occult invasive carcinoma of the cervix. AB - One hundred eighty patients with microinvasive and occult invasive squamous cell carcinoma of the cervix who were examined by colposcopy during a ten-year period are reviewed. Forty-two percent of patients with microinvasive carcinoma and 28% of patients with occult invasive carcinoma had an unsatisfactory colposcopic examination. Colposcopy led to the correct management in 90% of patients with occult invasive cancer and in 84% of patients with microinvasive carcinoma. Colposcopy appeared to be less sensitive in detecting microinvasive lesions than in detecting occult carcinoma. Two-thirds of the errors made were colposcopist related, either failure of interpretation or protocol violation. A small but definite group of patients will have lesions whose colposcopic appearance is not sufficiently distinct or characteristic to permit a diagnosis of early invasion. PMID- 3982728 TI - Stillbirth after nonstress testing. AB - The authors' experience with stillbirth within one week of a reactive nonstress test was reviewed to determine the reliability of this test in postdates patients and general high-risk patients. The corrected stillbirth rates were the same in both groups. Thirty-three percent of stillbirths in postdates patients occurred as early as 41.5 weeks' gestation. The cause of stillbirth in postdates patients was not clear even after careful autopsy. In the general high-risk group, 60% of stillbirths were due to an acute event with the remainder due to chronic fetal compromise that was not predicted by the nonstress test. Induction at 41.5 weeks' gestation or more comprehensive fetal surveillance than weekly nonstress testing are possible approaches to the management of postdates pregnancy, which need to be further studied. PMID- 3982730 TI - Surgical management of irradiation-induced small bowel damage. AB - Seventy-seven patients, presenting with radiation small bowel injuries at the University of Texas M. D. Anderson Hospital and Tumor Institute at Houston between 1962 and 1978, were analyzed retrospectively. The patients were divided into two categories: bowel bypass without resection, and resection of irradiated bowel. Each group was then analyzed for its short- and long-term complications. Ileocolectomy with end-to-end anastomosis was the surgical procedure of choice in those people undergoing resection. There was no difference in short-term complications noted between the two groups. The long-term complications of fistula formation and continued small bowel necrosis could be prevented by resection, as a primary procedure. The surgical details of ileocolectomy with end to-end anastomosis are presented, along with an analysis of the complications encountered in both groups. PMID- 3982731 TI - Misstaging of ovarian cancer. AB - The thoroughness of intraoperative evaluation of the extent of disease in 291 women with primary ovarian cancer was investigated. Notable differences among physician specialties but not types of hospitals where initial surgery was performed were observed. A review of medical record documentation revealed that 97% of the cases operated on by gynecologic oncologists had complete staging evaluations performed intraoperatively, but only 52 and 35% of cases operated on by obstetricians/gynecologists and general surgeons, respectfully, were adequately evaluated. Roughly one-half of the cases diagnosed in community hospitals and in hospitals with teaching affiliations were found to be completely studied, and 66% of those operated on in university hospitals received complete intraoperative evaluations. PMID- 3982732 TI - Partial trachelectomy in the elderly patient with abnormal cytology. AB - Because of an unsatisfactory colposcopic examination, cold knife conization of the cervix is frequently required for the evaluation of postmenopausal patients with abnormal cervical cytology. With advancing age, the cervix atrophies and retracts so that conization becomes increasingly difficult and results in a tissue specimen that is frequently inadequate. Dissatisfied with the results of the standard conization procedure, the authors performed partial trachelectomy in 26 elderly patients with atrophic, retracted cervixes. The operative complications were acceptable. Twelve of the 26 patients (46%), including four with severe dysplasia and carcinoma in situ (CIS) and eight with invasive carcinoma, received additional therapy. Eleven of 14 patients (78%) with cervical intraepithelial neoplasia (CIN) had clear surgical margins; ten of these required no further therapy. The authors conclude that partial trachelectomy may be preferable to conization for the evaluation of elderly women with small, atrophic cervixes. It provides a specimen of sufficient length, so as to reduce the incidence of positive surgical margins and to decrease the need for additional therapy if no invasive neoplasia is found. The technique of partial trachelectomy is described. PMID- 3982733 TI - Antepartal uterine hypercontractility secondary to nipple stimulation. AB - An alarming result was noted in conjunction with a nipple stimulation contraction stress test. In a 42-week pregnant woman with suspected postmaturity, gentle self stimulation of the right nipple through the clothing for one to 1.5 minutes caused the sudden onset of uterine hypercontractility, increased uterine tone, and severe fetal bradycardia. The bradycardia persisted for approximately five minutes despite supportive measures. Operative delivery was being considered when the fetal heart rate returned to a normal baseline. Ultimately, the patient delivered vaginally without further significant complication. This experience demonstrated that carefully controlled breast stimulation may result in unpredictable uterine hyperstimulation with fetal bradycardia. PMID- 3982734 TI - Endometriosis with massive ascites. AB - One case of extensive endometriosis with ascites in a young nulliparous woman is reported. The patient had been maintained on suppressive therapy with danazol for over two years, demonstrating the feasibility of conservative management in this extremely rare form of endometriosis. However, long-term efficacy and potential for fertility remain to be determined. PMID- 3982735 TI - Bilateral ovarian hemangiomas associated with diffuse abdominopelvic hemangiomatosis. AB - A case of bilateral ovarian hemangiomas and abdominopelvic hemangiomatosis associated with thrombocytopenia is reported. After total abdominal hysterectomy and excision of a hemangioma adhered to the colon, the platelet count returned to normal, and the patient has remained asymptomatic for five years. A review of three previous cases of bilateral hemangiomas associated with abdominopelvic hemangiomatosis reveals only one patient living two years after diagnosis. The etiology of the hemangiomas is unknown. The thrombocytopenia appears to be secondary to the hemangiomas. The recommended treatment is removal of all resectable hemangioma masses. PMID- 3982736 TI - Inaccuracy of Dubowitz gestational age in low birth weight infants. PMID- 3982737 TI - Microhysteroscopy: a new approach to the diagnosis of cervical intraepithelial neoplasia. PMID- 3982738 TI - Causes of maternal mortality in the United States. AB - Among 2475 maternal deaths that occurred in the United States from 1974 to 1978, 408 were related to pregnancies with abortive outcomes, and 2067 were related to other causes. Ectopic pregnancy was the most frequent cause of death in the former group. Embolism, hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric infection were the most common causes of death in the latter group. Women who were 30 years of age or older or of minority race were at increased risk of death. Nationwide surveillance of maternal mortality is feasible and should help to increase the safety of childbearing. PMID- 3982739 TI - Vaginal delivery after cesarean section: a five-year study. AB - All pregnancies that were complicated by a previous cesarean section were reviewed for a five-year period from 1978 to 1982. Of 799 such pregnancies, 216 underwent a trial of labor, and 66% experienced successful vaginal delivery. When the primary cesarean section was for cephalopelvic disproportion, 54% delivered vaginally, 75% breech, and 70% for fetal distress or other nonrepeating indications. There was no evidence of uterine scar disruption in the vaginally delivered group. Vaginal delivery after previous cesarean section can be a safe alternative for carefully selected patients cared for in the proper environment. PMID- 3982741 TI - The stillborn fetus: placental histologic examination in determining a cause. AB - This investigation was undertaken to determine whether or not histologic examination of the placenta contributed to a better understanding of the cause for an intrauterine fetal death. The placentas of stillborn fetuses delivered after the 20th gestational week were examined during a 4.5-year period (January 1979 to June 1983). Adequate information about the clinical history, autopsy examination, and placental histological examination was available in 89 cases. Delivery was usually within the first week after the fetal death. Significant histologic aberrations in the placenta were found in 87 (98%) cases. The most frequent abnormalities were those of vascular insufficiency, hemorrhagic endovasculitis, retroplacental hematomata, acute chorioamnionitis with fetal involvement, and erythroblastosis/hydrops. Histologic abnormalities were supportive of prior impressions in 67 (77%) cases, contradictory to prior impressions in ten (11%) cases, or the sole contributors in explaining the cause of death in ten (11%) cases. Routine histologic examination of the placenta after a recent fetal death provides helpful information in counseling the parents and in planning any future childbearing. PMID- 3982740 TI - Diminished bilirubin binding by the serum of pregnant women. AB - Enzymatic peroxidase oxidation was used to study albumin-bilirubin binding in the serum of pregnant women, their term infants, and nonpregnant women. When the bilirubin titration curves were corrected for differing albumin concentrations in the three groups, the bilirubin binding of pregnant women was inferior to that of control women but better than that of their infants. Diminished maternal binding could not be explained by altered affinity. This suggests that the function of albumin during pregnancy is impaired by a factor common to both fetal and maternal circulations that appears to act by decreasing the number of available bilirubin binding sites. PMID- 3982742 TI - Update on external cephalic version performed at term. AB - External cephalic version under tocolysis at term was investigated during a prospective study at the Los Angeles County/University of Southern California Medical Center from October 1, 1979 to March 16, 1983. Two hundred twelve patients were considered for attempted version. Forty-one patients were excluded, and 23 patients as previously reported were randomized to the control group. The procedure was successful in 73% (108 of 148). Of the 102 successful versions observed until delivery (six lost to follow-up), 93% (95 of 102) presented in labor with a vertex presentation; seven fetuses reverted to abnormal lies. The cesarean section rate in the success group with a vertex presentation was 24% (23 of 95). PMID- 3982743 TI - Isometric exercise test for predicting gestational hypertension. AB - One hundred normotensive young primigravidas underwent an isometric handgrip exercise test between 28 and 32 weeks of gestation. The same individual performed the tests and the results were withheld from the physician taking care of the patient. The study demonstrates a sensitivity of 81% and a specificity of 96.5%. These results demonstrate a reliable predictive ability of this simple exercise test for gestational hypertension. PMID- 3982745 TI - Endometrial biopsy, bacteremia, and endocarditis risk. AB - Although bacterial endocarditis in women at risk because of endocardial lesions frequently follows pregnancy-related pelvic surgery, endometrial biopsy with or without brushing for cytology was not known to be associated with bacteremia or endocarditis risk. Because a patient who developed acute bacterial endocarditis as a result of endometrial biopsy performed without antibiotic prophylaxis was encountered, 50 subsequent patients undergoing endometrial brushing and biopsy were studied and postprocedure bacteremia was found in four, all of whom were premenopausal. PMID- 3982744 TI - Association between mullerian duct malformations and Asherman syndrome in infertile women. AB - Mullerian duct malformations were found in 8% and Asherman syndrome in 4.8% of 537 infertile women undergoing hysterosalpingogram and/or hysteroscopy among 840 consecutive infertile couples evaluated. Among the 43 patients with mullerian duct malformations and the 26 with Asherman syndrome, seven had both mullerian duct malformations and Asherman syndrome (16 and 29%, respectively). This association was highly significant (P less than .005), especially for those patients with a septate uterus (P less than .001). Secondary infertility was present in 44% of the 840 infertile couples; 41% of the 537 women undergoing hysterosalpingogram and/or hysteroscopy and 44% of the patients with mullerian duct malformations versus 81% of those with Asherman syndrome (P less than .001). Prior reproductive performance was dismal for the patients with Asherman syndrome and/or mullerian duct malformations, and among all classes of mullerian duct malformations, and among all classes of mullerian duct malformations. The predisposing and causative factors leading to Asherman syndrome can be observed with mullerian duct malformations and a strong association in this population of infertile couples is reported for the first time. PMID- 3982746 TI - Postconception menses induction using prostaglandin vaginal suppositories. AB - Vaginal suppositories containing 15 methyl prostaglandin F2 alpha methyl ester in a high-melt base were administered to 60 women desiring early pregnancy interruption who were no more than 56 days' (eight weeks) pregnant as calculated from the first day of the last regular menstrual period (LMP). The purpose of this study was to evaluate the safety, efficacy, and patient acceptability of this mode of noninvasive early abortion. Some factors evaluated during the study included the time interval from insertion of the suppository to the onset of cramping and bleeding. Also measured were immediate and delayed blood loss, nausea, vomiting, and diarrhea. Of the 60 patients entered into the study, 55 procedures have been judged as successful by the prospective criteria set forth in the protocol. There were no deaths or serious complications. Four patients required hospitalization and follow-up dilatation and curettage (D&C). One patient withdrew from the study after receiving a suppository and subsequently delivered a preterm infant. PMID- 3982747 TI - Patient education in a women's hospital: attitudes of the medical and nursing staffs. AB - A survey was conducted among the medical and nursing staff of Prentice Women's Hospital in an attempt to examine attitudes toward patient education. Ninety-two percent of the obstetrician-gynecologists were surveyed, as were 81% of the nursing staff. Areas of evaluation included current practices at the hospital, attitudes toward patient education, principles of patient education, attitudes toward territorial imperative, perceptions of educational background, and perceptions of current role. Results indicate considerable disorganization in educational practices at the present time. Attitudes toward and understanding of principles of patient education did not differ between the two groups studied. However, there was strong disagreement in issues of patient ownership. Perceptions of educational training of, as well as current roles played by, each profession in educating the patient were highly polarized. The implications of such interprofessional conflict are discussed. PMID- 3982748 TI - Paratubal cysts: frequency, histogenesis, and associated clinical features. AB - A review of 79 cystic lesions found in the routine study of the fallopian tube and its surrounding areas between the years 1980 and 1982, revealed that the majority of the lesions represented accessory lumina of the fallopian tube. These tubal cysts commonly have been described as hydatids or parovarian cysts, but their relationship to the normal tube has not been identified clearly, their frequency has not been determined, their clinical significance rarely has been considered, and their embryologic origin remains imperfectly understood. PMID- 3982749 TI - Multifocal disease in the upper genital canal. AB - Multifocal disease, both benign and malignant, is seen commonly in the lower genital canal. Conversely, malignancies developing concomitantly in the uterus and ovary are frequently diagnosed as metastatic disease. In this series of 54 cases, the overall five-year survival was 72%, and 90% when the lesions were limited to the uterus and ovary, demonstrating that these lesions are multifocal and not metastatic. Furthermore, the frequency with which endometriosis is found in association with these malignancies dictates that the adjunctive therapy should probably be progesterone in most instances. PMID- 3982751 TI - Amniotic fluid infection with intact membranes in relation to stillborns. AB - The role of transamniotic fetal infection in the presence of intact membranes has attracted widespread attention. The present study is a reexamination of the autopsy material from 145 cases of macerated stillbirth observed in the National Maternity Hospital from 1979 to 1982. The objective was to ascertain the incidence of congenital pneumonia. No more than five cases were discovered, and in only two of these was there convincing evidence that the membranes were intact. The amniotic fluid infection syndrome seemed to be of little importance in the causation of late intrauterine death. PMID- 3982750 TI - Abdominopelvic computed tomography: evaluation in patients undergoing second-look laparotomy for ovarian carcinoma. AB - Preoperative abdominopelvic computed tomography results and operative findings were compared in 52 patients undergoing second-look laparotomy to confirm tumor status. Seventeen true-negative, 22 false-negative, and 13 true-positive scans were found. The sensitivity was 0.38, specificity was 1.0, and diagnostic accuracy was 0.58. Negative studies were associated with positive findings at laparotomy in 42% of all cases. Fourteen patients were identified who had computed tomography that would have enabled an attempt at the diagnosis of persistent cancer by computed tomography-directed needle aspiration or biopsy, thus avoiding laparotomy. Assuming 80% accuracy of needle aspiration, the cost of computed tomography in all 52 patients is considerably outweighed by the savings that could have been realized by eliminating the need for second-look surgery in these 11 women. PMID- 3982752 TI - Effect of work during pregnancy. AB - Obstetricians pay much attention to the diet and environment of the pregnant woman in prenatal care, but perhaps the woman's work also may affect pregnancy outcome. All women work in the home in addition to any work performed outside the home. The former component needs careful assessment; to get from home to work may be itself a stressful experience. In the workplace, women may encounter specific hazards of radiation or chemicals. More widespread are the problems of fatigue and boredom, which need careful assessment in relation to the outcome of pregnancy. These factors should be measured more precisely, thus allowing the physician to advise pregnant women better about the safe duration of work. Currently, advice tends to be overly cautious, as physicians are uncertain of the data on which such standards are based. PMID- 3982753 TI - Pregnancy complicated by homozygous hypercholesterolemia. AB - The course of pregnancy in a woman with homozygous type IIa hypercholesterolemia is described. Despite prepartum cholesterol levels as high as 700 mg/dL, her cholesterol level increased further during gestation. Pathological examination of the placenta did not reveal insufficiency or vasculopathy. PMID- 3982754 TI - Repair of vaginal prolapse and perineal hernia after pelvic exenteration. AB - Perineal hernias have been a significant complication of pelvic exenteration since the inception of this procedure. A variety of natural and artificial materials have been used to support the small bowel to prevent its descent into the lower pelvis with subsequent hernia and fistula formation. More recently, neovagina construction using gracilis myocutaneous flaps has provided both sexual function and support for the small bowel. A patient is presented who had prolapse of her neovagina and a perineal hernia 12 months after exenterative surgery. A technique to repair this complication is described, and a possible method of preventing it is discussed. PMID- 3982755 TI - Pelvic fibromatosis: an unusual gynecologic tumor. AB - Pelvic fibromatoses are only unusually encountered in gynecologic practice, but then consistently create a diagnostic and therapeutic challenge. The reported patient typifies the difficulties encountered in surgical excision. A discussion of theories of etiology and management options follows. PMID- 3982757 TI - Cervical cancer after negative Papanicolaou smears. PMID- 3982756 TI - Consolidation of hospital obstetric services. PMID- 3982758 TI - Maternal deaths in the United States by size of hospital. PMID- 3982759 TI - Despite pre-emption threat local right-to-know laws increase. PMID- 3982760 TI - Documentation: the weak link in audiometric monitoring programs. PMID- 3982761 TI - Cooperative programs cutting costs, accidents in construction. PMID- 3982762 TI - Is cost-effectiveness replacing quality as medical care priority? PMID- 3982763 TI - Providing replacement air necessary for ventilation systems. PMID- 3982764 TI - Smokers', nonsmokers' rights collide in the work environment. PMID- 3982766 TI - Hospice and acute care have place in treating terminally ill. PMID- 3982765 TI - Revival of house calls essential to improving health care practices. PMID- 3982767 TI - Regional poison centers: helpful resources for businesses. PMID- 3982768 TI - Health management consultants use diverse programs in achieving goals. PMID- 3982770 TI - Treating the heart patient: what's new? PMID- 3982769 TI - Using NIOSH lifting guide decreases risks of back injuries. PMID- 3982772 TI - Ethics in the eighties: contrasts and conflicts. PMID- 3982771 TI - Chemical dependency: a treatable disease. PMID- 3982773 TI - Ohio's environment: how safe is it? PMID- 3982774 TI - Acid rain: a threat to community health. PMID- 3982775 TI - Environmental viruses--can they be stopped? PMID- 3982776 TI - Nuclear medicine: how medicine is handling its own hazardous wastes. PMID- 3982777 TI - Earth's final hazard. PMID- 3982778 TI - The environment--another perspective. PMID- 3982779 TI - Osteoporosis in primary care. PMID- 3982780 TI - In vivo color analysis of human crystalline lenses. AB - Indirect measurement in vivo of nuclear color of 64 cataractous eyes was made using a method of image analysis of photographed lenses developed by the authors. The grade of yellow of lens color was characterized by its dominant wavelength and excitation purity in the CIE chromaticity diagram. The differences were small between nuclear color observed from in vivo and in vitro photographs. PMID- 3982781 TI - Disparate effects of calmodulin inhibitors on corneal epithelial migration in rabbit and rat. AB - We investigated the effects of two calmodulin inhibitors, trifluoperazine and N-6 aminohexyl-5-chloro-1-naphthalenesulfonamide, on corneal epithelial wound closure in rabbits and rats. Measured, round epithelial defects were made on corneas by gentle scraping. After 20 h in organ culture with or without inhibitor, the remaining wound area was measured and samples were fixed for microscopy. In the rabbit, these inhibitors had little or no effect on the rate of wound coverage. In the rat, however, both trifluoperazine (3-40 microM) and N-6-aminohexyl-5 chloro-1-naphthalenesulfonamide (10-100 microM) inhibited wound closure in a dose dependent manner. Thus we believe that calmodulin plays a crucial role in epithelial migration in the rat. In the rabbit, there seems to exist a mechanism that is not critically dependent upon an intact calmodulin pathway. PMID- 3982782 TI - Colloidal carbon as a combined ophthalmoscopic and microscopic probe of retinal and choroidal vascular integrity. AB - While studying an experimental retinal immunopathy, we searched for a vascular tracer that would permit us to test the anatomical and functional status of retinal and choroidal vessels by ophthalmoscopy, light microscopy, and electron microscopy in the same eye. We found that colloidal carbon, administered intravenously, can be seen ophthalmoscopically in the choroidal and retinal circulations, and abnormal deposits of it can be visualized in vivo. The ophthalmoscopic findings can be corroborated and extended by stereomicroscopy, and later the same specimens can be used for light and transmission electron microscopical studies. This tracer, thus, would allow the correlation of the ophthalmoscopic appearance of a clinical lesion with its histological and ultrastructural substrata. PMID- 3982783 TI - Intraocular lenses, tilt and astigmatism. AB - Concern has been expressed in the literature regarding the frequency and amount of astigmatism found in patients with intraocular lens implants. Postoperative tilting of the implants is one suggested cause. We have measured the effect of tilt on focal length in lenses supplied by two companies. The method used involved photographing the refractive effect of lenses on fine parallel laser beams as the lenses were tilted to varying degrees. The results show that: (a) drastic tilting (e.g. 20 degrees) is required to produce significant amounts of variation in focal length, (b) the effect on back vertex power is more important, (c) spherical aberration of the lenses is minimized. PMID- 3982784 TI - Morphological study on the human developing vitreous collagen fibrils and persistent hyperplastic primary vitreous. AB - The human primary vitreous fibrils were similar to the secondary vitreous fibrils on electron microscopic observation. On the other hand, the intravitreal strand in a persistent hyperplastic primary vitreous (PHPV) contained large numbers of collagenous fibrils with 40-50 nm diameters and about 65 nm cross-striation periodicity. Besides these, other types of noncross-striated fibrils, ranging in diameter from 10 to 30 nm were observed in the circumferential region of the intravitreal strand. Moreover, there was complete morphological continuation between the intravitreal strand and the optic disc. Their histochemical properties were very likely collagenous and in part glial. Although the results are based only on 1 case of PHPV, present observations showed that components of the intravitreal strand of PHPV considerably differed from the primary vitreous. PMID- 3982785 TI - New approach to area image analysis of Scheimpflug photos of the anterior eye segment. AB - Based on the Scheimpflug principle, the rotating photo slitlamp Topcon SL 45 can produce photos of a high depth of focus from a slit beam through the anterior eye segment. The Scheimpflug photos are digitized with a special semiconductor camera. A new method, using the digital picture subtraction, is presented. This method is suited for experimental and clinical studies dealing with the development of the lens opacities. PMID- 3982786 TI - Pharmacological study on the effects of some ocular hypotensive drugs on aqueous humor formation in the arterially perfused enucleated rabbit eye. AB - The effects of pilocarpine, isoproterenol, epinephrine, timolol, acetazolamide, ouabain, and dinitrophenol on aqueous humor production were investigated in enucleated rabbit eye. The metabolic inhibitors ouabain and dinitrophenol at a concentration of 10(-5) M produced a 50% inhibition in aqueous humor formation. Acetazolamide at the same concentration was without effect, but at 10(-4) M concentration lowered aqueous production by 40%. The autonomic drugs epinephrine and isoproteranol at a concentration of 10 micrograms/ml medium reduced aqueous humor formation by 64 and 52% respectively. Timolol, even at a concentration of 0.05 microgram/ml, suppressed aqueous humor formation by approximately 30%. Pilocarpine on the other hand was ineffective. Except for pilocarpine, these responses are similar to those reported to occur in the cat both in vivo and in vitro. PMID- 3982787 TI - Quantitative assessment of ocular norepinephrine concentration in the rabbit using liquid chromatography with electrochemical detection. AB - An assay technique that utilizes liquid chromatography with electrochemical detection to determine the norepinephrine (NE) concentration of the rabbit aqueous humor (AH) and iris-ciliary body (ICB) is discussed. NE concentration was monitored in control preparations as well as in experiments involving stimulation of the cervical sympathetic nerve (CSN) or 24 h following extirpation of the superior cervical ganglion. In 15 control rabbits, the baseline AH NE concentration was determined to be 7.2 and 7.8 ng/ml in the left and right eyes, respectively. Prolonged unilateral electrical stimulation of the CSN increased the AH NE concentration to 59.0 +/- 1.2 ng/ml on the stimulated side. Pretreatment with cocaine (12.5 mg/kg) and subsequent stimulation of the CSN increased the NE in the AH to 93.7 +/- 1.3 ng/ml on the stimulated side, and raised the baseline AH NE of the control (non-stimulated) side to 25.9 +/- 5.0 ng/ml. The baseline concentration of NE in the ICB was 5.4 +/- 0.8 micrograms/g. 24 h after a unilateral removal of the superior cervical ganglion, the NE content of the ICB was depleted by more than 90% in the ganglionectomized eye with no apparent change in the level of NE in the AH. The accurate analysis of catecholamines in the AH, ICB and other parts of the eye may be useful in providing information as to the extent of innervation and the possible role of sympathetic nerve supply in the overall control of AH dynamics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982788 TI - Effect of pilocarpine in ocular hypotension. AB - In patients with normal intraocular pressure (IOP), local ocular application of pilocarpine causes IOP elevation, reaching a maximum at 10-20 min, and a subsequent prolonged fall of IOP below the baseline. We have studied the effect of pilocarpine in normal subjects with low baseline IOP (less than 10 mm Hg). The initial rise was larger than in normotensive controls (21 vs. 12%) and the subsequent fall was of similar relative magnitude (20%) as that of normotensives. Lower baseline IOP values were associated with greater initial rises and smaller subsequent falls. The mechanisms that may explain the two phases of IOP response to the administration of pilocarpine are discussed. PMID- 3982789 TI - In vivo assessment of lens transmission for blue-green light by autofluorescence measurement. AB - A simple quantitative and reproducible method for evaluating lens transmission (lambda = 490 and 530 nm) is described. It is based on the measurement of autofluorescence in the anterior and the posterior part of the lens by means of a fluorophotometer, assuming an about equal fluorescence quantum efficiency in both parts. Consequently any difference in fluorescence between both parts can be attributed to a loss of exciting and fluorescent light in the lens. For both wavelengths, the average lens transmission is determined by this method in a normal population as a function of age. PMID- 3982790 TI - Monitoring lens transparency during in vitro incubation by Scheimpflug photography and densitometric image analysis. AB - Dragomirescu et al. [1983] described a 2-chamber flow system for the incubation of lenses with an inserted photometer to measure changes in lens transparency. Mester et al. [1984] applied the method to simulate conditions occurring during vitrectomy, which occasionally leads to reversible lens opacification. Using Scheimpflug photography (a modified SL 45 Topcon camera) instead of the transmission measurements of incubated lenses has the advantage that disorders in lens transparency can be exactly localized and the sensitivity is much higher than the photometer readings. Application of Scheimpflug photography required a modification of the incubation chamber. The application of the experimental set up was demonstrated with pig lenses under various incubation conditions. The results obtained by densitometric image analysis of Scheimpflug photos were compared with transmission measurements by photometer. PMID- 3982791 TI - Calcium dobesilate in diabetic retinopathy. A retrospective controlled study. AB - The effect of calcium dobesilate (Doxium) therapy on the evolution of diabetic retinopathy has been assessed in a retrospective study. 54 patients with diabetic retinopathy received calcium dobesilate (average 650 mg/day) for 6-30 months (average 18 months) and were compared to a correspondingly selected control group. The patients were divided into three subgroups (mild, moderate, and severe diabetic retinopathy). Microaneurysms, blot hemorrhages, striate hemorrhages, and hard exudates were assessed semiquantitatively from panorama fundus photographs, using a scoring system. The effect of calcium dobesilate was statistically significant for cases with moderate background diabetic retinopathy on summing up the scores of the various retinal lesions. There was no favorable effect on diabetic maculopathy or visual acuity. In the proliferative stages of diabetic retinopathy, photocoagulation is offering, in the majority of cases, the only chance to slow down the progression of this disease; however, drug therapy might be beneficial in nonproliferative diabetic retinopathy. PMID- 3982792 TI - [Association of an epithelial dermoid with alopecia and a sebaceous verrucose nevus: hologynic hereditary malformations]. AB - The association of alopecia with a sebaceous verrucose nevus and an epibulbar lipodermoid is a rare condition (8 cases reported in the literature). Only girls suffer from this disease; this suggests a hologynic heredity, as in the case of Aicardi's syndrome. The authors present a new observation of a 7-year-old girl who exhibits all the characteristics of this new syndrome. PMID- 3982793 TI - [Corneal pathology in Crohn's disease: electron microscopic study of a case]. AB - Corneal pathology in Crohn's disease is relatively rare. We had the opportunity to take a biopsy of a bullous mass in the cornea of a man with Crohn's disease. Analysis of electronic pictures shows an aberrant structure of the nucleus, a very dense nuclear membrane and fragmented nucleoles. The cytoplasm contains many patches without membrane; the basal membrane is composed of filaments, and the stroma possesses figures of fingerprint-type. This unclassified description of the cornea might be typical for Crohn's disease. PMID- 3982794 TI - Fluorescein angiography in inflammation of the peripheral fundus: the normal fluorescein angiographic pattern. I. AB - The normal angiographic pattern of the peripheral vasculature was studied in 25 healthy individuals. There was no pathologic leakage of dye from the choroid or retina. However, small areas of choroidal nonperfusion occurred even in young persons. Vessels which never filled with fluorescein represented a common feature of the peripheral retinal vasculature. As a rule, pars plana corporis ciliaris did not stain with dye during the whole angiogram. PMID- 3982795 TI - Primary meningioma of the optic nerve sheaths: case report. PMID- 3982796 TI - [Fibrous dysplasia of the osseous orbita with 'neuritis retrobulbaris']. PMID- 3982797 TI - Ocular tension: comparison between the two eyes. AB - We have compared IOP values in the two eyes in 13,000 presumably healthy subjects over the age of 40 years. The mean difference in ocular tension between the two eyes was 0.12 mm Hg (higher on the left), which is statistically significant but probably without physiological implications. Individual cases with delta IOP of 3 mm Hg or more were observed more frequently in older age groups and in subjects with elevated IOP values, and should arouse suspicion of incipient glaucoma. PMID- 3982798 TI - Excimer laser radial keratotomy. AB - The central corneal flattening obtained by radial diamond knife incisions has been duplicated by radial laser incisions in 18 enucleated human eyes. The incisions, made by 193 nm far-ultraviolet light radiation emitted by the excimer laser, produced corneal flattening ranging from 0.12 to 5.35 diopters. Both the depth of the corneal incisions and the degree of central corneal flattening correlated with the laser energy applied. Histopathology revealed the remarkably smooth edges of the laser incisions. PMID- 3982799 TI - Neodymium: YAG lasers. An FDA report. AB - Analysis of data from four neodymium:YAG laser manufacturers submitted to the Food and Drug Administration (FDA) on over 17,000 cases indicate the procedure is safe and effective for cutting opaque posterior lens capsules. A successful opening in the pupillary membrane was achieved in 98% of the cases, and vision improved in 84% of the cases. Clinically significant risks include: a rise in intraocular pressure two to four hours after treatment, damage to the intraocular lens, and rupture of the anterior hyaloid face. PMID- 3982800 TI - Clinical evaluation of fibronectin eyedrops on epithelial disorders after herpetic keratitis. AB - The clinical efficacy was investigated of fibronectin eyedrops on the nonhealing corneal epithelial defect after herpetic keratitis. Fibronectin eyedrops were prepared from the patient's own blood plasma by an affinity chromatography using gelatin-coupled agarose gel and by gel filtration technique. Twenty eyes with metaherpetic trophic ulcer with persistent epithelial defect that had not responded to conventional therapy were treated by the instillation of fibronectin eyedrops 6 times a day. The mean +/- standard deviation duration of epithelial defect was 61.5 +/- 66.1 days. The epithelial defects healed within 15.6 +/- 12.4 days. These results suggest that fibronectin eyedrops are a possible effective therapeutic approach in nonhealing corneal epithelial defect after herpetic keratitis. PMID- 3982801 TI - Familial band-shaped nodular keratopathy. AB - A family is reported in which two brothers have a bilateral, symmetrical corneal disorder characterized by small yellowish to amber-colored globules arranged in a band-shaped configuration in the central superficial layers of the cornea. The globules have a similar clinical appearance to those found in Bietti's "band shaped nodular dystrophy," a keratopathy that is nonfamilial, has an onset later in life, and initially involves the peripheral cornea. Light and electron microscopic studies of corneal tissue obtained from the proband showed that the globular deposits autofluoresce, that they stain black with Verhoeff's elastic stain, and that they correspond to an electron-dense material found within corneal epithelial cells and keratocytes and within the extracellular tissues of the anterior cornea. A third, younger brother appears to have the early corneal signs of the condition. Unlike the condition described by Bietti, the keratopathy we report is unique in its familial nature, early onset in life, and initial, marked central corneal involvement. PMID- 3982802 TI - Bulbar conjunctival follicles associated with dipivefrin therapy. AB - Large bulbar conjunctival follicles developed in 12 patients who received dipivefrin therapy for prolonged periods in the management of chronic open-angle glaucoma. In four patients, the follicles encircled the limbus. Although several of the patients were taking other drugs, the follicles disappeared within one month of discontinuing only the dipivefrin therapy. Therapy was switched to epinephryl borate in some patients and to other forms of therapy in others, without incident. The clinical course, the Giemsa staining of conjunctival scrapings, the conjunctival biopsy, and the results of patch tests suggest that this is an irritant reaction to dipivefrin rather than a reaction to preservatives or an allergic reaction. PMID- 3982803 TI - Pupillary abnormalities induced by argon laser photocoagulation. AB - Twenty-two patients who underwent panretinal argon laser ablation for proliferative diabetic retinopathy were studied for post-laser pupillary abnormalities. All 22 patients developed sector palsies of the iris sphincter. Fifteen demonstrated supersensitivity to 0.125% pilocarpine in the treated eye. Four of 12 patients developed accommodative paresis in the treated eye. Six showed light near dissociation in the treated eye. The sector palsies and associated cholinergic supersensitivity of the iris sphincter, the accommodative paresis, and light near dissociation imply that the laser treatment damaged the ocular parasympathetic innervation. PMID- 3982804 TI - Ptosis and cataract surgery. A multivariant computer analysis of a prospective study. AB - A prospective study investigated the effect of local anesthesia, eyelid edema and superior rectus muscle injury on postoperative ptosis. Patients were randomized into four groups to study these effects. Group A received a Van Lint eyelid block and a superior rectus bridle suture. Group B received a Van Lint block and an episcleral retraction suture. Group C received a Nadbath retroauricular facial nerve block and a superior rectus bridle suture. Group D received a Nadbath block and an episcleral retraction suture. Results of the study indicate that postoperative ptosis can be significantly reduced by varying our operative techniques. Postoperative ptosis was significantly increased in group A and reduced in group D. It appears that trauma to the superior rectus muscle complex is the most critical factor in postoperative ptosis. Fifty five and one-half percent of the population entered the study with preoperative ptosis. Preoperative ptosis had no effect on postoperative ptosis. Lid crease, superior sulcus fullness and lash rotation are poor anatomical landmarks of levator insertion in the elderly population, both preoperatively and postoperatively. PMID- 3982805 TI - Neuroretinitis in acquired syphilis. AB - Syphilitic disease of the retina and/or the optic nerve head, without choroidal involvement, occurred in our 4 cases and in another 19 cases. The condition almost always takes place in the secondary stage, frequently associated with meningitis, and rarely in tertiary meningovascular syphilis. Fluctuating visual loss and floating spots without ocular pain are the presenting symptoms. Retinitis, papillitis, and neuroretinitis are accompanied by an inflammatory reaction in the vitreous and, sometimes, in the aqueous. Paracentral scotomas and blind spot enlargement, related with posterior pole and papillary edema, are the most usual visual field defects. Almost complete visual recovery is the rule in the treated cases, although in some instances cystoid macular edema and retinal ischemia due to endarteritis cause permanent visual loss. Treatment with crystalline penicillin is mandatory in patients with concomitant neurosyphilis, whereas procaine penicillin is seemingly sufficient in those with a normal cerebral spinal fluid examination. PMID- 3982806 TI - Retinal histopathology of a carrier of X-chromosome-linked retinitis pigmentosa. AB - Autopsy eyes were examined from a 79-year-old female carrier of X-chromosome linked retinitis pigmentosa. At age 78 years, she had no visual symptoms but had intraretinal bone spicule pigmentation in the nasal and inferior periphery of both eyes. Rods, cones, and pigment epithelium in the central retina appeared normal. In the midperiphery, patches with advanced photoreceptor cell degeneration were observed overlying pigment epithelium containing melanolysosomes. Within these patches, rods and cones were reduced in number or absent, and pigment epithelial cells abutted the external limiting membrane. A precipitous decline in rod nuclei was observed in transitional zones between areas of apparently normal photoreceptors and areas of absent photoreceptors. In the far periphery, large areas lacked photoreceptors and pigment epithelium. Histopathologic findings in this elderly carrier are compared with those previously described in a 24-year-old man with X-chromosome-linked retinitis pigmentosa. PMID- 3982807 TI - Temporalis muscle transfer: a vascular bed for autogenous dermis-fat orbital implantation. AB - Nine patients with contracted avascular sockets who were unable to wear prostheses, and whose prospects for maintaining viable autogenous dermis-fat grafts were diminished, underwent temporalis muscle transfer into the orbit through a window in the lateral orbital wall. The temporalis transposition was used as a vascular bed for dermis-fat orbital implantation. Postoperatively, seven of nine patients were able to wear satisfactory prostheses and four of nine patients had amelioration of their superior sulcus deformities. PMID- 3982808 TI - Pigmented free-floating vitreous cysts in two young adults. Electron microscopic observations. AB - Pigmented free-floating vitreous cysts were observed in two young adults. In both patients, the cyst was in the visual axis; however, the size and extent of pigmentation of the cyst wall compromised the visual acuity only in case 1. In this case, the vitreous cyst was aspirated through the pars plana and studied by light and electron microscopy. Histopathologically, the cyst was lined by a heavily pigmented layer of cuboidal cells intermixed with sheets of nonpigmented cells forming papillae. Ultrastructurally, the pigmented cells contained predominantly large, mature melanosomes (0.9-2.2 micron). Scattered immature melanosomes with a scarcity of mitochondria and other cytoplasmic organelles were present. Additionally, the cells were invested by a thin polarized basement membrane and displayed apical microvilli. Numerous microvillous processes were noted under the plasmalemmae and between adjacent cells. The results of the light and ultrastructural studies provide support for the hypothesis that the cyst in case 1 originated from the pigment epithelium. The possibility of a traumatic etiology is proposed for these pigmented vitreous cysts. If significant visual impairment is present, surgical removal of the cyst through a pars plana approach can be safely performed as in our case 1. PMID- 3982809 TI - Enucleation-as-cause-of-metastasis theory in choroidal melanomas. PMID- 3982810 TI - Argon laser destruction of anterior chamber implantation cysts. PMID- 3982811 TI - Formation and maturation of the vestibular ganglion. AB - The morphologic development of the vestibular ganglia with their peripheral neuronal connections was followed from terminal mitosis until the adult stage (CBA/CBA mouse). Schwann cells enclose vestibular ganglion cells and their peripheral nerve fibres already on the 15th-16th gestational days. The morphological basis for at least some physiological activity is present already before birth. As compared with the spiral ganglion, the vestibular ganglion and its peripheral pathways become mature as much as 5-7 days earlier. An adult morphology is reached during the first postnatal week. PMID- 3982812 TI - Low ototoxicity and its mechanism of netilmicin. AB - The ototoxicity and nephrotoxicity of netilmicin were compared with those of dibekacin, kanamycin and amikacin using rabbits. Groups of 5 rabbits each were given doses of 50 or 100 mg/kg of either one of the four drugs for 30 days, and 10 days after the last injection, all animals were prepared for histopathological studies. Results show the least ototoxicity of netilmicin in comparison to the other three antibiotics. It has been concluded that the low ototoxicity of netilmicin is due not to its lack of accumulation in the perilymph but to its low toxicity to the hair cells. PMID- 3982813 TI - Brain stem auditory evoked potentials in patients with the lateral medullary (Wallenberg's) syndrome. AB - The purpose of this study is to investigate the diagnostic value of using brain stem auditory evoked potentials (BSEP) in patients with the lateral medullary (Wallenberg's) syndrome. The observed changes included: prolongation of the interpeak latency intervals from wave I to V and III to V; prolongation of the interaural latency difference for wave V; splitting or absence of wave III, and the presence of a broad partly fused wave III-V complex. The present study showed that BSEP can be used to confirm the diagnosis of this syndrome and ascertain the site of the lesion. PMID- 3982814 TI - Effect of atropine on the eustachian tube function. AB - The effect of atropine on the eustachian tube function was studied by means of a recently designed method. The results out of 20 examined ears showed that atropine significantly reduced both active and passive functions of the eustachian tube. The findings are discussed and it is concluded that the method used might be a valuable tool in forthcoming studies of pharmacological effects on the eustachian tube function. PMID- 3982815 TI - [The ouabain-sensitive Na-K pump in children with essential hypertension]. PMID- 3982816 TI - [Laboratory diagnosis of Zollinger-Ellison syndrome]. PMID- 3982817 TI - [Differentiation between glomerular and non-glomerular hematuria based on the morphologic study of erythrocytes excreted in the urine]. PMID- 3982819 TI - [Successfully treated oxprenolol (Trasicor) poisoning]. PMID- 3982818 TI - [Current questions concerning polytraumatization]. PMID- 3982820 TI - [Cardiac manifestations of Boeck's sarcoidosis]. PMID- 3982821 TI - [Reconvalescence in early childhood]. PMID- 3982823 TI - [Objectivity as a quality criterion in the control of development in maternal counseling]. PMID- 3982822 TI - [Significant factors influencing fitness of 1-year-old children for day care centers at the time of their adaptation phase]. PMID- 3982824 TI - [Theoretical and practical aspects of health protection for children and adolescents in East Germany]. PMID- 3982825 TI - [Effect of changed environmental conditions in the full-time pedagogic process on the health and ability of class 1 children in public facilities of education and child rearing]. PMID- 3982826 TI - [Health status of students in classes 1-10]. PMID- 3982827 TI - [Health status of early school dropouts]. PMID- 3982828 TI - [Theoretical aspects of the assessment of ability and fitness within the scope of the evaluation of the individual health status of adolescent workers]. PMID- 3982829 TI - [Initial results of experimental studies on the determination of continuous work physiology performance limit of adolescents]. PMID- 3982830 TI - [Results of a cross-sectional study on the physical development of adolescent workers]. PMID- 3982831 TI - [New occupation-related information material for students with health-induced limitations in work fitness]. PMID- 3982832 TI - [Evaluation of risk factors in the standard examination of adolescents]. PMID- 3982833 TI - [Evaluation of health and ability of the young generation]. PMID- 3982834 TI - Spatial summation of pre-pain and pain in human teeth. AB - The purpose of this work was to investigate the relation between the sensations of pain and 'pre-pain' evoked by stimulation of teeth in human subjects. Electrical pulses of progressively increasing amplitude, generated by a computer controlled stimulator, were applied to 1 or 2 teeth, and the subjects responded by indicating the nature of the resulting sensation. Pre-pain and pain could be readily and rapidly distinguished by all 11 subjects (response latency about 0.4 sec). Both sensations had stable thresholds with relatively small variance (S.D. 10-15% of threshold value) for a given subject. Subjects characterized the stimuli as indifferent or unpleasant, localized, and brief. By using special stimulation strategies (termed 'optimal trajectories') for exciting 2 teeth simultaneously, spatial summation for pre-pain was demonstrated in most subjects and for pain in almost all subjects. Spatial summation of pre-pain resulted in pain rather than in more intense pre-pain. These results are consistent with both the dual modality (separate afferent fibers for pre-pain and pain) and the single modality hypotheses (single type of afferent fibers) of tooth pulp sensibility, but favor single modality innervation. PMID- 3982835 TI - Responses of single cutaneous fibers to noxious thermal pulse stimulation of cat upper hind limb. AB - Previous experiments have shown that cats respond to noxious thermal pulse stimulation of the upper hind limb at an average latency of 2.3 sec. To determine if C fiber afferents could mediate this response, we recorded the response latency and threshold of single fibers of cat femoral cutaneous nerve to the same stimuli used in the behavioral experiments. Of 28 C fibers tested, 10 (36%) responded to heating; 4 (17%) of 24 fibers with conduction velocities of 2.5-30 m/sec responded to heat. All fibers but one discharged within 1.0 sec of thermal pulse onset (median: 800 msec) at an average and median threshold of 46 degrees C. Thermal nociceptors with C fiber afferents could mediate the initiation of behavioral nocifensive responses to heat in the cat. PMID- 3982836 TI - Sympathetic vasomotor changes induced by manual and electrical acupuncture of the Hoku point visualized by thermography. AB - Considerable evidence implicates sympathetic neural activity in acupuncture analgesia. However, the exact nature of these effects has not been specified in detail, and many experimental findings are contradictory. This study evaluated in normal conditions the specific sympathetic effects of both manual and electrical acupuncture applied to the same hand (Hoku) point. Thermographic measures of superficial skin temperature were used to assess sympathetic vasomotor tone in the face, hand and foot of 19 normal subjects. Baseline assessment, manual acupuncture and electrical acupuncture were performed in 3 separate sessions in a well controlled, 23 degrees C environment. Superficial skin temperature decreased slowly in the control condition. Both manual and electrical acupuncture produced a generalized long-lasting warming effect, indicating reduced sympathetic activity (sympatholytic effect). In addition, electrical acupuncture induced a localized short-term cooling effect, indicating a transient segmental increase in sympathetic activity (sympathomimetic effect). PMID- 3982837 TI - The effects of acupuncture versus placebo in the treatment of headache. AB - Forty-eight patients were entered into a placebo (mock TNS) versus acupuncture study to assess the effect of these therapies on headache. Treatment was evaluated by the use of patient diaries; each patient completed a daily diary for 4 weeks prior to treatment during 6 weeks of therapy and for 24 weeks of follow up. Thirty-nine patients completed treatment and follow-up. At most acupuncture appears to be approximately 20% more effective than a placebo in alleviating headache but no statistically significant difference between these two treatments could be demonstrated. The implications of this result particularly with respect to determining treatment success and study method employed are discussed. PMID- 3982838 TI - A comparison of phantom sensations among amputees whose amputations were of civilian and military origins. AB - 436 people experiencing phantom limb pain, whose amputations were unrelated to military service, filled out a survey concerning stump, phantom and other pain problems as well as demographic data. Their responses were compared with responses of American veterans, whose amputations were related to military service, who filled out an identical survey. The experiences of the two groups and the characteristics of the reported phantom sensations were remarkably similar. Treatment effectiveness was equally dismal for both groups with about 1% reporting effective relief. PMID- 3982839 TI - Observations on facial nociception in a monkey after destruction of the rostral part of the trigeminal sensory nuclear complex. AB - Facial sensibility was assessed in a cynomolgus monkey in whom the trigeminal main sensory nucleus and the rostral part of the trigeminal nucleus oralis on one side had been destroyed. The animal responded equally to noxious mechanical stimuli applied to the two sides of the face; no deficiency in nociception could be detected. This finding suggests that the synaptic connections made by nociceptor afferents from the face in rostral parts of the trigeminal sensory nuclear complex are not essential for facial nociception. These observations are also consistent with the opinion that, from a functional point of view, facial nociceptor afferents have their principal synaptic connections in the nucleus caudalis of the trigeminal spinal complex. PMID- 3982840 TI - The effects of persistent pain: the chronic headache sufferer. AB - A survey of the psychological characteristics of a large sample of chronic headache cases (n = 360), including classical and common migraine and tension headache sufferers, was carried out. Comparing groups defined in terms of the chronicity of their headache problems, it was found that those with a longer history of headache had a higher level of behavioural disruption and a stronger bond between pain experience, and both complaint levels and behavioural avoidance patterns. Despite the common somatic components (sleep disturbance, fatigue, irritability, etc.), depression was not found to be elevated in this chronic pain group. In addition, there was no evidence of depression levels being higher in the populations who had had a longer history of headache problems. Higher levels of complaint were found in those with higher depression and higher extroversion and neuroticism scores. Behavioural avoidance was significantly related to the emotional reaction component of pain. The implications of these findings with respect to the development of chronic headache are discussed. PMID- 3982841 TI - An evaluation of length and end-phrase of visual analogue scales in dental pain. AB - Visual analogue scales (VAS) of different lengths (5, 10, 15 and 20 cm) and with different end-phrases (troublesome, miserable, intense, unbearable and worst pain imaginable) were used to record pain in 50 male and 50 female patients with pulpitis or pericoronitis. All 100 patients successfully completed the questionnaire. High correlation was found between the scores on all the scales. Scales of length 10 or 15 cm had the smallest measurement error. The scale with the end-phrase 'worst pain imaginable' was found to be the best choice for comparing present pain or worst pain between different groups. Using this scale no significant difference was found between the scores of males and females or between those of patients with pulpitis and pericoronitis. This study suggests the use of 10 cm visual analogue scales with the end-phrase 'worst pain imaginable' as being the most suitable for measuring dental pain. PMID- 3982842 TI - Memory of dental pain. AB - The possibility that patients' memory for acute pain is reconstructed over time was tested by comparing the degree of pain remembered 3 months after a dental appointment with both expected and experienced pain, as reported immediately before and after the appointment. As hypothesised, there was a closer association between remembered and expected pain than between remembered and experienced pain, particularly for those patients who scored high on the Dental Anxiety Scale. These results suggest that the accuracy of patients' reports of pain experienced in the past may be suspect, and that dental anxiety may be slow to extinguish because the discrepancy between expected and experienced pain felt at one appointment may not be recalled accurately by anxious patients at their next appointment. PMID- 3982843 TI - Traumatic paraplegia in Algeria: orientation of early management. PMID- 3982844 TI - Evaluation of different methods of bladder drainage used in the early care of spinal cord injury patients. AB - In a series of 115 spinal cord injury patients four different methods of bladder drainage were used mainly during spinal shock. That is a) suprapubic fine bore cystostomy, b), indwelling Foley catheter, c) intermittent catheterisation; and d) both last methods consecutively. The methods of bladder drainage used did not influence the number of patients becoming catheterfree but determined significantly the length of period before patients became catheterfree. Patients on intermittent catheterisation had the shortest time from injury to established micturition. Patients on intermittent catheterisation and on cystostomy had few complications but in those patients treated with an indwelling Foley catheter the complication rate was high. PMID- 3982845 TI - New trends in surgical stabilization of thoraco-lumbar spinal fractures with emphasis for sublaminar wiring. AB - Sixteen patients with unstable thoracic and lumbar spinal fractures and fracture dislocations were treated surgically by contoured Harrington instrumentation and spinal fusion. Instrumentation was supplemented by sublaminar wires above and below the level of injury. Complications occurred in ten patients. All had solid fusion at follow-up. No loss of reduction occurred. Fourteen patients had a Fewett hyperextension brace post-operatively, and two had no immobilization. PMID- 3982846 TI - Temporal course of motor recovery after Brown-Sequard spinal cord injuries. AB - Recovery of voluntary motor function after incomplete spinal cord injuries is attributed to a variety of physiological mechanisms, such as resolution of conduction block in injured axons, and neuroplasticity mechanisms in spared axons. To better understand these recovery mechanisms, we have examined motor recovery in one type of incomplete cord injury, the Brown-Sequard Syndrome. This syndrome is observed in patients with unilateral injury of the spinal cord and is manifested as asymmetric weakness and pain/temperature sensory loss contralateral to the weakest extremity. We have followed the course of motor recovery in two patients and reviewed the literature in an additional 59. Common features of this motor recovery include: 1) recovery of ipsilateral proximal extensor muscles before ipsilateral distal flexors, 2) recovery of any weakness in the extremity with pain/temperature sensory loss before the opposite extremity, and 3) recovery of voluntary motor strength and a functional gait by 1 to 6 months. We discuss these observations with respect to three hypotheses to explain motor recovery and suggest that neuroplasticity mechanisms functioning in spared descending axons may mediate much of the observed recovery after Brown-Sequard cord lesions. PMID- 3982847 TI - Gentamicin disposition kinetics in humans with spinal cord injury. AB - The disposition kinetics of gentamicin, an aminoglycoside antibiotic, were studied in seven tetraplegic and six paraplegic volunteers. The volume of distribution of gentamicin in l/kg of body weight varied in a statistically significant way from values of this parameter measured in normal subjects. The elimination of gentamicin in spinal man proceeded in a log-linear fashion accurately characterized by a one compartment open-model with a half-life of approximately 2 hours. The clinical significance of altered disposition kinetics and an increased intersubject variability in gentamicin disposition in spinal man as compared to normal subjects is unknown. The existence of these observed differences in pharmacokinetic parameters, however, emphasizes the need to define individual pharmacokinetic profiles and individualize dosing regimens in spinal man. The data presented are supportive of the hypothesis that spinal man constitutes a discreet therapeutic population. PMID- 3982848 TI - A balanced viewpoint in the early management of patients with spinal injuries who have neurological damage. PMID- 3982849 TI - Attempts to induce resistance to Schistosoma mansoni and S. haematobium in Kenyan baboons (Papio anubis) using non-specific immunostimulants. AB - Non-specific immunostimulants were used in an attempt to protect baboons from infection by schistosomes. Subcutaneous vaccination with cord factor (4.50 mg) and muramyl dipeptide (4.56 mg) 6 days before percutaneous exposure to 3000 Schistosoma haematobium cercariae/baboon (c.p.b.) failed to protect naive baboons: baboons with a 7-month-old, 5000 c.p.b. S. haematobium primary infection had developed too strong a natural immunity to detect any protection attributable to vaccination. Subcutaneous vaccination with 0.4 ml of Bacillus Calmette-Guerin (BCG, 1-8 X 10(8) colony forming units/ml) 4 days before exposure to 1000 c.p.b. S. mansoni gave a significant (38%) reduction in worm load compared with controls. However, vaccination with 0.8 (intramuscular) and 0.2 (intradermal) ml of BCG 11 days before exposure to S. mansoni 800 c.p.b. did not protect naive baboons, nor did it significantly reduce challenge worm recovery from baboons with a 13-week-old, 500 c.p.b. S. mansoni primary infection. Obvious pathology was seen at the site of vaccination in the first but not the second BCG experiment. These results partly support the findings in mice that non-specific macrophage and monocyte activators give partial protection against schistosome infections but they also illustrate that rodents and primates do not necessarily react identically. Hence, findings from rodent models should be extrapolated to man with some caution. PMID- 3982850 TI - Isolation, fractionation and partial characterization of the tegumental surface from protoscoleces of the hydatid organism, Echinococcus granulosus. AB - Several approaches were adopted for the disruption and removal of the tegumental surface from protoscoleces of the horse strain of the hydatid organism, Echinococcus granulosus. The effectiveness of each method and the purity of subsequent microthrix-enriched fractions obtained by differential centrifugation were evaluated by electron microscopy, by the amount of protein released and by the degree of enrichment of surface plasma membrane marker enzymes. Incubation in saponin for 10 min produced the purest microtriche preparation, but in low yield; freeze/thawing, incubation in Triton X-100 for 10 min or in saponin for 20 min produced fractions containing significant amounts of relatively pure microtriches, but mild homogenization was a poor method for surface disruption and subsequent isolation of microtriches. Phosphodiesterase, adenosine triphosphatase (total and ouabain-inhibited), leucine aminopeptidase and glutamyltransferase were active in the protoscoleces but none were enriched in any of the microthrix fractions. In contrast, alkaline phosphatase, acid phosphatase, 5' nucleotidase and maltase were enriched significantly in all of the isolated microtriche preparations, which suggests that these enzymes are predominantly surface membrane bound. The protein profiles of the microthrix enriched fractions, following SDS-PAGE, were basically similar, although there were some qualitative and quantitative differences in the proteins released by each isolation procedure. Three major PAS-staining components were present in all the preparations and these probably originated from the glycocalyx. One of these PAS-positive components, with an approximate molecular weight of 110 kDa, may be a glycoprotein specific to the horse strain of E. granulosus. PMID- 3982851 TI - Impact of Nippostrongylus brasiliensis (Nematoda) on the serum albumin and amino acid concentrations of rats fed adequate or protein-deficient diets. AB - Food intake, body weight changes, serum protein and amino acid concentrations were measured during the course of primary infections of Nippostrongylus brasiliensis in rats fed on either a 2% protein (casein) diet or a 16% protein diet (Oxoid 41 B). Total serum protein concentration declined from 77.84 +/- 5.35 mg/ml in uninfected well-nourished rats to 54 +/- 3.29 mg/ml in rats at 9 days post-infection (p.i.). A reduction from 47.80 +/- 2.78 to 40.38 +/- 5.62 mg/ml had occurred in protein-malnourished rats by day 6 p.i. The hypoproteinaemia was accompanied by significant hypoalbuminaemia in the protein-malnourished rats and concentrations fell from approximately 33 to 19 mg/ml at the time of peak infection. Six days after inoculation, a significant increase was detected in the concentration of serum amino acids in both well-nourished and protein malnourished rats; the effect was more prolonged for non-essential than for essential amino acids. The results are discussed briefly in relation to recent work on the control of protein metabolism during malnutrition. PMID- 3982852 TI - Effects on cattle of artificial infestations with the tick Rhipicephalus appendiculatus. AB - Groups of ten cattle were exposed to 0, 40 and 400 adult Rhipicephalus appendiculatus feeding once a week for 24 weeks. Although no differences in cumulative percentage weight gain were found at the end of the experiment, animals free of ticks performed better during the first 12 weeks. A marked recovery of the 400-tick group was recorded during weeks 13-24 and after ticks were removed. Haemoglobin and packed cell volume values were lowered in tick infested animals but no clear trends were observed in red and white blood cells. No differences between the percentages of ticks feeding in the 2 tick-infested groups on day 2 were observed but higher numbers of females were feeding on the 40-tick group on day 5. More ticks were found on day 5 after tick application to the cattle during weeks 1-6 than in the rest of the experiment. Significant correlations were found between lymph node enlargement and ear damage when they were tested against tick load. R. appendiculatus nymphs feeding on the formerly tick-infested cattle were fewer, lighter and engorged in a shorter time than those on the control animals. The possible causes for the reduction in ticks feeding, the changes in cattle weights, blood composition and development of host resistance are discussed. PMID- 3982853 TI - Sex determination and sex differentiation in coccidia: gametogony and oocyst production after monoclonal infection of cats with free-living and intermediate host stages of Isospora (Toxoplasma) gondii. AB - Clones of single oocysts, single sporocysts, single sporozoites, single proliferative parasites, single cysts and single cystozoites of Isospora (Toxoplasma) gondii (KB-strain) were made under visual control using a de Fonbrune micromanipulator. Cloning was successful in 28, 32, 21, 8, 54 and 7% of the trials, respectively. All clones were used for monoclonal infection in non immune conventionally reared (CV) or specified pathogen-free (SPF) cats. Pre patent and patent periods, sporulation percentages of excreted oocysts, mouse infectivity of sporulated oocysts, antibody response and immunity to reinfection of CV cats were determined. For these parameters almost no differences were observed between monoclonal infections and infections described with the non cloned KB-strain. In all cats autopsied during the patent period, 5-8 days post infection, macrogametes, microgametes and oocysts were found. Since meiosis occurs during sporulation and since all free-living and intermediate host stages proved to be bisexual, it is concluded that sex differentiation in I. (T) gondii is not determined by segregation of sex chromosomes or sex genes but is caused by some final host factor(s) that induce(s) differential gene expression in genetically identical cells. PMID- 3982854 TI - Mycoses, bacterial infections and antibacterial activity in sandflies (Psychodidae) and their possible role in the transmission of leishmaniasis. AB - High incidence of mycoses were found in the guts and malpighian tubes of Phlebotomus papatasi from the Jordan Valley and P. tobbi from Zakinthos, Greece. Infections with several different bacteria were also found in the guts of female P. tobbi. Fungi cultured from guts of laboratory reared P. papatasi that had similar mycoses were identified as Aspergillus sclerotiorum and Saccharomyces cerevisiae. Fungi-infected laboratory reared P. papatasi were refractory to artificial infections with a Leishmania major strain specific to them. The crop contents of P. papatasi, where sugar meals are stored, demonstrated antibacterial activity against the following bacterial species in culture: Escherichia coli, Staphylococcus aureus, Shigella sonnei, Streptococcus group A and Pseudomonas aeruginosa. It is postulated that the bacteria-free gut normal to sandflies is effected by the bacterial inhibitor present in the crop. PMID- 3982855 TI - The identity of Leishmania tarentolae Wenyon 1921. AB - A double clone of Trypanosoma platydactyli Catouillard, 1909, derived from a single trypomastigote from the blood of the Moorish gecko, Tarentola mauritanica, was grown in vitro. Morphogenesis of the parasites led to a stable population of promastigotes which were identical, in general morphology, ultrastructure and the electrophoretic mobility of 8 enzymes, to those cultures previously considered to be Leishmania tarentolae Wenyon, 1921. These cultures included the strain isolated from the type locality in Algeria by Parrot (1949) and later used as a laboratory model for the genus Leishmania. T. platydactyli and L. tarentolae are synonymized and the present status of saurian Leishmania parasites is discussed. PMID- 3982856 TI - Neutralization of individual variable antigen types in metacyclic populations of Trypanosoma brucei does not prevent their subsequent expression in mice. AB - The Trypanosoma brucei metacyclic population in the salivary glands of the tsetse fly displays a characteristic set of variable antigen types (VATs) which represents only a restricted part of the parasite's total VAT repertoire. After introduction into the mammalian host by fly bite, the metacyclics transform into bloodstream forms which retain expression of the metacyclic VATs. Specific antibodies, both polyvalent and monoclonal, have been used to neutralize separately 4 individual VATs from metacyclic populations. Control experiments and visual observation confirmed lysis of each VAT. On injection of the surviving trypanosomes, after washing, into mice each neutralized VAT was nevertheless expressed within a few days. Simultaneous neutralization of 2 metacyclic VATs which usually switch to one another in bloodstream infections did not prevent expression of either on subsequent injection into mice. Expression of neutralized VATs was not influenced by the antigenic composition of the population originally ingested by the tsetse fly. Metacyclic forms and their immediate successors thus appear to switch rapidly to expression of other metacyclic VATs in bloodstream populations. PMID- 3982857 TI - [Formaldehyde prevention of ischemic damage to the brain]. PMID- 3982858 TI - [Use of inderal for preventing heart damage in mechanical asphyxia accompanied by clinical death]. PMID- 3982860 TI - [Current status and the tasks of Soviet pathophysiology]. PMID- 3982859 TI - [Vitamins E and A content and malondialdehyde formation in the tissues of rats in hypoxia]. PMID- 3982861 TI - [Effect of massive blood loss on the blood vessel-thrombocyte link in the hemostatic system and the level of metabolic hemostasis--regulating hormones]. PMID- 3982862 TI - [Beta-lipoproteins and proliferative cellular elements of the aortic intima in rabbits in the dynamics of experimental arterio-sclerosis]. PMID- 3982863 TI - [Muscle fiber density in motor muscle units at different stages of the development of a denervation-reinnervation process in man]. PMID- 3982865 TI - [Function of distal sections of the large intestine when interrupted]. PMID- 3982864 TI - [Echinocyte count of the blood of rats during carcinogenesis induced by chemicals differing in their mechanism of action]. PMID- 3982867 TI - GSR as reflection of decision-making under conditions of delay. AB - A total of 15 healthy individuals of both sexes, aged from 18 to 30 years, were studied. The subjects were presented a series of three audio signals in each of two conditions. Under condition A the subject made a first immediately after the third signal if all the three sounds were identical; under condition B, a fist was made if at least one sound was different from the other two. The GSR was particularly pronounced when the decision to make or not to make a fist was made under conditions where action was delayed. PMID- 3982866 TI - [Acid-regulating function of the kidneys in the dynamics of experimental nephritis in rats]. PMID- 3982868 TI - Heart rate deceleration is not an orienting reflex; heart rate acceleration is not a defensive reflex. AB - Graham and Clifton (1966) proposed an integration of Sokolov's theory of orienting and defensive reflexes with the stimulus intake/rejection dichotomy of the Laceys. This integration consisted of hypothesizing that heart rate deceleration is a measure of the orienting reflex, and that cardiac acceleration is a measure of the defensive reflex. This article demonstrates that Graham and Clifton failed to establish a valid integration of these two theories. This failure is a consequence of 1) their misconstruing Sokolov's theory, and 2) an inaccurate and selective review of the research literature then available. Consideration of more recent research would seem to rule out the possibility that their thesis was correct in spite of these flaws in its derivation. Cardiac responding in the OR context thus remains open to further investigation and interpretation. PMID- 3982869 TI - Appetitive differential conditioning of the rabbit's jaw movement response. Effects of cue similarity and US magnitude. AB - Two experiments examined appetitive differential conditioning of the rabbit's jaw movement response (JMR) in a two-phase procedure. The first phase entailed reinforced training with one conditioned stimulus (CS+), and the second phase involved intermixed presentations of CS+ and an unreinforced stimulus (CS-). In Experiment 1, CS+ was a 600-Hz tone, and CS- was either a 660-, 1,000-, or 2,100 Hz tone. In Experiment 2, the magnitude of the water unconditioned stimulus (US) paired with CS+ was either 1, 3, or 9 ml. The experiments revealed that 1) the level of responding to CS- rose for several days and then declined over the remainder of training; 2) the physical similarity between CS+ and CS- directly affected the level of responding to CS- but had no discernable effect on the level of responding to CS+; and 3) US magnitude positively affected the level of responding to CS+ and, to a lesser extent, CS-. The results are discussed in terms of their implications for Spence's gradient interaction theory and Pavlov's external inhibition hypothesis. PMID- 3982870 TI - Autoregulation of cerebral blood flow in the preterm fetal lamb. AB - The purpose of the present study was to determine if autoregulation of cerebral blood flow (CBF) is present in the preterm fetal lamb and, if present, to measure the range of mean arterial blood pressure over which autoregulation exists. Thirty-seven measurements of CBF were made in seven preterm fetal lambs (118-122 days gestation) over a mean carotid arterial blood pressure (CBP) range of 18-90 mm Hg. CBF was measured by the radionuclide-labeled microsphere technique. CBP was altered by graduated inflation of balloons placed around the brachiocephalic trunk and the aortic isthmus. To eliminate the effects of reflex changes in heart rate, the carotid sinus and aortic nerve were ablated bilaterally. CBF was linearly related to mean CBP from 18-45 mm Hg, constant over a mean CBP of 45-80 mm Hg, and again linear from 80-90 mm Hg. Resting mean CBP (normotension) was 53.8 +/- 1.9 mm Hg during the control period and 51.7 +/- 0.8 mm Hg during the equilibration periods. This study demonstrates that although autoregulation of CBF is intact in the preterm fetal lamb, the range is narrowed compared to the term lamb and resting mean CBP lies close to the lower limit of autoregulation. PMID- 3982871 TI - Alveolar pressure swings during high frequency ventilation in rabbits. AB - In order to understand the pressures and volumes delivered during ventilation with the Emerson flow-interrupting high frequency ventilator, we have measured dynamic and mean pressures at the airway opening, trachea, and alveoli as well as delivered volumes in vivo in closed-chest adult rabbits ventilated at rates of 2 37.5 Hz. To measure alveolar pressure we opened the chest, glued an alveolar capsule to the visceral pleural surface, punctured the pleura and lung surface through the capsule, inserted a pressure transducer into the capsule and closed the chest. We measured delivered volume with a pressure plethysmograph. Alveolar pressure swings fell with increasing frequency, as did delivered volume. Alveolar pressure swings were always lower than those at the airway opening or in the trachea. Removal of the rib cage resulted in a decrease in alveolar pressure swings although muscle paralysis had little effect. Mean pressures were equal at the airway opening, trachea, and alveoli at all frequencies. These results suggest that using the high frequency ventilator tested, to minimize alveolar barotrauma one should choose the highest frequency where gas exchange is adequate. PMID- 3982872 TI - Laser investigation of bilirubin-photobilirubin photoconversion. AB - The reversibility of the configurational photoisomerization process of bilirubin (BR) with laser lines in the blue-green spectral region is investigated. Photoisomerization efficiency of BR is found to depend strongly on wavelength, and to decrease when the excitation wavelength is increased from blue to green. Reversion of BR photoisomers (identical to photobilirubin, PBR) back to native BR is demonstrated for several laser lines by irradiating PBR/BR mixtures with wavelengths greater than the excitation wavelengths. Green lines turn out to be very efficient for PBR----BR reversion. The PBR concentrations at photoequilibrium, obtained from the spectrophotometric data, are in close agreement with the corresponding values measured with the high performance liquid chromatography technique in the case of 10 nm bandwidth filtered light reported in the literature. The 457 nm blue laser line produces 32% PBR concentration at photoequilibrium; only 14, 7, and 3% PBR concentrations are produced by the blue green lines at 488, 501, 514 nm, respectively. The effect on the photostationary PBR/BR mixture of successive irradiations with different wavelengths, and the influence of the wavelength sequence are reported. In the case of blue lines our results support the assumption of the first-order kinetics for the BR in equilibrium PBR photoreaction. Departures are observed with green-lines (501, 514 nm). The present results, together with the i) good clinical efficiency reported for fluorescent green lamps; and ii) slow elimination of configurational photoisomers in infants, tend to confirm the lumirubin-pathway as the main mechanism for phototherapy, and call for clinical investigation of narrow spectrum lamps with peak emission wavelength in the (biologically safer) 480 divided by 530 nm range. PMID- 3982873 TI - Day-to-day pneumogram variability. AB - To determine day-to-day variability in respiratory pattern, we obtained 188 comparisons of pneumograms performed during two successive 24-h intervals. The respiratory pattern values calculated were total duration of brief apnea (apnea density), periodic breathing episodes, longest apnea, number of apneas greater than 11 s, and number of apneas greater than 15 s. For day 1 values for apnea density, periodic breathing, and longest apnea which were within the 90th percentile for normal infants at age 1 month, day 2 values fell outside that range in 4.3, 3.5, and 18% of comparisons, respectively. There was a systematic tendency for the day 2 values to be less than the day 1 values. For each parameter, the day 2 range was lower, the slope of the day 2 versus day 1 regression line was significantly less than 1 (p less than 0.01) and the y intercept was significantly greater than zero (p less than 0.01). Knowledge of day-to-day pneumogram variability should be helpful in interpreting individual pneumogram results and in assessing the clinical usefulness of pneumogram recordings. PMID- 3982874 TI - Absorption of calcium in premature infants as measured with a stable isotope 46Ca extrinsic tag. AB - Absorption of dietary calcium was evaluated with the extrinsic tag approach and stable isotope methodology in growing premature infants. Fractional absorption of a bolus dose of 46Ca was determined on 16 occasions in 13 premature infants (birth weight 1135 +/- 40 g, gestational age 29.5 +/- 0.4 wk, mean +/- SE) and was found to be 84.4 +/- 2.2%. Fractional absorption of 46Ca ranged between 65 and 97%, and did not appear to be influenced by postnatal age, postconceptual age, body weight, or intake of preterm human milk, fortified preterm human milk, or premature formula. Therefore, if absorption of the 46Ca dose reflects that of dietary calcium, about 80% of dietary calcium is absorbed. PMID- 3982875 TI - Vitamin A status of neonates with bronchopulmonary dysplasia. AB - We prospectively assessed and compared the vitamin A status of two groups of preterm neonates (less than 1500 g birth weight, less than 32 wk gestation), one who developed clinical and radiographic evidence of bronchopulmonary dysplasia (BPD) (n = 10), and the other (control) who developed no significant lung disease (n = 8). The infants with BPD in this study required prolonged mechanical ventilation and supplemental O2 therapy, and had a higher incidence of cardiorespiratory complications when compared to controls. Their mean plasma vitamin A concentrations were significantly lower than those of controls at four sampling times in the 1st postnatal month. In contrast to the controls, infants with BPD showed a substantial decline in their plasma vitamin A concentrations from the initial values, and a high percentage of individual values of plasma vitamin A concentration in these infants were less than 10 micrograms/dl during the 8-wk postnatal period of observation. Delayed establishment of gastrointestinal feeding and a lower vitamin A intake in these infants relative to controls may have accounted for this decline. Our data show that preterm neonates who develop BPD have suboptimal plasma vitamin A concentrations for extended periods of time postnatally. We speculate that the necrotizing bronchiolitis and squamous metaplasia of conducting airways associated with vitamin A deficiency could influence the orderly repair of lung injury in susceptible neonates who are mechanically ventilated and could contribute to the pathophysiology of BPD in these infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982876 TI - The effect of nutritional rehabilitation on whole body protein metabolism of children with cystic fibrosis. AB - The effect of an increased energy and protein intake was studied on the whole body protein metabolism of 4- to 9-yr-old children with cystic fibrosis. The study was divided into an initial 1-yr period, followed by a treatment period of the same length. Rates of protein turnover were determined using a [15N]glycine label and the Picou and Taylor-Roberts model. The children had significantly higher intakes during the treatment year and grew faster. Nitrogen retention and utilization were significantly increased during the treatment year (p less than 0.01). There were no changes seen in whole body amino nitrogen flux, or protein synthesis rates. However, protein breakdown rates were significantly reduced during the treatment period, with the result that net anabolism (synthesis breakdown) was increased (p less than 0.05). The protein synthesis rates of about 6 g/kg/day were similar to those reported for healthy children of the same age. It was concluded that the changes in protein turnover seen were in response to the nutritional intervention and not to the children's basic genetic disease process. PMID- 3982877 TI - A differential effect of thyroxine and glucocorticoids on fetal brain and heart insulin receptor. AB - We investigated the effect of thyroxine (T4), glucocorticoids, and T4 + glucocorticoids on the maturation of fetal rabbit brain and heart insulin receptors. Five doses of T4 over 10 days (50 micrograms/kg body weight per dose) were administered to the mother; significant amounts crossed the placenta (fetal serum free T4 = 0.75 +/- 0.08 versus a control of 0.21 +/- 0.02 ng/dl, p less than 0.02) and increased the specific binding of [125I]insulin to 30-day-old fetal heart membranes from a control of 3.6 +/- 0.74% per 100 micrograms protein to 5.8 +/- 0.19% (p less than 0.05). Curvilinear Scatchard plots revealed an increase in receptor number X 10(7) micrograms protein-1 from 137 +/- 4 to 244 +/ 39 (p less than 0.05) with no change in receptor affinity. No appreciable alteration by T4 in the [125I]insulin-specific binding and receptor number of 30 day fetal brains was noted. Fetal heart glycogen content was decreased and there was a small increase in plasma glucose concentration in the T4-treated group (each p less than 0.02). Betamethasone at 0.17 mg/kg did not affect the specific binding of [125I]insulin to 27-day fetal heart or brain plasma membranes, although a decrease in heart glycogen content and an increase in plasma glucose concentration were observed (each p less than 0.02). Also T4 + betamethasone did not alter the [125I]insulin binding to 27-day fetal heart or brain plasma membranes, but resulted in an additive effect (a marked depletion) on cardiac glycogen (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982878 TI - Urinary excretion of an isomer of bilirubin during phototherapy. AB - Lumirubin, a water-soluble photoproduct of bilirubin formed in vivo during phototherapy, is excreted in the urine. In premature infants with little or no bilirubin conjugating activity, lumirubin is the principal yellow pigment found in the urine during phototherapy. The clearance rate of lumirubin in nine premature infants varied from 0.05 to 0.65 ml/min and increased with postconceptional age in parallel with increased creatinine clearance rate. The amount of lumirubin excreted per 24 h was estimated to be from 0.2 to 9.4 mg with a mean of 3.2 mg. The urinary excretion of lumirubin is a significant pathway for pigment elimination during phototherapy. PMID- 3982879 TI - The preterm rabbit: a model for the study of acute and chronic effects of premature birth. AB - The fetal rabbit delivered by caesarean section 0 to 5 days before term (32 days) can serve as a reliable animal model to study the short- and long-term consequences of premature birth. More than 80% of the fetal rabbits delivered at day 28 of gestation will survive 24 h if anesthetics are avoided during delivery and measures designed to meet the metabolic demands of extrauterine life are met. Sixty percent will survive up to and beyond the 7th day postpartum if the preterm pups are kept in a temperature and humidity controlled environment and are fed rabbit milk. Theoretical and practical advantages of this animal model are discussed. PMID- 3982880 TI - Phototherapy for neonatal jaundice: in vivo clearance of bilirubin photoproducts. AB - Phototherapy results in the conversion of native bilirubin to more water-soluble configurational and structural isomers. The serum half-life for the configurational isomer, the principal photoproduct in vivo, was determined by high pressure liquid chromatography in six premature infants following cessation of phototherapy. The mean half-life for this isomer was 15 h. The excretion of this isomer, calculated from the measured half-life, is less than half of daily bilirubin production, and therefore cannot account for the total bilirubin elimination observed during phototherapy. The serum concentration of the structural isomer, lumirubin, is lower than that of the configurational isomer; however, excretion is more rapid (serum half-life less than 2 h). Because of its rapid excretion, lumirubin may be an important pathway for bilirubin elimination during phototherapy. PMID- 3982881 TI - Circulating thyrotropin in the ovine fetus: evidence for pulsatile release and the effect of hypothermia in utero. AB - The secretion of thyrotropin (TSH) has been investigated in the chronically catheterized ovine fetus (term 145-150 days). Forty-two random plasma samples from 25 fetuses (86-149 days of gestation) were measured for TSH concentrations by radioimmunoassay. Plasma TSH concentrations were highest in the youngest fetuses [86-110 days, 3.9 +/- (SD) 5.5 microU/ml, n = 13]. Thereafter TSH concentrations declined to 0.4 +/- 0.6 microU/ml (n = 13, p less than 0.05) at 130-150 days of gestation. However, serial sampling at 15-20 min intervals for 180 min from 14 individual fetuses (91-139 days) showed that TSH was secreted in a markedly exaggerated pulsatile manner compared to that observed after birth. The mean amplitude of TSH pulses fell (p less than 0.005) from 5.9 +/- 8.1 microU/ml in the fetuses to 2.1 +/- 1.1 microU/ml in five neonatal lambs (6-22 days) and to 1.5 +/- 0.4 microU/ml in three adult nonpregnant ewes. The mean pulse frequency for the 14 fetuses was 0.7 +/- 0.3 pulses/h and was reduced (p less than 0.001) to 0.3 +/- 0.1 pulses/h in lambs and to 0.3 +/- 0.1 pulses/h in the ewes. In the neonate, hypothermia is a potent stimulus to TSH release. To examine the ontogeny of this response, the temperature of the fetus in utero (106 127 days of gestation) was lowered by circulating water (14-18 degrees C) at either a fast or slow rate through a coil placed either externally around the fetus or internally in the fetal esophagus and stomach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982882 TI - N-acetylneuramin lactose sulfate: a newly identified nutrient in milk. AB - The identity of a sulfate ester in rat milk has been determined to be N acetylneuramin lactose sulfate. This sulfate ester is present in rat mammary tissue and in human milk. The presence of this compound offers an explanation for the simultaneous delivery of sulfate and calcium via the milk, two essential nutrients in early life, without precipitation of calcium sulfate in the milk. N acetylneuramin lactose sulfate is hydrolyzed in the gut of the neonate and absorbed as inorganic sulfate. This is the first report suggesting that this ester may be of nutritional importance. PMID- 3982883 TI - Serum growth-promoting activity measured as [3H]thymidine incorporation into human activated lymphocytes and serum transferrin levels in newborns and mothers. AB - Serum growth-promoting activity measured as [3H]thymidine incorporation into human activated lymphocytes and serum transferrin levels were measured during the perinatal period in newborns and mothers. Both thymidine activity (TA) and transferrin levels were significantly increased at the time of delivery in mothers compared to control women, and there was a progressive return to control levels in the first 5 postpartum days. A significant correlation was found between TA and placental weight. In the newborns, TA was low in cord blood after vaginal delivery but not in the cord blood from babies born by cesarean section. In premature newborns, TA was lower than in full term newborns. In all newborns during the first 24 postnatal hours, there was an increase in TA with levels rising above adult control values: levels in cord blood were positively correlated with birth weight but not with thymidine activity. These data afford complementary insights into the humoral controls of growth in newborn infants. PMID- 3982884 TI - Correlation between fetal and maternal serum bile acid concentrations. AB - Serum concentrations of different bile acids (BA) were determined by radioimmunoassay in 56 human fetuses and mothers. Serum was obtained immediately after legal abortion, performed between the 14th and the 21st wk of gestation. Conjugated cholic (CCA) and chenodeoxycholic acid (CCDCA) concentrations were determined in 33 cases, conjugated lithocholic (CLCA) and deoxycholic acid (CDCA) in 20, and sulfolithocholyglycine (SLCG) in 15. In fetal blood, mean concentrations of CCA (0.80 +/- 0.40 mumol/liter), CCDCA (4.50 +/- 2.70 mumol/liter), and CLCA (1.70 +/- 1.04 mumol/liter) were significantly higher than those in the mother (CCA 0.34 +/- 0.17 mumol/liter; CCDCA 0.79 +/- 0.34 mumol/liter; CLCA: 0.70 +/- 0.30 mumol/liter; p less than 0.001); fetal serum levels of CDCA (0.46 +/- 0.32 mumol/liter) and SLCG (0.15 +/- 0.09 mumol/liter) were lower than in the mothers (CDCA 1.20 +/- 0.80 mumol/liter, p less than 0.001; SLCG 0.40 +/- 0.30 mumol/liter, p less than 0.01). There was no correlation between levels of BA and gestational age. Serum total protein and albumin concentrations were both reduced in 10 fetuses as compared with the mothers. These data support the concept of a state of physiologic cholestasis during development and suggest that placental transfer of primary BA occurs mostly in the fetal to maternal direction. This transfer could be facilitated by the reduced fetal plasma albumin concentration, since BA in free solution diffuse more easily through the placenta. There is evidence of lithocholic acid synthesis in the fetal liver, while deoxycholic acid appears to be mostly of maternal origin. Finally, sulfation of BA is poorly developed at this age of gestation. PMID- 3982885 TI - Effect of postnatal anoxia on bilirubin levels in rat brain. AB - The effects of a period of anoxia 18-24 h after birth on bilirubin levels in rat brain were investigated during anoxia, recovery, and development. Postnatal anoxia induces a significant, temporary increase (up to 200% with respect to control values) in newborn rat brain bilirubin levels during anoxia and short term recovery. Pretreatment of the newborn rats with a single dose of the drug sulfixosazole markedly enhances bilirubin accumulation in the brain of the anoxic rats. A second rise in brain bilirubin concentration is detected in a group of the newborn rats 3-6 days after oxygen deprivation. Autoradiographic localization of radiolabeled bilirubin following in vivo experiments suggests that this substance is preferentially accumulated in some areas of the newborn rat brain as a consequence of postnatal anoxia, and indicates, together with the effect of sulfixosazole, that as a result of anoxia, a displacement of unbound bilirubin from blood to the nervous tissue occurs. Our results confirm the importance of anoxia as a risk factor for the development of bilirubin-induced encephalopathy. The possible relevance of intracerebral hemorrhages caused by perinatal asphyxia producing delayed bilirubin accumulation in the newborn rat brain is suggested. PMID- 3982886 TI - Dysfunctional antithrombin III in sick premature infants. AB - Antithrombin III, a major inhibitor of activated coagulation factors has low immunologic levels in the human infant. The objective of this study was to determine if the antithrombin III molecule is fully functional in sick premature infants. The populations studied included: adult controls (n = 20), full term healthy infants (n = 18), sick premature infants on day 1 (n = 16) and at greater than 7 days of age (n = 10), and infants with disseminated intravascular coagulation (n = 11). This was diagnosed in the presence of prolonged screening tests, decreased levels of fibrinogen, and platelets along with elevated fibrin degradation products. Plasma antithrombin III levels were measured biologically (chromogenic substrate S2238) and immunologically (radialimmunodiffusion), and expressed as a percent of adult pooled plasma. Crossed immunoelectrophoresis were performed in the presence and absence of heparin. The antithrombin III biologic/immunologic ratios for adults, healthy full term infants, and sick premature infants on day 1 of life were all near unity. In contrast sick premature infants beyond the 1st wk of life and infants with disseminated intravascular coagulation had lower biologic activity compared to immunologic (B/I = 0.77 +/- 0.28, 0.78 +/- 0.17, p less than 0.01), respectively. In all groups, the antithrombin III molecule was normal on crossed immunoelectrophoresis except for one infant with disseminated intravascular coagulation. Sick premature infants may acquire a dysfunctional antithrombin III molecule in the postnatal period. PMID- 3982887 TI - Heat- and alcohol-induced neural tube defects: interactions with folate in a golden hamster model. AB - Maternal hyperthermia or ethanol each can induce fetal neural tube defects (NTD) following exposures on the 8th day of gestation in golden hamsters. To explore the relationship between NTD and varying doses of either heat or ethanol, timed pregnant golden hamsters were exposed to various doses of either 25% ethanol, or heat in an incubator at 39.5 degrees C on the morning of the 8th day of gestation. Two doses of 0.015 ml/g body weight of 25% ethanol 4 h apart resulted in a 44% incidence of NTD when fetuses were examined on day 13. Single doses of 25% ethanol (either 0.015 or 0.0075 ml/g) resulted in very low incidences of NTD that were not significantly different from zero. A 50-min exposure to heat resulted in a 35% incidence of NTD. A shorter exposure (44 min) resulted in a 23% incidence, and a longer exposure (56 min) resulted in a 68% incidence of NTD. A 0.0075 ml/g dose of 25% ethanol, followed by these same durations of heat, resulted in incidences of NTD that were not significantly different from heat alone. In order to determine what effect folate supplementation might have on ethanol- or heat-induced NTD, osmotic pumps filled with either folate or saline were placed subcutaneously in pregnant hamsters on the 6th day of gestation. Animals were then exposed to ethanol or heat on the morning of day 8. No significant protection from NTD was evident among fetuses from mothers supplemented with folate despite significant elevations in their red cell folate levels on day 8 of gestation. PMID- 3982888 TI - The effect of blood volume expansion on gastrointestinal oxygenation in piglets. AB - Regional and total gastrointestinal (GI) blood flow, O2 delivery, O2 extraction, and O2 consumption were measured before and after acute blood volume expansion in 2-day-old piglets. Blood flow was measured with radionuclide-labeled microspheres. Sixty minutes after a rapid transfusion of age- and hematocrit matched piglet donor blood, 51Cr-measured blood volume increased 19% while an increase in hematocrit suggested plasma transudation to the extravascular space had occurred in response to blood volume loading. Following transfusion, total GI blood flow and O2 delivery did not change, although O2 extraction decreased by 31 +/- 4%. O2 consumption by the GI tract decreased from 2.0 +/- 0.19 ml O2 X min-1 X 100 g-1 to 1.46 +/- 0.24 ml O2 X min-1 X 100 g-1 1 h after transfusion. Feeding was then accomplished via orogastric tube to determine if animals stressed by blood volume loading would increase GI O2 consumption in response to feeding. The postprandial increase in GI O2 consumption was similar to that previously reported in newborn piglets. Therefore, in the fasting state, acute blood volume loading disrupts GI O2 transport at the capillary level and decreases GI O2 consumption. However, animals subjected to blood volume loading appear capable of increasing GI O2 consumption after feeding. PMID- 3982889 TI - Intrauterine growth-retarded rat pups show increased susceptibility to pulmonary O2 toxicity. AB - We used a nutritional deprivation model to produce intrauterine growth-retarded (IGR) rat pups (birth weight = approximately 75% of normal). The IGR newborns evidenced a marked reduction in tolerance to greater than 95% O2 exposure: 10-day survival = 10/47 (21%) versus 18/36 (50%) for control pups, and LT50 = 7.2 days versus 10 days for controls (p less than 0.01). Various lung parameters at birth and during O2 exposure were examined to try to define why prenatal undernutrition should compromise the survival of IGR rats in hyperoxia. We found decreased lung glutathione peroxidase and glucose-6-phosphate dehydrogenase activity (with normal superoxide dismutase and catalase levels) in the IGRs at birth; decreased lung disaturated phosphatidylcholine content (even more markedly decreased in 1 day premature pups); and decreased lung surface area/body weight. These factors and other features of newborn IGRs reported in the literature may help to explain how prenatal undernutrition compromises postnatal tolerance to prolonged high-O2 exposure. PMID- 3982890 TI - Humoral and cell-mediated immunity in growth hormone-deficient children: effect of therapy with human growth hormone. AB - To delineate the role of growth hormone (GH) in the development and function of the immune system, immunological parameters including quantitative immunoglobulins, T and B lymphocytes, phytohemagglutinin lymphoproliferative response and delayed hypersensitivity skin tests were studied in nine GH deficient children prior to GH therapy and at 2 months and 9 to 12 months following therapy. The phytohemagglutinin response (74.1 +/- 37.6, mean +/- SD), and the T rosette (58.3% +/- 9.4), B rosette (21.1% +/- 6.1), IgG (810 +/- 241 mg/dl), (IgA 140 +/- 85), and IgM (176 +/- 70) levels in GH-deficient children were comparable to age adjusted values in normal children. Following GH therapy the phytohemagglutinin response increased significantly at 9 to 12 months post therapy, 123.2 +/- 51.9 versus 74.1 +/- 37.6, p less than 0.05. T and B rosettes, immunoglobulin concentrations, and hypersensitivity skin tests were not affected by GH therapy. Although an effect of GH was not demonstrable by these studies, a positive role of GH cannot be entirely excluded since total GH deficiency did not exist in all children. PMID- 3982891 TI - Studies on the conjugating activity of bile acids in children. AB - The unconjugated and conjugated bile acid levels in sera of 98 normal children and nine normal adults were measured by high performance liquid chromatography. The results showed that the mean total bile acid level was high, 11.0 +/- 8.7 mumol/liter (1 SD) during the neonatal period (0-4 wk) and then gradually decreased with age. The ratio of the concentration of conjugated bile acids to total bile acids in serum was as high as 90% or more in infants under 1 yr of age and slowly decreased with age. The mean ratio of cholic acid to chenodeoxycholic acid was high (1.7 +/- 1.1) during the neonatal period but decreased after 3 months to the adult level (0.4 +/- 0.2). The mean ratio of glycine conjugated bile acids to taurine conjugated bile acids was 3.0 +/- 3.1 during the neonatal period and the ratio during the 1st month of life was significantly lower than that after that period with little further change at any age. The mean ratio of the concentration of secondary bile acids to primary bile acids showed significantly lower values in infants less than 1 yr of age. The main bile acid was glycocholic acid in the neonatal period but after 1-3 months glycochenodeoxycholic acid predominated. With age, the serum bile acid pattern which was characteristic in infancy gradually approached that of adults. PMID- 3982892 TI - Exclusively breast-fed healthy infants grow slower than reference infants. AB - We have studied the nutritional adequacy of exclusive breast-feeding by following prospectively the growth and protein nutrition of healthy infants during the 1st yr of life. The number of exclusively breast-fed infants was 116 at the age of 6 months and 36 at 9 months. These infants had slower length velocity after age 3 months than a comparison group of 32 infants who were weaned early and given formula plus solids. As a group, the exclusively breast-fed infants lagged slightly, but progressively, behind in relative length. By 9 months, 45% of them versus 18% of the comparison group showed a greater than 1 SD decrease in relative length. No such decrease was found in relative weight. Skinfolds and weight for length index showed that they were heavier for their length than the comparison infants. At 6 and 9 months the calculated protein intake (0.9 g/kg/day) was much less than the recommended amount (2.0 g/kg/day). Serum prealbumin concentration was lower than in the comparison group but this was noted as early as 4 months. No relation was found between the parameters of growth and protein nutrition either individually or in general. Whether the slower growth of the exclusively breast-fed infants represents appropriate physiological growth or whether it indicates nutritional deficiency is not known but we did not find any evidence of protein deficiency. Six infants did, however, show subsequent catch-up growth which could indicate previous malnutrition. PMID- 3982893 TI - Food proteins and gut mucosal barrier. III. The influence of lactation and prolactin on the in vitro binding and uptake of bovine serum albumin and ovalbumin in the rat jejunum. AB - The everted gut sac technique was used to study adaptive changes in small intestinal handling and uptake of radiolabeled bovine serum albumin and ovalbumin during lactation in rats. Binding and uptake of both proteins by the gut sacs of lactating animals were significantly less, compared to controls (p less than 0.001, after 30 min of incubation). This change was reversible after lactation ceased. The differences could not be explained by oral immunization since there were no specific antibodies found in sera, mucosal extracts, or breast milk; prior exposure to the protein did not alter the observed differences. No differences in mucosal breakdown of bovine serum albumin could be demonstrated by precipitation with trichloroacetic acid (10%); an increase in breakdown of ovalbumin in the lactating animals was shown under the same conditions. The injection of prolactin produced differences in bovine serum albumin binding and uptake similar to the ones observed in the lactating group (p less than 0.01, after 30 min of incubation, compared to solvent-injected controls). Since food protein antigen binding, breakdown and uptake are functions of the local intestinal host defense, these findings suggest that there are adaptive changes of the gut mucosal barrier during lactation which decrease the transfer of dietary antigens from mother to infant. The adaptation of the maternal intestinal host defense was shown to be influenced by prolactin. PMID- 3982894 TI - Effect of maternal oxygen inhalation on the fetus with growth retardation. AB - Decreased nutrient and oxygen transfer to the fetus accounts for fetal growth retardation in pregnancies complicated by severe uteroplacental insufficiency. A model of uteroplacental insufficiency was produced by ligation of the uterine artery of one horn in pregnant rats at 17 days of gestation. The pregnant rats were assigned to environmental chambers containing a gas mixture of either an increased fractional inspired oxygen concentration of 0.40 (O2) or room air from day 17 through 21 of gestation. Supplemental oxygen inhalation resulted in increased survival of the fetuses from the ligated horn [34 +/- 6% in intrauterine growth retardation (IUGR)-room air versus 57 +/- 8% in IUGR-O2] and an increase in fetal weight, expressed as a percentage of nonligated appropriate for gestational age control littermates (67 +/- 2% in IUGR-room air versus 74 +/- 2% in IUGR-O2). A role for hypoxia in the suppression of fatty acid synthesis in IUGR fetal tissues had been postulated; however, maternal oxygen inhalation did not result in any increase in fatty acid content or specific activity in liver, lung, or carcass of IUGR fetuses. These data indicate that supplemental maternal oxygen inhalation improves survival and growth of fetuses compromised by uteroplacental insufficiency, but it has no apparent effect on lipogenesis at term. PMID- 3982896 TI - Breast-feeding by employed mothers: a reasonable accommodation in the work place. AB - A nonprofit voluntary community hospital, the Hunterdon Medical Center, has made a commitment to encourage breast-feeding among employees. In support of this commitment, arrangements were made for time off during the work day for nursing mothers to pump their breasts. An electric breast pump in a suitably accessible location and supportive professional advice were offered. Among those who chose to nurse their babies, it was found that mothers nursed for longer times and were more likely to continue nursing after return to employment when this program was available. PMID- 3982895 TI - White doctors and black patients: influence of race on the doctor-patient relationship. AB - Effective communication between doctor and patient, a skill not emphasized in medical education programs, is essential for patient satisfaction and optimal patient care. In many teaching hospitals, the doctor is commonly white and middle class and the patient black and indigent. Racial differences, even in the absence of social class differences, may have a negative impact on the quality of the doctor-patient relationship. The impact of racism is reviewed, and recommendations to enhance the relationship between white doctors and black patients, are made. PMID- 3982897 TI - Neonatal high-frequency jet ventilation: four years' experience. AB - During a 4-year period, 34 neonates were treated with high-frequency jet ventilation (HFJV) using two different HFJV systems. Twenty-three of the neonates had severe pulmonary air leaks, five had congenital left-sided diaphragmatic hernias, and six had end-stage respiratory failure without pulmonary air leaks. The two HFJV systems performed similarly in all pathologic conditions. Following HFJV, arterial blood gas values improved in 28 of the 34 patients (82%). Eleven patients (32%) ultimately survived. Of 23 patients with pulmonary air leaks, 17 (74%) improved, nine (39%) survived. One infant with diaphragmatic hernia and one with end-stage respiratory failure survived. Ten of 12 patients (85%) who died following eight or more hours of HFJV had significant tracheal histopathology in the region of the endotracheal tube tip. The lesions ranged from moderate erythema to severe necrotizing tracheobronchitis with total tracheal obstruction. HFJV can be useful in the treatment of severe pulmonary air leaks in neonates and may prove useful in the treatment of congenital diaphragmatic hernias. However, HFJV produces inflammatory injuries in the proximal trachea. More clinical and laboratory studies are needed to define the relative risks and benefits of this new therapy. PMID- 3982899 TI - Progressive varicella in three patients with Wiskott-Aldrich syndrome: treatment with adenine arabinoside. AB - Patients with Wiskott-Aldrich Syndrome have an increased incidence of serious infections, often with microorganisms that usually produce mild disease in immunologically normal subjects. Three patients with Wiskott-Aldrich syndrome complicated by progressive varicella are reported. There have been no previous reports of similar cases. Two of the patients were treated with adenine arabinoside and had rapid recovery. PMID- 3982898 TI - Early experience with illuminated endotracheal tubes in premature and term infants. AB - A major problem in the care of premature and other newborn infants is obtaining and maintaining correct position of an endotracheal tube. Improper placement of the distal tip of the endotracheal tube above the larynx or below the carina is a life-threatening hazard that not only impairs ventilation, but also may result in serious pulmonary complications such as lobar atelectasis and air leak. This problem was addressed by testing the hypothesis that a light source at the end of the endotracheal tube could be seen on the neck and chest and that, therefore, the endotracheal tube could be positioned and repositioned without radiologic guidance. The validity of this concept was confirmed in animals using a rigid bronchoscope light source and conventional endotracheal tubes. Then an endotracheal tube in which a fiberoptic strand was incorporated in the wall and which terminated near the tip of the tube was used. The illuminated endotracheal tube was used 33 times in 25 infants. This technique has been shown to provide a safe method (not requiring ionizing radiation) for positioning of the endotracheal tube by virtue of external visualization of a circle of light on the surface of the baby. This system will not permit differentiation of tracheal from esophageal intubation. PMID- 3982900 TI - Measles outbreak in a pediatric practice: airborne transmission in an office setting. AB - In February 1981, a measles outbreak occurred in a pediatric practice in DeKalb County, GA. The source case, a 12-year-old boy vaccinated against measles at 11 1/2 months of age, was in the office for one hour on the second day of rash, primarily in a single examining room. On examination, he was noted to be coughing vigorously. Seven secondary cases of measles occurred due to exposure in the office. Four children had transient contact with the source patient as he entered or exited through the waiting room; only one of the four had face-to-face contact within 1 m of the source patient. The three other children who contracted measles were never in the same room with the source patient; one of the three arrived at the office one hour after the source patient had left. The risk of measles for unvaccinated infants (attack rate 80%, 4/5) was 10.8 times the risk for vaccinated children (attack rate 7%, 2/27) (P = .022, Fisher exact test, two tailed). Airflow studies demonstrated that droplet nuclei generated in the examining room used by the source patient were dispersed throughout the entire office suite. Airborne spread of measles from a vigorously coughing child was the most likely mode of transmission. The outbreak supports the fact that measles virus when it becomes airborne can survive at least one hour. The rarity of reports of similar outbreaks suggests that airborne spread is unusual. Modern office design with tight insulation and a substantial proportion of recirculated ventilation may predispose to airborne transmission. PMID- 3982901 TI - Know thyself--adolescents' self-assessment of compliance behavior. AB - Noncompliance with contraception is a major cause of adolescent pregnancy. Studies of compliance predictors have produced conflicting results. The possibility that female adolescents' assessment of their own past compliance with other medications may be useful in predicting their future contraceptive compliance is explored. Accordingly, patients beginning an oral contraceptive regimen described their past compliance on a four-point scale, and a subset, in addition described themselves on the basis of a five-point scale ranging from "forgetful" to "well-organized." At 6-month follow-up, 75% of the patients were found to have described themselves accurately in terms of potential compliance behavior. Of patients who proved compliant, 64% had initially rated themselves as "well-organized" whereas none of the noncompliant patients had done so. These findings demonstrate the potential importance of the teenagers' self-assessment in determining those at risk for contraceptive noncompliance. The findings also suggest that compliance behavior among female adolescents may be generalizable across clinical situations, rather than being disease or medication specific. PMID- 3982902 TI - Auditory nerve and brainstem responses in newborn infants with hyperbilirubinemia. AB - To assess early bilirubin toxicity, a study was made of auditory brainstem responses in relation to total bilirubin levels as well as unbound bilirubin levels in 56 hyperbilirubinemic infants (total bilirubin greater than or equal to 15.0 mg/dL) and 24 infants who did not have jaundice. The latencies of wave I at 85 dB HL (hearing level) in hyperbilirubinemic infants were significantly greater than those in the control group. The latencies of wave I and V in hyperbilirubinemic infants with unbound bilirubin levels greater than or equal to 1.0 microgram/dL (group C) were greater than those in the control group and in the hyperbilirubinemic infants with unbound bilirubin levels less than 0.5 microgram/dL (group A) and with unbound bilirubin levels less than 1.0 microgram/dL (group B). There were no significant differences of the wave I-V interpeak latency between the control infants and the hyperbilirubinemic infants. Thirty of the 80 infants showed prolonged peak latencies (greater than the mean +/- 2 SD for the control infants) of wave I and/or V in one or both ears. The incidences of the prolonged peak latencies in group B (42%) and group C (89%) were significantly greater than that in the control group (12%). The serial determinations of auditory brainstem responses in infants treated with exchange transfusions revealed that the prolonged peak latencies before exchange transfusion improved at 48 and 96 hours after the procedure for wave I, and at 24, 48, and 96 hours after the procedure for wave V. The interpeak latency of wave I-V did not change with exchange transfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982903 TI - Aminophylline versus doxapram in idiopathic apnea of prematurity: a double-blind controlled study. AB - A double-blind controlled study, in two parts, was undertaken to compare the effectiveness of aminophylline and doxapram therapy in idiopathic apnea of prematurity. In the first part of this study, eight of 15 infants responded to doxapram therapy with complete cessation of apneic spells and six of 11 infants responded similarly to administration of aminophylline. These differences were statistically insignificant. In the second part of the study, assessment was made of whether the addition of doxapram to aminophylline therapy was effective in treatment of apnea of prematurity that had been unresponsive to aminophylline alone. Of ten infants who continued to have apneic spells during treatment with aminophylline, eight responded to the addition of doxapram with complete cessation of apnea. Nine infants received placebo in addition to aminophylline, and none had a reduction in frequency of apnea. PMID- 3982904 TI - Atrial flutter in infancy: diagnosis, clinical features, and treatment. AB - The clinical features and treatment of atrial flutter in eight infants (four male and four female) less than 2 months of age are presented. Atrial flutter was noted during the first week of life in six of the infants and between 6 and 8 weeks of life in the other two infants. Four of the eight infants had associated structural or functional cardiovascular disease, and in three infants a central venous pressure catheter was present in the atrium at the time atrial flutter was diagnosed. Classic flutter waves were apparent on 12-lead ECGs in only two infants. In six infants, flutter waves were not obvious on standard ECGs, but transesophageal electrogram recordings demonstrated the presence of atrial flutter with second degree atrioventricular block. The atrial cycle length during flutter ranged from 135 to 180 ms (mean 149 ms; mean atrial rate 403 beats per minute); there was a 2:1 ventricular response to atrial flutter. Successful termination of atrial flutter was accomplished using three modes of electrical cardioversion in seven of the eight infants: direct current cardioversion in one, transvenous atrial pacing in one, and transesophageal atrial pacing in five. One asymptomatic infant converted to normal sinus rhythm 24 hours following digoxin administration. One infant had multiple atrial flutter recurrences and required chronic procainamide therapy. In seven of the eight infants, no recurrences have been noted in 6 months to 3 1/2 years of follow-up. These results demonstrate that atrial flutter may be difficult to diagnose in infants with tachycardia unless transesophageal electrogram recording is utilized for evaluation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982905 TI - Atrial overdrive pacing for conversion of atrial flutter in children. AB - Twenty-three successive patients with 27 different episodes of sustained atrial flutter were treated with atrial pacing for conversion of the tachyarrhythmia; 15 patients with 16 episodes of atrial flutter underwent intracardiac right atrial pacing and eight patients with 11 episodes of atrial flutter were treated with transesophageal atrial pacing. Ten of sixteen episodes (63%) and eight of 11 episodes (73%) were successfully converted using intracardiac and transesophageal techniques, respectively. Mean flutter cycle length for all 27 episodes was 219 ms (mean heart rate 274 beats per minute); successful pacing conversion cycle length (n = 15) was 72% of the flutter cycle length. Hemodynamic, electrophysiologic, and roentgenographic data were not predictive of conversion by either technique. Induction of localized atrial fibrillation or failure to meet critical pacing criteria may explain pacing failures. Based on this experience, a trial of transesophageal atrial pacing for acute conversion of any episode of atrial flutter in children prior to direct current cardioversion is recommended. PMID- 3982906 TI - Cardiac decompensation following verapamil therapy in infants with supraventricular tachycardia. AB - Three infants with supraventricular tachycardia and congestive cardiac failure were given verapamil intravenously. In two of the infants, the rhythm was converted to sinus, but the third infant required direct current cardioversion. However, each infant demonstrated hemodynamic decompensation shortly after verapamil administration and required cardiopulmonary resuscitation. All three patients were stabilized and their tachycardia was controlled with digoxin. All three were doing well at the time of follow-up evaluation, and there was no evidence of structural heart disease. The risk of cardiac decompensation in infants with supraventricular tachycardia and congestive cardiac failure should be kept in mind prior to administration of verapamil. Alternative methods for conversion of supraventricular tachycardia should be considered. PMID- 3982907 TI - Tissue damage caused by the intramuscular injection of long-acting penicillin. AB - In order to elucidate whether tissue damage produced on occasion by intramuscular injection of long-acting penicillin is due to accidental intra-arterial injection or vasospasm, two types of experiments were carried out in rabbits. In the first set of experiments, six New Zealand White rabbits were given intra-arterial injections of 0.4 mL of a mixture containing 300,000 U of penicillin G benzathine and 300,000 units of penicillin procaine per milliliter (Bicillin C-R) into the left femoral artery and 0.4 mL of normal saline into the right femoral artery as autocontrol. In a second set of experiments, 0.4 mL of the same penicillin preparation was injected in the space surrounding the left femoral artery in five New Zealand rabbits, and 0.4 mL of normal saline was injected in a similar fashion around the right femoral artery as control. The legs of the rabbits that received the intra-arterial injection of penicillin invariably developed ischemic manifestations. None of the legs of rabbits given intra-arterial injections of normal saline had pathologic manifestations. None of the rabbits that received the periarterial penicillin preparation or normal saline developed abnormalities. These results strongly suggest that the tissue damage produced by penicillin is secondary to the intra-arterial administration of the drug. PMID- 3982908 TI - Colloid osmotic pressure of umbilical cord plasma in healthy and sick newborn infants. AB - Colloid osmotic pressure of umbilical cord plasma was measured in 242 healthy infants, in 34 infants with respiratory distress syndrome (RDS), in 18 infants with asphyxia, in 13 infants who were small for gestational age, in 15 infants born to mothers with diabetes mellitus, and in 18 infants born to mothers with pregnancy-induced hypertension. In healthy infants, colloid osmotic pressure correlated highly significantly with umbilical cord blood total protein level, gestational age, and birth weight. In infants with RDS, no correlation between colloid osmotic pressure and gestational age or birth weight was found. Infants with RDS and gestational age between 36 and 38 weeks had significantly lower colloid osmotic pressure than healthy infants, whereas colloid osmotic pressure of infants with RDS and gestational age between 32 and 35 weeks did not differ from that of healthy infants of corresponding gestational age. Healthy term infants delivered by cesarean section had significantly lower colloid osmotic pressure than infants delivered vaginally. Infants with asphyxia had significantly higher colloid osmotic pressure than healthy infants. Colloid osmotic pressure is related to the lung maturity of the near-term and term neonate. Infants with a colloid osmotic pressure greater than 16 mm Hg are unlikely to develop RDS. PMID- 3982909 TI - Epidemiology of neonatal hyperbilirubinemia. AB - Interview and record review data from 12,023 singleton deliveries were analyzed to determine the relationships between neonatal hyperbilirubinemia (10 mg/dL or greater) and maternal characteristics. Confounding variables were controlled by multiple logistic regression analysis. There was a statistically significant positive relationship between hyperbilirubinemia and low birth weight, Oriental race, premature rupture of membranes, breast-feeding, neonatal infection, use of the "pill" at time of conception, instrumental delivery, and history of first trimester bleeding. Maternal smoking and black race were negatively related to hyperbilirubinemia and statistically significant. In this study, other previously suspected etiologic factors such as epidural anesthesia, parity, use of oxytocin in labor, and white race were not associated with hyperbilirubinemia. PMID- 3982910 TI - Inadvertent intra-arterial injection of penicillin: an unseen danger. PMID- 3982911 TI - Hot tub drownings. PMID- 3982912 TI - Formula fixed. PMID- 3982913 TI - Unconvinced of value of antenatal transfer to level 3 intensive care units. PMID- 3982914 TI - Rehydration therapy. PMID- 3982915 TI - The National Institutes of Health point of view. PMID- 3982916 TI - Perception of voice characteristics of adult schizophrenics. PMID- 3982917 TI - Effect of diazepam on visuomotor reaction time. AB - 20 male and 10 female adult, normal, healthy subjects, whose mean age was 26.34 yr., participated in a double-blind study of the effect of a single dose (0.2 mg./kg. of body weight) of diazepam on visuomotor reaction time. Reaction time was measured before drug administration, and 60 min., and 120 min. after administration. Separate reaction times for the dominant and nondominant hand were recorded. There were no significant differences between the diazepam and placebo group at each of the three time intervals. Diazepam in the single dose employed does not appear to affect adversely visuomotor reaction time of relatively young, normal, healthy adults. For both groups the difference in visuomotor reaction time between the dominant hand and the nondominant hand was statistically significant as expected. PMID- 3982918 TI - Are the accessory facial movements of the stutterer learned behaviours? AB - The purpose of the present study was to explore the accessory nonverbal behaviours emitted by stutterers when their speech was fluent, normally disfluent, or stuttered. Subjects were 25 stutterers who were required to speak spontaneously for a 2-min. period. Seven types of nonverbal behavior were observed. Significant differences among the three speech categories were obtained for jaw movements, mouth movements, forehead movements, eyebrow movements, and head movements. Eyelid movements and eye blinks were nonsignificant. The results are discussed with respect to the various functions that can be attributed to nonverbal behaviour in stuttering. PMID- 3982919 TI - Unraveling subjects' perceptions of paraprofessionals and professionals: a pilot study. AB - This study examined 75 undergraduate women's perceptions of paraprofessional and professional therapists in an analogy study. The data indicated subjects were more willing to seek treatment from paraprofessional than professional therapists; no differences were found in predicted success of treatment. Subjects' perceptions of paraprofessional and professional expertness, attractiveness, and trustworthiness were also examined; the findings were nonsignificant. PMID- 3982920 TI - The myth of "ecological dyslexia": a reply to Pontius (1984). AB - Ways in which Pontius' rejoinder to the criticisms raised earlier about her 1982 study of white and Aboriginal Australians fall short of success are enumerated. PMID- 3982921 TI - Kindergarteners' selective attention in direct and observational learning. AB - The present study was designed to compare direct learning (learning by performing) with observational learning (learning by observing) in a version of central-incidental memory task. A 2 X 2 factorial design, containing methods of participation (performer, observer) and game-trials (1 and 5 games) was used. 80 kindergarteners (6 yr. old) were divided into four groups. In the performer and observer conditions, central recall scores were higher than incidental recall scores, five-game groups showed more central recall than one-game groups, five game groups showed more incidental learning than one-game groups, and recognition scores were higher than recall scores. The results suggested that the observers' attention to stimuli may be inferred to be very similar to the performers', for the observers' score patterns of the two measures were similar to those of the performers. PMID- 3982922 TI - Some comments on Shettel-Neuber and O'Reilly's "handedness and career choice: another look at supposed left/right differences" (1983). AB - A property of attitudes, namely, the fact that attitudes select facts, is used to comment upon a paper on handedness and career choice. PMID- 3982923 TI - Geophysical variables and behavior: XXIII. Relations between UFO reports within the Uinta Basin and local seismicity. AB - A strong temporal correlation was found between the numbers of reports of UFOs (unidentified flying objects) and nearby seismic activity within the Uinta Basin for the year 1967. The numbers of UFO reports per month during this classic UFO flap were correlated 0.80 with the sum of the earthquake magnitudes per month for events within 150 km of the report area. Numbers of UFO reports were not correlated significantly with earthquake activity at distances greater than 150 km but less than 250 km away. The strongest correlation occurred between UFO reports and nearby seismic activity within the same month but not for previous or consequent months. Close scrutiny of daily shifts in epicenters and reports of UFOs indicate that they occurred when the locus of successive epicenters shifted across the area. These analyses were interpreted as support for the existence of strain fields whose movements generate natural phenomena that are reported as UFOs. PMID- 3982924 TI - Effects of subject-to-experimenter distance and instructions on lateral eye movement. AB - Lateral eye movements and heart rate were recorded as 32 right-handed men answered verbal and spatial questions. Experimenter-to-subject distance (.8 and 1.5 m) and attention demand of instructions were manipulated in a 2 X 2 design. A significant main effect for distance and an interaction of distance by instructions appeared on the direction of eye movements independent of type of question. The greatest number of leftward eye movements occurred at the short distance with instructions demanding higher attention. These findings are consistent with evidence that emotional arousal produces greater right- than left hemisphere activation. PMID- 3982925 TI - Hypothesis testing and problem solving by learning disabled and nondisabled boys. PMID- 3982926 TI - On the association of effort and force of handgrip. AB - The connection between prescribed levels of effort and force of handgrip was investigated using a ratio-production procedure. Subjects were 24 male right handed students. The relation can be described as a linear function for both the right and the left hands. PMID- 3982927 TI - A follow-up study of cross-cultural validity of Developmental Test of Visual motor Integration. AB - A follow-up study with a younger group of mildly handicapped Japanese students was conducted to determine if the correlations between the Developmental Test of Visual-motor Integration and reading and mathematics achievement would substantiate the previous findings. For 30 mildly handicapped 11- and 12-yr.-old Japanese students, visual-motor integration scores were significantly correlated with both mathematics and reading scores. These results, added to the 1984 Webb and Abe data, further support the test's cross-cultural validity. PMID- 3982928 TI - Longitudinal changes in time estimation in affective disorders: a preliminary study. AB - 8 patients with hospital diagnoses of major affective disorder were studied by repeated measurements of time estimation using the three different methods of metronome adjustment, verbal estimation and operative estimation (production) of short time intervals. Retrospective estimations of longer intervals were also studied. The diagnoses were evaluated according to DSM III criteria. The degree of mental disturbance was rated with subscales of the Comprehensive Psychopathological Rating Scale. Earlier findings had indicated that manic patients tend to overestimate short time intervals and that some depressed patients underestimated time, but some investigators have reported different results. A longitudinal study could possibly support the earlier findings if the time estimations should vary with the clinical states of the patients. Such a variation was suggested by the results of 5 of the 8 patients. In several cases there were statistically significant correlations between the results of time estimations and the rating scores. This partly supports earlier findings. Associations between time estimations and changes in clinical state seem to be present in some cases of major affective disorders. Operative estimations were best correlated with ratings in most cases. PMID- 3982929 TI - I E S arrow-dot performance of Nigerian juvenile delinquents and secondary school students. PMID- 3982931 TI - Spontaneous eyeblinks elicited by vertical eye movements. AB - Two experiments were carried out to examine the relationship between eyeblinks and eye movements under a visual search task. Exp. I showed that the vertical eye movements brought about slightly more eyeblinks than the horizontal ones. In Exp. II, the vertical eye movements were accompanied with significantly more frequent eyeblinks than the horizontal ones. Upward saccadic eye movements especially were associated with the more frequent eyeblinks than the downward ones. These results suggested a possible relationship between the eyeblinks and Bell's phenomenon. However, the comparison of eyeblink rates between eye-movement and the no-eye movement conditions in Exp. II indicated that in the latter condition eyeblinks were significantly more frequent than in the former condition. Some psychological factors were suggested as likely important determinants of the frequency of eyeblinks. PMID- 3982930 TI - Psychology of spaceflight: II. Suggested bases of space motion sickness: perceptual disorientation and elevated stomach pH. AB - Suggested causes of space-motion sickness are inferred from the experiences of a group of astronaut candidates and from the vomit pH values of nonastronauts. Both groups experienced stimulated weightlessness in an airplane. PMID- 3982932 TI - Cognitive styles: illusory phenomena. AB - The relationship between cognitive style and illusion magnitude was examined using the assimilation and contrast Delboeuf distortions. As in previous research, field dependence correlated positively with assimilation; however, a significant negative correlation with contrast was also found, suggesting that, while field dependence may involve the illusory integration of the stimulus field, field independence may involve its equally illusory differentiation. PMID- 3982933 TI - A computational approach to visual recognition of arm movements. AB - A representation for the visual recognition of skilled arm movements is proposed that lies within Marr and Vaina's (1982) three-dimensional model representation for shape movements. Algorithms for segmenting arm movements into pieces are proposed. It is suggested that for a large class of arm movements recognition could be reliably achieved based only on the description of the hand shape and path in the body coordinates, without needing the detailed description of the variation of all the joint angles of the arm. PMID- 3982934 TI - Isokinetic endurance of men of high and low strength. PMID- 3982935 TI - Health versus activity in elderly persons' locus of control. PMID- 3982936 TI - Touching behaviors of winners and losers in swimming races. AB - This study compared touching behaviors of swimmers who were winners and losers. The number and location of interpersonal touches given and received by winners and losers of swimming races were recorded. Winners gave and received significantly more touches than losers. Most touches were hands, back, or shoulders, confirming earlier findings for college men and women. PMID- 3982937 TI - Effect of using mechanical devices for baseball batting on warm-up decrement. AB - The extent to which different mechanical baseball-batting devices used during a rest affected performance immediately after rest (warm-up decrement) was examined. Difference scores between the average of prerest Trials 8, 9, and 10 and each of 10 postrest trials were used to determine the presence of warm-up decrement. It was predicted that the use of a batting-T and the Batter's Aid machine (in which a batter swings at a ball popped up within the strike zone) would result in superior performance measured as the distance (ft.) a ball was hit and frequency of contacts on postrest performance reducing or eliminating the warm-up decrement. Performance of 33 boys, aged 11 and 12 yr., indicated that only use of the Batter's Aid eliminated warm-up decrement with respect to both the distance and frequency as compared to the batting-T and control groups. In addition, the batting-T condition solicited significantly better performance than the controls on the distance measure but was statistically similar to the controls in frequency of contacts. Also, superior performance was significantly related to heightened heart rate, a physiological index of arousal. A primary explanation of the results focused on the effects of heightened physiological and psychological arousal on warm-up decrement. PMID- 3982938 TI - Serial movement timing and musical experience. AB - Musicians and non-musicians were compared on a serial movement-timing task incorporating six continuous 11-cm segments. The serial pattern was structured for both spatial and temporal symmetry. There were seven subjects in each group and 50 test trials were analyzed for timing error. The non-musicians were less accurate and more variable for certain parts of the pattern. The findings supported the view that musical practice can assist the process of mapping internal representations of serial relations to novel spatio-temporal patterns of movement. PMID- 3982939 TI - Locus of control and effects of perceptual tasks on heart rate. AB - The hypothesis was tested that the relationship found in prior research between heart rate changes produced in biofeedback settings and locus of control scores derives from the heart-brain relationship described by the Laceys in 1967, as well as from "expectancies for control." 48 subjects were tested on two perceptual tasks known to elicit changes in heart rate. Significant heart rate changes were observed in response to both tasks, but those changes did not correlate with locus of control as measured by scores on the Rotter I-E Scale and the Multidimensional Health Locus of Control Scale. Explanations for these results are offered. PMID- 3982940 TI - Erratic eye movements and dyslexia: factors determining their relationship. AB - Studies of dyslexia often produce contradictory results. Studies of eye movement are not an exception to this rule. The differences between Black, et al.'s 1984 and Pavlidis's 1981 eye-movement results are mainly due to differences in: (a) unquantifiable and variable criteria for selection of subjects, (b) incompatible experimental designs and procedures, (c) varying stimulus characteristics, and (d) major differences in the methods of data acquisition and analysis. The solution of these problems requires the establishment of quantifiable Research Diagnostic Criteria for Dyslexia and the use of compatible methods of data acquisition and analysis. The adoption of these standards would lead to a better understanding of dyslexia and would also make possible meaningful replications of major studies. PMID- 3982941 TI - Recovery of performance during sleep following sleep deprivation in older normal and insomniac adult males. AB - Groups of 12 normal and insomniac male subjects aged 55 to 71 yr. were sleep deprived for 64 hr. In both groups, the sleep loss was preceded by four baseline sleep nights and followed by four recovery nights. Reaction time, immediate recall, sleepiness, and body temperature were measured at approximately 2300, 0115, 0330, 0530, and 0800 during baseline, deprivation and recovery nights. Significant performance or mood differences were not found between the normal and insomniac males on any measure or at any testing period throughout the study. Performance of both groups declined characteristically during sleep loss while subjective sleepiness increased. As in young adults, degraded performance was restored by 8 hr. of recovery sleep. However, subjective sleepiness did not return to baseline levels until early in the second recovery night. It was concluded that chronic insomnia does not result in group performance deficits similar to those seen after chronic sleep loss; and the restorative function of sleep operates as efficiently in older insomniac subjects (who apparently have reduced need to sleep) as in older normal subjects. PMID- 3982942 TI - Effect of scaling method on perception of textiles. AB - This study examined the effect of scaling methods on tactual ratings of fabrics. Four tactile attributes, namely, stiffness, thickness, roughness, and warmth, of 11 test fabrics with a wide variety of tactual qualities were evaluated by 75 college students enrolled in textile courses. The tactual ratings of all four attributes evaluated by touch and sight and touch were significantly correlated. The tactual evaluation made on a 7-point semantic differential scale on each test fabric was compared with tactual ranking by paired-comparison method. Significant correlations were found between two rankings of four attributes. PMID- 3982943 TI - Geophysical variables and behavior: XXI. Geomagnetic variation as possible enhancement stimuli for UFO reports preceding earthtremors. AB - The contribution of geomagnetic variation to the occurrence of UFORs (reports of UFOs) within the New Madrid States during the 6-mo. increments before increases in the numbers of IV-V or less intensity earthquakes within the central USA was determined. Although statistically significant zero-order correlations existed between measures of earthquakes, UFORs and geomagnetic variability, the association between the latter two deteriorated markedly when their shared variance with earthquakes was held constant. These outcomes are compatible with the hypothesis that geomagnetic variability (or phenomena associated with it) may enhance UFORs but only if tectonic stress and strain are increasing within the region. PMID- 3982944 TI - Hemisphericity, locus of control, and grade point average among middle and high school boys and girls. AB - The Learning Style Questionnaire and the Children's Nowicki-Strickland I-E Control Scale were given to 128 boys and girls in Grades 8 and 11 in the La Grande (Oregon) School District. Each subject's previous year's grade point average was obtained to determine the relationships among hemisphericity, locus of control, and achievement. Also assessed, including interactions, were differences in hemisphericity, locus of control, and achievement by sex and grade. There was a significant relationship (of low practical value) between locus of control and GPA only. The difference in hemisphericity scores with respect to grade was significant. PMID- 3982945 TI - Effects of a systematic program of exercise on selected measures of creativity. AB - 23 co-ed students ran for 20 min. for 16 sessions. During the first and last class sessions, before running, they and a control group, were tested on 3 measures of creative thinking (verbal adaptability, diversity and originality). After the exercise sessions there were small but significant gains in measures of Remote Consequences and Alternate Uses. PMID- 3982946 TI - Geophysical variables and behavior: XXII. The tectonogenic strain continuum of unusual events. AB - Transient and very localized geophysical forces are hypothesized to be a major source of phenomena that have been traditionally labelled as haunts and poltergeists. They would be generated by increasing tectonic stresses and would display electromagnetic and gravitational characteristics. Materials would be influenced according to their physical properties. Dielectric materials would respond differently from conductors. Organic semiconductors, of which the human being is an important subcategory, would be affected as well. The conspicuous overlaps between (non-convulsive) complex partial epilepsy and many episodes of poltergeists and haunts are expected in light of the direct stimulation of the observer's brain by the transient, intense magnetic fields and the liability of temporal lobe structures. Implications and some general predictions for the distribution of these phenomena in time and space are discussed. PMID- 3982947 TI - Effects of exercise on choice reaction latency and movement speed. AB - Performance and learning of an 8-choice RT-MT task was investigated as a function of two levels of interpolated arm exercise. Following a pretest under control nonexercise conditions, 90 subjects were given 60 trials under one of three experimental conditions (low intensity, high intensity, and vowel-cancelling). This was followed on a second day by a further 18 trials under control conditions. Predictions from the theory of exercise-induced activation received only limited support by the indication that the highly intense condition impaired RT. Exercise of low intensity did not facilitate RT. For MT no differential effects were found. Similarly, learning RT and MT was unaffected by exercise. These findings indicate that the theory of exercise-induced activation needs to be developed further to account for response situations that have high demand for attention. PMID- 3982948 TI - Relationship between emotions and muscle tension in oro-alimentary behavior. AB - The relationship between muscular tension in the right and left masseter and orbicularis oris and different forms of hostility measured through the Gottschalk test was examined for 24 female subjects. For the muscles of the right half of the body a direct relation was noted with overt outward hostility, while on the left half of the body only the tension of the masseter was related directly to ambivalent hostility. Our hypothesis about a link between modulation of aggressive behaviors and muscles involved in functions such as chewing and biting was confirmed. PMID- 3982949 TI - Perceptual skill in decoding facial affect. AB - The perceptual skill in identifying the briefly exposed photographs of facial affect was examined with 75 men and 75 women who were asked to judge six cross culturally recognizable slides, each expressing one of the six emotions exposed at three different time intervals. Each subject was required to give six judgments and the number of correct responses was considered his score. Analysis by a 3 X 2 factorial design indicated the longer the exposure of the photograph the better the recognition. Although there was no over-all sex difference, analysis by emotions confirmed significantly better accuracy by the women judging 'sadness' than by men, and men were more accurate for 'anger' than were women. PMID- 3982950 TI - Accuracy of remembering postdelivery pain. AB - Memory for pain after delivery was assessed by means of a verbal rating scale. 238 young women giving birth to healthy babies as a result of spontaneous delivery were asked to rate intensity of pain immediately following delivery. A day or two later, they were asked to remember how much pain they had experienced immediately after delivery. Analysis showed that the recall of pain was fairly accurate, irrespective of personality type, the level of education, and the number of childbirths. The findings provide some support for the reliability of pain reports from memory for a nonpatient population experiencing a rather unique pain experience. PMID- 3982951 TI - Food and a sustained release theophylline tablet on chronic dosing: bioavailability, peak-trough and trough-trough differences. AB - The bioavailability of theophylline and the serum concentration fluctuations after administration of a sustained release tablet (Theograd 250 mg, one tablet twice daily) were studied in the steady state in six volunteers. On postprandial administration of the 250 mg tablets the bioavailability was 89 +/- 16%. Good sustained release properties were obtained provided that the tablets were taken after a meal; Cmax was 7.9 +/- 2.0 mg X 1(-1), tmax was 5.3 +/- 1.6 h, the peak trough difference was 2.3 +/- 0.6 mg X 1(-1) and the serum concentration fluctuation was accounted for 42.8 +/- 11.2%. It was shown that on postprandial administration the mean serum concentration-time profile could be successfully calculated by means of multiple dose projection from single dose data. However, when the a.m. dose was given on an empty stomach and the p.m. dose 3 h after a meal, it appeared not to be possible to use the single diurnal dose data for calculation of the steady state serum concentration-time profile: the experimentally observed a.m. trough levels were significantly higher than the p.m. trough values and also the observed mean serum concentration was significantly higher than the calculated level. The possible causes for this discrepancy are extensively discussed. PMID- 3982952 TI - Pharmacokinetic interactions between indomethacin and paracetamol in the rat. AB - The influence of concurrent administration of paracetamol with indomethacin on the plasma concentrations of these drugs was studied in rats. Orally administered paracetamol reduced the plasma levels of indomethacin during the first 2 hours after oral administration. Later, 16 and 24 hours after administration of indomethacin, the plasma levels exceeded the control values due to the concurrent oral administration of paracetamol. These data suggest that paracetamol delayed the absorption of indomethacin. In contrast the plasma concentrations of paracetamol were not influenced substantially by indomethacin. When paracetamol was co-administered subcutaneously with oral indomethacin, the plasma levels of the latter drug were not influenced. It is concluded that the protective effect of paracetamol against the gastric injuring side effect of indomethacin, which also occurs with subcutaneous administration of paracetamol, cannot be solely due to lowered plasma concentrations of indomethacin. PMID- 3982953 TI - Decrease in membrane conductance induced by noradrenaline in the smooth muscle of guinea-pig vas deferens. AB - The electrical response of the smooth muscle of guinea-pig vas deferens to exogenously applied noradrenaline (NA) was examined using the double sucrose-gap method. NA evoked a depolarization of the smooth muscle membrane which was associated with an increase in the size of electrotonic potentials. A conditioning depolarization of the membrane induced by current application enhanced the size of NA-induced depolarization, whereas a conditioning hyperpolarization reduced it. When a conditioning hyperpolarization of 25 mV in magnitude was applied, the direction of potential change induced by NA was reversed. These results are discussed with respect to the ionic mechanism of the electrical event in response to NA in this tissue. PMID- 3982954 TI - Evidence for an increase in membrane conductance during adenosine triphosphate induced depolarization in the guinea-pig vas deferens. AB - The effects of exogenously applied adenosine triphosphate (ATP) on the smooth muscle of guinea-pig vas deferens were studied with the double sucrose-gap method. ATP evoked a membrane depolarization which was associated with a decrease in the size of electrotonic potentials. Conditioning hyperpolarization induced by current application caused an increase in the magnitude of the ATP-induced depolarization; the larger the conditioning hyperpolarization, the greater the ATP-induced depolarization. These results are discussed with respect to the ionic mechanism of the electrical event in response to ATP in this tissue. PMID- 3982956 TI - Stimulation by glucagon and PTH of Ca and Mg reabsorption in the superficial distal tubule of the rat kidney. AB - The effects of glucagon and PTH on electrolyte reabsorption in the distal tubule were investigated in rats deprived of vasopressin, calcitonin, PTH, and glucagon. Micropunctures of distal tubule, at a late and an early site of a same nephron, have been performed in 23 rats, nine control, seven infused with glucagon (5 ng X min-1 X 100 g-1 b.w.) and seven with PTH (5 mU X min-1 X 100 g-1 b.w.). The Ca and Mg reabsorptive capacity of the distal segment was increased by glucagon and by PTH. Moreover, fractional Na and Cl reabsorption was significantly higher than in control during PTH administration. A K secretion appeared during the administration of both hormones. No phosphate net transport was observed in any group. Finally, the data presented here, together with those previously reported, indicate that the increase of Ca and Mg renal reabsorption observed with glucagon and PTH results from an effect located in both Henle's loop, where the bulk of Ca and Mg is reabsorbed, and the distal tubule. PMID- 3982955 TI - Relative roles of vagal and sympathetic effector mechanisms in the baroreflex control of myocardial contractility in conscious rabbits. AB - The relative roles of vagal and sympathetic effector mechanisms in the baroreflex control of myocardial contractility have been assessed in the conscious normotensive and hypertensive rabbit. Graded increases in mean arterial pressure (MAP) were produced by inflation of a balloon occluder around the abdominal aorta. Stimulus response curves relating the change in MAP to the induced change in peak rate of change of left ventricular pressure (peak LV dP/dt) were produced when heart rate was allowed to change and when it was held constant by atrial pacing. These curves were repeated after sympathetic blockade with propranolol, vagal blockade with methylscopolamine and combined blockade with the two drugs together. Increase in MAP produced a reflex fall in peak LV dP/dt which was due to two components. There was a reflex negative inotropic effect which was independent of heart rate, occurring in animals in whom heart rate was held constant by atrial pacing, and there was also a reduction in peak LV dP/dt which was caused by the reflex bradycardia when the heart rate was allowed to change. Both sympathetic and vagal efferents contributed to the reflex fall in peak LV dP/dt seen after elevation of MAP, the sympathetic being primarily responsible for the direct negative inotropic effect and the vagus for the bradycardia and hence the secondary effects on peak LV dP/dt. The slope of the stimulus response curves relating the fall in peak LV dP/dt to the increase in MAP was similar in intact normotensive and hypertensive rabbits, both with and without atrial pacing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982958 TI - 36Cl fluxes in dispersed rat submandibular acini: effects of acetylcholine and transport inhibitors. AB - Acini isolated from the rat submandibular gland showed uptake of 36Cl in the absence of added test substances. A steady state of 36Cl content corresponding to 9.5 +/- 0.7 nM/mg protein was attained in 4-5 min and maintained for 25-30 min. This uptake of 36Cl was reduced 40-50% by previous exposure to 10(-3) M furosemide, 10(-3) M ouabain, or K+-free medium. The steady state of 36Cl content was reduced 34% by 10(-6) M acetylcholine while exposure of the acini to the stilbene sulfonic DIDS (10(-3) M) did not modify 36Cl uptake either in the absence (basal) or presence of acetylcholine. Acetylcholine caused a rapid reduction of 36Cl from tracer-preloaded acini (42% in 1 min), while furosemide induced a slower reduction of tracer content (45% in 9 min). Acetylcholine increased the rate of reduction of tracer content induced by furosemide and the latter caused a further reduction in 36Cl content of acini previously exposed to acetylcholine. It is concluded that a furosemide-sensitive Cl uptake is present in rat submandibular acini, which depends on the Na+ gradient generated by the Na, K pump and on external K+. These findings suggest that a Na-K-Cl cotransport system driven by the Na, K pump is present in salivary acinar cells. Acetylcholine induces a rapid net efflux of 36Cl, which probably masks any effect that this secretagogue may have on Cl uptake. The lack of effect of DIDS on 36Cl uptake suggests that anion exchange transport systems are either not present in rat submandibular acini or can only be ascertained under different incubation conditions. PMID- 3982957 TI - Effects of SITS on urate transport by isolated, perfused snake renal tubules. AB - Effects of an inhibitor of membrane anion-exchange transport processes, 4 acetamido-4'-isothiocyano-2,2'-disulfonic stilbene (SITS), on urate transport by isolated, perfused snake (Thamnophis spp.) proximal renal tubules were studied. SITS (10(-4) mol/l) in the luminal perfusate had absolutely no effect on net urate secretion (Jneturate) or on net fluid absorption (JV). This observation is compatible with other data that give no support to the concept of a mediated transport step for urate from the cells to the lumen. SITS (10(-4) mol/l) in the bathing medium reversibly inhibited Jneturate without affecting JV. At the time of maximum inhibition of Jneturate, the concentration of urate in the cell water was increased and the apparent permeability of the luminal membrane to urate was decreased, but the urate efflux across the peritubular membrane and the apparent permeability of the peritubular membrane to urate were unchanged. There was no evidence of significant intracellular binding or trapping of urate. Although an increase in the initial rate of urate transport into the cells across the peritubular membrane could not be demonstrated conclusively in nonperfused tubules, the results still suggest that SITS in the bathing medium may inhibit Jneturate by inhibiting urate movement from the cells to the lumen while actually enhancing transport from the bathing medium into the cells. PMID- 3982959 TI - Long-term recording of core temperatures with chronically implanted silicon diodes. AB - An electronic circuit for measurement of temperatures is described utilizing silicon diodes as temperature sensors and the feature that the reverse current flow of a diode is linearly related to temperature. Once calibrated and implanted into various sites of the body core of rabbits, the diodes preserved their precise temperature sensing qualities for periods longer than a year. Temperature changes of the atlanto-occipital membrane were found to be close to simultaneously measured intracisternal temperature, both temperatures being some 0.3 degree C higher than rectal temperature. This temperature-relationship persisted under conditions with different states of cutaneous vasoconstriction and thermal panting as observed in fever and during defervescence. These results indicate that extrahypothalamic brain regions as the cerebellum and the medulla oblongata do not benefit from the proposed protective function of brain cooling during stimulation of heat dissipating effector mechanisms. PMID- 3982960 TI - Medullary respiratory-related neurons with axonal connections to rostral pons and their function in termination of inspiration. AB - In urethane-anaesthetized, paralyzed and artificially ventilated rabbits, medullary respiration-related neurons (RRU) were classified according to the phase relation of their burst discharge to phrenic nerve activity. Phase-bound inspiratory (I) or expiratory (E) neurons were discriminated from phase-spanning expiratory-inspiratory (EI) or inspiratory-expiratory (IE) units. Mechanisms of termination of inspiration by electrical stimulation of rostral pontine nuclei (Nc. parabrachialis medialis; Lc. coeruleus) were examined firstly to demonstrate whether RRU receive descending excitatory and inhibitory afferents as well as ascending efferents and secondly to analyse the time course of the neuronal pathways involved. Of 120 RRU, 38 neurons were demonstrated to receive pontine afferents. About 33% of all E neurons became orthodromically excited during rostral pons stimulation whereas 18.2% of all I cells became orthodromically inhibited. Some RRU were shown to project up to the rostral pons. 50% of these were of the phase-spanning IE type. The onset of inspiratory inhibition induced by rostral pons stimulation occurred 3.4 ms after the onset of single electrical pulse stimulation. Based on these results a neuronal model for a pontine mechanism terminating inspiration is proposed. PMID- 3982961 TI - Sinus slowing and pacemaker shift caused by adenosine in rabbit SA node. AB - Adenosine has a negative chronotropic effect in a number of species. The studies reported here were undertaken to characterize further the effects of adenosine using isolated perfused rabbit hearts and isolated SA node tissue. In the isolated perfused hearts (n = 9) the threshold doses for slowing by adenosine and 2-chloroadenosine, an adenosine analog, were 1 X 10(-5) M and 1 X 10(-7) M, respectively. In the isolated hearts adenosine, in addition to slowing sinus rate, also caused a change in the activation pattern of the right atrium. During adenosine infusion the earliest site of activation shifted from the SA node region to the right atria near the crista terminalis. The pacemaker shift was reversible upon washout of adenosine. The adenosine -induced shift in pacemaker could also be demonstrated using microelectrode recordings in the isolated SA node preparation that included the crista terminalis and some of the surrounding tissue. During control the activation of SA node preceded that of the crista terminalis (CT) by 44 +/- 4.1 ms (n = 11). Adenosine infusion caused an increase in cycle length and, in addition shifted the earliest site of activation from the SA node region to CT, i.e., in the presence of adenosine CT preceded SA node activation by 26.68 +/- 3.2 ms. All the effects were reversible after washout of adenosine. Adenosine also caused conduction block within the sinus node. No effect on the action potentials or on conduction in the CT was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982962 TI - Correlation of sinus slowing and hyperpolarization caused by adenosine in sinus node. AB - The effect of adenosine on sinus node cells was examined in a preparation that precluded pacemaker shift. It was found that adenosine produced a dose-dependent slowing in rate. In examining the effects on the action potential parameters (n = 10), adenosine caused a significant increase in the maximum diastolic potential (control = -62 +/- 2 mV, adenosine, 1 X 10(-4) M, = -67 +/- 3 mV) and a significant increase in the rate of rise of the action potential (control = 3.3 +/- 0.6 V/s, adenosine, 1 X 10(-4) M, = 7.2 +/- 2 V/s). There was only a slight shortening of the action potential duration and a small increase in the action potential overshoot. Adenosine caused a significant decrease in the rate of diastolic depolarization (control = 100 +/- 19 mV/s, adenosine, 1 X 10(-4) M, = 42 +/- 5 mV/s). Acetylcholine caused similar effects. The effects of adenosine were not affected by atropine or propranolol but were antagonized by aminophylline, an adenosine competitive antagonist. In another set of experiments (n = 12) we sought to understand further the mechanism of sinus slowing caused by adenosine and compare with the effects of acetylcholine. The increase in cycle length due to different doses of adenosine and acetylcholine was measured. The preparation was then arrested with D-600 or NiCl2. The cells were then exposed to the same concentrations of adenosine and acetylcholine and the amount of hyperpolarization from the resting potential (means = -40 +/- 4 mV) was measured. The change in cycle length and amount of hyperpolarization were linearly correlated (r = 0.86).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982963 TI - Passive cation permeability of turtle colon: evidence for a negative interaction between intracellular sodium and apical sodium permeability. AB - The role of intracellular sodium in the regulation of apical sodium permeability was investigated in an electrically "tight" epithelium, the turtle colon. In the presence of low mucosal sodium (3 mM) and serosal ouabain, an inhibitor of the basolateral sodium pump, the apical membrane retained a substantial amiloride sensitive, sodium conductance and the basolateral membrane exhibited a barium sensitive potassium conductance in parallel with a significant sodium (and lithium) conductance. In the presence of a high mucosal sodium concentration (114 mM), however, inhibition of active sodium absorption by ouabain led to a disappearance of the amiloride-sensitive, transepithelial conductance that was due, at least in part, to a virtual abolition of the apical sodium permeability. Two lines of evidence indicate that this permeability decrease was dependent upon an increase in intracellular sodium content. First, raising the mucosal sodium concentration from 3-114 mM in the presence of ouabain reversibly inhibited the amiloride-sensitive conductance. The time course of the decline in conductance paralleled the apparent intracellular accumulation of sodium in exchange for potassium, which was monitored as a transient deflection in the amiloride sensitive, short-circuit current. Second, the inhibitory effect of mucosal sodium addition was markedly attenuated by serosal barium, which prevented the accumulation of sodium by blocking the electrically coupled, basolateral potassium exit. These results support the notion of a "negative feedback" effect of intracellular sodium on the apical sodium permeability. PMID- 3982965 TI - Proximal tubular transport and urinary excretion of sodium after renal denervation in sodium depleted rats. AB - The effect of unilateral renal denervation on renal handling of water, sodium and potassium was studied with clearance and micropuncture techniques in sodium depleted anaesthetized rats in the nondiuretic state. In clearance experiments renal denervation resulted in a +140 and +320% increase in urine flow and potassium excretion, but sodium excretion of innervated (I) and denervated (D) kidneys was similar (I: 12.0 +/- 2.0, D: 14.0 +/- 3.6 nM . min-1 . g-1; NS). However, upon the loop diuretic furosemide (1 mg . kg-1), a marked denervation natriuresis was observed (I: 2.8 +/- 0.9, D: 5.9 +/- 1.0 microM . min-1; P less than 0.05) and denervation diuresis and kaliuresis persisted, too (+95 and +60%, respectively). Micropuncture results revealed that fractional reabsorption of filtrate to late proximal puncture site was depressed by renal denervation from 62 to 49% while no change in time control rats was seen (64 +/- 2 vs. 64 +/- 1%; NS). In micropuncture experiments besides augmented urine flow (+82%) from D kidneys also a small denervation natriuresis was present (I: 21.6 +/- 6.4, D: 29.2 +/- 7.0 nM . min-1; P less than 0.05). It is concluded that the lack or marked attenuation of denervation natriuresis in sodium depleted rats were the result of an almost complete compensatory distal reabsorption of the excess sodium (but not of water and potassium) leaving the proximal tubule after denervation. The distal adaptive response can be overcome by furosemide. PMID- 3982964 TI - Regulation of volume reabsorption by thyroid hormones in the proximal tubule of rat: minor role of luminal sodium permeability. AB - In order to investigate whether changes in luminal membrane sodium permeability can explain the increase in isotonic fluid reabsorption (Jv) found in proximal tubules of thyroidectomized rats (TX) treated with tri-iodothyronine (T3), experiments were carried out on TX rats and TX rats treated for 3 days (TX + T3) with physiological doses (10 micrograms/kg body wt) of T3. Two sets of experiments were performed: 1) in vivo, using the micropuncture technique for the measurements of Jv; 2) in vitro, using isolated brush border membrane vesicles for the direct measurement of Na+ permeability. In micropuncture studies a 65% increase in Jv of TX rats was observed after treatment with T3. Luminal perfusion of proximal tubules of TX rats with Amphotericin B (10 micrograms/ml), to increase luminal sodium permeability, enhanced Jv only by 15%. Brush border membrane vesicles isolated from TX and TX + T3 rats showed the same sodium permeability in uptake or efflux experiments. These results were confirmed by the fact that sodium gradient dependent histidine transport into brush border membrane vesicles did not change after T3 treatment. Finally, measuring the amiloride sensitive sodium uptake, it was also found that Na+-H+ exchange was also only slightly affected by T3. These micropuncture and vesicle data indicate that the large effect of T3 on the trans-cellular sodium transport and volume reabsorption in the proximal tubule, cannot be explained by an action of T3 on the sodium entry step across the brush border membrane. PMID- 3982966 TI - Streaming potentials and diffusion potentials across rabbit proximal convoluted tubule. AB - The streaming potential, defined as the transepithelial potential appearing in the presence of an osmotic water flow, was measured in rabbit kidney proximal convoluted tubules perfused in vitro. The S2 segments studied were dissected from mid-cortical and juxtamedullary portions of the kidney and the streaming potential induced by the addition of raffinose in bath was compared for each tubule with the diffusion potential corresponding to an imposed NaCl gradient in the absence of osmotic gradient. The amplitude of the measured streaming potential was found to vary from positive to negative values (+0.9 to -1.8 mV) according to the location of the dissected tubule: the more juxtamedullary the nephron, the more lumen negative was the streaming potential. This correlated well with the diffusion potentials recorded on the same tubules and the amplitude of the streaming potentials was a close function of the PNa/PCl ratios calculated from these diffusion potentials. This is in agreement with the hypothesis of solute polarization in an unstirred layer as the origin of the streaming potential; a calculation of hydraulic permeability (Pf) of the proximal tubule, taking the role of such an unstirred layer into consideration is proposed. PMID- 3982967 TI - Pelvic afferent reflex control of rectal motility and lumbar colonic efferent discharge mediated by the pontine sympatho-inhibitory region in guinea pigs. AB - Rectal motility and the efferent discharge of lumbar colonic nerves (LCED) have previously been shown to be affected by reflex activity activated by rectal stimulation. The sensory limb of this reflex is represented by afferent fibers in pelvic nerves. The present study revealed that this reflex is modulated by supraspinal sympatho-inhibitory regions. Pelvic afferent stimulation led to rectal contraction through the withdrawal of a tonic inhibitory influence of lumbar colonic nerves. The supraspinal region responsible for this antagonism of the rectal-inhibitory colonic nerve activity was localized to the pons. Neither the intravenous administration of atropine nor that of guanethidine (and Eisai compound 865-123, another adrenergic neuron blocking agent) effected the ability of pelvic afferent stimulation to inhibit tonic discharge of lumbar colonic efferent nerves; nevertheless, both agents eliminated the mechanical response of the rectum to stimulation of pelvic afferents. These observations suggest that lumbar sympathetic nerves may tonically inhibit the release of acetylcholine from excitatory neurons in the rectal myenteric plexus. We conclude that descending fibers from the pons are activated as a result of pelvic afferent nerve stimulation. These descending pontine fibers in turn inhibit the firing of sympathetic lumbar colonic nerves. Removal of this tonic restraint leads to rectal contraction. PMID- 3982968 TI - Anion dependence of electrical effects of bicarbonate and sodium on cultured bovine corneal endothelial cells. AB - Using intracellular microelectrode technique, the effect of anion substitution on the voltage responses to extracellular bicarbonate and sodium was explored in cultured bovine corneal endothelial cells. The overall amplitude of voltage changes induced by periodic changes of [HCO-3]o (depolarization upon removal of HCO-3 and hyperpolarization upon readdition) was reduced when Cl- was replaced by organic anions (cyclamate, methylsulfate, benzenesulfonate) or by SO4(2-), and to a lesser extent by substitution with Br-. There was a similar effect of anion substitution on the response to changes of [Na+]o. In both cases, in the absence of Cl, the voltage V returned at a slower rate to baseline levels after it had been transiently changed by either an imposed Na- or HCO3- gradient, indicating a slower dissipation of these gradients. The direct response of V to these imposed gradients was affected only to a minor degree. Replacement of Cl- by SO4(2-) or organic anions led to a slow, reversible depolarization of the cell, while substitution with Br- had only a slight effect. The effect of anion substitution on the voltage responses to HCO-3 or Na+ could not be mimicked by a depolarization induced by Ba2+ (1 mM). Furosemide (10(-3) M) led to a slight reduction of the voltage responses to HCO-3, but could not suppress the effect of anion substitution on these reactions. It could neither suppress the depolarization induced by anion substitution and had no effect on steady-state PD. It is suggested, that cultured bovine corneal endothelial cells, in addition to a previously demonstrated electrogenic HCO-3-Na+-cotransport, which is probably not dependent on Cl, possess an electroneutral mechanism for HCO-3 and/or Na+-movement, which depends on Cl. No evidence for a Cl-conductance could be obtained. PMID- 3982969 TI - Effects of aldosterone and dexamethasone on apical membrane properties and Na transport of rabbit distal colon in vitro. AB - The effects of pre-treatment in vivo with aldosterone and dexamethasone were investigated on rabbit distal colon. Apical Na-permeability and net sodium transport were measured in vitro. In this epithelium, Na-transport is entirely electrogenic. It can therefore be measured electrically as the fraction of short circuit current which is blockable by amiloride. The epithelia were studied in an Ussing chamber and the electrical values recorded by a computerized digital voltage clamp. Transepithelial parameters, and the transapical membrane parameters (in preparations depolarized from the serosal side) were investigated after treatment with the two hormones. Under transepithelial conditions, aldosterone and dexamethasone stimulated the short circuit current (Isc) from control (17.4 microA/cm2) to a similar degree (86.6 and 93.8 microA/cm2). However, whereas aldosterone did not alter the transepithelial resistance (RT) significantly, dexamethasone reduced RT from 357 to 167 omega X cm2. The stimulation of the potential difference (VT) under control condition (6.6 mV) was therefore significantly different between aldosterone (28.7 mV) and dexamethasone (16 mV). Mucosal amiloride (0.1 mM) inhibited Isc and VT completely under all conditions. Steady state current-voltage relations were obtained by voltage clamping the tissues in "staircase" increments before and after mucosal treatment with amiloride. As measured by the difference between these two states, Na currents were calculated both for the transepithelial and the transapical condition. Intracellular Na-activity and apical Na-permeability were then calculated by the Nernst and Goldman-Hodgkin-Katz equations. These values were found to be increased after treatment with both hormones. Dexamethasone was a more potent stimulator of both values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982970 TI - NADH in human skeletal muscle during short-term intense exercise. AB - The influence of high-intensity bicycle exercise on the redox level and lactate accumulation in skeletal muscle (m. quadriceps femoris) of man has been investigated. Six subjects exercised to exhaustion at a load corresponding to 100% VO2max. Muscle content of NADH, determined by the bioluminescence technique, increased from (means +/- SEM) 0.089 +/- 0.007 mmol/kg dry wt. at rest to 0.190 +/- 0.031 after 2 min of exercise (P less than 0.05) and to 0.213 +/- 0.021 at exhaustion (P less than 0.05). Values after 2 min exercise and at exhaustion were not statistically different (P greater than 0.05). Muscle lactate was increased 13-fold after 2 min of exercise and 22-fold at exhaustion as compared to the resting value. After 10 min recovery NADH was restored back to the pre-exercise level whereas muscle lactate was still elevated. The increase of muscle NADH during exercise is in contrast to earlier studies on isolated animal muscles, where an oxidation of NADH was observed during contractions. The difference might be due to the experimental model (isolated muscle vs. in vivo) or to the analytical method (qualitative data by reflectance fluorimetri from the surface of intact muscle vs. quantitative data from muscle extracts). Calculations of the cytosolic NADH concentration from the lactate dehydrogenase equilibrium show that 95% or more of the NADH is confined to the mitochondrial compartment. The observed increase of muscle NADH therefore imply that the redox potential of the mitochondria is decreased during intense exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3982972 TI - Pharmacological zero for electromagnetic renal blood flow measurement. AB - Measurement of blood flow in chronically instrumented laboratory animals using electromagnetic flow probes depends on a reference "zero flow" value. The latter is usually obtained by mechanical vessel occlusion. We tested an alternative method: a bolus of angiotensin II was injected in the abdominal aorta resulting in an immediate decrease of renal blood flow. Diastolic blood flow at this stage appeared to be identical to the zero level obtained by mechanical occlusion. Thus, pharmacological interruption of renal blood flow may serve as a zero reference in the dog. PMID- 3982971 TI - Regulation of isometric force and isotonic shortening velocity by phosphorylation of the 20,000 dalton myosin light chain of rat uterine smooth muscle. AB - The regulation of isometric force maintenance and isotonic shortening velocity by phosphorylation of the 20,000 dalton light chain of myosin has been examined for potassium-depolarized rat uterine smooth muscle. Following a transient peak in myosin light chain (LC20) phosphorylation at 20 s of contraction (0.46 mol PO4/mol LC20), phosphorylation declined to a steady-state by 2 min (0.28 mol PO4/mol LC20) with no significant change from 2-90 min of contraction. Isometric force developed more slowly, reaching a maximum at 2 min with no further change out to 90 min. Lightly-loaded (0.1 F0) shortening velocity, like LC20 phosphorylation, increased initially to a peak of 0.034 L0/s at 20 s of contraction and then declined to 0.023 L0/s by 2 min. However, unlike LC20 phosphorylation and isometric force, shortening velocity decreased approximately 4-fold from 0.023 L0/s at 2 min to 0.006 L0/s at 90 min of contraction. Graded activation with reduced extracellular calcium was associated with proportional changes in steady-state isometric force and LC20 phosphorylation. Shortening velocity was also decreased with reduced calcium, however, unlike LC20 phosphorylation, the greatest changes in velocity occurred at low levels of developed force. Moreover, in contrast to the large reductions in shortening velocity observed during 90 min contractions where force and LC20 phosphorylation were unchanged, similar reductions in shortening velocity did not occur with graded activation in spite of significant (greater than 3-fold) decreases in both force and LC20 phosphorylation. These results suggest that factors other than light chain phosphorylation are involved in the regulation of isotonic shortening velocity during extended isometric contractions of uterine smooth muscle. PMID- 3982973 TI - The effect of high K+ depolarization and verapamil on 45Ca2+ fluxes in the canine myocardium. AB - The effects of high K+ depolarization and verapamil on Ca2+ uptake and the total intracellular Ca2+ content of canine ventricular muscle strips (approximately 0.5 mm thick) were investigated. High K+ (96 mM) increased Ca2+ uptake above control and maintained this enhanced uptake throughout a 90 second measuring period. Verapamil (5 X 10(-6) M) significantly (p less than 0.05) inhibited this high K+ stimulated uptake. However, verapamil (5 X 10(-6) M) also had a direct effect on Ca2+ fluxes, causing a significant increase in both Ca2+ uptake (p less than 0.001) and total intracellular Ca2+ content (p less than 0.001) in the resting tissue. Therefore, verapamil's apparent inhibition of high K+ stimulated Ca2+ uptake may have resulted from some mechanism other than Ca2+ channel blockade. PMID- 3982974 TI - The effect of ranitidine and cimetidine on single-dose diltiazem pharmacokinetics. AB - The effects of two histamine 2-receptor antagonists, cimetidine and ranitidine, on the single-dose pharmacokinetics of diltiazem were studied in 6 healthy subjects. A single 60-mg oral dose of diltiazem was administered alone, after ranitidine 150 mg twice daily for 7 days, and after cimetidine 300 mg 4 times a day for 7 days. Plasma samples were obtained over a 10-hour period and analyzed for the parent drug and one of its metabolites, deacetyldiltiazem (DAD). Concurrent cimetidine produced a significant (p less than 0.05) increase in diltiazem levels at most time points, in peak concentration and area under the concentration-time curve. These variables were also increased during concurrent ranitidine administration but did not reach statistical significance. The DAD plasma concentration was below measurable levels during the control phase but increased during concurrent cimetidine and ranitidine administration. Caution should be exercised when diltiazem is administered concurrently with cimetidine and possibly, ranitidine. PMID- 3982975 TI - Problems in designing hemodialysis drug studies. AB - A clear understanding of the pharmacokinetics of a drug and of the proper methods for calculating dialyzer clearance is essential in designing hemodialysis studies. Hemodialysis should not begin until drug distribution is complete. Institution of dialysis prior to distribution equilibrium will result in increased removal of drug compared to what would be found in the clinical setting. All methods of calculating dialyzer clearance should be compared to that using total amount of drug recovered in the bath divided by the area under the drug concentration versus time curve during dialysis. To adequately probe the effect of the artificial kidney on drug concentrations sufficient plasma samples must be drawn postdialysis to define the rebound phenomena. PMID- 3982976 TI - Candida meningitis: a growing threat to premature and fullterm infants. PMID- 3982977 TI - Clinical features and abnormal neutrophil function in disseminated staphylococcal disease. AB - Clinical features and immune status have been studied in seven previously healthy children with disseminated staphylococcal disease. Six of seven patients had a history of a viral-type illness before developing disseminated staphylococcal disease. Five patients had a petechial rash. Endocarditis occurred in three patients, two of whom had a cerebral embolism. All seven patients had an abnormal urinary sediment, and in two it was suggestive of glomerulonephritis. Two had transient renal failure. Three patients had evidence of pneumonia, one of the three developed pneumatoceles and one developed a pleural effusion. Four had osteomyelitis and/or septic arthritis. All patients had a transient abnormality of intracellular bacterial killing by neutrophils. One patient died. Three patients have residual valvular heart disease; one of the three patients has weakness of one arm and another has a seizure disorder. Cellular and humoral immunity in all six surviving patients is normal. We speculate that an antecedent viral infection temporarily suppressed neutrophil function and predisposed these children to secondary and severe staphylococcal disease. PMID- 3982978 TI - Agreement between capillary and arterial serum gentamicin concentrations in neonates. AB - Due to inherent difficulties in blood sampling in neonates, specimens for laboratory analyses are often obtained by heel puncture technique. While agreement between venous or arterial and capillary concentrations of some substances has been reported, that for gentamicin, when obtained by heel stick, has not. Simultaneously obtained heel stick (capillary) and umbilical artery (arterial) serum samples were analyzed for gentamicin concentrations in 20 preterm neonates. Further, 14 subjects underwent manual manipulation of the heel to encourage blood flow before sampling to test the effect of such manipulation on gentamicin concentration. The agreement between capillary and arterial serum concentrations of gentamicin was found to be excellent in infants greater than 1000 g body weight. Manipulation of the heel had no effect on this agreement. PMID- 3982979 TI - Infectious illnesses in the first two years of life. AB - The number and types of infectious illnesses experienced in 1 year by 279 inner city infants younger than 12 months were examined and correlated with some personal and social attributes and the children. Only 24 (8.6%) infants incurred no infectious illnesses in 12 months. The children experienced an average of one episode of otitis media (OM), one upper respiratory illness and three total illnesses during the year. Only 7.5 and 2.2% of the children experienced more than two episodes of upper respiratory illnesses and gastroenteritis, respectively, but 19% of the infants incurred more than two episodes of OM. The months with the highest number of illnesses for both the entire cohort and the infants who were enrolled at 1 month or less of life were March-April and October November. The months in which the fewest illnesses occurred were August-September for both groups. The only variable associated with an increased number of total illnesses was a personal history of eczema or allergy (P less than 0.01). No variables were found to be associated with the occurrences of pneumonia, gastroenteritis or upper respiratory illnesses. Multiple episodes of OM during the study period were associated with male sex (P less than 0.01), bottle feeding (p less than 0.05) and a history of OM before the onset of the study (P less than 0.01). PMID- 3982980 TI - Tuberculosis in a mother and her infant. PMID- 3982981 TI - Glomerulonephritis, pulmonary hemorrhage and coagulopathy associated with Haemophilus parainfluenzae endocarditis. PMID- 3982982 TI - Severe neonatal rubella following maternal infection. PMID- 3982983 TI - The effect of maternal measles on the fetus. PMID- 3982984 TI - Fatal gonococcal septicemia. PMID- 3982985 TI - Vaginal flora of premature and full term infants. PMID- 3982986 TI - Persistent fever and subdural effusions. PMID- 3982987 TI - Rare complications and unusual syndromes associated with Epstein-Barr virus. PMID- 3982988 TI - Treatment of bacterial pneumonia. PMID- 3982989 TI - Measles and blindness. PMID- 3982990 TI - Newer aspects on the treatment of erythropoietic protoporphyria. PMID- 3982991 TI - Risk of cutaneous carcinoma in psoriatic patients treated with PUVA. AB - A total of 1047 psoriatic patients treated with PUVA were examined for lentiginosis, actinic keratosis and skin cancer. 128 patients had earlier been treated with arsenic, 4 with ionizing radiation and 6 with methotrexate. Lentiginosis was found in 6.2% and actinic keratosis in 1.8% of the patients. 2 patients had histologically verified basal cell carcinoma, 1 had squamous cell carcinoma and 1 Bowen's disease. In patients followed for more than 4 years, those who had received a cumulative dose of UVA greater than or equal to 1000 J/cm2, as well as those who had received more than 150 irradiations had significantly greater frequency of lentiginosis and actinic keratosis. This seemed to be the case also in patients with earlier arsenic treatment. The number of skin malignomas detected did not significantly exceed the expected incidence in the normal Finnish population of the same age-group. PMID- 3982992 TI - A pharmacokinetic comparison in dogs of seven brands of 8-MOP and five new formulations. AB - A pharmacokinetic comparison was carried out with 7 commercially available brands of 8-methoxypsoralen and 5 new formulations. The purpose of the study was to determine the brand or formulation with the least interindividual variation and thus the best standardized 8-methoxypsoralen plasma levels. The experiment was performed on dogs and not on human subjects because each of the 12 preparations had to be given to the same individual. The 8-methoxypsoralen plasma levels were measured by high performance liquid chromatography. One commercial and one self made formulation showed a significantly earlier peaking time and higher peak concentration than the other brands tested. At 1 hour after administration the same commercial preparation and 4 self-made formulations showed significantly higher plasma levels than the other formulations. At 2 h, however, 10 of the 12 brands or formulations did not show statistically significant differences in 8 methoxypsoralen plasma levels. PMID- 3982993 TI - Effect of ultraviolet irradiation of photopatch test substances in vitro. AB - The mechanisms behind allergic photocontact reactions are not clear. For certain photoactive substances the generation of photoproducts may be one step in the sequence of events inducing photoallergy. 26 photoactive substances were studied by thin layer chromatography (TLC) before and after long-wave or medium-wave ultraviolet irradiation for 1, 3 and 5 h (10.8, 32.4, 54 J/cm2 and 1.1, 3.2, 5.4 J/cm2). The formation of photoproducts was demonstrated for 13 substances. For 8 of these, photoproducts were formed regardless of type of ultraviolet exposure while for 5 compounds photoproducts were demonstrated only after long-wave ultraviolet irradiation. All photoactive compounds forming photoproducts did so after UVA irradiation which is in accordance with the finding of action spectra for photoallergic reactions in human skin within this region. No photoproducts were demonstrated for 13 of the tested substances. PMID- 3982994 TI - Sunscreen seawater resistance: comparison of human and guinea-pig test models. PMID- 3982995 TI - Spectroradiometry. PMID- 3982996 TI - [Humoral immunity in hepatitis A and B among workers in an infectious disease hospital]. PMID- 3982997 TI - [Computerized tomography in the differential diagnosis of the causes of cholestasis]. PMID- 3982998 TI - [Q fever cases 1983]. PMID- 3982999 TI - [Use of the ZX-81 microcomputer in medicine]. PMID- 3983000 TI - [Rate of membrane sodium transport and calcium and magnesium concentrations in the granulocytes of patients with primary arterial hypertension]. PMID- 3983001 TI - [Acute ulcerative aortic valve endocarditis and acute glomerulonephritis in staphylococcal septicemia]. PMID- 3983002 TI - [Fever as the first symptom of prostatic cancer]. PMID- 3983003 TI - [Treatment of respiratory and urinary tract infections with low doses of mezlocillin]. PMID- 3983004 TI - [Porphyrins and their precursors in the urine of patients with suspected porphyria; a 16-year experience]. PMID- 3983005 TI - [Physical fitness of patients with coronary disease and normal electrocardiogram at rest and adrenergic system function]. PMID- 3983006 TI - [The electrocardiographic picture of persons chronically exposed to lead]. PMID- 3983007 TI - [Role of health education and preventive studies in the control of lung cancer]. PMID- 3983008 TI - [Social aspects of hemophilia in Poland]. PMID- 3983009 TI - [Favorable transformation of the initial stage of Hodgkin's disease in children- decrease in the incidence of lymphocyte depletion type]. PMID- 3983010 TI - [Our experience with epidural chemical neurolysis in the treatment of chronic pain syndromes]. PMID- 3983011 TI - [Case of olfactory groove meningioma with 6-year psychiatric anamnesis]. PMID- 3983013 TI - Thymoma. A clinicopathologic study of 98 cases with special reference to three unusual cases. AB - 98 thymomas were assessed in respect to clinical manifestations, gross and histologic pathological findings and clinicopathologic correlations. 34% of patients were asymptomatic and thymoma was detected fortuitously. The most common presenting symptoms were related to myasthenia gravis, symptoms due to pressure on mediastinal structures were next in frequency. The symptom-diagnosis interval ranged from 0 to 120 months with a median of 4,5 months and was longer in invasive thymomas (median 6 months) than in noninvasive thymomas (median 2 months). 52% of thymomas were encapsulated and showed no cytologic atypia and were therefore classified as benign encapsulated thymomas. 26% showed gross invasion of peripheral structures and 3% were thymic carcinomas on histologic grounds. Histologically 55% of thymomas were epitheloid cell type, 17% spindle cell type and 20% mixed type thymomas. Epidermoid type thymoma occurred in 3% of the cases. 3 cases showed some unusual morphologic feature: one was localized intrapulmonal, another had an outspread like a mesothelioma, and the third was a basaloid carcinoma with unusual goblet cell metaplasia. In the three cases immunohistological methods were used as a diagnostic tool. The lectins UEA-I, PNA and HPA and an anti-keratin allowed the diagnosis of epithelioma (in 2 cases) and showed some more cellular and structural differentiations (in 1 case). PMID- 3983012 TI - Beta-glucuronidase-positive erythrocytic inclusion bodies--a hitherto unknown phenomenon. AB - A combined cytochemical and electron microscopical study has delineated a new type of an erythrocytic inclusion body. Enzyme cytochemically these inclusions are characterized by beta-glucuronidase as a marker enzyme. In part, the inclusions may contain acid phosphatase and ferritin. The inclusions develop in mature erythrocytes since beta-glucuronidase normally does not occur in erythroblasts and, in general, this type of inclusion body is not found in erythroblasts. Based upon our preliminary findings, the hypothesis is extended that beta-glucuronidase is taken up via receptor-mediated endocytosis into erythrocytes and is finally put into clustered cytolysosomal vaculoes, that account for the inclusion bodies as seen at light microscopy. Exogenous beta glucuronidase might be contributed for by breakdown of cells (e.g. hepatocytes) producing this enzyme in considerable amounts numbers. This view is corroborated by the observation that most patients with beta-glucuronidase-positive inclusions suffered from various chronic disorders of the liver. PMID- 3983014 TI - Necrosis of aorta, myocardium and brain in rabbits following orthostatic shock: main aortic involvement. AB - A microscopical examination of aorta, myocardium and brain of 10 New Zealand White male rabbits submitted to orthostatic shock was performed. In addition six normal animals were used as controls. Seven animals were sacrificed 24 hours following shock by perfusion fixation and three animals three and half to seven hours thereafter. Necrotic changes were present and severe in aortic media, mild in myocardium and minimal in brain neurons. The great difference of involvement of these organs may be related to less vascularization of aortic media as compared with myocardium and brain, and presence of autoregulatory mechanisms of circulation during shock in myocardium and brain. Severe degenerative alterations of aortic media often leading to tissue necrosis due to shock is of importance for the pathogenesis of dissecting aneurysms and experimental atherosclerosis. PMID- 3983015 TI - Postnatal development of myocardial cells after oxygen deficiency in utero. AB - Pregnant rats were kept at a simulated altitude hypoxia (5000 m = pO2 11.38 kPa) for eight hours every day from the 16th to 21st day of pregnancy. The heart musculature of the left ventricle of newborn male rats underwent electron microscopic qualitative and morphometric quantitative examinations on the 2nd, 5th, 11th and 22nd day. Prenatal hypoxia leads to delayed development of the heart. The reduced weight on the 2nd day compared with that of control animals is compensated on the 22nd day. Prenatal hypoxia causes matrix disintegration and cristolysis of the mitochondria. Volume density, which is lower on the 2nd day (0.24: 0.29 (control animals], reaches that of the controls by the 22nd day. But the specific surface density of the cristae mitochondriales is markedly higher in the animals subjected to hypoxia (2nd day 31.0: 20.6; 22nd day 44.0: 38.1). Prenatal hypoxia causes an increase, in the postnatal period, in the autophagocytosis processes, which normally already exist in the heart musculature; this is recognizable by an increase in the volume density of the autophagic vacuoles (2nd day 0.0049: 0.0034; 22nd day 0.0098: 0.0045). The changes observed are regarded as reversible, i.e. as adaptive processes. PMID- 3983016 TI - Endoscopic and bioptic study of the upper gastrointestinal tract in Crohn's disease patients. AB - In the present study, virtually all of 225 patients suffering from Crohn's disease of the lower gastrointestinal tract (small and/or large bowel) were subjected to endoscopic examination of the upper gastrointestinal tract (esophagus, stomach, duodenum); while histologic examination of the upper gastrointestinal tract was performed in a portion of the patients (54 initial esophageal, 221 initial gastric and 210 initial duodenal examinations). Statistical evaluation of the findings from the upper gastrointestinal tract revealed that: Endoscopic lesions were observed in the esophagus of 15%, the stomach of 49%, and the duodenum of 34% of the 225 Crohn's disease patients. Of the 54 patients from which esophageal biopsies were taken, 31 (57%) revealed histopathologic alterations. Of the 221 patients from which gastric biopsies were obtained, 60% revealed histopathologic alterations; the rate was 53% in the 210 patients from which duodenal biopsies were taken. Calculated from the present data, noncaseating granulomas, i.e., Crohn's disease, were present only in the stomach of 29.4% of the patients, only in the duodenum in 3.4% of patients, and in both the stomach and duodenum in 4.9% of patients. Gastric granulomas were confined to the region of the stomach body and fundus in 3.4% of the patients from which gastric biopsies were obtained and to the antrum in 15.6% of the respective patients. Both gastric regions were involved in 8.3% of the respective patients. The incidence of gastric granulomas was significantly increased in young patients, patients with enterocolic manifestations of Crohn's disease, and those with brief duration of disease. Patient sex or previous drug therapy had no effect on the incidence of granulomas. The most frequent endoscopic findings in the stomach of patients with Crohn's disease were mucosal edema, mucosal redness, and acute or chronic erosions. Only chronic erosions were of significant predictive value for the presence of granulomas, i.e., diagnosis of Crohn's disease. The most frequent endoscopic lesion in the duodenum was mucosal redness, followed by mucosal edema and aphthous lesions. Ulcers, stenosis, and mucosal redness had significant predictive values for the presence of granulomas. PMID- 3983017 TI - Immature teratomas of childhood. Report of 21 cases. AB - The benign or malignant nature and the biological behaviour of immature teratomas of childhood are difficult to predict. The age of the patient at diagnosis, the anatomical site of the tumour and the degree of immaturity are considered to be important prognostic parameters. In this study the pathological-anatomical findings and the most important clinical features of 21 patients with immature teratoma (including two with supposedly malignant monodermal teratoma with immature neuroectodermal structures) were evaluated. Significant results were: Twelve tumours occurred in infancy or infants who died in the perinatal period, the other nine tumours in children between the ages of 7 and 16 years. The most frequent anatomical sites were the ovary (6 tumours), sacrococcygeal region (4), testis (4) and mediastinum (3). In contrast to most of the tumours of other localizations, immature ovarian teratomas did not occur in children under 7 years of age (in four cases in association with gliomatosis peritonei). The immature tissue components of the tumours were mostly neuroectodermal structures. Eight tumour specimens showed grade 1, four grade 2 and nine grade 3 malignancy. Grade 3 tridermal teratomas chiefly occurred in young children, whereas two grade 3 monodermal tumours developed in older children. Immunohistochemical analysis of the neuroectodermal components showed that mature astrocytes contained glial fibrillary acid protein, whereas mature nerve cells, nerve fibres and a few groups of immature cells reacted with an antibody to neuron-specific enolase. Six of the 21 patients died; two were stillborn immature infants, two were premature infants, one died postoperatively and one died of metastatic disease. One patient with metastatic disease was alive. None of the 19 children with tridermal immature teratoma showed distant metastases. Metastatic disease was observed in only two patients with presumptive monodermal malignant teratoma. In early childhood the biological behaviour of immature teratomas is evidently similar to that of mature teratomas (provided that the tumour can be totally excised). In older children malignancy must be assumed when the tumour is located in the ovary and/or grade 3 immaturity is determined. PMID- 3983019 TI - Venomous fish stings on the European seashore. PMID- 3983018 TI - Microphotometric quantitation of enzyme activities in giant cell tumor of bone. A case study. AB - In a proliferating giant cell tumor of bone the activities of tartrate-resistant acid phosphatase (acPase) and of NADH-tetrazolium reductase were demonstrated by enzyme histochemical methods. Quantitative microphotometry made it possible to determine the relative enzyme activities per given volume unit in the cytoplasm of giant cells of several sizes. The activity of tartrate-resistant acid phosphatase increases with increasing cell size, whereas the activity of tetrazolium reductase will decrease in proportion. This coincidence of high acPase activity and low tetrazolium reductase activity in larger giant cells is interpreted as an expression of degenerative change. PMID- 3983020 TI - Leprosy in the United States. Risks, recognition, regimens, resources. AB - Although leprosy is increasing in incidence in the United States, it is confined almost entirely to immigrants from developing countries and their close contacts. While the clinical disease has not changed, leprosy has diffused more widely throughout the United States as a result of migration. Primary care physicians should maintain a high index of suspicion in foreign-born individuals with skin or peripheral nerve problems. Punch biopsy of skin lesions is the most practical diagnostic method for both the multibacillary and paucibacillary types of leprosy. Because of resistance to dapsone, multi-drug treatment is now the rule; most patients are referred to or managed in consultation with a regional Hansen's disease clinic for long-term treatment. Consultation is available to any physician through the National Hansen's Disease Center in Carville, Louisiana. PMID- 3983021 TI - Analgesic-associated nephropathy. Unappreciated cause of renal dysfunction. AB - Analgesic-associated nephropathy is a preventable renal disease that leads to end stage renal failure when it is not recognized and treated. Patients with this disorder are usually evaluated initially by the family physician, whose awareness of the entity and high degree of clinical suspicion will result in specific questioning regarding analgesic intake. A history of analgesic abuse, coupled with associated laboratory and radiologic abnormalities, usually suffices to make the diagnosis. A favorable prognosis is dependent on early diagnosis and discontinuation of all analgesic use. PMID- 3983023 TI - Surgery in the hypertensive patient. A delicate balancing act among a trio of disciplines. PMID- 3983022 TI - Urinary tract stones. Medical management. PMID- 3983024 TI - Psychiatric symptoms in endocrine diseases. Keys to identifying the underlying disorder. AB - Several important points should be considered regarding psychiatric symptoms in endocrine disorders. The presence of cognitive deficits in a patient presenting with anxiety, depression, or another apparently "functional" psychiatric complaint should raise the index of suspicion of organic etiology, with endocrine disorders high on the list. Psychiatric symptoms secondary to endocrine disturbance generally reverse, albeit slowly, with treatment of the primary hormonal abnormality. When significant disruption of cognitive functioning is evident, residual deficits may develop. Treatment with psychotropic agents for symptomatic relief of psychiatric complaints should be undertaken with great caution in patients with endocrine disorders. PMID- 3983025 TI - Cystic fibrosis. A disorder of adults too! AB - Cystic fibrosis is the most frequently occurring lethal hereditary disorder among whites. Many persons with cystic fibrosis now live into their adult years, and some cases are not diagnosed until adulthood. As a result, the disorder is no longer rare in adults. Respiratory symptoms and findings usually predominate, but a host of other complications that arise in adults also present therapeutic challenges to physicians. While no cure is yet available for cystic fibrosis, genetic counseling can help couples determine their relative risk for parenting a child with the disorder. PMID- 3983026 TI - Be serious about siriasis. Guidelines for avoiding heat injury during 'dog days'. AB - Heat injury is a threat to athletes performing in a hot, humid environment. High metabolic rate, dehydration, and hidromeiosis all interfere with regulation of core body temperature and compromise athletic performance. Precautions can be taken to prepare athletes for these adverse conditions and to minimize potentially serious consequences. Physicians working closely with coaching staffs and athletes can establish a sound medical program aimed at prevention of heat related injuries and, when injury does occur, at immediate, decisive management. PMID- 3983027 TI - Mitral valve prolapse. Recognizing and treating its manifestations and complications. AB - Mitral valve prolapse is a common, multisystem syndrome for which the myxomatous mitral valve provides an anatomic hallmark. Symptoms are often unrelated to the valvular abnormality and rarely hazardous and should generally be handled conservatively. In contrast, cardiovascular complications are not rare and should be anticipated and treated aggressively. PMID- 3983028 TI - Opiate and cocaine dependencies. Techniques to help counter the rising tide. AB - Clonidine (Catapres) is a safe and effective agent for detoxification of selected opiate addicts. It seems best suited for transitional treatment between opiate dependency and aftercare with naltrexone (Trexan). The current epidemic of cocaine abuse in the United States is associated with intensified usage patterns and an increased prevalence of adverse medical consequences. Successful treatment of the cocaine abuser may require either hospitalization or structured outpatient treatment in a specialized program. PMID- 3983029 TI - Lyme disease. The tick bite, the rash, and the sequelae. AB - Lyme disease may present as a characteristic skin eruption, an acute arthritis, or less commonly, an acute neurologic or cardiac illness. A carefully taken history, including a travel history, provides the key to diagnosis. Laboratory tests other than spirochetal antibody studies are nonspecific. Prompt antibiotic treatment is important not only for reducing the intensity and duration of the skin eruption but for preventing major sequelae. PMID- 3983031 TI - More on mental health deinstitutionalization. PMID- 3983030 TI - Diet and coronary heart disease. Helping patients reduce serum cholesterol level. AB - Although coronary heart disease (CHD) remains the No. 1 cause of death in the United States, the CHD mortality rate has shown a recent decline. This has been attributed to lower fat consumption in the general population, with associated lower serum cholesterol levels. Thus, diet seems to be an important factor in controlling cholesterol level. Acting on this hypothesis, primary care physicians can help patients make appropriate dietary changes. We believe that persons at risk of hypercholesterolemia need to be identified in adolescence by measurement of total serum cholesterol level and that testing should be done every two years after age 25. The American Heart Association's prudent diet is recommended for all patients, especially those with a serum cholesterol level above 240 mg/dl. When dietary restriction does not bring the level within this limit, use of cholesterol-lowering agents is considered. To be lasting, dietary change must be gradual; realistic immediate and long-term goals should be established. In addition, the diet must be nutritionally sound and the patient must receive support from family members. PMID- 3983032 TI - Prostatitis: a matter of gravity. PMID- 3983033 TI - More comments on heat stress. PMID- 3983034 TI - Another cause of facial nerve palsy. PMID- 3983035 TI - Dysphagia. Pathophysiology, causes, and evaluation. AB - The two types of dysphagia, oropharyngeal and esophageal, involve different phases of swallowing, are accompanied by different symptom complexes, and have different etiologies. They can usually be distinguished by history, which often will also suggest the specific cause. The initial evaluation of oropharyngeal dysphagia entails a general history and physical examination, careful examination of the pharynx and hypopharynx, and barium esophagography (preferably with videotape recording). The initial evaluation for esophageal dysphagia entails barium esophagography and fiberoptic endoscopy. Esophageal manometry is indicated when a motor disorder is suspected. PMID- 3983036 TI - Medicine in China today. PMID- 3983037 TI - Anal lesions. When to suspect carcinoma. AB - Anal carcinoma appears in a variety of forms and may be easily confused with a benign disorder. Diagnosis must be confirmed by biopsy. All anal lesions require careful evaluation and follow-up to ensure resolution of benign disease or proper treatment of malignancy. PMID- 3983038 TI - Controversies in the treatment of plasma cell myeloma. PMID- 3983039 TI - Controversies in the medical management of breast cancer. PMID- 3983040 TI - The evaluation of clinical trials. PMID- 3983041 TI - Deep vein thrombosis--the impedance phlebogram. PMID- 3983042 TI - A case of herpes zoster associated encephalitis with rapid response to acyclovir. AB - A case of herpes zoster encephalitis which responded very rapidly to acyclovir is presented. The differential serum: cerebrospinal fluid antibody response was followed and its value in making the diagnosis is discussed. The penetration of acyclovir into the cerebrospinal fluid was measured, and found to be in agreement with predicted values. PMID- 3983043 TI - Enophthalmos as a rare manifestation of metastatic orbital involvement. AB - Two cases in which orbital metastasis produced enophthalmos, instead of the usual exophthalmos, are reported. Only fourteen other cases have been described previously and they are reviewed. At time of diagnosis of the enophthalmos, meningeal carcinomatosis coexisted in the first case and probably also in the second case. This association can lead to diagnostic errors with either the orbital metastasis or the meningeal carcinomatosis being missed. In addition, as in our second case, the enophthalmos can be the initial manifestation of cancer. PMID- 3983044 TI - Coexisting primary hyperparathyroidism and Albright's hereditary osteodystrophy- an unusual association. AB - Primary hyperparathyroidism associated with Albright's hereditary osteodystrophy was diagnosed in a 22 year old Japanese woman, the second such case to be reported. Albright's hereditary osteodystrophy (AHO) appears to be associated with a larger number of disorders than the well recognized pseudohypoparathyroidism. AHO and pseudo-pseudohypoparathyroidism are essentially identical. PMID- 3983045 TI - Hypothyroidism presenting as destructive arthropathy of the fingers. AB - A patient presenting with destructive arthropathy of the proximal interphalangeal (PIP) joints of the hands is described. She was initially believed to have rheumatoid arthritis but non-steroidal anti-inflammatory drugs were of no help. The patient was subsequently found to have hypothyroidism and erosive osteoarthritis of the fingers. Joint swelling, pain and stiffness responded dramatically to thyroid hormone substitution. The PIP joint spaces reappeared on the radiographs within 9 months. This case suggest that hypothyroidism may induce destructive arthropathy of the finger joints. As thyroxine replacement may reverse the rheumatic complaints, hypothyroidism should be considered in the differential diagnosis of a destructive arthropathy of unclear aetiology. PMID- 3983046 TI - Raynaud's syndrome and carpal tunnel syndrome. AB - We report three cases of Raynaud's syndrome with digital ischaemic ulceration, in association with carpal tunnel syndrome. In all cases, the aetiology of the Raynaud's syndrome was probably unrelated to the nerve compression. However, symptoms were worse on the side of the median nerve lesion in two patients and worse on the side with the most severe nerve dysfunction in the third; symptoms were relieved by carpal tunnel decompression in two patients. We suggest that carpal tunnel syndrome may exacerbate Raynaud's syndrome and should be considered particularly in patients with asymmetrical digital lesions. PMID- 3983048 TI - Secondary hypertension accompanying high pressure chronic retention. AB - Two middle-aged men were referred for control of severe hypertension, presumed to be 'essential'. Late-onset enuresis, a small palpable bladder, and slight prostatic enlargement were elicited in one patient; history and examination were unremarkable in the other patient, apart from moderate prostatic enlargement. Intravenous urography revealed massive bilateral hydronephrosis with hydroureters in both patients. Surgical relief of retention was associated with post obstructive diuresis and normalization of blood pressure, although recurrence of hypertension occurred later in one patient. These patients suffered from high pressure chronic retention, a syndrome characterized by impairment of renal function and hypertension. Surgical relief of retention was accompanied by prompt correction of hypertension, and gradual, sustained recovery of renal function. PMID- 3983047 TI - Jejunal perforation secondary to metastatic bronchogenic carcinoma. AB - A case of peritonitis secondary to the perforation of a bronchogenic small bowel metastasis is reported. To our knowledge this is only the fourth case in which peritonitis was the presenting feature of a squamous cell carcinoma of the bronchus. The publications to date are reviewed and the need to biopsy every small bowel perforation found at laparotomy is stressed. PMID- 3983049 TI - Isolated renal mucormycosis. AB - Isolated renal mucormycosis is very rare and we describe such a case masquerading as a hypernephroma in a poorly-controlled diabetic. PMID- 3983050 TI - Ovarian carcinoma presenting as pyrexia of unknown origin. AB - A patient with a poorly differentiated clear cell adenocarcinoma of the ovary presenting as pyrexia of unknown origin is reported. Following resection of the tumour, her pyrexia resolved completely. PMID- 3983051 TI - Puerperal ovarian vein thrombophlebitis. AB - A 16 year old Chinese female with puerperal ovarian vein thrombophlebitis following uneventful vaginal delivery is reported. This infrequent, but potentially fatal, complication in the febrile postpartum patient may present as a surgical emergency. Non-invasive diagnostic procedures and conservative treatment with heparinization and antibiotics have been suggested. However, early exploratory laparotomy for ovarian vein or caval ligation may be life-saving if the diagnosis is in doubt or the response to conservative treatment is unsuccessful. PMID- 3983052 TI - Torsion of a wandering spleen. AB - We present an unusual case of torsion of a wandering spleen in a 14 year old boy. Wandering spleen is an entity which has rarely been reported in infants and children. Although patients may be asymptomatic, some may present as an acute surgical emergency if trauma or torsion of the vascular pedicle occurs, as in our case. The treatment of this condition is splenectomy. PMID- 3983053 TI - Retroperitoneal fibrosis with normal intravenous urogram. AB - A 58 year old male presented with a two week history of low back pain and malaise. The intravenous urogram (IVU) at presentation was normal but within three months he had developed renal failure with bilateral ureteric obstruction on repeat IVU. Primary retroperitoneal fibrosis was confirmed at operation. This case demonstrates that retroperitoneal fibrosis may progress rapidly to renal failure within a few months of the first symptoms. In addition, the IVU may be normal in the early stages of the illness. PMID- 3983055 TI - The clinical response to treatment in adult Cushing's syndrome following remission of hypercortisolaemia. AB - The clinical response of 57 adult patients with Cushing's syndrome due to bilateral adrenocortical hyperplasia or adrenocortical adenoma is documented following resolution of hypercortisolaemia by various forms of treatment. Despite satisfactory biochemical remission of the disease the clinical result was far less satisfactory when assessed by persistence of obesity (55%), menstrual irregularity (41%), hypertension (29%) and insulin-dependent diabetes (22%). Myopathy, hirsuitism and psychological abnormalities persisted to a lesser extent. The mortality rate of the series over a 30 year follow-up period was 4 times that of a general population matched for sex, age and year of entry into the series. Cardiovascular disease was the cause of death in 85%. Irreparable cardiovascular disease is produced early in the course of hypercortisolaemia, emphasizing the vital importance of the earliest possible recognition and treatment of this disease. PMID- 3983054 TI - Cerebrovascular disease in dementia: the importance of atrial fibrillation. AB - The relationship between cardiovascular disease and cerebral infarction was analysed in a prospectively assessed post mortem series of 48 demented patients. Hypertension was rare in this group of patients whose mean age was 82.7 y. Atrial fibrillation was the most important underlying cardiac abnormality. It is suggested that atrial fibrillation is more important than hypertension in the aetiology of cerebral infarction in the very aged and that this may be relevant to the pathogenesis of cerebrovascular dementia. PMID- 3983056 TI - Perforated gastric ulcer. AB - Thirty-four patients presenting with gastric perforation over a ten year period were studied, retrospectively. Five patients (14%) died either as a result of delay in treatment or wrong diagnosis. In addition, 2 patients (6%) died from postoperative complications. Twelve patients (38%) were on potentially ulcerogenic drugs. Patients who had either simple closure of ulcers (n = 17) or partial gastrectomy (n = 6) had few symptoms at follow-up, but patients who underwent truncal vagotomy and pyloroplasty (n = 7) had poorer results. There were 2 recurrent ulcers following simple closure. PMID- 3983057 TI - Parathyroid carcinoma presenting as tertiary hyperparathyroidism. AB - A case of malignant transformation in established secondary hyperparathyroidism presenting as tertiary hyperparathyroidism is reported. Although rare, this occurrence has important medical and surgical implications. PMID- 3983058 TI - Amiodarone-induced vasculitis and polyserositis. AB - A dose-dependent cutaneous leukocytoclastic vasculitis developed in a 34 year old man who was given amiodarone for supraventricular tachycardias resistant to other drugs. This adverse reaction disappeared within 2 weeks after discontinuation of amiodarone despite its very long half-life of 52 days in this patient. During previous treatment periods with amiodarone, the patient had experienced photosensitivity and dose-dependent polyserositis. Since high doses of amiodarone have been recently proposed for the treatment of resistant cardiac arrhythmias, dose-dependent adverse effects as described here may be encountered with increasing frequency. PMID- 3983059 TI - Thoracic inlet compression due to amiodarone induced goitre. AB - We report a case of amiodarone induced toxic goitre, presenting with thoracic inlet obstruction which required surgical intervention. Though thyrotoxicosis caused by amiodarone is recognised, to our knowledge thoracic inlet compression has not been previously described. PMID- 3983060 TI - Tuberculous perforation of the small bowel. AB - Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. Patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended. PMID- 3983061 TI - Delayed encephalopathy following cardiac arrest. AB - A 46 year old woman suffered a post-operative cardiac arrest associated with prolonged depression of oxygenation and respiration. She made a good initial recovery but one year later insidiously developed symptoms of widespread central nervous system damage compatible with a delayed post-hypoxic encephalopathy. This case is unusual in the length of time between the hypoxic insult and the later deterioration and also illustrates other atypical features of a delayed post hypoxic syndrome. PMID- 3983062 TI - Fatal splenic rupture in Ehlers-Danlos syndrome. AB - A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition. PMID- 3983063 TI - Severe Coombs positive autoimmune haemolytic anaemia associated with ulcerative colitis. AB - We describe a case of severe autoimmune haemolytic anaemia developing in newly diagnosed ulcerative colitis of moderate severity. Full immunosuppression with steroids and azathioprine failed to bring about a full remission and a splenectomy was performed which resulted in a remission enabling immunosuppression to be discontinued. This case is compared with three previously described cases of autoimmune haemolytic anaemia associated with severe colitis requiring splenectomy. PMID- 3983064 TI - Erythema multiforme (Stevens-Johnson) precipitated by Fansidar. PMID- 3983065 TI - Immune complex-mediated cutaneous vasculitis in a scar--the importance of local anatomical factors. AB - A vasculitic rash developed on the legs and arms of a 47 year old woman. Similar vasculitic lesions also erupted in a scar sustained ten years previously. Circulating immune complexes consisting of IgG were detected by Clq binding. We discuss the factors involved in the localization of vasculitic lesions, and in particular stress the role of microvascular injury. PMID- 3983066 TI - Asymptomatic osteomyelitis of the symphysis pubis. PMID- 3983067 TI - Malaria reactivated by pregnancy. PMID- 3983068 TI - The painful shoulder. PMID- 3983069 TI - Low back pain syndromes. PMID- 3983070 TI - Surgery of the knee. PMID- 3983071 TI - Painful conditions of the ankle and foot. PMID- 3983072 TI - Musculoskeletal disease in the pain relief clinic. PMID- 3983073 TI - Joint replacement 20 years on. PMID- 3983074 TI - Repeat self-poisoning: who is at risk? PMID- 3983075 TI - Differentiation between medical and surgical jaundice. PMID- 3983076 TI - Rectal absorption of a theophylline solution in asthma. PMID- 3983077 TI - [Diagnostic and therapeutic progress in nontuberculous mycobacterioses]. PMID- 3983079 TI - [Pleural mesothelioma in an autopsy sample of the Institute of Pathology of the Spandau Hospital]. PMID- 3983078 TI - [The bronchospasmolytic effect of eprazinone]. PMID- 3983080 TI - [Frequency of allergic reactions of the immediate type in tuberculosis patients. Supplementary report]. PMID- 3983081 TI - [Risk of cancer caused by formaldehyde. Viewpoint of the German Society for Pathology and the German Pathologists Association]. PMID- 3983082 TI - [Adenocarcinoma of the nose following occupational exposure to sawdust]. PMID- 3983083 TI - [Therapy-induced tumor regression. Morphological findings in malignant primary and secondary liver tumors following intensive regional cytostatic treatment]. PMID- 3983084 TI - [A clinical case of an unusual metastasis of cervical carcinoma]. PMID- 3983085 TI - [Classification, histological and cytological grading and assessment of regression grading in prostatic carcinomas. A recommendation of the Pathologic Urological Task Force on Prostatic Carcinoma]. PMID- 3983086 TI - [Duchenne's muscular dystrophy. Report of a clinical case]. PMID- 3983087 TI - [Teratoma of the umbilical cord. Report of a clinical case]. PMID- 3983088 TI - [Causes of death of pathologists--the possible effect of formaldehyde]. PMID- 3983089 TI - [Sudden death in children: histological findings in the salivary glands]. PMID- 3983090 TI - [Granulomatous and eosinophilic myositis due to Onchocerca volvulus]. PMID- 3983091 TI - [Intrahepatic sclerosing cholangitis. Morphology, morphogenesis and diagnosis]. PMID- 3983092 TI - [Ubiquinone-9 and ergosterol from Candida paralipolytica yeasts]. AB - Ubiquinone-9 and ergosterol were extracted with hexane from the yeast Candida paralipolytica after hydrolysis with KOH in EtOH with the yield 0.026 and 0.14%, respectively. Ubiquinone-9 was purified by chromatography and recrystallization from absolute alcohol. PMID- 3983093 TI - [Cause of dehydroascorbic acid accumulation in the blood of patients with insulin dependent diabetes mellitus]. AB - It is known that dehydroascorbic acid (DHAA) produces a diabetogenic effect and its content in the blood increases in diabetes mellitus. It was previously established that the generation of reducing equivalents (RE) in the course of hexosemonophosphate shunt, CO2 production and SH-glutathione regeneration in erythrocytes with and without moderate and maximum oxidation load in vitro were not disturbed in diabetes. The authors have proposed a procedure to study blood and erythrocyte DHAA reductase activity in suspension in health and in insulin dependent diabetes mellitus by means of redoxstatometry using a device of original design. A significant acceleration of RE transfer through the erythrocyte membrane was detected in diabetes. A lowered participation in this process of the AA in equilibrium DHAA "shuttle" system was recorded in the blood of patients with diabetes mellitus what was mostly expressed under the conditions of acidosis in vitro. Probably "shuttle" function in diabetes was provided by some other redox system which might be located in the plasma. The predominant functioning of this redox system and a decrease of DHAA reductase activity in diabetes resulted in the accumulation of DHAA in the blood of patients with type I diabetes mellitus. PMID- 3983094 TI - [Changes in immunochemical properties of serum ferritin after its post translation modification with glucose in patients with diabetes mellitus]. AB - The paper is concerned with experimental and clinical problems. Posttranslation modification of ferritin with glucose has been shown to cause change of its immunochemical properties. Changes in iron metabolism and in the level of glycosylated hemoglobin A1c were noted in patients with different forms of diabetes mellitus. PMID- 3983095 TI - [Dyslipoproteinemia, oxygen-transport system of blood and oxygen balance in the tissues at early stages of diabetes mellitus]. AB - The nature of the blood serum lipoprotein spectrum, blood oxygen transport function and tissue oxygenation were studied in 89 patients with early forms of diabetes mellitus and in 20 healthy persons. A higher level of pre-beta lipoproteins and beta-lipoproteins was revealed; a lowered level of alpha lipoproteins was determined above all by triglycerinemia. Hyperlipoproteinemia even at early stages of diabetes mellitus is capable of causing diverse changes in the blood oxygen transport system. PMID- 3983096 TI - [Effect of cryopreservation of thyroid parenchyma on iodoamino acid composition of thyroglobulin and its iodination]. AB - The content and distribution of iodoamino acids in thyroglobulin of the cryopreserved thyrotoxically-changed thyroid parenchyma were studied, as was thyroglobulin iodination. Thyroid tissue obtained during operations of patients with diffuse-toxic goiter was investigated. The thyroid parenchyma was cryopreserved according to the method developed at the Institute of Cryobiology and Cryomedicine Problems, Academy of Sciences of the Ukrainian SSR. The tissues were stored for 4-6 months. Thyroglobulin was isolated by gel filtration of the thyroid saline extract through a column packed with Sephadex G-200. Thyroglobulin was iodinated with KI + I2 water solution, pH 9.2, at 37 C for 30 min. The amount of iodine added was 100 moles of I2 per protein mole. Protein concentration was determined by the biuret reaction. Thyroglobulin iodoamino acid composition was determined by direct spectrophotometry. Absorption spectra were measured by an EPS-3T recording spectrophotometer ("Hitachi", Japan). The processes of freezing (-196 degrees C) and thawing of the thyroid parenchyma were shown to induce no changes in the thyroglobulin iodoamino acid composition. Cryopreservation of the thyroid parenchyma considerably affected iodine incorporation and formation of iodoamino acids in the thyroglobulin during its in vitro iodination. It may be supposed that cryopreservation of the thyroid tissue affects the thyroglobulin conformational status, that results in increased iodination of this iodoprotein. PMID- 3983097 TI - [Effect of various methods of treating patients with the diabetic type of glucose tolerance]. AB - A study of the frequency of "remissions" of disorders of the glucose tolerance test (GTT) of the diabetic type depending on therapy: diet and diet combined with sulfanilurea derivatives in 130 patients revealed the absence of significant dependence on the method of treatment of patients with a low level of glycemia following glucose load (below 11 and 8.25 mmol/l after 1 and 2 hours, respectively) and a significant rise of the frequency of the GTT return to normal (from 7% to 40%) with the use of sulfanilurea derivatives together with diabetic management from the moment of diagnosing the disease in patients with a higher level of glycemia in the process of the GTT (over 11 and 8.25 mmol/l 1 and 2 h, respectively after glucose load). On the other hand, in 38% of persons with the different GTT disturbances of the diabetic type receiving no therapy, with glycemia level after 1 hour up to 11 mmol/l and 8.25 mmol/l after 2 h, spontaneous GTT improvement can be observed in 3-6 years to come. To raise the frequency of remissions, the authors recommend differentiated treatment of patients with GTT of the diabetic type in the initial period of treatment depending on the glycemia level in the process of the GTT. PMID- 3983098 TI - [Study of protein synthesis regulating hormones in human milk]. AB - A study was made of the content in human milk of hormones which regulate together with their specific function processes of protein assimilation and synthesis. These hormones (thyroxine, triiodothyronine, 17 beta-estradiol, prolactin, 11 hydroxycorticosteroids) were determined in the first days of lactation, in the most important period in the nutrition of a newborn and in the formation of lactation. Chromatography, radioimmunoassay and fluorometry were used. The aim of the study was to determine the levels of exogenous hormones which influence the metabolism of proteins received by a newborn. During the first 10 days of lactation the content of prolactin in human milk was 154.5-546.0 muunits/ml, that of 17 beta-estradiol 34.2-124.4 pg/ml, that of thyroxine 0.5-1.1 micrograms%, that of triiodothyronine 8.6-20.8 ng%. A possible involvement of milk hormones in the regulation of anabolic processes of a newborn as well as changes in the first 3-6 days of lactation of the prolactin and 17 beta-estradiol content in milk in connection with the regulation of the start of lactation are discussed. PMID- 3983099 TI - [Cerebral nanism associated with diabetes insipidus and hyperprolactinemia in a patient with a history of neuroinfection]. PMID- 3983100 TI - [Effect of enkephalins on the calcium-regulating function of the endocrine glands]. AB - Experiments on rats have shown that administration of a synthetic analog of leuenkephalin at a dose of 100 mg/kg did not change the content of the immunoreactive parathyroid hormone in the blood plasma but removed the parathyroidin stimulating effect on the cAMP concentration in the renal tissue and AP activity in the blood. It is concluded that enkephalins do not influence the secretion and metabolism of the parathyroid hormone but block its peripheral effects and stimulate thyroid C-cell function. PMID- 3983101 TI - [Growth and development of pre-implantation rat embryos in vitro. Effect of various hormonal factors]. AB - The effect of 17 beta-estradiol and polypeptides of hypophyseal origin (prolactin, adenohypophysis cell culture secretion products) on the development of 5-day rat embryos in vitro was studied. Preimplantation rat embryos grew and developed normally in medium 199 enriched with 10% embryonic calf serum. The addition into this medium of estradiol in the concentrations of 10(-6) M, 10(-8) M or prolactin (0.01 micrograms/ml) did not produce an injuring effect on the growth of embryos incubated in vitro. A clear embryotoxic effect was noted in the incubation of embryos in a medium with high concentrations (0.1-1 microgram/ml) of prolactin or in a 3-day culture of rat adenohypophyseal cells. It may be inferred that the inhibitory effect of high doses of prolactin on embryo development is one of the possible causes of the embryotoxic effect of adenohypophysis cell culture secretion products. PMID- 3983102 TI - [Acid and alkaline phosphatases of the rat prostate and the androgenic status of the body]. AB - A study was made of the activity of acid and alkaline phosphatases in the prostate of rats with disorders of the hormonal status induced by gonadectomy followed by injection of testosterone and its metabolite, 5 alpha dihydrotestosterone in order to define specific functional indices, enabling gonadal androgenic function to be assessed. The activity of both prostatic phosphomonoesterases decreased after gonadectomy and rose after the substituting injection of the androgen. The efficacy of the androgens was to a great degree dependent on the dosage, duration of the drug action, and animals' age. The data obtained indicate that the activity of the phosphomonoesterases depends on androgenic saturation of the body and that both acid and alkaline phosphatases may serve as markers of androgenic activity. PMID- 3983103 TI - [Lipid peroxidation in erythrocytes of patients with diabetes mellitus and diabetic angiopathies]. AB - An elevated level of the products of lipid peroxidation was revealed in the erythrocytes of patients with diabetic microangiopathies as compared to healthy donors. The level of the products of lipid peroxidation did not depend on the severity of disease, the degree of compensation of carbohydrate metabolism, the level of serum lipids and depended on the severity of vascular lesions. A considerable decrease in the content of polyunsaturated fatty acids with a simultaneous increase in the level of saturated acids was noted alongside with an elevated level of diene conjugates in the erythrocytes of patients. PMID- 3983104 TI - [Comparative analysis of estrogen receptor level in the liver and angiotensinogen level in the blood plasma of rats after administration of estradiol in association with other endocrine factors]. AB - A study was made of the level of hepatocyte estrogen receptors (ER) and of angiotensinogen [AG) in the blood plasma of rats after the administration of different doses of estradiol (E2) in combination with the exposure to some other endocrine factors. A single administration of E2 has been shown to cause two types of effects depending of the dose of a hormone administered and the time following injection: an increase in the AG level in the plasma and interrelated changes of the ER content in the cytosol and hepatocyte nuclei. These effects were most noticeable after the administration of 500 micrograms of E2. In this case the ER content decreased significantly in the cytosol and increased in the cell nucleus. An elevated ER level in the nucleus was preserved for 6-24 h and at this period AG production in the hepatocytes occurred and gradually increased within 24 h. An increase in AG production and the level and time of ER delay in the nuclei (r = +0.75, P less than 0.01) showed a high direct correlation. The expression of the effect of E2 high doses inducing AG synthesis depended on the body endocrine status which in its turn determined a certain level of E2 reception in hepatocytes. A low level of ER in the hepatocytes of hypophysectomized or immature rats corresponded to the absence or suppression of the E2 effect on AG production in the liver. An increase in the ER concentration in the cell as a result of the growth hormone administration to hypophysectomized or mature female rats was accompanied by the appearance or a rise of the sensitivity to the E2 effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3983105 TI - [Uptake of 125I-triiodothyronine by the thyroid gland: effect of adrenergic agents and low temperatures]. AB - A study was made of the binding of 125I-triiodothyronine with the sections, nuclei and mitochondria of the euthyroid thyroid under the conditions of adding adrenergic agents, cooling to 0 degree C and freezing to--196 degrees C. It was noted that 125I-T3 got no less with adding unlabeled T3 and thyroxine that might suggest the unsaturated nature of the process. Among the studied adrenergic agents (noradrenaline, neoepinephrine, propranolol, pyrroxane in the concentration of 1 X 10(-4) M) noradrenaline only influenced this process. It stimulated binding and pyrroxane inhibited it. 125I-T3 binding got less at 0 degree C, after freezing to--196 degrees C the preservation of the basal activity of the process and disappearance of the noradrenaline stimulating effect were noted. The results obtained do not confirm assumptions as to the mechanism of thyroid autoregulation function with T3 by the short feedback type. PMID- 3983106 TI - [Effect of thyroxine on methemoglobin content and the activity of antioxidant enzymes of human erythrocytes in vitro]. AB - A study was made of the effect of thyroxine in vitro on the activity of antioxidant enzymes: superoxide dismutase (SOD) and catalase, and on the methemoglobin content in the erythrocytes of 23 healthy persons aged 17-25. Erythrocyte incubation was performed in different media: in their own plasma, a weak solution of NaOH, tris-HCl buffer solution (pH 7.4) with thyroxine in the physiological concentration and without it. The enzyme activity was compared in the native and incubated erythrocytes. After the incubation of erythrocytes with thyroxine in their own plasma the SOD and catalase activity showed a statistically significant rise, and the methemoglobin content decreased. This effect was undetectable in the incubation of erythrocytes with thyroxine in tris buffer solution. Direct incubation of SOD with thyroxine isolated from the erythrocytes did not cause any changes in enzyme activity. Probably the interaction of thyroxine with erythrocyte membrane components is important for the implementation of the hormonal effect. Some unidentified factors contained in the blood plasma may play a role in the SOD activation. The authors discuss thyroxine ab to cause rapid regulation of the activity antioxidant enzymes. PMID- 3983107 TI - [Autonomic cardiac neuropathy in patients with insulin-deficient diabetes mellitus]. AB - Altogether 60 patients with insulin-deficient diabetes aged 16-40 with a disease standing of 11.2 +/- 0,93 years were examined. Diabetic autonomous cardiac neuropathy was detected in 73% of the patients by means of a study of the R-R interval variation in normal and deep breathing and Valsalva's index. Direct correlation of the time-length of diabetes with retinopathy and distal polyneuropathy was found. Orthostatic hypotension was diagnosed in 10% of the patients. PMID- 3983108 TI - [Risk of reactivation of residual tuberculous lesions in the lungs]. PMID- 3983109 TI - [Diagnosis of tuberculosis and other lung diseases with similar clinico roentgenological signs]. PMID- 3983111 TI - [Tasks and objectives of the journal "Problemy tuberkuleza' in 1985]. PMID- 3983110 TI - [Computerized tomography in the diagnosis of spherical formations in the lungs]. PMID- 3983112 TI - [Clinico-roentgenological characteristics and complications of chronic diffuse forms of pulmonary sarcoidosis]. PMID- 3983113 TI - [Bronchological examination of patients with minor forms of pulmonary tuberculosis]. PMID- 3983114 TI - [Clinico-roentgenological characteristics of patients with recurrent pulmonary tuberculosis from urban and rural areas]. PMID- 3983115 TI - [Classification of postoperative reactivation of pulmonary tuberculosis]. PMID- 3983116 TI - [Complex chemotherapy of pulmonary tuberculosis in adolescents using rifampicin and levamisole]. PMID- 3983117 TI - [Liver and kidney functions in patients with pulmonary tuberculosis]. PMID- 3983118 TI - [Use of a membrane oxygenator for elimination of CO2 in acute respiratory insufficiency]. PMID- 3983119 TI - [Sarcoidous pneumonia]. PMID- 3983120 TI - [Case of tuberculoma of the nasal cavity]. PMID- 3983121 TI - [Effectiveness of tissue electrophoresis and ultrasonics in the complex treatment of patients over 50 years of age with newly detected pulmonary tuberculosis]. PMID- 3983122 TI - Carcinoma of the stomach. PMID- 3983123 TI - Hospital dietetics: the doctor's needs. PMID- 3983124 TI - Hospital dietetics: the dietician's needs. PMID- 3983125 TI - Intestinal gas. PMID- 3983127 TI - Eating in 2000 AD--meat and two veg or stones into bread? PMID- 3983126 TI - A vital role for aquatic resources in feeding a hungry world. PMID- 3983128 TI - Unconventional foods: salvation or sensuality. PMID- 3983129 TI - Identification and partial characterization of a 25K protein structurally similar to prolactin. AB - Peptide mapping of individual pituitary proteins within the gel after separation by electrophoresis in NaDodSO4-polyacrylamide gels has revealed a high-molecular weight (mol wt) protein whose fingerprint is similar to that of prolactin (PRL). This protein is approximately 4000 greater in mol wt than the traditional pituitary PRL, but does not appear to be the latter's prohormone. Its concentration ranged from 3 to 15% of the major PRL protein in the pituitary glands of several species examined. The protein isolated from sheep pituitary glands partly cross-reacted with a polyclonal antibody raised against the main PRL, but the material from mouse pituitary glands was completely noncross reactive. The substance eluted from denaturing gels failed to significantly stimulate mucosal growth in the crop sac of the pigeons, a commonly used test for PRL's bioactivity. Its biological activities remain to be characterized. PMID- 3983130 TI - Structural evaluation of anorectic action induced by 1,5-anhydro-D-glucitol. AB - In previous studies, 1,5-anhydro-D-glucitol (1-DG), an endogenous glucose analog, was found to significantly influence physiological feeding behavior. The relationships between the hydroxyl group positions on the pyranose ring carbons and the anorectic action induced by 1-DG and its analogs are discussed. To investigate the effects of these glucose analogs on ingestive behavior, 24 mumole of test solution was injected into the rat third cerebral ventricle immediately before normal eating time, which starts at the beginning of the dark. After initial transient hyperphagia, 1-DG suppressed feeding during the first 12-hr dark period. It prolonged postprandial intermeal interval beginning shortly after injection, but eating rate was not affected and meal size did not decrease until near the end of the normal feeding period. The incidence of drinking episodes decreased concomitant with feeding suppression. Feeding and drinking suppression were also produced by 1,2-dideoxy-D-glucose, 1,3-dideoxy-D-glucose, and 1,4 dideoxy-D-glucose, although they were less potent than 1-DG. They suppressed feeding by prolonging the postprandial intermeal interval, but did not change meal size or eating rate. The anorectic effects of 1-DG were abolished by removal of the hydroxyl group at carbon 6 and by epimerization at carbons 2, 3, and 4. These findings indicate that feeding suppression induced by 1-DG and its analogs is induced mainly by prolongation of the postprandial intermeal interval, and the presence or absence of a hydroxyl group on each carbon of 1-DG is important for its feeding suppression. PMID- 3983131 TI - Failure of injection of rat placental lactogen to inhibit prolactin in vivo. AB - In an attempt to demonstrate a negative feedback of rat placental lactogen (rPL) on prolactin secretion, pregnant rats were hysterectomized and injected intraperitoneally with placental extracts. Hysterectomy alone prolonged the incidence of nocturnal prolactin surges and injection of placental extracts did not alter this response. However, the absence of rPL in the serum following the injections indicated a primary reason why no inhibition was seen. Only when rPL was given intravenously was there detectable amounts found in the blood. The slow disappearance of rPL from the circulation following hysterectomy in Day 11 pregnant rats suggests that the lack of rPL in the blood following ip injection of placental extracts is not due to rapid clearance of rPL from blood. The failure to show a negative feedback of rPL on prolactin in vivo may be due primarily to the lack of appearance of rPL in the circulation following an ip injection of placental extracts. PMID- 3983133 TI - Fetal glycerol metabolism in experimental maternal lipemia. AB - Maternal lipemia (L), one of the consequences of poorly controlled diabetes in gestation, was induced in pregnant rats by feedings of a diet containing 45% fat. The maternal condition was associated with fetal L and moderate ketonemia. L fetuses had an elevated liver glycerol kinase (EC 2.7.1.30), when assayed 1 day before term (L = 82.5 +/- 3.8 nmole/min X mg protein and controls (C) = 67.4 +/- 3.9 nmole/min X mg protein; means +/- SE, P less than 0.01). However, neither hepatic cytosolic glycerophosphate (GcPO4) dehydrogenase (EC 1.1.1.94) nor mitochondrial GcPO4 oxidase (EC 1.1.99.5) were altered. GcPO4 oxidase was lower in the striated muscle of L than in that of C fetuses (13.7 +/- 1.2 nmole/min X mg protein vs 17.2 +/- 0.5 nmole/min X mg protein, P less than 0.05). The results of the present study suggest that L, in utero, may cause an alteration in overall glycerol oxidative capacity in liver and GcPO4 in muscle. These changes appear to be compatible with a shift in the capacity of L fetuses to handle glycerol which may relate to postnatal fuel utilization by L offspring. PMID- 3983132 TI - Vascular responses to sodium arachidonate in experimental hypertension. AB - This study characterizes vascular responsiveness to sodium arachidonate (C 20:4) in four models of hypertension [deoxycorticosterone acetate (DOCA) hypertensive rats, two kidney-one clip (2K-1C) renal hypertensive rats, spontaneously hypertensive rats (SHR), and psychosocial hypertensive mice]. Isolated arterial strips (aorta, mesenteric artery, tail artery) were equilibrated under optimal resting tension in physiological salt solution for measurement of isometric force generation. Dose-response curves to arachidonate (10(-10) to 10(-4) g/ml) in arteries from DOCA and 2K-1C hypertensive rats were shifted to the left compared to those in arteries from control rats. In arteries from SHR and psychosocial hypertensive mice, the dose-response relationships were unchanged compared to normotensive values. Arteries from DOCA hypertensive and 2K-1C hypertensive rats developed greater maximal contractile responses to arachidonate than controls; maximal responses in arteries from SHR and psychosocial hypertensive mice were unchanged compared to normotensive values. Contractions to arachidonate were inhibited by indomethacin (0.5 and 5 micrograms/ml) and by aspirin (5 and 50 micrograms/ml). The fatty acid, oleate (C 18:1), had no effect on the contractile state of the arteries, whereas prostaglandin F2 alpha caused contraction. These results indicate altered responsiveness to exogenous arachidonate in arteries from DOCA and 2K-1C hypertensive rats, but not in arteries from SHR and psychosocial hypertensive mice. PMID- 3983134 TI - Induction of alpha interferon by membrane interaction between viral surface and peripheral blood mononuclear cells. AB - Cells infected with viruses and fixed when viral antigens appeared at the cell membrane induced much higher alpha interferon (IFN-alpha) levels in human peripheral blood mononuclear cells (PBMC) than free virions. Relatively few inducer cells were sufficient for triggering IFN production. Optimal IFN yields depended on inducer/producer cell ratio. The response was peculiar to PBMC as it was not found in other cells in which IFN can normally be induced by free virions. IFN inducing activity was also exerted by live virus-infected PBMC, showing that this type of induction may have physiological importance. These findings confirm that viral induction of IFN-alpha is activated by some interaction between viral components presented at the cell surface and PBMC membrane. Thus induction of IFN by circulating cells infected by viruses and presenting viral antigens at the surface may be an efficient host defense mechanism. Since IFN yields close to 10(6) international units per milliliter are obtained, this system has potential for large scale production of native IFN alpha. PMID- 3983135 TI - Actions of nicotine on renal function in dogs. AB - Renal excretory and circulatory responses to nicotine were investigated in anesthetized dogs under three sets of conditions: (a) infusion of nicotine into the left renal artery (ia) at a dose of 0.5 microgram X min-1 X kg body wt-1 X 15 min; (b) ia nicotine after 1.0 mg/kg ia propranolol; and (c) ia nicotine after bilateral adrenalectomy. Measured and calculated left and right renal excretory variables included sodium, potassium, and chloride excretion rates (UNaV, UKV, and UClV, respectively), total solute excretion (UOsV), glomerular filtration rate (GFR), fractional sodium excretion (FENa), and urine flow rate. Systemic arterial pressure and left renal artery blood flow (RBF) were also measured. In seven intact dogs administered nicotine alone, there were significant increases in UNaV, UClV, UOsV, GFR, and urine flow rates from both kidneys. However, nicotine did not significantly affect UKV, FENa, arterial pressure, or RBF. The lack of circulatory effects of nicotine was also observed after either propranolol or adrenalectomy. However, when nicotine was administered after propranolol, the drug evoked significant decreases in UOsV, UNaV, UClV, and GFR, compared with prenicotine values. When nicotine was administered after bilateral adrenalectomy, the drug evoked decreases in the excretory parameters similar to those observed after propranolol. These findings seem to support several inferences: (a) nicotine stimulates renal excretory functions-the alkaloid is saluretic and diuretic; (b) the action of nicotine on the kidney is mediated mainly by the release of catecholamines from the adrenal medulla; (c) catecholamines released by nicotine act mainly on beta-adrenergic receptors; and (d) the saluresis prompted by the release of catecholamines in response to nicotine is due to a subsequent increase in GFR. PMID- 3983136 TI - Prevention of cataract development in severely galactosemic rats by the aldose reductase inhibitor, tolrestat. AB - With a fixed time period of galactose feeding, the rate of appearance of lenticular opacities depended on the severity of galactosemia, while with a fixed amount of galactose fed, the rate was time dependent. The capacity of tolrestat, a structurally novel inhibitor of aldose reductase (AR), to control cataract development was assessed in rats fed 30-50% galactose with the diet for 7 to 277 days. In rats fed 30% galactose for 31 days, the controlling effect of tolrestat was dose dependent, and no cataracts were detected at a dose of 35 mg/kg/day. In rats given tolrestat with the diet for 14 days, then rendered severely galactosemic with a diet containing 50% galactose, and subjected to continued treatment with tolrestat at a dose of 43 mg/kg/day, no changes were detected by slit-lamp microscopy after 207 days. The preventive effect was also dose dependent. In view of the established similarity in the pathogenesis of galactosemic and diabetic cataracts, the results obtained with tolrestat support its potential for controlling cataract development in diabetics. PMID- 3983137 TI - Biologically available iodine in goitrogenic diets. AB - Eight different sources of low-iodine diet (LID) were tested in mice over 14 years. The available iodine in each diet was measured by isotopic equilibration. Commercially prepared Remington diets contained 6.8 to 69.3 ng available iodine/g, and the results were usually different from shipment to shipment. Some samples produced greatly enlarged thyroids. The Remington diets from two sources were occasionally low in iodine but produced little thyroid enlargement. Between 1977 and 1980 only one shipment of Remington diet was found to contain less than 10 ng available I/g, and it resulted in large goiters. Since 1980 other compositions of LID have been used, but they caused additional abnormalities during breeding or chronic feeding. A low-iodine wheat diet produced goiter in mice more readily than in rats. In the course of testing for unavailable forms of dietary iodine, it was found that only 34.2% of thyroxine iodine was available to the thyroid iodine pool of mice. It is concluded that unidentified nutritional deficiency or dietary contaminants can alter the goitrogenic response to restricted iodine intake. Furthermore, at least one natural form of potential dietary iodine is incompletely available to mice. PMID- 3983138 TI - Glomerular filtration and fluid balance in genetically hypertensive mice. AB - The Schlager genetically hypertensive mouse has been shown to be a valuable animal model with which to study human essential hypertension. Previous studies have characterized renal morphology, juxtaglomerular index, hematocrit, prostaglandin levels, brain catecholamines, social behavior, and patterns of inheritance. The present study continues the phenotypic characterization of this animal model. Using desiccation, isotope dilution, and clearance, the total body water, extracellular fluid volume, and glomerular filtration rate (GFR) in hypertensive and normotensive animals during normal postnatal development were measured. Additionally, using an electron microscopic tracer, the relative permeabilities of the glomerular filter in these animals were assessed. The data indicate a volume expansion in the young hypertensive animals along with a reduction in GFR. As the animals mature the volume expansion in the hypertensives subsides and is eventually reversed resulting in a lower than normal fluid volume level. The significance of the reduced GFR in the hypertensives is also diminished with age although not to the same degree as that of the fluid volume. The indication of a reduced glomerular permeability may account for the above in light of Guyton's cascade hypothesis. PMID- 3983139 TI - Dopamine blockade reverses the inhibition of prolactin which results from intrahypothalamic pituitary grafts. AB - When mated with fertile bucks, rats with anterior pituitary (AP) tissue grafted into the hypothalamus did not exhibit prolongation of the diestrous cycle. Treatment of these rats with alpha-methyl-p-tyrosine, reserpine, or haloperidol for 1 or 2 days after mating increased the interestrous interval by a few days in all rats and to more than 8 days (leading to pseudopregnancy or pregnancy) in 20% of the cases. The same treatment in unmated normals resulted in 80% becoming pseudopregnant. To get more than 70% of rats with hypothalamic AP grafts pregnant or pseudopregnant required dopamine-blocking drugs for 3 or 4 consecutive days. Pregnancy was prolonged in 50% and lactation was impaired in 78% of the grafted rats which littered. Both impairments, like the original failure of the luteotrophic response, are attributed to the effects of PRL autofeedback from the hypothalamic AP grafts. These experiments provide further evidence that the mechanism whereby PRL in the hypothalamus inhibits PRL secretion involves elevation of dopamine. PMID- 3983140 TI - Nephrotoxic effects of oxygen transport media in the isolated rat kidney. AB - Perfusion of isolated kidneys from rats demonstrated the following nephrotoxic effects of Fluosol-DA: decreased glomerular filtration rate (GFR), urine flow rate (UFR), and fractional reabsorption of potassium (FrK+) (P less than 0.01). Fluosol-DA perfusions were at flow rates about equal to the physiologically normal rodent renal plasma flow rate of 4 ml/min. Stroma-free hemoglobin (SFH) perfusions, also at 4 ml/min, were associated with physiologically normal renal functions, as were those of control Krebs-Ringer bicarbonate (KRB) perfusions at 32 ml/min. PMID- 3983141 TI - European Economic Community's concerted action on congenital anomalies: the Eurocat Project. PMID- 3983142 TI - The comparative value of prospective and retrospective fetal diagnosis in preventing inherited disease. PMID- 3983143 TI - The northeastern France birth defects monitoring system. PMID- 3983144 TI - Genetic diagnostic amniocentesis. PMID- 3983145 TI - [Registers and research]. PMID- 3983146 TI - The effect of prenatal therapy in pregnancies with small-for-date fetuses on the psychoneurologic development of the infant. PMID- 3983147 TI - Introductory remarks: workshop on occupational hazards. PMID- 3983148 TI - Is paid employment during pregnancy detrimental to the offspring? PMID- 3983149 TI - Occupation and outcome of pregnancy: a population-based study in Norway. PMID- 3983150 TI - A methodology for studying the effect of industrial exposure on adverse pregnancy outcome. PMID- 3983151 TI - Design and execution of a very large birth-defects case-control study. PMID- 3983152 TI - Pregnancy outcome in the Seveso area after TCDD contamination. PMID- 3983153 TI - Congenital defects and environmental factors during pregnancy: nationwide surveillance. PMID- 3983154 TI - Parental occupation and congenital malformations in a series of 35,000 births in Israel. PMID- 3983155 TI - The possible contribution of industrial chemicals (organic solvents) to the incidence of congenital defects caused by teratogenic drugs and consumer goods- an experimental study. PMID- 3983156 TI - Prevention of physical and mental congenital defects. Part B: Epidemiology, early detection and therapy, and environmental factors. Proceedings of an international conference of the Institut de la Vie. Strasbourg, France, October 10-17, 1982. PMID- 3983157 TI - Report of the epidemiological methods workshop. PMID- 3983158 TI - Occupational hazards workshop: summary and recommendations. PMID- 3983159 TI - Incidence of clinical infections in a defined population of pregnant women. AB - The incidence of clinical maternal infections was determined in a prospective study of 44,016 pregnant women at 12 university hospitals. Viral and bacterial infections were the most frequently reported. Overall, the highest incidence of infections was for vaginitis, influenza/"flu"-like disease, and infections of the kidney, ureter, bladder; parasitic and fungal infections occurred at low rates. Most women experienced only one infection during pregnancy (89.7%); however, some had two different infections (8.5%), and a few had three or more (1.7%). The analysis of the effects of some of the maternal infections on the pregnant women and their children have been published, and further studies are in progress. PMID- 3983160 TI - Prevention of the congenital rubella syndrome: the Israeli experience. PMID- 3983161 TI - The child health record and its uses for epidemiological purposes. AB - The lack of correlation between the disabling conditions found in the school-age children and the congenital anomalies identified at birth has been discussed. It has been suggested that more emphasis be given to identifying disabling conditions in older children which require research into prevention. A child Health Record/Carnet de Sante de l'Enfant kept by the parents is suggested as a way of identifying and studying disabling conditions in children. PMID- 3983162 TI - [Prevention of toxoplasmosis: observations on follow-up experience in France]. PMID- 3983163 TI - Specific diagnosis of toxoplasmic chorioretinitis by demonstration of intraocular toxoplasma IgG antibodies. PMID- 3983164 TI - Report of the workshop on nutrition. PMID- 3983165 TI - Trace elements and their interactions as causes of congenital defects. PMID- 3983166 TI - Detection and investigation of subtle epidemics. PMID- 3983167 TI - Skeletal development, mineral and vitamin D nutrition in low birthweight infants. PMID- 3983168 TI - The role of malnutrition in common forms of physical and mental congenital defects among Nigerian Africans. PMID- 3983169 TI - Nutritional teratogens: a survey of epidemiological literature. AB - Alcohol seems to be, by far, the most important nutritional teratogen. Assuming an incidence rate of 1.3%o, 240 newborns with fetal alcohol syndrome per year would be expected in the Netherlands alone. Only a minor fraction of this number is diagnosed as such. Even moderate drinking during pregnancy results in developmental disturbances. There is no safe consumption level. Therefore the intake of alcohol during pregnancy should be abandoned completely. There is conflicting evidence on the effects of caffeine with regard to pregnancy outcome. A slight decrease in birthweight among the offspring of women drinking at least 4 cups of coffee per day seems to be the most consistent finding. In view of the many uncertainties on this subject the intake of caffeine-containing foods and drugs should be curtailed as far as possible. There is a lot of circumstantial evidence in favour of the assumption that high-risk mothers do benefit from vitamin supplementation in the periconceptional period. More research however is needed to elucidate the role of vitamins and other nutrients before supplementation can be recommended in practice as a prophylactic measure. PMID- 3983170 TI - Computer image analysis of mother-infant interaction. PMID- 3983171 TI - Intellectual and affective development of the very low birthweight premature infant. PMID- 3983172 TI - Some problems with investigations and epidemiologic studies relating to pregnancy. PMID- 3983174 TI - Influence of fetal and neonatal environment on physical, psychological, and intellectual development: workshop summary. PMID- 3983173 TI - Neonatal behaviour disturbances in infants of epileptic women treated during pregnancy. AB - Infants exposed in utero to antiepileptic drugs showed significantly more behaviour disturbances such as sedation (p less than 0.05) and hyperexcitability (p less than 0.01) than infants of a control group. The presence of these clinical symptoms and the time of their appearance did not seem to be dependent on the type of maternal medication, nor on the drug serum concentration in cord blood nor on the rate of drug disappearance from the infant's plasma. PMID- 3983175 TI - [Congenital abnormalities: epidemiology by syndromes]. PMID- 3983176 TI - Birth defects and environmental pollution: the Cubatao example. PMID- 3983177 TI - The assessment of embryotoxicity risks in man-made ecology: a permanent multidisciplinary inquiry. PMID- 3983178 TI - Teratoepidemiology. PMID- 3983179 TI - Pre- and postnatal bacterial infections as risk factors of the perinatal leucoencephalopathies. PMID- 3983180 TI - Screening of perinatal risk factors leading to deviations of physical development and/or mental retardation of the child and their prevention. AB - We tried to demonstrate some results obtained from the analysis of one selective and one countrywide follow-up study the mode of detection of risk pregnancies and of risk factors that could be the cause of physical and mental congenital defects; the search for optimal form of screening and prevention in these cases; and verification of the effectivity of these measures. PMID- 3983181 TI - Developmental mechanisms, normal and abnormal. Proceedings of a workshop on Molecular Aspects of Abnormal Development. Salzburg, Austria, October 1983. PMID- 3983182 TI - Role of extracellular matrix in the development of skin and cutaneous appendages. PMID- 3983183 TI - Studies on the control of proteoglycan synthesis in normal and genetically abnormal avian cartilage. PMID- 3983184 TI - A paradox in development: masculinization of the brain without androgen receptors. PMID- 3983185 TI - Abnormal sexual differentiation: male pseudohermaphroditism (MPH) and abnormal steroid synthesis metabolism and action. PMID- 3983186 TI - Interactions between developmental biology and teratology. PMID- 3983187 TI - Somitogenesis: investigations on the mechanism of compaction in the presomitic mass and a possible role for fibronectin. PMID- 3983189 TI - Pepsinogens in man. Clinical and genetic advances. PMID- 3983188 TI - Appearance of basement membrane components during the differentiation of limb bud mesenchyme cells in culture. PMID- 3983190 TI - On chromosome mapping of human pepsinogen gene loci. PMID- 3983191 TI - Serum pepsinogens I and II and gastric acid output: effect of gastritis. PMID- 3983192 TI - Serum pepsinogen I levels: assessment of gastric acid secretion? AB - We measured serum PG I levels by an Elisa technique before and after stimulation with pentagastrin in 260 patients (161 males and 99 females). The serum levels were correlated to basic acid output (BAO), maximum acid output (MAO) and peak acid output (PAO). The correlation coefficient between serum PG I and PAO varied between -0.482 and 0.744 depending on the diagnosis. This indicates that a simple measurement of PG I cannot replace the pentagastrin test in estimating gastric acid secreting capacity. However, since all patients who were achlorhydric had a serum PG I level of less than 50 micrograms/l the measurement of serum PG I can be recommended as a screening test for achlorhydria. PMID- 3983193 TI - Electrophoretic and immunochemical heterogeneity of human urinary pepsinogens. PMID- 3983194 TI - The relation of serum pepsinogen to gastric cancer and its precursors in Hawaii Japanese men: a progress report. AB - Prospective epidemiologic studies among Hawaii Japanese indicate that serum PG I levels below 20 micrograms/1 are highly specific for the presence of intestinal metaplasia and the intestinal type of gastric cancer; but this test shows a low level of sensitivity. Substitution of the PG I/PG II ratio for the PG I level results in a modest improvement in the level of sensitivity at the expense of some loss in specificity. Antral gastritis and intestinal metaplasia are gastric cancer precursors in this population. Abnormally low values of serum PG I or the PG I/PG II ratio predict high stage tumors in the majority of cases. It therefore does not seem likely that estimates of serum pepsinogen are likely to increase the frequency of the diagnosis of early intestinal type carcinoma of the antral portion of the stomach in this population. PMID- 3983195 TI - Urinary pepsinogen I: A multigene family? PMID- 3983196 TI - Serum pepsinogen I in hereditary hypergastrinemic peptic ulcer syndromes. PMID- 3983197 TI - Nomenclature Committee report: pepsinogens. Nomenclature Committee of Human Gene Mapping Conference. PMID- 3983198 TI - Quantitative serum pepsinogen: genetics and relationship to urinary and gastric phenotypes. PMID- 3983199 TI - Serum pepsinogen I levels in relation to pepsinogen phenotypes. AB - Serum PG I levels were measured by an enzyme linked immuno sorbent assay (ELISA) in 567 blood donors and 171 patients from a routine gastroscopy program to study the relationship between PG I phenotypes and serum levels. In normal subjects no association was found between PG I phenotypes and serum levels. A low serum PG I level in patients was associated with phenotypes characterized by intense PG I fraction 5. This probably reflects the high frequency of these phenotypes in patients with atrophic gastritis or gastric cancer. The mean (+/- SD) serum PG I level was 45.8 +/- 17.7 micrograms/1 in control subjects. Serum PG I levels were lower in females (41.4 +/- 17.5) than in males (47.3 +/- 17.7) and increased with advancing age up to 65 years. PMID- 3983200 TI - Changes in erythrocyte and liver aldehyde dehydrogenase isozymes in alcoholics. PMID- 3983201 TI - Further characterization of aldehyde dehydrogenase isozyme variant in Japanese. PMID- 3983203 TI - Kinetic and spectroscopic characterization of the sheep liver aldehyde dehydrogenase acyl-enzyme. PMID- 3983202 TI - Bovine lens aldehyde dehydrogenase: improved purification and characterisation. PMID- 3983204 TI - Chemical modification of human aldehyde dehydrogenase. PMID- 3983205 TI - The reaction of cytoplasmic aldehyde dehydrogenase with various thiol-modifying reagents. PMID- 3983206 TI - Chemical probes for the active site of aldehyde dehydrogenase. PMID- 3983207 TI - Concentration effects in assays of sheep liver mitochondrial aldehyde dehydrogenase and their interpretation in terms of enzyme dissociation. AB - Enzyme assays exhibit lag-phases during which the rate of acetaldehyde oxidation or p-nitrophenylacetate hydrolysis accelerates. A steady-state rate is achieved, but the time taken for this to occur increases as the enzyme concentration is decreased. With 0.009 microM enzyme this takes about 15 minutes. Analysis of experimental results suggests that the activation occurs because the tetrameric enzyme dissociates to a more active species. Gel filtration behaviour of the enzyme at different concentrations and stability tests with urea provide some general support for this hypothesis. PMID- 3983208 TI - Spontaneous dissociation of tetrameric horse liver mitochondrial aldehyde dehydrogenase to dimers. PMID- 3983209 TI - Recent studies of the regulation of aldehyde dehydrogenase activity during rat hepatocarcinogenesis. PMID- 3983210 TI - Failure to establish a conditioned place preference with ethanol in rats. AB - Previous studies have demonstrated that many drugs of abuse are able to produce a conditioned place preference in rats. We sought to determine if ethanol, injected in a wide range of doses, could also produce a conditioned place preference. Statistical analysis of our results indicated that the IP administration of the drug (50, 100, 150, 300, 600, 800, or 1000 mg/kg) failed to produce either a conditioned place preference or aversion compared to vehicle injected control rats. Under similar testing conditions a conditioned place preference was obtained with amphetamine (2 mg/kg) and this preference was not secondary to conditioned hyperactivity. In another experiment, rats were injected with ethanol through indwelling jugular cannulae at doses similar to those reported [24,26] to support (1, 2 mg/kg) or not to support (8 mg/kg) self-administration by rats. We also failed to obtain a conditioned place preference using these doses. Blood and brain ethanol levels, determined 1, 2 or 5 minutes after the administration of 2 mg/kg (IV) indicated very low ethanol levels. These results may suggest that rats do not self-administer ethanol for its intoxicating properties, and that the affective state produced by ethanol administration per se is not readily conditionable to environmental cues. PMID- 3983211 TI - Apomorphine increases ethanol discrimination. AB - Rats were trained to discriminate between the stimulus properties of 600 mg/kg ethanol and saline in a two-lever, food-motivated operant task. Once trained, rats showed a dose-related decrease in discriminative performance with lower ethanol doses and analysis of the dose-response curve indicated an ED50 of 372 mg/kg. Pretreatment with 0.16 mg/kg apomorphine produced increased discriminative performance at each ethanol dose and the combination generated a dose-response curve parallel to ethanol administered alone with an ED50 of 232 mg/kg. This significant shift to the left of the ethanol dose-response curve after apomorphine administration is discussed in relation to dopaminergic neuronal systems and the clinical use of apomorphine alcoholics. PMID- 3983212 TI - Motor hypoactivity induced by neurotensin and related peptides in mice. AB - The tridecapeptide neurotensin (NT) induces a variety of behavioral changes in animals. The present study characterizes the behavioral hypoactivity observed after intracerebroventricular (ICV) injection in mice. At doses higher than 25 ng, NT induced a reduction of general motor activity and increases in immobility which lasted for about one hour. The NT-related amphibian skin peptide xenopsin was about 70-fold more potent than NT itself. After repeated NT-injections, tolerance developed within 2-4 days and disappeared within 2-4 days after cessation of the treatment. The motor hypoactivity induced by NT was not attenuated by pretreatment with naloxone (5 mg/kg, SC). Furthermore, amphetamine induced locomotor activity was not blocked by NT or xenopsin. These results suggest that the NT-effect is not mediated by a stimulation of opioid mechanisms or attenuation of dopamine-mediated events. PMID- 3983213 TI - Isolation and striatal (3H) serotonin uptake: role in the voluntary intake of ethanol by rats. AB - Ethanol preferring rats were selected and showed a constant voluntary intake of a 12 percent ethanol solution during 14 days (about 5 g/kg body weight daily). Analysis of 3H serotonin uptake by striatal synaptosomes showed that steady state 3H serotonin synaptosomal levels were lower in alcohol preferring rats. Grouping these rats (5 per cage) reduced both voluntary intake of ethanol and synaptosomal 3H serotonin uptake. Furthermore, blocking the serotonin uptake by clomipramine 5 mg X kg-1 or 10 mg X kg-1 also reduces voluntary intake of ethanol. These data are in agreement with the hypothesis of a modulation of the voluntary intake of ethanol both by chemical and housing stimulation of striatal receptors for serotonin. PMID- 3983214 TI - An examination of heroin conditioning in preferred and nonpreferred environments and in differentially housed mature and immature rats. AB - The study addressed two issues. First, we examined the effectiveness of heroin as a conditioning agent in a preferred environment using a place preference paradigm. Four daily injections of 80 micrograms/kg (SC) of heroin HCl were paired with environments that rats initially found to be either preferred or non preferred. In subsequent tests, only those that had experienced the drug effects in the non-preferred environment increased the percentage of time spent in that environment. Rats conditioned in the test chamber that was initially preferred failed to increase the amount of time spent in that chamber post-conditioning. These results suggest that the conditioned place preference paradigm does not simply assess the rewarding consequence of heroin injections. We also examined the effects of grouped and isolation housing conditions on the heroin-produced conditioned place preference. Rats were housed under these conditions either immediately post weaning or at 120 days of age. There was a difference between the magnitude of the place preference produced by 20 micrograms/kg heroin in the isolated but not in the group housed rats. When isolated at weaning the rats were less sensitive to the drug than were rats isolated at maturity. These data are discussed with particular reference to the development of the endogenous opioid system. PMID- 3983215 TI - Effects of prenatal exposure to morphine on the development of sexual behavior in rats. AB - Females exposed to morphine sulfate in utero (5-10 mg/kg twice a day on days 11 18 of gestation) displayed precocious vaginal opening and had increased body weight from the 8th week after weaning. In addition, there was a substantial inhibition in adult feminine sexual behavior. Male rats that received either morphine or saline prenatally did not show any body weight differences, and most of the measures of masculine sexual behavior did not differ between the two groups. However, the male rats exposed to morphine had a significantly shorter post-ejaculatory intromission latency than the saline controls. Examination of cytosol estrogen receptor levels in the hypothalamus-preoptic area (HPOA) of both saline and morphine sulfate-treated female rats revealed essentially identical patterns of depletion and replenishment. Additionally, estrogen treatment was equally effective at inducing HPOA progestin receptor synthesis in both groups. These results show that prenatal morphine treatment at the times and dose level administered disrupts the development of reproductive function in females but has only minor effects on male reproductive function. PMID- 3983216 TI - Alcohol effects on plasma luteinizing hormone levels in menopausal women. AB - Plasma luteinizing hormone (LH) levels were determined in five healthy post menopausal adult females prior to, during, and following a period of acute alcohol intoxication. LH levels were also determined in the same women following acute administration of a nonalcoholic beverage which had identical isocaloric value of alcohol. Plasma samples were collected at 30-minute intervals from an indwelling intravenous catheter from 120 minutes prior to alcohol or isocaloric beverage administration to 300 minutes following beverage intake. All women became moderately intoxicated after acute alcohol administration and developed peak blood alcohol levels of 94 mg per dl between 60 to 90 minutes following alcohol intake. LH levels determined before administration of alcohol or isocaloric beverage were not significantly different and were within the range of normal values for healthy, post-menopausal women. No significant differences were found between LH levels following alcohol administration when compared with LH values after isocaloric beverage. These data indicate that acute alcohol intake which produces blood alcohol levels slightly below usual legal limits of intoxication does not suppress LH in post-menopausal females. Since post menopausal females do not have significant estradiol feedback control of LH secretory activity, and since LH secretory activity in post-menopausal women (in contrast to pre-menopausal females) is more sensitive to the inhibitory actions of drugs which may affect adrenergic and dopaminergic pathways in brain, the findings obtained in this study do not support an acute alcohol effect upon hypothalamic-pituitary modulation of gonadotrophin release in humans. PMID- 3983217 TI - Injections of atropine into the caudate nucleus impair the acquisition and the maintenance of passive avoidance. AB - Two experiments were performed to test the hypotheses that cholinergic activity of the caudate nucleus (CN) is involved in the acquisition and in the maintenance of passive avoidance behavior. Rats were trained, in one trial, to avoid one of two compartments of a conditioning box and retention of the task was measured 24 hours later. Several doses of atropine were injected into the CN of independent groups of animals. In Experiment 1 the atropine was injected 2 minutes after training and in Experiment 2 it was injected 6 minutes before retention testing. In both cases a dose-dependent retention deficit was found. These results indicate that striatal cholinergic activity is indeed involved in the processes that mediate passive avoidance conditioning. PMID- 3983218 TI - The acute effects of antidepressant drugs on the performance of conditioned avoidance behavior in rats. AB - The effects of acute administration of 10 different antidepressant drugs were examined on the performance of a two-way conditioned avoidance response in rats. The antidepressant drugs impaired avoidance behavior by decreasing avoidance responding and increasing the number of escape failures. The order of effectiveness for increasing overall response latency at a common dose of 10 mg/kg was: desipramine, maprotiline, protriptyline, (+) oxaprotiline, nortriptyline, imipramine, amitriptyline, (-) oxaprotiline, fluoxetine, and chlorimipramine. Avoidance behavior was impaired most by those antidepressant drugs that are also potent inhibitors of norepinephrine uptake. PMID- 3983219 TI - Tolerance, cross-tolerance, and receptors after chronic nicotine or oxotremorine. AB - Saline, 8.0 mg/kg/hr nicotine, or 1.0 mg/kg/hr oxotremorine was continuously infused into the jugular veins of DBA female mice. After 10 days of treatment, respiratory rate, Rotarod performance, Y-maze crossings, Y-maze rears, heart rate, and body temperature were measured after challenge with 2.0 mg/kg nicotine or saline or 0.2 mg/kg oxotremorine. Nicotine-infused mice were tolerant to the effects of nicotine for all six tests and oxtremorine-infused mice were tolerant to the effects of oxotremorine for all six tests and to the effects of nicotine on heart rate and body temperature. Oxotremorine infusion reduced the Bmax for [3H]-L-QNB binding, but had no effect on Bmax for either [3H]-DL-nicotine or [125I]-alpha-BTX binding. Conversely nicotine infusion did not alter the Bmax for [3H]-L-QNB binding, but increased the Bmax for both [3H]-DL-nicotine and [125I] alpha-BTX binding. These results indicate that tolerance developed to the effects of two cholinergic agents, nicotine and oxotremorine, and that some cross tolerance to the effects of nicotine occurred in oxotremorine-treated mice. Treatment with oxotremorine caused down-regulation of muscarinic receptors, while treatment with nicotine caused up-regulation of nicotinic receptors. Although some cross-tolerance to the effects of nicotine occurred in oxotremorine-treated mice, this did not appear to result from changes in nicotinic receptors. PMID- 3983220 TI - Learned tolerance to ethanol in a spinal reflex separated from supraspinal control. AB - We have recently reported that ethanol-induced inhibition of the tail flick reflex in intact and spinal rats is diminished during an eight day period if the animals are tested daily under the influence of ethanol. Ethanol only, or testing before ethanol administration, is not followed by tolerance. In the present study we used the tail flick testing of spinal rats to investigate the effect on tolerance development of repetitively triggering the tail flick reflex during intoxication, and of just placing the intoxicated animals in the test apparatus. We also investigated if damage to the tail tissue, due to repetitive prolonged test exposure, would facilitate the reflex and thereby reduce the inhibitory effect of ethanol. The results indicated that triggering of the reflex in the presence of ethanol was necessary for the tolerance to develop. Facilitation of the tail flick reflex, due to damage of the tail tissue, was not revealed. Thus the tolerance observed seems to be caused by an adaption to ethanol learned by structures involved in the tail flick reflex. PMID- 3983221 TI - Passive avoidance deficits in mice following ethylcholine aziridinium chloride treatment. AB - High-affinity choline uptake (HACU) appears to be the rate-limiting step in the synthesis of the neurotransmitter acetylcholine. The present experiment was designed to examine the effects of irreversible inhibition of HACU by ethylcholine aziridinium chloride (ECA) on passive avoidance retention in mice. Animals were injected intracerebroventricularly, and one-trial passive avoidance retention evaluated 21 days later. A significant retention deficit was observed in ECA-treated animals upon retest 24 hours after training. ECA-induced changes in retention were accompanied by significant reductions in choline acetyltransferase (CAT) activity in only two of seven brain regions tested, hippocampus (48% of control) and cerebellum (76% of control). The results support the involvement of hippocampal cholinergic activity in mediation of passive avoidance learning. PMID- 3983222 TI - Radial maze performance in young and aged mice: neurochemical correlates. AB - Young (8 month) and aged (27-28 month) male C57BL/6J mice were trained in a spatial discrimination task requiring working memory. The mice were tested during three trials daily in an eight-arm radial maze for 36 test days. Correct choices were reinforced with isotonic saline. In contrast to past reports, young mice learned the task. Old mice also learned the task, and no significant age-related differences in performance were observed. Following maze training, the mice were killed, the brains removed, and the specific activities of choline acetyltransferase (E.C.2.3.1.6., ChAT) and L-glutamic acid decarboxylase (E.C.4.1.1.15., GAD) were assayed in the hippocampus, and in frontal, sensorimotor, and cingulate areas of the cerebral cortex. The activities of these neurotransmitter synthetic enzymes did not differ significantly between young and old mice. Correct responding in the radial maze was positively correlated to ChAT activity in the cingulate cortex and negatively correlated to ChAT activity in the sensorimotor cortex. There was a similar pattern of correlation between performance and regional GAD activity, although none of the correlations involving GAD reached statistical significance. PMID- 3983224 TI - Efficacy of trazodone as an anti obsessional agent. AB - Eight patients with chronic Obsessive-Compulsive Neurosis were subjected to Trazodone, an antidepressant acting on the serotinergic system. After 4 weeks of treatment, 6 showed significant reduction in the obsessional symptoms which was sustained after a 6-week follow-up. The 2 patients who did not show improvement had a significantly higher trait score than the others on psychometric ratings. PMID- 3983223 TI - Intracortical 5,7-dihydroxytryptamine depletes brain serotonin concentrations without affecting spontaneous activity. AB - Microinjections of either 2 or 4 micrograms of the serotonergic neurotoxin 5,7 dihydroxytryptamine (5,7-DHT) were made into either the right or left frontal cortex of male rats pretreated with desmethylimipramine. Although both the 2 and 4 micrograms doses produced significant depletions of serotonin concentrations in the cortex and median raphe, neither dose produced a significant increase in spontaneous activity. This is in contrast to our findings with the noradrenergic neurotoxins, 6-hydroxydopamine and DSP-4, which produced hyperactivity following right but not left hemisphere injections. These findings do not rule out the involvement of 5-HT in the asymmetrically elicited hyperactivity but they do suggest some transmitter and neural pathway specificity to the lateralized response to cortical injury. PMID- 3983225 TI - Erythrocyte and liver characteristics in low and high glutathione Finn sheep. AB - Selenium-uptake, glutathione peroxidase (GSH-Px), hepatic microsomal cytochrome P 450 and hepatic glutathione contents were studied in Finnsheep. The erythrocytes of low-GSH sheep had higher Selenium uptake and GSH-Px activity than did those in high-GSH animals. The low Se uptake in high-GSH sheep could be due to continuous pumping of Se from the cells into the erythrocytes, which reflects the active role of these cells, compared to those in low-GSH sheep. Significant differences in hepatic microsomal cytochrome P-450 content were found in the two groups of sheep. The greater activity among the low-GSH sheep suggests that they may have more active detoxification mechanisms than the high-GSH animals. The glutathione content in the liver was similar in both high and low-GSH sheep. PMID- 3983226 TI - Lack of renal tubular and hemodynamic effects of non-selective and delta-opioid receptor antagonism. AB - The renal pharmacological actions of the non-selective opioid receptor antagonist naloxone and the selective delta (delta)-opioid receptor antagonist ICI 154,129 were examined in conscious dogs. Neither naloxone nor ICI 154,129 altered glomerular filtration rate, renal blood flow, blood pressure, heart rate, or renal excretion of water, Na+, K+, or Cl-. In addition, urine and plasma osmolality and electrolyte concentrations and hematocrit were unchanged, suggesting that neither agent produced physiologically significant alteration in plasma vasopressin levels. These data suggest that (a) naloxone and ICI 154,129 exert no renal pharmacological effects in dogs and (b) under resting physiological conditions, delta-opioid receptors, as well as other opioid receptor subtypes, probably are not involved in the tonic regulation of renal hemodynamics or tubular function. PMID- 3983227 TI - Methylphenidate, but not other CNS stimulants, inhibits red blood cell calcium activated potassium efflux. AB - The first-order rate constant of net potassium efflux, measured in human red blood cell (RBC) suspensions by means of a K+-sensitive electrode, was increased 26 fold (from 0.0025 min-1 to 0.0656 min-1) by 0.5 microM of the calcium ionophore A 23187. Both the basal or the calcium-stimulated potassium efflux remained unchanged following the addition of different CNS stimulants (nikethamide (1 mM), pentylenetetrazol (1mM), doxapram (1 mM), strychnine (0.1 mM), picrotoxin (0.1 mM), or nomifensine (0.1 mM). Methylphenidate (10-100 microM), however, inhibited in a concentration-dependent manner the calcium stimulated, but not the basal potassium efflux. An IC50 of 190 microM was estimated for this effect. PMID- 3983228 TI - In vitro inhibition of rat arterial smooth muscle cell growth by extractive sulfated mucopolysaccharides. AB - The effect of a sulfated mucopolysaccharide mixture of known composition, extracted from pig duodenum, was studied on the proliferation of rat arterial smooth muscle cells cultured from rat aorta. Cell growth, stimulated by fetal calf serum, was monitored by direct cell count and by determination of the mitotic index. The extractive mixture was studied in comparison with commercial heparin, with heparin with different electrophoretic mobilities in barium acetate and with dermatan and heparan sulfates. Heparins and the extractive mucopolysaccharide mixture inhibited cell growth measured at various time intervals, and in their presence the proliferation of smooth muscle cells plateaued at lower cell densities. Dermatan and heparan sulfates were either inactive or significantly less effective than the other mucopolysaccharides. A short preincubation (3 h) of smooth muscle cells with the extractive mixture, followed by incubation with the growing medium with no mucopolysaccharides added, slowed the cell growing rate, suggesting an interaction of the mixture components with the cell surface. PMID- 3983229 TI - Effect of alcohols on the permeability of blood-brain barrier. AB - Effect of alcohols on the permeability of blood-brain barrier was studied in anaesthetised dogs using sodium fluorescein as circulant. Entry of sodium fluorescein in the cerebrospinal fluid (CSF) was measured spectrophotofluorometrically. Methyl, ethyl, propyl and butyl alcohols were used in the study. Methyl alcohol did not increase the entry of sodium fluorescein in CSF compared to control. However, ethyl, propyl and butyl alcohols significantly increased the entry of sodium fluorescein. The increase was dependent upon the length of alkyl chain of alcohols. Longer was the aliphatic chain more marked was the effect. The increase in permeability was also dependent upon the concentration of the alcohol. Thus 90% ethyl alcohol was more effective than 30% and this effect was concentration-dependent. The increase in permeability of blood-brain barrier could be correlated to the lipid solubility of alcohols. PMID- 3983230 TI - The physics of red cell sedimentation. AB - Blood was withdrawn from the ante-cubital vein of five normal volunteers and the erythrocytes were washed and resuspended in isotonic saline. The rate of descent of the erythrocyte-saline boundary was measured every hour for a period of at least 4 h for different suspended cell concentrations. The velocity of this boundary remained constant during the period of observation for a specific concentration. There was, however, an experimental variation of sedimentation rate with red cell concentration. Extrapolation to zero concentration allowed the 'Svedberg constant' for normal red cells to be evaluated. A continuum physics theory was used to explain the observations. The sedimentation rate was also measured in anticoagulated whole blood. The rates of descent in whole blood and the red cell-saline suspension were significantly different. Furthermore, the erythrocyte boundary in whole blood displayed both acceleration and deceleration during the period of observation. These experiments support the concept, proposed in an earlier theoretical study, of an internal energy dissipative mechanism which occurs in heterogeneous fluids (such as blood) but not in homogeneous fluids (such as water). PMID- 3983231 TI - Ultraviolet and visible radiation transmission properties of some types of protective eyewear. PMID- 3983232 TI - Elastic scatter computed tomography. PMID- 3983233 TI - A mathematical model for the quantitative study of left to right cardiac shunt. AB - Non-invasive radioisotope cardiographic techniques have become a useful tool for studying the anatomy and function of the heart. The mathematical model described justifies the phenomenological analysis of pulmonary time-activity histograms and was invented for quantitative study of left to right cardiac shunt. The model also gives a theoretical insight into such an empirically proposed diagnostic method and represents an adequate framework for the understanding of other possible approaches to the problem of left to right shunt. PMID- 3983234 TI - Effects of scattered X-rays on CT images. AB - Scatter to primary radiation ratios at detector positions were calculated for uniform cylindrical water phantoms in both third and fourth generation x-ray CT scanners using the Monte Carlo simulation method. A rapid method for determining the scattering angle is given. In the process of image reconstruction, the effect of scatter was isolated by applying our new calculation technique. The decrease in CT number due to scatter was found to be less than 10. In the third generation CT scanner the rate of scatter is larger at the centre than at the edge because of the effect of the collimator at the detectors. As a result the cupping artefact occurs in the CT image. The collimator cannot be used in the fourth generation CT scanner and, therefore, the rate of scatter is almost uniform, leading to the appearance of rounded-off edges. PMID- 3983235 TI - Gamma camera spatial resolution as measured by the bar phantom. PMID- 3983236 TI - Reply to 'Importance of internal noise in models of observer performance'. PMID- 3983237 TI - Development from birth to 3 years of age of 15 children at high risk for central nervous system dysfunction. Interim report. AB - The purposes of this study were to determine if a group of infants at high risk for later developmental abnormality could be selected on the basis of large numbers of serious neonatal problems, ascertain how early developmental outcome could be predicted, and document the development of the infants longitudinally during the first year of life. Fifteen infants were selected on the basis of high scores on a neonatal risk assessment scale. They were examined with a variety of developmental tests at regular intervals during their first year, at age 2 years, and at age 3 years. The results suggest that the selection process successfully identified a group of infants with developmental problems and that motor performance at 3 months was predictive of neurologic outcome at 3 years. Different patterns of neuromotor development in the first year were identified among those infants with severe cerebral palsy, those with milder neurologic problems, and those with apparently normal outcome. PMID- 3983238 TI - Evaluation of sensory nerve conduction velocity testing of the superficial radial nerve. AB - The purposes of this study were to evaluate the methods for examining the superficial radial nerve and to compare velocities and amplitudes of responses based on electrode shape and placement and site of stimulation. We selected 51 subjects with a mean age of 37 years from a healthy group. Twenty additional subjects with a mean age of 28 were also examined. Nerve conduction was done by stimulating over the dorsal forearm and lateral arm and recording from the superficial radial nerve where its branches cross the extensor pollicis longus tendon. The second group of subjects were stimulated at the same site and also at the elbow. Recording was done with a rectangular-shaped electrode placed in the area between the extensor pollicis longus and the extensor pollicis brevis tendons. We found a mean conduction velocity of 61 m/sec +/- 4.91 in the first group with a mean amplitude of response of 36.7 microV +/- 11.7 when we stimulated at the forearm site and 4.06 microV +/- 6.75 when we stimulated at the lateral arm site. In the second group of subjects, conduction velocity from lateral arm to forearm site was 63 m/sec +/- 4.50; from the lateral arm to elbow, 66 m/sec +/- 10.4; and from the elbow to the forearm site, 64 m/sec +/- 9.71. Amplitudes of response were 43.8 microV +/- 14.45 at the forearm stimulation site, 18.06 +/- microV +/- 7.37 at the elbow site, and 6.7 microV +/- 4.25 at the lateral arm site. We compared the mean velocities from the two methods and found no significant differences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3983239 TI - Contribution of pelvic and lower limb motion to increases in the angle of passive straight leg raising. AB - We undertook this study to determine the relative contributions of pelvic and lower limb motion to increases in the angle of passive straight leg raising in the sagittal plane. Seventeen healthy subjects underwent passive straight leg raising of their relaxed left lower limb while their right lower limb was held firmly against the table. Each subject's pelvis and left lower limb were marked so that cinematography could document motion of the pelvis and left lower limb during passive straight leg raising. Film analysis revealed that pelvic rotation began within 9 degrees of the beginning of passive straight leg raising and that the relative contribution of pelvic rotation to the angle of passive straight leg raising in relation to the horizontal plane increased in conjunction with the angle of straight leg raising. Clinicians using the passive straight-leg-raising test should be aware of the contribution of pelvic rotation to the angle of straight leg raising when interpreting test results. PMID- 3983240 TI - Orthotic design from the New England Regional Spinal Cord Injury Center. Suggestion from the field. PMID- 3983241 TI - Effectiveness of repeated prolonged loading for increasing flexion in knees demonstrating postoperative stiffness. A clinical report. PMID- 3983242 TI - Effect of videotape replay on the quality and accuracy of student self evaluation. AB - This study was designed to determine the effect of videotape replay on the quality and accuracy of student self-evaluation. Thirty-two junior physical therapy students were asked to perform a clinical skill and to assess their performances using the Performance Evaluation Form (PEF) designed for this study. The students in the Experimental Group assessed their performances after viewing a videotape replay. Students in the Control Group assessed their performances without viewing videotape replays. Faculty judges used the PEF to rate each student's performance. The instructor and student ratings were compared to determine the accuracy of student ratings. In addition, two faculty judges used a scale designed for this study to rate the degree of quality of each student's self-evaluation. No significant differences were found between the Experimental Group and the Control Group on either of the variables tested. The data gathered in this study indicated that videotape replay lacks value in enhancing self assessment when evaluation immediately follows the performance of a skill. Further study is indicated. PMID- 3983243 TI - Excited state properties of alpha-terthienyl and related molecules. PMID- 3983244 TI - Optical penetration in human intracranial tumors. PMID- 3983245 TI - Conformational fluctuations in alpha-chymotrypsinogen A powders. PMID- 3983246 TI - The teaching hour/course duration ratio. PMID- 3983247 TI - Elementary hemodynamic principles based on modified Bernoulli's equation. PMID- 3983248 TI - Principles and techniques of bilateral complete cleft lip repair. AB - Important principles for repair of bilateral complete cleft lip are symmetry, primary orbicularis continuity, proper prolabial size and shape, median tubercle and mucocutaneous ridge formation from lateral lip tissue, and early construction of nasal tip and columella with anatomic placement of the alar cartilages. A two stage repair employing techniques based on these concepts is described. At the initial procedure, the lateral crura are positioned and a tiny biconcave prolabium is shaped in anticipation of the changes with growth. The second stage (nasal correction) includes apposition of the alar genua, medial crural relocation, and intranasal transposition of banked forked flaps without disjunction of the columella-labial angle. The complete bilateral cleft lip is a four-dimensional problem. PMID- 3983249 TI - The superficial musculoaponeurotic system in the upper lip: an anatomic study in cadavers. AB - Ten cadavers were employed to demonstrate the presence of the SMAS in the upper lip using macroscopic and microscopic techniques. The relationships and attachments of the SMAS to the dermis of the upper lip are described. In cadavers, medial traction on the SMAS in the upper lip in conjunction with superolateral traction on the SMAS in the cheek is found to decrease the depth of the nasolabial fold. Superior traction on the SMAS in the upper lip elevates the interlabial line, reestablishes the convexity of the lateral vermilion border, and partially increases concavity of the profile. PMID- 3983250 TI - Biostereometrics and computergraphics for patients with craniofacial malformations: diagnosis and treatment planning. AB - Utilizing the techniques of biostereometric photography and current state-of-the art computergraphics, topographic contourgrams have been generated in a series of patients with complex craniofacial malformations. These contourgrams are considered useful in diagnosis and treatment planning and as an aid in postoperative follow-up. We hope that the technique will provide a means to study longitudinal growth in unoperated and operated patients with craniofacial malformations. Comparisons between these groups and normal patients are currently being investigated. PMID- 3983251 TI - Inclinations of the facial profile: art versus reality. AB - The average inclinations of five basic facial profile lines and five individual facial profile segments were determined by direct anthropometry in a total group of 232 healthy young adults, all North American Caucasians. Significant sex related differences were found only in the inclination of the forehead, the lower face, and the lower third of the face, with greater inclinations in males. These results were compared with data obtained from 49 art works produced by ancient, Renaissance, post-Renaissance, and contemporary artists and drawings of the face in scientific papers published by anthropologists, orthodontists, anatomists, and plastic surgeons. In the population study the average inclination of the general and the aesthetic profile lines, the lower face, the forehead, and the lower lip show a receding trend. The upper face is slightly protruded in the males and close to vertical in the females. The chin and the nose are equally prominent in both sexes. The only significant difference is in the greater recession of the lower face in males. The average female population values are reminiscent of those of the Renaissance. The average male inclinations come closest to the findings in the statues of antiquity. The population sample and the contemporary artists showed similar inclinations of the nasal bridge and the lower lip. Generally, the average inclination of the chin in the population is smaller than in any artistic style. PMID- 3983252 TI - Argon laser therapy of port-wine stains: effects and limitations. AB - One hundred and one patients (112 parts) with port-wine stains were treated by argon laser therapy. We strictly evaluated all patients according to color shift, scar formation, and pigmentation. We observed good to excellent results in 44 percent of patients, and less satisfactory results in 56 percent. The relationship between the effects of treatment and several factors, such as patients' age, anatomic site, and histologic type of the lesions, were investigated. More satisfactory results tended to be obtained in patients with neck lesions and with histologic type III lesions (dilated type). To date we have not discerned any definite criteria for precisely predicting the response of port wine stains to argon laser therapy. Consequently, the performance of a test seems to us to be the best way of discovering the response and course of healing of an individual port-wine stain after laser therapy. Thirty-six consecutive patients were studied to determine whether compression and cooling would improve the outcome of argon laser therapy. The use of this method did not produce any noticeable effects. PMID- 3983253 TI - Pigmentation after dermabrasion: an avoidable complication. AB - A 20-year retrospective study of patients undergoing dermabrasion is reported. All patients included in this study met the strict criteria of a minimum of a 6 month follow-up examination, abstention from exposure to sun, and photographic documentation. Fifty-nine percent were seen at 1 year or more, and 41 percent were seen at 5 years or more. Unfavorable pigmentation as a result of dermabrasion was encountered in only eight patients. In seven, this receded with the passage of time. The eighth was lost to follow-up. Hypopigmentation was noted in three patients: two blacks and one Caucasian. Persistent redness occurred in three Caucasian patients. Recurring pigmentation with exposure to sun, continuing years after the procedure, was reported in two black patients and two Caucasian patients. Hispanic patients appear to be more aware of subtle pigmentary and textural changes. Adverse pigmentation does not appear to be an inevitable consequence of dermabrasion in patients who abstain from exposure to sun in the initial postoperative period. Dermabrasion is viewed as a valuable surgical procedure for improvement of acne and other scar deformities. PMID- 3983254 TI - Crescent mastopexy and augmentation. AB - We have defined a group of patients with a lesser degree of moderate breast ptosis whose ptosis correction is not adequately improved by augmentation alone but requires some elevation of the nipple-areola complex. We have selected the crescent excision mastopexy to provide this additional needed lift. Experience with 26 patients employing this technique has helped to define the indications and limitations for this approach. It seems to adequately provide the additional needed lift when nipple descent has been no more than 1.5 to 2 cm below the inframammary crease. Complications such as scar widening (46 percent) were reviewed, but seemed to be well tolerated by the patients. PMID- 3983256 TI - New concepts on the arterial vascularization of skin and muscle. AB - From a personal anatomic study, the author describes here the principles of cutaneous and muscular arterial blood supply and proposes a new classification. The cutaneous arterial blood supply depends on musculocutaneous arteries and on direct cutaneous arteries. With the exception of some cutaneous flaps that are supplied by direct cutaneous arteries, most other cutaneous areas are supplied by musculocutaneous arteries. The dissection of a fasciocutaneous flap reveals a new possibility for repairing large skin defects. The subcutaneous aponeurosis possesses a rich vascular supply and an important arterial network. The muscular arterial blood supply is fully studied here with the description of two main groups of muscles corresponding to an adequate blood supply. PMID- 3983255 TI - The acute effects of cigarette smoke exposure on experimental skin flaps. AB - Random vascular patterned caudally based McFarlane-type skin flaps were elevated in groups of Fischer 344 rats. Groups of rats were then acutely exposed on an intermittent basis to smoke generated from well-characterized research filter cigarettes. Previously developed smoke inhalation exposure protocols were employed using a Maddox-ORNL inhalation exposure system. Rats that continued smoke exposure following surgery showed a significantly greater mean percent area of flap necrosis compared with sham-exposed groups or control groups not exposed. The possible pathogenesis of this observation as well as considerations and correlations with chronic human smokers are discussed. Increased risks of flap necrosis by smoking in the perioperative period are suggested by this study. PMID- 3983257 TI - Burn care and the plastic surgeon. PMID- 3983258 TI - Ear reconstruction with rotation-advancement composite flap. AB - The rotation-advancement of a composite auricular flap for reconstruction of a large defect involving the triangular fossa as well as most of the crura of the anthelix is presented as an alternative method for reconstruction. The technique is simple, safe, and a one-stage operation. PMID- 3983259 TI - The proboscis lateralis--a 14-year follow-up. AB - A short historical review of proboscis lateralis is given and some of the important contributions highlighted. Forster was the first to mention this abnormality. I collected 34 cases from the literature (including one of my own) and have divided them clinically into four groups. The proboscis is most commonly associated with deformities of the ipsilateral half nose, the eye, and its adnexa. The various lines of management of this problem are discussed. I recommend dilating the canal of the proboscis as a useful step when it is used for reconstructing the absent heminose. A case of a left proboscis lateralis associated with an ipsilateral heminasal aplasia, a bilateral cleft of the lip and palate, a congenital cleft ala, and microphthalmia with a coloboma of the lower eyelid is documented. PMID- 3983260 TI - Scalp stretching with a tissue expander for closure of scalp defects. AB - The authors show a way of reconstruction of scalp defects with excellent results using a tissue expander. This method creates "new" scalp tissue for coverage of defects with normal hair-bearing skin having a dense and even growth of hair. The hairs grow in the correct direction. The authors also show that almost all of the "new" hair-bearing scalp gained by the tissue expander is a result of stretching the scalp over the expander and its close surroundings and that only a very minute portion is gained by migration of the scalp from farther away. PMID- 3983262 TI - Functional reconstruction of both hands by free transfer of combined second and third toes from both feet. AB - The correction of severe trauma to both hands by two major microsurgical operations and additional minor interventions on the already functioning transplants is described. The excision of combined second and third toes as transplants inflicts an injury on the foot, but for our patient this iatrogenic trauma was justified. Careful investigation of the feet after transfer shows that their condition does not significantly impair the quality of the patient's life. The special importance of the patient's desire to regain his or her abilities and to collaborate with the medical staff is emphasized. PMID- 3983261 TI - Compression neuropathy from muscle fibrosis induced by repeated meperidine injections. AB - The combination of myopathy and neuropathy with fibrosis and contractures has apparently not yet been reported from the use of meperidine. We describe a patient addicted to meperidine in whom bilateral hand numbness and weakness developed and electrodiagnostic studies revealed moderate slowing of motor nerve conduction velocities. Neurolysis of the median and ulnar nerves resulted in markedly improved symptoms. PMID- 3983263 TI - A technique for draping of the infant for surgery of the head and neck. AB - A method of draping a young infant for head and neck surgery exposing the entire patient and still maintaining a sterile field is presented. This provides an additional aid in helping to monitor the young patient during surgery. PMID- 3983264 TI - Simplified biopsy technique for labial minor salivary glands. PMID- 3983265 TI - External fixation for fractures and pedicle flap immobilization: a convenient and inexpensive substitute. AB - A simple, inexpensive, broadly applicable, and quickly applied substitute for the Hoffman apparatus is demonstrated. The procedure uses materials commonly available in hospital operating rooms and provides an excellent immobilization of transosseous pins in pedicled flap surgery and various open and closed fractures of long bones. PMID- 3983266 TI - The importance of the lymphatic system. PMID- 3983267 TI - Greater omentum for vascular supply to free flaps. PMID- 3983268 TI - Aesthetic vaginal labioplasty. PMID- 3983269 TI - Epigastric flap in the rat. PMID- 3983270 TI - Free grafts in rhinoplasty. PMID- 3983271 TI - Reconstruction of a skin defect of the posterior heel by a lateral calcaneal flap. PMID- 3983272 TI - The calvarial donor site: an anatomic study in cadavers. AB - In a study of 200 fresh adult cadavers, calvarial thickness was measured at selected points. The variables of age, height, weight, sex, and race were subjected to multiple regression analysis to determine which were significant in the determination of skull thickness. The results indicate that weight, race, and sex are the most important variables. However, the magnitude of the effects of these variables is minimal when considered in relation to clinical requirements. The study provides the clinician with a reasonable basis to obtain preoperative estimation of the thickness of calvarial grafts in the adult at four commonly utilized points. PMID- 3983273 TI - Long-term histologic follow-up of phenol face peels. AB - Deep phenol peels were done on 11 middle-aged white women with severe actinic damage. Subsequently, face lifts were carried out after periods of 1.5 to 20 years. This made it possible to obtain a full-thickness specimen extending several centimeters on either side of the border between peeled and unpeeled skin. In contrast to the markedly abnormal elastotic appearance of unpeeled skin, a new band of connective tissue 2 to 3 mm in width was laid down in the subepidermal region. Fine elastic fibers formed a dense network in the band of regenerated collagen. The disarray and cytologic abnormalities of sun-damaged epidermis were also largely corrected. Melanocytes were not eliminated, but melanin synthesis was evidently impaired, accounting for the bleaching effects. The effects of a phenol peel are very long lasting and adequately account for the effacement of wrinkles and obliteration of actinic keratoses, mottling, and freckling. PMID- 3983274 TI - Vastus medialis myocutaneous and myocutaneous-tendinous composite flaps. AB - This report describes a new myocutaneous territory and introduces a new myocutaneous flap based on the vastus medialis muscle. Dissection, arterial dye perfusion, and specimen angiography of 32 fresh cadaver legs defined a vastus medialis myocutaneous territory directly overlying the muscle and also defined a segment of quadriceps femoris tendon vascularized by the muscle. This vascular unit provides a myocutaneous flap for closure of anterior knee defects. This flap can also be designed as a composite myocutaneous-tendinous flap by inclusion of the vascularized quadriceps femoris tendon segment, which allows reconstruction of missing patellar tendon segments. The distal advancement flap design with retention of motor innervation preserves vastus medialis contribution to knee extension. Clinical applications of vastus medialis myocutaneous and myocutaneous tendinous flaps are illustrated by their use in three patients with knee defects and patellar tendon losses. The potential value of vascularized tendon (versus vascular free tendon grafts) for patellar tendon reconstruction is discussed. PMID- 3983275 TI - Successful replantation in the face of absent venous drainage: an experimental study. AB - Inadequate venous outflow is the factor most responsible in digital replantation failure and is a common cause of tissue loss in general. An experimental replantation model utilizing the rabbit ear was used to study the extreme example of venous congestion: absent venous drainage in the replanted part. Results of this study support the use of single arterial inflow along with an efferent AV fistula for outflow in the management of replants with absent venous drainage. Potential indications for the use of an efferent arteriovenous fistula in digital revascularization include the following: (1) the finding of distal veins too small to reanastomose, as is often the case in children and at distal levels in adults; (2) preferential destruction of distal venous structures, as commonly seen in degloving or other dorsal injuries; and (3) in the management of postreplant venous thrombosis. PMID- 3983276 TI - Experimental microarterial grafts: the use of freeze-dried human placental vessels as heterografts. AB - Freeze-dried human placental grafts, when grafted onto the rabbit femoral artery, have a patency rate of 85 percent at 2 weeks that drops to 55 percent at 3 months. Histologic and scanning electron microscopic studies show that the original graft disintegrates and is replaced by a new fibrous layer on top of it. PMID- 3983277 TI - When should nerve gaps be grafted? An experimental study in rats. AB - In conclusion, animal experiments have shown the following: (1) extensive elevation (mobilization) of a nerve from its bed does not interfere with its capacity to regenerate as long as the longitudinal epineural vessels are preserved, (2) suturing nerve ends under tension has a deleterious effect on the final results, (3) when a segment of nerve has been resected, the remaining nerve and the site of repair can lengthen to accommodate joint extension (within limitations), (4) if there is a segmental loss of nerve and if the nerve ends can be approximated with 10-0 epineural sutures, even if the joints must be fully flexed, the result is better than using a nerve graft, and (5) when a graft is required, it is important to avoid reversing the nerve graft. We believe direct nerve repair is preferred when flexion of the joints and mobilization of the nerve ends permits approximation with 10-0 epineural suture. PMID- 3983278 TI - Results of treatment of extensive volar wrist lacerations: the spaghetti wrist. AB - A series of 38 volar wrist lacerations is reviewed with regard to epidemiologic aspects and results. In general, return of tendon function was quite good, and return of nerve function in this series was also satisfying. We attribute the generally good results to immediate repair of all structures, microscopic repair of significant arterial injuries, microscopic grouped fascicular nerve repair, early mobilization (dynamic splinting and intensive occupational therapy), and a generally youthful group of patients. Review of this series has strengthened our opinion that aggressive primary repair of all injured structures is appropriate for these extensive lacerations. PMID- 3983279 TI - Carpal tunnel syndrome and routine blood chemistries. AB - A total of 110 of the 175 patients examined had symptomatic carpal tunnel syndrome. We were able to isolate 10 patients with carpal tunnel syndrome and electrical evidence of an associated peripheral neuropathy from these 110 patients. We feel that patients with peripheral neuropathies probably warrant an extensive laboratory evaluation for primary and treatable disorders. In contrast, we feel patients with isolated carpal tunnel syndrome, normal ulnar latencies, and normal ankle jerk reflexes do not warrant initial erythrocyte sedimentation rates, thyroid profiles, or blood sugars unless there are other historical or physical factors that suggest a predisposition to diabetes mellitus, thyroid disease, or rheumatic disorders. PMID- 3983280 TI - True median cleft of the upper lip associated with three pedunculated club-shaped skin masses. AB - A rare case of true median cleft of the upper lip associated with three skin masses is reported. While 114 cases of median cleft of the upper lip have been reported, in our literature review we found only 1 case, reported by Sharma, in which the median cleft was associated with skin masses. The embryology of this case is also discussed. PMID- 3983281 TI - Management of squamous cell carcinoma in a patient with dominant-type epidermolysis bullosa dystrophica: a surgical challenge. AB - Epidermolysis bullosa dystrophica is a rare congenital skin disease inherited either as a recessive or dominant form, the latter form being less common and much less severe. Squamous cell carcinoma is a rare complication in the dominant form of the disease, only three such cases being reported before, making this case the fourth known case. Although the squamous cell carcinoma is well differentiated by histopathology, it has a poor prognosis owing to its invasiveness, distant metastases, and multicentricity. Its management also poses a great challenge to the surgeon and personnel involved in patient care. A complete outline of the total management of such a case is described with some interesting observations not mentioned previously in the literature. All the previous three patients are deceased, and this is the only known surviving patient. PMID- 3983282 TI - Virginal hypertrophy. AB - A patient with extensive juvenile hypertrophy of the breasts has been presented. Several interesting facts in the case history are as follows: After pregnancy, the breasts did not regress with "hormone shots" to stop lactation. The patient took high-dosage estrogen birth control pills for 3 years before the breasts started to grow rapidly. Within 1 month after reduction mammaplasty and despite 20 mg dydrogesterone per day, the breasts started to enlarge. A total of 60 mg b.i.d. of dydrogesterone did not stop breast regrowth. Tamoxifen citrate did cause regression of the breasts. After two reductions, the breasts regrew with a subsequent pregnancy. The breast tissue regrew in the axilla with a subsequent pregnancy after simple mastectomy-subcutaneous mastectomy and free nipple transplants. Chronic marijuana use may have an effect on the breast tissue in certain susceptible females as well as in some males. Much needs to be learned about the control of growth of female breast tissue. PMID- 3983283 TI - A simple method for cooling fingers during replantation surgery. PMID- 3983285 TI - Orbital blowout fractures. PMID- 3983284 TI - Penile curvatures. AB - Penile curvatures are common. They are caused by tethering inelastic tissues that can be from the skin externally, from the congenital fibrous tissue of hypospadias and epispadias, and from inelastic tunica albuginea as in fractures, trauma, or Peyronie's disease. At the present time, with sexual organs exposed in photographs, human sexuality talked about with more freedom, and sexual experiences more open, a great deal of mental stress and anxiety can be produced by penile curvatures. Adjunct to this are impotency and other sexual problems. Surgical treatment is generally curative with grafts, flaps, excision of tunica albuginea, or repositioning and coaptation of the corporal bodies. Also, the use of a sex therapist can offer additional aid to the physician and realistic acceptance by the patient. More attention should be given to the patient with this problem. It is not well recognized by most physicians, and therefore, patients may suffer needlessly in silence without adequate help. PMID- 3983286 TI - Clinical use of nerve stimulation. PMID- 3983287 TI - The stair-step flap for nasal alar reconstruction. PMID- 3983288 TI - The effects of allogeneic macrophages on a resistant wound infection and wound repair. PMID- 3983289 TI - [Clinico-psychologic studies on the problem of functional psychotic deterioration in schizophrenia]. AB - Our concept of the functional-psychotic mental deterioration of schizophrenia approximately characterizes the same point of view as Kraepelin's terminus "Dementia praecox". The first result of our psychological examination on 225 schizophrenic persons with defect psychotic symptoms was the statement of the deficit in achievement between the former school education (average IQ of the school-type) and the results of examination of intelligence during our research. The functional-psychotic mental deterioration as well appears as a decrease of memory and psychomotoric speed deficiency, furthermore as mental deconcentration and increase of psychoorganic signs in the Rorschach-Test. The psychometric results of this research were statisticly significant. PMID- 3983290 TI - [Cognitive disorders in endogenous psychoses]. AB - Cognitive disorders of schizophrenics as well as subjects with affective psychosis were studied with the aid of 10 tests. Differences between schizophrenics and patients with affective psychosis could hardly be detected. Subgroup differences within the two broad diagnostic categories are pointing to the importance of the severity of illness. However, some differences between two small samples (N = 9) carefully matched with regard to several relevant aspects - especially concerning the severity of disorder - show that the diagnostic category is not wholly unimportant. Judged on the basis of these differences, there are probably no deficits of a fundamentally different nature; the assumption of divergent cognitive styles or defence mechanisms considering comparable basic deficits seems more plausible. PMID- 3983291 TI - [Brain function disorders in 8-year-old children--from a field and consultation population]. AB - The concept of "cerebral dysfunction" was investigated in a several years' epidemiological study involving eight-year-olds in a general population and those seen in a child guidance clinic. Some of the findings differed markedly from what is commonly asserted. The yielded results indicate that brain dysfunctions do not form a single uniform syndrome, that the afflicted children do not show a specific psychopathology and that the disorders can not be traced back to a uniform etiology. The relevance of brain dysfunctions for the child psychiatric morbidity could be proved. PMID- 3983292 TI - [Influence of psychologic-social factors on the success of psychopharmacotherapy- effect of treatment milieu]. AB - Interactions between psychopharmacological drugs and milieu factors are reported in the clinical and experimental literature as well. This seems not to be a very striking discovery since both, milieu and psychopharmaca do in fact influence human behaviour. However, little is known about the underlying mechanisms on which this kind of interellations can be based. So some of the hypothetical pathways to be considered are briefly discussed. PMID- 3983293 TI - [Illness concepts of patients]. AB - The term "Illness concept" compromises all assumptions, interpretations, explanations, and predictions in regard to one's health status. Therapists and patients hold illness concepts which may differ from each other. Illness concepts can be described under formal, phenomenological and psychological-functional aspects. Illness concepts influence perception of illness, cooperation and satisfaction with treatment by the patient. To respect the illness concepts of patients means to respect the patient himself. The patient's perspectives are valuable completions of the therapist's perspectives and should, therefore, be integrated in the planning of therapy. PMID- 3983294 TI - The matching paradigm: an exact test procedure. PMID- 3983295 TI - Effects of deficient reporting on meta-analysis: a conceptual framework and reanalysis. PMID- 3983296 TI - Nonparametric one-way multivariate analysis of variance: a computational approach based on the Pillai-Bartlett trace. PMID- 3983297 TI - Chronic pain and depression: does the evidence support a relationship? PMID- 3983298 TI - "Spontaneous" causal thinking. PMID- 3983299 TI - The status of the minimum principle in the theoretical analysis of visual perception. PMID- 3983300 TI - Cross-cultural universality of social-moral development: a critical review of Kohlbergian research. PMID- 3983301 TI - MANOVA method for analyzing repeated measures designs: an extensive primer. PMID- 3983302 TI - Levels of processing, encoding specificity, elaboration, and CHARM. PMID- 3983303 TI - Understanding and solving word arithmetic problems. PMID- 3983304 TI - Morphine tolerance as habituation. PMID- 3983305 TI - Elements of prognosis in psychotherapy. PMID- 3983306 TI - Canonical analysis of the MMPI and WAIS in a psychiatric sample. PMID- 3983307 TI - Correlates of job satisfaction of public school teachers: moonlighting, locus of control, and stress. PMID- 3983308 TI - Preventive health behaviors related to the ten leading causes of mortality of health-fair attenders and nonattenders. PMID- 3983309 TI - Relationship of nontraditional sex-role attitudes to severity of women's criminal behavior. PMID- 3983310 TI - Development of a heart disease locus of control scale. PMID- 3983311 TI - Recording psychological testing: the Psychological Testing Report Form. PMID- 3983312 TI - Extrapolated Stanford-Binet IQs for severely and profoundly retarded adults. PMID- 3983313 TI - Relation of expression of hostility to coping with stress. PMID- 3983314 TI - Burnout and selected variables as components of occupational stress. PMID- 3983315 TI - Type A and academic performance: a negative relationship. PMID- 3983316 TI - Effects of verbal reinforcements upon WAIS scores of examinees high and low in anxiety. PMID- 3983317 TI - Relationship between the WAIS-R and the WRAT in a geriatric sample with suspected dementia. PMID- 3983318 TI - Influence of attentional focus on reaction time. PMID- 3983319 TI - Replication of alcoholism acceptance scores as a function of treatment. PMID- 3983320 TI - Loneliness and use of six mass media among college students. PMID- 3983321 TI - Socialization, locus of control, and dogmatism as related to counsellors' office settings. PMID- 3983322 TI - On the relationship between Machiavellianism and anxiety among Italian undergraduates. PMID- 3983323 TI - Sex differences in pentobarbital-induced sleep time. PMID- 3983324 TI - Comparison of feedback modalities in biofeedback temperature training. PMID- 3983325 TI - Death concern and businessmen's mid-life crisis. PMID- 3983326 TI - Effect of thirst on the acoustic startle reflex. PMID- 3983327 TI - Changing orientations of medical students to patients' care: biomedical versus biopsychosocial models. PMID- 3983328 TI - Startle potentiation and heart rate as affected by fear and hunger. PMID- 3983329 TI - Annual NCDEU meeting (1984). Abridged proceedings. New Clinical Drug Evaluation Unit, NIH. May 20-23, 1984, Key Biscayne, Florida. PMID- 3983330 TI - A clinical rating scale for symptoms of psychosis in Alzheimer's disease. PMID- 3983331 TI - FDA's monitoring of clinical trials. PMID- 3983332 TI - Psychopharmacologic treatment and informed consent: empirical research. PMID- 3983334 TI - Desipramine in the treatment of attention deficit disorder in adolescents. PMID- 3983333 TI - Methylphenidate challenge tests and course of schizophrenia. PMID- 3983335 TI - Adherence to methylphenidate therapy in a pediatric population: a preliminary investigation. PMID- 3983337 TI - Haloperidol plasma levels and clinical response: basic concepts and clinical data. PMID- 3983336 TI - Implications of noncompliance on research in affective disorders. PMID- 3983338 TI - Haloperidol and thioridazine drug levels and clinical response in schizophrenia: comparison of gas-liquid chromatography and radioreceptor drug level assays. PMID- 3983339 TI - Does a therapeutic window for plasma haloperidol exist?: Preliminary Chinese data. PMID- 3983340 TI - Plasma haloperidol levels and clinical response: confounding variables. PMID- 3983341 TI - Absence of relationship of serum haloperidol concentration and clinical response in chronic schizophrenia: a fixed-dose study. PMID- 3983342 TI - An early Phase II clinical trial with followup of tomoxetine (LY139603) in the treatment of newly admitted depressed patients. PMID- 3983343 TI - A prospective study of lithium-induced nephropathy: preliminary results. PMID- 3983344 TI - Effects of naloxone on cognitive deficits following electroconvulsive therapy. PMID- 3983345 TI - Statistical studies on the prognosis of anorexia nervosa. AB - Statistical studies on the prognosis of anorexia nervosa were carried out by our research group. Subjects were 224 cases from 36 university hospitals throughout Japan. A questionnaire was mailed to each of the 224 patients in cooperation with their doctors. The outcome of 143 of the 224 cases was judged by their doctors as 'good' in 47 cases, 'intermediate' in 69 cases and 'poor' in 19 cases. 8 of the patients had died. The prognosis of typical cases was much poorer than that of atypical cases. PMID- 3983346 TI - Patient-therapist sexual contact. I. Psychodynamic perspectives on the causes and results. AB - The problem of patient-therapist sexual contact is a substantial one, perhaps involving 5-10% of male therapists, and we suggest that the structure of psychotherapy and abundance of rescue fantasies make it inevitable. While skeptical of claims that there are any positive effects, we catalogue many negative effects: ambivalence and mistrust of subsequent therapists; patients doubting their own sense of reality; childhood trauma repeated and fixated instead of being interpreted; bondage to the offending therapist; original complaints of sexual dysfunction and problems in intimacy with men are exacerbated; burdens of guilt and shame carried by the patient; fantasy aspects of sexuality difficult to discuss in subsequent therapy, and the abrupt ending of the relationship leaving patient stranded and/or disorganized. PMID- 3983347 TI - Patient-therapist sexual contact. II. Problems of subsequent psychotherapy. AB - We use the catalogue of negative effects of sexual contact with the therapist (part I) to discuss the problems of subsequent therapy. Patient issues center around problems of trust, and anxiety and guilt around eventually exploring characterological issues involved in the sexual contact. From the therapist side (either as consultant or long-term therapist) problems include that of finding the best way of evaluating and understanding the patient's story (including its credibility); how to avoid repeating, in some new and disguised form, the previous therapist's counter-transference problems, and finally, the questions of if, when, and how is it therapeutic for the patient to report and press charges against the previous therapist. We recommend an ongoing role for the initial consultant in instances where such charges are to be pressed. PMID- 3983348 TI - Prebioptic psychological characteristics of breast cancer patients. AB - 63 women were examined the day before breast biopsy using psychological ratings, speech analysis and questionnaire testings. Ratings revealed differences (benign vs. malignant, a = 5%) in 8 of 10 scales, cancer patients being inaccessible, altruistic, suppressing feelings, rationalizing and harmonizing. The biopsy's result was predicted in 75% of all cases. Questionnaire testing showed differences in 7 of 16 scales. It proved cancer patients to be more dependent, anxious, aggressive, health-conscious, family-bound and antisexual. A discriminant analysis correctly identified 77% of cancer and 87% of benign patients. Speech analysis (Gottschalk-Gleser) revealed only minor differences: fewer aggressive and more anxious utterances from cancer patients. Conclusions are drawn for the care and treatment of breast cancer patients. PMID- 3983349 TI - Alexithymia and chronic respiratory disease. A review of current research. AB - Alexithymia within a chronic respiratory illness population has been given considerable attention in the psychiatric/psychological literature over the course of the past 5 years. Various observations as to the alexithymic trait within the chronic respiratory diseases (asthma, chronic bronchitis/emphysema, and tuberculosis) have revealed significant findings as to the manner in which alexithymia manifests itself and impacts on chronic respiratory disease. The present paper reviews the literature on alexithymia that has emanated from National Jewish Hospital and Research Center/National Asthma Center and raises questions for future research as regards alexithymia in chronic respiratory diseases. PMID- 3983350 TI - Relations between pain, anxiety, mood and muscle tension in chronic pain patients. A correlation study. AB - The relationship between psychological variables, particularly depressed mood and anxiety, and pain has received a good deal of attention. In this study, 16 chronic pain patients rated their mood, anxiety level, pain, muscle tension, and reclining time daily over a period of about 6 weeks. Correlations were calculated for each combination of variables for each individual patient. The results indicated a good deal of variability between patients. The majority of patients did have significant correlations for pain vs. mood, pain vs. anxiety, pain vs. reclining time, anxiety vs. muscle tension, anxiety vs. mood, and reclining time vs. mood. However, the size of the correlations was sometimes small, and some patients even occasionally had correlations in the opposite direction of that predicted. Overall, the data suggest that psychological variables are related to the experience of chronic pain, but that the size of the relationship may be smaller than previously thought. Furthermore, the high degree of individual variability needs to be stressed. PMID- 3983351 TI - [Compensation neurosis: a psychosocial arrangement--II]. PMID- 3983352 TI - [Psychosomatic day clinic: initial experiences]. PMID- 3983353 TI - [Stress and type A behavior, risk factors of coronary heart disease? A critical review]. PMID- 3983354 TI - [Psychological reactions and disease processing in dialysis patients]. PMID- 3983355 TI - Pharmocogenetic implications of polymorphic debrisoquine hydroxylations. PMID- 3983357 TI - Thyrotoxicosis and stress. AB - There have been many attempts to incriminate stress as a precipitant of both physical and psychiatric illness. An inventory of life events made on 100 patients attending the thyroid clinic of a general hospital for the first time showed a slight excess of stressful events in the histories of the thyrotoxic patients. Their timing in relation to the onset of symptoms did not support a causal relationship. PMID- 3983356 TI - Pharmacokinetics and clinical toxicity of quinine overdosage: lack of efficacy of techniques intended to enhance elimination. AB - We report clinical details in 16 cases of quinine poisoning. Plasma quinine concentrations above 15 mg/l were associated with increased risks of permanent visual damage and of cardiac arrhythmias from which one of our patients died. The rate of quinine elimination was not significantly altered by forced acid diuresis in five patients (t 1/2 25.1 +/- SEM 4.6 h) as compared to eight patients treated conservatively (t 1/2 26.5 +/- SEM 5.78 h). Neither urinary pH or flow rate correlated consistently with urinary quinine clearance. In three other patients charcoal column haemoperfusion, haemodialysis and exchange transfusion were performed. These were also ineffective in increasing quinine elimination. It is concluded that techniques advocated to increase quinine elimination are ineffective in the management of quinine poisoning. PMID- 3983358 TI - An investigation into the validity of the present classification of inflammatory bowel disease. AB - To assess the validity of the present subdivision of patients with inflammatory bowel disease into those with Crohn's disease of the small bowel or of the colon and those with ulcerative colitis, 252 patients with inflammatory bowel disease have been studied by questionnaire and case note review. One hundred and seventy two variables concerning the nature and frequency of symptoms in remission and relapse, the incidence of complications and results of investigation have been analysed by computer. As expected, there were many highly significant variables between patients with ulcerative colitis and those with Crohn's disease of the small bowel. The latter showed evidence of a more severe disease course with more complications. There were similar, although less marked, differences between patients with Crohn's disease of the colon and those with Crohn's disease of the small bowel. There were very few differences in disease course between patients with Crohn's disease of the colon and those with ulcerative colitis. The results suggest that while separate classification of patients with Crohn's disease of the small bowel is justified on clinical grounds, the present separation of patients with disease confined to the colon into groups labelled ulcerative colitis or Crohn's disease of the colon is not. Alternative methods of classification should therefore be investigated. PMID- 3983359 TI - Serum-thyroxine levels in microwave-exposed rats. AB - The nature of the response of the thyroid gland in animals exposed to microwave irradiation is controversial. An enlarged thyroid and an increase of radioiodine uptake in microwave workers have been reported. Absence of thyroid disorders has also been reported in other exposed populations. Animal experimentation has contributed to the controversy because both increased and decreased thyroid functions have been reported. The thyroxine concentration in rats as representative of thyroid function in animals exposed to 2.45-GHz, 120-Hz amplitude-modulated microwaves has been studied. Comparison was made between thyroxine concentrations in microwave- and sham-exposed rats by Student's t test. After a 1-hr exposure, an increased thyroxine concentration was found in rats exposed at 40 and 70 mW/cm2, but not at 1, 5, 10, 20, 50, or 60 mW/cm2. After a 2 hr exposure, increased thyroxine concentration was noted in rats exposed at 25, 30, and 40 mW/cm2, but not at 1, 5, 10, and 20 mW/cm2. After a 4-hr exposure, thyroxine concentration increased in rats exposed at 1 mW/cm2 and decreased in rats exposed at 20 mW/cm2; but changes were not noted at 5 or 10 mW/cm2. Other experiments included animals that were exposed once for 4 hr (0.1, 1, 10, 25, and 40 mW/cm2), sampled 24 hr after a 4-hr exposure (0.1, 1, 10, 25, and 40 mW/cm2), or exposed for 4 hr 3 times (1, 10, 20, 30, 40, and 55 mW/cm2) and 10 times (1, 10, 20, 25, 30, and 40 mW/cm2), to evaluate the consistency of the thyroxine response. None of the rats in these experiments displayed any alteration of thyroxine concentration, except that decreased thyroxine was noted in rats exposed at 40 mW/cm2 for the third time. These studies covered a long time span; rats from two commercial sources (BS and CR) were used and subjected to different numbers of exposures, and therefore these data were evaluated for their stability. Two factors could influence the result significantly, i.e., source of animal and number of sham exposures. Rats used in the 2-hr exposures were from two different commercial sources; rats from CR had a higher (but normal) thyroxine concentration than did rats from BS. Therefore the data of these animals were separated by commercial source for reevaluation. Instead of increased thyroxine concentration in rats exposed at 25, 30, and 40 mW/cm2, changes were not noted in any microwave-exposed rats. The influence of sham exposure revealed that appropriate concurrent control and specification of animal source are needed in longitudinal studies.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3983360 TI - Interactions of radioprotectors and oxygen in cultured mammalian cells. I. Dithiothreitol effects on radiation-induced cell killing. AB - Radioprotection in vitro by sulfhydryl (SH)-containing compounds is usually greater in aerated than in hypoxic cells. This observation has been cited recently as one of the reasons for the relatively greater effectiveness of radioprotectors such as WR-2721 in normal tissues compared to tumor cells. It is demonstrated herein, however, that hypoxic V79 cells irradiated in vitro under carefully controlled conditions are protected to a greater extent by low concentrations (1-2 mM) of the SH compound dithiothreitol (DTT) than are aerated cells. The reverse, more general phenomenon is seen at high concentrations of DTT (greater than 2 mM). This complex SH concentration and oxygenation dependence results in an increase in the oxygen enhancement ratio (OER) at low concentrations of DTT relative to the OER in the absence of DDT, followed by a decrease in OER at concentrations greater than 2 mM DTT. The possible radiation chemical basis for this finding and its importance to the clinical use of SH containing radioprotectors are discussed. PMID- 3983362 TI - Neural, pituitary, and mammary tumors in Sprague-Dawley rats treated with X irradiation to the head and N-Ethyl-N-nitrosourea (ENU) during the early postnatal period: a statistical study of tumor incidence and survival. AB - To study the late effects of early postnatal treatment with N-ethyl-N-nitrosourea (ENU) preceded by X irradiation to the head, 226 neonatal CD rats were divided into six groups which received the following treatment: (1) 500-rad X irradiation to the head on the third postnatal day (pnd); (2) injection ip with 30 mg/kg ENU on the fourth pnd; (3) injection ip with 30 mg/kg ENU on the seventh pnd; (4) a combination of 500-rad X irradiation to the head on the third pnd, followed by ip 30 mg/kg ENU on the fourth pnd; (5) a combination of 500-rad X irradiation to the head on the third pnd, followed by ip 30 mg/kg ENU on the seventh pnd; and (6) untreated controls. The results indicate that (1) X irradiation to the head alone significantly extended the life span of females compared to that of control females, and did not affect survival of males; (2) X irradiation did not influence the latent period or mortality from neurogenic tumors when ENU was given 1 or 3 days afterward; (3) ENU itself was a factor in shortening latent periods for mammary tumors; (4) X irradiation alone did not increase the incidence of mammary tumors, and revealed no protective effect on the ENU-induced mammary carcinogenesis; (5) X irradiation increased the prevalence of pituitary tumors in the females; (6) no enhancement of pituitary tumors by ENU was observed: and (7) there was a statistically significant association of pituitary and mammary tumors in females. PMID- 3983361 TI - Effect of age on the efficacy of Zn-diethylenetriaminepentaacetic acid therapy for removal of Am and Pu from beagles. AB - Decorporation of intravenously injected monomeric 241Am and 237+239Pu by the administration of 30 mumole Zn-diethylenetriaminepentaacetic acid (DTPA)/kg each day beginning 2 weeks after radionuclide injection was compared in beagles entered into the experiment when 3 months (juveniles). 1.9 years (young adults), or 10 years (mature adults) old and studied for about 5 months. DTPA therapy was most effective in the juvenile dogs and least effective in the mature adults. Retention of 241Am in the liver decreased from a pretreatment value for adults of about 50% of the injected activity to about 10% in the mature adults and less than 1% in the young adults at 140 days of treatment, while the liver retention of juveniles decreased from pretreatment values of about 16% to undetectable levels by 28 days of treatment. Plutonium retention in the liver decreased from adult pretreatment levels of about 30% of the injected activity (corrected for radioactive decay) to near 10% in the mature adults and 6% in the young adults at 140 days of treatment, while juvenile liver retention decreased from pretreatment values near 15% to undetectable levels by 56 days of treatment. Nonliver Am retention (mainly skeleton) decreased in mature adults from pretreatment values of about 45% of the injected activity to near 25%, in young adults from 35 to 20%, and in juveniles from roughly 70 to 9% by 140 days of DTPA administration. Nonliver Pu retention decreased from pretreatment values of about 50% of the injected activity (corrected for radioactive decay) for mature and young adults to about 30% by 140 days and from 75 to 16% in juveniles over the time period. PMID- 3983363 TI - Comparison of binding of [3H]misonidazole and [14C]misonidazole in multicell spheroids. AB - Uptake of [2-ring-14C]misonidazole and [3H]misonidazole with tritium in the side chain has been compared in 1-mm EMT-6/UW spheroids using liquid scintillation counting and autoradiography. The uptake of both labeled sensitizers as a function of incubation time was virtually identical. Uptake by the spheroids exceeded levels in the medium by 11/2 to 2 hr and was well modeled as a first order binding process, with rate constants of 0.00324 hr-1 for 3H and 0.00388 hr 1 for 14C. The similar uptake of the two versions of this sensitizer labeled in different positions suggests that the metabolic actions which allow the drug to bind in hypoxic cells do not principally involve metabolites which separate the number 2 carbon of the imidazole ring from the side chain. The pattern of silver grains in autoradiographs was similar for both labeled sensitizers, with most labeled drug bound in an intermediate zone of cells between the necrotic center and the actively proliferating rim of the spheroids. The superior resolution possible with the tritiated compound showed that both nucleus and cytoplasm in viable looking cells were labeled while pycnotic cells were not labeled. PMID- 3983364 TI - Late nonstochastic changes in pig skin after beta irradiation. AB - Late radiation-induced changes in pig skin have been assessed following irradiation with beta-rays from a 22.5- or 15-mm-diameter 90Sr/90Y source and a 19- or 9-mm-diameter 170Tm source. Late damage, in terms of dermal atrophy, was assessed 2 years after irradiation from measurements of dermal thickness in irradiated and normal skin. After 90Sr irradiation maximum atrophy, a dermal thickness of 40-50% of the control value, occurred at a dose of approximately 40 Gy from the 22.5-mm source and approximately 75 Gy from the 15-mm source. In the case of 170Tm the 19- and 9-mm sources produced similar degrees of atrophy at equal doses. Maximum atrophy occurred at approximately 70 Gy, when the dermis was approximately 70% of the thickness of normal skin. Significant late tissue atrophy was seen at doses, from both types of radiation, which only produced minimal erythema in the early reaction. Such late reactions need to be taken into account when revised radiological protection criteria are proposed for skin. PMID- 3983365 TI - Ataxia-telangiectasia homo- and heterozygous cells show a normal repair and fixation response to anisotonic NaCl treatment after irradiation. AB - The effect of anisotonic NaCl treatment on fixation and repair of radiation induced potentially lethal damage (PLD) was tested in normal human cells and in three homozygous ataxia-telangiectasia (A-T) and two heterozygous A-T cell strains. Fixation of radiation-induced PLD occurred in all cell strains exposed to 0.05, 0.5, or 1.5 mole/liter NaCl solutions immediately after irradiation. This effect was observed in both plateau-phase and exponentially growing normal and A-T cells. When an incubation period at 37 degrees C was introduced between irradiation and the subsequent anisotonic treatment, recovery was observed in both normal and A-T cells strains. These data show that A-T cells are as proficient as normal cells in repairing PLD that is sensitive to anisotonic NaCl treatment. It is proposed that two PLD repair systems may exist, one that is expressed after irradiation in proliferatively arrested cells and another that occurs in plateau-phase as well as exponentially growing cells, and is expressed by the postirradiation treatments described here and by Raaphorst and Azzam (Radiat. Res. 86, 52-66 (1981]. PMID- 3983366 TI - DNA repair-deficient Chinese hamster ovary cells exhibiting differential sensitivity to gamma rays under aerobic and hypoxic conditions. AB - The survival of the wild-type parent and two mutant lines of Chinese hamster cells, known to be defective in DNA repair, has been determined as a function of exposure to gamma rays under aerobic and hypoxic conditions. When compared to the wild-type line, one of the mutants selected for sensitivity to ethyl methyl sulfonate (EMS), and known to be defective in the repair of DNA strand breaks, exhibits a markedly enhanced sensitivity to aerobic irradiation but a reduced enhancement to hypoxic irradiation and thus an enhanced oxygen enhancement ratio (OER). In contrast, the other line, known to be defective in the incision step of excision repair, exhibits the reverse pattern of sensitivity and hence a reduced OER. The results are compared to findings in bacterial mutants and cells obtained from ataxia telangiectasia (AT) patients and heterozygotes. PMID- 3983367 TI - Sequence specificity of DNA cleavage by Micrococcus luteus gamma endonuclease. AB - DNA fragments of defined sequence have been used to determine the sites of cleavage by gamma-endonuclease activity in extracts prepared from Micrococcus luteus. End-labeled DNA restriction fragments of pBR322 DNA that had been irradiated under nitrogen in the presence of potassium iodide or t-butanol were treated with M. luteus gamma endonuclease and analyzed on high resolution, denaturing, polyacrylamide gels. Gamma endonuclease was found to cleave irradiated DNA preferentially at the positions of cytosines and thymines. DNA cleavage occurred immediately to the 3' side of pyrimidines in irradiated DNA and resulted in fragments that terminate in a 5'-phosphoryl group. These studies indicate that both altered cytosines and thymines may be important DNA lesions requiring repair after exposure to gamma radiation. PMID- 3983368 TI - Reduction in sperm levels after testicular irradiation of the mouse: a comparison with man. AB - The potential and limitations of applying extrapolation factors (EFs) to the results of animal studies to predict effects of toxic agents on human male fertility were evaluated using radiation data. The EF is the ratio of the dose to produce a given effect in the mouse to that necessary to produce the same effect in man. Sperm counts in mouse testes were compared to those in the ejaculates of human males (D. K. Clifton and W. J. Bremner, J. Androl. 4, 387-392 (1981)) at several different times after irradiation. EFs of between 2.6 and 7 were obtained at the time when minimum counts occur. However, it must be noted that the sperm being measured arose from different cell types: differentiating spermatogonia in the mouse vs stem spermatogonia in man. Sperm counts performed at times at which the sperm develop from irradiated stem cells in both species yielded EFs between 11 and 44. However, if sufficient time was allowed for maximum recovery in both species, the EF was less than 1.7. These results indicate that man appears to be much more sensitive than the mouse to the testicular effects of irradiation at 2 to 9 months postexposure, but both species are comparable in their sensitivity to irreversible damage. The use of EFs may be appropriate, but since the EF is very dependent on the time at which the comparison was made, different values must be used for prompt and permanent testicular injury. PMID- 3983369 TI - Teratogenic, biochemical, and histological studies with mice prenatally exposed to 2.45-GHz microwave radiation. AB - Pregnant CD-1 mice were exposed to 2.45-GHz continuous wave microwave radiation at an incident power density of 30 mW/cm2. The local specific absorption rate near the uterine area (deep colonic location), as determined from time temperature profiles measured with a Vitek thermistor probe, was 40.2 mW/g. Groups of mice were exposed 8 hr per day through Days 1-6 or 6-15 of pregnancy. Other groups of animals were exposed to an elevated ambient temperature of 31 degrees C which increased the colonic temperature 2.3 degrees C, the same as that produced by the microwaves. Sham-irradiated groups of animals were treated exactly the same as the microwave-exposed animals. For the two conditions, temperature exposed and sham exposed, two groups of animals were used. One group was handled in the same manner as the microwave-irradiated group and the other group was not handled so as to evaluate the effects of stressing the animals by handling. Eleven groups of animals were used in the complete study: five groups for gestational Days 1-6, five groups for gestational Days 6-15, and one group of cage control animals. On Day 18 of gestation the dams of all experimental groups were sacrificed and their reproductive status was determined. The fetuses were examined for visceral and skeletal alterations. Brain cholinesterase activity and histology were evaluated in the groups exposed on Days 6-15. The results show that microwave radiation increases embryo lethality at the early stages of gestation (exposure Days 1-6). Fetal toxicity and teratogenicity were not significantly increased by exposure to microwaves on either Days 1-6 or 6-15 of gestation. Cholinesterase activity and histology of the brain of 18-day-old fetuses were not adversely affected. PMID- 3983370 TI - Hyperthermia in radiofrequency-exposed rhesus monkeys: a comparison of frequency and orientation effects. AB - To compare the effects of exposure to a near-resonant frequency of microwaves at two orientations with a higher frequency exposure, five rhesus monkeys were exposed for 4 hr to 225 MHz, electric field oriented parallel to the long axis of the body (225 MHz-E), and to 225 MHz, magnetic field orientation (225 MHz-H), or to 1290 MHz, electric field orientation. On a separate occasion, the monkeys were exposed at night to 225 MHz-E. Exposures were conducted with the animal chair restrained in an anechoic chamber with rectal temperature continuously monitored. Blood samples were taken hourly during the 225-MHz-E exposures for cortisol analysis. The power densities used were 0, 1.2, 2.5, 5.0, 7.5, 10.0, and 15.0 mW/cm2 for 225 MHz-E (day), 0 and 5 mW/cm2 (225 MHz-E night and 225 MHz-H), and 0, 20, 28, and 38 mW/cm2 (1290 MHz). The monkeys were unable to tolerate exposure at power densities equal to or greater than 7.5 mW/cm2 (5.1 W/kg) at 225 MHz-E for longer than 90 min. The criterion for tolerance was that the rectal temperature would not exceed 41.5 degrees C. Average rectal temperature increases for day exposure to 225 MHz-E were 0.4 and 1.7 degrees C for 4-hr exposures to 2.5 and 5.0 mW/cm2 (1.7 and 3.4 W/kg). No changes in circulating cortisol levels occurred during any exposures to 5 mW/cm2 or less. Night exposures to 5 mW/cm2 (3.4 W/kg) at 225 MHz-E raised mean rectal temperature 2.1 degrees C. Exposure to 5 mW/cm2 (1.2 W/kg) at 225 MHz-H for 4 hr resulted in a 0.2 degree rise in mean rectal temperature. For 4 hr of 1290-MHz exposure to 20, 28, or 38 mW/cm2 (2.9, 4.0, and 5.4 W/kg), the mean body temperature increases were 0.4, 0.7, and 1.3 degrees C, respectively. The degree of hyperthermia caused by radiofrequency (rf) exposure was shown to be frequency and orientation dependent for equivalent power densities of exposure. PMID- 3983371 TI - Further characterization of 4-bromomisonidazole as a potential detector of hypoxic cells. AB - [14C]Bromomisonidazole was prepared by direct bromination of [ring-2] [14C]misonidazole in dioxane. The uptake and binding of the two labeled sensitizers were compared in vitro in 1-mm EMT-6 spheroids which contain a necrotic core. Using liquid scintillation counting it was shown that spheroids incubated with 50 microM [14C]bromomisonidazole concentrated drug above levels in the medium by 1 1/2 hr and achieved maximum concentration by 10 hr with no further increase at 23 hr. Spheroids incubated with 50 microM [14C]misonidazole may concentrate the sensitizer more slowly but ultimately reached the same fivefold increase over levels in the medium by 23 hr as was observed for bromomisonidazole. Autoradiographs prepared from spheroids after incubation with [14C]misonidazole or [14C]bromomisonidazole showed silver grains preferentially located over viable hypoxic cells in the inner half of the spheroid rim adjacent to the necrotic center, with lower grain density over nonviable necrotic areas and many fewer grains over oxic cells at the periphery of the spheroid. The results indicate that both severely and moderately hypoxic cells may preferentially bind [14C]bromomisondiazole. The data support the potential of radiolabeled bromomisonidazole for in vivo imaging pending additional studies of the metabolism of this agent. PMID- 3983372 TI - Role of membrane lipids and membrane fluidity in thermosensitivity and thermotolerance of mammalian cells. AB - The role of membrane lipids and membrane fluidity in thermosensitivity of mammalian cells is not well understood. The limited experimental data in the literature have led to conflicting results. A detailed investigation of lipid composition and membrane fluidity of cellular membranes was undertaken to determine their relationship to cell survival after hyperthermia. Ehrlich ascites (EA) cells, mouse fibroblast LM cells, and HeLa S3 cells differed in thermosensitivity as expressed by a D0 of 3.1, 5.2, and 9.7 min, respectively, at 44 degrees C. No correlation with cellular thermosensitivity could be found with respect to the amount of cholesterol and to the cholesterol to phospholipid ratio in the particulate fraction of the cells. By growing the cells for some generations in different media, cholesterol and phospholipid content could be changed in the particulate fraction, but no difference in cell survival was observed. When mouse fibroblasts were grown for 24 hr in a serum-free medium supplemented with arachidonic acid (20:4), all subcellular membranes were about eight times richer in phospholipids containing polyunsaturated acyl (PUFA) chains and membrane fluidity was increased as measured by fluorescence polarization of diphenylhexatriene (DPH). The alterations resulted in a higher thermosensitivity. When mouse fibroblasts were made thermotolerant no change in cholesterol and phospholipid content could be found in the particulate fraction of the cells. The relative weights and the quality of the phospholipids as well as the fatty acid composition of the phospholipids appeared to be the same for normal and thermotolerant cells. Fluidity measurements in whole cells, isolated plasma membranes, and liposomes prepared from phospholipids extracted from the cells revealed no significant differences between normal and thermotolerant fibroblasts when assayed by fluorescence polarization (DPH) and electron spin resonance (5 nitroxystearate). It is concluded that the mechanism of thermal adaptation resulting in differences in lipid composition as reported in the literature differs from the mechanism of the acquisition of thermal tolerance. The lower heat sensitivity of thermotolerant cells, as initiated by a nonlethal triggering heat dose followed by an induction period at 37 degrees C, does not involve changes in lipid composition and membrane fluidity. However, a prompt and clear (also nonlethal) change in membrane fluidity by an increase in PUFA does result in an increased thermosensitivity, probably because of an indirect effect via the lipids in causing disfunctioning of proteins in the membrane and/or the cytoskeleton. PMID- 3983373 TI - Patients' perceptions of a mammographic examination. AB - A study was conducted to identify the patient's perception of the support function of the radiologic technologist and the degree to which it was performed. The patient's perceptions were examined through the relationships of responses in three distinct categories. The 60 women surveyed believed the technologists provided the necessary support through explanation of the procedure and encouragement of questions. The technologists did, indeed, demonstrate concern for each patient as an individual human being. PMID- 3983374 TI - The radiographic appearance of a ceramic total hip replacement. AB - A new total hip replacement has been approved for use in the United States. This system utilizes ceramic articular components and a metal stem. This article reviews the history of total hip replacement (THR) and the construction and advantages of the ceramic total hip replacement. Additionally, the radiographic appearance of current THR systems are compared with the new systems. PMID- 3983375 TI - The anterior diaphragmatic attachments: an anatomic and radiologic study with clinical correlates. AB - A study of the anterior attachments of the respiratory diaphragm was performed using gross anatomic specimens, plain radiography, and computed tomography with multiplanar image reformatting. The anterior portions of the diaphragm are affixed to the lower six ribs and the sternum. The line of attachment of each hemidiaphragm begins at the anterior axillary line and extends cranially and medially to meet at the xiphoid process. These structures can be visualized along with contiguous pathologic subdiaphragmatic and/or infradiaphragmatic air collections. In the semierect patient, free intraabdominal air may preferentially collect in the anterior subdiaphragmatic regions rather than below the domes of the diaphragm, providing a subtle but reliable indication of pneumoperitoneum. An understanding of the normal anatomy of the anterior diaphragmatic attachments is valuable in assessing a variety of anterior paradiaphragmatic air collections. PMID- 3983376 TI - Enlarged umbilical vein as a sign of portal hypertension: detection by lateral radiography. AB - An enlarged umbilical vein was detected on lateral chest radiographs of three patients with liver cirrhosis. It appeared as a round or lobulated shadow in fatty tissue of the anterior abdominal wall. PMID- 3983377 TI - The vascular converging points of the right pulmonary hilus and their diagnostic significance. AB - The shadows of the right descending pulmonary artery, the superior pulmonary vein crossing it, the middle lobe artery, and branches of the artery supplying the superior segment of the lower lobe converge distinctly at the right hilus. Because the right pulmonary artery bifurcates within the mediastinum, the arteries of the right upper lobe form a second though less obvious converging point above this level. In contrast, the left pulmonary artery does not bifurcate until it reaches the left hilus, providing only a single converging point on that side. A survey of 100 chest radiographs showed that the two converging points on the right could be distinguished in 95 cases, with the upper one being situated somewhat above the single point on the left in 83. In the absence of lobar resection, finding only one converging point on the right is suggestive of collapse of either the upper or lower lobe, whereas visualization of both points excludes major atelectasis. PMID- 3983378 TI - Pseudoprominent aorta: radiographic findings and CT correlation. AB - The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented. PMID- 3983379 TI - Transverse esophageal folds: association with corrosive injury. AB - Two cases are presented in which transverse esophageal folds were observed in children following ingestion of corrosive material. Strictures developed at the sites that initially manifested this serrated mucosal appearance. These findings lend additional credence to the concept that transverse folds, reflecting contractions of the muscularis mucosae, represent a pattern of pathologic motility rather than merely a variant of normal mucosal anatomy. PMID- 3983380 TI - Local recurrence after sphincter-saving resection for rectal and rectosigmoid carcinoma. Value of various diagnostic methods. AB - The authors reviewed 51 cases of local recurrence after sphincter-saving resection for rectal and rectosigmoid carcinoma to assess the sensitivity of current diagnostic procedures. A combination of follow-up serum CEA levels and rectoscopy was found to be most efficient during the first two years after surgery in terms of the time, frequency, and location of the recurrence as well as the cost-benefit ratio. On the other hand, almost all recurrent lesions developed extraluminally, infiltrating the suture line secondarily; moreover, one fourth extended outside the bowel wall. Thus in addition to endoscopy, CT is useful as a means of defining the entire mass at the anastomosis as well as detecting pericolic recurrence and is essential if repeat resection is contemplated. PMID- 3983381 TI - Esophageal varices: correlation of left gastric venography and endoscopy in patients with portal hypertension. AB - Selective left gastric venography was performed via percutaneous transheptic catheterization in 100 patients with portal hypertension to study hemodynamics and left gastric collaterals. Flow was hepatofugal in 81 patients, while 63 had varices supplied by the left gastric vein; azygos/hemiazygos collaterals were seen in 27 patients, gastrorenal shunts in 18, and other collaterals in 58. In 79 cases, enlarged, tortuous veins arising from thin parallel vessels at the esophagogastric junction on venography corresponded with varices on endoscopy in both size and course. Venography failed to show small varices which were seen endoscopically, whereas endoscopy often interpreted non-tortuous veins as varices. Using endoscopy as a reference, the sensitivity of venography for varices was 76%, specificity 100%, and accuracy 78%. There was a significant correlation between venographic demonstration of varices and previous hematemesis. Left gastric venography is necessary prior to embolization of varices and is also useful in their diagnosis as well as study of hemodynamics and assessment of bleeding risk. PMID- 3983382 TI - Outpatient therapy of intra-abdominal abscesses following early discharge from the hospital. AB - Although percutaneous aspiration and drainage of abdominal abscesses will frequently avert an open surgical procedure, patients remain hospitalized during drainage. The authors treated 9 patients for abscesses using percutaneous drainage catheters and sent them home with the catheter in place. All had an uneventful recovery. An average of $12,050 was saved in each case. The authors suggest that outpatient drainage of abdominal abscesses is significantly less expensive than inpatient treatment, yet does not jeopardize patient care. PMID- 3983383 TI - Gluteal artery occlusion: intra-arterial chemotherapy of pelvic neoplasms. AB - Intra-arterial chemotherapy of pelvic tumors may be complicated by coincident flow to the buttocks. Transcatheter occlusion of both the superior and inferior gluteal arteries may have a role in directing the flow of chemotherapeutic agents away from the buttocks and toward the true pelvis. The results of flow studies using technetium-99m-labeled macroaggregated human serum albumin were compared in 12 consecutive patients examined before and after transcatheter arterial occlusion, and the best results were obtained by selective occlusion of those arteries that demonstrated increased flow to the buttock on the initial study. Without the preselection of patients in whom the initial flow went mainly to the buttock, the results were inconsistent. Because of the increase in the procedure time and the occurrence of minor complications, such as local pain during or after the occlusion procedure, in all patients, proper patient selection is important. PMID- 3983384 TI - Choanal atresia: precise CT evaluation. AB - Computed tomography facilitates the diagnosis of children with choanal atresia. This modality defines the full anatomic abnormality of bony choanal atresia: medial bowing and thickening of the lateral wall of the nasal cavity, enlargement of the vomer, and fusion of these elements. Bony atresia patients can be clearly separated from those with membranous choanal atresia. In membranous atresia, the lateral wall of the nasal cavity is minimally affected and the vomer is normal. This precise anatomic evaluation aids in determining the surgical approach. PMID- 3983385 TI - Metabolic bone disease in pseudohypoparathyroidism: radiologic features. AB - We reviewed the radiographs of six patients with pseudohypoparathyroidism (PHP) manifested by variable renal and skeletal resistance to parathyroid hormone (PTH). Features compatible with hyperparathyroid bone disease, osteomalacia, and rickets were observed. Skeletal changes of hyperparathyroidism included (a) subperiosteal bone resorption, (b) radiolucent lesions, caused by either brown tumors or bone cysts, (c) slipped capital femoral epiphyses, (d) focal areas of osteosclerosis, (e) periosteal neostosis, and (f) osteopenia with reduced cortical and trabecular bone volume. Histologic bone features were compatible with osteitis fibrosa in all patients, which suggests that the skeleton responded to the bone-remodeling effects of PTH despite hormonal resistance at other target sites. Skeletal changes of rickets included metaphyseal irregularities, cupping, and widening of the growth plates. Osteomalacia was indicated by Looser zones in one patient and confirmed by histologic evidence in three patients. PMID- 3983387 TI - Agenesis of the corpus callosum: magnetic resonance imaging. AB - Three patients who had complete agenesis and two patients who had partial agenesis of the corpus callosum (ACC) underwent magnetic resonance (MR) imaging. In addition to excellent visualization of the indirect signs of ACC, direct vivid display (short T1) of the corpus callosum on sagittal images allowed better evaluation of subtle abnormalities than has been possible with other modalities. Associated abnormalities were also well-displayed. MR is the initial procedure of choice in evaluation of the corpus callosum. PMID- 3983386 TI - Cystic intracranial lesions: magnetic resonance imaging. AB - Thirty-three patients with cystic intracranial lesions were examined with both magnetic resonance (MR) imaging and CT scanning. The abnormalities imaged included 11 arachnoid cysts, 10 cystic tumors, six postoperative cysts, and three colloid cysts. The intensity patterns of the cyst contents as encoded with routine spin-echo imaging sequences enabled subdivision of the cysts into three categories. Arachnoid and postoperative cysts had an intensity pattern identical to cerebrospinal fluid. More proteinaceous cysts, including inflammatory cysts and nonhemorrhagic tumoral cysts, had an intermediate intensity pattern with characteristically low intensity on the short TR sequence (0.5 sec), but had clearly higher intensity than cerebrospinal fluid on the long TR sequences (2 sec). Finally, three cystic tumors with hemorrhagic fluid and three colloid cysts had a distinctly different pattern of high intensity on all four MR sequences through the same section. MR was superior to CT in characterizing intracranial cystic lesions because of its ability to categorize cysts into these three groups on the basis of the intensity pattern of cyst contents, thereby improving diagnostic specificity and patient management. PMID- 3983388 TI - Outpatient lumbar myelography with metrizamide. AB - A prospective study of 70 adult patients was undertaken to determine whether lumbar metrizamide myelography can be performed as an outpatient procedure without an increased incidence of side effects and without undue risk. In selected patients and with a specific protocol, the incidence of common sequelae was similar to that in previous studies of inpatients either in bed with the head elevated or ambulatory after lumbar metrizamide myelography. No patient in this series experienced seizures or other severe complications. This approach provided increased cost effectiveness without increased risk. PMID- 3983389 TI - Acute otomastoiditis and its complications: role of CT. AB - Acute bacterial (suppurative) otomastoiditis responds to antibiotic treatment; radiologic study is required only when there is clinical suggestion of coalescent mastoiditis, intracranial complications, or an underlying chronic disease. Computed tomography (CT) is the method of choice for evaluating otogenic intra- or extra-cranial complications. CT scans can show stages of disease progression when infection has spread by way of soft tissue, blood, and bone pathways into the dural venous sinuses, meninges, labyrinth, facial nerves, epidural and other intracranial spaces. When there is clinical suggestion of acute coalescent mastoiditis, a CT scan of the temporal bone can confirm the presence of rarefying osteitis, coalescence of the air cells, and subperiosteal abscess. PMID- 3983390 TI - Aortic dissection: magnetic resonance imaging. AB - Fifteen patients with suspected or known aortic dissection were imaged with magnetic resonance (MR). Thirteen of these patients were eventually shown to have dissection. In most instances the diagnosis was established by aortography and/or computed tomography (CT) prior to the MR study. Surgical proof (6/13) and/or aortographic proof (10/13) were available in 11/13 patients with aortic dissection. MR demonstrated the intimal flap and determined whether the dissection was type A or type B. In addition, MR: differentiated between the true and false lumens; determined the origins of the celiac, superior mesenteric, and renal arteries from the true or false lumen in the cases where the dissection extended into the abdominal aorta (8/12); allowed post-surgical surveillance of the dissection; and identified aortoannular ectasia in the three patients who had Marfan syndrome. In addition to the 13 cases with dissection, there were two cases in whom the diagnosis of dissection was excluded by MR. Our early experience suggests that MR can serve as the initial imaging test in clinically suspected cases of aortic dissection and that the information provided by MR is sufficient to manage many cases. Additionally, MR obviates the use of iodinated contrast media. PMID- 3983391 TI - Thoracic aortic dissections: magnetic resonance imaging. AB - Six patients with documented dissections of the thoracic aorta (two Type A, four Type B) were examined by magnetic resonance (MR) imaging using a 0.6-Tesla superconductive magnet. Cardiac gating was applied in five cases. Correlation was made with CT and angiography. MR imaging demonstrated the dissection in all six cases and accurately differentiated Type A from Type B dissections. Coronal and sagittal MR sections were advantageous in establishing the relationship of the three arch vessels to the dissection. In addition, cardiac-gated MR was useful in demonstrating mural thrombus and in distinguishing the true from the false lumen based on differences in signal intensity resulting from different flow rates. In five cases, the information obtained by MR was equal to or surpassed that obtained by CT. In the one case of a completely thrombosed dissection, the CT scan was more helpful. MR should become an important imaging modality in the evaluation of aortic dissections. PMID- 3983392 TI - Differentiation of volume averaging and mass on magnetic resonance images of the mediastinum. AB - Volume averaging of high intensity mediastinal fat and low intensity flowing blood in mediastinal vessels can mimic a mediastinal mass on magnetic resonance (MR) images of the chest. However, when different repetition times (TR) are used to perform two imaging sequences, volume averaging can be distinguished from true disease, since the ratio of intensities of mediastinal fat, which is volume averaged, to nonvolume-averaged fat will remain relatively constant on a pair of images obtained using different TR times. Mediastinal masses, on the other hand, will exhibit predictable alterations in intensity relative to fat with changing TR. PMID- 3983393 TI - Hepatic cavernous hemangioma: magnetic resonance imaging. Work in progress. AB - Using a 0.35-T superconducting magnet and spin echo imaging, we prospectively evaluated 11 patients who had proved hepatic cavernous hemangioma. Magnetic resonance (MR) identified more lesions than either contrast-enhanced CT, or ultrasonography. The MR appearance was consistent; hemangiomas were homogeneous and generally isointense at short TR and TE intervals but were hyperintense at long TR intervals and greatly hyperintense at long TR and long TE intervals. However, the MR appearance of hemangioma was not specific; 2/14 other focal hepatic masses had similar features. The calculated relaxation times (T1, T2) were not useful in lesion characterization, although the intensity ratio of hemangioma to normal liver at the TR = 2.0 sec TE = 56 msec pulse sequence was useful in diagnosis since hemangiomas always had a ratio greater than 1.4. PMID- 3983394 TI - Bone marrow imaging: magnetic resonance studies related to age and sex. AB - Measurements of T1 and T2 relaxation values and spin density of the lumbar vertebral bone marrow were performed in 212 patients, and the results were correlated with the patients' age and sex. T1 and T2 relaxation times for bone marrow in the lumbar vertebral bodies showed a progressive decrease with age for both sexes (except for the T2 relaxation values in female patients). The replacement of hematopoietic marrow by fatty marrow could explain the decrease in T1 and T2. The T1 and T2 values were in the same range for the first two age groups (age 1-10 years and age 21-40 years) and became slightly greater for the older female patients (age 51 years and older) than for the older males. This could be due to the loss of bone and mineral content, which is more rapid and significant for women. These normal T1 and T2 values may provide a baseline for future evaluation of diseases involving the lumbar spine. PMID- 3983395 TI - Orientation of tendons in the magnetic field and its effect on T2 relaxation times. AB - In vitro studies of spin-spin relaxation times of the protons or hydrogen nuclei which make up the tendon demonstrated significant dependence of T2 on orientation at physiological levels of hydration. T2 varied from approximately 250 mu sec. with the tendon aligned with the magnetic field to 22 msec. at an angle of 55 degrees or 125 degrees and 4 msec. at deviations of +/- 15 degrees from 55 degrees and 125 degrees. 55 degrees and 125 degrees are the so-called "magic angles" at which 3 cos2 theta - 1 = 0. As a result, the signal from human tendons in vivo will depend on their orientation; however, T2 is generally short enough that the signal intensity will approach 0 in MR images regardless of the orientation of the tendons, thereby preventing this phenomenon from being observed in most studies. PMID- 3983396 TI - Multiple spin-echo magnetic resonance imaging. AB - Spin-echo magnetic resonance (MR) imaging detects a variety of pathologic states with great sensitivity. A technique for producing multiple spin-echo images in multisection operation is presented. This method of intensity-image acquisition is compared with retrospective intensity-image synthesis from routine data sets. Both yield long echo time (TE) images with similar image contrast and comparable and often increased diagnostic utility. Technical and clinical considerations are addressed, including signal-to-noise levels, flow effects, and patient throughput. PMID- 3983397 TI - Computed tomographic studies of the painful abdomen. AB - Abdominal CT scans were reviewed in a series of 53 patients who had abdominal pain without objective physical, radiographic, or laboratory abnormalities. Forty patients presented with abdominal pain alone, while the remaining patients had abdominal pain associated with nausea, vomiting, or mild weight loss. Abdominal CT scans in all patients were interpreted as normal. In all but one patient, the final diagnosis was an insignificant benign condition. One patient had a pancreatic carcinoma discovered at surgery one month after the CT scan was obtained. The patients were followed up for 6 to 12 months to confirm absence of significant disease. Our analysis suggests a very low yield from abdominal CT in patients with abdominal pain and no other objective findings. PMID- 3983398 TI - CT densities in delayed iodine hepatic scanning. AB - Sixty patients underwent CT scanning of the liver prior to, immediately after, and four hours after intravenous administration of 60% meglumine diatrizoate. Twenty patients received a 50 ml bolus of contrast material (14.6 g of iodine), 20 received 100 ml (29.2 g of iodine), and 20 received 200 ml (58.4 g of iodine). In each group, delayed CT scanning safely raised the inherent density of the liver significantly (increase of 14.3% using 50 ml; 23.9% using 100 ml; and 40.7% using 200 ml). Thus, delayed scanning with doses presently used in abdominal and neurological CT examinations may be helpful in detecting hepatic lesions. PMID- 3983399 TI - Detection of intra-articular osteochondral bodies in the knee using computed arthrotomography. AB - A new technique using air arthrography followed by computed tomography enables identification of free osteocartilaginous fragments in the knee joint. Clinical examples with useful diagnostic information are presented, and potential pitfalls in the interpretation of this information are discussed. PMID- 3983400 TI - Use of I-131 labeled, murine Fab against a high molecular weight antigen of human melanoma: preliminary experience. AB - High molecular weight antigen (HMWA) is a tumor-associated proteoglycan of human malignant melanoma. I-131 labeled Fab fragments of these specific antibodies were used for preliminary feasibility studies for radioimmunodetection and therapy of human subjects who had inoperable metastatic melanoma. Ten patients received tracer doses of 5-13 mCi (185-481 MBq) of I-131 (anti-HMWA) Fab. All patients (8/8) who had melanoma lesions greater than 1 cm by correlative diagnostic methods had one or more lesions that had localization to tumor of the radiolabeled Fab. In all, 17 of 23 (74%) documented metastases were seen. There were no false positives in this series. Two patients who had avid uptake received potentially radiotherapeutic doses of 142 mCi (5,254 MBq) (one patient) and 181 mCi (6,697 MBq) and 193 (7,141 MBq) (total: 374 mCi or 13,838 MBq) (one patient). For both of these patients, whole body imaging studies showed that the localization of the high dose I-131 Fab was predominantly in tumor. The patient who received the larger dose showed a greater than 50% reduction in the size of pelvic and pericaval nodes, with stabilization of disease at the smaller nodal size for a period of three months. On whole body images, the anti-Fab HMWA appears to be more tumor selective than Fab preparations that target the p97 antigen for melanoma, and there is less uptake in liver. PMID- 3983401 TI - Radioimmunodetection of melanoma utilizing In-111 96.5 monoclonal antibody: a preliminary report. AB - The murine 96.5 monoclonal antimelanoma antibody (MoAb) was labeled with In-111, and 1-20 mg were administered to 21 patients who had proved or suspected melanoma metastases. One patient was studied twice. In four patients, unlabeled 96.5 MoAb was administered prior to the radiopharmaceutical. All of the patients tolerated the procedure without toxicity regardless of the mass of MoAb administered. The scans were interpreted by two observers, one with full knowledge, the other with no knowledge of the cases. Increasing the MoAb mass or preinfusing unlabeled MoAb prior to the administration of In-111 MoAb resulted in a prolongation of the serum half time, and appeared to improve tumor detection. Lesions were best seen at 72 hours after infusion or later. In all patients who had metastatic disease, at least one tumor site was apparent. Fifty-six per cent of known lesions 1.5 cm or greater in size were detected by the physician who had knowledge of the cases when data from all doses were considered. There were eight lesions detected that were not suspected in the workup of the patient. When these are included, the detection rate rises to 61%. Forty-nine per cent were detected by the other physician. Subtraction techniques were not employed. Lesions were often better seen with single photon emission computed tomography than with planar imaging techniques. The 96.5 In-111 MoAb appears to have utility for the detection of metastatic melanoma. Further clinical evaluation of 96.5 In-111 MoAb is warranted. PMID- 3983402 TI - Cutaneous lymphoid hyperplasia: results of radiation therapy. AB - Four cases of cutaneous lymphoid hyperplasia (CLH) were treated with radiation therapy. Sixteen separate areas of the skin were irradiated. Only two received more than 18 Gy (1,800 rad). Follow-up ranged from eight months to seven years. No infield recurrences were observed, and cosmetic results were excellent. The authors suggest that radiation therapy can be highly effective in the treatment of CLH. PMID- 3983403 TI - Radiation therapy of lymphoblastic renal masses--benefit or hazard? AB - A child with non-Hodgkin lymphoma and massively enlarged kidneys received a single dose of 300 rad (3 Gy) to the right kidney before initiation of chemotherapy. Measurement of the split renal function with 99m-Tc-DTPA four days postirradiation revealed that the function of the right kidney had substantially deteriorated, suggesting that hazards may be involved with the use of radiation therapy for lymphoblastic renal masses. PMID- 3983405 TI - Early rectal tube removal for improved patient tolerance during double-contrast barium enema examination. AB - During a five year period, 62 patients each underwent two barium enema examinations. The length of time that the rectal tube remained in place varied in each subject. Early rectal-tube removal resulted in better patient acceptance of the double-contrast barium enema examination. PMID- 3983404 TI - Videofluorography and pulsed fluoroscopy using a 512 X 512-pixel digital image system. AB - The combination of videofluorography and pulsed fluoroscopy using an analog videodisc system has previously been investigated with regard to image quality and potential for dose reduction. The authors found that the system could be improved still further by replacing the analog disc with a 512 X 512-pixel digital image system, thereby increasing fluoroscopic image quality and permitting stored images to be recorded with a multiformat camera. The pulsed method is compared with low-dose-rate fluoroscopy, in which a continuous image is obtained at 1/4 of the normal rate. Whereas image quality using a low dose rate was inadequate for any useful purpose, pulsed fluoroscopy was sufficient for all but the most critical stages of the examination. PMID- 3983406 TI - A new pyeloureteral drainage catheter. AB - We describe a new pyeloureteral drainage catheter that can be used for both genitourinary tract stenting and drainage, as well as tamponade of bleeding from the renal parenchyma or subcutaneous tissue. Primary indications for the use of this catheter and recommendations on insertion techniques are presented. With the exception of one case of minor kinking of the catheter, we have had no complications or failures with this catheter. While insertion through an unprotected tissue track is somewhat difficult, we have had good success introducing the catheter through a 24-F or larger Teflon working sheath. The catheter has excellent patient retention properties. It can be converted from external to internal drainage or vice versa simply and quickly on the ward. PMID- 3983407 TI - Detachable steel spring coils for vessel occlusion. AB - Spring coils for vessel occlusion were modified to include a screw-on attachment for delivery wire, which permitted safe and accurate placement of the coils. We successfully implanted coils in a dog and a lamb. They were easily retrieved from within the delivery catheters and the vessels, which is not possible with conventional coils. Coil design is described. PMID- 3983408 TI - A new universal radiolucent handle. AB - A new universal radiolucent handle is described that permits needle placement under continuous fluoroscopic observation, while maintaining the operator's hands outside the primary beam. The handle accommodates nearly all needles used for biopsy, anesthesia, nephrostomy, cholangiography, and biliary drainage, which represents a major advantage over previously described radiolucent handles. Reduced operator-hand exposures, improved needle guidance, and quick handle release are also major advantages of the universal handle. It is inexpensive, reliable, and reusable. PMID- 3983409 TI - CT collimator damage: detection by testing scan beam and laser-light alignment. AB - A test for CT scanner laser-light alignment is described. Ready-pack film is taped around a cylindrical phantom, and laser-light position relative to x-ray beam track is indicated by an arrangement of pin pricks through the film jacket. Performance of this test after x-ray tube replacement showed a band of stray radiation running parallel to the scan beam. The errant beam was caused by a failure to interlock the prepatient collimator and scatter shield correctly. PMID- 3983410 TI - Airway responses to aerosolized leukotriene D4 (LTD4) in normal and Ascaris reactor primates. AB - Normal and Ascaris reactor primates were compared for their bronchial pulmonary response to aerosolized leukotriene D4 (LTD4). When 10 micrograms/ml LTD4 was aerosolized (total amount delivered to endotracheal tube was 1.0 micrograms) into the lungs of 6 normal primates, a small increase in total lung resistance (RL) was noted (4.4 +/- 4.5% increase, in 19 separate challenges). However, a larger effect was seen in compliance (27.6 +/- 15.8% decrease, n = 19). Ascaris reactors (n=4) demonstrated a larger RL effect than normals with almost an identical Cdyn change (RL 36.1 +/- 27.7% increase, Cdyn 32.8 +/- 18.8% decrease n = 12). When the pharmacological blockers diphenhydramine, 0.5 mg/kg and atropine, 0.5 mg/kg were administered iv separately before LTD4 challenge, significant antagonist activity was seen. Diphenhydramine inhibited the LTD4 response in normal primates (RL 64.2 +/- 44.3% and Cdyn 50.5 +/- 40.9% n = 6) and in reactors (RL 47.8 +/- 43.1% and Cdyn 19.2 +/- 20.8% n = 4). Atropine inhibited normals (RL 100% and Cdyn 73.1 +/- 32.7% n = 2) and reactors (RL 96.3 +/- 7.7 and Cdyn 47.4 +/- 35.1% n = 3). These results indicate that the LTD agonist action is partially mediated through histamine, primarily acting on lung resistance (large airways) and, in addition, may have a reflex atropine-sensitive component. The difference between the response of normal and reactor primates to LTD4 is primarily a histamine mediated large airway response. PMID- 3983411 TI - ["The Mark of Oppression". Ethnopsychoanalytic study of Jews and homosexuals in a relatively permissive culture]. PMID- 3983412 TI - [Freud's "Katharina"--background, origin and significance of an early psychoanalytic case history]. PMID- 3983413 TI - [Ego, id and the unconscious]. PMID- 3983414 TI - [Socio-medical aspects of families of former prisoners of Hitler's concentration camps]. PMID- 3983415 TI - [Health status of concentration camp children in the light of the Lower-Silesian Center of Medical Diagnostics]. PMID- 3983416 TI - [Psychiatric sequelae of Hitler's concentration camps in the progeny of former prisoners]. PMID- 3983417 TI - [Remote sequelae of Hitler's persecutions in the families of survivors]. PMID- 3983418 TI - [Psychopathology of hunger in concentration camps]. PMID- 3983419 TI - The nature of phonological processing in oral reading: evidence from surface dyslexia. PMID- 3983420 TI - Associability of a previously conditioned stimulus as a function of qualitative changes in the US. PMID- 3983421 TI - Running recognition of configural stimuli by fornix-transected monkeys. PMID- 3983422 TI - Late results of multiple fractions per day (MFD) with misonidazole in advanced cancer of the head and neck. A pilot study of the EORTC radiotherapy group. AB - In the EORTC Radiotherapy Group, the feasibility of multiple fractions per day (MFD) was tested in a pilot study from 1978 to 1980. Three daily fractions of 1.6 Gy were given (4 h interval) during 2 weeks (total dose 48 Gy), with a boost to about 70 Gy after 3-4 weeks. In 53 of the 179 patients, misonidazole was given on every irradiation day (1 g/m2, total 13-14 g/m2). Data on tolerance and early treatment results were published previously; results with a minimum follow-up period of 3 years are now available. Survival (actuarial is 21% and locoregional tumor control was obtained in 34% of patients; no significant differences were seen between the subregions in the head and neck area. Survival is better in patients treated with misonidazole (probably due to selection), but locoregional control was identical as in patients treated without the sensitizer. In February 1984, 38 patients were alive, 35 without evidence of local tumor (5 after rescue surgery). Metastases were seen in 16% and a second tumor in 7% of patients. Seventeen patients (9%) died of causes, possibly related to treatment; necrosis was observed in 8 (4 with local tumor). Late effects in the long survivors were comparable to what is usually seen after high-dose radiotherapy. PMID- 3983423 TI - Time-temperature relationships for hyperthermal radiosensitisation in mouse intestine: influence of thermotolerance. AB - Thermal enhancement of radiation injury to the crypt compartment of mouse small intestinal mucosa has been measured as a function of heating time for temperatures in the range 41.0-44.0 degrees C. All the hyperthermal treatments used were themselves subthreshold for gross tissue injury. With this limitation, thermoradiosensitisation increased linearly with duration of hyperthermia for temperatures in the range 42.3-44.0 degrees C. Using temperatures below 42.0 degrees C, there was a saturation in effect for treatments longer than approximately 40-90 min, possibly due to the development of thermotolerance. The thermoradiosensitisation isoeffect curve relating heating time with temperature was biphasic with the transition occurring between 41.8 and 42.0 degrees C. For temperatures above the transition, a 1 degree C change was equivalent to a factor of 2.6 in heating time; below the transition, a 1 degree C change was equivalent to a factor of 5.4. Time-temperature relationships for thermoradiosensitisation in other rodent tissues are reviewed and compared with the general relationships for direct thermal injury, previously derived from experimental studies. The results are discussed with relevance to the interpretation of in vivo thermal enhancement of radiation injury. PMID- 3983424 TI - Repopulation in irradiated pig skin: late versus early effects. AB - In the first 16 weeks after irradiation, two distinct waves of reaction can be observed in pig skin, the first wave (3-9 weeks) represents the expression of damage to the epithelium while the second is indicative of primary damage to the dermis, mediated through vascular injury. Following beta-irradiation with a strontium-90 applicator, a severe epithelial reaction was seen with little subsequent dermal effects. X-rays (250 kV), on the other hand, produced a minimal epithelial response at doses which led to the development of dermal necrosis after 10-16 weeks. Comparison of single doses with two equal doses separated by 28 days produced a D2-D1 value of 14.0 Gy at the doses which produced moist desquamation in 50% of fields (ED50) after strontium-90 irradiation. After X irradiation, comparison of ED50 doses for the later dermal reaction suggested a D2-D1 value of 4.2 Gy. These values of D2-D1 for epithelial and dermal reactions in pig skin were compared with earlier data from this laboratory for similar split-dose experiments with a one-day interval. Such a comparison allowed for the estimation of the component of recovery in the present 28-day interval experiments due to repopulation. This component was found to be 6.5 Gy for the early epithelial damage, but was zero for the later dermal damage. PMID- 3983425 TI - The effect of breathing 100% oxygen on lung response to radiation in mice. AB - The response of the lung after single doses of radiation was measured in mice breathing air, or 100% oxygen, or in air-breathing mice given the hypoxic cell sensitizer misonidazole 30 min before irradiation. There was a clear enhancement of only the pneumonitis response in the mice breathing oxygen when breathing rate or lethality was used to assess injury. Less enhancement of the late fibrotic reaction was observed in these animals. No enhancement of either phase of lung response was observed in the misonidazole-treated mice. Dose reduction factors (DRF) were estimated from these data and used to calculate oxygen concentration in the lung, giving values ranging between 187 and 250 micron oxygen. PMID- 3983426 TI - Multiple small fractions per day versus conventional fractionation. PMID- 3983427 TI - [The sitting position. A source of knowledge]. PMID- 3983428 TI - [Apropos of 6 cases of esophageal perforations]. PMID- 3983429 TI - [A new automatic system for the elimination of anesthetic gases and vapors]. PMID- 3983430 TI - [Epidural catheterization. Radiologic study]. PMID- 3983431 TI - [Medical assistance to the popular marathon in Valencia (1984)]. PMID- 3983432 TI - [Anesthetic management of young sheep in open heart surgery]. PMID- 3983433 TI - [Postanesthetic shivering]. PMID- 3983434 TI - [Tracheal tube obstruction caused by nitrous oxide]. PMID- 3983435 TI - [Fistulization of the epidural space and skin]. PMID- 3983436 TI - [Anesthesiology, resuscitation and reality]. PMID- 3983437 TI - [Report of the Section of Ischemic Cardiopathy and Coronary Units. Effort tests in cardiology]. PMID- 3983438 TI - [Quantitative analysis of left valvular insufficiency by the utilization of radioisotopic technics in equilibrium]. PMID- 3983439 TI - [M-mode echocardiographic registration of the pulmonary valve from the subxiphoid region]. PMID- 3983440 TI - [Change of velocity in the echocardiographic dimensions of the left ventricle: its diagnostic value in severe mitral stenosis or insufficiency]. PMID- 3983441 TI - [Atrioseptostomy with blade catheter. Initial experience in 12 children]. PMID- 3983442 TI - [Prevalence of congenital cardiac defects in a population of 38,674 students]. PMID- 3983443 TI - [Total abnormal pulmonary venous drainage: surgical treatment, results and postoperative follow-up]. PMID- 3983444 TI - [Aneurysms of the ascending aorta. Analysis of a consecutive series of 52 cases]. PMID- 3983446 TI - [Pulmonary hypertension in Sjogren's syndrome: an uncommon association]. PMID- 3983445 TI - [Left ventricle-right auricle communication in the infant. Apropos of 2 cases treated surgically]. PMID- 3983447 TI - [Morphometric study of the caudate nucleus of rats 3 and 4 months after portacaval shunt]. PMID- 3983448 TI - [Value of computed axial tomography in the diagnosis of diseases of the liver parenchyma]. PMID- 3983449 TI - [Hepatic resection in hydatidosis]. PMID- 3983450 TI - [Gastrointestinal manifestations of systemic mastocytosis and its treatment with antagonists of H1 and H2 receptors. Experimental study]. PMID- 3983451 TI - [Behavior of the secretion of pancreatic polypeptide by the PP cell in acute pancreatitis]. PMID- 3983452 TI - [Injuries of the large intestine. Experience in the Central Hospital of the Venezuelan Institute of Social Insurance]. PMID- 3983453 TI - [Our experience in carcinomas of anal canal and anus]. PMID- 3983454 TI - [Carcinoid tumor of the stomach. Considerations on a new case]. PMID- 3983455 TI - [Giant cystadenoma of the appendix]. PMID- 3983456 TI - [Duplication of the appendix]. PMID- 3983457 TI - [Primary melanoma of the anus in Spain]. PMID- 3983458 TI - [Rehabilitation instead of resignation. Must the nursing home be the end station?]. AB - The numbers of old people are increasing, as are the amounts of finance required for the care of the elderly. In addition sickness funds, too, are confronted with rising funding requirements due to the multimorbidity of old people. The causes underlying the increases in nursing and care expenditure to be carried by the communities, as well as of services and benefits to be made available by the health insurance sector, are put forth. Early rehabilitation would be capable of eliminating many of the causal factors involved, and doctors in particular have to become more aware of the importance and potential of geriatrics. This approach could remedy the resignation found in many of those concerned, hence stimulate overall rehabilitation efforts. Rehabilitation of senior citizens aims at reducing the functional limitations experienced by old people, seeking to reduce the extent of disablements in daily living, i.e. to preserve a high level of independence in the seniors. The services and programmes necessary for achieving this aim are described. PMID- 3983459 TI - [Are patients in geriatric clinics rehabilitated?]. AB - In order to verify the effectiveness of various rehabilitation activities commonly used in geriatric clinics or nursing homes, a total of 453 persons from seven clinics/nursing homes had been assessed four times in 12 months by staff from the respective facility. First, the thesis of the multimorbidity in old age was confirmed by an average 4.4 diagnoses per patient. Rehabilitation measures were found to have been only rarely provided, with rehabilitative efforts having focussed mainly on the patients in better shape. On the other hand, visits from close relatives such as children or spouse are more frequent for patients who function at lower levels. It has been possible by cross-lagged correlation to demonstrate the positive effects of concentrated rehabilitative efforts undertaken over a period of twelve months. A significant correlation to specific rehabilitation techniques has not been stated. PMID- 3983460 TI - [Achievement concepts, mental status and psychological stability of the elderly]. AB - Considerations within a broader theoretical framework are presented that relate psychic well-being and psychic stability of both older and younger persons to their self-concepts of achievement and ability: The better the "psychic well being" and the higher the degree of "psychic stability", the more "favourable" or "positive", i.e. with more socially desired characteristics, are the various self concepts of achievement and ability of both younger and older individuals. 87 psychiatric patients with a diagnosis of "depression", considered a population with lower levels in respect of "psychic stability" and "psychic well-being", had been compared to a sample group without psychiatric problems. Initial evaluations of available empirical findings, i.e. the data for three differentiated self concepts of achievement and ability and a self-concept of sensitivity and general emotional state, obtained from a total of 174 subjects (91 aged 50-81, 83 aged 23 49), have failed to falsify our hypotheses but have, rather, substantiated them. The 87 psychiatric subjects from various age groups had significantly less "favourable" self-concepts of achievement and ability and a significantly less "positive" self-concept of sensitivity and general emotional state than the subjects in the parallel sample. PMID- 3983461 TI - [Memory related training in advanced age]. AB - Development, trial and evaluation of a training approach to aging memory are described. The 6-unit small-group programme is based on empirical findings concerning age-related reductions in memory functioning. Initial controlled evaluation of the training effects indicates improvements in various memory functions, suggesting the programme's usefulness in applied gerontopsychology. PMID- 3983462 TI - [New scientific and practical education for successful reading training under difficult circumstances]. AB - Neither traditional dyslexia research nor intensive efforts undertaken by the special education sector in reading-writing education have hitherto been able to remedy the fact that relatively large numbers of special education students are unable to read and write when they leave school. Learning to read and write continues to mean drudgery for many children. Experimental research in reading and writing learning processes has achieved approaches capable of providing effective help specifically to the "hard-core" cases of reading and writing failure. This, however, presupposes an understanding of the information processing and storage processes required in reading function, or, rather, of the deficiencies involved. The present contribution therefore intends to familiarize the special education practitioner with the still widely unknown psychological foundations of cognition and memory that are indispensable for implementing effective reading education course. PMID- 3983463 TI - [Psychosocial rehabilitation in advanced age]. AB - The psychosocial rehabilitation of older persons is one of the main problems in health policy. About one quarter of the over 65-year-olds face psychic problems, without, to a large extent, receiving adequate treatment and rehabilitative care. Substantial deficits exist above all in the out-patient and non-residential service sectors. In in-patient care, existing methods for psychosocial intervention (such as psychoanalysis, behavioural, client-centered, family, Gestalt, milieu, or music and dance therapy, psychodrama, reality orientation training, or resensitization techniques) are hardly ever used. This absence of applied geronto-psychology is attributable to the shortcomings of available assessment methods, multiple methodical problems of intervention research, and- above all--to insufficient staff positions for psychosocial professions in the gerontological sector. Provision of further permanent posts for psychosocial workers; development of age-specific assessment methods; interdisciplinary and systematic interventional research; the development of ambulatory, community based services as well as intensive support for existing self-help efforts are therefore called for. PMID- 3983464 TI - [Forgotten rehabilitation]. AB - Based on the development of gerontology and geriatrics in the Federal Republic of Germany, various geriatric rehabilitation issues are presented. The different types of geriatric facilities are described. PMID- 3983465 TI - Evaluation of two distinctive beta-carbolines on serotonin binding in human platelets. AB - 6-MeOTHBC binds to both high and low affinity receptors in human platelets. The beta-carboline is less active than chlorimipramine at the low affinity site, and it is weaker than methysergide, a known 5-HT antagonist, at the high affinity site. The other beta-carboline, B-CCE, is not active at either receptor in platelets. The data supports the view that platelets could be used as a limited model for studying 5-HT-ergic neurons. PMID- 3983466 TI - Benzylamine oxidase activity in spontaneously hypertensive rats. AB - Benzylamine oxidase (BzAO) activity was assayed in aorta, atria and serum from 20 week old spontaneously hypertensive (SH) rats and Wistar Kyoto (WKY) control rats. Atrial BzAO activity was reduced by 50% in SH rats compared with WKY control. Aorta and serum BzAO activity did not differ significantly between the two groups. Thus, BzAO activity of serum and cardiovascular tissues appears unrelated to pressure-induced changes in connective tissue production. PMID- 3983467 TI - Antidepressant drugs suppress growth of the human pathogenic protozoan Giardia lamblia. AB - The tricyclic antidepressant drug chlorimipramine, some of its congeners, and its mammalian metabolites inhibited the growth in vitro of the human intestinal pathogen Giardia lamblia. The inhibitory action may reside in their ability to inhibit the membrane-associated ATPase characteristic of eukaryotes. Synthesis of other compounds of the tricyclic class may produce drugs of potential therapeutic use in the treatment of giardiasis and possibly other protozoal diseases. PMID- 3983468 TI - Trazodone, a nontricyclic antidepressant, is an inhibitor of adenosine deaminase. AB - Trazodone, a nontricyclic antidepressant drug, is a noncompetitive inhibitor of adenosine deaminase. The specific activity of adenosine deaminase in rat brain cortex homogenate is 140 +/- 15 (SEM) nm/min/gm tissue, while the apparent Km of adenosine is 77 microM. The apparent Ki of trazodone for the brain cortex enzyme is 1 X 10(-4)M, and 6 X 10(-5)M for purified calf intestine mucosal enzyme. PMID- 3983469 TI - The involvement of an oxidative mechanism in the adriamycin induced toxicity in neonatal rat heart cell cultures. AB - In order to investigate the oxidative component of adriamycin-induced cardiotoxicity in the rat, we used neonatal cardiac myocytes in culture. All incubations, with or without adriamycin (ADM), were performed under normoxic circumstances and additionally under circumstances which make cells more vulnerable towards oxidative challenges: hyperoxia or treatment with 1,3-bis(2 chloroethyl)-1-nitrosourea (BCNU). ADM (100 microM) produced a decrease in the beating rate and enzyme release of the cultures. These effects were potentiated by hyperoxia and by BCNU treatment. Cellular GSH was depleted due to ADM. However, no significant increase in GSSG could be detected, even if the O2 concentration was increased. Lipid peroxidation, measured as thiobarbituric acid reactive material, could be detected only in case ADM plus additional stress were given to the cells. It is concluded that redox-cycling of ADM occurs in rat cardiac myocytes. Formation of ADM-glutathione conjugates or mixed disulfides is strongly indicated. From this it can be inferred that ADM-toxicity in cardiac cells may involve an oxidative mechanism. An important role for the glutathione system is indicated in the detoxification of reactive intermediates. In addition the results implicate that neonatal rat heart cell cultures provide a good screening system for the evaluation of oxidative challenges in the cardiotoxic action of anthracycline analogs. PMID- 3983470 TI - Effect of the antioxidant (+)-cyanidanol-3 on H2O2 formation and lipid peroxidation in liver microsomes. AB - (+)-Cyanidanol-3, a flavonoid with antioxidant properties, leads to an increase of hydrogen peroxide production when added to liver microsomes from untreated and variously pretreated rats. No distinct extra production of hydrogen peroxide was observed in liver microsomes from guinea pig, rabbit and man. The optimal stimulatory concentration was 100 microM; at higher concentrations a lesser degree of stimulation was obtained. Metyrapone inhibited the stimulation process, indicating that cytochrome P-450 function may be involved. Increase of hydrogen peroxide formation occurred at the same (+)-cyanidanol-3 concentrations that were capable to inhibit lipid peroxidation, suggesting that the interference of (+) cyanidanol-3 with the oxidase function of cytochrome P-450 does not compromise its antioxidative activity towards lipid peroxidation. PMID- 3983471 TI - Rapid, substrate-specific, and dose-dependent deactivation of liver cytosolic glutathione S-transferases in vivo by 1,1-dichloroethylene. AB - Administration of 200 mg 1,1-dichloroethylene (1,1-DCE)/kg to fasted male rats rapidly decreased liver cytosolic glutathione (GSH) S-transferase activities by half within 1 hr. This early decrease was not associated with increased serum activities of this soluble enzyme and is considered due to enzyme deactivation. The early decrease in enzyme activities was concomitant with a three-fourths depletion of cytosolic GSH and preceded changes in cytochrome P-450 and the onset of liver cytotoxicity, both of which occurred abruptly between 2 and 3 hr. Substantial changes in GSH S-transferase activities at 4 hr were produced only by severely hepatotoxic doses of 1,1-DCE. The early decrease in hepatic GSH S transferase activities was selective for substrates dichloronitrobenzene, chlorodinitrobenzene and 1,2-epoxy-3-(p-nitrophenoxy)-propane with apparent sparing of activity towards ethacrynic acid. The rapid, selective and dose dependent deactivation of the hepatic GSH S-transferases could be relevant to the catastrophic hepatotoxicity of 1,1-DCE. PMID- 3983472 TI - Comparison of ethanol and imidazole pretreatments on hepatic monooxygenase activities in the rat. AB - Ethanol and imidazole have been shown to cause similar changes in the hepatic drug metabolizing enzymes of rabbit liver. The effects of these agents on hepatic monooxygenase activities were compared in the rat to test whether similar changes might also occur in this species. Ethanol feeding caused 4- to 5-fold increases in rates of the microsomal metabolism of aniline and p-nitrophenol, and smaller increases in rates of dealkylation of 7-ethoxycoumarin and aminopyrine. Ethanol doubled cytochrome P-450 content and increased the staining intensity of a polypeptide with an apparent molecular weight of 54,000 as determined by SDS polyacrylamide gel electrophoresis. Imidazole pretreatment also enhanced rates of the microsomal metabolism of 7-ethoxycoumarin and aminopyrine, but did not affect rates of aniline or p-nitrophenol hydroxylation. In addition, imidazole did not affect cytochrome P-450 content or the electrophoretic profile of microsomal polypeptides. Thus, the effects of ethanol and imidazole pretreatments on hepatic drug metabolism vary substantially between rabbits and rats. PMID- 3983473 TI - [Treatment of recurrent pulmonary thromboembolism with direct infusion of urokinase into the pulmonary artery]. PMID- 3983474 TI - [A case of left ventricular aneurysm with normal coronary arteries following acute myocardial infarction]. PMID- 3983475 TI - [Topics on cough receptor and bronchoconstriction]. PMID- 3983476 TI - [Usual and unusual types of idiopathic interstitial pneumonia (IIP)]. PMID- 3983477 TI - [Evaluation of cardiac diastolic performance using nuclear stethoscope]. PMID- 3983478 TI - [Mechanism of alternating bundle branch block]. PMID- 3983479 TI - [Response of right ventricular ejection fraction to exercise stress in coronary artery diseases]. PMID- 3983480 TI - [A quantitative analysis of left ventricular behavior in cineangiogram]. PMID- 3983481 TI - [Morphometric analysis of the disorganization process of the alveolar structures in paraquat toxicity]. PMID- 3983482 TI - The roles of medullary extracellular and cerebrospinal fluid pH in control of respiration. AB - To determine the effective stimulus to the central chemoreceptors, we measured CSF and medullary extracellular fluid (ECF) pH and phrenic activity in 11 anesthetized, paralyzed, vagotomized and glomectomized cats. Flat-tipped pH electrodes (2 mm diam.) were used to measure ECF pH on the ventral surface of the medulla and CSF pH 2 mm above the surface. Changes in alveolar/arterial PCO2 were produced by airway occlusions of 10-20 sec durations. Changes in CSF PCO2 and pH were made by infusing 100% CO2 or an acid buffer into the CSF. Airway occlusion caused an increase of alveolar/arterial PCO2. ECF pH began to fall 6-10 sec later, with a maximum decrease of 0.032 pH unit at 21.9 sec. Phrenic activity increased as ECF pH decreased, the greatest activity occurring when ECF pH was most acid. CSF pH decreased after a longer delay. Its maximum decrease at 54.1 sec was smaller (0.026 pH unit) than ECF pH and did not correlate with the increase of phrenic activity. Addition of 100% CO2 or an acid buffer into the CSF produced an acid shift in the CSF pH but no change in ECF pH or phrenic activity. Prolonged (greater than 30 min) increase of acidity of CSF did not alter phrenic activity until ECF pH developed a delayed acid shift. Even then, the change of ECF pH was much smaller than that of CSF. We conclude that medullary chemoreceptors do not respond to changes of CSF pH or PCO2 and that change of pH of CSF minimally affects ECF pH. On the other hand, respiratory responses are closely linked to changes in ECF pH. PMID- 3983483 TI - Taylor laminar dispersion in human airways. AB - Healthy subjects took breaths of approximately 200 ml or approximately 600 ml, from functional residual capacity, of a mixture of He, Ar, SF6 (approximately 7% each), 21% O2, balance N2. Without breath-holding they expired steadily to residual volume. Concentrations of He, Ar and SF6 were measured continuously near the lips and expressed in each case as a fraction of the inspired concentration. After the bigger breaths the order in phase 2 was SF6 greater than Ar greater than He and at the end of phase 3 He greater than SF6, in agreement with other workers. After small breaths, and especially with low inspiratory flows, the early part of phase 2 showed, in a highly significant number of experiments, the order He greater than Ar greater than SF6; in these cases phase 3 still showed He greater than SF6. These results are fully consistent with the occurrence, during inspiration, of Taylor laminar dispersion (TLD) in airways situated within about 200 ml from the lips. They show that the end of phase 3 cannot be used to infer the presence or absence of TLD, and that correction for the response of the mass spectrometer is of crucial importance in the interpretation of phase 2. PMID- 3983484 TI - Breathing pattern and diaphragm EMG after SO2 in rabbit intra- or extrathoracic airways. AB - In anesthetized rabbits under SO2 block of slowly adapting stretch receptors (SAR) in intrathoracic airways TI increased by 49.7 +/- 6.9% and VT by 19.5 +/- 3.7%. TE decreased for small increases of TI and vice versa. Slope of moving average of diaphragm EMG (M.A.) decreased by 16.7 +/- 4.1% from 0 to 30% TI control, and increased by 26.3 +/- 8.1% from 30 to 70%. Considering that discharge from intrathoracic SAR increases during inspiration, these changes of M.A. indicate that their input facilitates inspiration at its beginning, but inhibits it later on, in line with previous conclusions based on SAR block which included 2/3 of extrathoracic trachea (ETT). Neither SO2 nor pressures from -40 to +40 cm H2O in ETT changed breathing pattern or M.A.. Hence, SAR of ETT do not affect parameters studied in rabbits. When extrathoracic airways were exposed to SO2 TI increased by 30.5 +/- 8.2%, TE by 37.9 +/- 5.1%, VT did not change. Hence, some receptors rostral to trachea, involved in respiratory control, are affected by SO2. PMID- 3983485 TI - Stimulation of group III and IV muscle afferents reflexly decreases total pulmonary resistance in dogs. AB - Although previous investigations have shown that stimulating group III and IV afferents reflexly decreased transverse tension from the trachealis muscle, these measurements provided no functional information about airway caliber. We therefore electrically stimulated gracilis muscle afferents in paralyzed, chloralose anesthetized dogs while recording total pulmonary resistance breath by breath. In addition, we recorded compound action potentials to determine which afferents were stimulated by current intensities of 3, 5, 20, 70 and 200 times motor threshold. We found that stimulating (20 Hz) the nerves at 3 times threshold, a current intensity which activated only group I and II afferents, had no effect on total pulmonary resistance, whereas stimulating the nerves at 5, 20 and 70 times threshold, current intensities which activated group I, II and III afferents, significantly decreased this variable. Stimulating the nerves at 200 times threshold, a current intensity which activated group IV as well as group I, II and III afferents, decreased total pulmonary resistance significantly more than did stimulating the nerves at 5, 20 or 70 times threshold. In addition stimulating the nerves at 200 times threshold but at frequencies of 2 and 5 Hz significantly decreased total pulmonary resistance. The decrease in total pulmonary resistance evoked by electrically stimulating the nerves at 200 times threshold was unaffected by propranolol but was abolished by atropine methylnitrate. We conclude that stimulating group III and IV gracilis muscle afferents in dogs reflexly decreases total pulmonary resistance, an effect due to the withdrawal of a tonic cholinergic input to the airways. PMID- 3983486 TI - Peripheral circulatory responses to 96 hours of eucapnic hypoxia in conscious sheep. AB - Conscious sheep acclimatizing to hypoxia (PaO2 40 mm Hg, PaCO2 24 mm Hg) respond with increases in cardiac output (Qco) and cerebral blood flow lasting for 24 and 48 h, respectively. Coronary flow increases in a sustained fashion, while there are progressive decreases in renal, splenic and pancreatic flows. In the present study, 5 adult ewes were exposed to similar levels of normobaric hypoxia (PaO2 40 mm Hg) but the PaCO2 was maintained at eucapnic levels (32 mm Hg). VE increased (+210%) while VO2 decreased by 35%. Ventilatory sensitivity to CO2 was unchanged. Qco (thermodilution) was elevated for 96 h (+20%) as stroke volume was maintained at normoxic levels and heart rate increased (+36%). Pulmonary artery pressure increased (+35%) along with plasma catecholamine levels (+116-196%). There were sustained elevations of cerebral flow (radiolabelled microspheres) from 79.1 (+/- 9.2 SEM) to 121.6 ml X min-1 X 100 g-1 (+/- 10.8), coronary flow from 183 (+/- 22.1) to 373 ml X min-1 X 100 g-1 (+/- 46.3), diaphragm flow (+400%) and intercostal muscle flow (+186%) with no apparent redistribution of Qco. Therefore, the cardiac and peripheral circulatory response patterns are altered significantly in eucapnic hypoxia. The rate of O2 delivery to brain and several abdominal viscera is higher. PMID- 3983487 TI - The muscular basis of aerial ventilation of the primitive lung of Amia calva. AB - Anatomical analysis, electromyography, pressure recordings, high-speed X-ray and light movies of the mechanism of air ventilation in Amia calva reveal that aerial ventilation proceeds by the action of a specialized pulse pump. The interhyoideus muscle is the dominant muscle being active during both the preparatory phase and the final, prolonged compressive phase during which new air is forced into the lung. Amia retains a relatively large residual volume in the lung and does not repeat inhalation. It often expels excess air from the buccal cavity after the lung has been fully reinflated. The pressure, kinematic and air flow patterns during air ventilation in Amia closely resemble those of the air breath in the lungfish Protopterus. We hypothesize that the basically similar electromyographic profiles of homologous muscles so characteristic for the air ventilation mechanism of Protopterus and Amia reflect a homologous anatomical as well as functional neuromuscular pattern, which has had a common and early evolutionary origin among the Teleostomi. PMID- 3983489 TI - Training of aerospace medicine physicians. AB - In the U. S. there are 23 recognized medical specialty boards. One of these is preventive medicine. Within preventive medicine there are three areas: Aerospace Medicine, Occupational Medicine, and Public Health/General Preventive Medicine. The preventive medicine specialties have a common core of required training including biostatistics, epidemiology, health services administration and environmental health. These, plus associated topics are covered during year one of training. Year two of training involves clinical rotations specifically tailored to the eye, ear, heart, lungs and brain, plus flight training to the private pilot level, and a Masters Degree research project for the required thesis. During year three the physicians in aerospace medicine practice full-time aerospace medicine in a NASA or other government laboratory or a private facility. To date, more than 40 physicians have received aerospace medicine training through the Wright State University School of Medicine program. Among these are physicians from Japan, Australia, Taiwan, Canada and Mexico. In addition to the civilian program at Wright State University, there are programs conducted by the U. S. Air Force and Navy. The Wright State program has been privileged to have officers from the U. S. Army, Navy and Air Force. A substantial supporter of the Wright State program is the National Aeronautics and Space Administration and a strong space component is contained in the program. PMID- 3983488 TI - Verification of a model for the mechanisms controlling expiratory duration in rabbits under various conditions. AB - A mathematical model for the mechanisms controlling expiratory (E) duration was verified through comparison of its prediction with the relationships between TE and waveform parameters of various input patterns obtained by bilateral, simultaneous electrical stimulation of the largest vagal afferent fibers in vagotomized, paralyzed rabbits at normal or elevated chemical drive under light or deep barbiturate anesthesia. The model accurately reproduced experimental results in each animal and condition; it suggests that in the absence of vagal input (v.i.) an exponentially decaying central activity (phi) prevents inspiratory (I) onset until a time independent threshold (phi thr) is reached; the vagal component of phi results from fixed gain, long time constant (tau = 1.07 +/- 0.03 sec; mean +/- SE for N = 37 for N = 37 animals) temporal summation of expiratory v.i., being unaffected by inspiratory v.i.; central and vagal components share a common mechanism, the same value of tau applying to v.i. integration and to phi decay in the absence of v.i. under all conditions; the amplitude of the central component is proportional to tidal changes in central I activity, independently of the condition studied; and phi thr increases at elevated chemical drive, is unaffected by v.i., and decreases under deep anesthesia. PMID- 3983490 TI - [2d symposium of the University of Occupational and Environmental Health. 20 October 1984, Kitakyushu, Japan. Abstracts]. PMID- 3983491 TI - JTC-11 cells derived from Ehrlich ascites tumor deficient in a growing medium containing citrulline. AB - JTC-11 cells derived from an Ehrlich ascites tumor do not proliferate and do not synthesize DNA in a medium which contains citrulline but not arginine. Mouse L and HeLa cells grew well in citrulline medium. Since JTC-11 cells have been transplanted intraperitoneally in vivo and cultured in vitro for a long period, these cells may spontaneously lose the ability to synthesize arginine from citrulline. PMID- 3983492 TI - [Quantitative analysis of urinary ethylene glycol in rats exposed to ethylene oxide]. AB - A gas chromatographic method was used for determining ethylene glycol in urine. The analytical procedure is based on an azeotropic distillation and on esterification with n-butyl boronic acid. The linear calibration curve was obtained up to 500 micrograms/ml of ethylene glycol. The detection limit was estimated to be 10 micrograms/ml and relative standard deviation was 3.5% for 100 micrograms/ml of ethylene glycol. This method was applied to determine the urinary excretion of ethylene glycol in rats exposed to ethylene oxide at various concentrations (from 50 to 500 ppm). The excretion amounts of ethylene glycol were observed to be dependent on the concentration of ethylene oxide exposed. PMID- 3983493 TI - Unusual findings of M-mode echocardiogram in a case with left ventricular thrombus. AB - The unusual echo findings of the left ventricular thrombus by M-mode echocardiogram is reported. The patient was a 41-year-old man with hypokinesis of the inferior and inferolateral wall due to acute myocardial infarction. The findings of M-mode echocardiogram revealed dense thick linear echoes just below the anterior wall of the apex, which had a higher density than the myocardium and looked "band like". These abnormal echoes obtained by M-mode echocardiogram were also detected through examinations by 2-dimensional echocardiogram, computed tomogram and left ventriculogram, and were assumed to arise from the index finger sized thrombus in the left ventricle at the time of surgical procedure. Although this abnormal echo, revealed to have a "band like" feature by M-mode echocardiogram, is usually seen in the left ventricular myxoma, we assume that this "band like" echo by M-mode echocardiogram arose from the left ventricular thrombus under conditions such as myocardial infarction, ventricular aneurysm, dilated cardiomyopathy and long-term congestive heart failure. PMID- 3983494 TI - [An autopsy case of well differentiated leiomyosarcoma of the jejunum]. AB - A 54-year-old man had a leiomyosarcoma of the jejunum, 8 X 6 X 5 cm in size resected, on December 17, 1982 and died of liver metastases with hemorrhagic ascites (4,000 ml) on July 5, 1984. The malignant potential of a smooth muscle tumor based on the mitotic index of tumor cells has been stressed for many years. However, our biologically malignant autopsy case showed not only an exceptionally low mitotic index in tumor cells of the surgical specimen but also in those of the autopsy specimen. In this report, the fact that the degree of mitotic figures sometimes fail to indicate biological behavior is discussed. PMID- 3983495 TI - Teaching and training in aviation medicine in the United Kingdom. AB - In the United Kingdom, training in aerospace medicine is provided by a range of post-graduate courses at the Royal Air Force Institute of Aviation Medicine. An Introductory Medical Officers' (IMO) course lasts for two weeks and is attended by all RAF doctors within the first few months of their entry to the Service. Its objective is to teach the elements of aviation physiology and medicine that they will need in the care of aircrew at a flying station. Four courses are held each year. A General Aviation Medicine (GAM) course is available to civilian doctors who wish to gain recognition as Authorized Medical Examiners of commercial aircrew, or who merely have an interest in the subject. It runs concurrently with the IMO course, and much of the material is common to both. Greater emphasis is, however, given to clinical teaching and to civil aviation. The GAM course also occupies two weeks of teaching. A course leading to the Diploma in Aviation Medicine is held once each year, and lasts for six months. It is open to all who have at least one year of previous experience, and has been attended by 244 military and civilian doctors from 25 countries. The D Av Med course covers every aspect of aerospace medicine at an advanced level, and its standard is at least as high as that of a M Sc degree. The Diploma is a recognised academic qualification awarded by the Royal College of Physicians. Royal Air Force medical officers receive an extra three weeks of training immediately following the D Av Med course, to educate them in procedures and policies specific to the RAF. This Advanced Course is essentially practical, and those who complete it are designated as Flight Medical Officers. They receive refresher training given at regular intervals thereafter. Aircrew are taught the basic principles of aviation medicine when they attend the RAF Aviation Medicine Training Centre for training in the use of their personal protective equipment assemblies. These courses are specific to the type of aircraft to be flown, and a pilot will undergo at least four during his flying career. Short courses of a specialised nature are also offered to clinical consultants, medical students, senior Air Force officers, nurses and others. It is now recognised in the United Kingdom that aviation medicine is a component of occupational medicine, and the Royal College of Physicians accepts the D Av Med as evidence of formal education in that branch of medicine.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3983496 TI - International workshop of UOEH on environmental influences on water balance: basic physiology of neurohypophysial control. September 12, 1984, University of Occupational and Environmental Health, Japan. Abstracts. PMID- 3983497 TI - [Ruptured aneurysms of the abdominal aorta]. PMID- 3983498 TI - [Intensive care of abdominal aortic aneurysms]. PMID- 3983499 TI - [Asthma and its pitfalls]. PMID- 3983500 TI - [Cytogenetics and hematology]. PMID- 3983501 TI - [Detection, clinical aspects and etiopathogenesis of abdominal aortic aneurysms]. PMID- 3983502 TI - [Elective interventions for aneurysms of the subrenal abdominal aorta: apropos of 229 cases]. PMID- 3983503 TI - [Current procedures in the therapy of urolithiasis: the end of conventional stone surgery?]. PMID- 3983504 TI - [Modification of intestinal parasitoses in refugees from South Asia by routine mebendazole administration]. PMID- 3983505 TI - [Leg edema]. PMID- 3983506 TI - [A case from practice (34) (myxoma). Female patients B.M., born 12-24-1918, housewife]. PMID- 3983507 TI - [How long should urinary tract infections be treated?]. PMID- 3983508 TI - [The effect of self-measurement of blood pressure on compliance in hypertensive patients]. PMID- 3983509 TI - [Practical aspects of inhalation therapy with aerosols]. PMID- 3983510 TI - [Delivery of newborn infants of less than 1500 g. at the Lausanne Maternity Hospital during 3 distinct periods: 1960-62; 1970-72; 1980-82]. PMID- 3983511 TI - [Emergencies in hand injuries]. PMID- 3983512 TI - [Psychosomatic syndromes in child psychiatry and therapeutic strategies]. PMID- 3983513 TI - [Anatomoclinical conference of the Department of Internal Medicine and the Institute of Pathology of the Vaud University Hospital Center, Lausanne. Pathological abdominal mass after double cancer]. PMID- 3983514 TI - [Child and adolescent psychiatry: a secret medical specialty?]. PMID- 3983516 TI - [Guillain-Barre syndrome in pregnancy]. AB - Three cases of Landry-Guillain-Barre syndrome in association with pregnancy are reported. In two, the polyradiculoneuritis occurred once. The third patient presented relapsing episodes during pregnancy and when taking oral contraceptives. The evolution of the disease in relation with pregnancy, labour and the possible effects on the foetus are examined. The relapsing polyradiculoneuritis provides a most appropriate case to investigate the relationship between hormonal and humoral modifications of pregnancy and the pathophysiology and etiology of polyradiculoneuritis. PMID- 3983515 TI - [Cerebral hemorrhage complicating early anticoagulant treatment of transient ischemic attacks]. AB - Two patients received intravenous heparin shortly after carotid transient ischemic attacks (TIAs), and developed a cerebral hemorrhage in the same area with 24 hours. CT scan performed before starting anticoagulation was normal, blood pressure was not too high when the hemorrhage developed, although the patients suffered (treated) chronic hypertension, and the Partial Thromboplastin Time did not exceed 90 seconds. No definitive explanation can be provided for this severe complication but recent studies suggest that in some TIAs, significant local ischemic changes may persist after the resolution of clinical symptoms. This risk, although very low, should be considered in cases with chronic arterial hypertension (even treated), because of disturbances of cerebrovascular regulation. In the near future, nuclear magnetic resonance scanning might allow detection of the cases with TIAs, in which focal metabolic alterations persist after disappearance of clinical symptoms. PMID- 3983517 TI - [Juvenile distal cerebral ischemia: value of pulp biopsy]. AB - Juvenile distal cerebral ischemia has been attributed to small artery atherosclerosis (Arnold, Benoit, Merlen, Dobbelaere, Delandsheer, 1979), based on clinicopathologic findings in one male patient and results of big toe pulp biopsy in three other cases. Pathological findings were obstruction of small artery lumens by hypertrophic endothelium and loose fibrocellular bands, their origin being the result possibly of partial intimalization of media by elastic neogenesis. Appearances were similar to those described by Dahl in human cerebral atherosclerosis in 1976, and approached those of the initial stages of experimental atheroma (Ross, Glomset, 1976). Arterial exiguity was also present in the 4 cases. Results of biologic, metabolic, inflammatory and immunologic examinations were negative. The present study concerns 4 additional cases of juvenile distal encephalic ischemia. One case in a female patient not on oral contraceptives confirmed the hypothesis of intimalization of media of arterioles of big toe pulp. Elastic neogenesis was present in the tunica media in areas where there was a change of direction of myocytes, and was apparent at a distance from the internal elastic layer. The latter was fragmented, sometimes doubles and of variable color. In another case, a woman taking oral contraceptives, there was almost total obstruction of the pulp arteriolar lumens with a very thin tunica media. Elastic neogenesis encircled two very narrow lumens in the center of the vessel and there were also elastic changes common to both.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3983518 TI - [Balo's concentric sclerosis: lesions restricted to the pons]. AB - A clinico-pathological case of Balo's concentric sclerosis is reported. Besides the rarity of the disease, this case was interesting because of the late onset of the illness (50 years) the normality of the CSF and the localization of the lesions which were restricted to the pons. PMID- 3983519 TI - [Multiple intracranial aneurysms associated with primary hyperaldosteronism]. AB - Multiple intracranial aneurysms have been reported in association with polycystic disease of the kidney, brain tumor, pituitary adenoma and coarctation of the aorta. We report the association of multiple aneurysms with primary hyperaldosteronism due to bilateral adrenal hyperplasia in an 18 year old left handed man who presented with subarachnoid hemorrhage and arterial hypertension. We report the excellent outcome of this patient in spite of a difficult and surgical management. Ligation of all three intracranial aneurysms was performed after an extra-intracranial arterial bypass was done as a protective measure. PMID- 3983520 TI - [Multifocal infarction of the basilar trunk region. Persistence of a trigeminal artery]. AB - A multifocal haemorrhagic infarction of the basilar artery territory, linked to the persistence of a trigeminal artery is reported. This was associated to hypoplasia of the basilar artery and of the posterior communicating arteries. The trigeminal artery supplied most of the distal part of the basilar territory. At post mortem there was no arterial occlusion and the infarction probably resulted from embolism from the heart or from the carotid artery. PMID- 3983521 TI - [Isolated ipsilateral lateropulsion caused by bulbar hematoma]. AB - A case of hematoma involving probably the reticular formation of the medulla oblongata is reported. Examination showed a soft palate paresis and an ipsilateral axial lateropulsion without vertigo or oculomotor disorders. The mechanism of the lateropulsion is discussed. During the spontaneous recovery a transient hydrocephalus was observed. PMID- 3983522 TI - [Hypoglycorrhachia and postpartum aseptic cerebral thrombophlebitis with meningeal hemorrhage]. AB - A 42-year-old woman had a puerperal aseptic cerebral thrombophlebitis with repeated episodes of subarachnoid hemorrhage. Cerebrospinal fluid studies revealed a delayed, severe and lasting low sugar and high protein levels. The possible mechanisms of low sugar levels are discussed. PMID- 3983523 TI - Frequency and characteristics of hyperbilirubinemia associated with bacteremia. AB - One hundred consecutive patients with blood cultures positive for microbial growth were prospectively surveyed for the presence of hepatic abnormalities and clinical evidence of infection. Complete data for 82 patients were available for analysis. Fifty-four percent had elevated bilirubin levels, and 34% had total bilirubin values of greater than or equal to 2.0 mg/dl. The levels of total bilirubin were disproportionately elevated compared with those of aspartate aminotransferase, alkaline phosphatase, and cholesterol. Nine of the 23 patients with elevated bilirubin levels had an increase in serum bilirubin one to nine days before their initial positive blood culture. Disproportionate elevations of direct and total serum bilirubin values compared with values for other liver function tests appear to be associated with bacteremia in adults more frequently than previously recognized and may have some predictive value in such patients. PMID- 3983524 TI - Selective primary health care: strategies for control of disease in the developing world. XVII. Hookworm infection and anemia. AB - Approximately one-quarter of the world's population is infected with either Ancylostoma duodenale or Necator americanus. Humans transmit the hookworm by fecal contamination of the soil. The eggs hatch and the larvae may survive several months in warm, damp soil. Humans are infected when the larvae penetrate the skin and migrate through the body to the intestines, where the median survival time of the hookworm is one year. The loss of red blood cells into the gut is proportional to the worm load. Symptoms result from iron deficiency anemia and protein loss caused by a heavy worm burden. The peak age-specific prevalence of infection occurs in adult life, but only a small proportion of those infected ever become symptomatic. Possible control measures include chemotherapy to reduce the intensity of infection and the transmission potential and sanitation. PMID- 3983525 TI - [Pregnancy in a patient with an isotopic pacemaker placed for surgical atrioventricular block following treatment of tetralogy of Fallot. Apropos of a case. Review of the literature]. AB - We report on a patient with an isotopic pacemaker who had a subsequent normal pregnancy. This device was implanted because of a surgically-induced atrioventricular block which occurred during an operation for tetralogy of Fallot. The pregnancy and postpartum course were normal and without complications. PMID- 3983526 TI - [Ovarian hyperstimulation: treatment of voluminous cysts by percelioscopic puncture]. AB - Enlarged fluid-filled cysts are a complication encountered with ovarian overstimulation. In order to hasten their resolution, and to avoid the possibility of adnexal torsion, we drained cysts greater than 4 cm in diameter by laparoscopic puncture. PMID- 3983527 TI - [Uncomplicated pregnancies following recovery from acute pregnancy-related hepatic steatosis]. AB - The authors report the case of a patient with acute yellow atrophy of the liver who subsequently had two uncomplicated pregnancies bringing the total number to 8 cases already published in the literature. After reviewing the diagnostic criteria, they discuss the risk of recurrence, considering the course of the illness, clinical, histological, and physiopathological features. The present risk of recurrence of AYAL must be considered to be very low. PMID- 3983528 TI - [9 years of systematic cytologic examinations of expressed galactophorous discharge. Detection of cancerous and precancerous conditions]. AB - Nine years of experience performing cytologic examinations on expressed breast discharge has enabled the identification of precancerous and cancerous conditions of the breast. Three thousand women were monitored. The only abnormal findings were cytologic (clinical and radiological examinations were normal). One case of atypical hyperplasia, 3 cases of cancer in situ, and 2 invasive cancers were identified upon histologic examination. Three women were lost to follow-up and subsequently developed invasive cancer. PMID- 3983529 TI - [The "white" cervix: a new anatomo-clinical entity?]. AB - The authors describe a very particular histologic pattern of the cervical epithelium. Many types of histologic lesions are involved and are almost always found in association one with another. This particular histologic pattern is characterized principally by well-differentiated epithelium, immature, with early necrosis of the superficial layers, associated with metaplastic endocervicitis. In addition to this particular association, there is a remarkable finding: this histologic pattern was found consistently in fifteen cases selected uniquely from their appearance at colposcopy. Could this be a new anatomic-histologic entity? PMID- 3983530 TI - [Improvement in feto-neonatal prognosis in twin pregnancies. Comparison of 2 series of 158 pregnancies before and after establishing a therapeutic protocol]. AB - We undertook certain measures in twin pregnancies: early screening during the second month of gestation with routine ultrasonography, cerclage of the cervix, cessation of work, with rest, hospitalization at 7 3/4 month's gestation for daily cardiotocographic monitoring, identical indications for cesarean section as for a single fetus. The outcome was clearly improved in 158 pregnancies when compared to an equal number of twin pregnancies from an earlier period. PMID- 3983531 TI - Peripheral blood mononuclear cells stimulate N-acetyl-beta-glucosaminidase levels of human synovial fibroblast-like cells. AB - Fibroblast-like synovial cells isolated from intact joints of non-arthritic human donors released up to nine-times higher activity of the lysosomal acid hydrolase N-acetyl-beta-glucosaminidase (NAG) than controls when incubated in conditioned medium from homologous peripheral blood mononuclear cells (MCCM). This increase occurred without decrease in cell numbers or other evidence of cytotoxicity. An increase in cell-associated NAG activity was also suggested, but this was not statistically significant. Indomethacin present during production of MCCM or added with MCCM to fibroblast cultures did not alter the response to MCCM, indicating that the effect of MCCM was not due to the presence of products from the cyclo-oxygenase pathway. At a concentration known to block protein synthesis in most cells (10(-5) M), cycloheximide markedly suppressed the NAG releasing response to MCCM. The secretion of NAG due to MCCM was not affected by all-trans retinoic acid (10(-6) M) but was suppressed by the corticosteroid, dexamethasone. PMID- 3983532 TI - The nonspecific clearance function of the reticuloendothelial system in patients with immune complex mediated diseases before and after therapeutic plasmapheresis. AB - The nonspecific clearance function of the reticuloendothelial system (RES) in six patients with immune complex mediated systemic vasculitis was determined by the evaluation of the disappearance rate of technetium 99m labelled microaggregated human serum albumin colloid (MHAC) injected IV before and after therapeutic plasma exchange. Three patients with systemic lupus erythematosus (SLE) and one patient with immune complex vasculitis (ICV) exhibited a significant clinical improvement after plasmapheresis which was paralleled by an accelerated MHAC elimination rate following plasma exchange therapy. One patient with ICV and unresponsive to plasma exchange showed delayed MHAC elimination. In one patient with myasthenia gravis (MG), the elimination rate was not altered by plasmapheresis. The data obtained indicate that nonspecific clearance of the RES may be one effect of plasma exchange therapy in patients with immune complex mediated diseases. PMID- 3983533 TI - Serum lipids and lipoproteins in patients with primary gout. AB - Serum lipid and lipoprotein values of 32 male patients suffering from gout were quantitated and compared with corresponding values of a random control group which did not differ significantly with regard to age, body weight index and socio-economic status. All patients were on therapy with allopurinol which lasted on average for 6 years. The most striking differences between patients and controls were the increased triglyceride and apo B values and the decreased HDL cholesterol (HDL-C) and HDL-phospholipid (HDL-PL) values in the patient group. The values of total cholesterol, LDL-cholesterol, apo A-I and Lp (a) were not significantly different between patients and controls. The great differences in the ratios of apo B/LDL-C, apo A-I/HDL-C and apo A-I/HDL-PL values suggest that gout is connected with changes in the chemical composition of the major lipoprotein classes. In three normolipemic individuals who were treated for 3 weeks with allopurinol no changes in lipoproteins and apolipoproteins were apparent. The results are discussed in view of the atherosclerosis risk of patients suffering from gout. PMID- 3983535 TI - Coexistence of severe palmo-plantar Dupuytren's contracture, Raynaud's phenomenon and digital joint erosions. PMID- 3983536 TI - [Experiences with the nonionic contrast medium iopamidol in cerebral angiography]. AB - The rate of cerebral angiographies is bound to diminish in the present era of new imaging methods of low invasiveness. However, this examination method will continue to be an often decisive method to effect diagnostic visualisation of the cerebral vessels, so that the introduction of contrast media with low toxicity and good tolerance represents a great step forward, the more so since the risk of general anaesthesia can be often avoided. This fact, together with the substantial improvement in catheter technique, raises the method--provided it is conducted in special well-equipped departments--to a level of high diagnostic value, complications having become extremely rare if not completely eliminated. PMID- 3983534 TI - Amyloid deposits in human knee and hip joints. AB - A systematic search for articular amyloidosis was carried out on both knees of 53 autopsy cases and on 26 femoral heads resected during surgery for hip prosthesis. Typical amyloid deposits exhibiting green apple birefringence following Congo red staining and thioflavin T fluorescence were found in 58.5% and 29% of the cases, in the knee and hip joint respectively. They occurred more frequently in articular cartilage than in the synovium, and in elderly subjects more than young ones. In the knee joint, the osteoarthritic changes and to a minor extent synovial inflammation appear to be positively correlated for the presence of intraarticular amyloid deposits. Such a correlation was not observed for the presence of calcium pyrophosphate dihydrate crystal deposits. PMID- 3983537 TI - [Modification of the quality of the roentgen image by screen and film- experimental studies]. PMID- 3983538 TI - [Bile leakage, bile ascites and bilioma--nuclear medicine diagnosis- demonstration of typical cholescintigraphic findings]. AB - Cholescintigraphy (hepatobiliary sequential scintigraphy) with 99m Tc-marked IDA derivatives results in a specific identification of bile in free intraperitoneal fluids (bile ascites) or encapsulated intraperitoneal fluids (bilioma). To detect or exclude a biliary leak, cholescintigraphy was performed in 42 patients. In contrast to sonography and CT ("anatomical imaging"), which are capable of detecting an intraperitoneal accumulation of fluid with high sensitivity, cholescintigraphy ("functional imaging"), alone can help to identify the presence of bile in such fluids, both specifically and on a non-invasive basis. Modern gamma cameras are of such high sensitivity that they can identify even the most minute of activity (bile) quantities with satisfactory anatomic allocation. PMID- 3983539 TI - [Nutritional requirements and recommended intakes for normal children (excluding newborn infants)]. PMID- 3983540 TI - [Vitamin deficiencies in pediatrics]. PMID- 3983541 TI - [Breast or bottle feeding?]. PMID- 3983542 TI - [Acute diarrhea in infants and children: diet and return to normal food]. PMID- 3983543 TI - [Child nutrition and school canteens]. PMID- 3983544 TI - [Elementary symptomatology and methods of studying injuries observed in sports pathology]. PMID- 3983545 TI - [Traumatic pathology of cyclists]. PMID- 3983546 TI - [Prevention, diagnosis and treatment of osteoarticular and musculotendinous complications related to the practice of football and rugby]. PMID- 3983547 TI - [Prevention, diagnosis and treatment of osteoarticular and musculotendinous complications related to the practice of running]. PMID- 3983548 TI - [Injuries in skiing]. PMID- 3983549 TI - [Prevention, diagnosis and treatment of osteoarticular and musculotendinous complications related to the practice of tennis]. PMID- 3983550 TI - [The therapeutic arsenal in the medical treatment of gastroduodenal ulcer disease]. PMID- 3983551 TI - [Therapeutic strategy in gastroduodenal ulcer disease (excluding complications)]. PMID- 3983552 TI - [Which ulcer patients should be surgically treated?]. PMID- 3983553 TI - [Endoscopy: for whom and when?]. PMID- 3983554 TI - [Psychiatry: why, how?]. PMID- 3983555 TI - Clinical psychological and electrographic evolution during pre- and puberal period in children with slight neurological and electroencephalographic alterations. PMID- 3983556 TI - Nervous reactivity changes in patients with epileptogenic cerebral tumours (II). PMID- 3983557 TI - Auditory-evoked potentials during biofeedback training of sensorimotor rhythms. PMID- 3983558 TI - [Cutaneous fistula from a popliteal cyst in a female patient with rheumatoid arthritis]. PMID- 3983559 TI - [Bone manifestations in systemic amyloidosis. Apropos of a case]. PMID- 3983560 TI - [Myopathy during treatment with cimetidine]. PMID- 3983561 TI - [Treatment of rhizomelic pseudopolyarthritis with cyclosporin A. Preliminary result]. PMID- 3983562 TI - [Systemic lupus erythematosus. A new look]. AB - The systemic lupus erythematosus is a chronic inflammatory condition in which many abnormalities of the immune system have been described. Recent work has shown a subset of antiphospholipid antibodies which are apparently independent of the classical antinuclear antibodies. Their association with the false positive VDRL and the lupus "anticoagulant" is statistically significant. Clinically, these antibodies are associated with thrombosis, thrombocytopenia, thrombotic and demyelinating neurological features. PMID- 3983563 TI - [Lesions of the rotator cuff of the shoulder. Surgical treatment. Apropos of 100 surgically treated cases]. AB - After reviewing 98 cases with an average follow-up period of one to nine years, the authors describe the surgical indications for simple reinsertion of the supraspinatus muscle, reinsertion with muscle belly transfer, acromioplasty, and simple removal of intratendinous calcifications. The painful shoulder without tendinous tears confirmed by arthrography and with anterior involvement is easily improved by resecting the acromiocoracoid ligament, the anterior border and the inferior portion of the acromion. This anterior release can be associated with a curettage of calcifications if present. Tears of the supraspinatus can be reinserted on the greater trochanter without muscles transfer in 90% of cases. Satisfactory pain relief and function return while only very extensive tears with significant muscle retraction may require transfer of the muscle belly. Surgical repair of the rheumatologic should however, is performed rarely, and should be reserved for the infrequent cases that do not respond to medical therapy. PMID- 3983564 TI - [Value of the femorotibial angle in 244 patients without knee arthrosis]. AB - Measurement of the femorotibial angle was performed in 244 patients (134 women and 110 men) without knee arthrosis with roentgenograms taken in the upright position. The values were grouped according to sex and to decade of life. The average value was approximately 0. As defined by the average upper and lower values of the two types of angulation, the normal value in women was 4 degrees of varus and 4 degrees of valgus. In men, the normal value of the right leg was 5 degrees of varus and 5 degrees of valgus; the left leg demonstrated up to 6 degrees of varus and 5 degrees of valgus. After sixty years of age, 5 percent of patients had angulation above these normal values in valgus and varus. PMID- 3983566 TI - [The environment and health in a socialist society. 12th Faculty seminar of the School of General Medicine of Charles University in Prague. 10-11 October 1984. Abstracts]. PMID- 3983565 TI - [Psychological aspects of rheumatoid arthritis. Attempt at a better understanding of the problem]. AB - This study is an attempt to identify the principle causes of stress in patients affected with rheumatoid arthritis. It is based on personal experience with 62 patients treated in a multidisciplinary manner over a time period of two years. The psychological impact of these stress factors on the patients were evaluated in an effort to further the treatment methodologies in this area. Among the factors considered are: the disease as a chronic process and as a result the progressive destruction of bodily function, the limitations produced by a disease of the joints, the presence of pain and the side effects produced by the medications. As a step to lessen the mental distress caused by RA, it is proposed that the physician team should seek to inform the patient in a clear and concise manner about RA to establish a working doctor-patient line of communication, and to encourage activities that promote the maintenance of patient self esteem. PMID- 3983567 TI - The thought behind the words: a view of schizophrenic speech and thinking disorders. AB - Chaika (1982) has proposed that what is frequently viewed as a schizophrenic thought disorder should more precisely be regarded as a speech disorder. We suggest, however, that one should emphasize constructs concerning disordered schizophrenic thinking. We support this position since the schizophrenic's strange speech can fit into a larger view about his disordered thinking which is grounded in a nomological net involving various different types of strange behavior. Other support comes from (1) the use of tests assessing disordered nonverbal behavior, (2) evidence that schizophrenics intermingle personal concerns (ideas) into their verbalizations, (3) bizarre schizophrenic behavior, and (4) the very large percent of schizophrenics with delusions. There is an intricate link between language--which includes a system of symbols, words, and meanings--and thinking. Thus, we have proposed that the disturbance most frequently observed in schizophrenic verbalizations be viewed as involving conceptual-linguistic activity, and not just a problem of speech activity. PMID- 3983568 TI - Relationships among neurological functioning, intelligence quotients, and physical anomalies. AB - The relationships among IQ, neurological signs, and minor physical anomalies--all measures of central nervous system status--were assessed in the index and control children of the study. The strongest correlation was found between neurological functioning and IQ; the relationship between anomalies and neurological functioning was less strong; and no relationship was found between anomalies and IQ. Consistently, the most poorly functioning children tended to be offspring of schizophrenic patients (index cases), although the same children did not always perform poorly on all tests. What emerges is a set of clusters of individuals with varying combinations of functional/developmental problems. PMID- 3983569 TI - Clinical observation of high-risk children. AB - Systematic observations of the behavior of high-risk and control children were made during the clinical interview, the neurological examination, psychometric testing, and the experimental psychological test battery. Children were unaware that observations of them were being made and recorded. In all four examination settings, index children were seen as impaired relative to control children in their communication skills, ability to relate to the examiners, and motor behavior. There were no consistent differences between town and kibbutz subjects, and no interactions with genetic background. However, index boys showed a general trend toward greater pathology than index girls. PMID- 3983570 TI - The family interview. AB - Families of study children were interviewed, with a focus on parents' observations of the personality and behavior of their offspring. The family interview was also the primary source of information about the home environment and possible psychopathology in nonschizophrenic parents. By parental report, index children were more likely than controls to have developed psychopathological symptoms related to mood, social withdrawal, antisocial behavior, eating, and obsessive-compulsive behavior. Traits of self-esteem, adaptability, reliability, and degree of task orientation were more poorly developed in index than control subjects. Index subjects also tended to have poorer relationships with both peers and family members. While boys and girls showed similar patterns of psychopathology, boys tended to have somewhat higher levels of impairment. No differences or interactions due to type of rearing were found. PMID- 3983571 TI - The teacher interview. AB - The teachers and caretakers (on kibbutzim) of the index and control children were questioned about a variety of behaviors, including emotional adjustment, school performance and achievement, interests and activities, and relations with others. Index children were rated as more impaired or disturbed than control subjects in the following areas: schoolwork, mood, suspiciousness, daydreaming, antisocial behavior, hypochondriasis, and accident proneness. No differences were seen in anxiety, aggression, phobias, obsessive-compulsive behavior, eating and sleep disturbances, shame, and frustration tolerance. There were few differences between assessments of index and control children on kibbutzim and towns. Male index subjects tended to be seen as especially poorly adjusted. PMID- 3983572 TI - Clinical-subjective evaluation of high-risk children: integration and discussion. AB - Clinical evaluations of index and control children from the point of view of the clinical interview, observations of the subjects during testing, the subjects' parents, and their teachers were compared. There was general agreement that index children showed more psychopathological symptoms, poorer ego development, poorer interpersonal relations, and poorer use of leisure time than their controls. By contrast, behaviors related to aggression, phobias, shame, sleep pathology, eating disorders, frustration tolerance, sexual behavior, and verbal communication skills failed to show consistent group differences. Index boys showed greater anxiety than their controls, while there were no such differences among the girls. Rearing environment exerted no apparent effect on the psychosocial functioning of the children. Factor analysis disclosed that a general factor, accounting for 32.6 percent of the variance, discriminated between index and control children, while several special factors, which represented rarely seen traits, did not discriminate. Group differences, therefore, appeared to stem from global impairment of psychosocial functioning rather than from several distinct patterns of deficit. The present results are in general agreement with previously reported evaluations of children at risk for schizophrenia. PMID- 3983573 TI - A narrative account of contacts with two study subjects. AB - The following document includes an account of the visits to Oranim (and some related materials) of two of the subjects of this investigation. A. (No. 19) is a kibbutz-index case whose father was diagnosed as schizophrenic; H. (No. 81) was a town-index case whose mother had that diagnosis. Each of these parents had had one period of hospitalization. In both cases the observations extend over a period of 7-8 years, and attest to the warm, close contact between the subjects and the staff of the study. The rapport built up between subjects and staff is unusual, and it facilitated the high followup rates: 93 of the original cohort were seen in the 1973 followup and 90 of the surviving 99 in the 1981 followup. The observations are presented virtually unedited so as to convey the richness of the interaction and the special contact between Mrs. Loni Bonwitt, the project secretary, and the subjects. In the 1981 followup, A. (No. 19), the kibbutz-index case, received a DSM-III diagnosis of neurotic depression; H. (No. 81), the town index case, received no diagnosis. PMID- 3983574 TI - The NIMH-Israeli schizophrenia project: the history of a high-risk study. AB - We have reviewed some of the difficulties encountered in bringing this study to completion. Among our special problems were the necessity of collecting large numbers of measures on a relatively small study population, the need to recruit and maintain a staff over long periods of time, the wide geographical separation between staff members responsible for design and those responsible for execution of the study, and the difficulties of conducting longitudinal research in a politically unstable part of the world. Centralization of data and data analysis proved a crucial step in bringing the study to its present level of completion. PMID- 3983575 TI - Adult outcomes of high-risk children: differential effects of town and kibbutz rearing. AB - We conducted a followup study 15 years after the initial examination of 46 of the Israeli children at risk for schizophrenia (index cases) and 44 of the control children. Thus, we were able to contact and examine 90 of the surviving 99 subjects of the investigation. Half of the subjects had grown up in the communal child-rearing setting of a kibbutz, and half had been raised by their own parents in cities in Israel. The kibbutz-index cases, at average age 25, show the highest incidence of psychiatric disorder. Environmental factors that may have led to this outcome are discussed. PMID- 3983576 TI - First person account: making the best of it. PMID- 3983577 TI - Omission in review of treatment interactions. PMID- 3983578 TI - Overall design and methodology of the Israeli high-risk study. AB - The unique contribution of the Israeli high-risk study is the comparison of children at risk for schizophrenia with matched controls in two settings: those raised in nuclear families in towns, and those raised in children's houses on kibbutzim. Such a design makes possible direct comparison of genetic and environmental effects on the psychosocial functioning of a group of high-risk children, over time. In this article we describe methods of collecting and examining the sample, provide an overview of the examination procedures, and describe the basic principles of data analysis. PMID- 3983579 TI - The clinical interview. AB - Subjects were given in-depth interviews aimed at assessing their level of functioning within their families, with peers, at school, and in leisure activities. Subjects were interviewed when the mean age of the study population was 11 and again at mean age 16. At the time of the first interview, index subjects were impaired relative to controls in interpersonal relations, work and play activities, self-esteem, and mood. There were no apparent differences due to rearing environment or sex, and no interactions with genetic background. At the time of the second interview, index-control differences were even more widespread, with index children showing impairment in virtually all examined areas of psychosocial function. Again, there were no group differences or interactions involving environment or sex. While index and control subjects remained highly discriminable from preadolescent to adolescent periods, there was less evidence of symptom stability in individual subjects over the 5-year period. PMID- 3983580 TI - Personality and neuropsychological performance of high-risk children. AB - The present article reports findings on intelligence and personality functioning during the school period and at adolescence in a sample of kibbutz and urban Israeli children at risk for schizophrenia, as measured by a standard psychological test battery. On the first round of testing it was found that the index subjects, when compared with their controls, showed a significantly lower level in arithmetic proficiency, perceptual-motor functioning, and several specific verbal and thought patterns. These findings suggest an overall pattern of attentional dysfunctioning and a basic distortion in cognitive integration. Followup data did not show intergroup differences in perceptual-motor functioning, but did indicate a consistent picture of a significantly lower overall intelligence level and several indices of clear personality problems. No consistent sex or kibbutz-city differences were found. Findings are interpreted in the framework of a developmental model of vulnerability in subjects at risk for schizophrenia. PMID- 3983581 TI - Psychophysiological reactivity in high-risk children. AB - This study was designed to test and extend previous reports of differences in autonomic responsivity between offspring of schizophrenic patients and control subjects. In specific, greater galvanic skin response (GSR) to stimuli and quicker GSR recovery have been reported in high-risk children. In the present study we found no evidence of autonomic hyperactivity, as evidenced by GSR to tones, in high-risk as compared to control subjects. There was some trend for index subjects to show slower GSR recoveries than control subjects, which is opposite to findings from earlier studies. Subjects were also presented with the Information Detection Test, in which GSR responses to emotionally meaningful vs. neutral stimuli were compared. Index children were less reactive than control subjects to the meaningful stimuli, and they discriminated between meaningful and neutral stimuli more poorly. Our findings do not confirm the learning theory of schizophrenia suggested by Mednick, but do suggest that developmental lags in high-risk as compared to control children may contribute to the psychophysiological differences that we found. PMID- 3983582 TI - Perceptual-motor and memory performance of high-risk children. AB - Subjects were examined with a battery of protocols based on principles of experimental psychology and designed to measure motor control, perceptual-motor coordination, attention, learning, and memory. Differences between index and control subjects were found on the mirror-drawing protocol, reflecting visual motor coordination, and the distractibility protocol, in which subjects divided their attention between verbal and visual stimuli. There were no differences in subjects due to conditions of rearing, and no interactions. Differences between index and control children were subtle, and tended not to appear on simpler tasks. The stage of processing leading to poor performance by the index children awaits further study for elucidation. PMID- 3983583 TI - Neurological findings in high-risk children: childhood assessment and 5-year followup. AB - The results of the two neurological examinations of the Israeli children, both original and followup, are presented. The multidimensional scalogram analysis technique was used to identify children with multiple areas of neurological dysfunction. These children consisted almost exclusively of the offspring of schizophrenic patients: 22 of the 50 index cases were in this region of poor functioning during at least one of the testing periods, as compared with only 3 of the 50 control cases. The most common neurological signs were "soft" perceptual-sensory signs, poor motor coordination, poor right-left orientation, poor balance, and motor overflow. No "hard" neurological differences were found between the groups. This is the first major report of long-term stability of neurological soft signs in the offspring of schizophrenic persons. PMID- 3983584 TI - [Hypercalcemia in non-Hodgkin lymphoma]. AB - In a retrospective study, hypercalcemia was found on one or more occasions in 14 of 156 patients with newly detected, still active or relapsing non-Hodgkin's lymphoma (NHL). The incidence of hypercalcemia correlated with the histological grade of malignancy: patients with high grade NHL had a hypercalcemia incidence of 23%. Half of the patients had hypercalcemia-related symptoms, and 4 of 14 had hypercalcemia-induced renal impairment. The occurrence or recurrence of hypercalcemia correlated with progression of NHL. Remission-inducing chemotherapy and symptomatic treatment of hypercalcemia corrected the serum calcium. PMID- 3983586 TI - [Hereditary antithrombin III deficiency as a cause of an increased tendency to thrombosis. Case report]. AB - A family with antithrombin III (AT III) deficiency is described. Four brothers or seven siblings show markedly reduced AT III levels (functional assay 39-47%, immunoassay 54-58%). Three developed thromboses and pulmonary embolism at the ages of 11, 17 and 20 years respectively. Longterm oral anticoagulation therapy has been instituted in all four brothers. PMID- 3983585 TI - [Oxygen home therapy in chronic respiratory insufficiency. Report of experience with 70 patients]. AB - The effect of home long-term oxygen therapy has been evaluated in 70 patients (52 men and 18 women) with chronic respiratory insufficiency due to chronic obstructive pulmonary disease. The mean duration of the observation period was 17.5 months, lasting at least 6 months and in a few cases over 40 months. The cumulative death rate was 22.6% in the first 12 months, 36.5% after two years and 40.7% in the third year. Compared to a previous period of 19.5 months there was an obvious reversal in hypoxemia, an increase in physical capacity and a reduction in the hospitalization rate. Patients with marked respiratory failure and with the clinical features of the "blue bloater" type of chronic bronchitis responded better to the home oxygen therapy than a group of "advanced pink puffers" with hypercapnia and high pulmonary arterial pressure. The present results do however confirm the beneficial effects of long-term domiciliary oxygen administration, and should encourage critical use of this new therapeutic regimen according to the indications so far recommended. PMID- 3983587 TI - [The celery-carrot-mugwort-condiment syndrome: skin test and RAST results]. AB - Celery is a frequent food allergen: not only raw, but also cooked and as a spice it can produce various reactions of immediate type, from oral contact urticaria to anaphylactic shock. Most celery-allergic patients suffer from hay fever and show a skin sensitization to mugwort. An associated allergy to several spices is quite common, and therefore the term "celery-mugwort-spice-syndrome" has been proposed. The authors have investigated 35 patients, 85% of them women, in whom a current celery allergy of varying severity was diagnosed during the first 8 months of 1984. A positive skin test to celery was seen in 16 patients who denied any symptoms from it. Thorough skin testing and RAST screening with different celery preparations, other foodstuffs and mugwort-pollens were performed on all patients. The modified prick test with native celery-root proved to be the best method for detecting celery sensitization, showing a positive result in 88.6%. The scratch test with celery-salt was positive in 70.5%, intracutaneous testing with commercial extract in 63.5% and the RAST with celery-sticks in 66% of the patients. Sensitization to mugwort was absent in 8 patients only. The mugwort sensitive group frequently showed a positive test to ragweed-pollens, a common plant in North America, and this appears to indicate cross-reactivity amongst the family of the Asteraceae. Cross-reactivity amongst the Apiaceae is the cause of the many positive results obtained with carrot, parsely, anise, fennel and caraway, the carrot allergy being of clinical importance in 50% of cases, including one with a history of anaphylactic shock after ingestion of raw carrots.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3983588 TI - [Benefits of routine automatic blood picture differentiation]. AB - The benefits of automated blood smear differential cell counting as a supplementary laboratory examination have been studied. The investigations focussed on patients of whom hematology requisitions were limited to total leukocyte count and hemoglobin determination. The specimens were derived from patients of departments of surgery and obstetrics and gynecology. For specimen collection the vacutainer system was used. The blood smears were prepared in a Coulter Electronics slide spinner, stained with a Hematek II slide stainer and analyzed in the Coulter Electronics Diff 3-50 cell classifier. A total of 1700 blood smears were examined. Following processing of each sample, the classification of each cell was inspected. Corrections were performed, if necessary, and the number of classification changes performed for each smear was registered. Using the in-house normal ranges, 34.5% were pathological smears. Since this group included a large number of borderline cases, new discrimination limits for clinically relevant pathological findings were set empirically. According to these wider ranges, the fraction of pathological slides amounted to 15.2%. Among these, immature granulocytes, eosinophilia and lymphopenia were the most frequent pathological findings. Microscopic control proved in 57.6% of the total number of smears. This complemental procedure was not found to be time consuming. PMID- 3983589 TI - [Invasive pulmonary aspergillosis--a diagnostic and therapeutic problem in patients with severe aplastic anemia]. AB - Three young patients with severe aplastic anemia undergoing intensive immunosuppressive therapy developed fever and pulmonary infiltrates during longlasting severe granulocytopenia, despite multiple broad spectrum antibiotic combinations and granulocyte transfusions. Invasive pulmonary aspergillosis was diagnosed only by thoracotomy. In conjunction with high dose amphotericin-B therapy complete resolution of aspergillosis was achieved in two cases, paralleled by slow recovery of bone marrow function, whereas in the third case only a partial remission was possible together with transient amelioration of granulopoiesis. We suggest early aggressive surgical methods to establish the diagnosis of aspergillosis in these severely menaced patients, so that antifungal therapy with high dose amphotericin-B can be initiated at an early stage. PMID- 3983591 TI - [Nutrition and cancer]. PMID- 3983590 TI - [The course of pregnancy in a representative Swiss sample (Aarau Pregnancy and Newborn Infant Study). II. Stimulants in pregnancy]. AB - Within the framework of a study on the course of pregnancy, a cohort of 996 Swiss mothers was interviewed upon admission for delivery at Aarau Maternity Hospital regarding nicotine, alcohol, caffeine and narcotics consumption. The data are presented and compared with analogous data on the entire female population of the same age group in Switzerland and with epidemiologic reviews of pregnancy events from other countries. The relationship between these data and effects on the newborn is also discussed. This group of mothers aged 20-40 years had, even prior to pregnancy, below-average alcohol and nicotine consumption. During pregnancy nicotine use in the last trimester, though reduced, was still admitted by 18% of the gravidae despite the fact that about 3/4 of the mothers were well informed about detrimental effects on the offspring. Nicotine use by the mother had several somatic effects on the newborn, in contrast to consumption of caffeine and small amounts of alcohol. The behavioral assessment was altered by previous use of nicotine and caffeine. PMID- 3983592 TI - [Quality of life following heart valve prosthesis]. AB - The subjective and objective health status of 69 patients with a mean age of 58 +/- 9 years was evaluated 2-4 years after replacement of the aortic or mitral valve. All findings were compared to the preoperative status. Subjectively, 80% of all patients felt a considerable improvement following surgery and the mean NYHA functional class dropped postoperatively from 2.68 +/- 0.63 to 1.32 +/- 0.53 (p less than 0.001). 66% of all patients felt better mentally as well. However, 64% of all patients indicated that their intellectual capacity had decreased postoperatively. Objectively the signs of congestive heart failure had decreased significantly (edema -50%, rales -83%, neck vein distention -87%). Cardiomegaly and redistribution had improved in 77% and 80% of all patients, and left ventricular hypertrophy on ECG had disappeared in 46% of all cases. Despite this important subjective and objective improvement, there was little change in the degree of postoperative employment. Thus, valve surgery leads to a dramatic subjective and objective improvement of cardiac performance and quality of life. However, the improvement has little influence on postoperative resumption of work. Results of this study also suggest that cardiac surgery has a negative effect on intellectual capacity. PMID- 3983594 TI - [Does dipyridamole (Persantin) have antithrombotic action?]. PMID- 3983593 TI - [Continuous arteriovenous hemofiltration for the treatment of acute kidney failure]. AB - Continuous arterio-venous haemofiltration (CAVH), a simple technique not employing pumps, was used for treatment of acute renal failure in 25 intensive care patients (mean age 52 +/- 16 [SD] years). Acute renal failure was due to trauma in 9 patients, occurred after surgery in 7 patients and was related to septicaemia in 5 patients, peritonitis in 2 patients and pancreatitis in one patient; in one patient acute renal failure developed during pregnancy after preexisting renal disease. Seventeen patients were oliguric and 8 patients were non-oliguric, with a mean daily urine output of 507 +/- 407 ml. At the start of CAVH the serum creatinine level was 511 +/- 198 mumol/l. The duration of treatment with CAVH was 1 to 36 days (average 9.3 days). Access to the circulation was by cannulation of the femoral artery and vein in 23 patients and by Scribner shunt in 2 patients. After an initial systemic dose of 2000 IU heparin, a continuous infusion of 250-1000 IU/hr into the arterial blood line was administered, adjusted to a partial thrombin time of 58 +/- 28 sec. With this heparin regimen a single haemofilter could be used for an average time of 2.6 +/- 1.2 days. The mean spontaneous filtration rate was 6 +/- 2 ml/min, resulting in the following serum levels: creatinine 490 +/- 187 mumol/l; urea 39 +/- 12.5 mmol/l; potassium 4.5 +/- 0.5 mmol/l. Nine catheter-associated complications occurred in 5 patients. The most important aspect of CAVH was its simplicity, optimal control of fluid balance and the possibility of unlimited parenteral nutrition. Uremia was adequately and continuously controlled. Prognosis of ARF was related to the patients' underlying illness. PMID- 3983595 TI - [Transluminal removal of intravascular foreign bodies]. AB - Removal of catheter tip or guide wire emboli is needed for most cases with this complication. An alternative to surgery is transvenous retrieval. The authors present their experience with a simple self-made loop-catheter, which in 11 of 12 cases proved successful for extraction of 9 catheter tips and 3 guide wires located in the central venous system, the right ventricle and the pulmonary artery in 10 patients, and in the aorta in 2. No further complications were caused by this procedure. Due to the serious hazards of embolized foreign bodies there is a need to remove them, and the authors believe that the transluminal route, preferably with the loop catheter, should be the primary approach to this iatrogenic complication. PMID- 3983596 TI - [Prevalence of infectious diseases at the Vaud University Hospital Center]. AB - The prevalence of infectious diseases at our hospital (Centre hospitalier universitaire vaudois, Lausanne [CHUV], 900 beds) was studied retrospectively over a two years period (1980-1981). The medical diagnosis of 30203 patients recorded in the computerized medical archives, representing 93% of the patients admitted during the period of observation, was reviewed. To assess the reliability of the computerized data, quality control was carried out through detailed analysis of all the histologically proven appendicitis recorded during 1981. 88% of the histologically proven appendicitis were registered in the computer and the diagnosis was specific in 87% of cases. An infectious disease was the primary reason for admission in 12.8% of the patients (3873) during the study period. Altogether, 20.2% of patients presented with an infection during their hospital stay. Because of the retrospective nature of the study it was not possible to determine whether these additional infections were nosocomially acquired. The organ systems most frequently infected were the respiratory tract (28.5% of all infections), the digestive tract (20.5%), the skin and osteoarticular system (16%) and the urogenital tract (11.6%). An infection was the primary reason for admission of 40.2% of the patients hospitalized in the dermatology service, of 19.7% of patients admitted in internal medicine, of 15 17% of the patients admitted in pediatrics, ENT and general surgery, and of 1-2% of the patients admitted in neurosurgery and radiotherapy. These observations highlight the continuing importance of infectious diseases in a modern hospital, in spite of high socio-economic levels, stringent hygiene and epidemiologic measures, and modern antibiotic availability. PMID- 3983597 TI - [Pulmonary hypertension and chronic obstructive ventilatory disorders- correlation between hemodynamic parameters and pulmonary function]. AB - We evaluated 74 patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease and compared pulmonary function tests as well as capillary blood gas values with pulmonary hemodynamic parameters. Thirty-four patients demonstrated pulmonary hypertension only at exercise, fourty patients had pulmonary hypertension at rest (mean pulmonary artery pressure greater than 20 mm Hg). There was a significant correlation between capillary oxygen tension and mean pulmonary artery pressure as well as pulmonary vascular resistance, both at rest and during exercise. The relation between capillary PCO2 and pulmonary hemodynamics were statistically less significant. The correlation between criteria of pulmonary obstruction and/or increased lung volumes and mean pulmonary artery pressure and pulmonary vascular resistance were not as significant. The 34 patients with pulmonary hypertension only at exercise differed significantly from the other groups of patients with pulmonary hypertension at rest as seen in all pulmonary function parameters. Furthermore there was also a difference in the capillary oxygen tension during exercise, but not in the capillary carbon dioxide tension. In conclusion, of all pulmonary function tests the most efficient criteria for pulmonary hypertension are reduced FEV1/VC and low oxygen tension at rest respectively a fall during exercise. PMID- 3983598 TI - [Effect of an enema on the macroscopic and microscopic appearance of the rectal mucosa]. AB - In flexible fiberoptic sigmoidoscopy the application of an enema is mandatory. By contrast, rigid sigmoidoscopy can be performed without preparation. In 16 patients we tested the influence of a hypertonic enema on the macroscopic and microscopic appearance of the rectal mucosa. As a first step in the unprepared patient the mucosa was assessed and a rectal biopsy obtained. After enema this procedure was repeated. Development of mucosal edema was observed, although the histopathologist was not always able to decide whether or not the biopsy was taken before or after the enema. Histological assessment of edema requires histometric measurements which cannot be obtained from biopsy specimens. A knowledge of these changes is particularly important in assessment of inflammatory bowel disease, where edema of the unprepared mucosa means slight proctitis, and we recommend that the histopathologist be informed if enemas are used for bowel preparation. PMID- 3983599 TI - [Acute myocardial dysfunction in meningococcal septicemia]. AB - A progressive myocardial dysfunction is known to occur in prolonged septic shock. The cases of two patients with acute meningococcal infection and Waterhouse Friderichsen syndrome are reported. Hemodynamic measurements showed, in the early stage, the classical picture of hyperdynamic septic shock, with increased cardiac output and low systemic vascular resistances. However, rapidly progressive cardiac failure then occurred, with high filling pressures and low cardiac output. One patient went into irreversible shock. In the other the administration of inotropic agents was beneficial, with a slow but progressive improvement in left ventricular function over several weeks. Acute myocarditis has been frequently observed in patients with meningococcal infections. It is suggested that the acute myocardial failure observed in those circumstances is caused by the myocarditis. PMID- 3983600 TI - [Clinical significance of antimitochondrial antibodies]. AB - Clinical, histological and serological data of 72 patients with antimitochondrial antibodies (AMA) were analyzed. 56 (78%) of the patients exhibited chronic cholestatic hepatopathy; in 30 of these primary biliary cirrhosis (PBC) was diagnosed and in 26 "possible PBC". The remaining 16 patients were subsumed in an "other illness' group. A collagen or autoimmune disease was found in 8 patients of the chronic cholestatic hepatopathy group and in 3 of the "other illness" group. Histological findings were diagnostic for PBC or cirrhotic liver in 90% of the patients with clinical signs, while 64% of the symptomfree patients had unspecific histological liver alterations. In general, increasing serum IgM, alkaline phosphatase, gamma-GT and symptoms paralleled increasing AMA titers, although asymptomatic patients with high AMA titers were also seen. The prevalence of hepatopathies rose with increasing AMA titers, but otherwise no association of AMA titers and diagnosis was observed. Therefore, a positive AMA test bears out suspicion of hepatopathy, but cannot be regarded as specific for PBC when other liver signs are absent. PMID- 3983601 TI - [Critical remarks on computer tomography of the chest in the staging of bronchial cancer]. AB - The planning of treatment in patients with non-oat cell carcinoma of the lung requires an extensive diagnostic work-up. As far as TN-staging is concerned, the role of CT is controversial. On the basis of 25 operated and histologically proven cases of non-oat cell cancer of the lung, the results of both CT and conventional radiography are critically evaluated. In the present study CT is found to be more sensitive but not more specific than conventional radiography in detecting pleural invasion and regional, especially mediastinal, lymphnode metastases. These results are in accordance with those of others. Since both modalities follow the same diagnostic criteria (lymphnode size, contact to pleura), an increase in sensitivity is intimately related to a corresponding loss of specificity. The relatively high sensitivity of CT on the one hand, and the relatively high specificity of conventional radiography on the other hand, suggest the following procedure: if conventional radiography is definitely positive, additional CT can be omitted. If CT proves negative as well, the presence of mediastinal metastases or pleural invasion is very unlikely. Positive findings on CT, however, need histologic verification. PMID- 3983602 TI - [Sick sinus syndrome--clinical presentation, diagnostic and therapeutic measures in an ambulatory patient sample]. AB - Incidence, clinical picture, ECG features, as well as chosen diagnostic and therapeutic measures were investigated in patients attending the Basel University Medical Outpatients Department with the diagnosis of sick sinus syndrome. A retrospective study was conducted by selecting patients' charts with this diagnosis during the period 1979-1983. Forty-four patients (17 women, 27 men, mean age 64.5 +/- 14.5 years) were "discovered" and divided into three groups: Group 1: asymptomatic patients with pathological ECG (n = 7), Group 2: symptomatic patients with pathological ECG (n = 22), Group 3: main symptom syncope (n = 15). All patients had had an ECG and 15 a 24-hour-ECG. Carotid sinus massage was performed in three patients and sinus node recovery time was measured in another three. Seventeen patients remained without treatment, 13 received a permanent pacemaker, 9 of whom had additional medication, while 12 were anticoagulated. Three patients who were not anticoagulated suffered a stroke. More invasive electrophysiological investigations should be undertaken only with caution. In group 1, further diagnostic or therapeutic consequences need to be drawn. In the symptomatic patients from group 2, 24-hour-ECG is indicated when there is a history of palpitations, dizziness or severe heart failure. The immediate implantation of a pacemaker is justifiable in group 3 patients. Drugs with antiarrhythmic activity should be avoided in these patients before pacemaker implantation. PMID- 3983603 TI - [Can familial Eyelid ptosis be an expression of Ehlers-Danlos syndrome?]. AB - A case of congenital familial ptosis with simultaneous Ehlers-Danlos syndrome type II is presented. Since coincidence of these two rare hereditary diseases would be unlikely, the ptosis in this case may be a so far undocumented manifestation of EDS. PMID- 3983604 TI - [The course of pregnancy in a representative Swiss population (the Aarau Pregnancy and Newborn Infant Study). I. Social medicine aspects]. AB - Excluding multiple births, a cohort of 996 Swiss mothers was interviewed upon admission to the labour ward regarding the overall course of pregnancy, illnesses, disorders, use of drugs, and nicotine and alcohol consumption. During the postnatal stay at the hospital additional information on socioeconomic background, mental and physical stress and the pattern of medical care during pregnancy was obtained. The data are presented and compared with analogous data on the entire female population of the same age group in Switzerland and with epidemiologic reviews of pregnancy events from other countries. This group of pregnant women represents a cross-section of the average mixed small town and rural population of German-speaking Switzerland. The socioeconomic conditions for motherhood appear favorable, though the percentage of women from lower socioeconomic classes was lower than in the general population. Employment during pregnancy had no influence on birthweight and neonatal morbidity, in contrast to chronic physical and emotional stress. On average the women had eight medical checkups during pregnancy. PMID- 3983605 TI - [Curing from the current viewpoint]. PMID- 3983606 TI - [Regulation of foreign compounds in meat and meat products in the conflict between politics versus toxicology]. PMID- 3983607 TI - [Risk of infection for the personnel of slaughterhouses and and meat-processing plants]. PMID- 3983608 TI - [Cleaning and disinfection in the production, distribution and kitchen preparation of meat]. PMID- 3983609 TI - [Timely food control for effective consumer protection]. PMID- 3983610 TI - [Meat in the discussion of health]. PMID- 3983611 TI - [Quality criteria for meat selection]. PMID- 3983612 TI - [Technology of processing meat of varying quality]. PMID- 3983613 TI - Purification and primary structures of duck fibrinopeptides A and B. AB - Duck fibrinopeptides A and B were purified by Dowex 50 W X 2 ion exchange resin and DEAE-Sepharose CL-6B. The complete primary structures of duck fibrinopeptides A and B were determined by manual Edman Sequence determination. The primary structure of duck fibrinopeptide A is pyr. Asp. Gly. Lys. Ser. Ser. Phe. Gln. Lys. Glu. Gly. Gly. Gly. Val. Arg., and that of duck fibrinopeptide B is Pyr. Ala. Ser. Thr. Asp. Tyr. Asp. Asp. Glu. Asp. Glu. Ser. Thr. Val. Pro. Glu. Ala. Arg. PMID- 3983614 TI - Electrophysiological studies on the nucleus isthmi of the lizards Gekko gekko and Shinisaurus crocodilurus. AB - This report studies visual responses of the isthmic units in Gekko gekko and Shinisaurus crocodilurus using extracellular recording and cobalt sulfide marking techniques. Our results indicate that: (i) the nucleus isthmi pars magnocellularis (Imc) is a visual center; (ii) there are luxotonic units in Imc; (iii) Imc units respond vigorously to moving contrast targets, of which 35% units burst only at the moment when targets are moving into and out of their receptive fields, none react to either tactile or auditory stimulation; (iv) there exist binocular units in Imc; and (v) visual field is topographically projected onto Imc. PMID- 3983615 TI - The effect of a self-referral scheme on the pattern of hospital admissions for acute asthma. AB - An analysis of the pattern of admissions for acute asthma to a respiratory unit which operates a self-referral scheme showed that patients included in such a scheme were admitted to hospital more frequently, and much more quickly. The findings suggested that it is possible to recognise 'high-risk' asthmatics and that these patients make full and effective use of well organised self-admission facilities. An attempt to discover what provoked acute attacks of asthma yielded little useful information except to identify a small group of young women in whom hysterical hyperventilation may have been a relevant aetiological factor. PMID- 3983616 TI - Acute renal failure: the tip of the iceberg? AB - This study reports the experience, during a six-year period, of the Aberdeen Renal Unit in the treatment of patients with acute renal failure. The combination of a relatively stable population base and a single regional dialysis centre has allowed the incidence of acute renal failure to be assessed. Approximately 30 patients per million population were dialysed annually for acute renal failure; 69 per cent of these patients (20.5 per million population per year) were dialysed for acute reversible intrinsic renal failure (ARIRF) and mortality in this group was 44 per cent. Patients with more severe disease at the time of presentation to the renal unit, as defined by a clinical severity score, had significantly reduced survival rates. However, it was not possible to predict the outcome in individual cases; ten of 24 patients with clinical severity scores which indicated a poor prognosis survived the period of oliguria and were discharged from hospital. The fact that other renal units dialyse fewer patients per million population per year for ARIRF probably reflects a reluctance to refer patients whose general condition appears poor. As the overall mortality rate reported in this study does not differ significantly from rates reported previously from centres treating a smaller proportion of patients, such decisions may not be correct. It is well known that facilities in Britain for treating patients with end-stage renal disease are inadequate; it now appears likely that some patients who might benefit from acute dialysis are being denied treatment for a potentially reversible disease process. PMID- 3983617 TI - Endocrine studies in cyanotic congenital heart disease. AB - Seven male patients with cyanotic congenital heart disease were studied. Serum testosterone, androstenedione, dehydroepiandrosterone, thyroxine and triiodothyronine levels did not differ significantly from control values. Thyroid stimulating hormone and prolactin responses to injected thyrotrophin releasing hormone were normal. Impaired gonadotrophin responses to injected gonadotrophin releasing hormone were noted in two patients. The hypothalmic-pituitary testicular axis appears to be better preserved in cyanotic congenital heart disease than in chronic obstructive airways disease and restrictive lung disease for a similar degree of hypoxia. Possible explanations are discussed. PMID- 3983618 TI - Genito-urinary tuberculosis in Glasgow 1970 to 1979: a review of 230 patients. AB - Two hundred and thirty patients with genito-urinary tuberculosis presenting between 1970 and 1979 were reviewed. In 22 per cent there was a history of previous tuberculosis and a family history in 14 per cent. Night sweats and weight loss were uncommon. The mean duration of medical treatment was 17 months. Surgery was necessary in 49 per cent of patients but reconstructive procedures were only performed in 7 per cent of cases. The mean follow-up period after diagnosis was 46 months. Patients with initial renal calcification were followed up for a similar time to those with no calcification. Complications during follow up were no more common in those with initial renal calcification than in those without this feature. With the exception of 1971 and 1972, there was a steady incidence of 20 or so new cases of genito-urinary tuberculosis per year in Glasgow. PMID- 3983619 TI - Pycnodysostosis in a Pakistani family: case presentation and review. AB - Pycnodysostosis is described for the first time in a Pakistani family. Two cases are presented and are contrasted with cases of osteopetrosis seen in this hospital over a twenty year period. The possibility of confusion with osteopetrosis is indicated and discussed. PMID- 3983621 TI - Headache and temporal arteritis. AB - A patient presented with headache, soreness over her scalp and general malaise. She was treated for hypertension, but later went blind in one eye. Following referral to the Eye Department, she was treated successfully for six episodes of blindness in her second eye. The case highlights the ways in which temporal arteritis may present. Prompt treatment will save vision, but a missed diagnosis may result in blindness. PMID- 3983620 TI - Osmosin and ileal ulceration: a case report. AB - A 78-year-old woman presented with an acute abdomen and was found to have a perforation of her terminal ileum. She did not survive the post-operative period and at necropsy was found to have numerous ulcers of the ileum. In the ulcerated areas there was a transmural chronic inflammatory infiltrate, but no evidence of granulomata. We believe that this ulceration was caused by ingestion of Osmosin tablets containing indomethacin and suggest a possible pathogenesis. PMID- 3983622 TI - Genital tract metastases from renal cell carcinoma--a case report and discussion. AB - A case of renal cell carcinoma presenting with metastases in the female genital tract is reported. Clinical and histological features distinguishing primary and secondary clear cell adenocarcinoma of the genital tract are discussed. It is emphasised that when a clear cell adenocarcinoma is found, particularly in a post menopausal woman, metastatic renal carcinoma has to be excluded. Although so far there are 61 cases reported in the world literature from English speaking countries, we believe that this is the first case reported from the United Kingdom. PMID- 3983623 TI - Ischaemic optic neuropathy and retinopathy associated with acute pancreatitis. AB - A man with previously undiagnosed chronic renal failure developed acute pancreatitis. He had severe abdominal pain and simultaneous loss of vision. Ophthalmoscopy showed pale, swollen optic discs, soft exudates and superficial retinal haemorrhages similar to that of Purtscher's retinopathy. We suggest that the ocular changes may be due to fat microemboli secondary to acute pancreatitis. PMID- 3983624 TI - Membranous nephropathy in a patient with nail-patella syndrome nephropathy. AB - Membranous nephropathy is described in a patient with nail-patella syndrome who also had the characteristic changes of nail-patella syndrome nephropathy on electron microscopy. This combination has not previously been reported. Nail patella syndrome nephropathy is reviewed in relation to other glomerular lesions which have been reported. PMID- 3983625 TI - Bone mass in corticosteroid treated patients with rheumatoid arthritis, asthma and polymyalgia rheumatica. PMID- 3983627 TI - Uptake of 226radium and 228radium by the lichen genus Umbilicaria. AB - The 226Ra and 228Ra content of the lichens Umbilicaria cylindrica, U. deusta, U. murina and U. hirsuta has been determined as a function of the growth altitude above sea level, based on data derived from material collected from localities in southwest Poland. These data are interpreted as graphs and formulae to show the influence of environmental factors, particularly altitude, on the concentration of 226Ra and 228Ra, and the coefficients of accumulation calculated. PMID- 3983626 TI - The results of coronary arteriography in young men after myocardial infarction in north-east Scotland. AB - The case records of 50 consecutive male patients aged 40 years or under who were investigated by selective coronary arteriography after myocardial infarction were reviewed. Fourteen patients had normal coronary vessels and 36 patients had significant occlusive disease. Eighteen were considered to be in need of surgical treatment. The features of myocardial infarction on the ECG were less marked in the group of patients with normal coronary arteriograms. Many of these patients were asymptomatic and had complete resolution of the ECG changes. As well as having normal coronary arteries, many also had normal left ventricular angiograms. Cigarette smoking was very common in the whole group, 86 per cent of patients being moderately heavy cigarette smokers. Five of the 14 patients in the 'non-occlusive' group were non-smokers and only two of the 36 patients in the 'occlusive' group were non-smokers (P less than 0.01). The fasting serum cholesterol was significantly lower in the 'non-occlusive' group than in the 'occlusive' group. There was no significant difference between the two groups regarding blood pressure, family history of ischaemic heart disease, obesity or alcohol consumption. There was, however, a high incidence of heavy alcohol consumption amongst patients who subsequently required coronary artery surgery. Many of the patients in the 'non-occlusive' group were considered to have had smaller, more localised myocardial infarctions and a lesser degree of coronary disease which may not be detected by coronary arteriography. Others, with more widespread cardiac damage, could be explained on the basis of thrombosis and subsequent recanalisation. PMID- 3983628 TI - Sponge 'sentinel' of heavy metals. AB - The possibility of monitoring siliceous sponges as an ideal bioindicator of 17 trace metals and halogens was investigated. Of the two species of Demosponge from the Indian coastal waters receiving stable and radioactive nuclides (54Mn, 63Ni, 65Zn, 60Co, 75Se, 113Sn, 90Sr, 131I, 137Cs), Spirastrella cuspidifera was found to accumulate Cd, Cr, and Sn in the range of 15-2000 micrograms g-1 dry tissue, some 5-7 orders of magnitude higher than in the ambient waters. Prostylyssa foetida, from the same microecological niche, was found to be totally free of these three metal ions. The bioaccumulation of Ni was also significantly higher in S. cuspidifera (400-2250 micrograms g-1) than in P. foetida (7-15 micrograms g 1). The former species was also found to be an ideal sentinel for detecting levels of Co, Zn, and Ti; levels of Cu, Mn, Pb Fe and Sr were higher in P. foetida, but those of the halogens I and Br were practically identical in both species. Furthermore, bioaccumulation of metal ions was found to be a function of sponge tissue itself, rather than that of either obligate or facultative symbiont microflora. In view of the high degree of species specificity which sponges exhibit while accumulating many trace metal ions, a 'sponge watch programme' is proposed on a global scale for monitoring the health of coastal ecosystems against a variety of potentially toxic pollutants. PMID- 3983629 TI - Determination of total sulphur in fuel oils by molecular emission cavity analysis. AB - Molecular emission cavity analysis (MECA) is used for the determination of total sulphur in fuel oils. The sulphur is reduced by heating the sample with Devarda's alloy in an HCl medium, with subsequent liberation of H2S and measurement of the chemiluminescent S2 emission intensity in the MECA cavity. The total sulphur recovery from different sulphur-containing compounds and fuel oils is always ca. 100%. The precision and accuracy are good. Applications to certified and commercial fuel oils are discussed. PMID- 3983630 TI - Mutagenicity of three agricultural soils. AB - A chemical and biological testing protocol was employed to evaluate the mutagenic potential of the organic compounds extracted from three agricultural soils. The analytical procedures used included bioassays with Salmonella typhimurium and Aspergillus nidulans for the detection of point mutations and a gas chromatography/mass spectrometry/computer system to identify major organic constituents. The extracts of all three soils exhibited mutagenic response in the bioassays. At a dose level of 1000 micrograms per plate, the organic extract of the Bastrop clay induced 434 net revertants; while at the same dose level the Norwood sandy clay and the Sassafrass sandy loam induced 35 and 178 net revertants, respectively, in the Salmonella assay with metabolic activation. In the Aspergillus assay, the extract of the Norwood and Bastrop soils induced a positive response without metabolic activation; this effect was reduced or eliminated in the presence of metabolic activation. Chemical analysis identified a variety of initiators, promotors, inhibitors, and cocarcinogens; however, there were no mutagenic compounds identified in any of the soil extracts. The results of this combined testing protocol indicate that the agricultural soils tested had an inherent level of mutagenic activity, which was not detected by GC/MS analysis alone, and this activity may be related to the past history of agricultural practices, including biocide applications, fertilization, and cultivation. PMID- 3983631 TI - Geometrical differences among homologous neurons in mammals. AB - The dendritic arbors of sympathetic neurons in different species of mammals vary systematically: the superior cervical ganglion cells of smaller mammals have fewer and less extensive dendrites than the homologous neurons in larger animals. This difference in dendritic complexity according to body size is reflected in the convergence of ganglionic innervation; the ganglion cells of progressively larger mammals are innervated by progressively more axons. These relations have implications both for the function of homologous neural systems in animals of different sizes and for the regulation of neuronal geometry during development. PMID- 3983632 TI - Leukotriene C4 transport by the choroid plexus in vitro. AB - Nanomolar concentrations of peptidoleukotrienes evoke sustained cerebral edema and arterial constriction. Peptidoleukotrienes are thus considered to play an important role in eliciting cerebral edema after cerebral ischemia and vasospasm after subarachnoid hemorrhage. It was hypothesized that the choroid plexus, the locus of the blood-cerebrospinal fluid barrier, might minimize the vasoactivity of locally generated or systemically derived leukotrienes by transporting leukotrienes from cerebrospinal fluid into the blood. Consistent with this hypothesis, leukotriene C4 in vitro was transported into and released from isolated rabbit choroid plexus by a system that was specific, energy-dependent, probenecid-sensitive, and depressed by cold temperatures. The accumulation of leukotriene C4 in the choroid plexus was not dependent on tissue binding or metabolism of leukotriene C4. PMID- 3983633 TI - Functional properties of individual neuronal branches isolated in situ by laser photoinactivation. AB - The functional properties of an isolated dendritic branch of an identified sensory interneuron in the cricket were studied. The branch responded to wind stimuli directed at the animal and displayed a distinct directional sensitivity to those stimuli. A technique was used that allows a neuron to be specifically lesioned in a semi-intact preparation during intracellular recording. Lesioning was achieved by dye-sensitized photoinactivation with a laser epi-illumination stereomicroscope. PMID- 3983634 TI - Hypertension and sodium salts. PMID- 3983635 TI - Some computer-based developments in sociology. AB - Sociological data sets are now being computer analyzed by means of a variety of sophisticated procedures, to produce results that reflect the intricacy of social life. Computers also are being used to conduct simulations of social processes based on mathematical models and to collect the data for analysis. Portable computers allow computing power to be used in field studies, and the relatively low cost of computers is expanding the range of sociologists who use them. While opening up new research opportunities, computers also bring certain problems for social researchers and teachers. PMID- 3983636 TI - Generics, Roche joust for Valium market. PMID- 3983637 TI - A specific 37,000-dalton protein that accumulates in regenerating but not in nonregenerating mammalian nerves. AB - A 37-kilodalton protein is synthesized at higher rates in the peripheral and central nervous system of newborn rats than in adult animals. As a specific response to denervation, the synthesis of the 37-kilodalton protein is increased in the mature peripheral and central nervous system; however, this protein accumulates only in the peripheral nervous system. The differences in accumulation of the protein correlate with the apparent differences in the ability of peripheral and central axons to regenerate. The synthesis of the 37 kilodalton protein is inhibited when proper innervation or reinnervation is established. PMID- 3983639 TI - Crystallographic structure of the octameric histone core of the nucleosome at a resolution of 3.3 A. AB - The structure of the (H2A-H2B-H3-H4)2 histone octamer has been determined by means of x-ray crystallographic techniques at a resolution of 3.3 angstroms. The octamer is a prolate ellipsoid 110 angstroms long and 65 to 70 angstroms in diameter, and its general shape is that of a rugby ball. The size and shape are radically different from those determined in earlier studies. The most striking feature of the histone octamer is its tripartite organization, that is, a central (H3-H4)2 tetramer flanked by two H2A-H2B dimers. The DNA helix, placed around the octamer in a path suggested by the features on the surface of the protein, appears like a spring holding the H2A-H2B dimers at either end of the (H3-H4)2 tetramer. PMID- 3983638 TI - Genetic origin of mutations predisposing to retinoblastoma. AB - Retinoblastoma is one of several human tumors to which predisposition can be inherited. Molecular genetic analysis of several nonheritable cases has led to the hypothesis that this tumor develops after the occurrence of specific mitotic events involving human chromosome 13. These events reveal initial predisposing recessive mutations. Evidence is presented that similar chromosomal events occur in tumors from heritable cases. The chromosome 13 found in the tumors was the one carrying the predisposing germline mutation and not the homolog containing the wild-type allele at the Rb-1 locus. These results suggest a new approach for identifying recessive mutant genes that lead to cancer and a conceptual basis for accurate prenatal predictions of cancer predisposition. PMID- 3983640 TI - Molecular clocks scrutinized. PMID- 3983641 TI - Location of gene for beta subunit of human T-cell receptor at band 7q35, a region prone to rearrangements in T cells. AB - The T-cell receptor is formed by two chains, alpha and beta, for which specific clones were recently obtained. In this report the gene for the beta chain of the human T-cell receptor was located on the long arm of chromosome 7, band q35, by means of in situ hybridization. This chromosome region in T cells is unusually prone to develop breaks in vivo, perhaps reflecting instability generated by somatic rearrangement of T-cell receptor genes during normal differentiation in this cell lineage. PMID- 3983642 TI - Genes for beta chain of human T-cell antigen receptor map to regions of chromosomal rearrangement in T cells. AB - The T-cell antigen receptor is a cell-surface molecule that participates in the immune response. In the present experiments the genes encoding the beta chain of the T-cell receptor were found to reside on the long arm of human chromosome 7 at or near band q32. Related sequences were found on the short arm of chromosome 7 in bands p15-21 in some experiments. Chromosomal rearrangements in T-cells from normal individuals and patients with ataxia telangiectasia have previously been observed at and near these map assignments for the beta-chain genes. PMID- 3983643 TI - Comparative toxinology of Loxosceles reclusa and Corynebacterium pseudotuberculosis. AB - In contrast to other kinds of phospholipases, phospholipases D that are toxic for humans and animals are not commonly encountered as constituents of venoms or as products of pathogenic microorganisms. Toxic phospholipases D are present, however, in the venom of the brown recluse spider (Loxosceles reclusa) and in supernatants or filtrates of cultures of Corynebacterium pseudotuberculosis. Although the two enzyme toxins are derived from phylogenetically disparate entities, they are similar in molecular weight, charge, substrate specificity, and in several biological activities. They are immunologically distinguishable. PMID- 3983644 TI - Ethanol neurotoxicity: effects on neurite formation and neurotrophic factor production in vitro. AB - The effects of ethanol on chick embryo sensory and spinal cord neurons growing on one of several biological substrates (poly-D-lysine, laminin, or neuron-produced neurite-promoting materials) were examined. Ethanol inhibited process formation by the neurons in a dose-dependent manner and inhibited the production of neurotrophic factors. Neuronal attachment to the substrates, survival of attached neurons, and receptor interactions of sensory neurons with nerve growth factor were not influenced by ethanol. It appears that ethanol alters certain metabolic characteristics of developing neurons. PMID- 3983645 TI - Detection of a cellular oncogene in spontaneous liver tumors of B6C3F1 mice. AB - An active cellular oncogene was demonstrated in hepatocellular neoplasms arising spontaneously in 24-month-old B6C3F1 mice. DNA isolated from the tumorous tissue and transfected into NIH 3T3 cells showed an 82 percent (9 of 11 animals) frequency of foci induction. In contrast, DNA isolated from the surrounding nontumorous hepatic tissue from the same animals and DNA from other 24-month-old B6C3F1 mice without tumors did not cause transformation in the NIH 3T3 cell assay. This strain of mouse is used extensively in carcinogen bioassays, and the observed high frequency of transformation (82 percent, compared to 10 to 20 percent in humans) supports the concept that the B6C3F1 mouse is hypersusceptible to liver tumor development. It also emphasizes the need to further understand the mechanisms of oncogene activation in animals used for long-term studies of toxicity and oncogenicity before evaluating potential human risk. PMID- 3983646 TI - Regenerating fish optic nerves and a regeneration-like response in injured optic nerves of adult rabbits. AB - Regeneration of fish optic nerve (representing regenerative central nervous system) was accompanied by increased activity of regeneration-triggering factors produced by nonneuronal cells. A graft of regenerating fish optic nerve, or a "wrap-around" implant containing medium conditioned by it, induced a response associated with regeneration in injured optic nerves of adult rabbits (representing a nonregenerative central nervous system). This response was manifested by an increase of general protein synthesis and of selective polypeptides in the retinas and by the ability of the retina to sprout in culture. PMID- 3983647 TI - Habitat selection in a clonal plant. AB - Rhizomatous growth may permit the nonrandom placement of ramets into different environments, but whether clonal plants are able to use this means to exercise adaptive habitat choice is not known. Western ragweed (Ambrosia psilostachya) plants are shown to preferentially colonize nonsaline soil over saline soil patches, and clones with the strongest preference for nonsaline soil are those least able to grow when restricted to saline conditions. In clonal plant species, nonrandom associations of genotypes with specific environments may thus reflect habitat selection by plants as well as selective mortality imposed by different habitat patches. PMID- 3983648 TI - Amygdalectomy impairs crossmodal association in monkeys. AB - Monkeys trained on both visual and tactual versions of an object memory task (delayed nonmatching-to-sample) received bilateral ablations of either the amygdaloid complex or the hippocampal formation of the brain. Although both groups performed well on the two intramodal versions (visual-to-visual and tactual-to-tactual), the amygdalectomized monkeys were severely impaired relative to the hippocampectomized monkeys on a crossmodal version (tactual-to-visual). The findings suggest that the amygdala is critical for certain forms of crossmodal association and that the loss of such associations underlies many of the bizarre behaviors that make up the Kluver-Bucy syndrome. PMID- 3983649 TI - Abnormal rates of gastric emptying. PMID- 3983650 TI - Thyroid hormone homeostasis and the liver. PMID- 3983651 TI - Liver disease and the hypothalamic pituitary gonadal axis. PMID- 3983652 TI - [Personal experience with quantitative high performance thin layer chromatography]. AB - In 5 substances from the group of non-barbiturate hypnotics (methaqualone, nitrazepam) and psychopharmaceutical preparations (thioridazine, dosulepin, imipramine) the author selected for quantitative high performance thin-layer chromatography a method of direct densitometry, i.e. assessment of absorption in visible light after colour detection by the transmission technique. The assembled results are evaluated by statistical methods. By suitable adjustment of the chromatographic separation and of the parameters of measurement during densitometry in each investigated substance a correlation coefficient r better than 0.997 and a variation coefficient V lower than 10% can be obtained. PMID- 3983653 TI - [Fatal occupational injuries due to falls from heights--from the viewpoint of causes of injuries and possibilities of prevention]. AB - From a group of 2669 serious and 887 fatal work injuries in the North Moravian region in 1974-1983 injuries caused by fall from a high place were analyzed in more detail and in this group fatal injuries and severe injuries contracted during work of fitters. The authors deal in particular with the causes of 71 fatal and 243 severe injuries with regard to age, the time of the day, the time relation of the working shift, professiography and the effect of disease or alcohol. Obvious pathological causes were revealed in a minority of cases although in 69,7% of necropsies pathological changes were detected in the organism. The part played by alcohol is obvious only in 4.45%. Suggestions for a preventive orientation with emphasis on psychological factors are submitted. PMID- 3983654 TI - Who is qualified to interpret electrocardiograms? PMID- 3983655 TI - Role of perinatal associations in the 1980s: competitive or cooperative? PMID- 3983656 TI - Improved perinatal knowledge in community hospitals through a self-instructional program. AB - The Perinatal Continuing Education Program (PCEP) was conducted throughout South Carolina. The program was well received and greatly valued; however, participants requested more information covering obstetrics. To meet this need, we developed the Perinatal Education Program for Community Hospitals (PEPCH), patterned after and similar to PCEP, and tested it in South Carolina and southern California. In the South Carolina trial, the posttest was found reliable (Kuder-Richardson index = .77). In the California trial, the pretest/posttest reliability was confirmed. Learning for nurses was documented (pretest = 30.8 +/- 5.3, posttest = 36.8 +/- 5.5, P less than .001). Completion rate for this voluntary program was 84%. We conclude that a self-study program based in the community hospital can improve knowledge of perinatal professionals. PMID- 3983657 TI - Amniotic fluid embolism: prophylaxis with heparin and aspirin. AB - The thromboplastic activity of amniotic fluid (AF) from women in labor may be a significant factor in amniotic fluid embolism (AFE) and obstetric disseminated intravascular coagulation (DIC). Infusion of AF from women in labor into laboratory animals was found to depress the platelet count, as seen in DIC. In this study we also investigated the ability of heparin and aspirin to block the thromboplastic activity and thrombocytopenia subsequent to AF infusion. In animals, heparin prophylaxis before infusion of AF prevented thrombocytopenia, whereas aspirin prophylaxis did not. Heparin prophylaxis may be useful in the management of coagulation defects associated with AFE and labor. PMID- 3983658 TI - Painful crises and menstruation in sickle cell disease. AB - Fifty-two women with sickle cell disease, having genotypes of hemoglobin SS, SC, and S-thalassemia, participated in a questionnaire study pertaining to the relationship of their menses and the occurrence of painful crises. The data indicated that those patients who had sickle cell crises were significantly older and had been menstruating longer, with heavier periods. The results point to the onset of menstruation as a possible precipitant of painful crises in some women with sickle cell disease. PMID- 3983659 TI - Intracranial tuberculosis: manifestations on computerized tomography. AB - Intracranial tuberculosis is often insidious, may be difficult to diagnose clinically, and is neurologically devastating if untreated. The advent of computerized tomography has permitted earlier detection of the structural abnormalities associated with intracranial tuberculosis than was possible with older techniques. Correct radiologic interpretation can heighten the index of suspicion for what is often an overlooked diagnosis and can lead to earlier treatment, with decreased morbidity and mortality. We present four cases that cover the spectrum of abnormalities of intracranial tuberculosis shown by CT. PMID- 3983660 TI - Mediastinal tumors and pseudotumors: evaluation by computerized tomography. AB - In this series, thorough evaluation of 250 mediastinal lesions by various diagnostic methods showed that contrast enhanced CT scans of the mediastinum were superior to other modalities in differentiation and precise localization of the various types of lesions. Such superior evaluation may have a profound effect on the management of patients. PMID- 3983661 TI - Proper management of renal artery injury from blunt trauma. AB - Blunt trauma to renal arteries often receives suboptimal management because of delayed diagnosis, incomplete preoperative evaluation, associated injuries, or unknown functional capacity of the contralateral kidney. We propose a rational treatment plan from an analysis of our three cases and a review of 118 cases. Two thirds of the patients were male, and left-sided injuries predominated over right 42.9% to 30.6%. In 20 cases the insult was bilateral. Associated injuries occurred in 72%, averaging 1.6 injuries per case, of which one half were intra abdominal. Flank and/or abdominal pain was present in 73% of cases, tenderness in 65%, and gross or microscopic hematuria in 74%. Repairs were attempted on 38 renal arteries. "Successful" repairs were accomplished in 16 arteries, while repairs failed in 22. Subsequent hypertension developed in 32% of successes. Repair should be attempted in stable patients with unilateral injury of less than four hours' duration, bilateral injuries of less than 20 hours' duration, or injuries with nonocclusion on arteriogram. PMID- 3983662 TI - Spigelian hernia: uncommon or unrecognized? AB - Spigelian hernia may be a more common clinical entity than previously recognized or reported. We report seven cases, four diagnosed and treated in the past 12 months at a large military hospital. Diagnosis can be difficult because of failure to consider it, incomplete understanding of the anatomy, and the nonpalpable intraparietal nature of the hernia. A careful history and physical examination are essential. Any patient with persistent localized pain in the proper anatomic location--just lateral to the outer border of the rectus muscle and usually below the umbilicus--warrants surgical exploration. PMID- 3983663 TI - Infected abdominal aortic aneurysm. AB - In the surgical literature, 37 survivors of infected abdominal aortic aneurysmorrhaphy have been reported. The diagnosis is suspected if a patient with fever, leukocytosis, and abdominal pain is noted on physical examination to have a pulsatile abdominal mass. Confirmation is best obtained with computerized tomography and angiography. We used a protocol for surgical diagnosis and management to successfully treat two patients who are added to the list of known survivors of infection of an abdominal aortic aneurysm. PMID- 3983664 TI - Childhood sarcoidosis in Arkansas. AB - Sarcoidosis, a granulomatous disease of unknown etiology, is most often seen in young adults. Childhood cases have been reported primarily from Virginia, North Carolina, and South Carolina. Thirty children have been seen in Arkansas between 1957 and 1982, which suggests that the endemic area for childhood sarcoidosis should include both the south central and southeastern United States. The median age was 11 years; 29/30 were black; and 90% were symptomatic, 60% with systemic symptoms. Manifestations included abnormal chest roentgenograms (100%), restrictive pulmonary functions (79%), lymphadenopathy (63%), splenomegaly (40%), skin lesions (30%), granulomatous uveitis (27%), hyperglobulinemia (72%), and hypercalcemia (30%). Course and prognosis were similar to those in adults at follow-up of two to 11 years. Four with uveitis had serious residua in the eyes, three had crippling restrictive lung disease, and two died of respiratory failure. Sarcoidosis seems to be an immunologic response to an unknown inhaled antigen, probably present in the southeastern and south central US. PMID- 3983665 TI - Patient-physician communication and interaction: a unifying approach to the difficult patient. AB - Many difficult patients encountered by the primary care physician may be understood in terms of severe unmet dependency needs. These patients often evoke negative feelings on the part of physicians. A mutual participation approach to the patient-physician relationship is a means of providing effective care for these patients, at the same time preventing frustration and burnout in the physician by preserving his energies. PMID- 3983666 TI - Choledochal cyst complicating a twin gestation. AB - Cystic dilatation of the common bile duct is rare and dangerous during pregnancy. We have described a case of a twin gestation and a concomitant choledochal cyst. Surgical release of the dilatation is urgent in light of the overdistended uterus. A conservative surgical approach in the antepartum period is supported by the successful outcome of this case. PMID- 3983667 TI - Isolated nodular pulmonary amyloidosis: diagnosis by percutaneous needle aspiration biopsy. AB - We have reported three cases of isolated nodular pulmonary amyloidosis, a rare condition whose roentgenographic presentation frequently mimics tumor metastatic to the lung or primary lung cancer. Computerized tomography is not helpful in diagnosing this condition. In our experience, the specific diagnosis could be made by aspiration needle biopsy, avoiding thoracotomy. PMID- 3983668 TI - Congenital complete heart block with maternal primary Sjogren's syndrome. AB - We have described a case of congenital complete heart block associated with maternal primary Sjogren's syndrome. This diagnosis should also be considered when evaluating mothers of children with congenital heart block, especially when no connective tissue disease is otherwise clinically apparent. The potential significance of antibodies to SSA in this association remains to be determined. PMID- 3983669 TI - Dissecting retropharyngeal abscess due to Fusobacterium necrophorum in an adult. AB - I have described an adult patient who had dissecting retropharyngeal abscess complicated by pneumonia, mediastinitis, pericarditis, sepsis, and status epilepticus. PMID- 3983670 TI - Coexisting adenocarcinoma and cystadenofibroma (malignant cystadenofibroma) of the ovary. AB - We have described an adenocarcinoma observed as a grossly discrete area within a cystadenofibroma of the ovary. Fewer than 35 cases of malignant cystadenofibroma have been reported. We find our observations lend support to the prevailing thought that these neoplasms most often originate from preexisting cystadenofibromas. PMID- 3983671 TI - Mexiletine therapy for ventricular tachycardia. AB - We have described a patient with sustained ventricular tachycardia that could not be controlled by any of the readily available oral antiarrhythmic agents. Because of the patient's response to intravenous lidocaine, she was treated with mexiletine, which has given excellent results. PMID- 3983672 TI - Bilateral simultaneous spontaneous rupture of quadriceps tendons in a diabetic patient. AB - We have described a case of bilateral simultaneous spontaneous quadriceps tendon rupture. The diagnosis is established by clinical examination. Definitive treatment consists of surgical repair followed by cylinder cast application for six to eight weeks. PMID- 3983673 TI - Angiokeratoma: a cause of scrotal bleeding. AB - Although angiokeratotic lesions of the scrotum have been described as benign lesions occurring only in the elderly, more recent reviews suggest they also occur in young men and are not always trivial. The two cases reported here illustrate the complications of bleeding without trauma and physician failure to diagnose the lesion. PMID- 3983674 TI - Acute oliguric renal failure due to ibuprofen overdose. AB - We have described a patient who had acute oliguric renal failure after ingesting a single large overdose of ibuprofen. This patient had no predisposing underlying disease, and subsequently had complete resolution of renal failure. PMID- 3983675 TI - Drinking in America. PMID- 3983676 TI - Cefoxitin: another Porter-Silber chromogen. PMID- 3983677 TI - [Peristaltic function of gastric and duodenal stumps after pylorus-sparing resection]. PMID- 3983678 TI - [Prevention of ischemic kidney damage after shutting off renal blood flow]. PMID- 3983679 TI - [Pulmonary circulation in chronic renal failure (clinico-morphological studies)]. PMID- 3983680 TI - [Helium-neon laser and dibunol in gastric and duodenal ulcer]. PMID- 3983681 TI - [Determining regional blood flow in gastric mucosa by hydrogen clearance]. PMID- 3983683 TI - [Prevention of diabetes mellitus]. PMID- 3983682 TI - [Computerized tomography in the diagnosis of abscesses in the small pelvis]. PMID- 3983684 TI - [Improved method of prevention of cholelithiasis]. PMID- 3983685 TI - [Control of antithrombotic therapy]. PMID- 3983686 TI - [Thoracoscopy with drainage of the pleural cavity in the treatment of pleuritis in oncological patients]. PMID- 3983687 TI - [Metastatic lung tumors]. PMID- 3983688 TI - [Indicators of nonspecific immunity in purulent infection in diabetes mellitus]. PMID- 3983689 TI - [Method of endorectal ileoanal anastomosis]. PMID- 3983690 TI - [Secretin-pancreozymin test after surgical treatment of cholelithiasis]. PMID- 3983691 TI - [Predicting hepatic coma in viral hepatitis]. PMID- 3983692 TI - [Causes of diagnostic difficulties in geriatrics]. PMID- 3983693 TI - [Successful treatment of aneurysm of a femoral artery prosthesis]. PMID- 3983694 TI - [Clinodactyly of the thumb]. PMID- 3983695 TI - Changing trends in the neurosurgical management of chronic pain. PMID- 3983696 TI - Spontaneous atlantoaxial fusion in psoriatic arthritis. A case report. PMID- 3983697 TI - Unusual presentation of spinal osteomyelitis in a patient taking propylthiouracil. A case report. PMID- 3983698 TI - Delayed vertebro-basilar insufficiency following cervical spine injury. PMID- 3983699 TI - Spine duplication. AB - Spinal column duplication in association with other vertebral, gastrointestinal, and genitourinary tract anomalies is reported in a female infant. An embryologic explanation is postulated, in which the combination of anomalies is attributed to a single embryologic insult occurring the latter half of the third week of gestation. PMID- 3983700 TI - A profile of metastatic carcinoma of the spine. AB - Metastatic bone disease in 322 patients was analyzed to assess the frequency and behavior of disseminated carcinoma to the vertebral column. Breast, lung, and prostate neoplasms were the most frequent tumors of origin in the 55% of patients who had vertebral lesions. The lumbar spine was the site of the greatest number of metastases. Back pain did not occur in 36% of the 179 patients with spinal disease. Cord compression occurred in 20% of the patients with vertebral involvement, and prostate tumors were the most frequent neoplasm to cause epidural spinal cord impingement. Hypernephroma was the most common cancer to present as a neurologic deficit secondary to an undetected primary malignancy. PMID- 3983701 TI - The developmental segmental sagittal diameter in combined cervical and lumbar spondylosis. AB - Spondylosis diffusely affects the vertebral column but is more pronounced in the cervical and lumbar regions where mobility is greatest. Of 214 patients treated for symptomatic spinal spondylosis, 63 patients (29%) were found to have symptoms related to the cervical spine alone: 123 (58%) had symptoms relative to the lumbar spine alone; 28 (13%) were found to have symptoms relative to both the cervical and lumbar spine in a retrospective clinical study. The incidence of occurrence of a narrow spinal canal was determined. In the patients with cervical spondylosis alone, 40 patients (64%) were found to have midcervical sagittal diameters below average. Eighty-seven patients (71%) with lumbar spondylosis had spinal canals below the average measurements. In the group of patients with combined disease of the cervical and lumbar spine, 18 of the 28 patients (64%) had spinal canal diameters below the accepted average values. PMID- 3983702 TI - The orientation of laminae and facet joints in the lower lumbar spine. AB - The relationship between the angulation of the facet joints and that of the caudad parts of the corresponding laminae in the transverse plane was investigated with computed tomography (CT) at the vertebral levels L3-L4, L4-L5, and L5-S1. At the level of L3-L4, both the facet joints and the caudad portions of the laminae tend toward a sagittal orientation, while at L5-S1 this is more toward the frontal plane. At the level of L4-L5, they occupy an intermediate position. A highly significant correlation between the orientation of these structures is demonstrated. The caudad parts of the laminae may be considered buttresses for the inferior articular processes of the same vertebra. PMID- 3983703 TI - Simultaneous measurement of intraosseous and cerebrospinal fluid pressures in lumbar region. AB - Intraosseous pressure (IOP) and cerebrospinal fluid pressure (CSFP) in the lumbar region were measured simultaneously in two groups of patients with either spinal canal stenosis or disc herniation, to compare dynamic changes with positional changes, and to learn whether these pressure changes may have some role in the onset of claudication. IOP and CSFP showed almost the same change patterns with positional changes in two groups. They were lowest in the prone position and highest at the standing position. In standing with flexion, they were almost the same as in the prone position, but in extension they increased above the standing pressure. These dynamic pressure changes could act as a compression force to the cauda equina in the patient with spinal canal stenosis. PMID- 3983704 TI - Water and electrolyte content of human intervertebral discs under variable load. AB - The human intervertebral disc acts as an osmotic system. Water, salt, and other low-molecular substances penetrate the cartilage plates and annulus fibrosus. The content of water, sodium, potassium, and ashes in different regions of 69 human lumbar intervertebral discs was examined before and after being loaded with certain weights. Under load, the disc loses water (annulus 11%, nucleus 8%) and gains sodium and potassium. The higher concentration of electrolytes in the disc after a long period of loading increases its osmotic absorption force and enables the disc to hold back the remaining water, even against a considerable pressure. After reduction of the pressure, water is quickly reabsorbed and the disc gains height and volume. The pumping mechanism maintains the nutrition and biomechanical function of the intervertebral disc. PMID- 3983705 TI - Redundant nerve roots in patients with degenerative lumbar spinal stenosis. AB - Extensive fundamental and clinical investigations have been performed concerning redundant nerve roots (RNR) and the pathogenesis of cauda equina claudication (CEC) in degenerative lumbar canal stenosis (DLCS). These investigations consisted of (1) anatomic observations on RNR in 117 fixed cadaveric specimens, (2) myelographic study in 117 patients with or without DLCS, (3) operative observation on neural elements with special reference to the cauda equina in 56 DLCS patients (including a postoperative follow-up), and (4) electrophysiologic tests using spinal cord action potential recording under walking load preoperatively and intraoperative measurement of nerve conduction velocity of RNR. The RNR have neuronal losses resulting from a longer duration stenosis that suggests a sort of friction neuritis. Complicated factors contribute to the pathogenesis of CEC and the development of root gripping, such as the magnitude of RNR, the extent of the stenosis, a narrowed sac, age-dependent axial shortening of the spinal canal, and dynamic or postural factors. In cases with severe RNR, satisfactory operative results can be obtained only after thorough decompression with dural incision. PMID- 3983706 TI - Symptoms and signs of sciatica and their relation to the localization of the lumbar disc herniation. AB - Neurologic symptoms and signs in patients with sciatica were prospectively studied and compared with myelographic and operative findings in 403 cases with lumbar disc herniation as the cause of sciatica with special reference to accuracy of the clinical level diagnosis. Fifty-six percent of the herniations at L4-5. However, pain projection into the first sacral distribution was most common. Neurologic symptoms and signs of involvement of a single root were present in 239 cases and of two roots in 154 cases in L4-5 and L5S1 herniations. Pain projection into the fifth lumbar distribution was a very important symptom for identification of clinical findings of the fifth lumbar root involvement gave a level diagnostic accuracy comparable with myelography, while pain projection into the first sacral distribution was less reliable especially in cases with signs of two roots. The neurologic picture of high herniations was completely unreliable. Lumbar myelography or computer tomography is recommended as a routine preoperative study. PMID- 3983707 TI - Dural puncture using the lateral approach for chemonucleolysis. AB - The lateral approach for chemonucleolysis was developed to avoid dural puncture, which occurs with midline and posterolateral approaches. It is important to check for dural punctures during the procedure. If the dura is penetrated, a potential pathway is created for chymopapain to enter the subarachnoid space. Large doses of intrathecal chymopapain are highly toxic and small doses show a variable response. Because of the potential disastrous complications associated with intrathecal chymopapain, the chymopapain injection is contraindicated in the presence of a dural leak. PMID- 3983708 TI - Epidurally placed free fat grafts visualized by CT scanning 15-18 years after discectomy. AB - Four patients operated on in 1965-1968 for disc protrusion had CT scanning of the area operated on. In all patients viable fat tissue was demonstrated in the area in which fat tissue had been transplanted on the dura 15-18 years earlier. PMID- 3983709 TI - Paravertebral marcaine in postoperative lumbar laminectomy pain relief. PMID- 3983710 TI - Indomethacin reaction. PMID- 3983711 TI - The birth of a child with a congenital anomaly. Part III. Response of parents to the diagnosis. AB - The parents of 90 babies diagnosed as suffering from cystic fibrosis (17 cases), Hirschsprung's disease (30), oesophageal atresia (23) and anorectal malformations (20) were interviewed to investigate their reactions at the time of learning the diagnosis. The majority of parents were satisfied with the manner in which the diagnosis had been conveyed to them: the most pervasive factor in this respect was the attitude of the teller. Where this was sympathetic, parents responded positively even when too little information had been given or one parent had been told alone. The largest proportion of dissatisfied parents were from the cystic fibrosis group, in which, in contrast to the surgically correctable anomalies, the element of hope was not present. PMID- 3983712 TI - Indirect traumatic rupture of the ligamentum patellae. A case report. AB - Rupture of the patellar tendon is uncommon. A case of indirect traumatic rupture of the ligamentum patellae occurring in a 54-year-old man is reported. PMID- 3983713 TI - Traumatic rupture of the thoracic aorta. An autopsy and histopathological study. AB - Over the 9-month period 1 March - 30 November 1983, 118 consecutive autopsies were conducted on victims of motor vehicle and train accidents. The thoracic aorta was examined for evidence of contusion, partial tearing or rupture, particular attention being paid to the known usual sites of rupture. All lacerations or disruptions were excised together with a segment of surrounding aortic tissue, and processed, sectioned and examined by conventional light microscopy for the presence and extent of aortic tears. Several findings emerged: (i) in nearly two-thirds of cases there was some degree of aortic disruption; (ii) multiple rather than single tears occurred in 41,2% of the 51 subjects in whom aortic tears were found; (iii) tears of the media occurred in more than 60% of cases, highlighting the involvement of this layer of the aortic wall in traumatic lesions; (iv) there was a high (81,4%) incidence of concomitant multiple injuries; (v) most of the victims (75,4%) were dead on arrival at a medical facility; and (vi) positive blood alcohol levels ranging from 0,04 mg/dl to 0,42 mg/dl were found at autopsy in 80% of the subjects. PMID- 3983714 TI - Pernicious anaemia, neurological changes and gastric ulceration in a Malawian woman. A case report. AB - Gastric acid is held to be necessary for the development of gastric ulcers. The absence of gastric ulcers in patients with pernicious anaemia is cited as evidence for the pivotal role of acid. There have been a few reports of gastric ulcers occurring in elderly persons with pernicious anaemia. Presented here is a 35-year-old Malawian woman with pernicious anaemia who also had gastric ulcerations and neurological changes. This report of gastric ulceration in a patient with pernicious anaemia is thought to be the first from Africa and the patient is the youngest on record. PMID- 3983715 TI - Prevalence of delta hepatitis virus in South Africa. PMID- 3983716 TI - Multiple renal arteries. PMID- 3983717 TI - Interpreting drug levels. AB - The interpretation of drug concentrations in plasma or serum depends on an understanding of drug behaviour. Summaries of the latter are provided for the use of doctors who do not have easy access to pharmacokinetic and pharmacodynamic information. This approach would be vital to a scheme for a nation-wide pharmacological analytical service. PMID- 3983718 TI - Evaluation of a new blood glucose reflectance meter and comparison with visually interpreted strips. AB - The utility of a new glucose reflectance meter (the Reflolux; Boehringer Mannheim) and the accuracy of visually interpreted strips (Haemo-Glukotest 20 800R; Boehringer Mannheim) for the determination of blood glucose levels were assessed in a study of 50 insulin-dependent diabetics who regularly used the strips for home monitoring of their blood glucose levels. There was a highly significant correlation (r = 0,970, P less than 0,0001) between readings on the meter and results of a laboratory reference plasma glucose determination method. The patients' visual assessment of their blood glucose levels using the strips also correlated with the results of a reference method in 44 cases (88%), especially at levels below 11 mmol/l (r = 0,944, P less than 0,0001). However, readings from 6 patients were inaccurate, despite the fact that these patients regularly used the strips. A patient's ability to use the strips should be properly evaluated before it is recommended that they be used for monitoring of blood glucose levels at home. Reflectance meters are not usually necessary for satisfactory blood glucose monitoring at home. This meter may prove useful in training patients to read blood glucose assessment strips accurately, and is suitable for hospital or office use. PMID- 3983719 TI - Serum zinc and copper levels in the 1st year of life. AB - Zinc and copper concentrations in the serum of 240 healthy infants aged 1-12 months were measured by the atomic absorption spectrophotometric method. The study was designed so that on completion there would be 20 infants in each of 12 groups according to age by month. The mean serum zinc levels remained fairly constant in all the age groups except for a significant fall from levels at 1 month (77,11 +/- 12,85 micrograms/dl) to those at 2 months of age (66,60 +/- 15,18 micrograms/dl) (P less than 0,025). Another significant decline in serum zinc levels was present between 4 and 5 months of age (P less than 0,05), which was followed by a significant increase between 5 and 6 months of age (P less than 0,05). The infants' mean serum zinc levels were lower than those of normal adults at all ages (P less than 0,05). The mean serum copper levels were low at 1 month of age (71,17 +/- 17,30 micrograms/dl), and increased significantly between 1 and 2 months (P less than 0,001) and 3 and 4 months of age (P less than 0,02). Mean serum copper levels similar to those of adults were reached at 4 months of age. These levels remained fairly constant from 5 months of age onwards, the only significant decline being noted at between 7 and 8 months of age (P less than 0,05). The present study substantiates previous findings that a specific pattern of change in serum copper concentrations which differs from the trend in serum zinc levels occurs in infants after birth. To detect zinc and copper depletion it is important to interpret serum concentrations in relation to normal values for age. PMID- 3983720 TI - Analbuminaemia. Clinical and laboratory features in a South African patient. AB - A 10-year-old white boy suffering from primary analbuminaemia presented with a 6 month history of ankle oedema. From infancy he had suffered from asthma and respiratory tract infections. His somatic growth was retarded but his mental and motor development was normal. The plasma albumin level was markedly reduced (81 mg/l) but a number of other plasma protein levels showed compensatory increases above the normal range. A study of the binding of unconjugated bilirubin added to the patient's plasma in vitro revealed an accumulation within the high-density lipoprotein fraction. It is suggested that the relative absence of severe illness in analbuminaemia reflects similar compensatory mechanisms afforded by the increase in non-albumin plasma protein levels and by other metabolic adjustments. PMID- 3983721 TI - Sinusoidal fetal heart rate pattern associated with congenital hydrocephalus. A report of 2 cases. AB - Two cases of hydrocephalus with an intrapartum sinusoidal heart rate pattern are presented. In the first patient, the diagnosis of toxoplasmosis during pregnancy and congenital hydrocephalus was made antenatally. Intrapartum the fetal heart showed intermittent periods of a sinusoidal pattern, alternating with a normal heart rate pattern. At birth there were signs of congenital toxoplasmosis. In the second patient there was a sinusoidal heart rate pattern associated with late decelerations and a loss of beat-to-beat variation. A brief review of the literature shows that the debate still continues over the aetiology, pathogenesis and prognosis of this entity. PMID- 3983723 TI - Thrombo-embolism of the subclavian artery. A case report. AB - Acute thrombo-embolic occlusions of the subclavian artery account for less than 1% of all acute arterial occlusions of the extremities. One such case is presented and the management discussed with special reference to the technique of embolectomy and the treatment of the reperfusion syndrome with either fasciotomy or mannitol. The question of anticoagulation is also examined. PMID- 3983722 TI - Amrinone after cardiopulmonary bypass surgery. A case report. AB - A 22-year-old woman underwent emergency aortic valve replacement. Administration of intravenous amrinone (Inocor; Sterling-Winthrop) enabled successful discontinuation of cardiopulmonary bypass after conventional measures had failed. The possible role of amrinone in this clinical situation is discussed. PMID- 3983724 TI - First-trimester fetal diagnosis. PMID- 3983725 TI - Decreasing incidence of sigmoid volvulus at Baragwanath Hospital Johannesburg. PMID- 3983726 TI - Anaemia among the inhabitants of a rural area in northern Natal. AB - Haematological and parasitological investigations were carried out on apparently healthy subjects in a rural area of Natal. Anaemia was highly prevalent and of a moderate to severe degree (haemoglobin value less than 11,0 g/dl) in 42% of males and 52,5% of females. In 50% of subjects the anaemia was hypochromic and iron deficiency appeared to be the major contributing factor. However, failure to utilize iron, giving rise to hypochromia, was not excluded as a complicating factor. Subnormal serum vitamin B12 levels were found in some subjects, and this frequently coexisted with iron deficiency. The presence of parasites was not considered to have contributed to the production of anaemia. It was concluded that the anaemia was to a large extent nutritional in origin. PMID- 3983727 TI - Factors affecting the reliability of an objective structured clinical examination (OSCE) test in neurology. AB - Inconsistencies in individual student scores from one year to the next prompted attempts to produce a more accurate objective structured clinical examination (OSCE) test in neurology. A study of factors affecting the reliability of this test revealed that in spite of efforts to control patient and examiner variability, residual inaccuracies due to these effects remained. Also, the use of a uniform test structure may have led to student cueing. Student performance did not appear to be affected by the OSCE format per se. Innovations that might improve test reliability in subsequent OSCEs were identified. PMID- 3983728 TI - The influence of contrast media on serum osmolality, haematocrit and cardiac output. A comparative study in dogs. AB - Thirty-two mongrel dogs were used in a comparative study to assess the effect of normal saline solution, metrizamide and Cardioconray on serum osmolality, haematocrit and cardiac output. The study demonstrated that the higher the osmolality of the test substance, the greater the reduction in haematocrit and the higher the increase in cardiac output. PMID- 3983729 TI - Acid corrosive gastritis. A case report. AB - A patient who ingested concentrated hydrochloric acid and in whom early stricture of the gastric antrum formed is presented. Attention is drawn to the fact that the stomach usually bears the brunt of the injury following the ingestion of exogenous acid. Aspects of management are discussed, including the place of endoscopy and surgery. PMID- 3983730 TI - Ethical implications of cost containment. PMID- 3983731 TI - Ulcer recurrence. PMID- 3983732 TI - Pruritus vulvae, sex and printer's ink. PMID- 3983733 TI - Clinical characteristics of and prognosis in acute transmural anterior, transmural inferior and non-transmural myocardial infarction. A comparative retrospective study. AB - This retrospective study was undertaken to determine whether there was any difference in the clinical characteristics of and prognosis in white patients admitted to the Intensive Coronary Care Unit (ICCU) at Tygerberg Hospital with acute non-transmural, transmural anterior and transmural inferior myocardial infarction (MI). The three groups were carefully matched, taking into consideration the possible influence of previous MI and congestive cardiac failure (CCF). There were 187 patients with non-transmural MI, and 176 with transmural anterior and 209 with transmural inferior MI. Patients with acute transmural anterior MI had the worst prognosis while at the ICCU, at 3 months' follow-up and at long-term follow-up (mean 22,2 months). This group had the greatest frequency of CCF, cardiogenic shock, acute pericarditis, ventricular premature beats, ventricular tachycardia, left anterior hemiblock and complete left bundle-branch block and the highest mortality. Acute transmural inferior MI was responsible for the highest frequency of ventricular fibrillation in the ICCU and had a worse prognosis than non-transmural MI. Acute non-transmural MI resulted in the highest incidence of early and late myocardial reinfarction; although death in the ICCU was least frequent, mortality among this group had increased dramatically by 3 months' follow-up. Hence, acute non-transmural MI is not benign and an unstable period exists for 3 months thereafter. Because of this, more aggressive diagnostic measures should be instituted during this period in order possibly to improve prognosis in this group. It would appear that this is the first such study undertaken in South Africa. PMID- 3983734 TI - Prevalence of hepatitis virus and some arbovirus infections in Kavango, northern SWA/Namibia. AB - A survey of the frequency of hepatitis B markers in 258 subjects from Kavango, northern South West Africa/Namibia, was undertaken during February - May 1983. The hepatitis B surface antigen and hepatitis B e antigen carrier rates were 13,6% and 2,7% respectively. Only 1,9% of the subjects were negative for all the markers tested, indicating that infection had been present at some stage in 98,1% of the sample. No known transmission method of the virus seems to fit this high exposure rate. The possibility that arthropod transmission of the virus may play a role in the epidemiology of the disease in Kavango is being investigated. All subjects tested for antibodies to hepatitis A virus were found to give a positive result. Of the arboviruses tested for, West Nile virus was usually predominant and was probably responsible for most of the arbovirus infections. Antibodies to the Sindbis, Chikungunya, Germiston and Rift Valley fever viruses were also found. PMID- 3983736 TI - The silent menace. PMID- 3983735 TI - Ehlers-Danlos syndrome in the Western Cape. AB - The Ehlers-Danlos syndrome (EDS) is an uncommon heterogeneous inherited disorder in which articular hypermobility is associated with cutaneous extensibility and tissue fragility. A wide variety of complications may occur and although some forms of EDS are innocuous, others can cause serious disability. The condition has been reported from many parts of the world, but there is little information about it in Africa. To elucidate the local situation 12 affected people from the Western Cape have been investigated and information concerning 8 others has been analysed. PMID- 3983737 TI - A peculiar kidney. PMID- 3983738 TI - Anaesthesia for microsurgery. AB - The data from a retrospective study of 32 anaesthetics administered for free-flap tissue operations are analysed. We suggest balanced analgesic-dominated general anaesthesia, supported wherever possible by continuous regional block. Special attention is paid to full control over the cardiovascular system and the haemodynamics, including the microcirculation and optimal rheological properties of the blood, as well as metabolic ability. Our results suggest that factors such as adequate infusion therapy guided by central venous pressure and urinary output and strict body temperature control, supplementary use of regional blocks and peri-operative use of dextran 40 (Rheomacrodex) can contribute significantly towards the overall success of free-flap surgery. PMID- 3983739 TI - Comparison and ranking of cancer mortality rates in the various populations of the RSA in 1970. AB - Age-adjusted mortality rates (MRs) in all four population groups in the RSA (age range 25 - 74 years) for different types of cancer were compared and ranked. Lung and stomach cancer had the highest MRs in white, Indian and coloured males. In white males lung cancer ranked 1st (MR more than twice as high as that for stomach cancer), while in Indian and coloured males stomach cancer ranked 1st and lung cancer 2nd. The MR for lung cancer in coloured males was a little higher than that in white males. In black males oesophageal cancer ranked 1st and liver cancer 2nd. In white females breast cancer ranked 1st and lung cancer 2nd. In coloured females cancer of the cervix ranked 1st followed by cancer of the breast and of the stomach. In black females cancer of the oesophagus and of the liver ranked 2nd and 3rd after cancer of the cervix, and in Indian females the rank order was stomach cancer 1st, breast cancer 2nd, and cervical cancer 3rd. Cancers of the rectum and bladder were low in the rank order in both males and females of all four population groups. The main feature of age-specific MRs for the more common cancers was the fact that MRs for stomach cancer in both coloured males and females were relatively high in the younger age groups. Also, the MRs for cancer of the cervix in coloured and black females were not only higher at all ages (except in the highest age group in blacks) but were particularly high in the younger age groups compared with figures for the other populations. PMID- 3983740 TI - The iron status of urban black subjects with carcinoma of the oesophagus. AB - Non-haem iron concentrations were measured in 65 specimens of liver obtained from 50 male and 15 female black adults who died from carcinoma of the oesophagus in the Johannesburg area between 1971 and 1980. The results were compared with those obtained in two earlier studies on subjects who died from other causes. The first was carried out on 220 men and 164 women in 1959/1960 at Baragwanath Hospital, Johannesburg, and the second series, which consisted of 248 men and 181 women, was obtained at the same hospital in 1976. During the intervening period there was a marked drop in the incidence and severity of iron overload in urban blacks. A direct comparison between subjects with carcinoma of the oesophagus and the 1976 group showed that the geometric mean hepatic iron concentrations in the carcinoma patients were significantly higher in the 40-49, 50-59 and over-60 age groups. While geometric mean hepatic iron concentrations in the various age groups were also higher than those obtained in the 1959/1960 study, the differences only reached statistical significance in subjects over the age of 60 years. Seven of the 15 women had significant hepatic iron deposits (greater than 0,5% dry weight). These results suggest that the excessive consumption of home brewed alcoholic drinks contaminated with iron may be directly or indirectly associated with the development of carcinoma of the oesophagus in urban black adults. PMID- 3983741 TI - Johannesburg Hospital neonatal statistics--1983. AB - An analysis of Johannesburg Hospital neonatal admissions and deaths is presented for the period 1 January-31 December 1983. Infants weighing less than 1 500 g accounted for 25% of admissions and 47% of deaths. Compared with a previous report, a 68% increase in the admission of neonates weighing less than 1 000 g is shown. This increase probably reflects a more aggressive approach to the treatment of infants in this weight category. Despite a protracted period of hospitalization for survivors and some of those who did not survive, intensive care of the infant of very low birth weight (VLBW) appears to be justified, since: the major causes of death in this group are related to prematurity and are potentially preventable; and preliminary studies of VLBW survivors suggest a favourable outcome. PMID- 3983742 TI - Eclampsia in the black population of the Natal midlands. AB - A prospective analysis of age, parity, antenatal care, number of convulsions, level of consciousness, first fit-delivery interval and maternal and fetal outcome was carried out in 55 patients with eclampsia seen over 12 months. Several alterations to current management protocols are suggested. PMID- 3983743 TI - Intra-ocular tuberculosis associated with a penetrating injury. A case report. AB - A case of histologically proven intra-ocular tuberculosis is described. The condition was preceded by penetrating trauma, and no evidence of systemic tuberculosis other than a positive Mantoux test was found. Numerous acid-fast bacilli were seen in pathological sections of the eye. We suspect that a tuberculosis bacillaemia from an undetected healed focus coincided with the trauma and thereby produced intra-ocular tuberculosis. PMID- 3983745 TI - Amputations in vascular disease. PMID- 3983744 TI - Anaesthesia for abdominal hysterectomy in Charcot-Marie-Tooth disease. A case report. AB - A 44-year-old white woman with Charcot-Marie-Tooth disease underwent an abdominal hysterectomy. The pre-operative preparation and anaesthetic management are presented, and the specific problems discussed. PMID- 3983746 TI - Methaemoglobinaemia in pregnancy. PMID- 3983747 TI - Coronary risk factors in the coloured population of the Cape Peninsula. AB - A cross-sectional study of risk factors for coronary heart disease (CHD) in a random sample of 976 coloured people revealed a population greatly at risk of CHD. The major reversible risk factors--hypercholesterolaemia, hypertension and smoking--were very common, with 56% of the men and 40% of the women smoking, 18% of both men and women being hypertensive and 17% of both sexes being hypercholesterolaemic. At high cut-off points 62,8% of the men and 59,4% of the women had at least one major reversible risk factor. At lower but real levels of risk, over 80% of the population was affected. Other risk factors such as inactivity, overweight, hyperuricaemia, hypertriglyceridaemia and a positive family history of CHD were all common in this population group. A 'protective' high-density lipoprotein cholesterol level of greater than or equal to 20% of the total serum cholesterol level was found in 74,5% of the men and 81,1% of the women. A comparison with available data on other South African population risk profiles shows marked differences. The need for preventive strategies in the coloured population is clear. PMID- 3983748 TI - Four sins of medicine: 1984. PMID- 3983749 TI - Weaver's syndrome--primordial excessive growth velocity. A case report. AB - We report on a black child with the Weaver syndrome of primordial overgrowth, the seventh and largest case thereof yet recorded. His birth weight was 10 200 g and he has continued to grow at an excessive velocity. At the age of 14 months his weight was 30 kg, his height 105 cm and his radiological bone age between 6 and 7 years. Other features which conform to previous reports are a peculiar face with a long philtrum, protuberant lower lip, relative micrognathia, large dysplastic ears, excessive loose skin folds around the scalp, neck and trunk, large hands with camptodactyly, varus deformities of the feet and a hoarse, low-pitched voice. A significant feature in this patient is lumbar kyphosis due to hypoplasia of the second and third lumbar vertebrae. Biochemical and endocrinological tests did not reveal an abnormality. PMID- 3983751 TI - [A quarter of a century after the Philadelphia chromosome]. PMID- 3983750 TI - Mesangial proliferative glomerulonephritis with Legionnaires' disease. A case report. AB - Although the clinical and biochemical features of renal involvement in Legionnaires' disease have been well described, only a few case reports detailed the histological changes. A patient with Legionnaires' disease who developed acute renal failure is described; a biopsy specimen revealed mesangial proliferative glomerulonephritis. The renal morphological changes in Legionnaires' disease are reviewed. PMID- 3983752 TI - Nocturnal asthma and use of long-acting theophylline. PMID- 3983753 TI - Reactivation at Heaf test and BCG vaccination sites. PMID- 3983754 TI - Hemorrhagic right pleural effusion complicating pancreatitis. PMID- 3983755 TI - Blalock-Taussig shunts and modified Blalock-Taussig shunts. AB - Between January 1981 and December 1983, 53 systemic-to-pulmonary artery shunts, Blalock-Taussig shunts (BTSs) and modified Blalock-Taussig shunts (MBTSs) were carried out either as a preliminary procedure before complete correction of heart defects or as a means of permanent palliation. Central shunts continue to pose early and late problems and we seldom use them. Fifteen patients underwent a BTS and 38 an MBTS with a 5 mm polytetrafluoro-ethylene (PTFE) graft. Their ages ranged from 3 days to 11 years; 21 patients were less than 3 months old and of these 15 had an MBTS; 36 patients were less than 1 year of age and 27 of them had an MBTS. Three patients were receiving prostaglandin at the time of surgery. The overall early hospital mortality was 5,6% (3 cases); these were babies less than 2 months old. The late mortality was 3,7% (2 cases); these deaths were not shunt related and were in babies less than 4 months old. There were 4 cases of shunt failure (7,5%) at 6, 22, 26 and 27 months after operation; a second shunt was performed in all these patients. The 48 survivors have been followed up for an average of 23 months (range 5-41 months); 6 have already undergone a complete repair. Long-term results are difficult to assess accurately because of problems with follow-up. Eight of the 53 patients had mild congestive heart failure which responded to digitalis. Because of the reliability and excellent late patency of the PTFE prosthesis, we consider it to be superior to the Waterston shunt for relief of cyanosis in the neonate and infant and as reliable as the BTS. PMID- 3983756 TI - Pulmonary artery banding. AB - Between January 1981 and December 1983 22 children underwent pulmonary artery banding at the Red Cross War Memorial Children's Hospital, Cape Town. The indications for banding in this group were control of pulmonary overperfusion and severe congestive cardiac failure. The underlying cardiac defects were tricuspid atresia with ventricular septal defect (VSD), transposition of the great arteries and univentricular heart, large or multiple VSDs, double-outlet right ventricle, atrioventricular canal defect, persistent truncus arteriosus and the VSD-patent ductus arteriosus-coarctation syndrome. Three children died (13,6%) in the first 30 days postoperatively and another 3 died 5-7 weeks after surgery. PMID- 3983757 TI - Ketoconazole in the treatment of vaginal candidiasis. AB - In a preliminary open prospective study ketoconazole (Nizoral; Janssen) 200 mg twice daily for 5 consecutive days was found to be extremely effective in treating vulvovaginal candidiasis, producing cure rates of 96% at 7 days and 92% at 28 days. The oral route of administration has definite advantages over the vaginal route and improves patient compliance. No side-effects related to treatment were found in this study. PMID- 3983758 TI - Outcome after admission to an intensive care unit. A 6-week study at Baragwanath Hospital. AB - This study reports the short- medium- and long-term outcome of treatment in patients admitted to the Baragwanath Hospital Intensive Care Unit; 81% were discharged in a satisfactory state, but the morbidity rate of 11% was unacceptably high. PMID- 3983759 TI - Renal oncocytoma. A report of 3 cases. AB - Three cases of renal oncocytoma are presented; all were in women and involved the lower pole of the kidney. The patients presented with renal masses, but haematuria was not a feature. Unexplained monocytosis was found in 2 cases. Ultrasound investigations and intravenous pyelography gave non-specific results and the diagnoses were made on the basis of the histopathological findings. PMID- 3983760 TI - Life-threatening haemolytic anaemia and infectious mononucleosis. A case report. AB - A 36-year-old man with infectious mononucleosis presented with massive intravascular haemolytic anaemia. The diagnosis was established by a positive Paul-Bunnell test, the demonstration of IgM antibodies against Epstein-Barr virus capsid, and IgG antibody to early antigen. The direct and indirect antiglobulin tests were negative; the pathogenesis of the severe haemolysis was attributed to the temporary synthesis of anti-i cold agglutinin having a high thermal amplitude. Although life-threatening, the episode was short-lived and responded to supportive therapy with blood transfusion and folate administration only. This case illustrates a rare association between severe haemolytic anaemia and infectious mononucleosis, it emphasizes the value of IgM-specific fluorescent antibody tests in diagnosis when patients have otherwise unexplained haemolysis. PMID- 3983761 TI - Spontaneous regression of large theca lutein cysts in a twin pregnancy. A case report. AB - A case of bilateral theca lutein cysts in a twin pregnancy is presented. Under ultrasound surveillance the cysts were seen to undergo spontaneous regression which was not matched by a falling human chorionic gonadotrophin titre. PMID- 3983762 TI - [Medical research--are we in earnest?]. AB - The need for extensive medical research in the RSA, with its four major population groups of widely divergent cultures, genetic compositions and developmental stages and living within a greatly varying geographical and climatic environment, is again emphasized. This country with its ills, such as tuberculosis and many other rampant infections and parasitic diseases, differing forms of cancer, high incidence of cardiovascular disease and of accidental death, should be seriously engaged in more meaningful medical research programmes. Despite a favourable governmental attitude towards research and effective and functional organizational structures including the South African Medical Research Council, there is a relatively small medical research community and a much less than optimal research effort. The major restrictions identified are those of the attitudes towards research of the public and the medical profession itself; these are reflected in the official low-priority ranking--12th among the 18 more important socio-economic sectors of research. This has led to a shortage of research manpower and funds. PMID- 3983763 TI - The management structure for research in the RSA, with a proposed management model for medical faculties. AB - Government accepts responsibility for stimulating and supporting research and development for the welfare of the entire community. Research is therefore a matter of serious concern which should be approached with the greatest degree of responsibility by those trained and qualified to engage in its pursuit. A description is given of those institutions established for overall planning of matters of common concern to all research bodies: the Scientific Advisory Council, the Science Planning Branch of the Department of Constitutional Development and Planning, and the Scientific Priorities Committee. Medical research has made significant progress since the establishment in 1969 of the Medical Research Council, which has devised a management structure to discharge its responsibilities effectively on a national basis. This structure and its underlying philosophy are discussed. There is a great need to strengthen the management structures of research at medical faculties, teaching hospitals and other medical institutions to ensure cost-effectiveness and provide an ongoing flow of research manpower. A research structure for this purpose is proposed and described. PMID- 3983764 TI - Effects of piretanide on potassium balance in hypertension. AB - Ten hypertensive patients completed a trial lasting 12 weeks to measure the effect of long-term treatment with piretanide, a new, powerful 'loop' diuretic, on total body potassium (TBK). After 2 weeks of placebo treatment, they received 6 mg piretanide twice daily. This dose was increased to 6 mg 3 times a day if blood pressure was not satisfactorily lowered after 4 weeks. Blood pressure and plasma potassium levels were measured weekly. The TBK was measured fortnightly. In this study potassium balance was not significantly affected by the administration of piretanide. PMID- 3983765 TI - Pleural sinography in the management of thoracic empyema. A study of 52 cases. AB - Pleural sinography is indicated in the management of empyema thoracis. The factors influencing the successful completion and interpretation of this procedure are discussed. A retrospective study of 86 sinograms from 52 patients with pleural empyema was undertaken to identify how the information obtained influenced management decisions and affected therapy. Pleural sinography is a valuable study within the limitations of correct performance and interpretation. PMID- 3983766 TI - Coarctation and coarctation syndrome. A 5-year review. AB - The management of and results of treatment in 57 children with coarctation of the aorta are presented. In this series, 75% of the patients presented in the 1st year of life and 51% presented as neonates. Among the 50 patients who underwent surgery the total surgical mortality rate was 14%. The higher mortality in young infants is closely related to associated cardiac anomalies. We suggest that neonates with coarctation presenting with heart failure should be operated on early, as this significantly reduces the mortality. PMID- 3983767 TI - The effect of surgical glove powder on cleavage of two-cell mouse embryos in an in vitro fertilization programme. AB - The effect of surgical glove powder on the development of early mouse embryos was studied. Embryos from F1 hybrid mice (C57 B1/6 X CBA) were suspended in Whittingham's T6 growth medium with 10% human serum, using Petri dishes (Falcon 3001). Contamination was brought about by a sterile, powdered, surgical glove touching the surface of the growth medium for less than a second in group I, and in group II the same procedure was followed but the glove was rinsed beforehand with sterile, four times distilled water and air-dried. In the control group (group III) no contamination with surgical glove powder occurred. In group I only 9 of 137 embryos (7%) reached the blastocyst stage, in contrast with 110 of 196 (56%) in group II and 258 of 287 (90%) in group III. The differences in results between groups I and III, groups I and II, and groups II and III were found to be statistically significant (P less than 0,001) by the chi-square test. It is concluded that surgical gloves are a potent inhibitor of early embryonic growth. In an in vitro fertilization programme including follicle aspiration and embryo transfer, contamination of embryos with these gloves should be avoided at all costs. PMID- 3983768 TI - Standards for the assessment of visual evoked potentials in an ethnically heterogeneous adult population. AB - Visual evoked potentials (VEPs) were recorded by chequerboard pattern-reversal stimulation in 276 normal adult subjects aged 15-73 years. The sample comprised comparable white, coloured and black groups of both sexes. Significantly shorter latencies of the major positive component were found in both male and female black subjects compared with those in whites. No significant differences were found between the amplitudes in the different population groups, but females in each population group showed significantly higher amplitudes of the major positive component than males. There was a close relationship between latency and amplitude for both right and left eyes. Except in coloured females, a non-linear relationship of the major positive component with age was demonstrated, the shortest latency being at about 35 years of age. It is suggested that the following criteria be used in the evaluation of VEP recordings: latency as well as the difference between latencies and amplitudes of the two sides of the major positive component (P1) as compared with standardized values for ethnic, sex and age groups. PMID- 3983770 TI - X-ray equipment for routine investigations--the WHO Basic Radiological System. AB - In an attempt to increase the extent and quality of primary medical care, the World Health Organization (WHO) has identified one factor in the need for simple X-ray examinations at the primary health care level. Using modern technology, the WHO has devised an X-ray unit capable of functioning with an 'indifferent' electrical supply. Although simple to use, it is capable of producing excellent radiographs, covering 80% of the radiological examinations required in any hospital or clinic. The relatively low initial outlay for these units, together with their low installation and maintenance costs, makes them ideal for dealing with routine radiography not only in Third World countries but also in countries with more sophisticated medical systems where complex and expensive equipment is all too often unnecessarily used for simple examinations. PMID- 3983769 TI - The HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome in severe hypertensive crises of pregnancy--does it exist? AB - The HELLP syndrome, comprising haemolysis, elevated liver enzyme values and a low platelet count, was studied in 26 women with hypertensive crises of pregnancy and in matched controls. Platelet counts and bilirubin, lactate dehydrogenase, aspartate transaminase and haematocrit levels together with peripheral blood smears were studied on the day of admission and on the 7th day after delivery. Only 1 woman with pre-eclampsia was found to have had the HELLP syndrome; the case report is presented and the laboratory investigations are discussed. PMID- 3983771 TI - Onyalai in pregnancy--effects on the mother and the newborn. AB - Eight pregnant Kavango women with documented active onyalai during pregnancy or a history of previous attacks of onyalai gave birth to 8 healthy infants who had no clinical signs of a tendency to haemorrhage and had normal platelet counts. Postpartum haemorrhage occurred in 2 patients. A splenectomy was successfully performed on the 7th day after delivery in 1 patient to control postpartum haemorrhage, and 3 months after confinement in another patient to control haemorrhage from another clinical attack of onyalai. Corticosteroids are not indicated in the management of onyalai. Infants of mothers with onyalai, unlike infants of mothers with idiopathic thrombocytopenic purpura, do not appear to be at risk of thrombocytopenia and haemorrhage. PMID- 3983772 TI - The Small-Carrion penile prosthesis--local results. AB - Poor operative technique, resulting in sepsis and extrusion, is threatening the reputation of the Small-Carrion penile prosthesis in some areas. A series of 50 consecutive cases in which no sepsis or spontaneous extrusion occurred is reviewed. It is concluded that strict adherence to the principles of prosthetic surgery makes the Small-Carrion prosthesis safe and reliable. PMID- 3983773 TI - The antibacterial action of honey. An in vitro study. AB - The reported antibacterial effect of pure honey was evaluated by an in vitro study testing the growth of various Gram-positive and Gram-negative bacteria in media containing varying concentrations of honey. It was found that most pathogenic bacteria failed to grow in honey at a concentration of 40% and above. The possible mechanisms of this effect are briefly outlined. PMID- 3983774 TI - Low-density lipoprotein receptor deficiency resulting in familial hypercholesterolaemia in a black man. A follow-up study. AB - The binding and catabolism of low-density lipoprotein (LDL) was measured in cultured skin fibroblasts and Epstein-Barr virus-transformed lymphoblastoid cells from a South African black man. On the basis of LDL receptor activity, the patient was classified as a familial hypercholesterolaemic homozygote of the LDL receptor-defective type. PMID- 3983776 TI - Intra-operative orthograde colorectal wash-out in colonic trauma. PMID- 3983775 TI - Achalasia in Zimbabwean blacks. AB - The incidence and clinical features of achalasia in Zimbabwe have not previously been documented. During a 10-year period (1974-1983) 25 cases were seen in Bulawayo and Harare. The estimated incidence is 0,03/100 000 members of the population per year, which is much less than the incidence in Europe and America. Achalasia occurred at any age and there was a preponderance of cases in males. Dysphagia was invariable and its duration varied from 2 weeks to 15 years. Parotid enlargement was found in 2 patients and respiratory infections occurred relatively frequently. The importance of excluding oesophageal carcinoma is emphasized. PMID- 3983777 TI - Artificial insemination by donor at Groote Schuur Hospital. AB - An artificial insemination by donor (AID) service was started in the Infertility Clinic at Groote Schuur Hospital, Cape Town, in response to repeated requests by patients, doctors and social workers. The methods, results of treatment, and reasons for reorganizing the work of the clinic are presented. Future management at the clinic is also outlined. The clinic has been reorganized and work on semen cryopreservation is being carried out by the Andrology Service at Groote Schuur Hospital. A semen bank has also been established. The ethical, religious, legal and genetic aspects of AID are reviewed. PMID- 3983778 TI - Placenta praevia and intra-uterine growth retardation. AB - In 297 cases of placenta praevia, intra-uterine growth retardation was noted in 17,5% of the neonates. This indicates the need for careful monitoring of fetal growth and function during the conservative management of placenta praevia. PMID- 3983779 TI - The birth of a child with a congenital anomaly. Part I. Some difficulties experienced by parents in the maternity home. AB - An investigation study of 90 cases in which a baby had been born with cystic fibrosis, oesophageal atresia, Hirschsprung's disease or an anorectal malformation was undertaken to establish the duration of the prediagnostic phase and the difficulties experienced by parents before discharge from the maternity home. The congenital anomalies requiring immediate surgical intervention were diagnosed very soon after birth. A wider diversity of problems were encountered in the case of those conditions with a longer prediagnostic phase. The problems encountered by parents, viz. lack of communication with staff, fantasies of gross anomalies with fear for the baby's life, and the lack of viewing and mothering of the baby are discussed, and some long-term effects are highlighted. PMID- 3983780 TI - [Teenage pregnancies in the Paarl hospital]. AB - Of the 20 590 mothers delivered at the Paarl Hospital from the beginning of 1973 to the end of 1983, teenagers numbered 6 284 (30,51%). About 5% of all mothers were 16 years old or younger. No other country has such an alarming incidence of young teenage mothers, and no country can afford the vicious circle of socio economic demands that will be generated by this catastrophe. Worst of all, the babies born are often defective at birth, with little chance of holding their own in life because of their subsequent inferior intellectual and somatic development. The demographic consequences are formidable. PMID- 3983781 TI - Bleeding from varicose vein--still potentially fatal. A case report. AB - A 57-year-old woman was admitted to hospital with spontaneous profuse haemorrhage from a small acute varicose ulcer of the left leg. She was in shock, semicomatose and anaemic because of blood loss. The haemorrhage was easily controlled by elevating the leg, applying compression bandages and administering a blood transfusion. The patient made an uneventful recovery. PMID- 3983782 TI - Severe chronic headache treated by simple dental procedures. Case reports. AB - Seven cases of severe unremitting headache caused by temporomandibular joint dysfunction and the myofascial pain dysfunction syndrome are reported. Most patients had been examined and treated by one or other representative of the medical disciplines. PMID- 3983783 TI - Nephrocalcinosis, hypercalcemia, sarcoidosis or primary hyperparathyroidism? PMID- 3983784 TI - Trans unsaturated fatty acids in margarines. PMID- 3983785 TI - Low plasma pyridoxal-5'-phosphate levels in children with the nephrotic syndrome. AB - Of 35 children with the nephrotic syndrome in relapse, 88% were found to have low circulating plasma pyridoxal-5'-phosphate (PLP) levels. Remission of the syndrome was associated with spontaneous normalization of plasma PLP levels in 23 such children. A significant (P less than 0,001) positive correlation (r = 0,81) was found between plasma albumin and PLP levels and a significant (P less than 0,001) negative correlation (r = -0,66) between plasma PLP and serum cholesterol levels. The low plasma PLP levels may be due to enhanced urinary excretion of albumin bound PLP in view of the severe proteinuria which characterizes the nephrotic syndrome. PMID- 3983786 TI - Rupture of the gravid uterus. AB - A detailed analysis of 129 cases of rupture of the gravid uterus between 1980 and 1983 is presented and compared with two previous reports from King Edward VIII Hospital, Durban, over the last 2 decades. Statistically significant decrease in the occurrence of this condition (from 2,7 to 1,06/1000 deliveries (P less than 0,001; chi 2 = 20,38)) and in the maternal mortality rate (from 12% to 3%) have taken place since the initial study. The most probable reasons for this improvement are the provision of a community-based obstetric service, the early detection of cephalopelvic disproportion, awareness of the condition, immediate and adequate resuscitation once the diagnosis is established, and the performance of a total abdominal hysterectomy as definitive treatment in most cases. PMID- 3983787 TI - The birth of a child with a congenital anomaly. Part II. The prediagnostic phase after discharge from the maternity home. AB - Thirty babies discharged from the maternity home undiagnosed were subsequently found to be suffering from cystic fibrosis (12 cases), Hirschsprung's disease (13) or an anorectal malformation (5). The efforts of parents in this respect and the factors influencing the establishment of a diagnosis were investigated. Maximum periods of 3,9 years, 3,75 years and 5 years respectively were required to confirm a diagnosis in patients with the above three conditions. Although the severity of symptoms is an important factor in speed of diagnosis, other mediating variables had influenced the outcome in our sample; patients referred to a children's hospital were diagnosed sooner. For this reason patients from the lowest social class were diagnosed earlier than those from the higher socio economic groups. The problems experienced by parents during this phase are reviewed. PMID- 3983789 TI - Women and social security. PMID- 3983788 TI - Effects of an intravenous bolus calcium injection on glomerular filtration rate and electrolyte excretion in the kidney in conscious pigs. AB - This paper reports the changes observed in the concentration of various constituents of plasma and in their excretion in the urine after a bolus intravenous injection of 2,2 mM calcium gluconate into conscious pigs weighing 20 kg. In the plasma, both ionic and total calcium concentrations increased but returned to normal within 35 minutes, while sodium, potassium and inorganic phosphate did not change significantly. In the kidney, the urine volume, glomerular filtration rate (GFR) and fractional sodium excretion increased slightly during the first 10 minutes but became significantly depressed later. Potassium and phosphate levels decreased, the latter significantly, while the calcium concentration increased significantly and only returned to normal after 70 minutes. These results suggest that since the disturbances in urinary volume, GFR and fractional phosphate excretion persist after both the plasma calcium and urinary calcium levels have returned to normal, factors other than these calcium values may be responsible for changes in the former measurements. PMID- 3983791 TI - Fifty years ago. PMID- 3983790 TI - Women social security beneficiaries aged 62 or older, 1960-83. PMID- 3983792 TI - The role of peripheral lymphocytes in the prediction of recurrence in Crohn's disease. AB - Sixty-five patients with Crohn's disease admitted for surgical treatment to The Mount Sinai Hospital were studied prospectively to determine whether or not preoperative peripheral lymphocyte counts correlate with early recurrence. Twenty four patients had symptomatic recurrent disease develop within three years after operation. Patients who had recurrences were found to have significantly lower preoperative lymphocyte counts than patients doing well three years after surgical resection. Sixty-nine per cent of the patients with preoperative lymphocyte counts of less than 1,000 cells per cubic millimeter had recurrent disease develop within three years of the operation. In contrast, only 8 per cent of the patients with preoperative lymphocyte counts of more than 2,100 cells per cubic millimeter had recurrences. It appears that patients with marked preoperative lymphocytopenia are more likely to develop early symptomatic recurrences after surgical treatment than patients with normal lymphocyte counts. PMID- 3983793 TI - Ischemic colitis complicating reconstruction of the abdominal aorta. AB - A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence of 0.5 per cent was revealed for full-thickness necrosis. The mortality was 70 per cent since diagnosis was made first since perforation and peritonitis had occurred. On the basis of these findings vital prophylactic measures and diagnostic possibilities are discussed herein. PMID- 3983794 TI - The continuing problem of tetanus. AB - Thirty-eight instances of tetanus were treated during a recent 20 year period at the University of Mississippi and Jackson Veterans Administration Medical Centers. One patient had received a single prior dose of tetanus toxoid and the remainder had never received tetanus toxoid. Sixteen patients sought medical care for their tetanus wound prior to the onset of clinical tetanus, but none received specific antitetanus prophylaxis. The majority of tetanus wounds were located on lower extremities and often were chronic vascular ulcers. The over-all mortality was 37 per cent and survival rate was not affected by patient age, duration, location or severity of the tetanus wound or presence of associated diseases. Aggressive surgical treatment of the tetanus wound was associated with decreased mortality for uncertain reasons. Although low mortality from tetanus is possible with improved intensive care technology, the disease should be virtually preventable by the provision of proper tetanus prophylaxis to all patients at risk. PMID- 3983795 TI - Surgical treatment for carcinoma of the esophagus in the elderly patient. AB - There were 250 Japanese patients with carcinoma of the thoracic esophagus who had been admitted to the Second Department of Surgery at the Kyushu University Hospital from 1972 to 1982. Resection for carcinoma of the esophagus was performed upon 160 of these patients (64 per cent). These 160 patients were classified into three groups according to age, and preoperative examination, postoperative complications, mortality and late results were reported. In patients more than 70 years old, the incidence of abnormal findings at preoperative examination was high with a statistical difference and the incidence of postoperative complications was also high in elderly patients. Although the over-all mortality within one month after operation was seen in eight of 160 patients (5 per cent) surgically treated, the rate was 12.8 per cent when confined to those patients more than 70 years old. Thus, the indication for surgical treatment should be carefully determined for elderly patients with carcinoma of the esophagus. If the elderly patient can tolerate the surgical procedure, the five year survival rate is equal to that of younger patients. Since there is an increase in people more than 70 years old, the surgeon must be prepared for the challenge of treating elderly patients with carcinoma of the esophagus. PMID- 3983796 TI - Lack of effect of glucocorticoids upon plasma thromboxane in patients in a state of shock. AB - Twenty-five patients with sepsis were studied retrospectively to examine the effects of methylprednisolone on plasma thromboxane B2 levels. Although the plasma iTxB2 level was elevated in patients dying from sepsis, the use of glucocorticoids did not reduce plasma iTxB2. Aspirin, a cyclo-oxygenase inhibitor, did reduce the plasma iTxB2 value in four patients. It does not appear that glucocorticosteroids significantly affect the conversion of arachidonic acid to thromboxane in septic patients. PMID- 3983797 TI - Reconstitution of intestinal continuity after resection for neonatal necrotizing enterocolitis. AB - Thirty-five infants were treated surgically for neonatal necrotizing enterocolitis during the past eight years. Twenty-five of these, managed by resection and exteriorization, later underwent reconstitution of the intestinal tract. Eleven infants (69 per cent) with ileostomy and three (100 per cent) with jejunostomy exhibited stenosis or severe dehydration, electrolyte loss and acidosis requiring closure to achieve positive caloric balance. Fewer serious postoperative complications were observed after reanastomosis by Roux-en-Y enteroenterostomy and single limb ileostomy (Bishop Koop) versus end to end anastomosis. Operative mortality for small intestinal stoma closure was 10 per cent. Complications from colostomy formation occurred in 67 per cent. However, fluid and electrolyte loss was not observed and adequate weight gain was achieved in four of six patients allowing for elective closure by end to end anastomosis. Operative mortality for colostomy closure was nil. PMID- 3983798 TI - Peritoneal lavage with metronidazole. AB - It is rational and safe to use metronidazole in peritoneal and wound lavage for the treatment of severe infection. The results of this study compare favorably with that of other studies. In this study, new light has been shed on the treatment of intraperitoneal sepsis, but there is still more work to be done in evaluating the therapeutic value of metronidazole lavage in wounds. PMID- 3983799 TI - A simplified method of wedge liver biopsy. PMID- 3983800 TI - Streamlined fluorescein photography. AB - A simple, accurate inexpensive method for obtaining Polaroid pictures after the intravenous injection of fluorescein is presented. The method relies on an interference filter system and modifications permitting the use of high speed film. The resultant photographic images are equivalent to the ultraviolet light fluorescence. The photographs may be used as either a diagnostic tool or for documentation purposes. PMID- 3983801 TI - Popliteal artery to saphenous vein vascular access for hemodialysis. AB - A graft placed between the popliteal artery and proximal saphenous vein for hemodialysis is an excellent alternative when more conventional arteriovenous fistulas cannot be accomplished. This technique has proved to be safe and reliable. The procedure is easily and rapidly performed. It provides a long segment of material with excellent accessibility. PMID- 3983802 TI - A new forceps for removal of biliary tract stones. PMID- 3983803 TI - Construction of an omental envelope as a method of excluding the small intestine from the field of postoperative irradiation to the pelvis. AB - A technique for excluding the small intestine from the true pelvis in order to permit high dose radiotherapy is described herein. The procedure is done postoperatively after incomplete resection for carcinoma of the colon and rectum. PMID- 3983804 TI - A technique for intraoperative arteriography following carotid endarterectomy. AB - This technique provides a simple and reliable means of obtaining an operative arteriogram after carotid endarterectomy. Detection of unsuspected abnormalities before the wound is closed allows the surgeon to correct any abnormalities immediately with hopes of decreasing the incidence of postoperative neurological deficits. PMID- 3983806 TI - Somatosensory evoked potentials in hysterical paraplegia. AB - Somatosensory evoked potentials were determined in three patients with hysterical neurologic deficits after minor trauma. In each case the patient denied any sensation of the stimulus in the affected extremity; however, normal evoked potentials were recorded. Objective evidence of the hysterical nature of the neurologic deficit was, therefore, provided. PMID- 3983805 TI - Spontaneous occlusion of traumatic carotid cavernous fistula after orbital venography. AB - A 50-year-old man was admitted to our hospital with a diagnosis of traumatic carotid cavernous fistula. The fistula was observed to disappear spontaneously just after orbital venography. This was confirmed by clinical examinations and subsequent carotid angiogram. The possible mechanisms responsible for the spontaneous occlusion of carotid cavernous fistula are discussed. PMID- 3983807 TI - Intrapetrous neurinomas of the facial nerve. Report of three cases. AB - Three cases of intrapetrous neurinomas of the facial nerve are reported and their diagnostic and surgical problems are discussed. Two of them revealed rare intracranial extensions and the other was a typical intrapetrous expansion of the tumor. The literature of intracranial neurinomas of the facial nerve is reviewed in detail. PMID- 3983808 TI - Prolonged survival after severe traumatic injury limited to the brainstem. AB - It has been suggested that primary traumatic lesions of the brainstem do not occur in the absence of widespread injury to other parts of the brain. We describe a patient who suffered a severe head injury that left him with paralysis of three extremities and weakness in the fourth. Intellectual function was entirely preserved. Neuropathological examination 39 years after the injury disclosed the presence of a cavitary lesion within the basis pontis. There was no pathological evidence of traumatic injury to any other part of the central nervous system. PMID- 3983809 TI - Chronic meningitis with marked unilateral tentorial pachymeningitis. AB - Two cases of chronic meningitis with marked granulomatous thickening of the cerebellar tentorium are presented. The clinical features of both cases were those of chronic meningitis, namely, incessant chronic headache, long-lasting moderate increase of intracranial pressure, multiple cranial nerve involvement, slight lymphocytosis, and increased protein in cerebrospinal fluid. The characteristic finding on computed tomography scan was slight, high density of the unilateral cerebellar tentorium with marked contrast enhancement. Both patients died of complications, and necropsy revealed marked granulomatous thickening of the unilateral cerebellar tentorium. Although noninfectious disease was strongly suspected, the etiology could not be specified either clinically or by necropsy. PMID- 3983810 TI - Bilateral decerebration in head-injury patients. An analysis of sixty-two cases. AB - The factors that contributed to recovery were reviewed in 62 head-injured patients with bilateral decerebration. The most important prognostic variables were age, mode of accident, time interval since injury, results of initial neurological evaluations, and the type of intracranial mass lesion. A higher survival rate was recorded in patients less than 20 years of age, those involved in nonvehicular accidents, those admitted within 6 hours of the accident, and where the vestibuloocular reflexes were preserved. Patients with extradural hematomas and those with nonsurgical intracerebral mass lesions also had a relatively better prognosis. In no patient was elective ventilation, steroid, or megadose barbiturate therapy utilized. Twenty patients (32%) of the 62 survived, and 11 patients had a good functional recovery. PMID- 3983811 TI - Port wine nevus associated with ipsilateral saccular aneurysms: treatment by intraarterial balloon trapping. AB - A 21-year-old woman with a port wine nevus presented with ipsilateral monocular visual loss. A computed tomography scan of the brain revealed a round suprasellar mass. Angiography demonstrated aneurysm of the right external carotid artery, and petrous, cavernous, and giant ophthalmic internal carotid aneurysms. Four detachable balloons were deployed with arteriographic guidance, resulting in occlusion of the right carotid artery. The association of aneurysms and phakomatoses is discussed. The use of detachable balloons in the treatment of nonresectable aneurysms represents a safe and advantageous option. The use of detachable balloons for carotid occlusion has proven to be an effective modality in the treatment of giant supraclinoid and carotid-cavernous aneurysms. Giant intracranial aneurysms have been surgically treated with carotid ligation proximal to the aneurysm and by direct approach using microsurgical technique. In cases in which direct ligation is not possible balloon occlusion represents an effective alternative. This case illustrates treatment by carotid trapping performed entirely with intraarterial balloons. In addition the association of saccular aneurysms in a patient with a port wine facial nevus is reported. PMID- 3983812 TI - "Numb, clumsy hands". PMID- 3983813 TI - Pitfalls in computed tomographic evaluation of the cavernous sinus. AB - Computed tomography (CT) is the diagnostic procedure of choice in cavernous sinus evaluation. Two patients are reported with painful ophthalmoplegia due to metastatic carcinoma to the cavernous sinus in which initial CT scanning was considered to be normal. These cases illustrate the necessity of thin tomographic sections (5 mm or less), multiple projections (axial, coronal) and large doses of intravenous contrast medium (bolus and drip infusion). Careful technique is essential in order to thoroughly evaluate the parasellar region and avoid a false negative CT examination. PMID- 3983815 TI - Rate of progression in breast cancer and the disease-free interval. AB - Patients with breast cancer have been classified as having slow, intermediate, or rapid rates of disease progression through the use of a clinical index, which depends on data from the patient's history. Patients without evidence of adverse progression of disease who waited 4 months or more between their first symptom and treatment were classified as slow; those waiting less than 4 months, intermediate. Patients with evidence of adverse progression were classified as rapid. We evaluated the 616 patients who had no evidence of distant disease at the time of treatment from an inception cohort of 685 patients to assess the correlation between the slow, intermediate, and rapid strata and the disease-free interval. Ten percent were in TNM stage I, 63% in TNM stage II, and 26% in TNM stage III. Among the 43% (266/616) of patients who developed recurrent disease, the median disease-free interval was longest in the slow stratum (33.6 months) and shortest in the rapid stratum (19.5 months). The difference in the 10-year disease-free survival rates in the three strata was significant (chi 2 = 26.4; p less than 0.001). The findings were similar when prognosis was assessed within the TNM stage or nodal groups. For example, in the rapid stratum, node-negative and node-positive patients had almost identical disease-free intervals. The independence of the contribution of the rate of disease progression strata to predicting disease-free survival was confirmed through the Cox analysis. If breast cancer did recur, the manifestation occurred sooner in patients who were demarcated as rapid by the clinical index. Thus the index estimates the aggressiveness of residual disease when it is present. PMID- 3983814 TI - Unusual visual symptoms. AB - Three cases with unusual and interesting symptomatology are presented. In each case the symptoms alone can lead the physician to an accurate localization of the lesion. PMID- 3983816 TI - Influence of different anesthetic agents on the release of cholecystokinin in dogs. AB - The purpose of this study was to investigate the effect of pentobarbital, halothane, and chloralose anesthesia on the endogenous release of cholecystokinin 33 (CCK-33) in dogs prepared with duodenal fistulas. Release of CCK-33 was induced by intraduodenal infusion of a medium-chain triglyceride (corn oil, 1 gm/kg/hr). Plasma CCK-33 concentrations were measured by means of a specific radioimmunoassay. Pentobarbital and chloralose were administered intravenously, and halothane was administered by a vaporizer (semiclosed technique), with O2 and N2O used as carriers. No incidence of hypotension was found with the use of these anesthetic agents. Basal concentrations of plasma CCK-33 were elevated, although not significantly, during pentobarbital or chloralose anesthesia. In conscious dogs (control study), peak plasma CCK-33 concentrations of 529 +/- 53 pg/ml were measured 30 minutes after intraduodenal infusion of fat. Under pentobarbital anesthesia, peak plasma CCK-33 concentrations of 452 +/- 264 pg/ml were found 80 minutes after infusion of fat. Under halothane anesthesia, fat-induced release of CCK-33 was abolished, whereas chloralose anesthesia did not influence fat-induced release of CCK-33. These findings may have implications for the design of future studies of gastrointestinal physiology. In CCK-33 studies that require anesthesia, chloralose appears to be an appropriate anesthetic agent. PMID- 3983817 TI - Ventricular sepsis and abdominally related complications in children with cerebrospinal fluid shunts. AB - In a retrospective study of 300 children who underwent placement or revision of cerebrospinal fluid (CSF)-peritoneal shunts during a 10-year period, 15 (5%) developed shunt-related abdominal complications with ventricular sepsis and two developed acute perforated appendicitis. Abdominal complications and associated shunt infections suggested two potential modes of development: (1) descent of contaminated CSF from an infected shunt into the abdomen (CSF ascites--four patients, CSF pseudocysts--four patients, and shunt-induced abscess/peritonitis- five patients); and (2) ascent of bacteria into the shunt from an abdominal source (visceral perforation by the shunt catheter--two patients and acute perforated appendicitis--two patients). Three types of shunt systems were placed during the study period; five of the seven (71%) most serious septic complications were associated with the use of Raimondi spring-reinforced catheters. Bacteria isolated in this series were associated with differing modes of sepsis: those involving descent of bacteria into the abdomen from an infected shunt were predominantly gram-positive, cutaneous microorganisms, whereas those associated with ascent of bacteria from the abdomen into the shunt were mixed, gram-negative intestinal microorganisms. Appendicitis did not result in shunt infections. Aggressive treatment resulted in no operative or complication-related deaths. Removal of the shunt catheter from the abdomen and intravenous antibiotics were essential for eradication of sepsis; laparatomy was required only for cases with suspected peritonitis. In eight of the 17 (47%) patients, reestablishment of CSF-peritoneal shunts was performed after resolution of shunt related complications. In recent years improved shunting materials and supportive care have reduced the incidence of the most serious of these complications. PMID- 3983819 TI - Liver amino acids in sepsis. AB - The metabolic derangement of sepsis leads to changes of the plasma and muscle amino acid (AA) pattern. In this study the influence of a septic process on liver AA pattern was investigated. In seven patients with abdominal sepsis, liver AA concentrations were determined during surgery and compared with those of four patients who had undergone cholecystectomy. In sepsis lowered AA levels were found for most of the AAs. Outstanding decreases exhibited the levels of the gluconeogenetic AAs (especially threonine and alanine), the branched chain AAs, lysine, and taurine. In the patients who did not survive the septic process, the depletion of these AAs was even amplified. Slightly increased AA levels were analyzed for P-ethanolamine, cystathionine, citrulline, beta-alanine, tyrosine, and phenylalanine. The results indicate a disturbed free AA pattern of the septic liver. Despite the increased flux of gluconeogenetic AA from muscle to liver in sepsis, as reported by several authors, no accumulation of these AAs occurs in the liver. PMID- 3983818 TI - Recovery of left ventricular function after graded cardiac ischemia as predicted by myocardial P-31 nuclear magnetic resonance. AB - The purpose of this study was to determine noninvasively some critical level of high-energy phosphate stores that relates to the recovery of ventricular contractile function after graded cardiac ischemia. Rabbit hearts (n = 30) were equipped with an intraventricular balloon to monitor developed pressure and +/- dp/dt and placed in a nuclear magnetic resonance magnet (Bruker, 4.7 Tesla). Each heart underwent 10, 20, 40, or 60 minutes of global ischemia followed by 1 hour of reperfusion. The pH as determined by nuclear magnetic resonance dropped from 7.14 +/- 0.04 to 7.07 +/- 0.07 (p less than 0.02) at 1 minute and to 6.19 +/- 0.08 at 30 minutes of ischemia; pH ceased to fall thereafter. Phosphocreatine was depleted to 10% +/- 7% of its preischemic control in 10 minutes. Adenosine triphosphate (ATP) concentrations were 71% +/- 14% and 1% +/- 2% at 10 and 60 minutes. Regression analysis of recovered developed pressure on end-ischemic ATP (EIATP) revealed: developed pressure = 0.93 (EIATP) + 23 (r2 = 0.99). We conclude that: anaerobic metabolism as evidenced by a fall in pH appears to be active for 30 minutes after normothermic ischemia and then ceases; phosphocreatine buffers the fall in ATP during early ischemia; there is a tight correlation between EIATP and recovery of left ventricular contractile function with a threshold content of approximately 80% below which recovery of function will not be complete. PMID- 3983820 TI - Healing of ischemic colonic anastomoses in the rat: role of antibiotic preparation. AB - In this study we evaluated the relative effects of ischemia with and without antibiotic bowel preparation on colonic wound healing. Thirty-two Sprague-Dawley rats (185 to 300 gm) were divided into five study groups: Groups I and II (n = 14) had no colonic ischemia, half receiving antibiotic bowel preparation before colocolostomy. Groups III, IV, and V (n = 18) had colonic ischemia induced by division of the marginal artery and ligation of the arteries to the splenic flexure and pelvic colon, assuring that all blood supply to the left side of the colon was intramural. Enteral (neomycin and erythromycin) antibiotic preparation was given in group III, no antibiotics were given in group IV, and parenteral (clindamycin and gentamicin) preparation was given in group V. The mid-left side of the colon was transected and an everting anastomosis was constructed with continuous 6.0 silk sutures. All animals were killed on the seventh postoperative day. Anastomotic healing in unprepared, ischemic rat colon was severely impaired, with an 83% dehiscence rate. In the colon prepared with enteral antibiotics, no adverse effect of ischemia was found. No animal had dehiscence, proximal dilation of the colon, or intra-abdominal abscess. This study may have clinical relevance in patients with ischemic intestinal disorders. PMID- 3983821 TI - Effects of regenerating liver cytosol on drug-induced hepatic failure. AB - Despite various interventions, the mortality rate after acute hepatic failure remains extremely high. Although it has been shown that administration of regenerating liver cytosol (RLC) after hepatic failure improves the survival rate of animals, the sequence in which various hepatic functions are altered after acute hepatic failure and their improvement by RLC remain unknown. To study this, fulminant hepatic failure in rats was produced by intraperitoneal injection of 1.5 gm/kg D-galactosamine (GAL). Twenty-four hours after 68% hepatectomy in normal rats, RLC was prepared and 4 ml of this solution (40 to 50 mg protein) was injected intraperitoneally in other animals at 6 or 24 hours after GAL administration. The long-term survival rate was 19.4% in the GAL-vehicle (control) group, 26.7% in the GAL-treated rats given liver cytosol from normal rats, and 72.2% (p less than 0.01 compared with both groups) in rats given RLC even 24 hours after GAL administration. Reticuloendothelial function was depressed at 24 and 48 hours after GAL administration; however, treatment with RLC but not vehicle or normal liver cytosol at 6 or even 24 hours after GAL administration significantly improved reticuloendothelial function 24 hours after GAL administration. DNA synthesis (an indicator of cell proliferation) did not increase in any group 24 hours after GAL administration; however, it increased strikingly at 48 hours in the GAL-RLC groups. Serum bilirubin levels were also lower in the RLC group 48 hours after GAL administration. Thus RLC administration improved survival, reticuloendothelial function, DNA synthesis, and hepatocyte function after GAL-induced acute hepatic failure. Improvement of reticuloendothelial function by RLC occurred before stimulation of DNA synthesis and appears to play an important role in improving survival after hepatic failure. PMID- 3983822 TI - Autologous blood predeposit for elective surgery: a program for better use and conservation of blood. AB - We report the results of a pilot study on predeposit autotransfusion for elective surgery. In 2 years 319 U, each consisting of 350 ml of blood, were donated by 206 patients. Each patient gave 1, 2, or 3 U according to hematocrit levels within 10 days of undergoing surgery on the gastrointestinal tract, lung, liver, kidney, brain, thyroid, arteries, or breast. A hemoglobin drop of about 0.8 gm/dl occurred after each blood donation. A total of 259 autologous and 128 homologous U were transfused to 166 patients during surgery or within postoperative day 4; 40 patients required no blood transfusion. About 70% of patients did not need homologous blood products in addition to autologous units. The most active team of surgeons and anesthesiologists covered about 40% of the patients' blood needs during the study period with autologous units. No patient experienced untoward reactions before, during, or after surgery. Surgeons' and anesthesiologists' responses to the program improved during the study as soon as the advantages of the procedure became clearer. However, gentle pressure from the Transfusion Center was essential for the program's expansion. The patients' acceptance was excellent. We conclude that predeposit autotransfusion is a safe and feasible procedure for transfusion treatment in elective surgery. PMID- 3983823 TI - Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. AB - A duodenum-preserving resection of the head of the pancreas was carried out in 57 patients with chronic pancreatitis and a benign tumorous enlargement of the head of the pancreas. The resected tissue showed a diameter of more than 5 cm in 64% of the patients. The postoperative mortality rate was 1.8%. The postoperative hospitalization period was 19 days (median). In a follow-up period of 2.0 years (median) with a minimum of 1 month and a maximum of 10.5 years, the late mortality rate was 3.6%. Of the patients, 85.7% are completely rehabilitated occupationally. In contrast to the Whipple procedure, the duodenum-preserving resection of the head of the pancreas preserves stomach, duodenum, jejunum, and extrahepatic bile ducts in an advantageous way. The subtotal resection of the head of the pancreas decompresses the common bile duct without disturbance of the blood flow to the duodenum. PMID- 3983824 TI - Surgical treatment of cavernous hemangioma. AB - Congenital cavernous hemangioma of the lower extremity is a form of congenital angioplastic dysplasia involving the venous trunks and capillaries. Although elastic support offers good symptomatic control, surgical removal of large, abnormal, superficial veins and ligation of incompetent perforators may be of definite additional benefit in carefully selected cases. Also, surgical excision of thrombosed veins, eroding cutaneous veins, and localized cavernous hemangiomas will lessen the chronic disability caused by this venous anomaly. But before any surgical treatment is undertaken, it must be determined that the deep venous system is adequate. PMID- 3983826 TI - Endoscopic treatment of stomal stenosis after choledochoduodenostomy: preliminary report. AB - Stomal stenosis occurs rarely after choledochoduodenostomy and is usually corrected by surgical revision. We describe four patients treated by diathermy enlargement of the orifice at duodenoscopy. The results justify further evaluation of this technique in patients who are prohibitive surgical risks. PMID- 3983825 TI - Growth and function of transplanted fetal rat intestine: effect of cyclosporine. AB - After transplantation of fetal rat small intestine in rat strains with major genetic differences, the effectiveness of cyclosporine (CyA) as an immunosuppressive agent and its effect on intestinal function were evaluated. Substrate absorption, disaccharidase activity, DNA concentration, and histologic appearance were measured and compared with those of fetal intestine transplanted in syngeneic animals. Sixteen of 20 grafts survived in the control (syngeneic) group and 14 of 20 grafts survived in the nonsyngeneic group when treated with CyA (25 mg/kg/day). None of the 10 nonsyngeneic grafts survived when no CyA was administered. Absorption of 14C-galactose in the syngeneic transplants was 0.70 +/- 0.70 mumol/cm2 intestine compared with 1.03 +/- 0.16 mumol/cm2 intestine in the nonsyngeneic transplants treated with CyA. Absorption of 14C-glycine in the respective groups was 1.63 +/- 0.22 mumol/cm2 intestine (syngeneic group) and 1.75 +/- 0.20 mumol/cm2 intestine (nonsyngeneic group treated with CyA). DNA concentration was 410 +/- 43 micrograms/mg intestine mucosa (syngeneic group) and 477 +/- 27 micrograms/mg intestine mucosa (nonsyngeneic group). There was a significant decrease in maltase and sucrase activity in the group treated with CyA but lactase activity was comparable in both groups. Evidence of mild to moderate cellular rejection was seen in only 25% of the nonsyngeneic grafts treated with CyA. When this rat fetal intestine transplant model is used, CyA appears to be an effective immunosuppressive agent and does not significantly impair growth and development of the intestine. PMID- 3983827 TI - Myocyte transplantation for treatment of complete heart block. AB - We hypothesize that it may be possible to treat complete heart block by transplanting right atrial myocytes directly into the ventricular wall where they may set the rate of ventricular contraction at their own intrinsic rate. The biologic background for this conjecture has already been determined to a large extent. However, a few critical unanswered biologic questions must be addressed before the development of this suggested new therapy becomes a mere technologic exercise. PMID- 3983828 TI - Total occlusion of the intracervical internal carotid artery secondary to vasculitis. AB - A case of total occlusion of the cervical internal carotid artery secondary to vasculitis is presented. Although vasculitis rarely causes total occlusion of the internal carotid artery, it directly contributed to a left hemispheric stroke in our patient. In the absence of the usual etiologic factors for internal carotid artery occlusion, vasculitis should be considered. PMID- 3983829 TI - [Dispensary care and the organization of polyclinic treatment for patients with nonspecific lung diseases]. PMID- 3983830 TI - [Clinical aspects of acute and chronic respiratory syncytial virus infection in adult polyclinic patients]. AB - A total of 224 workers and employees engaged at the Smolensk flax spinning plant, suffering from acute respiratory diseases, were examined on an outpatient basis. Virus etiology of the diseases was established in 84 patients (37.7%) with the aid of the serological tests (HI and CF) and immunofluorescent techniques. Respiratory syncytial virus infection was diagnosed in 19 patients (8.5%). As regards the clinical picture the symptoms of intoxication were unmarked. Half the patients demonstrated moderate involvement of the upper respiratory tract which persisted for 7 days. Obstructive bronchitis was recognized in 8 out of the 19 patients. Subsequent dispensary follow up of the patients who suffered respiratory syncytial virus infection, including repeated serological and immunofluorescent studies, made it possible to reveal 2 cases with a chronic course of respiratory syncytial virus infection running in the form of bronchitis. PMID- 3983831 TI - [Phosphorus and calcium metabolism and its hormonal regulation in chronic kidney failure]. AB - In order to elucidate the blood serum calcium, inorganic phosphorus, parathyroid hormone (PTH) and calcitonin (CT) content in the course of the development of chronic renal failure (CRF), 80 patients with chronile glomerulonephritis were examined. Of these, in 24 glomerular filtration (GF) was normal, whereas 56 had CRF of varying degree. Thirty-three out of the 80 patients had the nephrotic syndrome (NS). The parameters enumerated were also determined in 45 patients with CRF treated by hemodialysis. In patients without the NS, hypocalcemia was discovered only at the final predialysis stage of CRF, while in the presence of the NS, it was detectable in normal GF and was aggravated as CRF progressed. The PTH level ascended if GF was lower than 40 ml/min, not correlating with calcium concentration in the serum. A direct correlation was disclosed between the PTH level and that of inorganic phosphorus. The role of the latter in stimulation of PTH and CT secretion in CRF is discussed. In patients treated by hemodialysis, the PTH level significantly rose with treatment time increase. There was also a tendency toward elevation of CT concentration. The activity of the osseous fraction of blood serum alkaline phosphatase in patients treated by hemodialysis was increased in 61-84% of cases depending on the treatment period. PMID- 3983832 TI - [Prevention of cardiohemodynamic disorders at the preclinical stage of chronic fluorine poisoning]. AB - Sixty-four workers having contact with fluorine compounds under industrial conditions showed a rise in urine fluorine concentration, prolongation of the period of left ventricle tension primarily due to the isometric tension phase. The ejection was shortened mainly due to the phase of rapid ejection. The shortening of the time of pulse wave distribution, a decrease in vascular elasticity, and an increase in the peripheral resistance index were noted. Intake of fruit gel from apple pectin promoted a decrease in urine fluorine concentration, improved the hemodynamics and myocardial contractility. PMID- 3983833 TI - [Tasks of the department of polyclinical therapy in a medical institute]. PMID- 3983834 TI - [Problems of restructuring the teaching of internal diseases]. PMID- 3983835 TI - [Age-related dynamics of the prevalence of ischemic heart disease and arterial hypertension and the mean level of basic risk factors in men 20 to 69 related to the nature of their nutrition]. AB - Analysis of the data derived in the course of examination of men aged 20 to 69 years demonstrates a distinct rise of the prevalence of CHD and AH with age. The level of the total cholesterol also increases with advancing age, reaching a maximum at 40 to 49 years as does the level of Tg (maximal at 50 to 59 years). The body weight also shows a linear increase. Emphasis should be placed on a high alpha-cholesterol content in persons aged 30 to 39 years. Analysis of the nutrition pattern of the male population aged 20 to 69 years revealed an atherogenic nature of nutrition marked by a high quota of fat, saturated fatty acids, low ratio of polyunsaturated to saturated fatty acids, and high cholesterol consumption with food. The highest consumption of energy sources and animal products was noted in persons aged 30 to 39 years. The same age demonstrated the lowest consumption of products of vegetable origin. Persons aged 50 to 59 years showed a reduction in consumption of protein of animal origin and essential polyunsaturated fatty acids as well as an increase in consumption of readily available sugars, which may lead to the development of obesity and hypertriglyceridemia and therefore to a higher risk of CHD development. PMID- 3983836 TI - [Mean values and distribution of the blood lipid level in men and women aged 20 to 69 (an epidemiological study)]. AB - The mean values of blood plasma lipids were studied in two age groups (20 to 29 years and 60 to 69 years) from a randomized sample of 1238 men and 1247 women. The levels of the total cholesterol, alpha-cholesterol and Tg were studied and compared according to the mean values in each age group. The cut-off points of percentile distribution of the upper 10% for the total cholesterol and the magnitude of the lower 10% decile for alpha-cholesterol were determined. PMID- 3983837 TI - [Physical loading tolerance in male population groups 20 to 69 years of age without the angina syndrome and normal and altered resting ECGs]. AB - The authors analyse the results of the treadmill test, obtained in a male population (868 persons) representing three groups aged 20 to 39, 40 to 59 and 60 to 69 years. Persons with angina pectoris of effort were excluded from the population of the three groups. The rate of the ischemic reactions was minimal in the youngest group (0.8%), drastically rising in the second group (up to 7.1%). The highest rate of the reactions was observed in the third group. The presence of changes common to coronary heart disease on the initial ECG deteriorated exercise tolerance and increased the rate of the ischemic reactions (up to 25.5% in the second group). Submaximal exercise is one of the most available and efficacious methods for recognizing latent CHD under the conditions of the epidemiological surveys of men over 40 years of age. PMID- 3983838 TI - [Dispensary care--the most important trend in protecting the people's health]. PMID- 3983839 TI - [Interrelation of cardiovascular function and the level of general physical work capacity in practically healthy men of different ages and the possibilities for their prediction]. AB - The relationship between the functional possibilities of the cardiovascular system and general work fitness has been analyzed in practically healthy males aged 20 to 60 years. The level of work fitness has been defined, corresponding to adequate and inadequate functioning of the circulatory apparatus. A method for predicting the possibilities of the above parameters is suggested. PMID- 3983840 TI - [Myocardial electrical activity and hemodynamic indices in the early stage of the rehabilitation of myocardial infarct patients]. AB - Available indirect methods were employed to examine 52 patients with a history of myocardial infarction and 18 normal subjects by the end of the early rehabilitation period. Hemodynamic overload of the left atrium was revealed. The main hemodynamic parameters and processes marking contractile and electrical myocardial functions did not return to normal. The symptoms of left ventricle failure persisted thus requiring treatment continuation. PMID- 3983841 TI - [Results of the rehabilitative treatment of patients with a history of myocardial infarct depending on the clinical course of the disease (based on long-term observational data)]. PMID- 3983842 TI - [Effect of a course of pentoxifylline (trental) treatment on microcirculatory and central hemodynamic functions in chronic ischemic heart disease patients]. AB - The author studied the effect of trental therapy lasting one month on the functions of the microcirculation and central hemodynamics in 45 patients with chronic coronary heart disease (CHD). It was established that as regards the clinical response to the treatment all the patients could be distributed into 2 groups: responsive and refractory to therapy. In patients who responded to the treatment (36 persons), the rate of the microlymph flow and capillary permeability substantially increased. The increase in capillary permeability led to a lowering in the CPV and BCV, which in turn gave rise to a reduction in the parameters of the cardiac output. There were no changes on the whole in the microhemodynamics. In patients refractory to therapy, trental treatment did not bring about any changes in the central hemodynamics, microhemodynamics or lymphodynamics. Capillary permeability dropped with a high degree of significance. The data obtained point to the necessity of a differential approach to the treatment of CHD patients with trental. PMID- 3983843 TI - [Role of microcirculatory hemodynamics, blood oxygen balance and carbohydrate metabolism in the pathogenesis of the initial (preclinical) stage of heart failure in ischemic heart disease]. AB - A total of 207 patients with chronic coronary heart disease in the preclinical stage of heart failure were examined. In the majority of patients with the lack of marked changes in myocardial contractility at rest, the initial stage of heart failure was chiefly caused by microcirculatory disturbances that led to a change in blood oxygen balance, activation of glycolysis, pentosophosphate cycle and the Krebs cycle of tricarboxylic acids under the conditions of reduced aerobic oxidation of carbohydrates. PMID- 3983844 TI - [Electrocardiographic characteristics of the male and female population aged 20 to 69 (an epidemiological study)]. PMID- 3983845 TI - [Approaches to assessing the effectiveness of the medical rehabilitation of hypertension patients at a polyclinic]. AB - A total of 306 patients with stages I, II and III of essential hypertension were examined for the microcirculation, central hemodynamics, physical working capacity and personality traits with the use of the MMPI test. Criteria were obtained for assessing the efficacy of a long-term treatment of patients. They included positive dynamics on the part of the resistive component in the microcirculatory system, decrease in the blood pressure and peripheral resistance to the bloodstream, recovery of the physical working capacity to the level seen in practically normal subjects. PMID- 3983846 TI - [Retrospective analysis of the quality of medical care for hypertension patients based on figures on those dying suddenly]. AB - The standards of the health services for patients who died suddenly from essential hypertension, rendered during the last three years of life of these patients (from 1977 to 1980), were evaluated on the basis of the medical documentation. It is concluded that examination and treatment of outpatients suffering from essential hypertension fell short of ideal. Elimination of the shortcomings discovered could be promoted by introduction of annual dispensarization of the entire population. PMID- 3983847 TI - [Role of outpatient polyclinic institutions in providing the mass prophylaxis of cardiovascular diseases]. PMID- 3983848 TI - [Results of 2-year nondrug treatment of patients with a mild form of arterial hypertension at the health centers of an industrial enterprise]. AB - Results of two years of observation over groups of intervention among men and women indicate that the efficacy of non-medicamentous treatment of mild arterial hypertension in women was 1.5 times higher than in men (90 and 65%, respectively). During the same observation period, the mean level of the DBP in women dropped to a larger degree than in men while in women, the treatment usually made the DBP return to normal whereas in men, only the borderline DBP level could be attained. Thus, the systematic control of the BP in patients with mild arterial hypertension, the patients' counselling as regards the healthy way of life, aiding the patients in the observance of health recommendations, early transfer of patients to drug therapy, if the disease takes an unfavourable course, make it possible to attain satisfactory therapeutic effects, the hypotensive effect included, without resorting to permanent use of drugs. PMID- 3983849 TI - [Interrelation between arterial hypertension and the data of their obstetrical and gynecological anamnesis in women aged 30 to 54--workers in a Moscow industrial enterprise]. AB - The population studies carried out among women engaged in automotive industry have demonstrated the relationship between arterial hypertension (AH) and an aggravated obstetric and gynecological anamnesis. In climacteric women, AH has been found to occur twice as frequently as in those of the same age with preserved menstrual function. PMID- 3983850 TI - [Dynamics of the basal gastrin concentration of duodenal ulcer patients during the development of remission of the disease]. AB - The authors describe the results of studying basal gastrin secretion in patients with peptic ulcer of the duodenum at different phases of disease treated in 3 stages. It was revealed that basal secretion of gastrin experienced substantial changes in the course of transition from the phase of exacerbation to the phase of disease remission. It was noted that the onset of the clinico-endoscopic remission of peptic ulcer did not correlate in all the cases with normalization of basal gastrin level. Patients who did not show normalization of basal gastrin level during treatment were more prone to the development of repeated exacerbations. Based on the data obtained the authors determined the prognostic importance of radioimmunoassay of gastrin basal concentration over time. The increment of gastrin concentration by more than 35 pg/ml of the level seen during peptic ulcer exacerbation is a prognostically unfavourable sign, for the probability of relapses rises up to 79% during a year. PMID- 3983851 TI - [Diagnosis of measles in the outpatient polyclinic service]. PMID- 3983853 TI - Epithelial changes of the nasal columella of the palatal slit and cleft palate defects in C57BL/6 mouse fetuses. AB - Palatal slit and cleft palate are induced in fetuses of C57BL/6 female mice treated with triamcinolone acetonide. In this study, the progressive changes in the epithelia of the presumptive fusion areas of the nasal columella and the anterodorsal part of the secondary palate were examined histologically. No difference was seen in the epithelial changes of the nasal columella of fetuses with palatal slit and those with cleft palate. In the treated palates the basal cuboidal epithelial cells in the presumptive fusion area of the nasal columella extended further toward the nasal cavity, and the vacuolization of the nasal epithelial cells appeared earlier than in the untreated palates. Although the treatment produced epithelial changes of the presumptive fusion area, its primary effect does not seem to be the disturbance of the epithelial fusion processes. The induction of palatal slit may be due to a failure of the primary and secondary palates to make adequate contact and fuse at the appropriate developmental stage because the secondary palate closure is delayed. PMID- 3983852 TI - Injection of diethylstilbestrol on the first day of incubation affects morphology of sex glands and reproductive behavior of Japanese quail. AB - Japanese quail eggs were injected with DES (0.9-1,000 micrograms) dissolved in 50 microliter of corn oil on day 1 of incubation. Higher doses of DES (250-1,000 micrograms) reduced hatchability to 37-33% compared to 61% for corn oil-injected controls. Lower doses of DES (0.9-125 micrograms) had no effects on hatchability. In a second study, eggs were injected with 0.9 or 1.9 micrograms of DES and the survivors were assessed up to 12 weeks posthatch. DES did not affect hatchability, but did increase mortality during the first 4 weeks posthatch. Females were affected more than males. At 10 days of age, open-field activity of some birds was examined. The acquisition and reversal of a visual discrimination task was studied at 6 weeks of age. DES had no effect on these measurements. Ten females from each group were chosen randomly to determine egg production over a single 28-day period beginning at 6 weeks of age. Exposure to DES blocked egg production in these birds. The oviduct weights of 12-week-old females were decreased by 50%, but ovarian weights were not affected. Testicular weights were not affected. In a third study reproductive behaviors and social-dominance behaviors of males were markedly attenuated in birds exposed to 0.48 or 1.9 micrograms DES in ovo. PMID- 3983854 TI - Maternal toxicity: a possible etiological factor in embryo-fetal deaths and fetal malformations of rodent-rabbit species. AB - Data from animal teratology studies were surveyed to determine whether embryo fetal mortality and fetal malformations result from a primary action of the agent on the conceptus or if they are secondary to maternal toxicity--a consequence of administration with high dose levels of test chemicals. A fairly strong association between embryo-fetal mortality and maternal toxicity was revealed by analysis of data from hamsters, mice, rats, and rabbits in 234 studies of chemical and physical agents, of which 83 were conducted at both maternotoxic and nonmaternotoxic doses, 94 only at maternotoxic doses, and 49 at nonmaternotoxic doses. In the above studies, only nine chemicals (four each in hamsters and rabbits and one in rats) were reported to induce embryo-fetal deaths at apparently nonmaternotoxic doses. These findings tend to suggest a contributory role for maternal toxicity in the induction of embryo-fetal deaths. The previously reported hypothesis that certain fetal defects in mice may perhaps be caused by maternal toxicity was also found to be true in a review of data on hamsters, rats, and rabbits. Salient maternal toxicity-associated fetal malformations were exencephaly, encephalocele, micro- or anophalmia, and fused ribs in hamsters and defective (fused, missing, or extra) ribs, vertebrae, and sternebrae, ex-, an-, or microphthalmia, and cleft palate in rats and rabbits. These malformations occurred at low frequencies, generally with no readily apparent dose-response relationship. Presumptive evidence indicates that embryo fetal deaths, and the above-mentioned fetal malformations in experimental animals, which in published literature are presently attributed to chemical induction for a large number of chemicals, may be a consequence of maternal toxicity per se. PMID- 3983855 TI - Teratogenic effect of maternal zinc deficiency and its co-teratogenic effect with cadmium. AB - The teratogenic effects of feeding pregnant mice with the levels of zinc that were severely deficient (0.5 ppm), marginally deficient (10 ppm), or zinc replete (50 ppm) were studied. All groups of animals were fed the experimental diet from 1-18 days of gestation (dg) except for one additional group which received 0.5 ppm Zn diet from 5-14 dg. The effects of a single dose of 2.0 mg/kg of cadmium chloride (CdCl2) injected on 8 dg in mice fed the marginally zinc-deficient or the zinc-replete diets were also investigated. We found that more than 95% of fetuses exhibited a variety of external and skeletal malformations in the severely zinc-deficient groups and that the frequency of malformed fetuses in the marginally zinc-deficient group was similar to that of the control animals. Injection of CdCl2 produced a significant increase in the incidence of malformations in the marginally zinc-deficient mice, but not in zinc-replete animals. These results demonstrate that severe zinc deficiency is teratogenic in mice and that a marginal zinc intake influences the teratogenic potential of cadmium. PMID- 3983856 TI - Embryolethality in rats caused by retinoic acid. AB - Retinoic acid (25 mg/kg) administered by gavage to rats at 216 hours of gestation killed almost all conceptuses by 288 hours and all by full term. The embryolethal dose50 was 12.3 mg/kg. Embryos died from damage to the allantois leading to agenesis or hypogenesis of the chorioallantoic placenta. Suppression of cell division in, disturbed fluid entry into, and impaired normal vascularization of the allantois underlay the abnormality, the predominant element depending principally on when exposure occurred. Hydremia (Br. J. Exp. Pathol., 57:525-541, '76) affected over 50% of the sacs. Relating data from the literature to resorption patterns suggested that 25 mg/kg of retinoic acid raised a lethotoxic level (approximately 2 micrograms/ml) of retinoate in the plasma for about 5 hours. This, together with asynchronous development, was used to help explain why groups of embryos responded to the teratogen for 18 hours longer than single embryos and why exposure 18 hours before the allantois on average appears, killed some young. Comparison showed that retinoic acid was 4.8 times as embryolethal as retinol. Otherwise, each behaved qualitatively similarly, suggesting that either retinol acts through retinoic acid or via a common path entered independently by each. Placental agenesis is well documented in Soviet literature. It is almost unknown in Western teratology even though it is probably the most important cause of embryonal death following teratogenic procedures around the time of placentation. PMID- 3983857 TI - Alcohol enhancement of marihuana-induced fetotoxicity. AB - In two separate studies marihuana and alcohol were administered, either separately or in combination, to pregnant mice or rats. Control animals were given vehicle only or were nontreated. Marihuana-, alcohol-, and vehicle-treated animals were pair-fed and pair watered with animals given marihuana plus alcohol, to control for drug-related undernutrition. The combination of marihuana and alcohol caused a 100% fetomortality in mice and a 73% fetomortality in rats, whereas neither marihuana nor alcohol alone had any effects on fetomortality that differed significantly from vehicle treatment. These studies suggest a potential danger to pregnancy resulting from the combined use of two commonly used drugs that is far greater than that associated with use of either drug alone. PMID- 3983858 TI - The effect of isoproterenol on cardiovascular function in the stage 24 chick embryo. AB - The developing cardiovascular system of the chick embryo is susceptible to teratogenic effects of catecholamines. Yet the mechanism for the teratogenetic action is unclear. Since catecholamines affect cardiovascular physiology, we studied the acute effect of the beta-agonist isoproterenol on mean atrial pressure, heart rate, mean dorsal aortic blood flow, mean arterial pressure and vascular resistance in stage 24 chick embryos. Dorsal aortic blood velocity was measured with a 20-MHz pulsed-Doppler velocity meter and intravascular pressure was measured with a servo-null pressure system. Isoproterenol in doses of 2 X 10( 4) micrograms (2.5 micrograms/kg), 8 X 10(-4) micrograms (10 micrograms/kg), and 1.2 X 10(-3) micrograms (15 micrograms/kg) was injected intravenously in 5 microliters aliquots of chick Ringer's solution. Additional groups of embryos were treated with the beta-antagonist propranolol, and isoproterenol plus propranolol. Control embryos received 5 microliters chick Ringer's solution to assess the hemodynamic effects of a volume injection. We found that isoproterenol caused no change in mean atrial pressure, heart rate, or mean arterial pressure. However, isoproterenol caused a dose-related decrease in dorsal aortic blood flow and a 2.5-fold increase in vascular resistance. The effects of isoproterenol were blocked by propranolol, which suggested that the increase in vascular resistance was mediated by beta-receptor stimulation. PMID- 3983859 TI - Spontaneous and retinoic acid-induced postaxial polydactyly in mice. AB - A spontaneous postaxial polydactyly, similar to type B in humans, was found in a partially inbred ICR mouse strain. The supernumerary digit could be detected grossly as early as day 14 of gestation. The incidence of polydactyly decreased with increasing gestational age. All-trans retinoic acid (RA) administered on day 10 or 11 of gestation, but not on day 9, increased the incidence of polydactyly at each gestational day examined. The day 18 levels of polydactyly were greatest after day 10 treatment. No clear dose-response relationship was observed in term fetuses following treatment on day 9, 10, or 11. RA administered on day 10 produced extra digits which were morphologically more advanced than those in the untreated controls. RA, given to the inbred C57B1/10 strain, produced low levels of polydactyly if administered on day 9, but not on day 10 or 11. F1 embryos, from reciprocal crosses between the two strains, were intermediate in response to RA. On day 14, cell death in the postaxial marginal mesoderm was apparent in all protopolydactylous embryos examined, whether treated or untreated. The supernumerary digits varied in size on day 14. The smaller digits appeared to be filled with necrotic mesodermal cells, whereas the larger digits had a necrosis free area. The size of the extra digit on day 14 seemed to be the most important factor in the persistence of the digit until day 18. PMID- 3983860 TI - Differential dysmorphogenesis induced by microinjection of an alkylating agent into rat conceptuses cultured in vitro. AB - A technique of microinjection of small quantities of teratogens into extraembryonic compartments or specific organ primordium of rat conceptuses of pregnancy day 11 is described. Conceptuses microinjected with 50 nl tissue culture medium developed normally for 44-45 hr when cultured in homologous rat serum, indicating that the microinjection procedure itself did not produce any deleterious effects on growth and differentiation of embryos. Microinjection of an alkylating agent, phosphoramide mustard dissolved in tissue culture medium, into the exocoelom produced anomalous embryogenesis, consisting of retarded embryonic growth, anomalies of the neural tube, and general necrosis of various organ primordia. In contrast, the embryonic development remained relatively unaffected by microinjection of identical amounts of this alkylating agent into the amniotic cavity. However, neural-tube differentiation was markedly affected when phosphoramide mustard was injected into anterior neural-tube fluid, producing anencephalic or microcephalic embryos without significant effect on postcephalic organ differentiation. The morphogenesis of the anterior limb was unaffected by local injection of the agent into somitic tissues adjacent to the presumptive limb-bud region. Therefore, it appears that differential dysmorphogenesis could be induced by microinjection of an alkylating agent into different conceptus compartments. These results indicate that even during early embryogenesis various cell types are not equally susceptible to a given teratogen, and that the differential cytotoxicity of the teratogen toward specific embryonic or extraembryonic cells and tissues may account for embryonic anomalies characteristically produced by that agent. PMID- 3983861 TI - The induction of microphthalmia, encephalocele, and other head defects following hyperthermia during the gastrulation process in the rat. AB - The aim of this study was to ascertain whether there is a period during early embryonic development of the rat that is particularly sensitive to hyperthermia. Pregnant Sprague-Dawley rats were partially immersed in a water bath at 43.5 degrees C until their core temperatures, monitored by a rectal thermistor probe, were elevated to 43.5 degrees C. The procedure was repeated 6 hours later. The regimen of two heatings was performed over a range of development from early gastrulation (8 days 18 hours) to about the 12 somite stage (10 days 18 hours). The rats were killed on days 17-19 and the fetuses were examined. Each group contained a minimum of five litters. The main teratogenic effect of the hyperthermia was the induction of one or more head defects, notably microphthalmia, encephalocele (either a single, large, parietal encephalocele or multiple small protuberances), and maxillary hypoplasia. Microphthalmia was the most common defect with approximately 90% of surviving fetuses having small eyes when heating occurred between 9 days 6 hours and 10 days 0 hours (9.06 and 10.00). Encephaloceles were induced by heating between 9.00 and 10.00 with a peak sensitivity between 9.12 and 9.18 when 57% of surviving fetuses were affected. Maxillary hypoplasia resulted from heating between 9.06 and 10.06 with up to 20% of surviving fetuses being affected. Control rats were exposed to the same experimental procedure in a water bath at 38 degrees C on 9.12 and 9.18, the gestational time most sensitive to hyperthermia induced malformations. There were no abnormal fetuses in the controls. The critical period identified spans 9 days 6 hours to 10 days 0 hours gestational age. In developmental terms this includes a large proportion of the gastrulation process. PMID- 3983862 TI - Congenital tracheal stenosis in lambs induced by maternal ingestion of Veratrum californicum. AB - Seven of nine lambs born to six ewes gavaged with Veratum californicum root and rhizome material on days 31, 32 and 33 of gestation died from asphyxia within 5 minutes after birth. Five of the seven were autopsied and found to have severe stenosis of the trachea. None of the 12 lambs born to seven control ewes had tracheal stenosis. The defect was characterized by lateral flattening of the trachea throughout its entire length. Cartilaginous tracheal rings were reduced in number, nonuniform in size and shape, irregularly spaced, and with abnormal orientation. The rings were thinner than those of control tracheas, and had zones of chondrogenesis on outer and inner surfaces which were of equal width, rather than of unequal width as in controls. The smaller size and relatively noncurved shape of the cartilaginous rings of the stenotic trachea resulted in a nondistended lumen. PMID- 3983864 TI - Carcinoma of the bladder. PMID- 3983863 TI - Zinc deficiency in pregnant Long-Evans hooded rats: teratogenicity and tissue trace elements. AB - The Long-Evans hooded rat is widely used in experimental teratology. This study determines the teratogenicity of maternal Zn deficiency in the Long-Evans hooded rat, and examines the effects of Zn deficiency on Zn, Fe, and Cu concentrations in maternal and fetal tissues. Dams were fed an egg white-based diet containing 100 micrograms/g Zn for 1 week prior to mating. At mating rats were fed diets with 0.5, 4.5, 9.0, or 100 micrograms/g Zn ad lib, or 100 micrograms/g Zn pair fed to 0.5 micrograms/g Zn dams. Laparotomies were performed on day 21 of gestation. Live fetuses and resorptions were counted. Fetuses were weighed and examined for external malformations. Some fetuses were used for Zn, Fe, and Cu determinations, others for internal or skeletal examination. Zn, Fe, and Cu levels were determined in maternal liver, kidney, and plasma. The 0.5 micrograms/g Zn dams lost weight during pregnancy; 27% of implantation sites were resorbed, 91.7% of live fetuses were malformed, and fetal weight was low. There were no malformed fetuses in the 4.5 micrograms/g Zn or 9.0 micrograms/g Zn groups; litter weights were low in the 4.5 micrograms/g Zn group. Tissue Zn was correlated with dietary Zn. Increased Fe concentration occurred in all maternal and fetal tissues in the 0.5 micrograms/g Zn group. The teratogenicity of Zn deficiency in the Long-Evans rat appears similar to that previously reported in the Sprague-Dawley strain. PMID- 3983865 TI - Profound lactic acidosis in a young woman treated with nalidixic acid. PMID- 3983866 TI - Studies of possible acrylonitrile poisoning antidote. PMID- 3983867 TI - Professional liability a decade later. PMID- 3983868 TI - Medicine and the law. The Hyde decision. PMID- 3983870 TI - Effective medical referral communications. PMID- 3983869 TI - Lipoid pneumonia and Mycobacterium fortuitum pulmonary infection: successful treatment with sulfisoxazole. PMID- 3983871 TI - Central Texas Medical Foundation: a working ideal. PMID- 3983872 TI - The physician-patient relationship--creation and termination. PMID- 3983873 TI - [What does a chronic pyelonephritis scar mean?]. PMID- 3983874 TI - [Megacalycosis]. PMID- 3983875 TI - [Occult pathology of renal system duplication]. PMID- 3983876 TI - [Stenosis of the pyeloureteral junction: genesis, diagnosis, therapy and surgical results]. PMID- 3983877 TI - [Pyeloureteral stenosis in adults]. PMID- 3983878 TI - [Primary obstructive megaureter in adults]. PMID- 3983879 TI - [Hypospadias and possibilities of repair]. PMID- 3983880 TI - [Testicular torsion: a primary malformation?]. PMID- 3983881 TI - [Sponge kidney and urinary calculi]. PMID- 3983882 TI - [Horseshoe kidney. Review and clinical and therapeutic analysis of a series of 24 patients]. PMID- 3983884 TI - Bronchodilator actions of xanthine derivatives administered by inhalation in asthma. AB - The airway response to the inhalation of four alkyl xanthines was studied in 17 subjects with moderately severe asthma (mean FEV1 1.19 litres, 42% predicted). Theophylline (10 mg/ml), glycine theophyllinate (50 mg/ml), theophylline ethylenediamine (aminophylline 50 mg/ml), and diprophylline (125 mg/ml) were administered by nebulisation and the airway response was measured as percentage change from baseline of specific airway conductance (sGaw). All xanthine derivatives had an unpleasant taste and produced coughing at the onset of nebulisation. All four xanthines produced a significant increase in sGaw by comparison with saline placebo, with a maximum mean increase from baseline of 35% for theophylline, 40% for glycine theophyllinate, 60% for aminophylline, and 32% for diprophylline. Inhalation of 200 micrograms salbutamol from a metered dose inhaler produced an additional increase in sGaw of 149%. Thus alkyl substituted xanthines administered by inhalation to patients with asthma cause significant short lived bronchodilatation, but this effect is small compared with that of a conventional dose of an inhaled beta 2 adrenoceptor agonist. PMID- 3983883 TI - Tracheobronchial mucociliary clearance in asthma: impairment during remission. AB - Tracheobronchial mucociliary clearance was measured in eight non-smoking patients with asthma in complete remission. The patients were symptom free and required no medication whatsoever for one to six months before assessment. Mucociliary clearance was measured with an objective, radioaerosol technique. For comparison, mucociliary clearance of eight non-smoking, healthy subjects with physical characteristics and pulmonary function similar to those of the asthmatics was also measured on two occasions. In their first assessment the healthy subjects inhaled the tracer radioaerosol under experimental conditions similar to those used for the asthmatics; in the second assessment they inhaled the radioaerosol rapidly to simulate the asthmatic pattern of deposition. Under similar experimental conditions the radioaerosol was deposited more proximally in the asthmatic subjects than in the normal subjects and the difference was statistically significant (p less than 0.01). When, however, the depth of radioaerosol lung penetration was similar in the two groups, there was evidence of a significantly (p less than 0.01) poorer mucociliary clearance six hours after radioaerosol inhalation in the asthmatic than in the healthy group. These findings raise the question whether asthma ever remits completely. PMID- 3983885 TI - Nebulised salbutamol without oxygen in severe acute asthma: how effective and how safe? AB - Thirty two patients with severe acute asthma, all of whom were hypoxaemic, entered a double blind comparative assessment of three doses of salbutamol (1.25, 2.5, and 5 mg) nebulised by an electrically operated air compressor. The study lasted for two hours, during which oxygen and corticosteroid treatment were withheld. All patients were observed in an intensive care area during this period. Four patients had to be withdrawn from the study. Two became distressed immediately after receiving salbutamol and were excluded from further analysis. Two other patients were withdrawn, one with persistent respiratory distress and an unchanged one second forced expiratory volume (FEV1) and the other because of the development of profound hypoxaemia and a deteriorating FEV1 within 60 minutes of treatment. No significant differences were observed between the three dosage groups. In the 28 patients completing the study there were only small increases in mean FEV1 (0.8 to 1.1 l) and forced vital capacity (FVC) (1.3 to 1.8 l) over the two hours. There was a fall in the mean pulse rate at 120 minutes of 15 beats per minute (117-102). No significant change in oxygen tension (PaO2) was observed at 15 or 60 minutes after administration of nebulised salbutamol in any of the three groups. Salbutamol nebulised in air, in a single dose of 5 mg, produces only slight relief of airflow obstruction and no worsening of hypoxaemia in severe acute asthma. PMID- 3983886 TI - Adverse reactions to piperacillin in adults with cystic fibrosis. AB - Nine adult patients with cystic fibrosis, nearly a quarter of the 38 patients with this disease who were treated with piperacillin (59 courses in all) during 1981-3 at the Brompton Hospital, developed a swinging pyrexia after a mean of 13.5 days' treatment with this antibiotic. The fever resolved shortly after the piperacillin treatment was stopped, as did the widespread rashes in the two patients who developed them. Three of four patients who had probable reactions to azlocillin may have been sensitised by piperacillin. As piperacillin does not appear to be any more effective than other antipseudomonal penicillins in cystic fibrosis, it is no longer used at the hospital for treating bronchopulmonary exacerbations in such patients. PMID- 3983887 TI - Surgical treatment of primary lung cancer and solitary brain metastasis. AB - Twenty patients with carcinoma of the lung and a brain metastasis have undergone combined lung and brain surgery, which was synchronous in five. There were no operative deaths. Survival from the first surgical intervention was less than one year (3-10 months) in four patients (20%), one to two years in four (20%) and more than two years (26-66 months) in five patients (25%). Seven patients (35%) are alive and well after an average period of three years and three months (15-66 months). Actuarial survival at five years is 33.6%. All patients had severe neurological symptoms and 18 (90%) had a complete remission. Our experience and data reported in the literature point to the effectiveness of combined lung and brain surgery in prolonging symptom free survival in patients with lung cancer and solitary brain metastasis. PMID- 3983888 TI - Adenocarcinoma in cystic fibrosis. PMID- 3983889 TI - Regression of pulmonary metastases with long term remission in a patient with renal carcinoma. PMID- 3983890 TI - Alveolar soft part sarcoma presenting as asymptomatic pulmonary nodules: report of a case with ultrastructural diagnosis. PMID- 3983891 TI - Comparison of oral prednisolone and intramuscular depot triamcinolone in patients with severe chronic asthma. PMID- 3983892 TI - Proceedings of the British Thoracic Society. 6-7 December 1984, London. Abstracts. PMID- 3983893 TI - Physiologic variables affecting thromboxane B2 production in human whole blood. AB - Thrombin-induced thromboxane (TX) A2 production in whole blood, as reflected by serum TXB2 measurements, has proven to be a simple and reproducible capacity related index of platelet TXA2 production ex vivo. In the present study we have determined the influence of a number of physiologic variables on serum TXB2 measurements performed by radioimmunoassay in a group of 177 subjects undergoing evaluation for atherosclerosis risk factors. Serum TXB2 averaged 300 +/- 108 ng/ml in the whole group, with a normal distribution. No statistically significant correlation was found between serum TXB2 and the continuous variables examined (age, BMI, blood pressure, cigarettes, serum cholesterol, triglyceride, glucose and wine consumption) except for the number of platelets. Platelet TXB2 production did not differ between men and women (296 +/- 119 vs 302 +/- 100 ng/ml). We conclude that, within the limits of the examined variables, serum TXB2 is an easily measurable and highly reproducible capacity index primarily related to platelet cyclooxygenase and TX-synthase activity, which can be used for monitoring drug- or disease-induced changes of these enzyme activities. PMID- 3983894 TI - Detection of antithrombin III microheterogeneity. AB - Antithrombin III microheterogeneity was investigated by isoelectric focusing and immunofixation in healthy individuals and in patients with clinical conditions in which antithrombin III is known to vary (liver disease, nephrotic syndrome, after surgery and anticoagulant therapy). In normal plasma microheterogeneity was present with ten bands of varying intensity being visible in a pI range from 5.0 5.7. One variant was observed which was not associated with a clinical disorder. Low concentrations of antithrombin III were detected in some patients with liver disease, nephrotic syndrome and those on anticoagulant therapy and these demonstrated a decrease of intensity in all bands. Alterations in microheterogeneity were seen in patients tested after surgery and those with nephrotic syndrome. This indicates that changes in the subpopulations of antithrombin III can occur and may be relevant to clinical abnormalities. PMID- 3983895 TI - Inhibitory effect of 3-deazaadenosine on the thromboplastin response of stimulated human monocytes. AB - Immune complexes (IC), 12-O-tetradecanoylphorbol-13-acetate (TPA), endotoxin (LPS) and phytohaemagglutinin (PHA) induce thromboplastin activity in human peripheral blood monocytes. In the presence of transmethylation inhibitors 3 deazaadenosine (DZA) and homocysteine a dose-dependent inhibition of the thromboplastin response reaching about 60 per cent was observed, when IC, LPS or PHA was used as the stimulant. TPA-induced thromboplastin synthesis was more resistant (maximum 20 per cent inhibition). PMID- 3983896 TI - In vitro studies of a new synthetic thrombin inhibitor. AB - (2R, 4R)4-methyl-1-[N alpha-(3-methyl-1,2,3,4-tetrahydro-8-quinoline- sulfonyl)-L arginyl]-2-piperidine carboxylic acid monohydrate (MCI-9038) was found to be a potent synthetic inhibitor of thrombin. In concentrations as low as 1 microM, the thrombin time, prothrombin time, and partial thromboplastin time were more than doubled. The venom (Bothrops atrox) time was similarly prolonged. The drug also inhibited the thrombin-induced activation of factors VIII and XIII. While MCI 9038 in concentrations of 10(-4) M had no effect on platelet aggregation induced by collagen, ADP, epinephrine, and arachidonate, nanomolar concentrations inhibited thrombin-induced platelet aggregation and the release of platelet ADP. The drug also significantly inhibited the adhesion of thrombin-treated platelets to cultured bovine aortic endothelial cells. We conclude that MCI-9038 is an extremely potent inhibitor of the effects of thrombin on platelets and clotting factors. PMID- 3983897 TI - Purification and characterization of 3 fibrinogens with different molecular weights obtained from normal human plasma. AB - Fibrinogen was purified from fresh citrated human plasma by precipitation with beta-alanine in the presence of citrate and protease inhibitors. From this material, fractions corresponding to the HMW (high molecular weight), LMW and LMW' fibrinogen fractions of plasma were obtained by step-wise precipitation with ammonium sulfate. Electrophoresis revealed that HMW was contaminated with 4% LMW, LMW was contaminated with 6% HMW, and the LMW'-fraction was a mixture of LMW' (50%), LMW (20%) and two derivatives of intermediate m.w.. The HMW fraction (mw. 340 000) contained intact Aa-chains, while the molecular weight of LMW was reduced to 305 000 and that of LMW' to 270 000 due to proteolysis of the -COOH terminal end of one (LMW) or both (LMW') Aa-chains. The clottability of HMW was 98%, of LMW 92% and of LMW' about 80%. Thrombin clotting times (1 NIH U/ml) were 14", 20" and 25" resp. These differences were highly accentuated when clotting was performed with reptilase (14", 38" and 120"). Contamination with soluble fibrin was less than 2% and the contents of fibronectin and AT-III were low. No thrombin or plasmin activity was generated upon 24 hours incubation at +4 degrees C as evidenced by increased content of fibrinopeptide-A and fragment Bb-15-42 resp. PMID- 3983898 TI - The appearance of exhausted platelets due to a duration of hypertension in stroke prone spontaneously hypertensive rats. AB - Using strains of spontaneously hypertensive rats with different degrees of hypertension, the influence of the duration of hypertension on platelets was examined through changes in platelet serotonin contents. The blood pressures of these strains were in the descending order of m-SHRSP greater than SHRSP greater than SHR greater than WKY. Serotonin content in normotensive WKY platelets was maintained in the range of 0.715 +/- 0.048(17) n mole/10(8) through ages 5-50 weeks in both sexes. In contrast with WKY of the same age and sex, a significant decrease in platelet serotonin content began to be observed in male m-SHRSP at 18 weeks of age, in female m-SHRSP and male SHRSP at 22-weeks of age, and in female SHRSP at 32-weeks of age, respectively. The content in SHR platelets of both sexes was unaltered up to 40-weeks of age. The time of the appearance of these exhausted platelets coincided with the reported time of scanning electron microscopic observation of vascular injuries in each strain of rats. It has been concluded that a long duration of hypertension causes platelets to become degranulated and exhausted due to in vivo activation of platelets at sites of arterial injury. Thus the changes of platelet contents could be an indicator of vascular injuries. PMID- 3983899 TI - The adsorption of thrombin to polypropylene tubes: the effect of polyethylene glycol and bovine serum albumin. AB - The adsorption of 125I-thrombin to polypropylene tubes has been studied with thrombin dissolved in tris-buffered saline (TBS), TBS with 0.66% polyethylene glycol (PEG), and TBS with 0.01% or 0.20% bovine serum albumin (BSA). Adsorption stabilized over time from all three solutions, increased with increasing concentrations of unadsorbed thrombin, and was reversible by repetitive washing. At equilibrium, more thrombin adsorbed from TBS-PEG than from TBS. The difference was attributable to an increased amount of thrombin deposited by evaporation during aspiration of the polypropylene tubes. Adsorption equilibrium and capacity were otherwise relatively unaffected by the presence of PEG. However, PEG was effective in retarding thrombin adsorption by markedly reducing the adsorption rate. Reduction of adsorption in the presence of BSA, on the other hand, was explained by competitive inhibition. Pretreatment of the tubes with PEG or BSA was also shown to be effective in reducing thrombin adsorption from TBS. PMID- 3983900 TI - Effect of ticlopidine on platelet aggregation, adherence to damaged vessels, thrombus formation and platelet survival. AB - Ticlopidine (100 mg/kg/day or 400 mg/kg/day) was administered to rats and rabbits for 48 hr before and during the experiments. Aggregation studies of twice-washed platelets resuspended in Tyrode solution containing apyrase and 0.35% albumin showed that inhibition by ticlopidine of aggregation induced by ADP, collagen, sodium arachidonate or thrombin persisted after resuspension, as did inhibition of the release of 14C-serotonin from prelabeled platelets. Thus the inhibitory effect of ticlopidine or its metabolite is not readily reversed. In both species, ticlopidine prolonged platelet survival when it had been shortened by the insertion of an indwelling aortic catheter, although only the higher dose was effective in rabbits. In this species, this dose also prolonged platelet survival in sham-operated animals. Ticlopidine did not have a significant effect on the clearance of rabbit platelets when their survival had been shortened by pretreatment with neuraminidase. Ticlopidine did not affect the number of 51Cr labeled platelets that accumulated on the injured vessel wall in rats with indwelling aortic catheters or the amount of thrombus that formed around the catheters in the aortas of the rabbits. It also did not affect the accumulation of platelets in vivo on rabbit aortas de-endothelialized with a balloon catheter. Thus, although ticlopidine inhibited platelet aggregation and release and prolonged shortened platelet survival, it did not inhibit platelet adherence to the damaged wall or thrombosis caused by chronic arterial injury. It is evident that effects on platelet survival and thrombosis do not correlate. The reason for the prolongation of platelet survival is unknown. PMID- 3983901 TI - Fibrinogen Seattle II: defective release of fibrinopeptide A in a slow clotting fibrinogen. AB - A functionally abnormal fibrinogen was detected in a 27-year-old woman with no prior history of bleeding. Investigation of the defect revealed abnormal release of fibrinopeptide A and incomplete polymerization of fibrin monomers. Crosslinking of polymerized fibrin by Factor XIII was normal. To further characterize the dysfibrinogen, the increase in mechanical impedance during clot development was measured. Fibrinogen Seattle II showed several differences from normal fibrinogen: delayed onset of clotting, decreased rate of clot formation, and lower final clot impedance. Taken cumulatively, these data are consistent with an amino acid substitution at or near residue 16 in one of the A alpha chains, the point at which thrombin cleaves. PMID- 3983902 TI - Effect of monovalent cations on bovine alpha- and beta-thrombin: importance of substrate structure. AB - The relative ability of bovine alpha- and beta-thrombin to hydrolyze selected anilide and ester substrates in presence and absence of monovalent cations has been evaluated. The hydrolysis of both TosGlyProArgpNA and H-D-PhePipArgpNA by either alpha-thrombin or beta-thrombin is more effective in the presence of 0.1 M NaCl than in the presence of 0.1 M KC1. The hydrolysis of BzArgpNA by alpha thrombin was less effective in the presence of sodium ions than in the presence of potassium ions. The hydrolysis of this latter substrate by beta-thrombin was similar in the presence of either sodium ions or potassium ions. These results suggest that the ionic composition of the solvent affects that catalytic efficiency of alpha-thrombin and beta-thrombin in different ways dependent on the nature of the substrate. PMID- 3983903 TI - Abnormal release of storage pool adenine nucleotides from platelets of dogs affected with basset hound hereditary thrombopathy. AB - Platelets from dogs affected with Basset Hound Hereditary Thrombopathy (BHT), have a thrombasthenia-like aggregation defect but release storage pool ATP in quantities not significantly different from normal controls or BHT heterozygotes when stimulated with 1 X 10(-5)M ADP and 0.22 U/ml thrombin. However, the release occurs so rapidly in the BHT platelets stimulated with ADP that it is complete in approximately one-sixth of the time required for release from normal control and heterozygote platelets. Sequential electron micrographs reveal early release of BHT dense body constituents 30 seconds after stimulation with 1 X 10(-5)M ADP while resting BHT morphology is indistinguishable from normal control animals. PMID- 3983904 TI - Clotting factors secreted by monocytes and macrophages: analytical considerations. AB - The secretion of clotting factors by rat spleen macrophages and human peripheral blood monocytes has been studied. The results show that the amount of clotting factors measured depends critically upon the characteristics of the assay system used. The presence of warfarin, salicylic acid or thrombin in the culture medium is shown to decrease the vitamin K dependent clotting factor activity in the supernatant after in vitro culture of rat spleen macrophages and human peripheral blood monocytes. PMID- 3983905 TI - Separation of plasma fibronectin from associated hemagglutinating activity by elution from gelatin-agarose at pH 5.5. AB - Human plasma fibronectin prepared by elution of the adsorbed protein from gelatin agarose by pH 5.5 citrate buffer is very low in hemagglutinating activity toward trypsinized rabbit erythrocytes, an activity previously associated with the purified plasma protein. Hemagglutinating activity is present, however, in a subsequent fibronectin-poor 4M urea eluate which contains plasma immunoglobulins and/or other unidentified gelatin-binding proteins. This activity is partially inhibited by antibodies to human immunoglobulins, and the inhibition is reversed by excess non-specific human immunoglobulin. PMID- 3983906 TI - Changes in coagulation and fibrinolysis occurring in dogs during hypothermia. AB - Changes in fibrinolysis, platelets and coagulation during hypothermia were investigated in anesthetized dogs. Strong activation of plasma fibrinolysis was observed in the hypothermia group. The maximum fibrinolytic activity determined with standard fibrin plates was markedly higher than that of the control sample (mean values: 67 and 15 mm2/0.03 ml plasma, respectively). On the other hand, no fibrinolysis was observed by the plasminogen free plate method. Activation was not observed in the control group or the hypothermia group premedicated with chlorpromazine. The platelet count was decreased from 100% to 14.7% and the collagen induced platelet aggregability from 61% to 2.3% during hypothermia. Recovery from both reductions occurred on rewarming. In the control and premedicated groups, the recalcification time was reduced progressively (from 93.6 to 60.9 sec and from 101.1 to 71.8 sec as mean times, respectively). The tendency towards shortening of the recalcification time was not related to the core temperature. PMID- 3983907 TI - Hirudin insensitive thrombin-stimulated platelet release. AB - It has been previously proposed that platelet stimulation may involve two platelet-thrombin complexes: an initial platelet-thrombin complex (P-T) which is converted to an activated platelet-thrombin complex (P*-T). By using the release of radioactive serotonin as a measure of thrombin stimulation, we have demonstrated that under appropriate conditions, a hirudin sensitive and a hirudin insensitive complex can be differentiated. At short platelet-thrombin preincubation times (0-2 minutes) at 4 degrees C, in a buffer containing 18.7 mM phosphate, added hirudin almost completely inhibited the release of radioactive serotonin obtained upon subsequent warming to 37 degrees C (only the hirudin sensitive complex exists). If platelets were preincubated with thrombin for longer periods of time (30 minutes), hirudin became less effective in inhibiting the release obtained upon subsequent warming to 37 degrees C. The same results were obtained whether or not the platelets were washed after incubation at 4 degrees C and before warming to 37 degrees C. We postulate that this change in hirudin sensitivity may reflect a slow conversion of the first platelet-thrombin complex (P-T) to an activated platelet-thrombin complex (P*-T) which can undergo release upon warming. This transition appears to be much faster in acetatetris buffer since at short platelet-thrombin incubation times at 4 degrees C, added hirudin had little or no effect on the release obtained upon warming to 37 degrees C. The difference in the ability of hirudin to inhibit thrombin-induced release in the two buffers was shown to depend upon the presence of phosphate and on variations in ionic strength, and not due to a change in the inhibition constant (Ki) for hirudin. PMID- 3983908 TI - Treatment with stanozolol before thrombolysis in patients with arterial occlusions. AB - The administration of the anabolic steroid stanozolol during 7, 8 days as pretreatment before thrombolytic therapy of acute or subacute arterial occlusions enhances the fibrinolytic potential significantly. On average the plasminogen increased from 101% to 133%, the euglobulin lysis time after venous stasis was shortened and the alpha 2-antiplasmin remained constant. This effect could be favourable to prepare patients undergoing thrombolytic treatment. PMID- 3983909 TI - Fibrin degradation products increase lung transvascular fluid filtration after thrombin-induced pulmonary microembolism. AB - The effect of fibrin degradation products (FDP) on pulmonary transvascular fluid and protein exchange was examined in the sheep lung lymph fistula preparation. The pulmonary lymph was used to assess changes in pulmonary lymph flow (Qlym) (a measure of net transvascular fluid filtration rate) and the lymph/plasma protein concentration ratio (L/P) (a measure of protein seiving across the microvascular barrier). Studies were made in 3 groups: Control-Thrombin (n = 7) received 96.9 +/- 9.4 U/kg of alpha-thrombin, Control-FDP (n = 6) received infusion of FDP prepared by plasmin digestion of fibrin, and Thrombin-FDP (n = 5) received thrombin (102.0 +/- 7.5 U/kg) and then an FDP infusion was begun at 60 min after the thrombin. In the Control-Thrombin animals, Qlym increased without a change in the L/P after thrombin, indicating an increase in vascular permeability to proteins. In the Control-FDP group, infusion of FDP had no effect on Qlym and L/P. In the Thrombin-FDP group, thrombin increased Qlym with no change in the L/P and the subsequent infusion of FDP further increased Qlym but slightly decreased the L/P, an effect not seen in the Control-FDR group. The results indicate that FDP infusion alone does not alter pulmonary transvascular fluid and protein exchange. However, in the presence of thrombin-induced pulmonary microembolization FDP infusion enhances the net transvascular fluid filtration rate, probably by increasing the capillary hydrostatic pressure. PMID- 3983910 TI - AT-III as predictor of postoperative pulmonary embolism. PMID- 3983911 TI - Hemophilia BM in a female. AB - A 28 year old pregnant woman was referred for genetic counselling because of a bleeding tendency and a family history of hemophilia. The hemophilia patients had 0.02 units/ml of factor IX activity and a normal concentration of factor IX antigen. In addition they had a prolonged coagulation time with bovine thromboplastin and were therefore cases of hemophilia BM. At the age of six the patient was hospitalized because of prolonged bleeding after a tooth extraction. At the age of 20 and 24 she gave birth to healthy daughters. The first delivery was complicated by a serious bleeding seven days post partum whereas the second delivery was without complications. Factor IX activity when she was three months pregnant was 0.02-0.03 units/ml and the factor IX antigen concentration was normal. Coagulation time with bovine thromboplastin was prolonged. Delivery was again normal, and she had a daughter with carrier values of factor IX. Her mother also had carrier values whereas her father was normal. The patient's hemophilia BM was probably due to extreme Lyonization in a heterozygote. PMID- 3983912 TI - A double antibody sandwich microELISA for measuring human platelet factor 4. AB - With the aim of investigating patients with a higher risk of thrombosis we developed a method for determining platelet factor 4 (PF4) in human plasma. Using the double antibody sandwich ELISA technique we set up a test system that allows the determination of PF4 concentrations in plasma samples from 1 to 100 ng/ml. This method is more sensitive and as specific as commercially available RIA kits, but has the advantage of being cheaper and less time consuming. Furthermore the ELISA does not require radioactive materials. The complete reaction is carried out in microtiter wells, and an ELISA-reader connected to an Apple computer does all the calculations needed for quantitative measurements. PMID- 3983913 TI - The effect of thrombin on fibronectin in cultured human endothelial cells. AB - Cultures of human endothelial cells (EC) incubated for periods up to 24 h with highly purified thrombin (2 NIH u/ml) contained considerably less cell-associated fibronectin fibrils than corresponding controls. The loss of fibronectin fibrils was evident after 4 h and was accompanied by a 2-3 fold increase in the concentration of fibronectin in the incubation medium. Hirudin inhibited the effects of thrombin. Thrombin also induced characteristic shape changes of EC. These shape changes were reversible within a 4-6 h period and could not be reinvoked by new additions of thrombin. Thus, structural refractoriness to thrombin coincided temporally with a period when EC-associated fibronectin fibrils were markedly reduced. PMID- 3983914 TI - FXIII induced gelation of human fibrinogen--an alternative thiol enhanced, thrombin independent pathway. AB - Factor XIII induced gelation of human fibrinogen in the presence of calcium ions. At the end of this reaction between 95 and 100% of the fibrinogen was incorporated into the gel matrix. The gelation was dramatically enhanced by DTT. Cysteine and beta-mercaptoethanol also enhanced the reaction, but less efficiently. Thrombin activated factor XIII led to shortened gelation time and increased the rate of gelation. The reaction was inhibited by p chloromercuribenzoate and iodoacetamide. Neither fibrinopeptide A, nor fibrinopeptide B were released during gelation, while quantitative release of FPA by thrombin was demonstrated from preformed gel matrices. SDS-PAGE showed the presence of gamma-dimers and alpha-polymers in the gel matrix. In the clot supernatants gamma-dimers were observed already before the gel point. We also observed that the clotting of fibrinogen by thrombin was perturbed by DTT. Preincubation of fibrinogen with calcium ions prevented this effect of DTT. PMID- 3983915 TI - [Intensive treatment of tetanus]. PMID- 3983916 TI - [Palatal injuries]. PMID- 3983917 TI - [Rounded atelectasis. An important differential diagnosis to lung tumors]. PMID- 3983919 TI - [Immotile cilia syndrome]. PMID- 3983918 TI - [Radiographic findings in rounded atelectasis. An atelectatic pseudotumor]. PMID- 3983921 TI - [Retrospective assessment of causative factors in disease]. PMID- 3983920 TI - [Anticarcinogenesis. Possibilities in preventing cancer]. PMID- 3983922 TI - [Conservative breast surgery]. PMID- 3983923 TI - [Emergency hospitalization in a surgical department. A prospective study of treatment routines and resource consumption]. PMID- 3983924 TI - [Acute traumatology/orthopedics at the Ulleval hospital]. PMID- 3983925 TI - [Acute gastroenterological surgery at the Ulleval hospital]. PMID- 3983926 TI - [Effects of physical activity on risk factors in coronary heart disease. A review of the literature]. PMID- 3983927 TI - [Radiography of the abdomen in pseudomembranous colitis]. PMID- 3983928 TI - [Use of analgesics in surgical emergency patients]. PMID- 3983929 TI - [Rape as a medical problem]. PMID- 3983930 TI - [Cooperation between primary health care providers and hospitals. A prospective study from the Surgical Department of the Ulleval Hospital, with special reference to hospitalization practices and procedures for surgical admissions]. PMID- 3983931 TI - [Immediate aid in the outpatient department of a local hospital]. PMID- 3983932 TI - [Elderly patients with dementia]. PMID- 3983933 TI - [Senile dementia. An underdiagnosed condition? Consequences influencing the situation in somatic nursing homes]. PMID- 3983934 TI - [Smoking and risk of death among aged men in Norway]. PMID- 3983935 TI - [Hyperthermia treatment of cancer]. PMID- 3983936 TI - [Idiopathic segmental infarction of the greater omentum]. PMID- 3983937 TI - [Acute meningitis following metrizamide myelography]. PMID- 3983940 TI - [Our plastic nervous system]. PMID- 3983938 TI - [The general practitioner service and hospital admission rate]. PMID- 3983939 TI - [Home visiting and hospital admission rates]. PMID- 3983941 TI - [Psychiatric aspects of new religious sects]. PMID- 3983942 TI - [Cesarean section in the father's presence]. PMID- 3983943 TI - [Radiotherapy. Locally advanced colorectal cancer with and without 5 fluorouracil]. PMID- 3983944 TI - [Hyalinosis cutis et mucosae. Lipoid proteinosis, Urbach-Wiethe disease]. PMID- 3983945 TI - [Neoplastic colonic polyps. Occurrence, therapeutic principles and control routines]. PMID- 3983946 TI - [Cooperative research work between university hospitals and the pharmaceutical industry. With special reference to subspecialization within internal medicine and surgery]. PMID- 3983947 TI - [Physicians in the drug industry]. PMID- 3983948 TI - [Drug toxicity in piglets following long-term consumption of medicated feed]. AB - The effect of the addition of various drugs to the feed on the performance of recent weaned piglets was studied. The following procedures were examined: no additive, 50 ppm of carbadox, 50 ppm of carbadox plus 400 ppm of furazolidone, 50 ppm of carbadox plus 22 ppm of lincomycin plus 22 ppm of spectinomycin, 400 ppm of furazolidone and 22 ppm of lincomycin plus 22 ppm of spectinomycin. Each treatment was carried out in ten groups of eight piglets. The trials were continued from the fifth to the eighth week of life. Addition of lincomycin and spectinomycin improved both growth and feed conversion. Combined administration of lincomycin and spectinomycin with carbadox resulted in the best performance. Supplementation of carbadox alone did not produce any beneficial effects. Addition of 400 ppm of furazolidone resulted in a significant depression of growth. Combined administration of 400 ppm furazolidone and 50 ppm of carbadox resulted in the poorest performance. The growth depressing effect of this combined treatment was observed as early as the first two weeks of the experiment. The animals undergoing this treatment showed a greyish-white colour of the skin and very hard stools. PMID- 3983949 TI - [Poisoning]. PMID- 3983950 TI - HLA-B15 heterogeneity in different populations. PMID- 3983951 TI - The HLA system in the prevalent Mexican Indian group: the Nahuas. AB - Results of HLA-A, B and C typing as well as haplotype frequencies in the Nahuas, who are the predominant Indian group in Mexico are presented. ABO and Rh blood groups show the genetic homogeneity of this population, since all of them were group O and Rh+. The most frequent antigens and haplotype are in general, the same as in some, but not all Amerindian tribes (Papago, Pimas, Zuni from North America and Ixils from Guatemala). When compared to other Mongoloids, the HLA pattern is very close to the Japanese population. Antigens Bw39 and Cw4 look like markers of Nahuas and because Bw16 cells from four individuals could not be assigned either as Bw38 or Bw39, and 6 subjects did not type for any of the Bw22 splits, new subtypes of these antigens are probable. PMID- 3983952 TI - HLA antigens in ulcerative colitis: a study in the Sicilian population. AB - HLA antigens were investigated in 41 Sicilian patients with ulcerative colitis and in 151 healthy controls. Frequencies of HLA-B5 and DR2 were increased in the group of patients with ulcerative colitis whereas the DR3 antigen frequency was decreased. However the corrected p values were not significant. Thus, present results indicate that in ulcerative colitis HLA linked genetic factors play a marginal role, if any. PMID- 3983953 TI - Postheparin plasma lipoprotein lipase activity in heterozygotes of familial lipoprotein lipase deficiency. AB - Serum lipoprotein pattern, apoproteins and two postheparin triglyceride lipases were analyzed in a patient with familial lipoprotein lipase (LPL) deficiency and her family. Serum of the patient showed extreme hyperchylomicronemia and her postheparin plasma LPL activity was distinctly decreased. None of heterozygotes had any type of hyperlipoproteinemia. The mother and brother of the patient had moderately decreased LPL activity. There were no consistent changes in hepatic triglyceride lipase (H-TGL) activity among heterozygotes. These results suggest that assay of LPL may be helpful for detection of heterozygotes in familial LPL deficiency. PMID- 3983954 TI - Concurrent endometrial hyperplasia with carcinoma of the corpus uteri. AB - Using 117 uteri which were extirpated in cases of carcinoma of the corpus uteri, a study was made to investigate the relationship between the site of the cancer and the site of associated endometrial hyperplasia. It was found that 75% of the cases had carcinomas of the upper portion of the uterus primarily of the uterine fundus. About 50% of the cancers were associated with adenomatous or atypical hyperplasia, and these two types of hyperplasia were frequently found in the fundus or upper portion of the uterus. In contrast, there was no site of particular prevalence in cases with concurrent cystic hyperplasia. About 70% of the cases had adenomatous or atypical hyperplasia on one or both of the histological blocks adjacent to the cancer. PMID- 3983955 TI - Autoantibodies, including antibasement membrane antibody, in patients with selective IgA deficiency. AB - Laboratory data are presented on 48 patients with selective IgA deficiency. Sixty percent of the patients had autoimmune diseases or related disorders. We found antibasement membrane antibody (ABMA) in the sera of four IgA deficient patients and the incidence of ABMA seemed to be related to clinical symptoms. The incidence of various other antibodies was found to be increased in selective IgA deficiency. This phenomenon might be derived from the lack of local immune system. Inadequate IgA barrier might permit the exessive gastrointestinal absorption of food antigens or autoimmunogens in metabolic products which are excreted into the gut lumen. PMID- 3983956 TI - An application of fluorescein-conjugated monoclonal antibodies to the diagnosis of Chlamydia trachomatis infection in children. AB - A method for rapid identification of Chlamydia trachomatis (C. trachomatis) from clinical specimens using fluorescein-conjugated monoclonal antibodies was evaluated. Attempts to isolate C. trachomatis by McCoy cell cultures were simultaneously performed. C. trachomatis was isolated from 8 of 62 newborns with neonatal conjunctivitis in tissue culture as compared with 12 positives using monoclonal antibodies. C. trachomatis was isolated from 2 of 7 infants with pneumonia in tissue cultures as compared with 3 positives using monoclonal antibodies. In order to identify either elementary bodies (EB) or reticulate bodies (RB) in clinical specimens, EB and RB of C. trachomatis L2/434 strain were isolated, purified and reacted with monoclonal antibodies. Majority of fluorescence observed in the clinical specimens was considered to be EB. PMID- 3983957 TI - Gastric acid secretion, intraduodenal pH and gastroenteropancreatic hormone release to bombesin in antrocolic transposition dogs. AB - The effects of bombesin on gastric acid secretion from the Heidenhain pouch (HP), intraduodenal pH and gastroenteropancreatic (GEP) hormone levels were compared between 4 dogs with antrocolic transposition (ACT) and 4 non-ACT dogs. Bombesin, infused i.v. at a dose of 0.5 microgram/kg for one hr, produced a significant increase in gastric acid secretion from HP and a decrease in intraduodenal pH in both groups. However, these changes were more marked in ACT dogs. The intravenous infusion of bombesin also produced, in both groups, an increase in the plasma levels of gastrin, secretin, motilin, insulin, glucagon and pancreatic polypeptide (PP) with a different shape of curve for each hormone. Comparison between the two groups showed significantly greater plasma gastrin, secretin and insulin responses, and smaller plasma PP response in ACT dogs than in non-ACT dogs. These results demonstrate that the mechanism of GEP hormone release by bombesin may be complex and hormone responses to infusion of bombesin are influenced in a state of acid hypersecretion induced by ACT. PMID- 3983958 TI - Some red blood cell abnormalities in patients with liver cirrhosis and ascites. I. Red blood cell sodium, potassium and water content. AB - In 22 normal subjects and 22 patients suffering from liver cirrhosis and ascites, sodium, potassium and water concentrations in the red blood cell and plasma were determined. In patients with liver cirrhosis complicated by ascites (compared with control subjects) we found out: Red blood cell sodium concentration was significantly increased in cirrhotic patients (p less than 0.001). The potassium and water content in red blood cells was not significantly different in the 2 groups. Sodium concentration in the plasma of cirrhotic patients was significantly decreased (p less than 0.01). PMID- 3983959 TI - Expression of receptors for Fc portion of IgM (Fc mu . R) and surface neuraminic acid on the human peripheral lymphocytes. AB - The purpose of this investigation is to establish a method of quantitation of sialic acid on the lymphocyte membrane surface and to clarify the importance of sialic acid in the functional manifestation of the lymphocyte receptor for the Fc portion of IgM (Fc mu . R) as well as the cell surface. The experiments yielded results leading to the following conclusions: Cell surface sialic acid can be exclusively recovered at consistent rates by treatment of lymphocytes with 0.1 IU of neuraminidase in the presence of Ca++ at 37 degrees C for 30 min. The sialic acid obtained, though in minute quantities, was accurately quantitated by the TBA method. By these procedures, the amount of sialic acid present on the cell membrane of human peripheral blood lymphocytes was determined to be 2.46 micrograms/10(7). Surface sialic acid on lymphocytes cultured at 37 degrees C after treatment with neuraminidase was resynthesized sufficiently at about 6 hr. On the cell membrane of lymphocytes deprived of Fc mu . R by treatment with neuraminidase, the receptor for IgM Fc became redetectable following incubation of the cells at 37 degrees C; the time-course of redevelopment of Fc mu . R showed a striking coincidence with that of sialic acid resynthesis. A sufficient redevelopment of Fc mu . R occurred in 6 hr of incubation of neuraminidase treated Fc mu . R-deprived lymphocytes; the time required for sufficient redevelopment was comparable to that reported for pronase-treated lymphocytes. It is concluded from these findings that Fc mu . R deprived of sialic acid is no longer repaired while the receptor is resynthesized de novo on incubation of lymphocytes under adequate conditions. PMID- 3983960 TI - Mustard procedure for simple transposition of the great arteries. AB - From May 1980 through April 1982, 9 patients underwent the Mustard operation for simple transposition of the great arteries (simple TGA) at the Tohoku University Hospital, Sendai. There was no early postoperative death, although one patient was lost with pulmonary venous obstruction in the late postoperative period. No pulmonary venous obstruction occurred since the introduction of expanded polytetrafluoroethylene (EPTFE) intraatrial baffle. Normal sinus rhythm has been preserved in all patients since direct, high superior vena cava cannulation was adopted. Postoperative hemodynamic study at an average 12 months after surgery revealed normal right ventricular function at rest. Work-function curve which is related to the right ventricular end-diastolic pressure and minute work index revealed good response of the right ventricle in two of three patients after methoxamine infusion test. All late survivors are acyanotic and clinically well. The Mustard procedure has dramatically improved the survival rate and quality of life for those with simple TGA. Presently, we continue to utilize the Mustard procedure for simple TGA until the superiority of other operations are demonstrated. PMID- 3983961 TI - Influence of maternal antibody anti-Jra on the baby: a case report and pedigree chart. AB - A Jr(a-) female (proposita) who has developed anti-Jra during her second pregnancy and her pedigree chart are reported. The antibody anti-Jra of the proposita and her baby was determined to be IgG and was eluted from their red cells. The baby's bilirubin rose to a peak on day 4 without clinical problem except for prophylactic phototherapy carried out. Two other examples of Jr(a-) blood type were detected in her elder sister and the first baby of the proposita with investigation of her pedigree chart. PMID- 3983962 TI - Microcosting an emergency department. PMID- 3983963 TI - Toxicity determined in vitro by morphological alterations and neutral red absorption. AB - A method is described which combines the use of a visual morphological cytotoxicity assay with a quantitative neutral red (NR) spectrophotometric test, for the assessment of the effect of toxic agents on 3T3 cells in culture. These sensitive and reproducible assays lend themselves to a screening procedure of potential toxicants which can help reduce the use of animals for toxicity testing. PMID- 3983964 TI - Changes in the levels of polyunsaturated fatty acids in the lung and lecithin cholesterol acyl transferase activity in plasma of monkeys exposed to ambient levels of ozone. AB - A group of 8 sub-adult bonnet monkeys (Macaca radiata) was exposed to 0.15 ppm ozone (O3) and another group of 8 to 0.3 ppm O3, 8 h/day, for 90 days. Four monkeys in the control group breathed filtered air during this period. Polyunsaturated fatty acids (PUFA) comprised about 22% of total fatty acids in the lungs of controls. The PUFA level decreased to about 90% and 6% in monkeys exposed to 0.15 ppm and 0.3 ppm O3, respectively. Lecithin cholesterol acyl transferase (LCAT) activity in the plasma of monkeys exposed to 0.15 ppm O3 was similar to that in the controls. However, the LCAT activity of plasma was significantly increased by the exposure of monkeys to 0.3 ppm O3. PMID- 3983965 TI - Effects of rifampin pretreatment on hepatic parameters in the rabbit. AB - Rifampin pretreatment in the rabbit caused a selective induction of hepatic parameters resembling in some respects phenobarbital induction. Concomitant with induction, a transient selective inhibition of hepatic parameters was also observed. This two-fold effect of rifampin offers an explanation for the discrepancy surrounding the dosage and species differences in hepatic induction reported in the literature. PMID- 3983966 TI - Effects of long-term cadmium exposure on the testis of rabbits: ultrastructural study. AB - Six male rabbits received for 9 months drinking water containing 20 micrograms/ml of cadmium (Cd). At the end of the treatment, the Cd contents of kidney and testis were 175 +/- 34 and 0.8 +/- 0.2 micrograms/g wet weight, respectively. Ultrastructural examination by transmission electron microscopy (EM) showed that, in the Sertoli cells, the size of the lysosomes was increased; spermatogenetic cells, vessels and Leydig cells showed no significant alterations. Observations with both transmission and scanning EM did not evidence changes in the blood testis barrier, but our results do not exclude that male fertility may be affected by chronic exposure to cadmium. PMID- 3983967 TI - Inactivity of styrene in the mouse sperm morphology test. AB - Male F1-mice (C3H/He X C57B1/6J) were exposed to styrene by inhalation (150 and 300 ppm; 6 h per day; 5 days) or intraperitoneally (175, 350 and 700 mg/kg per day, 5 days). No statistically significant increase was detected in the frequency of abnormal sperm heads 3 weeks (spermatids exposed) or 5 weeks (late spermatogonia/early spermatocytes exposed) after the beginning of the exposures. PMID- 3983968 TI - Opacity of bovine cornea in vitro induced by surfactants and industrial chemicals compared with ocular irritancy in vivo. AB - The ability of 8 surfactants and 5 industrial chemicals to induce bovine corneal opacity in vitro was investigated using a simple specially constructed instrument, the opacitometer. Concentration-effect curves were constructed for each agent. The relative extent to which the agents caused the development of corneal opacity in vitro correlated well with published data on their ocular irritancy in vivo. It is suggested that the measurement of irritant-induced opacity of isolated bovine cornea in vitro may have certain advantages over in vivo irritancy testing as well as over other alternative in vitro techniques and that it may provide the basis for an objective, cost-effective alternative to many current in vivo ocular irritancy tests. PMID- 3983969 TI - Influence of ozone on pentobarbital pharmacokinetics in mice. AB - Previous studies have indicated that acute exposure to ambient concentrations of ozone (O3) as low as 196 micrograms/m3 (0.1 ppm) increases pentobarbital (PEN) induced sleeping time in female mice. To elucidate potential mechanisms involved, additional studies were performed. A 3 h exposure to 9800 micrograms O3/m3 (5 ppm) did not affect brain concentrations of PEN at time of awakening, even though sleeping time was increased. Exposure for 3 h to 9800 micrograms O3/m3 (5 ppm) did not alter the pattern of brain or plasma metabolites of PEN. Pentobarbital clearance followed first-order kinetics with a one-compartment model. Mice exposed to 9800 micrograms O3/m3 (5 ppm) for 3 h had a 106% increase in the plasma half-life of pentobarbital; at 1960 micrograms O3/m3 (1 ppm) for 3 h, a 71% increase was observed. It therefore appears possible that PEN-induced sleeping time might be increased due to an decrease in hepatic metabolism of PEN. PMID- 3983970 TI - A compact multichamber gas inhalation exposure system for mice. AB - A multi-unit, dynamic flow, inhalation exposure system which is capable of accommodating 12 mice per unit has been described. Components of the system include a mixing board, one or more glass distributing tubes, and detachable glass chamber tubes. The flow of a specified concentration of test gas exits from the mixing board, enters a distributing tube, and is then distributed equally to 12 chamber tubes housing one mouse each. Advantages includes quick equilibration time (10 min), relatively low flow rates (20 l/min per distributing tube), ease of disassembly for cleaning, compact size, modest expense and minimal temperature, pressure and physico-chemical effects. PMID- 3983971 TI - Clinical and biochemical changes in chronically exposed organophosphate workers. AB - Health effects of occupational organophosphate exposure were investigated by subjecting 22 workers chronically exposed to an organophosphate pesticide, fenthion (O,O-dimethyl-O-(4-methylmercapto-3-methylphenyl)-phosphorothioate) to clinical evaluation, estimation of serum cholinesterase, serum alkaline phosphatase (SAP), serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT). The mean age of the workers was 31 years and the mean duration of fenthion exposure 8.2 years. Headache (59%), giddiness (50%), ocular symptoms (27%) and paresthesia (18%) were the commonest symptoms. Serum acetylcholinesterase and butyrylcholinesterase levels were significantly lower than in controls. After withdrawing the workers from organophosphate exposure for 3 weeks, the follow-up study revealed absence of transient symptoms. There was no change in their neurological status, and serum acetylcholinesterase and butyrylcholinesterase levels were raised significantly, whereas the other serum enzymes showed no significant change. For monitoring of occupational organophosphate exposure, the importance of both clinical and biochemical parameters is emphasised. PMID- 3983973 TI - Oxidation of pesticides by purified cytochrome P-450 isozymes from mouse liver. AB - 5 cytochrome P-450 isozymes were purified from the livers of uninduced mice and reconstituted with purified NADPH cytochrome P-450 reductase and phospholipid. The pesticides parathion, fonofos, DEF, Mocap and profenofos were oxidized by the reconstituted monooxygenase system to form acetylcholinesterase (AChE) inhibitors. The bioactivation varied with the pesticide substrate and the cytochrome P-450 isozyme. Aldrin epoxidation occurred with all 5 isozymes, with cytochrome P-450 A1 being the most active. All fraction metabolized the pesticide synergist piperonyl butoxide (PBO) to form an inhibitory cytochrome P-450-PBO metabolite complex. The reduced complex produced a spectrum in the Soret region which was characteristic for each of the cytochrome P-450 isozymes. Inhibition of aldrin epoxidation by PBO was found to be unrelated to the nature of the Soret spectrum. PMID- 3983972 TI - Transport of conjugates of toxicants by blood proteins. AB - Binding of naphthol and its glucoside and glucuronide conjugates by blood proteins was studied in vitro and in vivo. Binding was found to be primarily to the albumin fraction of human blood and the binding constants were moderate to low. Both in vivo (mice) and in vitro (human) experiments suggest that a substantial portion of naphthol and two conjugates are transported in bound form to the site of elimination. PMID- 3983974 TI - Protective effect of selenium on the inhibition of erythrocyte 5-aminolevulinate dehydratase activity by tin. AB - The protective effect of selenium (Se) on the inhibition of erythrocyte 5 aminolevulinate dehydratase (ALAD) activity by tin (Sn) was examined in mice. When mice were intraperitoneally (i.p.) administered 10 mumol/kg of stannous chloride, the activity of erythrocyte ALAD decreased to 35% of control. When more than an equimolar dose of sodium selenite was injected i.p. simultaneously with Sn, the ALAD activity was completely protected. Mortalities and weight gains of mice treated with Se were also reduced when Sn was administered simultaneously. PMID- 3983975 TI - Pressure sensitive adhesive tape for maintaining tissue orientation while embedding in glycol methacrylate. PMID- 3983976 TI - A method for serial sampling of cell cultures for examination by light or electron microscopy. PMID- 3983977 TI - Simple apparatus for the rough trimming of electron microscope specimen blocks. PMID- 3983978 TI - A reliable and simple method for oriented epoxy embedding of tissue sections and strips using horizontal polyethylene Beem capsules. PMID- 3983980 TI - A cross-country study of commercial contraceptive sales programs: factors that lead to success. AB - This report presents results from a comparison of subsidized commercial contraceptive marketing programs in 11 developing countries, and makes recommendations for program planning based on findings. The analysis, based on a combined quantitative approach of analysis of variance, factor analysis, and regression analysis, suggests that the successful sale of oral contraceptives is related to level of socioeconomic development, the absence of prescription requirements, and the level of commitment to family planning activities. On the other hand, the successful sale of condoms is related to marketing factors, which include price and advertising. A final discussion of the possible effect of qualitative factors suggests cultural and historical variables that could account for the remaining unexplained variations in sales performances. PMID- 3983979 TI - Social and psychological perspectives on voluntary sterilization: a review. AB - This paper reviews social science research on the antecedents and consequences of voluntary sterilization. The major conclusions are that socioeconomic status has little impact on the decision to be sterilized and that sterilizations are rare among those without sons and among male non-whites. Significant others are important sources of encouragement and information, and good marital relations increase the likelihood of having the procedure performed. Most acceptors experience no change in sexual activity, quality of marital relationships, or work-related behavior, and few regret their choice. Negative consequences are more likely among those in India, those coerced into having a sterilization, those who did not understand the consequences of the procedure, those with health complications after sterilization, and those couples who have unstable marriages or who disagree about sterilization. PMID- 3983981 TI - Contraceptive use during lactation in developing countries. AB - Contraceptive use by breastfeeding women in developing countries has led to concern about potentially harmful effects of steroid contraceptives on the health of breastfed children. In this paper, breastfeeding women's use of the pill and hormonal injections is investigated using survey data from 17 Latin American, Asian, and African countries. The results indicate that while the proportions of breastfeeding women who use these methods were small in most countries at the time of the surveys, the proportion using the pill was not inconsequential. In general, younger lactating women with higher education and more live births who live in urban areas are more likely to use the pill than other breastfeeding women. PMID- 3983982 TI - Noncompliance among oral contraceptive acceptors in rural Bangladesh. AB - The levels of noncompliance among 175 oral contraceptive acceptors in a rural area of Bangladesh were monitored for three to four months. Unexpectedly high levels of noncompliance were observed, including both overconsumption and underconsumption of oral contraceptive pills. Although the study was designed to investigate only the levels of noncompliance and not the causes and consequences of noncompliance, some useful indications of the factors associated with noncompliance were obtained. The results indicate that noncompliance is a significant factor in family planning programs and, as such, warrants further in depth investigation. PMID- 3983983 TI - [Changes in the Ca2+ concentration in subcellular fractions of myocardiocytes in sudden death in coronary disease]. PMID- 3983984 TI - [Postmortem changes in the thiamine content of the brain, liver and small intestine wall]. PMID- 3983985 TI - [Forensic expert testimony with regard to trauma in cases of hospital death]. PMID- 3983986 TI - [Estimation of the time of thoracic and abdominal injuries]. PMID- 3983988 TI - [Characteristics of fatal automobile injuries in the Moscow district]. PMID- 3983987 TI - [Fractological studies of bones in forensic medicine]. PMID- 3983989 TI - [Logical methods in forensic medicine]. PMID- 3983991 TI - [Complex psychologico-psychiatric expert testimony with regard to affective reactions in mentally normal persons and in psychopaths]. PMID- 3983990 TI - [Process of ethanol formation in the late postmortem period]. PMID- 3983992 TI - [Method of postmortem diagnosis of air embolism of the cerebral arteries]. PMID- 3983993 TI - [Analysis of imprints of seminal stains on sticky film]. PMID- 3983994 TI - [Shortcomings of reports of forensic medicine experts with regard to the professional malpractice of medical workers]. PMID- 3983995 TI - [Echo-ophthalmological examination in forensic medicine]. PMID- 3983996 TI - [Fatal blood loss caused by leeches]. PMID- 3983998 TI - [Effect of environmental factors on sudden death in the Far North]. PMID- 3983997 TI - [Combined poisoning with caffeine, morphine and ephedrine]. PMID- 3983999 TI - [Test-retest reliability of category-bound word production in psychogeriatrics]. AB - Fifty patients with a dementia syndrome were tested and retested with a category fluency task. On each occasion subjects retrieved items from two categories: articles of clothing and fruits. The test-retest interval was two or three weeks. Test-retest correlation coefficients for the two categories were .84 and .83 respectively. The standard error of measurement was computed for investigating the statistical significance of score changes for individual subjects. The quantitative stability of successive retrieval from semantic memory contrasted with qualitative variability. Many category examples (57% of articles of clothing and 43% of fruits) retrieved during the second testing had not been retrieved during the first testing. This is consistent with a hypothesis of access deficits during retrieval from an otherwise intact knowledge base. PMID- 3984000 TI - [Psychogeriatrics in Great Britain--report of the Nottingham course 1984]. AB - The British Council's Course 'Psychogeriatrics' at the University of Nottingham reflects the state and development of the internationally acknowledged psychiatry of old age in Britain. This article describes the contents of the course in terms of epidemiology, organization, diagnosis and treatment, with special attention to aspects of education and research. It concludes with a remark on the identity of the subject, stating that psycho-geriatrics has its emphasis in training and research rather than being a medical subspecialty. PMID- 3984001 TI - [Vitamin C deficiency in patients in a nursing home]. AB - The Dutch Nutrition Council recommends an average daily intake of at least 50 mg of vitamin C. In a Dutch centre for nursing and rehabilitation this amount in the food as consumed by 272 patients and as served by the kitchen was calculated to be below 20 mg. About half of the patients consumed additional food - rich in vitamin C - each day either bought or acquired. Symptoms pertaining to the disease scorbut, were observed in a considerable number of these patients, but these may also be caused by other diseases. Patients completely dependent on food served by the central kitchen, had very low values of plasma vitamin C, in contrast to patients who used extra fruit each day. Centres for nursing and rehabilitation are recommended to serve 150 ml vitamin C-rich fruit juice each day, thereby combining the advantages of providing enough fluid intake and preventing obstipation. PMID- 3984002 TI - [Mourning after suicide; an exploratory study]. AB - After the death of a relative a variety of emotional and behavioral responses occur, which can be labeled as 'mourning'. After summarizing some theories on mourning, a pilot study is described among 12 persons whose partner have committed suicide. The findings were compared with existing studies on mourning after a natural death. The feelings which form a part of the mourning process after a suicide, also appear after the loss by natural death: sorrow, anger and guilt. In case of suicide it seemed that the intensity and persistance of especially feelings of anger towards the partner and feelings of guilt were stronger. The motive behind the suicide was crucial to all interviewees. The answer to the question 'why' seems to have a stronger influence on the mourning process than in case of a natural death. Feelings of shame and fear of being accused by others restrained many interviewees to tell the real cause of death. In comparison with studies among relatives whose partner died a natural death, in this study it occurred more frequently that contacts with in-laws were broken. Many interviewees had the experience that others avoided discussing the suicide, with the result that they became isolated. PMID- 3984003 TI - The persistence and significance of elevated alanine aminotransferase levels in blood donors. AB - The level of alanine aminotransferase (ALT) in blood donors has been related to the frequency of posttransfusion hepatitis in recipients. Sixty-seven donors with elevated ALT levels were evaluated to define the duration and significance of the elevation. The ALT level remained elevated in 41 donors (61%) for a mean interval of 9 months. The ALT level was greater than the aspartate aminotransferase in all of the donors. Alcohol intake did not correlate with ALT level. Donors with persistently elevated ALT levels had a significantly higher mean percent ideal body weight (128 +/- 3.9) than donors whose ALT level became normal (116 +/- 3.1). Nine donors with elevated ALT levels for at least 6 months had needle biopsies of the liver. Seven had prominent fatty vacuolization of hepatocytes without evidence of alcoholic hepatitis. One biopsy demonstrated chronic persistent hepatitis. No other cause for the elevated ALT levels could be identified. An overweight male donor with an isolated ALT elevation may need no further investigation unless clinical evaluation suggests a source of liver injury. PMID- 3984004 TI - Unnecessary blood transfusions in elective colorectal cancer surgery. AB - In this 3-year study, we analyzed the transfusion pattern of 288 patients undergoing potentially curative resection of colorectal cancer to determine the magnitude and causes of unnecessary blood transfusions. Transfusions were considered unnecessary if the preoperative hematocrit exceeded 36 percent or the discharge hematocrit exceeded 33 percent. Twenty-five percent of the units of blood administered were unnecessary by these criteria. Excessive intraoperative transfusion (67 patients) and the practice of administering blood in pairs of units (33 patients) without reevaluating the hematocrit between successive units accounted for 90 percent of unnecessary transfusions. This study indicated that determination of the hematocrit immediately before administration of each unit of blood will reduce blood consumption of elective colon resections by 25 percent. PMID- 3984005 TI - Acute hemolysis and renal failure with rifampicin-dependent antibodies after discontinuous administration. AB - Acute hemolysis as a reaction to rifampicin is extremely rare; case reports number less than 15. We recently evaluated a 65-year-old Cambodian refugee who self-regulated the use of rifampicin and isoniazid for pulmonary tuberculosis. Fifteen minutes after a single discontinuous oral dose, he developed flank pain, chills, rigors, vomiting, diarrhea, fever, and brown turbid urine. Laboratory tests at presentation showed acute intravascular hemolysis. Nonoliguric renal failure ensured, and he was transferred to our institution 2 days later. The patient was group A, Rh (D) positive, P1 negative with a cold autoantibody and cold anti-P1 alloantibody. The direct antiglobulin test was negative at the time of transfer. To evaluate the hemolysis, studies were done to test for rifampicin- or isoniazid-dependent antibodies. Rifampicin-dependent antibodies were detected in the antiglobulin phase with broad spectrum anti-human globulin, monospecific anti-gamma chain, and anti-complement antisera. Agglutination titers did not change after dithiothreitol reduction of the patient's serum. We conclude that this patient developed rifampicin-dependent IgG antibodies with complement-fixing capability. The presence of rifampicin-dependent antibodies should be suspected in a patient with hemolysis and/or renal failure taking rifampicin. PMID- 3984006 TI - A delayed hemolytic transfusion reaction due to anti-Cob. AB - A delayed hemolytic transfusion reaction precipitated by anti-Cob is described in a multiple transfused primigravida woman with sickle-cell disease. Sixteen days after the prophylactic transfusion of the first of 4 units of red cells, she experienced a fall in hemoglobin concentration accompanied by a newly positive antibody screen and direct antiglobulin test. Anti-Cob was identified both in the patient's serum and in an eluate prepared from her red cells. PMID- 3984007 TI - Survival of Er(a+) red cells in a patient with allo-anti-Era. AB - 51Chromium-labeled Er(a+) red cells survived nearly normally (T1/2 of 21 days) in a patient with allo-anti-Era. Transfusion of Er(a+) blood was without significant reaction and did not affect the anti-Era titer. PMID- 3984008 TI - An unusual Donath-Landsteiner antibody detectable at 37 degrees C by the antiglobulin test. AB - A 14-year-old boy with no history of transfusion experienced a hemolytic crisis attributed to paroxysmal cold hemoglobinuria. The Donath-Landsteiner test was positive. The IgG autoantibody had anti-P specificity but was unique in that it also reacted strongly by indirect antiglobulin test at 37 degrees C. PMID- 3984009 TI - Comparison of a modified manual hexadimethrine bromide (Polybrene) and a low ionic-strength solution antibody detection technique. AB - Manual hexadimethrine bromide (Polybrene) tests (Polybrene in low-ionic medium) were used in parallel with manual low-ionic-strength solution (LISS) procedures for the routine testing of patient samples referred to a general hospital blood bank. Of 5646 consecutive sera tested, 5167 (91.5%) did not react with either technique; 320 sera (5.7%) reacted in both methods. The Polybrene technique detected 63 antibodies which did not react in the LISS methods. One hundred sera did not react in the Polybrene test, but did react in the LISS methods. Sera showing discrepant results between the two methods were further tested in a reference laboratory. Polybrene tests appeared to be better in avoiding reactions due to clinically nonsignificant antibodies. The LISS methods, however, appeared to be more sensitive in detecting antibodies of potential clinical significance. PMID- 3984010 TI - The effect of storage on degranulation by human neutrophils. AB - We investigated the possibility that the functional impairment in neutrophil (PMN) chemotaxis which occurs during granulocyte concentrate storage might be due to autotoxicity from the release of neutrophil granule contents during storage. Preliminary experiments confirmed that the exposure of fresh PMNs to the intracellular contents of disrupted PMNs, decreased the subsequent chemotaxis of the fresh PMNs by 63 +/- 5 percent compared to control PMNs (p less than .01). Freshly harvested neutrophils were stored at low (2 X 10(7) PMN/ml) or high cell concentration (8 X 10(7) PMN/ml) with or without 15 mM sodium bicarbonate (in order to maintain pH). Prior to storage, and 24 and 48 hours after storage at 22 to 24 degrees C, we measured the cell and unit plasma content of lactate dehydrogenase (LDH), beta-glucuronidase, and lysozyme. These enzymes served as markers for cell lysis, and primary and specific neutrophil granule contents, respectively. We also measured the effect on neutrophil chemotaxis of adding a protease inhibitor, phenylmethylsulfonyl fluoride (PMSF), to the storage medium. In addition, we measured the ability of PMNs to degranulate in response to an inflammatory stimulus before and after storage. The cell content of granule markers was largely unchanged during storage, except in the case of the units at a concentration of 8 X 10(7) PMN per ml stored without bicarbonate. In these units, lysozyme activity decreased by 15 +/- 7 percent after 48 hours of storage (p less than 0.02 vs. fresh PMNs). Likewise, the plasma content of LDH, beta glucuronidase, and lysozyme increased significantly during storage, especially in units of high cell concentration stored without bicarbonate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3984011 TI - Elution of anti-Cra. Superiority of the digitonin-acid elution method. AB - Six examples of IgG anti-Cra were absorbed onto group O, Cr(a+) red cells and subsequently eluted by five elution methods. Five of the anti-Cra antibodies were eluted only by the digitonin-acid method. The sixth example was recovered by all elution methods; however, the digitonin-acid and Lui freeze-thaw methods recovered more antibody activity than did the dichloromethane, ether, or 56 degrees C heat methods. This is the first report of multiple examples of antibodies with the same specificity demonstrated preferentially by a single elution technique. PMID- 3984012 TI - AIDS, ethics, and the blood supply. A report of a conference of the American Blood Commission and the Hastings Center, Institute of Society, Ethics and the Life Sciences, January 29 and 30, 1985. AB - Although the conference was not held to determine policy, certain issues emerged which should be of interest to all involved with the initiation of anti-HTLV-III testing. First, there was a consensus that an implementation period during which donors will not be notified of the test results is essential. During this period, test proficiency, data confidentiality safeguards, and positive donor counseling procedures can be established. Also, during this period alternative test sites can be established; this was considered a critical step to maintain the safety of the blood supply. Second, there was a perceived need for legislation to protect the confidentiality of sensitive test data, whether in the laboratory or as part of a deferral list system, from subpoena. Third, there was not agreement about whether inventory should be tested; donors who provided that inventory did not know it was to be tested, and might not have consented if the implications of testing had been known. But, inventory testing is clearly in the interest of the recipient. Finally, there was an awareness in the blood banking community of their new role in monitoring a public health menace, and a beginning acceptance of this role emerged. PMID- 3984013 TI - Limitations of the immediate spin crossmatch when used for detecting ABO incompatibility. AB - In the eleventh edition of the AABB's Standards for Blood Banks and Transfusion Services the requirement for an antiglobulin crossmatch was deleted if no clinically significant unexpected antibodies are detected in recipient serum testing and if there is no history of detection of such antibodies. Test methods that demonstrate ABO incompatibility remain a requirement; however, the means to accomplish this may prove controversial. The immediate spin crossmatch has been used for the purpose of detecting ABO incompatibility by many workers. Nonetheless, limitations of this technique became apparent in tests between A2B donor red cells and group B patient sera. The results of 204 of 531 immediate spin crossmatches, between these two blood groups, were found to be negative. PMID- 3984014 TI - Jehovah's Witnesses and autologous transfusion. PMID- 3984015 TI - Red cell survival techniques. PMID- 3984016 TI - Yt (Cartwright) blood groups among Israeli Jews. PMID- 3984017 TI - Disposable plastic transfer pipets in the blood bank. PMID- 3984018 TI - Report of transfusions of M- and P1-positive red cells to a patient with anti-M and anti-P1. PMID- 3984019 TI - Two types of delayed hemolytic transfusion reactions. PMID- 3984020 TI - Measurement of viability of stored red cells. PMID- 3984021 TI - Origin of decidual cells in murine pregnancy and pseudopregnancy. PMID- 3984022 TI - Evidence that decidual cells are not derived from bone marrow. PMID- 3984023 TI - Histopathology of a possible graft-versus-host reaction induced by nude mouse spleen cells. PMID- 3984024 TI - Restoration of delayed hypersensitivity in mice receiving immunosuppressive drugs by cimetidine. PMID- 3984025 TI - Cyclosporine-associated renal damage in the mouse. PMID- 3984026 TI - Localization of MN blood group antigens in kidney. PMID- 3984027 TI - [Conservation of bone marrow CFUc in different phases of the cell cycle during cryopreservation]. AB - The effect of low temperature (-196 degrees C) preservation on the recovery of colon-forming units (CFUs) of bone marrow at different phases of the cell cycle before cryopreservation is dealt with. The intact bone marrow "enriched" with CFUs in S phase of the cell cycle and the bone marrow without colony-forming units in S phase were exposed to cryopreservation. After cryopreservation of the bone marrow enriched with CFUs in S phase and th bone marrow without colony forming units in S phase the number of CFUs decreases by the same value as in the cryopreserved bone marrow obtained from intact mice. PMID- 3984028 TI - [Calculation of the duration of mitosis for a population with an exponential growth of the cell number]. AB - A formula was received for the mean mitotic duration of a cell population being at the phase of exponential growth of the cell number with the cell loss: tM = nM.tD.(1-phi)/ln 2, where nM is the mitotic index, tD is the doubling time of the cell number, and phi is the Steel cell loss factor. In the case when after irradiation of such a population a 100% radiation G2-block arises, the method of calculation of the tM according to the curve of the relative mitotic index decrease was shown to be independent on the value of parameter phi and to coincide with the same method to be used in the case when the cell population is at the steady state before irradiation. As the result of analysis of literary experimental data the following values were received: tM = 20 min and tM = 37-42 min for two cell subpopulations of the Ehrlich ascite tumour, resp., tM = 39 min for epithelial cells of the mouse cornea, and tM = 29 min for enterocytes of the mouse jejunum. It has been also shown that the values of the dose of cell irradiation and of the mean duration tG2" of the subphase G2" localized at the end of phase G2 and preceded by the G2-block satisfy the next formula: Ig D = -a . Ig tG2" + b. PMID- 3984029 TI - [Mathematical modeling of the kinetics of a heterogeneous cell population during tumor growth. II. A numerical study and some generalizations]. AB - The phasic portrait of the system describing dynamics of a heterogeneous cell population of the tumor is built up by means of numerical methods. The decisions of the system are examined for a sufficiently common consideration on the functional relations of the intensities of changeable processes between the fractions of cell populations. PMID- 3984030 TI - [Changes in the ultrastructure and intensity of lipid synthesis in the adipocytes of subcutaneous fatty tissue of piglets following birth]. AB - In the subcutaneous adipose tissue of new-born pigs (before taking up the colostrum) poly-vacuolar adipocytes prevail, containing a small amount of triacylglycerols (triacylglycerines). In the investigated tissue of 1 day old piglets, the increase in triacylglycerols is associated not only with the deposition of colostrum lipids, but also with the intense synthesis of fatty acids de novo from (U-14C)-glucose. In the adipose tissue of 5 day old piglets (U14-C)-glucose is incorporated intensively in the fraction of acylglycerols, whereas in 1 day old animals phospholipids make up 40% of the lipids synthesized by adipocytes. The revealed peculiarities of lipogenesis in the pig adipose tissue are associated with the hyperplasy and hypertrophy of cell elements. PMID- 3984031 TI - [Effect of elevated temperatures on human lymphocyte chromosomes]. AB - The influence of elevated temperatures (38-41 degrees C) on chromosomes of human lymphocytes on different phases of the cell cycle was studied. A high thermosensitivity of chromosomes was demonstrated during (S + G2)-phases of the cell cycle. There was a significant increase in the number of aberrant cells at t greater than 38.5%. The main types of chromosome aberrations were chromatid and chromosome deletions. Cells with 3-5 aberrations and induction of chromosome aberrations due to breaks in the centromere region were noticed at high temperatures (40-41 degrees). PMID- 3984032 TI - [Cytochemical determination of the enzyme activity of cerebrospinal fluid lymphocytes in dogs]. AB - Cytochemical methods commonly used in hematology were applied to studying the liquor lymphocytes of dogs. According to our observation of decreasing their activity, the enzymes examined are placed in the following order: alpha glycerophosphate, glutamate, lactate, and succinate dehydrogenase. High and reliable values of asymmetry and excess coefficients show the absence of the normal distribution of enzymatic activity in the investigated population of lymphocytes. PMID- 3984033 TI - [Growth of lymphoid cell cultures of the Raji line in a medium containing low molecular serum components]. AB - The effect of fetal bovine serum ultrafiltrate, containing low-molecular components (lower than 14 000 D), on the growth of cultures of the lymphoid Raji cells and fibroblasts BHK-21 was studied. The growth of the former did not differ from that in the control (in the medium with the whole fetal serum), while the latter did not proliferate in the medium with the ultrafiltrate. Thus, the growth of the lymphoid Raji cells and fibroblasts BHK-21 is controlled by different serum components. The Raji cells were exposed to an ultrafiltrate (up to 14 000 D) of the adult animal serum whose growth stimulating activity is known to be lower than that of the fetal serum. After the removal of components with molecular weights higher than 14 000 D from the adult animal serum, the growth stimulating activity of such a serum was seen increased, but not up to the level of the fetal serum. BHK-21 cells did not proliferate in the medium with this ultrafiltrate. It is proposed that the increase in the growth stimulating activity of the whole bovine serum in respect to the Raji cells after the removal of the components with high molecular weights may be due to the removal of lymphocyte growth inhibitors whose activity depends on the age of the animal serving a donor of serum. PMID- 3984034 TI - Supervised intermittent chemotherapy for pulmonary tuberculosis in a rural area of China. AB - In order to ensure regularity of ambulatory treatment of new cases of pulmonary tuberculosis, a fully supervised intermittent chemotherapy regimen was tried in two rural counties of Beijing. The bare-foot doctors of the village health co operatives were designated to administer and supervise treatment. The regimen consisted of isoniazid and streptomycin daily for 1 month, then every 3 days for 5 months and then every 5 days for a total of 12 or 18 months. For smear-negative cases the daily phase was omitted. The compliance rate among 229 patients in 1 year was 99.4%. The sputum conversion rate among 104 cases harbouring sensitive bacilli was 95.2%. Discontinuation of the regimen due to side-effects as necessary in 3 cases (1.3%). Since 1979, this treatment programme has been adopted in the whole rural area of Beijing, and the coverage rate among newly diagnosed smear-positive cases in 1983 reached 90%. A reserve regimen consisting of rifampicin and ethambutol for patients who do not convert their sputum after 6 months of treatment with isoniazid and streptomycin was added. The overall conversion rate achieved in 1981 was 97.8%. The average overall cost of drugs for each patient treated in this treatment programme was 49 yuan (RMB), about $24.00 U.S. PMID- 3984035 TI - Does infection with environmental mycobacteria suppress the protective response to subsequent vaccination with BCG? AB - Using a guinea pig model of experimental airborne tuberculosis, we were unable to find evidence to support the hypothesis that infection with environmental mycobacteria (M. simiae or M. avium-intracellulare) interferes with the induction of a protective response in animals subsequently vaccinated with BCG. PMID- 3984036 TI - Human leukocyte antigens and circulating immunoglobulin levels in Indian patients with pulmonary tuberculosis. AB - Histocompatibility antigens (-A, -B and -C loci) and circulating antibodies (IgG, IgM, IgA and IgE) were studied in 63 pulmonary tuberculosis patients and regionally matched healthy volunteers from Uttar Pradesh, India. A previously described association with antigen B15 in an heterogeneous sample of North India was not confirmed but a slight increase of antigen B18 was found. The levels of immunoglobulins in the plasma of these patients showed a significant increase in IgG, IgA and IgE. Although the increased levels of IgG and IgA are in agreement with previous studies, the role of the increased IgE is not clear and needs further investigation. Patients who were antigen B14 and B18 positive tend to show significantly low levels of IgG, which suggests a possible genetic influence on the expression of immunoglobulin levels. PMID- 3984037 TI - Haptoglobin: an immunoregulatory role in tuberculosis? AB - A significant correlation was found between levels of haptoglobin in sera from Indonesian patients with tuberculosis and the extent to which these sera suppressed mitogen-driven activation of normal lymphocytes in vitro. As in a previous study we showed that there was an inverse relationship between haptoglobin levels and the circulating lymphocyte count in the same group of patients, it is now suggested that this protein has an immunoregulatory role in tuberculosis. Similar observations have been made by other workers on patients with cancer. There was no difference in the distribution of the 3 allotypes of haptoglobin in patients and healthy subjects nor was there any association between such allotypes and the lymphocyte count, the dermal reactivity to tuberculin or the degree of suppression. PMID- 3984038 TI - The diagnosis of tuberculous ascites in a rural African community. AB - Tuberculous ascites can be a difficult condition to diagnose. In the rural African population served by Jane Furse Hospital both tuberculosis and ascites are common conditions. Between 1 November 1982 and 31 October 1983, 80 patients were admitted with ascites. Open peritoneal biopsy was used in 18 patients in whom the cause was uncertain. In 5, biopsy showed caseating tuberculosis in the absence of any other evidence of active disease. In 6 the biopsy showed non specific changes which may be associated with tuberculosis or cirrhosis of the liver. No significant complications were encountered and it was concluded that this procedure was a useful, safe and rapid means of diagnosing tuberculous peritonitis. PMID- 3984039 TI - Mycobacterium szulgai--a case of cutaneous infection? AB - An infant presented with a carbuncle over the angle of her jaw which grew a scotochromogenic mycobacterium, subsequently identified as Mycobacterium szulgai. The problems of identification of this organism and its possible pathogenic role are outlined. PMID- 3984040 TI - The impact of treatment programmes on the epidemiology of tuberculosis. PMID- 3984041 TI - Species level identification of non-tuberculous mycobacteria from South Indian BCG trial area during 1981. AB - In 1981, non-tuberculous mycobacteria (NTM) were obtained from 8.6% of 16 907 sputum specimens in a trial in the Chingleput district of Madras state to test the efficacy of BCG vaccination in the prevention of tuberculosis, but from only 0.6% of 672 autoclaved specimens cultured as part of a quality control procedure. This finding suggested that the NTM were truly derived from the sputum of the BCG trial subjects. The mycobacterial species could be identified in 966 (96.6%) of the first 1000 isolates of NTM: 54.6% were potential pathogens and 73.0% were slow growing. The species isolated most frequently were M. avium/intracellulare (22.6% of all NTM), M. terrae (12.5%) and M. scrofulaceum (10.5%). Those species accounting for 8-5% of all NTM were M. fortuitum, M. chelonei, M. flavescens, M. gordonae and M. vaccae. PMID- 3984042 TI - Morphology and progression of preneoplastic changes in methylcholanthrene-induced mouse mammary tumorigenesis. AB - Susceptible BALB/c virgin female mice were treated with 3-methylcholanthrene in almond oil (0.5%) by skin painting and killed at monthly intervals. The mammary glands were prepared as whole mounts for stereoscopic study of the glandular tree with removal of any focal change for histology. The results showed a marked disarrangement in the architecture of the glandular tree, a prevalent ductal tree, and an overcrowding of ducts. Focal hyperplastic changes were frequently observed, including hyperplastic alveolar nodules, hyperplastic ductal nodules, noduloids and intraductal epithelial growths, and their respective rates of malignant transformation observed at histology were 22%, 15%, 7% and 50%. Data suggest a different weight of these preneoplastic changes as sources of malignant transformation and a prevalent ductal origin of the methylcholanthrene-induced neoplasms. PMID- 3984043 TI - Gastritis cystica polyposa: a possible precancerous lesion. AB - Twenty polypoid lesions at gastroenterostomy stomas (the so-called gastritis cystica polyposa-GCP) were endoscopically removed from gastroenterostomy stomas of 16 male and two female patients previously operated for benign lesions. The interval from surgery ranged from 3 to 40 years (mean: 16.2 years). At light microscopy GCP showed 2 histologic patterns: a) with cystic glands limited to the mucosal layer (gastritis cystica superficialis); b) with cystic glands also spreading into the submucosa (gastritis cystica profunda). Atrophy of specific gastric glands, intestinal metaplasia and dysplastic changes also occurred. Local chronic ischemia and inflammatory reaction as a consequence of gastric surgery and suture at gastroenterostomy together with bile reflux were considered responsible for the development of GCP. The sites and the histologic features of GCP resembled those of experimental stomal polyps preceeding carcinoma in rats after partial gastrectomy. The sites of formation, the sex incidence, the interval from previous operation as well as the histologic findings suggest that GCP is a possible precancerous lesion. PMID- 3984044 TI - Local morphologic changes related to laryngeal carcinoma. AB - In a series of 178 patients who underwent partial or total laryngectomy for laryngeal carcinoma, the morphologic changes at a distance from the neoplasm were investigated with whole organ serial sections. We found 60 cases with extensive squamous metaplasia of the epithelium outside of the vocal cords, 24 case with hyperplastic epithelium of the vocal cords, 29 cases with mild or moderate dysplasia, 5 cases with foci of in situ carcinoma, 3 cases with a second carcinoma with minimal stromal invasion, and 4 cases with a double synchronous primary carcinoma. In 55 cases we observed the contemporary presence of a carcinoma and a mono-or bilateral laryngocele. In the excretory ducts of the salivary glands present in the laryngeal mucosa we found a reserve cell hyperplasia in 100% of the cases, a mature squamous metaplasia in 25%, and an oncocytic metaplasia in 14%. These observations led us to consider the laryngeal cancer as an organ disease, in which the oncogenic stimulus operates on all the laryngeal structures and determines lesions of different severity up to neoplasm. PMID- 3984045 TI - The value of endometrial cytology in a high risk population. AB - Between January 1982 and November 1983, 335 women at risk for endometrial carcinoma, with or without symptoms, were screened on an out-patient basis at the 3rd Department of Obstetrics and Gynecology of the University of Milan for endometrial carcinoma and its precursors. Cytologic diagnosis of material obtained with the Milan-Markley helix (Mi-Mark) was compared, in terms of acceptability and diagnostic accuracy, with histologic diagnosis of material obtained by Vabra curettage. The Mi-Mark was better accepted by the patients and there were almost no complications. Sensitivity was 93% for adenocarcinoma, 62% for atypical hyperplasia and 76% for hyperplasia without atypia. According to epidemiologic data and to our results, we suggest this screening procedure for asymptomatic obese women. PMID- 3984046 TI - Cutaneous carcinomas and soft tissue sarcomas induced by ionizing radiation therapy. Presentation of a series of 42 cases. AB - Forty-two cases of tumors of the skin and of the soft tissues immediately beneath the skin, presumably induced by ionizing radiotherapy, are reported: 35 were carcinomas, 2 angiosarcomas, 2 leiomyosarcomas of the dermis and 3 fibrosarcomas. In 31 of the 35 cases of carcinomas, multiple neoplastic foci were found in the skin area exposed to the ionizing radiation. The median age of the patients at the time of exposure to ionizing radiation was 32.5 years for those with carcinomas and 30 years for the others. The relatively young age at exposure to the ionizing radiation may have influenced onset of the tumor. The median interval between exposure to ionizing radiation and clinical finding of the tumor was 18.1 years for the carcinomas and 16 for the other tumor types. The radiation dose to which the patients had been subjected varied for the carcinomas from 12 to 25 Gy and for the other tumors from 40 to 50 Gy, administered over 1 to 4 years in the cases of carcinomas and 4 to 5 weeks in the other cases. The dose administered to the cases with cutaneous carcinomas was rather low, since almost all these patients had benign disease; however, it is in this dose range (12-25 Gy) that, according to Gray, a relatively high incidence of induced tumors is verified. In the opinion of the author of the present paper, the multiplicity of neoplastic carcinomatous foci in the skin area exposed to radiation confirms Gray's hypothesis; also, the time over which the dose was administered was presumably important in determining such multiplicity. The soft tissue sarcomas occurred only in patients previously subjected to radiotherapy, according to traditional modalities, for malignant neoplasms. The carcinomas were observed almost always in the trunk, and like spontaneous carcinomas at this site they were almost exclusively of basal cell type. PMID- 3984047 TI - Cardiotoxicity as a result of 5-fluorouracil therapy. AB - We report the case of a patient bearing a sigmoid colon carcinoma, stage IV, who after 11 months of antiblastic therapy, having completed a dose of 81,000 mg of 5 FU and CCNU, suffered a myocardial infarct. We attribute this complication to 5 FU. Due to the fact that the coronary angiogram did not confirm the arteriosclerotic nature of the lesion, we suggest that it could have been caused by an endoarteritis, resulting from an immuno-allergic or toxic cumulative process. PMID- 3984048 TI - Pharmacologic data and technical feasibility of intraperitoneal doxorubicin administration. AB - Seventy intraperitoneal administrations of doxorubicin were performed in 12 patients with malignant disease in the abdominopelvic space. Peritoneal and hematologic drug levels were measured by fluorimetric assay. A first-order decline in the peritoneal level was determined (T 1/2 96 +/- 18 min), with a mean drug absorption of 84% in 4 h (range 40-96%) and a mean ratio of a peak dialysate/peak serum level of 111 (range 12-390). Gastrointestinal toxicity was common and peritoneal phlogosis occurred twice. The doxorubicin level and the time of peritoneal exposure seem to be critical factors for major local toxicity. At a moderate concentration doxorubicin can be intraperitoneally administered, but its usefulness is probably confined to patients with minimal abdominal disease. PMID- 3984049 TI - Multifactorial analysis of NOC lung carcinoma radiotherapy. AB - In order to evaluate survival of non-oat-cell lung carcinoma patients treated exclusively with radiotherapy, the authors analyzed a series of 791 cases irradiated at the Istituto del Radio "O. Alberti" from 1978 to 1982. The authors selected a homogeneous group of 131 patients, treated with high energy photons and with a fractionation course of a dose ranging from 1.75 to 2.00 Gy per fraction, 5 fractions per week, total dose ranging from 40 to 65 Gy within 4 to 8 weeks and with a time dose factor (TDF) ranging from 60 to 108. The survival curve was computed according to several prognostic factors by means of the Kaplan and Meier approach; a multifactorial analysis was carried out according to Cox's model. No factor significantly affected survival at the level P less than 0.05, except complications: anyway, TDF and tumor size seem to play a particular role. The non-oat-cell lung carcinoma patient who can profit from radiotherapy may be only partially featured: an improved survival and quality of life may be achieved if there are correct criteria to include the patient in the radiotherapy program, if the tumor is small, heavy complications are absent and treatment TDF ranges from 82 to 92. PMID- 3984050 TI - Severe pericarditis as a presenting sign of bronchogenic carcinoma. AB - An exudative pericarditis was the only sign of an adenocarcinoma arising from the right main bronchus of the lung for two and a half months. No metastases were found at the time of diagnosis. Pericarditis relapsed quickly after repeated pericardiocenteses, and systemic chemotherapy did not influence its course. Cardiac tamponade caused the death of the patient. PMID- 3984051 TI - Primary non-Hodgkin lymphoma of the parotid gland associated with Sjogren's syndrome: a case report. PMID- 3984052 TI - Echocardiographic findings of dilated right coronary artery. PMID- 3984054 TI - Neonatal chylothorax. PMID- 3984053 TI - A case of Holt-Oram syndrome severely affecting the skeleton of the upper limbs. PMID- 3984056 TI - Tietze's syndrome. Report of a case with juvenile onset and review of the literature. PMID- 3984055 TI - Congenital erythropoietic porphyria. PMID- 3984057 TI - Pyloric atresia. PMID- 3984058 TI - [Non-traumatic necrosis of the femoral head associated with alcohol abuse]. PMID- 3984059 TI - [Neurilemmoma of the small intestine]. PMID- 3984060 TI - [Human yersiniosis. Study of the spread of infection by Yersinia enterocolitica serotype 0:3]. PMID- 3984061 TI - [Omeprazole treatment in the Zollinger-Ellison syndrome]. PMID- 3984062 TI - [Implantation metastasis after fine-needle biopsy of cecal carcinoma]. PMID- 3984063 TI - [Acute tumor embolism in the brachial artery]. PMID- 3984064 TI - [What types of housing do elderly people want?]. PMID- 3984065 TI - [Analysis of complicated indoor environmental climates. Illustrated by a concrete case under the Danish Labor Inspection Service]. PMID- 3984066 TI - [Practice of reporting of occupational diseases and accidents in issuing death certificates. Results of a questionnaire study]. PMID- 3984067 TI - [An account of Danish psychiatry to the year 2000]. PMID- 3984068 TI - [Treatment of malignant pleural effusion]. PMID- 3984069 TI - [Cholescintigraphy in suspected cholecystitis. Further experience with a diagnostic test]. PMID- 3984070 TI - [Production of fresh frozen plasma by machine plasmapheresis]. PMID- 3984071 TI - [The Monk metal cap hemiarthroplasty in the treatment of medical fractures of the femoral neck]. PMID- 3984072 TI - [Sick-leave after abdominal surgery]. PMID- 3984073 TI - [Vaginal evisceration after vaginal hysterectomy]. PMID- 3984074 TI - [Sudden deafness in multiple sclerosis]. PMID- 3984076 TI - [Prescription control at pharmacies]. PMID- 3984075 TI - [Schistosomiasis and acute appendicitis]. PMID- 3984077 TI - [Compulsory commitment to psychiatric hospitals 1978-1983]. PMID- 3984078 TI - [Training in geriatrics. Who shall teach? Who shall be thought?]. PMID- 3984080 TI - [Anaerobic bacteriuria as the cause of dysuria and pollakisuria]. PMID- 3984079 TI - [Causes of dysuria and pollakisuria in women in general practice]. PMID- 3984081 TI - [Withdrawal of antihypertensive drugs in elderly patients]. PMID- 3984082 TI - [Germ cell tumors of the ovary]. PMID- 3984083 TI - [Radiography of the esophagus in suspicion of foreign body]. PMID- 3984084 TI - [Introduction of a temporary pace catheter via the subclavian vein]. PMID- 3984085 TI - [Cardiac tamponade in rheumatoid arthritis]. PMID- 3984086 TI - [Neuropathic arthropathy of the spinal column]. PMID- 3984087 TI - [Perforated gastric ulcer during a slimming regime]. PMID- 3984088 TI - [Intermittent claudication--an intervention study. A prospective study of the value of preventive medical advice]. PMID- 3984089 TI - [Have the expectations concerning hospital planning been fulfilled? A study of the extent to which hospital plans improve efficiency, the basis for decisions and the possibilities of guidance in the hospital sector and the extent to which these provide information for the population and authorities]. PMID- 3984090 TI - [Nutrition handbook for hospitals. A proposal for a general description of hospital food]. PMID- 3984091 TI - [Problems in epidemiological surveys in developing countries. An attempt at a population study in Bangladesh]. PMID- 3984092 TI - [Leprosy control in Bangladesh. Evaluation of a 5-year control project in the northern part of Bangladesh]. PMID- 3984093 TI - [Fractures of the lumbar spine and the lower thoracic spine--surgical technic and results]. AB - Improved healing results are achieved by surgical treatment of fractures of the lumbar spine and of the thoracic transition, if the indication is correct, i.e. in case of splintered fracture with severe instability or neurologic troubles, but also in case of luxations occurring rarely in the region of the lumbar spine. The anterior fusion of fractions with bone defects in the region of the vertebral body is more logical with regard to the biomechanical aspect. PMID- 3984094 TI - [Diagnosis and therapy of traumatic posterior shoulder dislocations]. AB - In cases of dislocation of the shoulder the humeral head almost always dislocates anteriorly. Only rarely does the dislocation result in a posterior position of all or part of the humeral head. The diagnosis of posterior dislocation is not always as easy as the diagnosis of anterior dislocation and for this reason the injury is often missed. Cisternino et al. found that over 50% of patients with posterior dislocation of the shoulder were missed on initial examination. The longer the time between accident and treatment, the more difficult that treatment becomes and the harder it is to achieve a satisfactory functional result. Therefore it is vital to think of this injury in all cases of severe contusion of the shoulder and if there is the slightest suspicion of this injury, the patient must be aggressively investigated to establish the relationship between the humeral head and the glenoid. PMID- 3984095 TI - [Indications for the surgical and conservative treatment of juvenile supracondylar humeral fractures and their results]. AB - In the period from 1977 to 1982 78 children were treated for supracondylar fractures of the humerus at the Berufsgenossenschaftliche Unfallklinik Frankfurt/Main. Indications and methods for operative and conservative treatment are described. The results of therapy were reviewed by means of a questionnaire or reexamination in 68 patients with regard to function, elbow deformity and nerve lesions. Fractures of a grade I severity are to be treated conservatively by immobilisation in a POP-cast. Only in exceptional cases of grade II severity can a closed reduction be recommended. All remaining types of fractures of grade II and III severity should primarily be treated by open operations within 8 hours of the accident. Under these conditions the risk of infection is no higher than with percutaneous Kirschner-wire-osteosynthesis. Complications such as appreciable varus deformity, poor function and nerve lesions can largely be avoided in this way. The so-called extension-treatment offers no advantages in comparison with operative treatment. PMID- 3984096 TI - [Late results following femoral shaft fractures in childhood]. AB - The results of 102 children with fractures of the femur shaft treated by osteosynthesis with dynamic compression plates (DCP) in comparison to 87 children which underwent a conservative treatment by extension are presented. Of 329 patients in a 15-years period, 238 children had a follow-up examination with evaluable data and 49 patients were excluded because of a different therapy such as plaster traction, cast, osteosynthesis with screws or nails etc. The children were divided into two groups: series I from 1968 to 1977 and series II from 1978 to 1982. 19.6% of the patients had a residual difference of more than 1 cm in the length of the legs. Operated children were twice as often afflicted as the conservative group. The amount of difference in the length depended on the duration of instability and increased when several repositions were required in the conservative group, or when an operation was carried out secondary to inadequate traction therapy. Axial deviation was found to be much more common in the extended group (16.1%) than in the operated group, in which only 4% axial deviations persisted in series II when DC-plates were used exclusively. Predominant in the conservative group was a persisting antecurvation in 13 of 14 children. Residual rotation malalignment of significant degree was found only in the group treated by extension, while the operated group averosed at minor torsion deformities. Children with closed epiphysis on the date of examination, who had a persisting rotation failure, had been treated nearly exclusively by extension (50% versus 15%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3984097 TI - [Lateral ligament ruptures of the upper ankle joint in children]. AB - This report about 44 cases of fibular ligament lesions compares the results of two series of 22 cases, one investigated from 1978 to 1981 and the other from 1981 to 1983. Introduction of a special holding device in 1981 has resulted in more objective diagnostics. To prevent false indications for surgery the displacement under stress need to be compared with the healthy ankle. If there is 8 degrees difference an operation is indicated in children. Following the example of adult traumatology the introduction of a longitudinal epifibular incision and new techniques employed in ligament surgery have clearly improved the results of treatment. PMID- 3984098 TI - [Talus injuries]. AB - Due to function and anatomy the talus plays a special part among the tarsal bones. The extended joint surfaces cause a high rate of arthrosis in fractures, the difficult blood supply leads very often to a disturbance of the supply of the talus in the case of vulneration. Fractures are divided in central and peripheral forms which could be caused either by simple or compound fracture mechanism. The computed tomography offers precious informations in the diagnosis of talus vulnerations. Besides the conservative therapy of peripheral fractures there is the operative treatment of central fracture forms. Infection, arthrosis and necrosis of the talus are to be mentioned especially as postoperative complications. PMID- 3984099 TI - [Starting a physician's practice]. PMID- 3984100 TI - A combination of plastic and plaster of Paris (Kombigips) in fracture treatment. AB - A new model of plaster bandage with combination of gypsum and plastics is presented and its economic use is compared with traditional technics. "Kombigips" in 12 patients was more efficient in staging of fracture healing than traditional plaster bandages, because the X-ray properties of "Kombigips" are more profitable. "Kombigips" is much more cheaper than use of pure plastic bandages and nearly as cheap as use of traditional plaster bandages. PMID- 3984102 TI - [Plasma norepinephrine and cardiac sympathetic activity during dynamic exercise in man: what is the relationship?]. PMID- 3984101 TI - [Abdominal injuries accompanying pelvic fractures]. AB - During the years of 1969 to 1982, 361 patients with blunt abdominal trauma were treated at the General Surgical Hospital of the University of Giessen. 46 out of these patients (12,7%) had also a fracture of the pelvis. The mortality was high with 43,5% (20 patients), however, all these patients had multiple injuries. In most cases hemorrhagic complications were responsible for death. Peritoneal lavage is an important diagnostic measure. In case of injuries to inner organs, generally several organs are concerned. Therapeutic methods should be time sparing because of the great risks involved in these injuries. Retroperitoneal hemorrhages allow only seldom a vessel reconstruction. Angiographic localization with subsequent vessel embolization should be tried. PMID- 3984103 TI - [Surgery and research on biomaterials]. PMID- 3984104 TI - [Antiseptics in the hospital milieu]. PMID- 3984105 TI - [Acinus cell adenocarcinomas of the parotid. Apropos of a case with rib and vertebral metastases]. PMID- 3984106 TI - [Obstruction of the nostril due to a primary melanoma of the inferior turbinate mucosa]. PMID- 3984107 TI - [Congenital intradermal cellular nevus]. PMID- 3984108 TI - [Medullary carcinoma of the thyroid. Histochemical confirmation]. PMID- 3984109 TI - [Life expectancy in good health]. PMID- 3984110 TI - [Influence of education on the physician-patient relationship (Balint) in the practice of psychotherapy]. PMID- 3984111 TI - [The development of P50 and 2,3-DPG during exchange-transfusion in neonates]. PMID- 3984112 TI - Bullet colic. AB - Ureteral obstruction by intramural bullet, buckshot, or related missle following penetrating abdominal trauma is rare; a search of the literature revealed only 4 previously described cases [1-4]. A fifth case of a bullet migrating from the renal pelvis to the ureter has been reported at autopsy [5]. We present 2 new cases of delayed symptomatic ureteral obstruction ("bullet colic") after abdominal gunshot wounds. PMID- 3984113 TI - Relationship between hair/eye color and primary vesicoureteral reflux in children. AB - The relationship between hair/eye color and primary vesicoureteral reflux was analyzed in more than 900 children. Children with blonde hair/blue eyes did not show an increased prevalence of reflux nor did any other hair/eye combination. With the possible exception of rufous coloring, the color of the hair and eyes are poor predictors of the competence of the ureteral orifice. PMID- 3984114 TI - Percutaneous occlusion of ureteral leaks and fistulae using nondetachable balloons. AB - High-output ureteral fistulae were managed percutaneously in 3 patients with pelvic malignancies. Urine flow was diverted by combining percutaneous nephrostomy catheter drainage with transrenal balloon occlusion of the affected ureter proximal to the site of extravasation. This technique can be used either alone as the definitive method of treatment or as the initial procedure to preserve renal function and reverse the inflammatory reaction prior to subsequent surgical repair; its primary application is in patients in whom antegrade or retrograde ureteral stenting is not feasible or possible. PMID- 3984115 TI - The role of spermatic venography after surgical high ligation of the left spermatic veins: diagnosis and percutaneous occlusion. AB - Bilateral spermatic venography was performed in 40 patients who had previously undergone surgical high ligation of the left spermatic vein. Indications included recurrent or persistent varicocele or oligoteratospermia syndrome. Despite the prior surgery, 21 patients had venographic demonstration of a left-sided varicocele. Right-sided varicocele was demonstrated in 19 patients, 9 of whom also had left varicoceles. Only 9 patients did not have a varicocele demonstrated on either side. The various mechanisms of varicocele filling are discussed. Whenever a varicocele was demonstrated, immediate occlusion using steel coils was performed. PMID- 3984116 TI - Xanthogranulomatous perinephritis: unusual cause of renal vein and vena caval thrombosis. AB - Xanthogranulomatous pyelonephritis is an uncommon form of chronic renal infection which can be confused clinically, radiographically, and pathologically with renal carcinoma. Occasionally, xanthogranulomatous changes are more prominent in perinephric tissue than in the renal parenchyma itself. We present a case of locally invasive xanthogranulomatous perinephritis associated with thrombosis of the renal vein and inferior vena cava. With this constellation of findings, infections as well as malignant etiologies should be considered in the differential diagnosis. PMID- 3984118 TI - Giant fibrous polyp of a calyx. AB - A case of a giant fibrous polyp of the pyelocaliceal system producing hydronephrosis is described. The presentation of the findings in this case as well as brief review of the literature are included. PMID- 3984117 TI - Persistent wedge-shaped contrast enhancement of the kidney. AB - A case with a single wedge-shaped high-density area of the kidney that persists after urography was observed by CT scan. This might be an aberrant form of acute renal failure with multiple wedge-shaped contrast enhancement. PMID- 3984119 TI - Giant vascular malformation of the kidney: computed tomographic and angiographic appearances. AB - Two cases of giant vascular malformation of the kidney demonstrated by computed tomography and angiography are presented. The vascular malformations form completely outside the kidney. They arise from the renal parenchyma, simulating renal cyst, and present as a renal pelvic mass causing hydronephrosis. The finding of a renal mass with a markedly and uniformly contrast enhancement demonstrated by computed tomography should suggest the possibility of a vascular malformation. PMID- 3984120 TI - Survival with localized carcinoma: radical prostatectomy vs radiation therapy. AB - The charts of all patients receiving radical surgery and radiation therapy for cancer localized to the prostate in the years 1950 to 1977 in the State of Connecticut were reviewed. Long-term survival rates at ten and fifteen years were considerably better in those patients treated with radical surgery. PMID- 3984121 TI - Renal adenocarcinoma in young adults. AB - Survival following the diagnosis of renal adenocarcinoma in a group of young adults, twenty to forty years of age, was distinctly better than that found in adults over age forty. This disparity could not be accounted for by a larger proportion of younger patients with early stage disease, nor by a greater percentage of non-cancer deaths in the older group. Perhaps a more favorable host tumor immunologic balance is present in younger individuals. PMID- 3984122 TI - Alcohol occlusion of segmental renal arteries as alternative to kidney resection. AB - Treatment of postoperative urine leakage after a lower pole resection by embolic occlusions of segmental arteries using pure ethanol in a thirty-four-year-old man is described. There were no postoperative complications, and follow-up examination at two years showed a functioning but small kidney in a patient without symptoms. PMID- 3984123 TI - Office laser surgery for urologists. AB - More than 100 cases have been treated with an office-situated Neodymium: Yag laser. Bladder tumors, genital condylomata, and urethral strictures have been photoradiated under local anesthesia, without hemorrhage, perforation, or the need for catheterization. The Neodymium: Yag laser appears to be an effective office modality for many common urologic problems. PMID- 3984124 TI - Urethral advancement in management of penoscrotal transposition. AB - Surgical repair of penoscrotal transposition usually leaves the urethral meatus in a perineal position. A Thiersch-Duplay skin tube created from perineal skin advances the urethral opening to the penoscrotal junction. This leaves the meatus in a more suitable position for definitive reconstruction. PMID- 3984125 TI - Incidence of urinary tract complications with myelomeningocele. AB - Children born with myelomeningocele face the morbidity of urinary tract complications after they have survived the neurologic complications of the first years of life. The incidence of urinary tract complications was evaluated in 258 children before any operation or intermittent catheter management was performed. In 119 children under one year of age the incidence of urinary tract infection of more than 10(5) colonies was 23 per cent, reflux was 22 per cent, and upper tract dilatation was 6 per cent. In children of all ages the incidence of urinary tract infection of more than 10(5) colonies was 26 per cent, reflux 34 per cent, upper tract dilatation 18 per cent, and urinary incontinence 87 per cent. In 11 children with complete denervation of the pelvic floor muscles reflux developed in 2 (18%) and upper tract dilatation in 1 (9%). In 13 children with slight or moderate denervation of the pelvic floor muscles reflux developed in 5 (38%) and upper tract dilatation in 7 (54%). The development of upper tract changes with myelomeningocele was mainly related to some innervation of the pelvic floor muscles (including periurethral striated muscle) with incoordinate detrusor/sphincter activity. These changes mainly occurred in the first two to four years of life. PMID- 3984126 TI - Hemorrhagic infarctions of testis due to intimal fibroplasia of spermatic artery. AB - Two cases of hemorrhagic infarctions of the testis are presented. The infarctions were due to intimal fibroplasia of the branches of the spermatic artery; to our knowledge, a condition described only in the kidney. The differences between intimal fibroplasia and the lesions of polyarteritis nodosa and thromboangiitis obliterans are discussed. PMID- 3984127 TI - Treatment of bladder carcinoma with tumor-immune pig lymph node cells. Phase I study. AB - A total of 77 patients with invasive TCC of the urinary bladder each received a single arterial injection of tumor-immune pig lymph node cells (LNC), into the tumor blood supply. The patients were divided into 4 groups: those receiving pig LNC as the only treatment (16 patients); those who received pig LNC on relapse (judged by EUA cystoscopy and biopsy) following radical radiotherapy, 5,500 cGy (34 patients); those who received pig LNC followed after an interval of six weeks by radiotherapy, 4,000 cGy (10 patients); as in Group 3 but with the dose of radiotherapy increased to 5,500 cGy (17 patients). Complete remission was characterized by complete disappearance of the tumor (for a varying time) following treatment. Partial remission was defined as: a reduction in the level of symptoms and a decrease in tumor size on EUA and/or cystoscopy. There were 1 complete and 3 partial remissions among the patients in Group 1, 5 complete and 7 partial in Group 2, 6 complete and 2 partial in Group 3, and 8 complete and 1 partial in Group 4. Of the 20 patients showing complete remission, 7 lived for more than five years after treatment. PMID- 3984128 TI - Effects of chlorpromazine on ischemic rat kidney: a functional and ultrastructural study. AB - The effects of chlorpromazine, an agent with inhibitory effects of calcium influx, phospholipase activation, and Na-K-ATPase, on preserving renal function and proximal tubular ultrastructure were evaluated in renal ischemia. After right nephrectomy chlorpromazine (0.025 mg) or 1 ml of 0.9 per cent saline was selectively administered to the rat kidney immediately prior to a sixty-minute occlusion of the remaining renal artery. Pretreatment with chlorpromazine resulted in a significant attenuation in the rise in postischemic serum creatinine. Hypothermia of the kidney during ischemia provided an additional protective effect. Electron microscopic study of the proximal convoluted tubule demonstrated that the structural damage was less severe in chlorpromazine-treated rats and virtually complete preservation of a normal ultrastructure was observed when hypothermia was added. PMID- 3984129 TI - Combined retrograde and antegrade manipulations for percutaneous nephrolithotomy of ureteric calculi: "push-pull" technique. PMID- 3984130 TI - Dissemination of carcinoma: unusual complication of percutaneous nephrostomy. AB - Percutaneous nephrostomy is a safe and highly effective means of urinary diversion. We report a case of unusual complications: severe peritonitis and massive intraperitoneal dissemination of carcinoma. PMID- 3984131 TI - Technique which eliminates need for assistant during prostatic needle biopsies. PMID- 3984132 TI - Case profile: Crossed fused ectopia misdiagnosed as retroperitoneal tumor. PMID- 3984133 TI - New self-developing film for intraoperative renal stone localization. AB - The use of intraoperative radiography for localization of small renal calculi has been a valuable adjunct to surgery. Unfortunately, because of the considerable time required for mobilization of the kidney, the development of x-ray films and the not infrequent need for repeat exposures, considerable time can be added to the operation. We have found that the use of Polaroid film can give high-quality intraoperative radiographs. The main advantage of Polaroid film over the standard Kodak kidney film is that the film is developed in the operative suite and, in most cases, requires less than one minute. PMID- 3984134 TI - New location of milk-of-calcium. AB - A case of milk-of-calcium with an exceptional location is reported. The characteristics of milk-of-calcium are presented, with stasis and urinary tract infection being the most important etiologic factors in this case. Structurally the stones are formed by a central core of calcium phosphate surrounded by magnesium-ammonium phosphate (struvite). PMID- 3984135 TI - Vesical dysfunction in multiple sclerosis. AB - Sixty-four patients with multiple sclerosis and associated symptoms of neurogenic bladder dysfunction underwent urodynamic evaluation. The most common symptoms were urgency, incontinence, and frequency which did not correlate with urodynamic findings. Cystometrography demonstrated hyperreflexic bladders in 78 per cent and areflexic bladders in 20 per cent of patients. In those patients with hyperreflexia, voiding cystourethrography revealed poorly sustained uninhibited contractions associated with ineffective bladder emptying in 50 per cent, well sustained contractions in 38 per cent, and detrusor-sphincter dyssynergia in 12 per cent. Therapy consisted of intermittent catheterization, pharmacologic manipulation, or transurethral resection of the external sphincter, according to urodynamic evaluation. PMID- 3984136 TI - Use of carbon dioxide laser in microsurgery. PMID- 3984137 TI - Regional node aspiration cytology in staging penile cancer. PMID- 3984138 TI - [Endothelial microscopy in cataract surgery with simultaneous implantation of an intraocular lens]. PMID- 3984140 TI - [Cataract surgery in the very old]. PMID- 3984139 TI - [Effect of contact adhesion of polymethylmethacrylate on the corneal endothelial layer. An experimental study]. PMID- 3984141 TI - [Lamellar keratectomy with biological protection of the tissue bed]. PMID- 3984142 TI - [Total vitrectomy in eyes with recurrent hemophthalmos]. PMID- 3984143 TI - [Disorders of choroidal circulation in arterial hypertension]. PMID- 3984144 TI - [Effect of training on an accommodation apparatus on the clinical course of initial myopia]. PMID- 3984146 TI - [Replacement of Bagolini glass with a cellophane hatched film]. PMID- 3984145 TI - [Optical aberrations of the eye in keratoconus]. PMID- 3984147 TI - [Correlation between the obstetrical risk factor and refraction in preschoolers born at term and prematurely]. PMID- 3984148 TI - [New-model device for reflection densitometry of the fundus oculi based on the Retinophot apparatus]. PMID- 3984149 TI - [Importance of the photostress test in diagnosing dry and transudative forms of macular dystrophy in myopia]. PMID- 3984150 TI - [Intraocular pressure dynamics in the early postoperative period after intracapsular cryoextraction of a cataract]. PMID- 3984151 TI - [Experience in profiling the teaching of ophthalmology in a dental department]. PMID- 3984152 TI - [Case of surgical treatment of an ocular form of myopathy]. PMID- 3984153 TI - [Case of an eye lesion in mushroom poisoning]. PMID- 3984154 TI - [Pathogenetic approach to the treatment of posttraumatic glaucoma. I. Pathogenetic classification]. PMID- 3984155 TI - Nonsuppurative meningoencephalomyelitis of unknown etiology in mink. AB - A central nervous system disease of mink occurred in three unrelated fur farms in Oregon in September, 1981. Only kits four to five months old were affected. Clinical signs consisted of posterior ataxia progressing to complete posterior paralysis with loss of motor control and sensation. Complete or partial recovery occurred in approximately 1.5 months in most mink. Microscopic lesions consisted of severe nonsuppurative meningoencephalitis and meningomyelitis with vacuolation of the white matter of the brain and spinal cord. Canine distemper virus infection and other recognized causes were ruled out on the basis of clinical signs, history, lesions, or laboratory findings. Experimental inoculations of mink with brain and spinal cord specimens from affected mink failed to reproduce the disease. PMID- 3984156 TI - Primary intestinal lymphangiectasia in three dogs: a morphological and immunopathological investigation. AB - Morphological and immunological findings of three dogs with primary lymphangiectasia are described and compared with three normal dogs. Scanning electron microscopy showed distended and fused intestinal villi in dogs with intestinal lymphangiectasia, and morphometric evaluation revealed deeper crypts in the small intestine of dogs with intestinal lymphangiectasia. Although plasma cells of all classes were diminished in the cranial parts of the small intestine, there was an absolute and relative increase of immunoglobulin G-containing plasma cells in the caudal small intestine in dogs with intestinal lymphangiectasia. PMID- 3984157 TI - Microscopic lesions associated with the isolation of Haemophilus somnus from pneumonic bovine lungs. AB - Sixty-one of 68 sets of bovine lungs from which only Haemophilus somnus was isolated had microscopic lesions of purulent bronchiolitis and bronchopneumonia. In 37 of 61 lungs, the bronchiolar exudates were markedly necrotic with accompanying necrosis of the adjacent bronchiolar epithelium. Bronchiolitis obliterans was prominent in 23 of 28 lungs affected with chronic lesions with abscesses present in seven. Alveolar filling with inflammatory cells (neutrophils with fewer macrophages) was limited to peribronchiolar alveoli in 25 of 61 lungs and was multifocal to diffuse in the other 36. Lesions in the remaining lungs (7 of 68) were classified as fibrinous pneumonia with bronchiolitis (2), fibrinous pleuritis (2), suppurative interstitial pneumonia with vasculitis (2), and diffuse congestion (1). PMID- 3984158 TI - Lesions of spinal cord parelaphostrongylosis in sheep. Sequential changes following intramedullary larval migration. AB - Spinal cord nematodiasis epidemiologically, clinically, and histologically consistent with Parelaphostrongylus tenuis infection was noted in two flocks of sheep. Spinal cords from two sheep with active infection and one from a partially recovered animal were studied in an effort to determine the sequence of lesions following larval invasion of the central nervous system. In the former two sheep, migration of larvae within the spinal cord induced asymmetrically irregular tracks of disrupted and necrotic tissue, primarily in white matter. Subsequently, macrophages infiltrated these regions and phagocytized the necrotic tissue, which led to cavity formation. Swelling and loss of axons, diminished myelin staining, mononuclear cell infiltration and increase in astrocytic fibers were often seen in adjacent tissue. Only occasional coiled larvae were found in these actively infected animals. Late stage lesions in the white matter in the partially recovered sheep included multiple small astrogliotic regions with diminished myelin and axonal content, and a single large multicavitary, atrophic, gliotic zone. PMID- 3984159 TI - Adrenal lesions in the baboon (Papio spp). AB - A histological survey was conducted on 604 pairs of adrenal glands from yellow (Papio cynocephalus) and olive (Papio anubis) baboons used in drug safety evaluation studies. Spontaneous lesions were found in 372 glands--34 of which had more than one change. Cortical lesions consisted of accessory nodules (190), nodular hyperplasia (7), hepatoadrenal adhesion (18) and partial fusion (1), focal mineralization (20), ectopic bone marrow (6), and focal fatty change (60). Medullary lesions were confined to focal lymphocytic (66) and plasma cell (1) infiltrates. PMID- 3984160 TI - Erythrocyte membrane alterations associated with the attachment and replication of Eperythrozoon suis: a light and electron microscopic study. AB - Erythrocytes from pigs with experimental porcine eperythrozoonosis were examined using light microscopy and scanning and transmission electron microscopy. Three distinct forms of Eperythrozoon suis were attached to the plasma surface of erythrocyte membrane. Erythrocytes were initially parasitized by one or several immature forms. Immature forms enlarged and developed into juvenile and mature forms. The parasite replicated by budding of small immature forms from larger immature forms, juvenile forms, and mature forms. Small immature forms attached to adjacent membrane of the same erythrocyte or a nonparasitized erythrocyte. E. suis organisms were intimately associated with, but distinctly separated from erythrocyte membrane by a 30-nm electron lucent zone. Cell membrane in this area was denser than adjacent nonparasitized membrane. Early interaction between erythrocyte membrane and small immature forms resulted in no membrane deformation, but as this form enlarged, it later became embedded in a deep cup like membrane invagination. As the immature form developed into the juvenile form a shallow, broad-based depression was observed in the membrane. A similar depression that covered a greater surface area was observed in the membrane parasitized by the mature form. The interaction between the parasitic forms and erythrocyte membrane resulted ultimately in severe membrane deformation. Parasite membrane interactions may play an important role in the development of misdirected immune responses in experimental porcine eperythrozoonosis. PMID- 3984161 TI - Liver changes, following diethylcarbamazine administration, in microfilaremic dogs infected with Dirofilaria immitis. AB - Livers of dogs which were microfilaremic due to infection with Dirofilaria immitis were studied after the administration of diethylcarbamazine. Most dogs had a severe shock-like clinical reaction. The main hepatic features were congestion and hemorrhage around the central vein and irregularly scattered foci of inflammation. The severity of the vascular reaction was associated with the number of microfilariae in the livers. Mast cells associated with the vascular reaction were not degranulated, suggesting that histamine-mediated anaphylaxis was not the cause of the reaction. The observations suggest that the mediator of the hepatic vascular reaction originates from the microfilariae and is influenced or activated by diethylcarbamazine. PMID- 3984162 TI - An unusual morphologic form of hepatic amyloidosis in a goat. PMID- 3984163 TI - Coccidia associated with cutaneous nodules in a dog. PMID- 3984164 TI - Developmental abnormalities of a newborn two-headed calf, with special reference to the anterior vessels and compound heart. PMID- 3984166 TI - Familial feline epibulbar dermoids. PMID- 3984165 TI - Intra-axonal parasites in the fish Notropis cornutus (Mitchill). PMID- 3984167 TI - Unusual prolapse in gilts. PMID- 3984168 TI - Hemlock poisoning in piglets. PMID- 3984169 TI - Metacestode of Taenia hydatigena recorded in Malaysia. PMID- 3984170 TI - Allium species poisoning. PMID- 3984171 TI - Eradication of some infectious pig diseases by perinatal tiamulin treatment and early weaning. AB - From 10 days before the expected date of farrowing onwards, 97 sows infected by Mycoplasma hyopneumoniae and Treponema hyodysenteriae were given tiamulin daily at a dosage of 20 mg/kg bodyweight via the feed. Three days before farrowing the sows were washed with a disinfectant and transferred to an isolated farrowing house. The sucking piglets remained with their dams for five days, during which time the sows continued to receive the tiamulin-containing feed. The sucking piglets also received tiamulin daily at a dosage of 30 mg/kg bodyweight. At six days old the weaker piglets of the litter were returned to the original herd, together with their dams. A total of 574 piglets of about 1.5 kg bodyweight each were transferred to an isolated and previously disinfected pig farm and reared there. A total of 13.8 per cent of these pigs died by 50 days old. On the isolated farm, 10.9 per cent of the 829 second generation piglets born to the 101 first generation sows, died up to the age of 50 days. On the isolated farm about 2000 pigs were subjected to repeated clinical, pathological and laboratory examinations for M hyopneumoniae, T hyodysenteriae, Aujeszky's disease virus and Leptospira species during the three year period of study. No evidence of infection with any of these agents was found in the 2000 pigs of the isolation herd, although the original sow herd had been latently infected by these pathogens. No maternally derived antibodies against these pathogens were detectable in sera of three-day-old sucking piglets of the second and third generations. PMID- 3984172 TI - A practical approach to establishing a practice. PMID- 3984173 TI - Nitrogen dioxide (silo gas) poisoning in pigs. AB - Toxic silo gases are a potential danger to livestock housed in close proximity to silos. On the fourth day of ensiling, five fattening pigs were found dead in a pen adjoining a grass silo. Post mortem examination revealed extensive lung damage and methaemoglobinaemia. A dense reddish-brown gas was concentrated at floor level to a height of 1 m in the pen and had diffused into adjoining pens, where dry and suckling sows and litters were showing signs of respiratory distress and weakness. The gas was identified as a mixture of nitrogen dioxide and dinitrogen tetroxide. These gases may be produced in the early stages of silage making. In this case, they had accumulated in a slurry channel below the silo and leaked through an adjoining wall into the piggery. The production and toxicological effects of silo gases are discussed. PMID- 3984174 TI - Heartwater in the Caribbean: isolation of Cowdria ruminantium from Antigua. AB - Adult Ambylomma variegatum ticks were collected from 184 cattle, 13 sheep and one goat in Antigua, and ground in phosphate buffered saline. The resultant supernates were cryopreserved in liquid nitrogen. Five supernate pools, each derived from approximately 100 ticks collected from different herds, were thawed and each was inoculated intravenously into a separate experimental goat. One goat exhibited a febrile response with Cowdria ruminantium demonstrable in brain biopsies; after recovery, this animal showed no reaction to a lethal challenge with a Guadeloupe isolate of C ruminantium. PMID- 3984175 TI - Paraphimosis in seven debilitated horses. AB - This paper reports seven cases of penile paraphimosis which occurred in both entire and castrated horses in association with general debility. Two cases were discharged after treatment while still suffering from partial paralysis; one was discharged at the owner's request with complete paralysis; three were destroyed and one died during treatment. Identified causes of debility were malnutrition, severe parasitism, glucose malabsorption and salmonellosis. PMID- 3984176 TI - Treatment of equine sarcoids with BCG. PMID- 3984177 TI - Nutritional myopathy in cattle associated with monensin toxicosis. PMID- 3984178 TI - Benzimidazole resistance in field strains of nematodes from goats in France. PMID- 3984179 TI - Paracooperia nodulosa infection in a water buffalo (Bubalus bubalis) calf. PMID- 3984180 TI - Treating athletic injuries in horses. PMID- 3984181 TI - Briard eye donor scheme. PMID- 3984182 TI - Non-specific reactions to the Brucella abortus SAT. PMID- 3984183 TI - Removal of growth from lioness's lip. PMID- 3984184 TI - Anticoccidials and turkeys. PMID- 3984185 TI - Acorn and ergot poisoning in cattle suspected. PMID- 3984186 TI - Concentrations of luteinising hormone and progesterone in pregnant and non pregnant heifers. AB - An experiment was conducted to determine if concentrations of luteinising hormone or progesterone were different in pregnant or non-pregnant heifers for seven days before and 20 days after a successful or non-successful insemination. Heifers with an oestrous cycle length of 18 to 24 days only were used and they were bled at 08.00, 16.00 and 24.00 each day for seven days before and for 20 days after insemination with thawed semen (treatment 1) or semen diluent (treatment 2). Animals allocated to treatment 3 had the embryo nonsurgically flushed from the uterus at days 10 to 12 while animals allocated to treatment 4 were inseminated with semen diluent and then had a viable embryo transferred to the uterus between days 10 and 12. All animals were slaughtered between 19 and 21 days after insemination and pregnancy rate determined. There were no differences in basal luteinising hormone levels between treatments. Blood concentrations of progesterone were not different before insemination and for 16 days after insemination for pregnant (11 out of 15) and non-pregnant heifers (14) allocated to treatments 1 and 2. Between days 17 and 20, progesterone concentrations declined in non-pregnant heifers. Transfer of an embryo to non-pregnant heifers on day 10 to 12, did not affect progesterone concentrations, but non-surgical flushing of the embryo caused a decline in blood concentrations of progesterone. It was concluded that basal blood concentrations of luteinising hormone and progesterone, in samples taken three times daily were not different in pregnant or non-pregnant heifers before and for 16 days after insemination. PMID- 3984187 TI - Blood flow parameters associated with udder oedema in Jersey cattle affected with rectovaginal constriction. AB - Udder oedema was studied in eight Jersey cows with rectovaginal constriction (RVC) and three normal Jersey cows. A complete physical examination was performed at least two weeks before parturition, at parturition and two weeks after parturition. Jersey cows with RVC developed udder oedema as early as 14 days before parturition, and condition persisted for three to 10 days following parturition. Mammary blood flow and cranial superficial epigastric venous blood pressure were measured in three Jersey cows with RVC with udder oedema and three normal Jersey cows. The former with udder oedema had a significant decrease in mammary blood flow at parturition compared to the normal Jersey cows (P less than 0.05); there was no significant difference in mammary blood flow between Jersey cows with RVC and normal Jersey cows two weeks before parturition (P greater than 0.05). A significant mean increase in cranial superficial epigastric venous blood pressure occurred at parturition when compared to two weeks before parturition in Jersey cows with RVC (P less than 0.05), but normal Jersey cows had no significant increase in cranial superficial epigastric vein pressure during these two periods of measurement (P greater than 0.05). There was no significant increase in jugular vein blood pressure during the two periods of measurement in Jersey cows with RVC or normal Jersey cows (P greater than 0.05). There was a significant negative correlation between mammary blood flow and cranial superficial epigastric pressure at parturition (r = 0.733, P less than 0.05). PMID- 3984188 TI - Runting in broilers associated with temporary maldigestion. PMID- 3984189 TI - Control of toxaphene-resistant Boophilus decoloratus with chlorfenvinphos. PMID- 3984191 TI - Stranded whales. PMID- 3984190 TI - Selective medium for the isolation of P multocida and B bronchiseptica. PMID- 3984192 TI - Weight loss in Samoyeds. PMID- 3984193 TI - Airgun injuries. PMID- 3984195 TI - Unusual prolapse in a gilt. PMID- 3984194 TI - Selenium/vitamin E and cancerous conditions. PMID- 3984196 TI - Suspected poisoning of a goat by giant hogweed. AB - A five-year-old male African pygmy goat became ill four weeks after transfer from a zoological garden to a municipal park. The animal was subdued, refused to eat and drink and showed profuse salivation. Examination of the mouth revealed severe ulceration. The condition gradually responded to nursing and supportive therapy. Circumstantial evidence suggested the possibility that the lesions were caused by giant hogweed (Heracleum mantegazzianum). Supportive evidence that the plant could produce lesions was provided by the application of a cut stem to the hard palate and a solution of various dilutions to clipped areas of the backs of two ewes. Both ewes produced reddened skin when the concentrated solution was applied and both showed marked reddening of the gingival mucosae and in one animal small ulcers developed in the rostral part of the mouth. It is suggested that H mantegazzianum may be a potential hazard for grazing ruminants. PMID- 3984197 TI - Use of carfentanil and a ketamine-xylazine mixture to immobilise wild grey seals (Halichoerus grypus). AB - Carfentanil was used to anaesthetise 46 adult grey seals (Halichoerus grypus) on 78 occasions during two breeding seasons. The mean dose was 9.92 micrograms/kg bodyweight during the first season and 10.22 micrograms/kg during the second. Naloxone hydrochloride was used as the antagonist, averaging 0.53 mg/kg and 1.73 mg/kg over the two periods although the latter is probably unnecessarily high. Ketamine and xylazine at a ratio of 5:1 were also used during the same two seasons, 57 seals being anaesthetised on 104 occasions. The average dose of ketamine was 4.96 mg/kg and 5.15 mg/kg with xylazine in proportion. Complications arose on a number of occasions and these are discussed. PMID- 3984198 TI - Selection of Swaledale sheep of reduced susceptibility to experimental scrapie. AB - A flock of 294 Swaledale sheep was injected with brain tissue from different sources so as to include strains of natural scrapie currently affecting the Swaledale breed. Discounting intercurrent deaths, 85 per cent of the flock developed clinical scrapie within an observation period of 2557 days (seven years). Scrapie cases fell into distinct early and late groups, occurring at (mean +/- sem) 287 +/- 7 days and 1207 +/- 38 days after injection, respectively. Breeding groups were formed from the survivors after the early cases had occurred and successive lamb crops were produced. Two groups of progeny and two groups of controls were injected with scrapie. The incidence of scrapie in the progeny (27 per cent) was much lower than in the controls (64 per cent). The incidence in the progeny was also assessed in relation to the response of their parents: it was high (about 40 per cent) when one or both parents developed late scrapie but otherwise very low (about 5 per cent). Hence the progeny of surviving parents had a greatly reduced susceptibility to the strains of scrapie used. Seventy-two of these selected progeny formed a nucleus flock which is being bred at Redesdale. The next stage of the experiment is to assess the effect of selected rams in recorded flocks with a high incidence of natural scrapie. PMID- 3984200 TI - Vocal cord paralysis following endotracheal intubation in a bitch. PMID- 3984199 TI - Selective medium for isolation of Haemophilus somnus from cattle and sheep. AB - Incorporation of vancomycin (5 micrograms/ml), neomycin (5 micrograms/ml), sodium azide (50 micrograms/ml), nystatin (100 iu/ml) and cyclohexamide (100 micrograms/ml) into 5 per cent horse blood agar results in a selective medium for the primary isolation of Haemophilus somnus from cattle and sheep. Addition of thiamine monophosphate (1 microgram/ml) to the medium enhanced growth of this bacterium. Gram-positive bacteria did not grow on the medium and colonies of many Gram-negative bacteria were eliminated or reduced in numbers and size. Colonies of H somnus were larger on the selective medium than on sheep blood agar but retained typical morphology. Recovery of 18 laboratory strains was 73 to 166 per cent (mean 112) on selective medium compared to sheep blood agar. H somnus was isolated from the vagina of a total of 136 (28.6 per cent) of 476 cows surveyed, 79 (16.6 per cent) on sheep blood agar and 129 (27.1 per cent) on selective medium. The selective agents and thiamine were stable indefinitely as a freeze dried mixture while prepared plates were stable for two weeks. PMID- 3984201 TI - Entropion in sharpeis. PMID- 3984202 TI - Paracetamol poisoning in a cat. PMID- 3984203 TI - Balanoposthitis in breeding bulls. PMID- 3984204 TI - Anticoccidials and turkeys. PMID- 3984205 TI - An evaluation of commercial discs for the determination of the growth factor requirements of avian haemophili. AB - The ability of 2 brands of growth factor discs (Oxoid and Mast) to identify correctly the growth factor requirements of 41 isolates of Haemophilus paragallinarum and 17 isolates of H. avium was evaluated. The percentage of isolates correctly identified as requiring V factor varied with both the brand of the disc and the medium used. On basic nutrient media both brands gave low percentages of correct results: on Isosensitest Agar (Oxoid) the Oxoid discs gave 26% and the Mast discs 24% while on Heart Infusion Agar (Gibco) the Oxoid discs gave 54% and the Mast discs 28%. However, on a more complex medium (TM/S) the percentage of correct results was considerably higher with the Oxoid discs 100% and the Mast discs 52% accurate. PMID- 3984206 TI - Antibody response of cattle to rinderpest vaccine. AB - Antibody production was studied in cattle infected with rinderpest vaccine virus. Vaccinated cattle produced both IgM and IgG serum antibodies. The IgG antibodies were mainly those of IgG2 subclass. No IgA antibody response was detected in vaccinated animals. PMID- 3984207 TI - Suprathreshold contrast perception at different luminance levels. AB - Magnitude estimation experiments show that the perceived contrast of sine waves is a linear function of stimulus contrast at some mean luminance (Lm), spatial frequency and contrast levels, but not at others. For monocular vision at both low and high contrast levels, linearity is observed within a limited zone which, at high Lm levels, does not include intermediate frequencies. Binocular vision gives similar results at high contrast levels, while for low levels, the linearity zone comprises intermediate frequencies in a wide Lm range. It is demonstrated that if a threshold correction is introduced into the obtained psychophysical functions, the described linearity zones extend to wider Lm and contrast ranges. PMID- 3984208 TI - Ultraviolet photosensitivity in goldfish: an independent u.v. retinal mechanism. AB - Heart rate conditioned goldfish were sensitive to u.v. stimuli at wavelengths down to 340 nm. A u.v. peak had maximum sensitivity at about 380 nm and was depressed selectively by a u.v. adapting background. An opaque cone restricted light to the eye, reducing the probability of a dermal or pineal gland source of the response. Three experiments demonstrated a retinal origin for the u.v. peak. The conditioned response to u.v. stimuli was abolished following injection of Lidocaine into the eye. U.V. sensitivity remained when the cornea, iris and lens were extirpated. Finally, the u.v. peak showed an orderly change in sensitivity with alteration in adapting u.v. illumination. PMID- 3984209 TI - Frequency dependence in scotopic flicker sensitivity. AB - Sensitivity to rod-mediated (scotopic) flicker was parametrically studied in the parafoveal retina of human observers. Confirming prior studies, the present results show that sensitivity to scotopic flicker has many similarities to that at photopic levels. Specifically, our results show that the frequency response function for scotopic flicker is characterized by both low- and high-frequency cutoffs and that sensitivity to low frequencies is described by Weber's law. Overall, however, scotopic flicker sensitivity is characterized by higher increment thresholds and lower frequency tuning than photopic flicker. The influences of spatial factors and the prevailing level of illuminance on sensitivity is sufficiently different for relatively low (less than 3 Hz) and relatively high (greater than 5 Hz) temporal frequencies to suggest that they may be mediated by different channels. This possibility is also suggested by selective adaptation experiments. These show that adaptation to flicker frequencies of 3, 5, and 7 Hz have a similar influence on sensitivity to subsequent flicker which is different from the influence on 1 Hz flicker adaptation. Results are compared with prior evidence for channeling within both the scotopic and photopic visual systems. PMID- 3984210 TI - Effects on grating detection of vertically displaced peripheral gratings. AB - Contrast threshold for a sinusoidal target in the simultaneous presence of the vertically displaced peripheral gratings was measured as a function of the peripheral contrast and the separation. When the signal and peripheral gratings were in phase, the low-contrast peripheral gratings produced the improvement in signal threshold, while the high-contrast gratings produced threshold elevation. The facilitation effect was extended to the separation equating to 10 grating cycles, whereas the inhibition effect was restricted to the region near the border. When the two gratings were out of phase, the low-contrast peripheral gratings produced threshold elevation, while the high-contrast gratings exerted little effect on signal threshold. The results were explained in terms of spatial summation and lateral inhibition. PMID- 3984211 TI - Contrast sensitivity to drifting low spatial frequency gratings in central and peripheral retinal areas. AB - We measured contrast sensitivity to drifting sine wave gratings in central (20 degrees) and peripheral (from +/- 10 degrees to +/- 30 degrees) retinal areas. Low spatial frequencies were used (0.1-3 c/deg). The spatiotemporal sensitivity for spatial frequencies above 0.8 c/deg was found to be better in the central than in the peripheral retina. However, for spatial frequencies below 0.8 c/deg, the spatiotemporal contrast sensitivities of central and peripheral retinal areas were found to be the same. These results were obtained without scaling the peripheral gratings by the reciprocal of the cortical magnification factor. PMID- 3984212 TI - Color vision in squirrel monkeys: sex-related differences suggest the mode of inheritance. AB - Behavioral tests of vision in squirrel monkeys (Saimiri sciureus) reveal that there are widespread individual variations in color vision in this species. The variation has a sex-related component: whereas both trichromatic and dichromatic color vision occurs among female monkeys, males appear exclusively dichromatic. This finding suggests that, unlike humans, squirrel monkeys have only a single photopigment locus on the X chromosome. PMID- 3984213 TI - Irregularity and aliasing: solution? AB - Although irregularity in a sampling array reduces the Moire effects caused by undersampling, it makes interpolation more sensitive to noise. The advantages of irregularity are considered with this in mind. PMID- 3984214 TI - A schematic eye for the mouse, and comparisons with the rat. AB - The thicknesses and spheric and aspheric curvatures of the optic components were measured from cross-sections of frozen eyes of C57B1/6J mice. The equivalent refractive index of the crystalline lens was obtained from its back-vertex power in albumin. Refractive indices of the cornea, aqueous and vitreous humors were obtained by refractometry or interferometry at four wavelengths across the visible spectrum. The measurements parallel earlier ones on the hooded rat. The eyes of the mouse and rat differ mainly in size, by a linear scale factor of 1.9 2.0, and only slightly in refractive index. Thus refraction, chromatic aberration, and retinal illumination are easily compared in the two species. An analysis of the contribution of each optical surface to refraction may facilitate extrapolation to other strains of mice. Chromatic aberration is discussed with respect to depth of field and the retinoscopy artefact. PMID- 3984215 TI - The spatiotemporal properties of the r-g X-cell channel. AB - Analysis of the simple-opponent r-g receptive field of the X-channel shows that it is tuned to both high and low temporal frequencies, high and low spatial frequencies, and that its spectral sensitivity is both chromatic and achromatic. PMID- 3984216 TI - Temporal sensitivity in amblyopia: an explanation of conflicting reports. AB - Although the spatial characteristics of contrast sensitivity in amblyopia are well established, it is still not clear how temporal vision is affected. A wide range of spatial stimuli have been used to measure flicker sensitivity in amblyopia and we have considered the possibility that reported inconsistancies in results are due to a confounding of spatial and temporal stimulus parameters. To address this question we have measured contrast sensitivity from a sample of eight strabismic/anisometropic amblyopes using (1) stationary sinusoidal gratings, (2) uniform field flicker and (3) counterphased flickering gratings. In each case the contrast sensitivity deficits were predictably determined by the spatial properties of the stimulus (spot size or spatial frequency), and the spatial characteristics of the amblyopia. Results are nearly independent of the temporal properties of the stimulus. Specifically, when the stimulus is sufficiently large, or consists of low spatial frequencies, no temporal deficits are found. We conclude that conflicts between previous reports are attributable primarily to differences in spatial characteristics of the stimuli used. PMID- 3984217 TI - Is amblyopia spatial frequency or retinal locus specific? AB - The visual deficit associated with amblyopia is thought to be both spatial frequency and retinal locus dependent. However, most data that have been obtained can be accounted for by either of these factors or by a combination of both. We have tried to distinguish between these three possibilities by measuring contrast sensitivity at different retinal loci using discrete localized patches of grating. For five of nine amblyopes, we find the contrast sensitivity deficit to be constant across the retina for a given spatial frequency. In only two cases were there substantial changes as a function of retinal eccentricity. Therefore, most of our data suggest that the visual deficit in amblyopia is primarily spatial frequency and not retinal locus specific. PMID- 3984218 TI - Is reduced vernier acuity in amblyopia due to position, contrast or fixation deficits? AB - Poor vernier acuity, exhibited by amblyopes, may reflect anomalies related to eccentric fixation, deficient position sensitivity, or reduced contour visibility. We have examined these factors by measuring contrast and vernier sensitivities with stimuli consisting of extended sinusoidal gratings of several spatial frequencies. Vernier thresholds were measured using both a classical single step position change and also a grating that was position-modulated sinusoidally along its entire length. For both types of target amblyopes exhibited deficient displacement sensitivity although accurate fixation was not strictly required. The vernier deficits were not critically dependent upon the type of displacement used, and the magnitudes of the vernier and contrast sensitivity deficits were closely related. Both were largest at high spatial frequencies, and those amblyopes with larger contrast sensitivity deficits also had larger vernier acuity deficiencies. Typically, contrast sensitivity and vernier acuity were normal, or nearly so, at very low spatial frequencies. Also, vernier acuities for the amblyopic and non-amblyopic eyes were approximately equal if grating contrast was set at some fixed multiple of detection threshold. We did not find a close relationship between the magnitude of the vernier deficit and reported perceptual distortions. PMID- 3984219 TI - Spatial frequency tuning of transient non-oriented units. AB - Thresholds for a vertical test stimulus with a 1.0 octave bandwidth were measured as a function of the spatial frequency of a horizontal flickering cosine mask. Both test and mask were temporally modulated at 8.0 Hz, as low temporal frequencies were found to produce very little masking. Separate experiments were run at each of 10 test frequencies from 0.25 to 8.0 cycles per degree (c/deg) at 0.5 octave intervals. Masking curves thus obtained for each of three subjects were used to compute the spatial frequency sensitivities of three non-oriented mechanisms. Compared to previous masking studies of orientation selective units, non-oriented units have somewhat broader spatial frequency sensitivity curves, in agreement with primate neurophysiology. PMID- 3984220 TI - Photokeratometric and photorefractive measurements of astigmatism in infants and young children. AB - We have measured corneal and total astigmatism on 161 eyes of 90 normal infants and young children aged 2 months to 5 years using the techniques of photorefraction and photokeratometry. Both the mean corneal and mean total astigmatism were found to decrease with increasing age. We found large and significant correlations between corneal and total astigmatism in the 0-1, 1-2 and 2-3 year-old infants and children. Previous studies have shown that photorefractive measurements of astigmatism compare well with retinoscopic measurements of the same infants. As part of this study we measured the corneal astigmatism of 19 adults (38 eyes) by photokeratometry and with a clinical keratometer and found that the two measures were well correlated (r = 0.820). We conclude that the major component of total astigmatism seen in uncyclopleged infants of ages 0-3 years is corneal in nature. PMID- 3984221 TI - Eye position during fixation tasks: comparison of macaque and human. AB - Two macaques and three humans fixated luminous targets in a dark field. All subjects had greater dispersion of eye position from trial-to-trial (between trial variability) than would be predicted from sampling error and within-trial variability. Monkeys had greater between-trial dispersion on the vertical meridian than humans because of less precise control of saccades. Mean vertical eye position of the monkeys varied idiosyncratically with the fixation task (spot dim or line-tilt). Between-trial fixation variability of both monkeys and humans was large enough to affect the interpretation of experiments relating visual performance to retinal anatomy or to neurophysiology. PMID- 3984222 TI - Texture discrimination: representation of orientation and luminance differences in cells of the cat striate cortex. AB - Neuronal texture discrimination in the cat striate cortex was investigated by measuring the responses of single cells to different pattern structures. The representation of two independent features, texture orientation and texture luminance, was analysed in detail and the sensitivity of neurones to either feature was studied at different levels of structure density. Texture patterns were systematically moved across the receptive field. From the cell response to various parts of the pattern, "response patterns" were generated which displayed the cell transform of the textured stimulus pattern. Only when texture structures were coarse, were cells able to encode the texture orientation of an area. Differences in texture luminance, on the other hand, were detected only in fine texture structures. Further, these textural features were processed in a different manner: Cells responded to differences in texture luminance but continuously to areas of similar texture orientation. Thus, responses of striate cells reveal an ambiguous representation of texture features and a failure to uniquely encode texture borders. PMID- 3984223 TI - [Concentrating ability of the kidneys in patients with polycystic kidneys during a stage of normal values of glomerular filtration].